1 100 150 https://digital.lib.buffalo.edu/files/original/3039bccadab0079a5c6eb0eb0207b3d3.pdf 81bef2c7133727dc260cecc70eab6662 PDF Text Text Universitv at Buffalo The State University nf New Ynrk �M THE Buffalo Physician ASSOCIATE VICE PRESIDENT FOR UNIVERSITY COMMUNICATIONS Dr. Carole Smith Petro DIRECTOR OF PERIODICALS Sue Wuetcher Dear Alumni and Friends, EDITOR Stephanie A. Unger ART DIRECTOR Alan J. Kegler n August 21, 2002, new affiliation agreements between the University at Buffalo and its DESIGN David J. Riley teaching hospitals were announced. These agreements mark a seminal event in the history of the UB School of Medicine and Biomedical Sciences because they represent a 'sea DESIGN ASSISTANT Karen Lichner change' not only in the school's relationship with its affiliated teaching hospitals, but also CONTRIBUTING WRITERS Lois Baker and Ellen Goldhaum with its faculty and residents. By recalibrating these relationships to better support our school's primary mission, which is to educate students and train residents, we are putting in place girders upon PRODUCTION COORDINATOR Cynthia Todd-Flick which we can help build a healthcare system that more effectively serves our region. The new affiliation agreements, which you can read more about on page 21 of this issue of Buffalo Physician, will result in our school's faculty being paid either through the state or through the faculty practice plan. Over time, it is hoped that this will result in faculty members establishing a primary allegiance to the school in lieu of the individual inpatient facilities with which they are affiliated in the community. If this change in culture can be accomplished, I believe it will greatly strengthen our school's foundation over the next 25 to 30 years. With regard to graduate medical education, the agreements take the hospitals out of the educational system and place the onus for training residents square­ ly under the purview of the school, where it should be. This, in and of itself, is a historic change in view of the fact that the residency programs in New York State were originally sponsored by hospitals. In fact, UB did not sponsor any of the residency programs until the Buffalo Graduate Medical-Dental Consortium was formed in 1983, and even that was only a partial sponsorship. The hospitals had in essence taken ownership of residency training, so these new agreements bring our community—which was about 45 years behind the rest of the country—in line with where it should have been a long time ago. Also, as I look to the future, I anticipate that the federal government will mandate changes in Medicare law. Under the new affiliation agreements, the school will be in a much better position to react in a timely way to these changes. Lastly, from the community's perspective, there is now the potential to undertake UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. Michael Bernardino, Dean EDITORIAL BOARD Dr. John Bodkin Dr. Martin Brecher Dr. Harold Brody Dr. Linda J. Corder Elizabeth Volz, Class of 2005 Dr. James Kanski Dr. Elizabeth Olmsted Dr. James R. Olson Dr. Stephen Spaulding Dr. Bradley T. Truax Dr. Franklin Zeplowitz TEACHING HOSPITALS Erie County Medical Center Roswell Park Cancer Institute Veterans Affairs Western New York Healthcare System KALEIDA HEALTH: The Buffalo General Hospital The Children's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital CATHOLIC HEALTH SYSTEM: Mercy Health System Sisters of Charity Hospital strategic healthcare planning for our region, should its leaders have the critical will to do so. This will certainly require a willingness to give-and-take among the various hos­ pitals. But if this flexibility can be managed, the school will have an opportunity to graft on to a single, high-quality clinical program rather than participate in multiple smaller Niagara Falls Memorial Medical Center © UNIVERSITY IIBIIFFUO. THE STATE UNIVERSITY OF NEW YORK programs, none of which can compete locally, regionally or nationally. If this type of planning is made a priority, then I envision our school serving as an umbrella under which such initiatives can move forward. This does not mean that the school would be interested in dictating outcomes for healthcare in our region, but it does mean that it could serve as a facilitator for change in a new climate of cooperation where, ultimately, quality of patient care is the only measure of success. - it i $ t M I C #h A E L E . B E R N A R D I N O , M D , M B A Dean, School of Medicine and Biomedical Sciences Vice President for Health Affairs Letters t o t h e Editor Buffalo Physician is published quarterly by the University at Buffalo School of Medicine and Biomedical Sciences in cooperation with the Office of Communications. Letters to the Editor are welcome and can be sent c/o Buffalo Physician, 330 Crofts Hall, University at Buffalo, Buffalo, NY 14260; or via e-mail to bp-notes@buffalo.etlu. Telephone: (716) 645-5000, ext. 1387. The staff reserves the right to edit all submissions for clarity and length. University a t B u f f a l o The State University of New' YorK �P H Y S I C I A N Features 2 10 16 Gray Matters Rohit Bakshi, MD '91, neurologist and mentor extraordinaire, gives multiple sclerosis a new image B Y Lois B A K E R Pain's Mystery, a Mindful Approach Funded by a $2 million grant, UB researchers study biobehavioral treatments for irritable bowel syndrome BY S. A. UNGER Budget Talks A conversation with Michael Bernardino, MD, MBA, dean of the School of Medicine and Biomedical Sciences Stephen Pollack, MD '82. welcomes Jodi-Ann Oliver at the White Coat Ceremony. Jodi-Ann's twin. Leri-Ann. Is also a member of the Classof 2006. For more on this event, turn to page 22. COVER PHOTO BY K. C. KRATT FJgHH ^PmLVKY ^ Medical School 22 White Coat Ceremony 23 Toni Ferrario receives 2002 Humanism in Medicine Award 24 Inaugural Student Clinician's Ceremony Research News 26 Update on Pathways 30 News about Buffalo Center of Excellence in Bioinformatics 28 Anthony Campagnari's research stimulates industrial collaboration faculty, staff, students and alumni 31 GonzalezFernandez joins UB as inaugural chair holder 34 Faculty awards Student Column 36 Fourth-year student and volunteer fire fighter Laura Rendano reflects on her dual roles Development 39 A DNA research gift 40 Annual list of endowments Classnotes 44 News from your UB classmates and other alumni ��en years ago people with multiple sclerosis (MS) could expect little from the medical profession other than drugs to help relieve their symptoms and canes or walkers to help them get around as their physical disabilities mounted. That was before researchers were able to focus the full power of advanced neuroimaging techno­ logies on the disease. By using the latest magnetic resonance imaging (MRI) methods in tandem with one of the most powerful supercomputing systems in the world, University at Buffalo researchers in the Buffalo Neuroimaging Analysis Center (BNAC) are providing insights into the disease that were never before possible. Some are creating three-dimensional images of the brain and brain structures of MS patients that show the process of atrophy under the onslaught of the disease. Others are linking stages of atrophy Perhaps the most im­ with physical and cognitive symptoms portant development to and are developing a "standardized" im­ come out of the center age of one affected brain structure, which will serve as a model for assessing disease to date is the research­ stage and predicting progression. ers' discovery that the Still other scientists are using advanced imaging techniquesand computing power brain's gray matter, to study the amount of whole-brain shrink­ where higher function­ age that occurs in MS and to develop accu­ rate ways to measure brain deterioration. ing is centered, is involved in MS. A Neuro Image of Atrophy Perhaps the most important development to come out of the center to date is the researchers' discovery that the brain's gray matter, where higher functioning is centered, is involved in MS. "Traditionally, MS was thought to be strictly a In addition to pursuing his own research. Rohit Bakshi. MD. University at Buffalo associate professor of neurology, front. has assembled a group of energetic student researchers to work in the Buffalo Neuroimaging Analysis Center. "The students are the lifeblood of the center." says Bakshi. "Their enthusiasm, dedication and fresh ideas make our research go forward." Pictured, back row. left to right, are medical students Michael Sanfilipo. Rob Bermel and Andrew Fabiano. 'white matter disease,"' explains Rohit Bakshi, MD '91, Autumn 2002 !u ff aI a Physician �UB associate professor of neurolo­ gy and director of the BNAC. We thought it affected only the 'road­ ways' in the brain." (White matter, or myelin, is the covering that allows various gray matter structures to communicate with each other.) This finding resulted from the re­ searchers' work with a brain structure situated deep in the gray matter called Class of 2003 fourth-year medical of Neurology, Alpha Omega Alpha conducted research in neuropharm­ student at the University at Buffalo medical honor society and the Uni­ acology as a Howard Hughes Under­ School of Medicine and Biomedical versity at Buffalo. !u If a I i P h y s i c i a n A u t u m n graduate Research Fellow. In 1998, he Sciences, has been chief research In May 2001, Bermel was awarded worked at the U.S. Oepartment of assistant at the Buffalo Neuroimag- the American Academy of Neurology's Energy's Brookhaven National Labora­ ing Analysis Center since May 2000. G. Milton Shy Award for medical stu­ tory, where he studied addiction con­ His work includes an honors thesis on dent research in clinical neurology, trol and breast cancer therapy using the use of MRI in detecting brain based on studies he conducted onthe brain positron emission tomography. atrophy in multiple sclerosis (MS), use of the bicaudate ratio as an MRI Bermel is interested in pursuing mentored by Rohit Bakshi, MO '91. marker of brain atrophy in MS. This research was funded by student While pursuing his bachelor of grants from the American Academy arts degree in biology at UB, Bermel the caudate nucleus, an important nerve center for con­ trolling movement and cognitive processing. Other labo­ ratories have studied the role of the caudate nucleus in Alzheimer's Disease and Huntington's Disease; however, the BNAC is the only center studying it in MS patients with state-of-the-art MRI techniques. "Through our computerized imaging analysis capa­ bilities we have been able to visualize the caudate nucleus in MS patients in new ways, and we found it was atro­ phied," explains Bakshi. "Moreover, the atrophy is not 4 associated with the amount of white matter damage. "If we are going to treat this disease," he says, "we have to know where the damage is." MS strikes people primarily between the ages of 20 and 40, and there is no cure. The most common cause of progressive neurologic disability in young adults, the dis­ ease is most prevalent in mid-North America and North­ ern Europe. Symptoms vary widely, depending on where and how much brain damage is involved. A leap forward in treatment occurred in 1996 when a 2 0 0 2 a residency in neurology following graduation from medical school. drug developed by the late Lawrence Jacobs, MD, chair of UB's Department of Neurology, was approved by the Federal Drug Administration after several years of clinical trials that were supervised by Jacobs. The drug, interferon beta-la (Avonex), slows progression of disability in the relapsing-remitting form of the disease and reduces the frequency of flare-ups. It is now the most widely prescrib­ ed treatment for MS. "Our challenge today is to uncover mechanisms in the brain that could lead us to a new therapy, building on �T "We've been able to correlate gray matter hypointensity with brain atrophy and physical impairment. This leads us to think that hypointensity in the deep gray matter is a strong predictor of disability, progression of the disease and sub­ sequent brain atrophy." a third-year medi­ Kenmore, New York, before matricu­ After five semesters. Fabiano cal student at the University at lating to the University of Illinois at graduated with Highest Bepartmen- Buffalo School of Medicine and Chicago (UIC). While at UIC, he parti­ tal Distinction and was elected to Phi Beta Kappa. Biomedical Sciences, has been a cipated in research with Br. John research assistant at the Buffalo llekis and Br. Erol Bnel, isolating nov­ Fabiano's work at the BNAC fo­ Neuroimaging el genes involved in spermatogene­ cuses on assessing gray matter sis. He also contributed to research damage in multiple sclerosis and Analysis Center (BNAC) since May 2BB1. A native of Buffalo and the third at the UIC Medical Center on positron diabetes using MRI diffusion imaging of six children, Fabiano attended emission tomography screening for and T2 relaxation. St. Joseph's Collegiate Institute in coronary calcification. Dr. Jacobs's work," says Bakshi. "One possibility might be a drug cocktail that in­ cludes interferon and a neuroprotective agent to target and preserve the gray matter." Bakshi's own research could point to one possible drug approach. He is first au­ thor on a study published in the January 2002 (Vol. 59) issue of Archives of Neurology that reports that brains of MS patients appear to contain excess iron deposits. "In our imaging studies, the gray matter structures of MS patients appear very dark on one type of MRI scan," says Bakshi. "This evidence points to high levels of iron in the brain, which suggests that iron could be causing cell damage. The brain's mechanism to regulate iron could be impaired or shut down in MS. "We've been able to correlate gray matter hypointensity with brain atrophy and physical impairment," he adds. "This leads us to think that hypointensity in the deep gray matter is a strong predictor of disability, progression of the disease and Autumn 2002 I ii f f a I n P h y s i c i a n 5 �subsequent brain atrophy." If these findings hold up through longitudinal studies, a treatment de­ signed to prevent iron buildup could prove beneficial. Student Scientists In addition to pursuing his own re­ search, Bakshi has assembled a group of energetic student researchers from various disciplines to work with senior neurologists on several projects. "The students are the lifeblood of Michael SanfiliDO Class of 2005 the BNAC," says Bakshi. "Their enthusiasm, dedication, and fresh ideas make our research program go forward. "Our goal is to train the students in the necessary neuroimaging analysis techniques and then rapidly help them to develop their own line of investigation under supervision," he continues. "This mentor-mentee approach has led to each student taking the lead on projects, including data analysis and interpretation, presentation of data at national research meetings, and manuscript preparation." Among the researchers is Robert Bermel, a fourth-year medical student at UB, who is concentrating on the cau­ date nucleus. Bermel is collaborating with specialists in UB's Center for Computational Research who are taking ology internship at the Manhattan Summer Research Fellowship to medical student at the University at Psychiatric Center,he was a research study whether cerebral gray matter Buffalo School of Medicine and Bio­ associate at New York University, abnormalities in MS are related to medical Sciences, joined the Buffalo where he conducted neuroimaging cognitive impairment. NeuroimagingAnalysis Center (BNAC) research (PET, MRI. fMRI) in schizo­ He has authored 31 research in 2002 to perform quantitative MRI phrenia under Dr. Adam Wolkin. He articles, six as first author. His cur­ research in multiple sclerosis (MS). then conducted fMRI researchin sub­ rent research interests include A native of Buffalo, Sanfilipo stance abuse at the Medical College MS. schizophrenia, neuroimaging. of Wisconsin under Dr. Elliot Stein. MRI, biostatistics and neuropsy­ earned his bachelor's and master's degrees in psychology from Syracuse Sanfilipo received a UB School of University. After completing a psych­ Medicine and Biomedical Sciences chology. In the future, he plans a career in academic neuroscience. "Our goal is to train the students in the necessary neuroimaging analysis techniques and then rapidly help them to develop their own line of investigation under supervision." —Rohit Bakshi, MD '91 6 I u If aI o Physician A u t u m n 2 0 0 2 �data from high-resolution MRI scans of the structure in MS patients and converting them into three-dimensional images that can be displayed on a computer monitor and rotated in any direction interactively. The studies are aimed at looking at how disease of the gray matter is detected in the brain and how it relates to MS progression. "Before we had the ability to create three-dimensional images, we were able to use computers only to obtain quantitative data, such as the structure's volume and di­ mensions," says Bermel, who is working in Bakshi's labo­ ratory. "Now we are able to visualize structures, to actually see where atrophy is occurring." Bermel presented a poster at this year's American Academy of Neurol­ ogy meeting detailing his findings, which showed that caudate nuclei in MS patients were smaller than in healthy controls. The atrophy of this brain structure wasn't associated with any other measures of disease pro­ gression, such as whole-brain atro­ phy, duration of disease or extent of brain lesions. "This suggests that another unde­ termined mechanism may play a role in gray matter disease," notes Bermel. "The study also demonstrated that new computer-assisted imaging ca­ pabilities can show gray matter dis­ ease, which previous MRI's could not detect. It opens a new window into the brain." Bermel and his colleagues in the UB Center for Computational Re­ search noware establishing a database of three-dimensional images of cau­ date nuclei from MS patients and cor­ relating each image with each patient's ability to function. This will allow re­ searchers to track the association be­ tween atrophyand MSsymptoms and, by matching images from new patients to the database, to predict their disease stage and progress. Another young researcher is Andrew Fabiano, a thirdyear medical student at UB, who is analyzing diffusionweighted MRI scans of gray matter structures in MS pa­ tients. This type of scan measures the amount of water that passes through a brain structure: the higher the diffusion rate, the less dense the tissue. Fabiano is assessing the diffusion rates of two different categories of disease—relapsing-remitting and secondaryprogressive—and comparing them to patients' symptoms. In results presented at this year's American Academy of Neurology meeting, Fabiano reported that the diffusion rate was higher in secondary-progressive patients than in relapsing-remitting. In the caudate nucleus, a higher diffu­ sion rate was linked to greater physical disability. His findings suggest that this type of scan could be used as a noninvasive method to determine and monitor gray matter tissue damage in MS patients. Fabiano was awarded a prestigious research grant from the Alpha Omega Alpha Medical Honor Society to continue this work in Bakshi's lab this past summer. As the newest member of the BNAC team, Michael Sanfilipo, a second-year UB medical student, is applying his Autumn 2002 Buffalo Physician 7 �prior neuroimaging experience in the area of schizophre­ nia to address the question of whether the specific cortical gray matter areas responsible for "higher" cognitive abilities are atrophied in MS. Sanfilipo recently received a UB Summer Research Fellowship to carry out this project us­ ing a statistical brain mapping program to be run in part­ nership with the Center for Computational Research. Also within the BNAC, Jitendra Sharma, MD, a graduate student at Roswell Park Cancer Institute, is collaborating with a researcher at the University of Trieste in Italy to develop a highly reliable measure of whole-brain atrophy. Jin Kuwata, a UB psychology graduate, is administering cognitive tests to MS patients and comparing their perfor­ mance with the amount of atrophy shown on their brain scans, making the connection between gray matter damage and mental function. Christopher Tjoa, a computer science and premed major at UB, is performing brain mapping in an effort to develop a standardized image of a healthy brain against which MS brain images can be compared. Rohit Bakshi While current work at the center will continue to con­ centrate on MS, in the future researchers will be analyzing brain scans of persons with juvenile diabetes, as well as those with other conditions, such as lupus, stroke, demen­ tia and epilepsy. "Our main thrust is to determine through MRI analysis the sites and mechanisms of disease in the brain and to provide new information about how diseases progress," explains Bakshi. "The applications of this work include a more accurate diagnosis of neurologic disorders and the ability to accurately predict the disease course at the time of the earliest symptoms. "Also, through studying diseases with sophisticated MRI analysis, we begin to untangle the great mystery of how the brain functions. Ultimately, this information could lead to new treatments and—in the best scenario— to cures for a variety of brain disorders. This is what we all work toward.''CT> is founding director of Upon graduation from medical scientific papers in such journals as the Buffalo Neuroimaging Analysis school in 1991, Uakshi served a one- the NewEngland Journal of Medicine, Center (BNAC), an associate profes­ year internship at the Massachu­ Journal of Neuroscience, Neurology, sor of neurology in the University at setts General Hospital and Harvard Multiple Sclerosis, and Journal of Buffalo School of Medicine and Bio­ Medical School, followed by a neur­ Neuroimaging. He is also first author medical Sciences and a neuroimager ology residency at the University of of a 200-page chapter on brain MRI at the Jacobs Neurological Institute California at Los Angeles, where he for the textbook Baker's Clinical in UB's Department of Neurology. conducted neuroimaging research Neurology, updated for 2001. A Buffalo native.Bakshi is a grad­ with Ur. John Mazziotta. He returned Oakshi received the 1998 William uate of Cornell University and the to Buffalo in 1995 to complete an H. Oldendorf Award for his neuroim­ UB School of Medicine and Biomedi­ MRI/CT neuroimaging fellowship at aging research in multiple sclero­ cal Sciences. As an Alpha Omega the Uent Neurologic Institute. sis. In 1999,he was appointed to the Alpha scholar, he completed a neuro­ Bakshi is board certified in neu­ board of directors of the American science research fellowship in neu­ rology and is certified in MRI/CT by Society of Neuroimaging and joined ropharmacology and stroke with the American Society of Neuroimag­ the faculty of Medscape.In 2000.he Dr. Alan Faden at the University of ing. A neurologist and neuroimager. was appointed to the editorial board California at San Francisco. he has published 7U peer-reviewed of the Journal of Neuroimaging. �wealth of Talent and Resources Multidisciplinary research program thrives in Buffalo & W he Buffalo Neuroimaging Analysis Center (BNAC) is located in the Jacobs Neurological Institute at Kaleida Health's Buffalo General Hospital, part of the Buf­ falo-Niagara Medical Campus. The center, which is affiliated with the Department of Neurology in the University at Buffalo School of Medicine and Biomedical Sci­ ences, has received more than $1 million in funding since opening two years ago. The sources of funding, which reflect the center's multidisciplinary research program, include the Na­ tional Multiple Sclerosis Society, the Juvenile Diabetes Foundation, the National Institutes of Health and the University at Buffalo. (Computer systems at the BNAC are maintained by the Engineering Node Service of UB's School of Engineering.) "One of the strengths of the BNAC is that we have thrived on various collaborations with UB investiga­ tors from other departments and other schools, taking advantage of the wealth of talent and resources avail­ able right here in Buffalo," says Rohit Bakshi, MD '91, UB associate professor of neurology and director of the BNAC. Other neurologists at the Jacobs Neurological Insti­ tute who have participated in the work of the BNAC include: Bianca Weinstock-Guttman, MD, UB assis­ tant professor of neurology; Steve Greenberg, MD, UB associate professor of neurology; and Frederick Munschauer, MD, UB clinical professor of neurology. In addition, Ralph Benedict, PhD, a neuropsychologist and UB associate professor of neurology, has collabo­ rated with the BNAC on numerous projects that involve the study of cognitive and behavioral disorders using magnetic resonance imaging (MRI). . s & v r-A" - «v v, r,uv| • m Bakshi has also :? sr i \ i ' " f \ % *K ,xv> '5 ^%vs formed a collabora­ -f. • . tion with Julian g\'*y 8BJS Ambrus Jr, ScD, T- ;iCi '3 ® T MD, UB research • ^• ~t> • ^ • i professor of medi­ cine, to study au­ toimmune diseases, such as antiphospholipid antibody syndrome. Richard Chan, MD, UB assistant professor of neurology (affiliated with the Jacobs Neurological Institute), and Adnan Qureshi, MD, UB assistant professor of neurosurgery (affiliated with UB's Toshiba Stroke Research Center), are partnering with the BNAC to use MRI to study brain changes associated with cerebrovascular disease. Murali Ramanthan, PhD, UB associate professor of pharmaceu­ tical sciences, is working with the BNAC on a $500,000 study supported by the National Multiple Sclerosis So­ ciety to correlate changes in gene expression with lesions and atrophy on brain MRI scans in patients with MS using powerful DNA microarray technology. In addition, Bakshi has been named the imaging point person for the Buffalo Center of Excellence in Bioinformatics, according to Bruce Holm, PhD, senior vice provost at UB. "This [collaboration] will allow the BNAC to assist in fostering imaging applications toward a variety of disease states in public-private partnerships," says Holm. "I am confident," says Bakshi, "that the imaging data obtained through the bioinformatics program will de­ velop better patient care and research, as well as economic spin-offs to benefit our community." The BNAC is also involved in national and interna­ tional collaborations with research groups in Florida, England and Italy. For more information on the research described in this article or other studies under way at the Buffalo Neuroimaging Analysis Center, visit the BNAC website at www.bnac.net. e> �y S sterv. roach $2 million NIH grant to study irritable bowel syndrome RRITABLE BOWEL SYNDROME (IBS) IS A GASTROINTESTINAL DISORDER CHARACTERIZED BY RECURRENT ABDOMINAL PAIN AND ABNORMAL BOWEL MOVEMENTS. / Second only to the common cold as a cause of work absenteeism in the United States, IBS affects an estimated one in six Americans and accounts for some three million visits to physicians annually. Although the etiology of the disorder is poorly understood, the enormous impact IBS has on society is clearly documented by these and other statistics, which leave little question as to why medical researchers are stepping up their efforts to find new, more effective ways to treat this often debilitating condition for which there is no standard medical treatment. One such effort is being undertaken by Jeffrey Lackner, PsyD, a University at Buffalo assistant professor of medicine, who is collaborating with researchers from the University at Albany to conduct a four-year clinical trial to test the effectiveness of cognitive therapy and self-help support in relieving symptoms of IBS. 10 Buffalo Physician A u t u m n 2 0 0 2 [ j I ��Pain's Mystery; a m i n d f u l a p p r o a c h he study, funded by a $2 million grant from the National Insti­ tutes of Health, builds upon a series of smaller studies Lackner and his group have conducted in recent years that demonstrate significant promise for these biobehavioral approaches to treat­ ment of IBS. "Irritable bowel syndrome affects quality of life as much or more than congestive heart failure. It can seriously disrupt virtually every aspect of life, from work and travel to recre­ ational activities and relationships with family and friends," says Lackner, who points out that 70 percent of individuals with J.V1 any patients — address a patient's beliefs and attitudes toward their pain, their coping skills or job satisfaction could result in ineffective treat­ ment or continued pain." IBS is a good example of a disorder whose painful symptoms are poorly understood in terms of underlying disease, according to Lackner. "Because of the nature of IBS symptoms and the fact that standard medical tests do not indicate a problem with the physical structure of the bowel, the disorder is often wrongly dismissed by healthcare providers as something other than a real medical condition," he explains. and even their physicians—are surprised to discover that more effective strategies for managing pain can be learned and that the research supporting cognitivebehavioral treatments is some of the most stringent and impressive in the chronic-pain literature—Jeffrey Lackner IBS are women. "Sufferers often feel like they are spectators in their own lives as they struggle with emotions of helplessness, embarrassment, anxiety and frustration." The result, unfortunately, is that many patients suffer in silence, failing to discuss their symptoms with friends, family and health professionals. Diagnostic Criteria Established A s director of UB's Behavioral Medicine Clinic in the UB Pain Center at Erie County Medical Center, Lackner focus­ es his research on identifying the biobehavioral factors that worsen pain and limit function, as well as on devising ways to help people suffering from chronic pain resume productive lives. "Most physicians and patients see pain as a symptom of an underlying disease," observes Lackner. "However, with chronic pain, there frequently is no clearly discernable physical cause. This doesn't mean that these patients are weak malingerers or that the pain is only in their heads; it means that, like all of us, their experience of pain is influenced by a distinctive mix of physical, psychological and environmental factors. Failing to 12 if13 Io Physician A u t u m n 2 0 0 2 While no one knows for sure what causes IBS, the consensus among experts now is that it is not a psychiatric disorder, nor is it caused by a specific biological or anatomical abnormality. Instead it is considered a functional disorder of the bowel in that its symptoms cannot be explained by an underlying structural abnormality, such as inflammatory bowel disease, or by bio­ chemical abnormalities, such as lactase deficiency. Because IBS symptoms mimic other diseases whose symp­ toms correspond with physical abnormalities, patients with IBS often undergo extensive workups before receiving a correct diagnosis. While these tests may have utility in evaluating certain gastrointestinal problems, they are not necessary to establish a diagnosis of IBS. "Because there is no objective marker of IBS symptoms, establishing a diagnosis requires recognizing the clinical features associated with IBS and excluding other medical disorders that may have a similar clinical presentation," explains Lackner. "The old view that IBS should be viewed as a 'wastebasket diagnosis' has been supplanted by an empirically validated symptombased diagnostic system known as the 'Rome criteria.'" These criteria were developed with the consensus of more �than 30 international authorities and describe the symptoms, clinical features and diagnostic guidelines for IBS. Currently, the criteria characterize patients with IBS as having 12 or more weeks (not necessarily consecutive) in the preceding year of abdominal pain accompanied by at least two of the following features: (1) pain is relieved by defecation; (2) onset of pain is associated with change in stool frequency and (3) onset of pain is associated with a change in stool appearance. (For more details on these guidelines, visit www.romecriteria.org.) Pain Theory and Therapy D espite the difficulty in diagnosing IBS, the good news is that the disorder is treatable, and some of the most promising interventions include the biobehavioral plans devised by Lackner and his team at UB. The rationale for behavioral medicine interventions comes from research showing an association between IBS and dys­ function in the interaction between the central nervous system and the enteric (small intestine) nervous system. Scientists now believe that this dysregulation of the "brain-gut" neuroenteric systems leads to abnormal patterns of motility (the ability to move spontaneously; in this case, the gut), enhanced pain sensi­ tivity and increased hyperactivity of the autonomic nervous system (the part of the nervous system that controls involuntary bodily functions). "Because 'crosstalk' between the brain and gut is bidirec­ tional, the higher-order brain processes—such as information processing, attention, beliefs, moods and attitudes—have the capacity to modify signals between the brain and the intestinal tract," says Lackner. Beyond their influence on gut motility and sensation, behav­ ioral factors have been found to influence pain reporting, phy­ sician visits, medication use and treatment outcome, according to Lackner. "This is particularly true regarding patients with IBS who seek treatment, versus those with the disorder who don't seek treatment—not in terms of the severity of their symptoms, but in terms of psychosocial makeup," he emphasizes. What this finding has suggested to scientists is that not only does the learning of these higher-order brain processes play an important role in the development and maintenance of IBS, but the 'unlearning' of the same processes can result in a reduction of IBS symptoms. "This information led our research team to develop a learn­ ing-based behavioral treatment program that teaches patients a set of practical, concrete skills to reduce gastrointestinal symp­ toms in much the same way as patients can learn to lower their blood pressure by modifying health behaviors," says Lackner. The 10-week program, designed by Lackner and his colleague Leonard Katz, MD, and Susan Krasner, PhD, are collaborators on the study. Susan Krasner, PhD, is individualized for each patient based on an intensive interview aimed at assessing the different aspects of a patient's pain, including its quality, location and triggers, as well as factors that maintain it. "We get far beyond 'Does it hurt?' and 'Where does it hurt?"' Lackner says. "For us, the important question is, 'What per­ sonalized treatment plan based on available scientific research stands the best chance of improving this patient's function­ ing for his or her specific pain syndrome?' By integrating data from our medical pain specialists with data from behavioral A u t u m n 2 0 0 2 Buffalo Physician �Pain's Mystery, a m i n d f u l a p p r o a c h BRAIN IMAGING S t u d y rritable bowel syndrome (IBS) is a com­ Study participants undergo a positron with IBS. Goals of the current UB study mon gastrointestinal condition present in emission tomography (brain imaging) scan include adding to this body of research, as an estimated 25 million people in the and sensory testing prior to commencing a well as discovering whether brain areas United States. While the cause of IBS is not 10-week nondrug biobehavioral program that do not function correctly in IBS pa­ completely understood, scientists believe for IBS (see article, opposite, for a descrip­ tients are normalized following completion that symptoms are provoked by hyper­ tion of this program). of the 10-week biobehavioral program. sensitive nerves sending abnormal levels of pain signals to brain regions that register At the conclusion of treatment, a sec­ ond set of tests is conducted. The study's principal investigator is Jeffrey Lackner, PsyD, a University at Buf­ pain sensations. Research has shown that The sensory testing task involves place­ falo assistant professor of medicine; these pain signals—which follow intestinal contractions, stress, hormonal changes, ment of a balloon catheter in the lower large coprincipal investigator is Alan Lockwood, intestine (colon) by a board-certified gastro- food intake and bloating—trigger a differ­ enterologist. The balloon catheter is connec­ MD, UB professor of neurology, nuclear medicine and communicative disorders ent pattern of brain activity in IBS patients ted to a computerized pump that inflates the and sciences and director of the UB-VA than in individuals without IBS. balloon to specific pressure levels, which, at PET Center. Thomas Mahl, MD, UB associ­ their highest, are moderately uncomfortable ate professor of clinical medicine, and These findings suggest that IBS involves "faulty wiring" of the nerves connecting for a short period of time. The patient's re­ Leonard Katz, MD, UB emeritus professor the gastrointestinal system and the brain. sponse to the balloon inflation is measured of medicine, are serving as the study's gas­ The Behavioral Medicine Clinic of the Uni­ by taking the PET scan, which creates pic­ trointestinal specialists. Funding is provided versity at Buffalo School of Medicine and tures of brain blood flow patterns that allow by an Interdisciplinary Research and Cre­ Biomedical Sciences and the University at scientists to visualize not only the fine struc­ ative Funds award from the University at Buffalo-Veterans Affairs' PET center are tures of the brain but also the level of activ­ Buffalo and the National Institutes currently conducting a study designed to compare brain activity to visceral (bowel) ity taking place in various parts of the brain. of Health. To date PET research has been very im­ For information on this study, or how stimulus of individuals with IBS versus healthy volunteers. portant in identifying specific regions of to participate in it,contact the UBBehavioral the brain that are more active in patients Medicine Clinic at (716) 898-6254. —S. A. UNGER evaluations, we identify the environmental, physical and per­ sonal factors that contribute to pain and then work to improve functioning." Armed with a clear picture of the type of pain and the type of person, Lackner and Krasner set out to teach their clients how to work around the pain and return to a better quality of life. To accomplish this, they draw on a variety of clinically proven behavioral techniques. A plan may include learning behavioral self-management tools to challenge information processing errors that influence pain and response to treatment. "For example, pain patients learn to recognize the earliest thoughts and reactions that accompany a pain flare-up and to modify their responses to them," says Krasner, who is also a pain psychologist and UB clinical assistant professor of anesthesiol­ ogy. "Patients are taught that 'automatic thoughts,' such as 'the pain will never end' and 'there is no hope,' can be replaced with substitutes, such as 'the pain has always lessened in the past' and 'change is possible; there is always hope,' to help to reduce pain and related distress." 1 4 Buffalo P hf s i ci a n A u t u m n 2 0 0 2 Impressive Results, Further Research O ver the past 15 years, this behavioral self-management approach has been subjected to rigorous scientific stan­ dards in a series of clinical trials. The results show that 70 to 80 percent of IBS patients achieve a clinically significant—50 per­ cent or more—reduction in IBS symptoms and maintain these gains for up to three months of follow-up. "A major goal of our current NIH trial is to assess the extent to which treatment gains are maintained at 12 months after the completion of treatment," says Lackner. "Many patients—and even their physicians—are surprised to discover that more effective strategies for managing pain can be learned and that the research supporting cognitive-behavioral treatments is some of the most stringent and impressive in the chronic pain literature," he continues. "Cognitive-behavioral therapy can't promise patients total freedom from a medical problem as complex as IBS pain," he �says, "but it can teach patients to feel less hampered by it." To date, 200 people from Buffalo and Albany have been enrolled in the NIH clinical trial. In addition to monitoring the effectiveness of the treatment a year after its conclusion, the researchers are seeking to determine if participation in cogni­ tive therapy or a support group improves symptoms compared to a control group. They are also attempting to establish which aspects of treatment are responsible for a decrease in symptoms, as well as which symptoms may predict positive outcomes. Working alongside Krasner, who is a therapist on the Buffalo study, is Leonard Katz, MD, UB emeritus professor of medicine, who is serving as the study's gastrointestinal specialist. "We think the findings from our preliminary studies are very promising, but we don't help our patients as much as we'd like," says Lackner. "We need to improve on what we're doing. There is still a lot we don't know, and we think our current work will provide many more answers." B 'rimary care physicians can treat an estimated 70 percent of patients with irritable bowel syn­ drome. Only 30 percent of patients have moderate to severe symptoms that occur two or more times per week and interfere with daily activities. In complex cases, patients do not typically re­ spond to treatments that only target normaliza­ tion of the gut; instead they may require formal instruction in symptom self-management skills. Studies show that, even in severe cases, treat­ ment such as that offered at the University at Buffalo's Functional Gastrointestinal Disorders Center can significantly reduce IBS symptoms by up to 80percent. To learn more about the ongoing National Institutes of Health clinical trial for treatment of Lois Baker, senior editor in News Services at the University at Buffalo, contributed to this article. IBS described in this article—or criteria for refer­ ring a patient to this trial—call (716) 898-6254 or (716) 898-5671. G> We practice law for those who practice health care. Phillips, Lytle understands that health care providers face unique legal challenges. HIPAA, STARK, compliance issues, DOH regulations, reimbursement, the OPMC, and let's not forget about MFCU audits. These are all hot topics that we are prepared to help you with. Experience Breadth Depth Have questions or concerns? Call or e-mail Lisa McDougall, Esq., the health care practice group coordinator, at (716) 847-5478 or lmcdougall@phillipslytle.com. P H I L L I P S , L Y T L E , H I T C H C O C K , T T O R N E B L A I N E Y 8 H U B E R L L P S est. 1834 3400 HSBC Center, Buffalo, N Y 14203 (716) 847-8400 website: www.phillipslytle.com B UFFALO • F REDONIA • |AMESTOWN • N E W Y ORK • R OCHESTER Autumn 2002 Buffalo Physician �M E D I C A L S C H O O L N E W S A Conversation with Dean Michael Bernardino N APRIL 1998, Michael Bernardino, MD, MBA, was named vice president for health affairs at the University at Buffalo, respon­ sible for overseeing the clinical and col­ laborative activities of the university's five health sciences schools: medicine and bio­ medical sciences, dental medicine, health related professions, nursing, and pharmacy and pharmaceutical sciences. In this role, he has also been responsible for spearheading • 1 0 0OO< • ,/IMOaom • /Miooeai ///IGOODOJ ^•/MOOOOAM 0D«0* •"HI Ooo^t teaching hospitals and for leading the Woatao cuting joint and cooperative programs of teaching and research. In June 2001, UB Provost Elizabeth D. Capaldi announced that Bernardino would also serve as dean of the School of Medicine and Biomedical Sciences. Buffalo Physician /«A» *0«B< the university's relations with its affiliated health-science deans in planning and exe­ 16 • A u t u m n 20 0 2 ^mioa* �rior to coming to UB, Bernardino was direcI tor of managed care for the Emory University Ql Where do revenues come from to support the School of Medicine and Biomedical Sciences? I System of Health Care. He also served as professor of radiology at Emory University A; The school receives revenues from multiple sources School of Medicine, director of magnetic that include the state, tuition, practice plan, endow­ resonance imaging and abdominal radiology ments, and in indirect costs recovered from grants. at Emory University Hospital and professor The money we receive from the State of New York comes primarily in lines for faculty and administrative in the Winship Cancer Center. A native of North Canton, Ohio, Bernardino is a graduate of Case Western Reserve University and salaries, and it varies by department, but I'd say, in the aggregate, it's somewhere between 10 and 15 percent. Ohio State University, where he earned his medical degree. He completed his residency training in diagnostic radiology at George Washington Uni­ versity and earned his master's in business admini­ stration from the Goizueta Business School at Emory University. That's not a lot of support from the state. Al No, and what many people don't realize is that the type of money we receive makes a big difference. If it's state money we receive for salaries, it carries fringe benefits. However, if we use philanthropic money At our invitation, Dean Bernardino from the UB Foundation to hire some­ recently sat down to talk with Buffalo Physician about issues he faces as he attempts to position the School of Medicine and Biomedical Sciences for The reason why the hiring freeze is selective the future in a healthcare environment is because there are that, by many standards, is under­ certain departments going change and upheaval to a degree that is unprecedented. Because funding considerations underlie all decisions he must make, we focused the conversation on the that are critical to the school's mission and these core departments must be healthy if the topic of the school's budget. Future issues of Buffalo Physician will intermittently publish other con­ school is to be healthy. versations with the Dean on a variety of topics, as well as conversations with the school's senior associate deans: Margaret Paroski, MD, (medical education and admissions), Roseanne Berger, one, we have to come up with another 30 to 40 percent to cover benefits, which means that money doesn't go as far as state money does. So, if you look at our state tax sup­ port, it's certainly not increasing. As a matter of fact, over the last five years, we've had two UUP [United University Professions) increases to absorb. The state signed the contract approving the increases, but didn't fund them. There­ fore, we haveto come up with the money for the increases, which means there's less money available. Q: How much are these increases, and how are they being absorbed? MD, (graduate medical education) and Suzanne Al The most recent raise [effective in August 2002] was Laychock, PhD, (research and biomedical education), 3.5 percent, and our school's component amounted to each of whom will be asked to talk about issues perti­ $1.4 million. In lune, Provost Capaldi said she will nent to her respective areas of responsibility. cover the raise for all schools throughout the univer­ The goal in publishing this series of interviews is to sity, including ours. The caveat, however, is that the inform our readers about the complex economic, po­ deans are being asked to trim costs in their respective litical, regulatory and historic considerations school schools, although no firm number has yet been pro­ leaders must weigh in making decisions and to pro­ vided to us by the provost. Further complicating the vide a larger context within which to understand the picture is the fact that one week after the provost many new developments taking place on campus. agreed to cover the UUP increases, we were informed Comments and questions, and suggestions for that there will be an additional 1 percent state budget future topics, are welcome and can be emailed to cut, SUNY wide, effective January 1, 2003. What that bp-notes@buffalo.edu or mailed to the address listed means is that we're going to have to turn over 1 percent on the inside front cover of the magazine, below the in state operating dollars, and this will be done pri­ heading "Letters to the Editor." marily through retirements. That money will go back —S. A. UNGER, EDITOR to SUNY Central, to the governor's office. Autumn 2002 Buffalo Physician 17 �M E D I C A L S C H O O L N E W S Not everyone gets what they want, but in an era that demands management with zero growth in resources, there's no other way to do it. Essentially, it requires prioritization in a global budgetary sense, which is very difficult in any kind of academic situation. We also have been alerted to the fact that there may yet be another tithe next spring after the elections. Nothing is for certain, but this "alert" and the other uncertainties in revenue stream that I've described puts me in a very difficult position because how can I in all good conscience tell people to go ahead and hire if I may not have the money to fund the positions? Q: Is this why you announced a selective hiring freeze this summer, effective July 1? Al Yes. It makes it very difficult to manage with these types of funding variables, these uncertainties. The reason why the hiring freeze is selective is because there are certain departments that are critical to the school's mission and these core departments must be healthy if the school is to be healthy. This may offend and anger some chairs and faculty; but on the other hand, it's a fact of life: If you're looking to the future, you must have core departments, such as medicine, pediatrics and surgery, that are functioning well, or else we will have difficulty teaching 135 students. So what we've done is delay some of the hiring. If I feel that we have enough money in the future to cover what might be the tithe, then we'll go back to the original game plan for hiring. Q" What were the budgetary challenges you faced when you first came to UB four and a half years ago? What have open records, and there are boards that oversee their operation. A significant result of this is that we now have a budgeting process that is consistent and uniform, as well. We meet with departmental chairs about 6 to 7 months in advance of the new fiscal year and we look at what their wish list is and give them a budget of how much we can spend in their departments. This planning has been very beneficial. In the past, this process varied a great deal. There is still some variation—especially in terms of knowledge—but the chances of significant financial shortcomings have been dramatically lessened. That doesn't mean that any one of the departments won't have trouble in any one year, depending on the local healthcare environment, but it's far less likely to take place than in the recent past. Not everyone gets what they want, but in an era that demands management with zero growth in re­ sources, there's no other way to do it. Essentially, it requires prioritization in a global budgetary sense, which is very difficult in any kind of academic situa­ tion. 1 would absolutely love to make everyone hap­ py, but the fact is we don't have that kind of money, and it's unlikely we'll have it in the next few years. Another significant outcome of this reform pro­ cess is that there is now a clear understanding of the school's—not just the practice plan's—sources of revenue and expenses. All sources can be identified. you done to confront these challenges? A? When I first came to UB, I focused on trying to gain some semblance of understanding about the practice plan, which varied from department to department and was very fragmented. We have reformed the plan as far as possible within the parameters of the state's rules, regulations and labor contracts. We now have a single accounting system for all of the practice plans— a single 'lockbox'—that operates under an umbrella organization called UB Associates. All departments have a uniform accountingsystem; they all 'look alike,' and theyare all nonprofit organizations. All plans have II f f a Io Physician Autumn 2002 Q: In a recent Town Hall meeting*you said that there has never been a comprehensive plan for using the state money that the school receives but that, in the future, these funds would be allocated in a more systematic way. Can you elaborate on this? Al To put this in perspective, you have to remember that there was a plethora of money coming into the school in the late '70s and early '80s; the school had a lot of money and was very well off. However, what happened is that between 1990 and 2000, over $10 million was taken out of the school, primarily for the North Campus. Money is no longer being redirected �from the South Campus to the North Campus, but the fact of the matter remains that if this had not happened, the school's state operating budget would have been $10 million more than it is now. Secondly, if you look at how state funds have been distributed to clinical faculty, there doesn't appear to have been a formula governing this disbursement. Granted, the rationale for these disbursements may have been more evident in years past, but, in retro­ spect, it doesn't make sense that certain departments receive a disproportionate amount of money in rela­ tion to the number of medical students taught. In the future, what I think we need to look at is this: There should be for both the clinical and the research faculty a standard method for determining how money is allocated. For example, if a clinician comes in at an associate professor level, his or her salary will be in the 'x' dollar range, while a clinician who comes in as an assistant professor will qualify for a salary in the ly' dollar range. If an individual comes in and is going to conduct research half time, then he or she gets compensated for that propor­ tionally because we are buying that research time. I think, in the past, some people could have argued that certain departments in the school were subsidiz­ ed by the state and to some extent their affiliated hos­ pitals were also being subsidized. So, this is problem thing over the last five years, so there's no new money for facilities, and it's going to be very, very difficult to progress with refurbishing projects on the South Campus over the next year. However, in the last five years we have done a lot of rehabbing of laboratory space and classrooms, which we've equipped with state-of-the-art educa­ tional technologies. Going forward to the next fiveyear plan, we had hoped to refurbish Acheson and move the School of Pharmacy into it, but that has been delayed. So, this extension of the capital plan does not just affect the medical school, but all of the health sci­ ences schools. Everyone needs new classrooms and laboratory space, but it's all had to be delayed. Ql You have talked a lot about the importance of the school increasing the amount of philanthropic dollars it receives, especially unrestricted dollars. Why are these dollars so important to the school, both now and into the future? Al When I look at the whole budgetary picture, this is a glaring weakness as we go forward. There are prob­ lems in the local environment and there are problems in the state environment, but our school currently has some 9,000 living graduates, yet receives only about $200,000 annuallyfrom its alumni. I would very much like to see this increase to a minimum of $1 million a that is not going to be solved overnight because of year; ideally, to $4 or $5 million. existing labor laws and contracts, but it is something This is the single biggest piece that needs to be fixed we are looking at as we move ahead. in terms of funding. And I think about this when I hear people say that a priority for the school should be to Qi In the Town Hall meetings, you have also discussed the gather top faculty. Quite frankly, we cannot do this fact that the university is in the fifth year of a five-year bud­ until we have increased philanthropic support. get capital plan that has been extended another year. Can Making philanthropy a top priority is going to you explain how this extension affects the school's budget? require a paradigm shift in culture on the part of Al The capital plan is of course for the refurbishing of faculty and administrators alike. Our primary mission our facilities—buildings, classrooms and laborator­ must be to support our students in any way necessary ies. If there had not been a budget crisis in the state to ensure that they have the best and most positive this year, the five-year capital plan would have ended. medical education experience possible. We currently Instead, it has been extended another year. What are assessing all aspects of the medical school experi­ this means is that we've pretty much expended every­ ence at UB to determine ways we can do this. But programs that sup­ * In October 2001, Dean Bernardino began hosting a series of ongoing Town Hall meetings port our students require for faculty, staff, students and residents a t various community hospital sites and on t h e more than a commitment South Campus. The purpose of these meetings is t o update attendees about developments of time and energy; they a t the School of Medicine and Biomedical Sciences and t o provide them with an opportunity require a financial invest­ t o ask questions of t h e dean and t h e school's three senior associate deans. Because the school is so geographically disbursed, many of the challenges it faces are unique t o a ment as well, and this is particular clinical or academic site. Dean Bernardino has viewed the Town Hall meetings where we need to look to a s an integral part of t h e school's commitment t o addressing these challenges and t o our alumni and friends of recognizing solutions that have been implemented in response t o them. our school for assistance. Autumn 2002 Buffalo Physician 19 �M E D I C A L S C H O O L N If our students leave here and have not had a good experience, then they are not going to remain connected to the school and give back to it. If we can do the right things for our students now, then they will be motivated to help their fellow alumni once they graduate and move on in their careers. We can talk in great detail as we have here today about the difficulties of obtaining and equitably dis­ tributing support from external government sources, but ulti­ mately, I believe the key to securing the school's future and to maintaining its stature lies with the support we can receive from our alumni. If this problem were solved, this school would be sailing. fji In general, how do you feel about the school's financial future, given the budgetary changes you've implemented? Are you optimistic? A; The bottom line is that the school is no longer in the red. With the changes we've discussed, I will say that the school is poised to withstand an adverse environment much better that it was four or five years ago. And it should be noted that a lot of other medical schools, E W S even those within the SUNY system, are experiencing serious financial problems. There's a tendency to just look at what is happening in Buffalo, but quite frankly there are other places that are in much worse shape. Some of the other SUNY health science centers had to absorb the 3.5 percent UUP increase, plus the state's one percent, so they're facing a 4.5 percent setback. I'm not saying that things are perfect at our school, but if you look at it in relationship to what is going on around the country, there are many states that are not doing well; in fact, my under­ standing is that as many as 40 state governments are operating in the red this year. To answer your second question, yes, I am optimistic about the school's future. I'm even more optimistic now that we have signed new hospital affiliation agreements [see story opposite, as well as "From the Dean" on the inside front cover of this issue]. These agreements are the structural building blocks for our school and I am confident they will be a very good foundation upon which to build its future. So, I feel the school will survive financially. And, again, if we can look forward to an increase in philan­ thropy, I believe it will not only survive, but it will thrive. When is a house more than a home? ...When it is a Patio Home at Canterbury Woods. Come and learn more about what makes our new Patio Home Community so unique. ml Informational Seminar Seating is Limited Call 929-5817 To Reserve your Date and Time Episcopal Church Home and Buffalo Physician Autumn 2002 705 Renaissance Drive, Williamsville, NY 14221 �New Hospital Affiliation Agreements N Set the stage for revitalizing delivery of region's healthcare ew affiliation agreements negotiated between the University at Buffalo and its teaching hospitals have defined and fun­ damentally changed the working relationship between the UB School of Medicine and Biomedical Sciences and these entities. The new agreements also lay the groundwork for improved and more cost-efficient healthcare in Western New York. The agreements between UB and Kaleida Health and UB and the Erie County Medical Center announced on August 21, 2002, spell out the roles of the university and the hospitals in the healthcare system. In particular, they stipulate that the university will have responsibility for medical re­ search and educating medical students and residents, while the hospitals will have responsibility for patient care. A similar agreement between UB and Roswell Park Cancer Institute, the Veterans Affairs Western New York Healthcare System and the Catholic Hospital System are expected to be finalized by the end of the year. At the press conference held on August 21, 2002, to announce the new agreements between UB and ECMC and Kaleida Health, Michael E. Bernardino, MD, MBA, UB vice pres­ ident for health affairs and dean of the School of Medicine and Biomedi­ cal Sciences, said the agreements are designed to enhance the mission of all parties. "This new order provides the gird­ ers for building a high-quality regional healthcare system," Bernardino said. "These new affiliations can set the stage for revolutionizing and revitalizing healthcare delivery in this region." Noting that this is the first time the relationship between the hospitals and the medical school has been so clearly defined, Bernardino described the de­ velopment as "a seminal event in the medical school's history that promises tremendous rewards for the commu­ nity." He added that the agreements could serve as the basis for regional health planning "by helping us strate­ gically plan for academic missions. The community could end up with the best thing of all: rational alloca­ tion of healthcare resources. Better planning for care will mean better care and more cost-efficient care." Major features of the new affilia­ tion agreements between UB and Kaleida Health and ECMC include: • UB will become the sole sponsor of the training of resident physicians and dentists in affiliated hospitals, bringing this training in line with that of medical schools across the country. (The resi­ dency programs in Buffalo have been sponsored by the Graduate Medical and Dental Consortium of Buffalo.) UB also will assume responsibility for all medical student educational activi­ ties that take place in the hospitals. • Hospitals will pay the medical school for the clinical services provided by UB faculty, rather than paying faculty or departments directly. In turn, those funds will be deposited into the respec­ tive departmental practice plans,which are managed by UB Associates, a sepa­ rate nonprofit organization. • All research funds generated by UB faculty conducting research in affili­ ated hospitals, with the exception of Roswell Park Cancer Institute, will be managed by the SUNY Research Foundation or the UB Foundation. The new affiliation agreements ac­ knowledge the need to ensure that the clinical practice plan of each depart­ ment supports the medical school's academic programs; to promote faculty collegiality and excellence in teaching, research and clinical activities; to guar­ antee maintenance of common goals and a common clinical philosophy among the medical school's depart­ ments and faculty, and to make sure affiliated hospitals can provide highquality medical care for patients. Bernardino and the chief operat­ ing officers of affiliated health sys­ tems will form the Joint Affiliation Committee (JAC), which will advise the medical school in its academic strategic planning and approve the fi­ nancial plan for operation of all resi­ dency programs. In turn, the JAC will provide the structure under which the hospitals can develop mutually beneficial working relationships. CD —Lois BAKER AND ARTHUR PAGE nggS! •SSSSi " ' " A u t u m n 2 0 0 2 I f a I D Physician 21 �% M e d i c a l S c h o o l N e w s Donningthe White Coat First-year students initiated into their new roles O n August 16, 2002, the University at Buffalo School of Medicine and Biomedical Sciences welcomed its Class of 2006 at the fifth annual White Coat Ceremony, held in Slee Hall on the North Campus. The ceremony is a rite of pas­ sage for first-year medical students, who are reminded of their responsibility to care as well as cure patients by endorsing a psychological contract of professional­ ism and empathy at the start of their med­ ical careers. To formalize this commitment, they are officially "cloaked" with their first white coat, after which they recite the Physician's Oath, a modern version of the ancient Hippocratic Oath. Opening remarks were delivered by Michael E. Bernardino, MD, MBA, vice president for health affairs at the Uni­ versity at Buffalo and dean of the School of "Of all the skills you Medicine and Biomedical are going to learn in Sciences, who then intro­ medicine, learning to duced the keynote speak­ er, Richard Sarkin, MD, communicate with clinical associate profes­ patients and family is sor of pediatrics. Sarkin talked to the the most important." students about the re­ sponsibilities and privi­ leges inherent in the profession they are entering and shared with them advice about how to make the journey through medical school as healthy and positive an experience as possible, despite the great pressure each student will feel. "It's not easy being a physician, which you all are going to find out very soon, and gatherings like the White Coat Ceremony are just a start to understanding what the role of the physician really is," Sarkin said. 22 Buffalo Physician A u t u m n 2 0 0 2 Stephen Pollack, MD '82. vice president of the Medical Alumni Association, cloaks Marilyn Augustine. Class of 200G. He then shared simple, yet profound, ad­ vice he received from an older physician many years ago—advice, he says, that has influenced him throughout his career. "This person said to me that I should treat each of my patients with the same respect and compassion that I would ex­ pect a member of my family to receive," he recalled. Sarkin then set forth "a few suggestions for the coming years" for the students to follow in order to bring balance to their lives. "First, learn to communicate very well with patients and family," he advised. "Of all the skills you are going to learn in medicine, learning to communicate with patients and family is the most im­ portant. The average physician conducts more than a hundred thousand inter­ views over the course of his or her career. Learning to communicate and learning to listen are essential qualities of out­ standing physicians. "Second, find some balance. Work hard, but find some things to do outside of medical school that are meaningful to you. That could be family, friends, hob­ bies or community service. These are �things that should be meaningful to you and important to you. I can't tell you what they are, but seek them out.... Balance is hard to find, but it's essential. t "M ext, take care of yourself. If you don't rest and find balance, you will become I stale," cautioned Sarkin, who used the analogy of a tree cutter who had to work much harder to accomplish his goal be­ cause he hadn't taken the time away from his work to sharpen the blade of his saw. "This is the story of all of our lives," Sarkin noted. "It's the story of everyone here on this stage today, of your family and friends. You need to figure out how to find time to sharpen your saws. You've got to eat well, exercise, rest, find ways to reduce stress, find a way to do some fun things. You're going to tell your patients to do just this, so you have to find a way to do it yourself. "Lastly, make medical school fun," Sarkin concluded. "You're going to work long and hard; I can promise you that. But don't take school too seriously and don't take yourself too seriously. "Things go by so quickly. If you can think about ways to make med­ ical school fun, it's going to be much more useful to you." Following Sarkin's address, Toni Ferrario, MD, UB clinical assistant professor of surgery, was presented with the Human­ ism in Medicine Award (see article, opposite). Margaret Paroski, MD '80, MMM, senior associate dean for academic affairs and admis­ sions, then gave an overview of the Class of 2006 and intro­ duced each of the students as he or she was being cloaked. The ceremony concluded with Dean Bernardino leading the students in reciting the Phy­ sician's Oath. G> —S. A. UNGER 2002 Humanism Award Toni Ferrario, MD, clinical assistant professor of sur­ gery, was presented with the University at Buffalo School of Medicine and Biomedical Science's Human­ ism in Medicine Award at this year's White Coat Ceremony. Nominations for the award are made by students in the clerkship years. In presenting the award, Charles Severin, MD '97, PhD, assistant dean for years one and two in the If I Office of Medical Education, read a composite of the com­ k % ;§ ments made by students who nominated her for thisaward. "Dr. Ferrario is absolutely outstanding in every category that you listed. I watched her deal with terminally ill patients at the VA medical center with The annual White Coat Ceremony is sponsored by the Arnold P. Gold Foundation, UB's Medical Alumni Association, and the Medical School Parents' Council. phenomenal compassion and empathy. One patient in par­ Ferrario ticular comes to mind who had inoperable colon cancer. Dr. Ferrario made all the arrangements for the family to work with hospice and others in order to help them come to terms with their "Class" Profile—2 loved one's prognosis. In that sense, she was like no other surgeon I have had the opportunity to observe. "Dr. Ferrario was always available and enthu­ siastic in her interactions with me when it came time Number of Applicants: L ,819; INTERVIEWED 454 to showing me what surgery was all about, both in Class Size: 135 and out of the operating room. Male-Female Ratio: 59 MEN> 76 WOMEN off hours for extra help and was always friendly and Where They Call Home: 44 FROM WESTERN NEW YORK.; approachable. She treated everyone around her with 27 FROM EXTENDED WESTERN NEWYORK ; 10 FROM UPSTATE; respect, whether they were students, residents, hos­ 46 FROM DOWNSTATE; 8, OTHER pital staff or fellow attendings. Age: AVERAGE AGE IS 23; THE OLDEST IS 44; THE YOUNGEST, 20; from the standpoint that I think that she, as a woman, "She made herself available to students during "She was an outstanding role model, especially 17 ARE OVER 26 must have faced additional obstacles in becoming a Academic Background: AVERAGE GPA IS 3.54; OVERALL surgeon." AVERAGE MCAT SCORE IS A LITTLE UNDER 29. TWELVE HAVE Support for the Humanism Award is provided by MASTER'S DEGREES; 95 ARE SCIENCE MAJORS AND 40 ARE the Healthcare Foundation of New Jersey. NON-SCIENCE MAJORS. —S. A. UNGER Autumn 2002 <1J Buffalo Physician 23 �N M Student Clinician's Ceremony T Recognizing the transition to the clinical years he inaugural Student Clinician's they move into their clerkships. Following their remarks, Nancy Nielsen, Ceremony at the University at Buffalo School of Medicine and MD '76, PhD, assistant dean for student Biomedical Sciences was held affairs, addressed the audience, saying that August 18, 2002, in the Center for it was her privilege to "spring a surprise" on everyone present. Nielsen, who is vice the Arts on UB's North Campus. speaker of the American Medical As­ The ceremony was initiated by the school's Professional Conduct Com­ sociation's (AMA) policy-making House mittee through a grant from the Arnold P. of Delegates, began by noting that last year, when members of the Class of 2003 Gold Foundation. Opening remarks were delivered by were about halfway through the first half fourth-year student Elizabeth Bourke, of their first clerkship, the events of Sep­ who took a lead role in planning the event, tember 11th took place, followed by the the highlight of which was the presentation of the Humanism and Excellence in Teaching Awards to six residents selected by students in the Class of 2003. Addressing an audience of stu­ dents, family, friends and faculty that filled the auditorium to cap­ acity, Bourke explained that the Student Clinician's Ceremony "is a celebration of the transition to the clinical years of medical school. Its goal is to introduce the new third-year students to those who will provide guidance, example and inspiration throughout the Elizabeth Bourke, 03, left, congratulating Marsilia Seiwel. MD '99 last two years of medical school and throughout their careers. It's a chance cases of inhalational anthrax. for students to reaffirm their commitment "What those events brought home to to compassionate, patient-centered care by physicians across the country," said Niel­ reciting the oath that we took at the White sen, "is that we are a community of hu­ Coat Ceremony. Our vision for this cer­ man beings, and that geographic borders do not matter the way they used to; just as emony is that students will be inspired to spend their careers with a focus on the now, when you go to the clinics and you see a 65-year-old woman with encepha­ humanistic side of medical care." Following Bourke's remarks, Michael litis, you have to think of West Nile virus Bernardino, MD, dean of the School of as part of that differential diagnosis. Up Medicine and Biomedical Sciences, and until May of 1999, nobody in this country Margaret Paroski, MD '80, senior asso­ had paid attention to that disease, which ciate dean for academic medicine, each was certainly present in the Congo." As a result of these and other events, she welcomed the students and talked to them briefly about the communication skills said, representatives of organized medicine and discipline they will need to cultivate as from every state and territory in our nation 24 Buffalo Physician BY S. A. UNGER Autumn 2002 gathered last December at the AMA's House of Delegates and adopted the "Declaration of Professional Responsibility: Medicine's Social Contract with Humanity," which is an affirmation of the role and the respon­ sibility of the physician in our world. Nielsen then invited Dean Bernardino to the podium to receive a framed copy of the declaration. In presenting it to him, she stated that he was the first dean of a medi­ cal school in our country to receive the document, which will be sent to all medi­ cal schools in the United States. Following this presentation, the keynote address was delivered by Jack F. Coyne, MD '85, clinical as­ sociate professor of pediatrics at the University at Buffalo, medical di­ rector and coordinator of pediatric medical education for Mercy Hos­ pital in Buffalo and medical direc­ tor of the Child Advocacy Centers of Erie, Niagara and Genesee coun­ ties, which he helped establish. In keeping with Nielsen's theme of medicine being a social contract with humanity, Coyne en­ couraged the students to seek ways to fulfill this contract, whether at home or abroad. "Effecting a change, inspiring others, touching another life happens because we choose to make it happen," he said. "It can be painful to effect any change," he cautioned. "You may experience trau­ ma or emptiness—experiences that, hope­ fully, will force you into action. Your soul is touched and you begin to make good choices. I have seen students and residents do just that. And that's the reason why we're here today, to celebrate our awardees and your new life." Coyne talked in depth about such phy­ sicians as Tom Dooley, who have inspired him by working around the world to serve humanity. �Humanism and Excellence in Teaching Awards Students in the Class of 2003 selected six residents to receive the Arnold P. Gold Foundation Humanism and Excellence in Teaching Award, based on their demonstrating H e also talked about how, prior to enter­ ing medical school, he traveled to a refugee camp in Cambodia located in the Killing Fields, where there were many children who had lost their parents and who were hanging onto life by a thread themselves. The camp, which was spon­ sored by the Red Cross, was run by a phy­ sician whose energy, compassion and dedication inspired Coyne. "It was here that I regained my enthu­ siasm to become a physician," Coyne told the students. "This doctor was a very sen­ sitive man, lending a healing hand amidst much pain, sorrow and agony. He was bringing some relief and warmth to these forgotten orphaned children. My thoughts, while they were piling bodies alongside a fence outside the camp was, 'there should be more of him here."' Coyne said that he well understood that not all physicians could take their families and move to a foreign land to provide this kind of care, but he encouraged the stu­ dents to look for opportunities to help where they could, whether it be a short trip overseas to see patients for a week or two through a medical-relief organiza­ tion, or to provide care to a forgotten child in our own city, region or country. "There is a little of Dr. Tom Dooley in all of us," he added. "All we need is the opportunity and the willingness to stay on course." At the close of Coyne's address, fourthyear student David Flint introduced the six residents who were chosen to receive this year's Humanism and Excellence in Teaching Awards (see article, opposite). After the awards were presented, James Boyle, Class of 2003, read an excerpt from a poem titled "When You Come into My Room," by Stephen A. Schmidt. The ceremony closed with Dean Ber­ nardino leading the students in the recita­ tion of the Physician's Oath, a commitment to teaching and compassionate treatment of patients and families, students and colleagues. Residents selected to receive thisyear's award are listed below, followed by a comment that was submitted by a student who nominated them: Ashfaq Balla, MD, was chief resi­ dent in internal medicine at Sisters Hospital. Dr. Balla made a sincere effort to treat me as one of the team, with responsibilities but also respect. He was devoted to ed­ ucating without harassing or embarrassing me. He respected my opinions. I felt like myefforts were of value, and that I brought something to the team. Christopher Kling, MD '01, was an intern at Sisters Hospital. Currently he is a resident in dermatology at St. Louis University. Left to right: Donald McDonald. MD: Amy McDonald. MD: Ann Bruder of the Arnold P. Gold Foundation; Marsilia Seiwel. MD. Nasseer Masoodi. MD. and Dean Michael Bernardino Dr. Kling is extremely compe­ tent and knowledgeable, and if he did not know something he would look it up and share the information with the team. He demonstrated no judgmental attitudes toward any of the patients regardless of their race, ethnicity, medical problem or substance history. Nasseer Masoodi, MD, is a resident in internal medicine at Sisters Hospital. Dr. Masoodi was perhaps the best resident I've ever had the pleasure of work­ ing with. He knew how to handle the patients, the staff, the students and the administrators, and he combined this with an unbelievable knowledge base. It was truly an honor working with such a wonderful physician. Amy McDonald, MD '01, is a resident of internal medicine at the University at Buffalo. In the course of a month, [I had the opportunity to observe Dr. McDonald treat] many terminally ill patients. It was wonderful to have a role model who is such a well-rounded, humanistic physician as she is. Donald McDonald, MD '00, is a resident of internal medicine at the University at Buffalo. Most of [Dr. McDonald's] time was spent educating the patients, as well as myself. He would always comment on how pleasant his patients were, and I was certain that it was actually the sunshine he brought into the hospital on his white coat that the patients couldn't resist responding to. Marsilia Seiwel, MD '99, is chief resident for obstetrics-gynecology at Sisters Hospital. Dr. Seiwel is the first resident that I can say is a true role model. Her patients literally love her and have complete trust in her. I was able to witness the value of the doctor-patient relationship because her patients confided in her and asked her questions at a level other doctors just are not able to get with their patients. o A u t u m n 2 0 0 2 Buffalo Physician 25 �35l Center of Excellence in Bioinformatics Construction set to begin next summer stablishment of the Buffalo Center of Excellence in Bioinformatics continued to build momentum over the B f The foundation for the center's A r t i u r speech in Buffalo in early June, has P a summer, with New York State Governor George E. Pataki pledging $61 million in state funds to the University at Buffalo to construct and equip a building to house the center in downtown Buffalo. ultimate success, Pataki said in a been created by unprecedented collaboration between state government and the private and university/research sectors in the community. In announcing that $110 million had been allocated in this year's state budget for support for the Buffalo Life Sciences Pataki, who proposed creation of the jobs in Western New York. Complex, which includes a building for center in his January 2001 "State of the The Buffalo Center of Excellence in State" address, has envisioned it as "the Bioinformatics will merge high-end tech­ informatics, Pataki praised Western New state-of-the-art facility, not just in the nology, including supercomputing and York for coming together and responding United States, but in the world" in the visualization, with expertise in genomics, "in a way that others thought could not field of bioinformatics, and an engine to proteomics, bioimaging and pharmaceu­ be possible." spur economic development and the cre­ tical sciences to foster advances in science ation of thousands of high-technology and healthcare. the Buffalo Center of Excellence in Bio­ Pataki noted that in a short period of time, the private sector, including corpo- Advisory Board Named Seven preeminent scientists have been named to the Scientific Advisory Board for the Buffalo Center of Excellence in Bioinformatics, as follow: Charles R. Cantor, PhD, chief the Human Genome Center of of neuroblastoma, molecular ematical method scientific officer and member, the Department of Energy at genetic changes in leukemia, to a wide variety of board of directors, Lawrence Berkeley Laboratory. and genetic analysis of brain chemical structures SEQUENOM, Inc. tumors and breast cancer. that led to his re­ Cantor previously John K. Cowell, PhD, DSc, served as professor chair, Department of Cancer Herbert Hauptman, PhD, Nobel Prize in chemistry. His and chair in the Genetics, Roswell Park Cancer Nobel Laureate and president current work is concerned with ceipt of the 1985 Department of Biomedical En­ Institute and professor, Cel­ of Hauptman-Woodward the development of methodsfor gineering and Biophysics, and lular and Molecular Biology Medical Research Institute. determining molecular struc­ tures using X-ray diffraction. director of the Center for Ad­ Program, Roswell Park Grad­ Hauptman pioneered and de­ vanced Biotechnology at Bos­ uate Division of the Universi­ veloped a mathematical meth­ ton University. A member of ty at Buffalo. Cowell's research od that changed the field of Barry Honig, PhD, professor the National Academy of Sci­ focuses on mol­ chemistry and opened a new of biochemistry and molecular ences, he has held faculty posi­ ecular genetics of j ^ era in research in the determi­ biophysics, Columbia Univer­ tions at Columbia University cancer and cancer nation of molecular structures sity. Honig is a biophysicist who and University of California at predisposition, of crystallized materials. It was specializes in bioinformatics Berkeley, and was director of molecular analysis the application of this math­ and in developing theoretical Buffalo Physician Autumn 2002 �rate giants HP, Veridian, Informax and Stryker Communications, had pledged in­ vestments of more than $150 million in the center. Also on board as partners and re­ cruited with the help of UB scientists were Dell Computer Corp., Sun Microsystems Inc., Invitrogen Corp., Q-Chem, SGI, Amersham Pharmacia Biotech, AT&T, Wyeth Lederle, Human Genome Sciences, Inc. and the Alfred P. Sloan Foundation. UB is the lead academic institution for the center with academic partners Roswell Park Cancer Institute and HauptmanWoodward Medical Research Institute. The UB facility, for which $61 million was pledged, will be connected to the new Center for Genetics and Pharmacology being built by Roswell Park Cancer Insti­ tute with $41 million in state funding, as well as to the facility being built by Hauptman-Woodward Medical Research Institute with $8 million in state funds. Groundbreaking is slated to begin in August 2003 for all three facilities, methods for ana­ lyzing the physical chemical proper­ ties of macromolecules. He is noted for developingmethods to com­ pute and display the electro­ static potentials of macromolecules based on their 3D struc­ tures. The computer programs DelPHi and GRASP were de­ veloped in his laboratory and are widely used bythe academic and industrial communities. Eugene V. Koonin, PhD, se­ nior investigator with the Evo­ lutionary Genomics Research Group at the National Center for Biotechnology Information which will be located in the Buffalo Niag­ ara Medical Campus (formerly referred to as the "High Street medical corridor"), south of Roswell Park Cancer Institute. The Buffalo Center of Excellence in Bioinformatics also is receiving major federal support through separate congressional appropriations garnered by Representative Thomas Reynolds and Senator Hillary Rodham Clinton, totaling $3.1 million. These funds were key to recruiting the center's di­ rector, Jeffrey Skolnick, PhD, and to al­ lowing for an upgrade of the UB supercomputer. In addition, UB is seeking an additional $12 million in federal support of the center this year under four separate appropriation bills. Also playing a role in attracting Skol­ nick and two of his colleagues was $1.9 million provided by Pataki, along with a $1,542,000 three-year grant from the John R. Oishei Foundation. of the National Library ofMedicine, a department of the Na­ tional Institutes of Health. Koonin's work concentrates on sequence analysis, protein struc­ ture/function analysis and gene identification. His Evolutionary Genomics Research Group has developed computational meth­ ods for isolating clusters of orthologous groups—appear­ ances of the same gene in differ­ ent organisms— across the 40 or so completes genomic sequences now in the public domain. Michael Levitt, PhD, professor and chair of the Department of The Buffalo Center of Excellence in Bioinformatics is an integral part of Pataki's plan to develop centers of excel­ lence across the state to harness the strengths of universities and the private sector to create strategically targeted hightechnology centers of innovation aimed at spurring economic development and creating jobs. O Structural Biology, Stanford University School of Medicine. A newly elected member of the National Academy of Sciences, Levitt is known for his work in computa­ tional biology, es­ pecially protein folding. His pioneering use of an all-atom potential energy function and Cartesian coor­ dinate energy minimization on an entire protein made molecu­ lar dynamics simulations pos­ sible. It also led to the popular Jack-Levitt method for refin­ ing coordinates against X-ray data. Levitt also pioneered simulation of protein unfold­ A u t u m n ing in solution, emphasizing qualitative aspects and using film to show protein motion. Harold Scheraga, PhD, George W. and Grace L. Todd Profes­ sor of Chemistry, Emeritus, in the Baker Laboratory of Chem­ istry and Chemical Biology at Cornell University. A pioneer in the field of protein folding, his work involves genetic engi­ neering and hydrodynamic, spectroscopic immunochem­ ical and other physicochemical measurements on proteins, synthetic polymers of ami­ no acids and mod­ el compounds. 2 0 0 2 I u f fa I D Physician �STOR What's in for the Future HE UNIVERSITY AT BUFFALO Center for Advanced Technology (CAT) has awarded $200,000 to a team of researchers that in­ cludes Anthony Campagnari, PhD, pro­ fessor of microbiology in UB's School of Medicine and Biomedical Sciences; CUBRC (Calspan-UB Research Center); and industrial partner HandyLab. In addi­ tion to the CAT award, CUBRC has also provided $200,000 in matching funds in support of this research effort. HandyLab, a venture-backed spin-off company based on advanced research conducted within the University at Michigan, is developing a point-of-care diagnostic test instrument that combines PCR and microfluidic technology. Michael D. Farmer, president and CEO of HandyLab,announced in J une 2002 that the company is locating four researchers in Buffalo to collaborate with researchers at UB. Together, the team will work to further refine the specificity and sensiti­ vity of a hand-held device that is capable of rapidly identifying microorganisms. There's "a great fit" between the tech­ nology HandyLab is developing and commercialization opportunities for UB, according to Farmer. By providing Handy­ Lab with access to expertise in bacteriol­ ogy and molecular biology, UB is creating a collaborative industry-university project with commercial potential. "Tony Campagnari is a foremost re­ searcher in the field of infectious diseases. We are pleased to be working with him and CUBRC," Farmer adds. The new medical device incorporates HandyLab's patented "lab-on-a-chip" technology with Campagnari's long­ standing research efforts in the areas of sexually transmitted diseases (STDs) and human respiratory pathogens. "Sexually transmitted diseases remain a major source of morbidity worldwide," Campagnari says, pointing to a recent report The research of Anthony Campagnari. PhD. professor of microbiology, is stimulating industrial collaboration. Buffalo Physician A u t u m n 2 0 0 2 UB OFFICE OF SCIENCE, TECHNOLOGY TRANSFER AND ECONOMIC OUTREACH (STOR) from the U. S. Centers for Disease Control and Prevention that states that an estimated 15 million new cases of STDs occur in the United States annually, resulting in health­ care costs of approximately $16 billion. "My group has focused on the identifi­ cation of virulence factors, conservedsurface targets and potential vaccine antigens, and we will use our expertise to assist HandyLab in developing rapid, sensitive and specific assays designed to identify the presence of STDs in various biologic samples," he explains. This research is particularly important in the areas of Chlamydia and gonorrhea, according to Campagnari, since both dis­ eases are associated with a high trans­ mission rate and a significant rate of asymptomatic infections. "Not only does the HandyLab technol­ ogy have the potential to rapidly identify infected individuals, but it could also be used to identify carriers harboring these bacteria, which would be a major advance in this field," says Campagnari. Despite this project's exciting poten­ tial, the collaborative group will not limit its efforts to the detection of STDs, since one of the most important advantages of the HandyLab technology is its combina­ tion of versatility and adaptability. "There are numerous areas where one can envision the use of a hand-held device that rapidly and accurately detects the pres­ ence of a microorganism within a matter of minutes," says Campagnari. "For example, it is possible to use this technology to diag­ nose infections by identifying the presence of microorganisms in microliter amounts of blood, sputum or other relevant secre­ tions. Also, this technology can easily be adapted to the identification of contam- �inating organisms in food products, produce, water and other environmental samples." Another important focus of this coop­ erative research effort will involve the de­ velopment of assays designed to detect the presence of biothreat agents. In light of the terrorist events that occurred in the U.S. last year, such research initiatives have become a high priority for many federal agencies, including the Department of Defense, the Food and Drug Administra­ tion and the National Institutes of Health. The biothreat research conducted by the collaborative group will rely heavily on the biological defense expertise of the CUBRC team, according to Campagnari. Furthermore, the HandyLab technol­ ogy and expertise, together with the biodefense expertise of CUBRC and the microbial pathogenesis expertise of the Campagnari laboratory, puts this diversi­ fied group of researchers in a uniquely qualified position to compete for federal funding in the future, with an emphasis on studies designed to impact this impor­ tant area of homeland defense. CAT is part of the UB Office of Science, Technology Transfer and Economic Out­ reach (STOR), which is directed by Robert J. Genco, DDS, PhD, UB vice provost and SUNY Distinguished Professor. STOR is UB's primary technology-transfer and com­ mercialization office, supporting product and business development from the labora­ tory to the marketplace through its Intel­ lectual Property, Research Funding and Commercialization Divisions. (The Research Funding Division includes CAT, which is directed by William M. Mihalko, MD, and the UB Technology Transfer Fund.) The HandyLab agreement is the first use of venture capital committed by HP as part of the Buffalo Center of Excellence in Bioinformatics. HP committed a total of $10 million to support economic development in Western New York, a portion of which was allocated to HandyLab to attract the company to this region. —S. A. UN G E R A N D LO R R A I N E O.WA P P M A N Long-Standing Question Answered Role of bacteria in COPD flare-ups elucidated U COPD, Murphy noted. The B Y NIVERSITY AT BUFFALO re­ searchers have found an three major pathogens impli­ Lois B a k e r association between bac­ cated in causing exacerbations teria in the sputum of pa­ were H. influenzae, M. catartients with chronic obstructive rhalis, and Strep. Pneumoniae, the new study showed. pulmonary disease (COPD) and In addition to elucidating the role of exacerbations of the disease, an­ bacteria in exacerbations, these findings swering a long-standing ques­ tion about the role of pathogens and are important because they point to COPD flare-ups. novel ways of treating or preventing ex­ acerbations, Murphy says. Results of the prospective study ap­ peared in the August 15, 2002, issue of "This information should lead to the development of the New England Journal of Medicine. COPD is the fourth-leading cause of vaccines to prevent coloniza­ death in the U.S., according to the Am­ tion by the offending strains. erican Lung Association, and fatalities It also provides a better under­ are closely linked to exacerbations. Up standing of what the bacteria Murphy to 90 percent of cases of the disease are are doing, which allows us to caused by long-term smoking. modulate a patient's immune "For years, people have hypothesized response to the bacteria." that bacteria played a role in COPD ex­ The findings are based on a acerbations, but studies performed de­ total of 1,975 clinic visits by 81 cades ago found no difference in bacte­ patients over 56 months con­ Sethi rial presence during stable periods and ducted at the Veterans Affairs flare-ups," says Timothy Murphy, MD, (VA) Western New York Hospital Sys­ professor of medicine and microbiol­ tem. Sputum samples were collected ogy in the University at Buffalo School monthly and during exacerbations. Bac­ of Medicine and Biomedical Sciences, teria isolated from thesamples were sub­ and senior author on the study. jected to molecular typing. "Using the new technology of mol­ Results showed that exacerbations ecular typing, where you can look at were twice as likely to occur in con­ turnover of bacteria in the respiratory junction with the appearance of a new tract in a more accurate way, we have bacterial strain. An exacerbation was shown that that hypothesis is correct." diagnosed at 33 percent of the clinic visits that involved isolation of a new Sanjay Sethi, MD, associate professor strain, compared to 15.4 percent of of medicine in the University at Buffalo School of Medicine and Biomedical Sci­ visits where no new strain was found, ences, is first author of the study, which the researchers reported. began in 1994. Sethi, Murphy and col­ "Our findings don't prove that a new strain causes an exacerbation," Murphy leagues found that it is the particular says. "We also found that some patients strain within a bacterial species, not the had new strains without flare-ups and volume of bacteria in general, that is some had flare-ups without new strains. associated with a COPD flare-up. This observation is a change in the way physi­ CO N T I N U E D O N PA G E 4 8 cians have viewed the role of bacteria in I Autumn 2002 Buffalo Physician �# NEWS ABOUT UB'S SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES AND ITS ALUMNI, FACULTY, STUDENTS AND STAFF Pathways Nesathurai Named Chair of PM&R Shanker Nesathurai, MD, interim chair of the Depart­ ment of Rehabilitation Medicine at Boston Uni­ versity School of Medicine, has been named chair of the Department of Physical Medicine and Rehabilitation in the University at Buffalo School of Medicine and Biomedical Sciences, effective July 1, 2002. In addition, he holds the title of NESATHURAI Capen Professor of Rehabilitation Medicine. A specialist in spinal cord injury and rehabilitation, Nesathurai is principal investigator on a $1.5 million, five-year grant from the National Institute on Disability and Rehabilitation Research to develop national strategies to increase employ­ ment of people with disabili­ ties. He also conducts basic research related to spinal cord injury. 30 Buffalo Physician A u t u m n 2 0 0 2 Nesathurai received his medical degree and residency training at McMaster Uni­ versity in Hamilton, Ontario. He joined the faculty at Boston University in 1995 as an assistant professor and was named acting chair of the Department of Rehabilitation Medicine in 1998. He became interim chair in June 1999 and was pro­ moted to associate professor in July 2000. He also served as chief of rehabilitation services at Boston Medical Center, in addition to his academic responsibilities. Nesathurai has authored several book chapters and has edited four books on spinal cord and traumatic brain injury. joined the University at Buffalo as dean of the School of Dental Medicine. Buchanan previously served as dean of the college and for five years as dean of the University of Medicine and Dentistry of New Jersey. A graduate of the Univer­ sity of Texas-Austin, Buchanan earned a doctorate in dental medicine from the University of Pennsylvania School of Dental Medicine. He began his career in academia at Georgetown University School of Dentistry, where he was an —Lois taking a faculty position at the University of Texas Health Science Center in BAKER Buchanan Appointed Dental School Dean Richard N. Buchanan, DMD, director of advanced clinical education at Baylor College of Dentistry, The Texas A&M University System Health Science Center in Dallas, has instructor for a year before San Antonio. During his 16-year tenure at the University of Texas-San Antonio, he rose to the rank of professor and held several administrative positions. These included chair of the �the Southwest Academy of University of Rochester. Restorative Dentistry and the The goal of the Division of Ira G. Ross and Elizabeth Pierce Olmsted Ross Chair Omicron Kappa Upsilon Biostatistics is to foster the Honorary Dental Society, biostatistical/academic among other professional mission of the Department of affiliations. He served on the member of the House of Social and Preventive Medicine, the medical school and the university as a whole, Delegates of the American as well as to form strong Dental Education Association collaborative relationships with medical, dental and 2002 from the University of Virginia, where he established a clinical from 1990-2000. —Lois BAKER public-health researchers. gram in photoreceptor molecular and cell biology. He is the principal Hutson Joins UB as Chief of Biostatistics closely with biostatisticians at National Eye Institute aimed at understanding the structure and func­ Roswell Park Cancer Institute, tion of a novel glycolipoprotein secreted by vertebrate rod and cone The Department of Social and will form ties to the photoreceptors. and Preventive Medicine in Buffalo Center for Excellence the School of in Bioinformatics. Discus­ Council of Deans and was a The division is working Medicine and sions also are under Biomedical Sciences way to convert the at the University at division into a full- Buffalo has named fledged department in Alan D. Hutson as the proposed School of Public Health. chief of its Division The division of Biostatistics. Hutson comes to UB from the currently is home to HUTSON one assistant profes­ Federico Gonzalez-Fernandez, MD, PhD, has been named the inaugu­ ral holder of the Ira Gile Ross and Elizabeth Pierce Olmsted Ross, MD, Chair in Ophthalmology at the University at Buffalo School of Medi­ cine and Biomedical Sciences. Gonzalez-Fernandez, who has also been appointed an associate professor in the Department of Ophthalmology, came to UB in June program in ocular pathology, as well as a productive research pro­ investigator for a National Institutes of Health R01 grant from the One important feature of the retina is its ability to adapt to the dark by increasing its sensitivity. This involves delivering vitamin A to the rods and cones in order to regener­ ate bleached rhodopsin via a system of proteins that support the "visual cycle." The interphotoreceptor-retinoid-binding protein that GonzalezFernandez is studying is thought to play a key role in the visual cycle. Federico Gonzalez-Fernandez and Elizabeth Olmsted Ross His laboratory group has cloned the gene for this protein from a University of Florida, where sor, a lecturer and two staff he served as an associate members in addition to of the putative vitamin A binding domain. This research is also con­ professor in the Department Hutson, who holds a position tributing new insights into the pathogenesis of retinal drusen, the of Statistics, associate as an associate professor. Five earliest clinical sign of age-related macular degeneration (ARMD), director of the Division of new faculty member are which is now the most common cause of blindness among people Biostatistics in the Depart­ expected to be recruited. over 55 years of age. ment of Statistics, and —Lois BAKER Gonzalez-Fernandez is conducting his research in a 1,500-squarefoot suite of laboratories in the research building at the Veterans director of the General Clinical Research Center (GCRC) Informatics Core, variety of species, and recently determined the X-ray crystal structure Leonard Receives NIH's MERIT Award Affairs Western New York Healthcare System, where he will also have access to shared state-of-the-art research equipment. Gonzalez-Fernandez earned his medical degree and doctoral which is responsible for the University at statistical components of Buffalo 50-70 active clinical trial researcher tomic pathology and his fellowship training was in molecular biology protocols yearly. Kenneth E. and neuropathology (University of Virginia). He has been on the fac­ He received bachelor's degree in neuroscience from the Medical Scientist Training Program of the Baylor College of Medicine. His residency training was in ana­ Leonard, PhD, ulty at the University of Virginia (Departments of Ophthalmology and and master's degrees in an interna­ Pathology) for the past 10 years. The recipient of numerous honors statistics from UB and tionally and awards, he has published over 40 journal articles and several master's and doctoral de­ recognized book chapters. < 2 > grees in statistics from the LEONARD —S.A. UNGER scholar in the A u t u m n 2 0 0 2 !u 11a I o Physician �^jjjj area of addictions, has received a prestigious MERIT Award for his research from the National Institutes of Health's National Advisory Council of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Leonard is a senior research scientist in UB's Research Institute on Addictions (RIA) and director of the Division of Psychology within the Department of Psychiatry in the UB School of Medicine and Biomedical Sciences. The MERIT (Method to TIP Extend Research in Time) Award is a selective and highly coveted award that is extended to investigators who have demonstrated superior creativity, skill and outstand­ ing productivity during the course of their research careers. They relieve investi­ gators from writing frequent renewal applications by providing the opportunity to gain up to 10 years of uninterrupted support. Leonard's award is one of only five made in the last decade by the Prevention Research Branch of NIAAA. Marshall Heads RPCI's Cancer Prevention Program A member of RIA since 1986, Leonard focuses his research on marital/family processes, parenting and infant development, interper­ sonal aggression, bar violence and domestic violence. He currently is the principal investigator on three projects funded by the NIAAA. In 1996 Leonard was named a fellow in the Division of Addictions by the American Psychological Association. He has coauthored three books and numerous book chapters. —KATHLEEN WEAVER James R. Marshall, PhD, has been appointed senior vice president for Population Sciences and Cancer Preven­ tion at Roswell Park Cancer Institute (RPCI), following an extensive nationwide search. In this role, he will be responsible for the overall direction of the Cancer Prevention Program of the institute's cancer center support grant and expansion and oversight of prevention and populations sciences programs at RPCI. Marshall SURVIVAL 101 Expect the unexpected. PACT You'll need stuff. SAVE TIME... Order your medical books online at efollett.com University at Buffalo The State University of New York UNIVERSITY BOOKSTORE Main Street I II I f a I o P h y s i c i a n Autumn 2002 �MARSHALL comes to RPCI Buffalo, where he served until and book chapters and is an a Finalist Award of The from the Arizona 1981. Between 1981 and 1996, associate editor for the Endocrine Society and Cancer Center Marshall was a faculty member American Journal of Epidemiol­ Pharmacia Corporation in Tucson, where of UB's Department of Social ogy and Cancer Epidemiology, International Award for he served since and Preventive Medicine, Biomarkers and Prevention. Excellence in Published 1996 as associate School of Medicine and —DEBORAH PETTIBONE Clinical Research director of Biomedical Sciences, rising Cancer Preven- in rank from assistant to full tion and Control professor (1981-1983), and in and professor of public health UB's School of Health Related and medicine at the University Professions (1991-1996). of Arizona College of Medicine. Marshall earned his doctoral Marshall's research interests focus on the identification and degree in sociology from the testing of chemoprevention University of California at Los strategies in human popula­ Angeles in 1977. He joined the tions. He has authored or faculty of the Department of co-authored more than 200 Sociology at the University at journal publications, abstracts in The Journal of Dandona's Research Publications Recognized Clinical Endocri­ Paresh Dandona, MD, head of award was the Division of Endocrinology in University at Buffalo's School of Medicine and Biomedical Sciences and director of the DiabetesEndocrinology Center of Western New York, received nology and Metabolism. The presented during The Endocrine Society Awards DANDONA dinner, held during the society's annual meeting in San Francisco. —SUE WUETCHER "We practice law for your peace of mind." Estate Planning ~ Personal Injury Real Estate ~ Matrimonial Elder Law HOGAN & WlLLIG, PLLC Attorneys at Law hoganandwillig.com One John James Audubon Parkway • Amherst, New York 14228 • 716.636.7600 Autumn 2002 I II I f a I o P h y s i c i a n �# PA T H W A Y S Louis A. and Ruth Siegel leaching Awards FACULTY AWARDS The Louis A. and Ruth Siegel Awards are presented annually in order to recognize the importance of superior teaching in the clinical and preclinical years, as well as to encourage ongoing teaching excel­ lence. Recipients of the awards are chosen by students through a nomination process, with final input The following from a committee comprising representatives from each of the school's four classes. awards were sity at Buffalo School of Medicine and Biomedical Sciences for 21 years. In 1977, he and his wife, Ruth, Louis A. Siegel, MD '23, served as an assistant professor in obstetrics and gynecology at the Univer­ endowed the Siegel Excellence in Teaching Awards. presented at the University at Buffalo School of Medicine and Biomedical Preclinical Volunteer Clinical Linda Wild, MD Jack Coyne, MD Steven Noyes, MD, associate '76, associate '85, associate professor of clinical medicine professor of clinical professor of pathology clinical pediatrics Sciences' Annual Faculty Meeting, House Staff and Special Awards held on May 29, 2002. RENEE DAVID ELEFTHERIOS BAUGHMAN, MD '99, PIERCE, MD, MERMIGAS, gynecology/obstetrics instructional support Stockton Kimball Award honors a faculty member for academic accomplishment and worldwide recognition as an investigator and researcher. Stockton Kimball, MD '29, was dean of the University at Buffalo School of Medicine from 1946 to 1958, and his contributions to the training of physicians in Buffalo spanned more than a quarter of a century. The 2002 recipient of the StocktonKimball award is L.Nelson (Nick) Hopkins, MD, professor and chair of neurosurgery and professor of radiology at the University at Buffalo. Hopkins, who also serves as director of UB's Toshiba Stroke Research Center and as Buffalo Physician chair of neurosurgery at Millard Fillmore Hospitals, has published extensively in areas involving endovascular neurosurgery, including the microsurgical treatment of intracranial and extracranial vascular disease. Most recently, he has focused his research on experimental an­ eurysms, cerebral vasospasm and intravascular stents. Hopkins has served in numerous leadership capacities in the Congress of Autumn 2002 Neurological Surgeons, the American Academy of Neurological Surgeons, the New York State Neurosurgical Society, the American Association of Neurological Surgeons, and the American Heart Association. In addition, he has been a visiting professor at many major research universities and has served on the editorial board of Neurosurgery. "Dr. Hopkins has been an active researcher and respected professional colleague at the University at Buffalo for most of his career and exemplifies excellence in its broadest sense, which is the hallmark of the Stockton Kimball Award," says Suzanne Laychock, PhD, senior associate dean for research and biomedical education at UB, who presented the award. —S. A. UNGER �Dean's Award The Dean's Award is given in special recognition of extraordinary service to the School of Medicine "Dr. Duffner and Biomedical Sciences. has done many, many things This year, Dean Bernardino presented the award to Patricia K. Duffner, MD '72, professor of neurology and pediatrics and a physician in the Department of Neurology for the school, and has really gone above and beyond in all her efforts." at Kaleida Health's Children's Hospital of Buffalo. Duffner served the school as interim chair of neurology for 18 months and was elected president of the UB Medical Alumni Association this past spring. She also respresented the school as a member of Kaleida Health's board of directors. "In addition, Dr. Duffner did yeoman's work on the LCME self-study this past year and chaired a separate sub-committee for this study," said Dean Bernardino. "She has done many, many things for the school, and has really gone above and beyond in all her efforts, which are greatly appreciated,"he added. <_L«* THE AUDIOLOGY CENTER GENESEE HEARING SERVICES 61 Wehrle Drive (Near Harlem) Amherst 14225 630 Orchard Park Rd. (Near Ridge Rd.) West Seneca 14224 837-6213 712-2000 since 1954 • Diagnostic audiometric evaluations (pediatric and adult) • Digital & programmable hearing aid fittings on 60-day trial basis • Tinnitus evaluation and therapy Vestibular evaluation for patients with dizziness/vertigo • Vestibular therapy • State of the art facilities 'The Ear is the Road to the Heart" (Voltaire) Daniel Schneider, AuD Jennifer Schneider, MA Autumn 2002 Jerri Kaplan Joyce, MA Buffalo Physician �D E N T B Y LAURA R E N D A N O , CLASS OF 2 0 0 3 Rookie fire fighters and first-year medical students listen intently to lectures.are overwhelmed by details, and intermittently wonder if they will ever learn the abundance of information taught. Both fields are wellstudied sciences and imperfect arts C O L U M N Up [ladder of Reflections on what medicine and fire fighting have in common HE FAMILIAR GRUMBLE OF THE AIRBRAKES filled the cab of the fire engine. In a quavering voice the driver shouted back to us, "We have smoke showing." My pulse quickened as I clicked off my seat belt, thrust myself forward and released my harnessed air pack from its storage bracket. When I stepped from the truck, I got my first glimpse of smoke puffing rhythmically from the roof s edge. The eaves seemed to breathe. Checking my facemask for a seal, I reached for the hose nozzle and rushed toward the house. My partner, with a portable radio affixed to his pocket, grabbed an axe and helped to splay 250 feet of hose behind us. Drop­ ping our identification tags by the door, we knelt on the porch, locked in our respirators and signaled for water. As I cracked the nozzle to purge air from the hose, my partner prepped the radio and reported, "Interior attack to Command, be advised we are entering the building." With those words, we forced the door open and were immediately engulfed in swirling black smoke that blinded us. Using the wall as a guide, we crawl­ ed from room to room. My partner reminded me to listen to the fire: "The crackles will tell us where it hides." As we breached an archway, we felt the rush of heat and saw the glow of the flames racing up the wall and rolling across the ceiling toward us. Opening the nozzle, my partner, diligent and experienced, helped me to control the spray as we leaned backward in tandem. The steamy mixture of charred ash and ceil­ ing fragments covered us and sprinkled the floor. We paused to let Command know we had extin­ guished the flame, while fellow fire fighters helped to pull down walls, break ceiling panels and move furni­ ture as we quenched hidden embers. Later, with our helmets off, air packs removed and water bottles drained, we analyzed the process. The smell of smoke seeped from our pores and clung to our hair. Fortunately, this call was only for training. Volunteer fire fighting is how I have spent my 36 Buffalo Physician Life A u t u m n 2 0 0 2 weekends throughout medical school. On Friday af­ ternoons or on Saturday mornings following hospital rounds, I get in my car, which is packed and ready to go, and head east on Interstate 90. With my bulging backpack on the seat next to me and my fire gear loaded in the trunk, I drive home, listening to taped lectures or my voice-dictated notes. After 100 miles I veer off the highway and into another weekend filled with the potential to help my hometown, which is an opportunity I cherish. Several small towns later and $3.10 poorer, I am greeted bya familiar green sign:Welcome to Tompkins County. With the flip of a switch, my pager, clipped to the visor, emits a shrill sound that energizes me and signals my transition into my weekend world. After stopping at my mom's place of work to get a quick hug, I head to 80 Ridge Road, home of the Lansing Fire Department's Central Station. Parallel Paths—and Stresses W hen I joined the fire department seven years ago, I was unaware that it would be a defining experi­ ence in my life. I was naive to the opportunities, friendships and self-development that would emerge from my involvement as a fire fighter and EMT. Moreover, I did not know how the lessons learned through my participation would so closely parallel the various skills and talents required in my professional career path. These similarities became profound as I embarked on my medical school training. The two worlds—medical school and volunteer fire fighting—are steeped with tradition. Both jour­ neys begin with the presentation of a uniform: a jacket that proudly displays my affiliation. As a medical student, this ritual took place in Butler Auditorium at the elegant White Coat Ceremony; for fire fighting, in a shadowy storage room at the fire hall. Over time, I collected the accoutrements required for each trade: oto-ophthalmoscope, stethoscope and tuning forks or door chocks, flashlights and extrica­ tion goggles. �Rookie fire fighters and first-year medical students numerous patient encounters and other misfortunes listen intently to lectures, are overwhelmed by details, that I have witnessed involving personal acquaint­ and intermittently wonder if they will ever learn the ances or fellow fire fighters. One incident in particu­ abundance of information taught. Both fields are lar involved a two-car head-on collision with one well-studied sciences and imperfect arts. person ejected. Upon arrival at the scene, I learned The likeness between both of these endeavors be­ that one of the injured was a family friend. His par­ came more obvious when I entered the hospital wards. ents had witnessed the accident, and they yelled for As is the case with the various ranks within the fire me to help their son. Frequent eye contact with the department, the hospital system upholds a clearly father and encouraging nods helped us both main- defined hierarchy of attendings, chief residents, in­ terns and medical students. The more critical the call, the more leading-rank individuals are involved. In the hospital, this sometimes-unspoken chain of command is evident as a full code unravels. The intern trembles while obtaining the essential intravenous ac­ cess, the chief resident barks commands to swarms of people who have entered the tight quarters, and the attending physician offers suggestions or pronounces death. The medical students, squished to the wall and standing atop chairs, shake their heads and wonder if they will ever have the confidence to be a chief resident while simultaneously being thankful they are expected to know less than the intern—at least for now. I lso common and essential to both fields is a sup­ port staff. This includes nurses or fire fighter families, as well as ancillary services, such as housekeeping, food service, or law enforcement and highway departments. There exists a system in which multiple disciplines must cooperate to maximize outcomes. The permutations are endless. Lansing, my fire district, covers 67 square miles . It is home to an airport, a county correctional facility, a salt mine, a power plant and two juvenile detention centers, in addition to homes, apartment complexes, farms, businesses and malls. As in medicine, each encounter presents an opportunity to learn and im­ prove upon mistakes and inefficiencies. In both disciplines, individuals face the potential, or brutal reality, of helping someone they know. This LAURA RENDANO someone may be a coworker, a family member, a tain control. The ending was a dream come true, neighbor or a friend. Within the first two weeks of although the event itself a nightmare. my third-year clinical rotations, I was presented with Learning medicine and volunteering as a fire high troponin values belonging to one of my profes­ fighter are exhilarating and enjoyable activities. At sors. Furthermore, several classmates delivered chil­ times, however, this enthusiasm is lost in drained dren, broke bones, and had car accidents and were emotion, as exhaustion is also part of both careers. filtered through the healthcare system where other After many hours in the operating room or delivery students circulated. suite, I crawl wearily into bed knowing that I face The same challenges have presented themselves in my work with the fire department. There have been another equally grueling day tomorrow. My closing thoughts are for a few hours of uninterrupted sleep. A u t u m n 2 0 0 2 Buffalo Physician �S T U D E N T C O L U M N One weekend recently, I found myself making the same plea as I returned home at 3 a.m. following a barrage of fire department calls. I heard my father whisper, "Everything okay?" and I gently responded, "Yeah, thanks. A busy night; I'm tired." Crisis and Convergence F riday, June 18, 1999, 1400 hours: For the first time, my two worlds—each filled with a vague semblance of the other—collided. Invigorated from having completed year one of medical school, I took my dogs with me to run a few quick errands. As I crested the hill just a few hundred yards from my home, I saw man­ gled vehicles, smelled burning rubber, and heard scared cries of a victim. Instructing my dogs to stay, I jumped from my car and yanked my gear from the trunk. One car had come to rest straddling a ditch, trapping two people, one of whom was crying for help; the other was completely unresponsive. At once, I was required to be a fire fighter, an EMT Keyser Cadillac Upstate New York's only exclusive Cadillac Dealer Keyser Cadillac 4130 Sheridan Drive • Williamsville, NY and a traffic director. Knowing the closest fire truck was at least 10 minutes away, I used a glass punch to break the passenger-side window. As I climbed inside, the man whimpered, "I broke my neck and I can't move my arms or legs." Visions of gross and neu­ roanatomy flashed through my mind as I wondered where his cord damage was and what the radiological studies would reveal. I assessed him and clinically verified what he already knew: he was facing the po­ tential of living life as a quadriplegic. With limited resources, I treated this 22-year-old man for 45 minutes before my fellow fire fighters were able to remove him from the wreckage. I know his name, his job, his favorite music, his athletic interests, his pets and some of his dreams. I don't know if he has ever taken another step. Power of the Human Spirit C alls like this one serve as a constant reminder to me of the precious sanctity of human life. We were all made painfully aware of this realization following the horrifically tragic events of September 11, 2001. The sense of loss, which permeated the nation and communities worldwide, was devastating for mem­ bers of fire departments everywhere. That day, the heroic fire fighters and medical personnel were among the fallen. The loss of these lives, as well as thousands of others, will not be forgotten; rather, they will serve as symbols of strength, courage and the power of the human spirit. The rewards of fire fighting are countless. Being a volunteer fire fighter has allowed me to help people endure some of their toughest life experiences. Unfor­ tunately, their needs don't end as we, the fire fighters, drive away in our rescue vehicles. My future career as a physician will allow me the opportunity to continue addressing these needs and easing the suffering of others. As I slip on my white coat, I remember the binding truths between fire fighting and medicine: Bravery. Courage. Honor. Teamwork. Dedication. Patience. Integrity. Confidence. Self-Development. Exhilaration. With my fond memories from the Lan­ sing Fire Department, I will remain close to my roots and imagine where my patients may have come from. In either case, at day's end I will think back and smile because, to someone, I made a difference. cn> 634-4100 Laura Rendano is a student at the University at Buffalo keysercadillac.com School of Medicine and Biomedical Sciences. She will graduate in 2003 with an MD/MBA degree. I»f f a Io Physician Autumn 2002 �N A DNA Research Gift By Linda J. Corder, PhD, CFRE LLAN WADE PARKER has never been on the campus of the University at Buffalo nor seen the city of Buffalo. He was born in Seattle, graduated from the University of Wash­ ington and completed graduate studies at Harvard. He served in the United States Air Force during World War II and retired a lieutenant colonel. Mr. Parker had a success­ ful business career in the food industry, with special ex­ pertise in manufacturing machinery for food process­ ing. He lives in San Francisco, where he has both a professional relationship and personal friendship with Martin Terplan, MD, a 1955 graduate of our school. Through discussions with Dr. Terplan, Mr. Parker revealed his belief in the importance of medical research and his personal dream of underwriting promising sci­ entific initiatives that might further the understanding of life—through elucidating its smallest and often elusive components. At the same time these private conversations were taking place, there was an exciting public announcement in Buffalo re­ garding the collaboration between the Uni­ versity at Buffalo and Hauptman-Woodward Medical Research Institute to form a new De­ partment of Structural Biology within the UB School of Medicine and Biomedical Sciences. Dr. Terplan shared this information with Mr. Parker, and then asked me to visit and join in those discussions. IT IS HIS HOPE THAT THESE TWO UNIVERSITIES WILL BE ABLE TO COMBINE KNOWLEDGE AND The ultimate result is that this year Mr. Parker saw one of his dreams come true. Realizing that research tends to be collabo­ rative in nature, and often synergistic, he established research funds at two major medical schools: at the University of Wash­ INNOVATIVE ington, his alma mater, for the Department STUDIES ALREADY of Genome Sciences; and at UB for the De­ UNDER WAY AT partment of Structural Biology. His DNA EACH Research Gifts will give future generations of INSTITUTION. selected doctoral student researchers, post­ doctoral fellows and young faculty research­ ers in both medical schools the opportunity to delve more deeply into the mysteries of the human genetic code, its CONTINUE THE attendant proteins and other component parts. It is his hope that these two universities will be able to combine knowledge and continue the innovative studies already under way at each institution. He also hopes, by his example, to encourage other scientifically minded and philanthropically inclined in­ dividuals to participate in what is ultimately important for everyone, the betterment of all life on Earth. Endowment gifts comprise a small, but increas­ ingly significant, source of future income for the school. As with all endowment (perpetual) gifts to the school, the principal of Mr. Parker's gift will be held and invested, with a small percentage of its market value disbursed each year. These annual disbursements provide a steady income stream for a designated pro­ gram, for a specific department or for a stated pur­ pose, such as student scholarships. These resources are a hedge against inflation, economic downturns, fluc­ tuations in the state's political climate and variations in the numbers of alumni and friends who support the school through annual gifts. Today's students, residents, faculty and staff benefit from earlier en­ dowment gifts. Tomorrow's school is being creatively strengthened by today's contributions. In the pages that follow, the school's endowments are listed. If you would like information about initiating a named endowment, making a gift to an existing fund or have questions about the school's combined endow­ ment, please contact me. All of us who learn, teach and conduct research in this unique institution extend our appreciation and thanks to alumni and friends who made endowment gifts during the past year. Linda (Lyn) J. Corder is associate dean for alumni affairs and development. She can be contacted at 1-877-8263246 (UBMDBIO) or via e-mail at ljcorder@buffalo.edu. Autumn 2002 Buffalo Physician �D E V E L O P M E N T N E W S ., , Medicine iomedical Sciences elow we list the endowments held by both the UB Foundation and the state for the benefit of the School of Medicine and Biomedical Sciences and the Health Sciences Library. Endowments that received additional contributions between 7/1/01 and 6/30/02 are in bold print. An asterisk (*) indicates a new fund that was established during this time frame. A bold name combined with an asterisk represents a new endowment that also received initial gifts to fund the principal and/or associated "spendable" account. If you would like more information about initiating a named endowed fund, or if you have any questions regarding the school's combined endowment, please contact Linda (Lyn) J. Corder, asso­ ciate dean for alumni affairs and development, toll free at 1-877-826-3246, or via e-mail at ljcorder@buffalo.edu. MARVIN A. AND LILLIAN BLOCK FUND icaf Sciences H.W. ABRAHAMMER MEMORIAL SCHOLARSHIP DR. WILLARD AND JEAN BOARDMAN FUND SIDNEY ADDLEMAN MEMORIAL DR. SOLOMON G. BOOKE AND ROSE YASGUR BOOKE FUND DR. GEORGE J. ALKER FUND FOR NEURORADIOLOGY JAMES H. BORRELL UROLOGY FUND THEODORE & BESSIE G. ALPERT SCHOOL OF MEDICINE SCHOLARSHIP ANNE AND HAROLD BRODY LECTURE FUND ALPHA OMEGA ALPHA LIBRARY FUND CLAYTON MILO BROWN MEMORIAL ALPHA OMEGA ALPHA ENDOWMENT GEORGE N. BURWELL FUND AMERICAN ACADEMY OF FAMILY PHYSICIANS PRESIDENT'S AWARD DR. WINFIELD L. BUTSCH MEMORIAL LECTURE IN CLINICAL SURGERY ANESTHESIOLOGY DEPARTMENT ENDOWMENT VINCENT CAPRARO LECTURESHIP FUND—CLASS OF 1945 BACCELLI MEDICAL CLUB AWARD DR. CHARLES F. CARY MEMORIAL L. B. BADGERO MEDICAL SCHOOL FUND DR. AND MRS. JOSEPH A. CHAZAN MEDICAL SCHOLARSHIP VIRGINIA BARNES ENDOWMENT CLINICAL PREVENTATIVE MEDICINE FELLOWSHIP DR. WALTER BARNES MEMORIAL SCHOLARSHIP ALMON H. COOKE SCHOLARSHIP DR. ALLEN BARNETT FELLOWSHIP IN PHARMACOLOGY PATRICK BRYANT COSTELLO MEMORIAL DR. CHARLES A. BAUDA AWARD IN FAMILY MEDICINE CTG ONCOLOGY FUND THOMAS R. BEAM, JR. MEMORIAL FUND JAMES H. CUMMINGS SCHOLARSHIP GILBERT M. BECK MEMORIAL FUND EDWARD L. CURVISH M.D. AWARD DR. ROBERT A. BENNINGER FUND IN ORTHOPEDICS ALFRED H. DOBRAK, M.D. RADIOLOGY LECTURE FUND ROBERT BERKSON MEMORIAL AWARD IN THE ART OF MEDICINE ALFRED H. DOBRAK, M.D. RADIATION RESEARCH FUND* ERNST BEUTNER SKIN IMMUNOPATHOLOGY AWARD MAX DOUBRAVA, JR. SCHOLARSHIP FUND LOUIS J. BEYER SCHOLARSHIP THE ELIZABETH MEDICAL AWARD PAUL K. BIRTCH M.D. FUND DR. ROBERT M. ELLIOT SCHOLARSHIP Buffalo Physician A u t u m n 2 0 0 2 �THESE ANNUAL DISBURSEMENTS PROVIDE A HEDGE AGAINST INFLATION, ECONOMIC DOWN­ t u r n s , FLUCTUATIONS IN THE STATE'S POLITICAL CLIMATE AND VARIATIONS IN THE NUMBERS OF ALUMNI AND FRIENDS WHO SUPPORT THE SCHOOLS ANNUAL APPEAL. —LYN CORDER ENDOWMENT FUND FOR MEDICINE DR. FRANK WHITEHALL HINKEL SCHOLARSHIP FUND ELEANOR FITZGERALD FAIRBAIRN SCHOLARSHIP RALPH HOCHSTETTER MEDICAL RESEARCH FUND EXPERIMENTAL NEUROLOGY FUND DR. SUK-KI HONG MEMORIAL FUND FAMILY MEDICINE ENDOWMENT ABRAHAM M. HOROWITZ FUND FEYLER FUND FOR RESEARCH IN HODGKIN'S DISEASE LUCIEN HOWE PRIZE FUND DR. GRANT T. FISHER FUND DR. MYROSLAW M. HRESHCHYSHYN MEMORIAL ENDOWMENT* L. WALTER FIX, M.D. '43 ENDOWED SCHOLARSHIP FUND R.R. HUMPHREY & STUART L. VAUGHAN NU SIGMA NU ALUMNI EDWARD FOGAN MEMORIAL FUND SCHOLARSHIP FORD FOUNDATION FOR MEDICAL EDUCATION HILLIARD JASON AND JANE WESTBERG FUND FOR EDUCATIONAL THOMAS FRAWLEY, M.D. RESIDENCY RESEARCH FELLOWSHIP FUND INNOVATION FUND FOR CELEBRATING PHILANTHROPY JAMES N. JOHNSTON SCHOLARSHIP MARCOS GALLEGO, M.D. CLINICAL EXCELLENCE FUND C. SUMNER JONES LIBRARY FUND RONALD GARVEY M.D. STUDENT LIFE ENRICHMENT FUND HARRY E. AND LORETTA A. JORDON FUND JAMES A. GIBSON ANATOMICAL PRIZE H. CALVIN KERCHEVAL MEMORIAL FUND LAWRENCE AND NANCY GOLDEN LECTURESHIP IN MIND & BODY MEDICINE DEAN STOCKTON KIMBALL MEMORIAL AWARD WALTER S. GOODALE SCHOLARSHIP DEAN STOCKTON KIMBALL MEMORIAL SCHOLARSHIP IRENE PINNEY GOODWIN SCHOLARSHIP DR. JAMES E. KING POSTGRADUATE FUND CONGER GOODYEAR PROFESSORSHIP OF PEDIATRICS MORRIS LAMER AND DR. ROBERT BERNOT SCHOLARSHIP GEORGE GORHAM FUND DR. HEINRICH LEONHARDT PRIZE DR. BERNHARDT S. AND DR. SOPHIE B. GOTTLIEB AWARD DR. CHARLES ALFRED LEE SCHOLARSHIP ADELE M. GOTTSCHALK SCHOLARSHIP FUND DR. GARRA K. LESTER STUDENT LOAN CARL GRANGER, M.D. ENDOWMENT LLOYD LEVE FUND DR. PASQUALE A. GRECO LOAN FUND THE LIEBERMAN AWARD GLEN E. GRESHAM, M.D. VISITING PROFESSORSHIP HANS J. LOWENSTEIN AWARD GLEN E. AND PHYLLIS K. GRESHAM FUND FOR CLINICAL RESEARCH* LUPUS SCHOLARSHIP FUND ADELAIDE AND BRENDAN GRISWOLD SCHOLARSHIP* WILLIAM E. MABIE D.D.S. AND GRACE S. MABIE FUND DR. THOMAS J. AND BARBARA L. GUTTUSO SCHOLARSHIP & AWARD DR. WILLIAM H. MANSPERGER FUND GYNECOLOGY-OBSTETRICS DEPARTMENT ENDOWMENT MEDICAL ALUMNI ENDOWED SCHOLARSHIP JEAN SARAH HAHL MEMORIAL ANNUAL PARTICIPATING FUND FOR MEDICAL EDUCATION ENDOWMENT EUGENE J. HANAVAN SCHOLARSHIP MEDICAL SCHOOL CLASS OF 1957 SCHOLARSHIP FLORENCE M. & SHERMAN R. HANSON FUND FOR MEDICAL EDUCATION MEDICAL SCHOOL CLASS OF 1958 SCHOLARSHIP DEVILLO W. HARRINGTON LECTURESHIP MEDICAL SCHOOL CLASS OF 1963 SCHOLARSHIP THE HEKIMIAN FUND MEDICAL SCHOOL CLASS OF 1973 SCHOLARSHIP HEWLETT FAMILY ENRICHMENT FUND FOR PSYCHIATRY MEDICAL SCHOOL PROFESSORSHIP FUND CHARLES GORDON HEYD MEDICAL RESOURCES FUND ENDOWMENT FUND FOR MEDICINE A u t u m n 2 0 0 2 BUFFALO PHYSICIAN �MARIAN E. MELLEN FUND IRA G. ROSS AND ELIZABETH P. Ross, M.D. CHAIR OF OPHTHALMOLOGY MICROBIOLOGY ENDOWMENT FUND DR. SHELDON ROTHFLEISCH MEMORIAL FUND DR. DAVID KIMBALL MILLER AWARD HAROLD S. SANES AND THELMA SANES MEDICAL SCHOLARSHIP EUGENE R. MINDELL, M.D. CHAIR IN ORTHOPAEDIC SURGERY PHILIP P. SANG MEMORIAL FUND G. NORRIS MINER, M.D. MEMORIAL AWARD MARIA NAPLES SARNO, M.D. SCHOLARSHIP COLLEEN C. AND PHILLIP D. MOREY, M.D. SCHOLARSHIP SCHAEFER FUND IN CARDIOVASCULAR DISEASE RICHARD NAGEL, M.D. ANESTHESIOLOGY RESEARCH SCHOLARSHIP OF THE PROGRESSIVE MEDICAL CLUB OF BUFFALO DR. ANGE S. NAPLES MEMORIAL SCHOLARSHIP SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES UNRESTRICTED THE DR. S. ROBERT NARINS MEMORIAL AWARD ENDOWMENT FUND NATIONAL MEDICAL ASSOCIATION BUFFALO CHAPTER SCHOLARSHIP FUND LILLIE S. SEEL SCHOLARSHIP JOHN P. NAUGHTON AWARD ENDOWMENT IRENE SHEEHAN FUND NEPHROLOGY RESEARCH ENDOWMENT DEWITT HALSEY SHERMAN AND JESSICA ANTHONY SHERMAN FUND DR. ERWIN NETER MEMORIAL DR. LOIS A. AND RUTH SIEGEL TEACHER'S AWARD ANTOINETTE AND LOUIS H. NEUBECK FUND S. MOUCHLY SMALL, M.D. AWARD IN PSYCHIATRY FUND FOR NEUROANATOMY MUSEUM S. MOUCHLY SMALL, M.D. EDUCATION CENTER FUND NEUROLOGY DEPARTMENT ENDOWMENT FUND IRVINE AND ROSEMARY SMITH CHAIR IN NEUROLOGY FUND DR. BENJAMIN E. & LILA OBLETZ PRIZE FUND IN ORTHOPAEDIC SURGERY DR. IRVING M. SNOW FUND DR. ELIZABETH P. OLMSTED FUND IN BIOCHEMISTRY MARY ROSENBAUM SOMIT SCHOLARSHIP FUND OPHTHALMOLOGY FUND MORRIS AND SADIE STEIN NEUROANATOMY PRIZE FUND JOSEPHINE HOYER ORTON TRUST FUND DIANE AND MORTON STENCHEVER LECTURE FUND VICTOR A. PANARO MEDICAL SCHOOL FUND JOHN J. AND JANET H. SUNG SCHOLARSHIP FUND F. CARTER PANNIL, JR. M.D. MEMORIAL ENDOWMENT JOHN H. TALBOTT VISITING SCHOLARSHIP FUND STEPHEN J. PAOLINI, M.D. MEMORIAL FUND KORNELL L. TERPLAN M.D. LECTURE FUND ALLAN WADE PARKER DNA RESEARCH GIFT* TREVETT SCHOLARSHIP PARKINSON RESEARCH FUND RICHARD E. WAHLE RESEARCH FUND JOHN PAROSKI MEMORIAL AWARD FUND MILDRED SLOSBERG WEINBERG ENDOWMENT ROBERT J. PATTERSON RESIDENT AWARD E. J. WEISENHEIMER OPHTHALMOLOGY AWARD DR. MARK PETTERINO MEMORIAL DR. MARK WELCH AND BEULAH M. WELCH SCHOLARSHIP PHI CHI MEDICAL FRATERNITY SCHOLARSHIP FUND JAMES PLATT WHITE SOCIETY ENDOWMENT PRIMARY CARE ACHIEVEMENT FUND WILLIAMS/BLOOM MEDICAL RESEARCH FUND PROGRESSIVE MEDICAL CLUB OF BUFFALO FUND DR. MARVIN N. WINER FUND FOR DERMATOLOGICAL RESEARCH PSYCHIATRY DEPARTMENT ENDOWMENT FUND WITEBSKY FUND FOR IMMUNOLOGY DR. HERMAN RAHN MEMORIAL LECTURE ENDOWMENT DR. ERNEST WITEBSKY MEMORIAL FUND REHABILITATION MEDICINE ENDOWMENT FARNEY R. WURLITZER FUND ALBERT AND ELIZABETH REKATE CHAIR IN CARDIOVASCULAR DISEASE DR. MARK ZALESKI AWARD ALBERT C. REKATE REHABILITATION MEDICINE LIBRARY FUND HERMAN AND ROSE ZINKE MEMORIAL SCHOLARSHIP DONALD RENNIE PRIZE IN PHYSIOLOGY DOUGLAS RIGGS AWARD IN PHARMACOLOGY AND THERAPEUTICS Health tees Library THE RING MEMORIAL FUND ROBERT L. BROWN HISTORY OF MEDICINE COLLECTION MEYER H. RIWCHUN, M.D. PROFESSORSHIP IN OPHTHALMOLOGY DR. BERNHARDT S. AND DR. SOPHIE B. GOTTLIEB COLLECTION IN THE BEHAVIORAL SCIENCES EMILE DAVIS RODENBERG MEMORIAL AWARD THOMAS A. RODENBERG AND EMILE DAVIS RODENBERG SCHOLARSHIP FUND C. K. HUANG LECTURE FUND ELIZABETH ROSNER FUND STOCKTON KIMBALL SCHOLARSHIP IN MEMORY OF SYLVIA KIMBALL DR. EDGAR R. MCGUIRE HISTORICAL MEDICAL INSTRUMENT FUND 4 2 BUFFALO PHYSICIAN A u t u m n 2 0 0 2 �MEDICAL ALUMNI ASSOCIATION Dear Fellow Alumni, hope you're having a great autumn! In the midst of the beautiful weather in Buffalo this time of year, the Medical Alumni Association has been busy organizing student activities and making plans for next year's Spring Clinical Day and Reunion Weekend. One of our most important student-related activities is the Physician-Student Mentoring Program in which freshman are assigned a mentor from the medical community who remains in contact with the student throughout his or her four years of medical school. This has been a valuable experience for both students and mentors and would be particularly worthwhile for those physicians who do not teach on a regular basis. Our medical students are wonderful and seem to get better every year. Why not become a mentor and get to know them? If you're interested, please contact the Medical Alumni Office at 829-2773 as soon as possible. The 2003 Spring Clinical Day and Reunion Weekend (April 25-26) will be moving downtown! The topic will be "Bioinformatics," or "How Computers are Changing Medicine." In view of the multi-million dollar federally funded Buffalo Center of Excellence in Bioinformatics to be built on the Buffalo-Niagara Medical Campus, we thought we'd hold this event downtown so you could experience firsthand the exciting developments under way (see related article on page 26). The Friday night cocktail party will be held at the beautiful Jacobs Executive Mansion on Delaware Avenue (if you've not been there, don't miss this opportunity to see what Buffalo was like in its glory days). Lectures will be held at Roswell Park Cancer Institute's Hillboe Auditorium (a state-of-the-art facility), and lunch will be served at the classic Buffalo Club. In the afternoon, tours of the Buffalo-Niagara Medical Campus will be provided. I suspect that even many local alumni haven't seen the Buffalo-Niagara Medical Campus or heard about the updated plans for it. The area and the campus are generating a lot of excitement, and I'd like our medical alumni to be part of it! Sites for the class dinners, as usual, will be chosen by the class chairs. In subsequent mailings, additional information will be provided on events at Shea's Buffalo, Studio Arena, Irish Classical Theater, the Philharmonic, and more. Finally, with the falling stock market and sluggish economy, many medical students are having difficulty paying their tuition. To make matters worse, tuition went up $2,000 for the 2001-2002 academic year, and went up another $1,000 for 2002-2003 academic year. The Medical Alumni Association Scholarship Fund is able to give out only eight $2,000 scholarships per year. If our endowment increased, however, we could give many more scholarships to our students. We don't want to lose the opportunity to recruit bright, caring students just because we have less scholarship money available than competing schools. Please consider donating to the scholarship fund, either in the envelope provided in this magazine, in your dues statement, or as part of your class gift. I hope the rest of your autumn goes well. In the next issue of Buffalo Physician, I will report on the Distinguished Medical Alumnus dinner and the White Coat Ceremony and update you on the events and programs discussed above. - PATRICIA K. DUFFNER, MD '72 President, Medical Alumni Association Autumn 2002 Buffalo Physician 43 �> f t O L A 1940s "Every­ Douglas Rosing. MO '67. Rheumatology at Con­ thing!" lives in Bethesda, MD, necticut Children's Medi­ Vincent S. Cotroneo. MD E-mail James Zeller. MD '52, lives where he practices cardi­ cal Center in Hartford '42, is retired from family address: in New Philadelphia, ology in a group practice and professor of pediat­ practice and lives in Buf­ jaegermd OH. He retired from and is on staff at Subur­ rics at University of Con­ falo, NY. Favorite medical @aol.com. general surgery in 1985. ban, Shady Grove necticut. My clinical Favorite medical school Adventists Hospital and interests include Lyme disease, chronic pain in school memories: "Pro­ fessors that were wonder­ Hans Kipping. MD '47. ful; student association; Favorite medical school memories: "Meeting [my wife] Lorraine. Mike Washington Hospital Center. Favorite medical childhood, and rheumatic ability to graduate." memory: "My telephone Greengold, Class of '51." school memories: "(1) disorders. Jesse and I cel­ Saturday morning ana­ ebrated our 15th anniver­ call to the office at the Glenn R. Arthurs. MD '47. Medical School and after Richard F. Mayer, MD '54. tomy quizzes with sary this year, and we're writes: "I live in Stuart, several writes: "I am now pro­ Dr. O.P. Jones (2) party­ going strong. Josh is 25, FL, from October to minutes fessor emeritus of neu­ ing with Armstrong, living in Boulder, CO, June, then Point Com­ of wait­ rology at the University Lagratta, Lieberman, and passionate about fort, Quebec, Canada, ing at the of Maryland School of (Maisel), Smith, (3) playing music and during the summer, with phone, Medicine." E-mail preceptorship with building a spiritual one or two cruises in the sec­ address is: rmayer@som. Dr. Donald Becker, and community; Michael between. Lots of fishing, retary umaryland.edu. (4) working on research is 14, starting high school bridge and some golf. returned projects with Dr. Francis and is discovering the joys Sorry to have missed the to state I was accepted for Klocke." E-mail address of adolescence; Noah is 9 reunion. My best to all." the Class of 1947." is drosing@erols.com. and agreed to hike the E-mail address is Henry S. Gardner. MD '47, hanskip@aol.com. lives in Sedalia, CO, and is a semi-retired consult­ Jack Lippes, MD '47, lives ant to the Social Security in Buffalo, NY. Favorite Disability Branch. Favor­ medical school memory: ite medical school mem­ "Joking around in the ory: "Primarily the anatomy lab." E-mail great classmates. Also, address is: jlip@acsu. Dr. Hubbard, who taught buffalo.edu. pharmacology and was somewhat absent mind­ ed. He gave one lecture without missing an idea AUTUMN 2002 while he kept searching his pockets. Near the end, he found a slip of paper, and said, 'There they are—my lecture George H. Mix, MD '47, notes.'" E-mail address writes: "I was in the prac­ is: ahgardner@pol.net. tice of anesthesiology until 1970, at which time 1960s John Randall "Andy" Anderson, MD '67, lives in Depew, NY. He is semi-retired from family practice and works two and a half days a week at the Research Institute on Addiction. White Moutains (NH) James Strosberg, MD '67, with me every year, lives in Schenectady, NY. 'forever.' It doesn't He is board certified in get much better." internal medicine, geriat­ rics and rheumatology Nedra J. Harrison, MD'77, and is on staff at writes: "I'm doing breast Sunnyview Hospital Re­ surgery in private, solo habilitation Center and practice again. I'm in Ellis Hospital. Favorite Scottsdale, AZ, and abso- assnotes James Giambrone, MD '67, lives in Williamsville, NY, where he practices internal medicine. Favor­ medical school memory: lutely love it! It is the best "Dr. Donald Becker's decision I ever made. welcome speech for Favorite medical school freshman." memory: My one-month Robert Mason Jaeger. MD we retired to the Florida ite medical school '47, is retired from neu­ Keys. We are now back in rosurgery and lives in the Melbourne area, memory: "Saturday anatomy sessions with 1970s Allentown, PA. Favorite where I practiced in a O.P. Jones, MD." Larry Zemel, MD '73, writes: medical school memory: retirement community." Buffalo Physician A u t u m n 2 0 0 2 "I am currently chief of the Division of Pediatric elective as a senior medi­ cal student at Millard Fillmore Hospital on Dr. Philip Wels' service." E-mail address is: njharriso@hotmail.com. �RELOCATION HUNT REAL ESTATE ERA in epidemiology at Harvard University School of Public Health, augmenting my work in health services research." E-mail address is dgood man@northwestern.edu. Andrew Friedman, MD '85. writes: "I left the Univer­ sity of Nebraska and the Richard Berkson. MR '72, lives in Rancho Palos Verdes. Gi, and practices endocrinology in Long Beach, CA. Favorite medical school memory: "While working in the Ruffalo General Clinic, I came across notes my father had made at the clinic many years before." E mail address is: rberkson@medicity.com. Pictured above is Richard, his wife. Andrea, and daughters Meredith. Kathryn, Alanna and Elisabeth. U.S. Army Reserves and commissioned as a lieu­ tenant colonel, active duty in the U.S. Army. I am practicing plastic surgery at Walter Reed Army Medical Center in Washington, DC." Duret Smith. MD '77. lives in Bay Village, OH. He is an orthopaedic surgeon E-mail address is: andrew. 1980s friedman@us.army.mil. Dave Weldon. MD '81. was in group practice and on elected to his fourth term staff at Lakewood Hos­ in the U.S. House of Rep­ pital, Fairview Hospital resentatives in November and St. John's Westshore 2000. This year he is run­ Hospital (in Cleveland). ning for a fifth term. He E-mail address is: is involved in healthcare dddes@aol.com. policy and serves on the Science Committee. Marciana Washington Wilkerson. MD '77. lives Denis M. Goodman. MD '83. in Bethesda, MD. She is writes: "I continue to en­ an OB/GYN in group joy my work in the pedi­ practice and on staff at atric intensive care unit George Washington at Children's Memorial University and Columbia Hospital in Chicago and Hospital for Women in Northwestern University Washington, DC. She School of Medicine. I and her husband, Dwight recently completed a Ford, have two children: master of science degree Drew, 19, and Christina, 17. Favorite medical school memories: "Biochemistry with Dr. Murray Ettinger, and gross anatomy with Dr. Lee." we help people move. writes: "This spring I Call for a free relocation portfolio regarding your destination city. Call 1-800-688-1170 or go on-line and visit our web site at was named acting senior huntrealestate.com David S. Kountz, MD '85. associate dean for clinical affairs at UMDNJ-Robert Wood Johnson Medical School, and was selected as a Master Educator at the university, one of 36 out of 2,000 faculty members. I continue to practice general internal medicine, teach and con­ duct research in medical education. Last year I had the opportunity to travel to Minsk, Belarus, as part of a grant from the Totally customized service portfolio including • Nationally trained relocation experts • Complete family needs analysis • Global home sale assistance • Special services for seniors • Full community tour • A complete cost of living analysis • A list of all school systems throughout WNY • Complete spousal placement assistance including resume writing and corporate contacts • 24 hour or less response time • Confidentiality assured American International E-maiL j >1 ? *•> I ) MARY CROGLIO Corporate Relations Officer Classnotes can also be submitted by e-mail to: bp-notes@buffalo.edu Hunt ERA Relocation Center 5570 Main Street Williamsville, New York 14221-5410 Email: huntrelocation@huntrealestate.com A u t u m n 2 0 0 2 Buffalo Physician �C L A Health Alliance to return to hematology/ Susan Bank. MD '88, lives in develop a clinic model to oncology with Century Chicago, IL, where she screen patients at high Medical Associates in practices psychiatry. She risk for developing cor­ Williamsville." writes: "Am expecting in onary artery disease." E-mail address is: October 2002!" E-mail address is: RRRomanow@cs.com. E-mail address is: kountzds@umdnj.edu. susanbank@aol.com. Lorie Leonard. MD '87, Roslyn Romanowski writes: "Big numbers for Thomas Joly. MD/PhD '89. MD '86. writes: "My us—29 years of marriage lives in Cleveland husband, Robert for Marty and me, 12 Heights, OH. He com­ Campo, son Richie years with Amherst pleted his residency in (4) and I welcomed Pediatrics. Our 24-year- ophthalmology at Case twins Jocelyn and Peter old daughter, Kim, is a Western Reserve Univer­ on May 14, 2002. I'm fourth-year medical sity in 2001 (and training medical school memo­ (now Gais) and Sharon getting up at night again student at UB and our in oculoplastic and or­ ries: "Skipping lectures to Ziegler at night to find just like a resident, but daughters Lindsey and bital surgery at the Uni­ stay home and read all out what was actually we're having lots of fun. Kristen are ages 17 and versity of British Colum­ day, then getting together covered in lectures." After maternity leave, I'll 12 respectively!" bia in 2002). Favorite with Dawn Jedrzejewski Tom and Lee Joly with their children, left to right: Amelia, Celeste, Grayson and Nathaniel. "Hi, I'm Susan Hunt. I invite you to come to see my Mom's new home . . . the Amberleigh Retirement Community. Are you interested in publishing an advertisement in Buffalo Physician? If so, contact: Sharon Russell-Moore Account Representative Sharmore Enterprises 248 Broad Street Tonawanda, NY 14150 (716) 863-1569 You'll smile too!" AMBERLHGH A Rental Retirement Community 2330 Maple Road, Williamsville For a free brochure or personal tour, call 689-4555 4 6 Buffalo Physician Autumn 2002 �1990s Cynthia (Leberman) Jenson, MD '92, lives in Which can you afford to waste? Bangor, ME, and is board certified in anes­ thesiology. She is in group practice and staff FEATURES Cindy and Mark Jenson with their chil­ dren Erica, age 4, and Alexandra, age 7, March 2002. at Eastern Maine Medical Center. Favorite medical school memories: "The Follies, Dive of the Week, Dermatones." E-mail address is: mcaejenson@adelphia.net. Eva M. Rorer. MD '92, lives in Germantown, MD. She completed residency training in ophthalmology in 1996 at Brookdale Univer­ sity Hospital and a fellowship in ocular im­ munology and uveitis in 1999 at the Wilmer Eye Institute, Johns Hopkins School of Medi­ BENEFITS • Electronic submission of all major insurance claims • Increase your accounts receivable turnover • Follow-up of all unpaid claims and open patient accounts • Improve collection ratio and reduce bad debts • Advisement on and assistance with insurance carriers and government regulations • Optimize revenue through proper monitoring of charge master • Choice of processing options including on-line or full-service • Eliminate costs associated with computer software and maintenance • Easy start-up or conversion from present billing system • Transition smoothly and quickly while maintaining cash flow • Appointment scheduling software available on request • Improve office efficiency and patient satisfaction • Expertise on existing and new • Assure your patients' rights are corporate compliance guidelines protected • Practice management with • Gain peace of mind from professionally trained staff and knowing that your finances are experienced C.P.A.'s being managed optimally cine. She is currently on staff at the Johns Hopkins Hospital. Thomas A. Maher, C.P.A. Katharyne M. Sullivan, MD '92, lives in President Leesburg, VA. She is board certified in general psychiatry, child and adolescent psychiatry and is on staff at Graydon Manor in Leesburg. She and her husband, Alan, have two children: Robert, age 4, and Hannah, age 2. Richard J. Kozak, MD '94, writes: "I've been PROFESSIONAL BUSINESS SYSTEMS MEDICAL BILLING SPECIALISTS J 50 Alcona Avenue Amherst, NY 14226 Tel: (716) 834-1191 Fax: (716) 834-1382 e-mail: pbs50@aol.com living in Eugene, OR, (Go Ducks!) since |CONTINUED ON PAGE 48 Servihg tha.MedicaljProfesHion Since 1960 Autumn 2002 H Buffalo Physician �Monica J. Simons. MD '97, completed her residency Cheryl Taurassi. MD '00. Mt. Sinai Hospital in writes: "I am in the sec­ New York City. She is ond year of my pediatric currently a staff member residency at Schneider Howard Wallace, II, PhD '99 at Bronx Lebanon Children's Hospital, Howard L. Wallace, II, died on June 20, 2002, as a result of injuries he sustained in Hospital Center. Long Island Jewish an automobile accident. A member of University at Buffalo's Department of Micro­ Center." E-mail biology, Wallace conducted breast cancer research in the laboratories of Drs. Nejat David Lin, MD '98, is address is: ctaurassi K. Egilmez and Richard B. Banker! He joined the department in 1991 and per­ currently in a cardiology @hotmail.com. formed his doctoral work in the laboratory of Dr. John (Ian) Hay. After earning his fellowship program at the doctorate in 1999, Wallace worked for two years at Roswell Park Cancer Institute, University of Rochester, before returning to UB, where he distinguished himself as a highly competent and having finished his inter­ meticulous researcher. Wallace was held in high regard by his co-workers for his nal medicine residency at scientific acumen, and he will always be remembered for his charming wit, humor the University of Michi­ and the very thoughtful and sensitive way he interacted with all of his colleagues. gan. E-mail address is: lindavel@hotmail.com. Keith D. Herr. MD '99, |C O N T I N U E D F R O M P A G E 4 7 writes: "I am currently in residency in emergency Bronx, NY, in 2001. She residency in family prac­ medicine—a hippie col­ is in a group practice and tice in 2001 at North lege town in the Pacific also on staff at Southern Colorado Family Medi­ Northwest— Maryland Hospital Cen­ cine in Greeley, CO. She paradise. I recently mar­ ter. Favorite medical is currently on staff at ried (7-28-01) my long­ school memories: "Match Fairbanks Memorial time love since medical Day and graduation!" Hospital. Favorite medi­ school, Patricia E-mail address is: cal school memories: Bledinger. She just fin­ ayannaj@earthlink.net. "Driving cross-country— from Washington State ished optometry school. No plans for kids yet and Janine McAssey, MD '97, to Maine—interviewing no plans to leave Eugene. lives in Pittsburgh, PA. at residency programs." I'm working in a com­ She completed her resi­ munity ED and as EMS dency in internal medi­ medical director.... Life cine/women's health in is good." E-mail address 2000 and a Fellowship is: rkozak2020@aol.com. in general medicine/ women's health in 2002, Thomas Elmer. MD '97, is both at the University of chief resident in pediatric Pittsburgh Medical Cen­ ophthalmology at Louisi­ ter, where she is currently ana State University. on staff. Her husband, E-mail address is: Robert Frank, is an emer­ thomaselmer@hotmail.com. gency medicine physi­ cian. E-mail address is: Ayanna James. MD '97, jmmcassey@hotmail.com. lives in Largo, MD. She 4 8 2000s in OB/GYN in 2001 at completed her residency Gina Parlato Pender. MD in OB/GYN at Our Lady '97. lives in Fairbanks, of Mercy Medical Center, AK. She completed her Buffalo A u t u m n Physician 2 0 0 2 my fourth and final year of psychiatry at Emory in Atlanta, and I am toiling over deciding between a fellowship in forensic psychiatry versus private practice/academics. Any sage advice welcome. Well wishes to all." E-mail address is: kdherr@ yahoo.com. Paul A. Guttuso, MD '97, lives in Lakeland. FL. He completed his residency in family practice at UTMB in Galveston, TX, in 2000 and a sports medicine fellowship in June 2001. Favorite medical school memory: "Finkelstein laughing at his surprise birthday party." He is pictured here with his wife, Trinia, and twins, Christopher Paul and Anthony Peter, born February 13,2002. |C O N T I N U E D F R O M P A G E 2 9 Bacteria However, the results contribute to the grow­ ing body of evidence that bacteria cause a significant portion of exacerbations. "This new infor­ mation will act as an important guide in developing novel ways to treat and prevent exacerbations. More importantly, it is pos­ sible that such inter­ ventions could actually slow the progressive loss of lung function that occurs in COPD. That will be one of the goals of our on­ going research in the study clinic." Additional research­ ers on the study were Nancy Evans, a re­ search nurse with the VA Western New York Hospital System, and Brydon J.B. Grant, MD, UB professor of medicine and physiology. O �Removal of stones from the bladder was one of the earliest and most frequently performed operations. By the 19th century, it had become a highly successful procedure and carried one of the lowest mortality rates. However, the sequelae, in addition to frequent infection and lack of anesthesia, made the operation dreaded by most patients and led to the development of instruments such as these Lithotomy Forceps from a set manufactured by Charriere in Paris, circa 1840. The instrument is part of the Edgar R. McGuire Historical Medical Instrument Collection, housed in the Robert L. Brown History of Medicine Collection, Health Sciences Library, Abbott Hall, on the University at Buffalo's South Campus. �Buffalo Physician Non-Profit Org. University at Buffalo U.S. Postage The State University of New York • PAID 3435 Main St. Buffalo, NY Bldg. 22 Buffalo. New York 14214-3013 P C 1 A N Permit No. 311 Address Service Requested UB ' s HISTORY OF MEDICINE COLLECTION PRESENTS PHARMACOPOEIA This illustration was dig­ itally reproduced from offizinellen Gewachse, a four-volume edition of pharmaceutical plants and their medicinal uses, published in German in 1863. The pharmacopoeia by Otto Karl Berg (18151866) is part of the Rob­ ert L. Brown History of Medicine Collection, lo­ cated in the Abbott Hall Health Sciences Library. Picture here is the Almond, one of a series of botanical images digi­ tally restored as part of an initiative to preserve and highlight unique re­ sources from the library's collection. Reproductions are available for purchase through the library, and can be viewed online at iMedia.buffalo.edu/art/. Image restoration was performed by iMedia, the instructional media ser­ vices department of Com­ puting and Information Technology at UB. BP 00 04-02 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 2002 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2002-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v37n02-2002-Autumn Table Of Contents A list of subunits of the resource. Gray Matters Pain's Mystery, a Mindful Approach Budget Talks Medical School Research News Pathways Student Column Development Classnotes Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v37n02 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright 2002 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/d75add02e7ca527bfed3f0cf6d8fb92b.pdf b88bf87e92d5146d1da68331f60900c8 PDF Text Text The Buffalo Physician SUMMER 1970 t VOLUME 4, NO. 2 • SCHOOL OF MEDICINE • STATE UNIVERSITY OF NEW YORK AT BUFFALO �Medical Alumni Officers Dr. Anthone Dr. Roland Anthone, clinical assistant professor of surgery at the University, is the new president of the Medical Alumni Association. He is a 1950 graduate of the Medical School. He is on the staff of the Buffalo General, Child­ ren's, and Veterans Adminis­ tration Hospitals. Dr. Anthone succeeds his twin brother, Sidney. He did his undergraduate work at Harvard College and his residency at the Buffalo General Hospital and Roswell Park Memorial Institute. Dr. Anthone served 20 months in the armed forces during World War II. He and his wife have three children. He has published some 20 articles for professional jour­ nals and is active in several local, state, and national medi­ cal associations.• A 1954 Medical School graduate is the new vice presi­ dent. He is Dr. Louis C. Cloutier, a general surgeon. He is president of the Emergency and Sisters of Charity Hos­ pital staffs. Dr. Cloutier received his bachelor's degree from Canisius College in 1950. After re­ ceiving his medical degree he took his internship and resi­ dency in general surgery at Sisters of Charity and Emer­ gency Hospitals. Currently he is co-ordinator of the surgeryresidency program at Sisters Hospital. He is a member of the Buffalo Surgical Association, a Fellow of the American Col­ lege of Surgeons, and a Diplomate of the American Board of Surgeons. Dr. Cloutier and his wife have five children.• Dr. Cloutier Dr. O'Brien Dr. John J. O'Brien is the new secretary-treasurer. The 1941 Medical School graduate is a clinical assistant professor of medicine at the University and on the staff of the Buffalo General and South Buffalo Mercy Hospitals. He has been on the faculty since 1951. He did his undergraduate work at Canisius College, his internship at the United States Naval Hospital, Philadelphia; and his residency at the Vet­ eran's Administration Hos­ pitals in Buffalo and Batavia. He was in military service from 1941-47. Dr. O'Brien is a past presi­ dent of the Annual Participat­ ing Fund for Medical Educa­ tion; and the Western New York Society of Internal Medi­ cine; and a Fellow of the Amer­ ican College of Physicians. He is also active in several other professional organizations.• �SUMMER, 1970 Volume 4, Number 2 THE BUFFALO PHYSICIAN Published by the School of Medicine, State University of New York at Buffalo IN THIS ISSUE EDITORIAL BOARD Medical Alumni Officers Editor inside front cover ROBERT S. MCGRANAHAN Managing Editor MARION MARIONOWSKY Dean, School of Medicine DR. LEROY A. PESCH Photography 2 New Health Care System 3 Medical Manpower Committee 4 International Federation Meeting HUGO H. UNGER EDWARD NOWAK Medical Illustrator MELFORD J. DIEDRICK Graphic Artist RICHARD MACAKANJA Secretary FLORENCE MEYER CONSULTANTS President, Medical Alumni Association DR. ROLAND ANTHONE President, Alumni Participating Fund for Medical Education DR. MARVIN BLOOM Provost, Faculty of Health Sciences DR. DOUGLAS M. SURGENOR Associate Dean for Continuing Medical Education DR. HARRY J. ALVIS Vice President, University Foundation JOHN C. CARTER by Marc Leitner, Class of 1972 7 Health Care Changes 8 Water Pollution 9 Alumni Reception in New York 10 Effects of Carbon Monoxide 11 Eye Bank Anniversary 11 Dr. O'Connor Returns 12 The University as a Care Deliverer by Dr. Peter Regan and Dr. S. Mouchly Small 18 National Intern Matching Program 21 Spring Clinical Days 26 Ten Class Reunions 28 Ernest Witebsky, A Personal Vignette by Dr. James F. Mohn Director of Public Information JAMES DESANTIS Director of Medical Alumni Affairs DAVID M. KRAJEWSKI President, University Foundation DR. ROBERT D. LOKEN Director of University Publications THEODORE V. PALERMO Vice President for University Relations DR. A. WESTLEY ROWLAND 33 25 Days of Campus Unrest 34 Heart Failure Detection 35 Health Sciences Clinical Center 38 Health Sciences Library 40 People 43 In Memoriam 45 Alumni Tours The cover features the annual Spring Clinical Days, the biggest event of the year for the Medical Alumni Association. The story of this year's event is on pages 21-27. The pictures were taken by Hugo Unger and the cover was designed by Richard Macakanja. THE BUFFALO PHYSICIAN, Summer, 1970 — Volume 4, Number 2, published The Buffalo Physician quarterly Spring, Summer, Fall, Winter — by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. Please notify us of change of address. Copyright 1970 by the Buffalo Physician. �New Health Care System This is a summary of what Dr. John H. Knowles said at a news conference February 13, and at the third annual Har­ rington Lecture at the School of Medicine. THE POPULATION EXPLOSION, Harrington Lecturer Dr. John H. Knowles repeatedly emphasized, is our most serious problem. Every other problem — including environmental pollution, better health care — pales when confronted by this explosive force. The general director of the prestigious Massachusetts General Hos­ pital was bypassed as assistant secretary of health and scientific affairs, Health, Education and Welfare because of reported oppo­ sition by the American Medical Association. President Nixon named Dr. Roger O. Egeberg, dean of the University of Southern California Medical School, to the post. Over 40 per cent of all funds earmarked for health services to­ day are used to cover services to the aged 65 and over, he said. But what about the children in this country who have been disen­ franchised? In New York City over 300 children are dying from heroin poisons. Each year in this country 400,000 illegitimate chil­ dren receive no type of health service. "There is a population ex­ plosion," he repeated, "and 5J/2 million women of child-bearing age do not have family planning knowledge available to them. And they do want it. If you are really interested in health," the internist who is an outspoken critic of his profession implored, "you have to be interested in these subjects." He predicted that one day the spiraling costs for hospital care may well rise to $1,000 per day. This, he pointed out, makes a na­ tional health insurance plan inevitable. "We are the last de­ veloped country in the world to reach this point. But we must first prove to the citizens in our country that we can structure such a health insurance plan." He pointed to the problem-ridden Medi­ care and Medicaid programs. Quality ambulatory facilities and low cost health benefits must be provided to our 45 million poor or "we may well have a revolution on our hands." While he feels that the role of government lies in the policy making and funding areas, the "ultimate responsibility for health care must be in the hands of the medical profession." The over 300 health sciences student/and/faculty audience heard Dr. Knowles indict American medicine which does not op­ erate in a free economic system. "When it comes to medical care, the consumer has only the most tenuous way of judging the qual­ ity of the product. He's not in a position to bargain or shop for medical services," he said. The physician noted that competition in medical services is con­ sidered unethical but economists believe the medical industry has more of the characteristics of a monopoly than a competitive busi­ ness. While he does not feel that government control is the an­ swer, "our best defense is the offense of solving consumers' problems." He feels that our new health care system will call for a new emphasis on health education and preventive medicine. The changes that he is seeking will first be realized in the minds of medical students. "Here is where the revolution in medicine will be, they will want to get out into the community to prevent rather than to treat disease." 2 THE BUFFALO PHYSICIAN �Dr. Knowles chats with medi­ cal students prior to giving the annual Harrington Lec­ ture. Tomorrow's hospital, envisions the man who feels that physi­ cians must assume greater responsibility for solving society's trou­ bles, will be an institution which will "feed" satellite health centers located close to the poor in inner city communities. Such a center, he noted, has been established in Boston by the Massachusetts General Hospital to service poor whites. "The poor must be edu­ cated to their health rights, but once educated, we must be pre­ pared to deliver."D The School of Medicine has named a special seven-man Com­ mittee on Medical Manpower. Chairman of the Committee is Dr. Edward }. Marine, executive associate dean and director of aca­ demic programs at the Medical School. Serving with Dr. Marine will be Drs. Edward H. Wagner, M'65, clinical assistant instructor of medicine; James McDaniel, Jr., clinical associate of gynecology and obstetrics and assistant to the dean of medicine; Richard Carter, clinical assistant professor of social and preventive medicine; John Dower, professor of com­ munity pediatrics and associate professor of social and preven­ tive medicine; David L. Davidson, assistant professor of psychi­ atry; Christopher D'Amanda, M'62, resident assistant professor of medicine and assistant to the Dean of Medicine. Dr. Marine said the committee is charged with an evaluation of all current efforts in community medicine, ambulatory care and family practice. This includes an analysis of existing and planned facilities and resources in terms of their adaptability to a major new program in family practice and community medicine. The committee will develop specific proposals including facilities, fac­ ulty and curriculum in response to the new General Practice Act, passed by the New York State legislature March 25, 1969. The act states in part that medical schools that are a part of a state-op­ erated institution be required to establish and maintain a depart­ ment of general practice under the direction of a qualified general practitioner. The courses of study, a family care program, clinical experience, preceptorships, internships, and residencies will also be under the supervision of qualified general practitioners.• SUMMER, 1970 3 Medical Manpower Committee �The International Federation Meeting by Marc Leitner, Class of 1972 Today the newspapers are filled with reports of the war in Vietnam, the Biafran Ni­ gerian Conflict, and the smol­ dering hostilities in the Mid­ dle East. However, for us as medical students, the only war that should really exist is the fight against poverty and dis­ ease, a war with no geographic boundaries, and truly global in scope. The problem of good health care is one of the ma­ jor concerns of the Interna­ tional Federation of Medical Student Associations [1FMSA], This organization, set up over 18 years ago, consists of na­ tional medical student associa­ tions of over 40 countries. As the delegate from the Society of International Medicine, I hereby submit my report of the 18th General Assembly of the International Federation of Medical Student Associations which took place in Jerusalem, Israel, August 18-31,1969. 4 'J-'he OPENING CEREMONIES included many Israeli dignitaries, the director of the Ministry of Health, the deans of Israel's two medical schools, and representatives from 19 countries. The two-week conference schedule devoted the first week to reports and discussions from various working committees fol­ lowed by plenary sessions of the General Assembly which dealt with resolutions formulated in the working committees. For 18 years, the most successful activity of IFMSA has been its international medical student exchange program whereby over 5,000 medical students annually enjoy international clerkships. But many delegates, including myself, questioned whether this program was sufficient justification for an international organiza­ tion s existence. Was IFMSA willing to relegate itself to a posi­ tion of just being an international student travel bureau or could it serve a more useful role? Basically the discussions centered around the very fundamental question: "What are the medical student's responsibilities and in what way can IFMSA function to fulfill these tasks?" Two general conflicting philosophies were expressed. One, ad­ vocated by the European Common Market countries and ex­ pressed by the Italian delegate (other Common Market countries were boycotting the conference] was that political, social, and economic factors that operate in a country are very important in the pathogenesis of disease. There must therefore be changes in these areas if there is going to be any meaningful resolution to health problems. The opposing view, expressed by delegates from Canada, Czechoslovakia, and Ghana, was that IFMSA is strictly an a-political organization dealing only with medical and health problems and should not become involved in anything "political.' Thus, the European Common Market countries oppose IFMSA sending books, drugs, or supplies to a clinic in a developing country because this would only treat the symptoms of a disease and not try to eradicate the underlying cause of the problem. This conflict over whether IFMSA should become "political" was a frequent source of controversy and the subject of many discussions throughout the entire conference. SCOH (Standing Committee on Health] In the past IFMSA has had some very successful projects through the efforts of a few individual countries. Due to lack of interest on the part of its members, such IFMSA programs as the international book and drug appeal were completely ineffec­ tive during the past year. The major committee activity was to set general guidelines and work procedures for MESTUDEC projects (Medical Students to Developing Countries], In my opinion, these projects can be­ come one of the most important activities of IFMSA and serve concretely toward the realization of its goal of solving health problems, especially in the developing countries where they are the most severe. The idea is to have teams of senior medical stu­ dents going into the "bush" areas of developing countries to set up badly-needed health clinics. By several countries cooperating on the project, clinics could function continuously by staffing them on a rotational basis. THE BUFFALO PHYSICIAN �The South African Medical Student Association has already started such a project by sending teams of six students into the surrounding countries of Botswanna and Malawi. Other countries' programs and their needs follow: . . . International Drug Appeal—Denmark and the United King­ dom heavily contributed drugs which were distributed to World University Service clinics in Sudan, Ceylon, Indonesia, and Honduras. . . . Textbook Drive—A severe need of medical textbooks exists in developing countries, especially Africa. On his trip to Af­ rica, the President of IFMSA reported that the Congo des­ perately needed French medical textbooks. Sweden ran a suc­ cessful book appeal for the benefit of Afghanistan. . . . Medical Student Involvement—Canada sent 70 medical stu­ dents to Jamaica during a three-week period over the sum­ mer. The MESTUDEC project for Denmark involved 4-6 stu­ dents who spent six months in Indian leprosy hospitals. Because of the closing of their medical school as a result of guerilla fighting, medical students in Laos expressed a desire to continue their training in French-speaking countries. The only specific health problem discussed was one that I in­ troduced—severe health problems created by the Nigerian Biafran Civil War. I stated that if IFMSA was truly sincere in its objec­ tives to combat health problems and disease, it could not remain silent or inactive in light of the overwhelming human suffering. Initially there was much opposition to IFMSA involvement in a political situation. But after considerable discussion, the follow­ ing resolution was accepted: Whereas enormous health and medical problems of mal­ nutrition, disease, and starvation exist as a result of the Nigerian-Biafran conflict; we hereby propose that IFMSA/SCOH issue an appeal to its member associa­ tions requesting them to organize a campaign to con­ tribute to the existing relief efforts to both sides of the conflict in whatever way each association is capable. A report of each member association's activity in this area should be sent to the Director of SCOH and the in­ formation should be forwarded to SCOP and included in the IFMSA Newsletter. The Nigerian medical student association, in consistency with the Amsterdam Resolution 29, be requested for its approval before relief is sent to the Nigerian side of the conflict. SCOME (Standing Committee on Medical Education) The director of SCOME criticized delegates for paucity of news and information to IFMSA. Consequently they were unable to print the Medical Education Newsletter or complete its booklet on core curriculum. The committee organized an excellent symposia on Medical Ethics, emphasizing Human Organ Transplantation, at the Hadassah Medical School. A panel of Israeli transplantation experts— internists, surgeons, and psychiatrists—were featured. It was in­ teresting exchanging views with delegates from different parts of SUMMER, 1970 5 Mr. Leitner �the world on such problems as: "Should human life be preserved at all times, especially in circumstances dealing with cardiac re­ suscitation?" In my opinion this was perhaps the most meaningful discussion of the entire conference. Virtually all of the delegates attending the General Assembly felt that to be really meaningful IFMSA has to be more than just a clearing house for exchange of medical students. The major problem is how IFMSA can serve as a voice and act as a force to help medical students meet their responsibilities throughout the world. The answer, a very difficult one, evidenced by the philo­ sophical split between countries who want IFMSA to become more active in the political, social, and economic realm, and those who favor activism on purely medical matters. Its future de­ pends on a compromise between the two camps. I feel that by its very nature, the international body of IFMSA has certain politi­ cal connotations and cannot operate in a vacuum. It will there­ fore be influenced by political reality and at certain times must do what it deems necessary despite political consequences. Ex­ amples of IFMSA acting as a force in the world community: a let­ ter sent by a past president to the South African government supporting the South African Medical Students Association's ef­ forts to have equal pay scales for all African doctors; efforts by one of its past presidents to free two Spanish medical students arrested for protesting against the Franco government from jail. Perhaps its entire structure, as it is now constituted, is inap­ propriate for a truly active international organization. At the grass roots level, the individual medical student is bypassed and does not become involved. This results in apathy by member countries. The actions of the General Assembly reflect those of an or­ ganization in crisis. Rather than elect a new president, an interim director, Geoffrey Lloyd of the United Kingdom, served until the special winter General Assembly was held in Chur, Switzer­ land. This meeting was open to all countries and all organiza­ tions interested in international health to analyze and evaluate the present crisis of IFMSA and to make the necessary changes so as to produce a dynamic international medical student asso­ ciation. Among the benefits derived from my trip, aside from my fan­ tastic personal experiences of meeting medical students from all over the world and traveling to Israel: —Availability to the Medical School's registrar's office of valu­ able information on international summer clerkships, and the procedure of student exchange through IFMSA, as well as addresses of medical students in 20 different countries. —Valuable information based on other delegates' experiences in setting up MESTUDEC Projects (Medical Students to De­ veloping Countries], We are investigating the possibility of sending a Buffalo medical student team to a developing coun­ try such as Paraguay. —The Society of International Medicine's participation in the relief effort to Biafra has been continued by successfully in­ volving IFMSA in the problem.D 6 THE BUFFALO PHYSICIAN �c, IHANGE IS ESSENTIAL in today's system for delivery of health care, a Princeton political scientist said to the pediatrics faculty at Children's Hospital recently. But Dr. Herman M. Somers feels that it is still too early for a compulsory national health plan. "If you pour additional resources into our present system, a bad one as it now stands, you will freeze it." The only pressure for changing any system, he pointed out, is financial strain. But how do you best reorganize a system in need of a great deal of reform? More experimenting, the Princeton professor of poli­ tics and public affairs feels, is the answer. "We need to know more, to demonstrate projects that will work, so that we are sure that we are financing the right thing." An advisor to the Department of Health, Education and Welfare on both medicare and medicaid, Dr. Somers has served on four presidential commissions and task forces concerned with health problems. He was the second lecturer in the Pediatrics Depart­ ment's Experiment in Medical Education, a program now in its second year to acquaint both medical students and young physi­ cians with important areas outside of their traditional studies in medicine. Medicredit, a plan proposed by the American Medical Associa­ tion, is a way of getting universal financing without making any changes in the health system. "In this plan," he explained, "every­ one makes something on it. The government subsidizes insurance premiums paid by the taxpayer to an insurance company of his choice through a system of tax credits. While the poor receive a rebate of 100 percent or equivalent credit, the highest income group also receives a tax credit in the amount of 25 percent." The AMA, he feels, will fight for its plan but it probably will not win. But if it does succeed in holding back other reform, there will probably be a violent reaction. The need for change is so great that he cautioned we may not be able to negotiate. Many qualities of medical care can be improved, he feels. As a result of the great success of the Kaiser Plan, a managerial mas­ terpiece resulting in a string of hospitals located on the West Coast that offer complete health care to its subscribers, a group of prestigious physicians organized the San Joaquin Valley Plan, their defense mechanism in answer to the Kaiser Plan. In the licensing of physicians, Dr. Somers said that a periodic reevaluation of medical competence by peers will lead to better health care. But why hasn't group practice grown? Is money really the restrictive factor? No, he says, joint patient responsi­ bility is the real test. Physicians, both individually and collectively, wield a tremen­ dous amount of political influence in the field of medical care. While new arrangements are needed, they continue to offer great resistance to change. New problems that deal with both or­ ganization and management face the physician who was attracted to medicine because he did not want to become a businessman. Only society in trouble is receptive to change, he concluded, but it is difficult to attract an environment of change when the af­ fluent outnumber the poor.D SUMMER, 1970 7 Drs. Somers, Mitchel I. Rubin, Program Coordinator. Health Care Changes �Water Pollution Dr. Massaro \I\IATER POLLUTION is a byproduct of any technological so­ ciety and is here to stay says Dr. Edward Massaro, a young Uni­ versity biochemist, who is studying the effects of water pollution on the growth and development of fishes and fish populations. "What we must do is to learn how to live with it, to limit it to levels that are compatible with our health and economic well being." Can we do this? "Well, we can't wait for organisms to evolve and thereby 'fit' into new environments. One way to attack this problem may be biologically, that is, to understand the physiologi­ cal limits of adaptation of aquatic organisms and to restart its biological cycle in polluted waters with organisms that can sur­ vive and reproduce in less than ideal conditions." The assistant professor feels that this may be the only way we can hope to con­ trol this major national problem. "We cannot ask an industry that is employing large numbers of people to leave a city and thus end up with major unemployment and associated problems. Even if industry treats its chemical wastes to its economic limit, it may not be able to keep from pol­ luting water to a level that is deadly to organisms living in the water. But if we can maintain pollution at low levels, find or­ ganisms that can survive in polluted environments and intro­ duce them into these waters, we will have gone a long way to­ ward solving the problem of pollution," Dr. Massaro said. Through a major research effort, the University of Texas grad­ uate feels that it is feasible to look for organisms that may be able to thrive in polluted environments. "Our approach to the water pollution problem is to study the biochemistry and physiol­ ogy of adaptation in fishes. But an understanding of biological adaptation in general will be necessary to control environmental pollution intelligently." However, he cautioned that this will mean a national expenditure of billions for research; a major commit­ ment by the Federal government, private industry, and individuals as well. Bodies of water that are now relatively clean probably will be­ come badly polluted. And there are no existing techniques known today that warn us of incipient water pollution. "We need to solve very fundamental questions. For example, how do we de­ tect a change in the environment of a lake before it is too late? A biological probe, such as an alteration in the biochemical makeup of a particular fish species, may be able to tell us when the change — due to some alteration in the quality of the water — is taking place." But he pointed out that we now know too little to make this possible. Pollutionwise, Lake Erie is in very bad shape. If we can find answers to our questions, we may be able to save the lake. But we must start to do something immediately. If not, Dr. Massaro feels that we would do better to fill it in and erect on it a housing development. In another 20 years it may be one big bog. Why doesn't the University establish a first-rate department of environmental sciences to attack the pollution problems of lakes and New York State in general? THE BUFFALO PHYSICIAN �Industry is not the only polluter of water. It may be caused by the runoffs of agricultural fertilizers and pesticides so necessary to make certain areas inhabitable, or to offshore oil drilling (Santa Barbara and the Gulf Coast) which should be stopped. Certain shell fishes that reside at the mouth of the Connecticut River are now accumulating radioactive materials emitted from a nearby atomic power station, and numerous shellfish beds now harbor hepatitus virus. Our adjacent oceans are being fished to death by Russia, Scan­ dinavia, and Japan while the United States "zealously" guards only its three-mile off-shore limits. Pollution of our fresh water systems continuously pollutes our continental shelfs. Eventually, at the present rate, we will destroy our ocean's capacity to supply the world's increasing population with sufficient food. "Nothing is going to take care of itself," Dr. Massaro con­ cluded. "We have got to make a major commitment to solve the pollution problems ourselves."• A total of 41 alumni and faculty and their wives participated in the annual Medical Society of New York Convention and reception February 9 at the Americana Hotel, New York City. Mr. David M. Krajewski, Director of Medical Alumni Affairs, hosted the informal reception. In attendance were: Doctors Guy S. Alfano, M'50; J. Edwin Alford, M'34; Marvin L. Amdur, M'36; Harry Bergman, M'34; Paul K. Birtch, M'43; Vincent I. Bonafede, M'30; J. C. Brady, M'16 Thomas S. Bumbalo, M'31; Joseph Campo, M'54, and Mrs. Campo Max Cheplove, M'26, and Mrs. Cheplove; Louis C. Cloutier, M'54 George L. Collins, Jr., M'48; John Constantine, M'34; Thomas S. Cotton, M'39; Kenneth Eckhert, M'35, and Mrs. Eckhert; Donald Ehrenreich, M'53, and Mrs. Ehrenreich; Daniel Fisher, M'24; Soil Goodman, M'37; Bernhardt Gottlieb, M'21; Donald Hall, M'41 and Mrs. Hall. Also — Doctors Theodore C. Jewett, Jr., M'45; Herbert E. Joyce, M'45; Kenneth A. Kelly, M'50; Hans Kipping, M'47; Robert Kohn, assistant clinical professor of medicine, and Mrs. Kohn; L. Maxwell Lockie, M'29; William Major, M'44; Walter T. Murphy, M'30; Ber­ nard M. Norcross, M'38; James Nunn, M'55, and Mrs. Nunn; James F. Phillips, M'47; Edward C. Rozek, M'41; Sidney M. Schaer, M'44; S. Mouchly Small, Professor and Chairman, Department of Psy­ chiatry; William J. Staubitz, M'42; Clarence A. Straubinger, M'38; Wayne Templer, M'45, and Mrs. Templer; Joseph C. Tutton, M'63; Walter Scott Walls, M'31; David H. Weintraub, M'37; Carlton Wertz, M'15. Mr. Krajewski will host a medical alumni reception during the AMA Convention at the Palmer House in Chicago June 22 at 6 p.m.D SUMMER, 1970 9 Alumni Reception in New York �• Effects of Carbon Monoxide Dr. Farhi A BUFFALO PHYSIOLOGIST is one of nine contributors to a pio­ neering work on the effects to man of carbon monoxide, one of our major environmental pollutants. He is Dr. Leon Farhi, pro­ fessor of physiology at the University, who was invited by the di­ vision of medical sciences of the National Research Council to join a cooperative national effort to assess information known about carbon monoxide and to recommend further research that may provide some of the answers to those responsible for the development of a sensible and workable solution to environ­ mental problems. Said Dr. Farhi, "Our cooperative study revealed that there is no level of carbon monoxide in our environment that is known to be without effect. It is therefore important that we minimize our exposure to this pollutant." Each contributor to the recently published report worked on a specific aspect of the effect of low levels of carbon monoxide found on city streets and in traffic tunnels. They evaluated new psychologic and physiologic tests to assess the effects and at­ tempted to balance the factors of optimal health to those of eco­ nomic well being. While too high a level of carbon monoxide is harmful to the health of some, limiting carbon monoxide produc­ tion too severely may hurt the economy, Dr. Farhi said. With a carbon monoxide-free atmosphere therefore an impossibility, the question we want to answer is "what is a tolerable atmosphere?" With this in mind, Dr. Farhi, in collaboration with Dr. Solbert Permutt of Johns Hopkins University, reported on tissue hypoxia and carbon monoxide. What is the basic reaction of carbon monoxide to man? Its im­ portance, the report points out, lies in its ability to combine with hemoglobin, the oxygen-carrying pigment of blood. When it com­ bines to form carboxyhemoglobin, it can no longer carry out this function. This reaction however is reversible when exposure to carbon monoxide is reduced and, in time, the hemoglobin will once again be free to carry oxygen from the lungs to the body tissues. Attention has switched from studying carbon monoxide's acute effects during short-term exposure to its lasting effects during long-term exposure. In the early 1900's its sources were either from coal-burning heating devices or leaking illuminating gas fixtures. It was found that a healthy person could survive from its acute effects with moderately high levels (from 20-40 percent] of blood carboxyhemoglobin for as little as a minute to as long as a week. But today, with cigarette smoke and the internal com­ bustion engine as the two main sources of carbon monoxide, its long-term effect may last anywhere from a month to a lifetime and produce as little as 0.5 percent of blood carboxyhemoglobin. While this appears to be a trivial amount, research shows that there is a decrease in mental performance on breathing low levels of carbon monoxide. Also being looked at carefully is the circulatory system; recent studies of the effects of long-term, low-level exposure to carbon monoxide suggest circulatory effects. Further studies may prove even more important for those whose functioning has already 10 THE BUFFALO PHYSICIAN �been affected by disease or aging. Preliminary studies on deaths from heart attacks raise the possibility that part of the increase in deaths associated with cigarette smoking may be caused by the carbon monoxide content of tobacco smoke. The report on E f f e c t s of Chronic Exposure t o L o w Levels of Carbon Monoxide on Human Health, Behavior, and Performance, published by the National Academy of Sciences and the National Academy of Engineering, raises questions with important implica­ tions. Further research is needed to find the answers.• A 1927 Medical School graduate has been president of the Buf­ falo Eye Bank for the last 12 years. He is Dr. Milton A. Palmer. The Eye Bank is celebrating its 25th anniversary this year. Dr. Charles H. Addington, clinical assistant professor of sur­ gery (ophthalmology), heads the medical advisory committee. Since its founding the Eye Bank has received 5,400 eyes, and there has been 2,700 sight restorations through corneal trans­ plants. The other eyes are used for study and research by physi­ cians and medical schools. The Lions International Clubs of Western New York and north­ west Pennsylvania support the Buffalo Eye Bank through legacies and memorial gifts. These come from people in all walks of life. Police and sheriffs' departments assist in the speedy delivery of eyes to the Buffalo Eye Bank. A library on ophthalmology and eye surgery was given to the Medical School by the Eye Bank. Ophthalmologists from India, Brazil, Tasmania, and several other countries have sought guid­ ance from the Buffalo Eye Bank. Twenty-five years ago a patient requiring a corneal transplant had to go to New York, Baltimore, or Boston. Today eight local ophthalmologists transplant corneas in Buffalo hospitals.• Eye Bank Anniversary "Service in Vietnam was the most broadening experience of my life." That is what Dr. Thomas P. O'Connor said about his stint in Southeast Asia. He is a 1967 Medical School graduate, who is one of three physicians on the Entrance and Examining Section of the Buffalo Induction Center. "In Vietnam I spent eight months in the highlands among the primitive Montagnards. These people live in thatched huts on stilts. Underneath the hut the owner keeps his water buffalo or cow." It was here that Captain O'Connor and his staff provided medical aid for the seriously ill or injured Montagnards as well as our fighting men. During his last four months in Vietnam he con­ ducted a dispensary in Saigon. Although convinced that sooner or later, we must disengage our armed forces from Vietnam, he said, "it will be very difficult to leave nearly 17 million people to the unscrupulous North Vietnamese and Vietcong who are determined to impose, savagely, their rule upon the South Vietnamese." After his two-year term in the service Dr. O'Connor takes his residency at the Buffalo General Hospital, where he interned.• Dr. O'Connor SUMMER, 1970 11 Returns From Vietnam �The University as a Care Deliverer by Dr. Peter F. Regan and Dr. S. Mouchly Small The university has long recognized its obligation to pursue the health sciences as scholarly disciplines and to train health care professionals. But to what extent should the university serve as a deliverer of health care services? Aspects of this question are considered in the following paper co-authored by S. Mouchly Small, M.D., professor and chairman of the Department of Psychiatry (School of Medicine) at the University, and Peter F. Regan, M.D., professor of psychiatry and the University's act­ ing president. The address was originally presented November 21, 1969, before a meeting of the New York State unit of the American Psychiatric Association. 12 American universities have traditionally emphasized teaching and research as their primary commitments with service as an integral but secondary aspect of their mission. In the past, many functioned as enclaves or sanctuaries where scholars congregated, often in splendid isolation from the world about them, to pursue the classical tasks of storing, creating and transmitting knowledge. Today, universities have been swept into the maelstrom of revolutionary, scientific and technologi­ cal changes and have become intimately involved in and part of the new social order. There are ever-increasing calls from the public and government for the universities to engage in applied research, to effectively communicate their knowl­ edge and follow it through to the operational level to insure its optimum utilization. Health services are now considered a human right rather than a privilege by all segments of our society. Medical pro­ fessionals are no longer sacrosanct and beyond criticism. Sci­ entific spectaculars, such as organ transplantation, continue to evoke exclamatory approval, but it is short-lived as in­ dividuals are repetitiously faced with poignant and proximate experiences with pain, illness, disability and death. As the people become more aware of our deficiencies in knowledge and the lack of an effective system of health care delivery, their mounting concern will become increasingly manifest in social and political pressures for improved services. The role of the university in care delivery poses innu­ merable troubling and provocative questions. It is clear that the universities and medical schools in our country do have a major responsibility in this area. Yet there are a host of questions asked by sincere and dedicated physicians and ad­ ministrators concerning the propriety, extent, balance and capability of universities in their commitment to service, teaching and research. Many become almost paralyzed by the enormity of the problem, searching frantically for guidelines and rapid solutions in this terra incognita. It is the basic argument of this presentation that the territory of care de­ livery is not unknown to universities and that relatively clear guidelines do exist. The Role of the University in Society As a first step let us review the role of the university in so­ ciety. On this issue, the essential fact to recognize is that the university's role does not emerge from within the academic community; instead it is determined from without. Society determines what its needs are and creates institutions to deal with them. It is society which rewards and punishes these institutions according to how well they satisfy its needs. So­ ciety provides each of its institutions with resources and re­ sponsibilities and expects them to respond dynamically to the changes that engulf our entire body politic. Thus, the uni­ versities do not determine their mission in isolation but are, in fact, responsive to the organized communities in which they exist. In historical perspective, society seems constantly to call upon the universities to satisfy three basic needs: the need for a repository of knowledge at the most advanced levels, in a broad variety of disciplines; the need for an adequate number of citizens educated at this advanced level, and prepared to work in society as intellectual leaders, scholars, or profes­ sional practitioners; and the need for keeping the most ad­ vanced knowledge and the education of citizens geared to the changing configurations of the society. THE BUFFALO PHYSICIAN �Thus, through the centuries, we can see the trends emerge. In the early years of this millennium, the thrust of universi­ ties was focused on the production of professional people well prepared to serve the kingly elite. As special needs de­ veloped, special additions were made to the universities; one college at Oxford, for example, was founded in order to guar­ antee an adequate supply of clergymen for Wales. As the centuries advanced and population grew, a wider leadership was necessary, and universities added a pattern of general education, which would qualify the gentlemen not engaged in professions to serve in more general leadership roles in society. Over the last three centuries, in the face of interacting industrial and scientific revolutions, more and more fields of knowledge were added to disciplines encom­ passed by universities, until now every major university em­ braces more than a hundred disciplines and professions. Fi­ nally, the societal changes of the last hundred years have led society to demand that larger and larger proportions of its citizens should have the benefit of the most advanced edu­ cation in the form of specific public programs. In the United States this change was signalled by the es­ tablishment of the land grant colleges in 1862. As pointed out by Don Price, from those colleges grew the experiment sta­ tion, the extension program and a whole interlocking system of institutions which led to the federal government playing a more effective role in the agricultural economy than the bureaucracy of any supposedly socialized state. Today, uni­ versities, as responsive organisms trying to satisfy the everchanging needs of the society which established and which nurtures them, are being called upon for greater and uni­ versal participation in higher education and public health programs among others. Within this panoramic view, one can see that nations and societies display differences in their expectations from uni­ versities with changes in emphasis reflecting public values, needs and demands. With respect to research in the United States, for example, society appears to expect that most basic research will be done within universities but turns to other institutions for the bulk of its applied research needs. Thus the effective transmission of basic research findings to benefit the lives of our citizens depends upon the existence of in­ stitutions geared to applied research. This is particularly ger­ mane to our discussion of health care. It is this key linkage —applied research on health care—which now confronts American society and American universities with their dilemma. SUMMER, 1970 The remarkable advances in medicine ranging from anti­ biotics and new vaccines to organ transplants are of limited value unless we can get these wonders to the people. How is this to be accomplished? The bitter truth is that we do not know and that we have no adequate present means for guaran­ teeing that our citizens will receive the best health care available to them. In fact, the evidence leads to the conclu­ sion that the availability of the highest quality of health care is actually becoming more remote. Life expectancy in the United States is less than that in a dozen other industrialized countries. Natal and neonatal mortality rates in many areas of our country are unconscionably high. Whole communities in our rural areas are without ready access to physicians and hospitals. Analysis of Related Problems A recent article by John W. Gardner (Reader's Digest, September, 1969), the former Secretary of Health, Educa­ tion, and Welfare, cites the need to redesign our society with institutions capable of continuous change, renewal and re­ sponsiveness. We have plenty of debaters, blamers, provoca­ teurs and glory-seekers, but we do not have enough prob­ lem-solvers. As part of our effort to do so let us define some of the pertinent facts and central issues related to the univer­ sity's responsibilities as a care deliverer. Outstanding among these problems are the role of poverty as a pathogenic influ­ ence, the lack and maldistribution of professional manpower, the underrepresentation of disadvantaged minority groups within the professional pool and in our health educational institutions, and the delivery of care to those who are not being served because of our lack of a comprehensive approach. Pathogenic Influence of Poverty Unusually high rates of illness, disability and mortality are commonly found among those in the poverty group. Of various parameters that one could study, inadequate family income correlates most highly with other common factors which contribute to prolonged maladaptation, excessive mor­ bidity and decreased life expectancy. The poor are plagued with sub-standard housing in high population density areas and show low utilization of preventive care either through lack of knowledge, poorly accessible health facilities or a lack of motivation. Poor families have three times more disabling heart disease, five times more mental disorders, and seven times more visual impairment than the general population. (Reference 1: Policies Statements of the Governing Council of the American Public Health Association adopted Novem­ ber 13, 1968, published in the American Journal of Public Health, Vol. 59, 158, January, 1969). Even more appalling 13 �is the fact that as many as 60 percent of the population eligible for public assistance does not receive payments. It is apparent that despite great advances in the biomedical sci­ ences, unless we deal with the concomitant socio-economic aspects of health and illness, the meaningful application and utilization of this information with those in greatest need will fail. Poverty in our affluent society is by no means a rarity. A Census Bureau report issued August 19th of this year, classi­ fies 25.4 million persons in the United States as poor in 1968. One-third of the Nation's Negroes are classed as poor. Quan­ titatively there are more poor white families, but the blacks and other non-whites suffer the highest prevalence of poverty. Although these figures suggest an improvement, the enormity of the problem is still quite apparent (The New York Times, Wednesday, August 20, 1969). Dr. Regan Dr. Small Professional Manpower It has been estimated that one out of every 20 individuals employed in the labor force is engaged in the health-care industry. Health manpower literally comprises well over 100 different types of careers totalling approximately 4 mil­ lion persons. Of these, fewer than 300,000 are practicing physicians. The need for more medically trained professionals has been repeatedly asserted in various reports, attested to by numerous unfilled academic and service positions and re­ affirmed by our continuing to import many more physicians from other countries than we export. The numerous accusa­ tions leveled at the United States epitomized in the phrase "Brain Drain" suggest that our debtor status extends across the board to include experts in many different fields. Criticism of university medical centers extends beyond the quantitative lack of medical professionals to include lack of sufficient general practitioners or family physicians and mal­ distribution of those who have completed their medical edu­ cation. Physicians tend to cluster in the larger population centers where modern facilities and equipment are accessible and where consultations in all specialties are readily available. It is stated that in six years (1975) we will need an in­ crease of a million persons over those now working in all health professions. (Francis Keppel, National Responsibility for Health Manpower. Proceedings of the Conference on Job Development and Training for Workers in Health Sciences, 1966, p. 11. S. S. Steinberg, E. O. Shatz and J. R. Fishman, New Careers: A Major Solution to the Environmental Health Problem, American Journal of Public Health, 59, 1118, July, 1969). With the increasing complexity of medical practice the number of allied health workers per physician will con­ tinue to show an upward trend. Thus, it is likely that short­ ages will continue to exist in medicine and in the allied health professions as well. There is substantial agreement on the fact that this prob­ lem of health care manpower cannot be resolved simply by playing the numbers game. The bitter reality is the fact that we are presently educating fewer people in the health profes­ sions than we need to maintain in the present inadequate system, e.g., only 8,000 of the needed 10,000 physicians to maintain our present level of relationship between physicians and population are graduated each year, with the balance being recruited from other countries. Even were it possible to dou­ ble the size of the present system in less than 20 years, thereby increasing the cost from the present level of more than six per cent of the gross national product to a level greater than 12 per cent of the gross national product, there is no guarantee whatsoever that such a size increase would actually achieve the goal of bringing health care to each individual. �First t o p e r f o r m heart surgery in Buffalo, Dr. John R. Paine (left), re­ ceived the Roswell Park Medal of the Buffalo Sur­ gical Society from the society presi­ dent, Dr. Charles E . W i l e s , M' 4 5 , (right). Dr. Joseph T. Andrews (cen­ ter), past presi­ dent, formally pre­ sented Dr. Paine at the dinner meet­ ing. He was the 22nd Buffalo sur­ geon to receive the honor. Dr. Paine retired last year as chairman of the department of surgery at the Medical School. He is now living at Jekyll Island, G e o r g i a .• Disadvantaged Minority Groups The difficulty in communicating in a meaningful way with disadvantaged minority groups has received increasing rec­ ognition. Suspicion and distrust bred by many years of dis­ criminatory treatment by the "white establishment" has com­ pounded the difficulty. A greater representation of members of minority groups in the medical and allied professions would help immeasurably in opening channels of commu­ nication. An approach which has the advantage of broadening the base of allied health workers, increasing the efficient use of the most highly trained professionals and utilizing minority group members in substantial numbers is the development of programs for the training and employment of local resi­ dents in community health service programs. These persons have been referred to as indigenous non-professionals and have proven to be effective bridges with the people heretofore not receiving health services. In psychiatry new careers such as mental health worker or technician coupled with "career ladders" programs both for the new and well established professions will hopefully help to minimize manpower short­ ages and provide improved contact with the underprivileged. Evaluation of University's Performance Given this situation, what are the universities to do? To an­ swer these questions we can best begin by attempting to evaluate how well the universities and their professional schools are meeting society's expectations in the field of health. • In terms of maintaining an awareness of the most defini­ tive information about health, they are performing their mis­ sion. Information about health care delivery systems, how­ ever, is inadequate. SUMMER, 1970 • In terms of generating a sufficient number of educated people capable of satisfying society's needs for professional personnel, we are doing a commendable but inadequate job. In the medical area alone, we are satisfying only 80 percent of the need, and those who graduate have inadequate prepa­ ration and knowledge in the area of health care delivery. • With respect to adapting to the changing needs of so­ ciety, there is little evidence outside schools and departments of public health and departments of psychiatry of concern with methods for coping with the disease as it exists in patients, each one experiencing his illness in a characteris­ tically unique way, nor the treatment of patients as they exist in society. The admissions criteria of university hospitals are phrased in many ways, but they might generally be expressed more bluntly: "Bring us the right disease, and we will give you the best treatment available. If you don't have the right disease, don't call us; we'll call you." Without in any way minimizing the difficulty of changing this system, what needs to be done is to transform a con­ siderable portion of the clinical care now being provided un­ der the aegis of our universities from an exclusive orienta­ tion on disease and basic scientific research, to a balanced orientation designed to study and teach improved methods of health care delivery for all the people in a given area. An appropriate segment of the clinical care conducted by uni­ versities can and should be redesigned to provide health care services to the poor and the minorities in facilities which are accessible, acceptable and utilized by them. It takes extraordi­ nary mental gymnastics to justify not doing so from an edu­ cational point of view, for how can we expect the students who have never had the learning experience of working in a good health care delivery system to engage in an appropriate practitioner's role? 15 �authority to various members of the patient care team. At this moment in time, the physician works with an average of 20 other people on such a team, and these may be drawn from more than 100 professions and skills. New methods for inter­ locking the efforts of this team must be a hallmark of the clinical programs conducted by universities, if the future pro­ fessionals are to achieve that multiplication of effectiveness necessary to meet the health care needs of the nation. Models for Transforming the Provision of Health Care Within the University Setting It is our contention that universities should in fact engage in the applied research necessary for developing better health care delivery systems. At the conceptual level, one may recognize that a univer­ sity or group of universities should create those clinical pro­ grams which satisfy a number of educational criteria. These are of two types: professional and social. The clinical programs operated under the aegis of universities may run under several different kinds of patterns. At one ex­ treme, the clinical programs may be funded by university resources, and operated in university-owned facilities, with total university staffing. At the other end of the spectrum, the pro­ grams may operate in a wide variety of affiliated agencies (in­ cluding health departments and voluntary hospitals) where major funding, the provision of facilities, and the provision of basic personnel for the clinical program are the responsibility of the sponsoring agency. At any point on this spectrum, it is clear that the university's role derives primarily from its educational mission. In almost every situation, it is equally clear that the university can assume a potent leadership role; certainly, it does so de facto in a university-owned facility, and can assume simi­ lar leadership within the terms of most affiliation agreements. In those pages which follow, an attempt was made to establish those guiding principles which might be used by universities, as they carry on their educational activities in clinical settings. For purposes of simplification, it is assumed that these principles will be similar, irrespective of the detailed sponsorship of the agency in which the education takes place. In such a context the clinical programs operated under the aegis of a university should reflect the highest standards in the following areas: 1. All patients who enter the clinical programs conducted by a university should receive the highest quality of in­ dividual medical care now available. This is a standard now adhered to by all university-conducted programs. And en­ larging its scope from a disease orientation to include a social orientation should in no way diminish this level of excel­ lence. Especially in psychiatry, we must be cognizant of both intrapsychic conflicts and those resulting from the interaction between the individual and society, differentiating psychopathology and social pathology. 3. It seems apparent that a clinical program operated un­ der university auspices should reflect a system of regional or sub-regional coordination. A store-front health informa­ tion center or core area clinic, for example, would constitute a heartless deception if it was not linked to other facilities which could provide comprehensive and specialized services of all kinds. Similarly, an ivory tower citadel is a deception if it is not linked to satellite operations extending through sev­ eral levels of sophistication, with its roots firmly planted in community health centers located in the neighborhoods in which patients live. The specifics of how best to organize a broad pattern of care delivery which encompasses preven­ tion, ambulatory patients, partial and 24-hour hospitalization, rehabilitation, extended care facilities and home care, re­ quires the kind of experimentation which universities can readily undertake. 4. A university operated clinical program will necessarily involve active participation in the decision-making processes by the community in which it operates. At this point, we should take note of a strange dichotomy which exists in mod­ ern society, which can recognize that the faculty of a univer­ sity can appropriately deal with the board of trustees of a major metropolitan affiliated hospital, but has difficulty in giving more than titular "advisory" responsibility to the representatives of a community in which a so-called "com­ munity" health center is established. As the clinical programs of universities extend into operations within the community, ways must be devised in which the people in the neighbor­ hoods and towns which are served have a legitimate and permanent role in the decision-making processes which can affect their lives and the lives of their families and neighbors. 5. The clinical programs operated by universities should be geared to the reality of the nation and the world. While it is self-evident that additional costs and supplementary man­ power must be associated with educational clinical pro­ grams, in order that appropriate teaching and research can be conducted within those programs, the hard core essence of the programs must be replicable. The core clinical pro­ gram must be designed and operated in such a fashion that similar programs can be replicated outside of university auspices, without bankrupting the financial or human re­ sources of the nation. 2. The clinical programs conducted by a university should reflect the contributions that a variety of professional people must make, if care is to be provided to all of our citizens. Thus, there should be a planned teaching and research pro­ gram concerned with the assignment of responsibilities and 16 THE BUFFALO PHYSICIAN �6. If the clinical programs operated by universities are to avoid moving rapidly back to a preoccupation with disease, and to avoid the danger of becoming hot-house plants in­ capable of survival elsewhere, they must be subjected to continual and objective scrutiny and evaluation. As the health professional schools engage in such programs, they should draw upon the research resources of other university disciplines. Research teams including economists, political scientists, architects, sociologists, and lawyers, to name but a few, must be drawn into an ongoing appraisal of the pro­ grams. Only by this means, can the excellence and viability of the programs in application be continually assured. run by universities should be geared to educational excel­ lence and to social reality. The concept which we have pro­ posed can be expressed in terms of a matrix, with check­ points along educational and social axes. While it may be true that one or another of our nation's university health centers cannot take affirmative action at each one of the checkpoints on the matrix, almost all clinical programs op­ erated by universities can, if the university desires, satisfy most of the criteria called for by the matrix. By coordina­ tion among medical schools and universities, there is no reason why adequate insurance at a national level cannot be provided. The clinical programs operated by universities should also satisfy certain social education criteria: With respect to these models, detailed or general, several minor points should be noted: 1. They should embrace all points in the socio-economic spectrum of society. There is little doubt that clinical pro­ grams now operated by universities tend to focus their clini­ cal efforts on one or another segment of the socio-economic system in the United States. Some university medical centers cater to the affluent white, some to the poverty-stricken black. If a clinical system is to be a proper vehicle for teaching and research, however, it must be more, rather than less, comprehensive. Thus, the population covered by clinical programs operating under university aegis should be de­ signed in such a way as to cover an area which includes sev­ eral points on the socio-economic spectrum, so that crossvalidation of the system's effectiveness can be attained. In the first period of emergence for such systems, the deplorable lack of care now provided to the poor and to the black and Puerto Rican minorities should claim particular attention, as it is difficult to defend even a developing system which tol­ erates such discrimination. 1. Financially, the role of the university should be to en­ gage in its education and research programs. Insofar as it conducts the clinical programs which have been described or postulated directly, and not through affiliations with other agencies, funding should be provided in a joint fashion. Those portions of the program which are dedicated to the education and research ends should be funded through direct university support. Those portions which are dedicated to the delivery of patient care itself, should be supported by appropriate national resources; in this connection, such re­ sources may be given to the university directly for patient care, may be provided by governmental support programs, or by national health insurance. Whichever method is used, it should be the responsibility of the sponsoring university to insure that the core clinical program (as distinguished from the educational and research association) operates at a cost level commensurate with that of national potential. 2. Equal attention must be paid to the age distribution of the population. It is all too easy to turn our attention away from the unglamorous needs of children and the aged— after all, preventive medicine and the care of chronic disease do not provide the virtuoso satisfaction of a spectacular cure of a rare disease. It is just such unglamorous areas, however, that can mean the difference between a good life and a poor life, for tens of millions of citizens. The programs operated by universities, therefore, must pay careful attention to in­ suring that the design of the health care system reflects the true distribution of the population, and the true needs of people within that population. 3. Health care systems operated by universities should take care to insure adequate geographic distribution. Already, there is apparent a tendency to cluster medical facilities and professional personnel in those geographic areas more marked by comfort and convenience than by unmet patient care needs. With the transportation availability now present in the United States, there is no reason why every clinical program conducted by universities should not provide care to at least a representative sample of the population in the densely crowded urban centers and in the sparsely-populated rural areas which surround them. The helicopter can be as im­ portant in transporting patients from the hills of Appalachia to Buffalo or Rochester, for example, as it is on the plains of Texas. No listing of the criteria which should be incorporated into a clinical program run by a university can expect to be complete or final, nor can it expect to be infallible. It does seem reasonable, however, to think that clinical programs SUMMER, 1970 2. Nothing could be so destructive to the educational in­ tegrity of universities (in satisfying the needs for which so­ ciety has established them) as to engage in clinical programs which are of larger size than that which is called for by the educational mission of the university. The size of the clinical programs operated by the university indeed must be limited to that size which is the minimum necessary for its educa­ tional mission, and not the maximum available to entrepre­ neurial greediness. Realistically, the size of such a clinical program will always be sufficient to satisfy most of the edu­ cational and social criteria which we have put forth in our general model. Summary It is all too evident that this nation confronts a paradoxical crisis in its health care delivery system. In the midst of affluence and technical excellence of the highest order, too many of our citizens are deprived of health because we have not learned, and we have not taught, the best methods for delivery of health care. Yet good health care is not only the right of every citizen, but universal availability of comprehen­ sive high quality health care is a goal to be cherished by every­ one. It is within our American universities that the poten­ tial for this health care has been built up over the last 50 years. At this moment, it is their responsibility to so range their educational and clinical programs and to design and op­ erate those model systems of health care delivery which will bring the fruits of basic research to every citizen, without in any way diminishing the continued excellence that they have already achieved in other areas. 17 �National Intern Matching Program Everyone in the class is matched. The tension exhibited by the 94 seniors who assembled in G-22 (March 16) to learn the results of the National Internship Matching Plan seemed to ease a bit. It is better this year than ever before. They waited to receive from associate dean Harold Brody the envelope that would reveal the results of the program which at­ tempts to match the preferences of the students with those of the hospitals. A quick exit, for some, to the nearest telephone to inform anxious relatives where "home" would be for the following year. Over one third, he said, will remain in Buffalo, while 23 others will complete their internships in New York State (21 in New York City, two in Rochester). California, which has received as many as 15 over the past years, matched only six. Fifteen other states accounted for the remaining 31. Two university programs filled. "Our contribution to medicine at Buffalo General/Meyer Hospitals is 16 and to pediatrics at Chil­ dren's is eight," he said. Other area hospitals are Meyer (one in psychiatry), Millard Fillmore (one in surgery), Veterans (one in medicine) and Deaconess (three rotating and two in family prac­ tice). More than half the class, he pointed out, received their first choice. "While 57 will participate in straight programs, 34 are matched in rotating programs," he said. Over two-thirds of the class (74) will intern in hospitals with major medical school affiliations, six will go to those with limited affiliations, one to a hospital with a graduate training program under a medical school, eight to nonaffiliated, and two to public health hospitals. "All of you are to be congratulated," Dr. Brody said to his third and final senior intern matching class. "If there is to be any im­ provement in internships for future graduates, it will depend on how well you perform." 18 THE BUFFALO PHYSICIAN �JAMES M. BAKER, Providence Hospital, Seattle, Rotating General WILLIAM F. BALISTRERI, Cincinnati General Hospital, Cincinnati, Straight Pediatrics RONALD H. BLUM, Baltimore City Hospitals, Baltimore, Straight Medicine BRIAN A. BOEHLECKE, Buffalo General/Meyer Memorial Hospitals, Buffalo, Straight Medicine DENNIS L. BORDAN, North Shore Memorial Hospital, Manhasset, Long Island, Straight Surgery ELLIOTT BRENDER, The New York Hospital, New York City, Straight Surgery PETER L. CITRON, Buffalo General/Meyer Memorial Hospitals, Buffalo, Straight Medicine MARY E. CLEMENS, Buffalo General/Meyer Memorial Hospitals, Buffalo, Rotating Medicine SEBASTIAN CONTI, St. Lukes Hospital Center, New York City, Straight Surgery DONALD P. COPLEY, Buffalo General/Meyer Memorial Hospitals, Buffalo, Straight Medicine VINCENT G. COTRONEO, Buffalo General/Meyer Memorial Hospitals, Buffalo, Rotating Medicine SETH C. CRAIG III, Children's Hospital, Buffalo, Straight Pediatrics RICHARD T. CZERNIEJEWSKI. Children's Memorial Hospital, Chicago, Straight Pediatrics ELLIOTT S. DACHER, Michael Reese Hospital & Medical Center,Chicago, Straight Medicine ALLEN DAVIDOPF, Kings County Medical Center, Brooklyn, Straight Medicine WILLIAM P. DILLON, Children's Hospital, Buffalo, Rotating Oh/Gyn FREDERICK R. DOWNS, Deaconess Hospital, Buffalo, Family Practice JULIE L. DRATCH, Hun tington Memorial Hospital, Pasadena, Straight Medicine THEODORE N. DRATCH, Kings County Medical Center, Brooklyn, Straight Medicine DENNIS P. DuBoiS, Buffalo General/Meyer Memorial Hospitals, Buffalo, Straight Medicine NANCY L. ECKHERT, Cleveland Clinic Hospital, Cleveland, Rotating Medicine CARL ELLISON, Cincinnati General Hospital, Cincinnati, Rotating General ROGER A. EVANS, Medical College of Virginia, Richmond, Straight Surgery STEVEN J. FAIGENBAUM, Montefore Hospital & Medical Center, Bronx, Rotating Medicine EBEN FEINSTEIN, Kings County Medical Center, Brooklyn, Straight Medicine WILLIAM J. FIDEN, JR., Deaconess Hospital, Buffalo, Family Practice ARNOLD E. FINGERET, Cincinnati General Hospital, Cincinnati, Straight Pediatrics ALAN FINK, Buffalo General/Meyer Memorial Hospitals, Buffalo, Rotating Medicine ALLEN J. FINLEY, Bronx Municipal Hospital Center, Bronx, Straight Pediatrics CHARLES A. FISCHBEIN, Cincinnati General Hospital, Cincinnati, Straight Pediatrics ELLEN FISCHBEIN, Cincinnati General Hospital, Cincinnati, Straight Pediatrics JOHN D. FOLEY, Children's Hospital, Buffalo, Straight Pediatrics ROGER FORDEN, Children's Hospital, Buffalo, Straight Pediatrics LAWRENCE S. FRANKEL, Georgetown University Hospital, Washington, D.C., Rotating Pediatrics DONALD J. GABEL, Strong Memorial Hospital, Rochester, Straight Oh/Gyn ROBERT P. GALE, University of California Medical Center, Los Angeles, Straight Medicine NEIL W. GARROWAY, Barnes Hospital, St. Louis, Straight Medicine FRED E. GENSLER, Cincinnati General Hospital, Cincinnati, Psychiatry JOSEPH D. GENTILE, Veterans Administration Hospital, Buffalo, Rotating Medicine CHARLES GOLDBERG, Buffalo General/Meyer Memorial Hospitals, Buffalo, Straight Medicine ARTHUR R. GOSHIN, E. J. Meyer Memorial Hospital, Buffalo, Rotating Psychiatry STEVEN B. GRABIEC, Children's Hospital, Buffalo, Straight Pediatrics ELLIOTT L. GROSS, Meadow Brook Hospital, New York, Rotating Surgery THEODORE J. HAJEK, Children's Hospital, Buffalo, Straight Pediatrics FRANK M. HALL, JR., Rochester General Hospital, Rochester, Rotating General MARVIN W. HARRISON, University of Oregon Medical School Hospitals, Portland,Rotating DAVID S. IRWIN, U.S. Public Health Service Hospital, Boston, Rotating General RICHARD A. JUSTMAN, University of Chicago Clinics, Chicago, Straight Pediatrics MARILYN R. KASSIRER, St. Elizabeth's Hospital, Boston, Straight Medicine DENNIS J. KRAUSS, Brookdale Medical Center, Brooklyn, Rotating General THOMAS V. KRULISKY, Buffalo General/Meyer Memorial Hospitals, Buffalo, Rotating Medicine JOEL KRUMERMAN, Jackson Memorial Hospital, Miami, Straight Surgery (ContinuedJ SUMMER, 1970 19 �ROBERT E. LEE, University of Connecticut, Medical Sociology ALAN I. LEIBOWITZ, Brookdale Hospital Center, Brooklyn, Straight Medicine LAURENCE LESSER, Buffalo General/Meyer Memorial Hospitals, Buffalo, Straight Medicine MICHAEL LIPPMAN, Bronx Municipal Hospital Center, Bronx, Straight Medicine BRUCE H. LITTMAN, New England Medical Center Hospitals, Boston, Straight Medicine BARIS LITVAK, Jackson Memorial Hospital, Miami, Straight Pediatrics RUSSELL MASSARO, Buffalo General/Meyer Memorial Hospitals, Buffalo, Straight Medicine JOSEPH V. MCCARTHY, U. S. Public Health Service Hospital, Boston, Rotating General FRANK MILLER, Deaconess Hospital, Buffalo, Rotating General SUSAN M. MOSHMAN, Montefiore Hospital, Bronx, Straight Medicine PAUL R. MOYCE, LOS Angeles County - USC Medical Center, Los Angeles, Rotating General JAN M. NOVAK, Bronx Municipal Hospital Center, Bronx, Straight Medicine THOMAS A. O'CONNOR, Buffalo General/Meyer Memorial Hospitals, Buffalo, Rotating Medicine DANIEL PALCZYNSKI, Long Island Jewish Medical Center, New Hyde Park, Rotating General JEFFREY R. PINE, Buffalo General/Meyer Memorial Hospitals, Buffalo, Rotating Medicine ALAN M. PODOSEK, Deaconess Hospital, Buffalo, Rotating General BRUCE M. PRENNER, Presbyterian Hospital, New York, Straight Pediatrics JOEL P. PURSNER, St. Vincents Hospital, Staten Island, Straight Psychiatry HERBERT H. RABINER, Long Island Jewish Medical Center, New Hyde Park, Rotating General CAROL (FARBER) REDDY, Children's Hospital, Buffalo, Straight Pediatrics JOHN A: RIDER, Children's Hospital, Buffalo, Straight Pediatrics JEFFREY S. ROSS, Massachusetts General Hospital, Boston, Straight Pathology DAVID J. ROSSMAN, Temple University Hospitals, Philadelphia, Straight Medicine JEFFREY G. ROTHMAN, University of Pennsylvania Hospital, Philadelphia, Straight Medicine DANIEL J. SCHAFFER, General Rose Memorial Hospital, Denver, Rotating General STEPHEN SCHLESINGER, Children's Hospital of Pittsburgh, Straight Pediatrics JOHN G. SECRIST, U.C.L.A. Medical Center, Los Angeles, Straight Medicine SAMI SEHAYIK, Bronx Municipal Hospital (Einstein), Bronx, Straight Surgery ARTHUR M. SEIGEL, Buffalo General/Meyer Memorial Hospitals. Buffalo, Rotating Medicine PETER E. SILVERSMITH, Millard Fillmore Hospital, Buffalo, Straight Surgery JAMES K. SMOLEV, Johns Hopkins Hospital, Baltimore, Straight Surgery BRUCE A. SOBIN, Long Island Jewish Medical Center, New Hyde Park, Rotating General AGNES V. S. SZEKERES, Buffalo General/Meyer Memorial Hospitals, Buffalo, Rotating Medicine BRENDAN D. THOMSON, Good Samaritan Hospital, Phoenix, Rotating General SHAFIC Y. TWAL, Children's Hospital, Washington, D.C., Straight Pediatrics ROBERT M, UNGERER, Hartford Hospital, Connecticut, Rotating Surgery HAROLD M. VANDERSEA, Deaconess Hospital, Buffalo, Rotating General STEVEN F. WEINSTEIN, University Hospital of San Diego County, San Diego, Straight Pediatrics HENRY L. WHITED, Rhode Island Hospital, Providence. Rotating Medicine HOWARD A. WIENER, New York University Medical Center (Bellevue), New York City.Straight Pediatrics ALLAN S. WIRTZER, Veterans Administration Center, Los Angeles, Straight Medicine RONALD W. ZMYSLINSKI, Buffalo General/Meyer Memorial Hospitals, Buffalo, Straight Medicine 20 THE BUFFALO PHYSICIAN �Spring Clinical Days Dr. Bisseli Three major challenges facing the physician today — sex edu­ cation, social hazards, peptic ulcer — were this year's theme at the 33rd alumni Spring Clinical Days that opened on a snowy and 35-degree day at the Hotel Statler. "What our children want and need to know is here to stay," said national director of sex information and education council Mary S. Calderone. Sex education, she pointed out to the 250 alumni, student and faculty audience, is needed to make a better world. The physician has a key role to play in the community — educating adults and serving as a consultant to schools. But she cautioned that physicians must be aware of sex-related problems. "There are patients who may not realize what these problems are and are now suffering from their effects." For the woman who has lost a breast, had a colostomy or a historectomy per­ formed, and is deeply concerned as to "what this will do to my sexual life," the physician needs to assure her that it will not interfere. Another high anxiety problem is masturbation, she pointed out. Many physicians do not even understand that as an integral part of the "self" it is harmless. Moderator Harold J. Levy intro­ duced a panel that presented its personal experiences on sex education in the community. "It is far better to give sex informa­ tion too early," pediatrician Robert J. Ehrenreich said, "than too late." While the Medical Society has initiated a new program in human sexuality for hospitals and schools, "we as physicians are only consultants and it must be the hospital that becomes involved." He believes that the physician's role is to educate the parents, to teach them healthy sexuality attitudes to pass on to their own children. He noted that medical students, perhaps more than ordinary citizens, have sexual hangups. A sex education activist (as gynecologist Morris Unher calls himself] insisted that a program in sex education is a "must" for children in kindergarten through grade 12. Psychologist Shepard Goldberg concurred that parent education is the key to a sex education program. At best a film is an audiovisual tool and will not do the whole job. "You must therefore answer all questions completely and honestly," he said. Psychoanalyst Bernhardt Gottlieb pointed out "we may be making history this afternoon. As far as I know this is the first time that we as physicians are looking at ourselves and situations that occur in our everyday life in order to arrive at an understanding of what we can do, not only for our colleagues but others who come to us as drug addicts." The easy availability of drugs frequently leads to its improper use, a Philadelphia psychoanalyst said. Dr. Ralph B. Little warned that in self medication "you eliminate the doctor/patient rela­ tionship." He pointed out that "it can never happen to me" often presages the drug problem in physicians. But, he continued, one SUMMER, 1970 21 Dr. Calderone Dr. Evans Dr. Gottlieb Dr. Hoerr Dr. Roth �M e d i c a l students a t t e n d t h e sessions. Mrs. Stockton K i m b a l l w i t h Drs. L o c k i e a n d H e i l b run. I t was an interesting panel. The annual Stockton K i i Drs. C h e p l o v e , S t a f f o r d , Pesc h . �n b a l l luncheon a t t h e S t a t l e r H i l t o n Drs. Herbert W e l l s , Oscar J. Oberkircher. D r s . Morhous a n d F u g i t t during a c o f f e e b r e a k . D r s . M i l f o r d C h i l d s , S a m u e l B 1e i c h f e l d . Drs. Regan, Anthone. �Drs. Block, Goldstein, Gottlieb. Drs. Anthone, Mindell. Drs. Chepiove, Milch, Berman. has to be ripe or preconditioned before he becomes an addict, and the physician may be unaware of his vulnerability. "Expect poor motivation in the beginning of treatment," said the physi­ cian who has been involved in a continuing study of drug prob­ lems in physicians for the past eight years. "In your initial con­ tact with the patient, be certain that you use the term 'addict' to convey the seriousness of the problem." Alcohol-addicted physicians, pointed out Roosevelt Hospital internist, LeClair Bissell, drift into other addictions. Suicide attempts, arrests, jail sentences for many of those studied, few sanctions by colleagues appeared to be the picture. She predicted that between 13,000 — 22,400 physicians are or will become alco­ holics and after looking around the room cautioned that one out of every 100 physicians sitting there will end up an alcoholic. What can we do about it? "We as physicians should not join the addict in his own denial. We must show concern and when necessary impose sanctions — loss of job or license. But, don't threaten without offering help and the location of that help." Physician suicides, psychiatrist Harvey L. P. Resnik pointed out, exceeds the number of graduates from a large medical school. When dealing with a patient with multiple complaints, consider asking him whether he is depressed or has felt so badly that he has considered taking his own life. It is a myth, he said, that by doing so you will precipitate a suicide. The chief of the National Center for Studies of Suicide, who is on leave from the UB Medical School, said "what it does is to open up an avenue of communication." He cautioned that 80 percent of the suicide attempts — and there is a relation between drugs and alcohol — utilize physician prescriptions. "Control a prescription," he admonished. Psychia­ trists have the highest overall suicide rate, he said, followed by otolaryngologists who are significantly older. "As physicians we are less prone to seek treatment for our­ selves. We should be more aware of mental illnes in ourselves and our fellow physicians." The final session on modern concepts of treating peptic ulcer moderated by James F. Phillips opened with an overview of the physiology of gastric secretion. Gastroneurologist William F. Lipp traced its history from Pavlov in 1889 who developed the nervouscephalic theory of digestive secretion to the Gregory/Tracy team who in 1959 reexplored gastrin and isolated two pure forms. By characterizing natural gastrin and proving its structure by total synthesis they made available both for the first time. Hunter's theory of the viability of tissue as a factor in the ageold question of why the stomach does not digest itself — the food that we eat plus the mucosa preventing this from happen­ ing— should lead to the development of the entire peptic ulcer story. Ulcers do heal, Dr. Samuel Sanes optimistically opened his discussion on the pathology of the peptic ulcer. A peptic ulcer, he pointed out, is a defect in that section of the mucosa in the 24 THE BUFFALO PHYSICIAN �alimentary tract that is exposed to acid peptic juice. Focusing on the duodenal ulcer he noted that it takes between 30-60 years for its development for the ratio of five males to every female. A drug may participate in pathology of ulcers, warned a University of Pennsylvania internist, Dr. James Roth, by inciting localized damage to the mucosa, stimulating mucosal increase, or reducing mucosal resistance and thereby interfering with the healing process. He pointed to the general agreement that aspirin is a dangerous drug and that with its ingestion one or more mechanisms may operate to cause erosion and bleeding. He pointed to phenylbutazone as potentially ulcergenic, the cellular toxicity of caffeine, as well as ACTH and the still controversial adrenal steroids that may interfere with the healing process. A surgeon from the Cleveland Clinic described his experience in surgical therapy for peptic ulcer. In performing gastroresection, vagotomy, or the several different drainage processes for the chronic duodenal ulcer patient, Dr. Stanley O. Hoerr cautioned that you must pick the operation that is best for the patient. His experience revealed that a vagotomy with the appropriate drainage procedure works in nine out of ten cases and offers the patient the lowest possible risk. He predicted that no matter what you do, 80 percent will heal but there is the 20 percent who don't respond to the stomach rest program of hourly feed­ ings in small quantities. At the annual alumni luncheon the Stockton Kimball Memorial Lecturer emphasized that the "quality of care and continuing education are not just inseparable, they are the same." A pro­ gram of continuing education, Dr. Robert E. Evans emphasized, is part of a "basic charge to a learned profession, to assure the ability and performance of its members." Two recent court decisions, the York Hospital director of medical education and professional services said, mandate vital involvement at all levels of hospital staff and administration in both quality of care and continuing education. One makes the "governing board, medical staff, and administration responsible for the quality of care within the institution." The other means a doctor "must be able to practice at a national level of competence and his failure to do so can be interpreted as criminal neglect." Governing treatment is the standard of medical care for an immediate area, past court decisions indicate. More efficient use of a physician's time in the hospital is needed to benefit his patients, his continuing education, and that of other physicians. Dr. Evans believes that one way to do so would be to lengthen service for hospital staff. This would not only avoid 'total anarchy' that results in administrating a multimillion dollar budget for short tenure personnel but will offer consistent staff operation. Attendance he feels should be required at these continuing education sessions that should be pertinent to identified medical needs in the hospital. Research, which in all hospitals is vital, should feed back into medical care. It can either focus on bio­ medical problems or on how best to perform or improve a hos­ pital function, he concluded. SUMMER, 1970 25 Six members of the 1920 class attend the reunion dinner Fri­ day evening. They are: (stand­ ing) -— Drs. Cecil L. Schultz, Leon J. Leahy, Salvatore F. Sorgi and Stephen A. Graczyk. Seated are Drs. Carl C. Koester and Alvah L. Lord. Among the fourteen scientific exhibits displayed, first prize went to Drs. Leonard Berman and Robert Milch's exhibit on Newer Endoscopic Techniques in the Diagnosis of Esophageal and Gastric Disease. Drs. Eu­ gene V. Leslie, George J. Alker, Jr., Edward G. Eschner, Victor A. Panaro and Mr. Benjamin J. Kutas' exhibit on X-ray Sub­ traction earned second place while third prize was awarded to the Clinical Application of Computers exhibit prepared by Drs. Ronald J. Foote, Elemer R. Gabrieli, Worthington G. Schenk, Jr. and George P. Reading. NEWER ENDOSCOPIC TECHNIQUES IN THE DIAGNOSIS Of E05PHAGEAL AND GASTRIC DISEASES 7%, V- McicA 3%t>. �Dean LeRoy A. Pesch told the alumni that the last two years seemed more like two decades. "The last year has been reward­ ing. We have strengthened our ties with our alumni with the appointment of David Krajewski as director of medical alumni affairs. We have more interaction and visibility between the Medical School and our alumni." The Dean also told the physicians that the Medical School would play an important part of the University's 125th celebration in 1971. He also noted the "hole in the ground at Children's Hospital" is proof of continuing affiliation between the Medical School and the hospital. Dean Pesch acknowledged alumni support as well as the con­ tributions of the volunteer faculty. He mentioned specifically the financial contributions of Drs. Charles Heyd and Bernhardt S. Gottlieb. Dr. Peter Regan told the physicians that we need "positive, forward action and educational experimentation so we can keep on going on the tight rope between stability and change — but more rapidly. The threat comes from change that is not an added improving element, but that destroys what is good." The acting president emphasized that all groups in our society must be drawn more closely together to find new ways of doing things better and faster. "We need changes to meet the demands of society just as physicians must find new ways of delivering better health care." Three days after Spring Clinical Days (April 14) Dr. Regan submitted his resignation as executive vice president effective August 31. He will become professor of psychiatry in the Medical School.• Dr. Graczyk Dr. Block Dr. Howard Ten Class Reunions A total of 178 physicians and almost as many wives attended 10 class reunions during spring clinical days. The 1920 class had its reunion Friday evening, (April 10) while the other nine classes met the following evening. Mr. David Krajewski, director of medical alumni affairs, organized the dinner reunions. The physicians attending were: Class of 1920: Dr. Stephen A. Graczyk, Chairman; Drs. Carl C. Koester, Leon J. Leahy, Alvah L. Lord, Cecil L. Schultz and Salvatore F. Sorgi. 26 THE BUFFALO PHYSICIAN Dr. Zittel �Class of 1925: Drs. Marvin A. Block, William M. Howard, Harold E. Zittel, Co-Chairmen, Drs. William T. Clark, Emerson J. Dillon, Francis J. Gustina, Margaret L. Hogben, Norbert W. Kuch, Lucian C. Rutecki, Milton J. Schulz and Ethan L. Welch. Class of 1930: Dr. Irving Wolfson, Chairman; Drs. Vincent I. Bonafede, Anthony R. Cherry, Benjamin S. Custer, R. Edward Delbridge, Raymond L. Feldman, Raymond J. Germain, Carleton A. Heist, James G. Kanski, Leo M. Michalek, Walter T. Murphy, Samuel Sanes, Harold H. Saxton, Frank B. Smarzo, Richard G. Taylor and Herbert J. Ulrich. Class of 1935: Dr. Kenneth H. Eckhert, Chairman; Drs. Carl E. Arbesman, John F. Argue, Willard H. Bernhoft, Russell F. Brace, James H. Gray, Miles W. Kelly, James A. Mark, Domenic S. Mesina, Herman S. Mogavero, Paul N. Stoesser, Carl J. Streicher, Harry N. Taylor, Clayton G. Weig and Philip Willner. Class of 1940: Dr. Albert C. Rekate, Chairman; Dr. Harold K. Palanker, Toastmaster; Drs. Julian J. Ascher, John M. Benny, Victor M. Breen, Milford N. Childs, Marshall Clinton, Stuart V. Collins, George A. Harer, William Hildebrand, Robert D. Hubbard, Corydon B. Ireland, Bernard W. Juvelier, J. Richard Kline, Warren R. Montgomery, Lyle N. Morgan, Russell E. Reitz, James P. Schaus, Charles H. Severson, Allan W. Siegner, Louis A. Trippe, William O. Umiker, Stanley T. Urban, John D. White and John G. Zoll. Class of 1945: Dr. H. Paul Longstreth, Chairman; Dr. George W. Fugitt, Jr., Toastmaster; Drs. Richard H. Adler, William S. Andaloro, Raymond S. Barry, Craig L. Benjamin, Norman Chassin, Paul Barry Cotter, James A. Dejute, Martin J. Downey, Jr., George M. Ellis, Alton A. Germain, A. Arthur Grabau, Donald N. Groff, John F. Hartman, Theodore C. Jewett, Herbert E. Joyce, Vito P. Laglia, Victor C. Lazarus, William D. Loeser, Milton J. MacKay, Cornelius A. McGrew, William N. Mcintosh, Stuart J. Miller, Eugene J. Morhous, John K. Quinlivan, John G. Robinson, Lillian E. Rowan, Joseph E. Rutecki, Robert C. Schopp, K. Joseph Sheedy, Jacob M. Steinhart, William R. Taylor, Wayne C. Templer, Peter Terzian, Edward L. Valentine, Charles E. Wiles and Jane B. Wiles. Class of 1950: Dr. Mary Jane Tillou, Chairman; Dr. William S. Webster, Toastmaster; Drs. Guy S. Alfano, Roland Anthone, Sidney Anthone, Herbert L. Berman, Charles Brody, Carl A. Cecilia, Vincent Ciampa, Anthony Conte, Joseph F. Dingman, Adelmo P. Dunghe, James C. Dunn, Charles A. Howe, O. P. Jones [Guest], Richard J. Leberer, Karl L. Manders, Leo E. Manning, Joseph M. Mattimore, Henry L Pech, Roy W. Robinson, George M. Sanderson, Jr., Helen F. Sikorski, George E. Taylor, Hyman Tetewsky, Anne A. Wasson and Myra R. Zinke. Class of 1955: Dr. Laurence T. Beahan, Chairman; Dr. James R. Nunn, Toastmaster; Drs. William J. Breen, Vincent S. Celestino, James R. Collins, John F. Foley, Albert A. Franco, James M. Garvey, Frank J. Gazzo, Michael J. Gianturco, John H. Kent, Winifred G. Mernan, Anthony B. Schiavi, Ray G. Schiferle, Jr., David F. Weppner and John A. Winter. Class of 1960: Dr. Roger S. Dayer, Chairman; Drs. Theodore S. Bistany, John M. Budzinski, Gerard J. Diesfeld, Algirdas Gamziukas, Edward J. Graber, Thomas J. Guttuso, Donald A. Hammel, James R. Kanski, Francis J. Klocke, Erwin R. Lamm, John I. Lauria, Marshall A. Lichtman, Robert L. Malatesta, Harry L. Metcalf, Eugene T. Partridge, Daniel A. Rakowski, Charles J. Riggo, William J. Stein and John A. Tuyn. Class of 1965: Dr. Joseph G. Cardamone, chairman; Drs. Anthony V. Grisanti, Patrick J. Houston, Myron H. Marshall, David G. Publow and Robert N. Schnitzler. SUMMER, 1970 27 Dr. Eckhert Dr. Dr. Longstreth �Ernest Witebsky A Personal Vignette by Dr. James F. Mohn This special tribute was pre­ sented at the International Convocation on Immunology Banquet to Honor Dr. Witeb­ sky Monday evening, June 17, 1968 by Dr. Mohn, professor of microbiology. Dr. Witebsky died December 7, 1969. Had he selected the alternative pathway at that moment of cru­ cial decision in his teen years, we immunologists would not be assembled here to honor him. Instead this gathering might be com­ posed of distinguished musicians. Perhaps his early intense in­ terest in playing the violin, at which he became so skilled that he seriously considered this as a professional career, may have been the direct result of a very outstanding, indeed unique musical in­ fluence. As a consequence of the geographic partition agreements made at the conclusion of the first World War, many Germans migrated from Strasbourg to Frankfurt am Main. His father, Dr. Michael Witebsky, an obstetrician, and his uncle, an otolaryngolo­ gist, who were long residents in Frankfurt, became physicians to this group. Most prominent among these refugees was the magnanimous, noble, late Dr. Albert Schweitzer. The families developed social as well as professional contacts and this friendship afforded young Ernest Witebsky the rare privilege of privately listening to Schweitzer as he practiced on the organ. Later in a church in Heidelberg, he had the signal honor of sitting next to him on the organ bench to turn the pages of the music during one of Schweitzer's recitals. Many years later after finishing his medical training he was now so impressed with this facet of Schweitzer's career that he journeyed to Lausanne in 1933 to discuss joining him in Lamberene. But, as he told me personally, he quickly discovered during their discussions that Schweitzer desperately needed physicians who were also carpenters, and in such manual arts Dr. Witebsky possessed no dexterity whatsoever. Most for­ tunately for us in Buffalo, he decided to immigrate to the United States instead. To go backward in time now once again to pick up the chrono­ logical thread, on graduation, if that is what it is referred to in Germany, from the Goethe Gymnasium in Frankfurt, he ma­ triculated in the University of Frankfurt Medical School. During these first university years and similarly the last year at the gym­ nasium, he became an avid skiing enthusiast. He was among the first students in 1920 of the internationally famous Austrian ski instructor, Hannes Schneider, who later founded skiing schools in this country. It was at Vorarlberg in the Austrian Tyrol that he came under Schneider's tutelage. This athletic interest continued on completion of his medical studies and every winter from 19261933 while he was working in Heidelberg he traveled to St. Moritz to ski. Alternating as was customary in Germany in his medical school training between Frankfurt and Heidelberg, he received his Doctor of Medicine degree from the University of Heidelberg in 1926. During these formative medical school years, he was profoundly influenced to pursue the study of human blood groups by the late Dr. Ludwig Hirszfeld during the latter's working visit to Heidel­ berg in 1922-23. As a senior medical student, he presented a stu­ dent seminar on blood groups in the Department of Medicine in 1924. Research studies on blood group antigens and antibodies were to play a very prominent role in his investigations for the next thirty or more years. 28 THE BUFFALO PHYSICIAN �To digress briefly, it is more than of casual interest to note that his successor as chairman of our department of microbiology, Felix Milgrom, known among some of us as Felix Maximus, was the senior student and long-time associate of Hirszfeld. How in­ terwoven are the threads of our lives! From 1925-1933, Ernest Witebsky was attached to the research division of the Cancer Institute of the University of Heidel­ berg Medical School, headed by Dr. Hans Sachs, the famous pupil of Paul Ehrlich, first as assistant from 1925-29 and then as Privat Dozeut until 1933. It is significant that his public address in 1929 as part of the ceremony in connection with his promotion to Privat Dozeut dealt with his preliminary experiments on the organ specificity of extracts of the thyroid gland which he attributed to thyroglobulin. He made an auspicious or inauspicious entry—depending upon the eternal difference in viewpoints between the senior research hierarchy and the young, upstart investigators—into scientific meetings with his first presentation of a paper on his own investi­ gative studies in 1926. The occasion was a meeting on legal medicine presided over by Dr. Fritz Schiff. His paper was pre­ ceded by one presented by a now nameless professor from the University of Kiel. This hoch geheimurat reported the results of his study on the blood group distributions among the faculty, es­ pecially the professors, at Kiel and among the prisoners in the Kiel jail. He found a higher percentage of the professors to belong to blood group A and a higher frequency of blood group B among the prisoners than among the normal population. Naturally his conclusion on the basis of such scientific evidence was that group A was a characteristic related to superior intellect and group B one that was linked to criminal behavior. Gulping a few times, I feel quite sure, the young investigator then spoke on the findings of his research that 40% of German swine possessed a group A antigen. As you can well imagine, Sachs was furious at such an audacious performance by a young intern, but as a di­ rect consequence he was forced to take Dr. Witebsky's deep in­ terest in studies of blood groups seriously and he shortly for­ gave him. Following this same vein of interest, in 1927 the fresh young man delivered an address on the validity of blood group determi­ nations in cases of disputed paternity before a distinguished as­ sembly of lawyers and judges in the court house at Frankfurt. Far too few blood group geneticists and immunologists are aware that Dr. Witebsky published one of the earliest and best mono­ graphs on the existing knowledge of human blood groups in 1932. This was entitled "Die Blutgruppenlehre Unter Besonderer Berucksichtigung Physiologisch-Serologischer Fragestellungen" and appeared in the Ergebnisse der Physiologie. As recently as three weeks ago I heard a speaker refer to the great gap between the book by the Italian Lattes which appeared in 1923 and that of Wiener published in 1935. By 1933 dark clouds of hate had thickened in the skies over Germany and especially over the academic halls with their con­ centrations of superior intellects, such as the University of SUMMER, 1970 29 Drs. Milgrom, Witebsky �,-L Immunology Summer School Heidelberg, always a threat to the survival of any political dema­ gogue. The final impetus to a decision to leave Germany came when Dr. Witebsky could not exclude a prominent, local mem­ ber of the Nazi party from the paternity of an illegitimate child on the basis of his blood group examination. Where should they go? Since his father was a citizen of Geneva and he, Ernest Witebsky, possessed similar dual citizenships (Germany and Geneva) by vir­ tue of Swiss inheritance laws the answer was Geneva. Where however would he continue his research and how would it be supported? No doors were opened to him in any of the departments a bacteriologist and immunologist would naturally gravitate to. Finally Dr. Franceschetti, the professor of ophthalmalogy at the University of Geneva—isn't that something for us to ponder over—gave him a laboratory in his department of clini­ cal ophthalmalogy. Perhaps this explains the soft spot Ernest Witebsky has had in his heart for opthalmalogists which I discov­ ered after working with him years later. It could hardly be prop­ erly referred to as a laboratory since it was in a dark corner of the basement and was devoid of all furniture and any laboratory glassware or other supplies. This he proceeded to furnish in a make-shift fashion and he bought a few pipettes and test tubes from his own funds. Yet in spite of these physical limitations and the obvious in­ adequacy of such a research environment, his investigations here in roughly one year's time—from 1933-34—resulted in four publications from the Laboratories of Normal Anatomy and of Clinical Ophthalmalogy. These papers reported his studies on the Forssman antigen with his demonstration of so-called primary serum toxicity. In 1934 he emigrated from Geneva to the United States to be­ come a research fellow at Mt. Sinai Hospital in New York City. Here he was joined by a former student of his in the University of Heidelberg, Dr. Erwin Neter, an association that continues to this day. In 1935 while working here, Dr. Paul Klemperer, the eminent pathologist, brought Dr. Kornel L. Terplan, then professor of pathology in The University of Buffalo School of Medicine, who was visiting Klemperer to Ernest Witebsky for him to demon­ strate his chick embryo-Forssman antibody serum toxicity experi­ ments. This led to an invitation to join Dr. Terplan's department in Buffalo as associate professor of bacteriology, a position he held from 1936-40. In 1940, he was promoted and his title changed to that of pro­ fessor of bacteriology and immunology. The University of Buf­ falo created the Department of Bacteriology and Immunology as a separate entity distinct from the Department of Pathology in 1941 and named Dr. Witebsky its head. This morning we were privileged to hear Dr. Terplan's gracious remarks on Dr. Witebsky's contributions in those early developmental years of our medical school. In recognition of his many accomplishments as a devoted teacher and renowned investigator he was made Distin­ guished Professor of Bacteriology and Immunology in 1954, a rank held by only three other members of the entire University faculty. 30 THE BUFFALO PHYSICIAN �Dr. Witebsky honored by sophomore class January 21, 1967 As a young, slightly overwhelmed, and I'm sure equally bewil­ dered, freshman medical student, in the spring of 1942 Dr. Witeb­ sky invited me to join him in some student research project, if I were at all interested. This extraordinary offer, from my humble position and freshman viewpoint, became the turning point of my professional career. The "new" department in those days consisted of one room approximately 14 x 20 feet, which during the teaching portion of the year was completely used for making media, cultures, and all other student materials. Much of the research therefore was carried out in the Bacteriology and Serology Laboratories of The Buffalo General Hospital. This was possible because Dr. Witebsky had been appointed bacteriologist and serologist to this univer­ sity-affiliated hospital in 1936 when he joined the University fac­ ulty. This was a tangible expression to me of one of his most fundamental philosophies concerning pedagogy in our basic sci­ ence—that successful teaching of medical microbiology and im­ munology was dependent on the triad of teaching, research, and service. My indoctrination to this field as a student was to serve as a routine, diagnostic bacteriology technician trainee after successful completion of adequate probationary periods in glassware wash­ ing and media preparation. Again this approach reflected his strong feeling that successful administration of such a diagnostic laboratory service at a postdoctoral period required personal fa­ miliarity with each aspect of the operation. The entire full-time staff of the medical school department at that time consisted of a devoted technician, Miss Anne Heide, and what we then referred to as a laboratory diener, Mr. August SUMMER, 1970 31 �Dr. Charles Banas presents alum­ ni award to Dr. Witebsky at the 1968 Spring Clinical Days. Dr. Witebsky meets Her Majesty, Queen Juliana of Holland in the Royal Palace in Amsterdam in June, 1968. Dr. Witebsky received the Cross of Merit from the Netherlands Red Cross. Fischer. The total budget for supplies required to teach about 70 medical students and 50 dental students was roughly $500 per annum. Things were tight in other ways too. This was the period of the "conscience cigars." I couldn't be­ lieve he had really said that the first time I heard it so I begged his pardon whereupon to my disbelieving ears I heard again "conscience cigars." He must have appreciated I wore a most confused countenance because he promptly proceeded to demon­ strate what he meant. One of his real pleasures he told me was smoking cigars, instantly adding that this was a foul habit. Every time he pulled out his desk drawer he was conscience smitten over what his children, Frank and Grace, were being denied for him to afford this personal pleasure. To solve his conscience, therefore, he kept in a drawer right below the more expensive ones, a box of nickel cigars—yes, five cents bought a White Owl cigar then—which were his "conscience cigars," ones he could smoke on such occasions joyfully. The better ones were saved to celebrate successful experiments at which time conscience did not enter into the picture. The rest is history which is familiar to all of you—I joined the faculty in 1945, followed by Noel Rose in 1951, Sidney Shulman in 1952, Almen Barron in 1954, Ernest Beutner in 1956 and Felix Maximus in 1958. Dr. Witebsky has won many honors in his career, but if he had the choice I seriously believe that deep in his heart he covets most the Chancellor's Medal of the University of Buffalo. This is an award made annually from the bequest of Chancellor Norton, specifically to one who has brought honor to this University and has dignified Buffalo in the eyes of the world. And I would like to read to you the concluding remarks of the late great Chancellor Samuel Paul Capen in 1950 when he awarded this medal. His University which now honors him has still another reason for bestowing upon him its accolade. Throughout the prosecution of his work he has exemplified the high­ est standards of the university scientist. He has been at pains to see that the associates who have assisted him should share with him whatever professional credit might come as a consequence of their joint labors. He has insisted that any profits derived from patents on his discoveries should go to the support of further research and not to his personal gain. Despite his constantly growing reputation and the recognition he has received from all over the scientific world, he has remained the simple, modest scholar whose courtesy and helpfulness and wisdom his colleagues have come to cherish in equal measure with his great scientific attainments. Well, sir it has taken 26 years to present to me the occasion, the situation, the audience and the opportunity, and now I have it. So I would like to say to you personally how much of my deep af­ fection and appreciation you have for what you have taught me, what it has meant to me and my family and to my associates, and I have for you a non-conscience cigarlD 32 THE BUFFALO PHYSICIAN �"On strike, shut it down!" That was the shout heard on campus between February 24 and March 21, the beginning of the spring vacation. During this 25-day period of campus unrest, many classes were boycotted [peaceful and violent] by students and faculty. No Medical School classes were cancelled. There were charges and countercharges by hundreds of individuals and many groups. There were thousands of words spoken and written. The Medical School's "Project Themis" [a $300,000 Naval Re­ search contract awarded to the physiology department] was one of the focal points of the student demonstrations. Among the other demands were — the immediate resignation of Acting President Regan; self determination for the colleges; support of engineering students and black student demands; open admissions; lifting of the court restraining order; reinstatement of Luigi Bianchi and Jon Hamann, former faculty members; dropping of disciplinary charges stemming from campus demonstrations; removal of Buffalo Police from campus [they were removed after 18 days]; and immediate abolition of Air Force ROTC. The crisis had been brewing for several months, perhaps years. Then suddenly there was active violence — broken windows, police-student skirmishes, arrests, injuries, and other types of van­ dalism. Many investigations were launched and are still going on by student/faculty groups, the grand jury, as well as other city, county and state committees, commissions and task forces. • SUMMER. 1970 33 25 Days of Campus Unrest As we go to press the Univer­ sity community is hard at work talking and trying to solve its many problems. There has been peace on the campus. Then on May 5 the students here and across the nation began demon­ strating against the war in Cambodia and the four student deaths at Kent State University (Ohio). This national protest is continuing and no one knows when or how it will end. • �A . SENSITIVE PROCEDURE to measure contractility of the heart holds promise for earlier detection of heart failure. It is the result of a combined medical/engineering approach at the Uni­ versity to estimate how well the heart muscle is functioning. A paper on " v max as an Index of Contractile State in Man" was presented March 1 at the 19th Annual Scientific Session of the American College of Cardiology. Co-authors are Drs. Herman L. Falsetti, assistant professor of medicine; Robert E. Mates, profes­ sor and chairman of the department of mechanical engineering; David G. Greene, professor of medicine; and Ivan L. Bunnell, as­ sociate professor of medicine. Dr. Falsetti Heart Failure Detection Over a two-year period, a group of 45 patients with various types of heart disease were studied by the investigators. The 16 males and 29 females ranged in ages from 17 to 65 and included those whose heart was forced to pump more blood (volume over­ load]; those with a narrowed heart valve (pressure load); and those with a poor heart muscle (no volume or pressure load]. Dr. Falsetti explained, "Hoping to find a sensitive indicator to the heart's performance, we assessed the various indices of con­ tractility by two methods. The first was by use of cardiac pres­ sure measurements alone. The second was by use of cardiac pres­ sure measurements together with cardiac geometry. In this latter, Dr. Mates was instrumental in developing a simplified mathemati­ cal model to describe the pumping action of the heart. A oneplane cineangiography method (movies of the heart], developed in Buffalo by Drs. Greene and Bunnell a decade earlier, made measurements and statistical correlations of heart function pos­ sible." Dr. Falsetti pointed out that consistency with clinical evidence was also an important factor in assessing the various indices of contractility. While this procedure has been applied in children by other investigators, he noted that "ours is the first comparative study of the most commonly measured parameters of contractility. Our procedure — to estimate how much damage there is to the heart muscle — is the most sensitive as well as the most accurate indicator of the heart's performance of all indices for contractility that we have tested." Dr. Falsetti started his research on stress/strain relationships three years ago under grants from the Western New York Heart Association and United Fund. The results of this preliminary work has been published in the January issue of Circulation Research.O 34 THE BUFFALO PHYSICIAN �The changing nature of health, including the increasing demand for health care by a more sophisticated public, the rapid increase in medical knowledge, the realization within the profession of the importance of both environmental and personal preventative services and many others has put an acute strain upon the present concept of the hospital. From the Desk of Dean Le Roy A. Pesch The new Health Sciences Clinical Center will strengthen exising community health systems and develop new ones. This facil­ ity will offer a range of services from general medical care through referral service to the larger medical institutions. It will function primarily on an out-patient basis. It will reach many people in need of health care: those who don't know where to go for help; those who are unable to travel to health care sources; those who are overwhelmed by the nature of the hos­ pital; and those who are unaware of their need for medical attention. Health Sciences Clinical Center We are planning a facility that is sensitive to the constantly changing needs of physicians, administrators, nurses, and other professional students and patients — as affected by medical and technological progress. The new facility will provide for ongoing activities of health professionals; flexibility to permit conversion of any area to a new use; integration of the expansion or addition of any health related function into the already existing circulation systems (of personnel, supplies, patient, etc.]; structural and mechanical efficiency; and human scale environments. SUMMER, 1970 35 Health Facilities Planning Personnel: Gyo Obata, principal in charge of design; Terrence Cashen, vice presi­ dent for design; Alvin Lever, vice president for design. The State Uni­ versity Construction Fund. Copyright © 1970 by Hellmuth, Obata & Kassabaum, Inc. ��zq BLJ * * Inpatient • Out Patient A Research R Therapeutic *- The concept of the module is being used in the design of the new Health Sciences Clinical Center. Each module provides enough air, light, mechanical services and space for the needs of one person. In this new "activity oriented module" concept we are developing space for a variety of func­ tions — diagnostic treatment centers, ambu­ latory and in-patient areas, research labora­ tories, teaching space and common facilities related to patient care and health delivery (food preparation, maintenance, information resources, etc.]. Investigations indicate that an area of approximately 10,000 square feet (one-fourth the size of a football field) is a very effective space for the conduct of these various activities. ^ H Dx Diagnostic LL J I i LJ Teaching The cores link modules together vertically and horizontally. Expansion of a particular activity can be accomplished by plugging in more modules to the existing network. This system eliminates disruption and disorgani­ zation caused by erratic and incoherent growth. The network provides the physical basis for connecting related activities. Each module can have as many as six adjacent modules: one above, one below, and four on the hori­ zontal plane. This allows formation of hori­ zontal, vertical and combination activity clusters. Modules must serve many different uses and must have the built-in capacity to change functions to accommodate new programs. This means every module must be designed to be capable of accepting sophisticated equipment if the program requires it. Since each module is a large open space partitions can be mounted and demounted as the pro­ gram dictates. In concept, the entire complex is organ­ ized on the modular grid. The open-space volumes between the major functional areas are also modules of approximately 10,000 square feet. At the main levels, these mod­ ules provide floor space and additional ver­ tical and horizontal circulation for the coremodule network. Above, the module vol­ umes are open and admit light and air into the complex. The network is the basis of all circulation of personnel, patients, students, materials, equipment, etc. To achieve the program flexibility neces­ sary for major health care facilities it is necessary to establish a network to tie the modules together. Each module is related to four cores which contain stairs, elevators, mechanical and electrical distribution, etc. The modular concept does not impose solu­ tions on health care administrators. Rather, it offers them the means to implement their philosophy, growing as programs are planned and the funds to back these activ­ ities become available.• SUMMER, 1970 37 �The Health Sciences Library Mr. M e y e r h o f f FACULTY AND STUDENTS are impressed with the new improvements of the Health Sciences Library at 141 Capen Hall. Librarian Erich Meyerhoff is happy with the acceptance of the "new look" and the increased use of the library. A $19,000 Medical Library Resources Grant from the National Library of Medicine triggered the improve­ ments. Everything is new — tables, chairs, desks, files, racks, and lights — not to mention drapes and carpet. It all adds up to a pleasant, noiseless atmosphere that makes for easy and improved study. "We changed the flow of traffic and are utilizing our floor space (14,490 sq. ft.] to better advantage," Meyer­ hoff said. Some 750 people visit the library daily. They are in search for something in one of the 107,585 volumes (twothirds are journals and one-third books) or from one of the 3,275 periodicals. • THE BUFFALO PHYSICIAN ��Dr. Carel J. van Oss, associate professor of microbiology, has been appointed Honorary Dutch Vice-Consul for Western New York. Previously he had been named in a royal commission by Queen Juliana of the Nether­ lands.• Dr. Joseph L. Campo, M'54, is the new presi­ dent of the medical staff of St. Joseph Inter­ community Hospital, Cheektowaga. Other of­ ficers are — Drs. Eugene Cisek, vice president; John S. Sauer, secretary; and Eugene F. Nor­ man, treasurer. • Three alumni were elected officers of the Mount St. Mary's Hospital medical staff, Niagara Falls. Dr. Boris A. Golden, M'40 is the new president; Dr. Glenn R. Arthur, M'47, vice president, and Dr. Melvin B. Dyster, M'52, secretary-treasurer.• Four alumni have been elected officers of the Buffalo Gynecologic and Obstetric Society. The new president is Dr. Harry E. Petzing, M'46. Others named are Drs. Carmelo S. Armenia, M'49, vice president; Morris Unher, M'43, secretary; and Donald W. Hall, M'41, treasurer. Three alumni were elected to the executive council — Drs. William A. Potts, M'44; Harold J. Feldman, M'43; and Henry L. Pech, M'50. • The first joint meeting of the 132-year-old New York Academy of Science and a foreign scientific society will be co-chaired by Dr. Ernst H. Beutner, professor of microbiology. The meeting will be in Stockholm May 13-15, and will focus on Developments in the Application of Defined Immunofluorescent Staining.D THOUGHTS IN A MICROBIOLOGY LAB (1968) The cry of the wheezing guinea pig Screams through the rainy day's air To shatter my ears with its impending Death. It suffers the pain of asphyxiation To educate us with irrelevancies. You say that you want to bring humanity Back into medicine. You say that you Live for life and the human race. Physician, heal thyself of thine ills And stop this wanton murder Of a lowlier species, and, with this, Return life not to the dead rodent, But return life to your dead soul. — Ken Solomon, '71 State University of New York at Buffalo Dr. Bloom (Reprinted from THE NEW PHYSICIAN, June 1969) Dr. Marvin L. Bloom, M'43, is the new presi­ dent of the Annual Participating Fund for Med­ ical Education. Other officers are Drs. Harry G. LaForge, M'34, first vice president; Kenneth H. Eckhert, M'35, second vice president; Don­ ald W. Hall, M'41, secretary; and Kevin M. O'Gorman, M'43, treasurer. The immediate past president is Dr. Max Cheplove, M'26. • 40 THE BUFFALO PHYSICIAN �Dr. Eric A. Barnard, professor and chairman of biochemistry, is editor of the Journal of Molecular Evolution. He is also chairman of the Medical School's negotiating committee with minority group representatives.• Dr. John F. Moran, assistant professor of biochemistry, has been elected to the Board of Directors of the United Health Foundation of Western New York for a three year term.D Dr. Charles E. Wenner, research associate professor of biochemistry, is associate editor of Cancer Research.• Co-authors of a book, "Roentgen Diagnosis of Rheumatoid Arthritis", is Dr. Ru-Kan Lin, clinical assistant professor of radiology, and Dr. David L. Berens, clinical associate. Both are on the staff of Buffalo General Hospital.• Dr. Joseph D. Godfrey, M'31, has been elected vice-president of the American Acad­ emy of Orthopaedic Surgeons. He is clinical professor of surgery at the University and team orthopaedist for the Buffalo Bills. Dr. Godfrey is also chief of orthopaedics at Mercy and Children's Hospitals and attending ortho­ paedic surgeon at Buffalo General Hospital. Dr. Godfrey became a Fellow of the Academy in 1948, the nation's largest organization for specialists in bone and joint surgery. He has directed postgraduate education programs in sports medicine in the Buffalo area the last two years. He is a founder member of the Orthopaedic Research and Education Founda­ tion, a member of the Orthopaedic Associa­ tion, International Society of Orthopaedics and Traumatology, and Pan American Medical Association, and is a former Governor of the American College of Surgeons.• Dr. Godfrey GEORGE MILLER STERNBERG (1838-1915) bacteriologist and epidemiologist of the US Army Medical Corps, was born in Otsego County, New York, the son of a Lutheran minister. He attended the Buf­ falo School of Medicine and the College of Physicians and Surgeons in New York city. He enlisted in the Federal Army early in the War Between the States and was captured in the Battle of Bull Run. Sternberg held various posts in the Medical Corps and during the Spanish-American War became Surgeon General. Maintaining meanwhile, a deep interest in basic bac­ teriology and immunology and experimental epidemi­ ology, he recommended Walter Reed to the patho­ logical laboratory at Johns Hopkins University in preparation for his experimental studies on yellow fever in Cuba. Sternberg's most important treatise, A Manual of Bacteriology, appeared in 1892 followed by a monograph, Infection and Immunity. While in the Surgeon-General's office he supported the program which provided for a corps of female nurses for per­ manent Army hospitals and sponsored the founding of the Army Medical School. He served as President of the American Medical Association in 1897-1898. (Composite by G. Bako with permission from the Editor of The Journal of the American Medical Association) SUMMER, 1970 41 �A 1921 graduate of the Medical School was honored in February for his 21 years as a member of the Erie County Board of Health. He is Dr. Antonio F. Bellanca, a 71-year-old physician, who was appointed to the board in 1948, when the Buffalo Health Department was merged into a county health department. Dr. Bellanca, who retired December 31, 1969, is confident that he and his colleagues on the board have done an outstanding job for the citizens of the county. He pointed out that the Erie County Health Department has kept abreast of health care advances such as health clinics and immunization programs. He was president of the Western New York Heart Association in 1953; the Erie County Medical Society in 1954; and is chief of medi­ cine at Columbus Hospital. He served almost four years in the Army in World War II, most of the time as chief of the 40th Medical Sta­ tion in North Africa. Looking back on almost 50 years he has en­ joyed meeting patients face to face in his of­ fice. He doesn't believe he could fit into the computerization that will soon be the pattern of modern medicine. "The personal touch will be gone. I feel too old and rigid to accept computerized medicine, even though I know we must reconcile our­ selves to it if we are to offer good quality medical service to everyone," Dr. Bellanca said. "I want to continue my own practice on a personal basis. I like to sit down in my office and talk to my patients. This is what I intend to continue doing."D Three alumni have been re-elected officers at Lafayette General Hospital. They are Drs. Lucien Potenza, M'58, vice president; Mario Collura, M'53, treasurer; and Victor Lazarus, M'45, secretary. Dr. Alexander Perlino was re-elected president. Dr. Franklyn Campagna, M'58, chief of medicine was elected to asso­ ciate membership.• Dr. Jules Constant, clinical associate profes­ sor of medicine, has authored a new book, "Bedside Cardiology."0 42 Dr. John K. Dustin, clinical assistant profes­ sor in medicine, is the new president of the medical staff of Millard Fillmore Hospital. Three alumni were elected to other staff of­ fices. Dr. Kenneth S. Kelly Jr., M'50, is presi­ dent-elect; Dr. Paul M. Walczak, M'46, is treasurer; and Dr. Donato J. Carbone, M'46, was re-elected secretary. The immediate past president is Dr. Pasquale A. Greco, M'41.D Dr. Vincent Scamurra, M'50, won the Buffalo Squash Racquets Association's Veterans Tour­ nament for the first time. The former city champion defeated defending champion Jinx Johnson, University Club, in the finals.• Dr. S. Mouchly Small, professor and chair­ man of the department of psychiatry, has been elected to "corporate membership" of the Muscular Dystrophy Association. He has been on the national advisory board since its in­ ception.• Dr. Paul M. Walczak, M'46, is the new presi­ dent of the New York State Society of Sur­ geons Inc. He is an attending surgeon at Mil­ lard Fillmore Hospital.• Two physicians were installed Fellows of the American College of Obstetricians and Gynecologists recently. They are: Drs. Ronald E. Batt, M'58, and Theodore Schulman, a clini­ cal instructor.• Dr. Walter S. Walls, M'31, is the new presi­ dent of the New York State Medical Society. He is also clinical associate professor of sur­ gery at the University.• Three alumni and their spouses were in a special group that participated in a combina­ tion "business-pleasure" trip to Africa. They were Drs. Thomas Syracuse, M'33, Harry Schweigert, M'39, and Elizabeth Olmstead, M'39. The trip included medical and surgical seminars, a tour of the American Hospital Ship, the SS HOPE, and a camera safari. The physicians also visited hospitals in Rabat, Nai­ robi, and Tunis.• THE BUFFALO PHYSICIAN �In Memoriam Dr. Heyd Dr. Charles Gordon Heyd, M'09, died Feb­ ruary 4 in New York City at the age of 85. The distinguished surgeon, who retired in 1955, was president of the AMA in 1936-37. He was the oldest living past president. Dr. Heyd was a former director of surgery at New York Post Graduate Hospital and Med­ ical School, and a professor of clinical sur­ gery at Columbia University. He had also served as president of United Medical Service, a prepaid medical insurance service, from 1948 to 1951. A native of Brantford, Ontario, he became a United States citizen in 1917. He graduated from the University of Toronto in 1905. After graduating from the UB Medical School, Dr. Heyd took post-graduate work at Harvard, and in London, Berlin, and Vienna. In World War I as a major, he commanded a hospital unit in France. He was president of the County Medical Society in 1932, the state society in 1933, and was vice president of the American College of Surgeons in 1932-33. He was a former con­ sulting surgeon to Greenwich (Conn.) Hospital and the New York City Police Department. He was also a former president of the Ca­ nadian Society of New York. Dr. Heyd received the Legion of Honor of France in 1932, and was author of "Liver and Its Relation to Chronic Abdominal Infection," and about 200 monographs on surgery. Dr. Heyd opposed compulsory health insur­ ance and socialized medicine but advocated voluntary medical insurance and public health testing. He urged free state medical service for those who required it but were unable to pay. He maintained close relationships with the University throughout the years. Dr. Heyd founded the first New York City Area Alumni Club, was its first representative to the Gen­ eral Alumni Association and was a former trustee of the School of Medicine Alumni As­ sociation. He played a leading role in explain­ ing the University's merger with State Univer­ sity and the need for continuing alumni sup­ port, through a pamphlet entitled "The Chal­ lenge of Adaptation," which was widely dis­ tributed to his fellow alumni in the early 1960's. • SUMMER, 1970 A clinical professor of medicine, who re­ tired in 1968, died February 14. He was 71year-old Dr. Donald R. McKay. He was former president of the American College of Chest Physicians, Buffalo Academy of Medicine, and the medical staffs of E. J. Meyer and Millard Fillmore Hospitals. He was director of the Buffalo and Erie County Tuberculosis Asso­ ciation for more than 20 years, and president for seven years. He was also president of the Tuberculosis and Respiratory Disease Associa­ tion of Western New York. After graduating from the University of Toronto Medical School in 1925, he interned and did his resi­ dency at Buffalo City Hospital (predecessor to the Meyer). He stayed on at the Meyer in charge of tuberculosis service until 1939. He was also consulting physician at Millard Fill­ more and nine other Western New York Hos­ pitals. He authored many papers on pulmo­ nary disease, held honorary memberships in tuberculosis associations of Brazil and Mex­ ico, and was active in many professional so­ cieties at the regional, state, and national lev­ els. In 1960 the American College conferred upon Dr. McKay the degree of master of the College of Chest Physicians.• Dr. Carlton C. Rausch, M'43, died January 29, after a short illness. The 48-year-old gen­ eral practitioner was on the medical staffs of Millard Fillmore (obstetrical anesthesia divi­ sion) and St. Francis Hospitals. Dr. Rausch was a Captain in the Army Medical Corps in World War II and the Korean War. He re­ ceived a presidential citation for his service in the Philippines. He interned at Millard Fill­ more and Buffalo General Hospitals. He was active in several local, state, and national pro­ fessional associations.• 43 �In Memoriam Dr. Lauren G. Welch, M'34, died March 17 at the Niagara Falls Memorial Medical Center. The 62-year-old physician was Niagara County Health Commissioner. He was appointed to this position in October of 1969, after serving as assistant commissioner for several years. He was also quarantine medical officer at Niagara Falls International Airport. Dr. Welch enlisted in the U.S. Navy at the outbreak of World War II and was discharged six years later. During his four-year tour of the Pacific theater, he received the Bronze Star and the Purple Heart. Following the war he entered Columbia and Ohio State Universities for postgraduate work in medicine. At one time he was chief of staff of Mt. St. Mary's Hospital in the town of Lewiston and at the former Memorial Hospital of Niagara Falls. Dr. Welch also worked in industrial medicine with the Carborundum Company. He was active in sev­ eral civic and professional organizations. • Dr. Carol B. Graham, M'43, a former inter­ nist and associate professor at the Medical School, died March 22 at Roswell Park Memo­ rial Institute after a long illness. She retired eight years ago. Dr. Graham was on the faculty for 19 years, specializing in endocrinology. She joined the staff of the E. J. Meyer Memo­ rial Hospital in 1943 and was head of the En­ docrine Service when she retired.• Dr. Gerald W. Grace, M'42, died March 2 of a heart attack. The 54-year-old physician was director of Sisters Hospital Outpatient Department and Canisius College Student Health Office. He was also head physician for Mt. St. Joseph Motherhouse, and on the staff of Emergency Hospital. Dr. Grace was a Cap­ tain in the Army Medical Corps in the Pacific during World War II. He was active in sev­ eral local, state, and national professional as­ sociations.• 44 Dr. Frank A. Kruse, M'15, died March 3 after a brief illness. Two years ago he was honored by the Erie County Medical Society for his 50 years in medicine. Dr. Kruse served with the army in World War I.O Dr. Anthony Romeo, M'43, died March 6 in the Pamona, California Community Hospital of a heart attack. The 53-year-old physician practiced in Buffalo from 1947 to 1960. He was on the staffs of Millard Fillmore, Deaconess and Columbus Hospitals. Dr. Romeo served in Europe during World War II with the Army Medical Corps.• Dr. Bernard J. Dolan, M'24, died March 11 in Sisters Hospital after a long illness. The 70-year-old physician had practiced medicine in Buffalo for 41 years, after interning at the E. J. Meyer Hospital. Dr. Dolan was a past president of the staff of Sisters Hospital, and active in several professional organizations.• Dr. Thomas G. Allen, M'21, died March 17 in Buffalo General Hospital. The 76-year-old physician took over an industrial practice from his father. Dr. Allen served in the medi­ cal corps during World War I, and was a draft board physician during World War II. He was active in several professional organ­ izations at the local and national levels. • Dr. Arthur L. Runals, M'll, died March 19 in Fort Lauderdale, Florida at the age of 81. He was chief of staff and head of the department of surgery at Olean General Hospital, Olean, N.Y. until his retirement in 1953. Dr. Runals was a Fellow of the American College of Sur­ geons, a member of the Medical Society of the County of Cattaraugus, the Medical Society of the State of New York and the AMA.D THE BUFFALO PHYSICIAN �Two 1970 Alumni Association Tours I. "EXPO-70" TOUR — AUGUST 16 - SEPTEMBER 5 (21-DAYS) $1,389.00 per person from Buffalo $1,339.00 per person from Chicago $1,183.00 per person from San Francisco (plus $13.72 taxes payable at time of booking) Stops include: San Francisco, Honolulu, Manila, Hong Kong, Kyoto (Expo-70), Tokyo, Honolulu. Tour Escort: Henry E. Mark of Hallmark Travel Agency, Inc. II. "BAHAMAS HOLIDAY"—NOVEMBER 15-27 (8-DAYS, 7-NIGHTS) $285.00 per person (twin room occupancy) at the exclusive KING'S Inn & Golf Club, Freeport, Grand Bahama Island For details write or call: Alumni Office, 250 Winspear Avenue State University of New York at Buffalo Buffalo, New York 14214 (716)831-4121 The General Alumni Board Executive Committee •— M. ROBERT KOREN, '44, President; ROBERT E. LIPP, '51, President-elect; HERMAN COHEN, '41, Vice-President for Develop­ ment; MRS. ESTHER K. EVERETT, '52, Vice-President for Associations and Clubs; EDMOND GICEWICZ, '56, Vice-President for Administration; JEROME A. CONNOLLY, '63, Vice-President for Activities and Athletics; JOHN J. STARR, JR.,'50, Vice-President for Public Relations; CHARLES J. WILSON, JR., '57, Treasurer; WELLS E. KNIBLOE, '47, Immediate Past-President. Past Presidents: DR. STUART L. VAUGHAN, '24; RICHARD C. SHEPARD, '48; HOWARD H. KOHLER, '22; DR. JAMES J. AILINGER, '25; DR. WALTER S. WALLS, '31. Annual Participating Fund for Medical Education Executive Board for 1970-71 — DRS. MARVIN L. BLOOM, M'43, President; HARRY G. LaFORGE, M'34, First Vice-Presi­ dent; KENNETH H. ECKHERT, SR., M'35, Second Vice-President; KEVIN M. O'GORMAN, M'43, Treasurer; DONALD HALL, M'41, Secretary; MAX CHEPLOVE, M'26, Immediate Past-President. SUMMER, 1970 THE BUFFALO PHYSICIAN �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET, BUFFALO, NEW YORK 14214 Address Correction Requested §SH§ •»*S— � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1970 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1970-Summer Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v04n02-1970-Summer Table Of Contents A list of subunits of the resource. Medical Alumni Officers New Health Care System Medical Manpower Committee International Federation Meeting by Marc Leitner, Class of 1972 Health Care Changes Water Pollution Alumni Reception in New York Effects of Carbon Monoxide Eye Bank Anniversary Dr. O'Connor Returns The University as a Care Deliverer by Dr. Peter Regan and Dr. S. Mouchly Small National Intern Matching Program Spring Clinical Days Ten Class Reunions Ernest Witebsky, A Personal Vignette by Dr. James F. Mohn 25 Days of Campus Unrest Heart Failure Detection Health Sciences Clinical Center Health Sciences Library People In Memoriam Alumni Tours Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v04n02 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright 1970 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/e73851d26a7d569de821b4d801f23cbf.pdf 38f65211cd9cd8ec85983cf6b4bf0e12 PDF Text Text �BUFFALO PHYSICIAN Volume 30, Number 4 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY S E R V I C E S Dr. Carole Smith Petro DIRECTOR O F PUBLICATIONS Kathryn A. Sawner EDITOR Jessica Ancker ART DIRECTOR Alan J. Kegler ASSISTANT DESIGNER Julie Greiten PRODUCTION MANAGER Ann Raszmann Brown STATE UNIVERSITY O F NEW YORK AT BUFFALO S C H O O L O F MEDICINE AND BIOMEDICAL SCIENCES Dr. John Naughton, Dean, Vice President for Clinical Affairs EDITORIAL BOARD Dr. John A. Richert, Chairman Dr. Martin Brecher Dr. Harold Brody Dr. Richard L. Collins Dr. Jack F. Coyne Dr. Alan J. Drinnan Brian Duffy Dr. James Kanski Dr. Barbara Majeroni Dr. Elizabeth Olmsted Dr. Charles Paganelli Dr. Stephen Spaulding Dr. Bradley T. Truax Dr. Franklin Zeplowitz TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital Michael Shaw The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Health System Frank Sava Niagara Falls Memorial Medical Center Roswell Park Cancer Institute Sisters of Charity Hospital Dennis McCarthy Veterans Affairs Western New York Healthcare System © The State University of New York at Buffalo Buffalo Physician is published quarterly by the State University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge, toalumni, faculty, students, residents and friends. The staff reserves the right to edit allcopy and submissions accepted for publication. Address questions, comments and submissions to: The Editor, Buffalo Physician, State University of New York at Buffalo, Office of Publi­ cations, 136 Crofts Hall, Buffalo, NY 14260 Dear Alumni and Friends, As THE MEDICAL SCHOOL ENTERS its next sesquicentennial period, the faculty have begun to introduce new, significant innovations into the curriculum. You are already aware from earlier reports that the third and fourth years have been reorganized to include a Family Medicine clerkship in the third year, and two advanced modules, one each in Internal Medicine and Surgery, in the fourth year. These changes have increased our emphasis on ambulatory education and generalism, and they havestrengthened students' experiences in medicineand surgery. In this academic year, major restructuring of the first two years begins with the implementation of two interdisciplinary courses, each of which will span two years. One, the Clinical Practice of Medicine, integrates all the previous coursesthat taught clinical skills, epidemiology, preventivemedicine, and commu­ nity health. The second course, the Scientific Basis of Medicine, emphasizes problem-based learning. Each course uses small groups and emphasizes independent learning. Clearly the introduction and implementation will require additional curricular reorga­ nization in the years to come. UB is fortunate that the first two directors are skilled and dedicated educators. Andrea Manyon, M.D., assistant professor of family medicine, will direct the Clinical Practice of Medicine course, and Murray Ettinger, M.D., Distinguished Teaching Professor of biochemistry, will direct the Scientific Basis of Medicine course. In preparation for these major undertakings, retreats have been held with the involved chairmen, faculty, and administrators. A two-and-a-half day workshop directed by a team from McMasters Medical School in Hamilton, Ontario focused on conducting problembased learning courses. The medical students are quite enthusiastic about the new directions. We will keep you posted on the school's progress in subsequent issues of Buffalo Physician. Sincerely John Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Dear Distinguished Alumni, THE CLASS OF 2000 has just begun medical school. They can almost touch their dream. When it's fulfilled, will their dream be anything like they imagined? 1 think so. More than half of these men and women will dedicate themselves to some form of primary care. They will engage themselves with the poor, the unemployed and underserved, the pregnant teen with AIDS, and the unwanted child. Managed care will not result in doctors overlooking these individu­ als. The medical community needs to remain stronger and more powerful than any special interest group. The students of the Class of 2000 will carry the message into the 21st century that doctors will heal and protect all patients, regardless of their ability to pay, or the pain and disease they may have. The Medical Alumni Association is dedicated to helping these medical students enter into the 21st century with a sense of vision and hope. Dr.Jack Richert, who has navigated the Alumni Association for the past 14 years, has fulfilled that mission as a liaison between the medical school and its graduates. It is with his leadership that we originated and supported some 37 new activities, including; the Match Day scroll, the hosting program for residency interviews, the Freshman Orientation Program, the Hope and Healing Project, student travel to scientific meetings, receptions at national medical meetings, the newsletter, community physicians' programs, and the past presidents' dinner. Dr. Richert has just announced his forthcoming retirement. Thank you, Dr. Richert, for your vision and energy. You will be missed and always remembered. Send address changes to: Buffalo Physician, 146 CFS Addition, 3435 Main Street, Buffalo, NY 14214 Sincerely, Cover photo by Frank Cesario Jack F. Coyne, M.D. President, Medical Alumni Association • �I U F F I L The Class of 2000 A FRESH PERSPECTIVE ON MEDICAL SCHDDL 14 V O L U M E 3O . N U M B E R 4 AUTUMN 1996 Double doctors RESIDENTS EARN M.D.S ALONG WITH THEIR ORAL FRDM UB'S NEWEST SURGERY CERTIFICATION STUDENTS by Andrew Danzo 20 The Women's Health Initative •N E W O M A N ' S S T O R Y by Jessica Ancker by Jessica Ancker photos by Frank Cesario Research and hospital news A student's perspective by Victor Filadora, class of 1998 PHOTO DYNAMIC THERAPY; THREE HOSPI­ TALS EXPLORE MERGER; ECMC EXPANDS INTO Letters Then and Now A DOCTOR FOR ALL COMMUNITY; HENRY SEASONS: ALBERT HEIMLICH JAMES MYER Medical school news by Bernard Wiggin MEL DIEDRICK; TEACHING AWARDS; STUDENT AWARD; SIMULATED PATIENTS Young faculty profile ALAN J . LESSE, M.D. Alumni news NEW ALUMNI POSITIONS; REUNION CHAIRS Classnotes �RESEARCH Photodynamic therapy: will oxidize anything it touches, kill­ ing the cancer cell but sparing sur­ rounding tissue. Because laser light doesn't penetrate far into tissue, PDT can only be used on tumors that are on or near the surface of organs that can be reached with an en­ doscope. Also, it is a local therapy; a treatment in one region of the body won't catch metastases elsewhere. Although it is not appropriate for all cancers, PDT is cheaper, quicker, and safer than many conventional cancer therapies. Photofrin's main side effect is that it renders patients' skin highly sen­ sitive to light. If they do not avoid pro­ longed exposure to the sun for 30 to 60 days after treatment, the photodynamic effect can cause severe sunburn. Re­ searchers are trying to develop new drugs without this side effect. In early experiments in the 1970s, Dougherty and his colleagues used PDT and conventional lamps to kill tumors DEVELOPED IN BUFFALO TO BENEFIT CANCER PATIENTS EVERYWHERE T STARTED OUT AS A NUISANCE that puzzled lab technicians: A chemical that was used to identify live cells in a culture could kill the cells if they were exposed to light. "I said, 'Hmm' when I found out about that," remembers chemist Thomas J. Dougherty, Ph.D., a UB research professor of radiation oncology at Roswell Park Cancer Institute. "The technician mentioned it to me asa warning, but I decided to see if this was something we could use." Canadian company that manufactures it under the name Photofrin. "Dougherty is the seminal figure in PDT," says Frank Mahoney, a project officer at the National Cancer Institute, which funds Dougherty's research. "Many of the people in the field around the country have passed through his lab." "The very first approval was a big hurdle because the FDA didn't know anything about it, and they had to look at the manufacturing methods and the laser equipment, as well as the drug." Was it ever. What began as a chemical's troublesome property led to a whole new modality of cancer treatment called photodynamic therapy, or PDT. Thanks in part to Dougherty's contin­ ued research activity in the field, Buffalo is now home to two photodynamic therapy centers. Researchers around the world are using PDT to treat cancer and other diseases, and the first PDT drug received Food and Drug Administration approval last year. The drug, porfimer sodium, was pat­ ented by Dougherty and Roswell Park Cancer Institute. It is licensed to a o PDT is a multistep process in which a harmless drug absorbed by body tissues is activated by laser light and releases cytotoxic substances inside tumors. First, the patient is injected with Photofrin, which is taken up by cells throughout the body, especially by rap­ idly dividing cancer cells. Then doc­ tors use a fiberoptic to deliver a beam of laser light at the correct frequency to the tumor. When Photofrin absorbs energy from the light, it releases a molecule called singlet oxygen. This molecule is so reactive that during its one-millionth-of-a-second life span, it B u f f a l o P h y s i c Thomas Dougherty, Ph.D., watches as colleague B. Dale Wilson, M.D., uses photodynamic therapy to treat a patient with basal cell carcinoma. i a n A u t u m n 1 9 9 6 �that had metastasized to the skin. "I found out later that a couple of re­ searchers had tried something similar much earlier—one in the 1930s, and one in the 1960s. But in those days, the equipment wasn't up to the demands, and they never did anything about it," Dougherty says. "It just shows you that there's nothing new. Somebody's always thought of it before." By 1980, with the development of lasers that could focus light of the correct wavelength through endo­ scopes, researchers in Japan began treating lung cancer. Scientists around the world have used PDT successfully on esophageal, blad­ der, stomach, and cervical cancers. In this country, Photofrin and the PDT laser equipment is only approved for treating late-stage esophageal cancer. Early-stage lung cancer may be next. "The very first approval was a big hurdle because the FDA didn't know anything about it, and they had to look at the manufacturing methods and the laser equipment, as well as the drug," Dougherty says. "I think future approv­ als should come much more quickly." Dougherty also blames himself for a tacticaf error that may have slowed the process of getting Photofrin on the mar­ ket. He and his colleagues started their own company to manufacture the drug, but lack of funds forced them to sell to Johnson &Johnson. The company then sold the rights to Photofrin to the Cana­ dian company, QLT, which finally made a success of it. "The new drugs will move through the process quicker, because we won't make the same mistakes," Dougherty says with a chuckle. Under Dougherty, the Photodynamic Therapy Center at Roswell Park is de­ veloping new PDT drugs, participating in clinical trials of new drugs and thera­ pies, and investigating the mechanisms that make PDT work. Roswell Park treats about 100 patients a year with PDT. B u f f a l o P h y s i c Meanwhile, following the FDA ap­ proval of Photofrin and PDT, the Buf­ falo General Hospital has opened its own photodynamic therapy center to begin treating esophageal cancer. The Buffalo General center is under the di­ rection of Thomas S. Mang, Ph.D., the former director of Roswell Park's PDT center and a longtime colleague of Dougherty's. In addition to patient treat­ ment, the Buffalo General center will also conduct phase II and III trials on another photosensitive drug, tin ethyl etiopurpurin, which is sensitive to a different wavelength of light. These tri­ als will build on successful preliminary trials on several cancers, including AIDSrelated Kaposi's sarcoma and recurrent breast tumors. Hiree hospitals explore merger THE BUFFALO GENERAL Hospi­ tal, the Children's Hospital of Buf­ falo, and Millard Fillmore Health System have announced they are ex­ ploring the possibility of merging. Officials from the three hospitals say that leadership committees are meeting to discuss whether a merger would be beneficial. It is not the first time that the region's hospitals have explored the possibility. In 1977, officials from Buffalo General, Children's, Deacon­ ess, and the former E.J. Meyer Me­ morial Hospitalasked medicalschool dean John P. Naughton, M.D., to lead a study into the feasibility of a merger. His report recommended forming a new nonprofit corpora­ tion to manage the consolidated hospitals, reduce underused bed ca­ pacity, and eliminate redundant ser­ vices. However, the plan failed to win the necessary support from the medical or lay community, or the Erie County Legislature. + i a n A u t u m n 1 9 9 Other potential uses for photodynamic therapy include treatment of psoriasis, port wine stain, and macular degenera­ tion, says Mang, UB research associate professor of oral surgery. Because pho­ tosensitive drugs accumulate preferen­ tially in cancer cells and fluoresce when exposed to the correct wavelength of light, they can also be used to pinpoint very early-stage cancers of as few as 100 cells. Dougherty welcomes the new PDT center at Buffalo General. "It's very helpful to have other people involved in PDT, because you expand your knowledge base," he says. The two neighboring centers are about to begin collaborating on a PDT training pro­ gram for gastroenterologists. "Besides, we are a research hospital," Dougherty adds. "It's important to get this technology out into other kinds of hospitals where it will benefit more and more people." + —BY JESSICA ANCKER ECMC expands into communityy T HE ERIE COUNTY MEDICAL Center Healthcare Network has opened four community-based primary care health centers, as well as the four already on the ECMC campus. All four provide health services for children, families, and seniors. In addition, the Cleve-Hill Family Health Center includes a dialysis center, and the Dr. Matt A. Gajewski Human Ser­ vices Center has pharmacy services, general dental services, eye and foot care, and human services. "We've seen tremendous growth in outpatients in the last couple of years, particularly in family medicine," ex­ plained hospital spokesman Joe Grano. "Since the industry is moving toward a more deregulated environment, it's very important that we maintain and build a strong outpatient base." + 6 o �HOSPITAL N E W S Henry Heimlich, M.D., gives grand rounds at Buffalo General DDLY ENOUGH, he has never used the technique that has made his name a household word. Henry Heimlich, M.D., laughed when asked about his own experience with the Heimlich maneuver. "You know, the chances of one per­ son out of the entire population of the world ever being in the situation of needing to use it are very slim," he pointed out during a coffee break in grand rounds at the Buffalo General Hospital in July. The 76-year-old surgeon and re­ searcher was in town to give a grand rounds presentation that whirled from subject to subject—from new ways to save lives with the Heimlich maneuver to plans to combat AIDS with malaria. "I just wanted you to know that my life is not over," he told the assembled residents and students. In an unexpected twist, Heimlich took the opportunity to criticize the Ameri­ can Red Cross on the subject of the Heimlich maneuver. He insisted that the American Red Cross is resisting evidence that the Heim­ lich maneuver should be the first rescue method used not only on choking vic­ tims, but also on victims of drowning. According to Heimlich, the Heimlich maneuver expels water from the lungs, jump-starts breathing, and massages the heart. Thus, he said, it should be used before mouth-to-mouth resuscitation is o A thoracic surgeon, Heimlich first gained prominence in the 1950s with his invention of the Heimlich operation, in which a damaged or defective esopha­ gus is replaced with stomach tissue. His Heimlich valve, which permits chest wounds to drain and seals them to pre­ vent lung collapse, saved lives during the Vietnam War and is still routinely used in thoracic surgery. He published his description of the Heimlich maneuver in 1974, after ex­ perimenting with pressure to different parts of the chest and back. He has founded his own nonprofit research and public education organiza­ tion, the Heimlich Institute, in Cincin­ nati, OH, and serves as its president. Heimlich concluded his Buffalo Gen­ eral talk by discussing his current re­ search into malariotherapy. In the 1920s and 1930s,doctors treated tertiary syphilis by infecting the patient with vivax malaria,which was then cured with quinine. A 1992 review article in the Journal of the American Medical Asso­ ciation concluded that the lack of mod­ ern controlled trials means that the effi­ cacy of the treatment was never proven. Heimlich pointed out that infection with plasmodium vivax is now known to increase the patient's levels of certain cytokines. He believes that these give a boost to the immune system that may be therapeutic for diseases including AIDS. His preliminary study on eight AIDS patients in the People's Republic of China indicated that a three-week course of malariotherapy increased patients' CD4 counts, he said. He presented his un­ published results at the 11th Interna­ tional Conference on AIDS in Vancouver, British Columbia, in July. Heimlich predicted that because ma­ lariotherapy was cheap, it would be ig­ nored by the big drug companies. Nev­ ertheless, Heimlich claimed, "This is the most promising method that was pre­ sented at that meeting." + tried on drowning victims. "It's ridicu­ lous to think you can blow air through water-filled lungs," Heimlich said. He said the Red Cross has included the Heimlich maneuver in its own drowning guidelines, but doesn't con­ sistently teach it. He accused the orga­ nization of being afraid to alter its pro­ tocol because it didn't want to admit that the old one was flawed. "People—particularly children—are dying because the Red Cross has not followed its own guidelines," Heimlich charged. "It's a coverup of past failures. The public has to be told that the same Heimlich maneuver they know for choking has to be used for people who are ' drowning." Heimlich has filmed two public service an­ nouncements on his theory. According to the American Red Cross handbook CPR for the Professional Rescuer, the organiza­ tion recommends using the Heimlich maneuver on a drowning victim only if the airway is obviously blocked, or if resistance to mouth-to-mouth resusci­ tation suggests a blocked airway. A spokesperson for the American Red Cross declined to comment on Heimlich's charges, saying only that the organization relies on medical consen­ sus when drawing up its guidelines. At this point, medical consensus does not support Heimlich. The Emergency Cardiac Care Committee of the Ameri­ can Heart Association recommends CPR and artificial ventilation for drowning victims. An Institute of Medicine panel concluded that "the available evidence does not support routine use of the Heimlich maneuver in the care of neardrowning victims." Their report was published in the May-June 1995Journal of Emergency Medicine. B u f f a l o P h y s i c -BY JESSICA ANCKER i a n A u t u m n 1 9 9 6 �TWO READERS RESPONDED TO THE SUMMER ISSUE OF BUFFALO PHYSICIAN MAGA­ "I N THE E ND— H OW ZINE , DOES MEDICINE DEAL WITH LETTERS DEATH." THEY HAVE GIVEN US THEIR PERMISSION TO PUBLISH THEIR LETTERS. Assisted death is protected by the IIS. Constitution Doctors must relieve pain F i To THE EDITOR: To THE EDITOR: n important fact that dominates the discussion of physician-assisted death was essentially absent in the articles on this subject in the Summer issue of Buffalo Physician magazine. Physician-assisted "suicide"—whether by removal of life-support or by making available a means to terminate life by the patient's own hand—is not an act that can be proscribed or allowed bylegislative or executive action; it is inherent in the individual rights protectedby the Constitution. Recent court cases have clearly placed this act in the same domain as that of the right of a woman to control her own body in her decision whether to continue or terminate a pregnancy. As Ronald Dworkin discusses in Aug. 6 New York Review of Books, the federal and state judiciaries are clearly establishing a reading of the Second and Fourteenth Amendments that extends the right to due process and to equal protection to individual action concerning one's own body as long as that action does not have consequences for another person or society at large. That is, the courts are saying that the state has no legitimate interest in what I do with my body, period. With respect to abortion, of course, this reading of the Constitution has raised the strong and significant question of the rights of the fetus, but with respect to a person's right to die, there is no such competing interest. Essentially, all of the physicians interviewed for the Buffalo Physician articles were expressing their moral values concerning life and death. It is certainly their right to do so, and it is their right to practice medicine in a fashion consistent with those moral values. However, their moral values have no standing in this issue as it is a point of law. What these articles could have done was to start from this legal reality and then to discuss how this reality was to be faced and dealt with in the patient-physician setting. As the articles pointed out, physician-assisted suicide is a reality. Physicians are not being convicted for it, even if prosecuted, and, at this point, it appears to be constitutionally protected. OK, so now what do we do to make this work? ifteen years ago, my wife was suffering constant pain from bony metastases. I gave her the sedative, anal­ gesic, and antidepressant tablets I had and called the physician in charge for a prescription for stronger narcotics. She sent me on an errand, and when I returned, she had killed herself. I blame myself for not supplying adequate analgesia, whether narcotics administration likes it or no. I do not blame her physician, for he was doing what many of us did, which is to worry more about addiction than about ad­ equate analgesia. This I have avoided since. In the 1940s, one of our teachers told us about an old doctor (him?) who treated terminal patients in pain by leaving a bottle of morphine tablets. "One or two for sleep or pain. If you take ten, you will not awaken." The pagan Seneca is quoted as saying, "If you can no longer live honorably, you may die honorably." Properly used narcotics will alleviate most pain. But there will be a difficult remaining few who find their lives intolerable and need a kindly assisted exitus. Few physicians could overcome ethics and training to do killing deliberately. Probably physician referral to the judicial process followed by technician intervention if or­ dered makes the most sense. There is an old Welsh legend about the "black draught" that a doctor gives to the terminal patient. The caring physician should not have to carry the "black draught" in his bag. Some of my old patients used to ask to see my "black draught" bottle. When they found I had none, they seemed relieved, as I would be. Sincerely, Donald N. Groff, M.D. '45 Sincerely, Daniel J. Kosman, Ph.D. UB Professor of Biochemistry B u f f a l o P h y s i c i a n A u t u m n 1 9 9 6 o �CO CO < THE O OF 2000 A fresh perspective on medical school from UB's newest students BY JESSICA ANCKER PHOTOS BY FRANK CESARIO "STUDY HARD. Fill out this questionnaire. Sit for this identification picture. Have compassion for your patients. Coop­ erate with your classmates. Sign up for this club. Study hard!" In a whirlwind of tours, lectures, instructions, and good advice, UB's Class of 2000 has been inducted into the world of medical school. Every day, professors make sure the new students understand the magnitude of their course load; school adminis­ trators make sure they know where to turn for help; senior students make sure they know where to go out on Friday nights. "I'm getting so much good advice I'm not sure who to listen to," says a bewildered—but pleased—first-year student, Julie Cheng. o B u f f a l o p h y s i c �Chuck Lau Jmajored in chemical engi­ neering as an undergraduate at UB, but he chose medicine because he wants to deal more closely with people. "I'd like to meet different kinds of people every day, and develop personal relationships with them." Lau says the little things are impor­ tant in the doctor-patient relationship. He remembers once undergoing some medical tests, and watching as the doc­ tor started writing up his report. "He could have told me right away that everything was fine, but he didn't say a thing until he was done filling out his forms," Lau says. "When I'm a doc­ tor, I'll try to remember how nervewracking that was!" The son ofTaiwanese immigrants, Lau has been a scout leader, an emergency room volunteer, and a designer of websites. "I thinkthere are otherthings I would be good at, but I want to apply my skills to an area where I can make the most difference," he says. He hopes to find time during the next four years to go fishing—at least once in a while. �Orientation In brief talks in Farber Hall's Butler Auditorium during the three days of orientation, Deanjohn P. Naughton, M.D., and other UB administrators and professors outline the first-year curriculum. Associate Dean Dennis Nadler, M.D., tells the students that they must shoulder the responsibility of the profession immediately, without waiting for graduation. To emphasize that, he leads the class in reciting a version of the Hippocratic oath. Then he says, "Welcome to the profession of medicine!" In a lighter moment, several senior students present a skit about cynical med school applicants. Outside the interview room, the mock applicants freely chat about their ambitions ("Surgery!" "Proctology!"). But in the interviews, they all parrot the answer they figure will get them into medical school: "Definitely primary care!" On the last day of orientation, the upper-level students divide the first-years into teams and send them on a scavenger hunt that introduces them to restaurants and landmarks all around Buffalo. Gross anatomy The first moment of gross anatomy lab feels like the real beginning of medical school. The students file in quietly, noting the smell of formalde­ hyde and trying not to be nervous. In the lab, they are urged to respect those whose bodies are on the covered tables, and they observe a moment of silence. "The tension was just building," Gretchen Schueckler says. "All I could think of was opening the cover, but first there was the introductory stuff, which seemed to go on and on." "I went in thinking, These are not people; they're just bodies,"' says Chuck Howarth. From that point of view, the introduction isn't exactly helpful. "Suddenly, it puts them back into the 'people' category." It is a relief, the students say, to uncover the body and get to work on the back muscles, selected as the first assignment because they are relatively easy to work on, and because the back of the cadaver is usually less upsetting to view. Lynn Barnhard admits, "I was looking around a little to see if anyone was going to faint." No one does. did," Barnhard says. "That's what you're there for. You're not just there to sit in a classroom all day, you're there to do something." But despite the changes in the curriculum, there's no way to avoid lecture classes altogether. By the end of the first week, Butler Auditorium, which had been so exciting during orien­ tation, is becoming old hat. The students are eager for labs, visits with doctors and real patients, and other forms of hands-on learning. Some stu­ dents choose to participate in a special section of the histology course in which an interactive computer program replaces videotapes. They also turn to an anatomy program that lets them perform an ideal dissection. In a virtual dissection, slips of the scalpel aren't irrevocable—each muscle, organ, and bone can be replaced! Student fellowship Within a week, most of the 135 students have met each other. Feeling a sense that they are all fighting a common battle against the massive workload, they begin forming study groups and teams. "The joy for learning is pulling people together," Charles Olisa says. He contrasts medical school with the intensive pre-medical course he has just completed, where he found the students competitive and a little suspicious of each other. "Here, there is no caution, or competition. People are eager to get in there and participate." Teamwork comes easy, Howarth says, because of the character of the students. "They're really nice people—which I guess isn't a surprise, because the school is looking for that kind of person to become a doctor." "We're all so happy to be here, I think," says Eric Kirker. "I've been walking around with a big stupid smile on my face all week." If they have happiness in common, they also share trepida­ tion. "I can't imagine how I'm going to learn all this stuff. Luckily, I know everyone else is scared, too," says Howarth. "I can tell right now that I'm going to be a miserable person for the next four years," he adds, grinning so widely it's hard to believe he means it. + Butler Auditorium —again? W h o are t h e m e m b e r s o f t h e Class o f 2 0 0 0 ? As part of UB's drive to begin clinical instruction earlier, the students take an intensive first-aid course in their first few weeks of class. The course includes certification in cardio­ pulmonary resuscitation. "I was really pleased that that was one of the first things we Their year of graduation isn't the only number that makes UB's Class of 2000 unique. The class's mean MCAT score of 10.39 has set a new high, in a substantial jump from last year's average of 9.77. And the o f f �students' undergraduate grade point averages have also set new records—3.56 in science courses and 3.65 overall. "People always say the quality of education is going down in this country, but it's certainly not true of our applicants," comments admis­ sions director Thomas Guttuso, M.D. '60. In part, that's because so many students are applying to UB. The number of applicants for this year's class was 3,39f (down slightly from a peak in 1994); there were 25 applicants for each of the 135 slots. But UB doesn't select its students based solely on grades and test scores. "We try to judge maturity, empathy, demon­ strated interest in medicine and in the commu­ nity and society," Guttuso says. "We're looking for something inside their hearts and souls, and not just inside their brains." As a result, it's no wonder this year's stu­ dents sound idealistic, enthusiastic, and dedi­ cated. An entrance survey conducted by assis­ tant dean Frank Schimpfhauser found that the top reason students gave for becoming doctors was a desire to help people and deal with them directly. Less frequently mentioned were earn­ ing a comfortable income, exercising leader­ ship, or winning community respect. The students are fairly savvy about the future of medicine. They understand that the changing marketplace is creating a greater demand for generalists, and they also know that UB is em­ phasizing primary care. About 50 percent of the entering class say they plan to enter one of the three primarycare fields—general internal medi­ cine, general pediatrics, and family medicine. Schimpfhauser's previous surveys have found that about 50 percent of students will change their career preferences during medical school. Even with all of those changes, however, just under half of last year's class did end up entering a primary care residency. Reflecting the applicant pool UB favors applicants from western New York; as a result, most members of the Class of 2000 are from the western part of New York State. The school also favors qualified members of f f Lynn Barnhard knows all about being a patient. Her enthusiasm for ballet, soccer, swimming, and cheerleading led to tendinitis and orthopedic problems at a young age. "Since it's your body, you're interested in it. I learned a lot about it." Sports are still important to her, though these days she only has time for a quick bike ride. Barnhard says her early experiences also taught her a lot about doctors, especially pediatricians, and how they interact with children and their parents. "That helped me develop a sense of what kind of doctor I'd like to be," she says. At Canisius College, she majored in biology and psychology and won guaranteed admission to UB's medical school as a sophomore under the early assurance program. o �underrepresented minority groups, such as Native Americans, African-Americans, and Latinos. Eight students are members of underrepresented minorities—down from previous years largely due to greater competition from downstate medical schools, Guttuso says. The average age of the students is 23, but 17 of them are 26 or older. Eleven members of the class have already earned master's degrees; for the first time in several years, none have doctorates. Women make up 47 percent of the class. Most students majored in science as undergraduates, but as always, a substan­ tial minority (46) studied non-science subjects instead. Many of them (32) earned their undergraduate degrees at UB. "In terms of demographics, we're gen­ erally approaching a mirror image of the applicant pool," Guttuso notes. Career Number Two Seventeen members of the Class of2000 are In t h e i r h e a r t s a n d s o u l s The lengthy admissions process involves an initial screening and interviews of almost 500 candidates by the 51 mem­ bers of the admissions committee. "It's fantastic. You meet unbelievable young men and women," Guttuso says. Over time, Guttuso has noticed changes in the applicants. "They've gotten more knowledgeable and wordly, more aware of problems that exist in the country and in the world," he says. "They're more mature. When I think of the way I was when I was 21,1 wouldn't have stood a chance with these people." + 26 or older. Most of them had begun careers and were earning comfortable salaries. What made these people want to return to school for four grueling years ? was ascending the career ladder in her human resources jobs in the banking industry when she realized her work wasn't fulfilling. "Every day at the bank, I thought, 'I'm doing nothing for society!remem­ bers Schueckler, 28. In an attempt to find more meaning­ ful work, she began volunteering in the Sisters Hospital emergency room in her spare time. "I loved working in the hos­ pital. Believe it or not, I even loved the way the hospital smelled!" Then her younger brother was accepted to the UB medical school. "That kind of put things in perspec­ tive for me," Schueckler remembers. She quit her bank position, got a job at the Buffalo General Hospital as a clerksecretary, and started working toward getting into medicalschool herself. "The initial pay cut was very difficult. I had to move out of my own apartment and move in with strangers. Plus, I was spending thousandsof dollars on school, so I had even less money!" She needed three years of evening classes in biology, chemistry, and phys­ ics before she could take the MCATs. Shueckler says that for the first time she found herself doing well in science. "In college, I was young, I was immature, I was distracted. But when I was taking evening classes, I loved it." During her years of preparation, she GRETCHEN SCHUECKLER �le doesn't ding the t Itherwise, began working at UB's Primary Care Resource Center, putting her human resources background to work counsel­ ing and recruiting medical students. All her efforts paid off: Shueckler was admitted to UB as part of the Class of 2000. "When I found out, I cried. It was the most incredible feeling." "My parents always told me, 'You would be the luckiest person in the world if you had a job you love,'" Schueckler says. "I think I've found it." Medical school is the culmination of a lifelong dream for CHARLES OLISA, a dream born during his childhood in a Nigerian refugee camp. During that country's civil war in the 1960s, Olisa lived and worked with his uncle, a doctor. "It was terrible," Olisa remembers. "There was a cholera epidemic going on and there were dead people all over the place." What reallyimpressed the young man was the single-minded dedication of his uncle and the rest of the medical team in caring for the victims and stemming the epidemic. "Cholera is very contagious. They could have caught it, but all they thought about was serving the sick people." Despite a four-year gap in his educa­ tion caused by the civil war, Olisa won a scholarship to come to the United States and study agriculture at Central Missouri State University. "My first choice was always medicine, but I couldn't get a scholarship to do that." After earning his degree, Olisastarted thinking about medical school again. But his mother in Nigeria retired, and he began working to help support his younger brothers. Most recently, Olisa worked for Corning Inc. During this time, he became an American citizen. "I always wanted to be a doctor, but as the years went by 1 thought it was slipping away." Finally, last year, he decided to go for it. He quit his job, and moved to Brook­ lyn, where he took an intensive postbaccalaureate pre-medical course and worked with AIDS patients at Montefiore Hospital. When he got a telephone call telling him he was admitted to UB, he didn't believe it. "I thought it was one of my friends playing games with me," he says. It wasn't until he received a faxed letter of admission that he decided it must be real. "It's a miracle, as far as I am con­ cerned," hesays. "I wake up every morn­ ing and thank God." At 38, Olisa is the oldest member of the Class of 2000. But he says there is such a sense of teamwork among the first-year medicalstudents that hedoesn't feel his age sets him apart. He does believe he has an easier time ignoring distractions. "It's taken me so many years to get here that I'm not going to let anything stand in my way!" Olisa hopes to join the National Health Service, which will underwrite his medical education in return for sev­ eral years of primary care work in underserved areas. "All I want to do is provide service where it is needed." + �The Oath of Medicine Chuck Howarth has a lot of unlikely skills, and they all came in handy during his first days in medical school. Hisfouryears asan emergency medicaltechnician made the CPR course a breeze. His under­ graduate major in mechanical engineering had given him a thorough knowledge of the equations governing capillary diffusion. And his high school job as a meat cutter had taught him what he needed to know to find his cadaver's scapula on the first try. But just because medical school feels famil­ iar, that doesn't mean it's boring—especially since Howarth was admitted to UB from the waiting list at the last minute. "I'm just so happy to be here. It's all so cool." A moment later, he is bemoaning the loss of his free time. He has always juggled hobbies, volunteering, school, and his job as a mechanical engineer, where he's been involved in products as disparate as a baby stroller and an artificial heart. "Doing a lot of different things always makes me happy. Now, I'm goingto have to focus on one thing." For the first time, UB administered a professional oath to students on the first day of orientation. "We want them to start internalizing these principles from day one," said associate dean Dennis Nadler, M.D. The oath used at UB is adapted from one written by Louis Lasagna, M.D., dean at the Tufts University School of Medicine. "I swear to fulfill, to the best of my ability and P®*" judgment, this covenant: I will respect the hardwon scientific gains of those physicians and sci­ entists in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. I will apply for the benefit of the sick all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism. I will remember that there is both art and science to medicine, and that warmth,sympathy, and understanding may outweigh thesurgeon's knife or the chemist's drug. I will not be ashamed to say, 'I know not,' nor will 1 fail to call in my colleague when the skills of another are needed for a patient's recovery. 1 will pursue the expansion of my knowledge throughout my life for the benefit of my patients. I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most certainly it is not my place to judge them. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But if it be merely within my abilities to help ease suffering at the end of a life, may I face this awesome responsibility with humbleness and awareness of my own frailty. I will remember that I do not treat a fever chart, or a cancerous growth, but a sick human being, whose illness may extract a substantial toll from both patient and family. My responsibility includes all related problems if I am to care adequately for the sick. I will prevent disease whenever I can; for prevention is preferable to cure. I will remember that I remain a member of society, with special obligations to all, those sound of mind and body, as well as the infirm. If I do not violate this oath, may 1 enjoy life and art, respected while I live, and remembered with affection thereafter. May I always act to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help." + �A party aboard the U.S.S. Little Rock on Buffalo's waterfront gives the new students a welcome chance to relax and mingle. The event is sponsored by the Medical Alumni Association. Julie Cheng comes from a family of doctors and nurses. But she says, that made it all the more important to decide for herself whether medicine was right for her. A native of Staten Island, Cheng worked for a year in a clinic in New York's Chinatown doing public health and educational activities. She also traveled to Brazil with a Christian group called Youth with a Mission. The group accompanied a doctor who was visiting remote areas of the Amazon region. Cheng was inspired by the doctor's dedication and skill. "There was no electricity, so everything he did he did with no diagnostic equipment or technology." She was also impressed by the importance his visit assumed for the local people. "They had no doctors, so they would travel for days to come to see him." The trip made her realize something important about the role of medicine in her life. "It's a way I can combine my faith and my skills." f f 0 �The former and current OMS department chairs; Joseph E. Margarone, D.D.S and Richard E. Hall, D.D.S.,Ph.D., M.D. DOUBLE DOCTORS surgery certification by Andrew Danzo 0 U f f �UB's six-year oral and maxillofacial surgery residency is now among a growing minority nationwide in which residents earn a medical school diplomaalongwith "The medical education is involved in all my their OMS certification. cases. It gives you a better global perspective The program, a joint on how to take care of those patients." effort of the School of J E F F R E Y Dental Medicine and the S . K I N G S B U R Y , D . D . S . , M . D . School of Medicine and Biomedical Sciences, is based in UB's Department of Oral and Maxillofacial Surgery. It has graduated six oral and maxillofacial surgeon/M.D.s since 1994. "It is quite successful," says Joseph E. Margarone, D.D.S., the former chair of the Department of Oral and Maxillofacial Surgery, who won the support of the medical and dental schools to initiate the program. "We have developed a wonderful relationship. The cooperation is more than I had hoped I could achieve at the time." UB's dental and medical schools have long had a close relationship. Students from both have mingled in shared basic science lectures for years. A number of faculty members have appointments at both schools. The dental school also cooperates with the medical school and area teaching hospitals as part of the Graduate Medical Dental Education Consortium of Buffalo. "That is a model that has caught the attention of people outside of Buffalo," notes John Naughton, M.D., UB's vice president for clinical affairs and dean of the medical school. "You don't often see dental schools and medical schools working together like that." B u f f a l o P h y s l c i a n A u t u m n 1 9 9 6 © �Recent graduate Jeffrey S. Kingsbury, D.D.S., M.D., practices in Buffalo. DOUBLE DOCTORS B • ® u f f a l o P h y s i c i a n A u t u m n 1 9 9 6 �Not that there isn't a bit of subtle rivalry. In Squire Hall, the dental medicine building, the new residency is known as the Oral and Maxillofacial Surgery/M.D. Program. But Medical OMS, or MOMS, is the favored label over at the medical school's end of campus. Licensing boards do not require a medical diploma to practice as an oral and maxillofacial surgeon, nor does the American Board of Oral and Maxillofacial Surgery, the specialty's national certifying body. Nonetheless, oral and maxillofacial surgeons have long received quite a bit of medical training, including clinical rotations in medicine and surgery. Margarone proposed the OMS/M.D. program shortly after the OMS residency was lengthened from 36 months to 48 months. "With that 48 months, we were almost but not quite mimicking the third- and fourth-year clinical courses of medical school," he recalls. "It seemed foolish that all this education was being acquired, but when they got through it they didn't have a medical degree." The first year of the six-year program is a combination of a traditional oral surgery residency and second-year medical school courses, after which the residents must pass the first part of the U.S. Medical Licensing Examination. During the second and third years of the program, the residents complete the last two years of medical school. They then do a year of general surgery in Buffalo, followed by two years of oral surgery, which includes clinical work, electives, and research. Along the way, the "It's really the specialty that bridges the residents must complete at least six months in other surgical specialties, such as neurosurgery or otolaryngology. gap between medicine and dentistry." William L. Cecere, D.D.S., M.D., who graduated from the residency in June and now practices in Buffalo, says that R I C H A R D it sharpened his abilities. "We learned invaluable patient E . H A L L , D . D . S . , P H . D . , M . D . care, patient management, and basic surgical skills," he says. The residency experience also promotes closer ties with medical colleagues. "We have a very good relationship with the surgical community," Cecere says. "I think it also helped in that a lot of people didn't know what oral and maxillofacial surgery was all about. It was an education for the medical community." The specialty includes the diagnosis and treatment of diseases, injuries, and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. Oral and maxillofacial surgeons might be called upon to treat anything from impacted wisdom teeth to jaw dysfunction to serious facial injuries. They play a particularly important role in early detection of oral cancer. And, as the American population ages, oral surgeons are expected to encounter more complex medical problems. "Most people think it's just pulling teeth out, but it's not," notes Margarone. "It's really the specialty that bridges the gap between medicine and dentistry," says Richard E. Hall, D.D.S., Ph.D., M.D., Margarone's successor as department chair. B u f f a l o p h y s i c i a n A u t u m n 1 9 9 6 0 �Hall's own education "bridges the gap" very well. He earned his D.D.S. from UB, then went to the University of Rochester to a joint program in which he earned a Ph.D. in microbiology along with certification in OMS. Then, Hall earned his M.D. at UB. Margarone points out that an M.D. alone does not qualify oral and maxillofacial surgeons for broader hospital privileges or wider scopes of practice than their singledegree counterparts. The M.D., however, does open the door to more advanced medical training and specialization in areas such as plastic and reconstructive surgery or cranialfacial surgery. Of the UB program's graduates, four are in private practice. Another went on to a burn fellowship in "It does not make anybody a better Chicago and is now in a plastic and reconstructive surgery fellowship, and the sixth is completing a fellowship in surgeon. It does enhance their total aesthetic facial surgery. The M.D. adds to the surgeon's clinical perspective. "It approach to a patient. does not make anybody a better surgeon," Margarone says. "It does enhance their total approach to a patient." I O S E P H M A R G A R O N E , Research can also be an important part of the MOMS D . D . S . residency. The Department of Oral and Maxillofacial Sur­ gery has been intensely involved in three research areas: laser surgery, photodynamic therapy, and endocrine control of cancer. "The clinic feeds the basic science with the observations to direct it, and the basic science feeds back into the clinic," says Charles Liebow, D.M.D., Ph.D., the department's research director. Liebow, who once served as associate scientific director of the National Pancreatic Cancer Project, works with OMS residents and dental Ph.D. students on a variety of research projects. Some intriguing observations have come from laser surgery. "Patients seemed to have decreased pain and much less bleeding, almost hemostatic," Cecere remembers noticing. The observations led to experiments on how laser surgery wounds heal. "I was DOUBLE DOCTORS 0 B u f f a l o P h y s i c i a n A u t u m n 1 9 9 6 �able to show that there was an increased amount of epidermal growth factor and nerve growth factor in areas of the hamster cheek pouch." Jeffrey S. Kingsbury, D.D.S., M.D., who worked on laser-cancer research before graduating from the residency in 1995, has a new paper in publication on photodynamic therapy's effectiveness in treating precancerous lesions. Now in private practice outside Buffalo, he continues to do research. "It's done at times that would otherwise be off time or leisure time," he says. Part of his week goes to Erie County Medical Center and the Buffalo General Hospital, where he and his partner, Joseph E. Margarone III (the son of the former department chair), are involved with both outpatient and Oral and maxillofacial surgeons might inpatient care. At ECMC they're more likely to see gunshot wounds than impacted wisdom teeth. "The medical education is involved in b e called upon to treat anything from all my cases," Kingsburysays. "Itgives you a better global perspective on how to take care of those patients." impacted wisdom teeth to jaw dys­ According to the American Association of Oral and Maxil­ lofacial Surgeons, 39 of the nation's 106 OMS residency programs function to serious facial injuries. They now offer integrated OMS/M.D. training. "It's not a requirement to practice," says Cecere. "But you never know if it will be required in the future to belong to some play a particularly important role in of these HMOs and insurance companies. There is an element of discrimination already against single-degree oral surgeons in the early detection of oral cancer. And, a s health-care industry." The program receives about 100 applicants a year for its two the American population ages, oral openings, Hall says. Applicants are evaluated by a joint board composed of members of the admissions committees of the dental surgeons are expected to encounter and medical schools. Medical school admissions director Thomas Guttuso, M.D., was invaluable in helping to create the OMS/M.D. program and setting up its admissions and interview process, Hall more complex medical problems. and Margarone say. He remains a strong supporter. The MOMS program aims to cultivate the common ground between medicine and dentistry, they say. In parts of Europe, they point out, dentistry was traditionally considered a specialty of medicine rather than a separate discipline. "1 look at our department and our specialty as the causeway and the port of interaction between the medical school and the dental school," Hall says. "The medical component changes the perspective of the individual in assessing and caring for the patient." + B u f f a l o p h y s i c i a n A u t u m n 1 9 9 6 0 �One woman explains what the Women's Health Initiative means to her The women in the dietary and hormone groups are also being recruited to partici­ pate in a randomized calcium and vitamin D trial intended to quantify the effect of those nutrients on bone fractures and colorectal cancer. une DiGiacomo doesn't mind answering nosy questions about Depending on when they join the her most private feelings, medical history, and general aches and study, the women in pains. In fact, she willingly drove an hour to Buffalo from her the WHI will be fol­ lowed for nine to 12 home in rural Indian Falls, NY, for the ordeal. "I'm doing it for years. UB has also re­ my daughter," she says. "If this can help her and other women in the ceived funding and NIH approval to con­ future, it's worth it." duct two ancillary studies, the Women's The 67-year-old DiGiacomo is one of Principal investigator Maurizio Health Initiative 164,000 women across the nation who Trevisan, M.D., the chairman of UB's Memory study, which are participating in one of the largest Department of Social and Preventive will measure the ef­ clinical trials ever; the $625 million Medicine, says that the Women's Health fects of hormone Women's Health Initiative. Sponsored Initiative is also designed to address replacement therapy by the National Institutes of Health, the previous research biases toward middle- on cognition; and a multifaceted study is expected to pro­ class white subjects. There are extra study of the relation­ duce a vast database on the health of efforts to recruit African-Americans, ship between bone postmenopausal women. Asian-Americans, Native Americans and density and perio­ The research will focus on diseases other minorities, and to enroll women dontal health. that are unique to women as well as from all economic groups. Recruiting women those that manifest themselves differ­ UB, one of 40 participating centers for the hormone trial ently in women and men—topics that around the country, is expected to reach has been the hardest, have receivedscant attention in the past. its goal of enrolling 3,900 subjects this the researchers say. Morbidity and mortality from cardio­ winter. The women, all between the Some women refuse vascular disease, cancer, and osteoporo­ ages of 50 and 79, are being divided into to try hormones sis will be studied. two trial groups and an observational under any circum­ "Women are different from men, and group. stances because of the people are finally beginning to realize In a dietary modification trial, 1,067 fear of cancer, while that," says Karen Falkner, Ph.D., the women are being taught how to severely others can't wait to try WHI recruitment coordinator for UB. reduce their fat intake. In a hormone them because of the "Part of the problem, of course, is replacement trial, 611 women are being relief they provide from hot flashes and that there haven't been a lot of women randomized and given hormones or pla­ other symptoms of menopause. It's hard researchers, and women researchers cebo. The remaining 2,222 women— to find women who do not have strong generally have more of an interest in including DiGiacomo—make up the opinions about hormone replacement doing research on women," adds Jean observational group. These women will and therefore would be willing to be Wactawski-Wende, Ph.D., a co-princi­ answer annual questionnaires and have placed in a random trial, they say. pal investigator. two physical checkups three years apart. "This is an extremely important part J © B u f f a l o P h y s i c i a n A u t u m n 1 9 9 6 �says June DiGiacomo, a participant in the Women's Health Initiative at UB. •'/ >1 4s m t< * of WHI, because there is conflicting information about hormone replace­ ment, and there are really no long-term, clinical trials," Trevisan notes. While enrollment is nearly finished, it will be years before the first results are released. Meanwhile, both researchers B u f f a l o P h y s i c and subjects take pride in feeling that they are part of a historic endeavor. "We all have daughters," DiGiacomo says, gesturing to several other WHI par­ ticipants in an office in UB's Farber Hall. The women, several of whom are friends, chat about their families and drink coffee i a n A u t u m n 1 9 9 6 as they fill out the questionnaires. "I know that this isn't going to do me much good because we won't start to get any answers for another ten years," she adds. "But it will do other women some good. That's why I wanted to do it." + — B Y J E S S I C A A N C K E R 0 IE * �MEDICAL What medicine looks like man of the medical school's Department of Pathology. Terplan let Diedrick set up an easel in a corner of the department and soon named him assistant curator of the Pathology Museum at $70 a month. When a photographer at Buffalo Gen­ eral Hospital died, Diedrick took a twoweek crash course in the use of the camera and was hired in his place, bringing his monthly salary up to $200. "That was enough to get married on,in those days," he says. In 1937, he married the hospital's chief switchboard operator, Bertha Wagner. Another supporter at the medical school was Wallace Hamby, M.D. "Luckily, I was there when neuro­ surgery came to Buf­ falo," Diedrick says. "Wally Hamby had just recendy estab­ lished a new neuro­ surgerydepartment. And I was interested in this new and ex­ citing division of sur­ gery. I was in the right place at the right time." Hamby not only gave Diedrick steady work in a fascinating new field, but champi­ oned the need for real medical illustra­ tion throughout the school. "Hamby encouraged Mel," agrees Mildred Sanes, the former medical editor of the Buffalo Evening News and a friend of Diedrick's. "He felt there was a future for him at the university." And there was: Diedrick became an integral part of the school, illustrating lectures, presentations, and articles for publication in medical journals. Then came World War II. With many physicians away at the front, the demand for illustrations dwindled. To support his growing family—including his young sons, Douglas and Curtis, Diedrick painted physicians' portraits. SEEING ANATOMY THROUGH MEL DIEDRICK'S EYES F or more than 40 years, Melford Diedrick advanced the state of medi­ cal scholarship in Buffalo and con­ tributed to medical learning and research throughout the world. But Diedrick isn't a doctor. He's an artist. Diedrick, now 84, was the first trained medical illustrator in Buffalo and served as UB's director of medical illustration from f947 until his retirement in f977. A Buffalo native, he studied illustration at the Rochester Athenaeum and Mechan­ ics Institute (now the Rochester Institute of Technology) in the early 1930s. Soon his longtime fascination with medicine and human anatomy led him to thejohns Hopkins University. There he studied in a department called Art as Applied to Medicine under German emigre Max Broedel, considered the father of medi­ cal illustration in the United States. From dissecting cadavers and observ­ ing autopsies, Diedrick learned not only how to draw the human form, but how it worked. "Max Broedel was a great influ­ ence," notes Harold Brody, M.D., re­ tired chair of UB's anatomy depart­ ment anda close colleague of Diedrick's. "He was a passionate person about details—he felt every detail of a medi­ cal illustration had to be absolutely correct." Despite his training, Diedrick found that bringing medical illustration to Buffalo wasn't easy. "When I first came to the University of Buffalo in 1935," recalls Diedrick, "the dean of the medical school didn't know what I meant by medical illustration. I had to pull an example out of my briefcase to show him." "The faculty didn't know either. They 0 were largely clinicians, and didn't realize how illustrations could help in their teach­ ing. For example, Dr. Roswell Park wrote an important surgical text, but it had few illustrations, and they were poor ones." Armed with his "graduation certifi­ cate" from Johns Hopkins (a hand-writ­ ten letter from Broedel), Diedrick took his mentor's advice and offered his services to the university free of charge. Relatives provided room and board. He earned pocket money the first summer by substitut­ ing for vacationing morgue attendants and cleaning animal cages. And he Mel Diedrick admires his great-grandson, Michael William White. Above, an illustration that Diedrick considers one of his best: "Gracilis muscle used to repair severe radiation damage," created for John Graham, M.D. preached the gospel of medical illustra­ tion to anybody who would listen. One of his first converts was Kornel Terplan, M.D., the newly named chair­ B u f f a l o P h y s i c i a n A u t u m n 1 9 9 6 �MEDICAL SCHOOL Things picked up when Max Thorek, M.D., offered him the opportunity to es­ tablish a Department of Medical Illustra­ tion at his American Hospital in Chicago. The offer spurred UB to act, and in 1947, the university gave Diedrick the title of director of medical illustration at a salary matching the Chicago offer. "Mel was an on-the-spot illustrator," recalls Brody, who regularly requested Diedrick's services. "He would go into the surgery room and drawwhile surgery was being done, making sketches which he would develop later." "Occasionally physicians would try to tell Mel how they wanted him to make a drawing," says Sanes with a smile. "He had no hesitancy about telling them that medicine was their field but drawing was his, and that he was the best judge of how to present the subject." His drawings played an important role in teaching medical students in this coun­ try and abroad, including Sweden, where he went at the invitation of a surgeon at the University of Goteborg. His illustra­ tions have been included in a number of surgical atlases. He also illustrated in the entire 500-page text Vaginal Surgery, by two former members of the UB faculty, David Nichols, M.D., and Clyde Randall, M.D., which is now in its fourth edition. The illustrations were some of the last Diedrick drew professionally. "The last illustrations 1 did were the most exciting for me," he says."They were the most productive for clinical work." He also helped make medical matters more comprehensible to the general pub­ lic. In the 1950s, he illustrated a medical television show, "Modern Medicine," and later illustrated some of Sanes' weekly features in the Buffalo Evening News. But he didn't spend all his life at the easel. In 1946, he became a founding member of the Association of Medical Illustrators. He served as its president in 1963, and 30 years later was the recipient of its Lifetime Achievement Award—the seventh member to have been chosen. An enthusiastic violinist, he was a founding member of the Cheektowaga Community Symphony Orchestra in 1961 and played in its violin section for11 years. In 1982, Diedrick moved to Queenstown, MD, where he now lives with his son, Douglas. His wife, Bertha, B a u f f a l o P h y s l c i died in 1995. Brody recalls fondly what he valued about Diedrick's drawings. "His aim was to teach the body, not idealize it. That perhaps is what is most important about his work." + — B Y L U K A S H A U S E R Siegel awards recognize excellence in teaching T he Louis A. and Ruth Siegel Teaching Awards recognize excel­ lence in teaching by members of the preclinical, clinical, and volunteer faculty at UB. Based on student nominations and review by a student committee, they are presented at the medical school's spring faculty meeting. The awards were estab­ lished by the late Louis A. Siegel, M.D., a volunteer faculty member of the Department of Gynecology and Obstetrics. 1996 PRECLINICAL AWARD: Perry Hogan, Ph.D., Physiology Commendations: Charles Severin, Ph.D., Anatomical sciences Perry Hogan, Ph.D. John Wright, M.D., Pathology Roberta Pentney, Ph.D., Histology James Marshall, Ph.D., Social and Preventive Medicine Reid Heffner, M.D., Pathology 1996 CLINICAL AWARD: Jerry Chutkow, M.D., Neurology Commendations: Mary Jane Petruzzi, M.D., Pediatrics Harvey Bumpers, M.D., Surgery n A u t u m n 1 9 9 6 Scott Zuccala, M.D., Obstetrics and Gynecology Mary McGorray, M.D., Medicine Ehsan Afshani, M.D., Radiology Robert Scheig, M.D., Medicine 1996 VOLUNTEER AWARD: Thomas J. Foels, M.D., Pediatrics Commendation: Tad Traina, M.D., Pediatrics 1996 HOUSE STAFF AND SPECIAL AWARDS: Karen Houck, M.D., Obstetrics and Gynecology Leszek Kolodziejczak, M.D., Surgery Jose Aranez, M.D., Obstetrics and Gynecology Patricia Sticca, M.D., Pediatrics Calphor Carty, M.D., Pediatrics Kee Wee, C.C. IV Anand Singh, C.C. II © �Tut the hest seat in the house in yourgarage. © Gift establishes award for minority medical sludenls i $10,000 gift from the National Medical Association will support an annual award to honor a graduating minority medical student. Charles L. Anderson, M.D. '73, spearheaded the NMA's fundraising efforts to establish the award in the name of the Buffalo chapter of the NMA. "As a student at UB and now as a member of the clinical faculty at the medical school, I've become very much aware of how important it is for minority medical students to be honored for their hard work," said Anderson, UB clinical assistant professor of family medicine and imme­ diate past president of the Buffalo chapter of the NMA, which is the oldest and largest organization for minority physicians in the United States. Award recipients will be chosen on the basis of academic achievement, leadership qualities, and commitment to serving minority populations. "Only 6 percent of American physicians are minorities. We must recognize the medical students who are representative of these minority groups and who clearly reflect the NMA's vision," said Buffalo NMA chapter president Luther K. Robinson, M.D., UB associate professor of pediatrics and director of clinical genetics and dysmorphologyat Children's Hospital of Buffalo. The first award will be presented next spring. + 1997 Buick Riviera Riviera: the most sophisticated personal luxury car Buick has ever offered. It is designed to stir the spirit and excite the soul. We at Paul Batt Buick are proud to serve the people of Buffalo and its surrounding communities. For the last 43 years, we have offered the lowest prices possible, along with the very best in service. We value the professional and the hard working labor force in our community and will continue our efforts to maintain their loyalty. When you enter our showroom you will find helpful people, not pressure—so when you think of Buick sales and service, we know you'll think of us! Joseph R. Pera Paul V. Batt, Jr. Margaret Paroski, M.D., past president of the Medical Alumni Association, William Siener, Ph.D., the director of the Buffalo and Erie County Historical Society, Kenneth J. Levy, Ph.D., senior vice provost of UB, and medical school dean John Naughton, M.D., meet to dedicate a plaque at one of the original sites of the UB medical school in downtown Buffalo. 0 f f 1717 Walden Ave., Buffalo, NY 891-5595 u t u m �A PART OF HISTORY... THE UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES has a long and distinguished history—and you are part of it. In celebration of its Sesquicentennial, a beautifully illustrated pictorial history of the Medical School is available for your personal library or office. This hardcover, 192-page keepsake, Another Era, contains 250 photos, including rare, historical photographs that will transport you to a time when... Q) a) u Medical School tuition was $65 a year and "good board, with room, fuel and lights" could be found for $4.50 a week. UB medical students were the first in the United States to witness a clinical demonstration of o live birth—which caused an outcry in newspapers nationwide! Retrace 150 years of achievement, trials and tribulations in this special limited volume, and take pride in the Medical School's vision for its future. To order Anotherfraby credit card call Wadsworth Publishing Company at 1-800-369-2646 ext. 3339 — I $39.95 including shipping and handling. Gift cards available upon request. Charges will appear on your statement as Wadsworth Publishing. B u f f a l o P h y s i c i a n S p r i n g 1 9 9 6 © �MEDICAL PI S C H 0 0 I Simulated patients help teach med students E ach examining room in the Uni­ versity Physicians Office holds a man or a woman in a white coat prodding and questioning a gownclad patient. Seems like business as usual— only these patients aren't sick. They're actors making $12 an hour to help teach medical students how to be doctors. In these "standardized patient ex­ ams," actors follow scripts detailing a standardized patient's history, physi­ cal conditions, and personal character­ istics. Some of the medical problems portrayed include lung cancer, ectopic pregnancy, AIDS, and depression. Medical students are videotaped and scored after each 15minute clinical en­ counter. The exams are meant to test com­ munication, historytaking, and physical exam skills. Students talk to pa­ tients and may go so far as to feel a stomach or look in an ear, but do not perform any other physical exams. If the student recom­ mends that the stan­ dardized patient un­ dergo a particular test or exam, the patient will offer paperwork © showing simulated results of the test. The actors are ordinary people in­ The standardized patient exam pro­ cluding medical personnel from the gram began three years ago after a University Physicians Office, their survey showed that professors and friends and family, and graduate stu­ medical students wanted more pre­ dents who respond to postings on bul­ cise, standardized, and immediate letin boards. Karen Zinnerstrom, the methods of assessing clinical ability. patient recruiter and trainer, said that A growing number of medical she looks for people who "don't mind schools around the country use stan­ talking about their bodies and aren't dardized patient exams; the National condescending towards students." Boards are expected to incorporate Some of the 20 patient profiles are them within a few years. UB does not written at UB, while others are pro­ use the scores for promotion or gradu­ vided by the National Boards or other ation now, but may do so in the future. medical schools in the U.S. or abroad. "You really utilize what you've read UB uses 40 actor-patients in all, with and what you've learned," says Keung two actors trained to portray each stan­ Lee, 29, a fourth-year student in the dardized patient. M.D./Ph.D. program. "It's not what After each exam, the medical stu­ you know, learn, or read in a text­ dent fills out a form assessing the book, but how you apply that knowl­ patient's condition and outlining treat­ edge to realistic situations." ment plans. Standardized testing with trained The patient also fills out a form actor-patients is intended to be uni­ evaluating the student's performance, form, objective, and reliable, accord­ including whether students properly ing to Frank Schimpfhauser, Ph.D., washed their hands and introduced assistant dean for educational research. themselves at the beginning of the exam. The program has had the unexpected benefit of making the standardized patients much more savvy in their real-life dealings with doctors. Heidi Kueber, a doctoral stu­ dent in education who has served as a stan­ dardized patient since 1994, says, "I have be­ come a better patient, and when I have to choose my next doc­ tor, I will feel more comfortable doing it." + —ERIN S T . JOHN KELLY B u f f a l o P h y s i c i a n A u t u m n 1 9 9 6 �A STUDENT'S PERSPECTIVE Could medical school provide a different learning environment? BY VICTOR FlLADORA r at grades and test scores to measure stamina, motivation, and persistence." If Gomez is correct, and grades do rep­ resent other factors in addition to knowl­ edge, there should be alternative ways to gauge a student's success. There are many medical students who strive to perform well for reasons other than obtaining good grades. If students are not motivated by grades, why con­ tinue with that system? Do professors not feel confident enough in their stu­ dents, or in their own objective evalua­ tion skills, to use more innovative meth­ ods? How will medical school graduates be measured? By their practices, or by grades? Studying for grades is a non-produc­ tive way to demonstrate knowledge. Per­ formance-based compensation, on the other hand, is a system that is used for professionals in many fields, and should be considered as a possibility in medical education as well. Thomas Guttuso, M.D., direc­ tor of admissions at UB's medical school, stresses that it is impera­ tive to have a good knowledge base to be a successful physician. "No matter how good your personal qualities may be, your effective­ ness as a good physician is based on your knowledge base. So the better your knowledge base is, the better you are able to integrate that knowledge into a clinical setting, and the more effective you will be." An important factor in attaining that knowledge base is motivation. The intelligence may be there, but if the individual is not properly moti­ very studenr in medical school is an accomplished individual with J a solid educational background. V In order to gain admission, stuI dents have met a standard of edu* • cational excellence, measured by grades and test scores. Since the first day of kindergarten, these grades and scores have represented competency and success, and they have become a part of our identity. Acceptance into medical school is the culmination of years of hard work, dedi­ cation, and accomplishment which is based in large part on academic success. In professionalschools such as medi­ cal school, why does competency con­ tinue to be judged by grades after stu­ dents have proven their worth through the admission process? Ellis Gomez, M.D., of Niagara Fam­ ily Health Center believes that "we look B u f f a l o p h y s i c i a n A u t u m n 1 9 9 6 vated, the highest levels of success will not be achieved. New incentives would increase indi­ vidual motivation and create students who are more eager to learn. Does it make more sense to reward students with grades, or with opportunities that could further their careers and benefit the school? Rewarding students with grants for summer research, internships, or oppor­ tunities to study abroad instead of grades could create a whole new breed of stu­ dents. Pride would no longer be bound to a letter. It could be attached to meaning­ ful events throughout a student's educa­ tional experience and would create a valuable knowledge base in each of us. Students can read about any topic, but the most effective learning occurs when you actually participate person­ ally. Performance-based opportunities could provide students with the ability to experience many things they have only read about. They would also help students to retain their love for medicine. Many students have very fine thoughts in their hearts and souls as to why they want to enter medicine. They're usually very humanistic, and unfortunately many of them change because of what they go through in medicine. Performancebased opportunities could assist stu­ dents in maintaining that motivation and focus. The fundamental question that must be asked is what makes more sense? Do medical schools want to produce clini­ cians with good grades being the mea­ sure of competency, or would it better serve the profession to provide meritbased opportunities as motivation to those who perform at the highest levels of mastery? + In every issue, Buffalo Physician invites a current medical student to write an opinion piece about a topic of his or her own choice. Victor Filadora is in his third year at UB School of Medicine and Biomedical Sciences. © �Alan J. Lesse, M.D. protective capsule. "We're not sure how it manages to evade the host's defenses in the absence of a cap­ sule," Lesse says. BPF has also been identified in central Australia. The emergence of the same infection in widely separated populations of H. aegyptius means that the bacteria has acquired virulence more than once—and could do so again. "Our hypothesis is that the viru­ lence of the BPF organism arises from a confluence of several differ­ ent virulence factors," Lesse ex­ plains. "When all the factors are present, then you can have an or­ ganism that invades the host." Lesse and his colleagues have iden­ tified some of those virulence factors in the surface proteins of the BPF organism. Some can arise spontane­ ously even when there's no outbreak In 1984, a small town in Brazil was devastated by a deadly illness. Ten children, ranging in age from three months to eight years, were suddenly attacked by a virulent disease that caused high fever, vomiting, abdominal pain, purpura, and shock. Within 48 hours, all the children were dead. The illness was named Brazilian purpuric fever (BPF). It took several years and other out­ breaks before researchers discov­ ered that the disease was caused by an unexplained mutation of a very common bacteria, Haemophilus influenzae biogroup aegyptius. This particular bacteria usually causes nothing more serious than conjunctivitis. Somehow, in the BPF outbreaks, it had been trans­ formed from an annoying local infection to an overwhelming sys­ temic disease with a 70 percent mortality rate. It may not be immediately obvi­ ous why a faraway childhood dis­ ease should be of interest to Veter­ ans Affairs medical center research­ ers in Buffalo. But this summer, the VA's Alan J. Lesse, M.D., won a $160,400 grant to perform a fouryear study of the disease. macology and Toxicology, and Microbiology, Lesse is also the as­ sociate program director for the Department of Internal Medicine's house staff. In addition to his re­ search, Lesse sees patients in the VA's clinic and wards, and teaches pharmacology and microbiology at UB. He has twice been the recipi­ ent of UB's Siegel Award, which is based on student nominations for excellence in teaching. Lesse, 40, earned his bachelor's degree and M.D. from the Univer­ sity of Virginia, completed an in­ ternship and residency in internal medicine at Temple University,and did a combined fellowship in in­ fectious disease at the University of Virginia and its Affiliated Hospi­ tals Program in Roanoke, VA. It was during his fellowship that Lesse first started researching H. influenzae in connec­ tion with meningitis. After coming to Buf­ falo, he turned his at­ tention to the bac­ teria's lipooligosaccharides. When the Centers for Disease Control distributed the BPF bacteria to in­ terested researchers, Lesse joined col­ leagues at UB to in­ vestigate it. Lesse explains that Brazilian purpuric fever, which has been classified as an emerging disease and a potential threat to the U.S., is relevant to the entire world. "No one knows how the Haemophilus bacteria acquired thevirulence fac­ tors that make it so deadly. If we understand how that works, it might help us learn something about other emerging diseases." Researchers also want to know whether bacteria can transfer these virulence factors, or epitopes, to other bacteria of the same or differ­ ent species, he adds. An associate professor in UB's Departments of Medicine, Phar­ B u f of BPF. In fact, one of the epitopes has been discovered in a 1981 culture from a patient in Buffalo. "You might be able to find in nature an organism that has one or two of these factors," Lesse says. "Our goal is to identify all or most of these factors and then deter­ mine how they interact with the host to cause the disease." + fay Jessica Ancker One mystery is that, unlike many virulent bacteria, the BPF organism is not surrounded by a f a l o P h y s i c i a n A u t u m n 1 9 9 6 �Why stay home for the holidayo? Reunion chairs prepare for reunion weekend festivities I ft, t's not too early to plan for the 1997 Spring Clinical Day and Reunion Weekend. A cocktail reception will be held on Friday, April 25, 1997. The 60th Spring Clinical Day and Reunion Dinners will be on Saturday, April 26. For more information, call the Medical Alumni Association at 716-829-2778. The reunion classes are the classes of 1947, 1952, 1957, 1962, 1967, 1972, 1977, 1982, 1987, and 1992. Here's what your reunion chair has to say to you! CLASS OF 1947 I I $399 mo. 59 mo. leave $o down # s f W CLASS OF 1957 CLASS OF 1952 The front-wheel drive 1nfiniti® G201 Germante Bancaldo, chair It's time to get to­ gether! We need to see each other. Burton Stulberg, co-chair Don't miss the 45th reunion. How great it will be to see how nobody really changes. It won't be hard to get reacquainted—and what fun it will be to get together again. $319 mo. 50 mo. leant . $0 down <A> CLASS OF 1962 Sebastian Fasanello J T\\ u f f a l o P h y s i c Our past reunions have been wonder­ ful—this one will be magnificent!! 1^9 •IT Help us to win the attendance trophy again by your pres­ ence at your 45th. Xj: Like every Infiniti, the G20 comes with an extensive list of standard luxury features; A 4-year/60,000 mile Basic New Vehicle Warranty; 2-l-hour Roadside Assistance Prayram Trip Interruption Benefits; and our Free Service Loan Car Propram. Neat Fuhr, co-chair B performance and oervtce of Infinite A 45th reunion may not seem as impor­ tant as a 50th, but don't waituntil then! Come to your 45th! Let's all get together and reminisce about the last 50 years as physicians. « An interior more opaciotu than a Roi/.i Royce Silver Spur III. An exceptionally generate' Hot of otandard luxury featured. A 190-hp V6 capable of out-accelerating many luxury V8o. And of couroe, the otandard-oetting Robert Baumler, co-chair William Bukowski, chair P\ The front-wheel drive Infinite' I 30'" a n A AUTO PLACE INFINITI 8129 MAIN ST., WILLIAMSVILLE 633-9585 East of Transit Rd., Near Eastern Hills Mall lb n i I N Ft NITI G20 42 mo./130 42 mo. lease with cash or trade equity down. (G20-5495) (130-5450). Bank fee + tax and license due at inception. 12,000 annual mileage. $.12 per mile in excess. u t u m n 1 9 9 6 © �HURWITZ & FINE, PC A T T O R N E Y S CLASS OF 1967 Donald Miller and Thomas O'Connor, co-chairs Thirty years ago we partied big time. Let's plan to do it again. It won't be the same unless you are here. We'll be in touch with all the details. CLASS OF 1982 CLASS OF 1977 NEEDS OF THE HEALTH SCIENCES COMMUNITY • Managed Care • Purchase & Sale of Practices • Business & Tax Planning CLASS OF 1987 • HCFA Safe Harbor Regulations and Physician Self-Referrals • Contracts with Private & Public Entities • Employee Relations Counseling Alan Beitler, co-chair Ten years—how time flies! Do you won­ der where everyone is, and what they are doing? Come to our reunion, catch up, and have a great time. See you there. • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues Thomas Smith, co-chair Ten years is no t long enough to forget all the fun we shared. Hope to see all at the reunion. • Facility Finance and Construction • Credentialing CLASS OF 1 992 and By-Laws Paul Paterson, chair Five years—such a short time, but so much has happened. Come get together in April 1997 to catch up! + Nedra Harrison, co-chair It has been 20 years since graduation! We have a lot to share with everyone. Come, enjoy, share, and have fun! • Hospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence M. Ross at 716-849-8900 Gregory Young, co-chair Twenty years have come and gone. Don't miss this chance to get together before any more slip by! Nedra and I are look­ ing forward to seeing you. Take the time to help us renew old friendships. © L A W SERVICING THE LEGAL Michael Cesar, chair "Blessed is the man that walketh not in the counsel of the ungodly, nor standethinthewayofsinners, nor sitteth in H Br the seat of the scorn• m ful. But his delight is in the law of the Lord, and in his law doth he meditate day and night." CLASS OF 1972 Murray Morphy, chair Jimi Hendrix and Janis Joplin won't be here, but we hope you will. Share life's best revenge and live well with your 25th reunion classmates next spring. A T 1300 Liberty Building Buffalo, New York B u f f a l o P h y s i c i a n A u t u m n 1 9 9 6 �Save $60 off Next Computer Purchase! UB alumnus heads medical society '66, is medical director and administra­ tor of the Millard Fillmore Surgery Cen­ ter and chair of the hospital's Depart­ ment of Anesthesiology. He served as an anesthesiologist in the Vietnam War. Elizabeth F. Maher '85 is the organization's new treasurer. An at­ tending physician at Medina Memo­ rial Hospital, she is also a clinical in­ structor in the UB Elizabeth L. Maher B ussell W. Bessette, D.D.S. '69, M.D. '76, was installed in May as the new president of the Medical Society of the County of Erie. Bessette, who is in practice with the Buffalo Medical Group, P.C., is the clinical chief of plastic surgery at Buffalo General Hospital and a clinical professor of surgery at UB. Currently serving a six-year term on the New York State Public Health Coun­ cil, he was appointed chair of the group this June. Bessette is also a past president of the UB Medical Alumni Association. Two other UB alumni were also in­ stalled into new positions with the Medi­ cal Society: Franklin Zeplowitz '58 as president-elect, and Nedra J. Harrison '77 as vice president. + Zeplowitz chairs UB fundraising organization f a l o P h y s i c Call for current pricing and availability! SURF THE NET! Create Your Own Web Page! Adobe PageMill MAC...$61 WINDOWS.... AVAILABLE THIS FALL! MODEMS F i J f Check Out Our Compaq Presario Line! • Adobe SiteMill Mac...$153 • PC Anywhere Win...$65 Win95....$73 • Netscape Navigator Mac...$55 WinAVin95..$45 Can't connect from home without one! ranklin Zeplowitz '58 is the chair of the James Piatt White Executive Committee. Founded in 1986, the James Piatt White Society is made up of donors whose annual gifts to the medical school are $1,000 or more. It is named after one of the founders of the UB medical school. + ack F. Coyne '85 began his tenure as president of the board of the Medical Alumni Association at this year's Spring Clinical Day in May. Coyne, a pediatrician at Niagara Falls Memorial Medical Center, is also a Greek Orthodox priest with a particular interest in providing medical and social services to the poor. He is medical director at Memorial Pediatrics, which provides a wide range of services for children and families. He is also the medical director of child advocacy teams in Erie and Niagara counties that in­ vestigate sexual abuse. Coyne's message to fellow alumni appears on the in­ side front cover of this is­ sue of Buffalo Physician. The Medical Alumni Association's new vice Jock F. Coyne president, Jared C. Barlow u COMPAQ. Department of Emergency Medicine. Maher chaired and mediated the May 1996 Spring Clinical Day program. + New alumni board members elected B Save 3% off advertised price on cash sales of $200 or more. Alumnus chairs radiology department INTERNAL Starting at... $79 EXTERNAL Starting at... $83 Many Brands! Supra • US Robotics • Boca Modems • Practical Peripheral • Global Village ngelo M. DelBalso, D.D.S. '72, M. D.' 78, has been appointed chair of UB's Department of Radiology. DelBaso, the author of Maxillofa­ cial Imaging, is director of radio­ logy at Erie County Medical Cen­ ter. He also holds faculty appointments at the Uniformed Services University of the Health Sciences in Bethesda, MD, and UB's School of Dental Medicine. A colonel in the U.S. Army Reserves, he is chief of radiology with the 865th U.S. Army Reserve General Hospital in Niagara Falls, NY. + WORKSHOPS Introduction to the Internet's Services...$119 Oct 15 & 16 (OR) Dec 4 & 5 Customized These private workshops are tailored to your needs. They are available and very affordable. Call 645-3560 for information! American Express Cards Welcome! Open Mon, Tues, & Fri 11am-5pm,Wed & Thurs llam-6:30pm Call for current pricing and availability. Prices subject to change without notice. UB •mM C R O A non-profit University program for students, facutty & staff The Commons » North Campus » (716) 645-3554 « Fax: 645-3884 i a n A u t u m n 1 9 9 6 ® �Elliott C Lasser, M.D, radiologist LASSER WINS DISTINGUISHED ALUMNUS AWARD FOR HIS WORK IN THE FIELD OF CONTRAST MATERIALS RESEARCH B Y J E S S I C A E A N C K E R lliott Lasser '46 didn't choose radiology. He was ordered into it. His career choice was made for him at Camp Lejeune, NC, where he was serving in the U.S. Navy after going through college and UB medical school in the accelerated military training program. "Our commanding officer, who hap­ pened to be a radiologist, had developed an anemia of some kind," Lasser re­ members. "He came to me and said, 'Lasser, from now on you're the radiolo­ gist around here.' I went to the books frantically looking up everything I needed to know." Despite this unpromising beginning, Lasser's marching orders developed into a lifelong love of radiology. During nearly 50 years of research and practice, Lasser has established the field's stan­ dard screening tests for new contrast media, learned how to identify patients at risk of severe reactions to contrast media, and determined ways to prevent the reactions. He is also the founder of an unusual set of international meetings that regularly bring together academics and representatives of rival pharmaceu­ tical companies to discuss contrast me­ dia research. Contrast Media Research '97 will be held in Kyoto, Japan. "If I really contributed anything of substance, that's probably the thing that will have the greatest impact over time," says Lasser, 73. "It's the only meeting where representatives of various com­ panies discuss their work without try­ © ing to hide everything from each other. It's contributed to the speed with which research is being carried on in this field." Lasser has served as chief of the radi­ ology departments at Roswell Park Can­ cer Institute, the University of Pitts­ burgh, and the University of California at San Diego, where he is an emeritus professor and an active researcher. "As long as I have the interest and funds I hope to keep on going," says Lasser, the winner of this year's Distin­ guished Alumnus Award from the UB Medical Alumni Association. Lasser began his formal training in radiology, after his two-year stint at Camp Lejeune was up, at the University of Minnesota, where he completed a radiology residency and earned a master's degree in radiology. He trained in neuroradiology at Serafimer Hospital in Stockholm, Swe­ den, where he learned special proce­ dures involving insertion of catheters to inject contrast media to targeted struc­ tures. Later, as chair of radiology at Roswell Park, he began investigating the causes of the occasional reactions to the contrast media, which could range from mild to fatal. "Every radiologist has had patients who experience reactions. I never had a death myself, but I was lucky," he says. "I went to the standard textbooks ex- Elliott Lasser, M.D. (right), with Medical Alumni Association president Jack Coyne, M.D., and Dr. Lasser's wife, Phyllis. Lasser was awarded the Distinguished Alumnus award in an October ceremony in Buffalo. B u f f a l o P h y s i c i a n A u t u m n 1 9 9 6 �RARANSKI AI'A'JUJUIJN "EVERY RADIOLOGIST HAS HAD PATIENTS WHO EXPERIENCE REACTIONS," LASSER SAYS. "I WENT TO THE STANDARD TEXT­ BOOKS EXPECTING TO FIND ALL THE INFOR­ MATION I NEEDED, AND TO MY SURPRISE I DIDN'T FIND ANYTHING ABOUT IT." Your advertising presents your company image to the public... and to prospective pecting to find all the information I needed, and to my surprise I didn't find anything about it." Contrast materials and patient reac­ tions became the focus of his research. He has found that patients with asthma, allergic diathesis, or certain other hy­ persensitivities are more likely to expe­ rience contrast media reactions. He has indentified at least three mediators that play a role in contrast media reactions: histamines, heparan sulfate, and bradykinin. Lasser's recent research involves nitric oxide and contrast media reac­ tions. It was Lasser who helped demon­ strate that a simple two-dose course of oral corticosteroids protects patients from reactions; the treatment is now routinely used for high-risk patients. Tests he developed are now used rou­ tinely by pharmaceutical companies evaluating new contrast media for tox­ icity. His interest in contrast media reac­ tions led to research into asthma that has suggested a possible evolutionary advantage to the condition. Lasser has B u f f a l o P h y s i c shown that a substance commonly found in asthmatics' blood, heparan sulfate, appears to protect against arteriosclero­ sis. Asthmatics also have higher blood levels of high-density lipoproteins, pro­ viding another level of protection against arteriosclerosis. "When I presented this to my own group, my colleague said, 'How can I get asthma?'" In his free time, Lasser enjoys tennis and golf. He also recently took up wood carving. He says he had never forgotten the good smell of carved wood from the summer camp he attended as a child, so with his wife, Phyllis, he took a few lessons from a friend. "I picked up a piece of wood from his wood pile, and tried it, and lo and behold, 1 wasn't as much of a klutz about it as I thought I would be." In fact, he has become pro­ ficient enough that his wife stopped doing it—she says he's too competitive about it. Lasser has no plans to give up radiol­ ogy any time soon, though. "Throughout my whole career I've been paid for something I love doing," he says. "I'm very lucky." + i a n A u t u m n 1 9 9 6 clients and customers. At Baranski Advertising, we are proud to represent some of the finest publications in Western New York, publications where your advertising message is sure to reach a quality audience. CALL US TODAY (716)645-6933 MICHAEL J. BARANSKI Marketing Representative P.S. We did this book! Q �T H E N a n d n o f Albert James Myer, the founder of the National Weather Service B Y B E R N A R D L . W l G G I N he man who developed the National Weather Service would have enjoyed the satellites and computers that it relies on today. Albert James Myer, who earned his M.D. from the University of Buffalo in 1851, was a man for innovation and advance. Myer, born September 20, 1828, spent much of his father, a Buffalo judge, died in 1857. youth in Buffalo with a straitlaced aunt who taught him He developed a military signaling system called the severe mores of a God-fearing Scottish home. "Wigwag" cross signal communications, using At the age of 14, he went to Geneva College (now flags in the day and torches at night. After the Hobart and William Smith), where hespread himself thin military adopted the Wigwag system, Myer be­ between studies, sailing, horseback riding, and faculty came a signal officer and later took charge of baiting. His interests were the sciences, languages, and the signal office. He served with valor in the mathematics, but for five years top grades eluded him. Civil War, where his signals helped summon After the University of Buffalo Medical School was founded in 1846, Myer returned to Buffalo, HE DEVELOPED A MILITARY SIGNALING SYSTEM CALLED "WIGWAG" becoming a telegraph op­ erator by night and a CROSS SIGNAL COMMUNICATIONS, USING FLAGS IN THE DAY AND TORCHES AT medical student by day. His graduate thesis, "A NIGHT. AFTER THE MILITARY ADOPTED THE WIGWAG SYSTEM, MYER BECAME A Sign Language for Deaf Mutes," showed his early SIGNAL OFFICER AND LATER TOOK CHARGE OF THE SIGNAL OFFICE. HE interest in visual commu­ nications systems. Myer suffered a physi­ SERVED WITH VALOR IN THE CIVIL WAR, WHERE HIS SIGNALS HELPED SUMMON cal breakdown after his graduation in 1851 and RELIEF TROOPS TO HELP THE UNION CAUSE IN SEVERAL TIGHT SPOTS. was ordered to have a complete rest. He soon recovered to practice medicine in Charleston, SC, and Monticello, FL. In 1854, relief troops to help the Union cause in several he received a commission as an assistant surgeon with the tight spots. U.S. Army. He was reorganizing the corps when he be­ He served at Forts Davis and Duncan in the heart of came involved with a bill authored by congress­ Apache country in Texas; married his grammar-school man and general Halbert E. Paine of Milwaukee sweetheart, Kate Walden; and became wealthy when her to create a national weather service. A Joint © B u f f a l o P h y s i c i a n A u t u m n 1 9 9 6 �T H E N A N Congressional Resolution was passed and signed into law in 1870 by President Ulysses S. Grant. To set up the new service, Myer asked for $15,000 for the first year and $25,000 for the second year. He solicited advice from scientists around the world, and expanded the Fort Whipple Signal School in Arlington, VA, to train weather observers. (Fort Whipple has since been renamed Fort Myer in his honor.) In October 1870, 25 weather observers with the rank of ser­ geant were sent on de­ tached duty to 25 loca­ tions between Boston, MA, and Omaha, NE. The reports were tele­ graphed to Washing­ ton and a selected list of reports sent back to the stations in under 90 minutes. At first, reports con­ sisted only of current weather information. Myer himself issued the first forecast on November 8, 1870, and soon hired profes­ sional forecasters. The National Weather Service be­ came a success almost overnight. Metropoli­ tan newspaperslike the New York Herald be­ gan to publish the com­ plete daily output of the weather bureau. More forecasters were hired and trained, and demand grew for such services as flood warnings and river stage reports. Under Myer, the National Weather Service began to exchange reports with Canada, and observation stations were established on Mt. Washington in New Hampshire and Pike's Peak in Colorado. Instrumented balloons were flown over the U.S. and Europe. Two polar expeditions carried observers from Myer's bureau. B u f f a l o P h y s i c i a n A u t u D N 0 W In 1873, the International Meteorological Conference in Vienna adopted Myer's idea of asking all countries to make simultaneous observations each day at 7:55 a.m., Washing­ ton time. Two years later, the first international weather bulletin was issued from Myer's office, followed in 1878 by a weather map covering the northern hemisphere. With his service attracting interna­ tional acclaim and curiosity, Myer re­ turned to Buffalo in failing health in 1880. Upon hearing of his illness, Congress pro­ moted him to briga­ dier general. Myer died Au­ gust 24 of that year in Buffalo's Palace Ho­ tel overlooking Lake Erie, surrounded by his wife and their six children and bya spe­ cial staff of medical friends. He had truly expended his life in the service of his country. + The late Bernard Wiggin worked for the National Weather Service in Buffalo from 1945 to 1965. This story is condensedfrom an article published in the December 1970 Smithsonian magazine, with the gracious permission of the author's wife, C. LeonaWiggin. In June of this year, the National Weather Service,now under the jurisdiction of the National Oceanic and Atmospheric Ad­ ministration, dedicated its new weather forecast office in Buf­ falo to Myer. It is the only weather forecast office to be dedicated to an individual. m n 1 9 9 6 1 3 5 �CLASSNOTES 9 3 O staff of the Cornwall Hospital in s and Lisa is in eighth grade. Cornwall, NY. KENNETH GOLDSTEIN '39. ELLIOTT A. SCHULMAN '74, of Williamsville, NY, retired in D A N I E L A . P I E T R O ' 7 3 , of of Wynnewood, PA, has moved 1983. He spends six months in Canton, MA, was recently named his neurology practice to Crozer- Florida and six months in medical director and vice presi­ Chester Medical Center in Williamsville each year, and he dent at Sturdy Memorial Hospi­ Chester County, PA. He is the tal in Attleboro, MA. He also director of the Center for Head­ continues to practice cardiology ache Management. He and his on a limited basis at the Harvard- wife, Bonnie, have two sons: Brockton-West Roxbury Veter­ David (10) and Andrew (9). plays tennis three times a week and golf four times a week. T H E O D O R E W . K O S S ' 4 1 , of ans Affairs Medical Center, and Smithville, TN, had a total hip is assistant professor of medi­ replacement but writes that he cine at Harvard Medical School KATHLEEN BRAICO '74, of was "up and about in no time." and Brigham and Women's Hos­ Queensbury, NY, share a pediat­ Retired, he livesa half-mile from pital. He recently celebrated his ric practicewith three other doc­ his fishing boat, Marian, and goes 25th wedding anniversary and tors and a nurse practitioner in fishing every day. 19 6 s I R V I N G S . K O L I N ' 6 5 , ofWinter Park, FL, will participate as BRAICO '74 Glens Fall, NY, at the edge of the of surgery at UB and an adjunct Terresa are at Tufts University, Adirondacks. As well as practic­ clinical associate professor at the Daniel is a junior in high school, ing general pediatrics, John is heavily New York College of Osteopathic Medicine. involved in tionwide studies of a new psy­ choactive compound to be tested ALAN in the treatment of schizophre­ Wilmington, DE, was voted by nia. He also made a presentation fellow physiciansone of the "Top J. FINK '70, of AND CALL ME IN THE MORNING! ft on "New advances in the treat­ Docs in Delaware" in neurology ment of drug dependency" at in Delaware Today magazine. the winter meeting of the Fink American OsteopathicSociety in Lippmann '70, who is in pulmo­ St. Petersburg, FL. nary medicine in Philadelphia, higher education level than was named to a "Top Docs" list any other car owner group, of Kailua-Kona, HI, writes, " I writes that Michael M I C H A E L B A R O N ' 7 1 , of 1996 and working for Kaiser Blountville, TN, is affiliated with Permanente at their Kona Clinic Midway Medical Group in as the pediatrician." Bristol. He writes, "I am con­ of East Aurora, NY, has been elected 1996-97 president of the Sisters Hospital medical staff. A surgeon specializing in breast care, Eckhert is the medical di­ hospital are trying to manage health care and not be managed by it." Iowtomid20's; leases starting at $299 per month. * According to the Insurance Institute for Highway Safety (IIHS), the Saab 9000 has the lowest fatality rate of any (FRON^ f 56J" (H«IR^ production car on the market. SOUTHTOWNS SAAB $ 3580 Southwestern Blvd JOHN Center. He has been chief of Washingtonville, NY, has been surgery at Sisters since 1988. He elected president of the medical E. K N I P P ' 7 2 , of B u f f 0w*\ fOefe/. * Saab purchase prices starting tinuing my practice of pulmo­ in an area where the doctors and yOuf * Fact: Saab owners have a nary and critical care medicine rector of the Sisters Breast Care © iryJ in Philadelphia magazine. am moving to Hawaii in August KENNETH H. ECKHERT '68. the TAKE TWO... principal investigator in two na­ DONALD J . WALDOWSKI '65, and has four children. Michael and is an assistant clinical professor 0 JOHN (1 Mile east of Rich Stadium) (716)662-8008 �CLASSNOTES neurodevelopmental evalua­ in the United Kingdom, and I as director of refractive sur­ Carolina in Charleston, SC. 1 tion of children with learning teach at both Tufts Medical gery and director of the have just begun a general ra­ disabilities. Kathy also serves School and the New England Montefiore Laser and Eye Cen­ diology practice at Heritage as the medical director of the School of Acupuncture. My ter. He previously spent more Hospital in Tarboro, NC, and Hole-in-the-Woods camp for first two books, Natural Medi­ than 12 years in Tampa, FL, at an outpatient clinic in Rocky seriously ill children in Lake cine for Heart Disease and where he served as director of Mount, NC. I am married with Luzerne, a Paul Newman Natural Medicine for Back Pain, cornea services and vice chair four children, ages 7-13." camp. She describes it as "not have just been published by of the Department of Ophthal­ unlike repeating one's resi­ Rodale Press." Emma, the old­ mology at the University of dency every summer!" est of his four children, is start­ South Florida. G L E N N S . R O T H F E L D ' 7 5 of '76, M.D. '79. of Williamsville, NY, was chosen for the ing at Columbia University this fall. Somerville, MA, is the founder LEONARD G. FELD, PH.D. B A R R Y R O S E N B E R G ' 7 8 , of American Health special issue Rocky Mount, NC, is board featuring "The Best Doctors in America: The Nation's Top and medical director of Spec­ L E W I S R . G R O D E N ' 7 7 , of certified in internal medicine trum Medical Arts of Arling­ Pleasantville, NY, has returned and practiced in West Palm M.D.'s Chosen by their Col­ ton, MA, a primary care prac­ to New York to join the full- Beach, FL, for 10 years. "I have leagues." Chief of pediatric nephrology at the Children's tice combining conventional time faculty of the Department recently made a change in and complementary medicine. of Ophthalmology, Montefiore careers, having completed a Hospital of Buffalo and a pro­ He writes, "I trained in acu­ Medical Albert radiology residency at the fessor at UB, he is a pediatric puncture in Leamington Spa Einstein College of Medicine, Medical University of South representative to the National Center, WNY's Largest Volume BMW Dealer IF BEING STARED AT MAKES YOU BLUSH, PLEASE CONSIDER YOUR CHOICE OF COLORS ACCORDINGLY. THE ULTIMATE DRIVING MACHINE.' town | R G. DOWNING Towne BMW 3030 Orchard Park Rd. Orchard Park, New York 14224 Phone: 675-2550 $29,320 With a plethora of colors to choose from, you'll want to pick a roadster that goes with the crimson hue you'll be sporting each time you take it for a spin. 1996 BMW Z3 Service Loaners Available...Minutes From Rich Stadium B u f f a l o P h y s I c I a n A u t u m n 1 9 9 6 © �CLASSNOTES Pediatric Transplant Commit­ JOHN CLAUDE KRUSZ '83, It was great seeing everyone at tee of the United Network of of Dallas, TX, is the medical the reunion. See you all again Organ Sharing. director of Nursefinders Home in 5?" Health Co. He writes that he is the only board-certified neu­ C A R L G . C O L T O N ' 8 6 , of rologist also certified in Lancaster, PA, began working pain management in the as a gastroenterologist in July north Texas area. 1995 in Lancaster. He and his wife, Mary Katherine, have Buffalo Physician has e-mail! three children: Ashley (8), '84, of Worthington, OH, Brittany (5), and Graham (2). was granted tenure at Ohio M I C H A E L T . R O S S ' 8 1 , of Detroit, MI, is developing and implementing a customer ser­ vice and communication train­ ing program for medical and State University, where he ANDREW P. GIACOBBE '86, was promoted to associ­ of Buffalo, NY, is enjoying his ate professor of neurology. third year of plastic surgery He remains director of practice in Buffalo and recently neuro-oncology. His fam­ became certified by the Ameri­ ily announces the birth of daughter Ashley Rene New­ can Board of Plastic Surgery. He and his wife, Laura, re­ ton, born onjanuary 23, 1996. cently celebrated the birth of She weighed 8 pounds, 13 their second child, Andrew ounces and was 22 inches long. Alexander. Their daughter, Cristina, is 4. Ashley's older brother, Alex, is 3. Our e-mail address support staff of the Henry Ford for dassnotes and Health System in Detroit. He continues to work in emer­ J O N W A R D N E R ' 8 5 , of Ann gency medicine. He writes, Arbor, MI, is "in busy group private practice in central New "Jacob Edward, our third PM&R practice at St. Joseph Jersey as a board-certified child, joined the family on Mercy Hospital and a clinical general surgeon. She has two March 29. We're ecstatic. instructor at the University of boys: Jonathan (5), and Vanessa, now 7, enjoys piano, Michigan Medical School. Had Nathaniel (1). She writes that a rendezvous with Jim Esser classmate Bob Halpern is an comments is bpnotes@pub.buffalo.edu Please send us the ballet, and acrobatics. Joshua, 3, loves raising Cain." latest news about ARLENE ROSE CURRY '82, your life, career, and of Brooklyn, NY, is working fulltime in the Department of L E I L A S . G R A Y S O N ' 8 7 , of Freehold, NJ, has relocated to '85 at the University of Michi­ emergency department physi­ gan/Indiana University foot­ cian at Edward Hospital in Naperville, IL. ball game in Bloomington in October 1995. He came in from Kentucky. Michigan won." PEGGY (MOREY) STAGER '88, of Cleveland Heights, OH, family. Don't forget Emergency Medicine at Saint Vincent's Hospital in New K A R I N E . C H O Y ' 8 6 , of Las to include your home York City. "My husband, Vegas, NV, writes, "I'm leav­ nounce the birth of their son, ing the chilly winds and snow­ address and the year John, and I are the proud par­ ents of Alyssa (4 1/2) and Tristan (1)." Samuel, on April 1, 1996. you earned your M.D. from UB. A L B E R T S P E A C H ' 8 2 , ofLex- ington, KY, and his wife, Terri Speach, announce the birth of Byron Nelson Speach on May 2, 1995. © HERBERT B. NEWTON B U F F falls of New England for the heat of the Desert Southwest to start up a new pediatric clinic for Kids Health Care, an outpatient center affiliated with Columbia-Sunrise Chil­ dren's Hospital in Las Vegas. Everyone come visit and play! and her husband, Richard, an­ M I T C H E L L T U B L I N ' 8 8 . and Mary C. Davitt '88, have re­ cently moved to Albany, NY, where they have joined the faculty of the Albany Medical College as assistant professors of radiology and pediatrics, �CLASSNOTES respectively. They proudly an­ nounce the birth of their sec­ DOUGLAS P. PREVOST '90, ond son, Joshua Martin, born of Snyder, NY, writes, "My April 15, 1995. wife, Anita, and I are proud to announce the birth of our P A U L A S A N D L E R ' 8 9 , of fourth child, Jack Anthony, Yonkers, NY, has started a fel­ who arrived May 8, 1996. He lowship in neurology, voiding joins his two brothers, Ryan dysfunction, and urodynamics (4) and Connor (2 1/2), and at Columbia University. Be­ his sister, Claire (17 months). fore that, she had been in pri­ It is quite a houseful!" vate urology practice in Beckley, WV, since complet­ H O W A R D L . S T O L L III ' 9 0 , ing her residency injune 1994. Vf of Charlottesville, VA, is com­ pleting a residency in radio­ H O W A R D C H A N G ' 8 9 , of San logy at the University of Vir­ Diego, CA, will be joining the ginia, and will be returning to pulmonary and critical care Buffalo to join the Southtowns medicine group at Sharp Me­ Checkpoint Foreign Car, Inc. Radiology Group. "My wife, morial Hospital in San Diego. Sales and Service TheDollar Doctor... • 487 Kenmore Avenue Buffalo, NY 14223 836-2033 Information Insights Opinions Finances Stocks & Bonds Call in Listen In Your WNY Leasing Specialist Serving WNY proudly for 33 years WWKB, 1520 Saturdays 9:05 to 10:00 am (J§)aperston I. I I S I A . I S I C : i a i . I N C . Member: American Stock Exchange, NASD, SIPC 237 MAIN STREET Tel: 854-7541 B u f f a l o P h y s i c i a n A u t u m n 1 9 9 6 © �CLASSNOTES Theresa, and I had our first resident in orthopedics at the child, Christopher Howard University of Colorado. They Stoll, on Nov. 16, 1995." add, "Neil Waldman '92 lives ROHIT "ROB" BAKSHI '91, of Buffalo, NY, writes that he is "pleased to have returned to c around the corner. He just took an ER position in Montrose, CO, and is married to Nori Garcia, D.D.S." his hometown to begin an aca­ demic practice at the Dent A N D R E W B A U E R ' 9 3 , of Neurologic Institute and the Tacoma, WA, completed his UB DepartmentofNeurology." pediatric residency at Madigan After medical school, he served Army Medical Center in an internship at Massachusetts Tacoma and is moving to General Hospital and Harvard Heidelberg, Germany. In Medical School before com­ March, he presented a poster pleting a neurology residency at the Uniformed Services Pe­ at the UCLA Medical Center. diatric Society meeting in He has recently completed an Maclean, VA. Bauer has a new MRI and CT neuroimaging daughter, Samantha, born fellowship at the Dent Insti­ Jan. 18, 1996. Marriott tute. A board-certified neu­ rologist, he will concentrate MICHAEL F. SWEENEY '93, on both clinical and research of Akron, OH, is married to interests in the areas of Liz (Zylka) and has a daugh­ neuroimaging and multiple ter, Molly Erin (1 1/2). He is sclerosis, as well as a general in the fourth year of his OB/ neurology practice. GYN residency at Akron City elebrate the From elegant parties to informal get-togethers, let the Buffalo Marriott host a celebration filled with warm fellowship and gracious hospitality. A , For Exceptional Entertaining . . . Banquet rooms accommodating 10 to 1000 "(S) Superb catering with choice of packages Expert planning assistance Hospital. MARY For Your Office Festivities . . . (CAPPUCCINO) BONAFEDE '91 and JOE BONAFEDE '91 , of Cleveland Heights, OH, announce the birth of their first child, Jo­ seph Samuel ("Sam") on Jan. 15, 1996. GAYLE(FRAZZETTA) SINGH ' 9 2 and VINEET SINGH '92. of Denver, CO, announce the birth of Vijay Rocco Murphy Singh in September 1995. They write, "Call for the story of (Vijay's) name. He spends *•'*» O B I T U A R I E S Enjoy a special holiday luncheon or dinner with Panache Restaurant's delicious steaks, seafood and pasta. G O R D O N J . H I P P E R T ' 4 5 . of For Anytime Holiday Cheer! Tucson, AZ, died May 12. He fgj Stop in The Night Club Lounge for dan< and socializing with old friends and new! served as a captain in the U.S. Book your holiday party today! Army Medical Corps before Call the Catering Office at 689-6900 Ext. 61. returning to UB for his resi­ dency in obstetrics and gyne­ Harriott. BUFFALO cology. A founding member of the American College of Ob­ stetrics and Gynecology, he 1340 Millersport Highway Amherst, NY 14221 (716) 689-6900 (800) 334-4040 FAX (716) 689-0483 was chief of staff at St. Mary's Hospital and Tucson Medical Center. most of his time eating and laughing—the apple doesn't fall far from the tree." Gayle is enjoying private practice in family medicine, and Vin is a © B u f f a l o P h y s i c i a n A u t u m n 1 9 9 6 �Our Risk Management Education Programming is always prime time. Who says there's nothing good on TV? As busy as they are, physicians and other health care providers always take the time to watch MLMIC's top-rated risk management education programs. • When they tune into high quality programming broadcast over our satellite network, viewers know whatthey see will help enhance patient safety and reduce injuries. They also appreciate the policyholder discounts available to participating physicians. • MLMIC programming is sponsored by the largest Risk Management Department of any professional liability insurer in the state. Policyholders also enjoy the protection of one of the country's largest and most experienced professional liability Claims Departments. Most importantly, MLMIC has successfully defended more physicians than all other available insurers combined. E These are some of the reasons why MLMIC is the only medical liability insurer approved by the Medical Society of the State of New York. • To find out more, call 1-000-356-4056 in Upstate New York, or 1-000-ASK-MLMIC in the New York metropolitan MLMSC area. Ask for free copies of our risk management Medical Liability 3 Mutual Insurance Company guide for office practices. • Our defense never rests. INVESTIGATE OUR NEW LOWER RATES. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 ©1996 Medical Liability Mutual Insurance Company �BUFFALO PHYSICIAN Non Profit Org. STATE UNIVERSITY OF NEW YORK AT BUFFALO U.S. Postage 3435 MAIN STREET -• BUFFALO NEW YORK 14214 -- Buffalo, NY ' Permit No. 3 ADDRESS CORRECTION REQUESTED PI.ANTING A TREE UNDER WHICH YOU WILL NEVER SIT DR. DEVILLO W. HARRINGTON, class of 1871, knew how to make his money grow. In fact, this man who in 1905 provided $5,000 through his will for the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. T H I S P E R M A N E N T endowment in Dr. Harrington's name has grown to over $300,000 and today it supports the famous Harrington Lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed funds at the school. They enable UB to provide scholarships to outstanding students, enhance scientific research, support excellence in teaching and meet the ever-changing needs of the school. You TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you develop a smart financial plan. A charitable bequest provides the satisfaction that comes from planting a tree under which you will never sit, but which will bear fruit for generations to come. FOR A CONFIDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact: STEPHEN A. EBSARY, JR. ASSISTANT DEAN AND DIRECTOR OF DEVELOPMENT, SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES UNIVERSITY AT BUFFALO UNIVERSITY AT BUFFALO (716) 829-2773 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1996 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1996-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v30n04-1996-Autumn Table Of Contents A list of subunits of the resource. Class of 2000 Double Doctors The Women's Health Initiative Research and Hospital News Letters Medical School News A Student's Perspective Young Faculty Profile Alumni News Then and Now Classnotes Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v30n04 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright 1996 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/acfbca490d0d46a29daa4cd49fe460a7.pdf d977bd88a38ba6e93f3ba303194d32e0 PDF Text Text �_ F R O M T H E D E A N Buffalo Physician VICE PRESIDENT FOR UNIVERSITY ADVANCEMENT Jennifer McDonough ASSISTANT VICE PRESIDENT FOR NEWS SERVICES AND PERIODICALS Arthur Page Dear Alumni and Friends, EDITOR Stephanie A. Unger ART DIRECTOR & DESIGN Alan J. Kegler and David J. Riley n August I had the pleasure of speaking to the Class of 2007 at their White Coat Ceremony. This ceremony is held as a symbolic "rite of passage" to mark their first steps towards en­ tering the medical profession and emphasizes the importance of professionalism and empathy in the practice of medicine. I warned these students that part of our profession involves telling people things they don't want to hear. This is not restricted to telling a patient he or she is facing a fatal illness. We deliver far more mundane "bad news" on a daily basis. I recalled a colleague once telling me, "If you never want to see a patient again, tell them they're fat or tell them they're crazy. If you really never want to see them again, tell them they're fat and crazy!" While said in jest, this remark high­ lights how uncomfortable most physicians are about talking to patients about these issues. We don't want to embarrass an obese patient by bringing up the topic of weight loss, and as a result obesity has become a national epidemic. We don't want to upset a patient by suggesting that a referral to a psychiatrist would be helpful, so conditions such as anx­ iety and depression go untreated. Our discomfort with discussing these issues is hurting our patients and we need to address it. Money is one of those topics that can be difficult to talk about. For years, our Medical Alumni Association has prided itself in being a "friend-raiser," not a fund-raiser. We were willing to solicit donations for class gifts at reunions, but otherwise wanted to stay at arm's length from the perceived distastefulness of fund-raising. We no longer have that luxury, because our discomfort with fund-raising is compromising the growth and evolution of our school. Years ago, when my father, James A. Werick,MD '49,was chief of medicine at St. Francis Hospital, he was concerned about how little money the hospital had available for con­ tinuing education for the nursing staff. So he started a fund called "Gimme Your Dough" (I kid you not, that was really the name; subtlety was never my father's strong suit!). I once asked him if he found it embarrassing to strong-arm the medical staff (which by then included me) into making donations. Not at all, he assured me. Not only was he not embarrassed, he was proud to raise money for this worthy cause. So today it is with pride, not embarrassment, that I am asking you to invest in the future of your medical school. Calvin Coolidge counseled us, "No person was ever honor­ ed for what he received. Honor has been the reward for what he gave." A recent cartoon in The Chronicle of Philanthropy showed one gentleman earnestly telling another. "I'm always embarrassed that I'm not giving more, so I don't give anything." Many of us assume that because we don't have the funds to endow a chair or a named scholarship, that our gift is meaningless. I assure you that every dollar donated makes a measurable difference in the quality of our school. If you haven't already, you will be receiving a call from a student about making a gift to the annual fund for the School of Medicine and Biomedical Sciences. Your generosity will make a real difference and your investment will generate important and tangible returns for our students, faculty and programs. M A R G A R E T PAROskf) M D " s o , M M M Interim Dean, School of Medicine and Biomedical Sciences Interim Vice President for Health Affairs DESIGN Karen Lichner CONTRIBUTING WRITER Lois Baker PRODUCTION COORDINATOR Cynthia Todd-Flick UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. Margaret Paroski, Interim Dean EDITORIAL BOARD Dr. John Bodkin Dr. Harold Brody Dr. Linda J. Corder Dr. James Kanski Brian Neubauer,Class of 2006 Dr. Elizabeth Olmsted Ross Dr. James R. Olson Dr. Stephen Spaulding Dr. Bradley T. Truax Dr. Franklin Zeplowitz TEACHING HOSPITALS Erie County Medical Center Roswell Park Cancer Institute Veterans Affairs Western New York Healthcare System KALEIDA HEALTH: The Buffalo General Hospital The Women and Children's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital CATHOLIC HEALTH SYSTEM: Mercy Health System Sisters of Charity Hospital Niagara Falls Memorial Medical Center © UNIVERSITY AT BUFFALO. THE STATE UNIVERSITY OF NEW YORK Letters to the Editor Buffalo Physician is published quarterly by the University at Buffalo School of Medicine and Biomedical Sciences in cooperation with University Communications. Letters to the Editor are welcome and can be sent c/o Buffalo Physician, 330 Crofts Hall, University at Buffalo, Buffalo, NY 14260; or via e-mail to bp-notes@buffalo.edu. Telephone: (716) 645-5000, ext. 1387. The staff reserves the right to edit all submissions for clarity and length. I University a t Bu f f alo , 9 The State University of New yotk �V O L U M E 38, N U M B E R © P H Features Remembering Samuel Sanes Professor—and cancer patient— whose teachings about physician communication skills still resonate 25 years after his death BY JACOB STEINHART, MD '45 Where Are We Today? A look at how UB medical students and residents today are being trained to be skillful communicators BY MARIA SCRIVANI Roseanne Berger. MD, senior associate dean for graduate medical education, left, and surgeons Robert Milch, MD '68, center, and James Hassett, MD, right, are leading efforts to teach communications skills to UR residents. COVER: PHOTO OF SAMUEL SANES PROVIDED BY UNIVERSITY ARCHIVES Medical: 18 UB selected by the AMA to develop professionalism curricula 19 Humanism in Medicine Award 22 "Lights, Camera, Suction," a look at the work of emergency medicine physician and photographer Elsburgh Clarke, MD '77 i isaipu Dealing, MD '43, endows dermatology chair at UB 32 2003 Stockton Kimball Award, Dean's Award 34 In Memoriam: Ellen Dickinson, Leon E. Farhi 36 UB molecular biologists discover novel way to inhibit the replication of poxvirus Development Classnotes 40 More on 45 News from Samuel Sanes and his legacy "Beyond the Classroom" 41 Annual list of endowments your UB classmates and other alumni 4R In memoriam: Harold Planker, MD '40 �E d i t o r ' s n o t e : Samuel Sanes, MD '30, was a much-loved professor of pathology and legal medicine who taught at the University at Buffalo for forty years, retiring in 1971. In the 1950s, he was coordinator of Modern Medicine, one of the first medical shows on television. He was also a moderator of the university's Summer Medical Roundtable, a talk show first on radio, then television. Sanes was dedicated to educating the public, and when he contracted cancer in 1973, he wrote a series of ten articles for Buffalo Physician on what he learned being a patient. Remembering The articles evoked strong and widespread responses from readers; by the time the fourth article was published, Sanes had received more than 100 letters from 17 states and two foreign countries. The majority of writers were physicians, colleagues and former students representing 24 areas of medicine; others included residents, spouses of physicians, nurses, members of the religious community and the public, including cancer patients and their families. Samuel Sanes P A T H O L O C S T T E A C H E R F R I E N D This year marks the 25th anniversary of Sanes's death. In the following article, Jacob Steinhart, MD '45, a former student and friend of Sanes, honors this anniversary by reviewing and commenting on the articles Sanes wrote for Buffalo Physician about his illness. In doing so, Steinhart acknowledges that, among other things, these articles played a role "in awakening our profession to the fact that medical students need to be taught communication skills while in school, rather than expecting them to learn these skills in a haphazard way through 'on-the-job-training.' He also commemorates the fact that "much progress has been made in end-of-life care over the past 25 years." — S.A.Unger I L L U S T R A T I O N S Buffalo Physician B Y M I C H A E L C E L E N A u t u m n 2 0 0 3 �n 1943,1 was a medical student in Dr. Samuel Sanes's pa­ thology class at the University of Buffalo* School of Med­ icine. I remember him so well. He was extremely popular. No one fell asleep during a session with him, as his booming voice kept us alert and eager to be prepared when called upon. Some brave souls even volunteered to give answers. If a student did not give a correct answer, however, he was never berated or left to feel bad. In the early 1970s I was invited to join the medical school's admissions committee and I sought Dr. Sanes's advice since he had been a member of the committee for many years. He generously gave me advice, which made me enthusi­ astic, and three years of interesting experiences followed. When he retired in 1971 after teaching at UB for 40 years, Dr. Sanes was looking forward to relaxation and travel. Because he was embarking on a new phase of life, he thought it advisable to have a thorough physical checkup. This he underwent, and his doctor gave him a clean bill of health except for previously detected cervical arthritis. He was ad­ vised to go ahead with the plans he had made for retirement and was not told to restrict his activities in any way. Sadly, 17 months later, in February 1973, he found a lump on his shoulder that on biopsy showed disseminated reticu­ lum cell sarcoma. He then had a complete diagnostic work­ up, from urinalysis and blood count to lymphangiograms and total body gallium scan, which confirmed the diagnosis. When I learned of Dr. Sanes's illness, I phoned him sev­ eral times to see if he would like a visit. I felt close to him not only because of these calls and the earlier advice he had given me, but also because he had sent me postcards when he traveled abroad. As his health continued to decline, he never had me over to visit. At first this left me disappointed and confused; later, I was able to understand his not wanting to be seen as his condition deteriorated. He was a very courageous man. He was a fabulous teacher. *In 1962, the University of Buffalo, a private institution founded as a medical school in 1846, merged with the State University of New York system to become University at Buffalo, The State University of New York. He was always well organized. He was a good friend and counselor. -J.S. A u t u m n 2 0 0 3 Buffalo Physician 3 �This year marks the 25th anniversary of Dr. Sanes's death. Those of us fortunate enough to be his students and his colleagues know that he not only was a talented teacher but also a gifted philosopher. This was demonstrated in a series of ten articles he published in Buffalo Physician between 1974 and 1978, titled "A Physician Faces Reticulum Cell Sar­ coma in Himself," in which he chronicles his illness. On the following pages are passages excerpted from these articles, along with brief commentaries I have added in an attempt to provide a context for Dr. Sanes's remarks where needed. It is clear to anyone reading these passages—whether 25 years ago, or today—that Dr. Sanes hoped his experiences and insights would prompt physicians and other caregivers to closely reflect on how they care for and communicate with patients who have a terminal illness. Certainly his writings had their desired effect on me, as having read them, I was—and am—more able to comfort­ ably and competently visit and talk with cancer patients. I can't help but think that Dr. Sanes's effort to publish these articles also played a role in awakening our profession to the fact that medical students need to be taught commu­ nication skills while in school, rather than expecting them to learn these skills in a haphazard way through 'on-the-job training.' As Dr. Sanes's experience demonstrated, this former way of learning left a wide and lonely gap in the care provided to some patients and, at times, put the patient in the position of having to better educate the physician. By publishing excerpts from these articles, it is my hope that we may be reminded of the fact that first and foremost Dr. Sanes was an exemplary teacher and that, through his writings, his legacy endures and is honored. Perhaps by reprinting his words here we will also be reminded of how much progress has been made in end-oflife care over the past 25 years. This, in turn, may inspire physicians practicing today to rededicate themselves to ensuring that this momentum continues. Excerpts from Buffalo Physician Part I A Physician Faces Reticulum Cell Sarcoma in Himself OMEONE ONCE SAID cancer is a lonely disease. It is especially true if its victim is a physician. No one who hasn't faced cancer in himself can truly imagine what a cancer patient is experiencing. Even those closest to the patient, who love him, can only sympathize. They can't empathize. Individual reactions toward disease and death spring from individual minds and hearts. They depend on various fac­ tors in one's personal life situation, character and personality, social and cultural background, what one knows about his disease. The cancer patient has not only a medical problem but a semantic one. The word "cancer" carries terrifying connotations accumulated over the centuries when it was practically 10Q. percent untreatable, incurable, fatal. u ffa Io Physician Autumn 2 oo3 Dr. Sanes found that the first three months following his diagnosis were the most difficult, as they were devoted largely to treatment, follow-up exami­ nations and resting at home. During this time, all of his physical problems seemed traceable to the radiation treat­ ment; for example, loss of hair, loss and perversion of sense of taste, diminu­ tion of appetite, fairly constant nausea, dry mouth, painful swallowing, weight loss, fatigue, and an episode of herpes zoster with fever. Before treatment he had no com­ plaints apparently referable to his dis­ ease, except the lumps. He was active, met social obligations and traveled. The disease and its treatment will be a monkey on a patient's back for the rest of his life. To the healthy person, even if he is no longer young, the future seems infinite. With his cancer diagnosis a curtain drops across it. Life becomes a matter of day-to-day planning. Goals are short-term ones. There is gratitude for a remission and despair over a relapse or resistance to further treatment. Many patients have to curtail social, recreational, orga­ nizational and community activities... Before taking a trip he may have to make arrangements for seeing a physician or physicians at intervals during his absence from home. To fight emotional and mental battles, Dr. Sanes formulated what he called "The Three A's": Acceptance of his disease, Adjustment to it, and �Assurance ... with the latter dependent His battle was won with time. As the cancer patient adjusts to life on the attention, notice, understanding Time, he found, was not only a with its limitations, through reason and sympathy of others. medium in which reason could neu­ and determination or as many do, tralize the potency of fears, but in itself through faith and prayer, he also adjusts When his cancer appeared, reason fail­ acted as a dilutent. His thinking and to death. No matter how self-sufficient ed to allay and dispel his fearful feeling became more positive. He de­ the patient may have been before his dis­ thoughts and he became increasingly termined to continue living and en­ ease wasdiagnosed, hecannotdo it alone. self-occupied. His fears were not so during, to make the best of life within Like most cancer sufferers, I needed much for his life as for the loss of all the limits imposed by his disease, to the assurance of others, wanted desper­ ately to be remembered by family, that made life worthwhile and enjoy­ fulfill as best he could his personal and able: useful work, multiple interests, social roles; in other words, not let the friends, professional colleagues and professional and personal relations. cancer take over all aspects of his life. co-workers. P a r t II R e s p o n s e s o f Lay P e r s o n s a n d P h y s i c i a n s to Patients with Disseminated Cancer R. SANES ATTENDED a clinic at Ros- education and practice. well Park Memorial Institute (now Ros- ... during the past one-and-a-half well Park Cancer Institute), where he years, with the exception of my immedi­ ate family, I have felt closer to no one met patients with disease similar to his. more than my fellow lymphoma patients. Forgetting the chronically ill—especially those with disseminated cancer—is easy for those who are chronically healthy. don't want to be reminded of death!" Thus the patient with disseminated Dr. Sanes further felt that physi­ cancer, who must contend with his own cians who are trained in oncology ap­ When we do respond to disease in an­ fears, is deprived by the fears of the healthy proach the patient and his family in a other person, we do so best when his illness of the assurance he needs. Unfortunately more understanding way, yet hold out is one that leads to recovery or cure after physicians in general have the same hang no false hope. five to ten days in the hospital and a brief ups about cancer that lay persons do. convalescence at home... But what of the For medical students, Dr. Sanes You might assume that as students in quoted the following words from Dr. Frances Peabody, professor of patientwhose recoveryis complicated;e.g., medical school and teaching hospitals by a stroke? ... The visitors stop coming. they should have acquired a holistic and medicine at Harvard University, who The occasional person who does drop in human approach to their patients, one died from malignant disease at age 46: enters the room reluctantly and departs as that would enable them to look at any­ quickly as possible. Few Americans re­ one with cancer as a sick person with a spond with understanding to chronic, lin­ variety of problems and needs, thoughts not just a photograph of a man sick in gering disease in other persons. and feelings. bed. It is an impressionistic painting of "What is spoken of as a 'clinical picture' is Patients with disseminated cancer [The physician] looks at patients in carry the heaviest burden. Psychologi­ terms of overcoming disease in as rapid a work, his relations, his friends, his joys, cally, I did need reassurance that I was fashion as possible, or holding it in check his sorrows, hopes and fears ... thus the still part of life. I didn't want to feel over the long run. Fie is liable to think less physician who attempts to take care of a forgotten, discarded, cut off from the about relief and almost not at all about patient while he neglects this emotional real world. comfort and consolation. factor is as unscientific as the investigator the patient surrounded by his home, his An empathetic physician can be the who neglects to control all the conditions crucial factor in preventing a family from that may affect his experiments ... Treat­ throwing away their time and money on ment of disease immediately takes its pro­ quackery ...I realize that in what I have per place in the larger problem of the care "People are cowards; they're terrified written about care and empathy for merely by the word 'cancer.' They don't chronic "incurable" patients I may have of the patient... the treatment of disease may be entirely impersonal; the care of want to see sickness or suffering. They done an injustice to today's medical the patient must be completely personal." He quoted a nurse who had years of practice with cancer patients: Buffalo Physician �P a r t III R e s p o n s e s o f P r o f e s s i o n a l C o l l e a g u e s a n d C o w o r k e r s to a Physician with Disseminated Cancer I AM NOW—18 months after diagnosis Dana Launer, MD '73, who had been of disseminated reticulum cell sarcoma diagnosed with Hodgkin's disease while and the onset of therapy—psychologi­ a second-year student. (Dana was in cally adjusted to my disease and its treat­ the last laboratory section Dr. Sanes ment. I am physically fairly comfortable taught before his retirement and, for­ and leading a satisfying active life intel­ 4. I would not overlook or minimize his tunately, his disease came under con­ lectually and socially. Yet it is good to symptoms or physical state and as­ trol and he graduated. Currently, he is hear from old friends and former stu­ sume—or pretend—that everything chair of surgery at Scripps Memorial dents, to know they are thinking of me, is the same as it was before his diag­ Hospital in La Jolla, CA. See related nosis and treatment. article on page 40; also, comments from that I am not forgotten. 5. I would guard against revealing any Based on his own experience, Dr. Sanes listed ways in which a physician should respond to a patient with dis­ seminated cancer: John Wright, MD, on page 11.) undue pessimism or offering extrava­ gant optimism on prognosis. 6. As to ways of expressing assurance, "Dr. Sanes, I heard through the med­ ical grapevine of your illness and can't I would consider the needs of the tell you what shocking news that was to patient. me. To be faced with malignancy is never 1. I would keep in touch with him, 7. As to discussions and conversations, I an easy experience, but to have this particularly during critical periods of would keep in mind some patients burden so soon after starting a 'new' life his illness. with disseminated cancer want to talk makes matters so much more difficult. 2. I would not necessarily express my openly about their disease. assurance and good wishes in the "I have felt the fear and frustration you feel now. I know very well what it is conventional way ... such as those Dr. Sanes found discussion of his for a patient with a recoverable, con­ experiences to be a catharsis. It helped Carpe Diem.' We must learn to ap­ trollable, curable disease. him accept reality and make adjust­ preciate each day and prize every oppor­ ments easier. tunity to enjoy our lives and loved ones." 3. I would determine whether he wel­ comes the opportunity to discuss his He appreciated receiving the follow­ disease and its treatment and, if so, ing note from a former student of his, like to wonder what the future will bring. discuss it with him. P a r t IV H i s R e l a t i o n s h i p w i t h O t h e r C a n c e r P a t i e n t s a n d S o m e o f t h e T h i n g s He L e a r n e d f r o m T h e m s a surgical pathologist turned lympho­ nisms of facing and coping with cancer, ma patient I came to see cancer as more about the meaning of anger, of faith and than a structural abnormality in a gross prayer, of humor and wit, of mutuality. specimen and histologic specimen. I also I must go on. I'll beat this son-of- saw it as involvement of the total hu­ man being in all the relatedness to him­ 6 a-bitch. cancer institute I have found myself a This is the anger bent on life and self, to other persons, and to the world source of information, a partner for sci­ survival. This is the anger I felt and around him ... I became keenly aware of entific discussion, a depository for con­ expressed. the changes that cancer, particularly dis­ fidences and a provider of assurance and We derive our philosophic ways of seminated cancer, brings about in inter­ personal example to other cancer pa­ coping from our upbringing, education personal relationships ... As a physician tients ... I have learned from my fellow and personal thinking and experiences. in the lymphoma-leukemia clinic of the patients'.. 7 of the fundamental mecha­ Buffalo Physician Autumn 2003 Men and women who have prided �Dr. Sanes did not turn to the super­ natural, but stated the following: patient's faith and prayer as part of the The cancer patient who believes in God as call in a qualified clergyman to assist in ity, cachexia and dehydration, urinary a loving Father, is never alone ... faith the care of the patient, particularly if the and fecal incontinence. and prayer are important coping mecha­ patient indicates an interest in religion but has no clergyman of his own. themselves on their self-sufficiency are no longer able to go it alone in the face of fear and depression, insomnia, pain, nausea and emesis, loss of weight, debil­ The wise physician will utilize a therapeutic armamentarium ... He can nisms for many cancer patients. Conclusion ANCER IS NOT a matter for levity and The empathy of flippancy. cancer patients for Cancer patients resent—even more each other can be of than healthy patients do—any indica­ real value as a coping tion that others take cancer lightly. mechanism ... A college girl composed ... an epic is an excellent coping mechanism for some New patients are "surprised" and "re­ poem, covering the whole struggle for cancer patients. It saves them from deny­ adjustment by the patient discovered to ing their predicament, from indulging in lieved" that others felt have lymphoma-leukemia: self-pity. It relieves inner tensions. It per­ helplessness, uncer­ 'Mope mits them to make other patients as well tainty and frustration Hope as themselves feel brighter and better. just as they do. Cope' Cancer patients identify with each Humor, genuinely felt and expressed, other... Part V Response of Readers by Letter t o Dr. S a m u e l S a n e s ' s S e r i e s here were many wonderful letters. The response to the series indicated that Dr. Sanes's experiences, observations and reactions struck a common note beyond anything he had anticipated. A typical letter stated, "I am glad you chose to communicate your expe­ rience to us in order to help us treat our patients with more understanding." P a r t VI, A, A C a n c e r : I t s E f f e c t s o n t h e F a m i l y o f t h e P a t i e n t r. Sanes introduced his next article, published in the winter 1976 issue of Buffalo Physician, with the following explanation: winter in Guadalajara, Mexico, I re­ families—pay more than superficial at­ my former students, who is now retired tention to the family of a cancer patient in Florida. "What did that for the present' In the autumn 1975 issue of Buffalo Physician, the Editors mentioned that experience of cancer in their immediate ceived a letter from a pathologist, one of mean?" she asked? "When are you going to resume the series?" for whom they have accepted primary responsibility? The physician who accepts a cancer pa­ tient professionally... has a dual respon­ my series of articles . . . had ended Here is my answer. sibility. Primarily he is responsible for for the present.' How often I thought do physicians— the well-being of the affected person, but A few months later, spending the healthy themselves and without the also, in a measure for that of his family. Autumn 2003 Buffalo Physician 7 �In any type and stage of cancer both Cancer in a family may be so divisive On the other hand, it may be so may need help in coping with the initial and destructive a force that it produces strengthening and unifying that it leads psychologic shock and panic induced by sufficient tension and friction to lead to to a closer, deeper and more sustaining the diagnosis. estrangement, separation and divorce. relationship than ever existed before. P a r t VI, B, Cancer: I t s E f f e c t s on t h e Family of t h e Patient OR SOME PHYSICIANS, communi­ cation with the family of the cancer patient is ... more difficult than com­ V «f5Tr'" i £ sometimes more so. Lack of proper com­ it difficult to talk frankly and sufficiently, emphatically patients and their families as total, inti­ and helpfully with the family ... mately related, interdependent human The following are a number of factors Dr. Sanes identified in an at­ tempt to explain this: as lay persons to the mental, emotional, economic and other effects of the disease, munication with the patient ... Some physicians ... find A physician who has cancer, and mem­ bers of his family, can be just as vulnerable munication intensifies that vulnerability. Some physicians may think or find beings, especially in a chronic, serious themselves too busy professionally and illness like cancer. personally to spend time communicating Conventional medical education has with patients and their families ... done little to equip the young doctor with I must be fair. knowledge how to convey the diagnosis Sometimes communication with the Even before applying for admission to of a potentially fatal disease or how to family of a cancer patient is notaproblem medical school, some individuals offer continuing emotional support which lies in the physician's personality through inborn and acquired influ­ along with physical care. ... Rather, it's a dilemma imposed upon ences develop a type of personality that Some primary care physicians relin­ the physician by the cancer patient him­ will inhibit or prevent them from re­ quish their relationship with a patient self who requests that the family not be sponding openly and confidently, un- and his family after they refer the patient informed of his disease. derstandingly and compassionately to to a center, clinic, group or specialist. Part VI, C, Communication, continued assistance and reassurance. The physician, too, benefits from free g^\ OMMUNICATION WITH a fellow pro- \- j fessional or his family in regard to cancer The patient who knows his diagnosis and open communication with the involves the same consideration as com­ and understands his disease with its family and with the patient. They will munication with a layman and his family. treatment and prognosis is better able to have more confidence in him, accept his (It) should include not only the giv­ cope and adapt to it than the patient recommendations and carry out his or­ whose physician keeps him in the dark. ders more faithfully. ing of the facts of the diagnosis and management of the disease, but help in ... and the knowledgeable, under­ (The physician) who so often feels understanding the treatment, course standing family is better equipped to defeated by medicine's failure when a and prognosis. It embraces continuing give him the day-to-day care and sup­ patient dies may find positive satisfac­ professional attention, information and port he needs. In so doing the family is, tion in continuing his relationship with referral for certain practical problems at the same time, helping to preserve its and supporting the remaining members that may arise (transportation, finan­ own well-being, stability, unity, perhaps of the family. cial assistance, etc.) and psychologic its very existence. Buffalo Physician Autumn 2003 �Part VI, D, Communication, continued E MUST CONSIDER both the giver and Patients and family welcome ancil­ receiver of information and support. lary personnel if they need and want The first is the physician—or those information and support that their members of today's medical team whom physicians cannot or will not give them. he calls in for communicating in their special fields of expertise. Ancillary personnel can smooth the ture, the primary care physician should path almost every step of the way but... The second is the family member or retain his relationship with the family, will not satisfy patients and their fam­ members who deserve, seek and need visiting the patient daily when he is in ilies when it comes to information about the hospital and continuing his visits as the medical aspect and problems of needed after the patient returns home. their disease. information and support. Even when specialists enter the pic­ Part VI, E, Communication, continued T ALL TIMES the physician should tell (The physician) at no time should ... Tell the truth as far as it is known the responsible family member or destroy hope by projecting personal feel­ from a scientific clinical basis. Beware of members the truth as far as it is known. ings, fears and liang-ups. He should not personal, emotional influences which That means during the initial workup, make unjustified predictions based on project pessimism and defeatism or false at diagnosis and throughout the entire his own lack of up-to-date knowledge optimism. Preserve hope if possible. course of the illness. and experience in oncology. Take all measurable and unidentified In his relationship with a family Hopelessness and helplessness may variables into consideration. Avoid spe­ member, or members, a physician ought disorganize family life. They can send cific chronologic predictions. Keep in not be just a scientific diagnostician and patients and families to other physi­ mind the possibility of future diagnosis therapist. He should also be an all- cians or even lead them to consult and treatment. Set up control as a more around compassionate communicator. quacks or to use scientifically unproven realistic goal than cure at a certain limit He should supply factual information, methods at a time when cancers may of oncologic knowledge and practice. educate, advise, counsel, make arrange­ still be in controllable form. ments and referrals, support the family psychologically. The family should be impressed with the fact that the threat of cancer never ends, even with a supposed "cure," and that it is good insurance to have periodic checkups. Samuel Sanes giving his final lecture upon retirement from the medical school in 1971. Autumn 2003 Buffalo Physician �P a r t VI, F, C o m m u n i c a t i o n , c o n t i n u e d OR THIS FINAL ARTICLE, Dr. Sanes no Here are some of the reactions he can longer could write because of muscular expect from families: weakness; instead, he dictated to his wife. 1. No apparent reaction or denial 2. Pyschologic shock The WAY we tell a patient and the family is as important asWHAT, WHY, WHEN and WHERE we tell them. ... if a physician can't be all things to all people there are steps he can follow to communicate with all of his patients. 3. Tears 12. See that the family gets information, 5. Insistence on more communication, nonmedical problems that may arise a second or third opinion, referral to as a result of the patient's cancer. another physician or to a medical or 13. Give the family your phone number. cancer center, a written report. Don't 1. Establish rapport. Advise them they should feel free 2. Be available and be on time. to call. 14. Advise the family that you will stick 3. Take time. 4. Go through the formalities of intro­ duction. Be calm and poised, open but not casual, objective but not cold, with the patientand with them for the and to expand upon it. 5. Avoid interruptions. 6. Be truthful and honest within the limits of available knowledge. 7. Use simple, understandable English, not medical terminology or jargon. 8. Avoid expressing your thoughts and emotions in nonverbal form which developments, including changes in Physician is still publishing my articles, I shall write about the HOW of commu­ 17. Keep your promises to the patient and nication during the apparent terminal the family. 18. Don't get angry if asked about a new proven or unproven treatment or 9. If the patient has cancer, say the elsewhere and whether it could be applied to the patient's case. 19. Don't get angry if a friend of the family intervenes. 10. Use a printed sheet or diagram to help 20. Preserve hope, encouragement and support as far as possible. get the message across. If I live long enough, if my physical treatment and reasons for them. procedure reported in the press or explain it. A final n o t e by Dr. S a n e s reads: condition permits and if Buffalo facial expression, tone of voice, etc.). When you do give a verdict of cancer, thing that is going to happen, and exactly how and when. 16. Keep the family informed as to new may upset the patient or family (e.g., word. And specify the type of cancer. respond angrily. 6. An obsessive desire to know every­ duration of the illness and beyond. 15. Don't try to give all the information at one time. Be prepared to repeat... warm and concerned. 4. Anger or rage education, advice and counsel about 11. Listen to the questions the family member asks and then answer them to the best of your ability. episode, of course based on my wife's observations and experience. There were no more articles due to Dr. Sanes's death. One can see that just as he taught us about tissues, organs, and the human body, he was even more determined to teach us about humanity, empathy and understanding of patients and their families facing the strong possi­ bility of death from cancer. We should be forever grateful. About the Author J a c o b M. S t e i n h a r t , MD ' 4 5 . i s a clinical p r o f e s s o r e m e r i t u s of p e d i a t r i c s a t t h e University a t B u f f a l o S c h o o l o f M e d i c i n e a n d B i o m e d i c a l S c i e n c e s . F r o m 1 9 5 1 t o 1 9 9 5 , h e w a s i n p r i v a t e a nndd g r o u p p r a c t i c e in A m h e r s t . NY. d u r i n g which t i m e h e a l s o s e r v e d on t h e f a c u l t y of t h e UB m e d i c a l school. He continues to teach one morning a week in the ambulatory clinic a t Kaleida Health' Women and Children's Hospital of Buffalo, where he supervises students, residents and nurse practitioners. Buffalo Physician Autumn 2003 �r Comments from Former Students and Colleagues t~l ONE OF THE MOST MOVING presentations I ever witnessed was one in which Sam teamed up with a UB medical student who, unknown to his classmates, was being treated for Hodgkin's disease.* Since it was Friday afternoon, the class was, to put it mildly, 'restless.' He introduced the student and observed they had become close friends; then he asked what a young medical student and an older man like himself had in common. When the medical student replied, 'We both have cancer,' silence was immediate—you could hear a pin drop. Sam, as usual, had the students' rapt attention for the duration of the session and not only taught them the pathology of lymphoma but dealing with malignacy in general. He was truly a marvelous human being and a teacher extraordinaire. His former students—most of us getting a little on in years—fondly remember this outstanding mentor, educator and friend. John R.Wright. MO Professor of Pathology *Seepage 40for more about this student, Dana Launer, MD '73. . DR. SANES SPENT much of his time at Millard Fillmore with the pathology residents and the OB/GYN residents ... He was always available to those of us who wished to learn and listen to his mini-lectures at our microscope. At these moments he was no longer the lecturer but an understanding teacher. A few years later, something momentous occurred when this gentle, quiet, modest man startled us with articles about his own illness, and more importantly, how he had been received within the medical community. In his later years he grew in stature. He became a voice for reform and compassion, and for some of us, a hero. Ray G. Schiferle. MD Clinical Assistant Professor Emeritus of Medicine IT IS AN HONOR to be asked to comment on Dr. Samuel Sanes. I remember being so impressed with the series of articles he wrote in this very same [magazine]. Thankfully, I had a chance to express to him that I thought they should be required reading for everyone in family practice residency. This is hereby recommended to every doctor who takes care of patients. George Ellis, MD '45 Cornersville, Indiana THE WEEK BEFORE SAM DIED unable even to turn from one side to the other without assistance, he lay in his hospital bed in Roswell Park Memorial Institute. I sat at his side. "Anyway," he murmured, knowing what lay ahead, "I still have my children." For a moment I thought he was dreaming! "Children?" I asked. "Yes," he replied, "my students." That says it all. He loved you all. Thank you for loving him too. Mrs. Mildred Spencer Sanes Former Buffalo EveningNews medical writer l! Unabridged versions of the articles Dr. Sanes wrote for Buffalo Physician—and additional comments from former students and colleagues—can be read at www.smbs.buffalo.edu/bp. The articles are also published in a book, titled A Physician Faces Cancer in Himself. which is available at the University at Suffalo's Health Sciences Library. Autumn 2003 "J Buffalo Physician 1 �Where ARE WE Today ? Assessing communication skills 25 years later BY MARIA SCRIVANI The practice of medicine, lately dominated by high technology and rampant pharmacology, is getting a heart transplant. a return to the kinder, gentler medical art practiced before the mid- to late-20th century avalanche of information— and the more recent focus on costs—had a decidedly negative impact on the doctor-patient relationship. Such was the insight of the revered UB professor of pathology Samuel Sanes, MD '30, who, prior to his death from cancer 25 years ago, wrote a series of articles in Credit a dedicated team of professors at the University Buffalo Physician about his experience as a patient (see re­ at Buffalo School of Medicine and Biomedical Sciences for lated article on page 2). "The physician looks at patients in aiding in the development of this treatment, which focuses terms of overcoming disease in as rapid a fashion as pos­ on training medical students and residents to be better sible, or holding it in check over the long run," he wrote. communicators. Among other things, this includes edu­ "He is liable to think less about relief and almost not at all cation in ways to present bad news to patients, as well as about comfort and consolation." how to skillfully address complex issues that arise in the care of patients with terminal or life-altering illnesses. In the years since Sanes's death, an appreciation for the need to teach medical students and residents effective and "It's not just about making patients feel better; it's sensitive communication skills has only increased, accord­ about practicing better medicine," says Jack Freer, MD '75, ing to David Milling, MD '93, assistant professor of clini­ an ethicist and UB associate professor of clinical medicine cal medicine and director for the introduction to clinical who helped develop the "How to Deliver Bad News" mod­ medicine course for second-year medical students. ule in the clinical practice of medicine course at UB. "What we've come to realize is how important it is for What is being taught today in the medical school the physician to understand the impact information has classroom and on residents' rotations is "an alternative on the patient. The patient must be made to feel comfort­ approach to being cool, collected and scientific," says able asking questions and must get the answers needed," Roseanne Berger, MD, a family physician and senior explains Milling, who is also assistant dean for multi­ associate dean for graduate medieafedacation at UB. It is cultural affairs in the UB Office of Medical Education. �Giving students a global perspective is the goal, he continues. "They tend to have tunnel vision when they come in, thinking communication skills are important in delivering bad news to, say, a cancer patient. But it's teaching and training programs in the field include a psy­ chologist or a behavioral scientist on its faculty to focus on teaching students and residents about communication and doctor-patient relations," she explains. "The expan­ much more than that. In a recent rehabilitation-medicine session, for example, we had a patient speak to a portion of the class about his experience with medical care. What he remembered most was how the news that he wouldn't walk again was delivered to him." Starting about 25 years ago, three factors in health care began to push patient-physician communication skills to the foreground, according to lames Hassett, MD, UB pro­ fessor of clinical surgery and director of the medical school's surgical residency training program. "The first was the realization that we had a responsi­ bility to interact more effectively with patients who were dying," he says. "The second factor was informed consent. How can a patient give this without being well informed? "The third was malpractice—and, over the years, what we have learned is that physicians are vulnerable to this not because of what they do so much as what they say or don't say; that is, how they discuss issues with a patient and his or her family." In the past five years, two additional factors have plac­ ed further emphasis on the need to train physicians to be good communicators, says Hassett. sion of this emphasis into other specialties has been very exciting." "The first is that patients are much more knowl­ edgeable about their health condition than they used to be," he explains. "They come to their physician's office with pages from the Internet and online queries and all sorts of other information. And they're right to do so, but they have much higher expectations and have learned to ask better questions." The second new factor is that the Accreditation Council for Graduate Medical Education (ACGME) now requires that communication skills be taught to residents. "And not only are we required to teach these skills to residents," Hassett notes, "but we must also prove that we have taught them before we can graduate the residents." Berger points out that family medicine was the first area of medicine to formally recognize the importance of teaching communication skills. "Ever since the inception of family medicine as a medical specialty, it has been mandated that all STANDARDIZED PATIENT PROGRAM EXPANDED A decade ago, UB instituted the Standardized Patient Clinical Competency Program to ad­ dress concerns that third- and fourth-year students were not learning the skills necessary to forge good doctor-patient relations. Standardized pa­ tients are persons trained to portray patients in specific scenarios in order to help evaluate medical students' com­ munication skills. "It's a way of carefully looking at perfor­ mance and trying to improve it,"says Karen H. Zinnerstrom, PhD, program coordinator for training and evaluation. Since its inception, the Standardized Patient Program has expanded to include first- and second-year students, as well as residents. During their first semester, first-year students are taught how to conduct a medical interview, including how to introduce themselves, how to elicit a chief complaint, how �to do a history of personal illness, and how to take a doctors, nurses, social workers and chaplains, so they get pharmacy record, according to Zinnerstrom. to see the patient through other professional eyes. Too, The students then combine what they have been taught and practice their skills with a variety of patients; for they take part in team meetings and family conferences to get used to the idea of communicating frequently." example they are required to complete a medical interview This is not the traditional multidisciplinary model, with a teenager and a geriatric patient. During the second where the doctor is on top and "everyone else tags along semester, they also learn how to complete a medical inter­ after," emphasizes Milch. Communication in the old mod­ view with a patient involved in domestic violence. In their second year, students take the "How to Deliver el is inconsistent, infrequent and too often "through the chart," rather than face-to-face or mouth-to-ear, he says. Bad News Module" and continue developing the clinical In addition to gaining exposure to a rich hospice exam skills they were introduced to during the second experience, participants in the elective also receive train­ semester of their first year. ing in other kinds of palliative care, such as that available "Currently, we also work with residents in surgery, family medicine and psychiatry," explains Zinnerstrom. "In psychiatry, for example, how do you tell someone through Roswell Park Pain Clinic, where participants can learn firsthand about symptom management. Within the elective, there is also a strong communica­ that his or her son has schizophrenia? There are many tion skills component, and the standardized patient pro­ different forms of bad news. gram is implemented. "Because we are teaching students and residents the "The focus is on dealing with the family and psychoso­ skills required for such difficult interactions, I think they cial and spiritual issues," explains Freer, course coordina­ are a lot more comfortable than they used to be." tor for the palliative-care elective. This focus, he adds, Getting doctors-in-training to hone their communi­ must take into account the fact that "ours is a death- cations skills is sort of like "imprinting in ducks" in the denying culture, and death has meant failure to us as phy­ sense that a skill learned early on is a skill retained and sicians, as well as to the system within which we work." passed on, according to Robert Milch, MD '68, medical Given this context, communication skills taught in the director for the Center for Hospice and Palliative Care and elective include how to begin talking to a patient about UB clinical professor of surgery and family medicine. "We the possibility that there is no cure, that his or her hopes have lost the opportunity to mentor, particularly at the cannot be met, and that it is time to start thinking bedside," he observes. "More and more medical work is about hospice. being done in the office and at outpatient clinics. You don't get to see the great doctors at work anymore." Milch sees a tremendous need for physicians to return Establishing a comprehensive and patient-centered care plan is the goal under these circumstances, explains Milch. "The one thing we hammer home with residents to the old model of hands-on medical care, especially and students is that they must ask: 'What are the patient's when treating highly symptomatic or terminally ill pa­ goals of care?' Then a plan of care is much easier to tients. "Our medical capabilities have rapidly outstripped articulate. The goals might be to maximize comfort, pro­ our wisdom," he says. vide psychosocial support to stressed family members, and PALLIATIVE CARE ELECTIVE It all adds up to better medicine for the patient and, to look at the body and mind needs in an advanced illness. A t Hospice, Milch and his colleagues oversee UB's palliative-care elective, designed to give professionally, it's a lot more gratifying for the doctor." participants "a full experience" with Hospice COMMUNICATIONS SKILLS—A CORE COMPETENCY and palliative care—interdisciplinary care that addresses the multiple needs of patients with ad­ vanced illness. "They learn about our services, what we can offer, and when it is appropriate to make a Hospice refer­ ral," he explains. "They are taught about the hospice Med­ icare benefit on which all hospice care is based, regardless of whether someone is a Medicare patient or not. They spend time in the unit, and make home care visits with irst-year surgical residents at UB are required to spend a week in the palliative-care elective, learning the kind of communication skills not generally attributed to those in this technology-driven specialty. (UB is one of the first schools in the nation to require this for surgical residents.) "Communicating with a patient about routine health �concerns is one thing, but communicating about end-oflife issues is very different and hard for surgeons to do," says Hassett. "It's hard because they're accepting defeat. "Many surgeons in training also have a sort of person­ al battle with cancer or trauma," he continues. "Although they realize they aren't going to be able to help everyone all the time, it's extremely difficult because they see them­ selves in that terminally ill patient and it forces them to admit, 'Hey, I'm just as vulnerable; that could be me.' So, it's a very complex process. That's why we place such an emphasis on learning these skills, not only in the one-week elective, but also at every conference we can, every activity." Berger, who focuses on resident medical education,em­ phasizes the fact that the ACGME recently revamped its standards for residency program curricula across the coun­ try. "Communication skills have been identified as one of the core competencies physicians must acquire," she notes. "Residents, as opposed to medical students, are playing a central role in patient care. My hope is that, through our initiatives, UB medical faculty and residents will become more comfortable with not just delivering bad news, but dealing with dying patients," she continues. "Ifyour patients aren't comfortable sharing informa­ tion with you, then you do not have all the data you need to treat them effectively, nor can you assist them in making informed decisions." Hassett adds: "The most inti­ mate thing you can do to someone else is operate on them, and if a patient is going to allow you the privilege of doing that, you have to be able to talk to them about their options and about the relative risk of doing a procedure. And if, as a surgeon, you don't have the com­ munication skills to do that, it doesn't matter how much you know or how well you can perform a procedure. Sooner or later, you will have a real problem because the patient won't trust you." The most common reason resi­ dents do not complete training to­ day is their failure to communicate well, according to Hassett. "If they can't explain an issue to a patient or can't communicate well with other physicians or colleagues, then we begin to exclude them because they can't compete," he says. In an ongoing effort to teach residents how to commu­ nicate in a skillful, compassionate way, a new training tool called the National Wit Project was recently incorporat­ ed into UB's graduate medical education program at the suggestion of Milch. Wit, a film in which Emma Thompson plays a literature professor afflicted with ovarian cancer, is a wrenching por­ trayal of a dying patient who does not receive the human contact she needs from her physicians. A copy of the film is distributed to all UB medical residents, who then attend discussions facilitated by Milch and Freer. A ROAD MAP FOR DIFFICULT TERRAIN I n emergency medicine, physicians refer to the first hour of care following trauma as the "golden hour" because what happens—or doesn't happen—then determines treatment options from that point forward. For physicians working in the palliative-care setting, it could be said that the gold­ en hour for their patients is the time they are told of the �serious nature of their illness, because how this informa­ tion is presented will significantly affect the patient from that point forward. Recognizing that the communication skills needed to deliver bad news in a caring, effective way are best learned in a supervised setting rather than haphazardly on the job, medical educators at UB have integrated the teach­ ing of these crucial skills into the school's curriculum in recent years. "When you give a patient unhappy news, it's difficult. And because it's something that's hard to do well, we've tended to avoid it. As a result, it's a skill that was not taught—until now," says Freer, who five years ago as­ sisted Alan Baer, MD, associate professor of medicine, to develop the "How to Deliver Bad News" module at UB. Though the structure of the module is continually being revised and updated, the key components remain the same. In a lecture format, Freer outlines a simple, clear protocol for breaking bad news, as developed by Robert Buckman, MD, an oncologist and professor of medicine at the University of Toronto. To help students quickly grasp the fundamentals of the protocol, the mne­ monic "SPIKES" is used. "S" is for setting: arrange for privacy, close the door; both patient and doctor should be sitting down. "P" is for perceptions: find out what the patient knows. "I" is for invitation by the patient for the information: Do they want lots of detail? Is there some­ one else they'd like to be involved in the decision making? If a patient says, "Do you have my test results?"—that's an invitation to a dialogue. "K" is for knowledge, as in sharing the knowledge. "E" is for emotions, and dealing with those emotions in a direct way. The final "S" is for summarize. Following the lecture, Freer shows a video of Buckman delivering bad news to a standardized patient. The class is invited to critique the doctor's performance, according to the objective outline. "I've been doing this for about five years, and everyyear the students come up with new observations," says Freer. The didactic portion of the program is followed by a more hands-on exercise that provides students with an opportunity to meet with patients one-on-one and in larger groups. Actual cancer survivors participate in a panel discussion with the UB class. Notes Freer: "This is a wonderful opportunity for students to learn from pa­ tients. How were they told about their disease? How might it have been handled better? "In teaching clinical medicine, which is basically teaching someone how to practice medicine, there are cognitive elements—the book learning and'the memoriz­ ing—in which all the medical students do well," he con­ tinues. "They're good at that; that's how they got into medical school in the first place. "But then there are the skills like learning how to deal with actual patients. The truth is, [in this module] we're practicing on people; there's no other way to do it. "People such as cancer survivors, who have been in dire situations, sometimes have been hurt by a caregiver's inexperience. That's why we take any opportunity to give students a chance to work with these patients, as well as standardized patients, before they talk to someone who is really vulnerable. It's as if we're providing a road map for how to do these things." COMPREHENSIVE, INTEGRATED TRAINING ilch envisions a coordinated curriculum J\ /I in palliative care for all the health sciences I \/ I schools at UB, a goal that is only partially attained right now, as each of the schools has at least some involvement with the program. "We need to start at the beginning of the education process to get that interdisciplinary communication going," he stresses. "Doctors should be learning early on to work with nurses and social workers." In his articles in Buffalo Physician, the prescient Sanes warned 25 years ago of our current predicament when he commented that "... the treatment of disease may be entirely impersonal; the care of the patient must be com­ pletely personal." At UB, the problem of physicians' poor interpersonal skills has been recognized and addressed, but how is pro­ gress measured? Anecdotally, there are many reports of residents and students feeling more comfortable and test­ ing better in simulated patient settings. "In the real world, we have the instant feedback of compliments or com­ plaints from patients," notes Berger. "Hospitals are asking patients to fill out satisfaction surveys after a stay, and physician communication skills are part of that." In addition, the ACGME measures competency with tools like the "360-degree evaluation" in which residents are evaluated not only through the eyes of their attending physicians or their teachers but also through the eyes of nurses, other hospital staff, and patients, thereby provid­ ing multiple assessments of residents' skills. There also is a self-evaluation form, as well as peer-evaluation process in which residents observe and assess each other. "Residents need to become good self-assessors," says Berger. "Some of our programs have begun to use portfolios in evaluations that contain written examples �of consultations, lists of procedures performed, letters from patients, and so on." With all these efforts under way, Milch is full of hope. "It's a relief that we're finally doing something," he says. "We can identify deficits and figure out the tools we need to address them." A challenge now, Freer concludes, is to "get this new information out there, so more general internists, surgeons and neurologists who are teaching can incorpo­ rate it into their lessons and it becomes part of the med­ ical culture. "My hope," he says, "is that someday we won't need to teach these types of skills because everybody will be prac­ ticing them and learning from one another." Hospice Care in Buffalo Almost 30 years ago, an ecumenical group of physicians, nurses, clergy members and University at yospicE Buffalo faculty members began discussing a concept that started in England. They wanted to bring to BUFFALO Buffalo a hospice, a unique organization that helps to comfort, counsel and care for the terminally ill tn > pa and their families. Hospice Buffalo was born from these visionaries and celebrates its 25th anniversary of service this year. In fact, 2003 marks the silver anniversary of New York State's approval for c,n 1 9 7 8 - 2 0 0 3 hospice to become part of the state's health-care system. Hospice Buffalo began in 1978 with 20 patients. Today, it is the core program of The Center for Hospice & Palliative Care, serving more than 2,400 patients a year in homes, hospitals, nursing facilities, adult homes, and at the Hospice Mitchell Campus in Cheektowaga. —ROSEMARY COLLINS For young and old. For patients and families Hospice care touches everyone, including children with a sick mom or dad, grandparent or sibling. Wit chaplains and social workers helping out, the whole family feels better. The sooner you call, the more we can help Hospice. A plan for living. 686-8077 hospicebuffalo.com T H E C K V I t R F O R HOSPICE & PALLIATIVE CARE �M Medical Professionalism UB s e l e c t e d t o d e v e l o p c u r r i c u l a B Y The University at Buffalo School of Medicine and Biomedical Sciences is one of 10 medical schools nationwide selected by the American Medical Association (AMA) to participate in a new initiative aimed at integrating medical professionalism issues into the medical-school curriculum. L O I S B A K E R and sounding boards for uncomfortable emotions and difficult situations. "The integration we are planning com­ bines a reflective look at the art and liter­ ature of medicine with their own daily encounters on the wards and a variety of experiences that we think are key to devel­ oping professionalism," she adds. The readings, case studies and Webbased learning assignments will be based on specific study topics geared to each medical school year. The "Professional­ ical errors, the AMA noted in announcing ism" course begins with the White Coat Teaching and Evaluating Professionalism, the selections. The 10 institutions taking part Ceremony that initiates students into the or STEP. Nancy H. Nielsen, PhD, MD '76, in the initiative will develop educational medical world. First-year issues to be ad­ clinical professor of medicine and interim programs to incorporate these issues and dressed include medical codes and oaths, senior associate dean for medical educa­ others into a medical school curriculum. The initiative is called Strategies for tion, developed the UB medical school's proposal and will direct the project. health-insurance regulations, paternalism model, four-year, self-directed course in in medicine, ethical disparities in medical "We're delighted and honored to par­ professionalism. ticipate in this important undertaking," The plan involves says Nielsen. "There's nothing more criti­ Web-based and cal in the education of a physician than printed readings, developing an understanding of profes­ case studies, stan­ dardized patient sionalism." Issues of professionalism unrelated to encounters, on- specific clinical proficiencies currently are site experiences, addressed by each institution individually. and student jour­ Through the STEP project, the AMA aims nal keeping. "There to develop a set of educational tools that is a can be used by all medical educators and body of material would establish consistency across U.S. that needs to be medical education. imparted," says care and impairment in "Students need to reflect, health professionals. to experience and to inter­ studied during the sec­ act with faculty mentors years of medical school who can serve as guides and sounding boards for uncomfortable emotions and difficult situations." Nielsen, "but the Today's physicians confront increasing­ privacy and confidentiality, federal UB's contribution will be to develop a Issues that will be ond, third and fourth include cultural compe­ tence, health literacy, domestic violence, endof-life care, homelessness, human sexuality, organ donation, com­ plementary medicine, spirituality in health care, ethics of managed ly difficult ethical and professional chal­ students also need to combine earlier care and malevolent and benevolent uses lenges, given the scientific advances of knowledge with later experiences and to of medical science. modern medicine and the need to address make the concept of 'professional' mean­ Students will spend time at a refugee issues such as end-of-life care, rationing of ingful in their daily lives. Students need to shelter, clinic for the homeless, hospice, expensive medical technologies, potential reflect, to experience and to interact with conflicts of interest and disclosure of med­ JacuJty mentors who can serve as guides I 11 f I a I 1 P h y s i c i a n A u t u m n 2 0 0 3 I CONTINUED ON PAGE 21 �f 2003 Humanism Award Chester Fox, MD, clinical associate professor of family medicine, was presented with the University at Buffalo School of Medicine and Biomedical Sciences' Humanism in Medicine Award at this year's White Coat Ceremony. In addition to his teaching and practice responsibilities, Fox serves as sole physician advisor to UB medical student volunteers at the Lighthouse Free Medical Clinic. Nominations for the award are made by students in the clerkship years. In presenting the award, CharlesSeverin, PhD, MD '97, interim associate dean of medical education and admissions, read a composite of the comments made by students who nominated Fox for the award. "I can think of no more deserving individual than Dr. Fox. He not only meets but far exceeds all of the attributes this award recognizes. Before the Lighthouse Free Clinic ever opened its doors, Dr. Fox worked tirelessly to establish its foundational building blocks. He selflessly set aside countless hours when we need­ ed his guidance or that extra assurance that our dreams and our vision for this clinic were indeed obtainable. "Dr. Fox consistently demonstrates compassion and empathy and delivers the same quality of care for the less fortunate among us as he does for his regular patients at Deaconess Medical Center. With our clinic's diverse clientele we are lucky to have Dr. Fox to demonstrate the sensitivity needed to develop a trusting, caring and productive relationship with all patients. "It has been said that the most effective way to learn is by having a living example. Dr. Fox is ours." Support for the Humanism Award is provided by the Healthcare Foundation of New Jersey. < l-> —S. A. UNGER White Coat Ceremony, a "Class Profile" The sixth annual White Coat Ceremony at the University at Buffalo School of Medicine and Biomedical Sciences was held on August 15, 2003, in Slee Auditorium. During the ceremony, Charles Severin, PhD, MD '97, interim associate dean of medical education, shared the following "profile" of the Class of2007: Class Size: 135 The 2004 Spring Clinical Day and Reunion Weekend will be held April 30 to May 1 at Roswell Park Cancer Institute. Male-Female Ratio: 63 MEN, 72 WOMEN Where They Call Home: 54 FROM WESTERN NEW YORK.; IS FROM Events include the first- EXTENDED WESTERN NEW YORK; 14 FROM UPSTATE; 30 FROM DOWNSTATE; 19 FROM OUT OF STATE ever All Reunion Class Dinner at the Pierce Arrow Age: AVERAGE AGE IS 23; THE OLDEST IS 34; THE YOUNGEST, 20-, Car Museum. 12 ARE OVER 26 Academic Background: AVERAGE GPA IS 3.57; MEAN MCAT IS 9.48. ONE STUDENT HAS A PHD AND EIGHT HAVE A MASTER'S DEGREE; 109 ARE SCIENCE MAJORS AND 26 ARE NON-SCIENCE MAJORS For more information, call the medical school's Office Number of Applicants: 2,063; INTERVIEWED 464 of Alumni Affairs and Devel­ opment at (716) 829-2773; The White Coat ceremony is sponsored by the Arnold I! Gold Foundation, the University at Buffalo Medical Alumni Association, and the UB Medical School Parents Council. Autumn 2003 or email: kventi@buffalo.edu. I ii f f a I o Physician 1 �M E D I C A L S C H O O L N E W S Residents Honored Student Clinicians' Ceremony S ix University at Buffalo residents were presented the Arnold P. Gold Foundation Humanism and Ex­ cellence in Teaching Award at the Student Clinicians' Ceremony held on August 3, 2003, in Slee Audito­ rium on UB's North Campus. The ceremony was initiated last year by the School of Medicine and Biomedical Sci­ ence's Professional Conduct Committee. This year's awards were presented by Troy Pittman, Class of 2006, on behalf of Recipients were chosen by Class of 2004 based on Rating a commitment to [compassionate treatment lilies, students and col[lts selected to receive the aelow, followed by a comj by a nominating student: VID, earned a medical deveis University in BudaI in 1998, after which he served a preliminary year in surgery at UB. Currently, he holds a position in psy­ chiatry at the Medical College of Virginia. "Dr. De Luca was always approachable and eager to help and teach me. Each day he tried to show me something new, and SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES University at Buffalo The State University of New York ireil; YY?' - Left to right: Jeanette Figueroa. MD 01; George Deeb. MD: Jan Penvose-Yi, MD: John Improta. MD; Toni Ferrario, MD. assistant professor of surgery, who delivered the keynote address; and Mark De Luca. MD. anatomic pathology (1997) and anatomic/ clinical pathology (2003), the latter of which was at UB. Currently he is an oncologic surgical pathology fellow at Roswell Park Cancer Institute. In 2004, he will begin a hematopathology fellowship at the University of Wisconsin, Madison, WI. whether it was a new procedure or a new concept for me, he was the ultimate teacher. // University School of Medicine. Upon graduation, he entered residency training in psychiatry at UB. Currently, he is resi­ dent representative for the American Psy­ chiatric Association, Western New York chapter. In 2003, he received the Resident Service Award for outstanding service to the Department of Psychiatry. "Dr. Deeb is an outstanding teacher. He It was a pleasure to watch him and to learn makes an effort to gradually increase stu­ "The special thing about Dr. Improta's from his interactions. I have come to think dents' responsibilities. He creates a relaxed teaching style is that he does not just talk at of Dr. De Luca as a mentor and a friend. environment that encourages discussion and you. Rather, he draws the answers out of He has all of the qualities of knowledge, un­ questioning. He is always professional and you, which builds your confidence and keeps derstanding of disease, compassion and bed­ respectful when interacting with colleagues. you engaged. In addition to being a solid side manner that I hope to have one day." And, finally, he sets a superb example that I teacher, he demonstrates a professional hope to emulate as I enter my residency." attitude and solid ethical behavior. Dr. John Improta, MD, a native of Buffalo, NYYeafried Amedical degree at St. George's edge that medical students need to witness George Deeb, MD, graduated from Dam­ ascus University School of Medicine in Syria, in 1995. He completed residencies in Buffalo Physician Autumn 2003 Improta personifies the energy and knowl­ during their third year of medical school." �Jan Penvose-Yi, MD, a native of the City of Tonawanda, NY, graduated cum laude from Rensselaer Polytechnic Institute in 1992 with a bachelor of science degree in chemistry. She worked for several years as a medicinal chemist before returning to school to earn a medical degree at Michi­ gan State University College of Human Medicine. Currently she is a second-year resident in obstetrics/gynecology at UB. "Dr. Penvose-Yi is the type of physician that I which is home to a predominantly underserved Hispanic population. "Dr. Figueroa's most noteworthy character­ istic is her sensitivity to others. She demon­ Match Day Correction strates compassion and empathy on a daily basis, not only to her patients, but to her In the summer 2003 issue of Buffalo Phy­ colleagues and students. She is a role model sician it was incorrectly reported that of ethical behavior and cultural sensitivity. Elizabeth Bourke, Melissa Franckowiak She knows what resources are available in and Maria Podebryi-Tsur-Tsar, Class of the community so that she can provide ad­ 2003, matched for residency training in vice that is specific and helpful. She treats all anesthesiology at New York Presbyterian want to be and the kind that I want as my her patients with respect—so much so that Hospital (Cornell Campus), New York. All doctor. She treats every patient with respect, you can't imagine her giving better, more three are training in anesthesiology in the regardless of their situation. She always has sensitive care to her own family or friends. I SUNY at Buffalo Graduate Medical-Dental an encouraging word for her students and hope to someday display a similar level of Education Consortium. colleagues. When I think of an ideal phys­ patience, empathy, sensitivity and compe­ ician, Dr. Penvose-Yi comes to mind." tence in my teaching and clinical practice." Jeanette Figueroa, MD '01, a native of Buffalo, NY, graduated cum laude from UB in 1994 with a bachelor of science degree in biochemical pharmacology. She earned a medical degree from UB in 2001. Emily Tenney, MD '02, graduated from St. Lawrence University 1997, after which she earned a medical degree at UB. "From her dedicated teaching to her compas­ the answers to other questions and situations. Currently, she is a third-year resident in family medicine. Her outpatient clinic is located in Buffalo's Lower-West Side, sion and professionalism, Dr. Tenney is an Her commitment to teaching is evident in every interaction she has with her students." encouraged our desire to be active members of the team and therefore gave us the opportu­ nity to do that. She not only answered our questions, but provided the context to apply intern that any medical student or physician would love to work beside. She respected and —S.A. UNGER Medical Professionalism continued from page 18 organ procurement agency and other sites as necessary. They will meet quarterly with faculty mentors to review their progress and to evaluate their understanding of the principles of professionalism studied. Standardized patient cases, exams and essays will be used to assess students' competency. "We've already begun planning activi­ ties," Nielsen says, "and we'll join with the other schools chosen in a fall meeting. Elements of the project will be implemen­ ted with the incoming first-year class." Core faculty for the STEP program, in addition to Nielsen, are Margaret Paroski, MD '80, professor of neurology, interim vice president for health affairs and in­ terim dean of the medical school; Jack Freer, MD '75, clinical associate professor of medicine;Charles Severin, MD '97, PhD, associate professor of pathology and ana­ tomical sciences and interim associate dean for medical education; David Mill­ ing, MD '93, clinical assistant professor of medicine and assistant dean for multi­ cultural affairs; Robert Milch, MD '68, clinical assistant professor of surgery and medical director for the Center for Hos­ pice and Palliative Care, and Jack Coyne, MD '85, clinical assistant professor of pediatrics. David Block, incoming fourthyear medical student, who spent a year at the AMA Institute of Ethics before com­ ing to medical school, will serve as the core's student advisor. Also selected as STEP program par­ ticipants were medical schools at Indiana University, Loyola University Chicago, McGill University, Michigan State Uni­ versity, New York University, University of Minnesota, University of North Dakota, University of Pennsylvania and University of Texas-Houston. < ' -* Autumn 200 3 Buffalo Physician 21 ��After 25 years as an emergency medicine physician, ilsburgh Clarke, MD 77, is harmoniously in synch with an erratic and highly spontaneous line of work, the nature of which is aptly symbolized by the wide-angle lens and high-speed Kodachrome he reaches for to capture lives on film when he's not busy saving them. In addition to his demanding work as a physician, Clarke is a professional photographer who, not surprisingly, is drawn to creating tableaux that are steeped in emotion and energy, whether they be of emergency departments, NASCAR race tracks, NFL end zones or U.S. Naval Academy midshipmen. Clarke is currently medical director of emergency services at the Methodist Medical Center of Illinois in Peoria, Illinois, a 40,000-visit-per year, Level 2 trauma center. In this position, as throughout his career, he has successfully melded his dedication to medicine with his passion for photography, earning a reputa­ tion as a talented practitioner in both fields. In 1997, photographs that Clarke entered in Emergency Medicine News's annual photography contest were selected "Best Overall" by a panel of judges, one of whom stated, "The emergencyphysician [who took these] may have missed hiscalling as a photographer." Autumn 2003 Buffalo Physician �Navy vs. Georgia Tech graphy," but notes that it became more than a curiosity when he left home to attend Howard University in In 1997. this photograph Washington D.C. by Clarke was named "My father used to take pictures, and he kept a scrapbook of his college days that he would show me," "Best Overall" by the Clarke recalls. editorial board of When it was time for Clarke to depart for college, his emergency Medicine father gave him a Kodak Instamatic camera, thinking his News in its annual son might like to chronicle his own college experiences. photography contest.lt After graduating from Howard with a bachelor of science was taken at Milford degree in zoology, Clarke bought himself a 35mm Pentax Memorial Hospital in K1000 with his first American Express card. But it wasn't until he arrived at the University at Buffalo's School of Milford. Delaware, where Medicine and Biomedical Sciences in 1973 that his pas­ Clarke served as medical sion for photography started to become a force in his life. director of the Emergency Soon after arriving in Buffalo, Clarke began to take Department prior to advantage of Western New York's world-famous scenery to improve his photography skills. "I lived in Tonawanda moving to Peoria. and I used to drive up to Niagara Falls in the dead of Rather than feeling that he's missed out, Clarke prefers winter just to take pictures of the natural beauty," he to think he's been extraordinarily fortunate to have the says. "This allowed me to be outdoors, which I enjoyed." opportunity, and artistry, to fulfill his dual calling in life. I Since Clarke had no formal training in photography, Born in Westchester County and raised on Long Island, he learned by trial and error, by reading about photo­ Clarke remembers "always having'an interest in photo­ graphic processes and by talking to other photographers. �Indy Racing League,Dover Downs NASCAR. Dover Downs San Francisco 49ers vs.the Los Angeles Rams Soon after coming to UB Clarke purchas­ working with black-and-white film. Using the darkroom facilities at the LA Arts Center, Sipsey taught Clarke how ed a Nikon and started to shoot, develop and print black-and-white photo­ snapping candid pho­ graphs, which further sparked his interest in the photo- tos of his fellow classmates—between classes, at class func­ journalistic style. It didn't take long for Clarke to get per­ tions, and any time an opportunity arose—gradually mission to photograph action in the hospital's ER and to becoming a kind of unofficial documentarian of student launch an avocation that continues to the present day. life. Many of Clarke's photos from this time were publish­ Following his residency, Clarke spent 13 years as a cli­ ed in the 1977 edition of Iris, the medical school yearbook. nician and administrator in the emergency departments In particular, Clarke remembers how gratifying it was to at a number of Los Angeles-area hospitals, including 10 have taken photos of classmate Leonard Spicer, who died years at Pomona Valley Medical Center, five of which several months before graduation. were as assistant director of the emergency department. The spontaneity of photographing unposed subjects is In 1993, he moved back East to become medical what appealed to Clarke early on, he says, as did the director of the emergency department at Bayhealth- challenge of documenting the essence of a scene. "I enjoy Milford Memorial Hospital in Milford, Delaware, as well capturing moments," he observes. "Every photographer's as medical director of the Sussex County Paramedics. At dream is to capture people's moments on film because that time, the governor of Delaware also appointed him After completing his internship at the University of Committee and the EMS Oversight Council. In addition, California at Irvine, in 1978, Clarke began his residency Clarke served as chair of both the State Trauma Commit­ in emergency medicine at the LA County/University of tee and the Sussex County EMS Advisory Committee. those moments will never happen again." to the Emergency Medical Services (EMS) Improvement Southern California Medical Center. There he befriend­ While living in Delaware, Clarke continued to photo­ ed Jeff Sipsey, MD, one of the attendings on staff, who was graph hospital ERs, often collaborating with his wife, an experienced photographer with a strong interest in Patricia, also a photographer. Together they shot thou- Autumn 2003 Buffalo Physician �Firefighters, Los Angeles County Fire Department Rams' quarterback in a 1993 game against the Giants sands of emergency department photos in hospitals where Clarke worked, as well as at Bellevue Hospital and Bronx Jacobi Medical Center in New York City, and while ac­ companying paramedics at trauma scenes. In 1997, Clarke was named photo editor for the maga­ zine Emergency Physicians Monthly, a national trade mag­ azine, and in 2001, a chapter he wrote, titled "Medical Photojournalism," was published in the Handbook of Medical Photography. An accomplished essayist, Clarke also published a series of photojournalism features for the regional magazine Delaware Today between October 1999 and June of 2000. These included an article titled "On the Edge," which gave an insider's view of two hos­ pital emergency departments, including BayhealthMilford Memorial Hospital; an article, titled "Crash Course," on the NASCAR medical clinic at Dover Downs, where he'd worked as both a photographer and a physi­ cian; an article profiling three female midshipmen from Delaware who were attending the U.S. Naval Academy; and an essay about a historic black barbershop. Sports photography, another one of Clarke's special­ ties, has led to freelance assignments with several Na­ tional Football League teams, including the Philadelphia 26 Buffalo Physician Autumn 2 003 Eagles, the Miami Dol­ phins and the former Los Angeles Rams. He has also completed as­ signments for the U.S. Naval Academy foot­ ball team, NASCAR, and the 1995 United States Olympic Festi­ val Committee. Though action in the ER can at times be as fast-paced as a sport­ ing event, Clarke's approach to photographing ER scenes is somewhat different. He almost always uses black-andwhite film instead of color, which results in more dramat­ ic pictures, he says, and avoids the greenish tint so often inherent in photos taken under an ER's fluorescent light­ ing. He rarely uses a flash, preferring instead to use a faster film speed of at least 400 or higher in whichever one of his eight Nikons he's using that day. He takes lots of pictures, sometimes as many as 30 to 35 rolls of 36exposure film. (When using a motor-drive camera, as �Clarke does, and shooting 1 to 2 frames per second— compared to the 3 to 5 frames per second in sports photography—it's easy to go through a lot of film.) Looking back on some of the photos he took 20-odd years ago, Clarke notes that he has not only chronicled patients and their caregivers, but also a bit of medical history. He says it's interesting to see that some equip­ ment used at the time, such as an EKG machine, looks dated now because of rapidly changing technology. When taking photographs, Clarke says he tries to cap­ ture the intensity, emotions and feelings of his subjects. "I like to photograph the eyes," he explains. "1 like clarity; I like close-ups of a person's hands." Clarke feels that one of his most enduring medical photographs in terms of emotion and intensity is a black- says he hasn't had as much time for taking pictures as he would like due to his increased responsibilities and the emergency department's high patient volume. Still, he and his wife plan to continue working on a book that will be a series of photo essays about the daily activities of emergency medical physicians, nurses and staff. When envisioning this ambitious project, Clarke says he'd like to take advantage of his close proximity to Chicago, two hours away, to shoot some of that city's ERs. Another project he's considering is a 24-hour photo essay on Peoria. Would Clarke ever give up emergency medicine for photography? "Maybe—if I won the lottery," he says with a laugh. "But I love the ER, too," he quickly adds. "With photogra­ and-white shot he took of a surgeon holding a heart, "cradling and massaging it over the patient's open chest, literally holding life in his hands." Since moving to Peoria in November 2000, Clarke phy I get to meet people and it's an extension of what 1 do every day, which is take care of people. Ultimately, it's about capturing moments: I love people, and I love to capture their expressions. To me, that's priceless." "Come Discover What My Mom Has Found!" • Beautiful private 1 & 2 bedroom apartments THEN GET TO BUFFALO. • 3 meals a day in elegant dining room Pressure at your current position just too much to handle? • Weekly housekeeping Is your practice giving you way too many headaches? If so, then its time to shuffle off to Buffalo! • Scheduled Worried about the snow? No sweat. Buffalo only averages about 25 days of snow a year. Snowfalls that • Activities & exercise programs problem here! And our average summer temperature • Hair salon, on-site bank, library, billiards is a perfect 79 degrees. The Bills, The Sabres, The Toronto Blue Jays Physicians Going over Niagara Falls in a barrel Lifetime Health is a not-for-profit complete care provider featuring state of the art health centers. We are seeking BC/BE physicians to join our prestigious Come Home to Amberleigh AMBERLEIGH CAPITAL SLSK >K CORPORATION Here's what we've got! would bring life in some citiesto a grinding halt are no A Rental Retirement Community 2330 Maple Road, Williamsville For a free brochure or personal tour, call 689-4555 roster of health care professionals. Suicide wings at the Anchor Bar Reeling in fresh fish for sizzling backyard BBQ Find out how Lifetime can fit your life by sending CV to: Physician Recruitment, Lifetime Health, 205 Park Club Lane, Buffalo, NY 14221. PH: 877-217-7465 FAX: 310-917-5062 EMAIL: lscreeney@earthlink.net Lifetime Health Autumn 2003 Crossing into Canada for an evening of fun Downhill winter adventures on snow covered mountains www.fitsyourlife.com Equal Opportunity Employer, m/f/d/v. B u f f a l o P h y s i c i a n �# NEWS ABOUT UB'S SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES AND ITS ALUMNI, FACULTY, STUDENTS AND STAFF Patnways Fischer Joins Bioinformatics Center Daniel Fischer, PhD, who coordinates the bioinfor­ matics track at Ben-Gurion University of the Negev in BeerSheva, Israel, has been named di­ rector of educa­ tional programs for the University at Buffalo Center of Excellence in FISCHER Bioinformatics. FISCHER WILL DEVELOP UB'S EDUCATIONAL PROGRAMS IN BIOINFORMATICS AT THE UNDER­ GRADUATE AND GRADUATE LEVEL, AS WELL AS CERTIFICATE PROGRAMS. BuM9I a Physiciin In addition, he will serve as a professor in the Department of Computer Science and Engineering in the UB School of Engineering and Applied Sciences. As director of educational programs for the UB Center of Excellence in Bioinfor­ matics, Fischer will develop UB's educational programs in bioinformatics at the under­ graduate and graduate level, as well as certificate pro­ grams. He will also teach and conduct research in the UB Graduate School of Education. A u t u m n 2 0 0 3 For the past five years, Fischer has been with BenGurion University, where he is a tenured senior lecturer in its Department of Computer Science. He holds a bachelor's degree in computer science from Universidad Autonoma Metropolitana in Mexico, a master's degree in computer science with honors from Technion, Israel Institute of Technology and a doctoral degree in computer science with honors from Tel Aviv University in Israel. Before joining the faculty at Ben-Gurion, Fischer was an assistant researcher in the Molecular Biology Institute at UCLA from 1995-1998. He also has worked as a CAD developing engineer with Intel in Haifa, Israel, and as a postdoctoral fellow in the Department of Mathematical Biology at the National Cancer Institute of the National Institutes of Health. —ARTHUR PAGE Kuramitsu Elected a Fellow in the AAM Howard Kuramitsu, PhD, University at Buffalo Distinguished Professor in the Depart­ ment of Oral Biology in the University at Buffalo School KURAMITSU of Dental Medicine, has been elected a fellow in the American Academy of Microbiology, an honorific leadership group within the American Society of Microbiology. One of only 1,800 scientists elected to fellowship status in the academy's almost 50-year history, Kuramitsu was recognized for his work defining virulence factors of potentially pathogenic oral biology. Kuramitsu holds a joint appointment in the Depart­ ment of Microbiology in the UB School of Medicine and Biomedical Sciences and is a member of the Center for �* Refiling Endows Dermatology Chair At his 60th Class Reunion in April, Ralph T. Behling, MD '43, announced plans to endow a $1.5 million chair in dermatology at the University at Buffalo School of Medicine and Biomedical Sciences. "Dr. Behling's generous gift will help the University at Buffalo attract nationally known faculty to the Department of Dermatology," says Margaret W. Paroski, MD '80, UB interim vice president for health affairs and interim dean of the School of Medicine and Biomedical Sciences. "Although he moved across the country years ago, he has never forgotten his roots here at UB, and for that we are grateful." A native of Buffalo, NY, Behling graduated from UB with degrees in pharmacy and medicine. His remarkable career as a dermatologist and his pioneering work with penicillin and the Pap test were highlighted in the summer 2003 issue of Buffalo Physician. The chair, which will be known as the Rita M. and Ralph T. Behling, M.D., Chair in Dermatology, in part memorializes his first wife, who died in 1998 and who also was a UB graduate. Behling says his motive for endowing the chair is to ensure that "future students enjoy the same kind of quality education I had at UB." Behling lives in San Mateo, CA, with his second wife, Eileen. Between them, they have ten children, all over age 40. —Lyn Corder, PhD, associate dean Advanced Molecular Biology and Immunology (CAMBI) at UB. He and his colleagues have found that oral bacteria can exchange genes, raising the possibility that organisms in the oral cavity can be transformed from harmless to destructive, and from antibiotic-susceptible to antibiotic-resistant. —S U E W U E T C H E R Fudyma Named Medical Director The Erie County Medical Center (ECMC) Healthcare Network Board of Managers has appoint­ ed John R. Fudyma, MD '85, to the position of medical director of the Health­ care Network. FU D Y M A Fudyma previously served as associate medical director of ECMC (2001-2002) and as a member of the ECMC board of managers (1998-2001). He is currently associate profes­ sor of clinical medicine in internal medicine (1998present) and associate program director of the Internal Medicine Residency Program A (1996-present) at the UB School of Medicine and Biomedical Sciences. Originally from Utica, NY, Fudyma obtained his under­ graduate degree in biology from Hamilton College, Clinton, NY, and his medical degree from UB in 1985. He completed his resi­ dency in internal medicine in Buffalo (1990) and a year as chief medical resident at ECMC (1991). — JO E CI R I L L O Urologic Oncology Chair Named James L. Mohler, MD, has been named chair of the Department of Urologic Oncology at Roswell Park Cancer Institute (RPCI). He comes to RPCI from the University of North Carolina (UNC), Lineberger Compre­ hensive Cancer Center, Chapel Hill, NC, where he served as associate professor of surgery, associate professor of pathology and laboratory medicine, and director of the UNC Prostate Cancer Research Program. At RPCI, Mohler will work with Robert Huben, MD, chief of clinical urology, on training programs for urologic oncology residents and fellows, as well to enhance as RPCI's translational research activities. Mohler received a medical degree from the Medical College of Georgia, Augusta, GA, and completed an internship in internal medicine at Duke University Medical Center, Durham, NC. He completed residency training in surgery and A u t u m n urology at the University of Kentucky Medical Center, Lexington, KY, and a research fellowship in urologic oncology at The Johns Hopkins University School of Medicine, Baltimore, MD. —D E B O R A H P E T T I B O N E Vision Research Funded by NIH Two researchers in the University at Buffalo School of Medicine and Biomedical Sciences have received grants from the National Institutes of Health to conduct research into the function and development of the human vision system. Malcolm M. Slaughter, PhD, professor of physiology and biophysics, has received a grant of $369,700 to study the different ways in which glycine can increase vision clarity and benefit the nervous system. A pioneer in the study of vision, Slaughter has r CONTINUED ON PAGE 31 20 03 Buffalo Physician �V A ^ PA T H W A Y S BREAST CARE CENTER OPENED I n July 2003, Kaleida Health opened its Breast Care Center on the fifth floor of the Women and Children's Hospital of Buffalo. Staffed by eight, the center includes state-of-the art mammography equipment, ultrasound, a patient resource center, and a stereotactic core biopsy suite. In addition, KENNETH ECKHERT JR LISA A. HANSEN genetic counseling and evaluation are provided for patients and families. The Breast Care Center's concept—which is to provide patients optimal diagnoses and treatment in days, instead of weeks—was developed by breast surgeon and center director Kenneth Eckhert Jr, MD '68, assistant clinical professor in the University at Buffalo School of Medicine and Biomedical Sciences. Eckhert is a founding partner of Breast Health Associates, a private practice focused on the evaluation of management of breast conditions. Prior to joining Kaleida Health in October 2002, he served as chief of surgery at the Sisters of Charity Hospital in the Catholic Health System. Lisa A. Hansen, MD '91, was recruited back to Buffalo to serve as a dedicated mammographer at the Breast Cancer Center. Following graduation from UB medical school, Hansen completed a pediatrics internship at Children's Hospital of Buffalo. She finished her residency training in radiology at the University of Toronto, followed by a breast imaging fellowship at Thomas Jefferson University in Phila­ delphia, PA. Prior to joining Kaleida, Hansen was director of the Breast Imaging Clinic at the University of Mississippi in Jackson, MS. The Genetics Division located at The Women and Children's Hospital, led by Richard W. Erbe, MD, will provide genetic counseling and evaluation for Breast Care Center patients. fr> RICHARD W. ERBE Hospital Name Change THE WOMEN AND CHILDREN'S HOSPITAL OF BUFFALO In April, Kaleida Health's Children's Hospital of Buffalo was renamed The Women and Children S Hospital of Buffalo. One impetus for the change, as reported in the KaleidaScope newsletter, was a decision by the hospital's OB/GYN group to remain at the facility, where it will play a key role in the development of new services for women in the entire Kaleida Health organization. Another reason for the change was the hospital's history of offering specialized services and facilities for women, including care for low- and high-risk pregnancies, a perinatal center, and The Breast Care Center. ""We've been caring for women for more than 85 years. The staff is very excited that the hospital is being recognized for the work we do for women," says Craig L. Anderson, MD, the hospital's chief medical officer and Kaleida Health vice president. In a parallel move, Kaleida Health is looking at the gap in women's services nationwide, asking health-care professionals, community leaders and women what services they'd like to see offered, according to Cynthia Ambres, MD, executive vice president and chief medical officer for Kaleida Health. "It's critically important for us to listen to what the community has to say as we work to develop a strategic plan for women's services throughout our system," she says. C3> 30 Buffalo P hy sic ia i A u t u m n 2 0 0 3 �such injury. His research group is studying the molecular basis of inherited retinal diseases and is focusing on developing gene-directed therapeutic approaches for these blind­ ing disorders. |CONTINUED FROM PAGE 29 published past research findings in Nature and Science, as well as in leading journals in the vision field. His research focuses on information processing in the retina; in particular, the events that occur at synapses. Shahrokh C. Khani, MD, assistant professor of ophthal­ mology and biochemistry, received a $271,703 grant to study the enzyme rhodospin (which can cause retinal disease) and the susceptibility of the retina to light-induced —SUE WUETCHER Bodkin Wins Top Research Honors A project submitted by John J. Bodkin, III, a master's candidate in physiology in the University at Buffalo School of Medicine and Bio­ medical Sciences, received injury and how to prevent second place at the annual in­ ternational meeting of the Under­ water Hy­ perbaric Medical Society held in Quebec City, Quebec. His project was titled "Prevention and Treatment of Decompression Sickness: Potentially Field-Usable Methods to Enhance Inert Gas Elimination." Bodkin, who earned a bachelor of science degree in physiology and neurobiology in 2000 at the University of Connecticut, was mentored on the project by Claes Lundgren, MD, PhD, professor of physiology and biophysics at UB and director of the university's Center for Research and Education in Special Environments. Timothy B. Curry, MD, PhD, at the Mayo Clinic in Rochester, MN, collaborated on the project. Bodkin plans to continue research in hyperbaric medicine and to pursue a doctorate in physiology. —S. A. UNGER Osteoporosis causes a spine fracture every 45 seconds KyphX Xpander® Inflatable Bone Tamp (Balloon)a new minimally invasive tool doctors are using in the treatment of spine fractures Vertebral compression fracture Through two small incisions, the doctor creates narrow pathways into the fractured bone and inserts two KyphX Xpander Balloons. The KyphX Xpander Balloons are inflated, moving the collapsed portion of the vertebra. The purpose is to restore the fractured bone to its original shape. Once the doctor has achieved the desired result, the KyphX Xpander Balloons are deflated and removed. The doctor can then finish the procedure. KV^j-KHvfc• ' UB I 1350 Bordeaux Drive Sunnyvale, CA 94089 877-459-7466 £ www.BalloonsForBones.com M' * .> ^ KyphX Xpander Inflatable Bone Tamps are intended to be used as conventional bone lamps for the reduction of fractures and/or creation 8 v0'd 'n cancellous bone in the spine, hand, tibia, radius and calcaneus. For complete information regarding precautions, method of use, warranties and limitations of liability, please reference the device Instructions for use. ©2000-2003 Kyphon Inc. All rights reserved. 16000135-02 Autumn 2003 Buffalo Physician �F)earis Award THE DEAN'S AWARD IS GIVEN IN SPECIAL RECOGNITION OF EXTRAORDINARY SERVICE TO THE SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES. This year, Interim Dean Margaret Paroski, MD '80, presented the award to Alexander C. Brownie, PhD, DSc, SUNY Distinguished Professor Emeritus, "for his phenomenal dedication to developing and rolling out the new curriculum for the preclinical years." "In addition to teaching extensively in the new curriculum, Dr. Brownie has helped collect feedback, integrate modules and revise the content of the modules," says Paroski. "He is ever present for the students and has helped soothe the anxieties— of students and faculty—regarding the new curriculum. This kind of commitment and enthusiasm is what impressed the LCME about our new curriculum." A member of the University at Buffalo faculty since 1963 and former chair of the Department of Biochemistry (1977-1989), Brownie has received many awards from the UB School of Medicine and Biomedical Sciences. These include the Louis A. and Ruth Siegel Excellence in Teaching Award (1983) and the Stockton Kimball Award (1986) for his research on control of the adrenal cortex, as well as for his outstanding teaching and service to the university. In 1993, Brownie was named SUNY Distinguished Professor, the highest rank in the State University of New York System, by the SUNY Board of Trustees. A native of Scotland, Brownie was educated at Edinburgh University. In 1996, he was elected a Fellow of the Royal Society of Edinburgh. —S. A. UNGER We practice law for those who practice health care. Phillips, Lytle understands that health care providers face unique legal challenges. HIPAA, STARK, compliance issues, DOH regulations, reimbursement, the OPMC, and let's not forget about MFCU audits. These are all hot topics that we are prepared to help you with. Experience Breadth Depth Have questions or concerns? Call or e-mail Lisa McDougall, Esq., the health care practice group coordinator, at (716) 847-5478 or lmcdougall@phillipslytle.com. P H I L L I P S , L Y T L E . H I T C H C O C K . T T O R N E B L A I N E Y 8 S est. 1834 3400 HSBC Center, Buffalo, NY 14203 (716) 847-8400 website: www.phillipslytle.com BUFFALO 32 u f f a Io Physician A u t u m n 2 0 0 3 • FREDONIA • JAMESTOWN • NEW YORK • ROCHESTER H U B E R L L P �Sforlcfori Kimball Award Stanley Schwartz, MD, PhD T he Stockton Kimball Award honors a faculty member for senior associate dean for research and academic accomplishments and worldwide recognition as an biomedical education at UB, who presented investigator and researcher. Stockton Kimball, MD '29, was him with the award. the dean of the University at Buffalo School of Medicine from "He has been recognized by his peers not 1946 to 1958, and his contributionsto the training of physicians in Buffalo only as demonstrated by his competitive fund­ spanned more than a quarter of a century. ing record, but also his selection to serve on The 2003 recipient of the Stockton Kimball Award is Stanley Schwartz, the editorial boards of several top immunol­ MD, PhD, professor of medicine, pediatrics and microbiology, and direc­ ogy journals," she added. "In hiscareer, Stan tor of the Division of Allergy, Immunology, and Rheumatology in the UB has been rewarded and honored with an NIH Department of Medicine. Research Career Development Award, the Schwartz received a doctorate in cellular biology from the University Metier Award for Outstanding Research (Memorial Sloan-Kettering of California at San Diego in 1968, and a medical degree from Albert Cancer Center), and as an American Association for the United Nations Einstein College of Medicine in 1972. He was a postdoctoral fellow at World Travel Fellow, among others." the University of California, San Diego, and later at the Albert Einstein According to Laychock, Schwartz has published well over 100 scien­ College of Medicine, where he was an American Cancer Society Postdoc­ tific articles, most recently on the subject of AIDS and immunoregulatory toral Scholar. He completed residency training at the Albert Einstein activities of HIV-1 proteins and their effects on cytokine expression. College of Medicine and continued his research training as a clinical Besides outstanding scholarship, the Stockton Kimball awardee also fellow in immunology at Memorial Sloan-Kettering Cancer Center and must demonstrate significant service to the University at Buffalo. Since Sloan-Kettering Institute for Cancer Research. joining the University at Buffalo, Schwartz has served as director of the Schwartz began his clinical academic career in 1978 at the University Division of Allergy, Immunology and Rheumatology. He has also served as of Michigan, Ann Arbor, where he rose through the ranks to become chair and facilitator for the Ad Hoc Committee on Specialist Training, on professor of pediatrics and communicable diseases and professor of the Program Directors Committee for the Graduate Medical/Dental microbiology and immunology (1983-92). He also became a charter Education Consortium of Buffalo, as a member of the Buswell Fellowship member of the University of Michigan Cancer Center. Committee, and on the professional staff of the Witebsky Center for In 1992, Schwartz joined the faculty at the University at Buffalo as professor of medicine and, subsequently was appointed professor of pediatrics and microbiology. Immunology at UB, in addition to other service activities. "Dr. Stanley Schwartz exemplifies the balance of research and clinical dedication that makes for an outstanding academic clinician and transla- Throughout his career, Schwartz has primarily focused his research tional scientist," concluded Laychock. "The Stockton Kimball Award is a on the mechanisms of immunoregulation in humans and the immuno- testament not only to the success of Dr. Schwartz as one of UB's most pathogenesis of HIV infections. talented professors of medicine but also his participation as a generous "Stan has been consistently funded by NIH grants and other grants and awards to support his research," said Suzanne Laychock, PhD, and concerned faculty member who has contributed to the betterment of our university and the School of Medicine and Biomedical Sciences." A u t u m n 2 0 0 3 Buffalo Physician �Leon E. Farhi, MD exchange and the human circulatory Born in Cairo and raised in department chair from 1982 to —Former chair of physiology system. He was instrumental in Lebanon and Italy, Farhi moved to 1991. He was promoted to the and biophysics developing new approaches for mea­ Israel in 1947 to fight for the Israeli rank of Distinguished Professor— suring cardiac output and distri­ underground. He received his medi­ the highest rank in the SUNY Leon E. Farhi, bution of respiratory gases within cal degree in 1947 from the system—in 1989. MD, SUNY the lung and tissues of the body. Universite St. Joseph in Beirut and Distinguished Farhi ran the Themis Project, a Farhi received numerous honors completed his medical training in and awards over the course of his Hadassah Hospital in Jerusalem. career, including the Stockton Professor in the Defense Department-funded study Department of that assessed the effect of different Physiology and environments on breathing. Inter­ the United States in 1952 to treat of Medicine and Biomedical Biophysics, died ested in how deep-sea diving and tuberculosis patients at Saranac Sciences, a Humboldt Fellowship on July 9, 2003, high- and low-gravity environments Lake. After serving postdoctoral fel­ and a fellowship in the American in the Cleveland Clinic while under­ affected respiration, he conducted lowships at Johns Hopkins University Institute of Medical and Biological going surgery for a heart infection. experiments for NASA with astro­ and the University of Rochester, he Engineering. He was 79. nauts on Spacelab missions, as well joined the UB faculty as an assistant as in the human centrifuge in UB's professor. Farhi rose through the 54 years, Haya; daughter, Nitza F. 1958, Farhi studied physiological Center for Research and Education ranks at UB, being promoted to full Ellis, MD '77, clinical assistant problems of human lung-gas in Special Environments. professor in 1966 and serving as professor of pediatrics in the UB A UB faculty member since A pulmonologist, he came to Kimball Award from the UB School Survivors include his wife of GENESEE HEARING SERVICES THE AUDIOLOGY CENTER 61 Wehrie Drive (Near Harlem) Amherst 14225 630 Orchard Park Rd. (Near Ridge Rd.) West Seneca 14224 837-6213 712-2000 since 1954 • Diagnostic audiometric evaluations (pediatric and adult) • Digital & programmable hearing aid fittings on 60-day trial basis • Tinnitus evaluation and therapy • Vestibular evaluation for patients with dizziness/vertigo • Vestibular therapy • State of the art facilities "The Ear is the Road to the Heart (Voltaire) " Buffalo Physician A u t u m n 2 0 0 3 Daniel Schneider, AuD Jennifer Schneider, MA Jerri Kaplan Joyce, MA �School of Medicine and Biomedical Ellen Dickinson, MD and had served the university in a neurologist there and at Millard Sciences; and son, Eli R. Farhi, MD, —Interim chair of psychiatry many capacities, including a term Fillmore, the Veteran Affairs West­ associate professor of clinical medicine, also at UB. Contributions can be made to Ellen S. Dickinson, a neurologist and psychiatrist who served as as co-chair of the medical school's ern New York Healthcare System admissions committee. and BryLin hospitals. She was chair Dickinson also was clinical of the psychiatry department at the Leon E. Farhi Memorial Fund interim chair of director of psychiatric services c/o UB Foundation and addressed the Department at Erie County Medical Center to P. Davison, Department of of Psychiatry in (ECMCI for eight years. In May having a double specialty when she Millard Fillmore from 1992 to 1995. Dickinson fulfilled her dream of Physiology and Biophysics, 124 the University at 2002, she was the first woman attended Cornell University for resi­ Sherman Hall, University at Buffalo, Buffalo School honored as Physician of the Year dency training in psychiatry in 1983. School of Medicine and Biomedical of Medicine and at ECMC's annual Springfest. Sciences, 3435 Main Street, Biomedical Sci­ Buffalo, NY 14214. —SUE WUETCHER ences, died on A native of Barker in Niagara County, Dickinson received a In May 2003, Dickinson was named a distinguished fellow of the American Psychiatric Association. July 31, 2003, in Roswell Park Can­ bachelor's degree from Ohio cer Institute after a brief illness. Wesleyan University and a medical Dorothy Wilson Dickinson, of Buf­ She was 61. A clinical assistant professor, Dickinson taught at UB since 1971 Survivors include her mother, degree from Indiana University. falo, and two brothers, James L. of She completed residency training Barker, and Robert J. of Buffalo. in neurology at ECMC and worked as —SUE WUETCHER at CANTERBURY WOODS COMMUNITY. It's a full, worry-free lifestyle for independent adults, 62 and older, offering asset protection and health care guaranteeconvenience and value you won't find anywhere else. Episcopal Church Home and Affiliates Call today for more information and a personal prospectus... Canterbury Woods • 705 Renaissance Dr., Williamsville, NY 1422 Autumn 2003 1 II f I a I o Physician �\ 1 R E S E A R C H N E W S Poxvirus REPLICATION INHIBITED Work could result in a new treatment for smallpox BY LOIS BAKER M olecular biologists at the Univer­ sity at Buffalo have discovered a novel way to inhibit the replica­ tion of poxviruses (the group that includes smallpox virus) by interfering with messenger RNA synthesis necessary for the viruses to reproduce in a host or­ ganism. The discovery, which has a patent pending, could lead to the development of drugs to treat the potentially deadly disease in the event of a bioterrorismrelated outbreak. Such drugs also would be effective against related poxviruses such as monkeypox, which recently has infected dozens of people in the U.S who came in contact with animals imported from Africa, where monkeypox is indigenous. "Any success that results in a treatment is a success for everyone," says Edward Niles, PhD, professor of microbiology and biochemistry in the University at Buffalo School of Medicine and Biomed­ ical Sciences and primary discoverer of the new anti-replication mechanism. "We need something." Work that could lead to new drugs is in the early stages, Niles notes. To date, there is no effective treatment for smallpox or other poxviruses. Small­ pox was declared eradicated in 1980 after a worldwide vaccination campaign. The U.S. and Russia maintain the only autho­ rized repositories of the virus, but virolo­ gists acknowledge that the virus may exist outside these sites. Existing vaccines that could be used to Buffalo Physician Autumn 2003 Edward Niles. PhD. professor of microbiology and biochemistry, left,and Mohamed Ragaa Mohamed. PhD. right, a postdoctoral fellow who collaborated with Niles on the poxvirus research. protect against smallpox bioterrorism have a high incidence of side effects and may not be administered to certain seg­ ments of the population, notably preg­ nant women, persons with compromised immune systems due to disease or medi­ cations, persons with a history of eczema and children under one year of age. Drugs developed using this novel ap­ proach could be stockpiled for use if an outbreak occurs, says Niles. If a new small­ pox vaccination campaign were under­ taken, such drugs also could be available to treat persons who have serious reactions to the vaccine. Niles's discovery, achieved working with vaccinia virus, exploits a peculiar as­ pect of poxvirus biochemistry: Instead of creating copies of itself in the nucleus of the infected cell like other DNA viruses do (such as the herpes virus), poxviruses rep­ licate in the cell's cytoplasm, the gel-like material surrounding the nucleus. "Since poxviruses replicate in the cyto­ plasm, they can't use the host's enzymes present in the nucleus to make viral mRNA, which is translated to synthesize viral proteins," explains Niles. "These vi­ ruses have evolved in a manner that allows them to produce their own enzymes, �which are used to express their genes and permit their replication. "This quirk in the poxvirus replication process should make it possible for scien­ tists to design drugs targeted to those unique viral enzymes without interrupting nor­ mal cellular functions," he says. Vaccinia virus is the virus strain used for immunization against smallpox. The initial interest of Niles and colleagues was to understand the basic process in the early stage of poxvirus gene expression (virus gene expression takes place in three stages: early, intermediate and late). "The early phase is unique in that for transcription (mRNA synthesis) to pro­ ceed, it requires an initiating event at a site on the DNA called a promoter," he explains. "Another signal, called a termi­ nator, is required to stop the early gene transcription. We wanted to know what that terminator signal does." To study this mechanism, the UB re­ searchers synthesized a short RNA frag­ ment, or oligonucleotide, that contained the known termination signal. They then added the fragment to a test tube transcrip­ tion reaction and measured RNA synthesis. "We expected the oligonucleotide to inhibit the termination reaction," says Niles, "but instead of stopping it, the pres­ ence of the oligonucleotide stimulated premature termination. This resulted in the synthesis of truncated RNA mole­ cules, which would be unable to direct the synthesis of normal proteins. "This termination mechanism is unique to poxviruses, and this method of inhibition of gene expression should work on all poxviruses," he continues. "If this oligonucleotide could be delivered as a drug, it would inhibit synthesis of all pox­ virus proteins early in infection and stop the virus from replicating in the host." The work is in its very early stages, Niles cautions, with many steps that must be completed before a viable drug can be developed. "We have to identify the most active compounds in vitro, test their activities on virus replication in tissue culture, and then figure out how best to deliver it in an animal model before we can even begin to test it in humans." Mohamed Ragaa Mohamed, PhD, a postdoctoral fellow working in Niles's lab­ oratory, collaborated on the research, which was funded by the National Insti­ tute of Allergies and Infectious Diseases of the National Institutes of Health. CT> An article about this work was originally published in the Journal of Biological Chemistry. An abstract can be found at JBC Online at www.jbc.org/cgi/content/ abstract/278/14/11794. A law firm that stands out..., Suburban location, extended hours and personal service. We practice law for your peace of mind. Autumn 2003 Buffalo Physician �S T C O L U M N The Electronic 1 Patient Record i^&9g Will it finally happen? his past summer, I participated in a conference that could presage a sea change in the way patient medical records are kept. The conference, "Developing a National Action Agenda forNHII (National Health Informa­ tion Infrastructure) 2003," was sponsored by the U.S. Department of Health and Human Services. It set forth what its organizers called "an initiative to improve the effectiveness and efficiency of overall quality of health and health care in the United States." Keynote speaker Secretary Tommy Thompson challenged the invited stakeholders to "develop a comprehen­ sive, knowledge-based network of interoperable systems of clinical, public health and personal health informa­ tion that would improve decision making by makinghealth information available when and where it is needed." Over the course ofthe three-day meeting, certain standards were recommended, but the program is voluntary and does not envision a centralized database of medical records or government regulation. P atient medical records are traditionally paperbased and kept by the patient's doctor or hospital. As a patient moves from one doctor or hospital to another, medical knowledge becomes fragment­ ed and no one has a clear, long-term view of the pa­ tient's progress. In an electronic era, medical data on a patient could be shared; however, all systems now in use were originated to address particular local conditions and utilize disparate hardware and software. As a result, data cannot be readily moved from one such system to another. Government concern over this problem is not new. In 1991, the Institute of Medicine recommend­ ed that "health-care professionals and organizations adopt the computer-based patient record (CPR) as the standard for medical and all other records related to patient care." Since then, much effort has been ex­ pended to realize a common model, but consensus has Autumn 2003 been elusive. The NHII initiative challenges stake­ holders in health care to come up with a "national health information infrastructure" and offers leader­ ship, as well as possible financial incentives. A point made at the conference is that health care currently spends much less on information technology than do many grocery chains. One expert warned, however, that throwing more money into conventional dataprocessing approaches would be pointless. Patient Privacy versus Public Good I fundamental tenet of medical record keeping is that patients are unlikely to disclose to their phy­ sician intimate details that are necessary for their proper medical care unless they trust the physician to keep that information confidential. Clearly, no one should have access to private health-care information without a patient's authori­ zation, and patients should be able to see their records �and correct erroneous information in them. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 tried to apply these basic privacy rules in an era of electronic communication, and at a time when the U.S. health-care market was driven by large health plans and fiercecompetition, as it is today. The original HIPAA rules were complex and have since been changed several times, reflecting the fun­ damental conflict between the need for privacy for the patient and desires of public health workers, researchers, insurers, employers and others to gain access to the patient data. Even the use of medical rec­ ords in research currently has no national standard, and local institutional review boards often retain dis­ cretionary authority to grant waivers of consent. My Interest in Medical Informatics T hroughout my professional life I have been fasci­ nated by how medical information is categorized and utilized. A particular area of interest was how diagnoses were made. When individual computers became affordable I began to develop programs for that purpose. Gradually I became aware that the diag­ nostic problem was part of a larger task. If I could organize all medical knowledge, then diagnosis would be a subtask of a universal organization. This approach became "Framemed," a computer-based framework for medical knowledge that is based on hierarchies in various domains of medicine. "Diseases" became a hierarchy, as did "Agents," "Findings," "Tests," "Pro­ cedures" and more than 20 other traditional areas in medicine. When the concept of a computer-based patient record (CPR) became popular, that task began to dominate my activities with Framemed. Fortu­ nately, I was able to interest my son, Geoffrey, who brought to the problem the newer computer skills involving Web technology with browsers and servers. The Framemed CPR I he Framemed CPR is built on the premise that the patient controls his or her own record and how its content may be used. The key is that the patient appoints a surrogate (e.g., a hospital, health mainte­ nance organization, or physician group) to maintain the CPR on its server. At each medical encounter, the patient asks the surrogate, over a secure Internet con­ nection, to download the CPR. Results of the medical encounter are appended to the CPR, and it is uploaded to the surrogate's server. The patient may empower a doctor (or other health-care professional) to read or write on the CPR. The results of all laboratory testing, procedures and consultations are returned to the CPR, where the patient can immediately see them. The patient may record his or her own findings, such as weight, blood pressure, blood glucose, accidents, etc. All encounters in the CPR are dated and signed by the initiator and may not be altered thereafter except that encounter amendments may be added. To further protect patient confidentiality, the CPR is divided into two parts: an administrative file and a medical file. The latter contains no direct identification of the patient and hence its data may be used for statistical purposes without infringing on patient confidentiality. A surrogate managing many CPRs possesses a valuable cross section of medical data. With the pa­ tients' permission, the surrogate can make aggregate medical data available to outside agencies for various uses; for example, how many in the group have asth­ ma and how many take a particular drug. The mortal­ ity and morbidity following certain procedures can be assessed. Unusual activity of a particular nature might signal an impending or even in-progress epidemic or terrorist attack. Such data could flow from the CPRs without revealing any patients' identities, hence rec­ onciling patient privacy with public good. Also, in the Framemed system, concepts in the various hierarchies (e.g., diseases, drugs, tests) are hyperlinked to corresponding knowledge records, a feature that can be utilized independently (as a medi­ cal encyclopedia) or as part of the CPR (to find out more about a concept before selecting it from a pick list in our CPR). Moving On About the Author Charles W. Bishop, PhD, is associate professor of medicine and biochemistry at the University at Buffalo School of Medicine and Biomedical Sciences and a facilitator in the problem-based learning program for first- and second-year D octors have traditionally scribbled their patients' records and retained them. The government now asks if these can be incorporated into standardized, lifetime patient records for effective and efficient patient health care. Framemed has developed the soft­ ware by which a patient can keep his or her own, professional-quality medical record. We have recently set up a secure Web site to test and improve this software. The next step is for surrogates to license our medical students. He can be e-mailed at cbishop@buffalo.edu. software and offer patients generally the ability to maintain their own medical records. Doctors and medical groups can use the same records, leading to true patient-centered medical records, as promoted by the NHII initiative. Autumn 2003 Buffalo Physician �D N Beyond the Classroom By Linda J . Corder, PhD, CFRE S IS EVIDENT BY THIS ISSUE OF BUFFALO PHYSICIAN, mother died of breast cancer when he was 11. Dana met memory of Samuel Sanes, MD '30, lives on at our school. It Sam during his first semester in medical school; in his is here that he spent innumerable hours teaching students second year, he was diagnosed with Hodgkin's disease. pathology, answering their questions and assuaging their During Dana's initial treatments, Sam visited him every frustration—and fatigue—by listening and providing re­ day in the hospital, taking a bus from Millard Fillmore sponses that elicited laughter, or at least a chuckle. Sam Hospital to Buffalo General. He tutored Dana, kept his Sanes's dedication to students extended beyond classroom spirits up and convinced him to stay in doors, however, as reflected through myriad stories of medical school. When Dana returned to former students. class and reported sitting through lectures Take Maxine Hayes, MD, '73, who returned to UB in in the middle of a ring of empty seats, Sam 2000 to deliver the Stockton Kimball Lecture. Maxine was listened. When Dana's father died of lym­ raised in the South in the 1950s. Her family was poor and phoma four months after Dana's diagnosis, "lived on the other side of the tracks"; however, they instilled Sam comforted him. He also encouraged him in her the belief that there was nothing she couldn't do if she through clinical rotations and helped to find worked for it. She was awarded a scholarship to Spelman "someone to take a chance" on him for resi­ College in Atlanta and had an opportunity to study abroad dency training. in 1968. That year, Martin Luther King, Jr, and Robert Shortly before Dana began his residency, Sam was diag­ Kennedy were assassinated, protests against the Vietnam nosed with cancer, which subsequently claimed his life in War were at their height and demonstrators called for changes 1978. Suddenly the tables were turned and Dana became the throughout society. As a result, leaders in higher education teacher, encouraging Sam through rounds of chemotherapy began to reconsider admissions policies. In 1969, UB sent and radiation similar to what he had experienced. During recruiters to Atlanta who met with Maxine and offered her a his residency, Dana couldn't visit Sam often, but he wrote place in its medical school and a scholarship. to him regularly. During her time in Buffalo, Maxine, who is African American, had difficulty finding a place to live. However, Later, Dana moved to California. Currently, he is chief of surgery at Scripps Memorial Hospital in La Jolla. she was mentored and encouraged by Sam Sanes and his For both Maxine and Dana, Sam's friendship made all wife, Mildred, who frequently invited her to their home. the difference in their lives. Today they each remain friends They applauded her residencies at Vanderbilt University with Mildred while carrying the memory of Sam—an ex­ and Children's Hospital Medical Center in Boston, her traordinary teacher and a true gentleman—in their hearts. completion of a master's degree in public health at Harvard A decade after Sam's death, his sister, Thelma, estab­ University and her establishment of a family health clinic in lished a scholarship in her name and the name of their Mississippi (which recentlycelebrated its 25th anniversary). brother, Harold. Neither Harold nor Thelma went to col­ Today, Maxine serves as the Washington State Health lege, and Sam had to work his way through. This was the Officer, working closely with the medical community, local reason Thelma gave for wanting to help others at health departments and community groups to provide the "Sam's medical school."CO public the latest scientific information on how to become and stay healthy. Lyn Corder, PhD, is associate dean in the Office of Develop­ Or ask Dana P. Launer, MD, '73, who was raised in New York City by his father and future mother-in-law after his 40 Buffalo Physician Autumn 2003 ment and Alumni Affairs. She can be contacted via e-mail at ljcorder@buffalo.edu; or by phone at 1-877-826-3246. �Endowments ofJ the School AND BIOMEDICAL SCIENCES Endowments, especially for scholarships, are vital to the future of this school. A list of all of the school's current endowments—as well as those for the Health Sciences Library—follows. Those with an asterisk (* ) were initiated during the past fiscal year. Those in bold print had one or more additional gifts during this timeframe. New endowments that were funded or partially funded have both an asterisk and appear in bold. Read through the list. Thank your friends, colleagues, classmates who have initiated endowments or those you know who are helping to build funds, such as the Medical Alumni Endowed Scholarship Fund, through annual gifts. Please consider the school's endowment program in your philanthropic plans, either by adding to an existing fund or by setting up a new one. As always, your friends in the Office of Alumni Affairs and Development will answer any questions you might have. School of Medicine and Biomedical Sciences PAUL K. BIRTCH, M.D., FUND H.W. ABRAHAMER MEMORIAL SCHOLARSHIP MARVIN A. AND LILLIAN BLOCK FUND SIDNEY ADDLEMAN MEMORIAL WILLARD H. BOARDMAN, M.D., AND JEAN BOARDMAN FUND DR. GEORGE J. ALKER FUND FOR NEURORADIOLOGY DR. SOLOMON G. BOOKE AND ROSE YASGUR BOOKE FUND THEODORE M. & BESSIE G. ALPERT SCHOOL OF MEDICINE SCHOLARSHIP JAMES H. BORRELL UROLOGY FUND ALPHA OMEGA ALPHA ENDOWMENT ANNE AND HAROLD BRODY ANATOMY LECTURE FUND ALPHA OMEGA ALPHA LIBRARY FUND CLAYTON MILO BROWN MEMORIAL AMERICAN ACADEMY OF FAMILY PHYSICIANS PRESIDENT'S AWARD BUKOWSKI FAMILY ENDOWMENT* ANATOMICAL SCIENCES LIBRARY FUND GEORGE N. BURWELL FUND ANESTHESIOLOGY DEPARTMENT ENDOWMENT DR. WINFIELD L. BUTSCH MEMORIAL LECTURE IN CLINICAL SURGERY ANNUAL PARTICIPATING FUND FOR MEDICAL EDUCATION VINCENT CAPRARO LECTURESHIP FUND—CLASS OF 1945 BACCELLI MEDICAL CLUB AWARD DR. CHARLES F. CARY MEMORIAL FUND L. B. BADGERO MEDICAL SCHOOL FUND DR. AND MRS. JOSEPH A. CHAZAN MEDICAL SCHOLARSHIP VIRGINIA BARNES ENDOWMENT CLINICAL PREVENTATIVE MEDICINE FELLOWSHIP DR. WALTER S. BARNES MEDICAL SCHOOL FUND ALMON H. COOKE SCHOLARSHIP DR. WALTER S. BARNES MEMORIAL SCHOLARSHIP FUND PATRICK BRYANT COSTELLO MEMORIAL DR. ALLEN BARNETT FELLOWSHIP IN PHARMACOLOGY CTG ONCOLOGY FUND DR. CHARLES A. BAUDA AWARD IN FAMILY MEDICINE JAMES H. CUMMINGS SCHOLARSHIP THOMAS R. BEAM, JR MEMORIAL FUND EDWARD L. CURVISH, M.D., AWARD IN BIOCHEMISTRY GILBERT M. BECK MEMORIAL FUND ALFRED H. DOBRAK, M.D., RADIOLOGY LECTURE FUND RITA M. AND RALPH T.BEHLING.M.D., CHAIR IN DERMATOLOGY* ALFRED H. DOBRAK, M.D., RADIATION RESEARCH FUND DR. ROBERT A. BENNINGER FUND IN ORTHOPEDICS MAX DOUBRAVA, JR SCHOLARSHIP FUND ROBERT S. BERKSON MEMORIAL AWARD IN THE ART OF MEDICINE THE ELIZABETH MEDICAL AWARD BERNHOFT FUND FOR THE NEUROANATOMY MUSEUM DR. ROBERT M. ELLIOT SCHOLARSHIP ERNST BEUTNER SKIN IMMUNOPATHOLOGY AWARD GEORGE M. ELLIS, JR, M.D. ENDOWMENT FUND FOR MEDICINE LOUIS J. BEYER SCHOLARSHIP ELEANOR FITZGERALD FAIRBAIRN SCHOLARSHIP Autumn 2003 II u f f a I 0 P h y s i c i a 1 41 �I I j I EXPERIMENTAL NEUROLOGY FUND HILLIARD JASON AND JANE WESTBERG FUND FOR EDUCATIONAL INNOVATION FAMILY MEDICINE ENDOWMENT JAMES N. JOHNSTON SCHOLARSHIP FAMILY MEDICINE RESEARCH FUND* C. SUMNER JONES LIBRARY FUND FEYLER FUND FOR RESEARCH IN HODGKIN'S DISEASE HARRY E. AND LORETTA A. JORDON FUND DR. GRANT T. FISHER FUND FOR MICROBIOLOGY H. CALVIN KERCHEVAL MEMORIAL FUND L. WALTER FIX, M.D., '42 '43, ENDOWED SCHOLARSHIP FUND DEAN STOCKTON KIMBALL MEMORIAL AWARD EDWARD FOGAN MEMORIAL LECTURE/PRIZE FUND DEAN STOCKTON KIMBALL MEMORIAL SCHOLARSHIP FORD FOUNDATION FUND FOR MEDICAL EDUCATION DR. JAMES E. KING POSTGRADUATE FUND THOMAS FRAWLEY, M.D., RESIDENCY RESEARCH FELLOWSHIP FUND MORRIS LAMER AND DR. ROBERT BERNOT SCHOLARSHIP FUND FOR CELEBRATING PHILANTHROPY DR. CHARLES ALFRED LEE SCHOLARSHIP MARCOS GALLEGO, M.D., CLINICAL EXCELLENCE AWARD FUND DR. HEINRICH LEONHARDT PRIZE RONALD GARVEY, M.D., STUDENT LIFE ENRICHMENT FUND DR. GARRA K. LESTER STUDENT LOAN JAMES A. GIBSON ANATOMICAL PRIZE LLOYD LEVE FUND LAWRENCE AND NANCY GOLDEN LECTURESHIP IN MIND-BODY MEDICINE THE LIEBERMAN AWARD WALTER S. GOODALE SCHOLARSHIP HANS J. LOWENSTEIN AWARD IRENE PINNEY GOODWIN SCHOLARSHIP LUPUS SCHOLARSHIP FUND A. CONGER GOODYEAR PROFESSORSHIP OF PEDIATRICS WILLIAM E. MABIE, D.D.S., AND GRACE S. MABIE FUND GEORGE GORHAM FUND MILFORD C. MALONEY AND DIONE E. MALONEY SCHOLARSHIP FUND* DR. BERNHARDT S. AND DR. SOPHIE B. GOTTLIEB AWARD DR. WILLIAM H. MANSPERGER FUND ADELE M. GOTTSCHALK SCHOLARSHIP FUND MEDICAL ALUMNI ASSOCIATION LIFE MEMBERSHIP FUND* CARL V. GRANGER, M.D., ENDOWMENT MEDICAL ALUMNI ENDOWED SCHOLARSHIP DR. PASQUALE A. GRECO LOAN FUND MEDICAL SCHOOL CLASS OF 1957 SCHOLARSHIP GLEN E. AND PHYLLIS K. GRESHAM FUND FOR CLINICAL RESEARCH MEDICAL SCHOOL CLASS OF 1958 SCHOLARSHIP GLEN E. GRESHAM, M.D., VISITING PROFESSORSHIP MEDICAL SCHOOL CLASS OF 1963 SCHOLARSHIP ADELAIDE AND BRENDAN GRISWOLD SCHOLARSHIP MEDICAL SCHOOL CLASS OF 1973 SCHOLARSHIP DR. THOMAS J. AND BARBARA L. GUTTUSO SCHOLARSHIP & AWARD MEDICAL SCHOOL PROFESSORSHIP FUND GYNECOLOGY-OBSTETRICS DEPARTMENT ENDOWMENT SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES ENDOWMENT JEAN SARAH HAHL MEMORIAL MARIAN E. MELLEN FUND EUGENE J. FIANAVAN SCHOLARSHIP MICROBIOLOGY ENDOWMENT FUND FLORENCE M. & SHERMAN R. HANSON FUND FOR MEDICAL EDUCATION DR. DAVID KIMBALL MILLER AWARD DEVILLO V. HARRINGTON LECTURESHIP EUGENE R. MINDELL, M.D., CHAIR IN ORTHOPAEDIC SURGERY THE HEKIMIAN FUND G. NORRIS MINER, M.D., MEMORIAL AWARD HEWLETT FAMILY ENRICHMENT FUND FOR PSYCHIATRY COLLEEN C. AND PHILLIP D. MOREY, M.D., SCHOLARSHIP CHARLES GORDON HEYD MEDICAL RESOURCE FUND RICHARD J. NAGEL, M.D., ANESTHESIOLOGY RESEARCH DR. FRANK WHITEHALL HINKEL SCHOLARSHIP FUND DR. ANGE S. NAPLES MEMORIAL SCHOLARSHIP RALPH HOCHSTETTER MEDICAL RESEARCH FUND DR. S. ROBERT NARINS MEMORIAL AWARD DR. SUK-KI HONG MEMORIAL FUND NATIONAL MEDICAL ASSOCIATION BUFFALO CHAPTER SCHOLARSHIP FUND ABRAHAM M. HOROWITZ FUND JOHN P. NAUGHTON AWARD FUND LUCIEN HOWE PRIZE FUND NEPHROLOGY RESEARCH ENDOWMENT DR. MYROSLAW M. HRESHCHYSHYN MEMORIAL ENDOWMENT DR. ERWIN NETER MEMORIAL FUND R.R. HUMPHREY & STUART L. VAUGHAN NU SIGMA NU ALUMNI SCHOLARSHIP ANTOINETTE AND LOUIS H. NEUBECK FUND BUFFALO PHYSICIAN A u t u m n 2 0 0 3 �NEUROLOGY DEPARTMENT ENDOWMENT FUND IRENE SHEEHAN FUND DEPARTMENT OF NUCLEAR MEDICINE ENDOWMENT FUND* DEWITT HALSEY SHERMAN AND JESSICA ANTHONY SHERMAN FUND DR. BENJAMIN E. & LILA OBLETZ PRIZE FUND IN ORTHOPAEDIC SURGERY DR. LOUIS A. AND RUTH SIEGEL TEACHERS'AWARD FUND DR. ELIZABETH P. OLMSTED FUND IN BIOCHEMISTRY S. MOUCHLY SMALL, M.D., AWARD IN PSYCHIATRY OMEGA UPSILON PHI OF PHI CHI MEDICAL FRATERNITY SCHOLARSHIP FUND S. MOUCHLY SMALL, M.D., EDUCATION CENTER FUND JOSEPHINE HOYER ORTON TRUST FUND IRVINE AND ROSEMARY SMITH ENDOWED CHAIR IN NEUROLOGY VICTOR A. PANARO MEDICAL SCHOOL FUND DR. IRVING M. SNOW FUND F. CARTER PANNILL, JR, M.D., AWARD ENDOWMENT MARY ROSENBLUM SOMIT ENDOWED UNDERGRADUATE SCHOLARSHIP FUND STEPHEN J. PAOLINI,M.D., MEMORIAL FUND MORRIS AND SADIE STEIN NEURAL ANATOMY PRIZE FUND ALLAN WADE PARKER DNA RESEARCH GIFT DIANE AND MORTON STENCHEVER LECTURE FUND PARKINSON'S DISEASE RESEARCH FUND JOHN J. AND JANET H. SUNG SCHOLARSHIP FUND JOHN PAROSKI MEMORIAL AWARD FUND JOHN H. TALBOTT VISITING PROFESSORSHIP FUND PARTICIPATING FUND FOR MEDICAL EDUCATION KORNEL L. TERPLAN, M.D., LECTURE FUND DR. MARK A. PATRINO MEMORIAL AWARD TREVETT SCHOLARSHIP ROBERT J. PATTERSON RESIDENT AWARD UROLOGY DEPARTMENT ENDOWMENT FUND* PRIMARY CARE ACHIEVEMENT FUND RICHARD E. WAHLE RESEARCH FUND PROGRESSIVE MEDICAL CLUB OF BUFFALO FUND MILDRED SLOSBERG WEINBERG ENDOWMENT PSYCHIATRY DEPARTMENT ENDOWMENT FUND E. J. WEISENHEIMER OPHTHALMOLOGY AWARD DR. HERMAN RAHN MEMORIAL LECTURE ENDOWMENT DR. MARK W. WELCH AND BEULAH M. WELCH SCHOLARSHIP FUND REHABILITATION MEDICINE ENDOWMENT JOHN A. WENDEL ENDOWMENT FUND* ALBERT AND ELIZABETH REKATE CHAIR IN CARDIOVASCULAR DISEASE JAMES PLATT WHITE SOCIETY ENDOWMENT ALBERT C. REKATE REHABILITATION MEDICINE LIBRARY FUND WILLIAMS/BLOOM MEDICAL RESEARCH FUND DONALD RENNIE PRIZE IN PHYSIOLOGY DR. MARVIN N. WINER FUND FOR DERMATOLOGICAL RESEARCH MARY CECINA RIFORGIATO STUDENT AWARD IN BIOTECHNICAL AND WITEBSKY FUND FOR IMMUNOLOGY CLINICAL LABORATORY SCIENCES DR. ERNEST WITEBSKY MEMORIAL FUND DOUGLAS RIGGS AWARD IN PHARMACOLOGY AND THERAPEUTICS FARNEY R. WURLITZER PRIZE FUND THE RING MEMORIAL FUND FARNEY R. WURLITZER PSYCHIATRY FUND MEYER H. RIWCHUN, M.D., PROFESSORSHIP IN OPHTHALMOLOGY DR. MAREK B. ZALESKI AWARD FUND EMILE DAVIS RODENBERG MEMORIAL AWARD FRANKLIN AND PIERA ZEPLOWITZ, M.D., SCHOLARSHIP FOR MEDICAL THOMAS A. RODENBERG AND EMILE DAVIS RODENBERG SCHOLARSHIP FUND HARRY AND FAYE ROSENBERG PEDIATRIC ONCOLOGY RESEARCH FUND* STUDENTS* HERMAN AND ROSE ZINKE MEMORIAL SCHOLARSHIP ELIZABETH ROSNER FUND IRA G. ROSS AND ELIZABETH P. OLMSTED ROSS, M.D. CHAIR OF OPHTHALMOLOGY Health Sciences Library DR. SHELDON ROTHFLEISCH MEMORIAL FUND ROBERT L. BROWN HISTORY OF MEDICINE COLLECTION HAROLD S. SANES AND THELMA SANES MEDICAL SCHOLARSHIP DR. BERNHARDT S. AND DR. SOPHIE B. GOTTLIEB COLLECTION IN THE PHILIP P. SANG MEMORIAL FUND BEHAVIORAL SCIENCES SARKARIA FAMILY PROFESSORSHIP IN DIAGNOSTIC MEDICINE C. K. HUANG LECTURE FUND MARIA NAPLES SARNO, M.D., SCHOLARSHIP STOCKTON KIMBALL SCHOLARSHIP IN MEMORY OF SYLVIA KIMBALL SCHAEFER FUND IN CARDIOVASCULAR DISEASES DR. EDGAR R. MCGUIRE HISTORICAL MEDICAL INSTRUMENT FUND SCHOLARSHIP OF THE PROGRESSIVE MEDICAL CLUB OF BUFFALO LILLIE S. SEEL SCHOLARSHIP A u t u m n 2 0 0 3 BUFFALO PHYSICIAN �MEDICAL ALUMNI ASSOCIATION Dear Fellow Alumni, hope you're having a great autumn! With the start of the academic year, the Medical Alumni Associa­ Officers and Board Members 2 0 0 3-2 0 0 4 tion (MAA) Governing Board has remained busy, organizing activities within student and alumni circles and making plans for next year's Spring Clinical Day and Reunion Weekend. The board has been revitalized this year by the addition of three new members: Helen Cappuccino, MD '88, Charles Niles, MD '83, and Indrani Sinha, MD '96. PRESIDENT Stephen B. Pollack MD '82 VICE PRESIDENT Colleen Mattimore MD '91 TREASURER Martin L. Brecher MD '72 Helen, Chuck and Rini have already proven to be energetic, outspoken board members who will play an active role in the functions of the organization. Addition­ ally, we have been able to retain the expertise of our outgoing past president, John Bodkin II, MD '76, who has agreed to remain on the board as an emeritus member. During Orientation Week, the MAA proudly sponsored the annual White Coat Ceremony, in which first-year students were presented with their first white coats. The association also sponsored the Student Clinician Ceremony, helping the third-year medical students "kick off' their clinical training. MEMBERS Rohit Bakshi MD '91 Helen Cappuccino MD '88 Martin C. Mahoney MD '95, PhD Colleen Mattimore MD '91 Charles Niles MD '83 In September, the past presidents of the MAA gathered with friends, guests and alumni of the medical school to honor our newest distinguished alumnus, Michael Cohen, MD '61. We congratulate Dr. Cohen on receipt of this award and invite you to read more about his career and accomplishments in the winter issue of Buffalo Physician. Plans are taking shape for Spring Clinical Day and Reunion Weekend, scheduled for April 30May 1, 2004. After noting the fantastic response to this year's program, which showcased downtown Buffalo, we will invade the city again next spring. The Clinical Day program is titled "Medicine 2004: Challenges 8c Innovations." We are pleased to report that Richard O. Dolinar, MD '72, a renowned expert on diabetes, will serve as our Stockton Kimball Lecturer. In addition to the wonderful venues Indrani Sinha MD '96 utilized last year, the Pierce Arrow Museum (one of Buffalo's well-kept secrets!) will be the site of the EMERITUS MEMBERS events planned for the weekend. John J. Bodkin II MD '76 Donald P. Copley MD '70 Robert E. Reisman MD '56 REGIONAL MEMBERS Joseph A. Chazan MD '60 Rhode Island Max Doubrava MD '59 Nevada Saturday evening Reunion Dinner Reception. In the next issue of Buffalo Physician, I will preview On a financial note, I must report that review of the MAA's annual budget has driven home the fact that the cost of providing these and other services continues to escalate. After many years of maintaining member dues at $65 a year, it will be necessary to raise dues slightly, to $75 a year, in order to continue to support our medical school, students and alumni. This increase will take effect with the 2004-2005 year. Additionally, the cost of lifetime membership will increase to $1,000. That means that a lifetime membership—at this year's price of $750—is a bargain! For your convenience, membership materials are enclosed in this issue of the magazine. As always, your support of our alma mater through your interest, time, membership in the MAA and gifts remains the backbone on which our efforts and accomplishments are built. We are all part of the family; let's show it in any way we can. Dorothy C. Rasinski MD '59, JD California STEPHEN B. POLLACK, MD '82 President, Medical Alumni Association �lassnotes AUTUMN 2003 1940s Correct! Maxine Hayes. MB '73, 2003 issue of MPH, Wash­ Buffalo Physician, the University of also assistant professor Washington, School in the Department of of Public Health. Molecular and Cellular Biophysics at RPCI. ington State Peter R. Reczek, PhD '79, has Reczek earned his doc­ the photograph of health of­ been appointed director toral degree in Physiology the Class of 1948 ficer, was presented the Washington of technology transfer in Fiscal Administration, and Biophysics from RPCI Graduate Division, Office of University at Buffalo in Health Foundation's 2003 Health Re­ 1979 and completed a Heroes of Health Care search, Inc. (HRI) at postdoctoral fellowship in Award on June 19, 2003. Hayes has been with the Roswell Park University in 1980. He Cancer In­ through California State Department of Health stitute (RPCI). Reczek has served on the faculty at Harvard Medical School University, Dominguez since 1991 and is clinical served as a consultant to and the Dana Farber Can­ Jay B. Belsky, MB '51. Hills. I was fortunate to professor of pediatrics at RPCI since 2001 and is cer Institute until 1989. writes: "I have been re­ have been able to attend on page 39 was 1948 Class chair Daniel Fahey. center, with classmatesWilliam iloom. left.mi Francis Peisel. 1950s incorrectly dentified as the ilass of 1943. tired since 1988, after my medical school 50th practicing for over 33 Reunion in 2001, and I years with Kaiser am looking forward to Permanente in Harbor the 55th in 2006. My City, CA. I was a staff in­ ternist, then chief of the first wife, Georgette, died Department of Internal years of marriage. I re­ Medicine, then area asso­ married a year later to ciate medical director. In Carolyn. Between the two 1976 I ended my admin­ of us, we have seven istrative work, took a adult children, ranging in year off to retrain and recertify in internal age from late 30s to early medicine, then returned to practice as a staff ranging from 9 to 23, and three great grand­ internist until my retire­ children, ranging in age ment in 1988. After retir­ from several months to ing, I became involved in adult literacy tutoring, several years." Favorite medical and tutoring of young school memory: "I have children through the lo­ loving and happy memo­ ries of Oliver P. Smith, who gave me the won­ derful news that I had cal library and Boys and Girls Club. For the past several years, I have been a member of Omnilore, a learning-in-retirement program adminstered Lifetime Achievement biochemistry at Brandeis Doc? ion form in 1983, after almost 38 50s, 20 grandchildren, been accepted to medical school and who was my favorite teacher." YOUR CLASSMATES WOULD LIKE TO HEAR FROM YOU! Here's how to update them in three easy steps... Visit the UB School of Medicine and Biomedical Sciences' Web site at www.smbs.buffalo.edu click on Alumni click on What's Up, Doc? Things your fellow alumni tell us they would like to read about: • family updates • interesting 'trips and trails' • happy occasions, humorous interludes • moves/promotions • retirement • honors and awards • publications • public service/election to office • research endeavors • musings on life as a doc .... A u t u m n 2003 B u f f a l o P h y s i c i a n �s 1980s N O T E s ing Schering-Plough, lege of Law on May 18, Cohen, Fetter & Burstein, provide health services to Koestler served as a se­ 2003, summa cum laude PC, in Syracuse, NY. women has been ex­ Thomas P. Koestler. PhD nior vice president and (highest academic aver­ Knoll's wife, Maritza panded to include con­ '82, has been appointed head of global regulatory age). A member of the Alvarado. MD '85, contin­ sultative second opinions executive vice president affairs at Pharmacia Cor­ Syracuse Law Review, his ues her work as an at­ for breast cancer. The for worldwide regulatory affairs, worldwide re­ search quality assurance poration, which has since tending neonatalogist. services are being pro­ merged with Pfizer. He note, "Mea Culpa, Mea Culpa: A Call for Privi­ The couple celebrated vided at NFMMC by has more than 20 years lege for Self-Disclosure of their 17th anniversary Helen Cappuccino, MD and project management experience in the phar­ maceutical industry and is credited with securing Error in the Setting of in October. tion," won the 2002 Helen Cappuccino. MD '88. more than 60 regulatory American Health Law­ The collaboration be­ approvals, including ap­ proval of 24 new molecu­ lar entities. yers Association Student Writing Contest and was tween brings an expertise in Roswell breast cancer that previ­ published in 35 Journal of Park Cancer ously was unavailable to Health Law 419 (2002). Institute women locally," said Andrew M. Knoll. MD '84. He has accepted a posi­ (RPCI) and Joseph A. Ruffolo, the JD, FACP, internal medi­ cine, graduated from Syracuse University Col­ tion as an associate in the at Schering-Plough Research Institute (SPRI). In this role, he will also assume leader­ ship of the allergy and inflammation therapy team at SPRI, charged with ongoing develop­ ment of strategies and direction for this area of research. Before join­ '88, clinical assistant pro­ Primary Medical Educa­ fessor of surgery health law department of Scolaro, Shulman, at RPCI. "Dr. Cappuccino Niagara Falls Memorial Medical medical center's presi­ dent and chief executive Center (NFMMC) to officer at the time the ex- "Experience the tranquility of Tropical Fish" LARGEST SELECTION IN THE AREA Surgeons Onnnn tltn Complete set-ups from table/desk top to large central displays Equipment and supplies Tropical fish, gold fish & Koi (domestic & imported), dwarf frogs, bottom feeders, mollusks, crustaceans & other unusual varieties. Imported livestock and frozen foods • Wide selection of aquarium accessories and decorative items • Food, antibiotics and water conditioners • Aquatic plants (live & artificial) • Lighting accessories MAT IDEAS: «• Numerous Dry-Scape Displays in Our Showroom Beta Vase Plant Aquariums #" Lucky Bamboo Plants Are you interested in publishing an advertisement in Buffalo Physician? <•" Set-Up and Maintenance Programs Available If so, contact: Sharon Russell-Moore Account Representative Gift Ideas & Gift Certificates Tropi^1 Pish Sharmore Enterprises 248 Broad Street Tonawanda, NY 14150 Transitown Plaza 634-9344 www.tdstropical.com OPEN: Mon, Wedjhurs 9am-9pm;Tues & Fri Noon-7:30pm Sat 10am-6pm; Sun Noon-5pm Buffalo Physician A u t u m n 2 0 0 3 Visit 'Little Joe'- the Giant Pacu (roughly 30 lbs.) or Our Large Predator - Tiger Shovel Nose Cat-Fish. Main St. - Rt. 5 n Tropical Fish TRANSITOWN PLAZA -I-90- �RELOCATION HUNT REAL ESTATE ERA E-mailr pansion in services was Department of announced. "Roswell Cell and Mo­ Park is nationally re­ lecular Biology nowned as a cancer treat­ from RPCI's ment center. We are Graduate Division most fortunate to have and completed one of its physicians as a postdoctoral training consultant to our out­ in the Department of standing team of surgeons." Molecular Virology, 1990s Classnotes can also be submitted by e-mail to: bp-notes@buffalo.edu Immunology and Medi­ to that, she served as re­ cal Genetics at OSU. His search assistant profes­ research interests include sor in the Department of the study of DNA methy- Social and lation, its contribution to Preventive currently living in Alex­ the carcinogenesis and andria, VA. In June 2003, Medicine identification of potential he earned a master of at UB. DNA methylation targets McCann Paul Seeman. MO '93. is public health degree. E-mail address is: paul seeman@sprintnrail.com. Dominic J. Smiraglia. PhD '97, has been appointed assistant member in the Department of Cancer Genetics at Roswell park Cancer Institute (RPCI). for early detection and earned a diagnosis of cancer. doctorate in epidemiol­ Smiraglia has authored or ogy and community co-authored more than health at UB in 1998 and we help people move. 30 journal publications, is also a registered dieti­ Call for a free relocation portfolio regarding your destination city. Call 1-800-688-1170 or go on-line and visit our web site at book chapters and ab­ tian. Her research inter­ stracts. He is an ad hoc ests focus on nutritional reviewer for the Journal of and molecular epidemi­ Medical Genetics and Can­ ology, including the im­ cer Research. pact of diet on cancers of He returns to RPCI from the Division of Human huntrealestate.com Totally customized service portfolio including the reproductive organs. Susan McCann. PhD '98, She is currently conduct­ has been appointed as­ ing an investigation of State University (OSU), sistant member in the the relationship between where he served as a Division of Cancer Pre­ dietary phytoestrogen in­ research scientist. In vention and Population take and genetic suscepti­ 1997, Smiraglia earned a Sciences at Roswell Park bility to breast cancer. doctoral degree in the Cancer Institute. Prior Cancer Genetics at Ohio Tc Michael D. Banas, MD '00, and Anne C. (Wolpiuk) Banas, MO '02 Michael writes [in late June]: "Anne and I just re­ • Nationally trained relocation experts • Complete family needs analysis • Global home sale assistance • Special services for seniors • Full community tour • A complete cost of living analysis • A list of all school systems throughout WNY • Complete spousal placement assistance including resume writing and corporate contacts • 24 hour or less response time • Confidentiality assured turned from our honeymoon in Maui. We are living in Williamsville, NY. Anne finished her preliminary year in internal medicine at UB, where she is now a neurology resident. I finished my residency in inter­ nal medicine at UB and started a fellowship in MARY CROGLIO Corporate Relations Officer cardiology at UB, where I am also working as a research fellow at The Center for Research in Cardiovascular Medicine." Hunt ERA Relocation Center 5570 Main Street Williamsville, New York 14221-5410 Email: huntrelocation@huntrealestate.com A u t u m n 2 0 0 3 Buffalo Physician �Victor A. Filadora, Jr, MO '99, has been appointed to the Department of 2000s Rose C. Graham-Maar. MD, Anesthesiology and 00. writes: "I completed Critical Care Medicine my pediatrics residency at In Memoriam at Roswell Park Cancer The Children's Hospital Institute. He comes from of Philadelphia and began Brigham and Women's a three-year fellowship in Harold K. Palanker, a long time Buffalo surgeon, died on March 24, 2003, at Hospital, Harvard Medi­ pediatric gastroenterology his home in Albuquerque, NM. He was 89. Harold K. Palanker. MD '40 cal School, Boston, MA, and nutrition at CHOP where he completed on July 1, 2003.1 married age of 17. Following graduation from UB medical school in 1940, he com­ residency Stefan Maar on June 14, pleted his residency at Buffalo General Hospital (BGH). He then entered pri­ training 2003, in Delaware. We vate practice and held surgical and teaching positions at Children's Hospital in the had a fantastic honey­ of Buffalo and BGH. Palanker was also associate professor of surgery at UB Depart­ moon in Hawaii. E-mail and served as president of the Buffalo Surgical Society. After retiring from ment of address is: rosecorinne private practice in 1979, he moved to Albuquerque, where he worked for Anesthesia. @alumni.brandeis.edu. <3> eight years in the Ambulatory Care Unit of the Veterans Hospital. He earned his medical A native of Romania, Palanker moved to the United States in 1930 at the Surviving are his wife of 55 years, the former Janice Powsner of Albu­ degree in 1999 and querque; four daughters: Maureen Leshendock of Reno, NV, Robin and completed an internship Abby Gail, both of Los Angeles, CA, and Leslie of Paris, France. in medicine in 2000 at UB. ^ — — • www.buffalo-medical.bkstr.com Your medical resource is just a click away. University a t Buffalo The State University of New York UNIVERSITY MEDICAL BOOKSTORE Main Street • Phone:(716)833-7131 Buffalo Physician A u t u m n 2 0 0 3 �nsatisfied with midafternoon programming, 17-yearold Melissa Stagg sat in front of a 25-inch television screen, changing the channels with a remote control. "Stop flipping those channels like that," her mother, Shirley Dawson of Buffalo, called out. "You're not at home." But for Melissa, a senior at Grover Cleveland High School, making a trip to Dr. Vincent Cotroneo's of­ fice was like visiting a relative. Cotroneo, 86, who recently retired from his prac­ tice after 57 years of service, said he wouldn't have had it any other way. At first glance, the reasons for Melissa's comfort were obvious. The wildlife paintings covering the walls and the oversized chairs and large brown couch made for a seating area with all the comforts of home. Signs on the walls, encouraging patients to "Make an appointment for your next mammogram" and "Sign in at the desk," were the only indications there was a doctor behind the dark wooden doors leading into the office. "I've always wanted my patients to feel comfortable," Cotroneo said. "I try to take care of both their physical and emotional needs. I've always tried to be both a friend and a doctor." An old-fashioned family practitioner and surgeon, Cotroneo said he has delivered thousands of babies over the years, including members of the Stagg family. "He took care of my mother, father, aunts, uncles and my grandmother, too," said Melissa. "He took care of my whole family. He even delivered me and my brother and my mother." "I really don't want to see him go," said Dawson. "I'm really going to miss him. He's an honest man, he comes right out and tells you what's wrong without beat­ ing around the bush." Born and raised in South Buffalo, Cotroneo earned his medical degree from the University of Buffalo and served as a physician during World War II. For his efforts during the war, he received the Silver and Bronze stars. Shortly after returning from the war, Cotroneo pur­ chased his home at 777 McKinley Parkway. The first floor became his family practice, and on the second floor, he and his late first wife, Rose, raised eight children. "We would come home from school and there would always be patients sitting on the steps, waiting to see him," said his son, Carl. "I think some of them were there more to socialize than to be treated for an illness." Cotroneo continued to make house calls and was a member of the medical staff at Our Lady of Victory and Mercy hospitals until he retired at the end of June. "He's a little sad about leaving," said Paula, Cotroneo's wife. "Many of his patients begged him to stay. He's always treated his patients as if they were family members. I know he'll miss them all. Reprinted with permission from the Buffalo News. �Buffalo Physician University at Buffalo The State University of New York 3435 Main St. Bldg. 22 Buffalo. New York 14214-3013 Non-Profit Org U.S. P o s t o g e d I) r F A L u P H Y S I C I A N Address Service Requested Remember this old friend? Between June and November of 2003, University at Buffalo undertook an ambitious project to renovate the Hayes Hall bell tower, restoring the South Campus landmark to its former glory. Masonry was updated, windows replaced and rust from structural steel removed. Before UB acquired the 1870s Georgian-style building, it served as an insane asylum, as the Erie County Almshouse and, later, as the county hospital. UB added the tower during a 1927 renovation. The bell chimes and tower clock were installed in 1928, a gift of Kate Robinson Butler, wife of a former publisher of The Buffalo News. The four gigantic bells inside the tower range in weight from 400 to 1,800 pounds. They are Westminster chimes and are tuned to F, B flat, C and D. When the bells were temporarily silenced during the renovation project, UB received calls from residents in the university neighborhood: "Hey, what happened to the bells?" BP 0004-03 p^gp B u f f a l o , NY P e r m i t No. 3 1 1 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 2003 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2003-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v38n02-2003-Autumn Table Of Contents A list of subunits of the resource. Remembering Samuel Sanes Where Are WeToday? Medical School Alumni Pathways Research Development Classnotes Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v38n02 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright 2003 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/b3b4f366c107aeef5d132a68e63d822d.pdf bbf6bde95fa05a2a7dc4d35e6b9c29f5 PDF Text Text MANAGING MEDICAL INFORMATION IN UB'S �Dear Alumni and friends, BUFFALO PHYSICIAN Volume 28, Number 1 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY ADVANCEMENT Dr. Carole Smith Petro DIRECTOR O F PUBLICATIONS Timothy J. Conroy EDITOR Nanette Tramont Kollig, R.N. ART DIRECTOR Alan J. Kegler ASSOCIATE ART DIRECTOR Scott Fricker PRODUCTION MANAGER Ann Raszmann Brown STATE UNIVERSITY O F NEW YORK AT BUFFALO S C H O O L O F MEDICINE AND BIOMEDICAL S C I E N C E S Dr. John Naughton, Vice President for Clinical Affairs, Dean EDITORIAL BOARD Dr. John A. Richert, Chairman Dr. Martin Brecher Dr. Harold Brody Dr. Richard L. Collins Dr. Alan J. Drinnan Dr. Timothy Gabryel Dr. James Kanski Dr. Charles Massaro Dr. Charles Paganelli Dr. Robert E. Reisman Dr. Thomas Rosenthal Dr. Stephen Spaulding Dr. Bradley T. Truax TEACHING H O S P I T A L S AND LIAISONS Batavia VA Medical Center Arlene Kelly The Buffalo General Hospital Michael Shaw Buffalo VA Medical Center The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Hospitals Frank Sava Niagara Falls Memorial Medical Center Roswell Park Cancer Institute Sisters of Charity Hospital Dennis McCarthy © The State University of New York at Buffalo Buffalo Physician is published quarterly by the State University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alumni, faculty, students, residents and friends. The staff reserves the right to edit all copy and submissions accepted for publication. Address questions, comments and submissions to: Editor, Buffalo Physician, State University of New York at Buffalo, University Publications, 136 Crofts Hall, Buffalo, New York 14260 A lthough a little over two years away, a working committee co-chaired by Dr. Harold Brody and Dr. Ronald Batt and staffed by Dr. Joyce Vana, has begun to plan the Sesquicentennial events with special emphasis directed to UB's anniversary found­ ing date on May 11, 1996. More will be reported about the proposed activities. However, the Health Sciences Campus development on the Main and Bailey Campus and future planning is moving forward. 1 am pleased to report that construction of the new research building is well ahead of schedule and occupancy should be underway in late 1994 or early 1995. The program planning that will convert Harriman Hall to the administrative locus for the medical school and serve as the main entrance to the complex at this site is well underway. We are hopeful that this project, together with the removal of Diefendorf Annex, can be completed by the anniversary date. Once completed, the medical school and its health sciences colleagues will have a core that will I include the Health Sciences Library; the School of Dental Medicine; the new research building; the animal facility; and the components of » Cary, Farber and Sherman Halls together with the Schools of Nursing and Health Related Professions. Despite all this, more will be needed. In the formative stage is the concept to develop a Comprehensive Health Education Center that can house those programs that will emphasize and direct our efforts in primary care, community medicine, epidemiology, preventive medicine and statistics. We hope you will join us when we celebrate the good fortune of reaching 150. Sincerely, John Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Dear Fellow Alumni I n September a new activity of the Medical Alumni Association was initiated with the first visiting lectureship by an outstanding alumnus, Dr. Joseph Chazan. Dr. Chazan, Class of 1960, is medical director of the Artificial Kidney Centers of Rhode Island and director of the renal division at Rhode Island Hospital. While in Buffalo, he conducted nephrology grand rounds at the Buffalo VA Medical Center and consulted with the nephrology service. A second visiting lectureship is planned for later in the year. This educational activity exemplifies the strong desire of the Medical Alumni Association to add unique dimensions to the teaching program, taking advantage of the exceptional qualifications of many of our alumni. The Community Physicians Program has been enthusiastically received by the first- and second-year medical students. This year, the program, chaired by Elizabeth Maher, M.D., Class of 1985, has expanded to four sessions. Physicians from various specialties dis­ cuss their medical practice from the viewpoint of what they do, their practice commitments and life styles. This innovative program provokes unlimited questions concerning the effect that different types of medical practice have on all aspects of professional and personal life. The Governing Board again solicits your continued support in order to maintain and expand these representative functions. Best regards, Send address changes to: Buffalo Physician, 146 CFS Addition, 3435 Main Street, Buffalo, New York 14214 Robert E. Reisman, M.D. '56 �i i r F i i V O W I L . N 2 T 8 E N R 1 O 9 9 4 Research Hospital News Computing the Need • The medical school enters the information age as it undertakes an ambitious new program to integrate computers into every aspect of education, research and patient care. Building the Future • UB s plan for its Health Sciences Campus makes sense for now and the years to come. Medical School Alumni The School of Dental Medicine's William Feagans retires after over 20 years. Page 21. A Spoonful of Humor Graduate Education Classnotes Hcautjonary tale. Page 22. Alum Deborah Richter — working for people in need. Page 24. �RESEARCH Chemotherapy shown effective in treating brain tumors in infants i multi-center study headed by a Uni­ versity at Buffalo pediatric neurolo­ gist has shown that very young children with brain tumors can be treated successfully with chemo­ therapy immediately after surgery, postponing, and in some cases eliminat­ ing, the need for radiation treatments that are devastating to the developing brain. The study was the lead article in the June 17 issue of The New England Jour­ nal of Medicine. "To understand the importance of these results," said Patricia K. Duffner, M.D., professor of neurology and pedi­ atrics, "you need to consider the situa­ tion when we began this study in 1986. At that time, children less than one year old with brain tumors were let die. The only treatment available was radiation, and the survival rate was terrible. Children who did sur­ vive were so profoundly retarded, so damaged, that survival brought no quality to life." The study, which was conducted by the Pediatric Oncology Group in institutions in both the United States and Europe, involved 198 children under the age of three with malig­ nant brain tumors. Following com­ plete or partial removal of their tu­ mors, 132 children who were less than 24 months of age when diag­ nosed received multi-agent chemo­ therapy for two years. Sixty-six chil­ dren between the ages of 24 and 36 months when diagnosed received the chemotherapy regimen for one year. Following completion of che­ motherapy, all children received radiation therapy. The results showed that chemo­ © B u f f a l o therapy produced a complete or greater than 50 percent reduction in the tumor size in 39 percent of the children. Cancer had not progressed in 41 percent of the older group after one year of chemo­ therapy and in 39 percent of those under 24 months after two years of chemo­ therapy. Researchers found no deteriora­ tion of brain function as a result of the chemotherapy. Certain tumors responded better than others, the study showed. Emryonal tu­ mors did not respond well, while 61 percent of infants and very small chil­ dren with ependymoma tumors were still alive after three years. Results showed children who had no tumors following chemotherapy sur­ vived nearly as long as children whose tumors were removed completely through surgery. + | fPfiP Low cholesterol levels found in Mennonite men despite their diets ne of the first dietary studies of clois­ tered Old Order Mennonites provides further evidence that physical activity can help lower cholesterol levels. The UB study found that despite consuming a diet high in saturated fat and cholesterol, the Mennonite men, who do the daily farm work, not only had lower cholesterol levels than their female counterparts — a reversal of the national norm — but had significantly lower cholesterol levels and blood pres­ sures than the national average for males. Information on the community's eat­ ing habits also showed that members know they should avoid foods high in saturated fat and cholesterol, but be­ cause such foods are basic to their agrar­ ian diet, they eat them regularly anyway. In addition, half of the members reported a family his­ tory of heart disease. The study of 250 adults was conducted by Andrew Michel, M.D., and Myron Glick, M.D., while they were medical stu­ dents, and Thomas Rosenthal, M.D., chair ofthe department of family medicine. Resultsof the study were published in The Journal of the American Board of Family Practice. Little scientific data exist on life among Old Order Menno­ nites; anecdotal evidence sug­ gests their diet puts them at risk for heart disease. The aim of the researchers was to assist primary care physicians respon­ sible for their care by defining the population's cardiovascular risk factors. + Hard work equals low cholesterol for Mennonite men. P h y s i c i a n w i n �1st cervical' or Atlas. 2nd cervical -0 or Axis. RESEARCH 3-1 New pain relief technique speeds recovery for back surgery patients D B neurosurgeons have pioneered a new method to relieve pain fol­ lowing surgery to repair a herni­ ated disk that increases comfort dramatically and gets patients on their feet and out of the hospital two to three days sooner than conven­ tional pain-control methods. A research team headed by Kevin J. Gibbons, M.D., assistant professor of neurosurgery, placed an absorbable gela­ tin sponge filled with morphine over the disk-surgery site in 45 patients before suturing the incision. The team com­ pared the comfort and recovery time of these patients with a control group of 15 disk surgery patients who received stan­ dard post-surgery morphine injections to control pain. All surgeries were per­ formed at Millard Fillmore Gates Circle Hospital. Thirty-three of the patients receiving the morphine sponge were able to walk the same day they had disk surgery, and all were walking by the following day, Gibbons reported. More than a third required no additional pain medication on the day of surgery, and by the first post-operative day, half of the patients needed no further pain relief, he said. Thirty-one were discharged on the first post-operative day, 10 on the sec­ ond, three on the third and one on the fourth. None of the 15 patients who received conventional treatment for pain could go home on the first post-operative day, he reported. Three were discharged on the second day following surgery, eight on the third post-operative day and four on the fourth. "We hit upon the idea of injecting morphine into the sponge as a possible way to provide effective, long-lasting u f f a I o P h New polio vaccine schedule could eliminate vaccine-related disease pain con­ \\ trol after the surgery," he said. UB neurosurgeons 2 have been using the morphine sponge successfully for 18 months. Other surgeons have begun using the technique as reports of its effective­ ness have spread by word of mouth, Gibbons said. Additional members of the research team were Adrienne P. Barth, a certified neuroscience nurse; Arvind Ahuja, M.D., clinical assistant instructor of neurosurgery; James L. Budny, M.D., clini­ 1st lumbar.. cal I noculating infants with two doses of a new enhanced-potency form of inactivated poliovirus vaccine followed by a single oral dose of live attenu­ ated virus may be the best way to protect against the disease and guard against vaccine-related cases. f" A study by UB researchers showed that children who received the vaccines in that sequence dem­ onstrated the highest antibody ti­ ters during a four-year follow-up after being challenged with a single dose of the oral attenuated poliovirus vaccine (OPV) at age five. Howard Faden, professor of pediatrics and co-director of the division of infectious diseases at The Children's Hospital of Buffalo, who directed the study, said, "The use of sequential immunization with EIPV (enhanced potency inactivated poliovirus vaccine) followed by OPV may be a major step toward ultimate eradication of poliomyelitis." The Buf­ falo study involved 158 children who received three immunizations in one of four sequences — OPV-OPV-OPV, EIPV-EIPV-EIPV, EIPV-OPV-OPV or EIPV-EIPV-OPV — at two, four and 12 months of age. Follow-up serologic evaluation showed that both forms of vaccine were "highly effective" in stimulating pro­ tective levels of immunity, but that two doses of EIPV followed by a single dose of OPV produced the highest neutralizing antibody titers. Faden's co-authors were Linda Duffy, Ph.D., Martha Sun and Cynthia Shuff. + tr 1 w associate professor of neurosurgery, and L. Nelson Hopkins "'(MS® III, M.D., professor and chair of neurosurgery. Gibbons presented the study results at the annual meeting of the American Association of Neurosurgery. + — B Y y s L O I S B A K E R i 37. -Lateral c i a n W i n t e r 1 9 9 4 © �HOSPITAL N E W S Children's Hospital appoints Dias chief of pediatric neurosurgery able by the new ablation procedure, which is typically performed under lo­ cal anesthesia, are generally those that are mediated by an extra electrical path­ way, according to Donald Switzer, M. D., UB clinical assistant professor of medi­ cine and electrophysiologist at Millard Fillmore Hospitals. He adds that physi­ cians "traditionally have had to resort to chronic drug therapies, which are often only partially effective and may result in side effects for these patients." The radio-frequency ablation proce­ dure uses specialized, electrode-tipped cardiac catheters that are positioned within the heart at specific abnormal targets. The high-energy, radio-fre­ quency current is then passed directly through the catheter to cauterize the abnormal pathway within the heart, destroying only the targeted area with­ out affecting the overall heart function. Following the procedure, the heart's electrical system stabilizes to a normal conduction pattern. Patients are monitored overnight and generally resume normal activity the next day. Switzer adds that "over 95 percent of these abnormal pathways can be effec­ tively and permanently cured with this procedure." + T he Children's Hospital of Buffalo has appointed Mark Dias, M.D., chief of the division of pediatric neurosurgery. Dias was previously an attending neurosurgeon at Children's Memorial Medical Cen­ ter in Chicago and assistant professor of neurosurgery at the Northwestern Uni­ versity School of Medicine. Dias obtained his medical degree from the Johns Hopkins University School of Medicine. He also completed neurosurgical resi­ dency training at the University of Pitts­ burgh and neurosurgical fellowship training at Primary Children's Medical Center of the University of Utah. In 1987 he received the Pittsburgh Neuroscience Society Award for Clinical Re­ search. The author of various publications in pediatric neurosurgery and developmen­ tal neurobiology, Dias maintains a spe­ cial interest in developmental malfor­ mations of the brain and spinal cord and in the surgical management of pediatric brain tumors. + Construction begins on Summit Park Medical Mai expansion C Millard Fillmore offers radiofrequency ablation procedure onstruction began in late August for a 21,000-square-foot expansion of the Summit Park Medical Mall in the Town of Wheatfield. The expansion will accommo­ date the Summit Immediate Treat­ ment Center, a new service operated by Niagara Falls Memorial Medical Center since May. Memorial will also operate a linear accelerator at the expanded site to illard Fillmore Hospitals is one of a limited number of facilities in the country using radio-fre­ quency ablation to treat certain types of tachycardia. The tachycardias that are cur­ B u f f a l o P h y s i c i a n W provide radiation therapy as part of its comprehensive cancer treatment pro­ gram. The expansion also includes ad­ ditional space for physician office suites. Construction is expected to be com­ pleted this spring. The Summit Park Medical Mall is a 30,000-square-foot medical office com­ plex that opened in 1990. In addition to physician offices, the complex houses primary care and outpatient services provided by Memorial Medical Center. The complex includes the Summit Im­ mediate Treatment Center; Niagara Fam­ ily Medicine; X-ray, laboratory, physi­ cal therapy and pharmacy services; and a satellite office of the Milestones pro­ gram that provides treatment for alco­ hol and substance abuse. + Rosweil Park inks referral pact with Daughters of Charily system T he Daughters of Charity National Health System (DCNHS) and Rosweil Park Cancer Institute have signed a memorandum of under­ standing to facilitate patient refer­ rals from any DCNHS hospital to Rosweil for specialized cancer treat­ ments, including bone marrow trans­ plants. The agreement, which culminates 18 months of deliberation, is expected to foster development in the areas of pa­ tient care, research and understanding. It will see Rosweil, the nation's first cancer treatment and research center, assist and consult in the development of specific cancer treatment and educa­ tion programs at DCNHS hospitals and in the training of DCNHS physicians at Rosweil. The Daughters of Charity National Health System — with more than 60 facilities in 18 states and the District of i n t e r 1 9 9 4 �HOSPITAL N E W S Columbia — includes acute care hospi­ tals, nursing homes and psychiatric fa­ cilities. Four of its hospitals are located in New York State: Our Lady ofLourdes Memorial Hospital in Binghamton, St. Mary's Hospital in Rochester, St. Mary's Hospital in Troy and Sisters of Charity Hospital in Buffalo. Roswell Park Cancer Institute is a National Cancer Institute-designated comprehensive cancer center that serves patients from 38 states and 17 coun­ tries. It is in the process of a $241 million renovation project that includes all new clinical facilities. The DCNHS-Roswell agreement will explore a variety of activities, including participation of DCNHS patients in Roswell's special cancer registries, the development of continuing medical education programs and the creation of special education programs in such areas as cancer prevention and detection. + Enrollment is limited to 30 to 35 cancer cases and deaths. "We have the ways and the means to patients with advanced cancer, particu­ larly lung cancer patients, who have provide direct assistance to families who failed to respond to either conventional may be at high risk for developing colorectal cancer," or investigational therapies. said Miguel A. Rodriguez-Bigas, The research­ M.D., associate chief er's goal is to de­ of the department of termine opti­ surgical oncology mum drug dos­ and director of the ages, evaluate registry. "Our objec­ side effects and tive is not only to identify — and collect research later target — data, but also to pro­ those cancers vide important care, that respond best genetic testing and to the taxolcounseling, educa­ carboplatin regi­ tion and peace of men. mind to those who Co-investiga­ are registered." tors on the Ros­ well Park trial are: The Family Can­ cer Syndrome Reg­ VickyJones,M.D.; Ellis Levine,M.D.; istry identifies fami­ Tracking the course of cancer. lies in which at least Gregory Loewen, three members in D.O., Neal Meropol, M.D., Raymond Perez, M.D., and two generations have had colorectal can­ Lakshmi Pendyala, Ph.D., all of the de­ cer, with one of the members diagnosed partment of medicine, and Youcef before age 50. Such families are known Rustum, Ph.D., and Raymond Baker, to carry the gene for Hereditary Ph.D., of the department of experimen­ Nonpolyposis Colon Cancer. The Family Cancer Syndrome Regis­ + tal therapeutics. try becomes the third registry estab­ lished and headquartered at Roswell. The Familial Adenomatous Polyposis Registry was established in the mid1980s and currently lists 42 registered families with 25 living affected persons new cancer registry designed to and 55 persons at risk. The Gilda Radner pinpoint, track and ultimately re­ Familial Ovarian Cancer Registry — duce a family's genetic predisposi­ named after the comedienne who lost tion to colorectal cancer has been her life to the disease — is an interna­ established at Roswell Park Can­ tional listing of women with two or more first-degree relatives who have cer Institute. developed ovarian cancer. Established The Family Cancer Syndrome Regis­ by M. Steven Piver, M.D., chief of the try is designed to help individuals whose department of gynecology, it is the only family medical history reveals a dispro­ one of its kind in the country. + portionately high number of colorectal Roswell Park conducting clinical trials of taxol and carboplatin B oswell Park Cancer Institute is one of only a handful of research facilities in the country conduct­ ing clinical trials to assess the ef­ fectiveness of taxol and carboplatin in patients with ad­ vanced cancer. Taxol has been widely publicized in the popular media for its dramatic, but preliminary successes with ovarian can­ cer. Researchers began clinical studies of taxol in 1983, and some reports sug­ gest that the drug is also effective in treating cancers of the breast and lung. Patrick Creaven, M.D., Ph.D., senior investigator, and Derek Raghavan, M.D., Ph.D., chief of the division of solid tu­ mor oncology and investigational thera­ peutics, head the studies. B u f f a l o P h Family Cancer Syndrome Registry will track genetic propensity i y s i c i a n w i n t e r 1 9 9 4 �w mi • B Y N A N E T T E T R A M O N T K O L L I G n a science as information-intensive as medicine, it was only a matter of time before scientists would use computer technology to manage that information. At UB's School of Medicine and Biomedical Sciences, the time is now as the medical school and its affiliated teaching hospitals embark on an ambitious new medical informatics and medical information processing program that puts them in a leadership role for now and the future. Medical informatics — the academic discipline associ­ ated with the processing and management of medical information — involves areas such as expert systems development, clinical information systems, computer-as­ sisted instruction and software programs that can bring new information on a patient to a student or clinician. And although the management and processing of medical data isn't necessarily done with computers, principally nowa­ days it is. I L L U S T R A T I O N S B Y T R O Y The medical school's project consists of a number of initiatives on both the academic and clinical fronts in various stages of development; all will serve to make medical information more accessible to practitioners and further the school's mission of quality education, research and patient care. Among the initiatives are the medical school's mandatory undergraduate medical computing course; a database to aid the physician credentialing process; the linkage of hospitals and physicians' offices to T H O M A S iNJO ThE to �MOUSING the medical school, its Health Sciences Library and each other via computer network; and real-time, on-line con­ sults and sophisticated videoconferencing capabilities. A recent $1.5 million gift will establish a chair in medical informatics at the medical school, one of the first in the country. Also under development is an electronic patient index shared between the teaching hospitals, and perhaps the ultimate realization of the promise medical informatics holds for medicine — the computer-based patient record. The main thrust of UB's medical information process­ ing program — and the infrastructure that supports many of its initiatives — is the development of the Western New York Health Sciences Consortium Interfacility Communi­ cations Network. When complete in 1997, this "informa­ tion superhighway" will link the school and its affiliated teaching hospitals with communications capabilities able to transmit complex medical data such as PET images from one to another in a matter of seconds. The development and implementation of the network is under the direction of John Hammond, director of infor­ mation services for the Western New York Health Sciences Consortium, a spin-off of the Graduate Medical Dental Consortium of Buffalo, formed in 1987. "Each hospital campus has its own internal communi­ cations network already. What we establish will become a 'network of networks,' or what is known as a CHIN — Comprehensive Health Information Network," Hammond explains. Phase 1 of the project, to be completed in 1995, will see UB linked with Millard Fillmore Hospitals' Gates Circle facility, The Buffalo General Hospital and Erie County Medical Center via New York Telephone's FDDI (Fiber Distributed Data Interface) Network lines. FDDI lines operate at a band width of 100 million bites per second and are able to accommodate the transmission of images and real time, motion data, Hammond says. Erie County Medical Center and Buffalo General already have in place between them a microwave Ethernet connection (Ethernet connections transmit informa­ tion at 10 million bites per second) and a T-l existing phone line that sends data at a "snail's pace" 1.54 million bites per second. A chest X-ray, which requires 2 million bites of infor­ mation, now takes about two seconds to transmit, Hammond says. Phase I also will realize Ethernet connections between the Buffalo VA Medical Center and UB, and Roswell Park Cancer Institute and UB via microwave. The completion of Phases II and III (from mid-1995 until 1997) will see FDDIs emanating from a central New York Telephone hub to Sisters Hospital, Millard Fillmore Suburban, The Children's Hospital of Buffalo and Mercy �Hospital, as well as the existing Phase I hook-ups. Millard Fillmore will also have a T-l between its Gates Circle and Suburban facilities. A connection to the Southern Tier hospitals, which have already formed their own rural health care network supported by Sprint's Healthcare Application Network Delivery System, New York Telephone's fiberoptic and digital network and Compres­ sion Labs Inc.'s videoconferencing equipment, will also be established. Other potential FDDI sites include Roswell, Blue Cross, Blue Shield, Niagara Falls Memorial Medical Center and the Maple Road MRI Center. "Seventy percent of medical data is already available in some form of digitized information already. What we have to do is construct a central repository for the data, which now exist in eight, nine or 10 areas. "And we want to have automatic feeds as much as possible," Hammond says, adding that of the affiliated teaching hospitals, Erie County Medical Center is farthest along in its systems development. "After each repository has that in place, we have to find a logical mechanism to connect them." He estimates it will take eight to 10 years and $20 million to develop and implement the CHIN. Representatives from UB have already engaged in dis­ cussions with SUNY Central to solicit support; UB's project could serve as a model for other academic health centers in the system. "We could establish it here," Hammond says, "and then give it to Upstate and the others. "And we're so diverse," he adds. "It's one of our strengths. If it can work here, with all our diversity, it can work anywhere. "We have a federal facility, a county facility, a cancer center, a children's facility, two Catholics and two not-forprofit privates. Our information services directors meet regularly and the CEOs meet every two weeks." Hammond credits those CEOs and information services directors for working to establish the network. "The direc­ tors develop a list of what each has worked on and it's my job to broker deals to move those things along in a shared fashion. We capitalize on ways to benefit and increase the chances to exchange information to make it available at multiple sites," Hammond adds. The network and its participant hospitals will also realize monetary savings in its economies of scale as well as the cost- and time-savings benefits inherent in medical information processingsystems. According toJohnLoonsk, M.D., director of medical computing and assistant profes­ sor of biophysics at UB, the implementation of these systems in hospitals can have dramatic care and costsaving benefits. "There's evidence that by giving quality information to residents, attending physicians and students at the time of decision-making and ordering, you can encourage good practice patterns," Loonsk says. One study, he said, demonstrated an over $800 reduc­ tion in cost per hospital stay when residents were given information on the cost and appropriate parameters of their orders at the time they placed them. "There are some examples of actual length of stay reductions with similar systems," he adds. The network will also foster the development of a physician-credentialing database that would automati­ cally track physicians credentialed at multiple facilities; most medical staff are re-credentialed every two years. A similar system, albeit based only at the medical school's office of graduate medical education, tracks and aids in the management of resident credentialing. In addition to its benefits to the medical school and its teaching hospitals, UB's medical informatics project meshes well with projected health care reforms as well as the medical school's existing primary care focus, notes John Naughton, M.D., vice president of clinical affairs and dean. �"It makes the educational outreach to community aca­ tools such asjournals (among them TheNew England]ournal demic practice sites more real," he says, putting more of Medicine, The Lancet, Pediatrics, JAMA) and textbooks expert tools in the hands of primary care physicians in (suchas Scientific American Textbook ofMedicine) with graph­ both the clinical and educational arenas. ics, the Cancerlit database, the Physician's Desk Reference, "Bringing more information to practice is also re-engi­ drug information databases and clinical information systems neering relationships in medicine," the dean notes. "It's such as expert systems, computer-assisted instruction and a really on the cutting edge of reform." health care planningand administration And most experts agree that one of database. the main thrusts of reform will be in "HUBNET is an integration of many HUBNET THE HOSPITALSreforming the way medical informa­ resources from several difUB LIBRARY RESOURCES tion is ordered, stored and retrieved, ferent database providers. and what is done with it. NETWORK — WAS CREATED Some are updated quar­ UB's multifaceted program offers terly, some even weekly," AT A COST OF $ 2 5 0 , 0 0 0 practitioners many innovative features explains John Loonsk, THROUGH THE JOINT EF­ that will benefit both them and the M.D., director of medical FORTS OF THE MEDICAL ultimate end-users of health care — computing and assistant SCHOOL'S OFFICE OF M EDI their patients. professor of biophysics and CAL COMPUTING, UB'S HEALTH SCI­ iBNE[ ENCES LIBRARY AND THE WESTERN NEW YORK HEALTH SCIENCES architect of the HUBNET system. Users of the system now have access to the equivalent of 6.5 million pages of medi­ cal data, Loonsk adds. In addition to its menu of resources, HUBNET provides physicians, resi­ dents and medical students with a uni­ form access method to those resources as they rotate from hospital to hospital. Previously, users had to learn several systems to gain access to only part of the information that is now available llhl .^a!i CONSORTIUM. EACH HOSPITAL Created through the SHIBr CI WILL PAY $ 9 , 1 0 0 ANNUALLY joint efforts of the medical I school's office of medical TO SUBSCRIBE TO THE ELEC computing, the Health TRONIC SERVICE Sciences Library and the hospital librarians through the Western New York Health Sciences Consortium, HUBNET (Hospitals-UB Library Resource Network) provides the hos­ on the system. pitals (as well asanyone with the right computer hardware, HUBNET also runs Internet-enabled electronic mail. software and a password to log onto it) with immediate "And we're bringing up a bulletin board service as well," access to UB's fifth-ranked-in-the-nation Health Sciences Loonsk says. Library and its considerable electronic resources. Jack Freer, M.D., a 1975 medical school graduate who HUBNET offers its users the National Library of is now a clinical assistant professor of medicine based at Medicine's MEDLINE resource (previously only the miniMillard Fillmore Hospitals, praises the new system on a MEDLINE bibliography was available at UB), full-text number of fronts. H �"It's super for getting messages to people who have became clear that the mini-medfile system was aging and not mailboxes and regularly check their mail. For example," up to modern standards. Freer says, "I'm the course coordinator for the third year "Two of the hospitals were on the cusp of changing to try ethics course, and the pediatric coordinator and I can get to offer these types of resources to more sites than just their messages back and forth in no time — often the same day. single hospital sites," Loonsk says, adding, "but the costs We also have a patient management system that prints then go up dramatically. progress notes and prescriptions." "So we had interest from a num­ Freer also cites FIUBNET for its po­ ber of places." tential to improve the quality of prac­ Funded as well as developed THE SCHOOL USES SOPHISTI­ tice. jointly by the medical school and its CATED COM PUTER-ASSISTED IN­ "You can use it to teaching hospitals, HUBNET went search in a matter of "live" last fall when its network con­ STRUCTION PROGRAMS SUCH AS minutes virtually any­ nections (existing and special phone ADAM (ANIMATED DISSECTION thing you could do in a lines as well as Ethernet and micro­ OF ANATOMY FOR MEDICINE), A library.Just yesterday," wave connections), hardware and soft­ SOFTWARE PROGRAM THAT AL­ he says, "a question ware development and acquisition were LOWS STUDENTS TO "DISSECT" came up about a new completed. treatment using beta blockers for heart "There are some hospitals and medi­ - FROM GROSS ANATOMICAL STRUC­ failure, which have traditionally been cal schools with shared medical data­ TURES RIGHT DOWN TO THEIR HIS­ contraindicated. Now there are reports bases," Loonsk says. TOLOGY ON A COMPUTER that it is useful if used judiciously for "But few have the mag­ SCREEN AND MULTIMEDIA tachycardia. nitude of the resources TEACHING TOOLS THAT WILL With the MEDLINE you can search we have, few have the beta blockers and come up with 1,500 system's communica­ BECOME COMMONPLACE IN articles, then search heart failure and tions capability and few THE NEXT DECADE. come up with 1,200 articles and then represent the level of co­ combine them and come up with 70 operation we have here." articles. Annual operating "All you need is a computer and a costs of the $250,000 library resource modem," Freer notes, adding, "the resi­ network are expected to tally about $100,000. dents and students use it from home." "Each hospital contributes $9,100 a year to subscribe to At Millard, officials are trying to ensure an adequate HUBNET," Loonsk says. number of computers will be available for use at its large "When people see what's available, and its potential, we number of off-site facilities, Freer says. hope to bring other resources on line, such as Poisondex, In large part, FIUBNET got its impetus when the medical a database used in emergency situations for dealing with school and its teaching hospitals wanted to switch from poisoning. A citation index is also attractive," Loonsk mini-MEDLlNE to MEDLINE "over a year ago when it adds. © �Medical Informatics in the Classroom screen. Other developments include computer-based multimedia teaching tools that may eventually replace microscopic and other conventional teaching tools and Well ahead of most medical schools in its use of medical techniques, as well as serve as resources that can be informatics in the classroom, The School of Medicine and retrieved in clinical settings. Biomedical Sciences has required its medical students to take A computer-based patient record (CPR), developed by a medical computing course in their sec­ Loonsk and M.D.-Ph.D. student ond year since the mid-1980s. Harold Litt, is also in use. Students are "It's not really a computer literacy assigned a patient case — each CPR course," says John contains a complete intake history and Loonsk, M.D., director physical, admitting notes, orders, labo­ VIDEOCONFERENCING — WHICH of medical computing ratory data and radiological studies — and assistant professor INTEGRATES VOICE, DATA AND and are asked to review all of the of biophysics who VIDEO CAPABILITIES BRINGS clinical information, apply medical in­ teaches the course. formation tools contained in the CPR REAL-TIME SU B SPECIALIS T CON"But we do have to ad­ to their patient and determine a diag­ SULTS TO PR I MARY CARE PRACTI dress literacy issues in a nosis and suggested treatment. TIONERS AT THEIR PRACTICE remedial fashion in some instances," he adds. SITES AS WELL AS "BRINGS" "The course is designed to give stu­ PATIENTS IN RURAL LO­ dents exposure to and the theory be­ CALES TO URBAN MEDICAL hind medical informatics tools as they CENTERS FOR EVALUATION would apply them to clinical cases," AND ASSESSMENT. Loonsk says. Videoconferencing — "It's a brief overview of diagnostic which integrates voice, programs, designed as an introduction data and video capabili­ to ensure people are comfortable with ties — has the ability to computers, since they're so common in bring real-time sophisti­ hospitals," says medical student Tom cated subspecialist consults to primary Guttuso, currently on a leave-of-absence care practitioners at their practice sites as for a Howard Hughes Medical Institute Research Training well as "bring" patients in rural locales to urban medical centers Fellowship after completing his second year. for evaluation and assessment. The school has only recently begun using computer"We're doing a lot with videoconferencing," according to assisted instruction — such as ADAM (Animated Dissec­ John Hammond, director of information services for the tion of Anatomy for Medicine), a software program that Western New York HealthSciences Consortium. Hammond allows students to "dissect" — from gross anatomical has worked to establish the Western New York Health structures right down to their histology — on a computer Sciences Consortium Interfacility Communications Net- B u f f a l o P h y s i c i a n w i n t e r 1 9 9 4 �"He has a video otoscope scheduled for implementation work that will carry videoconferences from one site to early this year." another. A link between rural Cuba (New York) Memorial Hos­ pital and Children's Hospital has already been in place since last spring when physicians from Children's evalu­ ated a six-year-old patient in Cuba — saving the girl and The capability of computers to manage her parents the 150-mile round trip and integrate the array of diverse data they have had to regularly travel dur­ and information inherent in the prac­ ing her recovery and C O M P U T E R B A S E D P A T I E N T tice of medicine probably will realize rehabilitation from the its ultimate application in the com­ cerebral hemorrhage RECORD DEVELOPMENT HAS puter-based patient record (CPR). she suffered two years BEEN SPURRED BY RECOMMEN Computer-based patient record ago. DATIONS FROM THE FEDERAL development and implementation have The Cuba link is the INSTITUTE OF MEDICINE. MOST been bolstered by recommendations start of a connection to HEALTH CARE REFORM PRO from the federal Institute of Medicine Southern Tier hospitals as well as by practical that have already POSALS ALSO CALL FOR application as hospitals formed their own rural health care AUTOMATION OF PATIENT DATA use computers to man­ network supported by Sprint's FROM MEDICAL RECORDS TO age the wealth of infor­ Healthcare Application Network De­ BILLING INFORMATION TO mation they amass on livery System, New York Telephone's AVOID DUPLICATIONAND REDUCE their patients. Most fiberoptic and digital network and health care reform pro­ Compression Labs Inc.'s video­ PROCESSING INEFFICIENCIES posals also call for auto­ conferencing equipment. mation of patient data — Using the technology, the hospitals from medical records to billing informa­ will be able to send diagnostic-quality tion — to avoid duplication and reduce images to specialists for viewing on processing inefficiencies and their inherent costs. high-resolution, gray-scale monitors or printed onto film for traditional light box viewing, regardless of image Toward that end, the Western New York Health Sci­ modality — CT, MRI, DSA, X-ray, ultrasound, etc. "We ences Consortium has already begun to develop the first can use the techniques developed to exchange information step in building a CPR — a patient index, listing the name, address and identifying number of every patient served by and teach," Hammond adds. "We've identified three groups of physician practices its members, according to John Hammond, director of that want to move to implement. Dave Ellis [M.D., assis­ information services for the consortium. The index would tant professor of emergency medicine at ECMC] has be shared and integrated among the teaching hospitals and probably gone the farthest, using the technology to triage eventually provide a complete medical record that would "follow" a patient regardless of which hospital he is treated patients at New York State Department of Corrections prison sites. at. Computer-Based patient Rpcort © �John Loonsk, M.D., director of medical computing and assistant professor of biophysics, and M.D.-Ph.D. student Harold Litt have developed a prototype computer-based patient record used to train students using case-based learning. The CPR includes systems for writing and dis­ playing physicians' notes, orders, con­ sults, lab values and radiological stud­ ies, including actual images, and re­ ports. Perhaps the most immediate ben­ efit the CPR offers is its ability to allow physicians to view all clinical informa­ tion about a patient in one place, with access to lab values, consults, medical imaging and reports, ostensibly as soon as they are completed. The computer-based patient record in use at the medical school also has integrated medical information tools, such as drug references, clinical manu­ als, textbooks, literature searching, ex­ pert system decision support and elec­ tronic communication, that students can use to facilitate diagnoses and the development of treatment plans. The CPR uses a Win­ dows format that allows users to use and display several items (or "pages" from a chart) of information at the same time. UB's CPR is modeled on existing B u f f a l o P h y s i c paper-based medical records — with data from different sources presented independently — but with some no­ table enhancements. The computer-based patient record offers users the ability to view lab results in two different ways: all the values for a given day and lab group, with high and low values noted; or a single value followed graphically over time. Other enhance­ ments in the works include increasing the flexibility oflabdata represen­ tation to allow graphical display and statisti­ cal analysis of many values over time and incorporating special computer languages that would allow commu­ nications with mainframe patient da­ tabases. But Loonsk sees almost unlim­ ited potential in a newer paradigm of medical information management that moves away from the existing paper-based structure of the patient chart — the visual chart, which would use object-oriented program­ ming techniques to allow a more visual and intuitive representation of medical data and offer a way of using and interacting with data that would change the way physicians practice medicine. + i a n w i n t e r 1 9 9 4 © �I r | 1J y ) "i| J— . < r I w/ I N ^ J J r1 ^ R y '1 | 1J J- J B u f f a l o P y s i c BY ANDREW BANZO $ "I h U| 1 l. 1 (J) w/ A L- i a n W i n t e r 1 9 9 4 �UB takes the first steps toward an integrated health sciences campus hen Charles V Paganelli, Ph.D., arrived at UB 35 years ago, the east wall of Sherman Hall was several steps from the room he now occupies. Today, there's a set of swinging doors in that wall, and beyond them is the Hermann Rahn Laboratory of Environmental Physiology. The laboratory, a two-stage addition built in the early 1970s and mid-1980s, is home to the Center for Research in Special Environments. Inside one theater-sized room is a centrifuge that can subject a person to seven times the force of gravity. Across the hall, in a room filled with instruments, is a hypobaric/hyperbaric chamber that can simulate conditions ranging from the edge of space to the ocean floor. "It's got a pressure capability as great as any pressure chamber in this country," proudly declares Paganelli, professor of physiology and interim chairman of the Physiology Department. B u f f a l o P h y s i c i a n W i n t e r 1 9 9 4 ( J ) �he laboratory addition is just one of the developments that have occurred in recent years at the UB School of Medicine and Biomedical Sciences. Any­ one who's been away for a while will still find much that is familiar on the campus. But from the school's new wing to the six-story research build­ ing now nearing completion, some striking changes have been taking place. "The campus has now had about a decade of infusion of support that came with the promise when the state took it over to make a health sciences complex on this campus," says John Naughton, M.D., the medical school's dean and vice president for clinical affairs. Now, the university is on the verge of taking another big step toward that goal. Officials from UB and the State Univer­ sity Construction Fund started preliminary work this fall on a new master plan that could serve as a blueprint for the final transformation of the Main Street campus into an integrated health sciences center. Officials caution that it isstill too early to get into specifics, but the outline is clear. "Our goal is to have the South Campus operate as the health sciences campus for UB," says Ronald Nayler, associate vice president for university facilities. Naughton sees definite benefits. "It's a concentration of the faculty expertise in the various health science areas and the ability to integrate, where appro­ priate, certain educational and training opportunities for future professionals," the dean says. "As this movement toward health reform comes, the interrelationship of physi­ cians and nurses and therapists working in a team model will evolve, and we can better structure those educational oppor­ tunities." In the early 1960s, when the state absorbed UB, it was thought that the entire university might move to one huge new campus. But there wasn't enough money, and it soon became obvious that the South Campus would continue to play an important role. The university decided to gradually move remaining academic departments from the South Cam­ pus to the new North Campus in Amherst over a period of years, with the eventual aim of turning the South Campus into a health sciences complex. That's why there's been so much renovation and new construction on the South Campus in recent years. But until the new effort to update the master plan, the work had been piecemeal, occurring without a comprehensive blueprint. "There had never been a physical layout, there had never been detailed planning as to how that should be accom­ plished," says Nayler. "So we had the goal and some specific �objectives, but we never had a physical plan. This will get us there." Over the coming 18 to 24 months, UB administrators will work with faculty, state officials and others, including com­ munity representatives, to develop a consensus on where the university is headed and what facilities it needs to get there. They will pore over everything from classroom and labora­ tory requirements to plumbing and roadway design. Along the way, they're even putting the campuses' existing blue­ prints onto computer. "It's mainly looking at what exists and what the possibili­ ties are," says Naughton. The resulting master plan will serve as the physical design to achieve UB's long-range goals, among them the health sciences campus. UB will forward the plan to Albany. "Then it's a question of, given the fiscal status of the state, how quickly that can be accomplished," says Nayler. It probably will take years to implement larger goals like the health sciences campus, and the work will most likely be incremen­ tal. But the master plan will give UB a better platform to set priorities and establish needs when it makes its funding requests, Nayler explains. "Our goal is sooner rather than later, of course," he adds. Even without the new master plan, the South Campus already has seen considerable progress in the shift toward health sciences. "I think the South Campus renovation projects to make it B u f f a l o P h y s i c i more of a health sciences complex began around 1982," says Naughton. "The first major change was the conversion of Squire Hall, formerly Norton Union, which had been the student union until that time, into the School of Dental Medicine." Nayler says dentistry still has room to grow in Squire Hall. The school is developing plans to expand the use of dental clinics, and he says that probably will be possible without new construction. Another big change was renovation and expansion of Abbott Hall into the Health Sciences Library during the mid1980s. "We preserved all the historic aspects of that building on the Main Street side, and now we have a first-rate health sciences library," says Naughton, adding that the library is rated the fifth best in the nation. He also cites the rehabilitation of what had been cramped space in Foster Hall for laboratory facilities and the addition of a small wing for clinical practice activities. "We ended up with a very first-rate facility," the dean says. About four years ago the Department of Nuclear Medicine began moving into Parker Hall on the southwest corner of the campus. And this summer it finished installation of a cyclo­ tron in Parker as part of the PET imaging center operated in conjunction with the Buffalo VA Medical Center. Of course, there is also the medical school's new wing, known as the Cary-Farber-Sherman Addition and opened about six years ago. a n W i n t e r 19 9 4 © �arts center opened in August, taking in the school of Arts and Letters, which vacated Harriman and Wende halls on the South Campus. Naughton says he would like to renovate Harriman after next summer, then move the medical school administration there. Also next summer, the university hopes to move the Chemistry Department into a new natural sciences and math complex under construction on the North Campus. Nayler says the first phase of that complex, including an eight-story tower, will be ready for the fall semester, and preliminary planning is underway for the second phase, which will include math, computer science and geology. "That's our next highest priority in terms of facilities for the North Campus," Nayler says. In all, the state has spent about $200 million on new construction and renovation at the North and South cam­ puses in recent years, he says. The flurry of activity owes partially to the recent availability of bond funds, he adds. When chemistry moves to the North Campus, that will free up Acheson Hall on the South Campus. The intention is to use Acheson for health sciences, but final decisions have yet to be made, Nayler says. In any case, he added, "We'll need to do almost a gut renovation." There is no date yet for math to move from Diefendorf Hall, but Naughton says he expects the Diefendorf Annex to be razed by 1996, restoring the mall that the warehouse-like building has occupied for nearly three decades. Once the natural sciences are consolidated on the North Campus, the only non-health program remaining on the South Campus will be Architecture and Planning. Though there currently is no money budgeted for it, Nayler says plans have long called for moving that school to the North Campus, too. "In fact, there's a site that's been chosen, and we've intentionally kept it open," he added. The School of Pharmacy, meanwhile, seems settled in Amherst. "There are some natural interactions between the chemistry and pharmacy faculties," says Naughton. "So 1 would think it would remain on the North Campus." While it's too early to say what the South Campus would look like as a health sciences center, administrators would like to bring Nursing and Health Related Professions closer to the main academic core. They are now in Kimball Tower, part of the dormitory complex on the campus's north end. The dormitories will probably change, too, as the number of undergraduates on campus shrinks. The new master plan is expected to take account of the housing and social needs of older students, including married couples. "It will be a changing campus," says Nayler. + THE FIRST MAJOR CHANGE WAS THE CONVERSION OF SQUIRE HALL9 FORMERLY NORTON UNION, WHICH HAD BEEN THE STUDENT UNION UNTIL THAT TIME, INTO THE SCHOOL OF DENTAL MEDICINE, "That greatly improved our teaching ability," says Paganelli. The CFS Addition includes classrooms, laboratories, an animal facility, a modern auditorium and offices. It was designed to provide a more comfortable learning environ­ ment, right down to the lobby space. "We furnished it so that students, between classes and at exam time, could use the facility more to their needs," says Naughton. The new space also allowed the medical school to consoli­ date faculty in areas like biochemistry and biophysics. They previously were based at the old Bell Aircraft plant on Buffalo's West Side, the Ridge Lea building in Amherst and other locations. As the health sciences improvements were going on, the university was also building on the North Campus to accom­ modate departments moving from Main Street. A new fine B u f f a l o P h y s i c i a n W i n t e r 1 9 9 4 �UB'S NEW RESEARCH BUILDING BLENDS FORM WITH FUNCTION f all the recent changeson UB's search building may now encourage them to do that. South Campus, the medical "I view the new building not simply as extra space, but as school's new research build­ a catalyst by which we can revamp or expand a variety of ing is easily the most visible. research programs," he added. When it's ready for occu­ As researchers move to the new building, UB plans to pancy, possibly as soon as early renovate existing research space in the Cary-Farber-Sherman 1995, the 112,000-square-foot Addition. "It'll be an ongoing process over the next several building will also be one of the years," Holm says. "There are already plans for whole floors university's major assets. Lo­ to be revamped." cated between the dental Recently the medical school's primary care initiative has school and the CFS Addition, its six floors will house labora­ been attracting grant money, and though the amount is small tories, offices and conference rooms, as well as animal facili­ compared to basic science, the research effort is growing. ties for pathogen-free work. Primary care studies tend to rely more on offices than the "Everyone's sort of excited about it," says John Naughton, traditional "wet" labs used in basic science, and the university M.D., vice president for clinical affairs and medical school dean. will be reviewing those needs as it develops its new master "The laboratories will be state of the art, flexible and easily plan. expandable," says Ronald Nayler, associate vice president for Holm, however, emphasized that researchers need not fear university facilities. "It's going to be one of the better research a new competition between "wet" and "dry" laboratory needs. facilities in the country for a medical school in terms of the "One of the messages that needs to get out to the faculty is that we're not forsaking one for the other," he says. "We can and way it's designed and outfitted." will be strong in both." + Total cost is expected to be more than $50 million. Bruce Holm, Ph.D., the medical school's associate dean for research and graduate studies, says ap­ plications to use the building will be reviewed in coming months, and deci­ sions are expected during the summer. "Space will be assigned based on the existence of interdisciplinary centers," he adds. Such centers, which bring scientists from different backgrounds together under a common theme, provide en­ hanced research capability and are more competitive in securing grants, Holm says. Some already exist at UB, such as a microbial pathogenesis center that deals with parasitology, infectious dis­ ease and sexually transmitted disease. Holm says there are other research groups that are similar, but haven't formally organized themselves as in­ The six-story, 112,000-square-foot research building will house laboratories, offices and terdisciplinary centers. The new re­ conference rooms, as well as animal facilities for pathogen-free work. B u f f a l o P h y s i c i a n W i n t e r 19 9 4 Q �UB physicians play critical support role in World University Games I Susan Udin, Ph.D., Thomas J. Guttuso, Jr. and one of their research subjects. Thomas J. Guttuso, Jr, receives Howard Hughes research grant T homas J. Guttuso, Jr., a UB medi­ cal student who recently com­ pleted his sophomore year, has received a year-long grant under the Howard Hughes Medical Institute's Research Training Fel­ lowships for Medical Students program. Guttuso, son of assistant dean and director of medical school admissions Thomas J. Guttuso, will receive a $24,000 stipend to study the effects of the pineal gland on neuronal plasticity in aquatic frogs. He will take a year'sleave of absence from medical school and re­ main in Buffalo to complete his research. "The main application of the research is strongly related to healing and regen­ eration," he says. "I'm working on de­ velopmental issues. It's found that young frogs heal a lot better — as do young humans — because they have a 'plastic' system." Guttuso credits Susan Udin, Ph.D., professor of physiology, for sup­ + porting his research efforts. ast summer, UB played host to college athletes from around the world as the World University Games '93 were held in Western New York. But while the focus was on the athletes, another group was hard at work behind the scenes to meet the Games' medical needs. Led byfour UBphysicians, this group was responsible for managing and staff­ ing the medical office on UB's North Cam­ pus and coordinating care at venue sites. The Games' four chief medical offic­ ers were James Hassett, Jr., M.D., asso­ ciate professor of surgery and a surgeon at Millard Fillmore Hospitals; Richard LaFountain, M.D., assistant professor of emergency medicine and director of emergency services at Millard Fillmore Gates Circle; Richard Weiss, M.D., as­ sociate professor of orthopaedic sur­ gery and a surgeon at The Buffalo Gen­ eral Hospital, and Gregory Young, M.D., clinical associate professor of emergency medicine and clinical assistant profes­ sor of internal medicine and corporate director of Millard's emergency services. Hassett, medical director for hospital­ ization, coordinated support for patients admitted to Millard, the designated pri­ mary receiving hospital. Of the 7,000plus athletes and officials from 89 coun­ tries, only five required hospitalization. "The staff of the hospitals provided tremendous support and expertise," Hassett says. "Since most of the patients could not speak English, we had to use translators and provide for their needs." LaFountain, director of the Village Polyclinic, was responsible for arrang­ ing continuous coverage by 180 physi­ cians and medical personnel. Together, they treated 550 people, including ath­ letes, officials and Games staff. "We transformed dormitory and office space into an emergency facility complete with X-ray, pharmacy, physical therapy and exam/resuscitation services that simply are not available in many of the athletes' own countries," LaFountain says, add­ ing staffing was totally voluntary. Weiss was responsible for the venues and recruiting physicians as well cover­ age for the opening ceremonies at Rich Stadium. "A great deal of intensity ex­ isted at the venue sites because minor injuries affecting the athletes would in­ volve discussion with the Games' site physician, the country's physician and FISU [the Games' governing body]," Weiss says. Young, medical director of emergency services, coordinated spectator care, en­ sured advanced EMTs were available at all sites and worked closely with the advanced life support coordinators of three counties as well as the coordinator from the Prov­ ince of Ontario to provide equipment and necessary supplemental staffing. + Naughlon honored as Citizen of Ihe Year by Columbus Hospilal J ohn Naughton, M.D., vice presi­ dent for clinical affairs and dean of the medical school, and Ernestine Green, a Buffalo educator and Nia­ gara Frontier Transportation Author­ ity commissioner, were recently honored as Citizens of the Year by the Buffalo Columbus Hospital Foundation. Naughton was recognized for his dis­ tinguished service as dean, his leader­ ship in health, hospital and medical education issues, and for his more re­ cent advocacy for and assistance to Buffalo Columbus Hospital's develop­ ing clinical affiliations with the medical school and its resources. + �Wrapping up a distinguished career F ORMER DENTAL SCHOOL DEAN W ILLIAM F EAGANS RETIRES AFTER OVER TWO DECADES AT U B i fter over 20 years as Dean of UB's School of Dental Medicine, Will­ iam Feagans, D.D.S., Ph.D., has overseen the education of count­ less doctors of dental surgery, and left a brick and mortar legacy that will live on as countless more reap its benefits as they learn the profession of dentistry. That legacy — in the form of the dental school's state-of-the-art Squire Hall facility — is one of the many rea­ sons UB's school was cited assixth in the nation in a 1992 U.S. News and World Report, "America's Best Graduate Schools," another Feagans accomplish­ ment, as is his bolstering of the school's research and graduate education pro­ grams. And, perhaps ironically, if Feagans had listened to his parents advice not to William Feagans, D.D.S. go into teachingwhen he graduated from dental school in 1954, probably none of it would have happened. "1 practiced in Kansas City after get­ ting my dental degree, but I wanted to get more into education," Feagans says. A graduate of the University of Mis­ souri at Kansas City, Feagans taught at the Medical College of Virginia in Rich­ mond from 1960 to 1966 after getting his Ph.D. in anatomy. In 1970, Feagans came to UB from Tufts University to become the dean of the School of Dental Medicine, a posi­ tion he held until he retired last year. "I took over forJim English, who was working on changing the course of den­ tal education. He worked on combining the clinical program with research," Feagans says. "My mission was to con­ tinue the thrust he began," he says, adding, "especially try­ Feagans' career at UB was not without controversy. The move to Squire Hall— then Norton Union — the planning for which began in the late 1970s, caused "a big uproar because the students were going to be left without a union," he says. "No effort was made for an alterna­ tive space for the students." Despite the controversy, the dental school was nev­ ertheless moved into Norton Hall — now known as Squire Hall — in 1986, leaving the students without a union from 1982 when the move began until 1984 when the Student Activities Cen­ ter opened on the North Campus. The $30 million Squire Hall renova­ tion project included the addition of state-of-the-art clinics that feature indi­ vidual operatories, each with its own dental chair and fixed cabinetry, devel­ oped specifically for the school. Stu­ dents learn their profession in the same environment in which they will eventu­ ally practice. Squire Hall's support fa­ cilities include laboratories, X-ray rooms with nearby processing facilities, a plas­ ter room, instrument and dispensing rooms and a demonstration room. ing to expand on the research mission." Feagans' efforts to­ ward this end were re­ warded in 1988 when the School of Dental Medicine received Feagans' tenure as dean of the School of Dental Medicine also realized inter­ national implications with the estab­ lishment of sister school relationships with dental schools in several countries, more funding that year from the National In­ stitute for Dental Re­ search than any other Taiwan. institution in the na­ tion. "It was a great credit to Jim English and to the faculty," he says modestly. "It gave the dental school national and international publicity." including Japan, Chile, Iraq, Israel, Mexico, Panama, Paraguay, Poland and Feagans' legacy will be carried on by LouisJ. Goldberg, D.D.S., Ph.D., former chair of the department of oral biology at the UCLA School of Dentistry, who took over as dean of the dental school when Feagans retired. Goldberg holds a dental degree from the New York University College of Dentistry and a Ph.D. in anatomy from the University of California. + — B Y C A R R I E A . L I B E R A N T E �MEDICAL T H E N A N D N 0 W SCHOOL Physicians - Heal Thyselves! OR, HOW TWO 1849 UB GRADS GOT EXPELLED FROM THE MEDICAL ASSOCIATION FOR CHARGING TOO LITTLE I t wasn't charging too much, but too little, that got two 1849 University of Buffalo graduates in trouble. John D. Hill, M.D., and Eldred P. Gray, M.D., were expelled from the county Medical Association for con­ "wrongfully and unlawfully" of partici­ pation in the association's counsels and actions, brought him "into disrepute" among his "professional brethren and others" and caused "great damage." The court issued an alternative writ tracting with the Erie County Board of Supervisors to render services for less than specified in the association's 1854 fee schedule. "Acceptance of any specific of­ fice for a different amount or for remuneration in any different way than by salary is clearly an infrac­ tion of both the letter and the spirit of the fee bill resolutions," the association declared. The member who does so, it added, "has forfeited his claim as a mem­ ber of this association." Hill, who had been the top man in his class at UB, ignored the $600 salary prescribed by the Medical Association for a physi­ cian serving the county's almshouse. Gray agreed to "visit the jail and perform medical ser­ vices" for $1 per visit — the aver­ age fee for a private patient — rather than the association's prescribed $150 salary. Injanuary, 1855, the association voted to expel Hill, and in June, 1856, Gray. Both physicians vehemently pro­ tested their expulsion and continued to attend association meetings, but as "by­ standers," were not allowed to express opinions or vote. II, M.D of mandamus: "either reinstate him or show why you cannot or will not," it told the Medical Association. The association's answer, when it came, was laughable. Hill should never have been expelled because he was never truly a member, the association said, contending that when Hill applied for membership in 1849, he had not yet deposited a copy of his diploma with the county clerk, and thus was not.legally authorized to prac­ tice medicine. And only those autho­ rized to practice medicine could be Finally, both physicians — first Hill and then Gray — appealed to the State Supreme Court to be reinstated. Hill said his expulsion deprived him © B u f f a l o P h y s i c i a n w members of the Medical Association. Furthermore, he had not garnered the required two-thirds vote of the members present when his membership was con­ sidered — although he was, at the time, "admitted" — and he had neglected to sign the bylaws and pay the treasurer $1 for a certificate of membership. The Supreme Court didn't buy the argument and ordered Hill reinstated. When Gray was brought up on charges, he argued that he was not actu­ ally accepting less than the required salary from the county by charging $1 per jail visit since his fees would amount to more than the association's prescribed $150 yearly salary. In fact, Gray's fees totaled $178. The association was, at first, big-hearted. It offered to let him retain his membership if he "im­ mediately retires from the posi­ tion which he holds in violation of the rules of the association." He refused, arguing that for the association "to prescribe the rate of compensation I may receive for services rendered is an illegal re­ striction of my individual rights as a member. Fixing salaries for our public institutions" is a mat­ ter "over which they have no ju­ risdiction whatever, such duty being confided to other powers." He had, he said, "obligated myself to the Board of Supervisors for a faithful rendi­ tion of my services for the term of one year and I am unwilling to dishonor my contract or to give up an office which amply compensates me for myservices." The association voted to expel him. He was reinstated in 1858 by order of the State Supreme Court to his "stand­ ing and position" in the association. And 30 years later, in 1888, Hill was elected president of the association! + — B Y i n M I t L e D R r E D S 1 A 9 N E 9 S 4 �T H E N N 0 MEDICAL W S C H O O L Adopted by the Buffalo Medical Association To Regulate the Medical and Surgical charges of its Members. Adopted November 15th, and ordered to go into effect January 1, 1854. Medical visit within the present City limits $1.00 A single medical visit within the same limits, made to transient persons B Introducing a catheter or bougie, first time (in addition to visit) 2.00 Introducing a catheter or bougie, subsequent times (in addition to visit) 2.00 1.00 Detention after the first hour, except in cases of obstetrics — for each hour during the day or night 1.00 Night visit, between 10 P. M. and sunrise 5.00 Remaining at the house, by previous arrangement, during the night, except in cases of obstetrics 5.00 - 10.00 Rising at night and prescribing 1.00 First consultation visit, medical or surgical 5.00 Each subsequent consultation visit 2.00 Advice and prescription in ordinary cases at office 50 Investigating and prescribing by letter or orally 1.00 - 10.00 Ordinary obstetrical attendance, including abortions and premature labors 10.00 - 20.00 For detention beyondsix hours in obstetrical cases there may be charged for each hour additional 1.00 Instrumental delivery and turning 25.00 - 50.00 All visitsmade subsequent to the accouchement, the same as for regular medical visits, viz 1.00 Venesection in addition to visit 1.00 Cupping 2.00 Introducing seton or issue, or applying moxa 2.00 Prescribing for gonorrhoea 10.00 - 25.00 Prescribing for primary syphilis 10.00 - 25.00 Prescribing for secondary or tertiary, not less than for primary, and additional charge optional. In venereal case the fees, or the security therefor, always to be required in advance. Trephining 25.00 - 50.00 Operation for cataract 25.00 - 50.00 Operation for fistula lacrymalis 10.00 - 25.00 Extraction of nasal polypus 10.00 - 25.00 Excision of a tonsil or uvula 5.00 - 10.00 Tracheotomy 25.00 - 50.00 Reducing hernia by taxis 5.00 Application of truss to hernia 5.00 Operation for strangulated hernia 50.00 - 100.00 Operation for fistula or fissura in ano 25.00 - 50.00 Operation for haemorrhoids 25.00 - 50.00 Tapping for hydrocele 5.00 Operation for radical cure of hydrocele 10.00 - 25.00 Paracentesis abdominis (first time) 10.00 - 25.00 Paracentesis abdominis (subsequent times) 5.00 - 10.00 Removal of calculus from bladder by an operation .... 100.00 - 200.00 Removal of uterine tumors or polypi 25.00 - 100.00 Operation for phymosis or paraphyosi 10.00 Amputation at hip joint 100.00 - 200.00 Amputation at shoulder joint 50.00 - 100.00 Amputation at thigh through its shaft 50.00 - 100.00 Amputation at fingers and toes 5.00 - 20.00 Amputation at extremities at other points 25.00 - 50.00 Amputation at breast 50.00 - 100.00 Extirpation of testis 25.00 - 50.00 Extirpation of tumors 5.00 - 10.00 Reducing dislocation of hip joint 20.00 - 50.00 Reducing dislocation of shoulder joint 10.00 - 25.00 Reducing dislocation of other joints 5.00 - 10.00 Post mortem examination before a Coroner 10.00 Post mortem examination made by request of the family . 5.00 - 10.00 An opinion involving a case of law 10.00 Life insurance certificate for the company 2.00 Life insurance certificate, for your own patient 1.00 u f f a l o P h y s i c i For all other medical or surgical services not mentioned in this bill, the charge shall be in the same ratio, the ratio being determined by the relative responsibility of the services and the time occupied. Visits beyond the present City limit are to be charged as City visits, with the addition of 1.00 per mile, for the first five miles. All fractions of a mile shall be charged as a full mile. Visits made to several patients in the same neighborhood, shall be deemed regular visits to each individual, and shall be charged as such. Incidental visits, as when a physician passing a house in the country is called in, are to be charged as in the City, one dollar: but should it be necessary to continue attendance, each succeeding visit shall be charged with mileage. It shall be considered dishonorable for any member of this Association to attend families or individuals by the year; or to take any other bargain or arrangement, the tendency of which will be to avoid the full purport and effect of the foregoing list of charges. All bills shall be considered due when services are rendered, and bills are to be presented, at least once a year, and settlement requested. It is particularly recommended to each member of the Association that all his unsettled bills be presented at the close of each year. Uniformity in this respect is considered of great importance to the interest of the profesIt shall be considered proper to make liberal deductions to all persons in moderate circumstances, excepting in cases of venereal disease. a n w i n t e r 19 9 4© �ALUMNI Working around the health care system IN THE MIDST OF THE NATIONAL REFORM MOVEMENT, DEBORAH RICHTER '86, PUSHES FOR CHANGE f system (similar to the Canadian system) and President Clinton's proposed plan is the elimination of insurance compa­ nies, which Richter says would save an estimated $20 billion a year in industry profits and overhead in addition to re­ ducing its considerable bureaucracy. "I feel like there's a bureaucrat sitting between me and my patients," she says. The system she advocates would also preserve fee-for-service. There is noth­ ing in Clinton's plan for this, Richter says. "We treat health care as a commod­ ity. I don't think people should profit from keeping people healthy," she says. "Let people profit from selling things like cars." Health care, she says, "should be a human right, like police and fire protec­ tion. You wouldn't ask someone to pay hen Deborah Richter, M.D., got out of medical school, she wanted to help the poor. But the system got in her way. "I had to treat people differ­ ently based on their insurance," says Richter, a 1986 graduate of the School of Medicine and Biomedical Sci­ ences. "I had to treat the insurance rather than the patient. I have a problem with insurance companies telling me how to treat my patients," she says. Richter explained that she has had patients "beg" her not to be sent to an emergency room because emergency room care is not covered under their insurance plan. "I'm not sure I can continue to prac­ tice medicine in this system." she says. So she has looked for a way to practice medicine without feeling trapped be­ tween treating patients and pacifying insurance companies. At Buffalo's county-run Geneva B. Scruggs Community Health Center, where the poor are her patients, Richter has struck a balance. She joined the staff there after com­ pleting a residency in family medicine at the University of Rochester's Highland Hospital. A staunch advocate of health care reform, Richter is local chapter presi­ dent of Physicians for a National Health Program, an organization she's been involved with since 1991. She believes the single payer system, under which a centralized payer would pay hospitals, HMOs and private practice physicians, would be best for the country. The main difference between this B u f f a l o for police protection, would you?" As a long-time advocate for a na­ tional health plan, she is very disap­ pointed in Clinton's proposal. "It will ruin health care." "I can't disagree with the ideology. The benefit package would be good if he could deliver it," she says. "But man­ aged care, I don't agree with." Richter argues managed care won't contain costs, and although Clinton's plan would eliminate all the small insur­ ance companies, it would "leave all of the large ones owning health care lock, stock and barrel." " [Under Clinton's plan] the large in­ surance companies will buy up the HMOs and own the doctors and the decisions," she says. "Treating people is not that simple." Richter believes one of the problems with the way medicine is practiced today is that everyone is interested in his or her bottom line. "We don't want to put the bottom line on hospitals. They shouldn't have to worry that if they take a patient who's on Medicaid, they won't make any money," she says. Deborah Richter, M.D., and a very satisfied patient. P h y s i c i a n W i n t e r 1 9 9 4 �Richter says that what she considers routine care is often perceived as unnec­ essary treatment by the insurance com­ panies — counseling, for example — which "renders the patient harmless," insurance jargon that in essence means neither the patient nor the insurance company is responsible for paying the bill. "Clinton's plan will encourage this," she added. In addition to Richter's opposition to insurance companies, she also is wary of Clinton's plan because she questions how it will be paid for. "We spend about $90 billion a year on unnecessary paperwork," she says. "With that money, you could reinvest it into the system." Richter says that paying for health care doesn't have to be as complex as the government makes it out to be. She is especially concerned about the poor and elderly because they "don't do well in HMOs," noting that this group makes up 10 percent of the population but uses 72 percent of the health care resources. Richter feels that one of the most important parts of her job as a physician is what she calls "mass education." Be­ sides educating her patients and the public about the single payer system, she likes to educate her patients on a one-to-one basis about health care. "I had a 16-year-old mom who brought her baby in every time he got the sniffles," she says. "So, I gave her a chart stating exactly when I should see the baby. Then she only brought the baby in when he needed it." Richter notes that women now make up about 50 percent of the graduating classes at UB's medical school. "I believe that women will change medicine," she says. "People want their mommies when they're sick." + Speaking of health care reform — First Lady Hillary Rodham Clinton, visiting Niagara Falls on November 5, talks about the president's health care reform plan with medical school dean John Naughton, M.D., right. Naughton greets Rep. John J. LaFalce, D-North Tonawanda, as Mark Celmer, president and CEO of DeGraff Memorial Hospital, looks on. Help us find your classmates! The Medical Alumni Association isseeking the whereabouts of the following missing alumni. If you can help us, please contact the Medical Alumni Office at (716) 829-2778. CLASS OF 1944 Angel M. Ayala William Burgoyne CLASS OF 1954 Leonard Constantine CLASS OF 1959 Ronald K. Hoyt Eugene D. Means Frederick Wurapa CLASS OF 1969 William Cunningham Peter D. Sirof CLASS OF 1974 Ann C. Ganczewski CLASS OF 1964 George R. Cohen Jan M. Gorzny Gugu R. Nxumalo Keith F. Russell CLASS OF 1979 Marion Alice Barnhart Mary Louise Fedash Theodore R. Hall Carol H. Hinds Avril Sampson David M. Simpson CLASS OF 1984 Maurice Wolin CLASS OF 1989 Young Bum Huh Louise LoBalsamo John P. Osborn Yasmin Panahy Joseph P. Spychalski 1993 Distinguished Medical Alumnus — William F. Balistreri, M.D. '70, (center) receives the specially designed crystal buffalo award from John Naughton, M.D., (left) vice president for clinical affairs and dean of the medical school, and Robert Reisman, M.D., '56, president of the Medical Alumni Association. �ALUMNI Spring Clinical Day and Reunion Mend set for April 29 - 30 M ark your calendars and be sure to set aside the time to attend the 57th Annual Spring Clinical Day and Reunion Week­ end at the Buffalo Marriott. Cocktail re­ ceptions for all reunion classes will be held on Friday, April 29, 1994, with Spring Clinical Day on Saturday, April 30. This year's Stockton Kimball Lecturer will be Jerome Kassirer, M.D., '57, editor of The New England Journal of Medicine and 1991 Distin­ guished Medical Alumnus. + CLASS OF 1959 CLASS OF 1964 CLASS OF 1984 "Looking forward to see­ "Step across the enchanted "Ten years have passed, we have a lot to catch up on. ing all of you again at our portal 35th Class reunion." Reunion's Magic Kingdom! Free up your schedules now JOSEPH F. MONTE, M.D.. Enter joyously and cel­ to return to Buffalo and see ebrate our old friends." CHAIRPERSON of our 30th conviviality! Welcome home!" NORA E. MEANEY-ELMAN. MARVIN Z. KURLAN. M.D., M.D., CHAIRPERSON CHAIRPERSON CLASS OF 1944 "Hope to see all that are able at the 50th." JAMES R. SULLIVAN. M.D., CHAIRPERSON CLASS OF 1969 CLASS OF 1989 CLASS OF 1974 "It's hard to imagine that "Twenty years have gone five years have passed. We by fast. Let's get together lookforward to seeingyou. us for Spring and renew old friendships." Please join JAMES A. SMITH, M.D., Clinical Day and the re­ CHAIRPERSON union parties." LEE R. GUTERMAN, M.D., CHAIRPERSON "Twenty-fiveyears. It's the right time to return for a "For the Class of '54, ev­ great weekend." ery reunion is special. HANLEY M. HORWITZ, Come celebrate our 40th!" M.D., CO-CHAIRPERSON NICHOLAS C. CAROSELLA, "Don't miss our 25th. We M.D. CO-CHAIRPERSON CLASS OF 1949 need you to make it a suc­ "Looking forward to see­ "Come join your class­ cess." ing your attractive and in­ mates for a weekend of GERALD • . STINZIANO, telligent faces again. Please nostalgia at our 45th re­ CLASS OF 1979 M.D., CO-CHAIRPERSON "Come back to our 15th come!" union." CARMELO S . ARMENIA, M.D., CHAIRPERSON EDWARD A. RAYHILL, Reunion, reminisceand see M.D., CO-CHAIRPERSON how we, the school and Buffalo have changed." PETER E. SHIELDS. M.D, CHAIRPERSON © B u f f a l o P h y s i c i a n W i n t e r 1 9 9 4 �A L U M N I 1993 reunion classes donate $101,050 to medical school I ast year's reunion classes donated over $100,000 to the medical school. Following is a listing of participat­ ing classmembers and class totals. Dr. Raphael S. Good Dr. Myron Gordon Dr. Harold L. Graff Dr. Robert J. Hall Dr. Vernon C. Lubs Dr. Daniel G. Miller Dr. Raymond E. Moffitt Dr. Kenneth R. Niswander Dr. Norman L Paul Dr. Richard C. Proplesch Dr. James G. Robilotto Class of 1953 — Dr. Max M. Bermann Dr. James R. Blake Dr. Anothony M. Foti Dr. Paul A. Lessler Dr. Donald A. Levine Dr. Don L. Maunz Dr. Robert M. Post Dr. Eugene M. Sullivan, Jr. Dr. John M. Wadsworth Dr. Sander H. Fogel Dr. Ronald F. Garvey Dr. Thomas G. Geoghegan Dr. Jack Gold Dr. John W. Handel Dr. Curtis C. Johnson Dr. Milford C. Maloney Dr. Richard J. Nagel March — Total: $6,000 Dr. Jacob B. Shammash Dr. Alfred S. Evans Dr. Arthur M. Goldstein Dr. David S. Berger Dr. Donald L. Ehrenreich Dr. Molly Seidenberg Dr. Eugene M. Farber Dr. Thomas J. Dwyer Dr. Joseph C. Tutton Class Total: $13,550 Dr. John M. Donohue Dr. Patricia J. Flanagan Total: $4,650 Dr. Stanley L. Cohen Dr. Donald O. Rachow Dr. Robert J. Collins Dr. Kevin S. Ferentz Dr. Charles S. Tirone Dr. James M. Orr Dr. Richard J. Buckley Dr. Jack R. Cavalcant Dr. Yung C. Chan Total: $9,100 Class of 1943 — Dr. Kenneth W. Bone Dr. James S. Williams Class of 1963 — Dr. Howard C. Smith Dr. Raymond M. Smith, Jr. Dr. Harold Smulyan Dr. John N. Strachan Dr. Michael A. Sullivan Dr. John D. Voltmann Dr. Charles J. McAllister Dr. Neal T. Smith Dr. Robert J. Smolinski, Dr. John C. Bivona,Jr. Dr. Arthur W. Mruczek, Sr. Dr. Anthony J. Bonner, Jr. Dr. William E. Clack Dr. Vincent G. Natali Dr. Adolph Soto, Jr. Dr. Patrick L. O'Connor Dr. Robert S. Stall Dr. Geoffrey E. Clark Dr. Robert L. Penn Dr. Mark A. Venditti Dr. Marc N. Coel Dr. Daniel A. Pietro, Jr. Dr. Renata Wajsman Dr. Gary H. Cramer Dr. Andre Raszynski Dr. Stuart Y. Wernikoff Dr. Geraldine F. De Paula Dr. Jacob D. Rozbruch Dr. Kenneth S. Zimmerman Dr. Barry Sanders Dr. Gregory' Zuccaro, Jr. Dr. George L. Druger Dr. Stephen A. Edelstein Dr. Michael A. Sansone Dr. Frank G. Emerling Dr. Ronald J. Friedman Dr. Arthur C. Sgalia, Jr. Dr. Robert M. Simon Dr. Bruce H. Gesson Dr. Gary J. Wilcox Dr. Theodore Hopens Dr. Lynda M. Young Dr. Kenneth L. Jewel Dr. Lawrence Zemel Dr. Andrew Cappuccino Dr. Helen M. Cappuccino Class of 1978 — Dr. Sandra L. Everett Dr. Ronald E. Batt Dr. David Kramer Dr. Winslow P. Stratemeyer Dr. David A. Berkson Dr. Harold L. Kulman Dr. James W. Taft Dr. Melvin M. Brothman Dr. Francis J. LaLuna December — Total: $7,550 Dr. Gary N. Cohen Dr. Sanford E. Leff Dr. Bernice S. Comfort Dr. Kenneth W. Matasar Dr. Carl A. Contino Dr. Robert A. Milch Dr. Thomas G. Cummiskey Dr. Roger B. Perry Dr. William F. Deverell Dr. Howard W. Raymond Dr. Robert C. Dickson Dr. Robert D. Rodner Dr. Frederick W. Dischinger Dr. Robert T. Rosen Dr. Benson L. Eisenberg Dr. Elias S. Rosenblatt Dr. Domonic F. Falsetti Dr. George P. Saba, II Dr. John W. Float Dr. Barbara B. Sayres Dr. Eugene A. Friedberg Dr. Lawrence J. Schwartz Dr. Michael T. Genco Dr. John E. Shields, Jr. Dr. William L. Glazier Dr. Timothy S. Sievenpiper Dr. Gerard T. Guerinot Dr. Leo A. Kane Dr. Sara R. Sirkin Dr. Lesbia F. Smith Dr. Marie Leyden Kunz Dr. Stuart C. Spigel Dr. Jacques M. Lipson Dr. Richard H. Stamile Dr. Michael A. Mazza Dr. Bruce C. Stoesser Dr. Robert J. Perez Total: $3,885 Dr. Lucien A. Potenza Dr. Richard A. Rahner Dr. William H. Bloom Dr. Richard R. Romanowski Dr. David P. Buchanan Dr. Walter H. Rothman Dr. Glenn B. Doan Dr. Morton Spivack Dr. Thomas J. Enright Dr. Daniel J. Fahey Dr. Alfred M. Stein Dr. Richard D. Wasson Dr. William F. Gallivan,Jr. Dr. Reinhardt W. Wende Dr. Morris Unher Dr. Paul J. Wolfgruber Class of 1948 — Dr. Claudia Fosketl '85 Dr. Lawrence J. Dobmeier Dr. Ralph E. Smith, Jr. Dr. Robert W. Moyce Dr. Gwen L. Nichols Dr. Charles R. Niles Dr. Daniel J. McMahon Dr. Julian R. Karelitz Dr. John C. Ninfo Dr. Sharon Kuritzky Dr. Albert W. Biglan Dr. Roger M. Baretz Dr. Amos J. Minkel, Jr. Dr. Francis C. Mezzadri Dr. Paul Kuritzky Dr. Lawrence D. Baker Dr. Nathan P. Segel Dr. Anthony J. Marano Dr. William J. Mayer Dr. John T. Klimas Dr. Allen D. Rosen Dr. Gary D. Karch Dr. C. Philip Lape Dr. Younghee Limb Dr. Robert Huddle, Jr. Dr. Mark Schwager Dr. John V. Armenia Dr. Richard J. Jones Dr. Fredric M. Hirsh Dr. Mary Jane Massie Dr. Walter R. Petersen Dr. E. George Heus Dr. Mary M. Lee Dr. Joel M. Andres Dr. Brian S. Joseph Dr. Richard F. Kaine Dr. John P. Guinther Dr. Stephen L. Kinsman Dr. Marc E. Heller Dr. Cynthia A. Pristach Dr. Elroy E. Anderson Dr. Edward B. Crohn Dr. Maxine D. Hayes Dr. Thomas A. Lombardo, Jr. Total: $17,350 Dr. B. Joseph Galdys Dr. William F. Hanavan Dr. Richard D. Jackson Dr. Ralph R. Hallac Total: $16.625 Dr. Ruth F. Krauss Dr. Ronald E. Martin Dr. Paul A. Cline Dr. Jonathan A. Graff Dr. Vincent J. Fuselli Dr. Robert E. Noble Dr. Marvin Wadler Dr. Louis F. Ciola Dr. Robert G. Fugitt Dr. Dana P. Launer Class of 1958 — Dr. Peter A. Casagrande Dr. Denise M. Goodman Dr. Robert S. LaMantia Dr. Joseph V. Hammel Dr. Ivan L. Bunnell Dr. Catherine A. Goodfellow Dr. Lee A. Evslin Class of 1968 — Dr. Richard S. Fletcher Dr. Ralph T. Behling Dr. Demetrius Ellis Dr. Arnold W. Scherz Total: $4,675 Class of 1988 — Total: $1,680 Dr. Stephen F. Achilles Dr. John J. Barbaccia Dr. Charles Everett Dr. James E. Hohensee Dr. Thomas R. Achtyl Dr. Gerald P. Igoe Dr. Stewart R. Altmayer Dr. Kevin W. Kopera Dr. Louise T. Barbieri Dr. William R. Kuehnling Dr. Michael H. Blume Dr. Nancy J. Lisch Dr. Daniel P. Cannucciari Dr. Pierre T. Martin Dr. Richard R. Curran Dr. Robert F. Mennella Dr. Kathleen A. O'Leary Dr. Stuart L. Dorfman Dr. Richard S. Elman Dr. Karen S. Reed Dr. Fred H. Geisler Dr. Robert F. Reed Dr. Kenneth L. Glick Dr. Nicole L. Sasson Dr. Stephen E. Killian Dr. Robert A. Sicoli Dr. Mark J. Kramer Dr. Wayne R. Waz Dr. Roberta Meltzer Dr. Janet M. Williams Dr. Paul Miles-Matthias Dr. Charles W. Morgan Editor's Note: While every effort Dr. Matthew J. O'Brien, Jr. is made to verify the accuracy of Dr. Lois A. Polatnick this listing, omissions or Dr. Robert P. Pszonak misprints may occur. This report Dr. Joel J. Reich lists all donors who have made Dr. Paul A. Rutecki Dr. Steven M. Seidman gifts as of November 4, 1993. If Dr. Richard J. Sternberg comments or concerns, please Dr. Jeffery S. Stoff Class of 1983 — call Michael E. Benzin, Acting Dr. Robert E. White Total: $7,860 Class of 1973 — Total: $21,675 Dr. Bruce M. Abramowitz Dr. William J. Ackerman Dr. William S. Bikoff Dr. Frederick R. Buchwald Dr. Peter J. Accetta you have any questions, Director of Annual Giving, at (716) 645-3312. Thank you. Dr. Deidre Bastible Dr. Melinda S. Cameron Dr. Susan E. Champion Dr. Michael J. Chaskes Dr. Victor Chehebar Dr. John A. Feldenzer © �A S p o o n f u l o f H u m o r © S t u S i l v e r s t e i n , M . D As the World Turns BIG CHANGES I N FOREIGN AFFAIRS AND DOMESTIC HEALTH CARE ARE ONLY T H E BEGINNING ment eliminate paperwork? They in­ vented it — in 1852. This is like putting Ted Danson in charge of the NAACP. I graduated from residency last year and got my first taste of managed care. I still don't know what it is. I thought PPOs caused mycoplasma pneumonia. Well, there I am billing for my ser­ vices and the hospital HMO says, "Sorry, we can't pay you." "Why not?" "Because you haven't paid us your fee." If I'm not mistaken, this used to be called protection money and it was col­ lected by the Mob. I guess HMO stands for Higher Mafia Organization. They might as well have some guy sitting outside the OR with a cash register! "HEY MAC! Before you scrub, that'll be 10 bucks. Let's see some ID." We are already seeing an onslaught of news coverage on the health profes­ sion. In order to facilitate proper cover­ age, we offer this abridged glossary of non-clinical terms used in medical con­ text that cannot be found in any stan­ dard medical dictionary or spell checker. Last fall, we witnessed the successful completion of the Biosphere project, where groups of individuals were locked inside a building for two years, having to deal with each other and eat what­ ever food was available without any assistance from the outside world. This used to be called Residency. At this point I understand they're actually board eligible in pediatrics and psy­ chiatry. Of course the biggest news was the signing of the Middle East peace ac­ cords. Lots of dignitaries were in atten­ dance, including ex-presidents and vice presidents. In a case of mistaken iden­ tity, Dan Quayle asked Yasser Arafat what it was like to play drums with the Beatles on the Ed Sullivan Show. Our sources tell us that Yitzhak Rabin agreed to shake hands as long as there was no hugging and kissing. The Israeli prime minister looked a bit stiff and uncomfortable — he made A1 Gore look like a speed-addicted aerobics instructor. Now that he has the foreign situa­ tion under control (with the exception of NAFTA, Somalia, Haiti, Bosnia and the Toronto Blue Jays winning two World Series in a row), the president has finally turned his attention to health care reform. As you know, the biggest problem facing doctors today is there just isn't enough paperwork out there. Bill Clinton says that under his plan pa­ perwork is going to be totally elimi­ nated. Since when does the U.S. govern­ © B u f f a l o Allied Health Professional — A person who works in a health field that is allied with the practice of medicine, i.e., the First Lady. Attending Physician — A physician on the medical staff who is legally responsible for the care given to a patient. He is the physician frantically looking for a stetho­ scope to borrow from the medical stu­ dents. Capitation — Formerly called castra­ tion. Cherry Picking—Accepting only healthy people for insurance coverage, i.e., pro­ viding hurricane insurance for the midwest and tornado insurance for resi­ dents of Hawaii. Clinical Autonomy — The ability of physi­ cians to make medical judgments based on their training, experience and spe­ cialty, without outside interference, practiced during the Paleozoic Era, now extinct. Discounted Rate — A payment arrange­ ment in which providers agree to accept reimbursement that is based on a per­ centage lower than their usual billed rate. (See Wal-Med.) Medical Students — Students who spend time in a hospital learning clinical medi­ cine. They can be identified by their white coats, the 59 pounds of medical equipment they carry and as the ones frantically volunteering their stethoscopes to the attending physi- Stu Silverstein, M.D., president of Stondup Medicine Seminars of Son Francisco, California, lectures notionwide on humor in medicine. P h y s i c i a n W i n t e r 1 9 9 4 �GRADUATE EDUCATION The Emergency Medicine Residency program will be Buffalo General Hospital. D Emergency Medicine residency program wins ACGME approval B's Emergency Medicine Residency program has won provisional ac­ creditation status from the Accredi­ tation Council on Graduate Medi­ cal Education. The program, which consists of three years of training beginning at the PGY-1 level, officially begins in July of 1994 with its full complement of 10 residents. Residents will be based at The Buffalo General Hospital and will rotate through Erie County Medical Center, The Children's Hospital of Buffalo and Millard Fillmore Hospitals. George Braen, M.D., pro­ fessor and chairman of emer­ gency medicine, will direct the program. Clinical trainingwill con­ sist of rotations in medicine, based af The trauma and burns, surgical intensive care, anaesthesiology, pediatric emergency care, orthopaedics, coronary care, plas­ tic and hand, as well as rotations in emergency health services systems and administrations. "We're in the process of recruiting residents for next year," said Dan Dike, M.D., assistant to the chair, noting that the existing undergraduate program rotations have "attracted some very good people who are interested in staying in Buffalo. "Buffalo General Hospital is building a new emergency department and of­ fices for the overall residency program and ECMC is building a new emergency department," Dike said. "And Millard is reconstructing its suburban emergency department, which is where the resi­ dents will be rotating." + Hand fellow joins staff of Our Lady of Lourdes Medical Center I cottF. Garberman,M.D.,whocom| pleted a fellowship in UB's depart­ ment of orthopaedic surgery, divi­ sion of upper extremity and microsurgical reconstruction, has recently joined the medical staff at Our Lady of Lourdes Medical Center, in Camden, Newjersey. Garberman earned his medical degree from Hahnemann University in mm \ Philadelphia and W / finished a residency in general surgery at Abington Memorial Hospital in Abington, Pennsylvania. + BUFFALO COLUMBUS HOSPITAL and the UNIVERSITY AT BUFFALO PARTNERS in PROGRESS At Buffalo Columbus Hospital, we're incorporating our family of community health centers into the U.B. healthcare family to provide a new level of excellence. By combining the resources of the University at Buffalo School of Medicine and Biomedical Sciences with an 85-year tradition of caring, Buffalo Columbus Hospital is taking a visionary approach to the challenges of health care in the '90s. G OLUMBUS BUFFALO COLUMBUS HOSPITAL 300 Niagara Street Buffalo, New York 14201 (716) 845-8300 For more information, call: 1-800-77-CARE-4 B u f f a l o P h y s i c i a n W i n t e r 1 9 9 A © �CLASSNOTES T H O M A S P . H A M I L T O N II ' 5 7 , June 1993. Dr. Marks is the Theology at Virginia Union Uni­ R A L P H T . B E H L I N G ' 4 3 , of writes, "I retired from the U.S. Deputy Director for Public versity in September 1987. This San Mateo, California writes, Army May 9,1993. Most recent Health Practice at the Center for fall he completed requirements "I'm taking our five children and positions were chief, preventive Chronic Disease Prevention and for a master's degree in divinity. their 'mates' on a Caribbean medicine division, Army Medi­ Health Promotion, Centers for cruise in September to celebrate cal Department Center and Disease Control and Prevention M A R K S . G L A S S M A N ' 7 8 , has School (chair and full profes­ in Atlanta, Georgia. He is the been named director of pediat­ sor) and Deputy Commander, son of Dr. and Mrs. Eugene M. rics at New Rochelle Hospital Marks '46. Medical Center. Dr. Glassman LINDA SHRIRO SCHENCK ing inpatient pediatric capabili­ medal is awarded for signifi­ ' 7 7 , has been appointed to the ties, developing a practice in cant contributions to the Admissions Committee of the pediatric gastroenterology and University of Minnesota Medi­ serving as a liaison between New cal School and to the Governor's Rochelle Hospital Medical Cen­ our 50th Anniversary." H E R B E R T E . J O Y C E ' 4 5 . re­ Director of Medical Education ceived the Max Cheplove medal and Commander, Brooke Army on October 23, 1993. The progress of Family Medicine. Dr. Joyce is the 25th recipient of the medal. Medical Center." 1 9 6 0 s MORTON E. WEICHSEL, JR. '62, was appointed chief of pro­ fessional services, Los Angeles EUGENE J. MORHOUS '45, informs us that his wife of 48 years died in May of acute lym­ phocytic leukemia. Dr. Morhous resides at 57 Sherwood Drive, White Sulphur Springs, West Virginia 24986. 1 will be responsible for enhanc­ 9 County, California Children's Services and also professor of pediatrics and neurology at UCLA School of Medicine. 0 lege. He is board certified in both husband, Carlos Schenck '76, is pediatrics and pediatric gastro­ still with the Minnesota Regional enterology and also holds a Sleep Disorders Center at master's degree in human nutri­ tion from the Institute of Hu­ R A L P H D ' A M O R E ' 6 5 , is di­ ter. They have three children, man Nutrition at Columbia Uni­ rector of emergency services at Carly, Nicholas and Teddy. versity College of Physicians and R O B E R T A . M I L C H ' 6 8 , medi­ sis from the Southern California '53. received Brown University's cal director of Hospice Buffalo, Psychoanalytic Institute in June Senior Teaching Citation has been appointed clinical as­ 1993. Dr. Seitelman teaches at Award at the 1993 Commence­ sistant professor of family medi­ the institute and has a private ment. His daughter Paula re­ cine at the University at Buffalo practice in psychiatry in Seal ceived her MA from Columbia School of Medicine and Biomedi­ Beach, California. His son Rob, School of Journalism in 1993. cal Sciences. Dr. Milch will be age 14, attends the Orange teaching palliative care to family County High School of the Arts; medicine residents and devel­ his wife,Judy, is a business writer erside, California, was installed oping a curriculum to include a and has her own business. as president of the Riverside rotation at Hospice Buffalo. Dr. County Medical Association. Milch also serves on the Ethics Dr. Kanel is an associate clini­ Committee of the Erie County cal professor of orthopaedic Medical Society. sity. J A M E S S . M A R K S ' 7 3 , was nounces that he is retiring from practice in January 1994. He is currently an AMA delegate. © e u f f a i Journal of Gastroenterology and the Journal of Allergy and Asthma for Pediatricians. Dr. Glassman and his family live in Connecticut. 1 9 8 0 s P A T R I C I A F L A N A G A N ' 8 3 , as­ sistant professor of pediatrics at Brown University School of Medicine, has been named the first Fleet Scholar for Social Pe­ C O V I A L . S T A N L E Y ' 7 8 , was surgery at Loma Linda Univer­ J O H N S . P A R K E R ' 5 7 . an­ torial boards of the American received a Ph.D. in psychoanaly­ HERBERT P. CONSTANTINE H A R R I S H . K A N E L ' 5 7 , ofRiv- Surgeons. He serves on the edi­ JEFFREY K. SEITELMAN '77, Rouge, Baton Rouge, Louisiana. s ter and New York Medical Col­ cally Engineered Organisms. Her Hennepin County Medical Cen­ the Medical Center of Baton 5 Advisory Committee on Geneti­ installed as the pastor of Mount diatrics at Brown University. The Rona Baptist Church in New­ award is for a three-year period. port News, Virginia, in June The scholarship was established 1993. After closing his private to support young, promisingaca­ practice in obstetrics/gynecology demic faculty whose research in 1987, he moved to Richmond, will address topics of concern awarded the Public Health where he worked at the Virginia for the well-being of children Service's highest award, the Dis­ Department of Health. He began according to changing needs tinguished Service Medal, in taking courses at the School of over time. Dr. Flanagan's area of o P h y s i c i a n W i n t e r 1 9 9 A �CLASSNOTES research interest is in the evalu­ D E B O R A H W H I T E ' 8 7 , and her ation of neurodevelopmental husband Chris White (M.S. '84), outcome of infants born to ado­ announce the birth of a daugh­ lescent mothers. She is a pedia­ ter in January 1993. She joins a trician on staff at both Rhode brother, age 4. Dr. White is in Island Hospital and Women and practice in internal medicine in Infants Hospital. Dr. Flanagan's Medina, New York. background encompassesa wide S U S A N L . B E H E N ' 8 8 , com­ range of social issues surround­ ing adolescent pregnancy. She is pleted a residency in general currently a member of the Rhode surgery at the Johns Hopkins Island Attorney General's Task Hospital and accepted a fellow­ Force on Sexual and Violent ship at the University of Texas at Physical Abuse of Children. Houston. H E R B E R T N E W T O N ' 8 4 , and VERONIQUE JAMES '88, his wife Cheryl, proudly an­ works in the pediatric clinic of nounce the birth of their first Bridgeport Hospital, and Richard child, Alexander James ("AJ") Ho (MSTP '92) is a second-year Newton, 8 lbs. 11 3/4 oz., born medicine resident at Yale. They August 24, 1993. announce the birth of Kathryn JOHN V. Veronique James '88 BOSSO '85, was Nicole on August 7, 1993. Forster '85 is area service chief J E N N I F E R L . C A D I Z ' 8 7 , is G I N A B . D I N U N Z I O ' 8 9 , joined named chief of the division of of pediatrics for the N orthern Vir­ currently a staff oncologist at Wil­ allergy at Nyack Hospital, Nyack, ginia area of Kaiser Permanente. liam Beaumont Army Medical the faculty at the Medical College New York and elected a fellow of He is in private practice in oph­ Center. of Virginia as an assistant profes­ the American College of Allergy thalmology and is chief of the and Immunology. He and his uveitis service at Georgetown wife, Janet, are expecting their University. "We have two won­ second child in October. derful children: Christopher, 2, sor of obstetrical anesthesia. She B L A K E K E R R ' 8 7 , writes, "I and her husband, Monte Cox, work as a general practitioner in announce thebirth of their daugh­ Eastern LongIsland, andjust pub­ ter, Heather Cox, injanuary 1993. lished Sky Burial, Moble Press, and Sara, 3 months." about traveling to Everest in 1987 R O G E R A . D A L E Y ' 8 5 , is an ANTHONY L. CAPOCOLLI '89. assistant professor and head of NICHOLAS D'AVANZO '86. and becoming swept up in Ti­ writes, "Now a neurosurgery resi­ the hand and upper extremity writes, "I am practicingin a four- betan National Demonstrations." dent at SUNY Downstate Medical section in the department of man group of pediatricians in orthopaedic surgery at the Medi­ North Carolina. We just had our cal College of Wisconsin. second child, Stephen Nicholas, Center. Married "Cristy" from LIJ. MARY MCDONELL Baby a-comin' in 9/93." (O'BRIEN) '87, is in private prac­ tice in Niagara Falls. She is chief June 1, 1993, 10 lbs. 5 1/2 oz." clinical instructor in pediatrics A N D R E W F R I E D M A N ' 8 5 , is now on staff at the University of JO for the family practice residency ANDREW P. GIACOBBE '86. Nebraska, Omaha, as a plastic, writes, "I completed my plastic program as well as assistant chief hand and microvascular sur­ surgery residency in June and 1 of pediatrics at Niagara Falls geon. He and his wife, Susan, am now in private practice. My Memorial Medical Center. She have two children,Jacob, 4, and wife, Laura, my daughter has two children: Seamus, 2, and William, 2. Cristina, and I are living in Buf­ Rhiannon, 4 months. Since the falo." birth of her second child she has D A V I D F O R S T E R ' 8 5 , informs 1 9 9 0 R O N A L D A . A L B E R I C O ' 9 0 , is a member of the executive com­ mittee of the resident's sections of the New York State Radio­ logic Society. He has two chil­ dren: Karissa, 10 months, and Zach, 2 1/2. given up a pediatric clinic. us that his wife Carol (Hammer) B u f f a l o P h y s i c i a n W i n t e s r 1 9 9 4 �GAIL BURSTEIN '90, writes, training program at San Bernar­ "My husband, Peter Bloom '90, dino County Hospital and was and I are working in a rural its first chairman. hospital in South Africa for nine ,, ,, , , ,, ... months this year. 1 shall run the / CURZON CADY FERRIS '46 pediatric ward and Peter plans died July 27, 1993 in Abilene, We are pleased to inform you of your eligibility to purchase microcomputer and informa­ tion technology products at special educational prices at UBMicro, the University at Buffalo's non-profit com­ puter resale program. Consulting and pricing information is available weekdays 9:30am to 5pm, Wednesdays and Thurs­ days to 7pm, or by calling 645-3554. Holiday Specials Texas. Before his retirement to work on an N1H grant to study from the US Air Force in 1970 African iron overload." he commanded the 819th Medi­ JOHN G. GELINAS, JR. '91, cal Group and Dyess USAF Hos­ $1,313 writes, "I presented a paper pital. Following his retirement, called 'Neuroleptic Malignant he was in private practice in Syndrome and Polymyositis' at Abilene as a general surgeon. In the 1993 Annual Convention of 1975 he was appointed Director Features include 8MB RAM, 160MB Hard Disk, 68040 Processor, 25 MHz, mouse, & Campus Software Set. (Monitor and keyboard purchased separately.) the American Psychiatric Asso­ of Public Health for the Abilene- ciation in San Francisco. 1 mar­ Taylor County Health Depart­ Macintosh Quadra 610 8/230 Macintosh Quadra 610 8/230 (w/ CD/ROM) ried Carole H. Buddenhagen on ment. He retired from the November 30,1991, and we have Hendrick Medical Center staff a son, Andrew John Thomas in 1988. Macintosh Quadra 610 8/160 SPENCER O. RAAB '54, died of hematology-oncology at East an internship in general surgery Carolina University School of at Union Memorial Hospital in Medicine and a member of the Baltimore and is beginning or­ Board of Directors of the Ameri­ thopaedic surgery at George can Cancer Society. He started Washington University. He in­ outreach clinics in eastern North forms us that Marie Christine Carolina. Durnan '92 and Michael Longo $1,799 Insight 486DX33 4/340 Features include a 14" color monitor, a 32 bit Local Bus 1MB Graphics Acc. SVGA card, 33MHz, 4MB RAM, 340MB hard drive with cache, 3.5" and 5.25" floppy drives, 2 serial, 1 parallel, and 1 game ports, mouse and keyboard, DOS and Windows. Insight 486DX/66 Desktop EO JOSEPH HEAPHY '56, '92 are engaged to be married. DCIL Features include 33 MHz, 4 MB RAM, 1MB video RAM, 170MB hard drive, Ultrascan 14" color monitor, 3.5" or 5.25" floppy drive, a performance keyboard, mouse, DOS 6.0 & Windows 3.1. June 22, 1993. Dr. Raab was chief JAMES D. KUHN '92. finished $1,648 $1,959 $1,979 Dell 486 Optiplex "L" 4/170 Gelinas, born December 8, 1992. We live in West Hartford, CT." - $2,049 died June 4, 1993 at his residence in Raleigh, North Carolina after a O B I T U A R I E S long illness. Dr. Heaphy was a EILEEN L. EDELBERG '44. monary diseases, particularly oc­ of the pancreas. She had been an cupational respiratory diseases. associate physician (Emeritus) at He testified about these mala­ Smith College in Northampton, dies before many regulatory Massachusetts. ROBERT W. MOYCE '44, died in Stinson Beach, California, af­ efforts were instrumental in ob­ ter a long battle with cancer. He taining federal and state legisla­ was the founding president of tion regarding worker compen­ the San Bernardino, Riverside sation County, OB-GYN Society. Dr. byssinosis and related diseases. u $125 $95 Microsoft Excel for Windows Microsoft Excel for Macintosh $139 $139 and safeguards Call 645-3554 for pricing on other products. Open Weekdays 9:30 am - 5pm / Wed & Thurs until 7pm f f a C R O UB for A non-profit University program for students.; facuity & staff Th© Commons • North Campus • (716) 645-3554 • Fax: 645-3884 Moyce established the residency B WordPerfect 6.0 for Windows WordPerfect 6.0 for DOS agencies, including several Con­ gressional subcommittees. His ^ $129 $99 nationally known expert on pul­ died on April 19, 1993, of cancer f Microsoft Word for Windows Microsoft Word for Macintosh l o P h y s i c i a n W i n t e r 1 9 9 4 ��BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET UNIVERS, , i C1/ UOPMENT BUFFALO NEW YORK 14214 9 U A N - 3 AM IQ: t O Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 ADDRESS CORRECTION REQUESTED 148 FRANCES WILSON CENTER FOR TOMORROW U8 FOUNDATION CAMPUS MAIL The only liability coverage with this seal of approval Medical Liability Mutual Insurance Company (MLMIC) is the only professional liability insurer approved by the Medical Society of the State of New York. Since its founding in 1975, the physicianowned and managed company has success­ fully defended more physicians than all other available insurers combined. Additionally, MLMIC has the largest and most experienced professional liabil­ ity claims department in the country, the largest risk management department of any New York State professional liability insurer, and the state's only true peer review of claims experience. Call 1-800-ASK-MLMIC (metro) or 1-800-356-4056 (upstate) for more infor­ mation and an application. MLM|C Medical Liability 3 Mutual Insurance Company Our defense never rests, 2 Park Ave., New York, NY 10016 250 Harrison St., Syracuse, NY 13202 90 Merrick Ave., East Meadow, NY 11554 © 1993 Medical Liability Mutual Insurance Company Partners' Press. Inc. 14 Abgott Printing, Inc. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 1994 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Buffalo physician and biomedical scientist Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1994-Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v28n01-1994-Winter Table Of Contents A list of subunits of the resource. Research Hospital News Computing the Need Building the Future Medical School Alumni A Spoonful of Humor Graduate Education Classnotes Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v28n01 Extent The size or duration of the resource. 36 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Rights Holder A person or organization owning or managing rights over the resource. Copyright 1994 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/9740c2b55fe915c22eaca63e78c4be41.pdf 1bc2271b1718c6558c519f2e291cea35 PDF Text Text SCHOOL OF MEDICINE STATE UNIVERSITY OF NEW YORK AT BUFFALO SUMMER 1972 : the Buffalo Physician AU^ajtowM - UM<*yiew C o M W t H s * u r ¥ VOLUME 6, NUMBER 2 �Medical Alumni Officers Dr. John J. O'Brien is the new president of the Medical Alumni Association. The 1941 Medical School graduate is a clinical assistant professor of medicine at the University and on the staff of the Buffalo General and South Buffalo Mercy Hospitals. He has been on the faculty since 1951. He did his undergraduate work at Canisius College, his internship at the United States Naval Hospital, Philadelphia; and his residency at the Vet­ eran's Administration Hospitals in Buffalo and Batavia. He was in military service from 194147. Dr. O'Brien is a past presi­ dent of the Annual Participat­ ing Fund for Medical Educa­ tion; and the Western New York Society of Internal Medi­ cine; and a Fellow of the Amer­ ican College of Physicians. He is also active in several other professional organizations.• A 1946 Medical School grad­ uate is the new vice president. He is Dr. Lawrence H. Golden, who has been on the faculty since 1951. He is a clinical as­ sociate professor of medicine. Dr. Golden is chief of cardiol­ ogy, attending physician, and chairman of the department of medicine a t t h e Millard Fill­ more Hospital. He is also at­ t e n d i n g p h y s i c i a n a t t h e E. J . Meyer Memorial Hospital. He did his undergraduate work at UB, his internship at the Jersey City Medical Center, and his residency at Millard Fillmore Hospital. He was a Cardiovascular Teaching Fellow at the University (1950-54) and had a Fellowship in Cardiology at Tulane University (1956-58). From 1954-56 he was a Captain in the United States Air Force (medical corps). Dr. Golden is a Fellow in the American College of Physicians, American College of Chest Phy­ sicians, and American College of Cardiology. He is also a Diplomate, American Board of Internal Medicine.D A 1954 Medical School grad­ uate is the new treasurer. He i s D r . P a u l L. W e i n m a n n , w h o is director of the department of dermatology at St. Joseph's In­ ter-community Hospital. Dr. Weinmann was gradu­ ated from Bennett High School, Buffalo, in 1947. He did his undergraduate work at the Uni­ versity of Michigan, returning to Buffalo in the fall of 1950 to enter Medical School. He in­ terned at the Buffalo General Hospital in 1955, and took his dermatology residency at the University of Chicago. He re­ turned to Buffalo in 1958. Dr. and Mrs. Weinmann and their two children live at 199 Ruskin Road, Eggertsville.Q �Summer 1972 Volume 6, Number 2 THE BUFFALO PHYSICIAN Published by the School of Medicine, State University of New York at Buffalo IN THIS ISSUE EDITORIAL BOARD Editor ROBERT S. McGRANAHAN Managing Editor MARION MARIONOWSKY Photography HUGO H. UNGER EDWARD NOWAK Medical Illustrator MELFORD J. DIEDRICK Graphic Artists RICHARD MACAKANJA DONALD E. WATKINS Secretary FLORENCE MEYER CONSULTANTS President, Medical Alumni Association New Officers (inside front cover) 2 More Money 3 Trauma Study Center 7 4,200 Applications/Dr. Markello 8 Medical Genetics 11 AMA/Dr. Leslie 12 New Book 13 Dr. H. C. Clarke 14 Health Therapy 17 Dr. Armenia/Medical Education 18 Summer Fellowship 19 Dr. Schenk 20 Computerization 21 Capitation Grant 22 Health Insurance DR. JOHN J. O'BRIEN 23 Abused Children President, Alumni Participating Fund for 24 Harrington Lecture Medical Education DR. MARVIN BLOOM 27 Rural Externship 28 Community Health Center DR. CLYDE L. RANDALL 30 Health Reservoir Vice President, University Foundation Vice President, Faculty of Health Sciences 31 Practicing Attorney JOHN C. CARTER 32 Health Education Center Director of Public Information 33 X-rays/Sponsored Research 34 Today's Students 36 Sperm, Egg JAMES DeSANTIS Director of Medical Alumni Affairs DAVID K. MICHAEL 37 Intensive Care THEODORE V. PALERMO 38 Respiratory Unit Vice President for University Relations 39 $5,000 Gift 40 Medical Artist 42 Mental Health Center 44 The Classes 46 People Director of University Publications DR. A. WESTLEY ROWLAND the Buffalo Physician 47 In Memoriam 48 Dr. Paine Dies The cover design by Richard Macakanja focuses upon some of the services of the new Allentown-Lakeview Community Health Center (pages 28-29). THE BUFFALO PHYSICIAN, Summer Spring, Summer, Fall, Winter — by York at Buffalo, 3435 Main Street, paid at Buffalo, New York. Please by The Buffalo Physician. 1972 — Volume 6, Number 2, published quarterly the School of Medicine, State University of New Buffalo, New York 14214. Second class postage notify us of change of address. Copyright 1972 �Chancellor Pledges Medical School Money Chancellor Ernest L. Boyer pledged more money for SUNY's Medical Centers in spite of the state's present financial difficulties. "We are educating 1,800 physicians, more than any other university in the world, and we have 22,000 in our special admissions programs." Dr. Boyer predicted that the State University would survive the current state fiscal crisis and emerge from the current decade with untold strength. He also called the 1970's "a period of pri­ orities and consolidation" for the University system after the "tre­ mendous growth" and "terrible anxieties" in the 1960's. "Our problem is a serious economic one that has touched every organization and family. The simple fact is one of a lessening income for public institutions, coupled with rising costs in operation and maintenance. We are faced with $20-30 million in additional commitments for next year and our income is about at zero. Our only option was to update the preannounced tuition schedule — an unfortunate but unavoidable decision." The combined increase of $200 in the cost of tuition and room and board will help bridge the financial gap. Dr. Boyer said he could not support "full cost tuition nor free tuition." He said he advocated "some sharing of total educational costs at the upper level years for those with the ability to pay. But I can't in good faith, argue for free tuition at this time. I can't support a runaway tuition scale either." The Chancellor pointed out that the additional funds from the tuition hike would provide for — an increase in next year's freshman class by an additional 1000 students; better library services; needed funds for disadvantaged and lower-middle income students; sum­ mer sessions continuing at the same level; and more money for the medical centers. Dr. Boyer proposed four major areas of concern for this decade and said the University must: (1) "Rethink the direction of our growth in terms of the dollar. We must think of the dollar in terms of human priorities rather than building contracts. (2) We must re-examine existing academic programs on the campus. In some cases it seems we have more professors in certain graduate courses than we have students. (3) We must provide more flexible patterns of study within the University. (4) We must reaffirm the University as a monument of hope in future generations and in the dignity of the human individual; and we must reaffirm it in loud, clear, and unequivocable terms."• 2 THE BUFFALO PHYSICIAN �A. T r a u m a S t u d y Center, specifically designed by the department o f s u r g e r y a t t h e E. ). M e y e r M e m o r i a l H o s p i t a l , is m a k i n g a n i m p a c t on the high cost of accident injuries and death in this country. Now in its third year of National Institutes of Health support — $210,000 this year — it is o n e of only ten such nationally funded sites for the study of trauma in man. Its approach to investigations into the sequence of vital body organs (lungs, kidney, heart) that fail following a severe injury or wound to the body is a multidisciplinary o n e — surgery, medicine, biophysics, biochemistry. Its knowledge, gained from long-term animal studies, is n o w being applied to man. The team, under principal investigator Dr. Worthington G. Schenk, Jr. (chairman of surgery) and project director, Dr. John R. Dr. Border Border (professor of surgery) includes surgeons Murray Andersen, Gerard P. Burns, Erich Moritz and Tan Ho (he is now in service), biophysicists Robert A. Spangler and Darold C. Wobschall, bio­ chemist Rapier H. McMenamy a n d internists Joel J. Schnure a n d Maximillian E. S t a c h u r a . "Recognizing the patient with severe injuries — the hidden as well as obvious ones — as quickly as possible is our major goal," pointed out Dr. Border. "For, when the patient is diagnosed a t a very early stage, therapy is not much of a problem. Thus, the seriously injured — most often from auto accidents — can be prevented from progressing into the irreversible organ failures which lead to death. "What we are trying to do," the Harvard medical graduate who has also completed biophysics and biochemistry research fellowships said, "is to build a base of knowledge on the mech­ anisms of organ failures and their interrelations. This is only possible through the study of trauma in man." The patients — for its clinical studies which are underway in a room adjoining the hospital's intensive care unit — are selected be­ cause of their high probability of death. Said Dr. Border, "we now insist on a screening program for every patient found in a severe accident. For we want to learn about every injury as soon as possible." He cautioned that what is not easily recognized in the critically i l l i s p u l m o n a r y f a i l u r e , a n a l m o s t i r r e v e r s i b l e p r o b l e m if n o t t r e a t e d promptly. "All patients who have been in a severe accident," he warns, "whether or not they have apparent severe injuries, must be suspected of having cardiac and pulmonary injuries which are checked for automatically with electrocardiograms and arterial blood gases." As a result he pointed to the large number of patients with this problem who have been detected early and therefore easily treated. What has made a tremendous difference to the patient suffer­ ing from trauma, he continued, is pulmonary therapy. "We do everything possible to keep the lungs filled with air. The key to patient survival is to see that the lungs d o not collapse. For, after several hours they cannot be reinflated, the heart is damaged d u e to a severe lack of oxygen in the blood, and the patient dies." But there SUMMER, 1972 are also electrocardiograms, liver function and 3 The Trauma Study Center �pancreatic tests as well as X-rays of the chest and abdomen for the trauma patient. As a result of what now has become "standard procedure" in the Trauma Study Center, none of the more than 30 patients selected for its studies over the past two years has died other than from irreversible brain damage. Said Dr. Border, there are only a few critically ill patients with trauma who reach the hospital that are not initially resuscitated. Death generally occurs after several days or weeks of resuscitative efforts and complications. He cautioned that the problem with trauma is that it is "everybody's business and therefore nobody's business. It is something that everyone treats but in which no one takes a specific interest." A teaching and training program, to be initiated over the sum­ mer by the Trauma Study Center, may change all of this. It hopes to produce two types of specialists to manage trauma. "The special­ ly-trained orthopedist will know how to recognize hidden injuries and resuscitate patients with trauma," Dr. Border said. "And the traumatologist — we need only a small number of this specialist — will be able to manage almost any problem associated with multiple trauma but who will, more importantly, be able to simultaneously manage the several organ failures which also occur simultaneously." The lack of a safe way to monitor changes in cardiac and pulmonary function in critically ill patients (there is risk attached to catheter placement in veins and arteries) precipitated develop­ ment of a noninvasive monitoring technique. Cardiothoracic impedance plethysmography (where electrodes are placed around neck and chest) now scan a large number of in­ jured who may have developed life-threatening cardiopulmonary complications. "When several math problems connected with this technique are resolved," Dr. Border said, "and with the assistance At trauma conference Dr. Border (right) reviews some X-rays of postoperative fracture with Dr. John Rubinstein (left) head resident and attending Dr. Richard Williams (center). �Checking the data led by cardiothoracic im­ pedance plethysmography on a patient in the trauma study unit are Pascquale Bochiechio, trauma technician, jacquie Miller, trauma nurse technician, and Dr. Border. of a small computer, we will be able to read out on a screen at the patient's bedside how much blood the heart is pumping, how strong it is, how much air is moved in and out of the lungs, and how the patient is functioning in terms of pulmonary edema. And it will involve minimal discomfort and risk to the patient." Experiments on simulating steering wheel injury in the dog have produced massive multifocal atelectasis, a condition not rec­ ognizable on a conventional chest X-ray. And there are no apparent external characteristics of trauma that will point to it. Over several days severe pulmonary failure following trauma developed in the dog. If treated early, Dr. Border explained, it is easily reversible. Studies on man with severe trauma also suggest that many may have multifocal atelectasis. "But if you wait for the obvious clinical symptoms; it is too late," he said. In another study, fat emboli that may occur with trauma, the team discovered a new treatment therapy — a serotonin antagonist. By studying the protein catabolic state in a dog severely infected, it was found that if sufficiently infected there occurred a considerable decrease in the dog's tissue carnotine levels, so important in metab­ olism of fat. Therefore, the inability of the body to burn fat at the same rate may be one reason for its increased rate of destruction of protein. Future research efforts will focus on controlling this protein catabolic state. While it is now possible to support cardiopulmonary/renal function in the severely injured man, the protein catabolic state still presents major problems. Sufficient nutrition SUMMER, 1972 5 Because ol the expertise ol the trauma study center, one of its "real triumphs" is about ready lor discharge This patient almost died. �Dr. Border reviews pre and postop- gations into fat emboli, erative X-rays on leg fracture. may be given in the hope of overwhelming the catabolic state by intravenous hyperalimentation. However, said Dr. Border, "if we could convert the protein catabolic state of trauma to a starvation state (a different magnitude of response) we will be farther ahead." There is also a joint surgical/medical study on management of the stress ulcer that sometimes causes the critically ill patient with trauma to bleed to death. For, if all other problems are under control, that patient may still die from this one. Temporary pyloric occlusion, it was found, by reducing the reflux of intestinal con­ tents reduces occurrence of ulceration and diminishes changes in the gastric mucosa. But the team is also interested in the head trauma patient who may develop post-traumatic pulmonary insufficiency. "That is also something that we are not clinically recognizing," cautioned Dr. Border. "When there is pulmonary insufficiency with arterial hypoxia, we are causing more serious subsequent brain damage. There is also underway an epidemiological study to determine the amount of drug and alcohol present in the blood stream of each entering hospital patient through a blood sample. But Dr. Border is also interested in introducing to Buffalo a system of in­ ternal fixation of a fracture. Developed by the Swiss, the surgical system avoids the use of casts and provides early use of the injured extremity. Over the years the Trauma Study Center has investigated organ and function to better understand major organ and metabolic failure and its interrelations, to change failures and basically prevent them as soon as possible, to diagnose at the earliest possible time, and to vigorously treat the trauma patient. Now being developed is a Trauma Care Center, to be located in the new Meyer Hospital. Here, techniques developed in the research unit for resuscitation and care of the patient will be com­ bined with detailed clinical studies on patient care. And of course teaching will continue to remain an important facet of the trauma program. Dr. Border, who wants to teach it better than anyone else, is now organizing a really unique teaching and training program. But what the efforts of the trauma investigators really means to the critically ill trauma patient is a minimizing of his organ failures which lead to death.• THE BUFFALO PHYSICIAN �T here are 4,200 applicants for the 135 places in the Medical School's first year class this fall. This is 2,400 more than a year ago, according to Dr. John Robinson, assistant dean for admissions. This is a national trend. There are 34,000 applicants for 13,000 openings in 108 medical schools. Dr. Robinson, w h o is also an associate professor of psychiatry, pointed out that the Downstate and Brook­ lyn Medical Schools have more than 5,000 applications each, Syra­ cuse University has 4,500 applications and the University of Roch­ ester has 3,200. "Some of the increase is because the Medical School has joined a central clearing house that processes applications and then sends them to as many medical schools as the applicant wishes," Dr. Robinson said. "Another noticeable trend is the number of ap­ plicants with advanced degrees and doctorates." The admissions dean noted that New York State furnishes more medical school applicants than any other state in the nation, but the rate of acceptances for state students is about "40 per cent or less whereas students from some other states have a 60 per cent chance." The Medical School does not have "cut-off points" for college grade averages or aptitude tests, but does insist applicants be "wellqualified." Dr. Robinson estimates that 75 per cent of the minority students w i l l g a i n a d m i s s i o n t o M e d i c a l S c h o o l s . U B m a y n o t b e a b l e t o fill the openings it has committed toward minorities because private medical schools have more money available for scholarship aid.D Dr. Ross Markello is the new chairman of the department of anesthesiology at the School of Medicine. He has been acting chairman since December 1, 1969. Dr. Markello received his M.D. degree 1957. He also did his undergraduate work Medical School faculty on July 1, 1961 as anesthesiology. He was named professor October 1, 1971. from the University in at UB. He joined the a clinical assistant in of anesthesiology on In 1957-58 Dr. Markello interned at the Millard Fillmore Hos­ pital, Buffalo. He was an assistant resident in anesthesiology at the E. J. M e y e r M e m o r i a l H o s p i t a l , B u f f a l o f r o m 1 9 5 8 - 1 9 6 0 . H e w a s named chief resident in anesthesiology the following year. Dr. Markello has co-authored several scientific papers for pro­ fessional journals. He has served both as chairman and member of several university and hospital committees. His research includes — studies on various effects of hyper­ ventilation during anesthesia, including cerebral blood flow and cardiac output; studies on effects of anesthesia on ventilation-perfusion distribution in the lung; and effect of cardiopulmonary bypass on cerebral blood flow. Dr. Markello is a Diplomate of the National Board of Medical Examiners, a n d the American Board of Anesthesiology. He is also active in several other professional organizations.• SUMMER, 1972 7 y 200 FifSt Yeflf ' A DDllCatioiTS Anesthesiology Chairman Dr. Markello �Medical Genetics For CARRIERS of hereditary anemias—there are millions through­ out the world—a handful of clinical researchers operating out of the medical genetics unit at the Buffalo General Hospital offer some hope. For in severe cases of these birth defects, the toll in human suffering, medical need, and economic burden can only be limited at this time through early detection and counseling. The unit was started nine years ago, back in 1963, by Dr. Robin Bannerman, a Scotsman who arrived in Buffalo via Johns Hopkins (a Fellow in medical genetics), Washington University at St. Fouis (a Fellow in hematology) and England (he graduated in medicine from Oxford in 1952 and held staff appointments at Fondon's St. Thomas Hospital and Oxford's Radcliffe Infirmary). Dr. Bannerman continues studies on determining how much iron is in the new born mouse. He was joined a year later by Dr. Martha Kreimer-Birnbaum, a young Argentine biochemist (PhD, National U. of Buenos Aires 1963). Both had studied under famed Moises Grinstein — Dr. Bannerman on heme synthesis in thalassemia while she gained an excellent knowledge of lead poisoning and porphyrin methodology. Rotating through the unit have been several Fellows who are now teaching or in practice. One, Dr. John Edwards, a Fiverpool Uni­ versity graduate (1959), remained to add his experience on hema­ tologic and protein investigations to unit studies. "We have always emphasized a team concept," explained Dr. Bannerman as he pointed to clinical and research responsibilities of the medical geneticists that legitimately cut across many fields. Unique approaches to genetic disorders are a result of team experi­ ence gained from both clinical and research responsibilities that have led to many significant discoveries in Buffalo. In one way or another every team member is contributing to a major study in disorders of the red cell. In the search for experi­ mental animal models for severe human forms of anemia, they have turned to hereditary anemias in mice, a good model for understanding human problems. Said Dr. Bannerman, "each mouse anemia studied tells us about another genetic step and thus be­ comes an excellent analytical tool for its investigation." On his return to Buffalo in 1963 he brought back a breeding stock of mice carrying the unique "sla" or sex-linked anemia mutant. The under­ lying mechanism in this disorder has since been fully worked out, leading to new knowledge of iron metabolism. The XYY syndrome, first identified in Buffalo by Avery Sandberg and co-workers in 1961, was further studied by the medical genetics unit and medical student Richard Berkson. They discovered new 8 THE BUFFALO PHYSICIAN �cases, investigated their background and behavior. In addition to "increased height" in males studied, those who displayed antisocial behavior all came from broken or unsatisfactory homes. Because of good patient rapport established by the research team, the chromo­ some study will continue. Psychological and hormonal correlations are being made on a group of six patients in collaboration with researchers at Children's Hospital. A rare genetic disease, camptobrachydactyly, was identified by Dr. Edwards, and the dominant trait of hand and foot deformity was traced by him and former medical student Robert Gale in several generations. A third genetic disease, X-linked spondyloepiphyseal dysplasiatarda, was first described in Buffalo by Dr. Wilmot Jacobsen in 1939. It has been restudied in depth by Drs. Bannerman, James Mohn and Gillian Ingall. In this disorder, short stature is inherited as an X-linked recessive trait. Bony changes lead to secondary osteo­ arthritis, troublesome when one reaches the forties and disabling by the sixties. A report in 1966 by Dr. Kreimer-Birnbaum and other members of the unit identified an unusual brown pigment excreted in the urine of patients with severe thalassemia. This work provides a significant clue to understanding the mechanisms of blood destruc­ tion in this and other related diseases. A better understanding of the pathophysiology of thalassemia for better therapeutic control of the patient is what the team is after. "Our work on dipyrroles," Dr. Bannerman said, "should clarify one important aspect of metabolism in thalassemias." In cooperation with the U. S. Navy's Chelsea Laboratory in Boston, it was found that in the "disappearing blood syndrome" in severely injured men, despite blood transfusions there was no in­ crease in hemoglobin concentration or usual evidence of hemolysis, perhaps pointing to an unusual pathway of blood destruction in­ volving dipyrroles. Laboratory-proven techniques for measuring globin chain labeling ratios in vitro are critical tools that have been used in the unit laboratory to rule out diagnosis of possible thalassemia in otherwise complicated cases of this known or suspected disease. Continuing, Dr. Bannerman referred to a search for applica­ tions of available techniques to learn more about heme synthesis and metabolism in the fetus as part of a broader program in the study of fetal development initiated by Dr. R. G. Davidson at the Children's Hospital. For there is little known about the beginnings of the essential process of hemoprotein biosynthesis that must be present in all animals from the very earliest stage of development. While on a W.H.O.-supported sabbatical, last year, Dr. Bannerman spent 1 0 weeks visiting laboratories and hospitals in Europe, centers of study for thalassemia and related problems. Several publications have resulted. One is a 90-page chapter in Hema­ tologic Reviews on recent advances in thalassemia research and treatment. He also returned with a collection of pigment samples from around the world that have been partially processed there. They SUMMER, 1972 9 Dr. Edwards and laboratory technician lames Hoke place mouse in whole body scintillation counter. �will be further studied in Buffalo. While millions in Italy and Greece are afflicted with thalassemia there remain many Americans of Italian and Greek ancestry with the same problem. Work on urinary dipyrroles continues as do collaborative efforts initiated there, in this country, and in Canada. Initial unit interest in blood studies evolved naturally enough into studies of specific populations only to return full circle back to studies on world populations. To fill out the blood group map of the world, during a teaching visit to Paraguay in 1967 Dr. Bannerman collaborated in studies on the Chulupi Indians. Never before studied, they inhabit a remote northern corner of that country. Dr. Bannerman receives samples ol Ireeze-dried pigment samples from Italy. Nearer home, studies among Seneca Indians have been a major interest of the unit over the years. Blood groups were studied by Dr. James Mohn and former Fellow Thomas Doeblin. In a survey headed by Dr. Doeblin to learn more about diabetes in this group, it was found that every third Seneca adult exhibited this disease chemically. The number however dropped to every sixth clinically but still indicated almost ten times the prevalence in the white population. At weekly clinics supported by the Erie County Health Department, Mrs. Kathleen Evans of London's Medical Research Council Clinical Genetics Unit, and Gillian Ingall, have followed families in which both parents are diabetics. But it is not only medical data but the customs and mores of world populations that make Dr. Bannerman's investigations so interesting. For instance, intermarriage in Western New York has resulted in the rarity of severe forms of thalassemia. Italians no longer tend to marry only Italians, or, more simply, carriers are less likely to marry other carriers. Patricia Rusnak (left) and Dr. KreimerBirnbaum prepare porphyrins from blood extracts. Clinical responsibilities? Not only are there weekly genetic clinics at both Meyer and Buffalo General Hospitals (coordinated by Gillian Ingall with 1000 pedigree files that contain detailed informa­ tion about families and have been collected since 1964 under her administrative responsibility) but consultation and counseling serv­ ices at the Meyer, VA, and Gowanda State Hospitals. The cyto­ genetics laboratory at Buffalo General, run by Michelle Marinello, and the clinics are closely affiliated with Albany's Birth Defects Institute. Teaching? It is another important facet of the medical genetics unit program. Both Drs. Bannerman and Edwards teach genetics and hematology courses to sophomores as well as internal medicine on the wards to house staff and students. There is also collabora­ tive teaching in a graduate nursing course by Gillian Ingall and in a general biochemistry course by Dr. Kreimer-Birnbaum. What could the assurance of more funds mean to the unit? The spinoff of new genetic disease identification for one. Although the unit maintains a pedigree register for recording hereditary diseases, lack of time and support hinder investigation of a majority of new cases and new genetic diseases. "With more continuity of support for clinical associates and secretarial help, we could do a great deal more toward advancing longer-term studies in clinical genetics," Dr. Bannerman said.D 10 THE BUFFALO PHYSICIAN �Mrs. Herbert J. UI rich is the author of a 77-page history of the Woman's Auxiliary to the AMA. Her husband, a Buffalo physician, is a 1930 Medical School graduate and a clinical associate in med­ icine on the faculty. The book, which details the first 50 years of the auxiliary, is titled "The Right Side of the Caduceus." The auxiliary was founded in 1922. The Auxiliary has assisted the AMA in programs dedicated to the advancement of medicine and public health. It has raised up to $550,000 annually to educate more physicians, and up to $624,000 for recruitment, scholarships and loans for young people in the allied health professions. It has also collected medical equipment, text­ books, drugs and supplies for needy nations. Mrs. Ulrich has been active in county, state and national affairs of the auxiliary. She is a past president of both the county and state auxiliaries and past editor of their publications. Nationally she is past vice president of the eastern region. Currently she is chairman of the public health and education and the drug abuse committees of the Erie County Auxiliary; chairman of revisions and resolutions of the State Auxiliary; and chairman of the 50th anniversary history committee of the National Auxiliary.• AMA History Radiology Chairman Dr. Eugene V. Leslie has been named chairman of the department of radiology at the School of Medicine. Dr. Leslie is Buffalo born and educated, and has been on the Medical School faculty since 1958. He received his B.A. degree in 1949 from the University and his M.D. degree in 1951. On January 1, 1972 Dr. Leslie was promoted to clinical professor of radiology. The radiologist did his internship and residency at the E. J. Meyer Memorial Hospital, Buffalo, from 1951 to 1956. During 1956-57 he had a special traineeship in neuroradiology (N.I.H.) at the National Hospital for Nervous Diseases, Queen Square, London, England. In 1957 Dr. Leslie joined the E. J. Meyer Hospital as a neuro­ radiologist. In 1961 he was named associate director of the de­ partment of radiology, and acting director July 1, 1971. He is also director of the residency training program at the hospital, and has been president of the Medical-Dental staff. Since 1962 he has been chairman of the Radioisotope Committee at the hospital. Dr. Leslie has presented 23 professional papers at National and International meetings in the United States and Europe. In addition he has co-authored 22 additional scientific papers that have ap­ peared in professional journals. Dr. Leslie is a Diplomate of the American Board of Radiology. He has been active in several professional organizations at the local, state, national and international levels. He also participates in civic affairs.• SUMMER, 1972 11 Dr. Leslie �Psychiatry Professors Write Book I i What was the impetus for a new book in which two University psychiatrists collaborated and that its publisher, the American Psychiatric Association, found "most timely and stimulating?" Ur­ gency, says the authors, Drs. S. Mouchly Small (professor and chair­ man of psychiatry), Peter F. Regan (professor of psychiatry), and Flugh T. Carmichael (American Psychiatric Association's director of continuing education) about the poor state of continuing medical education. In their monograph, Prospects and Proposals: Lifetime Learning for Psychiatrists, they discuss appropriate strategies on which to build a program of continuing education over a lifetime as well as pinpoint resistances to learning that must be overcome. How to establish such a program? Through a national strategy, respond the authors, that will not only feature continuing educa­ tion programs and thereby insure an ongoing high degree of pro­ fessional competence but will also improve knowledge and clinical skill. i Recommended? In lieu of the current 12 years of formal educa­ tion following high school, eight or nine years. Thus, the saving in time to a practicing physician should be utilized by periodic three to six-month periods of continuing educational experience during his practicing years. Integration, they point out, is needed between the two educa­ tional formats — the formal, with its too rigid, uniform and not always clinical relevant lockstep method that does not motivate a student to seek techniques for a lifetime of leaning; and continu­ ing education. There are two kinds of knowledge, orientations and skills that are taught. One, a "permanent core" includes such things as ge­ netic/development concept of personality structure and function, and practicing skills as interviewing and how to perform a proper examination. But equally important essentials that differ in dur­ ability and permanence make up the "time-bound core." Among these are roles of social institutions and professionals, status of knowledge in such fields as psychopharmacology, neurochemistry and related areas. Both cores are taught in the formal educational format while "time-bound elements" are properly emphasized in continuing education. Formal education, the authors caution, needs to scrutin­ ize and revise its "time-bound elements" regularly while con­ tinuing education should provide practicing physicians with a planned sequence of education in time-bound elements on a regular basis. These, the authors point out, can be planned simultaneously by one overall educational group, thus saving in time, effort, and money. What a medical school should not be, they caution, is a finish­ ing school where the student thinks he is completely "taught." Rather, it must be a preparatory school where habit patterns of study are included for a lifetime of learning. As part of a nationally organized continuing education pro­ gram for psychiatrists, the APA fosters a periodic self-assessment experience. Through this, a specialist may learn his areas of strengths and weaknesses. A bibliograph, with specific page referDr. Small 12 THE BUFFALO PHYSICIAN �Dr. Regan ences that is furnished in lieu of answers to questions, assists in this "self-assessment" educative process. As a result, many physi­ cians have updated their own libraries, and have read and studied more. Perhaps, h o p e the authors, it will also lead t o greater partici­ pation in continuing education courses and experiences. In the initial APA effort, psychiatrists utilizing the self assess­ ment test were able to pinpoint major areas within the specialty such as clinical knowledge, basic science information, administra­ tive-social, and patient-management problems and determine their relative competence in each. Psychiatry, point out the authors, is showing the way in tack­ ling problems of resistance — whether it b e institutional, human or social — in this country to large-scale continuing medical educa­ tion programs. Priorities, they urge, must be realigned in our in­ stitutions to meet individualized needs of practitioners as well as periodic assessment of patient care. Educational programs must be geared to the types of problems that one is faced with in the prac­ tice of medicine, with individual flexibility in curriculum and meth­ odology to reflect individual needs as well as patterns of learning. The very structure of psychiatry, they point out, together with its built-in curiosity, makes it the ideal field in which to establish a model to serve other specialties of medicine and to act as a catalyst in the development of a national program. Their final plea? IT IS TIME T O TAKE THESE IDEAS OFF THE DRAWING BOARD AND PUT THEM INTO ACTION. NOWO Dr. Clarke Devises New Instruments D r . H . C o u r t e n a y C l a r k e , a r e s i d e n t p h y s i c i a n a t t h e E. J. M e y e r Memorial Hospital, has devised and used instruments that enable him to perform minor gynecological procedures through two tiny "punch holes" in the lower abdomen of patients. Dr. Clarke de­ scribed his instruments and their potential in Buffalo and before the American Fertility Society in New York City in February. The surgeon first inserts a laparoscope — through which he can view the internal organs — into the umbilicus or navel. Then, with a view of the area where he wishes to work, he can insert the instruments — a ligator, or cutting instrument; a needle; or a tissue forceps — through the punch holes as necessary. The punch holes are about half the diameter of a lead pencil. Dr. Clarke has done approximately 20 such procedures. Patients can go home within 24 h o u r s a s c o m p a r e d w i t h s i x d a y s if t h e a b d o m e n i s o p e n e d s u r g i ­ cally. Dr. Clarke is enrolled in the Medical School's residency pro­ g r a m .• SUMMER, 1972 13 �Health Care Therapy IT IS GENERALLY AGREED that America's health care system is sick. Various observers, even though they agree that illness is present, stress different symptoms, arrive at different diagnoses, and recom­ mend different therapies. These are the matters that I should like to discuss: the symptoms, diagnoses, and treatment of the ailment. Symptoms: The first symptom that I speak of it is familiar to all: the fact that national health expenditures are high and are increasing in a most rapid fashion. In fiscal 1960, total health expenditures in the United States were $26 billion. In fiscal 1970 expenditures had risen to $67 billion, from $145 per person in 1960 to $324 per person in 1970. Some of this increase is accounted for by popula­ tion growth, some by increases in utilization, but a substantial portion is attributable to the rapid inflation in medical care costs. Inflation, of course, has been present in virtually all sectors of our economy. Yet, it is clear that the medical care sector has been among the hardest hit. In addition to the concern about the past, we are aware that expenditures are likely to continue to increase. The Office of Research and Statistics of the Social Security Administration projects that in 1980 health expenditures will total between $156 billion (8 percent of our gross national product) and $189 billion (9.8 percent of our gross national product). We must recognize, however, that there is no inexorable law of nature that says that the assumptions upon which these projections are based cannot be altered. The high level of expenditures, in part, supports an inefficient industry and one whose services are maldistributed. These symptoms can be treated. Treatment will alter the projections. There is another symptom of sickness in the health care sector that asks: what are we getting for these expenditures? The National Center for Health Statistics tells us that children ages 5 to 14 in families with income under $3,000 averaged only 1.5 physician visits per person per year, while the same age group in families with incomes over $10,000 averaged 3.5, or more than twice as many visits. Only 8 percent of the physician visits made by whites took place in the hospital clinic or emergency room but this was true of 26 percent of the visits by nonwhites. If medical care is a right —and I believe it is —there are many in our population (rural Americans, inner-city dwellers, persons who are medically indigent) who find that they cannot exercise this right. Excerpts from The Fenton Lecture State University of New York at Buffalo delivered by Professor Rashi Fein Harvard Center for Community Health and Medical Care Boston, Massachusetts October 1971 The third symptom is related to inefficiency: there are a large number of individuals using hospital services who do not need to be there, there is an oversupply of physicians in certain specialties, our insurance system provides benefits for procedures taking place in a hospital instead of a physician's office, large numbers of physicians spend major proportions of their time doing things which do not require their skill. There is much additional evidence of waste, waste that leads to higher costs and maldistribution. 14 THE BUFFALO PHYSICIAN �Diagnosis: In my view, the various symptoms — rising costs, inequitable sharing, lack of access, and inefficiency — are interrelated. They are part of the same disease, and relate to a basic problem. That problem is that, in spite of the fact that many of us agree that medical care is a right, that medical care should be treated as a public good, that it should be taken outside of the normal market, we have failed to take the necessary actions. We continue to behave as if medical care were like television sets to be rationed to those who can afford them and as if the availability of and accessibility to medical services should depend on normal economic forces. The medical market place has characteristics quite unlike those of other markets: consumer knowledge is less, risks are greater, competition is less, the price elasticity of demand is low, there are few substitutes, licensing restrictions play their role, supply response is sluggish, and so forth. Furthermore, all of this is overlaid with the mystique of the physician and with government dollars which affect the industry even if there be those who feel that they are simply sprinkled around in some neutral fashion. The root problem relates to the fact that medical care operates in a different market, that it should be viewed from a different perspective and as a public good, and that in spite of this we behave as if there is little public responsibility. Our failure to recognize that we are dealing with a $70 billion industry that affects all Americans and that the therapy involves more than small actions is disappointing. Therapy: I assume we would all agree that we should avoid using more potent therapy than is required, but we also dare not prescribe treatment which is less powerful than is necessary. There are those who argue that we have taken the necessary action and all we need is a little time for the therapy to take effect. They argue that the problems in the health sector can be attacked through existing federal-funding mechanisms. I believe, however, that they fail to take into account that fact that part of our difficulty is related to the problem of leverage and to the fragmentation in and multiplicity of payment mechanism. To those who advocate use of the existing federal-funding mechanisms I would point out that only 23 percent of total personal health care expenditures of fiscal 1970 were federal dollars and, of these, only $2.7 billion went for professional services, accounting for about 15 percent of total expenditures for such services. Thus, 85 percent of the leverage lies elsewhere —in the private sector. Nor, it seems to me, are the small and modest approaches to the problem of maldistribution sufficient unto the problem. In the President's budget for fiscal 1972, partnership for health centers, maternal and child health centers, and O.E.O. centers will be serv­ ing only 2 million people. This is insufficent to treat the problem. The difficulty with piecemeal legislation and piecemeal change is not that it may not represent some improvement. It may. Never­ theless, less than a comprehensive approach is not likely to alter the health care delivery system, will not remove inequities, will not contain costs. SUMMER, 1972 15 A summary and pictures of the 35th annual Spring Clinical Days will appear in the next issue of the Buffalo Physician.• �The Medical Alumni Association and the School of Medicine will co-host a reception during the AMA meeting in San Francisco Monday, \une 79, 7972. Mr. David K. Michael, director of medical alumni affairs, will announce the time and place at a later date.D What therapy do I believe is required? What would I recom­ mend so that the projections for 1980 do not become a reality? There is, in my view, an alternative to piecemeal action, a way to assume public responsibility, a way to finance care equitably, and to provide stimulus for organizational and system change. This alternative lies in national health insurance. Only if the financing patterns are linked to the delivery system can we address the various symptoms that affect the medical care system. Let me focus on a few basic considerations that are involved in a national health insurance program. One consideration is that national health insurance must be structured in a manner that would be responsible, that would exercise restraints on rising ex­ penditures, that would stimulate changes in the organization of the delivery system, and that would develop mechanisms to stimulate efficiency. In health, as in other fields, it is necessary to decide how much to spend and to learn to live within that total budget. The payment mechanism must permit diversity even while striv­ ing for efficiency. This, it seems to me, requires that the dollars — budgeted, not open-ended dollars —flow from Washington to re­ gional levels and from the regional levels to various communities, permitting each community to develop that combination of mech­ anisms that seem to be appropriate to its situation. A second consideration involves universality in coverage and equity both in health expenditures and in collection of tax revenues. National health insurance should collect revenues on the basis of ability to pay and should finance as much of the health expenditures as possible — also in order to achieve equity. What is required is that the total costs of health care be distributed in relation to in­ come. This means that the coverage must be comprehensive even as it is universal. We have developed a variety of mechanisms that are designed to change consumer behavior, but this has failed to recognize the critical role of the physician. We must develop incentives that help the physician reach responsible decisions and that remove economic incentives for him to hospitalize the patient. This is a very different issue than making it expensive for the consumer to purchase hospital care. Equity in financing, provision of incentives, development of new organizations, changing the structure of the delivery system: these are among the criteria that can be used to assess suggested solutions to the health crisis. I would urge that each of you develop your own more specific criteria and examine the proposals to see how they measure up. We will be told that a national health in­ surance program is too expensive. The question is: who shall bear the cost and what would the program do to future costs. A national health insurance program that is comprehensive in scope and universal in coverage and addresses the delivery system does not represent new dollars but a transfer of dollars. It does not increase the percent of our gross national product going for health services but is a substitution of public dollars for private dollars. To provide the therapy that is required for the problem will necessitate educating many people. It will require a willingness 16 THE BUFFALO PHYSICIAN �to recognize that the problems will not solve themselves and will not be solved by the disparate actions of motivated they may be. individuals, however Individuals, as individuals, cannot solve a national problem. Structured as t h e medical marketplace is, they cannot deliver that which we have come to believe all Americans should have: the right to good quality medical care — delivered in an efficent way — without regard to income. The education that I refer to has begun. W e can all hope that the debates proceed in a thoughtful fashion. We can also hope that the day is not far off when the medical care system in the United States will be healthy and will be doing the job for all of us that we would like to see done.Q Ophthalmology Acting Head Dr. John V. Armenia is the new acting head of the division of ophthalmology. The 1958 Medical School graduate is a clinical professor of surgery (ophthalmology). He is Buffalo born and educated. Dr. Armenia interned at Sisters of Charity and Emergency Hospitals. H e c o m p l e t e d his residency a t t h e E. J. M e y e r M e m o r i a l Hospital in 1962. He has been on the faculty of the School of Medicine since 1965, and on the Meyer Hospital staff since 1963. Dr. Armenia has certifications and fellowships in the American Board of Ophthalmology, American Academy of Ophthalmology and Otolaryngology, Society of Eye Surgeons, and American Col­ lege of Surgeons. He has consulting appointments at St. Mary's Hospital, Lewiston, and Batavia School of the Blind. He is active in several regional and national professional organizations.D Dr. Armenia Continuing Medical Education Seven continuing education courses will be offered by the Medical School during May, June and August. All are open to practicing physicians and medical students. May 4, 5—Surgical Aspects of Gastroenterology, Parkway Inn, Ni­ agara Falls, N. Y. May 17—Pediatric Cardiology, Children's Hospital. M a y 1 9 — C o m m u n i t y Psychiatry in t h e G e n e r a l H o s p i t a l , E. J. M e y e r Memorial Hospital. June 5-9—Refresher Seminar in Pediatrics, Hotel Lenox. June 12-15—Immunology International Convocation, Statler Hilton Hotel, J u n e 2 8 , 29— I m m u n o d e r m a t o l o g y , E. J. M e y e r M e m o r i a l H o s p i t a l . August 14-18—School Health (site to be announced).• SUMMER, 1972 17 �Measuring Intrapulmonary Shunts T he SUMMER FELLOWSHIP request submitted by junior medical student, John P. Visco, to measure intrapulmonary shunts was so outstanding that it earned a $1,000 stipend. It was preceded by five years of research investigations under Dr. Francis J. Klocke (professor of medicine and assistant professor of physiology) where he was helped to approach basic research problems experimentally and his desire to pursue a career in cardiology was strengthened. To measure intrapulmonary shunts, a hydrogen detector device, developed in Dr. Klocke's research laboratories, was used. The indicator selected was hydrogen gas. For, not only does its low solubility in plasma permit elimination by the lungs after just one circuit but, as it is biologically inert, there is no involvement in metabolism and it is therefore not lost in transit. But it also has the essential characteristic of adsorption into a platinum surface, oxidizing and giving off electrons to generate a current. Thus, it permits its quantification in solution with a platinum detector. The simultaneous use of indocyanine green bolus injection permits the measurement of shunted blood rather than a purely qualitative determination. i lohn Visco prepares the apparatus for in vivo use. John's summer assignment was a refinement of earlier work to design and develop an external cuvette system that would house a platinum sensor through which blood is withdrawn by using a pump. Thus, rather than the conventional insertion of a platinum tipped catheter intravascularly which requires some minor surgery as well as fluoroscopy only arterial puncture is necessary to determine cardiac output and intrapulmonary shunt at bedside. Said John, who is also a dental school graduate (SUNYAB 1970), "our initial cuvette design was a cylindrical lucite chamber where a platinum rod centered in a stream of blood flow. However, by injecting boluses of hydrogenated saline, the resulting curves re­ vealed some distortion, a "hangup" of hydrogen in the washout phase. Therefore, it was felt there must be a geometric problem in the design. Through modification, dead space was eliminated. And suffi­ cient turbulence minimized any surface/boundary phenomenon. Following many tests, it was found that optimum conditions for making hydrogen measurements fell in the range of a polarographic "plateau," where any current produced by change in po­ tential on the platinum tip is relatively insignificant. Therefore, any current produced, it was felt, must be due to hydrogen concentration around surface of platinum detector. And by changing hydrogen concentration of resistance characteristics of measuring circuit, the size and relative position of the "plateau"' could be altered. 18 THE BUFFALO PHYSICIAN �Results, in their experimental model, matched their predic­ tions. And shunts in animals representing from 5 to 25 percent of cardiac output have been successfully measured. What is now hoped is utilization of this device in patient studies with measure­ ments of alveolar-arterial oxygen gradients during 100 percent oxygen breathing. Also, simultaneous measurement of arterial nitro­ gen pressure will differentiate true intrapulmonary shunts from ventilation-perfusion imbalances. Summed up John, "these studies should provide a distinction between intrapulmonary arterial-venous shunts and alveolar with low ventilation-perfusion ratios that was not previously possible. Our proposed approach is ideal for identifying and measuring small as well as large intrapulmonary shunts. And observations made at the bedside require only a few minutes thereby making this apt for pre- and post-therapeutic interventions."• John Visco and Dr. Francis J. Klocke are doing some in vitro testing of the system. New Surgery Chairman Dr. Worthington G. Schenk, Jr. is the new chairman of the depart­ ment of surgery at the School of Medicine. Dr. Schenk joined the Medical School faculty May 11, 1954 as an instructor in surgery. He has been a professor of surgery since July 1, 1966, and acting chairman of the department of surgery since July 1, 1969. Dr. Schenk received his M.D. degree from the Harvard Medical School in 1945; his B.A. from Williams College in 1942. He was a surgical intern at Massachusetts General Hospital, 1945-46 and served in the United States Navy from 1946 to 1948. He came to the E. J. Meyer Memorial Hospital, Buffalo, in 1948 as a surgical resident. He was appointed associate attending surgeon in 1959; attending surgeon in 1960; and director of surgery in 1966. The surgeon has authored 85 scientific papers for professional journals. He is a Fellow in the American College of Surgeons and a Diplomate, American Board of Surgery. In 1966 he held office in two national societies — secretary, Society of Clinical Surgery; and treasurer, Society for Vascular Surgery. Dr. Schenk has served on several University committees, been active in civic affairs, and local, state and regional professional organizations. Dr. Schenk is listed in American Men of Medicine, 1961; Who's Who in Science, 1969; Who's Who in the East, 1970; and Who's Who (national volume), 1971.• SUMMER, 1972 19 Dr. Schenk �Computerized Medical Records Within the next two years a computerized medical records system may be in use according to Dr. Elemer R. Gabrieli, director of the Clinical Information Center at the E. J. Meyer Memorial Hospital. Dr. Gabrieli, who is also a clinical assistant professor of pathology, believes this new system will begin in Buffalo and spread across the country. Meyer Hospital has been a local and national pioneer in the development of computerized medical records. Dr. Cabrieli has been involved in research on computer medicine for the last seven years and is one of the nation's top experts in this field. He has been chosen to represent the United States at an international conference on computerized records in Sydney, Australia in May. He is also a national board member of the Society for Computer Medicine. "Computerization of medical records will force physicians to produce good records which can be used to help deliver better health care, to control costs and provide valuable statistics. Com­ puterized medical records will be most helpful in providing a comparison of treatment offered by various physicians because today no one really knows how complicated diseases are treated by different physicians," Dr. Gabrieli said. "Without a national medical records system doctors work as individuals and communication is poor and records are fragmented. A patient is a very poor carrier of information and serious con­ sequences can result if a doctor is unaware of the patient's history. "One of the most difficult hurdles in the development of a computerized record system is the necessity for the creation of a universal language of all medical terms," Dr. Gabrieli said. He is currently involved in a national project to develop a standard lan­ guage and expects to have this project completed by the end of the year. Dr. Cabrieli Dr. Leonard Katz, assistant professor of medicine, has been working with Dr. Gabrieli to develop a chart which will include all necessary information about a patient with the minimal number of words. "Medicine is very suspicious about any more forms because 30 per cent of the average doctor's overhead goes toward paper­ work. We have to convince the medical profession that a com­ puterized system will result in less paperwork at less cost and with better results." All of the Buffalo physicians involved in the project believe that medical data systems must be developed and run by inde­ pendent advisory boards without federal support. "We feel that the system must pay for itself. As soon as there is government money there is a tendency for the government to want to control the sys­ tem," Dr. Gabrieli said. The clinical professor believes that everyone's privacy can best be protected through careful supervision of records and a policy of a patient's ownership of the records. "There will be a new profession — the computer supervisor — who will decide who can use the records and for what purpose. The patient, however, will have the final decision." 20 THE BUFFALO PHYSICIAN �With a computer system we would have a day-to-day monitor­ ing of the health care system in this country which would prove extremely valuable in both the prevention of disease and cost conr trol, he said. "The computer system is a vital necessity. The al­ ternative will be that the country will rapidly go into bankruptcy because of the increasing medical and welfare costs. We must have a computerized medical records system before we can adopt any form of national health insurance. The AMA agrees that unless we have an automated system that will tell us exactly how much we are spending for each service we cannot have any program of cost con­ trol," Dr. Cabrieli said. The computer expert anticipates that both state and federal governments will set up data centers and make use of data from regional centers. The data supplied to government centers would be without names except in cases where local advisory boards determine that it is in the national interest for certain information to be released.• The Medical School will probably receive about $1.39 million through the Comprehensive Health Manpower Training Act of 1971. President Nixon signed this bill and the Nurse Training Act of 1971 into Law November 18. The two health bills are designed to en­ courage and help finance the training of more doctors, dentists, nurses and other professionals. If t h e p r o g r a m s a r e f u l l y f u n d e d , s c h o o l s o f m e d i c i n e , o s t e o ­ pathy and dentistry will be allowed per capita grants of $2,500 a year for the first three years of a student's training and $4,000 in the fourth year for graduating students. There will be an in­ centive of $6,000 additional per student in the third year for schools who allow students to graduate in three years instead of four. To be eligible for the grants, the medical schools must pledge to increase their enrollments. The UB Medical School plans to enroll 135 students in the first year class in September. This is 15 more than were enrolled in the 1971 freshman class. D r . M e r l i n K. D u v a l J r . , t h e a s s i s t a n t s e c r e t a r y o f H e a l t h , E d u c a ­ tion and Welfare for Health and Scientific Affairs said the program should spur an additional enrollment of 1,200 students in medical schools in 1972 and "wipe out" a shortage of physicians that otherwise might reach 50,000 by 1980. The objectives are to in­ crease the number of practicing physicians to about 436,000 by 1978 and the number of nurses to roughly 1,100,000 by 1980. There are now about 332,000 physicians in active practice and about 700,000 nurses. The manpower bill also offers incentives to medical schools to train more doctors w h o will go into family practice. It offers inducements to attract students from minority and disadvantaged groups and to provide more health professionals who will practice in places where manpower shortages are acute. That means pri­ marily the urban slums and sparsely populated rural areas.• SUMMER, 1972 21 Capitation Grant �National Health Insurance Senator Jacob K. Javits called the establishment of a national health care insurance plan among the country's greatest reforms of the century. "We will have a national health care system within the next three years," he said. The New York Republican was the last speaker on the annual James Fenton Lecture Series on "Comprehen­ sive Health Care" at the University. Javits, ranking Republican member of the Senate Labor and Public Welfare Committee, is author of the National Health Insurance and Health Services Im­ provement Act of 1971. "For decades, this country has lagged behind Russia and other European countries in closing the disparity in the type of health care available to the rich and the poor. The poor suffer three times as much heart disease, seven times as many eye defects and five times as much mental retardation. These are dreadful things,'" the Senator said. Javits called "a depressing fact" the increasing number of Americans for whom "the cost of decent medical care has become prohibitive." He pegged that number at "about 15 per cent" of Americans and said health care cost is "one of the large factors" on the escalating cost of living. America is short 50,000-150,000 doctors and five per cent of the counties in America don't have a doctor. In one New York county, the Senator related, the only physician within a reasonable area was drafted, leaving the people without a doctor for a 50-mile radius. In other areas, people face health problems which are just as serious. The Senator told of children in New York City who have become mentally retarded because of lead poisoning and of a retired man in Queens who ran out of the funds necessary for kidney dialysis. He is facing death. "All of these crises exist even though America spends seven per cent of its Gross National Product on Health Care. Our objective for the seventies must be to overcome the health crisis which threatens to deny adequate care to millions of Americans; and no economic reason should prevent our providing every man, woman, and child in the United States with accessible, quality, and comprehensive health care. We cannot shrink from the magnitude of the effort required to improve improper and inadequate allocations of health resources, as evidenced by marked shortages and maldistribution of health manpower and by obsolete and outmoded health facilities. This situation has seriously impaired America's ability to deliver basic health protection for all Americans who need it." To solve the problems, five health care bills have been intro­ duced in the Congress. The Javits bill would use the present Medi­ care and Medicaid package as an "absolute minimum base criterion of health care." The package's combination of hospitalization cover­ age and supplementary physician benefits would be extended to the population at large. All existing institutions in both the public and private sectors would be used to provide this coverage. These institutions would be under strict supervision and would have to meet exacting standards, but if the hospital performed more effec­ tively or efficiently than the standard, it would be given a bonus. Funding for the system would come from a tax shared by both employer and employee, similar to the current Social Security tax. 22 THE BUFFALO PHYSICIAN �If a c o m p a n y h a s i t s o w n p l a n t h a t m e e t s o r e x c e e d s t h e F e d e r a l standard, however it would be excluded from the national program, the Senator explained. In addition to the system of health care, Javits' bill also sets up an extensive system of HMO's across the country that would supply dental care and "at least" one physical a year to those cov­ ered. Emphasis would be on "diagnostic care." Other parts of the bill would establish a drug co-payment plan under which people would pay only $1 per perscription for long term medication, and provide additional money for training health care personnel. Setting up the Javits system would take "at least three to five years." "Whatever the final form of national health insurance the public must realize it can only be implemented as the personnel are trained and the facilities built to provide the vastly increased services," Javits concluded.• A clinical associate in pediatrics hopes to establish a national net­ work to protect children who have been abused. Dr. Theodore I. Putnam also wants to provide counseling for the parents at the 50 children's hospitals throughout the nation. He hopes to initiate this nationwide program at Children's Hospital in Buffalo and have it connected with other hospitals, through a federal center. Dr. Putnam said, "there is n o consistent medical followup after a child has been placed in his home or a foster home. One of the best ways to prevent abuse would be to require regular routine physical exams of the child every month for two or three years. The physician would be able to see that the child is thriving and well, that he doesn't have scars or fractures. It would give social workers a chance to have continuity with the family." In 1968 Dr. Putnam joined Children's Hospital as a resident. He became interested in child abuse when he read a three-year study made by the Children's Aid & Society for Prevention of Cruelty to Children. He has proposed the creation of a hospital-based unit with a part-time physician director, three full-time social workers and three full-time public health nurses. The other specialists on hospital staffs including psychologist and psychiatrists would be a v a i l a b l e if n e e d e d . D r . P u t n a m i s w i l l i n g t o b e t h e p a r t - t i m e physician to be sure the program is started properly. Dr. Putnam's studies and examinations have convinced him that families that abuse children do so repeatedly. "The abused girls and boys that I saw included children who had been scalded, starved, kicked in the stomach. Most frequent were bruises and cuts, but there were some broken bones. The 11 cases of severe malnutrition were so bad that the pictures were things you might have seen out of Biafra." Foster parents as well as parents have been at times known to abuse children, the pediatrician said. "If parents who felt they wanted to batter their kids could call up and get some help with their feelings, it would be just tremendous. The persons who batter the child need help. This is not a punitive p r o g r a m . " • SUMMER, 1972 23 PfOtCCt AbllScd Children �Dr. Schoenfeld visits with students — Michael Koren (left) and Martin Kilgore (far right). Dr. Schoenfeld chats with medical students — Sus Robert Penn and Donald Greene. The University radio station, WBFO, interviews Dr. Schoenfeld. 1 i The Harrington Lecture 24 THE BUFFALO PHYSICIAN �an Henke, traveling secretary; Virginia Sybert, Dr. Thomas C. Cummiskey, assistant dean, Mrs. Carole Levine, wife of a medical stu­ dent, Dr. Schoenfeld at the coffee hour. SEX, DRUGS, TREASON. All three were explored in depth by Dr. Eugene Schoenfeld — physician, syndicated medical columnist and author of two books, "Dear Doctor HIPpocrates—Advice Your Family Doctor Never Cave you" and the soon to be published "Drugs, Sex, and Treason"—at this year's annual Etarrington Lecture, sponsored by medical students and created through the will of the late Dr. Deville W. Harrington, professor of genital and urinary diseases at the School of Medicine. "The biggest failure," pointed out Dr. Schoenfeld - he re­ ceived his medical degree from the University of Miami in 1961, a Master's in Public Health from Yale in 1964 following several years of extensive research into hallucinogenic drugs at the Albert Schweitzer Hospital in Africa, and a stint at Berkeley's Student Health Clinic — "is not teaching about the normal functions of the human body. This lack of emphasis on preventive medicine, on human physiology, should be basic to any education. For we could eliminate about 60 percent of visits to doctors that are due to functional reasons — headaches, etc. "If people knew more about their bodies," the young physician reemphasized, "fewer would be harming themselves through the use of drugs." There is no completely harmless drug, he cautioned, and he cited aspirin that kills more children than any other kind. While LSD has more adverse reactions than marihuana — it gets into the unconscious - he believes that mature people should be able to make their own decisions about using drugs, etc. "The more freedom a person has, the better off he is and he shouldn't have to go to jail for using drugs." But he cautioned that enlighten­ ment is not to be found in the pill. "It is in our minds." SUMMER, 1972 25 �Sarah Lain, second year medical student, gets a satis­ factory answer during the informal coffee hour. About sex? Even in the most enlightened families, it is still difficult to talk about. "More and more," the volunteer one after­ noon a week at a student treatment clinic in California who reads and writes the remainder of the time said, "society must depend on the schools for sex education." The new frontier of medicine? It will be nutrition for "we are still in the dark ages concerning it." He pointed to the cultures of the world where people survive on many diets. Treason? He referred to the mockery of the free enterprise system and the sacred confidentiality between patient and healer. He pointed to the American Medical Association "wanted notice" placed in its weekly newspaper and two specialty journals, one in dermatology, to help capture a young (chronic severe acne) woman indicted for conspiracy to transport illegal explosives across state lines. And to the "deep sense of revulsion" in the ITT case where a woman's alleged medical history was used in an attempt to ex­ plain an incident causing great embarrassment to the administration in power. Not only did he cite ITT, where antitrust laws, designed to pre­ vent diminution of competition, had failed, but the government guaranteed funds to Lockheed Corporation, a giant corporation. In his afternoon talk to medical students, he pointed to the mistake of specializing too early. "Interests may change," he said. Dr. Schoenfeld's did. He started with an interest in psychiatry and while he still is involved in mental processes he hopes that what he is now doing, health education, is of more importance. "By taking a period of time off from medical school and following your own interests, you sacrifice nothing. And you gain a great deal." Dr. Schoenfeld's travels to Europe and Africa were subsidized by short stints of employment at various medical establishments. But he pointed to a quarter of his medical class who never com­ pleted their education. They were driven by an irrational and un­ justified fear, of pressure imposed by peers and faculty. In his standing room only public lecture he reviewed many of the questions and answers on sex, drugs, nutrition, and now en­ vironment that first appeared in the underground Berkeley Barb, a student newspaper and is now a syndicated column. Why write when you are a physician? "I like both," he replied. "And there is a need for this type of information."• 26 THE BUFFALO PHYSICIAN �Rural Externship Program For the second consecutive year 50 health sciences students will participate this summer in a rural health care "externship" program. Last summer 22 students representing the Schools of Dentistry, Health Related Professions, Medicine, Nursing and Pharmacy were placed with preceptors in 11 Western New York rural communities for nine weeks. Mr. Carl Anderson is the project coordinator. The program is funded by the Lakes Area Regional Medical Program and by local contributions from hospitals, physicians, and counties throughout the region. "The 1972 program will again be a cooperative service and educational program between rural health care practitioners and health science students in the delivery of health care. The students will spend the summer living and working in the communities where they are assigned," Mr. Anderson said. All participating students will receive a $100 per week stipend. The students are assigned to a preceptor — either a physician, nurse, dentist, pharmacist, or allied health professional — in the rural area who will be responsible for the general professional supervision of the student. The students will keep a diary of their experiences and will develop a profile of health care in their respective com­ munities based on their interactions with patients, local health professionals and other externs. Arrangements have been made in these 8 Western New York health facilities for the program. Several more facilities will be added. Jamestown, N. Y—W.C.A. Hospital — Gregory Thorsell, M.D.; Eleanor Edman, R.N.; George Lawn, D.M.; Bert Klein, D.Pod. Warsaw, N. Y. — Wyoming County Hospital—James MacCallum, M.D. (M'37); Fred Heller, L.P.T. Warsaw, N. Y. — Wyoming County Public Health Department — Patricia Stopen, R.N. Portville, N. Y. — Duncan C. Woermer, M.D. Olean, N. Y. -Olean Medical Group—Arthur L. Beck, M.D. (M'57). Newfane, N.Y. - Newfane Intercommunity Hospital—Lee Vermeulin (Pharmacy). Dunkirk, N. Y. — Brooks Memorial Hospital — William Kunz, M.D. (M'53); Wes Sly, L.P.T.; Ray Hunt (Pharmacy). Salamanca, N. Y. — Salamanca District Hospital — Ruth Knoblock, M.D.; David Widger, M.D.Q SUMMER, 1972 27 �Two technicians trom the Erie County Health Department (Rath Building), Ted Franciszkiewicz and Bernice Walker, take a chest X-ray. Community Health Center T he DREAM of providing better health care in the Buffalo inner city is becoming a reality for at least five medical students, a dental student, and a dental hygienist. They are all actively involved in the new Allentown-Lakeview Community Health Center at 273 Mary­ land Street. The Center opened at this location February 1, 1972, after nine months at the Shaw Memorial African Methodist Epis­ copal Zion Church, 453 Porter Avenue. A fourth-year medical student, Steve Levine, is the man behind the project. He is ably assisted by Alan Calhoun, first-year student, and three second-year students, Diane Matuszak, Susan Hammond, and Carmen Ramos. Miss Sharon Gardner, a dental hygienist, and Daniel Martinez, a fourth-year dental student, are involved in the preventive dentistry program at the Center. The Center has a dental chair, a light and other equipment. Dr. Daniel C. Dudley, a practic­ ing dentist, supervises the program. All of the students average one night a week on the project, plus a few odd daytime hours. Two interested visitors. "Our primary thrust is preventive medicine," Steve said. Miss Matuszak and three other female medical students are having week­ ly classes (8 to 11 p.m.) at the Health Center for women (under 40) in the area. They discuss a wide range of topics from first aid and hygiene to prenatal care, infant mortality, family planning, TB, and VD, drugs and alcoholism. Mr. Calhoun is developing a special program in nutrition for area residents. Other students are urged to develop other programs that will improve the health of citizens. Steve was among the 12 medical students who had the idea in 1969 to establish a community health center in this area. They were assisted by two faculty members — Drs. Christopher D'Amanda, clinical professor of medicine, and John R. F. Ingall, assistant pro­ fessor of surgery and director of the Lakes Area Regional Medical Program, Inc. 28 THE BUFFALO PHYSICIAN �DRIVER J RIOCK LEAD | CUI0AT0RE Steve is the first to admit that they have had a lot of help from several agencies and many individuals who have volunteered their services. "The Erie County Department of Health and the American Red Cross and three physicians — Drs. Errol Daniels, an optometrist; E. Peter Isacson, associate professor of social and preventive med­ icine; and Robert Wallace, clinical instructor of social and preven­ tive medicine — all have been most helpful," Steve said. The services that are offered are: —transportation of patients to clinics, hospitals, doctors' or dentists' offices; —educational classes on health topics; —medical programs in eye screening and immunization to prevent disease; —referral—getting patients in contact with hospitals, agencies and health professionals; —interpreters—who will go with patients to various agencies and act as translators (many patients are Spanish speaking). The overall objective is to improve the quality of health care in the Allentown-Lakeview community with a meaningful input by the community in decision making and provision of services. A 25member committee — residents of the area, that includes a diverse population of blacks, Spanish speaking Puerto Ricans, Indians, Italian-Americans (old and young) — have been active in the plan­ ning and development of the Center. Most of the operating budget — $28,000 for the current year — is from the American Freedom from Hunger March. Over the last two years the Center has received $1,500 from the medical student activity budget and another $1,500 from SAMA, the national or­ ganization of medical students. The rent for the quarters is $80 per month. There are four paid staff aides — Ira Stohl, project coordinator, and his assistants, Paul Martinez, Gladys Marrero, and Ann Beutner. Two of the aides are bilingual. The transportation program — taking people from their homes to the doctor, dentist or welfare office — is one of the most used services. The station wagon purchased for this service is on the go 12 to 15 hours daily. Many volunteers in the community also pro­ vide rides. "Our long range goals will cost more money. We want to enlarge our staff to include physicians and other health professionals so we can have a more comprehensive health program. We hope to be able to do more things right here at the Center — such as first aid, examinations, and therapy. We want to provide personal human continuing medical care for the people of the area," Steve said. "We want this community project to be flexible enough to allow for a variety of forms in the delivery of health services. We want the cooperation of hospitals, private practitioners, and other health professionals so that we can improve the delivery of health care in this area." Steve hopes to have a volunteer Medical Advisory Board avail­ able for advice and counsel on the Center's health education and disease prevention programs within a few weeks.D SUMMER, 1972 29 Miss Gladys Marrero, community aide, checks the appointment schedule with Mrs. Carole Levine, wife of Steve. The project co-ordinator, Ira Stohl, chats with a friend. �Health Resources Reservoir THE H O S P I T A L i s a n d w i l l c o n t i n u e t o b e t h e m a j o r r e s e r v o i r o f a community's health resources, according to a prominent phy­ sician-educator. Dr. Edmund D. Pellegrino, vice president for health sciences and director of the health sciences center at the State Uni­ versity at Stony Brook, pointed out that hospitals will have to make community and preventive medicine part of their spectrum of de­ partmental services. "They must add personnel and facilities suit­ a b l e f o r p u b l i c e d u c a t i o n i n h e a l t h . If i t e x p a n d s i t s f u n c t i o n s t o become a community health center, the hospital can be the most effective integrating force in the health of most communities." Dr. Pellegrino defined three elements in health maintenance: (1) The containment and amelioration of established chronic dis­ eases; (2) The detection of unsuspected disease by screening methods; (3) Forestalling t h e development of n e w diseases — that is primary prevention through immunization, environmental con­ trol and modification of personal behavior. "Non-physicians of several types are ideally suited to provide the various services that constitute health maintenance. It has al­ ready been demonstrated that non-physicians can handle most of the personal and technical aspects of screening and detection. Ap­ plication of health maintenance on a national basis is probably most dependent upon the rapid training of non-physician personnel — some in existing professions, others anew. "A national health maintenance program should include vary­ ing emphasis on disease containment, detection, and primary pre­ vention. The first essential of organization is the location of re­ sponsibility and authority for health maintenance in some agency or body, private or public. The major deterrent to effective change in the health care system today is the failure to assign this re­ sponsibility and authority. I personally favor the creation of local health authorities, organized as quasi-public utilities composed of consumers and producers and constituting the policy-making authority for all health matters in the region. Policy-making would be distinct from the managerial level and the professional-tech­ nical experts. Integration of all three levels is essential in arriving at policy decisions and implementing them," Dr. Pellegrino said. "The task of educating personnel for the major roles in health maintenance will fall to the schools of allied health in collaboration with medical schools. Medical schools will have the responsibility of devising health maintenance services as models in which to educate those physicians with a particular interest in this specialty as supervisors, as applied epidemiologists, as evaluators and de­ visors of the new modalities of maintenance. These models should also be the training ground of non-physicians in health maintenance. This is a summary of Dr. Edmund D. Pellegrino's address "Health Maintenance: An Idea in Search of an Organization" that was de­ livered October 20. The School of Health Related Professions cosponsored his appearance with the annual James Fenton Distinguished Lecture Series for 1971. "I favor a program of health maintenance directed to certain clear and accessible goals that will become the lever for making our health care system more responsive to the other major unmet needs of our people — primary, preventive and emergency medical care." Dr. Pellegrino suggested two approaches to effect the character of the total care system and to advance the cause of preventive health care. 30 THE BUFFALO PHYSICIAN �— Provide incentives for establishment of centers for health maintenance integrated with the present system of crisis medicine. Such centers should be located in communities and neighborhoods and linked to hospitals. — At these centers, the major emphasis in health maintenance would be on those preventive and maintenance measures known to be effective. "The key feature is to establish a complementary segment of the health care system that provides the public with a readily acces­ sible means for health maintenance, as well as crisis medicine. Another way we can weave health maintenance into the fabric of the health care system is t o redirect large scale programs like medi­ care, medicaid and veterans' care in this direction. Funds for these or similar programs could be contingent on the provision of mainte­ nance services by the agency or facility receiving such funds. Physicians and institutions could satisfy the requirement by provid­ i n g s u c h s e r v i c e s t h e m s e l v e s , if e q u i p p e d t o d o s o , o r b y e s t a b l i s h ­ ing linkages with systematized health maintenance services in their communities. This is another way to tie maintenance and curative Dr. Pellegrino medicine together and establish some semblance of a continuum of health services." In conclusion Dr. Pellegrino pointed out that w e are poised for a national effort to establish Health Maintenance Organizations, with large expenditures and much human effort in the offing. "It w o u l d b e s a l u b r i o u s if f o r o n c e w e c o u l d c l e a r l y d e f i n e o u r g o a l s before setting out in pursuit of another salvation theme in health which will lead only part way or even be self-defeating."• A third year medical student is a practicing attorney evenings and weekends. He is Jon Rubach, who has a degree from the Notre Dame University Law School. While at Notre Dame Jon did personal injury work for an attorney in South Bend. "I had to read so many medical books that it all caught on. After taking the bar examina­ tions in July of 1969, I started medical school the following Sep­ tember (with the consent of my wife)." Jon admits that law school helped prepare me for medical school. "I already knew how to study and study hard, in an or­ ganized way. Medical school is a lot harder. It also has something that law school doesn't — and this is first-hand experience. The fact that I'm actually working in a hospital (Buffalo General) is worth everything to my medical studies. In law you don't get that practical application, n o t till you've g o t that Doctor of Jurisprudence Degree and you are out in the field ready to use it." Currently Jon is an attorney for the law firm of Moot, Sprague, March, Landy & Fernbach. Jon works full time for the law firm dur­ ing the summer. The rest of his activities revolve around his wife, Peggy, and their 20-month-old daughter, Kristin. " S o m e d a y I'll h a v e t o d e c i d e b e t w e e n law a n d medicine. But today I just can't tell. All my lawyer friends say, 'pick medicine.' All my doctor friends say, 'be a lawyer.' It's easy for them, though, the grass is always greener."n SUMMER, 1972 31 Practicing Attorney �Health Education Center The School of Medicine along with the four other University health sciences schools — Dentistry, Health Related Professions, Nursing, and Pharmacy — are participating in the development of the Lake Area Education Center (LAHEC) at the Veterans Adminis­ tration Hospital in Erie, Pennsylvania. The purpose of the Center is t o provide basic and continuing education for medical and allied health personnel and to provide better health services to the surrounding communities in north­ western Pennsylvania, southwestern New York and northeastern O h i o . Mr. Michael C. J. Carey, executive director of t h e Center, said, "this tri-state health care watershed has an estimated popula­ tion of 500,000." The Center a t Erie is o n e of eight sponsored by the Veterans Administration in Washington and the first to be funded for a oneyear planning stage. The Carnegie Commission has suggested the development of 126 new area health education centers. The Re­ gional Medical Program of Western New York provides the liaison between the university level health sciences and the Lake Erie Health Education Center. The Center will evaluate health care delivery systems in the area and survey health care manpower and its utilization. LAHEC will also collaborate with Erie County's several colleges and secondary school systems to coordinate current training programs for health care professionals and develop new programs. " T h e emphasis is upon developing a health care delivery system that is more effective, efficient, economical, accessible and acceptable to all levels of society. W e will cooperate with all area hospitals and all other health care facilities and clinics, and any health related community agencies to make LAHEC a viable, prag­ matic reality," Mr. Carey said. The development of this and other area health education centers may be a significant factor in overcoming some of the un­ even distribution of physicians in relation to population clustering. It has been found that more than half of those doctors in resi­ dency training tend to remain and practice in the locale where they received that training. The Lake Area Center will hopefully at­ tract practicing physicians to the area, who will find an atmosphere conducive to continuing competence and progressive medical practice. LAHEC will also provide a broad based and community level clinical experience for students in nursing, dentistry, and allied health care professions. "We are strategically located some 100 miles from three citiesBuffalo, Cleveland, Pittsburgh — that have medical schools. LAHEC can be affiliated with all three. Special arrangements will be made for residents to rotate from these teaching centers to obtain ex­ perience in community medicine alongside that of the highly specialized cases available in university communities," Mr. Carey concluded.• 32 THE BUFFALO PHYSICIAN �A man who has frequent diagnostic X-rays may be increasing his chances of getting one of two common types of leukemia, accordi n g t o D r . S a x o n L. G r a h a m , c l i n i c a l p r o f e s s o r o f m e d i c a l s o c i o l o g y in t h e department of social and preventive medicine. The study is based on 1,414 adult leukemia cases and 1,370 adult "controls" in Upstate New York, Minneapolis and Baltimore. The study shows that a man who has had 11 or more X-rays to any part of his body has a 60 per cent greater chance of getting chronic myelocytic leukemia than a man who has had none. The risk is nearly tripled for men who have had 41 or more films. The risk noted in the study group was greatest when the X-rays were taken of the trunk of the body. Here the man who had had 11 or more films had double the chance of getting leukemia and the one who had 41 had seven times the chance. The relationship be­ tween irradiation and the acute form of myelocytic leukemia is just as striking, according to Dr. Graham. The study revealed no significant association between irradiation and leukemia in women, only in men. Dr. Graham emphasized that the study does not prove that ir­ radiation is the only, or even the major cause of leukemia. "Only a small proportion of the irradiated population develops leukemia, and irradiation accounts for only a small proportion of leukemia cases. Only approximately 8.8 per cent of the chronic myelocytic leukemia in men in our study may be due to exposure to 11 or more X-ray films. Therefore factors other than irradiation definitely play a part in the cause of the disease. These may include viruses, heredity, sex or susceptibility factors."D $17 Million in Sponsored Research University expenditures on sponsored research and training amounted to $17,202,022 during fiscal 1970-71, an increase of 6.5 per cent over 1969-70. The Faculty of Health Sciences accounted for 65.5 per cent or $10.7 million of the total. Dr. Saxon Graham, clinical professor of medical sociology in the department of social and preventive medicine, received the largest grant, $1,510,855 for three years in support of an Afghanistan Population Study. The sec­ ond largest, $300,000, was continued support for the Laboratory for Environmental Physiology. The Regional Medical Program, di­ r e c t e d b y D r . J o h n R . F. I n g a l l , c o n t i n u e d t o b e t h e l a r g e s t s i n g l e program supported by an outside agency, expending $1.3 million in Federal funds last year.n SUMMER, 1972 33 DiaPtlOrftC & X-rays �Today's Medical Students Change is the name of the game. Even among medical students at the University. The current crop of medical students have more social consciousness. They are changing just like society — more social justice, equality — especially in the delivery of health care. Medical students are concerned about the health care crisis in this country. They are looking to themselves for the solution, not neces­ sarily the government. Steve Levine, a fourth year medical student, pointed out that many people don't have a doctor. "They go to the emergency room of hospitals for care that the emergency rooms are not equipped for. What these people are seeking is a patient clinic. If community-run neighborhood clinics can fulfill a person's need for preventive medicine, and can run spot screening programs and provide emergency service, then a load will be taken off existing, overloaded medical services." Steve plans to practice medicine as an internist in indigent communities. He will work from a neighbor­ hood center with a hospital base where cases would be referred. Currently he is working at the Allentown-Lakeview Community Center, a store-front facility, at 273 Maryland Avenue. This studentinitiated center is now involved in special health programs under the auspices of the American Freedom from Hunger Foundation. It stresses preventive education and spot screening. Another similar health center in Buffalo has been set up by the Student Black Health Association at the Student University Urban Center at 220 Delaware Avenue. Kenneth Gayles, a third year med­ ical student, has been working at the center where screening and referral programs are being conducted, with complete physical examinations and laboratory tests. The Center operates on weekends and is financed through donation only. Some Buffalo physicians are working with some 20 black students who are contributing their time to the center. "One of the things in the black community has been the lack of preventive medicine. The only time they go to a doctor is when something acute happens. Visits for a routine check­ up are not a reality for them," Gayles said. Steve Levine Kenneth Gayles For Miss Louise Stomierowski, a second-year medical student, her dedication to service takes another direction. She wants to practice family medicine in a small town or rural area. "There is such a shortage of doctors in the rural areas," she said. Another second year medical student, Miss Elaine Wilt, plans to take up family practice or pediatrics in a rural area. She feels that high school guidance counselors are not aware enough of the pos­ sibilities for women in medicine. "They don't encourage girls in that direction. When a girl is interested in the health field she is likely to be steered toward nursing or some other allied health pro­ fession." Girls in medical school thoroughly revolutionize the tradi­ tional idea of the family doctor —who is supposed to be about 55 years old, with overshoes and spectacles. "It's a cultural-pat­ terned thing. In Russia, 75 per cent of all doctors are women, with an average salary of $200 per month." 34 THE BUFFALO PHYSICIAN �Todd Wallens Thomas Varecka Elaine Wilt The problem of keeping up with medical advances will be solved by attending periodic workshops and continuing education programs. " O n e of the solutions to that is group practice," said Thomas Varecka, a second-year student. "Every man realizes he can't do everything. We'll try to solve problems together." Through specialization, too, a doctor can keep up with at least one area of medicine. The several medical students agreed that financing a medical education is no problem. "There is money available." From Mr. Gayles' point of view, the problems of attending medical school for a poor black student is less financial than psychological. "If you are a black student and you don't see blacks in medical school, you figure you won't be there either." Kenneth has always wanted to be a doctor. "I said it to an MD and h e helped m e . " A fourth-year student, Todd Wallens, said "we should not close our eyes to the good things going on today." Tom Dwyer, another third year student, says that many con­ cepts advanced are extreme — just short of revolutionary. "These changes have been initiated by dissatisfied people." Tom will con­ centrate on 'primary health care' after graduation. The medical students are serious about seeking workable solu­ tions to alleviate the health care crisis. One of these is shorter train­ ing periods for "medical specialists." Many medical schools are training physicians' assistants. Both the physician and the general public must realize that the physician is n o t the only o n e w h o can give medical care. The medical students agreed that they weren't interested in earning $75,000 or more a year. They just want enough money to live comfortably and educate their children. Today's medical student has come out of hibernation. He is participating in health care and talking about current issues. He is asking questions that a student did not dare to ask a few years ago. But the real test will come after he graduates.• SUMMER, 1972 35 Tom Dwyer Louise Stomierowski �Spernij Egg Handbook It started as an independent project in Medical School and grew until Bruce and Wayne Middendorf found themselves authors of a 30-page booklet on birth control. The fruit of their labors "A Sperm and Egg Handbook" is a down-to-earth pamphlet covering the ground from conception to abortion to venereal disease. Written in a very readable manner, the text spells out everything and, when­ ever possible, uses humor to get the point across. The authors, twin brothers who are both second year medical students, became interested in population control during their un­ dergraduate days. When they started medical school a year ago last fall, Wayne and Bruce decided to write a birth control pamphlet to help educate other medical students. Their professors liked it and they had the material reviewed by local gynecologists. After their OK, the 23-year-old twins took it to Jean Hutchinson at Planned Parenthood. She thought it was pretty good but needed "something to liven it up." This is where Bruce took over. By then it was April, 1971. Wayne was getting married and leaving for the midwest, so Bruce worked on it solo all summer. After eight drafts, the booklet finally came out in August, 1971. The pair is satisfied with the result. "We made it to the point as much as possible," Bruce explains, "and laid everything out on the line." He defends the corny humor — "it makes it easier for people to read." And his work at Meyer Memorial Hospital in counseling unwed mothers convinced him of the necessity of de­ fining every term. At "The Meyer," he worked with 11, 12, and 13year-old unwed mothers who didn't know why they were pregnant. "They didn't know that intercourse caused babies; they just thought it sort of grew inside them," he remembers. As a result, words such as sexual intercourse, conception and contraception are completely explained. In another effort to make everything easily understood, the Middendorfs organized subjects so they are complete on one page or at the most on a two-page spread. As a result, venereal disease is explained on two facing pages, while there's one page on "Getting It Straight about Myths." Tables, lists and illustrations are also included. A seven-item list of signs of pregnancy is divided into possible and probable signs and a full explanation of pregnancy tests follows. Melford Diedrick, director of medical illustrations for the Medical School, did eight drawings showing not only the male and female reproductive systems but also the sites of placement for various methods of birth control. He also designed the cover which depicts a sperm fertilizing an egg. Wayne Middendorf The explanation of birth control methods is divided into sec­ tions headed effective, fairly good, less effective and not recom­ mended. The authors go through 11 different categories of methods, fully explaining and listing the advantages, disadvantages and effec­ tiveness of each. Following this is a table listing the cost of each method. Another chart goes over the average clinical failure rate — a measure of the effectiveness of the method when it is used under average conditions by average people. 36 THE BUFFALO PHYSICIAN �Throughout the book, the theme of partners sharing the re­ s p o n s i b i l i t y i s s t r e s s e d . It d o e s n ' t m a t t e r w h o t a k e s t h e p r e c a u t i o n s , the book contends, just as long as someone does. As the authors point out, "taking a chance 'just this once' may be once too often." The brothers feel strongly that it is "ignorance that causes unwanted pregnancies and spreads venereal disease." In order t o get the booklet printed and make it widely avail­ able, the brothers worked through the Community Action Corps (CAC). CAC is now distributing free copies at Norton Union. Copies will also be distributed at the Birth Control Clinic in Michael Hall. The handbook has been well received in the community and by Planned Parenthood centers across the country. Dr. Jack Lippes, developer of the Lippes Loop (one of the first lUD's available), says it is " o n e of the best college books on the subject." Other area gynecologists are also backing it. So far, 6,000 copies have been distributed and another 5,000 were just printed. Bruce intends to keep working o n the pamphlet, up-dating it when necessary. He viewed the project as part of both his medical training and the responsibility doctors have. Both of the Middendorfs firmly believe that "healthy understanding of human sexuality goes hand in hand with a healthy mind and body . . . and that sexual responsibility entails a full knowledge of your human sexuality."n Intensive, Emergency Care Program Two Buffalo physicians and a nurse have developed an intensive emergency care program with emphasis on heart resuscitation skills. Mrs. Betty Lawson, assistant professor of nursing, and director of the coronary care unit of the Lakes Area Regional Medical Program, Inc., Dr. David Dean, assistant professor of medicine and Dr. Louis Young have worked o u t a "first aid plus" course with Mr. Robert B. Howard, Buffalo Commissioner of Fire. Rescue Squad 9, which serves the downtown Buffalo area, was the first group to be trained. The 30 men in Squad 9 attended three weeks of eight hour classes and are now certified to use defibril­ lators. "The men were eager and quick to pick up the complicated information needed to pass the course," Mrs. Lawson said. "There isn't one of these men I wouldn't let take care of me. I have con­ fidence in their abilities." The training program is only a beginning. Eight squads remain to be trained and it is hoped that after seeing Squad 9 in action improvements in the training program can be made.D SUMMER, 1972 37 �Respiratory Intensive Care Unit The Millard Fillmore Hospital opened a new Respiratory Intensive Care Unit in March. Dr. John W. Vance, clinical associate professor of medicine at the Medical School, is the director of the new unit. It was funded by a $197,000 grant from the Lakes Area Regional Medical Program (formerly RMP of Western New York). "It will be as completely equipped a unit as we can devise," Dr. Vance said. The unit includes an isolation room for one patient and a complete air conditioning system. "Filtered air is of crucial im­ portance to these patients. The unit will be the center for team care by the nursing staff, the attending and house staff, respiratory therapists and pulmonary therapists." Dr. Vance will have three consultants on rotating call duty, Drs. Frederick R. Beerel, associate director of t h e Chronic Respira­ t o r y D i s e a s e P r o g r a m ; J o s e p h E. F r a c a s s o , c l i n i c a l a s s i s t a n t , a n d H . Paul Longstreth, attending physician. They are all members of the Medical. School faculty.Q 38 THE BUFFALO PHYSICIAN �A research project at the University that promises help to arm paral­ ysis cases received financial aid recently. Gifts totalling $5,000 were given by the Buffalo Community Relations Committee of the Ford Motor Company ($3,000), the Thomas J. Connors Foundation ($1,500) and Servotronics, Inc. ($500). The announcement of the grants was made by Mr. J. Sam Miller and Dr. William P. Walsh, $5,000 Gift For Arm Paralysis directors of the Rehabilitation Medicine Engineering Laboratory at the University. These funds will be used for further research studies using the "Buffalo Arm," a power brace for use in paralysis cases. "We have shown that arm paralysis following stroke may be reduced by therapy sessions in this brace," Mr. Miller said. Within four weeks of daily exercise in the devise, much of the normal arm motions had returned in two stroke patients. Dr. Walsh cautioned that this is still a research project, but indications are that this may be a real break-through in stroke rehabilitation. The Rehabilitation Medicine Engineering Laboratory was started in 1970. It is in the School of Medicine at the University and is clinically affiliated w i t h t h e E. J. M e y e r M e m o r i a l H o s p i t a l . • Dr. William P. Walsh demonstrates the "Buffalo Arm" brace for Mr. I. Sam Miller and Mr. James F. Terry, chairman, Buffalo Community Relations Committee, Ford Motor Company. Mr. Terry presented a $5,000 check to Dr. Walsh and Mr. Miller. I �Medical Artist Thi• vascular pedicle is divided the ureter is mobilized well up the renal simts cmeerv inp as m et the pelvic Hare as possible ) A laminedo over the ord I is placed thru. f) THYLtSt WP'M rescteeteJ • ureter $nu(l>l ST' m- tumid tor the tUfiv « mjdr ^'^ertebrol Mu md " ' Paravertebral muscle hi Hunt dissection Mr. Diedrick V �A unique combination of artistic talent and medical knowledge best describes Melford D. Diedrick. The medical illustrator has been on the faculty since 1947. He is a talented, successful artist, who has considerable knowledge of biology, anatomy, histology and many other things. His three staff members — photographer, graphic artist, secretary — are also very knowledgeable. "I' v e l e a r n e d m y p r o f e s s i o n t h e h a r d w a y — t h r o u g h c l i n i c a l observation, study and research. The first step is acquiring informa­ tion — usually verbal communication with the physician-author. No one can make a good medical drawing without knowing his subject. Often I search the scientific literature of the last 10 or 20 years. Sometimes I spend several hours in a hospital viewing a pro­ cedure. Then I apply a scientific approach to my illustration. "Anything visual is a means of communication. No task is too small. A graceful letter is very demanding and contributes to the efficiency for the highest level of illustration," Diedrick said. Most of his illustrations are for the printed page — periodicals, journals and books. On any given day one or more of the 1,000 Buffalo physicians might ask Diedrick to create a picture of a patched heart, show a prepyloric ulcer or illustrate the latest tech­ nique for pinning a fractured hip. Whatever the project, the artist has one objective, depict the subject clearly and truthfully. He works mostly with pencil for preliminary sketching, and wash or print ink for the finished rendering. But he also uses a camera. "Often a camera will show too much or two little. Drawings can eliminate the non-essential details a n d focus m o r e dramatically o n t h e main element. It is also difficult to show the differences in tissue with photography, but in a drawing this can be accomplished by contrasting colors and stylized surface characteristics." Mr. Diedrick was a student (1932-34) of the late Max Broedel, who taught the world's first formal class of medical illustrators at Johns Hopkins Medical School. Mr. Diedrick then returned to his native Buffalo to become its first medical illustrator in 1935. He worked with faculty and other physicians at the Buffalo General Hospital, and at the same time was assistant curator of the Medical School's pathology museum, before joining the faculty. The medical illustrator is proud of his many achievements — especially the principal illustrator of three widely used specialty books — "Atlas of Operative Teaching Anus Rectum and Colon" b y Drs. H a r r y E. B a c o n a n d S t u a r t T. Ross in 1 9 5 4 ; " A n Atlas o f Surgical Exposures of the Extremities" by Drs. Banks and Laufman in 1953; and "An Atlas of Neurosurgical Techniques" by Dr. James Poppen in 1960. "Today there are so many demands on my time that it would be impossible for me to spend several months on illustrations for one book," Diedrick said. His thousands of illustrations over the last 37 years have been a potent teaching tool for students, professors and physicians.• SUMMER, 1972 41 �Community Mental Health Center If a l l g o e s w e l l f i n a n c i a l l y t h e B u f f a l o G e n e r a l H o s p i t a l C o m m u n i t y Mental Health Center may open sometime in 1973. That is the goal of Dr. Stanley R. Platman, executive director. He hopes his $ 2 , 6 0 3 , 6 4 9 f e d e r a l s t a f f i n g g r a n t a p p l i c a t i o n w i l l b e a p p r o v e d . If Washington approves it, the federal government will be under­ writing the 1973 salaries for 256 of the center's personnel whose work brings them in direct contact with patients. Then, for seven years, there will be additional funds for staff salaries, but in de­ creasing amounts. After that, suDport of the center will be up to the state and county. Under Dr. Platman's direction the new center will reach out into the community it serves — a large section of the east side, parts of Cheektowaga and Amherst, and all of Clarence and Newstead. It will establish three neighborhood counseling services with bases in buildings at Jefferson and Best, Genesee and Bailey, and in Akron. They will be staffed from 8 a.m. to 12 midnight seven days a week. The Center itself will be open around the clock, and its emergency facilities will be available during the hours the neigh­ borhood counseling services are closed—from midnight until 8 a.m. 42 THE BUFFALO PHYSICIAN �Three-fourths of the persons staffing the neighborhood coun­ seling services and the center will be paraprofessionals — men and women from the areas served who have an education below the level of a master's degree. All will have six months of on-the-job orientation in working with persons with mental and emotional problems. The Center will establish a "career ladder," so that the paraprofessional who does a good job can progress to more and more responsibility and higher salary brackets. "Paraprofessional workers, who know the people of their areas and the problems that confront them are more helpful in solving those problems, many times, than trained professional psychiatrists, psychologists, social workers and psychiatric nurses," Dr. Platman said. Approximately one-third of the cost of building the $4.8 million Center came from the federal government. The Center at 80 Goodrich Street consists of two buildings. One will house three in-patient units of 20 beds each, one of which will be used as an alcohol and drug detoxification unit. Emergency facilities, educa­ tional and play areas for children also will be located in this build­ ing. The second building houses an auditorium, a gymnasium, a shop, activity suites, out-patient facilities, and offices. It is these facilities that Dr. Platman hopes will be used by other community agencies as well as patients of the Center.D Multi-purpose auditorium. �The T^e ^lasses °'t,1e i930's Dr. Thomas S. Bumbalo, M'31, has been Classes e'ectec' to a one-year term as vice president of the Medical Society of the State of New York. He is a clinical professor of pediatrics at the Medical School and is associate medical direc­ tor at the E. J. Meyer Memorial Hospital. Dr. Bumbalo is a past president of the Erie County Medical Society. He will be a delegate from the state society to the AMA along with Dr. Walter Scott Walls, M'31.D Dr. Frank J. Gazzo, M'35, is a clinical as­ sociate in gynecology-obstetrics at the Medical School. Recently he was featured in The Cour­ ier Express (Buffalo) as a young man, who worked his way through college delivering newspapers. Dr. Gazzo has been practicing medicine for nine years. He and his wife and four children live at 11 Hancock Terrace.D can Academy of Orthopedic Surgeons, Diplomate of the American Board of Orthopedic Surgeons, and Fellow of the American College of Surgeons. Dr. Willner lives at 40 Union Avenue, Irvington, New Jersey.• The Classes of the 1940's Dr. Anthony S. Merlino, M'47, is the new chief of medicine at the Buffalo Columbus Hospital. He is a specialist in internal medicine and a clinical assistant professor of medicine at the Medical School. He is also on the staffs of Buffalo General and Sisters Hospitals.• Dr. Josephine A. W. Richardson, M'48, is associate director of the Rehabilitation Center, Louisville, Kentucky. She is an Adjunct As­ sistant Professor of Medicine at the University of Louisville School of Medicine. Among her professional membership affiliations are Amer­ ican Academy of Physical Medicine and Re­ habilitation; American Academy for Cerebral Palsy; American Academy of Family Physicians; American Medical Women's Association; American Association of Academic Physiatrists; and the Pan-Am Medical Association. Dr. Richardson lives at 501 Quail's Run, Louis­ ville.• The Classes of the 1950's Dr. Peter S. Battaglia, M'55, is the new presi­ dent of the Niagara Falls Area Chamber of Commerce. He is a clinical instructor in med­ icine at the Medical School. Dr. Willner Dr. Philip Willner, M'35, has been elected Chief of Staff of the United Hospitals Ortho­ pedic Center, Hospital for Crippled Children and Adults. He most recently held the post of Director of Orthopedic Surgery and Director of Medical Education. The new chief of staff is attending orthopedic surgeon at St. Barnabas Medical Center, associate clinical professor of New Jersey College of Medicine and Dentistry, consulting orthopedic surgeon of West Hudson Hospital and Memorial General Hospital, and adjunct orthopedic attending at Newark Beth Israel Hospital. He is a member of the Ameri­ 44 Dr. Philip Brunell, M'59, associate professor of pediatrics at New York University Medical Center, is on sabbatical for a year at the Clin­ ical Research Centre in London, England. His home address is 81 Carolina Drive, New York City.D The Classes of the 1960's Dr. Rae R. Jacobs, M'62, assistant professor of surgery, University of Kansas Medical Center (effective 7/1/72) has been awarded the North American Traveling Fellowship by the Ameri­ can and Canadian Orthopedic Association, April-May, 1972. Dr. Jacobs presented a paper on "Pressure-Flow Catheter" for cardiac work and vascular resistance studies to the annual meeting at Association for Advance of Medical Instrumentation, Las Vegas, in April.• THE BUFFALO PHYSICIAN �D r . A l a n L. P o h l , M ' 6 2 , is a r e s i d e n t in p l a s t i c and reconstructive surgery at the University of Texas Medical Branch in Galveston. He com­ Dr. David Fugazzotto, M'67, will finish his pediatric residency in August and enter private practice with a group in Birmingham, Alabama. pleted his surgical residency in 1968 at Tufts He is now affiliated with University of Mis­ University New England Medical Center, Bos­ ton, and was a U. S. Naval Surgeon at U. S. souri School of Medicine at Children's Mercy Hospital, Kansas City, Missouri. Send con­ Naval Hospitals in Key West, Florida; Yoko- gratulations to 7233 Belinder (Kansas City) on suka, Japan; and 3rd Medical Battalion Viet the birth of daughter, Dana Helene, in De­ cember, 1971.• Nam (Chief of Surgery) until 1970. His present research (in press) is "Effect of Primary Pharyn­ geal Flaps on Speech and Facial Development Dr. John W. Cibbs, Jr., M'67, is an anesthetist in Cleft Palate Children." Dr. Pohl lives at 314 Mackeral Avenue, Galveston.• in Santa Barbara, California. He lives at 255-B Elise P l a c e . • Dr. Frank Ehrlich, M'63, is a teaching fellow Dr. John C. Bivona, Jr., M'68, is at the United States Army Hospital, West Point Military in pediatric surgery (University of Pittsburgh) and chief resident surgical service at Pittsburgh Children's Hospital. In July he will return to full time active duty in the U. S. Navy as the first trained pediatric surgeon utilized as such. Academy (New York), after a two-year general surgery residency at Center.D Kings County Hospital Dr. Bruce N. Bogard, M'68, is a clinical in­ This will be the first pediatric surgical service structor of headed by a trained specialist in the U. S. Mil­ Medical School. He was chief resident (1971- itary. Dr. Ehrlich completed his general surgery 72) at Long Island Jewish Medical Center, New residency in 1970 at Boston Naval Hospital.• pediatrics at SUNY's Downstate Hyde Park, New York and in 1971 received the AMA Physician Recognition Award. Dr. Bo­ structor (psychiatry) at the University of Miami gard writes that he and Mrs. Bogard have a two-year old son and expect another child in School of Medicine. He lives at 2441 NE 200 July, and live at 163-02 Booth Memorial Ave­ Street, North Miami Beach, Florida.• nue, Fresh Meadows.n Dr. Harvey Liebeskind, M'63, is a clinical in­ Dr. Paul Sussman, M'64, is a clinical instruc­ Dr. Brian S. Joseph, M'68, is directing a drug rehabilitation and education center in Viet­ tor in medicine (rheumatology) at UCFA. He is nam. The program is a three-week affair that a Diplomate in Internal Medicine and lives at 15600 Woodfield Place, Sherman Oaks, Cali­ games, and classes and therapy sessions. Dr. f o r n i a .• Joseph admits that there is n o real good way of treating heroin addicts. "We must do every­ Dr. Vincent P. Frantz, M'64, completed his residency involves some isolation and involvement with in General and Vascular Surgery u n d e r D r . M i c h a e l E. D e b a k e y in J u n e , 1 9 7 1 . He entered private practice in Houston at a large suburban medical complex, where he is also director of emergency room services. He is also a teaching affiliate a t Baylor College of Medicine affiliated hospitals. His home address is 13734 Camara Lane, Houston, Texas.• thing we can to warn soldiers before they get hooked."• The Classes of the 1970's Dr. Neil W. Garroway, M'70, is a resident in medicine at Barnes Hospital, St. Louis, Missouri. He lives at 4355 Maryland Avenue #118, St. Louis.Q Dr. Jeffrey Rothman, M'70, is currently a Dr. J. Richard Gunderman, M'65, is a n as­ resident in medicine at the Hospital of the University of Pennsylvania, Philadelphia. He sistant professor of pediatrics and neurology and Mrs. Rothman are pleased to announce at Indiana University School of Medicine. His h o m e address is 7356 Bentley Drive, Indian­ a p o l i s .• SUMMER, 1972 the birth of Joshua Daniel, on September 10, 1971. The Rothmans live at 312 East Baltimore Avenue, Clifton Heights.• 45 �Dr. John H. Talbott has joined the University of Miami Medical School faculty as a clinical professor of medicine. From 1946-59 he was professor of medicine at UB and chief of medicine at the Buffalo General Hospital. He is editor-emeritus of the Journal of the Ameri­ can Medical Association.• Three alumni have been elected to the board of directors of the New York State Society of Surgeons Incorporated. They are Drs. Louis C. Cloutier, M'54, Alfred F. Luhr Jr., M'43, and Everett W. Woodworth, M'27, Dr. Irving Cram­ er of Utica is the new president succeeding Dr. Paul M. Walczak, M'46-O Two alumni have been granted membership in the American College of Physicians. They are Drs. Anthony C. Borgese, M'64 of Niagara Falls, and Alf M. Tannenberg, M'59, of Buffalo. Dr. Tannenberg is a clinical assistant professor of medicine at the Medical School.• Dr. Denton A. Cooley (left), surgeon-in-chief of the Texas Heart Center in Houston, receives the Roswell Park Memorial Medal from Dr. Florian M. Zaepfel (right), president of the Buffalo Surgical Society. Dr. W. C. Schenk )r. (center) is past president of the society and professor and chairman of the department of surgery at the Medical School.fZl Buffalo Evening News photo One of the nation's oldest awards in med­ icine, the Gold Headed Cane, went to Dr. Sid­ ney Farber, a Harvard pathologist, for his work in the treatment of leukemia and other forms of cancer in children. The award, presented in Cincinnati by the American Association of Pathologists and Bacteriologists, is a reproduc­ tion of a cane used from 1689 to 1825 by physicians to the British royal family. Dr. Farber's best-known achievement was the dis­ covery, in 1947, of two drugs that bring tem­ porary remission of acute leukemia in children. Dr. Farber did his undergraduate work at UB.D Parents can reduce allergies in some chil­ dren and help prevent their development in others, even without medical help, according to a newly published book by Dr. Doris J. Rapp, clinical associate in pediatrics at the Medical School. She is on the staff of Chil­ dren's Hospital where she took her internship and residency. In her book, "Allergies and Your Child," published by Holt, Rinehart and Winston, Dr. Rapp suggests that parents who have a history of allergies can prevent or delay the development of symptoms in their chil­ dren. They can decrease dust in bedrooms and stop smoking. They can keep houses free of pets and wool carpeting and make sure that furniture, pillows, and mattresses are not stuffed with kapok, cotton, feathers or horse hair. "It required a detectivelike imagination to deduce the causes of allergies."• A Children's Hospital research team, who are also Medical School faculty members, have fertilized mice eggs in the laboratory, grown them to the blastocyst stage, implanted them in substitute mothers and produced normal male and female mice. The Buffalo team of Dr. Anil B. Mukherjee, resident assistant professor of pediatrics, and Dr. Maimon M. Cohen, as­ sociate professor of genetics in the department of pediatrics, is the first to show that the egg cell of an animal can be fertilized in the labor­ atory, grown in a chemical culture, trans­ planted into a female animal, and carried to full-term to produce a normal offspring. Similar studies have been done elsewhere, on both rabbits and mice.D THE BUFFALO PHYSICIAN �pA*- In Nlemonam Dr. Stuart Vaughan, M'24, died April 3 after a \ short illness. The 71-year-old physician headed the Buffalo General Hospital Division of Clini­ cal Pathology from 1938 to 1966. Dr. Duncan Whitehead, who was a clinical associate professor of psychiatry for 17 years, died February 3 in Tucson, Arizona. He was 66 years old. He was also director of Buffalo State Hospital (1952-62) and co-ordinator of gradu­ ate education in the psychiatry department of the Medical School. Dr. Whitehead was a Diplomate of the American Board of Psychiatry and Neurology and a Fellow of the American Psychiatric Association and the American Col­ lege of Physicians. He was also a past president of the Buffalo Neuropsychiatric Society, chair­ man of the subcommitttee on mental health of the Erie County Medical Society, and a mem­ ber of the Mental Hygiene Subcommittee of the State Medical Society. In 1965 the Mental Health Association gave him its first Dr. Hyman L. Levin A w a r d in r e c o g n i t i o n o f h i s c o n t r i b u ­ tions to the association.• He was a member of the Medical School faculty for 43 years. He retired in 1970 as clinical professor of medicine and head of the Division of Clini­ cal Pathology. Dr. Vaughan was a specialist in internal medicine and hematology and presi­ dent of the UB General Alumni Board in 1962 and 1966. He also was a member of UB Foundation Board of Trustees. the In 1971 the UB Alumni Association presented Dr. Vaughan with a Distinguished Alumni Award "for notable and meritorious contribu­ tions to the university." He was a past presi­ dent of the Buffalo Academy of Medicine, the Medical Historical Society of Western New York, the Buffalo General Hospital's Medical Board, Medical Union of Buffalo and Nu Sigma Nu Fraternity. Dr. Vaughan was a Fellow in the American College of Physicians and a Diplomate of the American Board of International Medicine and Pathology was active in the (Hematology). He New York State Medical Society, the AMA and the Erie County Medical Society. He was a charter member of the Inter­ national Society of Hematology. T"/' Dr. Samuel Bleichfeld, M'28, died February 1 8 in Millard Fillmore Hospital. He was 68 years old and had been a general practitioner 44 years. He had been on the staff of Veterans After graduating from the School of Med­ icine Dr. Vaughan interned in clinical pathol­ ogy at the Buffalo General. In 1928 he was ap­ pointed pathologist of Wesley Memorial Hos­ Administration, and Millard Fillmore Hospitals. pital, Chicago. He was a past president of the medical staff 1931 he received his doctor of philosophy de­ of Rosa Copeland Jewish Home and Infirmary gree from Northwestern University. His hobbies and a past member of its board of directors. were athletics, travel and the Buffalo Audubon For several years he was medical examiner for Society.D Before returning to Buffalo in the Buffalo Jewish Boy Scout Council Camp. Dr. Bleichfeld did post graduate work in Dr. Vincent M. Recktenwalt, M'48, died Vienna in radiology and internal medicine. He March 22 at his home. was a distinguished Army Medical Corps of­ and had practiced for 15 years in Buffalo until ficer d u r i n g W o r l d W a r II, serving in t h e North his retirement in 1970. African campaign, the European Theater and internal medicine. He was 45 years old, He was a specialist in Dr. Recktenwalt served his was a veteran of the Battle of the Bulge. He internship and was awarded the Legion of Merit, Bronze Star Hospital and was a member of the courtesy with cluster, Silver Star, and the Purple Heart staff. He was also an associate member of the for the invasions of North Africa, Sicily and Normandy. Dr. Bleichfeld was one of the first attending medical staff at Kenmore Mercy Hos­ medical officers ashore in Normandy on D- residency at Millard Fillmore pital. From 1952 to 1955 he served in the Army Medical Corps in Salzburg, Austria. Dr. Reck­ Day June 1944. Although wounded, he directed tenwalt, a the establishment of a beach-head hospital. School faculty, was a Fellow of the American He was a Colonel when discharged from the College of Physicians and a member of several other professional organizations.• Army in 1 9 4 5 . • SUMMER, 1972 former 47 member of the Medical Dr. Vaughan �/ Dr. Paine Dies The man who was chairman (or co-chairman) of the department of surgery at the Medical School for 20 years is dead. Dr. John R. Paine died in his sleep at his home in Jekyll Island, Georgia February 29. He was 65 years old. From 1949 to 1966, Dr. Paine was co-chairman of the surgical department with Dr. John Stewart, who headed the E. J. Meyer Memorial Hospital's surgical department. When Dr. Stewart retired in 1966, Dr. Paine was named chairman. Dr. Paine was the first surgeon to perform heart surgery in Buffalo. That was August 1947, two months after he came to Buffalo from the University of Minnesota. His patient was a 24year-old bellboy at the Statler Hilton, who had been a "blue baby' as a result of an inborn heart defect. Dr. Paine joined the faculty as professor of surgery July 1, 1947, and headed the depart­ ment of surgery at the Buffalo General Hospital since that date. He retired November 18, 1971, but had been on leave since January 1, 1970. In 1967 Dr. Paine was awarded the fifth Stockton Kimball Award of the Medical School for teaching, service and research. In February 1970 he received the Roswell Park Medal of the Buffalo Surgical Society for "his eminent service to his profession and humanity." He received his bachelor's and medical degrees from Harvard in 1927 and 1931. In 1936 he re- Dr. Paine ceived his master's from the University of Min­ nesota and his Ph.D. in 1938. During World War II he served for three and one-half years with the 25th General Hospital in Europe, re­ tiring as a Lieutenant Colonel. Dr. Paine was the author or co-author of more than 30 scientific papers. He was a Diplomate of the American Board of Surgery and the Board of Thoracic Surgery and a Fellow of the American College of Surgeons. He was also an active member of several state and na­ tional professional associations. His son, Dr. Jonathan Paine, is a 1969 Medical School grad­ uate. He is a resident in orthopedic surgery at the University of Utah, Salt Lake City.D The General Alumni Board Executive Committee — DR. EDMOND J. GICEWICZ, M'56, President; MORLEY C. TOWNSEND, '45, President-elect; JOHN G. ROMBOUGH, '41, Vice-President lor Activities; FRANK NOTARO, '57, VicePresident lor Administration; MRS. CONSTANCE MARX GICEWICZ, Vice-President lor Alumnae; JAMES J. O'BRIEN, '55, Vice-President lor Athletics; DR. FRANK GRAZIANO, D.D.S., '65, Vice-President lor Constituent Alumni Croups; JEROME A. CONNOLLY, '63, Vice-President lor Development and Membership; G. HENRY OWEN, '59, Vice-President lor Public Relations; DR. HAROLD J. LEVY, M'46, Treasurer; Past Presidents: ROBERT E. LIPP, '51; M. ROBERT KOREN, '44; WELLS E. KNIBLOE, '47; DR. STUART L. VAUGHAN, M'24; RICHARD C. SHEPARD, '48; HOWARD H. KOHLER, '22; DR. JAMES J. AILINGER, '25. Medical Alumni Association Officers: DRS. JOHN J. O'BRIEN, M'41, President; LAWRENCE H. GOLDEN, M'46, Vice President; PAUL L. WEINMANN, M'54, Treasurer; LOUIS C. CLOUTIER, M'54, Immediate Past-President; MR. DAVID K. MICHAEL, M.A. '68, Secretary. Annual Participating Fund for Medical Education Executive Board for 1971-72 — DRS. MARVIN L. BLOOM, M'43, President; HARRY G. LaFORGE, M'34, First Vice-President; KENNETH H. ECKHERT, SR., M'35, Second Vice-President; KEVIN M. O'GORMAN, M'43, Treasurer; DONALD HALL, M'41, Secretary; MAX CHEPLOVE, M'26, Immediate PastPresident. 48 THE BUFFALO PHYSICIAN �A MESSAGE FROM JOHN J. O'BRIEN, M'41 PRESIDENT MEDICAL ALUMNI ASSOCIATION The University of Buffalo Medical Alumni Association needs your dues contribution more than ever before. It helps provide much needed School of Medicine-community interplay, such as: 1. 2. 3. 4. 5. 6. 7. SCHOLARSHIPS for medical students. CONTINUING EDUCATION. The Spring Clinical Days. REUNIONS of your graduating class. RECEPTIONS at selected medical conventions. CLUBS on a national basis. TOURS. Vacations highlighted by scientific sessions. MISCELLANEOUS. Office Expenses and other services focused at making ours a complete alumni program. We invite you to join the physicians who gave last year. Please use the envelope below and make your check payable to the "Medical Alumni Association." Your gift will add new meaning and flexibility to our program. First Class Permit No. 5670 Buffalo, N. Y. BUSINESS REPLY NO POSTAGE STAMP NECESSARY IF MAILED IN THE MAIL UNITED STATES POSTAGE WILL BE PAID BY — Medical Alumni Association 2211 Main Street Buffalo, New York 14214 Att.: David K. Michael �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET, BUFFALO, NEW YORK 14214 THE HAPPY MEDIUM Fill out this card; spread some happiness; spread some news; no postage needed. (Please print or type all entries.) Name Year MD Received Office Address Home Address If not UB, MD received from In Private Practice: Yes • No • In Academic Medicine: Yes • Specialty, No • Part Time • Full Time • School Title Other: Medical Society Memberships: NEWS: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.? Please send copies of any publications, research or other original work. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1972 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1972-Summer Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v06n02-1972-Summer Table Of Contents A list of subunits of the resource. New Offices More Money Trauma Study Center 4,200 Applications/Dr. Markello Medical Genetics AMA/Dr. Leslie New Book Dr. H. C. Clarke Health Therapy Dr. Armenia/Medical Education Summer Fellowship Dr. Schenk Computerization Capitation Grant Health Insurance Abused Children Harrington Lecture Rural Externship Community Health Center Today's Students Sperm, Egg Intensive Care Respiratory Unit $5000 Gift Medical Artist Mental Health Center The Classes People In Memoriam Dr. Paine Dies Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v06n02 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright 1972 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/8b028761600abf97ed9259b96a21aea2.pdf f3539170bce0f861a1391503dcab00a1 PDF Text Text the buffalo physician SCHOOL OF MEDICINE 1 VOL. 6, NO. 3, FALL 1972 ^STATE UNIVERSITY OF NEW YORK AT BUFFALO �25 Seniors Honored Twenty-five senior medical students shared 17 awards at the annual Class Day Exercises of the Medical School May 11 at Kleinhans Music Hall. Four earned two apiece. They are Stephen J. Levine, Stephen I. Pelton, James A. Singer, and George C. Newman, Jr. The awards were presented by Dr. Clyde L. Randall, acting dean and vice president for the Faculty of Health Sciences. Alpha Omega Alpha (National Honorary Society) — Richard DiBianco, Michael Gordon, Frederick S. Hust, Thomas J. Lawley, Stephen J. Levine, Marc J. Leitner, William T. Murray, George C. Newman, Jr., Stephen N. Newman, Stephen I. Pelton, Richard A. Savage, Paul A. Seligman, Craig R. Smith. Thesis Honors — Areta O. Kowal Upjohn Award (advancement in medical studies) — Patricia K. Duffner Buffalo Surgical Society Prize in Surgery for junior, senior years) — John W. Kraus (academic excellence Dr. Heinrich Leonhardt Prize in Surgery (academic excellence) — Joseph E. Tripi David K. Miller Prize in Medicine (demonstration of Dr. Miller's approach to caring for the sick — competence, humility, humanity) — Robert DiBianco Gilbert M. Beck Memorial Prize in Psychiatry lence) — Karen A. Price (academic excel­ Philip P. Sang Memorial Award (efficiency in practice of medi­ cine, dedication to human values) — George C. Newman, Jr. Morris Stein Neural Anatomy Award (excellence in neural anat­ omy) — Thomas J. Lawley Maimonides Medical Society Award (application of basic science principles to practice of medicine) — Stephen J. Levine Hans J. Lowenstein Award in Obstetrics (academic excellence) — James A. Singer Bernhardt and Sophie B. Gottlieb Award (combination of learn­ ing, living, and service) — Gary H. Lyman Lange Award (excellence in work) — Lynda A. Kam, James A. Singer Mark A. Petrino Award (sincere interest, best characteristics for general practice of medicine) — Andrew J. Kane Lieberman Award (interest, aptitude in study of anesthesiology) Virginia F. Hawley — Emilie Davis Rodenberg Memorial Fund (academic excellence in study of diabetes, its complications) — Stephen I. Pelton Baccelli Award (continued excellence in research) — Ira L. MintzerD �Fall 1972 Volume 6, Number 3 THE BUFFALO PHYSICIAN Published by the School of Medicine, State University of New York at Buffalo IN THIS ISSUE EDITORIAL BOARD Editor ROBERT S. McGRANAHAN 2 Managing Editor MARION MARIONOWSKY Photography HUGO H. UNGER EDWARD NOWAK Medical Illustrator MELFORD J. DIEDRICK Graphic Artists RICHARD MACAKANJA DONALD E. WATKINS Secretary FLORENCE MEYER CONSULTANTS President, Medical Alumni Association DR. JOHN J. O'BRIEN President, Alumni Participating Fund for Medical Education DR. MARVIN BLOOM Vice President, Faculty of Flealth Sciences DR. CLYDE L. RANDALL Vice President, University Foundation JOHN C. CARTER Director of Public Information JAMES DeSANTIS Director of Medical Alumni Affairs DAVID K. MICHAEL Director of University Publications 3 4 5 7 8 9 10 11 12 13 15 16 19 21 23 24 26 27 28 32 36 40 41 42 THEODORE V. PALERMO Vice President for University Relations DR. A. WESTLEY ROWLAND the b^^physjaan.. 53 54 59 62 63 67 69 Seniors Honored (inside front cover) SPRING CLINICAL DAYS Drug Addiction Professional Corporation Canadian Abortion Legal Abortion Local Abortions/Skin Cancer Drug Ramifications Health Crisis Personal Touch Health Politics Admissions, Budget Health Care Flight Surgeon/Dr. Ranney CLASS DAY EXERCISES Class President Speaks Medentian Response Dr. Randall's Congratulations Dr. Sullivan Retiring Faculty Residents, Interns Dr. Eckhert Intern Matching Dr. Sanes University Health Service Medentian Honors Professors Eden Physician/Medical Education Working with Others for Optimum Care of Patients by Ruth T. McGrorey, Ed.D. Dean, School of Nursing RMP Grant/Seniors Honor Faculty Immunology Convocation Summer Fellowships VP Search Committee The Classes People In Memoriam The cover design by Richard Macakanja focuses upon our national election. Among the many campaign issues is the delivery of health care. THE BUFFALO PHYSICIAN, Fall 1972 — Volume 6, Number 3, published quarterly Spring, Summer, Fall, Winter — by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. Please notify us of change of address. Copyright 1972 by The Buffalo Physician. �The Stockton Kimball luncheon. Drug Addiction T H E PANEL on Modern Approach to Drug Addiction reviewed a 20-minute New York State Health Department film on emergency treatment of drug users. The film was taken over a nine-month period at the Mt. Sinai Hospital (New York City) emergency room. It showed patients coming off LSD trips and others with overdoses of heroin and barbiturates. It was a moving, emotional film that "told it like it is." It also showed follow-up person to person talks between the patients and physicians, nurses and social workers. In the discussion that followed Dr. Gary W. Healey, staff psy­ chologist at the Masten Park Community Rehabilitation Center said, "drug abuse is a complex, multifaceted problem. W e know very little about the different types of addicts. We don't know whether they have been taking drugs for two months or 20 years. These facts are all very important to the diagnosis and treatment of the patient. "We must avoid relying on single uniform diagnosis and singu­ lar treatment approaches. There are four distinct classes of drug users — the experimenters, the recreational or social users, the involved abusers (housewife on diet pills), and the dysfunctional abusers which include the narcotics addict and non-opiate abuser such as the methamphetamine abuser." Dr. Healey suggests the multimodality treatment approach be­ cause of the many differences that exist among drug abusers. This approach seeks to determine what characteristics of a drug de­ pendent person can be matched with a particular treatment ap­ proach. This approach may also be used for non-narcotic abusers. "There is n o universal addict o r drug abuser, but rather a variety of drug dependent people who will respond only to a variety of treatment approaches. That is why no single treatment approach will work. It is a long-term process that may range from detoxi­ fication to day centers." 2 THE BUFFALO PHYSICIAN �Dr. Oscar S. Lopez said we must change our concept from punishment to treatment of the drug abuser. The Masten Park staff psychiatrist stressed three facets — the chemical property of drugs, personality of the patient, and the culture of the people. "Nation­ ally there must be a change in the physician's prescribing of drugs. The treatment of the drug abuser necessitates limiting drug en­ forcement. There must also be changes in media concept and in the medical school curriculum so graduates will know more about the problem and how to cope with it." The panel concluded the discussion by saying that there are some centers available to send patients for treatment, but not enough in Buffalo or any other community.D Spring Clinical Days Two attorneys and a dentist who are tax specialists, reviewed the historical background of the "professional corporation" and its benefits. They agreed that the tax shelter for earnings is the pri­ mary purpose in forming such a corporation. "It also provides an easier way for estate planning, limits personal liability and is not as cumbersome as a partnership," attorney Raymond Roll, Jr. said. He went on to say that a professional corporation is a legal entity, must be operated like a corporation and that its principals must be members of the same profession. Attorney Jack Geller said, "we are not here to sell you anything or badger you. Every individual has a different set of cir­ cumstances. Do what is right for you. Not every physician needs a professional corporation. We urge you to get advice from your attorney and tax consultant. Make an individual analysis of your Professional Corporation own situation. "The employment contract is the key document of the profes­ s i o n a l c o r p o r a t i o n . T h i s i s v e r y e s s e n t i a l if m o r e t h a n o n e p h y s i c i a n is practicing. This document gives the corporation substance." Mr. Geller went on to say that in the corporate plan you can name your own officers, make your own investments as long as they are prudent, name yourself as chief administrator and be an individual trustee. The panel listed other advantages of the professional corpora­ tion such as health benefits, accumulative pension and profit shar­ ing, life insurance, flexibility, the right to declare dividends and the option to purchase a building. The panel also pointed out that the professional corporation will not affect daily operations. But during the first year of operation they emphasized the physician must maintain close counsel with his tax consultant and attorney.• Good food, fellowship �CORPORATE VS. UNINCORPORATED PRACTICE A Comparative Analysis of Economic Benefits and Tax Results Gross Income of Professional(s) Less general overhead and office staff cost ($20,000 general; $10,000 salaries - est.) Corporation Unincorporated $93,000.00 $93,000.00 30,000.00 30,000.00 $63,000.00 Corporate Salary . . Personal Tax Exemptions and Deductions Taxable Income Federal Income Tax $63,000.00 Practice 50,000.00 Income 63,000.00 10,000.00 10,000.00 $40,000.00 $53,000.00 12,140.00 18,590.00 $37,860.00 $44,410.00 Corporate "Fringe" Benefits Profit Sharing Plan $7,500.00 Life Insurance 500.00 Disability Insurance 2,000.00 Hospital Insurance 250.00 Total Corporate "Fringe" Benefits 10,250.00 "AFTER TAX DOLLARS" $48,110.00 Economic Benefit from corporate practice over unincorporated: Canadian Abortion Two panel members (abortion) Drs. Fortier, Lippes, watch a demonstration. $44,410.00 $3,700.00 "Health is the key to the Canadian abortion law that was modified in 1967. It allows abortion when performed in a hospital after approval of the hospital committee," according to Dr. Lise Fortier, a gynecologist at the University of Montreal School of Medicine. "The law as formulated can be interpreted any way one wishes to, and hospitals are not forced to have committees. This makes for a different kind of medicine depending on whether the patient lives in a large city or village, whether she is French or English, whether she attends a non-confessional or a Catholic Hospital. We are still 25 years behind the United States in abortion, but we are making progress. Twelve years ago we couldn't mention sterili­ zation, abortion or contraception without a reprehend from the medical society. Today we can automatically abort teenagers, all mentally deficient women and those with physical problems." Dr. Fortier believes the reluctance to abortion is more male inspired than religiously inspired. "Medicine has been a man's world, and only recently have women been accepted in medical schools and graduated with M.D. degrees. The Canadian abortion committees have been all male. Only recently have they included one or two women on the committee. Our family planning clinics have been all male. But we are making some progress in getting women into these clinics." 4 THE BUFFALO PHYSICIAN �The gynecologist went on to say that for years physicians have convinced women that pregnancy is normal, desirable and socially accepted. "They have told women that not to have children is bad. Pregnancy may not be a disease but often there are dreadful complications, much uncomfortableness, and a higher mortality rate after the 10th birth. Statistics show that the 10th pregnancy is five times more hazardous than the first. "Speaking as a gynecologist we must be sure that every woman who ventures into pregnancy does so of her own free will with knowledge of the dangers. Then every birth will be a happy and desired event," Dr. Fortier concluded.• Spring Clinical Days Sarah Lewit, an associate of Dr. Christopher Tietze, director, bio-medical division, The Population Council in New York City, spoke about the early medical complications of legal abortion. She reviewed the highlights of the Joint Program for the Study of Abortion (JPSA) which received data on 73,000 abortions performed in 60 hospitals and six clinics (not located in hospitals) in 12 states and the District of Columbia between July 1, 1970 and June 30, 1971. The major findings and conclusions of JPSA are: —While the type of patient most frequently seen in JPSA institutions was a young, single, white woman pregnant for the first time and aborted as a private patient, the proportions of married, black, parous, and non-private patients increased signifi­ cantly in the course of one year, with little change in the age distribution of the women. —About three out of four abortions were performed in the first trimester of pregnancy, and the remaining one-fourth, at 13 weeks or later; the proportion of early abortions increased substantially over the year. —Late abortions were most frequent among women under 18 years of age, nonprivate patients, black women, and mothers of six or more children. —Most abortions in the first trimester were done by suction and most abortions at 17 weeks or later, by saline. Classical D & C accounted for 4.5 percent of all abortions and hysterotomy and hysterectomy together, for 2.4 percent. Over the year, the share of the last three procedures was almost halved. Legal Abortion The 1927 class reunion dinner. FALL, 1972 5 �:~C J&'$J§yS Dr. Tarik Elibol's exhibit "Fiberoptic Gastrointestinal Endoscopy" won third place. He is a clinical instructor in medicine at the University and on the staff of Kenmore Mercy Hospital. At the Stockton-Kimball luncheon the Anthone twins, Drs. Roland and Sidney, were presented with special awards of appreciation by the Medical Alumni Association. The citation: "For his outstanding leadership and years of dedicated service to the School of Medicine and the Medical Community —The incidence of early medical complications, including minor complaints, during the first trimester of pregnancy was on the order of one in 20 abortions; the risk of major complications, as defined in this report was one in 200 abortions. —The risk to health associated with abortions was about three times as high in the second trimester of pregnancy as in the first trimester. —Complication rates were higher for abortions performed at 6 weeks' gestation or less than at 7-10 weeks' gestation, especially for major complications. However, the risk to health was far smaller for the earliest abortions than for abortions in the second trimester. —As might be expected, the risk of postabortal complications, and particularly major complications, was higher for women with known pre-existing complications than for apparently healthy women. —Nonprivate patients had significantly higher complication rates than private patients, especially for abortions in the second tri­ mester. —Complication rates were lowest for abortions by suction, followed in ascending order by classical D & C, saline, hyster­ otomy, and hysterectomy. —Complication rates in the second trimester increased marked­ ly with age of woman and parity; for the first trimester, there was no association with parity and a slight downward trend with age of woman. —The incidence of complications increased markedly when abortion by suction or D & C was combined with tubal sterilization, except for sterilization by laparoscopy. —Complication rates for abortions by suction were lowest at 7-8 weeks' gestation, from which point they increased steadily to 15 weeks or more; this trend was repeated with minor irregularities for specific types of complications. —Complication rates for abortions by suction, excluding women with pre-existing complications and/or sterilizing opera­ tions, were lower for clinics than for hospitals and lower for hos­ pital outpatients than for hospital inpatients; these differentials were due in part to variations in periods of gestation and in type of service (private vs. nonprivate). Other factors which probably contributed to the differentials were: (a) more rigorous selection of patients, (b) greater experience of physicians, and (c) less complete recording of complications. —Local anesthesia was associated with a higher incidence of complications than general anesthesia at each period of gestation among patients aborted by suction, and with a notably higher rate of repeat curettage. —Complication rates for abortions by suction declined approxi­ mately fifty per cent from the third quarter of 1970 to the second quarter of 1971.• 6 THE BUFFALO PHYSICIAN �t The 1962 class reunion dinner. In 1971 there were 9,462 abortions performed in Erie County (55 per cent in hospitals), according to Dr. Emma Harrod, Deputy Commissioner of Health in Erie County. "Women can have an abortion performed in Erie County safely and quickly. The cost ($250 to $700) is often a big hurdle for the poor women who are not covered.by medicaid or insurance. There has been an over­ whelming demand for this service, not only in Erie County, but nationwide." Local Abortions Dr. Harrod went on to point out that in spite of more younger childbearing age women in the last 20 years, there has been a decline in the birth rate and fertility rate by 33 per cent. "The rapidly declining birth and fertility rate began long before abortion services were available. The abortion law has facilitated this decline by providing another method of fertility control. However, the chang­ ing attitude toward family size and the availability of family plan­ ning resources have contributed to this decline." In closing Dr. Harrod compared the Erie County birth rate of 1 5 per 1,000 with the death rate of 7.5 per 1,000. " W e still have some way to go before things are stabilized," she said.D Cancer of the face or carcinoma of the skin, the most frequent form of cancer, was reviewed by four physicians. There are over 100,000 new cases a year but there is now a 95 per cent cure rate, according to Doctors John Quinlivan, Gorden H. Burgess, Joseph R. Connelly and John T. Phelan. They agreed that the successful treatment of skin cancer depends on a team effort. "Get all the professional heads together — dermatologist, pathologist, radiolo­ gist, plastic surgeon, and chemo-surgeon — and plan the treatment." As slides of the skin cancer patients were shown, the four experts discussed the various types and suggested treatment. Most of the time they agreed on the treatment, but occasionally there were differences. Basal and squamous cell epithelioma are the two most com­ m o n f o r m s o f s k i n c a n c e r . Early- d i a g n o s i s i s i m p o r t a n t . W h i l e basal cell exhibits slow growth it can be destructive as it invades vital areas. However, it never metastasizes as does the squamous FALL, 1972 Skin Cancer �The cancer of the face panel (sitting) Drs. Corden H. Burgess, Joseph R. Connelly, John T. Phelan, and John Quinlivan (standing). Drug Ramifications cell type that has a five to ten per cent rate and is therefore the most dangerous. It invades underneath the skin, can ulcerate, and be covered with a crust. Carcinoma of the skin, it was explained, is usually caused by solar changes, to areas of the body exposed to sun. Protection by a beach umbrella will not afford sufficient coverage, for the body still receives a high amount of radiation. Most susceptible to this form of cancer are the Kelts (the Scots and Irish) who exhibit a high incidence of skin cancer. Many of these people immigrated to the United States, New Zealand and Australia. How does sun damage lead to skin cancer? It is the effect of ultra violet light that forms a bridge to the DNA molecule which is then incapable of forming a reasonable message. The outcome — the forming of clones of cancer cells. Says Dr. Connelly, "the large recurrent local tumor cells have the identical invasive features of basal cell carcinomas." Dr. Phelan agreed with him in that the whole area of a tumor field must be excised following a program of chemotherapy which in itself requires certain skills. But the panel emphasized that it was no longer necessary to estimate the range of the tumor field involved in carcinoma of the skin. With microscopic control now a reality by the pathologist, there is a good cancer procedure available. Also discussed were lesions on the nose, eyelid, lip and cheek in which all agreed that when there are deepseated tumors, one must forget the cosmetic appearance of the patient and go for the "wide excision." Another pointed to the necessity of checking for lesions to other organ systems as well as the obvious one. For out of 50 cases there were three in which lesions were found in other areas as well. In the Buffalo area the basal cell lesion is the more prevalent. A warning to use a SUN SCREEN for those with light colored hair and eyes, who freckle easily, and are in jeopardy from heavy solar radiation was also given. Sailors, farmers, sun bathers and construction workers are most prone to skin cancer. The top of the ears and head, the tip of the nose and chin are the areas most exposed to the sun. The lips, cheeks, eyelids, and neck are other areas of concern.• Three attorneys and two physicians discussed the Medical and Legal Ramifications of treating patients with new and experimental drugs. Attorney Daniel T. Roach said "the Doctrine of Informed Consent means that you as a physician advise your patient on the consequences of a drug or surgery. A patient is entitled to know this. In some cases you may want some formal written statement from your patient. With new and experimental drugs no one knows all the side effects, but you must tell your patient all that you know about the drug at the time he takes it." Dr. John Webster said that very often "informed consent" is impossible. "I believe that every physician must assess each patient and then decide how much information the patient needs. The 8 THE BUFFALO PHYSICIAN �physician must decide whether the information will do the patient any good. If you aren't sure of the consequences of a new drug, tell your patient. At Roswell Park we do get the consent from patients before treatment and experimentation." Attorney Roach said, "We need better ground rules and stand­ ards for malpractice suits. We must get away from a lay jury second guessing physicians two or three years after something happens. However, you can't have a set of rules that covers every case. There must be better ways to resolve these cases in the next few years." Dr. Jack Zusman said, "there are not adequate medical stand­ ards and ethics. Even those outlined by the AMA are inadequate and it is often left to the attorneys to decide and interpret. We definitely need more guidelines on advice and consent." He went on to say that experimentation must be carried on by all M.D.'s — not only in a hospital or institution. "We need guidelines and pro­ tection of the M.D. for research. The key question is the welfare of the individual vs. the welfare of society. The patient doesn't want to be experimented with only as a last resort. Society on the other hand wants experimentation to continue as long as it isn't on him. The physician is caught in the middle of this conflict and held legally responsible." Attorney William A. Carnahan said "the medical profession has not set its own standards to guide its destiny. I believe the courts would buy your own ground rules if you are honest and reasonable in the treatment of your patients. Until the medical profession takes an interest and decides on how to police itself, the courts will do it in a way that is not satisfactory to the physicians. Of course there is never a problem in experimental drugs if the treat­ ment is successful. "You are not judged by the realities of everyday practice, but rather what the law considers the realities should be — and this is the nub of the problem," Mr. Carnahan concluded.• The panel on new developments in the delivery of health care agreed that American medicine is faced with one of its greatest challenges. "The crisis is of such magnitude and importance that we cannot be allowed the luxury of opinion. What is needed is plan­ ning and evaluation. Plans must be evaluated as to completeness, comprehensiveness, quality, cost and efficiency," Dr. Timothy F. Harrington, chief resident, Family Practice Center, Deaconess Hos­ pital said. Today's physician is often called on to do counseling. "Let the physician who wants to counsel do so. But also let the physician who does not choose to counsel still provide for his patient's needs. Make the latter aware of the need and let him refer such problems to a competent party. We must decide what the physi­ cian can do well and let him do it. But let's not forget the total welfare of the patient." Dr. Harrington suggested the team approach to medical care. "It is time that we decided that physicians cannot be all things to all people, but they can be the entry point for providing FALL, 1972 9 Spring Clinical Days Drs. Ernest Haynes (sitting) and Hi­ ram B. Curry discussed "New Devel­ opments in Health Care Delivery." Health Crisis �Dr. lames C. Dunn, exhibits chairman, congratulates Paul H. Wierzbieniec (class of 1974) for runnerup in the exhibits. The "Chronic Pulmonary Diseases" exhibit was prepared with the help of Dr. Mario Montes, a clini­ cal associate professor of pathology at the University. He is on the Buffalo General Hospital staff. Personal Touch services outside their sphere of interest or competence. We must stop pretending that we like to listen to social problems, if in fact, we do not, and say to the patient "I cannot help you with this, but Ms. X can and I will arrange for her to see you." This is pro­ fessional honesty and is not passing the buck, it is seeing that the patient receives needed care. "To use this approach requires extraordinary people. People who know their limitations and are able to work together. It is not always easy to relinquish a "part" of a patient, but sometimes it must be done if total care is to be achieved. Many physicians in practice do this easily and refer patients to pastors, counselors and other experts as a matter of routine. What is needed now is an extension of this practice to physicians who have not yet done so, without making the physician feel he has failed."• Dr. Hiram B. Curry said the public has lost confidence in our pro­ fession because physicians have not responded to problems that lead patients to better health. Dr. Curry is professor and chairman of family practice, Medical College of South Carolina. "Family practice as a specialty offers the best vehicle for change, the best opportunity to resolve the current imbalance in medical care, and to meet the needs of families and individuals. Today there are 101 family practice programs and 665 family practice residents in the United States," he said. "The public wants comprehensive care with continuity and concern. There must be a personal touch and communication between the sick and the physician. An affluent society is not an easy one to satisfy. The more it has, the more it wants. People want what they want when they want it. We must meet this chal­ lenge. "The imbalance in the ratio of primary to secondary and tertiary physicians is the greatest impediment to providing excellent health care and a leading cause of inefficiency. Society is challeng­ ing the medical profession to organize its services so as to render comprehensive care to persons, to coordinate generalist and spe­ cialist and to efficiently utilize bed and ambulatory, acute and 10 THE BUFFALO PHYSICIAN �Spring Clinical Days The 1922 class reunion dinner. chronic, diagnostic, curative, preventive and rehabilitative facili­ t i e s . If t h e h e a l t h c a r e s y s t e m is t o w o r k e f f i c i e n t l y t h e r e m u s t b e a workable balance between the problem and the solution. The complexity of the problem must be matched with the training of the medical personnel attending the patient. To have a highly e d u c a t e d a n d skillful p h y s i c i a n e v a l u a t e a p a t i e n t w i t h a s o r e t h r o a t is w a s t e f u l . It is l i k e h a v i n g a P h . D . m e c h a n i c a l e n g i n e e r change the tires on your car. No society can wisely afford such a health care system," the South Carolinian said. In c o n c l u s i o n D r . C u r r y s a i d w e m u s t p e r s u a d e m e d i c a l s t u ­ d e n t s t h a t t h e " g o o d l i f e " is t h a t o f t h e f a m i l y p h y s i c i a n . T h e n o u r graduates will flock to this type of program and this will eliminate many of the complaints of the public.D " T h e d a y o f s t a t u s q u o i n h e a l t h c a r e is o v e r . C h a n g e is t h e key word and medicine must assume a more responsible leadership role in working more closely with the other health professions in the implementation of new programs and systems of health care delivery. We talk a lot about the health team concept, but the team is n e v e r t a u g h t . W e a r e d o i n g v e r y l i t t l e o n t e a c h i n g h e a l t h p r o ­ f e s s i o n a l s t o w o r k t o g e t h e r . " T h a t is w h a t D r . J. W a r r e n P e r r y , d e a n of the School of Health Related Professions at the University told the 100 physicians attending the Saturday morning session. He w e n t o n t o s a y t h a t if h e a l t h c a r e c e n t e r s d o n ' t c h a n g e , t h e f e d e r a l and state governments, augmented by consumer support, will force c h a n g e s in t h e h e a l t h c a r e s y s t e m . "Federal programs are being designed to respond to some of these needs and manpower resources are being identified for the strengthening and development of the educational and clinical programs for the allied health professions." D e a n P e r r y p o i n t e d o u t t h a t h e a l t h is a p o l i t i c a l i s s u e t o d a y . He listed several other significant changes on the national scene: —Regional Medical Programs are no longer oriented only to medical research programs of heart disease, cancer and stroke. T o d a y t h e m a j o r e m p h a s i s is t o w a r d s y s t e m s o f h e a l t h c a r e d e l i v e r y and the coordinated approach to these along with availability of care and emergency of care; FALL, 1972 11 nnj T) 1 ' -L fOo ± Ol/TTZLS r j 1 OT j j 1J.6CllT10 �Spring Clinical Days —the VA hospitals are changing to a health care center with out-reach programs and out-patient services to veterans and their families; the 155 VA hospital centers represent the largest health care delivery service in the nation; —100 Health Maintenance Organizations (HMO's) projects have been funded and are operating although no legislation has been approved; —114 new career programs — physicians assistants, specialty programs — have been funded by the federal government, but none in this area; —the federal government is moving into new systems of health care — HSO's, HCC's, AHEX — and one or more of these may be the new design of the future for health professionals' new careers and specialty programs; —the Bureau of Health Manpower is one of the largest sections of the federal government. There are five manpower divisions in this bureau physicians, dental, nursing, allied health and interdisci­ plinary relationships among all fields; —there are 72 colleges and universities in USA with divisions, schools or departments of allied health. There were only 15 five years ago. "The National Academy of Science has just establishd its Insti­ tute of Medicine. Its first task will be to look at interprofessional relationship of health professionals. They will coordinate this proj­ ect with AMA, AAMC and others. In the planning stage is the first national and international conference on health professional inter­ disciplinary education." On the state level Dean Perry said there are 40 community colleges in the state system that have divisions of allied health. He went on to say that New York State has the largest educational commitment to allied health training in the world. In conclusion Dean Perry said "the hub of the health delivery system of the future must continue to be the hospital even though there is a shift in emphasis from acute and intensive care to compre­ hensive care involving satellite clinics. We must also utilize all the health manpower available to do a better job."D AdmissionSj Facultyj Budget Drs. Bart A. Nigro, M'20, Herbert f. Wells, M'15, Walter C. Haywood, M'15, and Thurber E. LeWin, M'21. Admissions, budget, faculty recruitment, and emphasis upon health care delivery (as opposed to research) are major concerns of the Medical School, according to Dr. Clyde Randall, acting dean. He is also vice president of the Faculty of Health Sciences. "We are sorry that your son or daughter can't get into your school, but they are all candidates for the following year (1973). We had 4,200 applications for 135 places, and 600 have already been interviewed. There is emphasis on recruiting capable minority students and those who are economically deprived. We have six equally capable candidates for every one of the 135 places in the first year class. �Mrs. Stockton Kimball at the annual luncheon. "We are tooling up for the team concept of health care, which you know is a national trend. The recruitment of qualified faculty, a new Medical School dean and a new vice president for Health Sciences, is also high on our list of priorities." Dr. Randall pointed out the difficulties in competing with other departments of the University for money, when so many people think the Medical School already gets too much of the university dollar. He pointed out that it costs twice as much to train a physi­ cian as a Ph.D. He also cited the acute space problem which won't improve until more space is available on the main street campus. This will come about only when other schools and departments move to the Amherst campus. Medical School classes have in­ creased from 100 in 1952 to 135 in 1973, but we have had no additional space.Q In his Stockton Kimball lecture, entitled "Health Care and Edu­ cation," Dr. Robert J. Glaser, Vice President of The Common­ wealth Fund, addressed himself to the general problem of health care delivery. He enumerated some of the factors which have contributed to the current health care crisis, including the lack of adequate planning on the part of government, medical educators and physicians in general. "Despite the accumulation of data after World War II that called attention to the impending physician shortage, relatively little was done about expanding medical school enrollments, and decreasing the period of training. We paid little attention to health care delivery or to the ambulatory patient," Dr. Glaser said. The enormous growth in support for research, and the result­ ing expansion in the body of knowledge brought new opportuni­ ties in medicine and helped focus the public's attention on the whole subject of medical care. "Yet until very recently, the voice of the consumer has not been heard, and relatively little attention has been paid in most medical circles to health care delivery — especially ambulatory care. One notable exception has been the Kaiser-Permanente Medical Care organization," the former Stanford University Medical School Dean said. "In the university medical centers particularly, emphasis has been placed on the care of patients suffering from acute, episodic FALL, 1972 13 Health Care, Education Visiting between sessions. �disease. This is obviously an extremely important area, and one which deserves continuing attention. Yet at the same time, health maintenance merits far more attention than it has received in the past. The care of the whole family must be made more attractive to medical school graduates. Dr. Cloutier congratulates Dr. Claser on his excellent address. Dr. joseph C. Lee, professor of anat­ omy, receives his plaque from Dr. Dunn for his winning exhibit "Frac­ tionation and Transplantation of Ex­ perimental Intracranial Tumors." "In our educational programs, we must begin to take into account factors that will impinge on health care delivery. A major consideration in this respect is the application of technology. For example, the computer has been introduced into medicine in a significant way. It is incumbent on us to determine how the ap­ plications of technology can enhance medical care. At the same time, we must not lose sight of the economic factors — we must avoid unnecessary duplication and the application of high cost technology which cannot be justified in terms of the benefits pro­ vided. For example, every hospital should not do open heart surgery. It is too costly and an unnecessary duplication of service and personnel. In New York City, 17 hospitals perform open heart surgery, and three hospitals do 85 percent of the surgery. "We must continue to concern ourselves with the expansion of the health manpower pool. Not only do we need more physi­ cians and paramedical personnel, but we must learn how to deploy them efficiently and how to organize health care teams. Although the physician will play a key role, we must mobilize talent of many others (law, political science, bio-medical scientist, engineer, economist, system analysis, and other health professionals). The university is the ideal focal point for this mobilization. "We must recognize that new knowledge will continue to accrue; as we learn more about cause and treatment of certain diseases, the health care system will be affected. For example, the advent of a successful means of preventing poliomyelitis has erased dramatically the need for acute care facilities during polio epi­ demics as well as the need for long term rehabilitation facilities. "It seems certain that some form of national health insurance will be enacted in the relatively near future. Attention should be paid to the impact of such a program on the demand for health care and on the mechanisms by which that demand can be met. "Finally we must pay more attention to public education. In many instances the public understands very poorly what medical care has to offer and what it does not have to offer; particularly the public lacks understanding about the ways in which the indi­ vidual himself can improve or protect his health status. For example, the deleterious effects of smoking on the incidence of heart disease and lung cancer are well documented. Yet the populace continues to use tobacco in increasing amounts. This reflects a failure in our educational effort. Similarly, sensible diets, adequate exercise and other relatively simple measures, if applied widely, could do much to decrease the morbidity and mortality of certain forms of heart disease. F)ere again, we have been inadequate and ineffective in getting the measure across to the public. "We can do a lot for ourselves and the public can do a lot for itself in preventive medicine, and this is very important to a better health care system," Dr. Glaser concluded.• 14 THE BUFFALO PHYSICIAN �Dr. Sarah Nunneley will soon be measuring the effects of gravity and exercise on man's heart and respiratory systems in the new Laboratory for Environmental Physiology. The assistant professor of physiology is a pilot and former flight surgeon at NASA's Flight Research Center in the Mojave Desert near Los Angeles. Her work as a flight surgeon was part of a three-year program at Ohio State University where she received a master's degree in preventive medicine. She has her medical degree from the University of Minnesota. As an undergraduate at Mount Holyoke College she was fascinated with space ships. Her parents and professors thought she must be crazy to consider a career in areospace medicine. Since joining the Medical School faculty in September of 1971 Dr. Nunneley has lectured students on the effects of gravity, ac­ celeration, and the impact of jet fatigue or crossing a number of time zones in a short period of time. She is also part of a research team studying the effects of gravity on both animal and human subjects. This will be d o n e in the new lab when the centrifuge is completed. It is the only o n e of its kind specifically designed to measure the physiological effects of increased gravity on man. "From this research we hope to learn more about what constitutes physical fitness, what exercise improves health and how much exercise should be done by heart patients and others with similar ailments. After studying the effect of increased gravity on healthy people we hope to be able to apply our knowledge to people who faint," Dr. Nunneley said. Dr. Nunneley is not particularly excited by flying, although she is a licensed pilot. "I consider it just like driving a car but I am fascinated by all types of airplanes and space ships."• Dr. Nunneley Flight Surgeon Studies (gravity Dr. Ranney Honored Dr. Helen M. Ranney, professor of Medicine at the University, was among 36 recipients of the first Reverend Dr. Martin Luther King, Jr. Medical Achievement Awards in Philadelphia April 11. The awards banquet is sponsored by the Philadelphia Chapter of the Southern Christian Leadership Conference. Dr. Ranney received the award for her research in sickle cell anemia. She joined the Buffalo Medical School faculty in 1970. She is a 1941 cum laude graduate of Barnard College and received her M.D. from the College of Physicians and Surgeons, Columbia University in 1947. Before com­ ing to Buffalo Dr. Ranney had been on the faculties of three medical schools — Albert Einstein, Columbia and Yeshiva. She has also served in several hospitals in the New York metropolitan area. Dr. Ranney has authored or co-authored 50 papers and articles o n h e m o g l o b i n . S h e i s b a s e d a t t h e E. J. M e y e r M e m o r i a l H o s p i t a l , but also has teaching assignments at the Buffalo General and Veter­ ans Administration Hospitals. Co-chairmen of the awards banquet were Governor Milton J. Shapp and Muhammad Ali; honorary chair­ m e n w e r e M a y o r F r a n k L. R i z z o a n d t h e R e v e r e n d D r . R a l p h D a v i d Abernathy.Q FALL, 1972 15 Dr. Ranney �Final instructions. The Marshals, charged with the conduct of the class day exercises at the Medical School, led the 126th class to be granted the degree, Doctor of Medicine, to their seats. The families of the 120 graduates — parents, wives, and infants — were waiting in Kleinhans Music Hall to share the traditional but awesome proceedings with them. Challenges to Faculty., Graduates by GARY H. LYMAN President, 1972 Class I appreciate this opportunity to convey some observations on our medical education and to express both gratitude and a challenge to each of those involved in this process. As a class we have ex­ perienced much over the duration of the past four years . . . most of it good, some of it less so. We have seen a vitalization of the medical curriculum, an increased enrollment of minorities in con­ trast to the pallor evident in our present graduating class, and we have witnessed an increased awareness of major health issues among younger health professionals. Yet, unfortunately, many of these positive changes have been offset by the narrowing of per­ spective at the University level through the appointment of a provincial president and subsequently the departure of the dean and assistant dean most instrumental in implementing these changes. Only with time will we know if this trend will extend into the selection of the new dean. But this is not the time or place for us to debate the correct­ ness or incorrectness of these decisions made over the past few years but rather a time to reflect on our educational experience in the hope of some insight into those factors by which we have benefited and into others that should be changed. So I will briefly direct my comments — both of thanks as well as challenge to the three principles involved in our education — the administration, the faculty, and, we, the graduating class. To the administration and others involved in the coordination of our education I would like to extend our sincere gratitude. We readily realize that most of what you do for us goes unnoticed 16 THE BUFFALO PHYSICIAN �until something goes awry. But we truly appreciate your help in assisting us in the scheduling of course work and in guiding and promoting our search of internship appointments. I'm sure that the full significance of your endeavors will not be realized until we ourselves assume similar administrative positions. To the administration I offer two challenges. First, I would like to see you play a more direct role in the medical education process. By this I mean that first of all you should involve the students more directly in your affairs including that of decision making. You must not be afraid to allow the students to play signi­ ficant and decisive roles in the formation of school policy, ad­ missions criteria, and curriculum reform. What the student lacks in experience he may make up for in his direct contact with other students and in his direct involvement in the educational process. He probably knows better than anyone else how good a course is, what new courses he needs to complement his education, and which should be altered. I would also ask the administration to have more faith in the ability of the students to make thoughtful and informed decisions of a policy nature. This, I think, should all be considered as an important phase of our education. As I said, many from this class will sooner or later hold positions of respon­ sibility as administrators. It appears that the physician is being forced more and more into such positions of responsible decision beyond that of patient care. So I believe that the time to start train­ ing for this responsibility is during medical school and not later when he won't have the trained supervision to guide his decisions. The second challenge I offer the administration is not to wait until there is overt hostility before taking action. You must be open to change and willing to consider student proposals before open confrontation is necessary. The hooding of class president Gary Lyman by Drs. Philip Wels and Donald Rennie. To the faculty I would like to extend the class' thanks and appreciation for days and weeks spent, often with little compen­ sation, in instructing us and guiding our interests. Certainly this education is only possible because of your efforts. We only hope that we can in turn pass on some of this knowledge to others with the dedication you have shown. To the faculty, I also offer two challenges. First, I would challenge you to be open to changing medical perspectives and to recognize that we need to train not only competent scientists but sensitive physicians with a broader concept of social respon­ sibility that extends beyond that of simple physical disorders. Most of us will be involved in the continuing care of people helping them to solve problems of a diverse nature. We must all come to realize that the problem of good health care is not merely that of a localized disease. But it is the poverty that prevents proper clothing and nutri­ tion; to the inadequate education that delays the seeking of proper medical care; it is the social injustice that allows improper housing with lead paint on the walls and rats in the basement; it is the commercial pollution that poisons our lungs and our food; and it is the immorality of a war that maims and murders in the name of peace and justice. FALL, 1972 17 . �The Lakes Area Regional Medical Program's Telephone Lecture Network worked overtime during the lune floods. The TLN was the only means of communications for the hospitals at Wellsville, Hornell and Bath. It was also used by the VA Hospital in Bath to communicate with Washington, D. C. officials.• It is the system that assumes that the physician's primary duty is not that of keeping you well but getting you well when you are obviously ill; in which the physician is asked to rely for his livelihood on those that not only come to him sick but must pay to get well; and in which the most successful physician is he who sees the most patients, charges the highest fees, and keeps his pa­ tients sick the longest. Secondly, I would ask the faculty not to squelch but instead to direct and sustain student idealism. This idealism needs support and guidance, not sarcasm. From the first year we have periodically encountered the attitude that idealism is a dirty word. However, directed and informed idealism is the quality that generates needed change in institutions that have become static and ineffective. Many of you share our idealism, but also many of you have gone through the same dampening process as we have. We've been told to face reality and to protect ourselves in the competitive outside world. But I have come to believe more and more that man's great­ est potential and perhaps a physician's greatest responsibility is to actively create the world in which he lives and not simply be a passive interactor with fate. To my fellow graduates, I want to extend thanks for four years of friendship and increased awareness. I have been impressed not only with your ability to learn quality medicine but more, I think, with the wide range of interests held beyond the confines of the hospital. You have made me realize more than ever that a good physician is not one who simply memorizes many medical facts but who blends his knowledge with an awareness of the value of life in the broadest sense. To you I offer the challenge of radicalism. Flere I don't neces­ sarily mean protest marches and draft board raids, although I certainly wouldn't rule them out. What I mean is that none of us, as we go into whatever area or situation to use what we've learned, should accept the health care and social situation as it exists. Radicalism is the fervent discontent with the way things have been that goes beyond simple talk to action directed at changing the situation. Whether you end up in a plush suburban practice or in a free clinic in the inner city, medical care in this country must be improved and more evenly distributed, social situations must be altered, and lethal governmental policies must be elimin­ ated. No matter how good a particular situation may appear, we must remain sensitive to areas of possible improvement, especially in the quality and distribution of health care to everyone. I guess my biggest fear is that we might fall into the trap of complacency. The complacency of: "Well, it isn't that bad," or "Well, what can I do, I'm only one person?" "It might not be per­ fect, but it's better than elsewhere." How can we ever become com­ placent when in the wealthiest country in the history of the world, we are currently 13th in maternity death rates, 18th in male life expectancy, 11th in female life expectancy, and our infants die at twice the rate of the Scandinavian countries. How can we ever become complacent when the giant $12 billion dollar private health insurance industry pays only 1/3 of the total cost of private health 18 THE BUFFALO PHYSICIAN �care leaving 2/3 to be paid out of the pocket of the patient at the time of his illness and in the words of Senator Kennedy; "minor epi­ sodes of illness become heavy financial burdens and serious illness is transformed into enormous debts and even bankruptcy. Those who can pay for care find themselves priced out of the market and for millions of Americans in rural areas or inner cities, care is just not available at any price." The minute we stop searching and challenging for new and better alternatives; that moment we begin to grow old and decay. And, although awareness of t h e situation is t h e first step, w e must not stop there but we must prosecute with all our effort the changes that are necessary. The sedate acceptance that seems to pervade any long established institution certainly has not evaded the medical profession and the American Medical Association has long served as an outstanding example. So, in conclusion, my challenge is not o n e of mere question­ ing and sensitivity to the health care problems around us, but one of action; an actual direct encounter with the issues and problems involved. Don't be ready to accept the status quo and fall back into a state of self-complacency, but actively seek change in a direc­ tion of improved and equality health care in the widest sense, realizing that until all people are free of hunger, poverty, oppres­ sion, and war will we be able to say that we are satisfied.• "Dr. Randall, Fellow Members of the Faculty, Graduates, Parents and Friends . . . I must begin by thanking the students for this honor. I know of nothing that could possibly give me more pleasure or have more meaning to me than this dedication, even though I don't deserve it . . . no one person does. I believe this gesture reflects your ap­ preciation and perhaps a little affection for the Staff of the De­ partment of Pediatrics, our House Staff and Children's Hospital. I almost feel like I'm graduating again myself. My wife and children are here and so are my own parents along with yours and I'm just as nervous now as I was then . . . or perhaps even more so. I wondered then, as you are wondering now, what would become of me as a physician. How would I react with my first patient when there wouldn't be anyone around to countersign those orders? What would I do after my internship? I have a very close friend with whom I grew up. We went through high school together and then entered the same University, he in business a d m i n i s t r a t i o n a n d I, i n p r e m e d . A f t e r g r a d u a t i o n , h e w e n t o n to graduate work in accountancy and finally into his father's busi­ ness, a fairly large steel pipe industry which he soon found himself running, due to the untimely death of his father. Meanwhile, after my internship, I trained in pediatrics, then a fellowship in genetics, the last year of which was spent in London, England. Naturally, I had not yet earned a farthing of income. That year, my friend came to England on a business trip and arrived in the laboratory to visit me. After the usual tour of the department, a department FALL, 1972 19 Response to JS/ledentian Dedication by RONALD G. DAVIDSON,M.D. Professor of Pediatrics �of biochemistry by the way, he asked me to tell him what I was actually doing. So I went to the blackboard and told him all about genes, and chromosomes, and funny looking enzyme bands on starch gels, and after I finished my dissertation, he looked at me for a few seconds and said "Ronnie, what are you going to be when you grow up?" Well, in many ways I hope I never grow up, and I tell you this little story to emphasize the vast number of opportunities available to you as physicians. As each year of your training begins, regardless of what you do, you will be faced with the major decision, what next? You will worry and sweat, weigh the pros and cons, develop your post prandial and prechordial pains, but try to remember, almost all your decisions lie among a large group of good choices — there are hardly any bad ones, so do your thinking and relax. Those kinds of decisions are indeed important, but whatever you choose you will be right, and you can proceed with gusto and no real need to grow up, if growing up means that you cease to feel excited by whatever you do and that you cease enjoying your work. Dr. Davidson i If "not-growing-up" is to be my theme, let me illustrate that notion again, this time by telling you about a study comparing pedi­ atric interviewing skills of freshman and senior medical students, carried out at the University of Colorado Medical Center in Denver. They used video-taped interviews with programmed mothers — by that I mean, young women who were given a set of information about a supposed child with serious organic disease and related psychosocial problems. The aim of the study was to test the hy­ pothesis that freshmen would obtain more interpersonal and less factual information from mothers of sick children than would seniors, who would have "grown-up" in the system. The results clearly indicated that, indeed, freshmen obtained significantly more interpersonal information — like the effect of the illness on the child and the family, and they asked fewer leading questions. Seniors obtained more facts. Now that is not very startling. But let me give you an anecdote from the study. One programmed mother was supposed to have a three year old retarded child with meningomye­ locele and hydrocephalus, severe defects of the central nervous system. She was also supposed to be both three months pregnant and most concerned about the outcome of the pregnancy. Not one senior discovered those latter facts, the pregnancy and the worry, in his interview. The first freshman asked, "Are you going to have any more children?" After learning of her pregnancy, he replied, "you must be worried that you will have another baby with the same problem." Clearly the freshman knew little of organic disease and had to talk about something, but the study suggests a very worrisome possibility, that as medical students move through their training, a certain degree of their innate ability to communicate with mothers of sick children, and, of course, with patients in general, is programmed out of them by the desire to obtain factual information. So don't "grow up," if it means to lose your com­ passion for the family in your haste to solve the most immediate, the most apparent, medical problem. 20 THE BUFFALO PHYSICIAN �Finally, a subject that must surely be covered in every talk to every graduating class: how little you know today, how much more there is for you to learn, how important it is for you to con­ tinue your medical education. The problem is how. I certainly don't know the answer to that one and I am sure you will find ways to d o this. I mention the problem, although it is almost cliche, perhaps to justify some of the gadgetry; the TV, com­ puters, sound/slide lectures and so on, that you have used in p e d i a t r i c s a n d i n o t h e r d e p a r t m e n t s . D o n ' t s t o p u s i n g t h e m . If you are practicing near a center where these teaching aids are available, keep at them. While you are waiting for that baby to appear at three o'clock in the morning, run through a tape on "what's new with resuscitation of the newborn," or whatever else you feel you need to review at that moment. I don't mean to imply that programmed learning is the answer to continuing med­ ical education, but it certainly can be helpful, especially with the developing techniques for immediate self-evaluation and identifica­ tion of various areas of weakness. Don't "grow up" to be so sophisticated that only a week of high-powered lectures at Harvard, or Hopkins or Buffalo is your only form of graduate education. Lest you think that all my thoughts are with the graduates today, let me add a final word of advice to the rest of the assemblage: as we proudly watch these young and eager physicians take up their internship posts and await that first patient of their very own, I suggest to you, parents and friends, here and across the country, t h a t if a t a l l p o s s i b l e , if t h e r e ' s a n y t h i n g y o u c a n d o t o a v o i d i t , don't get sick in July!"• "Today it is my privilege to express to each of you the congratu­ l a t i o n s a n d t h e b e s t w i s h e s e a c h o f t h e F a c u l t y w o u l d e x p r e s s if there was opportunity now for each of us to shake the hand of each of you. As unreasonable and as questionable as you may have con­ sidered us to be at times, from here on the road widens rapidly, and the freedom of choice is yours. While w e of the faculty will, for the most part, return to virtual repetition of the course again next year, your horizons now appear as electives, virtually un­ limited. We realize that to date, your road has been long and not easy, but we can assure you that the life of the profession provides opportunity for many satisfactions, satisfactions that will always be yours to appreciate and even more often, will be satisfactions you can bring to others. Today, perhaps more than before, all of us recognize the generation gap. Today, however, I will wager most of you see t h a t g a p i n t h e y e a r s a h e a d , b u t I'll w a g e r a l s o , t h a t b y t o m o r r o w you will become conscious of the gap that is widening behind you. Very soon yours will be the dual task of not only continuing to learn, yours will also be the responsibility of attracting, by your interest and example, ever younger generations to the studies, the practices and the arts we call medicine. FALL, 1972 21 More Responsible Health Care by CLYDE L. RANDALL, M.D. Acting Dean, School of Medicine Professor of Gynecology-Obstetrics �Interesting and satisfying as we believe our profession to be, today we shall recognize but not belabor, the deflated prestige we carry into today's political and social arena. Today even the medical establishment recognizes that for too long American medicine has considered that the health needs o f o u r p e o p l e w o u l d b e p r o v i d e d f o r , if t h e d o c t o r w a s f r e e to develop his own knowledge and skills, was free to make his abilities available to those who would seek his services, and, the c i t i z e n , p a t i e n t - c o n s u m e r , if y o u w i l l — w a s f r e e t o c o n s u l t a n d be cared for by the physician of his or her choice. In a day when virtually all physicians might have been considered about equally competent to recognize the cause of virtually any disease or disability the patient might evidence, such a one-to-one system would in all probability have been considered satisfactory by most of the people who were in need of health care. Today, however, we are facing stark realities and the deficien­ cies of what our critics like to refer to as our non-system of health care. We can resort to oversimplification and admit that our pres­ ent critical shortages of health manpower are largely the result of the fact that our health professionals, physicians, dentists, nurses — all of us, have been pretty free to obtain the amount and type of special training we have wanted, in order to be able to practice where we want to, and how we want to, with relatively little consideration being given to where those services are in short supply and most needed. Today one frequently hears current conviction that the public w o u l d b e p r o v i d e d w i t h i m p r o v e d h e a l t h c a r e if w e g r e a t l y d e c r e a s e the number of specialists and greatly increase the number of socalled primary family physicians, but this change alone would not be likely to solve large parts of the problem we all share. The well intended physician who develops a possessive interest in the care of individual patients can all too easily convince both himself and his patient that he is quite capable of handling the problem. Robert Folman, Stanton Schiller, Stuart Rubin �.. This degree of interest and willingness on the part of the physician can result in the failure of a patient to benefit from the best treat­ ment for his or her disease that is readily available in the com­ munity. I do not personally believe our patients or our profession would be well served by the often called for "complete overhaul" of our present system of health care, nor do I believe every physician should go into a prepaid group practice or a health maintenance organization. On the other hand, neither do I be­ lieve the physician who is satisfied with his income from an es­ tablished practice should remain unmoved and uninvolved in the profession's efforts to provide more care for many more patients than most of us have individually felt responsible for in the past. F a r b e t t e r f o r b o t h c o n s u m e r a n d p r o v i d e r if w e a c c e p t r e s p o n ­ sibility for the work that assisting personnel can d o in health teams. No improvement in the situation is likely so long as the physician insists (1) that h e cannot relegate his responsibilities t o a system and (2) that h e is caring for as many patients as h e can personally b e r e s p o n s i b l e f o r . If m a n y o f u s t a k e t h a t a t t i t u d e , c u r r e n t d e m a n d s for more health care particularly in thinly populated rural areas and in the overly populated areas of the inner city, seem certain to result in legislation that will establish several degrees or types of assisting health personnel as licensed, independent practitioners said to be capable of providing for a portion of the health needs of our population. To protect all of us from the ambition and even the good intentions of independently practicing but only partially educated allied health professionals, the medical, dental and nursing pro­ fessions must insist upon standards established as a result of gener­ ations of experience in the responsibilities for health care. This job is a big o n e and as w e assure you of our congratulations and best wishes, we can also assure you that your interest and your efforts will be appreciated."• Dr. Michael Sullivan Honored A slide presentation of works of art in medicine was the highlight of Dr. John Talbott's talk before the Buffalo Academy of Medicine. The dinner honored out-going president Dr. Michael A. Sullivan, M'53. In the audience of 100 were many former students of Dr. Talbott. He was co-chairman of the department of medicine at the Medical School and head of the same department at the Buffalo General Hospital from 1946-59. Reproductions of many of the art works shown in the slides appeared on covers of the Journal of the American Medical Associa­ tion which Dr. Talbott edited when he left Buffalo. He is now edi­ tor emeritus of the journal and a clinical professor of medicine at the University of Miami, Florida. He also edits his own journal, Seminars in Arthritis and Rheumatism.• FALL, 1972 23 Robert DiBianco, Dr. Cummiskey �7 Faculty Members Serve 243 Years OEVEN RETIRING medical faculty members from the University — six volunteer part-time and one full-time - with a combined total university service of over 243 years — were honored at the Annual Medical School Faculty meeting, May 19 in the Faculty Club. The retirees, who officially will be ending their university careers on August 31, are Dr. Max Cheplove (clinical associate professor of family practice in the department of social and preventive medicine and clinical associate in medicine); Dr. Francis J. Gustina (clinical associate professor of pediatrics); Dr. Milton Kahn (clinical assistant professor of gynecology-obstetrics); Dr. Niels C. Klendshoj (clinical professor of toxicology in the department of legal medicine); Dr. Harry G. LaForge (clinical professor of gynecology-obstetrics); Dr. Werner J. Rose (clinical assistant professor of medicine); and Dr. Mitchell I. Rubin (professor and former chairman of pediatrics). Dr. Cheplove, educated in Buffalo (BS 1922, MD 1926 UB), began in 1954 as an assistant in medicine. The 70-year old family practitioner has served and held offices in many county, state, and national medical organizations. He has been president of the Erie County Medical Society, the county and state chapters of the As­ sociation of American General Practitioners, and the Association of Participating Fund for Medical Education. A pediatrician, Dr. Francis J. Gustina, following his graduation from UB medical school in 1925 and graduate training at the Buffalo City Hospital and St. Fouis Children's Hospital, in 1928 joined the university staff as a resident hospital instructor in pediatrics. A year earlier he started to instruct in the nurse training school at Buffalo City Hospital. Among his memberships are many city, state, and county medical associations. The 71-year old physician was the first resident in pediatrics at the E. J. Meyer Memorial Hospital, then headed the department he literally created, and later became chief consulting pediatrician. Dr. Milton Kahn, gynecologist, obstetrician, is Buffalo-born and educated. He received his medical degree in 1925 from UB, completed an internship and residency at the Buffalo General Hos­ pital from 1925-27 and continued postgraduate studies in Europe. He joined the faculty in 1929 as an assistant in gynecology and was also an assistant to the late Dr. James E. King. The 70-year old alumnus is a Diplomate of the American Board of Obstetrics and Gynecology and was the first clinician at the Planned Parent­ hood Center in 1933. He has published in his field and has served as president of the Buffalo Ob/Gyn Society (1959) and holds memberships in other city, state, and national medical associations. He holds staff positions in Ob/Gyn at the Buffalo General, Chil­ dren's, Deaconess, and Millard Fillmore Hospitals. Dr. Niels C. Klendshoj, a Danish-born scientist, entered medi­ cine by accident. While the chemical engineering graduate from the University of Copenhagen (1926) visited friends in Buffalo, he took a temporary job with a small pharmaceutical concern, the Arner 24 THE BUFFALO PHYSICIAN �Company. He ended up in its research department and attended medical school conjointly, graduating from UB in 1937. There was much collaborative effort with Dr. Ernest Witebsky, the late dis­ tinguished professor of bacteriology and immunology and many publications resulted. In 1941 he was honored as coisolator of the B-blood complex, considered a major step in making modern blood transfusions safe and practicable. In 1941 he became assistant in medicine at the University. Gynecologist and obstetrician, Dr. Harry G. LaForge, in 1937 became assistant in pharmacology. Also Buffalo-born and educated (PhG 1923, MD 1934 UB, and residency at Buffalo General and E. J. Meyer Memorial Hospitals), he served as president of the soph­ omore, junior and senior years at Medical School. A Diplomate of the National Board of Medical Examiners, Founding Fellow of the American College of Surgeons and of the executive committee, As­ sociation of Participating Fund for Medical Education, he also holds memberships in many city, county, state, and national organiza­ tions. He has served as president of the Buffalo Chapter of the American College of Surgeons, the Buffalo Ob/Gyn Society and the UB Alumni Association. In 1961 he received the Samuel Paul Capen Alumni Award. In 1944 he established student loan fund for medical/pharmacy students. Four years later he established a research fund at the Buffalo General Hospital where he has been past president of its medical board. The 70-year old physician served as a member of the UB Council for 12 years prior to its merger with the State University in 1962. Cardiologist Werner J. Rose was born in Hamburg and edu­ cated in Buffalo. Following two years of premedical education at Canisius College where he won the Pasteur gold medal for highest honors, he completed his medical education at UB (MD 1926 and residency at the Buffalo General and Meyer Hospitals). In 1927 he was appointed an assistant in medicine at the University. The 70year old vice president for medical affairs at International Life Insurance Company feels that he had opportunities that are not available today. He served as a student assistant to physiologist Frank Hartman who performed the first experiments leading to the discovery of cortisone and with pathologist Anton Ghon, discover­ er of the Ghon Tubercle Lesion. With clinical training in cardiology and a fellowship in pathology, he continued postgraduate training with Dr. Samuel Levin at Army Base Hospital (23rd) during World War II. Dr. Rose saw service in Africa, Italy, and France and out of 32,000 patients treated at the 23rd Army General Hospital there were only two deaths from TB meningitis, three from infectious hepatitis, one from meningitis septisemia, and one from Hodgkin's Disease. Penicillin had just been introduced. He was also the last Fellow to study under pathologist Benjamin Roman. To earn his keep he performed postmortems at Buffalo General, Children's, Marine, State and Emergency Hospitals plus clinical pathology duties. Private physician to John J. Albright he lived for a time in the Albright Mansion in Buffalo and while he took care of Ansley Wilcox recalls that he slept in the Theodore Roosevelt Room at the Wilcox Mansion> FALL, 1972 25 The Telephone Lecture Network begins its third year Tuesday, Sept. 72 with a special program for physicians. It will be beamed into 40 hospitals in Western New York and Pennsylvania at 11:30 a.m. On the third Tuesday of ev­ ery month (11:30-12:30) Dr. Harry Alvis, clinical associate professor of social and preventive medicine, will moderate a series of physician programs direct from Millard Fill­ more Hospital. There will also be a special "breakfast hour" pro­ gram beginning October 5 and continuing on the first Thursday of every month. These programs are sponsored by the Lakes Area Regional Medical Program.D �Dr. Mitchell I. Rubin, pediatrician, joined the University staff in 1945 as professor and head of the department of pediatrics and as pediatrician-in-chief of the Buffalo Children's Hospital. For the past five years, following his resignation of the above positions in 1967, he has continued as professor of pediatrics. A prolific author and productive researcher in pediatrics, Dr. Rubin has dedi­ cated more than 45 years of his life to teaching and to patient care. He has also served as an advisor to the National Kidney Foundation and the Children's Bureau of the Department of Health, Education and Welfare among other health organizations. This semester, Dr. Rubin has been on sabbatical in England.• 79 Residents, 49 Interns Receive Diplomas Diplomas were granted to 79 residents and 49 interns who have completed their specialty training at University affiliated hospitals — Buffalo General, Children's, E. J. Meyer Memorial, and Veterans. Chairing the University Residency Program Committee is Dr. Wil­ liam J. Staubitz, professor of surgery/urology. GYN ECOLOGY/OBSTETRICS Residents — Drs. Marcos B. Gallego, Myrna T. Solis Gallego, Mi Yong Kim, Jongsook Park GYN ECOLOGY/OBSTETRICS and MEDICINE Internship - Drs. John M. Antkowiak, William P. Dillon MEDICINE Residents - Drs. Richard D. Antal, Donald P. Copley, Dennis P. DuBois, Stephen A. Katz, Anthony Kulczycki, John Q. A. Mattern, Jeffrey L. Miller, John R. Molinaro, Thomas A. O'Connor, Carl A. Perlino, Douglas L. Roberts, Joseph J. Ryan, Peter R. Stahl, Ronald W. Zmyslinski Cardiology — Drs. John L. Carrigan, Joseph W. Cervi Gastroenterology — Dr. George E. Davis Medical Otolaryngology — Dr. Stephen X. Giunta Renology — Dr. Hossein L. Keyvan Internship/Residency - Dr. Edward H. Wagner Internships _ Drs. Micha Abeles, Michael A. Arcuri, James A. Brennan, Gabriel E. Chouchani, Kenneth J. Clark, Philip Compeau, John C. Daimler, Lawrence J. DeAngelis, David E. Hoffman, Mona S. H. Kaddis, Harry Kolodner, Stanley B. Lewin, Richard A. Manch, Martin N. Mango, Howard R. Marcus, Thomas K. Mayeda, Michael F. Miniter, Paul M. Ness, Kenneth M. Piazza, Jack A. Resnick, Warren M. Ross, Paul Schaefer, Bruce R. Sckolnick, James A. Scovil, Charles A. Stuart, Daniel R. Synkowski, Morris Tobin, James Trief, llja J. Weinrieb, Howard E. Weinstein, Robert C. Weiss, Daniel H. Yellon, Bennett G. Zier PATHOLOGY Residents — Drs. Farbood Farhi, Shaukat Nayat, M. L. Janardhana, Shamin G. Khan, Sang-Tsun Kuo, Ralph Landsberg, Anne Saldanha, Alina Wiecha 26 THE BUFFALO PHYSICIAN �PEDIATRICS Residents — Drs. Sogba K. Bosu, Ronald T. Bruni, James L. Cavalieri, Alice S. Chen, Maria Colombi, James A. Dunlop, Frank G. Emerling, Roy M. Fazendeiro, Albert B. Finch, Warren L. Gilman, Steven V. Grabiec, Sherwood B. Lee, Paul L. McCarthy, Ellen C. Moore, Cheryl C. Rosenblatt, Uma Viswanathan Internships — Drs. Thomas G. Barton, Sogba K. Bosu, James L. Cavalieri, James A. Dunlop, Frank G. Emerling, Roy M. Fazendeiro, Albert B. Finch, Warren L. Gilman, Steven V. Grabiec, Sherwood B. Lee, Paul L. McCarthy, Ellen C. Moore, Cheryl C. Rosenblatt PSYCHIATRY Residents — Drs. Martin L. Gerstenzang, Annik Mawas, Chuitataya Panpreecha, Joong Oh Rhee SURGERY Residents — Drs. Refugio Andaya, Sirous Arya, Byunghak Jin, Abdul Khan, Elias Kokkinopoulos, Pang Lay Kooi, Surendra Kumar, John LaDuca, Hyuk Lee, Shai-Yuan Liu, Leo Michalek, Martin J. Murphy, H. John Rubenstein Neurosurgery — Dr. Walter Grand Orthopaedics — Drs. Charoen Chotigavanichaya, Paul R. Danahy, Anthony L. LoGalbo, Vergilio C. Victoriano Otolaryngology — Drs. Robert J. Brown, Federico G. Doldan Thoracic/Cardiovascular — Drs. Emil A. Anaya, Gizaw Tsehai Urology — Drs. Mohammed E. Darwish, A. Reed Hoffmaster, Richard J. Saab Internship/Residency — Drs. Barry P. Berlin, James Hassett Internship — Dr. Nohra ChaoukeyCH Dr. Kenneth H. Eckhert talked about the "turmoil in our health care delivery systems and future trends" at the 5th annual awards Z7 Z, / + JLJV. LhCK,K)6YT night of the School of Health Related Professions at the University. p About 150 graduates, their families and faculty attended the con- jpeaks to tiealth vocation. "Despite the criticisms, we have the finest, most effective health care system the world has ever known. But because it grew in response to population demand it is basically a 'non-system' with problems of cost and health care distribution with obvious gaps in service that must be closed," Dr. Eckhert said. "You as members of the allied health professions, have an in­ creasing role to play in these better coordinated services." He stressed the need for hospitals in a locality such as Western New York to work as a unit and said the university will play a great part in coordinating medical knowledge, but warned against the creation of a "health czar" who would over-centralize health services. The 1935 Medical School graduate is a clinical instructor in legal, social and preventive medicine at the University. He is also a surgeon at Deaconess Hospital and chairman of the Western New York Comprehensive Health Planning Council.• FALL, 1972 27 1 jj Ti £ • J ± TOJCSStOfldlS 1 j �The count down Kenneth Lindyberg Intern Matching The Sanford Karshes "There is reason to be proud of the results of this year's National Intern and Residency Matching Program," assistant Medical School dean Thomas Cummiskey informed the obviously nervous 120 members of the graduating class (all of whom had been matched), and their families — wives and offspring. "Many of you will be working in some of the most prestigious hospitals in this country," he pointed out to the seniors who will be distributed among 23 states. The largest number (27) will enter straight medicine, followed by 16 in rotating, 15 in straight surgery, 11 in straight pediatrics. While ten will enter directly into residency programs, seven have selected family practice programs (four at Deaconess Hospital). Entering University affiliated hospitals will be 84 of the 1972 graduating class while four will intern at unaffiliated hospitals and the remaining 24 at limited ones. Three university programs filled. They are straight pediatrics at Children's Hospital (12), straight medicine (16), and rotating medicine (12) at the Buffalo General and E. J. Meyer Memorial Hos­ pitals. The straight surgery program at the Meyer received 2 of 6 requested, while 1 of 5 at the Buffalo General was filled. Thirty-nine will remain in Buffalo to complete their internship training, while more than half will remain in New York State (19 in New York City and 3 in other parts of the state). The second largest contingent of seniors will intern in Massachusetts (9) while California and Maryland will each receive 7. Two will enter Public Health Service in Boston, and one will join the Army Medical Services. Hard work on the part of the seniors, faculty effort, and out­ standing performance by previous graduating classes, Dr. Cummis­ key feels, have been the key to acceptance into the training pro­ grams regarded as real "plums." Two seniors will intern in straight medicine at Johns Hopkins, three will train at the University of Virginia (two in straight medicine and one in rotating pediatrics), and one will enter the straight pediatrics program at Los Angeles Harbor General Hospital. The national matching program attempts to match the student preference with those of hospitals throughout the nation. 28 THE BUFFALO PHYSICIAN �% V i ANDREW ABRAMS, University of Florida, Gainesville, straight surgery ALAN AST, University of Miami Affiliated Hospitals, Florida, anesthesiology RICHARD A. BERKSON, Buffalo General/Meyer Hospitals, medicine RICHARD F. BLANCHARD, Baltimore City Hospitals, Maryland, medicine HAROLD B. BOB, Wilmington Medical Center, Delaware, surgery WILLIAM J. BOMMER, Buffalo General/Meyer Hospitals, medicine BRUCE T. BOWLING, Charles S. Wilson Memorial Hospital, Johnson City, N. Y., family practice MARTIN BRECHER, Children's Hospital, Buffalo, pediatrics DAVID S. BUSCHER, Santa Barbara Cottage Hospital, California, rotating general NEIL D. CARR, University of Maryland Affiliated Hospitals, psychiatry GERALD A. CONIGLIO, 5t. loseph's Hospital, Denver, Colorado, surgery ROBERT A. COOPER, University of Maryland, Baltimore, surgery )OHN J. D'ALESSANDRO, Nassau County Medical Center/Meadowbrook, Fast Meadow, N. Y., surgery ROBERT DIBIANCO, Buffalo General/Meyer Hospitals, straight medicine RICHARD O. DOLINAR, Buffalo General/Meyer Hospitals, rotating medicine PATRICIA K. DUFFNER, Children's Hospital, Buffalo, straight pediatrics LARRY ECKSTEIN, Public Health Service, Boston, Massachusetts, rotating general ROBERT EINHORN, N. Y. Medical College - Metropolitan Hospital, New York City, radiology residency RUSSELL ELWELL, Deaconess Hospital, Buffalo, rotating general T h e Gary Lyman family ARNOLD S. FABRICANT, Maricopa County General, Phoenix, Arizona, straight surgery DAVID FASCITELLI, Mount Auburn Hospital, Cambridge, Massachusetts, rotating general ROBERT FIALKOW, Talmadge Memorial Hospital, Augusta, Georgia, straight medicine ROBERT FOLMAN, Buffalo General/Meyer Hospitals, rotating medicine IAN M. FRANKFORT, Deaconess Hospital, Buffalo, family practice ALAN G. GASNER, Buffalo General/ Meyer Hospitals, rotating medicine RICHARD S. GOLDMAN, Buffalo General/ Meyer Hospitals, straight medicine MICHAEL GORDON, Washington Hospital Center, Washington, D. C., rotating general STUART GREENE, Washington Hospital Center, Washington, D. C., rotating general DENNIS R. GROSS, University of Miami Affiliated Hospitals, Florida, straight pediatrics JERRY HAMM, Medical College of Virginia, Richmond, rotating surgery VIRGINIA F. HAWLEY, Good Samaritan Hospital, Portland, Oregon, rotating general MARTIN T. HOFFMAN, Children's Hospital, Buffalo, straight pediatrics SANFORD J. HOLLAND, The Brookdale Hospital Center, Brooklyn, New York, rotating anesthesiology FREDERICK S. HUST, University of Virginia, Charlottesville, straight medicine ISMIL ISMAEL, Buffalo General/Meyer Hospitals, rotating medicine DAVID L. JOHNSON, Deaconess Hospital, Buffalo, family practice LINDA A. KAM, University Hospitals, Columbus, Ohio, straight pediatrics ANDREW J. KANE, Deaconess Hospital, Buffalo, family practice SANFORD KARSH, Long Island Jewish Medical Center, New Hyde Park, New York, straight medicine ROSS S. KENDALL, St. Christopher's Hospital for Children, Philadelphia, straight pediatrics MARK KISHEL, Boston City Hospital, Massachusetts, straight pediatrics ROBERT KLAW, Metropolitan Hospital Center, New York City, straight medicine STANLEY KLUGHAUPT, Beth Israel Hospital, New York City, internal medicine residency JOHN E. KNIPP, Hahnemann Hospital, Philadelphia, straight medicine GEORGE KOTLEWSKI, E. J. Meyer Hospital, Buffalo, rotating medicine KONRAD P. KOTRADY, University of Utah Affiliated Hospitals, Salt Lake City, family practice ARETA O. KOWAL, University of Iowa Hospital, straight pediatrics JOHN W. KRAUS, Johns Hopkins Hospital, Baltimore, straight medicine ROBERT KROOPNICK, Sinai Hospital, Baltimore, straight medicine PAUL S. KRUGER, Children's Hospital, Buffalo, ob/gyn rotating ROBERT A. KUWIK, Mount Auburn, Cambridge, Massachusetts, rotating medicine FALL, 1972 29 Paul V i l a r d i �I THOMAS J. LAWLEY, Buffalo General/Meyer Hospitals, rotating general MARC J. LEITNER, L.A. County-Harbor General, California, straight pediatrics WILLIAM D. LEVIN, Medical Center of Vermont, Burlington, straight surgery STEPHEN J. LEVINE, Buffalo General/Meyer Hospitals, rotating medicine JOANNE E. LEVITAN, Indiana University Medical Center, Indianapolis, straight surgery ROBERT H. LEVITT, Washington Hospital Center, Washington, D. C., general rotating LESTER J. LIFTON, Buffalo General/Meyer Hospitals, straight medicine KENNETH R. LINDYBERG, Letterman General Hospital, San Francisco, rotating surgery GEORGE LOHMANN, JR., Chicago Wesley Memorial Hospital, Illinois, straight surgery GEORGE LUNDGREN, Buffalo General/Meyer Hospitals, general rotating GARY H. LYMAN, North Carolina Memorial Hospital, Chapel Hill, straight medicine The lohn Krauses ALAN MANDELBERG, Buffalo General/Meyer Hospitals, rotating medicine JOSEPH A. MANNO III, St. Vincent's Hospital, New York City, ophthalmology residency IRA L. MINTZER, Boston City Hospital, Massachusetts, medicine MURRAY A. MORPHY, E. J. Meyer Memorial Hospital, Buffalo, psychiatry residency CHARLES A. MOSS, Maricopa County General Hospital, Phoenix, Arizona, rotating general PHILIP C. MOUDY, Buffalo General/Meyer Hospitals, rotating general WILLIAM T. MURRAY, Buffalo General/Meyer Hospitals, straight medicine DENNIS NATALE, Montefiore Hospital and Medical Center, New York City, straight surgery GEORGE C. NEWMAN, JR., University of Virginia Hospitals, Charlottesville, straight medicine STEPHEN M. NEWMAN, Meadowbrook Hospital, East Meadow, New York, rotating medicine CHRISTOPHER N. NOELL, University of Virginia Hospitals, Charlottesville, rotating pediatrics JOSEPH J. OLIVER, Millard Fillmore Hospital, Buffalo, straight surgery Dr. Cummiskey STEPHEN I. PELTON, Boston City Hospital, Massachusetts, straight pediatrics JEFFREY S. PERCHICK, Montefiore Hospital, Pittsburgh, straight medicine LAWRENCE S. POHL, Washington Hospital Medical Center, Washington, D. C., rotating general RICHARD W. POHL, Nassau County Medical C.enter-Meadowbrook, East Meadow, New York, straight pediatrics JEROME C. PORRETTA, Rochester General Hospital, New York, straight medicine GLENN L. POST, Cedars Sinai Medical Center, Los Angeles, rotating medicine KAREN A. PRICE, Grady Memorial Hospital, Atlanta, rotating anesthesiology KENNETH C. RICKLER, Veteran's Administration Hospital, Los Angeles, straight medicine RICHARD J. RIVERS, Buffalo General/Meyer Hospitals, straight medicine STEVEN J. ROSANSKY, Maimonides Hospital, Brooklyn, New York, rotating medicine GEORGE M. ROSENFELD, St. Joseph's Hospital-Upstate Medical Center, Syracuse, New York, family practice JAMES ROSOKOFF, St. Francis Hospital, Hartford, Connecticut, rotating general STUART RUBIN, Deaconess Hospital, Buffalo, family practice NOEL SALEM, Public Health Hospital, Boston, Massachusetts, rotating general EDWIN A. SALSITZ, Beth Israel Hospital, New York City, ob/gyn residency RICHARD A. SAVAGE, Cleveland Clinic, Ohio, pathology STANTON R. SCHILLER, St. Louis University Hospitals, Missouri, straight surgery LAWRENCE H. SCHREIBER, University of New Mexico Affiliated Hospitals, Albuquerque, rotating pediatrics PAUL A. SELIGMAN, Buffalo General/Meyer Memorial Hospitals, rotating medicine MICHAEL J. SHREEFTER, Berkshire Medical Center, Vermont, rotating general ARTHUR L. SIEGEL, Long Island Jewish Medical Center, New Hyde Park, New York, rotating general ANDREW SILVERMAN, University of Michigan Affiliated Hospitals, Ann Arbor, straight ob/gyn ANITA SILVERMAN, Millard Fillmore Hospital, Buffalo, general rotating DAVID SILVERSTEIN, Buffalo General/Meyer Hospitals, rotating medicine JAMES A. SINGER, Buffalo General/Meyer Hospitals, straight medicine CRAIG R. SMITH, Johns Hopkins Hospital, Baltimore, Maryland, straight medicine PAUL J. STECKMEYER, 30 THE BUFFALO PHYSICIAN �Stephen Pelton, Mr. & Mrs. Martin Hoffman The Frederick Hust family LEWIS STERN, Medical College of Virginia, Richmond, rotating medicine )ACK J. STERNBERG, Mt. Sinai Hospital, Cleveland, Ohio, straight medicine LEONARD STRICHMAN, Bronx Municipal Hospital Center, New York, straight surgery RICHARD L. SYLVAN, Baltimore City Hospitals, Maryland, straight medicine STUART R. TOLEDANO, Montefiore Hospital and Medical Center, Bronx, New York, straight pediatrics EUGENE R. TONER, Millard Fillmore Hospital, Buffalo, straight surgery JOSEPH E. TRIPI, Presbyterian Hospital, New York City, straight surgery STEVEN B. TUCKER, Buffalo General/Meyer Hospitals, straight medicine PAUL J. VILARDI, Mercy Hospital Medical Center, San Diego, California, rotating general WILLIAM T. WALLENS, Buffalo General/Meyer Hospitals, straight medicine RICHARD N. WARNOCK, Millard Fillmore Hospital, Buffalo, straight surgery JAMES T. WEBBER, University of Miami Affiliated Hospitals, Miami, Florida, rotating pediatrics HAROLD J. WEINSTEIN, Cincinnati General Hospital, Ohio, rotating general STEPHEN W. WELK, Buffalo General/Meyer Hospitals, rotating general KENNETH R. WILKES, Nassau County Medical Center-Meadowbrook Hospital, East Meadow, New York, psychiatry residency BYRON J. WITTLIN, Los Angeles County-USC Medical Center, California, psychiatry rotating JOHN W. ZAMARRA, Buffalo General/Meyer Hospitals, straight medicine LAWRENCE ZEROLNICK, Long Island jewish Medical Center, New Hyde Park, New York, rotating general MARK J. ZLOTLOW, Springfield Hospital, Massachusetts, straight pediatricsO FALL, 1972 31 �Back Row: John V. Walsh, William F. White, John Ambrusko, Rose M. Lenahan, George F. Koepf, Charles F. Banas, Soil Good­ man, Francis E Ehret, Niels Klendshoj. Front Row: Samuel A. Dispenza, Joseph M. Mele, Samuel Sanes, Augustus J. Tranella, David H. Weintraub, Charles R. Borzilleri, Jr., William L. Ball. Dr. Sanes Compares the 1937, 1972 Classes Dr. David Weintraub, clinical profes­ sor of pediatrics, arranged the alum­ ni reunion dinner program. Dr. Charles Borzilleri, jr., chaired the din­ ner. In the Class of 1933, 48 out of 60 are still living; 27 practice in West­ ern New York. Eighteen are general practitioners. Seven out of 120 in the Class of 1972 will intern in family practice. This is a summary of Dr. Samuel Sanes' address. "Incredible" must have been the response of physician alumni to Dr. Samuel Sanes' statistics on the graduating class of 1937 and that of its 35-year successor (1972). When the former professor of pathology, who retired last summer following 40 years of teach­ ing, pointed to an attrition rate of about 38 percent in the 1937 graduating class to that of a zero comparison in this year's class, their expression must have turned to one of disbelief. But these are the facts painstakingly researched by Dr. Sanes. In 1937, 47 graduated out of a 77-freshman class compared to 120 in 1972. Over three quarters of the entering class in 1933 came from the eight-county region of Western New York as com­ pared to only 49 out of 120 graduating in 1972. The graduating class in 1937 included advanced standing students as well as repeats — a total of 60. But in the senior class of 1972 there were no dropouts or repeats following admission. All 104 seniors who were originally admitted as freshmen, plus transfer students with advanced standing, graduated. Changes in admissions procedures in Buffalo during the early forties, pointed out Dr. Sanes who graduated from the Medical School cum laude in 1930, were triggered by AMA (committee on medical education) recommendations for establishment of an ad­ missions committee in Buffalo to work as an autonomous unit outside of the dean's office. Dr. Oliver P. Jones was its first chair­ man. 32 THE BUFFALO PHYSICIAN �Of the 73 men and four women admitted in 1933, few were married. These few were "older" returnees to school who had worked for a few years; one had become a mother. There were no additional marriages during the next four years. In 1968 the ratio of nine married out of a class of 104 freshmen skyrocketed by the senior year to more than half the class (64). While Capen Hall construction in 1953 permitted accommo­ dation for 100 freshmen, budgetary restrictions limited class size to 80. But in 1962 UB, a private university, merged with the State University system. Albany called for a minimum freshman medical class of 100. In 1968 the 104 admittees — 96 men and 8 women — who graduated this year filled the request. However in 1971, 120 students were admitted (35 were women, blacks and third world). This fall (1972) the number of freshmen will increase by 15, to 135 places to be filled from about 4,300 applications. This is 2,500 more than a year ago. And nationally there are 34,000 applicants for 13,000 openings in 108 medical schools. Some of this increase is due to participation by med­ ical schools in a central clearing house that processes applica­ tions and sends them to as many schools as an applicant wishes. This national picture reveals that three-quarters of the minority applicants (women, blacks, third world) were accepted as compared to only 40 percent of all those applying to medical schools. Few in 1933 applied for financial assistance to defray the $500 annual tuition for medical students. However, a good many medical freshmen in 1971 — New York State residents — who paid $1,200 for tuition, received financial aid of some sort. For students from families earning less than $20,000 taxable income, there is a tuition decrease through a scholar incentive program. Regents scholarships also provide from $350 to $1,000 a year for up to four years of study based on income. Regents scholarship awards based on competitive exams range from $1000 to $4000 and depend on need. They may be held for up to four years. Winners commit themselves to serve nine months as physicians in a designated medical shortage area for each year's scholarship. Certain New York State counties finance medical educa­ tion without exams on commitment of subsidized students to serve in the county. Annual tuition however for this year's entering class will rise to $1,500 for N. Y. S. residents. Back in the thirties there were practically no hospital or medi­ cally connected opportunities for the medical student through financially assisted summer fellowships, etc. Spare time meant hunting for a job, from selling to construction, to earn sufficent money to help pay for medical education. One look at today's bulletin boards reveals a large choice of financial opportunities for the medical student especially over the summer where fellowships offer anywhere from $500 to $1,000 for an eight to ten week research or clinical experience in whatever area interests the student to $750 for ten weeks at an urban teach­ ing hospital for Fellows who will work from 8 to 5 with minimal night work plus room and board for singles. One freshman worked as an orderly in a hospital for $115 a week. FALL, 1972 33 �There are also public health opportunities vying with $85 a week for a ten-to-12 week period plus a reasonable charge for room and board. "Myasthenia gravis" offers $900, and the Ameri­ can College of Radiology $800 to first and second years students for an eight-week stint. Internships? In 1937 it was up to the senior to arrange one. Most internship experiences were of a rotating type. Today the student receives advice and counsel from the assistant dean for student affairs. And the National Intern Matching Program (in which the Medical School participates) attempts to match student interest with those of hospitals. Increasing numbers of straight internships have been offered and accepted. Also internships today are not required for certain specialties such as pathology. And a motion to abolish the internship period altogether will be voted upon at the Fall AAMC meeting. In 1937 at the Medical School's teaching hospitals there was no salary for an intern at the Buffalo General Hospital. However the "Learning" servant did receive room and board plus uniforms but little in the way of organized teaching. Residents at the Chil­ dren's Hospital earned from $300 to $900 a year plus room and board. And at the E. J. Meyer Memorial Hospital interns were paid $750 with no room and board. They were on call every other night and had to buy their own uniforms. Today, through the University Internship Program in Buffalo, Meyer (as well as other teaching hospitals) interns receive $9,500. Fringe benefits cover full Blue Cross/Blue Shield coverage for in­ tern and family, malpractice liability insurance, free uniforms and laundry service for same, on call every third night (hot meal served), and two weeks paid vacation. For residents there is $10,000 plus $500 for each additional year, and all of the above fringe benefits. Dr. L. Maxwell Lockie, M'29, clinical professor of medicine, was among five to receive Distinguished Alumni Awards in May. Dr. Lockie has been on the Medical School faculty since 7 932.• In 1933 a medical student went to school "to learn all the facts of medicine." There was no questioning the authority of the dean or the faculty for little or no satisfaction could be gained from these strict disciplinarians. There was no time or interest for "social" awareness. Today this contrasts with a student voice in policy, management and disciplinary actions at the University as well as student input into search committees for a new medical school dean and vice president for health sciences. The curriculum, back in 1933, was a prescribed, rigidly struc­ tured all-inclusive one that demanded a minimum 80 percent class attendance. Exams were either essay, oral or practical and students received either letter or numerical grades. But over the last few years the curriculum features a core and track curriculum with elective courses. Clinical instruction starts in the freshman year. It is flexible with an all-elective senior year. Students take courses in other schools both in the U. S. and abroad. Vacations can be arranged at the convenience of the student. One can take anywhere from three and a half years to more than four to complete medical school. Exams are chiefly multiple choice or objective types. Grades are no longer numerical or letter'type but range from satisfactory/ unsatisfactory to pass/fail. 34 THE BUFFALO PHYSICIAN �Class of 1922 at Spring Clinical Days Franklin T. Clark; Lynn Rumbold; Carl S. Benson; Irwin M. Walker The student attitude in 1933 of "fear" due to faculty and peer review has now changed to one of confidence that once you are accepted graduation is almost assured. Back in 1937 tuition accounted for over 103 percent of the Medical School's operating budget of $165,137.90. This sum equaled the dean's office budget for 1970-71. In 1971 tuition was only six percent of the total operating budget allocated by the State to the Medical School, $5,930,000. Sponsored research however was set at an equal sum, while in 1933-37 it was minimal. Annual salaries then ranged from $4,941 for a senior professor and depart­ ment head to $1,750 for a fulltime instructor. However their off­ spring were entitled to free tuition at the University as well as part payment at certain other schools. Today a fulltime instructor receives a minimum of $12,000 while a department head gets a minimum of $28,000 with fringe benefits such as pension, medical and hospital benefits. In the thirties all research was in the basic sciences; most supported from the medical school's own budget. There were only 18 full-time teachers in the basic sciences located at the School, as well as 200 outside part-time paid and volunteer teachers. There was no clinical full-time faculty except for a professor of military sciences and tactics detailed by the Surgeon General of the U. S. Army. This contrasts to 280 full-time basic sciences and clinical faculty and 1,232 volunteers in 1972. In the early thirties, when a student took pharmacology, there were no sulfa drugs or antibiotics to learn about for ordinary in­ fections, no drug/chemical/hormonal prescriptions for tuberculosis and cancer including leukemia. In Public Health there were no vaccinations for polio, measles, mumps or rubella. In Internal Medicine there were no functional tests such as PBI, radioactive (Cont'd on page 38) FALL, 1972 35 �University Health Service Maureen O'l and Allie Frej Dr. Hoffman counsels a student. The University Health Service offers a wide range of free medical services. Dr. Paul F. Hoffman, medical director since 1962, points with pride to the more than 40,000 visits by the University family — students, faculty, staff annually. "We have 70 full and part time professionals, some of whom are on call 24 hours a day. These include physicians, dentists, nurses, psychiatrists and clerical per­ Dr. John Benny, staff a student. physician, examines Dr. Marie Kunz, an allergist, discusses problem with a student. a sonnel. "On a very busy day we may have upwards of 250 people visit the Health Service. Only one out of every 10 are referred to local physicians and hospitals for further treatment. Most students seek treatment for common diseases such as respiratory infections, mononucleosis, gastro-intestinal disorders, and strains or sprains," Dr. Hoffman said. The Health Service maintains both inpatient (28 beds) and out­ patient departments and five special clinics — allergy, dental, immunization, ob/gyn, and psychiatric. Other services include lab­ oratory tests, first aid, preventive medicine, consultant-referral, personal health evaluation, treatment and diagnostic procedures, en­ vironmental health and safety, and health education. Dr. Hoffman and Dr. M. Luther Musselman, assistant director, both clinical associate professors of medicine in Student Health, head a staff of five full time and eleven part time physicians. "We are interested in maintaining a state of optimum health (physical and emotional) in the University family and at the same time instilling proper attitudes and habits of personal and commun­ ity health. Another main objective is to promote environmental conditions conducive to health, safety and learning, through the THE BUFFALO PHYSICIAN i �Irien, student social worker, Dr. Lloyd Clarke, chief of psychiatry, kman, director of social workers, have an informal conference. Dr. George Coldfarb, director of the student health dental clinic, explains the X-rays to his patient and a dental student. Environmental health and safety are the responsibilities of Mr. Robert E. Hunt. He is reviewing plans for play­ ground and equipment for Day Care Center submitted by students of the School of Architectural and Environ­ mental Design. Mr. Hunt is a clinical assistant professor of social and pre­ ventive medicine. Dr. Musselman talks to a student-patient. department of Environmental Health and Safety (administratively a part of Operations and Systems). The Center, located in the basement and first two floors of Michael Hall, is open to all students. There is no compulsory health fee and no health service charges for services or medication. There may be charges for services or supplies provided by off-campus facilities. "Trying to provide excellent medical care with a limited budget and rigid operational procedures is our biggest frustration. We need more money not only for staff but for equipment and facili­ ties. At this time there is no guarantee that we will have new facilities on the Amherst campus, Dr. Hoffman said.D FALL, 1972 37 �DR. SANES (Cont'd from page 35) isotopes, and enzyme determinations. There were no antithyroid and hypertensive drugs. Nor was there cardiac surgery, monitoring, recovery room, intensive care unit, blood bank, etc. And there were no prepaid medical plans for patients such as Blue Cross/Blue Shield, Medicare or Medicaid. In 1937 the Medical School was part of a private university and, except for ties to the Dental School (it shared the same dean, Dr. Edward Koch, who also headed pharmacology and therapeutics) it was relatively independent. Its first assistant dean, Dr. Elmer Heath, was appointed two years earlier. Today, aside from a vice president of health sciences who at present is also acting dean of the School of Medicine, there is an associate dean, an assistant dean, as well as a part-time assistant dean for admissions. In addi­ tion to that in medicine, teaching is done on the graduate level and in health sciences programs such as dentistry, nursing, and health related professions. As part of the State University system, the Medical School is now subject to decisions handed down by Albany, its governor, the legislature, Board of Regents, as well as public pressure. It is one of five units (dentistry, pharmacy, nursing, health related pro­ fessions, medicine) in the Health Sciences complex. Social habits have also changed. From the occasional drink, usually a beer in 1937, a recent Medical School (Buffalo included) survey revealed that 44 percent of the students responding smoke marijuana. Nine out of ten "drink" regularly. Changes in sex education are just as startling. From one moral­ istic lecture on sex given by the professor of dermatology and syphilology, there is now an elective course on human sexuality that is well attended. Today there are courses offered on health prob­ lems in the inner city and in one of the University's experimental colleges, College A, plans are underway for courses in change of the health care delivery system, new roles in health services and personnel, etc. Students are welcome to serve on a committee for delivery Dr. A. H. Aaron, M'12, (right) received the 22nd Samuel P. Capen award for "contributing and influencing the growth and improvement of the Univer­ sity." He is a Buffalo physician and emeritus professor of medi­ cine, known for his work in gastroenterology. Pictured with Dr. Aaron is Mr. Whitworth Ferguson, Sr., (left) president of the Ferguson Electric Construc­ tion Company, winner of the UB Chancellor's medal and Mr. Wells Knibloe (center), chair­ man of the awards committee of the General Alumni Associa­ tion.• �of health care to the Attica Correctional Facility. In recent years such speakers as Dr. William H. Masters of the Masters and Johnson team, and Dr. Eugene Schoenfeld who runs a syndicated column titled Dear Dr. HIPpocrates with emphasis on problems of the youth subculture have been featured on the student-organized Harrington Lectureship that before 1966 was arranged through the dean's office with speakers and subjects of its selection. Some factors inside the Medical School and Medicine leading to the disparities between 1937 and 1972, Dr. Sanes believes, are the AMA inspection of the Medical School about 1940 and its subse­ quent recommendations, full-time clinical teachers, World War II, the postwar years with its national emphasis on research, the Edu­ cationist movement in the fifties led by Drs. George E. Miller and Edward M. Bridge in Buffalo, the strengthening of the basic sciences departments through Capen and Sherman Hall additions, the growth of knowledge, going STATE in 1961-62 with its large doses of financial assistance, trend toward specialization, the Health Sciences concept in 1967 as well as student "social consciousness" and awareness and its subsequent activism that included demon­ strations, protests and emphasis on health care to all as a human right. Concluded Dr. Sanes, "some of us may be astonished by the changes in medical education at our Medical School during the past 35-40 years. Others may be perturbed by specific ones. Still others may find certain changes commendable and necessary. It is reasonable that changes should occur in medical education as time passes. Medicine is not taught in a vacuum for it is influenced by social, economic, political, ethical, scientific, technological, and medical factors in American society and in the world. Medical education should however retain the decision as to changes in its structure and function. "In regard to certain changes, medical education can be faulted for not having recognized their need soon enough. The question, in making changes, is how to distinguish the newest enthusiasms and latest fads, regardless of outside pressures, from the substantive and permanent. Simplistic, impulsive answers," he continued, "to adapt medical education to problems in medicine and society may not turn out to be effective, long term solutions. "Medical education must remain flexible and open to changes. But we must be careful that forms, methods, and gimmicks do not divert medical education from its primary goal and values — to train scientific and humanistic physicians who eventually will prevent disease and care for the sick within adequate standards under any system of health care delivery. "A medical faculty member ought not to look upon his posi­ tion merely as a means of personal interest and satisfaction. His first responsibility is to maintain and further medicine in terms of a healing profession with the development of qualified practicing physicians who will help human beings live as long as possible, physically as comfortable as possible, mentally as alert as possible, emotionally as happy as possible, and socially, economically as pro­ ductive as possible."D FALL, 1972 39 �ftAedentian Honors Two Professors I Dr. Jung Dr. Davidson Two professors have been cited for their teaching skills and interest in students in the Medentian, student yearbook for the Schools of Dentistry and Medicine. The dental students honored Dr. Evelyn L. Jung, and the medical students honored Dr. Ronald C. Davidson. Dr. Jung is professor of oral diagnosis, clinical pathology and radiology, and has been on the dental faculty since 1931. She is a 1930 graduate of the Dental School. She teaches radiology to first and third year students. She also teaches seminars for seniors. Dr. Jung has written several articles on her research specialty, "Demineralization and Embedment of Bone Specimens." She is a past president of the Academy of Radiology and has been active in the 8th district dental society. Dr. Davidson is professor of pediatrics and associate chairman. He has been on the faculty since 1964. He received his M.D. degree from the University of Western Ontario Faculty of Medicine, Lon­ don, Ontario in 1957. At Children's Hospital Dr. Davidson is also di­ rector of the Birth Defects Center, the division of human genetics and the division of instructional communications. From 1957 to 1959 the Canadian-born physician interned and took his residency in pediatrics at Vancouver General Hospital, Vancouver, B. C. He was also an assistant resident in pediatric pathology, Children's Hospital Medical Center, Boston in 1959-60, and the following year at Boston City Hospital. He was a Fellow in pediatrics at The Johns Hopkins Hospital, Baltimore in 1961-63. The following year he was a Fellow in Biochemical Genetics, University of London King's College, London, England. He has written 20 articles, 16 abstracts and contributed two chapters for books. In the dedication to Dr. Jung the dental students said "her primary interest is in the student. She has a one-to-one teaching style that never fails to drive the point home. Her seminars and weekly quizzes have given her students a real working knowledge of radiology techniques and diagnosis. She is known by dental educators around the world, but remains a very unassuming indi­ vidual and always has time for her students. Friendly, patient, knowledgeable, and always ready to illustrate her conversation with anecdotes, she has made everyone's life a little better for having known her. We, the class of 1972, thank you, Dr. Evelyn Jung." In the dedication to Dr. Davidson, the medical students said, "in the third year teaching program in pediatrics he has brought to that program some exciting new approaches to clinical teaching, including the use of computer assisted education, television, sound/ slide productions and films."• 40 THE BUFFALO PHYSICIAN �A 1943 Medical School graduate was recently named "Man of the Year," in Eden, N. Y. where h e has been practicing for 25 years. Dr. Ronald Martin was honored in April for giving remarkable med­ ical service along with community service. Dr. Martin came to Eden in 1946 to practice with his Uncle. After a second stint in the Army he returned in 1953, and opened his own office in 1956. Ete was a school physician at Eden Central School for 12 years and gave up his only "day off" each week to serve at the Indian Reservation Clinic at Cattaraugus. Dr. Martin was in the Battle of the Bulge in Europe during W o r l d W a r II. H e w a s c a p t u r e d b y t h e G e r m a n s a n d f o r c e d a s a PW to treat wounded Germans as well as captured GIs. He bailed out two weeks later during a counter attack. As a battalion surgeon with the beleagured 10th Armored Division, he received the Silver Star, Bronze Star and a cluster for the Bronze Star and a great assortment of citations and battle ribbons. Dr. Martin interned at St. Margaret Memorial Hospital, Pitts­ burgh for nine months before entering the Army January 1, 1944. He finished his internship in the Army and Navy Hospital, Hot Springs, Arkansas. It was here that h e " m a d e o r missed" medical history. He worked with Dr. Philip Hench and helped him in the research that led to the discovery of ACTH and then Cortisone. This led to the Nobel Prize for Dr. Hench in the field of physiology in medicine in 1950. Dr. Martin said that the great breakthrough was the result of a question asked in a seminar conducted by Dr. Elench. The answer bugged him — and Hench — and the solution was one of the great achievements in medicine. Dr. Martin is a Diplomate of the National Board of Medical Examiners. He is active in local and state professional organiza­ t i o n s .• Eden Physician Honored Ten medical continuing education courses will be offered by the Medical School during September, October, November and De­ Continuing Medical Education cember. September 20-22—"Trends in Internal Medicine" Buffalo General Hospital October 3-4 — "Obstetrics for the Family Physician" Deaconess Hospital October 20-22 —"Allergy" (In cooperation with Midwest Allergy Forum) Statler Hilton November 9 — "Community Medicine" Statler Hilton November 10 —"Workshop in Respiratory Management" Statler Hilton Five additional programs have been selected but the dates have not been established. They are: "Surgical Aspects of GynecologyObstetrics," "Exercise Testing and Training for Coronary Heart Disease," "Advances in the Care of the Injured Patient," "Psychi­ atry for Psychiatrists," "Use of Blood" (In Cooperation with Amer­ ican Red Cross).• FALL, 1972 41 �Working with Others for Optimum Care of Patients by RUTH T. McGROREY, Ed.D. Dean, School of Nursing "New times demand new measures and new men; The world advances, and in time outgrows The laws that in our father's day were best." (Source unknown) The search for a common conceptual framework for what we have long called the health team has been a painful growing process for all of the health professions. In nursing the parallel development of the nursing team with all of its ramifications introduced a variety of communication barriers. The creation of new workers in the midst of unprecedented medical, social and organizational change brought about a definition and redefinition of the functional activ­ ities of health workers that confused roles, opened up legal ques­ tions of practice, and to a large extent closed off the informal inter-change between professional groups that insured mutual planning and evaluation of patient care. For almost a hundred years from Kaiserwerth to World War II, the art of nursing was definable, circumscribed and clearly func­ tional in the context of clearly prescribed medical care. In the past quarter century the growing sophistication of health care and the proliferation of highly specialized health disciplines have increased the complexity of therapy and its delivery to the patient in ways which challenge our imagination to develop new and more effective ways of working together to insure the best possible care for our patients, not only to get them well, but to keep them well and to help them achieve the highest potential of wellness that is possible for each of them as individuals in our society. Nursing, as one of the components of the health team has sug­ gested a variety of ways to approach new ways of working together. They involve not only a reconsideration of the ways in which people work together as individuals and as professionals, but a reconsidera­ tion and analysis of the total community and institutional environ­ ment in which care takes place. Most of these concepts are not new, they have been tried, accepted and/or abandoned and, in many instances, studied without implementation. The successes, I am sure, have been achieved because of mutual concern, faith, and continuing mutual effort. The failures may (or may not) reflect the opposite philosophy. In any event, both success and failure in learning and achieving the art of working together must be sup­ ported by environmental goals and climate that support this kind of relationship. Dr. McCrorey has been Dean of the School of Nursing at the Uni­ versity since 7966. She received her master's and doctorate degrees from Teacher's College, Colum­ bia University.O These are some of the approaches which I believe would be helpful in fostering the health team concept in our own planning. They are also basic approaches which I believe to be generally applicable to working together in achieving mutual goals for health care in any situation. Understanding the Sociological Framework of Patient Care The health team begins with the professionalization and sociali­ zation of those students whose professional practice will be focused upon the solution of these problems of care which serve the goal of health maintenance in our society. High level wellness, living up to one's fullest health potential and other synonyms arise from 42 THE BUFFALO PHYSICIAN �Class of 1927 at Spring Clinical Days Back Bow: Joseph F. Kij, Sr., Arthur G. Elsaesser, Norman J. Wolf, Meyer H. Riwchun, Herbert Berwald, Kenneth G. Jahraus, Richard L. Saunders, Arthur C. Hassenfratz, Raymond F. May, J. Theodore Valone, Frank M. Criden. Front Bow: John A. Leone, William S. Ruben, Milton A. Palmer, J. Frederick Painton, Lawrence L. Carlino, William S. MacComb, Arthur L. Funk. time to time. Basically, as a human right, health as an optimum goal is served by the collaboration of the health professions. As students, professionals should learn the social factors and processes that are relevant for patient care, particularly the inter­ acting parts of a dynamic social system. "The ways in which man thinks, believes, and acts depends largely on the culture and society in which he dwells. It is within these societal boundaries that his group life and sub­ sequent interpersonal relationships are structured. In these relationships man develops goals and aspirations that lead him to action. The more a health worker understands the development and consequences of these relationships, the better he will comprehend patient beliefs and behavior as well as his own." Trends and social movements in our culture create change in family structure, education, preceptions, values and the norms of life as well as the conceptions of health and illness which determine society's demands for health services. The professional needs to understand his own role as a person and as a professional and his need to move with the stream of life in order to understand it. The kind of professional being who emerges from the educational process determines to a large part his perception of his function. If members of the health team come to understand the cultural components of society, the factors of communication, socialization, social movements, professions and the family, patient perceptions, patient problems and potential solutions for those problems together, then the probable prediction for working together in practice is considerably enhanced. FALL, 1972 43 �Understanding the Delivery Patterns of Health Care A. The traditional system: Systems of care have been organized formally in large-scale in­ stitutions on bureaucratic or hierarchical lines. Such systems have tended to create and recreate communication problems antagonistic to achieving positive objectives of "team care" and individualization of patient care planning. Inherent in the traditional health care organizations are char­ acteristics of a value system long esteemed in our American cul­ ture. Responsibility, authority, command status, prestige, obedience and submission were and are the operational standards which conflict with the knowledge we now have about group dynamics and human relations. The conflict in a system of care which has not provided for social change, for facilitation of horizontal as well as vertical com­ munication, serves to disrupt the very services it seeks to provide. The splitting off of a variety of health workers whose philo­ sophical and personal values are different from their predecessors serves to fragment the communication of "caring" into isolated services on a functional basis. The hierarchical organization which admits patients and cares for them in a longitudinal structure of systems separated into disease entities and specialty units disregards the fact that patients come from a family and a community, go through a developmental proc­ ess of illness to wellness and return back to that family. He is sel­ dom seen in his totality as a person nor do the many people who provide services to him coordinate their care in terms of total patient "wellness" goals. Back Row: Marion J. Chimera, Joseph M. Smolev, Angelo F. Leone, Hugh J. McCee, Jr., Ernest C. Homokay, Arthur W. Strom, Marvin H. Milch. Front Row: William W. Pierce, Elmer Friedland, Myrtle W. Vincent, Benjamin E. Obletz, Bronislaus S. Olszewski, Carlton H. Goodman. Class of 1932 at Spring Clinical Days 44 THE BUFFALO PHYSICIAN �Class of 1962 at Spring Clinical Days Back Row: Joseph P. Armenia, Seth A. Resnicoff, Philip D. Morey, Robert C. Ney, Jack C. Fisher, John L. Kiley, Michael H Madden, Adolph J. Brink. Front Row: Morton P. Klein, David E. Carlson, George R. Tzetzo, Anthony J. Floccare, Owen G. Bossman, Gerald E. Patterson James T. Bumbalo, Richard C. Lisciandro. Until we move out of the traditional systems of care, the health team can function neither effectively nor dynamically in the direc­ tion of positive health. B. N e w s t r a t e g i e s o f p a t i e n t c a r e : Communication with coordination of and ease of movement for patients and personnel are components of any new strategy to improve health services to people. Communication is critical — coordination of patient care de­ pends on it. When no fewer than twenty to twenty five different occupational groups can be counted in a typical hospital unit, one begins to realize the enormity of the task. Studies have been made on why lateral communication is impeded on the inadequacy of written communication, on the nature of oral communication and the relation of these to meeting patient's needs. Attempts have been made to determine the effects of different work models on motivation and to group patients into different "need" settings for better utilization of staff. "Progressive patient care" has been tried in many ways and degrees of operation, and although the strategy has been known by different names, the grouping of patients to achieve certain care goals has greatly con­ tributed to improvements in recognizing the ways in which patients move through an illness experience. It is imperative to recognize the shift from earlier primary tasks of care and comfort, changes in disease patterns, transforma­ tion in the tasks performed in hospitals which result from greatly improved and complicated therapies, and a growing array of new specialized diagnostic and therapeutic techniques of a technical and professional nature which need to be performed for an in­ creasing preparation of patients. FALL, 1972 45 �I To cope with these changes we need new strategies in educa­ tional practice and in patient care and in the way^ealth profes­ sionals learn together in the clinical setting. Professional care in its supplementary and complementary relationships must identify the mutual contributions each profession can make to patient care goals. C. Patient and Community Participation — New Expectations for the Seventies The challenge of the seventies calls for an increased aware­ ness of the nature of patient care for the majority of patients who are rational, responsive and able to do things for themselves. An understanding of the nature of communication and its methodology, and a sensitivity to the need of increased nurse-patient communica­ tion are urgent concerns. The rapid change in the information sciences, the demand of the public for more information about their health services, and an increasing citizen awareness of health related problems call for expanding citizen involvement in planning for patient care. The goals of patient care services and the education of health workers are different and rightly so. The goal of a service is care of the patient and the goal of a school is the education of students. However, they are irrevocably linked in the development of a product sensitive to patients' needs, able to cope with them and to work with others to fulfill them. Understanding the Interrelationships of Health Personnel Whatever the future planning for clinical learning experiences for the five schools of the Health Sciences i.e. Medicine, Nursing, Dentistry, Health Related Professions and Pharmacy one challenge is clear. An opportunity must be provided for moving out of the traditional roles which have prevented professional nurses and Back Row: Ward A. Soanes, Edwin J. Lenahan, Jr., Murray N. Andersen, Daniel E. Curtin, Hans F. Kipping, John B. Sheffer, James F. Stagg, Raymond W. Blohm, Jr., David H. Nichols, Robert H. Wildhack. Middle Row: Arthur J. Schaefer, Richard J. Kenline, James F. Phillips, Anthony S. Merlino, Joseph C. Todoro, Robert J. Dean, William S. Edgecomb, William M. Bukowski, Peter J. Julian. Front Row: Jerome I. Tokars, Carl J. Nicosia, Frederick D. Whiting, Marvin G. Drellich, Robert J. Ehrenreich, Salvatore Aquilina, Thomas B. Clay, Jr., William C. Baker. Class of 1947 at Spring Clinical Days 46 THE BUFFALO PHYSICIAN �Class of 1952 at Spring Clinical Days Back Row: James F. Zeller, Alfred Lazarus, Donald F. Dohn, Colin C. MacLeod, Donald H". Sprecker, S. Jefferson Underwood, Stanley Pogul, Albert A. Gartner, Jr., Robert A. Baumler, Joseph E. Genewich, Neal W. Fuhr. Middle Row: Victor A. Panaro, John Y. Ranchoff, Robert M. Wilson, Phoebe E. Saturen, Oliver J. Steiner, Burton Stulberg, Kurt J. Wegner, Leonard I. Berman. Front Row: Melvin B. Dyster, Richard A. Bahn, Roy J. Thurn, John J. Banas, Bernie P. Davis, Francis A. Fote, Imre Szabo. their colleagues from maintaining and promoting expert clinical practice which is complementary to each other. Further, opportunity must be provided for students in these respective disciplines to ex­ plore their historical and educational foundations together and to continue these relationships in the care of patients. The principles of progressive patient care is to provide better treatment and care by organizing hospital services around the in­ dividual's nursing and medical needs rather than around the de­ partmental and clinical nature of his illness. At least six elements are incorporated in the progressive patient care concept: intensive care, self-care, long-term care, home care, and ambulatory care, usually provided on an out-patient basis. The full utilization of the concepts of progressive patient care help to integrate the flow of educational activities with clinical facilities. Supporting this principle, the following terms are defined: Intensive Care —For critically and seriously ill patients (includ­ ing surgical postoperative cases) who are unable to communicate their needs or who require extensive nursing care and observa­ tion. These patients are under close observation of nurses who have been selected because of their special skills, training, and experi­ ence. All necessary lifesaving emergency equipment, drugs, and supplies are immediately available. Intermediate Care — For patients requiring a moderate amount of nursing care. Some of these patients may be ambulatory for short periods of time. Emergency care and frequent observation are rarely needed. Included in this group are those patients who are beginning to participate in caring for themselves. In addition, the terminally ill may be cared for here. FALL, 1972 47 �I Self-Care — For ambulatory and physically self-sufficient pa­ tients requiring therapeutic or diagnostic services, or who may be convalescing. In this homelike atmosphere, provision is made for relaxation and recreation. Here the patient is instructed in selfcare within the limits of his illness. Long-term Care — For patients requiring skilled prolonged medical and nursing care. Rehabilitation, occupational therapy, and physical therapy services may be needed for these patients. In addition, emphasis is placed on instructing those patients who must learn to adjust to their illness and disability. Home Care — For patients who can be adequately cared for in the home through the extension of certain hospital services. A hospital-based home care program provides personnel and equip­ ment from the hospital or through community agencies, such as the local health department or the Visiting Nurse Association. The hospital, however, usually assumes responsibility for coordinating the services, whether they are furnished by the hospital or another agency. Extended Care — For patients who need medical and/or nurs­ ing supervision after discharge from the hospital to provide con­ tinuity for the therapeutic plan and to move toward fulfillment of the patient's health goals of high level wellness or optimum health potential. Regardless of future planning for clinical facilities these con­ cepts are part of system changes essential to improved patient care, improved educational programs, and improved health service de­ livery. Back Row: Sherman Woldman, Sarantos J. Yeostros, Richard F. Miller, Ross Markello, John S. Parker, James Boncaldo. Front Row: John K. Cusick, Sol Messinger, R. Ronald Toffolo, Jacqueline E. Ihrig, John J. Ihrig, Arthur L. Beck, Jr. Class of 1957 at Spring Clinical Days 48 THE BUFFALO PHYSICIAN �Class of 1942 at Spring Clinical Days Back Row: Howard N. Fredrickson, Frank M. Hall, Edward J. Zimm, Joseph E. Anderson, Vincent J. Parlante, Michael A. Jurca, William J. Staubitz, Leon Yochelson. Middle Row: Boris L. Marmolya, Robert Blum, Charles A. Bauda, Richard Ament, Richard Milazzo, Joseph A. Johengen, Horace L. Battaglia. Front Row: Kent L. Brown, O. P. Jones, Albert J. Addesa, Urban L. Throm II. With this distribution of health services, the quality of patient care is enhanced as a result of effective use of personnel, facilities, equipment, supplies and funds. Through the home care program an important link is formed with other health groups and community agencies, which may lead to greater cooperation by all concerned in providing health care. The Health Team representing the several disciplines mutually determine roles and functions for each phase of care. Each pro­ fession identifies and interprets his or her own capabilities and educational preparation. The patient's needs determine the con­ stellation formed by the health professions for each patient's needs, and a mutual determination is made through joint planning as to the identification of the coordinator's role. We have tended to make broad generalizations about who does what and have put into neat little boxes our predetermined functions whether they are appropriate to the situation or not. I believe that our collective future as mutually concerned pro­ fessions depends on our willingness to work together in ways that benefit the patient in reaching his goals for high level wellness and help him achieve his fullest potential. The following diagrams reflect one way in which organizational concepts of the health team and patient care might be viewed. (Appendices 1, 2 and 3) The dialogues are just beginning. We must both speak and listen as we have never spoken and listened before. FALL, 1972 49 �Appendix 7 I AN ORGANIZATIONAL CONCEPT FOR PATIENT CARE The Patient's Health Goals Appendix 7 Figure 1: The Patient's goals for high level wellness in keeping with the maximum health potential for each patient is the organizational base from which patient care plans, medi­ cal care plans and nursing care plans can grow. 50 THE BUFFALO PHYSICIAN �Appendix 2 PROGRESSION OF CARE Quality patient care is the goal of all members of the health professions. The indices represent facets of care as identified in physical, mental, etc. The factors are stated as questions to identify the qualitative aspects of patient care practices. Evaluation of the plan of care and its execution elicjt the why and the how. Figure 2: The major components of progression of care in the quest for quality. FALL, 1972 51 �Appendix 3 THE RELATIONSHIPS OF PATIENT CARE SERVICES IN THE MODERN HOSPITAL The excellence of patient care in the clinical setting will depend upon the strategic professional relationships which are built into new organization. Nursing in its present form does not, will not, cannot meet the extra-ordinary challenges of tomorrow . . . Only a radical shift of the nurse's professional practice from management of the situation to management of patient care in the nursing con­ text directly with patients will change the balance of priority from those things which are peripheral to those nursing practices which are essential for optimum quality of care. These shifts in practice relate definitively to colleague practice relationships established in the mutual planning of patient care. Figure 3: Care, Cure and Coordination . . . the functional base of good patient care.D 52 THE BUFFALO PHYSICIAN �A grant of $1,774,617 has been awarded to the Lakes Area Regional Medical Program, Inc. by the Department of Health, Education and Welfare. The Buffalo-based program, which encompasses seven Western New York counties — Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, and Wyoming — and Erie and McKean in Pennsylvania, serves over two million residents of the region. This program has received $6,092,307 from HEW since 1966. Dr. John R. F. Ingall, Executive Director of the Lakes Area Re­ gional Medical Program, Inc., said the award covers a 14-month period of operation ending April 30, 1973. Dr. Ingall indicated that the funds will be used to continue present health-related projects and initiate new ones. Regional Medical Programs are pri­ marily concerned with activities that increase the availability of quality health care and make the delivery of health care more efficient. Projects currently funded are: Telephone Lecture Network, a private telephone system linking 42 hospitals and other stations which provides continuing education programs for all health disci­ plines; Tumor Service Registry, a centralized computerized regis­ try designed to supply physicians with confidential cumulative data on cancer patients; Information Dissemination Service, which provides free library services to all health personnel in the region; Chronic Respiratory Disease Program, a many-faceted, comprehen­ sive project featuring screening and training of hospital personnel, a home care program, and an Associate Arts degree program in Inhalation Therapy; Model Program for Comprehensive Family Health, a family practice center in Buffalo, New York, to be used as a model to demonstrate the effectiveness of family physicians; Allegany County Mobile Health Vehicle; Comprehensive Continu­ ing Care for Chronic Illness, a project geared toward the inner city population; and Master Plan for Planning and Articulation of Allied Health Education, to identify manpower needs, training programs and develop a master plan for linking professional education pro­ grams based on need.Q Seniors Honor Faculty Fourteen medical faculty were "recognized for their teaching efforts" by the senior class at the Medical School. They are Dr. Richard H. Adler, professor of surgery; Dr. Henry E. Black, clinical instructor in medicine; Dr. Jules Constant, clinical associate profes­ sor of medicine; Dr. Mary O. Cruise, associate professor of pedi­ atrics; Dr. Charles M. Elwood, clinical associate professor of medi­ cine; Dr. Joseph C. Lee, professor of anatomy and research associate professor of surgery; Dr. Margaret H. MacGillivray, associate pro­ fessor of pediatrics; Dr. Joseph E. MacManus, clinical professor of surgery; Dr. James R. Markello, assistant professor of pediatrics; Dr. Mohamed Megahed, assistant professor of neurology; Dr. Thomas T. Provost, research assistant professor of medicine; Dr. Samuel Sanes, retired professor of pathology; Dr. Roy Seibel, clinical assist­ ant professor of radiology and Dr. James F. Upson, clinical assistant professor of surgery.^ FALL, 1972 53 774 617 ' ' RMP Grant �Dr. Carl E. Arbesman Listening to one of the scientific sessions are Professor Pierre Crabar, Institut Pasteur, Dr. Elvin A. Kabat, Columbia University and Dr. Noel R. Rose. Third Immunology Convocation It was a highly successful International Convo­ cation on Immunology. So agreed the over 450 scientists from across the nation, Canada, England, France, Sweden, Denmark, The Philip­ pines, Australia, Israel, and Argentina who at­ tended the third such biennial sponsored by The Center for Immunology. Over four days they exchanged data and explored areas for future progress on three related aspects of im­ 54 munology — how antibodies are made, how they react with antigen, and how this reaction produces clinical manifestations. Setting the stage was the Ernest Witebsky Memorial Lecturer, Columbia University's Dr. Elvin A. Kabat. hie described our current knowledge on the anatomy of antibody mole­ cules. By reviewing much of the chemical in­ formation reported in the scientific literature and with the aid of a computer, he was able to construct a model of the way in which amino acids combine to form a molecular guardian which can recognize and protect the body against foreign substances that invade it — germs, cancer cells or toxic substances from the environment. The first day's session expanded on these themes. Described were techniques such as x-ray crystallography and electron micro­ scopy by which immunoglobulin antibodies (IgG and IgM) can be actually visualized. One speaker, Dr. Thomas Tomasi (professor of medicine, SUNYAB), described special anti­ bodies (IgA) found in secretions in the gut and elsewhere which act as the body's first line of attack against environmental hazards. An­ other, Johns Hopkins' Dr. Kimishige Ishizaka THE BUFFALO PHYSICIAN �r e p o r t e d o n a n a n t i b o d y (IgE) h e d i s c o v e r e d and that plays a central role in human allergy. Opening the discussion on antigenic struc­ ture was Roswell Park Institute's Dr. David Pressman who explained how the chemical structure of antigens determine its reactions with these kinds of antibodies. He pointed to the precise requirements of molecular speci­ ficity in antigenic structure. Columbia Univer­ sity's Dr. Samuel Beiser then gave an excellent demonstration on the types of antibodies to nucleic acids that can be elicited by immuniz­ ing animals with nucleic acid bases conjugated to appropriate carrier molecules. He illustrated the potential usefulness of such antibodies in typing chromosomes — the prospects here are quite exciting for clinical applications. An impressive description by Wayne State University's Dr. Zouhair Atassi (formerly of SUNYAB's department of biochemistry) on how chemical modification of individual amino acid residues in myoglobin can lead to a comprehensive picture of antigenic structure in a globular protein was capped by Pittsburgh University Dr. Thomas Gill's authoritative re­ view on the ways in which synthetic polypep­ tides have advanced our understanding of the antigenic structure of proteins. Columbia University's Dr. Samuel Beiser and Dr. Giuseppe A. Andres. Co-chairing session on cellular sites of antigen recogni­ tion are Drs. Gustavo Cudkowicz and Pierluigi E. Bigazzi. Binding sites of antibodies were then dis­ cussed. Described were several approaches used to understand the small part of an imFALL, 1972 55 �I Dr. Stanley E. Cohen munoglobulin molecule that interacts with antigenic determinants. Identified was amino acid sequence, specific components, config­ uration of the molecule, and how they affect interaction with the antigen. While Roswell Park Institute's Dr. Allan L. Grossberg, in his approach, first protected the antigen combin­ ing site, identified it through this protection, then removed the protective group to see which part of the immunoglobulin molecule was involved. Dr. Oliver A. Roholt described isolation of peptides and amino acids that react with a particular antigen. A different part of the antibody molecule was reviewed by SUNYAB professor of pathol­ ogy Dr. Stanley Cohen. The part of the im­ munoglobulin involved in both protective and allergic reactions is distinct from the antigen combining site which the previous speakers have described. He showed how this region, the Fc piece, functions in complement fixation and allergic reactions. The studies made use of both chemically modified antibodies and Enjoying the coffee break are Dr. Felix Milgrom and graduate student Alan Gewirtz. 56 Pittsburgh's Dr. Thomas /. Gill makes his point. computer models based on the experimental results. Explained Center for Immunology di­ rector, Dr. Noel Rose, these fundamental kinds of studies help us to understand how antibod­ ies in some cases protect the individual against disease while at other times produce harmful effects such as allergies and the rejection of grafted organs. A major feature emerging from the Convo­ cation was a tool to explore the mechanisms of the immune system, man's defense against disease. It is the human cancer, multiple mye­ loma, that provides much information on anti­ body molecule and its function. The malignant cells in this disease are derived from a single abnormal ancester cell that sometimes produce a pure substance in large amounts that is very similar to the normal antibody. Explained Na­ tional Institutes of Health Dr. Michael Potter, the information gathered by this tool will be used not only to treat this kind of cancer but other cancers as well as many other kinds of disease. But there are also other types of antibodies, those of limited heterogeneity as well as pro­ teins of multiple myeloma with antibody ac­ tivity. Massachusetts General Hospital's Dr. Edgar Haber reviewed techniques that have led to production and characterization of hoTHE BUFFALO PHYSICIAN �mogeneous antibodies which resemble mye­ loma protein. By using bacterial vaccines as antigenic stimulants he was able to produce large amounts of homogeneous antibody in many of the rabbits studied, thereby creating a tool by which to understand better the rela­ tionship between this homogeneous antibody's molecular structure and its specific function. Although the impetus for production of such antibody still remains unclear, Dr. Haber be­ lieves that two important factors may be the characteristics of material injected and the genetic constitution of the animals involved. Recent work concerning the antigenic de­ terminants or "markers" on antibody mole­ cules that distinguish antibody of one spe­ cificity from that of another was discussed by Dr. Alfred Nisonoff from the University of Illinois. These individually specific markers appear to be related to or identical with the structure of the molecule which composes the antibody binding site. The markers, which are called idiotypic determinants, can be used to study the genetic control of antibody syn­ thesis. This has led to the concept that genes, which control the biosynthesis of the constant and variable portions of antibodies, are very closely linked. Summed up Dr. Nisonoff, anti­ bodies made against the idiotypic markers are proving to be powerful tools in leading to an understanding of the cellular basis of anti­ body synthesis. Drs. Erwin Neter and Caret I. van Oss. Dr. Allan L. Grossberg, Weizmann Institute of Science's Dr. David Givol, Professor Grabar, Dr. David Pressman. Reception and buffet dinner at Albright-Knox Art Gallery. �Johns Hopkins' University's Dr. Dr. Thomas B. Tomasi, Jr. Dr. Kimishi ge Ishizaka Dov Sulitzeanu. and Hebrew Program focus then shifted to "signals" which tell a cell in the body when to synthe­ size antibodies. Several speakers pointed to cells that have a trigger which resembles anti­ body and specifically recognizes antigen. When the antigen "pulls" this trigger the cell is switched on; it begins to multiply and produce antibody. This trigger was first visualized by Dr. Dov Sulitzeanu of Hadassah Medical School in Jerusalem who labelled the antigens which react to it. Much of this work was performed during his stay at Roswell Park Institute several years ago. A banquet honored Professor Pierre Grabar, Institut Pasteur, Paris, who has made many important contributions to the study of anti­ gens and antibodies, and has done much to stimulate the development of immunology as a discipline in France and throughout the world. The final session dealt with the means by which the body regulates the production of antibody. Roswell Park's Dr. Yasuo Yagi told of studies of antibody formation in cell cul­ tures while Dr. Matthew D. Scharff of Albert Einstein College of Medicine discussed spe­ cific steps (which he successfully duplicated in the laboratory) by which antibody mole­ cules are put together. New York University's Dr. Jonathan Uhr spoke of control mechan­ isms which regulate the production of anti­ bodies. 58 The entire proceedings will be published as the third in a series of international volumes sponsored by The Center for Immunology which was established at the University in 1967 to foster training and research-in immunology. Staffing The Center are faculty from the Uni­ versity and Roswell Park Institute, actively en­ gaged in work which covers all aspects of im­ munology. Its first director, Dr. Ernest Witebsky, Distinguished Professor of Bacteriology and Immunology, died unexpectedly on De­ cember 7, 1969. Its present director is Dr. Noel R. Rose, professor of microbiology, and its as­ sociate director is Dr. Stanley Cohen, profes­ sor of pathology. Program committee for this third International Convocation on Immunol­ ogy were Drs. David Pressman, Thomas B. Tomasi, Jr., Allan L. Grossberg, James F. Mohn, and Noel R. Rose.D Albert Einstein's Dr. Matthew D. Scharff and Dr. David Pressman. THE BUFFALO PHYSICIAN J �For 96 medical students classes were not over when the academic year ended in mid-May. Through the unique opportunity of summer fellowships, 40 freshmen, 53 sophomores, and three juniors will receive either a $500, $750 or $1000 stipend for an eight to ten week clinical or research experience. In reviewing applications received from medical students that outlined proposed research or clinical projects under specific preceptors, the six-member summer fellowship committee (3 faculty from basic sciences and an equal number of clinical representatives) under its chairman, Dr. Carl J. Bentzel, found six that were con­ tinuations of outstanding projects begun last year. In some cases these projects were as carefully planned and pursued as research programs by senior faculty. Freshman Leonard M. Klein and sopho­ mores Jon Rosenberg, Virginia Sybert, Craig A. Traugott, Robin L. Trumbull, and Robert M. Weiss were awarded $1000 stipends. Said Dr. Bentzel who is an assistant professor of medicine, "the emphasis on this year's applications appears to be in research." Over half (61) will be working on projects that encompass research in basic medical sciences, clinical research and research in health care delivery. The remaining 35 will seek to further their education by preceptorships in the clinical field. Of this figure, eight will work in rehabilitation medicine under Dr. John J. O'Connor at the E. J. Meyer Memorial Hospital, while 17 will work closely with family practitioners. More than three quarters of the group (88) will remain in Buf­ falo to work in University laboratories or at local hospitals. Five will work in European hospitals or laboratories, six at New York City medical institutions, two in California, and one each in Con­ necticut and Florida. Summer Fellowships CLINICAL Local Project Site, Faculty Introduction to care, management of handicapped child, rehabilitative aspects Tumor immunology; cell mediated cytotoxic assays in v i t r o Brown, Ian S. '74 Endocrinology Cohen, William F. '75 Dysnki, Sister Marguerite '75 Clinical preceptorship Goodman, Marianne '74 Pediatric Surgery Comparative Study of Organs controlling salt, water balance Hochberg, Lynn B. '75 in Lebistes, Fundulus Clinical Clerkship Mruczek, Arthur W. '73 Stomierowski, Louise M. '74 Obstetrics-Gynecology Clinical correlation of surgical pathology Szymula, Norbert J. '74 Gastric secretory response to insulin infusion, other drugs; Whelan, Kathleen M. '74 exp. visceral cryosurgery Block, Joel '75 REHABILITATION MEDICINE — E. ). Meyer Memorial Hospital Bauer, C. Donald '75 Colman, Marc '75 Franklin, Hal A. '75 Hanlon, Donna M. '75 Holifield, Edward W. '75 Neumann, Peter R. '75 Sadow, Stephen W. '75 Severin, Hayden '75 FALL, 1972 59 Children's Hospital—Dr. R. Warner Roswell Park—Dr. G. Moore Children's Hospital—Dr. T. Aceto St. Joseph's Hospital, Elmira—Dr. F. Brand Children's Hospital—Dr. T. Jewett Anatomy, SUNYAB—Dr. E. Hayes Arnold Gregory Memorial Hospital—Albion S. Buffalo Mercy Hospital—Dr. D. J. Nenno Sister's Hospital—Dr. P. Milley VA Hospital—Dr. A. Gage �Foreign Project Site, Faculty Alpert, Bernard S. '74 Pietraszek, James C. '74 Ramos, Carmen R. '74 IFMSA International Exchange Clinical Clerkship IFMSA International Exchange Clinical Clerkship Neuropathology, clinical neurology fellowship Medical Center, Lund, Sweden Medical Center, Lund, Sweden Maida Vale Hospital, London, England Studies on arrangement of nucleoproteins in sperm heads of various urodeles and humans Phenomenology of focal experimental epilepsy Preceptorship in intensive care and trauma study units Nurse training program in primary health care delivery Biology, Canisius—Dr. K. Barker RESEARCH Local Barker, Marilyn '75 Bartkowski, Henry M. '74 Boyd, Marvin T. '74 Brady, Brendan '75 Braico, John C. '74 Budny, James '74 Burdick, James P. '75 Culmer, Viola L. '74 Dahn, Michael S. '75 Ford, Leslie G. '74 Giaccio, Richard '75 Groskin, Stephen '75 Gustafson, Paul B. '74 Hart, Benjamin A. '74 Hedger, John '75 Hershcopf, Richard J. '74 Hrushesky, William '73 Kostrada, Nina C. '75 Layne, Gregory D. '75 Lee, Richard S. '74 Leffke, David '74 Licciardi, Ludwig '75 Lo, Hing-Har '74 Lovecchio, John '75 Manzella, John P. '74 Muido, Leo '74 Nakao, Michael '75 Nathanson, Jan T. '74 Piirmann, Margaret '75 Purgess, Jan R. '74 Rade, Michael P. '75 Rinow, Michael E. '75 Roehmholdt, Mary E. '75 Rosenthal, Thomas C. '75 Rowland, Michael C. '75 Sorge, Anthony C. '75 Sampson, Hugh A. Jr. '75 Sdao, Michael W. '74 Protection of animals from pulmonary oxygen toxicity by steroids Neutrophil physiology in infectious states and in diseases characterized by defective neutrophil function Kidney perfusion and preservation Early stimulation of high risk infants Common properties of osmotically induced, solute coupled transepithelial water flow Research, clinical applications of human genetics Determination of inulin space in isolated muscles Specimen preparation for gross anatomy Introduction to care, management of handicapped child stressing rehab, aspects Improved method forT-4 assays by competitive proteinbinding analysis using anion-exchange resin and radiothyroxine Investigate stimulation sequence facilitating digitalis induced arrhythmias in animal, man Computer simulation of blood coagulation dynamics Evaluate experimental chemotherapeutic drugs in new solid tumor model of renal carcinoma Nonhistone chromosomal proteins; effect on genetic expression of normal, neoplastic tissue Development of bioassay of androgen action on bone maturation using Pertechnetate-99 Comparison of myocardial function determined by angiocardiography vs. systolic time intervals Success of bronchial, pleural biopsies in making specific diagnoses Objective study, evaluation of drug rehabilitation centers in Erie County Immunology Anatomical techniques Calculation of pulmonary artery pressure from P2-V peak interval Family constellation under stress of terminally-ill patient Perception of stimuli alternating between receptive surfaces in audition, somesthesis Study of fatal methadone overdose in Erie County Effect of intrauterine malnutrition on hepatic drug metabolism Cancer immunology Adjustment of blood volume, intrarenal perfusion at birth Attitudes, outlook of terminally-ill child Transepithelial conductance in response to alternating currents Planning of demonstration health care delivery model Lymphatic involvement in arteriosclerosis In Vitro study of oxyhemoglobin dissociation curve of human blood under hypothermic conditions at pH for that temperature Immunochemical detection of human species specific esterase in interspecies hybrid cells Evaluate, analyze, utilize mental health facilities at Lackawanna Community Health Center 60 Physiology, SUNYAB—Dr. W. Noell Meyer Hospital—Dr. J. Border Social, Preventive Medicine, SUNYAB— Dr. H. Sultz Meyer Hospital—Dr. R. Markello Children's Hospital—Dr. M. MacGillivray Roswell Park—Dr. G. Murphy Psychiatry, SUNYAB—Dr. N. Solkoff Veteran's Hospital—Dr. D. Hare Children's Hospital—Dr. R. Davidson Physiology, SUNYAB—Dr. E. Ohr Anatomy, SUNYAB—Dr. J. Lee Children's Hospital—Dr. R. Warner Children's Hospital—Dr. W. R. Slaunwhite, Jr. Meyer Hospital—Dr. S. Wittenberg Biochemistry, SUNYAB—Dr. D. Surgenor Roswell Park—Dr. G. Murphy Biology, SUNYAB—Dr. T. Wang Children's Hospital—Dr. W. R. Slaunwhite, Jr. Children's Hospital—Dr. E. Lambert Millard Fillmore Hospital—Dr. S. Messinger Erie County—Dr. L. Nemeth Microbiology—Dr. N. Rose Anatomy, SUNYAB—Dr. J. Lee Buffalo General Hospital—Dr. J. Constant Psychiatry, SUNYAB—Dr. M. Plumb Psychiatry, SUNYAB—Dr. S. Axelrod Meyer Hospital—Dr. J. Lehotay Children's Hospital—Dr. C. Catz Roswell Park—Dr. Minowada Children's Hospital—Dr. W. Rahill Psychiatry, Meyer Hospital—Dr. M. Plumb Veteran's Hospital—Dr. C. Bentzel Social, Preventive Medicine, SUNYAB— Dr. H. Sultz Meyer Hospital—Dr. G. Reading Children's Hospital—Dr. W. J. Rahill Center for Immunology—Dr. N. Rose Lackawanna Clinic—Dr. R. Wolin THE BUFFALO PHYSICIAN �Local Project Site, Faculty Stratford, William '75 Stubenbord, John C. '75 Cardiovascular changes in swimming Physiologic significance of extra oxygen deficit incurred in man during bromide Effect of 6-aminoicotinamide on developing nervous system of rat Bone pathology Clinical Genetics: Study of Linkage in two or more families Physiology, SUNYAB—Dr. D. Rennie Pharmacology, SUNYAB—Dr. J. Winter Uhl, Natalie J. '75 Varecka, Thomas F. '74 Wolman, Stuart A. '74 Pharmacology, SUNYAB—Dr. F. Kauft'man Meyer Hospital—Dr. E. Mindell Buffalo General—Dr. R. Bannerman National Cukierman, Jack '74 Campanella, Vincent '74 DiSanto, Joseph '75 Gershbein, Bart '74 Goldstein, Howard R. '74 Greene, Donald R. '74 Hirsch, Eugene H. '75 Kleinman, George M. '74 Morris, Steven J. '73 Schiff, Jill B. '75 Removal of metabolites from peritoneal cavity with new device Pulmonary changes secondary to bodily injury in man Study of growth, development of newborn with hyper­ bilirubinemia treated with phototherapy Pilot study of occupation and prostatic cancer Anatomic pathology (microscopic and gross) Pilot study of occupational and prostatic cancer Investigate chemical maturation of mouse brain tissue invitro and insitu Anatomical pathology, emphasis on neoplasms of nervous system Measure cardiac output, stroke volumes, myocardial con­ tractility, other parameters of cardiac function by thoracic impedance cardiography Research, group therapy in children, adolescents with chemical Diabetes Mellitus Brooklyn Jewish Hospital, N. Y. Albert Einstein College of Medicine Elmhurst General Hospital, Queens University of California at Berkeley Albert Einstein College of Medicine University of California at Berkeley Mt. Sinai School of Medicine, N. Y. C. Bridgeport Hospital, Connecticut St. Barnabas Hospital, Bronx Mt. Sinai Hospital, Miami Foreign Truax, Bradley T. '74 Walsh, Thomas L. '74 Neuropathology Clerkship in radiotherapy Maida Vale Hospital, London, England St. Bartolomew's Medical College, London, England Studies in detection of anti-platelet antibodies Bromide intoxication: text of Stein's theory of schizophrenia Effects of cytochalasin-B in human lympocytes Electrophoretic analysis of creatine phosphokinase isozymes in human skeletal and cardiac muscle, pathologic sera Characterize resistance factor product mediating tetracycline resistance in E. Coli. Determine cytotoxicity of antisera prepared by immunization with neuraminidase treated 6C3H-ED lymphoma Children's Hospital—Dr. L. MacDougal Pharmacology, SUNYAB—Dr. J. Winter Children's Hospital—Dr. R. G. Davidson Biochemistry, SUNYAB—Dr. E. Massaro $1,000 Category Klein, Leonard M. '75 Rosenberg, Jon '74 Sybert, Virginia '74 Traugott, Craig A. '74 Trumbull, Robin L. '74 Weiss, Robert M. '74 Pharmacology, SUNYAB—Dr. A. Reynard Roswell Park—Dr. J. Bekesi Family Practice (arrangements by Dr. James Nunn) Brown, Albert '74 Chmielewski, Thomas '74 Cintron, William C. '74 Jimenez, Ruffino '74 Langford, Edward '74 Lasser, Daniel '74 Meggett, Isaiah '74 Portale, Anthony '74 Purgess, Jan R. '74 Rivera-Arguinzoni, Ramon '74 Simon, Joel A. '74 Welch, Peter C. '74 Wetter, James M. '74 Whelan, Kathleen '74 Xistris, Evangelos '74 Yang, Linda L-C. '74 Younkin, Donald P. '74 FALL, 1972 350 Alberta Drive, Amherst 826 East Delavan Avenue, Buffalo 1282 Stony Point Road, Grand Island 350 Alberta Drive, Amherst 3435 Bailey Avenue, Buffalo 3435 Bailey Avenue, Buffalo 1453 Jefferson Avenue, Buffalo 2567 Sheridan Drive, Tonawanda 41 Crowley Avenue, Buffalo Dr. Ray G. Schiferle Dr. John Gabbey Drs. Robert H. Miller and Edward A. Rayhil Dr. James R. Nunn Dr. Herbert E. Joyce Dr. Robert W. Haines Dr. Frank G. Evans Dr. Eugene C. Hyzy Dr. Fred Shalwitz 142 Bidwell Avenue, Buffalo 1275 Delaware Avenue, Buffalo 350 Alberta Drive, Amherst 350 Alberta Drive, Amherst 509 Cleveland Drive, Buffalo 531 Center Road, West Seneca 3435 Bailey Avenue, Buffalo 33 Center Street, East Aurora Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. 61 Max Cheplove Philip Goldstein Thomas W. Bradley Robert Corretore Charles A. Massaro Frederick C. Nuessle Harry L. Metcalf Elbert Hubbard, III �Vice President Search Committee Named President Robert L. Ketter has charged the recently named 14member Search Committee for Vice President for Health Sciences to recommend candidates who are "visionary, who will look to the future, who can cope with and force rapid change, who are not tied to what each of us know as the traditional methods of education, and who can lead Buffalo to pre-eminence as a center for the development of new and effective health care systems." The current vice president for the Faculty of Health Sciences, Dr. Clyde L. Randall, will retire soon. The Vice President for Health Sciences, Ketter told the Com­ mittee, "is charged with the development, coordination and ad­ ministration of the Schools, centers, institutes and programs located within the Health Sciences Center and, at the same time, is respon­ sible for the formal and informal relationships between this Uni­ versity and the hospitals, clinics and other patient care facilities with which we maintain cooperative relationships." He "must also maintain a close working relationship within this University community and play a key role in undergraduate and graduate program development," Ketter said. Also, "The Vice President for Health Sciences is our chief spokesman and representative in matters of health to SUNY and to the many public and private agencies with which we deal." Ketter pinpointed the primary responsibilities of the Health Sciences as "teaching and research," but, he said, "we cannot ig­ nore the crying needs of society for better access to total health care, which includes prevention of disease as well as treatment of it. It would seem most logical to assume that the university centers of our country are best equipped to mount the multidisciplinary, interdisciplinary attack which can meet those needs." Members of the Search Committee are: Mrs. John (Mildred) Campbell, community representative; Dr. Lawrence Cappiello, as­ sistant to the executive vice president, secretary; Miss Sara Cicarelli, Medical Technology; John Coulter, assistant to the dean, Pharmacy; Dr. James Dunn, Anatomy; Dr. Daniel Fahey, member, U/B Council; Dr. Andrew Gage, Veterans Hospital; Dr. Milo Gibaldi, Pharmaceutics; Dr. L. Saxon Graham, Sociology; Dr. George Greene, Oral Pathology; Dr. Donald Rennie, Physiology; Dr. Jeanette Spero, Nursing; and Dr. William Staubitz, Surgery, Meyer Memorial Hospital, chairman. Health science students elected Miss Dorothy Ackerman, a fourth-year student in nursing and Mr. Daniel Botsford a secondyear student in medicine to the committee.D 62 THE BUFFALO PHYSICIAN �The 1915 Class Dr. W. Gifford Hayward, M"15, is retired and living in Cocoa Beach, Florida (131 Sunny Lane). The urologist practiced for many years in Jamestown, N.Y. Fie was a past president of the W.C.A. and Jamestown General Hospital staffs. Dr. Hayward was also a past president of the Jamestown and Chautauqua County Medical Societies and the Northeast Section of A.U.A. and past chairman of the Section on Urology, New York State Medical Society. Dr. Hayward wrote extensively for the Journal of Urology, the Urologic and Cutaneous Review, from 1938 to 1953. The Classes of the 1920's Dr. Bart A. Nigro, M'20, who is semi-retired, is on the Honorary Staff at Buffalo Columbus Hospital. The former diagnostician of Buffalo and Erie County Health Departments, is a member of county, state and national medical societies. He lives at 229 Irving Terrace in Kenmore.D Dr. Irwin M. Walker, M'20, was honored in May by the Niagara County Medical Society for his 50 years of medical practice in the area. He received a certificate from the State Medical Society.D Dr. Joseph V. Farugia, M'21, was honored in May for his 50 years of medical practice in Niagara Falls. Dr. Boris Golden, M'40, was guest speaker and Dr. Peter lannuzzi was master of ceremonies. Dr. Farugia was de­ scribed as "a unique man because he practices good medicine and is interested in many other things as well."D Dr. Franklin T. Clark, M'22, was honored in May by the Niagara County Medical Society for his 50 years of medical practice in the area. He received a certificate from the State Med­ ical Society.D Dr. Caryl Koch, M'23, retired from general practice in 1966 to assume duties as full time medical director of the Orchard Park Central School System. He is a member of local, state and national medical societies and on the FALL, 1972 Board of Directors of the New York State School Physicians Association.• Dr. W. Yerby Jones, M'24, the only black physician to head a department in both the E. J. Meyer Memorial Hospital and the Medical School, was honored at a testimonial dinner May 3. He retired from the faculty last year after 25 years of service. The ophthalmologist will continue his private practice.• The Classes of the 1930's Dr. Thomas S. Bumbalo, M'31, was elected to serve a one year term as Vice President, Medical Society, State of New York at the organization's annual convention. He is a clinical professor of pediatrics at the Medical School. Currently serving as Assistant Medical Di­ rector at E. J. Meyer Memorial Hospital, Dr. Bumbalo is a Past-president of the Medical Society, County of Erie and Immediate pastpresident of the Eighth District Branch Medical Society, State of New York. He has acted as Medical Society representative, and Specialty (Pediatrics) representative to the State society for a number of years. In this capacity he has also acted as caucus chairman at the MSSNY annual convention. Most recently he has served as State Society delegate to the American Medical Association. Dr. Bumbalo will occupy a seat on the Council of the State Society by virtue of his new office.D Dr. and Mrs. Joseph D. Godfrey were hon­ ored for contributions to Canisius High School at the annual June Commencement. Dr. God­ frey is a 1931 Medical School Graduate and a clinical professor of surgery (orthopedic) at the University and Buffalo Bills team physician. Both of the Godfrey's sons graduated from Canisius. They are the Reverend Joseph J. God­ frey, S.J., now in graduate study at the Uni­ versity of Toronto and William R. Godfrey, who graduated from Notre Dame University this spring.D Dr. Edison E. Pierce, M'33, was honored in April by the East Aurora Kiwanis Club. He received the club's distinguished service award for serving the community 37 years as a gen­ eral practitioner. Dr. Pierce is a member of the Buffalo General Hospital surgical staff.D Dr. Norbert G. Rausch, M'33, terminated his private practice of dermatology in October, 63 �1970. He is now V.D. consultant to the Erie County Health Department and attending der­ matologist at Veterans Hospital. He is also a clinical associate in medicine (dermatology) at the University.• After a lengthy U. S. Public Health Service career (1939-1972), Dr. Thomas C. McDonough, M'36, is now in limited private practice, specializing in insurance examinations. Dr. McDonough was in charge of the USPHS Out­ patient Clinic, Buffalo from 1968-1972. His address is 41 Berkley Place, Buffalo.• Dr. Robert B. Newell, M'36, a surgeon, has retired from private practice in Rock Island, III. to join North Carolina's High Point Memorial Hospital's Emergency Room staff. He lives at 213 North. Point Avenue, No. 217A, High Point.D Dr. Theodore T. Jacobs, M'38, has been elected president and chief executive officer of the Buffalo General Hospital. He has been on the hospital staff in various administrative positions since 1959. Dr. Jacobs is an assistant clinical professor of surgery at the School of Medicine.• Dr. Roy E. Seibel, M'39, has been named a Fellow of the American College of Radiology. He is a clinical assistant professor of radiology at the Medical School.• department of internal medicine at St. Fouis University School of Medicine and was recently appointed Governor of the American College of Physicians, Missouri. His term of office lasts until 1974. Dr. Frawley is a co-author with Dr. George W. Thorn, M'29, of a book entitled The Adrenal Cland.Ci Dr. William J. Rogers III, M'45, a surgeon who lives at 4080 Delaware in Tonawanda, New York, has been elected president of the newly-formed NYS Society of Orthopedic Surgeons.D Dr. Albert P. Sutton, M'48, a urologist who is an assistant clinical professor at the Albert Einstein College of Medicine, is president of the Brooklyn-Fong Island Urologic Society. He lives at 38 Hemlock Drive in Kings Point, Great Neck.D Dr. Irving R. Fang, M'49, has been named chief of obstetrics and gynecology at Clifton Springs Hospital and Clinic, New York. Dr. Lang did his residency in obstetrics and gyne­ cology at the E.J. Meyer Memorial Hospital and was an assistant clinical professor at the Med­ ical School before moving to Newark 10 years ago. He is currently president of the New York State Divisions of the American Cancer Society.D The Classes of the 1950's The Classes of the 1940's Dr. John Persse, M'42, was honored at a testimonial dinner April 27 for his 21 years of service as chief of surgery at Mercy Hospital (Buffalo). He is a Fellow of the American Col­ lege of Surgeons and a Diplomate of the American Board of Surgery. Dr. Persse served his internship at Mercy Hospital and his sur­ gical residency at Alexander Blain Hospital, Detroit.D Dr. Alexander Slepian, M'43, received the annual brotherhood Citation from the Cana­ dian Council of Christians and Jews in Niagara Falls in May.D Dr. Charles J. Tanner, M'43, is president of the South Buffalo Mercy Hospital Medical Staff (1972). He lives at 785 Orchard Park Road, West Seneca.• Dr. Thomas F. Frawley, M'44, whose speci­ alty is Internal Medicine (Endocrinology) is physician-in-chief, St. Fouis University Hos­ pitals. He is professor and chairman of the 64 Dr. Robert H. Burke, M'51, an obstetriciangynecologist, lives at 811 York Street, Oakland, California. He is a member of the American College Ob-Gyn and Surgeons (Board ObGyn).D Dr. Bernie P. Davis, M'52, an orthopedic surgeon who lives at 666 Colvin Avenue in Kenmore, is president of the Western New York Orthopedic Society and Phi Lambda Kappa, a medical aid society, as well as vice president of the medical staff at North Tonawanda's DeGraff Memorial Hospital. He is an instructor of orthopedic surgery at the Uni­ versity.• Dr. Frank S. Cascio, M'54, is an associate professor of medicine at the University of Ken­ tucky in Lexington. He is Director of the Health Service at the school. Dr. Cascio is a Diplo­ mate, American Board of Internal Medicine and a Fellow of the American College of Physicians and also the American College of Chest Physicians.• THE BUFFALO PHYSICIAN �Dr. Ernest H. Meese, M'54, a surgeon who is assistant clinical professor at the University of Cincinnati Medical Center, is a member of many national and state medical societies. He has been elected vice president of the Cin­ cinnati-Hamilton County unit of the American Cancer Society and to the American Heart As­ sociation of SW Ohio's board of trustees and executive board. Dr. Meese lives at 174 Pedretti Road in Cincinnati.• A 1955 Medical School graduate, Dr. Milton Alter, discussed "Clues to the Cause of Mul­ tiple Sclerosis" at the annual public education program sponsored by the Multiple Sclerosis Association of Western New York in May. Dr. Alter is professor of neurology at the University of Minnesota and director of the multiple sclerosis clinic. He is also chief of neurology at Minneapolis Veterans Hospital.• Dr. William J. Sullivan, M'55, a psychiatrist who is on the faculty of the University of South California's Psycho-Analytic Institute, is a Diplomate of the American Board of Psychi­ atry and Neurology. He lives at 2204 Westridge Road in Los Angeles.• Dr. Germante Boncaldo, M'57, has been elected a Fellow of the American College of Physicians. He is a clinical instructor in medi­ cine at the Medical School.• Dr. Hilliard Jason, M'58, is stepping down from his position as Professor and Director of the Office of Medical Education Research and Development, College of Human Medicine, Michigan State University, to return to more active teaching and research. Dr. Jason founded the department six years ago at this new medi­ cal school. For the coming year he will be on leave of absence serving as "Scholar in Resi­ dence" at Lister Hill Center for Biomedical Communications at the National Library of Medicine in Washington, D. C. His home ad­ dress is 947 Roxburgh Road, East Lansing.D Dr. Thomas Doeblin, M'59, has been elected a Fellow of the American College of Physi­ cians. He is a clinical assistant professor of medicine at the School of Medicine.• Dr. Seymour D. Crauer, M'59, a surgeon who is an instructor at New York University is also a member of a group-type (prepaid medical plan) practice in Hicksvilie. The Fellow of American College of Surgeons lives at 20 Deerpath Lane in Syosset.D FALL, 1972 The Classes of the 1960's Dr. Harris C. Faigel, M'60, whose'specialty is Adolescent Medicine, is a clinical instructor in pediatrics at Boston University. His home address is 123 Sewall Avenue, Brookline, Mas­ sachusetts.• Dr. Marshall E. Barshay, M'63, a nephrologist on the staff of Los Angeles' Wadsworth VA Hospital, is a member of the American Society of Clinical Hypnosis and an associate of Amer­ ican College of Physicians. Dr. Barshay lives at 3630 Sepulveda Blvd., Apt. 135, Los Angeles.Q Dr. Lee N. Baumel, M'63, a psychiatrist who lives at 9270 Warbler Way in Los Angeles, is president of AWN (All We Need), a national ellemosynary foundation for dialysis and trans­ plantation, and vice president of Probus Pro­ ductions (productions for TV). Among his other memberships are Cedars Sinai Medical Center, Southern California Psychiatric Society, APA, and he serves as psychiatric consultant to Kidney Dialysis and Transplantations Pro­ grams.• Dr. Robert S. Zeller, M'63, a pediatric neur­ ologist, has moved to 302 Gentilly Place, Houston, Texas (from Buffalo).• Dr. Robert W. Harding, M'64, an internist, lives at 310 Tanner Street, Rutherforten, North Carolina. He is a Diplomate, Board of Internal Medicine and a member of the American Col­ lege of Physicians. He is Chief of Staff at Rutherford County Hospital and County Dele­ gate to the North Carolina State Medical Society.D Dr. Ronald S. Mukamal, M'64, a general sur­ geon at the USAF Hospital, George AFB in Cal­ ifornia, has been honored by the Jewish Chap­ laincy in "grateful recognition of (his) loyalty and devotion to God and country as a surgeon in USAF Hospital, George AFB, California." He lives at 4 California Court in Victorville.D Dr. Bernard S. Potter, M'65, recently com­ pleted his dermatology residency at Temple University Health Sciences Center, The Skin and Cancer Hospital of Philadelphia (7-1-69 to 6-30-72). He has now entered private practice of dermatology at 410 Wolf Hill Road, Dix Hills, New York.D 65 �Dr. David L. Buchin, M'66, has completed military service in July at Denver's Fitzsimons General Hospital where he was a psychiatrist. He plans to move to Phoenix, Arizona for ad­ ditional residency training^ Dr. Ira Feldman, M'66, who was recently in the U. S. Army at Fort Jackson, Columbia, South Carolina, is now starting the 2nd year of a Cardiology Fellowship (July, 1972) at Har­ bor General Hospital in Los Angeles. His first year fellowship was the same institution from 1969-1970. In March, 1971, Dr. Feldman be­ came a Diplomate of Internal Medicine. He has co-authored articles appearing in THE AMERICAN JOURNAL OF MEDICINE, CIRCU­ LATION, and CHEST Magazine.D Dr. Marcella F. Fierro, M'66, is a resident in pathology at the Medical School of Virgin­ ia, Richmond. Her address is 2901 Wighton Drive, Richmond.• Dr. Robert M. Tabachnikoff, M'66, who has been chief resident in OB/Gyn at Hartford Hospital, (Connecticut), will open a private practice in his specialty in Sarasota, Florida in September.n Dr. Eugene B. Wolchok, M'66, is in his last year of residency in ophthalmology at Massa­ chusetts Eye and Ear Infirmary and is also a teaching fellow at Harvard Medical School. He lives at 59 Mosman Street, West Newton.• Dr. John R. Anderson, M'67, recently en­ tered full time Emergency Medicine practice (May, 1972) at the Community Hospital of Ro­ anoke Valley, Virginia, after serving in the U. S. Navy. Two case reports of Dr. Anderson were published in Aerospace Medicine of October and November, 1971. His new address is 3782 Tomley Drive, Roanoke.• Dr. Robert M. Benson, M'67, is now finishing up his pediatric assignment in the U. S. Army at Dewitt Army Hospital, Fort Belvoir, Virgin­ ia. In September, 1972 he will begin a fellow­ ship in pediatric endocrinology at Johns Hop­ kins Hospital. He took previous pediatric train­ ing at the UCLA Hospital and William Beau­ mont General Hospital.• Dr. Richard H. Daffner, M'67, is a resident in diagnostic radiology at Duke University Medical Center, Durham, North Carolina. He is contributing editor, radiology, THE NEW PHYSICIAN (SAMA).Q Dr. Douglas Roberts, M'67, is now a Cardi­ 66 ology Fellow at Strong Memorial Hospital, Rochester, New York. Until July, 1972 he was chief resident in medicine at Meyer Memorial Hospital.• Dr. Margaret A. White, M'67, (nee Brown) completed her residency in pathology in July and has been appointed to the Medical Col­ lege of Virginia as an instructor in pathology. Her new address (she was married in May) is 8830 M Three Chopt Road, Richmond, Vir­ ginia.• Dr. S. K. Bosu, M'69, is an assistant clinical instructor (pediatrics) at McGill University Med­ ical School, Montreal, Quebec, Canada. He is also doing a 1-2 year fellowship in neonatol­ ogy at the Montreal Children's Hospital.• Dr. Lang M. Dayton, M'69, is now serving a 2 year USPHS obligation and is also an In­ structor in Medicine at the University of West Virginia Medical Center. He was formerly a Fellow in Pulmonary Diseases at the University of Colorado Medical Center. His address is 916 Hawthorne Avenue, Morgantown, West Virginia.• Dr. John R. Fish, M'69, is a resident, ortho­ pedic surgery, at the University of Minnesota. His address is 3472 North Milton Street, St. Paul.D The Classes of the 1970's Drs. Charles and Ellen Fischbein, M'70, have both completed pediatric residencies at the University of Cincinnati. Charles (now at Har­ vard University) will do a fellowship in pedi­ atric cardiology at Boston Children's HospitalEllen (Boston University) will do a fellowship in pediatric radiology at Boston Children's and Boston City Hospitals. Their new address is 307 Windsor Drive North, Framingham, Massachusetts.• Dr. James K. Smolev, M'70, wife Linda, and daughter, Jennifer Deborah (born February 28, 1972) are now at Fort Defiance, Arizona, where he is on active duty, U. S. Public Health Serv­ ice at the Indian Hospital. He had previously completed his internship, department of sur­ gery, Johns Hopkins Hospital. After two years in P.H.S., Dr. Smolev expects to return to Hop­ kins for a residency in urology.D Since July 1 Drs. Donald Marcus and Allen Berliner, both M'71, are in the National Health Service Corps division of the U. S. Public Health Service, Mono County, California.• THE BUFFALO PHYSICIAN �People President Nixon named Dr. Gerald P. Mur­ phy, director of Roswell Park Memorial In­ stitute, among his 18 appointees to the new National Cancer Advisory Board. Dr. Murphy is a research assistant professor of surgery (urology) at the Medical School.• Dr. Eleanor A. Jacobs, clinical assistant pro­ fessor of psychology in the department of psy­ chiatry at the Medical School, was awarded a plaque and $1,000 for her research in learning and memory in aging at a symposium at Miami Beach in March. She is also on the staff of Veterans Administration Hospital. Dr. Jacobs was the first recipient of the award for "ex­ cellence in research." She is trying to ascertain if an increased oxygen delivery to the brain can alleviate some of the symptoms associated with senility.D Dr. Daphne J. Hare, assistant professor of medicine and biophysical sciences, has been appointed to the NIH Renal Disease and Urol­ ogy Training Grants Committee. She is on the staff of Veterans Administration Hospital.• Two members of the Department of Social and Preventive Medicine at the Medical School have accepted positions at the University of Iowa, Iowa City. Dr. Peter Isacson, associate professor and head of the Vaccine Evaluation Unit since 1966, will become professor and chairman of the Department of Preventive Medicine and Environmental Health at Iowa. Dr. Robert B. Wallace, clinical instructor and acting director of the preventable disease service in the Erie County Health Department, will become assistant professor in the same department. He has been on the Medical School faculty since 1971.• Three alumni have been elected officers in the Heart Association of Western New York. Dr. William J. Breen, M'55, is the new presi­ dent; Dr. Victor L. Pellicano, M'36, is the president-elect and Dr. Francis J. Klocke, M'60, is the first vice president. Dr. Anthony J. Federico, clinical assistant professor of surgery, is the new secretary. Dr. Joseph J. Zizzi, M'58, is the immediate past president.Q FALL, 1972 A pre-medical student, Martin Barron, (right) was one of three to win a Clifford C. Furnas $1,000 Scholar-AthleteGraduate Scholarship. He was an outstanding breastslroker on the swimming team. Pictured (left to right) are — Bruce Fraser, football linebacker; Gerry Philbin (class of 1964) New York Jets defensive end, who was master of ceremonies at the 63rd annual "Block B" ban­ quet; Dale Dolmage, hockey center; and Martin Barron.• A fourth year medical student, David H. Breen, is a regional trustee of the Student American Medical Association.• Dr. Emma Harrod, clinical assistant profes­ sor of pediatrics and research assistant in­ structor in medicine, is the new deputy com­ missioner of health in Erie County. For the last two years she has been director of ma­ ternal and child health services in the Erie County Health Department. Before joining the department in April of 1970 she was clin­ ical director of the Birth Defects Center at Chil­ dren's Hospital. Dr. Harrod is a Fellow of the American Academy of Pediatrics.• Dr. David C. Dean, assistant professor of medicine, is the new president of the Buffalo Academy of Medicine. He succeeds Dr. Michael A. Sullivan, M'53.D Dr. Theodore H. Noehren is shifting from the University of Utah Medical Center to the Holy Cross Hospital in Salt Lake City. He will continue as a full-time member in the depart­ ment of medicine (pulmonary division) of the University Medical Center. Dr. Noehren was a member of the UB Medical School faculty from 1952 to 1968. When he resigned he was an associate professor of medicine. He is a graduate of the University of Rochester Med­ ical School.• 67 �Dr. Palanker Four alumni are officers of the Buffalo Sur­ gical Society. Dr. Harold K. Palanker, M'40, is the new president. Dr. Andrew Gage, M'44, is the newly elected vice president, while Dr. Ralph E. Smith, M'43, is the new secretary, and Dr. Carroll J. Shaver, M'44, is the new treasurer. Drs. Floyd M. Zaepfel, M'41, Charles Wiles, M'45, and Worthington G. Schenk Jr., pro­ fessor and chairman of surgery, are society council members. The society consists of sur­ geons who are active in community health activities and interested in a progressive med­ ical school. Dr. Palanker is a clinical assistant professor of surgery at the Medical School. He is also chief of one of the three surgical divi­ sions of the Buffalo Children's Hospital, At­ tending on the surgical staff of St. Joseph In­ tercommunity Hospital, and on the active teaching service of the Buffalo General Hospi­ tal. Dr. Palanker is past president of the West­ ern New York Chapter of the American College of Surgeons. He served with the Harvard Med­ ical Unit overseas during World War II and later finished his training in surgery at the Buffalo General and Children's Hospitals under the late Dr. John R. Paine.D Dr. S. Mouchly Small has been named official consultant for the Jerusalem Mental Health Center-Ezrath Nashim. He presented several seminars in June on the treatment of the aged with hyperbaric oxygenation. Dr. Small is pro­ fessor and chairman of psychiatry.D A biochemistry professor, Dr. Willard B. Elliott, was honored in May for his scientific contribution in spectroscopy, clinical chemistry, education and concern for the community. He received the Distinguished Service Award of the Niagara Frontier Section of the Society for Applied Spectroscopy.D Dr. Felsen Dr. Irwin Felsen of Wellsville was re-elected president of the Lakes Area Regional Medical Program. He is a clinical instructor in family practice at the Medical School. Dr. Theodore T. Bronk, clinical associate professor of pathol­ ogy, was named secretary and Dr. John C. Patterson, clinical associate in gynecologyobstetrics, was elected treasurer.D 68 Dr. Edmund Klein has been successfully eradicating skin cancer with immunotherapy. The research professor of medicine (derma­ tology and syphilology) at Roswell Park Me­ morial Institute began his research in 1963 and is using his technique as a last-ditch effort to save patients with intractable internal can­ cers manifested in the skin. In May at a Na­ tional Cancer Institute conference in Gatlinburg, Tenn. the physician-researcher reported that of 32 such cases treated so far, 24 had achieved remissions ranging from six weeks to six years.• Dr. Margaret Acara, who received her Ph.D. in pharmacology in 1971 from the university has been awarded a "graduate women in science grant-in-aid" from Sigma Delta Epsilon, an organization of national women scien­ tists. Dr. Acara's $750 award was one of three. She is currently working in Dr. Barbara Rennick's (professor of pharmacology) laboratory as a Postdoctoral Fellow, supported by a fellowship from the United Health Founda­ tion.• Dr. William A. Isaacs, a hematologist from the University of Ibadan in Nigeria, spent the last three months in the Medical Genetics Unit, Buffalo General Hospital, on a research fellow­ ship to study sickle cell anemia. He worked with Dr. Robin M. Bannerman, professor of medicine at the Medical School. Dr. Isaacs pointed out that about 17 of every 1000 blacks in Nigeria has this disease, compared to three in every 1000 blacks in the United States. He saw sickle cell patients being treated at the hospital and did laboratory investigation of factors which precipitate sickle cell crises. Some of this lab work could not be done in Nigeria, he said.D Dr. John Edwards has been elected a Fellow of the American College of Physicians. He is a research assistant professor of medicine and a Buswell Fellow at the Medical School.• Dr. Robert M. Kohn, clinical associate pro­ fessor of medicine, is president-elect of the New York State Heart Assembly. He is also director of the Buffalo Cardiac Work Evaluation Unit.D THE BUFFALO PHYSICIAN �Dr. Kunwar P. Bhatnagar, who received his Ph.D. in Anatomy in 1972 at the university is now an assistant professor at the University of Louisville School of Medicine (Kentucky).• Dr. Donald P. Shedd, chief of Roswell Park's department of head and neck surgery, and associate research professor in surgery at the University, lectured to the Puerto Rico Chapter, American College of Surgeons last February on oral cancer.Q Several alumni and Medical School faculty members are serving as officers and committee chairmen with the Erie County Medical Society. Dr. Leonard Berman, M'52, clinical associate professor of surgery, is the new president. He succeeds Dr. Anthony P. Santomauro, M'56. Dr. James H. Cosgriff, assistant clinical pro­ fessor of surgery is the new president-elect, and Dr. Frank J. Bolgan, M'51 is the newly elected vice president. He is a clinical as­ sociate in surgery at the Medical School. The new secretary-treasurer is Dr. C. Henry Severson, M'40. Standing committee officers are: legislation — Dr. Carmelo S. Armenia, M'49; public health — Dr. Alfred R. Lenzner, clinical assistant professor of medicine; economics — Dr. James M. Cole, M'59; medical education — Dr. John J. O'Brien, M'41; ethics — Dr. John J. G i a r d i n o , M ' 5 8 ; p e e r r e v i e w — D r . B e r n a r d M. Reen, clinical instructor in medicine.D O n e alumnus, Dr. Daniel R. Tronalone, M'22, was among the seven physicians honored for 50 years of practice by the Erie County Medical Society. The others are — Drs. Max S. Aber, Paul Beck, Arthur N. Bodenbender, Archibald S. Dean, George G. Martin and Kurt Mathews.D Dr. Ralph Sibley, research assistant professor of pediatrics at the Medical School, is the new president of the Citizens Committee for Chil­ dren of Western New York Inc. A 1962 gradu­ ate, Dr. Oscar Oberkircher, is the new treasur­ e r , a n d D r . L i s e l o t t e K. F i s c h e r i s a s s i s t a n t t r e a s ­ urer. She is a clinical associate professor of psychology in the departments of psychiatry and pediatrics at the University. Mr. Steve Knezevich is the new vice president.D FALL, 1972 In Memoriam Dr. William H. Hall Jr., M'43, was killed in a one-car accident in Western New York June 10. The 53-year-old physician lived at Bemus Point and had a general practice in Jamestown. At one time he was chief of the medical staff of WCA Hospital, Jamestown. He did his residency in surgery and cancer at Memorial Center, New York City. For the last 10 years Dr. Hall served as medical coordinator for the Chautauqua County Fire Service. He served as chairman of the Public Education Committee of the American Cancer Society, New York State Division. Dr. Hall was also active in sev­ eral other professional organizations.Q Dr. Ethan Lee Welch, M'25, died March 16 in St. James Mercy Hospital, Hornell, N.Y. following a three-week illness. The 70-year-old physician-surgeon started his Hornell practice in 1926, after interning at Buffalo General Hos­ pital. He was chief of staff at St. James Mercy H o s p i t a l a n d d u r i n g W o r l d W a r II h e w a s medical officer in charge of the Navy unit at Alfred University. He was also on the staff of Bethesda Community Hospital in North Hor­ nell. Following his retirement in 1968 he and his wife traveled extensively in this country and the Orient. His medical memberships in­ cluded the AMA, medical societies of New York and Steuben County and the American Society of Abdominal Surgery.D 69 �"p1 In Memoriam V1 Dr. William Brady is dead at 91. He was a 1901 Medical School graduate. Dr. Brady, who reached out to millions through the nation's first syndicated health column — "Personal Health Service" — died of uremia February 25 at his home in Beverly Hills, California. His loyal followers will remember the doc­ tor for his no-nonsense health advice. He ad­ vocated "oxygen on the hoof, bowling on the green, and somersaults" — and he practiced what he preached until he snapped a verte­ bra while turning somersaults at 83. Generations of Americans grew up with Dr. Brady; among his most faithful readers of re­ cent years were the grandchildren and great­ grandchildren of his first readers. Born March 26, 1880, he practiced medicine in upstate New York for 15 years before finally giving up private practice to write full-time. Over-stating to make his point, Brady ex­ plained: "I couldn't make a living in private practice. First, I told patients the truth, and that drove 'em to other doctors. In my inno­ cence I thought patients would like that, but I realized too late that they didn't. Second, I had too many patients who believed a doctor earns his money easily and hence can wait until all other bills have been paid — which too often proves forever." Dr. Brady's column, which is syndicated by National Newspaper Syndicate, started in 1914. For 58 years he carried out a war against "nostrum manufacturers," "klinic racketeers," and "merchants of medicine." condition of modern Americans, the doctor urged his readers to ride less and walk more. He also favored belly breathing, better chewing of food, and conservation of the teeth. "Real or replacement, count each tooth as worth $10,000," he said. The doctor him­ self used a birch toothpick with soap-andwater mouthwash. He fought the over-emphasis on new-fangled instruments, medicines, and methods. Yet, despite his ceaseless wars on "klinic racke­ teers," Dr. Brady urged his readers to consult reliable doctors. "Few men valued more high­ ly the worth of good medicine and good den­ tistry," remembers Robert C. Dille, head of the National Newspaper Syndicate and a long­ time friend of Brady's. "Perhaps more than any other man, Dr. Brady took his readers out of the Dark Age of mystery and mysticism and led them to a proper respect for science and medicine." Pomp and ceremony held no appeal for Dr. Brady. His last request was that no funeral or memorial service be held for him. He willed his body to the medical school of the Univer­ sity of California. "I never fret about eternity," he once said. "I came to a very satisfactory conclusion about that years ago: Leave it to God." Dr. Brady's wife died in 1960. He is sur­ vived by two daughters, Mrs. Charles (Helen) Redford and Mrs. Willis (Elizabeth) Ader, two grandchildren, and five great-grandchildren.• \0 His salty style and wry humor delighted mil­ lions of avid followers. Another physician once suggested that Dr. Brady was wrong in attrib­ uting the death of a patient to calcium short­ age. "Autopsies reveal that adults don't have as much calcium as children," the other doc­ tor said. "And why do you think there was an autop­ sy?!" Brady retorted. Firmly believing that nutrition is the secret of good health, Dr. Brady strongly advocated the use of vitamins and minerals as a basic part of the everyday diet. Teetotaler Brady regarded alcohol as a nar­ cotic, and urged youngsters not to smoke until they were 21. Deploring the physical 70 jV-^ Dr. Paul A. Fernbach, M'39, died of self in­ flicted gun wounds June 16. The 56-year-old clinical assistant professor of surgery at the Medical School was an associate surgeon at both Buffalo General and Children's Hospitals. He served his internship and residency at the Buffalo General Hospital. Dr. Fernbach spe­ cialized in surgery of the peripheral blood vessels. He was a Diplomate of the American Board of Surgery and a Fellow of the American College of Surgeons. He was also a member of the American and International Colleges of Angiology and the Phlebology Association of America., During and after World War II he served as a Major in the Army Medical Corps in the Asiatic Pacific Theater from 1941 to May 1946.D THE BUFFALO PHYSICIAN �Dr. Warren C. Fargo, M'13, died December 23, 1971. He had practiced pediatrics in the greater Cleveland, Ohio area for 50 years. He was head of the pediatrics department of Saint Luke's Hospital from 1929 to 1939. Dr. Fargo was born on April 18, 1890 in Warsaw, New York. His ancestors came from St-Fargau in France in 1670. The Wells and Fargo families founded an express service, Wells-Fargo Company, which was rooted in Western New York State and became a roman­ tic part of the history of The United States. With this background, Dr. Fargo became a member of The National Society of The Sons of The American Revolution. He interned at the Buffalo General Hospital in 1913. His residency training in pediatrics included The New York Nursery and ChiIds' Hospital, Seaside Hospital of St. John's Guild and The Children's Medical Division of Belleview Hospital. He had fellowships in pediatrics at Washington University and The Finkelstein Clinic in Berlin, Germany. Warren Fargo served with distinction in the Army Medical Corps in Tries, Germany in W o r l d W a r I. I t w a s h e r e t h a t h e m e t h i s l o n g time friend, Dr. Willard C. Stoner, Sr., former Director of Medicine at Saint Luke's Hospital. It w a s D r . S t o n e r w h o p e r s u a d e d h i m t o c o m e to Cleveland to practice. He also served in W o r l d W a r II a s a C o l o n e l a n d w a s t h e C o m ­ manding Officer of the Brook General Hos­ pital at Fort Sam Houston in San Antonio, Texas. On February 25, 1946 he received the Legion of Merit for "Exceptionally meritorious conduct in the performance of outstanding services" while he was in charge of this facility. Dr. Fargo was Chief Medical Director of The Children's Fresh Air Camp and Hospital, now known as Health Hill, for forty-two years. He was honored in 1963 when a hospital unit was named for him. The doctor was a member of the Ohio State Medical Association, The American Medical Association, The American Academy of Pedi­ atrics and was certified by The American Board of Pediatrics. He was a member of the Cleveland Academy of Medicine and a former Editor of THE ACADEMY BULLETIN. He was also a member of Nu Sigma Nu Fraternity.D FALU 1972 D r . L. G o r d o n L a P o i n t e , M ' 3 7 , d i e d s u d d e n l y on January 10 of a coronary. He was living in South Pittsburg, Tennessee at the time of his death. Dr. LaPointe interned at Sisters of Charity Hospital and had seven months of surgical pathology at Buffalo General Hospital. He did his surgical residency at New York Post Gradu­ ate Hospital from 1939-41. He continued his work, serving as personal assistant to Dr. John J. M o o r h e a d u n t i l 1 9 4 7 . D r . L a P o i n t e s e r v e d in the United States Navy during World War II. All of Dr. LaPointe's active surgical career was in New York City until July 1969, at which time he resigned from his private practice and from his position as Vice President and Medi­ cal Director of the Manhattan Life Insurance Company, to become staff surgeon at the South Pittsburg Municipal Hospital, South Pittsburg, Tennessee. Dr. LaPointe was a member of various mediical and professional organizations including Diplomate of the American Board of Surgery, Fellow of the International College of Sur­ geons, Fellow of the New York Academy of Medicine, Member of the Chattanooga-Ham­ ilton County Medical Society, State of Tennes­ see Medical Society, Non Resident Member State of New York Medical Society, and AMA.D D r . D o r i t a A . N o r t o n ', r e s e a r c h a s s o c i a t e / professor of biophysical sciences, died May 21. The 41-year-old scientist was also executive director of the Medical Foundation of Buffalo. At one time she was an assistant to Dr. George E. M o o r e , f o r m e r d i r e c t o r o f R o s w e l l P a r k Memorial Institute.• ( ) ' D r . G e o r g e B. U b e l , M ' 1 5 , d i e d M a y 2 4 . T h e 79-year-old specialist in internal medicine had practiced for 57 years in Grand Island and Buffalo. He had gone into semi-retirement in 1970. He was on the Medical School faculty (1945-59) and on the staffs of Buffalo General, Kenmore Mercy and Millard Fillmore Hospitals. In 1969 Dr. Ubel was named "Senior Citizen of the Year" by the Grand Island Chamber of Commerce. He was active in several local and state professional organizations-^ 71 �/YVD In Memoriam Dr. Porter A. Steele, M'16, died June 4, after a one week illness. The 79-year-old Buffalo surgeon was a member of the Millard Fillmore Hospital staff for 45 years and its president from 1956 to 1958. He was attending surgeon from 1927 to 1959, then consulting surgeon before becoming emeritus surgeon in 1971. Dr. Steele's practice spanned a 56-year period. He was president of the Erie County Medical So­ ciety in 1946. He was a Fellow in the American College of Surgeons and studied at the Uni­ versity of Vienna and the University of Buda­ pest. He was an instructor in anatomy at the Medical School from 1936 to 1945. He in­ terned at the Buffalo General Hospital and completed his residency at the New York Post Graduate Hospital, New York City. A member of the Sports Car Club of Amer­ ica, Dr. Steele served on the medical team at the Grand Prix in Watkins Glen from 1956 to 1971. He was also an antique car buff. He served in the Army Medical Corps in France during World War I and was discharged a lieutenant. Dr. Steele was a founding member of the Science, Progress and Research Club of Buffalo, and a member of the AMA, American Society of Abdominal Surgeons, New York State Society of Surgeons and the Buffalo Academy of Medicine. He was also active in several other civic organizations.• " Dr. Howard Osgood, 82, one of Buffalo's early allergists died May 23 at the Presbyterian Home where he had lived for the past two years. He was an assistant professor of medi­ cine at the Medical School from 1921 to 1926. Dr. Osgood had been chief of the allergy clinic at the Buffalo General Hospital from 1929 to 1954 and was widely known for his research in allergy caused by caddis flies. He also did research in allergic chest conditions among grain handlers. He was a 1916 graduate of the Harvard Medical School. Dr. Osgood served overseas as a Captain in the Army Medical Corps in World War I. He moved to Buffalo in 1920. From 1924-30 he was on the staff of Buffalo City Hospital, later Meyer Memorial. During World War II he was an examiner in internal medicine at the Armed Forces Induction Center and from 1924-46 he was school physician at Nichols School. After his retirement he served as an attending physi­ cian for the Red Cross Blood Program. Dr. Osgood became a Diplomate of the American Board of Internal Medicine with cer­ tification in allergy in 1937. He was a former vice president of the American Academy of Allergy and represented the Academy at the first international congress of Allergy in Zurich, Switzerland in 1951. He was a founder of the International Association of Allergists. He was a member of the AMA, Erie County Medical Society, the New York Medical Society and a life Fellow of the American College of Physicians.n The General Alumni Board - MORLEY C. TOWNSEND, '45, President; DR. FRANK L. GRAZIANO, D.D.S., '65, President­ elect; GEORGE VOSKERCHIAN, Vice President for Activities; FRANK NOTARO, '57, Vice President for Administration; MRS. PHYLLIS MATHEIS KELLY, '42, Vice President for Alumnae; JAMES J. O'BRIEN, '55, Vice President for Athletics; ROBERT C. SCHAUS, '53, Vice President for Constituent Alumni Croups; DR. GIRARD A. GUGINO, D.D.S., '61, Wee President for Development and Membership; G. HENRY OWEN, '59, Vice President for Public Relations; ERNEST KIEFER, '55, Treasurer; CHARLES M. FOGEL, '38 and ESTHER K. EVERETT, '52, Members of the Executive Committee; Past Presidents: DR. EDMOND J. GICEWICZ, M'56; ROBERT E. LIPP, '51; M. ROBERT KOREN, '44; WELLS E. KNIBLOE, '47; RICHARD C. SHEPARD, '48. Medical Alumni Association Officers: DRS. JOHN J. O'BRIEN, M'41, President; LAWRENCE H. GOLDEN, M'46, Vice President; PAUL L. WEINMANN, M'54, Treasurer; LOUIS C. CLOUTIER, M'54, Immediate Past-President; MR. DAVID K. MICHAEL, M.A. '68, Secretary. Annual Participating Fund for Medical Education Executive Board for 1971-72 — DRS. MARVIN L. BLOOM, M'43, President; HARRY G. LaFORGE, M'34, First Vice-President; KENNETH H. ECKHERT, SR., M'35, Second Vice-President; KEVIN M. O'GORMAN, M'43, Treasurer; DONALD HALL, M'41, Secretary; MAX CHEPLOVE, M'26, Immediate PastPresident. 72 THE BUFFALO PHYSICIAN �ALUMNI TOUR ROMAN CARNIVAL Departing Oct. 6, 1972, Jet flight from Niagara 8 days and 7 nights — $429.00 complete per person double occupancy, plus 10% tax and services. • Rome — 5 days and nights • Romantic South — 3 days and 2 nights (Naples, Pompeii, Sorrento, Capri) • Deluxe Accommodations • Full American Breakfasts, Gourmet Dinners Nightly • Free sightseeing tour of Rome For details write or call: ALUMNI OFFICE, SUNYAB 123 Jewett Parkway Buffalo, N. Y. 14214 (716) 831-4121 First Class Permit No. 5670 Buffalo, N. Y. BUSINESS NO POSTAGE STAMP REPLY NECESSARY IF MAILED IN THE MAIL UNITED STATES POSTAGE WILL BE PAID BY — Medical Alumni Association 2211 Main Street Buffalo, New York 14214 Att.: David K. Michael �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET, BUFFALO, NEW YORK 14214 THE HAPPY MEDIUM Fill out this card; spread some happiness; spread some news; no postage needed. (Please print or type all entries.) Name Year MD Received Office Address — Home Address — If not UB, MD received from In Private Practice: Yes • No • In Academic Medicine: Yes • Specialty. No • Part Time Q Full Time • School Title Other: Medical Society Memberships: — - NEWS: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.? — Please send copies of any publications, research or other original work. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Fall 1972 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1972-Fall Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v06n03-1972-Fall Table Of Contents A list of subunits of the resource. Seniors Honored Spring Clinical Days: Drug Addiction Professional Corporation Canadian Abortion Legal Abortion Local Abortions/Skin Cancer Drug Ramifications Health Crisis Personal Touch Health Politics Admissions, Budget Health Care Flight Surgeon/Dr. Ranney Class Day Exercises: Class President Speaks Medentian Response Dr. Randall's Congratulations Dr. Sullivan Retiring Faculty Residents Interns Dr. Eckhert Intern Matching Dr. Sanes University Health Service Medentian Honors Professors Eden Physician/Medical Education Working with Others for Optimum Care of Patients by Ruth T. McGrore, Ed.D. Dean School of Nursing RMP Grant/Seniors Honor Faculty Immunology Convocation Summer Fellowships VP Search Committee The Classes People In Memoriam Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v06n03 Extent The size or duration of the resource. 76 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright 1972 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/6316cb8f0468e5738605025fc6e6415e.pdf aac4b651bc20d7d46a3dda0fd3386774 PDF Text Text �STAFF DIRECTOR OF PUBLICATIONS Nancy Tobin BUFFALO PHYSICIAN EDITOR Connie Oswald Stofko ART DIRECTOR Alan J. Kegler ASSISTANT ART DIRECTOR Scott Fricker ADVISORY BOARD Dr. John Naughton, Chairman Dr. Harold Brody Ms. Nancy Glieco Dr. James Kanski Dr. Joseph L. Kunz Dr. Charles Paganelli Mr. Paul D. Paterson Dr. Antoinette Peters Dr. Charles Pruet Dr. Luther Robinson Dr. Thomas Rosenthal Dr. Saleela Suresh Dr. Burton Singerman Dr. Stephen Spaulding Dr. Nelson Torre Mr. Edward Wenzke Dr. Jerome Yates Dear Alumni and Supporters of the UB medical school: M edical schools and the health care establishment must contribute ideas and programs to meet the needs of our rural citizens. This was the consensus of a recent confer­ ence of legislative leaders, faculty from New York State public and private medical schools, and national leaders held in Buffalo. Dr. Thomas Rosenthal of the Department of Family Medicine was in­ strumental in organizing the event. Clearly, departments of family medicine will play an impor­ tant role in directing training efforts to produce medical manpow­ er to populate these underserved areas, and in fostering innovative mechanisms that provide continuing education opportunities and professional linkages between a medical school and the rural phy­ sicians. With the leadership of our department and the strengthening of the conference participants' resolve, I am sure that this unmet need will be dealt with constructively in the years ahead. Sincerely, WRITERS Wendy Brown Milt Carlin David Himmelgrecn Collin McCulley David M. Snyderman John Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences ILLUSTRATORS Alan E. Cober Dan Zakroczemski PHOTOGRAPHERS Antoinette Mucilli Simon Tong Robert Walion TEACHING HOSPITALS AND LIAISONS Batavia Veterans Administration Medical Center Buffalo General Hospital, Mike Shaw Buffalo Veterans Administration Medical Center, John Pulli Children's Hospital, Karen DryjaSwierski Erie County Medical Center, Marion Marionowsky Mercy Hospital, Chuck Telesco Millard Fillmore Hospital, Joseph R. Ciffa Roswell Park Memorial Institute, Judy Rice Sisters Hospital, Dennis McCarthy Produced by the Division of University Rela­ tions in association with the School of Medi­ cine and Biomedical Sciences, State University of New York at Buffalo. THE BUFFALO PHYSICIAN AND BIO­ MEDICAL SCIENTIST (USPS 551-860) Late Winter 1989-90, Volume 2.3, Number 5. Published five times annually: Spring, Summer, Autumn, Early Winter, and Late Winter — by the School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Third class bulk postage paid at Buffalo, New York. Send address changes to THE BUFFALO PHY­ SICIAN AND BIOMEDICAL SCIEN­ TIST, 146 C.F.S. Addition, 3435 Main Street, Buffalo, New York 14214. Dear Colleagues: S pring Clinical Day and Reunion Weekend will be held April 28. A series of outstanding speakers will address the theme "Changing Aspects of Medical Practice." The Stockton Kim­ ball Lecture will be given by Dr. Arnold Relman, editor-in-chiet of the New England Journal of Medicine. Please plan to attend. I'm sure you will be happy you did. Plans are firming up for the first annual UB Medical Alumni "West Coast Mini Spring Clinical Day" to be held in Long Beach, Calif, on May 12. A videotape of Dr. Relman's lecture, in addition to other discussions, will be presented. If you are able to attend, please contact Dr. Richard Berkson at 1868 Pacific Ave., Long Beach, Calif. 90806, or phone (213) 595-4718. Your association and the school are once again seeking nomi­ nations for the Distinguished Medical Alumnus/a Award. If you have a nominee, please submit his or her name on the card located in the front of the magazine. Looking forward to seeing you all at our alma mater on April 28. *v f ! / / / Joseph L. Kunz, M.D. ( • President, Medical Alumni Association �BUFFALO PHYSICIAN vol. 23, No. 5 JL and Biomedical Scientist Late winter 1989-90 Features Urban family medicine. Training physicians to bring "private practice" care to the poor in the inner city is the goal of a new UB program. The other enemy of World War I. Buffalo fared better than most cities during the influenza epidemic of 1918-19, thanks to the leadership of the UB medi­ cal school and its alumni. Volunteers in Third World, page 14- Volunteering in the Third World. Three physicians had three very different experiences, but all encourage their colleagues to share the adventure. Departments Q] Medical School News. Lila Amdurska Wallis, M.D., F.A.C.P., a crusader for women's rights, told a UB audience that it's time to make medicine a bi-gender profession—not only in body count, but in spirit. Serving the underserved, page 2. Research. UB's new Multidisciplinary Center on Ag­ ing focuses on the country's ever-growing popula­ tion of elderly. Alumni. Scholarships, generously provided by alum­ ni, help today's students achieve their dreams. QJ People. We could solve world problems if we used our money for medical research instead of wasting it on weapons, says Guiseppe A. Andres, M.D., as he reflects on social issues and his 20-year career at UB. V- - Cover: Battling an epidemic, page 8. Photo courtesy of the Buffalo and Erie County Historical Society. Classnotes. EQ Hospital News. -oJ Independence for the elderly, page 24. �Letters 2 High Altitude Paradise Editor: A note confirming that ex-Buffalonians do read the Buffalo Physician and Biomedical Scien­ tist, and comments on the article, "Mountain Medicine" (Autumn 1989). My wife and 1 live near Conifer, Colorado at 8,225 feet and spend considerable time climbing and hiking at higher altitudes. Snowmass is at 8,575, not 11,000 feet. Our highest town is Leadville, at 10,152 feet. One town, Silverton, at 8,316 feet has only 14 frostfree days. Dr. Robert Gerner, formerly at Roswell Park Memorial Institute, practices general surgery at Vail (8,150 feet). Personally, I have never heard of any na­ tive suggesting breathing in a paper bag for altitude sickness and I have no knowledge of anyone having severe altitude sickness at 8,000 feet, nor fatalities at 9,000 feet. Heavy smokers, whose adjusted "altitude" would be about 10,000 to 13,000 feet, might have trouble. Rapid, competitive climbing, especially by youngsters, commonly can promote the on­ set of cough, headache, giddiness, and nausea, but rarely serious "mountain sickness." In winter, the associated increase in energy ex­ penditure may lead to a dangerously impaired judgment. The only practical solution is to head downhill. We see other problems in flatlanders before they adjust to this high altitude paradise: • There is the teenager welded to his third can of pop who ascends rapidly on the ski lift and then jumps and soars over the moguls down the valley floor, only to roll in pain from pneumatosis intestinalis. • There is the young lady who misses a commercial flight and heads up over the mountain in an un-pressurized plane, only to learn that her gas-filled prostheses have placed her in double jeopardy. • Of course there was the huge Texan who died on the slopes and wouldn't fit in the lar­ gest available coffin. The local coroner insert­ ed an aspiration tube, and shipped him home in a shoe box. The advice to spend one day at Vail (8,150 feet) or at Aspen (7,980 feet) in mild activi­ ties before climbing a 14,000-foot peak (there are over 50 of them) is reasonable. Your re­ ward will be some of the most beautiful scenes in the world! Cheers, George E. Moore, M.D., Ph.D. LATE WINTER 1989-90 Professor of Surgery Chairman, Division of Surgical Oncology Department of Health and Hospitals City and County of Denver (Editor's Note: Dr. Moore was director of Roswell Park Memorial Institute from 1952 to 1967 ) John Krasney, Ph.D., whose work was described in the article, replies that neurologist Marcus Raichle and some mountaineers, not natives, ad­ vocate the paper bag treatment for acute moun­ tain sickness. Recent evidence indicates that both sides of the argument may be right, Krasney said. Breathing 3 percent carbon dioxide may alleviate symptoms of acute mountain sickness, while it is uniformly agreed that higher levels can exacerbate the con­ dition. He notes that heavy exertion during climbing by non-acclimatized and unfit individuals can indeed lead to serious problems. He agrees that it is rare for people to experience severe acute mountain sickness at 8,000 or 9,000 feet, but it has been documented in a Colorado skier and several climbers on Mt. Fuji. These individuals pmbably have only a minimal increase in venti­ lation drive, which allows them to get sick at modest altitudes. This Historian Never Sleeps Editor: I read.with,greatinterest David Snyderman's article "From Rags to Stitches" (Autumn 1989). Dr. Border is a treasure and without equal as an expert in his field. His knowledge of physiology and trauma is encyclopedic. However, I feel compelled to correct an in­ accuracy within the article. Quoting Border, Snyderman writes: "There was no real profes­ sional anesthesia until World War II. At that time, the armies trained and designated anesthetists." This is not true. The Mayo Clinic residen­ cy program in anesthesiology dates from the late 1920s, as does the program at the Univer­ sity of Wisconsin. The American Society of Anesthesiologists began to issue certificates which certified a physician as a specialist in 1936. The American Medical Association recognized anesthesiology as a medical specialty, on an equal footing with surgery, in 1940. The University at Buffalo can be proud of the role it played in the early organization of anesthesiology. The first academic appoint­ ment here predates the First World War and there was a residency training program in place in Buffalo in 1937. The Second World War accelerated the process of specialization, not only in anesthesiology, but in most fields of medicine. The recognition of anesthesia as a specialty in the '20s and '30s, along with the role played by the University of Buffalo, is a research in­ terest of mine. While these facts may be some­ what obscure, they are fairly well known, at least among anesthesiologists. I thank you for the opportunity to educate and erase a popular yet inaccurate view of my profession. Most sincerely, Douglas R. Bacon, M.D. Staff Anesthesiologist Roswell Park Cancer Institute Clinical Instructor in Anesthesiology Graduate Student, UB Department of History John R. Border, M.D., replies that anesthesia was first practiced as a specialty in the '30s by a few people, but did not become generally accepted or generally organized until after World W a r II. Letters The Buffalo Physician and Biomedical Scientist welcomes letters from its read­ ers. Address them to Buffalo Physician and Biomedical Scientist, 136 Crofts Hall, University at Buffalo, Buffalo N.Y. 14260. ;ALO PHYSICIAN AND BIOMEDICAL SCIENTIST �'Private Practice' for the Inner City' NEW UB PROGRAM BRINGS PERSONALIZED CARE TO THE URBAN POOR Understanding his patients is a goal of David Hoi den, M.D., left. B y D A V I D H I M M E L G R E E N mother brings her sick toddler to the hospital emer­ gency room. The wait is long and the child begins to cry. The mother is confused by the forms she has to fill out in order for her child to be seen by a doctor they've never met. The physician, overworked and tired, is brusque and appears to be unsympathetic. Mother returns home vowing never to return. But she will be back. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST LATE WINTER 1989-90 �AT RIGHT, ADRIANA ALVAREZ, M.D., AND BELOW, DANIEL LASSER, M.D., TRY TO STOP THE "CONVEYOR BELT" APPROACH TO MEDICAL CARE IN THE INNER CITY. LATE WINTER 1989-90 "Where do the urban poor go for medical care? They are frequently driven, in an almost cattle-like mode, to the ERs of major inner-city hospitals and health clinics where they are shuttled from doctor to doctor," said David Holden, M.D., professor and chairman of UB's department of family medicine. "Patients are put through a system which is sometimes analogous to a conveyor belt," added Daniel Lasser, M.D., clinical director of the Family Medicine Department at the Erie County Medical Center. "There is little opportunity for in­ teraction between the doctor and patient. It's not a conducive situation for any of the parties." But Buffalo is in the forefront of a better ap­ proach. Lasser is the director of a new UB program called Urban Family Medicine. Its mission is to pro­ vide a more personalized kind of health care for the urban poor in Buffalo. "What we are trying to do is to introduce a pri­ vate doctor's office into the inner city," explained Peter Kowalski, M.D., clinical assistant professor in family medicine. "We try to ensure that each patient gets to see a specific doctor on a continuous basis," added Adriana Alvarez, M.D., clinical assistant professor in family medicine. "By doing this we build a bond of trust with our patients and the community." The street is dotted with stores that have closed down, marked by their white-washed windows. The weather-warped porch on one house sags in the mid­ dle. Several other houses could use a fresh coat of paint. Children play on sidewalks strewn with litter. The blight of the inner city intertwines with the problems of the Third World on the lower west side of Buffalo. The people are poor, primarily Hispan­ ic and African American. Recent emigres and ille­ gal aliens bring with them the diseases of their native countries. It is not uncommon to find mal­ nutrition, tuberculosis, and intestinal parasites. The people in that neighborhood are also vexed by the inner-city health problems commonly found throughout the U.S. Infant mortality is high. Al­ coholism, drug abuse, and hypertension tear at the heart of the community. And diabetes is another problem, particularly among the Hispanic popu­ lation. At 514 Niagara St. there is a ray of hope called the Niagara Family Health Center. A bright and cheery office with light colored walls and shiny linoleum floors, it's airy and warm, not cold and sanitized. The health center is a test site for the Ur­ ban Family Medicine Program, and the program hopes to open more like it. The staff is small, consisting of two nurses, a receptionist, a secretary, a medical student and in­ ternist who work part time, and a community volunteer who speaks Spanish and English. The only full-time physicians are UB's Alvarez, the center's director, and Peter Kowalski. A small staff helps to foster a private-practice mentality, David Holden believes. The Niagara Family Health Center is run by Millard Fillmore Hospital, which pays for the build­ ing and the salaries of the staff. Because it filed a certificate of need for the center, Millard Fillmore is reimbursed by Medicaid at a higher rate than usual. It's more cost effective for patients to visit the center than to visit an emergency room. Emergen­ cy rooms always cost more because they must pay for a doctor to be on call, noted Alvarez. Plus, the patient pays twice because another doctor must fol­ low up. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �he nice thing about the clinic is that it doesn't cost the patient a cent" said Reid Heffner, M.D. "We don't spend a lot of time worrying about how much money they make in order to determine their eligibility." At the center, the patient can see the doctor, get lab tests, be treated and schedule a follow-up appointment, she added. In the long run, costs will come down because this continuity of care at the center will decrease the number of people who visit the emergency room. Because physicians are reluctant to open a prac­ tice in areas that are economically depressed and have high crime rates, the Urban Family Medicine Program tries to provide incentives to attract phy­ sicians to the inner city. "We will offer physicians both faculty and research positions with the University," said Lasser. "Additionally, we can help them to change their Medicaid rate structure to increase their income by getting them affiliated with local hospitals. "These incentives make it worthwhile to open a practice in the inner city." "Being affiliated with Millard Fillmore Hospital, my reimbursements for working at the clinic are better than if I opened my own office," noted Al­ varez, who supplements her income through the University by teaching and doing research. Working in the inner city brings other rewards as well. "I like working with inner-city populations be­ cause the patient-doctor relationship is important and because the people are generally very grateful," noted Kowalski. "It's really nice to work with people who need BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST you," added Nancy Cotter, a fourth-year medical student at UB who is doing a rotation at the Niagara Street center. Most of the people seen during the day have Medicaid, while a few have other insurance. For those who fall through the cracks—patients who can't afford insurance but don't qualify for Medicaid—the center offers a free clinic each Wed­ nesday evening. The clinic is staffed by volunteers. Parishoners from St. Paul's Cathedral perform clerical tasks and make sure the office runs smoothly. A nurse and two medical students work with patients. While 13 physicians are signed up to take shifts at the clinic, more are always needed. Free lab work and securi­ ty personnel are provided by Millard Fillmore Hospital. "The nice thing about the clinic is that it doesn't cost the patient a cent," said Reid Heffner, M.D., who conceived the idea of opening the free clinic. "We don't spend a lot of time worrying about how much money they make in order to determine their eligibility." Heffner, who is professor of pathology and direc­ tor of laboratories at the Erie County Medical Center (ECMC), added that the paperwork isn't intimidating, so patients aren't afraid to come to the clinic. "The idea is to take away all of the red tape," he said. "Let somebody come into the office in much the same way a patient visits a doctor in Williamsville. This way of doing things creates a bond of trust and goodwill." Aside from the Hispanic and African Ameri­ can community, the free clinic serves the homeless, recently released prisoners, and transients who pass through Buffalo. "It is clear that most of the people that come to us don't have the means to pay for health care," Heffner stated. The old man waits at the bus stop as the snow be­ gins to swirl with increasing intensity. The wind cuts LATE WINTER 1989-90 �through his tattered coat and makes his bones ache. The bus, as usual, is late and the traffic speeds by, spitting up black slush that seeps through his old tennis shoes. He's apprehensive about his visit to the clinic and it doesn't take long for him to change his mind. He turns around and makes his way home. THE CENTER TRIES TO OPERATE LIKE A PRIVATE DOCTOR'S OFFICE IN THE INNER CITY, EXPLAINS PETER KOWALSKI, M.D., RIGHT. LATE WINTER 1989-90 The Niagara Street health center experiences a relatively high no-show rate by the patients, but this will come down as the patients become more comfortable with the system, Alvarez predicts. "It sounds pretty simple for a patient to make an appointment for things such as physicals or im­ munizations," Holden remarked. "But many of our patients are not yet accustomed to the process of preventive health care. They have not been edu­ cated to go to a physician that they know and feel comfortable with." "It takes a lot of effort to make sure that patients show up for appointments," Alvarez added. "We make special provisions such as calling them up the night before and getting them cabs to pick them up and take them home." Many people in this country have trouble get­ ting medical appointments at all. The number of people unable to get health care has gone up dra­ matically over the last decade, Lasser pointed out. In 1987, nearly 37 million Americans lacked health insurance. "Many of these people fall between the cracks," he said. "They don't qualify for Medicaid. And the jobs they work at don't provide health insurance or don't pay enough money for health care coverage." Although health care technology is at the cut­ ting edge in the U.S., it means nothing to people who can't get medical care. "The U.S. ranks high in infant mortality com­ pared with other developed countries," Lasser reported. "Yet we spend more per capita per baby than any other country in the world. There's some­ thing wrong with what we're doing. "We spend more money on beds for premature babies and not enough to prevent the premature births of infants. "Why is it that Buffalo has so many institutions dedicated to infant and child health, and yet the city has such a high infant mortality rate?" Adding additional hospital beds or sophisticated equipment to a ward will not solve the problem, he noted. We need better prenatal care. Lasser has a strong interest in primary health care for the urban poor. He came to UB this sum­ mer from Massachusetts, where he worked in med­ ically underserved communities. He holds a master's degree in Public Health from Harvard University and was an associate professor in the Department of Family and Community Medicine at the University of Massachusetts Medical School. In New York State, ensuring that urban resi­ dents get the health services they need is a major public health issue, noted John Naughton, dean of the medical school and vice president for clinical affairs at UB. Part of the problem of access to care has been that too many physicians were entering specialties and not enough chose primary care, he explained. The Graduate Medical-Dental Education Consor­ tium has set a goal of steering 50 percent of UB medical students into primary care by 1993. "We have to ensure the proper education and training of physicians as well as quality health care now" for two underserved groups: urban and rural residents, he noted. UB already has a successful rural health pro­ gram, which was started in 1985. Holden points to that as an example of what can be done when the University and community join forces. Urban Family Medicine may set up similar links. The community seems willing—George McCoy, chief executive officer of ECMC, came to the Department of Family Medicine with the idea of developing a stronger primary-care base within the city, Lasser explained. As a result, the hospital es­ tablished a new department of family medicine which operates a new family care center. "We need to develop a coalition that involves departments within the University, the county, lo­ cal hospitals such as Buffalo General and Millard Fillmore, and community health clinics like the Geneva B. Scruggs Health Care Center," Lasser add- BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �ed. "A collaborative effort will enhance the access and quality of health care for the urban poor." One example is the longstanding collaboration between UB's Family Medicine Department and Buffalo General Hospital to operate the Family Prac­ tice and Immediate Treatment centers at the Dea­ coness Center. Another example is the Emerson K. Young Health Center, a small family practice office staffed by physicians from the Department of Family Medi­ cine and operated by Sheehan Memorial Hospital in the Perry Housing Project. Another goal of urban family medicine is to de­ velop a group of physicians who understand the language and culture of their patients. "We are actively trying to recruit minorities into family medicine," Holden said. "In fact, our program has the largest number of black and Hispanic resi­ dents of any residency associated with the con­ sortium." He did note however, that any resident interest­ ed and committed to working with inner-city popu­ lations would be encouraged to join the program. The Department of Family Medicine also offers a fellowship in urban family medicine for physicians who have just completed their family practice residency. The fellowship is designed to sharpen the skills of the physician, as well as encourage partici­ pation in teaching and research, Lasser pointed out. Special training is needed because physicians in urban family medicine must recognize problems that are magnified in the inner city, such as alco­ hol and drug abuse or issues of gay and lesbian BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST health, he said. "Family medicine takes a biopsychosocial ap­ proach to the problems of people," Holden noted. Students and residents are taught that their jobs aren't limited to the diagnoses of pathological med­ ical problems, explained Lasser. "Our job it to find out why they hurt," he added. Finding out what is wrong may take time and patience, said Holden. He pointed out that it may take three or four visits before a patient opens up and begins to tell the doctor what is really going on. "I had a black preacher come to me about his hypertension," Holden said. "He seemed withdrawn and unwilling to open up to me. After several visits, I could tell that he was beginning to trust me. So, he starts telling me about the problems his two sons are having with the police and how he was being accused of obstructing justice because he intervened one time when the police were dragging one of his sons off to the police station. "Here's a man who never had any trouble with the law in his whole life. I intervened with a social worker to clear the charges of obstruction. Subse­ quently, his blood pressure came down. I think these problems had a lot to do with his health, and his blood pressure probably wouldn't have dropped by just changing his medication. "By communicating with this man and finding out about his life, I was able to improve his health." Communication goes beyond understanding the complexities of high-technology medicine; keen observation skills and sensitivity to the vagaries of human behavior are required. Coupling these skills with continuity of care, the new Urban Family Medicine Program at UB aims to bring the best of personalized care to the urban poor. • URBAN FAMILY MEDICINE: SERVING THE UNDERSERVED • Goal: providing personalized medical care to the urban poor and training physicians to practice in underserved urban areas. • Program offers monetary and other incen­ tives for doctors to practice in inner city. • Test site called Niagara Family Medicine Center is located on Buffalo's lower west side, and the Emerson K. Young Health Center is located on the east side. • The centers are run by area hospitals and receive money through Medicaid reim­ bursement. • Weekly free clinic is staffed by volunteers. To volunteer, call Kim Griswald, R.N. at 887-8243. LATE WINTER 1989-90 �»»« ONLY THE BUBONIC PLAGUE OF 542 A.D AND THE BLACK DEATH OF THE 14TH CEN­ TURY KILLED MORE PEOPLE THAN THE IN­ FLUENZA EPIDEMIC OF 1918-19 �O T H E R E / v FLU UB marshalled its forces to fight the biggest killer of World War I n uring World War I, Buffalonians worried about their boys "Over There," fighting to keep the Kaiser in check. But in 1918, the City of Buffa­ lo was visited by a foe more powerful than the Kaiser: influenza. The Great Influenza Epidemic of 1918-19 was the second of three waves of the disease that caused millions of deaths as it swept across the globe. Flu was a big­ ger killer than the war. While the official U.S. death toll from the war was 116,516, more than 550,000 Americans died from the 1918-19 epidem­ ic and its complications. World-wide, the war killed 10 million people; twice as many died from influenza. D E B O R A H BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST i> <* *' B R U C H "I'm 96 years old, and I never went through a period where an epidemic scared people like it did then," said Lloyd Graham, the father of UB Professor Saxon Graham. "A lot of people died. And doctors didn't have anything to effect a cure. Hospitals were jammed full and doctors were run ragged. "It was worse than the war news at the time." The city was virtually shut down by the epidemic for several weeks. Buffalo weathered the crisis better than most other cities its size, however. One major reason: the leadership provided by the UB medical school and its alumni. U C K I , R . N M LATE WINTER 1989-90 �A PRIME TARGET A bustling industrial center in 1918, Buffalo was playing a significant role in jq the American war effort. With more than 475,000 residents, it was the 10th largest city in the United States. But Buffalo was a prime candidate for an in­ fluenza disaster. Recent immigrants from southern and eastern Europe—nearly half of the city's population—were at high risk. Coming from isolated, rural areas that were large­ ly unaffected by earlier waves of influen­ za, they had little immunity to the virus they would face in congested urban areas. This group suffered the highest mortality and morbidity rates, noted ond and third weeks of October, the ill­ Robert S. Katz in his 1974 study on the ness was reaching pandemic proportions. epidemic. Buffalo was a busy railroad hub, se­ cond only to Chicago, with large num­ bers of troops and supplies passing through. This provided an opportunity for the disease to be brought into the city. While Buffalo had excellent medical resources, they were severely taxed by the demands of war. The city boasted an in­ ternationally renowned expert on pub­ lic health, Francis E. Fronczak, as its health commissioner. Unfortunately, Dr. Fronczak, a UB graduate, was with the American army in Europe when the pan­ demic struck. The ranks of health care providers had been depleted by the city's generous response to the call for military volun­ teers. On Oct. 7, 1918, the Buffalo Even­ ing News reported that there was "a minimum of doctors and nurses in the city, and if the spread of the disease should reach epidemic proportions, the city would be handicapped in combat­ ting it." At the peak of the epidemic on Oct. 20, 138 people in Buffalo and Erie County died from influenza and pneu­ monia. Those diseases accounted for 33 percent of the total deaths in 1918, ac­ cording to the annual report of the act­ ing health commissioner, Franklin Gram. Influenza, both in Buffalo and nation­ ally, hit young adults the hardest. The statistics demonstrated "the greatest mor­ tality during the age period from 20 to 30, at the very prime of life, and it also showed that influenza put at naught all accepted ideas relative to disease resistance," concluded Dr. Gram. Victims were more likely to be male than female. There was an apparently low mortality rate among African Americans, probably because they had acquired immunity during the 1892 epidemic. Death generally resulted from respira­ tory complications, such as pneumonia. The technology was too rudimentary to identify the infecting virus, so treatments were limited. MARSHALLING FORCES The influenza pandemic struck Boston All doctors could do was try to allevi­ before hitting other east coast cities, giv­ The News story proved to be prophet­ ate symptoms, which included "abdomi­ ic. Four days later, another newspaper, nal and gastric pains, gradually appearing As acting health commissioner, the the Buffalo Commercial, reported that Dr. deafness . . . severe and often persistent first thing Dr. Gram did was to form a ing medical officials some warning. Walter S. Goodale, head of the Buffalo cough, pain along branches of the sen­ special advisory committee, which met City Hospital (now Erie County Medi­ sory nerves . . . severe and most distress­ daily through the worst part of the epi­ demic. Several of the physician members cal Center) "and his force are unable to ing headache, pain in the eyes, usually cope with the situation there." Mean­ deep-seated, scotoma, severe dizziness, were associated with the UB medical while, a transit workers' strike had crip­ and apoplectiform seizures," according to school. They included Dr. Gram, Class pled the city, hampering transportation an article by George F. Cott, professor to and from medical facilities. of 1891; Dr. DeWitt H. Sherman, a UB of otolaryngology at UB, in the Decem­ graduate and professor of pediatrics; Dr. ber 1918 issue of the Buffalo Medical Edward J. Meyer, a UB graduate and Journal. faculty member who was president of the Influenza first appeared in Buffalo at the end of September 1918. By the sec- LATE WINTER 1989-90 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �11 3 s z =5 o Q Z < g < o u g 5 •• • ORDINARY CITIZENS—NOT JUST PHYSICIANS AND DENTISTS—WORE GAUZE MASKS TO AVOID CONTAGION. BECAUSE INFLUENZA WAS EASILY SPREAD THROUGH CROWDS. BUFFALO PROHIBITED ASSEMBLIES OF MORE THAN IO INDIVIDUALS, THEN SHUT DOWN ALL SCHOOLS, THEATERS. SALOONS, CHURCHES, AND STREETCARS. ••• Buffalo City Hospital's Board of Managers, and Dr. Walter S. Goodale, Class of 1903, who would later become chair of the medical school's Department of Preventive Medicine. Under the leadership of the advisory committee, the City of Buffalo mobilized aggressively to combat the pandemic. Hospitals were asked to dedicate half of their beds to influenza cases. Beds were in such short supply that Buffalo's Cen­ tral High School (today Hutchinson BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST LATE WINTER 1989-90 �3 0 5 m 7 g S" n RD O _ T3 cr ^ ro ro CL 71 CJ" W 3 o T> 03 CA rt I pr Ep ro P 3 P 2 P co < T3 3 3 ** I O I H •< CA cP 1-1 CJQ' p rt ro P p <ro o 3 r-t P ro >-t 3 ro o p 3 £" re ro P 03 P CA w rt P P 3 P P ro P r 5. ^ O P p 3 3 S » =r » •Ti? 5' ro rt 03 03 ro z 03 ro &a- CP ro ccr » rt r-t P 0 LJ P o rt rD ro CO P CO CP P a- 5" rt P 03 P r-t ro •"1 03 P ro" r-t P CP CP -< O ^ o 3 p 3 ro rt CA o SI p BL ro 03 3 ro" 03 ro" CP £ 03 03 3 c o 3" p p_ cp CA r-t 0 ro CTQ5" r-tCP o' ro H o CA CP p P 03 ro CA ro BL o r-t 03 TO CA ro TO ro p03 CP ro r-t o Q 0 rt 3 "2ro 0 P ro 03 P ro O 3 p" p 3 P ro ro 03 (JQ ro o o P ro CO <R rt 0 3 rt P CA AN 7 CO j-t N ON " I •§ O 2 03 Eg on £ ro i—> ro 2- P CP 2 FT € o 3 =r co ~ Z a> > P o p> rD n co o rt rt <•* ^ n a- 2. TO T> 5' (JQ X ro co ^ rt P 3 * •8 8 2 m > p 1" I. ""S QTQ o o 3 3 era p o 3 CP > BJ a- cr p rD rt ^ P CP ro ro P O p ro ro i— > ro rt rD rt CP P P P a> -< (JQ p-r- >-u rt ro i-> CA rt ? 2 CA CP CP 3 RD CA' CA i-e 0* P TO 03 ro P 3 03 • s O n> o p ^ CO CP P o c c 3 BL 3 p (Jq A> R-T r-t P ~1 < ro p • 03 ro' (JQ CA 0 —ro 3- CA CO 03 03 CA CA ro P BL X ~ ro BL P r-t P < ro § CL W ^ « p 03 < ro & (JQ 3 n 03 P J> CA * s ^ o' ST ? CA n 5^' CA O ^ N — ^ 2 O' P O* O P CP p CP M U1 n -• C c p D (JQ 2 ^ A- 03 O -< £ .—. O £ '-T T3 CP O B R O n ^ B p P _ 00 rt n- P- CA 2 p p rD n> P 03 CP rD s rD r-t 3 o O c_ P r>' D. CL 03 R O 5' $ 3 o r-t n> 3 3 ^ 03 -« CTQ r-t rD -1 EL 03 c ^ 3 03 ft o ° p p P CP « 3 S, CA r-t p rD CJ. 2 £_ 3' « 03 C2 1. •a 0. 3* " -< P P n CD CA y5 c < CP *o T3 ft rD -< 1-5 « s rri ?? £§ SL 3 r-t CA CD o 2. p ^ p » 3 BL o " O ^ o F O P a • CP r-t CD rr o 3 3 8 3 » & SI (D^ N CA P CP p ft n" O m •§ 0o 3' ' rD 3- ^ 3 P n P P rt- P o ro p 2 3 cp 3 s ^ C 03 B'| 03 CA rt 3 £? 5 3 > P c ro CP CO r-. CP S! 8 or -{ RD RD CP rD C ft D3 ^ rt O * CO P n> CP C ° 3 M CL < r-t 5' OQ O- « 3^- 5* 3~ (JQ W - CP 'V 1/3 P 2 - a o 5 o rD O Q- o RD 3 ara 3 3 A. 5 —. 3 ? P ST H < ™ c= ? rD " 3 G S SL O a CA N n M o" w CA o~ 0 CA P > 3 5' 1" t— 03 ^ P. 03 CO Q O- -A o " 3 :• O O T8- o — ^ RD "a o 3 ' 2 3 <T rtTO 2O -< "A A> CP P a> S o N . —K Y g CA 03 8 P "a CTQ p P H ~ 03 3 3 2 3 ~ 3 O < O 03 8 w 3 SI TO 3-<g O 0 P 3 03 P P- ro ro p 03 P2 (JQ c ro 3 71 ^ C/5 03 TO TO rj P rD CP 3 n o % p 5' 3 o CP >3 1 <I &* ^ -< 5 ( era O 3 3 cr. 3- « ft g ^ ™ roro 03 ro CL Q3 RO RR • P ^ . 03 (JQ < ro O CD Z* CL a A N 8 p P "2•< -< (D CP c c ^ 03 P —. "O5 P P ro QI 3 COURTESY BUFFALO AND ERIE COUNTY HISTORICAL SOCIETY 3 ET P P p P n" P BL o" ro P 3 CA P 0 m < 03 O ro 3 ro P (JQ 03 03 r-t CTQ P P* CA CP ro rt ro ro TO ro 0 P O P 3 ro O P ro ro ro r-t CA O 0 3 ro' CP 8- ° TO 03 rt n n c P CP rt ro CP 03 3 O ro P O ro CA P 3 « CL ro FT TO p ro ro n ro ro p- r-t ro CA CA 8 3 o 1 « I FD R-- 3 ^ EG -A 3. P rt CO 3 2 p. CP O RO CA s r -1 H AT CR ^ CP ro rD ro r-jO G P -a SL T BL ' r-, CO 3 0 3 P 3 P rt P i " ! r-t ro <" r-t ^ 2 JO H 3 3 O. 3- 2 o ro -• 03 CA P 3D O 3 ^ O ro < ro P 3 P TO Z- ° 5' P 3 ro 3' ro ^ O P 8 ro ro V 5" N P 3 3 rD ro CP 3 TO n g. (JQ £ ro rt ro ro1 ro 03COro 3 P ro ro 3 Q- TO 3_ CP ro ro 5' O CAro Br P CA P CA* ro (JQ 5" < ^ °ro < O ^ CA ro 1 5 ' 8- c p _J ZL ro o C CA R^ R. p P ro lu ro CP S. 1 -1 ^ 0- 35 y> ro W I 1P CA P r-t C^ ro ro ro> p O P O -< o ro PI RO 03 2 3 - 1 rt 3^ -a ro rt ro 03 a- ^ rt p ro o. S y c 2 § rt rt TO TO O era 03 O O *2- P 03 0 , 1 Er ro 2ro ro <ro 3 O—t PCA ro •2 0' n rt ro TOro O* rt ro P03 0 0 CA o" O rt 8" CA O 0 p CO ro CA CA 3 CA CA 3' 03 CP rt 2 DO ^ 3 ro -N S O Q3 CJQ § rt W 1 JP TO G P CP O* P O CO < ro 5, 8^ SR § ^3 ro Z N" 03 P o P ro 03 ro CP < CP ^ 3 > 03 ^ 5 3 n ^ rt' O CP 3 « i 0 7T CA & r^03 P^ CA ro ro t ^ = 5' (JQ PP ro CP ro 3= P P 3 2- P 3 P_ M P p < ro ro ho 3 ro 2 O Pi P CP r-t 03_ P CP ro TO O 03 O rt rt P 5' DO P 1 § D3 P H-] CO O CP ro- 03 'p u o P ro o * 51 ? I. TO O 3 P P S P ro ro rD- 03 SH 3 § P §1 O P n CP 03 3 o r-t p P 03 ro py 5 P 3. 5 ? " BL PO ro <: ro CP 3 03 ro rt 2 p « 3 ro n O 3 ro p ro » 2" P « i rt CL CL fit rt ro § "2. °2 •-< ft CA ^ oo' 2 3- ^ P ro ro <d 7 n O 3 3 o CP p P 03 ro r-S TO r-t p' 03 (JQ £ r-t u CA" "|Z s 0 'A P O CO CA 3 SI P 03 03 ro 03 <S _ P u 3 rt P Z O TO0 TOro ro j , O 3 O P U- ON rD P 1—1 NO o° 0 rj O ro — ro ro^ rt UX c§" p 03 p ro 0 H 3~ ro CP CO P CO ro r-t 3- ? 51 ro 3 CP CA_ tm < P r-t 5' 0Q CA 3 ro r-t ro P 03 CA r-t P rt P CP CO 03 CRA ro ro TOro O 3 3 ro r-tro ro {0 CP ro CA ro E <' SI ro P ro ro ro < ro ro Z p n ro 3 CA T3 ro P ; ca • ro O r-t 03 "O TO ro co r-t 5' (JQ CO < O CP p (FQ CP < n CO* O ro P CP CO n rt o5 rt o TO FT rt P CA P O O r-t CA CP rt ro ro 3 CP O P CA O P £ P* (JQ n 0 3 3 CA P O 0 p rD rD 3 n 03 ro 0 ro 3 TO P 3 P 03 P en" P P ro CA P P rD CP 3 03 ro' [5 « ™ O n n CO P' 3 M rD ro co ro CA k; p g> 3 0s ^ o c p g; 7r (JQ 0 3 os n P s::r Pi ca a TJ n —t O O 03 TO ro 03 rt 1 3 ro ca —> r-t 3 c El Br FT O n P 3 CA 03 O P CP —TO . CA n 3 CP 3 3 rt ro ro ro CA P ro Pro TO 0 03 p (JQ p P r-t ro' CA P " 3 . CA rt •« O I 3 ro _ --t ^ ro ro3 3 rt £. sT co ro CP T5 < M CA rt ° 3 -t ^ •< ro P o ^ O — 3 3 ^ 3 3 rt ro ro p 3. 3 (JQ S - ro oT CA P I r ��""" NOT LIKE HOME An ophthalmologist saved sight and lives in Kenya and Nepal; a medical researcher tangled with ethical questions high in the Himalayas, and another physician fled Sri Lanka when he found himself in the middle of a bloody civil war. Three doctors from UB found different kinds of adventure and adversity while volunteering in the Third World. By DAVID M. SNYDERMAN n the Third World, an ophthalmologist can lift a death sentence by performing a cataract operation. There, "blindness is fatal," explained ophthalmologist Robert Maynard, M.D. "In Nepal, the expected life span of a blind person is three to five years." Maynard, a 1953 graduate of the UB medical school, is one of many UB physicians who volunteer their time overseas to help the less for­ tunate. In the past few years, Maynard has spent a month in Nepal and three weeks in Kenya, restor­ ing sight to the people in those countries. "I like to travel, and it's a good way to travel. I also like to leave a country better than we found it," said Maynard. "The rate of blindness in both Nepal and Kenya is 20 times that of the United States and it's most­ ly due to cataracts." The need is so great, the ophthalmologists had to work frantically. Maynard said they would see BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST 50 to 100 patients a day with the help of ophthalmic assistants who also acted as interpreters. Maynard found that medical care is lacking in both places, especially Nepal. "In Nepal, outside the major cities, Western medicine is practically non-existent," he said. "In Kenya, things are much better. They do have some medical facilities there." The living conditions were also somewhat primitive. "In Nepal, things were very basic," Maynard ex­ plained. "It was much like it must have been in the middle ages: they do their cooking over a small wood fire. We weren't camped out in tents, but we stayed in a hotel which was still pretty basic. The people lived much as you and I might live if we were backpacking. "The machine has not hit Nepal. In Kenya, things are more progressive but living is still very basic. We had rooms in the eye center in Kenya. It was quite comfortable there." LATE WINTER 1989-90 15 �N ot all physicians can have the same dramatic effect that Maynard has had in restoring sight and thereby saving lives, according to Richard Lee, M.D., chief of the division of maternal and adoles­ cent medicine and a professor of medicine and pediatrics at UB, as well as the head of the Depart­ ment of Medicine at Children's Hospital. "Ophthalmologists probably have the best of all worlds," Lee said, explaining that ophthalmologists can do a lot of good in a short period of time without the need for a continuation of treatment. "The others who are able to do a lot of good are plastic surgeons. They can convert someone from being despised or ostracized" for their looks LATE WINTER 1989-90 into someone who appears normal, he added. Acting as an internist, Lee has been "everywhere except the South Pole and Australia," he joked, although his travels have taken him primarily to the Amazon region of Brazil, the mountains in Chile and the Himalayas, and refugee camps in Thailand. He spends varying amounts of time when he visits, often making several trips per year. "We do some good and we give out some aspirin and vaccines," Lee said, but noted that he can't make the kind of difference in a person's life that some specialists can. "I think the good we do for the people is very small, actually. Some people do a lot of good in a BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �short period of time, like ophthalmologists. Going into an Indian camp and beginning treatment for leprosy is good, but that treatment must continue for years and as soon as there is another political upheaval it will stop," he explained. The one area where Lee has been able to make a real difference, he said, is in the Thai refugee camps. "That's been a very successful program," Lee said. "We send two to seven medical students to Thailand per year. They've worked in a variety of camps." Lee explained that these medical students teach basic first aid and sanitation to the refugees. Because the students have just learned these things themselves, the methods are still fresh in their minds. "As fourth-year medical students, they are very helpful," he added. The other benefit that comes from Lee's trips is in the field of research. "Most of these things have been done as part of a long-term, on-going interest in the biology of isolated populations," he said. "Those include Indian tribes, specifically in the Amazon region of Brazil, mountain people, certain ethnic and political groups like refugees. We treat them, that's part of our thing, but we do studies on them in terms of infectious diseases, their im­ mune systems, and their genetics. "Much of these populations are genetically in­ bred.... These were isolated people for centuries, for millennium." Because these people have been isolated, they have had to learn to live without harming their en­ vironment. Lee gave as an example his patients in the Himalayas. "They are interesting people," he said. "They are fairly stable ecologically. They have not deforested the area and they are subsistence farmers." However, living in harmony with the land is not without cost, Lee said. "They do pretty well, but they lose a lot of kids," he said. "The price of ecological stability is high in­ fant mortality: 60 per 1,000 (pregnancies) end in still births or (the babies) die within a few hours of birth. A quarter of those who survive the first day will die before they reach puberty." Asked whether his team is trying to bring down the mortality rate, which is between three and six times greater than the rate in New York State, he answered: "I don't see that as our responsibility. We treat what we can but we're only there for a week. There is a limit to what we can do and there is a limit to what should be done. "Perhaps that is a biologically necessary kind of thing," he said, adding that attempting to change the infant mortality rates could have the net effect BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST 17 I mi jflie H n Himalayas, people live ami Lairanomiy wiltlk nine flannel, LnaJ annfanaJ mraorJaflnJy as Inagln, nuotles Raelnaird Lee, M.D. ALove, Lis as ttalce Lody mraeasimreiraneniifts Jo delermranirae effecJs of daeJ. LATE WINTER 1989-90 �of unsteadying the Himalayas' stable population base. "That's a real issue for a lot of the world's popula­ tions living in small villages," he explained. "All of this stuff raises some very serious questions about what medicine's purpose is." very different challege was faced by Brian McGuiness, a 1984 graduate of the UB medi­ cal school. When he was sent by the Christian Blind Mission to Sri Lanka, Sinhalese groups revolt­ ed against the Sri Lankan government and he found himself in the middle of a civil war. "We arrived in August of 1988" said McGuiness, an ophthalmologist who is a member of a private practice group in Southampton, N.Y. "There was a group called the JDP ("People's Liberation Front" in Sinhalese). When we arrived, they started car bombings, harassments, and death threats. "During the period we were there, there were seven general strikes that closed the clinic — if you opened the clinic, they would bomb it." McGuiness was supposed to stay for four years, working at the Ruhunu Eye Hospital, but he and his wife left after four weeks. "We left after there was an assassination of four people. Their bodies were hanged by their necks on our streets. Since then, Christian Blind Mission has pulled out their workers," McGuiness explained. Originally, McGuiness had planned on volunteering in Africa, but the Christian Blind Mission "felt they had more need in Sri Lanka." McGuiness seems disappointed at the problems he encountered. "I had always planned on this in medical school," he said. But his plans are merely deferred, not canceled. "I intend to go back to Africa a month or two months each year." His advice to potential volunteers? "If you plan a long-term commitment, do not trust the people who are sending you. Go check out the conditions yourself. It's a small world — go volunteer for a month" in whatever country you intend to spend several years. Maynard, whose volunteering periods have been on a less permanent basis, had no qualms about recommending his experiences to others. "I would encourage them. I found it very satisfying and rewarding." Lee also was quick to encourage future volunteers. "Have them call me," he suggested. "I think this is a much neglected area of medicine. Most of the world does not live like we live in the United States." If you do go, look to friends, colleagues, and business associates to help you prepare for your trip. McGuiness said that many of the physicians from A LATE WINTER 1989-90 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �1 19 r* left, tike Eyes of Iludflh.i to tke Seva Eye Clinic is Nepal keep a careful wailek over RoLeril Maymaril, M.D. Left, in ike his residency at the New York Eye and Ear Infir­ mary donated supplies for him to use in his travels. "Anything I brought with me in the way of medical equipment, I or my sponsors paid for." Lee found the pharmaceutical corporations helpful when he asked. "We usually bring our own (drugs). We would ask for donations from the drug companies — they're actually pretty good. In the Himalayas, there are a few supplies provided by the government." One thing McGuiness found to his liking dur­ ing his short stint in Sri Lanka was the less restricted medical climate. "There is no malpractice, therefore, there is no fear," he said. "You work with one thing in mind: doing good." • BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST Tanililkawa eye camp in Nepal, Ike performed sunrgery Ly flashlight (Lofltom). LATE WINTER 1989-90 �Medical School M.D. = Male Doctors? Crusader says \glass ceiling bars women's progress in medicine By WENDY BROWN " I t is time to make medicine a 'biI gender' profession—not only in I body count, but also in spirit," said Lila Amdurska Wallis, M.D., F.A.C.P., a crusader for the rights of women physi­ cians and patients. Wallis, president of the American Medical Women's Association (AMWA), recently addressed a meeting of the Women Physicians' Association, the Buffalo chapter of the AMWA. A clinical professor of medicine at Cornell University Medical College, Wallis also founded the National Coun­ cil on Women in Medicine, an educa­ tional group focused upon the treatment of women patients. Noting that for centuries medicine had been dominated by men, Wallis said that progress has been made, but women in medicine must still struggle to revise the system. "Change it we must," she stressed. "There are many ills in the system which concern mainly us." Women face difficulties when trying to become doctors and raise families at the same time. Commenting that there is no such thing as a "mommy track" in medi­ cine, Wallis said that due to the demands of a medical program, it is nearly impos­ sible for a woman planning a career in medicine to start a family before she is 30. "There is no reason to listen nervous­ ly to the ticking of your biological clock," she told her audience. "You should be able to have it all and enjoy it all." Wallis advocates the creation of day- LATE WINTER 1989-90 care facilities attached to teaching hospi­ tals, and believes that there should be time allowances for physicians, men and women, to spend with their families. "They are cut off from normal family life," she said. "Human society creates physicians who become less than human beings." Another symptom of the problems with the system, noted Wallis, is the fact that only four out of 11 medical students are women, and that it takes them twice as long to climb the academic ladder. Ad­ ded to that is the actuality of women physicians who still earn only 60 percent of what their male counterparts take home in salary. "It is wrong," she admonished, "when a women must be twice as smart and work twice as hard." But work alone may not be enough to rise above the "glass ceiling," the phenomenon where one sees men being promoted while women, even those who are more competent, are left behind. "We only become aware of it when we bump our heads against it," said Wallis. Striving for leadership is a hollow pur­ pose without skills, Wallis said. She en­ couraged women physicians to attend workshops and conferences which de­ velop skills in assertiveness in dealing with colleagues, patients, and the media. Although these skills may help lead to empowerment, Wallis criticized the American Medical Association (AMA) for being reluctant to relinquish leader­ ship positions to women and minorities, even though they make up the fastest growing section of the medical profession (now standing at 25 percent). "We deplore the AMA's disinterest in women," she said. She maintains that the AMWA is not in competition with the American Medical Association and that their purposes are different. "We can live with the differences as long as we are strong." However, of the 90,000 women physi­ cians in America, only 12,000 are represented in Wallis' organization. "We're growing," Wallis commented, "but not fast enough. "This is not the time for queen bees, not the time for free riders. This is the time for all women doctors to hook together." AMWA, under Wallis' leadership, has undertaken the mission of safeguarding and protecting the rights of women in medicine, both physician and patient. Lobbying in Washington on behalf of women physicians, the group has initiat­ ed educational programs to help women handle the problems of a career in medi­ cine. (See related story.) "We want to destroy the glass ceiling, let the fresh air in, and the sky will be the limit," Wallis said. • INITIATIVES AID FEMALE PATIENTS & PHYSICIANS L ila Amdurska Wallis, M.D., EA.C.P. looks forward to a day when medi­ cine "will not be biased," but will ac­ curately reflect the health needs of BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST ��Medical School women—patients as well as physicians. In 1979, she founded the National Council on Women in Medicine, an educational group that tries to improve the treatment of women patients. As an advocate of women's health, the council examines such problems as os­ teoporosis, premenstrual syndrome, and the comfort of patients during exami­ nations. One result was a movement to find a better way to teach breast and pelvic ex­ ams that would be more sensitive and dignified for the patient. This led Wallis to initiate the Teaching Associates Pro­ gram at the New York Hospital-Cornell Medical Center. This program, which also covers examinations of the male genito-rectal area, is employed by 95 schools in the U.S. and Canada today. Wallis, who is also president of the American Medical Women's Association (AMWA), recently addressed a meeting of the Women Physicians' Association, the Buffalo chapter of the AMWA. She commended the UB students for their efforts to educate area high school stu­ dents on the hazards of smoking, which Wallis calls the "black plague." Another problem we face today is the "white plague." That's how Wallis refers to osteoporosis, the abnormal weakened condition of bone affecting one in four women over the age of 65. It causes dis­ ability, deformity, and death. She stressed the importance of calcium intake and weight-bearing exercise in the prevention of the disease. Under Wallis' leadership, the AMWA has embarked on an education campaign targeted at health care professionals and the public. In addition to this, the organization has set up task forces on leadership train­ ing, smoking education, osteoporosis, and dependent care. • — By Wendy Brown LATE WINTER 1989-90 VISITORS COMPARE MED SCHOOL PRACTICES IN SPAIN AND U.S. T uition for medical school in Spain is about $500 a year, comparable to what an American might pay for a year of parochial grade school. And admission to a Spanish medical school or university is based solely on the score one receives on a national test. If a medical school has 400 openings, the 400 applicants with the highest scores get in. It takes six years to complete medical school in Spain, and there are no electives. These are some of the differences that were discussed when two Spanish phy­ sicians visited the UB medical school in November as part of a tour of American universities sponsored by the U.S. Infor­ mation Agency. Eduardo Lopez de la Osa Gonzalez, a gynecologist, is the vice rector for foun­ dations at the Complutense University of Madrid. Juan Lopez Arranz, a doctor of medicine and surgery, is rector of the University of Oviedo. (A rector is the highest authority in a university.) Their group toured the United States to learn about American university ad­ ministration. Under a law passed in 1983, Spain is changing from a highly centralized university system with a na­ tional curriculum and national degrees to a more decentralized system. Students enter medical school at age 18 after finishing a combined high school-baccalaureate program. After six years of medical school, they receive their M.D.s at age 24. Like Americans, they then start a residency, which averages four years. Some Spanish faculty members would like to compact the six years of medical school into five years, and students favor that plan, said Lopez de la Osa. The problem, he explained, is that no department chairman feels the time spent teaching his own subject can be cut. Also complicating attempts at change is a move toward standard accrediting procedures in Common Market coun­ tries. Along with this move, by 1992 a physician licensed in one Common Mar­ ket country will automatically be licensed in the other countries. Therefore, a proposal to compact med­ ical school curriculum would need the agreement of the other European medi­ cal schools, said Lopez de la Osa. He noted that the American system of medical education has some advantages over the Spanish system. The American system is more practical because it has a higher proportion of clinical work to classroom work. There is also more flexibility in the cur­ riculum. Students can choose courses that better prepare them for their final choice of specialty, he said. A group in Spain is looking at a proposal to add electives to the medical school curriculum without changing the length of study. Because there are no electives now, the Spanish medical students get a wider outlook on every field of medicine, Lo­ pez de la Osa said, but he questioned whether that really is the best way to serve someone who has already decided to specialize in a certain field. • BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Medical School HARRINGTON PROFESSOR CHOSEN FOR AUTUMN Tikoscoi-n ; \i. nssi I A Ivan R. Feinstein, M.D., professor of medicine and epidemiology at Yale University School of Medi­ cine, will deliver the Fall Harrington Lecture. The event will be held at 4 p.m. Thurs­ day, Oct. 18, in Butler Auditorium at UB. Feinstein is a pioneer in the use of clin­ ical epidemiology. The author of Clinimetrics, he asserts that much of medical research is inadequate because statistical studies of disease ignore distinctly hu­ man factors such as pain, suffering, and symptoms. • Anne Kelly, a second-year student, was one of four students who received a $500 First Honors Prize in UB's 1989 annual Student Research Forum held in Decem­ ber. Her work on arthroscopic surgery using a laser was conducted at the Hospital for Special Surgery in New York City. The other top winners were Flyunbo Shim, a second-year student; Mukesh Jain, a third-year student, and Gerard Dil­ lon, a second-year student. EVENTS H ere are some post-graduate courses scheduled for 1990 which are ac­ credited by the American Medi­ cal Association and the American Academy of Family Physicians. June 28 to July 1 The Amelia Island Plantation Pediatric Conference will be held from June 28 to July 1 at the Amelia Island Plantation, Amelia Island, Fla. Elliot F. Ellis, professor of pediatrics at UB, is the chairman. The Nemours Chil­ dren's Clinic in Jacksonville, Fla., is the sponsor. The fee is $275 for physicians and $155 for other health professionals. For more information, contact Rayna Saville, coordinator of continuing medical edu­ cation, 219 Bryant St., Buffalo, N.Y., 14222-2099, (716) 877-7965. July 13 to 15 The 13th National Conference on Pediatric/Adult Allergy and Clinical Immu­ nology will be held July 13 to 15 in the Four Seasons Hotel, Toronto. Elliott Middleton Jr., professor of medicine and pediatrics at UB, is the chairman. UB's Department of Medicine is the sponsor. The fee is $275 for physicians and $155 for other health professionals. For more information, contact Rayna Saville, coordinator of medical continuing edu­ cation, 219 Bryant St., Buffalo, N.Y., 14222-2099, (716) 877-7965. August 3 to 5 The Cape Cod Conference on Pediatrics will be held Aug. 3 to 5 in the Tara Hyannis Hotel, Hyannis, Mass. Elliot F. Ellis, professor of pediatrics at UB, is the chair­ man. The Nemours Children's Clinic in Jacksonville, Fla., is the sponsor. The fee is $275 for physicians and $155 for other health professionals. For more BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST information, contact Rayna Saville, coordinator of continuing medical edu­ cation, 219 Bryant St., Buffalo, N.Y., 14222-2099, (716) 877-7965. August 20 to 24 . The scientific meet­ ing of the Interna­ tional Society of Psychoneuroendocrinology will be held Aug. 20 to 24 in the Hyatt Regency Ho- |£|HJP tel, Buffalo. Uriel Halbreich, professor of psychiatry and research professor of gynecology and ob­ stetrics at UB, is the chairman. The UB Department of Psychiatry is the sponsor. For more information, contact Hal­ breich at 462 Grider St., K-Annex, Buffa­ lo, N.Y. 14215, (716) 898-3036. LATE WINTER 1989-90 �Research 24 A program to help workers who are burdened with caring for elderly parents or other relatives is one example of the direct research being con­ ducted at UB's new Multidisciplinary Center on Aging. (For details on the creation of the center, see story on page 26.) Attracting the interest of local indus­ tries and lawmakers, the program for workers caring for elderly relatives has resulted in the establishment of an "In­ stitute of Work/Family Fit." The statesupported institute was started by Gary Brice, an associate director of the center, and Robert Rice, Ph.D., a UB professor of psychology. The major goal of the Multidiscipli­ nary Center on Aging, aside from the center's own research projects, is to "stimulate a significant expansion of research relating to aging" on the part of -investigators throughout the University, said Evan Calkins, M.D., UB professor of medicine and family medicine who is the director of the center. Pointing out that virtually all segments of the University can become involved in gerontology research projects, Calkins views the need to solve problems relat­ ing to the nation's ever-growing popula­ tion of elderly citizens as a "challenge for America." The study of aging, he added, is an in­ terdisciplinary field. A basic question for researchers, he pointed out, is: "What can be done to foster independence for Challenge New center serves ever- By MILT Illustrations by Alan E. Cober LATE WINTER 1989-90 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Research 25 for America growing population of elderly CARLIN BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST delve more deeply into such diverse sub­ jects as retirement and Social Security policy issues; preventive medical care; de­ sign of roads, traffic signs and eyeglasses for elderly drivers; accident prevention on the road, at work and at home; hous­ ing design; nutrition; legal and ethical is­ sues, and education. In working toward its goals of enhanc­ ing the depth and quality of gerontology research at UB, the new Multidisciplinary Center on Aging takes three approaches: direct research, en­ hancement of aging-related research on the part of others, and faculty and career development. The center defines "direct research" as that conducted by staff members \ of the LATE WINTER 1989-90 �Research 26 center and by faculty closely associated with it. Other examples of direct research include: • A study of physician practice pat­ terns in New York State nursing homes and their impact on quality of care, be­ ing conducted by Jurgis Karuza, Ph.D., assistant professor of medicine and an as­ sociate director of the center, and Paul R. Katz, M.D., a staff member of the Buffalo VA Medical Center and an as­ sistant professor of medicine at UB. • A study of nursing home patients' at­ titudes toward quality of life and lifesustaining treatment, and how their opinions correlate with those of their families and physicians, also by Karuza and Katz. • Studies of muscle function in elder­ ly persons, especially those with osteo­ arthritis. Investigators are Calkins, David Pendergast, Ed.D., UB professor of phys­ iology, and Glen Gresham, M.D., chair of rehabilitation medicine at UB. • A research program, supported by the New York State Department of Ag­ ing and other agencies, to identify pat­ terns of social and health support being received by minority elderly and to project future requirements. Investigators are Arthur G. Cryns, Ph.D., professor of social work, and Kevin M. Gorey, UB research scientists. • A study of the effect of anesthesia on the cognitive ability of elderly persons, funded by the National Institutes of Health. Investigators are Cryns and Marion Goldstein, M.D., an associate professor of psychiatry at UB and a staff member at the Erie County Medical Center. As part of its work in faculty and career development, the center conducts a series of workshops on current develop­ ments in gerontology for faculty and graduate students. There is also a pro­ gram of summer research fellowships for LATE WINTER 1989-90 graduate and undergraduate students who want to develop pilot gerontology research projects. • NEW CENTER ON AGING FORMED BY MERGER U B, a pacesetter in the field of gerontology, has decied that one center for dealing with is­ sues related to aging is better than two. The new Multidisciplinary Center on Aging has been formed by the merger of UB's Multidisciplinary Center for the Study of Aging and the Western New York Geriatric Education Center. The basic mission of the new center is to enhance the depth and quality of gerontology research at UB. It receives federal, state and University funding. Continuing as a separate component of the new center is the Western New York Geriatric Education Center, which was founded in 1982 to provide training in geriatrics and gerontology to individu­ als involved in education. The former Multidisciplinary Center for the Study of Aging was established at UB in 1973 as a resource for gerontol­ ogy research throughout SUNY. The new center also houses the Net­ work in Aging of Western New York, Inc. The network is a community-based or­ ganization providing a framework for educational institutions, elderly con­ sumers, students and providers of health and social services for the elderly. Serving as director of the new center is Evan Calkins, M.D., professor of medi­ cine and family medicine. Calkins con­ tinues as director of the Western New York Geriatric Education Center. John N. Feather, Ph.D., a research as­ sistant professor of medicine, is associate director and administrator of the new center, headquartered in Beck Hall on the UB South (Main Street) Campus. He also is co-director of the geriatric educa­ tion center. • ALZHEIMER'S MAY LOWER BLOOD PRESSURE A lzheimer's disease may have effects beyond alterations in an individ­ ual's cognition and behavior, ac cording to a study in the Division of Geriatrics/Gerontology at UB. A review of medical records showed a similar prevalence of hypertension in the past in a group of women with Alzheim­ er's disease and a dementia-free control group. Researchers found, however, that more Alzheimer's disease patients with past hypertension later became normotensive (5 of 7) than did dementia-free patients (1 of 12). Although lacking an explanation, they discounted medications and changes in risk factors for hypertension as account­ ing for the resolution of high blood pres­ sure in the women who became normotensive. • BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Alumni SCHOLARSHIPS ATTRACT TOP STUDENTS TO UB T he ability to attract top-notch stu­ dents is one of the greatest benefits of private giving to the University at Buffalo. Maximo Lockward, a third-year medi­ cal student, is one of the many outstand­ ing students who, over the years, has benefitted from the Dr. Mark W. and Beulah M. Welch Scholarship Fund. "It is a great honor to be chosen for an award," said Lockward, who was raised in Puerto Rico and graduated from Loui­ siana State University with a 4.0 aver­ age. "It makes you feel good to realize that people recognize and appreciate your achievements and consider them im­ portant. "Financially, a scholarship award helps a lot with the expenses. As a medical stu­ dent, there is little free time to make ex­ tra money." Although Lockward was accepted to other schools, he said he chose UB be­ cause the other schools didn't offer scholarships. "Academically, it's an incentive for ex­ cellence," Lockward added. Faith Grietzer, a native of Binghamton and a graduate of Cornell, is another third-year student who benefitted from the Welch scholarship fund. The scholar­ ship has helped provide the basics— books, food and rent. "My father is deceased and my mother is a housewife with six children, so I'm trying to put myself through school," she said. "I chose UB because it's a good school and the price is right. Some of my friends are starting out $150,000 in debt. I am getting a quality education for much less, and with the extra help of a scholarship." Mark Welch '15 MARK WELCH M'15 DIES,WAS UB BENEFACTOR M ark W. Welch, M.D., Class of 1915, one of the oldest alumni of the UB medical school and one of its most generous benefactors, died in Rochester, N.Y., on Jan. 25, just 13 days shy of his 100th birthday. A memorial service was held Feb. 7, the date of his birth, in the church he built and endowed, St. Mark's in Ken­ dall, N.Y. Dr. Welch's life exemplified and per­ sonified the full meaning of the word philanthropy — the love of mankind. Fie contributed generously not only to UB, but to many other universities, hospitals, and churches. Many UB medical students have already benefited from the Dr. Mark W. and Beulah M. Welch Scholarship Fund established in 1975. (A story on two of those students, prepared before the editors received word of Dr. Welch's death, precedes this article.) Over the years, his contributions to this fund have totaled nearly $500,000. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST In addition, Dr. Welch made a bequest in his will that nine percent of his estate go to the University at Buffalo Founda­ tion for the fund. In 1988, the University honored Dr. Welch for his generosity by naming him the 39th recipient of the Samuel Capen Alumni Award, the Alumni Associa­ tion's highest honor. He was born in West Bloomfield, N.Y., and Dr. Welch's family wanted him to become a priest. But he said he always knew he wanted to become a doctor and entered the UB medical school in 1911. As a student, Dr. Welch helped in­ struct other anatomy students in the dissecting room. "It was very unusual to have a student teaching," he noted in an interview in the Buffalo Physician and Biomedical Scientist in 1987. "But I was a damn good student. I knew anatomy and they knew I knew it." Upon completion of a one-year intern­ ship at Sisters of Charity Hospital in Buf­ falo in 1916, Dr. Welch decided to start his own practice in Endicott, N.Y., a ci­ ty of 10,000 residents about 10 miles west of Binghamton. Dr. Welch often performed surgery in the homes of his patients, using ether in the homes lit with electricity, and using the less-volatile chloroform in the homes lit with gas lamps. Although it was a small town, several substantial manufacturing companies were located in Endicott, including one that would later be renamed Interna­ tional Business Machines Corp. In 1925 he started working part time as company physician for IBM at a salary of $3 a month. After 10 years, he was named the company's medical director and re­ mained in that position for 30 years, working there part time while continu­ ing his private practice. He retired from IBM in 1955. LATE WINTER 1989-90 �Alumni JAMES PLATT WHITE SOCIETY HEARS PROGRAM ON GERIATRICS In 1957, Dr. Welch closed his private practice and traveled extensively with his wife Beulah for two years in Europe, Asia and Africa. The couple had no children. Dr. Welch remained active, walking G nearly four miles each day, until his re­ eriatrics was the subject of a pro­ cent illness. gram presented to the members of Gifts in memory of Dr. Welch can be the James Platt White Society at made to the University at Buffalo Foun­ dation. their fourth annual meeting. • Held Oct. 20 in the Lippschutz Room of the UB medical school, the program SPRING CLINICAL DAY TO Focus ON CHANGE involved both the clinical and basic science faculty. It touched on the topics of geriatric education and research at UB, the biology of aging, how the medi­ "^^Phe Changing Aspects of Medical cal specialties relate to geriatrics, and a I Practice" will be the theme of this young physician's perspective on geri­ Iyear's Spring Clinical Day and Re­ union Weekend. The event starts off with atrics. Arnold S. Relman, M.D. The program was spearheaded by Evan a cocktail party Friday evening, April 27. Calkins, M.D., UB professor of medicine Spring Clinical Day will be held Satur­ Peter Millock, general counsel with the day, April 28. New York State Department of Health.• The keynote speaker will be Arnold S. Relman, M.D., editor of the New England Journal of Medicine, who will address "The Changing Climate of Medical Prac­ tice and the Choices Physicians Face." Other topics and speakers are: • "Managed Care: The Group Practice Perspective with a Note on Medical Edu­ cation" will be discussed by Edward Ma­ rine', M.D. He is the medical director of Health Care Plan in Buffalo. DEADLINE APPROACHES FOR AWARD NOMINATIONS T and family medicine who is director of the Multidisciplinary Center on Aging, and Harold Brody, M.D., chairman of anatomical sciences. A cocktail reception was held in the home of UB President Steven B. Sample, followed by dinner at the Country Club he deadline is fast approaching for nominations for the second annual Distinguished Medical Alumnus/a Award. Names must be in by June 1. A postcard for nominations is pro­ vided at the front of the magazine. • "Medical Malpractice 1990: Scope, The award is presented to a graduate Causes of Injury and Potential Solutions" of the UB medical school who has dis­ will be discussed by Donald W. Aaron- tinguished himself or herself nationally son, M.D. A clinical assistant professor or internationally in the eyes of his or of Buffalo. The 65 members who attended each received a pewter Jeffersonian cup as a memento of the day and in appreciation for their support of the school. The James Platt White Society is com­ posed of individuals who have contri­ buted $1,000 or more annually to the school. The current members are: of internal medicine at the University of her peers and has made an outstanding Dr. Bruce Abramowitz Illinois College of Medicine, he is editor contribution to medicine, the arts, or hu­ Dr. Carlos C. Alden Jr. of Medical Malpractice Prevention. manity during his or her career. Dr. Kenneth M. Alford Dr. William S. Andaloro • "Ethical Considerations" will be dis­ The selection will be made during the cussed by Robert L. Dickman, M.D. He summer and the award will be presented Dr. George Baeumler is director of the Department of Family in the fall at a special dinner. Dr. Eugene L. Beltrami Medicine at the Mt. Sinai Medical Center in Cleveland, Ohio. • "The Future of Physician Discipline in New York State" will be discussed by LATE WINTER 1989-90 The 1989 winner was George W. Dr. Richard A. Berkson Thorn, M.D., a medical pioneer whose Dr. Willard H. Bernhoft achievements as clinician, scientist and Dr. Theodore S. Bistany teacher have spanned 60 years. Ms. Anna Bleich • BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Alumni 29 Dr. Willard H. Boardman Dr. Harold Brody Dr. August A. Bruno Dr. Elaine M. Bukowski Dr. John L. Butsch Dr. Nicholas J. Capuana Dr. Joseph A. Chazan Dr. James Cole Dr. Joseph D. Concannon Dr. Julia M. Cullen Dr. Daniel E. Curtin Dr. Sterling M. Doubrava Dr. Ronald Dozoretz Dr. William Dugan Dr. Robert Einhorn Dr. George M. Ellis Dr. Daniel Fahey and Dr. Maria Runfola Dr. Donald M. Fisher Dr. Grant T. Fisher Dr. Thomas Frawley Dr. and Mrs. Kenneth L. Gayles Dr. Penny A. Gardner Dr. Matt Gajewski Dr. John W. Gibbs Jr. Dr. Seymour D. Grauer Dr. Wilson Greatbatch Dr. Mala R. Gupta Dr. Thomas J. Guttuso Dr. Eugene J. Hanavan Jr. Mr. and Mrs. Edward A. Hansen Dr. and Mrs. Gerald J. Hardner Dr. and Mrs. Kenneth L. Jewel Dr. Stephen T. Joyce Dr. James R. Kanski Jr. Mrs. Sidney R. Kennedy Jr. Dr. Israel Kogan Dr. Daniel C. Kozera Dr. Marvin Z. Kurlan Dr. Richard A. Leone Dr. Eugene V. Leslie Dr. Richard Levine Dr. Harold J. Levy Dr. Milford C. Maloney Dr. Don L. Maunz Dr. Harry L. Metcalf Mrs. Constance Plummer Miller Dr. Merrill L. Miller Dr. Eugene R. Mindell Dr. Joseph F. Monte Dr. John D. Mountain Dr. Arthur W. Mruczek Dr. Richard J. Nagel Dr. and Mrs. John Naughton Dr. Masao Nakandakari Dr. Richard B. Narins Dr. Charles Natalizio Dr. Timothy Nostrant Dr. Benjamin E. Obletz Dr. Charles O'Brien Dr. Elizabeth P. Olmsted Dr. John S. Parker Dr. Robert J. Patterson Mrs. Patricia Patterson Dr. Clayton A. Peimer Dr. James F. Phillips Dr. David E. Pittman Dr. Frank Riforgiato Dr. Richard Romanowski Dr. Albert G. Rowe Mr. and Mrs. James Samotowka Ms. Thelma Sanes Dr. Joseph I. Schultz Dr. Roy E. Seibel Dr. Elizabeth G. Serrage Dr. Arthur C. Sgalia Dr. John B. Sheffer Dr. John E. Shields Ms. Alice Simpson Dr. James K. Smolev Dr. John J. Squadrito Dr. Eugene M. Sullivan Jr. Dr. Michael Taxier Dr. Henry A. Teloh Dr. Raymond C. Thweatt Dr. Charles S. Tirone Dr. Hazel Trefts Dr. Russell J. Van Coervering II Mrs. Victoria Van Coervering Dr. Barbara Von Schmidt Dr. Franklin E. Waters Dr. Pierce Weinstein Dr. Mark W. Welch Dr. Philip B. Wels Mrs. Harriet E. Wesp Dr. Paul H. Wierzbieniec Dr. Gary J. Wilcox Dr. James S. Williams Dr. Stephen A. Yerkovich Dr. Franklin Zeplowitz Dr. and Mrs. David Ziegler The J a m e s P i a t t W h i t e S o c i e t y hears a p r e s e n t a t i o n o n g e r i a t r i c s . BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST LATE WINTER 1989-90 �People Make Research, Not War Guiseppe Andres reflects on social issues and his 20-year Buffalo career W ith the technology we have to­ day, many of the world's problems could be solved if money wasn't wasted on weapons, said Guiseppe A. Andres, M.D., a professor of microbiology, pathology and medicine at UB. Andres, 66, a leading researcher in kid­ ney disease, was honored for his lifetime research and teaching achievements at a symposium in November at Buffalo General Hospital. He's leaving Buffalo, but emphasized that he's not retiring in­ tellectually. "I don't know fishing," Andres said. "I only know how to do my work." Although Andres doesn't like to talk about himself, he becomes animated when the topic turns to the issue of fund­ ing for science. Andres for many years was a consultant to the study section which analyzed and funded research in immunology and immunopathology at the National Institutes of Health. "The total budget of the National In­ stitutes of Health is $7.7 billion for all the medical research in the country," he pointed out. "Consider that one of the stupid B-2 airplanes (stealth bombers) costs $600 million, and we don't even know if they will be useful. $600 million is the total budget of one of the institutes of the NIH. "We are at a period now where new tools are available for research, so the limitation is just the limitation of LATE WINTER 1989-90 money—so much money is wasted on weapons. We know that with the tech­ nology today, if the money was used for medical programs, problems would be solved, especially in the Third World." The lack of money makes life difficult for Ph.D.s because they're finished if their grants aren't funded. "How can you convince a young stu­ dent of medicine to go into research?" Andres asked. "I think students should be more involved politically and the voice of the scientists should be louder." Andres, who came to the United States from Italy, added that scientists "should convince the public that bio­ medical research is very important, espe­ cially in this country, because we foreigners came to love and admire the United States because of its leadership in science. "If the trend is not corrected, at a cer­ tain point, Europe and Japan will take over the role that the United States has had in the past." The recent warming of relations be­ tween east and west makes this an excit­ ing time. "It is true that in the last 40 years we've had peace. But those 40 years of peace were built on a balance of terror," Andres said. "If it will be possible to maintain peace without this balance of terror, so many others things could be done." The symposium at which Andres was honored was sponsored by Buffalo Gen­ eral Hospital, the hospital's medical staff, and the UB medical school. The symposium presented research on immunological-mediated diseases, partic­ ularly as they affect the kidney. The key­ note speaker was Robert T. McCluskey, M.D., an internationally recognized ex­ pert on immune complex disease. He is the Benjamin Castleman Professor of Pathology at Harvard Medical School and chief of the Department of Patholo­ gy at Massachusetts General Hospital. McCluskey was professor and chair­ man of the Department of Pathology at UB in 1970 when he and Felix Milgrom, now distinguished professor of microbi­ ology at UB, convinced Andres to come to Buffalo. "At the beginning of the '70s, Buffalo was probably one of the strongest centers for immunology," Andres said. He ticked off a long list of notables who were in the department, including Thomas B. Tomasi, now director of Roswell Park Cancer Institute, who described IgA, the body's first line of defense; the late Ernest Witebsky, the in­ ternationally known immunologist who did research in blood groups, and Noel Rose, who, with Witebsky, described thyroiditis caused by an immunological mechanism. "For me, it was a very good, very in­ teresting experience to work in Buffalo," Andres said. "It was possible to do research on a national and internation- BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Guiseppe A. Andres, M.D. al level." Andres directed the Renal Research Laboratory at Buffalo General Hospital from 1973 to 1988. For 10 years, it was designated by the World Health Organi­ zation as a diagnostic, reference, and training laboratory for the immunopathology of renal disease. Buffalo General Hospital is a great as­ set because the renal laboratory has a group of very well trained technicians, he noted. Andres and his colleagues studied many aspects of kidney disease, includ­ ing how immune complexes produce damage to the kidneys. They also wrote the first description of a rare condition that can affect patients who receive kid­ ney transplants. When an infection strikes, he ex­ plained, antigens are released into the circulation. To defend against the anti­ gens, antibodies are formed. But sometimes antibodies turn traitor and attack the body. Some patients who receive kidney transplants develop an in­ flammatory condition called tubulointerstitial nephritis. In 1973, Andres and his collaborators found this can be caused by antibodies reacting with the basement BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST membrane of a structure in the kidney called the proximal convoluted tubules. "This is interesting because usually pa­ tients develop antibodies to the base­ ment membranes of glomeruli (the filters in the kidney), not of the tubules," Andres explained. "This was the first description of what turned out to be a very rare disease." It was later found that some individu­ als who haven't had kidney transplants can also develop this condition, he added. The work was done with John Klassen, M.D. who was a fellow in the depart- LATE WINTER 1989-90 , �People ment and is now at the University of Calgary; Felix Milgrom, M.D., distin­ guished professor of microbiology at UB; the late Charles Elwood, M.D. who was a nephrologist at Buffalo General Hospi­ tal; renal transplant surgeons Roland Anthone, M.D., and Sidney Anthone, M.D., both clinical professors of surgery; Kyochi Kano, M.D., now professor of im­ munology at Tokyo University; A.B. Menno, M.D., clinical assistant professor of surgery, and Marion Sepulveda, who was the laboratory supervisor at Buffalo General Hospital. At the Buffalo General laboratory, which serves as a diagnostic and refer­ ence laboratory for all of the nephrologists in Buffalo, Andres splits his time between diagnostic work and research. "I think I got the most pleasure in clin­ ical activity—having the impression your work made a difference helping a pa­ tient," he said. "If you compare the kick you may get out of one of the four branches of aca­ demic life—patient care, administrative work, research or teaching—I think there is no question in my mind that the clin­ ical activity is best, probably because I was trained as a physician." After receiving his medical degree in his native Italy in 1949, Andres worked in the Department of Infectious Diseases at the University of Pisa. For several years he conducted kidney research at Columbia University, and was a research fellow at the Karolinska Institute in Stockholm. He worked with Thomas E. Starzl, M.D., the renowned transplant surgeon, in Denver. In 1982, he received UB's Stockton Kimball Award for outstanding teaching, research and service. He has published widely, both in Italian and English, on clinical immunol­ ogy, human and experimental immunopathology, and kidney transplantation.* LATE WINTER 1989-90 PANEL RECOMMENDS COMBINED TREATMENT FOR DESTRUCTIVE BEHAVIOR A combination of treatments rather than a single therapy is the most effective way to treat destructive behaviors in persons with developmen­ tal disabilities, according to a panel of medical experts convened by the Nation­ al Institutes of Health (NIH). Robert E. Cooke, M.D., UB professor emeritus of pediatrics, was on the 14-member panel of the Consensus De­ velopment Conference on the Treatment of Destructive Behaviors in Persons with Developmental Disabilities held in Sep­ tember. Nearly 4 million people in the U.S. have developmental disabilities such as mental retardation or autism, and ap­ proximately 160,000 exhibit behaviors that injure themselves or others or des­ troy property. In 1988, the cost of treat­ ment of these destructive behaviors exceeded $3.5 billion. Many of these self-injurious behaviors, such as head banging, face slapping, eye poking, ruminative vomiting, and swal­ lowing harmful substances, can be life threatening. The two most frequently employed treatment approaches are behavioral — using a system of reward or punish­ ment—and drug therapy. While the panel did not rule out the use of any therapy, including some con­ troversial punishment techniques, it strongly cautioned that such treatments designed to rapidly reduce destructive be­ haviors should be used only in a com­ prehensive and individualized program and only after appropriate review. The panel also said the prevalence of drug treatment is disturbingly high and lacks robust scientific validation. The panel recommended that the use of drugs should be limited to persons with iden­ tified psychiatric syndromes or used to facilitate behavioral, educational, or other therapies. Despite their widespread use, there has been relatively little scientific research on the effectiveness of any of these methods. The panel called for additional research on treatments, as well as basic research into the cause of the behaviors. Louis Bakay, M.D., professor emeritus in neurosurgery, received a Distinguished Alumnus Award from Harvard Medical School and Massachusetts General Hospital for his pioneering work on blood-brain barrier studies and his elu­ cidation of the pathophysiology of brain injury. • Robert E. Cooke, M.D. Evan Calkins, M.D., professor and head of the Division of Geriatrics/ Gerontology at UB, has been elected to the Johns Hopkins Society of Scholars. Calkins did his internship in medicine at Johns Hopkins Hospital in 1945-46 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �People 33 Hospital, as well as director of the Genet­ ics Division at the Shriver Center in Waltham, Mass. • Shepard Goldberg, Ph.D., clinical as­ sistant professor of psychiatry at UB, is president-elect of the American Associ­ ation of Psychiatric Services for Chil­ dren. He is executive director of the Child and Adolescent Psychiatric Clinic. • Lauracinnie D. Jenkins, M.D., clini­ cal assistant professor of family medicine at UB and medical director at the Dea­ coness Family Medicine Center, was honored at the 17th annual Black Achievers in Industry awards dinner. • Lauracinnie D. Jenkins, M.D. Daniel M. Green, M.D., associate professor of pediatrics at UB, has been appointed to the scientific committee of the International Society of Pediatric Oncology. A cancer research pediatrician at Roswell Park Cancer Institute, Green is an international authority on the late effects of cancer therapy in children. • and was an assistant resident in medicine there from 1948-50. Chief of the Gerontology Section at the Buffalo VA Medical Center, Calkins is director of the Multidisciplinary Center on Aging at UB. A master of the American College of Physicians, he recently received the Walter Beattie Award of the New York State Society of Gerontologic Educators and the Walter Cooke Award, presented by the UB Alumni Association. He re­ cently completed a three-year term as a member of the National Advisory Coun­ cil on Aging and is chair-elect of the Clinical Medicine Section of the Geron­ tological Society of America. • Emanuel Lebenthal, M.D., professor of pediatrics at UB, has received a pres­ tigious 1989 UNICEF Quality of Life Award. He was honored for his lifetime commitment to improving the quality of life of children world-wide and his research in chronic diarrhea and mal­ nutrition in infants and young children. Chief of gastroenterology and nutri­ tion at Children's Hospital of Buffalo, he is director of its International Institute of Infant Nutrition and Gastrointestinal Disease. • Richard W. Erbe, M.D. has been ap­ pointed professor of pediatrics at UB and director of the Division of Human Genetics at the Children's Hospital of Buffalo. Erbe was associate professor of genetics at Harvard Medical School and served as chief of the Genetics Unit and pediatrician at Massachusetts General Philip T. LoVerde, Ph.D., professor of microbiology at UB, has received the 1989 Henry Baldwin Ward Medal, the highest award presented by the Ameri­ can Society of Parasitologists. LoVerde, also a professor of pathology at UB, has distinguished himself in the field of research focusing on blood flukes BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST Philip T. LoVerdi called schistosomes. He currently is involved in studies aimed at developing a vaccine that would prevent schistosomiasis, a chronic, de­ bilitating and often fatal ailment caused by the parasites. Especially in the Third World, the disease is a major public health problem. • John Marzo, M.D., clinical assistant in­ structor in orthopaedic surgery, was hon­ ored by the Western New York Chapter of the American College of Surgeons for his essay related to his study on neck in­ juries in football players. James P. Nolan, M.D., chair of the Department of Medicine, has been elect­ ed to the Board of Regents of the Ameri­ can College of Physicians. From 1985-1989 he served as governor of the college's New York State Chapter and in 1988 was named its national "Governor of the Year." Nolan is also director of the department of medicine at the Erie County Medical Center. LATE WINTER 1989-90 �Classnotes Education at St. John's Mercy Medical Center in St. Louis, Mo. Steven G. Cline (M'47) • of At­ lanta, Ga., writes, "I recently retired from radiology. I am now pursuing a new career as a certified financial planner." 1950's James A. Curtin (M'50) • was Milford C. Maloney '53 1930 5 Arthur W. Strom (M'32) • was elected laureate of the Michigan Chapter of the American College of Physicians in 1988. 1940's Theodore W. Koss (M'41) • of Smithville, Tenn., has retired from the practice of medicine. Vincent J. Parlante (M'42) • re­ tired from the practice of medicine in 1988. Dr. Parlante lives in Hillsboro, 111. Thomas F. Frawley (M'44) • was one of five notable graduates to receive the Distinguished Alum­ ni Award presented by the Univer­ sity at Buffalo Alumni Association at its 50th annual banquet in June. Dr. Frawley is chairman of the Department of Graduate Medical LATE WINTER 1989-90 Jerome P. Kassirer (M'57) • received a Distinguished Teacher Award for excellence in clinical teaching from Alpha Omega Al­ pha in conjunction with the As­ sociation of American Medical Colleges. He was also honored by his colleagues for his 30 years of outstanding service to the Division of Nephrology of the New England elected to the Board of Regents of the American College of Physicians and is continuing as chairman of the Department of Medicine at Washington Hospital Center, Washington, D.C. Medical Center. Kassirer is the Sara Murray Jordan Professor of Medi­ cine at Tufts University School of Medicine. Roy J. Thurn (M'52) • was re­ cently promoted to clinical associ­ ate professor of Family Practice at the University of Minnesota, Maplewood. Morton E. Weichsel (M'62) • David H. Weintraub (M'37) • received the Teacher of the Year Award 1988-1989, presented by the Department of Pediatrics at St. Luke's Hospital, Cleveland, Ohio. Dr. Weintraub is an assistant profes­ sor emeritus at Case Western Reserve University Medical School. Reeber is a past president of the Headwaters Medical Society. Milford C. Maloney (M'53) • is president-elect of the American So­ ciety of Internal Medicine. Dr. Maloney is a past president of the New fbrk State Society of Internal Medicine, the Western New "fork Society of Internal Medicine, the Medical Society of the County of Erie, the Heart Association of Western New fbrk and the UB Medical Alumni Association. He subspecializes in cardiology in his solo practice in Buffalo. William J. Sullivan (M'55) • of Los Angeles is a diplomate of the American Board of Psychiatry and Neurology. He is certified in psy­ chiatry and psychoanalysis and is now specializing in forensic psy­ chiatry. Eric Reeber (M'56) • of Bagley, Minn., has been re-elected to a third term as trustee of the Min­ nesota Medical Association. Dr. 1960's was recently appointed director of Quality Assurance and Utilization Review in medical management of the Martin Luther King Jr. Medi­ cal Center, Los Angeles. He has also been appointed professor of pediatrics and neurology at the UCLA School of Medicine and the King/Drew Medical Center. Marvin Z. Kurlan (M'64) • has been appointed a deputy director general of the International Bio­ graphical Center of Cambridge, England. He will assist in the plan­ ning and running of the interna­ tional congresses of the IBC held in major world cities. Dr. Kurlan is a governor of the American Biographical Institute and is the recipient of its World Decoration of Excellence Medallion. Dr. Kurlan is president of the Buffalo Surgical Society and was elected to lifetime membership in the Leadership So­ ciety of the American College of Surgeons and inclusion in The Directory of Medical Specialists, Who's Who in America, 5,000 Per­ sonalities of the World, Men of Achievement, Dictionary of Intema- M a r v i n Z. K u r l a n ' 6 4 tional Biography, and The First Five Hundred. Jerome S. Litvinoff (M'65) • has a neurosurgical practice in San Diego, Calif., and is chairman of the Department of Surgery at Scripps Memorial Hospital in Chula Vista, Calif. Irving S. Kolin (M'65) • has been appointed medical director of Glenbeigh Hospital-Orlando, a pri­ vate psychiatric hospital specializ­ ing in the treatment of eating disorders, substance abuse and related psychiatric disorders in adolescents and adults. Dr. Kolin is a founding member of the American Academy of Psychiatrists in Alcoholism and Addiction. He was in the first group of physicians to achieve certification by the American Medical Society for Al­ coholism and Other Addictions. 1970s Kenneth Solomon (M'71) • was recently appointed associate profes­ sor of the division of geriatric psy­ chiatry, Department of Psychiatry and Human Behavior at St. Louis University School of Medicine. He BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Classnotes / Deaths 35 received a Presidential Citation from the Maryland Occupational Therapy Association and is an honorary member of the State Psy­ chiatric Society of Minas Gerais, Brazil. John W. Zamarra (M'72) • has been elected to fellowship in the American College of Cardiology. He is currently in private cardi­ ology practice in Brea, Calif. Arthur W. Mruczek Sr. (M'73) • has been appointed director of the contact lens service at the Erie County Medical Center, where he is a staff ophthalmologist. He prac­ tices medicine with a subspecialty in contact lenses and eye surgery in Medina, N.Y. Eric J. Russell (M'74) • was recently named to the editorial board of the journal Radiology. Dr. Rus­ sell is currently an associate profes­ sor of radiology at Northwestern University Medical School. He and his wife, Sandra, have two daugh­ ters, Gabrielle, 7, and Meredith, 2. Dennis C. Whitehead (M'75) • was elected to the position of vicespeaker of the council of the American College of Emergency Physicians. He is an emergency physician at Dickinson County Memorial Hospital, Iron Moun­ tain, Mich., and is an associate clin­ ical professor at Michigan State University, Lansing. Bruce M. Benerofe (M'79) • writes "I am happy to announce my marriage to Barbara Lipton (M'81) on Sept. 17, 1989. Barbara is practicing cardiology in New York City and 1 am practicing ophthalmology in New Jersey." Margaret J. Graf (M'79) • in­ forms us that she married Alan S. Berkeley, M.D. in 1984 and their daughter Sara was born in 1986. Dr. Graf is an assistant professor of OB/GYN at New York Hospital Cornell Medical Center. fellowship in kidney transplanta­ tion at Washington Hospital Center. "I'm starting anesthesiology — plan for critical care. Wise switch! Happily mar­ ried!" Jill D. Joyce (M'79) • writes, "I delivered my second daughter, Kel­ ly Samantha, in 5/89. First daugh­ ter, Victoria Lynn, born 12/87." Dr. Joyce is currently a staff psychiatrist at Mt. Vernon Community Men­ tal Health Center, Alexandria, Va. John F. Centonze (M'87) • writes, "I am currently a general medical officer on board the U.S.S. Iwo Jima. I have been pre­ selected to begin residency in otolaryngology-head and neck surgery in July 1990 Jennifer Cadiz, please write!)." 1980's Edward J. Rockwood (M'80) • is a glaucoma specialist at the Cleveland Clinic, Department of Ophthalmology. Richard Roy (M'80) • was in­ ducted into the American College of Surgeons in October. Dr. Roy is in group practice of urology in Detroit, Mich. George Foltin (M'81) • is direc­ tor of Pediatric Emergency Service at Bellevue Hospital, New "fork City. Dr. Foltin married Jessica Cooper of Providence, R.I. and is living in Riverdale, N.Y. Daniel P. Schaefer (M'81) • presented a paper on "The Acute Management of Eyelid Lacera­ tions" at the fourth annual Na­ tional Eye Trauma Symposium held in Philadelphia. John A. Feldenzer (M'83) • writes, "Karen, the kids and I have moved to Virginia. I've begun a pri­ vate practice of neurosurgery." Mark C. Steckel (M'84) • writes, "I completed a fellowship in pedi­ atric ophthalmology and strabis­ mus at Columbia-Presbyterian Medical Center and have joined an ophthalmology practice at 4699 Main St., Bridgeport, Conn. We also just moved to 27 Buena Vista Drive, Westport, Conn." BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST Eric J. Russel '74 Blackford Middleton (M'85) • writes, "Jon and Niki Wardner (M'85) visited while on a Western vacation. Enjoyed Wynton Marsalis in the Frost Am­ phitheater at Stanford under the hot sun!" Lynda Stidham (M'85) • of Glenwood, N.Y., writes that she finished residency at Children's in 1988 and is now enjoying life in a rural pediatric practice. Lance A. Besner (M'86) • is now chief resident of psychiatry at the Erie County Medical Center. He was married in April to Luisa Marengo. Michael J. Horan (M'86) • an­ nounces the opening of a new practice in pediatrics with Jean Marfurt (M'86). Their new of­ fice, Suburban Pediatrics, is locat­ ed at 1630 Maple Rd., Williamsville, N.Y. Bryon E. Labrenz (M'86) • has finished his family practice residency and is now employed in a new family practice residency program at St. Francis Hospital in Poughkeepsie, N.Y. Nilda E. Salaman-Dennis (M'86) • has finished a junior Mary C. Davitt (M'88) and Mitchell E. Tublin (M'88) • were married August 12, 1989, in Albany, N.Y. "Many of our friends from the University at Buffalo Medical School were able to join us in the celebration. We are now living in Pittsburgh." Charles Everett and Sandra (Frederickson) Everett (M'88) • proudly announce the birth of their son, Kristian, on July 15, ps Deaths Winfield L. Butsch (M'30) • a surgeon in Buffalo for many years, died Oct. 24, 1989. Dr. Butsch was an avid mountain climber who ascended to Mount Everest's firstlevel base camp when he was 68 years old. The W.L. Butsch Surgi­ cal Lecture Fund has been estab­ lished in his memory through the UB Foundation. James W. Weigel (M'51) • of Columbia, Mo., died on Oct. 11, 1989. Dr. Weigel had a private fa­ mily practice in New Jersey for 20 years before moving to Columbia where he worked at the Universi­ ty of Missouri-Columbia Student Health Center until his retirement. LATE WINTER 1989-90 �Hospital News 36 RESEARCHERS FIND POSSIBLE KEY TO MALIGNANCY R esearchers at Roswell Park Cancer Institute believe they may have zeroed in on the process that makes a cell malignant. "To place our findings in perspective and to paraphrase Churchill, in terms of the War on Cancer, this is not the end; it is not even the beginning of the end," said Garth R. Anderson, Ph.D., assistant research professor. "But, perhaps by com­ heart Nov. 2 at Buffalo General Hospi­ tal during an operation that left his own heart in place. This was the first "piggy­ back" or heterotopic heart transplant done in Western New York. Aponte suffered from coronary artery disease and had been hospitalized since July 1 at Buffalo General. Because Aponte had pulmonary hypertension (high blood pressure in his lungs) doctors decided that the new heart by itself would not be strong enough to overcome the pulmonary pressure. pleting our understanding of what fun­ damental cellular processes cancer represents, our findings may prove to have been the end of the beginning." The researchers reported that when a normal cell called a fibroblast is exposed to a lack of oxygen, such as during the early stages of wound healing, a tightly controlled series of responses is triggered. But if the cell loses control of that se­ ries of responses, it becomes malignant, the researchers believe. The results pro­ vide an important new focus for future studies aimed at understanding the com­ plexities of malignancy. The work was done by Anderson and Daniel L. Stoler, Ph.D., and Lisa A. Scarcello, M.S., all of the Department of Molecular and Cellular Biology at Roswell Park. The breakthrough findings were reported in the Journal of Biological Chemistry (Volume 264, page 14885). • OPERATION LEAVES MAN WITH TWO HEARTS A Rochester man has two hearts af­ ter an operation through UB's Heart Transplant Program. Alfredo Aponte, 54, received a new LATE WINTER 1989-90 Doctors attached the left atrium of the new heart to the left atrium of Aponte's heart, and did the same with the right atriums. The two aortas were connected to each other. A Dacron graft was used to connect the pulmonary arteries be­ cause they were too short. The piggy-back transplant isn't done routinely because a patient suffering from angina or chest pain would continue to have the pain if his heart were left in place. There are other risks as well. The Aponte transplant was the first of three transplant operations performed at Buffalo General in two weeks. UB's Heart Transplant Program has performed 14 transplants since it began in May 1988, and eight of those were performed in the six months between May and November of 1989. The rising number of transplants is due to the increased availability of donor organs because of a Nov. 1 change in regulations, according to the program's staff. If a heart becomes available in New York, it is now offered first to one of the two transplant centers within the state.* GRANT HELPS BABIES OF DRUG ABUSERS C hildren's Hospital of Buffalo has received a grant of up to $350,000 over five years to help the babies of women who abuse drugs, especially cocaine. The grant, from the U.S. Bureau of Maternal and Child Health and the American Academy of Pediatrics, was one of only 10 awarded nationally. The project was the focus of a visit to Buffa­ lo by Louis W. Sullivan, M.D., secretary of Health and Human Services. "Approximately 13 percent of pregnant inner-city women are abusing drugs," said Maureen Montgomery, M.D., co-director of the project. "In most cases, infants are discharged from the hospital into the care of the drug-abusing parent." The project provides preventive health care for the children, who are at high risk of abuse, and home-based support and education for the families. "Resource mothers," minority women trained to provide surrogate parenting, are hired to pay weekly visits to the homes of the substance abusers, lending support and teaching by example. The project will also provide regular well child visits, coordination with local child protective agencies and dissemina­ tion of tracking information and educa­ tion for community agencies providing care to these families. Montgomery is assistant professor of pediatrics at UB and attending pediatri­ cian in the Section of Ambulatory Pedi­ atrics at Children's. The other co-director is Karen Blount, R.N. • BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �iwjl M Buffalo Physician & Biomedical Scientist State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 Address Correction Requested mrMw&rmrmm, Non-Profit Org. U.S. Rbstagc PAID Buffalo, N.Y. Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Late Winter 1989-1990 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1989-1990-Late Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v23n05-1989-1990-LateWinter Table Of Contents A list of subunits of the resource. Urban Family Medicine The Other Enemy of World War I: Flu Volunteering in the Third World Medical School News Research Alumni People Classnotes Hospital News Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v23n05 Extent The size or duration of the resource. 38 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright 1990 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/0eb92cfb6d89676e7d0279b69d09718b.pdf 1c83ddd2e9e2c38820843d54959eeb3c PDF Text Text ie buffalo physician the buffal falo physician the buffalo physi| sician the buffalo physician th ie buffalo physician the buffal ilo physician the buffalo physi cian the buffalo physician the uffalo physician the buffalo ph hysician the buffalo physician le buffalo physician the buffal F> physician the buffalo physicil I buffalo physician the buffalo pf tysician the buffalo physician jo physician the buffalo physician th? ^sician the buffalo physician the bu pian the buffalo physician the buffa^ i buffalo physician the buffalo ph | buffalo physician the buffalo pj; lysician the buffalo physician physician the buffalo physicj je buffalo physician the buf Ian the buffalo physician the physician the buffalo phy: Ifalo physician the buffalo^ o physician the je buffalo physician the I |sician the buffalo physi( ysician the buffalo ph^ physician the buffalo | buffalo physician the bj| the buffalo physician the bJ Lthe buffalo physician physician the buffalo ffalo physician the buffalo phy alo physician the buff T BUFFALO �This is a typical Jecture-demonstration situation. At the front of the room assisting Dr. Beverly Bishop, associate professor of physiology, is Nancy Urbscheit, a graduate teach­ ing assistant in physical therapy, and Mr. Nassir Sabah, a lecturer in the School of Health Related Profes­ sions. Closed Circuit Television Closed circuit television is being used for the first time this semester in teaching Introduction to Physiology. The 260 students enrolled in this course have a variety of interests — some are history, physical education and English majors, while others are pre-meds, pharmacists, nurses, biologists, occupational and physi­ cal therapists. This demonstration approach to experimentation allows the pro­ fessor and students to explore together the ways in which a living organism functions. Some physiological events, such as action po­ tentials, are too rapid to be recorded on a penwriter and must be displayed on a cathode ray oscilloscope (CRO). The short persistence of the ordinary CRO beam and the small screen of the CRO tube limit the usefulness of oscilloscopic displays for demonstrations to large classes. Whenever the entire class can simultaneously view identical responses it is a great teaching advantage, according to the physi­ ology faculty. Now that the physiology faculty have the facilities for closed circuit TV (room 128 Capen] they are finding a variety of exciting ways to supplement their lectures and laboratory sessions. Closed circuit TV and video tapes promise to narrow the gap between basic science and clinical medicine by resolving patient availability problems, and spanning the time, space and knowledge barriers. • SPRING, 1970 THE BUFFALO PHYSICIAN �SPRING, 1970 Volume 4, Number 1 THE BUFFALO PHYSICIAN Published, by the School of Medicine, State University of New York at Buffalo IN THIS ISSUE EDITORIAL BOARD Editor ROBERT S. MCGRANAHAN Managing Editor MARION MARIONOWSKY Dean, School of Medicine DR. LEROY A. PESCH Photography HUGO H. UNGER EDWARD NOWAK 2 6 7 8 10 11 Medical Illustrator MELFORD J. DIEDRICK 12 Graphic Artist RICHARD MACAKANJA Secretary FLORENCE MEYER CONSULTANTS President, Medical Alumni Association DR. SIDNEY ANTHONE President, Alumni Participating Fund for Medical Education DR. MAX CHEPLOVE Provost, Faculty of Health Sciences DR. DOUGLAS M. SURGENOR Associate Dean for Continuing Medical Education DR. HARRY J. ALVIS Vice President for Alumni Affairs JOHN C. CARTER Director of Public Information JAMES DESANTIS Director of Medical Alumni Affairs DAVID M. KRAJEWSKI President, University Foundation DR. ROBERT D. LOKEN Director of University Publications THEODORE V. PALERMO 13 14 15 16 17 18 22 24 27 28 30 33 34 35 36 37 38 Vice President for University Relations DR. A. WESTLEY ROWLAND 39 40 42 43 45 Closed Circuit Television inside front cover Dean Pesch Reports Infectious Disease AMA Recognition Dr. Milch Honored Community Services Grant Dr. Rekate Replaces Dr. Hummel New Assistant Veteran's Director Family Practice A Unique Medical Team Pediatric Fellowship Drug Control Children's Hospital Contract President Meyerson Resigns Children's Hospital Addition Dr. Wilbee Medical Education Buffalo General Alumni Spring Clinical Days Health Care Inhalation Therapists Meyer Hospital Facilities Different Kinds of Obesity by Gail McBride Tribute to Dr. Leak Millard Fillmore Physicians Honored Alumni at Walter Reed Dr. Orr Heart Study Dr. McDaniel Dr. Cheplove People In Memoriam Dr. Witebsky Dies Alumni Tours The cover design by Dick Macakanja refers to Aries, Taurus, and Gemini, which are symbols denoting astrological influences from March 21 through June 21. THE BUFFALO PHYSICIAN, Spring, 1970 — Volume 4, Number 1, published quarterly Spring, Summer, Fall, Winter — by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. Please notify us of change of address. Copyright 1969 by the Buffalo Physician. �From the desk of LeRoy A. Pesch, M.D. Dean, School of Medicine The events which have occurred at this Medical School November 3 to 10 have served to bring into sharp focus many urgent and deeply rooted problems in our society which are related to the health of this nation. Health indicators from many sectors and census tracts clearly show the inadequacy of our present health care system. While the present focus is on disadvantaged segments of society, the overall problem affects all people and all levels of the health care system. The demands which were presented to the Medical School are not new demands nor are they directed at the Medical School alone. They are demands directed at society, a society which has toler­ ated the oppression of people and tolerated the disadvantages imposed on one of our most important human resources — our young people. Our disadvantaged minorities are tired of being oppressed and tired of being called disadvantaged and oppressed. They are tired of the handouts of society, tired of welfaresupported indigent medical care, tired of programs such as medi­ caid which perpetuates second-class medical care. The demands are for equality — equality of educational opportunity, equality of educational effort and advantage, and equality of medical care. In short, our society is demanding that we produce the man­ power, the delivery systems, the opportunities for full and equal participation by all people in the effort to develop the total capa­ bility for elevating the health of this nation to the highest level we are capable of achieving. We must respond, not next year, not next week, not tomorrow, but today. In coming to this University as Dean of the School of Medicine a little over a year ago, I made my own demands for an action pro­ gram that would respond to the urgency of the problem of health. Among these were demands for: —a curriculum which would be responsive to compensation for any educational disadvantage which might result from a truly open admission policy and yet would provide the very best of educational and research opportunities for all of our students; —an organization within the student body which would accept responsibility for meaningful participation in the programs of the school; —appropriate identification and organization of a Faculty of Medicine which would be cohesive in its efforts to produce educational excellence for all students in the school, as well as in residency and postdoctoral training programs; —working together with our affiliated hospitals to build a com­ munity-based, university-coordinated system of health care; —an organizational structure within the university which would cut through our own barriers of academic and governmental bureaucracy so that implementation of our programs for action could be immediate. We have made progress in all of these areas; some more signifi­ cant than others. We must continue to work on all of them. The demand for health care is not the responsibility of this Medical School or this University alone. It is the responsibility of all of us. The community and the nation must provide the facilities, resources, and imaginative programs if we are to get the job done. 2 THE BUFFALO PHYSICIAN �It is no longer a question 'should we?' It is a fact to which we must respond. And we must find the answer to how it can be done. There are many things going on at university campuses at the present time. Some are very difficult to understand. However, this is a quality University. We have a good Medical School and are dedicated to making both of these institutions excellent. Further­ more, we are committed to equality of educational opportunity and to responding to the community and the region we serve. There­ fore, we must say 'no' to violent confrontation, to destructive acts as well as to coercion as tolerable techniques for change. On the other hand we must respond with action and not words. Thus, on the basis of our commitment, when our students who are disadvantaged for any reason ask: Will you provide us with equality of opportunity? We can say 'yes'. Will you guarantee equal educational standards and advantage? We can say 'yes'. Will you equalize financial assistance in such a way that we can do our best? We can say 'yes'. Will you help us achieve more and better health care? We can say 'yes'. Not a qualified or second-class 'yes', but a resounding 'yes'. • As we begin a new year, I would like to take this opportunity to initiate a series of regular reports on matters of concern to all of us. In this way it is my hope that communication may be improved and we may be better informed about developments within the school. At the outset I would like to alert the faculty to a meeting which will be called by the Secretary of the Faculty in the very near future. Its purpose will be to consider the report of a faculty committee on bylaws and the possible adoption of the committee report as an amendment to the bylaws. The substance of the report calls for the establishment of a Faculty Council which will represent the faculty in matters of school policy. You will recall that the committee report was distributed and discussed at the Annual Faculty Meeting last spring. The report will be distributed with the agenda and the call to the meeting. The second matter concerns the current status of programs related to increased enrollment for next year and progress in the area of disadvantaged minority group admissions. At the present time the following format has been established in concert with elected representatives of student groups: —The school will expand the size of the entering fall class by approximately 20 places. —There will be a single Medical School Admissions Committee with an equitable faculty membership from groups formerly under-represented. —There will be a single mechanism for appeals on suspension or dismissal from the School of Medicine. SPRING, 1970 Dean Pesch The Dean Reports �The Buffalo General Hospital dedicated the Oscar J. Oherkircher Urological Suite in De­ cember. It is part of its $7.3 million addition. The national­ ly known urologist, Dr. Oberkircher, M'15, left, first joined the hospital staff in 1917. He examines a portrait and the plaque in the new wing with his sons, Paul, M'59, Oscar, M'52, and David, M'59, all physicians. • Buffalo Evening News Photo —There will be a major recruiting effort for disadvantaged students along the lines of the Career Development Program recommended by Medicine and other Health Science Schools in March 1969. We have developed a harmonious and con­ structive relationship with the community, university faculty, and student groups most directly involved. It is our intention to institute a summer program, comparable to the Harvard Career Development Program this summer. Dr. Chris­ topher D'Amanda has been appointed Acting Director of the Health Sciences Career Development Program with some exciting results in the area of recruitment already demonstrated. Faculty and financial resource development are presently under study. Dr. Eric Barnard has been appointed chairman of a Commit­ tee on Space and Facilities to evaluate and recommend the changes necessary to accommodate the anticipated increase in class size for next fall. Dr. Edward Marine has been working closely with Dean Claude Welch of the University College to develop academic pro­ grams which may include five, six or seven-year curricular tracks with cross-registration between the College and the School of Medicine leading to the M.D. degree. A committee for coordinating the development of these programs will be appointed. 4 THE BUFFALO PHYSICIAN �Another important faculty committee being established is called the ad hoc Committee on Medical Manpower. This committee has been in the planning stages for several months. It will evaluate current efforts in the areas of Community Medicine, Ambulatory Care and Family Practice and will be charged with recommending academic program development in response to the local and regional manpower shortage with particular emphasis on com­ munity and family medicine. Dr. Marine has agreed to serve ini­ tially as chairman of this committee. The final matter I would like to bring to your attention at this time is an important and major change in the administrative or­ ganization of the Dean's office. The most immediate needs of the school call for the resolution of administrative complexities in­ herent in the pattern of the organization of the school. Because we operate major programs in a variety of institutional settings, in­ cluding several within the community, the school has a continuing responsibility in providing leadership to find imaginative solutions to the unsolved problems of our clinical programs, postgraduate education, and the integration of the medical center with the community in which it functions. Consequently, several steps will be taken over the next few months to provide a more effective and efficient administrative organizational structure than the School has had in the past. The first of these changes is the establishment of the position of Executive Associate Dean and Director of Academic Programs. This position will have the authority and responsibility for direct­ ing and coordinating admissions, curriculum development and academic affairs, student affairs, special program development, together with coordination of the interaction between the Student Polity and the Faculty Council. I am delighted to announce that Dr. Edward Marine has agreed to accept this position effective immediately. I feel very fortunate indeed in having a person with his capabilities assume this important administrative position, and I have every confidence that under his leadership major progress will be made in all these areas which are so vital to our educational and clinical programs. Other changes in the area of institutional relationships, fiscal management, and planning and development are under study and will be announced in the very near future.• SPRING, 1970 5 �I Dr. Allen Infectious Disease Dr. Allen teaching at one of the smaller didactic weekly sessions. UST A MINUTE," responded an enthusiastic voice, that of Dr. James C. Allen who came from Baltimore's Johns Hopkins last August to head the first university-wide infectious disease program in Buffalo. "I am just winding up this experiment." In a small office tucked into a corner of a laboratory—in the usual disarray ac­ companying the final throes of occupancy—we talked about in­ fectious disease. "Infection is mainly an acute problem," the young, tall and spare associate professor of medicine pointed out. "The patient recovers or dies. Or he may develop an infection during treatment for another illness. Tuberculosis and venereal disease are two of the major exceptions," he said. Clinical duties in this major subspecialty of the department of medicine are heavily teaching oriented. When house staff is faced with a problem—increasing use of antibiotics, cancer drugs, and corticosteroids over the past decade have changed the pattern of hospital infections—"we are called in," he said. "We counsel them on an approach to diagnosis and therapy." Teaching continues as the basic tenets of appropriate infectious disease practice are em­ phasized during grand rounds and at the smaller, more didactic weekly sessions where students on service at the hospital join in. For the first time this fall, a student elective in infectious disease will be offered. In his approach to research, Dr. Allen looks for the combination of both basic and clinical application. "I want my basic question to be a steppingstone toward the application of a practical answer I want to find the ways and means such as hypersensitivity to bac­ terial products causes tissue damage and disease manifestations. "We pursued the literature hint that hypersensitivity may be a tool toward answering certain basic questions in the pathogenesis of tuberculosis," he said. Over a three-year period, TB-induced pleural fusions in animals were investigated utilizing refined meth­ ods of studying protein and water movement. The result—a specific physiologic lesion related to this type of delayed hypersensitivity phenomena can now be defined. �"Our studies have shown us the 'way' to demonstrate hyper­ sensitivity in this type of manifestation, the 'way' delayed hyper­ sensitivity can cause significant physiologic lesions in the living animal." But even with the best available techniques, a significant percentage of the tuberculous causes of pleurisy cannot be proven. It is often the young, he said, who will subsequently develop significant extra-pleural TB if not treated. "By using the 'tool' of hypersensitivity we hope to understand this process in man. A study is currently underway." Is drug hypersensitivity through antibiotic use clinically signifi­ cant? Dr. Allen and his assistant, Dr. William Lerner, think so. They are zeroing in on an area in which little is known—delayed hyper­ sensitivity following antibiotic use. They are combining the basic question—how the body combats infection—with its practical ap­ plication, the adverse effects of antibiotic drugs themselves. There is a delayed hypersensitivity system, their yearlong study on the experimental model has conclusively proven. A certain response specifically related to the structure of antibiotics can be defined in this system. When their studies are completed, they hope to interpolate their findings to man. A pioneer in the isolation and identification of meningococci anti­ gens will be joining the team in July. He is Dr. Michael Apicella, active in the study of hypersensitivity phenomena, who will be working on problems involving the meningococcus as a casual as well as pathogenic inhabitant of man. In a collaborative study with Dr. Allen, he will focus on certain problems in host resistance.• The Continuing Medical Education lecture series presented over the two-way Telephone Network of the Regional Medical Program of Western New York has been recognized by the American Medical Association. Dr. Harry Alvis, associate dean for continuing medical education, said that physicians who participate in the programs can now receive credit for the required category towards attain­ ing the AMA Recognition Award in Continuing Medical Education. This award involves no academic credit but is a means of acknowl­ edging the genuine desire of many physicians to keep up with advances in their field. Recognition of the network programs as an effective means of edu­ cation was possible only because the programs are organized under the auspices of the Medical School faculty which had already re­ ceived accreditation for its conventional short-term courses. The series started in the spring of 1968 with 15 hospitals in the network. Today there are 51 hospitals in Western New York and Pennsyl­ vania on the network. The regular series of programs for physicians is presented every Tuesday at 11:30 a.m. There are several other network programs for dentists, nurses, pharmacists, physical thera­ pists, podiatrists, medical record librarians, hospital administration and supervisory personnel, dieticians, and environmental health personnel.• SPRING, 1970 7 AMA »-» Ivt!l_.UJ= �Dr. Milch Honored by Albert Einstein Medical College A 1933 graduate who has been on the Medical School faculty since 1938 (except for military leave during World War II) was honored recently by the Albert Einstein College of Medicine of Yeshiva University. He is Dr. Elmer Milch, clinical professor of surgery. He is also acting chairman of the surgery committee at Buffalo General Hospital and a surgery consultant at Roswell Park Memorial Institute. During a reception and dinner Dr. Milch was presented a plaque for "his service to the advancement of medicine." The surgeon has been active and honored by several other medical and civic organizations. Dr. Milch's address, which follows, was entered into the Con­ gressional Record by Congressman Thaddeus ). Dulski of New York on November 6,1969. I should like, first, to express my sincere appreciation for the honor you do me this evening. Recognition is gratifying at any time, but it is recognition by one's peers such as the men at Albert Einstein Medical Col­ lege which is deeply and truly valued. As an individual who has been engaged modestly in medical education for more years than I care to admit publicly, these moments are treasured not only for the infrequency of their occurrence, but also for the oppor­ tunity to speak out in a reflective and philosophical mood both as a physician and a layman. In a rapidly changing society—such as has been ours during the past 3 to 4 decades, we have watched the practice of medicine become a public utility subject to federal, state, and municipal regulatory bodies and laws, which have attempted by their actions to reduce physi­ cians to one common denominator. As a result of these actions excellence is in danger of becoming an increasingly vestigial structure and the resolve to pursue it may soon give way to disillusion. This we must never permit to happen to our youth. What course then is open to our youth, to those in whom we intrust the future and health of our society, and if you will, the future of all mankind? Disillusionment? I hope not. Callous cynicism and an attitude of "what the hell, I'll play ball their way?" I hope not. Petulance and withdrawal from our society, contenting themselves with pouting predictions of apoc­ alypse for the world in which they feel condemned to live? I hope not. I hope that those who one day join the medical pro­ fession will be taught to take none of the easy ways out, but will continue to pursue excellence—for the selfrespect of knowing that one has done his best, for the joy of the pursuit, for the very love of excellence itself. 8 THE BUFFALO PHYSICIAN �MUST TEACH BY EXAMPLE But this hope will be in vain if we do not teach the young by our example. Today, as the moral vacuity of our country is replaced by the moral vacuity of the crash pad, our society is learning the truth of the biblical admonition that it must reap as it has sown. We, in medicine, as practitioners and teachers must try not to repeat the same errors. We just cannot afford the pious invocation of one set of values while we conduct ourselves by another. If we as a profession are to retain our self-respect, we must demand excellence of ourselves first or else we must not demand it of those who will succeed us. Nowhere is the dual nature of that imperative more manifest than in our medical schools. If we are to expect our students to forget the lessons of compromise and expediency, then we must retain the most vigorous standards of excellence in their training. We cannot heed the political call for instant physi­ cians, in a futile, hasty effort to correct years of neglect and mistakes. We cannot and must not play games with our youth and our health because of a wrong sense of priorities permitted to exist over the years. SOCIETY MUST DEFEND STANDARDS If we are to preserve the self-respect of the medi­ cal profession, then society as a whole must defend the standards of excellence. For only through such a defense by the public itself can we hope to produce physicians who will be worthy of their calling and our trust. For only by being the instruments of our own support and standards can we hope to teach the young the necessity of integrity. Only by ourselves turning away from the bastions of mediocrity which would prostitute these principles in the name of political expediency can we hope to one day view ours as a profession which serves as an ex­ ample to society rather than partaking of its present ills. And these facts society must understand and must help us as teachers and physicians do. It is because Albert Einstein Medical College in the comparative short time of its existence has demon­ strated these standards and principles of excellence. It is because as a private institution depending greatly upon public support it has held its head high and to date has refused to bow to the pressures of mediocrity —that I, as an individual, am very proud to be honored this evening and to accept this plaque in behalf of all grateful practitioners and teachers of medicine.• SPRING, 1970 Mr. Edward Kavinoky, co-chairman of the testimonial, presents award to Dr. Miich, "for his service to the advancement of medicine." �$900,000 Grant to Community Services Program The staff of the Community Services Research and Devel­ opment Program includes spe­ cialists in epidemiology, so­ cial work, sociology, statistics, and medicine. Co-directors with Dr. Sultz are Dr. Edward F. Marra, professor and chair­ man of the department of so­ cial and preventive medicine at the Medical School, and Dr. William E. Mosher, Erie County Health Commissioner. J.HE COMMUNITY SERVICES Research and Development Program at the Medical School has received a five-year grant of $900,000 from the National Center for Health Services, Research and Devel­ opment of the U.S. Department of Health, Education and Welfare. The grant will underwrite studies and projects for improving over­ all medical care in Western New York. The first-year budget will be $140,283 with the remainder of the grant allocated over the next four years, according to Dr. Harry A. Sultz, a former dentist and now associate professor of social and preventive medicine and director of the program. "Our objective is to find ways to make the advances of modern medicine and dentistry available to all of our people," Dr. Sultz said. "There is still much that we do not know about disease, but there is much that we do know that is currently of little benefit to large numbers of Americans. We must make it available to them— and make them aware of how and where to seek it." The several projects currently underway include: —a study of how group psychotherapy aimed at allaying anxiety may affect the prognosis of coronary patients—in collabora­ tion with Dr. Michel A. Ibrahim, Deputy Commissioner of Health for Erie County; —a study, for the Regional Medical Program, of the need for health manpower, new clinical techniques and other resources in the care of stroke patients in the Western New York region in collaboration with Dr. Ibrahim and Dr. Harvey Borden of the U. S. Public Health Service; —a study of out-of-wedlock pregnancy and contraception, in collaboration again with Dr. Ibrahim; —for residents of one part of the "inner city," compilation of a Health Rights Guide by medical and nursing students who staffed a clinic in the area last summer—so that residents will know where and how to get medical aid quickly; —publication of a Physician's Desk Reference of Community Services, for the Western New York region, which will be published in the fall and will list 400 services related to health needs, such as hospitals, nursing homes, adoption agencies, or places to obtain wheelchairs or counseling. This is funded by the United Health Foundation and the Erie County Department of Mental Health. The research initially started in 1962 when the then community services unit of the preventive medicine department was asked by the New York State Department of Health to undertake the Erie County Survey of Long-Term Childhood Illnesses. When this mas­ sive study was completed, in 1965, the unit decided to stay to­ gether as a full-fledged research group. Federal support of this program, prior to this grant, has totaled approximately $500,000. The purpose of this first study, whose results have attracted widespread interest, was to ascertain the incidence and prevalence of 70 long-term childhood diseases for which services were not (yet) provided under the state crippled children's program, so that they could be given more informed consideration in terms of state and local health planning.• 10 THE BUFFALO PHYSICIAN �A 1940 Medical School graduate was named acting director of the E. J. Meyer Memorial Hospital January 1. He is Dr. Albert C. Rekate who has been on the faculty since 1947. He succeeds Dr. L. Edgar Hummel, who retired as superintendent of the hospital December 31. The title of the top hospital post was changed from superin­ tendent to director. Dr. Rekate is also associate dean for clinical affairs in the School of Health Related Professions, professor of medicine, and director of rehabilitation medicine at the hospital. He has been on the Meyer staff since completing his internship there in 1941, except for three years in the Army Medical Corps from 1944 to 1947. The new director has co-authored seven major articles for medi­ cal journals, including a treatise on "Liver Function in Alcoholism" in 1963. Two years later he organized a rehabilitation program at Meyer which embraced alcoholism along with drug addiction, men­ tal illness and other conditions. He has held other Meyer appoint­ ments—assistant residency, attending physician, associate director of medicine, assistant psychiatrist, and acting head of the cardiol­ ogy department.• Dr. Rekate Dr. Rekate Named Director of Meyer Hospital Dr. Hummel Retires Dr. L. Edgar Hummel, superintendent of the E. J. Meyer Memorial Hospital since March 1, 1957, retired December 31. He has been a member of the hospital's medical-dental staffs since 1939, and on the School of Medicine faculty since 1938. Dr. Hummel reached retire­ ment age in April, 1968. He did his undergraduate work at UB, and in 1931 received his M.D. from Harvard Medical School. "It has been a fruitful and satisfying experience to have headed up one of the great municipal hospitals of the country," Dr. Hummel said.D Dr. Christopher D'Amanda is the new assistant to the Dean in the Medical School. He will be acting director of the new Health Sci­ ences Career Development Program. He will also serve as interna­ tional liaison officer of the Medical School and be involved with the delivery of health services and care in the community. The 35year-old physician is also an assistant research professor in the department of medicine at the E. J. Meyer Memorial Hospital. In 1956 Dr. D'Amanda received his bachelor's degree in English Literature from Harvard University. He received his M.D. degree from the State University at Buffalo in 1962. He was an intern and resident at the Buffalo General Hospital from 1962 to 1966. During July, August and September of 1966 Dr. D'Amanda was preparing himself for a special assignment at the National Communical Dis­ ease Center, Atlanta, Georgia. From November, 1966 to November, 1969 he was at Upper Volta and the Ivory Coast, West Africa, in the measles control and smallpox eradication program. This pro­ gram was sponsored by the United States Public Health Service.• SPRING, 1970 11 New Assistant to the Dean Dr. D'Amanda �Mr. Speer Veteran's Hospital Director "Part of the challenge in my coming to Buffalo," said new Vet­ eran's Hospital Director Eugene E. Speer Jr., "is participating in the expansion of the hospital's training and ongoing research pro­ grams." For the 57-year old Alabama born director, this means better patient care, a more active affiliation and cementing of rela­ tions with the Medical School. The 1937 graduate of Athens College in Alabama, who as a boy really wanted to be a surgeon while his family hoped for a min­ ister, pursued graduate work at George Washington University. He later lectured there on hospital budget and outpatient records. He received the equivalent of a master's degree in sociology and per­ sonnel administration from the University of Alabama. The blue eyed administrator, who "won't stay if I can't keep things moving ahead" has 23 years' Veterans Administration ex­ perience in four hospitals. He comes here from Louisville, Ken­ tucky where he held an equivalent directorship. This was pre­ ceded by five years' service with the Air Force, enlisting as a private and discharged as a captain. He worked most of the time in military hospitals. That's where he became interested in hospital adminis­ tration. But he has also taught at all grade levels in Decatur, Alabama following graduation. And he has held principal and vocational advisor positions as well. Leisure time, if there is any, finds Mr. Speer either rebuilding stereo equipment, dabbling in hybrid dahlias or reading sports magazines. About 25 years ago he was a Red Cross water safety instructor and he readily admits that both he and Mrs. Speer find the outdoors one of the best means of relaxation. Golf and fishing are also high on the agenda. "Things are moving ahead," said the new director. "We are mak­ ing progress."• New Family Practice Plan Three young physicians, all May Medical School graduates, are practicing family medicine as the first resident physicians in the new specialty of family practice at Deaconess Hospital. They are — Drs. Michael Smallwood, Timothy Harrington, and Robert J. Gibson. Patient families will be assigned to each one of the three resi­ dents, who will handle their problems personally, calling in con­ sultants as necessary, including a social worker who will be assigned to the program. The resident will practice "preventive medicine," working not just with the sick in the family, but with the well, to keep them from getting sick. When the resident is not seeing patients, he will be encouraged to pursue a program that will be helpful in whatever circumstances he elects to practice after his residency. The residents will be encouraged to learn more about facilities available to their patients in the community, such as public health nursing. They may also spend some time in compre­ hensive health planning, medical society or regional medical pro­ gram offices.• 12 THE BUFFALO PHYSICIAN �A Unique Medical Team The James D. Felsens form a unique medical team. Since 1967 they have been working with three tribes of Indians in Arizona (Hualapis, Havasupais, San Carlos Apaches). Dr. Felsen is a 1966 Medical School graduate, and his wife is a nurse with the Head Start Program. The husband-wife team dou­ bles in everything from educator to social work to pharmacist. They have come a long way in three years—from a mule-back clinic to administrator of a modern U. S. Public Health Service Hospital with a staff of 75 on the San Carlos, Arizona Apache Res­ ervation. Before completion of the hospital the Felsens loaded mules with supplies every three weeks and rode horses into the canyon to conduct a clinic for the tribe. The Arizona and New Mexico Indians have problems of improv­ ing their socio-economic status, and fitting themselves into the mod­ ern world, according to Dr. Felsen. "It is amazing how far they have come in three generations, since they were overpowered by the cavalry." The single most isolated group of American Indians is the 300 Havasupai who live at the bottom of the Grand Canyon. The Apaches are a more advanced tribe, but the problems the health workers face are similar. "We have the facilities, but very few Indians see themselves as responsible for their health. They shift the responsibility to the doc­ tors and the Public Health Service," Dr. Felsen said. "Curative medicine for the Indians is as modern as anywhere in this country, but preventive medicine is only in its infancy," he said. "I'm not so sure this doesn't carry through into Buffalo and other cities. The facilities are there, but hundreds of thousands of people are not getting services because they don't know they exist," Dr. Felsen said. The Felsens went to serve among the Indians because of the op­ portunity to see "raw disease." They stayed because of the need and the desire "to progress into community medicine." They both agreed they are being rewarded because "the Indians are beginning to demand services on their own rather than waiting for us to insist on their participation." The Felsens spent August and September in Africa giving medi­ cal care to Sierre Leone's Peace Corps volunteers and gained some new ideas for bringing better community medicine to the Indians of the Southwest.D SPRING, 1970 13 �Pediatrics Fellowship A Both Julie and Dr. Rubin admire a pretty dress. L/rUg Control N INTEREST IN PEDIATRICS? A curiosity about kidney disease following lectures on the kidney by Charles M. Elwood ? That sums up Julie Dratch's summer fellowship at the Children's Hospital. "I wanted pediatrics and an opportunity to work under Dr. Mitchell I. Rubin," the petite dark haired senior said. "The daily clinical rounds, the workups in the outpatient clinic where I can follow my patients have been really exciting. One, an eight year old girl, will be in again this morning. Proteinuric, we are treating her with steroids and I am eager to see how she is responding." It is also an opportunity to become familiar with research and laboratory procedures. There is Dr. James Brennan's weekly biopsy conference at the Buffalo General Hospital. And there is Julie's study on the nephrotic syndrome. By recording laboratory and clinical data on 55 patients who have evidence of minimal disease documented by renal biopsy, she feels that "we may be able to predict prognoses based on what we have seen happening." The future? Hopefully an internship in a New York City hos­ pital. She has worked at Roosevelt, one of Columbia's teaching hospitals where many of the patients are Puerto Rican. She is taking Spanish lessons twice a week because "if I am accepted at Roosevelt I want to be able to talk to them."D The recent explosion of drug use should be a warning to society to establish a "system of anticipatory control" today for mindeffecting narcotics sure to appear in the very near future. That is what Dr. Cedric Smith, professor and chairman of the department of pharmacology, told the State Joint Legislative Committee in Pro­ tection of Children, Youth and Drug Abuse. "There will be new and different drugs for changing the way one thinks. Our present system of research and education is too inertiabound to respond to the protection of the populace. It was evident ^* ve t o t e n y e a r s ago that psychedelic and marijuana use was spreading rapidly," Dr. Smith said. The professor called for a control system of psychedelic agents including: [1) a monitoring group responsible for recognizing new compounds and techniques for thought manipulation, for assessing potential and for initiating research; (2) a research group for studies on man and animals in both short and long range periods; (3) a program to keep the public educated on new techniques for combating drug abuse. Dr. Smith warned that lack of proof that a drug does permanent harm does not give it an automatic clean bill, noting that "both thalidomide and DDT were widely used before it was realized that they were harmful."• 14 THE BUFFALO PHYSICIAN �Following a year's review and analysis by University and Hospital authorities, the up-dated contract of affiliation between The Chil­ dren's Hospital of Buffalo and the University Schools of Medicine and Dentistry was signed by Dr. Peter Regan and Mrs. Robert B. Adam, President of the Hospital's Board of Managers on January 8, 1970. Dr. Regan is Acting President of the University. Hospital-University affiliation originated in 1936 and was up­ dated in 1942. Both the previous agreements, however, only stated the intention of the two parties to affiliate without specific com­ mitment as to what the agreement would entail. Both institutions, realizing the necessity for maximizing their efforts to obtain State and Federal funds of benefit to both decided to re-draft the document spelling out specific principles within a legal context. The document in no way alters the status of the hospital. It still maintains complete control of its operation as a non-profit corpora­ tion chartered under the laws of the State of New York directed by a 24 member Board of Managers from the community at large. The document includes provisions for appointments and promo­ tions within the framework of the Medical Staff Bylaws of the hospital. It now also provides for representation of Administration and Hospital Board members on University policy committees which involve the Hospital including search committees for hos­ pital department head positions. At the same time it provides for recognition and representation of University representatives on the Hospital's Board of Managers. In both cases, representation is exofficio. Both parties feel that this mutual cross representation will provide a more complete flow of information between the two institutions. With a singleness of purpose they can thus provide the best possible care for children of Western New York and the best possible teaching program for the Medical and Dental students of the University.D Children's Hospital Contract Signed President Martin Meyerson has been elected president-designate of the University of Pennsylvania. He will assume his new position in September. He succeeds Dr. Gaylord P. Harnwell, who will retire in September. Mr. Meyerson came to Buffalo in September, 1966 as the succes­ sor to Dr. Clifford C. Furnas, who had reached mandatory retire­ ment age. Since September, 1969 Mr. Meyerson has been spending two-thirds of his time as chairman of the Assembly on University Goals and Governance, which is studying the functions and pur­ poses of American Colleges and Universities. Mr. Meyerson, who was a member of the Pennsylvania's city planning faculty from 1952-57, will become the 19th chief executive officer of the institution. "This decision has been the most difficult one of my life," Mr. Meyerson said.D Pennsylvania Lures President Meyerson SPRING, 1970 15 Mrs. Adam, Dr. Regan, Dean Pesch �Children's Hospital Addition This is how Children's H o s p i t a l w i l l l o o k i n 1 9 8 0 . A t t h e e x t r e m e l e f t [ A ] i s the nurses' residence. The 10-story buiiding (B] is under construction. Adjacent (CJ is the existing Tanner Buiiding, and in the (D) area is where the research facility will be built. A few remarks at the groundbreaking ceremony by Mr. Frank Muddle, hospital director; Mrs. Robert B. Adam, President, Board of Managers; Mr. B. John Tutuska, Erie County Executive; and Dr. Jean Cortner, Professor and Chairman of Pediatrics. Ground was broken December 3 for the first phase of Children's Hospital's $11.5 million, 10-story addition on Bryant Street. It includes construction of the basement, sub-basement, installation of elevators and completion of the first two floors plus exterior walls for the bal­ ance of the 10-story building. This building, scheduled for completion in 1973, will be financed with hospital funds, government grants and $7 million from a com­ munity-wide campaign that will be completed in 1971. It will house administrative offices, hospital services, the Outpatient Department and clinics. Rehabilitation and mental health facilities will also be expanded to meet the increasing needs of 22 regularly scheduled clinics on subjects ranging from allergy to well-baby care. The master plan, scheduled for completion in 1980, includes construction of another 10-story research build­ ing fronting on Hodge Street. This building will pro­ vide laboratories and offices for the hospital's burgeon­ ing research programs in surgery, kidney disease, hered­ ity, allergy and other conditions. The new buildings are tailored to meet the rapidly expanding needs of the hospital's Outpatient Depart­ ment and the teaching and research requirements of the hospital staff and the School of Medicine. The hospital is the only Children's Hospital in New York State.• THE BUFFALO PHYSICIAN �Dr. Robert H. Wilbee has two new assignments. He is assistant dean at the Medical School and acting associate director at Meyer Memorial Hospital. At the University Dr. Wilbee's main responsibilities will be in the areas of student and academic affairs, while at the Meyer he will be co-ordinating planning for the new hospital and assist in administration. Dr. Wilbee was born in Edmonton, Alberta, Canada in 1929, but was raised in Western New York, and graduated from Kenmore High School in 1947. He then attended Dartmouth College and was awarded an A.B. in Psychology in 1951. He served in the United States Army during the Korean War and returned to the University of Buffalo School of Medicine to graduate in 1959. His postgraduate training included a rotating internship at the University of Cali­ fornia in San Francisco and a four year residency in General Surgery at the Buffalo General Hospital. From 1964 to 1968, he was associated in practice with Dr. Joseph Dziob at the Bethlehem Steel Corporation with a main interest in trauma surgery. In 1968 he was appointed Assistant Professor of Surgery at the University. He directs the Emergency and Trauma Services at the E. J. Meyer Memorial Hospital. He is a member of Alpha Omega Alpha (honorary Medical Society), the County, State and American Medical Association, the Buffalo Surgical Society, a Fellow of the American College of Surgeons, and a Diplomate of the American Board of Surgery. He is on the staff of the E. J. Meyer Memorial, Buffalo General, Chil­ dren's and Veterans Administration Hospitals.• New Duties for Dr. Wilbee Ten continuing medical education programs will be offered this spring, according to Dr. Harry J. Alvis, associate dean for continu­ ing education. Continuing Medical Education March 6 DEPRESSION IN THE MEDICALLY ILL PATIENT March 12 — June 11 (12 Thursday Evenings) — Physical Examination of the Cardiac Patient April 9 —NEUROLOGY SEMINAR DAY April 10 and 11 — 33rd Annual UB Medical Alumni SPRING CLINICAL DAYS — "THE PHYSICIAN and SOCIETY" April 23 and 24 — MODERN CONCEPTS IN CORONARY CARE May 7 — OTORHINOLARYNGOLOGY May 14 and 15 — NEW ADJUNCTS IN ANESTHESIOLOGY May 27 and 28 — GERIATRIC MEDICINE June 1 and 2 — REHABILITATION OF STROKES and SPINAL CORD INJURIES June 1 - 5 — REFRESHER SEMINAR IN PEDIATRICS SPRING, 1970 17 Dr. Wilbee �As clinical clerk Kenneth Piazza examines anesthetic machine, resident Richard Saab adjusts cystoscope and Nurse Behr explains its fiber optic cord into light supply. Buffalo General Hospital Adds New Wing A quick in/out surgery unit . . . a new urology suite that may be the finest in the country . . . 108 new beds in spacious, light rooms that are accented by bright colors, print draperies, and carpeting . . . a new reference library. They are all located in a new four story wing at the Buffalo General Hospital that is only the first phase of a planned 16story tower. 18 Spelling relief to an acute hospital bed shortage is the ground floor emergency de­ partment. It is geared toward patients whose surgical or diagnostic requirements can be handled on a one-day basis. Four fullyequipped operating rooms are backed by an orthopedic room large enough to treat four patients at one time, its own x-ray facilities, and laboratories where emergency blood counts or urine analyses can be performed. Laboratory work for scheduled minor opera­ tions are performed on an outpatient basis a day or two before surgery. And the patient need report no earlier than an hour prior to surgery. While under observation as he recovers from a local anesthetic, or in need of a spe­ cialist or a specific test, the patient occu­ pies one of the department's eight holding beds. By nine the next morning he will either have been discharged by the attending phy­ sician or admitted to the hospital. The new Oberkircher urology suite has both outpatient and operative facilities for patients suffering from diseases of the urin­ ary tract and related conditions. There are consultation rooms where minor treatment not requiring anesthetics can be performed. There are also three cystoscopic rooms equipped with the most modern and up-todate equipment to allow the physician to look THE BUFFALO PHYSICIAN �into the patient's bladder, outline the kidney, do all of the necessary techniques, and even operate. The fourth operating room for pros­ trates, bladders and tumors is the transurethroresection room. The specially equipped x-ray room — urology depends so much on x-ray studies — has an adjoining darkroom where the x-ray is developed in just 90 seconds. Patients in the recovery room nearby are watched through a window wall from the nursing station directly opposite. It is not unusual to find a renal isotope laboratory under medicine's Dr. Charles Elwood located in this suite. Urology and kidney disease are closely allied. Locker rooms, toilet facilities, dressing areas. Every nook and cranny re­ veals a storage area for supplies. The two-in-a room 108 beds are located on 3 floors, 36 on each. Each individually tem­ perature controlled room has its own bath­ room and shower. Each bed which can be raised and lowered by the patient, has its own TV set adaptable to closed-circuit use for inhospital communications. In the new Dr. A. H. Aaron Library, house staff and students have access to all of the hospital's reference volumes housed in book stacks. Or they may relax in the comfortable reading room at one of the study booths while they glance through a current medical journal located in the racks. Space, light, bright colors, print drapes, carpets. Just aesthetic touches to what is the first phase of a new teaching and patient care facility.• On grand rounds in the new wing with medicine chief, Dr. James Nolan. One of the smaller student conference rooms that are located on all four floors of the new wing. SPRING, 1970 19 �Medical intern John Breen listens to an elderly patient who complains of food lodged in his esophagus. Clinical clerk Ronald Blum works up an emergency blood count in one of the new laboratories. THE BUFFALO PHYSICIAN �Buffalo General (cont'd) Associate director, Dr. Theodore Jacobs, and director of ambulatory services, Dr. Wilfred Fuge, check emer­ gency oxygen supply in one of the new 2-bed patient rooms. The new Dr. A. H. Aaron library located on the second floor of the new wing. Medical students attend a urology conference in new urology suite. SPRING, 1970 21 �33rd Annual State University at Buffah Theme: "THE PHYSICIAN AND SOCIETY" April 10 and 11,1970 Prrofjrcim STATLER HILTON HOTEL Empire State Suite FRIDAY, APRIL 10 8:15 a.m. Registration 9:30 -10:00 a.m. Welcome: DR. SIDNEY ANTHONE, M'50 President, UB Medical Alumni Association Announcements: DR. HARRY J. ALVIS Associate Dean for Continuing Medical Education 10:00 -12:00 THE ROLE OF THE PHYSICIAN IN SEX EDUCATION: Panel Discussion Moderator: DR. HAROLD J. LEVY, M'32 Clinical Associate in Psychiatry "Education for Human Sexuality" DR. MARY S. CALDERONE Executive Director, Sex Information & Education Council of the United States, New York City "COMMUNITY EXPERIENCE IN SEX EDUCATION" The Pediatrician's Role DR. ROBERT J. EHRENREICH Clinical Associate in Pediatrics The Gynecologist's Role DR. MORRIS UNHER, M'43 Clinical Assistant Professor of Gynecology-Obstetrics The Clinical Psychologist's Role DR. SHEPARD GOLDBERG Clinical Associate in Psychology in Department of Psychiatry 12:00 -12:30 p.m. Business Meeting Election of Officers 12:30- 2:00 p.m. Luncheon 2:00 - 4:00 p.m. THE SOCIAL HAZARDS OF A PHYSICIAN'S LIFE: Panel Discussion Moderator: DR. BERNHARDT S. GOTTLIEB, M'21 Psychiatrist, Private Practice, New York City 22 THE BUFFALO PHYSICIAN �Medical Alumni Spring Clinical Days 6:00 p.m. The Drug Problem in Physicians DR. RALPH B. LITTLE Psych o - A n a l y s i s t , S e n i o r A t t e n d i n g I n s t i t u t e of t h e P e n n s y l v a n i a H o s p i t a l , Philadelphia The Alcoholic Problem in Physicians DR. LeCLAIR BISSELL Co-ordinator, Alcoholism Service, D e p a r t m e n t s of Medicine a n d P s y c h i a t r y , The Roosevelt Hospital, New York City The Suicide Factor in Physicians DR. HARVEY L. P. RESNIK C h i e f , C e n t e r for S t u d i e s of S u i c i d e P r e v e n t i o n , National I n s t i t u t e of M e n t a l H e a l t h ( o n l e a v e U B , P r o f e s s o r of P s y c h i a t r y ) Fiftieth Class Reunion Reception and Dinner • Georgian Room Empire State Suite SATURDAY, APRIL 11 8:15 a.m. Registration 9:30 - 11:30 a.m. PEPTIC ULCER: Panel Discussion Moderator: DR. JAMES F. PHILLIPS, M'47 Clinical A s s i s t a n t P r o f e s s o r of Medicine Physiology of Gastric Secretion DR. WILLIAM F. LIPP, M'36 C l i n i cal Associate Professor of Medicine Pathogenesis of Peptic Ulcer Disease DR. SAMUEL SANES, M'30 P r o f e s s o r of P a t h o l o g y Drug-induced Peptic Ulcer Disease DR. JAMES L. A. ROTH P r o f e s s o r of Clinica l M e d i c i n e , D i r e c t o r of I n s t i t u t e of G a s t r o e n t e r o l o g y , U n i v e r s i t y of Pennsylvania School of Medicine Surgical Therapy of Peptic Ulcer DR. STANLEY O. HOERR Chairman, D e p t . of Surgery, C l e v e l a n d C l i n i c 11:30 - 12:00 "Adaptations and Change in the University" DR. PETER F. REGAN Acting President 12:30 - 2:45 p.m. Terrace Room UB MEDICAL ALUMNI ANNUAL LUNCHEON and STOCKTON KIMBALL MEMORIAL LECTURE "Teaching and Learning Where the Product is Delivered — The Com­ munity Hospital" SPRING, 1970 DR. ROBERT L. EVANS V i c e P r e s i d e n t — Me d i c a l A f f a i r s , Y o r k H o s p i t a l , York, Pennsylvania 23 �Health Care Dilemma A NEW NATIONAL HEALTH CARE SYSTEM for all—agreed the panelists (industrialist, labor leader, economist, mayor) at the 80th annual meeting of the American Association of Medical Colleges. Four revolutions, pointed out Carnegie Corporation president Alan Pifer, will form the matrix to radically mold it. They are emergence of consumer voice, quest for social justice, new atti­ tude toward medical care as a right, and concept of health main­ tenance on a national scale. A major start toward this system, this layman believes, will appear within the next decade. Can our country build on its present foundations a system of health care capable of serving the entire population? Can it find the means to bring both public and private interests together into a single focus? Will it be the catalyst to set starts of performance, encourage experimentation in delivery of health care, coordinate existing resources, save private facilities from financial collapse, design and fund a system of national insurance, meet costs of training increasing numbers of physicians and other health work­ ers? "Yes," Mr. Pifer answered, "if there is a national will and the nation's top leadership responds to that will." Can there be good health without improved education, housing or economic opportunity? Health planning, he pointed out, cannot be isolated from other kinds of social planning. There must be an interface. Is there a sense of outrage within the medical profession over our present nonsystem for health care, a determination to seize the leadership in bringing into being an equitable national system of comprehensive care? Mr. Pifer replied, "Among individuals per­ haps. The best we can expect from the medical profession—that it not offer the kind of bitter, rear guard opposition to a national system of health care as in the past—Medicare. "On more limited fronts, you who direct the affairs of 350 great medical centers, can: —design and try out experimental new delivery programs to de­ fined population groups; —initiate new educational programs for physicians to train them as broadly-grained in social sciences as in biomedical fields; —institute programs to produce on an experimental basis new kinds of professional health workers; —mount new programs to help answer old and new questions as nation girds for national system of comprehensive health care." But, he clearly stated, you can, you must get together, continue to work together not to plead but to demand Federal support for research, experimentation and training of physicians and health workers, especially from minority groups. "For you in medical centers, the day is past when you can set your faces against change . . . with all of your great experience and competence you have a far more demanding responsibility—how to design the brave new world and its changes," he concluded. A private health plan was outlined by Kaiser Industries board chairman Edgar J. Kaiser. One of the nation's largest contracting organizations, Kaiser Industries has experimented with a number of medical programs since its first big Cuban highway project in 24 THE BUFFALO PHYSICIAN �1927 where arrangements for good medical care had to be made. At Hoover Dam, their first large construction job, 5,000 employees and their families made up a small city of 15,000. Their most serious health care problem was in the spread of incomes between supervision and hourly workers. At Booneville adequate medical facilities from a Portland hospital association 40 miles away were furnished on a fee-for-service basis. A young doctor's capitation payment system was adopted at Grand Coulee Dam. Families under full coverage brought hospital charges down to 7 cents per day for wives and 25 cents per week for each child. Not only was the system self-supporting financially, but enthusiastically received. During the second World War, 100,000 workers employed at each of Kaiser's two Navy yards were basically covered by the same plan. But it was optional, and proved a great success. The war ended. Kaiser had helped to develop one workable solution. "As the basic incentives were good," the dynamic industrialist said, "it was decided to open the plan to the public. Twenty-four years later, it is the largest group practice prepayment plan in the country. It provides comprehensive, prepaid medical and hospital care to two million members on a direct service basis in 19 of its own hospitals, two extended care facilities, and 52 clinics." Mr. Kaiser further pointed out, "each group is independent and autonomous; the contractual agreement is between the doctors and the group." But facing the medical care industry today is how to provide adequate medical care to all segments of our population. Nine out of ten Americans under age 65 are covered by voluntary health in­ surance plans. But there are the aged whose voluntary health in­ surance is inadequate and the totally disabled who represent a significantly higher cost group for personal health services. It is here, he feels, where the Federal government should play a sig­ nificant role in the financing mechanism. A promising development in experimentation is Medical School involvement in organizing ghetto health care services. New ap­ proaches, he pointed out, are not only justified but imperative if our nation is to solve its pressing domestic problems. "There is a gap between demand for better health care and capa­ bility of present American industry to meet that demand," Mr. Kaiser emphasized. "Government, at all levels, can help us close the gap. I believe that working together—in a constructive coales­ cence—we can and will meet the challenges within our free and pluralistic system." A national health service corps where students, recruited on a volunteer basis in lieu of military service, will provide direct per­ sonal health services to the poor. The charismatic United Auto Workers' Union president, Walter P. Reuther, feels that nothing will do more to counteract the sense of alienation of American youth. "We must give them a feeling and a sense of purpose, relate their education to the central problems that cry for solutions in our great cities. "We are in trouble in America, deep trouble," he warned the 80th AAMC audience. "It goes into the body politic because our values are out of focus. There is too little concern about the qual- SPRING, 1970 25 �ity of our goals and too much concern with the quality of our goods. If the national commitment is there, we can do anything." Ninety percent of a!) scientists in history are alive today. More technical progress, he feels, will be done over the next 25 years than during the past 2,500. But it is how we commit this fantastic power that is crucial. Both science and technology are neutral, he said. They have no ideology or morality. But man has. Somehow, he must relate his scientific and technical know-how to the knowwhy of human and social problems. "Our cities, housing, schools, are in crisis, our environment de­ teriorating dangerously through pollution. High on America's agenda of unfinished business is the restructuring of the health care system. The annual cost of health care services is 60 billion dollars. It is the second largest expenditure, second only to the military, and its costs are skyrocketing." His argument was not directed to the American doctors but to­ ward the obsolete 'model T' system that "... we remain wedded to, a system incapable of bringing about a rational, effective ser­ vice of resources, manpower, facilities. We need a new model, a new national health care system." A national committee on health insurance—Mr. Reuther is a member—is directed toward this commitment. The committee does not have all the answers, he pointed out, but "we ask your full participation as we search for the answers. Ingenuity and social inventiveness are essential if we are to determine how best a free society shall structure such a national program." A new medical care system will not be the result of one single piece of legislation, Harvard economics professor, John T. Dunlop, said. It will come only as a result of small changes by a great many people working on its separate elements. More money, he feels, is not what the medical industry needs. The federal estimate for the 70's is five times the outlay for the present decade. "What are we getting for what we pay?" Training may be the answer but only if it is related to other activities. Professor Dunlop cautioned that a new system of financ­ ing care should not be confused with its method of delivery. The consumer, poorly advised on the quality of health care, comes to the "bargaining table" with less than equality for his health. "Health is a kind of public good. And the sin of medicine is that its research is determined by deliberate public expenditure rather than the market itself." Medicine should play a greater role. It must take the real costs of capital into account. While medical facilities are needed Pro­ fessor Dunlop feels that they should not be so closely tied in with hospitals. And wages of hospital workers, interns, residents, can no longer be treated as an outgrowth to industry's role, but must reflect an evolution of our health care system. Medical schools will not be so isolated in the future. To intro­ duce students to problems of the public sector, it must interface with social sciences. The new kind of doctor will see his career in the public sector. Medical schools, having more to say about medi­ cal practice in their communities through health care centers and 26 THE BUFFALO PHYSICIAN �programs, will play a greater role of leadership in developing paramedical personnel, training programs and standards. In the days ahead, the Harvard economist summed up, the medi­ cal school must provide leadership to begin to pull together the diffuse and separate developments. As a Mayor who entered San Francisco politics two years ago, Joseph L. Alioto feels that he has had a front seat on things hap­ pening in the big cities. While 1.2 million labor union members in California participate and contribute $750 million annually in vari­ ous health plans, medical services in the ghetto are obviously in­ adequate. Fifty percent of their children are not immunized against disease and 54 percent do not see a dentist. "We must look toward a national comprehensive health plan," Mayor Alioto emphatically stated. He feels that more professionals from minority groups must be trained and it is up to the Medical Schools to do so. "The gap between black/white communities can and must be closed." "The greatest free society is threatened by change—quite radi­ cal," he alarmingly pointed out, "unless we are up to the com­ petitive challenges. And your challenge is to work out a system of delivery of health care services to all."D A 1952 Medical School graduate has started a special two-year training program for inhalation therapists. He is Dr. Jerome J. Maurizi, an internist and specialist in pulmonary diseases and clinical assistant professor of medicine. There are 19 students enrolled in the first class. This special pro­ gram is a cooperative venture between Erie County Community College and three hospitals—Deaconess, Meyer and Millard Fill­ more—where students receive laboratory training. The Regional Medical Program of Western New York is funding the program. Science courses over the two-year period include general chem­ istry, anatomy and physiology, physics, microbiology, pathology, and pharmacology. Other courses include English, ethics and ad­ ministration, sociology, and psychology. Students, who complete the course successfully, will receive an associate degree. This will enable them to apply for registry by the American Registry for Inhalation Therapy. Dr. Maurizi pointed out that lung diseases are second only to heart diseases in their incidence among humans. One out of every five persons admitted to a hospital today makes use of some type of inhalation machine. Furthermore, inhalation therapy has become almost standard procedure in postoperative care. The internist estimates that hospitals in the Western New York area need about 200 inhalation therapists. Many working as tech­ nicians now need upgrading because the machines are more com­ plicated and diversified. Dr. Maurizi predicts that within five years, the two-year program will be made into a full four-year program offering a regular de­ gree, and New York State will be licensing inhalation therapists just as they do x-ray technicians.• SPRING, 1970 27 Inhalation Therapists i K a r l Lisnerski, c h i e f i n h a l a t i o n t h e r ­ apist and Marilyn Heim, inhalation therapy technician of Deaconess hospital, carefully inspect respira­ t o r y e q u i p m e n t w i t h Dr. Jerome J. Maurizi. �New Research Facilities at Meyer Hospital 1. Rats, cats, rabbits, mice, guinea pigs, and goats. Whatever the need for investi­ gators, they are supplied by the Animal Unit. Supervising technician Edward Halsted checks bacterial injections in rats— part of an infectious disease program. 2. A seven day a week, 24 hour a day toxicology laboratory operated by Erie County and the School of Medicine. "We investigate all chemical causes of death" chief toxicologist Thomas A. Rejent pointed out. Attempted suicides, accidental poisonings, hospital emergencies involving comas and causes unknown, identification of drugs, monitoring of people in industry exposed to hazardous agents—he gets them all. The usual time for an ultra violet scan of a compound to determine what patient took and how much is circulating—45 min­ utes. 3. Research problems are discussed and information exchanged at the surgery re­ search laboratory meeting. 4. Ongoing research on PKU (phenylketo­ nuria) and inborn errors of metabolism. Technician Lynn Allen operates the spectrom while administrative assistant Sally Bloom checks research data with technician Phyllis Pepe. 5. Six research laboratories zeroing in on infectious diseases. Open to all area hospitals on a no charge basis is the testing of sera from patients suspected of having disgammaglobulin, anemias, liver disease, allergic reactions or skin problems. Ultracentrifuge chromatography on a blood sam­ ple is performed by research assistants Do­ lores Czerwinski and Charlene Romanello. "After we isolate its particular protein, our study really begins." 6. Dr. Morris Reichlin and technician Nancy Bailey check the results of an ex­ periment. 7. Dr. Thomas Tomasi works in one of his infectious disease laboratories. 8. A unique collection of 3,000 teaching slides methodically documented and most of them photographed by Dr. Louis Bakay. They will prove an invaluable tool for pre­ senting all types of patient problems to residents. 28 THE BUFFALO PHYSICIAN �SPRING, 1970 29 �Different Kinds of Obesity by Gail McBride Miss McBride was a science writer at the University before joining the AMA press relations staff. "Just as there appear to be a number of different kinds of cancer and mental illness, there may also be different kinds of obesity," says Dr. Lawrence A. Frohman, associate professor of medicine. "Thus a weight reduction regimen that helps one person may not suffice for another." Dr. Kenneth H. Kurtz, professor of psychology at the University, agrees; "We have every reason to believe how much we eat is determined by a large number of factors, both psychological and physiological. I suspect that the complex system regulating food intake can break down at various points and that people overeat for different reasons. For some, overeating may be due to poor eating habits; for others, there may be a disturbance in the setting of the 'fat regulator' in the body so that these individuals cannot satisfy their hunger without becoming overweight." To substantiate their ideas about hunger and obesity, the two scientists and their associates are experimenting with rats — fat ones, thin ones, young ones and old ones, and hungry and nonhungry ones. As a result of these studies Dr. Frohman and colleagues Drs. Lee Bernardis, assistant research professor of pathology, Jack Goldman, assistant professor of medicine and J. David Schnatz, associate professor of medicine, believe they are zeroing in on a major cause of obesity. They are advancing the theory that in some persons there is an insidious biochemical defect in the central nervous system that is genetically determined and results in the secretion of unusually high insulin levels into the bloodstream. The increased insulin levels in turn cause certain appetite control mechanisms to go hay­ wire, and the subject gradually becomes obese as, for example, with advancing age. "High insulin levels are the hallmark of obesity," says Dr. Frohman, "and it has been felt up to now that they result from overeating; that is, more insulin is needed to handle the increased amount of glucose entering the body in foods. We believe, how­ ever, that the reverse is true. High insulin levels may, in a rather complex way, actually cause obesity." It is known that when high insulin levels and low growth hor­ mone levels are present in the body for any reason, there is an increase in the depositing of fat. This can occur even when the person or animal is eating normally, because the excess insulin causes more than enough glucose to be shunted into cells, and that which is not needed for energy is converted into fat. The controls for most of this, scientists believe, reside in a small area of the brain called hypothalamus. It contains, among other things, the appetite stimulating center and the appetite sup­ pressing center. These are generally distinct but are interrelated in certain ways; they also can affect other portions of the brain. The Buffalo researchers found in their experiments that when the appetite suppressing portion was destroyed in very young rats with an electric current (via a needle inserted into the brain), a number of things happened: Growth hormone levels went down, and body growth decreased. Food intake decreased slightly, then returned to control levels. Insulin levels in the bloodstream went 30 THE BUFFALO PHYSICIAN �Dr. A. Edward Maumenee, professor of ophthalmology at Johns Hopkins University (right) accepts the Lucien Howe Medal from Dr. Peter F. Regan (left), acting president of the university. Also pictured are Dr. Eugene H. Radzimski, M'41, president of the Buffalo Ophthal­ mologic Club, and Dr. Thurber LeWin, M'21, chairman of the selection committee. The award was presented to Dr. Maumenee in recognition of his teaching and research in his field. The award has been pre­ sented only 10 times since it was established in 1930. • up and, as they did so, followed along somewhat with the amount of food intake. Fat levels in the blood went up and the actual amount of fat in the body increased. A relationship was detected between the high fat levels and high insulin levels. Furthermore, at the end of the experiments, the fat levels and the insulin levels in the bloodstreams of animals that had been subjected to surgery were nearly double that of normal rats of the same age. The food intake levels never rose to abnormal heights but because of the excess insulin and low growth hormone there was a pronounced increase in the laying down of fat in the body. And Dr. Frohman and colleagues think that something of this nature can occur in human beings — a biochemical (probably enzyme) defect resulting in gradually rising levels of insulin and eventually, obesity. "It could start to happen at any age," says Dr. Frohman. "And we have recent evidence that obesity is not determined by the type of diet. Rats that have high insulin levels can become obese on both high fat and fat free diets," he adds. At present, Dr. Frohman and co-workers are studying the obese, high-insulin rats to see how their bodies handle carbohydrates, fats and proteins entering the body in foods. Later the animals will be given various drugs, such as those that inhibit insulin secretion, to see what changes might occur. Help for human beings afflicted with a biochemical defect of this nature is far in the future but might consist of giving drugs to SPRING, 1970 31 �speed up a chemical reaction in the brain or to suppress insulin secretion. In a somewhat different vein, psychologist Dr. Kurtz is studying the general processes which regulate hunger and the amount of food consumed. "This actually means studying weight regulation in the normal range," he says, "since we must first understand this in order to completely understand obesity." Dr. Kurtz believes that eating may be influenced as much by learning as by some innate "drive" to eat. His idea is that an ani­ mal's urge to eat depends in large part on how long he has been deprived of food. The animal has learned in prior experience to associate food with the physiological state of hunger and when it is hungry or deprived for some time food becomes more palatable than usual -— the attractiveness of the reward is enhanced. "Our older idea about eating and other behavior says that we are being goaded or pushed by aversive stimuli to do certain things," says Dr. Kurtz. "But another way of looking at such behavior is that we are being 'pulled' by the attractiveness of the reward. Presumably, food is more attractive to an animal that is hungry than to one that is not. This view suggests that we can measure someone's motivation for a particular goal by determining how much effort he is willing to expend or how much discomfort he will tolerate to get that goal." "In India there is no obesity because there is not enough food. But in America, there is an abundance of highly palatable foods," Dr. Kurtz continues. "This, coupled with other factors such as boredom, may lead to overconsumption of foods, even at the great cost of overweight. Improving self-control may consist of finding some way to tip the balance so as to make the remote possibility of weight gain more important than the immediate satisfaction of eating. A person may find it easier to resist eating if he avoids the environment in which the learned motive to eat is strong." "Much more work is needed," he comments, "but we might speculate that sometime in the future we could predict the period of roughest going in a reducing diet and give the person some type of treatment to tide him over."D 32 THE BUFFALO PHYSICIAN �Very few physicians who heard Dr. Glenn H. Leak lecture on "The Solitary Thyroid Nodule" last May knew that Dr. Leak had discovered such a nodule in his own neck and as a specialist in cancer knew that he was probably doomed to die of the disease. He gave the lecture over the Tele-Lecture Network of the Regional Medical Program. Dr. Harry }. Alvis, who did know, told the story on the network in December after Dr. Leak's death. As associate dean for continu­ ing medical education, Dr. Alvis had invited Dr. Leak to give the lecture in the fall of 1968. When the time grew near, however, Dr. Leak called to say that he doubted if he could keep the commitment. He gave no reason but, when Dr. Alvis asked if he would suggest a colleague who could pinch-hit for him, he replied "the man I've chosen to do my own operation is the one in whom I have the most confidence." A few days later, however, Dr. Leak changed his mind and called Dr. Alvis to say: "I'll be able to handle that assignment myself. Don't worry further about it." "We met at the studio at the appointed hour," Dr. Alvis said. "When the questions came in from physicians throughout the area, they were searching, penetrating, asking about the prospects for palliation and for cure, what the alternatives might be, the risks of operation and the probable outcome. "As we sat together in this small room, no one else knew that this man was talking so calmly and dispassionately about his own problem. As he answered the questions, recounted the statistical and clinical evidence and the prospects such a patient faced — the tension I felt became almost more than one could bear. We parted, neither mentioning it. "All too often people think of heroes as being military figures. Heroes are to be found in all walks of life, and some of the bravest are not recognized as such until they have passed from the scene."• j/\ Tribute , to UT. LGQK The new McAuley Building of Mercy Hospital opened De­ cember 12. This is the first of three phases of construction to make the hospital the most automated in the Buffalo area. The total cost will be almost $10 million. Architect Mortimer f. Murphy said that the concept of a hospital where "every­ thing but the patient will be on conveyor belts" would reduce hospital costs, since an aver­ age of only 2.7 employees would be required per patient as compared with 3.4 in the average hospital. • �The Gates Circle complex. The Millard Fillmore Hospital is planning a new 150-bed hospital in Amherst, plus the expansion of the present Gates Circle complex. Both proj­ ects, costing nearly $16 million, will probably be completed in 1972. The four-level Amherst Hospital (near Maple and Hopkins) will house an obstetrical department, an emergency room, medical and surgical facilities, radiology and pathology services. The expansion at Gates Circle will permit dou­ bling the size of emergency, radiology, and medical records departments and an expanded surgical suite. The pathology, central supply, physical therapy, and outpatient services will also be expanded. When the new wing is opened the present building will be remodeled to provide such new units as a six-bed pulmonary intensive care unit, a cardiac intensivecare section, and a 44-bed extended-care section which will have its own kitchen, dining, recreation, and occupational therapy rooms. • Millard Fillmore Expansion The 150-bed hospital in Amherst. m- « \..w 34 THE BUFFALO PHYSICIAN �Honors Achievement Awards Five Buffalo-area physicians — all on the Millard Fillmore Hos­ pital staff, Department of Pulmonary Research — received the Honors Achievement Award for their creative efforts in the field of vascular medicine and surgery. This 5th annual national award [one of 25) is sponsored jointly by the Purdue Frederick Company of Yonkers, New York and the Angiology Research Foundation of New York City. The School of Medicine also received a citation "for providing the climate and facilities for research." Three of the physicians are on the faculty. The five physicians are: Drs. Edward M. Cordasco, senior re­ search physician at the Millard Fillmore Research Institute and clinical associate in medicine at U.B.; Frederick R. Beerel, clinical assistant in medicine at Millard Fillmore and clinical assistant pro­ fessor at the School of Medicine; John W. Vance, attending physi­ cian at Millard Fillmore and clinical assistant professor of medicine at the University; Reinhard W. Wende, M'58, associate attending radiologist at Millard Fillmore; R. Ronald Toffolo, M'57, attending radiologist at the Hospital. The physicians each received an Honors Citation Volume of the Journal ANGIOLOGY for the month in which the honors research was published, and an Honors Certificate commemorating this event. The title of the published research: "Newer Aspects of the Pulmonary Vasculature in Chronic Lung Disease." Colonel Alfred Gentilcore, USAF (Ret.), of the Angiology Re­ search Foundation, made the awards at the Medical School. Dr. LeRoy A. Pesch, Dean of the Medical School, said he was grateful to the Purdue Frederick Company and the Angiology Re­ search Foundation for honoring his faculty members and the Medical School. • Regional Medical Program of Western New York Two-Way Telephone Conferences This year the two-way telephone conference continues in an expanded format. Four series of programs are presented: —a weekly series of general interest considered useful to any and all physicians. This series is presented on Tuesday morn­ ings; —the once-a-month city-wide Obstetrics and Gynecology Con­ ference meeting at 9:00 A.M., usually on the first Wednesday of the month; —the once-a-month Pediatrics Conference from Children's Hospital presented at 10:00 A.M., on the second Friday of each month; —the once-a-month series on trauma presented on the fourth Thursday at 10:30 A.M.; There are now 51 hospital-outlets on the network which contin­ ues to grow.D SPRING, 1970 35 Dr. E d w a r d M. Cordasco, Dr. Fred­ erick R. Beerel, Colonel Alfred Gentilcore (USAF, Ret.) from the Angiology Research Foundation, Inc., and Walter H. Kaempf, Jr. of the Purdue Frederick Company. �Alumni Head Walter Reed Departments . Blohm Blemly Two medical school alumni are new department heads at Walter Reed General Hospital. They are Colonel Raymond W. Blohm, Jr., new chief of the department of medicine, and Colonel Nelson R. Blemly, chief of radiology service. Colonel Blohm has served as assistant chief of the Department since 1964, a position that was interrupted for a one year tour of duty in Vietnam in 1966 as medical consultant to the U. S. Army forces. A native of New York State, Colonel Blohm received his medi­ cal degree from the University in 1947 and entered the military service that year. He completed a year's internship at Letterman General Hospital in San Francisco, then went to Brooke General Hospital, Ft. Sam Houston, Tex. for a two years' residency in medicine. In 1950 he returned to Letterman for his third year residency in medicine. After completing the Regular Army Medical Basic Officers Course at Fort Sam Houston, Tex., Colonel Blohm was assigned to the 10th Field Hospital in Wurzburg, Germany as chief of medicine. In that capacity he served consecutively at Ft. Monroe, Va., Ft. Dix, N. J., Ft. Devens, Mass., and Ft. Ord, Calif. During the last two assignments he was also chief of professional services. In 1964 he was assigned to WRGH. The Colonel is a Diplomate of the American Board of Internal Medicine, a member of the American Medical Association, a Fellow in the American College of Physicians, a member of the Associa­ tion of Military Surgeons, the Phi Chi Medical Fraternity, and the Loyal Order of the Boars. He is an associate Clinical Professor of Medicine at Georgetown University and is a member of the Ad­ visory Board appointed by the Regional Governor of the American College of Physicians for the District of Columbia. In 1966, he was awarded the "A" prefix by the Surgeon General for proficiency and experience in his specialty in Internal Medicine. In June 1967, he was awarded the coveted Legion of Merit fol­ lowing his tour of duty in Vietnam. He has twice been awarded the Army Commendation Medal. The colonel and his wife, Elizabeth, reside in Kensington, Md., with their five children, Raymond, 20, Michael, 18, Jeffrey, 15, Steven, 14, and James, 8. Colonel Blemly has served as assistant chief of the Radiology Service since 1966. A native of New York State, Colonel Blemly earned his bache­ lor's degree at the University of Rochester in 1945 and his medi­ cal degree at the University of Buffalo in 1949. He returned to col­ lege in 1961 to earn his master's degree at the University of North Carolina. The colonel served in the Navy during World War II and in June 1949 entered the Army Medical Corps. He completed his medical internship and residency at Walter Reed General Hospital and in 1954 was assigned to Tripler General Hospital in Hawaii as as­ sistant chief, Radiology Service. From 1957-1961 he served as chief of Radiology Service at Valley Forge General Hospital in Phoenixville, Pa. After a year at the University of North Carolina, Colonel Blemly was assigned to 36 THE BUFFALO PHYSICIAN �WRAIR for a two year fellowship in radiobiology. He then served as chief, Radiobiology Section, Ft. Detrick, Md., prior to his as­ signment at WRGH beginning in 1966. In 1967 Colonel Blemly was awarded the "A" Prefix in radiology. The "A" Prefix is recognized as the highest military occupational specialty rating offered for professional accomplishment in the Army Medical Department. The Colonel and his wife, Phyllis, reside in Rockville, Md. with their four children, Michael, 20, Craig, 17, Yvonne, 16, and Chris­ tian, 14.• «rn XODAY IS A SPECIAL DAY," said Dr. Edward C. Lambert. It is the dedication of the entire eighth floor of Children's Hospital to a distinguished folmer chief who contributed so much to the hospital and the community. How do you best remember a man? A man like the late William J. Orr? Some remember him as Buffalo's Mr. Pediatrics. Some, as the man who brought national recognition to the hospital during his 35 years on its staff. Others considered him Buffalo's represen­ tative to the Academy of Pediatrics. Not only is he remembered for his interest in child care but "he anticipated community medicine" recalled Dr. Mitchell I. Rubin, his successor as pediatrician-in-chief of the hospital. "His work in the community—past president of the Erie County Medical So­ ciety, the Eighth District branch of the State Medical Society, the Academy of Medicine, the hospital medical board, the University and Medical Alumni associations—should remind each of us of our responsibility." Earlier Johns Hopkins days were recalled by contemporary and long-time staff member J. Wilmot Jacobsen. "While I worked on the wards, 'Bill' worked in a basement laboratory with Emmett Holt, Lawson Wilkins, and two others. Two years later, the now legendary paper on calcium phosphate metabolism in rickets was published. "I was arbiter in the decision of order of collaborators' names to appear on the paper. The selection was based on a piece of paper marked "1" inserted under beer mugs in the corner tavern. Luckily, Bill picked no. 1." Dr. Orr, who died two years ago, taught in the Medical School since four years after his graduation in 1920, and rose from as­ sistant to clinical professor of pediatrics. "For these many blessings we dedicate today this portion of the building which he—Dr. Orr—helped to build." A portrait of the late pediatrician, to hang in the hospital, was presented by pediatrics head, Dr. Jean Cortner, to the Board of Managers president, Mrs. Robert P. Adam.D SPRING, 1970 37 Dedication to Dr. Orr Dr. Cortner with portrait �Research Team Studies Heart Dr. McDaniel Named Assistant to the Dean McDaniel A seven-man research team representing the Medical School, en­ gineering department and Cornell Aeronautical Laboratories are working together on heart problems. They have combined their knowledge in the development of a probe no larger than the tip of a needle to measure the flow of blood through the heart. The scien­ tists expect that soon they will be able to insert the probe, which has been used successfully in tests on animals, into the heart of a human and monitor the flow of blood in the aorta. The four physicians are Drs. Ivan Bunnell, M'43, and George Schimert, associate professors of medicine and surgery respec­ tively; David G. Greene, professor of medicine, and Herman L. Falsetti, assistant professor of medicine. Two members of the University engineering department, Drs. Gerald P. Francis and Kenneth M. Kiser, associate professors of mechanical and chemical engineering respectively are working on the project with Robert J. Vidal, an aero dynamist with Cornell. This group began serious research last July when they were awarded a $64,000 grant from the Heart Association of Western New York. "The probe will prove valuable in a number of heart problems, including disease of the aortic valve, its circulatory control and ir­ regular rhythm. I also anticipate its use in measuring distortions in blood flow in artificial valves, which are sometimes troubled by clotting. Until now it has been impossible to measure the flow of blood for more than a few heart beats. Other techniques have been tried, but have been too complicated to be successful," Dr. Greene said.D Dr. James B. McDaniel, Jr. has been named assistant to the dean at the Medical School. He has been on the School of Medicine faculty since 1963. At the present time, he is a clinical associate in gynecology and obstetrics, and will continue in this capacity. Dean LeRoy A. Pesch said Dr. McDaniel will also serve on the Admissions Committee of the Medical School and work in student affairs and in career development programs aimed at increasing the number of minority group students. He will also represent the gynecology and obstetrics department on the Community Medical Manpower Committee. Dr. McDaniel received his Bachelor of Science and M.D. degrees from Howard University, Washington, D. C. in 1950 and 1957, respectively. He did his internship at Freedmen's Hospital, Wash­ ington, D. C. in 1957-58; and his residency at D. C. General Hospital, 1958-62. In 1965 Dr. McDaniel was appointed to the American Board of Obstetrics and Gynecology, and in 1969 to the American College of Obstetricians and Gynecologists. He is president of the local chapter, National Medical Association, and on the Board of Directors of the Erie County Cancer Society. He is on the staff of Buffalo General, Children's, Deaconess, and E. J. Meyer Memorial Hospitals. He has written articles on pregnancies for several pro­ fessional journals.• 38 THE BUFFALO PHYSICIAN �The Dr. Max Cheplove Award Dr. Matt A. Gajewski, M'39, president of the Buffalo Board of Education, was honored at a testimonial dinner recently by the Adam Plewacki Post 799, American Legion. He was honored for his contributions as a physician, board member, and leader of servicemen's organizations.• Six medical alumni are newly elected of­ ficers of two Buffalo General Hospital Boards. Elected to the Senior Medical Board are: Drs. Everett H. Wesp, M'39, president; }. Edwin Alford, M'34, vice president; and Marshall Clinton, M'40, secretary-treasurer. Elected to the Adjunct Medical Board were: Drs. James F. Phillips, M'47, president; Paul K. Birtch, M'43, vice president; and Albert A. Gartner, M'52, treasurer. Dr. Nancy J. Stubbe was re­ elected secretary.• Dr. Richard J. Leberer, M'50, is the new pres­ ident of the Catholic Physicians Guild.• Dr. Thomas J. Murphy, M'51, received a special plaque from the Firefighters Union "in appreciation for his service."• Dr. Steven G. Cline, M'47, has been ap­ pointed clinical associate in radiology at the Woodruff Medical Center, Emory University, Atlanta, Georgia. He is also in the x-ray de­ partment of South Fulton Hospital.• The Erie County Academy of General Prac­ tice has established an annual award, The Dr. Max Cheplove Medal. It will honor a physician or layman who makes "the out­ standing contribution to the ideals and prin­ ciples of family practice on the national and international scene." The first recipient of the silver medal was State Senator William T. Conklin of Brook­ lyn, co-author of the Conklin-Cook bill passed at the 1969 session of the State Legislature. The bill requires tax supported medical schools in New York State to establish de­ partments of family practice. Dr. Robert W. Haines, M'54, president of the chapter, made the presentation. Dr. Cheplove, a 1926 Medical School grad­ uate, has been responsible (more than anyone else] for increasing the stature of the general practitioner in Erie County. He was an or­ ganizer and past president of the chapter. He is also past president of the New York State Academy of General Practice and the Erie County Medical Society. In November, 1968, the Erie County Medi­ cal Society named him "Family Doctor of the Year" for "his achievements in fostering and maintaining the quality of family doctors to serve the health needs of American families." One month later The Buffalo Evening News named him one of its "outstanding citizens" of the year.D The Medical Foundation of Buffalo re-elect­ ed Dean LeRoy A. Pesch to a three-year term on the board. Dr. George F. Koepf, M'37, is ex­ ecutive director. Mr. E. Douglas Howard II was re-elected president; Allen O'Donnell, vice president; and Dwight Campbell, sec­ retary.• Dr. Syde A. Taheri, clinical instructor in surgery and associate attending in cardiovas­ cular surgery, Millard Fillmore Hospital, re­ ceived the Honors Achievement Award for his research and studies in Angiology at the 15th annual meeting of the American College of Angiology in Las Vegas, Nevada in Oc­ tober. His paper, "Abdominal Pain Due to Isolated Narrowing of the Celiac Artery" was selected as worthy of such recognition.• Dr. John M. Benny, M'40, has accepted a position as physician in the University's Stu­ dent Health Services. He had been on the E. J. Meyer Memorial Hospital staff for 24 years. He resigned as medical superintendent December 31.• Three of 15 physicians who signed as incorporators of Blue Shield of Western New York 30 years ago were honored as special guests of the Board of Directors September 25. They are: Drs. Julius Y. Cohen, M'09; Carlton E. Wertz, M'15; and John D. Naples.• SPRING, 1970 39 �People Dr. Stanley }. Cyran, Jr., M'46, has been named assistant vice president for Medical Services for Penn Central Company. He has been Medical Director for Penn Central in Philadelphia since 1964. Dr. Cyran served a rotating internship at the E. J. Meyer Me­ morial Hospital, and a residency in internal medicine at Sisters of Charity Hospital. He then became Battalion Surgeon of the 26th Infantry Regimental Combat Team and was on the medical staff of the 98th General Hos­ pital in Munich, Germany. While overseas he did graduate work in medicine at the Univer­ sity of Vienna and in pathology at the Uni­ versity of Munich. After military service, he entered private practice at Tonawanda.D Dr. John C. Patterson, clinical associate in gynecology-obstetrics, is director of the Tu­ mor Registry for the Regional Medical Pro­ gram of Western New York. The Registry will provide physicians with cumulative data for the improved management of cancer patients. Regionally, it will provide increased experi­ ence for teaching hospitals and feedback of quality controlled data to hospital staffs.• Three alumni are officers in the United Health Foundation of Western New York. Dr. Thomas S. Bumbalo, M'31, was re-elected president; Drs. James R. Nunn, M'55, and Stephen A. Graczyk, M'20, are vice presidents for research and professional education, and finances and treasurer; Dr. Frank Husted, as­ sociate dean, School of Health Related Profes­ sions, is vice president for program develop­ ment.• Dr. Barry M. Epstein, M'67, saved a man's life on the Colorado River Indian Reservation near Parker, Arizona recently. The senior as­ sistant surgeon in the Public Health Service Hospital on the reservation saved the life of Augustine Lopez, who broke his neck in a dive into shallow water. Dr. Epstein will re­ turn to Buffalo in June to become a resident at the Buffalo General Hospital.• 40 Dr. Eugene J. Lippschutz, a cardiologist, has been appointed Associate Provost of the Fac­ ulty of Health Sciences. He has been on the School of Medicine faculty since 1934. Cur­ rently he is professor of medicine and asso­ ciate chairman of the Department of Medi­ cine. The 62-year-old physician received his bachelor and medical degrees from George­ town University, Washington, D. C. Dr. Lipp­ schutz interned at the Buffalo General Hos­ pital in 1932-33, where he has been physician and chief of clinical cardiology. Dr. Lippschutz is a Diplomate of the Ameri­ can Board of Internal Medicine and a Diplo­ mate of the Board of Cardiovascular Disease. He is also a Fellow of the American College of Physicians. In 1967 he received the Award of Merit of the American Heart Association. Dr. Douglas M. Surgenor, Provost of the Fac­ ulty of Health Sciences, said that Dr. Lipp­ schutz would concentrate his efforts in the general area of academic development and re­ tain his professorship in the School of Med­ icine. n Dr. Erwin Neter, professor of microbiology, is editor and chief of a new journal, "Infection and Immunity" of the American Society for Microbiology. The new journal will be de­ voted to the advancement and dissemination of fundamental knowledge concerning patho­ genic microorganism and infection; ecology, epidemiology, and host factors; antimicrobial agents and chemotheraphy; and immunology. This journal will be the successor to the cor­ responding section of the Journal of Bacteriol­ ogy, edited by Dr. Neter. He is also Director of Bacteriology at Children's Hospital and for­ mer editor of Bacteriological Reviews.• Dr. Charles A. Bauda, M'42, was elected secretary of the National Federation of Cath­ olic Physicians' Guilds in Denver, Colorado recently. He is chief of the General Practice Department at Emergency Hospital and on the staff of Columbus and Sisters Hospitals. Dr. Bauda is also a director of the National Fed­ eration's Region II and program director for the 1970 International Congress to be held in Washington, D. C.D THE BUFFALO PHYSICIAN �Two faculty members have received re­ search awards from the Mid-Hudson Heart Association, Inc., Kingston, New York. They are Drs. }. David Schnatz, M'57, associate pro­ fessor of medicine, and P. D. Papahadjopoulos, research assistant professor of biochemistry. Dr. Papahadjopoulos will continue his work in phospholipids and proteins, while Dr. Schnatz is doing research on the relationship of an area of the central nervous system and blood lipids thought to cause blood-vessel disease. • Dr. Riggo Three medical alumni radiologists are lead­ ing the fight against cancer and other diseases at the Wyoming County Community Hospital in Warsaw, New York. They are Drs. Hyman Tetewsky, M'50, Charles Riggio, M'60, and Charles Tirone, M'63, all of the nuclear medi­ cine department. They have a new $55,000 organ-scanning isotope machine called a Gamma Camera used to detect cancer and its metastases. It is used to scan the brain, liver, lungs, kidneys, and bones. Services of the Gamma Camera are available to all patients. The project is funded by the Regional Medical Program of Western New York. The three radiologists have also initiated a special training program for isotope techni­ cians. Currently there are six students en­ rolled in the combined two-year program in x-ray and isotope technology.D An associate clinical professor of biochem­ istry is the new associate director of the Erie County Laboratory. He is Dr. Max E. Chilcote. He will be working with Dr. Noel R. Rose, lab­ oratory director, administering the several di­ visions located at Meyer Memorial Hospital and City Hall. • A grant for $10,000 has been awarded to Dr. Eric A. Barnard, Professor and Chairman, Department of Biochemistry, by the Muscular Dystrophy Associations of America, Inc., for 1970. The grant is for work on a project en­ titled "Cholinesterases at Single Nerve Junc­ tions in Developing and Dystrophic Muscle".• SPRING, 1970 Six alumni are officers of the Meyer Me­ morial Hospital medical staff. Re-elected presi­ dent is Dr. Eugene V. Leslie, M'51. Returned to office with him are: vice-president, Dr. Ross Markello, M'57 and treasurer Dr. Joseph A. Zizzi, M'58. Dr. Daniel A. Rakowski, M'60, was elected secretary, and Dr. Norman Chassin, M'45, was elected voluntary staff representa­ tive. Dr. Albert C. Rekate, M'40, is president elect. He is also acting hospital director. • Dr. Harold Brody, professor of anatomy and associate dean, School of Medicine, has been named chairman of the American Biology Re­ search Committee of the International Associ­ ation of Gerontology for a three-year term. As chairman of this committee Dr. Brody is an automatic member of the American Executive Committee for the 9th International Congress of Gerontology which meets in Kiev, Russia in August 1972. Dr. Brody's appointment was an­ nounced by Dr. Nathan Shock, International Congress President. • Three alumni, who are members of the Med­ ical School faculty will head departments at the Millard Fillmore Hospital. Dr. Lawrence H. Golden, M'46, will be chairman of the depart­ ment of internal medicine; Dr. Robert V. Moesch, M'46, chairman of the department of obstetrics and gynecology; and Dr. James R. Nunn, M'55, chairman of the department of general practice. Dr. Golden is a clinical assist­ ant professor, while Dr. Moesch is a clinical associate professor, and Dr. Nunn a clinical associate.• 41 People �In Memoriam Dr. Sherman Little, 62, who was professor of pediatrics and assistant professor of psy­ chiatry from 1946-58, died November 15 in London, where he was spending a sabbatical leave. After leaving the Medical School fac­ ulty he became professor of pediatrics and child psychiatry at the University of Southern California.• A former clinical instructor at the Medical School, Dr. Reeve M. Brown, died November 23. He had been medical director of the Chev­ rolet Motor Division River Road plant for 31 years. He was one of the founders and chief of occupational medicine at Kenmore Mercy Hospital. He was also a member of the Mil­ lard Fillmore Hospital staff and instructor in the Nursing School from 1943-48.• Dr. Albert M. Rooker, M'06, died January 18. The 90-year-old physician retired in 1959. Dr. Rooker was a life member of the American College of Ophthalmology and Otolaryngology and a Fellow of the American College of Sur­ geons. He was also a member of the AMA, and local and state professional organizations. • Dr. William C. Byrnes, M'24, died January 14 in Sisters Hospital after a long illness. He had been a member of the Sisters Hospital staff since 1939. The 69-year-old general practitioner retired last September. He had also been an assistant pathologist at Veterans Hospital. After interning at the Buffalo General Hospital in 1924, he joined the staff. Dr. Byrnes was active in several professional organizations. • A Buffalo surgeon, who devoted his entire professional career to the fight against cancer, died of the disease December 15. He was Dr. Glenn H. Leak, 53, a 1940 School of Medicine graduate. He was a clinical associate professor of surgery and co-ordinator of the cancer teaching at the Medical School. He was also president of the Medical Alumni Association in 1962-63. A specialist in cancer surgery, Dr. Leak was a past president of both the Erie County Unit and the New York State Division of the Amer­ ican Cancer Society, and the James Ewing Society, an organization of physicians and scientists who devote most of their time to 42 cancer work. In 1958 the ACS named him the recipient of its Division Annual Award for outstanding service. Six years later The Buf­ falo Evening News cited him as an outstand­ ing citizen for his work in revitalizing the so­ ciety's state division. Dr. Leak interned and served as an assistant resident in pathology at the Buffalo General Hospital. In 1942 he entered the Army and served with the 23rd General Hospital. While in the service he received five battle stars and a unit citation of merit. After his discharge in 1946, he took postgraduate work in cancer surgery at the Memorial Center for Cancer and Sloan Kettering Institute in New York from 1947-50 before returning to Buffalo to en­ ter private practice. He was elected to the board of directors and the Executive Committee of the Erie County Unit of the Cancer Society in 1951, and was still a member of the board at the time of his death. He served as president of the unit in 1955 and 1956. Ten years later he was named a delegate from the unit to the state di­ vision's representative assembly. On the state level, he served as president in 1964 and 1965, and as chairman of the Executive Committee for seven years. He was director of the Ameri­ can Cancer Society for Region I from 195763; vice chairman of its medical and scien­ tific committee since 1966; chairman of its sub­ committee on professional films; and a mem­ ber of the research reference, Cancer Cru­ sade, public education and personnel manage­ ment study committees. In 1962 at his own expense he traveled to Moscow to attend the International Cancer Congress. During his years with the Cancer Society he gave many speeches to lay groups on various phases of the disease, stressing the importance of early diagnosis. His own dis­ ease, unfortunately, gave no early symptoms and had already spread from the original site when it was diagnosed. Dr. Leak was also a past president and member of the board of directors of the Har­ vard Club of Western New York; a Fellow of the American College of Surgeons; a Diplomate of the American Board of Surgery; a founder and member of the Society of Head and Neck Surgeons; a member of the Erie County and New York State Medical Societies and the American Medical Association.• THE BUFFALO PHYSICIAN �Dr. Witebsky Dies Dr. Ernest Witebsky, an internationally fa­ mous immunologist at the University, died December 7 of a heart attack. He was 68 years old. Dr. Witebsky joined the School of Medicine faculty in 1936 as associate profes­ sor of bacteriology in the department of path­ ology. In 1941 he was named professor and head of the department of bacteriology and immunology. In 1954 he was named "Distin­ guished Professor." From 1958 to 1960 he served as Acting Dean and then Dean of the Medical School. From 1964-66 he served as acting director of the Erie County Labora­ tory. When he retired in August 1967 he was named director of the newly created Center for Immunology. Dr. Witebsky's three major contributions to medical knowledge were all made after he came to the University as a refugee from Nazi Germany. They were: (1) Isolation of the blood Group "B" sub­ stance, which he accomplished with Dr. Niels Klendshoj, also a member of the University faculty. (2) Discovery that "A" and "B" substances, in forms similar to powdered sugar, could be added to "O" Group blood to produce a "uni­ versal type" of blood which could be given in an emergency to patients whose blood groups were not known. The blood studies led in turn to a method of determining blood groups with greater accuracy than ever be­ fore. This is done by giving "A" substance to persons with "B" blood and vice versa, and using their blood serum for testing other per­ sons' blood groups. (3) The discovery that it is possible for the body to build up antibodies against constitu­ ents of its own tissues, something previously believed impossible. One of Dr. Witebsky's colleagues said, "it is rare to find that a whole area of medicine owes its establishment and clarification of its many facets to a single investigator. Dr. Witebsky belongs to this extraordinary cate­ gory." Dr. Witebsky grew up with medicine. He was born in Frankfurt, Germany on Septem­ ber 3, 1901. His father, Dr. Michael Witebsky, SPRING, 1970 was an obstetrician in Germany and an uncle was a famous nose and throat specialist. At the University of Heidelberg, where Dr. Witebsky received his medical degree (1926), he was a pupil of Hans Sachs, who had been the pupil of Paul Ehrlich, the father of im­ munology. Dr. Witebsky served as assistant to Dr. Sachs in the research division of the Can­ cer Institute at Heidelberg from 1925-29, and continued as assistant professor of immunol­ ogy until 1933. He and his parents went to Switzerland, and in 1934 he became a Fellow at the Mt. Sinai Hospital in New York City. When he became head of the department of bacteriology and immunology at the Univer­ sity, his full-time staff consisted of one tech­ nician and one laboratory assistant and his annual budget, exclusive of salaries, was $500 for teaching 70 medical and 50 dental stu­ dents. At the time of his retirement the fulltime staff numbered more than 100 and had research grants totaling $800,000. Over the years Dr. Witebsky authored more than 300 publications in German, French, English and American medical journals deal­ ing with problems in immunology and bac­ teriology. He was consulting editor of four professional publications—Transfusion, Clini­ cal & Experimental Immunology, Blood and in German, Blut. He was also past editor of the Journal of Immunology. The teacher-researcher won many honors for his work including: —the Karl Landsteiner Memorial Award of the American Association of Blood Banks; —"Dr. Med. honoris causa" from the Uni­ versity of Freiburg (1958); —selection as a NATO visiting professor, University of Munich (1965); —election as a member of the Deutsche Akademie der Naturforscher Leopoldina in East Germany in 1966 (one of the most distinguished groups of scientists in the world); —the Cross of Merit awarded by the Neth­ erlands Red Cross for exceptional service to the Red Cross in 1968. At the recep­ tion marking the 25th anniversary of the Blood Transfusion Service of the award­ ing group, he was introduced to Queen Juliana of the Netherlands; 43 �In Memoriam —the Ward Burdick Award of the Ameri­ can Society of Clinical Pathologists, 1967; —The Chancellor's Medal of the University of Buffalo (1950) for accomplishment "which dignifies the performer and Buf­ falo in the eyes of the world;" —Selection as one of T h e B u f f a l o Evening News' "outstanding citizens" for 1968; —A plaque from the Buffalo Academy of Medicine (1969) in recognition of his "out­ standing activity as physician and inves­ tigator;" —The Stockton Kimball Faculty Award of the School of Medicine (1963). Although he had never attended the Uni­ versity, the Alumni Association of the Medi­ cal School made him a member in 1968. A year earlier, the 1969 graduating class (as sophomores) made him an honorary member of the class, the last one he taught as head of the department. Dr. Witebsky formerly served as head of the department of bacteriology and serology at The Buffalo General Hospital and director of its blood bank. He was co-founder of the In­ ternational Society of Hematology, and his prestige brought the Society to Buffalo for its first meeting in 1948. He was a Fellow of four societies—the American Association for the Advancement of Science, the American Public Health Association, the American Academy of Microbiology, and the New York Academy of Sciences. The British Society for Immunology made him an honorary member in 1960 and the Royal Society of Medicine an affiliate in 1958. He was also a member of the Royal Society of Health, and the Pan American Medical As­ sociation made him a Diplomate in 1964. He was also a member of many professional or­ ganizations at the local, state, regional, and national level. Dr. Witebsky had been certified by the American Society of Clinical Pathologists, the College of American Pathologists in "clinical pathology" by the American Board of Pathol­ ogy and in "public health and medical labora­ tory immunology" by the American Board of Microbiology. The first two named him a Fellow. Dr. Witebsky is survived by his wife and two children — Dr. Frank G. Witebsky, a Captain in the Medical Corps of the Air Force, and Mrs. Grace E. Hamilton of Kenmore. Captain Witebsky had returned from Vietnam four days before his father's death.• Dr. Earl D. Kilmer, M'04, died November 30 in Olean General Hospital after a long illness. The 88-year-old physician was for­ merly Town of Rushford health officer. After graduating cum laude from the Medical School, he practiced at Rushford until 1919 when he moved to Olean. He retired in 1947. Dr. Kil­ mer was active in many local, regional, and state professional and civic organizations.• Dr. Harry A. Chernoff, M'26, died December 23 while attending a meeting at the Montefiore Club. He had been a general practitioner and specialist in internal medicine for 43 years. He had been a member of the medical staff at Sister's Hospital since 1926 (president in 1963), and attending physician in parisitology. He was also on the Medical School faculty for several years, and was a medical consultant in the field of compensation claims. The 65-year-old physician came to America from Russia. He interned at the Buffalo Gen­ eral Hospital and was the company physician at the Larkin Company from 1926 to 1930. He served in the Army Medical Corps in Italy and Africa during World War II, and held the rank of Colonel in the Reserves when he retired in 1963. Dr. Chernoff was a founder and director of the Rosa Coplon Jewish Home and infirmary. He was active in many local, state and na­ tional civic, religious and professional organi­ zations.• Dr. Anthony J. Manzella, a prominent Buf­ falo surgeon for more than 30 years, died December 8 in Sisters Hospital after a long illness. He was 63 years old. He was president of his medical school class in 1930 the year he graduated. Dr. Manzella was a former chief of surgery at Emergency Hospital where he was on the board of directors. He retired in May 1968. He was a Fellow in the American College of Surgeons, and was active in many local, regional and national professional or­ ganizations.• 44 THE BUFFALO PHYSICIAN �Two 1970 Alumni Association Tours I. "EXPO-70" TOUR — AUGUST 16 - SEPTEMBER 5 (21-DAYS) $1,389.00 per person from Buffalo $1,339.00 per person from Chicago $1,183.00 per person from San Francisco (plus $13.72 taxes payable at time of booking) Stops include: San Francisco, Honolulu, Manila, Hong Kong, Kyoto (Expo-70], Tokyo, Honolulu. Tour Escort: Henry E. Mark of Hallmark Travel Agency, Inc. II. "BAHAMAS HOLIDAY" — NOVEMBER 15 - 27 (8-DAYS, 7-NIGHTS) $285.00 per person (twin room occupancy) at the exclusive KING'S Inn & Golf Club, Freeport, Grand Bahama Island For details write or call: Alumni Office, 250 Winspear Avenue State University of New York at Buffalo Buffalo, New York 14214 (716) 831-4121 The General Alumni Board Executive Committee — M. ROBERT KOREN, '44, President; ROBERT E. LIPP, '51, President-elect; HERMAN COHEN, '41, Vice-President for Develop­ ment; MRS. ESTHER K. EVERETT, '52, Vice-President for Associations and Clubs; EDMOND GICEWICZ, '56, Vice-President for Administration; JEROME A. CONNOLLY, '63, Vice-President for Activities and Athletics; JOHN J. STARR, JR.,'50, Vice-President for Public Relations; CHARLES J. WILSON, JR., '57, Treasurer; WELLS E. KNIBLOE, '47, Immediate Past-President. Past Presidents: DR. STUART L. VAUGHAN, '24; RICHARD C. SHEPARD, '48; HOWARD H. KOHLER, '22; DR. JAMES J. AILINGER, '25; DR. WALTER S. WALLS, '31. Annual Participating Fund for Medical Education Executive Board for 1969-70 — DRS. MAX CHEPLOVE, M'26, President; HARRY G. LaFORGE, M'34, First Vice-President; MARVIN L. BLOOM, M'43, Second Vice-President; DONALD HALL, M'41, SecretaryTreasurer; JOHN J. O'BRIEN, M'41, Immediate Past-President. SPRING, 1970 THE BUFFALO PHYSICIAN �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET, BUFFALO, NEW YORK 14214 HARRY HOFFMAN & SONS PRINTING 1 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1970 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1970-Spring Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v04n01-1970-Spring Table Of Contents A list of subunits of the resource. Closed Circuit Television Dean Pesch Reports Infectious Disease AMA Recognition Dr. Milch Honored Community Services Grant Dr. Rekate Replaces Dr. Hummel New Assistant Veteran's Director Family Practice A Unique Medical Team Pediatric Fellowship Drug Control Children's Hospital Contract President Meyerson Resigns Children's Hospital Addition Dr. Wilbee Medical Education Buffalo General Alumni Spring Clinical Days Health Care Inhalation Therapists Meyer Hospital Facilities Different Kinds of Obesity by Gail McBride Tribute to Dr. Leak Millard Fillmore Physicians Honored Alumni at Walter Reed Dr. Orr Heart Study Dr. McDaniel Dr. Cheplove People In Memoriam Dr. Witebsky Dies Alumni Tours Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v04n01 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright 1970 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/2d5714277b155c64632542b7bc2e7420.pdf ad6bb46ec8554cd2fec2b3b861450a33 PDF Text Text fhc Buffalo Physician SCHOOL OF MEDICINE STATE UNIVERSITY OF NEW YORK AT BUFFALO �Dr. Carl 5. Benson, M'22 Dr. I. Frederick Painton, M'27 Nine Class Reunions April 7, 8 Pictures were not available lor Drs. William C. Baker, William M. Bukowski, Richard /. Kenline, cochairman, class ol 7 947, and Dr. R. Ronald Tofiolo, class of 7957. Dr. Elmer Friedland, M'32 Dr. John Ambrusko, M'37 Nine Classes will have reunions during Spring Clinical Days April 7 and 8. Approximately 400 physicians and their wives are expected to attend the reunion dinners. Mr. David Michael, director of med­ ical alumni affairs, is organizing the reunion dinners with the help of reunion chairmen pictured here. Dr. Carl S. Benson of 109 Murray Avenue, Binghamton, New York is chairman of the 50 year class reunion (1922). O t h e r living members of this class: Doctors Franklin T. Clark, 4825 Lewiston Road, Niagara Falls, N e w Y o r k ; F t a r r y L. C l a r k , 9 3 0 O c e a n A v e n u e , B r o o k l y n , N e w Y o r k ; Thomas P. Moylan, 53 Ardmore Road, West Hartford, Connecticut; Lynn Rumbold, 33 Indian Spring Lane, Rochester, New York; Daniel R. Tronolone, 139 North Ogden Street, Buffalo; and Perry G. Vayo, 1400 East Avenue, Rochester, New York.D �Spring 1972 Volume 6, Number 1 THE BUFFALO PHYSICIAN Published by the School of Medicine, State University of New York at Buffalo IN THIS ISSUE Class Reunions EDITORIAL BOARD (inside front cover) Editor ROBERT S. McGRANAHAN Managing Editor MARION MARIONOWSKY 2 Dr. Eccles 7 Maternal, Child Medical Center by Jean A. Cortner, M.D. Photography HUGO H. UNGER EDWARD NOWAK 9 Continuing Education Courses 10 Fetal Care Unit MELFORD J. DIEDRICK 12 Dr. Miller Retires Graphic Artists 13 Cummings Foundation Grant/ Indonesian Researcli Medical Illustrator RICHARD MACAKANJA DONALD E. WATKINS 14 VA Hospital Secretary 16 Dr. Cudkowicz FLORENCE MEYER CONSULTANTS President, Medical Alumni Association DR. LOUIS C. CLOUTIER President, Alumni Participating Fund for Medical Education DR. MARVIN BLOOM Vice President, Faculty of Health Sciences 17 Immunodermatology Conference 18 Hypertension 20 Immunology Convocation 21 RMP Goals/Dr. Cammer 22 Screening Drugs 23 $1,073,849 Grant 26 Student Convocation 27 Ear Grant/Brains DR. CLYDE L. RANDALL 28 Spring Clinical Days Vice President, University Foundation 30 Ecology JOHN C. CARTER 31 Immunology Center/ Dr. Edgar C. Beck Director of Public Information 32 Mental Health Center JAMES DeSANTIS 33 Dr. George W. Thorn DAVID K. MICHAEL 34 Health Care Challenge Director of University Publications 40 Family Practice Center Director of Medical Alumni Affairs THEODORE V. PALERMO Vice President for University Relations DR. A. WESTLEY ROWLAND The Buffalo Physician 44 Scuba Class 46 Canadian Medicare 47 Dr. Samuel Feinstein 48 The Classes 53 People 56 Alumni Tour/In Memoriam The cover design by Richard Macakanja focuses upon Dr. John Eccles' study of the cerebrum (pages 2-6). THE BUFFALO PHYSICIAN, Spring 1972 — Volume 6, Number 1, published quarterly Spring, Summer, Fall, Winter — by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. Please notify us of change of address. Copyright 1972 by The Buffalo Physician. �Dr. Eccles Dr. Eccles Takes a Philosophic Look at the Cerebrum \ L n studies the brain because all that matters in his life is a result of its functioning. Not only does it account for his immediate perception — his vision, hearing, memory, emotion, thoughts, ideals, imagination, technical skills —but his creative achievements — his art, philosophy, science — as well. I n v e s t i g a t i o n s , b e g u n a f t e r W o r l d W a r II b y a n A u s t r a l i a n n e u r o physiologist led to his knighthood in 1958 and to a Nobel prize in 1963. Sir John Eccles —"Dr. Eccles" as he prefers to be called in this country — heads the Center for the Study of Neurobiology. He came to Buffalo in July 1968 from the Australian National University in Canberra where he had been professor of physiology for 17 years. As a Rhodes Scholar from Australia he went to Oxford to work under Sir Charles Sherrington, distinguished physiologist and Nobel Laureate. There he was introduced to the scientific examination of the nervous system and later derived a philosophical approach to the problems of the nervous system from Dr. Sherrington. Sherrington's philosophy, published in Man on his Nature, has guided Dr. Eccles in his efforts to understand the way in which the brain is related to mind. From analytical studies of individual nerve cells, Dr. Eccles has developed theories of how they function, the means by which impulses are passed from one cell to another, and the manner of their interconnection. New insights into both reflex actions and the formation of thought within the brain by the eminent scientist — he is a philosopher as well — provide a firm base for future progress. Before man can experience even the simplest sensation, Dr. Eccles explained, millions of cerebral nerve cells must be activated in just a matter of milliseconds. They must then be woven into pat­ terns by both space and time. And the limitless possibilities of con­ nectivity between them provide an infinite variety of patterned operations. Ten billion cerebral nerve cells — each a living entity — endow man with potentialities adequate for any achievement. He explained that what exemplifies man's essential uniqueness is his attempt to understand his work through accumulated experiences over a life­ time. In his self consciousness, Dr. Eccles pointed to man's transcendance over animals. "Man has imagination, a sense of values, and systemization of knowledge stored and transmitted in the coded form of written language, thus permitting progressive de­ velopment. Man has the power to understand nature and to con­ trol it." But, for this amazingly young 68-year old scientist, there remains a fundamental mystery of man's existence that transcends any biological account of the development of his body including his brain with its genetic inheritance and its evolutionary origin. While he accepts the explanation of his own origin — animal an­ cestry — as well as a well-established biological mechanism of evolution through mutation and natural selection, they provide but a partial explanation. 2 THE BUFFALO PHYSICIAN �For the slim, relaxed man with gray eyes and thinning gray hair, "in some way completely beyond my understanding, my thinking changes the operative patterns of neuronal activities in my brain. Thinking thus comes eventually to control discharges of impulses from pyramidal cells of my motor cortex, eventually contracts my muscles, and so gives the behavioral patterns that stem therefrom." There is general agreement, said the holder of the Royal Society's 1962 Royal Medal, that for every conscious experience there is a counterpart in man's neuronal mechanisms. "We may be on the threshold of understanding the basic principles responsible for memory traces, patterned engrams as they are termed." These engrams, he continued, are available for recall in memory when there is an appropriate input into its circuitry. The Nobel Laureate — Dr. Eccles won the prize at age 60 — further explained that a neuronal pathway, activated by a particular sensory input will, on repeated activation, achieve a kind of stabi­ lization through enhanced synaptic functions of its neuronal link­ ages. While neuronal mechanisms involved in perception are known, there is much less understanding of the neuronal mech­ anisms underlying conscious experience. Science, said the distinguished professor of physiology and biophysics, is loaded with "values." It represents the sum total of each scientist's personal performance to explain some aspect of nature. This explanation is then offered for critical judgment and experimental testing by others to eliminate error. Scientists therefore can only develop hypotheses approaching progressively nearer to the truth. "If only mankind understood that science is a very human en­ deavor to understand nature, to present in all humility the best of our feeble efforts to do so," the former president of the Australian Academy of Science said, "perhaps it could then be appreciated as a great and noble human achievement rather than as a destructive force, as some great monster to be either feared or worshipped." Drs. Peter Scheid, Ingmar Rosen, lohn and Helena Eccles record impulses from nucleus of brain stem in cerebel­ lum (has control of movement) in a decerebrated cat. SPRING, 1972 This material has been ex­ trapolated from Dr. Eccles book, "FACING REALITY: Philo­ sophical Adventures by a Brain Scientist" published by SpringerVerlag, New York in 1970. In this book Dr. Eccles expresses his efforts to understand a hu­ man individual, namely himself, as an experiencing being with an evolutionary origin. The book was published in the hope that it may help man to dis­ cover a way out of his aliena­ tion and face up to the ter­ rifying and wonderful reality of his existence with faith, and hope.n courage, �For Dr. Eccles, chances that life exists elsewhere in the cosmos are infinitely small. But he points to the immense projects that are planned for Mars to search for forms of life. Says the Melbourne medical graduate (1925) who received his doctorate from Oxford four years later, "we must realize the full negative impact of new knowledge derived from the study of the Moon, Venus, Mars, and the problems of space travel. As physiologists, he explained, "we can predict with complete assurance that man is forever earthbound. We share this earth as brothers and there will never be anywhere else to live." Although its mode of operation cannot yet be explained sci­ entifically, Dr. Eccles feels certain that there is freedom of will. For, he said, "we experience, do things, have conscious control of move­ ment." While he feels that scientific activity is an affair of man's rational, conceptual thought with exercise of will, movement, and sensory perception, he cautioned that creative illumination can only come to minds prepared by assimilation and critical evaluation of knowledge in a particular field. In the subconscious mind, he pointed to evidence for creativeness — enormous development of complex, highly specialized engrams in the neuronal network with its stored memories and critical evaluations, its permanency resulting from increased function in synaptic use. These "plastic" patterns, he said, point to the "knowhow" of the brain. Drs. Cary I. Allen, Cian B. Azzena, Tadao Ono record impulse from motor cortex, relay nuclei to the cerebellum. For creative imagination to exist, Dr. Eccles pointed to the need for an adequate number of neurones, and a wealth of synaptic con­ nection between them to build up limitless engrams of highly specific character. If there is potency for unresting activity in engrams so that spatio/temporal patterns continually weave into complex/interacting forms, then the stage is set for creative imag­ ination. Continuing, he explained that continuous intensive interplay of these patterns of neuronal activation are necessary for the sub­ conscious operation of the mind. New emergent patterns can then be expected and if these patterns have organization to combine and transcend existent ones, "some new idea born of creative imagina­ tion will emerge." But he cautioned that if creative imagination is to be fruitful "there must be a process of conscious criticism, evaluation to dis­ cover flaws in a new idea, a consistency with existing knowledge, the design and carrying out of experimentation to test predictions from this new idea. And," he added, "finally there must be new hypotheses." Science, says Dr. Eccles, is an art and must therefore be learned in a strange way. What he feels is needed is creative imagination, experimentation, and a good idea of what to expect from past ex­ perience. He cautioned that while expectations may be fulfilled it is the "something else coming in that you take no notice of . . . the something that keeps reappearing, that is nature's way of trying to tell me something" that is essentially the way he has made dis­ coveries. 4 THE BUFFALO PHYSICIAN �CAT CEREBELLUM The structure of the neuronal network? More complex than a vast telephone exchange says Dr. Eccles. Its 1 0 billion densely packed nerve cells — within the folded surface sheet of the cerebral cortex — communicate with each other by specified regions of close contact called synapses. While each nerve cell receives many thousands of these synaptic contacts via branches or axons that stem from other nerve cells, each in turn influences hundreds or thousands of others when triggered to discharge an impulse along its own efferent pathway (axon) with its numerous branches. Each nerve cell receives information from hundreds of others by convergence and in turn gives to hundreds by divergence. While excitatory synapses stimulate, inhibitory ones counteract or silence what otherwise might turn into a convulsion of millions of activated nerve cells. SPRING, 1972 5 �Dr. Eccles recognizes the existence of three worlds. The first is that of matter and energy (World I), the second is conscious ex­ perience (World II), and the third is civilization and culture (World III), that is dependent for its continuity on coded information in books and other artefacts. While the subjective world (World II) is dependent on the neuronal mechanisms of the brain — ready for recall — the world of objective knowledge (World III) is where prob­ lems, theories, and arguments are coded in some appropriate form to ensure their objectivity and continuing independence. But knowledge of all three worlds he believes to be a result of human intellectual activity. Science, for example, gives us our knowledge and understanding of World I and also is concerned with World II. He asks! Does not the mystery and wonder of our origin and nature surpass myths whereby man in the past attempted to explain his origin and destiny? And cannot life be lived as a challenging and wonderful adventure that has meaning to be discovered? And he responds! "We must appreciate man's greatness, we must regain faith and hope in man and his destiny. Else all is lost."D Drs. Takeloshi Ono, Saburo Kawaguchi, Tadao Ono prepare some electrodes for stimulation of various structures in the brain. THE BUFFALO PHYSICIAN �During the first half of this century, many children's hospitals were built in the United States, most of which were "free-standing," that is, separate from other major medical facilities in the community. This was understandable and even desirable at the time because oediatricians were fighting an uphill battle for independence from he domination of internal medicine. The results were excellent in that pediatricians, surgeons, nurses and other professional and paraprofessional personnel congregated into specifically and efficiently designed units for the care of children. Laboratory and X-ray pro­ cedures more appropriate to the child were developed, and a social a n d p s y c h o l o g i c a l s e t a i m e d a t u n d e r s t a n d i n g a n d h e l p i n g t h e ill child occurred. Dr. Cortner Some of the children's hospitals were built in university com­ plexes and many others moved into university or medical com­ plexes in the course of time, but in most cases merely constructing buildings next to each other failed to supply the magic necessary to produce continuous excellent care for the child from conception through adolescence. The majority of newborns arrive into this world unannounced to the pediatrician and with little or no pertinent past or family history immediately available to him. Perhaps the very fact that we use birth date instead of conception date to mark the beginning of life testifies that w e d o not recognize that a live child is under­ going his most important period of growth and development in utero. Within the last decade, we have learned how to communicate better with the child in utero and, although still severely limited, w e c a n d e t e r m i n e i n t h e f i r s t t r i m e s t e r o f p r e g n a n c y if h e h a s c e r t a i n genetic disorders, such as mongolism or other chromosomal anomalies, or certain biochemical defects, such as Tay Sachs and Lesch-Nyhan disease, thereby giving the parents the option of pre­ vention by abortion. Maternal and Child Medical Center Concept by Dr. Jean A. Cortner In the third trimester of pregnancy, we have been able to in­ stitute diagnosis and therapy of the child severely affected with erythroblastosis. Also, we can determine fetal age much more accurately and therefore prevent some hyaline membrane disease, about which w e have been able to d o so little o n c e it occurs. All of this, plus the many neonatal complications that relate directly to maternal health and disease, argues forcefully for better integra­ tion of obstetrical and pediatric services. Dr. William Silverman and other neonatologists have long argued that the mother is the best neonatal transport unit despite man's r e c e n t e f f o r t s a t r e d e s i g n i n g t r u c k s . If w e a r e g o i n g t o m a k e u s e o f this fact and attempt to bridge the abrupt transition of care at birth, high-risk pregnancies must be delivered where both the mother and infant can receive optimal care. At the other end of the pediatric spectrum, we have the same problem with adolescents. The healthy teenager goes through another of the most important periods of growth and development without an orderly transition of his care from the pediatrician to the internist. The adolescent with a chronic condition has an even worse time, as demonstrated by the diabetic who gets caught beSPRING, 1972 7 Dr. Cortner is professor and chair­ man of the department of pedi­ atrics and physician-in-chief at Children's Hospital. He presented this paper at the Pediatric Section of the AMA convention in Atlantic City, lune 27, 7977. �tween two disagreeing physicians, undermining his confidence in both. A few model adolescent units have already demonstrated that internists and pediatricians can work together and present a united front to the patient, even though they may disagree privately. Under these conditions, the adolescent is properly introduced to the in­ ternist who will ultimately take over his complete care, and he receives continuous care in the process. Dr. Schoenfeld A physician, columnist, author will give the annual Harrington Lecture March 17 at 8:30 p.m. in G-22, Capen. He is Dr. Eugene Schoen­ feld, who is on the Student Health Service Staff at the Univer­ sity of California at Berkeley. He received his M.D. degree from the University of Miami in 7967. In 1964 he received an M.P.H. degree from Yale University's School of Public Health. Dr. Schoenfeld is famous for his book, "Dear Doctor HIPpocrates — Advice Your Family Doctor Never Gave You." He is also noted for his medical column related to sex, drugs and dieting. In the 1960's Dr. Schoenfeld work­ ed with Dr. Schweitzer at Schweitzer Hospital in Africa.• the Of course, all of this can theoretically be provided in a large general hospital, assuming that a critical mass of obstetrical and pediatric patients is attained, and that the various disciplines work together rather than independently within the same walls. Perhaps, however, it can be done even better in a "maternal and child medi­ cal center," which attempts to provide a continuum of care from conception into young adulthood. What then are the major ingredients necessary to convert a free-standing children's hospital into a maternal and child medical center? First of all, a large obstetrical service is required. Ideally, this service should deliver 4000 or 5000 newborns per year in order to attain the critical mass necessary for all of the supporting services, such as obstetrical anesthesia. This obstetrical service should cater to the high-risk mother and infant and, in addition to having its own obstetrical clinic at the medical center, should have outreach clinics in high-risk areas. It has already been shown that these clinics can be run in major part by well trained paraprofessionals with the backup of a single attending obstetrician per clinic. The pediatrician should work with the obstetrician in these clinics, also using paraprofessionals if necessary or desirable, to give well and sick child care. Gynecologists/obstetricians have already recognized that there are at least three major subdivisions of their specialty: perinatology, endocrinology and fertility, and gynecologic oncology. The maternal and child medical center should be the ideal place for the perina­ tologist to care for the mother and child. Endocrine and fertility specialists and internists should be available to care for the medical problems associated with the high-risk mother, such as diabetes, hypertension, renal disease, etc. Laboratory services must be ex­ panded to provide the tests pertinent to the care of the mother and the developing fetus, including the techniques for prenatal detection of genetic disorders and fetal monitoring during labor and delivery. A division of perinatal medicine should be administered jointly by the departments of obstetrics and pediatrics and should contain obstetricians, pediatricians, basic scientists and even in­ ternists concerned with the intrauterine and immediate postpartum health of the child. At the other end of the spectrum, a division of adolescent medicine should be jointly run by the departments of internal medicine and pediatrics, and at least one full or part-time internist should be a member of each pediatric specialty team, such as hematology, endocrinology, renology, etc., in order to assure continuous care for children with chronic diseases as they emerge into the adult world. The center must also supply rehabilitation for all of those afflicted with a chronic disease, a portion of which 8 THE BUFFALO PHYSICIAN �should be supplied by a department of family psychiatry concerned with the individual in his family and social setting. Pediatricians have long known that " a n o u n c e of prevention is worth a pound of cure." Such a medical center dramatically illus­ trates this axiom and provides the ideal substrate for medical re­ search aimed at prevention as well as cure or improved quality of life. American College of Physicians Cocktail Party Hosted By: SUNV at Buffalo Medical Alumni Association Open to: could legitimately be called "old wine in new bottles" unless, in All Alumni and Friends Wednesday, April 19, 1972 Atlantic City addition to the changes noted above, the traditional intradisciplinary attitudes of obstetricians, pediatricians and internists yield to patient- Check Convention newspaper for hotel and room. The problems in health care recognized here are not new and oriented concern for interdisciplinary continuous care. O n e children's hospital in this country is attempting t o estab­ lish the type of maternal and child medical center described, and in so doing accepts the responsibility for evaluating the care given in order ultimately to present hard data rather than opinion and anecdote. The Children's Hospital of Buffalo has the good fortune of already having an obstetrical service which currently delivers approximately 2,600 children per year. This is being expanded and oriented toward the delivery of the high-risk mother and infant. Outreach clinics are being established in several so-called high-risk areas in the community. Departments of Internal Medicine and Family Psychiatry and Divisions of Perinatology and Adolescent Medicine are in the planning stages. Perhaps most importantly, frequent discussions of the problems that we conceptualize solving are being held in order to develop the appropriate attitudes among the various professional disciplines. The responsibility for evalua­ tion will be assigned to competent epidemiologists who have no personal ax to grind. This is the third trimester of the 20th century. We must re­ e v a l u a t e o u r p o t e n t i a l s a n d p r i o r i t i e s if w e a r e t o p r e v e n t a r e ­ tarded 21st century.• Eight continuing education courses will be offered by the Medical School during the next four months. All are open to practicing physicians and medical students. March 9 — Kidney Disease, Diagnosis and Treatment: The Role of Kidney Biopsy, Hotel Statler Hilton (with the Kidney Foundation of Western New York). March 24 — Child Development: On the Importance of In­ fancy, Statler Hilton Hotel. April 7 and 8 — Thirty-fifth Annual U/B Alumni Spring Clinical Days, Goodyear Hall, University campus. April 13 and 14 — Highlights of Current Problems of Clinical Anesthesia a n d Intensive Care, Treadway Inn, Niagara Falls, N. Y. May 4 and 5 — Surgical Aspects of Gastroenterology, Parkway Inn, Niagara Falls, N. Y. May 17 —Pediatric Cardiology, Children's Hospital. M a y 1 9 — C o m m u n i t y Psychiatry in t h e G e n e r a l H o s p i t a l , E. J. Meyer Memorial Hospital. June 5-9 — Refresher Seminar in Pediatrics, site to be an­ n o u n c e d .• SPRING, 1972 9 Continuing Medical Education Courses �Dr. Ray discusses fetal monitoring ol patient with Dr. Dan McMahon as Nurse Syers and husband ol patient look on. Delivering a better baby who is at high risk is the major goal of ]^0YV p 0 t c l l p „ „ p IT n i f a nGW ^6la' Care Un't ^ a S ' 3 e e n °P e n e d by the department of obstetrics and gynecology at the Children's Hospital. Explained its director, Dr. Michael Ray, "it is done through a two-phase approach in evaluating fetal well being. By continuous monitoring of the fetal heart rate from the capillaries of the scalp and automatic recording onto strip charts of the stress of uterine contractions (the physiological phase) the physician can tell at any time during delivery how well the baby is doing. "But if an abnormality is indicated," said the 32-year old Buffalo born (Children's Hospital) and educated (Canisius High School 1957, SUNYAB medical graduate 1965, internship in mixed medicine 1966, and residency in gyn/ob 1970) "we are equipped to go to the next step to determine the biochemical half or the acid base balance of the unborn child through a sample of its blood from capillaries of the scalp." While well over 95 percent of pregnancies are normal ones, pointed out the assistant professor of obstetrics and gynecology who divides his time equally between the Children's and E. j. Meyer Memorial Hospitals where a monitoring program is also underway, "we are primarily interested in that small percentage of patients with special problems. They may range from severe toxemia (metabolic disturbances) to diabetes, heart or kidney disease, an rh incompatibility or a postmature baby in need of special care." There are at least 250,000 babies or about three percent of births a year in this country displaying neurological damage which may be due to a genetic condition such as Mongolism or from a virus infection such as Rubella. But when it is due to either birth asphyxia or perinatal hypoxia — a lack of oxygen at some stage of birth — then Dr. Ray believes that something can be done. 10 THE BUFFALO PHYSICIAN �More than 120 babies at high risk, or a little over ten percent of all hospital deliveries at the Children's were monitored during the unit's first half year of operation. Eliminated has been the guess­ work on how well a baby is doing during its journey through the birth canal, the most hazardous that any of us will ever undertake. For it is during these 24 hours surrounding delivery w h e n t h e d e a t h rate is higher than a t any other period during a lifetime. Finding a better way to evaluate how well a baby is doing dur­ ing labor and delivery became a quest for Dr. Ray. For the two parameters used during delivery while he was a resident were listening to a baby's heart beat — valuable only in the most ominous conditions — and looking for meconium staining of the amniotic fluid — a signal of potential problems. Together they lacked reliable predictive value and could not point to the degree of danger that the baby was undergoing. With encouragement and support through a Buswell Fellowship by the department of obstetrics and gynecology, and funds from the United Health Foundation of Western New York, the young physician over the next year (1970-71) studied continuous fetal heart rate monitoring — stressed in the literature at that time — at the University of Southern California. As a postresident fellow at Los Angeles County Hospital under Dr. Edward H. Hon, the pioneer in electronic fetal monitoring, Dr. Ray cared for patients in the perinatal intensive care delivery room or more simply the research center where various maternal and fetal parameters were studied with respect to certain methods of anesthesia (such as paracervical blood and its effect on the baby in utero and after birth). He also worked on a uterine relaxant, for there are times when a physician would prefer to stop labor until the baby recovers in utero and then proceed with the delivery. Explained Dr. Ray, there is nothing better than a uterus as incubator or a normal placenta as an organ of biochemical and blood gas exchange. Drs. Jim Brennan and John Antkowiak chock remote monitor while Mesdame^ Fuhrmann and Rellinger chart the findings. SPRING, 1972 �Returning to Buffalo in 1971, Dr. Ray developed and set up the new fetal care unit at the Children's Hospital where training is also an important feature. Resident physicians and medical students rotate through the unit, and a summer elective is offered to under­ graduates. "We are doing normal things with normal patients in a new way," said Dr. Ray who is happy to be back in Buffalo. "We are utilizing electronics in fetal monitoring. Monitoring has been used in adults," he continued, "but never before in the intrauterine patient." As an undergraduate, he completed two summers as a Fellow with Dr. David Dean in a cardiopulmonary laboratory working on cardiac problems in adults. A subsequent elective was spent in pediatric cardiology with Drs. Edward Lambert and Arno Hone. But he has taken one step in time backward, to the intrauterine patient. With funding, Dr. Ray hopes at some future date to start a research delivery room where he again can study multiple maternal/ fetal cardioparameters. For it is only through the triad of research, service, and teaching that optimal care for the intra or exo-uterine patient can be assured.• Dr. Miller Retires Dr. Miller Dr. David K. Miller, who has served both the School of Medicine and the E. J. Meyer Memorial Hospital for more than 34 years, re­ tired last fall. The outstanding teacher, scholar and clinician was professor of medicine and associate director of medicine at the county hospital at the time of his retirement. Dr. Miller received a bachelor's degree from Illinois Wesleyan College in Bloomington in 1925 followed by a medical degree from Harvard University in 1929. After completing an internship at Boston City Hospital he studied in both Germany and Austria. From 1931 to 1937 he was assistant in medicine and assistant resident physician at the Rockefeller Institute for Medical Research before coming to Buffalo as instructor in medicine. Two years later he became director of medicine and head of the department of medicine at E. J. Meyer Memorial Hospital (19391967) as well as professor of medicine at the University. From 1937 to 1948 he directed the laboratories at Meyer Hospital. In July, 1967 Dr. Miller asked that he be relieved of his hospital duties. A Fellow in the American College of Physicians, a member of county, state, and national medical societies as well as the Buffalo Academy of Medicine, American Society of Clinical Investigation, Society of Experimental Biology and Medicine, and the Harvey Society, he has also written numerous articles on anemia, blood and bone marrow. The 67-year-old physician was the recipient of a spe­ cial plaque at the annual 1969 Stockton Kimball Luncheon for "his contributions as outstanding teacher, scholar and clinician."• 12 THE BUFFALO PHYSICIAN �$39,000 Cummings Foundation Grant to Dr. Barnard A $39,000 grant from the Cummings Foundation of Buffalo has been awarded to Dr. Eric A. Barnard, professor and chairman of the biochemistry department to set up a protein-sequencing laboratory. The equipment purchased under the grant will be used in research of muscular dystrophy and other genetic diseases, as well as on the evolution of protein molecules. According to Dr. Barnard, the new equipment will reduce from years to weeks the time needed to determine the sequential arrangement of amino acids, the building blocks of protein mole­ cules. Changes in these sequences have been linked to genetic diseases. Dr. Barnard said, "This equipment exists so far in only a few laboratories in the world. Its acquisition puts the University ahead in this field." He added, "It will lead in time to an acceleration of our studies of the differences between protein molecules found in the muscles of animals and children with muscular dystrophy and those found in normal muscles." This research is largely supported by the Muscular Dystrophy Associations of America. Currently four faculty members of the U/B Biochemistry Department are involved in bio-medical research projects on proteins, in which this equip­ ment will be a great aid.D Indonesian Research A young couple will be working on Indonesia during the next six months. two different projects in Dr. Zebulon C. Taintor, an assistant professor of psychiatry, will be working with psychiatric hospitals in the computerization of patients' histories. They will be based in Djakarta. His wife, Mavis, will d o research for her doctoral thesis in political science. Her topic: "The Communist Party in Indonesia from 1951 to 1965." This is her second visit to Indonesia. She was there in 1968 to begin her research while her husband was a volunteer physician in Vietnam. Dr. Taintor said, "there is an effort to get a world-wide report­ ing system among psychiatric hospitals by having patients' histories computerized. This will enable us to determine the influence of local conditions, culture and other factors on mental illness." His Indonesian studies are sponsored by the International Com­ mittee Against Mental Illness and by the World Health Organization. Dr. Taintor has been head of the Medical School's graduate and resident psychiatry p r o g r a m s c e n t e r e d a t t h e E. J. M e y e r M e m o r i a l Hospital. He has also helped in establishing the drug emergency program at Meyer Hospital.• SPRING, 1972 13 Dr. Barnard with the new time saving equip­ ment. �Medical School Research at Veterans Hospital 1. A team that is investigating transport processes across biological membranes under Dr. john W. Boylan, professor of medicine and physiology, move into new quarters at Veteran's Hospital. 2. Dr. Stephen Wittenberg, assistant professor of medicine, joined three team members for coffee. Left to right: Dr. Wittenberg; Dr. Judith Van Liew, research assistant professor of medicine; Dr. Daphne Hare, assistant professor of medicine and biophysical sciences; Dr. Theodore Herman, research assistant professor of medicine. 3. Pretty much "at home" in their new laboratories are several of the 15-member immunology unit team. Under Dr. Morris Reichlin, professor of medicine, studies on immunity in health as well as in disease are underway with particular em­ phasis on the antigenic structure. They are also studying abnormal antibodies in certain connec­ tive tissue disease and muscle proteins in certain muscle diseases. Left to right: Mrs. Patricia Dix, graduate student; Miss Bonnie Reid, secretary; Dr. Morris Reichlin; Dr. Martha Mattioli, research assistant instructor in medicine; Miss Nancy Ball­ ing, technician. 4. In the hematology unit, under Dr. Robert W. Noble, Jr., assistant professor of medicine and biochemistry, studies on immunology, specifical­ ly the chemistry of reaction of hemoglobin with oxygen, are underway. Graduate student Miss Sandy 5. McDonald performing fast kinetics of hemoglobin reactions. In the endocrine unit, studies on the control of carbohydrate incubate tissue and lipid metabol­ ism are underway, particularly the effects of ex­ perimental obesity in rats. Under Dr. Jack K. Goldman, assistant professor of medicine, resi­ dents rotate through the service while medical students perform their research under his super­ vision. Discussing some aspects of her project with Dr. Goldman is o n e of two laboratory tech­ nicians, Mrs. Elizabeth Gabel, while Mrs. Marjorie Kodis works at centrifuge. 6. In the rheumatology unit, Dr. Floyd A. Greene, associate professor of medicine, works with red cell membranes, rh factor, and lipid protein in­ teractions. Also performed by the unit is s o m e clinical work in immunoglobulins. the lab is technician Mrs. Doreen 7. At work in Milbrandt. A bit of research on tests related to Hodgkins Disease is under underway hematology in the hematology consultant Dr. Ben unit Fisher along with some work on cell culture to measure phosphatase. Bordenave. At work is technician Mrs. Anna ��DR. G U S T A V O C U D K O W I C Z , a n internationally r e n o w n e d p r o ­ fessor of pathology and microbiology at the Medical School and a member of the advisory board of its Center for Immunology, has been invited to participate in a joint United States/Australian re­ search thrust on cancer as well as American/French cooperation on human transplantation. At an international cancer conference to be held in Sydney, Australia March 13-17, world experts in leukemia, melanoma and skin cancer will report on new information in the hope of improving the understanding of its causes and mechanisms. Dr. Cudkowicz will participate in the sessions on leukemia and report results from his own investigations relevant to immunologic rejection of leukemic cells. From there he will join an American/Australian symposium on current cancer research to be held in Melbourne the following week as one of 12 U. S. representatives on cancer research efforts. He has also been invited to present seminars on immunology and transplantation a t Melbourne's famed Walter and Eliza Hall Institute of Medical Research. In response to an invitation from the French Public Health Service (INSERM), Dr. Cudkowicz will also journey to Paris for two weeks as a visiting scholar. He will visit several medical institutions and lecture on the above subjects at the Pasteur Institute, the Col­ Dr. G u s t a v o Cudkowicz lege de France, and the Institute de Cancerlogie et d' Immunogenetique. To better predict the outcome of a bone marrow graft by "typing," Dr. Cudkowicz will also formulate plans for future re­ search with Dr. Jean Dausset, one of the pioneers in identifying human transplantation antigens at the Institut de Recherches sur Conferences in les Maladies du Sang in Paris. These experiments will be carried out under a Franco/American Agreement for Transplantation. The Australia, France contemplated studies on about a dozen families who have already for Dr. Cudkowicz ing additional antigens that are tissue specific. These may be ex­ been typed for major transplantation antigens are aimed at identify­ clusively expressed on hemopoietic cells which are responsible for blood formation. This will be the first attempt at "typing" humans for tissue-specific transplantation antigens of bone marrow cells. To date, explained Dr. Cudkowicz, studies on hemopoietic cell antigens have only been carried on in Buffalo. They have been confined to the laboratory mouse, a good transplantation model for man. In­ vestigations have revealed that these particular antigens determine whether bone marrow grafts will either "take" or be promptly rejected. Why is bone marrow transplantation so important? "In a num­ ber of inborn immune deficiency diseases and blood disorders (such as agammaglobulinemia and sickle cell anemia) and in acquired diseases (such as bone marrow aplasia due to an overdose of drugs)," said Dr. Cudkowicz, "marrow grafts act as replacement therapy. For not only do such grafts replace the blood-forming system but the immune system as well. Thus, once a foreign marrow graft is accepted, the recipient will also accept other organs from the same donor." 16 THE BUFFALO PHYSICIAN �Details of the test systems for the joint collaborative effort with Dr. Dausset and for the shift from laboratory to hospital are present­ ly being worked out in Buffalo's department of pathology. A team has been working with Dr. Cudkowicz over the past few years on identifying, defining, and elucidating the kinds of cells that partici­ pate in humoral and cell-mediated immune reactions. In their experiments in the mouse, the current team (Eva Lotzova, Ph.D., instructor of pathology; Domenico Trizio, MD, and Toshiya Kino, MD, both Buswell Fellows and research assistant professors of path­ ology) has found that hemopoietic specific antigens are controlled by independent genes. The major one, the team discovered, is close­ ly linked to the chromosomal region that is responsible for the usual transplantation antigens. Said Dr. Cudkowicz, "there is a strong possibility that the same holds true in man." Considerable progress by the team has permitted an insight into cellular events leading to immune response and marrow graft rejection in mice, a natural prelude to work on man. Explained the Italian-educated physician/researcher, "what we are basically after is a better understanding of h o w the many facets of the immune system are regulated. Armed with this knowledge, we could then intervene more effectively by therapeutic treatment of the patient." In their unique approach the team has sought the key to the immunobiology of hemopoietic grafts and genetic regulation of immune reactivity. "This last variable," said Dr. Cudkowicz, "is of great importance for the morbidity of the patient and may represent the key to what is known as 'predisposition' for certain diseases. Our research is aimed toward finding a useful tool by which w e can select donors for bone marrow grafts on one hand, and for identify­ ing by a simple laboratory test the 'predisposed' on the other."D Immunodermatology Conference, June 28, 29 The department of microbiology at the Medical School will sponsor a "Immunodermatology Work Shop Conference" on June 28 and 29. Dr. Ernst H. Beutner, professor of microbiology, will direct the two day conference. He will be assisted by three of his associates in the department. Dr. Tadeusz Chorzelski of the Academy of Medicine in Warsaw, Poland, and Dr. Robert Jordon of the Mayo Clinic, will be among the distinguished experts participating. The workshop will include reviews and demonstrations of current methods for immunopathologic studies of skin diseases.• SPRING, 1972 17 Checking data (left to right) are Drs. Cudkowicz, Toshiya Kino, Domenico Trizio and Eva Lotzova. �For the one out of every ten in this country who has a hypertensive condition, a multidisciplinary attack by a unique team at the Univer­ sity may have profound effects. In over eight years of research the team of investigators—bio­ chemists, pathologists—has pinned down the pathogenesis of some forms of experimental hypertension in the rat. Team studies, con­ firmed by those of others, point to oversecretion of a hormone — 11-deoxycorticosterone or DOC as it is referred to — as the causative agent. Chief research assistant Luther Joseph and Dr. Brownie compare loss oi muscle, iat, etc. on tumor-bearing rat with one that is normal. But the studies in experimental hypertension began back in 1962 when a large grant in pathology research, prepared by path­ ology chairman Floyd Skelton, was funded. Fie was joined a year later by a young Scottish-born and educated biochemist, Dr. Alex­ ander Brownie, who continued his research into the steroid bio­ chemical aspects of hypertension. Upon the untimely death of Dr. Skelton in 1967, Dr. Brownie assumed responsibility for the $1,000,000 research and training grants in the relatively new field of experimental pathology. They were among the largest recorded in Medical School annals. A threeyear renewal recently awarded to the 40-year old research associate professor of pathology and professor of biochemistry assures con­ tinuation of the team attack into the problem of hypertension. Experimental Hypertension Headquartered in four thousand square feet of well-planned, well-equipped space in the Old Bell Plant, a satellite of the Uni­ versity, the experimental hypertension team interest centers on its three important aspects — pathology, steroid biochemistry, and electronmicroscopy. "So well do we as investigators cooperate," Dr. Brownie said, "that the same six animal models of experimental hypertension are used for all three purposes." In the steroid biochemistry effort, Drs. Brownie and Samuel Gallant, a Ph.D. graduate of the training program in experimental pathology, are looking for the mechanism that will explain how hypertension — that is more prone in the male than the female — works. To determine the abnormalities that exist in function, models related to abnormalities in hormone production are being used. Ultra-structural investigations are the responsibility of Drs. Peter A. Nickerson and Iwao Nakayama. Now in his fifth year of research with the team, Dr. Nickerson — he is a Clark biology alumnus — feels that what will ultimately lead to our complete un­ derstanding of the pathogenesis of hypertension and especially the role of the adrenal gland will be knowledge derived from ultra structural studies correlated with the steroid biochemical work of Dr. Brownie. Dr. Nakayama, who was the first to identify the ACTH-secreting cells in the pituitary by using models of hypertension, joined the team following a two-year absence. He continues studies on the fine structure of hormone-secreting cells of the anterior pituitary. But these electronmicroscopists are interested in looking at hypertension from other angles as well and have turned their atten­ tion to tumors in the pituitary that secrete very large amounts of pituitary hormones. They are now able to develop hypertension in 18 THE BUFFALO PHYSICIAN �animals bearing ACTH, growth hormone, and prolactin secreting tumors. Because of success with animal, models, attention has been turned to the human, and to development of micromethods to measure hormones in the blood. Pathology efforts, headed by Dr. Agostino Molteni, center on the effect of hypertensive disease on various organs of the body, but specifically the kidney. Techniques gained in experimental models have been translated by the Milanese physician (he joined Dr. Skelton in 1965, earned a doctorate in ex­ perimental pathology in Buffalo two years ago) into a community testing program for the diagnosis of renal vascular hypertension. In a screening program with Buffalo General Hospital's Drs. David Greene and Ivan Bunnell, DOC in both normal as well as hypertensive individuals is being measured t o determine its role in human hypertension. In a study of hypertension in children with Dr. Joseph RahiII, blood levels of renin by radioimmuno and bioassays have revealed some very interesting connections between renin and hypertension. At the burn treatment center at Emergency Hospital, there is an i n v e s t i g a t i o n u n d e r w a y w i t h D r s . L o u i s C l o u t i e r a n d L. M o l t e n i o n renin and steroid hormone levels in the high percentage of severely burned patients that are hypertensive. As the development of spontaneous hypertension in animals correlates a bit closer to hypertension in the human, much of Dr. Molteni's present efforts are directed toward the role of salt in this experimental model. Because of team findings with experimental models, an attempt will be made to prevent hypertension. In its approach, an immuno­ logical one, Dr. Gallant has achieved some success in preparing a n t i b o d i e s a g a i n s t D O C i n t h e r a t . It i s h o p e d t h a t i n d u c t i o n o f antibodies in animals against DOC will deter the effects of hyper­ secretion of DOC. An antisera will also be prepared to be used in the radioimmunoassay of these steroid hormones. Teaching pathology and biochemistry to both medical and dental students remains an important task for these investigators Dr. Nakayama and graduate students Carl Porter and Michael Tseng join Dr. Nickerson in a demonstration of material by electronmicroscopy. At planning session Dr. Brownie illustrates a point to Dr. Nakayama as Drs. Nickerson, Gal­ lant, and Molteni look on. SPRING, 1972 19 �while support, through a training grant, assures a future supply of experimental pathology researchers. Over the past two years eight doctorate degrees in this field have been awarded. And at any one time there are about a half-dozen pre- and post-doctoral fellows training under the team. It is coordinated team effort that has led to its success. And for its ebullient young principal investigator — who has returned from an Edinburgh sabbatical committed to continue collaborative efforts begun there, to lead in the ninth year of research efforts into experimental hypertension, to co-chair the Medical School curriculum committee, to pursue his own research interest in the mechanism of action on ACTH, and whose medical school classes in biochemistry are highly regarded — it is raising the question that DOC may be involved in hypertension that is most satisfying. For "it is something that has not been looked at very seriously in the past." a problem with Dr. In summing up the work of the group, Dr. Brownie feels that "our work with experimental models, where DOC has been con­ stantly involved, makes it absolutely necessary to evaluate its role in human hypertension. While it may not be the causative agent in the human, it must be eliminated. For if it is not DOC then it is probably another adrenal cortical hormone."• Immunology International Convocation The third International Convocation on Immunology will be June 12-15 at the Statler Hilton Hotel. This is the third of a continuing series of biennial convocations sponsored by The Center for Im­ munology at the Medical School. The Center was established in 1967 to foster training and research in immunology. The Ernest Witebsky Memorial Fecture will be given at the opening session by Dr. Elvin A. Kabat, professor of microbiology, at Columbia University. His topic: "General Features of Antibody Molecules." A special feature of the four-day convocation is a banquet in honor of Professor Pierre Crabar, Institut Pasteur, Paris. He has made many important contributions to the study of antigens and antibodies, and has done much to stimulate the de­ velopment of immunology as a discipline in France and the world. The purpose of the Convocation is to bring together scientists from all over the world to present and discuss the current status and future trends in various areas of immunologic research. This program will be concerned with the properties of the specific sites on immunoglobulin molecules responsible for their reaction with antigens and with the specific receptors on cells whose interaction with antigen triggers the immune response. The program will probe the relation of the structural features of antigens, antibodies, and cell receptors to the specificity of their interactions.O 20 THE BUFFALO PHYSICIAN �The Regional Medical Program of Western New York is changing its priorities to meet the health needs of the people of this region. The three new goals: (1) t o stimulate a n d p r o m o t e preventive serv­ ices in health maintenance. (Prevention includes efforts to limit the progression of disease at any stage, reduce the likelihood of its recurrence and to maintain health). (2) To develop and improve primary care services (augmenting availability and distribution of first-stage medical care in under-served rural and inner city areas). (3) To encourage the development, expansion and integration of rehabilitation services into the continuum of medical services (effec­ tive home care, social services, patient education and the extension of physical and occupational therapy services out into the com­ munity under the direction of the primary physician).• New Goals for RMP Dr. Cammer's Career For 25 years a 1939 Medical School graduate has had a reputation as a distinguished medical practitioner, educator, author, consultant and lecturer. Dr. Leonard Cammer has been a clinical associate professor of psychiatry at the New York Medical College since 1948. He was founder (1959) and first medical director of Cracie Square Hospital, New York City. In 1962, Dr. Cammer authored a textbook, "Outline in Psy­ chiatry," that has been used in many medical schools throughout the world. In 1969 h e authored " U p From Depression" that was o r i g i n a l l y p u b l i s h e d b y S i m o n a n d S c h u s t e r . I n 1 9 7 1 it w a s p u b l i s h e d by Pocketbooks, New York. Modern Medicine in commenting on the book said, "it is a splendid book for the laity which should b e very helpful to all those persons who have a close relative who has become depressed." Dr. Cammer has also authored or co-authored 25 original papers, and has made several presentations at professional meetings in this country and Mexico. Dr. Cammer is a Fellow in the American Psychiatric Association, American College of Psychiatrists and Acad­ emy of Psychosomatic Medicine. He holds membership in several other state and national professional organizations. He also has appointments to four New York City area hospitals and serves as a consultant to several state and national agencies. After graduating from the College of the City of New York in 1933, Dr. Cammer entered UB. In 1937 h e received his master's degree in physiology. After graduating from medical school he took a two-year rotating internship at City Hospital, Welfare Island, New York City, 1939-41, and was a commander in the Naval Medical Corps from 1941-1946. From 1944 to 1947 he was in psy­ chiatric training as a Commonwealth Fund Fellow, Institute of Penn­ sylvania Hospital; the Pennsylvania Hospital for Nervous and Men­ tal Diseases; and the New York State Psychiatric Institute and Hospital. Dr. Cammer appeared on over 50 local and national tele­ vision and radio broadcasts during 1969-1971.• SPRING, 1972 21 Dr. Cammer �Screening Program for Drugs "Exceptional" was the summer fellowship committee's ranking of an application submitted by Lynda M. Young to explain possible effects of drugs on a mammalian fetus during development. It placed the sophomore medical student in the category reserved for those projects that "in some cases were planned as carefully as senior research programs." For Lynda the summer fellowship was her opportunity to get back into embryology and to find out what research, that is so closely allied to medicine, is all about. Her screening program for drugs was a continuation of some of the pioneering work in teratol­ ogy begun by Drs. Sumner Yaffe, Maimon Cohen, and Anil Muk­ herjee. Lynda M. Young A search through the literature revealed little clinical investiga­ tion into the effect of drugs on the fetus until the Thalidomide disaster of a decade ago. Subsequent animal studies however show teratogenic effects — its mechanism as yet unknown — of drugs to be both dose- and time-related, with the fetus highly susceptible during the first three months of gestation. Alarmingly a women takes an average of four to five medica­ tions during her pregnancy. And common drugs such as most vita­ min preparations, aspirin, antacids, diuretics, cathartics, antihista­ mines, barbiturates, she discovered, are taken without medical su­ pervision or knowledge. Dr. Anil Mukherjee and Lynda examine plate through double microscope. Drugs may affect maternal tissues by reducing oxygen-carrying capacity of blood, altering level of blood glucose, reducing availabil­ ity of either essential vitamins, hormones, aminoacids or trace ele­ ments. Or they may have a direct effect on embryonic cells in structure to cause deformity or may interfere with the passage of oxygen, glucose or other vital substances across the placenta. Because of inadequate enzyme systems the fetus is unable to metabolize drugs in the same way as mature organisms. Therefore drug administration during pregnancy should be minimal, with bene­ fits to mother carefully weighed against possible harm to fetus. Said Dr. Mukherjee, "one of the things that we are learning is that more and more women are becoming aware that they must not take medicine during pregnancy." With so little data on drug effect available in the early stages of development, Lynda felt drawn to this type of research. She selected the drug sodium salicylate for use in her experimental model for while it is a popular nonprescription medication taken for a variety of ailments it also causes neonatal bleeding and coagulation defects. Concentrations of this drug paralleled doses used in treatment schedules. In her attempt to develop an in vitro system to serve as a model for screening drugs she hoped that her methods would provide some insight into the problem. 22 THE BUFFALO PHYSICIAN �Lynda rapidly became adept in growing embryos over the summer. She tested all cell stages up to the blastocyst stage. The embryos, grown in vitro, were exposed to different drug concentra­ tions for varying lengths of time. Observations were made over a 24-hour period for gross morphological abnormalities or death of the embryos. Dosage, she discovered, was a more important factor than length of drug exposure in producing teratogenic effects. Lynda, who is now a junior, will continue her screening pro­ gram over the academic year. Together with Drs. Mukherjee, Cohen, and Yaffe, she has submitted her work for publication in the journal Teratology.• Denise Bash discusses a point with Lynda. Dr. Farhi Receives $1,073,849 Grant A $1,073,849 grant was awarded to Dr. Leon Farhi, professor of physiology and project director of the Laboratory of Environ­ mental Physiology. Funding, by the National Heart and Lung In­ stitute over the next five years, will permit expansion of studies into the cardiovascular effects of changes in environmental factors. " W e a r e p r o u d t h a t a t t h i s t i m e o f f i n a n c i a l s q u e e z e yve a s a department (physiology) have been found worthy of such an award," Dr. Farhi said. Funding of this comprehensive proposal will allow the department to support not only individual investigators but also the electronic and mechanical facilities of its unique new central laboratory — its human centrifuge, submergence basin, run­ ning track and high pressure chamber rated at 170 atmospheres. With other laboratories opening into its area, this new labora­ tory provides a focal point for the team of investigators. There is thus maximum efficiency in an enlarged team effort to study the effects of air, water, artificial atmospheres such as pressure and temperature, inspired gas composition, and gravity field on three interrelated physiology. areas — cardiovascular, respiration and circulatory While fundamentally still interested in the basic processes that affect man under environmental stresses (the Eskimo, etc.), the ex­ pert in pulmonary physiology points o u t that " t h e r e is n o d o u b t that we are looking very seriously at things that are important in the everyday life of an urban population," Dr. Farhi said. Ecological application of one, greater involvement into the effects of carbon monoxide on the population, has already been made. For in a pioneering work on the effects of carbon monoxide in man to which Dr. Farhi has m a d e a major contribution, it was found that there is n o level of this gas in o u r environment that is without effect. It therefore becomes important to minimize man's exposure to it.D SPRING, 1972 23 �"""" I 1A mSI0U" ™»» « *"»»»« m „ mcmrr .. '""L w i y A C H, july I971 Either, and V take this RL W^g9 will last •mbers iq„0 -d wiU tacinde ^om"^o%^iol°^TtWs occaB^a mnich*X^ )Otiies ;eit dt to join this dinner ail in the best wishes Pahn Wot\otaT"y C°»™M5 �It was a chance to see one another, to have a good time following the 25th International Congress of Physiological Sciences held in July in Munich. But to the former Fellows who were trained in their earlier days in Buffalo's department of physiology under Dr. Her­ mann Rahn, and to current faculty, the Buffalo Reunion was also an opportunity to honor this leading physiologist. It was their way of paying homage to the man who has had such an enormous impact on world health through his teaching. For through the understand­ ing of life processes—he imposed a rigorous discipline for careful work, accumulation of good data, and its imaginative interpretation —has come the foundation for good medicine. In his presentation of an enormously broad overview of science to the more than 70 foreign scholars from 21 countries who have trained in Buffalo over the past dozen years, Dr. Rahn has covered the whole spectrum, from the little one-celled animal to man journeying into outer space. Many of these Fellows are now de­ partment heads, leaders in the field in both Europe and South America. They are training hundreds of others. This international exchange program, initiated in 1957 by Dr. Rahn when he joined the Buffalo faculty as its physiology chairman, features not only a scholar/student/technician/lecture exchange, but cooperative publications and field studies to far-flung corners of the globe. Most of the foreign scholars in residence were originally trained as doctors of medicine. In order to pursue some area of physiology, they later went into basic research. Not only was there Gemutlichkeit (comradeship) at the tradi­ tional Brotfest (beer, bread, cheese, radishes) at the Augustiner Garten that afternoon, but there were moments of solemnity as well. To four eminent physiologists who, through their students, have maintained a long association with Buffalo, were presented Honorary Buffalo Awards by festivities chairman Dr. John Boylan. The "Honorary Buffaloes" are Dr. Kurt Kramer (Munich), Dr. Klaus Thurau (Munich), Dr. Rodolfo Margaria (Milan), and Dr. Pierre Dejours (Strasbourg). In his presentation of the Order of the Avian Egghead, Dr. Charles Paganelli alluded to the similarities between the work of its recipient, Dr. Rahn (doing physiology studies on the embryo of an unhatched egg) to that of an outer space ship that must also learn to live in its unusual environment. Dr. Rahn proudly wore the medallion the remainder of the day. What manner of teacher is Dr. Rahn? Said a former student, "he taught me most of what I know. He has always been a great believer in learning through doing. He would always challenge students, not tell them what to do. As a guide rather than a trainer, he would watch us do our own thing."• SPRING, 1972 25 Dr. Rahn, Dr. Pierre Dejours, one ol Honorary Buffalo's, Dr. Boylan �Ccorge Newman jr., Dr. Sumner Yaffe 21 Medical Students Honored Twenty medical students shared 14 awards at the annual fall Medical School Convocation in Butler Auditorium. A senior, George New­ Dr. Peter Regan, Mary lane Massie man, Jr., received three awards — Lange and Alumni Association, both for outstanding achievement during the third year, and the Children's Hospital prize for ability to understand childhood disease. The other recipients and awards: Merck and Company Award (for academic excellence during the third year) Patricia K. Duffner and Richard A. Savage; Mosby Award (for high performance during the previous year) Third Year: Robert DiBianco, Frederick S. Hust; Second Year: Susan J. Hakel, Steven J. Morris; First Year: Barry Kilbourne; Lange Award (for high performance during the previous year) Third Year: Marc J. Leitner; Second Year: Michael V. Murphy, Tim­ othy T. Nostrant; First Year: Bernard S. Alpert, Susan P. Ham­ mond ; Farny R. Wurlitzer Award (for outstanding work in psychiatry) Mary Jane Massie; Physiology Award (for outstanding performance in physiology) Don­ ald R. Greene; Ernest Witebsky Memorial Award (for outstanding performance in microbiology) Timothy T. Nostrant, Michael R. Savona; Dr. Felix Milgrom, Michael R. Savona, Timothy T. Nostrant James A. Gibson and Wayne J. Atwell Anatomical Award (for high­ est record of anatomy during first year) George M. Kleinman; Kornel L. Terplan Award (for demonstration of best knowledge of pathology during second year) Barry Sanders; Roche Laboratories Award (for highest ranking student during first and second years) Michael R. Savona; Pfizer Award (for three years of academic excellence) Thomas J. Lawley; Dr. John Watson Award (for excellence in medicine) John W. Kraus; Alpha Omega Alpha (honorary society) Robert DiBianco, Frederick S. Hust, Thomas J. Lawley, Marc J. Leitner, Stephen M. Newman, and Richard A. Savage.• 26 THE BUFFALO PHYSICIAN �Dr. Joel M. Bernstein, M'61, clinical associate in surgery (otolaryn­ gology), at the University, received a $10,000 grant from The Deaf­ ness Research Foundation of New York City. The money will be u s e d f o r r e s e a r c h t o d e t e r m i n e if a u t o i m m u n e d i s e a s e o f t h e i n n e r ear can be produced experimentally. "To the best of our knowledge, no American investigator has studied the problem of autoimmune disease of the inner ear," Dr. Ear Research Grant Bernstein said. "Except for several articles in the German literature and one by a Japanese investigator, there have been no fundamental experiments on autoimmune disease of the cochlea." Dr. Bernstein went on to say that he hopes this research will shed some light on some inner ear diseases whose causes are un­ known. Hopefully we may be able to provide some information on Meniere's Disease, sudden deafness and sensorineural hearing loss, following stapedectomy. Dr. Bernstein is the principal investigator. He will be assisted by Dr. Noel R. Rose, M'64, director of the Center for Immunology at the University, w h o is the co-investigator. The Center for Im­ munology laboratories at the University and the Temporal Bone P a t h o l o g y L a b o r a t o r y a t t h e E. J. M e y e r M e m o r i a l H o s p i t a l , a l o n g with the Animal Research Laboratory at the hospital will all be used for the project. Dr. Daniel Fahey, M'48, directs the Temporal Bone D r . Bernstein Pathology Laboratory and is a clinical associate professor of surgery (otolaryngology). The Deafness Research Foundation carries the endorsement of leading professional bodies in the fields of otology and otolaryn­ gology, and it is the only national, voluntary health agency devoted primarily to furthering research into the causes, treatment and pre­ vention of hearing impairment and other ear disorders. Now in its fourteenth year of operation, it is responsible for having directed more than $3.7 million to otological research and other related ob­ jectives since its establishment.• Nobel prize winning Dr. John C. Eccles, Distinguished Professor of physiology and biophysics at the Medical School participated in a symposium on Human Rights, Retardation and Research in Wash­ ington, D. C. recently. Professor Eccles participated in a panel dis­ cussion of "Why Should People Care." "What is o n e of the most serious problems confronting man today?" h e asked. " I t is not war. It is n o t pollution. It is essentially that man has lost faith in himself. The alienation of man is my deep concern." Calling retarded persons those who "got a bad deal genetically," Dr. Eccles said science still does not know " h o w re­ tardation happens" and suggested the key to the mystery may lie with current research into "how human weekend session was sponsored Foundation.• SPRING, 1972 brains are built." The by the Joseph P. Kennedy Jr. 27 Building Brains �35th Annual State University at Buf Theme: "CURRENT SOCIAL & ETHICAL ISSUES IN MEDICINE" April 7 and 8, 1972 V. rocjram MAIN CAMPUS -SUNYAB Goodyear Hall, 10th Floor FRIDAY, APRIL 7 9:00 a.m. Registration 9:30 a.m. Welcome: LOUIS CLOUTIER, M.D.'54 President, UB Medical Alumni Association 9:45-10:45 a.m. MODERN APPROACHES TO DRUG ADDICTION (feature film: "What Did You Take?") Moderator: NATHANIEL WEBSTER, M.D. Staff Physician, Masten Park Community Rehabilitation Center Panelists: GARY W. HEALEY, Ph.D. Staff Psychologist, Masten Park Community Rehabilitation Center OSCAR S. LOPEZ, M.D. Masten Park Community Rehabilitation Center 10:45-11:15 a.m. Intermission 11:15-12:15 p.m. DELIVERING HEALTH SERVICES IN THE FORM OF PROFESSIONAL CORPORATIONS Moderator: CASPER FERRARO, D.D.S. Consultant, Professional Services, Marine Midland Bank of Western New York Panelists: RAYMOND ROLL, JR., J.D. Senior Partner, Lipsitz, Green, Fahringer, Roll, Shuller, & lames, Attorneys JACK GELLER, J.D. Attorney, Lipsitz, Green, Fahringer, Roll, Shuller, & lames 12:15-12:45 p.m. Business Meeting, 12:45-1:45 p.m. Luncheon 1:45-3:15 p.m. ABORTION IN NEW YORK STATE ONE YEAR AFTER THE LAW Moderator: Election of Officers JACK LIPPES, M.D.'47 Associate Professor of Gynecology-Obstetrics Medical Director of Planned Parenthood, Buffalo Panelists: LISE FORTIER, M.D., F.R.C.S. (C) Gynecologist, University of Montreal, School of Medicine, Montreal, Quebec, Canada EMMA HARROD, M.D. Director of Maternal and Child Health, The Erie County Health Department CHRISTOPHER TIETZE, M.D. Director of the Bio-Medical Division, The Population Council, New York City 3:15-3:45 p.m. Intermission �falo Medical Spring Clinical Days 3:45-4:45 p.m. CANCER OF THE Moderator: FACE JOHN QUINLIVAN, M.D.'45 Plastic and Reconstructive Surgeon, Buffalo Mercy Hospital Clinical Instructor in Surgery Panelists: GORDON H. BURGESS, M.D.'63 Dermatologist, Roswell Park Memorial Institute JOSEPH R. CONNELLY, M.D. Plastic and Reconstructive Surgeon, Buffalo Mercy Hospital JOHN T. PHELAN, M.D. General Surgeon ot Oncology, Buffalo General, St. lerome (Batavia) Hospitals Clinical Instructor in Surgery 6:30 p.m. Fiftieth Class Reunion—Plaza Suite, Reception and Dinner SATURDAY, APRIL 8 9:00 a.m. 9:30-10:30 a.m. Registration MEDICAL AND LEGAL RAMIFICATIONS O F PATIENTS SUBJECTED TO NEW AND EXPERIMENTAL DRUGS AND TREATMENT Moderator: RALPH HALPERN, J.D. Partner, Raichle, Banning, Weiss and Halpern, Attorneys Panelists: WILLIAM A. CARNAHAN, J.D. Partner, Carnahan, DiGiulio, LaFalce, Moriarty, and Hill, Attorneys DANIEL T. ROACH, J.D. Partner, Adams, Brown, Starrett, and Maloney, Attorneys JOHN H. WEBSTER, M.D. Chief Therapeutic Radiologist, Roswell Park Memorial Institute JACK ZUSMAN, M.D. Director of the Division of Community Psychiatry, School of Medicine, SUNYAB 10:30-11:00 a.m. Intermission 11:00-12 noon NEW DEVELOPMENTS IN Moderator: HEALTH CARE DELIVERY ERNEST HAYNES, M.D. Director, Family Practice Center, Deaconess Hospital Clinical Professor of Family Practice Panelists: HIRAM B. CURRY, M.D. Professor and Chairman, Department of Family Practice, The Medical College of South Carolina KENNETH ECKHERT, SR., M.D.'35 Chairman, Comprehensive Health Planning Council of Western New York Clinical Instructor in Legal, Social, Preventive Medicine J. W A R R E N PERRY, P h . D . Dean, School of Health Related Professions, SUNYAB 12:30 p.m. Medical Alumni Annual Luncheon and Stockton Kimball Memorial Lecture, Main Dining Room G u e s t Lecturer: ROBERT J. GLASER, M.D. Vice President Commonwealth Fund, New York City �Dr. Harry L. Metcall, M'60, (left) president of the Erie County Chapter of the New York State Academy of Fam­ ily Physicians and Dr. Max Cheplove, M'26, congratulate Dr. John Schoff Millis, win­ ner of the organization's 1971 Dr. Max Cheplove Award for "significant advancement of the cause of family medi­ cine." Dr. Millis is chancellor emeritus at Case Western Re­ serve University, Cleveland. Both Drs. Cheplove and Metcalf are on the clinical fac­ ulty of the Medical School.C3 Buffalo Evening News Ecology of Health Dr. Edward M. Cordasco, clinical assistant professor of medicine, is one of the founders of the Niagara Frontier Environmental Edealth Research Foundation. It will conduct a three-year pilot study of the "ecology of health" in Erie and Niagara Counties, including the environmental aspects of lung disease. The foundation was con­ ceived about 15 months ago when Mrs. Florence Briggs of Niagara Falls approached area physicians and the UB Research Institute with financial backing for environmental health studies. The project became a reality in early December with the election of a board of directors and board of advisers, according to Dr. Cordasco. Utilizing Niagara County health personnel, the foundation is canvassing area residents to determine individual health histories of respiratory processes as well as testing healthy persons and those with a history of respiratory ailments. More than 20,000 persons will be tested in the next three years to determine the related factors leading to lung disease such as smoking, allergies, air pollu­ tion and heredity. Erie County will also be included in studies and the foundation's long range plans include a "multi-county" opera­ tion. Other studies will deal with the effects of water and land pollution on health. This is the first environmental health group in New York State and one of the first in the nation, according to Dr. Cordasco.• 30 THE BUFFALO PHYSICIAN �Immunology Center in Jeopardy Buffalo, which is known all over the world as a mecca for immunol­ ogy, is in clanger of losing that reputation. For, without an e n d o w ­ ment of its own, the Center for Immunology can no longer keep or for that matter even attract the brightest young scientists who must look to other institutions for security and a chance to build a solid medical career. The Center was established at the State University at Buffalo in December 1967 as an integral part of the School of Medicine and the Health Sciences Center where a wide scope of immunological re­ search and teaching could continue to advance. Would it not b e tragic to see the goals and dreams of o n e of our most illustrious faculty, the late Dr. Ernest Witebsky, distin­ guished professor and past chairman of the department of bac­ teriology and immunology who served as The Center's first director, also die? For he envisioned Buffalo as the focus for immunology and Dr. Forlier started practicing in 1957 and since 1960 has been a very active protagonist of Family Planning and went on to defend abortion on demand even in a very Catholic, French Quebec which is already changing rapidly in its position on the subject. In fact the birth rate in Quebec which, many years ago was the highest in Can­ ada, is now the lowest. Dr. Fortier will appear on the abortion panel Friday afternoon at Spring Clinical Days.[J helped to build it into o n e of the few institutions in the world to include the most important fields of immunology as it applied to human health and disease. It would b e here, at The Center, w h e r e teaching and training of future bright young scientists would con­ tinue to add lustre to Buffalo's reputation. Will you help to keep' The Center open through a contribu­ tion to the Ernest Witebsky Fund for Immunology — U.B. Founda­ tion, 250 Winspear Avenue, Buffalo 14215?D Dr. Beck Honored Dr. Edgar C. Beck was honored at a retirement dinner in Novem­ ber. Many of the guests were colleagues and patients. The 1919 Medical School graduate was a specialist in the treatment of dia­ betes. He was on the clinical faculty 45 years and retired in 1966 as clinical professor of medicine. In 1923 h e was o n e of the first Buffalo physicians to treat diabetic coma with insulin. In the 1950's he promoted administering the simple painless diabetes detection test on a mass scale in such places as department stores. Dr. Beck recalled that many doctors treated patients in their homes, day and night. House calls led the doctor to an intimate knowledge of his patient's family and financial, emotional and social problems. "Often this had to serve in the diagnosis in lieu of a battery of laboratory tests." Dr. Beck said, " he was often able to relieve mental and physical pain because of his experience, his sympathetic understanding and his closeness to the family. This was known as the art of medicine and I h o p e that it will not b e completely lost because it can greatly supplement the scientific approach." Dr. Beck believes his hopes will be fulfilled. He bases his optimism on the eagerness of today's medical students to serve the underprivileged. In 1953 Dr. Beck won UB's Samuel P. Capen Award for instituting the Annual Participating Fund for Medical Education.• SPRING, 1972 31 Dr. Beck �Mental Health Center Director Dr. Stanley R. Platman, deputy director of the South Beach Psychi­ atric Center in Brooklyn, N. Y., is the new executive director of The Buffalo General Hospital Community Mental Health Center. The appointment was announced by Dr. Theodore T. Jacobs, director of Buffalo General. At the same time, Dr. S. Mouchly Small, chairman of the department of psychiatry in the School of Medicine an­ nounced Dr. Platman's appointment as a clinical professor in the department of psychiatry. The 37-year-old Dr. Platman is presently an associate professor in the department of psychiatry at the Downstate Medical Center, SUNYAB, in Brooklyn. Construction of Buffalo General's Community Mental Health Center was completed late last year, but the opening of $4.8million facility has been delayed, largely because of the search for a director. Dr. Jacobs said BGH was "very pleased to obtain a man of Dr. Platman's stature to assume direction of our Community Mental Health Center. We have great confidence that he can bring this fine facility to its fullest potential in providing a vitally needed service to our community." Dr. Platman's appointment as director of the center was confirmed by the Mental Health Department of the Erie County Health Department and by the Community Board of the Community Mental Health Center. Dr. Platman will strive to staff the BGH CMHC as quickly as possible and begin its psychiatric services to one-sixth of Erie County. The BGH CMHC has 60 in­ patient beds for adult patients and outpatient facilities for both adults and children. Dr. Platman was born in London, England. He received his bachelor of medicine and bachelor of surgery degrees from Queens University in Belfast, Ireland, in 1959. He became a member of the Royal College of Physicians in London in 1963, and completed his Dr. Platman American Boards in Psychiatry in 1970. He served his internship as a physician in Belfast City Hospital and, as a surgeon, at Whittington Hospital in London. Dr. Platman was a Medical Officer with the British Medical Service in Swaziland from October, 1960, to Octo­ ber, 1961. He was a resident in psychiatry and neurology at Tara Hospital and the University of Witwatersrand in Johannesburg, South Africa, from October, 1961, to May, 1963, before beginning general practice in London. Dr. Platman came to the United States in November of 1963 as a research scientist at the Bureau of Research in Neurology and Psychiatry, Princeton, N. J. In June of 1964, he joined the Depart­ ment of Medicine at Presbyterian Hospital, Columbia University, New York City, where he did research in endocrinology. In June of 1966, he went to the New York State Psychiatric Institute, Columbia University, as the head of a metabolic research unit. Dr. Platman then moved on to the South Beach Psychiatric Center and the Downstate Medical Center in May, 1969. At the psychiatric center, he began as chief of clinical service and advanced to his present position as deputy director in November, 1969. 32 THE BUFFALO PHYSICIAN �Dr. Platman is the author of approximately 50 papers in psychi­ atry. In 1969 he received the Aesculapius Award from Rome Univer­ sity, Rome, Italy, "for work with the use of cations in psychiatry." In addition to being a member of the Royal College of Physicians, Dr. Platman is a member of the American Association for the Ad­ vancement of Science, the American Medical Association, the Ameri­ can Psychiatric Association, the Association for Research in Nervous and Mental Disease, Inc., the Association of New York State Mental Hygiene Physicians, the American Public Health Association, the British Medical Association, the Canadian Psychiatric Association and Sigma Xi.G Dr. George Thorrt Honored The annual report of the Peter Bent Brigham Hospital in Boston has been dedicated by Dr. George W. Thorn, a 1929 graduate of the Medical School. Dr. Thorn is physician-in-chief and the Hersey Professor at the Harvard Medical School. He was cited for bring­ ing a new era of biological chemistry to the hospital. "The scope of his knowledge seemed almost limitless and to each problem he added a new dimension or direction of investiga­ tion. This intellectually facile and imaginative teacher knew no peer in his generation. Equally distinguished are his scientific contribu­ tions — too many to set forth at this time but which encompassed original and fundamental contributions not only in endocrinology but also in the wide field of medicine," said the annual report author, Dr. Eugene C. Eppinger. Dr. Thorn delved into the study of adrenal cortex diseases when the function of this organ was almost obscure and its diseases poorly understood and fatal. Effective treatment today is based on the fundamental knowledge of structure and function provided by George Thorn's work. The doctor was praised for his virtues of loyalty to his as­ sociates, for his teaching success which is personified by more than 200 former students holding professional positions in medical schools throughout the world, and for his " . . . Herculean efforts in the 'dark days' of the hospital which were important and probably crucial in maintaining the integrity of the hospital," said the dedi­ cation. "George Thorn should also be cited for his remarkable fore­ sight in establishing fundamental sciences as an integral part of the hospital. His efforts in this regard which are now so widely copied were indeed pioneering two decades ago. Without doubt the im­ pact of his contribution has served to bring the proceeds of the biological science to medicine on a scale far exceeding that of the Brigham itself."G SPRING, 1972 33 Dr. Thorn �Educators Meet Health Care Challenge T he NATION'S MEDICAL EDUCATORS grappled with ways to improve the system by which their physician graduates prescribe medical care for Americans at the 82nd annual meeting of the Association of American Medical Colleges in Washington, D. C., Oct. 28-Nov. 2. They hope to meet the challenge that has resulted from pressures and criticisms that politicians, the public, commis­ sions, students, faculty and physicians have leveled against medical education. The chairman of the Association of American Medical Colleges, declaring an end to what he called "the days of ivory tower isola­ tion" in academic medicine, prescribed a 12-point program "to accomplish our task of bringing the nation's health system to an optimal level by 1985." In his address to the 82nd AAMC annual meeting, Dr. William G. Anlyan, vice president for health affairs at Duke University proposed: • Development of a time-availability health-care system in which no one in the nation would be beyond one hour's time of a doctor's care. • Building into the system equal care for all under a non­ voluntary insurance program, but with the options of pre-payment or fee-for-service financing. • Establishment of a peer review system for recertification of physicians every five years and making continuing education manda­ tory. • Instilling a greater awareness among physicians that, in the health-cost spiral, "the doctor's order in the hospital or office is far costlier than any other trigger mechanism." • Increasing medical school admissions to a level of 25,000 by 1985—double the current number of medical freshmen. • Creation of a separate, cabinet-level rank of Secretary of Health, and coordination of all health programs of the present Department of Health, Education and Welfare, the Veterans Ad­ ministration and the Department of Defense under a Federal Health Council reporting directly to the President. Dr. Anlyan also called for sustaining a "first-rate national effort in bio-medical research," noting that "a thriving research and de­ velopment program is a vital component of every industry, and the health industry is no exception." He said that in addition to in­ creasing the numbers of specialists in medicine, schools should make a major effort to train primary care physicians based in general internal medicine or general pediatrics, and that selected com­ munity hospitals should serve as their educational laboratories. Among his other points, Dr. Anlyan called for greater flexibility within medical curriculums; educational programs for upgrading the quality of management in academic health centers; restructur­ ing their organizational charts to fit administrative responsibilities; and acceptance by academic medical centers of "the total con­ tinuum of medical education" and assumption of "new roles tailored to the health-care needs of society." 34 THE BUFFALO PHYSICIAN �Congressman Paul G. Rogers also called for a Federal Depart­ ment of Health headed by a cabinet officer. The Florida Democrat w h o is Chairman of the House Subcommittee o n Public Health and the Environment exploded several myths including the myth that there is a coherent system of Federal health programs under govern­ mental leadership; that the priority of health in HEW comes first (not welfare). And the greatest myth is the mythical 22.2 billion dollar health figure (for the 12 months ending June 30, 1972) created by the Office of Management and Budget. The figure in truth covers a wide range of services bearing little relationship to health maintenance of the American people. The 92nd Congress is already an activist in health legislation and major decisions are being made. "The production of men of medicine by universities and colleges constitutes the production of a national resource. Inventory has been taken of existing manpower resources and comparison of needs examined and for the first time a goal set. We are gearing legislation to meet that goal," Congress­ man Rogers said. The Congressman challenged the medical educators to extend themselves beyond the confines of teaching. "We need your ex­ pertise, your leadership to guide us to excellence in methods of service past the walls of your institutions to the point that you be­ come a resource for your entire region. Leadership must come f r o m y o u a n d y o u r i n s t i t u t i o n s a n d n o t t h e s t a t e if t h e i n s t i t u t i o n i s to maintain its integrity. I know Congress will try to give health the priority it deserves. W e can give it support and help build the structure, but you must give it life and vitality. The genius of medical knowledge and manpower is in the university teaching college and hospital." The president of the National Academy of Sciences said the government will n o longer support research that is vague even though this type of research has done much in the last two decades. Dr. Philip Handler reminded the educators that today's medical student comes to our medical school much better prepared. "We must revise the content of our basic science courses. We have overtrained physicians in science. Our bio-medical courses must be more clinically oriented. "Scientific medicine has overtaken and bypassed most of us in this room," Dr. Handler said. Senator Warren G. Magnuson proposed that many experts in a variety of medical specialties be sent abroad for brief periods to study health-care systems of foreign countries. He is chairman of the Senate Commerce Committee and the HEW Subcommittee, and one of the Senate's leaders on health affairs. Mr. Magnuson's idea is aimed at exposing more American medical professionals to the good and bad points of existing health plans and at stimulating discussion among their peers and the public when they return to their every-day jobs in research, teach­ ing and practice. "Such a program could have considerable impact on the problem of understanding the difficulties of providing better health care for Americans." SPRING, 1972 35 "The Federal health establishment is entitled to have a lull-time Sec­ retary ot Health who can be heard in the White House over the guil­ lotine of the Office of Manage­ ment and Budget." — Congressman Paul C. Rogers �Medical school deans and faculty members are encouraged to come to Washington—to write letters and visit with their congressmen often so they can have some input into federal health bills that are in the planning stage. Faculty members must also talk to lay groups in their respective communities. The pub­ lic wants to meet, see and hear from the scientist, the physician— so they can have a better under­ standing of medicine.D Such trips, for about three months each, would be for the purpose of studying the foreign systems, not for research or treating exotic diseases, the Washington Democrat said. "I would like to get 100 or so biomedical representatives—medical professors, research­ ers, private practitioners, nurses and other allied health workers— to learn first hand about other systems." "Through NIH we have brought foreign nationals, outstanding in some phase of health, to the United States. We must make that a two-way street. This will help us understand our own health-care system and differences in others," Senator Magnuson said. "Today American doctors have reached the point where they are technologically the best trained physicians in the world. But we are not providing optimal medical care. We must seek to solve today's problems in ways that do not create bigger new problems for tomorrow. "I have often thought that we need new and different types of trained health manpower—different than you and I have even thought about. We need people who can do new things in health care. I am an optimist. With your help and leadership we can affect change. We must narrow the gap in health between what is and what should be," Senator Magnuson concluded. HEW Secretary Elliot L. Richardson told the educators that "we all want a healthier nation. A nation where the right to health care is protected but freedom of choice is preserved. Where our doctors stand on the frontiers of research but are also present in the inner city and rural America. Where we train the finest specialists in the world but provide every American with access to primary care. Where we build a profession on scientific excellence but insure that all peoples in our pluralistic society are participants. The letter of the law may soon be on the books, but the spirit depends upon your perceptions of the need and your commitment to fulfilling it. "The burden falls primarily on you. For it is in the medical schools that the attitudes and aspirations of your profession are formulated. The potential of a new Federal role in health man­ power is not that it provides greater financial security for the pres­ ervation of the status quo, but rather that it challenges you to prevent as well as cure, to replace the arrogance of knowledge with the humility of service and to open up the ivory towers of medical research and reach out to the people in need," Secretary Richardson said. 'We reach for the stars and our expectations outrun our achievenents. There is a limit somewhere o the productivity of a society and onsequently on how much can be lone, by how many in all the ealms for which we hold limitless imbilions, including health." —Chancellor Alexander Heard The Alan Gregg Memorial lecturer reminded his audience of the "limitless scope of health concerns today." The Chancellor of Vanderbilt University, Alexander Heard, pointed out that health is affected by poverty, diet, as well as air and water pollution. "The scope of health concerns is all-embracing. All health is now public health. Neither public nor private hospitals, nor medical schools, nor their universities, nor combinations of institutions, can address the intricate problems they face except through and with the aid 36 THE BUFFALO PHYSICIAN �of government (local, state, regional, national). Government, after all, is the vehicle for comprehensive common action in our country," the Alan Gregg Memorial lecturer said. "All health professionals will find that what they do and want to do are matters of public policy. The relationships with the rest of society of those concerned with health care will increase in in­ tricacy, frequency, and importance. The full health education of physicians and other types of health personnel will not be complete in the future without attention to the social and political context within which they must function. They are participants in the political process, whether they desire to be or not. Their effective participation will be greatly influenced by their breadth of view­ point, their understanding of the full society within which they function, and of the processes of decision-making that will ul­ timately determine what they and their institutions are asked to do, permitted to do, forced to do." Mr. Heard outlined four conspicuous needs: (1) Increased labor and financial efficiency is a necessity because health ex­ penditures have been growing faster than the gross national product. (2) The role of the physician as the uniquely central, dominant figure in health care is changing and will change more. (3) There is no cost-free benefit. We can improve our environment if we increase productivity. But we can do it then only if we use the pro­ ceeds that flow from increased productivity to restore the environ­ ment, rather than to purchase additional amenities of life. That is the type of choice to be made. (4) The goals we expect from a health system require searching, ethically oriented scrutiny. The society and its health professionals need more closely defined and limited objectives in the competition for social priorities and the resources to reach them. Senator Edward M. Kennedy outlined his views on the issue of Federal health policy. He expanded upon three areas — health manpower, conquest of cancer, and health maintenance organiza­ tions. He is Chairman of the Senate Health Subcommittee. "If the American people are going to underwrite a substantial and growing proportion of the costs of educating this nation's health manpower, then they have a right to know what those costs are. I believe Congress will provide significantly greater resources for health manpower than it ever has in the past. And I believe it will do so because of the growing recognition that adequate numbers of the appropriate types of health manpower is one of the keys that can unlock the health crisis which confrohts this nation. "The basic philosophy of the Senate Health Manpower bill was to encourage the medical schools to accelerate their efforts to pro­ duce more of the right kinds of health manpower. And to do it as rapidly as possible. It is painfully obvious that the research grant is a woefully inadequate mechanism for assuring the stability of high quality educational programs addressed to national health care needs. SPRING, 1972 37 "The future of hospitals, of med­ ical schools, medical of university-based centers, of health care generally, very directly depends on the quality of the governments of our country, in all their forms and operations."—Chancellor Alexander Heard The Chancellor reminded medical educators of Health Organization's the the World 7946 defini­ tion which has become famous: "Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease and infirmity." �"Biomedical research is the only aspect of America's health care in­ dustry that can fairly be evaluated as excellent." "We must delivery refashion our health system. And we must harness the enormous leverage of the public financing of health care. For, properly harnessed, that lever­ age can turn the rhetoric of reform into reality." — Senator Kennedy. "We must develop a new kind of 'multi-hospital teaching institu­ tion'." — Dean Rogers (Dr. Rogers assumed the presi­ dency of the Robert Wood Johnson Foundation on January 15, 1972). "For too long the financing tail has wagged the health care dog. The time has come to change that sorry situation. For, if we do not, we will only compound the very serious policy mistakes we have al­ ready made. Comprehensive HMO legislation can and should be­ come the cutting edge of reform of the health delivery system. To view it otherwise is to diminish the opportunity that now exists. "If comprehensive HMO legislation is the cutting edge of re­ form, national health insurance is its essential companion. If we really mean business when we talk of a delivery system which renders quality services on an equitable basis, then we must face the fact that no program of project grants or loans guarantees can suffice. HMO's can only prime the pump. Continuity of care, quality care, economical care, and equity of access to that care demands equitable national health insurance. That, ladies and gentlemen, is what national health insurance is all about. "The debate on national health insurance is far from over and I firmly believe the public's interest is best served by the most searching, critical, and strenuous debate possible. I favor the Health Security Act because it is the best answer I see to this crisis," Senator Kennedy said. Dean David E. Rogers of the Johns Hopkins School of Medicine stressed the importance of making our medical schools more adapt­ able and more responsive to the needs of our students and society. "Unless we do it immediately, medical educators will be sup­ planted by others who might do it even worse." Dean Rogers continued, "Although I don't see much evidence in our teaching medical centers for a change, we must assume a leadership role. We must join with others in society to create a real unit of health. Unless we do we will find ourselves an unimportant force in the health care picture. We must be excited by and be will­ ing to experiment with new methods and new objectives. But time is running out, and we must get about it. "We should continue to be deeply involved in the advance­ ment of biomedical science. Society will be sold short if we are not. On the other hand, it is time that we owned up to the fact that our compelling interests in science do not necessarily educate physicians properly for their roles in society and the delivery of medical care. "Our programs for teaching health professionals are in need of dramatic overhaul. We should design programs which would recognize the commonality of certain kinds of learning for doctors, nurses, physician assistants, psychologists, and other health pro­ fessionals so that they would get acquainted earlier with one an­ other and their individual professional aspirations. If the physician is indeed to be the captain of a health care team, would it not be reasonable to train him as a member of the crew as well as the captain so that he understands and appreciates the areas of re­ sponsibility which will fall to his other health colleagues? Training the physician in splendid isolation does not make sense to me if we are designing for the future. How can one be an effective captain of a team that one has never played on? 38 THE BUFFALO PHYSICIAN �" W e should redesignate what is meant by a 'university' hospital " W e in universities cannot pro- or teaching service . . . University teaching centers should accept mole any unity in the health sys­ full responsibility for the differentiation period of education of the tem if a physician now labelled the 'residency' program. Let's place all post­ 'white hats' graduate specialty hospital, while the 'other residency training programs directly under university a u s p i c e s . If w e t r u l y b e l i e v e w e h a v e r e s p o n s i b i l i t i e s f o r e d u c a t i n g physicians — not untried young men and women labelled M.D.'s — let's take it o n . "Acceptance of full responsibility for all of the postgraduate residencies would bring more realism into our medical teaching centers without disabling them, would encourage the development of university based multi-track programs for physicians which were responsive to the actual health of our country, and might do much to eliminate the disunity between those who 'practice' and those who 'teach' in our profession," Dean Rogers said. An intern at the Duke University Medical Center, Dr. Douglas S. Lloyd, said "house staff members are a new force in medicine and they intend to make the 1970's a decade of transition to new health care delivery and an educational system. They are seeking new approaches to medical education, and then want a chance to help design them. Specifically house officers want to serve on policy committees at departmental and institutional levels. They want a voice in matters which involve patient care and allocation of re­ sources. Often they are closer to the problems of patient care than the senior staff, and so they want the opportunity to effect change in the management of these problems." The dean of the UCLA School of Medicine, Dr. Sherman Melinkoff, urged his colleagues to keep an open mind to new ideas, but cautioned not to stampede. "If one school decides to try an experimental approach to family medicine, well and good. Let's see h o w it turns out. But let us not encourage legislators to make the funding of all medical schools dependent upon the creation of De­ p a r t m e n t s o f F a m i l y P r a c t i c e . If o n e s c h o o l d e c i d e s t o t r y c l a s s e x ­ perimental techniques, again let us keep an open mind. But let us not at once hail this trial as the revealed advent of a better era and promptly legislate fiscal penalties for not toeing the line."D SPRING, 1972 39 full time faculty are the who run the super- guys' run primary care, community hospitals or ambulatory programs." —Dean Rogers �To C R E A T E FAMILY PHYSICIANS by intent —not by default." Deaconess That is the motto at the Family Practice Center of Deaconess Hos­ Hospital's Family operational in October of 1970 and is the h o m e of the only fully Practice Center pital, 840 Humboldt Parkway in Buffalo. The Center became fully approved Residency Program in Family Practice in this area. There are now 73 approved Residency Programs in Family Practice in this country. At the present time there are eight residents in the program. This will increase to 14 in July and ultimately to 24 — eight in each of the three years. Three 1969 Medical School graduates will com­ plete the program in June —Dr. Robert Gibson, Dr. Timothy Har­ rington, and Dr. Michael Smallwood — all eligible for board certifi­ cation in Family Practice. Dr. E. R. H a y n e s is Director of t h e P r o g r a m in Family Practice. He is also Clinical Professor of Family Practice in the Department Third year resident Dr. Michael Smallwood at work in the laboratory. o f S o c i a l a n d P r e v e n t i v e M e d i c i n e i n t h e M e d i c a l S c h o o l . "T h e m a i n objective of our program" said Dr. Haynes, "is to provide realistic graduate educational experiences in Family Practice equal to those which have hitherto been only available in the established disci­ plines." In February of 1969, the AMA formally recognized the new specialty of Family Practice —the 20th specialty and the first to a p p e a r in m o r e than 2 0 years. It also recognized board certification in Family Practice. Board certification is now open to practicing Family Physicians who can meet basic study requirements and satis­ factorily pass the examinations. Board certification in Family Prac­ tice is by examination only. Already, almost 4,000 physicians have become board certified in this new specialty. After 1978, certifica­ tion will be open only to graduates of approved programs. 40 THE BUFFALO PHYSICIAN �The patients attending the Family Practice Center are treated as individuals against the background of society, e.g. as family units. their family and of their When the family first comes to the Center, it is assigned to o n e of the young physicians, and from that point on the Center takes 100 percent responsibility for meeting or arranging for that family's health care needs. The physician to whom the family is assigned sees them by appointment in his office a t the Family Practice Center. If a c o n s u l t a t i o n o r r e f e r r a l i s i n d i c a t e d then patients are referred to appropriate specialists. The majority of patients who need hospitalization are admitted to Deaconess Hospital under the care of members of the Center Staff and ap­ propriate consultants. The major emphasis in the Program is on practical experience with a representative cross-section of ambulatory patients. Families registered with the Center receive continuing comprehensive care with the help of the allied health professionals and appropriate community resources. The accent is o n the " t e a m approach" to health care and reflects anticipated future patterns of practice. Approximately 35 per cent of the Center's patients are on medicaid and 6 per cent on medicare. The remainder pay fees personally on a fee for service basis or are covered by insurance plans. Patients unable to pay their bills in full may make arrangements to pay their bills on a monthly basis. Dr. Neal Meade, first year resident, Dr. Michael Smallwood, third year resident, Dr. Ernest R. Haynes, and Dr. Frederick Downs, second year resident, discuss ideal office layouts. SPRING, 1972 41 Dr. Timothy Harrington, chief resident, checks laboratory tests with head nurse Miss Denyse Wade. �Dr. Haynes and Mrs. Elizabeth Harvey, associate professor of social work, discuss a problem. Dr. Gregory Swift, first year resident, checks fundi. The majority of residents in this program start as rotating Interns at Deaconess Hospital. At the end of this program, the resident ob­ tains his license t o practice in New York State and is qualified t o par­ ticipate in the care of patients outside the hospital setting. There are three main aspects to the program in the last two years of the residency. The first of these has already been mentioned — the continuing care of a representative cross-section of patients. The second is a series of electives — many on a preceptorship or one-toone basis — which allows the resident to obtain additional in-depth experience in all the disciplines of medicine appropriate to future family physicians. These include such areas as medicine, pediatrics, gynecology, psychiatry, E.N.T., dermatology, and many more. A master's degree course in epidemiology is also a popular choice. The third aspect of the program is a continuing series of seminars and conferences on a daily basis. The topics discussed range widely and involve specialists from many fields. Drs. Haynes and Wm. Fiden, a second year res/dent, with a patient. 42 �In 1970, Dr. Haynes stated that h e saw four major challenges to b e m e t if t h e n e w p r o g r a m s i n F a m i l y P r a c t i c e w e r e t o b e s u c c e s s ­ ful. These were: student interest; development of faculty; adequate funding; and the understanding and cooperation of those in the established disciplines. Now, in 1972, student interest is so great as almost to be an embarrassment, and the understanding and cooperation in those in established disciplines has been demonstrated. The two major problems that remain are the development of faculty and of ade­ quate funding. Only time and the interest of dedicated men will solve the former. The latter—adequate funding—is now recognized as a problem a t the federal level a n d funding is now being d e ­ veloped for both undergraduate and graduate programs in Family Practice. Such a development is essential as the capital cost of such Programs is high and their continuing expense significant. " O u r Program is one of 73 in this country responding to society's need for an adequate number of well educated Family Physicians. At this time there are 550 residents in Family Practice. This number will increase to over 1,000 in July. I am glad that most of our graduates intend to practice Family Medicine in rural Western New York communities and in the Buffalo area" Dr. Haynes said.D SPRING, 1972 43 Mrs. Joyce Cais, a nurse, prepares lor an EKC,. �The skin and scuba class in action. The submergence basin is 8 feet deep and 8 ieet wide and 198 ieet in circumference. Scuba instructor loseph Cunningham visits with Dr. Edward Flynn, postdoctoral fellow (also scuba instructor), Mrs. Nancy Ledger, a secretary, Miss Sally England, a technician, Nancy Urbscheit, a graduate student. Dr. Amos Ar, post doctoral fellow, is standing in back with arms folded and Dr. Alan Saltzman, postdoctoral fellow, is working with two colleagues (backs to camera). 44 THE BUFFALO PHYSICIAN �Climbing out oi the submergence basin are Dr. lames Vorosmarti, postdoctoral fellow, Dean Markey, technician, and Robert Mazzone, a graduate student who is also a qualified diver and scuba instructor. Dr. lames Vorosmarti, postdoctoral The Scuba Class Watermanship was a family affair for 15 mem­ bers of the physiology department recently. All of the swimmers learned the art of scuba and skin diving during an 8-week after hours class in the new Laboratory for Environmental Physi­ ology facility. The class was a mix of men and women—faculty, students, secretaries and tech­ nicians, all members of the physiology depart­ ment. The scuba instructors were qualified professional divers, who were also members of the department. The participants donned fins, masks, snorkels and mouth pieces and plunged in to learn the techniques of underwater swimming and breath holding along with other water techniques. "We want a nucleus of people in our de­ partment trained in working effectively under water. They will serve as subjects when our laboratory becomes operational," Dr. Hermann Rahn, chairman of the department said.Q SPRING, 1972 fellow. �Canadian . A QUEBEC PHYSICIAN told his Buffalo colleagues about his own Medicare W. Herbert Burwig lecture sponsored by Deaconess Hospital, Dr. province's stormy controversy over total medicare. At the annual Robert A. Kinch said, "American doctors must present a united front and have the best public relations man in the States on your side in debates over socialized medicine." The chief of obstetrics and gynecology at Montreal General Hospital pointed out that the medical profession in Quebec was badly mauled by the press and public when the general practitioners and specialists split over the "tarif unique," a provision of the medicare system mandating the same fee for an operation regardless of the training or qualifications of the o n e performing it. The government threatened fines when the specialists decided to withhold their services in opposition to the provision. But the strike coincided with the kidnapings of Labor Minister Pierre Laporte and British diplomat James Cross and rumors of a general FLQ uprising and massive casualties persuaded the doctors to relent. "The government feared that the most highly paid, and pre­ sumably the best, doctors would not participate in medicare. The well-off could conceivably get a better quality of medical care than the poor," Dr. Kinch said. Since the plan took effect in January 1971, it has become very difficult to see a physician on short notice and some patients have complained about "a mass production type of practice" instituted by doctors unwilling to spend much time with any patient because of the lower fees. "Despite the controversy and initial computer problems, every medical act that the physician carries out is paid for and physicians' incomes in general have increased," Dr. Kinch said.D Buffalo Evening News Dr. Norman Courey (left), Dr. W . Her­ bert Burwig (center) and Dr. Robert A. Kinch of Montreal, who gave the Dea­ c o n e s s Hospital's annual W . Herbert Burwig l e c t u r e at the Statler Hilton. Dr. Kinch also re­ c e i v e d an award as an outstanding gynecologist. �Dr. Feinstein Honored Buffalo Evening News Dr. Samuel Feinstein, retired director of the West Seneca State School, was honored recently by the state's top mental hygiene officials and 250 of his colleagues. The 1931 Medical School gradu­ ate is a clinical associate professor of psychiatry a t the University. State Mental Hygiene Commissioner Alan D. Miller and deputy commissioner Frederic Grunberg headed the well-wishers who paid tribute to Dr. Feinstein. He became director of the West Seneca School in July 1961 and retired October 31, 1971. In his tribute Dr. Miller said, "I think of him as I would a superb artist or athlete who knows his craft so well that others say of him 'it looks so easy'. I don't know of anyone in the de­ partment w h o is s o universally esteemed as Sam." Dr. Feinstein served his internship at Deaconess Hospital and his residency in psychiatry at St. Lawrence. Later he became staff psychiatrist and through a series of promotions rose to become its clinical director in 1949. He was appointed to a similar post at Buffalo State Hospital in 1954. In 1960 Dr. Feinstein drew the task of converting the J. N. Adam Memorial Hospital in Perrysburg, then a tuberculosis center, to a facility for the mentally retarded. The Erie County Association for Retarded Children cited Dr. Feinstein in 1967 for "distinguished service to the mentally retarded" and in June 1969 Commissioner Miller presented him with the state's distinguished service citation as "a master planner and organizer of treatment and habilitation for the retarded." Dr. Feinstein is a Diplomate of the American Board of Psy­ chiatry and Neurology, a Fellow of the American Psychiatric As­ sociation and a member of the American Association of Mental De­ ficiency, as well as the AMA and the Erie County Medical Society. He is a past president of the Western New York District Branch of the American Psychiatric Association and the Buffalo Neuropsy­ chiatry Society.• SPRING, 1972 47 Dr. Samuel Feinstein (left) retired director of the West Seneca State School with two top officials of the State De­ partment of Mental Hygiene — Dr. Alan D. Miller, the commissioner (center) and Dr. Frederic Crunbery, his deputy commissioner for mental retardation. �The Class of 1904 One of the Medical School's oldest alumni is Dr. Julius Richter, who will be 96 in December. He moved to Buffalo in 1880 from Allegheny, Pennsylvania. Dr. Richter received his medical degree in 1904 and attended the New York Post Graduate School for a course in General Surgery. In 1913 he returned to Buffalo, entered private practice and was appointed to the Medical School faculty. When he resigned in 1928 he was an assistant professor of surgery and associate professor of anatomy. He was also a Consulting Surgeon at Millard Fillmore, the E. J. Meyer Memorial and Lafayette General Hospitals. He was also an associate member of the Lafayette General staff. Dr. Richter is a well known artist. He has exhibited at the Albright-Knox Art Gallery and in national • exhibitions, winning many prizes. He is a member of the Buffalo Society of Artists and served on its council for many years. He was also a member of the Buffalo Print Club. Dr. Richter was a founder and past president of the Buffalo Surgical Society and a founding member of the National Board of Surgery. He also served on the Board of Directors of the Lafayette General Hospital, the Erie County Medical Society and the Buffalo Academy of Medicine. Dr. Richter's first wife died in 1958, and in 1969 he married Elizabeth T. Sinclair. The couple is living at 916 Delaware Avenue (Apt. 1-C), Buffalo.• The Class of 1919 Dr. Joseph R. LaPaglia, M'19, of 50 Lincoln Avenue, Dunkirk, New York, is a general prac­ titioner who has been on the Board of Educa­ tion there for 16 years and president of the board for 8 years.• Dr. Lrank H. Valone, M'19, an ear, nose and throat specialist in Rome, New York lives at 1409 North George Street, Rome.D The Classes of the 1920's Dr. Allen E. Richter, M'20, a retired surgeon, lives at 201 N. Ocean Boulevard, Apartment 1203, Pompano Beach, Florida.• 48 Two members of the 1921 class—Drs. Antonio F. Bellanca and Gaetano P. Runfola—were hon­ ored by the BaccelIi Medical Club of Buffalo on their 50th anniversaries of graduation from the Medical School. Dr. Bellanca, chief of medicine at Columbus Hospital since 1948, is a past president of both the Erie County Medical Society and the medical and dental staff. Dr. Runfola, a school physician for 35 years, is a member of the Erie County School Boards As­ sociation.• Dr. Caryl A. Koch, M'23, family practitioner, lives at 6435 W. Quaker Street, Orchard Park, New York. He is a school physician at Orchard Park Central School and president of Ismailia Temple A.A.O.N.M.S. Medical Unit.n Dr. Hobart Reimann, (left) a 1927 Medical School graduate, discusses a portrait, "Moslem Mullah" that he painted with Dr. Saied Hojat. The water color was made from a photograph Dr. Reimann took in I960 when he taught at the University of Shiraz (Iran). Dr. Hojat recog­ nized the subject in an exhibit on display in the library. The Iranian religious leader was his grandfather. Dr. Reimann is associate director of medical affairs at The Hahnemann Medical College and Hospital of Philadelphia.• �Dr. Milton A. Palmer, M'27, an ophthalmol­ ogist, has been re-elected president of the Buf­ falo Eye Bank and Research Society, Inc. (his 15th consecutive term). He holds the past presi­ dent's plaque (1951-53) from Buffalo Ophthal­ mologic Club. Dr. Palmer practices and lives at 18 Park Boulevard in Lancaster.D The Classes of the 1940's Dr. Francis J. Audin, M'41, is Director of the Department of Anesthesiology, New England Deaconess Hospital, Boston. He is also senior partner of Audin Anesthesiology Associates and is active in state, county and city medical so­ cieties. His address is 54 Lowell Road, Wellesley Hills, Massachusetts.• The Classes of the 1930's Dr. Arthur W. Glick, M'31, has been ap­ pointed acting chairman of the departments of dermatology of the Mount Sinai School of Medicine and the Mount Sinai Hospital. He succeeds Dr. Samuel M. Pack, who has retired. Dr. Glick came to the hospital in 1938 as a re­ search assistant in dermatology. In 1962 he became attending dermatologist, and in 1966 he was appointed clinical professor of derma­ tology at the School of Medicine. Prior to com­ ing to New York, Dr. Glick was affiliated with the Montefiore Hospital, Allegheny General Hospital and the Falk Clinic of the University of Pittsburgh School of Medicine.• Dr. Louis A. Vendetti, M'33, a general prac­ titioner, is chairman of the Cheektowaga Air Pollution Board and police surgeon. He lives at 225 George Urban Blvd., Cheektowaga.• Dr. Paul A. Burgeson, M'36, an internist, re­ signed as chief of staff and of medical service at Wyoming County Community Hospital in August, 1971 to direct SUNY College at Geneseo's Student Health Service. Dr. Burgeson was a Fellow, American College of Physicians, and was recently awarded honorary life member­ ship, Wyoming County Medical Society. He is a consultant, internal medicine, Wyoming County Community Hospital. Dr. Burgeson lives at 141 West Court Street, Warsaw, New York.D Dr. Ruth C. Burton, M'39, recently assumed a post as psychiatrist, Student Health Service, Syracuse University. She is also an assistant clinical professor at Upstate Medical Center. Previously, Dr. Burton had been supervising psychiatrist, Onondaga County Department of Mental Health, acting as a consultant to social agencies and courts. Her address is 770 James Street, Syracuse, New York.D SPRING, 1972 Dr. Richard Ament, M'42, of 22 Lake Ledge Drive, Williamsville, New York, is a clinical professor in anesthesiology at the University. He is on the board of directors and chairman, of the American Society of Anesthesiologists' Committee on Manpower, and on the panel of consultants for the American Medical As­ sociation's Advisory Committee on Allied Health Professions.• Colonel Ralph R. Chapman, M'42, a surgeon with the U. S. Army Medical Corps has re­ turned from duty as deputy commander of the Medical Command of the U. S. Army in Viet­ nam. Since his return in May, he has been serving in the Office of Secretary of Army as medical'member of Army Council of Review Boards at the Pentagon. Dr. Chapman was certified by the American Board of Surgery in 1957. He and his family (wife and four children) live at 7704 Hemlock Street in Bethesda.D Dr. Thomas R. Humphrey, M'43, a pathologist on the staffs of Lancaster Community and Antelope Valley Hospitals, California, was med­ ical missionary to the Belgian Congo from 1946-1961. His article on "Plegmorphic Carci­ noma of Larynx Archives of Pathology" was published in the ARCHIVES OF PATHOLOGY (1967). Dr. Humphrey lives at 43828 Gadsden Avenue in Lancaster.• Dr. Edmund M. Collins, M'44, a surgeon (maxillofacial), is clinical associate at the Uni­ versity of Illinois. A member of the Board of Trustees, American Association of Medical Clin­ ics, he is also president of the Champaign Chamber of Commerce. He lives at 9 Greencroft, Champaign, Illinois.• 49 �Dr. John G. Allen, M'46, an obstetrician Golden Key Award at Dallas meeting of Texas gynecologist, has been nominated to receive Association for Children with Learning Disabil­ the 33rd degree, the highest honor of Scottish ities. He lives at 1285 Thomas Drive, Beaumont, Rite Freemasonry at a meeting of the Supreme Texas.• Council of Scottish Rite in Boston. Dr. Allen, who is a former Captain in the Army Medical Dr. Irving R. Lang, M'49, of Newark has been Corps, has provided leadership in sex educa­ elected president of the American Cancer So­ tion programs for young people in Corning. He ciety, New York State Division.• lives at 31 Forest Hills Drive.• The Classes of the 1950's Dr. Eugene M. Marks, M'46, who was certi­ Dr. Allen L. Goldfarb, M'51, is the new direc­ fied last summer by the American Board of tor of the Millard Fillmore Hospital's Acute Preventive Medicine in field of occupational Coronary Care Unit. He is a clinical associate medicine, is associated with Bridgeport's Rem­ in medicine at the Medical School. Dr. Gold­ ington Arms Company in that field. A Fellow farb interned and took his residency at Millard of Fillmore. the American Academy of Occupational He succeeds Dr. Chavalit Svetilas, Preventive who joined a new cardiac surgery team at Medicine, Royal Society of Health, he lives at Arnot-Ogden Memorial Hospital, Elmira, New 22 Grand Place, Newton, Connecticut-^ York.D Medicine, American College of Dr. Milton Robinson, M'51, has joined the Dr. Raphael S. Good, M'48, is a clinical as­ Niagara Falls Memorial Medical Center as full- sociate professor of obstetrics-gynecology at the University of Miami School of Medicine. time director of the new Community Mental Health Center. The Buffalo State Hospital (Ni­ After 15 years of ob-gyn private practice in agara Unit) "After Care Program" is located in Miami, Dr. Good began a residency in psychi­ the Center. The Center is also associated with atry in April, 1971 at Jackson Memorial Hos­ pital, Miami. His address is 3431 Poinciana dren. Dr. Robinson served his psychiatric resi­ Avenue, Miami, Florida.• the West Seneca Psychiatric Center for Chil­ dency at Buffalo State Hospital and did post graduate work at the Syracuse Psychopathic Dr. Myron (Mike) Gordon, M'48, an obste­ trician/gynecologist, is an associate professor at New York Medical College, director of Fam­ ily Planning Service, and a Fellow of the Ameri­ can College of Surgeons. He has also been appointed perinatal consultant in research branch of National Institute of Neurological Disease and Stroke. Dr. Gordon, who was married in December to Karol B. Tucker in Valley Stream, Long Island, lives at 530 East 90th Street, New York.D Hospital. Dr. Robinson has headed Memorial's Division of Psychiatry since 1960. In 1971 the Division was given full departmental status. Before coming to Niagara Falls, Dr. Robinson was a senior psychiatrist and supervising psychi­ atrist at Buffalo State Hospital.• Dr. Jerome J. Maurizi, M'52, director of the respiratory therapy department at Deaconess Hospital, has been appointed a member of the Board of Trustees of the American Registry of Inhalation Therapists. He is one of eight phy­ sicians in the nation named to this board. Dr. Dr. Paul C. Weinberg, M'48, of 1307 Mount Vieja Street, San Antonio, Texas, is an associate Maurizi is a clinical associate professor of medicine at the Medical School and professor professor in obstetrics-gynecology at the Uni­ and chairman of the Erie Community College versity of Texas (San Antonio).• Inhalation Therapy Program.• Dr. Percy W. Bailey, Jr., M'49, a psychiatrist, Dr. Julian Kivowitz, M'58, a child psychiatrist, is chairman of the Governor's Advisory Council is an assistant professor in psychiatry at UCLA. for children with Language and Learning Dis­ He lives at 2473 La Condesa Drive in Los An­ abilities in Texas. geles.• He also received the 1971 50 THE BUFFALO PHYSICIAN �Dr. Donald Lewis Cohen, M'59, clinical and Dr. David T. Carboy, M'63, an ophthalmolo­ anatomical pathologist, lives at 539 Boyd Drive, gist, lives at 118 Leedsville Drive, Lincroft, New Sharon, Pennsylvania. He is Director of Labora­ Jersey and is on the American Board of Oph­ tories at Sharon General Hospital.• thalmology (1969).• Dr. Elton M. Rock, M'59, a gastroenterologist, is a clinical instructor in medicine at the Uni­ versity, and gastroenterologist and member of department of internal medicine at Sisters Hos­ pital. He lives at 56 Old Orchard Drive in Williamsville.D Dr. Leonard Jacobson, M'64, an ophthal­ mologist, lives at 7752 Montgomery Road, Apt. 4, Cincinnati.• Dr. Sheldon Rothfleisch, M'64, who lives at 32 Argyle Terrace, Irvington, New Jersey, spe­ cializes in plastic reconstructive and hand sur­ gery. He is an instructor in plastic surgery at the New Jersey College of Medicine.• The Classes of the 1960's Dr. Harris C. Faigel, M'60, is a clinical in­ structor in pediatrics at Boston University, and Dr. David C. Ziegler, M'64, is Head, Division directs Adolescent Medicine at the Kennedy of Neurology, Department of Neuropsychiatry, Memorial Hospital in Brighton. He is on the U. S. Naval Hospital, Oakland, California. He is editorial board of Clinical Pediatrics, board of also director of the Electrodiagnostic Labora­ directors of Mass. Planned Parenthood, acting tory and clinical director of neurology at the chief of pediatrics at Kennedy Memorial Hos­ pital, vice president of medical staff at Kennedy Everett A. Gladman Memorial Hospital of Oak­ Memorial Hospital and is doing research on Danville.• land. His home address is 121 St. Francis Court, anemia in adolescents, postdental bacteremia, and computer-administered health question­ naires in adolescents. He is also active in two treatment programs for adolescent Dr. Ralph D. D'Amore, M'65, writes that he is "in solo Family Practice in Hamilton, New drug York and enjoying every minute of this 'new' abusers. He lives at 123 Sewell Ave., Brookline, enriched specialty." Dr. D'Amore lives on West Massachusetts.• Lake Road, Hamilton.• Dr. Joseph A. Cimino, M'62, has recently been appointed Deputy Commissioner of Health, New York City Department of Health. He is also an instructor of environmental medi­ cine at New York University Medical School. Dr. Cimino acquired Master's degrees in Public Health and in Industrial Health from Harvard after leaving UB Medical School and went on to positions in New York City as Medical Director of Poison Control Center; Chief Medical Offi­ cer New York City Civil Service Commission, and was the first Director of Health and Safety for the Environmental Protectional Administra­ tion. He lives at 6 liana Lane, Thornwood, New Dr. Michael S. Feinberg, M'65, specializing in surgery of the hand, is in private practice at 50 High Street. He completed an orthopedic residency at the Buffalo General Hospital and a year as preceptee in hand surgery with Los Angeles' Dr. Joseph H. Boyes. He lives at 20 Old Spring Lake, Williamsville.n Dr. Ira Hinden, M'65, a family practitioner, lives at 1508 Hawthorne Drive, Wooster, Ohio. He is president of the B'nai B'rith Wooster Lodge. Dr. Hinden served two years in the U. S. Air Force at Clark AFB Hospital, Philip­ pines (1968-1970).• York.D Dr. Calvin Marantz, M'65, a pathologist, has completed four and one-half years of active Dr. Rae R. Jacobs, M'62, will move in July to duty with the U. S. Navy and is now practicing the University of Kansas Medical Center as as­ general pathology at the Turtin Community sistant professor of surgery, from the Augusta, Hospital in Turtin, California. He lives at 13691 Georgia Veterans Administration Hospital.• Tea House, Santa Ana.n SPRING, 1972 51 �Dr. Harry D. Verby, M'65, a pediatrician, lives at 651 Columbia Drive, San Mateo, California. He is a clinical instructor at the University of California at San Francisco; a Fellow, American Academy of Pediatrics; and a Diplomate, Amer­ ican Board of Pediatrics.• Dr. )ames D. Felsen, M'66, has recently moved from Tulsa, Oklahoma to Suite 307, 33 Lancaster Terrace, Brookline, Massachusetts. He is studying for a M.P.H. at Harvard School of Public Health, probably in the field of Interna­ tional Health.• Dr. Deming L. Payne, M'66, is a resident surgeon at the Medical College of Virginia fol­ lowing three years at the Eglin Air Force Base in Florida and the Air Force Base in Thailand. He lives at the Hampshire Place, Apt. 623A, Westover Hills Boulevard, Richmond.• Dr. John M. Pifer, M'66, is in the State of Bihar in India where he will be working the next two years in smallpox eradication. He worked in this same field the last three years with the United States Public Health Service in Nigeria. "Our goal is to eradicate smallpox from the world by 1975. It is gone now except for the Sudan and Ethiopia in East Africa and the Indian subcontinent including parts of India, Pakistan and Afghanistan." Accompany­ ing Dr. Pifer is his English bride, Sue, who he met in Nigeria.• Dr. Cary Presant, M'66, an instructor in medicine at Washington University (St. Louis), has been appointed to the staff of John Coch­ ran Veterans Hospital. The hematologist/oncologist is collaborating on research in phytohemagglutinin receptor sites on red, white and cancer cells with Dr. Stuart Kornfeld. Dr. Presant lives at 8914 Eager Road, Brentwood, Missouri.• Dr. John R. Anderson, M'67, is a U. S. Navy Flight Surgeon, Advanced Jet Training Squadron 26, Chase Field, Beeville, Texas. In 1968-69, Dr. Anderson completed his anesthesiology residency at Philadelphia Naval Hospital. From September, 1969 to April, 1970, he was at the Naval Aerospace Medical Institute, Pensacola, Florida. He expects to leave Texas in May or June of 1972 to begin a radiology residency, 52 probably at Bethesda Naval Hospital. Dr. An­ derson received AMA's Physician's Recognition Award in Continuing Medical Education in 1970.• Dr. William M. Burleigh, M'67, who lives at 102 W. Rampart Drive, #P211, San Antonio, Texas, is a pathologist at the Fifth U. S. Army Medical Laboratory at Fort Sam Houston.• Dr. John C. Bivona, Jr., M'68, is now at the U. S. Army Hospital, Department of Surgery, West Point Military Academy, after completing two years of general surgery residency at Kings County Hospital Center. He lives at 1-31 Thayer Road, West Point, New York.D Dr. Gilbert B. Green, M'67, a psychiatrist, graduated from the Menninger School of Psy­ chiatry last June and has been with the U. S. Navy at the Marine Corps Recruiting Depot in San Diego. He lives at 8511 Porter Hill Terrace in La Mesa, California.• Dr. Kenneth L. Jewel, M'68, is a radiologist, who lives at 800 Victory Boulevard, Staten Island, New York. Upon completion of his residency in diagnostic radiology in June, 1972, he will join the radiology staff at Columbia Presbyterian Medical Center. His article "Pri­ mary Carcinoma of The Liver: Clinical and Radiologic Manifestations" has been published in The American Journal of Roentgenology, Radium Therapy and Nuclear Medicine, Vol. CXI 11, No. 1, September, 1971.• Dr. Roger B. Perry, M'68, returned in July from active duty with the U. S. Army and is now a radiology resident at Michael Reese Hos­ pital. He lives at 2801 S. King Drive, Apt. 1805, Chicago.• Dr. John E. Shields, Jr., M'68, who lives at 200 Carman Avenue, Apt. 12-J, East Meadow, New York, is a resident at Nassau County Medi­ cal Center.D Dr. Jeffrey S. Stoff, M'68, an internist, is a staff research associate at the National Institutes of Health. He will begin an assistant medical resi­ dency at Boston City Hospital—Harvard Medical Service in July 1972. Dr. Stoff lives at 7553 Springlake Drive, Bethesda.• THE BUFFALO PHYSICIAN �People Dr. Charles F. Nicol, clinical assistant profes­ sor of neurology, is the new president of the Buffalo Catholic Physicians Guild. Dr. Richard R. Romanowski, M'58, was named vice presi­ Drs. Stephen T. Joyce, M'63, and David M. dent, and Dr. Eugene T. Partridge, M'60, is the Richards, M'62, were inducted as Fellows of the n e w treasurer. Dr. Cornelius J. O ' C o n n o r , clin­ American Academy of Orthopaedic Surgeons ical instructor in family practice, is t h e newly at the group's annual meeting in Washington, elected D. C. in January.• M'36, was named a delegate to the National Federation.• secretary. Dr. Hubbard K. Meyers, Dr. Thomas B. Tomasi, professor of medicine, is the author of a book, " T h e Secretory Im­ munologic System," the only o n e of its kind. Dr. Carel Jan van Oss, associate professor of microbiology, has been invited to serve as a It is t h e official proceedings o n a Conference on Secretory Immunologic System of Decem­ consultant to NASA via the Universities Space ber 1969 at Vero Beach, Florida. The book is sponsored by the U. S. Department of Health, periments on "Electrophoresis and other Chem­ Education and Welfare, National I to be launched in 1 9 7 3 . • Institute of Research Association for the evaluation of ex­ ical Separation Processes," planned for Skylab Child Care and Human Development.• Dr. Noel R. Rose, professor of microbiology Dr. Barbara G. Steinbach, clinical instructor, and director of the Center for Immunology, is has been elected a candidate member of the the new secretary-treasurer of the Academic American Academy of Pediatrics. She is a mem­ Clinical Laboratory of Physicians and Scientists. b e r o f t h e p e d i a t r i c a t t e n d i n g staff a t t h e E. J. Meyer Memorial Hospital.• ences Chapter of the Senate Professional As- He is also president of the Buffalo Health Sci­ Seven Buffalo physicians were inducted as sociatioh, chairman of the Faculty Senate Com­ mittee on Academic Freedom and Responsibil­ ity, and councillor of the new Western New new Fellows of the American College of Sur­ York Branch of the American Society for Micro- geons in Atlantic City during the 57th annual biology.D Clinical Congress. They are: Drs. Robert M. B a r o n e , M ' 6 6 ; J o h n L. B u t s c h , c l i n i c a l i n s t r u c t o r in surgery; Roger S. Dayer, M ' 6 0 ; James F. Dr. Erwin Neter, professor of microbiology, Mumma, clinical assistant professor of surgery is president of the Western New York Branch (proctology); Gerald P. Murphy, research as­ of the American Society for Microbiology. He sociate professor of surgery (urology); Hertzel is also a member of the Clinical Laboratories Rotenberg, Advisory Committee of the New York State assistant professor of surgery (otolaryngology) a n d J a m e s F. U p s o n , clinical Department assistant professor of surgery.• chairman of of Health, and was appointed the Committee on Proficiency Testing Materials by Assistant Surgeon General David J. Sencer.G Miss E d n a L. H a b i c h t r e c e i v e d t h e N e w York State Award for Distinguished Service from the Easter Seal Society in November. She was cited for 10 years of voluntary effort as publicity Dr. Felix Milgrom, professor and chairman of the department of microbiology, has been ap­ chairman in Erie County for the annual drive pointed to the Advisory Committee on Immun­ to support the New York State Society for Crip­ ology and Chemotherapy of the American Can­ pled Children and Adults. Miss Habicht is public relations director for Children's Hos­ cer Society; and to the Arthritis and Metabolic p i t a l .• SPRING, 1972 Disease Program Project Committee of National Institutes of Health.• 53 the �While attending the American Society of Hematology meetings in San Francisco in De­ cember, Dr. Oliver P. Jones, distinguished pro­ fessor of anatomy who retired as department chairman last June after 28 years, met 14 of his former students. They are: Doctors Marvin Bloom, Flossie Cohen, Cary Presant, Morton Spivack, Samuel Armstrong, Paul Archambeau, Marshall Lichtman, May Leong, Louis Wertalik, Spencer Raab, Glenn Tisman, Ed Shanbron, O. Odujinrin, Alvin Volkman.n Dr. Marguerite T. Hays, associate professor of medicine, has been elected secretary of the Eastern Great Lakes Chapter of the Society of Nuclear Medicine. The assistant professor of biophysical sciences is also a member of the President's Committee to study educational and academic attachments of the Western New York Nuclear Research Center.• A research professor of medicine, Dr. Julian L. Ambrus, received the annual scientific award of the Hungarian Medical Association of America, Inc. Dr. Ambrus is also director of the Springville Laboratory, a facility of the Roswell Park Memorial Institute.• Three alumni have been elected officers of the medical staff at Mercy Hospital. A general surgeon, Dr. Charles J. Tanner, M'43, is the new president, succeeding Dr. Milford Maloney, M'53. Dr. Joseph Griffin, M'49, is the new vice president and Dr. Henry Petzing, M'46, is the new secretary. Dr. Joseph Prezio, clinical assistant professor of medicine, is the new treasurer.• Dr. Thomas F. Anders is first director of the division of child psychiatry at Children's Hos­ pital. He comes to Buffalo from the Albert Einstein College of Medicine at Montefiore Hospital, New York City. He is serving on a part time basis until June. Dr. Anders will also head the pediatric division of behavioral sci­ ence at Children's Hospital.• At the annual meeting of the American Col­ lege of Chest Physicians, Dr. Edward M. Cordasco, assistant clinical professor, was ap­ pointed a member of the executive committee of the air pollution section of the National Environmental Committee.• 54 Three alumni are officers of the Mt. View Hospital in Lockport, N. Y. Dr. Thomas C. Regan, M'48 is the new president and chief of staff. Dr. J. Revitt Oldham, M'38, is the newly elected vice president and Dr. David Denzel, M'59, is the new chief of surgery. Other offi­ cers are: Dr. Consan Dy is the chief of medicine and Dr. Fidelis Camorotta, secretary.• Dr. John R. F. Ingall, director of the Regional Medical Program of Western New. York, is the new chairman of the national steering com­ mittee for all 56 regional medical programs. Dr. Ingall is an assistant professor of surgery and associate dean for planning and program development.• Dr. Pasquale R. Greco, M'41, a clinical as­ sistant professor of surgery (urology) has been named to the Kidney Disease Institute Advisory Committee by Governor Nelson Rockefeller. Dr. William E. Mosher, Erie County Commis­ sioner of Health and clinical professor of social and preventive medicine, was also named to the committee along with Mildred D. Spencer, medical writer, Buffalo Evening News.D Dr. Michael L. Boucher is a clinical instructor of psychology in the department of psychiatry at the University. Dr. Boucher, who received his doctorate from Syracuse University in 1970, is headquartered at the E. J. Meyer Memorial Hospital. He lives at 61 Lorfield Drive, Am­ herst, N. Y.D Dr. Fred M. Snell, professor of biophysics, has written a computer program to randomize test procedures for patients of the methadone maintenance clinic at Sister's Hospital.• Dr. William J. Staubitz, professor of surgery and head of the division of urology, is the first American to be elected vice-president of the Canadian Urological Association. He will be president-elect in 1973 and he will be the president at the Ottawa meeting in 1974. Dr. Staubitz is also president-elect of the North­ eastern Section of the American Urological As­ sociation and he will be president in 1973 at the Toronto meeting.• THE BUFFALO PHYSICIAN �Dr. Edward L. Valentine, M'45, director oi the Bufialo Red Cross regional' blood program with Drs. Eckherl and Surgenor. A professor of biochemistry, Dr. Douglas M. Dr. Franz E. G l a s a u e r , a s s o c i a t e p r o f e s s o r in Surgenor, was named chairman of a commit­ neurosurgery, lives at 87 Bridle Path, Williams- tee of medical and scientific personnel form­ vilie. This 1955 University of Heidelberg (Ger­ ed to advise the Buffalo Regional Red Cross Blood Program on scientific developments in 20 publications in various national and inter­ blood services. This new group, the Blood many) medical school graduate has contributed national journals. Following the presentation Program Scientific Advisory Committee, was of two papers on cisternography and on echo- formed by Dr. Kenneth H. Eckhert, M'35, chair­ encephalography at the Third man of the Greater Buffalo Regional Chapter Congress in Sao Paulo, Brazil this fall, he visited of the American Red Cross. The duties of the Buenos Aires as a representative of the Capital committee will include advising blood program Foundation for International Education in Neu­ personnel of new developments in blood re­ rosurgery to evaluate a former neurosurgical search. Currently Dr. Surgenor is studying and resident. examining options for the National Blood Re­ memberships is temporary director and repre­ sources program.• sentative of Western New York to the newly- Among Pan-American his numerous professional founded New York State Neurosurgical Society. A research assistant professor of surgery, Dr. T h o m a s L. D a o , h a s r e c e i v e d a s e c o n d g r a n t of $53,876 for research seeking development Dr. jimmie Holland, psychiatrist, w h o is a of a cure for breast cancer by the Mary Flagler graduate (1952) of Baylor, is director of psychi­ Cary Charitable Trust. Dr. Dao is also chief of atry a t t h e E. J. M e y e r M e m o r i a l Hospital. S h e the department of breast surgery at the Roswell Park Memorial Institute. The original grant of is a Diplomate of the American Boards of Neurology and Psychiatry and has held offices $197,300 provided for an annual expenditure in t h e Western N. Y. District Branch of t h e over a five-year period.• American Psychiatric Association since 1959. Dr. Holland directs two grants, one that sup­ ports teaching of psychosomatic principles to Dr. H e n r y E. Black of 8 0 3 E. Fillmore A v e n u e , medical house staff and a fellowship in psy­ East Aurora, N. Y. is a clinical instructor of medicine at the University. He received his de­ chosomatic medicine and the other, teaching gree in cardiology from the University of Birm­ She and her family live at 137 Depew Avenue, ingham Medical School, England in 1 9 5 8 . • Buffalo.• SPRING, 1972 depression and suicide in a general hospital. 55 �Alumni Tour .... Spain — Costa del Sol March 31 — April 8, 1972 • 8 days, 7 nights, $299 (plus 10% tax & service) per person, double occupancy (single supplement — $60.00) • Round Trip Jet from New York City • Breakfast & 7-course Gourmet Dinner served daily • All facilities at PLAYMAR Hotel, Torremolinos (Malaga) • For details write or call: ALUMNI OFFICE, SUNYAB 123 Jewett Parkway Buffalo, N. Y. 14214 (716) 831-4121 In Memoriam Dr. Faye H. Palmer, M"I2, died December 26 after a long illness. He had been a general practitioner in Erie County for 50 years. He retired in 1962. Dr. Palmer was a first lieutenant in the Army Medical Corps during World War I and was an examining physician for a local draft broad during World War II. He was active in local, regional and national professional or­ ganizations.• Dr. Theodore C. Krauss, clinical assistant pro­ fessor of medicine, died November 16 in Mil­ lard Fillmore Hospital. He had been on the faculty since 1957, and was a pioneer in the field of geriatrics. He was on the staffs of Mil­ lard Fillmore and Meyer Memorial Hospitals, and medical director of the Rosa Coplon Jewish Home and Infirmary. He was a consultant on the aging and served on many county, state and national committees. In 1961 Dr. Krauss was a member of the state delegation to the White House Conference on the Aging. The same year the Buffalo Evening News recognized him as one of Buffalo's 10 "Outstanding Citi­ zens." The Czechoslovakian native was gradu­ ated from the Royal University of Bologna School of Medicine and the Royal University of Franz Joseph. He interned in Budapest and New York City.D The General Alumni Board Executive Committee — DR. EDMOND J. GICEWICZ, M'56, President; MORLEY C. TOWNSEND, '45, President-elect; )OHN G. ROMBOUGH, '41, Vice-President lor Activities; FRANK NOTARO, '57, VicePresident lor Administration; MRS. CONSTANCE MARX GICEWICZ, Vice-President lor Alumnae; JAMES J. O'BRIEN, '55, Vice-President tor Athletics; DR. FRANK GRAZIANO, D.D.S., '65, Vice-President for Constituent Alumni Croups; JEROME A. CONNOLIY, '63, Vice-President lor Development and Membership; G. HENRY OWEN, '59, Vice-President for Public Relations; DR. HAROLD J. LEVY, M'46, Treasurer; Past Presidents: ROBERT E. LIPP, '51; M. ROBERT KOREN, '44; WELLS E. KNIBLOE, '47; DR. STUART L. VAUGHAN, M'24; RICHARD C. SHEPARD, '48; HOWARD H. KOIHLER, '22; DR. JAMES J. AILINGER, '25. Medical Alumni Association Officers: DRS. LOUIS C. CLOUTIER, M'54, President; JOHN J. O'BRIEN, M'41, VicePresident; LAWRENCE H. GOLDEN, M'46, Treasurer; ROLAND ANTHONE, M'50, Immediate Past-President; MR. DAVID K. MICHAEL, M.A. '68, Secretary. Annual Participating Fund for Medical Education Executive Board for 1971-72 — DRS. MARVIN L. BLOOM, M'43, President; HARRY G. LaFORGE, M'34, First Vice-President; KENNETH H. ECKHERT, SR., M'35, Second Vice-President; KEVIN M. O'GORMAN, M'43, Treasurer; DONALD HALL, M'41, Secretary; MAX CHEPLOVE, M'26, Immediate PastPresident. 56 THE BUFFALO PHYSICIAN �O n e finds it difficult these days to consider change as synony­ mous with improvement, but your Alumni Executive Committee looks forward enthusiastically to the 35th Annual Spring Clinical Days. This year will find us on campus again but in new surroundings. The school's spring recess provides the time and Goodyear Hall, the place. The 10th floor suite provides a better view and we have the traditional listening in store for us. Again, the five year class reunions will fill o u t t h e w e e k e n d of April 7 a n d 8. R e m e m b e r , t o o , the scholarship needs have steadily mounted and our aim is to in­ c r e a s e , if p o s s i b l e , o u r a i d t o m e d i c a l s t u d e n t s . Y o u r c o n t r i b u t i o n s are our only source of this aid.D First Class Permit No. 5670 Buffalo, N. Y. BUSINESS REPLY MAIL NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES POSTAGE WILL BE PAID BY— Medical Alumni Association 2211 Main Street Buffalo, New York 14214 Att.: David K. Michael �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET, BUFFALO, NEW YORK 14214 Address Correction Requested THE HAPPY MEDIUM Fill out this card; spread some happiness; spread some news; no postage needed. (Please print or type all entries.) Name —— Year MD Received. Office Address Home Address If not UB, MD received from In Private Practice: Yes • No • In Academic Medicine: Yes • Specialty, No • Part Time • Full Time • School_ Title Other: — Medical Society Memberships:. NEWS: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.?. Please send copies of any publications, research or other original work. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1972 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1972-Spring Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v06n01-1972-Spring Table Of Contents A list of subunits of the resource. Class Reunions Dr. Eccles Maternal, Child Medical Center by Jean A. Cortner, M.D. Continuing Education Course Fetal Care Unit Miller Retires Cummings Foundation Grant/ Indonesian Research VA Hospital Dr. Cudkowicz Immunodermatology Conference Hypertension Immunology Convocation RMP Goals/Dr. Cammer Screening Drugs $1,073,849 Grant Student Convocation Ear Grant/Brains Spring Clinical Days Ecology Immunology Center/ Dr. Edgar C. Beck Mental Health Center Dr. George W. Thorn Health Care Challenge Family Practice Center Scuba Class Canadian Medicare Dr. Samuel Feinstein The Classes People Alumni Tour/In Memoriam Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v06n01 Extent The size or duration of the resource. 60 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright 1972 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/44e3b13470c52d374e441803ec5c4fd7.pdf f67c113022a327d1d5de23019976230f PDF Text Text spring clinical i ^ days �From the desk of — Lawrence H. Golden, M.D. '46 President, Medical Alumni Association Are Alumni Really Necessary? THE MAJOR STUDENT role is primarily to learn. The faculty have clear cut assignments in areas of instruction, investigation and administra­ tion. Do alumni have a genuine function? Hopefully, we are more than the source of potential financial support in a time of tight govern­ mental funds. Other organizations have tried this approach and after initial enthusiasm, faltered. Many are committed to active teaching of students particularly in the clinical years that require hospital assignments. Recently there has been an even greater involvement of alumni in policy making in various departments as well as in the administrative aspects of the School of Medicine. As important as all these functions are — are they enough? I suggest that they are not. What is needed is a concept that implies tenure, a feeling of belonging. Although the student graduates, he remains an integral part of the University the rest of his professional life. His activities reflect on the University just as the status of the University reflects on his own personal evaluation. The alumnus must therefore respect this University and be concerned about its welfare. The University like every institution in this country has strengths and weaknesses; problems that are obvious and many that are unrecognized. The University needs its alumni now more than ever and I suggest that we become more aware of the University for the single reason that we are a part of the University, as vital a part of it as its students and its faculty. Our special strength lies in the fact that we have moved from its walls and this permits mature surveillance and the opportunity for wise counsel and guidance. With this concept of alumni — the problems may not be all solved immediately, but a spirit that lends itself to grappling with them will be nurtured.• THE BUFFALO PHYSICIAN �Fall 1973 Volume 7, Number 3 THE BUFFALO PHYSICIAN Published by the School of Medicine, State University of New York at Buffalo EDITORIAL BOARD IN THIS ISSUE Editor ROBERT S. MCGRANAHAN Managing Editor MARION MARIONOWSKY Photography HUGO H. UNGER EDWARD NOWAK Medical Illustrator MELFORD J. DIEDRICK Visual Designers RICHARD MACKANJA DONALD E. WATKINS Secretary FLORENCE MEYER CONSULTANTS President, Medical Alumni Association DR. LAWRENCE H. GOLDEN President, Alumni Participating Fund for Medical Education DR. MARVIN BLOOM Vice President, Faculty of Health Sciences DR. F. CARTER PANNILL Executive Officer, School of Medicine DR. CLYDE L. RANDALL Vice President, University Foundation JOHN C. CARTER Director of Public Information JAMES DESANTIS Director of Medical Alumni Affairs DAVID K. MICHAEL Director of University Publications PAUL L. KANE Vice President for University Relations DR. A. WESTLEY ROWLAND 2 3 6 14 16 20 23 24 25 27 28 30 35 36 37 38 41 42 45 46 48 51 52 54 62 63 64 65 66 68 69 72 75 76 Are Alumni Necessary? ( i n s i d e f r o n t c o v e r ) Spring Clinical Days Record Keeping Drug Reaction Health Security Nuclear Medicine Intern Matching Outer Space Resources/Executive Officer Commencement Seniors Honored 5,853 Graduates Oncology Unit Summer Fellowships Hospital Head/Dr. Larson Professors Honored Dr. Gottlieb/Alumni Receptions New Experience Medical Education/Chicago Reception West Side Health Center 141 Residents, Interns Learning Center Environmental Physiology Lab Alumni Luncheon/Emergency Communications New Campus Our First Professor of Medicine by O. P. Jones, M.D. Physicians Retire $10,000 Gift Dog Racing Dr. Greco Millard Fillmore Hospital Research Award The Classes People In Memoriam Alumni Tours The cover design by Donaid Watkins features Spring Clinical Days. The picture story of this annual event is on pages 2-15. THE BUFFALO PHYSICIAN, Fall 1973 — Volume 7, Number 3, published quarterly Spring, Summer, Fall, Winter — by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. Please notify us of change of address. Copy­ right 1973 by The Buffalo Physician. FALL, 1973 �The Stockton Kimball luncheon. Problem Oriented Record Keeping A SYSTEMS TYPE APPROACH to caring for the patient was described by Dr. Robert L. Dickman, M'68, at the opening session of 36th annual Spring Clinical Days. The director of ambulatory services at the Buf­ falo General Hospital said "the use of computerized, problemoriented medical record is now widely accepted." It was designed by Dr. Lawrence Weed in Cleveland several years ago. "This is no gimmick. I have seen it work and I am a believer," Dr. Dickman said. Its four components — parelleling the four phases of medicine — were described by Dr. Dickman. The first is gathering of a data base (physical, history, profile, lab data). This leads to its second component, defining the patient's problem(s), — social, psychiatric and demographic. This problem list then allows the physician to make plans, the third part of the record, to diagnose and set priorities in treating the patient. And to plan for patient education. In the fourth component, the physician notes the progress on patient prob­ lems. This is done subjectively, objectively, through an assessment where you have what "you think is going on." And finally, plans for the patient are noted. Use of this tool all but eliminates one of the greatest problems in treating a patient, the error of omission where material buried in the back of the medical record is irretrievably lost. But its advan­ tages are numerous, Dr. Dickman pointed out. Once the problem list is defined, care becomes more directed. "To have a summary or index before you helps you make the decisions as 'total problems' you will deal with on that particular day, and to set priorities," he continued. "There are no set rules on the work sheet. Take a piece of paper and make your own problem list — anyway you 2 THE BUFFALO PHYSICIAN �want to. The data base will differ for different situations but once it is decided upon, it must be obtained consistently and reliably on everyone in that group. Never neglect to note a problem simply because you have no good explanation for it. Always update and alter the problem list as new data is obtained." It is a reflection of where you are, where you came from and perhaps where you are going." It also has potential as a medical education tool in teaching students, and house officers. It is a handle by which to audit perfor­ mance, to determine whether care planned has done any good by consults and review. No longer need there be a standardized hospital workup for each patient readmitted. One need only refer back to the problem list "in front of you and staring you in the face." Dr. Dickman also pointed to the written record that holds up in a court of law, the saving of time for the physician when a patient fills out an automated questionnaire and returns it. Now the physician can practice what he has been trained to do — to diagnose and to treat. "The Problem Oriented Medical Record is an invaluable tool which allows us to deliver more comprehensive patient care. By using the problem list both for inpatient and outpatient care we insure continuity and avoid obtaining data in one setting and neglect­ ing it in another. "By using this record comprehensive care is insured by forcing the physician to at least consider all of the patient's problems every time he sees him," Dr. Dickman concluded. Qnrinn TA a ^JJilllg LjlllllCal UciyS "Allergic reactions to drugs continue to be a major medical problem. And the effects of a combination of drugs on a patient is complicated and unpredictable. Many times there are serious complications." That was the unanimous agreement of the four-man panel on Drug Reactions, Interactions and Toxicity. Drug dosages needed for optimal therapeutic effects differ widely among patients. The 'usual dose' of most potent drugs accomplishes little in some persons, causes serious toxicity in others, and is fully satisfactory in few. The inability of standard dosage schedules to exert a sufficiently intense pharmacologic effect in many patients is often misinterpreted as therapeutic ineffectiveness of drugs. Con­ versely, drug toxicity is often caused by the failure to reduce the usual dosage appropriate in other patients, according to Dr. Jan KochWeser, associate professor of pharmacology and chief of the clinical pharmacology unit, Massachusetts General Hospital. How can we determine the optimal dose of a drug for each patient? Dosage adjustments are easy when the intensity of a drug's pharmacologic effects can be accurately and simply quantitated dur­ ing its clinical use. For example, dosage requirements for guanethidine or warfarin can vary by a factor of 50 from one patient to another. Nevertheless, the drugs are useful therapeutic agents. With many drugs, the best dosage for individual patients is difficult because the pharmacologic response is not quantifiable in the usual clinical situation. The physician may not even know whether tfmj T^TM l (J T? O Q /"""M OD C J—'J- *-*-£3 vDOU L-LW-L ±o FALL, 1973 3 > �Drs. Moloney, Yaffe, Keisman, Koch-Weser, Hurwitz Spring Clinical Days fc) J Drs. Edward Eschner, Yerby Jones prescribed dosage is producing the expected therapeutic benefit, particularly when the drug is given for prophylactic purposes. "Hypersensitivity reactions to drugs can be defined as those adverse reactions mediated by immune mechanisms, involving either humoral antibodies or sensitized lymphocytes," Dr. Robert E. Reisman said. Understanding of these hypersensitivity reactions and appropriate diagnostic tests require identification of the antigen and type of antibody involved. Most drugs such as penicillin are of small molecular weight and by themselves are generally unable to stimulate antibody formation. They act as haptens, combining with body pro­ teins to become antigenic and this leads to antibody formation. "The multiplicity of allergic reactions which can occur from one drug such as penicillin is due to differences in the participating antigen and antibody. Appropriate therapy for a drug reaction is at least partially dependent upon the immunopathogenesis. From a clinical viewpoint factors affecting allergic drug reactions include presence of atopy, prior drug reactions, age, type of drug adminis­ tered, prior drug exposure, and route of drug administration." Dr. Sumner J. Yaffe told the physicians that administration of a drug to a pregnant woman presents a unique problem to the physi­ cian. "Not only must the physician consider maternal pharmacologic mechanisms, but he must also be aware of the fetus as a potential recipient of the drug. It is estimated that a pregnant woman takes an average of four or five medications during her pregnancy. In some of these therapeutic endeavors directed toward maternal disease, consequences of such drug usage have often been unexpected, with tragic results in the developing fetus for who the drug was not intended. "The teratogenic effects of drugs are dose and time-related. The fetus is highly susceptible during the first three months of gestation. It is possible for teratogenic drugs to exert their effects on a fetus 4 THE BUFFALO PHYSICIAN �within 11 days of conception — before the woman suspects her pregnancy. The mechanisms of teratogenic agents are little understood, particularly in the human. "The inadequate enzyme systems of the fetus prohibit them from metabolizing drugs in the way mature organisms do. The effects of this inability are not known. Given the present lack of scientific knowledge, it is felt that throughout the entire period of pregnancy, administration of any drug should be held to the minimum The benefits to the mother must be carefully weighted against the possible harm to the fetus. Be aware of the problems connected with drug interactions, warned Dr. Aryeh Hurwitz, a University of Kansas assistant professor of medicine and pharmacology. "Be able to pinpoint what is happen­ ing if you see an unexpected presence. The combination of drugs is complicated. We may be unable to predict when an undesired reaction may occur." The effect of a drug, he continued, is related to its time duration. If it is somehow bound in the gut, it prevents absorption. But if a drug is 99 percent protein bound, its free fraction unbound, it becomes an active drug — increasing five fold in its activity. Acetic drug use, he pointed out, replaces other potent drugs from protein bindings. "And there will be predictable hemorrhaging," Dr. Hurwitz said. And he emphasized that "if you forget everything else that I say, don't forget about my caution against the use of Doriden. Don't use itTj > A general session FALL, 1973 5 The M e d i c a l Alumni A s s o c i a t i o n A w a r d of A p p r e ­ c i a t i o n w e n t t o Dr. C l y d e L. R a n ­ dall, acting dean and vice presi­ d e n t for t h e H e a l t h S c i e n c e s "for his outstanding leadership and years of dedicated service to the School of Medicine and t h e m e d i c a l c o m m u n i t y . " In h i s v e r y brief r e m a r k s Dr. R a n d a l l said " h e w a s t h r i l l e d t o b e a part of d e v e l o p i n g o u t s t a n d i n g m e d ­ ical s t u d e n t s i n t h i s c o m m u n ­ i t y . A l t h o u g h w e are l a c k i n g i n n e w , m o d e r n facilities w e h a v e a medical school in the city w h e r e t h e p r o b l e m s a r e . " Dr. Moloney made the presenta­ tion. Mr. Woodcock is also pictured. • �Health Security and the Healing Arts by Leonard Woodcock, President International Union, United Auto Workers As I travel about the country I am asked from time to time why I as a union leader take a major interest in reforming our nation's health care system. My response is that the safeguarding of health is of the greatest importance to the worker and his family. He recog­ nizes that without good health the hard fought gains in his economic situation, won at the collective bargaining table, are almost without meaning. If his health becomes poor and he can't work, he knows he and his family can barely live. The disability rate for families below the poverty level is at least 50 percent higher than for middle and upper income families. Our members almost all grew up in poor families. They are all too aware that a child born in poverty has twice the chance of dying before age 35 as a child born into a middle income family. And so union members feel an urgent need to have ready access to decent, comprehensive health services at prices they can afford. For some thirty years the UAW has negotiated with employers to provide funds to make possible this access to good health care. But despite rapidly escalating expenditures our efforts in this area are becoming less and less productive. Our members have been ready and willing to give up wages for health protection. Today it costs them one month's wages to pay for private health insurance that does not provide full and needed coverage. According to HEW, in seven years it will cost them two month's wages to pay for the same partial protection. In recent years we have come to recognize that the problems of fragmentation of health services, disorganization in the delivery system and shortages of professional personnel, with the resultant skyrocketing costs will not be solved by our diverting more and more money from wages to buy private health insurance. The prob­ lems in health care are problems of the society. So we in the labor movement are making a major effort to bring about needed change through social reform. This is the primary reason why I am here today. I have the greatest respect and admiration for the tremendous advances made in medicine and science in the last forty years, and for you, the splendidly trained practitioners who have added to this knowledge, and who apply it. I am well aware that you are much more interested in your program subjects like "Nuclear Medicine" and "Drug Reac- Drs. O'Brien, Randall, Mr. Woodcock, Drs. Golden, Moloney, President Ketter 6 THE BUFFALO PHYSICIAN �Spring Clinical Days The registration desk tions and Toxicity" than in an address on health care by a union president. But you, like we in labor, have no choice. You must con­ cern yourselves with the major problems of health care organization, delivery and costs, if your valued services are to reach fully those who require them. So I have come to Buffalo with the sincere hope that as a result of meetings such as this, clarifications of viewpoints on the major issue of national health insurance will emerge. I must also say that I take some pleasure in noting from your program, that in part because you are willing to listen to me, the AMA Council on Medical Education and the Academy of General Practice will approve ten credit hours for you. The other day two physicians who are also Congressmen offered a diagnosis of the current state of health care legislation. One a Democrat, the other a Republican, they agreed that a national health insurance law is coming soon. They agreed that physicians will lose control over their own profession if organized medicine continues to fight against public demands for real improvements in health insurance and against more consumer influence in shaping the deliv­ ery of health care. And they agreed that physician self-interest demands that they cast off their negative approach. I think that many physicians recognize that the AMA's Medicredit proposal is a negative approach. It sets the course of medical care in a hard and fixed frame when it should invite innovation. It assures higher costs when it should reduce waste and duplication. It encourages unnecessary surgery when it should promote preven­ tive medicine and quality controls. It is insurance industry oriented when it should be patient oriented. To illustrate one of its many serious deficiencies, look at the dental benefits. The AMA was criticized by the American Dental Association for excluding dental benefits from the previous Medicredit bill. This year, the AMA representatives are boasting of the inclusion of dental benefits. But they fail to make clear that th FALL, 1973 7 �— Spring Clinical Days Mrs. Stockton Kimball benefits are limited to children age 2 to 6. They don't broadcast the fact that there is a $100 deductible per child, per year. This is the tooth fairy in reverse: the parent will leave $100 under the pillow before the dentist provides any services. The dental benefit, really, is consistent with the rest of the Medicredit bill in that it completely ignores the needs of both patients and physicians. Reforms are conspicuous by their absence. The lure of tax credits would theoretically result in better and broader health insurance coverage for all. But the facts are that only the working poor with incomes below about $6,000 annually would have any real incentive to buy the policies proposed by the AMA. And they would be incouraged to buy the worst kind — individual policies that return only 50 cents on the dollar to the health system. The other 50 cents stays with the insurers. The whole Medicredit plan is really a sellout to the insurance industry. As practicing physicians, you should tell the AMA you won't buy it. But to date, I wonder how many physicians have had the time, or taken the time, even to read the national health insurance plan that is being presented in your behalf to Congress. You ought to read it and understand it because 200 Congressmen and Senators have signed their names to it on the word of AMA lobbyists that you, the physicians of America, are solidly behind it. Few people have read and fully digested the 17 different national health insurance bills before the Congress. It's too much to ask of doctors. So I'm here today to talk about just two of them — the Health Security bill and the AMA's Medicredit bill. And I'm here to tell you that, according to your own principles and standards, the Health Security bill rather than the AMA bill has the doctors' interest at heart. There's a high level game being played by the AMA. They are using your dues to promote the interests of the insurance industry. You'd think that Mutual of Omaha and Aetna would spend their own money to lobby Congress for favors to the private insurance companies. But the AMA is spending your money for that purpose. The Medicredit bill does not serve doctors well. It does not serve the interests of patients. But it certainly will create billions of dollars in new business and profits for the insurance companies. It has been said a thousand times by the AMA hierarchy that we who support the Health Security bill don't care about you. I'm here to tell you we care a great deal about you. It is time we had a sensible dialogue to explore and expand the wide areas of agreement that we share. No such dialogue has been possible with an intransig­ ent organization purporting to represent you that is responsive only to its most conservative constituents. But I say to you that if you or any other group of physicians has suggestions about improving the Health Security bill, within its broad principles, then we are eager to hear from you and to sit down and talk with you. We have done this with the 26 physicians who are members of our Committee for National Health Insurance and with literally hundreds of others. We can't talk with the medico-politicians in Chicago. They tell you that Health Security will come between patient and doctor. Show us where that is, and we'll change it. To my knowledge, the AMA has never released any poll of its membership on the subject of national health insurance but the 8 THE BUFFALO PHYSICIAN �An honor guard table magazine, Modern Medicine, reported the reactions of 17,000 physi­ cians last year. Understandably, because they do not like change, most physicians were against any form of national health insurance. But, those who saw any merit in national health insurance proposals, by a slightly higher percentage, preferred the Health Security program to those of the AMA or the Nixon Administration. A later poll, con­ ducted by the Gallop Organization, found 51 percent of physicians favorable to some form of national health insurance. Numerous national and state polls show that about two-thirds of all patients want governmental health insurance to replace private insurance, which most find ineffective or defective, or both. Doctors and patients may differ on what are the most pressing problems in American health care. But they agree on many things. They agree that our present health insurance programs aren't working well and ought to be changed. They agree that we ought to expand medical education and produce more doctors and also physicians' assistants. They agree that hospital facilities ought to be expanded and improved and that both basic and applied research in health science and health care should be well-funded. These are matters on which both patients and doctors are in firm agreement. But to date in Washington, we find that representa­ tives of patients are struggling to stop the budget-cutters at the OMB from axing health programs that ought to be strengthened, while the AMA, in line with its consistent policy that health care for all Americans should be the responsibility of no one in particular, has raised no audible objection or concurred with most of what's going on. Meanwhile, Federal Administration engages in prolonged flights of fancy about its accomplishments, but the President's health budget reveals a harsh insensitivity to the needs of both patients and doctors. President Nixon wants to cut into health services research and development and cut out entirely the regional medical program. He gives no additional support to biomedical research and proposesj ^ FALL, 1973 9 On June 18 President Nixon signed a major bill that would extend through the fiscal year health programs totaling $1.2 billion. Included were several programs the Administration had planned to eliminate — Hill-Burton hospital construc­ tion at $197-million, regional medical programs at $159million, public health and other training program at $68-million and new mental health pro­ grams at $174-million. • �A class reunion dinner to phase out all NIH fellowship and training grants. Who will provide for biomedical research which is essential to your clinical practice when the government support stops? The Administration says it will come from the normal economic forces of the private market­ place. The faculty and governing body of your Medical School here will tell you such a statement at best derives from ignorance and at worst deceit. Because Community Mental Health Centers have demonstrated great success, Mr. Nixon and Mr. Weinberger want to stop supporting them. But what does this mean to your patient: the adolescent who needs the counselling you are unable to provide in a busy practice, the addict, the alcoholic, the emotionally disturbed? Within this troubled society many look to the Community Mental Health Center as a vital, and often only resource. But of the 2,000 centers planned throughout the nation, only 560 have been established. They have relieved the overcrowding and stress in state mental hospitals and the pressures on the family physician. Mr. Nixon wants the Commun­ ity Mental Health Center legislation to expire this June 30th. Even though the OMB has developed ingenuous devices for obscuring their intentions, the facts are that no health program entirely escapes the budget cutter's axe. Not health manpower educa­ tion, nor preventive health services, nor disease control. Not allied health training nor population research and family planning, nor medical libraries. Instead of proposing innovation for the Hill-Burton program, they propose interment. They would replace Public Health Service hospitals and clinics with vacant lots. They would cut back on Medicare. It is not surprising that the AMA benignly watches as these cuts occur. Nobody has ever accused the AMA of any leadership in protecting the patient's rights or improving his lot. But everyone knows that the practicing physician is deeply concerned about his patient. And if he does not have the time to crusade for the rights and needs of other doctors' patients, he is still concerned. 10 THE BUFFALO PHYSICIAN �I say now is the time to express your concern. But let your Congressman know that you support good governmental health activities and oppose budget cuts that rank health low in national priorities. And let Mr. Nixon know, too. Last year I had the privilege of addressing the annual meeting of the American Society of Internal Medicine at Atlantic City. I made the point then that of all the proposals before the Congress for national health insurance, only the Health Security bill measured up to that Society's own standards. It was and is the only bill meeting their first principle — "that every American should have comprehensive health insurance cover­ age." The AMA plan, the Administration plan and each of the others fails to provide comprehensive coverage. Even though so-called "catastrophic insurance" is being promoted in these plans this year, their enactment would only result in a delay of comprehensive cover­ age. The prospect of catastrophic insurance already is encouraging promoters and entrepreneurs both within and outside the medical profession to "go public" with exotic and esoteric machinery and treatment, some of it bordering on quackery and little of it geared to the needs of the physician and his patient. Catastrophic insurance says to the consumer: "If you get real sick, we'll start paying your bills. But don't get too sick because we'll stop paying them." That isn't what you need to practice good medical care. It isn't what your patient needs. The primary physician is the forgotten man in that equation, and so is his patient. The philosophy that holds that a patient's serious illness should be a financial disaster for his family is inconsistent with the professional motivation of the physician. In the Health Security program, which emphasizes early diag­ nosis and treatment, the primary physician has a special place. If he is a solo practitioner, he is offered alternatives in the payment methods which are not available to other specialties. He can elect to be paid by fee-for-service or by a capitation method, with fair and reasonable sums paid him for each patient. If he selects the capitation method, he is encouraged through financial incentives to establish formal linkages for his patients with other health care providers and institutions, including hospitals, nursing homes and home health services. In other words, he will be able to write an order for his patient outside the hospital just as he now does in the hospital, and thereby activate a system providing needed services for his patient. And in selecting capitation, he is assured not only of economic parity with the fee-for-service practitioner, but funds from a separate account for personnel to run a good office. If he is in a prepaid group practice involving other specialties, the primary physician practicing under the Health Security program will receive special financial and professional recognition of his primary role as the provider and manager of comprehensive personal health care. And he will have his own "Professional Standards Review Organization" to give practical effect to the art and science of quality controls. I think the public is becoming more acutely aware of the need for better quality controls in the medical care system. Particularly FALL, 1973 11 Spring Clinical Days �President R o b e r t L. Ketter told the al umni that pre­ eminence in medical education is our goal. "We want to develop a strong l i n k b e t w e e n t h e M e d i ­ cal School and the University. W e h a v e just h i r e d a n e x t r e m e l y a b l e v i c e p r e s i d e n t fo r t h e H e a l t h S c i e n c e s (Dr. P a n n i l l ) , a n d w e are s e a r ch in g for a n e w dean for the School of Medicine. We want a nationally prominent man. Your aiumni president, Dr. Golden, is a member o/ the search committee." • the stream of reports of unnecessary surgery and its effects on friends and neighbors is causing consternation. I know many of our five million UAW members and their families are shocked by these reports. We also agree that a well trained physician is in an excellent position to evaluate the quality of care. We have some trouble in understanding why he must be from the local group and subjected to the social, organizational and referral pressures that come from having to pass judgment on one's neighbors and friends. We wonder if a physician is any less competent to review a surgical report or a tissue analysis if his practice is four hundred miles removed from the site of the surgery, than if it is four miles removed. Is it unreasonable to expect that patients may have meaningful views about how they are handled by physicians, the ways in which they are referred, the information they are given or not given about their conditions, and the instructions which are passed on to them during the following treatment? Our experience in the UAW leads me to believe that these are important aspects to quality which require consumer input. The overwhelming majority of consumers have no knowledge as to whether they have had too many procedures inflicted upon them or not enough. They have no assurance that the care they receive is, in fact, consistent with the best modern medical knowl­ edge. They must look to you and the control procedures you set up to give them this assurance. Most encounters with physicians and health services take place not in hospitals, but behind the closed doors of physicians' offices. In this setting there are exceedingly few if any checks on what hap­ pens. We therefore are in agreement about the need for effective quality safeguards. If you will broaden your view to take into account the quality considerations as seen by consumers, it seems to me it is quite possible for us to work out with you an appropriate mechanism. The AMA has spread a myth about the Health Security program that it is "monolithic". It has become their favorite scare word. I want to dispel that myth right now, if I can. We believe there ought to be a Social Security-type trust fund to pay for health services, instead of an army of insurance company claims clerks. There are presently 1800 insurance companies selling thousands of different kinds of health insurance policies. But we do not believe in a monolithic structure for the delivery of services. We believe in pluralism. We believe that many types of organizational arrangements should be encouraged and evaluated. Contrary to what doctors are being told, we do not reject solo practice, fee-for-service medicine. We favor flexibility, not rigidity. And we don't favor socialized medicine. It is not our position that doctors should become civil servants or that hospitals should be taken over by the govern­ ment. The people who are making these allegations about a "mono­ lithic" Health Security bill know full well that the bill encourages pluralism in the delivery system. Any who takes the time to read it knows it, too. Your society and our union agree there is a great need to increase the availability of medical services, and that increasing physician productivity should receive equal emphasis with increasing the number of physicians. 12 THE BUFFALO PHYSICIAN �Dr. Edward Zimmerman entertains the 1923 class. Obviously, we cannot project needs for future physician man­ power without assessing possible productivity gains through new organizational arrangements. This should be based on reasonable, practical planning. But once there is identification of goals, we should move realistically toward their attainment. . 1 TA In 1931, there were 1,097 persons in the United States for every OPTLILG LJIIIIICCII IJciyS general practitioner. In 1970, as you well know, there were almost four times that many persons per general practitioner and an increas­ ing number of them were foreign nationals and graduates of foreign medical schools. Furthermore, the shortages of health personnel in the urban ghettos and the rural areas have reached the desperate stage. Not only are they statistically far worse off than other areas, but as you well know, the majority of these physicians are elderly, often past the retirement age. It is therefore of little value to make funds available to consumers when with those funds they cannot obtain the needed services. The Health Security Act implements the principle of increasing the availability of medical services and increasing physician produc­ tivity. There is a substantial Resources Development Fund to provide new support for the education and training of new health profession^ mmn jsstaas mtu [" tSU Mtmi mm 1rnmmimam PHOTO* I £[£080*1 The winning exhibit. �Dr. Oscar Oberkircher Nuclear Medicine Dr. Steinbach als, with priorities for groups which have been disadvantaged in the past. There is technical assistance and the start-up support for new health plans. There is a way to pay for all the services provided by these plans. There are incentives for primary physicians to utilize ancillary services for their patients, including physician assistants as appropriate. Health Security is a program providing universal coverage for patients and incentives for doctors to better organize themselves to deliver care, and with cost containment and quality safeguards. The doctor will remain the key and essential figure. Only he will prescribe for his patient and the financial barrier between them will be removed. I am here today to suggest that a new spirit of cooperation between the physician and the representatives of his patients is possi­ ble and desirable. Cooperatively, we can deal with all of the problems which currently plague the delivery of health care in this country. We can work together toward the goal of a health care system approp­ riate to the needs and desires of our advanced nation. Such a system * S P o s s i ^^ e o n ^ i n a s o c i ety which has its priorities straight — a society that puts the health and well-being of its people at the top of its agenda. "Ninety-five per cent of nuclear medical procedures are diagnostic in character. These studies have reached their present level of impor­ tance in the practice of medicine because they provide vital diagnos­ tic information with little or no discomfort to the patient." Dr. Merrill A. Bender, clinical professor of nuclear medicine also said "the radia­ tion dose to the patient is very modest and in most instances compar­ able to that received from diagnostic X-ray studies. "In the early days of nuclear medicine it was hoped that radio­ isotopes would provide an effective tool for the treatment of a signifi­ cant number of malignant and benign diseases. Unfortunately this hope has not been realized, and only two or three disease states have been successfully treated with these materials. These include hyperthyroidism and selected cases of cancer of the thyroid and advanced heart disease treated with radioactive iodine, and certain blood disorders." Dr. Bender told the physicians that "imaging" of radioisotope distributions has allowed us to detect pathological processes in many different organs — the brain, thyroid, liver, pancreas, kidneys, bone as well as circulating ailments involving lungs, heart, great vessels and spleen. Of equal importance in the field of nuclear medicine is the evaluation of function and the measurement of the size of various 'spaces' in the body — blood volume. In just 10 minutes the circula­ tory condition of a patient undergoing major surgery can be evaluated. The most common function study is that of the thyroid gland where a radiation detecting technique determines the percent trapped there. By measuring concentration/excretion through the kidney, one can diagnose and evaluate nephritis, hypertension, renal transplant and for those concentrations that localize in the liver, evaluation of cirrhosis and hepatitis. 14 THE BUFFALO PHYSICIAN �"The quantitative scintillation camera gives us a new diagnostic procedure. Not only does it visualize redioisotope distribution but quantifies the amount of compound in a specific location as a function of time. We can also evaluate the degree of cardiac disability in acquired heart disease and measure renal and cerebral blood flow. The latter is proving very useful in the evaluation of strokes." The thyroid scan or "scintigram" is a pictorial representation of the regional activity of the thyroid gland. "The scan is most fre­ quently helpful in situations where the thyroid gland is palpably enlarged. In patients with normal or slightly reduced thyroid func­ tion, the thyroid scan may be useful in evaluation of palpable nodules. These nodules are classified as 'hot, warm or cold', by whether they concentrate more, the same or less radioactivity than does the sur­ rounding tissue. When the nodule is 'warm or cold', the value of the scan depends largely upon the morphology which it demonstrates." Another panelist Dr. Jehuda J. Steinbach pointed out that the field of competitive radioassays is the most rapidly expanding field in nuclear medicine today. "A few years ago only a few selected laboratories could perform only one or two selected tests. By contrast today the available procedures and laboratories that can perform them are almost too numerous to count." Brain scanning has become widely available during the past 10 years, according to Dr. George J. Alker. "Today most hospitals are equipped to perform this examination and in most nuclear medicine departments it is the single most frequently performed imaging procedure. Although originally intended to be a means of localizing brain tumors, it was soon recognized that a number of non-tumorous diseases of the central nervous system can also be diagnosed and localized by this technique. Today brain scanning is firmly established as an important vart of the workup of patients with a wide variety of neurological diseases." Dr. R. Ronald Toffolo reviewed the 205 placental scans carried out in the nuclear medicine department at Millard Fillmore Hospital from April 1965 to March 1973. "Approximately three per cent of patients show vaginal bleeding in the last trimester of pregnancy; of these placenta previa is the cause in less than one per cent. A standard five inch crystal rectilinear scanner and flat field collimator are used." Dr. Hays Spring Clinical Days Dr. Yehuda G. Laor pointed out that liver scanning is rather simple and does not involve any patient preparation. "Spleen scan­ ning has become easier and simpler in recent years with the intro­ duction of Technetium 99m Sulfur Colloid, and Indium-113m colloid for liver scanning. Because of the short half-life of these isotopes, larger doses can be injected for routine studies. Pancreas scanning has not progressed in recent years. And because of the difficulty of performing and interpretation of pancreas scans as well as the high cost, these studies are not as widely performed as liver and spleen scans." Dr. Joseph Prezio discussed pulmonary emboli and the lung scan; Dr. Monte Blau, nuclear medicine overview; Dr. Suraj P. Bakshimd, bone scanning; Dr. Marguerite Hays, thyroid scan, and Dr. Eugene V. Leslie, clinical professor of radiology, chairman of the radiology department and acting chairman of the nuclear medicine department, moderated the panel. • FALL, 1973 15 . �r.rvrm:, Relaxing in the student lounge. Intern Matching After announcing the "matchings" Dr. Cummiskey said he was leaving the University to join the department of radiology at the Meyer Hospital as a resident. Michael Haberman, Louis Zibelli, Mark Heller "Two thirds of you were 'matched' with your first choice of hospital and 85 percent ranked with a hospital listed among your first three choices." That's what Dr. Thomas G. Cummiskey, assistant dean at the School of Medicine told the 115 members of the graduating class. To further point out the high calibre of this class he pointed to the "matches" with the prestigious Johns Hopkins Hospital, Los Angeles Harbor Hospital, Vanderbilt, Michael Reese and Columbia Presbyterian Hospitals. Under the National Internship Matching Plan, which attempts to match the preferences of the students with those of the hospitals throughout the country, 44 will remain in Buffalo and 22 others will continue their training in other parts of New York State. The remainder will go to 20 other states, with California receiving the largest number of 10. One will go into the Public Health Service in New York City. Fourteen members of the class did not participate in the matching plan electing to make their own arrangements. Eighty-two of the seniors chose to continue their training at University-affiliated hospitals. Twenty-nine others will go directly into specialty residencies, bypassing the internship which appears to be phasing out throughout the country. Of this group, six have selected the specialty of family practice, previously known as general practice. Four will complete their training at the Deaconess Hospital's Family Practice Program. The University Program at Buffalo General and Meyer Memorial Hospitals received all 20 of the interns it requested in straight medicine and 14 of the 15 asked for as general rotating interns. Children's Hospital received eight of the 14 pediatric residents it requested. Two of the three psychiatry residencies were filled at the Meyer and one of five surgery interns requested there was filled. Four of 12 surgery residents were filled at the combined Buffalo General/Meyer Hospitals program as well as. two of four rotating general. 16 THE BUFFALO PHYSICIAN �BRUCE M. ABRAMOWITZ, St. E l i z a b e t h , Boston, straight medicine WILLIAM J. ACKERMAN, University of C a l i f o r n i a ( S a n D i e g o ) , A f f i l i a t e d H o s p i t a l s , r o t a t i n g CHARLES L. ANDERSON, Deaconess Hospital, Buffalo, family practice residency FREDERICK K. BECK, Bridgeport Hospital, Connecticut, rotating WILLIAM S. BIKOFF, Buffalo General/Meyer Hospitals, Buffalo, rotating medicine DONALD R. BLOWERS, Hennepin County General, Minnesota, rotating LAWRENCE B. BONE, E.J. Meyer Memorial Hospital, Buffalo, straight surgery DAVID H. BREEN, Cedars Sinai Medical Center, Los Angeles, straight medicine FREDERIC R. BUCHWALD, Public Health Service, New York City, rotating FERNANDO J. CAMACHO, Mont e f i o r e H o s p i t a l , N e w Y o r k C i t y , s t r a i g h t medicine JACK R. CAVALCANT, Meadowbrook Hospital, East Meadow, N.Y., rotating medicine YUNG CHEUNG CHAN, Henry Ford Hospital, Detroit, surgery residency ABBY COHEN, Herrick Memorial Hospital, Berkeley, rotating JEREMY COLE, University of California (Los AngelesJ, straight medicine RAYMOND DATTWYLER, University Hospital, Madison, Wisconsin, straight medicine MARK M. DECHTER, University 0/ Virginia Hospital, Charlottesville, family practice RICHARD DUNDY, Detroit General Hospital, Michigan, rotating THOMAS DWYER, Buffalo General/Meyer Hospitals, Buffalo, rotating DEMETRIUS ELLIS, Children's H o s p i t a l , Pittsburgh, Pa., straight pediatrics LEE A. EVSLIN, Maine Medical Center, Portland, rotating RETA D. FLOYD, Huntington Memorial H o s p i t a l , Pasadena, C a l i f o r n i a , r o t a t i n g ROBERT G. FUGITT, Deaconess Hospital, Buffalo, straight surgery VINCENT FUSELLI, University Hospital, Columbus, Ohio, straight pediatrics KENNETH L. GAYLES, M i c h a e l Reese Hospital, C h i c a g o , straight m e d i c i n e THOMAS E. GILLETTE, Washington Hospital, D.C., rotating JOSEPH M. GRECO, Millard Fillmore Hospital, Buffalo, surgery residency RICHARD GREEN, St. Joseph's Hospital, Phoenix, Arizona, straight medicine MICHAEL A. HABERMAN, E.J. M e y e r Memorial H o s p i t a l , B u f f a l o , p s y c h i a t r y residency THOMAS E. HAGUE, D e a c o n e s s H o s p i t a l , B u f f a l o , general rotating RALPH R. HALLAC, B u f f a l o G e n e r a l / M e y e r H o s p i t a l , B u f f a l o , straight m e d i c i n e MAXINE D. HAYES, V a n d e r b i l t University, A f f i l i a t e d H o s p i t a l s , Tennessee, straight pediatrics MARC E. HELLER, Mary Imogene Bassett H o s p i t a l , C o o p e r s t o w n , N . Y . , rotating JEFFREY P. HERMAN, Monte/iore Hospital, New York C i t y , s t r a i g h t pediatrics FREDERIC M. HIRSH, Deaconess Hospital, B u f f a l o , f a m i l y p r a c t i c e r e s i d e n c y DONNA HRUSHESKY, B a l t i m o r e C i t y H o s p i t a l s , Maryland, straight medicine WILLIAM HRUSHESKY, B a l t i m o r e C i t y H o s p i t a l s , Maryland, straight medicine ROBERT HUDDLE, R o c h e s t e r General H o s p i t a l , N e w Y o r k , straight surgery ISRAEL J. JACOBOWITZ, Bellevue H o s p i t a l C e n t e r , N e w Y o r k C i t y , surgery residency BRUCE R. JAVORS, N.Y. Med. College/Metropolitian, New York City, radiology/diagram residency DANA E. JOCK, Mary Imogene Bassett H o s p i t a l , Cooperstown, N.Y., rotating LEELAND JONES, Buffalo General/Meyer Hospitals, Buffalo, rotating medicine BARRY A. KASSEL, H a r t f o r d H o s p i t a l , Connecticut, surgery residency DOUGLAS L. KIBLER, Buffalo General/Meyer Hospitals, Buffalo, rotating JOSEPH T. KING, Cleveland Clinics, Ohio, general rotating MICHAEL KLEIN, Syracuse Medical Center, New York, ob/gyn residency JOHN T. KLIMAS, Johns Hopkins Hospital, Baltimore, pediatrics residency PAUL KURITZKY, Millard Fillmore Hospital, Buffalo, rotating medicine SHARON KURITZKY, Millard Fillmore Hospital, Buffalo, rotating medicin FALL, 1973 17 �ROBERT S. LaMANTIA, B u f f a l o G e n e r a l / M e y e r H o s p i t a l s , B u f f a l o , r o t a t i n g medicine DANA P. LAUNER, North S h o r e / M e m o r i a l H o s p i t a l , N e w Y o r k C i t y , surgery residency DEXTER S. LEVY JR., Santa Barbara C o t t a g e H o s p i t a l , C a l i f o r n i a , rotating NANCY L. LIEBERMAN, New E n g l a n d Medical Center ( T u f t s ) , straight p e d i a t r i c s JEFFREY LIGHT, C e d a r s Sinai M e d i c a l C e n t e r , Los Angeles, straight medicine JOHN I. LOWENSTEIN, Washington H o s p i t a l , D . C . , rotating general THOMAS A. LOMBARDO JR., Millard F i l l m o r e H o s p i t a l , B u f f a l o , surgery residency The Art Mruczeks JAMES S. MARKS, University o f C a l i f o r n i a ( S a n F r a n c i s c o ) , pediatrics residency MARY JANE MASSIE, E.J. Meyer Memorial Hospital, Buffalo, psychiatry residency C H A R L E S J. M c A L L I S T E R , M e a d o w b r o o k H o s p i t a l , E a s t M e a d o w , N . Y . , s t r a i g h t m e d i c i n e RICHARD B. McCORMICK, Charity Hospital, Louisiana, straight surgery DANIEL J. McMAHON, Deaconess Hospital, Buffalo, family practice residency STEVEN J. MORRIS, Grady Memorial Hospital, Atlanta, straight medicine ARTHUR W. MRUCZEK, Buffalo General/Meyer Hospitals, Buffalo, straight medicine MICHAEL V. MURPHY, Millard Fillmore Hospital, Buffalo, rotating general JOSEPH M. MYLOTT, Deaconess Hospital, Buffalo, straight surgery STEPHEN A. NASH, Maricopa County G e n e r a l , P h o e n i x , rotating general VINCENT NAT A LI TIMOTHY NOSTRANT, U n i v e r s i t y o f Michigan, A f f i l i a t e d Hospitals, Ann A r b o r , straight medicine PATRICK L. O'CONNOR, M i l l a r d Fillmore Hospital, r o t a t i n g surgery PAUL A. ORENS, St. Peters Hospital, Albany, radiology/general residency RONALD D. OSGOOD, Mercy Hospital, Buffalo, rotating general EUGENE OSTROFF, Buffalo General/Meyer Hospitals, Buffalo, rotating general PAUL A. PALMA, Presbyterian H o s p i t a l , N e w Y o r k C i t y , straight pediatrics GARSUTIS K. PALYS, Hershey M e d i c a l C e n t e r , P e n n s y l v a n i a , f a m i l y p r a c t i c e r e s i d e n c y ROBERT L. PENN, N.C. Memorial, Chapel H i l l , N . C . , straight medicine DANIEL A., PIETRO JR., B u f f a l o G e n e r a l / M e y e r Hospitals, B u f f a l o , r o t a t i n g medicine IRA H. PORES, B u f f a l o General/Meyer H o s p i t a l s , B u f f a l o , rotating medicine MELVIN R. PRATTER, A l b a n y H o s p i t a l , N e w Y o r k , straight medicine JOHN E. PRZYLUCKI, M i l l a r d Fillmore H o s p i t a l , B u f f a l o , surgery residency STEVEN T. PUGH, M e d i c a l C o l l e g e o f Virginia, Richmond The Dan Wistrans The Ralph Hallacs THE BUFFALO PHYSICIAN �T h e babies stole t h e s h o w Re t a Floyd (right) and friend ANDRE RASZYNSKI, C h i l d r e n ' s H o s p i t a l , B u f f a l o , pediatrics residency SCOTT G. READER, Buffalo General/Meyer Hospitals, Buffalo, rotating general MICHAEL A. RIOZZI JR., St. Mary's Hospital, Long Beach, California, rotating LYNNE S. ROSANSKY, Maimonides Hospital, Brooklyn, rotating medicine J U D I T H R O U S S O , E.J. M e y e r M e m o r i a l H o s p i t a l , p s y c h i a t r y r e s i d e n c y JACOB D. ROZBRUCH, New York/Memorial Hospital, pediatrics residency JON P. RUBACH, Buffalo General/Meyer Hospitals, Buffalo, rotating medicine BARRY SANDERS, B u f f a l o General/Meyer H o s p i t a l s , B u f f a l o , rotating medicine MICHAEL A. SANSONE, B u f f a l o G e n e r a l / M e y e r H o s p i t a l s , B u f f a l o , straight medicine MICHAEL R. SAVONA, Presbyterian H o s p i t a l , N e w Y o r k C i t y , straight medicine MARK N. SCHEINBERG, C h a r i t y H o s p i t a l , Louisiana, straight ob/gyn ARNOLD W. SCHERZ, Bronx M u n i c i p a l H o s p i t a l C e n t e r , B r o n x , pediatrics residency ROBERT SCHULMAN, Children's Hospital, B u f f a l o , pediatrics residency DENNIS SCHUSTER, University o f K e n t u c k y M e d i c a l C e n t e r , L e x i n g t o n , straight surgery ARTHUR SGALIA, B u f f a l o G e n e r a l / M e y e r H o s p i t a l s , B u f f a l o , straight medicine ROGER SIMON, B u f f a l o G e n e r a l / M e y e r Hospitals, B u f f a l o , rotating medicine ROY W. SLAUNWHITE III, Children's H o s p i t a l , B u f f a l o , pediatrics r e s i d e n c y STEPHEN A. SMILES, Bellevue H o s p i t a l C e n t e r , N e w Y o r k C i t y , straight medicine RICHARD A. SPECTOR, Charity H o s p i t a l , Louisiana, rotating DENNIS E. STEMPIEN, University of Minnesota, Minneapolis, straight medicine DARLENE THORINGTON, Deaconess Hospital, B u f f a l o , f a m i l y practice residency T h e Barry Sanders JOHN P. VISCO, E.J. M e y e r Memorial H o s p i t a l , B u f f a l o , straight medicine RONALD L. WASHBURN, University of Michigan, Ann Arbor, r a d i o l o g y / d i a g . r e s i d e n c y THOMAS D. WASSER, Rochester G e n e r a l H o s p i t a l , N e w Y o r k , rotating general MATTHEW H. WEBER, E.J. M e y e r Memorial H o s p i t a l , B u f f a l o , rotating surgery RICHARD L. WIGLE, K e e s l e r A i r Force Base, B i l o x i , M i s s . , straight medicine GARY J. WILCOX, Los Angeles County Harber General, C a l i f o r n i a , s t r a i g h t p a t h o l o g y CHARLES E. WILES III, E.J. M e y e r Memorial Hospital, B u f f a l o , surgical r e s i d e n c y EDWARD L. WILSON, Millard F i l l m o r e H o s p i t a l , B u f f a l o , rotating medicine JONATHAN WISE, Memorial Hospital, New York City, pediatrics residency DANIEL C. WISTRAN, Rhode Island H o s p i t a l , Providence, straight medicine ROBERT A. WOOLHANDLER, B u f f a l o General/Meyer H o s p i t a l s , B u f f a l o , rotating medicine HENRY M. WYMBS, B u f f a l o General/Meyer Hospitals, B u f f a l o , rotating medicine LYNDA M. YOUNG, Children's Memorial Hospital, C h i c a g o , straight p e d i a t r i c s LAWRENCE ZEMEL, Children's H o s p i t a l , B u f f a l o , pediatrics residency LOUIS R. ZIBELLI, Monte/iore H o s p i t a l , N e w Y o r k C i t y , straight medicine FALL, 1973 19 �In cold room working with electrophoresis are Mrs. Eddy and Drs. Giilman, Bigazzi and Van Oss. I Separating Living Cells in Outer Space 20 NCREASING THE DEFENSE MECHANISMS of those who suffer from immunological disease may be a step closer to reality through pioneering investigations underway by a team of immunologists at the Medical School. Headed by Dr. Pierluigi E. Bigazzi, the team is devising a way to separate living cells through their electrical charge, something that has always been hard to do because of interference from the force of gravity. Their proposal, to study this phenomenon where there is no problem — in outer space where at zero gravity there is no cell sedi­ mentation and therefore separations can be per­ formed easily with simple devices — was awarded a major NASA contract. The group who is working with the research associate professor of microbiology are Dr. Cetewayo Giilman, research associate; Mrs. Martha Eddy, research technician, the staff of the department of microbiology's immunochemistry laboratory directed by Dr. Carel J. van Oss. Consultants are Drs. Noel R. Rose and Stan­ ley Cohen of The Center for Immunology at the University. THE BUFFALO PHYSICIAN �"The most important cell for immunologic reactivity," said Dr. Bigazzi who is a graduate of the University of Florence (Italy), "is the lymphocyte." Subdivided into at least two populations, they are T (thymus-dependent) and B (bone marrow-derived) cells. T cells, involved in cell-mediated immunity, make up a variety of substances known as "lymphokines." B cells, on the other hand, are involved in antibody formation. Deficiencies in T and/or B cells cause severe human diseases such as agammaglobulinemias, Di George's syndrome, etc. Or they may occur in patients with various malignancies such as Hodgkin's disease and chronic lymphatic leukemia. "It is clear," Dr. Bigazzi said, "that if we want to restore immunological compe­ tence to a deficient individual we must be sure that we are giving the right kind of lymphocytes or their products to the patient. If we can do so, we can specifically strengthen the protective defenses of those who suffer from certain types of tumors, chronic infections or who need to undergo organ transplantations." Electrophoretic separations are done by allowing the negatively charged cells — in sus­ pension in water — to migrate in an electric field toward the positive electrode. T cells, more negatively charged than B ones, must migrate faster. But during the time it takes for T cells to run significantly ahead of B cells, all of the cells will have settled to the bottom of the vessel at one (1.0) gravity on earth. Until now the only way that T and B cells have been separated is through microanalytic methods that have produced minute quantities and with the help of very complicated steady state fluid flow electrophoresis contrivances. The Buffalo team hopes to find a simple method to separate them in larger amounts for later use in clinical situations. But to do this they must find ways to simulate by different densities something close to the zero gravity that is found in outer space. Explained Dr. van Oss, "we must be able to simulate on earth what we hope to accomplish in outer space." And the team has already begun to get resultsj ^ Dr. Gillman and Mrs. Heide count the number of lymphocytes in fraction separated preparation by electrophoresis. FALL, 1973 21 �"With the aid of heavy water at one grav­ ity," the professor of microbiology continued, "we have been able to fool lymphocytes into thinking for a short time that they are at zero gravity. And by using electrophoretic migration from the bottom to the top of a tube, we have recently succeeded in having the most nega­ tively charged (T) cells overcome gravity and rise to the top before the B cells." While separations are now being achieved with quantities of cells running about several hundred thousand per fraction, the team hopes to separate millions to billions of cells. When enough data are collected in their laboratory on earth, experiments for Skylab and its con­ tinuous Shuttle will be planned. But first prior­ ity of the team is to devise a method to freeze lymphocytes for their trip to Skylab and immediate return to earth following separation. On the trip of Apollo 16 to the Moon an electro­ phoretic separation of different inert latex parti­ cles was achieved at zero gravity. This demon­ strated the feasibility of doing electrophoresis at zero gravity. Work is now underway in Buffalo's immunochemistry laboratory as well as at NASA to prepare the way for more sophisticated zero gravity cell electrophoresis experiments. Explained Dr. van Oss, "Although this approach awaits the development of continuously operating space laboratories to be applied routinely to clinical problems, these pioneering investigations should open the way for such applications. • The "team" discuss progress on electrophoresis of lymphocytes. �President Robert L. Ketter has appointed a five-member Task Force to study the utilization of University staff, facilities and funds now devoted to teaching and research in the life sciences. Einstein Profes­ sor Jui H. Wang will chair the Task Force on the Utilization of Life Science Resources which has been charged with determining whether the present organizational structure contributes "in an optimal fash­ ion to the accomplishment of our teaching, research and service missions." Two Medical School faculty members — Sir John C. Eccles, Nobel Laureate and distinguished professor of physiology and bio­ physics, and Dr. Om P. Bahl, professor biochemistry — are on the task force. The other members are Dr. Peter T. Lansbury, professor of chemistry and Dr. Frank A. Loewus, professor of biology. Dr. Ketter, in a letter to the Task Force, noted that "The Univer­ sity's organizational chart suggests, at first glance, a possible duplica­ tion or overlap" of resources. He noted that there are eight depart­ ments involved in the study of biology or specialized areas of biology. There are five departments concerned with chemistry. Pharmacology is offered in departments located in the Schools of Medicine and Pharmacy and at Roswell Park Memorial Institute. Dr. Ketter asked the Task Force to examine the present organiza­ tional structure and answer the question "Are there alternative modes of organization which might lead to a better utilization of University resources and a more efficient accomplishment of our objectives?" No deadline was set for the group, but Dr. Ketter said he wishes to impress upon its members "the primary importance and urgency of the problem" and that he hopes the Task Force will present a report to him as soon as possible. • Medical School Executive Officer Dr. Clyde L. Randall, vice president for health sciences at the Univer­ sity since 1970 and acting dean of the School of Medicine since 1971, has been appointed executive officer of the School of Medicine. Dr. Robert L. Ketter, president, made the appointment on the recommendation of Dr. F. Carter Pannill, who became vice president for health sciences on July 1. Dr. Randall will hold the post until a permanent dean is appointed. An 11-member search committee, chaired by Dr. Alan J. Drinnan, was appointed in March to find and recommend candidates for the deanship. No deadline for the committee has been set, although Vice President Pannill has said that he would like to have the new dean appointed as soon as possible. Referring to Dr. Randall's new assignment, President Ketter said, "We are deeply indebted to Dr. Randall for accepting this interim assignment with the same dedication he has shown in his key position as vice president for health sciences during the past three years. We are most fortunate to have his experience and ability as we launch a new era for health sciences at this University." • FALL, 1973 Life Science Resources �Dr. Edward F. Marra gives final instructions to the graduates. 127th Annual Commencement It was traditional. There was the procession of cap-and-gown clad Doctor of Medicine candidates and faculty, the Invocation, and oathtaking (Maimonides as well as Hippocratic). There was the hooding and signing of the Book of Physicians where family and friends individually acknowledged their loved ones. There was the dedi­ cation of the medical/dental school yearbook, MEDENTIAN by the class to Dr. Jules Constant and his eloquent response. There was the class president's moving charge to the graduates, as well as recog­ nition for outstanding work through awarding of prizes. But, added was the graduates' plea to support Dr. Mohamed Megahed denied tenure and promotion — and the conferring of Mas­ ters and doctor of philosophy degrees to basic sciences candidates at the School of Medicine ceremonies. • The processional. The Medical School had its own commencement for the first time in recent years. It was com­ bined with the annual class day awards. The University had 15 separate Commencement Ceremonies in May for the first time. • 24 �18 Seniors Honored Eighteen senior medical students shared 1'5 awards at commence­ ment exercises of the School of Medicine, May 20 at Kleinhans Music Hall. One, Michael R. Savona, earned three while three others, Wil­ liam J. Ackerman, Robert L. Penn, and Michael A. Sansone, earned two each. The awards were presented to the following by Dr. Clyde L. Randall, acting dean of the School of Medicine and vice president for Health Sciences who also conferred 115 MD degrees to the seniors. To basic sciences graduate students 43 PhD degrees, 24 Master of Arts degrees, and four Master of Science degrees were awarded. Alpha Omega Alpha (National Honorary Society) — William J. Ackerman, Dana E. Jock, Nancy L. Lieberman, Charles J. McAllister, Robert L. Penn, Melvin R. Pratter, Michael R. Savona, Stephen A. Smiles, Richard A. Spector, Dennis E. Stempien. Thesis Honors — Daniel C. Wistran U p j o h n Award (zeal, diligence, application in study of medicine) — Maxine D. Hayes B u f f a l o S u r g i c a l Society Prize in Surgery (academic excellence) — Dana P. Launer David K . Miller Prize in Medicine (demonstration of Dr. Miller's approach to caring for the sick — competence, humility, humanity) — Michael A. Sansone Gilbert M. B e c k Memorial Prize in Psychiatry (academic excellence) — James S. Marks Philip P. Sang Memorial A w a r d (efficiency in practice of medicine, dedication to human values) — Michael R. Savona Morris Stein Neural Anatomy Award (excellence in neural anatomy) — Michael V. Murphy Maimonides Medical S o c i e t y Award (application of basic science principles to practice of medicine) — William J. Ackerman Hans J. Lowenstein Award in Obstetrics (academic excellence) — Michael R. Savona B e r n h a r d t a n d Sophie B. G o t t l i e b Award (combination of learning, living, serving) — Michael A. Sansone M a r k A . Petrino Award (demonstrated interest, aptitude for general practice of medicine) — Daniel J. McMahon Lieberman A w a r d (interest, aptitude in study of anesthesiology) — Steven T. Pugh Emilie D a v i d Rodenberg Memorial Fund (academic excellence in study of diabetes, its complications) — Kenneth L. Gayles Dr. Heinrich Leonhardt Prize in Surgery (academic excellence) — Robert L. Penn • FALL, 1973 25 Linda Young, Dr. Cummiskey Michael Sansone, class president all four years, said "complete and competent medical care is our prime motivation . . . that he (Dr. Megahed) has literally devoted mind/soul to educating students, caring for patients." �"I have always used teaching as a way to make learning easier /or myself . . . I have learned much from teaching you," Dr. Jules Constant said. He was honored in the Medentian. Graduate students receive their master's and Ph.D. degrees. Five black students were among the 115 medical graduates. Only six black physicio graduated from the Medical School before 1967. Roger Simon receives congratulations from William C. Baird, chairman of the University council. Charles Anderson, Dr. Thomas Cummiskey Kenneth Gayles, Dr. Cummiskey THE BUFFALO PHYSICIAN « �In a commencement luncheon address on the tenth floor of Goodyear Hall, President Robert L. Ketter said that the 1973 graduating class of 5,853 students is the largest in the school's history and brings to a total of 71,928 the number of graduates of the school since it was founded in 1846. More than half of that total, 38,767, have graduated in the eleven years U/B has been a member of the State University of New York. As a private institution, the University graduated only 33,161 in the 116 years from 1846 to 1962. Dr. Ketter made special note of the 97 Equal Opportunity Program students receiving their degrees, 23 of whom have achieved honors. 16 were graduated cum laude, 5 magna cum laude and 2 summa cum laude. One of the summa cum laude students maintained an academic average of 3.8 of a possible 4.0. The Equal Opportunity Program was initiated at U/B for underprivileged students following the assassination of Martin Luther King in 1968. This year's class is the program's second full graduating class. In analyzing the total number of 1973 U/B graduates, Dr. Ketter said that 484 doctorates, 1,290 masters, 3,664 bachelors and 45 associate degrees are being awarded. 115 medical doctors and 75 dentists were graduated, while the School of Law awarded 180 Juris Doctor degrees. The graduates came from 49 New York State counties, 18 states, and 35 foreign counties. Commenting on U/B's decentralized commencement ceremonies initiated this year, Dr. Ketter described "preliminary opinions" as "favorable." He said that the 15 separate ceremonies attracted more than 13,000 friends or members of the families of graduates and a higher proportion of graduates than participated last year. Dr. Ketter concluded his remarks by citing seven members of the U/B faculty and staff retiring this year after a combined University service of 225 years. They are: Dr. Gregory Breit, distinguished profes­ sor of physics; Dr. Raymond Ewell, former vice president for research; Miss Dorothy M. Haas, former director of Norton Hall; Dr. John Horton, professor of American history and former department chairman; Dr. A. Margaret Larsen, former chairman of functional nursing; Dr. Harriet F. Montague, professor of mathematics, and Dr. Oscar A. Silverman, director emeritus of university libraries and former Eng­ lish Department chairman. • Drs. S. Mouchly Smali, Cedric Smith, Edward Marra. FALL, 1973 27 5,853 Graduates �Drs. EJJison and Ronald Rohe, a Fellow in oncology and hematology, examine a patient. T, A New Medical Oncology Unit REATMENT, TEACHING AND RESEARCH are the main thrusts of the first Medical Oncology unit at the E. J. Meyer Memorial Hospital. Here, Dr. Rose Ruth Ellison and a team of oncologists, fellows, and residents will study and treat the gamut of neoplastic diseases seen in the outpatient service and in the hospital. They will also provide consultation and work with physicians and surgeons treating patients who have neoplastic diseases. "Our group," says Dr. Ellison who is an associate professor of medicine, "will be particularly involved with patients who have recurrent disease and those with neoplastic problems who are no longer amenable to surgical or irradiation treatment." The investigator, who has over 20 years of experience in clinical cancer research, drug trials, clinical pharmacology in leukemias, lymphomas, and solid tumors, is planning a joint medical oncology/hematology training program where medical house staff and fellows will study the natural history of these diseases. "We want them to learn about methods of specific and supportive care for these patients," Dr. Ellison, who is also the hospital's associate direc­ tor of medicine, said. The fellows will also participate in clinical pharmacologic studies that must precede the therapeutic evaluation of new drugs in patients with cancer. For medical students, there will be a joint medical oncology/sur­ gery approach to their cancer teaching program. The medical oncology team will join the surgical group headed by Dr. Gerard Burns, who is associate professor of surgery, in clinical conferences, discussion of patient care and didactic lectures for the student who will have access to cancer teaching materials. For those seniors who want a more concentrated approach, there will be the opportunity of an elective in the medical oncology unit. Says Dr. Ellison, "Before we give any drug to a patient, we want to complete a wide range of clinical and laboratory studies to arrive at a profile of a tumor in that patient. We then treat according to protocols that take advantage of the chemical structure and bio­ chemical activity of the drugs involved. Such protocols standardize the routes and schedules of drug administration, the measurement of the effects of a compound on the tumor in a particular disease, the kinds of patients to be treated, and the methods for analyzing the effects. We have developed a standardized type of record keeping that involves an enormous amount of cooperation among national investigators as a means to learning more about clinical cancer and improving available treatment." 28 THE BUFFALO PHYSICIAN �Dr. Ellison, a graduate of Columbia University College of Physi­ cians and Surgeons, will continue as executive officer of an inter­ national cooperative group, Acute Leukemia Group B, which is active in evaluation of new chemotherapeutic methods in leukemias, lymphomas, and solid tumors. In this research group, funded by the National Cancer Institute and headed by Dr. James F. Holland, research professor of medicine and chief of Medicine A at Roswell Park Memorial Institute, are clinical and laboratory scientists from over 50 hospitals and six countries who study the results of treatment in more than 1500 patients a year. Such patients, are treated under formal controlled protocols with standardized methods of treatment, record keeping and evaluation. Clinical research in such cooperative studies, points out Dr. Ellison, has already led to development of markedly improved treatment for acute leukemia in children. Less marked, but definite improvement in available treatment for acute leukemia in adults, is now being seen. "While chemotherapy alone is curative only in some patients with choriocarcinoma, Wilm's tumor and Burkitt's lymphoma (and hopefully in some children with lymphocytic leukemia), it is pallia­ tive in numerous other situations," says the former associate chief of Medicine A at Roswell Park Memorial Institute and staff member at Memorial Hospital and Sloan-Kettering Institute in New York City. "It is expected that large-scale study of combinations of drugs — alone or in combination with other modalities of therapy — will lead to considerable improvement in the treatment of other cancer," she said. Dr. Ellison is a member of the Advisory Committee on Clinical Investigation of the American Cancer Society, The Cancer Clinical Investigation Review Committee of the National Cancer Institute, and the National Board of Trustees and the Medical and Scientific Advisory Committee of the Leukemia Society of America, Incor­ porated. She is also secretary-treasurer of the American Society of Clinical Oncology, and will continue to be a consultant at Roswell Park. Dr. Ellison's husband, Dr. Solon A. Ellison, is professor and chairman of the Oral Biology Department in the Dental School at the University. • Dr. Edward S. Hender­ son is the new chief of Medicine A at Roswell Memorial Institute. He served as head of the Leukemia Service Department, National Cancer Institute, Bethesda, Md., since 1965. Dr. Henderson re­ places Dr. fames F. Hol­ land who joined the staff of Mt. Sinai Hospi­ tal, New York City. Dr. Stephen AJpert, Dr. Ronald Rohe, Dr. Ellison, Stephen Yerkovich, 3rd year medical student, Donald Younkin, 3rd year medical student, and Dr. Richard Bettigole, associate professor of medicine, examine a patient. �Summer Fellowships For 49 medical students, studies were not over when the spring session ended in May. Through the unique opportunity of $750 to $1000 fellowships, 30 freshmen, 16 sophomores, and 3 juniors are spending a ten-week period in a new or continuing clinical or research experience. In reviewing applications received from medical students that outlined proposed research or clinical projects under specific precep­ tors, the six member summer fellowship committee (three from basic sciences, an equal number representing clinical departments) under chairman Dr. Carl J. Bentzel awarded nine $1000 fellowships to con­ tinue outstanding projects begun earlier. Through this program, the associate professor of medicine hopes to encourage medical students to continue project-oriented research on their own time during their four years of medical school. Pointed out Dr. Bentzel, "some of these projects are as carefully planned and pursued as research projects by senior faculty." Receiv­ ing these special stipends were Jack Cukierman, John Hedger, Lynne Hochberg, Michael Nakao, Mary Roembolt, Ian S. Brown, James Burdick, Nina Kostraba, and Robert Weiss. Over half of the students (31) are working on projects involving basic medical sciences, clinical research as well as in the study of health care services. The remaining 18 are furthering their educa­ tion through preceptorships in the clinical field. Most (43) remain in Buffalo to work in University research laboratories and at Roswell Park Memorial Institute, in local hospitals or in health clinics located in the county. Two traveled to Ecuador and Colombia (South America) to gain insight into medical practices there while one is spending the summer at a Brooklyn Medical Center, another at the University of Rochester. $1,000 Continuing Fellowship Local Project Cukierman, Jack '75 Testing implanted device for peritoneal dialysis Hedger, John '75 Hochberg, Lynne '75 Nakao, Michael '75 Roemboldt, .Mary '75 Brown, Ian S. '74 Burdick, James '75 Kostraba, Nina '75 Weiss, Robert '76 Effect of antiarrhythmic drugs on digitalis-induced atrial arrythmias Morphological study of two neurosecretory systems related to salt/water balance in Lebistes Reticulatus Perception/processing of stimuli alternating between receptive surfaces in audition/somesthesis AC current response to altering epithelial morphology Sensitization of human lymphocytes to autologous malignant cells Induction/treatment of Wilm's tumor in Wistar/Firth rats Nonhistone proteins/gene regulation Enhanced sensitization of cultured human lymphocytes to autologous malignant cells CLINICAL Bishop, William C. '76 Experience in a mental health emergency clinic Gitterman, Benjamin '76 Community medicine Goldfield, Norbert '76 Societal response to managing drug abuse 30 Jewish Hospital/Medical Ctr., Brooklyn, Dr. B. Levowitz E.J. Meyer Hospital, Dr. S. Wittenberg Anatomical Sciences, Capen Hall, Dr. E.R. Hayes Psychiatry, 2211 Main Street, Dr. S. Axelrod Veterans Hospital, Dr. C. Bentzel Roswell Park Mem. Institute, Dr. J. Mitchen Roswell Park Mem. Institute, Dr. G. Murphy Biology dept., Dr. T. Wang Roswell Park Mem. Institute, Dr. J. Mitchen E.J. Meyer Hospital, Dr. M. Gerstenzang Jesse Nash Health Center, Dr. A. Goshin E.J. Meyer Hospital, Dr. C. D'Amanda THE BUFFALO PHYSICIAN �Kramer, Stanley J. '76 General preceptorship in a state school Krawczyk, Justine A. '76 Experience in treatment of alcoholism Krypel, Geraldine '76 Community health care/delivery Lichtenstein, Howard '76 Preceptorship in geriatrics Pohl, Melvin I, '76 Ritter, Thomas L. '76 Child psychiatry Rural clinic/hospital experience Russell, Keith '74 Evaluating infants born to methadone dependent mothers Shriro, Linda '76 Tardino, John A. '76 Child psychiatry Rehab, approach to physically handicapped/retarded children Weiss, Barry D. '76 Rehab, approach to physically handicapped/retarded children RESEARCH Local Anderson, Serafin C. '76 Bartkowski, Henry '74 Cohen, William I. '75 Bowe-Anders, Constance '76 Ferraras, Richard '75 Friedes, Francine E. '76 Fogel, Marshall A. '76 George, Donald E. '76 Horner, Douglas '76 King, Janet '76 King, Peter '76 Kulick, Kevin B. '76 Lazoritz, Stephen '76 Neander, Michael J. '76 Nocek, Marie A. '76 Project Compare blood pressure measurements in low birth weight infants by three different methods Electron microscopic studies of human ependymal linings in hydrocephalus Idiopathic hypopituitarism Postnatal dev/funct. differential of mammalian retina Antibody response to specific bacterial infections Relating ob/gyn patient's sex edu/attitudes on menustration/ovulation/pregnancy to socio/econ status Estrogen antagonism of activating effect of androgens on prostatic membrane ATPase Isolate/characterize hexoseaminidase A; invest. Tay-Sachs disease Factors affecting cadmium distr/excretion in rat Evaluate psychiatric problems in patients undergoing radical surgery for cancer therapy Specimen preparation for gross human anatomy Study knowledge/attitudes on pre/postabortion counseling of male Investigate relationship between pharmacokinetics of anti­ bacterial agents/clinical success of drug therapy in urinary tract infection of pediatric patient Prepare prosected specimen for gross anatomy Samuel, Agnes L. '76 Schenk, Carlos '76 Study ligation of intestinal lymphocytes; effect on serum lipids DNA content of normal/abnormal cells in retina of rat Failure of prenatal masculinization Szfler, Hanley J. '75 Renal clearance of digoxin used as guide to drug therapy Wagman, Bernard '76 Anesthesia procedures, respiratory physiology Warner, Natalie '75 Zak, Thaddeus A. '76 Effect of 6-aminonicotinamide on dev. nervous system/rat Physiologic function of superoxide dismutase; a "new" enzyme Rowland, Michael C. '75 West Seneca State School, Dr. L. Huzella Veterans Hospital, Dr. L. Lewandowski Lackawanna Community Health Ctr., Dr. A. Goshin Buffalo State Hospital, Dr. N. Winkelstein Children's Hospital, Dr. T. Anders Concord Medical Grp, Springville, Dr. C. Rodgers E.J. Meyer Hospital, Dr. C. D' Amanda Children's Hospital, Dr. T. Anders Children's Rehab. Center, Dr. E. Warner Children's Rehab. Center, Dr. D. Kerr-Grant Children's Hospital, Dr. G. Ciacoia Anatomical Sciences (Capen Hall Neurosurgery (Meyer), Drs. J.C. Lee, L. Bakay Children's Hospital, Dr. T.Aceto Neurosensory Lab., Dr. W. Noell Children's Hospital, Dr. E. Neter E.J. Meyer Hospital, Dr. L. Hevizy Veterans Hospital, Dr. W.E. Farns worth Children's Hospital, Dr. R. Davidson U. of Rochester, Dr. J.C. Smith Roswell Park Mem. Institute, Dr. M. Plumb Anatomic Sciences (Capen Hall), Dr. J.C. Lee Erie County Medical Group, Mrs. E. Kaiser, C. Lechner Children's Hospital, Dr. T.Aceto Anatomical Sciences (Capen Hall), Dr. J.C. Lee Veterans Hospital, Drs. D. Dean, A. Gage Neurosensory Lab., Dr. W. Noell Children's Hospital, Dr. H. Meyer-Bahlburg Millard Filmore Hospital, Dr. F. Kauffman E.J. Meyer Hospital, Dr. R. Markello Pharmacology Dept., (Capen Hall), Dr. F. Kauffman Biochemistry Dept., (Capen Hall), Dr. M. Ettinger FAMILY PRACTICE (arranged by Dr. James R. Nunn) Cassiano, Coley J. '75 Dr. Robert Haines, 3435 Bailey Avenue Franklin, Hall A. II '75 Dr. Herbert E. Joyce, 3435 Bailey Avenue Zinn, Steven '75 Drs. E.R. Haines, J. Nunn, Deaconess Hospital INTERNATIONAL Burke, Alan M. '76 Trautman, Paul D. '75 FALL, 1973 Clinical Urdess, Guayaquil (arranged by Dr. E. Beutner) Ibaqune, Columbia Medical practice in Ecuador Clinical preceptorship in a Colombian hospital 31 �Drs. Cohen and Bigazzi go over research results. Cellular Immunity Dr. C o h e n h a s contributed over 50 scientific articles and is editor of three journals in his field. He has co-authored a book with Dr. Robert T. McCiuskey of Harvard University, who served as chairman of path­ ology at UB from August 1968 to September 1971 on Mechan­ isms of Cell-Mediated Immun­ ity. It d e t a i l s v a r i o u s a r e a s o f immunology mentioned in this story. • 32 There is a diverse approach in Buffalo to the study of a rapidly-growing field of immunologic research called cellular immunity. A team of investigators with Drs. Stanley Cohen and Takeshi Yoshida, are looking at a specific class of immune reaction that is mediated by living cells called lymphocytes rather than by anti­ bodies. This immunologic response functions as an enhancing system. For it makes inflamma­ tory cells work more effectively at sites where antigen is present in the body. Responsible for this activity are factors known as lymphokines. Soluble substances pro­ duced by sensitized lymphocytes, they also pro­ duce profound effects on many other kinds of cells. The first lymphokine to be discovered, migration inhibition factor (MIF) by Dr. John David of New York University and Dr. Barry Bloom of Albert Einstein University, is now under study in the laboratories of Dr. Cohen. What the professor of pathology and former acting director of The Center for Immunology basically wants to do "is to identify new lymphokines, characterize them in relation to one another, and explore the range of their bio­ logical activity." This approach was pursued in his studies with Dr. Hidekichi Sonozaki on the effects of lymphokines on inflammatory exudate cells within the peritoneal cavity of guinea pigs. Not only did they show that MIF (previously defined only in vitro) could function within the intact animal but that a specific kind of lymphocyte, called a T-cell, was responsible for the reaction. Also pinpointed in some lymphokines was another important property known as chemotaxis. These are chemical agents which attract living cells. These findings led to a series of experi­ ments on chemotaxis of various inflammatory cells with Dr. Motomichi Torisu and University of Connecticut's acting pathology chairman Dr. Peter Ward. The investigators were the first to THE BUFFALO PHYSICIAN �discover the mechanism by which eosinophils are attracted to immunologic reactions in cer­ tain allergies and autoimmune diseases. This mechanism involves the formation of a sub­ stance called ECF by sensitized lymphocytes. Said Dr. Cohen who is a Columbia College of Physicians and Surgeons graduate (1961), "during our investigations we continually ask whether substances under study have any real significance inside the body. While it is obvi­ ously worthwhile to describe a factor affecting cells in a test tube or tissue culture system, until we know that it functions in vivo we have no proof that it is useful in protection against disease." He cited a lymphokine discovered through a biophysical technique pioneered by micro­ biologist Dr. Carel J. van Oss that affects the surface tension of inflammatory cells. However it awaits the defining of an in vivo system to prove whether it may play an important role in modifying inflammatory cells by making them more efficient scavengers. Dr. Yoshida checks a lymphocyte culture. FALL, 1973 Dr. Cohen "asks" the results of a computer program. Because of continued concern with human applications, the investigators, joined by Dr. Takeshi Yoshida, turned to studies of mediator substances which could be directly extracted from immunologic reactions. They showed that many factors previously found only in cultures of sensitized lymphocytes could be detected in tissue extracts as well. "We seem to have established a link in the chain of events," said Dr. Cohen, "which begins with the 'switching on' of a specific lymphocyte and ends with an immunologically-induced inflammatory reaction." The lymphokines provide one route by which the immune system serves a protective function. It is especially important in diseases involving viruses, fungi, and certain intra­ cellular parasites. However the 36-year old immunopathologist is quick to point to similar factors made by other kinds of cells in the body that also play a role in resistance to disease. Their production is not dependent upon the immune system. He pointed to interferon pro­ duction as an example. Could cells infected by viruses be induced to produce substances which function like lymphokines as well as interferon? asked Drs. Cohen and microbiologist Dr. Tom Flanagan. With Drs. Peter Ward and Takeshi Yoshida they showed that mumps virus and Newcastle dis­ ease virus could induce nonlymphoid cells in tissue culture to produce MIF as well as chemotactic substances. I 33 cr �A group of investigators check a radioactive immunologic assay. Further investigations with oral biologist Dr. Robert Genco showed that mumps infection of monkey parotid glands led to the release of similar factors within the glands themselves. Extracts of these glands, when injected into nor­ mal tissues, produced identical inflammatory reaction to those in infected glands. Encouraged by results in infectious dis­ eases, the Buffalo team turned to a study of vari­ ous malignant states. With Dr. Pierluigi Bigazzi, they showed that certain oncogenic (tumorproducing) viruses could induce infected cells to make lymphokine-like substances. Moreover, in a series of experiments with Dr. Richard Zeschke lymphokines themselves were found able to modify the behavior of tumor cells. In cooperative studies with Drs. Ben Fisher of the Veterans and Richard Bettigole of the Meyer Hospitals, patients with lymphoma and leukemia are being studied for similar effects. Already demonstrated is the appearance of MIF in the sera of some of these patients at certain stages of their disease. Future studies are 34 planned by Dr. Cohen to correlate this promis­ ing lead with the extent of malignant disease or response to therapy. These diverse multidisciplinary ap­ proaches to the study of mechanisms of inflam­ mation and immunity involve pathologists, internists, surgeons, and microbiologists. Even computers are members of this informal "team." Continuing an interest he developed as a resi­ dent at the Massachusetts General Hospital and while training in immunology under Dr. Baruj Benacerraf at New York University, Dr. Cohen is performing computer simulation studies on the above phenomena. Much of the work has been done with Martin Milgrom, a medical stu­ dent at Columbia University This collaborative approach extends to training programs in which Dr. Cohen participates such as basic pathology course, an advanced elective in computer programming, W.H.O.-sponsored immuno methodology courses, and a series of international convoca­ tions sponsored by The Center for Immunology. • THE BUFFALO PHYSICIAN �Mr. Marshall G. Ause, director of management and planning for the Chicago-based American Hospital Association (since 1968) is the new director of the E.J. Meyer Memorial Hospital. He assumed his new duties August 1. A native of Minnesota, Mr. Ause has 27 years of experience in hospital administration. He holds a master's degree in hospital administration from the University of Minnesota and received his bachelor's degree from St. Olaf College, Northfield, Minnesota. He has held top level administrative posts at military hospitals in North Little Rock, Arkansas and St. Cloud, Minn., at civilian hospitals in Orange, Calif., Brooklyn, N.Y. and Milwaukee, Wisconsin. Mr. Ause has served on the advisory council for the Hospi­ tal Administration course at the University of Minnesota's School of Public Health and has' lectured at several West Coast colleges and universities. His responsibilities in Buffalo will include planning the operation of the county's new $87.5 million Comprehensive Health Center, under construction adjacent to the Meyer. "I was attracted to this position by the high quality of medical care, the dedicated hospital advisory board, the new facility under construction and the hospital's affiliation with the University Medi­ cal School. Also I think Buffalo will be a very attractive place to live." • Ause Heads Meyer Hospital Dr. Donald Larson Joins Faculty Dr. Donald A. Larson has been named associate vice president for health sciences and professor of biology. Since 1959 he has been professor of botany and director of education for health professions at the University of Texas at Austin. Dr. Larson, a native of Chicago, received his bachelor of science degree (1953) from Wheaton College and master of science (1955) and doctor of philosophy (1959) degrees from the University of Illinois. He received a Teaching Excellence Award from the University of Texas Students' Association in 1966. He is a member of the Botani­ cal Society of America, American Society of Cell Biology and Sigma Xi. He has authored more than 30 papers published in professional journals. • FALL, 1973 35 Dr. Larson �Two Health Sciences faculty members were cited for their dedication to teaching and concern for students in the Medical/Dental schools' student yearbook, Medentian. Dr. Gerard Wieczkowski, Jr. was hon­ ored by the dental students and Dr. Jules Constant by the medical students. Dr. Constant Medentian Honors Two Professors Dr. Wieczkowski Dr. Wieczkowski, 31, is assistant professor of operative and pub­ lic health dentistry. He joined the dental faculty in July 1969 as a teaching fellow following graduation from SUNYAB dental school. While a dental student he served as senior class president, editorin-chief, Medentian, was a member of the Med/Dent Student Council, on the dean's search committee, faculty conference on education, and received the senior class alumni award. As a faculty member he has lectured extensively throughout the state on preventive medicine among other subjects, and has been deeply involved in both student/faculty relations. His current research centers on developing a protocol to study anterior restorations and a staff study of pit/fissure sealants. Dr. Constant, 51, is clinical associate professor of medicine who has been on the faculty since 1962 when he was instructor in medicine. The Canadian-born cardiologist received his MD degree from the University of Toronto in 1953, interned at Washington, D.C.'s Central Dispensary and Emergency Hospital, followed by a residency in general practice in Arizona and a year of general practice in Canada before resuming his training in the field of internal medicine in San Diego's Mercy Hospital. A year in private practice there preceded a fellowship in cardiology in London with Dr. Paul Wood. He returned to Buffalo in 1960 to spend the next four years as a research fellow in cardiology at Buffalo General Hospital. He he authored several articles and two books, Bedside Cardiology and Learning Electrocardiography, (a complete course). In their dedication to Dr. Wieczkowski, the dental students said "in the four short years that Dr. Wieczkowski has been on our clinical staff he has shown a talent for teaching that has gained him the respect and admiration of those he has guided. Only when concern for the student and concern for the design of his educational experi­ ence are held primary, can the teacher most effectively achieve his goals. Dr. Wieczkowski is always available and approachable whether in or out of the clinic. He has taken active part in committees of faculty-student interaction where his unique background as recent graduate and instructor make him sensitive to the positions of both parties. In appreciation for his work and desire to serve us, we the Class of 1973, make this dedication." In their dedication to Dr. Constant, the medical students said "it is with great pleasure that the Class of 1973 dedicates this yearbook to Dr. Jules Constant . . . represents a very rare breed of medical educator — one who literally spends all his time with medical stu­ dents. There are very few members of the Class of 1973 who did not attend and thereby profit from his weekly sessions in cardiac physical diagnosis and electrocardiography during our sophomore year. And during any month of the school year at the Buffalo General Hospital one can see several senior students trailing behind him as they head for the coffee shop and a discussion or to one of the floors for a consult. It is his enthusiasm as a teacher and his neverending willingness to inconvenience himself and his family for the sake of students that has earned our deepest respect and gratitude." 36 THE BUFFALO PHYSICIAN �A1921 honor graduate of the Medical School was among eight leaders in education, business and politics honored in June at the 34th annual installation and awards dinner of the University's Alumni Associa­ tion. Dr. Bernhardt S. Gottlieb received the Distinguished Alumni Award. He is still in psychiatric practice in New York City and teaches at the State University Downstate Medical Center and New York University. Dr. Gottlieb interrupted his long practice for a three-year residency at the New York State Psychiatric Institute. He has also earned a bachelor's degree in social sciences from City College of New York, and a doctor of medical science in psychiatry from Colum­ bia University College of Physicians and Surgeons. Bernhardt Gottlieb has been president of Metropolitan New York City Medical Alumni of U/B, a member of the General Alumni Board and donor of an award which is given annually to a U/B medical graduate who combines living in the community and academic abil­ ity. He maintains a lively interest in alumni affairs and in particular, the Bernhardt S. and Sophie B. Gottlieb Psychiatric Library Fund. Mr. Gerald C. Saltarelli, chairman and president of Houdaille Industries, Inc., and Mr. Charles K. Bassett, businessman and philanthropist, received the Capen and Cooke Awards. Mr. Morley C. Townsend, immediate past president of the alumni association, received the President's Award from Dr. Robert L. Ketter. Four others — Hon. Earl W. Brydges, Hon. Charles S. Desmond, Dr. Anthony S. Gugino, and Dr. Olive P. Lester — received Distinguished Alumni Awards. • Dr. Gottlieb Honored Dr Future Alumni Receptions Since its inception in July' 1969 as a part of the annual alumni program, 611 alumni have attended cocktail receptions hosted by the Medical Alumni Association. Mr. David Michael, director of medical alumni affairs, said that the following receptions planned for 1973-74 are open to all alumni, faculty and friends of the Medical School. American College of Surgeons October 15-19, 1973 — Chicago, Illinois (Alumni Reception October 16, 1973 at Conrad Hilton) Medical Society of the State of New York February 24-28, 1974 — New York City Americana Hotel American College of Physicians April 1-5, 1974 — New York City American Medical Association June 22-27, 1974 — Chicago, Illinois American College of Surgeons October 21-25, 1974 — Miami, Florida, Fountainbleau Hotel • FALL, 1973 37 C nt+Hoh �JUNIOR MEDICAL STUDENTS are now coming For Steven Yerkovich who visits a patient in the home, "the home setting benefits both patient and physician. At least psychoiogically the patient is much better off." New Experience for Juniors 38 face-to-face with some of the major social prob­ lems that medicine is up against in health care for the poor outside of the hospital setting. As part of their medicine elective, students may now spend a full week getting indepth exposure in the E.J. Meyer Memorial Hospital's alcohol­ ism program, hemophilia or drug addiction cen­ ters (one is at the Sisters Hospital also). Or they may be assigned to either the Lackawanna or Allentown clinics or to the University Health Center. "Some students," pointed out Dr. Leonard Katz who is coordinator of third year medicine and heads this new learning experience for juniors, "are even selecting their own rural prac­ titioners in order to become familiar with a dif­ ferent set of social problems." For students assigned to the Lackawanna Clinic, there is not only an opportunity to help care for patients but to learn something of their socio/economic backgrounds during home vis­ its arranged by a family health worker. Agreed assigned students "the home setting benefits both patient and physician. At least psycho­ logically the patient is better off." But they debated whether better health care can be pro­ vided in the home. One student saw this type of medical experience as the "up and coming form of medi­ cine," and the Lackawanna Clinic as one of the "few places where we as students can get this more personal kind of experience" that he would have liked to last longer than a week. Others felt a week to be sufficient during the junior year. THE BUFFALO PHYSICIAN �Some students enjoyed dealing with the younger population "not sick enough to be in the hospital but too ill to remain in their rooms." At the University Health Service they witness a "real change from the wheelchair or bedridden hospital patient." Pointing to greater student responsibility was Dr. Luther Musselman who heads the Ser­ vice program for "illness here is not so serious." Students often make the decision as to what to prescribe. He felt the experience of all 13 students rotating through the service last year to be satisfactory to all concerned. Starting in the fall, each new week's group of students will hear a seminar arranged by Frank Corbett, Director of Urban Affairs at the University who has helped Dr. Katz plan this learning experience on health care for the poor. • Frank Corbett and Dr. Katz review plans for the fall program. John Pinneila exam­ ines a patient's foot during a home visit with family health worker Rosie Reves watching. FALL, 1973 39 �JUNIORS Dr. Carol Segal who runs Lackawanna Clinic program and Michaei Sdao see patient during ciinic hours. Keith Russell examines a student in the University Health Center as Dr. John B. Benny looks on. 40 THE BUFFALO PHYSICIAN �Continuing Medical Education Nine Continuing Medical Education Programs are scheduled during Fall, 1973, according to Mr. Charles Hall, director of continuing medical education. Dates, titles and chairmen of the programs are: September 6 —Arrhythmias, Dr. Jules Constant, clinical associate professor of medicine. October 2-3 —Human Sexuality, Dr. Norman Courey, clinical assistant professor of Ob/Gyn. October 11-12 —The Future Role of the State Hospital (sponsored by Division of Community Psychiatry, CME assisting), Dr.Jack Zusman, professor of psychiatry. October 25 —Hypertension (with Ciba Pharmaceutical), Dr. Charles M. Elwood, clinical associate profes­ sor of medicine.. October 29-31 —Computers in Clinical Practice (sponsored by Journal of Clinical Computing, CME assist­ ing), Dr. Elemer Gabrieli, clinical assistant professor of pathology. November 15 October 30 November 6 (Evening) December 4-5 —Evolving Patterns in Community Health, Dr. Henry P. Staub, associate professor of pediatrics. — Today's Management in Pulmonary Disease, Dr. John W. Vance, clinical associate professor of medicine. Gynecological Surgical Techniques, Dr. David Nichols, clinical professor of Ob/Gyn and Dr. Vincent J. Capraro, clinical professor of Ob/gyn. • Twenty-three alumni, wives, residents, faculty and guests attended the American College of Physicians alumni reception at the Conrad Hilton Hotel, Chicago, April 10. Mr. David Michaels, director of medical alumni affairs, was the host for the reception. Those attending from Buffalo were: Doctors George and Mrs. Bauemiller, M'59; Ron Boersma, resident; Marshall and Mrs. Clinton, MAO; John McConville, resident; Thomas G. Cummiskey, M'48; Sattar Farzan, faculty; Merrick Fisher, resident; Mahendra Mirani, facul­ ty; James Morris, resident; Bernard Norcross, M'38; Raymond and Mrs. Partridge, faculty; Sheldon Schwartz, resident; Kamal Tourbaf, faculty. Also — Paul A. Burgeons, M'36, Warsaw, New York; D. King, Philadelphia, Pennsylvania, guest; Michael and Mrs. Lippmann, M'70, Morgantown, West Virginia; James F. Stagg, M'47, Tuc­ son, Arizona; Jack and Mrs. Sternberg, M'72, Cleveland, Ohio. • FALL, 1973 41 Chicago Reception �Mothers sign in with their children. West Side Health Center Adequate health care for every person living on Buffalo's West Side. That is the motto of the West Side Health Center at 17 Pennsylvania Street, according to Mr. Ira Stohl, program coordinator. Mothers with their children flock to this outpatient clinic, located in an apartment house development area. It is here that a group of spirited health professionals (physicians, dentists, nurses, medical students and other volunteers) are working to bring better health care to residents of the area. The Center started as the AllentownLakeview Community Health Center on 273 Maryland Street on February 1, 1972. The Center's main source of income is the annual March on Hunger. In 1972 the Center's share was $6,700; in 1973 $5,000 (estimated). There are three free clinics twice a week — well-baby, maternity and dental. There are other programs to combat lead poisoning, pro­ vide immunization and test for tuberculosis. The free dental clinic is available twice a week in the Rath Building. The Erie County Health Department provides the dentists. The children entertain themselves. Rosemary McCarthy, a public health nurse, visits with a mother at the baby clinic. 42 THE BUFFALO PHYSICIAN �Helen Stephenson, a public health nurse, makes a few notes. Dr. J. Bhattacharyya examines a youngster. Perhaps more important, the center is will­ ing to take on any number of problems that con­ front individual residents of the area. If the Center can't provide a certain health service, it has a list of hospitals and clinics that can. This means providing transportation for neigh­ borhood residents who can't get to the hospitals or physicians' offices. Sometimes it means pro­ viding interpreters in Spanish and Italian to go along to hospitals and clinics with people who don't speak English well, to help them fill out forms, to stay with them if necessary until they receive the help they need. It even means deal­ ing with health-related problems — negotiating with the gas company about an unpaid bilhj ^ Dorothy Hodges, R.N. of the Erie County Health Department chats with several youngsters. The West Side Health Center's exhibit won third place at Spring Ciinicai Days. FUTURE FALL, 1973 - — - — Center plans to develop additional programs will provide compre-, hansive health care to 10 of the 25 thousand persons in its target area Community re si -1 d«ntsj^u_controI policies of th^renter I �Ira Stohl In the fall of 1969 a group of medical stu­ dents at the University conceived the health center. The Medical School students were react­ ing to what they felt was a failure on the part of the profession to recognize and respond to the need of the communities for communitybased health services. Now the original Center on Maryland Street is used as an administration office and for referral services. Currently there are about 40 Medical School students involved with the Health Center. There are six regular volunteers and about 15 other University students (not medical students) on the staff. The Pennsylvania Street clinic cost only about $400 to equip. There were many dona­ tions from private physicians and the Medical School, and Buffalo General Hospital. One pediatrician, about to retire from practice, donated all his office equipment to the clinic. There are five examining rooms, a waiting room, a lab and counseling space in the clinic. The Erie County Health Department has assigned one full-time county nurse to the clinic as well as physicians who conduct the wellbaby clinic every Tuesday morning and the maternity clinic on Wednesday mornings. • The reception room. Betty Coggins with mother and baby. "4 \ vs.• s <3 hs;« h1 44 THE BUFFALO PHYSICIAN �141 Residents, Interns Honored Certificates were granted to 141 residents and interns who completed all or part of their specialty training at University participating hospi­ tals — Buffalo General, Deaconess, Children's, E.J. Meyer Memorial, Millard Fillmore, Veterans, and Roswell Park Memorial Institute. Chairing the University Residency Program Committee is Dr. William J. Staubitz; professor of surgery and chairman of urology. ANESTHESIOLOGY Residency — Drs. E. Wan Kyo, Yik-Shyang Liauw, Jacob Remple GYN ECOLOGY-OBSTETRICS Residency — Drs. Elyas Bonrouhi, Norman Kenneth DeFoe, Said Dounel, Louis Hevizy, Eduardo N. Madambo GYN ECOLOGY-OBSTETRICS and MEDICINE Rotating Internship — Dr. Paul S. Kruger GYNECOLOGY-OBSTETRICS and ANESTHESIOLOGY Rotating Internship — Dr. Edwardo Moreno MEDICINE Residency — Drs. Hassan Amjad, Joseph Badros, Vankataraman Balu, Cecelia Bautista, Ronald Boersma, James Brennen, Anthony Buscaglia, Kenneth J. Clark, Mary Clemens, Joann Data, Merrick S. Fisher, Romesh Kohli, Stanley Lewin, Russell Massaro, John McConville, John McDevitt, Stanley Michalski, James B. Morris, Thomas O'Callaghan, Deolindo Ocampos; Kanubhal M. Patel, Jeffery Pine, Sheldon Schwartz, Uma Shukla, Daniel Yellon Cardiology — Drs. Raymond Aronson; Andrew Ang, P.M. Ignatius, Rene Oliveros Gastroenterology — Drs. Luis Maas, David Vastola Immunology — Dr. Michael Liebling Nephrology — Dr. Arshad M. Saeed Pulmonary — Dr. Richard T. Milazzo Rheumatology — Dr. Alberto Gentiletti (continued on page 47) FALL, 1973 45 �Dr. Eugene MindelJ, who heads the library committee at the Meyer Hospital, shows some of the resource material to Dr. Leonard Katz. A learning resources center, to aid students as well as housestaff acquire clinical skills through self learning is now underway in the E.J. Meyer Memorial Hospital's department of medicine. A satellite has opened at the Buffalo General Hospital. And, says Dr. Leonard Katz who coordinates third year medicine, "the centers have proved a stimulus to continuous self learning. They also serve as means of self assessment." Located in the hospitals' medical libraries (at Meyer under Anthony Ciko; at Buffalo General under Rita Winer) they have been open daily from 9 a.m. to 8 p.m. and Saturdays from 1 to 3 p.m. over the past year under National Fund for Medical Education sup­ port and capitation funds. In its study carrels are tape decks, slide projectors, videocassette playback decks, and TV monitors. "One can choose from 80 different multimedia programs with slide tape lectures and slide sets," says Dr. Katz. "And with the aid of our xerox machine, material from a core collection of reference texts or reprint files can be duplicated." But, points out Meyer's GI Unit head, "our materials, carefully selected by faculty and reviewed by students, are also used for group instruction." Dr. Katz looks forward to the broader interdisciplinary look to the program as orthopedic and nursing materials are added to its multimedia collection. • Librarian Nancy Fabrizio reviews some of the audio/visual material with ferry Banks, Class of 1974. Resource Learning Center 46 �(residents, interns — continued from page 45) Internships — Drs. Thomas R. Beam; Leonard Berkowitz, Richard A. Berkson; William J. Bommer, Robert DiBianco, Robert S. Folman, Alan G. Gasner, Richard Goldman, Elbe J. Goldstein, Robert M. Hof­ fman, Ismil Ismael, Leslie R. Jaffe, George Kotlewski, Lester Lifton, Ronald Liteplo, William T. Murray, Arthur E. Orlick, Richard J. Rivers, Paul A. Seligman, Henry T. Shenfield; James A. Singer, Laurie B. Tolin, Richard Tolin, Kenneth J. Tomecki, Steven B. Tucker, Wil­ liam T. Wallens, Robert B. Whitney, John W. Zamarra Rotating Internships — Drs. Mary Clemens, Richard O. Dolinar, Leslie R. Jaffe, Paul Kruger, Thomas J. Lawley, Stephen J. Levine, George Lundgren, Alan Mandelberg, Philip C. Moudy, David Silverstein, Stephen Welk, Bennett G. Zier NUCLEAR MEDICINE Residency — Dr. K. L. Parthosarthy NEUROSURGERY Residency — Dr. Anthony Avellanoso ORTHOPEDICS Residency — Drs. Richard C. Burnside, Joseph G. Cardamone, Jeffrey L. Kahler, Richard M. Stamile OTOLARYNGOLOGY Residency — Drs. Mohamad Amhad Afify, Homer Uy Bunag, George Robert Cohen, Arden Merrill Kane PATHOLOGY Residency — Drs. Saeed Ahmad, Robert Genovese, Mehroojan Kianian PEDIATRICS Residency — Drs. Chiaw-Charn Charavejasarn, Gerald E. Daigler, Francis Jeyaraj, John P. Menchini, John P. Sauer, Arthur W. Simington Internships — Drs. Richard E. Madison, Robert S. Smith Internship-Residency — Drs. Kenneth A. Burling, Seth C. Craig, III, John D. Foley, Roger A. Forden, Theodore J. Hajek, Roswitha Moehring, Carol F. Reddy, John A. Rider, Thomas S. Svensson PSYCHIATRY Residency — Drs. Richard Joseph Fischer, Jong Sung Lee REHABILITATION MEDICINE Residency — Dr. Shash Kala Sethi SURGERY General - Residency — Drs. Boonsong Anantalabhochai, Alan Bul­ lock, Mario Caniza, Victorino Cumagun, Janak Desai, Ernesto Figueroa, Ross Guarino, Shaukat Hayst, Richard Helffrich, Hanley Horwitz, Israel Kue, Jorge Melendez, Robert Milch, Roger W. Seibel, J. Myron Stern, Catherine Vlastou, Tzu-Lang Wu Thoracic and Cardiovascular residency — Dr. Victor N. Ambruso UROLOGY Residency — Drs. Harvey E. Butler, James F. Conway, Jr., Howard A. Rottenberg, Chang-Tsung Tsai • FALL, 1973 47 �Cutaway drawing shows centri/uge with monitoring platform attached (left center), the circular "submergence basin" to study swimmers, and banked track around outside. Windows under the track flower right) permit observation 0/ swimmers, and the control room is to left of the platform on top of the stairs. The Environmental Physiology Laboratory The centri/uge. (The following article was written by Phil Gunby, communi­ cations division, AMA. It appeared in the medical news section 0/ /AMA (p-1341) on June 4, 1973). The world's newest—and perhaps most unusual— centrifuge starts spinning for science this month. Besides being the latest of a handful of bio­ medical centrifuges around the world, it is unique in that it is: • one of the few in a university environment— THE BUFFALO PHYSICIAN �Testing the oxygen consumption, efficiency and proficiency of swimmers on the monitoring platform. A runner is being tested for efficiency, proficiency and oxygen consumption. the Buffalo medical campus of the State University of New York (SUNY); • surrounded by an 0-shaped "submergence basin"—a swimming facility 2.4 meters deep, 2.4 meters wide, and 60.4 meters in circumference; • further encircled by a banked running track just outside the circular pool, and • designed to permit attachment of a platform on which researchers can circle above the water (and along the inside perimeter of the track) to monitor and take measurements on swimmers or runners. The device is a human centrifuge, large enough to accommodate both an experimental subject and an observer—usually a physician—for the sub­ ject's protection. There is room for the subject to work, such as pedaling an ergometer. Additional monitoring of the subject is handled in the control room (which has an unobstructed view of the centrifuge from above) by closedcircuit television and continuous electrocardio- gram recording. The control room also has twoway radio contact with the centrifuge cab. Other safety aspects of the Buffalo centrifuge include rapid emergency stop ability (10 seconds from 30 revolutions per minute to complete halt), a secondary hatch for access to the cab, presence of a safety officer and emergency life support equipment 5 meters from the centrifuge in the center area around which the cab revolves, and crawl space for technicians to reach the two elec­ tric motors while the centrifuge is in operation. Until now, all the new centrifuge's whirling has been in test runs for engineers of Rocker Corp., Oakland, Calif, who designed, built, and have been installing it. This has been literally under the eye of Leon E. Farhi, MD, whose office overlooks the 930-square-meter Department of Physiology addition that houses the centrifuge. Dr. Farhi, professor of physiology at the SUNYBuffalo School of Medicine, is project director for the Environmental Physiology Laboratory, ^aj ^ FALL, 1973 49 �facility for which the total price tag, including centrifuge, building, related laboratories, and com­ puter system is $1.5 million. The physiology department at SUNY-Buffalo has a strong record of scientific study of man and his environment. Hermann Rahn, PhD, pro­ fessor and chairman, was one of the first to study physiological problems of high-altitude flight. Dr. Rahn and Donald W. Rennie, MD, also professor of physiology, also have studied the ama, Korean woman sponge-seekers who regularly dive to con­ siderable depths in icy waters without protective equipment. Other faculty members have carried out a variety of studies on altitude, gravity, temperature, and pressure. Dr. Farhi believes this record may have per­ suaded the Office of Naval Research more than five years ago to choose SUNY-Buffalo as the centrifuge site. Present funding comes from the National Institutes of Health. Although the new centrifuge is designed for people, most of its early riders will be dogs. "We are planning bona fide experiments with these animals," Dr. Farhi says, "but we also want to be thoroughly experienced and have good base­ line data before working with humans." This is part of the centers-of-excellence con­ cept, the Buffalo researchers point out, empha­ sizing: "We are working on valid physiological inquiries, not research dictated by the military." One of the studies under way now deals with locomotion in water—a study that makes full use of the centrifuge as a rotating laboratory/monitoring station. An interesting preliminary find­ ing of this work: Women swimmers have, on the average, higher ratios of efficiency to drag. Thus, while women theoretically should move faster than men for the same energy expenditure, they seldom beat male swimmers in top competition because of the man's ability to generate greater muscular power. What is sought at SUNY-Buffalo, Dr. Farhi says, is not a centrifuge that is "busy a half-hour a day, but a top-notch team working its head off and making maximum and varied use of a unique new device."• The second floor features the compu­ ter center, labs, offices and confer­ ence room and overlooks the sub­ mergence basin. 50 THE BUFFALO PHYSICIAN �President Robert L. Ketter visits with Dr. and Mrs. L. Maxwell Lockie during the first annual 50 year aiumni luncheon. A total of 109 people attended the luncheon that honored the UB graduates of 50 years or more. Dr. Ketter said, "this University is very much a university of the present and the future, but our ties with the past will never be severed." Emergency Medical Communications The Erie County Health Department received a one year grant of $250,000 from the Lakes Area Regional Medical Program for the Emergency Medical Communications Systems Project. Most of the money — $175,000 — is for the purchase of radio equipment. Dr. James Cosgriff Jr. is the project director. The emergency medical services system will provide for a radio communications network linking all police and fire departments, fire base stations, hospitals and transit authorities for emergency services in the county. The project will include a Medical Emergency Technician Training program for 5000 ambulance and rescue squad attendants over a 3-year period. The training includes 36 hours of formal training and an observation session in a hospital emergency room. This training program, for commercial ambulance attendants, is mandated by New York State and strongly recommended for volunteers. Dr. John R.F. Ingall, LARMP director, said "This project in the most elemental way answers the Administration's requirements for community direction, participation and contribution because the operation and maintenance of the system, once installed, becomes the responsibility of hospitals, ambulance operators, county health organizations and volunteer fire companies." • FALL, 1973 51 �i&i r ?h "> Looking across the lake from Millersport Highway. Students will be living on the new North Campus in Amherst in September. The 920-bed Governor's Residence Hall will be occupied. The John Lord O'Brian Law and Jurisprudence Building housing the law school and economics department will also be occupied in September. There will also be student activity rooms, cafe, library and bookstore open in this building, according to Mr. John D. Telfer, vice president for facilities planning at the University. The bus service that now operates between the South Campus (Main StreetJ and the Ridge Lea Campus will be expanded to the new North Campus. Students Living on New Campus In the fall of 1974 the 38-building Joseph Ellicott Complex hous­ ing 3,200 students in a living-learning setting will be ready for full occupancy. This facility has dormitory rooms, classrooms, faculty offices, libraries and bookstores. Five other buildings — education and philosophy, industrial engineering, biology and pharmacy, physics and chilled water plant — will be completed before fall, 1975. The four other Health Sciences Schools — medicine, dentistry, nursing and health related professions — will remain at their present location, but will have additional facilities when other segments of the campus move to the Amherst site. 52 THE BUFFALO PHYSICIAN 1 �The electrical station. �Our First Professor of Medicine Austin Flint (1812-1886) by Oliver P. Jones, Ph.D., M.D. Distinguished Professor of Anatomy JA.USTIN FLINT was born in Petersham, Massachusetts, 20 October 1812. He was descended from Thomas Flint (ca. 1603-1663) who came from Derbyshire, England in 1638 and settled in Concord, Mass. [It was a pleasant surprise to learn that three of my grandchildren, the Bradford S. Browns, also descended from Thomas Flint through his great granddaughter, Eunice Flint (1748-1810).] He was fourth in succession of a medical ancestry. Edwin Flint, his great grand­ father, was a physician in Shrewsbury, Massachusetts. His grand­ father, Austin Flint, was a highly esteemed surgeon in the Army of the Revolution. Joseph Henshaw Flint, the father, was a dis­ tinguished surgeon of Northampton and afterward of Springfield, Massachusetts. The younger Austin, received his general education partly at Amherst and partly at Harvard. He took his degree from Harvard Medical School in 1833 and at once began to practice in Boston. In 1835 he married a daughter of N. W. Skillings, Esq., and the couple had one son, Austin Flint, Jr., born 28 March 1836 at Northampton, Massachusetts. When Dr. Flint came to Buffalo in 1836, the antiphlogistic treat­ ment of most diseases was in its zenith. Inflammation was considered the great pathological element in practical medicine. All the fevers were regarded as either dependent on local inflammation or as deriv­ ing their gravity from inflammatory complications. He was admitted to the Erie County Medical Society in 1841 and was appointed health physician of Buffalo the following year. In the fall of 1843 an epidemic fever occurred at North Boston (eighteen miles from Buffalo) affecting twenty-eight of the forty-three inhabitants which proved fatal in ten instances. Superintendents of the poor were employed by Dr. Flint to investigate the nature and origin of the disease. He subsequently published his article in the American Journal of Medical Sciences and announced his conclusion that typhoid fever is a water-borne Front flow: Norman F. Graser, Joseph A. Syracuse, Edward J. Zimmerman, Harry A. LaBurt. Back Row: Leon A. Chadwick, Henry Galantowicz, W. Herbert Burwig, Caryl A. Koch, Donald W. Cohen. Class of 1923 at Spring Clinical Days 54 THE BUFFALO PHYSICIAN �Class of 1928 at Spring Clinical Days Front Row: Joseph Rosenberg, Thelma Brock, Bruno Shutkeker, Eugenia Fronczak Bukowski, Harry Spiegelman. Back Row: George F. Etling, Raymond J. Rickloff, Howard L. Stoll, Richard M. Gardner, Vincent A. Hawro, Albert J. Voelkle, Clyde W. George, Walter F. King, George N. Guthiel, Floyd C. Bratt. disease and that it had been transported to North Boston by a sick traveller from Warwick, Massachusetts. In general treatises on typhoid fevers, this article is a classic study. He achieved a national reputation and in 1844 he was appointed Professor of the Institutes and Practice of Medicine at Rush Medical College. He delivered a public introductory lecture on The Reciprocal Duties and Obliga­ tions of the Medical Profession and the Public. The occasion was the first annual anniversary of the organization of the Rush Medical College. He outlined how far the public is concerned in and responsi­ ble for the complete accomplishment of the legitimate objects and duties of the medical profession. He spoke about the general public apathy towards the establishment of medical schools and their finan­ cial support. Some remarks were directed to the legislators regarding their indifference to making the study of anatomy a legalized pursuit and the public was told about the value of post mortem examinations. Since two classes of medical students were present, Flint reminded them of the necessity for high scientific attainments, elevated princi­ ples of honor, integrity, uniform courtesy — the qualities of a gentle­ man, philosopher and Christian. Dr. Flint returned to Buffalo in 1845 and founded the Buffalo Medical Journal which he owned and edited for the next eight years. His introductory occupied two and a quarter pages. It was written on 1 June 1845 and a portion of it is quoted here because it so clearly tells us about the true nature of the man who was destined to become our first Professor of Medicine. . . . We would add that the Journal is pledged to no inter­ ests apart from those which relate exclusively to the progress of Medical Science, and the advancement of the Medical Profession. It is not instituted for any sec­ tional objects, or partisan views; but to serve as an organj f FALL, 1973 55 �Class of 1933 at Spring Clinical Days Front Row: Wilfrid M. Anna, Elroy L. Fulsom, Elmer Milch, G. Harold Warnock. Second Row: Louis Kolbrenner, Louis A. Vendetti, Louis A. Scinta, Thomas J. Syracuse, Norbert G. Rausch, George M. Masotti. Rack Row: Henry Haines, W. Donald Leslie, Wilfred H. Ferguson, Reuben H. Hamman, Ernest G. Homokay, J. Curtis HellriegelJEugene W. Wallace. for the impartial and untrammelled utterance of opinion on any matters pertaining directly or indirectly to its professed objects . . . In the fourth number of the B u f f a l o M e d i c a l Journal, Dr. George N. Burwell (1819-1891) published an abstract of Flint's article on typhoid which appeared in the American Journal of Medical Sci­ ences, because most physicians did not subscribe to it. This was Dr. Flint's first conspicuous success, and it is more than probable that it laid the foundation of his future as a clinician. In his obituary for James Piatt White, Austin Flint credited the establishment of the Medical Department of the University of Buffalo largely to White's exertions. At any rate, these two physicians were able to attract five professors from Geneva Medical College to form the first faculty of the University of Buffalo. According to Harvey Cushing (1934), our faculty for the first five years made "as notable a faculty of energetic men as one could hope to find anywhere". Austin Flint served as Professor of Principles and Practice of Medicine and Clinical Medicine. The Annual Circular for 1846 said: The Professor of Practice will hold a Clinique at the College buildings, each day except Sundays, at 4 o'clock, P.M. at which time counsel will be given and medicines administered free of charge to the poor. Special attention will be given to Auscultation and Percussion, and for this purpose cases of supposed disease of the heart, lungs, etc. will be examined carefully before the class. Eruptive diseases will be treated at this Clinique. Dr. Flint, a protestant, was instrumental in persuading the Right Rev. John Timon, first Bishop of Buffalo, to purchase property on Pearl Place (near Virginia Street) to establish a hospital to be managed by the Sisters of Charity. 56 THE BUFFALO PHYSICIAN �In 1852, Austin Flint left Buffalo to accept a corresponding chair in the University of Louisville. While there he travelled abroad to visit hospitals and clinics in Paris during the spring of 1854. Five letters about his experiences and observations were published in the Buffalo Medical Journal. In 1856 he again returned to Buffalo and resumed his connection with the Medical Department of the University of Buffalo as Professor of Pathology and Clinical Medicine. He spent the winters of 1858-59, '59-'60 and '60-'61 in New Orleans where he served as Physician to the Charity Hospital and Professor of Clinical Medicine. It was there that he first heard the presystolic murmur which bears his name today. From 1858 to 1860, his son, Dr. Austin Flint, Jr. was t h e editor a n d proprietor of t h e B u f f a l o Medical Journal. In 1859 he left Buffalo and settled in New York City. To bring an outsider to occupy any position of prominence in a medical com­ munity has always excited jealousy, envy and even enmity. Failure for Flint was freely predicted and active opposition encountered. Some of his junior rival consultants seem never to have forgiven his success. His first appointment was in 1861 as Professor of Path­ ology and Practical Medicine at Long Island College Hospital in Brooklyn, a position which he held for seven years. In 1861 he was also appointed one of the physicians to Bellevue Hospital. He was one of the original members of the Faculty of Bellevue Hospital Medical College and filled the chair of the Principles and Practice of Medicine and Clinical Medicine until the time of his death in 1886. After Flint left Buffalo, the Sisters of Charity recognized the need for a psychiatric hospital and they appealed to him for assistance. Flint sold them his farm and farmhouse then at the junc­ tion of Main Street and Scajaquada Creek. In the administrator's Front Row: Russell J. Catalano, Samuel L. Lieberman, Clarence A. Straubinger, Charles Donatelli, Vincent L. Rutecki, Richard N. Terry. Back Row: Norman J. Foit, Chester J. Kaminski, Eustace G. Phillies, Anthony F. Rizzo, Walter L. Sydoriak, Alfred A. Mitchell, Harry C. Law, Leo J. Doll, Jr. Class of 1938 at Spring Clinical Days FALL, 1973 57 �office of the present hospital is a copy of the deed dated 8 September 1860. Dr. Flint's yellow brick, two-story farmhouse now houses the surgical research laboratory, a medical research unit and the hospital paint shop of The Sisters of Charity Hospital. What kind of a teacher was Dr. Flint? It was while searching all possible sources for the answer to this that several errors in dates regarding his positions and honors were discovered. Who Was Who in America has Flint founding the University of Buffalo one year after the Charter was signed and leaving Buffalo two years after he had already been in New York City. American Medical Bio­ graphies has Flint as Professor of Medical Theory and Practice from 1836-1844 but the Charter for the University was not signed until 1 1 M a y 1 8 4 6 a n d t h e r e w e r e n o t s e v e n e d i t i o n s of h i s P r a c t i c e o f Medicine. Biography of Eminent American Physicians and Surgeons has Flint establishing the Buffalo Medical Journal in 1846 when he wrote and published his first editorial 1 June 1845 and it also has the university being founded one year after the Charter was granted. The most accurate accounts of Flint's life and activities are in two editorials in the Buffalo Medical Journal. Da Costa (1887) used material from these editorials as a basis for his Biographical Sketch of Flint. Austin Flint, Sr. was a great physician and a great teacher who distinctly improved the quality of medical teaching of that era by his oral lectures and his classic text-books. One editorial says: . . This position he achieved, too, without having made any noteworthy discoveries (Like Morton and Sims), it was rather his clear and precise way of dealing with Sitting: Alfred J. Simon, Alexander Slepian, Richard J. Buckley,Kenneth W. Bone, Robert D. Glennie, Jr., Frederick B. Wilkes, John C. Ninfo, Robert J. Collins. Second Row: Gertrude S. Swarthout, Adrian J. Pleskow, Richard S. Fletcher, William H. Georgi, Salvatore J. Brucato, John M. Donohue, Joseph E. Holly, Harold P. Graser. Back Row: Alfred F. Luhr, Jr., Duncan K. MacLeod, Raymond W. Mitchell, Jr., Ralph E. Smith, Jr., L. Walter Fix, Norman Haber, Robert C. McCormick, Eugene T. Donovan, Gustave P. Milkey, Charles C. Richards, George H. Selkirk. Class of 1943 (April) at Spring Clinical Days 58 THE BUFFALO PHYSICIAN �Class of 1943 (December) at Spring Clinical Days Front Row: Kevin M. O'Gorman, Salvatore J. Colangelo, Morris Unher, William C. Niesen, Edmund M. Tederous, Harold J. Feldman, Charles J. Tanner, Jr. Back Row: Paul J. Wolfgruber, Robert D. Kelsey, Anthony J. Mancini, Amos J. Minkel, jr., Payson B. Jacobson, John R. Williams, Marvin L. Bloom, Joseph J. Ricotta. the facts already at command — after all, one of the rarest of faculties — than any tinge given by him to the doctrine of practice of his time that won him his pre-eminence ... Yet it can not be said that he was not an original contributor to our knowledge, for it is difficult to imagine that anything like our present appreciation of cardiac murmurs of differences in pitch in resonance, or of a multitude of facts connected with the diagnosis of thoracic affections, could, but for him, have been reached for many years to come . . ." Flint's most notable text-book was A treatise on the Principles and Practice of Medicine which went through six editions from 1866 to 1886. A seventh edition was anticipated but never published because of Flint's death. Over 40,000 copies had been published before the sixth edition appeared. The London Lancet (12 March 1887) said "Americans may well be proud of having produced a man whose indefatigable industry and gifts of genius have done so much to advance medicine ... It has few equals, either in point of literary excellence, or of scientific learning, and no one can fail to study its pages without being struck by the lucidity and accuracy which characterize them . . The Cincinnati Medical News (Oct. 1886) said, "In every state and territory of this vast country the book that will be most likely to be found in the office of a medical man, whether in city, town, village, or at some cross-roads, is Flint's Practice . . ." When Flint was called to the Chair of Theory and Practice of Medicine at the University of Louisville, Samuel D. Gross was Profes­ sor of Surgery. This was the beginning of a warm friendship between these two eminent men. There they taught each other's son for two lecture terms and both boys, Austin, Jr. and Samuel W., graduated FALL, 1973 59 �Class of 1948 at Spring Clinical Days Front Row: Darwin D. Moore, Warren L. Hollis, Cletus J. Regan, Raphael S. Good, Vernon C. Lubs, Middle Row: Harold L. Graff, Norman Minde, William H. Bloom, Albert P. Sutton, Francis J. Peisel. Back Row: Seymour P. Zola, Paul Weinberg, Myron Gordon, Lester H. Schiff, Warren H. Hanson, Daniel J. Fahey, Robert J. Hall, Ansel R. Martin, James G. Robilotto, B. Edward Heckmann, Richard C. Proplesch. from Jefferson Medical College in 1857. In his Autobiography, Gross speaks of Flint: . . . Tall, handsome, and of many form, with a well mod­ ulated voice of great compass, he is a lecturer at once clear, distinct, and inspiring. During his hour in the class­ room no student ever falls asleep ... I know of no one who is so well entitled as Austin Flint, Sr. to be regarded as the American Laennec. Gross goes on to say that he had the pleasure of seeing Dr. Flint elected president of the American Medical Association (188384) after he had nominated him. "In choosing him the Association honored itself more than it honored the New York veteran physician." He was president of The New York Academy of Medicine in 1872. He was chosen to be president of the International Medical Congress to be held in Washington, D.C. but did not live to do more than to begin some of the organization. He was corresponding member of the Academy of Medical Science in Palermo; an Honorary Member of the Medical Society of London of the British Medical Association; his name is on the role of Foreign Honorary Members of the Clinical Society of London, and the American College of Physicians made him a Fellow in 1868. Yale University made him Doctor of Laws in 1881. 60 THE BUFFALO PHYSICIAN �The extraordinary care and industry with which he collected the facts that were to serve as a basis of his work may be judged by a statement made by Austin Flint, Jr. that his father had begun his record of cases in 1833 and had filled sixteen thousand nine hundred and twenty-two folio pages with them. Da Costa said, "a statement more eloquent in its bare mention than the most elaborate panegyric on his marvellous industry and untiring energy." Austin Flint died of apoplexy, 13 March 1886, as he had wished, rapidly, not lingering or painful. • References 1. Flint, A. The Reciprocal Duties and Obligations of the Medical Profession and the Public. Chicago, Eastman, 1844. 2. Flint, A. Account of an epidemic fever which occurred at North Boston, Erie County, N.Y. during the months of October and November 1843. Am.J.Med. Sci. N.S. 10: 21-35, 1845. 3. Editorial. Austin Flint, M.D., L.L.D. Buffalo Med./. 25: 425-33, 1886. 4. Da Costa, J.M. Biographical Sketch of Dr. Austin Flint. Trans. Coll. Physns. Philad. 3rd Ser., 9: 461-470, 1887. 5. Autobiography of Samuel D. Gross, M.D. Ed. by his sons, Philadelphia, Barrie, 2 Vols., 1887. 6. Potter, W.W., Fifty years of medical journalism in Buffalo. Buffalo Med./., N.S. 35: 65-113, 1895-96. 7. Dictionary of American Biography. New York, Scribners, VI, 471-472, 1931. 8. Genealogy of John Fiske Brown (1901-). Front Row: James M. Orr, Joseph F. Ruh, Donald L. Ehrenreich, Bertram A. Portin, John W. Handel, Donald Rachow. Middle Row: John D. Voltmann, Richard J. Nagel, Thomas G. Goeghegan, Stanley L. Cohen, Michael A. Sullivan, Thomas Comerford, Jr., Marvin Wadler. Back Row: John N. Strachan, Jr., Howard C. Smith Jr., Jerome E. Hurley, James W. Carlin, Thomas W. Atkins, Raymond M. Smith, Jr., Albert G. Bickelmann Jr., Robert S. Sobocinski, Herbert W. Simpkins, Milford C. Maloney, Jack Gold. Class of 1953 at Spring Clinical Days FALL, 1973 61 �Nine Physicians Retire EN MEDICAL FACULTY at the University — nine are physicians, one an attorney — who are age 70 will retire August 31, after collectively serving a total of 346 years. Nine were born in Western New York; eight are Medical School graduates. They are Drs. Marvin A. Block, John Burke, Clyde W. George, Martin L. Gerstner, Ramsdell Gurney, L. Edgar Hummel, Joseph G. Krystaf, L. Maxwell Lockie, Meyer H. Riwchun, and Joseph L. Guariglia (LLB). Five have served in the department of medicine. Dr. Marvin A. Block, born in Buffalo and educated here (M'25) is a clinical assistant professor in medicine who joined the faculty in 1928 as an assistant. He received the American Medical Association's medal of achievement for his 25 years of service in the field of alcoholism and his role in gaining AMA recognition of alcoholism as a disease. Dr. Clyde W. George, a 1929 alumnus, is a clinical associate in medicine who joined the faculty in 1943 as an assistant (medicine/therapeutics). The internist and primary physician to many was always a volunteer teacher. Buffalo-born and educated (M'29) Dr. Ramsdell Gurney is a clinical associate professor in medicine who started in 1932 as an assistant. The Diplomate, Ameri­ can Board of Internal Medicine served as Buffalo General Hospital's first outpatient department director and as one of the founders of the Buffalo Medical Group. Dr. L. Edgar Hummel, born in Darien Center, is a 1931 Harvard graduate. The clinical assistant professor in medicine has been on the faculty since 1938 and has always had a keen interest in research. He retired from the directorship of the Meyer Hospital in January, 1970. Kneeling: John V. Armenia, Richard R. Romanowski, Elroy E. Anderson, Gaspare A. Alfano, Robert J. Perez. Second Row: Lucien A. Potenza, Franklin N. Campagna, William L. Glazier, Reinhardt W. Wende, Gary N. Cohen, Anna A. Tracy, Franklin Zeplowitz, Eugene A. Friedberg. Third Row: Michael T. Genco, Joseph A. Zizzi, Richard A. Rahner, John P. Murphy, Domonic F. Falsetti, Leo A. Kane, Samuel Shatkin, Thomas G. Cummiskey, Gerald T. Guerinot. Back Row: John J. Giardino, John W. Float, James S. Williams, Richard D. Wasson, Michael A. Mazza, Richard C. Boyle, Ronald E. Batt, Marie L. Kunz, Alfred M. Stein, Melvin M. Brothman. Class of 1958 at Spring Clinical Days 62 THE BUFFALO PHYSICIAN �Dr. L. Maxwell Lockie, born and educated (PhG'23 and M'28) in Buffalo, has been a clinical professor in medicine since 1932 when he joined as an assistant. The Associate Fellow of the American College of Physicians has served as professor/head of the division of therapeutics since 1939 and has made significant contributions both locally as well as nationally to the field of rheumatology (ex officio member, Medical/Scientific Committee, Arthritis and Rheumatism Foundation; consultant in rheumatology to HEW; chair­ man, executive committee, American Rheumatism Assn.). Two are Buffalo-born and educated otolaryngologists. Dr. Martin L. Gerstner (M'29), a clinical associate professor, has served since 1938 when he joined as an assistant. Dr. Joseph G. Krystaf (M'27), a clinical assistant professor, came to the faculty in 1944 as clinical associate. Retiring from the department of surgery is Dr. John Burke. The clinical associate professor since 1936 (joined as an instructor) was born in Buffalo and is a Yale alumnus (1928). While serving with the Marine Corps the Lt. Colonel was assistant and chief of the Surgi­ cal Service of the 23rd General Hospital. Dr. Meyer H. Riwchun, clinical professor of ophthalmology, headed the division of ophthalmology at the Children's Hospital (1960) and has served as co-head of the department of ophthalmology. The Buffalo-born and educated (M'27) ophthalmologist joined the faculty in 1934 as an assistant. He is a Diplomate, American Board of Ophthalmology and a Fellow of the American College of Ophthalmology/Otolaryngology and American College of Surgeons. He is a past president of the Buffalo Ophthalmologic Society, Buffalo Eye and Ear Hospital, and Maimonides Medical Society. Mr. Joseph J. Guariglia, born in Buffalo and a 1928 UB law school graduate, has served as a lecturer in the department of legal medicine since 1959 (he joined as an assistant). He has served as counsel to the Erie County Medical Society and as assistant attorney to the Buffalo Legal Aid Bureau. All were honored at the School of Medicine's annual faculty meeting May 24. • A $10,000 gift from the estate of the late Elizabeth Crosby Gardner of Buffalo has been made to the School of Medicine. Mrs. Gardner, who died in July of 1972, was the daughter of William H. Crosby, a former treasurer of the University of Buffalo and a member of its Council. His contributions and those of his family made possible the construction of Crosby Hall on the U/B Main St. campus in 1931. Crosby Hall now houses offices and class­ rooms for the School of Management and several modern language departments. The donor specified that the $10,000 be used at the discretion of the University Council for the benefit of its School of Medicine. The gift was made through the University at Buffalo Foundation, Inc., a private, non-profit corporation chartered by the New York State Board of Regents to act as U/B's agent in the soliciting, collecting and administering of private monies. • FALL, 1973 63 <£ 4 /T QflQ CplU,UUU �Dog Racing Hobby A1925 Medical School graduate has been training racing greyhounds for more than a quarter of a century. Dr. Lucian C. Rutecki usually owns about 20. He became interested in 1936 when there was a dog racetrack in Cheektowaga. He has been training dogs ever since. Dr. Rutecki buys them at the early age of six or eight weeks, when no one can be certain of their speed or eagerness to run. He has discovered a way to stimulate a dog to quicken his pace toward the end of a race. He does not apply any drug or artificial stimulant. "It is accomplished through the spoken word. Although I am absent from most races run by my dogs, they respond to the voice of the crowd urging them on." A racing greyhound can attain a speed of 40 miles per hour, according to the physician. But he can maintain that speed for only about 30 seconds. He is certain that greyhounds love to race. Even if there wasn't an artificial rabbit, they would run purely for the competition with other dogs. A greyhound may begin a racing career at the age of 14 months. At five years the dog is retired. If his record is excellent, he is used for breeding. Dr. Rutecki finds homes for most of his five-year-old greyhounds. They become affectionate pets and excellent watchdogs. During the racing season the physician's dogs are cared for by a handler in Florida. Every spring Dr. Rutecki and his family drive to Florida to watch their dogs race. He also helps train the dogs on his farm in the Town of Pendleton. "The strenuous exercise keeps me fit." • Kneeling: John M. Wadsworth, Lawrence J. Sobocinski, David N. Malinov. Middle Row: Anthony M. Fot, Frank V. DeLaus, Gordon H. Burgess, Stephen T. Joyce, John J. LaMar, Jr., George L. Sterner, Albert J. Maggioli. , , _ Back Row: Richard D. Hasz, John N. Stumpf, Jason E. Rudisill, John A. Repicci, Charles S. Tirone, John F. Bentley, John K. Fanelli, Eugene M. Sullivan, Jr., Richard E. DuBois, Joseph C. Tutton, William C. Heyden. Class of 1963 at Spring Clinical Days 64 THE BUFFALO PHYSICIAN �Dr. Greco, Mrs. Greco and Richard F. Torrey, dinner chairman. A 1941 Medical School graduate, Dr. Pasquale A. Greco, accepted the 1973 Honor Award of the National Jewish Hospital in Denver with a plea to private donors to take up the slack being left by cuts in government support of disease and research. A check for $35,908 was presented to the hospital, a nonsectarian complex specializing in chronic respiratory diseases. "We cannot delegate to another our responsibility for helping our fellow man," said the Buffalo urologist and NJH trustee. Despite scarce government resources, "the National Jewish Hospital is not going to stop moving forward precisely because of people like you." Dr. Greco's citation was presented by a longtime friend and patient, John M. Galvin, former chief executive officer of Marine Midland Bank-Western. Few in the audience have not been touched, Mr. Galvin said, by Dr. Greco's unselfish work as chairman of urology departments of Millard Fillmore, Emergency and Columbus Hospi­ tals. He is also a member of the Buffalo Planning Board and an adviser to area colleges and civic organizations. Dr. Greco is also a clinical assistant professor of surgery (urology) at the Medical School. Dr. Greco was also praised for "his great warmth and profound personal commitment to his patients and to philanthropic work which has made him one of the city's best loved physicians." • FALL, 1973 65 Dr. Greco Honored �This is how the Mil­ lard F i i i m o r e H o s p i t a l at G a t e s Circle w i l l l o o k a f t e r expansion. At the left is the West Building with a s e v e n - s t o r y a d d i t i o n fo r the new coronary and pulmonary care units (estimated completion February, 1974). In the center are elevator towers and at the right is the new four-story Medical Service Building that will be com­ pleted in June, 1975. The surgical space will almost be doubled. Also in this n e w facility will b e a 19b e d r e c o v e r y r o o m , a 10bed surgical intensive care unit, emergency-outpa­ tient departments, radi­ ology department for ad­ vanced X-ray procedures, and a 125-seat lecture hall, plus more warehouse and central supply space. A t t h e e x t r e m e right i s t h e new boiler house with a June 1973 completion date. There will also be extensive remodeling of the present building, scheduled for completion in November, 1976. $59 Million Millard Fillmore Hospital Expansion Gates Circle addition. The new suburban hospital. 66 This is t h e architect's drawing of the Millard Fill­ more Suburban Hospital on Maple Road in Am­ herst. The three floor building will have 150 beds (110 medical, 34 maternity, 6 intensive care). It is being designed for e x p a n s i o n t o 7 0 0 b e d s with all necessary ancil­ lary services. The new hospital will have five operating rooms and a nine-bed recovery room. Other facilities include radiology and laboratory departments. Construc­ tion has started and the estimated completion date is June 1974. THE BUFFALO PHYSICIAN �The Gates Circle expansion as it looked in J u l y . The Amherst hospital near Hopkins a n d Maple. �John L. Lovecchio (left) with Dr. Joseph Krasner, measures the fluorescence of a drug sample in the developmental pharmacology laboratory o/ Children's Hospital. Research Award A sophomore medical student is among the handful to receive a $1,000 Pharmaceutical Manufacturers Association Foundation award for research and training in the field of clinical pharmacology. He is John L. Lovecchio whose keen interest in how infants respond to drugs led to his winning proposal on how drugs and protein interact. His three-month summer traineeship will be in the Children's Hospital's department of clinical pharmacology. Headed by Dr. Sumner J. Yaffe, research focuses on drug metabolism, drug-protein interaction, and its effect on the developmental process and disease states in infants. Under research assistant professor of pediatrics Dr. Joseph Krasner, Mr. Lovecchio will investigate how several drugs "bind" to plasma protein. These are diphenylhydantoin, diazepam, salicylate, Nafcillin and bilirubin. While the latter is not a drug it is important for hyperbilirubinemia occurs almost universally in the premature newborn. From sera obtained from normal and sick infants and children, Mr. Lovecchio will determine the amount of drug- protein interaction at several concentrations through equilibrium dialysis. There will also be participation in daily discussions of problems in clinical pharmacology that appears in the hospital as well as problems of drug metabolism both in vivo and in vitro. Said Dr. Yaffe of this honor, "the clinical significance of Mr. Lovecchio's research program will enable more precise determina­ tion of pharmacological effectiveness of drugs in common clinical usage." • 68 THE BUFFALO PHYSICIAN �The class of 1918 Dr. Everett T. Mercer, M'18, a general prac­ titioner, is now semi-retired. He lives at 4 7 Char­ lotte Avenue, Harrisburg, New York • Dr. Willard G. Fisher, M'36, is the new president of the Foundation of Deaconess Hospital. Other officers elected: Vice president, Clarence J. Ostermeier; secretary, Milton E. Kaeselau, and treasurer, Vernon A. Reed. • The classes of the 1930's The classes of the 1940's Dr. Joseph D. Godfrey, M'31, received a spe­ cial award from D'Youville College in May for his concern with the education of nurses and doctors and his aid to needy patients. • Dr. Francis R. Coyle, M'32, is a School Physician for the Erie County Health Department. • Dr. Matt A. Gajewski, M'39, was elected president of the Buffalo Board of Education in May. He was appointed to the board in 1968 and re-appointed in 1972. • Dr. Victor L. Pellicano, M'36, is the new president of the Heart Association of Western New York. • Dr. John D. Ambrusko, M'37, has been re­ appointed to the Erie County Alcoholic Bever­ age Control Board for a term ending April 30, 1975. • FALL, 1973 Dr. Marshall Clinton, M'40, is president­ elect of the medical staff of the Buffalo General Hospital. He is serving a three-year term on the board of governors, American College of Physi­ cians. Dr. Clinton was also elected governor of the Upstate New York area. He is a clinical associate professor of medicine and clinical assistant professor of pharmacology at the Medi­ cal School. • Dr. Abraham S. Lenzner, M'41, is a clinical associate professor of psychiatry at Cornell University Medical School. He is a Fellow, American Psychiatric Association and treasurer of the Board of Trustees of the Nassau Academy of Medicine. He recently published "Psychiatric Vignettes from a Coronary Care Unit" Psychosomatics, Vol. 13, No. 3, May-June 1972, and "Psychiatry of Aging" Chapter in "A Practical Guide to Long Term Care and Health Services Administration," Panel Publishers, Green vale, N.Y. 1973. He is also in private practice at One Sussex Road, Great Neck, New York. • 69 The Classes �The Classes Dr. Charles Bauda, M'42, has spoken out strongly about the Supreme Court's decision giving women the right to medical abortions during the first six months of pregnancy. Dr. Bauda represents some 6,000 Catholic physi­ cians in the United States. He is president of the National Federation of Catholic Physicians. • Dr. James R. Brill, M'43, retired from fulltime practice (psychiatry and primary medicine) at the Gowanda State Hospital in March, 1972. He now practices part-time and is also with the Erie County Health Department. His home address is Hanford Road, Silver Creek, New York. • Dr. Alfred S. Evans, M'43, is professor of epidemiology at Yale University School of Medicine. He is Director, World Health Organi­ zation's Serum Reference Bank; president, Beau­ mont Medical Club, and president of the Ameri­ can Epidemiological Society. He has published more than 100 papers in various magazines of his specialty. Dr. Evans lives at 38 Dogwood Circle, Woodbridge, Connecticut. • The classes of the 1950's Dr. Joseph F. Dingman, M'50, of Boston is the author of a major feature on management of antidiuresis in the May 28 issue of Modern Medicine, a national medical journal. Dr. Dingman, whose article appears under the heading "Perspectives in Clinical Medicine," is senior associate in medicine at Peter Bent Brigham Hospital and lecturer on medicine at Harvard Medical School. He also has served the Lahey Clinic Foundation, beginning in 1961, as direc­ tor of medical research. A New York native, Dr. Dingman is a specialist in endocrinology, and a member of the American Association for the Advancement of Science, American Federation for Clinical Research, American Diabetes Association, Endocrine Society, American Rheumatism Association, American College of Physicians, and Society of Nuclear Medicine. • Dr. Walter A. Olszewski, M'54, has been appointed head of the department of neurology at the Buffalo General Hospital. He has been acting head since 1968 and on the hospital staff 70 since 1961. Dr. Olszewski is also director of Buffalo General's neuropathology laboratory, multiple sclerosis clinic and assistant direc­ tor of the organic brain syndrome clinic. He is an assistant professor of neurology and clini­ cal associate professor of anatomy at the Medi­ cal School. • Dr. M. David Ben-Asher, M'56, won the Outstanding Physician Award for 1973 for his work with victims of kidney disease and the Arizona Kidney Foundation. He was also influential in helping to establish Tucson's first Artificial Kidney Center and was chairman of the Renal Advisory Program of the Arizona Reg­ ional Medical Program. Dr. Ben-Asher is chief of the medical staff at St. Mary's Hospital in Tucson, Arizona. • Dr. Daniel C. Kozera, M'59, is a clinical instructor in Ob/Gyn at UB Medical School. He is a member of the Biology Council at Canisius College. • The classes of the 1960's Dr. Virginia Verral Weldon, M'62, was recently (July, 1973) promoted to associate pro­ fessor of pediatrics at Washington University School of Medicine, St. Louis. She is codirector, Division of Endocrinology and Metabolism-Pediatrics at the school. She is on the Board of Directors, St. Louis Diabetic Chil­ dren's Welfare Association. Dr. Weldon, her two daughters, ages 8 and 6, and her husband, Dr. Clarence S. Weldon (Professor of Surgery and Head of Cardiothoracic Surgery at Barnes and St. Louis Children's Hospitals) live at 4967 Pershing Place, St. Louis. • Dr. Barton L. Kraff, M'65, is an assistant clinical professor of psychiatry and behavioral sciences at George Washington University, Washington, D.C. He is also Director of Admis­ sions and Intake Services at The Psychiatric Institute of Washington. Dr. Kraff lives at One Old Coach Court, Potomac, Maryland. • Dr. Dean Orman, M'65, began practice in July, 1972 with the Buffalo Medical Group, 85 High Street. His specialty is Internal Medicine and Gastroenterology. He is a Diplomate of the American Board of Internal Medicine. • THE BUFFALO PHYSICIAN �Dr. Marjorie A. Boyd, M'66, completed her fellowship in Hematology at Boston University in January, 1971 and has been in practice in Portland, Maine since that time. She is also a clinical instructor at Tufts University and Maine Medical Center. Her address is Two Lights Road, Cape Elizabeth, Maine. • Dr. Donald M. Pachuta, M'66, is an assistant professor of medicine at the University of Mary­ land School of Medicine, Baltimore. He is chair­ man of the Drug Abuse Committee, Baltimore City Medical Society. • Dr. Cary A. Presant, M'66, was recently appointed assistant professor of medicine at Washington University School of Medicine, St. Louis. He accepted a joint appointment in Hematology and Oncology at the Jewish Hospi­ tal of St. Louis. He is a member of the American Society of Hematology and a Diplomate of the American Board of Internal Medicine in Hematology. • Dr. Robert M. Tabachnikoff, M'66, is now in private practice at the Medical Arts Building, Sarasota, Florida. He is an obstetriciangynecologist. • Dr. Eugene Wolchok, M'66, is an instructor of ophthalmology (part-time) at the University of Florida Medical School, Jacksonville. He is also in private practice at 3604 University Build­ ing, Jacksonville. • Dr. Richard H. Daffner, M'67, recently joined the staff at the University of Louisville (Kentucky) as an instructor in radiology. He completed a residency in diagnostic radiology at Duke University Medical Center in July. He has published in Radiology, American Journal Roentgenology, Radium Therapy and Nuclear Medicine. • Dr. Adele M. Gottschalk, M'67, recently completed her residency in general surgery and will be starting work as a full time general sur­ geon at the Harbor City branch of the Southern California Permanente Medical Group. She lives at 916 Esplanade, Redondo Beach. • FALL, 1973 Dr. George Steven Starr, M'67, passed his pediatric boards in March. He is completing a Fellowship year with the Program of Learning Studies, Children's Hospital of the District of Columbia, working in the area of school and learning problems. In July he will enter in private group practice at 50 Presidential Plaza, Suite 102, Syracuse, New York. • Dr. Cal Treger, M'67, was Board Certified in Internal Medicine in 1972. He is a senior Fellow in Dermatology at the University of Washington, Seattle. • Dr. Timothy Harrington, M'68, is a Lieute­ nant Commander in the United States Navy, stationed at Pensacola Naval Hospital in Florida. He was recently named director of the Family Practice Residency Program. • Dr. Alan H. Peck, M'68, is a staff psychiat­ rist at Lewisburg Penitentiary, USPHS. His paper "An Interim Program for Emergency Psychiatric Evaluation in Baltimore City" appeared in the Maryland State Medical Jour­ nal, Dec., 1972. • Dr. Jonathan Ehrlich, M'69, who recently completed service with the U.S. Army Hospital at Redstone Arsenal, Alabama is now in private practice at Northside Hospital Doctors Building, Atlanta, Georgia. He is an obstetriciangynecologist. • The classes of the 1970's Dr. Ronald H. Blum, M'70, recently com­ pleted his USPHS commitment as special assistant to the associate director for cancer ther­ apy evaluation, National Cancer Institute. He is going to Harvard for his senior medical residency and has a fellowship in medical oncology there. Dr. Blum lives at 248 Summit Avenue, Brookline, Massachusetts. • Dr. Lawrence S. Frankel, M'70 is a pediatric resident at Baylor University Hospital. He lives at 5759 Ludington Drive, Houston, Texas. • 71 The Classes �Mrs. S. Mouchly Small received the Outstanding Volunteer of the Year Award from the Mental Health Association of Erie County in May. She is the wife of the chairman of the psychiatry department at the Medical School. For the last 13 years Mrs. Small has been either a member or chairman of the psychiatric clinic at Jewish Family Services and is founding presi­ dent of the Organization for Rehabilitation through Training. • Dr. Thomas B. Tomasi, professor of medicine, has accepted a position as chairman of the department of immunology at the Mayo Medical School, Rochester, Minnesota. He has been on the UB faculty since 1965. • A second year medical student, AniJ B. Mukerjee (right) was a finalist in a scientific exhibit competition sponsored by the pharmaceutical firm, E.R. Squibb S* Sons, Inc. Dr. Muker/ee won $500 and a gold medal from the Student Medical Association, co-sponsors of the exhibit. Mr. Mukerjee's exhibit, "Induction of Enzyme in Deficient Rats Follow­ ing Grafting of Normal Liver," is viewed by Howard Baldock, Squibb's director of medical relations. The exhibit was also displayed at the AMA's annual meeting in New York City in June. • Dr. K. Nicholas Leibovic, associate profes­ sor of biophysical sciences, is the author of a new book, Nervous System Theory, by Academic Press. • Dr. Howard Pattee, visiting professor of bio­ physical sciences, is the author of a new b o o k , H i e r a r c h y T h e o r y — T h e C h a l l e n g e of Complex Systems, by Doubleday in Canada and George Braziller in New York. • Dr. James C. Upson, clinical associate pro­ fessor of surgery, is the new president of the Buffalo Academy of Medicine. Dr. Charles P. Voltz, M'39, clinical assistant professor of medicine, is secretary-treasurer. Dr. Carl J. Bentzel, associate professor of medicine, and Dr. Jules Constant, clinical associate professor of medicine, are program co-chairmen; and Dr. David B. Harrod, clinical instructor of surgery, is arrangements chairman. • 72 Dr. John C. Dower, professor of community pediatrics in pediatrics and associate professor of social and preventive medicine, is moving to San Francisco where he will be professor of pediatrics at the University of California. Dr. Dower joined the faculty July 1, 1968. He was the first to occupy the Goodyear Chair at the University. • Dr. Uma Meenakshi Viswanathan is a clini­ cal instructor and attending pediatrician at the School of Medicine, University of Rochester, N.Y. and at Strong Memorial Hospital. He is also on the staff of the Northern Livingston Health Center in Geneseo, N.Y. He lives at 2134 North Littleville Road, Avon, N.Y. • Seven medical students are on summer fellowships sponsored by the New York State Division of the American Cancer Society. They are Miss Nina C. Kostraba, Ian S. Brown, Robert M. Weiss, James P. Burdick, Donald E. George, Mrs. Jane T. King and Marshall A. Fogel. • The Board of Trustees of the State Univer­ sity of New York has waived the mandatory retirement age regulation for two faculty mem­ bers. Sir John Eccles, Nobel Laureate and dis­ tinguished professor of physiology and bio­ physics, and Dr. Mitchell Franklin, professor in the Department of Philosophy and the School of Law, have both been granted appointments from September 1, 1973 to August 31, 1974. Dr. Eccles was 70 years old in January; Dr. Franklin is 71. The policies of the Board of Trustees require retirement of faculty members at age 70 unless the special waiver is granted. • THE BUFFALO PHYSICIAN �Two alumni are the new officers of the med­ ical staff at Deaconess Hospital. Dr. George L. Eckhert, M'42, is the new president and Dr. Her­ bert E. Joyce, M'45, is the new treasurer. Dr. Charles D. Bull, clinical associate in medicine, is the new vice president and Dr. Albert E. Menno, secretary. • Dr. Robert Kohn, a cardiologist and associate clinical professor of medicine, is the new president of the New York State Heart Assembly. • Mr. Fraser M. Mooney, assistant admini­ strator at the E.J. Meyer Memorial Hospital, is the new president of the Board of the Psychiatric Clinic, Inc. • Two alumni and two Medical School faculty members have been elected officers of the Erie County Medical Society. Dr. Frank J. Bolgan, M'51, is president elect and Dr. Victor Panaro, M'42, is secretary-treasurer. Dr. James H. Cosgriff Jr. is the new president. He is a clini­ cal assistant professor of medicine. The new vice president and delegate is Dr. Ralph J. Argen, clinical assistant professor of medicine. • Two alumni and two Medical School faculty members are new officers in the Pedi­ atric Society. Dr. Peter Dishek, clinical instruc­ tor in pediatrics, is the new president and Dr. James Markello, assistant professor of pediat­ rics, is vice president. Dr. John Hartman, M'45, is treasurer and Dr. Laurence Nemeth, M'66, is secretary. • President Robert L. Ketter was honored as V.I.P. of the Year by the Amherst Chamber of Commerce at its Seventh Annual V.I.P. Dinner in June. Dr. Ketter, who became president of U/B in 1970, was being cited for furthering good relations between the Town of Amherst and the University. As U/B vice president for facilities planning from 1967 to 1969, Dr. Ketter coordi­ nated the planning of the Amherst campus. • The Buffalo General Hospital has announced three administrative appointments. Mrs. Florence E. King, director of nursing ser­ vice, will also be assistant administrator while Mr. Charles E. Woeppel, administrative assistant will be an assistant administrator. Mr. Neal E. Wixson, administrative trainee, has been promoted to administrative assistant. • Dr. Ronald G. Vincent, chief of chest sur­ gery at Roswell Park Memorial Institute, is the new president of the Cumorah Stake of the Church of Christ of Latter-day Saints. • Dr. J.F. Cunanan, is Teaching Coordinator in Ob/Gyn at Deaconess Hospital, Buffalo. He received his medical degree in 1955 from the University of the Philippines. • Dr. William J. Staubitz, professor and chair­ man of the department of urology, was elected president of the 400-member Canadian Urologic Association. He is the first American to hold this office and will be installed at its annual meeting in Ottawa in 1974. • After 30 years of service Dr. Alfred Lechner, an obstetrical anesthesiologist at Children's Hospital, is retiring. He has instructed thousands of student nurses, attended at more births than any other medical person now at Children's and presided at more than 80,000 anesthesias — some 50,000 of them spinal blocks — a figure some medical personnel con­ sider a national record. • Dr. Edwin Neter, professor of microbiology, has been re-elected president of the Buffalo Chamber Music Society. • FALL, 1973 73 Pp n r » l P cUjJltJ �Dr. Helen M. Ranney, professor of medicine at the Medical School since 1970, was appointed chairman of the department of medicine at the University of California, San Diego on July 1. In May Dr. Ranney was one of 95 American scientists elected to the National Academy of Sciences. Last year she was pre­ sented the Dr. Martin Luther King, Jr. Medical Achievement Award "for outstanding contribu­ tion in the field of sickle cell anemia." Dr. Ran­ ney is president-elect of the American Society of Hematology. • Dr. Om Bahi, p r o f e s s o r o f biochemistry [ l e f t ) i s con­ gratulated by Prime Minister Indira Gandhi on being awarded the Padma Bushan Medal (India's highest award) for contributions to the public good of India. Presentation of the medal was made by President Giri in the Presidential Palace in New Delhi in March. Dr. Bahl was hailed /or his successful isolation and analysis o/ a hormone from human pregnancy urine. • People Two Medical School faculty members are officers in the Lakes Area Regional Medical Pro­ gram, Inc., Dr. Theodore T. Bronk, director of laboratories at Mt. St. Mary's Hospital, Lewiston, is the new vice president. He is also a clini­ cal associate professor of pathology. The new treasurer is Dr. John C. Patterson, clinical associate in ob/gyn and on the staff of Roswell Park Memorial Institute. The new president is the Reverend Cosmas Girard, OFM, Ph.D., a sociologist-anthropologist from St. Bonaventure University in Olean. Dr. Bert Klein, a Jamestown podiatrist, is the new secretary. • • 74 Dr. Charlotte S. Catz, associate professor of pediatrics at the Medical School, received a Fulbright grant to conduct research in developmental pharmacology at the Center of Biological Research on Newborns in Paris in September. She has been named as associate professor at the University of Paris where she will inaugurate a course on the pharmacology of the fetus and newborn. Dr. Catz came to Buffalo in 1966 and has been clinical director of the Birth Defects Center and associate attend­ ing physician at Children's Hospital. • Dr. Anke A. Ehrhardt, a clinical associate professor in pediatrics and psychiatry, is co­ author of a new book, Man &• Woman, Boy fr Girl, published by The Johns Hopkins Univer­ sity Press, Baltimore and London. Dr. John Money, professor of medical psychology and pediatrics at The John Hopkins Hospital, is the co-author. Dr. Ehrhardt heads, in collaboration with her husband (Dr. Heino F.L. MeyerBahlburg) the Psychoendocrinology Program at Children's Hospital. How do men become men, and women become women? How does a child establish gender identity? By what processes is the human being directed toward reproductive maturity as either male or female — are a few questions that are answered. • Dr. Edward J. Marine, clinical associate pro­ fessor of medicine at the Medical School, has been appointed chief of the department of inter­ nal medicine at Deaconess Hospital. From 196971 he served as associate dean and then execu­ tive associate dean and director of academic program at the Medical School. • THE BUFFALO PHYSICIAN �A Letter to Medical World News Birth of Obstetrics Teaching Birth of Obstetric Teaching SIR: In Dr. Fishbein's editorial "From 'Lying-in' to Modern Obstetrics" (MWN, July 14), he stated: "Almost unbelievably, bedside teaching of obstetrics did not begin until 1889; the innovator was Prof. Barton Cooke Hairst of Philadelphia." Not so, say we. For in 1850, Dr. James P. White, a professor of obstetrics and diseases of women and children, introduced "demon­ strative midwifery" for the first time in an American medical school. Dr. James P. White was born in Columbia County, N.Y., in 1811 and settled in Buffalo after graduating in medicine from Jefferson Medical College in Philadelphia in 1834. Twelve years later, in 1846, he and others organized the medical department of the University of Buffalo. He was appointed profes­ sor of obstetrics, a position he held until his retirement in 1881. On January 18, 1850, he introduced an innovation in the teaching of obstetrics — illus­ tration of labor with a living subject — before the graduating class. It was believed to be the first [lessonj of its kind in America. On separate occasions, Dr. White allowed the 20 members of the graduating class to see the woman during the ten days before her expected date of confine­ ment and to auscultate the fetal heart sounds by means of a stethoscope. At time of labor, students — brought into the room one by one — examined the patient under his guidance. At the end of the second stage, the entire class was called in, the patient placed on her left side, bed clothes drawn back to expose genitalia and buttocks, and the child was delivered by Dr. White before the class. So startling was this innovation in teaching that students passed a series of resolutions thanking Dr. White. VINCENT J. CAPRARO, M.D. Clinical Professor of Gynecology-Obstetrics MARION MARIONOWSKY Assistant to the Dean, Medicine State University of New York at Buffalo In Memoriam Dr. Anna P. Walsh, M'17, died June 5 in Buffalo General Hospital after a brief illness. She was 78 years old and had been a Buffalo physician for more than 50 years. Following her internship and residency at Bellevue Hospi­ tal, New York City, she returned to Buffalo to practice medicine and joined her late brother, Dr. Thomas J. Walsh. She was the founder of the American Medical Women's Association and active on the staffs of both Sisters of Charity and the E.J. Meyer Memorial hospitals. She was also a member of the Erie County Medical Soci­ ety and the AMA. • Dr. Theodore E. Goembel, M'30, died April 15 in Buffalo General Hospital. The 68-year-old FALL, 1973 physician received his undergraduate degree from Colgate University. Dr. Goembel, who practiced for 34 years, was on the staff of Deaco­ ness Hospital and served on the faculty of the Medical School 27 years (1933-1960) as assistant in medicine. He was a member of several professional organizations. • Dr. Frank S. Warzeski, M'60, died April 19 in Hartford, Conn, of a heart attack. He was 51 years old. From July 1967 to November 1971 Dr. Warzeski was attending psychiatrist at the E.J. Meyer Memorial Hospital. He was a native of New York City and held a Master's Degree in chemical engineering from M.I.T. • 75 �ACAPULCO VACATION February 23 — March 2, 1974 AIRLINE: Air Canada — charter HOTEL: Marriott — twin beds, air conditioned rooms with balcony and bath. COST: $439.00 per person includes full breakfast and lunch or dinner daily, scientific meetings and more. SCIENTIFIC MEETINGS: Continuing education sessions are being planned which will qualify this trip as TAX DEDUCTIBLE. RESERVATIONS: $100.00 will hold your reservation; the 150 passenger aircraft will be filled on a first-come — first-served basis. Make checks payable to U/B Alumni Association. For further information please contact: MEDICAL ALUMNI AFFAIRS 2211 Main Street — Bldg. E Buffalo, New York 14215 (716) 831-5267 The General Alumni Board — DR. FRANK L. GRAZIANO, D.D.S., '65, President; JAMES J. O'BRIEN, '55, President­ elect; GEORGE VOSKERCHIAN, Vice President for Activities; WILLIAM McGARVA, '58, Vice President for Admin­ istration; MRS. PHYLLIS MATHEIS KELLY, '42, Vice President for Alumnae; DR. GIRARD A. GUGINO, D.D.S., '61, Vice President for Athletics; RICHARD A. RICH, '61, Vice President for Development and Membership; DR. DANIEL T. SZYMONIAK, D.D.S., '47, Vice President for Public Relations; ROBERT E. LIPP, '54, Vice President for Govern­ mental Relations; ERNEST KIEFER, '55, Treasurer; Past Presidents: MORLEY C. TOWNSEND, '45; DR. EDMOND J. GICEWICZ, M'56; ROBERT E. LIPP,'51; M. ROBERT KOREN, '44; WELLS E. KNIBLOE, '47; RICHARD C. SHEPARD,'48. Medical Alumni Association Officers: DRS. LAWRENCE H. GOLDEN, M'46, President; PAUL L. WEINMANN, M'54, Vice President; MILFORD C. MALONEY, M'53, Treasurer; JOHN J. O'BRIEN, M'41, Immediate Past-President; MR. DAVID K. MICHAEL, M.S.'68, Secretary. Annual Participating Fund for Medical Education Executive Board for 1973-74 — DRS. MARVIN L. BLOOM, M'43, President; HARRY G. LaFORGE, M'34, First Vice-President; KENNETH H. ECKHERT, SR., M'35, Second VicePresident; KEVIN M. O'GORMAN, M'43, Treasurer; DONALD HALL, M'41, Secretary; MAX CHEPLOVE, M'26, Immediate Past-President. 76 THE BUFFALO PHYSICIAN �ALUMNI TOUR TO GREECE November 3-11, 1973 $359.00 plus 10% tax and service (per person, double occupancy) — Round trip jet to Athens with stops in Niagara Falls and New York City —Deluxe twin-bedded accommodations at the new Royal Olympic Hotel — Continental breakfast daily (tax and tip included) —Gourmet dinner each evening (your choice of either lunch or dinner — tax and tip included) —Tours to Acropolis and Athens Museum — Other low cost optional tours — All gratuities and transfers First Class Permit No. 5670 Buffalo, N. Y. BUSINESS REPLY MAIL NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES POSTAGE WILL BE PAID BY — Medical Alumni Association 2211 Main Street Buffalo, New York 14214 Att.: David K. Michael �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET, BUFFALO, NEW YORK 14214 THE HAPPY MEDIUM Fill out this card; spread some happiness; spread some news; no postage needed. (Please print or type all entries.) Name Year MD Received Office Address Home Address — - If not UB, MD received from In Private Practice: Yes • No • Specialty In Academic Medicine: Yes • : No • Part Time • Full Time • School_ Title — Other: Medical Society Memberships: NEWS: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.? Please send copies of any publications, research or other original work. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Fall 1973 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1973-Fall Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v07n03-1973-Fall Table Of Contents A list of subunits of the resource. Are Alumni Necessary? Spring Clinical Days Record Keeping Drug Reaction Health Security Nuclear Medicine Intern Matching Outer Space Resources/Executive Officer Commencement Seniors Honored 5,853 Graduates Oncology Unit Summer Fellowships Hospital Head/Dr. Larson Professors Honored Dr. Gottlieb/Alumni Receptions New Experience Medical Education/Chicago Reception West Side Health Center 141 Residents Interns Learning Center Environmental Physiology Lab Alumni Luncheon/Emergency Communications New Campus Our First Professor of Medicine by O. P. Jones, M.D. Physicians Retire $10,000 Gift Dog Racing Dr. Greco Millard Fillmore Hospital Research Award The Classes People In memoriam Alumni Tours Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v07n03 Extent The size or duration of the resource. 80 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright 1973 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/663cda77eb3ba0e8c9defe14381323fb.pdf fd40bc468fa479391da0d5d76cf32679 PDF Text Text IJ Surfactant Therapy Comes of Age �BUFFALO PHYSICIAN Volume 33, Number 4 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY S E R V I C E S Dr. Carole Smith Petro DIRECTOR O F PUBLICATIONS Kathryn A. Sawner EDITOR Stephanie A. Unger ART DIRECTOR/DESIGNER Alan J. Kegler PRODUCTION MANAGER Cindy Todd STATE UNIVERSITY O F NEW YORK AT BUFFALO S C H O O L O F MEDICINE AND BIOMEDICAL SCIENCES Dr. John Wright, Dean EDITORIAL BOARD Dr. Bertram Portin, Chair Dr. Martin Brecher Dr. Harold Brody Dr. Linda J. Corder Dr. Alan J. Drinnan Dr. James Kanski Dr. Barbara Majeroni Dr. Elizabeth Olmsted Dr. Stephen Spaulding Dr. Bradley T. Truax Christopher Adams Dr. Franklin Zeplowitz TEACHING HOSPITALS Erie County Medical Center Kaleida Health— The Buffalo General Hospital The Children'sHospital of Buffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital Roswell Park Cancer Institute Veterans Affairs Western New York Healthcare System Catholic Health System— Mercy Health System Sisters of Charity Hospital Niagara Falls Memorial Medical Center Dear Alumni and Friends, BY NOW YOU SHOULD HAVE RECOVERED from the pictorial extravaganza, featuring your new dean, in the winter issue of Buffalo Physician. Now, as I travel around the countryside meeting alumni, 1 will perhaps have become a more familiar face. Having just returned from such a trip (Houston, Dallas and San Antonio) it occurred to me that perhaps, as important as these excursions might be for maintaining contact with the school, they also represent marvelous opportunities for connecting alumni with others in the region. For example, in addition to getting together with classmates, more recent UB graduates are able to meet established alumni who just happen to live and work in the same area of the country. In Houston, where Robert Hall, class of 1948, hosted a dinner and reception, the graduation dates of alumnus representation spanned 56 years, including two graduates enrolled in the early years of their respective residency training programs. These residents were able to make contacts with established UB alumni—well placed and highly respected within the local academic and medical community, as well as nationally. In turn, the more "chronologically challenged" alums had opportunities to compare their experiences at UB with those of the more recent graduates. At our Dallas meeting, hosted by Ken Altschuler (Class of 1952), the represented dates of graduation spanned 46 years and provided similar networking opportunities, as did our subsequent meeting in San Antonio, hosted by Bradley Aust (Class of 1949 ), where two alumni were able to join the Dean's Advisory Council for a reception and dinner. Clearly, this kind of local networking is something we should try to encourage and facilitate through these events. Indeed, as we plan to repeat the Texas circuit of visits on a more regular basis, hopefully the word will get out about these affairs yielding even greater turnouts—and consequently, enhanced networking opportunities. Spurred on by the success of these recent meetings, we are planning additional outings to include California and Florida. Please be receptive to any of the forthcoming invitations to participate in one of these gatherings. I look forward to meeting with as many of you as possible.11 is particularlygratifying to meet former students but it is also great fun to trade anecdotes with pre-1963 graduates. Although my chair tenure in Buffalo began in 1974,1 was also at UB and actively teaching, between 1963 and 1967 (in fact, it isa little-known fact that I personally crafted many of the pathology exams during that time). Accordingly, I feel I know at least some of the students from that era as well. If we don't have an opportunity to meet on one of these future trips, I hope to see as many of you as possible at the upcoming Spring Clinical Day, which is scheduled for the first weekend in May. See you there! John R. Wright, MD Dean, School of Medicine and Biomedical Sciences © The State University of New York at Buffalo Buffalo Physician is published quarterly by the State University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alumni, faculty, students, residents, and friends. The staff reserves the right to edit all copy and submissions accepted for publication. Letters to the editor, address changes or other correspondence should be addressed to: The Editor, Buffalo Physician, State University of New York at Buffalo, Office of Publications, 136 Crofts Hall, Buffalo, NY Dear Fellow Alumni, 1 KNOW MANY ALUMNI HAVE NO IDEA how the Medical Alumni Association is governed, so this letter is my attempt to change that. The Governing Board oversees the various activities of the association. It consists of three officers,seven to nine active members, the immediate past president, three emeritus members and regional members representing alumni from outside Western New York. The board has several committees that oversee finances, medical student affairs, alumni awards and Spring Clinical Day/reunion activities. The purposes of the Medical Alumni Association (as stated by our Bylaws) is to promote the general welfare of the medical school, to advance the cause of medical education, to instill a fraternal spirit in the student body and to sustain that spirit among its alumni. The Governing Board meets ten times per year, in addition to the annual business meeting during Spring Clinical Day. Dues-paying members are invited to attend meetings and are encouraged to notify board members or the alumni office of their interest in becoming involved. It has been my honor to serve as the president of the Medical Alumni Association this year. 1 would like to acknowledge the support and help received from Mrs. Nancy Druar, the association's administrative assistant. She has had a particularly arduous year with our offices being moved and telephones being changed multiple times, as I am sure anyone who has tried to contact the office knows. Despite these hardships, she has sustained all the good works of our organization with much grace. I will pass the gavel to Richard Collins, '83, on May 1, 1999, at Spring Clinical Day. 1 hope to see many of you there. 14260. We can also be reached by phone at (716) 645-6969; by fax at (716) 645-2313; or Elizabeth L. Maher, MD by e-mail at President, Medical Alumni Association bpnotes@pub.buffalo.edu �II f f » [ 2 The Surfactant Story A SPECIAL REPORT ON 14 V O L U M E 3 3 , N U M B E R 4 S P R I N G Our Duty Toward Children and Family MAXINE HAYES, CLASS 18 1 9 9 9 New Health Care Business Center ORGANIZATION BUFFALO'S HISTORIC OF 1 9 7 3 , ASSISTANT DESIGNED TO SUPPORT ROLE IN DEVELOPING SECRETARY OF COMMUNITY REGIONAL HEALTH-CARE SURFACTANT THERAPY AND FAMILY HEALTH FOR IN BUFFALO, ONTARIO, by S. A. Unger WASHINGTON STATE ROCHESTER photos by Paul Francis by Mary Van Vorst by Ellen Goldbaum CORRIDOR Student Column Medical School News THE ROLE OF THE NEW PLACES, NEW PATIENT IN MEDICINE— FACES—OVERVIEW OF A FIRSTHAND ACCOUNT CHANGES ON SOUTH by James J. Mezhir CAMPUS by Lois Baker Hospital News CATHOLIC HOSPITAL MERGER TAKES SHAPE Development Research News JAMES PLATT WHITE ADVANCES AT UB'S TOSHIBA S ociety — M E D I C A L STROKE RESEARCH CENTER SCHOOL DONORS RECOGNIZED COVER PHOTO BY PAUL FRANCIS PICTURED ON THE COVER is nine-month-old Kristie Ponter, who wos born at 23 weeks andweighed 1.4pounds. She developed respiratory distress syndrome and was given surfactant shortly after her birth, according to her parents, Joelle and Rick Ponter of Gasport, New York, At her last checkup, Kristie weighed over 10 pounds. Classnotes DEBORAH A. WHITE, CLASS OF 1 9 B 7 , MOURNED �Special Report Buffalo's historic role in surfactant therapy, and the man who led the way t hurt me to see that when infants were born too early and had difficulty breathing, really nothing could be done about it. They were just left to die." In one breath, these are the words spoken by Goran Enhorning, obstetrician, as he talks about his motive for beginning his tortuous, but historic, quest to develop exogenous pulmonary surfactant 35 years ago. His hopes then, as they are today, weresimple and straightforward:to alleviate thesuffering and prevent thedeath of premature babies afflicted with respiratory distress syndrome (RDS), a condition that, previous to "the surfactant era," killed 70 percent of its victims. In his next breath, Goran Enhorning, Swedish research physiologist and inventor, moves away from the realm of the heart and into the mind, where, with softly accented words, he struggles to translate into layman's language the scientific insights he has experienced throughout his controversial career, a career he is still fully engaged in at age 75. Leaning forward in his chair in his office at the Children's Hospital of Buffalo, he explains that surfactant is a naturally occurring substance in the lungs that helps make breathing possible by decreasing surface tension at the airway-fluid interface in the alveoli. "Surface tension was described by LaPlace's Law—you know, P equals two times T over R, with P representing the pressure that must be generated to overcome surface tension, T, and R representing the radius of the alveolus ..." o B u f f a l o P h y s i c i a n S p r i n g 1 9 9 9 �UB professor of gynecology and obstetrics, is credited with playing a pivotal role in convincing the international medical community that surfactant-replacement therapy is a valid treatment for premature infants suffering from respiratory distress syndrome (ROS). He is pictured here with Alex Collura, who received surfactant therapy for RDS at Children's Hospital of Buffalo. Alex, who weighed 1 pound, 14 ounces at birth, is the son of Susan and Joseph Collura of Hamburg, New York. �n talking with Enhorning, it becomes clear how his affinity for both basic science and medicine enabled him to make crucial contributions that kept the field of surfactant research alive in years past, when leading experts worldwide dismissed its viability. It also becomes clear that his work contributed to making Buffalo, New York, a hub for surfactant research—a place where world-class scientists converged in free­ wheeling collaboration to help make real the dream Enhorning first envisioned many decades ago. These scientists include Enhorning's long-time colleague and sometime rival Edmund "Ted" Egan II, MD, professor of pediatrics and physiology at the University at Buffalo School of Medicine and Biomedical Sciences. In the early 1980s, Egan and his collaborators—building on Enhorning's seminal work—spurred on a highly contentious international race to develop the first exogenous surfactant product. Today, despite the behind-the-scenes jostling that continues among these competitors, there are several surfactant products on the market and, as a result, the mortality rate for infants born with RDS has dropped to 5 percent. This dramatic, innovative work has not ended in the clinic, however. As the 1990s draw to a close, Buffalo is equally noted for the contributions its scientists are making to basic research in the area of surfactant therapy— contributions that are leading the field into the 21st century, where it promises to impact a wide range of respiratory disorders affecting adults, as well as neonates. Bruce Holm, PhD, associate dean for research and graduate studies at UB's School of Medicine and Bio­ medical Sciences, is one of the preeminent scientists recruited to UB in the late 1980s by Enhorning and Egan. Like many others worldwide, he readily acknowl­ edges the pioneering contributions made by Enhorning, whose fortitude against all odds is now as well honored as his science. "If it weren't for Goran Enhorning, we wouldn't have the low neonatal mortality rates we have today," states Holm, "and we wouldn't have been able to develop our understanding of the science behind pul­ monary surfactant to the extent we have. And, clearly, there's a good deal for the Buffalo medical community to be proud of regarding its contributions to surfactant therapy and research. "But the surfactant story isn't over yet," he adds. "Even though it has already resulted in what would have to be considered one of the most dramatic breakthroughs in the past 50 years in terms of what neonatologists have in their repertoire for treating prematurely born infants, everyone involved believes there's much more to come." first espoused the theory that in order for the lung to function, it needed an agent that would coat the inside of the airway, particularly the tiny air sacs called alveoli (of which an adult human lung has about three million). He surmised that this coating would prevent the alveoli from collapsing during expiration, when they become very small. Working from an understanding of the Law of LaPlace, he deduced correctly that this agent causes surface tension in the lung to change its value and that the agent is composed of a phospholipid or protein. • e became so frustrated trying to get his work published, he gave up," explains E Enhorning. Medical historians often cite || von Neergaard's finding as a classic exampleofa "prematurediscovery," asnothing was done with his promising line of research until the early 1950s, when Richard Pattle in England and John Clements in the U.S. independently rediscovered the concept of an alveolar surface-active material that came to be known as "surfactant." "John Clements was and probably still is the biggest name in surfactant research," explains Egan. Working at the University of California at San Francisco, Clements, in the 1950s, was shoring up his reputation as a giant in his field by focusing on the problem of surface tension in the lung and the role surfactant plays in alveolar stability. His research in those early years was primarily basic, which put his career in perfect synch with the pioneering phase the science of lung physiology was undergoing at that time. "You have to understand that during that era— between 1940 and 1965—scientists were just beginning to gain a sophisticated understanding of how the lungs work and how we control breathing by mixing gas and air," says Egan. "And in the 1950s, these studies were being led by two or three great centers in the United u\ Discovering How the Lungs Work—or Don't To get a sense of the fortitude Enhorning, Egan and others needed to bring exogenous surfactant to where it is today—and to appreciate the promise it holds for tomorrow—it's necessary to go back to 1929, when the "surfactant story" begins. That year, a pulmonologist named Kurt von Neergaard, who was living in Switzerland at the time, o B u f f a l o P h y s i c i a n S p r i n g 1 9 9 9 �The Surfactant Story "If it weren't for Goran Enhorning, we wouldn't have the low neonatal mortality rates we have today, and we wouldn't have been able to develop our understanding of the science behind pulmonary surfactant to the extent we have." — BRUCE HOLM States, one of which was at the University at Buffalo, where key contributions were being made by Hermann Rahn, Leon Farhi and many others in our Physiology Department." A spin-off of the basic research going on at UB and elsewhere during this time was that scientists began to develop a more sophisticated understanding of lung diseases and their etiology, according to Egan. With the stage thus set, a giant leap in surfactant research took place in the late 1950s, when a pediatri­ cian named Mary Ellen Avery was invited to complete a fellowship in the laboratory of Jere Mead, a Harvard University physiologist. "Avery and Mead were think­ ing about the premature babies who had a progressively more difficult time breathing and then died. Their lungs were totally collapsed and looked like livers, and they had the idea that maybe these babies were missing this lung surfactant," explains Egan. Following through on this idea, Avery and Mead completed a complex project in which they studied the lung material of infants who died of RDS (then called hyaline membrane disease), compared with the lung material found in babies with normal respiratory sys­ tems who died of other causes. In a now-famous paper published in 1959, the researchers "showed that surface tension was higher in infants dying from RDS than it was if you got the lung material from infants dying from other causes," says Enhorning. Based on their findings, Avery and Mead put forth the idea that babies who have RDS are surfactant deficient, in the same way somebody with diabetes is insulin deficient. "This idea really sparked enormous interest," Enhorning comments. "This was very esoteric science," Egan emphasizes. "It wasn't anything the great majority of physicians around the country had any training in; they didn't understand it. There simply wasn't a good paradigm for it." Soon after publication of the Avery and Mead paper, the scramble was on to concoct an exogenous surfactant material and get it into the lungs of babies born with RDS. Around the world, research groups moved into action, hoping to be the first to produce a lifesaving substance that would put a stop to a disease that killed approxi­ mately 10,000 babies each year in the U.S. alone. At about this same time, in 1961, Goran Enhorning had just completed a PhD in physiology at Karolinska Institute's Medical School in Stockholm, Sweden, where B u f f a l o P h y s i c i a n S p r Bruce Holm, PhD, associate dean for research and graduate studies at UB's School of Medicine and Biomedical Sciences, came from the University of Rochester in 1988. That year, he teamed up with Sadis Matalon, then a UB physiologist, to show for the first time that high concentrations of oxygen can damage the cells in the lungs that produce surfactant. Today, the innovative studies conducted by Holm and his UB collaborators continue to help define the forward edge of surfactant research worldwide. in 1952 he had earned his medical degree. Upon gradu­ ation he was awarded a Fulbright scholarship to study at the University of Utah, where he began research into surfactant. Normally, Fulbright scholars are limited to a one-year stay, but an exception was made for Enhorning and his visit was extended for another year. During this second year, Forest Adams, a well-known surfactant researcher from the University of California at Los Angeles (UCLA), came to the University of Utah to lecture, at which time he was introduced to Enhorning. As a result of their meeting, Adams i n g 1 9 9 9 o �arranged for yet another year extension for Enhorning and made a place for him in his lab at UCLA. In Adams's lab, Enhorning continued work he had begun in Utah on an ingenious apparatus he called a bubble surfactometer, which he readily admits took him more than 15 years to fully develop. In the decades that followed, however, the bubble surfactometer would greatly enhance scientists' ability to run physical tests on surfactant preparations in order to assess their surface tension-lowering properties prior to in vivo studies. Adams's lab also provided the setting for Enhorning to work alongside another young scholar, Tetsuro Fujiwara of Japan, who, like Enhorning, would go on to devote his career to the elusive goal of developing a surfactant-replacement product. One of the requirements of Fulbright scholars is that they return to their country of origin for a minimum of seven years upon completion of their studies abroad. As a result, in 1964 Enhorning left Los Angeles to return to Sweden, but that was not the last he and Fujiwara would see of one another. D The Rush to Find a Cure uring the years that Enhorning and Fujiwara were studying in the U.S., the race had intensi­ fied amongscientists who hoped to be the first to determine the active components of lung surfac­ tant and to discover a replacement substance. Foremost among the scientists exploring this prob­ lem was Clements in San Francisco, who, in collabora­ tion with M. H. Klaus, was studying the biochemistry of surfactant. Using the limited testing technology they had available to them at the time, they concluded that the surface tension-lowering component of the material resided in its phospholipid, most specifically a biologi­ cally rare molecule called dipalmitoylphosphatidylcholine, or DPPC. Convinced that DPPC was the active surface tensionlowering substance in surfactant, the San Francisco group then decided to take a step that remains contro­ versial to this day. "They took this DPPC material, which they had only tested in physical systems, not biologic systems," says Egan. "It looked like surfactant. Best of all, it was easy to make, easy to work with, and they were really convinced they had the 'guts' of it, so their next thought was, 'Let's test it in babies.'" Additional motivation to push ahead with testing had come in 1964, when a Canadian group, which had rapidly followed up on Clements's findings, published a paper reporting that they had found some improvement in babies with RDS who had been treated with a DPPC mist. In 1965, therefore, with their new DPPC solution in hand, the Clements team boarded a plane for Singapore, where they had access to a large population of babies and could complete their studies quickly. "They took aerosolized forms of DPPC and fogged it into the babies," recounts Holm. "And remember, these are the days before mechanical ventilation. The babies were in these plastic hoods, and they just put this mist of DPPC in the hood and that was the concept of ventilation. Looking back on it, most of the DPPC probably stuck on their hair and face. I'm sure almost none of it got in their lungs. If it had, it probably would have had some positive benefit. But they hadn't done any animal studies so, among other things, they didn't know how to deliver it correctly." Upon returning, the group published a landmark 60-page paper in Pediatrics in 1967, concluding that exogenous surfactant was not efficacious for the treat­ ment of infants with RDS. "So here you have the biggest names in surfactant research saying thatsurfactant therapy doesn't work," says Egan. "And not only that, but concluding that surfactant deficiency was a result of RDS rather than the cause of it." Once the paper was published, interest in surfactantreplacement research for RDS, in large measure, came to a sudden halt. "Clements's conviction alone and his stature in the academic community were such that the publication of this paper turned the entire field of surfac­ tant research in the wrong direction for more than 10 years," Egan explains. Pausing, he adds, . . with the exception of one kind of idiosyncratic, brilliant intellectual who lived in Sweden and was an obstetrician by training." "This Has Been Tried Before and Does Not Work" Back in Sweden, with his bubble surfactometer in tow, Goran Enhorning was running some tests of his own. "DPPC wasinexpensive, it was sterile, it didn't have any antigenic proteins, so it was appealing. If you could use DPPC, it would have been wonderful. But you couldn't. It was hopeless. I found that out with the bubble surfactometer," he recalls. At this point, Enhorning turned to a pathologist named Bengt Robertson for help, and together the scientists experimented with various surfactant prepa­ rations, which they began early testing of on rabbit neonates. "What they found," Egan explains, "is that the rabbits lived longer and breathed better. But because the medical establishment was by now con­ vinced that surfactant deficiency was not the cause of RDS, they had trouble getting their work published. "I think people in the field ignored Goran's early work because he was producing evidence that was contrary to conventional wisdom, because he was up in �The Surfactant Story In the 1950s, these studies great centers in the United States, one of which was at the University at Buffalo, where key contributions were being made by Hermann Rahn, Leon Farhi and many others in our Physiology Department. Edmund "Ted" Egan II, MD, UB professor of pediatrics and physiology and founder, president and CEO of ONY, Inc., holding a vial of the company's exogenous surfactant product, Infasurf. In the early 1980s—building on Goran Enhorning's seminal contributions—Egan worked with Robert Notter at the University of Rochester to develop the drug. Their efforts fueled a race among scientists around the world working toward this same goal. Sweden and because he had very distinguished people openly pooh-poohing his work." After years of having his work essentially blackballed by the scientific community, Enhorning finally met with temporary success in 1972. "The editor of Pediatrics who accepted the paper Robertson and 1 coauthored was an exception," recalls Enhorning, "and he invited me to follow up with an editorial on our work." Despite publi­ cation of this paper, however, Enhorning and Robertson again found their work ignored; between 1972 and 1976, few journals accepted their papers. "Papers we submitted were rejected with one line: This has been tried before and does not work,'" recalls Enhorning. published a paper describing, in depth, his bubble surfactometer, which has since become a staple tool used by scientists studying surfactant. Based on the work Enhorning and Robertson were doing in the 1970s, researchers began revisiting the idea of creating a synthetic surfactant material. Some were once again testing the DPPC substance that Clements had unsuccessfully experimented with in the mid-1960s. For example, in 1976 Fujiwara was back at UCLA and was working with Adams in an attempt to duplicate the Enhorning and Robertson studies by depositing DPPC in the upper airways of sheep. Frustrated with their results, they concluded that surfactant therapy didn't work. "During a trip to Los Angeles that year, Robertson visited Adams's lab and was told about the frustrating results of the experiments. He told them that what they needed to use was natural surfactant from adult animals, not a synthetic mate­ rial like DPPC. So they changed their techniques and then could confirm our studies," explains Enhorning. Shortly thereafter, Robertson returned to Sweden permanently and Enhorning began collaborating with Fred Possmayer, a biochemist who worked in London, Ontario, at the University of Western Ontario. Their A year before publication of the paper in Pediat­ rics, Enhorning had moved to Canada to take a position at the University of Toronto. There, he continued collaborating with Robertson, who still lived in Sweden but made extended visits to Canada. "In 1973 and 1974,1did a study with Robertson I consider very important," says Enhorning. "We depos­ ited surfactant in the pharynx of premature rabbit neo­ nates, who inhaled it with their first breath, and X rays showed how it opened up their lungs. We published this goal was to develop a surfactant material that would be safe to test in babies. "One of the big problems we had was that the raw material—the natural surfactant—was very difficult to get," Enhorning recounts. To overcome this problem, Enhorning paid a visit to a local slaughterhouse in Toronto. "I got really lucky because one of the investigators working in research at the slaughterhouse had just hada baby who developed RDS,so study in 1975, and it was at that point that we started thinking about seriously testing it in babies." Toward this goal—and with publishing no longer an insur­ mountable hurdle—Enhorning and Robertson submit­ ted a steady stream of papers on animal studies they conducted throughout the latter half of the f970s. It was during this time, in 1977, that Enhorning first B u f f a l o P h y s i c i a n S p r l n g 1 9 9 9 o �There's no doubt that Enhorning and Possmayer were much farther down the with our synthetic product. was primarily interested in a synthetic product. Biochemist Fred Possmayer, PhD, of the University of Western Ontario in London, Ontario, collaborated with Goran Enhorning in the late 1970s to prepare a sterile and active exogenous surfactant product using material obtained from the lungs of large calves. It was this product that Ted Egan and Robert Notter used as a basis for developing Infasurf for treatment of neonates with respiratory distress syndrome. he arranged for me to get lung lavage from large calves." The surfactant material that Possmayer made using raw material obtained at the slaughterhouse was ex­ tremely active in terms of its surface tension-lowering properties; however, when they attempted to sterilize it with gamma rays or by autoclaving, this crucial activity was lost. "We felt this was due to its high protein content," says Enhorning, who by this time understood, as did all researchers in the field, that surfactant was a complex mixture composed of 90 percent lipids and 10 percent proteins. "In an attempt to rid the material of these proteins, we extracted the surfactant lipids and resuspended them in saline solution, and the material we obtained could then be autoclaved and sterilized without it losing its surface activity," he explains. However, unbeknownst to Enhorning and Possmayer at the time, a few tiny apoproteins slipped through and made it into their experimental material. It wasn't until the mid-1980s that scientists made the critical discovery that these apoproteins of pulmonary surfactant, which have since been named SP-B and SP-C, are essential for an immediate expression of surface activity. "Possmayer and I extracted the phospholipids from the material. By doing that, we thought we would get rid of the proteins, which we felt might be dangerous and which interfered with our attempts to sterilize the material," says Enhorning. "We thought we had removed all the proteins but, serendipitously, we hadn't. Later we found out that about 2 percent of the extract was made up of proteins that had slipped by when we analyzed its properties." Once Enhorning and Possmayer discovered how to produce their sterile, active substance, they wrote about it extensively in journal publications. o f f Coming Around to Goran Enhorning's Idea "By the late 1970s, everyone had come around to Goran Enhorning's idea of 10 years earlier: that it probably is surfactant deficiency that causes RDS," Egan explains. "The obvious next step, then, was determining what kind of surfactant-replacement therapy you're going to give. Basically, you have two options—synthetic and natural." E gan, himself, entered the field of surfactant research at about this time. In 1977 he moved to Buffalo, where he had accepted a joint appoint­ ment as chief of neonatology at Children's Hospi­ tal of Buffalo and professor of pediatrics and physiology at the University at Buffalo's School of Medi­ cine and Biomedical Sciences. "Ted Egan was a physiologist who had some world renown for his work in lung-water clearance," explains Holm, referring to the process in which, at birth, a baby absorbs the liquid that fills its lungs and establishes breathing. "And as a neonatologist and chief of neona­ tology at Children's, he obviously was interested in developments with surfactant therapy." Once in Buffalo, Egan set up his lab, where he conducted ongoing studies on sheep related to his research. Soon he met Robert Notter, a scientist who earlier in his career had given up a faculty position in chemical engineering at Pennsylvania State University in order to go to medical school, which he felt would better prepare him to pursue a consuming interest he had in lung surfactant. After he completed medical school at the University of Rochester, he stayed on as a faculty member, dedicating himself to his research. �The Surfactant Story what we had used was whole lung surfactant as we had planned," Egan says. "But when it worked so well, I said, 'This whole surfactant is great!'" It was at this point that Notter informed Egan that what they were testing was an extract he had prepared based on the published works of Enhorning and Possmayer, an extract that he had slightly modified to his own specifications. "There's no doubt that Enhorning and Possmayer were much farther down the road with their natural extract in 1981 than we were with our synthetic prod­ uct. Until we ran this test, Bob was primarily interested in a synthetic product. But once this new extract looked so good and once I found out that there was almost no protein in it, I thought, 'We're home,"' Egan recalls. It was from this point onward that Egan and Notter abandoned their quest for a synthetic surfactant and focused their efforts on refining a natural extract. y 1980, Bob Notter had a synthetic mixture of surfactant that we both thought would work, and we decided that the best way to find out was to test it in my sheep," recalls Egan. Egan and Notter were encour­ aged by a paper that had just been published in Cambridge, England, which reported that surfactant had been tested on babies with very good results. Based on the Cam­ bridge study and others, they were acutely aware that groups around the world were hard at work in the ongoing race to develop their own surfactant products. They knew, for example, that Fujiwara had returned to Japan and was working there; that Clements was working in San Francisco; that Robertson had returned to Sweden, where he was continuing his research; that a group in San Diego was approaching the problem by extracting surfac­ tant from amniotic fluids; and that Enhorning and Possmayer continued their work in Toronto. A Which Way to Go? ll the scientists working on surfactant worldwide had come to this difficult junction in their re­ search. Obviously a synthetic product was attrac­ tive: It would be easier to mass-produce, would be available in limitless quantities, could be more easily controlled for quality and could be patentedand sold as a brand-name product, something that was sure to attract the needed support of pharmaceutical companies. Natural products, on the other hand, while holding exceptional promise, posed very formidable challenges. It was with great anticipation, therefore, that Egan and Notter began their experiments in 1981. Notter had exten­ sively tested his surfactant preparation in physical systems and had found it very promising. "We took this synthetic product and put it in preemie lambs that were surfactant deficient, and the results were disastrous," Egan recalls. Frustrated with their lack of progress, Egan andNotter decided they needed to pull back and reassess their methodology because, as Notter pointed out, everything was looking good on his physical systems, so perhaps they needed to look at whether Egan's "experimental setup" was flawed. "In other words, he was saying to me, If we have good stuff, would we even recognize it? " Egan says. Thinking there was only one sure way to determine this, the scientists decided they would put their synthetic mixture aside and instead test a dose of whole surfactant taken directly from the lungs of an animal. "We were simply looking for a positive control," Egan says. However, what occurred that day in March of 1981, when they tested the new surfactant mixture, was something Egan says he will never forget. "It was stunning. It was probably as exciting a lab event as I've ever participated in. Surfactant-deficient sheep are pretty doleful animals, let me tell you. But when we gave them the surfactant Bob provided, they were acting like mature fetal sheep getting ready to be born. It was fantastic." But the biggest surprise was yet to come. "I thought "In 1980 we knew that natural surfactant was about 10 percent proteins and that one of these proteins was very large. Like the proteins in your blood, it clots, coagulates and you can't sterilize it; it has all kinds of problems," Egan explains. "So we were faced with two issues: if we were going to develop a natural replacement product, it had to be one that wouldn't hurt the patient, yet was hardy." In 1983, despite these complications, the BuffaloRochester team of Egan and Notter and the Toronto team of Enhorning and Possmayer had each begun small, prospective placebo-controlled trials of natural surfactant extract to prevent RDS in preemies—at last marking the start of full-fledged efforts on the part of the two groups to test the drug in babies. Two years later, both the Buffalo-Rochester group— now joined by clinicians Melinda Kwong and Donald Shapiro—and the Toronto group had completed larger randomized clinical trials, which they each reported on in the August 1985 issue of Pediatrics. Using what were similar extracts, they demonstrated that calf-lung "We were simply looking for a positive control," Egan says. However, what occurred that day in March of 1981, when they tested the new surfactant mixture, was something Egan says he will never forget. u f f a l o P h y s i c i a n S p r i n g 1 9 9 9 o �surfactant extract did prevent lung disease in premature babies and could significantly reduce the severity of respiratory disease. "After seeing the results of these clinical studies, all of which were so compelling for this particular material, Ted took it on as a crusade to go out and see that it became widely available," recounts Holm. "Early on, he had offered the calf-lung surfactant, pretty much free, to pharmaceutical companies, but they had already com­ deficiency; therefore, the accepted belief was, 'It can't be part of the issue."' B y the late 1980s Holm, who had admired Enhorning for many years, began to collaborate with the senior scientist and others on studies demonstrating a mechanism by which plasma proteins were shown to inhibit surfactant func­ tion. These findings, published in 1988 in the Journal of Applied Physiology, helped introduce the concept that surfactant-replacement therapy could be of benefit to a much wider range of lung conditions than just RDS. "While we were off doing clinical studies, Holm was working with researchers throughout this area—in Buf­ falo, Rochester, Toronto and London, Ontario—to find out that you can inhibit lung surfactant, which was a brand new concept," explains Egan. "They were showing that surfactant plays a role in lung diseases, not just when it is missing, but when it becomes deactivated by things seep­ ing into the lungs that don't belong there and which start tearing up the surfactant, making it terribly difficult for people to breathe. We began to see it as being similar to autoimmune diseases, where the body turns on itself." In 1988 Holm also teamed up with Sadis Matalon, mitted to marketing products developed by other groups. Also, another reason why they weren't interested in the material was that it had been reported on in professional journals to such an extent it was considered to be in the 'public domain,' so it couldn't be patented. "So this really was the genesis of the idea 'Let's go out and make and market our own product.'" In hindsight, Holm adds, "Remember, these were academic physicians with no background in commercializing a drug, and so they were too naive to know that they couldn't go through the FDA process without any financial backing." What they did have, according to Holm, was "the best of intentions and a belief that what they were doing was for the greater good." Determined to provide a parent company for his orphan drug—which has since been dubbed "Infasurf"— Egan founded ONY, Inc. (Ontario New York), in 1985 and set up offices in the Baird Research Center located near the University at Buffalo campus. who was then a physiologist at the University at Buffalo, and others to publish a study that showed for the first time that high concentrations of oxygen can cause changes in Type II pneumocytes, the cells that produce surfactant. A Boost from Basic Research "Obviously, this was really very important because we use oxygen as an essential therapy for treating lung diseases," explains Egan, who notes that, today, the 40-year-old Holm is recognized as "one of the world's leading experts on oxygen toxicity." "Not only did Holm and Matalon document that oxygen can damage cells in the lungs that make surfac­ tant, but they also showed that if you give an animal surfactant, it will speed its recovery, diminish the injury or even prevent it," he adds. While studying oxygen toxicities, Holm also refined a technique for isolating the Type II pneumocytes. This was a very important development, as well, according to Enhorning, because "more and more, physiologists are studying disease at the cellular and molecular level." While surfactant was entering its clinical-trial phase, other equally momentous developments were again tak­ ing place on the basic-science side of surfactant research. Much of it centered onBruce Holm, who in 1981 came to work in Notter's lab at the University of Rochester while pursing a doctorate in toxicology. Over the next seven years, Holm gained considerable recognition for a series of contributions he made to the field of surfactant. In the mid-1980s, it was Holm and Jeffrey Whitsett, a researcher at the University of Cincinnati, who conducted a study that finally identified apoproteins as the mystery component in surfactant that enables it to be efficiently adsorbed by the lungs. In their paper, which was published in Pediatric Research in 1986, they were the first to show the functionality of the apoproteins SP-B and SP-C. From the start, Holm was primarily interested in studying adult respiratory distress syndrome (ARDS) Critical Mass Converges in Buffalo As the years passed, it became increasingly clear that, philosophically, the Buffalo-Rochester group had much in common with the Toronto group and that, together, they stood apart from other groups worldwide. Most important, they shared the philosophy that both lipids and proteins must be included in surfactant prepara­ tions if they were to produce optimal results. Further- and its potential connection to surfactant. "No one had ever really wanted to study surfactant in adults," he explains. "Initial attempts to do so went nowhere because the dogma at the time was that surfactant deficiency was related to a quantitative deficiency—as in the case of premature babies—but not to a qualitative 0 B u f f a l o P h y s i c i a n S p r i n g 1 9 9 9 �The Surfactant Story "It's this cell-biology aspect that will take us to the next level. The philosophy shouldn't just be 'Okay, we can keep them alive.' That, of course, is very important for the physician, but, for a scientist, you always want to go one step farther; you want to see if you can prevent this from happening Robert Notter, MD, gave up a faculty position in chemical engineering at Pennsylvania State University to earn a medical degree, which he felt would better prepare him to pursue a consuming interest he had in lung surfactant. In the 1980s, as a faculty member at the University of Rochester, he collaborated with Ted Egan at the University at Buffalo to develop the surfactant drug Infasurf. more, they felt strongly that both SP-B and SP-C must be present because their research had shown that the two apoproteins work synergistically. In contrast, in the late-1980s Clements's group in San Francisco, which had by then partnered with Burroughs Wellcome, wasdeveloping a synthetic prepa­ ration called Exosurf that was composed primarily of DPPC and contained no protein. In turn, Fujiwara's group in Japan, which had partnered with Abbott Labs, was testing a patented product called Survanta, manu­ factured from a mince of whole cow lung, supplemented with synthetic phospholipids and neutral lipids, but containing only trace amounts of the SP-B apoprotein. G iven the long years of collaboration between the Buffalo-Rochester-Toronto researchers, it came as no surprise when Egan successfully recruited Enhorning to Buffalo in 1986, fol­ lowed in 1988 by Holm, who came from the University of Rochester to complete a postdoctoral fellowship at UB, during which time he worked with Enhorning and others to continue his novel work on surfactant inhibition. There's So Much at Stake Once the randomized clinical trials were completed on Infasurf in 1985, Egan initiated the process whereby he hoped to win Food and Drug Administration (FDA) approval for the drug. Immediately, he was told by the FDA that in order for Infasurf to be considered for approval, controlled studies of it had to be completed. in the first place." — BRUCE HOLM "This meant some of the babies would getsurfactant and some of the babies would get nothing," recalls Egan. "So I said, 'I can't do that.'" Egan's appeals to the FDA to make an exception to their rule did not meet with success. As a result, he decided to delay controlled clinical trials until other surfactant drugs came on the market, at which time he could compare one surfactant to another. In 1990, his wait ended when Exosurf was approved by the FDA and debuted as the first surfactant drug available in the U.S., followed closely by Survanta in 1991. In the intervening years, while waiting for Exosurf to come on the market, Egan made Infasurf available to all babies in Buffalo who needed it, something he was able to do while Infasurf was classified as an "investigational new drug." This strategy was given a boost in 1989, when the FDA gave Egan's company, ONY, Inc., per­ mission to charge for Infasurf so that costs for its development could begin to be recouped. However, the FDA gave the company permission to do this with the stipulation that it upgrade its manufacturing facilities to meet the requirements for a commercial venture. The only way to get the needed equipment in a timely manner was for the owners of the company to guarantee a loan, which Egan did personally after buying out the other owners. "I was placed in a position where I felt we had developed something that was really a super therapy but which, because it wasn't a mainstream commercial venture, was about to be abandoned," Egan says. "I thought about my own motivation up to this point—why I went into this in �the first place—and I felt it really didn't do any good to develop an optimal product and then watch it die." In 1989, therefore, Egan gave up his position as chief of neonatology at Children's Hospital of Buffalo and went to a part-time status at the hospital in order to fully devote his energies to ONY, Inc. present, while Infasurf contains it in quantities normally found in healthy mammals." To demonstrate what he calls "a night-and-day difference" between protein-based surfactant drugs and those containing no proteins, Holm points out that as soon as Survanta became available, "Exosurf rapidly lost its majority share of the market, which tells you what the clinicians using the two drugs are finding. We feel that Infasurfs inclusion of both apoproteins makes it a drug with notable differences when compared with W hen Exosurf came on the market in 1991, Infasurf finally entered the clinical-trial phase for FDA approval, as studies were conducted in which the two drugs were compared. To facilitate this process, ONY, Inc. formed an Survanta and one that defines the 'next generation' in surfactant drugs." alliance with Forrest Labs, which has its headquarters in New York City. With Forrest Labs providing the person­ nel and financial resources needed for this costly process, FDA trials of Infasurf were completed between 1991 and 1994, with all data submitted to the agency by 1995. In 1995, when it looked like Infasurf would finally make it out the other end of the FDA pipeline, Egan's plans hit yet another snag and were ground to a halt. When the FDA approved Survanta in 1991, it designated it an "orphan drug" because it was determined to be the first pharmaceutical of its kind. "Being designated an 'orphan drug' by the FDA puts you in a category that gives you some tax breaks and provides you market exclusivity against similar or same drugs for seven years. It's like having a patent for that period of time. What happened in 1995 was the FDA decided that, under the orphan-drug rules, Infasurf was the same drug as Survanta. That doesn't mean that we are the same drug, like a generic drug, but just that we are a 'similar' drug," Egan explains. The effect of this ruling, therefore, was that Infasurf had to stay off the market until 1998, since Survanta had made its debut in 1991. Despite repeated requests for the FDA to change its ruling, the decision held fast. Today, Egan simply says, "What it came down to with the FDA is that both drugs came from cows." On July 1, 1998, the exclusivity clause for Survanta expired, and Infasurf finally became an FDA-approved drug. What would have otherwise been a banner day in the history of Infasurf, however, was clouded by yet another obstacle. In 1994, Abbott Laboratories claimed Infasurf infringed on Survanta's patent, and hearings on the ensuing case began in June 1998. Despite the ongoing legal battles (see article, page 13) Egan is convinced that as Infasurf becomes widely avail­ able to physicians working on the front line in neonatal intensive care units, it will win a significant share of the market through its own merit. "Physicians are looking for the best product," he says, "and any margin of improve­ ment will be huge because there's so much at stake." The Stage Has Been Set Throughout the 1990s, scientists in the informal Buffalo-Rochester-Toronto research network have con­ tinued to pursue independent interests, as well as to collaborate with each other on groundbreaking studies that have helped define the leading edge of surfactant research worldwide. "We're looking at cell-directed therapies now," Holm says. "We know that surfactant can take care of many of the symptoms of lung disease and that it has reduced infant mortality related to RDS to 5 percent, down from a high of 70 percent in the 1960s. So now what we want to do is take a step back and ask ourselves, Can we stimulate the cells so you can never get the symptoms in the first place? That involves looking at what the mechanisms are for cellular function, and what we've dis­ covered is that you can do pharmacological manipulations, n" Holm is emphatic about the difference between Infasurf and the Survanta and Exosurf products. "In our opinion, and in the opinion of many scientists, the most effective surfactant drugs are those that contain the lipids as well as the two apoproteins B and C. Our studies have shown that these two proteins work synergistically and that, of the two, B is the most important. Exosurf contains no proteins, and in the Survanta preparation only minute amounts of the B protein are particularly with I* oxidant stress, and *» > i T •' L © B u f f a l o P h y s i c i a n S p r i n g 1 9 9 9 �The Surfactant Story you can prevent this damage from occurring in vitro and in vivo." Citing a series of diverse investigations that build on surfactant research, Holm talks about studies ongoing at UB whereby researchers are hoping to find improved ways of treating ARDS, pulmonary dysplasia and hypo­ plastic lung from congenital diaphragmatic hernia. Referring to the latter condition, he says, "For example, we have shown that the blood-flow problem that exists there and the stiffness of the lung can be corrected by giving exogenous surfactant. But the lungs are still small, so we've been doing things directly to the Type II cells in this and other injuries. By tweaking those cells and putting mechanical stressors and growth factors in, lo and behold, we're finding we can grow the lung back to normal size in two weeks in vivo. "So, we're branching out, and it's interesting because it's all growing out of surfactant," he adds. "It's this cellbiology aspect that will take us to the next level. The philosophy shouldn't just be, 'Okay, we can keep them alive.' That, of course, is very important for the physi­ cians, but, for a scientist, you always want to go one level farther; you want to see if you can prevent all of this from ever happening in the first place." Enhorning couldn't agree more and has headed off on his own to again champion a controversial theory in which he contends that surfactant dysfunction The Pro rogress IjT e courts and new clinical trials W hen the Food and Drug Administration (FDA) approved Infasurf in July 1998, ONY, Inc., and Forrest Labs implemented a licensing agreement which stipulated that ONY, Inc., would manufacture Infasurf and Forrest Labs would mar­ ket it under its label. Despite this progress, ONY, Inc., still faced a legal challenge from Abbott Laboratories, which in 1994 claimed Infasurf infringed on the patents of its surfactant drug, Survanta. A trial was held in the summer of 1998 in the District Court in Buffalo. "To be honest, Abbott is a 13-billion-dollar-a-year company and their attitude toward a multimillion dollar lawsuit is very differ­ ent from that of a 20-employee embryonic company," says Edmund "Ted" Egan, MD, ONY's founder, president and chief executive officer, who isalso a professor of pediatrics and physiology at the University at Buffalo School of B u f f contributes to symptoms of asthma. To assist in the elucidation of his new theory, he has again invented an apparatus, which he calls a capillary surfactometer. "I feel the capillary surfactometer is the most important work I have done; I think it has the most promise," he states matter-of-factly. Egan is following Enhorning's new studies with great interest and says, "Goran has this fascinating, very innovative theory about asthma and, again, he's going against the tide, he's way out in left field. He's challeng­ ing conventional wisdom and almost nobody thinks he's right because he's saying that the reason why asthmatics have a tough time getting air is not because there is a spasm of the muscles of the airway and not because the airway is clogged with inflammation, but because they have surfactant dysfunction. And you better watch him, because he may be right again." " Fortunately, history may not repeat itself for Goran Enhorning. "Some people are looking at what Goran is saying and have approached us about doing some studies in asthma and respiratorysyncytial virus," Holm reports. "But, really, the big battle has been won, and that battle was getting enough evidence out there to finally convince the international medical community that surfactant-replacement therapy is a valid treatment for premature infants. That set the stage; now the science will continue to develop." + Medicine and Biomedical Sciences. In September 1998, the jury in the case ruled in favor of Abbott Laboratories, but a final judgment has not been entered and appeals are expected to extend the legal dispute well into 2000. Commercial sales of Infasurf await resolution of the law­ suit, according to Egan. Meanwhile, Infasurf continues to make impressive in­ roads in the scientific arena. In January 1999, Critical Care Medicine (Vol. 27, No. 1) published a study led by Douglas F. Willson, MD, of Children's Medical Center of Charlottesville, Virginia, in which it was shown that pediat­ ric patients who received the drug for a spectrum of respiratory disorders demonstrated rapid improvement in oxygenation and, on average, were extubated 32 percent sooner and spent 30 percent less time in the pediatric intensive care unit than control patients. "The success of surfactant replacement therapy in newborn infants with respiratory problems is well established now, so scientists are looking at its efficacy for children beyond the neonatal period," says Egan, who was a coauthor of the study. "While these findings are very encouraging, a larger, blinded, controlled trial is necessary, and this is something that's being planned before recommendations can be made for use of surfactant in pediatric patients with respiratory failure," he adds. 0 �WHEN PEDIATRICIAN MAXINE HAYES entered medical school at the University at Buffalo in 1969, she was planning on a career in oncologic research. However, after her first year at UB, she decided she could make a greater contribution as a clinician, so for the first time she began to ponder her career options as a physician. "I wasn't going to pursue pediatrics because that was the unspoken gestalt of that time: Women were supposed to become pediatricians," she recalls. During her clinical rota­ tions, she discovered she had promise as a surgeon, but, still, something wasn't quite right. This "something" suddenly began to clarify when she completed her final clinical rotation, which was in pediatrics. Hayes says she found that the people who were drawn to pediatrics were different from those in other medical disciplines. "They were highly sensitive to social issues. They weren't necessarily interested in making a lot of money, and they were very public-health oriented," she explains, adding with a chuckle, "They were a lot like me." ��"EVERY CHILD HAS A RIGHT TO A GOOD AND AFTER THAT A CORE OF GOOD PREVENTIVE HEALTH SERVICES. LI I HESE INTUITIVE PROMPTINGS eventually compelled Hayes to redefine her career goals, and in the two and a half decades since graduating from UB, she has gone on to become not only one of the more prominent pediatricians in the United States, but also a public health advocate widely recognized for her dedication to policies that promote maternal and child health. Today, Hayes is the assistant secretary of community and family health for Washington State's Department of Health, where she oversees a staff >f more than 200 and manages an annual budget of over $300 million (70 percent of the Department of Health's budget). Maxine Hayes's push to succeed can be traced back to her childhood in Jack­ son, Mississippi. Raised in thesegregated South of the 1950s and '60s—where she says there was literally a railroad track separating blacks from whites—she grew up poor, but admits she never knew it. "My family taught me there was nothing 1 couldn't do," she says. In addition to poverty and racism, Hayes remembers battling the specter of sexism in high school, as well, and reflects, "I guess I was always trying to prove girls could do things boys could do, and do them better. It tickled me to death when I was valedictorian of my senior class and a boy came in second." It was during her high school years that Hayes was singled out by an African American women'sservice club, LINKS, Inc., which every year took under its wing one promising African American girl or boy from each of the three public high schools in Jackson. The women in this club introduced their young charges to art, music and literature. Also, to compensate for segregationist practices that banned blacks from fine restau­ rants, the women hosted elaborate social dinners in their homes, taking the opportunity to teach etiquette to Hayes and the others. Among the women in the club was a graduate of Spelman College in Atlanta who, over time, became Hayes's mentor. Convinced Hayes would flourish in the all-girls' setting at Spelman, the woman encour­ aged her to apply. When the college responded with an offer for a scholar­ ship, Hayes was on her way to Atlanta. © While at Spelman, where she ma­ because she wanted to dedicate her jored in biology, Hayes won a Charles career to finding a cure for cancer and Merrill scholarship to study abroad in UB's affiliation with Roswell Park Can­ Vienna for a year, an opportunity whose cer Institute strongly appealed to her. timing would lead to events that would "I felt there was a reason why all of alter her life's path in ways she never that happened, and that attending medi­ could have imagined at the time. By cal school was going to provide me with choosing to go abroad an opportunity to and opting to study do something for outside her major, my community Hayes delayed her and the greater graduation by a year. good. As the say­ And that year— ing goes: 'To 1968—was a momen­ whom much is tous one marked by given, much is also the assassinations of required,"' Hayes both Robert Kennedy says. "I had class­ and Martin Luther mates in my biol­ King, acts of violence ogy classes at that resulted in politi­ Spelman who cal upheaval and calls would have given for change. One fallout from Hayes says she has long had anything to go to medical that tumultuous year was an appreciation for the social school. But they graduated that the country began to context of medicine. "We on time and were not given examine its college and post­ that opportunity. That all physicians need to have a role graduate entrance policies turned around in one year, in impacting policies," she for minorities. As a result, and I have always felt it was contends. "We need to ensure for a reason." the extra year Hayes added that the technical knowledge to her undergraduate stud­ After her first year in medi­ ies put her in the right place brought to healing is such that cal school, Hayes spent a at the right time when medi­ it gets to the root causes of why summer working as a medi­ cal schools began working people are sick in the first cal extern at a family health place, things such as poverty to attract minority students. clinic in Mississippi. It was When she had entered and social disparities." there that she realized her Spelman, Hayes's goal had family had shielded her from been to eventually earn a PhD in biology the stark realities in her home state, as or cytology; however, in 1969, when that summer she not only wrote pre­ recruiters-from UB's medical school of­ scriptions for medicine, she wrote pre­ fered her a scholarship, she accepted it, scriptions for food. "I began to see all the turning down a scholarship to Harvard social ills and to realize that having the f f �wasted S o MUCH OF WHAT WE SPEND IS technical knowledge of medicine was not going to be sufficient," she recalls. Following graduation from UB in 1973, Hayes pursued her postgraduate training in pediatrics at Vanderbilt Uni­ versity Hospital in Nashville and at Children's Hospital Medical Center in Boston, finishing in 1976. In 1977, she went on to earn a master's degree in public health at Harvard University. She then returned to Mississippi, where she established a primary care family health clinic on the outskirts of Jack­ son, becoming the first and only pedia­ trician in Rankin County and serving a population of some 60,000. Word of Hayes's success in her Mis­ sissippi clinic began to circulate among public health professionals and, in 1985, "out of the clear blue," she says, she received an offer from Children's Hospi­ tal and Medical Center in Seattle to serve as medicaldirector for the Odessa Brown Children's Clinic, which delivers primary care to a predominantly lowincome population in central Seattle. Hayes accepted the offer and moved West, leaving her home state but not its problems, which she soon discov­ ered to be much the same in Washing­ ton State, except that instead of poor rural families, there were poor innercity families. Hayes says her move to Seattle was nothing short of culture shock. Though soft-spoken, she acknowledges, "I'm very intense, very competitive—a TypeA personality. "When I arrived in Seattle, the first thing everybody noticed was my inten­ sity, and people in the Northwest are definitely not intense. I was amazed you could be so productive and casual at the same time." Over time, as people got to know her, she says, "They told me, 'Loosen up,' so, now, Birkenstocks are definitely part of my wardrobe, and I carry a backpack at all times, even on the rare occasion when I'm wearing a business suit. I've been won over!" During her three years as medical B u f f a l o P h y s i c i ON TRYING TO CURE THINGS THAT COULD HAVE BEEN PREVENTED." director at the Odessa Brown Children's Clinic, Hayes worked to expand its mis­ sion. In addition to seeing patients her­ self, she set up educational programs for unemployed single mothers, established a sickle-cell screening program and ad­ vocated for policies that ensured better access to health care for foster children. Hayes's dedication and organizational talents caught the attention of Jule Sugarman, one of the founders of Headstart and then-secretary for the Department of Social and Health Ser­ vices for Washington State. Sugarman had a vision for children's health in Washington and needed a pediatrician who had credibility in the private com­ munity to go to work in the public sector. In 1988, hesuccessfully recruited Hayes to come to work with him for the express purpose of getting a bill passed in the legislature that would launch a maternity care access program called First Steps. "I'm not asking for your life, only two years," she recalls him saying in response to her hesitation to leave a job she loved. Sugarman, who had al­ ready gotten Children's Hospital to agree to "loan" Hayes to the state for that period of time, told her: "Go and get this bill implemented, and then you can go back." What really hooked Hayes, she says, was when he asked her, "How long do you want to take care of kids one by one and deny the opportunity to take care of every single one of them?" B ecause her original appoint­ ment was to be temporary, Hayes decided to stay in her home in Bellevue, a suburb east of Seattle, and make the daily threehour round-trip commute by vanpool to the state capital of Olympia. That was 10 years ago, and she's still at it. Hayes, a single mother of two boys, ages 12 and 16, starts each day at 5:30 a.m. Carpooling by van allows her time to work en route and frees her to spend time with her sons after her busy days, which usually include a visit to the gym, a n S p r i n g 1 9 9 9 where she says she follows "a very disci­ plined exercise program." Hayes's initial appointment in 1988 was as director of the Division of ParentChild Health Services, and one of her first accomplishments was to help win passage of the First Steps legislation as Sugarman had hoped she would. In1990, she was promoted to assistant secretary of Parent-Child Health Services, and three years later she moved into her current position as assistant secretary of community and family health. Hayes believes her most important contribution to public health is her abil­ ity to solve problems. "I see opportuni­ ties where others see challenges," she says. Last year she created a new office in her division, called the Office of Com­ munity Wellness and Prevention. By targeting the pediatric population, in particular, this office strives "to approach chronic disease by looking at common risk factors, such as tobacco, physical inactivity and nutrition, especially as it relates to obesity," Hayes explains. An­ other innovative idea she implemented was to position the state's Women, In­ fants and Children (WIC) program as a counterpart to existing chronic disease prevention programs. "When you look at chronic diseases, you realize you can begin to intervene against many risk factors for these diseases in childhood by focusing on good nutrition," Hayes notes. "Our health department is the only one in the country where you'll find this 'upstream' approach to chronic disease prevention." Hayes says she has long had an ap­ preciation for the social context of medi­ cine. "We physicians need to have a role in impacting policies," she contends. "We need to ensure that the technical knowledge brought to healing is such that it gets to the root causes of why people are sick in the first place, things such as poverty and social disparities." She is particularly adamant on the CONTINUED ON PAGE 26 o �MEDICAL New Health Care Business Center Opened — CAPITALIZING ON MARKETABLE PRODUCTS AND PROCESSES THAT DEVELOP FROM RESEARCH I M A G I N E B U F F A L O , Rochester and Ontario as an internationally recog­ nized corridor for innovation in health care, with the University at Buffalo a critical component. That's the vision that led to the formation of the new Health Care Business Center (HCBC), a joint venture between UB and the Health Care Industries Association that will allow the region's health-care industry to capitalize on marketable products and processes that develop from research projects at UB, Roswell Park Cancer Institute, Kaleida Health and the Catholic Hospitals. According to the Health Care Indus­ tries Association, a nonprofit organiza­ tion designed to support and promote the regional health-care industry, this corridor, dubbed the "Lake Affect Region," represents the fourth-largest medical development market in North America, with more than 100 research institutions, 265 medical manufactur­ ers and 95 hospitals. Strategically located in Cary Hall in the School of Medicine and Biomedical Sciences on UB's South Campus, the HCBC serves as a focal point for foster­ ing new opportunities between local companies and UB researchers—whether G O L D they are in medicine, dental medicine, pharmacy, engi­ neering, management or arts and sciences. "Locating the Health Care Busi­ ness Center at the hub of medical research at UB is key," says Luke Rich, vice president for regional development for the Empire State Development Corp. In the past six years, 35 percent of the inventions registered with the UB Office of Technology Transfer have been in the © TORONTO W JPBP o rsi ~r .•if ii ROCHESTER R i o BUFFALO RXL Y <3 V< K. EE W nology Transfer. Also, with state funding obtained through the A C A D E M I C R E S E A R C H I S M O V I N G IT efforts of Assemblyman Robin Schimminger, the HCBC has FROM THE PAPER OR PROJECT STAGE been able to hire Rebecca TO THE PRODUCT STAGE. THAT'S A Weimer, an experienced tech­ COMPLICATED PROCESS AND THAT'S nology-transfer liaison who worked for 10 years at MDS WHERE THE HEALTH CARE BUSINESS Matrx, most recently as director CENTER CAN REALLY HELP." of the international department. "Hiring someone who under­ area of health care. But, stands how to transfer the research and explains Rich, getting to the knowledge gained by the research com­ next step—where an inven­ munity at UB and Roswell to companies B A U M tion is refined, adapted and that can turn them into products, grow marketed—is hardly auto­ new jobs and expand is one of the most matic. "Traditionally, the difficulty with important functions of the new Health academic research is in moving it from Care Business Center," says Rich. the paper or project stage to the product Together with Mary Ellen Rashman, stage. That's a complicated process, and executive director of the Health Care that's where the Health Care Business Industries Association, Weimer will Center can really help," he says. strive to maximize networking between TfieUCBC will work closely with the and among UB health-care researchers UB Business Alliance's new marketing and industry. For both researchers and manager and with the UB Office of Tech- business professionals, she says, the key TRADITIONALLY, THE DIFFICULTY WITH B u f f a l o P h y s i c i a n S p r i n g 1 9 9 9 �MEDICAL to a flourishing health-care sector in Western New York is networking. "The whole foundation of the health-care industry is networking. People like to do business with people they know and like," she emphasizes. To that end, the HCBC is putting out the welcome mat for both local and regional health-care companies and to UB researchers. "The morewe learn about how professors work and develop re­ search, the better we will be at connect­ ing them with business people," she adds. "This is a hotbed of opportunities for collaboration; we've got to make sure that starts happening, with the goal of keeping business in Western New York." The most pressing goal of the HCBC is to start to turn around the venture-capital climate in Buffalo, according to Weimer. To that end, the HCBC, in cooperation with Rand Capital, Inc., sponsored the "First Western New York Venture/ Equity Forum" March 3-4, 1999, at the Hyatt Regency in downtown Buffalo. Efforts now are also under way to bring in venture capitalists from outside Western New York to listen to presenta­ tions on the strength of the local health­ care market in order to convince them to invest in local companies and start-ups. "We are putting together a program that will bring a focus to this area as a health­ care mecca," Weimer says. In addition to presentations by officials from major investment firms, a technology show­ case will demonstrate the great variety of medical products being developed locally and at UB, some of which are available for licensing. In recognition of the fact that most start-ups form with an emphasis on engineering expertise, as opposed to business skills, the HCBC is creating a Business Development Program. Com­ posed of Health Care Industries Associa­ tion members, it will provide a resource for new businesses in the areas of marketing, financial planning, human resources and regulatory issues. With the cooperation of all the major health-care institutions, as well as UB, HCBC has developed an economicdevelopment proposal and submitted it to the office of New York State Governor George Pataki. To date, feedback has been positive, reports Weimer. "There's a really exciting feeling about this. Everybody has signed off on it, including UB, Roswell Park, Kaleida Health and the Catholic Hospi­ tals. Everybody's on the same page." For further information on the Health Care Business Center, contact the center by telephone at (716) 829-3888 or by fax at (716) 829-3885. + IN MEMORIAM EDITH E. SPROUL, 92, PROFESSOR EMERITUS OF PATHOLOGY E dith E. Sproul, 92, professor ot the UB School of Medicine ond Biomedi­ cal Sciences and associate chief cancer research pathologist at Roswell Pork Cancer Institute, died January 19,1999, at Roswell Park after a brief illness. Sproul was renowned for her work with George Papanicolaou of the Cornell University Medical School in New York City, which led to development of the pap smear. Sproul received her medical degree from the Columbia College of Physicians and Surgeons. Before coming to Buffalo, she was a professor of pathology at the Columbia Medical College and later was chief executive officer of the Department of Pathology of the American University in Beirut. While in New York, she was the first to describe the relationship between general thrombophlebitis and pancreatic cancer and the first pathologist to describe the histological characteristics of early prostatic cancer. Along with Charles Gutman of Mt. Sinai Hospital in New York, she discovered the association between prostatic cancer and the prostate specific enzyme acid phosphatase. Sproul was a founding member of the pathology committee for the Eastern Cooperative Oncol­ ogy Group and a member of the American Association for the Advance­ ment of Science. She is survived by her husband, Arnold Mittelman, professor emeritus of surgery at Roswell Park and UB. + B u f f a l o P h y s i c i a n S p r JAEL SABINA SOBEL, 63, PROFESSOR OF ANATOMY AND HISTOLOGY J ael Sabina Sobel, 63, professor of anatomy and histology in University at Buffalo's School of Medicine and Biomedical Sciences, died December 5,1998, of breast cancer. A native of Israel, Sobel came to the U.S. in 1944 and graduated from Cornell University in 1957. She received a master's degree from Columbia University and a doctorate in zoology from the University of Wisconsin at Madison in 1964. She completed a postdoctoral fellowship at the Sloan Kettering Memo­ rial Institute for Cancer Research in New York, where she was one of the first scientists to successfully fuse a cancer and non-cancer cell. In 1970, Sobel returned to Israel to perform research and teach at Tel Aviv University. She returned to the U.S. in 1977, working at the University of California for two years. She came to UB in 1979 as an assistant professor, performing research in embryology. Sobel's teaching duties included medical and dental students, who voted her outstanding teacher in 1983. Survivors include two sons, Daniel and Jeremy, and an extended family in Israel. i n g 1 9 9 9 0 �MEDICAL New Places, New Faces Relocation of Communicative Disorders and Sciences The Department of Communicative Disorders and Sciences (CDS) moved from Park Hall to the South Campus in late December 1998, although it remains aligned academically with the College of Arts and Sciences. The move unites the department's various components on one campus: Its Center for Hearing and Deafness, a UB Center of Excel­ lence, which concentrates on basic research into the neurobiological and environmental causes of deafness, has been located in Parker Hall on theSouth Campus since 1987. CDS faculty offices now are located on the first floor of Cary Hall, in space formerly occupied by the Department of Biophysics, which merged with the Depart­ ment of Physiology in 1997. That combined department is headquartered in Sherman Hall. The Speech, Language and Hearing Clinic now occupies the ground floor of the BEB, which formerly housed the University Physicians Office. The Center for Hearing and Deafness will remain in Parker Hall. —CHANGES COME TO THE SOUTH CAMPUS HOSE WHO THOUGHT they had finally mastered the intricacies and idiosyncrasies of the Cary-Farber-Sherman complex in the School of Medicine and Biomedical Sciences may need yet another new mental map. Michael Bernardino's arrival as vice president for health affairs, with respon­ sibility for overseeing the university's health sciences schools and revamping the medical school's clinical practice plan, has set in motion a series of office and departmental relocations. Also, a new abbreviation—BEB—has been added to the South Campus lexicon; it refers to the Biomedical Edu­ cation Building, known since its con­ struction in 1982 as the CFS addition. The Biomedical Education Building is not to be confused with the Biomedical Research Building (BRB), the campus's newest structure, which was completed in 1996. The following is a summary of sig­ nificant changes on the campus, all of which were completed inJanuary 1999. Vice President's Wing The first floor of the south wing of the Biomedical Education Building, formerly housing Dean John Wright and the medical school support staff, has been transformed into the vice president's wing. This suite of offices now houses Bernardino and his secre­ tary, along with the staff of the newly formed UB Associates, the medical service organization that will provide centralized accounting, management and legal services for the clinical practice plan. 0 The assistant vice president and general counsel, the assistant vice president for resource management (for health affairs), the chief operat­ ing officer for the practice plan and the medical compliance officer for the practice plan are also located here. Dean's Wing Wright and his staff have moved into the first floor of the BEB's north wing, above the atrium, in an area formerly occupied by student study carrels and the medical admissions office. The study area is now located on the third floor of Farber Hall, while medical admissions has moved downstairs to the ground floor, into the former student locker area. Student lockers have been decentralized throughout the building. Bruce Holm, associate dean for research and graduate studies, and his staff have moved into offices across the hall from Wright's suite, in reno­ vated space used formerly for a staff lounge and a small conference room. The Lippshutz Conference Room oc­ cupies the remaining space in this wing. Medical school development and alumni affairs offices, formerly located on the BEB's first floor in what is now the vice president's suite, are now located on the first floor of Cary Hall. B u f f a l o P h y s i c Standardized Patient Center In 1998, UB's School of Medicine and Biomedical Sciences was designated a regional center for testing medical stu­ dents in basic clinical skills, medical history taking and patient interaction, using standardized patients (persons trained to simulate actual patients for use in medical education). To accommodate this new function, the school renovated space on the sec­ ond floor of Cary Hall into a Standard­ ized Patient Center, which contains examination rooms equipped with video cameras to record student performance, as well as observation rooms for faculty monitors. + i a n S p r i n g 1 9 9 9 �M E D I C A L New Faculty and Staff EW FACULTY AND STAFF have arrived on the South Campus in recent months. Several individuals have come on board to staff UB Asso­ ciates, which will administer the clinical practice plan (see winter 1999 issue of Buffalo Physician), while others were hired to fill vacancies at the School of Medicine and Biomedical Sciences. Kathy R. Lamb, assistant vice presi­ dent and general counsel, is a nurse practitioner and holds a law degree from Syracuse University School of Law. She came to UB from the Roches­ ter law firm of Harris, Beach and Wilcox, L.L.P., where she was a part­ ner in the Corporate/Health Care Prac­ tice Group. Prior to working at Harris Beach and Wilcox, Lamb was a part­ ner with Falk and Siemer, L.L.P., of Buffalo, handling corporate health­ care issues. She also has served as a health-care attorney with Hancock and Estabrook in Syracuse and a litigation associate with Jaeckle, Fleischmann and Mugel in Buffalo. Her UB duties include handling legal issues involving the clinical practice plan and administering contracts with the teach­ ing hospitals. Tony Campanelli, formerly assistant vice president for fiscal affairs in the UB School of Medicine and Biomedical Sciences, has joined the staff of the vice president for health affairs as assistant vice president for resource management. Patrick J. Dinicola, chief operating officer of the clinical practice plan, holds an MBA from Cornell University B u f f Graduate School of Business and Public Administration. Most recently, he was senior vice president for finance and administration at Trico Products Oivision in Buffalo; prior to that he spent three years at Trico's Texas Oivision. He also has held financial management positions with Frontier Corporation, Computer Consoles, Inc., and Schlegel Corporation, all of Rochester. Maryann O'Brien, compliance audi­ tor, holds a degree in medical records administration from Daemen College and is in the master'sdegree program in health services administration at D'Youville College. Before coming to UB, she was a full-time instructor in the Health InformationTechnology Program at Trocaire College. Brian W. Murphy, formerly a research physicist in the U B Department of Nuclear Medicine, now directs the Health Profes­ sions Information Technology Partner­ ship. His group manages educational software development for the healthsciences schools and provides information-technology support. Tim Bleiler is an instructional de­ signer and software developer for the Information Technology Partnership. He came to UB from the University of Iowa, where he developed several types of instructional programs, including software to study head and neck anatomy, and simulations of human temperature regulation. He is develop­ ing a program that can be customized to teach histology. Brian Schroeder is a computer artist and multimedia designer for the Infor­ mation Technology Partnership. He is a 1996 graduate of UB's fine arts program. Stockton State College and Saginaw Valley State University in Michigan. Hamilton graduated from SUNY at Oneonta and holds a master's degree from Atlanta University and a doctorate from the University at Albany. Sandra Drabeck, formerly assis­ tant dean for resource management for the School of Health Related Professions and the School of Nursing, has moved to the School of Medicine and Biomedical Sciences to become its assistant dean for resource management. A UB economics graduate, Drabeck has been at UB for nine years. She also has served as assistant to the provost for budget and personnel administration. Thomas Martin has been appointed director of Laboratory Animal Research Facilities. An Australian, Martin formerly was director of the animal-care program and a senior lecturer at the University of South Wales, the most senior position in Australia in laboratory animal medi­ Carolyn Hamilton, assistant dean for cine. He has extensive experience minority affairs, fills the vacancy cre­ with a range of species and has ated by Maggie Wright's retirement. practiced as a veterinarian in She will help recruit and retain minor­ several countries, including England ity medical and graduate students and and Iran. He holds a doctorate in secure funds to support these efforts. veterinary pathology from the Hamilton was assistant director of ad­ University of Sydney and an MBA missions at the University at Albany from New York University. He is a before coming to UB; prior to that she research professor in the UB held thesame position atSUNYat Delhi. Department of Pathology, working She also spent nine years as Educa­ in the areas of serological diagnosis, tional Opportunity Fund advisor at neurological effects of bacterial Stockton State College in Pomona, New endotoxin, and orthopedic repair us­ Jersey, and has taught Afro-American ing biocompatible and bioabsorbhistory and culture courses at both able collagen. Kimberly Krzemien, who is legal assistant to Kathy Lamb, formerly was with the firm of Cooper and Coo­ per in Hamburg. �HOSPITAL HI N E W S Area Catholic Hospitals Merge and Restructure —PRESERVING AND FOSTERING A MISSION O F COMPASSIONATE CARE C onsider the situation of Western New York's Catholic hospitals the fact it involved 10,000 employees, 7,000jobs and 1,700 physicians. "Ocean liners don't make sharp turns," notes St. Arnold. The creation of CHS, along with that of Kaleida Health, has reverberated throughout Western New York, chal­ lenging the community's capacity for change. But St. Arnold emphasizes there really has been no other alternative for the region's hospitals, given the local, state and national health-care climate. "I don't think there was any question of what we should do. Otherwise, it would have been a case of waiting to see which institution was the last standing, based on financial depth, and nobody had a lot of financial depth. Everybody kept their head above water, but never very far above water. There is still a fair amount of unsettledness, but at least we can control the changes so they match the needs of the community," he says. John Wright, MD, dean of University at Buffalo School of Medicine and Bio­ medical Sciences, lauds the merger, say­ ing anything that stabilizes the regional health-care environment is good for the medical school and the region at large. "Their moving together to act more as a unit will help avoid duplication and will presumably strengthen each individual unit. It gives us the opportunity to bet­ ter coordinate our efforts, which is a positive step." three years ago: They and their sister secular hospitals could be likened to cardiac patients living with multiple risk factors while fearing the occurrence of a major life-threatening event at any time. Their risks were empty beds, rising costs, an aging and declining population and the mandating of shorter inpatient stays and more outpatient treatments by managed care. The "event" came in 1997 in the form of a one-two punch: passage oi the Health Care Reform Act of New York State followed by passage of the Bal­ anced Budget Act by Congress. Under the Health Care Reform Act, hospitals in the state lost their guaranteed payments from health insurers and moved into a free-market environment virtually overnight. The Balanced Budget Act introduced sweeping changes in the Medicare and Medicaid programs, in­ cluding a reduction of $258 million in payments to Western New York health­ care providers through the year 2002. Without dramatic intervention, the prog­ nosis for Catholic hospitals, like many other hospitals, was a sure,slow decline. Merger was the treatment of choice and the process, which was formalized in February 1998, appears to be a lifesaver. Today, the Catholic Health System (CHS) is on the road to recovery. The merger that created the new system is described as a "virtual merger" in that member institutions will share revenues, and all CHS services and func­ tions are combined under a central administration, much the same as a fullasset merger. However, the system's religious sponsors—the Sisters of Mercy, © Daughters of Charity, Franciscan Sisters of St. Joseph and the Diocese of Buffalo—retain their assets. The 18-member, systemwide board of directors in­ cludes representation by organizational entities that govern the hospitals: Catholic Health East (formerly Eastern Mercy Health System), Daughters of Charity National Health System, and the Diocese of Buffalo. A key remaining question, however, is, How long will the process take to transform CHS into a fully integrated health-care delivery system? "Five to seven years, if everything goes well," predicts Dale St. Arnold, president and chief executive officer of CHS. "Do 1 think we can do it? Yes. It's been done other places. The challenge here is the pace of change in the health-care envi­ ronment; it's very, very fast. We're try­ ing to accomplish in a few years what other communities have been working toward for 10 or 15 years," he adds. Plans for merging Western New York's Catholic-affiliated hospitals and their multitude of outpatient services began in 1996. Common roots and mis­ sions made theirs a natural coalescing, but not necessarily an easy one, given B u f f a l o P h y s i c W right says he expects the school's current medicine and family medi­ cine residencies to remain in the Catholic system, but notes that some changes could occur. "We know we will be required to reduce the size of our residency program. How it will affect the Catholic system and our other i a n S p r i n g 1 9 9 9 �HOSPITAL N E W S partners, however, is not entirely maternity and pediatric services at clear at this time," he says. Mercy, while transforming OLV "Perhaps more noteworthy into a center of excellence for is the fact that we have many ambulatory, clinical and reha­ volunteer faculty within the bilitation hospital services, Catholic system who are partnering with Baker very important to us," he Victory Services. OLV adds. "The new configu­ already was a major com­ ration of the system will ponent of the region's determine how that comprehensive head works out, as well." trauma system, serving St. Arnold also em­ as the primary inphasizes the importance hospital rehabilitation of maintaining an edu­ unit. A similar assessment cational function in the will be completed at Sister's system. "Physicians like to Hospital in North Buffalo, teach," he says. "They like Kenmore Mercy Hospital in to demonstrate their abili­ Kenmore and St. Joseph Hos­ ties, and it helps to keep them pital in Cheektowaga. sharp. Our challenge is to deter­ In Batavia, St. Jerome mine how to serve that function in a Hospital and Genesee Memorial period of diminishing Hospital, which were affiliated with CHS resources. through Genesee As initially struc­ T H E C R E A T I O N O F C H S . A L O N G WITH T H A T O F KALEIDA Mercy Healthcare, tured, the CHS com­ spun off from the prised six hospitals HEALTH, HAS REVERBERATED THROUGHOUT WESTERN original group of and nearly 100 health N E W Y O R K , C H A L L E N G I N G T H E COMMUNITY'S CAPACITY hospitals and had and health-related been negotiating its services, including FOR CHANGE. BUT ST. ARNOLD EMPHASIZES THERE own merger for the family health centers, past three years. In diagnostic facilities, REALLY H A S B E E N N O O T H E R ALTERNATIVE F O R T H E February 1999, CHS home care services, R E G I O N ' S H O S P I T A L S , GIVEN T H E LOCAL, S T A T E A N D announced thatspon­ nursing homes, adult sorship of St. Jerome residences and be­ NATIONAL HEALTH-CARE CLIMATE. havioral health pro­ Hospital will be trans­ ferred to the Genesee grams. In 1998, the system served an Memorial Hospital One of the first mandates was to de­ Group, ending the 82-year sponsorship estimated 1.1 million outpatients and fine and correct redundancies in the of the hospital by theSisters of Mercyand 44,780 inpatients. While the hospitals continue to carry system. This effort began with an assess- removing the Batavia hospitals from CHS. out their mission, St. Arnold and his ment of facilities and services in Also, a tentative contractual rela­ board have set to work securing the Lackawanna and South Buffalo. The tionship has been dissolved between system's financial stability. "We've fin­ analysis lead to the decision to redefine CHS and the Health System of Niagara, ished a very thorough analysis of what the roles of that area's two Catholic which was comprised of Mount we have in this organization," he says of hospitals—Mercy Hospital and Our Lady Saint Mary's Hospital in Lewiston and the first year's accomplishments. "It was of Victory (OLV) Hospital—both Niagara Falls Memorial Medical Center. like pulling together several households full-service institutions located two This development, which came about into one. In addition to that, we are miles apart. due to the breakup of the Health System The plan calls for concentrating addressing the question of where we C O N T I N U E D O N P A G E 2 5 medical and surgical acute care and want to take the organization." B u f f a l o P h y s i c i a n S p r i n g 1 9 9 9 © �"Helping Hands" lor Young Cancer Patients I ver rhe past 30 years, there has been a dramatic increase in the number of childhood cancer patients experiencing long-term remission and cure. Through research and new clinical breakthroughs, almost three-quarters of today's newly diagnosed children will be treated successfully and resume their everyday lives. Left behind by these many lifesaving advancements is a lengthy trail of research data and study results—informa­ tion easily accessed and understood by health-care profession­ als, scientists, medical-scientific writers and others "in the know." But what if the information seeker is a 10-year-old leukemia patient, or her parents, siblings, teachers or friends? "The information is available to can­ cer patients and their families, provided they know how to properly access, correctly interpret and effectively personalize it," says Michael A. Zevon, PhD, chair of psy­ chosocial oncology at Roswell Park Cancer Institute (RPCI). "Indeed, the first battle in a family's war with cancer—and cancer is a family's war—begins with the search for helpful, if not definitive, answers on all aspects of the disease." Traditionally, patient information takes the form of written materials and face-to-face meetings with health-care professionals and families. An innova­ tive technology that is moving beyond this framework to help meet the infor­ mation needs of patients and their families is multimedia-based computer-assisted learning. Multimedia programs are being used more often in settings that require rapid, efficient transfer and learning of complex information. In an active dialogue with the computer, a variety of audio, text, video, graphics and animation components are inte­ grated to provide the individualized, on-demand information needed to engage and enlighten the user. Zevon and RPCI psychologist James P. Donnelly, PhD, have developed the "Helping Hands" project, a program that harnesses the educational poten­ tial of computer technology, enabling young patients, their families, peers and teachers to gain the information and skills needed to help the patient return to the routines of daily life. "Helping Hands" provides cancer facts at an age-appropriate level and coping models designed to help man­ age the potentially devastating emotional aspects of the disease. A fam­ ily with a newly diagnosed child, for i MUty Pediatric oncology patients and their families can access patient information via a new multimedia, computer-assisted learniny program at Roswell Park Cancer Institute. © B u f f a l o P h y s i c i a n S p r i n g 1 9 9 9 �HOSPITAL N E W S example, will be able to look up other families whose child is receiving treat­ ment at RPCI. The family can watch and listen as others describe and share their thoughts on effective coping. Selecting from a menu of specific topics, the fam­ ily can view a presentation of the same family discussing the selected topic. The family will have the option of making personal contact with the computer family. Thissupport can be important to the newly diagnosed patient and family. What if the family wants specific infor­ mation on blood counts? The program will illustrate the various blood components, explain their functions, define terms and provide a printed guide to understanding the importance of the child's hematologic status during treatment. "Helping Hands" comprises three specific modules: the Pediatric Patient Module, the Parent Module and the School Module. The Pediatric Patient Module has programs for children both over and under age 12. In the first interaction with the program, the child is asked his C O N T I N U E D F R O M P A G E 2 3 of Niagara, has resulted in Mt. Saint Mary's continuing as a contractual part­ ner with CHS, while Niagara Falls Me­ morial Medical Center is pursuing an alternate affiliation. The result is a leaner system composed of five hospitals and further consolidation of services is sure to follow. "We want to continue to organize our services around specific disease entities," explains St. Arnold. "For example, we are going to be look­ ing at where the best places are for cardiac diseases. We may have one loca­ tion doing knee replacements, while concentrating neurosciences in one or two hospitals," he says. "Our decisions will be based on where B u f f a l o P h y s i c i or her name and age. This information is used to respond to requests in an ageappropriate manner; that is, the computer will only access displays written at the child's reading and comprehension levels. "Today's young person has a comfort level with comput­ ers that makes this technology particu­ larly appealing to them," says Zevon. A menu of choices is then presented. Topics are available that will guide the child through the hospital experience, and provide medical information, coping strategies and the chance to meet other kids who have "been there," and answer the top 10 most frequently asked questions. The Parent Module is an adult version of the Pediatric Patient Module, with two additional topics: Managing Your Life from the Hospital and Talking with Your Children. The School Mod­ ule instructs teachers and classmates about cancer in the context of the psy­ chosocial aspects of growing up. This project would not have come this far, explains Donnelly, without the help of many individuals, most notably students from UB's Department of Art. "In 1995, Professor Anthony Rozak pro­ vided the initial technical assistance on the program's conceptual design and helped make critical hardware and soft­ ware decisions." Since the inception of the project, Robin Sullivan, also of UB's Department of Art, has coordinated the continuing recruitment and involvement of UB art students. Using Macintosh computers, the students have translated the ideals of pediatric patient and family education conceived by the Psychology Department into a prototype that is currently being evaluated. The psychologists have also recruited consultants from RPCI's pediatric and adolescent families, making the effort a true collaboration. Rounding out the team are the Roswell Park Alliance and the many donors whose generosity provided fundamental support for the project. For more information on the "Help­ ing Hands" project, contact Dr. Zevon at (716) 845-3052. + the specialists are and how to align equipment, people and buildings to get our inpatients and outpatients back to health and to keep them well," he adds. The net effect, St. Arnold says, should be a streamlined system with enhanced quality of care and cutting-edge com­ puter technology that will free staff to spend more time with patients and less time on record keeping. "The goal is to create enough surplus so we can make reinvestments," hesays. "The challenge is the pace of change in this environment. We are going at warp speed into the future without the neces­ sary tools to deal with this pace." How has the merger been received? St. Arnold says the answer depends on whom you ask. "I think the business community wonders if this merger will actually lead to cutting costs. We've tried to demonstrate that we're moving in that direction." With that said, St. Arnold notes that health costs in West­ ern New York are already among the lowest in the nation. The community in general is sup­ portive, he feels. "The merger helps pre­ serve and foster Catholic health care in this region. People are very strongly behind that. If there are fears, they are of getting lost in a large system and of losing track of our mission to provide compassionate care. "However, I think people are begin­ ning to realize that by Catholic hospitals coming together, we can reduce over­ head costs and redundancies and free up resources so we can do an even better job of fulfilling that mission." + a n S p r i n g 1 9 9 9 © �CGF Health System Renamed Kaleida Health J 20, 1999, N ANUARY Western New York's largest health-care system announced a new corporate identity. Known by the in­ terim name of CGF Health System for the past two years, the merged entity created from the union of the Children's Hospital of Buffalo, Buffalo General Health System, Millard Fillmore Health System and DeGraff Memorial Hospital, is now Kaleida (pronounced Ka-ly-dah) Health. The name is derived from the word kaleidoscope. Kaleida— from the Greek words "kalos," which means "beautiful," and "eido," which means "shape"—suggests the system's spectrum of health-care professionals, facilities and services, according to John E. Friedlander, Kaleida Health's president and chief executive officer. "Like a kaleidoscope itself, the strength and promise of C O N T I N U E D FROM PAGE 1 7 subject of children. "Every child has a right to a good birth, and after that a core of good preventive health services. So much of what we spend is wasted on trying to cure things that could have been prevented." In particular, Hayes has a strong personal commitment to reducing unintended pregnancies "be­ cause 1 think child-health battles begin with whether or not a child is wanted." Hayes has been widely recognized for her vision for public health and, in 1995, she was elected to a two-year term as president of the National Asso­ ciation of Maternal and Child Health Programs, a honor of which she is especially proud. "Having had an opportunity to take that organization into a period of leadership for kids at a federal level was one of the most satisfying things I've done," she says. Presently, Hayes serves on the Ameri­ 0 KALEIDA A H f f a l o T H Kaleida Health comes not from a single color or pattern, but from the ideal combination of skills and services by the thoughtful union of diverse parts." Kaleida Health and its various entities include five hospitals, four long-term-care facilities, the region's largest home health­ care service and numerous primary-care and outpatient facilities. The organization employs more than 12,500 people, and its medical/dental staff includes nearly 2,000 practitioners. international cooperation in advancing women's health issues. In further testimony to the impact she has made in her field, Hayes was notified in 1995 that she was on the short list for the post of Surgeon Gen­ eral in the Clinton Administration. She has also been offered a number of other federal positions, all of which she has so far declined. "I feel Seattle is a great place to raise kids, and because I'm a single parent, I'm more inclined to stay put. Once my boys are out of high school, 1 feel I will be more inclined to pursue some of the more global, international interests I have," she says. Considering Hayes's uncompromis­ ing belief in putting children first—at home, in her city, state and nation— one senses that the larger, "more global" issues she chooses to turn her attention to in the future will benefit in no small part from her compassion and dedication. can Public Health Association's Children's Health Task Force and has been appointed to the National Research Council and the Institute of Medicine's Board on Children, Youth and Families. In July 1998, she was named acting health officer for the Washington State Department of Health. "I'm humbled by the fact that people tell me I have the ability to talk about the duty we all have toward children and family in a language that others can understand," she says. In 1997, Hayes's ability to clearly set forth her vision won her an invitation to be a featured speaker at Harvard University's celebration of the 75th anniversary of its School of Public Health. This past December—at the invitation of Donna Shalala, secretary of Health and Human Services—she joined a 3CP person delegation representing the U.S. at a binational conference in Jerusalem, Israel, held to promote u L P h y s i c i a n S p r i n g 1 9 9 9 �MEDICAL Alumni Scholarship Makes a Difference F Several UB medical students have received financial support through the Medical Alumni Association Scholarship, which, in recent years, has not had a high level of visibility. This year, however, Medical Alumni Association president Elizabeth Maher, MD, reinvigorated the program. "The reality is that students are begging for loans, and the obligation to pay those loans back often keeps young physicians from doing the kind of work they really want to do since it may not offer them the reimbursement they need," says Maher. "There has been a signifi­ cant decline in state support for medical education, and we as fel­ low physicians and graduates of UB need to take some responsibility for making medical education more affordable." Copley, now an emeritus member of the Medical Alumni Association, is impressed by the determined effort Maher has made to strengthen the scholarship program he first envisioned. "I couldn't agree more with Dr. Maher that we should be doing more for the young students. We need to recognize the impact we can have on the overall life of a future physician." The decline in state support for medical education has only empha­ sized the need for such a scholarship, adds Copley. Mary Glenn, development officer in the medical school, says steps are being taken to ensure that the scholarship program continues in future years. "We are raising awareness about the scholarship fund by increasing its visibility to alumni and making it easier for those who would like to designate funds toward it," explains Glenn. "Beginning in 1999, we also hope to start publishing an annual report of the fund that also would highlight each year's scholarship recipient." Cone appreciates the generosity of the alumni and says he would like to thonk them and make them aware of what an incredible difference it makes. "Realistically, from a financial perspective, the scholarship allows me to be in medical school." He also feels the scholarship program helps to preserve a sense of tradition at UB. "It has influenced and encouraged me to carry on that tradition by giving back to UB when I become a physician." or Jesse Cone, a first-year student at the University at Buffalo School of Medicine and Biomedical Sciences, the Medical Alumni Association Scholarship is making "all the difference in the world" to his education. The scholarship, made possible by the generosity of alumni through their reunion class gifts, is providing Cone with $16,000 over four years for his medical school education. Recipients are selected by the admissions committee accord­ ing to considerations of financial need and academic merit based on the incoming students' applications. Originally from Pavilion, New York, Cone has been interested in medicine since high school. As an undergraduate at UB, he became in­ trigued by the connection between biology and English as studies of life and graduated in 1998 with a bachelor's degree in English. "I was very pleased to receive the scholarship," says Cone, who is the oldest of six children. He explains that since he comes from such a large family, his parents are unable to support his educa­ tion financially. "I was accepted to other medical schools but this scholarship made it possible for me to go to UB with the least financial difficulty later on in my career." By alleviating some of the financial pressures of school, he says the scholarship is allowing him to work less and spend more time on his studies. Donald Copley, MD, past president of the Medical Alumni Associa­ tion, founded the scholarship program in 1993 with the help of John Naughton, MD, former dean of the medical school. "Dean Naughton and I were aware that first-year students were struggling financially, and so we decided to coordinate class reunion gifts for a scholarship," recalls Copley. "There was—and still is—a great degree of enthusi­ asm among the UB medical school community about the program. "We as alumni share a universal feeling of concern for the firstyear medical students. The sentiment is amplified when we come back [to the school] and think about how they are just beginning to face the challenges that we have already conquered." B u f f a l o P h y s i c i a n S p r i n g 1 9 9 9 © I �A STUDENT'S The Role of the Patient in Medicine A unknown. The patient was then taken to the operating room where he under­ went Whipple procedure for his pancreatic mass and a repeat right thoracotomy for excision of his medias­ tinal mass. Of significance is the fact that there was question oi injury to the phrenic nerves which did compromise his postoperative course." At first when I read this, I had diffi­ culty comprehending that these masses had been mine. I wasn't sure who they belonged to, but they certainly weren't mine. However, 1 did comprehend the reference to my postoperative course be­ ing "compromised" since I do remember spending the next two weeks intubated. This was necessary because I couldn't breathe on my own due to the fact that my mediastinal mass had attached to my phrenic nerves. (I have since learned that the phrenic nerves innervate the dia­ phragm. If injured, they tend to leave "the patient" with an elevated diaphragm, which I have to this day.) After about a month or so of recovery, I had to begin the real battle: chemo­ therapy. One day prior to beginning this phase of my treatment, I was finally given my diagnosis of non-Hodgkin's lymphoma after an ensemble of patholo­ gists finally figured out what my cancer was. It was a huge shock that day to also learn that I would have towear a Hickman catheter for a year in order to undergo 12 months of chemotherapy. Being that it was the middle of June and my parents had just put in a pool, having a tube coming out of my chest was not my idea of appropriate summer attire. I thought the surgery was bad, but it pales in comparison to what chemotherapy feels like. I remember my first treatment well. My oncologists, who are all dear to me, entered the room with a tray of enormous syringes filled with colorful medications. They did their best to list the possible side effects of the medications to my family and me: "Well, this medication has been known to cause stomatitis, —A PERSONAL PERSPECTIVE track team and an avid athlete. As my second season progressed, 1 was T AGE 15,1 WAS ON THE GRAND ISLAND HIGH SCHOOL periodically awakened in the night by a crushing pain in my chest, which 1 disregarded, attributing it to weight lifting. Over time, however, I also began having a hard time breath­ ing whenever I exerted myself. I felt like something was restricting my heart from beating, and eventually I had to quit track practice and rest. After a few weeks, the pain in my chest worsened and I found myself being rushed to the Children's Hospital of Buffalo. By the time I arrived at Children's, I I asked, "Where did they come from?" was doubled over from the pain in my The surgeon's response was one I stomach and chest. After receiving a will never forget: "I am the best at what physical exam from the emergency room I do. I have written books and trained at resident, I was immedi­ the Mayo Clinic. All I ately introduced to the can tell you is that you concept of a nasogastric have had a run of bad J A M E S tube. The nurse pumped luck, Jimmy." out of my stomach what And my luck didn't J . M E z H I R seemed like gallons of necessarily improve. dark red blood. I recall a After starting my sec­ sense of relief that the hospital staff had ond year of medical school this fall, I found the problem and that I would be sent for my medical records. When I sat able to return to practice soon. But that down to read all about the 17 hours of wasn't the case. surgery I underwent and the treatment I was admitted to the hospital, began that followed, I felt a mixture of emo­ vomiting blood every few hours, and tions. One moment, it was almost as if I over the course of the next two days were outside looking in—reading the underwent a barrage of tests. I remem­ chart of a hospital patient that my pre­ ber very clearly the day the chief of ceptor wanted me to see; yet, the next pediatric surgery and a group of short- moment, it was as if I were viewing and long-coated doctors entered my things from the inside looking out— room to tell me my diagnosis. understanding, perhaps for the first time, "You have tumors in your chest and whatthe words "the patient" reallymean. stomach, Jimmy," 1 was told. I elect to provide here a few details "Are they malignant or benign?" I about my treatment based on what I remember asking. learned from my medical records. In "I am afraid they are malignant, and reference to a biopsy of a 10 by 20 cm we have to go in and take them out." mass in my chest,*! found the following Curious to know what any human description: "Pathology came back as a being in my situation would want to know, malignant process. Exact tissue type 0 u f f a l o P h y s i c i a n S p r i n g 1 9 9 9 �A STUDENT'S INCREDIBLE LIFE EXPE­ RIENCES IMAGINABLE. AMONG OTHER THINGS, IT SEEMS TO FINALLY LEND MEANING TO WHAT HAPPENED TO ME AS A TEENAGER. cardiotoxicity, seizures, leukopenia, alopecia, nausea/vomiting. . Hearing this, I began to wonder what the hell I was thinking when I signed the consent form! Many people have asked me what chemotherapy feels like. Depending on who's asking—a patient about to begin treatment, or a curious classmate—my answer varies. Basically, the feeling you have when you're undergoing chemo­ therapy can be conveyed by asking a person to imagine how he feels when he has a bad case of the flu. Then, ask him to magnify that feeling by five while simultaneously coming to the realiza­ tion that it's not going to subside for 12 months. Finally, add to this the fact that there are no guarantees the drugs will work (about a 60 percent chance), and if they don't, you may have to start another regimen all over again after that. B u f f a l o P h y s i c Having the opportunity to be a medi­ am also aware of and have respect for cal student after being a cancer patient is the fact that every patient's experience one of the most incredible life experi­ is unique in many ways. Therefore, one ences imaginable. Among other things, thing I have worked to do is silence the it seems to finally lend meaning to what thought "I know" that goes off in my happened to me as a teenager. It also mind when a patient remarks about helps me realize that there's a big differ­ postoperative pain, persistent nausea, ence between reading in a journal about or what it is like being intubated. While survival rates for a disease and having to there is always the sense that I truly do face the statistic yourself. Although I understand more of what they are talk­ had to wait until my second year of ing about, I also know it's important for medical school, I have finally begun to me to learn how to listen because being see my cancer experience through the a good listener, 1 feel, is one of the best eyes of medicine. I understand the mean­ skills a doctor can have. ing of terms like "elevated LFTs," Thank you for allowing me to share "invading mediastinal mass" and with you this medical student's perspective "jaundice" as a medical professional, on the role of the patient in medicine. + and also as a patient. Now, as I begin to work with patients James J. Mezhir is a second-year student at the as a medical student, I find that I am University at Buffalo School of Medicine and using what I learned as a patient. Yet I Biomedical Sciences. i a n S p r i n g 1 9 9 9 © �Prototype Camera Views Brain Stents B esearchers at the University at Buffalo's Toshiba Stroke Re­ search Center have developed a prototype camera that can turn blurred X-ray images of brain stents made of thin wire into images clear enough to detect the con­ dition of wire as fine as a hair. The development marks the first use of this technology, called a highresolution region-of-interest microangiographic digital detector, for viewing stents placed inside blood ves­ sels in the brain. The stents can pre­ vent stroke by shoring up weak spots in arteries or blocking off aneurysms. The UB prototype provides images that are significantly clearer than can be produced by any current system, and may allow the viewing of even the tiniest blood vessels in the circulation system, according to Stephen Rudin, PhD, principal investigator and UB professor of radiology, neurosurgery and physics. Rudin heads a radiation physics group within the center whose efforts to develop a clinical prototype of the device are being funded by a three-year, $1.2 million grant from the National Institute of Neurological Disorders and Stroke. Intravascular interventions use the body's circulation system as a tunnel to the brain. To complete these procedures, neuro­ surgeons or neuro­ radiologists thread micro-thin instru­ ments through the large artery in the groin until they reach the damaged area, an approach that avoids the need to open Blurry image of stents on the right was taken using conventional X-ray image the skull. intensifier technology; clear image on the left was taken using the high-resolution Having clear X-ray region-of-interest microangiographic digital detector being developed at UB. Each images of the vessels photograph shows two stents separated by a 26-gauge needle. The stent above the and instruments is needle is a self-expanding Wallslent with 80 micron stainless steel wire; the stent critical to reaching below the needle is a balloon expandable MultiLink stent with 50 micron wire. the repair site with­ out damaging vessels along the way. "Even with the most capability should allow viewing of advanced imaging equipment avail­ vessels as small as 50 to 200 microns, able at present, we weren't seeing including those called perforators, features we knew existed," Rudin which are located at the very end of the says. "We expect this detector proto­ circulation system of the brain and type to help us locate the stent cannot be seen at all with conventional optimally in the vessel, visualize its imaging equipment. integrity in place and reposition it if "Without this new capability, we necessary. If you can't see exactly would have difficulty treating aneu­ what condition the stent is in when rysms that are near these vessels it's deployed, it's not possible to because we cannot see well enough to change the deployment. avoid damaging the very small "The detector technology is simi­ healthy perforators." lar to that being introduced now in Additional members of the research mammography," he says. "In mam­ team are Ajay Wakhloo, MD, and mography, the site being viewed is Daniel Bednarek, PhD, both associate static. We are developing the tech­ professors in the UB School of Medi­ nology so it can be used in rapidcine and Biomedical Sciences, and sequence imaging at that very Chang-Ying J. Yang and William E. high resolution." Granger, doctoral candidates. Rudin says this enhanced imaging L o i s B A K E R �New Technique to Treat AVMs More Effectively normal path, full oxygenation of the brain is restored and the threat of bleed­ ing or stroke is eliminated. For this technique to work maxi­ mally, neurosurgeons must be able to gauge the exact rate of blood flow through the AVM so they can determine the transit time of the glue from the injection point to the site to be blocked. They then can formulate the gluing agent so it hardens at the proper point as it is carried along by the blood flow.This ensures that blood flow is blocked to the AVM without occluding the main artery or vein. Current techniques for determin­ ing rate of blood flow use two approaches, both involving injecting a contrast medium into the AVM through a tiny catheter threaded through the large artery in the groin until it reaches the damaged area. The contrast medium is tracked via digital X-ray imaging. droplets of a poppy seed oil-based agent containing radioactive iodine. These droplets provide the necessary leading edge to provide precise infor­ mation on speed of the flow. But new technique for determining because the contrast medium doesn't the rate of blood flow, developed dissolve and fill the vessel, tracking by researchers at the University the oil droplets alone provides no at Buffalo Toshiba Stroke information on the path, or distance, Research Center, will enable the drop has traveled, which is neces­ neurosurgeons, using digital sary for determining the rate of flow. radiographic imaging, to characterize Granger's idea was toadminister both and treat arteriovenous malformations contrast media simultaneously. Dual(AVMs) more effectively. contrastinjection allows neurosurgeons The technique—which has not been or neuroradiologists to gauge both used elsewhere for this condition—is distance and time with one interven­ called dual contrast injection and has tion. He says the technique never has been used on 21 patients at the center been used elsewhere for determining with no complications, according to the rate of blood flow in AVMs. lead researcher William Granger, a "The two methods together allow UB physiology and biophysics more exact means of determining rate of doctoral candidate. flow," Granger says. "We can determine An AVM is a tangle of fragile vessels in. the exact time for the glue to reach the the brain or spinal chord that forms arteriovenous junc­ between an artery, which tion. Our method is carries oxygen-rich blood GRANGER'S IDEA WAS TO ADMINISTER BOTH more accurate in de­ to the brain, and a vein, termining flowvelocwhich drains oxygenCONTRAST MEDIA SIMULTANEOUSLY. DUALity than either single depleted blood back to the CONTRAST INJECTION ALLOWS NEUROSURGEONS soluble or nonsoluble lungs for replenishment. It OR NEURORADIOLOGISTS TO GAUGE BOTH DIS­ injections alone." creates a short circuit be­ Additional mem­ tween the two circulation TANCE AND TIME WITH ONE INTERVENTION. bers of the research systems, shunting blood di­ group are Afshin A. rectly from the artery into One approach involves injecting a Divani, doctoral candidate in mechani­ the vein, effectively bypassing the brain. soluble contrast medium, which is cal and aerospace engineering; Stephen An AVM can leak or rupture if it isn't effective in showing the internal con­ Rudin, PhD, professor of radiology and treated. The condition, thought to be tours of the vessel and its twists and physics; Ajay K. Wakhloo, MD, associ­ congenital, is diagnosed most frequently turns, enabling neurosurgeons to de­ ate professor of neurosurgery; Baruch in young adults, Granger says. termine distance through the AVM. B. Lieber, PhD, associate professor of One way of treating AVMs—and the But because the contrast medium mechanical and aerospace engineer­ method of choice of neurosurgeons at dissolves and diffuses into the blood ing; Daniel R. Bednarek, PhD, associate the UB Toshiba Stroke Research Cen­ stream, it does not produce a clear, professor of radiology and physics; and ter—is to seal off the entrances to the leading edge necessary to track how Lee R. Guterman, PhD, MD, all of UB. blood vessels nourishing the AVM, called fast the flow is moving. Their work was funded by a grant from feeding pedicules, with a glue-like An alternate approach uses a Toshiba American Medical Systems. + substance. With the feeding pedicules nonsoluble contrast medium: small sealed off, circulation resumes its — L o i s B A K E R i B u f f a l o P h y s i c i a n S p r i n g 1 9 9 9 C 3 1 �News "•T DEVELOPMENT B Y L I N D A J . C O R D E R . P H D , C F R E A Word from the Director of Development C memorial gift to our school, rather than her college. We ONGRATULATIONS AND THANKS to those who never know where our influences will fall. The endowment supported the School of Medicine and Biomedical Sci­ will provide scholarships to young women studying to ences at such an outstanding level last year. In so doing, become physicians, and the first award will be given in the they became members of the "Class of 1998" James 1999-2000 academic year. Piatt White Society. Several individuals and couples are in the society for the Since its founding in 1986, the society has grown first time. Those marked with an asterisk (*) are Gold from a small group of dedicated medical school alumni to an organization of over 200 alumni and friends who are members, "graduates of the last decade," whose gifts during generous investors in the future of medical education, resi­ 1998 totaled between $500 and $999. The lower "entry level" dency training and biomedical research and graduate studies. for younger graduates was instituted in 1996 to encourage A volunteer executive committee (comprised of active soci­ newer alumni to take their place in this society. ety members) works with the development staff to increase Most individual contributions were designated for the philanthropy to the school and to plan recognition events for school's general fund, disbursed at the dean's discretion. A few members. Publishing this annual list of the school's most gifts were designated to special projects, such as the Neu­ generous philanthropists gives Dr. Wright, the executive roanatomy Museum, or to departmental funds, which are committee, and those of us who work daily on behalf of the disbursed at the discretion of the school, an opportunity to show our appreciation. department chair for such uses as The James Piatt White Society provides two types of research seed money or student recognition—annual and lifetime. A gift within any year medical association activities. confers an annual membership for the following year. When The donors listed in this Honor cumulative contributions reach $50,000, honorary lifetime Roll collectively contributed membership is granted. There are also a few "special" mem­ approximately $340,000 to the bers who received "term memberships" for a specified time School of Medicine and Bio­ frame. Although no new "special memberships" have been medical Sciences. We are deeply granted since 1992, we honor those earlier commitments. appreciative of all gifts to the Most "special memberships" will expire at the close of 1999. school, especially those that have A year ago, the society made the transition to a calendar the potential to make a trans­ year-recognition cycle. During the "14-month year" of 1997, forming difference in the quality membership passed the 200 mark. Another increase was of medical education, residency shown in 1998, as the "Honor Roll" list grew to 216 training and research contributing members. in the basic sciences. Individuals and couples who support the school I invite you to read Publishing this annual list gives us an at an outstanding level are seen as its closest through the roster of friends. They receive additional information, invi­ members, and to opportunity to show our appreciation. tations to certain school and university events, as thank your friends well as special recognition in the society. Best of and colleague for their all, this group keeps expanding. It is a welcoming outstanding support. and inclusive organization, since the more "best friends" the If you are not yet in this group, please consider increasing school has, the more outstanding it becomes. your contributions to the school. The executive committee The society welcomed one new founder this year, Mr. John would like to see this honorary group continue to expand, Goodwin Jr, who established a scholarship in memory of multiplying its significant and positive impact on the his wife, Mrs. Irene Pinney Goodwin. Mr. Goodwin gradu­ academic environment of the UB School of Medicine and ated from Harvard, Class of 1927, and was a businessman Biomedical Sciences. in Western New York. His family's physician was a gradu­ ate of UB's school of medicine, and Mr. Goodwin told me Linda J. Corder (Lyn) is the associate dean and director of how impressed he was with this young person, especially development. She may be reached by phone at (716) 829-2773 during his wife's last two illnesses. Irene, he said, placed or our toll-free number 1 (877)826-3246. Her E-mail address is high value on both education for women and healthy ljcorder@.buffalo.edu. living. As a result, Mr. Goodwin decided to make her 0 U f f �Richard J. Nagel, MD, and Mrs. Florence Nagel Orchard Park, NY Dr. Richard B. and Mrs. Ellen Narins East Aurora, NY Dr. Albert C. and Mrs. Linda Rekate January 1 , 1 9 9 8—D e c e m b e r 3 1 , Hilton Head Island, SC 1 9 9 8 Dr. Elizabeth P. Olmsted Ross Buffalo, NY Miss Thelma Sanes L I F E T I M E Williamsville, NY M E M B E R S f hen cumulative contributions reach $50,000 or an irrevocable deferred gift is completed for $100,000 or more, a couple or individual is granted lifetime mem­ bership in the Society. Combinations of outright and deferred gifts in appropriate proportions can also be the basis of lifetime membership. Names of Founders are repeated in an annual category in any year that they make a new gift to the School. Mrs. Grant (Evelyn) Fisher FOUNDERS' CIRCLE UB's founders, primarily physi­ cians and attorneys, envisioned a school to train students for service to the community. The Society's Founders help to actu­ alize that vision by providing a generous base of support for pro­ grams and activities that enrich the academic environment and enhance medical training. Lakeview, NY Buffalo, NY ANNUAL MEMBERS DEAN'S CIRCLE Individuals or couples qualify as members in the Dean's Circle with generous gifts of $25,000 or more. Dr. George M. Ellis Jr. and Mrs. Kelly Ellis Mrs. Catherine Fix Connersville, IN Martinsburg, WV Dr. Thomas Frawley and Mrs. Marigrace Frawley Dr. Thomas F. Frawley and Mrs. Marigrace Frawley Chesterfield, MO Chesterfield, MO Mr. John H. Goodwin, Jr. Mrs. Christina Gretschel Genner Williamsville, NY Potomac, MD Mr. John Goodwin CHAIR'S CIRCLE Williamsville, NY Dr. Kenneth M. and Mrs. Joan Alford Philip B. Wels, MD, and Mrs. Elayne Wels Just as a department chair leads a program, donors of leadership gifts in the range of $10,000 to $24,999 are given special recog­ nition. Dr. and Mrs. Pasquale A. Greco Buffalo, NY Buffalo, NY Mrs. June M. Alker Dr. Glen E. and Mrs. Phyllis K. Gresham Williamsville, NY Snyder, NY Dr. Charles D. Bauer and Mrs. Mary A. Bauer Dr. Thomas J. and Mrs. Barbara L. Guttuso Williamsville, NY East Amherst, NY Dr. Willard and Mrs. Clarite Bernhoft Dr. Eugene J. Hanavan Jr. Snyder, NY Buffalo, NY Dr. Harold Brody and Anne Brody Amherst, NY Dr. and Mrs. Daniel Miller Scarsdale, NY Dr. and Mrs. Philip Morey Dr. Joseph and Mrs. Helene Chazan Mrs. Morris Lamer Providence, RI New York, NY Dr. Kenneth H. Eckhert Sr. and Mrs. Marjorie Eckhert Mrs. Grace S. Mabie Williamsville, NY Mrs. Sophie Small Brockton, MA Orlando, FL Buffalo, NY Dr. Eugene R. and Mrs. June A. Mindell Dr. George M. Ellis Jr. and Mrs. Kelly Ellis Buffalo, NY Connersville, IN B u f f a l o P h y s i c i a n S p r i n g 1 9 9 9 �P R O F E S S O R S ' CIRCLE A strong faculty is central to a great university. Likewise, central to the future of our School is the dedication of a cadre of supporters whose annual gifts range from $5,000-$9,999. Dr. Joseph G. Cardamone Mrs. Susan G. Cardamone and Eden, NY Dr. Claudia D. Fosket and Dr. Robert Smolinski Dr. Richard A. Berkson Dr. and Mrs. Mark R. Comaratta Rancho Palos Verdes, CA East Amherst, NY Orchard Park, NY Dr. Michael E. Bernardino and Mrs. Joan W. Bernardino Dr. Bernice S Comfort-Tyran Buffalo, NY Buffalo, NY Dr. linda J. Corder Dr. Charles McAllister Dr. Willard H. Bernhoft and Mrs. Clarice L. Bernhoft Buffalo, NY Dr. Robert J. Gillespie Clearwater, FL Dr. Daniel E. Curtin Snyder, NY Dr. Nancy H. Nielsen Orchard Park, NY Dr. Joel M. Bernstein Orchard Park, NY Dr. David R. Dantzkerand Mrs. Sherrye Dantzker Williamsville, NY Dr. Max Doubrava Jr. Dr. John S. Parker and Mrs. Doris M. Parker Las Vegas, NV La t robe, PA Buffalo, NY Dr. Robert Hall and Mrs. Dorothy N. Hall Dr. Richard R. Romanowski Dr. Theodore S. Bistany Houston, TX Williamsville, NY Buffalo, NY Dr. John C. Newman Dr. James White Dr. Willard H. Boardman Lewiston, NY Buffalo, NY Dr. Melvin J. Steinhart and Mrs. Susan S. Steinhart Delmar, NY Dr. Charles S. Tirone and Mrs. Anne R. Tirone Williamsville, NY Dr. and Mrs. Harold M. Vandersea New Bern, NC Dr. Syeda Fazila Zafar and Ms. Mona S. Zafar East Amherst, NY F E L L O W S ' CIRCLE Fellows within the School are recognized for added depth they bring to postgraduate study. Within the Society, Fellows are honored for gifts that total $2,500 to $4,999. Dr. William H. Bloom Bay Shore, NY Dr. Melvin M. Brothman Snyder, NY Dr. Yung C. Chan Draper, VA Drs. Charlearmsee and Charoen Chotigavanich Thailand Dr. and Mrs. Jack C. Fisher La Jolla, CA Los Altos, CA Dr. David L. Berens Roslyn, NY Drs. Roger and Roberta Dayer Buffalo,NY Dr. and Mrs. David E. Denzel Lockport, NY Winter Park, FL Dr. Gerard J. Diesfeld Dr. and Mrs. Dennis L. Bordan Arcade, NY Port Washington, NY S C H O L A R S ' C I R C L E One strength of an outstanding institution is the caliber of those who study there. Scholars within the James Piatt White Society have made gifts to the School totaling $1000 to $2,499 during the past year. Those marked with asterick (*) are young scholars, graduate of the last decade who qualify with gifts of $500 to $999. Ronald I. Dozoretz, MD Dr. Suzanne F. Bradley Norfolk, VA Whitmore Lake, MI Dr. Melvin B. Dyster Dr. Martin Brecher Niagara Falls, NY Amherst, NY Dr. Robert Einhorn Dr. James B. Bronk and Mrs. Suzanne Bronk North Brunswick, NJ Dr. and Mrs. Domonic F. Falsetti Napa, CA Lewiston, NY Dr. August A. Bruno, Sr. Dr. and Mrs. John A. Feldenzer Buffalo, NY Roanoke, VA Dr. Alan H. Bullock Dr. Helen Marie Findlay and Dr. Albert Schlisserman Longmeadow, MA Dr. Kenneth M. Alford and Mrs. Joan W. Alford Dr. William M. Burleigh Eggertsville, NY Buffalo, NY Rancho Mirage, CA Dr. Kenneth Z. Altshuler Dr. Jennifer L. Cadiz Dallas, TX Mechanicsburg, PA Dr. William S. Andaloro Drs. Evan and Virginia Calkins Caledonia, NY Hamburg,NY Dr. J. Bradley Aust Jr. Dr. David T. Carboy and Mrs. Jacqueline G. Carboy San Antonio, TX Dr. Susan Fischbeck and Dr. Patrick Hurley East Concord, NY Dr. and Mrs. Thomas D. Flanagan Williamsville, NY Dr. Neal W. Fuhr Williamsville, NY Lincroft, NJ Dr. George Bancroft and Mrs. Susan K. Bancroft Dr. Penny A. Gardner Dr. Nicholas C. Carosella Los Altos, CA Hamburg, NY Appleton, NY Dr. Jared C. Barlow, Sr. and Mrs. Barbara A. Barlow Dr. Norman Chassin and Mrs. Charlotte S. Chassin Grand Island, NY Kenmore, NY Dr. Paul D. Barry Dr. Charles Kwok-Chi Chow and Mrs. Patricia Chow Bethesda, MD Dr. Ralph T. Behling and Mrs. Rita Behling San Mateo, CA Dr. Ronald Garvey Dallas, TX Dr. Kenneth L. Gayles Amherst, NY Dr. and Mrs. Lawrence H. Golden Hong Kong Eggertsville, NY Dr. Michael E. Cohen and Mrs. Joan Cohen San Diego, CA Dr. Michael Goldhamer Williamsville, NY 0 B U F F A L O P H Y S I C I A N S P R I N G 1 9 9 9 �ALUMNI Dr. Myron Gordon Dr. Masao Nakandakari Dr. Albert G. Rowe Honolulu, HI Tonawanda, NY Albany, NY Dr. Robert A. Klockeand Mrs. Barbara Klocke Dr. Jonathan A. Graff Williamsville, NY Dr. Richard and Mrs. Ellen Narins Dr. Eric J. Russell Williamsville, NY Dr. Jacob S. Kriteman Orchard Park, NY Chicago, IL Dr. Peter H. Greenman Danvers, MA Fairfax Station, VA Dr. Ivan W. Kuhl Dr. Kathleen O'Leary and Mr. Michael J. Collins* Dr. Arthur J. Schuefer and Mrs. Elizabeth Ann Scbaefer Dr. Glen E. Gresham and Mrs. Phyllis Gresham Wimberley, TX Buffalo, NY Snyder, NY Drs. Marie Leyden and Joseph Kunz Dr. Thomas P. O'Connor Dr. Adolphe and Mrs. Nancy Schoepflin Williamsville, NY Lockport, NY East Amherst, NY Tucson, AZ Dr. Robert T. Guelcher Dr. Gordon R. Lang Mrs. Marguerite T. O'Gorman Dr. James N. Schmitt Erie, PA Chicago, IL Eden, NY Kenmore, NY Dr. Ralph R. Hallac Dr. Andre D. Lascari Dr. Joseph J. Oliver Dr. David S. Schreiber Englewood, NJ Poestenkill, NY Rock Springs, WY Westwood, MA Mrs. Gilda L. Hansen Dr. Phyllis Leppert Drs. Donna and Dean E. Orman Dr. Joseph I. Schullz Williamsville, NY Buffalo, NY East Amherst, NY San Pedro, CA Dr. Reid R. Heffner, Jr. and Mrs. Elenora Heffner Dr. Harold J. Levy and Mrs. Arlyne Levy Dr. James M. Orr Dr. Fred S. Scbwarz Amherst, NY Gallipolis, OH Buffalo, NY Dr. Marshall A. Lichtman and Mrs. Alice Jo M. Lichtman Dr. Victor A. Panaro Mr. Mark R. Schufman Dr. Anita J. Herbert Snyder, NY Woodside, NY Bradford, PA Rochester, NY Dr. Margaret W. Paroski Dr. Orvan W. Hess Dr. Hing-Har Lo Buffalo, NY Dr. Edward Shanbrom and Mrs. Helen Shanbrom North Haven, CT Blacksburg, VA Dr. William J. Hewett West Hartford, CT Dr. Thomas A. Lombardo Jr. and Mrs. Donna M. Lombardo Dr. Robert J. Patterson and Mrs. Patricia M. Patterson Dr. Fredric M. Hirsh Buffalo, NY Santa Ana, CA Dr. Roy E. Seibel Sr. and Mrs. Ruth Seibel Snyder, NY Eggertsville, NY East Aurora, NY Dr. Norman L. Paul Williamsville, NY Dr. Susan V. McLeer Lexington, MA Dr. Arthur M. Seigel and Mrs. Ellen M. Seigel Dr. John M. Hodson Buffalo, NY Guilford, CT Rochester, NY Williamsville, NY Drs. Harry L. and Kaaren J. Metcalf Dr. Clayton A. Peimer and Mrs. Susan Peimer Dr. Walter D. Hoffman Williamsville, NY Eggertsville, NY Williamsville, NY Dr. Merrill L. Miller Dr. and Mrs. James F. Phillips Dr. Elizabeth G. Serrage Dr. Robert H. Huddle, Jr. Hamilton, NY Buffalo, NY Portland, ME Dr. Molly R. Seidenberg Elmira, NY Dr. and Mrs. Howard Mindell Dr. Charles W. Pruet Dr. John B. Sheffer Dr. Herbert E. Joyce and Mrs. Mary Joyce Shelbourne, VT Williamsville, NY Williamsville, NY Dr. Timothy S. Sievenpiper and Mrs. Karen S. Sievenpiper Lockport, NY Dr. Maynard H. Mires Jr. Dr. John V. Ranchoff Dr. Robert M. Jaeger Georgetown, DE Fairview Park, OH Allentown, PA Dr. Joseph F. Monte Dr. Bert W. Rappole East Aurora, NY Drs. James R. and Genevieve Kanski Dr. Roger M. Simon Buffalo, NY Jamestown, NY Eggertsville, NY Mr. and Mrs. Robert Montgomery Dr. Frederic D. Regan Las Vegas, NV Drs. Julian R. and Mayenne A. Karelitz Lake View, NY Boca Raton, FL Dr. Edward H. Simmons Beverly Hills, CA Dr. Frank T. Riforgiato and Mrs. Mary-Cecina Riforgiato Williamsville, NY Dr. James J. Kelly Dr. Philip D. Morey and Mrs. Colleen C. Morey Buffalo, NY Williamsville, NY Buffalo, NY Carbondale, IL Dr. Albert Somit Dr. Kenneth K. Kim and Mrs. Susan Kim Dr. John D. Mountain Dr. Bruce H. Robson Dr. John J. Squadrito Clinton, NY Manhasset, NY Geneva, OH Sarasota, FL Dr. and Mrs. Arthur C. Klein Dr. Arthur W. Mruczek Sr. Dr. Jeffrey S. Ross Dr. William C. Sternfeld Los Angeles, CA Medina, NY Lebanon Springs, NY Sylvania, OH Dr. Richard L. Munk Mr. and Mrs. James Rosso Dr. Burton Stulberg Sylvania, OH Buffalo, NY Buffalo, NY f f 0 , �A I U M N I Dr. Michael A. Sullivan Dr. Harold J. Weinstein Dr. Michael S. Taxier • Van Nuys, CA Worthington, OH Drs. Charlotte and Hyman Weiss Dr. Wayne C. Templer • Highland Park, NJ Corning, NY Dr. and Mrs. James Tibbetts Dr. Paul H. Wierzbieniec Sturgeon Bay, WI Amherst, NY . Clearfield, PA Lancaster, NY Williamsville, NY Dr. Barbara Von Schmidt Mr. and Mrs. Gilbert J. Yager Oakland, CA Dr. Charles E. Wiles Dr. and Mrs. Gregory Young . Holland, NY Dr. Richard D. Wasson and Mrs. Janet Wasson After Six Custom O R IA M The following individuals left generous bequests or made arrangements for gifts from testamentary trusts. Mrs. Virginia Barnes Dr. David W. Butsch Dr. Mark W. Welch Montpelier, VT Sherman Hanson Ms. Janet Butsch Anonymous Dr. John L. Butsch We have made every effort to ensure Buffalo, NY accuracy in these lists. If you have any questions or corrections, please Dr. and Mrs. Marvin Z. Kurlan Dr. Lynda M. Young-Sorrenti call Mrs. Mary Glenn tollfree at Williamsville, NY • Worcester, MA Holiday, FL Walnut Creek, CA Aurora, CO Durham, NC Grand Island, NY Sarasota, FL Dr. Clara A. March Dr. John R. Wright and Mrs. Deanna Wright Mr. James J. Trzaska Mrs. Marvin (Helen) Winer Dr. David C. Ziegler and Mrs. Susan D. Ziegler A few individuals and couples were granted multi-year mem­ berships based on generous gifts made betweeen 1989 and 1993. Dr. Richard G. Williams Lewiston, NY Buffalo, NY SPECIAL MEMBERS Carlsbad, CA Dr. Bradley T. Truax Buffalo, NY M EM • Dr. Gary J. Wilcox Dr. George Toufexis Williamsville, NY Dr. John Naughton Dr. Franklin Zeplowitz and Mrs. Piera Zeplowitz Dr. Arnold Wax . Henderson, NV Williamsville, NY 1 (877)826-3246. Years Of Shipping Top Systems We Thought I t Might Around The Quality World, Be Time To Say Hello To The Home Town. Custom Computer Systems From TDN, Built For Your Business, Built For Your Budget, Built I n Buffalo. S1,399 Enterprise Series 300MHz Pentium II- Processor • 64 MB 10 NS SDRAM • 6.0 GB Ultra IDE Hard Drive • Iomega Zip Drive atapi • 17" .27NI SVGA Digital Color Monitor • 8 MB AGP Graphic Accelerator • 56K V.90 PCI Fax/Modem • 36x IDE CD-ROM 0 • Sound Blaster 128 PCI Stereo Sound Card • Soundimage Subwoofer System • 3.5" High Density Floppy Drive • Microsoft Windows* 98 • Corel* WordPerfect Suite 8" (includes; Wordperfect 8*. Quattro Pro 8s, Presentations 8~) • Zodiac 1000 CD Bundle t f Complete systems, components, and peripherals, PLUS friendly service and support. All right around the corner! 1 7 1 6 7 4 3 0 1 9 5 TECHNOLOGY DISTRIBUTION NETWORK www.tdn.net 1000 Young Street. Suite 270 . Tonawanda NY 14150 . Fax: (716) 743.0198 �CLASSNOTES egy development and other is­ EDWARD HOHENSEE, MD '54, sues affecting local physicians. writes: Thank you for printing Major has 25 years of experience my note in the winter issue of as a practicing physician and Buffalo Physician. However, you medical administrator. He is a printed my email address incor­ board-certified cardio-thoracic rectly! The correct address is: surgeon and formerly was direc­ tor of Cardio-Thoracic Associ­ edhohensee@aol.com ates of WNY, P.C. He has also WILLIAM J . SULLIVAN, MD '55, been an associate clinical profes­ writes from Los Angeles, CA: sor at UB's school of medicine "Recently, I changed my medi­ since 1981. Pictured above are the children of Matthew J. Phillips, MD '91, and his wife, Toula. From left to right are James, Michael, newborn daughter Markella Aretee, and Matthew, Jr. THOMAS G. DISESSA, MD ' 7 t , anchors Jack Ford and Jodi cal practice from a solo forensic psychiatric one to a partnership structure with other forensic psychiatrists. This will permit more time off, longer vacations and greater flexibility in my working schedule. I now func­ tion as the medical director of NBC Weekend Today Show with writes: I recently accompanied Applegate. Applegate has inter­ the surgical team of the Interna­ viewed Moore on diverse women's tional Children's Heart Founda­ health issues, including compli­ tion to Zagreb, Croatia. While cations of pregnancy, menopause, 1 9 9 0 S MATTHEW J . PHILLIPS, MD '91, writes: My wife, Toula, and I joyfully announce the birth of our daughter, Markella Aretee, born December 21, there, I performed ten inter­ hormone replacement therapy, ventional catheterization proce­ aging, contraception and mi­ dures on children two months graines. Moore has also recently old to 14 years. I dilated six been awarded the Woman of the K. patients with coarctation, two Year Award in Health/Medicine MAJOR jr., patients with aortic stenosis and from New Jersey's Somerset has coil closed two ductus. In Janu­ FAITH E.GRIETZER-FRANKEL, MD MD '69, County Commission on the Sta­ been named ary, I went to Peru for the sec­ '91, is a pediatrician in private tus of Women for her role in new execu­ ond time and may return to practice in Fairfax, VA. She re­ women's health research, advo­ tive director of Croatia in the future. cently contributed to a video on cacy, education and leadership. SIDS prevention, which is avail­ the group." Wi l l i a m the Individual Practice Asso­ NIRANJAN M. KUMAR, PHD '88, ciation of Western New York (IPA/WNY), the physician orga­ nization of Independent Health, Buffalo's largest health mainte­ nance organization. In this posi­ tion Major is responsible for the day-to-day business of the IPA/WNY, including D O N N I C A L . M O O R E , M D ' 8 6 . If writes: I have joined Wyeth- the Lederle Vaccines and Pediatrics trio in the photograph below look Pharmaceutical Company in familiar, it's because you mayhave Pearl River, NY. I was a visiting seen them while channel surfing scientist at Merck and Company, Saturday or Sunday morning. Inc., prior to this appointment. In the center is Donnica L. Moore, a regular guest on the San Diego, CA. ependent Health's able nationwide through the One Step catalogue. Her husband DOUGLAS FRANKEL, MD '91, is in private practice in trauma/ internal medicine in Maryland. He is also a physician for profes­ sional boxing. They have three sons: Maxie, Aidan and Riley, utes outside ofWashington, DC. wife and two daughters in closely with Ind­ pictured above. fered a stroke due to an AVM. tice medicine. He lives with his cians and working four; and Matthew, Jr, two; and live in Maryland, 15 min­ MD '89, He is currently unable to prac­ budsman for physi­ ers: James, age five; Michael, suf­ HOWARD CHANG, serving as an om­ 1998. She joins her three broth­ HOWARD S . PODOLSKY, MD ' 91, writes: Following completion of my residencyin internal medi­ cine at The Christ Hospital/ senior management University of Cincinnati, my on health-care poli­ wife, Rabbi Elizabeth B. Hersh, cies, programs, strat­ and I have settled in St. Louis, e u f f a l o P h y s i c i a n S p r i n g 1 9 9 9 ^37^ �MO. In 1994,1 joined the staff of KETAN DAVAE, MD ' 9 6 , writes: "I he published in 1960 and revised Buffalo General Hospital for a Southwest Medical Center as an completed a surgical internship in 1981. Bergman moved to year prior to serving in the mili­ attending physician. Since that at Michigan, radiology residency Florida from New York when he tary for two years. From 19481951, he was a resident in psy­ chiatry at Buffalo State Hospital. time, I have cultivated a largely at Tufts, vascular interventional semi-retired in 1978. He was geriatric practice in a multi- radiology at Harvard, and mus­ a professor of urology at the specialty group environment. I culoskeletal, Cornell." university of Miami's School of In 1955, he moved to Madison, Medicine and worked as a clini­ WI, toserve as clinicaldirector at cal professor at Jackson Memo­ Mendota State Hospital, a posi­ sur­ rial Hospital in Miamifor lOyears. tion he held until 1962, at which geon and cancer researcher, died At age 21, Bergman graduated at time he went into private prac­ of heart failure on December 14, the head of his class tice with the newly at UB and, at the time, formed Madison Psy­ continue to function as a resi­ dent instructor as well as a men­ tor to medical students who are interested in pursuing a career in internal medicine. My IN MEMORIAM HARRY BERGMAN, MD '34, wife is now the associate rabbi of 1998, in Hollywood, FL, at age the United Hebrew Congrega­ 87. Lastspring, Bergman received was the university's chiatric Associates. an Award of Special Recognition youngest medical He was a staff psy­ In the fall of 1998, fulfilling my from the Dean's Advisory Coun­ school graduate. A chiatrist at the Dane quest to remain a perpetual cil of UB's School of Medicine successful practice as County student, I was accepted, as a tion located in Chesterfield, MO. Mental and Biomedical Sciences for his a urologist and sur­ Health Center dur­ Dean's Scholar, into theSt. Louis life's work in urology. The award geon in Manhattan ing the 1970s and an University School of Law. After recognized that, in 1947, and Bronx, NY, fol­ associate clinical pro­ one semester of evening classes Bergman devised an instrument lowed. As his prac­ fessor of psychiatry and early morning rounds, 1 capable of obtaining an early tice grew, so did Gilbert "Ben" Tybring, MD '45 at the University of neoplastic degeneration inside Bergman's reputation have come to long for the days of merely being a resident. While an apparent benign tumor, an 1960s and early 1970s. Follow­ accomplish­ a person who had a tremendous ing his retirement in 1984, he ment for love of people," said Albert Sirota, established and edited a state he a friend. "Henever hada negative newsletter, The Wisconsin Psy­ received an word to say about anybody. He chiatrist. In 1993, the newsletter award from believed if you didn't have any­ won the Newsletter of the Year I encounter the law school expe rience, I continue to draw on the many skills E-mail school career. As 1 look to the future, I hope to become involved which the Ameri­ thing good to say about some­ award from the American Psy­ can Cancer body, don't say anything.He was chiatric Association. In addition in a practitioner who really cared." to hiswife,Jane, he is survived by 1948. It also Bergman is survived by his wife, the children of his first marriage submitted by E-mail at: acknowledges Mollie Holtzman Bergman, and (his first wife, Jean Agnes Smith Bergman's dis­ daughter Ann Sue Matasar of of North Tonawanda, NY, died bpnoles@pub.buffalo.edu covery of a ra­ Chicago, IL. in 1970), Gilbert Benson IV of I acquired dur­ ing my medical Wisconsin in the for doing pro bono work. "He was Classnotes can also be in Society diological sign health-care for cancerof the policy while ureter, named continuing my work in primary "Bergman's Sign" in his honor by care. Rofay@aol.com John Emmett, professor of urol­ E L I Z A B E T H C O N R O Y , M D ' 9 2 , and husband, Jeff, proudly announce the birth of their third child on February4,1999, a daughterJulia Grace, 8 pounds, 3 ounces. Eliza­ beth is a practicing dermatologist with Buffalo Medical Group. ogy at the Mayo Clinic, and first catalogued in Dorland's Medical Dictionary in 1981. Also noted in the award wasBergman's work as a writer and editor of many pub­ lications, including his highly respected text, The Ureter, which Lakeland, FL, Nancy MorningGILBERT"BEN"TYBRING, MD'45, died on February 1,1999, of heart star ofPalomar, CA, and William Mark of West Bend, WI. failure at age 79, in Madison, WI. According to his wife, Jane, he H A R O L D P E S C O V I T Z , M D ' 4 7 , died also had been diagnosed with in March 1999 at his winter home Alzheimer's disease. Originally in Amberley Village, FL, at age from Endicott, NY, Tybring 74. A native of New York City, graduated from the New York Pescovitz moved to Cincinnati, State College for Teachers— OH, after he earned his medical Albany in 1942 (now SUNY at degree at UB. In Ohio, he com­ Albany). After earning his medi­ pleted his residency and prac­ cal degree at UB, he interned at ticed general surgery at Jewish �ClASSNOTES Hospital, after which he entered Support Appreciated for Summer Exterastiip Program private practice in Avondale, Fairfield and North Bend. T Pescovitz, whose first wife, Anita, he Primary Care Summer Externship is preparing for its seventh summer and would preceded him in death, is sur­ vived by his wife of seven years, like to thank the institutions who have pledged their generous support for 1999. Shirley; sons Mart of Carmel, IN; These include a renewed commitment from the Charles E. Culpeper Foundation, the Robert of Los Angeles, CA; Michael of Evendale; Charles Independent Health Foundation, and the Lake Plains Community Care Network, as of Symmes Township; Rick of well as new support from the New York State Department of Health Minority Hyde Park; David of San Fran­ Participation in Medical Education Initiative. Each of these institutions has demonstrated a cisco, CA; and daughters Pam Tiemeyer of Farmington Hills, long- term commitment to primary-care education. Their support will have a direct impact on MI, and Maxa Pescovitz-Gider of the development of physicians educated in Western New York, many of whom will be the Pembroke Pines, FL. future health-care providers for our community. + FERDINAND A . PAOLINI, MD '47, died on February 16,1999, in Erie County Medical Center after a of California, John of Chicago, Crandall Jackson, Charlene would come from programs help­ IL, James, Alan and Joseph; and Crandall and Dr. Melanie ing "people who can't take care of six grandchildren. long illness. He was 74. Paolini, savings from a private program who was born in L'Aquila, Italy, came to Buffalo when he was two years old. Following graduation themselves." In his teaching ca­ from Canisius College and UB's reer at the medicalschool and as a Crandall McMahon; son Dr. Blane Crandall,brothers, Vernon CLARENCE CRANDALL, MD '50, and Rodney; sister, Carol Everett; and eightgrandchildren. medical school, he served a resi­ longtime member of the school's died on November 12, 1998, at dency in internal medicine at the Admissions Committee, he influ­ his home in Melbourne, FL. He former Edward J. Meyer Memo­ enced the lives of many dentists was 77. Crandall was born in HERSHEL rial Hospital, now Erie County and was Kennedy, NY. In 1942, he en­ Sanford Ullman, MD '38, writes: known as a gifted teacher, with a listed in the Army Air Force "My brother, Hershel, died Feb­ ruary 2, 1999, at the age of 76. Medical Center (ECMC). He re­ physicians. Paolini ULLMAN, MD 'SO. turned to the hospital after flair for quoting maxims in Latin and served as an armament in­ completion of service with the and Greek during his lectures to structor for three years. Upon He was an internist/cardiologist Army Medical Corps. Later, dur­ students, as well as passages from leaving the service, he enrolled in Los Angeles, CA. ing the Korean War, he served as his favorite authors and poets— in UB's medical school. Follow­ a captain at theSecond Army Hos­ Shakespeare, and ing graduation, he practiced pital in Fort Campbell, KY. After Housman. He retired from the medicine in Holt, MI, for four his Army service, Paolini began a medical school as emeritus clini­ years. In 1954, he moved to the lifelong association with the cal professor of medicine in 1979. old ECMC and the UB school of medi­ He then was appointed medical Melbourne, FL, where he cine. He was director of clinics director of Brothersof Mercy Nurs­ worked until he retired in 1987. and ambulatory care as well as ing Home in Clarence and was A friend of Crandall's in president of the medical-dental instrumental in establishing the Melbourne said she wanted him staff at the hospital. He was acting facility as a major rehabilitation to be remembered for what a medical director during the center. Survivors include his wife former patient had once said of hospital's transition to a medical of 48 years, the former Emily him: "He treated me when I was center and expressed concern that Diakun; three daughters, Anne dirt poor as though I had all the care for needy patients would suf­ Shaw of Minneapolis, MN, Susan money in the world." Survivors fer at the hands of a private insti­ Quek of New York City, NY, and include his wife, Jean, of 56 tution. Paolini argued in 1978 that Judith Walton; five sons, Michael years, daughters n 1 B u f f a l o P h y s i c i a Dickens n S p r i g Eau Gallie 9 9 9 area of Valerie J O H N S . C A R L E T O N , M D ' 5 9 , died of heart failure on June 3, 1998, following a long illness. He was 70. After graduation from Harding University in 1944, Carleton entered the Navy. Fol­ lowing World War II,heentered the Air Force Aviation cadet pro­ gram, where he trained as a pi­ lot, later becoming a decorated fighter pilot during the Korean War. In 1952, Carleton chose to leave the Air Force and pursue a career in medicine. He entered UB, where his father, William { 3 9 ^ �CLASSNOTES Deborah A. White, MD, Physician, Wife and Mother, 1961-1999 S he was a physician who listened compassionately to her patients. She was a partner in a solid marriage. She and her husband, Christopher, were devoted to the three children who formed the center of their lives. How do we make sense of the tragic car accident on February 21, 1999, that claimed the lives of Oeb, Chris and their youngest son, Adam? I can't make sense of it, but I know the tragedy has affected many of us, particularly those in the Medina area, where Deb practiced. Her death has given me an opportunity to examine who she was and what her accom­ plishments were.She grew up on a dairy farm in Eden, NY, one of four children, two of whom still live in Eden, near her parents. She was a diligent student who worked hard to get into UB's school of medicine, graduating in 1987. She did her residency in internal medicine at Buffalo General Hospital while her husband, a cellular and molecular biologist, worked at Roswell Park Cancer Institute. In 1990, at the end of her residency and upon the birth of their first child, Andrew, Deb and Chris's lives took an unusual turn. Chris quit his job at Roswell to become the at-home parent and Deb joined a busy internal medicine practice with David Stahl, MD '79, in Middleport, New York. She went on to have two more children: Elizabeth, born in 1993, and Adam, in 1995. After each birth, Deb took off just a few weeks because of her commitment to her partner and practice. It was because of the support she received from her husband that she was able to "not miss a beat" with the birth of each of her children. Being a doctor in a small community, it was only natural that her practice extended beyond internal medicine. She was in much demand for the services she could provide not only to women in the community, but to children and adolescents, as well. Whenever I called her from the Emergency Department at Medina Memorial Hospital regarding one of her patients, she was always responsive and respectful, despite the frenzy in her office. At noon, I could always find her at home with the frenzy of the family in the background. "Frenzy," though, is not a word that relates to Deb at all. She had a way of listening and being there that made you feel like you were the only thing on her mind. I know her patients felt this way because they tell me so when I talk with them in the Emergency Department. I have searched for meaning in this tragedy but have found little. I am, however, comforted knowing that the surviving children, Andrew, age nine, and Elizabeth, age six, have been embraced by the wonderful extended families of both Deb and Chris. I am inspired by Mr. Preischel, Deb's father. He was able to articulate, while in the Emergency Department on the afternoon of February 21, that his daughter lived a full life. She wanted to be a doctor more than anything, and she became a remarkable physician. She wanted a family life, and she became a loving wife and attentive mother. — E l i z a b e t h M a h e r , M D ' 8 5 . Dr. Maher is director of Emergency Services at Medina Memorial Hospital, where Dr. White was a member of the medical staff. Wallace Carleton, and hisgrand­ hospital owned by theSaudi gov­ and later was promoted tration. He was widely father, John Falloon Carleton, ernment in Saudi Arabia from to chief of psychiatry published and pre­ had also attended medical 1981 to 1984. He is survived by services for the VA sented papers at con­ school. Following graduation, his wife, Alice (Sid) Carleton. Healthcare System of ferences worldwide. Western New York, as Morphy was a senior well as senior medical examiner for officer for the agency's American Board of he received his specialist train­ ing in otolaryngology (ENT) in MURRAY A. MORPHY, MD '72, pro­ Houston. He then practiced fessor and vice chair of the UB medicine in affiliation with Department of Psychiatry and se­ Baylor University in Texas nior medical officer for the Veter­ from 1962 to 1966 and in the entire health-care sys­ Psychiatry and Neuro­ ans Administration Western New tem of Western New York. Involved in the Murray A. Morphy, MD '72 logy and president of Arizona. Throughout his career, York Healthcare System, died training of hundredsof November 30, 1998, at his home tion of Carleton performed much vol­ young physicians studying to be­ in Snyder, NY, at age 51. Follow­ trists. He also served as president, unteer work, especially with come psychiatrists, he is credited children. He was invited to ing UB, secretary and treasurer of the West­ by his peers with the ability to ern New York Psychiatric Society. establish an ENT program and Morphy served as chief of combine scholarship with excel­ physical ward at an Air Force psychiatry at Veterans Hospital lence in clinical care and adminis­ 0 graduation B u from f f a l o P h y s i c i a n S p r the National Associa­ i n g VA Psychia­ 1 9 9 9 �The Pulmonary Rehabilitation Center Garden Gate Health Care Facility is pleased to offer a rehabilitation program specializing in the care of individuals with pulmonary and respiratory disorders. \ Our Unit is coordinated under the guidance of Dr. Robert McDonald, Board Certified in Pulmonary and Critical Care. The unit is staffed by Respiratory, Physical and Occupational therapists and a team of professional support staff educated on the specifics of caring for and treating pulmonary disorders. In addition, Dr. McDonald is a Fellow in the American College of Chest Physicians, President of the WNY Pulmonary and Critical Care Society and partner with Buffalo Cardiology & Pulmonary Associates, P.C. Our team will develop an interdisciplinary care plan and provide a comprehensive education program, tailored specifically to your patient's needs during treatment at our center and after discharge. In addition, a summary of your patient's progress will be forwarded upon discharge or as requested. L Pulmonary Rehabilitation Services • Asthma & Asthmatic Bronchitis • Bronchiectasis • Chronic Obstructive Lung Disease (COPD) • Emphysema • Neurological Disorders • Non-invasive Ventilation (CPAP and BiPAP) • Pneumonia • Post ARDS • Post-Ventilator Therapy • Tracheostomy Care & Management Additional Services: • Educational Training • Support Groups (Smoking Cessation Programs) • Post-Discharge Exercise Regimens • In-Home Assessments Five Star Care Our facilities were rated outstanding in the community with five stars out of five, according to the Inside Guide to America's Nursing Homes. THE cMcGUIRE REHABILITATION ^ CENTER at Garden Gate Heath Care Facility 2365 Union Road • Cheektowaga, New York, 14227 • (716) 929-1715 or 1-888-POSTACUTE �Non Profit Org. BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO y j pos|age 3435 MAIN ST. p^iy BLDG' 2 2 Buffalo, NY BUFFALO NEW YORK 14214-3013 Permit No. 311 ADDRESS SERVICE REQUESTED Your stock may pay more dividends than you thought possible You dabbled in the market long before It became a fad and your hunches paid off. But now you need income, and your shares are only producing low annual dividends. So how can you make the most of your securities and still achieve your personal and financial goals? Give your stock to the university at Buffalo. With careful planning, your gift may provide you with income for life, a charitable deduc­ tion and reduce or eliminate taxes. And for UB it can mean more scholarships, research funds or the realization of your own personal vision and goal for the University. To learn how your gifts of stock can benefit you and the University at Buffalo, please call the Office of Gift Planning at (716) 645-3312. University at Buffalo State University of New York University at Buffalo • Office of Cift Planning • 103 Center for Tomorrow • Buffalo, New York 14260-7400 • 716-645-3312 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1999 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1999-Spring Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v33n04-1999-Spring Table Of Contents A list of subunits of the resource. The Surfactant Story Our Duty Toward Children and Family New Health Care Business Center Medical School News Hospital News Research News Student Column Development Classnotes Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v33n04 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright 1999 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/86d2f4dbf7b45b0ca01007a52121f3f9.pdf e83c7e8f50f6b1507d9057cfd3f5e149 PDF Text Text the Buffalo Physician ^ SUMMER 1971 VOLUME 5, NO. 2, SCHOOL OF MEDICINE STATE UNIVERSITY OF NEW YORK AT BUFFALO I �Learning By Closed Circuit TV The pharmacology class quickly filled the auditorium on the third floor of Veterans Hospital located across Bailey Avenue from the Medical School. They were the first medical class to utilize the new closed circuit TV system that will soon link the hospital to the Medical School. Had there been more laboratory time available to them, they would have performed the experi­ ment which they were about to view. Through the Starling Heart/ Lung operation being performed on a dog, this teaching film would illustrate many of the important fundamental features of cardiac action. Not only would they review the physiology but the sophomores would obtain a concept and understanding of glycoside effects. Video tape can be made in the control room at the hospital in mobile color and in black and white. In the fall when two coaxial cables connect the hospital and the Medical School two captive channels — 9 and 11 — both audio and video can be tuned in. Through its ITFS selection zoom lens, the camera is able to focus onto a specific spot, making it ideal for surgery. But the connecting coaxial cable TV hookup has reciprocal merits. Not only can medical students now see heart operations and other procedures performed at the hospital, but house staff can tune into lectures, seminars or discussions at the medical school. An additional new service, Dial Across Medical Lectures, will fill in the gap where a consultant is not readily available. Spon­ sored by the VA and Wisconsin Regional Medical Program, the recorded service is available on a 24 hour basis. By dialing a federal telecommunications service number, a doctor or student at the hospital has instant access to a short five or six minute lecture on a large number of medical subjects — from blood transfusions to suicide.• The pharmacology class learns via closed circuit TV. Mr. Richard S. Levy and Mr. William H. Maier Audio-visual Company explain the closed circuit William Chardack, associate professor of surgery, Richert, assistant to the Dean and Registrar. responsible for the VA part of the program. from the Seneca equipment to Dr. and Dr. John A. Dr. Chardack is �SUMMER, 1971 Volume 5, Number 2 THE BUFFALO PHYSICIAN Published by the School of Medicine, State University of New York at Buffalo IN THIS ISSUE EDITORIAL B O A R D Closed Circuit TV Editor inside front cover ROBERT S . MCGRANAHAN 2 The Prescription Team MARION MARIONOWSKY 5 A Presidential Inauguration Dean, School of Medicine 7 Repression by Default Managing Editor DR. LEROY A . PESCH by President Robert L. Ketter Photography HUGO H . UNGER EDWARD NOWAK Medical Illustrator 11 The Chronically 111 12 A Summer in England by Ira Mintzer, Class of 1972 MELFORD J . DIEDRICK Graphic Artists 14 Witebsky Memorial Lecture RICHARD MACAKANJA DONALD E. WATKINS 15 Better Health Care Secretary 16 Summer Fellowships 18 Intern Matching 21 Human Sexual Response CONSULTANTS 25 Cassettes Aid Teaching President, Medical Alumni Association 26 Computer Mapping 27 APFME Scholarships FLORENCE MEYER DR. ROLAND ANTHONE President, Alumni Participating Fund for Medical Education DR. MARVIN BLOOM 28 Laboratory Advisory Board Vice President, Faculty of Health Sciences 29 Ending Pregnancy 30 Living Cell JOHN C . CARTER 32 Heart Repairing Director of Public Information 33 3-D Process DR. CLYDE L. RANDALL Vice President, University Foundation JAMES DESANTIS 34 Alumni Reception/Muscular Dystrophy DR. ROBERT D. LOKEN 35 RMP/Furnas Scholarship Director of Medical Alumni Affairs 36 Family Planning 37 VA Programs 38 Dr. Sanes Honored 39-43 The Classes/People 44 In Memoriam 45 Alumni Tour President, University Foundation DAVID K. MICHAEL Director of University Publications THEODORE V . PALERMO Vice President for University Relations DR. A . WESTLEY ROWLAND the Buffalo Physician The cover design by Richard Macakanja focuses upon learning by closed circuit TV. Please see the opposite page for details. THE BUFFALO PHYSICIAN, Summer, 1971 — Volume 5, Number 2, published quarterly Spring, Summer, Fall, Winter — by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. Please notify us of change of address. Copyright 1971 by the Buffalo Physician. �The Prescription Team Physician, Pharmacist, Manufacturer By David F. Burkholder, Pharm.D. From January 1, 1967 to June30, 1970 Dr. Burkholder was Associate Profes­ sor and Director, Center for Pharma­ ceutical Practice, School of Pharmacy, State University of New York at Buf­ falo, and Director, Pharmaceutical Ser­ vices, Buffalo General and Children 's Hospitals. He is now Associate Profes­ sor, Hospital Pharmacy at the Univer­ sity of Missouri, Kansas City.• (reprinted from M O D E R N M E D I C I N E , December 29, 1969) IN THE WORLD OF HEALTH CARE there are many teams, At almost any meeting of health professionals during this decade one could surely expect some discussion of the team concept as it applies to health care planning and organization. Curiously, there has been a great deal said about the team concept but very little done in the way of its actual implementation. Everybody pays lip service to the idea, particularly within individual disciplinary circles, but this in itself is a contradiction to the team approach and suggests a clinging to the old provincial roles with only gradual change through unilateral planning. Historically, the physician was often his own dispenser and the pharmacist was his own producer and sometimes even prescriber for the common complaints and ailments he encountered among his clientele. Early in this century, a pharmaceutical indus­ try began to emerge which was capable of producing high-quality products of more specific pharmacological action. The efficient mass production of convenient dosage forms of consistent quality has now all but completely replaced the pharmacist's role as a producer of his own prescription drugs in their finished forms. By our present-day standards, we identify the physician as the prescriber, the pharmacist as the dispenser, and the manufacturer as the producer. This is the pattern of things as learned by most of us in our professional education and training. Within each of these areas, however, many changes are taking place with a new level of sophistication in the services being provided. This "new look" in drug utilization, especially within major teaching hospitals, is reflected in such specialties as clinical pharmacology in medicine, clinical pharmacy in pharmacy, and clinical coordina­ tion by manufacturers in pharmaceutical research. Notice the "clinical" modification common to all the older disciplines: pharmacology, pharmacy, and pharmaceutical research. Implicit in this clinical orientation is the desire to direct all effort toward the improvement of patient care. The literal meaning of clinical is the laying of hands on the patient, and yet no one of these disciplines touches the patient more than the nurse. The meaning of the word clinical here refers to the ultimate benefit derived from the optimal use of drugs, with the desire to reach the patient's objectives rather than to reach for the patient per se. Such clinical coordination among physicians, pharmacists, and pharmaceutical manufacturers in deriving greater knowledge and experience will require a concerted effort to function as a team. Let's look very briefly at the whole contemporary pattern of drug utilization in this country. On the one hand, hundreds of drug manufacturers produce thousands of drug products under rigid standards of quality control with rather specific accounta­ bility required for the disposition of these products. On the other hand, there are tens of thousands of physicians prescribing drugs for millions of patients amounting to billions of doses, each pro­ ducing multiple pharmacological effects. In the latter situation, there are few standards and essentially no control in drug utiliza­ tion except in certain hospitals where institutional policy generally allows for it or clinical research efforts are directed specifically to study some aspect of drug utilization. The pharmacist is the 2 THE BUFFALO PHYSICIAN �middleman, and although he controls the prescription, his prescrip­ tion records, a tangible source of information, are seldom utilized for study purposes, and the final control in drug utilization is lost the moment he dispenses the drug to the patient. Because the loss of control in drug utilization is so general and so diverse, it is necessary to set up study groups, research teams, and drug review committees, mostly in hospitals and out-patient clinics where a structured environment lends itself to more closely following the care and treatment of a given population of patients. It is within this more academic setting, rather than in private practice, that we see the emergence of a prescription team to study the patterns and precise character of drug utiliza­ tion. This is where we find the specialized professionals with the clinical orientation mentioned earlier. When a new drug first undergoes clinical investigation, as phase II and III studies, a great deal of careful attention is paid to the control factors associated with the study according to a predesigned protocol. This is carried out through the combined efforts of the drug manufacturer (sponsor) and clinical (principal) investigator, a team of two. Unfortunately, the pharmacist is not usually brought into this team effort, and as a result, the com­ plete and detailed records of their ultimate disposition within the hospital or clinic are left to a clerk or secretary of the investi­ gator which can later lead to problems for the sponsor. The moment a New Drug Application has been approved by the Food and Drug Administration for production and marketing of a new drug product, the manufacturer becomes less involved in the actual utilization of the new product and the pharmacist suddenly becomes deeply involved. Now we againhavea team of two working together, but the manufacturer's interest in the new product has tended to shift administratively from its medical de­ partment to its departments of production and sales. At this point, the amount of control and interest in studying the most effective utilization of a new drug is greatly decreased. There seems to be a false assumption that just because a new drug product has been approved by the FDA there is no further requirement to study its continued use to determine the limits of its efficacy and safety in a variety of patients. This shift in emphasis of interest ironical­ ly occurs at a time when the greatest amount of information and benefit could be derived from the much larger experience gained through its intended use in tens of thousands of patients under a variety of conditions. I would like to propose the establishment of so-called "phase IV studies" by the prescription team: physician (or clinical phar­ macologist), pharmacist (or clinical pharmacist), and manufacturer (or clinical coordinator). These studies, although not required by law, would serve the purpose of adding to our present drug knowledge more precise information based on actual experience with these drugs as they are used in practice. Within the many hospitals and clinics of our country lies a wealth of information which is based on the factual experience of drug use and therefore is self-generating. Undoubtedly, the pro­ grammed collection and organization of this information would provide the strongest evidence in determining the character of SUMMER, 1971 3 Dr. Burkholder �drug selection, drug utilization, and even drug performance for many newer drug products now in use. The value of this informa­ tion has been demonstrated thus far in only a few widely scat­ tered teaching hospitals. But even with this limited experience, it is quite clear that programs of this type, now being coordinated between the hospital's pharmacy and medical staffs, have taken a major step in providing a more rational basis for the selection and use of drugs in patient care. Through the coordination of effort by a prescription team, a continuous monitoring program could be established for each manufacturer to determine: 1] Choice of drug product and frequency of choice for a given clinical condition 2] Size and frequency of dosage used 3] Duration of drug use 4] Drugs given in combination 5] Other treatments (non-drug) given concurrently 6] Pattern of pertinent laboratory values or other parameters used to determine the patient's progress 7] Relationship of patient's progress to specific drug therapy employed in a time-dose relationship 8] Frequency of adverse reactions and side effects under a var­ iety of clinical conditions. The collection of such data would enable the manufacturer and others to better assess optimal drug use—efficacy as well as safety—in specific types of patients; provide more detailed in­ formation on drugs used in combination, drug interactions, and drug interference with special diets and diagnostic tests; and determine physiological availability of the drug under different pathological conditions. In addition to aiding the teaching mission of our health practitioners concerned with drug therapy, this information would be useful to the drug manufacturer in devel­ oping improved drug products and new dosage forms. The value of such information in marketing research would be far superior to a mere analysis of sales figures in assessing the acceptance of a new product. Undoubtedly, the drug manufacturer could initiate this team effort and organize a type of phase IV study program for moni­ toring the use of selected drug products. Provided the con­ fidentiality of the hospital or clinic, physician, and patient could be assured by the appropriate use of codes, such a team effort would not only seem feasible but would be very desirable in providing a much needed body of useful information for the clin­ ical pharmacologist, the clinical pharmacist, and the clinical co­ ordination program of the manufacturer. By a contractual ar­ rangement with the hospital, the hospital pharmacist, again the middleman on the team, could be responsible for all data col­ lection. This is easily facilitated by the fact that the pharmacy is the one place in the hospital where all the drug orders are received for all the patients undergoing treatment and care. Because the medical departments of most pharmaceutical man­ ufacturers have concerned themselves primarily with new drugs undergoing initial clinical evaluation (prior to marketing), it would be necessary for them to extend their interest to the continued use of marketed products through phase IV studies as proposed.• 4 THE BUFFALO PHYSICIAN �A Presidential Inauguration D p ROBERT L. KETTERwas inaugurated as the University's third 'R. president and 11th chief administrator February 15 by Dr. Ernest L. Boyer, State University Chancellor at Kleinhans Music Hall. Approximately 1,800 people gave Dr. Ketter a standing ovation following the installation. Prayers were offered by clergymen of three faiths - Msgr. Joseph E. Schieder, Pastor of St. Andrews Church; The Reverend Ralph W. Loew, Pastor of Holy Trinity Lutheran Church; and Rabbi Martin Goldberg of Temple Beth Zion. Representatives of 180 universities and professional societies marched in the aca­ demic procession led by Dr. John T. Horton, University Marshall, and professor of history. Speaking on behalf of the Undergraduate Students Associa­ tion Mark Huddleston said, "will you have the vision to restore the sense of unity and excitement that marked the administration of Martin Meyerson?" "We can look forward to many years of positive leadership," responded William C. Baird, chairman of University Council. He cited Dr. Ketter's achievements as a scholar and successful ad­ ministrator. "You were chosen for your ability to interpret a large, growing facility to its many publics. We have total con­ fidence in your ability to lead the University to even higher rank." Speaking for the academic community, Dr. John S. Toll, pres­ ident of the State University at Stony Brook, pointed out that a university president has only a "razor edge of maneuverabil­ ity" in dealing with current problems. "The academic community rejoices on this occasion, but can you?" Other speakers on the 90-minute program were Michael Rosen, president of the Graduate Student Association; Dr. William H. Baumer, chairman of the Faculty Senate and associate professor of philosophy; and Robert E. Lipp, president of the General Alumni Association. Mr. Rosen asked the new president to promote personal dig­ nity and to realize that the "dignity of one person is no higher than the rest of humanity." Representing the faculty, Dr. Baumer described Dr. Ketter's presidency as "characteristic of beginnings — times of hopes and dreams, fears and uncertainties." He proposed an effort on the part of the University community to develop "a community of scholars in every best sense of that phrase." Alumni President Lipp praised the new president's actions during the first seven months of his term. "You have led capably and we are most pleased." In inaugurating Dr. Ketter, Chancellor Boyer presented him a silver medallion which is the emblem of the president's office. It incorporates the UB seal, a cluster of books radiating from a central core and represents the unity of knowledge gained through the university's diverse faculties. SUMMER, 1971 5 Drs. Boyer, Ketter Dr. Ketter, a 42-year-old eng­ ineer, was named president in June, 1970 by the State Univer­ sity Board of Trustees. He had been a member of the faculty for 12 years. �The University Brass Ensemble, under the direction of Frank J. Cipolla, played the National Anthem and accompanied the Uni­ versity Chorus in Tomas Luis de Victoria's "O Magnum Mysterium". Mrs. Sylvia Dimiziani directed the Chorus. After the ceremony there was a special luncheon at the Ridge Lea Campus dining room. The group also heard messages from the community and central SUNY administration. Chancellor Boyer gave greetings not only to the new president but also to his family, speaking of the "family commitment" that must be made as well as the presidential one. Buffalo City Comptroller George O'Connell brought the "feli­ citations of the City of Buffalo" to "President Bob" on behalf of Mayor Sedita. President Ketter was given a "gold plated letter opener" with the seal of the County of Erie in its handle by B. John Tutuska, Erie County Executive. Tutuska said the seal represented the "appreciation and gratitude" the County has for the new president. Greetings to Dr. Ketter were also extended by Dr. Albert Berrian, associate commissioner for higher education, State of New York, the Very Reverend James M. Demske, S.J., president of Canisius College, and Allen Dekdebrun, supervisor of the Town of Amherst.• Dr. John T. Horton The luncheon THE BUFFALO PHYSICIAN �Chancellor Boyer, Mr. Baird, members of the Council of State University of New York at Buffalo, members of the Board of Trustees of State University of New York, Distinguished Visitors, Delegates, members of the University faculty and student body, Reverend Clergy, Alumni, Ladies and Gentlemen. This moment revives for me a feeling I experienced when I was first appointed to office and which I am sure all of my pre­ decessors shared, for I am standing now, as they did, at the crossroads between tradition and innovation, between the impera­ tive to preserve an inheritance from the past and the sense of the opportunity to give a shape to the future. For each of my predecessors the interplay between tradition and innovation has had a unique meaning, since the point at which they meet shifts from generation to generation. In my opin­ ion, the area of crucial concern here and now is the relation between academic freedom and academic responsibility. Therefore, on this occasion, I want to make that relationship the focus of my remarks. I In an article which appeared last August in one of the national dailies, it was reported that thirty-two states had enacted legisla­ tion designed specifically to control campus disorders. There has not yet been sufficient time to analyze fully the implications of these measures; nevertheless, I would submit that such laws are repressive at worst and at best, they are regressive, for they are certain to erode the institutional autonomy which is a prerequisite for true academic freedom. Traditionally, universities have opposed any attempts to cir­ cumscribe their autonomy, reasoning that an attack against the conditions under which academic freedom exists is in fact an attack against academic freedom itself. In general, their opposi­ tion has not been misplaced; for the privilege of autonomy has rarely been granted without a struggle, and even then, society has demonstrated a reluctant acquiescence rather than a positive commitment to the concept. Unfortunately, our concentration on preventing external inter­ ference has deflected our attention away from internal responsi­ bilities. We have looked outward at the expense of looking in­ ward, and now find ourselves faced with an uncomfortable para­ dox: our very preoccupation with external threat has helped to bring it about. Nor has the internal neglect resulted only from our struggle for autonomy and academic freedom. It also has come out of arrogance and fear, an arrogance which has placed us above responsibility, and a fear which has paralyzed our will to adhere to the demands of responsibility even when we have perceived them. Lewis Mayhew and numerous other educators have warned us of the gravity of the crisis that these attitudes have created. If the university does not put its own house in order, the political SUMMER, 1971 7 Repression by Default Robert L. Ketter President State University of New York at Buffalo �establishment, in response to public pressure, will attempt to do so. We will have squandered our inheritance of both autonomy and freedom. We cannot continue to invite repression by default. It is im­ perative that we, ourselves, define our responsibilities and de­ termine to meet them. This is one of the primary opportunities the future holds for each of us. II Drs. Strauss, Mohn, Brody The mission of a university is to contribute to the welfare of society — through education. This contribution has traditionally been made in the areas of teaching, research and public service. To properly serve in these areas the university has required that it be given the autonomy which insures free inquiry into the truth of all phenomena, and the free dispensation of the results of that inquiry. Samuel Capen, Chancellor of this University from 1922 to 1950, wrote that what we have asked is "to be protected against every form of reprisal" that the truth might provoke. This is to be given a uniquely privileged status, one which almost implies ab­ solute freedom. Judge Learned Hand pointed to the danger in this extreme interpretation: "A society in which men recognize no check upon their freedom," he said, "soon becomes a society where freedom is the possession of only a savage few . . . ." The academic profession has recognized the validity of this warning and has sought to avoid the abuse of its freedom by selfimposed precepts: a reliance on scholarship rather than opinion, reason rather than power, intellectual exchange rather than dogma, and above all humanity in its relations to others. But academic freedom is now threatened. It is true that the university is one of many social institutions confronted today by a loss of confidence. It is also true that dissatisfaction with the university has been heightened by changes in other sectors of society. But we are still faced ultimately with the realization that the atmosphere of freedom on campus has been invaded. It has been invaded by those whose impatience and ill-conceived goals demand the destruction of the university, as the only solution to the problems of an institution which reflects many of society's deficiences and injustices. It has been invaded, too, by those who wish to suppress expression of unpopular views, who do not distinguish between violent revolt and peaceful dissent. The university has been peculiarly vulnerable to these invasions be­ cause its commitment to freedom and to the complexities of truth has often paralyzed its ability to act. In reviewing recent educational history, it must be concluded that while less visible, no doubt because it was less volatile, serious abuses of academic freedom began to afflict universities in their early years of burgeoning affluence following World War II. These abuses were caused by arrogance, an arrogance which has done much to provoke the disorder which many have cited as the justification for the present threats to our autonomy. This arrogance has been manifested in the imposition of an auto­ cratic lecture system which too frequently has denied students 8 THE BUFFALO PHYSICIAN �the freedom of inquiry which we have claimed for ourselves. We have expected our own conclusions, expounded at length, to be returned dutifully at the end of the term. We have thus displayed in ourselves the closed minds which we have been so quick to condemn in others. Our research, and sometimes our pretensions to research, have interfered with our teaching. Light course loads have been used as opportunities not to devote more time to individual stu­ dents, but to pursue our own interests, whether or not these interests are of benefit to those whom we teach. Our offices are more often closed than open to students and much of our teaching has been left to the least experienced. Our research in­ terests have too often been dictated by available funds which have led to an eager relinquishing of autonomy and self-direction. The excess of wealth that has mushroomed our research has been matched by our hubristic claims that have created unrealistic expectations among the students and in the community. To whatever extent these charges are applicable to institutions and individuals, then to that extent the institutions and the indi­ viduals have abrogated their responsibility to the purpose of higher education. This denial, this arrogance of self-interest, must be accorded its own proper role as a factor in the erosion of con­ fidence in the academic profession. For it is a pervasive sense of disenchantment, not alone a reactionto campus disorder, which has created the current threat to autonomy and academic freedom. Ill There are many who now recommend that research institutes, separate from the universities, be created; that universities no longer act as certification boards for employers in business and in the professions; and that the public demand for the services of higher education be limited. These recommendations — which come from within the university as well as from without — sug­ gest that there is a widespread belief that the university has over-extended itself, has attempted to fill too many roles. These proposals may have some merit, but I do not believe that we are going to restore the trust we have lost simply by proposing remedies dependent upon elements outside the univer­ sity. The teaching, research and service functions have been part of the role of universities since their creation in medieval times, and I do not foresee a time when one or another of them will be abandoned: they are too interrelated. I believe first we must recognize that teaching is primary, and that research and service are valuable to the university in the degree to which they facilitate the former. It is through teaching that the university and the individual in the university will make their broadest contribution to the welfare of society. The teacher must never allow the pursuit of his own interests to lead to neglect of the intellectual growth of his students. As the largest graduate center in the State University of New York, this institution at Buffalo has a particular obligation to re­ search. But, if we insist that our activities in both the pure and applied fields are to be carefully selected to enhance the teaching SUMMER, 1971 Dr. Randall, Dean Pesch �Chancellors, Presidents 1. Millard Fillmore 1846-1874. 2. Orsamus H. Marshall 1882-1884. 3. E. Carleton Sprague, 1885-1895. 4. James 0. Putnam 1895-1902. 5. Wilson S. Bissell 1902-1903. 6. Charles P. Norton 1905-1920. 7. Samuel P. Capen 1922-1950. 8. T. Raymond McConnell 1950-1954. 9. Clifford C. Furnas 1954-1966 10. Martin Meyerson 1966-1970. 11. Robert L. Ketter 1970Including acting chancellors and presidents, Ketter would be 16th: 1. Fillmore; 2. Marshall (there was no acting chancellor between Marshall and Fillmore); 3. Sprague; 4. Putnam; 5. Bis­ sell; 6. George Gorham, "acting" between Bissell and Norton; 7. Norton; 8. Walter P. Cooke, "act­ ing" between Norton and Capen; 9. Capen; 10. McConnell; 11. Seymour H. Knox, "acting" between McConnell and Furnas; 12. Furnas; 13. Claude E. Puf­ fer, "acting" while Furnas was on leave as assistant secretary of defense; 14. Meyerson; 15. Peter F. Regan, "acting" while Meyer­ son was on leave during 196970, and 16. Ketter. As for the presidential num­ ber, Furnas was the first presi­ dent; the title was changed from chancellor after the merger with State University. That would make Ketter the third president. process, then we will maintain our integrity as a true institution of learning. Realistically, this selection will have to be made among interests which individuals, businesses, foundations, and governments are willing to finance. It would be foolish to argue that social utility is not a powerful institutional influence. Never­ theless, careful selection among our options can preserve our right to define our own priorities while simultaneously serving societal advancement. Public service, apart from the service inherent in teaching and research, has occupied during the last several years an increasing amount of time and resources within the university. It is obvious by now, however, that the university cannot be honed into a cut­ ting edge for social change. That role would require attributes that are antithetical to the objectivity demanded by scholarship. Therefore, in exercising this function we must make sure that our programs of service have a broad educational value, and that an advocacy of special interests does not usurp the critical stance that the university at all times must maintain. IV Can the responsibilities of the university community be ob­ served without a formal and enforceable code of ethics? It is true that our universities have become more legalistic in nature as a result of campus disorders. Nevertheless, the disciplinary codes and due process measures that have been drawn up to deal with these problems have not stilled the public outcry for yet more stringent regulations. Reacting to this external pressure and out of a genuine concern for the viability of freedom on the campus, many educators have suggested the need for a well-defined code which includes an en­ forcement mechanism. The Association of American University Professors recently released a statement on freedom and respon­ sibility; the American Association of State Colleges and Univer­ sities has issued its own statement on "academic freedom, re­ sponsibility, and tenure"; and at both Berkeley and Stanford the faculties have been considering the strong enforcement of "codes.'' I feel very strongly that this concern for professional ethics is healthy, for all too often in the past we have emphasized freedom without sufficient regard for responsibility. It is my personal hope, however, that California is not, as it has been labeled, "the nation's weather vane." I do not share the view of those persons who feel that the consensual and uncodified guidelines for academic freedom and academic responsibility are too illdefined to be useful; and I do not want the University placed in the position of having to create a formal code and enforcement procedures as a means of avoiding that creation by others. If this possibility can be averted, it will be done so through institutional and individual commitment to self-discipline. It is this quality which enables us to sublimate our self-interests to the advancement of the human good and to thereby fulfill the purpose of higher education and of this University. The quality is intrinsic to scholarship; it is both our defense and our freedom. The time has now come to reclaim it.D 10 THE BUFFALO PHYSICIAN �Help for the Chronically 111 If you had any preconceived notions that health personnel in Buffalo work together to benefit the chronically ill and their families, you were quickly disillusioned. Invited members of the community, attending the conference, asked the same question many times: WHERE DO I GO FOR HELP? WHO DO I SEE? Attempting to answer the questions were the 500 physicians, allied health professionals and social workers attending the Family Management of the Chronically 111 Conference. From the man whose homelife had turned into a kind of "hell" because of lack of help for a daughter born with a severe birth defect thus precipitating a disintegration of relationships with his wife and three other children — to the health guide who was continuously rebuffed in her attempts to gain help for a World War I paralyzed veteran and his partially paralyzed wife, the evidence remains that "you can dial a phone number and try to get an answer. And if you are lucky you may get another number to call." But at least two seekers of help left the conference with some sort of hope for a beginning at solving some of their prob­ lems. Moderator Dr. Samuel Sanes called upon the professionals in the audience to supply a list of names and numbers to call. What was so glaringly evident to all was WHY DON'T WE KNOW ABOUT AGENCIES IN THE COMMUNITY? There still remains a paucity of information on overall services offered that makes it difficult for the professionals to direct a patient to resources that exist. Agreement was reached that evaluation is the key to a pro­ gram developed for a chronically ill patient. And that rehabili­ tation must start for the patient the day that he enters the hospital and not wait until after his operation. And if the indi­ vidual cannot adapt to his environment, the environment must adapt to him. But a computerized health care system for Western New York, now in its first phase, Dr. fames R. Nunn pointed out, will match hospital patients who are ready for nursing home care with existent vacancies. What of the future? If medical students are not taught to work as members of a community-wide health team, the group were cautioned, the future will be no better than the past. There are many resources, many private agencies who stand ready to help those in need. HOW TO RESPOND TO THESE PROBLEMS? There is a need for a central referral system, to dial a number and get the as­ sistance you need. But it has to be an excellent system to work properly, it was pointed out. It is not because of professional failure, the conferees were reminded, that is at fault, but because of human failure. An impassioned plea from a physician to "stay with a call for help until you get the answer" ended the conference.• SUMMER, 1971 11 �A Summer in Socialized Medicine By Ira Mintzer, Class of 1972 Ira Mintzer My eight week clinical fellowship at Addenbrooke's Hospital in Cambridge, England presented a view into a somewhat dif­ ferent system of medical care than is practiced in our country. Cambridge is a city with a small population. Therefore Addenbrooke serves as a referral center for much of the East Anglia area. The Hospital has two sites. The older and more centrally located building is used for general medical care and emergencies while the newer site is devoted to outpatient clinics, accident emergencies, and to surgical care. I was attached to a general medicine firm at the hospital. This hospital unit consisted of consultant, senior registrar, registrar, and houseman. All patients referred to the consultant by a gen­ eral practitioner are cared for at Addenbrooke by this firm. My particiular firm was headed by Drs. T. M. Chalmers and P. Adams, medical consultants interested in endocrine physiology, notably abnormalities of calcium metabolism. Besides patient workups, presenting cases during rounds, I attended teaching rounds and outpatient clinics. My firm conducted a special bone clinic, emphasizing calcium metabolism, stone formation, and diagnostic problems involved in parathyroid dis­ ease. And there were visits to Fulbourne Mental Hospital and the Ida Darwin Center for Mental Retardation with Dr. Adams, a consultant to these smaller community hospitals. Attachment to this firm certainly was a rewarding introduction into clinical medicine. To broaden my view of the British National Health Service and clinical sciences, my Cambridge fellowship sonsor, Dr. Chalmers, arranged a number of medical subspecialty sessions. The first centered around neurology under consultant neurologist Yearland. There were outpatient and Parkinsonian clinics, and ward rounds that were especially instructive, because of the question/answer type of dialogue between physician and stu­ dent. It enabled me to think in terms of differential diagnoses about various disease states. The MRCP rounds also utilized this Socratic type of examination. Students, along with candidates for Royal College of Physician examinations, were taken to the bedside and asked to elicit physical signs. The cases presented often demonstrated rare or classic entities — Wilson's disease with Kayser-Fleischer rings, Sjogrens disease or various metabolic disturbances such as acromegaly or Paget's disease. The second special session featured the radiotherapy unit at Addenbrooke. Here I observed radiotherapy techniques of both diagnosis and treatment — radio-isotope scanning, x-irradiation, radium implantation, and lymphangiography. I learned histories of various malignant diseases such as mycosis fungoides, its diagnosis, treatment, and outcome. 12 THE BUFFALO PHYSICIAN �At Chesterton Hospital, devoted to the subspecialty of geria­ trics, I participated in ward rounds with occupational and physio­ therapists, medical and surgical personnel. And I was introduced to the problems of diagnoses, care, rehabilitation (prostheses, etc.) and social work when joining the latter on home visits to geriatric patients. Additional time in the hematology department involved anti­ coagulant clinics serving to follow patients during their course of anticoagulation. Laboratory visits covered testing procedures, prothrombin and partial thromoplastin times, techniques of blood sample examination with the Coulter Counter for RBC, WBC, and hematocrits. I followed various diagnostic procedures, sternal punctures, and subsequent marrow examinations, and was able to correlate clinical problems with hematological investigations. On visits to the blood bank I learned about the National Donor Center which supplies needed blood to the hospital where it is subsequently crossmatched and made available preoperatively. Final sessions were spent with a general practitioner, the foundation of medical practice in England. All treatment in Eng­ land is initiated at the GP level and through him referrals are made to the consultant and firms described. The GP is family counselor, obstetrician, pediatrician, and provider of general medical care. Mornings in his office were followed by afternoons making house calls, a regular part of the English practitioner's day. The doctor/patient relationship is reinforced in this non-hospital setting. We also visited the public health laboratory, a unit of the National Health System which provides to the community bacter­ iological and virological studies. Diagnostic tests are performed for both hospital and general practitioner as are routine checks on milk, water, etc. In addition epidemiological studies are made to prevent outbreaks of salmonella, brucella, etc. CRITIQUE OF THE SYSTEM Health care in the British medical system is provided to all in need. Care is not dependent on the wealth of the individual but on facilities available and seriousness of disease state. A young patient in renal failure will more easily obtain the use of limited renal dialysis units than will an elderly patient with congestive heart failure, dia­ betes, and renal shutdown. The British medical system is pyramidical; the general practitioner forms the base and the consultant the apex. While about 15 percent of all medical graduates obtain hospital positions, the majority enter general practice with limited or no hospital privileges. All referrals and initial diagnosis stem from the GP, the foundation of the system. The quality of this key physician may vary, thus forming at times a weak link in the system. Perhaps great­ er hospital responsibility to the local physician would assure higher standards. In this rigidized system of hospital medicine, only the most qualified reach the highly regarded consultantship position. Careful modification of this sys­ tem may be needed. SUMMER, 1971 13 The next issue of the Buffalo Physician will feature a picture story of the 34th annual Spring Clinical Days.• �National Health Service, overseer of medical care in England, regulates professional salaries, a factor influencing the "brain drain" to the U.S. However, high standards of care are maintained. An important area that is controlled are drug prices and standards. All drugs under this service are free except for a 2 and 6 fee, equivalent to 30 cents. The patient bene­ fits from prescribing of generic names of drugs. Despite the rigid control of medicine in England, the system works and it works well. There is much to be learned from it. Doctors, nurses, occupational and physio­ therapists are dedicated to the care of the patient. Often facilities are inadequate and more physicians are needed. But the basic plan of the system — medical care for all who are in need — is one which serves as a foundation for growth and improved medical care.D Dr. Witebsky Memorial Lecture There is considerable circumstantial evidence that a virus may cause cancer. That is what Dr. Werner Henle, professor of virology at the University of Pennsylvania, said at the first Dr. Ernest Witebsky Memorial Lecture February 8. Dr. Henle cited an impressive list of findings that pinpoint a virus of the herpes family — a family known to cause shingles, cold sores and chickenpox. It is known as the Epstein-Barr virus, named for the sci­ entist who first saw it in cultures of cells from patients with a malignant disease known as Burkitt's lymphoma. Dr. Henle and his wife Gertrude [also a virology professor) are in the forefront of those studying the virus. They and other scientists have found the virus in all patients with Burkitt's lym­ phoma, and in all patients with another type of cancer found in Hong Kong, cancer of the postnasal space. They also learned that the virus is present in 100 per cent of the patients who have, or have had, infectious mononucleosis. It may be simply a "passenger" virus. Why should a virus found so commonly throughout the world cause cancer in some instances but not in others? Dr. Henle sug­ gests this is because the virus does not work alone, but with accomplices such as diet, chemicals, heredity, and other factors. The nature of the cancer depends upon the accomplice chosen. Both Dr. and Mrs. Henle were students at the University of Heidelberg where the late Dr. Witebsky taught before coming to America. Dr. Witebsky died Dec. 7, 1969. He was a distinguished professor of microbiology and the first director of the Center for Immunology at the University. An Ernest Witebsky award for proficiency in microbiology during the past year was presented to four students: Miss Doris V. Goldchain, a graduate student; Michael Gordon and Stanton R. Schiller, junior medical students, and Stanley Shainbrown, a junior dental student.• 14 THE BUFFALO PHYSICIAN �Better Health Care I\ EEPING PEOPLE HEALTHY rather than stressing treatment only in times of severe illness is the goal of the Nixon administration's health plan, according to Dean LeRoy A. Pesch. He also serves as health manpower consultant to the United States Department of Health, Education and Welfare. The basic idea of the new plan is to build on the present system as opposed to tearing down the old and substituting something for it. Dr. Pesch mentioned six specifics: (1) Fill the need for an increased supply of health profes­ sions by aiding and improving education. (2) Provide better facilities by promoting construction and efficient utilization of existing facilities. (3) Insure that people will be able to have the kind of medical care they need when they need it—not just when they are sick, but before they are so ill that they require hospitalization. (4) The number of physicians trained in medical schools would be increased by expanding opportunities for graduates to pay off federal loans by working in ghettos or rural areas where the supply of doctors is too low to meet needs. (5) A larger loan fund for low-income medical and dental students. (6) Granting $93 million to medical schools to encourage expansion. The main initiative of the new health plan is the so-called Health Maintenance Organization (HMO). These groups include the Health Insurance Plan of New York, the Kaiser Plans of the Middle West and California and the Puget Sound Health Plan in Washington state. About eight million Americans are now en­ rolled in these plans which emphasize preventive medicine. Ac­ cording to Dr. Pesch HMO would be private groups of physicians, who could be attached to a corporation, a hospital, or any other existing organization. They would provide regular medical care for a person whenever the individual felt it was needed. "The intent is to provide health service to a group of people in a way that shifts the emphasis to maintenance of health, rather than just illness. This would control some of the high costs of treating illness. Many kinds of people could qualify. To help new HMO's to get started $23-million has been allocated for planning grants to aid potential sponsors in both the private and public sector. The Nixon administration also proposes a series of new area health education centers in places which are medically under-served.• SUMMER, 197) 15 There are several other na­ tional health plans being dis­ cussed. Most evolve around whether the mechanism of the restructuring should be public, in the form of a compulsory national health plan, or private, with the government role limited to health insurance subsidies and financial incentives. Some of the other proposals: Senator Kennedy plan; AMA Medicredit; Aetna Life & Casualty Co.; Senator Javits plan; AFL-CIO plan; Sen­ ator Claiborne Pell plan; and American Hospital Association (Ameriplan). �New Twist to Summer Fellowships "We were hoping that all 71 medical students who were awarded summer fellowships this year could receive a stipend of $1,000 rather than the traditional $600 sum. But," said Dr. Carl Bentzel who heads the fellowships committee, "limited funds prevented us from doing so. We had to look for a new approach in allo­ cating available committee support funds on a competitive basis." This led to an additional option to the traditional educational experience one finds in medical school. For those freshmen, sophomores and juniors who could, with excellence, imagination and initiative, present a problem and outline ways in which they hoped to solve it, there would be the reward of a higher stipend for the summer. Some of the applications that the fellowship committee re­ ceived were as good as many senior investigator grant proposals. The fellowship committee, composed of basic science and clinical faculty plus two student appointees, awarded the higher stipend to eight applicants (see table) whose proposals were judged to be outstanding. What will the 71 medical students do? Fifty-six will remain in Buffalo to work in the areas of clinical, research or family practice over an eight week period. Nine will obtain a different type of medical experience in five other American cities while four will spend the summer in England and two others in Israel. RESEARCH Local Project Site, Faculty Brown, Ian S. '74 Rosenberg, Jan '74 Szymula, Norbert J. '73 Weiss, Robert M. '74 Inhibition of synoptic transmission in autonomic ganglia Tolerance to lysergic acid diethylamide Work in pathology laboratory Research in cancer immunology Pharmacology, SUNYAB—Dr, R. Mclsaac Pharmacology, SUNYAB—Dr. J. Winter Sister's Hospital—Dr. P. Milley Roswell Park—Dr. J. Bekesi CLINICAL RESEARCH Local HIS bundle recordings with particular reference to heart block and WPW Anderson, Timothy, W., Jr. '74 Drug abuse and addiction Changes in limb lead qrs voltage as indication of Barnett, Paul H. '74 immediate prognosis in myocardial infarction Clinical immunology, immune response of patients Budny, James '74 with bacterial and viral infections Sex education for inner city adolescents Floyd, Rita D. '73 Abramowitz, Bruce '73 Hakel, Susan J. '73 Sex education for inner city adolescents Hallac, Ralph '73 Haberman, Michael A. '73 Hammond, Susan P. '74 Hart, Benjamin A. '74 Evaluation of immune response to milk proteins Neutrophil alkaiine phosphatose in Hodgkin's disease Search for helper viruses to Yaba virus Thyroidal I; specific peroxidase as aid in diagnosis of critinism, hypothyroidism Immune response of patients with bacterial infections Spinal cord compression in lymphomas Studies in cryosurgery for tumors Hypoxia in pneumonia Pediatric surgery Studies of radiation-induced nephritis in mice Antenatal detection of genetic disorders Public health and community medicine Developmental assessment of infants, children Cardiology Dermatology Heller, Marc E. '74 Hrushesky, Donna M. '73 Huddle, Robert H. Jr. '73 Klaw, Robert '72 Kruger, Paul S. '72 Manzella, John P. '74 Marks, James S. '73 McAllister, Charles J. '73 Palma, Paul A. '73 Pores, Ira H. '73 Poretta, Jerome C. '72 16 Veterans Hospital—Dr. I. Besseghini Meyer Hospital—Dr. C. D'Amanda Buffalo General Hospital—Dr. J. Wanka Children's Hospital—Dr. M. MacGillivray Westminister and St. Augustine Centers— Dr. J. Dower Westminister and St. Augustine Centers— Dr. H. Sultz Meyer Hospital—Dr. A. Yurchak Veterans Hospital—Dr. B. Fisher Roswell Park Institute—Dr. J. Ambrus Children's Hospital—Dr. R. Slaunwhite Children's Hospital—Dr. I. Neter Roswell Park Institute—Dr. L. Stutzman Veteran's Hospital—Dr. A. Gage Buffalo General Hospital—Dr. O. Bossman Children's Hospital—Dr. J. Allen Buffalo General Hospital—Dr. A. Prezyna Children's Hospital—Dr. R. Davidson Erie County Health Dept—Dr. M. Ibrahim Children's Hospital—Dr. Kerr-Grant Veteran's Hospital—Dr. D. Dean Roswell Park—Dr. E. Klein THE BUFFALO PHYSICIAN �Riozzi, Michael A. Jr. '73 Sanders, Barry '73 Sansome, Michael A. '73 Schulman, Elliott A. '74 Scherz, Arnold W. '73 Severin, Hayden D. '74 Stern, Lewis J. '72 Sybert, Virginia P. '74 Whelan, Kathleen M. '74 Wymbs, Henry '73 Aspects of leukemia virus and erythropoietin Melabolism of INH in patients undergoing chronic dialysis E v a l u a t i o n o f response of hepatic and pancreatic t i s s u e t o heterologous antisera and globulins Investigation of myocardial state in acutely ill man Cardio-respiratory failure following operation Liver and gastrointestinal diseases E f f e c t o f drugs on bilirubin binding capacity in n e w b o r n Induction of crossing-over and recombination in human somatic ceils B leomycin therapy fo r a d vanced squamous cell carinoma Clinical approach to diagnostic chest disease Roswell Park Institute—Dr. E. Mirand Meyer Hospital—Dr. A. Tannenberg Roswell Park Institute—Dr. E. Holyoke Meyer Hospital—Dr. H. Falsetti Veteran's Hospital—Dr. K. Olson Buffalo General Hospital—Drs, Ali, Nolan Children's Hospital—Dr. S. Yaffe Children's Hospital—Dr. M. Cohen Veteran's Hospital—Dr. A. Gage Meyer Hospital—Dr. C. Pietraszek CLINICAL Local Ackerman, William J. '73 DiBianca, Robert '72 Launer, Dana P. '73 Levin, William D. '72 Leiberman, Nancy '73 Russell, Keith F. '74 M e d i c i n e w i t h special emphasis on evaluation Cardiology Pediatric surgery Surgery Pediatric oncology Introduction and guidance to orthopedic surgery Veteran's Hospital—Dr. J. Acquilina Buffalo General—Dr. J. Constant Children's Hospital—Dr. T. Jewett Buffalo General—Dr. R. Adler Roswell Park—Dr. L. Sinks 1008 Humboldt Pkwy., Dr. R. Worrell Role of state health dept in chronic disease control and its relationship t o medical care delivery system General Practice Anesthesiology Pediatrics Pediatrics Clinical cardiology General Practice R o l e o f s t a t e health d e p t . in chronic disease control and its relationship t o medical care s y s t e m Family practice in rural setting Health Dept., Providence, Rhode Island National Alpert, Bernard '74 Camacho, Fernando J. '73 Gershbein, Bart '74 Goodman, Marianne '74 Napolitano, Guido J. '74 Natali, Vincent G. '73 Pietro, Daniel A, '73 Thaler, Paul '74 Thorington, Darlene '73 Staten Island Hospital, New York Veteran's Hospital, Boston, Mass. Albert Einstein School of Medicine Montefiore Hospital, New York City Tucson Medical Center, Tucson, Ariz. Staten Island Hospital, New York Providence, Rhode Island MK&T Hospital, Parsons, Kansas Foreign Gordon, Michael Hematology Jacobowitz, Israel '73 Leitner, March '72 Mintzer, Ira '72 Microbiology, Hadassah Hospital Evaluation of Israel's health care system Clinical medicine in Great Britain Newman, Stephen '72 Hematology Pohl, Lawrence S. '72 Hematology Addenbrooke Hospital, Cambridge, England arranged by Dr. J. Mohn Jerusalum, Israel-arranged by Dr. A. Barroi Israel-arranged by Dr. C. D'Amanda Addenbrooke Hospital, Cambridge, Englant arranged by Dr. J. Mohn Addenbrooke Hospital, Cambridge, England arranged by Dr. J. Mohn Addenbrooke Hospital, Cambridge, England arranged by Dr. J. Mohn FAMILY PRACTICE Anderson, Charles L. '73 Gayles, Kenneth '73 Herman, Jeffrey P. '73 Jones, Leeland A. '73 Kuretzky, Sharon '73 McMahon, Daniel J, '73 Schuster, Dennis I. '73 Dr. Frank G. Evans, 1453 Jefferson Avenue, Buffalo Dr. David Bull, Veterans and Deaconess Hospitals, Buffalo Clinical experience in inner city, Erie County Health Dept., Dr. P. Isaacson Dr. David Bull, Veterans and Deaconess Hospitals, Buffalo Dr. James Nunn, 350 Alberta Drive, Buffalo Dr. James Nunn, 350 Alberta Drive, Buffalo Dr. Charles Massaro, 509 Cleveland Drive, Buffalo SPECIAL $1,000 FELLOWSHIP Culmer, Viola L. '74 Hrushesky, William J. '73 Hust, Frederick S. '72 Traugott, Craig A. '74 Trumbull, Robin L. '74 Young, Lynda M. '73 Visco, John P. '73 Reader, G. Scott '73 SUMMER, 1971 Description of world of black child through fingerpainting Meyer Hospital, C. P. O'Kane Ethyl methyl suiphonate induction of renal adeno carcin­ Roswell Park Institute—Dr. G. Murphy oma in five groups of Sprague Dauley rats Evaluation of radiothaiamate determined extramoiecular Buffalo General Hospital—Dr. C. Elwood space in anuric and hemodialysis patients B iochemical characterization of minimal deo ration Biochemistry, SUNYAB—Dr. E. Massaro heparoma cultured in vivo and in vitro Mechanism of R factor induced tetracycline resistance Pharmacology, SUNYAB—Dr. A. Reynard in E. Coli E f f e c t s o f drugs on preimplantation in mouse embryo Children's Hospital—Dr. S. Yaffe grown i n vitro Quantitation of intrapuimonary shunts Meyer Hospital—Dr. F. Klocke Quantitative correlation of eiectrocardiogy and Veteran's Hospital—Dr. D. Dean cineangiography 17 �Dr. Thomas G. Commiskey, assistant dean, congratulates Lawrence D. Lubow (Mil­ lard Fillmore Hospital) as Henry Milgrom (Mount Sinai Hospital) waits his turn. Almost half (46] of the class of 111 senior medical students who will graduate from the School of Medicine this spring will remain in Buffalo to do their internships. Last year the figure was just a bit over one third of the class. Results of the National Intern Matching Program, which at­ tempts to match the preferences of the students with those of the hospitals throughout the country were announced March 29. Ten of the seniors have been "matched" for university pedi­ atrics internships at the Children's Hospital; 18 for medical intern­ ships at Buffalo General/Meyer Hospitals; nine for rotating gen­ eral internships at Deaconess Hospital; one each for straight surgery at Buffalo General and Meyer Hospitals; and six for the Millard Fillmore Hospital—two in rotating medicine and six for National Infprn ± ^ctLiwiicti u n c i ii , 1 • ^ Matcnmg Straight surgery. Twenty-one other members of the class will do internships in New York State—20 in the New York City area and one in Albany. Seventy-five seniors received their first choice of intern­ ships while 11 received second choice and 10 their third choice. Of the eighteen states in which graduating seniors will intern, California received the second largest share — 7. With north, south, east and west represented, five will intern in Ohio and a like number in Washington, D.C., while one will intern in Ha­ waii. Two will serve in the U.S. Air Force at Travis, California while three others will join the Public Health Service (two at Staten Island and one in California], Two of the internship programs at the University were com­ pletely filled. They are medicine at the Buffalo General/Meyer Hospitals and pediatrics at the Children's Hospital. Of the thirty requested in the Medicine Internship at the Buffalo General/Meyer Hospitals, 18 were matched from the UB Medical School and the remaining 12 from other medical schools. Children's Hos­ pital, which asked for 13, received 10 UB graduating seniors and three from other medical schools. One, in the entire medical class that was "matched," will intern in the prestigious Massachusetts General Hospital while two others will go to Johns Hopkins University. 18 THE BUFFALO PHYSICIAN �MLCHA ABELES, Buffalo General/Meyer Hospitals, Buffalo, Rotating Medicine/Surgery RICHARD M. ANSCHER, Meadowbrook Hospital, Meadowbrook, N.Y. Rotating Med J Psychiatry JOHN M. ANTKOWIAIC, Children's Hospital Buffalo, Rotating Medicine/ Ob/ Gyn MICHAEL A. ARCURI, Buffalo General/Meyer Hospitals, Buffalo Rotating Medicine/Surgery MICHAEL H. ARMANI, Deaconess Hospital, Buffalo, Rotating Medicine/Surgery MICHAEL B. BARON George Washington Center, Washington, D.C. Straight Medicine PAUL D. BARRY, Queens Hospital, Honolulu, Hawaii, Rotating Medicine/Surgery MICHAEL G, BAXT, University of Colorado Affiliated Hospitals, Denver, Straight Medicine BARBARA A. BENNETT, Children'S Hospital, Buffalo, Straight Pediatrics GERALD M. BERESNY, St. Barnabas, Livingston, New Jersey, Rotating Medicine ALLEN I. BERLINER, Meadowbrook Hospital, Meadowbrook, N.Y. Straight Medicine DAVID A. BLOOM, University of California Hospital, Los Angeles, Straight Medicine JERRALD A. BOVINO, Mount Sinai Hospital, New York City, Straight Medicine BARRY G. BROTMAN, Washington Hospital Center, D.C., Rotating Medicine ALAN H. BULLOCK, Medical College of Virginia, Richmond, Virginia, Rotating Medicine KENNETH A. BURLING, Children's Hospital, Buffalo, Straight Pediatrics NICHOLAS J. CAPUANA, Deaconess Hospital, Buffalo, Rotating Medicine/Surgery MANNY E. CHRISTAKOS, Edward J. Meyer Memorial Hospital, Buffalo, Straight Surgery KENNETH J. CLARK, JR., Buffalo General/Meyer Hospitals. Buffalo, Straight Medicine TERENCE M. CLARK, Mary Imogene Bassett Hospital, New York City, Rotating Medicine CARL I. COHEN, Medical College of Pennsylvania, Philadelphia, Rotating Medicine/Psychiatry ARTHUR C. CRONEN, Public Health Service, Staten Island, N. Y., Rotating Medicine/Surgery ERIC M. DAIL, U.S. Air Force, Fairfield, California, Straight pediatrics JOHN C. DAIMLER, Buffalo General/Meyer Hospitals, Buffalo, Straight Medicine BARBARA I. DATTWYLER, Children's Hospital, Buffalo. Straight Pediatrics SANFORD S. DAVIDSON, Public Health Service, San Francisco, California, Straight Surgery LAWRENCE J. DEANGELIS, Buffalo General/Meyer Hospitals, Buffalo, Straight Medicine RICHARD J. DIGENNARO, Deaconess Hospital, Buffalo, Rotating Medicine/Surgery THOMAS G. DISESSA, University of California Hospital, Los Angeles, Straight Pediatrics NORMAN S. ELLERSTEIN, Children's Hospital, Buffalo, Straight Pediatrics JEFFREY D. FLEIGEL, The New York Hospital, New York City, Straight Surgery HENRY GEWIRTZ, University Hospital, Boston, Massachusetts, Straight Medicine CHARLES GOLDSTEIN, Good Samaritan Hospital, Phoenix, Rotating SIGMUND S. GOULD, Deaconess Hospital, Buffalo, Rotating Medicine/Surgery COLLEEN GRATTO, Johns Hopkins Hospital, Baltimore, Psychiatry HARVEY GREENBERG, New York Medical College-Metropolitan, N.Y. City, Rotating Med/Surg. JOHN C. GUEDALIA, UCLA Affiliated Hospitals, Los Angeles, Rotating Medicine BARRY W. HAIGHT, Cincinnati General Hospital,Ohio, Rotating Med/Surg/Ob/Gyn JOHN M. HALL, Cincinnati General Hospital, Ohio, Psychiatry MARK S. HANDLER, Albert Einstein Medical Center, Philadelphia, Rotating JAY A. HAROLDS, Georgetown University, Washington, D.C., Straight Medicine DAVID E. HOFFMAN, Buffalo General/Meyer Hospitals, Buffalo, Rotating Medicine JOHN R. HUNTER, University of Kentucky Medical Center, Lexington, Rotating The senior class is "uptight" awaiting intern matching announcements. �Louis G. IANNONE, Good Samaritan Hospital, Phoenix, Rotating ANNIE B. JACKSON, Vanderbilt University Affiliated Hospitals, Nashville, Straight Pediatrics CHARLES G. JACKSON, Vanderbilt University Affiliated Hospitals, Nashville, Straight Pediatrics ROBERT B. KAUFMAN, University of Pennsylvania Hospital, Philadelphia, Straight Medicine SCOTT D. KIRSCH, Evanston Hospital, Illinois, Straight Surgery DOUGLAS W. KLOTCH, North Shore Memorial Hospital, Manhasset, N.Y., Straight Surgery LEONARD W. KRAM, University of Miami Affiliated Hospital, Fla., Rotating Medicine/Psychiatry , JONATHAN W. LEHRMAN, Cambridge City Hospital, Cambridge, Mass., Rotating Medicine JONATHAN S. LEVY, San Francisco General Hospital, California, Rotating Medicine/Psychiatry STANLEY B. LEWIN, Buffalo General/Meyer Hospitals, Buffalo, Straight Medicine JEFFREY B. LICHTMAN, Deaconess Hospital, Buffalo, Rotating Medicine/Surgery JERALD J. LITTLEFIELD, Deaconess Hospital, Buffalo, Rotating Medicine/Surgery LAWRENCE B. LUBOW, Millard Fillmore Hospital, Buffalo, Rotating Medicine Michael G. Ball (Colorado Uni­ versity Hospital, Denver) con­ gratulates Francis J. Ttvarog (left) on his "match" to Massachusetts General Hospital. RICHARD A. MANCH, Buffalo General/Meyer Hospitals, Buffalo, Rotating Medicine MARTIN N. MANGO, Buffalo General/Meyer Hospitals, Buffalo, Rotating Medicine DONALD H. MARCUS, Meadowbrook Hospital, Meadowbrook, New York, Straight Medicine STEPHEN R. MARDER, Denver General Hospital, Colorado, Rotating Medicine/Psychiatry ROBERT S. MARKMAN, Meadowbrook Hospital, Meadowbrook, New York, Straight Medicine THOMAS K. MAYEDA, Buffalo General/Meyer Hospitals, Buffalo, Rotating Medicine DENIS G. MAZEIKA, Cleveland Clinic Hospital, Ohio, Rotating Medicine JAMES J. MCCOY, Millard Fillmore Hospital, Buffalo, Straight Surgery HENRY MILGROM, Mount Sinai Hospital, New York City, Straight Pediatrics MERRILL L. MILLER, Children's Hospital, Buffalo, Straight Pediatrics MARVIN S. MORDKOFF, New York Medical College-Metropolitan, Straight Medicine ASKOLD D. MOSIJCZUK, Children's Hospital, Buffalo, Straight Pediatrics RICHARD L. MUNK, Millard Fillmore Hospital, Buffalo, Straight Surgery DENNIS A. NADLER, Children's Hospital, Buffalo, Straight Pediatrics PAUL M. NESS, Buffalo General/Meyer Hospitals, Buffalo, Straight Medicine LAWRENCE H. OLIVER, Long Island Jewish, Med. Ctr., New Hyde Park, Rotating Medicine LAWRENCE D. OSTROW, St. Elizabeths Hospital, Washington, D.C., Psychiatry ROY M. OSWAKS, Millard Fillmore Hospital, Buffalo, Straight Surgery ROBERT W. PALMER, Millard Fillmore Hospital, Buffalo, Rotating Medicine JOEL H. PAULL, Buffalo General Hospital, Buffalo, Straight Surgery KENNETH M. PIAZZA, Buffalo General/Meyer Hospitals, Buffalo, Rotating Medicine VALENTINE P. PIEROTTI, Deaconess Hospital, Buffalo, Rotating Medicine/Surgery DAVID W. POTTS, Cincinnati General Hospital, Ohio, Straight Medicine ELIAS PUROW, Meadowbrook Hospital, Meadowbrook, New York, Straight Medicine D. S. RICHARDSON, Georgetown University, Washington, D. C., Straight Medicine DENNIS J. ROSEN, Boston University, Massachusetts, Straight Pediatrics WARREN M. ROSS, Buffalo General/Meyer Hospitals, Buffalo, Rotating Medicine/Surgery DAVID M. ROWLAND, Deaconess Hospital, Buffalo, Rotating Medicine/Surgery RICHARD S. ROWLEY, Deaconess Hospital, Buffalo, Rotating Medicine/Surgery WILLIAM F. RYCKMAN, U.S. Air Force, Fairfield, California, Straight Pediatrics The Dennis Nadlers (Children's Hospital. Buffalo) The Kenneth Solomons (Albany Hospital) NEIL J. SAPIN, Meadowbrook Hospital, Meadowbrook, New York, Straight Medicine SAM SEIDMAN, Public Health Service, Staten Island, New York, Rotating Medicine/Surgery NEIL M. SENZER, Johns Hopkins Hospital, Baltimore, Straight Pediatrics ANDREW Y. SILVERMAN, University of Michigan Affiliated Hosp., Ann Arbor, Straight Ob/Gyn. KENNETH SOLOMON, Albany Hospital, Albany, New York, Rotating Medicine/Psychiatry RICHARD I. STAIMAN, Yale-New Haven Medical Center, New Haven, Conn. Straight Pathology MARVIN L. STEIN, Mount Sinai Hospital, New York City, Straight Surgery WILLIAM STERNFELD, University Hospitals, Cleveland, Ohio, Straight Surgery ALLEN STONE, Meadowbrook Hospital, Meadowbrook, New York, Straight Pediatrics DONALD F. STORM, Children's Hospital, Buffalo, Straight Pediatrics CHARLES A. STUART, Buffalo General/Meyer Hospitals, Buffalo, Straight medicine THOMAS S. SVENSSON, Children's Hospital, Buffalo, Straight Pediatrics HAROLD TRIEF, Buffalo General/Meyer Hospitals, Straight Medicine FRANCIS J. TWAROG, Massachusetts General Hospital, Boston, Straight Pediatrics WILLARD VAN NOSTRAND, III, Santa Barbara Cottage Hospital. California. Rotating General DALE A. VANSLOOTEN. Monmouth Medical Center, Long Branch, New Jersey, Straight Surge: STEPHEN N. VOGEL, Millard Fillmore Hospital, Buffalo, Straight Surgery THOMAS C. WAITZ, Maricopa County General Hospital, Phoenix, Straight Surgery ILJA J. WEINRIEB, Buffalo General/Meyer Hospitals, Buffalo, Straight Medicine ROBERT C. WEISS, Buffalo General/Meyer Hospitals, Buffalo, Straight Medicine JOHN M. WENDELL, JR., Riverside Hospital, Newport News, Virginia, Rotating TERRY WILLIAMS, Mount Sinai Hospital, New York City, Straight Surgery CHARLES F. YEAGLE, III, Edward J. Meyer Memorial Hospital, Buffalo, Straight Surgery BENNETT G. ZIER, Buffalo General/Meyer Hospitals, Buffalo, Rotating Medicine/Surgery JOHN J. ZYGMUNT, C. S. Wilson Mem. Hospital,Johnson City, N.Y., Rotat. Med/Surg/Ob/Gy* THE BUFFALO PHYSICIAN r �T, .HERE WAS STANDING ROOM only for the medical community and laity overflowing three auditoriums and Capen Hall corridors. They came to listen to the leading expert in the study of human sexuality who immediately established rapport by his opening remark "there appears to be a certain interest in the subject." Dr. William Masters reminded the audience that it took two years back in the 50's to obtain permission to do research on sex at Washington University in St. Louis. From the dean to the chancellor to the trustees was the route before he was assured in 1954 that "the university supports the concept of sex research on campus." "What are you going to do now that you have permission?" asked the chancellor of Dr. Masters. With not the vaguest idea he haunted the library. But there was only one book, Dickinson's Atlas on Human Sexuality that had been sketched for obstetrics. And it was on the reserve shelf, restricted for use of full pro­ fessors and above. The associate professor had to appeal to a chairman before the book could be removed from the reserve shelf. He soon turned to the professionals in the field. For the next two years he literally lived with the prostitute population — there was so much to learn. Realizing that "a man is never going to know anything about female functioning" he needed an inter­ preter. Jinny Johnson, the female member of the team, now his wife, joined him. There was no question but that the dual sex team led to its objectivity and survival. But what are the facts and fallacies on sexual functioning and dysfunctioning, the topic of Dr. Masters' talk? Communica­ tion or lack of it, misinformation, taboos, etc., are at the root of sexual hangups, he quickly explained. "What people need more than anything else is some basic information. For the couple who want a child, there are questions about when and how frequently they should have intercourse." And an exclama­ tion that it takes 30 to 40 hours to replace the sperm count after every ejaculation. They are then sent home to try for three months. One out of eight will conceive during that time. He found misinformation and misconception on every edu­ cated level in our society. To the question "does any form of masturbation lead to psychoses" that up to a few years ago was always asked of him by a member of the medical community, he responded — No! "If we can talk about sex as a natural subject then masturbation is natural. It is universal and practiced by both males and females." The amount of masturbation? Kinsey's sta­ tistics, the only information available, are a quarter of a cen­ tury old. It was difficult to find any among the hundreds interviewed by Dr. Masters who could state how much masturbation was too much. What he did find to be the case was that much misinforma­ tion was accredited to the subject. Discussion of human func­ tion has just not been allowed. It was not until 1960 that the first course in human sexual functioning was taught in our medical schools. Few physicians practicing today have had any formal education in this field, he said, and they are basing their teaching on their own personal experiences. SUMMER, 1971 21 Human Sexual Response Dr. William H. Masters pre­ sented the annual Harrington Lecture March 19 to an overflow crowd in Butler Auditorium and two adjoining lecture rooms (139 and G-22) on closed circuit tele­ vision. The student - sponsored lecture also was beamed to 17 hospitals on the Telephone Lec­ ture Network of the Regional Medical Program. Dr. Masters is professor of clinical obstetrics and gynecology at Washington University, and director, Repro­ ductive Biology Research Founda­ tion, both in St. Louis. He is co-author with his wife (Mrs. Virginia Johnson Masters) of the best selling "Human Sexual Re­ sponse" in 1966 and "Human Sexual Inadequacy" published in 1970. The Harrington Lectures were created in 1896 by the will of the late Dr. Devillo W. Harring­ ton, professor of genital and urin­ ary diseases, at the Medical School.• �The student-sponsored Harrington Lecturer quickly established his theme that "sex is a perfectly natural function." People are not taught to breathe or eat. These things are natural. So is sex. There is no way to teach them. But if sex is a perfectly natural function, why then do we have so much trouble with it? Sex­ ual function is so unique in our culture that it can be pulled out of context and delayed indefinitely. "You will recall in the history of our civilization that many people dedicated sexual function to the gods, thus resulting in many of the taboos and miscon­ ceptions that we have today." But let us clear up the misconception about the female orgasm, he said. From a physiological point of view the female goes through the same changes in her body regardless of the area of stimulation, be it clitoral, vaginal, etc. "The same thing happens regardless of the cause of stimulation." From an anatomical point of view, he explained to the laity, there is no physical possibility of the female having intercourse without direct clitoral stimulation. And he explained the wonder- �ful degree of accommodation of the vagina that will expand to al­ low a baby's shoulders and head to pass through, and accept any size penis. What about the potential sexual response of males/females? The female, he assured the audience, has the greater potential response from a sexual point of view than the male ever dreamed of having. Naturally multiorgasmic, if she is so in her younger years she will continue to be so into her eighties. In our culture, he said, the male is supposed to be the sex expert. While anatomically the clitorus has the same tissue as the penis, manipulation of the clitorus may be irritating rather than stimulating to the female. But rarely does she have the courage to say, "look, let me show you how." There is so little communication between the male and female —and he specifically pointed to the marital state — in the area of sexual responsibility. It is very difficult if the female does not tell the male what pleases her. For the female who does not respond and let the male know is inevitably the one who asks "what is wrong with him?" SUMMER, 1971 23 The Harrington Lecture Student Committee: Richard Berk son, David Breen, David Buscher, Robert Penn, Andre Raszynski, James Singer, and Thomas Wasser.• �"How simple a thing if we could take sex and make it a natural thing again." But he explained that it takes a lot more courage than most of us have. "If things get going and going well, it is in spite of ourselves." What about the male? Most males are concerned about the size of their penis. Dr. Masters receives at least two letters a week from Vietnam expressing this concern. What most people do not realize, he said, is that when measured the penis is usually in a flaccid state. The size changes tremendously during an erection and we are just not well informed about the ability of the vagina to accept any size penis. "This simple misinforma­ tion has made men miserable for the rest of their lives," he pointed out. As the male ages certain things happen. While sex is just as natural in his fifties he may find it a bit slower to achieve an erection. But so are his other reflexes a bit slower. He may also notice a reduction in volume and pressure. But he emphasized that no matter how old, if the male is in reasonably good health and has an interesting partner he will not lose his ability to ach­ ieve an erection. What about the aging female? What happens to her? If she is not having regular intercourse following menopause, her vaginal barrel shrinks in size, and the lining of the vagina becomes thin and atrophic. She may not lubricate well but this can be re­ stored with hormones, regularity of intercourse, and clitorus exposure. While her sexual interest is maintained, it may be more diffi­ cult for the aging female to find partners, so a return to mas­ turbation increases. The fantasy and dream world do not stop and she will continue to have these dreams in the eighty year group. He reasserted - SEXUAL FUNCTION IS PERFECTLY POSSIBLE AT ANY AGE. There is no uninvolved partner where there is sexual dys­ function. That is why the Masters team treats the problem through the relationship and not by separating partners. In the past, medicine has treated the impotent man and the nonorgasmic woman as separate entities and the therapy has been less than effective. How about the homosexual? He does not consider homo­ sexuality anything but a perfectly natural activity. The homo­ sexual is a man and the lesbian is a woman. Most have had a mutuality of sexual experience — heterosexual and homosexual. Historically, it is a perfectly natural function. If a male has trouble with his potency, he changes his role. During 1965, over 60,000 men were booked into the New York City Police Bureau for homosexual activity. ANY FORM OF PHYSICAL EXPRES­ SION CONDUCTED BETWEEN CONSENTING ADULTS IN PRIVATE IS ACCEPTABLE. This was stated and restated by Dr. Masters throughout his lecture. What he is dedicated to is an adequate postgraduate medical training program. And over the next decade, he hopes to bring premature ejaculation, the easiest of male dysfunctions to treat effectively, under control. Currently being trained are teams of three members each (a physician and two other professionals] to carry on this teaching role at Yale, Columbia, Duke and Wis­ consin.• THE BUFFALO PHYSICIAN �Junior medical student Joseph A. Matino III takes notes from an audio-visual cassette projector. Computers, Cassettes Supplement leaching at Children's Hospital c CHILDREN'S HOSPITAL is using audio-visual cassettes, computers and cameras to instruct medical students in caring for patients. Dr. Ronald G. Davidson, professor of pediatrics, doesn't expect the machines to take over. They are just "extra hands" for the physician. The machines free the physician from routine tasks that are often repetitive and boring and enable him to devote more time to what he is best equipped to do — instructing and supervising students at the bedside. The machines are available at all hours of the day and night so individual students can learn at his own rate. Each audio­ visual cassette, for example, consists of a 20-minute taped lecture with slide illustrations. If a student wants to learn more about a given subject, he can select the cassette lecture and listen as the tape unwinds and the slides appear on a screen. If he doesn't understand the first time, he can listen again, and again. And if he still has questions he can call the lecturer who taped the program. The computer can actually assist in the diagnosis of specific problems in child patients. The machine's memory has been pro­ grammed with details of several hundred "syndromes" — specific combinations of defects and symptoms. No human mind could have so much information at its command. After a student, or a member of the house staff, has examined a patient, he "feeds" the pertinent historical, physical and laboratory findings into the computer according to their numbers in a program book. The computer takes all the findings and gives back a list of the most likely syndromes. For each syndrome it lists the percentage of the findings that are compatible with that diagnosis, the findings that are usually present for that syndrome, and those that are missing. And it cites a reference to which the student can go for further information. With this help, the student can return to the patient, or the laboratory, to get whatever information he needs to firm up his diagnosis. Dr. Davidson predicts that audio-visual devices and the com­ puter are destined to play an increasingly important role in teaching medicine at all levels and in the evaluation of teaching programs.• SUMMER, 1971 25 Two junior medical students, Robert H. Levitt and Lawrence Zerolnick, are using the computer to assist in the diagnosis of a specific problem. �Computer Mapping for Better Health Dr. Sultz, Mr. Donald Brothers, cartographer (COMPUTER MAPPING, a new dimension in studying populations, will lead to sounder health care planning decisions for the eight counties of Western New York. It is a three-dimensional approach to epidemiological studies by the department of social and pre­ ventive medicine that combines computer technology, geography, and graphics. How does it work? Maps of the eight counties have been enlarged. An 18-member team under Dr. Harry Sultz, asso­ ciate professor of social and preventive medicine, have identified every street intersection, railroad crossing, etc. This information — or nodes as they are termed—have been processed into the computer as have the 1970 census tapes covering the eight counties of Western New York. To this information will hope­ fully be added the geographic portion of the enormous amount of health services data elaborately collected and stored in file cab­ inets of health care agencies throughout the city. Computer mapping is really building a file of information on block levels, explained Dr. Sultz. "It will enable us to produce health care delivery maps of the entire eight county region that will show the number of patients living on each block, their medical conditions, and sources of health care." At any given time the team will be able to determine the number of elderly persons, for example, who live on "A" street and have been treated for chronic diseases. Or the number of children who live on "B" block. They will have the ability to pinpoint the largest incidence of infectious diseases as well as have at their fingertips a host of additional information that this plotting technique will reveal. The team is currently mapping the ambulatory service areas of the seven major hospitals that serve the inner city to determine the population that is being treated. This "marketing research data" will enable each hospital to make a more valid decision regarding expansion, modes of treatment, etc. Said Dr. Sultz, "what makes this service unique is its ability to graphically illustrate three variables at the same time. For example if we are talking about emergency rooms, not only can we find out the use of each hospital's facilities, but the number and kinds of patients (emergencies, etc.) that use these facilities at both peak and slow hours during the day." Summing it up, Dr. Sultz said that just as good medical therapy begins with an accurate diagnosis, "sound planning depends on a valid com­ munity diagnosis. " • 26 THE BUFFALO PHYSICIAN �1970-71 APFME Scholarship Winners John Antkowiak, '71 Cheektowaga, N.Y. Canisius College James Budny, '74 Buffalo, N.Y. Canisius College Yung-Cheung Chan, '73 Kowloon, Hong Kong Hobart College Thomas Lawley, '72 Buffalo, N.Y. Canisius College Diane Matuszak, '74 Buffalo, N.Y. Canisius College Sarah Moore, '73 Auburn, N.Y. Douglass College William Murray, '72 Eggertsville, N.Y. SUNYAB Ten Students Receive $8,600 from Annual Participating Fund for Medical Education Guido Napolitano, '74 Mt. Vernon, N.Y. Fordham University SUMMER, 1971 Timothy Nostrant, '73 West Seneca, N.Y. University of Rochester 27 Donald Storm, '71 Cheektowaga, N.Y. SUNYAB �Mr. Miller shows a powered hand-splint to Dr. Walsh, Congressman Jack Kemp, and Mr. Steffan. Laboratory Advisory Board An 18-man advisory board of civic, educational, business and medical leaders was named in January to guide the Rehabilita­ tion Medicine Engineering Laboratory at the School of Medicine. The announcement was made by Mr. J. Sam Miller and Dr. Wil­ liam P. Walsh, director and medical director, respectively, of the new laboratory. The purpose of the new laboratory, according to Mr. Miller, is to apply modern research technology in the development and production of new instruments for rehabilitation medicine. The engineering activities are conducted at the Bell Plant, a campus annex located at 2050 Elmwood Avenue. The clinical evaluations are performed at the Rehabilitation Medicine Department of the E.J. Meyer Memorial Hospital. As the laboratory develops it will provide employment for the handicapped and disadvantaged in the area's sheltered workshops. It will also be a practical setting for training students in the various rehabilitation fields. Since June 1, the laboratory has been operating with local grant funds from the University of Buffalo Foundation, Inc., and Federal Grant funds through the rehabilitation medicine division of the Medical School. The chairman of the new advisory board, elected at a recent meeting, is Mr. Walter J. Steffan, a leader in area charitable and higher education groups. All members serve on a volunteer basis. They are: James G. Dyett, Chairman of the Hard Company; Har­ old Farber, Chairman and President of the International Life In­ surance Company; Robert B. Fleming, State University at Buffalo Advocate; Charles F. Light, Executive Vice President, Buffalo Area Chamber of Commerce; William Moog, President, Moog, Inc.; Joseph R. O'Connor, M.D., Acting Director, Department of Rehabilitation Medicine, E.J. Meyer Memorial Hospital; Albert C. Rekate,M.D., Director, E.J. Meyer MemorialHospital; Ira G. Ross, Erie County Economic Coordinator; Cora G. Saltarelli, Ph.D., Director, Bioengineering Department, Roswell Park Memorial Institute; Edgar J. Schiller, Executive Director, Niagara Frontier Vocational Rehabilitation Center, Inc.; Paul A. Schoellkopf, Jr., Chairman of the Board, Niagara Share Corporation; Mayor Frank A. Sedita; Mrs. Walter J. Steffan, a leader in area charitable and civic groups; Charles E. Stewart, Executive Director, The Buffalo Foundation; James Sweet, Executive Director, Buffalo Goodwill Industries, Inc.; Nicholas D. Trbovich, Chairman and President, Servotronics, Inc.; County Executive B. John Tutuska.D 28 THE BUFFALO PHYSICIAN �Chemical Solution to End Pregnancies One of the leading researchers in chemical methods of popu­ lation control is Dr. Om P. Bahl, associate professor of bio­ chemistry at the University. His research, if successful, will enable a woman to end an unwanted pregnancy by drinking a solution containing a nontoxic chemical. Dr. Bahl is a native of India. After receiving his doctorate at the University of Minnesota and doing post-graduate work at the University of California at Los Angeles, he began doing research on the hormone Human Chorionic Gonadotropin or "HCG." Dr. Bahl came to the University in December 1, 1965. HCG is found in the urine of pregnant women, and also persons having a type of stomach cancer that can resemble pregnancy. After three years as a Dernham Fellow of the American Cancer Society, Dr. Bahl shifted his emphasis to HCG's actions during pregnancy. "I was interested in human beings, and it came down to deciding whether to work among them on social problems directly affecting them, or working on problems such as disease or population control which affect a great many of them," Dr. Bahl said. His first $50,000 three-year grant from the United States Public Health Service was given "rather reluctantly, I think, because the project was so complex. But we made unusually rapid progress, so the next grant was given more readily." The first grant covered only equipment, materials and salary of one post-doctoral fellow, so Dr. Bahl did most of the technician's duties himself. The second grant is much larger and provides for the salaries of one technician and two post-doctoral fellows, Dr. N. Swaminathon and Dr. K. L. Matta. Dr. Bahl spends about 12 hours a day at the University, and when he isn't teaching his graduate course in the Medical School, he is in his lab. "College teaching may be thought of as glamorous, but in the sciences it definitely is not. A scientist doesn't want to see his life wasted. He wants to leave behind something that will benefit mankind. Even if we never do isolate the agent that will chemically terminate pregnancy, our contribution to the under­ standing of reproduction still will be of value," Dr. Bahl said. The scientist-researcher-teacher will speak at several symposia during the year including an international meeting in Belgium in September.• SUMMER, 1971 29 Alumni Association Cocktail Party for Alumni, Faculty, Friends during the AMERICAN MEDICAL ASSOCIATION CONVENTION Monday, June 21, 1971 5:30 to 7 p.m. at the Chalfonte-Haddon Hall Atlantic City Host: Mr. David Michael, Director of Medical Alumni Affairs �Research Team Creates Synthesis of Living Cell A RESEARCH TEAM at the University has RESEARCH TEAM -Dr. James F. Danielli, left, poses with members of the research team who successfully syn­ thesized living cells from components. With Danielli, left to right, are Dr. Charles R. Ault. Dr. I. Joan Lorch, Mrs. Eleanor Sattler and Mrs. Lor­ raine Powers. Not shown are Dr. Kwang J eon. and technicians Mrs. Kathy Col­ lins and Mrs. Eu nice Mashimo. successfully reassembled a living and reproducing one-celled organism from isolated com­ ponents, but described a stumbling block in assumbling such or­ ganisms from unrelated species. Dr. James F. Danielli, director of the Center for Theoretical Biology at the University, Dr. I. Joan Lorch, Dr. Kwang W. Jeon, and Dr. Charles R. Ault, de­ scribed at a news conference December 7 how the team used microsurgery to dismantle amoebae and then reconstitute the or­ ganisms. First the nucleus was removed by means of a microprobe. Sec­ ondly the cytoplasm was withdrawn with a tiny pipette or by centrifuge. Finally the cell membrane was refilled with cyto­ plasm and a nucleus inserted, the cytoplasm and nucleus being from one or more different cells. In experiments with more than 700 such syntheses, the scientists found that while 85 per cent of the amoebae lived normally when the same strain or the or­ ganism was involved, components from unrelated strains contained a "lethal factor" which allowed only about 35 per cent of such reassembled cells to divide and less than one per cent continue to reproduce indefinitely. The "lethal factors" discovered by Drs. Kwang Jeon and Joan Lorch "are present in many strains," explained Dr. Danielli, and have the peculiarity of being quite harmless to the cells in which they are synthesized or to closely related cells. But when they are injected into dissimilar cells, cell death results. "To get a higher proportion of successful reassemblies using distantlyrelated components, we must know how much 'lethal factor' is in a cytoplasm, and then find out how it can be 'outwitted' ", he continued. The scientists here found that the amount of "le­ thal factor" is roughly ten lethal doses in the average cytoplasm. In a paper presented at the news conference, Drs. Lorch and Jeon (who is presently at the University of Tennessee, Knoxville), said "the results of our studies so far show that the lethal factor from one strain inhibits the synthesis of ribonucleic acids in the other strains of amoebae, and this results in the failure of these cells to divide and eventual cell death." When the lethal factor is active, they indicated, its action is to prevent formation of RNA. "One remarkable finding," they continued, "is that the le­ thal factor of amoeba is active not only against other strains of amoebae but also against two strains of mouse cells cultured in the laboratory. Thus it appears that the lethal factor has a further significance. It seems essential," they said, "for us to remove the lethal factors or overcome their actions before we can bring together components of different amoebae into a living cell. Our preliminary results show that this can be done." 30 THE BUFFALO PHYSICIAN �Dr. Danielli said the team is encouraged by the results ob­ tained by other scientists using cell fusion techniques, when the cells from higher animals and plants have been brought together and fuse to give new cells having characteristics of both species. "It is our present belief that, within limits, cell components from widely different sources are compatible," he concluded, "and when marked incompatibility is observed, it is usually due to a special mechanism, which has evolved to prevent genes on one species (from) setting up home in a second species and thereby threatening the integrity and success of the second species." What do the successful experiments with cell reassembly mean? Dr. Danielli thinks that now "new cells canbe built containing a variety of components." For example, a defective component might be built into a new cell to find out why the damaged component is unsatisfactory. Or, scientists can now study the assembly of cells which would be theoretically capable of living on Mars, where the environment for life is considerably different from Earth's. Furthermore, the question of what is essential for life — a question which must be answered if we are to conduct a search for life on other planets — can now be studied outside the realm of theory, and explains the great interest the National Aeronautics and Space Administration (NASA) has had in the research. Dr. Danielli predicted that over the next five years man can expect to see the artificial assembly of cells "from the most varied sources, including plant-animal mixes; the artificial as­ sembly of egg cells; the synthesis of new organisms by cell fusion; and of course a continuation of the formation of new organisms by the classical techniques of breeding and genetics." He also expects to see "a considerable effort to synthesize new genes, and to incorporate these genes into chromosomes or other cellular organelles." The Welsh-born biologist did talk about some of the possi­ bilities cell synthesis has for the betterment of mankind. He said that improvement of nitrogen-fixing plants, and the transfer of nitrogen fixation to food plants "should have high priority." Other possibilities being considered at the Center for Theoretical Biology are: —The development of new crops for semi-arid areas. —The development of special organisms for environmental control, e.g. for desalination of water (converting ocean water to drinking water), and for more efficient treatment of sewage. —Partial replacement of present methods of chemical engi­ neering with biological synthesis using tailor-made organisms. Biological synthesis has the advantage of being seldom toxic which can be contrasted with present-day chemical plants. Also, biological synthesis is usually much more efficient than standard industrial chemistry. —The transfer of the capacity to synthesize human antibody and human hormones to microorganisms. Synthesizing hormones and antibodies in such a way would be inexpensive, and thus "immensely extend the resources of clinical medicine," ex­ plained Dr. Danielli. SUMMER, 1971 31 Dr. Danielli says: "The age of biological synthesis is upon us. "Within a century we will probably be able to synthesize artificially any biological system or entity. These could range from viruses and bacteria to entire social systems. Some of these achievements could come within a few years. "I have been working on the problem (synthesis of a living cell) for at least 25 years. Four years ago, I had come 80percent of the way. No one seems to realize how fast we are moving. We've seen the first synthesis of a gene, the first synthesis of a virus, and recently the first reassembly of a living cell. In biology, we are moving from an age of analysis into an age of synthesis. "Our efforts must now be turned to the synthesis of a chro­ mosome and creation of actual egg cells among other things. "We owe a particular debt to Dr. Ernest Pollard of the Biophysics Department at Penn­ sylvania State University (and chairman of the External Advi­ sory Committee of the Center for Theoretical Biology) whose en­ ergetic exploration of the field ov­ er the last eight years has been an inspiration."• �—The development of new life forms for other plants, which "may vastly extend the value of these planets," in Dr. Danielli's view. NASA has a keen interest in such work. "Thus one can say without hesitation that immense benefits will ensue from the artificial synthesis of new life forms," Dr. Danielli remarked. What about ethical implications? Dr. Danielli and Dr. Robert Rosen, assistant director of the Center for Theoretical Biology, view the synthesis of new organisms in the same context as "older methods of hybridization and selective breeding," in­ volving "no really new ethical principles." They said that "care must be taken to discover any undesirable or harmful new pro­ perties" in synthesized organisms, and the effect on existing ecological conditions must be assessed before introducing these organisms into the environment at large. These considerations are essentially of a technical nature." While both scientists agreed that "with appropriate care," there is no reason why new species should not be of scientific and material benefit to the world, they did see the possibility of the development of "bad things," and the possibility that pathogenic (bad) organisms "may arise by accident." They sug­ gested a special group be established by an organization such as the National Academy of Sciences or the National Science Foundation, which would "keep watch on this situation" and "be able to advise research workers in this field of the steps that should be taken to protect the community against risk." The project is funded through the National Aeronautics and Space Administration and the State University of New York.D \T TT . l>eW LlQoXV T) • • . Jxepairing i-Tp i . lccnnicjlic A new surgical technique has enabled 34 infants to undergo operations at Children's Hospital to correct congenital heart defects during the last year. That is what Dr. S. Subramanian, the hospital's chief of surgery, told the Heart Association of Western New York recently. He is also a clinical associate professor of surgery at the Medical School. The technique, pioneered in Japan, involves cooling the body with ice to 68 degrees to halt circulation for an hour to surgically correct transposition of the two great arteries of the heart, ac­ cording to Dr. Subramanian. Among the infants operated on was a two-month-old, the youngest to undergo the operation on this continent. The operation will be performed on even younger babies, he said. "The results will be better because as babies with this defect get older, they get sicker. Buffalo and Seattle are the two places in America where this procedure is being used in numbers," he said. Heart fund contributions for research are greatly needed to counterbalance a reduction in federal funds, Dr. Subramanian said. "This past year it was a tragedy that we didn't have the funds to finance all the worthwhile programs. Perhaps in the next 10 years we will have the answer to rejection in heart transplants. "• 32 THE BUFFALO PHYSICIAN �Physicians May Benefit from 3-D Process Techniques for determining the three-dimensional structure of an object from a number of different two-dimensional views have been developed at the Center for Theoretical Biology at the Uni­ versity. This will enable a physician or surgeon to obtain threedimensional or stereoscopic view of the interior of a patient — views which could prove much more helpful than the usual flat views in diagnosing illness. This new method is called ART, for "Algebraic Reconstruc­ tion Techniques." ART is a method by which the three-dimen­ sional structure of an object is determined by applying a system of equations to a small number of flat views (approximately 10] of the object. The various views are photographed from several known angles by tilting the specimen carrier in the microscope. The scientists — Dr. Richard Gordon, Dr. Gabor T. Herman and Robert Bender — said they are now able to "obtain threedimensional views of any object which may be resolved by whatever imaging system is appropriate, in the case of biological ultrastructure, the electron microscope." Dr. James F. Danielli, director of the center said, "the struc­ ture of many minute parts of cells whose structure cannot be readily determined by previous techniques of electromicroscopy, can now be discerned with some accuracy, so that accurate three-dimensional models of these components can be obtained." The techniques may also give scientists a better picture of what viruses look like and the points at which antibodies manu­ factured to fight them hook onto them. This will facilitate classi­ fication and identification of viruses, Dr. Danielli predicted, and open up a new area of study which may be called "immunomorphology." The Center is the only institution of its kind in the world. It got its start in 1962 when Dr. Daniel H. Murray — then head of the School of Pharmacy, now acting vice president for academic affairs — persuaded Dr. Danielli to leave England and come to the University. He came to Buffalo from King's College, London where he was professor of zoology and chairman of the department. The basic aim of the Center in Dr. Danielli's words, "is to reach a thorough understanding of the nature of living systems. As this understanding develops it becomes possible to relate hitherto isolated facts, to make predictions, and to de­ velop applications in specific fields of social interest." A 20-member team headed by Dr. Danielli may team up with NASA to seed new life forms transforming lifeless and hostile planets into places useful to man. NASA announced in November that it is considering "planetary or cellular" engineering, the tailor-made creation of new life forms to be placed on Mars and other planets provided it can be established that more good than harm would result. Before Mars would be seeded with arti­ ficial life, it must first be explored to rule out the possibility that life already exists.• SUMMER, 1971 33 NEW ART — Robert Bender, Dr. Richard Gordon and Dr. Gabor Her­ man (left to right) pose near some of the equipment used in their art — " 'Algebraic Reconstruction Techniques of determining the three-dimensional structure of objects. An Optronics In­ ternational high-speed scanning microdensitometer is in foreground. In the background is a contoured computer printout of some electron photomicro­ graphs of ribosomes, a printout of data produced from the densitrometer. �|- \ | ^ / • \. i ^ limn] / | LIU New York Lllv p . " Keception , r ^ ' t a i l Ol Mu^cu lar Dv^trOjlllV A total of 45 alumni, faculty, wives and guests attended the Medical Society of the State of New York cocktail party on February 15, in New York City. Mr. David K. Michael, Director of Medical Alumni Affairs, hosted the cocktail party. Attending the party at the Americana Hotel that evening were: Doctors Jack Milowsky, M'39, Buffalo; Louis Cloutier, M'54, Buffalo; William Staubitz, M'42, Buffalo; Walter Walls, M'31, Buffalo; Theodore and Mrs. Jewett, M'45, Buffalo; Thomas Cot­ ton, M'39, Buffalo; Paul A. and Mrs. Burgeson, M'36, Warsaw, New York; Donald and Mrs. Hall, M'41, Buffalo; George and Mrs. Collins, M'48, Buffalo; Garra Lester, M'29, Chautauqua; Benjamin and Mrs. Gilson, M'38, Brooklyn; Edward Rozek, M'41, Buffalo; Irwin Felsen, M'39, Allegany; Charles and Mrs. Bauda, M'42, Buffalo; John N. Constantine, M'34, Oneonta, New York; Ken­ neth H. Eckhert, M'35, Buffalo; Max and Mrs. Cheplove, M'26, Buffalo; James and Mrs. Nunn, M'55, Buffalo; William Stein, M'50, Lockport, New York; Jane Wiles, M'45, Buffalo; Charles Wiles, M'45, Buffalo; Arthur and Mrs. DeAngelis, M'69, Buffalo; Rose Lenahan, M'37, Buffalo; Daniel Fisher, M'24, Clarence Center, New York; Alfred George, M'34, Batavia, New York; Anthony J. and Mrs. Federico (faculty], Buffalo; Andrew and Mrs. Gage, M'44, Buffalo; Mitchell and Mrs. Oestreich (faculty), Buffalo; John A. Winter (faculty), Buffalo; James and Mrs. Phil­ lips, M'47, Buffalo; and Mr. Joseph Manno, (student '70), Buf­ falo.• The nickels, dimes and dollars which thousands of Western New York children and adults have contributed to the Niagara Frontier Chapter of the Muscular Dystrophy Association of America through Kiddy Carnivals, telethons, and house-to-house marches has been channeled into needed research into the muscle disease which afflicts children. A grant of $12,000 was presented by chapter President Edward R. Leiser to Dr. Morris Reichlin, associate professor of medicine and research, associate professor of biochemistry at the medical school. Dr. Reichlin will use the funds for equipment and per­ sonnel to evaluate the quality of myoglobin in diseased and nor­ mal muscles and also to study the rate of muscle destruction. Myoglobin, a protein, binds oxygen to muscle tissue in much the same manner that hemoglobin carries oxygen in the blood. In 1970 and 1971, the Niagara Frontier Chapter of the Mus­ cular Dystrophy Association of America gave $20,000 to Dr. E. A. Barnard, professor and chairman of biochemistry. Dr. Barnard used these funds to study the presence of enzymes known as the cholinesterases in the dystrophic muscles of chickens. Buffalo thus has become one of seven cities of the world where medical research is making progress against the dread child killer, muscular dystrophy. Other research centers are in New York, London, Tokyo, Padua, Italy, Paris and Los Angeles.• 34 THE BUFFALO PHYSICIAN �J. HE REGIONAL MEDICAL PROGRAM may soon move into new fields. That was the prediction of Dr. Harold Margulies, director of the Regional Medical Programs in the department of Health, Ed­ ucation & Welfare. He envisions the Regional Medical Programs of the future as being more concerned with the over-all quality of health care in their respective areas. He does not see them ren­ dering such care but working with consumers and providers of care to assure the best possible allocation of limited numbers of professionals and tight dollars. "Regional Medical Programs are a new kind of social insti­ tution. They provide technical and financial support to private agencies and are in a unique position to serve as a bargainer in improving health care delivery," Dr. Margulies said. "Heart, Cancer and Stroke are major killers, but the individual whose life is threatened by some other disease is just as entitled to con­ cern." When Dr. Margulies visited the Western New York oper­ ation last fall he said, "Regional Medical Programs are a sort of political-social instrument in which there is a working rela­ tionship between the Federal structure and a private system that permits the latter to work comfortably in producing progressive changes in the health care system of which it is a part, and to do it entirely on an autonomous self-directed basis with Federal funds and Federal cooperation. The concept of Regional Medical Programs is being looked at as a possible pattern for accom­ plishing decentralization at both the Federal and state levels. My thesis has been that the concept of a community trusteeship is the most viable element in our society, and Government must be willing to deal on a local basis with issues that can be iden­ tified and corrected locally. My responsibility is to make it possible for that to happen. I believe we should move away from Federally directed activities and towards really autonomous re­ sponsibilities on the part of the Regional Medical Programs."• wLJm i Dr. Margulies RMP Plots New Course C.C. Furnas Scholarship Mr. James Webber, a medical student, is one of six seniors to receive the C.C. Furnas Scholarship for the 1971-72 academic year. Webber, the first Furnas Scholar in 1968, received a $3,000 stipend for medical studies at the University. He holds a masters in physiology from the University. As an undergrad­ uate Webber was a member of the intercollegiate football and track teams for two years. In his senior year he received three awards for his athletic and academic accomplishments. The Furnas Scholarships were established by the late chancel­ lor and president in 1965. Dr. Furnas' original gift for the fund was augmented by $100,000 subscribed by alumni and friends in a special campaign at the time of his retirement. The fund, ad­ ministered by the University at the Buffalo Foundation, Inc., honors Furnas' "long and devoted service" to the University.• SUMMER, 1971 35 Mr. Webber �Family Planning J <£> DID WE INITIATE MALTHUS Students for Population Study, ^HY last summer s at the Medical School? "We, as medical students, believe that family planning must be an integral part of our future medical practice," Lester Lifton, society president and a junior medical student, replied. "No matter what each of us specializes in, we must be able to provide information and advice to our patients as well as to the community on family planning." As a national trustee for SAMA, the student AMA group, he has also been active in its subcommittee on population explosion. With the impetus of an enthusiastic freshmen class, an active group of 20 medical students plus one student nurse, Lifton stood ready to personally "do something," that was not political­ ly motivated. A survey of obstetric and gynecology departments at medical schools revealed that while many did offer a course on family planning as part of their curriculum, there was little if any student activity. "Why should more care be given the 70-year-old cor­ onary patient than the 17-year-old-girl who wants contraceptives?" Incorporation, the group found, would permit them to file federal grant applications on several projects they had planned and needed funding. Under their corporate name, Center for Advancement of Population Studies in Medicine, they applied for funds to cover an eight-week summer program. In cooperation with Planned Parenthood World Population, 30 medical students will work in planned parenthood clinics across the country. Also a survey of physicians and medical students in Erie County was made to determine their attitudes on the role of physicians in handling problems on family planning and population. An in­ formation service specifically geared to medical students to furnish them with the latest information on contraceptives and family was collected by the summer program participatees. Counseling" at a hospital are Bruce and Wayne Middendorf, Jockular Ford, Guido Napolitano and Wayne Glazier. �Now in the working stage of the society is a pamphlet on the various aspects of conception, contraception, and abortion, community facilities available to them, names, clinics, hours, etc. It will be distributed this spring to all university under­ graduate students and to all freshmen in the fall. "We are trying to get the University to do more," Liftonsaid. "We feel students should have information available to them." There is but one course on population and family planning at the University and that is limited to 40. It is taught by Dr. Jack Lippes, associate professor of gynecology and obstetrics, medical director of Planned Parenthood and who, as advisor to Mathus and the center, has been so enthusiastic and of great help to them. But the society feels that one course is just not enough. They are working on a course to be included this fall as part of the medical curriculum. And an eight-week extra curricular sex education course that they offered on Wednesday evenings last fall has ended. They hope to repeat this course, that attracted over 60 medical students, this spring. And there is also a seminar on population growth at the national SAMA meeting schedule in May in St. Louis which they will offer. The Center, student organized and administered, has a nation­ wide Advisory Committee of experts in the field of family plan­ ning and population growth. Its national offices in Buffalo, are adjacent to the medical school. But they strongly feel that information must also filter out into the community as well. Another program on which they are working calls for medical students to counsel mothers in hos­ pitals following delivery on the availability of birth control information. "Although there seems to be much literature around, it is not getting to every woman who should have an opportunity to know what is available so that she can make up her own mind about how many children she wants and when she wants them," Lifton said. Other officers — Treasurer Craig Traugott, Vice presidents Daniel Botsford, Marianne Goodman, Bruce and Wayne Middendorf, James Pietraszek, Michael Sdao, and Sandra Schneider, a nursing student.• The Buffalo Veterans Administration Hospital has a $17 million budget approved for fiscal 1972 which begins July 1. This is an increase of more than $500,000 in operating funds for new programs (intensive care, drug abuse treatment, hemodialysis center) for patients, according to Mr. Eugene E. Speer Jr., hos­ pital director. This hospital is one of five affiliated with the Medical School. It has 951 beds, 25 full-time physicians, 35 part-timers, 37 medi­ cal residents, 162 full-time nurses and 59 on part-time, and more than 200 consultants. Buffalo, like most, if not all of the 166 VA hospitals throughout the country still has to cope with a chronic shortage of staff members, particularly full-time physicians.• SUMMER, 1971 37 New Programs at VA Hospital �Dr. Samuel Sanes, seated, receives congratulations from Louis N. Bunis, center, past president of the United Jewish Federation, and Dr. Max Cheplove, M'26, chairman of the dinner honoring Dr. Sanes. Buffalo Evening News Dr. Sanes Honored A. pathology professor, who has been on the faculty for 35 years was honored in March by the United Jewish Fund. For Dr. Samuel Sanes it was his "second" retirement, 10 years after the first. He first retired in 1961 when he gave up his every­ day practice to devote full time to teaching. Dr. Sanes has been teaching medical students ever since his graduation from the UB Medical School in 1930. He will retire June 30. From 1954 to 1966 he was also professor and head of the Department of Legal Medicine. Dr. Sanes was founder and president of the Erie County Chapter, American Cancer Society, and served as president of the state society. From 1956-58 he was president of the Jewish Center of Buffalo, a member of the National Jewish Welfare Board, the United Jewish Fund Board of Governors, and the Anti-Defamation League Executive Committee. In 1953 Dr. Sanes was named an outstanding citizen by The Buffalo Evening News.n 38 THE BUFFALO PHYSICIAN �The Classes of the 1920's Dr. Julian F. Johnston, M'21, of 21 Van Doren Avenue, Chatham, New Jersey, is a general practitioner and has an emergency room position at Overlook Hospital, Summit, New Jersey.• Dr. Caryl A. Koch, M'23, is the school physician of Orchard Park Central School. He was also past president of the Lions Club, named legionaire "Citizen of the Year" in 1970, and is president of the Ismailia Temple Medical Unit. His address is 6435 W. Quaker Street, Orchard Park, New York.D Dr. Daniel C. Fisher, M'24, was honored March 5 by the Clarence Rotary Club and the Clarence Citizens Council. The 74-yearold physician has been a life-time resident of this Western New York town. For 12 years he was president of the Erie County Health Advisory Board, and from 1928 to 1950 Dr. Fisher was town health officer. He was health officer of the Clarence Central School District for 40 years, and chaired the Clarence Planning Board for 20 years. He was the first president of the Clarence Historical So­ ciety. Dr. Fisher is immediate past president of the New York State Association of School physicians and past president of the Medical History Society of Western New York. He was president of the Board of Directors of Clarence's Sesquicentennial in 1958 and a member of the Board of Directors of the Amherst-Clarence Hospital Association.• Dr. Raymond J. Rickloff, M'28, lives at 2534 South Tracy Drive, Erie, Pennsylvania and specializes in dermatology. A captain in the Medical Corps of the Army from 194244, he was past president of the Erie County Medical Society, consultant for the Erie Vet­ erans Administration Hospital, past president of Hamat Hospital, and St. Vincent and Zem Zem Hospitals.• SUMMER, 1971 Dr. Walter Scott Walls, M'31, outgoing President of the 27,000-member Medical So­ ciety of the State of New York addresses policy-making House of Delegates of this So­ ciety at its 165th annual convention, Ameri­ cana Hotel, New York City, February 14-18. The Classes of the 1930's Dr. Ronald W. Steube, M'32, of Fond du Lac, Wisconsin, is Director of the Pathology Department of the Nursing School at St. Agnes Hospital. He retired April 1, and will move to 540 Port Side Drive, Naples, Florida.• The Classes of the 1940's Dr. Peter G. Brandetsas, M'43, a general surgeon, is at regional office, Veterans Ad­ ministration, Roanoke, Virginia. A Fellow of the American College of Surgeons, and Diplomate, American Board of Surgery, he ap­ peared in Who's Who in America (1960). He has published extensively and was a Lt. Colonel, M.C. and former director of medical services, U.S.A.R.D Dr. Frank L. Tabrah, M'43, a pediatrician, is associate professor in clinical pharmacology at the University of Hawaii. The co-author of numerous publications, he lives in Kapaau, Hawaii (P.O. Box 308).• Dr. M. E. Hodes, M'47, of 648 Edgemere Drive, Indianapolis, Indiana, is a professor of medicine and biochemistry at Indiana Uni­ versity.• 39 �The Classes of the 1950's Dr. Eugene M. Teich, M'51, a cardiologist, lives at 275 Southdown Road, Huntington, New York. He is a Fellow, American Col­ lege of Physicians; and Associate Fellow of American College of Cardiology. He is author of "Afebrile Bacterial Endocarditis" which appeared in the JOURNAL, Mt. Sinai Hos­ pital [November, 1969).• Dr. Herbert W. Simpkins, M'53, is a gen­ eral practitioner in Irvington, New Jersey. His home is at 380 Elmwood Avenue, Maplewood, New Jersey.• Dr. Ernest H. Meese, M'54, a thoracic and cardiovascular surgeon, lives at 174 Pedrett Road in Cincinnati, Ohio. He is cur­ rently Head of Open Heart Surgery Team at Good Samaritan Hospital, Cincinnati. As Com­ mander and Chief of thoracic surgery at Naval Hospital in Portsmouth, Virginia, he completed six years in 1965. He is secretary of board, and chairman of the service com­ mittee of Cincinnati-Hamilton County Unit, American Cancer Society. He is a Fellow of American College of Surgeons; Fellow of American College of Cardiology; Fellow of American College of Chest Physicians; Fellow of American College of Angiology.D Dr. Leonard R. Schaer, M'55, is chief of nuclear medicine at Kaiser Foundation Hos­ pital, Walnut Creek, California. He participated in the clinical development of the Scintillation Camera (Anger Camera) while a full time re­ search associate at University of California at Berkeley's Donner Laboratory. He is a Fellow of American College of Physicians, a member of the Society of Nuclear Medicine and the American Society of Hematology. Dr. Schaer lives at 107 Post Road, Walnut Creek, California.• Dr. Bernard S. Shapiro, M'57, was Chief Surgical Service at Station Hospital, Quonset Point, Rhode Island from 1962-64. He was discharged as Lieutenant Commander, USNR. He is at present attending surgeon at Griffin Hospital in Derby, Connecticut, a physicianin Yale-New Haven Hospital's out patient de­ partment and consultant in general surgery at Laurel Heights Hospital in Shelton, Connecti­ cut. He is a Fellow, American College of Surgeons and has published extensively.• 40 Dr. Herbert Silver, M'57, is an assistant professor of pathology at the University of Connecticut School of Medicine, Hartford. He has been Director of the Blood Bank and Immunohematology at Hartford Hospital since July 1970. He has published extensively — TRANSFUSION (Nov.-Dec. 1970); AMERI­ CAN JOURNAL OF CLINICAL PATHOLOGY (April 1971); BRITISH JOURNAL OF MEDI­ CAL TECHNOLOGY (April 1971) being the most recent. Dr. Silver lives at 32 Beacon Hill Drive, West Hartford, Connecticut.• Dr. Ronald W. Byledbal, M'58, is a psy­ chiatrist in Santa Rosa, California. His home is at 3031 Terra Linda Drive, Santa Rosa.D Dr. Morton Spivack, M'58, a hematologist, is assistant professor in Medicine at the Albert Einstein College of Medicine. He is also a member of the Board of Examiners, New York City Department of Health since 1968. Co-author of numerous publications, he lives at 620 West 239th Street, Bronx, New York.D Dr. Richard H. Musgnug, M'59, a derma­ tologist, is on the staff at Thomas Jefferson Medical College and Temple University Sci­ ences Center in New Jersey. He is Chief of the department of dermatology at The Cooper Hospital, Camden, New Jersey and chairman of the hospital's medical division. His address is 65 Onondago Trail, Medford Lakes, New Jersey.• Dr. Robert H. Wilbee, M'59, who was associate director at E.J. Meyer Memorial Hos­ pital, resigned that position in February. He announced that he will return to private prac­ tice in surgery. He has left Buffalo for a "strictly non-administrative position" with a small community hospital opening in Las Cruces, New Mexico in June, 1971. Dr. Wilbee was formerly assistant dean at the UB School of Medicine in the area of student and aca­ demic affairs. He is a Fellow of the American College of Surgeons and a Diplomate of the American Board of Surgery.• THE BUFFALO PHYSICIAN �The Classes of the 1960's Dr. Edwin R. Lamm, M'60, a general surg­ eon, is clinical instructor in surgery at George Washington University. He lives at 2702 Largo Place, Bowie, Maryland and is a Diplomate of the American Board of Surgery. He is President of the Belair at Bowie Medical/ Dental Association and alternate delegate to the Medical-Chirurgical Society of Maryland.• of Missouri and published numerous papers on the intrarenal regulation of sodium execretion while there. He is a member of the American and International Societies of Neph­ rology, the American Physiological Society, the American Association for the Advance­ ment of Science and the American Federation of Clinical Research. Dr. Knox lives at 2249 Nordic Court, Rochester, Minnesota. • Dr. Martin S. Wayne, M'60, a psychia­ trist who lives at 814 Sleepy Hollow Road in Briarcliff, New York gave up his fulltime position as clinical director at Mount Vernon Mental Health Clinic in March 1970 to head a center in Yonkers, New York for adoles­ cents unable to learn in normal schools. Dr. Wayne has spoken on drug addiction in adol­ escents and psychiatry in Vietnam to the Tarrytown area residents. He became board certified in psychiatry in 1969.• Dr. Michael I. Weintraub, M'66, a neuro­ logist, is on the staff at Boston University School of Medicine, and recently entered the U.S. Navy as staff neurologist at Boston Naval Hospital, Chelsea, Massachusetts. In 1969-70, Dr. Weintraub completed his neuro­ logy residency training at Yale, New Haven Medical Center and was appointed chief resident in neurology at Yale University. He has published extensively and lives at 31 Risley Road, Chestnut Hill, Massachusetts.• Dr. Rae R. Jacobs, M'62, is chief residentorthopedics, at the Medical College of Georg­ ia. A member of the Association for Advance­ ment of Medical Instrumentation, she has published numerous articles and has several in press. Dr. Jacobs lives at 3208 Sylvan Court, Augusta, Georgia.• Dr. Jacob S. Kriteman, M'67, is in the U.S. Air Force at the USAF Hospital Griffiss, Griffiss AFB, New York. He is a candi­ date for the American Academy of Pediatrics and lives at 2412-B Snark Street at Griffiss AFB.G Dr. Robert A. Klocke, M'62, is an as­ sistant professor of Medicine at UB. He lives at 190 Cottonwood Drive in Williamsville.D Dr. Albert J. Maggioli, M'63, left the U.S. Army in September, 1970. He is now associated in pediatric practice with Dr. Sher­ man Woldman, M'57, in Buffalo. Dr. Mag­ gioli lives at 288 Robinhill Drive in Williamsville.D Dr. Arthur C. Sosis, M'67, is a first year resident in dermatology at the Skin and Cancer Hospital of Philadelphia, Temple Uni­ versity Health Sciences Center in Philadel­ phia. He served two years in the U.S. Air Force as a general medical officer, before starting a three-year residence in dermatology at Temple University. Dr. Sosis lives at 7901 Henry Avenue, Apartment B-110, Philadel­ phia, Pennsylvania.• Dr. Paul Sussman, M'64, an internist specializing in rheumatology lives at 14033 Sherman Way, Van Nuys, California. He recently qualified by American Board of Internal Medicine.• Dr. Barry S. Shultz, M'68, who lives at 5385 Wyngate Drive, Norfolk, Virginia, will begin his urology residency in July, 1972.• Dr. Franklyn G. Knox, M'65, is a renal physiologist, and associate professor at the Mayo Graduate School of the University of Minnesota. He had previously been in the Department of Physiology at the University Dr. David H. Atkin, M'69, a resident in anesthesiology at Albert Einstein College of Medicine, lives at 99 Shore View Drive, Yonkers, N.Y.D SUMMER, 1971 41 �ople Two faculty members are on standing committees of the American College of Sur­ geons. Dr. J. Edwin Alford, clinical associate professor of surgery, is chairman of the proctology committee, and Dr. Richard H. Adler, professor of surgery, is a member of the New York (Upstate) advisory committee.• Dr. John H. Talbott is the author of "A Biographical History of Medicine." In re­ viewing the book Dr. Morris Fishbein said, "it is different from any of the other works in this field. It is not a book of reference and it is far more than a textbook in the history of medicine. It is a book for ex­ ploratory browsing, and for the enjoyment of those readers who particularly enjoy bio­ graphical works." From 1946-59, Dr. Talbott was professor of medicine at the Medical School and chief of medicine at the Buffalo General Hospital. He is now editor emeritus of the Journal of the American Medical As­ sociation. Dr. Talbott gave the Stockton Kim­ ball Lecture in 1965 at Spring Clinical Days.D Three alumni are new officers in the Western New York Heart Association. Dr. Joseph Zizzi, M'58, is the new president, and Dr. Victor L. Pellicano, M'36, of Niagara Falls is the new vice president. Dr. Francis J. Klocke, M'60, is secretary. The immediate past president is Dr. Andrew Gage, M'44.D Dr. Theodore C. Krauss, clinical assistant professor of medicine, is chairman of the committee on aging, research and planning for community services. He is also chairman of the Erie County White House Conference on Aging.• An assistant clinical professor of medicine, Dr. John K. Dustin, was re-elected President of the Millard Fillmore Hospital medical staff. Five alumni were elected to other positions. They are: Drs. Donato Carbone, M'46, secre­ tary; Paul M. Walczak, M'46, treasurer; An­ thony Postoloff, M'39, Paul Stoesser, M'35, and William Kinkel, M'54, all officers-atlarge.D 42 5t;e diversity. ..Our Ciuii^ futur^ 125th ANNIVERSARY 1846-1971 State diversity of ffeuj V6r^at Buffalo A design by John O'Reilly, 30, of Cheektowaga has been selected as the official symbol of the 125th Anniversary of the University. O'Reilly's design was selected from a field of 55 entries from both the University and the community in a contest sponsored by the Policy Committee for the 125th Anniversary. The amateur artist, employed by Printing Prep of Buffalo, received a $50 prize for his entry, which he said was inspired by the theme of the celebration, "The University - Our Living Future." O'Reilly said that the symbol reflects his view of U/B as an institution whose grad­ uates are to him the "key to world improve­ ment." The University, he said, does not just "push out students," but is educating individuals with a deep concern for human problems. The Policy Committee said the symbol was selected because it incorporated not only the required Anniversary information, but also the present University seal and the concept of U/B's wide-ranging contributions to society.• THE BUFFALO PHYSICIAN �Seven members of the Department of Bio­ physical Sciences faculty presented papers at several professional meetings recently. They are assistant professors Dr. M. T. Hays, Dr. C. Y. Jung, Dr. S. Szuchet, Dr. D. C. Wobschall, Dr. C. R. Zobel, Dr. K. N. Leibovic, an associate professor, Dr. H. A. Hauptman, research professor, and Dr. }. T. Hoogeveen, assistant research professor.• Nine members of the Department of Bio­ chemistry faculty presented papers at dif­ ferent professional meetings recently. They are research associate professors Dr. David A. Cadenhead, Dr. Wells A. Farnsworth, Dr. Demetrios Papahadjopoulos, Dr. Morris Reichlin, Dr. George L. Tritsch, Dr. Herbert Weinfeld, Dr. Charles E. Wenner, Dr. Eric A. Barnard, professor and chairman, and Dr. Om P. Bahl, associate professor.• Dr. Pierluigi E. Bigazzi, research assistant professor, Center for Immunology at UB School of Medicine, received his medical degree in 1959 from the University of Florence Medical School in Italy. He lives at 1525 Millersport Highway in Williamsville.D Dr. Arnold A. Abramo, a pediatrics in­ structor at UB School of Medicine, is a 1954 alumnus of Loyola University Stritch School of Medicine. Among his memberships are American Academy of Pediatrics, Military Section of American Academy of Pediatrics, and Senior Member of Air Force Internists and Allied Specialists. Dr. Abramo lives at 18 Boxwood Circle in Hamburg, New York.D President Robert L. Ketter was one of five men to receive the 1971 Missouri Honor Award for Distinguished Service in Engineer­ ing. Dr. Ketter graduated from the University of Missouri in 1950 with a bachelor's degree in civil engineering, before going to Lehigh University where he received his master and doctorate degrees. The award is symbolic of a person's contribution to society through engineering education or practice of profes­ sional engineering.• SUMMER, 1971 President Robert L. Ketter resigned as chairman of the Comprehensive Health Plan­ ning Council of Western New York in March. Dr. Ketter won the election in June, 1970 before he was named President of the Univer­ sity. Dr. Kenneth H. Eckhert, M'35, vice chairman, moved into the chairmanship.• Two alumni have been elected officers to the Buffalo Sisters Hospital medical staff. Dr. William Bukowski, M'47, is the new presi­ dent, and Dr. Charles E. Wiles, M'45, is the new treasurer. Dr. Conrad G. May was named vice president, and Dr. Ambrose A. Macie, secretary.• Dr. Jean A. Cortner, professor of pedia­ trics, has been appointed to the New York State Committee for Children. The75-member committee will make recommendations on child care to the Joint Commission on Mental Health of Children, a federal agency. Dr. Cortner is also chairman of the Department of Pediatrics at Children's Hospital.• Dr. J. Edwin Alford is chairman of the Advisory Council for Proctology of the Amer­ ican College of Surgeons. He has also been elected international vice president of the In­ ternational Society of University Colon and Rectal Surgeons. Sao Paulo, Brazil. Recently he was elected to an additional four-year term to the American Board of Colon and Rectal Surgery. Dr. Alford, clinical associate professor of surgery and acting head of the Division of Proctology at the Medical School, is on the advisory staff, Niagara Frontier Ileostomy and Colostomy Society.• Dr. Bertram A. Portin, clinical assistant professor of surgery (proctology], is secretary, Section on Gastroenterology and Proctology, Medical Society of the State of New York.D Dr. Douglas Holyoke, research instructor in surgery, has been named chief of the de­ partment of general surgery at the Roswell Park Memorial Institute.• 43 People �In Memoriam Dr. Julius Y. Cohen, M'09, died March 28 in Miami Beach, Florida where he was vaca­ tioning. The 83-year-old general surgeon was on the "emeritus" staff of Millard Fillmore Hospital. In 1951-52 he was president of this hospital staff, one that he had been affiliated with since 1912. In 1939, Dr. Cohen was one of the founders of Blue Shield of Western New York. He was honored by this organiza­ tion in 1969. He was on the governing board from 1939 to 1947. Dr. Cohen studied surgery in Vienna, Austria, and completed his resi­ dency at Sisters Hospital. He served as a First Lieutenant in the Army Medical Corps during World War I. He was past president of the Maimonides Medical Society, a founder of the Planned Parenthood organization of Buffalo, a Fellow in the American College of Surgeons, and active in several professional organizations.• Dr. Glee W. Chessman, M'18, died Feb­ ruary 23, one month after retiring. The 76year-old eye-ear-nose and throat specialist practiced in North Hornell and Canisteo for 45 years. Dr. Chessman did graduate work at George Washington University's Medical School, after graduating from UB. In 1968 he was honored by the State Medical Asso­ ciation for 50 years of service. He was on the staffs of Bethesda and St. James Hos­ pitals.• Dr. Raymond C. Fess, M'09, died March 17 in the Jamestown General Hospital (NYJ. He had been a general practitioner in Jamestown for more than 50 years. Dr. Fess was a native of Bowmansville, N.Y. He was a First Lieuten­ ant in the Army Medical Corps in World War I. He was active in civic affairs. • The General Alumni Board Executive Committee — ROBERT E. LIPP, '51, President; DR. EDMOND GICEWICZ, M'56, President-elect; JOHN J. STARR, JR., '50, Vice-President for Administration; JEROME A. CONNOLLY, '63, Vice-Presi­ dent for Development; G. WILLIAM ROSE, '57, Vice-President for Associations; JOHN G. ROMBOUGH, '41, VicePresident for Activities; MORLEY TOWNSEND, '45, Vice-President for Athletics; G. HENRY OWEN, '59, Vice-Presi­ dent for Public Relations; MRS. ESTHER KRATZER EVERETT, '52, Vice-President for Alumnae; DR. HAROLD J, LEVY, M'46, Treasurer; M. ROBERT KOREN, '44, Immediate Past-President, Past Presidents; WELLS E. KNIBLOE, '47; DR. STUART L. VAUGHAN, M'24; RICHARD C. SHEPARD, '48; HOWARD H. KOHLER, '22; DR. JAMES J AILINGER, '25; DR. WALTER S. WALLS, M'31. Annual Participating Fund for Medical Education Executive Board for 1970-71 — DRS. MARVIN L. BLOOM, M'43, President; HARRY G. LaFORQE, M'34, First Vice-President; KENNETH H. ECKHERT, SR., M'35, Second Vice-Presi­ dent; KEVEN M. O'GORMAN, M'43, Treasurer; DONALD HALL, M'41, Secretary; MAX CHEPLOVE, M'26, Immediate Past-President. Medical Alumni Association Officers; DRS. ROLAND ANTHONE, M'50, President; LOUIS C. CLOUTIER, M'54, VicePresident; JOHN J. O'BRIEN, M'41, Secretary-Treasurer; SIDNEY ANTHONE, M'50, Immediate Past President. 44 THE BUFFALO PHYSICIAN �Alumni Association Tour EUROPE — AUGUST 3-24, 1971 $890.00 per person plus $17.50 tax and services • Visit Amsterdam, Cologne, Heidelberg, Munich, Innsbruck, Venice, Florence, Rome, Lucerne, Paris and London • Round-trip jet from Buffalo • Land transportation via deluxe Motorcoach • All hotels personally selected • All meals with 8 exceptions in order to allow free time to enjoy European cuisine on your own • Multilingual guide for the 22 days • Special guides in Venice, Florence, Rome, Paris and London • Tips and gratuities • Sightseeing tours, excursions and transfers • Personally escorted For details write or call: Alumni Office, 250 Winspear Avenue State University of New York at Buffalo Buffalo, New York 14214 (716) 831-4121 First Class Permit No. 5670 Buffalo, N. Y. BUSINESS REPLY MAIL NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES POSTAGE WILL BE PAID BY — Medical Alumni Association 2211 Main Street Buffalo, New York 14214 Att.: David K. Michael �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET, BUFFALO, NEW YORK 14214 Address Correction Requested YOU'VE GOT WHAT IT TAKES! . . . we know you like to keep your records current. So do we. Please complete this card, detach it and mail. No postage is required. (Please print or type all entries.) Name Year MD Received Office Address Home Address If not UB, MD received from In Private Practice: Yes • No • Specialty In Academic Medicine: Yes • No • Part Time • Full Time • School Title Other: Medical Society Memberships: NEWS: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.? Please send copies of any publications, research or other original work. Partners' Press, Inc. Abgott t Smith Printing � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1971 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1971-Summer Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v05n02-1971-Summer Table Of Contents A list of subunits of the resource. Closed Circuit TV The Prescription Team A Presidential Inauguration Repression by Default by President Robert L. Ketter The Chronically Ill A Summer in England by Ira Mintzer, Class of 1972 Witebsky Memorial Lecture Better Health Care Summer Fellowships Intern Marketing Human Sexual Response Cassettes Aid Teaching Computer Mapping APFME Scholarships Laboratory Advisory Board Ending Pregnancy Living Cell Heart Repairing 3-D Process Alumni Reception/Muscular Dystrophy RMP/Furnas Scholarship Family Planning VA Programs Dr. Sanes Honored The Classes/People In Memoriam Alumni Tour Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v05n02 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright1971 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/39fa076c82fb4ea293b5bdb3f0964231.pdf 52b5c8fa09fd89e2201347f8ef4423b3 PDF Text Text �Dr. Shefier, Donald Greene Michael Adao congratulates Dr. Lee. Bruce Middendorf, Daniel Botsford, )ohn Clark and Tone Johnson give their approval. Sophomores Honor Faculty Five faculty at the Medical School, who have not only offered good teaching but have unselfishly responded to the needs of the stu­ dents, were awarded plaques by the sophomore class. They are Dr. Harold Brody, professor and chairman of the department of anatomy; Dr. Alexander C. Brownie, research associ­ ate professor of pathology and professor of biochemistry; Dr. Peter K. Gessner, associate professor of pharmacology; Dr. Joseph C. Lee, professor of anatomy and research associate professor of surgery (neurosurgery); Dr. John B. Sheffer, clinical associate professor and acting chairman of pathology. Inscribed on the plaques presented to the five whose outstand­ ing efforts may have gone unrecognized is "for insight and dedica­ tion to teaching, from the Medical Class 1974." Dr. Brownie, Thomas Varecka Dr. Brody Congratulations," said class president Bruce Middendorf, "for not only excelling in your specialty but for effectively communicat­ ing that knowledge to us as students. Your teaching has not only been good but it has been excellent." The unanimity of agreement among his classmates was obvious. Expressed by the recipients was the hope that this kind of recognition by students for good teaching would become a tradition here at the Medical School.• �Winter 1972 Volume 6, Number 4 THE BUFFALO PHYSICIAN Published by the School of Medicine, State University of New York at Buffalo IN THIS ISSUE Faculty Honored EDITORIAL BOARD Editor ROBERT S. McGRANAHAN Managing Editor MARION MARIONOWSKY Photography HUGO H. UNGER (inside front cover) 2 5 6 7 8 by President Robert L. Ketter EDWARD NOWAK Medical Illustrator MELFORD J. DIEDRICK Graphic Artists RICHARD MACAKANJA DONALD E. WATKINS Secretary FLORENCE MEYER CONSULTANTS President, Medical Alumni Association DR. JOHN J. O'BRIEN President, Alumni Participating Fund for Medical Education DR. MARVIN BLOOM Vice President, Faculty of Health Sciences DR. CLYDE L. RANDALL Vice President, University Foundation JOHN C. CARTER Director of Public Information JAMES DeSANTIS Director of Medical Alumni Affairs DAVID K. MICHAEL Director of University Publications PAUL L. KANE Vice President for University Relations DR. A. WESTLEY ROWLAND Pacemakers Alumni Receptions SLE Test Children's Hospital University/Hospital Partnership 12 13 15 17 18 19 20 22 23 24 25 26 28 29 30 33 34 35 37 39 40 41 42 43 44 45 46 48 49 50 52 53 54 55 56 60 62 63 66 70 Drug Abuse Roswell Park/Psychiatry Director Rural Health Care Prenatals Gonorrhea Test Gyn/Ob Head/Chinese Student Teaching Techniques Continuing Medical Education Community-University Day Polluted Waters New Journal/Psychiatry Grant Dr. George Thorn Moral Issue BGH Expansion Allergic Disease Center LARMP/Microbiology Grants Hallucinogens Dermatology Chairman The 1976 Class Family Practice/Dr. Murphy Surgery Chairman Dr. Regan/Scholarships First Complex Hormone Dr. Vaughan Lab/Health Center Infectious Diseases VA Hospital Director Lackawanna Health Center Health Resources/Dr. LaPaglia Surgery VA Drug Treatment Mental Health 10,000 Mile Cruise Medical Van New North Campus Heart/Lung Studies Swimming Analysis Faculty Promotions The Classes People In Memoriam The graphic cover design by Richard Macakanja symbolizes the holiday season. THE BUFFALO PHYSICIAN, Winter 1972 — Volume 6, Number 4, published quarterly Spring, Summer, Fall, Winter — by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. Please notify us of change of address. Copyright 1972 by The Buffalo Physician. �Over 200 investigators from around the world attended a postgraduate symposium on cardiac pacing held in the Medi­ cal School in 7965. Dr. Chardack "demonstrates" in the laboratory. Pioneers in PACEMAKERS One of the first devices developed by the team. T w o PIONEERS IN the development of battery-powered pace­ makers made history again by implanting the first nuclear-powered device in this country last July. They are Drs. William M. Chardack, chief of thoracic surgery, and Andrew A. Gage, chief of surgery at the Veterans Administration Hospital, who also are associate pro­ fessor and professor of surgery respectively at the Medical School. The hospital was the first in the nation to be granted a license by the U. S. Atomic Energy Commission to use the radioisotope pace­ maker. Four patients, who have now been operated on, have made uneventful recoveries. The history of the Veterans Administration Hospital's surgical service and its research laboratory lists many "surgical firsts." In 1950, the initial year of hospital operation, Drs. Chardack and James D. MacCallum performed the first successful resection of a "Pancoast Tumor followed by radiation therapy. This rapidly fatal type of cancer of the apex of the lung until then was thought to be incurable and inoperable. The patient, who lived for over five years, died from an unrelated disease. Following reports by the two surgeons in 1953 and 1955, the combination of surgery/radiotherapy, was accepted as the standard treatment for this condition. It has yielded a significant number of cures. In 1953 a resection of the bifurcation of the lower aorta was performed at the hospital. The resected segment of the large vessel was replaced by a homograft. It was the first operation of this type to be performed in this part of the country. THE BUFFALO PHYSICIAN �When the hospital opened in 1950 there was no space pro­ vided for a surgical research laboratory. Dr. Chardack accepted an invitation from the late Dr. John R. Paine to start experimental work in the old "firehouse laboratory" at the Buffalo General Hos­ pital. Three years later, in 1953, Drs. Chardack and Gage established the first surgical laboratory at the VA Hospital. Recalled Dr. Char­ dack, "it was located in small, improvised quarters that were orig­ inally part of the hospital laundry." Since that time the hospital's surgical laboratory and general research facilities have greatly ex­ panded and now serve an increasing number of investigators based there and at the Medical School. Early experimental work at the hospital was concerned with the measurement of coronary flow, a standardized experimental model of coronary obstruction, and an experimental evaluation of surgical procedures for the relief of coronary arterial disease. They were forerunners of the now widely-practiced modern operations for this disorder. Experimental work on a self-contained and implantable pace­ maker to correct complete heart block began in 1958 by the two investigators in cooperation with Wilson Greatbatch, an electronics engineer and assistant professor of electrical engineering at the Uni­ versity of Buffalo. Its clinical implantation was performed and reported by the team two years later, in 1960. The first longterm success with this operation led to its immediate acceptance throughout the world as Dr. Chardack CONNECTORS FUEL CAPSULE THERMOPILE DC/DC C0NVERT0R CIRCUITRY HERMETICALLY SEALED CASE PULSE GENERATOR DEMAND CIRCUITRY I S 0 T 0 P I C POWER SUPPLY Cross-sectional diagram ol the nuclear-powered unit. �One of the most recent electric pulse generators with conventional batteries. The first two patients, Anthony /. Tasca and Robert L. Peck, to receive nuclear pace­ makers in this country. the treatment of choice for this condition, which carried a 50 per cent mortality within a year after diagnosis and until then was un­ beatable by other means. Well over 100,000 patients have now been treated by such devices as well as pacemaker systems of increasing sophistication. And the surgical group at the VA Hospital have been prominently associated with many of the new techniques developed over the sixties. The latest, the plutonium-fueled pulse generator perfected by a French engineer/physician team and an American pacemaker manufacturer, uses circuitry and electrodes developed from the original design concepts of the Buffalo team. There are a number of related fields also covered by the VA Hospital's surgical service investigators. They are paired pulse stimulation of the heart and studies on ventricular fibrillation re­ ported on in cooperation with the hospital's chief of cardiology Dr. David C. Dean and Japan's Dr. Hiroshi Ishikawa. But, said Dr. Chardack, the laboratory has also made contribu­ tions to other fields. "Experimental and clinical applications of synthetic substitutes for skin used in treating third-degree burns were reported on in the sixties. And the introduction of cryosurgery by Dr. Maurice J. Gonder for treatment of prostatic obstruction and of cryosurgery for cancer in general by Dr. Gage have also received international attention and recognition."• 4 THE BUFFALO PHYSICIAN �A total of 22 alumni, wives, and guests attended the American Medical Association Convention alumni reception at the St. Francis Hotel, San Francisco on June 19. Mr. David Michael, director of medical alumni affairs, hosted the reception. Two Alumni Receptions Those attending were: Doctors Richard and Mrs. Ament, M'42, Buffalo; E. R. and Mrs. Auden, Minnesota, guests; William and Mrs. Ball, M'37, Warren, Pennsylvania; Charles Bauda, M'42, Buffalo; Philomena Bauda, M'42, Buffalo; Ron Friedman, M'68, Santa Monica, California; Fred and Mrs. Goldstein, M'56, 1000 Oaks, California; H. W. Hale, Jr., Phoenix, guest; Annabel Miller Irons, M'46, La Can­ ada, California; Don LaPlatner, M'60, St. Petersburg, Florida; William P. and Mrs. Magenheimer, M'44, Waterloo, New York; Joel and Mrs. Paull, M'71, Buffalo; Sam Sanes, M'30, Buffalo; Miss Mildred Spencer, Buffalo, guest; Barry and Mrs. Weinstein, M'69, Rochester, New York. Mr. Michael also hosted the American College of Surgeons alumni reception held in October in San Francisco at the Hotel St. Francis. There were 72 alumni, faculty, wives and guests attend­ ing. Doctors Richard Albert, Los Angeles (guest); Roland and Mrs. Anthone, M'50, Buffalo; John and Mrs. Ambrusko, M'37, Buffalo; Joseph G. Antkowiak, M'60, Pittsburgh; Robert M. Barone, M'66, Buffalo; Delmer E. Batcheller III, M'51, Canandaigua, New York; Charles and Mrs. Becker, M'38, Buffalo; Willard and Mrs. Bernhoft, M'35, Buffalo; Herbert Berwald, M'27, Napa, California; William and Mrs. BlaisdelI, M'59, Albuquerque; David A. Bloom, M'71, Los Angeles; Mr. Ronald Brown, Los Angeles (guest); Richard J. Buckley, M'43, Buffalo; Joseph S. Calabrese, Buffalo (faculty); Thomas Cummiskey, M'58, Buffalo; Donald DeLeutis, M'59, San Francisco; Joseph M. Dziob, Buffalo (faculty); Jack C. Fisher, M'62, Charlottesville, Virginia; Vincent P. Frantz, M'64, Houston, Texas; Ronald F. Garvey, M'53, Dallas, Texas; Michael and Mrs. Gianturco, M'55, Buffalo; John G. Gleichauf, M'62, Sante Fe, N.M.; Francis Hammond, Los Angeles (guest); Glenn C. and Mrs. Hatch, M'28, Penn Yan, New York; Robert C. and Mrs. Hatch, M'61, Modesta, California; David B. and Emma Harrod (both faculty), Buffalo; William C. Hernquist, M'44, Wichita Falls, Texas; John and Mrs. Ingall, Buffalo (faculty); Wendy Jacobson, San Francisco (guest); Byron H. Johnson, M'45, Fresno, California; Harris H. Kanel, M'57, Riverside, California; Marvin and Mrs. Kurlan, M'64, Allentown, Pa.; Charles and Mrs. Leone, M'29, Erie, Pa.; Karl Manders, M'50, Indianapolis, Ind.; Randolph J. and Mrs. McConnie, M'43, Santurce, P. R.; J. P. and Mrs. Nesselrop, San Francisco (guests); Eustace Phillies, M'38, Buffalo; E. and Mrs. Pollack, California (for­ mer E. J. Meyer resident); Albertus W. Rappole, M'37, Virgin Islands; Bert W. and Mrs. Rappole, M'66, Tucson, Arizona; Vea J. and Henry Riegler, Temple, Texas (guests); Bernard and Mrs. Shapiro, M'57, Ansonia, Conn.; Carrol J. Shaver, M'44, Elma, New York; Russell C. Spoto, M'59, Thousand Oaks, Calif.; William J. Staubitz, M'42, Buffalo; Mr. James Stephens, University of Western Ontario (guest); Samuel A. Weissman, M'69, Rochester, New York; Robert H. Wilbee, M'59, Las Cruces, New Mexico; Charles Wiles and Jane Wiles (both M'45), Buffalo; Jean D. Williams, M'68, Buffalo; Richard W. Williams, M'64, Buffalo; Donald Yacht, M'59, Palo Alto, Cali­ fornia.• WINTER, 1972 5 Dr. M. Luther Musselman is the new chairman of the admissions committee at the Medical School. The 1937 Medical School graduate has been on the faculty since' 1947. He was in military service in 1943-44. He is a clinical asso­ ciate professor of medicine and assistant director of the University Health Service. �Prognosis from New SLE Test Drs. Reichlin, Mattioli Predicting which patients with systemic lupus erythematosis (SLE) will have a low probability of developing renal complications is now underway at the Veteran's Hospital. It is through a test involving a precipitin reaction in gel with serum from the patient (Ouchterlony Test) by Drs. Morris Reichlin (professor of medicine and research professor of biochemistry) and Martha Mattioli (research instructor in medicine) to identify an antibody to a nuclear RNA protein. Said Dr. Reichlin, "if precipitating antibodies to RNA protein antigen are present, it is a good prognostic sign. For the patient will rarely develop kidney disease." He pointed out that response to treatment for this group of patients is very good. "Many will improve spontaneously without specific medication," he said. "Therefore unless indications are strong, treatment should not be aggressive." Other correlations made by the investigators reveal that patients who make anti-RNA protein antibodies rarely possessed antibodies to DNA (complement-fixing antibodies to ssDNA). "The presence of the latter correlates well with the presence of renal disease," Dr. Mattioli said. This test has important predictive significance for in large groups of lupus patients a little more than half (60%) will get kidney disease, a leading cause of death. Said Dr. Reichlin, "the symptoms may disappear but the blood test remains the same. Antibodies to the RNA protein tend not to fluctuate and are present whether the patient is ill or well. While the cause of this disease is unknown or why patients make either antibodies to DNA or antiRNAprotein, we have accomplished something empirical which is useful." In the past, the only specific laboratory test for the diagnosis of SLE has been antibodies to DNA, long known to be quite specific for SLE patients. Antibodies to RNA protein seem also to be quite specific for these patients while patients with other connective tissue disease (such as rheumatoid arthritis) do not make antibodies to the RNA protein. "Our test," Dr. Reichlin said, "represents a further refinement in establishing prognosis and diagnosis in SLE." Over a five-year period the investigators have been performing this test and have found 39 positive cases (for antiRNAprotein) out of a total 130 SLE cases. While patients with this anti-RNA protein do have a more favorable prognosis, the answers to why there are so many immunologic reactions or the pathogenic mechanism of many of the clinical findings remain obscure. Concluded Dr. Reichlin "it is hoped that the correlation of specific immunologic reactions to specific clinical events will lead to a greater understanding of the disease."• 6 THE BUFFALO PHYSICIAN �Dr. Ehsan Afshani, assistant professor of pediatrics and radiology, with his new equipment. Dr. fames R. Markello, assistant pro­ fessor of pediatrics, with a young patient. The basement and the first two floors of the new Children's Hospital $15 million out-patient and research building are functioning. This part of the building includes a new emergency-room, acute disease clinics and an observation unit on the first floor. And eventually all 34 of the out-patient clinics will be located in the new building. The radiology department is occupying more than two-thirds of the second floor and the intensive care unit has been expanded from 12 to 18 beds. Three other clinics — surgery, eye and orthoptics — have been completed. Also in operation is an expanded X-ray department, pharmacy, administrative offices, admissions, chapel, gift shop and front lobby. The other four floors will be completed during the next several months. The bright, cheerful building is decorated with great splashes of red, yellow, blue with purple and orange accents.Q WINTER, 1972 7 �Thank you, Mrs. Lyle; ladies and gentlemen. I am here today as a surrogate for many persons: —for the two women of this community who in 1892 founded The Children's Hospital; —for all those women who in subsequent years have demon­ strated the continuity of concern that has provided basic support for the progress of this hospital; —for the physicians who have practiced here and have been primary shapers, not just of the hospital, but of the whole field of pediatric medicine; -for those nurses and other health specialists whose care and commitment have characterized and been essential to the hospital's development; President Ketter speaking at the dedication -for the administrators and their staffs whose first allegiance has not been to bureaucracy but to a vision of expanded achieve­ ment; —for the many women who have been patients in this the only children's hospital in the United States and Canada which has an obstetrical division; —for the infants and children whose fear and pain have been alleviated here, or who have been helped to cope with what they do not comprehend; and finally, I stand here as a surrogate A Hospital University Partnership by President Robert L. Ketter -for the University faculty and students in the Health Sciences who have been an integral part of the hospital since 1926, when pediatric instruction was first offered here to students in our School of Medicine. From this tentative beginning forty-six years ago, the relation­ ship between the University and The Children's Hospital has emerged as one which strengthens both institutions. Today, as we dedicate this new out-patient and research building, the prospects are favorable for a continued strengthening of the partnership. For some years, the University has shared in the compensation of the hospital-based faculty member; never before has it assumed any responsibility for monetary compensation to the hospital for space that is utilized for academic purposes. This aspect of the partnership has changed. In his address at the Children's Hospital dedication ceremonies President Ketter announced that he had signed a letter of intent to lease 45,000 square feet of space from the hospital. The annual rent­ al would amount to approximately $500,000. Each of the five schools in the Health Sciences — dentistry, health related professions, medi­ cine, nursing, pharmacy — will be using some of the new classroom and research space, Dr. Ketter said. I have today signed and officially transmitted a Letter of Intent for the University to lease space over and above what it now uses in its academic programs at the hospital. Although the letter is addressed to Mrs. Lyle, the President of the Board of Directors of the Hospital, I do not believe it is inappropriate to read to you one sentence of its contents on such an auspicious occasion: "It is the purpose of this letter to indicate the intention of the State University of New York at Buffalo to enter into further agreements with The Children's Hospital of Buffalo to lease approximately 45,000 net square feet of University dedicated space within the Hospital specifically designed and con­ structed to meet the unique educational requirements of the University which, because of its proximity and access to the clinical programs of Children's Hospital, has particular educa­ tional and teaching significance." 8 THE BUFFALO PHYSICIAN �I should note that the contractual arrangement in question should result in the realization by the Hospital of approximately $500,000 per year. This letter adds a new dimension to the legal relationship of affiliation between The Children's Hospital and the University. The hospital undoubtedly will experience some degree of budgetary relief. The University's Faculty of Health Sciences, with each of its schools using hospital facilities, will benefit greatly from the availa­ bility of new classroom and research space. This is especially true in view of the University's decision not to build a teaching hospital on its Amherst or Main Street Campuses. In the years ahead, the strengthened relationship between the University and the hospital should generate even more of the medical advances which have brought both national and interna­ tional attention to this community institution. Highlights of this progress include the unique development of a total program of "maternal and child health" — a program which now seems likely to undergo additional growth with the appointment of our new Chairman in the Department of Gynecology-Obstetrics. The first open heart surgery in the United States for the trans­ position of the great vessels on infants was performed here in this hospital. The hospital continues to be noted for its achievements in cardiovascular surgery; and its treatment of heart ailments has attracted children from great distances, even from foreign countrres. Significant contributions have been made here to the work that has been done in polio and epilepsy. Research conducted at Children's has uncovered new knowl­ edge for the improved treatment of kidney ailments in children. The "Guthrie Test" for the detection of PKU was developed here. And the list could continue. Research activity such as this is essential to providing im­ proved health care. So is the teaching function which the hospital An interested audience �fulfills for our students in the Health Sciences. Together they con­ tribute to the quality of care available to the persons who use this hospital; and it is the provision of this care which constitutes the hospital's third function. Not one of these purposes could be adequately served without proper facilities. The dedication of this new building and the impending contractual arrangement between the hospital and the University go far toward assuring the continued availability of the resources necessary for the hospital to fulfill its mission. Fifty years ago, in 1922, the first out-patient department at The Children s Hospital was established. The enormous increase in this type of care is well known; and the demand seems likely to g r o w , e s p e c i a l l y if w e a d o p t s o m e f o r m o f n a t i o n a l h e a l t h i n s u r a n c e . Nowadays, more than 75,000 visits are made annually to the out­ patient units in this hospital, and the new building we dedicate today provides the most modern facilities for these persons. The primary beneficiaries of this accomplishment will be the citizens of Buffalo and Western New York, who constitute the bulk of the hospital's out-patients. Therefore, the building symbolizes for me the community service which has been a hallmark of the hospital since its founding. Yet the hospital has been more than a community servant. In many respects, it has been a community venture. For instance, the importance of community-based volunteer groups to the hospital is well documented. The Tanner Building at the east end of this new construction was the result of a community financed effort. But perhaps the most dramatic illustration of the hospitalcommunity interdependence occurred in 1944, when Western New York experienced a devastating polio epidemic. More than fourfifths of the hospital's existing beds for children were given over to polio victims. For other illnesses, only patients in need of emergency treatment were admitted. �The main lobby Eventually, 706 positive diagnoses of polio were made and the patients hospitalized at Children's. Hundreds of others were exam­ ined and released. Every available space in the hospital was filled, including living rooms and conference and classrooms. The problems of what to do with the many children who needed extended care was solved when a prominent family made available a large indoor tennis court which was transformed into a temporary hospital annex. This was typical of the community sup­ port during those months of crisis. Volunteers came to serve meals and wash dishes; business executives came nightly to clean; entertainers came to perform. The Department of Education brought school to the annex; the Fire Department brought hospital-prepared meals through the snow on fire trucks; the scouts brought scouting. The community and hospital response to the crisis was total; and I believe the spirit still exists for such cooperation and service. This building certainly is an affirmation of it. Therefore, the dedication we make today should be to the continuation of the service The Children's Hospital has long pro­ vided to this community; t o the service it has rendered through its provision of health care and its teaching and research. Most im­ portant, we should make our dedication to the children who will benefit from this new building and the activities which will occur here. Isadora Duncan once wrote that "so long as little children are allowed to suffer, there is no true love in this world." Today, the University at Buffalo looks forward to a long relationship with The Children's Hospital and its efforts to show that such love can indeed exist.D WINTER, 1972 11 �Drug Abuse Plateau i One of the nation's leading drug experts warned physicians to be on the lookout for some of the "bizarre complications" that are being reported as a result of use of inadequately sterilized needles of heroin addicts. "One of these is the fatal invasion of the valves of the heart by an organism known as pseudomonas and another is meningitis caused by fungi," Dr. Donald B. Louria said. He is pro­ fessor and chairman of the department of preventive medicine and community health, College of Medicine and Dentistry of New Jersey, Newark. Dr. Louria spoke at the 52nd annual Trends in Internal Medicine program of Continuing Medical Education. The author of "The Drug Scene" and "Overcoming Drugs" also predicted much more malaria among drug users in the next several months. But he believes drug abuse has reached a plateau in America and is on the wane. This is what most of the current studies tell us. The physician believes such programs as "TIP—Turn in a Pusher" is wrong. "It is absolute disaster to have 100 or so 'square type kids' spying on one another in our schools. Introducing this hate technique is bad. You can't introduce hate and keep it only to the pusher." Dr. Louria went on to say that it is important to control the supplies that come into this country. "This is a societal problem and society must do something to make young people feel happy and wanted. Such unhappy and alienated students will only become more alienated by such programs as 'TIP'. Statistics show that the more alienated the student, the more apt he is to smoke marijuana frequently and to seek greater relief from more powerful agents. The pusher who sells him the marijuana may introduce him to other drugs or his companion may do so." "We must offer young people alternatives — playgrounds, athletics, work—to drugs. We must motivate people to get off drugs and be productive, successful citizens. Leisure time and boredom play right into the hands of the pushers." Dr. Louria told the symposium that studies indicate that the more frequently a student uses marijuana, the more likely he is to use other drugs. "If he smokes marijuana only occasionally his chances of going on to other drugs is only one out of five. If he uses marijuana more than twice a week, this increases to one out of two, and if he smokes it at least once a day, his chances of becom­ ing involved with other drugs rises to three out of four." Studies of 20,000 reasonably affluent high school and junior high school students in Northern New Jersey indicate that approxi­ mately 35 per cent used marijuana at least once, but only 15 per cent use it regularly, the physician said. "Five to eight per cent of the students use LSD and about the same number take speed and heroin intravenously. One of the alarming factors is that four to five per cent of the students in ninth grade are already on heroin or cocaine. Use of cocaine, which can be taken by mouth, injection or snuff, is increasing while the others have slowed down." Dr. Louria believes that methadone is the best program to combat heroin addiction but called for stronger controls to prevent it from getting on the street. 12 THE BUFFALO PHYSICIAN �D r . L a w r e n c e J. N e m e t h , c l i n i c a l i n s t r u c t o r i n p e d i a t r i c s a n d director of the adolescent drug program at Children's Hospital, spoke about the Erie County program. " W e have treated about 200 patients in the inpatient and outpatient program last year, and 40 per cent were over 21 years of age. We had some problems with the under 18-year-olds who didn't want their parents to know they were on hard drugs. But generally our problems are not as great as those of the New York City area." Dr. Nemeth hopes there can be better co-ordination among the 80 Erie County agencies dealing in drug a b u s e . • $5.5 Million to Roswell Park Roswell Park Memorial Institute received the largest federal grant ($5,523,822) in its 75-year history to build a cancer cell center in the block bounded by Ellicott, Carlton, Oak and Virginia streets. The grant amounts to almost one-third of the total construction funds set aside by the National Cancer Institute for the entire country. The cell center will probably be completed in 1975, according to Dr. Gerald P. Murphy, director of the institute. He is also a research associate professor of surgery (urology) at the Medical School. Dr. Murphy also received a one-year federal grant of $108,703 to help develop a national prostatic cancer project.• Child Psychiatry Director D r . T h o m a s F. A n d e r s i s t h e n e w d i r e c t o r o f t h e d e p a r t m e n t o f child psychiatry at Children's Hospital. He is also an associate pro­ fessor of psychiatry and pediatrics at the Medical School. Dr. Anders has been at the Albert Einstein College of Medicine since 1967. He has also been on the faculty of Columbia Psychoanalytic Clinic and the Columbia University Nursing School. Dr.. Anders received both his A.B. and M.D. degrees from Stan­ ford University in 1956 and 1960. He interned at Mount Sinai Hos­ pital, New York City. He was an assistant resident in pediatrics at the Children's Hospital Medical Center, Boston (1961-62) and senior resident in psychiatry, Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute, New York City. The new director has been an assistant visiting physician at Morrisania Hospital; an assistant and adjunct attending psychiatrist at Montefiore Hospital and Medical Center; and senior investigator a t t h e R o s e F. K e n n e d y C e n t e r f o r M e n t a l R e t a r d a t i o n a n d H u m a n Development, Albert Einstein College of Medicine. He holds a cer­ tificate in psychoanalysis from Columbia and was certified by the American Board of Psychiatry and Neurology in 1970. He has written several papers on the newborn.• WINTER, 1972 13 �Lawrence Millhofer, a second-year medical student, visits with head nurse (2nd floor) Mrs. Antoinette McCuire and Mrs. Dorothy Fuller, LMP, at the Wyoming County Hospital, Warsaw. An Upstate (Syracuse) Medical student, Leo Scarpino (white jacket) and a fourth-year UB physical therapy stu­ dent, Philip Morris, visit with a patient at the Jamestown W.C.A. Hospital. Miss Judith Stoyell, a fourth-year nurs­ ing student, and Mrs. Patricia Stopen, director of public health nursing, Wy­ oming County. Judith hopes to go into Public Health Nursing after graduation. THE BUFFALO PHYSICIAN �Rural Health Care "It was a fantastic summer experience in rural health care." That was the consensus of 34 Health Sciences students who participated in the third annual eight-week summer externship program in Western New York. The students in the Schools of Medicine, Den­ tistry, Pharmacy, Nursing, and Health Related Professions partici­ pated in the program. They were almost unanimous in their praise for their preceptors and how they went out of their way to help them get involved in community activities and affairs. The students liked the direct patient contact and they loved the rural living and the friendly environment. They were well accepted by the health professionals and the patients in the communities where they worked and lived for two months. One future physician said, "almost all the patients accepted me as a doctor and discussed their problems and ailments quite frankly. I was accepted well by the doctors, nurses, and other hospital per­ sonnel. In fact, any limitations placed on my activities were selfimposed. Areas where I lacked knowledge, I would let the doctor take over." Mark Twichell, a dental student said, "I got a better idea of rural health care and the local people liked the idea of a student being in the dental office." Lynn Piersall, a medical technology student said, "It was an invaluable experience. I learned many skills that I could only learn through a concentrated clinical practice." John Frischholz, a pharmacy student said, "It was a stimulating experience for me. Many of my unanswered questions were an­ swered." Richard Walcott, a medical student said, "I only wish the ex­ perience could have been 12 weeks or longer." Linda Fremming, a nursing student said, "I had the opportunity to observe, participate and learn about medicine and to see the patient and his problems." Other general student comments: "Most people as patients seemed happy to help 'young doctors' by reviewing their signs and symptoms; the people of both the hospital and town accepted me and it resulted in several new friendships; medical practice was quite sophisticated and very excellent; initially I held a stereotyped view of rural medicine as being inferior to or behind that of larger city hospitals. I have found this to be completely false. I discovered that small doesn't necessarily mean inferior, and rural should not be equated with behind the times." Robert Mohr, a medical student, outlined his experiences as follows: the first week was an orientation of the W.C.A. Hospital (Jamestown), its services and personnel; the second and third weeks were in the office of Dr. Carl F. Hammerstrom where I received an overview of the practice of an internist—helping with physical exam­ inations, blood tests, and taking histories; the fourth and fifth weeks WINTER, 1972 15 Joe Dolce, fourth-year pharmacy stu­ dent, and Ray Hunt, chief pharmacist, Brook Memorial Hospital, Dunkirk, check an order. Mark Twichell, a second-year dental student observes as Dr. Robert Watson of Gowanda examines Randy Agle's teeth. �we observed surgery; the sixth week we viewed pediatrics with Dr. Woodward; the seventh week was in maternity with Dr. Messinger; and the eighth week with Dr. Sinatra in family practice. "I spent my evenings in the emergency room where the phy­ sicians were extremely helpful. It was here that I had a chance to try out my diagnostic skills. I also spent time in physical therapy, speech and hearing, social service, with visiting nurses, dietary, coun­ ty health services and inhalation therapy. I saw all facets of medical and health professions. All areas of the hospital were open to us and we were able to communicate with the other students and medical and hospital staff," Mohr said. Listed below are the host preceptors, participating hospitals, the 34 health sciences students (college listed if other than UB), and their disciplines: Marge Wilhelm, fourth-year physical therapy student, and Dr. Wesley Sly, head of the department of physical therapy at Brook Memorial Hospital, Dunkirk, adjusting the head traction machine. Jamestown, N. Y. - H. Gregory Thorsell, MD'57; George Lawn, PhT, DM; Bert Klein, DPM (W.C.A. Hospital). Students — Robert Mohr, medicine; Philip Morris, physical therapy; Leo Scarpino (Upstate Medical Center-Syracuse) medicine; Steven Weinberg (N. Y. College of Podiatric Medicine), podiatry. Dunkirk, N. Y. — Ray Hunt, R.Ph; Edmund Tederous, MD'43; Ronald Passaforo, MD; Wes Sly, PhT, DM (Brooks Memorial Hospital). Students—Joseph Dolce, pharmacy; Nicholas Fuerst, medicine; Margaret Wilhelm, physical therapy. Olean, N. Y. — Rena Houghton, RN; Arthur L. Beck, MD'57; Anthony Torre, PhT; Sister Mary Josephine, medical technologist; Donald Jones, R.Ph (St. Francis Hospital). Students—Dorothy Ackerman, nursing; Dave Lillie, medicine; Mary Opalinski, physical ther­ apy; Lynn Piersall, medical technology; Patti Witt, pharmacy (University of Texas-Austin). Two students, Bob Mohr, second year UB medical student, and Steve Wein­ berg, New York College of Podiatry, observe as a nurse takes a patient's blood pressure at the Jamestown W.C.A. Hospital. Wellsville, N. Y. — Richard Green, R.Ph; Thomas Wick, PhT (Jones Memorial Hospital). Students — Michael Kellick, pharmacy; Deirdre Robinson, physical therapy. Portville, N. Y. — Duncan Wormer, MD. Student — John Marra, medicine. Dansville, N. Y. — Victor Breen, MD'40; Calvin Waterbury, R.Ph; Jean Goings, RN (Dansville Memorial Hospital). Students — David Breen, medicine; Albert Campagna, pharmacy; Richard Ferreras, medicine; Linda Fremming, nursing. Salamanca, N. Y. — David Widger, MD (Salamanca District Hospital). Student—Charles Natalizio, medicine. Gowanda, N. Y. — Fred Occhino, DO; Robert Watson, DDS. Students —Anibal Rivera (University of Puerto Rico), medicine; Mark Twichell, dentistry. Warsaw, N. Y. — Fred Heller, PhT; James MacCallum, MD'37; Patricia Stopen, RN (Wyoming County Hospital). Students — Richard Baumgardner, physical therapy; Lawrence Millhofer, medicine; Judith Stoyell, nursing; Richard Wolcott, medicine. Bradford, Pa. - Dorothy Ekas, RN; Lloyd Cannedy, PhD; Dorothy Blacklock, social worker (Bradford Hospital). Students — Amy Colella (University of Pittsburgh), nursing; David Klein (Mt. Sinai Program Hospital Administration), hospital administration; Bridget Robinson (Mt. Holyoke College), social work. 16 THE BUFFALO PHYSICIAN �Newfane, N. Y. — Lee Vermeulin, R.Ph; John Argue, MD'35 (Newfane-lnterCommunity Hospital). Students — John Frischholz, pharmacy; B. Dale Magee (Upstate Medical Center-Syracuse), medicine. Lockport, N. Y. — Christine Dini, LPT (Mount View Hospital). Stu­ dents — Kurt Elander, physical therapy; Steve Cash, physical therapy. Rotating Dental Project - Donald Bissell, DDS. Student - Carol Herzlinger, dentistry.D Children's Hospital and the School of Medicine will co-operate in a multi-faceted investigation of hereditary and environmental factors that affect a baby in its mother's womb. The three-year study is being done under a $500,000 grant from the National Institute for Child Health and Human Development. The principal investigator is Dr. Ronald G. Davidson, professor of pediatrics and director of the Division of Human Genetics at Children's Hospital. The goal of the project is to develop better techniques for prenatal detection of defective infants in time to treat them before birth, if possible, or to give a mother the option of having an abortion and trying again for a normal baby. Two research assistant professors of pediatrics, Drs. Mario Rattazzi and Patrick Carmody, are providing biochemical data for other researchers as well as information on a large group of in­ herited diseases which lead to degeneration of the nervous system resulting in severe mental retardation and early death. Seven other Medical School faculty members associated with Children's Hospital are participating in the project and their areas of research are: —The effect of environmental factors that may cause birth de­ fects by altering heredity-controlling genes, Dr. Judith A. Brown, re­ search instructor in pediatrics and Dr. Anil B. Muhkerjee, research assistant professor of pediatrics. —Possible effects of drugs taken by women who may be preg­ nant but are still unaware of the pregnancy, Dr. Sumner Yaffe, pro­ fessor of pediatrics and co-investigators. They are working with laboratory animal embryos and with volunteer human mothers. —The potential role of viruses and other infectious agents for the developing baby and ways to detect before birth the baby that is damaged by such infection, a team headed by Dr. Pearay L. Ogra, associate professor of pediatrics. —The role of immunoglobulins and white blood cells in the de­ velopment of mechanisms for resistance to infections, Dr. Margaret H. MacGillivray, associate professor of pediatrics. —The ability of the developing embryo to produce hemo­ globin, Dr. Robin Bannerman, professor of medicine, and Dr. Martha Kreimer-Birnbaum, research assistant professor of medicine and biochemistry. They hope to learn more about the mechanisms of normal blood development and abnormal development in diseases such as sickle cell disease.D WINTER, 1972 17 Detecting Defective Prenatals �A Better Test Gonorrhea Dr. Apicella in his lab at the Meyer Hospital A better serologic test for gonorrhea may stem from the research work of Dr. Michael A. Apicella in the unit of infectious disease, Department of Medicine. Studies in this laboratory have resulted in the isolation of the beta antigen of Neisseria gonorrhoeae from the crude alkaline extracted endotoxin of this organism. Says Dr. Apicella "studies of purified constituents from the cell wall of this organism might help to eliminate cross reactivity with other bacterial antigens, a major problem in serologic tests proposed for use in detection of acute gonococcal infection today." When the SUNY at Downstate graduate (1963) arrived in Buffalo two years ago, he had already studied the isolation and physicochemical properties of the capsular antigens in several sero­ types of Neisseria Meningitidis (while serving in the U. S. Air Force as director of the infectious disease research laboratory at Lackland Air Force Base). But, with the rise in venereal diseases and an urgency for the practical application o^ research to medicine, his laboratory added the study of gonococcal cell wall antigens for ultimate use in serologic testing systems to its continuing work on meningoccal antigens. A Buswell Fellow, Dr. Apicella began to experiment with an extract of the gonococcus previously described by Dr. Johann Maeland, a former Buswell Fellow in the Center for Immunology. From this crude preparation, Dr. Apicella was able to isolate purified beta antigen. The yield, extremely low, required approximately five grams of dry organisms to produce eight to ten milligrams of anti­ gen. Immunochemical analysis indicated the antigen to be an acidic glycoprotein free of gonococcal alpha antigen and common entero­ bacterial antigens. Explained Dr. Apicella, "recent epidemiological studies indicate that a large reservoir of asymptomatic individuals with acute gono­ coccal infection exist in our population. But, unlike Syphilis, little is known about the effect of long-term gonococcal infection in these individuals. However, they serve as a source for acute debilitating infection in others, necessitating therapy with potentially allergenic drugs and resulting in considerable loss of man and woman power. In addition, the gonococcus potentially can invade the blood stream of some infected individuals usually causing arthritis and, more rare­ ly and ominously, endocarditis. A serologic test, which could detect acute gonococcal infection, is the only way to eliminate the asymp­ tomatic carrier and halt the recent spiral in gonococcal infection, which has made this organism the causative agent in America's No. 1 reportable bacterial infection."• 18 THE BUFFALO PHYSICIAN �D r . W a y n e L. J o h n s o n h a s b e e n n a m e d p r o f e s s o r a n d c h a i r m a n o f the department of gynecology-obstetrics at the Medical School. He will also be chief of the gyn-ob service at Children's Hospital. He comes to Buffalo from the Indiana University School of Medicine where he has been a professor since 1969. He was also on the attending staff of Coleman Hospital, Indiana University Medical Center, and chairman of gyn-ob at Marion County General Hospital. Dr. Johnson received his medical degree from the University of Virginia School of Medicine in 1954. He interned at Cleveland Metropolitan Hospital and took his residency at the University of Virginia Hospital. He was a medical officer in the United States Army for two years (1955-57), and was on the faculty at the Univer­ sity of Virginia and the University of Washington Medical Schools after returning from the service. In 1967 Dr. Johnson was a special consultant for Project Hope in Peru and at Madigan Army Hospital, Tacoma, Wash, in 1968-69. He has authored or co-authored 40 papers. He is a Fellow in the American College of Obstetricians and Gynecologists and a Diplomate in the American Board of Obstetrics and Gynecologists. Dr. Johnson will assume his new duties in January.D Dr. Johnson Named Gyn/Ob Chairman mJi Dr. Johnson Chinese Medical Student Hing Har Lo, a Chinese born American citizen, is a third year student in the School of Medicine. She is o n e of approximately 400 Chinese students at the University. Before coming to Buffalo she worked for five years as a radiation physicist at the Massachusetts General Hospital. In May Hing Har Lo was awarded the Grace Le Gendre Fellow­ ship of $1,000 given by the New York State Federation of Business Professional Women's Clubs. The Amherst BPW sponsored her. Hing Har Lo received her bachelor's degree from Adelphi University, Garden City, N. Y. and her master's from Cornell University, Ithaca. She completed high school in Hong Kong. Her father was a repre­ sentative of General Electric in China. The family left for Hong Kong on the last commercial flight out of Chung King several years ago. She has two brothers and a sister in North America (California, Florida, Vancouver, B.C., Canada). Last summer Hing worked in research in immunology at the University. She hopes to specialize in nuclear medicine. She is proud of her U. S. citizenship and deems it a privilege to work and study in this country. "I am glad President Nixon visited China and I hope the two countries are drawn closer together. Although I am opposed to Communism, I always will have a feeling of love for the country of my birth," she said.D WINTER, 1972 19 Hing Har Lo �Students and faculty participate in a give-and-take session. Two second-year medical students, Donna Hanlon and Patricia Hart, are awed by the new revised manual. This manual is the "core" of the material that stu­ dents should know and be able to use. New Teaching Techniques in Pharmacology 20 THE BUFFALO PHYSICIAN �Students will list their top three choices and most are matched with their first choice. T H E PHARMACOLOGY DEPARTMENT h a s developed a new look based on variety, flexi­ bility, self-instruction and responsiveness to student needs. New teaching techniques and a newly revised manual are features of the basic medical course to start in January for 130 sec­ ond-year students. There will still be class lectures, but they constitute only about one-half of the scheduled class hours. Other learning opportunities in­ clude panel discussions, clinical conferences, demonstrations, seminars, films, tapes, and spe­ cial topic sessions, said Dr. Cedric Smith, pro­ fessor and chairman of the pharmacology de­ partment. All lectures and panel discussions will be taped and available for review by the students. "We will use problem and case-centered learning more extensively. This will encourage the utilization of knowledge as opposed to memorization for facts only," Dr. Smith said. " O u r basic goal will still be teaching stu­ dents the way drugs act and their rational use in therapy." "We will continue to prepare examinations to assist students in their own assessment and to help them identify areas of weakness. Stu­ dent input and discussion following each exam­ ination permits reinforcement of the material as well as improvement in the quality of the scoring. The examination, as well as student evaluations, makes it possible for the staff to continually improve the quality and effective­ ness of their instruction." Of perhaps most significance is an informal student group of 6-12 members chosen by the student class to meet periodically with no more than two staff members to discuss informally any problems that either students or staff have. These discussions have proven most fruitful to both groups last year and serve, in large part, to identify problems and to prevent bigger dif­ ficulties from arising. "These innovations clearly indicate the dedi­ cation of the staff for the teaching process," commented Dr. Smith. "We all look to con- Dr. Edson X. Albuquerque, professor of pharmacology, demons strates the new tape recorder to second year medical students, Jan Schwartz and William Hall, who is president of his class. One of the new learning tools will be a newly revised manual which will be a "core" of substantive material that all students of medicine should know and be able to use. This includes an outline of essential material as well as reference material and recommended reading. There are also problems and questions usually taken from medical case histories. Students will also have special topic sessions of two to three hours per week for five to eight weeks in groups of 5 to 12. In this period the students will have more than 14 options that include laboratory demonstrations, clini­ cal rounds, seminars by the students, inde­ pendent library work, formal classes and clinics. In these the students choose from a variety of topics — such as neurochemical aspects of p s y c h o t r o p i c d r u g a c t i o n , al c o h o l i s m , p h a r m a ­ cology in anesthesia, cancer chemotherapy, drug regulations, pediatric or neo-natal phar­ macology, clinical pharmacology, digitalis and heart function and behavioral pharmacology. WINTER, 1972 21 �Dr. Robert I. Mclsaac, professor of pharmacology, uses charts in his seminar sessions. tinued improvements." He sees the most press­ ing challenges as: (1) More flexibility in scheduling and greater utilization of self-instructional and selfpaced programs for both "core" ma­ terial and special topic activities, with the focus on problem and case-centered learning. (2) The introduction of rational drug man­ agement and clinical pharmacology so that eventually two courses, one pri­ marily basic and one primarily clinical, would be available. (3) Facilities and services that respond rap­ idly and efficiently to faculty needs in developing new educational programs.n Continuing Medical Education Eight Continuing Medical Education Conferences are tentatively scheduled beginning in January and ending in June. For further information contact Mr. Charles Hall, director of continuing medical education, at 2211 Main Street or call (716) 831-5526. Other pro­ grams will probably be added. January 4-May 31, Clinics in Physical Examination of the Heart Patient and Arrhythmia Workshops (20 Thursday evenings); Feb­ ruary, Modern Concepts of Coronary Care; April 4-6, Pediatric Endocrinology; April 6-7, Spring Clinical Days (sponsored by Medi­ cal Alumni Association); April 14-15, Anesthesiology; May 3, Post Operative Infections (with WNY Chapter, American College of Surgeons); May 16-18, Fetal and Neonatal Monitoring; June, Pedi­ atric Refresher Seminar.D 22 THE BUFFALO PHYSICIAN �Many people visited the basic science departments. Dr. Om P. Bahl, professor of biochemistry, explains some of his research. Dr. lack Lippes, associate professor of Cyn/ob, talks about family planning. Community-University Day It was a rainy Sunday afternoon, but 5,000 people came to the campus for the 2nd annual Community-University Day (open house). The Medical School did its share of "selling" the University to the community. The Medical School tested for Sickle Cell Anemia and had an exhibit on the "Physiological Effects of Transcendental Meditation." There were tours of the Amherst Campus and some 80 displays and exhibits (including moon rocks, movie­ making and computers). There were concerts by several musical groups, art exhibits and theater, as well as athletic events and demon­ strations. Others visited with President Ketter, faculty members and students. WINTER, 1972 23 �Polluted Waters Threaten World's Protein Supply Waters polluted by methyl mercury threaten the use of protein for human and animal consumption. That's what a biochemical in­ vestigator and expert on water pollution at the University found following a 290-day study on rainbow trout. Fed but a single dose of methyl mercury, Dr. Edward Massaro calculated that it would take the rainbow trout more than 1000 days to lose half of the pol­ lutant from their bodies. But, he warned, this would be true only if they were never again placed in a mercury-polluted environment. About half of the total original mercury dose is stored in the skeletal muscles (the edible portion) of the fish (55 percent of its weight). Seventy percent of the total mercury in the fish was found in its muscle tissue at 100 days. Only nine percent of the initial dose was lost by the fish during the last 190 days of the experiment. Through isotopic labeling, the associate professor of bio­ chemistry determined to what tissues mercury is distributed in the fish as well as how long it is retained. The blood, gills, spleen and liver took up high concentrations of methyl mercury at the fastest rate, one hour after feeding, reaching its maximum at seven days and dropping by day 100 to a third of its original value. However, uptake of mercury in the muscle, brain, and lens of the eye proceeded at a much slower rate and these organs held the pollutant the longest. While it took 60 days for muscle and 34 for the brain to reach maximum levels, the lens continued to take up mercury after 250 days. Perhaps, said Dr. Massaro, methyl mercury is a precipitating factor for the cataracts found by Japanese investi­ gators in some fishes. Dr. Massaro What are the implications for man? With a greater demand for protein as the population increases, an efficient way of removing mercury from lake waters may have to be found. Levels were very low in the brain of the fish — high concentrations would be lethal. Underway is a project by Dr. Massaro on the effect of mercury on the mammalian brain — learning and behavior. By introducing low levels of mercury intraperitoneally, the investigators — a team of biochemists and psychologists — observed rapid changes in brain metabolism and behavior of the mouse as well as prolonged mercury uptake in the brain. What are the implications for learning and of behavior in humans? Explained Dr. Massaro, "no one has looked at what effects very low levels of different toxic elements have on living systems, on behavior, etc. How much does it take to disrupt brain metab­ olism? What are the mechanisms that determine toxic material storage in the human?" Investigation currently underway on children intoxicated with lead are encouraging but until sufficient experimentation with ex­ perimental animals is concluded we cannot have all of the answers, he said. "Another area we would like to explore are the synergistic effects of a variety of different toxic materials on the human." Concluded Dr. Massaro, "pretty much the same kinds of things are going on in other species of fish as well. We must get going on the problem of water pollution and start working, in a serious way, on its many ramifications/'D 24 THE BUFFALO PHYSICIAN �New International Journal T h e first i s s u e o f a n e w i n t e r n a t i o n a l j o u r n a l d e v o t e d t o p r o m o t i n g , on a worldwide basis, the rapid dissemination of original work on all aspects of immunology, has just been published. It is immuno­ logical Communications, founded by The Center for Immunology of the School of Medicine. The six issues to be published each year are of eminent value to immunologists, biochemists, microbiologists, virologists, cell biologists, molecular biologists, pediatricians, sur­ geons, and those involved in internal medicine and cancer research. Its e d i t o r i a l c o m m i t t e e o f f i v e f r o m t h e U n i v e r s i t y u n d e r c h a i r ­ m a n D r . N o e l R. R o s e ( p r o f e s s o r o f m i c r o b i o l o g y , a s s i s t a n t p r o f e s s o r of medicine, and head, The Center for Immunology) are Dr. Pier L. B i g a z z i , r e s e a r c h a s s o c i a t e p r o f e s s o r o f m i c r o b i o l o g y ; D r . S t a n l e y Cohen, professor of pathology and acting head, The Center for Immunology; Dr. Allan Grossberg, research professor of micro­ biology; Dr. Morris Reichlin, professor of medicine and research p r o f e s s o r o f b i o c h e m i s t r y ; D r . C a r e l J. v a n O s s , p r o f e s s o r o f m i c r o ­ biology. A n d its 2 9 - m e m b e r e d i t o r i a l a d v i s o r y b o a r d i n c l u d e s m o s t o f the internationally renowned researchers in the field of immunology f r o m t h e U . S., C a n a d a , E n g l a n d , F i n l a n d , A u s t r a l i a , T h e N e t h e r l a n d s , Israel, Czechoslovakia and Japan.• Community Psychiatry Grant The Division of Community Psychiatry at the University has been awarded a $148,000 grant from the National Institute of Mental Health to measure the quality of mental health services. The threeyear project, headed by Dr. Jack Zusman, director of the Division and professor of psychiatry, has been supported for the past two years through funds from the United Health Foundation of Western New York, a United Fund agency. According to Dr. Zusman, "millions of public and voluntary dollars are spent annually in this community without any scien­ tifically v a l i d m e a n s o f a s s e s s i n g t h e q u a l i t y o r e f f e c t i v e n e s s o f t h e (mental health) services supported by these funds. Spending mil­ lions of dollars on services and only pennies to evaluate these s e r v i c e s is a f a l s e e c o n o m y a t b e s t . " T h e u l t i m a t e p u r p o s e o f t h e r e s e a r c h is t o d e v e l o p t h e s c i e n t i f i c t o o l s t o e n a b l e a n a g e n c y t o d e t e r m i n e t h e a d e q u a c y o f its s e r v i c e s a n d p i n p o i n t a r e a s w h i c h need improvement^ WINTER, 1972 25 �Dr. George Thorn, Emeritus Professor A. N INTERNATIONALLY respected endocrinologist, Dr. George Widmer Thorn is far more than a recognized expert on disturbances of t h e adrenal gland. He is the e p i t o m e of t h e medical triad; a teacher, clinician and researcher. Born in Buffalo, New York, in 1906, he attended the College of Wooster for two years and then entered the University of Buffalo School of Medicine, receiving the M.D. degree in 1929. Lor six years he remained at Buffalo, first as a house officer (1929-30) at the Mil­ lard Lillmore Hospital and then as an assistant in the dfepartment of physiology and medicine. It was during this time that he collabor­ ated with Dr. frank A. Hartman in preparing a crude form of adrenal-cortical extract used in the treatment of Addison's disease. These compounds compensated for the body's lack of cortisone and restored the natural sodium-potassium balance. Although "cortin" did not cure Addison's disease, it arrested its progress so that patients could again lead useful lives. In 1934 Dr. Thorn came to Harvard Medical School as a Rocke­ feller fellow in Medicine. Shortly thereafter (1936) he accepted an associate professorship of medicine at Johns Hopkins School of Medicine. He returned to Harvard in 1942 when he was appointed to the oldest and most distinguished chair in American medicine as Hersey Professor of the Theory and Practice of Physic. Simul­ taneously he became Physician-in-Chief at the Peter Bent Brigham Hospital, positions he now holds. In 1968 Dr. Thorn, with his ap­ pointment as Samuel A. Levine Professor of Medicine, became the occupant of two endowed chairs. Dr. Thorn's research has concentrated on endocrinology and metabolism. He pioneered in studies of salt and water metabolism, the effects of high altitude on adrenal function, the myopathy of thyroid disease, and he has made significant contributions in further­ ing medical knowledge of diabetes mellitus. George Widmer Thorn, M.D. Hersey Professor of the Theory and Prac­ tice of Physic, and Sam­ uel A. Levine Professor of Medicine, Harvard Medical School and Head of the Depart­ ment of Medicine at the Peter Bent Brigham Hospital; Physician-inChief, Peter Bent Brigham Hospital. On June 30, 1972 Dr. Thorn be­ came Emeritus Professor.• But perhaps his greatest contribution is his research on corti­ sone and ACTH (adreno-corticotropic hormone) and the develop­ ment of its use in the treatment of numerous diseases. He was among the first to show that complete adrenalectomy could be performed in man, and he initiated the earliest work in human kidney transplantation at the Peter Bent Brigham Hospital. In 1946, Dr. Thorn was attracted to the possibility of making an artificial kidney along the lines of that originally designed by Dr. Kolff, who, shortly after the War, told o n e or two American scientists about this development. Dr. Thorn immediately gathered around him an able team to construct this kidney and by 1948 and 1949, Dr. Thorn's Department was the first in the United States to have an active dialysis program for the treatment of renal failure. Dr. Thorn used this not only to treat renal failure, but as a basis for his later interest adrenalectomy for hypertension, in the patho­ physiology for advanced renal disease, and for his collaborative work with the Department of Surgery in the initial trial of kidney transplantation. This was done in 1951, and could not have occurred without Dr. Thorn's interest in dialysis and his original and pioneer­ ing work in the use and construction of an artificial kidney. 26 THE BUFFALO PHYSICIAN �More recently Dr. Thorn has devoted a substantial portion of his research and teaching interests to cardiovascular diseases. A major aspect of his endeavors has been in the diagnosis and treat­ ment of patients with hypertension. Through his efforts, stand­ ardized procedures have been developed, particularly for those patients with remediable hypertension due to adrenal gland overfunction and to kidney disease. Dr. Thorn is a highly respected teacher, known for his lucid presentations. His skill in the design, execution and interpretation of clinical experiments has been transmitted to many generations of Harvard Medical students who have gone throughout the world to extend his teachings in diverse fields of scientific investigation and clinical practice. His laboratory at the Brigham often has been called "a medical U.N." Dr. Thorn is one of the founding Editors of the medical text­ book "Principles of Internal Medicine" which has pioneered in new technics of presenting medical material to students as well as to practitioners. This textbook is now distributed on a world-wide basis and regularly translated into several languages. He is also the author of a monograph on Addison's Disease. He presently is on the Advisory Board of the "American Journal of Medicine". National and international awards bestowed upon Dr. Thorn are numerous. He holds eight honorary degrees: Harvard (1942); Dalhousie (1950); Temple (1951); Queens University, Ontario (1954); Over 700 physicians trom Canada and the states attended a two-day immunodermatology Workshop in june. During the conference, directed by professor of microbiology Ernst H. Beutner and his microbiology associates, clinical assistant professors Clark Triftshauser and William Hale, and assistant professor Russell Nisengard, the regis­ trants — practicing dermatologists and internists — were exposed to reviews and demonstrations of current meth­ ods for immunopathologic studies of skin diseases and its relation to other diseases involving auto-aggression. There were demonstrations of procedures for available diagnostic methods and a review of basic concepts to laboratory findings. Among the teaching faculty — all experts in the field — were microbiology chairman Felix Milgrom, Mayo Clin­ ic's Robert Jordon and Warsaw Academy of Medicine's Tadeusz Chorzelski. Co-sponsors of the two day con­ ference were the microbiology department, the Rochester Dermatology Society and the Eastwood Pharmacology Company of Buffalo.O �Medical Society of the State of New York Cocktail Party Hosted by: SUNY at Buffalo Medical Alumni Association David K. Michael Open to: All Alumni and Friends Monday, February 12, 1973 Royal Ballroom, B Americana Hotel New York City Medical Alumni Association 1973 Spring Clinical Days Statler Hilton Hotel April 6 & 7 Guest Speaker: Leonard Wood­ cock, President UAW, speak­ ing on Universal Health In­ surance Program will feature: Clinical Pharmacology with emphasis on drug reactions and inter­ actions as applied to all areas of clinical practice. 1973 REUNION CLASSES April 6-1923 April 7-1928, 1933, 1938, 1943, 1948, 1953, 1958, 1963. (details later) Louvain University of Belgium (1960); Suffolk (1961); College of Wooster (1963); and the University of Geneva, Switzerland (1965). Among his honors are: the American Medical Association's Gold Medal; Alvarenga Award; Gordon Wilson Medal of the American Clinical and Climatological Association; John Philips Memorial Award of the American College of Physicians; Modern Medicine Award; the George Minot Award of the American Medical Associa­ tion; and the Julius Adams Stratton Prize for Cultural Achievement from the Friends of Switzerland. Dr. Thorn is a fellow of the American Academy of Arts and Sciences, a member of the Executive Committee of the Corporation, Massachusetts Institute of Technology, a member of the Association of American Physicians (president, 1969-70), and a member of the American Clinical and Climatological Association (president, 195859), American Physiological Society, American Society for Clinical Investigation, Endocrine Society (president, 1963), Society for Ex­ perimental Biology and Medicine, Federation of American Societies for Experimental Biology, the Royal College of Physicians (Great Britain), the Royal Society of Medicine, the Royal Academy of Medicine of Belgium, Commander in the Order of Hipolito of Unanue, Peru, the Norwegian Medical Society and honorary mem­ ber of the Indian Society of Endocrinology. He is a Master of the American College of Physicians, Consultant to National Medical Care, Incorporated and Chairman of the Editorial Board of Medical Communications, Incorporated. Dr. Thorn is also a member of the Swedish Medical Society. Dr. Thorn will continue his activities as Director of Medical Re­ search of the Howard Hughes Medical Institute; as an editor of the PRINCIPLES OF INTERNAL MEDICINE; as a member of the Executive Committee of the Corporation, Massachusetts Institute of Tech­ nology; and effective last July 1 he began his duties as Editor-inChief of the MEDCOM Faculty of Medicine.• A Moral Issue A 20-minute film—"Witch Hunt of a Doctor" — that deals with a controversy over a moral issue at the Medical School in the 1850's has been produced by the Lakes Area Regional Medical Program. Co-operating in the venture was the Erie County Medical Society, the Medical Society of Western New York and the Health Sciences Faculty at the University. The film tells the story of Dr. James Piatt White, professor of obstetrics at the Medical School, bringing 22 medical students to a basement to witness a birth by an unwed mother. This was the first clinical observation by students in the United States. One member of the community wrote some letters to a Buffalo newspaper noting this practice by Dr. White as immoral and indecent. A court case ensued. The film describes the court trial and the birth of the baby.Q 28 THE BUFFALO PHYSICIAN �Artist's drawing of planned expansion at The Buffalo General Hospital. New build­ ing, at left, would be 73 sto­ ries high instead of the 76 as shown, but could be ex­ panded to 76 stories at some future date. Construction is expected to start in the spring of 1974 for the $75,800,000 expansion and modernization of the Buffalo General Hospital. Hospital officials are seeking agency approval and funding. A major feature of the building program will be incorporation of the hospital's emergency and outpatient clinics into an ambulatory services program that will provide continuous care for residents of the neighborhood as well as others in the hospital referral area. This will be in the basement of the new building. The project includes: —Expansion of the present Rudolf G. Hils Building from the cor­ ner of Ellicott and Goodrich Streets, horizontally to High Street and vertically to 13 stories over-all. The existing building is just four stories above ground. —An increase of the hospital's inpatient bed capacity to 704 from 689. A total of 589 of the 704 beds would be located in the Hils Building and the other 115 in the adjacent West Building, opened in 1951. —Demolition of the East Building, constructed in 1896, and elimination of the large patient wards located there, one of which has 27 beds. —Modernization of the West Building, Clifton Memorial, the first part of which was opened in 1917, and the South Building, opened in 1933. Non-conforming operating rooms will be eliminated and a new suite of operating rooms opened on the second floor. New diag­ nostic X-ray facilities will be on the third floor. Outdated electrical and ventilation systems will be revised. Office and laboratory space will be expanded for related teaching, research and development programs. Rogers, Butler, Burgun and Bradbury of New York City, who developed the hospital's long-range building program in 1964, are the architects. Phase I was completed and put into operation in November of 1969.• WINTER, 1972 29 $75.8 Million Expansion For BGH �Allergic Disease Center A husband and wife M.D. team, Atsuko and Tadao Okazaki, are working on histamine estima­ tion with Dr. Arbesman. BUFFALO has been added to the National Institute of Allergy and Infectious Disease network of nine allergic disease centers. One of only two to be funded this year, it will be directed by Dr. Carl E. Arbesman, clinical professor of medicine and microbiology who heads the allergy research laboratory at both the Buffalo General and Children's Hospitals. Under a $57,470 grant (it will cover the first year of a three-year The seven original Centers, estab­ lished in June 7977, are located at: Robert B. Brigham Hospital, Bos­ ton; Johns Hopkins University, Bal­ timore; Washington University, St. Louis; University of Wisconsin, Madison; Scripps Clinic and Re­ search Foundation, La Jolla, Calif.; and Children's Asthma Research Institute and Hospital and National Jewish Hospital and Research Cen­ ter, both in Denver, Colorado. In July of J972 two new centers were established at the University of Michigan and Buffalo General Hospital.• program) he will work with entomologists, biochemists and others in the field to find better methods of protection for the vulnerable from serious insect stings. From the venom of bees, wasps, hornets, and yellow jackets — more deaths in this country due from these than from poisonous snakes — the multidisciplinary team will try to develop more specific and effective extracts for use in immuniza­ tion against such stings. Said Dr. Arbesman who has contributed over 300 publications to the literature as well as a new tool to study various immunological factors involved in allergy — the anti E globulin, "reactions to sting­ ing insects may range from local swelling, disability for several days, hives, difficulty in breathing, to serious anaphylactic shock and death. It is this type of patient that we are most concerned about." 30 THE BUFFALO PHYSICIAN �Migration inhibition factor studies occupy the time of Drs. Lynne Burek and Konrad Wicher. Drs. tynne Burek and Robert E. Reisman do cell sensitization. Dr. Dorland Davis, director, National Institute of Allergy and Infectious Disease; Dr. Luz Froehlich, assistant for clinical programs; Dr. Arbesman, Dr. Reisman, and Dr. William Cay, associate director of extra-mural program for NIAID. �Allergic diseases, which affect over 31 million, take their toll in disability rather than in deaths. And they are the principal cause of disability for the "under 17" age group while the second or third major cause for the "under 45" category. Three National Institute of Allergy and Infectious Disease officials toured the unique research and clinical allergic disease facilities in Buffalo following award of the grant. Said its director Dr. Dorland Davis, "there are tremendous components in Buffalo for the new allergic disease center. The University itself is well staffed with highly-trained immunologists, the hospitals have ex­ cellent clinicians with great skills and interests, and Roswell Park is one of the leading institutions in medical science. We believe that through this concentration of resources—both in terms of pro­ fessional effort and funds—we can accelerate the process by which recent advances in immunology can be more effectively applied to the care of the allergic patient." Dr. Davis pointed to only four projects and $80,000 in grants in 1955 as compared to 280 projects and $15 million in grants today. In establishing these centers for allergy research he pointed to the Institute goal of better diagnosis, prevention and treatment of allergic diseases. "We hope that knowledge gained through these centers will result in better care for those who suffer the debilitating effects of allergy."D Dr. John Wypych and Peggy Kayne examine the fraction collector. Dr. Arbesman's multidisciplinary team: Dr. Robert E. Reisman, clini­ cal associate professor in medicine, pediatrics; Dr. Konrad Wicher, as­ sociate professor in microbiology and research assistant professor in medicine; Dr. John Wypych, re­ search instructor in microbiology and research assistant instructor in medicine; Dr. Willard K. Elliott, professor in biochemistry; Dr. Anthony Yurchak, research assis­ tant professor in medicine; Dr. Tadao Okazaki, research assistant instructor in medicine; Dr. Yosuke Fujita, research assistant professor in medicine; Dr. Allen Benton, as­ sociate professor in entomology; and consultant Dr. Noel Rose, pro­ fessor of microbiology, assistant professor of medicine and director of The Center for Immunology_• �A $630,000 federal grant has been awarded the Lakes Area Regional Medical Program by HEW to underwrite an emergency medical s e r v i c e s s y s t e m i n Erie C o u n t y a n d a H e a l t h E d u c a t i o n C e n t e r i n Erie, P e n n s y l v a n i a . D r . J o h n R. F. I n g a l l , d i r e c t o r o f L A R M P , s a i d t h e s e f u n d s w i l l b e u s e d t h r o u g h A p r i l 3 0 , 1 9 7 3 . T h e Erie C o u n t y Health Department will receive $250,000 and the Pennsylvania center $325,000. The remaining $55,000 will underwrite administra­ tion of the two projects. Both grants may be renewed in subsequent y e a r s if t h e p r o j e c t s p r o v e e f f e c t i v e . The development of the Lakes Area Health Education Center i n Erie, P e n n s y l v a n i a c a m e i n t o b e i n g a s a r e s u l t o f t h e 1 9 7 1 C a r n e g i e Commission Report on Higher Education and the Nation's Health, which proposed the establishment of 126 such centers in the United S t a t e s . T h e p u r p o s e o f t h e s e c e n t e r s is t o p r o v i d e b a s i c a n d c o n ­ tinuing education programs locally for health care professionals, which ultimately will improve the quality of health care delivered in and around the surrounding areas of the center. The LAHEC project has received some previous funding from the Veteran's Administration in Washington and St. Vincent Hospital and Hamot M e d i c a l C e n t e r o f Erie, P a . M i c h a e l C . J. C a r e y o f Erie is d i r e c t o r o f t h e LAHEC p r o j e c t . D r . R o b e r t T. R e n z , o f Erie, s e r v e s a s p r e s i d e n t o f LAHEC. D r . I n g all a l s o a n n o u n c e d t h a t a n e m e r g e n c y m e d i c a l s e r v i c e s system, designed to improve health care by establishing a functional e m e r g e n c y m e d i c a l s e r v i c e s s y s t e m i n Erie C o u n t y a n d e v e n t u a l l y to surrounding communities, will receive $250,000 from the new grant to establish this service. The project was developed by the Erie County Emergency Medical Care "Blue Ribbon" Committee, w h i c h s e r v e s in a n a d v i s o r y c a p a c i t y t o Erie C o u n t y H e a l t h C o m ­ missioner Dr. William Mosher, and the Lakes Area Regional Medical P r o g r a m . T h e s y s t e m is a r a d i o c o m m u n i c a t i o n s n e t w o r k w h i c h will link persons concerned with emergency medical needs such as individual crises to community-wide disasters. Radio equipment will be phased in over a three-year period to hospitals, ambulances, police and fire departments, fire base stations, transit authority, etc., for this use. The project also has an educational component where­ by over the next three years, some 5,000 ambulance and rescue squad attendants will receive special training. The program, Medical E m e r g e n c y T e c h n i c i a n (MET) is m a n d a t e d f o r c o m m e r c i a l a m b u l a n c e attendants and strongly recommended for volunteers by New York State.D S630 000 Gf3.nt ' Two grants have been awarded to a Buffalo microbiologist, Dr. Carel J. v a n O s s . U n d e r t h e f i r s t , a $ 3 2 , 8 0 0 t h r e e y e a r N a t i o n a l I n s t i t u t e s of Allergy and Infectious Diseases grant, the professor of microbi­ ology at the Medical School will continue studies on bacterial sur­ faces, virulence and complement sub-factors responsible for phago­ cytosis. In the second grant, a three year $100,227 National Institute of General Medicine grant, he will continue studies on separating blood serum proteins by ultra-filtration.• Microbiology Grants WINTER, 1972 33 tO LARMP �New Approach to Understanding Hallucinogens There is a new approach to understanding hallucinogens. It grew out of an idea of Dr. Jerrold C. Winter's, an associate professor of pharmacology, who felt that investigating stimulus properties of these drugs might prove informative. "As is true of many of my ideas," Dr. Winter said, "nothing came of it until I was able to convince a graduate student that it might be an interesting topic for a dissertation." The student, Dr. Ira Hirschhorn (he is now at the Medical College of Virginia) ex­ amined the stimulus properties of Mescaline and LSD in rats for two years, finished his thesis and, in Dr. Winter's words, "left me with the sure knowledge that the major emphasis of my personal research program would soon shift to the study of hallucinogens as discriminative stimuli." Explained Dr. Winter, "a traffic light may be thought of as a discriminative stimulus. A feature of our environment, it has come to control a part of our behavior as a result of our prior history of training. If a color-blind investigator had to determine whether a light was red or green he might put the problem to a number of motorists in the guise of a traffic signal and observe their behavior. "If a majority stopped upon encountering it he would conclude that the light was red. But if most drove on by it the color had to be green. Our investigator would thus obtain a nonverbal answer to an unspoken question." Similarly, continued the pharmacologist, by applying well-es­ tablished principles of behavior, communication can be established with nonverbal species or, he explained, "we can in a limited but very well-defined sense talk with the animals and they talk back." Dr. Winter In an experiment with rats, the stimuli are two colorless liquids — one a salt solution and the other containing a hallucinogen such as Mescaline — not red or green lights. Following injection of the drug, some of the lever-press responses made by the animal are reinforced by delivery of food. However, following treatment with saline, no responses are reinforced. They may be punished by de­ livery of a mild electric shock. A pattern of responding soon emerges. On days when mesca­ line is given, bar presses occur at a high rate. When saline is the treatment, response is almost nil. Said Dr. Winter "if we have been careful to rule out all other features of the animal's environment as possible cues, even in this simple experiment we have established a discrimination. Without words we have been told by the rat that it can tell the difference between saline and mescaline." In actual practice while many animals are used in precisely de­ fined experimental designs the principles remain the same. Not only can questions be asked about hallucinogens (as well as closelyrelated nonhallucinogenic drugs) but, as Dr. Winter said, "we can also begin to apply the techniques of neurochemistry and neuro­ pharmacology to the analysis of a behavioral phenomenon. Whether we will learn more about behavior or about hallucinogens is a moot question." A practical application of this investigator's work is the evalu­ ation of new drugs for hallucinogenic activity before they are used in man by comparison with known hallucinogens. Whatever im34 THE BUFFALO PHYSICIAN �portance the abuse of hallucinogens may have, Dr. Winter believes that "it is insignificant when compared with the potential good to be derived from an understanding on the mechanism of action of hallucinogens and the light such understanding may shed on the biological bases of mental illness." Following training as an organic chemist at the University of Rochester Dr. Winter served in the U. S. Navy for three years (he now spends one night a week teaching oceanography to fellow Naval officers). Upon release from active duty in 1962 he came to the University to earn a PhD in pharmacology (1966) and after post­ doctoral training at the University of Rochester Medical School, was invited to return to the University as a faculty member.D New Dermatology Chairman Dr. Richard L. Dobson has been named professor and chairman of the department of dermatology at the School of Medicine at Buf­ falo. He assumed his new duties June 1. He comes to Buffalo from the University of Oregon Medical School, Portland, where he has been an associate professor and professor of dermatology since 1961. He was also a senior scientist at the Oregon Regional Primate Research Center from 1964 to 1968. Dr. Dobson served on the University of North Carolina Medical School faculty from 1957 to 1961. During the 1969-70 year he was on sabbatical as a visiting pro­ fessor of physiology, Catholic University, Nijmegen, The Nether­ lands. Dr. Dobson was born in Boston, did his undergraduate work at the University of New Hampshire in Durham, and received his M.D. in 1953 from the University of Chicago School of Medicine. He interned at the Cincinnati General Hospital (Ohio) in 1953-54. He was a Fellow in dermatology at the Dartmouth Medical School, Hanover, New Hampshire from 1954 to 1956. Dr. Dobson was a Public Health Service Research Fellow of the National Institutes of Health in 1956 and an assistant in dermatology at the Hitchcock Clinic, Hanover, N. H. in 1957. Dr. Dobson has been active in several national and international professional organizations in dermatology and physiology. He has addressed international groups in Japan, Switzerland and Washing­ ton, D. C. Dr. Dobson has authored or co-authored 100 articles for professional publications. He is a Fellow of the American Associa­ tion for the Advancement of Science, the American College of Clinical Pharmacology and Chemotherapy and the American College of Physicians. He is listed in Who's Who and American Men of Science.O WINTER, 1972 35 Dr. Dobson ��' -9 The 1976 Class at Orientation It was a new world for the 135 new medical students (15 more than last year) who arrived on campus early for two days of orientation. There were many "welcomes" — one by Dr. Albert Somit, executive vice president of the University who promised "some significant changes here in the four years before you." As the Main Street campus is vacated he expects to see Health Sciences expand until "about the time you graduate most of this campus as you now see it will be a Health Sciences campus." He also pointed to an entirely different educational program four years hence that is as yet undefinable and perhaps a profound change in the medical profession where "in the doctor's role house calls may be reinstituted." WINTER 1972 �From Vice President of Health Sciences and acting dean of medicine Dr. Clyde Randall, a tribute for the promise shown by each one who sits in this freshman class as well as a reminder of the 30 who apparently did not make it for your place. There was also an assurance that a new vice president for health sciences and a dean of medicine is expected within the next year. "You are a unique class," he continued. "For you reflect the new role of the female in medicine as well as in all aspects of our lives (about one fourth of this class are women)." But he admonished that the variety of possibilities offered by medicine leave no reason to feel stifled or handicapped at any time. And there were rap sessions with sophomores about what courses to take, how to study, etc., a picnic supper and reception to meet faculty. There were also registration, pictures, tours, ad­ vanced placement tests for some and finding a place to live for others. It was a busy, frustrating experience, but everyone adjusted. Dr. M. Luther Musselman, chairman of admissions, said his com­ mittee conducted over 600 personal interviews. "These were se­ lected from the 4,244 applications. There are 36 women in the class and several more minority students than last year. They all come from New York State except 14. Eight of the 14 come from seven states — California, Florida, Mississippi, North Carolina, Ohio, Penn­ sylvania, and Washington, while six others come from the West Indies and Africa. Most of the new students are science majors, but a few majored in German, History, Philosophy, English, French, Anthropology, Engineering, Political Economics and American Studies. The students come from 68 undergraduate colleges and universities." The Class of 1976 did some diagnosing during orientation. Pa­ tient A, a 39-year old former construction worker, was a heavy drinker. He exhibited nausea, vomited, had diarrhea as well as four major epileptic episodes. Could they, as freshmen on their second day of orientation, make a diagnosis? They did. It was acute alcoholism, the greatest drug abuse of our times. It had completely disrupted Patient A's life, now di­ vorced, unable to continue in construction work, self-employed when possible. Program moderator Dr. Joseph Aquilina told the freshmen that the patient who started to drink as a teenager slowly built up a tolerance to alcohol. When the second patient, a master electrician by trade, com­ plained of weight loss, bloody stools and anemia, the question was raised as to whether he drank or smoked. No, his last drink was taken two years ago. Yes, he did smoke a pack a day. A bleeding peptic ulcer was diagnosed for Patient B whose history of ulcers started back in 1949.• 38 THE BUFFALO PHYSICIAN �The Family Practice Center at Deaconess Hospital received a $108,000 federal grant to triple its program. There are 12 residents in training to become family practitioners. This will be expanded to 36 with the admission of 12 new graduates for two years. This center is o n e of 52 in the nation to share a total of $5 million allocated by the Division of Physician and Health Professions Education of the Bureau of Health Manpower Education, U. S. Department of Health, Education and Welfare. Dr. Ernest R. Haynes is director of the Family Practice Center which opened in October, 1970. The residents, who train here, spend their first year in the nearby hospital, coming to the center periodically for conferences and to see patients. The second and third years are spent at the center treating their own patients. There is a volunteer faculty of 12 family practitioners and more than 40 others, including other medical specialists, nurses, clergymen and social workers. There are 800 families consisting of more than 3,000 individuals enrolled in the program. Dr. Haynes said he plans to add a full time internist and a full time psychiatrist to his staff. The physical facilities of the center will also be expanded. A second grant of $50,000 a year for two years from the Lakes Area Regional Medical Program is being used to study the results of the center's health care team concept in preventing and curing disease. This program is closely affiliated with the newly-created department of family practice at the Medical School.• Dr. Murphy Promoted Dr. Walter T. Murphy, who has been chief of the department of radiation therapy at the Buffalo General Hospital since 1963, has been promoted to consultant of the department. The 65-year-old physician is a clinical associate professor of radiology at the Medical School. He is a 1930 Medical School graduate and did his surgical internship and residency at St. Francis Hospital, New York City. Dr. Yehuda Laor, who worked with Dr. Murphy for nine years, will be the new Chief of the department. Dr. Murphy will continue working in the department. The two physicians are looking forward to new facilities that are part of the hospital's expansion program. Currently the department treats about 100 patients a day in radia­ tion therapy and another 100 per week in the division of nuclear medicine Dr. Laor, a clinical associate in radiology at the Medical School, was born in Germany. He moved to Israel (then Palestine) as a child and was graduated from the Medical School of the University of Zurich, Switzerland in 1957. He returned to Israel for his internship and residency, then came to the Roswell Park Memorial Institute in 1962. He joined the Buffalo General Hospital in 1 9 6 4 . • WINTER, 1972 39 Family Practice Receives Grant �Dr. John H. Siegel is the new head of the department of surgery at the Buffalo General Hospital and professor of surgery at the School of Medicine. Dr. Siegel, who has been an associate professor of surgery at Albert Einstein College of Medicine in New York City, took over his new duties September 15. Dr. Theodore T. Jacobs, president of the hospital, said "Dr. Siegel brings to Buffalo an outstanding record of accomplishment in a broad area of medicine and surgery." The 39-year-old Dr. Siegel becomes the first head of surgery at the hospital since the retirement of Dr. John R. Paine in July, 1969. Dr. Elmer Milch of the BGH Medical Staff had been serving as acting head of the de­ partment. Dr. Siegel Dr. Siegel Named Surgery Chairman Dr. Siegel was Director of the Renal Transplantation Service at Albert Einstein and Associate Director of the Clinical Research Center-Acute at the same college. He was an attending surgeon at the hospital of the Albert Einstein College, as well as at the Bronx Muncipal Hospital Center. Born in Baltimore, Md., Dr. Siegel graduated from Cornell University in 1953 and received his medical degree from Johns Hopkins University in 1957. He served a straight surgical internship at Grace-New Haven Community Hospital-Yale Medical Center in 1957-1958 and did his residency in the department of surgery at the University of Michigan Medical Center from 1961 to 1965. His research training included being a Henry Strong Denison Fellow in Pharmacology at Johns Hopkins University from 1956 to 1957; a Cardiovascular Fellow, Department of Surgery, Yale Univer­ sity, 1958-1959; at the Laboratory of Cardiovascular Physiology, National Heart Institute, 1959-1961, and in Academic Surgery, De­ partment of Surgery, University of Michigan, 1962-1965. Dr. Siegel was director of the Cardiovascular Physiology Labora­ tory, Department of Surgery, University of Michigan School of Medicine, from 1962 to 1965. He then joined Albert Einstein as an instructor in surgery, becoming an assistant professor of surgery in 1967 and an associate professor of surgery in 1970. He has been an attending surgeon at the hospital there since 1966. Dr. Siegel has been the principal investigator in several projects for the National Heart Institute, as well as the National Institute of General Medical Sciences. He has published nearly 80 papers, many of them involving the use of computers to aid diagnosis of various conditions. Dr. Siegel recently took the lead role in implementing the use of computers to more accurately diagnose the conditions of patients who have suffered heart attacks. As reported in "Newsweek" magazine on April 3 (1972), Dr. Siegel, in collaboration with experts from IBM, used a small computer at the bedside of patients in the Clinical Research Center-Acute at Albert Einstein to more precisely decipher the results of cardiac catheterization. By use of the computer, Dr. Siegel and his research team found that they could obtain much more critical information from the chart. They found that the dye dilution curve on the chart would indicate the heart's pumping power and the area of heart muscle 40 THE BUFFALO PHYSICIAN �which is actually damaged. Using this data, the doctors could determine whether the patient's heart needed immediate mechanical support or surgery. Dr. Siegel said these indications were often obvious some hours before ordinary clinical signs of the patient's decline became evident, thus enabling doctors to make faster deci­ sions on methods to save the patient's life.D D r . P e t e r F. R e g a n , p r o f e s s o r o f p s y c h i a t r y a t t h e M e d i c a l S c h o o l , has accepted a two-year appointment in Paris, France to head a study of the health care education and services of several foreign countries. Dr. Regan will serve as consultant to the Organization for Economic Cooperation and Development (OECD) which is sponsoring the study. T> A "dYlS /lppOintment pQy P)p Pj>pafi ' & Dr. Regan explained that the study will involve a comparative international approach. "There are 24 nations which belong to the OECD and virtually all of these countries are in a turmoil regarding health care education and the resulting health care services," he said. Working out of the OECD headquarters in Paris, Dr. Regan will review the various ways in which these nations have structured their health care education system to meet actual service demands. As an example, Dr. Regan noted that there are approximately 200 health related professions. "It is necessary," he continued, "that persons from all these professions work together, but how well is a given country's health education system preparing its students to work together?" Dr. Regan indicated that the specific countries which will be involved in the study have not yet been determined. Dr. Regan joined the U/B faculty in 1964 as vice president for health affairs. In 1967 he was appointed U/B executive vice presi­ dent and served in 1969-70 as acting president of the University. Fie is presently a full professor of psychiatry and adjunct professor of higher education. A native of Brooklyn, Dr. Regan is a graduate of the Cornell University Medical College.D Three Medical School alumni opened a Family Practice Medical Center in Wyoming County Community Hospital in July at Warsaw, N. Y. Drs. Michael Smallwood and Robert Gibson, both of t h e class of 1969 and Frederick R. Downs, M'70, are the first group returning to the county under terms of the scholarships they received to help defray their medical education expenses. The three physicians have completed their residency in the family practice program at Deac­ oness Hospital, Buffalo. Dr. Gibson has two years of military service to complete before joining his colleagues in Warsaw. The Center will not be a clinic, but a private operation inde­ pendent of hospital administration. The physicians want to provide continual, not periodical, health care for families in the area. There have been 10 scholarship students since 1964 and seven plan to practice in the county. The others dropped out to practice elsewhere.Q WINTER, 1972 41 Rural Area Scholarships �RESEARCH STUDIES by a professor of biochemistry at the School of Medicine may not only help toward developing a better means of fertility control but improve those that are now available (the pill, etc.). Dr. Om Bahl has successfully isolated and analyzed a hormone from human pregnancy urine. It is the human chorionic gona­ dotropin or HCG, as it is termed, and becomes the first hormone of such complexity whose complete structure we now know. Pro­ duced by the placenta during pregnancy, it is responsible for the maintenance of pregnancy and early growth of the embryo. While production levels of this hormone rise during pregnancy, in certain types of cancer of the uterus that resembles pregnancy, production levels are even greater. Said the India born and University of Minnesota trained scien­ tist (Ph.D. biochemistry 1962), "not only can we now separate the two subunits of this molecule (its 231 amino acids and 55 sugars) but we can recombine them in the laboratory as well. And when we fully understand how this hormone works — our next phase of research is to unravel its various metabolic steps leading to an understanding of its complete mechanism of action — we will de­ velop a means of suppressing ovulation and thus prevent preg­ nancy." Malfunction of this hormone — one of its subunits may be formed in excess — may be responsible for certain diseases as well. Underway is a study by Dr. Bahl on the relation of this hormone to other complex molecules that may have a different function (such as thyroid stimulating hormone; other polypeptide sex hormones) but still share something in common with HCG. In a study on hormones produced during cancer of the uterus, Dr. Bahl is seeking the relationship to its cause as well as looking into other disease states where production of this hormone is greater than normal. In order to successfully analyze such a com­ plex molecule, painstaking plans had to be formulated. Said Dr. Bahl, "many of the postdoctoral fellows in my training program have contributed to this research." To analyze the carbohydrate portion of the molecule, specific enzymes were first isolated and characterized in the laboratory. Working on this phase from 1966 to 1968 was Dr. K. M. L. Agrawal. In characterizing the enzymes, specific chemical compounds had to be synthesized in the laboratory. From 1969 to 1971 Dr. K. L. Matta worked on syntheses of enzyme substrates. This was followed by successful application of enzymes to structure. Determination of the complex structure of protein came next. And the method used to separate for the first time the subunits of this molecule (on the beta subunit structure of HCG Dr. N. Swaminthan from 1970-71 and Dr. Robert B. Carlsen from 1971-present; on alpha subunit structure Dr. Ronald Bellisario from 1971 to present) are now being applied to the study of other sex hormones. All of these tools, which were developed in the Buffalo lab­ oratories to understand the structure of the HCG hormone are being applied to similar molecules involved in other key metabolic roles such as cystic fibrosis. They will be used on the next phase of their research — relating structure to hormone function, explained Dr. 42 THE BUFFALO PHYSICIAN �Bahl, who is now attempting to determine the primary site of action in the cell as well as isolate the receptor protein for HCG and other related protein sex hormones. By using modified forms of HCG a n d r e l a t e d h o r m o n e s h e w i l l s e e if a n y w i l l a c t a s i n h i b i t o r t o s u p ­ press ovulation and thus control fertility. Grants from the Population Council and the National Institutes of Health over a five year period in the range of about $200,000 have supported the five long years of carefully planned research that has led to the complete understanding of the structure of the first human hormone of such complexity, HCG.Q Dr. Vaughan Lab The Hematology Teaching Laboratory of Buffalo General Hospital h a s b e e n n a m e d t h e D r . S t u a r t L. V a u g h a n L a b o r a t o r y i n h o n o r o f the hospital's former director of clinical pathology and hematology. He was also director of its School of Medical Technology for 26 years. Dr. Vaughan, a 1924 Medical School graduate, died April 3, 1972. He was on the Medical School faculty for 43 years and joined the hospital staff in 1931. Dr. Vaughan served as director of clinical pathology and hematology from 1936 to 1966. A plaque bearing the new name of the teaching laboratory has been placed near its door. A second plaque memorializing Dr. Vaughan's "outstanding services" has been hung near the main door to the Hematology Laboratories.• Construction has started for the $91 million Comprehen­ sive Health Care Center adja­ cent to the E. I. Meyer Me­ morial Hospital. Five con­ tracts totaling $23.4 million have been awarded. Erie County expects to occupy the new facility in 1975. �Finding Cause of Infectious Diseases Quicker Dr. Caret ). van Oss (right) and Mr. Cetewayo F. Cillman (sitting, left), with the contact angle measuring apparatus. Mr. Cillman is depositing a drop of saline water on top of a fiat layer of bacteria, in order to measure its contact angle with the help of the telescope and goniometer, visible somewhat to the left of the middle in the photograph. Mr. Cillman is now writing his doctoral dissertation on this application of the contact angle method. A quick and easy test to determine the culprit for making a patient ill has resulted from the studies of microbiologist, Dr. Carel J. van Oss. In the body's first line of defense against disease, a process known as phagocytosis, bacteria are "eaten up" or destroyed by our white cells or neutrophils as they are called. Dr. Carel van Oss is editing three scientific journals. He is ex­ ecutive editor of "Preparative Bio­ chemistry," an international jour­ nal for rapid communication de­ voted to preparative methods and procedures in biological, immuno­ logical, pharmaceutical and clin­ ical chemistry, molecular biology, biochemistry and biophysics. He is co-editor of "Separation and Purification Methods," a new jour­ nal that will cover all areas involv­ ing the separation and purification of both simple and complex com­ pounds. Articles will deal with the separations of inorganic and or­ ganic substances as well as bio­ logical materials. The professor of microbiology is also on the edi­ torial committee of another new journal, "Immunological Commu­ nications." This international pub­ lication has been founded by The Center for Immunology at the Medical School. It will be devoted to promoting, on a world-wide basis, the rapid dissemination of original work on all aspects of immunology. "But," explained the professor of microbiology, "because bac­ teria differ in their surface properties, some get eaten up faster than others. When this rate of destruction is fast enough, we remain in good health. And when it is not, the invading cells go haywire and we get sick." Dr. van Oss has identified and measured the surface properties of different species of bacteria. He has correlated these data with the speed at which our white cells phagocytise or eat up various types of bacteria. This has been determined by the use of contact angles that a drop of saline water make with a flat layer of cells. In this very easy method that takes only a few moments, the angle reveals whether a dangerous germ is involved or not. If the bacterium is more hydrophobic than white cells, the angle will be larger than that of white cells and they will get eaten. When they are more hydrophilic they get wetted more easily and their contact angle is lower than that of white cells. These are the dangerous ones! However antibodies and complement can aid in increasing the angle, explained Dr. van Oss. Circulating neutrophils are like policemen. As soon as bacteria become sufficiently hydrophobic they get eaten up. The dangerous ones — the hydrophilics — are those that do not get recognized by the policemen or white cells. By tagging them with antibodies they will become more hydro­ phobic and thus get eaten up. 44 THE BUFFALO PHYSICIAN �The thermodynamics, which very satisfactorily explains why particles are ingested by white cells, was developed together with Dr. Wilhelm Neumann while he was working at SUNYAB's depart­ ment of chemical engineering (he is now at the University of Toronto). He succeeded in translating contact angles into interfacial free energies (something like surface tensions). Graduate s t u d e n t C e t e w a y o F. G i l l m a n c o n t r i b u t e d m u c h t o t h e m e t h o d o l o g y on contact angles. Said Dr. van Oss, these studies will also allow us to look for a new class of antibiotics that will help to increase the contact angle of bacteria and thus encourage phagocytosis to take place in in­ fectious diseases.D VA Hospital Director Mr. Joseph Paris, former assistant director of the Buffalo Veterans Hospital, succeeded John R. Rowan as director July 1. Mr. Rowan will become director of the Veterans Hospital in Lexington, Kentucky. Mr. Paris has been director of the Butler, Pa., Veterans Hospital since January 1971. He began his VA career in October, 1945. In 1955 h e was named assistant director of t h e Batavia, N. Y. VA Hospital. He came to Buffalo in the same capacity in 1968. The new director plans to keep his hospital in the forefront of medical technology. He noted that it is the nation's only hospital licensed to perform nuclear-powered heart pacemaker implants. " M e d i c i n e i s c o n s t a n t l y c h a n g i n g a n d if w e d o n ' t k e e p u p w i t h i t we'll be left behind. We're going to be in the business of implanting both nuclear and conventional pacemaker here for quite a while," Mr. Paris said. "Continuing close contact with the Medical School at the University is vital to successful patient care. By working with the Medical School we can develop our own potential to a maximum. "We also plan to expand the VA Hospital's connections with other city hospitals and regional VA hospitals. A program of com­ bining our resources is necessary because we've got to bring the high costs of hospitalization down. We can't keep competing and duplicating costly equipment and specialists' expertise in each hospital. A regionalization plan for Western New York VA Hospitals is now taking shape to make them all like one big hospital," the new director said. Mr. Paris sees his role as a three-pronged mission—patient care, education and research. In the area of patient care he hopes to develop a more sophisticated out-patient treatment clinic. He said the hospital is now drawing up plans for an ambulatory patient building "so we won't have to tell people who just have a cold to wait and come back for treatment when they have pneumonia. Also in the future plans is a new research building."• WINTER, 1972 45 �Two nurses with a patient in the clinic. The Lackawanna Community Health Center Dr. Arthur R. Goshin, clinical instruc­ tor in social and preventive medicine, and director ot the clinic. When Arthur R. Goshin was a third year medical student in 1968, he, several of his classmates, and some community residents had an idea. They wanted to do something about providing first-class health services in certain medically disadvantaged areas. Today, Dr. Goshin is directing that idea, the Lackawanna Community Health Center. "I am pleased with the enthusiastic acceptance of the Health Center by the community. An estimated 25,000 patient visits will be made at the Center this year," Dr. Goshin said. "The Health Center is attempting to provide to the community a comprehensive system of family-oriented health services. Em­ phasis is placed upon preventive and health maintenance care rather than episodic, acute-illness services. Medical care is of the highest quality and being rendered in a numane, personal, dignified manner. The Center is open from 9 a.m. to 9 p.m. Monday-Friday and from 10 a.m. to 1 p.m. weekends. An answering service puts a patient in touch with a physician at all other hours around the clock." 46 THE BUFFALO PHYSICIAN �The island of rounded dentists. community is Lackawanna's First Ward. It is a residential 7500 persons in some 2000 families whose homes are sur­ by industry. It has only one part-time physician and no The Health Center at 33 Wilkesbarre fills the void. Besides Dr. Coshin there are three full-time physicians—Drs. Jack Piazza and Carol Segal, both internists, and Dr. K. Vishnu Jain, a pediatrician. There are about 20 other part-time physicians work­ ing at the Center. The rest of the staff includes: four public health nurses, three licensed practical nurses, four senior public health aides, one nutritionist, one caseworker, one laboratory technician, two laboratory assistants, one X-ray technician, five office staff, two dental assistants, five part-time dentists, one dental hygienist, one bus driver. Most employees are residents of the 1st Ward Com­ munity. Dr. Carol Segal, clinical associate in medicine, with a teen-age patient. A family health worker, Barbara Swygert, visits with a patient at her home. The Health Center staff is divided into two multi-disciplinary health care teams. Each team is responsible for coordinating and providing primary services to about 1000 families. Sharing of re­ sponsibilities and team review of family health problems are the rule. Emphasis is placed upon problem follow-up and home visits. In addition, the mental health staff consisting of part-time psychi­ atrist, psychologist and psychiatric nurse frequently make family home visits. All mental health staff are affiliated with Unit 6 of Meyer Hospital. The Health Center operates under the aegis of the Erie County Health Department. Using the Lackawanna Center as a model, Dr. Goshin and the Health Department plan to open two additional family health centers this year within Buffalo's inner-city area. Addi­ tional such centers are on the drawing board for other areas of need within the County. The principal financial support for the program comes from collection of fees from patients' health insurance — Medicaid, Blue Cross and Blue Shield, etc. Any deficit is shared equally by the County and the State. The Health Center has a Board of Directors made up of con­ sumers of Health Center services. They are involved in establishing all major policies, hiring of all personnel, investigating all grievances. This board helps to ensure that services will remain relevant and ac­ countable to the community. The Health Center is also now operating the Addiction Treat­ ment and Rehabilitation Program. This program provides a wide range of medical, social and rehabilitative services to drug addicts. Methadone maintenance is one of the treatment modalities now being utilized. The program, when fully operating, will have a staff of about 30 treating over 300 heroin addicts.D WINTER, 1972 47 Dr. tin Woong Rho, clinical instructor in gynecology-obstetrics, visits with a patient. �"The public must be better informed on health resources," accord­ ing to a Louisiana physician. Dr. Joseph A. Sabatier told area health officials that individuals want their health problems and those of their relatives and friends solved immediately. "They expect this because of the tremendous advances made in science in the last decade or two." Health Resources The director of the Louisiana Regional Medical Program said "there must be a more appropriate distribution of benefits of science so that the general public can reap the profits and pleasures of scientific planning for health care to prospective planning for community commitment for health. We must increase our capacity for quality and quantity of service to the people. "We must have conversation between the providers and con­ sumers — conversation that is understood by all. The fate of RMP's depends upon all of us getting across to the community the specific information that identifies it with the community. RMP must be a real asset to all people involved in the delivery of health care," Dr. Sabatier said. In conclusion the physician said, "RMP must win public sup­ port by solving people's health problems. When this happens we will be accepted because we have developed a consistent image." • •pv t p i* Ur. l^araglia RctlfCS A physician who never refused a request for a house call (unless jn May after a 53-year career in he was too sic|< to go) retjrec| Dunkirk, New York. Dr. Joseph R. LaPaglia Sr., a 1919 Medical School graduate served his internship at St. Mary's Hospital, Roch­ ester. He was graduated from the Fredonia Normal School where he won a $100 Regents Scholarship. But the scholarship was not allowed at the UB Medical School. Two years later, in 1917, his class was disbanded and he entered the U. S. Army. During the 1918 Asian influenza epidemic he was assigned to Columbus Hos­ pital, then a 35-bed institution in Buffalo. He returned to Medical School later the same year. Dr. LaPaglia's interest in people overflowed into his personal life. He used his free time to serve his community as public school physician, school board member, city board of health and the selec­ tive service system. He has signed citations from four PresidentsHarry S. Truman, Dwight D. Eisenhower, Lyndon B. Johnson, Richard M. Nixon—for his dedicated and uncompensated service for the Selective Service System. Dr. LaPaglia also has an engraved bronze medal from President Truman and a special citation from President Johnson. In 1968 friends and citizens recognized Dr. LaPaglia for his long service in Fredonia. The following year the Medical Society of New York State honored the physician for his professional con­ tributions. Dr. LaPaglia is living with his son at 39 Longbrook Drive, Byfield, Massachusetts.D 48 THE BUFFALO PHYSICIAN �Experimental Surgery Providing an understanding of the importance of humane use of live animals in biomedical research is among the objectives of a unique graduate course, being offered for the first time this sum­ mer, by the department of laboratory animal science, at the Uni­ versity. "Introduction to Experimental Surgery" is unique in several ways. Thirty graduate students from a variety of undergraduate backgrounds, some only indirectly related to animal research, are enrolled in the course. And it is possibly the only course of its kind available to students who do not possess a professional background in surgery. Dr. Thurman S. Grafton, director of the animal laboratory facilities, noted that at present a two-semester course in experi­ mental surgery is taught, but it is open only to those having a professional surgical background. "We noticed an obvious interest in experimental surgery by other graduate students. Thus in an attempt to accommodate these students, we designed this special introductory-level course. The response has been overwhelming," Dr. Grafton said. "Students taking the course come from a wide variety of disciplines including micro-biology, physiology, health sciences education and evaluation and Pharmacology. Each student has his own thoughts on how the course will help him with research in the particular discipline," he added. Dr. Shaheen M. Al-Nakeeb, associate professor in laboratory animal science who is the primary instructor of the new course, stated that serious regard is given to the humane aspects of con­ ducting research with animals. "The course begins with an introduction which deals with respect for living tissue, emphasis on humane care and handling of animals and the regulations governing the use of live animals. We are careful to make sure that each student realizes these aspects before conducting any animal surgery," Dr. Al-Nakeeb said. Preceding any actual surgery there are introductions to an­ atomy and physiology, anesthesiology, microbiology and surgical instrumentation and equipment. "These introductions enable a graduate student of any of the biological sciences to carry out certain select experimental, sur­ gical procedures on animals, and to utilize such skills in research within his own discipline. It is not intended to produce skilled surgeons in this short time," Dr. Al-Nakeeb added. Summing up the apparent success of the course, which has only been in existence a few weeks, Drs. Grafton and Al-Nakeeb both expressed favor in the sincere interest shown thus far by the students, terming it an "enthusiasm that is delightfully stimulating."D WINTER, 1972 49 Dr. Al-Nakeeb (left) and Dr. Thurman 5. Crafton, director of the laboratory animal facilities, prepare to use an intravenous anesthetic agent on one ot the lab's pets. �VA Hospital Treats Veterans on Drugs The primary commitment of the drug program at the Veterans Ad­ ministration Hospital has been described as a "therapeutic com­ munity." This means that the program depends more on the basis of person-to-person relationships among residents and staff than on chemotherapy such as methadone. "A therapeutic community," explained one of the resident addicts, "does work in finding out what the problem is." Once this is done, he said, "he has no need for drugs." The Drug Dependence Treatment Center (Ward 10C) is re­ ferred to as EPIC House (Encountering People in Crisis). It is headed by Dr. Peter Russell, program coordinator and clinical psychologist. The Center opened in July of 1971. Dr. Russell explained that there are three separate phases in the long-term program. The first phase is the Detoxification and Evaluation Unit (DEU). EPIC House is the second phase, and the outpatient treatment program is the final stage. The DEU unit has 20 beds and is the initial admittance ward for all those asking entrance to EPIC House. A veteran who comes to the hospital with a drug problem is immediately given a bed, Dr. Russell pointed out, "as long as he is eligible" (a dishonorable discharge prevents this). He is interviewed first, said Dr. Russell, "then shaken down. We want to make absolutely sure he's clean." Methadone is used in detoxification, according to Dr. Russell, but controlled "very, very carefully." The complete process takes from one week to ten days, perhaps longer "depending on the size of his habit." While the program handles mainly heroin addicts, users of other addictive drugs are also treated. "Our main idea is to get this fellow away from the street, give him a chance to get his head together and make an appropriate decision: 'What do I want to do with my life'?" The individual then participates in various types of therapy including group, indi­ vidual, occupational and recreational. He also gets daily medical checkups. "It's really a rather full schedule," added Dr. Russell, "and always oriented toward the idea, 'What are you going to do? What's your contract with us'?" graduate work at the University of Rochester and received his M.A. and Ph.D. degrees from Penn State.• The contract is one of three kinds: simple detoxification (the person is given a regular discharge at the end of "detox": secondly, referral to other community drug programs (DDTC often refers people who consider the program too hard to other agencies such as methadone maintenance programs). The third type of 50 THE BUFFALO PHYSICIAN �contract is to request admittance to EPIC House. "This," Dr. Russell said, "is where the commitment is. All the rest is very important, but it's just a stepping stone." Prior to entering EPIC House, one must first, if recommended by the DEU staff, appear before a screening committee. Here, Dr. Russell said, the individual is questioned "very thoroughly" on his motive for wanting to join EPIC House's long term treatment pro­ gram. Upon gaining the screening committee's approval, one is placed on Level 1. He would then participate in certain house activities and simply observe others. Level 1, according to Dr. Russell, gives an individual the opportunity to see EPIC House and how it operates, and also gives the residents and staff a chance to get to know the prospective resident. After a week at Level 1, the person is again screened. At this screening, the individual tells the committee what he thinks of the House so far and the committee members tell the individual their opinion of him. Promotion to Levels 2-6 entails increased responsibilities and privileges for the resident. For the first few levels, the resident is responsible only for himself and his actions, but as he progresses, explained Dr. Russell, he is expected to realize responsibilities for other, newer residents, and for the day-to-day operation of the House. An older resident said that it was his responsibility to "pull sheets off" someone breaking the rules, but he explained he doesn't see it as responsibility, but "more like caring." The complete EPIC House program takes about five months. Dr. Russell pointed out that the time varies for each level. "Each of the first five levels takes generally three weeks while Level 6 takes about six weeks." During residency the patient seldom moves out of the hospital, but at Level 4 he gets off-ward privileges and by Level 6 he can obtain weekend passes, day care rights (where the resident can be with his family), and work passes to prepare him for the outside world. The atmosphere in EPIC House is one of community involve­ ment to help individuals work out problems which must be dealt with in order to lead a drug-free, constructive life. In working toward this goal, residents take an active part in encounter groups, individual counseling, entertainment, educational seminars, work projects, job placement and many other types of therapy. Mail is the only legal contact with anyone on the outside until Level 4, and this is opened in the presence of a staff counselor and searched for contraband. The resident is encouraged to talk over mail received or sent with the counselor. "The more we as a staff can learn and get inside the fellow's head, the more we can help him to reorient to the outside world," Dr. Russell said. The final phase of the program is Outpatient Treatment. This is primarily for the graduated residents of EPIC House, although in certain isolated instances it may be available to patients who have participated only in DEU. "The purpose of this phase of treatment is to help the individual complete his readjustment to the community-at-Iarge and maintain a stable, drug-free life," Dr. Russell concluded.• WINTER, 1972 51 Mr. David Lowalewski, a social worker on Dr. Russell's staff em­ phasized three points: (1) "the program is open to all eligible veterans; (2) the program isn't the free and easy ride to rehabilita­ tion, rather a tough, total com­ mitment, no-nonsense approach; (3) the program works for some­ body who really wants to get straight and stay straight."• Three other VA hospitals in Battle Creek, Michigan, Salem, Virginia and Syracuse, New York have similar programs.D �An informal conference for professionals and paraprofessionals. Mental Health "There is no easy road to success in the mental health field. Patience and firm conviction about the necessity for hard work and contin­ uous learning is always in order." This is what Dr. Francine Sobey, a professor of social work at Columbia University, told some 150 mental health practitioners of Western New York at a Education and Training Team workshop. Dr. Sobey, who has written a book about "the nonprofessional revolution in mental health," was the keynote speaker. "Both professional and paraprofessionals have new roles to play in stimulating the development of peer-groups, offering appropriate groups leadership skills and providing liaison. Newer levels include the social advocate and the ombudsman or mediator," Dr. Sobey said. In commenting on the sudden economic slump that has affected many social services across the nation the educator said, "human needs can not be cut like budgets. There is statistical evidence of greater need in times of unemployment."D THE BUFFALO PHYSICIAN li �"Sure I got seasick," said Senior Assistant Surgeon Lawrence Frankel of the U. S. Public Health Service, "But then, so did most of the Commanders and Lieutenants." He hastily added with a twinkle in his eyes, "not too many of the bos'ns got sick though." Dr. Frankel, a 1970 graduate of University of Buffalo Medical School did his interning at Georgetown University hospital in Washington, D. C. He is the son of Mr. and Mrs. Joseph Frankel of Syosset, Long Island, N. Y. He graduated from Syosset High School in 1963. 10,000 Mile Cruise for Dr. Frankel Dr. Frankel is now at sea completing the last leg of a 10,000 mile cruise that has taken him from Little Creek, Va., through the Panama Canal, plus liberty stops at Acapulco, Mexico and Hono­ lulu, Hawaii. The cruise will end at Guam in early May. He provides medical attention for the nearly 300 active duty and Reserve Coast Guardsmen engaged in transferring three vessels from the East Coast to Guam. The three ships, the Cutters ABSECON, CHINCONEAGUE and McCULLOUCH, are to be transferred to the Navy as part of the President's program to reduce Federal ex­ penditures. The Coast Guard's reduction included the loss of 10 ships, several stations and 2,000 men. The three ships are scheduled to be turned over to the Navy around May 10. Dr. Frankel and the Coast Guard crews will return to their duty stations at that time. "Doc" will return to Yorktown, Va. where he provides medical attention for Coast Guard and Naval personnel and their dependents. Frankel, who has had special training in pediatrics and internal medicine, said, "Fortunately, there have been very few real prob­ lems during the cruise. It's almost like a vacation for me. But, I'm here in case of an emergency. Like an insurance policy, you might say." Frankel and the Coast Guardsmen left Little Creek, Va. in mid-March on a cold damp day. With a drastic change in climates, Dr. Frankel found treating sunburn cases and heat exhaustion taking up much of his time. He has also been busy inoculating the nearly 300 men against Cholera, Yellow Fever, Smallpox, Ty­ phoid, Diphtheria and Tetanus because of the epidemic areas on the cruise schedule. The officers in the wardroom say that "Doc" Frankel has truly added color to the cruise. As a matter of fact, it was the dye from his blue sweatshirt that changed the officers' khaki colored socks to an attractive powder blue. Dr. Frankel also serves as the Morale Officer for the Cutter ABSECON, providing movies for off hour entertainment, informa­ tion on ports to be visited, beach parties, general counseling and host of shipboard recreational activities. Dr. Frankel is married and has o n e child. He will serve with the Coast Guard until June 1973, when he will enter private prac­ tice. It is a sure bet that the Coast Guardsmen will miss his ex­ cellent health care and ability to add some fun into life .n WINTER, 1972 53 Dr. Frankel's Coast Guard duty started in 1971 and ended in May. As a uniformed Public Health Serv­ ice doctor, he enjoyed his sea duty. The 26-year-old was well liked and admired by Coast Guard officers and enlisted members.EJ �Allegany County Medical Van A SELF-SUFFICIENT, multi-purpose medical van is bringing health education and preventive health care services to Allegany County in southern New York state. The $52,000 unit was purchased by the Lakes Area Regional Medical Program. It is operated by the Alfred University School of Nursing in co-operation with the Allegany County Public Health Nursing Service. "This is the only unit of its type in the world. We have had inquiries from countries in the Middle East and several states from coast to coast," Dr. Virginia Barker said. She is mobile projects director and dean of the Alfred University Nursing School. D r . Barker "The response of people living in Angelica, Caneadea, Richburg, Whitesville and Alfred to our services has been overwhelming," Dean Barker said. Health-education classes and "health assessment" examinations of children and adults are the two main categories of service. The unit provides vision and hearing tests, blood sugar screenings, urinalyses and other tests designed to indicate deviations from normal patterns. Suspected cases of illness or health de­ ficiencies are referred to family physicians. Allegany County's two hospitals, Cuba Memorial in Cuba and Jones Memorial in Wellsville, are available for residents who have no family physician Mrs. Margaret Connelly pointed out that there are only 16 physicians providing primary health care in Allegany County (popu­ lation 46,500). She is director of nursing for the county public health service. Mrs. Connelly's staff of five public health nurses, five reg­ istered nurses, one physical therapist, one speech therapist and 12 home health aides are participating in the project along with nursing students and faculty from Alfred University. Dean Barker emphasized that the nurses are not practicing medicine. "Our slogan is 'don't' wait until you get sick."Q 54 THE BUFFALO PHYSICIAN �New North Campus The new North Campus in Amherst is becoming a reality. By 1977 more than half of UB will be at the new campus. Dormitories d e s i g n e d b y a r c h i t e c t I. M . P e i w i t h s l e e p i n g c a p a c i t y f o r 8 2 0 s t u ­ dents are expected to be ready for occupancy in January (1973) at the 1200-acre North Campus, according to Dr. John D. Telfer, vice president for facilities planning. Construction currently under way or completed at the North Campus totals $115 million, but much of it is in site preparation and utilities installation. Plans now call for conversion of the present South Campus on Main Street to a healthsciences oriented campus. There will be no mass exodus to the North Campus. The conversion will be "building by building" due to the staggered funding by the Legislature as monies become available, Dr. Telfer said.n �Heart/Lung Studies Dr. Francis Klocke and Ann Salter, ad­ ministrative assistant lor the heart/lung program, check order lor new com­ puter. A two million dollar National Institutes of Health grant to a medical/ engineering team at the University over the next five years assures continuation of studies on heart and lung diseases. Said its principal investigator, Dr. Francis J. Klocke who is professor of medicine, assistant professor of physiology at the University, and chief of cardiology at the E. J. Meyer Memorial Hospital, "we hope to im­ prove our understanding of abnormal physiological processes in specific cardiovascular and pulmonary diseases so that we can de­ velop better treatment of established disease and methods for earlier detection of latent disease." With senior investigators Dr. David G. Greene (professor of medicine and associate professor of physiology), Dr. Robert A. Klocke (assistant professor of medicine), Dr. Robert E. Mates (pro­ fessor of mechanical engineering and research associate professor of medicine), and Dr. Stephen M. Wittenberg (associate professor of medicine), 19 other physicians will carry on investigations in a research program begun seven years ago that is now attracting national attention at the Buffalo General and E. J. Meyer Memorial Hospitals as well as at the School of Medicine. Studies on the coronary circulation — its normal physiology and its alterations in coronary artery disease and hypertrophy states Dr. Djavad Arani, clinical assistant professor of medicine, Mrs. Cretchen Smith, chief research nurse, look over material related to a study in cardiac catheterization with Drs. Greene and Bunnell. 56 THE BUFFALO PHYSICIAN �Dr. Robert Klocke and technician Anne Coe measure rates of reaction of oxygen with red blood cells on continuous flow reaction apparatus. — are directed by Drs. F. Klocke, Greene and Ivan L. Bunnell who is associate professor of medicine. Agreed Drs. Greene and Bunnell, "methods developed earlier to document reduction of flow in pa­ tients with coronary disease are now being used to evaluate patients with chest pain and specific coronary arteriographic patterns." These methods are utilized when diagnostic studies are made in the cardiac catheterization laboratory. They involve the breathing of inert gases such as helium and the sampling of arterial and coronary sinus blood. There are also studies underway in the operating room with associate professor of surgery, Dr. George Schimert, to evaluate the effect of venous bypass grafts as well as a variety of supportive studies in animal experimentation. Another aspect of the program will focus on mechanisms of arrythmia production. There are now two experimental models available for the study of arrythmias — injury to the heart and digi­ talis overdose. Past studies of the Meyer Hospital and other groups have revealed that variations in heart rate profoundly alter the development and persistence of certain rhythm disorders. WINTER, 1972 57 �Under Dr. Wittenberg the Meyer group is focusing on the role which beat-to-beat changes in rate play in the development of digitalis-induced arrythmias. This is being done in intact animals, said Dr. Wittenberg, and in single heart cells. "The hope is that with these powerful laboratory tools, we will arrive at a better under­ standing of the immediate determinants of arrythmia in man," he said. Dr. Mates looks over computer output on a math model of blood flow in the coronary circulation. In investigations on gas exchange the investigators are looking for factors that cause mismatching of ventilation and blood flow in the lungs as well as a better understanding of frequency distribution of these ratios throughout the lungs in both normal and abnormal states. For in a number of lung diseases, such as pneumonia and emphysema, patients have very low oxygen content in their blood. Determining the speed at which the gas exchange occurs in the lungs and duplicating its physiologic picture in the laboratory are investigators under Dr. Robert Klocke. He is quick to point to other things under study that also influence the rate of this exchange — the movement of chloride and hydrogen ions in and out of the blood cells and substances inside the red cell such as the compound 2, 3diphosphoglyceric acid that influences the way we transport oxygen and carbondioxide. "The more of it around," he explained, "the harder it is for oxygen to bind with hemoglobin." In certain acid states, a complication of lung disease, the exchange of gases may not be complete, therefore not as efficient upon leaving the lungs. Dr. Francis Klocke and Dr. Rene Oliveros, a cardiologist from Peru, are measuring barometric pressure. 58 THE BUFFALO PHYSICIAN �Dr. Wittenberg and Mr. John Curran, electrical technician, are measuring and recording blood pressure of the animals used in their research. Through the use of his modified version of continuous flow reaction apparatus, measurements of these reactions — that are all interre­ lated—can now be made. In his studies to validate a specific method to measure cardiac output and to set limits under which it can be used, this investigator has found that indocyanine green, the most commonly used dye, takes longer to bind albumin than was previously thought. But there are also programs dealing with mathematical models of heart and lung function and the development of new methods for evaluating various aspects of heart/lung malfunctions. Explained Dr. Mates, "our group's overall objective is to develop quantifica­ tion descriptions relating the clinical measurements to basic physio­ logical functions." In their attempt to develop a model describing the fluid mechanics of coronory circulation in the presence of coronary artery disease, they want to understand what constitutes a severe obstructing of the coronary artery from a fluid mechanics point of view and to isolate the factors which could potentially cause catastrophic events such as myocardial infarctions. Summed up Dr. Francis Klocke, "we are trying to address our­ selves to the major cardiopulmonary problems with which physicians are now confronted. This grant is an invaluable mechanism for allowing us to approach our research on a stable, longterm and, we hope, creative basis."D WINTER, 1972 59 �Testing the oxygen consumption, efficiency and proficiency of swimmers on the monitoring platform are Drs. Rennie, diPrampero (visiting professor from Italy), Leon E. Farhi, Hermann Rahn, all of the physiology department. Swimming Analysis What are the forces that man must overcome when he swims or moves about in water? Or his mechanical efficiency of locomo­ tion? Or his energy cost in underwater activity? And how do the stresses imposed on the muscular, respiratory and circulatory sys­ tems in this cold and viscid medium differ from those in our more natural air environment? Through the implementation of a new experimental approach, members of the department of physiology are exploring these ques­ tions with subjects who are keen on knowing the answers — the SUNYAB swim team. 60 THE BUFFALO PHYSICIAN �A team of investigators under Dr. Donald W. Rennie (professor of physiology) has long been involved in problems of man in a water environment, especially his heat balance. In the concentric submergence basin of the Laboratory of Environmental Physiology they are now starting a systematic study of locomotion in water, beginning with swimming on the surface and later going on to underwater activity. Explained Dr. Rennie, "while a great deal is known about the energy cost, mechanical efficiency, and cardiopulmonary response to walking or running, this is not so in the case of the swimmer. For no one has determined the actual water resistance or his "body drag." A simple method devised by the team that was adapted unique­ ly to the annular pool will allow this determination to be made for all kinds of surface and underwater swimming techniques. And it will cover the entire range of swimming velocities. By coupling this to more conventional methods for measuring energy metabolism and the mechanics of swimming, the team hopes to develop a whole new approach to the quantitative analysis of swimming. In their systematic study of the crawl—a common swim­ ming style—the investigators pace members of the Buffalo swim team from a movable platform on which equipment is stored for measuring oxygen consumption and heart rate. This platform also contains apparatus necessary to determine the "drag" during swim­ ming. They have postulated that neither "body drag" nor mechanical efficiency of swimming by itself is sufficient to determine the velocity that a swimmer can attain. Of crucial importance should be the ratio of efficiency to drag — "E/D ratio." Actual measurements bear out the theory that the higher the ratio, the faster the velocity that a swimmer can attain. The method, as hoped, has differentiated between good and poor swimmers. For achieving the highest E/D ratios were the swim team's better swimmers. Interestingly, and unexpectedly, women swimmers were found to have higher E/D ratios than men and theoretically for the same energy expenditure should achieve higher velocities. That they do not beat men in top competition is therefore due to the male's abil­ ity to generate more muscular power, thus compensating for his lower E/D ratio. Additional evidence for women's higher E/D ratios — their superior ability to adapt to an aquatic environment — is previous work done on the diving women of Korea and Japan. They estab­ lished a superior ability to withstand the cold stress of water. And for the layman there are practical applications of these experiments. His ability to enjoy water sports may be enhanced by calculating in a quantitative way how he can improve his technique.D WINTER, 1972 61 Dave Sexton, a sophomore, talks over an experiment with William H. Sanlord, III, UB swimming coach. �95 Faculty Promotions The following 95 members of the Medical School faculty received promotions effective July 1, 1972. livan (medicine); James F. Upson (surgery); Walter T. Zimdahl (medicine). Promotions to Professor: Doctors Edson X. Al­ buquerque (pharmacology); Stanley Cohen (pathology); Andrew Gage (surgery); Franz E. Glasauer (surgery-neurosurgery); Joseph Kite (microbiology); Carel J. van Oss (microbiology). Doctors Frank Bolgan (surgery); George C. Brady (medicine); John L. Butsch (surgery); William A. Carnahan (forensic psychiatry in de­ partment of psychiatry); Tai Soon Choi (pedi­ atrics); Michael E. Cohen (neurology); Bernard A. Daly (anesthesiology); Allie H. Freeman (psychiatry); Albert A. Gartner (anesthesiol­ ogy); Ikram Haque (surgery-neurosurgery); Frederick Helm (medicine-dermatology); Stev­ en Joyce (surgery-orthopedic surgery); Michael A. Jurca (surgery-otolaryngology); Duck Jin Kim (surgery-otolaryngology); Joseph W. Kramarczyk (anesthesiology); Herbert Lee (anesthes­ iology); Desmond Moleski (psychiatry); Oscar R. Oberkircher (pediatrics); Marjorie M. Plumb (psychology in department of psychiatry); Susana S. Reyes (psychiatry); Ravinder Tandon (medicine); William Walsh (medicine-psychia­ try); Donald J. Yung (surgery-ophthalmology). Promotions to Associate Professor: Doctors C. John Abeyounis (microbiology); James Ed­ ward Allen (surgery); Carl J. Bentzel (medicine); Constantine Chlouverakis (medicine); Thomas D. Flanagan (microbiology); C. A. Glomski (anatomy); Kyoichi Kant (microbiology); Leon­ ard Katz (medicine); Frederick C. Kauffman (pharmacology); Luis L. Mosovich (pediatrics); Robert W. Noble (medicine); Pearay L. Ogra (pediatrics); Reinhold E. Schlagenhauff (neurol­ ogy); S. Subramanian (surgery); Zebulon C. Taintor (psychiatry); Stephen Wittenberg (med­ icine). Promotions to Assistant Professor: Doctors Jon O. Flom (pediatrics); Eva Lotzova (pathology); Murray W. Stinson (microbiology). Promotion to Clinical Professor: Doctor liam F. Lipp (medicine). Promotions to Clinical Associate Wil­ Professor: Doctors Karl Balthasar (neurology); Lee L. Ber­ nards (pathology in department of medicine); Francis J. Clifford (anatomy); Donald Ehrenreich (neurology); Sattar Farzan (medicine); Irwin Friedman (medicine); Emma K. Harrod (pediatrics), also Research Instructor in medi­ cine; Jack Herrmann (surgery); William Hildebrand (surgery-otolaryngology); Clair M. Hossenlopp (psychiatry); William R. Kinkel (neurol­ ogy); Salvatorq LaTona (medicine); Warren R. Montgomery (medicine); Cornelius J. O'Connell (medicine); Joseph R. O'Connor (medi­ cine-psychiatry); Harold K. Palanker (surgery); Theodore Papademetriou (surgery-orthopedic surgery); Robert E. Reisman (medicine); Gloria L. Roblin (psychology in department of psychi­ atry); Robert Spier (surgery); Michael A. Sul­ 62 Promotions to Clinical Assistant Professor: Promotion to Research Professor: Doctor Ger­ ald P. Murphy (surgery-urology). Promotions to Research Associate Professor: Doctors Pier Luigi Bigazzi (microbiology), Wil­ liam H. Murphey (pediatrics); Thomas Provost (medicine). Promotions to Clinical Associate: Doctors Gas­ pare A. Alfano (neurology); Anthony Aquilina (medicine); Henry E. Black (medicine); Charles D. Bull (medicine); Cyril S. Bodnar (surgeryotolaryngology); Barry Herman (medicine); Sanford R. Hoffman (surgery-otolaryngology); Courtland S. Jones, Jr. (surgery-otolaryngology); Fred Lieberman (medicine); A. Charles Massaro (medicine); John J. McMahon (medicine); Lo­ renzo T. Teruel (surgery-otolaryngology); Joseph C. Tutton (neurology); Ernesto G. Zingapan (surgery-otolaryngology); Robert J. Zwirecki (neurology). Promotions to Clinical Instructor: Doctors Juan Garcia (psychiatry); Leo Michalek (surgery); Lionel Sifontes (medicine); Sara R. Sirkin (sur­ gery-ophthalmology).• THE BUFFALO PHYSICIAN �The 1915 Class Two 1915 Medical School graduates are new officers in the Association of Past Presidents of the Medical Society of the County of Erie. Dr. Carlton E. Wertz was named president and Dr. Herbert E. Wells is the new secretary. Dr. Wertz was president of the society in 1939 and Dr. Wells in 1940.D The Classes of the 1920's Dr. Marvin A. Block, M'25, received the American Medical Society on Alcoholism's medal of achievement, the organization's high­ est award, during the group's third annual meeting in Atlanta. In making the presentation, Dr. Stanley E. Gitlow, society president, cited Dr. Block's 25 years of service in the field of alcoholism and his role in gaining the AMA's recognition of alcoholism as a disease. Dr. Block has played significant roles in the Na­ tional Council on Alcoholism, the Alcohol and Drug Problems Association of North America and in the American Medical Society on Alco­ holism. He has written over 50 professional articles and books, treated thousands of pa­ tients and has helped educate thousands of other people about alcoholism throughout the world. Dr. Block is a clinical assistant professor of medicine at the Medical School.• It was a "father-son" affair at the spring commencement. The Distinguished Professor of Anatomy Dr. O. P. Jones hoods his son, O. P. Jones, 3rd, who received his Ph.D. in English. The son is on the faculty of Ohio Wesleyan University, Delaware, Ohio. The Classes of the 1930's Dr. Joseph D. Godfrey, M'31, suggests the elimination of the position of pitcher in Little League Baseball. He told the American Acad­ emy of Orthopedic Surgeons meeting in Eu­ gene, Oregon that the risks of elbow joint changes were severe enough to warrant the step. "No kid of mine would ever pitch little league baseball. The possibilities of sustaining permanent elbow restrictions of motion or an abnormal area at the elbow may definitely stem from throwing overhand at an early age. I would recommend that methods such as a pitching machine, a tee as in golf, or a toss-up mechanism be used to set the ball up to hit in both practice session and games." Dr. Godfrey is chief of orthopedic surgery at Children's Hospital and clinical professor of surgery (orthopedic) at the Medical School. He is also team physician for the Buffalo Bills, pro­ fessional football team.D Dr. Carl T. Javert, M'32, an obstetrician-gyne­ cologist, is listed in "Who's Who in America." (1971) He recently joined Hubbard Regional Hospital, Webster, Massachusetts to direct and develop the obstetrical and gynecological service.D Dr. Albert John Magnus, M'35, has been in industrial medicine for 15 years. He writes that he has been in poor health for the past 2V2 years. His address is 3116 Culver Road, Roch­ ester, New York.D Dr. Elizabeth Pierce Olmsted, M'39, was one of five University women to receive a special citation from the UB Alumni Association and the UB Community Advisory Council for achieving distinction in her career through in­ volvement in community activities. Dr. Olm­ sted is chief of staff of the ophthalmology de­ partment at Deaconess Hospital and a clinical instructor in surgery (ophthalmology) at the Medical School. She was president of the Wettlaufer Clinic staff before it merged with Dea­ coness. She is director of the Buffalo Associa­ tion for the Blind and is a consultant with the National Society for the Prevention of Blind- �Dr. Milford C. Maloney, M'53, was named full-time chairman of the department of medi­ cine at Mercy Hospital June 1. He is a clinical assistant professor of medicine at the Medical School.• The Classes of the 1940's Dr. Harold ). Palanker, M'40, clinical associate professor of surgery, is a member of various county, state and national societies in his spe­ cialty. He lives at 66 Ruskin Road, Eggertsville, New York.D Dr. Richard Ament, M'42, has been elected to the Board of Governors of the American College of Anesthesiologists. He is a clinical professor of anesthesiology at the University and attending anesthesiologist at the Buffalo General Hospital. Dr. Ament attended the 5th World Congress of Anesthesiologists in Kyoto, Japan in September. He was one of 11 dele­ gates.• Dr. Lawrence H. Golden, M'46, is co-operat­ ing with the School of Pharmacy in setting up one of the nation's first clinical pharmacoki­ netics laboratories at the Millard Fillmore Hos­ pital. Dr. Golden is chief of medicine at the hospital and a clinical associate professor of medicine. Dr. William Jusko, assistant profes­ sor of pharmaceutics at the University, is super­ visor of the new lab that enables physicians to regulate and adjust their patients' medication according to their individual drug responses.D Dr. Raymond J. Trudnowski, M'46, has been named chief of the department of anesthesiol­ ogy at Roswell Park Memorial Institute. He also received his dental degree from the University. After 14 years as an oral and maxillofacial surgeon, Dr. Trudnowski turned to anesthesia. He trained in that specialty at Buffalo General and Children's Hospitals. He is the author of several publications.• Dr. Michel A. Glucksman, M'54, is a urologist practicing in Brunswick, Georgia. He is living at 152 Fairway Oaks Drive.• Donald R. Hauler, M'57, was recently pro­ moted to Captain, Medical Corps, U.S.N. While assigned duty as Senior Medical Officer in USS ENTERPRISE CVAN-65 (1969-1972), he was awarded the Navy Commendation Medal, Meri­ torious Unit Citation and Navy Expeditionary Medal. Captain Hauler's home address is 912 Kane Circle, Walnut Creek, California.• Dr. Ann Tracy, M'58, is a clinical assistant professor of pediatrics and psychiatry at the Medical School. She also works with children at the Children's Psychiatric Center at the West Seneca State School. Dr. Tracy entered Medi­ cal School in 1944 and completed three years before getting married. She then took a leave to raise her family (two sons) and returned in 1957 to complete her fourth year in Medical School. She interned at Children's Hospital and took her residency at Buffalo State Hospital. She did other post-graduate work at Harvard Medical School and Children's Hospital, Wash­ ington, D. C.D Dr. Robert A. Brenner, M'59, clinical instruc­ tor of orthopaedic surgery, Upstate Medical Center, Syracuse, New York, is planning to work overseas throughout the next school year as volunteer overseas missionary at McCormick Hospital and McKean Leprosarium in Chiengmai, Thailand.• The Classes of the 1960's The Classes of the 1950's Dr. Joseph M. Mattimore, M'50, is the new president of the Buffalo Allergy Society. He is a clinical associate professor at the University and a Fellow of the American Academy of Pediatrics. He is also chief of pediatrics at Mercy Hospital.• 64 Dr. William E. Abramson, M'60, is a senior staff psychiatrist at the Sheppard and Enoch Pratt Hospital, Towson, Maryland. He was re­ cently appointed director of the Comprehen­ sive Drug Abuse Program at the hospital for the State of Maryland's Drug Abuse Adminis­ tration. Dr. Abramson lives at 8281 Marcie Dr., Baltimore.D THE BUFFALO PHYSICIAN �Dr. Harris C. Faigel, M'60, is author of an article "Childhood Mortality is No Way to In May a 1968 Medical School graduate will return to the community that helped him with Measure a Nation's Health" that appeared in his medical education expenses. the April, 1972 issue of Clinical Pediatrics. Dr. Paul K. M u r p h y c o m p l e t e s his naval service h e Faigel lives at 1 5 Beaver Hill Lane, New Haven, will return to the Perry Medical Center, New Conn.D York with Dr. James R. Blake, M'63, was married to Miss Marilyn Amber Linnemann in May in Beverly Hills, California where Dr. Blake has a private practice.D When his wife and three children. Dr. Dr. Murphy took both his internship and residency at the Millard Fillmore Hospital.• Dr. Lawrence J. Schwartz, M'68, is Chief Resi­ dent in Ophthalmology, Pacific Medical Center, San Francisco. He was chief investigator on an Dr. Ronald S. Mukamal, M'64, has separated from the U.S.A.F. and is now in private practice of general surgery in Whiteville, North Caro­ lina. His address is 707 North Thompson St.D Dr. August J. D'Alessandro, M'65, a psychi­ atrist employed by the state of Connecticut, is co-ordinator of psychiatric services and med­ ical services, Security Treatment Center, Middletown, Conn. He is also consultant psy­ chiatrist for the Connecticut Youth Services Commission. He has recently had articles pub­ lished in Hospital Physician, Resident Physician, and Psychiatric Quarterly.[J article published in June 72 AMA ARCHIVES OF OPHTHALMOLOGY, entitled "Electrophysio­ logic and Fluorescein Studies in Vitelliform Ma­ cular Degeneration." He lives at 2090 Green Street, San Francisco.• Dr. James A. Dunlop, M'69, is the new direc­ tor of maternal and child health at the Erie County Department of Health. He is also a clinical assistant instructor in pediatrics.D Dr. Bruce S. Rabin, M'69, a former member of The Center for Immunology (1970-72), is now (July) Assistant Professor of Pathology at the University of Pittsburgh. Dr. Donald J. Waldowski, M'65, was recently appointed Director of Pediatric Education at Spartanburg General Hospital, Spartanburg, South Carolina (affiliated with Medical Univer­ sity of South Carolina). He lives at 116 Duval He will establish a division of Diagnostic Immunopathology there as its Associate Director. Dr. Rabin has authored 18 papers in the field of immunology and lives at 1235 Malvern Avenue, Pittsburgh.• Drive.• The Classes of the 1970's Dr. Jesse M. Hilsen, M'66, is on the faculty of Mt. Sinai Hospital and Medical Center (New York City) as research psychiatrist after com­ pleting an adult and child psychology residency Dr. Neil Garroway, M'70, is now at the Vanderbilt University School of Medicine, Nash­ ville, Tennessee.• there. He is consultant to Family Court of New York City; U. S. Public Health Service; Night­ Dr. Jan Martin Novak, M'70, is now (as of ingale Bamford School; psychiatrist for U. S. July 1st) an Associate Resident in Medicine at Air Force Reserve, as well as being in private Strong Memorial Hospital in Rochester, New practice at 35 East 85th Street, New York City.D York. He was formerly Assistant Resident in Medicine at Bronx Municipal Hospital Center, Dr. David Wallack, M'66, is a clinical instruc­ tor in medicine, University of Colorado Medical School. Albert Einstein College of Medicine. His ad­ dress is 77 Clintwood Court, Rochester.• He and his wife, Bonnie, announce the birth of their first child, daughter Adriana, Dr. D e n n i s J. Rosen, M'71, of 3 Ellsworth in April. T h e Wallacks live a t 1 0 9 1 E. P a n a m a Park, Cambridge, Massachusetts, is in pediatrics residency at Boston City.Q Drive, Littleton, Colorado.• WINTER, 1972 65 �People Dr. Vincent J. Capraro, clinical professor of gynecology-obstetrics at the School of Medi­ cine, has been awarded the Diploma of Honor by the International Federation of Infantile and Juvenile Gynecology "in recognition of his many contributions in the field of adolescent and pediatric gynecology." The award was presented at its First Sym­ posium held June 23-25 at the University of Bordeaux, France where Dr. Capraro presented four papers (gynecologic examination in chil­ dren and adolescents; management of anovula­ tion; breast problems in children and adoles­ cents; volvovaginoplasty—A new technique for vaginal agenesis). The Buffalo-educated physician (MD 1945 UB; internship and residency at E. J. Meyer Memorial Hospital 1945-46 and '48-51) joined the faculty in 1951. He is a Diplomate of the American Board of Obstetrics/Gynecology and a Fellow of the International College of Sur­ geons, American College of Surgeons, and the American College of Obstetrics/Gynecology. Dr. Capraro is also chief of the division of adolescent and pediatric gynecology at Chil­ dren's Hospital.• Dr. Jean A. Cortner has received a special fellowship from the National Institutes of Health to spend a year doing research in the Department of Human Genetics and Biometry, Galton Laboratory, University College, London, England. He is taking a year's leave of absence beginning Sept. 1 from his position as professor and chairman of the Department of pediatrics at the Medical School. He is also pediatricianin-chief at Children's Hospital. His wife and three children will accompany him to Eng­ land.• 66 Dr. Daniel Rakowski, clinical assistant pro­ fessor of psychiatry, has been named acting head of the department of psychiatry at the E. J. Meyer Memorial Hospital. He has been clinical director of the department. Dr. Jimmie Holland, associate professor of psychiatry, has resigned to accompany her husband, Dr. James F. Holland, to Moscow, where he will be the first chief medical liaison officer between the National Cancer Institute and the Soviet Union. He was a research professor of medi­ cine at the Medical School and chief of medi­ cine at Roswell Park Memorial Institute. He has taken a leave of absence from both posi­ tions. As a member of the National Panel of Con­ sultants on the Conquest of Cancer, Dr. Hol­ land was a principal architect of the National Cancer Act of 1971. In Moscow he will study Russian cancer research programs to learn what is being done there and to inform the Russian scientists of progress in America. His wife will be a special consultant in Russia for the Na­ tional Institute of Mental Health. Enroute to Russia the Hollands stopped in Israel where Dr. James Holland gave the Dameshek Mem­ orial Lecture to the Israel Society of Hematology.D Five Medical School faculty members are serving on the advisory board of the abortion clinic of the Erie Medical Center at 50 High Street. They are: Drs. Jack Lippes, associate professor of gynecology-obstetrics; Dean R. Goplerud, assistant professor of gynecologyobstetrics; Harold P. Graser, clinical assistant professor of psychiatry; Murray S. Howland, clinical professor of medicine; and Robert J. Patterson, clinical instructor in gynecology-ob­ stetrics. Also serving on the board is Edythe Goetz, intake supervisor and co-ordinator, Family Service Society and Clarice S. Lechner, R.N., associate professor, maternal health nurs­ ing, School of Nursing at the University.D THE BUFFALO PHYSICIAN �of aging. The Center for Immunology at the Medical School will be involved in the project. A clinical associate professor of pediatrics at the Medical School is expanding t h e lead poisoning testing program for inner city chil­ d r e n . D r . E m m a K. H a r r o d , E r i e C o u n t y D e p u t y Health Commissioner for maternal and child health, said the $225,000 grant from the Health Services and Mental Health Administration will be used to test about 10,000 children ages 1-5. The grant money will also be used to increase public education on dangers of lead poisoning and increase follow-up assistance to families of children suffering from the ailment. It is also hoped that within five years most of the leadcontent paint will be removed from many of the city's older homes.D The man who designs the covers for THE BUFFALO PHYSICIAN is Richard Macakanja, health sciences graphic artist. His cover design (reproduced in miniature) won an "excellence in design award" and placed second in the an­ nual Inhouse Publications Contest sponsored by Industrial Art Methods. The Texaco Star magazine won first place. Mr. Macakanja's cover design depicted the 1971 Spring Clinical Days. The photos were taken by Hugo Unger, health sciences photographer. Mr. Macakanja has been on the Health Sci­ ences staff for six years. He received his BFA degree from the University in 1960 and expects to receive his MFA in January, 1 9 7 3 . • Four alumni are newly elected officers of the Western New York Society of Internal Medi­ cine. Dr. William Breen, M'55, is the new presi­ dent and Dr. Joseph Zizzi, M'58, is the new first vice president. The new treasurer is Dr. Edward Craber, M'60, and Dr. James Kanski, M'60, is secretary. Dr. Louis Kramer, a clinical associate in medicine at the Medical School, is the sec­ ond vice president.Q Dr. Morton Rothstein, professor of biology at the University, received a $1 million 5-year grant from the National Institute of Child Care and Human Development to study the causes WINTER, 1972 Dr. Louis Bakay, professor of surgery (neuro­ surgery) at the Medical School and who heads the division of neurosurgery at the Buffalo G e n e r a l , C h i l d r e n ' s a n d E. J. M e y e r M e m o r i a l H o s p i t a l s g a v e t h e p r e s t i g i o u s D r . L. P . M o u s seau Memorial Lecture at the Edmonton Gener­ al Hospital in October on "The Blood-Brain Barrier: Its Theory and Clinic Utilization. Dr. John W. Boylan, professor of medicine and physiology at the Medical School is editor of the 1971 issue of Mount Desert Island Biological Laboratory, Salisbury Cove, Maine. In the 111-page bulletin are research reports of 31 investigative groups from 18 states and three other countries who worked at the in­ dependent marine biological station during the summer of 1971.• Dr. Michael D. Garrick, assistant professor of biochemistry, participated in two symposiums in Australia and New Zealand in May. His ad­ dress, "Hemoglobins and Evolution" was given at the University of Otago, Dunedin, New Zea­ land. The paper he gave in Sydney was "The Anaemia-Induced Reversible Switch from Hae­ moglobin A to Haemoglobin C in Goats and Sheep: The Two Haemoglobins are present in the Same Cell During the Changeover." He also gave a talk at the National Institutes of Health on "Hemoglobin Switching in Goats and Sheep."• 67 �People Dr. Franz E. Glasauer, professor of neuro­ surgery at the University, was recently elected a charter member of the International Society for Pediatric Neurosurgery (May, 1972). He has been the participating neurosurgeon at the Birth Defects Clinic (Children's Hospital) since its establishment in 1966. Many of his publica­ tions deal with the diagnosis, treatment, or other problems in pediatric neurosurgery. Dr. Glasauer is a 1955 graduate of the University of Heidelberg (Germany) Medical School.• Dr. Cohen Dr. Maimon Cohen, associate professor of genetics and head of the division of cytogenet­ ics at Children's Hospital, has left to establish and head the first department of human ge­ netics at Hadassah Hebrew University Medical Center, Jerusalem. He had been on the Uni­ versity staff since 1965.• Dr. Carel J. van Oss, associate professor of microbiology, is involved in space research. An experiment on "The Electrophoresis of Latex Particles at Zero Gravity" was done in Apollo 16 on its way to the Moon, during the weight­ less period. The experimental equipment was left on the Moon. However, the photographs which were taken every 20 seconds during the experiment and the Astronauts' tape were re­ turned to Earth for analysis. This is the first of a series of experiments aiming at the pre­ parative electrophoretic separation of living cells that will be continued on Apollo 17 and Skylab 1. Dr. van Oss is a member of the Uni­ versities Space Research Association Commit­ tee on Separation Methods.• Dr. Jack Herrmann, clinical associate profes­ sor of surgery, scored a hole-in-one at the Westwood Country Club in August. He used a 4-wood to ace the 175-yard third hole. Dr. Herrmann is on the Buffalo General Hospital medical staff.D Dr. Richard G. Cooper is the new president of the Erie County Unit of the American Cancer Society. Dr. Cooper is a clinical associate pro­ fessor of medicine. Dr. Alfred M. Stein, M'58, is the vice president and president elect. He is a clinical associate professor of medicine.D 68 Drs. John Dower, professor of community pediatrics and James Markello, assistant pro­ fessor of pediatrics, (both on the staff of Chil­ dren's Hospital) are teaching nursing students in two new programs that will train nursing clinicians, practitioners and teachers in the field of child health nursing. The two graduate programs, offered for the first time, received federal grants totaling $591,148.• Two Medical School faculty members have been named Fellows in the American College of Cardiology, Dr. S. Subramanian is a clini­ cal associate professor of surgery, a pediatric cardiac surgeon, and chief of the division of cardiovascular surgery at Children's Hospital. Dr. Walter T. Zimdahl, a cardiologist, is a clini­ cal associate professor of medicine and acting chief of medicine at Deaconess Hospital.• Dr. Herbert A. Hauptman, research professor of biophysical sciences, has been named vice president and research-executive director of the Medical Foundation of Buffalo. He is inter­ nationally known for his work in determining the crystal structure of steroid hormones and other biological substances.• Dr. Guyon P. Mersereau, clinical assistant professor of psychiatry, is the new director of the Erie County Forensic Psychiatry Service. He has been acting director since February, 1970.D A 635-page book based on a study of the in­ cidence of long-term childhood illnesses in Erie County between 1946 and 1961 has been pub­ lished by the University of Pittsburgh Press. Authors are Dr. Harry A. Sultz, professor of social and preventive medicine at the Medical School; Dr. Edward R. Schlesinger, formerly as­ sistant commissioner for special health services in the State Health Department; Dr. William Mosher, Erie County Health Commissioner; and Joseph G. Feldman, former clinical instructor in social and preventive medicine at the Med­ ical School.• Three Medical School faculty members are new Fellows of the American College of Physi­ cians. They are Drs. Germante Boncaldo, M'57, clinical instructor in medicine; Thomas D. THE BUFFALO PHYSICIAN �Doeblin, M'59, clinical assistant professor of Dr. S. Mouchly Small, professor and chair­ medicine; and )ohn A. Edwards, research as­ man of the Department of Psychiatry at the sistant professor of medicine.• School of pointed to Medicine has recently been the National Board of ap­ Medical Examiners, Part III Committee for Patient Man­ The Memorial Medical Center at Niagara agement Problems. Dr. Small is the only psy­ Falls, N. Y. has received a $748,154 federal grant chiatrist on this Committee. for the community mental health center. Dr. also serves on the Written Examination Com­ Milton Robinson, M'51, psychiatric In addition, he director, mittee of the American Board of Psychiatry and said the money would be used to expand serv­ Neurology and on the American Psychiatric Association's Self-Assessment Test Committee ices—especially prevention services at all levels of community involvement. The 5th, 6th and for Patient Management Problems. This puts 7th floors of the Memorial Medical Center are him in the unique position of serving on the used for the mental health center.D three major examination committees in Ameri­ can Psychiatry. There aren't many women forensic pathol­ ogists in the United States. Dr. Judith Lehotay, a clinical assistant professor of pathology at the Medical School, is one. She describes herself as a "medical detective" or a liaison between medicine and the law. She is in the Erie County Medical Examiners' Office. Her profession re­ quires examination of bodies of persons who died through violence (murder, suicide or acci­ dent) and those not attended by a physician With Professor Peter F. Regan of the Depart­ ment of Psychiatry and Dr. Hugh Carmichael of the American Psychiatric Association in Washington, D. C. as co-authors, he published a book this year on "Lifetime Learning for Psychiatrists." This book includes the impor­ tance of self-assessment examinations and ob­ jective-type examinations for an on-going eval­ uation of clinical knowledge, skills, and com­ petence for psychiatrists.• shortly before death. Dr. Lehotay is a native of Hungary. She and her husband came to Buffalo in 1957. She interned at Children's Hospital and took her residency at Sisters' Hospital.• The new president of the Erie County Medi­ cal Society is Dr. Leonard Berman, a 1946 grad­ uate of Wayne State University, Detroit. He is not a UB graduate as was reported in the Fall Dr. Walter J. Gannon, M'44, is the new Erie County Medical Examiner. The family physician replaces Dr. Michael A. Jurca, M'42, who re­ signed to take a full time position on the Medical School faculty. Another Buffalo sur­ issue of The Buffalo Physician. Dr. Berman, a clinical associate professor of surgery at the Medical School, spent two weeks last summer visiting hospitals and medical centers in Japan, Thailand and Hong Kong.n geon, Dr. Ernest Fernandez, was also appointed medical examiner for the County. He is a native of Puerto Rico and received his M.D. from the University of Chicago.Q man of the division of orthopaedic surgery at the Medical School and the E. J. Meyer Me­ While on sabbatical leave in London the last year, Dr. Mitchell I. Rubin wrote a book on pediatric nephrology. From 1945 to 1967 Dr. Rubin was chairman of Dr. Eugene R. Mindell, professor and chair­ morial Hospital, is the new president of the Orthopaedic Research Society. He will preside at the next annual meeting in January at Las Vegas, Nevada.• the department of pediatrics at the University and pediatrician-inchief at Children's Hospital. He and Mrs. Rubin will make their home in Charleston, S. C. where Dr. Helen M. Ranney, professor of medicine, he will be associated with the Medical College is president-elect of the American Society of Hematology.D of South Carolina.• WINTER, 1972 69 �In Memoriam Dr. Edward Cook, M'33, was killed October 10 when his auto failed to make the turn onto Main Street in Buffalo and struck a light pole. He was a specialist in internal medicine and was a clinical associate in medicine on the fac­ ulty for 34 years. Dr. Cook also served on the board of internal medicine at the Buffalo Gen­ eral Hospital. He was a lieutenant colonel in the Army Medical Corps during World War II.• Dr. William W. Kunz, M'53, died September 8 in Buffalo General Hospital after a five month illness. The 45-year-old specialist in internal medicine was a member of the staff of the Brooks Memorial Hospital, Dunkirk where he headed the department of electrocardiography. He was a member and past president of the Chautauqua County Medical Society, a Fellow of the American College of Physicians, a mem­ ber of the Medical Society of the State of New York, a Diplomate, American Board of In­ ternal Medicine, the American Society of In­ ternal Medicine, and the AMA. He was also active in the Narcotics Guidance Council at Dunkirk.• )r. William C. Werkheiser, research associ­ ate professor of biochemistry and pharmacol­ ogy, died suddenly September 1. He was also a Roswell Park Memorial Institute cancer re­ searcher. He joined the Roswell Park staff as senior cancer research scientist in the experi­ mental therapeutics department in 1956 and became associate cancer research scientist in 1961. The 52-year-old Dr. Werkheiser had been on the Medical School faculty for 12 years. He received his bachelor's degree from Brown University and his master's and doctorate in biochemistry from the University of Southern California. He was a pre-doctoral fellow of the American Cancer Society and studied at Oxford University as a post-doctoral fellow of the National Cancer Institute.• l-Or. Robert F. Sullivan, M'58, died October 2 in Mercy Hospital after a long illness. He was 53 years old. He had been a general practi­ tioner for 28 years and a member of the Mercy Hospital medical staff. Dr. Sullivan was active in sports. He pitched for Canisius College and the Buffalo Municipal Baseball Feague. He was also active in several professional organiza­ tions^ Dr. Winzler Dies Suddenly Dr. Richard J. Winzler, professor in the de­ partment of chemistry at The Florida State Uni­ versity, died suddenly at his home in Tallahas­ see, Florida September 27. The biochemist had been chairman of the biochemistry department at the UB Medical School from 1965 to August 1969. Dr. Winzler rx Dr. Winzler, born in San Francisco in Sep­ tember 1914 received both his Bachelor of Sci­ ence and Doctor of Philosophy degrees from Stanford University (1936 and 1938 respective­ ly). He was a Sterling Fellow at Yale and a National Research Council Fellow in Stock­ holm, Sweden (1939-40) and at Cornell Uni­ versity (1940-41). Dr. Winzler was associated with the National Cancer Institute in Bethesda, Maryland before accepting an assistant profes­ sorship at the University of Southern California. From 1952 to 1965 he was professor and head at the University of Illinois, department of bio­ chemistry in Chicago. He came to Buffalo in 1965 to head the department of biochemistry 70 at the University until he moved to Tallahassee in 1969. Among other honors Dr. Winzler was a Visit­ ing Professor at the University of Wisconsin in 1941, a Commonwealth Fellow at the Univer­ sity of Freiburg, Germany in 1958 and a con­ sultant in medical education at the University of Chiengmai, Thailand in 1962. Author of over 175 articles in the fields of glycoprotein chem­ istry, biochemistry of cancer tissues, and mem­ brane structure, Dr. Winzler has been editor for two journals, Cancer Research and Proceed­ ings of the Society for Experimental Biology and Medicine. He had been actively associated with work of the American Cancer Society and of the National Institutes of Health. The Dr. Richard J. Winzler Memorial Fund has been established. Contributions should be sent to Dr. Earl Frieden, department of chem­ istry, Florida State University, Tallahassee, Florida, 32306.• THE BUFFALO PHYSICIAN �)r. Cathryn Jones died September 28. She was the wife of Dr. Oliver P. Jones, retired chairman and distinguished professor of anat­ omy at the Medical School. She had been as­ sistant to the medical director of the Buffalo Red Cross for the past 15 years. She was a 1935 graduate of the University of Minnesota Medical School. She came to Buffalo with her husband in 1937. The couple had four children. She served as a physician with the Red Cross blood program in 1942-43. In 1952 she re­ turned to the Red Cross. In 1941 she was an instructor for medical technologists at the Mil­ lard Fillmore Hospital.• Dr. Edward Healy, M'39, died September 26. The 59-year-old family physician was chairman of the Emergency Room Associates at Sister's Hospital, a medical program that he started. He was also the physician to the Sisters at Mount St. Joseph Convent. In 1969 Dr. Healy received the Msgr. Francis J. O'Connor Award for 25 years' service to the children of St. Mary's School for the Deaf. Dr. Healy started practic­ ing in Buffalo in 1945 after being discharged from the Army. The Major served aboard a troop ship for four years as a surgeon. He was active in several professional organizations.• Dr. Michael F. Mogavero, M'39, died Sep­ tember 18 in Millard Fillmore Hospital after suffering a heart attack at his home. The 60year-old ophthalmologist retired in 1970 after a 31-year career. He began his career as a gen­ eral practitioner and became an eye specialist after completing training at the Harvard Medi­ cal School in ophthalmology and eye surgery. He served on the medical staffs at Columbus, Sisters and Millard Fillmore Hospitals and at the Wettlaufer Clinic. Dr. Mogavero was active in several local, state and national professional organizations-^ / Dr. Stanley A. Weglikowski, M'33, died Sep­ tember 23 in Buffalo General Hospital. The 61year-old general practitioner was affiliated with Mercy Hospital. He was active in several pro­ fessional organizations.• Dr. Rose R. Donk, M'11, 215 Church Street, Newark, N. J. died August 4, according to the Lincoln Rochester Trust Company, who is handling her estate.Q WINTER, 1972 Dr. Douglas P. Arnold, M'08, died July 26 after a long illness. The 87-year-old man was hailed by his colleagues as the one who brought modern pediatrics to Buffalo. He was head of the pediatrics department at three hos­ pitals — Children's, Buffalo General and Millard Fillmore. He was a 60-year staff member at Children's and continued as a consultant mem­ ber following his retirement in 1963. He was also in charge of the Infant Welfare Clinic of the Buffalo Health Department for nearly 30 years. Dr. Arnold was on the Medical School faculty for 15 years, retiring in 1950 as a clinical pro­ fessor of pediatrics (emeritus). When he re­ tired a lecture series was established in his honor. The Douglas P. Arnold Lecture brings an outstanding doctor to Buffalo annually to discuss some special field of medicine at Chil­ dren's Hospital. He began his Buffalo practice in 1914 and his method for replacement transfusions in Rhnegative babies earned him worldwide ac­ claim in medical circles. He was the first physi­ cian to perform that procedure in the Buffalo area. Dr. Arnold interned at the Buffalo General Hospital and took his residency at Harvard. He did postgraduate study in Berlin and Munich. He was a member and past president of the Canadian Society for the Study of Diseases of Children. He was also a Diplomate of the American Board of Pediatrics and was active in several local, state and national professional organizations-^ / Dr. Richard A. Bahn, M'52, died July 4 at his home in Oxford, N. Y. The 45-year-old surgeon had been in poor health for more than one year, but had continued to practice until five weeks before he died. Dr. Bahn spent seven years as an intern and resident in surgery at the E. J. Meyer Memorial Hospital and re­ turned to the hospital to practice in 1971. From 1959 to 1963 he was in Harlan, Ky. where he practiced in the United Mineworkers Hospital. When the hospital was sold he returned to New York State and opened a private practice in Norwich where he was on the staff of the Chenango County Memorial Hospital. One of his brothers, Dr. Robert C. Bahn, is a 1947 Medical School graduate and a member of the Mayo Clinic Staff, Rochester, Minnesota.• 71 �Cruise Carnival in Cabin Category from $299 to $499 Departing from Niagara Falls, N. Y. on December 30, 1972 Here's what's included: Caribbean Cruise Carnival to • San Juan, Puerto Rico; St. Marten; St. Thomas, • Round trip jet flight to Miami Virgin Islands; Nassau, the Bahamas. This cruise will feature a special scientific program for physicians and dentists by Mirdza Neiders, D.D.S., Professor of Oral Pathology, SUNYAB School of Den­ • Accommodations aboard TSS Mardi Gras for 7 days with air conditioned staterooms • Three meals a day tistry. • Captain's Cocktail Party The program will include: 1. Early Cancer Detection • All transfers and luggage handling 2. Differential Diagnosis of Jaw Lesions • Host escort throughout 3. Oral Manifestations of Dermatologic Diseases • Briefings on what to see in each 4. Systemic Diseases with Oral Manifestations 5. Case Presentations Program fee is an additional $50.00. The cruise with the scientific session is tax deductible. port-of-call For details write or call: Alumni Office, SUNYAB 123 Jewett Parkway Buffalo, N. Y. 14214 (716) 831-4121 Departing by jet Feb. 16 is the Majorcan Carnival — 8 days & 7 nights for $359.00. From this Mediterranean Island there is an optional day in Madrid. Other trips to London and Portugal are in the planning stage. The General Alumni Board - MORLEY C. TOWNSEND, '45, President; DR. FRANK L. GRAZIANO, D.D.S., '65, President­ elect; GEORGE VOSKERCHIAN, Vice President lor Activities; FRANK NOTARO, '57, Wee President lor Administration; MRS. PHYLLIS MATHEIS KELLY, '42, Vice President for Alumnae; JAMES J. O'BRIEN, '55, Vice President for Athletics; ROBERT C. SCHAUS, '53, V/ce President for Constituent Alumni Croups; DR. GIRARD A. GUGINO, D.D.S., '61, Vice President for Development and Membership; G. HENRY OWEN, '59, Vice President for Public Relations; ERNEST KIEFER, '55, Treasurer; CHARLES M. FOGEL, '38 and ESTHER K. EVERETT, '52, Members of the Executive Committee; Past Presidents: DR. EDMOND J. GICEWICZ, M'56; ROBERT E. LIPP, '51; M. ROBERT KOREN, '44; WELLS E. KNIBLOE, '47; RICHARD C. SHEPARD, '48. Medical Alumni Association Officers: DRS. JOHN J. O'BRIEN, M'41, President; LAWRENCE H. GOLDEN, M 46, Vice President; PAUL L. WEINMANN, M'54, Treasurer; LOUIS C. CLOUTIER, M'54, Immediate Past-President; MR. DAVID K. MICHAEL, M.A. '68, Secretary. Annual Participating Fund for Medical Education Executive Board for 1971-72 — DRS. MARVIN L. BLOOM, M'43, President; HARRY G. LaFORGE, M'34, First Vice-President; KENNETH H. ECKHERT, SR., M'35, Second Vice-President; KEVIN M. O'GORMAN, M'43, Treasurer; DONALD HALL, M'41, Secretary; MAX CHEPLOVE, M'26, Immediate PastPresident. 72 THE BUFFALO PHYSICIAN �A MESSAGE FROM J O H N J. O ' B R I E N , M ' 4 1 PRESIDENT MEDICAL ALUMNI ASSOCIATION The University of Buffalo Medical Alumni Association needs your dues contribution more than ever before. It helps provide much needed School of Medicine-community interplay, such as: 1. 2. 3. 4. 5. 6. 7. SCHOLARSHIPS for medical students. CONTINUING EDUCATION. The Spring Clinical Days. REUNIONS of your graduating class. RECEPTIONS at selected medical conventions. CLUBS on a national basis. TOURS. Vacations highlighted by scientific sessions. MISCELLANEOUS. Office Expenses and other services focused at making ours a complete alumni program. We invite you to join the physicians who gave last year. Please use the envelope below and make your check payable to the "Medical Alumni Association." Your gift will add new meaning and flexibility to our program. First Class Permit No. 5670 Buffalo, N. Y. BUSINESS REPLY NO POSTAGE STAMP NECESSARY IF MAILED IN POSTAGE WILL BE PAID BY — Medical Alumni Association 2211 Main Street Buffalo, New York 14214 Att.: David K. Michael MAIL THE UNITED STATES �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET, BUFFALO, NEW YORK 14214 THE HAPPY MEDIUM Fill out this card; spread some happiness; spread some news; no postage needed. (Please print or type all entries.) Name __ Office Address Home Address Year MD Received — —. If not UB, MD received from In Private Practice: Yes • _ No • In Academic Medicine: Yes • Specialty, No • —— Part Time • Full Time • School . Title Other: — Medical Society Memberships: NEWS: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.? — Please send copies of any publications, research or other original work. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 1972 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1972-Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v06n04-1972-Winter Table Of Contents A list of subunits of the resource. Faculty Honored Pacemakers Alumni Receptions SLE Test Children's Hospital University/Hospital Partnership by President Robert L. Ketter Drug Abuse Roswell Park/Psychiatry Director Rural Health Care Prenatals Gonorrhea Test Gyn/Ob Head/Chinese Student Teaching Techniques Continuing Medical Education Community-University Day Polluted Waters New Journal/Psychiatry Grant Dr. George Thorn Moral Issue BGH Expansion Allergic Disease Center LARMP/Microbiology Grants Hallucinogens Dermatology Chairman The 1976 Class Family Practice/Dr. Murphy Surgery Chairman Dr. Regan/Scholarships First Complex Hormone Dr. Vaughan Lab/Health Center Infectious Diseases VA Hospital Director Lackawanna Health Center Health Resources/Dr. LaPaglia Surgery VA Drug Treatment Mental Health 10,000 Mile Cruise Medical Van New North Campus Heart/Lung Studies Swimming Analysis Faculty Promotions The Classes People In Memoriam Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v06n04 Extent The size or duration of the resource. 76 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright 1972 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/d1f86cccff273e335d54dd3d190250a8.pdf cfdd047c185cab54354c9ff29bf85cb8 PDF Text Text �BUFFALO PHYSICIAN Volume 29, Number 1 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY ADVANCEMENT Dr. Carole Smith Petro DIRECTOR O F PUBLICATIONS Timothy J. Conroy PUBLICATIONS MANAGER Judson Mead PRODUCTION MANAGER Ann Raszmann Brown EDITOR Nanette Tramont, R.N. ART DIRECTOR Alan J. Kegler STATE UNIVERSITY O F NEW YORK AT BUFFALO S C H O O L O F MEDICINE AND BIOMEDICAL SCIENCES Dr. John Naughton, Vice President for Clinical Affairs, Dean EDITORIAL BOARD Dr. John A. Richert, Chairman Dr. Russell W. Bessette Dr. Martin Brecher Dr. Harold Brody Dr. Richard L. Collins Mr. Ravi Desai Dr. Alan J. Drinnan Dr. James Kanski Dr. Elizabeth Olmsted Dr. Barbara Majeroni Dr. Charles Paganelli Dr. Thomas Raab Dr. Stephen Spaulding Dr. Bradley T. Truax TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital Michael Shaw Buffalo VA Medical Center Arlene Kelly The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Health System Frank Sava Roswell Park Cancer Institute Sisters of Charity Hospital Dennis McCarthy © The State University of New York at Buffalo Buffalo Physician is published quarterly by the State University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, freeof charge, to alumni, faculty, students, residents and friends. The staff reserves the right to edit all copy and submissions accepted for publication. Address questions, comments and submissions to: Editor, Buffalo Physician, State University of New York at Buffalo, University Publications, 136 Crofts Hall, Buffalo, New York 14260; or by e-mail at notes@pub.buffalo.edu. Send address changes to: Buffalo Physician, 147 CFS Addition, 3435 MainStreet, Buffalo, New York 14214 Dear Alumni and Friends, T his issue of the Buffalo Physician focuses on the increased emphasis the medical school and the Graduate Medical Dental Education Consortium have directed to Primary Care education and on selected aspects of medical practice in Western New York and throughout the country. Ms. Nan Tramont, the Editor, has done an excellent job of coordinating a large amount of information on these important areas. As I have reported previously, the medical school and the Consortium have made ' , significant commitments to foster educational change at the medical student and graduate medical education levels. The faculty through­ out all aspects of the medical school are now involved in a thorough evaluation of the current curricular offerings, and are working diligently to ensure that new initiatives designed to prepare UB's graduates appropriately for the future will be ensured. Never before in the history of American medicine has the need to coordinate educational needs with future professional career needs been as intense and necessary. UB will continue to provide leadership in this important area, and through the Buffalo Physician you will be kept abreast of the school's progress. Best regards. Sincerely, John Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Dear Fellow Alumni, P lans are well under way for this year's Spring Clinical Day. Dr.Jack Coyne, program chairperson, has organized a morning program centering on the theme of the physician's role in recognizing child abuse. This topic, along with the increasing recognition of family abuse, has become a national concern. The planned program should be most educational and informative for all participants. This year's Stockton Kimball Lecture will be given at Spring Clinical Day by Dr. Richard Krugman, dean of the School of Medicine at the University of Colorado, Denver, Colorado. Recently, the five-year class reunion chairpersons met to review plans for their respective class dinners and social events. As part of this, many of you will be contacted by them for contributions to a class gift. Please be generous if you are called and remember that funds collected are used to benefit scholarship programs for deserving medical students. Recently, the Distinguished Medical Alumnus Award was pre­ sented to Dr. Noel Rose. This presentation was made at the Past President's Dinner and it recognized Dr. Rose's outstanding achievements, as well as the past efforts of numerous Medical Alumni Presidents. The academic year for medical students is well under way, and early reports show a very enthusiastic response by students for the Community Physician Program under Dr. Roger Dayer's direction. We on the board thank you for all your continued support and encouragement as we prepare for this year's major event at Spring Clinical Day. Sincerely, Russell W. Bessette, D.D.S., M.D. '76 President, Medical Alumnus Association �Making Primary Care Primary • UB's innovative Music's charms. Page 3. programs are leading the nation in the push for primary care. Practicing their Calling It's a brave new world for today's practitioner as physicians are finding the idyllic image of the solo practitioner as endan­ gered as the 10-cent phone call. Then and Now Medical School ElAlumni UB's emphasis an primary care makes it a national leader. Page 6. Spoonful of Humor Classnotes 1 On the cover: Residents David Milling, M.D., and Colleen Mattimore, M.D., (on the right), and medical students Tami Seaman and Steve Cook (on the left) help make up the cadre of new and future primary care physicians trained at UB. �Below-average cognition may herald treatment dropout risk drinkers who tended to have more pre­ vious treatment experience. But the most striking finding, researchers said, showed that treatment completers scored significantly differently than lcoholics who have below-average cognitive abilities are more likely dropouts on the NAART and Trails B to drop out of residential treat­ tests. ment programs than those with Over half of inpatients who scored average or above-average cogni­ below-average dropped out of treatment, tive abilities, according to a recent compared to only 19 percent of the study by the Research Institute on Ad­ inpatients in the above-average group dictions. and 28 percent in the aver­ RIA research scien­ age group. tists Donna M. Czarnecki recom­ Czarnecki, Ph.D., mends that providers as­ and Gerard J. sess clients' dropout risk Connors, Ph.D., stud­ at intake, taking into con­ ied 136 clients admit­ sideration how much they ted to the RIA's 28-day drink, their treatment his­ Clinical Research Center tory, general abilities and treatment unit. The study whether or not cognition is compared clients who impaired. completed the program "Because of the way with those who left be­ alcohol and other fore it ended, either drugs affect the brain, against medical advice many clients may have or because they were some impairment when discharged for adminis­ they first enter treatment. trative reasons. Initially, the cognitively Cognitively limited dients may The study showed rates need extra help in treatment. limited clients may be over­ similar to those generally whelmed by the standard reported for such programs: 69 percent treatment program. They may need of the clients completed the treatment something extra to help them in treat­ program; 31 percent did not. As part of ment." + their admissions screening, investiga­ tors administered the North American Adult Reading Test (NAART) and the Trailmaking tests. The NAART, which entails reading aloud, provides a rough estimate of intelligence. new study by UB researchers has "Reading is not usually affected by shown that breast-feeding prema­ long-term alcohol abuse, so this should ture infants during the first three provide a stable estimate of intelligence to four weeks of life may help or general ability," Czarnecki said. protect them from developing the "Trails B, which is a paper and pencil potentially life-threatening bowel test, is a behavioral measure that is sen­ inflammation, necrotizing enterocolitis. sitive to cognitive impairment." The findings show that premature in­ Clients who dropped out were heavier i Breast-feeding premature babies may offer protection bom NEC © B u f f a l o P h y s i c i a n W fants who are not breast-fed have about a three times greater risk of developing NEC during the first four weeks than premature babies who receive any amount of breast milk during that time. Risks were nearly the same for breastand bottle-fed babies at two weeks, the results showed, with the protective ef­ fect beginning to appear during the third week, when the risk of NEC for babies who had received no breast milk was twice that of breast-fed babies. Vivien Carrion, M.D., assistant pro­ fessor of pediatrics and lead investigator on the study, presented the findings at the Society for Pediatric Research meet­ ing in April. The retrospective case-control study involved 100 premature infants admit­ ted to The Children's Hospital of Buffalo between January 1986 and December 1992 who developed NEC, and a ran­ dom group of 100 infants from the same neonatal intensive care unit who did not. Babies were matched for age, weight — all weighed less than 1,500 grams at birth — and other significant factors. An analysis of feeding methods from the infants' medical records showed that breast-feeding was significantly more prevalent among the babies who did not develop NEC than among those who did. Babies in the control group also were breast-fed longer than infants in the case group. "Our study shows that infants fed any breast milk for three weeks or longer prior to diagnosis were at lower risk for NEC than those who were not breast­ fed," Carrion said. "There were no other factors that accounted for the difference between groups." Members of the research team also included Nadir Parsa and Linda Duffy, Ph.D., both of the department of pediat­ rics and Children's Hospital. l n f e r 1 9 9 5 �Music has charms to soothe a savage surgeon, UB study says IIB study shows most with SIBS do not go on to develop sepsis P B laying music during surgery may help some surgeons relieve stress and improve their performance, a UB study suggests. But only music selected by the surgeon had a strong positive ef­ fect during an experiment designed to mimic the stress of surgery. Results showed that music selected by the re­ searchers known specifically for its calm­ ing influence resulted in only slightly decreased cardiovascular activity and no improvement in performance. The study, conducted by Karen Allen, Ph.D., andjim Blascovich, Ph.D., of the Center for the Study of Biobehavioral and Social Aspects of Health, appeared in the Sept. 21,1994 issue of the Journal of the American Medical Association. Various studies have shown the role of music in relieving patients' anxiety and pain before, during and after medical pro­ cedures, including surgery. Allen and Blascovich said theirs is the first to study music's therapeutic effect on surgeons. They assessed how music affected sur­ geons' cardiovascular reactivityand per­ formance, enlisting 50 male volunteers who listened to music during surgery to perform mental arithmetic tasks in a laboratory setting. The tasks were performed twice un­ der three conditions — music of choice, music selected by the researchers (Pachelbel's Canon in D, a well-known classical orchestral piece often included in commercial "stress-reduction" tapes) and no music. Baseline cardiovascular readings were taken before and after each task, and readings monitored during each task and music condition. Performance was rated for speed and accuracy by a researcher blind to the study conditions. Results showed the surgeons per- B u f f a l o P h esearchers at the University at Buffalo's Center for Pharmaco­ epidemiology have concluded that one of the definitions of sepsis and the conditions that precede it — adopted two years ago to help identify patients at risk of the most com­ mon cause of death in hospital intensive care units—may, in fact, raise false alarms. The study found that contrary to the definitions promulgated by the Ameri­ can College of Chest Physicians and the Society for Critical Care Medicine, 72.3 percent of patients with systemic in­ flammatory response syndrome (SIRS), considered a precursor of severe sepsis, do not go on to develop the condition. The UB study included 1,754 patients — one of the largest databases compiled on patients at risk of developing sepsis. A total of 1,649 patients, or 94 percent of the group, developed SIRS. Self-selected music engendered the best performance. formed substantially better when lis­ tening to their own selection. Cardiovascular response also was sig­ nificantly lower during the self-selected music segment. Average pulse rate was 78 beats per minute during the self-selected music, compared to 110 during both the Pachelbel selection and when no music was playing. Both systolic and diastolic blood pressure rose significantly in re­ sponse to stress during the no-music and Pachelbel segments, but remained stable during the physicians' choice of music. No specific category of surgeon-selected music was associated with favorable physi­ ological responses and improved perfor­ mance. "This experiment lends credible support to the importance of individual taste and selection of music," the authors state. "James Galway and the Chieftans playing Irish music complete with drums and tin whistles had a more positive influ­ ence on the surgeon than the soothing Pachelbel used as the control." — y B s Y L i c O I i S B a n A K W E R i New name better reflects mission and origins of research group T o recognize the partnership of science and philanthropy that has been a part of the Medical Foun­ dation of Buffalo since its found­ ing in 1956, the board of direc­ tors has announced that the organization's name has been changed to the Hauptman-Woodward Medical Research Institute, Inc. The institute's new name recognizes the contributions of its president and UB professor of biophysical sciences, Herbert A. Hauptman, and the benefac­ tion of Helen Woodward Rivas and her daughter, Constance W. Stafford, as well as better describes its biomedical re­ search mission. n t e r 1 9 9 5 © �HOSPITAL Ft! N E W S Dent Neurologic Institute offers Positron Emission Tomography T he Millard Fillmore Health Sys­ tem has become the first private health care organization in West­ ern New York to offer Positron Emission Tomography through the Dent Neurologic Institute. Isotopes for the sophisticated nuclear imaging will be provided by UB, which was the first to bring the technique to the area at its Center for Positron Emis­ sion Tomography — a cooperative ven­ ture between the university and the Department of Veterans Affairs — lo­ cated at the Buffalo VA Medical Center. Millard's PET scanner — the Exact HR PET Scanner — is one of the three most technically advanced scanners in the world. It was installed at Millard's Gates Circle facility last spring. "The potential of PET is limitless. Its measurements of functional physiologic activity in the body will not only allow more timely service to patients in need, but will also facilitate a greater under­ standing of the functioning human body in all its complexity," said William Kinkel, M.D., founding director of the Dent. + strong community ties to her position at Roswell Park," said Thomas Tomasi, M.D., Ph.D., Roswell president and CEO. Well-known in the Western NewYork community, Bontempo is the recipient of the Outstanding Woman in Business and Industry Award from UB's Com­ munity Advisory Council; the Clifton C. Thorne Award for Outstanding Achievement in Health Care and Hu­ man Services from Empire Blue Cross/ Blue Shield; and the 1989 Western New York Chapter of the National Confer­ ence of Christians and Jews Certificate of Recognition in Medicine, among oth­ ers. She holds honorary doctorates from Niagara University and Canisius Col­ lege. Bontempo received her master's de­ gree in health administration from St. Louis University in Missouri and ad­ vanced certification in health manage­ ment and finance from Yale University. She is a fellow of the American College of Healthcare Executives and an active member of the American Public Health Association and Association of Cancer Centers. + Angela Bontempo takes senior vice presidential post at RPCI i ngela Bontempo, former president and chief operating officer of Sis­ ters of Charity Hospital, has been appointed senior vice president and executive director of Roswell Park Cancer Institute. Bontempo will oversee Roswell's ad­ ministrative, operational and fiscal man­ agement. "Ms. Bontempo brings a high level of administrative experience as well as O B u f f a l o P Angela Bontempo h y s i c i a n w Roswell and Millard lo establish outpatient cenlei al Suburban B oswell Park Cancer Institute and Millard Fillmore Health System have agreed to establish an ambu­ latory oncology facility at Millard Fillmore Suburban Hospital. The new center will provide the full range of outpatient cancer services, in­ cluding chemotherapy and radiation therapy. The agreement marks the first time that Roswell, a National Cancer Insti­ tute-designated comprehensive cancer center, will operate a satellite unit at a community hospital. The project must undergo review and win approval by the local Health Systems Agency and the state Office of Health Systems Manage­ ment. Roswell and Millard officials said the facility, to be known as the Ambulatory Oncology Centers of Roswell Park Can­ cer Institute and Millard Fillmore Hos­ pitals, will ensure access to high quality cancer care to more than 450,000 people in Millard Fillmore's primary service area. The 11,500-square-foot building is scheduled to be completed in the fall of 1995. Roswell will lease space in the facility. Roswell will be responsible for pro­ viding technical and professional sup­ port for radiotherapy services; Millard will be responsible for chemotherapy services and related support services. Roswell is recruiting a director for the center and Roswell and Millard will con­ tract with each other for various admin­ istrative services. As part of the agreement, a 6 MEV linear accelerator, which Roswell will acquire as part of its major moderniza­ tion project, will be located at the cen­ ter. + i n t e r 1 9 9 5 �HOSPITAL N E W S transplant immunology." Joseph Jacobs, founder and chairman of Jacobs Engineering Group, Inc., an international engineering and construc­ tion firm with headquarters in Pasa­ dena, California, described his brother as a "compassionate human being who left an indelible mark in the field of medicine in Buffalo and at Buffalo Gen­ eral." Conditions of the grant also stipulate that there be 100 percent participation by hospital and foundation trustees in the foundation's current "Campaign for Visionary Healthcare in the 21st Cen­ tury." + Sisters Hospital opens expanded women's specially referral cenler Artist's rendering of Buffalo General Hospital's Institute for Molecular Medicine and Immunology. Record gifl will establish center for immunology research al BGH he Buffalo General Foundation will receive a $3 million gift to support the creation of an Insti­ tute for Molecular Medicine and Immunology (1MMI) in memory of former Buffalo General Hospi­ tal President Theodore T.Jacobs, M.D., '38, who died last April at the age of 82. William V. Kinnard, Jr., M.D., dis­ closed that Joseph J. Jacobs, Ph.D., brother of Theodore, will provide the gift in the form of a challenge grant that requires BGH's foundation to raise an additional $6 million. "The grant is the largest ever received by Buffalo General and its foundation, and we are tremendously grateful to Joseph Jacobs and the Jacobs family for helping us to establish this vital re­ search facility," said Kinnard, who suc­ ceeded Jacobs as BGH president in 1975 and served in the position until 1990. Citing Buffalo General Hospital's strong commitment to organ transplan­ tation and programs involving the im­ mune system and disease, Kinnard said creation of the IMMI will have a major impact on improving patient care and enhancing the treatment of disease. Kinnard said plans for the IMMI are being developed in collaboration with UB's School of Medicine and Biomedical Sciences and with other local health care providers, including Roswell Park Cancer Institute and The Children's Hospital of Buffalo. He indicated that construction of the institute would be completed by the end of the decade. "As we envision it, the institute will consist of major sub-divisions encom­ passing cancer immunology, immunopharmacology, genetics and B y T u f f a l o P h s i c i a n w i S isters Hospital has opened the Sis­ ters Specialty Center for Women, a referral center staffed byspecialists to complement the care provided by a woman's primary care physi­ cian. The new center, located in the Seton Building adjacent to the hospital, will consolidate services already in opera­ tion, such as Sisters' Breast Care Center, with new programs "to further expand our program into a referral center which will support, not compete with, our private physicians," explained David R. Verstreate, vice president for operations at Sisters. "We offer a variety of spe­ cialty services all in one location and thus provide a continuity of care for women, originating with and led by their primary care doctor." The center will offer infertility ser­ vices, endocrinology, natural family planning, breast care, perinatal medi­ cine, medical obstetrics, urogynecology, post-reproductive gynecology and gy­ necological oncology. n t e r 1 9 9 5 © �M J A UB K I N G P R I M A R Y C A R E I BECOMES A NATIONAL LEADER IN THE PUSH FOR PRIMARY CARE S NATIONAL HEALTH CARE REFORM WAS GOING DOWN THE POLITICAL TUBES IN WASHINGTON LATE THIS PAST SUMMER, A REFORM PROGRAM THAT PROMISES TO HELP CHANGE THE FACE OF MEDICAL PRACTICE FOR DECADES TO COME WAS GAINING MOMENTUM IN BUFFALO. O B u f f a l o P h y s an w n t e r 1 9 9 5 �The highly regarded and ever-expanding initiative, which would increase the number of medical students and residents pursuing primary care careers, introduced its first programs in the autumn of 1992. Led by the University at Buffalo School of Medicine and Biomedical Sciences, in conjunction with the Graduate Medical Dental Education Consortium of Buffalo (GMDECB), the primary care program is already reshaping the way medicine is taught in Buffalo. This marks the first year, for instance, that a clerkship in family medicine becomes a routine part of the third year. Primary care faculty are attending workshops to enhance teaching skills, and a novel program that places primary care residents into community practices is growing. Last June, the medical school won a prestigious, three-year, $600,000 Robert Wood Johnson Foundation grant to continue the work; last September it won a two-year, $500,000 grant from New York State for the same purpose. "I think there's a lot to be excited about," John Naughton, M.D., vice president for clinical affairs and dean of the medical school, said as he rattled off a litany of initiatives. "We're seen as one of the leaders, I think," Naughton continued. "More of our people are being asked to give talks at national meetings on our experiences, and people are coming to visit us to see what is going on." One of those visitors was Randall Zuckerman, chair of the American Medical Student Association's Generalist Physicians in Training Program. He was particularly impressed by an "externship" program that allows undergraduate medical students to work alongside primary care physicians i n their practicesduring thesummer. "Ina lot o fschools, primarycare is ^ ^ talked about," said the third-year Dartmouth Medical School student. "But A n d r e w P h o t o s by D n n z o K.C. K r a t t you have the full weight of the institution behind it." The Buffalo program strives to tip back the specialist-generalist scale without using too heavy a hand. The boldest move was the medical school's declaration that it would cap the number of residencies and evenly distribute them between primary care and the sub-specialties. The remainder of the effort, however, employs a gentler touch — one that seeks not to force people into primary care, but to make Buffalo more hospitable to primary care, and thereby encourage more young professionals to choose it on their own. The strategy is both simple and radical — remaking the image of the generalist. "Students come in with a lot of misconceptions about what primary care in the community is like," said John Feather, Ph.D., executive director of the Primary Care Resource Center, which coordinates many of the Buffalo initiatives, "that they [generalists] are behind the times, that it's not as challenging intellectually. You know, the classic Norman Rockwell picture of the family physician listening to the little girl's doll." By improving teaching technique, encouraging research and exposing students to generalists in their own practices, the programs seek to transform the old model of Rockwell's kindly but quaint doc into a role model worthy of the best and brightest. "It really takes a broader range of skills to be a generalist, but that hasn't been where society was placing their values," noted Thomas Rosenthal, M.D., chair of family medicine and project director for the Robert Wood Johnson grant. u f f a l o P h y s i c i a n W i n t e r 1 9 9 5 �UB's primary care plishment in and of itself." In 1991-92, emphasis can be traced the GMDECB's primary care residency back a quarter century, slots totaled 40 percent; in 1992-93, to its establishment of 41 percent; in 1993-94, 42 percent; one of the nation's first and in 1994-95, 43 percent. family medicine pro­ As for UB medical school gradu­ grams. In the mid-1980s, ates, the proportion entering primary as medical graduates na­ care residencies has hovered around tionally were showing 40 percent since 1991, with a jump less and less interest in from 38 percent in 1993 to 42 percent primary care, Naughton in 1994. Since the first of the demon­ said he began thinking stration project's undergraduate pro­ about providing more grams didn't begin until 1992, this comprehensive ambula­ year's match may be a better indication tory experience for of their effect. "If you wanted to get a fourth-year students. completely accurate view you would Then, in 1989, the state have to look at five years after resi­ authorized a demonstra­ dency," said Feather. "The problem is "Primary care was the type of care I was interested in when I tion project in which UB's that all the initiatives are not going to entered medical school. UB strongly supports primary care. I feel consortium of teaching have an impact on those numbers for a hospitals would pool $5 decade. It's a very long process. We're encouraged to go in that direction rathher than disuaded." million from increased turning around a battleship." I education reimburseNaughton said that while he re­ TAMI SEAMAN 1 ments to fund a broad mains committed to the original goals, Analysts have grappled for years primary care initiative. The Reimburse­ "The object is not to reach 50 percent with the paradox of a medical educa­ ment Demonstration Project's center­ for 50 percent's sake." The most im­ tion system that turns out ever more piece was a commitment to cap the portant goal, he said, is to increase the physicians to practice at ever rising number of GMDECB residencies and proportion of generalists practicing in cost without improving access to health allocate half to primary care by the the community, adding that he thinks care. In 1978, an Institute of Medicine mid-1990s. The medical school also the last several years have laid the task force suggested that things would talked enthusiastically improve if 50 percent of physicians about sending 50 percent DAVID MILLING, M.D. were generalists, the minimum in most of its graduates into pri­ industrialized countries. The national mary care residencies. "What they're doing here — increasing the ambulatory care Council on Graduate Medical Educa­ The 50 percent goals experience, giving you more clinic and more contact on an tion has recommended the same. But remain to be met. there are still two specialists for every Residencies have been outpatient basis — really enhances the primary care ideal." generalist practicing in the United capped at 788, but the States. Even if every last medical school proportion of primary graduate were to suddenly choose pri­ care slots remains below mary care from here on, it would still half. take a full decade to reach a 50-50 "This is the year it was balance. supposed to reach 50 per­ "There's been much discussion of cent," said Roseanne C. this for years and years, but not much Berger, M.D., associate momentum," said Naughton. dean for graduate medi­ "In an era where scientific advances cal education. "But what and technological advances lend them­ we have done over the selves to creating more specialists, now last three years is increase we have to recognize that while those the total number of posi­ advances are important, the manage­ tions in primary care and ment of them has to be done in a different restricted growth in the way than we've been doing," he added. non-primary care posi­ "And that means a changing attitude in tions. And that has been the way medicine is practiced." viewed as a major accom­ O B u f f a l o P h y s i c i a n W i n t e r �foundation for that. In a broad sense, the effort is based on the notion that familiarity with pri­ mary care practice will breed respect for it. Planned changes in the medical school curriculum, for instance, would introduce patient-based clinical teach­ ing in the first year. An interdiscipli­ nary clinical correlations approach will enhance basic sciences, and there will be an emphasis on problem-solving and self-learning skills. "We feel that if we can produce students who feel real comfortable and well-skilled in the ability to discover the maximum amount of information through their eyes, ears and hands, and in talking to patients, taking histo­ ries and doing the physical exam, then they will feel better equipped to enter a broad-based generalist field," said Rosenthal. "We've been teaching medi­ cal students by giving them large amounts of information organized ac­ cording to organs. We would like to restructure it so that information is still learned, but now organized ac­ cording to real world presentation." Plans call for expanding the use of office settings for pediatric and inter­ nal medicine clerkships. At the same time, efforts are under way to increase ambulatory training op­ portunities for primary care residents. Key to these efforts is the Community Aca­ demic Practice program, which has designated nine community prac­ tices around the region as ambulatory training and research sites for pri­ mary care residents, as well as medical students. CAP sites must demon­ strate a community ori­ "The primary care externship program got me hooked. I got to see entation and be willing how patients progressed over time — not how lab values do. It's to make residents an in­ corny, but I really like that. It's why I went to medical school." tegral part of their prac­ tice. They must also be willing to participate in STEPHEN COOK practice-based research. Each CAP site is connected to gree of prestige," he said. HUBNET, the medical computer net­ On the undergraduate side, more work operated by UB and its teaching students are learning about generalist hospitals. Above all, each CAP must practice through the Primary Care meet strict quality criteria. "This is one Externships open to them in the sum­ of the first times that community prac­ mers after their first and second years. tices have had to undergo This voluntary program started in 1992 COLLEEN MATTIMORE, M.D. a thorough investigation with 40 students and grew to 60 stu­ of quality," noted Paul dents by last summer. This summer 70 James, M.D., coordina­ slots are planned for students who will "The academic faculty, world-renown for its research, combined tor of the CAP program. spend six weeks working side by side with the strong faculty of general pediatricians in the community, James said that since with a generalist in a variety of com­ offers the perfect blend of primary care medicine." the first sites were desig­ munity practices. nated last year, their role "They learn a great deal of clinical has been expanded to medicine, but the goal of the program serve as community- is to see what life is like as a primary based continuity clinics care physician," said Michael Edbauer, for some primary care D.O., assistant clinical professor of pe­ residents. "Many of us diatrics and externship coordinator. "I believe that it would take don't think people appreciate what a that sustained effort of positive feeling it is to interact with a three years before people family and have them put their faith in get a real clear picture of you, how much that means to a per­ the benefits of providing son." care outside the hospi­ The program pays $1,500 to partici­ tal," he said. pating first-year students and $2,000 James has been en­ to second-year students. Zuckerman, couraged by the number of the American Medical Student Asso­ of practices applying for ciation, said the stipend not only helps CAP designation. "There financially pressed students take ad­ seems to be a great de­ vantage of the externship, but it is also B U F F A L O P H Y S I C I A N W I N T E R 1 9 9 5 O �p r i m a symbol that generalists are valued. "As far as I know, there are no other schools in the country doing anything like that," he said. Other efforts aimed at elevating the stature of primary care involve teach­ ing and research. The Teaching Effec­ tiveness Program offers workshops and resource materials designed to enhance the teaching skills of residents, as well as full-time and voluntary faculty. Re­ cent workshops included "The Internet A R C Y and HUBNET," "The Preceptor as Mentor" and "Physician Self-Aware­ ness." The thinking behind the pro­ gram is that clinical teachers have a great effect on career choice, and bet­ ter teachers make better mentors, pre­ ceptors and role models. A related effort has led to a new master's degree program called Education for the Health Professions. The program, of­ fered by the UB Graduate School of Education, began this autumn with 10 a r e physicians, most of them in primary care specialties. UB is also offering primary care fac­ ulty and residents opportunities to learn or enhance research skills. According to one description of the program, "The development of a cadre of primary care residents and faculty with an interest in primary care research provides medi­ cal students with role models, and the research they conduct generates pri­ mary care experiences for students." Cooperation Marks the Movement to Balance UB's Generalists and Specialists Creating a more even balance between generalists and specialists doesn't come easy. Not in terms of the work required, and certainly not in terms of the anxiety pro­ duced. "I think there's concern among all faculty," said John Naughton, M.D., vice president for clinical af­ fairs and dean of the UB medical school. "Specialty faculty is con­ cerned that they don't lose their role in the medical education pro­ cess. And they won't. But they do have to join with the total faculty in not only educating physicians in their own discipline, but joining in the education of generalist physi­ cians." Naughton said that ultimately specialists have less to fear from educational changes than they do from the outside world. Managed care has begun altering the generalist-specialist balance on its own — so much so that about 60 percent of specialists will be unnecessary by the year 2000, according to re­ searchers at The Johns Hopkins School of Public Health who exam­ ined physician work-force require­ ments for the Council on Graduate Medical Education. Other areas continue to be underserved by even basic health care, and calls persist for a comprehensive national ap­ proach to work force strategy. In the current environment, UB's primary care emphasis may be as much a matter of sound career counseling as prudent public health policy. "By the year 2000 it's projected there will be over 125,000 excess specialists of all types in this coun­ try," said James Nolan, M.D., chair of UB's department of medicine. "The worry is, if we don't make the primary care specialties more at­ tractive we will end up training spe­ cialists and there won't be jobs for them." Nolan recently chaired theAmeri­ can College of Physicians' Task Force on Physician Supply. The panel, reporting in the Oct. 1,1994, issue of the Annals of Internal Medi­ cine, concluded that the generalistspecialist imbalance was so severe and so persistent that "a national commission is required with regu­ latory authority to set targets for the total number and types of physi­ cians." Gerald Sufrin, M.D., chair of both urology and the Council of Clinical Department Chairpersons, senses that all faculty members realize the urgency of UB's effort. "I don't de­ tect among the various specialty de­ partments that there is an over-em­ phasis on this," he said, adding that specialists want to play a continuing role in training generalists. "There's a real sense that we should be part of the solution," he said. According to the plan for imple­ menting the Robert Wood Johnson initiative, that will happen. In de­ scribing the use of psychiatry fac­ ulty as on-site preceptors to selected primary care residents, the plan states: "This effort is a beginning step in our commitment to use the generalist initiative to strengthen the roles of our specialty faculty in the training of generalist physicians." Thomas Rosenthal, M.D., chair of family medicine and project di­ rector for the Robert Wood Johnson initiative, noted that changes in medical education and training un­ der the initiative benefit everyone. "Clearly our intent is to produce excellent clinicians, and that more of those clinicians will go into pri­ mary care," he said. "But we hope we will have excellent specialists as well as excellent generalists." The basic sciences share an equally significant role with the generalist and specialist faculty, Naughton added. "Obviously, the challenge to the institution is that all three of these important elements are working in a synergistic way," he said. "And I think they are." — A N D R E W D A N Z O �Family medicine and social and preventive medicine assis­ tant professor CarlosJaen, M.D., Ph.D., recently completed a landmark study of residents of Buffalo's lower West Side that found them considerably sicker than the U.S. population at large. The results of the first comprehensive health survey of this population found that the West Side residents face major barriers to receiving adequate health care and that they suffer from higher-than-average rates of smoking, alcohol con­ sumption, asthma and diabetes. The Primary Care Resource Center instituted summer assistantships for health services and clinical outcomes re­ search beginning in 1992-93. Plans call for expanding the assistantships and incorporating primary care into existing student research programs. Complementing the research emphasis is a clinical scholars plan that would allow a generalist resident to work toward a related advanced degree, such as one offered by the department of social and preventive medicine. A program description notes that it "will contrib­ ute importantly to altering the dichotomous view of general­ ist and specialist physicians as occupying opposite poles of the intellectual continuum in medicine." The list of specific programs and plans designed to turn out more generalists goes on. A new recruitment program for primary care residents combines previously separate efforts; it is symbolized by a series of glossy brochures that proved so popular a second printing was needed. Efforts are under way to identify which medical school applicants are more likely to pursue primary care, as are plans to make greater use of interdisciplinary and collaborative opportunities in teaching and the development of a tracking process to better learn how all the programs are affecting ultimate career choices. "There seems to be a great deal of interest among stu­ dents," said Dennis A. Nadler, M.D., associate dean for academic and curricular affairs. "When you offer students opportunities, you engender interest, and I believe we have." The work going into it all is considerable. The Primary Care Resource Center, which has taken over ivy-covered Beck Hall, oversees many of the initiatives, coor­ dinating the medical school's primary care departments with the GMDECB's residency programs. More than 100 faculty members have been involved in planning and implementing the Robert Wood Johnson Generalist Initiative, which itself has seven goals and 35 objectives. Michael Beachler, a senior program officer for the Rob­ ert Wood Johnson Foundation, said Buffalo has been making a name for itself. "They're pretty good at getting their own graduates into primary care residencies," he said. "It's not just the medical school, it's also the consortium of hospitals around the area that have come together to move in that direction. That's pretty unheard of. From my end, kudos to both, the hospitals as well as the medical school leadership." B u f f a l o P h y s i c i A Primer on Primary Care at UB QUESTION: What is the primary care program? ANSWER: It is not so much a single program—there is not even a formal name for it — as it is a philosophical commitment by UB and its teaching hospitals to produce more generalists. The commitment has led to an array of initiatives. Some of the major ones involve: # Dedicating 50 percent of residency training slots to primary care. # Revamping the medical school curriculum to more closely link clinical experiences to the basic sciences, as well as to emphasize problem-solving and self-learning. # Developing new community-based sites for medical edu­ cation and training. # Improving teaching skills. # Emphasizing primary care research. QUESTION: How is it organized? ANSWER: The focal point is the Primary Care Resource Center, which operates under the direction of the Graduate Medical Dental Education Consortium of Buffalo and the UB departments of family medicine, medicine, pediatrics and social and preventive medicine. QUESTION: How is it funded? ANSWER: Funding started with the Reimbursement Dem­ onstration Project in 1989. Under this project, the state Department of Health made GMDECB hospitals eligible for higher academic medical center teaching reimbursements. In return, and in cooperation with area health insurers, they pooled $5 million to cap and redistribute residencies and to fund generalist projects, which began in 1992. Technically, the project expired in 1994, but it is being renegotiated and is expected to continue. In 1992, UB also won a $150,000 planning grant under the Robert Wood Johnson Foundation Generalist Physician Initiative, and it was one of 14 sites nationally to be awarded a follow-up implementation grant last June. That grant is worth $600,000 over three years. Last September, UB won another $500,000 grant from the state health department, also to support generalist initiatives. + a n W i n t e r 1 9 9 5 0 �Practicing Their Calling It's a brave new world for today's practitioner Only a few short decades ago, physicians had only a few choices to make to fulfill their calling, ft But as the nation's hand-wringing over health care costs continues, those who are making a career in medicine are finding that the idyllic image of the solo practitioner that many followed into medical school is as endangered as the 10cent phone call. Instead, many physicians are finding that surviving and thriving in private practice means negotiating an alphabet soup of coalitions with names like IPA, PPO and HMO. ft Today, private-practice physicians are finding a world of options in a climate of change, ft One option becoming increasingly more popular is the group practice, either a single-specialty group or a multi-specialty group that encompasses a variety of disciplines, ft A recent study by the American Medical Association showed that the number of group practices increased dramatically in the two decades following 1965, then largely leveled off. In 1991 (the latest year for which figures were available), the AMA reported 16,576 group practices were in operation. Yet the number of physicians practicing in groups has continued to increase. Also in 1991, 32.6 per­ cent of physicians (excluding those employed by the federal government) were part of a group. "Between 1965 and 1991," the report notes, "the number of groups increased by 286 percent and the number of group physicians increased by 550 percent." Multi-specialty groups were reported to include a mean number of 24.6 physicians — more than double the mean group size in 1965. Single-spe­ cialty groups grew from 4.1 physicians in 1965 to © 6.8 in 1991. The reasons for the increase are varied. "Over the last several years, medical groups are better positioned to deal with managed care contracts," said Penny Havlicek, manager of the AMA's group practice database and an author of the study. "[A health-maintenance organization] can find in one group practice a provider for a large region, and they'd rather do that than contract with a lot of independent physi­ cians. Certainly from a managed care perspective, groups are easier to deal with." �And more remu­ nerative for their phy­ sicians. Havlicek noted that 1991 figures showed the average group-practice physician's net income (after expenses but be­ fore taxes) was $202,000; for solo or two-physician practices, the figure was $173,100. And regardless of how Congress decides to structure the nation's health care deliverysys­ tem, powerful market forces already are at work. In Minnesota and California, two states where managed care has made significant inroads, physicians are finding HMOs and other coalitions impossible to ignore. "There certainly are pressures in existence that are serious pressures in terms of practic­ ing efficiently," said David W. Emmons, an economist with the AMA's Center for Health Policy Research. "There are regions where large numbers of the patients have moved into managed care programs." In such regions, he says, physicians find it advisable to contract with those programs — or risk being cut out of the patient stream entirely. Still, Emmons says, the trends may be less overwhelming than they seem. In 1993, he said, about 48 percent of the United States' 670,336 physicians had a contract with an HMO. But only about one-third of their revenues come from HMO, independent practice asso­ ciation (IPA) and preferred provider organiza­ tion (PPO) contracts. The balance comes from more traditional health insurance providers. Beyond economics, Havlicek said "lifestyle" issues may also come into play when physicians choose a situation in which to practice. "With women increasingly going into medi­ cine, and also raising families, group practices may be seen as more accommodating to women," she said. "This might be true of young male physicians as well" — motivated "YOU really by the regular hours, vacation and weekend coverage and other sup­ ports that a group prac­ tice provides. (Not that the life of a physician ever lends itself to copi­ ous family time — no matter what kind of practice they're in, doc­ tors average nearly 59 hours a week at work.) Still, what matters most is how effectively a physician can practice his craft and his art. We took a sampling of doctors in several private-practice situations — solo prac­ tice, multi-specialty group, single-specialty group, staff-model HMO, group-model HMO and hos­ pital staff — and asked about the opportunities and limitations they face. have to be more Solo practitioner of a businessman these days than in the past. The days of hanging out a shingle and making gobs of money are long gone." Edward A. Toriello, M.D. Orthopedic surgeon "You really have to be more of a business­ man these days than in the past," said Edward Toriello, M.D., '80, who works in a two-physi­ cian practice in Brooklyn. "The days of hang­ ing out a shingle and making gobs of money are long gone." That pragmatism is crucial to today's solo practitioners, who are feeling the squeeze eco­ nomically as never before. Toriello, whose orthopedics practice is not far from the neigh­ borhood where he grew up and very much based on that neighborhood's economics, said, "My little microcosm is kind of a dinosaur, in that many of us in this area are still solo physicians. It seems that Brooklyn and Queens have a lot of small industry. [By comparison], Long Island has Drummond Corp. If your community has 80 to 90 percent of its workers work at Drummond and Drummond decides to go managed care, you pretty much have no choice." Fduurd V. Toriello. >1.1). u f f a I o P h y s i c i a n W i n t e r 1 9 9 5 �Multi-specialty group But for now, Toriello is enjoying "the indepen­ dence and freedom that you have to practice medicine the way you feel is best, not only for myself but also for my patients. I like that." He and his associate, Chris Pavlides, M.D., share Richard L. Collins, M.D. Internist Buffalo Medical Group Richard Collins, M.D., '83, has seen many sides of medical prac­ tice: from working in a hospital outpatient clinic, to directing a community health cen­ ter, to two years as an HMO staff physician. For three years now, he says he has found the right balance — as an internist with the Buffalo Medical Group, a office staff and split the rent, but maintain sepa­ rate patient loads. Toriello sees patients three days a week, 25 to 30 patients a day. Many are elderly people whose insurance is Medicare, and so the orthopedist suffers what he calls "the constant downward pressure on Medicare fee schedules." When he's not in the office, there's plenty of surgery to do, and Toriello also performs independent medical evaluations for insurance companies, "to diversify my in­ come stream." He frequently works six-day weeks, and notes that traditional wisdom says "the first 10 years is really building a private practice and building relations with internists who will re­ fer patients to you. Following that, you're in a position where your feeders are pretty well established and you can take a day off." He is, he notes dryly, in his ninth year of practice. "There are days and weeks when I feel like I'm running faster just to stay in place," he acknowledged. "And I do see that I have to be ready to move should the situation change." Toriello says he has made contacts with the physician-hospital organizations of several lo­ multi-specialty group practice with multiple locations and 80 physicians. The situation appeals to the entrepreneur in him — and to the family man. "I enjoy the independence that comes from a practice like this. I can determine my own hours and patient load." At the same time, says Collins, who has three small children, "Within the group it is comfortable because we share. There are four other primary care physicians with whom I share weekend calls. Four out of five weekends "WITHIN THE GROUP it is comfort­ able because we share. Four out of five weekends I'm I'm not on call, and that's good for family and freedom. My family life remains my top prior­ ity." A multi-specialty practice, he says, tends to support itself through internal referrals—back and forth between the primary care physicians and Buffalo Medical Group's phalanx of gyne­ cologists, cardiologists, neurologists, general surgeons, allergists, orthopedists and so on. And the group's reputation is a built-in market­ ing tool; "people are always calling Buffalo Medical Group saying, 'I want to be taken care of by someone in your group.' I have four or five calls per day inquiring about setting up care," he said. The group recently strengthened its eco­ nomic position by announcing that it plans to ally with Health Care Plan, one of Western New not on call, and that's good for family and freedom. My family life cal hospitals, "trying to preserve the ability to negotiate with managed care organizations." Still, he says, his solo practice is "a fun thing as opposed to the drudgery of just going off to work every day. I went into medicine to be my own boss, to enjoy the freedom of working with patients and doing what I feel is best. The trouble with working for someone is, if they're paying the freight, they frequently can call the tune as well." remains my top priority." Richard L. Collins, M.D. B u f f a l o P h y s i c i a n w i n t e r 1 9 9 5 �York's largest HMOs. The two intend to re­ main autonomous but will develop a more comprehensive working relationship. But Collins, who serves as a clinical assis­ tant professor for UB's School of Medicine and Biomedical Sciences, stresses that he's solely responsible for his own patient panel. Group members share equip­ ment — the primarycare physicians share a portable EKG machine, for example — and also share the costs of the group's support functions to reduce their indi­ vidual costs. In addition, Collins employs a nurse and a secretary out of his own choice to meet the unique needs of his patients. There's also the less tangible benefit of collegiality. "You want to look at an organization that's going to give you support in terms of weekend coverageand the kind of people you're working with. If you're practicing by yourself, your knowledge base is limited to yourself and the books on the shelves in your office. It's very secure to be able to walk 10 feet and share a case with your colleagues. "And it's important to be compensated for the amount of work you do rather than simply be salaried. It's kind of nice to be compensated for the exact amount of hours that you do put in and see patients." "BEING IN A specialty practice has allowed us to cover most areas of my specialty with quality and cost-effective­ ness. That's really the crux of a large single- Single-specialty group practice specialty group." Sanford R. Hoffman, M.D. Otolaryngologist Buffalo Otolaryngology Group, P.C. It was nearly a quarter-century ago that Sanford Hoffman, M.D., '65, joined Irwin Ginsberg, M.D., to form the Buffalo Otolaryngology Group. "He had a very dy­ namic practice," Hoffman said. "It's a very varied specialty, and I wanted to practice as many aspects as I possi­ bly could." Today, the group encompasses nine part­ ner physicians and two new associates with a subspecialty in facial plastic surgery. And Hoffman, who is also a clinical assistant professor in the medical school, and chairs the department of otolaryngology for Millard Fillmore Health System, says he has never stopped learning. The group has a monthly meeting devoted to business and sci­ entific topics, and daily conferrals, both formal and informal, on specific cases and proce­ dures. The ear-nose-and-throat specialists also "cross-cover" each other in surgeries, he says, providing a second pair of eyes for the delicate procedures. "Being in a specialty practice has allowed us to cover most areas of my specialty with qual­ ity and cost-effectiveness," Hoffman said. "That's really the crux of a large single-spe­ cialty group. You can get some efficiencies of care. You can buy better equipment; you can afford to have your associates go to meetings and courses which will increase their knowl­ edge and also their efficiency; you can have more efficient building and appointment sys­ tems, even in multiple locations." Buffalo Otolaryngology has expanded into sinusology, rhinology and head and neck surgery. "If you have a large group," Hoffman said, "it allows you to talk with more authority to the insurers and the employers, the people who are paying the health dollars. You can show that you have these services, and you can really evaluate yourself and look at your own practice to make sure it stays quality-oriented." For example, he says, "We were among the first in the country to develop outcomes mea­ sures for sinus disease." Sanl'ord K. Hoffman. M.D. © �tionship with that per­ son. The whole program is based on that physi­ cian." It helps, he says, that the HMO has stan­ dardized record keep­ ing: "When I see that person, I have his full chart in front of me." And preventive care, he says, is "part of the history and tradition of HMOs. It's in everybody's interest to keep people well. We've devoted a lot of effort and energy to health education and preventive guidelines" — such measuresas flu vaccinations, mammography screening and childhood immunizations. "There's a real sense of group. People talk to each other," Katz said. "There's collegiality built into the practice. We're really being called upon increasingly to be efficient, to manage care as effectively as we can. And to do that well, it's harder and harder for an individual to accomplish that." Staff-model HMO Leonard A. Katz, M.D. Director of Research and Education Programs Health Care Plan "It's the model the country's talking about," Leonard Katz, M.D., says of the Buf­ falo health maintenance organization he serves. In a decade, Health Care Plan has grown from 35 physicians to nearly 100, says Katz, who is a practicing gastroenterologist, a former associate dean of the medical school and a professor of medicine in the department of medicine. Health Care Plan, he says, is a "true group practice" — a configuration of professionals in all specialties including primary care. And, he says, "because everybody is paid by the same source, the issue of finances basically is dropped out. The payment comes through the broader organization, and that means that we're really all in it together." Within the organization, small primary-care teams — a family physician, an internist, a pediatrician, nurse practitioners, physician as­ sistants, even office staff — work together at a particular site, and arrange for night and week­ end coverage. "That's what groups can do — they can develop systems of care," Katz said. "They can make all kinds of support arrangements for the care of patients they're looking after." The staff-model HMO is built around two tenets: the idea that a primary-care physician should coordinate all of a patient's care, and the idea that prevention is the best medicine. As a specialist, Katz says, he sees himself "trying to provide the best help I can to both the patient and to the [primary-care] physician, because that physician has a long-term rela­ "IT'S the model the country's talking about, a true group practice because Group-model IIMO Kenneth E. Bell, M.D. everybody is paid by the same Medical Director, Orange County Kaiser Permanente Medical Group Anaheim, California source; the issue of finances There's business. And there's medicine. And Kenneth Bell, M.D., '61, likes to keep a comfortable distance between them. Bell is an obstetrician/gynecologist who is medical director, Orange County, for the Kai­ ser Permanente Medical Group in Southern California. The group is a for-profit organiza­ tion that contracts exclusively with the Kaiser Foundation Health Plan, a non-profit insur­ ance company. This "group-model" approach — as op­ posed to a staff-model situation, in which phy- basically is dropped out." Leonard A. Katz. M.I). B u f f a l o P h y s i c i a n W i n t e r 1 9 9 5 �sicians work directly for the in­ surer — makes all the differ­ ence, he says. "All the quality clinical deci­ sions are made by physicians of the medical group," he said. "The physicians in this medical group take care of the practice of medicine. They have other people they have hired to take care of the business. When we see patients, we don't spend time worrying about how much it costs or whether the patient can afford it or whatever. "The bottom line is, my incentives are aligned with the patients. I don't earn more or less because of the amount of care I give. I have no incentive to operate on somebody, for example. On the other hand, I have a tremendous incen­ tive to keep people healthy, because that cuts the cost of care." Bell, who was Kaiser Permanente's chief of obstetrics and gynecology in Orange County for 10 years before becoming medical director, still sees some patients — "I like delivering babies," he said. He's a clinical professor of ob/ gyn at the University of California, Irvine. And he's in a position to see how economic trends are changing the practice of medicine. "There are many problems around the coun­ try with physicians being forced into groups they have no affinity for," he said. "They have to do this because this is the only way they can maintain a practice." Private-practice physicians, he says, for a long time had no limitations on their earning power. "Now we're having limitations, and the trick is to maintain and improve quality while cutting costs." Kaiser Permanente — "the largest private health care delivery system in the world," Bell notes — stresses continuing medical educa­ tion, encouraging physicians to spend a halfday each week on their own education. It's a team approach, and that, Bell says, places its own demands on physicians. "There's a loss of autonomy compared to somebody running his own little office," he said. "You have to work as part of a team, and there's tremendous peer pres­ sure to produce quality care, to practice efficiently and have good outcomes.There's no place to hide. "Somebody who has to do everything fully by themselves will not be happy in this. It does require a team-spirited belief that we can ac­ complish more as a group than each individual going off on his own." "ALL THE quality clinical Hospital stall Eric Ten Brock, M.D. Internist Buffalo General Hospital decisions are made by physicians of the medical group. The physicians in this medical group take care of the practice of medicine." "If you're doing something you like," says Eric Ten Brock, M.D., '80, "one of the natural things is to want to teach it to somebody and share it with somebody." And teach he does — at The Buffalo General Hospital, where he hired on in 1985 and where he built up the pulmonary and critical care programs that he now directs. Ten Brock, a clinical associate professor at the medical school, at any one time might be responsible for a pulmonary critical care fel­ low, a resident and maybe a medical student. He juggles that teaching load with staff respon­ sibilities that include administering the medi­ cal intensive care unit, the hospital's sleep apnea disorder lab and the pulmonary lab. He's also chairman of Buffalo General's ethics com­ mittee. He does see patients and shares on-call duties with "a few other physicians who are also full-time hospital-based." But he acknowl­ edges that "in solo or group practice a greater percentage of time is involved with direct patient care." Building up the hospital's pulmonary divi­ sion, though, has been its own reward. Ten Brock says it's the "if I were king" response — you see how it's done in various hospitals, find out where the problems lie and then try to make it all work better. "If you run an intensive care unit you see Kenneth E. Bell, M.D. u f f a I o P h y s i c i a n W i n t e r t 9 9 5 © �Holiday Specials $2542 Performa 6115CD • Apple Multiple Scan 15" Display • Apple Design Keyboard • 14.4bps Teleport/Gold Fax Modem • ClarisWorks 60 MHz 601 RISC processor, integrated FPU, 8MB RAM, 350MB hard drive. Performa 6115CD Software includes: System 7.5, eWorld, At Ease and Macintosh PC Exchange, Up to Date/Contact, ClarisWorks 2.1, Quicken 4, MacGallery Clip Art, Spin Doctor Challenger, MacLink Plus/Easy Open Translators 7.5, Click Art Performa Collection, American Heritage Dictionary, Spectre Challenger, Family Doctor, Around the World in 80 days, New Grolier's Multimedia Encyclopedia, 3D World Atlas, Time Almanac, KidSoft CD. "YOU'RE PART of a larger organiza­ PowerBook 520C • 9.5" backlit display • PowerPC upgradeable tion, so you're not necessarily the only person who has input as to whether a $2589 50/25 MHz, 68040 processor, expansion slots for a modem, RAM, processor direct slot (PDS), 160MB Hard Disk Drive, built-in 9.5" backlit dual scan passive-matrix LCD (256 colors). certain decision is made the way you would like it to be made." Price just $ 4 8 5 Dropped! HEWLETT t PACKARD certain things that you might not want to happen. You're not always called to 'put out a fire' — you're trying to prevent those things from happening if at all possible." For example, Ten Brock said, he has stan­ dardized the procedures for patients' "ad­ vance directives" — do-not-resuscitate or­ ders, health care proxies, living wills — that can be crucial in intensive-care situations. Another example: a review process for how well the staff responds to each cardiac arrest "code" emergency. "These are things that were either not de­ veloped or existed in an unstructured form" when he came on staff, he says. "A full-time physician like myself can help firm that up somewhat by making it a little more regi­ mented." A hospital staff position, Ten Brock says, means working within the system. "You're part of a larger organization, so you're not necessar­ ily the only person who has input as to whether a certain decision is made in the way you would like it to be made. You're building something for the hospital, not necessarily for your own ben­ + efit." Hewlett Packard 560C Inkjet Printer Macintosh (InkWriter), or Intel (Inkjet) drop on demand color inkjet prints 3-4 pages per minute with 600 x 300 dpi resolution, 6 built-in and 14 truetype scalable fonts; also prints a variety a paper styles and sizes. Get Microsoft Word, Excel, PowerPoint, Mail (workstation license), and Access (Profes­ sional version) for as low as $113!! V? Microsoft Office for Windows Standard...$113 Microsoft Office for Windows Professional...$143 Microsoft Office for Macintosh...$135 Please call for current pricing, availability, and eligibility. Prices are subject to change without prior notice. Apple • Compaq • Dell • Hewlett Packard • IBM Microsoft • WordPerfect • Sony • Texas Instruments Open Mon. and Tues. 9:30am to 5pm Wed. through Fri. 9:30am to 6pm A non-profit University program for students, faculty & staff The Commons • North Campus • (716) 645-3554 • Fax: 645-3884 Uric Icn Itrock. >1. ( D B u f f a l o P h y s i c i a n w i n t e r 1 9 9 5 �ACADEMIC HEALTH PROFESSIONALS INSURANCE ASSOCIATION Insuring care for those who care Subscriber Owned • Organized • Governed PHYSICIANS • DENTISTS HEALTH PROFESSIONALS NURSES • RESIDENTS Superior policies for academic full-time and voluntary clinical faculty tt Competitive premiums it Rewarding educational programs ttComplete legal service it- Comprehensive coverage it- Dividend opportunities Academic Health Professionals Insurance Association is a subscriber owned and organized reciprocal licensed by the Insurance Department of New York State. Policy and programs of the Association are determined by a representative Board of Governors elected by subscribers at SUNY Health Science Centers. Enrollment open at all times. Transfers arranged without loss. ACADEMIC HEALTH PROFESSIONALS INSURANCE ASSOCIATION Empire State Building 350 Fifth Avenue, Suite #1512 New York, New York 10118 Ph. 212-947-4541 Fax 212-947-4572 T \1 E • • A N D 0 C Evails and programs scheduled for Sesquicenlennial celebration A s the School of Medicine and Biomedical Sciences' Sesquicentennial celebration nears, the History of the Medical School Committee is busy developing and planning exhibits, programs and events to commemorate 150 years of medical education. Slated to begin in January 1996 and continue through com­ mencement 1997, the celebration would culminate on Founder's Day — May 11, 1996 — with commencement ceremonies, including the retaking of the Hippocratic Oath by the 50th anniversary reunion class. In the spring of 1996, the American History of Medicine will hold its annual meeting in Buffalo. Key also to the celebration is a medical school ethics symposium featuring several distinguished speakers in the field of medical ethics, slated for the fall of 1996. Other regularly scheduled medical school events and lecture series will also tie into the Sesquicentennial during the celebration. The Medical Alumni Associa­ tion will publish a special Sesquicen­ tennial edition of its alumni direc­ tory, producedby Harris Publica­ tions. Also to be published are a Pictorial History of the Medical School, a special edition of Buffalo Physician and a collection of es­ says. The medical school will also sponsor a series of community ex­ hibits of its his­ tory to be dis­ played at the Above, photographs taken from the amphitheater of the lecture teach i ng hospi tals OR in the old High Street building of the medical school by Edward J. Zimm, M.D., '42. and various other sites as well. + �MEDICAL SCHOOL Jacobs releases groundbreaking MS research results CLINICAL TRIAL OF RECOMBINANT BETA INTERFERON SHOWS DRUG SLOWS BOTH PROGRESSION OF DISEASE AND NUMBER OF EXACERBATIONS B ecombinant beCa inCerferon, ad- been done on multiple sclerosis," Jacobs minisCered intramuscularly in said. "Before this, there was no believ­ weekly doses to patients with ac­ able treatment." tive relapsing multiple sclerosis, The recombinant beta interferon used is the first drug to significantly in the trial is manufactured by Biogen; it slow the progress of the disease as is the first drug identical to natural beta well as lessen the number of its flareups, interferon used in a blinded study to according to results of a Phase 111 clini­ demonstrate a statistically significant cal trial conducted by Lawrence Jacobs, impact on the progression rate of the M.D., professor of neurol­ disease. Natural beta inter­ ogy, head of the department feron acts both as an antivi­ of neurology at The Buffalo ral and an immunomo­ General Hospital and chief dulatory agent. of the Baird Multiple Scle­ The multicenter trial rosis Center. studied the effects of the Jacobs presented his drug and a placebo on 301 groundbreaking results at patients with definite MS of the annual meeting of the the relapsing-remitting or American Neurological As­ relapsing-progressive type sociation last October. The of at least one year's dura­ Lawrence Jacobs, M.D. study marks the first time a tion. The patients, aged 18 drug in a blinded clinical trial slowed to 55 years, were free of exacerbation in the progression of disability in MS. In the two months prior to the trial. the trial, recombinant beta interferon The study showed that recombinant increased the time to progression of beta interferon lengthens the time for disability — the length of the period the disease to become more disabling, during which active relapsing patients demonstrating a 75 percent increase in sustain a particular baseline — by 75 the projected time it takes for the dis­ percent. The trial also showed a 31 ease to progress one unit on the Kurtzke percent reduction in relapse rate among Expanded Disability Status Scale (EDSS) patients experiencing the disease's de­ — a standard measure of disability pro­ bilitating exacerbations, and showed a gression in MS. At the end of one year of significant reduction in the number of treatment, 20.1 percent of placeboactive brain lesions measured on MRI. treated patients had progressed by 1.09 "This is the best study that has ever EDSS units, compared to 12 percent of © B u f f a l o P h y s i c i a n w patients on recombinant beta interferon. At two years, 36.3 percent of placebo patients had progressed, compared to 22.6 percent of treated patients. Based on an analysis of the data, predictions of median time to progres­ sion by 1.0 EDSS unit were 3.1 years for placebo patientsand 5.4 years for treated patients. Patients receiving recombinant beta interferon had approximately one-third fewer exacerbations (0.62 per year) than patients receiving the placebo (0.9 ex­ acerbations per year) — representing a 31 percent reduction in relapse rate among treated patients. Placebo patients were also twice as likely to have three or more attacks during the study as were treated patients. Data from MRI studies showed a sta­ tistically significant reduction in the number and volume of active lesions in treated patients compared to placebo patients — an approximately two-fold difference in the mean number and vol­ ume of such lesions. No discernible effects were seen on T2 lesion volume, a measure of both active and inactive le­ sions. Treated patients in thestudy reported only modest side effects, including oc­ casional and transient flu-like symp­ toms (an average of eight days over two years for treated patients compared with two days over the same time for placebo patients). Nine percent of recombinant beta interferon patients stopped treat­ ment — half of which were attributed to side effects. The study was conducted at four clini­ cal centers in the U.S.: UB and Millard Fillmore Hospital's Baird MS Center; the Mellen MS Center at the Cleveland Clinic, Cleveland, Ohio; the University of Oregon, Portland, Oregon; and Walter Reed Army Medical Center/Georgetown University, Washington, D.C. i n t e r 1 9 9 5 �MEDICAL SCHOOL Insuring care for those who care THE ACADEMIC HEALTH PROFESSIONALS INSURANCE ASSOCIATION CONTINUES TO GROW AS IT PROTECTS SUNY'S FACULTY PRACTITIONERS H early four years after its found­ ing, the Academic Health Profes­ sionals Insurance Association — formed by and for faculty practi­ tioners at the State University of New York's science centers — boasts a membership that has nearly tripled to its current 647. From the beginning, Buffalo physi­ cians and dentists played a pivotal role, numbering over half of the original 220 subscribers and maintaining that lead­ ership today. The reciprocal insurance company began as an outgrowth of the series of medical malpractice insurance crises that plagued New York State physicianssince the early 1970s. The realization that faculty practitioners at SUNY science centers had developed an excellent record of risk avoidance and control in medical malpractice, and that this ex­ cellence was not recognized by conven­ tional insurance companies, spurred physicians and dentists at Buffalo, Brook­ lyn, Syracuse and Stony Brook to decide they might do better on their own. After years of study, planning and, finally, advance funding, they formed the new company, electing William P. Dillon, M.D., associate professor of gynecology/obstetrics and chief of the di­ vision of maternal/fetal medicine at The Children's Hospital of Buffalo, its chair. Dillon still holds that post, presiding over a board of governors representing the four health science centers and the United University Professions. Subscribers at each center elect their board members for four-year terms, and members serve without compensation. Management is the responsibility of the attorney-in-fact, Medical Quadrangle, which has worked with Academic in initial planning and operations since its inception. All specialties are included, as well as residents and health professionals. About half of the membership are full or associate professors.Somewhat over half ANESTHESIOLOGY CRITICAL CARE DENTISTRY DERMATOLOGY EMERGENCY MEDICINE FAMILY MEDICINE INFECTIOUS DISEASES INTERNAL MEDICINE MEDICINE NEUROSURGERY NEUROLOGY NUCLEAR MEDICINE MICROBIOLOGY OB/GYN OPHTHALMOLOGY ORTHOPEDIC SURGERY OTOLARYNGOLOGY PATHOLOGY PEDIATRICS PLASTIC SURGERY PSYCHIATRY RADIOLOGY REHABILITATION MEDICINE SURGERY UROLOGY 0 B 10 u 20 f 30 f a 40 l 50 o 70 60 p h y 80 s 73 2 19 3 29 70 O 12 88 13 14 6 2 61 5 29 17 22 73 1 3 38 17 46 4 90 i c i a n W i are insured under claims-made policies — the only type available when Aca­ demic was licensed. A substantial num­ ber transferred to occurrence policies when this choice was authorized by law in 1992. (Claims-made policies cover only incidents arising and reported within the policy year but may go back to the first claims-made policy if these are held continually by the insured; occurrence policies apply to incidents occurring during the policy year, re­ gardless of when a claim is filed.) Supported by individual capital con­ tributions in the form of loans, pre­ mium payments and guarantees of fi­ nancial responsibility, Academic is fis­ cally sound with assets of over $ 10 mil­ lion. Dividendsare promised in the near future, pending approval of the State Insurance Department. Academic requires its subscribers to participate in risk management educa­ tion programs to maintain its superior record in claims frequency (the lowest in the state) and settlements. Premium credit of 5percent for two years is granted for successful completion of the basic or advanced course. During 1992-93, nine seminars were conducted and 377 sub­ scribers attended. — B Y I R V I N G L A D I M E R Baird receives 1994 Parke Davis Teacher Development Award B onald E. Baird, D.O., clinical as­ sistant professor of family medi­ cine, has received the 1994 Parke Davis Teacher Development Award. The award recognizes Baird's contributions as a clinically based in­ structor for both graduate and under­ graduate medical education. n t e r 1 9 9 5 �iH M E D I C A L S C H 0 0 L Neuroanatomy museum opens to the public UNIQUE INSTALLATION FEATURES EXTENSIVE COLLECTION OF SPECIMENS AND THE HISTORY OF IMAGING THE BRAIN FROM PNEUMOENCEPHALOGRAM TO PET i n unusual museum de­ voted exclusively to the human brain, thought to be the only installation of its kind in the U.S., opened officially at the medical school with the dedi­ cation of the UB Museum of Neuroanatomy last September. Harold Brody, M.D., Ph.D., professor of anatomy and cell biology at UB for more than 40 years and the museum's cre­ ator, said, "The brain is so fun­ damentally beautiful, I wanted the displays also to be attrac­ tive. I knew that if they didn't look appealing, it would turn people off." Brody, a 1961 graduate of the medical school and former chair of anatomy, said the idea became a spark in his mind ever since he saw a similar installation in Copenhagen, Denmark, while there on a Fulbright fellowship in 1963. Medical students in Europe tradition­ ally learned their anatomy from such permanent exhibits because of the scar­ city of cadavers for dissection, Brody said. He helped to establish a successful donor program at The University of Copenhagen, and brought back with him the idea for a neuroanatomy mu­ seum. Thirty years later, thanks to 30-year reunion gifts from his Class of 1961, the medical school's Class of 1962 and pri­ vate individuals, his idea has been trans- B u f f a l o P 0z c p z 0 1 U ) The extensive collection features specimens, Xrays and photographs, as well as CT, MRI and PET scans of the brain. formed into an extensive collection of specimens detailing the structure of the human brain from many viewpoints. Some 70 specimens are suspended in crystalline liquid in individual Plexiglas boxes, spotlights dramatizing their char­ acteristic folds and contours. Hand-made pins tipped in blue, orange, green, lav­ ender, red, and light blue identify each specimen's features. Lining the walls are color photo­ graphs of the brain, along with a series of X-rays, CT scans, MRI scans and PET scans. h y s i c i a n W i n t e r 1 9 9 5 �MEDICAL SCHOOL One display reveals the medial sur­ face of the right hemisphere; another is delicately dissected to reveal each layer of the brain. Other displays show the cranial nerve supply, the brain's blood supply and the path of nerve impulsesin the brain that ultimately produce vi­ sion. These and several dozen additional specimens fill 10 glass display cases. Each specimen is accompanied by a written description keyed to the colorcoded pins. Leaving no details to chance, Brody, along with his assistant, Thomas Wietchy — an anatomy master's degree candidate — and Katerina Smith, a se­ nior histology technician, made the pins themselves from dental wire dipped in acrylic pigments and epoxy. The speci­ mens were dissected by Brody, Wietchy and several medical students. Medical, dental and nursing students, occupational-therapy and physicaltherapy students, doctoral candidates in psychology and speech communica­ tion and hospital residents in neurology UB professor and researcher Thomas Beam dies suddenly A professor in the department of medicine and associate professor in the department of microbiology, Beam was chief of the Buffalo VA Medical Center's infectious diseases section for 11 years, and was serving as associate chief of staff for education at the hos­ pital at the time of his death. He was certified by the American Board of Internal Medicine. Beam received his bachelor's and T homas R. Beam,Jr., M.D., a pro­ fessor and researcher in the Uni­ versity at Buffalo School of Medi­ cine and Biomedical Sciences and consultant to the U.S. Food and Drug Administration, died un­ expectedly August 17, 1994 in his of­ fice in the Buffalo VA Medical Center. medical degrees from the University He was 48. of Pennsylvania in 1968 and 1972, Beam was an infectious-diseases ex­ respectively. He joined UB as an in­ pert known internationally for his structor in the department of medi­ work on drug-resistant bacteria and cine in 1974. viruses. In 1989, he was appointed to Widely quoted in the national news direct an innovative, two-year project media, Beam was featured in stories established by the FDA and Infectious about the mounting problem of drugof Diseases Society resistant bacteria on CBSAmerica to speed up the TV's "48 Hours" and in a FDA's approval process for cover story in Newsweek. new antibiotics, and to en­ A prolific researcher, hance its monitoring of Beam authored or codrugs on the market for authored numerous text­ early warnings of adverse book chapters and ar­ effects. ticles in professional He also chaired the journals. He was a re­ FDA's Anti-Infective viewer for many profes­ Drugs Advisory Commit­ sional publications, in­ tee and, in that capacity, cluding the Journal of the in October 1990 oversaw American Medical Asso­ hearings focusing on pro­ Thomas R. Beam, Jr., M.D. ciation, Journal of Infec­ posals for modifying the tious Diseases, Annals of FDA's guidelines for approval of new Pharmacotherapy and American Jour­ antimicrobial drugs. nal of Kidney Diseases. and neurosurgery have been using the exhibits as study aids for more than a year. Brody wants the exhibit to be used by everyone and is particularly inter­ ested in bringing in students from area public schools. Groups of high-school students al­ ready have toured the museum, as did a group of students on campus for the summer. Brody will add specimens and addi­ tional materials to the museum as time and money permit. In the meantime, he hopes to establish regular hours when the museum will be open to the public. "I feel this is such a valuable asset, that anybody interested in the structure of the brain should have access to it," he said. "I think this could make a tremen­ dous contribution in a very specific way to the medical school and the commu­ nity." + He was chairman of the Antibiotics Use and Clinical Trials Committee of the Infectious Diseases Society of America. He also served as the society's liaison to the European Community and was an honorary member of the Critical Care Medicine Society of Para­ guay. He was the editor-in-chief of two national medical journals: Infections in Medicine and Abstracts in Infectious Disease. Beam was a fellow of the American College of Physicians and the Infec­ tious Diseases Society of America, and was a member of many professional organizations. He also served as a con­ sultant to numerous health facilities in Western New York, including Roswell Park Cancer Institute; J.N. Adam, Craig and West Seneca Devel­ opmental centers; The Buffalo Gen­ eral Hospital; and the Erie County Medical Center. B y n u f f a l o P h s i c i a n W i t e r 1 9 9 5 © �MEDICAL Susan McLeer named lo chair department of psychiatry Richard Erbe co-authors textbook lor "electronic superhighway" her tenure as vice chair, McLeer was assistant and associate dean of under­ graduate medicaleducation from 1976 to 1982. A visiting professor of behavior usan V. McLeer, M.D., an expert in science at Catholic University in Lille, disorders of sexually abused chil­ France, she completed a four-year visit­ dren and battered women, has been ing professorship at Smith College in appointed chair of the department Northampton, Massachusetts, last June. of psychiatry. She also had a private psychia­ McLeer was formerly try practice in Philadelphia. professor and vice chair of the A fellow of the American department of psychiatry at Psychiatric Association and The Medical College of Penn­ the Philadelphia College of sylvania in Philadelphia and Physicians, she is a member director of its division of child of several other professional and adolescent psychiatry. societies, including the Ameri­ A member of the American can Academy of Child and Medical Association's work­ Adolescent Psychiatry, the Susan V. McLeer, M.D. ing group on domestic vio­ Coalition of Physicians lence, McLeer has testified on the bat­ Against Family Violence and Physicians tered woman syndrome in several for Social Responsibility. trials. She has published numerous ar­ ticles in refereed journals on domestic violence against women and children, and has lectured widely on these topics. She was principal investigator on a recently completed four-year study of aul R. Knight, M.D., Ph.D., profes­ symptoms and psychiatricdisorder per­ sor and chair of anesthesiology and sistence following child sexual abuse, professor of microbiology, was and will continue her research at UB in appointed to a four-year term on this area and in the field of post-trau­ the Surgery, Anesthesiology and matic stress disorder in children. Trauma Study Section, Division of McLeer earned her medical degree Research Grants, for the National Insti­ from The Woman's Medical College of tutes of Health. Pennsylvania, now the Medical College Study sections review grant applica­ of Pennsylvania, and holds a master's tions submitted to NIH, make recom­ degree in psychiatry administration from that institution. Following a pedi­ mendations on the applications to the atric internship at Strong Memorial appropriate NIH advisory council or Flospital in Rochester, she did her psy­ board and survey the status of research chiatric residency at the Medical Col­ in their fields of science. Knight was nominated to the post lege of Pennsylvania, and completed a fellowship in child and adolescent psy­ because of his demonstrated compe­ chiatry there and at the Eastern Penn­ tence and achievement as evidenced by the quality of his research accomplish­ sylvania Psychiatric Institute. ments, publications in scientific jour­ She joined the faculty of her alma nals and other significant activities, mater in 1976 and built her career there in achievements and honors. psychiatry and pediatrics. In addition to B ichard W. Erbe, M.D., professor of pediatrics and medicine and chief of the division of genetics at The Children's Hospital of Buffalo, has co-authored, with faculty from Harvard and Stanford, a medical textbook available on the electronic su­ perhighway. The textbook, "Scientific American Medicine," is designed to give general practitioners, medical students, resident physicians, nursesand other health care professionals an overview of medical disciplines outside their own. Erbe's chapter, "Medical Genetics," details advances made in the past 15 years in the prediction, diagnosis and management of genetic disorders. The textbook is available worldwide on CD ROM and locally on UB's electronic medical network, HUBNET. Erbe has been a researcher and teacher of genetics for more than 25 years. Be­ fore joining the UB faculty in 1989, he was an associate professor of pediatrics and genetics at Harvard Medical School. A former member of the editorial board of The New England Journal of Medicine, Erbe has authored or coauthored more than 70 scientific ar­ ticles, reviews and book chapters. + Knight appointed lo National Institutes of Health study section © B u f f a l o P h y s i c i a n Medical student wins James Coiner Minority Research award D B medical student N. Kalaya Okereke has been selected as one of 12 medical students across the country to receive a James Comer Minority Research Fellowship from the American Academy of Child and Adolescent Psychiatry. W i n t e r 1 9 9 5 �MEDICAL The fellowship is funded through the National Institute of Mental Health. The award offersoutstanding minority medi­ cal students early exposure to research in child and adolescent psychiatry. The award includes a $2,200 grant for sum­ mer research with a child and adoles­ cent primary investigator. Okereke is working with Gary Cohen, M.D., and Peg Bohnert, M.D., both of the departments of psychiatry and pedi­ atrics, and Richard Clopper, Ph.D., of the departments of psychiatry and psy­ chology ^ on a project at The Children's Hospital of Buffalo to assess the hospital's psychiatric consultation and liaison ser­ vices. + 0E Leon E. Farhi, M.D. Buck wins fellowship lo sludy tubal ligation safety, effectiveness Medical, biological engineering institute selects Farhi as fellow G I ermaine S. Buck, Ph.D., assistant professor of social and preventive medicine, has won one of two fel­ lowships sponsored annually by the Merck Company Foundation and the Society for Epidemiology Research. The $190,000, three-year award will allow her to begin a long-term study of the safety and effectiveness of tubal ligation. The study will involve 3,000 to 4,000 women who will be followed for 10 to 20 years. Buck was one of 40 researchers con­ sidered for the fellowships, which are awarded through a national competi­ tion. Winners are selected by an indepen­ dent scientific advisory committee that considers the accomplishments of the researcher, the soundness of the pro­ posed research project and the commit­ ment of the researcher's institution to the applicant and the research. B u f f a l o P h eon E. Farhi, M.D., distinguished professor and former chair of physiology, has been named a fel­ low of the American Institute of Medical and Biological Engineer­ ing. Farhi has studied the human circula­ tory system and physiological problems of human lung gas exchange for more than 35 years. He has authored or coauthored more than 100 scientific ar­ ticles and abstracts. He was instrumental in developing new approaches for measuring cardiac output and distribution of respiratory gases within the lungs and tissues of the human body. Working with colleagues at UB, he developed a technique to measure circulatory functions in a weightless state that was applied by NASA in a space shuttle flight in 1989. Farhi received his medical degree in 1947 from the Universite St. Joseph in Beirut, Lebanon. He has served as edi­ y s i c i a n W i tor-in-chief of theJournal ofAppliedPhysiology: Respiratory, Environmental and Ex­ ercise Physiology, an editor of Undersea Biomedical Research and on the editorial board of Respiration Physiology. He is the principal investigator of two NASA-spon­ sored research projects with funding of more than $3 million to study cardiopul­ monary function in microgravity. Slaplelon elected president of pediatric nephrology society F Bruder Stapleton, M.D., A. Con| ger Goodyear professor and chair of pediatrics and pediatrician-inchief of The Children's Hospital of Buffalo, was elected president of the American Society of Pediat­ ric Nephrology. He will serve a one-year term for the society, which represents 420 pediatric kidney specialists in North America, formed to foster professional and pub­ lic education, improve patient care and promote relevant scientific research. + n t e r 1 9 9 5 © �A L U M N I 1994 reunion classes donate over 154,000 to medical school for scholarship fund I ast year's reunion classes made generous do­ nations to the medical school during the an­ nual Spring Clinical Day and Reunion Week­ end festivities. In all, $54,302 was pledged to the medical school to be used for scholarships for worthy students. Following is a list of participating class members and class totals. CLASS OF 1944 — 35,500 Dr. Howard R. Barnett Dr. Willard H. Boardman Dr. Robert L. Brown Dr. Samuel Cassara Dr. Edmund M. Collins Dr. Herman Edelberg Dr. Richard W. Egan Dr. Thomas F. Frawley Dr. Frank T. Frost Dr. Raymond A. Hudson Dr. Frank H. Long, Jr. Dr. William K. Nowill Dr. Casimer F. Pietraszek Dr. William A. Potts Dr. Theodore C. Prentice Dr. Charles H. Rosenberg Dr. Joseph Ross Dr. Sidney M. Schaer Dr. James R. Sullivan Dr. Paul L. Weygandt Dr. Robert G. Wilkinson, Jr. CLASS of 1949 — $5,040 Dr. Carmelo S. Armenia Dr. J. Bradley Aust, Jr. Dr. Harold Bernhard Dr. Manuel H. Brontman Dr. Paul T. Buerger Dr. Ralph S. Canter Dr. Lawrence M. Carden Dr. Julian M. Cullen Dr. Philip C. Dennen Dr. John D. Egan Dr. George M. Erickson Dr. Jacqueline L. Paroski Dr. Max A. Schneider Dr. John T. Sharp Dr. Leonard D. Steiner Dr. Irma M. Waldo Dr. Judith Weinstein Dr. James A. Werick CLASS OF 1954 — $4,685 Dr. Nicholas C. Carosella Dr. Louis C. Cloutier Dr. John L. Conboy Dr. Leonard P. Cons tan tine Dr. Byron A. Genner III Dr. Robert W. Haines © Dr. William J. Howard Dr. Eugene C. Hyzy Dr. Allen L. Lesswing Dr. Lucille M. Lewandowski Dr. Charles H. Marino Dr. Donald J. Murray Dr. Walter A. Olszewski Dr. Robert M. Oshrin Dr. Robert J. Pletman Dr. Stephen A. Spink Dr. Edwin B. Tomaka Dr. Paul L. Weinmann Dr. Harry S. Weinstein Dr. Donald M. Wilson CLASS OF 1959 — $6,113 Dr. Charles W. Anderson Dr. George R. Baeumler Dr. William P. Blaisdell Dr. Robert J. Brennen Dr. Robert A. Brenner Dr. Robert J. Clayton Dr. James M. Cole Dr. ConstantineJ. G. Cretekos Dr. Thomas D. Doeblin Dr. Sterling Doubrava Dr. Joseph A. Ferlisa Dr. Jacob Krieger Dr. Joseph F. Monte CLASS OF 1964 — $4,275 Dr. Jeffrey S. Carr Dr. Walter A. Ceranski Dr. Joseph A. DiPoala, Sr. Dr. Lowell S. Eranstoft Dr. Michael Feinstein Dr. Norman A. Gerber Dr. George Glowacki Dr. Harold Glucksberg Dr. Gerald B. Goldstein Dr. Michael Goldhamer Dr. Arnold H. Israelit Dr. Stephen P. Katz Dr. David A. Leff Dr. Lillian V. Ney Dr. Robert G. Ney Dr. J. Frederick Painton, Jr. Dr. Noel R. Rose Dr. Stephen C. Scheiber Dr. JohnJ. Scomillio Dr. James C. Tibbetts,Jr. Dr. Francis R. Weis, Jr. Dr. Richard W. Williams Dr. Richard E. Wolin CLASS OF 1969 — $9,167 Dr. David H. Amler Dr. Alan J. Blanc Dr. Joel B. Bowers Dr. MoiraJ. Burke Dr. James L. Cavalieri II Dr. Carl J. DePaula Dr. Dorothea A. Downey Dr. Penny A. Gardner Dr. Robert J. Gibson Dr. Lawrence S. Greenberg Dr. Hanley M. Horwitz Dr. William K. Major, Jr. Dr. Bernard C. Muscato Dr. Jonathan T. Paine Dr. James A. Patterson Dr. Michael N. Pisick Dr. Michael M. Pugliese Dr. Douglas L. Roberts Dr. Cheryl C. Rosenblatt Dr. Steven J. Sandler Dr. Ian M. Schorr Dr. David S. Schreiber Dr. Robert S. Shaps Dr. Lester S. Sielski Dr. Wilbur L. Smith, Jr. Dr. Gerald D. Stinziano Dr. Harvey I. Weinberg Dr. JamesJ. White, Jr. Dr. Madeline J. White Dr. Frederick S. Wilkinson II Dr. Marion E. Wind CLASS OF 1974 —$7,288 Dr. Daniel R. Beckman Dr. Mark L. Bernstein Dr. Alan G. Burstein Dr. John H. Clark Dr. Stephen Commins Dr. Anna G. Engel Dr. Jockular B. Ford Dr. Nicholas E. Fuerst Dr. Wayne B. Glazier Dr. Howard R. Goldstein Dr. Richard Herschcopf Dr. Jayne E. Kremzier Dr. David W. Leffke Dr. John P. Manzella Dr. Diane L. Matuszak Dr. Bruce F. Middendorf Dr. Sarah E. Moore Dr. Daniel J. Morelli Dr. Kathleen M. Mylotte Dr. GuidoJ. Napolitano Dr. Benjamin I. Opara Dr. Lawrence A. Oufiero Dr. Sanford R. Pleskow Dr. Eric J. Russell Dr. Elliott A. Schulman Dr. Joel A. Simon Dr. James A. Smith Dr. Reginald M. Sutton Dr. Bradley T. Truax Dr. Robin L. Trumball Dr. Edward L. Valentine Dr. Robert M. Weiss Dr. James M. Wetter Dr. Stuart A. Wolman Dr. Evangelos D. Xistris Dr. Stephen A. Yerkovich CLASS OF 1979 —$5,856 Dr. Philip S. Anson Dr. W. Walter Backus Dr. Walter A. Balon Dr. Gale A. Barg Dr. Robert L. Baron Dr. B. Joy Blumenreich Dr. James P. Bracikowski Dr. Robert A. Brandis Dr. Mark E. Brenner Dr. Carl V. Bundschuh Dr. Linda A. Cardone Dr. Letitia R. Clark Dr. Peter Condro, Jr. Dr. Andrew T. Costarino, Jr. Dr. John W. Crofts Dr. Scott C. Denne Dr. Thomas C. Doolittle Dr. Bruce E. Dunlap Dr. Nancy G. Dvorak Dr. Frederick A. Eames Dr. James G. Egnatcik Dr. Frederick C. Finelli Dr. Charles J. Francemone Dr. Barbara A. Fretwell Dr. N.Joseph Gagliardi Dr. Kenneth A. Hogrefe Dr. Richard T. Irene Dr. Peter J.Jederlinic Dr. Roger E. Kaiser Jr. Dr. Tade A. Kashimawo Dr. Andrew J. Majka Dr. Ramon J. Pabalan Dr. Lewis A. Roberts Dr. Jessica Rockwell Dr. Robert J. Rose Dr. Betty S. Spivack Dr. David D. Stahl Dr. Todd D. Stern Dr. Sonia M. L. Wornum CLASS OF 1984 —$4,410 Dr. Dominic J. Altieri Dr. Robert F. Amberger Dr. Nancy Bach Dr. Ephraim E. Bach Dr. Mary T. Caserta Dr. James A. De Caprio Dr. John M. Fisch Dr. Diane T. Flanigen-Roat Dr. Douglas J. Floccare Dr. John K. Fong Dr. Andrew J. Francis Dr. Roland Greco Dr. Zina D. Hajduczok Dr. William M. Healy Dr. Andrew M. Knoll Dr. William C. Leskovec Dr. Gregory A. Logsdon Dr. Thomas C. Mahl Dr. Linda D. Mandanas Dr. Nora E. Meaney-Elman Dr. Michael G. Mercado Dr. Paul Misthos Dr. Herbert B. Newton Dr. JohnJ. Picano Dr. Lauren Pueraro Dr. William E. Reichman Dr. Richard M. Rosenfeld Dr. Martin Ross Dr. Ira J. Schmelkin Dr. Andrew M. Schneider Dr. Scott C. Sherman Dr. Rony Y. Shimony Dr. Ann K. Smith-Rudnick Dr. Michelle N. Stram Dr. Jeffery G. Straus Dr. Lin-Lan Tang-Huang Dr. Andrew S. Tanner Dr. Frederick W. Tonetti Dr. Carol W. Weinstein Dr. Charles S. White Dr. Edward A. Zane Dr. Benson L. Zoghlin Dr. Mitchell E. Zuckerman CLASS OF 1989 —$1,968 Dr. Christopher J. Bartolone Dr. David R. Bloom Dr. Joseph F. Ceravolo Dr. James Chong Dr. Hayley Cohen Dr. Barbara J. Creighton Dr. Raffi M. Der Sarkissian Dr. Jane K. Doeblin Dr. Fred L. Dreher Dr. Tai-Hwang M. Fan Dr. Wayne A. Forde Dr. Dawn A. Gais Dr. Joseph S. Giglia Dr. Thomas Grimaldi Dr. Lee R. Guterman Dr. Anne Kristina E. Hart Dr. Philip G. Lauria Dr. Salvatore S. Lauria Dr. Michael Licata Dr. Louis J. LoBalsamo Dr. James L. Meisel Dr. Alison R. Moliterno Dr. Yasmin Panahy Dr. Mark R. Pundt Dr. Anne G. Rizzo-Fantin Dr. Stephen G. Rohn Dr. Mary E. Schamann Dr. Kevin M. Senn Dr. Jeanette M. Smith Dr. Stuart R. Varon Dr. Reynold Villedrouin Editor's Note: While every effort is made to verify the accuracy of the listing, omissions and misprints may occur. This report lists all donors who have made gifts as of November 8, 1994. If you have any questions, comments or concerns, please call Michael E. Benzin, Director of the Annual Appeal, at (716) 645-3312. Thank you. �Spring Clinical Day and Reunion Weekend on for April 28 - 29,1995 ' ark your calendars and be sure to set aside the time to attend the 58th An­ nual Spring Clinical Day and Reunion Weekend at the Buffalo Marriott. Reunion dinners will be held on 1 Friday evening, April 28. On Saturday, April 29, Stockton Kimball lecturer Richard Krugman, M.D., dean of the University of Colorado School of Medicine, will speak on "The Physician —• Healing the Abuse in Our Families." Class of 1955 Class of 1975 "Forty years have passed. We have so much to share. Plan your sched­ ules now to gather here in Buffalo and see old friends." John H. Peterson, M.D. Chairperson "We would like to welcome you back to our 29th Year Re­ union. We need you to make it a success. Please join us." John C. Stubenbord, M.D. Chairperson John C. Stubenbord, M.D. John H. Peterson, M.D. Class of 1980 "It was 94 degrees in Buf­ falo for our 10th year reunion. Please come and heat up the town again!" Margaret Paroski, M.D. Chairperson Class of 1945 "Each season hasits own beauty and attainments. The continuum of life fixates beyond our peak years. This is our 50th year as physicians. Let us all join in our reunion circle on April 29,1995. The most — the best — reunion to date!" Herbert E.Joyce, M.D. Chairperson James R. Kanski, M.D. Margaret Paroski, M.D. Roger s. Doyer, M.D. Class of 1960 "Time to, once again, become reacquainted,share our memories and ruminate about the future." James R. Kanski, M.D. Co-Chairperson Roger S. Dayer, M.D. Co-Chairperson Class of 1965 "Let's get together and celebrate 30 years on April 29, 1995." Joseph Cardamone, M.D. Chairperson Robert J. Patterson, M.D. Sidney Anthone, M.D. Joseph Cordamone, M.D. Class of 1950 "Don't miss our 45th. We are counting on you to make it a success." Robert J. Patterson, M.D. Co-Chairperson Sidney Anthone, M.D. Co-Chairperson Donald Copley, M.D. Elizabeth Maher, M.D. Dona|d Ting|cy/ MD Class of 1985 "The medical school and Main Street in Buffalo look a whole lot different now compared to the early '80s. Come check it out and party with old friends." Elizabeth Maher, M.D. Co-Chairperson Donald Tingley, M.D. Co-Chairperson Class of 1970 Class of 1990 "Our 25th reunion sched­ uled for April 29, 1995, is too important to pass up. It should also be great fun because we expect more than 30 of our class­ mates will be attending. Please do your best to join us for this very special quarter-century celebra­ tion!" Donald Copley, M.D Chairperson "Yes, it has been five years. Mark it down — April 29, 1995 — our fifth year reunion. Come and see what residency has done to your class­ mates!" Raymond Paolini, M.D. Chairperson Raymond Paolini, M.D. �A L U M N I James Plall While Society holds Annual Meeting for members Members of the James Piatt White Society at the organization's 1994 Annual Meeting. T he James Piatt White Society held its annual meeting last October 21 at The Country Club of Buf­ falo. The distinguished organiza­ tion, based on the values and prin­ ciples of the former dean and founder of the School of Medicine and Biomedical Sciences, contributes gen­ erously to the school's mission of pro­ viding the highest quality education, research and patient care, and helps the school continue its leadership role as one of the premier medical schools in the country. Gifts to the medical school by members of the society have helped fund biomedical and clinical research, provide schol­ arships, purchase state-of-the-art laboratory equipment and maintain innovative programming. Members of the James Piatt WHite Society for 1994 are: Dr. Kenneth M. Alford '37 Dr. Kenneth Z. Altshuler '52 Dr. Richard Ament '42 Dr. William S. Andaloro '45 Dr. George R. Baeumler '59 Dr. Jared C. Barlow '66 Dr. Charles D. Bauer '46 Dr. Ralph T. Behling '43 Dr. Richard A. Berkson '72 Dr. Harold Bernhard '49 Dr. and Mrs. Willard H. Bernhoft '35 Dr. Theodore S. Bistany '60 Dr. John C. Bivona,Jr. '68 Dr. Willard H. Boardman '44 Dr. Dennis L. Bordan '70 Dr. Martin Brecher '72 Dr. Robert J. Brennen '59 Mrs. Ann Brody Dr. Harold Brody '61 Dr. Melvin M. Brothman '58 Dr. Robert L. Brown '44 Dr. August A. Bruno '51 Dr. William M. Burleigh '67 Dr. David W. Butsch Ms. Janet F. Butsch Dr. John L. Butsch Mr. David N. Campbell Dr. Joseph G. Cardamone '65 Dr. Nicholas C. Carosella '54 Dr. and Mrs. Norman Chassin '45 Dr. and Mrs. Joseph A. Chazan '60 Dr. Michael E. Cohen '61 Dr. James M. Cole '59 Dr. Donald P. Copley '70 Dr. Edward B. Crohn '43 Dr. Julia Cullen '49 Dr. Daniel E. Curtain '47 e Dr. Richard H. Daffner '67 Dr. Peter S. D'Arrigo '56 Dr. Roger S. Dayer '60 Dr. Alfred H. Dobrak '39 Dr. Sterling M. Doubrava '59 Dr. Kenneth H. Eckhert, Sr. '35 Dr. Robert Einhorn '72 Dr. and Mrs. George M. Ellis, Jr. '45 Dr. Alfred S. Evans '43 Dr. John A. Feldenzer '83 Dr. Jack C. Fisher '62 Dr. Thomas F. Frawley '44 Dr. Matt A. Gajewski '39 Dr. Penny A. Gardner '69 Dr. Kenneth L. Gayles '73 Dr. John W. Gibbs, Jr. '67 Dr. Mala Ratan Gupta Dr. Thomas J. Guttuso '60 Mrs. Gilda L. Hansen BA '44 Dr. Reid R. Heffner, Jr. Dr. William J. Hewett '61 Dr. Joseph M. Hill '28 Ms. Elizabeth H. Hiller Dr. John M. Hodson '56 Dr. Kenneth L. Jewel '68 Dr. Herbert E.Joyce '45 Dr. Stephen T. Joyce '63 Dr. James R. Kanski,Jr. '60 Drs. Julian and Mayenne Karelitz '68 Dr. Arthur C. Klein '62 Dr. Jacob S. Kriteman '67 Dr. Paul S. Kruger '72 Dr. Joseph L. Kunz '56 Dr. and Mrs. Marvin Z. Kurlan 64 Dr. Francis J. LaLuna '68 Dr. Andre D. Lascari '60 Dr. Won Yub Lee Dr. Eugene V. Leslie '51 Dr. Laurence M. Lesser '70 Dr. and Mrs. Harold Levy '46 Dr. Lucille Lewandowski '54 Dr. Jack Lippes '47 Dr. Hing-Har Lo '74 Mrs. Grace S. Mabie Dr. William K. Major, Jr. '69 Dr. Don L. Maunz '63 Dr. Charles J. McAllister '73 Dr. Margaret P. McDonnell '82 Dr. Harry L. Metcalf '60 Dr. Merrill L. Miller '71 Dr. Eugene R. Mindell Dr. Joseph F. Monte '59 Dr. Philip D. Morey '62 Dr. John D. Mountain '33 Dr. Arthur W. Mruczek, Sr. '73 Dr. Richard J. Nagel '53 Dr. Richard B. Narins '63 Dr. John P. Naughton Drs. Robert G. and Lillian V. Ney '62 and '64 Dr. Timothy T. Nostrant '73 Dr. Thomas P. O'Connor '67 Dr. Carrie P. Ogorek '81 Dr. Yasuyo Ohta Dr. Elizabeth P. Olmsted '39 Drs. Dean and Donna Orman '65 and '84 Dr. John S. Parker '57 Dr. and Mrs. Robert J. Patterson '50 Dr. Clayton A. Peimer Dr. Victor L. Pellicano '36 Dr. James F. Phillips '47 Mr. R. Willis Post Dr. Bert W. Rappole '66 Dr. Albert C. Rekate '40 Dr. Frank T. Riforgiato '39 Dr. Charles J. Riggio '60 Dr. Richard R. Romanowski '58 Dr. Charles H. Rosenberg '44 Dr. Jeffrey S. Ross '70 Dr. Albert G. Rowe '46 Dr. Eric J. Russell '74 Dr. Agnes Samuel '76 Miss Thelma Sanes Dr. Arthur J. Schaefer '47 Dr. Max A. Schneider and Mr. Ronald S. Smelt '49 Dr. Robert N. Schnitzler '65 Dr. David S. Schreiber '69 Dr. Joseph I. Schultz '57 Dr. Roy E. Seibel '39 Dr. Elizabeth G. Serrage '64 Dr. Edward Shanbrom '51 Dr. John B. Sheffer '47 Miss Alice Simpson Dr. James A. Smith '74 Drs. Robert Smolinski and Claudia Fosket '83 and '85 Dr. JohnJ. Squadrito '39 Dr. Melvin J. Steinhart '62 Dr. William C. Sternfeld '71 Ms. Elizabeth A. Storch MS '72 — Lib Mr. Barry S. Swartz Dr. Michael S. Taxier '75 Dr. James C. Tibbetts,Jr. '64 Dr. Charles S. Tirone '63 Dr. Edward A. Toriello '80 Dr. Bradley T. Truax '74 Dr. Arnold Wax '76 Dr. Harold J. Weinstein '72 Dr. Philip B. Wels '41 Dr. JamesJ. White, Jr. '69 Dr. Gary J. Wilcox '73 Dr. Richard G. Williams '80 Dr. and Mrs. Marvin N. Winer '39 Mrs. Rose Marie L. Wong BS '50 — Pharmacy Dr. John R. Wright Dr. Gregory E. Young '77 Dr. Wende W. Young '61 Dr. and Mrs. Franklin Zeplowitz '58 Dr. and Mrs. David C. Ziegler '65 Editor's Note: While every effort is made to ensure theaccuracy of this listing,omis­ sions and misprints may occur. This re­ port lists all membersbetween October23, 1993 and October 21, 1994. If you have any questions, comments or concerns, please call Michael E. Benzin, Director of the Annual Appeal, at (716) 645-3312. Thank you. �The Perfect Prescription For Tour Conference Needs 18,000 Square Feet of Meeting Space * Conference Planning Professionals * Convenient Downtown Location « Quick Metro Ride to Main Street Campus and Medical School * Close to Buffalo General, Roswell, ECMC and Children's Hospitals Noel Richard Rose, M.D., Ph.D., '64, receives the Alumni Association's specially designed crystal bison from association vice president Frank T. Schreck, M.D., '79. Noel Rose receives Distinguished Medical Alumnus Award for 1994 H oel Richard Rose, M.D., Ph.D., professor of molecular microbi­ ology and immunology at The Johns Hopkins University, re­ ceived the Distinguished Medical Alumnus Award at a dinner at the Park Country Club of Buffalo last Sep­ tember. Rose, a specialist and pioneer in the field of autoimmunity, is a 1964 gradu­ ate of the UB medical school. A gradu­ ate of Yale University, he received a doctorate from the University of Penn­ sylvania in 1951. He founded Wayne State University's department of immunology and micro­ biology in 1973, and in 1982 became the first chair of the department of im­ munology and infectious diseases, now the department of molecular microbiol­ ogy and immunology, atjohns Hopkins. Rose began his academic career at UB, joining the faculty as an instructor in bacteriology and immunology in 1951. At UB, he worked with Ernest Witebsky, distinguished scientist, re­ searcher and director of UB's Center of m Your Guests Can Walk to Theatre, Shops, Pilot Field, Restaurants, Entertainment CME Friendly w Great Banquet Food Please Talk To Us About Preparing A Proposal So You Can Bring Your Group's Next Convention To Buffalo (716) 856-1234 E XTENSION 6142 HYATT. WE'VE THOUGHT OF EVERYTHING™ H^Y-AXT R B u f E f G a E N l C o Y P Immunology. Rose became director of the center, which now bears Witebsky's name, after his mentor's death in 1969, and holds honorary life-long member­ ship on the Ernest Witebsky Center Committee. During his 22 years at UB, he also was director of Erie County Laboratories, head of the old E.J. Meyer Memorial Hospital department of laboratories and director of UB's diagnostic laboratories. Rose left UB in 1973 to establish and head Wayne State's immunology efforts. In 1982, he went to Johns Hopkins, where he chaired the department of immunology and infectious diseases for 11 years. He is a professor in the departments of molecular microbiology and immunology, medicine and envi­ h y s i c i a n W i ronmental health sciences and director of the World Health Organization Col­ laborating Center for Autoimmune Dis­ ease in Baltimore since 1968. Rose's current research is related to self-non-self discrimination and autoim­ mune disease. He has published more than 500 articles and abstracts in pro­ fessional journals and has edited 10 books. He is editor in chief of Clinical Immunology and Immunopathology and sits on several editorial boards. n t e r 1 9 9 5 �A T S p o o n f u l o f © S t u S i l v e r s t e i n , M . D ONE LAST STANDARDIZED TEST TO TAKE! his week I find myself spending all my spare time studying for the Pediatric Boards, which I will confront next Tuesday in a hotel room in Portland, Oregon. 1 hardly have any time to catch the details of the O.J. trial and the latest dilemmas confronting Judge Lance Ito I am awaiting the appearance of a cable channel devoted entirely to the O.J. case. ("I want my O.J.TV.") Whoops! I guess it already exists and it's called CNN, or the 300-hour PBS spe­ cial on the history of baseball. Base­ ball is the only sport in which a PBS special is more captivating than a live game. I am hoping that this is the last time 1 will have to spend what seems like an eternity filling in those microscopic circles with a number two pencil. I am also not looking forward to re­ ceiving instructions on how to fill in the holes. You would think they consider that since ev­ eryone in the room is a licensed physician and has spent the equivalent of one month each taking standardized exams, they would just say, "look you know what to do, go ahead and start." No such luck. They'll have that same woman from the sec­ ond grade with the blue hair tell­ ing us that the penalty for cheating © H u m o r is expulsion from the room and the possibility of serving on the O.J. jury. (I'll get the same feeling I get listening to the YAAWN. flight attendant explain again how to act in the events of a water landing even though we are flying over Idaho.) I'm not sure if I am more anxious about taking the Boards, or myjob prospects upon passing them. I have actually had pediatric col­ leagues tell me that I am lucky that I have comedy to fall back on. It was sup­ posed to be the other way around, wasn't it? Perhaps one day I'll tell my chil­ dren, "You want to be a doctor? You'llstarve! First do something that will put food on the table — standup comedy!" Newsweek even ran a story about patients look­ ing up their symptoms on the Internet and communi­ cating to others about them. I hope Hillary and her com­ mittee don't see the story, or patients will have to get used to hearing, "Take two bytes and call me in the morning." Stu Silverstein, M.D., president of Standup Medicine Seminars of San Francisco, lectures nationwide on humor in medicine. �CLASSNOTES the wedding of Rich Stamile's PHILIP C . DENNEN daughter in Tulsa. ' 4 9 , BERNARD C. MUSCATO '69, chapter of High Risk Pregnancy — Management Option, James, Steer, Weiner and Gonik, edi­ tors, published by Saunders last May. He has seven granddaugh­ ters and two grandsons. 5 O was appointed to a six-year term R I C H A R D I . A L T E S M A N ' 7 6 , of on the board of directors of Briarcliff Manor, New York, is Mercy Hospital of Buffalo. He is president of the Westchester a past president of the medical Psychiatric Society and received staff there. added qualifications to his boards in addictions psychiatry. He is medical director of Stony S J O H N B . F R A N K E L ' 5 3 , of St. Paul, Minnesota, returned from OB/GYN practice in Southern Bernard C . M u s c a t o ' 6 9 California in the early 1990s, of A R T H U R M . S E I G E L ' 7 0 , of Lodge Hospital in Briarcliff Guilford, Connecticut, just re­ Manor. He and his wife Linda ceived his pilot's license. His celebrated their 22nd anniver­ neurology practice, he says, sary recently. They have a son, keeps him busy. 14, and daughter, 12. "Anyone moved to Washington and JOHN J . LAMAR, JR. '63, helped establish a prenatal care Salem, Newjersey, was recently MICHAEL A. HABERMAN '73, clinic. He retired in June 1993 to appointed chief of pediatrics at of Atlanta, Georgia, was installed passing through New York City St. Paul and married a grade Memorial Hospital of Salem injuneasthe 140th president of school classmate. They have 13 County. His second grandchild the Medical Association of At­ children and 13 grandchildren. and first granddaughter, Skyler lanta, at 2,000 members, the larg­ Nicole Devine, was born lastjuly, est county medical society in the weighing 7 lbs., 10 oz. Medical Association of Georgia. 9 6 E D W I N R . L A M M ' 6 0 , of Lake­ land, Florida, became medical director of the Wound Care In­ patient Subacute Center, Merid­ ian Health Care Center,last May. He has been medical director of the Meridian Nursing Center since 1988. He has four grand­ children. Two of his four chil­ dren are married. JAMES M A R K E L L O ' 6 1 , of Greenville, North Carolina, re­ cently retiredas professor of pedi­ atrics from East Carolina Univer­ sity School of Medicine. He and his wife, Rhea Markello, R.N., who also recently retired her nursing management post from East Caro­ lina University Medical Center, spend summers at their Eden, New York, residence. was elected president of the Chicago Radiological Society. authored the "Forceps Delivery" 9 wife Sandra K. Fernbach, M.D., K E N K L E M E N T O W S K I ' 6 6 , of Grand Island, New York, spent time last July in Buffalo's sister city in Poland, Rzeszow, teach­ ing extracapsular cataract and implant surgery. He also took $250,000 worth of implants and ophthalmologic equipment do­ nated by vendors to Rzeszow. B A R R Y S H U L T Z ' 6 8 , of Sink­ ing Spring, Pennsylvania, has been re-elected president of the Urologic Society of Pennsylva­ nia. He is president of Genito­ urinary Associates of Reading. He has a daughter in graduate school at Dartmouth, a son in pre-med at Davidson and an­ other son in high school. He recently met with Tom Cumbo '68 and Bruce Stoesser '68 at He is the first psychiatrist to serve in this capacity. He was also elected as an alternate di­ rector to the Medical Associa­ tion of Georgia's board of direc­ tors. A fellow of the American Psychiatric Association, he served as the president of the Georgia Psychiatric Physicians should stop and say hello." 1 9 8 0 S P A B L O R O D R I G U E Z ' 8 1 , of Warwick, Rhode Island, was awarded the 1994 American Medical Association's Young Physicians Section's Community Service Award during the AMA's annual meeting in Chicago. He chairs the Rhode Island Minor­ ity Health Advisory Committee, which awards grants for minor­ ity community-based health pro­ motion programs. Association. He is in privateprac­ J O E S E R N A ' 8 2 , tells us he is tice in Atlanta. "fortunate to continue living, E R I C R U S S E L L ' 7 4 , of Chi­ cago, Illinois, has been promoted to professor of radiology at Northwestern University Medi­ cal School. He lectured at Sym­ posium Neuroradiologicum, in Kuamoto, Japan, on imaging of the nasopharynx. Daughters Gabrielle, 12, and Meredith, 7, attend Latin School of Chicago; roaches and all, at the center of the universe — Phoenix, Ari­ zona." He is a staff physician with the U.S. Indian Health Ser­ vice and is "still" the same rank as Data. His loving wife of 10 years, Ana Laura, continues to ask around his sixth or seventh night at home, "Don't you have a call night coming up soon?" They have four children, Jose © �CLASSNOTES M O L L Y A . O ' G O R M A N ' 8 6 , of Fuhrer had Evan Fuhrer last fall. J . CURTIS HELLRIEGEL '33, a Salt Lake City, Utah, is an assis­ longtime Buffalo obstetrician- W A L T E R J . G A U D I N O ' 8 7 , of tant professor of gastroenterology at the University of Utah's Pri­ Massapequa, New York, is the mary Children's Medical Center. acting chairman of the depart­ gynecologist, died lastJuly after a long illness. An early advocate of natural childbirth, he served ment of physical medicine and M I C H A E L J . B A R T I S S ' 8 7 , of rehabilitation at Nassau County Pinehurst, NorthCarolina, is prac­ Medical Center. He is married, as chief of staff at Millard Fillmore Hospital in 1966. He also was an associate professor ticing pediatric ophthalmology with a 2-year-old daughter and and strabismus surgery with Caro­ another child on the way. He'd lina Eye Associates. His daughter, like to hear from any classmates J U L I A N J . A S C H E R ' 4 0 , died Kelsey, 6, and son Nolan, 5, have in the Long Island area. last January after a long illness. MICHAEL E. ROSENBAND '89, J O H N G E R L I N G ' 4 3 , ofAtlanta, of New York, New York, com­ died in December 1993. of obstetrics and gynecology. a new baby sister, Maeve Kathleen, bornjuly 7,1994. "Momandbaby David Kountz '85 are doing fine." pleted his residency in internal JOHN K. QUINLIVAN '45, a Miguel, 9; John David, 6; Laura D E B I D E M E S T I H A S ' 8 7 , ofBuf- medicine at Mt. Sinai Hospital Andrea, 2; and Benjamin Adam, falo, is an attending in pediatric in June 1993. As an attending plastic surgeon who served as clinical assistant professor of 1. "Our daring colleague, Sin Ping emergency medicine and prac­ physician there in 1993-94, he Lee, is doing well as a solo practi­ ticing primary care pediatrics at was awarded the 1994 Physician plastic and reconstructive sur­ Health Care Plan. She married of the Year Award. He is pursu­ gery at UB, died last August after New York State trooper Shawn ing a fellowship in cardiology at a brief illness. tioner in Chandler, Arizona." D E N I S E M . G O O D M A N ' 8 3 , of Dalton last September. North Shore Hospital in Long Chicago, Illinois, has accepted a B. EDWARD HECKMANN '48, Island. He married Gattya Lahau died unexpectedly last June in position as assistant professor of B R I A N G A L E ' 8 7 , ofRiverdale, pediatrics and pulmonary and New York, is taking a fellowship critical care medicine at North­ in cross sectional imaging at the In int pprivate i i v a i t , practice pi i i v _ c. 1 ifrom 1U111 1949 X 717 to I 1975, he also worked for Erie western University Medical New York Hospital, Cornell School. She is also an attending Medical Center. His daughter, physician at The Children's Me­ Grace, turned 2 in September. morial Hospital of Chicago. He writes that Russell and Nancy in May 1993. his home in Snyder, New York. of County and New York State and Charlottesville, Virginia, is be­ was associated with Sisters and ginning her second year of a Millard Fillmore hospitals. PAMELA A. CLARK ' 9 0 , pediatric endocrinology fellow­ A N D R E W K N O L L ' 8 4 , of Syra­ M NETTE N E T T E M. M . MCDERMOTT M C D E R M O T T '83, '83, ship at the University of Vir­ KAJM died after a seven-year battlewith cuse, New York, has been pro­ ginia. She married Michael moted to the rank of commander DeHodge, a buyer for the Uni­ breast cancer. She had built a in the U.S. Naval Reserve. versity of Virginia, last June. large internal medicine practice in Waynesboro, Virginia, and DAVID KOUNTZ '85, of Sicklerville, New Jersey, assis­ tant professor of medicine at Hahnemann University in Phila­ Riviera Beach, Florida, home last versity School of Medicine and March. Molly A. O'Gorman '86 Graduate School. a ment, Inc., there. of John F. Kennedy, died in his exercises of the Hahnemann Uni­ f offered controversial testimony investigating the assassination Excellence at the commencement f J O S E P H R . D O L C E ' 3 1 , who before the Warren Commission Practicing Physician Award of u served as medical director for Skyline Rehabilitation Manage­ in 1964 as a ballistics expert delphia, received the Battafarano B OBITUARIES l o P h y s i c i a n W i n t e r 1 9 9 5 �PLANTING A TREE UNDER WHICH YOU WILL NEVER SIT I DR. DEVILLO W. HARRINGTON, class of 1871, knew how to make his money grow. In fact, this man who in 1905 provided $5,000 through his will for the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. T H I S P E R M A N E N T endowment in Dr. Harrington's name has grown to over $300,000 and today it supports the famous Harrington Lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed funds at the school. They enable UB to provide scholarships to outstanding students, enhance scientific research, support excellence in teaching and meet the everchanging needs of the school. You TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you develop a smart financial plan. A charitable bequest provides the satisfaction that comes from planting a tree under which you will never sit, but which will bear fruit for generations to come. FOR A CONFIDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact: STEPHEN A. EBSARY, JR. ASSISTANT DEAN AND DIRECTOR OF DEVELOPMENT SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES UNIVERSITY AT BUFFALO (716) 829-2773 �J BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3 4 3 5 MAIN STREET BUFFALO NEW YORK 1 4 2 1 4 Non-Profit Org. U.S. Postoge PAID Buffalo, NY Permit No. 311 ADDRESS CORRECTION REQUESTED 436C ROEERT LEVIN BECK HALL SOLTH CAMPUS mail The only liability coverage with this seal of approval. Medical Liability Mutual Insurance Company (MLMIC) is the only professional liability insurer approved by the Medical Society of the State of New York. Since its founding in 1975, the physicianowned and managed company has success­ fully defended more physicians than all other available insurers combined. Additionally, MLMIC has the largest and most experienced professional liabil­ ity claims department in the country, the largest risk management department of any New York State professional liability insurer, and the state's only true peer review of claims experience. Call 1-800-ASK-MLMIC (metro) or 1-800-356-4056 (upstate) for more infor­ mation and an application. MLM|C Medical Liability 3 Mutual Insurance Company Our defense never rests 2 Park Ave., New York, NY 10016 2 Clinton Sq., Syracuse, NY 13202 90 Merrick Ave., East Meadow, NY 11554 © 1993 Medical Liability Mutual Insurance Company pfasv I Partners' Press, Inc. 14 Abgott Printing, Inc. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Original Format If the image is of an object, state the type of object, such as painting, sculpture, paper, photo, and additional data Journals and magazines Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 1995 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1995-Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v29n01-1995-Winter Table Of Contents A list of subunits of the resource. Research Hospital News Making Primary Care Primary Practicing Their Calling Then and Now Medical School Alumni A Spoonful of Humor Classnotes Date Created Date of creation of the resource. 2022-09-15 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v29n01 Extent The size or duration of the resource. 36 p. Spatial Coverage Spatial characteristics of the resource. New York (State)--Buffalo Rights Holder A person or organization owning or managing rights over the resource. Copyright 1995 State University of New York at Buffalo Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/88787c314a1b7e8a1e1197d4c1d9581c.pdf f308abb79a62ccf4a16d8e0514985a76 PDF Text Text - �ltlfah ••rsicu• ASSOCIATE VICE PRESIDENT FOR UNIVERSITY COMMUNICATIONS Dr. Carole Smith Petro DIRECTOR OF PERIODICALS Sue Wuetcher Dear Alumni and Friends, EDITOR Stephanie A. Unger ART DIRECTOR/DESIGNER Alan]. Kegler DESIGN ASSISTANT Karen Lie/mer CONTRIBUTING WRITER Lois Baker PRODU C TION COORDINATOR Cynthia Todd-Flick UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. Michael Bernardino, Dean EDITORIAL BOARD Dr. john Bodkin Dr. Martin Brecher Dr. Harold Brody Dr. Linda]. Corder ]asott Hoffmarw, Class of 2004 Dr. ]ames Kanski Dr. Elizabeth Olmsted Dr. james R. Olson Dr. Stephen Spaulding Dr. Bradley T. Truax Dr. Franklin Zeplowitz TEA C HIN C HOSPITALS Erie County Medical Center Roswell Park Cancer Institute Veterans Affairs Western New York Healtltcare Sy stem K~lffl)A Ht A I/fl,' The Buffalo Geueral Hospital Tlte Childreu 's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital C .1 111 0 l/ C Hf-\IJII St li ff\1: Mercy Health System Sisters of Charity Hospital WOt.:LD LIKE TO BEC.I · :-.n FIRST :-.IESSA(;Ic to readers of Buffalo Physician by asking you to join with me in welcoming the Class of 2005 to the University at Buffalo's School of Medicine and Biomedical Sciences. On August 13,2001, members of the medical class participated in the school's Fourth Annual White Coat Ceremony, a symbolic rite of passage whereby incoming students are formally initiated into their roles as physicians-in-training by being "cloaked" in a white coat. While each class entering our school is unique, the Class of2005 holds the distinction of being the first to enter the new organ- and system-based curriculum that is being introduced this fa ll (see cover story, "Medical Education, for Life"). The implementation of this new curriculum is an important milestone because it directly impacts on our school's primary mission, which is to educate physicians and biomedical scientists. Over the next year, there are a number of important goals related to medical education at UB that will require a vast amount of energy. First, we need to prepare for a visit in August 2002 from the Accreditation Council for Graduate Medical Education (ACGME), the entity that oversees and accredits residency programs across the country. Following that visit, our objective will be to work toward transferring sponsorship of UB's residency training programs from the Medical-Dental Consortium to the university, a move that will result in our Office of Graduate Medical Education assuming a much stronger administrative function, emphasizing quality training. Once we establish the university's sponsorship of our residency programs, I anticipate that we will be revisited by the ACGME within two years to be evaluated for accreditation as the new residency program sponsor. In addition to the visit from the ACGME in August 2002, we are scheduled to be visited in October 2002 by the Liaison Committee on Medical Education (LCME), the accrediting body for medical schools. I am currently working to organize a task force, subcommittees and other data-gathering groups in advance of this visit, as it is critically important that Ni11gara Falls Memorial Medical Ceuter @ UIVIISITY liiUFFILI. THE SlATE UIIYEISITY If NEW Till Letters to the Editor we be well prepared. Each of these groups will play a key role in compiling a written report that we are required to send to the LCME by spring of next year, along with a strategic plan for the school. Also within the next year, we will attempt to negotiate a new affiliation agreement with UB's major hospital affiliates. The agreements under which we currently operate are outdated, having been established, for the most part, back in the mid- 1980s. Needless to say, many economic and regulatory changes have occurred since then. Essentially, it will be important that we have a clear understanding of how the university relates to the ho pitals we are affi liated with, as well as how they relate to us. In negotiations to date, we have emphasized that we consider both undergraduate and graduate medical T~ ~ University at Buffalo 17te State University ofNew York �- - -- --- --- ~-~ ~ - ~ - -~ -~ education-as well as research conducted by UB faculty at these affiliated hospitals-to be the university's responsibility. In reviewing these and other complex issues related to UB's School of Medicine and Biomedical Sciences it is obvious that no one individual can manage such a large institution in today's turbulent economic, social and regulatory environments. Recognizing this, I have reorganized the school's administrative structure, placing responsibility for financial matters, external hospital relations and practice plan management within the Office of the Vice President for Health Affairs. I have also expanded the academic component within the Dean's Office by establishing three senior associate dean positions: one for admissions and curriculum, one for graduate medical education and one for research. Working in a complementary role with these deans is the associate dean for alumni affairs and development, whose goal it is to continue to increase private philanthropy, primarily to support the academic component of our school. I am pleased to announce that Margaret Paroski, MD '80, clinical professor of neurology and medical director for Erie County Medical Center, has agreed to serve as senior associate dean for admissions and curriculum. Roseanne Berger, MD, associate professor of clinical family medicine and pediatrics and associate dean for graduate medical education since 1993, has agreed to serve as senior associate dean for graduate medical education. Bruce Holm, PhD, who has served as senior associate dean for research since 1999, will continue in this role, which expanded to encompass all of UB's health-sciences research programs when he was named senior associate vice president for health affairs earlier this year. Lyn Corder, PhD, who has served as associate dean for development since October 1997, will continue to coordinate activities with various constituencies that support You will note that this issue of Buffalo Physician contains a the school, including alumni, parents, faculty and emeritus faculty and friends. I will rely on these three senior associate deans to manage and lead their designated areas, each of which is crucial to our school's future. Our alumni and friends will continue to work with the associate dean for alumni affairs and development to enhance the academic mission through volunteering their time and providing much-needed financial support to make the experience for those who teach and learn within our walls as rich and full as is possible. response envelope. We trust that you will use it. Most of our peer institutions include these envelopes in every publication to help to underwrite their cost. Here at UB, the School of Medi- Despite the recent changes and many challenges that lie ahead, I think it is imperative that we not lose sight of our school's many strengths. Certainly any institution that has graduated 155 classes of medical students, as UB has, is an institution that is capable of adapting to the vicissitudes of time. Indeed, change is upon us, but by working together I am certain we can honor and sustain UB's formidable reputation as a place where some of our nation's finest physicians and scientists have been educated and trained. cine and Biomedical Sciences has published this magazine as a service to its alumni, faculty, residents, students and staff, at no charge, for years. We hope that the inclusion of a gift envelope in each issue will be suffi- Finally, as this issue of Buffalo Physician was going to press we learned of the tragic events of September 11. Our school has over 1,550 alumni living and working in the ew York City area, and an additional 600 or more within a 45-minute drive of Washington, D.C. Together, these individuals comprise about 30 percent of our living alumni. Many more undoubtedly have personal ties, family members or friends directly affected by the attack. It is at times like this that we are reminded of our interconnectedness, as well as our collective obligation to do everything in our power to foster the healing that must now take place. }~f.,. ~ :~=..B ERNARDINO, cient reminder that this publication-like so many activities, lectures, special events and reunions-are only possible through the generosity of our alumni and friends. Also, please feel free to use the envelope for any feedback or comments you may have about your school. MD, MBA Dean, School of Medicine and Biomedical Sciences Vice President for Health Affairs L n /. ( t ,,1, r, asso, 11llc dean fJr alumni affairs and de• clopment �Dear Fellow Alumni, '> 1 " LW Sl HOO! \ t \R START'>, I would like to welcome the students of the graduating class of 2005. Having just celebrated my 25th class reunion at this year's Spring Clinical Day and Reunion Weekend, my hope is that our incoming students will be as proud of their school in the years ahead as my classmates and I are of ours. While our students may not be aware of the changes occurring at our school, we, as alumni, have a responsibility to be aware of these changes, to adapt to them and support our school and its leadership in every way we can. In the Dean's Message, Dr. Bernardino talks about plans to restructure the residency program, with the university emphasizing quality training. He also describes negotiations to restructure the relationship between the university and its affiliated hospitals. The university must assume that the medical education programs-both graduate and undergraduate-as well as research conducted by UB faculty in the affiliated hospitals, are the responsibility of the School of Medicine and Biomedical Sciences. These goals represent changes in the way that these programs have been administered in the past, but they will bring UB in line with most medical schools in orth America with regard to their residency programs and teaching hospital affiliates. The reorganization of administrative structure within the school is a positive change. I believe that Dr. Bernardino has assembled a strong group of administrators to work with him. They are people who Jove the school and will help to make his job manageable. At the same time, they will assist in preserving UB's traditions within an institution that has done an excellent job of educating physicians, participating in important and groundbreaking research and serving the region in a variety of ways for more than a century and a half. Dr. Bernardino faces many challenges regarding the above issues, and has several difficult decisions to make to ensure that the school will operate on a solid financial footing well into the future, especially given the "turbulent economic, social and regulatory environments" that he mentions. Now is the time to step up to the plate and support our school. Be as generous as you can be with your time, your positive suggestions and with your resources. I see the current changes as positive. (The glass is more tha11 half full!) Think about it, the school has a sound business plan, excellent faculty, terrific students and a reorganized infrastructure. The School of Medicine and Biomedical Sciences, our alma mater, will not only be able to maintain its position as one of the most important entities in Western New York, but it has the potential for greater national prominence and recognition. BODKIN II, MD President, Medical Alumni Association jOHN j . �VOLUME 36, p H y s c A N Features 6 14 Medical Education, for Life Organ-based curriculum introduced this fall de-emphasizes lecture format BY S.A. UNGER Sure Hands Teach Hands·On Medicine ew Bedside Procedures/Clinical Laboratory course proves popular BY NICOLE PERADOTTO First-year student Garrett Zoeller listens intently as speakers representing Muslim, Christian, Jewish and Sikh faiths came together in Butler Auditorium to talk about the events of September 11, 2001. On page 48, POLITY president Jason Hoffmann describes the students' inspiring response to this tragic day. Cov~.:R u ... LUSTRAT 0'..; BY STEPHANIE CARTER 18 White Coat Ceremony and Humanism Award 20 ewMPH Program 22 Telemedicine's exanding applications 25 Virtua l-reality palpation glove developed and tested at UB 21 Kishbaugh and Ball receive a ugh ton Award 32 Research news briefs 28 jack Konsek, _ .......... u""'·-'"u""""''--1-- Development 37 Message from 30 David Block, MD '64, chose a career in medicine over golf, much to the relief of jack icklaus Class of 2003 , looks at ways medical students can help to reform managed care the director"Gifts that Strengthen our School" 38 Endowments listing 41 ews from your UB classmates and other alumni 48 Our students' response to the events of September ll �------ - ------- - ALittle Fire in the Belly DEAR EDITOR: "The recent Buffalo Physician [Summer 2001] featuring Don Pinkel is excellent. It had great meaning to those of us who knew him as a house officer." Jacob Steinhart. MD DEAR S.A. --....[·--·· ...-·-..--·------·-· .-:-·..·-·-· , Professor Emeritus, Pediatrics news to patients. Anyone interested in UNGER, Thank you for the splendid article about obtaining this article may request a copy by my brother, Dr. Donald Pinkel, in the e-mailing me at drsta!l@buffalo.edu. summer 2001 issue of Buffalo Physician. Robert Stall. MD '83 It certainly brought back memories of his lntema/ Medicine '86 studying-in the attic of our Kenmore Geriatric Medicine '88 house, and Mom taking him big dishes of ice cream! Loretta Pinkel Kelsey Buffalo, ew York Drs. Beutner and Jordan DEAR EDITOR UNGER, DEAR S.A. UNGER, Your article on Thank you for your excellent job of editing Buffalo Physician. I was especially excited to Dr. [Donald] Pinkel is read the Pathways article in the summer fascinating. And, of 2001 edition regarding the dermatology course, I love all the award given to Drs. Beutner and Jordan. references in it to my Dr. Beutner was a great inspiration to me wonderful husband in beginning an academic research career in [the late Dr. Mitchell '64 and the enthusiasm of Dr. Jordan (then Rubin] and the photographs a medical student) for the pemphigus of him, too. Buffalo Physician is a most interesting magazine. Maizie L. Rubin Charleston, South Carolina project which was ongoing in the lab at the time was also memorable. I would like to extend my congratulations to both of these gentlemen for the belated recognition of their pioneering work and to add my personal thanks for the Good Ways to Deliver Bad News help and inspiration I received as a fortunate witness to this creative work. DEAR EDITOR, Jerry A. Bash, PhD '71 I read M. D. Kinnamon's article, "Good Ways to Deliver Bad News," with great interest [summer 2001 issue of Buffalo Physician]. It is critical that all health-care professionals learn how to communicate bad new in a forthright, yet sensitive way. I have prepared a handout in which I describe my approach to conveying bad 4 IUII I ID Phy sicin A II I [/Ill II 2 0 0 I Letters to the Editor are welcome and can be sent via e-mail to bp-notes@buffalo.edu; or by post to Buffalo Physician, 330 Crofts Hall, University at Buffalo, Buffalo, NY, 14260. Letters may be edited for length and clarity. �- Buffalo-Niagara Medical Campus DEAR EDITOR, The article entitled "Buffalo- iagara Medical Campus" [B MC) in the summer 2001 edition of Buffalo Physician states ~--~ -------- --------- --- -- - - --- result in tamponade. This is part of medicine at the State University of Advanced Trauma Life Support [ATLS), York at Buffalo. Thank you, especially to ew and at SU Y at Buffalo-and at a rapidly Drs. Richard Braen, Richard Krause, increasing number of emergency Dietrich Jehle, Tony Billittier, Dave Ellis, residencies-this assessment is a skill Ron Moscati, Stan Spurgeon, Jeanne Basior, Dave Janicke, Josette Teuscher, incorrectly that "UB doesn't own land or Rob McCormack and Rick Lafountain. structures on the medical campus." McKinley's The B MC encompasses approximately 100 acres bounded on the north by ....... ........., Best Street, on the east by Michigan Street, ~ on the south by Goodell Street and on the west by Main Street. UB owns the five- Christopher J. Jaksa, MD Emergency Resident Buffalo Medical-De11tal Consortium 1997-2000 ---------··----- story, 116,500-square-foot building at 1021 Main Street that houses the University's Research Institute on Addictions [RIA]. RIA research scientists hold faculty appointments in the departments of psychology, psychiatry, sociology, social and preventive medicine, among others, and in the School of Social Work. During fiscal year 200 I RIA received in excess of $7.7 million in external grant and contract awards, mostly from federal sources. Dale M. Landi Vice President for Special Projects and Programs, University at B11jfalo McKinley Assassination belonging to the emergency physicians. Indeed, the person initially assessing Buffalo Physician Receives AAMC's Award of Excellence the President would be the emergency physician, who would activate the trauma team. Moreover, the emergency physician I am proud to announce that Buffalo Physician would intubate the President, as needed, magazine has been chosen to receive an Award of and the emergency attending would direct Excellence-the highest level of recognition- the overall resuscitation until a trauma in the 31st Annual Association of American attending was available. Medical Colleges/Group for Institutional Advance- My points are these: (1) the role of the ment Awards of Excellence competition. emergency physician is often crucial in Buffalo Physician won the award in the external trauma, and (2) one of the early propo- audience publications category. In his letter notifying nents of bedside ultrasound in trauma our school of the award, L. G. Blanchard, vice chair was Dietrich Jehle. Dr. Jehle just happens of public relations for the AAMC Group on to direct the Emergency Department at Institutional Advancement (GIAI, wrote "This is the Erie County Medical Center and, highest level of recognition among winners. You and DEAR EDITOR, ironically, is cited in the same spring your staff are to be highly commended for your out- I enjoyed Dr. Fisher's recent article on 2001 issue of Buffalo Physician for his McKinley's assassination [Buffalo Physician, spring 2001 issue). I also read Dr. Seibel's accompanying standing work. Over 130 entries were reviewed this year, and the level of competition was especially teaching and work on bedside ultrasound . rigorous .... Your fine work advances all of us in One more observation: Buffalo has an the GIA, our member institutions, and the practice impressive history, but has certainly article on the modern care the President struggled since at least the 1960s to would receive. He points out that maintain some vestige of the glory that was of medicine." Please join us in congratulating Stephanie A. Unger, editor of Buffalo Physician, and Alan J. penetrating abdominal trauma requires hers at the time McKinley was assassinated. Kegler, the magazine's art director and designer, exploration and that neither CT nor MRI There is a palpable yearning to compete for this very prestigious award. imaging studies is indicated, which is quite and excel-even as the city continues to right I think. What is not noted, however, lose population-and an unwillingness to in Washington, D.C., on November 3, 2001, at the is that bedside ultrasound would be used in concede the lessening of its once mighty annual AAMC meeting. The award was presented at a ceremony the first few minutes of the President's stature. I completed my residency just over arrival to see if there is free fluid (blood) in a year ago, and I can assure my Buffalo Michael E. Bernardino, MD, MBA the abdomen, and to see if there is any friends that there is one place that does evidence of pericardia! blood, which could excel; namely, the residency in emergency Dean, School of Medici11e m1d Biomedical Sciences \'ice President for Health Affairs A II t II Ill 11 2 0 0 I lu llal1 Ph ysiciu 5 �• n, �Illustrations by Stephanie Carter In particular, the new curriculum de-emphasizes the traditional lecture format in which students are taught the basic sciences within a department-based context (anatomy, pharmacology, biochemistry, etc.), and instead introduces a variety of teaching formats that complement lectures. These varied formats-such as small-group discussions and other activities intended to foster self-directed learning-are in turn being used as methods to introduce students to a new organbased approach to learning that not only integrates basicscience knowledge across disciplines, but gives this knowledge additional relevancy by placing it within a clinical context. In the new curriculum, therefore, the teaching of basic science is no longer departmentally based, but instead is organized around a series of nine organ-based (or system-based) modules that are preceded by a four-part series of"foundation" modules that all students are required to take their first semester to ground them in basic-science fundamentals. (See page 11 for a listing of the modules and module leaders.) "In each organ-based module, all the basic-science elements (physiology, pathology, biochemistry, anatomy, etc.) are integrated into the study of one organ, which also includes clinical elements with case presentations," says Heffner. "The goal of this new approach," he adds, "is to better equip third- and fourth -year students to integrate their knowledge in a similar way once they begin to work more intensively in a clinical setting." Autumn 2 001 lallala Pbysiciaa 7 �here are a number of reasons why the school's administration and faculty felt a change in curriculum was needed, according to Heffner. "One of the foremost reasons is that educators, in general, have come to understand that many people learn in a way different from the way we thought they did," he says. "We thought people listened to lectures, read books and memorized facts. But now we know that this isn't the only way to learn; in fact, the best way for many people to learn is for them to engage in what we call 'active learning,' where they make their own goals and learn at a pace and in an order that is appropriate for them." Heffner says he and others on the faculty have discovered firsthand about the viability of this mode of learning through their experience with the Scientific Basis of Medicine (SBMI course that was introduced into the school's curriculum in 1996. This course-many facets of which have been interwoven into the new curriculumwas the school's first attempt to teach basic science to students in small-group sessions that emphasized problem-based (or "case-based") learning, which puts the onus on students to learn in a self-directed, active way. "Active learning is the whole idea behind problem-based learning [PBL]," says Heffner, who notes that some medical schools around the country have gone exclusively to this format in recent years. "At UB, we have seen that students can become remarkably resourceful learners using PBL; however, one problem with using this approach exclusively, we felt, is that it's not very efficient, so what we' ve put in place at UB is a hybrid curriculum, where you have some PBL-some small-group, casebased learning-and some lectures, which give you a very quick overview of the subject in a concise, time-conserving way," he continues. Another reason why the curriculum has been changed is the fact that the amount of biomedical knowledge has grown exponentially in the past few decades, making it impossible for even the best and brightest of students to understand and retain it all. To accommodate this increase in knowledge, many, if not all, medical schools began to compact more and more information into lectures. As a result, the density of lecture material tended to overwhelm students and frustrate their attempts to prioritize information in terms of importance and relevancy. It also left them little free time to pursue independent learning in the library or in discussions with classmates and faculty. "Part of what all medical schools have tried to do in response to the information explosion is to jam more and more information into the curriculum, and at some point the 8 lu lfal1 Physiciu A [/ t II lit II 2 0 0 I shoehorn was not able to get the foot into the shoe," says Spurgeon. "This wellintended, but somewhat misguided, approach led to our throwing out a lot of isola ted facts to the students, rather than making sure they understood what the basic concepts were and learned how to build on them." The first-semester "foundation modules" in the curriculum-which include anatomy and embryology; fundamentals in molecules, cells and molecular genetics; an introduction to disease principles; and an overview of medicine and society-are key to addressing this problem, according to Spurgeon. "In these modules we have stripped basic science down to the very bare essentials because it wouldn't be sound education theory to take 135 students who have come out of college with very different backgrounds and not give them some similar basic science to begin with," he says. "Essentially, what we want to do is to make sure that the students entering the organ-based modules are well grounded in basic concepts and terminology." "Once the students report into the organ-based modules, we begin to bring together and integrate the biochemistry and anatomy and all the other basic sciences in a context that they will need to learn and use in medical practice," he continues. "So, now what they were once learning as isolated �facts they are learning in context, and we know students retain knowledge better when it is learned this way." A primary objective of the new curriculum, therefore, is to emphasize concepts rather than requiring students to memorize a myriad of facts, many of which are soon outdated, according to Heffner, who stresses that "the ever-increasing body of medical knowledge makes it imperative that we prepare students in this way for life-long learning." nother driving force behind the planning and implementation of the new curriculum is the goal of reinvigorating medicine-and its practitionerswith an appreciation for the art of medicine, as well as the science. "In the new curriculum, we want to start early [in the medical-education process] to reverse a trend that has occurred in American medicine since about the end of World War II, and that is the notion that the best way to as well as introduces students to preventive medicine, population-based medicine, epidemiology and biostatistics. Yet another reason for the new curriculum was the perception among clinical faculty that third- and fourth-year students who had been schooled in a lecture-dense, departmentally based curriculum knew a lot of facts, but were having difficulty pulling these facts together when confronted with a single-patient situation, according to Heffner. "One of the main things that we think is most valuable with the new curriculum," he says, "is that the students are exposed to patient situations where they can use all the pharmacology, pathology and physiology they would have learned in separate courses [in the past], and they can pull all this together in a more realistic clinical situation." Agreeing to aPlan of Action In the late 1990s, these and other reasons for instituting a new curriculum became more pressing and galvanized the faculty to A primary objective of the new curriculum. therefore. is to emphasize concepts rather than requiring students to memorize a myriad of facts, many of which are soon outdated, according to Heffner, who stresses that "the ever-increasing body of medical knowledge makes it imperative that we prepare students in this way for life-long learning." serve patients is to do a lot of tests and be extraordinarily scientific," Heffner says. "What has happened-and this is not news to anyone-is that physicians aren't doing as much of the things they used to, like sitting down with patients for a few minutes and explaining to them what they're being treated for and why. We've sometimes forgotten to do that, and we need to remind students from the very beginning that this is extremely important. "It's not that we haven't taught this before, but it was something that came more in the third year," he notes. "The feeling, though, is that if you don't introduce this to the students right away, but instead primarily emphasize molecules and cells, by the time they reach their third and fourth years and somebody tells them they need to listen to the patient, they may not be as receptive to this message." The concept of "humanism in medicine" is therefore strongly emphasized throughout the new curriculum, beginning with the first-semester Medicine and Society foundation module, which addresses "the role of the physician in society," work with former Dean John R. Wright to plan and implement change. Wright's predecessor, Dean John aughton, had earlier identified a need to "modernize" the medical-education curriculum, stressing that the lecture-based format as an exclusive means of teaching was rapidly becoming passe. His efforts, while not culminating in a complete reform of the curriculum, did result in the implementation of the Scientific Basis of Medicine course and its clinical counterpart, the Clinical Practice of Medicine (CPM) course. (The goal of CPM at that time was to introduce first- and second-year students to the clinical setting by teaching them such basic skills as taking a history, performing a physical examination and preparing a differential diagnosis. In the Autum11 2001 l1ffal• Physician 9 �new curriculum, CPM has been retained by closely integrating it into the systems based modules.) "What happened, at Dean aughton's insistence, is that SBM and CPM came into being," recalls Heffner. "However, these courses just got grafted onto an already dense lecturebased curriculum, so the hours and days became longer for the students." hen Wright became dean, Heffner further explains, "he decided to take a whole different approach and created his own task force in 1998 to look at the curriculum." Wright placed the responsibility for reforming the curriculum squarely in the lap of the Task Force, which was originally made up of a group of about 50 faculty members and students; however, he also took approach would be adopted, an eightperson subcommittee was charged with developing a recommended plan of action. Murray Ettinger, PhD, SUNY Distinguished Professor in the Department of Biochemistry, was a member of this subcommittee. "There was surprising agreement about several things everybody wanted in the new curriculum," says Ettinger, who, along with Alan Saltzman, MD, MBA, clinical professor of medicine, had been instrumental in establishing the SBM course five years ago. "First of all, there was rapid agreement that the curriculum should begin with foundation modules that provide students with the requisite "In the past this information mentally based c would have been presented in depart- , where it had no practical application to the students so they would ask, 'Why do we have to memorize all these enzymes?', whereas now we think they will say, 'Wow, we have to know all this because it applies to the clinical situation with an actual patient."' a strong stance on what the "ground rules" would be. "Dean Wright made a number of things very clear to the Task Force," Heffner explains. "We couldn't add anything to the curriculum, we had to shorten the hours students were in class, we had to move away from having lectures all day and figure out some other way to teach the students, and, finally, we needed to figure out what was important for the students to learn. We couldn't just take new material in our fields and integrate it into the curriculum by talking faster about it in a lecture." Once established, the Task Force and its Steering Committee spent the next year and a half studying various options. After it was decided that the organ-based 10 I U f f I II Ph y s i c i I n Autumn 2001 basic science they would need once they entered the modules integrated by physiologic systems. "It also was clear to everybody-even if they weren't thrilled with it themselves-that there was going to be small-group learning in each of the [organ-based] modules; we were not going to have three or four lectures in a row; all lectures were going to be in the morning, so the material we were teaching had to be broken up into different teaching formats; and many or most of the modules were going to include the basic structure we developed [in SBM], which incorporated problem-based learning." Once the subcommittee's plan was approved by the Steering Committee of the Task Force, the next step was to form the various module teams, which then set to work developing the curriculum. "By far the strongest component in the whole process has been the module teams. They are the ones who put the meat of this together and have been at the center of the work I CO NTIN U ED 0~ PA G E 1 2 �- I -- -------- --- --- New Organ-Based Modules and Leaders ach module is organized and directed by a module leader(s) responsible for such things as arranging and coordinating lectures, lining up laboratory instructors, and making sure faculty are available on a given day and handouts and objectives for each session have been submitted. Many faculty are involved in each module, some of which are as long as 13 weeks. Foundation Modules *ANATOMY AND EMBRYOLOGY Team Leader: Robert Hard, PhD *MEDICINE AND SoCIETY (epidemiology, biostatistics, population-based medicine, prevention, evidencebased medicine) Team Leaders: Carl K. Li, MD Maurizio Trevisan, MD * FuNDAMENTALS I: MoLECULES, CELLS AND MoLECULAR GENETICS Team Leaders: Murray Ettinger, PhD Donald Campbell, PhD John Cotter, PhD Mark O'Brian, PhD *FUNDAMENTALS II: PRINCIPLES OF DISEASE AND THERAPY Team Leader: Alan Reynard, PhD *MusCULOSKELETAL AND INTEGUMENT Team Leaders: John Cotter, PhD Reid Heffner, MD *NEUROSCIENCE/BEHAVIOR Team Leaders: Christopher S. Cohan, PhD Margaret W. Paroski, MD Linda F. Pessar-Cowan, MD *CLINICAL PRACTICE OF MEDICINE Team Leaders: Andrea T. Manyon, MD David Milling, MD *CARDIOVASCULAR AND CIRCULATION Team Leaders: Avery K. Ellis, MD Perry M. Hogan, PhD *LUNG AND RESPIRATION Team Leaders: Leon E. Farhi, MD Alan A. Saltzman, MD *GASTROINTESTINAL, METABOLISM AND Team Leaders: Michael Duffey, PhD Mulchand Patel, PhD Robert Scheig, MD UTRITION *ENDOCRINE/REPRODUCTION, BIOLOGY/LIFE CYCLE Team Leaders: Suzanne G. Laychock, PhD John A. Ryan Jr, MD *HEMATOLOGY Team Leaders: Amy M. Sands, MD Gerald Logue, MD *RENAL Team Leader: James M. Goldinger Jr., PhD Other Topics The subjects of microbiology, social and preventive medicine, genetics and pharmacology do not fit into any one organ-based module. Therefore, module leaders are working with leaders in these areas to ensure that the subjects are appropriately incorporated into the modules. A II t II "' " 2 0 0 I laffale Pbysiciaa 11 �MEDI C AL ED UC ATI O N . C ONTINUED FROM PACE 10 in developing the curriculum," says Ettinger, who notes that the Steering Committee was eventually enlarged to include all the module leaders, a move he credits with helping to keep the work on track and well coordinated. A ew Way oSpend aDay Out of this three-year process has evolved a curriculum that builds on the many strengths inherent in the way UB has traditionally trained medical students while at the same time integrating more modern educational methods. As the 2001 school year opened, second-year students continued with the old curriculum to maintain continuity the big difference comes in is in the manner in which the material is being presented," he says. To describe more concretely how the organ-based modules will work, Heffner also uses the example of the heart. "We might begin with a common clinical problem; let's say a patient has a heart attack. Well, that might involve the physiology of the heart: How does the heart pump? What is blood pressure? "This could lead to a discussion of the cellular abnormalities of the heart," he continues. "What happens to the heart in a heart attack? This would get into pathology and also metabolism: Why do we need oxygen in the first place, which would take us into biochemistry and would also bring in pharmacology and how you treat a heart attack. "It may sound confusing in the beginning because the students won't have some of the material ed to come to grips with this clinical problem. But we've learned from PBL that they can do it. The students become very resourceful; they learn how to look things up, they learn how to ask questions and what questions will yield the information they need. It may take awhile, but they do it." with their first-year studies, and the first-year students began their studies in the foundation modules. In keeping with the objective of encouraging the students to learn more independently, the class time in the new curriculum is mainly restricted to the morning, leaving afternoons and evenings for self-directed learning, according to Heffner. Students immersed in the organbased curriculum are not being taught material that is new in comparison to what students have learned in years past, so much as they are being taught the material in a new format, Spurgeon emphasizes. "We're not talking about different material because, largely, it's the same. Medical students still need to learn where the heart is located and what the four chambers of the hearts are. Where 12 I u I I a I o Pb y s i c i a 1 Autumu 2 001 "And then you could move into discussing things like the cause of a heart attack such as atherosclerosis, elevated blood lipids, which would turn you back toward biochemistry again. "All these put together would give you an understanding of what the patient's problem is with a heart attack," Heffner concludes. "In the past, this information would have been presented in departmentally based courses, where it had no practical application to the students so they would ask, 'Why do we have to memorize all these enzymes?', whereas now we think they will say, 'Wow, we have to know all this because it applies to a clinical situation with an actual patient."' student's day, therefore, may begin with a lecture on myocardial infarction in the morning, followed by a case presentation of heart attack in a small -group discussion, where the lecture material is further explored. "It may sound confusing in the beginning because the students won't have some of the material they need to come to grips with this clinical problem," says Heffner. "But we've �learned from PBL that they can do it. The students become very resourceful; they learn how to look things up, they learn how to ask questions and what questions will yield the information they need. "It may take a while, but they learn how to do it. And this certainly more accurately reflects the way they will need to learn new information as practicing physicians." Gentzke & Associates~ Inc. Registered Investment Advisor ALifelong Mission for Lifelong Learners In the years ahead, as the new curriculum becomes increasingly integrated into the fabric of the School of Medicine and Biomedical Sciences, faculty are convinced that it will continue to evolve based on ongoing evaluation of its effectiveness. In addition to ironing out logistical challenges, Ettinger feels that it will also be important at some point in the near future for the members of the Task Force to step back and assess the success of the new curriculum in relation to the mission statement they composed at the outset of the process. "In the very beginning, we spent quite a bit of time coming up with a mission/vision statement in which we said we should try to develop a curriculum that would cultivate in our graduates an approach to medicine that would represent a continuous, lifelong way for them to think about learning, even 15 or 20 years down the line," he reflects. "I think we should rekindle this mission statement and begin to ask ourselves whether we are in fact doing this, whether our students will someday tell us that a lot of their approach to medicine is based on what they learned here-that UB is a place they feel helped shape them, in a recognizable way, as physicians." If this can be accomplished, then the new curriculum will indeed be just a new way of perpetuating what has traditionCD ally been a hallmark of medical education at UB. Pri,·ate Pm1folio .\I anagcment Ta.~ Con!:'lulting E::,tate Plamring President and CEO Glenn Gentzke and Chief Investment Strategist Chris King F ee-Ba::,ed .\ ssct .\lanagcment L UB Commons TL\"\ -CREF .\ cki::,or _\ etwork 520 Lee Entrance Suite 205 Amherst. NY 14228 Certified QuickBooks Profc::,sional .\ chi::,or::, Tel: (716) 639-0475 www.gentzke.com A II t II Ill II 2 0 0 1 l ufllll Pbysicin 13 �l1flal1 Physic i ae AU/1111!11 200/ �• Staaley Spurgeon, MD, demnstrates pracdare to Maria I. Podebryi, Class If 2113. Standing behind Podebryi is Charles SeYeril, PhD, MD, assistant dean f1r first and second·year students. wko created tke uw course and team teachs it. BY . I !COLE PERADOTTO Autumn 2001 15 �HIS ELECTIVE GIVES STUDENTS AN OPPORTU ITY TO LEARN HOW TO PERFORM INVASIVE PROCEDURES ON A CADAVER RATHER THAN ON A PATIE T," EXPLAI MD, PHD, A LONGTIME COURSE AFTER RETUR UB A ATO MY PROFESSOR WHO WAS I SPIRED TO DEVELOP THE ING TO SCHOOL IN MID-CAREER TO EARN A MEDICAL DEGREE . "WHETHER OR NOT THEY USE THESE SKILLS I MEDICAL SCHOOL, THEY'LL DEFI "WHE S CHARLES SEVERIN, THEIR THIRD OR FOURTH YEAR OF ITELY HAVE TO USE THEM AS RESIDENTS," HE ADDS. THE TIME COMES, THEY MAY NOT REMEMBER EVERYTHING THEY LEARNED, BUT A LOT OF IT WILL COME BACK TO THEM AND THEY'LL BE THAT MUCH FURTHER AHEAD OF THE GAME . " The idea for the course took root in the spring of 1997, when Charles Severin was in his last semester of medical school at UB. During a neurology rotation at Buffalo Veterans Affairs Medical Center, he found himself battling a severe case of jitters while performing his first lumbar puncture. "I wanted to seem as calm as possible, even though my insides were churning," recalls Severin, now the assistant dean for first- and second-year students in UB's Office of Medical Education. "The attending was sitting beside me saying, 'Open the drape. Make sure you don't contaminate the field. Do this. Don't do that.' Now, if you were that patient, how comfortable would you feel about my inserting a needle in your back?" As is the case in many, if not all, medical schools around the country, Severin found that although he and his fellow students had been taught the "whys" of procedures, the "hows" were left to on-the-job training. "When I was attempting to perform that lumbar puncture for the first time, I didn't know what was in the kit; in fact, I didn't even know there was a kit. "! did know why the procedure was being performed and I knew what bac- 16 I u I I 1 I o Ph J sic i In A II t II Ill 11 2 0 0 I teria I might find because that was taught in medical school. But what wasn't taught was how to actually do the procedure." While experiences such as this in medical school may have inspired Severin to develop the new hands-on course, it was his expertise in anatomical sciences that gave him the necessary background to conceptualize the course and envision how it could be implemented in a practical way. Based on his teaching and research, he understood how conditions could be stimulated on a cadaver to mimic those of a living person; for example, pressurizing the vascular system with saline to reproduce normal blood pressure, or clouding the fluids with chalk dust to suggest an infection around the meninges. Fresh from his own experience in medical school, Severin says he also knows firsthand just how intensely students yearn for an opportunity to work in a hands-on way with patients. "Doing these procedures once won't make anyone an expert," he concedes, "but it will help students learn what to expect and it will familiarize them with the basic techniques and tools involved. My goal with this course has been to put students in a position where they're better prepared than I was." Giving Somet~ing Back to t~e Students When Severin decided to pursue a medical degree in his mid-40s, it wasn't with the intention of practicing; rather, he wanted to use the experience to better serve his students in his classroom. "I thought I could learn what it's like to be a medical student-the ups and downs, the highs and lows-and use that information in my teaching," he e>-'Plains. "At the time, I wasn't thinking of developing a course. I was just thinking that the experience would help my lectures in gross anatomy, or any other course I taught. But now that I have instituted the course, I feel I have fulfilled part of my goal in attending medical school by giving something back to the students." When the Bedside Procedures/Clinical Laboratory course was introduced in January 2001, 73 students expressed interest in enrolling. With only 32 openings, participants were chosen by a lottery. Among those selected was James Boyle, who gave the seven-week elective high marks. "Being prepared for what we're going to face in the hospital, where you're expected to know what to do and how to react, was what attracted me to this class," he says. "Even if we don't know all the answers, when we get there this gives us an edge." �"It's very practical," adds Betty Lim. "It teaches you how to wash your hands properly, how to handle the equipment, how specimens are labeled-all the protocol you won't find in a textbook." In fact, Severin has yet to find a text that covers all the topics discussed in the class. When he attended a meeting of the Association of American Medical Colleges last fall and presented a poster on the Bedside Procedures/Clinical Laboratory course, no one he spoke to about the course had heard of another quite like it. "To our knowledge this is something new and different. This is a unique opportunity for second-year students," says Stanley Spurgeon, MD, who team-teaches the class with Severin, Judith Tamburlin, PhD, assistant professor of biotechnical emphasize what Severin calls the "art of medicine," otherwise known as bedside manners. "You can turn out a lot of medical students who are very proficient in a technique. They'll hit the spot every time; they'll produce minimal pain. But as far as patient interaction is concerned, they're not good at all," he observes. "I saw that a lot during school. Students were ordering the right tests and giving the right medications, but there was really no interpersonal skill there. I want these students to know not just how to do the technique, but how to explain what they're doing to patients." Demystifying the laboratory Tamburlin and Gordon are responsible for a third component of the class, the the interpretation of laboratory results correlated with proper specimen collection and transport hasn't been taught." All the Ri~t Moves. without the Jiners During one Friday afternoon session of the class last spring, half of the course' s students peered through microscopes in the hematology lab . At the same time, the remainder of the class prepped for alumbar puncture on a cadaver. Severin and Spurgeon guided this group every step of the way, showing them just where to position the fenestrated drape, demonstrating how to apply betadine so it doesn't drip down a patient's back and stressing the precautions that need to be taken to keep the field sterile. As he helped one of the students angle the spinal Kit Ling Chang,/e/t, and Julie A. Gavin, right, Class of 2003, at work in the laboratory. and clinical laboratory sciences and pathology and anatomical sciences; and Mable Gordon, a clinical instructor in the UB School of Health Related Professions. "In the hospital, students frequently are given credit for knowing something they may not know, but there's a reluctance to say, 'What do you mm, doctor?'" adds Spurgeon, clinical assistant professor of emergency medicine and pediatrics. "That's part of what we're trying to address so they'll feel more comfortable doing the things they're called upon to do." Beyond exposing students to various clinical presentations and discussing accompanying case studies, the teachers laboratory. Guiding students through three makeshift labs-hematology, chemistry and microbiology-they describe what happens to a sample once a physician collects it. In addition to explaining how samples are transported, processed and analyzed, both teachers offer practical procedural-tips and discuss the necessary communication between physicians and laboratory specialists. "The students shouldn't be afraid to go to a lab. They should feel comfortable going there and discussing the results of a sample. It all plays into better patient care," Gordon says. "They learn a lot of things in their basic science courses," adds Tamburlin, "but needle correctly, Severin looked up at the class and admitted: "You know, the first time I did one of these I was scared. I was trembling. My hands were shaking." ot so for student Rob Bermel. Of course, the fact that he performed the procedure on a cadaver did wonders for his comfort level. And when it comes time for him to introduce that spinal needle into an actual patient? Bermel will be nervous, he says. But he'll be ready. "For two years we have been sitting in lecture halls and looking at books and projection screens. A lot of us came to medical school to perform hands-on medicine. Finally, we are having a chance." CD A11t11mn 2 001 l affale Physici11 11 �MEDICAL SCHOOL N E w S Donning the White Coat First-year students initiated into their new roles n August 13, 2001, the University at Buffalo School of Medicine and Biomedical Sciences welcomed its Class of 2005 at the fourth annual White Coat Ceremony held in Slee Hall on the orth Campus. The ceremony is a rite of passage for first-year medical students, who are reminded of their responsibility to "care" as well as "cure" patients by endorsing a psychological contract of professionalism and empathy at the start of their medical careers. To formalize this commitment, they are officially "cloaked" with their first white coats, after which they recite the Physician's Oath, a modern Neil Harris of Santa Barbara, California, being cloaked by lorie leonard, MD '87. version of the ancient Hippocratic Oath. Following Cappuccino's talk, Jack Opening remarks were delivered by insights into how they might strive to Coyne, MD '85, VB clinical associate Michael Bernardino, MD, MPH, dean of accomplish this balance despite the rigorous UB's School of Medicine and Biomedical demands that will be placed on them in the professor of pediatrics, was presented the Humanism in Medicine Award (see opposite Sciences and Vice President for Health years ahead. page) by Charles Severin, MD, PhD, Affairs at the university. assistant dean for students in the Office of After welcoming the students Medical Education. and their families, Bernardino Margaret Paroski, MD '80, senior assogave a brief history of the ciate dean for admissions and curriculum, ceremony and its underlying then introduced each of the students as philosophy. He then introthey were being cloaked. The ceremony duced the keynote speaker, concluded with Bernardino leading the Helen Cappuccino, MD '88, students as they recited the Physician's clinical assistant professor of Oath in unison. surgery at Roswell Park The White Coat Ceremony is sponsored Cancer Institute. Cappuccino by UB's Medical Alumni Association and talked to the students about The Medical School Parent's Council. ~ the importance of maintain S. A. UNGER ing a healthy balance in their lives as they begin their formal medical education Helen Cappuccino, MD '88, keynote speaker at the White Coat Ceremony. and shared many personal 18 I a I I 1 I o Ph J sic i I a Alllllmll 2001 �2001 Humanism Award Jack Coyne, MD '85, clinical associate professor of pediatrics, was presented the University at Buffalo School of Medicine and Biomedical Sciences' Humanism Award at this year's White Coat Ceremony (see article opposite). Nominations for the award are made by directors of the third- and fourth-year clerkships. Coyne was extolled by his nominators for "being a knowledgeable and enthusiastic teacher ••. who is a very kind and caring person, both with students and his patients." One student stated: "Dr. Coyne forms extraordinary bonds with patients, which I hope to imitate as a pediatrician." A"Class" Profile-2005 The students commended Coyne's many humanitarian projects, including his work as medical director for the Child Advocacy Center at Kalieda Health System's Children's Hospital of Buffalo. In this capacity, his nominators reported, "he works very hard to fight for the rights of children who have been abused, and he very often takes time out of Dr. Jack Coyne, right, receiving award. his busy schedule to testify in court for abuse cases that he sees." Coyne was also commended for his outreach efforts to students who are having difficulty coping with the stresses of medical school. In addition to making himself available by beeper 24 hours a day, he has opened an office in Michael Hall where students can drop by to talk with him. "Dr. Coyne truly cares for students in ways that many attendings don't because he always treats us as equals, as human beings," one nominator emphasized. "Even though I have said much more that I thought I would, I have not done justice to him. Words cannot describe just how extraordinary a physician, a mentor and-most of all-a friend he is." Support for the Humanism Award is provided by the Healthcare Foundation of New Jersey. S. A l "c CD R R A11t11mn 2001 lulfal1 Physician 19 �MEDICAL SCHOOL N E w s MPH Degree Offered at UB s \S l I health (MPH) aimed at training professionals to study and manage current and emerging community health issues has been approved at the University at Buffalo. The MPH program, which is offered through the Department of Social and Preventive Medicine in the School of Medicine and Biomedical Sciences, began enrolling students this fall. "We think this degree program fills a real need in this region," says Dennis Bertram, MD, clinical assistant professor of social and preventive medicine and program director. "People wh wanted an MPH in the past either had to leave the area or forgo the degree," he explains, adding that UB is now the only public university in the state west of Albany offering the degree. "The federal government is placing increasing demands on the states and counties to monitor and improve health, and the MPH is seen more and more as the basic training to fill the positions needed to do that work," Bertram continues. Enrollees in the program may choose between two concentrations-health services administration or epidemiology and biostatisticsin preparation to fulfill responsibilities in the following areas critical to a region's well-being: • Primary prevention of disease through identification of factors associated with the development of conditions that affect large segments of the population, such as heart disease, cancer or diabetes; • Monitoring and surveillance of infections, toxic agents, and environmental contaminants; • Targeting hard-to-reach populations for clinical services and developing outreach programs; • Collecting information on health outcomes to ensure quality health-care delivery; and • Educating the public about disease risks and preventive measures. Individuals interested in University at Buffalo's MPH program may call Marcia Wopperer at (716) 829-2975, ext. 625; or e-mail her at mwoppere@ acsu.buffalo.edu. 4D -LOIS BAKER 20 I af f If I Ph I I i Ci I D A11t11m11 2001 Assessment Tool Reshapes Rehab Care UB survey adopted by federal government, becomes new national standard I n early 2002, the federal agency , responsible for setting medical L )Is reimbursement policy for " Medicare and Medicaid programs will begin using an assessment survey developed at the University at Buffalo as the national standard for determining payment for inpatient medical rehabilitation. The federal Centers for Medicare and Medicaid Services (CMS), formerly called the Health Care Financing Administration, has elected to use UB's Functional Independence Measure, or FIMT" instrument, as the base for its new system of prospective payment for rehabilitation treatment provided in hospitals. In the past, rehabilitation hospitals have been reimbursed based on a facilityspecific rate per discharge, regardless of the number of days a patient remained in the hospital and the level of care the patient required. Under the new system, payment will be linked to the severity of each patient's disability when admitted. "This is a totally new approach, and it will change rehabilitation care as we all know it," says Carl Granger, MD, professor and chair of UB's Department of Rehabilitation Medicine and one of the developers of the FIMT" instrument. For rehabilitation hospitals, the new system means more equitable payment for facilities that take the most severe cases. �NAUGHTON AWARD '1111.....-lwri wlidlriCIIIi1a ..,...,, illalt llswlllllnl _.liCIIficallMbllillllsllllllsclllll. . . alllllillllll II • ., • ...... .._ If tiiiMaliiJ 11 ..... kllllllf •••••lcll Scillclltr.1171111• SICII• . .;It II. tlll .... llllll, Is • ......., II . . lilt Ill. illis • lllr 1W1- WIJ,IIIbs •ICIIIII. wiD hs lfllllllll llldiiiC--.IIb'llllll',llllhlilr . . . . . . fwtllllllllfalllan, Wllt,MIIIIcl....a,!llllilll ptilllCin ......." This year's winners of the Naughton Award are Donna Ball, assistant to the chair and senior staff assistant in the Department of Psychiatry, and Cheryl Kishbaugh, assistant dean for Graduate Medical Education. Donna Ball came to the Department ofPsychiatry in 1979 after nine years of service to the Research Institute on Addictions. She is responsible for all budgetary matters, personnel issues, purchasing and space coordination for the department. In addition, she supervises secretarial staff at three affiliated hospital sites and oversees all grants, contracts and report preparations. Those who nominated Ball for this award emphasized her "dedicated, conscientious and pleasant service to the department." They also highlighted the fact that she repeatedly demonstrates a willingness to "go the extra mile" to complete her myriad responsibilities and has an extraordinary ability to "trouble shoot difficult situations." For UB, the ruling brings additional international recognition for its work in rehabilitation science. "We are now seen as the experts. Our phone has been ringing off the hook since April, when it appeared the new system would be based on the FIMT" instrument," says Granger. "Everyone wants to talk to us. It's an affirmation of the work that has been accomplished at UB." he FIMT" instrument is an easy-touse assessment tool that allows trained personnel to assign a numerical value-the FIM rating-to a patient's ability to function, based on performance of 18 physical and mental tasks that represent a basic daily routine of personal care activities. 1 Cheryl Kishbaugh was the first employee in the Office of Graduate Medical Education (GME), which was created in 1982. Today, as assistant dean for GME, she is recognized for her direct and forthright style, her dependability and her dedication to the residents she serves. Skills that Kishbaugh's nominators cited her for having included: mastering complex Medicare regulations, serving as a primary resource for inquiries, and supervising residency program data entry for the National Resident Matching Program. She was also commended for her contributions as a member of committees charged with reviewing residency programs in Buffalo and, most notably, her championing of residents' causes. "If I had to characterize Cheryl in a single word or concept," a nominator wrote, "it would be 'resource.' She is someone you can depend on to always have, or know how to get, the answer to your question .... She is unfailingly cheerful, constructive, sensitive, 4D and ethical, yet objective and pragmatic." The FIMT" instrument was developed at UB 15 yea rs ago through a three-year grant to researchers in rehabilitation medicine from the ational Institute for Disability and Rehabilitation Research. Their mandate was to develop a standard for documenting the level of disability and outcomes of medical rehabilitation. The effort was spurred by Medicare's decision in 1983 to use diagnosis-related groups (DRGs) as the basis for reimbursement for care provided in acute-care hospitals. DRG reimbursement was not appropriate for payment for rehabilitation, however, because patients are treated based on level of disability, as well as on diagnosis. Lacking a federally accepted standard comparable to those used by acute-care hospitals, rehabilitation facilities have been reimbursed for care based on an allowance per case, regardless of the time and resources expended. Approximately 80 percent of the 1,100 acute care inpatient medical rehabilitation facilities in the U.S. currently use the FIMT" instrument to establish a baseline of functional limitations for each patient and to evaluate outcomes of care. These facilities also contract with UB's Uniform Data System for Medical Rehabilitation (UDSMR) unit to provide periodic performance reports and benchmarking studies. As a result, UDSMR now houses four million records, making it the largest database of medical rehabilitation treatment outcomes in the world. 4D Autum11 2001 laffal1 Physicia1 21 �he physician peered intently into his patient's eye, which had been B splashed with bleach while the man was doing laundry. Determining that the cornea had not suffered damage, he prescribed a two-hour saline irrigation. I p < 0 ' ) ( r o Conventional treatment, right? Not exactly. In this case, the physician was conducting his exam from 250 miles away, using a medical-grade television screen and a high-resolution camera to inspect the injured eye. What's more, a nurse administered the saline irrigation right where the patient lives. And home for this man-at least until he's released- is the Gouverneur Correctional Facility, a state prison near Ft. Drum and Watertown, New York. For many years, telemedicine has helped people living in rural areas by improving their access to health care. At Erie County Medical Center (ECMC), a teaching hospital affiliated with University at Buffalo's School of Medicine and Biomedical ciences, emergency room doctors are using the same technology to serve those who are serving time. The prison program bega n in 1994, linking ECMC with the Erie County Holding Center. Since then, it has grown to encompass 31 correctional facilities 22 l11fal1 Hysicill Autum11 2 001 through ew York State, from Watertown to Staten Island. "This is the largest [telemedicine] system designed specifically for emergency care," says David Ellis, MD, a clinical assistant professor at University at Buffalo's School of Medicine and Biomedical Sciences and director of telemedicine services at ECMC. "No other hospital in the world has these many facilities linked into the emergency room. It's unprecedented." Although the general aim of telemedicine is to offer help from afar, pris- oners make particularly good candidates for this genre of high-tech care for anumber of reasons. For one, receiving the necessary clearance to leave the prison takes time, a resource in short supply during medical emergencies. Treatment via telemedicine can be administered in a matter of minutes, and on-site. Secondly, because of the considerable security precautions and personnel required whenever a prisoner must be escorted off the grounds, transporting an inmate to the emergency room is expen- �sive, costing as much as $300 to $800 per trip. Telemedicine gives an emergency room physician the opportunity to evaluate the acuity of the situation and then decide if the patient needs to leave the prison, thereby reducing unwarranted trips. By how much? According to Ellis, the number of emergency room visits among prisoners at the participating correctional facilities has dropped by one-third. "We're able to get to problems earlier and intervene earlier. And if there is ever any doubt, we err on the side of transporting the patient to the emergency room." There's yet another benefit to reducing emergency room visits for prisonersone that has nothing to do with efficiency and everything to do with community relations. The sight of prisoners being escorted through a hospital in shackles and telltale orange work suits can be disconcerting for the public, Ellis observes. "You want to provide the care, but do it as much as possible at the facilities." Time and again, he has seen how feasible this is. Take the case of the prisoner at Riverview Correctional Facility who suffered an acute allergic reaction to something he had eaten. Examining his throat via a 27-inch Sony television, Dietrich Jehle, MD, clinical director of Emergency Services at ECMC and associate professor and vice chair of UB's Emergency Medicine Program, ascertained that the man's uvula had swollen. From 300 miles away, Jehle prescribed a regimen of epinephrine, antihistamines and steroids. The condition subsided and the inmate was treated without having to be transported. It's important to note that a telemedicine visit is often just a first step in the cycle of care. For example, if a patient is treated by a health-care provider at the prison in this manner rather than in an emergency room, an in-person follow-up exam with a specialist in the region is often scheduled. Conversely, if the inmate is first treated in an emergency room, the physician may conduct a follow-up assessment via telemedicine, with the inmate in the prison infirmary. Since ECMC's prison telemedicin e program began seven years ago, it has grown dramatically. In one month of this year, the medical center' s emergency room physicians fielded about 193 such cases. And the number of participating prisons is expected to double next year. Next-Generation Hardware What's more, the technology that makes telemedicine a reality is undergoing a major upgrade at UB. Currently, physicians are testing a portable, wireless system developed at the university that gives them an unprecedented degree of flexibility. "With the old system you have to bring the patient to the equipment. With this system we can bring the equipment to the patient," says its creator, James Mayrose, PhD, UB research assistant professor of emergency medicine. Because physicians must dial in to the older ISDN system over lines, it can't be moved around-at least not without a great deal of difficulty. But the new internet-based system is small and light and wireless, sitting on a portable cart that can be wheeled wherever it's needed at a moment's notice. Already, professors at UB's School of ursing use the new system to evaluate students during their emergency depart- A !It II Ill II 2 0 0 I l•lfall Physiciu 23 �ment rotations. "The roll-about device lets UB faculty see the student interacting with the patient, just as if they were on-site," Ellis says. "The faculty at UB can critique students and provide feedback. Rather than getting a report from the clinical faculty on site, they can see directly how their students are managing patients." The new system also connects hearingimpaired patients at ECMC with signlanguage interpreters at Strong Memorial Hospital in Rochester, ew York. "This program is designed to allow our staff to roll the telemedicine system to a patient's bedside and have a translator from Strong Memorial use sign language to communicate with the patient, and then relate that information back to our staff," Mayrose explains. The unit would also benefit rural hospitals, which often lack the space for traditional teleconferencing, he adds. "These facilities are usually small hospitals with very few patient beds. The mobility of the system would allow the staff to consult with medical experts at other fa cilities while at the patient's bedside, no matter what room the patient is in." Grand Rounds around the World Because medical education is an important aspect of practicing medicine at a distance, Ellis and Mayrose have been collaborating for several years with )ames Whitlock in UB's Division of Computing and Information Technology (CIT) to develop ways to make it feasible to teach between practice sites, despite distance being a factor. Their collaboration has led to a system of network multi-point conferencing units, video servers and gateway systems at CIT, as well as a portable video production unit within the Department of Emergency Medicine that can move to the sites of educational presentations throughout the UB School of Medicine 24 1 1flal1 Physician Autu11111 2001 and Biomedical Sciences and its affiliated teaching hospitals. Recently, they successfully broadcast grand rounds for the UB-Veridian Center for Traffic Injury Research through multipoint videoconferencing from ECMC to five participating sites, including Ohio State University, Syracuse University, University of Rochester, the ational Highway Traffic Safety Association in Washington, D.C., and SurfNet in the etherlands. The grand rounds were also simultaneously broadcast via video streaming to the internet through Cisco IP/TV and Windows Media Player. In addition, the digital recording of the presentation is available 24 hours a day from a server at UB. "This is something we dreamed about five years ago-being able to have many remote sites participate in our grand rounds through live video interaction, and then have that same grand rounds available at any time of the day to those who couldn't attend the program," says Ellis. "Five years ago, however, we didn't envision sites from around the world participating, but instead were thinking more about the medical community in Western New York. Having successfully completed this broadcast, we now see that these technologies are truly amazing and have tremendous potential to bridge distances for the purpose of teaching." "Screen-Side" Manners Ellis has also been encouraging physicians to refine their "screen-side" manner on the videoconferencing system. To date, he has supported clinics for psychiatry, infectious diseases, neurology and gastroenterology by giving the participating specialists an opportunity to teleconsult with prisoners throughout the state. "By the time physicians complete a clinic in that setting, they have an appre- ciation for what the technology can do, and their wheels start turning about how they can apply it in their own practices. Some of our physicians may be set in their own ways and are not comfortable in a new environment," Ellis says, "but overall it has been well received." Emergency medicine interns learn the system as part of their technology rotation with bedside ultrasound at ECMC. Because many new doctors were children of the Computer Age, they take to it with ease. "I was playing around with an Apple 2E at the age of seven. I grew up with computers, so I was pretty excited to use it," says Judith Toski, MD, an emergency medicine resident. "It appeals to me that we can manage patients well in such a cost-effective manner. And we know our limitations. We know what we can and can't do over the system." Like Toski, Richard Krause, MD, residency program director for the department of emergency medicine, is a telemedicine veteran. He observes that doctors who use the interactive video often spend more time with patients than they would in a traditional setting. "If you know you don't have all the diagnostic tools to go on, you pay that much more attention to the patient history. We take a very detailed history and have that much more of a face-to-face encounter with patients, who receive this in a positive way." Ellis couldn't agree more. Physicians don't need a lot of technological savvy to successfully navigate the system. They only have to tap into the qualities that physicians have relied on for centuries to care for the ailing. "Even if you're not at the patient's bedside, you can still pass on the same concern, the same sense of compassion," he says. "From miles away we still have the ability to show patients we are capable of helping them." 4D ' J �wo of the most important diagnostic tools that physicians have are their s y hands, which allow them to detect subtle signs of disease or injury just by touching a patient. Exercising that expertise has always required the B \ presence of two individuals in the same physical space at the same time: physician and patient. Until now. University at Buffalo researchers are developing a system that will allow physicians to use a new form of virtual reality, called physically based VR, to store information about what they are feeling during an exam and then go back and review it later after the patient has left, or share it with consulting physicians in a remote location. Autlllllll 2001 lallal1 Hysieiu 25 �Research Center (CUBRC). Kesavadas explains that, right now, there is no way for a physician who is not physically present to conduct a palpation exam on a patient. When a very serious case arises-particularly at a small, rural hospital, for example-often the patient must be airlifted to a more comprehensive medical facility where he or she can be examined in person by a specialist. The VR system under development at UB could make some of these costlynot to mention traumatic-airlifts unnecessary. "Using our customized data-collection glove and the detailed understanding we Using the "Virtual Human Model for Medical Applications," physicians wear a customized virtual-reality glove during the patient examination that collects data on what the physician is feeling through sensors located in the glove's fingertips. James Mayrose, PhD, UB research assistant professor of emergency medicine, is a senior designer of the glove and a coinvestigator on the project. Currently, he is conducting studies of the glove on human subjects at the Erie County Medical Center in collaboration with David Ellis, MD, a UB assistant professor of clinical emergency medicine, who has assisted in the development of the prototype device. In summer 2000, the research team reported on the progress of their work at the World Congress on Medical Physics and Biomedical Engineering in Chicago. "I think one of the great advantages of this technology is that it would allow us to accurately measure the bioelastic properties of the abdomen in its normal state and in its possibly diseased state," says Ellis. "Traditionally, we rely on the surgeon's touch during the abdominal exam. But the data from this electronic system will help give us a more objective way of interpreting information." are developing about the physics behind a physician's touch during an exam, we expect within two to three years to have a device in use that will allow a physician to use medical palpation virtually and in real-time," says Kesavadas. The UB work represents a departure from the usual route taken by researchers studying VR for use in medical situations, he adds. "Just about everyone who henkurussi Kesavadas, PhD, assistant professor of mechanical and aerospace engineering and director ofUB's VR Lab, is co-investigator on the project, which was supported in part by a 127,000 grant from the Center for Transportation Injury Research of the Calspan-UB 26 1111111 Physicial Au tumn 2 001 is looking at virtual medicine right now is interested in surgical applications." But those applications are many years away from being realized. For his part, Kesavadas sees no reason to wait to reap the benefits of VR for diagnostics. As is the case with many other virtualreality applications for medicine, UB's Virtual Human Model will be relevant for training physicians, as well. "Actually, the system started out as a teaching application, but we soon realized the implications it would have in telemedicine services and emergency diagnosis," Mayrose notes. The UB group currently is modeling on the computer the soft tissue and organs of the human abdomen, using atomic-unit type modeling that breaks up hwnan tissue into pieces that each measure no more than 8 mm. The system takes as its raw material the Visible Human Data Set developed by the ational Institutes of Health, which provide researchers with com plete digitized data sets of the human body. Using a very powerful graphics computer, the researchers "super-sample" smaller and smaller sections of the data set for a given body part or organ, which enables them to get more and more detailed pictures of each one and develop increasingly complex equations about how each tiny section will respond to applied forces. They then create layers of these sections, gradually building the �-- -- collection of samples up into the complete organ. "Our big contribution is that we are writing algorithms to model how soft tissue deforms as a real mass, rather than just as a surface, which is what many groups are currently doing. o one else is doing this in real time," says Kevin Chugh, PhD, research associate with the New York State Center for Engineering Design and Industrial Innovation at UB, and a coinvestigator on the project. "We will be able to touch the model with a haptic thimble (the physically based VR counterpart of a computer mouse) on the screen, apply the 'force,' using a 'haptics' feedback system and show how it deforms and then bounces back when the force is withdrawn." The work is based on a solid understanding of the physics behind what happens when pressure is applied to different parts of the human body. "While the physician is doing a palpation on a patient, the computer-through the VR glove-is picking up all the information about what anatomic-force characteristics the physician's finger is feeling," says Kesavadas. Only a handful of groups in the United States are doing atomic-unit modeling for an interactive VR environment, according to Kesavadas. "The advantage of our system," he says, "is that the physician can store data that describe and quantify the sensation he is feeling in his fingers while he is examining a patient. He can tell through touch if there are any diseased organs, if they are enlarged or hard or soft, and if there are tumors present." In addition to medical palpation exams, the system is expected to have applications in emergency services in the field, as well in the military. CD - - - - ---- - -- - TELEMEDICINE biblio aphy of books on telemedicine with direct links to A Comptled by Pamela M. Rose, MLS, Health Saen es L1bra Buffalo, 3435 Mam St., Buffalo, NY 14214. 16 829 E-mail: pmrose@acsu.buffalo.edu. Autumn 200/ lllfllt Hysicin 27 �Jo n Konsek, D'64, ch se medicine over golf, much to the relief of Jack icklau ACK 11'. THE LATE 19505 A~D EARLY '6os, an amateur golfer named John Konsek, a skinny kid from the streets of Buffalo, ew York, played so well that many thought he might become one of the game's superstars. But Konsek, who played tee to green with extraordinary consistency, had other plans: He chose to become a doctor instead of a touring pro, to make medicine his career and golf a beloved weekend diversion. Just how well could he play? A glimpse into that answer can be provided by Ward Wettlaufer, who recalls the start of one of Konsek's rounds from a qualifier for the 1960 Buffalo District Championship. "On the first hole, John hit a 3-wood to about eight feet and sank the putt for eagle. Then, on the second, he hit a 3-iron that bumped against the stick and ended about three inches away for a tap-in eagle." Konsek completed that round, played at the Park Country Club, site of the 1934 PGA Championship, with an eye-popping 28-33- 61. That opening side was nine under par and neatly contained in three pars, three birdies and three eagles. "I started playing when I was about seven," Konsek recalls. "My dad loved the game, so I decided to try it. My brother, Jim, and I would walk over to Grover Cleveland [Golf Course]. Sometimes we'd sneak on. It was so much fun hitting that ball around, playing that game, that we played just about every day." A few years later, Konsek's father opened a driving range, where John practiced and began to develop his game. But it wasn't until he was 14 that Konsek made a quantum leap in his skill. His father enlisted the Park Club professional Jack Pritchard, to work with his promising son. Pritchard was known as an unconPHoros BY ventional teacher. He taught that golf was K E\ I a right-handed or right-armed game, \f 1 Y ~ z ~ '- 1 �I - ------------- ----- snorting that Scottish pros who B' gave such importance to the left DA \f ~ T T I ~I did not know any better because they had never played baseball. "He kept telling me to swing down and through with the right arm, from the top of the backswing to the end of the swing," Konsek remembers. "There was to be no separate snapping or slashing with the wrists, either. And no conscious attempt to make the right arm cross over the left after the hit." For some 2 112 months, the disciplinarian kept Konsek for hours on the range. "He was tough!" Konsek says. "The worst part was that he wouldn't even let me play a round on a course." With a well-tutored knowledge of his own swing, Konsek began to win junior titles, among them the Buffalo District, ew York State and East Aurora Junior Masters. He went to the final of the 1957 National Jaycees, losing by one stroke to an up-and-coming Ohioan named Jack icklaus. Between 1958 and '60, Konsek was especially tough to beat. He won the New York State Amateur an unprecedented three consecutive years. During that time his Purdue University squad won the Big Ten team title and Konsek claimed the individual trophy. Back home, he won the Porter Cup and the Buffalo District Golf Association (following the previously discussed 61 in the qualifier). Some of Konsek's greatest drama, however, was in his meetings with icklaus. They clashed directly three times as collegians in 1960, when Konsek was a senior and Nicklaus a junior. In a meeting at Ohio State, icklaus beat Konsek by one stroke. In a match at Purdue, Konsek won by three. Then came the Big Ten Championship, back-toback 36-hole days at the new Michigan State course. The last day was damp and windy with temperatures in the low 50s and the spring ground still soft. Paired together, wearing knit caps and windbreakers, they were -- - even after 63 holes, but over the final nine Konsek shot 33 to 0 R E Nicklaus's 35 to win, 282-284. The third-place finisher was another 15 shots back. Speaking of Konsek's finish, icklaus called it "probably the best nine holes I had seen anybody shoot." Would Konsek have been a success on tour? "Are you kidding me?" asks Curt Siegel, now head pro at Laurel Valley Golf Club in Ligonier, PA, and the third member of the group to witness Konsek's 61. "Absolutely. John had fantastic focus before there were any sports psychologists around to use the word. His determination and intensity, not to mention his ball-striking skills, would have earned him a great career." But since early high school, Konsek wanted to become a doctor. "I pondered that choice facing me for two years," he says. "As I continually mulled things over in my mind, and that was no fun, I one day was hit with a flash of sudden understanding. I loved golf, but I loved it as an amateur loves it-as a game. When October came each year, I put the clubs away until next April. And I put them away gladly. Then I'd return refreshed to the game in April. I really didn't want golf to be a yearlong grind with me, a daily duty, a way to make a living. When the realization came, I found peace of mind. I made the decision for medicine freely and wholeheartedly." - -- ----- - they were answering questions after the round, someone called out, "Jack do you remember John Konsek?" "I sure do," he replied. There was a slight pause. "And by the way, if you had anything to do with talking John into becoming a doctor-and here icklaus broke into a wide grin"I want to thank you for that." 4D This article was reprinted with permission from Golf Journal, the official publication of the United States Golf Association. S o Konsek, golfer par excellence, enrolled in the Medical School of the University of Buffalo. He completed studies at the University of Chicago and moved his growing family to Wisconsin. He began practice in a four-person private clinic and saw it grow to be a 190person clinic serving three area hospitals. He played golf once every week or two. He was a cancer specialist, who treated individual patients. "I've had a very fulfilling life and a good career," he says with no regrets but plenty of memories. In 1966, icklaus and Arnold Palmer played an exhibition near Buffalo. When AlltUIIIII 200 1 laffalo Physician 29 �S T U D E N T COLUMN Managing Managed Care Bv D A B L 0 CLASS v I D c OF K Med i cal students have the power to influence reform 2004 rant that my patients have confidence in me and my art and follow my directions and my counsel. Remove from their midst all charlatans . . . who arrogantly frustrate the wisest purposes of our art and often lead Thy creatures to their death. -EX<.ERP During our conversation, he bluntly asked, "What are you doing here? You're in New York; you should be working on Wall Street." The message I inferred from his tone was "medicine isn't what it used to be," and I found myself unable to respond. 30 lulfale Pbysiciaa FRO\ THE PR\HR OF :-.l A MC' : >F' Between my junior and senior years of college, I participated in a summer medical work program at a community hospital in Long Island, ew York. Part of the experience included rotating through several hospital departments, including the operating room. One day during my OR rotation, I remember chatting with an anesthesiologist who was between surgeries. During our conversation, he bluntly asked, "What are you doing here? You' re in ew York; you should be working on Wall Street." The message I inferred from his tone was " medicine isn' t what it used to be," and I found myself unable to respond. Unfortunately, it was not the first time I have heard that message. Some other, mostly older, physicians whom I met during college had made similar comments. What had happened since these physicians began practicing medicine to leave them with such an attitude? After practicing medicine for many years, would I grow to adopt feelings similar to these doctors? The answer to my first question is "managed care," and to the second, "I hope not." This is both a thrilling and a daunting time to be involved in medicine. One need only glance at the cover stories in the science and medicine supplements of newspapers and magazines to see a wide array of articles on everything from the most recent revelation in gene therapy to the latest criticism of a health maintenance organization (HMO), blamed for denying or delaying needed care to a patient. As medical students, my classmates and I are poised to enter a medical system that- no matter how you look at it-is failing to do its job proficiently and justly. The United States spends more per capita on health care than any other country in the world, Au t um11 2001 yet leaves about one of every five citizens without health insurance. Millions more are underinsured. While advances to improve the quality and length of human lives occur weekly in biomedical science, the degree to which these improvements are made available to all patients needing and deserving them seems less sanguine. The challenge to current students and medical residents, therefore, lies in what we can and should do to fix a healthcare system in serious need of repair. I emphasize the role of the newest physicians and physicians-in-training in this task not to eliminate the role of other physicians in the process. On the contrary, one hallmark of medicine is its apprentice-like quality, where the more experienced help in the training of nascent physicians. Mature practitioners who have lived through fee-for-service and, more importantly, the transition to managed care, have been forced to adapt to a new form of medical reimbursement that may indeed be distasteful. Newly minted doctors, on the other hand, have never known fee-for-service nor a time when the autonomy of physicians went virtually unquestioned and unhindered (whether this is an asset or a disadvantage is arguable). aivete may, therefore, be what makes today's medical students and residents best suited to tackle the challenge of mending managed care. Before I look at what medical students can and should do to help reform managed care, it is essential to understand what managed care is doing right and what it is doing wrong. Managed care has been faulted for many shortcomings, including decreasing the amount of time physicians may spend with their patients, limiting treatment options, removing a significant level of professional autonomy formerly enjoyed by doctors, and compromising the quality of care patients receive. In light of these and other criticisms, one might liken managed care organizations to the "charlatans" chided and disdained above by Maimonides, the great Jewish theologian, philosopher and physician of the Middle Ages. Dealing with authorization and reimbursement rules certainly frustrates many doctors in their daily practices and some HMOs have been formally �- BEING A~ OPTI~1IST, I - ---- BELIEVE THAT ;\lY CLASS;\IATES A, 'D --- I ---- --- -- - ---- ~ ARE L. A CRUCIAL A, 'D 11'\FLUE. 'TJAL POSITIO.' WHEN CO"'SIDERING REFOR~1 OF MANAGED CARE. WHILE l\!EDICAL STCDE. 'TS ;\lAY BE Oi\1 THE LOWEST RUNG OF THE ;\lEDICAL HIERARCHY, THIS IS ·oTTO SAY WE HAVE , ·o VOICE OR POWER TO EFFECT CHA, 'GES. charged in lawsuits contending that denial or delay of care harmed or precipitated the death of a patient. Moreover, the strain on physicians is not limited to their clinical practices, as those involved in training students "find themselves under pressure to spend more time documenting how they spend their time" rather than teaching students or discussing cases.' Despite the criticisms made against managed-care organizations, there is good reason not to simply call for their immediate termination. By attempting to deliver quality medical care in a highly cost-effective manner, managed-care organizations can be seen as an essential, if inevitable, product of contemporary medical care. Over the last one hundred years, humankind has seen perhaps the greatest advances in science and medicine in its history. While the diagnostic and therapeutic tools available to today's clinicians are abundant, the associated costs with many interventions is equally great. Unfortunately, since healthcare resources are finite, sometimes a patient may be denied beneficial treatment because services are rationed. Whether this situation is "fair" or "right" is unresolved and regularly debated in the bioethical literature. What is clear, however, is that managed care is compelling physicians to reduce unwarranted tests and some treatments and-no matter how abhorrent the thought might be- to consider cost when making medical decisions. So, where does all of this leave medical students at the start of this new millennium? Being an optimist, I believe that my classmates and I are in a crucial and physician-assisted suicide, while the AMA was influential position when considering reform of man- staunchly opposed.~ This autonomy may be especially aged care. While medical students may important in managed-care reform, be on the lowest rung of the medical as the advocacy for the kind of hierarchy, this is not to say we have no Your Turn? broad, liberal changes needed to voice to effect change. Through organimend a limping United States healthJF YOU ARE A STUDENT OR RESIDENT INTERESTED zations such as the American Medical care system may not be immediately IN CONTRIBUTING TO Student Association (AMSA) and the forthcoming from the traditionally THIS COLUMN, E - MAIL AMA's Medical Student Section, docconservative medical establishment. BP - NOTES@BUFFALO. EDU TO SUGGEST A TOPIC. tors in training can become active in For what kinds of reforms should reform efforts. Furthermore, the opinmedical students be clamoring? In ions and mandate of the neA.'t generation of physi- my opinion, both the protection of patient welfare cians can be independent of the medical establish- and the right of all Americans to have a decent level ment, as occurred recently when AMSA filed an CO NTIN U ED ON PAGE 36 amicus brief to the Supreme Court in favor of David Block outside City Hall, Buffalo, New York. I Alll ll mTl 20 0/ l1ffal1 Hysicia1 31 �RESEAR C H Antibacterial Compound Developed E W S Institute, Trifluorosal also will undergo Phase I studies to examine the feasibility of developing it as a preventive agent for skin cancer. Therex is a graduate of the UB Technology Incubator and a subsidiary of OmniPharm, another graduate of the incubator. It previously was awarded grants totaling 650,000 from the ational Institute of Dental and Craniofacial Research to investigate the same compound's potential Potential for treati11g acne, gi11givitis and preventing skin cancer Scientists at the University at Buffalo and Therex Technologies, Inc. have developed a remarkably versatile, antibacterial compound with antiinflammatory "Trifluorosal is properties that they are inagent but since it is vestigating as a not an antibiotic, it potential topical has a very low treatment for potential for acne and gingiproducing bacterial vitis and as a preresistance. At the ventive agent for same time, it is an skin cancer. anti·inflammatory Trifluorosal, agent and has a which is derived molecular structure from the same similar to aspirin class of comand its toxicity is pounds as aspiextremely low." rin, will be evaluated in a clinical trial as an acne treatment beginning early next year under a 750,000 SBIR (Small Business Innovation Research ) grant Therex received from the ational Institute of Arthritis and Musculoskeletal and Skin Diseases. Under a $100,000 grant from the National Cancer an antibacterial 32 l11fal1 Phpicill for treating gingivitis. "If it turns out to be useful for several of these indications, the market potential for Trifluorosal is at the billion-dollar level, " says Joseph Dunn, PhD, president of Therex, and research associate professor in the Department of Oral Biology in the UB School of Dental Medicine. " If it turns out only to be useful in the application with the smallest market, then Au t um11 its potential is still in the hundreds of millions. " Despite this prospect, he cautions that there is a long way to go if the compound is deemed marketable, explaining that the road from a ew Drug Application to the marketplace takes three to five years per drug indication. It also takes anywhere from $25 million to 400 million in funding, a cost that makes partnering with a major company a necessity. Of note, therefore, is the fact that two major U.S. pharmaceutical companies have already expressed interest in Trifluorosal. Developed and patented by UB researchers in the university's School of Pharmacy and Pharmaceutical Sciences and School of Dental Medicine, Trifluorosal was licensed to Therex. In exchange for exclusive rights to the compound, UB has retained five per cent ownership of The rex, and will receive royalties from sales of any products that result. UB researchers identified the chemical precursor to Trifluorosal while conducting federally funded research in which they were searching for antibacterial compounds in products already on the market that adhered well to skin or mucous membranes. The idea was that if such compounds became the basis for new treatments, they would likely be safe since they already were on the market and since they were designed to be active only at the surface and not absorbed into the body," explains Robert ]. Genco, PhD, SUNY Distinguished Professor in the UB Department of Oral Biology and chair of the department. Genco and his colleagues found the precursor in shampoos and soaps, then modified it and developed Trifluorosal. Further work by UB and Therex researchers has resulted in a second generation of active compounds. "Trifluorosal is an antibacterial agent but since it is not an antibiotic, it has a very low potential for producing bacterial resistance," says Genco. "At the same time, it is an antiinflammatory agent and has a molecular structure similar to aspirin and its toxicity is very low. It is a member of the salicylanilide-type of agents, searc 200 1 �- which bind strongly to skin and mucous membranes." Genco and his UB co researchers, Robert Coburn, PhD, professor of chemistry and Richard Todd Evans, PhD, professor of oral biology, both principals with The rex, initially were interested in the compound as a dental plaque inhibitor. "Trifluorosal is as effective in inhibiting plaque and gingivitis as chlorhexidine, the most effective compound now on the market," says Genco. "However, it does not have the bad taste and tendency to stain teeth that characterizes chlorhexidine." Later, the researchers found that it also kills bacteria that cause acne. After Therex licensed the compound from UB, the company's researchers found it also absorbed ultraviolet light and enhanced the repair of skin damage caused by sunlight, and therefore may be an important ingredient in lotions that prevent sunburn and skin cancer. "The beauty of this agent is that it's very effective when applied topically, so we looked for diseases that could be treated or prevented this way," Dunn explains. "It is the inflammatory component that connects these diseases and what may turn sunburn into skin cancer. " The company is simultaneously investigating the applications for acne, skin cancer and gingivitis. "We're investigating several therapeutic tracks in parallel since there is a lot of overlap in this research, - ------- which makes it a very efficient research program," says Genco. "UB has been very supportive by working to patent these developments, by taking an equity position in Therex and by fostering development of this local company," he adds. Therex also has licensed two chemical libraries for drug screening from UB and to date has developed and filed patents for a drug candidate from one of them that shows significant promise for treating multidrug-resistant breast cancer. - EL LE N GO LDB AU M CD - - Stelios T. A~dreadis, PhD, left, director of University at Buffalo's Bioengineering Laboratory, has led a collaborative effort to develop skin with high mechanical stability and pliability. P D, ass1s ant pro sso eU Department of Chemical Engineering, director of the UB Bioengineering Laboratory and lead author on the paper, says the re- Genetically Engineered Skin Promotes Wound Healing Bioengineers at University at Buffalo and Shriners Burns HospitalBoston have created a genetically engineered skin that expresses a protein that promotes wound healing. It is believed to be the only artificial tissue designed to express keratinocyte growth factor, KGF. Their research, published in the FASEB Journal of the Federation of American Societies of Experimental Biology, suggests that a skin substitute could be developed that would accelerate the generation of new skin following severe injuries or burns. The research demonstrates for the first time that a growth factor can bring about significant changes in the three-dimensional organization and function of a skin equivalent in vitro. Stelios T. Andreadis, - searchers have submitted a grant proposal for animal studies aimed at confirming whether the artificial skin would have a therapeutic effect. "Our goal was to create genetically modified skin equivalents that secrete keratinocyte growth factor as a means to accelerate wound healing," explains Andreadis. "We also wanted to create a model system to study the effects of this protein on the development and morphogenesis of engineered skin tissues." The presence of KGF "appears to have profound effects on wound healing by spurring the proliferation of skin cells," Andrea dis says, adding that the genetically modified tissue substitute has a number of advantages that make it a good candidate for a skin substitute. "What's significant about our s e tains the natural composition and topography of skin," he adds. The genetically engineered skin also has high mechanical stability and is pliable, important advantages over skins made from collagen gels, which, he says, have a consistency similar to that of gelatin and therefore are much more difficult to use. Most important, Andreadis points out, the engineered tissue has good barrier function, preventing dehydration and protecting against pathogens. "This is very important for bum patients who have lost a substantial fractilln of their total body surface area and who suffer from excessive dehydration and bacterial infections," he says. "Because they are very much like real skin, these engineered skin equivalents can provide these functions." Co-authors of the study are Karen E. Hamoen, Martin L. Yarmush and Jeffrey Morgan, all of Massachusetts General Hospital, substitute is that it contains the Harvard Medical School and basement membrane-the matrix molecules that the cells of the Shriners Burns A11t11mll Oli -E L LEN GOLDB A UM 2 001 1-Boston. CD laffale Physician 33 �RE SEA R CH New Clues to the Cause of Tinnitus E W S "THIS ADDJTIO HAS 'T BEE Tinnitus, the disruptive ringing in AL LEVEL OF COMPLEXITY HELPS TO EXPLAI A SIMPLE SOLUTION TO THIS PROBLEM. THERE IS EFFECTIVE FOR THE RELIEF OF TI the ears that affects millions of THAT NO 0 people, originates not in the ear 0 DRUG THAT IS ITUS. MAYBE THE SYSTEM IS SO COMPLEX E DRUG CAN DO THE JOB ." -ALAN H. LO CKWOOD. MD but in the brain, and not even ex- Lateral gaze suppres· clusively in the brain's auditory ses auditory brain ac· centers, a new study has shown. tivity in normal sub· In research published in Neurol- jects, according to ogy, scientists at UB and the Buf- Lockwood. "This so- falo Veterans Affairs IVAI Medical called 'cross-modal Center show that some people inhibition' is a mecha- with tinnitus can change the ear· nism that enables the ringing by specific eye move· brain to suppress un- ments, evidence that one sensory wanted sensations. By system can affect another. suppressing hearing "These findings show us that in during lateral gaze, many cases, tinnitus is not caused the brain is telling us by a simple disturbance of brain to pay attention with function, but by a combination of our eyes. This cross- things, including an abnormal in· modal inhibition was teraction between the visual and absent in GET patients, auditory systems," says Alan H. indicating a disrup· Lockwood, MD, first author on the tion in normal brain study. Lockwood is professor of Study leader Alan H. Lockwood, MD, and his University at Buffalo colleagues were the first to show that tinnitus sounds originate in the brain, not in the chochlea, as scientists previously thought. neurology, nuclear medicine, and circuitry that may be at the core of the tin· one small group of these 'trick· communicative disorders and sci· unusual ability to control the loud- ences, and directs the Center for ness of the ringing by clenching sters.' If these findings gener· Lockwood's next step in his Positron Emission tomography their jaws. The researchers were alize to much larger groups, we continuing investigation of the (PET), a joint UBNA venture. mystery of tinnitus is to look at nitus phenomenon," he explains. able to track fluctuations in cere- will show that tinnitus is caused "This additional level of com- bral blood flow through PET scans by abnormalities in the major other "tricks" known to influence plexity helps to explain why there taken while these patients mani· brain systems.'' the condition and at how they hasn't been a simple solution to pulated their symptoms, creating The study-supported by this problem," he adds. "There is a map of the brain site responsible grants from the National Institute mechanism, called residual inhibi- no drug that is effective for the for tinnitus activity. of Deafness and Communicative tion, involves brief suppression of influence brain circuitry. One such relief of tinnitus. Maybe the sys· Their current research involved Disorders and the James H. tinnitus by overwhelming the audi- tern is so complex that no one drug a small group of people with tinni· Cummings Foundation in Buf- tory system with a very loud noise; can do the job." tus who can modulate their tinni- falo-focused on eight patients for example, a power saw, which tus by looking to the far right or left with GET, a condition that may one of Lockwood's patients finds Lockwood and colleagues were 34 WHY THERE the first to show that tinnitus of center, an unusual condition develop after surgical removal of effective in temporarily stopping sounds originate in the brain, not called gaze-evoked tinnitus !GET). tumors of the auditory nerve. As tinnitus sounds. the cochlea, as previously thought. "About 70 percent of tinnitus researchers mapped the brains of Study collaborators were Davis Lockwood and Richard Salvi, PhD, sufferers have some 'trick' they've these patients using PET, they S. Wack, Robert F. Burkard, Mary co-director of the Center for Hear· learned that changes the loudness found an unexpected imbalance Lou Coad, Samuel A. Reyes, Sally ing and Deafness, previously stud· of tinnitus," Lockwood says. "In between the auditory and visual ied tinnitus patients who have the this research we concentrated on parts of the brain. A. Arnold and Salvi, all with UB. - Lois Baker <Ii) luffale Physiciaa A II I II Ill II 2 0 0 I - u �------- Venom Shows Promise for Heart Attack - -~ - ------- -- - Center for Single Molecule Biophysics, along with colleagues at the University of Virginia, Michigan State and A specific protein isolated PS Pharmaceuticals, Inc., refrom the venom of a Chilean ported isolating the protein in tarantula by biophysicists in May 2000. At that time, they University at Buffalo's School suggested that it might have of Medicine and Biomedical many uses, based on its ability Sciences shows promise as the to block pores in cell membasis for new drugs for preventing atrial fibrillation, the branes called stretch-activated chaotic beating of the heart channels. These channels, that is a major cause of death which derive their name from following a heart attack. the fact that stretching the cell In a study published in membrane causes them to Nature, Frederick Sachs, PhD, open, are responsible for reguprofessor of physiology and lating the mechanical funcbiophysics, and researchers tioning of cells-a cellular from Georgetown University, sense of touch. Sachs and colreport they were able to preleagues discovered these chanvent atrial fibrillation in nels at UB in 1983 in skeletal muscle cells. rabbit hearts by an infusion of a peptide isolated Stretch -activated from tarantula ven channels have been om. This finding implicated in funcmarks the first time tions as diverse as the senses of touch and that the physiological hearing, blood presfunction of mechanosure and volume regusensitive ion channels lation, and coordinahas been demonstrattion of the voluntary ed in the heart. musculature, as well as The work-which the con traction of was funded by grants heart muscle. Comfrom the ational Inposed of 10 billion exstitutes of Health, U.S. citable muscle cells, the Army Research Office heart cells must conand NPS Pharmaceuticals, Inc.-is an extract in synchrony in ample of how basic re- Frederick Sachs. PhD, professor of physiology and biophysics. order to pump blood search can lead to clinical payoffs, according to Sachs. "No one in their right mind would have sought to block atrial fibrillation with spider spit," he comments. "We did it backwards. Since we had found venom worked on single molecules, we predicted it would also work on cells, tissues and organs. And it did. "This is a first step toward developing a new class of drugs that may be applied to cardiac pathology and to the pathology of other organs. Despite the fact that all cells have mechanical sensitivity, there are no other pharmacological agents specific to biological mechanical transducers," he adds. Sachs and postdoctoral researcher Tom Suchyna at UB's effectively. When heart tissue becomes stretched through disease, such as congestive heart failure, trouble ensues. The chambers of the heart expand, stretching cells. Furthermore, as a result of poor Allt llmn - blood perfusion, cells swell, stimulating stretch-activated channels to open and allowing an influx of positive ions. This influx is an excitatory stimulus to the heart that disrupts the electrical balance, causing the cells to fire erratically. The tarantula-derived peptide, known as GsMtx-4, blocks this process. The next phase of Sachs' research involves producing large 'This is a first amounts of the step toward peptide by re- developing a new combinant D A class of drugs that technology and may be applied to chemical synthe- cardiac pathology sis, studying the and to the mechanism of pathology of other action, identify- organs. Despite the ing other poten- fact that all cells tial biological have mechanical actions on stretch sensitivity, there are -activated chan- no pharmacological nels and collabo- agents specific to rating with a drug biological mechani· company to turn cal transducers." GsMtx-4 into a clinically useful drug. -L 0 I S B A K E R 4D Editor's Note: Dr. Sachs received the University at Buffalo School of Medicine and Biomedical Sciences ' Stockton Kimball A ward at this year's Faculty A wards ceremony, held in May. The award honors a faculty member for academic accomplishment and worldwide recognition as an investigator andresearcher. Stockton Kimball, MD '29, was dean ofUB's school of medicine from 1946 to 1958. 2 00 / l 1ffal1 Pbysici11 35 �R ES EAR C E H W S 12-Hour ADHD Drug Effective version of methylphenidate for tion, is the best way to treat ADHD, to use medication for their chil- ADHD. The double-blind design in· according to Pelham, whose on- dren with ADHD. A new 12-hour fonnulation of the volved three dosing regimens: im· going research in this area is "For those who do, however, most commonly prescribed drug for attention-deficit/hyperactivity mediate-release methylphenidate Concerta would appear to be a given three times a day; extended- supported by grants from the National Institute on Alcohol Abuse disorder, or ADHD, has proved to release methylphenidate given in and Alcoholism and the National be as effective as the standard the morning, and placebo. All chil- Institute of Mental Health. three-times-a-day dosing regimen, dren took each regimen for a week. Pelham also acknowledges a clinical trial conducted by Uni· v sity at Buffalo researchers has shown. Results showed that The extended· children performed release formula- Teachers and parents rated the children's behavior and ability to attain daily goals during the week. In addition, children spent that some ADHD children do not need medication in the evening, significantly better on both the three· times-a-day and the lion of methyphen- 12 hours on Saturdays in a class- date avoids the researchers to evaluate the effects need for children with ADHD to take medications in all medication during settings compared school or after- games and recess. to the placebo. Results showed that children school activities. The trial of Concerta was headed by William perfonned significantly better on E. Pelham, PhD, professor of psy- extended-release medications in both the three-times-a-day and the chology, pediatrics, and psy- all settings than when receiving the placebo. The extended-release for- chiatry at UB and one of the world's leading au- mulation maintained its effectiveness thorities on attention deficit disorder. Results appear in the elec- even after 12 hours tronic pages of the June in both the laboratory issue of Pediatrics. Sponsored by a ings indicated. Ratings were similar for both active grant from Alza fonnulations. Parents, teachers and was con- chil- dren in the study also took part in a ductedwith 68 children between the concurrent regimen of behavior modification, were taking a which, when combined with medica- 36 l 1ffal1 Physician ment package for ADHD," he says. 0 I s B A K E R CD - L and that some parents prefer not STUOE!IiT COLUMN. CONTI ~UEO FRO M PAGE 31 room laboratory setting to allow of each medication over time. Trained investigators monitored behavior during classroom work, extended-release good choice of stimulant medication as part of a total treat- Au t 1111111 2001 of medical care must be at the top of the list. However, we also must begin to turn keen attention to the idea that in a society where healthcare dollars are limited, patients cannot expect to receive-and physicians cannot expect to provide-every bit of beneficial care to every individual. This latter dilemma will require reform within the ranks of medicine, and medical students could take an active role in the ensuing debate by sharing with Congress, HMOs, and professional organizations some of the progressive ideals that many have brought to medical school. To accomplish these tasks, not only must medical students become involved and feel that they have a stake in the outcome, but medical schools must incorporate course work on the healthca re system (in such areas as medical sociology and biomedical ethics) into their curriculums so that students are informed participants in the debate and reform process. While it ma y be difficult to "squeeze" this kind of material into curriculums already bursting at the seams, the reward of such efforts will be a population of students and young physicians more prepa red and able to help reform and wo rk within managed care. By becoming more involved with our national and local student organizations and receiving adequate instruction about the healthcare system, my classmates and I stand in an excellent position to work towards bringing meanin gful chan ge to th e m a naged -care system and, ultimately, better care to our patients. CD Davuf Blotk 1s a .-econd-}·car student 'H • J1 ~• fed ·u n a t> 111 Unil•crsity at Buffalo's Hi • I< l'ca' 'lczc zce.-. Robert Kuttner, "Managed Care and Med ical Education," New England journal of Medicine 34 1 ( 1999): 1092- 1096. ' Salomeh Kejhani and julie I. Boyer, "Student Challenges to the Medical Establishment," jou mal of tire American Medical Association 278 ( 1997): 111 8. �- -------------------- - - - --- --~ - - - DEVELOPMENT --- E W - S Gifts that St en~hen Our School By Li nda J . Cor der , Ph0, CFRE of the University at Buffalo's School of Medicine and Biomedical Sciences. At the heart of philanthropic planning is our goal to increase the endowment. The Campaign for UB: Generation to Generation provides a fitting theme for these efforts. D. W. Harrington initiated the school's first endowment in 1896, on the 25th anniversary of his medical graduation. It was augmented in 1905 through a bequest. It then took about 60 years for the principal to double in size. The story changed drastically when this fund became part of the state-held endowment and was actively managed by professional investors. Today that lecture fund has a market value slightly over $645,000 and disburses much more annually than the amount of the original gift and bequest combined. It is one of 186 endowments established for the benefit of UB's School of Medicine and Biomedical Sciences. Collectively they provide for a variety of lectures, scholarships, research funding, student travel, activities outside of THE SCHOOL's ENDOWMENT traditional laboratories and classIS, IN A VERY REAL SENSE, ITS rooms, as well as some flexible SECURITY FOR THE FUTURE. funds to be designated annually by TODAY'S STUDENTS, FACULTY the dean. AND STAFF BENEFIT FROM ENIn response to UB's merger with the State University, Clifford DOWMENT GIFTS OF PREVIOUS Furnas, then president of the UniGENERATIOr<S. TOMORROw's versity at Buffalo, helped to create SCHOOL IS BEING CREATIVELY the UB Foundation (UBF). Most STRENGTHENED BY TODAY'S endowments established in the past forty years are held by UBF, CONTRIBUTIONS. which serves as the university'sand the school's-bank and investment manager. As of)une 30,2001, the school's combined endowments totaled over $138 million. This total is roughly 25 percent larger than it was four years ago, one year into the campaign, even with recent market volatility [prior to September 11]. During the past year, faculty colleagues of Dr. SukKi Hong worked with Dr. Harold Strauss, chair of the Department of Physiology and Biophysics, to build a departmental endowment in Dr. Hong's memory. For over 25 years, Dr. Hong was an outstanding teacher and role model for young scientists and aspiring physicians. Dr. Hong's enthusiastic and meticulously prepared lectures on renal function attracted many students to his laboratory. His intellectual standards-combined with honesty, a generous nature and personal warmth-made this experience a particularly rewarding one for students. Many former students were called by current faculty; several made gifts. The ultimate purpose of the fund will depend, in part, on the amount of contributions it receives. At present, it has over $43,000 and, as the following list shows, the Hong Memorial is one of many endowments that received new gifts during the year that ended June 30, 2001. Endowment gifts comprise a small-but significant and increasing-source of future income for the school. These annual disbursements provide a hedge against inflation, economic downturns, fluctuations in the state's political climate and variations in the numbers of alumni and friends who support the school's annual appeal. Some donors include a specific amount or percentage in their estate plan to "endow their annual gifts." Such bequests go into an unrestricted endowment to augment annual fund revenues in perpetuity. The school's endowment is, in a very real sense, its security for the future. Today's students, faculty and staff benefit from endowment gifts of previous generations. Tomorrow's school is being creatively strengthened by today's contributions. Those of us who learn, teach and conduct research in this unique institution extend our thanks to all alumni and friends who made endowment gifts during the past year. If you would like information about initiating a named fund or have questions about the school's combined endowment, please contact me. Linda (Lyn) f. Corder, is associate dean for alunmi affairs and development. She can be contacted at 1-877826-3246, or via e-mail at ljcorder@buffalo.edu. 4D A II t II Ill II 2 0 0 1 l1ffal• Pbysiciao 37 �D E V E L 0 P M E N T E W S (ndowments of t an edicine • ences ELOW WE LIST THE S cHOOL o Medicine and Biomedical Sciences' endowments held b 1 bv.h ..1t C.3 ;'ounc.atwn anc. lhe state. Endowments that received additional contribu- tions between 7/1/00 and 6/30/01 are in bold print. An asterisk ( *) indicates a new fund that was established during this time frame. A bold name combined with an asterisk represents a new endowment that also received initial gifts to fund the principal and/or assoCiated "spendable" account. If you would like more information about initiating a named endowed fund, or if you have any questions regarding the school's combined endowment, please contact Linda (Lyn) J. Corder, associate dean for alumni affairs and development, toll free at 1-877-826-3246, or via e-mail at ljcorder@buffalo.edu. 38 H.W. ABRAHAMMER MEMORIAL SCHOLARSHIP ERNST BEUTNER SKIN IMMUNOPATHOLOGY AWARD* SIDNEY ADDLEMAN MEMORIAL LOUIS). BEYER SCHOLARSHIP DR. GEORGE j, ALKER FUND FOR NEURORADIOLOGY PAULK. BIRTCH M.D. FUND THEODORE & BESSIE G. ALPERT SCHOOL OF MEDICINE ScHOLARSHIP MARVIN A. & LILLIAN BLOCK FUND ALPHA OMEGA ALPHA LIBRARY FUND DR. WILLARD AND )EAN BOARDMAN FuND ALPHA OMEGA ALPHA ENDOWMENT DR. SoLOMON G. BooKE AND RosE AMERICAN AcADEMY oF FAMILY PHYSICIANS PRESIDENT's AwARD )AMES ANESTHESIOLOGY DEPARTMENT E ANNE AND HAROLD BRODY LEC TURE FUND DOWME T H. YASGUR BooKE FuND BORRELL UROLOGY FUND BACCELLI MEDICAL CLUB AWARD CLAYTON MILO BROWN MEMORIAL L.B. BADGERO MEDICAL SCHOOL FUND GEORGE . BuRWELL FuND L. VIRGINIA BARNES ENDOWMENT DR. WINFIELD DR. \VALTER BARNES MEMORIAL S C HOLARSHIP EvAN CALKINS PRIMARY CARE AcHIEVEMENT FuND DR. ALLEN BARNETT FELLOWSHIP IN PHARMACOLOGY VINCENT CAPRARO LECTURESHIP FUND-CLASS OF 1945 DR. CHARLES A. BAUDA AWARD I DR. CHARLES CARY MEMORIAL FAMILY MEDICINE BUTSCH MEMORIAL LECTURE IN CLINICAL SURGERY A. CHAZAN MEDICAL ScHOLARSHIP THOMAS R. BEAM, )R. MEMORIAL DR. AND MRs. josEPH GILBERT M. BECK MEMORIAL FUND CLINICAL PREVENTATIVE MEDI C INE FELLOWSHIP DR. ROBERT BENNINGER FUND IN 0RTHOPOEDICS ALMON ROBERT BERKSON MEMORIAL AWARD IN THE ART OF MEDICINE PATRI C K BRYANT COSTELLO MEMORIAL l 11fal• Physicia1 A II t II 111 II 2 0 0 1 H. CoOKE SCHOLARSHIP �- - - - ~~--~~~ ----------~- -- -- - - - ----- THESE AN~'WAL DISBURSEMENTS PROVIDE A HEDGE AGAINST INFLATION, ECONOMIC DOWNTUR. S, FLUCTUATIONS IN THE STATE's POLITICAL CLIMATE AND VARIATIONS IN THE NUMBERS OF ALUM. I AND FRIENDS WHO SUPPORT THE SCHOOL's AN. UAL APPEAL. -LynCorder CTG ONCOLOGY FuND FLORENCE M. & SHERMAN R. HANSON FUND FOR MEDICAL EDUCATION )AMES H. CuMMINGS ScHOLARSHIP DEVILLO W. HARRINGTON LECTURESHIP EowARD L. CuRvtsH M.D. AwARD THE HEKtMtAN FuND ALFRED H. DoBRAK, M.D. FuND FOR LECTURESHIP IN NucLEAR MEDICINE HEWLETT FAMILY ENRICHMENT FuND FOR PsYCHIATRY MAx DouBRAVA, }R. ScHOLARSHIP FuNo CHARLES GORDON HEYD MEDICAL RESOURCES FUND THE ELIZABETH MEDICAL AWARD DR. FRANK WHITEHALL HINKEL SCHOLARSHIP FUND DR. RoBERT M. ELuoT ScHOLARSHIP RALPH HocHSTETTER MEDICAL RESEARCH FuND ENDOWMENT FUND FOR MEDICINE DR. SuK-KI HoNG MEMORIAL FuND ELEANOR FITZGERALD FAIRBAIRN SCHOLARSHIP ABRAHAM M. HoROWITZ FuND FAMILY MEDICINE ENDOWMENT HILLIARD )ASON AND )A FEYLER FuNo FOR RESEARCH tN HooGKtN ' s DISEASE E \VESTBERG FuND FOR EDUCATIONAL INNOVATION DR. GRA T T . FISHER F NO LUCIEN HowE PRIZE FUND L. R.R. HUMPHREY & STUART WALTER Ftx, M.D. '42, '43 ENDOWED ScHOLARSHIP FuND EDWARD FOGAN MEMORIAL PRIZE L. VAUGHAN Nu SIGMA ALUMNI SCHOLARSHIP FORD FOUNDATION FOR MEDICAL EDUCATION )AMES N. )OHNSTON SCHOLARSHIP THOMAS FRAWLEY, M.D. RESIDENCY RESEARCH FELLOWSHIP FUND C. FUND FOR CELEBRATING PHILAN T HROPY ' HARRY E. AND LORETTA A. )ORDON FUND MARCOS GALLEGO, M .D. CLINICAL EXCELLENCE FUND H. CALVIN KERCHEVAL MEMORIAL FUND SUMNER )ONES LIBRARY FUND RONALD GARVEY M.D. STUDENT LIFE ENRICHMENT FUND DEAN STOCKTON KIMBALL MEMORIAL AWARD )AMES GtBSON ANATOMICAL PRIZE DEAN STOCKTON KIMBALL MEMORIAL SCHOLARSHIP LAWRENCE AND DR. )AMES E. KtNG PosTGRADUATE FuNo ANCY GOLDEN LECTURESHIP IN MIND & BODY MEDICINE• WALTERS. GooDALE ScHOLARSHIP U MoRRIS LAMER AND DR. RoBERT BERNDT ScHOLARSHIP IRENE PtNNEY GooowtN ScHOLARSHIP DR. HEINRICH LEONHARDT PRIZE A. CoNGER GooDYEAR PROFESSORSHIP oF PEDIATRICs DR . CHARLES ALFRED LEE ScHOLARSHIP GEORGE GoRHAM FuND DR. GARRA K. LESTER STUDENT LOAN DR. BERNHARDT S. AND DR. SoPHIE B. GoTTLIEB AwARD LLOYD LEVE FUND ADELE M. GoTTSCHALK ScHOLARSHIP FuND THE LIEBERMAN AWARD CARL GRANGER, M.D. ENDOWMENT HANS LOWENSTEIN AWARD DR. PASQUALE A. GRECO LoAN FuND LUPUS SCHOLARSHIP FUND THE GLEN E. GRESHAM, M.D. VISITING PROFESSORSHIP WILLIAM E. MABIE D.D.S. AND GRACES. MABIE FUND DR. THOMAS). AND BARBARA L. GuTTuso ScHOLARSHIP & AwARD OR. WILLIAM H. MANSPERGER FUND GYNECOLOGY-OBSTETRICS DEPARTMENT ENDOWMENT MEDICAL ALUMNI ENDOWED SCHOLARSHIP )EAN SARAH HAHL MEMORIAL A EuGENE). HANAVAN ScHOLARSHIP MEDICAL SCHOOL CLASS OF I957 SCHOLARSHIP NUAL PARTICIPATING FUND FOR MEDICAL EDUCATION ENDOWMENT AutumTI 200/ luflale Pbysicia1 39 �MEDICAL ScHOOL CLASS oF 1958 ScHOLARSHIP EMILE DAvts RoDENBERG MEMORIAL AwARD MEDICAL ScHOOL CLASS OF 1963 ScHOLARSHIP THOMAS A. RODENBERG AND EMILE DAVIS RODENBERG SCHOLARSHIP FUND MEDICAL SCHOOL CLASS OF 1973 SCHOLARSHIP ELIZABETH ROSNER F MEDICAL ScHOOL LECTURESHIP FuND IRA MARIAN MELLEN FuND DR. SHELDON RoTH FLEISCH MEMORIAL FuND MICROBIOLOGY ENDOWMENT FUND HAROLD s. SANES AND THELMA SANES MEDICAL SCHOLARSHIP DR. DAVID KIMBALL MILLER AWARD MARIA APLES SARNO, M.D. SCHOLARSHIP EuGENE R. MINDELL, M.D. CHAIR IN 0RTHOPEAEDIC SuRGERY SCHAEFER FUND IN CARDIOVASCULAR DISEASES G. SCHOLARSHIP OF THE PROGRESSIVE MEDICAL CLUB OF BUFFALO ORRIS MINER, M.D. MEMORIAL AWARD PHILIP D. MOREY SCHOLARSHIP RICHARD APLES MEMORIAL SCHOLARSHIP s. ROBERT ARINS MEMORIAL AWARD ATIONAL MEDICAL AssociATION BuFFALO CHAPTER ScHOLARSHIP FuND AUGHTON AWARD ENDOW~1ENT )OHN P. Ross AND ELIZABETH P. Ross, M.D. CHAIR OF OPHTHALMOLOGY' SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES UNRESTRICTED AGEL, M.D. ANESTHESIOLOGY RESEARCH DR. AGNESs. THE DR. ENDOWMENT FUND LILLIE s. SEEL SCHOLARSHIP IRENE SHEEHAN FUND DEWITT HALSEY SHERMAN AND jESSICA ANTHONY SHERMAN FUND DR. Lots A. AND RUTH SIEGEL TEACHER's AWARD NEPHROLOGY RESEARCH ENDOWMENT S. DR. ERWIN NETER MEMORIAL S. MoUCHLY SMALL, M.D. EDUCATION CENTER FUND ANTOINETTE AND Louts H. NEUBECK FuND IRVINE AND RosEMARY SMITH CHAIR IN FUND FOR DR. IRVING M. SNOW FUND EUROANATOMY MUSEUM EUROLOGY DEPARTMENT ENDOWMENT FUND 1oucHLY SMALL, M.D. AwARD IN PsYCHIATRY EUROLOGY FuND MARY RosENBLUM SoMtT ScHOLARSHIP FuND DR. BENJAMIN E . & LtLA 0BLETZ PRIZE FuND IN ORTHOPAEDIC SuRGERY MORRIS AND SADIE STEIN NEUROANATOMY PRIZE DR. ELIZABETH P. OLMSTED FUND IN BIOCHEMISTRY DIANE AND MORTON STENCH EVER LECTURE FUND' OPHTHALMOLOGY FUND )OHN ). AND )ANETH. SUNG SCHOLARSHIP FUND• josEPHINE HoYER ORTON TRusT FuND jOHN H. TALBOTT VISITING SCHOLARSHIP FUND L. VICTOR A. PANARO MEDICAL SCHOOL FUND KORNELL F. CARTER PANNIL, )R., M.D. AWARD ENDOW~IENT TREVETT SCHOLARSHIp STEPHEN). PAOLINI, M.D. MEMORIAL FUND RICHARD E. WAHLE RESEARCH FUND PARKINSO MILDRED SLOSBERG \NEtNBERG ENDOWMENT RESEARCH FUND TERPLAN M.D. LECT REFUND )OHN PAROSKI MEMORIAL AwARD FuND E.). \VEtSENHEIMER OPHTHALMOLOGY AWARD ROBERT). PATTERSON RESIDENT AWARD DR. MARK WELCH AND BEULAH M. WELCH SCHOLARSHIP DtL MARK PETTRINO MEMORIAL )AMES PLATT WHITE SOCIETY ENDOWMENT PHt WILLIAMS / BLOOM MEDICAL RESEARCH FUND HI MEDICAL FRATERNITY ScHOLARSHIP FuND PROGRESSIVE MEDICAL CLUB OF BUFFALO FUND DR. MARVIN PSYCHIATRY DEPARTMENT ENDOWMENT FUND WtTEBSKY FUND FOR IMMUNOLOGY DR. HERMAN RAHN MEMORIAL LECTURE ENDOWMENT DR. ERNEST WtTEBSKY MEMORIAL FUND REHABILITATION MEDICINE ENDOWMENT' FARNEY R. WuRuTZER FuND ALBERT AND ELIZABETH REKATE CHAIR I ALBERT CARDIOVASCULAR DISEASE c. REKATE REHABILITATION MEDICINE LIBRARY FUND DoNALD RENNIE PRIZE tN PHYSIOLOGY DouGLAS RtGGs AwARD tN PHARMACOLOGY AND THERAPEUTICS THE RING MEMORIAL FUND MEYER H. RtWCHUN, M.D. PROFESSORSHIP IN OPHTHALMOLOGY. 40 G. ND lalfal1 Pbysicial Wi11t e r 2 000 . \YtNER FUND FOR DERMATOLOGICAL RESEARCH DR. MARK ZALESKI AWARD HERMAN AND RosE ZtNKE MEMORIAL ScHOLARSHIP �~ -~ -- ~--- C ----- -~--- L A s 0 T E ----·- --- --------- S Mary Botsford and Family I have had the privilege to follow-when and wherever possible-the many contributing efforts of our fine children and grandchildren .... Hang on to your hope, for tomorrow is another house at the Cape Coral Yacht Club. Am in a retirement community with a two-room, twobath. Barbara and I both enjoy excelle nt health." wellspring!" Pedro, CA, Internal Medicine, writes: "I will never forget my interview with Dr. 0 . P. jones, and after I was accepted into medical school (in the Elliott Lasser. MD •46, La Jolla, CA, Radiology, writes: "My favorite memory of medical school was graduation." E-mail address is elasser@ucsd.edu. 1950s 1940s George A. Gentner, MD "41 , Phoenix, AZ, Radiology, writes: "Enjoying retirement. Friends can reach me at my E-mail address: ggentnersr@hotmail.com." Charles Bauer, MD •46, Williamsville, NY, Internal Medicine, writes: "My wife and I are still very active with the medical school and of course with our family. We have five children." E-mail address is bauer_charles@msn.com. ----~------ fessor Humphries's ambidextrous neuro drawings; and receiving the sheepskin after years of stress." Robert A. Benninger, MD '50, writes: ''I'll be 80 next birthday. Gave up the big Jay Belsky, MD '51 , San old building on High Street), my wife and I walking downtown to tell my dad. I have fond memories of gross anatomy under Dr. jones. I loved it, and loved him, and, in general, had a blast." E-ma il address is tootsisdad@home.com. Robert E. Ploss, MD '51 , Vancouver, WA, Anesthesiology, writes: "My favorite memories always include Oliver Jones and his bones!" E-mail address is bobploss@home.com. William J. Sullivan, MD '55, writes, "I am continuing to work in forensic psychiatry, as the medical director of a group that specializes in defense medicallegal work. I take more time off work now, and my wife and I enjoy traveling the country in Maier Driver, MD '46, Lakewood, OH, General Surgery, writes: "Following retirement in 1983, after 30 years of solo general surgery practice, my beautiful wife, Marilyn, and I continued to enjoy many treasured moments until her untimely death in 1986. Since 1988, my wonderful wife, Jane, and Stanley J. Cyran, MD '46, Prospect, KY, writes: "I am retired. Three of my six children are physicians and the others are equally as successful. My favori te memories of medical school include: the thrill of going to medical school, attending O.P. jones's classes; Pro- Maier and jane Driver in Florida A11t11mn 2001 l 1 ffa l1 Pby si ci n 41 �C L A N 0 T E our large motorhome. We recently enjoyed a rafting trip down the Colorado River, in central Utah. We also traveled to the Canada's Northwest Territory this past winter to see the northern lights, which were most spectacular. '51,- Frederick Goldstein·Gretan, MD '56, MPH, is retired from Lorna Linda Unversity and lives in Simi Fred and Geri Goldstem- Valley,CA Gretan founded in 1959 to support the work of Catholic the first to recognize the tremendous gift that 1960s Dr. Rahner and his wife are to thei community Moira J. Burke, MD '69. and the wortd. Other awards Dr. Rahner has writes: "I have just been promoted to full professor on the clinical faculty in the Department of Ophthalmology in the School of Medicine at the University of South Florida. My elder son is a chief resident in general surgery; his wife is in her third year of the same program in Seattle. My younger son is studying computer science." E-mail address is mburke4908@aol.com. received include: The Bosnian Humanitarian Recognition Award; Doctor of the Year for the St. Vincent Health Center in Erie; and the John ~ Robision Humanitarian Award from the Boys and 1970s Elliot Gross, MD '70, writes: "I am one of the last few solo orthopaedic surgeons in Los Angeles. After raising two great kids, Lara, my wife, is about to resume her in- 42 l a llal 1 Pb ysici aa Autumn 2001 '71. writll:"'n'sa._.lftllwlfa .._dll.scllllllf....._CIIIIIf1171. ncati11i1( ..... wldi.flllilllil ......... '-t.llci.Ufr ,.,......,lnSiiCIIIIIIIU.ra" E.... IIMnssisnli*..._cea.. terest in physical therapy by volunteering to teach handicapped children to ski at Mammoth Mountain. Our daughter, Sheri, age 24-a UC Santa Barbara graduate and former captain of their tennis team-is a CPA and got married in August of this year. Our son, Adam, age 23, graduated from Haas Business School at UC Berkeley and played on their Division 1 tennis team. He is now working for Flipside.com." Bruce M. Prenner, MD '7D, writes, "My wife, Harriet, and I recently relocated to La Jolla, CA, from nearby San Diego. My practice of allergy includes a large research center devoted to conducting clinical trials for new therapies specific to asthma, allergic rhinitis and related disease . June 2, 2001. I live in Commack, Y, with my wife, Bonnie (UB Class of '70). We have two grown children who live and work in New York City. I served as director of a family practice residency program for 18 years. Currently, I am associate director at another program, focusing on resident supervision and training." David H. Breen. MD '73, writes: "My daughter, Patricia, was born on March 17, 1999, and my son, Jackson, was born on May 8, 2001! I have a pediatric practice in my home in Dansville, Y, where my father practiced. I was recently promoted to assistant professor of pediatrics at the University of Rochester School of Medicine, where I teach medical students. Life is good." Scott D. Kirsch. MD, '71 , writes: "! was installed as president of the New York State Academy of Family Physicians on Henry M. Bartkowski, MD '76, writes: "I recently moved to Akron, OH, to be chief of pediatric �-- ·- -------~ --- - - - - -- - - - -------- - - - -- - -- - - - - - -- ~-- --- -- writes: "My wife, Romana, and I have two children, Carrie and Christine. I work in a private practice in Buffalo . Some of my fondest memories are of the great parties at Bobbie, Beth and Diana's house. " assnotes neurosurgery at Akron Children's Hospital Medical Center. Ladonna and I have been married 23 years and have three children. Chris is a junior at New York University, in pre-law; Rebecca is a sophomore at the U of M and in pre-med; and Lindsey is in seventh grade." E-mail address is: hbartkowski@chmca.org. James J. Czyrny, MD '81, 1980s Elizabeth H. Donahue, MD Amherst, NY, Physical Medicine and Rehabilitation, writes: "I am in practice in Buffalo at University Physical Medicine and Rehabilitation Associates, Inc., as well as at ECMC and Kaleida Health. My wife and I have two children, Julie and Steven. I'll never forget those lobster dinners at Mulligan 's! " '81 , Rochester, Stanley L. Bukowski, MD '81 , Amherst, Y, Geriatrics/Internal Medicine, Y, Pediatrics, writes: " I worked in a private group practice. Currently, I'm out falty Award for UB's School Autumn 200/ I I II I II H I s i c i I I �C L N A 0 T E S Pano Yeracaris, MD '81, Brookline, MA, Family Practice, writes: "I completed my MPH at Harvard School of Public presented annually at the UniversitY at Biiffalo Health in 1998. Currently, I am the chief medical officer of the Health Services Partnership, a joint venture Robert F. Reed, MD '88, enjoy the great breadth of our practice, including write: "Robert continues obstetrics. I struggle to find time to ride my bike and maybe someday resume training in karate (currently stuck at the management services organization of two community health centers in Boston. We have a large blue belt). Mindy is prospering in her environmental law practice. jacob, age 12, and Rachel, age 16, continue to make tee made up of representatives from each of the immigrant population, and 40 percent of our us proud parents." E-mail is drben826@aol.com. served as assistant professor in obstetrics and patients are uninsured." ing in the clinical and preclinical years, as well as to encourage ongoing teaching excellence. Recipients nomination process, with final input from a commit· David Small, MD '81, on medical leave. My husband, Lawrence Donahue, MD, and I are very busy with our four children, ages ranging from 8 to 14 years old." E-mail address bhd59@aol.com. l tllllt Pbysicin Manlius, Y, General Internal Medicine, writes: "My wife and I have two children, Lee and Brett. I am on staff at Upstate Medical Center." A 11 1 u m 11 2 0 0 I and Karen S. Reed, MD '88, with the Guthrie Clinic in Corning, Y, and is starting an MPH program for occupational health. Karen is in private practice in anesthesiology in Elmira, Y. We have three children: Douglas, age 11, Laura, age 9, and Michael, 5. All keeping busy!" Freda Dreher, MD '89, writes: "As chief of Karin E. Choy, MD '86 Benson Logblin, MD '84 The e-mail address listed integrative medicine at Kaiser Permanente in I'm starting my fourteenth year in indepen- for Karin in the summer Santa Clara, CA, I am 2001 issue of Buffalo Phy- happily combining my dent family medicine sician is incorrect. The practice of physical practice in a suburb in correct address is KECMD 1@aol.com. wife, Ruth, endowed the Siegel Excellence in 44 Rochester, NY. We now have five full-time docs. I �I -- -- --~- - ~-~---~ medicine and rehabilitation with my new skills in medical acupuncture. I will be happy to hear from classmates and UB alumni. E-mail address is , freda.L.dreher@kp.org. ·-- - - 1990s Peter Bloom MD '9D and Gale Burstein MD '90. Gale writes: "Peter and I proudly announce the birth E-mai - -- - - - - - - - - - - of our son, joshua Samuel Bloom, born March II, 2001. josh joins his brother Zachy, who turned three years this past August. Peter is head of GI at the Atlanta VA Hospital and head of the GI fellowship program at Emory University. We both enjoy reading Buffalo Physicia11 classnotes." Pilomena Mufalli Behar, MD '92, writes: " jerry, julie and I are moving back to Buffalo! I will be joining - - - -~ ------- Pediatric Ear, ose and Throat Associates. We are excited to move back to Western ew York and be close to , family and friends. E-mail address is pmbehar@aol.com. Starleen Schaffer, MD '96 Hi everyone! How time flies. I hope you are all doing well. I have a new solo practice in internal medicine in Sebastian, FL, which is a small town on Florida's east coast, Best wishes to you all in medicine and life!" E-mail address is sflmia@aol.com. Thomas R. Cimato, MD/PhD '99, Philadelphia, PA, Internal Medicine, writes: ''I'm completing my internal medicine residency at the University of Pennsylvania, and I'll be starting a cardiology fellowship at johns Hopkins University in 2002." south of Cape Canaveral. "We practice law for your peace of mind." Estate Planning - Personal Injury Real Estate - Matrimonial Elder Law HoGAN & WILLIG, PLLC - - - - - - .\ttorn eyb nt L a w - - - - - - hoganandwillig.com One john james Audubon Parkway • Amherst, New York 14228 • 716.636.7600 A u t umtl 2 00/ l 1 ffa l1 Pbys ici aa 45 �AUTUMN .John D. O'Connor, MD '34 2001 from 1951 to 1968. He was upon to share his expertise, November 1999 in Anchor- a member of the Erie County Friedland was a frequent age, Alaska, where she had lived for 25 years. Medical Society, New York panelist on the television Orchard Park, NY, died on State Medical Society and program "UB Medical Round April23, 2001. He is the Buffalo 08/GYN Society, Table," and as a noted survived by his wife, Anna and was a founding fellow of diagnostician, his advice Crace L. Busch, MD'50 M. (Crostal O'Connor; sons the American College of was sought by patients as Gr ..e Lo , (Busch! Blech cousin of Stockton Kimball, Michael Patrick O'Connor of Obstetrics. Survivors include well as by other physicians. died at her home in Arizona dean of the then-University Silver Spring, MD, and John two sons, N. Joseph of He maintained a private on March 3, 2000. Born in of Buffalo's School of Medi- David O'Connor Jr; daughter, Pendleton, NY, and Daniel practice in Buffalo until he 1916 in Wingham, Ontario, cine from 1946 to 1958- Kathleen O'Connor-Mullen G. of Elma, NY; one daugh- retired in 1993. Friedland is Canada, Busch received her was born in Canton, OH, the (Mark Mullen!; and brother ter, Kathryn M. of Kenmore; survived by a sister, Edith bachelor of science degree son of the late C. Stockton James Kenneth O'Connor of five grandchildren; and one Ross, of Williamsville, NY. from Northwestern Univer- and Helen Harter. In 1949, Port Richie, FL. great-grandson. ohn u. 'Co " , MD, ot Alan C. Ha er, 76, of Lakeland, FL, died on April 19, 2001, at home following an extended illness. Harter-a sity in 1938, after which he received his bachelor's she earned certification as a degree in economics from registered medical technolo- Williams College, after gist in 1939 and worked for which he went on to attend Norman .J. Foit, MD'38 Elmer Friedland, MD'39 WinslowP. Stratemeyer, MD'42, Norman J. Fo1 , MD, who Elme Wins•u P. S atemeyer, several years in the field. medical school at UB, where delivered an estimated founder of Buffalo's first MD, died September 6, She then returned to school, he graduated at the top of 16,000 babies in a long and cancer detection center, 2000, in El Paso, Texas. receiving her master's de- his class. After completing varied medical career, died died on July 4, 2000, in his He was 83. gree from Northwestern Uni- his residency in internal June 8, 2001, in his Williamsville, NY, home Kenmore, NY, home after a after a long illness. He was short illness. He was 87. 90. In 1948, Friedland Born and raised in Buffalo, founded and then directed Richard E. McDowell, MD'43, cDowell, MD, versity in 1949 and her medicine at Dartmouth medical degree from the Medical School, he entered then-University of Buffalo private practice in Lenox, in 1950. She completed her MA, from 1959 to 1965. internship at Michael Reese In 1964, he received a Foit graduated from UB's the cancer detection center Richard E. school of medicine in 1938 that existed for 20 years as died January 17, 2000, after Hospital in Chicago in 1951 NASA-sponsored fellowship and served his internship part of the former E. J. a long illness. Following and her residency in internal at Harvard University, where and residency at Millard Meyer Memorial Hospital. graduation from the then- medicine at the Illinois he earned a master's degree Fillmore Hospital. Upon He also served as medical University of Buffalo, Masonic Hospital in Chicago in public Health. Harter then completing his training, he director of the central cytol- McDowell trained for four in 1952. That same year, joined NASA as chief of opened a private practice on ogy laboratory there in the years at the Mayo Clinic. Busch began her family Launch Site Medical Opera- Delaware Road in Kenmore, 1950s. Following graduation He then moved to Tulsa, medicine practice in Wilmette, tions at Cape Canaveral where he and his wife, Letha from UB's school of medi- Oklahoma, where he prac- IL, where she met and mar- Space Center, and in 1970 Buffum, who was a nurse, cine, Friedland, a Buffalo ticed general surgery at St. ried Dr. Joseph Blech. They was named the center's worked together until her native, entered the Anny John Medical Center for 40 raised their six children in chief of medical services. He death in 1996. Two years Medical Corps during World years. In 1977, he was ap- Wilmette until 1962, when left NASA in 1972 at the end later, he retired. In addition War II and served as chief pointed director of Medical the family moved to Chan- of the Apollo program. An to his private practice, Foit of medicine at a number of Affairs at the medical cen- dler, AI.. They opened up accomplished writer and was an associate attending military hospitals. After the ter, a position he held for their medical practice there, lecturer, Harter was the physician at Millard Fillmore war, in addition to directing 13 years until his retirement with Dr. Blech practicing author of Apollo-Saturn 240 Hospital from 1945 to 1970 the cancer detection center in 1990. McDowell is sur· until death in 1983 and Remembered, a personal vived by his wife, Agnes Busch continuing to practice account of the fire and ex- and an attending physician and the cytology laboratory, at Kenmore Mercy Hospital he was associate clinical Brungardt, and their chil- until 1988, when she retired. plosion of the first manned from 1951 to 1985. He professor of medicine at UB dren: Mrs. Kathryn Million, Busch is survived by her chil- Apollo Space Mission. From helped Dr. Daniel Stedem in and wrote a handbook on Dr. Richard M. McDowell, dren, Gerald Blech, Grace 1971 to 1972, he was pro- the planning for the building history-taking and physical Dr. Jack J McDowell, Marga- Schirard, Michael Blech, fessor of environmental toxi- of Kenmore Mercy Hospital diagnosis that was used for ret Quinlin, and Dr. Thomas Anne Blech and Nancy cology at the Institute of and served as its first chief many years at UB's school S. McDowell. His daughter, Purdy; her sister, Nancy Technology in Melbourne, of obstetrics and gynecology of medicine. Often called Mary Pat McDowell, died in Price; 18 grandchildren and FL, and senior aviation several great grandchildren. 46 Alan C. Harter, MD'55 1 1 11 111 Ph ysici11 A II t II Ill 11 2 0 0 / �I - - ------- -~- ----~~~- ----- -~ -- - - -- ~--- - - --- GET CoNNECTED • • • medical examiner with the son, attended Baldwin- FAA. Harter was then ap· Wallace College in Berea, pointed medical director of OH, where he earned a GE Corporation in Erie, PA, bachelor of science degree a position he held for ten in biology m 1973. He then years prior to his retire· attended the Medical Col- ment. Survivors include his lege of Virginia, where he wife of 20 years, Barbara E. completed a master of sci- Harter; two sons, Charles ence degree in microbiology Harter of Woodbridge, VA, prior to entering UB's doc- and Thomas Harter of toral program in 1978. Fol- 2625 Jamestown, NY; and a lowing graduation from UB, A DJACENT TO S r. J osEPH H osPITAL daughter, Elizabeth R. Smith Josephson went to Milwau· of Erie, PA. kee for a two-year clinical .Jonathan C. O'Brien, MD '90, Mt. Sinai Hospital. He then CARITAS MEDICAL ARTS B UILDING H ARLEM R OAD, C HEEKTOWAGA, NY post-doc in microbiology at served for almost three e years in the public health 25, 2000, at the St. Peter's department of Iowa at the Jon d1 • Hospice in Albany, NY. He University of Iowa Hospitals was 38. Originally from New and Clinics. For the past 13 York City, O'Brien practiced years, Josephson was direc- medicine in Schenectady, tor of microbiology at Rhode NY, at Ellis Hospital. He was Island Hospital and clinical a member of the congrega- assistant professor of tions Beth Abraham Jacob pathology and laboratory and Shomray Torah in AI· medicine at Brown Univer· bany and was very active sity School of Medicine. with Albany's Miamonides Most recently, he had left Hebrew Days School, where the hospital to become vice he chaired the Board of president of research at the Trustees. O'Brien is survived Milkhaus laboratory, Inc. by his wife, Vicky F. O'Brien; In his leisure, Josephson his parents, Joseph T. and enjoyed kayaking, bicycling Joan O'Brien of Albany, NY; and vacationing in Nan- and brothers, Jerald O'Brien tucket. Josephson is of Albany, NY, and James survived by his wife, Jean; O'Brien of Hartford, CT. MARIAN PROFESSIONAL CENTER 515 Asson R oAD, B u FFALO, NY A DJACENT ro M ERCY H osPITAL SETON PROFESSIONAL CENTER 2121 M AIN STREET, B u FFALO, NY A DJACENT TO S ISTERS H osPITAL his son, Christopher, who is a junior at Elmira College; StephenL. .Josephson, PhD'84, family requests that anyone Stepnen Jo epl son died wishing to make a donation 3 and a daughter, Kelly, a senior in high school. The PRIM E LOCATIONS (ALL CONNECTED TO AREA HOSPITALS VIA ENCLOSED WALKWAYS) 0 S uiTES N ow A vAILABLE 1000-5000 S QUARE FEET suddenly from in memory of Dr. Josephson a heart send their gift to the attack on July Barrington United Method- F oR M oRE INFORMATION 716.631.8000 24,2001. ist Church, 230 Washington Originally Road, Barrington, from Buffalo, 02806. 0 CIMINELLI NY, Joseph· Development Company, Inc. 8• s 1es A II I II Ill II 2 0 0 I lu ll a ll Pb ysi c iu 47 �Students' -Response t • nsm BY jASON HOFFMANN, POLITY PRESIDENT s members of the medical community, we are witnesses to disease, pain and death on a regular basis. However, nothing in our training could ever prepare us for the tragedy that occurred on Tuesday, September 11,2001. The student body of the School of Medicine and Biomedical Sciences has been deeply affected by these events. Many of us have close friends or family who have been lost in the tragedy. It is not possible to put into words exactly how we are feeling, but we all carry this pain and anger deep within our hearts and souls. This event has brought the school's student body closer together and has strengthened our desire to become physicians and to work to create a stronger, safer, more humane world. Although students were deeply hurt and angered by the terrorism, they immediately looked for ways to help. For example, an enormous number of medical students gave blood after the attacks. ln addition, Polity, the student government association of the medical school, created a fund-raising drive to help with the disaster relief efforts in New York City and Washington, D. C. More importantly, with the help of Polity, students began to plan events for our medical school community to mourn together and show our solidarity in response to this national tragedy. On Thursday, September 13, a candlelight vigil organized by James itzkorski, Kari Scantlebury, and jason Hoffmann (Class of 2004) was held outside the medical school. The vigil gave our medical students the opportunity to unite and reflect on the week's tragic events. Many people who attended were moved to tears as students, administrators, and local religious leaders spoke about the attack and how it has affected them. At the end of the vigil, as "America, the Beautiful" played in the background, the entire congregation raised their candles high in the air and joined in song. It was a moving conclusion to a beautiful service. A cultural awareness luncheon, lecture and panel discussion was also organized. On September 21, local religious leaders from Muslim, Catholic and Jewish faiths led a discussion about how our nation is responding to the terrorism. The Sikh religion was also represented at the event by two of our medical students, Nirmal Singh (Class of2004 ) and Kamaljot Dhingra (Class of 2003 ). Over ISO students, faculty and staff came together in Butler Auditorium to learn more about what this tragedy means for different religious groups in the United States and around the world. The students would like to thank Khalid Qazi, MD, who was the keynote speaker at the event, as well as Rabbi Gary Pokras and Father jack Led won, who also served on the panel. 4D Dr. Khalid Qazi, top, was keynote speaker at the Cultural Awareness program; seated to his right is Rabbi Cary Pokras. Bottom, left to ritflt, are Kamaljot Dhingra, Class of 2003, and Nirmal K. Singh, Class of 2004, who talked about the Sikh religion; center is Same era Fazili, contributing to the discussion; and right is Garrett Zoeller, both Class of 2005. 48 lulfal e H ysicin A II I II Ill II 2 0 0 I �Anesthesia inhaler, circa 1908, designed by Dr. Louis Dmbredanne, French surgeon 11871-19561. The instrument is one of two new additions to the Edgar R. McGuire Historical Medical Instrument Collection, housed in the Robert L. Brown History of Medicine Collection, Health Sciences library, Abbott Hall, on University at Buffalo's South Campus. The apparatus consists of a face mask with rings attached for the thumbs of the person administering the ether and a round chamber with a control knob on one side and a rebreathing bag on the other. Ether was poured into a sponge in the chamber through the opening in the top and was administered to the patient. �p H A R M A c 0 p 0 E I A UB's HISTORY 0 F ~f ED I C I ~ E COLLECTIO~ PRESE~TS PHARMACOPOEIA Digita l ly reproduced prints from a pharmacopoeia by Otto Karl Berg (r815 - 1866) were on display last fall in University at Buffa lo's Health Sciences Library (HSL), South Campus. The botanical show was developed by the HSL and the university's iMedia staff and is the first in a series of "Art in the Library" exhibits intended to promote the History of Medicine Collection through the display and sale of reproductions of selected works. Fred Kwiecien and Don Trainor of iMedia prepared the prints from the original art in the Berg volume, pub lished in Leipzig in I 863. P ictured is A!JmtKa Jragrarn ( utmeg). BP ()110 I 112. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 2001 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2001-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v36n02-2001-Autumn Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo physician and biomedical scientist Buffalo medical review Table Of Contents A list of subunits of the resource. Medical Education for Life Medical School Sure Hands Teach Hands·On Medicine Research Alumni Student column Development Classnotes Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v36n02 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Rights Holder A person or organization owning or managing rights over the resource. Copyright 2001 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/2106dddf637bbc3a46317db8d70fc66d.pdf f3380649633eeabb909cc072d4e7ab38 PDF Text Text y I C I SchoI ofMedi cineandBiomedical Sciences , University at uflalo �luffala Physician \ ! CF. PR£ . 1 l>E I\ ~ R In T IOR \I)\ ~, er. ME T Je1111ifer,\lcl)o11011glr D I RF CTO R 0 1 ~ r w s.F R\ I E­ Ar//111r Page DI Rf CTO Dear Alun1ni nd Friend or R . Ill' l\ '111 •tc/1a EDI TO R P E RI OD I .\1epl11111it· A . Unga the past few years, we have seen many noted," i hanges at the mcdi al chool. A _aul AJinsky A Rr DIR ECT OR & D E I G . Alan J. Ke.,;:/er1111dD111·idJ. Riley hange m ans mO\·ement. Movement means friction." For tho e who cra\·e Mabil­ these have been painful times. "The patient is stable" can mean that we have triumphed D 10 Karen l ic/111a over illness; however, a dead patient i · also stable, and th,11' not where we want to be. The changes we have made arc not random. ~!any have targeted areas where year of student feedback have told us that our pcrforman c is not optimal. I am frequently asked how we C.o - rR G \\ RITERS I B UT I Lois B11ka <1111/ Ell,·11Goldbaum '- Coo RDl"ATOR Cyntlria Tod,I -Flick PR O D UC.TIO know that change will actually impro\·e our situation. How do we kn w that the friction of change is polishing a gem and not grinding years of tr,1dition into NI\ E R 1n a pile of rubble? In reality, we annot guarantee that every hangc will S C H OOL have a positive outcome. But we do know that if we are not willing to 8! 0 8 ~T O f l f ~LO \! E DI tF DICAL l '- E : c iE, C ES Dr. ,\ltlrF,t1rt·t P11rosk1, /11teri111De1111 change, we will never improve. In rea ing the quality of our school and the education we offer our students is the mission that guides us. Our accrediting bodies the Liaison lion (LC 1E) and the American (A GMF)-are tD ommittee for Medical Edu a­ ollege for raduatc Medi al Education not content with the statu quo. Both have visited our s hoof in the p,1,t year and they liked the changes they sJ\\". a re ult, we re eived one of the first eight-year accreditations from the I. ,\IE and a full five-year accreditation from the ACGi\tE. However, we cannot rest on our laureL . .\s Will Rogers pointed out, even "if you're on the right tra k, you'll get run over if mu iust ,it there." IT O RI L B O AR D Dr. }Q/rn Botlki11 Dr. Harold Brodr Dr. I i11d11/. Corda Dr: /<1111 ,es K1111ski _ , 006 Br11111 , e11b1111er,Clt1.,s "f Dr . Elizabeth Olm ud Ro;, Dr . /t1111esR. O/s011 Dr. 1t·p/1en pa11ldi11g Dr. Brn,tley T. Tr11a, Dr. Frt111kl111 L,·pfo.,·itz lthough our new curriculum is only two year old, w have already made nu­ TEAC merou. changes and have done a lot of fine-tuning. With change comes the responsibility of determining whether we have achieved the desired outcome. We all agree that we want an educational cxpcrien e that re ults 111"better do tors," but we need to agree on a definition of"bettcr." n e\'en more difficult task 1. try­ ing to find a way to measure "better.". ome outcomes, such a. s ores on the 'nited Medical Licensing Exam (U ILL), are casilv qu,mtified. late, \\ h1le u h a standardized mt·asurcment b tatisti ally pleasing, it may not be our best indi ator and it crtainly does not en ompa s man)· of the qualitie our patients While I do not \,ant to diminbh the import,rncc of ,1ch1e\'ement on tandardizcd te. ts, a multiple choice ex,1111probably won't be the best measure of a curriculum that seeks to ~timulatc ,1e1ivelearning, analrtical thinking ,rnd lifelong disco\'ery. How do we measure these cognitive skills in the long term? How do we mea ure noncognitive attributes such as ,kills and professionalism? I would ask cath of you to reflect on what you rnmider to be the attributes of a "g od do tor" and how these attnbut O Ho. PIT A!. C,.,.,,., \ ,.t.'terans Affuin l\"r .(trrr~ . ·di'1l Ne" ' rork H,•altl1wr< >· K HEID.4 I H EALTII: The Buffalo G,·11eml Hospira . 1 T/1< · Wo111,·11a11<iClri/,lre11's Ho;p,111 of Bufjalo . . 1 .\fil/ar,/ F,llmorr (,<11,· , Ho,p•ta . 1 11111Ho>/'''" .\Ii/lard F1ll111orr\11/111rl onsidcr important. How many of you knm \,hat your personal ph)·si i,rn g ton the board ? I. that how you cho. e vour donor? comp,w,ion, good communication II I Erie County ,\frrlmrl Roswell Park C,wc.-r /r1,till•I< ' scan be measured. Pica c hare vour thoughts \,ith me (paroski " buffalo.edu) ,md help u shape the medi al education that \\'ill produce the kind of physician you want to take care of you and vour family! C HHOIIC Nia .~arJJl-,1/h \ltmoriul .\letlirnl C,•111t·r © unm1nn 1111u1. 111nm IIIYIISltlII 11!Ill Leners totheEditor Hut alo 1'11) s,,mn , puhh h«.l 4uJn rl> b the l "" er 11\ JI Butfal<• \ ,houl of. lcJ1unc and l11om,J1,al St.i~nu•~ m lOOp\.'r.ltlllll \\Ith L ni\a , it, I cttl·" /\I RCARET PARO.Kl. \f D 80, \l\f\l Interim Dean, c/1001of 1edicrne anti Biomedical /111erim Vice Preside11t for Health Affairs J-iEHT/1 \ 1,TE •I: \ltr <)' flra/1/1 \ys1t111 S,slers of U111ril)lfo .,p11t1I cie11ces ( ommu011..3tHHh. lo the Editor.ire'"-'11i.ornt nd ,an he cnl c u Ruf/,1/,,Pin'' '"~ HO< mil llall. lJnl\er"t Jl l!ultJJ,,, lluttalo. !'J'I l 121>0; or n1 c marl 1'' bp-no1c, bull.1!0.cdu. I ckrh (716) M, 5000. <xi, J 1~7. 1• 11< f, 1 '::i. lh · tall rc,cnc, 1h,· ngh111 all uhnmS1011tor dJrityJn.l ""~ 8 .,ffalo University at of. ,.., fork TI1c tale l 11n-(1'SIO I �\' 0 LU \I E '-I U M B E R 38. 0 p y H s C N A Features I New Vision ofCollaboration Plan for the Buffalo iagara Medical ampu take hap , effecting chang in biom dical education at UB BY COTT THO IA InStep withMedical Milestones 1 Ralph Behling, MD '43, look back on a car er of medical "fir t " BY COTTTHOMA Take Note Per onal digital a i tant enter m dical chool , giving tudent a new tool with which to learn BY '!COLE PER. DOTTO JaniceSunrceleratesrraduatin uywithherfather. Jo nSung.FormreontheUISchol 26. ofMedicine ndIi edicalSciences· 157thco mencement t rntopace C0\£1 DEPICTS Tiff LIFE Sc.;U~Cf<,;, ,1ro1c.,L CA,,,u~ .Medical School 1 'ipnng Clinical Day and alumni achic,·cment awards 18Match Da) 2003 listing 24 appuccino and .-chmitt, a well-matched couple 26 ,raduation celebration! Reseatc 23 Record high in rc,earch funding at UB 28 Piero Bianco uses laser tweeters to film double helix a, it unwinds Pathw s Reunion Weeend 32 l:li,abcth 39 Reunion Olmsted Ross rc,eives honoral") doctorate 33 icgel awards 37 · owak direct, scientific planningat UB Center in Bioinformati , Weekend 2003 photo collage-a time for old friend, and classm,1te, to reunite and reminisce about their medical school years COMPLE\ TO IE h, ..cr ,ao\ioro Classnotes 4-4:-.ew. from rour B da,-mates and other alumni 48 In memoriam: Daniel Ko,era, \\'illard Fi,chcr, fJne Freiberg, Jeffrey Perchick BUii r 0~ ,, IHC Tl-If: n1G11 Tom hontcra, Cl,1" of 2003, honored a, this year\ Jame, Platt \\'hitc - cholar BtHf.\10 ...L. l.\GJ\IA BurrALo. '.\'ii �• • new of collaboration The Buffalo Niagara Medical Campus 2 1111111 nyslci11 \ ' , ,, 0 0 ! �O i a boxy, andmember represent it: founding in titution , each COTT colored kybridge that takes pede triam, from THOM of whi h pays due. to belong to the organization Ro well Park ancer Institute north to Buffalo and so ha ave ted intt:rest in ensuring the uccess­ ful out ome of the new pr ject. The \"i ion of the ~ uncl­ General Ho pita!. There is omethingabout thi bridge that is perhap emblemati of the Buffalo medical ing in titution is to improve the overall environment of community's long truggle to find ornmon ground: head­ the campus and its infrastru ture in order to make it an ing north, it go s uphill. appealing pla e for people to eek are, provide are, Indeed, in the past, it ha been an uphill battl to bring onduct ba i and clinical re ear h, and teach and train together the element of them dical mmunity: hospital health- are pr fc ional . administrator , health-care providrr , researchers and While the concept of the B '~l a· a cohcsi\·e, inte­ medi al educator . But not far from thi uperimp . ed grated entitv ma} be new, the itc itself ha long been a walkway, a ne\, vi ion of collaboration i · taking hape in hub i r health are and biomedical education and re­ the heart of the ity. sear h in Buffalo. In fact, it wa at the corner of, 1ain and In April 2001, leader of the ni\'er ity at Buffalo, Virginia-the \'Cry heart of the pre ent-day ,ampus-that Roswell Park ancer In titutc, Hauptman-Woodward the UB hool of medi ine was fir. t built in J849. Kaleida Medical Research Institute, Kalcida Health y tern and Health'· Buffalo General Hospital, as well as Ro well Park Buffalo Medical roup Foundation announced the laun h ,rncer Institute, al o ha\'e b en located on the site for the of the Buffalo I iagara ~ledical ampus (B M ). better part of a centul'). Hauptman-Woodward ~ledical Re ·earLh Institute was e tablished on High treet in 1956. The \'enture i being undertaken in partner hip with In 19 5, Herbert A. Hauptman, PhD, the current president the city and ounty, a well as with neighborhoods ur­ of the institute, received the 1 'obel Prize in Chemistry for rounding the campu ·, which, in previou · year , had been a mathematical te hnique he de\'eloped to determine the informally referred to a the High treet 11edi al orridor. stru ture of biological molecule . The B, M i admini tered by a board of director whose .'-iummt'r 20U~ l1ff1l1 Hysicill 3 �lso located on the present-day campus arc the Buffalo ~ledical Group (the city\ largest consortium of practitio ners) and the lJB Research Institute on Addi tion . I ate this summer or early fall, com tru tion will begin at the 8. 1~1 on a modernistiL three -buildmg complex (see cover). The new 400,000-square-foot complex, ched uled for completion in two to three ·ears, will comprise the followmg interconnected buildings: The new home for the B enter of Excellence in Bioinformati s, a four-story, 129,000-square -foot build­ ing to be lolated at the wrner of l:llicott ,lnd Virginia Streets (currently the center b operating in temp rarr headquarters nearby at 90 I Washington Street) Roswell Park ancer I nstitute's new Center for Genetics and Pharmacology The new headquarters for the I lauptman-\Vood, ard ~fcdical Rese,1rch Institute (connected br skybridge). The three buildings will have more than 22,000 qua re feet of common space, including conference rooms, meet­ ing area . , auditoriums, a court}ard and lobby space. Io cated throughout the complex will be kitchen preparation rooms for catering; there, ill also be a food kio k where people from ,1IIthree institutions can dine in onjunction with seminars and classes, or meet informally for coffee rlum.h. rhere will also be 27,000 square feet of shared labora ­ tory space, where facilities and sen ices will be avai lable for "ientifiL staff from the three inslltutions. This in­ dudes five shared laboratories in Ros, ell Park's build ­ ing, four in ' B's building, and four in the I lauptman ­ Wooth~ard building. But the BN 1 is not just about buildings. What is being em ·isioned for the medical Lampus is a total environ ­ ment, with features including green pace and "pocket parks," fountains, special lighting and signs. The intent, planner sar, i to ·reate "an integrated place for living, '"orking and learning"-.1 place where workers, patients and ordinary cit11ens will want to spend some time. An Assetto the Region and its chool of Medicine and Biomedical cienccs are kev player in the proje t, which univers1t} officials sa} will benefit mediLallbiomedi al cdurntion as well as Buffalo's economy. 4 1 1 111 11 P•rsici11 II ,u Ill t• r 2 0 0 1 "Our . ense is that we need a stronger con entration of clinical a ti\'ity and clini al facult} than ha been there, " . ays ·s pre . ident William R. Greiner. "\ e need central places where faculty an be together. We need to rebuild a facull) culture on the linical ide of the medical school." The medical campus, he says, will reate opportunities for medical school profes ·ors, clinicians, students and re­ earchers to collaborate, compare notes--cven JU t have a cup of coffee and to s around ideas. S,1ys reincr: "There's nothing like face-t face." The univer ity will have a trong pre~ence on the B, ' MC this summer and earl}' fall, a construction on the new home for the L:B enterofl:xcellence in Bioinformatics begim. At this state -of-the -art focilil)•, researchers will use the uni ­ versity's massive ·uper mputing power to ondult ana ­ l)'tiLal work on genes and their protein produi:ts in hope of developing more sophistilated di,1gno tit: device , as well ,ts targeted drugs. " B has to be a major plarer in anrthing inrnlved with health, mediline and science in Buffalo, " says l-linbcth D. apaldi, UB provost. • he s,1r the univer it) anti ipates making "an appreciable economic impact" on the Buffalo community as a result of work conducted at the Center of Excellence in Bioinformatics. �The life-:cience indw,try based on work of the center will include the development of soft\\·are, di,1gn , tic te t , medical devices, therapeutic., bioinformat1 s services and genomics - and proteomics-based busine . se . ' urrcntlv, the fore asted demand for . uch prodults 1 formidable: The market for information-technology products in the lifeiences e tor alone i e timated to be -B billion by 2004. The biopharma euu al and biode\ice industrie are expect ­ ed to ontinue to grow at approximately ix percent an­ nually and to have worldwide annual ale in exces of -100billion by 2004, a wdl. Thi demand, ac ording to apaldi, ha the potential to translate work at the Center of Excellence into thou­ . ands of well-paying Jobs 111 Buffa! , ranging from com­ puter -support and lab ratory technicians to medical informatiLs and re:earch s ientists. Impacton MedicalEducation may be just a dra ­ matic, ay Margaret Paroski, MD, interim dean of the VB School of ~ledi ine and Biomedical ciences and interim vice pre ident for health affairs: " ne of the main prob­ lems that we have is that, unlike a lot of other medical schools that own a univer ity hospital, our tudents are trained in nine different hospital . n e you ·tart frag ­ menting and di ·persing people, you don 't have the orri ­ dor conversation and the type of collegiality that rou have when people are all in one pla e. There' an inherent ineffi ien y to it." The B ' f\.l , she ar, mjtigates such problems by creating opportunities for that collegialit}. f\.lany variable remain a the project begins to de, elop, Paroski say . \\'hat shape UB\ medical education will take in the future " i going to depend on what the campus real!) e,•olve into," he obsen •es. "\ e have 280 student doing a clinical rotati n at any one time. The) need expo ure to a whole range of fields: urgery, medicine, obstetri , ped­ iatrics, p rchiatry and a variety of ubspe ialties. [The medical campus ] be omes a focus fi.u a . ubgroup of ser ­ vices. It offer ' great po tential for resear h, for pecialt} · servi es and as an academic think tank." One possibilitv the medical chool is considering, she explains, is an ambufatory ,are center on the medical campu ·. uch a facilit,, he ays, would sen ·e inner-CH} residents who don't have cars to drive to the suburb for medi al are , as well a other city residents who imply prefer t seek treatment closer to home. And a. the detaih of the medical campus e\'olve, he ay. , UB will c ntinue to pla} the role of the ,·isionary motivated by intere ·t. other than profit. "The unher ity has the advantage f . en ·ing as the noncompetitive um ­ brella, as the coordinator f service with a f, cu . on regional need . rather than just the bottom line," she add . "We don't pretend to be the people calling all the hots. We can step back and look at all the parties and try to help coordinate their intere t . " For example . CB is providing a lot of the faculty who are driving the a ademic research piece of the project. B ha . a e, s to information and input from man}· sour e , o the \ •alue added ' that we bring to the table as an en tit}' that has it foot in e\'ery camp 1sthat we are in a good po . ition to appreciate \\'here everyone 1s coming from. " s for the medical campus's e onomic a. pects-its hoped -fi r role as a ataly t for th economic resurgence of Buffalo-Paroski is pragmati . "The better hape the city is in, the easier it is for us to attra l quality student and qualit) faculty," she says. ''L'B i a major player in the Western e,,· \ ork area, so we're obviou . I · intere ted in the health of the city. " But I think the medi al school look at thi . project from an educational and regional health-care per pective 11mmrr 200J 1 111111 nrsici11 5 �rather than from strictly a business perspective. The idea of being able to pull together the infrastructure to let groups work together is trcmendou Iv helpful." Thomas R. Bee her Jr., ,1 Buffalo attorney and inn'.st­ ment advisor, erves ,is volunteer chair of the nonprofit organization that i overseeing the B r-.1.. He say that identifying ne ,v way of, orking together has been kc> to the planning pr e s. For example, Bee1..herpoints to the proximity of Ros­ well Park ancer In titute to Buffalo General I lospital, institutions that require mu h specialized equipment and s ould sal'e mone} b~ sharing . me of it. Likewise, he point out that patients with can er often have other gen­ eral medical problems, o it make sense to faciliate their a e s to Buffalo ener,11. Bee her .ind others have seen how this kind of integra­ tion an work at such facilities as Longw d ~ledical enter in Bo ton. For one thing, he say , "the interplay between the ientish and the lini ians is ,·el) powerful. Even something as simple as a ommon meeting spa e, where people an share idea , i, l'Cry important." Memberof the "FruitBelt'' Neighborhood working to ensure g d relations with the medical ampu 's ncighb rs in Buffalo's "huit Belt" ection, holding publi information e · ions and making u h goodwill gestures as sponsoring a pring clean-up project. Repre. cn­ tati,·e from the I ru11 Belt and llc11to1 n neighborhood ,uc included on the planning committee for the medical campus. "For the project to be ucce ··ful, it re­ .illy h uld not have border. at all," empha izes Beecher. " mong other thing·, we "ant the Buffalo 'iagara ~1cdical ampus to provide jobs and health care for the neighborhood' re ident ." Indeed, one key to the mcdi al campus's u ce · will be the degree to I hich it encourage· the people who vi it and work there to explore the surrounding cit} .1 oward that end, Ike her ays, planner hope to ha,·e the '1agara Frontier 6 l 1fl a l 1 Pl ysiciu ~14mmt•r 100l Tran portation Authority reconfigure the Allen-Ho pital tation of the Metro Rail so that lien treet-whi h n I\ dead-end at .\lain treet, in front of the tation--can continue east toward the medi al campll5. ( step in that direction was re ently taken , hen the authori agreed to change the station's name to "Allen-.\ledical C.impu .. ") At the ven least, the reconfiguration of the talion should en ourage people Lo make the short walk across ;,,\ain Street and p,llronize the businesses on Allen, in the city's arts) Allentown di. trict. "1 here ha. been inspiration and leadership for the project from the universit} and the med ital chool," Bee her say . "Bill Greiner has been ver) intere ted in ollaborating a ro s instituti n , and now Dr. Paroski, as well. They already had a very. ignificant inve tment in people there. The) could see the benefit, from the univer ity 's perspective, of ha,·ing a presence." Amy .\1. chmit, the medical ampus\ project man­ ager, notes the "tremendous philanthropic . upport" for the project, in addition to inve tment br the component institutions ,llld the ity, count and tate. That charitable support, she ay , ha in luded a ·4.- million grant from the Margaret L. Wendt Foundation and 10.5 million from the John R. ishei Foundation. "There's public and private support that\ really going to ha,e a trcmendom effect on the economy of the region," chmit says. "These institutions, through their operation at the B,' 1 , generate over 600 million in annual e:,.pend1tures. \\. hat we're seeing here I the confluen e of a lot of good things." nother good thing hmit ha en ountcred while working to educate people about the B, '.\I is how the proje t is resonating in a ery p itive wa · with alumni of B's school of medi ine. "\Ve had a di pla) booth for the B 't-.1 at pring linical D,iy," he recounts. "It \\JS amazing to me the number of alumni who came up to our table and stopped to look at the map and to tell me uch thing a 'fifty year ago when I wa a tudent thi. i where I lived, this is where my las e were,' or 'I'd go down thi street to the ho pita!.' "I wa tou,hed to see how many people in the pring linical Day audience had ven• di 1111 tive memorie · of this geography and were really. enjoying the notion of it being brought back to life." 4D �Spring Clinical Day 2003 ScientificProgram program began with a briefoven-iewofthe Buffalo iagara Medical Campus by Matthew K. Enstice, a ociate director for campus development ( ·ee related tory on page 2). Following this pre entation, Martin Brecher, MD '72, program chair, introduced the day'· ·cientific peaker , as follow· : Roh it " Rob" Bakshi, MD '91, asso­ C1,te professor ol neurologr in the L n1versity at Buffalo 1..hool of ,\kdu ..1nc and R1omedical '-1..1ences, founding director of the Buffalo euroim,1ging naly i. C.enter and a BAK,111 neuroimager in the Jacobs 'eurological Institute, Kalcida Health's Buffalo General I lo pita!. Bakshi ·poke on "Brain i\lRI in the Bioinformatics Era." Robert Genco, DD , PhD, ·c Y Distinguished Professor of Oral Biology and. licrobiolog~ in the University at Buffalo School of Dental :--.kdi­ unc and vice provost of the B Office of cicnce, Technology Transfer and Economi .. Outrc,1 h. C,enco spoke on the "Role of Infection and lntlamma tion in CardiO\·ascular Disease." Medical Alumni Achievement Awards Bruce Holm, Ph D, professor of pediat­ rics, gynecology and obstetrics ,rnd phar­ macolog~ and toxi­ cology in the UB HOLM -.:hool of ~kdicinc and Biomedical cienccs, and scnior \·ice prm·ost at LB. Ho lm spoke on "Discovery­ Based Medicine in Buffalo." sentations, the audience had an opportunity to ask questions of a panel made up of the spc,ikt:rs, after which Jcffre) ·1eoL~1cK kolnic k, PhD, director of the B Center of Excclkm:e in Bioinformatics, deli\'ered the 5tod,­ ton Kimball Lecture. Fol!owmg the lecture, titled "Predi tion of Pro tein • tructure and fundion of the Human Genome," PatnC1a Duffncr, .\11) ·~2, pre. ented 'ikolnick with the to~kton Kimb,i!I \ward on bchalt of the B .\lcdical lumni ,\ ,o.:iation. The program concluded 1\·ith th(' pre,cntation of the 2003 :-.tcdi­ cal Alun ni Achic\'ement ,\\,ard,. Following graduation from med, ..al s hool, Portin interned in Florida, re turning to Buffalo for a urg1 .11re,i ­ den.. at the E. J. 1e, er Ho pit al no" nter . fter Erie ounn • I dical ~ompl ting re id n , train mg in I 959, he spent a car in J olore t,11prel.cp­ t r hip, beLommg u:rtificd in general urger. in 1960and in col n and r eta I urg r. m I 961. t B Portin ro e to th rank of dim al pro~ or of in 1983, a rank he ull hold 19 4-94, h crved a diredor I I fa ult, urgcry . From of th 111111, nysici11 1 �re~1den pro r.1m m lolore(tal sur gery; and from 1996 01. he ,cned a J i tant dean at the medi al '"-hool. Portm wa an • ttending surgeon at I >ca unc , Buffalo (,cncr.1I ,md i tcr Ho pitab. \t ister,, he en­ d • , prc,1dent of the medical st,1ff and a a member of the board nl di re tor . ationall , he en ed a, pr idrnt of the \meri-.rn 1"- ictv of olon and Re tal urgeon and I>rl' 1dent of thr meri"-an Board of olon ,md Rectal urger , rcrn.1m ing on the b .ml , ., enior e am itH'r until 1995. He repre ented urgcon • t the \ G 1E, the I .ind the \merkan ( ollegc of urg on , \\ here he n ed on the (Jraduate F.duLation <.ommittee. ( urrentl , l'ortin is a medical LO ordinator in the t )ffi1..cof Prok sion,1I ~ledi al C ondull .rnd th 'c\, \ork late I cpartment ot H alth. Sin--c 1997, he ha n d on th board of dire tors of th atholi llc,1lth t m and i ,1m mherol thee crnti, e rnrmrnttee and Lhair ol the bo.1rd of dir tor of the atholi I lealth }stem ll ime I le,1hh are Board. I olll•\\ ing graduation, Ziui rr,l i, ni .in appointm nt .1 a full time ,11tcnd ing ph rc.i.rn in medi in (...udiol­ og, ,11f..J. 1e, r lcmonal Ho pita) led Kai (enter),. 8 \11mmrr JOO~ position hc wntinue, to hold. In ad­ dition, h , rvnL1, dir1..·tor of dini1..al ardiolog} at the mrd1rnl enter from 1969 76, and again from 1991 to the prl' ent. I'll h.1 also held ,ariou fa ult appointments at thc B d10ol of.\lt:diLinc,111d Biom ·dk,11 1..11..•n c, whl.:'rchi.:' ontinu ·, to t1..•.11.;h. I or Zizzi, a high point in hi a­ reer 1..,11111.:' in thl.:' mid 1961h, "hen Pre ident I }ndon Johnson dedared J "' r" on hrart d1 <.'ae, troke and 1..an1..er.\\ ith the ne\\l} av,1il,1bk fund , Zizzi c.h, ired a rnmmittec that e,t,1hli,hed a < oron.irr ( ar1..•s hool for the 1r.1ining of nurse and para1111..'di1.., in the,r ficld .. I ht' training and It', d1ing of nurses \, a sub e qu nth ab orbed b} the l; B Lhool ol 'ur ing, and lhl p.1ramcd1 pro gram "a, ahsorhcd b, Eric ( om. rnunit ( ollt•g . Ziui ,1lso ,cn ed a, a, i t,rnt medial dir tor of H I<. and upcni d the mm l' from th<.'old mori,11 I lo pit.ii to the nc\~ f 1978. I h1..•log1stkal t~ k wa, a ,orn pli,heJ \\ ithout inident in one da · \\hile m,1intaining a full taffed cm r­ gcn, room during the ntire mlne. Zizz1's profe sional a ,odation, indud1..· ,cni(l a l1zz1 pre id1..•nt to thl.:' \\' 'Y o,iet ' of Internal M didne, \\. 'Y He,1rt \ o iation,and ~lcd1 • J­ ret,1n of th \\ Y Sodet 'of Internal 1cd- 'tS tlLil'tY 1L1n and a dire torofthe, of Int rnal lcdicine, a ,,di a Indl.:'­ pcndent Health. Ztzzi b • me a L>ip­ lomate of the mcri1..an Dcleg.1tc for the Hou e of Delegate , ~lcdi .1I o i et} ol , Y , in addition to holtling numcrnu other member hip . In addition to re ei, ing a B MediLal \lumm .:hit.'\ement \\ard this year, 11kh, medical director for the< .enter for Ho,pi1..e and P.1lliatl\e <.m in Buffalo, \,a hon rl.:'d by th LB \lumni \ od.ition, \\ h1 h I re ented him "ith it < ,mmunit} I .idcr hip \\,,ud at it ,rnnual clebrati lll of I ullenl..C.'l>inna, h Id on April 4. The award i gi,en "in re ogni­ llon of ,ind appre iation for out­ tanding contribution, to tht uni\ er­ it, communit ,er an e tcnded period of time or for a ingle, trul) rem,ukablc 1..,ireer." fter gr, duating from medkal Lhool, . likh Lomplcted hi, int rn­ hip and rt,idtn yin general sur 'Cl) at the Buffalo (,enaal l lo pita!, thl.:'n n d for t\,o ,ear a a urg on (IC DR) at 1hc l'nitcd tatc • a,al H pita! in Quant, o, \ irginia. In 1975, Mikh began ,rnrking in the prhatc pr,1uiu• of general .md ,a 1..ular urg1..'f')at the Buffalo 1cdi.,I <,roup. In 197/l, heh 1..,1m1..• the ftr I medi'-al diredor of I lo pk1..• Buffalo, a , oluntccr po,itil n he held until 19 4. in e 19 0 he ha been the dire tor ol th P.11liati, .ire l nit of the Buffalo (,eneral Ho pita), and in 1997 bee.am the dire tor of thr Pal- �liati\l.: Care ( onsultation <.:r.iu? of th K.ilrida lkalth tem. In 1993 h<.:left prirnte pradile to bclomc the mcdi al dire tor for the ( enter for H pi and Palliathe .ire. likh has had a falUlt) appoint­ llll'llt at thl· UB ,hool of ~kJiline .ind Biomedi al 1en e inle 1975, and he lUrrently holds th<.:ranks of profc or of dini­ l al urger and adjunl"t a . Oli,lte linkal professor offamil) medi ine. He hold, nu merou tealhing , ,,.ud and other it,llion , 111 luding: The Lifetime chie\l'lllcnt ,\ward from ( hildren', Ho. pi e lntern,1tional (l 99~ ), fhe Chandra )ut tanding < lini.:al Te,1 ·her Award from the lJB l>epart­ m ntof urgery(in 19,9and 1991), and th Robert •. Berk on 1emorial ward for , oluntcer facult • l' lei len in tea hing. Fcllm, of the merilan oil ge of urgcon , tikh er. e on the Pal­ liati, e C.ue Consensu uidclines Pan I of the 'ational anlerCenter 'ct,,ork, the Ethi ( ommittce of the Kai ida I lcalth ) stem ,rnd the E:.ri Counl\ 1 d1 al olit't). He \\,1 a founding offi er of the , c,, \ ork tat Canler .111dAID Pain lnitiati,e ,rnd i o hair of the ational urg1cal Palliative ar \\ orkgroup of th Robert \\ ood John on lmpro"ing are at the End of-Life Initiati\e. RobertE.Kaplan , MD'81 HEROBERI .BI::.RK0 1·,110,~lemorialAward in the rt of 0tlcdicine i - presented annuallv to a member of the \ olunteer facultv to hon;r the Dr. Berk on, value and ideal epitomized who,, as an e teemed family phy ician in Buffalo. Patient care was his forte; competence, compas ion, patience and dedication to teaching were his virtues. Hi pecial e.·pcrti e in the "art of mediune" i pt:r petuated in this award. b;· This rear ' award \\as present d to Robert E. K. plan , MD ',' I , b · Patricia K. Duffnrr,, ID ' 72, pre idcnt of thc UB ~kdical Alumn i A so<"ia­ llon , on pril 26 at Spring lini al D,n·. followmg graduation from thr nivcrsi ty at Buffalo School of , kJ11.ine and Bio1mdic, l c1cnces, Kaplan trained m pediatric. ,ll the hildren ' Ho pita) ofRuffalo (CHOB ). He then entered a fcllow hip at CHOB in hild neurologv for thret· war, during whid1 time he wrote an important article :;n benign fa;nili, 1; neonata l/infantile eizure , accordmg to Duffncr . " Boh ,,a ,lll out landing hil<l ncurologv re idtnt," he e plamrd, "hut when he completed his fellowship, he decided that ht' ,rnnted to return to hi fir t low , primarr pl·Jiatric and , ince that tim , has bcen m ,1Ctne prhatc pral"tice a a mrmberofthe Buffalo Pediatric i\ssoc1,1tes." '[ hroughout thc yrar , Kaplan ha wntinucd hi interest in r<.:earch , and currentl y he is wnducting a tud on ,cnous throrn ­ boembolism prophyl axis using elcctrllal stimulation . He ha, ho ,, ritten a paper , publi hed in Prduitric:, on telephone tre,ltment for ret urrcnt nursemaid ' clbm ·, and ha ,, ritten a hook, titled Parent ' Emcrgencr .\fedzcnlG111d c. ".\lost important, howe, er, and th<.:re,1son he wa <..hosenfor this p C.E 17 11mmer ZOOJ 1111,11 Plpiclu 9 �Ralph Behling, MD '43, looks back at a career of "firsts" ----------- ,,,__ In Ste ________. If anyon had told him back th n that hi childhood and youn to be notabl dventure It ju t didn't em "fountaineer''-a adulthood wer , Ralph T. B hlin , MD '43, would hav II that unusu I, he demurred. y , to work 14 hours I kefront dance hall n sod j rk-at destined day in the umm r r Buff lo, th n spend th chool ye r in South Florida. Plowin through omethin Admini on chool in thr e ye rs in t medical did; there was tering th ju t war on, you know. fir t injection available, and syphilis was wid And introducing th d of four? That wa of nicillin pr ad. It didn't Pap t Th In Buffalo? m momentous dru wa newly at the time. t to th western Un"ted State ? W I , if h h patho ogists into o'ng to d getting th ju wh r uired. If ever a career intersected with medical milestones of the mid-20th century, it was Behling's, even if it didn't seem remarkable to him at the time. Today, however, when one asks Behling about his early years in medicine, a new perspective arises-one that recasts his then-mundane historic proportions that he only now finds worthy of recounting. experiences into But first, the soda-jerk years. Behling's H parents ran Hamburg-on-the-Lake, a dance hall on Lake Erie south of Buffalo. During the summers, he worked there from 1 O in the morning until 2 the next morning, concocting "milkshakes with eggs and malt and whatnot" for the city dwellers who came to the resort to kick up their heels. "We'd sit around and listen to the bands from Chicago on the radio-Jimmy Dorsey, Tommy Dorsey, Shep Fields. Next morning I'd get up and start washing dishes," he says. 10 1,11a1, nysiciae \ummt't 2001 ��He also cut the lawn nee a week-four acres' worth. And a the per n re pon ibl for taking out the trash, he learned to loathe watermelon (a trash an full of watermelon rinds is a heavy one). "I al o learned to hate hard­ boiled eggs," he ays. "If you'd picked up a· many egg.hell a I did, vou'd learn to feel the ·ame way." But health concern made the future do tor un­ able to endure\ e tern I ew York' tough winter . "My father and I were both ickly," Behling recalls. "He had a thma, and I wa · a puny kid." oat the end of each i.ummcr, the family pi ked up and moved to Lake \'l'orth, Florida. The seed of an interest in medi inc were planted when Behling\ parent· bought a Buffalo drug tore and he went to the niversity of Buffalo's pharmacy school-then an undergraduate pro­ gram- o he c uld \ ork in the tore. \ ith a ba helor' degree in pharmacy, he launched right into UB's medi al school in 1940. The government wa · in a hurry to get do tors trained for the war effort, so the four-year program wa. queezed into three. After graduating, Behling wa delared "e ential" on the home front, o he tayed in Buffalo for his intern ·hip and residen y training. It was during his intern hip at Buffalo General Hospital-where he worked "for ab1oolutelyno pay"-that he wa introduced to a new won­ der drug, penicillin. "It was a powder in those day ," he re all . "Y u had to mi · one dose at a time under terile onditions with rubber gloves and then give it to the patient." It al o had to be administered every four hour -. But it worked, and that was important, gi\·en that syphilis and other venereal diseases were rampant in rie ounty. Behling worked hard as an intern, but when he became a resident at E. J. Meyer Memorial Ho pital (now Erie ounty Medical enter), he had to put his life into over­ drive 16 hour a day. ', 11 111 m ,• r }. 0 ti J Be ides treating patients and teaching enior medical tudent in the ho pital's Varicose Vein Clini and yphilis linic, he treated patient· in the outpatient Dermatology linic, and onsulted ever other night on all dermatology patient forrhe 1,000-bed ho. pita I. "I had o much to do," he ays, "I would ·tart a spinal on one patient, let the nur e collect the fluid and tart an ther spinal at the next table. l was busy, man. I have no idea how many patient I aw in a da>•·" The pre iou penicillin had to be kept under lock and ke '· "I need d it," he ·ay . "Th arthritic guys and \ hat­ not all wanted it but, tough, I needed it for my yphili patients." It was at E. ). Meyer that Behling met his future wife Rita, who was head nurse on the hospital's psychiatric ward." he wa the econd-prettie t nur e in the ho pital," he re all . "A friend f mine was dating the prettie t." But the pa e of the residency finally got to him. He went to his bo ·- a powerful dermatology profe or­ and pleaded exlrnustion. He needed to be omewhere el e. The pr fes r called the ., . urgeon general, and the next tage ofBehling's areer began with the Publi Health ervice (PH,). He moved to Bethe da, aryland, rented a room,. nd began working to eliminate disea e outbreaks, meanwhile flying back to Buffalo nearly every weekend to ee Rita,\ ho was still w rking at E. J. !eyer. Publi -health work metimes means being a one-man medi al S\\! AT team. A fi w month after he joined the PH , Behling was ent to Elkhart, Indiana, to deal with an out­ break of ringworm of the ·calp. T\ o thou and children in the late were infe ted and the ·chool · were decimated. "Kid were paying another kid 50 cent to borrow hi cap o they could get it and stay out of chool," he ay . The infe tation al ·o wa being pread in the front-row seat of movie theaters, when young moviegoer put their head on the ba k of the eats to look up at the reen. It wa a me s. Behling et up a linic in ea h chool and howed th children's moth r how to pull out the infected hair that had been detected u ing ultraviolet light. He also in tructed mother that the children' head hould be washed every morning before they went to ·chool. "They were all ure their kids were going to catch pneu­ monia," he says, "but I had already received a tatement from the I cal pediatricians that this wouldn't happen." He spent six month in Indiana and pers nally aw at lea t 1,000 patients. But at la t the outbreak wa · con­ trolled. "l wa a real hero with the mother ," Behling . ay . "J didn't have t buy very many dinners, and I g t �"You had t n1i, one do e [of penicillin] at a time under terile c ndition with rubber glove and then gi it to the patient." It al o had to be ad111in­ istered every four hour . But it worked, and that wa in1portant, given that yphili · and other v nereal di a e were ran1pant in Erie County. to go to all the ba ketball and football gam for free. In Indiana, that'· a big deal." Back in Maryland, Behling took n hi next a ·sign­ ment: can er ontrol. ongress, in a remarkable plurge, had allocated 14 million for can er ontrol and educa­ tion. Behling was one of a dozen PH worker cho en for the grant . His hare wa · I million, although, he ay , "I don't think I pent more than 400,000." Hi· charge was to ·et up tumor clini that would t t different treatment proto ol , with the goal of standardiz­ ing ancer treatment nationwide. He went to alifornia, where, among other prnje ts, he managed a comprehen­ sive can er urvey of an Fran i c and Oakland and tarted tumor clini in ma.ior ho pitals that, ideally, were clo e to medical chool in the western nited tate ·. It wa in that ontext that he introduced the Pap smear-now the gold tandard for dete ting and preventing cenical and uterine can er. The test was ju t coming into wider u. e in the Ea t, Behling ay , but doctor in the\ e t re ·i ted it. "In those day , it wa s rt of provincial out here," he ay from hi , an \1ateo, alifornia, home. "If it didn't ome from the We t, it couldn't be much good." First he had to get pathologi t trained to read the lide that the test produced. He found two likely candidate , and ver a wine-and-dine meeting-mo·tlywine,hesays on piratoriaJly­ he per uaded them to train for the pro edure back East with eorge Papanicolaou, MD, inventor of the Pap te t. 1ext he had to per uade d tor to use the te t. "I wa · really pu hing the Pap mear," Behling ay . "Talk, talk, talk, talk. It wa easy, on e I got omebody trained to read the slide . I'm a pretty good talker. And I wa a big shot from out of town, had an atta he a e and I million for anccr control.'' The te t became a tandard procedure. Behling till ha· a pi ture of Dr. Papanicolaou-with whom he rre ponded but newr met-on hi office wall. When the government asked him to return to Bethe da, Behling decided that alifornia wa where he wanted to tay. In 1950, he resigned from the PH to begin a private practi e in dermatology and to teach at the lJniver ity of alifornia/ an Franci o ch ol of ~ledi ine. He aL o ran the an Mate County venereal disease clinic for many year . After retiring from medi ine in 1984, Behling be ame involved in the real e tate business, managing mo tly commer ial propertie. Hi wife, Rita, died in 1997, and he married Eileen in 1999. Between them, they ha\'e I 0 hildren, all over 40 . Hi civi contributions include the Kiwani lub ("32 year f perfect attendan e," he boa t ), the Ma ons and the Chamber of ommerce. He i n the board of the lo al alvation Army, ing · in a barbersh p quartet and i a tenor in hi hurch choir. 'Tm bus}'," he ay . But lightly le s bu y, perhap , than tho c overdri e year· 3,000 mile a\ ay and half a lifetime ago. Chofce EmployeeBenefitsGroup LLC Specialized Products & Services For Group Medical Practices Howard N. Silverstein, CIC (716) 6 1-5033 • v II Free: 77-552-150 e-mail: h @choice,lbenefits.c m web: www.choice-lb n fit .com 6633 ain tre t • William \'ille, "'""'~' ew York 1-1221 2001 l 1lf a l1 H pi c i �'.\1 ED I C C\L H O O L lake Note Personaldigital assistantsenter medicalschool I 0 1 ER DO acade ic year was the aim 515. which first·year st e ts were a le to purchase alt at incl ded t e Pal , a protectiv tal car· rylng case and a sec rity encry tloo ro· gra . Eachs ring, staff in th dical Co ffic ti g will valuate new Dis end whichmodelthe Incoming class sho Idpurchase. Withthe rapidrate at whrc th device a d ap lications ar c angl g, it is estimate t at st dent will wantt t4 1 ,11, 1, p radet ir P ls everytwoyears. n ,sicia ■ \11mm,~r lOOJ rr ove ov r, Stedman' s.Make way, etter's.At the niv r ity at Buffalo chool of Medicine and Biom dical cienc , incoming m dical tu­ d nt areadding omethingn w-andhigh-tech­ to th ir li t of mu t-hav chool suppli : a p r onal digital a si tant, more commonly known a a PD During the 2002-03 acadcmi year, the school began requiring all firs t-year stu ­ dent to report for class with one of the palm-s1zed,computer - ompatibleorganiz ­ ers . tarting in the fall of 2003, students in all four dasses will be expected to own one. The PDA mandate comes at a time when rapidly growing number of health-care profc. sionals are u ing the de\'i es to access patient data, lab re ults, medi al rcferen c re­ sources and drug guidelines, all ,11the point of c.are. tudents are f, llowing suit, purchas­ ing the sleek little de\'ices to replace hand­ written "cheat heets," dog-cared rcferen e guide and other con\'entional, and some ­ times cumbersome, learning materials. "Quite hone ti}, we probablv didn't have to require PDAs of students because �they were going to have them anyway," ay Ray Dannenhoffer, PhD, asso iate dean for support en-ices and dire tor of medical computing. "This tool is ju t too powerful not to be completely embedded in how medicine is practiced." UB' policy regarding PD stem from it mandate to train tudent to be­ come the mo t proficient and efficient practitioners of tomorrow. A the PDA become pervasive in hospital and clinic , Dannenhoffer and others ee it as their duty to teach tudents to u e the te hnol­ ogy effectively and wi ely. "In thi · age, having information, and the technology to obtain that informa­ tion, at your fingertip. is becoming tandard pra tice," ob erve largaret Paro ki, MD ' 0, interim dean of the chool of ~Iedicine and Biomedi al ci­ ences and vice pre ident for health ,1ffoir at UB. "Rapid access to information at the bed ide make a big difference in the quality of patient are. Clearly, PD ~ of­ fer significant advantages in medicine, and we wanted ur tudents to be at the forefront of thi · technology." \\ hile ·ome at the medical hool quickly recognized the PDA as a powerful learning and teaching tool, ir \\a n't im­ mediately clear how the handheld device could be incorporated into the curricu­ lum. That ta k fell to t,,fichael Blumen on, enior LAN analyst and the school' man­ ager of wireles · appli ation . To Blumen · n, supporting tudent use of the PDA entail much more than re ommending a parti ular model and letting new u er fumble through it ap­ plicati n on the fly. Instead, the school is doing evef)1hing from ho ting training . ion -joking( · referred to as the "PD ;..t· • •H unit"­ to creating de troni calendar· for cour e and ·ch ol e,·ent and oftware that con­ nects third-year tudent · with their clerk­ ship director· during rotation . "We're trying to make the tran ition to handheld computing vef)· imple for the student," Blumen on ay . "\\'e're not only helping them in tall application , but for the absolute neoph}1e who are cared of the thing, we're an wering ba ic question about how to use it. We have a respon ibilitv to help them be omfi rtable with thi tech­ nology before they leave here." This flexible and hand -on approach is ju t what's needed if the device are to be effi tivelyintegrated, according to fir I-year student Brian eubauer, who say that the re ponsc among his cla mates to the PD ~ ha been mi.xed. " ome people use them every day and take ad,·antage of all a peel of the Palm, like the univer ity- pon ored alendar, clinical program , and ·o on. Oth­ ers, I dare . a), an not navigate much past turning it on," he ·ay . "I do feel that they arc a good ide,1, and that they urelywill be an integral part of medicine now and in the future," 'eubauer add . "But there need· to be a tronger effort to mak ure that all v.; tudent · are adept at their u c. Given what I've _c n, I'm confi­ dent that, in time, thi will be achieved." doing in the future, ·o I ·hould get myself u ed to u ing it a oon a po 'ible." Hoffmann estimates that at lea ·t 75 per­ ent ofhi third-year la own a PD . "You u ed to ee students arrying around the . e huge reference books and p ket guide that didn't really fit in their p k t . Or they would have Lorun to the library and lo k everything up. But thi i o com pa t and ·o much ea ier than a book that it' unbelievable. I'm looking forward to u ing mine more and more." Throughout hi third-year rotation·, Hoffmann estimate. that he relied on hi PDA anywhere from five to 30 times a day, referring primarily to ePo rates Rx, the clinical drug referen e program that on­ lain medical information on more than here a Kouo, la· of 2003, and Ja on Hoffmann la · of 2004, both pur­ cha ed PDA before their third year of medi al school-and well before they were required. "I thought it\\" uld b mu h more con­ venient to have resource available on a Palm rather than ha\ ing to can,· several pocketbooks around when on the wards," a , · Kouo. "J also thought that u ing a PD would be omething that I would be 1,600 medication., including dosing, contraindications and drug interactions. During hi· pediatri · rotation, Hoffmann purchased the 5-Minute Pediatric on­ ult, a software ver ion of the fa I-access refercn e of ondition ecn in infant , children and adolescent . "You feel intimidated when you're third-year tudent," Hoffmann note . "You're in a different etting every even weeks, and once you feel omfortable and n t nly h lping th 1n m tall appli ati n , but b r the , ho ar b lut thing, , re an­ d ering ba ic que ti n ab ut . , ho, to u It. ummer 200J 1111111 nysici11 15 �E D I L C C H O O L l \I observing, assist mg r performing." Linda Pes ar, \1D, profes or of linical p. r hiatl"} and director of medical student cdu ation in psychiatry, i the first clerkship director to field-test the ·s~tobile~kd and the Patient Encounter. he de cribe · the software as "excellent." ing it, he\ able to keep in regular contact with student and immediately address con ems thev, or stabll', you'rl' put in a new dini . It\ nice to know that with the PDA you ha\'e all these resoun:es at your fingertips." In addition to software they bur or download for free, students are also ben­ efiting from pedagogi al program that UB has tailor-made for their need . The team­ work of Blumenson and medical mput­ ing programmer .\1ark S hneggenburger u 'r n t training m dical pra tic today 1n dicin ' re training 1nedi tud nt t b abl t pra ti th 1n dicin f fi e nd IOy ar fr 111n ' Senior UNanalyst Michael llumenson . /eft, isrespon· sibleforteachinf students howtousethePOAs . Heis pictured herewiththird-year student JasonHoffmann . she, may have about their rotation. "One of the tasks of the course direc­ tor is to keep track of the tudent:,,' expo­ sure to different patient diagnoses and treatment modalities," says Pe sar. "But with the paper system we oftrn found ourselves behind the eight ball. We'd get the information fr m students in the middle of the rotation, and at the end. "\ ith the PDA Patient r.ncounter, I can know as frequently as I wi h what the students arc being exposed to, and I ha\'e the capacit} to interYene on their behalf to enrich their learning experience." Pessar add· that the Patient Encoun­ ter rncreases both the flm\ and the qu,1lity of communi ation between in­ tru tor and tudent. has re ulted in the B 1obileMed applica­ tion. One facet of this program helps stu­ dent during 1heirclinical rotations. Known as the Patient Encounter, it allows them to jot down patient information on their PD and send the electronic reports to their clerkship dircLlor, ia the Internet. "With the Patient Encounter, medical student quick)~-capture the c encc of the patient they're seeing," e. plain Blumcmon, who adds that ,,II the information revealed complies with the privacy rcquiremenh of the Health lmurance Portability and -\c­ countability Act. 'They can re ord ethni­ city, gender, what hospital they're working at and the attending they're working with; thev also capture what diagnoses they're exposed to and what procedures they're 16 1111111 nrs1c111 \umm, • r lO(J J "There is a note section on the Patient En ounter in which I have asked my stu­ dents to tell me interesting aspeLls of the ca e. What this means is that on a day-to­ day ba is I ha, e the ability to comment on Ill) tudent ' patient . "I can ay-as I have said-This is a very interesting point. I know there is a review article on the subject. If you're tn­ tere ted, why don't you look it up?' Or, 'Tell me something about the patient's history that leads you to this differential diagnosi .' r, 'This is reall} fa cinating. It' aca elikethisthatgotmeintopsychia­ try.' It allows me to have a mu,h more in­ timate encounter with the "tudcnt · than I would if I interacted with them in a group of 15 or 16." Beyond the Patient Encounter, both Blumen on and chneggenburger have completed or arc developing a number of PDA applications for use in ide of B 1obile~led and the medical school curriculum. They include: A calendar for school and cour e event as well as a student'· personal appoint­ ment . "If you really want nc integrated alcndar with rour whole life on it, you an use it that way," Blumenson say·. A task Ii t to help student organize and prioritize. Instructor , e retarie and administrator. an publish all sorts of information t the task list; for example, a reminder for fourth-year students to purchase their aps and gown , or for small group· creating custom a ign­ ments for one another. An de tronic . un·cr tool that would make obsolete the pencil-and-paper sun·eys students are frequentlv a ked to fill out during their medical school edu­ cation. Electr nil surwy would re ult in increased response rates, according to Blumenson, and a dramatic savings for the school. �• Additionally, the medicalcomputing taff has initiated a sy tern that allow tudents to tay in constant contact with the school when they're tationed at area hospital·. The traditional method of end ing and receiving information on a PDA requires a cradle attached to a personal computer. Using infrared technology, however, B tudents , resident and faculty can trans­ mit that information directly to the medi­ cal school without relying on either piece of hardware. "The impli ati n are ignificant," Blumen on ay . "We are giving rem te tudents the ' onduit' to ·end almost real­ time data to the chool. Likewise, the school can send imp rtant updates to the remote tudent and know th at enhancement and chedule change will be seen and read in a timely fa hion." Among everyone invo lved , there'· a en e of excitement about the PDA under ­ taking. fter all, B is blazing a trail to­ ward a ignificant and, ome would say, inevitable, development in medical hool educat ion. Dannenhoffer, who ha re­ ·earched the matter, estimate that only 15 to 20 percent of medical chool nation­ , ide have created an infrastructure to for­ mally upport student ' use of the P "We're not training medical tudent to practice today's medi ine; we're train ­ ing medical tud ent to be able to practice the medicine of five and 10 year from now, " he concludes. "If anyone thinks that in five or IO year ome kind of handheld reference devi ce is not going to be an ab olutely irreplaceable part of hO\ medicine is practiced, they're just mi ing something." C!i> For more i11for111atio11 011 tlie use of per­ sonal digital assistants at the University at Buffalo c/1001of Medicine and Bio111cdic11/ cie11ces,visit the Office of Medical Com­ puting's Web site at: www.s111bs.b11fjalo.ed11lpda/. "Come Discover What My Mom Has Found!" - t fi,,rcm.C7ti1/II • B autiful private 1 & 2 bedroom apartmen • 3 meal ' a day in elegant dining room • W kly housekeeping • • Activitie' program • Hair alon, on-si bank, library. billiard - Come Home to Amberleigh • A~~~~£J.!it 2330 Maple Road, William ville For a free bro ·hure or personal tour. call 689-4555 award, are hi c ntribution to medi ­ cal education," ·aid Duffn r. In addition to acting a pre eptor for enior pediatric re idents and a a mentor for first -year medical ·tu­ d nt , Kaplan ha volunteered at the Hodge Pediatric Clinic continuou ly ince 1996, teaching students and re ident the art of pediatric . "Re­ views of his tea hing have been uni­ formly out randing," Duffner noted. "It i lear that with the change in medicine today, e pecially the reduc- , ,4mm tion in the number of inpatients, we at the medi al chool mu t improve our ability to teach in the outpatient ar na. To do this, we must call upon our , oluntccr facultv to help teach our ·tudents and re ident , omc ­ thing Bob has been doing for the la t seven years. The Berk. on Award is for excellence in teaching the art of medicine by a member of the rnlun ­ teer faculty. urcly, we could not have cho en a more de erving indi,idual than Robert E. Kaplan." C!i> ,·r 20 0 1 I 11111, n ysic i 1, 17 �\f I ll I C \ L C H O O L E \\ S JillMarie Albrecht ·Pawlowski Regine lruny (NRMP) resultswereannounced onMarch 20byN ncyNielsen. PhD. MD '76,interim SL, \' AI Hi.;1 fALO (;RAlll n seniorassociate deanformedical education intheUniversity at Buffalo School of \I( lllf"AI 1)1 '-' I AL i:Jll'CA I Ill'-' ( ""'OR'I ll \I 'Bt:H.HO, 'Y Medicine andBiomedical Sciences. "Itwasa creatday!"saysNielsen . "Ourstudentsmatched wonderfully. andwe PierreSayed Aoukar areenormously proudofthem." According totheNRMP . therewere23.965 activeapplicants inthe2003match. Lh;i v I R, 1 1 ,. o I Ro, 1n, 1 L R/ Roc11r, JR,.·, over500morepanicipants thanlastyear. A.laker Dataprovided byeachyear's residency matchservesasasnapshot ofcareer April interestsamonc medical schoolcraduates . ThefollowinC arespecialty highlights CIRJH StlORI l,,J\IRSIT\ forthisyear: reponedbytheNRMP JiO,PiTAt/ •• , L 'iutn<ll (1 \lBERI .\lrrun /f\\ "H ,111,.,Co111t,1 I AT !oN<, \Ii !Ivor ·1" OF htA'-l> R/ 1:'<11 lll<'AL PARi-,.'Y lrandylethBryden L\J!), J-ROBIRI \\oon 1011;.so, \It ll JLAI St IICHll/ r,.;t\\' '""'<.:'-,.'I BRl C arltoaKuhn lyun ()I \11 experiencedfewer 115 matches thanlastyear. withafillrateof Family practice 76.3percent. U.S. seniorsfilled42percentofthefamily practice positions offered . down from47.2percentin2002. Theoverall fillrateforinternal medicine was95.1percent. upslightly fromlast year.U.S.seniorsfilled55.2percentoftheinternalmedicine positions offered in thematch . a decrease from58.7percentin2002. Pediatrics continued itsfive·year trendofplacing morepositions inthematch andexperienced anoverall 93.8percentfillratefor2003 . Surcery increased itsoverall fillratefrom9U percentlastyearto99percent in2003 . Thisyear,U.S .seniors filled82.7percentofPGY·1 surcery positions. upfrom 75.3percentin2002. Anesthesiology experienced a fillrateof96.3percentforits PGY-1 positions . with40morematches thanlastyear.Italsoexperienced a 95.6percentfillratefor PGH(second·year residency) positions. Diagnostic radiology PGY ·1positions filledatarateof97.8percent. compared to 94.7percentin2002.TherateforU.S.seniorsmatching intopathology positions increased from49.7percentin2002to59.8 percentin2003. lltCl'-1 \(,. H.\S,J I, ')' ,RAOl Joy 'EIlurnadett lallard ( s,. I Ho,r11 Rm ;'-.(() Guy JosephCappucc ino or Ron11,11RI R, \;)' 111,11 lrianlobenlennett ll ·1vF Ronlt Rst 1, "I 01 Roc111, r1 RI ,\I Bl Rl T111 BRo ·x. rw,· 1>,0II 11,·11A Ho,P1TAI n, You:,.') IRSHY IIRO\v hlltCAL-l>t IIAIO TAI ( o,soRtll•.,1/Ht•H '<C J , RI 1.,1/ T Dav idJonathan Brauer SL Y AT lit 11 RIA'­ I\ I RSI I y/ , l'RO\'llll 01 Co""1crtc ( ·y Karen Chi-Lynn Chan l'Rl SIIYTI RIA" I AL (COR'-111 'OR" l·ARMl'-GlON, 01 )/ (COR'-1!11 ·1\, YoRi.;,,'Y (A\lrl, LJ,t\ OL LH,> PFIORI , ·1 \\ YoRi.; l'Rlsu, Uizabetb Laetitia lourlce N, \\ I. (\I0'-1 Fnt'<nA­ JamesWillialoyle l c i 11 I l"STI \lfDIC:1;.i ·n ( 11,11 Ctl\'llA C\\tPt;, 11tta l 1 nys Anrelo Michael Caprarella ·y R, Roben A. lermel Ho,PI 18 ·y ) ORJ.; ;\J f llll AL COi LI t; H A I \\'1 STUii s rHR ;\Ji Ill< Al (' '-HRl\'AtllAILA, ,•y , 'bW SunilK marlansal L '-'l\'FR"1v . ATl­ .\TIU'< lh111.tnRI/ I 01 11.u 11\IORI, lll( 10,, GRAOl AlbenHeng-YaoChanr All· IIl flllJ<.:ATHl \lo,. Y Pierreloukar , /eh, cele rateswit An£elo Cararena. ritf,t.Aokaris eade•tot e Univrsityoflochesterand Caprarella, ta AlbenEinsteia Collere ofMedicine . ,111 ·1, F'-TFR/1 HosPtlAt L l ,111 '(,,, \Ii 'Y 1>JCAI �Rebecca Dwyer learns shewilltrainin family med icineatLoslngeles County­ Harbor-UCU Medical Cente r. CraigHorbinsk i isecstatic tolearnthataher year,bewilltrainin completinc atransitional ophthaloloCY attheMayo Clinic . ScottRobert Darling Hos Pl! Al BRoo"n $ KitlingCheng I 8t,FFAl.O BROO"I y OF P• , ,v1 Sl\'ERSl'I PA PHILADELPHIA, """Al c, '-'HR \''-,. FR/ Dionne Dillon ,'C 1n 1 r R or PA RGH, Lisa Ann Dos Santos YORK PRESD\'TI HosP!TAI ((OR'-iHI (A\lns)\N1-w Michelle Lynn Clark y _·i; • 10 Adam Jonathan Cohen AT TO"' , BRoo ·u, 'Y F1s,n1N AT BnH \ IEDl<.AI FGE Of hRAfL CE.'TFR, E\ , Yo11"-, Los 'Y A'<;F1 UCLA F' ou:- MLDIU,L TORRAli<.E, CA EoucATIO'­ l '1/BUHAL0, y Daniel Maurice Cotter Y Al Bu, ,Nl\'l'l<SITY HOSPITALS Of Cn,·H.A"DICAsF \\ 'os1 '"" RFs~Rv> "''ERs1n/ C11VFIA'll,OH ERL, Co-.;soRTIU\1/BunALO, Enu:.ATIO'­ '-JY l\Y AT Bt: FPAI o GRADUA rE ;\lF!>ICAt-D~"TAl fnt:cATION Co,-.s0RTltlM/Bu , HO, ·y Y Al RLII ! ALO GRAlll ATE ,\IEDl<.AL-DE ·1A1 Eotc ,t1os NY A 110, ..;y I ALO, ,_., t.Rsll'Y CATIO" n,. ·y OF :SORTH , ,.,CHAPH H1u, J'o:C Corey Adam Gilbert HO\\ARD ' '< l\'ERSJT\/ WASHl"GTO '- , DC Christina Therese Graczyk Andrew M.Freeman Sl, ·,oRnU'1/8uFFALO, Bn 'YArBtnA10GR,ot'.\1l C.,1<ou Peter Jonathan Frederick SUN) AT 8UFFAL0GRADl'A1E !'.IF Dlt:At-Dt "TAI EDlJCATIO Co,;soRTJt,M BUFFALO, '\ FAL0 GRADUATF ),.flDl<.AI-DE,-.TAL Co PRFSB\'l Ho,PITAL (CoR. ELL AM Pl s)\NE\\ YORK,,')' Lisa Estelle Esler -Brauer SU YORK " \ !FOICAL-Df' , TU fD o , ,oRTJl , 1/Bt rFAI BUc!ALOGll\l)l'\Tl· M1-01<.AL-Dt·TAt Co,soRTI SL Melissa Marie Franckowiak NEW GRADU.HI , T.u Lon ATIO E:-HR/ Samantha Elaine Easley NY AT BtlFAIO \1 1 0, '\Y Co,soRTILM1Bt:HA 1 Y-HARDOR­ SY AI0, Peterson Fortunato Giallanza .. Lo G11Anl'ATr E0t,< futcA-r10, tuMIBuH o , ,01<rn Cou Danielle Marcene Conley s AT Bun 1'lEDl('AL-DENlAL Rebecca Louise Dwyer ALBERT Mtoa·1,t l h,rAt ·,01t1 t:.) BaooK/ Y , ·y BtH,10(,RAIHAH .\IEDICAL-DE Dawid James Flint ),.I, 1)1(.Al HA\'>'-', T r1 RIA LisaAnn Gelman Bu, >ALO GR,nt:An MLDl<.AI -DE,TAL En <.A no. Co-.; s 0RTI L. \l , Bui I ALO, 'Y IIA\'E'- \ltw Co. SU Y" "lY Patricia Dramit inos CE,TtR, SU Y AT RIA, YORK, RY (COR.'!11 E\\ YoRt-., Julie Ann Ga.in SU 'Y AT llLFHlOGRADlAll ;\(FDl(.AJ-DE 'TAI [OllAllO o,;s0RTll ,1/Bl'f.FAL0, :\Y lairfishkin i\F\\ PR! YoRK \l rn1cA1- ,\!A ),.!A , HOSPITAi A\tPt:s Christopher first Michael Cf. ..,1, tR,1 rv HUAI lH P11not R<,HIP1nsRt )\[\\ :\'Y SeanGmin PA PHIA, Melanie RaeFiorella Laura Anne Cinsk i YALl. 0LU \ 1BIA '>:[ \\ YORK, EYE H os Pl I ALI PHILADII l,M\FRSlrl/Dt1RllA'1, Dtld BtTH 1'RA11. lhAco,ass ),.IEDICAL Cr• HR/Bos10S, tRIA" PRf\llYl ( U,;rnRSJT\ OF Roct1Fstr11/ Ro<H! 11R,,· , rl Y E R/Bo-ro,, YORK Ho S PITH CHI Pl' ·y KSOS Danielle Marie Dorsaneo Cnn ' 'E,, • ·1 \\ Da,id Robert Fintak \\'1u, Michae l Waliaula Chilungu ),.!1 Dll'AI • n, YoRK PRESB\TERIA HosP11 Al ( 01 l \IBIA CH1Pt:s)\, Y ORK,. lryanCarcano 1\'l RSI I\' OF />IIA\11-)M />h,\IORIAI ,\lHlllt:AI (tSl \IIA\11, HIAL TH SCH'<.l- GRADLATf 1At Fnl't:AT10, M Bt•1 1 ALO, NY ll Thomas Jungw anChi \T BROOKL\''- A Nathalie Dap in 0RlH HORfl"l\tRSITY Hos Pl I AL N Y ( HOOi or MHHt:l,r/\lA S HASSI r, 'lY SUN\ :,.:) ),.l101cA1-th, Co,,0R11t Esme Finlay SL' y , 'EWE. BRow, PRO\ IDE '(.[, RI Allred Thomas Frontera Jr. .H Bt'HALO \htHCAL-D£"TAl ,u,.,oRnt•M/RuH GIA D ),.1fo1cA1 F '<TER/Tl'FT. BoSTo,, \ 1A U,;1VERS1H/ l''1\'ERSl1 y/ David Michael Gray GRAl)lTAlE Ein•c,1 Ato, r10, OF\ "\'EIISIT\' 'Y Bt RI 1'G ro,. \ummrr 200~ ER\10 ,; T/ \'T l 1ffal1 Plys i c i u 19 �M E D C Maureen Anne Grossi ,\I Bl RI \I, l'F 1)1( THI H O ( 11-iTI R/C,IURGI L ' ( 01 l lld fp,;~'fll C L BRO ' Of (SAN o, R\trY ,)A1lln1A10(,RAOlAT1 to LAI II ORNIA l>nc;o)'SAN CA Drrt,o, s I\ DC 1,10N, ,\lro1cA1-D1,.iA1 l\'I t. \\"A,ui,,Gro, ·1nR,1n'\\'A,111. s Matthew Esreir Guest l, L Justin Chandler ltanaley 'Y '. O I 1n Aflt1" ,0RrllM/l\uHA10,,'Y Sara Ileneltaprove Kenneth G.Halliwell !\HIii hRAIL l>JAtll'-1" .\I 11111 Al Cr, l IR/Bo, SL~) Al B ltAIO GRADl/All ;\11 Ill( AL-Df. l Al f l>l C l JO. Co,,oRTIU\1/8 Daniel Kan NY 1 IAl(I, .\I.\ I ON, Kimberley llose Leonari Howard Hao \IRIRTEr, lll'COIIIGHOI .\111111'1'1~ Al )1w1,11 \1 l>l<AI \/1 W lh"IH l.O (I, y \l, Al Bl I JAi() Mr 1>1cA1-D1,1A1 Dorothy Helen Hedricks ( O'-'SORTI At ( 1 NTI II ') AT A1'D 'n, or. Yo11r../ Natasha Susan Manes C,RAJH!ATI fnt·t '1/B CottH,I HosPl1AI 't \\' YORK, RI Emily Li ANO 'Y PARK, \ho, U!Sl\'~RSIH/ l'ROVIDt. Frances Melinda llno1 I, I\I C.E TIR/ 1', S1. Vl'-n llkow, HAI O, E, AT10, ,\1R1R1 1 ')' .\11 nrn,n ,\I I ST~I" CnllfGf 81 HI I\RAll 01 Al ll!CAI C:1 II Rf ) ORK, I\\ SL .'LwYoRr..\hr>ICAI L-CTICllTI '\' lettylichlyLim YArBl11A10C,RAlllATI· I n1·cA110. \I/Ill 11 "o,. ·y \ho1<:AL-D1,1A1 ( o,,oRTI 11 '!Pl.I Jennifer Kathryn Korzen Sl\'I I'.-\ 1'1111 Alli I PHIA, Y AT Bur IA\ )111111 ON LNl\'IR Valerie LyR Marchi IT\/ PA IIO',l'IIAII Grace H.lin NAIi.Oii 'il Kauo Theresa I Aro Ill( Al-1>1\NT R',l1Y (I'll Stephen Dawid Hess SL \IJ ·1110 1'1111 Al>I t J>IIIA, '11VIRSITY/ C,RAllU.\ I· Ill'( AL 11 Sr. 11(),; ON\ORIIU\J/8lJIAIO,, l·r lfo,PJ[AL/,'1w Y r Lui- 1 ',-Roo,1.a ,Ha Ho,PIJAL ·t, S ·y ) ,~ Al 1/811 S\l\' hrucATIO-.; I'\ 'iL'-/Y \II AT 8UHAIO C u,,uR111,,1 llRIGIIAM (;RAOl/ATI Al l\tHAro,.'Y <ll .hl>l(I, BAYIORCOLIIGI Hou,1 o,;, IX t. '- ·, \\'0,1 .\lF1llCAI 1/ ,;J\'IRSI Co11H,f IM.1 JianLeLin llnsPr1A1/ n m OJ ("p,( '1w BlllfAIOGRAlll'ATf 1-r, CATl0" 'Y BtFIAIO, \oRr.. Sr \tNt.t \Ir 011 At • I\\ Craic Michael Horbinski 'All.OH , \1 \ \lflll<Al C"Oll[Gt, Marco K. McKenna r',ll<>PllAIANll Ca. 11 R 01 w , ·• YoRi-/ S A I ST ON\ , ') K ' l O, y Y 811ooi.;, YORK,.'\' 8 R 00 MaraKathleen Linscott Lawanda BaieLamar BR11;HAM /\NI> \\'0.11, R<,Y 'il,,'\'ArlkF1A10 llo,pn Al 01 11L·111a1/1'111so1 \J,.,o R<,11, <..11. Jl 'Roe Pr 11,- t\h.DICAI I',\ 111 ,11 ,R,.r> (;o,;,oR ,11 LIH't ' ATI01' 1)1 N1Al I [l .\J Bt 11 -\I 0, ')' Todd Anthony Janicki RL\I[ LI,'\' S,) Al STAI l·rn Bl'flAIO,, tAIO ,\1t nrl.At-DI 81,f!AJO(;RAllUAII \ I r 1>1cA1-D1 Co,,0111rt,f AT But ·y GRADllATI I Al [ Ill'< AT!O. Coi...,01111t tATro" 1 Rt ·y I fAIO,, (.1Hl.ORH,' 20 1,11111 Af[O,A[ nrs i c i 11 \!J lllCAJ \ II m '11 BUHAIO \It C,R 1>1<'Ar-lh tAI. l·ou1 I lt'M/But I HO,. Cos,nR 1• r 2 (} cJJ l'Rl\BYHR[A C Hll.AGO, Bos10,, .\If .\IA Oil.Al Sct!Otll \'!RGI :r. Lui-is/ IL [) ATE no ·y IA \JASON lfR'>IATTIJ,\\',\ D itryMalkin / Mattbew ThoasMcKenaa H\\ YORK. IL DH.Al 011 IGt T HI HR ,\1Hll<:AL C1,nRl\'ArH llA,!--:Y 0 • \\'1 Micheline l bin (t At H \R\'ARD RI Gregory David Myers Heatber Kristin Lehma Norah Ruth Janosy . y I\ FR\llY/ ·u, P11ov11H Darius Lopmanee I.· R,. BRO\\ 's \I\ HosPllAt/80,ro,, t\b ' INNATI \hn1c1NF./ Susannah Lauren Kum MJllll.AI-DINIAI Cu,soRrJU\I A ,;(l llo,PrrA1/IIAR\'ARll < HOOi 1 80\TO ['.OL'CATIO', EunTodd Hoover 'ilt\) Charles D.Marshall l1"1n11,tr1 Deborah lethKulick IIICAI-DINTAI B1,1 I AIU,•')' BRIIH,fPORT, James Matthew Lin ""' Donald Edward Hiers GkA[)lJAII .\h111cA1-lh,..rA1 l\'IR'-IJY "'" ·y fALO,. I\UHA!O 0'-SORTllJ\t ll,;I\JJl',JT\'01 1'1111 Alli I PHIA, All ·rAL P.nuA110 Cn,,0R·1 c1Nn R/1·•,H,,.G, • ·r 1 \'010;, YATBlllAlld,RAO \hn1cA1-D1 \h1>1tA1 .\11 OICAI Sl, \lull )' Al Bl I fAIO A[-0t'NIA[ ( O '\ORTIU\t/81. (,RADlJAH UoUCATIO, I fAI l>,. ") AT �Jeffrey M.Nonh Maria Podebryi-Tsur-Tsar 0 • 0RlllWE.T~RNLl fl At BERJ ,1£1" L "TERI PHIi Mn,1t \0fLPHIA, AL l'\fW Pc\ HOSPITAi A'IPUS \ORK l'RP,B\ I RI ( .0R."111 '1 \\ YORK, N l\"IRSIJY/ YAI ff\\ H/\\'f" .\lfl)ll CE TER (\\'ATI R!IUR\")/ IL (. HICAU>, HAVI lrentOD Pauliscili ·y OHIO--rATE Alison Erin Prestia·Cuptill "l\fR.IJY/ 1sv,, 011 Cm.u CT • YAI I FW HA\'! Cl. TFR HA\ I .• /\1 '1 \\' \\ All \!Elli ' AL RBUR\·)/, E\\ CT Joanna Ethel Shaw :'\hort:AI Joshua Daniel Non Ho. FRstn NI\ CtEVHA"I)' RESER\"l Ct I \"fl VJRGI PITA ts o, ASL \\'1 SlfR." IA .0.t\10'i\\ LI ·1\'FRSI rl" RICH ll, Hl. \'rRGI. 01 IA/ l-ALTH .L \ (CHIS 11 RI ILLD)/ \'A \!fill C.o . L, \ AT BUFHIO :-1u,1cA1-D1. Co U l\ 'E R JTVHfHtHCL·TEROF Prrr,eLRt,H 'Pn1,s1 RGH, PA Aaron Mauhew Dlde1 1v1RSITY Of Ro< Hl ROCHISTI R, Y OR11i;"/B 1-nUCATIO · ,·y HA10, Madbnilatba TERI II 'i All-. fl CFNTFR (\\'AJERBUR\ llA\F.,C.1 I.. Of flfl "'YL\ ' A."IA II Al)fLPHI/\, .\1 R· • I\\ DC C.o. S0Rl O GRAl>UA"l Ent• ll \I 8LHAI 0,. l\lEOIC,'.I Y. ·-QL:lE -~J\JA H;E CrNTrRIU 1/\1 A,, 'Y 1'-'CI \h Sasba Pavlov-Shapiro ' All Ho,Pn 1)1(1 0LIIGI I /CINCI Al :-1ro1CAI A Tl, Al IIUHALO ."l, y GR\O A"I Bt H/\L0 Melissa Marie Phillips "lA OH or RounsrrR/ E'l.·u1A Y Ar B HALO Al Bt•HAL0 J-NFw ·c11001J. hR,1 E\\ARI.:, "l\'FRslTY I /\lroH ') :At h ·, RSI y \!fDIC,U ,RAIHFATI f1n:c11noN ',;\ I\ I R\IT> Roe H~~TER/ nR,, ot Ho PtT11L/ Ror.11tsHR/ ·y Janice Sinae Sunc . lJ \ , I IIUFFAI 0 GRADl ATE \Ir l>ICAI-DlNT ,1 l'ot · c.Anor-. Daniel P. Scllneider sE11,,WoRctsHR, nr Gn,FRAt "\ LI"•'r Rsrrv ROCHE IW 1RAIHAT1 U RoCHFsllR Ro<Hl',IIR, Rachel Elizabetll Scb itt Carl Henry leyaolds Y ·t, , .Po11s,I ·y \lfOI< Al-lh. TAI EDl"CATIO. ·o,sORll -i/BLHAlll, ·y \lflll<'AL Y CHOO! OF :'\l.,ssAUll l\\A '• Co ·soR 11t \tlBl'HAt o, . ·y \I \ 'A. 'I. DnidEric C.Searls \htllCAL C1'1ER\MoRRm,, ._l\"I RSITY, GRAtiUATF l\llotcAt-l>INTAI ~DUIATI0 Co, 0RTI M/BUHAI0,, '\' AllA AH TH Fo CATION 1/Bt H LO, , ·y \llDIC.Al-lh. C.o ,oRTl A 0FM1111u 01 'Y Jennifer lnnSmoral (.·DIA U,\11) l\"~R,n\" Rn<HfSIIR, UNl\'l Rstn· EW YoRi.., Mro1cA1.-DE"r"1 Co oR11ts1'8tHAI0, I\ERs11\"01 Co11 • ,I !s111,o, KaaljotSintJ! David Sc lesinrer LaraJoycellendano SL 'Y M101cA1 ·rATL C1,nR/ ·y \ HILDRI (8ROOKI I w \oRK (RH.HMn,o ·y , FW YORK EW ·y Eric WeldnSchaefer 'IE\\" \ORI-. l,'"\"IRSITY ( t."HR Nn, \ORK, Elena latner OLU.IBIA YoRK,, n, 1 ATION LisaMarie leaves Al Co11 ( I Gerard Silva Yatin Patel l\11n1 YORI-. PRESBYTERIAN HoSPllAL CAMPts PA YAl 1C1.·11R I RAI Gt Nl\'I Hl'-'GTOS, ) /\T 8t 1 H/\I \!11>1cA1.-DE,T/\I Timothy Sebastian Pardee ' S~JT, Bosro,, \\ ASHl'-<,T0.. \\ 'il, y YoR ·y R/ lir i Sat~aoant a DI AL )/, 'rw PITAL AT BUFfALO ,RADIIAH Dll.A t-D, NT A Etll'CAT 10 C.o,,oRlllM/Bt · fFAlO, ·y Nfl, • ChristoperThomas Rossi GFORGf Brian Jo nPate :'\IA,SACHL llosPITAL \t Bt HALO, (,RADUAT[ TAI 'IT\" • ,oRTll, O GRADUAH fotCATIOS OH Michele lobinOdrobina SL \h H 8UHAI ' AL-DFNTAI MicelleCarol laczh l\"f"RSIIY/ AND, ,0LIFC.I I GA . ummer 2003 2 1 �Jennifer Louise Trask Chantale ¥ante '-1\ ' t.RsJT\' 01 Roc11r,, Roe H 1sn R, NY A I Bl FFAIO All .\111>1< AI­ ·1AI l·1nc ,110. l, , ' GRAil D1, Co,S<>R11c,1 Bl IHIO, Michael Joseph Viksjo / ,\181R 01 Ro, 111,, l RI Rou11 ,, 1 R <,,,111A1 Ho "1"1 / 'il ' Roe 111 U,1v1R Kristen Jennifer Thomas Stephen John Turkovich ',l, ·1\1Rs1n · 01 Rnc111,11R / ·y RocH!SllR, \l11>1CAI 8tll.\JO(,R11lllATI D1,1A1 lnt ( o ·,oit fll ,l / Bt 11 Alo, · cA110, , 01 ·y 01 COLJl(;f .\I, Ill ( ... I CI N I [ R ,1, ·111"TY I CA1110RN1A \oit>c L,1v,1ts,n " ·L\, Sol lo, TIii < 1n, \,c,111S,C 01 nH Co1, 1G• en \'1ac , 1,1A / Al , ,\llDH/11 • ' oRTII 'iHORI L,1\' F RSlll Hos1>11 Al 'sYl Sc HOOL T, \11 DIC ISi /, \IANII/\SSI 01 \/) Lh ,11 Al TI A1'! <H \ ' 11<<.;JSJII / ( lllLH,I Joyce Leanne Zmuda )cl11,, HoPi.;1,, u,1\ "LRSI n / :'\11) Jenniler Lynn Wiler UT .\ICP 11.. 11,1 SI\ ""'' P111IAIHLPHIA, I RSITY / PA We practice law for those who practice health care. Phillips, Lytle understands that health care providers face unique legal challenges. HIPAA, STARK , compl iance issues, DOH regulations, reimbursement, the OPMC, and let's not forget about MFCU audits. These are all hot topics that we are prepared to help you wit h . • Experience • Breadth Depth Have questions or concerns? Call or e-mail Lisa McDougall, Esq ., th e health care practice group coordinator , at (716) 847-5478 or lmcdougall @phi llipslytle.com. LYTLE . HI A T CHCOCK T T O . B BLAINE E Y S R est. 1834 3400 HSBC Cent r, Buffalo, NY 14203 (716) 847 -8400 website : www.ph1llipslytle .com BUIFALO 22 \ II mm 1:· r 2 0 0 t • V,\ \'111c;1,.i11 C0\1\10"' C ALI H U,J\' E RSIT\' Rl<.H\tONI> , \' .\ PH1LL1rs. 111 lobbiNicole Wu Shawn Roy Vainio R' · :'\ho, NY \ ' 1R<,1"'1A Co,1\Hl,\\lAtTH U ,I\FRSIH RIOl\10'-1> 81111 J\IORt, or YoRi.:, lossAlertYaple IV Tl R f ·, l\"IRSII\ R~IJY ·y Elizabeth An Yaple SanTuTran ,1v1 \/rw Ct,TER )/ NY I·'(, I..\' ll .\If llo,P1r111s /l \1Ts Bo,10, , \1 \ \h l>I< Al - 1>I '- I Al f lll ' C A I JO, CoN,oR111,,M Bt:11 ,10,. ·y ) Al . ll\' or Roc.:HE,1ER / Tina Wu 11 HORE ( ;\10'i ... I " .. ., BtllAJO(,JUDUAII Rouu,nR, L,s1v1a,1n Roc HISHR,. Julie Ann Yoeel :S:) ,1 fR, T l· "'Slfl'- :'\!Hl>I C I Nf I HI BRo,x, LJ,J\'FR,11\' Ro<.HI ra / '>;)' Deserie Silva Trojan PatrickSweeney Lyndsay Jean Willmott FREDO IA • )AM STOWN • EW YO RK • ROCH ESTlR HUBER LLr �hl' Bufl:110 Graduak' \ll'dical/lknt.11 l.duc.11ion Consortium, respon,ible tor .111the rnc:diLal spc:­ .:ialn training in \\'t•,tern 'c:w York, h,1s rc:cein:d a "fa\'or,1bll'" r,llini.: from thl' \ml'ri an Coun<.il for Gr,1duatc .\ll'di--al fduc.ttion (J\C(,MI ). Tht• rl',11 ..creditation i, for fivt yc,1r,, the ma. imum ll'ngth of time .11lowahlc between n:\'il'\\.,. ... hi, is n:rr good Oll\'S for Buffalo and our rl'sidcncr pro­ grams," say, Rosc:annl' lkrger, .\ID, st:nior ,1,soli.ttl' dl',m tor graduate nll'di1.al l'duc,1tion in the lJniver,it} ,It Buffalo chool of .\tedi-.inl' and Hiomedi<..,11 cil'nces." m, wl' c.111dt•\·ote our iull ,lltention to the businl'ss of l'du.:,11in!_.: residt•nh. Tht:r mu,t learn to use thl' best ,n ,1ilahle Lil'n<..c, nd rdine thl'ir kills to provide ,afr and '-ompa. sionatl' patient c,irl'. Our n:,id<nls .md facultv wekoml' thi, ..hallenge." Prcp,ir,1tion for thl' rl'view b<'g,111in _ooo.culminatin • in :i IL·ngth}' do<..ument submitted to the,\( G:-.11'in August 2002. A site re\ ie1H'r \ i,itl'd Bull,110 in Sq>tl'mher 2002 ,md met \\ ith m<'mhcrs of the Consortium Rl' itknh ' ( ommiltl't'. tht· dl'an of th<' B rnl'dic.11 chool, and the Graduate: • kdical Fdu ..ation (.ommittee, compri td ol n:,id n ) progr,1m dircdor , re,i­ Jents, dep, rtmc:nt ..hair , .md hospital offi i:il . Th,: nc1,· ti, e•} car re,i..crl'ditation will begin ffici,111},, h n from the the comortmm reLeiH·, the rm I announcement ,\ t;:,..t[, whi ..h is r pc .. ed thi summer. urrcntly, the um ort1um pon,or, 5 I ,1c rcdited re iden ..v ,rnd fdlow,hip training programs, ba,~d in nine mcmbl'r ho. pi­ t.1b, nd in ,ewr,11 Lommunit ·-b. ed location,. Becau c th<' LIB s..·hool of I kdi ..ine and Biomedical, ciences Jo<'s not oper,1k its m,n unhl'r,it}' ho pita!, n:,idenq· training 1. onducted in ih affiliatl'd hospital . Historically, the program have bel'n man aged bv the consortium, ,,hiLh " ..ompo ·ed ot repre L'ntati1 e, from the hospitals and the mcdiL.11,dmol. Thi, admini,trativl' structure will he pha,ed out in the wmmg month,, and re pon ihility fl r gradu:ik mc,lical tdu ...ition will be transfrrred to the U B mc:Jical sLhool. 1 ht' ho,p11,1b will re m,1in ,1, partnl'rs in tht program. Berger .1, · th, re, ie,, pro.. , ,, a conducted ,,ith th 1, tran fer in mmd. RECORD HIGH i Research Fund· ng BY ARTHUR C( CU LTY WHO AR E TH E P~GE )) BE T A D BRIGHTE T esearchfundingat the Universityat Buffalo increasedby more than 28 percentduringthe 2002 fiscalyear (FY 20021, increas­ ing to $239. 7 millionand representinga growthof $52.9 million overthe previousyear. Research in the life sciences accounted for $168.6 million in "We are vel)I pleased by the progress we've made in the past year funding, or 70.4 percent of the total FY 2002 research funding of in research funding-progress $239.7 million, with funding of medical research totaling $111 million, efforts and ability of our faculty to secure both research dollars and or 46.3 percent of the grand total. increased national recognition for the important work they do on a daily The record-high funding included a 33 percent increase in funds received from the federal govemment, which jumped by $32.2 million, from S96.6 million in FY 2001 to $128.8 million in FY 2002. The data, which was released in March 2003, covered the period that speaks directly to the outstanding basis," said UB President William R. Greiner at the time the data was reported. Greiner further noted that "while this increase in funding will only improve UB's standing as New York State's largest and most compre­ between July 1, 2001, and June 30, 2002, and was collected through the hensive research university, perhaps even more importantly, it demon• National Science foundation's (NSFJ Survey of Research and Develop· strates the depth of our commibnent to our research mission: We are ment Expenditures at Universities and Colleges. dedicated to continually expanding the boundaries of our knowledge The NSF survey data show that 88 percent of the total in research funding received by UB during FY 2002 was for basic research as oppos• ed to applied research. UB researchers whose funding is included in the report include those at the university, at affiliated teaching hospitals and at UB's Research and to sharing the benefits of our discoveries.. "Our faculty is comprised of the best and brightest ," he continued. "We count ourselves fortunate to have such gifted, dedicated research• ers working in our academic community, and we look forward to contin­ ued progress in the years ahead." Institute on Addictions. l 1llal1 rlpiclu 23 �■ GUY CAPPUCCI SCHMITT M O AND RACHEL BEAT THE ODDS Jtch Day is alw,1ysa sp.:-cialday for graduating medical tudents, but for ,uy appuc ino and his fiancee, Ra hcl fourth-year studcnh in the ni\'crsity at Buffalo ~chool ofl\lcdicine and Biomedical ciences-\1atch hmin-b th Day 2003 was magical. ,lppuccino had s.:-t his sights on entering a residency program in plastic and reconstrucuve ·urgery. Traditionally, student\ interested in pursuing a c.ireer in this field arc required to complete five years of training 1n general surgery, after which thl')' qualify to apply for fellowships in f lastk surgery. On'r the p,1st 15 years, how1.:vi:r,a new model for training in this field has ernlwd. residencies," thl'sl' programs ,ire open to student- upon completion of medical school. -ailed "integrated plastIC surgery ationwidc then~ arc onlv about 77 slots ,l\,1ilablc in the intl'gratcd programs each year, so competition is formidable, according to, 'ancy 1 iclsen, PhD, ID '76, inti:rim senior .1ssod,1te dean for m ... ·dical education. Amazer!r111rl ]1, "· · d ,\ native of 5tonr Point, Y, ,appuccino earned a bachelorof science degree in biochemistry through B\ Honors Progrnm, graduating summa cum laude in 1999. \\.'hile a second-year medical student, he met Shirley Anain, MD, a pediatric plastic and recon tructive surgeon at 'hildren 's Hospital of Bui alo, whom ht· .:redih with mentoring-and inspiring-him. "Dr. An,1inhas a stellar reputation in the communit}" for the work she does with children who ha,·c craniofacial deformities," says Cappuccino. "She has been very helpful to me and is current!)' mentoring other UB medical students." In addition to sh,1dowing nain, Cappuccino ,1ssi ted her in cases invoh ing children born with such defects ,1scleft lips and p,1late , and cranial synostoscs (where the skull bones fu e too earh ). 2, 1111111 nyslci11 ,'\ummer 200 ~ "When I saw the hildren born with thee deformitie coming out of surgery looking almost normal, there wa nothing else in the world I \\anted to do," sav Cappuccino. "l wa · amazed and in ·pired, and I knew as earl} as my second year in medical chool that I was meant to dedicate my life to this, ork." De pile his calling to enter the field, appuccino knew the odds were .:ig.iinsthis obtaining the goal he had et for himself: earning a coveted slot in one of the integrated plasti surgery re iden y pro­ gram , something no medical student at UB had ever done. 'everthele • he teadfostly pur ued hi g al through ut medical chool. During hi fourth year, in a final push to gain a competitive edge, he completed two intensive month-long vi iting extern hip in plastic and rcconstructive wrgery---one at Cornell l\ledicaJ College �"YO TF KF.TH T KI I CTE aid Cappuccino hen hefir.t ~ai,v the e candiclphoto­ graphs taken at Match [Jay while he and hi cla 111ate/ fiancee RachelSch1nitt,openedtheir envelope. ( lanhattan campu ) and the other at the Univer ity of tedicine and Denti try of ew Jer ey ( MD J). He then applied to the chool ' integrated re idency program , and both granted him an interview. Fa l ., • 'r. Rachel ' chmitt, appuccino' fiancee, had in turn decided to pursue a areer inane thesiology. A native of Clarence, Y, chmitt earned a bachelor of cience degree in biology at Le 1oyne College in yra­ cu e, Y, graduating umma cum laude. Ane the iology i al o a highly competitive pecialty, and it re• quire ompletion of a preliminary year prior to beginning training in the field. a re ult, the couple found them elve in the precariou po ition of needing to earn three re idency lot on Match Day, preferably in the ame location: a pla ti and recon tructive surgery . lot for appuccino, and preliminary training and ane the iology lots for ' hmitt. Both had ranked UMD J a their fir t choice. On March 20, member of the B medi al chool Cla of 2003 gathered with friends, family and faculty at the Pearl treet Brewery in Buffalo, where Match Day took place. The student were ummoned in random order to come fonvard to re eive an envelope that contained a letter announ ing the school and field of medicine in whi h they would be training. A it happened, appuccino's name wa called early. "When I received my envelope, I held it and we waited for about another 140 name to be called before Rachel received hers, then we opened them together." \ hen they did, Cappu cino and ' hmitt learned that they had indeed beat the odd : both were headed to UMD J. In addition, hmilt will be doing a preliminary year in general urgery, which mean the couple, who were married on Mar 30, 1 ill intern together in the Department of urgery as hu . band and wife­ a fir t for the department. Bybe oming the fir t B medi al tudentto pla e in an integrated pla tic urgery re idency program, appuccino has inspired and motivated other UB tudent to pur ·ue similar dream . "I 've been contacted by tudent asking me for advi e in plastics re idency; the · ay I've given them hope, " say appuccino, who relishe his trailblazing role. One of the rea on Cappuc ino mar feel so comfortable a a role model i becau c he i no tranger to folJowing in the footsteps of other he admire . His brother, Andrew , is a pine surgeon whose wife, Helen , i a general urgeon; both are 1988 graduate of UB' medical chool ( ·ee Reunion Weekend photograph on page -12). And appuccino's ister, Mary, is a pediatri infectiou di ease speciali t , ho e husband, Joe Bonafede, is an ear, no e and throat spcciali t; both arc I 991 graduates of the medical ·chool. ''I gue I'm carrying on a proud famil tradition, " ay appu cino. "But it end with me. I'm the younge t of even kids!" Sum mer 2003 llllale n1sltlai 25 �Rebecca Dwyer,leit, andChristinaGraczyk, right. dedicatingTheIris-. EvanHoover beinghooded by SeniorAssociate Dean Suzanne Laychock, PhD, left,and FrankSchimpfhauser, PhD.right. DavidBrauer, classspeaker; InterimDean andVicePresident for HealthAffairsMargaret Paroski, MD,andOBPresident WilliamGreinerpresentingKari Brossardwith her degree; AmyE.Kirby,thefirst biomedical sciences candidate to deliveranaddress ataOBSchool ofMedicine andBiomedical Sciences commencement; , Joyce Zmuda, left. andMargoMcllenna, right, Melanie Fiorella, /eh.andDavid Fintak, right,reciting theOath. 2& 1,11111 npicin \um mer JOO 1 �The 157th commencement for the University at Buffalo School of Medicine and Biomedical Sciences was held on May 23, 2003, at the Center for the Arts on the North Campus. This year, the school conferred 130 MD degrees, 3 MD/PhD degrees, 6 MD/MBAdegrees, 21 PhD degrees, 2 MOMS (doctor of medicine and oral maxillofacial surgery residency program} and 15 MA degrees. The honored speaker was CongresswomanLouise M. Slaughter, who is currently serving her ninth tenn in Congress as a representative of the 28th Congressional District of New York State. �R E E A R C E H I\' 'I DOUL3 erlw IS J II C 11 IQ U AL L OW C I E TIST , 0 FILM I 'GLF- IOLF< ! l BIOU -U . !ISi \\ HO PROD U· S 10\ IFS. I JI IS, HO\\ E\ l R, D ) 'OT t I !RO. ' !CLE 1 HL- HU,\IA . CO . Im 10 , \ I \ •s Tl BJE :::1 I H : HELi IA. BIOWC,\ ,ff l rs ~!OST BASJt- HOII YWOOD; ·r HE rRA ,' I Ot \110 .' .\ . ' I) DI G OID 1 A. Bian o, who is an a istant pr fessor of microbiology in the niver ity at Buffa) hool of Medi ine and Biomedical Sci­ ence , i the first to re ord on videotape in real time a molecule of a parti ular D A motor protein, or nanoma hinc, in the pro e s of"unzipping" a double strand of bacterial D A. To a ompli. h this feat, he u c a Le h­ niquc he developed ailed "la. er tweezer." U ing this tool, he can grasp and hold a D m le ulc long enough to aplure the action as the double helix unwinds. 'These la er tweezers allm\ u t look at nc molecule at a time and under tand how a pr tein really w rks," ay Bian o, who al o is a member of the enter for ingle M lecule Biophy i at B. "When you look at groups of proteins, all of the nu­ ance of individual pro­ teins are lo l. With this sy tem we can pull a D1 molecule out fa lution and a tually watch a single D heli ase mole ule (the m tor protein I take an individual D A molecule and pull it apart." If there were an Academy ward ~ r most imp rtanl ba ic cien c film, 28 1111111 n,sieiu S umrn l·r lOOJ Bianco's I ork urcly would be in the run­ ning. Knowing how D A unwind . , copic and repairs itself- what tarts it, what top it and why-will make possible ma­ jor advancement in c,mcer treatment and is vitally important to the progres · of gene therapy and re ombinanl D A re ear h. ince cancers arc caused by uncon ­ tr lied cell growth, and D A motor pro­ teins make this po sible by allowing D A to copy itself, the e proteins are natural drug target . Re earcher know that many ancer drugs stop cell growth, but they don 't know preci ely hm . Bianco i hop ­ ing to pr vidc ome detail . "We want to find out what happen when you put an amitumor drug in the\ ay of the motor protein, " ay Bian o. "If the drug tops cell growth, we want to find out exa tly how it doe - it. \Viii the protein start the unwinding with the drug present? If it tart , will it continue? Where will it stop, if at all?" The re­ ulting movie . will how how existing drugs work and will allow re earcher t test the efficacy of new drugs designed to inhibit D A repli­ cation and repair. Bianco developed his y tem while a po tdoctoral fellow at the niversity of alifornia at Davi , in collaboration with colleagues from Lawren e Livermore a­ tional Laboratory in Livermore, alifor ­ nia. reating it con urned everal years; the work culminated in publi at ion of the at11re in breakthrough in the journal January 2001. Learning hm a D motor protein function and capturing it on film po ed veral vexing technical problems at the time: how to natch a ingle D A molecule, stretch it out, and hold it table long enough to \ atch the motor protein (helica e) in action. Then there wa the problem of i1e: DNA motor protein are too mall to be observed under a micro cope. Bianco olved the c problem in a vari ­ ety of way . The laser tweezer form the crux of the y tem. By fi cu ing an infrared la er beam through a micro cope objective and aided by the law of phy i s, he can create an optical trap that tops a D A molecule in it tracks. The mole ule it elf i · t o clu ivc to be caught, however, Bianco tether the D A molecule to a microscopic poly ty ­ rene bead to give the tweezers omething to gra p. ext he atta hes a motor protein molecule to the oppo itc end of the D A mole ule, and tag both bead and D A with a fluore . cent dye. The dye creates an �-. • ... ..... • • Prr B co,P image suffi iently bright to be re orded b\ a microcamera de­ signed to perform under very low light onditiom. Technique to bind nuores ­ cent dye to the D A helicase have only recently been developed; 8ian o now has that capability at 8. S tretching out the mole ule and ini­ tiating the action c ur · in a now ell, a tinv, cu tom -made, Y-shaped appa­ ratus the size of a micros ope lide. 8ianc introduce the bead and it cargo f OJ and motor protein into one channel of the flow cell (one of the arm of the "Y"), in ert ATP-the molecular energy ource-int the other channel, and ~ u es an optical micro · ope and laer beam on the jun ture of the channel . The tretched -out molecule and its en­ ergy sour e flow in their . eparate hannel into the juncture, where the action begin . . The la er beam capture the poly tyrene bead in its tweezer -like grip. Manipulat ­ ing the la er beam, Bian o maneuver the D A into the path of the ATP, which jump -starts the heli a e. The breakthrough film described in at11re features a molecule of E · heri hia coli helica ·e called Re B D, which acts by unzipping the D mole ule from one end to the other. That movie how the tretched -out trand of glm ing D A becoming progres ivcly horter a the in­ vi ible motor protein unzip them, di placing the dye a it goe . Thi action i called pro e ive tran lo­ cation. n film, it look like a string of lights being witched off, one b}' one. Once D A trand are eparated, the elemental pr e · es of replication or re­ pair an begin. At U8, Bianco i nm working to adapt his ystem to inve ·tigate other, more com­ plex ba terial helicases. The pre ent target i Rm 8, a circular nan machine that drives a criti al late tep in geneti re om ­ bination called branch migration. ' nlike Re 8 D, thi · motor protein wraps it elf around D A like a doughnut on a tring , carrying out tran location in a different manner. The B et -up i · equipped with two optical trap · and i ignificantly more advanced than Bianco ' former r tern, allowing him to work with more compli ­ cated molecules such a RuvB. The overarching goal of Bianco ' reearch i to learn how cancer drug inter ­ fere with tran location. Thi information will, in turn, allow drug <level per to tar­ get chemotherapy drug to them t effe tive point in the pr ces . Bianco intend to define and film the action of everal m tor protein , then begin , orking with everal specific cancer drug provided by ollabo ­ rators at Ro well Park Cancer In titute . "There i potential here to an wer que . tions you could newr an wer an y other way," 8ian o note . <L> 1 111111 npici11 29 �p TIIW ,\YS WS A D I BOT BIO DI AL SUMMER IILI nu RI ( El I I) El RD I R Fl 1994, .lO 11 11 I (I 30 I I Fl). \umm, 2003 T FF 2003 Da, id Milling, i\lD '93, has been named assist.mt dean for multi ultur,11 affairs in the OffiLeof ~tcdical I.ducation at the niversity at Buffalo s hOl)Iof r-.tedicineand Biomedical Sl.iences. In this role he is resp nsiblc for de,·cloping a program to recruit and retain undergraduate ,rnd graduate medical students and trainees whosl' backgrounds reflect the diversit} of underrepresented populations in 'cw York ",tale. I le also works with fawlty and staff to implemenl these goals and objectives, ,is well as to procure funding to support the efforh of minority applicants. In addition, r,.,tilling continues to serve the school as assistant professor of dinic.al medilinc (a position he has held since 1996) and as ·r A D IT cour c director for the Clinical Practi c of :\lcdicine for ccond -vear student . i\lilling completed residency training in internal medicine at B, and from 1995 to 1996 served as hief resident at f-ric <..ounty Medical Center. 1--rom1997 to 1998 he completed a primary are faculty development fcllow,h1p at :\ltch1gan talc niversity in f-ast I ansing. :-.lilting received the iegcl \ward for Teaching Excel­ lence at B in 1994, and again in 2000 ( for full-time faculty clinical staff}. I o in 2000, he received the 1-.Carter Pannill Award for uhtanding Tea bing, which i. presented to a junior acult · member in the B Department of Medicine. - .. A. '1CtR niversity at Buffalo Pres­ R. ,reiner ident Willi,1111 announced in January 2003 that he is stepping down as the 13th president of 8. following this announce­ ment, a Presidential earch Ad, isor. Committee was establi hcd b) the 8 ouncil to solicit and c, ,1luate nominations and applica tiom for the president's position according to the guidelines established by the SU1 Y Board of Trustees. In Mar h, Jeremy .t\l. /a ob , chair of the 8 Coun ii and chair of the Pre idential earch Advisory .ommittec, named the 17 members of the committee, three of whom arc facult'r members in the B hool o 1cdicine and assi tant professor in �the departments of urgery and orthopaedic , who i nc of four member· of the ·B oun ii serving on the ommittee; Michael . ohen, 1D, chair of the acuity, cnate and profe sor of neurology and pediatric ; and Frederick . Morin Ill, MD, profe · ·or and chair of the Department of Pediatrics. For more information on the presidential earch, vi ·it http://www.buffalo.edu, presidentiabearch/. -ARTHUR Buc,;1 P GE Richard J. Bu kley, MD '74, a pra ticing surgeon with Amht:r. t urgi al As iates in Am her t,, Y, ,, as installed as the npre ·ident of the Medical ·otiety of the ountr of Erie on ;\lav 6, 2003. A natin~ of Buffalo, Bu klcv ompleted his undergraduate training at olorado ollege, 0, his master' degree at ,rnisius .ollege and mcdi al degree at the UB chool of l\ledicine and Biomedical cience . He is a diplomate of the Amerian Board of urgen·, a Fellow of the Ameri an ollege of urgeons and a delegate from Eric County to the House of Delegate of the l\ledical ocietv of the tate of I ew York. Buckle) is a clinical assistant professor at 8 and i. on raff at Kaleida Health and Kenmore ~1erq Hospit.il, now a part of the atholic Health Sy tem. . A. L nurses, te hnicians and support . taff who prO\·ide quality health care to the people of Western I ew York." A EO, Kaiser ,aid he \\;11focus on "high-qualit} medic,11care, u tomer satisfaction, employee growth and development and enhancing our information technology.'' GER Roger E. Kai er Jr. ~ID '79, ha been appointed chief execu­ tive officer of the Erie Healthcare Network. Kai er, who is a ociatc professor of linical anesthesiology at the UB chool of Medicine and Biomedical ciences, had been erving as the interim CEO ince October 2002 and medical dire tor ince 200 I. In addition, he erwd as clinical director of the E l\1 Department of ne~thesiol­ Og) from 1989-2003. "It will be a privilege and an honor to sen·e as EO," aid Kai, er at the time of his appointment in ~la}'. "A a practi ing physician at L MC for nearly 20 years, I am familiar with the personaliry of this organization and the talented team of phy icians, brain into various region . The resear h can potential!~ hed light on whether ognitive impairment in l\l is related to global or focal disease and whether this is located in gray or white brain matter. The AO is the onlr national medical honor o iety in the world; it is dedic,lled to upporting academic excellence and perpetuating ex ellence in the medical professi n. Third-year medical student -S. \ '\CFR Mi hael , anfilipo has been awarded a prestigious Alpha Omega Alpha (AOt\) tudent Research Fellow·hip. ebastian ( ian io, DDS, A n,lli\·e of Buffalo, U1 Y Di tingui hed en·ice , anfilip is a member of the Professor and chair of the Buffalo I euroimag111g Department of Periodontic naly is enter, where, under in the L niver ity at Buffalo the leader hip of Rohit hool of Dental /l.1edi inc, Bakshi, ,\tD '91, he is ha recei,ed the 2003 performing quantitative i\lRI Pharmacology, Therapeutics resear h in multiple s lerosi and Toxicology Re earch (;\L ). In 2002 he received a ward from the International L'B hool of ledicine and s.o iation for Dental Biomedical ciences Re earch Fellow hip to (IADR). The study whole brain gray­ award recognizes and-white matter iancio\ difference in :-.1· and " ignificant whether the e global contributi n to brain differen e are the field of related to cognitive dental research," impairment in l\L. and was pre\\'ith the QA award, ented to him m anfilipo will further Goteborg,, weden this June at inwstigate the relation hip the I DR General es ion. between cognitive dy fun -. UE \\ l;lTCHER tion in , I and variou. grav­ and-white matter region· by u ing three-dimen ional :-.rn1 techniques to ubdivide the umm,r 2003 1 1ll111 Hysiciu 31 �p t, T fl Y \ y regory . herr, MD, a vascular/endova cular surgeon, ha joined the medical staff at Erie unty Medi al enter (E M ); in ugust 2002, he joined niver ity at Buffa! chool of Medicine and Bi medi al cience a as i tant profe or of. urgery. A native of Roche ter, NY, and a graduate of Tuft niver ity ho I of 1edicine 111 Bo t n, 1 , herr ompleted a po tdoctoral re earch fellow hip and a clini al vascular fellow hip group led by Robert R •chtarik, PhD, s ni r re­ search scientist in the niver­ . tt} at Buffalo\ Resear h .B re. earch asso<.iate profe sor of ps hiatry and p y hology, ha_ received a · 2.3 million grant fr m the ational Institute n Alcoh I Abuse and koholism to study how and wh · different levels of care work for different people with al ohol problems. The study is being c nducted in collaboration with the rie ~ounty Medi al enter' (E M ) Divisionof hemical Depend ncy' outpatient and inp,llient rehabilitation programs. RobertB. Whitne , MD, 8 linical,1ssistant profcSM>rffamily medicine and psychiatry,and clinical director of E ~tC \ Division f hemi al Dependency,is a comn:stigator on the project. Other coinvestigatorsinclude RIA rescar h sdentist eil B. M ·(;illicuddy, Phl , and Gerard J. .onnors, PhD, direct r of RIAand B probsor of psrchology. l·or more information on work being condu ted at the Research Institute on ddict1om, nsit ii,\ ebsite at \ ww.ria.buffolo.cdu/. - KATHLEE lcdi ine in Ellr.abelh PierceOlmstedRoa, MD'39, recehedan honoraiy the Ameri­ can Board of Cu ERR urgery in general surgery and i a regi tered \ ,1sculartechnologist. In addition to perform­ ing vascular urgery, hcrr pe ialize in aortic ancury m repair and minimally inva ivc endova · ular surgery technique , in luding aneury rn repair, angio­ graphy, and angiopla ty/ stenting f arteries and veins. - \!£LANI! GRIFF! doctorof science degree on May 23, 2003, at the 157th commencement of the UnlYersitJat BuffaloSchoolof MedicineandBIGlnedical Sciences- A piollNr'.,g ophthalmologist c nlclan, lnYentorand mator,Olmsted Roa Isoneofthe Unlvenityat Buffalo's most dlstlnpishedalunmlandoneof WesternNewYortl'smost dedicatedphlanthroplsts. For six decades she has chan­ neled her expert! e into program for the visually Impaired, fromInstitutingcompanysafety pales and mak­ ing large-printbooksavailableIn publicschools to organiz­ ing vision-testing programsIn Buffalo'spreschools. Presenteda Lifetime Medical Alumna Achievement AwardIn 1999, OlmstedRosshas placed heralmamaterat th6 fotef1ont of vision researchwith the establishment of the Ira G. Rossand Elzabeth Pierce OlmstedRoss,MD, W "\lit FACS,chairIn ophthalmology at the UBSchoolof Medicine 3 2 11tfal1 n,siciu ~ummrr 2003 and BiomedicalSciences. �Louis A.and Ruth Siegel leaching Awards 2003 Siegel Awards Category I: for Excellence tyw in Teaching Category Ill: u t n-f ulty Recipient: Recipient: "Dr. Cohan is a professor with compassion, sensitidtv and a 10\·e of teaching. He take trong interest in his tudents and treats them with the utmost re pect. He took the time to learn everyone's name and created a very warm and friendly space for us to learn." Category II: h cl n cal c1 Recipient: "Dr. Fox erves as the sole physician advisor to the tudent volunteers of the Lighthou -e Free :-,tedical linic. A a physician, he is a role m del for every tudent who works in the linic. He approaches each intera tion with his students as an opportu­ nity to prepare them for their future medical career .. . He empower . us t take responsibility for every a pc t of the clinical encounter and teache us to be unbiased and com pas. ionate medical de i ion maker -." "Dr. Rabadi is one of the be t attending phy i­ ians I have had during my four years at UB. It is clear that Dr. Rabadi loves tea hing. He has a great ability to commun1 ate with and edu ate tudent in a fun, nonthreatening \\ay." Category IV: w rd 1d nt an Recipient: "Dr. Olawaiye 's attitude is a breath of fresh air. If you ever had a question, he gave you an entire I0- to 15-minute lecture on the topic. He never intimidated us, despite the fact that he b a 'walking HlJB. ' l:T' of information ... He created well- rafted storie to get us to remember clinical jewel -." Foryoung and old. Forpatients and families. Hospicecare touches everyone, including children with a sick mom or dad . sibling or grandparent . With chaplains and social workers helping out, the whole family feels better. The sooner you call, the more we can help. Hospice. A plan for living . 686 -80 77 hospicebuffalo.com. 111 1 ( l S IIR fOR H l SPICE& PAUlATIVE CARE Summer 2001 1111111 nysici11 33 �PATHWAY Alan D. Hut on, PhD, a·· iate profe · or and hief of the Divi ion of Biostatisti in the h ol of Public I lealth and Health Professions at the niversity at Buffalo, ha been awarded a 340,000 Faculty Development grant from the New York tate Office of cien e, Te hnology and Academic Re earch ( Y TAR) in recognition of academic excellen e in the field of bioinformatics. f that amount, 260,000 will be allocated for salarie and 0,000 for equipment. The support is part of Y TAR's Faculty evelop­ ment Program that a i t in ·titutions of higher education in 1ew York tate in the recruitment and retention of leading entre­ preneurial re earch faculty in science and technology fields with strong com­ mercial potential. An earlier Y TAR Fa ulry Development grant wa u ed to recruit Hut on, a key investigator in bio tati tics/statisti al geneti , to support the infrastru ture of the B enter of Excellence in Bioinformatics. Y TAR officials expect Hutson, who joined the UB faculty in eptember 2002, to make ·ignifi ant ontri­ bution to re car h in the areas of bioinformatic , bioterrorism/biosecurity and clinical trials, all of\ hich have commercial spin-off potential. He al o will continue hi linical re earch and will e tabli ha data coordinating center that will be a boon to clinical re earch­ ers and keep millions of dollars in New York tate that now are being contracted out to data coordinating enter in other state . - UE WUETCHER \ illiam L. Duax, H.A. Hauptman Distingui hed cienti tat the Hauptman­ Woodward Medical Re earch 111 ll\ a lull. worry-free lifestyle for independent adult, 62 and older oflenng as,et protec.t1onand health care guarantee conven,enc.e and value you wont find anywhere el,e C1/lto,foyfor mort111fonn,11to11 m11/a prrso,,,,/prosprdu (716) antcrbury 1 ,11111 npici11 'i ,, m m •· r 2 0 0 .~ \ oods 929-5817 • 705 Renaissance Dr., \ illiams.illc. Y 14221 �graphic re earch. The organization is al o rcsponible for maintaining interna­ tional tandard for data gathering, storage, and analy i , nomenclature and method . This, ork i vital to the infra truc­ ture of cience in Institute (H\\'I), and profes­ or in the Department of tru tural Biology in the Cni\'er ity at Buffa! hool of Medi inc and Biomedi al • ience , ha been elected pre ident of the International nion f ry tallog­ raphy (IUCr). The I U r, which 0UAX ha over 20,000 members from 60 countrie , i devoted to pr moting international cooperation in cry tall graphy and the publi ation of cry tallo- government laborato­ ries, univer itie , and indu tries throughout the world. As pre ident of the I r, Duax will focus on extending the benefit and ervice of the IU r to countrie that are not currently members. I le will al o be re ponsible for ensuring the u ce · of the next International ngre · and eneral A emblies of the Union that will take place in Florence, Italy, in 2005 and 0 aka, Japan, in 200 . Duax, who also erve as an adjunct as· iat profe or in UB' t.1edi inal hemi try Department and a an a ciate re ear h profe sor in the Bi hemistry Department at the Ro well Park Divi ion of B, ha publi hed over 300 manu cript . In addition, he ha· received many notable honor , in luding the Di tinguished cientist Award of the linical Ligand A ay o iety, and an Honorary Doctoral Degree from the Technical niversity of Lodz in Poland. He is a member of the ew York Academy of cien e and is a pa t member of the govern­ ing board and executi\'e board of the American Institute of Phy ic . TAVA HA. CHIJK THE AUDIOLOGY CE TER GEE EE HEARI G SERVICE 61 Wehrle Drive (Near Harlem) Amherst 14225 630 Orchard Park Rd. (Near Ridge Rd.) West Seneca 14224 837-6213 712-2000 • Diagno. tic audiometric valuations (pediatric and adult) • Digital programmable hearing aid fittings on 60-day trial ba ·i • Tinnitus e\aluation and therap • c tibular evaluation for patients with diuines /vertigo • tibular therapy • late of the art fa ilities "Th Ear i the Road to th R art /\,1//,J/R 0 / um mer 200 I lllfale nysiciu 35 �PATHWAY • VO K. ichael ummings, PhD, hair of the Department of Health Beha iors in the Division f an er Prevention and Population ciences at Ro well Park ancer Institute, wa awarded the 2003 Joseph W. ullen Memorial Award by the American o iety of Prevcnti c Oncology (A PO) at its annual national meeting in Philadelphia, P . fhe A P Award re og­ nizes distinguished achieve­ ment in national tobacco c ntrol effort , resear h, development of prevention and ce · ation programs with wide-reaching public health impa t, and public poli y and advo acy initiative . It also re ogni,e and honors an indi­ vidual who e leader hip, like that cu ,t mies f ullen, is e. emplified by a commitment to fostering llaboration among the wide netw-orkof basi and bchavi ral cientist , health care profe sional and public health advocates involved in the fight again t toba o and tobacco­ related di ea e. Cumming was honored by the A P for being an interna­ tionally re gnized authority n tobacco is ue who ha con­ tributed to several urgeons eneral Rep rt on moking and Health and to an Institute of Medicine rep rt on nicotine addiction in hildren. He wa · al cited for hi re ent work, in luding studies using internal toba co company documents to inve tigate cigarette marketing practices, the effectiveness of tob,teco ontrol poli ie on adult and youth moking behavior and consumer risk per eption about tobacco produ t · and nic tine delivery device . ummings ha publi. hed over 160 s ientifi papers and is the deputy editor of Tobncco 011trol:A11 llltemntional Journal. DEBORA II PETTIBO!S CD E NGtllnlREINTO YIIIR H ME& OFHCE "Experience the tranquility of Tropical Fish" LARGEST SELECTION IN THE AREA • Completeset-ups lrom table/desk top to large central displays • Equipmentand supplies • Tropicalfish, gold fish & Ko, (domestic& imported),dwarf lrogs. bottom leeders. mollusks,crustaceans & other unusualvaneues. • Importedlivestockand frozen foods • Wide selectionof aquarium accessoriesand decorative items • Food, antibioticsand water cond111oners • Aquatic plants (live & artificial) • Lighting accessones tlllTmfAS: ~ NumerousDry-ScapeDisplaysin Our Showroom ~ Beta Vase Plant Aquariums ~ Lucky Bamboo Plants ~ Set-Up and MaintenanceProgramsAva1labl ~ Gift Ideas & Gift Certificates V,s,t 'l.JrtleJoe·. !he Giant Pacu /roughly 30 lbs.) or Our Large Predator- T,ger Shovel Nose Cat-Ash Tran itown Plaza 634-9344 WWW tdslropical.com OPEN: Mon,Wed,Thurs9am-9pm; Tues& FriNoon-7:30pm Sat 10al1Hipm; SunNoon-Spm 36 1 111111 Plrsicl11 \ 11 m '" ,· r 2 0 0 J ~ D Tropical /; TRANS/TOWN P1RA j C) - -------1 J-q() Exll.49 Fi,,/1 -90-­ �Sc·enti 1cP anning Bv onna Jean Nowak, PhD, an internationally recognized scientist whose research has contributed directly to the Human Genome Jo H DELLA Co TRADA UB Provost Elizabeth D. Capaldi, announcing Nowak's appointment, noted that she "has an absolutely critical job at the UB Center of Excel­ Project, as well as to microa1Tay-basedapproaches to under­ lence in Bioinfonnatics-building standing heritable disorders and cancer, has been named integrating that with the infonnatics piece coordinated by director director of scientific planning for the University at Buffalo Center of Excellence in Bioinfonnatics. In this capacity, she will direct the Jeffrey Skolnick. "She will work with the deans at UB and our academic partners to integrated experimental component within the center that willbe crucial to recruit world-class researchers who can participate in our coordinated achieving the goal of creating a wortd-class center and advancing a bold systems-biology approach," Capaldi added. experimental initiative to complement its ongoing theoretical efforts. the "bio" part of bioinfonnatics and A native of Buffalo, Nowakearned a bachelor's degree in biology from An associate professor of biochemistry in the UB School of Medicine Canisius College, a master's degree in natural sciences from UB and a and Biomedical Sciences, Nowak previously served as director of the doctoral degree in experimental pathology, also from UB, where she Microarray and Genomics Facility, a collaborative research lab shared by received a New York State Predoctoral Fellowship in Cancer Research. the school and Roswell Park Cancer Institute (RPCII, and headquartered at RPCI. Prior to that, she was involved for 14 years in research at RPCI developing physical clone resources for cloning disease genes and map­ She completed her postdoctoral training in human genetics at RPCI under the mentorship of Thomas B. Shows, PhD. The UBCenter of Excellence in Bioinfonnatics was founded in 2001 by New York State Governor George E. Pataki, who proposed creation of ping the human genome. Among her major achievements, Nowak has authored landmark papers Centers of Excellence in Buffalo, Albany, Syracuse, Rochester and Long describing the cloning of several heritable cancer disorders, including a Island as part of an effort to leverage the state's expertise in high fonn of ataxia telangiectasia INijmegen Breakage Syndrome). Her work on technologies, attract new businesses and improve the state's economy. the Human Genome Project was published in the genome issue of Nature. To date, it has garnered more than $290 million in support from New Nowak also developed a microarray-based method for identifying numeri­ York State, the federal government, foundations and corporate partners. cal differences in DNAbetween tumor and nonnal cells and cells from UB's research partners in the center are Roswell Park Cancer Institute people with genetic disorders. The results of this work were published in and the Hauptman-Woodward Medical Research Institute. The UB Center of Excellence in Bioinfonnalics is located temporarily Nature Genetics. Nowak,who has received more than $3 million in research grants from at 901 Washington Street. Construction of a 129,000-square-foot to begin in late summer or in the National Institutes of Health, has authored or co-authored more than structure to house the center is scheduled SO research articles in leading scientific journals and is associate editor early fall 2003. The new building will be located at Ellicott and Virginia of Physiological Genomics. Streets on the Buffalo Niagara Medical Campus. --- Alp ha Omega Alpha Honor Medical Society Alpha Omega Alpha is a national organization dedicated to supporting academic excellenceand perpet!iating excellencein the medical profession.It is the 011/ynatioual medical honor society in the world;st11dentsare selectedon the basis of scholarshipand integrity. Neivly nominated AOA members of the University at Buffalo's Epsilon Chaprerfrom the Class of 2004 initiated this spring are: James R. Boyle Sara R. Connolly Carmine Alexander Grieco Christina L. Haverstock Cristina Lampuri Jennifer E. Nelson Jennifer L. Nowobilski Summ('r 1003 lllf al 1 Pl ysicin 37 �0E\ELOPIE~T f\\, • The flow ofGenerations I y Li nda J. Co r de r • Ph D. CFRE This continuity, this Oow of the river of co1noded with the B: e11eratio11lo Ge11ern1io11. institutional life, is what the ampaign for VB: Ge11eralio11lo Ge11eratio11celebrated. Tho.)c It struck me al both reunion weekend and commencement who hared their mem nes during the cam­ just how fitting that theme of generational continmtv ts for paign enriched the recorded history of our our institution. official end of the ampaign for tr,mscends time and d1stJnce. It is J Our community community that remembers it-. history and plans for its future. It is a community of memory and of hope. Our school was the first ,ic,1demic unit of gratitude for what the, received and their belief B. It sun ·1ved 1908. Among the shortcomings listed were the absence of,trts cxactlr right that the school topped ib 50 miUion goal as the and science prerequisites and the lack of a meeting 1.1blefor result of a gift m,1de hr the LB Council. The former 1,a solved in11iallyby institut ­ celebrate his sixtieth reunion. n,llion to their stories. During the w.ir, UB, like many medical B\ College of PRI l CC E TE TO PUBLIC," fcren e rooms. five mornings per week at 8 a.m. Fl'ery Friday after school, to the Hexner Report b still The un i,·er-,itr evolved successfully trom "private" to "public," and from being a ,1turdav morning they had intern hips and residencies ,1fter ,ictive duty; others were allr recognized research university. all the years ,rnd changes, All eight spoke glowingly of their regard for the chool, the alumni continue to return to celehr,lle their quality of their education, their preparation for the rest of roob. They wait in anticipation when their their lives. children, grandchildren, nieces and nephews One member of this class, Dr. Ralph Behling, chose this ,1pph to LB. !'heir eves moisten with tear as weekend to announce has plan, to endow a hair in dermatol ­ the) slip hoods over their children\ heads at ogy. his own spe ialtr (sec article on page IO). This is imply ,111dwat h the newest medical doctors re- his way of ensuring that future medical students and resi­ plans for the school\ future . They share th ir 01111 areer succe\Ses, as well as the 1,ays their cdu ation b making a difference, personally and to those they en ·e. nd many alumni take steps to make .irrangcments so th.11the s hool will continue to m,1ke ,1dilferencc to those who follm,. n,siclu they had a long march; even special drills for noncombatant officers .. omc finished their considered essential stateside and continued their training . lumni gather to hear ,rnd disLUss research finding, and lllfJlt )0111 solid regional institution 10 an internation­ peat the oath th,1t phvsicians have sworn for generations. 38 LOndensed to three year . ,\tcmber, of the Class of 1943 could the Army '>pec1alized Trainmg Program or the aw\ VI 2 Program . .\lcdical school then also included a muster 111response Through commencement chools, was on the "accelerated plan," \\ith the curri ulum the centerpiece of one of the s hool's con- built FRO I Eight of thirty -three )il'ing members of the Class of 1943 nion, whi h donated property and Arts and Scaen..:eswas established. The table E\ Ol\iED alumnu who returned to gathered to commemorate this mile tone. I listened in fosci­ of Buffalo's \\'omen\ rai. ed th required endowment of I 00,000, I\ ER ITV .1 generou Edu a­ commitment tional and Indmtrial l'ULD in the importance of this school to future gen­ a re ommend.ition of closure by the Flexner Committee in ing premedi al courses. Then, ,1 few rears later, through the U who participakd through gift erations of physicians and scienusts. Thus, it :;omehow !>l'emed philanthropic Tut school. Tho. and L>stateplans were expressing both their \ 11 111 111 er }. 0 Cl .I dents will have fulfilling experiences and that the,, in turn, will also eventuallr be .1ble to contribute to the school's con­ tinuity ... from generation to generation. CD �IEL faHE), cc,TER, \\ ILLIA\! V.ITH CL.A ·s I TE. BLOO\!, l.Fl'T A. D fRA c1.· PELl!L ..:; .J c,: 0:: = 0. "' :r. 0 , SEATED, LEFT TO RIC,IIT, RO ALD R CHO\\ A. D MICHAEL t;tll\A. \\JTH RICH RD "' 0 AGEL, '-TA\ DI. G, LEFT TO RIGHT BElffRA\I f-, SKIP GARVEY, PORTI 0 = =- D MILFORD MAL01'EY um mer 200 I llllile Plpici11 39 �• R nion ■ E, !ATE JOH I ,o l1flal1 P111ici11 LAMAR JR, LEFT B A D RM \ummer 100• 3 �s CU~IBO, LFfT MARCHETTI, A ·o ROBERT MILCH CLA:s D CocHAIRs ~IIcH>.EL SA:-. ·o. ·E icrr RTHUR MRUCZEK CF:.,TFR. \\ITH CLASS~IATES A. ·o BROTHERS FL! e, ' ummrr 2001 1111,1, n,siciu �'\'i 1TH '\'i lfE f I Lf.E Special thanks to Kenneth Zimmennan, chairfor the Class of 1983, and Sanjay "Ray" Ogra, chair for the Class 1993,for all their efforts. 42 1111111 nrs1c111 ')um m r 003 �Alunmi, Dear Felio r the time this edition of llficers u• le ■ hrs har• Zll3-Zll4 811ffa/oPhysicumgoes to press, I will have begun mr term as pre. idcnt of the }.kdi al Alumni A ociation ( MAA). I eagerly look forn·ard to sen ing in this capacitv, as the governing board of our association embarks on it annual goal of initiating and supporting social and academic proje b related to the medical school, its tudcnts and alumni . PRE. IDEST I would like to start by tipping mv hat to Patrici., Duffner, MD '72, who preceded St<'plte11B. Polfock \ff) 'X.? \ I F. PRE IDE me as president. Pattv led the go\'erning board with her unique blend of vivaciou - r ne,s, good humor and a\'OJr faire. The centerpie e of her tenure \\Js a • pring Col/e('11 \lattimorc \1() '9/ Tl(EA Clinical Day unlike any in recent memory, highlightmg downtown Buffalo, the t:RER Buffalo "iiagara Medi al Campu , and UB\ Center of b ellence in Bioinformatic-. In addition to \for1i11 I. Bralt,•r, .\Ji) '7.? Dr. Duffner, who will serve a past president, I \\'ill work along ·ide Colleen Mattimore, MD '91, and Martin Brecher, MD '72, who were elected vi e president and treasurer, re pectil·elv. t E I BER Rolrit U11k,/11, .\tv, •91 the alumni association continues to evolve in its relatiorn,hip " 'ith the Medical elopmrnt Office and the l f,,1.,,. ( appucn110, \II) 'xx hool Dev­ n1ver itr at Buffalo Foundation , I .1111pleased to welcome new individual. to active role. in the alumni office. These include Kimberh \ 'cnti, director of donor stewardship and .\fnrti11 C. \fo/l(lllt'I, \f [) '95, Pit I> constituent relations, and Jennifer Lobaugh, coordinator of special e,·ents. Kim and Jennifer are talented, energetic ,·oung women who have proven themseh·cs invaluable to the w cess of our C:o//<'n1 \ftitt1111ore, .\10 •91 programs in the short time they have worked with u . \\'ith a year under their belts, they will provide C/111,/,·, ;,'i/cs, \t D '113 tremendous support as we roll up our lee,·es and continue to do "great things" for the alumni, the f11dr11111i11/ra, \II) '96 medical students, and the school. As you enJO} your summer , your governing board ha begun to plan for the year ahead. The lr-.tERITU hMBER /ol,11 /. Roilki11 II, highly ,uc essful Phy. ician- tudent ~lentoring Program, in which each in oming medical tudent \t D '76 b matched to a community physician, will be presented to the tudent when they arril ·e for Donald P. Coplr)', \f [) '70 orientation. Rob,•rt l, Re, 1111111, .\t [) '56 we plan to take o,·er downtown Buffalo and build on the successes of the past year, o mark your pring Clini al l), 1} and Reunion Weekend b set for the weekend of pril 30, 2004- calendars and plan on being ,1 part of it! Rtc.10 L IBID R Iosep/, \, C/"1za11, .\11) '60 Rl,ode l,la11d TLPHDI \fo_, Do11/,r,11•11, ,\fl) '59 "'c1·ade1 Vorotlrr C. R11.,i11ki, '59, JI) <1lifomi11 p,.,side11t, 8. POLLACK Medical , MD ' 2 l1u1111iAssociatio11 P. . If you haven't alreadr renewed your ~fedical Alumni membership for 2003-2004, you ma) do so .\fl) by enclo ing payment in the em·elope inserted in this issue. Thank you! S 11 mmt • r 2 003 1 , 111 11 n rsi1i 11 43 �L ~ S N O T E LarryBeahan,MD'55. hJs puhlished a book titled SUMMER 2003 Allega11)'Ht'llbemla ·1ab, whi,h is dernted to Allegan)' talc Park, its histo11, lore and rnntro , crs}. The book i~ ,ivail­ able at \m.11on.,om. will be certified through EdwinR. lamm, MD'60. JosephI. Bellantl. MD'58. FICS.,, rites:"! finall, re­ wa ,elected b)' the Fdlow, of the Lollege .-- ---, of Allergy, Asthma ,rnd Immunol­ ogy to re ­ ceive the 200!. ,old I lc.1ded Cane A\\ard. Presented annually, the award re ognizcs an aller­ gist who has dcmon,1r,1tcd the higheM ,tandard, of s ·ientific excellence and intl-gnty while serving as ,I tired from active pradice 111 J,1nu.irv :!003, which gin:, u, more time to spend ,ll our rlorida (,ulf Coast home. \\ c now have eight grandchil drcn-all living nearby in Horid,1! Of our four chil­ dren , one .., an arti t; one ,1buildu/dc igner; one a tea ·her; and a on who i, still single and manages ,1 Sylvan Learning Center in Tampa. " Fdlow of the college for at least 20 year,. Bdl,rnti is a profc"or of pl'd1,1tri ·s ,rnd mi~ro ­ Correction: biology/immunology JI ,eorgctown nivcr,il) and founder ,1nd director of ,nrgctown\ lnterna tional Center for lnter­ ass JacobKriteman.MD'67, was misidcntifit:d as "Jml'ph" 111the spring :!003 issue of B11ffi1/o Pl,y ­ ,ic,1111 . I r. Kntem,111lives in Damers, Z\IA. disciplina11· 1ud1cs of Immunology. He is the rt>cipient of numerous other honors ,rnd awards, including the pr stigiou, I:. 1'.lc,1dJohmun \w,ird in Pediatric Research for his contributions in Jnti ­ dr.il immunit\. In 1992, he recein:d an honor,lr)' writes: "My wife, Karen, and I recently had a grand ·hild, Holden, and are en­ jo)'ing this degre<.' rom the niwr­ sity of Palermo, Ital . Bell,1nti is al,o a past recipient of the tock ton Kimball Award at L!B. new phase of our lives. I p.isscd the critical arc medkine reccrtifkation ex,1111 !,1stNowmbcr and MichaelBan,n.M '71. FCCP,Blountl'ille, K), \ummrr 2 UOt 2013. 1 MORE BOARD r :0.1SFORFVER! Prac­ fun ,llld chal tice is 1111 lenging sin e I moved rom i\1assachu cm sc1·rn year ago." f mail ad ­ dress is: km baron@ ch,irtertn.nct. ThomasDiSessa. MO'71. has been ,1ppmntcd pro ­ fc ~or of pediatrics and chief of pcd1,1tric cardiol­ Og} at the nivcr,ity of Kentu ky, Lexington, KY, where he has also ,1-sumed the position of director of the pediatrk c ho • rdiographv lab ra­ tory at the LIK lhildrcn \ hospital. I le and his wife, Patricia, mo, ·ed from Life employees. 1'.apili joined cw York Life in I 985 as Jn Jssociatc medical direc ­ tor in the Employee. · Health Department. Six year later he be ame medical dirc,tor, anti 111 2001 he was nam-ed a ,i e presi ­ dent, a position he held prior to his promotion. A native of the Phil ­ i\kmphis to Lexington in July. The) ha,c three children: Thom,1s Jr., 29; John, 27; and Prter 21. F mail address is: cchodx@>aol.com. ippines, Kapili earned hi. medical degree at B in 1977 and completed his residency training JI St. Vincent's Hospital .ind \tedical Center . He gr,1duatcd from Fordham l ,n, chool in \l,1y 2003. I le I a l'ellow of the American -\cadem) of Disabilit) haluating Phvs1cians .ind a Fellow of the \meric.in Bo,ird BerneeY. llapili, MD'77. of Internal i\ledicine. In ,1ddi1ion to his work with has bcrn named first vi<:e president in the Fmplov­ ecs' Health Department of the, cw York Life Imu ranee Company. In this capa ·it)-, he oversees .1 full}' staffed medical facility that offers a wide range t1f servkes, mclud ­ ing phy 1cal e,am111,1tion,, fertility treatment , emergenq , care, medi ,1I screenings, and wellness programs for ew York 1 'e" York Life, Kapili is a volunteer physician for the helsea \ illage Program for the Home ­ bound Elderly. es ( I1-1)in I995, after two ­ years of internal medi­ cine training and subse­ quentlr did a residencr in anesthesiology at Yale ' niversitr . After being on staff at Johns Hopkins Barvie1~ I\ !cdi al Center as a lmical instructor in ancsthes1ology, 1 re entl) served as a commander in the .. Publk Health ervice ,1cti,e reserve at \: alter Recd Army Medi ­ cal enter, assisting in the management of battkfidd casualties dur ­ ing the recent Operation Iraqi Freedom. I am mar ­ ried to Julia Wulkuhle, PhD, a staff scientist at the 'sill." E-mail address is: drjohncoopcr@yahoo.com. RohitMRob" Bakshi.MO'91. a sociate profes or of neurology and founding director of the Buffalo euroimaging An.ii pis Center m The Jacobs eurological !mtitute, has been elected to the mcri ­ can euro - ociation. John0. Cooper,MD'89, write : "! completed a fellow,h1p in molecular biolog) at the ational lmtitutes o I lealth ording to the Bakshi'. election follows rigorous rev ic" and is based on his "subst.inti,11 �RELOCATIO Ht, T REAi f<;TATf FR BruceThiershas been electedYicepresident-electof the AmericanAcademyof Ne will be installedin February2004, with histenureas vice presi­ Dermatology. dent beginningin February2005. Thiers,who practicesin Char1eston, SC, receivedhis medicaldegreefrom UB in 1974 and completedhis residencyat the State Universityof NewYorkat Buf­ falo AffiliatedHospitals.He Is cun-entlyinterimchair, professorof dermatology, and directorof clinicaloperations(dennatologylat the MedicalUniversity of SouthCarolinain Char1eston. Ne is alsochief of the Dermatology Serviceat the Char1eston VeteransAdministration MedicalCenter. web-based Thiersis the directorof the AmericanAcademyof Dermatology's CMEProgramand is a memberof Its Councilon Education.He is a past member of the Academy'sboardof directors,ExecutiveCommittee,PrioritiesCommittee, AssemblyCouncil.In additionto his numerousacademyactivities, and Scientific ThiersIs cun-entlypresidentof the South CarolinaDennatological Association. Theauthorof morethan 130 publications,Thiersis cun-entlythe editorof we help people move. the Yur Boolrof DHmatology and DennatolOgicSurgery and has servedas the all for a free relocation portfolio regarding your destination it)­ all 1-800-6 -1170 or go on-line and visit our web site at hu n treales tate.co m Academyof Dennatology. associateeditorof the Journalof the Americ1111 academic contributions to the field of neurology" and his "promise for the future." HowardPodolsky.MD'91, has been appointed vice pre ident-chief medical officer at JI.I t. M.iry\ Health in ·t. Louis, MO. enter "Thi announ ement follows .in extensive search process , given the pivotal n,llurc of this po ­ sition," said Kenneth W. Lukhard, Mary's . "It was \ital we find the best individual for thi key leader hip role. \\'e t. haw accomplished that goal with the appointment of Dr. Podolsky." Following gradua­ tion from UB, Podolsky completed his intern ­ hip and residency train­ ing in internal medicine at The Christ Ho pital in incinnati, OH. In I993, he completed an externship with the Department of Gastroenterology / Hcpatology .it the University of Chi ago. Later this rear, he 1,·ill complete a JDdegree in health la1>studies at t. Louis Uni1•ersity hool of L.iw. Totally cu tom iz ed servic e portfolio includin g Christine8. lmbrosone. PhD'94, ha been ap­ pointed chair of epidemi­ ology in the Department of ancer Prevention and Population cience · at Roswell Park Cancer Institute ( RP I). In this capacity, she is respon ­ sible for re. earch in mo­ lecular epidemiology and biomarkers and collabo­ rates with investigator in the hemoprevcntion, genetic and therapeutics • Nationally trained relocation experts • Complete family needs analysis • Global home sale assistance • Special services for seniors • Full community tour • A complete cost of living analysis • A list of all school systems throughout WNY • Complete spousal placement assistance including resume writing and corporate contacts • 24 hour or less response time • Confidentiality assured programs. Prior to thi,, Ambrosone served in the Molecular Epidemiology Division, National en tcr for Toxi ologu:al Research, Food and Drug Administration, in Jefferson, Arkan,as Hunl ERA Relocation Center 5570 Ma,nStreet Wil ,amsv,lle . New Yon<14221-5410 Email : huntrelocatoon@huntrealestate com S u mm e r 20 /J .l l 1if1l1 riysicin 4 5 �• ( 1996- 00); as a member of the .Arkama, Can er Rese,irch Center in Lillie Ro k ( 1996-02); and as Jeffrey Tessier.MD'95. focuses on molecular epi­ demiology and the role of genetic factors in modify­ ing rdatiomhip, between reprodudin:, dictan and Therese completed her general surger, residency at Eastern Virginia Medi cal School in 'orfolk, \'A. She subsequentl> · went on to complete a fellowsh1p in trauma sur gery/ ntical care at the 'niwr,ity of ,\1aryland ho k/Tr,1um.1 Center in Baltimore, \ID. he no\, holds ,1 faculty position in the Din,1011 of Trauma ·urgcn·, Emer­ gency Surgery, and C nt1"al (_arc.it the \ ledkal ollege of\ 1rginia/ \ 'irgima (_ommonwealth environmental exposure, ' niver,it~ in Richmond, a s ciate professor and director of the Can ­ cer Lp1de111iologr Program at the Dcrald 11. Ruttenberg Cancer Center at the ~lount Sma1 School of ~lcdicine in ·cw York (2000-02). Her research .ind cancer ri k. 46 ThereseDuane.MD'95. and l1tla l 1 n,s i c i 11 \' . Therese b married to clas. mate Jeftrcr Tessier, MD '95, and thev have recently added Luke John Duane-Tessier to the family. Jeffrey is leaving ,1Ct1, ·e sen ·i e in the U.. Navy lo pursue a re,ear h fellm,·,hip in in­ fectious disease, at the niversity of Virgini,1. edical lumni was elected president of the Medical AlumniAssociationon April 26, 2003, at SpringClinical Day. Pollack is a UB clinical assis­ tant professorof ophthalmologywho is in private practice in Williamsville,NY. will serveas the new vice presidentfor the association.Mattimore is a UB clinical instructorof pediatricsand is on staff at Kaleida Health'sWomenand Children'sHospital TimothyV.JordenJr.• MD '96. ha . iomed the 1:.ne Count) \lcd1cal Center\ Dep,ntmcnl of urger, ,, an attending phy,i ­ ci,rn. He aJ.,o currently ...crvcsa ,, clink,11 assis ­ B\ D,,1>artrncnt ofSurg~I). tant professor 111 of Buffaloand Mercy Hospital. will serve as treasurer. Brecher is chair of the Department of Pediatrics at Roswell Park Cancer Institute, chief of the Division of Pediatric Hematology/Oncology at Kaleida Health's Women's and Children's Hospital of Buffalo, and chief of pediatric hematology/oncology in the UB Department of Pediatrics. �THEN GET TO BUFFALO. Likelbr? Plesst1e yoo:curentpos.::Jn tw handle Is vw practice !JM11Q waytoo rr. , headilChe5 ~so -~~meto~olf oBuflar • Visit the UBSchool of MedlciN alNIm-edlcal Scletlces' website at www.smbs.buffalo.edu • click OIi Alumni • click on What's Up, Doc? Bu aJo only i!'ll!f alJOl.( 25!laysotsnowa 'fCiJf Snowf t ..-.rodIJll19 some Cl!JeS toag-inding ha ar '10 pr heft And<U agesummer •empcratll' Womed :WNfl Physicians Here's whatwe'vegot! TheBills.TheSabres , TheTorontoBlueJays GoingoverNiagaraFalls in a barrel prefrtcrmplet Suicidewingsat the AnchorBar llthealthcertffi • familyupdates • interestln&'trips alNItrails' • happyoccasions,11■-• tntert■cles • mo,nt~ • retirement • honon and awards • publications • publicsemce/electlo■ to office • researchendeawon • muslnp on life as a doc .... toJOI<U preslJ!llOl' Reelingin freshfishfor rOS!ef olhealth eveprole;siOOals. sizzlingbackyardBBQ F t yoo:I e by send L{e\lmeHealth205 Crossinginto Canada 221 PH 877Z'77465 for an eveningor fun ear f DownhillwinteradVentures on net snowCOYefed mountains Lifetime Health wwwfitsyoll'I ife.com alo-rnedical.bk!ib" .co m Your medical resource is just a click away . University at Buffa l o The State Universityof New York UNIVERSITY MEDICAL BOOKSTORE Main Street• Phone:(716)833-7131 • um mer 2003 1,11111 Plpitill 47 �S U MMER d C.Fi ch r schools by moving the children into their home in Willard G. Fischer died on February 27, 2003, in his Eggertsville, NY,residence followinga long illness. He was 92. A Buffalo native, Fischer was a family physi­ order to allow them to le­ gally attend schools outside their home districts. The Freibergs had five children of their own and Jane quit her practice at Kaiser after cian who was known for making house calls until the day he retired in 1991 at age 80 after practicing their first child was born. Their efforts to assist black medicine for 55 years. Followinggraduation from medical school in 1936, he served as chief of staff at Deaconess Hospital for several years and was a children to enter Palo Alto schools eventually led to the establishment of the Tinsley Transfer Program, a court• mandated effort to help chil­ dren from poor districts, according to Gertrude Wilks, member of the staff of Buffalo General Hospital. then Palo Alto's mayor. As a result of the Freiberg's, "so many doors have been During that time, he also served as president of the opened," Wilks said. Deaconess staff for two terms and president of the Deaconess Hospital Foun­ dation for several years. Survivors include two daughters, HollyMomberger of the Town of Boston, and Melinda Keirnan of Solon, OH;a stepdaughter, Martha Freiberg is survived by her husband, Kenneth, of Palo Alto; and children: Jo Ann Reagan of Farmington, CT;Donald of MountainView, CA;Andre of Hershey, PA; Ellen Freiberg of Santa Rosa, CA;and Paul of Palo Alto. "Mimi" Heaps of Orem, UT; Daniel Chartes Kozera, an obstetrician­ gynecologist Gerald Ford of Tempe, AZ, and Donald Ford of Logan, His wife, the former Helen Heinrich Ford, died in 1997. and treasurer for the UB Medical AlumniAssociation, died suddenly on February 24, 2003. He was 69. J • u r '3 Jane Auer Freiberg died in June 2001. A native of Buf­ falo, NY,she moved to Palo Alto, CA,following medical school. In the 1960s, she and her husband, Kenneth, helped black children from Pa lo Alto enter better 48 1111,1, n,si,in Lackawanna, West Seneca, and Derby. He was on the staff at both Our lady of Victory Hospital and Buffalo Mercy Hospital and held leadership positions includ­ ing department chair al both institutions. In addition, he was an obstetrician for Our lady of Victory Infant Home and Maria Goretti Home. Kozera was an accom­ plished physician and com­ munity leader. He was the first in Western NewYork to perform successful intrau­ terine transfusions for Rh hemolytic disease. He was past president of the Buffalo Gynecologicand Obstetric Society, the OB-GYNunit at Mercy Hospital and the Erie County Health Board. He a son, Craig W. of Rich­ mond, MA;two stepsons, UT;23 grandchildren; and many great-grandchildren. drafted into the Army, where he served as a captain in the Medical Corps and act­ ing chief of OB/GYNat Kenner Army Hospital at Fort lee, VA. Kozera practiced medi­ cine for more than 30 years and had offices in A native of Lackawanna, NY,Kozera graduated as salutatorian from Canlsius High School and cum laude was elected to the Wall of Fame at Mercy Hospital in 2000 for his years of service and dedication. Kozera Is survived by his wife of 46 years, the former Delphine M. Gorski of Lackawanna; two sons, Davidof Lynchburg, VA,and Michael of Prospect, CT; three daughters, Kathleen Roweof Delmar, NY,and Caryn laReche and Terese from Fordham University in 1955. Followingmedical Macpherson, both of Clifton school, he completed his residency at Sisters of Char• ity Hospital. In 1967, he was lotte of Lackawanna;a sis• ter, CarolynChlosta of Issue, MD; and 10 grandchildren. ~ 11 mm l r .2 (} tJ J Paril, NY;his mother, Char­ Jeffr y Jeffrey S. Perchick died on March 1, 2002, as a result of an apparent robbery. He was 55. Perchick was in the practice of oncology and hematology in the City of Poughkeepsie, NY.Previ­ ously, he was an attending physician at Vassar Broth­ ers Hospital, 2003 Pittsburgh and received fel­ lowship training in hematol­ ogy and oncology at Strong Memorial Hospital at the Universityof Rochester. He was In private practice limited to hematology and oncology since 1978 In Poughkeepsie, NY. Perchick is survived by his wife of 32 years, Jo Anne, and his children: Rebecca Kent of Poughkeepsie; Brian of St. Francis Hospital, and Hudson River Psychiatric Center. He was a Rochester, NY;and Larry, who is a student at Tufts Universityin Boston, MA.He is also survived by his two former senior medical direc­ tor at Hospice of Dutchess grandsons, Joshua Gilbert Kent and Jeffrey Perchick County, and former chair of Kent of Poughkeepsie. "Dr. Perchick was ex­ the Cancer Committee at Vassar Brothers Hospital. Followinggraduation from UBmedical school in 1972, Perchick completed his internship and residency training in int.ernal medi• cine at the Universityof traordinary. He was a great man and a great doctor, and he will be missed not only by his family, but also by his patients, whom he treated like 'family,"' said a former patient. 4D �James Scholar Alfred"Tom" FronteraJr.,Classof 2003 Pictured. left toritht.Jo ·s t er.Yer 1ca. Alfred Sr.. T , andsister en 1fer. he Jame PlattWhiteSocietyi a distinguihed group of donor that contribute 1,000 or more annually to the Univerity at BuffaloSchoolof Medicineand BiomedicalScience. . ·amed after Jame Platt White, .\10, one of the founders of the ~tedical hool, White wa. a pioneer in as both dean and pre ident of the ni\'ersity at Buffalo merican obstetric and gynecology who sen·ed B facult}. Each year at grnduation, the Jame Platt White . · iet}·honors a . tudent who e:em­ plifics the leadership qualities that personify those of Dr. White-foresight, intellectual ,·igor and moral courage. This year'· r cipient is Alfred ·1. Frontera Jr., or "Tom," as he is known to familr members and friends. Tom was hooded by his father, Dr. Alfred T. Frontera r., a neu­ rologist \\;th succe~ ful practices in their hometom1 of Kingston, . ;)'_ Tom i. following in his father's foot tep. by entering into residency training in neurol­ ogr at Columbia lJniwrsit}· College of Ph) iciam and urgcon . , eurolq,1y is a family affair, a,;Tom' sister, Jennifer, is in her fourth ye-..1r of rcsidenq-'in neurology at olurnbia. Tom recei"ed a Hitchcock hair adorned ,\;th the L'B hool of, fcdicinc and Bio­ medical Sciences insignia in recognition of thi special honor. �p H A R M A 0 p 0 E I A Thi 11lu tranon "''lls d,.,. uall reproduced from offizm ·lien Ce .. ach,e, a four ,olume cd1t10n of pharmaceutical plants and their m d1c111alu e , publi hcd m German m 1863. Thc ph rmacopoe1a b, 0110 Karl Berg (1815 1866) 1 part of the Roh rt L. Brown H1 tory of led,cme Colle 110n. lo c tcd m th \.bbott Hall Health c1encc Llhrnl'). 1'1ctun d h.-re 1 the Daphne, one of a ene of botanic I 11na c d1gi tally re to red a pa, t of an 1m11atl\e to pre .-,.,,e nd highlight umque re ourc from the libr I') collec11on, Reproduct 10n are av ,!able for purcha e throu h the hbran, and can be ,1ewcd onhne at 1 ledia.buffalo.edu an . Image re tora11on wa, performed b I ledUI. the 1n trucllonal m ,ha ser dep rtment of om pu1111g and Inform 1t10n 1 echnologi; t B \ICC 8 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 2003 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2003-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v38n01-2003-Summer Table Of Contents A list of subunits of the resource. New Vision of Collaboration In Step with Medical Milestones Take Note Medical School Research Pathways Reunion Weekend Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v38n01 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2003 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/19e427fcdda7c7fbf3a8aa72c2ea7814.pdf d0897c074d32cf00d5f2c64f456c63ff PDF Text Text inimally invasive approaches to stroke treatment �llffall Hysiciu VICE PRESIDENT FOR 'I\ ERSITY COMMUI'iiCATIONS u jennifer McDonough DIRECTOR OF NEWS SERVICES Arthur Page DIRECTOR OF PERIODICALS Sue Wuetc/Ier Paroski Named Interim Dean EDITOR Stephanie A. Unger ART DIRECTOR & DESIGN on January 15, 2003 , that he planned to resign Alan]. Kegler and David]. Riley effective February 14 as vice president for health affairs at the University at Buffalo and dean of DESIGN the UB School of Medicine and Biomedical Sciences. Karen LichtJCr CoNTRIBUTING WRITERS Lois Baker and Ellen Goldbarun PRODUCTION COORDINATOR CyrJtlria Todd-Flick At the same time, UB President William R. Greiner announced the appointment of Margaret W. Paroski, MD '80, the medical school 's senior associate dean for academic affairs and admissions, as interim vice president for health affairs and interim dean of the School of Medicine and Biomedical Sciences. LNIVERSITY AT BuFFALO SCHOOL OF MEDICINE AND BroMEDrc.AL SciENCES Dr. 1\fargaret Paroski, lnterzm Dean EDITORIAL BOARD Dr. john Bodkin Dr. Martin Brecher Dr. Harold Brody Dr. Linda J. Corder Elizabeth Volz, Class of 2005 Dr. fames Kanski Dr. Elizabetlr Olmsted Dr. James R. Olson Dr. Stephen Spaulding Dr. Bradley T. Truax Dr. Franklin Zeplowitz Greiner said UB "will hold off on the search for and appointment of a new vice president and dean until UB's 14th president has been appointed by the SUNY Trustees. " On January 13, 2003, Greiner had announced plans to retire as UB's 13th president effective June 30, or at a later date if requested by State University of ew York Chancellor Robert L. King, depending on the appointment of his successor. ln a message to faculty members at the time of his resignation, Bernardino said that he and his wife were moving back to Atlanta to be closer to their children . Prior to coming to UB as vice president for health affairs in April 1998, Bernardino, who also holds an MBA degree, had served as director of managed care with the Emory University System of Health Care, Inc. , and professor of radiology in the Emory University School of Medicine. TEACH!-.;G HOSPITALS Erie County MediCal Center Roswell Park Cancer Institute Veterans Affarrs Western New York Healthcare System As vice president, he oversaw the clinical and collaborative activities of PAR OS KI UB 's five hea lth-sciences schools-medicine and biomedical sciences, dental medicine, health related professions, nursing and pharmacy. He was named dean of the medical K,tLIIT>A Hf.-\LTH: Tire Buffalo General Hospital The Children's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital C.iTIIOll< Ht\1111 SL"iTE\1: Mercy Hea/tlr System Sisters of Cluuity Hospital Niagara Falls .\1emorial Medical Center ® UII[ISI!IIlllfflll. Ill Sill! UIHISllY If m!Ill Letters to the Editor Buffalo Physician is published quMtcrly by the Unive rsity at Buffalo School of Medicine and Biomedical Sciences in cooperation with University Communications. Letters to the Editor are welcome and can be sent c/o Buffalo Physrcian, 330 Crofts Hall, Umversity at Buffalo, Buffalo, NY 14260; or via e- mail to bp-notes@buffalo.edu. Telephone: (716) 645-5000, ext. 1387. The staff reserves the right to edit all submissions for clarity and length. T...::J:... University at Buffalo ~ 1'1teState Ut~iversityofNew York school in July 2001. "I think that this is an appropriate time to move on," Bernardino noted in his message. "We have accomplished the major goals that I set forth when I arrived in Buffalo: establishment of an infrastructure within the medical school, reorganization of the school, restructuring of the practice plan and the negotiation of new affiliation agreements with the teaching hospitals. The latter two I consider to be very significant events in the history of the medical school. And the last one, as important as it is to UB, probably is more important to the Buffalo community." Greiner noted that Bernardino's contributions to UB during the past five years "have been significant, and his departure is a loss to our entire UB community." He added: "Mike came to UB with a clear vision and action agenda: reform of the administrative structure of our faculty practice plans, and transformation of our relations with our affiliated hospitals regarding both the delivery of graduate medical education, and the fiscal and managerial relationships between the hospitals and the medical school vis-a-vis our shared responsibility for teaching, research and health-care delivery. �"These reforms have been made," Greiner added. "Our practice plans are on a sound fiscal basis, and our new affiliation agreements provide not only the platform for first-rate teaching and research programs, but also a new framework for regional health-care delivery. Beyond these extraordinary accomplishments, Mike has seen to it that the finances of the medical school and its administrative leadership are both in very strong condition." While Bernardino gave credit to many colleagues in and outside the university for their roles in those accomplishments, Greiner said that "he has been an extraordinary leader. UB, the medical school and all of us in the Buffalo-Niagara area owe Mike a debt of gratitude for all that he has done to date, and for the future prospects for Buffalo-Niagara, which his work here has greatly enhanced." UB Provost Elizabeth D. Capaldi praised Bernardino for "managing in a very short period of time to organize the clinical affairs of the School ofMedicine and Biomedical Sciences and to put the financial affairs of the school in excellent shape. "We now have a firm foundation to move forward," Capaldi added, "and all of us are indebted to Mike for his excellent work. I doubt anyone else could have accomplished what he has in this short a period of time. We will miss his leadership." Greiner said Parosk.i "is one of UB's most accomplished faculty members, and has proven herself an outstanding administrative officer. I have every confidence that she will provide excellent leadership for the medical school and for clinical affairs." Prior to joining the medical school's administration in May 200 I as director of admissions, Paroski served as medical director of the Erie County Medical Center for five years and as clinical director of neurology at the medical center for four years. She has been a member of the medical school's faculty since 1984 and is a professor of clinical neurology. A !980 graduate of the UB medical school, Parosk.i is president of the UB Alumni Association and past president of the UB Medical Alumni Association. An accomplished educator, Paroski was the 1988 recipient of the UB medical school's coveted Siegel Award for Excellence in Teaching. In addition to her administrative duties, she currently teaches in five medical school courses and serves as the course coordinator for the mandatory senior neurology rotation. She served for a year as the school's point person for curriculum development and implementation in preparation for the Liaison Committee on Medical Education Review, which took place in October 2002. She also has an active practice in neurology. A native of Buffalo, Paroski received a bachelor of arts degree in biology and psychology from Canisius College in 1976. She completed her residency training in neurology in UB's affiliated teach- HEALTH SCIENCES ing hospitals and is board certified in neurology. In 2000, she completed a master's degree in medical management at Carnegie Mellon University in Pittsburgh. -ARTHUR PAGE JUN I 3 20D.1 LIBRARY �Dear Fellow Alumni, y the time you read this message, the 2003 Spring Clinical Day and Reunion Weekend will have lfficers ~~~ liar~ Mn~ers ZIU-ZII3 taken place, and we will be in the process of preparing a full report for publication in the summer issue of Buffalo Physician. This year we had an outstanding scientific program that was organized by Marty Brecher, MD '72. Speakers included Rohit Bakshi, MD '91; Robert Genco, DDS, PhD; Bruce Holm, PhD; and Jeffrey Skolnik, PhD, (our Stockton Kimball Awardee), who discussed various topics in the field ofbioinformatics. Matthew Enstice, associate director of the Buffalo-Niagara PRESIDENT Patricia K. Duffner, MD '72 Medical Campus (BNMC) development, also gave a presentation on the past, present and future of the B MC. The recipients of the 2003 Achievement Awards were Bertram Portin, MD '53, VICE PRESIDENT Robert Zizzi, MD '58, and Robert Milch, MD '68. The Berkson Awardee was Robert Stephen B. Pollack, MD '82 Kaplan, MD '81. For the first time, the awards were presented immediately following MEMBERS Rohit Bakshi, MD, '91 Martin L. Brecher, MD '72 Martin C. Mahoney, PhD, MD '95 the scientific session so that those who could not attend the luncheon were able to congratulate these outstanding alumni. Planning for Spring Clinical Day and Reunion Weekend was helped immensely by Kimberly Venti, who was hired in December 2002 as director of donor stewardship and constituent relations in the Office of Alumni Affairs and Development in the School of Medicine and Biomedical Sciences (see introduction of Venti on page 36). We are very fortunate to have her as medical alumni administrator. In addition, I would like to recognize the essential role members of UB's Office of Special Events Colleen Mattimore, MD '91 played in the extensive planning required for this weekend event. Finally, I would like to extend a PAST PRESIDENT special thanks to Steve Pollack, MD '82, vice president of the Medical Alumni Association, for his excellent work with the reunion class chairs. fohn f. Bodkin, JI, MD '76 EMERITUS MEMBERS In closing, I have two sad pieces of news. The first is that Michael E. Bernardino, MD, MBA, vice president for health affairs and dean of the School of Medicine and Biomedical Sciences, has resign- Donald P. Copley, MD '70 ed effective February 14, 2003, to return to Atlanta and Emory University. During Mike's tenure, Robert E. Reisman, MD '56 affiliation agreement and carried us through the Liaison Committee on Medical Education (LCME) REGIONAL MEMBERS Joseph A. Chazan, MD '60 Rhode Island Max Doubrava, MD '59 Nevada Dorothy C. Rasinski, MD '59, /D Califomia he established a firm financial foundation for the University Practice Plan, negotiated a difficult visit last fall with flying colors (see article about the school's reaccreditation on page 28). Mike was extremely supportive of the Medical Alumni Association, assisting us in recruiting and funding our new, outstanding administrator, Kim, as well as providing funding to support a parttime staff member who is now working with us, Jennifer Lobaugh. Mike was also a great friend to me personally, and I will miss him. Secondly, Dr. William Greiner has announced that he will be stepping down as president of the University at Buffalo in June 2003 or at a later date if requested by State University of New York Chancellor Robert L. King, depending on the appointment of his successor. I first got to know Bill when we served together on the Kaleida board of directors during one of the more turbulent times in the history of medicine in Buffalo. Bill's voice was always one of reason and clarity. His great love Orestes G. Rosabal, MD '77 Florida for the university and for his job as president was apparent to everyone who met him. Bill has made me proud to be a UB alumnus and a member of his faculty. Eric f. Russell, MD'74 Jllinois PATRICIA K. DUFFNER , MD ' 72 President, Medical Alumni Association �VOLUME 37, NUMBER 0 p H y s c A N Features The Inside Passage 4 Minimally invasive treatment of stroke and other cerebral vascular diseases-Buffalo's neurosurgeons chart the way BY UNGER Acute Care, Astute Care 20 Two UB alumni develop pathway to ensure optimal care for acute cardiac patients BY 24 S. A . !COLE PERADOTTO On Course, Part II Cardiologist John Corbelli, MD '79 , left, and emergency room physician David Janicke, MD '88, PhD, right, are working to reduce our region's high rate of death from hean disease. For more, turn to page 20. A conversation with Margaret Paroski about medical education, curriculum and admissions PICTURED ON THE COVER ARE NEUROSUR G EON$ HOPKINS, RIGHT, AND LEE GUTERMAN, LEFT. PH 0 T 0 37 John Canty, MD '79, elected to Association of University Cardiologists 47 Tony g,MD '91, an update on Disaster Psychiatry Outreach 28 School of Medicine and Biomedical Sciences reaccredited for eight years 31 UB establishes School of Public Health and Health Professions 32 Merril T. Dayton, MD, named chair of surgery Frederick Munschauer named chair of neurology 33 Rob Bermel, MD '03, receives Oldendorf Award 30 Oishei and Wendt foundations support Buffalo Life Sciences Complex 39 James Platt White Society annual listing 43 ews from your UB classmates and other alumni 44 Francis Fote, MD '52, founder of Grounds for Health, volunteers around the world L. N . " I C K" BY ERIC FRI C K . Medical Student Research Forum, a showcase for achievements �L. N. "Nick" Hopkins, MD, chair of neurosurgery at the University at Buffalo, and his DB colleague, lee Guterman, PhD, '89, are recognized leaders in field of neuroendovascular surgery. Pictured with them is £lad levy M li f w �F.-AIR - -- Minimally invasive approac es to stroke treatment �ore o ent an ot, scientific advances come slowly and incrementally, each step dependent upon the work of earlier researchers whose focus, patience and plodding zeal were guided by a shared vision that at times may have seemed over· reaching, perhaps even a bit surreal. n cases where these incremental steps are successful, however, there comes a turning point when the quiet, behindthe-scenes evolutionary work reaches a critical mass and becomes revolutionary in its impact. Nowhere is this phenomenon better exemplified than in the work of neurosurgeons who over the past several decades have collaborated with other clinical specialists and basic scientists to make real the vision of treating stroke and other cerebral vascular diseases with minimally invasive surgical techniques. These techniques involve taking advantage of the body's circulation system to navigate micro-thin devices through the large artery in the groin until they reach injured or blocked vessels in the brain or neck, where treatment is provided using procedures and devices specially designed for endovascular surgery. Bolstered by ongoing iterative advances in the miniaturization and visualization of these devices-and 6 l ulfa l e Pb ysicin Sp r i 11 g 2003 the testing and perfecting of them in a large number of clinical trials-minimally invasive approaches to cerebral vascular diseases not only are here to stay, but within the decade are expected by many to become the gold standard for a growing number of neurological conditions requiring surgery. The reasons for this are numerous: The endovascular approach is less invasiverequiring only a needle puncture in the groin as opposed to opening the skull; the risk of infection is lower; postoperative recuperation is faster; hospital stays are shorter; expenses are reduced and the emotional stress on patients and their families is significantly decreased. A widely recognized leader in the field of neuroendovascular surgery is L. . " ick" Hopkins III, MD, chair and professor of neurosurgery and professor of radiology in the University at Buffalo School of Medi- �I - cine and Biomedical Sciences, who also serves as director of the UB Toshiba Stroke Research Center. Inspired by cardiologists, whom he readily credits with pioneering the concept of endovascular intervention, Hopkins has long made it his mission to take minimally invasive techniques as they apply to coronary arteries and adapt them for use in the more delicate, convoluted and difficult-to-access blood vessels in the brain. "While the concept is the same, the devices, techniques and training required to treat cerebral vascular disease with endovascular approaches are quite different from those used to treat coronary artery disease," he explains. "The intracranial circulation is much more tortuous and difficult to navigate, and the blood vessels in the brain are much thinner." Undaunted by the challenge of discovering new or better ways to safely navigate micro-devices deep within the brain, Hopkins, in collaboration with his UB colleagues, has been at the forefront of efforts to develop and test many of these devices and procedures and has meticulously built an Endovascular Surgical euroradiology Service at Kaleida Health's Millard Fillmore Hospital in Buffalo that is a magnet for patients from all over the United States. In addition, the service has become a top draw for talented residents and fellows seeking to learn advanced neuroendovascular surgical skills and to participate in groundbreaking research projects in collaboration with scientists at the Toshiba Stroke Research Center. Hopkins attributes the success of UB's neurosurgery program to its three-pronged approach of clinical care, research and education, as well as to the fact that the faculty is multidisciplinary. "We have always had very strong vascular surgery and neurosurgery here," he notes. "However, I think that the addition of the endovascular approach has made our center a leader because we can offer both traditional, open surgery, as well as endovascular surgery interchangeably, with no bias. By this I mean that all services are provided by one group of physicians, so there's not one specialist saying, 'I can do it better with open surgery' and another saying, 'I can do it better with endovascular surgery.' "As you might imagine," he continues, "as the lessinvasive endovascular techniques continue to mature and gain popularity, this is a very important advantage because there are centers where the two approaches are separated and it's getting to be a competition between ---- endovascular and traditional surgical techniques. In our department, because we're a multidisciplinary team, there's no competition, so we can avoid bias in deciding the best way to treat patients." The synergy among clinical specialists in the department is further enhanced by the fact that basic-science faculty in the Toshiba Stroke Research Center also represent a broad spectrum of disciplines, including radiation physics, biomedical and aerospace engineering and polymer chemistry. "One of the things I'm most proud of is that our program, because of the Toshiba Stroke Research Center, has always been in the lead in terms of researchmostly translational-type research-that goes hand in hand with the development of new techniques," says Hopkins. The concept of the Toshiba Stroke Research Center at UB was originated by Lee Guterman, PhD, MD '89, according to Hopkins (see page 16). "Over the years, it's been a truly exciting thing for me to be associated with great people, and my partner, Stent deployed to open ablocked carotid artery. Studies are ongoing to determine Lee Guterman, has the safety and efficacy of this procedure been one of those as aless·inrasire alternatire to opening people," says Hopthe neck and peeling out the plaque. kins. "Back when he was a medical student and resident at UB, Lee kept saying, 'We've got to be doing some research here.' And that led directly to the multidisciplinary team we put together in the early 1990s and, eventually, to our developing the concept of the Toshiba Stroke Research Center. "The ability to do the preliminary work at the research center and then to transfer, or translate, that research into the clinical setting very quickly has been a huge opportunity for us to have both a strong clinical and teaching program," he adds. Spri u g 2003 e 1111111 Hysici11 7 �The Ins and Outs of Ste ·ng and Coiling Two endovascular procedures that today have the potential to revolutionize the treatment of stroke are "stenting," which is used to prevent ischemic stroke (blockage of brain blood vessels), and "coiling," which is used to prevent hemorrhagic stroke, or aneurysm (burst blood vessels in the brain). Hopkins and his group have been involved in long-term clinical and laboratory studies that have directly contributed to the development of both of these procedures, neither of which has escaped growing pains as it inches its way toward winning acceptance as standard treatment for carefully defined patient populations. The primary cause of ischemic stroke is a buildup of plaque in the carotid arteries on each side of the neck, which supply blood to the brain. If patients present with TIAs, or transient-ischemic attacks (mini-strokes) and are found by Doppler ultrasound studies to have significant plaque buildup in their carotid arteries, the standard treatment over the past 50 or more years has been endarterectomy, a surgical procedure in which the artery is opened and the plaque is peeled out. Traditionally, the procedure has been performed by vascular surgeons; however, it is not uncommon for neurosurgeons to perform endarterectomy as well. Although safe and effective for many patients, endarterectomy does cause significant scarring and is a highrisk procedure for patients with severe medical co-morbidities, such as coronary artery disease or pulmonary disease, according to Hopkins, who began performing the operation about 25 years ago. In the early 1980s, Hopkins became convinced that alternatives to endarterectomy had to be found for high-risk patients, when he operated on the father of a friend. The patient was a physician who had severe diabetes, coronary disease and pulmonary disease and was obese. In addition, he presented with mini-strokes, which pointed to a severe blockage of his carotid artery. " All this meant that it was going to be a difficult operation," recalls Hopkins, "but we didn't have an alternative. So I operated on him and he made it through the procedure, but it was difficult. To make a long story short, he never made it out of the ICU. Right then, I said there has to be a better way." Shortly thereafter, a French surgeon began pioneering the use of balloon angioplasty for treatment of carotid artery disease. By the mid-l990s, surgeons were placing a tiny mesh cylinder, called a stent, over the balloon , so that when the balloon was inflated at the site of the occlusion, it expanded the stent, which then braced open the artery and maintained blood flow to the brain. Traditionally, this stenting procedure has Elad Levy, MD, senior fellow in endovascular neurosurgery, standing, reviews acase with radiologic technologist been performed by interventional cardioloGene Maziarski, seated, in the control room of the special procedures suite at Millard Fillmore Hospital. gists and neuroradiologists. 8 l1flala Hysitiaa Sp r irzg 2003 �Until recently, a serious drawback to the stenting and Drug Administration] has not approved a product. approach was the tendency for pieces of plaque to be We reserve it for the high-risk patients. I think they're a dislodged during the procedure and migrate up to the lot of places where people have been using this technobrain and cause a mini-stroke. This risk has been signi- logy pretty willy-nilly. We're just not ready for that yet. ficantly reduced by the development of a tiny filter that We don't know for sure that carotid stenting is as safe as is placed distal to the stent to collect any debris that is carotid endarterectomy, which is still a great operation. released during the pro- More studies, like the CREST, need to be done." As is the case with carotid artery disease, clinicians cedure, after which it is are determined to expand viable treatment options for removed. Over the past five patients with hemorrhagic cerebral aneurysm, a devasyears, there have been tating condition that affects some 30,000 Americans a ongoing studies assess- year, 15 percent of whom die within minutes and 50 ing the safety and effi- percent, within a month. cacy of stents in carotid For the past three decades, an intracranial surgical artery disease, and the procedure called clipping has been the standard treatUB group has been in- ment for aneurysms. This involves a neurosurgeon volved in six of them, opening the skull, finding the location of the bleeding with either Hopkins or vessel in the brain and placing a clamp on the section l tiny filter is now placed distal to the lesion to collect pieces of plaque if dislodged during the Guterman serving as of artery that has become weakened and has bulged procedure, significantly improving safety. principal investigator. out owing to pressure from the circulating blood. (In One of the most some cases, the clip is applied to the parent vessel of important trials to date the unruptured aneurysm-as opposed to the bleeding is the SAPPHIRE (Stenting and Angioplasty with vessel-to prevent a future rupture. ) Protection in Patients at High Risk for EndarterecOver the past 12 years, an endovascular approach tomy) Trial, in which patients considered at high risk called coiling has come into its own as a technique that for surgery were randomized to receive either surgery might someday supplant the need for invasive surgery or stents. to treat aneurysms. "Stents won overwhelmingly," says Hopkins, noting Performed by either a neurosurgeon or a neurothat the results of the study were reported at an Ameri- radiologist, coiling involves the use of computercan Heart Association meeting in ovember 2002. "It aided X-ray imaging to navigate a catheter from the proved for the first time that stenting is safer and better groin up into the brain to the site of the aneurysm, for surgery in patients who are at high risk." where micro-thin Slinky-like devices called coils are Currently, Hopkins is co-principal investigator for gently packed inside the aneurysm, where they form a a study called CREST (Carotid dense mesh catacomb that clots Revasculariza tion Endarterecoff the bleeding. Coil-type devices have been tomy vs. Stent), which is compararound for approximately 20 years; ing endarterectomy with stenting however, the technology was given a in patients who are not at high formidable boost in 1990, when risk for surgery. Guido Guglielmi-a neurosurgeon "One of the things I think is and neuroradiologist with electrical important to emphasize is that all expertise (then at the University of the way along in the development California at Los Angeles)-invented of this technology, our group has a coil that detaches from the catheter been extremely conservative in when zapped by a small electrical the way we have used it," Hopkins current. notes. "We don't use carotid Before and aher images of acarotid Over the past decade, however, stenting in the normal low-risk artery revascularized following stenting. coiling has not flourished as much patients for which the FDA [Food - S pr i n g 2 00 3 I a II a 11 n ysic i a a 9 �in the United States as it has in Europe owing to concerns that U.S. physicians have about the long-term efficacy of the procedure, as well as to differences in European and American health-care delivery and reimbursement systems. Questions concerning the efficacy of the procedure were recently addressed in a landmark European study funded by the Medical Research Council (the British equivalent of the FDA) that compared coiling to surgery for the treatment of aneurysms. As reported in the October 26, 2002, issue of The Lancet, the ISA T (International Subarachnoid Aneurysm Trial) was halted early when results after a year showed that 31 percent of patients who underwent surgery for an aneurysm were disabled or had died compared with 24 percent who had undergone the coiling procedure. Although these results are promising, U.S. physicians are calling for additional studies that will address specific long-range concerns they have regarding the question of recurrent hemorrhage after coiling compared to surgery. While the neurosurgeons are participating in ongoing trials to examine the efficacy of coiling and coiling devices, they are also working with their UB colleagues Angiogram at top depicts at the Toshiba Stroke Research Center to an aneurysm; in the develop improvements to existing coiling centerit has been packed technology, as well as next-generation with Slinky·like devices devices and procedures that have the pocalled coils, which tential to someday supplant coiling itself. prevent blood flow into the aneursym, bottom. One such improvement that was developed at the center is the idea of using specialized neuro stents to overcome a significant problem that had precluded coiling from being used to treat aneurysms that have a wide neck (the opening from the normal blood vessel into the bulge). For these types of aneurysms (an estimated 30 to 40 percent of all aneurysms), coiling doesn't work because the devices cannot be held in place- they slip out through the wide neck. Several years ago, Guterman and his colleague Ajay Wakhloo, PhD, MD, (now director of interventional radiology at the University of Miami) developed the concept of placing a stent at the base of a wide-necked aneurysm to hold the coils in place. Owing to the development of this new technique, which is now in clinical use, neurosurgeons and neuroradiologists can effectively treat a larger number of aneurysms using less invasive endovascular procedures. "The technique accomplishes three things," explains Guterman, UB assistant professor of neurosurgery and co-director for device development at the Toshiba Stroke Research Center. "One, it enables us to confine the coil within the aneurysm; two, it actually shapes the flow of blood, which is funneled by the stent back into the normal artery; and three, it straightens out a segment of the artery where the aneurysm is, which gives the blood a further hemodynamic boost." Image Is Everything 10 lulfalo Pbpician Spr1 11 g 2003 The idea to develop a next-generation device that might someday supplant coiling has evolved from a seemingly unrelated but highly successful area of research at the Toshiba Stroke Research Center that promises to advance all aspects of neuroendovascular surgery: the development of a prototype camera that can turn blurred X- ray images of tiny blood vessels and micro-devices into high-resolution images that can detect a structure as fine as a single strut on a neuro stent. Called a "high-resolution region-of-interest microangiographic digital detector," the camera, which was patented by UB in September 2002, is close to being ready to test in the clinic, according to Stephen Rudin, PhD, UB professor of radiology and physics, codirector of the center's Imaging Division and lead researcher on the project. Having clear X-ray images of vessels and instruments is critical to reaching a damaged or occluded site in the brain without injuring vessels along the way. Once at the site, improved visualization greatly enhances a Physicians at UB developed a clinician's ability to place or technique that uses stents in reposition a device. combination with coils, pictured here, to treat wide·neck Work on the camera beaneurysms, acommon type gan in 1999 with the support of aneurysm previously untreatable using coils alone. �of a three-year, $1.2 million grant from the ational angiography, which provides good-quality images at Institute of Neurological Disorders and Stroke. Much somewhat higher exposure, but not the continuous, progress has been made since that time. real-time imaging that you get with fluoroscopy," ex"We started with an existing camera chip that had plains Rudin. "What they'd really like-and what we'd about a centimeter-by-centimeter field of view, which like to develop for them-is one device that can switch is very impractical," explains Rudin. back and forth between the two. "We now have a five-centimeter-by-five-centimeter "To do that requires a non-trivial step from where we field of view and can correct for artifacts and nonlinear- are," he adds with a chuckle. "However, we do have all ities, something we couldn't do before," he continues. the elements of technology in place; they've been test"Also, we are able to take pictures at five frames per ed and have been successful enough to make it feasible second, at 50-micron pixel sizes. Since the images are for one of our students to earn his PhD on the topic." digital-just like you'd get from any digital camera-we Almost as exciting to Rudin and the research team at can place them in files in a computer, where they can be the Toshiba Stroke Research Center is a new capability processed, displayed and manipulated. These are all they have discovered for the camera-it allows them to things that conventional equipment can do at rough res- see well enough to rotate a stent on its axis. olution; but we are doing them at high resolution." While the camera is in the final phase of being readied for testing in the clinic, under development is a newer camera that the researchers hope will move the technology forward from five frames per second to 30. "This is the subject of one of our graduate student's thesis," says Rudin-"to be able to go to 30 frames a second, which is real-time." Another more longterm goal for the team is to take the camera, which is designed only for angiography, and develop it to a point where it can be integrated into a single device that can perform angiography in combination with fluoroscopy. " ormally what the surgeons do is switch back and forth between Stephen Rudin, PhD, professor of radiology and physics and co·director of the Imaging Division in the UB Toshiba Stroke Research Center, the fluoroscopy, which has played akey role in developing acamera that gives neurosurgeons high·resolution X· ray images of vessels and instruments. This provides real-time, lowimprovement in imaging has in turn led to anew concept for endovascular treatment for aneurysms called a"low·porosity patch." resolution imaging, and e Spring 2003 l1ffale Pbysiciae 11 �This realization has led the scientists to formulate a concept that may lead to the development of a new endovascular treatment for aneurysm: If stents can be clearly vis ualized and manip ulated, why not create a stent that has a low-porosity patch on it that can be maneuvered up against the neck of an aneurysm to seal it and thereby prevent it from growing and hemorrhaging? "Aneurysms are bulges in the vessel, and these bulges are not symmetrical," explains Rudin. "The advantage now is that we can use the camera to not only see at high resolution things as small as a strut [on a stent], but we feel that we can rotate the stent on its axis, and if there's any asymmetry, we'll be able to localize it and wall off the aneurysm with the low-porosity patch." This approach, Rudin and his group theorize, might someday make coils superfluous. e the Blocks New area of stroke research explored ne of the biggest challenges in stroke ment of Neurosurgery are exploring a novel treatment is finding a way to quickly open approach that combines the use of the country, the UB re- blocked vessels in the brain without caus- thrombolytics with minimally invasive searchers, led by Ad nan ing hemorrhage or another stroke. (endovascular) surgery to treat patients Qureshi, MD, used a newer, longer-acting Some blockages respond to intravenous with acute ischemic stroke. Results from a thrombolytic agent called reteplase, which thrombolytics (drugs that thin the blood and prospective trial they conducted, which they injected directly into the clot through dissolve the clot); however, these agents, were reported in the November 2002 issue a catheter placed intra-arterially, rather such as the standard tpA (tissue plasmino- of Neurosurgery, show that more than one- than through an intravenous line. If the gen activator), can cause bleeding in the third (7 of 191 of the patients-all of whom drug alone did not reopen the vessel quick- brain, even when given at recommended would otherwise have been expected to ly, then mechanical thrombolysis treat- dosages. Other serious impediments to the suffer severe deficits--returned to func- ment was used to break up the clot. drugs are that they must be administered tional independence. " This trial opens up new horizons for within three hours of stroke onset to be " If there is a major artery that's block- stroke treatment," says Qureshi, now at effective, they are active for only 6 to 10 ed, we know from our cardiology col- the University of Medicine and Dentistry of minutes and they aren't recommended for leagues [who treat blocked coronary arter- New Jersey. "It shows the feasibility of us- patients who have had a recent surgery. ies) that you can sing and dance and squirt ing both measures in combination to open Minimally invasive therapies such as drugs in there all you want, but if you don't up the blood vessels and reduce the risk of balloon angioplasty and stenting are used to remove the clot, if you don't reperfuse the hemorrhage. None of the 19 patients treat- compress the plaque against the walls of the heart or brain, the patient won't get bet- ed experienced symptoms of brain hemor- artery to establish a channel whereby blood ter," explains L. N. " Nick" Hopkins, MD, rhage. The two worked synergistically." flow can be restored; however, this "me- chair and professor of neurosurgery and " This pharmaco-mechanical, intra- chanical" approach increases the chance professor of radiology at UB. "So, we've arterial approach has launched our de- that fragments of plaque from the clot will been working on ways to use drugs that partment into a whole new area of stroke break off, migrate to the brain and cause block platelets and dissolve the clot in research," adds Hopkins. "Methodologies another stroke (see article on page 4). combination with the mechanical removal such as this have the potential to add of the clot." greatly to what we are doing already." To overcome these problems, researchers in the University at Buffalo's Depart- 12 of the first of its kind in l1flal• Hpicin Spriflg 2003 In the prospective trial, which was one �"In the past, people hadn't thought of this approach because there was no way to control the stent because you couldn't see it clearly enough," explains Rudin. "We would have to be very precise, very targeted when we're positioning these patches over the aneurysm," adds Guterman. "It can't be done sloppily because there are problems with putting low-porosity regions in neurovasculature. For example, there are tiny perforator vessels that come off the main vessels. You don't want to cover these up because they lead directly into brain tissue, and if you cover them up and stop the flow, you can cause severe damage. So the placement of this type of stent will require very careful guidance, which means you have to be able to see what you're doing, which means you have to have high resolution, which we now have with the new camera." A patent application has been submitted for the new device, called an asymmetric low-porosity stent, and in January 2002 the researchers received a $75,000 grant from the UB Office of Science, Technology Transfer and Economic Outreach (STOR) that will enable them to buy equipment needed for the fabrication of an array of prototype devices. Teaching the Teachers These and other clinical-research endeavors serve to attract the best and brightest residents and fellows from around the world, who, in turn, continuously rein fuse the UB neurosurgery group with energy, ideas and talent. Each year, the department accepts one or two residents; it also offers a two-year fellowship in endovascular neurosurgery that is open to two individuals at a time. (Other fellowship training is offered in neurooncology and in critical care and stroke.) To date, some 25 fellows have graduated from the UB program. "All of our alumni are out there starting their own programs, and that's even more exciting," says Hopkins. "This [training] is one of the main reasons why our service is strong. Because when there is a difficult decision to be made at the angiography table, we have the most incredible team of young people standing there kicking ideas around. "These kids are so smart that I find that after the first six months I'm learning as much from them as they are learning from me," he continues. "Oh sure, I've got a few gray hairs and when one of them gets into a technically difficult situation, I can sometimes go in and show them a little trick or two, but these young people are phenomenal. Every one of them has come to me with recommendations from their chair, saying: 'This is the best student I have ever trained,' and they send them here. "So I have been absolutely privileged to be able to teach and collaborate with the talented young people who choose to come here. They've given up two years to learn these new endovascular techniques because they feel, as I do, that the future of neurosurgery in the vascular area is going to be endovascular." Currently, the senior fellow in endovascular neurosurgery at UB is Elad Levy, MD, who earned his medical degree at George Washington University and has completed two years of residency training in neurosurgery at the University of Pittsburgh. "I think everyone [in the field] considers this to be the number-one endovascular fellowship in neurosurgery in the country," says Levy, who will complete his training at UB in June 2003, after which he will return to the University of Pittsburgh to finish his residency. Today's generation of neuro stents "Dr. Hopkins has been a are so tiny and pliable, they can go pioneer in the past decade. wherever microcatheters go within the brain's vascular system. He's really considered by many to be the 'father' of neuroendovascular surgery; he's constantly pushing the envelope. Most importantly, however, he is a mentor in every sense of the word. He teaches us not only about neuroendovascular surgery, but about patient care and about judgement. Judgement comes from experience, and I don't think anyone else has as much experience as Dr. Hopkins does." In terms of advances in clinical research, Levy says "Buffalo is the leader in intracranial stenting," and he explains why he thinks now is a particularly exciting time to be involved in neuroendovascular surgery. "As recently as two years ago, stents really had a lot of trouble going around the C- 1 arch, where the vertebral artery takes a very sharp turn before going into the skull base, or the intracranial cavity," he says. The reason for this is that the stents were designed for the heart, so were not delicate or pliable enough for neuroendovascular surgery, according to Levy. Today, however, finer, more pliable stents designed for neuro- e S prin g 20 0 3 l1ffale Pbysiciaa 13 �New and effectiv Opti • For reasons that are not entirely says Munschauer. "Clearly we don't clear, the rate of stroke in the Buffalo have all the answers; in general, how- could not be making their and Niagara region is higher than any- ever, the population is more obese and way into the clinic at a better time, as where in New York State and one of the more sedentary. We also have higher each year in the United States about highest in the United States, according rates than expected of hypertension, 750,000 people have a stroke. Of these, to Frederick Munschauer, MD, chair of diabetes and hypercholesterolemia. about 160,000 die, making it the third the University at Buffalo's Department leading cause of death in our country of Neurology, chief ofthe Jacobs Neuro- he adds. "We think there are probably after heart disease and cancer, and the logical Institute and founding director genetic and environmental factors that leading cause of severe neurologic dis- of the Research Center for Stroke and we have yet to explain." ability.* As the elderly segment of our Heart Disease at the institute. "But that doesn't explain it all," For more information on the Research population continues to grow, the "Our research at the Jacobs Neuro- Center for Stroke and Heart Disease in stroke death rate is predicted to reach logical Jnstitute is directed toward find- the Jacobs Neurological Institute, visit epidemic proportions. ing out why those rates are higher," http://www.strokeheart.org. Th five most common stro .........---toms includ sudd n: Stroke deaths per 100,000 population for year 2000 ERIE 80.9 • numbness or weakness of face, arm or leg, especially on one side of the body; WYOMING 80.6 • confusion, trouble speaking or understanding; AllEGANY 74.1 CHAUTAUQUA 72.3 NIAGARA 63.7 USA 60.9 ORLEANS 58.9 GENESEE S8.0 CATTARAUGUS 54.8 NY STATE 41 .8 • difficulty seeing in one or both eyes; • trouble walking, dininess,loss of balance or coordination; • severe headache with no known cause Call911 if you see or have any of these symptoms. Treatment is more effective if provided quickly; every minute counts. •source: National Stroke Association at http://www.stroke.org/. RESEARCH CENTER for STROKE & HEART DISEASE JACOBS "ELROLOGICAL I"STITLH �Collaboration Among Specialists logic applications can navigate vessels as small as two millimeters. "Essentially, you can just about go wherever micro-catheters go [within the body's vascular system]; that's how soft these stents are," notes Levy. "So, if a catheter can get in there, so can a stent." Levy is enthusiastic about the research opportunities he has had through his fellowship and is eager to describe a UB study he recently collaborated on that was published in the December 2002 (Vol. 97) issue of the journal of Neurosurgery. The study pertained to stenting for atherosclerotic disease in intracranial vessels using what Levy refers to as "a revolutionary technique." "Traditionally, surgeons just go in and stent the lesion, but there is a high incidence of dislodging plaque, which goes upstream and causes strokes," he explains. Under Hopkins leadership, the UB study group examined whether they could treat vertebrobasilar atherosclerotic disease with staged stent-assisted angioplasty, according to Levy. "The idea was to first treat the plaque with angioplasty to open up the vessel to give it a little bit more blood flow, then let it heal before returning in a month or two-after there had been some scar formation and protection-and then treat with stenting to provide the best revascularization. "Our question was: 'Is this a safer approach?' And there were no strokes in the subgroup of patients that we treated with this 'staged-stenting' approach." While large-scale, multiple-center trials need to be conducted before the efficacy of this new approach can be determined, Levy is convinced that studies like this are pointing to where his field is moving in the future. He is also convinced that his work on these studies is helping him to develop the endovascular expertise he will need as a neurosurgeon. "There's no such thing as a magic bullet, so the more tools surgeons have to treat neurovascular disease, the better position they are in, and the better surgeon they will be," says Levy. "And this removes bias. Most people [in the field] can do one or the other: Typically the endovascular procedures are done by neuroradiologists, and surgery is done by neurosurgeons. So there's always the possibility that there will be a clinical bias, a lack of information, or even a financial bias to treat your patients one way or another. But if you have a variety of tools, a variety of skills, it helps you to individualize patient care." As technical barriers continue to fall, clearing the way for a future that is sure to include endovascular approaches to cerebral vascular diseases, it will be physicians like Levy and his peers who will have to resolve the thorny, long-term issues related to which specialists will provide such care and, subsequently, which will reap the economic rewards-issues that, over the years, have evolved parallel to the technology. Leaders today, like Hopkins, can strive to lay a foundation but, ultimately, it will be the current generation of students, residents and fellows who will decide what the future will hold. "Over the years, I've tried to build bridges," says Hopkins. "In our service, and on more and more services throughout the country, neurosurgeons are working hand in hand with neuroradiologists to manage the whole schema of care for the neuroendovascular patient, from diagnoses through preoperative and postoperative care. This, I feel, is what the blueprint should be for the future. "From the patient's perspective," he adds, "it will be critical for specialists to find synergistic ways to provide these really wonderful new neuroendovascular techniques, many of which are certain to become standard care over the next decade." 6 Special thanks to Paul Dressel for illustrating this article and for providing editorial assistance. Spri11g 2003 luffalo Pbysiciaa 15 �,MD'89 UB Toshiba Stroke Research Center �The Toshiba Stroke Research Center was necessary to expand the was established at the University at models that were available for Buffalo School of Medicine and Biomedical testing, designing and implementing new technologies." Sciences in 1996 with a $3.6 million gift of As a result, Guterman went to the University of Wisconsin equipment from Toshiba America Medical to train in the latest laboratorytesting techniques, which he Systems. In the spring of 2003, the com· brought back to Buffalo. This training, he says, positioned pany continued its support for the center UB's Department of eurosurgery to be the third group in by equipping a second research suite the world to use the Guglielmi detachable coil for the neurowith its most advanced X-ray endovascular treatment of anangiographic machines. eurysms when it came on the market in 1990 (see BY S· The concept of establishing a research program at UB to study and perfect neuroendovascular surgery techniques was originally envisioned by Lee Guterman, PhD, MD '89, according to L. N." ick" Hopkins, MD, chair of neurosurgery at UB and director of the Toshiba Stroke Research Center. "Back when he was a medical student and resident at UB, Lee kept saying, 'We've got to be doing research here,"' says Hopkins. "And that led directly to the multidisciplinary research team that we put A· Unger together in the early 1990s and, eventually, to our developing the concept of the Toshiba Stroke Research Center." Prior to entering medical school at UB, Guterman earned a doctorate in polymer chemistry at Clarkson University in Potsdam, New York. After completing residency training in neurosurgery at UB, he pursued a fellowship in endovascular surgery under Hopkins, and in 1996 he joined the faculty of the UB School of Medicine and Biomedical Sciences. Today he is an assistant professor of neurosurgery at UB and codirector of device development at the Toshiba Stroke Research Center. "Back in the late 1980s, when you looked through the literature related to endovascular treatment for cerebralvascular disease, there really were no basic-science laboratories in the country other than one in Wisconsin and one in Los Angeles," recalls Guterman. "There was such a paucity of research, it was clear to me that in order for this fledgling new field to take off, it e related article on page 4). Soon thereafter, the Department of Neurosurgery received seed grants from the Margaret L. Wendt Foundation and the John R. Oishei Foundation, both of Buffalo, to support its research in this new field. "With that funding, we were able to get a laboratory going at the university," says Guterman. "We began looking at the use of stents along with coils for the treatment of aneursyms, and different types of imaging technology-specifically, we made images of aneurysms using an ultrasound probe that had been used to image coronary vessels, but never before used to look at aneurysms." Work in the one-room laboratory gained further momentum when Guterman teamed up with Stephen Rudin, PhD, UB professor of radiology and physics, to develop region-of-interest fluoroscopy. They and their UB collaborators were convinced that in order for neuroendovascular technology to move forward, it was critical that imaging methods be developed that would be capable of providing clear views of tiny blood vessels and micro-devices deep within the brain. "We found we could produce very high-quality images while at the same time limit the radiation dose to patients," explains Guterman. About the time that the device development and imaging research efforts were gaining ground, Hopkins and Guterman were approached by the chair of a company called Boston Scientific (now a major medicaldevice manufacturer), who told them about a young neuroradiologist named Ajay Wakhloo, PhD, MD, who was looking for a clinical-research position. Spring 2003 laflal1 Plysiciu 17 �"There was such a paUCity Of research, it was clear to me that in order for this fledgling new field to take off, it was necessary to expand the models that were available for testing, designing and implementing new technologies." Wakhloo joined the UB Department of eurosurgery and began collaborating on hemodynamic (blood-flow) research with Barry Lieber, PhD, UB professor of mechanical and aerospace engineering and current director of the UB Center for Bioengineering. "Blood-flow patterns have a major effect on arterial disease, including atherosclerosis, aneurysms and arteriovenous malformations-all major causes of stroke," notes Guterman. "For this reason, hemodynamics was another area of research we felt it was very important to develop." Wakhloo left UB in 1999 to become director of interventional radiology at the University of Miami. Currently, Hui Meng, PhD, UB associate professor of mechanical and aerospace engineering, and Kenneth Hoffmann, PhD, UB associate professor of neurosurgery, are furthering the blood-flow research by designing experimental models that mimic hemodynamic patterns through and around blood-vessel abnormalities. Based on this information, their colleagues in the Toshiba Stroke Research Center's Prostheses Design Division are custom tailoring implantable prostheses to correct the aberrant blood flow. "By the mid-1990s, we had achieved a critical mass of neurosurgeons working with physicists, chemists and mechanical and aerospace engineers," continues Guterman. It was during this time that Bruce Holm, PhD, who today is senior vice provost at UB, approached Hopkins and Guterman about moving the laboratory into the Biomedical Research Building that was being built on UB's South Campus. This invitation prompted the surgeons to begin looking for a corporation to donate equipment and funds to establish a state-of-the-art angiographic research facility. 18 lalfal1 Pbysician S pr111 g 2 00 3 In 1996 Toshiba America Medical Systems announced its support for such a facility, and the UB Toshiba Stroke Research Center was established with a gift of $3.6 million in equipment from the company. The mission of the new center was formalized to focus on the three areas of study that the UB researchers had identified a decade earlier as being critical to the advancement of the field of neuroendovascular surgery: image optimization and radiation dose reduction; device development and testing; and hemodynamics. Once the center was fully operational, its reputation quickly grew. By the late 1990s, physician-collaborators from all over the world began gravitating to Buffalo, not only to perform research experiments, but also to train in how to use the new, catheter-based medical technology. "It was this infusion of brain power that has really pushed our research forward," notes Guterman. Over the years, in addition to attracting physicians interested in receiving state-of-the-art training in neuroendovascular procedures and in collaborating on research projects, the center also has drawn medicaldevice equipment manufacturers eager to test new products or improve existing devices. Today, in order to maximize this synergy, researchers in the Toshiba Stroke Research Center closely collaborate with the UB Office of Science, Technology Transfer and Economic Outreach (STOR), directed by Robert ]. Genco, DDS, PhD, UB vice provost and SUNY Distinguished Professor. "To Dr. Genco's credit," says Guterman, "STOR provides UB with a unique opportunity to capitalize on the relationships that the center has developed with medical-device companies throughout the world. The hope is that we �will see medical technology that's either developed or enhanced here in Buffalo and then spun off to form start-up companies that would be based in Buffalo." This "seed mentality" at UB, as Guterman refers to it, has great potential not only to move forward the research at the center, but also to provide a source of jobs for the Buffalo community. Guterman credits both Holm and Genco for their leadership and vision in these areas, as well as Jaylan Turkkan, PhD, UB vice president for research, and Kenneth Tramposch, PhD, UB associate vice president for research. "The support at UB for translating research discoveries into products is remarkable," he notes. In collaboration with these administrative leaders, a new and increasingly important focus for center researchers is to win grants from the ational Institutes of Health to further support their basic-science studies. Given the role Guterman has played in the establishment and success of the UB Toshiba Stroke Research Center, it's only natural to ask him if he has been ap- proached about leaving Buffalo to pursue other opportunities in this burgeoning field of clinical research. Without hesitating, he responds: "When I look across the United States at jobs that have been offered to me over the years, it's been very difficult to consider leaving Buffalo because of the wonderful relationship I have with my partners, the outstanding clinical opportunity I have to practice neurosurgery and the access I have to a research laboratory that is the finest of its kind in the world," he says. "If you put those three elements together, it's almost impossible to consider taking a job anywhere else." <D For more information on University at Buffalo's Toshiba Stroke Research Center, visit the UB Department ofNeurosurgery's Web site at www.neurosurgerybuffalo.com/. For more information on the UB Office of Science, Technology Transfer and Economic Outreach (STOR), visit its Web site at www.stor.buffalo.edu/. When is a house more than a home? ... When it is a Patio Home at Canterbury Woods. Come and learn more about what makes our new Patio Home Community so unique. Informational Seminar Seating is Limited Call 929-5817 To Reserve your Date and Time Episcopal Church Home and [jfiliates $ 705 Renaissance Drive, Williamsville, NY 14221 Spri11g 2003 l1flale Pbysiciaa 19 ��Although !estern Ne xrYorkers would like to be known for their big hearts, 1 t~e the 're n1ore well known for their bad That's because this region holds a dubious claim to fame as the heart-disease capital of the United States. According to statistics from the Kaleida Research Center for Stroke and Heart Disease, Western New Yorkers are hospitalized more frequently for cardiovascular disease than people in any other region of the country. More disturbing still is the fact that the incidence of fatal heart attacks in the region is nearly 50 percent higher than the national average. In response to this health crisis, two alumni of the University at Buffalo School of Medicine and Biomedical Sciences have developed a comprehensive protocol for acute cardiac patients. Designed to ensure optimal care from a patient's first crucial minutes in the emergency department through the time of discharge from the hospital, the pathway focuses on faster diagnosis and intervention, with the aim of decreasing readmissions, medication errors and health-care costs-while, most importantly, increasing survival rates. He ') <? o R ~a1' Known as the Acute Coronary Syndrome Emergency Treatment Strategies program, or ACSETS, the pathway was created by John Cor belli, MD '79, UB clinical instructor and a cardiologist with Buffalo Cardiology and Pulmonary Associates; and David Janicke, MD '88, PhD (pharmaceutics), UB clinical assistant professor, emergency medicine research and residency director at Millard Fillmore Hospitals and an emergency physician with MFHS Physicians' Emergency Services, PC. "What we have done is come up with a standardized set of orders that help 'risk stratify' the patient," says Corbelli, who also serves as research director for his medical group. "It gives physicians a reference, right there in the emergency department, as to how they should be assessing a patient's risk. So, if a patient is at a certain level of risk, he would be treated with the level of medical therapy that would most effectively address his particular situation." The idea for the pathway-which was introduced into the Kaleida system last fall-has its roots in a May 2001 meeting of physicians and managed care representatives. At that meeting, UB Department of Neurology chair Frederick E. Munschauer III, MD, who is director of the Research Center for Stroke and Heart Disease, presented a hearts. raft of alarming statistics about Western ew York's escalated rates of hospitalization and mortality due to heart disease. At a follow-up gathering four months later, physicians began discussing the possibility of standardizing care for acute cardiac patients at Kaleida's four area hospitals. "It's clear that in terms of quality of care there are some things that can be done for acute coronary events in the emergency department that have been shown to improve outcomes," says Munschauer. "In much the same sense that pilots use checklists before they let a plane take off, we felt there should really be recommended practice guidelines. "It's not that we as a community of physicians are bad in this area," he adds, "but this makes us better." Corbelli and Janicke signed on to the project at the end of 2001 and began working on it in earnest in early 2002. As part of their research, they arranged video teleconferences with experts in the field from the Cleveland Clinic and Harvard University. The physicians also conferred with medical directors of area health maintenance organizations to make sure they would lend their support for such a program. During the summer before the program was launched, they educated Kaleida physicians and nurses about the system. "We did a lot of homework before this came out," says Janicke. "For six to nine months we were just fact-finding, getting all the information together and trying to come together with a consensus that everyone would be comfortable with in our region." When writing drafts of the protocol, the physicians relied primarily on the most recent guidelines from the American Heart Association and the American College of Cardiology. "There are a lot of complicated treatments that have come out, and it's hard to sort through them all," notes Janicke. "For instance, the recommendations from the American College of Cardiology are 95 pages long. It takes time for clinicians to gather the data and use that information. What we thought to do was to make it more simple and concise so people would be aware of what the recommendations actually are." The pathway begins in the emergency department when patients present with acute chest pain and possible acute coronary syndrome. "The forms are preprinted, so no body's struggling with handwriting," explains Corbelli. "They all include a risk-stratification outline followed by Sprrng 2003 1111a11 npiciu 21 �., -· an outline of recommended medications based on the individual patient's level of risk. It helps make the process very efficient, and it cuts down on medical errors." If a patient is admitted to the hospital, the emergency department orders follow him to the floor, ensuring that the admitting physician knows exactly which procedures and medications were administered and why. At this point, the physician refers to a separate set of orders so that the medications started in the emergency department are more efficiently carried on once the patient is admitted to the hospital. "One of the problems with people who have heart disease, is that they may not be on all the medications that have been demonstrated in the medical literature to help lower their risk of having another attack: an aspirin, a beta blocker, an ACE inhibitor, cholesterol-lowering medication and clopidogrel," explains Corbelli. "By combining a preventive approach with an acute approach to the treatment of these patients, the ACSETS pathway represents an unusual- perhaps even uniqueapproach compared to treatments in other areas of the country," he adds. Finally, when the patient is ready to leave the hospital, the physician discharges him with a form in duplicateone for himself and one for his referring doctor-that lists the medications that have been prescribed, why they have been prescribed and how they are pronounced. "A big problem is that patients either don't fill the prescriptions, or they fill the prescriptions and stop taking them," notes Corbelli. (As a general rule, the greater the number of drugs prescribed, the lower the patient's compliance is in taking them.) "The idea with this form is to help empower the patient to understand why the doctor is putting him on these medications so that, hopefully, he'll see the importance of staying on them," he adds. ow that the pathway has been launched in the Kaleida hospitals, the question remains: Will physicians follow the guidelines? That's something Anthony Bonner, MD '68, can address. Two years ago, he spearheaded a similar protocol for cardiac patients that remains in use at South Buffalo's Mercy Hospital. "The real battle is getting everyone to use them. To me, they just make life easier, but some people are reluctant to use them. They feel they're too 'cook-bookish,' says Bonner, UB clinical assistant professor of medicine and Mercy's chief of cardiology. "On the other hand, a lot of intelligent, well-read doctors made these guidelines ba ed on the best available information, and we should follow them as best we can." Janicke stresses that ACSETS is not intended to replace I ! I I I I i II 1111111 P~JIICIII s i a physician's judgment. "Any time a pathway or protocol is handed out, there's always reluctance. I've never seen there not be reluctance," he acknowledges. "But this is not a cookbook. This is a guideline for evidence-based treatment options. It still takes a well-trained clinician to make a timely diagnosis and decide how high risk the patient is in order to determine appropriate treatment. Emergency physician involvement is particularly crucial because the emergency department is where most patients present with acute coronary events and risk-stratification treatment needs to be initiated promptly. "Once the physicians and residents become aware of why we're recommending various treatments," he continues, "then the buy-in starts to be cumulative." Corbelli adds that ACSETS avoids battles that have limited the acceptance of other pathways because it is different in its fundamental concept. "It's an educational and communication vehicle serving not only to guide treatment but also to instruct the physician as to why different therapies are appropriate according to individual risk," he explains. "This communication/education approach facilitates patient understanding and therefore buy-in, as well." The Corbelli-Janicke plan includes a detailed review of the pathway that will allow physicians to identify not only how closely the hospital orders were followed for every patient admitted to a Kaleida hospital, but how well patients are complying with their medication regimen-and, not least of all, how the pathway affects patient outcomes. "In addition to the care pathway, there is a very detailed research protocol that looks at, one, whether physicians are using ACSETS consistently and, two, whether it really improves the quality of care in our region,'' explains Corbelli. "Also, once people are discharged, we plan to monitor whether they're actually taking their medications, and we're looking to see if there's a lower frequency of heart attacks, of patients needing angiograms, angioplasty and so on." Disseminating the Concept ACSETS will be updated to stay current with the literature and with the latest recommendations from the American Heart Association and the American College of Cardiology, according to Janicke. Furthermore, the physicians stand ready to make any changes to the forms to make them more reader-friendly for physicians, nurses and patients. "We're constantly thinking of ways to revise this,'' says Janicke. "That's the only way, really, to make this work." Last ovember, shortly after the ACSETS program was introduced, research findings reported at a meeting of J �More disturbing still is the fact that the incidence of fatal heart attacks in the region is nearly 50 percent higher than the national average. their pathway and research with hospitals outside the the American Heart Association pointed to the need for the standardized care it advocates. A group of studies highlighted a gap between what guidelines call for in preventing and treating particular heart conditions and what physicians actually prescribe for them. "We as physicians need to look at the results of all these clinical trials and assemble them into a coordinated, comprehensive plan so that we make sure that care is delivered in an optimal fashion," asserts Munschauer. "This ACSETS program really allows for everything to become systematized and eliminates the chance for variations from best practice." Months after completing the pathway's final draft, Cor belli sits at a desk that is still covered with the literature he scoured in preparation-the physical representation of what he describes as "a huge effort." With all the heavy lifting done, both he and Janicke are interested in sharing Kaleida Health system. Already, two other hospitals in the region-Niagara Falls Memorial Medical Center and Lockport Hospital-plan to use the ACSETS program. One advantage of smaller hospitals signing on, the physicians note, is that it provides a continuum of care for patients transported to a Kaleida hospital when specialized cardiac services are not available at an outlying hospital. "From the standpoint of health and, correspondingly, the cost of medicine, the acute coronary syndrome is a very significant problem in our area," stresses Corbelli. "That's why our goal is to disseminate this concept. We want to make this available to anyone who's interested." 4D The ACSETS pathway, along with a description of how it was developed and implemented, was published in the March 2003 issue of Critical Pathways in Cardiology. "We practice law for your peace of mind." Suburban location, extended hours and personal service. Fstate Planning • Corporate • Real Fstate • Elder Law Personal Injuty • Criminal Law • Family Law Taxation and Financial Planning HoGAN & W ILLI G, PLLC - - - - - A t t o r n e y s nt Lnw - - - - - Proud Sponsor of hoganandwillig.com The Tour de Cure • May 31, 2003 Ftmdraising event for tlte American Diabetes Association One John James Audubon Parkway • Amherst, New York 14228 • 716.636.7600 �1111111 Plpici11 Spr~ng 20Ul �The goal in publishing these articles is to inform our readers Q: When you consider a candidate for medical school at UB, do grade point about the complex economic, political, regulatory and historic average and MCAT score carry the most weight? considerations school leaders must weigh in making decisions A: Too often people think that getting into medical school means and to provide a larger context within which to understand the many new developments taking place on campus. that you just had the best grades. We recently rejected a candidate with a 4.0 grade point average from a top university and a 40 on '' Comments and questions, as well as suggestions for future topics, are welcome and can be e-m ailed to bp-notes@buffalo.edu or mailed to the address printed on the inside front cover of the magazine, below the heading "Letters to the Editor." his MCAT when one of our interview questions was, 'Tell me about a time when you couldn't stand spending one more minute on an activity needed for medical school.' And this student's answer was, 'Community service. I just couldn't stand dealing to medical school at UB? with those people.' So here at UB, you will find that our interview process is geared toward picking people who-in addition to how they look on paper-embody characteristics that we feel will make them a good fit for the profession. A: Q: What are the personality characteristics of the students you seek to -S.A. Unger, editor Q: What is the process students must follow in order to apply for admission To apply to medical school, for starters, you have to have the prerequisites. You can major in anything you want as long as you have taken four semesters of chemistry (two of which have to be organic) and two semesters of biology-all of which have to be with labs-two semesters of physics and two semesters of English. Everyone has to take the MCAT [Medical College Admission Test], except for candidates who come in through the early assurance program. They must also complete an AMCAS application, which requires that they write a personal essay. Letters of reference must also be submitted. All of these materials, combined with college grades, need to be submitted to apply. Now, for competitive applications, we want to see that these candidates have adequately tested their decision to go into medicine. For example, if someone applies who has a 4.0 GPA in art history and has a great MCAT score, but they have never set foot in a hospital, that person might want to try volunteering in a medical setting to see if they are going to faint every time they see blood! To become a physician, you have to complete a lot of years of school, and it costs a lot of money. We would really love to graduate every student we admit, so that makes us a whole lot pickier on the selection end. attract? Can you elaborate on this? A: We are obviously looking for someone who is motivated and altruistic and who has excellent analytical skills. We also assess candidates to see if they have intellectual curiosity, because we are looking for the lifelong learner. We also want to attract people who are open-minded and capable of changing their minds if new information is given, and capable of tolerating that which they have no intention of changing their minds about! We look for this because when you become a physician, you're going to treat a lot of people whose value systems are completely different from your own, and we have to know whether a person is going to be able to cope with the fact that there are patients out there who aren 't like them, but still need to be cared for by them. Too, we look for individuals who are able to make other people comfortable. So, in general, we look for a "good" personality and certainly the challenge is to define exactly what that is. At UB, the Admissions Committee has put together a composite list of characteristics that they feel define this. Spri n g 2003 llfl1lt Hysiciu 25 �Q: Who sits on the Admissions Committee, and what role do its members play in the admissions process? A: I want to start by saying that the Admissions Committee meets every Wednesday for five to six hours, eight months a year, so each member is asked to make a huge time commitment. These are incredibly dedicated people! The committee is made up of about 50 members, although only 20 to 30 are able to attend any given week. They represent a mix of basic-science, clinical and volunteer faculty, as well as some emeritus faculty. When the files from applicants come in, each is reviewed and scored separately by two different people on the committee. We have a system for scoring files that takes into account who the student is by way of his or her background, what they say in their personal statement, what others say about them in their letters of recommendation, and so on. These two scores provided by the comm ittee members are then added to what we call the "weighted score," which is a single number we arrive at through a formula that basically takes the hard-core numeric data we have available from tests scores and transcripts, adjusted for various degree-ofdifficulty factors. A composite score is determined by combining the two interviewers' scores and the weighted score, and then we rank the students and begin the interview process. Each week, we bring in anywhere from 20 to 25 candidates, each of whom is interviewed by two members of the Admissions Committee. How is the interview conducted? We have begun using a behavior-based technique, which is actually very popu lar in the business world, whereby-unlike the stock market- the belief is that past performance is the best predictor of future performance. So we no longer throw out a hypothetical question such as, 'How would you tell the parents of a five-year-old that their child is dying of leukemia?' After all, this is a class of 21 year olds, for the most part, and they have never had to do anything like this in their lives! Instead, we pose a question such as, 'Tell me about a time when you had to del iver bad news to someone. How did you prepare yourself? How did you handle yourself?' Everybody can come up with a time when they were the bearer of bad news-such as telling your sister that her dog was hit by a car-and how you handled it is a good predictor further down the line of how you're going to handle these types of situations with patients. As I explained earlier, the committee has compiled a list of characteristics that they feel are important attributes for a physician. Under each characteristic, we have multiple questions they can ask. They're not going to ask every candidate every question, 26 l 1 ff al1 Hysici11 Spr~11g 2003 but at least each question is one that we, as a group, have determined to be fair. Interviewers can certainly ask additional questions not on the list to explore each candidate's unique features and to round out the core questions. Because everyone is now interviewed using the same process, I think it's more objective and, frankly, I feel it's been much easier to make decisions. Q: What would you tell students to encourage them to come to UB when they have been accepted at other medical schools, as well? A: First, even though our tuition is going up, I would tell them that UB provides a relatively inexpensive education for what you get. More generally, however, something I would encourage prospective students to think about is a school's personality and culture and whether it's a good match for them. Some schools, for example, emphasize competition, whereas at UB we very much emphasize a collaborative approach to education. Our feeling is that when a student graduates and gets out in the hospital, he or she is not competing with the other physicians taking care of a patient. It's not that we don't expect them to strive for excellence, but we encourage them to compete for their personal best, as opposed to trying to beat the person sitting next to them. My theory is that all boats rise with the tide. In reality, I know that the students do have to compete in the outside world. If you want to go into orthopedics, you have to have a dazzling board score, but my conviction is that you can get that yourself by studying hard. Success doesn't have to come at the expense of other students. In essence, I think the students are pretty good at looking at schools and sizing up where they best fit. And I really don't want to encourage them to come here if they don't want to. I want students to come here who feel they fit UB's personality because, frankly, if we can meet their needs, they're going to be happier and all of our lives will be easier! Q: [Former] Dean Bernardino has said that recruitment of minority students to our school is a priority. Can you update our readers on some of the efforts being made in this area and the results to date? A: Yes, as we discussed earlier, Dr. Bernardino mandated that I admit classes that better reflect the demographics of the community we live in-the community our students are going to go out in and serve when they graduate. We have a great deal of diversity in Buffalo, Western ew York and throughoutthe state; in particular, we have large African American and Hispanic populations. In terms of updating you on progress in this area, our medical school has six minority students in the second-year class and 17 in the first-year class, so we have made a real effort over the past year. �l To assist us in this process, last August we brought in a consultant, Dr. Billy Ballard, who presented the Expanded Minority Admissions Exercise, which is a workshop designed by the Community and Minority Programs section of the AAMC [Association of American Medical Colleges]. The primary goal of the exercise was to increase our knowledge and sharpen our skills as they relate to assessing noncognitive attributes in minority students applying to medical school. These attributes, we learned, may be predictors of academic success, but often go unrecognized by admissions committees. By completing the exercise with Dr. Ballard, we were given guidance in how to go beyond the basics, such as what a student's GPAand MCATscores are, because minority students often come from disadvantaged backgrounds, where, for example, they may have had to work full time while in college and their GP A may not be the best reflection of their ability. So, in addition to looking at numeric data, the workshop walked us through how we can take a look at things like a student's support system, aptitude for realistic self-assessment and other things that tend to make or break how people do and help you select candidates who have the best chance of getting through medical school. We can't have one way of admitting minority students and another way of admitting non-minority students, and an increased understanding of the role of noncognitive attributes has helped us evaluate all our applicants. I think that, across the board, you have to be sensitive to characteristics that do or don't predict performance. For the same reason that I'm not going to admit a student with a 4.0 GPA from a top university with a 40 on the MCAT who states in the interview process that he doesn't like community service and working with people, I think it's reasonable to consider admitting someone who may not have such high numbers, but who brings all sorts of other things to the table. Another step we've taken to provide our office with the expertise it needs to effectively increase minority student representation at our school is to bring on board Dr. David Milling, who joined the staff of the Office of Medical Education in December of 2002 as assistant dean for multicultural affairs. A 1993 graduate of our school, Dr. Milling is the first physician to hold this position. As a respected teacher and clinician, I think he will serve as a terrific role model for our students. We are also indebted to Adrian Jones, assistant director for multicultural affairs, who runs our post-baccalaureate program and has played a critical role in improving our recruitment efforts. Q: What role do scholarships play in your ability to attract quality expenses, have to buy expensive equipment and books and need to have a car, the financial pressures they feel can be enormous. I have 135 students I must consider when I distribute that $90,000, so it doesn 't go very far-and I don't want to start giving out $50 scholarships! So, basically, what I have is very little money to use as an attraction. Now people may say, 'Well, your school is inexpensive. ' To that I say, 'There's nothing cheaper than free. ' By tha I mean, let's say I'm competing for a particularly attractive st dent and I can give him $6,000 toward his tuition, but Mayo is offering him a full scholarship; then my money doesn't really mean I I I anything. We have pitifully little endowment. Do we lose goods udents because of that? Absolutely. I have students on the multiple-accept list who as , "How much scholarship assistance am I going to get?" And t en they pick the school that offers them the best deal, and who can fault them? Many of our students today are looking at $70,000 t $100,000 debt when they graduate-a mortgage without a hous . We have to find ways to help them more. Q: If, 20 years from now, you were to ask members of the Class of 2006 what they feH about their medical education at UB, what - ould you like to hear them say? A: I would want them to say that we really prepared them for lifJ when they went out the door-that they do have e core education they need, they do have the learning skills the need in a fie! that is constantly changing, and that they do have the people skills they need to take good care of their patients. Finally, I'd like them to feel that they have basic lifetime skills that allow them to take good care of themselves so that they can take care of other people and enjoy themselves while they're doing it. I think this last point is often overlooked, and I hope it is something that we are able to teach and instill in our students. The bottom line is that if you don 't take care of yourself, you will not be in any shape to take care of anyone else, and medicine is a profession of giving. So, when I talk with our first-year students 20 years from now, I'd love to hear that when they get up each morning, they're looking forward to going to work. If that's the case, then the skills we taught them will be manifested in ways that their patients will gladly attest to. 4D students? v· : I have about $90,000 in scholarship money each year to hand out. ow, when you look at the fact that tuition at our school is $14,000 a year and that the students need to come up with living Spr i r~g 2003 l1ffal1 Plysicin 27 �MEDICAL SCHOOL E W S New curriculum, fiscal management lauded he School of Medicine ing the school's financial unand Biomedical Sciences derpinnings, were tasks the at the University at Buf- LCME had directed the medifalo has earned reac- cal school to achieve in order to creditation for eight receive its reaccreditation. In more years from the its final report, the LCME now Liaison Committee on labels both those areas specific institutional strengths. Medical Education(LCME). Most of the reaccreditation The action constitutes a work was accomplished under ringing endorsement of the school's educational program: the school's former dean, Eight years is the longest inter- Michael Bernardino, MD, who val between surveys allowed by resigned his post in February the LCME. The program's next after five years at UB to return accreditation survey will take to private radiology practice in Atlanta. The LCME notes place in 2010. Bernardino's contribu"To have LCME say, BY tions to the medical LOIS 'We'll see you in 2010' school as the first of five was great news, " says institutional strengths. Margaret Paroski, MD, The report commends him interim vice president for health affairs and interim dean as an effective agent for change of the medical school. "We have and lauds his leadership, coma few areas that need shoring munication with faculty and up, but by-and-large, the eval- students, and management of uators really liked our school 's the school's financial resources. Other specific strengths new curriculum. "Being involved in redesign- highlighted in the report are: ing the curriculum was one of • The new curriculum: "Colthe most exciting things I've laborative efforts of the dean's done in my academic career," educational administration and says Paroski, who directed the faculty have led to the creimplementation of this effort. ation of a new pre-clinical cur"The feedback from students riculum that promises a more has been very positive. We now cohesive educational environhave a living, breathingcurricu- mentand institutional culture." lum. ltmakes teaching so much The faculty: "The faculty more fun." displays noteworthy commitRedesigning the first two ment to its responsibility for years of the curriculum into teaching and supporting mediorgan-based modules instead of cal students. " department-based modules, The students: "Student moplus reorganizing and stabiliz- rale and enthusiasm about the 28 l•ffall Pbysici11 S pr~11 g 2003 school and its curriculum have shown significant improvement as a result of the faculty and administration's responsiveness to their concerns." • The Health Sciences Library: "The well equipped Health Sciences Library is responsive to the needs of a modern, electronically literate academic community, and functions as an important focal point for integrating the academic life of a multifaceted and geographically dispersed institution. " The report also notes five items in which the school was in partial or substantial noncompliance with LCME standards, and three "transition " areas outside the medical school that need attention in order for the school to sustain its ongoing accreditation. The transition areas named are lack of affiliation agree- Keyser Cadillac Upst:at:e Ne"WYork's only exclusive Cadillac Dealer Keyser Cadillac 4130 Sheridan Drive · Williamsville. NY 634-4100 key ercadillac.com �RELOCATION HU 'T REAL ESTATE ERA ments with teaching hospitals (Kaleida Health and ECMC have since signed agreements, Paroski notes), residency program management and oversight. UB is also addressing this concern, Paroski says, by phasing out consortium management of the residency program and transferring responsibility to the medical school. The final transition item warns that students and residents may not get enough exposure to patients in several specialty areas, in particular internal medicine, pediatrics, obstetrics and gynecology, and neurology, because of decreased hospital admissions and shortened hospital stays, a problem faced by teaching hospitals across the country. ''THEACTIO.'CO 'STITUTESARINGI~GE,'DORSEME TOF we help people move. THE SCHOOL'S EDUCATIO 'ALPROGRAM: EIGHT YEARS IS Call for a free relocation portfolio regarding your destination city. Calll-800-688-1170 or go on-line and visit our web site at huntrealestate.com THE LO. 'GESTI. 'TERVALB ETWEE.' SURVEYSALLOWEDBY THELCME. ' ' Totally customized service portfolio including Paroski reports that UB is addressing this problem by creating smaller clerkship groups, which gives each student maximum exposure to available inpatients, and by using standardized patients when necessary. Noncompliance issues that the LCME says must be addressed center on the need to set global objectives for the entire curriculum and establish ways to evaluate how the school is meeting those objectives. The report also says UB must offer students more career, residency (specialty) and financial counseling, areas in which the school has made substantial progress, according to Paroski. ancy Nielsen, PhD, MD '76, interim senior associate dean for medical education, has set up a program of one-on-one career counseling for third and fourth year students, Paroski says, and her entire staff is taking more responsibility for financial aid and debt management counseling. Establishing reliable ways to evaluate the new curriculum as a whole and student performance and improvement under the new curriculum will be a bigger task, Paroski says. ''I'm not sure how to measure a better doctor. It's a hard • Nationally trained relocation experts • Complete family needs analysis • Global home sale assistance • Special services for seniors • Full community tour • A complete cost of living analysis • A list of all school systems throughout WNY • Complete spousal placement assistance including resume writing and corporate contacts • 24 hour or less response time • Confidentiality assured thing to get your arms around." One approach will be to ask attending physicians who supervise third-year students to compare the performance of students who went through the old preclinical curriculum with those trained under the new curriculum, she says. "We want to see if we have created this 'active learner' as we had hoped." The LCME has requested a progress report on noncompliance and transition issues by September 2004. Hunt ERA Relocation Center 5570 Main Street Williamsville, New Yor1< 14221-541 0 CD Email: huntrelocation@huntrealestate.com S p ri n g 20 0 3 llffalt nysiciu 29 �BUFFALO LIFE SCIENCES COMPLEX B Y A R THU R P AGE John R. Oishei Foundation grants $9 million On March 6, 2003, the John R. Oishei Foundation announced grants research space to the BNMC. Construction will begin in the summer totaling $9 million to the three partners in the Buffalo Life Sciences of 2003. The complex will house the Hauptman·Woodward Center for Complex (BLSCI. Structural Biology, the Roswell Park Center for Genetics and Pharm- University at Buffalo will receive $2 million and Roswell Park acology, and the UB Center of Excellence in Bioinformatics. The BLSC Cancer Institute (RPCII and Hauptman-Woodward Medical Research will sponsor life sciences research designed to improve human health Institute IHWII each will receive $3.5 million. by developing new therapies to treat and cure disease. The award, the largest in the Oishei Foundation's 63-year history, With commitments totaling more than $11.7 million, the John R. is contingent on the BLSC institutions obtaining the necessary Oishei Foundation is the largest foundation supporter of "The commitments to reach their respective funding goals. It has been Campaign for UB: Generation to Generation," which has a goal of made to UB, HWI and RPCI as a partnership under the auspices of $250 million. Buffalo Niagara Medical Campus (BNMCI. The three organizations, Gifts from the foundation to the campaign have included 20 which have a long history of collaborative research, are cooperating separate grants supporting a wide range of projects. Among them are in the design and development of an integrated, three-building life more than $2 million for the Toshiba Stroke Research Center (see sciences research center, the Buffalo Life Sciences Complex, to be articles on pages 4 and 161; $1.5 million to the School of Medicine built at Ellicott and Virginia streets. and Biomedical Sciences to establish a Center for Research in Car- While the HWI and RPCI awards will be dedicated primarily to diovascular Medicine (see article on page 371; $1.2 million for facilities development, the money granted to UB will go toward the vascular disease prevention research; and $600,000 in support of recruitment, salaries and research of top-level scientists at the UB infectious disease research programs at the school (see article on page 351. Center of Excellence in Bioinformatics. An earlier grant from the Oishei Foundation to UB for $1,542,000 The John R. Oishei Foundation is committed to enhancing the was used to support the salaries and research of Jeffrey Skolnick, quality of life for Buffalo-area residents by supporting education, PhD, the center's director, and two other scientists recruited with health care, scientific research and the cultural, social, civic and Skolnick from the Danforth Plant Science Center in St. louis. other charitable needs of the community. It was established in 1940 The Buffalo Life Sciences Complex will consist of three new buildings adding more than 400,000 square feet of state-of-the-art by John R. Oishei, founder of Trico Products Corporation, one of the wor1d's leading manufacturers of windshield wiper systems. 4D Margaret L. Wendt Foundation awards $4.5 million 30 In December 2002, the Margaret l. Wendt the three partners in the Buffalo Life Sci· The Margaret l. Wendt Foundation is a Foundation announced grants totaling $4.5 ences Complex. Each institute will receive private, philanthropic organization that focuses its work in Western New York and is million to the University at Buffalo, Hauptman- $1.5 million, which will be used to reinforce Woodward Medical Research Institute (HWI) connectivity between the buildings they are devoted to the development of a stronger and Roswell Park Cancer Institute (RPCII- constructing as part of the complex. Western New York Community. 1 1 11111 Hysiciu Spriug 2003 �I UB School of Public Health and Health Professions established BY LOIS BAKER On January 31,2003, the University at Buffalo established its School of Public Health and Health Professions, which will train public health and health professionals in an environment focused on wellness, disease prevention, and environmental and population issues. ormed by merging the university's School of Health Related Professions, which has a strong track record in allied-health education and research, with the Department of Social and Preventive Medicine, which has been part of UB's School of Medicine and Biomedical Sciences and is a national leader in research into the epidemiology of disease, the school will continue highly regarded research programs investigating chronic disease and will develop innovative ways to meet emerging health needs of citizens in Western ew York, ew York State and the nation. Faculty and researchers in the School of Public Health and Health Professions will focus on key public health issues, including chronic diseases, environmental health, women's health, obesity, maternal and child health, rehabilitation and assistive technology. Their emphasis will be on studying the interaction of environmental factors and lifestyle habits (e.g., nutrition, physical activity, smoking) with genetic predisposition and evaluating their effects on the population burden of disease. UB's Center of Excellence in Bioinformatics will provide the supercomputing power to take public health research to the next level, integrating epidemiology with such disciplines as genetics, geographic mapping and telemedicine. A vital component of the school will be a Western ew York Population Health Observatory, a regional health and disease surveillance system that could serve as a model for establishing such systems throughout the U.S. The observatory, which will work closely with the eight Western ew York county health departments, will have three components: public-health surveillance and research, community participation, and education. Maurizio Trevisan, MD, who is interim dean of the School of Health Related Professions and chair of the Department of Social and Preventive Medicine in the UB School of Medicine and Biomedical Sciences, has been named by UB Provost Elizabeth Capaldi to serve as acting dean of the School of Public Health and Health Professions while a search is conducted for its first dean. Trevisan, an internationally recognized researcher in the epidemiology and prevention of cardiovascular disease, is the principal investigator of the Western ew York Center of the (national) Women's Health Initiative and is involved in a series of studies funded by the ational Institutes of Health investigating the relationship between oral health and cardiovascular disease. Structurally, the school will comprise the existing UB Departments of Social and Preventive Medicine, Exercise and Nutrition Sciences, and Rehabilitation Science, as well as the biostatistics unit, which will become a department. Three new departments are proposed: Environmental Health, Behavioral Sciences, and Public Health Practice and Health Policy. The UB Center for Assistive Technology, which houses two National Rehabilitation Engineering Research Centers-aging and technology transfer-and the UB Center for International Rehabilitation Research Information and Exchange (CIRRIE), will come under the school's umbrella, as well. The School of Public Health and Health Professions, which accepted its first students for the spring 2003 semester, currently offers degree programs leading to a master's in public health (MPH); master's and doctorate in epidemiology; master's in biostatistics; bachelor's, master's and doctorate in exercise science· ' bachelor's and master's in athletic training; master's in nutrition; doctorates in rehabilitation sciences and physical therapy (DPT) and bachelor's and master's in occupational therapy. In the future, the school plans to expand its offerings to include doctoral degree programs in public health, biostatistics and nutrition. CD Sp r ing 2003 luffale Hysicin 31 �PATHWAYS N Ews ABO UT UB' s ScHOOL O F M E DICINE AND BIOM E DICAL SCI ENCE S AND I T S ALU MNI , FACULTY, S TUD EN T S A ND S TAF F Dayton Named Chair of Surgery Merril T. Dayton, MD, chief of gastrointestinal surgery at the University of Utah College of Medicine, has been named chair of the ,:': . .. .... . Department of Surgery in the University at Buffalo School of DAYTO N Medicine and Biomedical Sciences, effective .~i'' . ···'·.· '. July 1, 2003 . Dayton earned a bachelor's [DAYTON] SERVH AS CHIEF 01 GENERALSURGER AT THE SALT LAKJ VA MEDICAL CENTFR FRO 1987 TO 1997 ANI: WAS NAMED CHIEF OF GASTROI~TES· 'II Al SURGERY AI THE UNJVERSIT) OF UTAH I 32 1 1 11 111 nysicill 1998. degree in zoology from Brigham Young University in Provo, UT, and a medical degree in 1976 from the University of Utah in Salt Lake City, his hometown . Following an internship and junior residency in surgery at UCLA Hospital and Clinics in Los Angeles, he completed a two-year fellowship at the Center for Ulcer Research and Education in the Wadsworth Veterans Administration Physiology Research Center, also in Los Angeles. Returning to UCLA, he served as senior S prirz g 2 0 03 and then chief resident of surgery and completed a one-year gastrointestinal surgery fellowship. Dayton spent three years as assistant professor of surgery at the University of Iowa College of Medicine before joining his alma mater's surgical faculty in 1986. He served as chief of general surgery at the Salt Lake City VA Medical Center from 1987 to 1997 and was named chief of gastrointestinal surgery at the University of Utah in 1998. He also served as assistant dean of admissions at the medical school from 1990 to 1995 and has maintained an active teaching schedule throughout his professional career. He was promoted to full professor of surgery in 1997. His primary clinical interests are inflammatory bowel disease and colorectal surgery. Dayton has been active in several professional organizations, including the Association for Surgical Education, which he served as president; the American College of Surgeons; the Society of University Surgeons; the ational Board of Medical Examiners and the Association of VA Surgeons. He has lectured and published widely. In 1996, Dayton was included in The Best Doctors in America: Pacific Region. - L O IS BAKER Munschauer Named Chair of Neurology Frederick E. Munschauer, III, MD, has been named chair of the Department of eurology at the University at Buffalo School of Medicine and MuNscHAUER Biomedical Sciences. In addition, he serves as chief of The Jacobs eurological Institute at Kaleida Health's Buffalo General Hospital and as founding director of the Research Center for Stroke & Heart �Disease at the institute. Munschauer earned bachelor of science degrees in electrical and mechanical engineering at Duke University in Durham, C, and a master of science degree in mechanical engineering from Massachusetts Institute of Technology in Cambridge, MA. He earned his medical degree at McGill University in Montreal, Quebec, in 1979, after which he completed residencies in internal medicine and neurology at The Johns Hopkins Hospital in Baltimore, MD, and a fellowship in neurologic and neurosurgical intensive care at the ational Hospital for ervous Disease, Queen Square, London, England. Munschauer is the recipient of numerous professional and teaching awards, including the 1995 and 1986 White Coat Award for outstanding clinical teacher, as voted by the UB medical house staff; and the 1985 Siegel Award for outstanding clinical teacher, as voted by the UB medical student body. His research interests include primary and secondary prevention of stroke and heart disease, as well as multiple sclerosis and its therapy. Rob Bermel, a fourth-year student in the University at Buffalo School of Medicine and Biomedical Sciences, has received the prestigious Oldendorf Award from the American Society of Neuroimaging (ASNJ. Named in honor of Dr. William H. Oldendorf, a neurologist who developed the principles of computed neuroimaging, the award is presented to a young investigator for outstanding neuroimaging research submitted to the annual ASN meeting. Bermel was cited for research he completed under the direction of Rohit Bakshi, MD '91, in the Buffalo Neuroimaging Analysis Center (part of The Jacobs Neurological Institute*) in collaboration with colleagues at the center, the Cleveland Clinic and the University of Colorado. The winning project was titled "Gray Matter T2 Hypointensity Predicts Longitudinal Brain Atrophy in Multiple Sclerosis: Effect of Intramuscular Interferon beta-1a Treatment." UB collaborators, in addition to Bakshi, included Srinivas Puli; Christopher ljoa; Andrew Fabiano (Class of 2004); Elizabeth Fisher, PhD; Richard Rudick, MD; Bianca WeinstockGuttman, MD; and Frederick Munschauer Ill, MD, chair, UB Department of Neurology. (Bakshi was the recipient of the Oldendorf Award in 1988, also for research conducted in Buffalo.) The award includes $500 in cash and coverage of expenses to attend the 26th annual meeting of the ASN, which was held March 6-9, 2003, in New Orleans. At the meeting, Bermel presented his research findings in a plenary lecture on March 7. In May 2002, Bermel was awarded the American Academy of Neurology's G. Milton Shy Award for medical student research in clinical neurology, based on studies he conducted at the Buffalo Neuroimaging Analysis Center on the use of the bicaudate ratio as an MRI marker of brain atrophy in multiple sclerosis. Following graduation from medical school, he will enter residency in neurology at the Cleveland Clinic. -S. A. Unger - S. A . UNGE R Spring 2003 1111111 Hysicin 33 �PATHWAYS Vela:z:que:z: Appointed Chair of Pathology In the winter 2003 issue of Buffalo Physician, it was announced that Francisco Velazquez, MD, had been named interim chair of the Department of Pathology and Anatomical Sciences in the University at VELA ZQUEZ Buffalo School of Medicine and Biomedical Sciences. On January 28, 2003, he was appointed chair of the department. Biomedical Sciences in ovember 2002 as head of the Division of Gastroenterology and S JTR I N utrition in the Department of Medicine. Sitrin' office is located in - S . A. UNG ER the new Gastrointestinal Suite on the eighth floor of the VA Sitrin Heads Medical Center and his Castroenterolo research laboratory is on the second floor of the VA Michael D. Sitrin, MD, joined Research Building (Veterans the University at Buffalo Affairs Western New York School of Medicine and Healthcare System), across from UB's South Campus. Prior to coming to UB, Sitrin was professor of medicine in the Section of Gastroenterology/Nutrition at the University of Chicago School of Medicine, where he also served as director of utrition Support Services, director of the Clinical utrition Research Unit, and medical director of University of Chicago Home Care. Sitrin is a member and former president of the American Society for Clinical utrition, and a member of the Velazquez has held the rank of clinical associate professor since August 2000 and has also served as pathologistin-chief at Kaleida Health. Recently, he was appointed division commissioner for Western ew York for the College of American Pathologists' Laboratory Accreditation Program. Phillips, Lytle understands t hat health care providers face unique legal challenges. HIPAA, STARK, compliance issues, DOH regulations, rei mbursement, the OPMC, and let's not forget about M FCU audits. These are all hot topics that we are prepared to help you with . Experience • • Breadth Depth Have questions or concerns? Call or e-mail Lisa McDougall, Esq., the health care practice group coordinator, at (71 6) 847-5478 or lmcdougall@phillipslytle.com . PHILLIPS. LYTLE . HITCHCO C K.. A T T 0 est . BLAINE 8 R N E Y S 1834 3400 HSBC Center, Buffalo, NY 14203 (716) 84 7-8400 website: www.phillipslytle.co m BUFFALO 34 l a fl ale Physiciaa • f REDONIA • jAMESTOWN • N EW YORK • ROCHESTER HUBER LLP �American Gastroenterological Association, the American Institute on utrition, and the American Federation for Clinical Research. He currently serves on the editorial boards of the journal of Critical Care Nutrition and Currellt Opinion in Clinical Nutrition and Metabolic Care. Sitrin earned a bachelor of science degree in zoology from the University of Michigan and a medical degree from Harvard University School of Medicine in 1974. He completed residency training in medicine and a fellowship in gastroenterology/nutrition at the University of Chicago in 1978, where he also served as chief instructor/resident in medicine in 1979. Sitrin's laboratory research interests include the molecular mechanisms of action of vitamin D in intestinal cells, the role of vitamin Din regulating cell growth, and the effects of vitamin D and calcium on colon carcinogenesis. His clinical research interests include nutrient absorption, metabolism, and requirements in patients with digestive disorders. - S. A. grants were awarded to Anthony Campagnari, PhD, professor of microbiology and medicine, who is researching sexually transmitted diseases; and Thomas A. Russo, MD, associate professor of medicine in the infectious diseases division, who is studying E. coli infections. Campagnari will lead studies analyzing virulence factors and potential vaccine antigens of Haemophilus ducreyi, the etiologic agent of chancroid, a sexually transmitted disease. Infection from H. ducreyi significantly increases the risk of human immunodeficiency virus (HIV) infection. Russo is seeking to develop a vaccine for extraintestinal I CON TI NU ED ON P AGE 36 UNG ER Kouo and Leonard Inducted into 101 Oishei Foundation Supports Research In December 2002, the John R. Oishei Foundation awarded two $300,000 grants in support of infectious disease research programs at the University at Buffalo School of Medicine and Biomedical Sciences. The For young and old. For patients and families. Hospice care touches everyone, including children with a sick mom or dad, sibling or grandparent. With chaplains and social workers helping out, the whole fam ily feels better. The sooner you call, the more we can help. Hospice. A plan for living. 686· 8077 hospicebuffa lo.com. ~Ls r 1 c E -z;2)~ T H E CE :-I TE R F O R H~SPICE& PAUlATIVE CARE 1978 - 2003 Spri11g 2003 l uf11l1 Pbpiciu 35 �PATHWAYS pathogenic E. coli, the most common cause of extraintestinal infection in ambulatory, long-term care and hospital settings. Typical infections due to E. coli include urinary tract infection, diverse intraabdominal infections, pneumonia, surgical site infection, meningitis and soft-tissue infections. "The strains of E. coli that cause extraintestinal infection are under-appreciated 'killers.' Each year in the United States, billions of direct health-care dollars are spent on millions of these infections, which are associated with thousands of deaths," says Russo. - SUZANNE CHAMBERLAIN Trump Nam d Editor Donald L. Trump, MD, senior vice president of clinical research and chair of the Department of Medicine at Roswell Park Cancer Institute has been appointed editor-in-chief of the journal Oncology. Trump was appointed to the position following the death of Paul TRuMP Carbone, MD, who had served as editor-inchief since 1992. Trump also serves as secretary/treasurer of the American Society of Clinical 36 laffall Hysici11 Oncology and is a reviewer and/or member of the editorial board for the New England Journal of Medicine, Journal of the National Cancer Institute, Cancer, Cancer Chemotherapy and Pharmacology, Journal of Urologic Oncology and Current Treatment Options in Oncology. Venti earned a bachelor of science degree in communications from the State University of New York - DEBORAH PETIIBONE College at Buffalo and will complete a master's degree in the field in 2003. Venti .loins Office of Alumni Affairs Kimberly A. Venti has been named director of donor stewardship and constituent relations for the Office of Alumni Affairs and Development in the School of Medicine and Biomedical Sciences. In this role, she is responsible for increasing membership and stewardship of the James Platt White Giving Society and coordination of class reunions. She will serve as the primary liaison for the Medical Alumni VENTI Association and Medical Emeritus Faculty Group. Venti comes to UB from Roswell Park Cancer Institute, where she served as director of development communications. In this capacity, she was responsible for all media relations, marketing and promotions for the Roswell Park Alliance Foundation. S pr i 11 g 2 00 3 - S. A. MoRELLI U NGER Morelli and Connolly Participate in NINDS Study and Report Daniel Morelli, MD '74, professor of family medicine, and Brian Connolly, MD, clinical associate professor of family medicine at the University of Buffalo School of Medicine and Biomedical Sciences were selected to participate in a symposium at the ational Institute of eurological Disorders and Stroke ( INDS) in December 2002. The symposium, titled "Improving the Chain Recovery for Acute Stroke in CONNOLLY Your Community," addressed public recognition of stroke; choosing your level of care; professional education; templates for organizing stroke triage; incentives for stroke treatment; and support systems for providers. Morelli worked with the Choosing Your Level of Care subgroup, while Connolly worked with the Support System Providers group. All six of the groups published their findings this spring as an update to the 1997 INDS Symposium on Rapid Identification and Treatment of Acute Stroke. - S. A. U N GE R CD �Sudden Cardiac Death Researchers in the University at Buffalo School if Medicine and Biomedical Sciences who are studying sudden cardiac death have received two generous grants in support of their work. r In February 2003, The John R. Oishei Foundation awarded $1.5 million to the University at Buffalo School of Medicine and Biomedical Sciences to establish a highly interactive, multidisciplinary Center for Research in Cardiovascular Medicine that will lead to better understanding of the mechanisms responsible for sudden cardiac death (SCD) in ischemic heart disease. At the time of the announcement, Thomas Baker, executive director of the Oishei Foundation, said: "The foundation's directors were impressed with the level of cooperation among departments and investigators working on this critical area of cardiac research. UB has taken the lead in research that could prove extremely beneficial in saving many lives." John Canty, MD ' 79, Albert and Elizabeth Rekate Chair in Cardiovascular Diseases at the UB School of Medicine and Biomedical Sciences, will serve as principal investigator of the project. He will lead a team of 11 others, including clinical scientists from the Division of Cardiology in the UB Department of Medicine, and basic scientists from the UB departments of Physiology and Biophysics, Biochemistry, Genetics (Roswell Park Cancer Institute), Pharmacology and Toxicology, and the Center for Positron Emission Tomography. "Our goal is to establish the University at Buffalo as a premier center of research in the area of sudden cardiac death," says Canty. "Cardiovascular disease continues to be the leading cause of mortality in the United States, and the aging of our population makes it a growing area of concern. Although great strides have been made in treating ischemic heart disease, myocardial infarction and heart failure, the impact of these advances has been disappointing with respect to preventing other types of cardiovascular disorders, such as sudden cardiac death from ventricular arrhythmias." The John R. Oishei Foundation's mission is to enhance the quality of life for Buffalo-area residents by supporting education, health care, scientific research and the cultural, social, civic and other charitable needs of the community. It was established in 1940 by John R. Oishei, founder of Trico Products Corporation, one of the world's leading manufacturers of windshield wiper systems. The foundation, a major supporter ofUB and its community-focused activities, has given or pledged nearly $12 million to "The Campaign for UB" for programs, including the Toshiba Stroke Research Center (see article on page 4). ;r T Canty has also received a three-year, $141,750 grant from the Mae Stone Goode Trust to support research on sudden cardiac death. Mae Stone Goode "left the funds for cure rather than care" and established the trust for medical research on tuberculosis, cancer and "other diseases of humanity," according to attorney William Yorks, co-trustee and second cousin to Mrs. Goode. She was a person who made many gifts anonymously during her lifetime, he notes, and the public should now know "about the generosity of this woman of strong character." Gifts from the trust are made in the names of Mae Stone Goode, who died in 1955, and her husband, Richard W. Goode, a real estate investor in Buffalo who died in 1928. r T p T( John Canty, MD, Albert and Elizabeth Rekate Chair in Cardiovascular Diseases at the UB School of Medicine and Biomedical Sciences, was recently elected to the prestigious Association of University Cardiologists (AUC). Founded in 1961, the AUC is limited to an active membership of 125 academic cardiologists from the United States, elected by their peers. The organization has a purely educational purpose and meets once a year for a two-day session of scientific interchange. Members are recognized as leaders in American cardiology whose efforts are actively shaping the course of research and training in cardiovascular disease in the United States. . Spring 2003 1111111 nysicill 3 7 �DEVELOPMENT E W S By li nda J . Cor de r , PhD, CFRE HE PHO E CALL CAME OVER A DECADE AGO. It brought mixed reactions, as the subject was painful to hear, and likely even more difficult for this alumnus to discuss. He wanted to let me know that he was leaving the school a bequest, but he was reluctant to give me even a ballpark figure. He had just found out he was in the early stages of Alzheimer's Disease and there were too many unanswered questions for him to predict how much money might be left. How long would he live? How much would his care cost? Would he outlive his wife? Underneath the spoken words were his silent questions, uncertainty, fear and frustration. In spite of these unanswerable questions, he was taking steps to ensure that he would leave his alma mater a portion of his worldly goods, while he was still able to direct his own affairs. This conversation seared itself into my memory, and over the years I kept my ears open for news from his friends. The disease took its expected toll. His wife died. His friends stayed in touch with him and oversaw his care. And, last year, Dr. Dobrak, medical class of 1939, died. His legacy to the school that he loved was generous. "What was left" was over four hundred thousand dollars. He had designated that it be divided among the Medical Alumni Scholarship Endowment, an endowment fund to underwrite an annual lecture in {'i ( p radiology and an endowed inter\\ R >U disciplinary radiology research fund. His gift to the scholarship fund increased it by approximately 45 percent at a time when rising student debt makes it critically important that funds be made available to qualified students. His support of radiology comes at a time when there is a national shortage of radiologists, and UB, like most medical schools nationally, is working to enhance the training of residents in radiology. Dr. Dobrak's bequest was a return on the investment that faculty 38 l 1 ff al1 Hpiciu Spri n g 2003 members in another era had made in him and his subsequent career. It was a wise decision relative to minimizing his taxable estate. Most important, it was a gift of love and a statement of faith in the future of his alma mater. There are many reasons that people make gifts to educational and other charitable institutions. Some mirror those of Dr. Dobrak. They support the groups' missions. An institution made a positive difference in their lives. They have generous hearts and want to expand possibilities for other individuals in similar circumstances to those they once faced. They wantto "repay" a gift or scholarship they received at an early time in their lives. Whatever triggers these gifts, we accept them all as a statement of faith in the future of this school. For that belief and regard, we say thank you to those who choose to share their resources with their alma mater, their hometown medical school, their nationally acclaimed institution where they have chosen to teach, work, conduct research and provide patient care. This year, we salute nearly 250 members of the James Platt White Society who made gifts during the 2002 calendar year to the UB School of Medicine and to the Health Sciences Library and its medical history collections. We applaud those whose lifetime commitments place them with the Founders' Circle of the Society. We acknowledge with sadness, love and appreciation our members whose lives ended during this past year, and with thanksgiving, those who have made arrangements for legacies in the future. The spirit ofphilanthropy is alive and well at UB's School of Medicine and Biomedical Sciences. For this we are grateful and express our heartfelt thanks to all donors. CD lz da L ' ( c>rda Phi>, 1~ a '"c ate c ec.n fc r , 1111'1111 dfmr .md .Je clop ·~··t Shl '"''be cJ•It•llte a e mazl tf he) J, r /lujf.l L td •, r b p Jll( at I 8~~ ~ '6 l.? "· �}ANUARY 1, 2002-DECEMBER 3 1 ) 2 0 0 2 Founded in 1846, the University at Buffalo School of Medicine and Biomedical Sciences has a proud history. James Platt White, MD (1811-1881), one of the nation's first practicing obstetricians and gynecologists, was a founder of the school. He later served as professor and was dean of the school at the time of his death. Because of]ames Platt White's contributions to society and the university, his name is associated with a group ofdistinguished donors who make leadership gifts to the UB School of Medicine and Biomedical Sciences through the James Platt White Society. Members of the society contribute $1,000 or more annually to the School of Medicine and Biomedical Sciences. This special group of donors may choose to support student scholarships; seed funding for ground-breaking scientific and clinical research; the Dean's Excellence Fund, which provides the dean flexibility to take advantage of unanticipated opportunities that arise mid-year; or any fund the donor may choose within the medical school. In forming Professor White's annual "class," we honor our history and recognize a very special group of donors. I. ,. UB•s founders, primarily physicians and attorneys, envisioned a school to train students for service to the community. The Society's founders help to actualize that vision by providing a generous base of support for programs and activities that enrich the academic environment and enhance medical training. Donors who have cumulative contributions of $50,000 or more, or who have established an irrevocable deferred gift for $100,000 or more, are granted lifetime membership in the James Platt White Society. Dr. George M. Ellis Jr. ' 45 & Mrs. Kelly Ellis Dr. Glen E. Gresham & Mrs. Phyllis K. Gresham '85 Mr. & Mrs. Edmund C. Lynch Newport, RI Connersville, IN Williamsville, NY Mrs. Catherine Fix Dr. Thomas J. Guttuso, Sr. '61 and Mrs. Barbara L. Guttuso Dr. Eugene R. Mindell & Mrs. June A. Mindell Mrs. Joan W. Alford Dr. William M. Chardack Buffalo, NY Gulfstream, FL Mrs. June M. Alker Dr. Joseph A. Chazan '60 & Mrs. Helen Chazan Providence, RI Martinsburg, WV Williamsville, NY Dr. Charles D. Bauer ' 46 & Mrs. Mary A. Bauer Mrs. Annette Cravens Dr. Thomas F. Frawley ' 44 Williamsville, NY Buffalo, NY Chesterfield, MO Dr. and Mrs. Ralph T. Behling '43 San Mateo, CA Dr. Ernst H. Beutner & Dr. Gloria Beutner '80 Eggertsville, NY Dr. Willard H. Boardman ' 44 and Mrs. Jean E. Boardman ' 48 Winter Park, FL Mr. Donald L. Davis Williamsville, NY Dr. S. Max Doubrava Jr. ' 59 and Mrs. Joan Doubrava Las Vegas, NV Mrs. Marjorie B. Eckhert Buffalo, NY Ms. Rose M. Ellerbrock Williamsville, NY Mrs. Christine Gretschel Genner Potomac, MD Dr. Lawrence Golden '46 and Mrs. Nancy Golden ' 48 East Amherst, NY Dr. Eugene J. Hanavan Jr. ' 41 Buffalo, NY Mr. & Mrs. Jeremy Jacobs East Aurora, NY Mrs. Pamela Jacobs Eggertsville, NY Buffalo, NY Dr. Pasquale A. Greco '41 & Mrs. Lois J. Greco Mrs. Morris Lamer Buffalo, NY Dr. Phil Morey ' 62 and Mrs. Colleen Morey Williamsville, NY Dr. Richard J. Nagel '53 & Mrs. Florence T. Nagel Orchard Park, NY Dr. Richard B. Narins ' 63 & Mrs. Ellen B. Narins East Aurora, NY New York, NY Buffalo, NY Spring 2003 luffalt Pbysiciaa 39 �DEVELOPMENT Mr. Allan Wade Parker San Francisco, CA Dr. Albert C. Rekate '40 & Mrs. Linda H. Rekate '71 Williamsville, NY Dr. Elizabeth P. Olmsted Ross'39 Buffalo, NY Dr. and Mrs. Edward Shanbrom '51 Santa Ana, CA Dr. Albert Somit Carlsbad, CA Dr. Janet H. Sung & Mr. John J. Sung Clarence, NY Dr. Philip B. Wels '41 & Mrs. Elayne G. Wels Williamsville, NY Mrs. Virginia S. Wendel Ft. Meyers, FL Dr. John and Mrs. Deanna Wright Williamsville, NY c The Dean is the School's leader. Every leader depends on a small circle of associates who help bring the organization's vision into reality. Individuals or couples qualify as members in the Dean's Circle with generous gifts of$25,000 or more during the calendar year. E W S Dr. Janet Sung and Mr. John Sung Clarence, NY Dr. Charles S. Tirone '63 & Mrs. Anne R. Tirone '94 Williamsville, NY Ms. Virginia S. Wendel Fort Meyers, FL Dr. James J. White, Jr. '69 Buffalo, NY cle Cha Fe o Just as a department chair leads a program, donors ofleadership gifts in the range of $10,000 to $24,999 are given special recognition. cle Fe ll ows within the school are recognized for added depth they bring to postgraduate study. Fellows are honored for gifts that total $2,500 to $4,999. Dr. and Mrs. Frederic D. Regan'45 Boca Raton, FL Dr. Melvin M. Brothman '58 Snyder, NY Mrs. Gloria C. Stulberg Buffalo, NY Dr. Jennifer L. Cadiz '87 Lemoyne, PA e cle A strong faculty is central to a great university. Likewise, central to the future of our School is the dedication of a cadre of supporters whose annual gifts range from $5,000 to $9,999. Dr. Charles D. Bauer, '46 & Mrs. Mary A. Bauer Williamsville, NY Mr. Sheldon M. Berlow Buffalo, NY Dr. Joseph G. Cardamone '65 & Mrs. Susan G. Cardamone '65 Eden, NY Dr. Joseph Chazan '60 & Mrs. Helen Chazan Providence, Rl Dr. Jack C. Fisher '62 Lajol/a, CA Dr. Anita J. Herbert '63 Bradford, PA Dr. Hani A. Nabi Buffalo, NY Dr. Nancy H. Nielsen '76 Orchard Park, NY Dr. Thomas P. O'Connor '67 & Mrs. Sandra S. O'Connor East Amherst, NY Dr. Edward A. Rayhill '54 & Mrs. Joanne Rayhill Grand Island, NY Mr. Jerry Ritch Piscataway, Nj Dr. & Mrs. Richard Ronald Romanowski '58 Williamsville, NY within the fames Platt White Society have made gifts to the School totaling $1,000 to $2,499 during the past year. Those marked with an asterisk (*) are young scholars, graduates of the last decade, who qualify with gifts of$500 to $999. Dr. Harold Brody '61 Getzville, NY Dr. Kenneth Z. Altshuler '52 Dr. James B. Bronk '81 & Mrs. Suzanne Bronk Napa, CA & Mrs. Ruth Altshuler Dallas, TX Dr. & Mrs. William S. Andaloro '45 Caledonia, NY Dr. Mark Anders Buffalo, NY Dr. Douglas Armstrong Buffalo, NY Dr. J. Bradley Aust Jr. '49 San Antonio, TX Dr. Rohit Bakshi '91 & Mrs. Lorain Bakshi Buffalo, NY Dr. George Bancroft '81 & Mrs. Susan K. Bancroft '79 Hamburg, NY Dr. Kevin Barlog '82 & Dr. Elizabeth P. Barlog '82 Amherst, NY Dr. Jared C. Barlow Sr. '66 & Mrs. Barabara Barlow Grand Island, NY Dr. Allen Barnett '65 Pi11e Brook, N] Dr. Michael B. Baron '71 Blountville, TN Dr. Paul D. Barry '71 St. Augustir1e, FL Mr. Donald l. Davis Williamsville, NY Ms. Ellen Freudenheim Brooklyn, NY Dr. and Mrs. Glen E. Gresham Williamsville, NY Dr. George A. Gentner '41 Phoenix, AZ Dr. Irving Sterman '64 and Mrs. Gail K. Sterman jacksonville, FL Dr. Robert A. Baumler '52 Amherst, NY Dr. Kim Griswold '94 Buffalo, NY Dr. Gerald Sufrin Snyder, NY Dr. Richard A. Berkson '72 & Mrs. Andrea Berkson Rancho Palos Verdes, CA Mr. Jeremy M. Jacobs, Sr. East Aurora, NY Mrs. Pamela R. Jacobs Buffalo, NY Mr. & Mrs. Edmund C. Lynch Newport, RI lllfal1 Hysiciaa Mr. Arthur H. Judelsohn Buffalo, NY Mr. Eugene M. Setel Buffalo, NY Mr. James I. Stovroff Buffalo, NY Sprt11 g 200 3 e One strength of an outstanding institution is the caliber of those who study there. Scholars Dr. Michael E. Bernardino & Mrs. Joan Bernardino Buffalo, NY Dr. Robert Bernot '60 & Mrs. Carol Bernot North Hills, NY Dr. Theodore S. Bistany '60 & Mrs. Undine Bistany Buffalo, NY Dr. Lawrence Bone '73 Orchard Park, NY Mr. & Mrs. William Bourke Orchard Park, NY Dr. Suzanne F. Bradley '81 Whitmore Lake, Ml Dr. Timothy Bukowski '87 & Dr. Naomi J. Kagetsu '86 Chapel Hill, NC Dr. Vern l. Bullough Westlake Village CA Dr. James P. Burdick '75 & Mrs. Sharon A. Burdick East Amherst, NY Dr. William M. Burleigh '67 Rancho Mirage, CA Mrs. John W. Buyers Williamsville, NY Dr. Evan Calkins & Dr. Virginia Calkins Hamburg, NY Dr. David T. Carboy '63 & Mrs. Jacqueline G. Carboy Lincroft, Nj Dr. Nicholas C. Carosella '54 & Mrs. Mary Carosella Appleton, NY Dr. Yung C. Chan '73 Draper, VA Dr. Norman Chassin '45 & Mrs. Charlotte S. Chassin Williamsville, NY Dr. Charles Kwok-Chi Chow & Mrs. Patricia Chow Hong Kong Dr. Eugene Cisek & Mrs. Ruth Cisek Buffalo, NY Dr. Geoffrey E. Clark '68 Portsmouth , NH Dr. Terence M. Clark '71 Clemson, SC Mr. Michael J. Collins '90 & Dr. Kathleen A. O'Leary '88 Buffalo, NY Dr. Mark Comaratta '85 East Amherst, NY �Mr. Anthony Conde & Mrs. Janette Conde Dr. Susan Fischbeck '82 & Dr. Patrick T. Hurley '82 Orchard Park, NY East Concord, NY Dr. Brian F. Connolly Dr. Thomas D. Flanagan '65 East Amherst, NY & Mrs. Grace Flanagan ' 70 Williamsville, NY Dr. Linda J. Corder Buffalo, NY Dr. J. Steven Cramer East Amherst, NY Dr. Julia Cullen ' 49 Buffalo, NY Dr. Daniel E. Curtin '47 & Mrs. Elaine Curtin Orchard Park, NY Dr. & Mrs. Raymond Dannenhoffer Amherst, NY Dr. David R. Dantzker '67 & Mrs. Shenye Dantzker New York, NY Dr. RogerS. Dayer '60 & Dr. Roberta A. Dayer ' 72 Buffalo, NY Dr. Ronald I. Dozoretz '62 Falls Chtach, VA Dr. Melvin B. Oyster ' 52 Niagara Falls, NY Dr. Robert W. Edmonds ' 41 Sun City Center, FL Dr. Robert Einhorn ' 72 North Brunswick, Nj Mr. John E. Estes '86 Malvern, Australia Dr. Domonic F. Falsetti '58 and Mrs. Margaret Falsetti Lewiston, NY Dr. Leon E. Farhi & Mrs. Haya Farhi Eggertsville, NY *Dr. Thomas Hugh Feeley '96 & Dr. Danielle Susan Notebaert '95 Elma, NY Dr. William A. Fleming '64 & Dr. Beth D. Fleming '67 Buffalo, NY Dr. Herbert E. Joyce '45 & Mrs. Ruth Marie Joyce East Aurora, NY Lockport, NY Dr. Frank A. Luzi '88 & Dr. Lori Luzi '88 Dr. Wendy A. Kaiser '85 & Dr. Roger E. Kaiser Jr. ' 79 Clarence, NY Dr. Robert J. Patterson '50 & Mrs. Patricia M. Patterson Snyder, NY Dr. John H. Peterson '55 Clarence, NY East Aurora, NY Dr. James F. Phillips ' 47 & Mrs. Marcella Phillips *Dr. Martin C. Mahoney '95 Buffalo, NY Clarence, NY Dr. Matthew Phillips '91 Dr. James R. Kanski '60 & Dr. Genevieve W. Kanski '84 Dr. William L. Marsh '46 Buffalo, NY Buffalo, NY Eggertsville, NY Bethesda, MD Dr. Stephen B. Pollack '82 Dr. Penny A. Gardner '69 Dr. Steven R. Kassman '87 and Mrs. Jeannine Kassman Dr. Ralston Rodcliffe Martin Williamsville, NY '90 Dr. Anthony V. Postoloff '39 Los Altos, CA Drs. Laura and Michael Garrick Getzville, NY Dr. Ronald F. Garvey '53 Tyler, TX Mr. Warren Gelman '70 & Mrs. Patricia C. Gelman Glendale, AZ Vellejo, CA Dr. Kenneth K. Kim '65 and Mrs. Susan Kim Dr. Conrad May '81 Clinton, NY Dr. Francis J. Klocke '60 Chicago, IL Buffalo, NY Dr. Robert A. Klocke '62 & Mrs. Barbara Klocke Dr. Lawrence H. Golden '46 Williamsville, NY & Mrs. Nancy P. Golden ' 48 Eggertsville, NY Dr. Joseph M. Kowalski '93 Amherst, NY Willia msville, NY Kensington, MD Dr. Linda G. Rabinowitz '82 M ilwaukee, WI Dr. Brian McGrath '87 Buffalo, NY Dr. Harry L. Metcalf '60 & Dr. Kaaren Metcalf ' 78 Dr. Kenneth John Raczka ' 72 & Mrs. Rita Raczka Amherst, NY Williamsville, NY Dr. & Mrs. Richard A. Rahner '58 Dr. William Mihalko Erie, PA Clarence Center, NY Dr. Merrill L. Miller ' 71 Dr. Bert W. Rappole '66 & Mrs. Mary Helen Rappole Hamilt011, NY jamestown, NY Dr. Michael Goldhamer '64 Mrs. Delphine Kozera San Diego, CA Lackawanna, NY Dr. and Mrs. Carl V. Granger Dr. Kenneth Krackow Dr. David P. Mindell & Mrs. Margaret H. Mindell Dr. Bernhard J. Rohrbacher '83 Buffalo, NY Williamsville, NY Ann Arbor, MI Getzville, NY Dr. Eugene R. Mindell & Mrs. June A. Minden Ms. Alice May Greer Dr. Jacob S. Kriteman '67 Niagara Falls, NY Danvers, MA Dr. Robert T. Guelcher '60 & Mrs. Elizabeth Guelcher Dr. Milton C. Lapp '52 Erie, PA Corning, NY Buffalo, NY Dr. Jeffrey S. Ross '70 Georgetown, DE Lebarwn Springs, NY Mr. James J. Rosso & Mrs. Cheryl Rosso Dr. Andre D. Lascari '60 & Mrs. Susan Lascari Dr. Shedrick H. Moore '55 Buffalo, NY Poestenkill, NY Costa Mesa, CA Dr. John H. Hedger ' 75 Dr. Thomas J. Lawley '72 Dr. John D. Mountain '33 Buffalo, NY Dr. Albert G. Rowe '46 Salisbury, MD Atlanta, GA Manhasset, NY Dr. Reid R. Heffner Jr. & Mrs. Elenora M. Heffner Dr. Dolores C. Leonard '87 & Mr. Martin Leonard Dr. Arthur W. Mruczek Sr. '73 Medina, NY Buffalo, NY East Amherst, NY Dr. Richard L. Munk '71 Dr. Ross G. Hewitt '79 Buffalo, NY East Amherst Williamsville, NY Dr. William Fiden ' 70 Dr. Richard T. Ho '92 and Dr. Veronique M. James '88 San Diego, CA Dr. Harold J. Levy ' 46 & Mrs. Arlyne Levy Honolulu, H I Depew, NY Rochester, NY Mrs. Patricia Papademetriou Blacksburg, VA *Dr. Randall J. Loftus '92 Eggertsville, NY Burlingame, CA Lancaster, NY Dr. Marc S. Fineberg Dr. Hilton R. Jacobson ' 45 Williamsville, NY Lakewood, NY Dr. Gerald L. Logue & Mrs. Joelle Logue Robert M. Jaeger, M.D. ' 47 Sylva11ia, OH Dr. Masao Nakandakari '55 Dr. John Naughton Mr. Paul F. Hohenschuh & Dr. Marjorie E. Winkler Williamsville, NY Orchard Park, NY Dr. Edwin A. Salsitz ' 72 Dr. Marshall A. Lichtman '60 & Mrs. Alice Jo M. Lichtman '58 '77 East Amherst, NY Dr. Joseph F. Ruh '53 Amherst, NY Dr. Hing-Har Lo ' 74 Dr. Thomas C. Rosenthal ' 75 & Mrs. Georgia Rosenthal Orchard Park, NY Dr. Maynard H. Mires Jr. '46 Dr. Christopher Hamill '89 Dr. Fredric M. Hirsh ' 73 & Mrs. Donna A. Hirsh Dr. Helen Marie Findlay '78 & Dr. Albert Schlissennan Dr. Thomas A. Lombardo Jr. '73 and Mrs. Donna M. Lombardo Dr. Robert Galpin Dr. Michael Ferrick '65 Buffalo, NY Dr. Cynthia L. Jenson '92 Bangor, ME New York, NY Mrs. Elizabeth Ann Schaefer Snyder, NY Dr. David S. Schreiber '69 Westwood, MA Dr. Daniel S. P. Schubert '65 Buffalo, NY Shaker Heights, OH Dr. John S. Parker '57 & Mrs. Dorris M. Parker Dr. Fred S. Schwarz ' 46 Latrobe, PA Buffalo, NY Dr. Margaret W. Paroski '80 Dr. Molly R. Seidenberg '53 & Mr. Peter Martin Buffalo, NY Rochester, NY Allentown, PA Spring 2003 lulfalt Pbysici11 41 �0 E V E L 0 P M E N T Dr. Joseph Tannenhaus ' 45 Homosassa, FL Dr. Timothy S. Sievenpiper '68 & Mrs. Karen S. Sievenpiper Dr. Michael Taxier ' 75 East Aurora, NY Columbus, OH Dr. Howard C. Smith '53 Dr. Wayne C. Templer '45 Huron, OH Coming, NY Dr. James A. Smith '74 Mr. Fritz Terplan Orchard Park, NY San Francisco, CA Dr. & Mrs. Robert G. Smith '49 Dr. Martin Terplan ' 55 Savannah, GA San Francisco CA Dr. Robert Smolinski '83 & Dr. Claudia Foskett '85 Dr. George Thorngate, IV '45 Orchard Park, NY Dr. James C. Tibbetts '64 & Mrs. Elspeth Tibbetts '64 Pebble Beach, CA E W S Dr. James E. Wild '83 & Dr. Andrea T. Manyon-Wild '83 Amherst, NY Dr. Richard G. Williams '80 Clearfield, PA Mr. Ralph C. Wilson Jr. Orchard Park, NY Dr. Lester E. Wolcott '51 Beverly Hills, CA Williamsville, NY Dr. James F. Stagg '47 Dr. Bradley T. Truax '74 & Mrs. Elizabeth Truax *Ms. Sanda Yu '95 Orchard Park, NY Dr. Melvin J. Steinhart '62 & Mrs. Susan S. Steinhart Delmar, NY Dr. Morton Stenchever '56 and Mrs. luba Stenchever Lewiston, NY Malden, MA Dr. Bernice S. TyraiH:omforl '58 Dr. Franklin Zeplowitz '58 & Mrs. Piera Zeplowitz Los Altos, CA Dr. Richard D. Wasson '58 & Mrs. Janet Wasson Holiday, FL Dr. Arnold Wax '76 Mercer lslarJd, WA Henderson, NV Dr. William C. Sternfeld ' 71 Dr. Paul H. Wierzbieniec '74 & Ms. Ellen Wierzbieniec Sylvflllia, OH Dr. lin-lan Tang '84 Plainfield, Nj Cmwndaigua, NY Buffalo, NY Dr. Gary J. Wilcox ' 73 Carlsbad, CA The Edmund Ha es Societ Tit is society is tutmed after General Edmund Hayes, all illtemationally renowned designer of bridges who in 1923 bequeathed nearly $390,000 to UB. Through the years, manygenerotls illdividuals have been inspired by the same conviction and have elected to build Oil Hayes' foulldation of support. Through their commitment to the university, and through their investment in Univer- Buffalo, NY Dr. David C. Ziegler '64 & Mrs. Susan D. Ziegler ..........., ........... ...........,.......... Socletr ...... ..., ..... Williamsville, NY Dr. & Mrs. John R. Wright . "' ... . _ .... Willa Mrs. Janet F. Butsch Aurora, CO Dr. Stuart Alan Wolman '74 Dr. Wende Westinghouse Young Dr. Philip M. Stegemann '82 North Hills, NY Dr. Marvin Z. Kurian '64 & Mrs. Eleanor Kurian Sturgeon Bay, WI Tucson, AZ Dr. Robert Bernot '60 & Mrs. Carol Bernot Lubbock, TX Carlsbad, CA Dr. Albert Somit generous gifts made between 1989 to 1993. Donors to the Health Sciences Library and the History of Medicine funds are also recognized as members of the society in the appropriate circle. ........... I8HI'OIII We have made every effort to ensure accuracy in these Walrwt Creek, CA Lists. Ifyouhaveanyques- Special Members call Kim Venti toll free at tions or corrections, please Those individuals and couples listed as follow were granted multi-year memberships based on Dr. Frances R. Abel 1-877-826-3246 or 716829-2773; ore-mail her at kventi@buffalo.edu. 4D Dr. Lance Fogan Dr. Benjamin E. Obletz Dr. & Mrs. Richard A. Rahner Mrs. June M. Alker Dr. Thomas F. Frawley Dr. & Mrs. Rohit Bakshi Dr. Ronald F. Garvey Dr. Charles A. Bauda Dr. Pasquale A. Greco Dr. John T. Cangelosi Dr. Eugene J. Hanavan, Jr. Dr. & Mrs. Edward A. Rayhill Dr. Albert C. Rekate Mrs. Edith Corcelius Dr. David Holden Dr. Myron G. Rosenbaum Dr. linda J. Corder Dr. Hilliard Jason & Dr. Jane Westberg Dr. Elizabeth P. Olmsted Ross Dr. Richard F. Kaine Dr. Daniel S.P. Schubert Dr. Julia Cullen Dr. Thomas G. Cummiskey Dr. Edward L. Curvish, Jr. sityat Buffalo, benefactors have taken part ill shapittgthe Dr. Leonard S. Danzig future of UB and sewrillg its legacy into the next Dr. Melvin Oyster celltury. Ifyou are interested in becoming a member of Ms. Rose M. Ellerbrock the Hayes Society, you cart contact our plmmed giving Dr. George M. Ellis, Jr. department at (716) 645-3312. Dr. Jack C. Fisher l afl a le Phy siciaa Spring 2003 IIIII fw the Scllool to receiYe Dr. J. Walter Knapp Dr. Albert Somit Dr. Harold J. Levy Dr. Eugene M. Teich Dr. Sanford H. Levy Dr. Max B. Weiner Dr. Milford C. Maloney & Mrs. Dione E. Maloney Dr. Karl L Manders Dr. & Mrs. Ralph M. Obler Dr. Pierce Weinstein Dr. John R. Wright & Mrs. Deanna Wnght Dr. Wende W. Young Anonymous 4 2 beqHIII or 131 �1940s Robert J. Dean, MD '47, anesthesiology, lives in Kinston, NC, where he is on staff at Lenoir Memorial HospitaL Favorite medical school memory: "jim Phillips entertaining the class as Dr. ]ones." 1950s James E. Lasry, MD '57, cardiology, lives in La jolla, CA, and is retired. Favorite medical school memory: "Professor Oliver P. )ones." Robert l. Baumler, MD '52, Sherman Waldman, MD '57, internal medicine, lives in Amherst, NY, with his wife, Jane. Favorite medical school memories: "Dr. 0. P. )ones' oral examinations in gross anatomy, as painful as they were." pediatrics, is in solo practice in Buffalo and is affiliated with Kaleida Health and the Catholic Health System. Favorite medical school memory: "0. P. )ones' recitations (with anxiety)." E-mail address is: swoldman @acsu.buffalo.edu. Melvin B. Oyster, MD '52, Richard l. Falls, MD '59, has family practice, lives in Niagara Falls, NY. He is in group practice with Niagara Family and is Director Emeritus of the FMMC family practice residency. Favorite medical school memory: "Hitchhiking daily from Buffalo to Niagara Falls until I got Neal Fuhr's old car!" E-mail address is: mbd3918@adelphia.net. been presented the 2003 Professional Service Award from The Prevention of Blindness Society of the Metropolitan Area [Washington, D.C.]. The award is given annually to the person who best exemplifies the spirit of the society's mission and its commitment assnotes to the community. Falls was chosen not only for his lifelong public service, but also for his many efforts to enhance the lives of patients and their families with vision challenges, according to the society. He has been active in the American Academy of Ophthalmology, Virginia Society of Ophthalmology and was past president of the orthern Virginia Academy of Ophthalmology. He is senior partner for the Northern Virginia Center for Eye Care and was chief of ophthalmology section at I nova Fairfax Hospital for 16 years. In 1992, Falls received the Clinician of the Year Award from Georgetown University Medical Center's Center for Sight for his voluntary efforts in resident education. 1960s Patrick J. Kelly, MD '66, joseph Ransohoff Professor of eurosurgery and chair of the Department of eurosurgery of ew York University School of Medicine, has been named trustee of Boys & Girls Clubs of America. In this position, Kelly will play an active role in securing financial support for the national youth organization and will help formulate strategies for positive youth development programs. As a child from a disadvantaged background, Kelly was a member of Boys & Girls Club in East Aurora, NY, and he credits the organization with setting him on a good path. "It's time to give something back," he says. Jonathan Ehrlich, MD '67, practices obstetrics and gynecology in the suburbs of Atlanta and, since 1973, has delivered over 4,000 babies. He has served as chair of the Medical Advisory Committee of Planned Parenthood of Atlanta and was the founding vice president of the Sandy Springs Branch of the American Cancer Society. Jn 1998, aware that the largely uninsured noncitizen Hispanic population in Atlanta had difficulty obtaining adequate obstetrical care, Ehrlich helped found a prenatal clinic with a local Hispanic business man to serve the Spri11g 2003 obstetrical needs of that community. Today he serves as medical director of the clinic-Centro Internacional de Maternidad (CIMA.). Since the clinic opened, the physicians and midwives of CIMA have deliv- ered over 2,000 babies. Largely through their efforts, the principal obstetric hospitals in Atlanta now distribute information packets and consent forms in Spanish and have full-time translators. For recreation Ehrlich skis, rafts and has run the ew York Marathon twice although, for the life of him, he cannot remember why. He has four children ("I believe in my product") and is married to Dr. Margaret Gorley Ehrlich from Eatonton, GA. She says he is everything her mother was afraid would happen if she moved to a big city. E-mail address is: dreobg@aoJ.com. JosephS. Kriteman, MD '67, pediatrics, lives in Dan Vers, MA, with his wife, Melody. They have two children: Lewis Scott Kriteman, MD, age 35; and Heidi Ruth )anock, age 31. E-mail address is: jskmbk@massmed.org. l1ffal• Physician 43 �Bv S. A. UNGER bstetrician/gynecologist Francis A. Fote retired in November 1987 and moved to Arizona in 1989. Prior to retiring, he had been in private practice in Buffalo since 1959 and had been an associate professor of OBIGYN at UB. In addition, he served as chief ofOBIGYN at Our Lady of Victory Infant Home (for unwed mothers and orphans), at Our Lady of Victory Hospital(l963 to 1982) and at Mt. Mercy Hospital(l982 to 1987). After retiring and living in Arizona for two years, however, Fote decided to return to work and began serving as a physician-volunteer and advocate for the poor and underserved around the world. The following is a brief outline of some of the projects he has been involved with since "retiring": In 1991, Fote spent two months in Northern Kenya with the Consolata Missions, where he worked with Ethiopian refugees fleeing civil war in their country. In 1992, he spent two weeks in El Salvador with the American Volunteer Medical Team IAVMT), providing medical care to the poor following civil war in that country. (The AVMT is a program begun by Cindy McCain, wife of Senator John McCain.) In 1994, he traveled to Santarem, Amazon, Brazil, where he spent a month introducing colposcopy and LEEP for management of uterine cervical dysplasia. In 1995, he worked for two months at the Common Health Center Hospital for the government of the Northern Mariannas on the island of Saipan. There, he supervised midwives, nurses and introduced LEEP. From 1995 to 2000, he served as a volunteer in the Gynecology Clinic at Luke Air Force Base Hospital in Glendale, Arizona, as a Red Cross Volunteer. From 1996 to 2002, he volunteered with Clinica Adelante, a community health clinic in Arizona that is dedicated to care of poor migrant farm workers. At the clinic, he taught colposcopy and helped establish obstetrical services. Currently, he serves on its Board of Directors. In 1997, he founded "Grounds for Health" IGFR), an international nonprofit organization providing health-care services to coffee-growing communities in Mexico and Central America. Also from 1997 to 2002, he worked with the San Pedro Pochutla Hospital in Oaxaca, Mexico, and the Huatusco Hospital, in Huatusco, Vera Cruze, Mexico, where he established a Dysplasia Clinic for the study of cervical cancer, the leading cause of cancer deaths for Mexican women. (The clinic is operated by local Mexican doctors and is supported by health-care volunteers such as Fote, who bring their own equipment and pay their own expenses. The health-care team Fote has worked with on this project include a cytopathologist nurse, physicians, and technicians, who volunteer a week of their time, twice a year.) If you are interested in participating in a health-care project overseas, Fote recommends contacting one of the following organizations listed below, or you can email him at ffote@aol.com. ( D 1) OPTIONS IPCII Project Concern International 3550 Afton Road, San Diego, CA 92123. Phone: (619) 694-0294; Internet postmaster@procon.cts.com (Fote has provided an OPTIONS catalog, which is available in the Office of Medical Education.) 21 Northwest Medical Teams International, Inc., Volunteer Program; P.O. Box 10 Portland, OR 97207 Phone: (503) 644-6000; fax (503) 644-9000 3) Grounds for Health, 286 College Street, Burlington, VT 05401. Phone: (800) 375-3398; www.groundsforhealth.org 4) Esperanca, 1911 West Earl Drive, Phoenix, AZ 85015. Phone: (6021 252-7772 (Amazonia and Madagascar) �David L. Larson, MD '67, psychiatry, lives in Wausau, Y, and is Vernon. I have three boys, and Debbie and I have now been married affiliated with North for 29 years. I am presi- Central Health Care. Favorite medical school dent of our hospital 's local IPA and president memory: "Anatomy recitation , freshman year. " of Pinnacle IP A, a sevenhospital IPA. " E-mail address is: dlarson @norcen.org. Mark Polis, MD '77, urol- l1ldlolo&YIIIreat ........ lhesi115ewema P•rk, MD, with ller husltMd, Rollert E. Buttles, ..... their two childl'lll: SarH, liP 10, •nd Rollert A., liP 8. F..nte medal scheol 11181Hries: "IIJ flnt cll•lul raUtiollln third,.... ..... I felt lille. '1"8111' doctor. The raUtioll ... surgery •nd I spellt sevenl weeks doilll ........ with Dr. Ross ......... He t.u&ht ... how to IUrt lVI .... how to ........... patlelds.lt .... nice, pluunt Introduction to c:llnluiMIIIIcille." ' . ogy, lives in Williamsport, PA, with his 1970s wife Denise. He has two Michael Kressner, MD '77, children: writes: " I live in Cory, age 26; Scarsdale, NY, and practice gastroenterology in ew Rochelle and Mt. and Chelsea, age 22. Favorite medical I CONT I NUED O N P AGE 4 6 BRING NATURE INTO YOUR HOME & OFFICE "Experience the tranquility of Tropical Fish" LARGEST SELECTION IN THE AREA • Complete set-ups from table/desk top to large central displays • Equipment and supplies • Tropical fish , gold fish & Koi (domestic & imported), dwarf frogs, bottom feeders, mollusk, crustacean & other unusual varieties. • Imported livestock and frozen foods • Wide selection of aquarium accessories and decorative items • Food, antibiotics and water conditioners • Aquatic plants (live & artificial) • L1ghtmg accessories " " " " Numerous Dry-Scape Displays in Our Showroom Beta Vase Plant Aquariums Lucky Bamboo Plants Set Up and Maintenance Programs rw'1"a'u'"' Gift Ideas & Gift Certificates Lifet1me Health 1s a not-for-profit complete care prov1der featunng state of the an health centers .We are seek1ng BC/BE phys1c1ans to JOin our prest1g1ous roster of health care profess1onals. Main St - At 5 J?: C Tropical Fish if TRANSITOWN PLAZA ~ F -----~-- 1-90-1·90 Exrt 49 Find out how Lifetime can fit your life by sendmg to Physician RecrUitment. Lifetime Health. 205 Park Club Lane. Buffalo. NY 14221 PH 877-217-7465 FAX 310·917·5062 EMAIL. lscreeney@earthllnk.net cv Lifetime Health Spr i n g Like J t : J r ? Here's what we've got! The Bills. The Sabres. The Toronto Blue Jays Going over Niagara Fails in a barrel Physicians V1sit 'Little Joe '- the Giant Pacu (roughly 30 lbs.) or Our Large Predator- Tiger Shovel Nose Cat-Fish. OPEN: Mon, Wed, Thurs 9am-9pm; Tues & Fri Noon-7:30pm Sat 1Oam-6pm; Sun Noon-Spm Pressure at your current poSition JUst too much to handle? Is your pract1ce g1v1ng you way too many headaches? If so. then 11 ~lime to shuffle off to Buffalo' Worried about the snow? No sweat Buffalo only averages about 25 days of snow a year Snowfalls that would bnng l1fe 1n some Cities to agnnd1ng halt are no problem here! And our average summer temperature is a perfect 79 degrees. NEED IDEAS: " THEN GET TO BUFFALO. 2 00 3 Suicide wings at the Anchor Bar Reeling in fresh fish for sizzling backyard BBQ Crossing into Canada for an evening of fun Downhill winter adventures on snow covered mountains wwwfitsyo 1.1'1 ife.com Equal Opportunity Employer. m/f/d/v. II f fIll Pb Is i c iII 45 �CLASSNOTES certified in internal medicine, geriatrics and clinical pharmacology. E-mail address is: is@doc.mssm.edu. CONTINUED FROM PACE 45 school memories: "General surgery rotations during third year; psychiatry rotation at Buffalo Asylum for the Insane; Dr. Lee's 1990s Philomena Mufalli Behar, MD '92, lives in Amherst, NY, with her husband Jerry, and their two-yearold daughter, Julia. She completed residency training in pediatric otolaryngology in Buffalo in 1997 and a fellowship at Emory University in 1999. She is in group practice and on staff at Children's Hospital of Buffalo. E-mail address is: pmbehar@aol.com. 1980s anatomy class, first year." E-mail address is: b.d.bop@suscom.net. Kathleen Grisanti Lillis, MD '87, pediatrics, lives with her husband, Michael Lillis, PhD, in Ira Salmon, MD '77, inter- nal medicine and geriatrics, lives in Elmhurst, Y. He is affiliated with Mount Sinai Medical Center and North Shore Hospital and is board Williamsville, Y. They have four children: Michael, age 9; Christopher, age 8; Alexandra, age 7; and J ulianna, 3. E-mail address is: klillis@upa .chob.edu. Elizabeth Conroy, MD '92, dermatology, lives with her husband. leffrev. in "Come Discover What My Mom Has Found!" - J ltoll/1 .!Tttm i • Beautiful private 1 & 2 bedroom apartments • 3 meals a day in elegant dining room • Weekly housekeeping • Scheduled • Hair salon, bank, library, billiards Come Home to Amberleigh ·A~~~~~ity 2330 Maple Road, Williamsville For a free brochure or personal tour, call 689-4555 4 6 l t f falt Pbpiciu Spr~ng 2003 �OUTREACH ANTHONY G, MD '91, MEDICAL DIRECTOR I n the winter 2002 issue of Buffalo Physician, Anthony Ng, MD '91, was featured in an article about his work as medical director of Disaster Psychiatry Outreach (DPO' in New York City during the weeks following the September 11 attacks. Over the past year, DPO has received a number of awards and honors for the seiYices it has provided. In October 2002, the New York State Office of~lental Health (OMH) recognized DPO with an award of special achievement for its response to 9/11, for which. 'g was present to accept on behalf of the organization. In November 2002, DPO was honored by the Philadelphia Psychiatric Society (PPS 1 at its annual Benjamin Rush Ball. Each year PPS members raise funds for an organization focused on the issues of mental health, and for 2002 they selected DPO to receive this funding. In other news, the United Nations has granted DPO nongovernmental (NGO) status. In a statement issued subsequent to this announcement, DPO administrators stated: "With this status, it is our intention to explore opportunities and expand on current projects that assist in training and outreach for international disasters. This association constitutes a commitment on the part ofDPO to disseminate information and raise public awareness about the purposes and activities of the United Nations and issues of global concern." Last fall, DPO representatiws participated in the September 9-11 th UN Annual NGO collaborative meeting, where discussions focused on ways in which the CN could collaborate with psychiatrists to provide treatment and assessments of UN staff involved in high-risk missions abroad. In April 2002, DPO held its 2 d International Congress on Disaster Psychiatry in New York City, which drew a large number of attendees. DPO has also been actively recruiting and training an increasingly large pool of volunteers who work in close collaboration with DPO and their local chapters of the American Red Cross. Buffalo volunteers have been active in working with the Erie County Department of Mental Health and the Office of Emergency Management in disaster mental-health preparedness in Western New York. Psychiatrists interested in volunteering with DPO can contact the organization at (212) 598-9995 or via e-mail at info@disasterpsych.org. <I;) S. A. Williamsville, Y. They have four children: Dylan, age 10; Jacob, age 7; Julia, 4; and Sam, 1. MG across the street; NY, NY, with ina." Classma tes can e-mail her at suzskiq@aol.com. Suzanne Rosenberg, MD '92, Yin and Gayle Singh, MDs pediatrics and physical medicine and rehabilitation, lives in Lakewood, CO. Favorite medical school memories: "The peanut butter party; Chevy's; pushing Rick's '92, live in Montrose, CO, with their three children: Vijay, 6; Arjun, 4; and Liam, 2. Vin practices orthopaedics and Gayle, family medicine. They completed their CNGER residency training at the University of Colorado and are currently in group practice and on staff at Montrose Memorial Hospital. Favorite medical school memories: "Peanut butter party; Rick's cottage; watching Reed rotate around the couch." E-mail address: vs ingh67@aol.com. Karen 1. Chojnacki, MD '95, has joined the Department of Surgery at Thomas Jefferson University Hospital in Philadelphia, PA. Prior to that she was a surgeon on staff at Bryn Mawr Hospital, where she had also served as a Spring 2003 Baltz Teaching Fellow and residency director, overseeing graduate and undergraduate medical education. Chojnacki's clinical and research interests include laparoscopic management of ben ign esophageal diseases and surgical treatment of pancreatic cancer and liver tumors. She is a fellow of the l 1 ffal e Hys i c i n 47 �CONTINUED FROM PAGE 47 American College of Surgeons and a member of the Society of American Gastrointestinal Endoscopic Surgeons. Her postgraduate training began at Jefferson University Hospital, where she completed a residency in general surgery and served as administrative chief resident. She also completed an advanced laparoscopic fellowship at the University of Southern California in Los Angeles, where she was a clinical instructor in surgery. medical school memory: "Being done with blocks." Jason Ho, MD '96, family practice/urgent care, lives in Pasadena, CA, and works in Valencia. Favorite medical school memory: "Gross anatomy lab and graduation!" E-mail address is: jasonhomd@yahoo.com. Joseph Chow, MD '97, Patrick V. Scott, DDS, MD '97, oral/maxillofacial surgery, lives in Hamburg, NY, with his wife, Gabrielle Scott, DDS. They have two children: Maxwell, age 5; and Nicholas, age 2. E-mail address is pscott@ bluemoon.net. Marc Richman, MD '98. Timothy Bukowski, MD '87, writes: "One of the residents in our urology training program at the E-mai family medicine, lives in Orchard Park, NY. He and his wife, Dawn, have a daughter named Elizabeth, age 2. Favorite University of North Carolina at Chapel Hill School of Medicine is Marc Richman, a 1998 UB medical school graduate. For the fourth consecutive year, Marc has scored in the lOOth percentile (highest) on the inservice exam given by the American Urological Association. I do not believe this has been done before. In july 2003, Marc will be joining a urology practice in Virginia Beach, VA." CD GENESEE HEARING SERVICES THE AUDIOLOGY CENTER 61 Wehrle Drive (Near Harlem) Amherst 14225 630 Orchard Park Rd. (Near Ridge Rd .) West Seneca 14224 837-6213 712-2000 • Diagnostic audiometric evaluations (pediatric and adult) • Digital & programmable hearing aid fittings on 60-day trial basis • Tinnitus evaluation and therapy • Vestibular evaluation for patients with dizziness/vertigo • Vestibular therapy • State of the art facilities "The Ear is the Road to the Heart" (Voltaire) 48 lulfal• Hysici11 Spring 2003 Daniel Schneider, AuD Jennifer Schneider, MA Jerri Kaplan Joyce, MA �The Medical Student Research Forum Poster Presentatio11 took place on Tuesday, January 14, 2003, in the Biomedical Education Building Atrium at the University at Buffalo School ofMedicine and Biomedical Sciences. A total of29 students participated, displaying the results of research projects they conducted at UB and other institutions. Each participant worked closely with a research mentor to complete his or her project, and a variety offimding agencies supported the students with stipends. "This forum provides students the opportunity to showcase their research and commwzicate and interpret their results to other students, as well as to faculty," says Debra L. Stamm, assistant dean for student services in the Office of Medical Education. "We recognize the importance of research training in providing the best medical care to patients and in providing fitture physicians with a well-integrated educational experience." Each research poster was evaluated by three faculty judges, and all student participants received a certificate of recognition. The three students with the top scoring posters each received cash prizes. TO THE FOLLOWING STUDENTS WITH THE TOP SCORING POSTERS: 1ST PLACE Jennifer Nowobilski, Class of 2004 PROJECT: Characterization of the Immune Response to '\on typeable Hemophilus Influenzae in Chronic Obstructive Pulmonar, Disease Left to right are Jennifer Gurske, Jennifer Nowobilski, and Shawn Ciecko, with Debra L. Stamm, assistant dean for student services. MENTOR: Timothy .\I urphy, .\ID, professor of medicine and Imcrobiology and chief of infectious diseases at CB and the \'eterans Affairs \\'estern , ' ew York Healthcare System 2ND PLACE 3RD PLACE Jennifer Gurske, Class of 2005 Shawn Ciecko, Class of2004 PROJECT: The Effects of Shoulder Rotation Positioning During Long Head of Biceps Brachii Tenodesis on Passive Range of .\lotion (PROM) of Fresh Frozen Cadaveric Shoulders ME TOR: William .\Iihalko, :\10, associate professor of orthopaediCs, research director for the Department ofOrthopaedicsand executn-e director of the lJB Center for Advanced Technology PROJECT: Endoscopic Approaches to the Th}Toid Compartment MENTOR: David Terris, .\!D, Division of Otolaryngology Head and. -eck Surgery, Stanford Universitv .\ledical Center �crnnsc CATHY GEARY HEALTH SCIENCE LIBRARY 130 ABBOTT HALL SOUTH CAftPUS p H A R M A c p 0 E I A 0 l B's HISTORY OF :\1EDJCINE COLLECTION PRESENTS itally reproduced from offizinellen Gewachse, a four-volume edition of pharmaceutical plants and their medicinal uses, published in German in 1863. The pharmacopoeia by Otto Karl Berg (I8I5r866) is part of the Robert L. Brown History of Med1cine Collection, located in the Abbott Hall Health Sciences Library. Pictured here is the Bitterwood, one of a series of botanical images digitally restored as part of an initiative to preserve and h1ghlight unique resources from the library's collectiOn. Reproductions are available for purchase through the library, and can be viewed online at iMedia.buffalo.edu/ art/. Image restoration was performed by iMedia, the instructional media services department of Computing and Information Technology at UB. I· Bl· 0002·03 0 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 2003 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2003-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v37n04-2003-Spring Table Of Contents A list of subunits of the resource. The Inside Passage Acute Care, Astute Care On Course, Part II Alumni Medical School Pathways Development Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v37n04 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2003 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/1485f88b0d716aba78a368ac0f4b5d8f.pdf 90848b6cc9a03855aadebcfb1e95cdb4 PDF Text Text �l1ffale r•ysicial ASSOCIATE VICE PRES I DENT FOR UNIVERSITY COMMUNICATIONS Dr. Caro le Smith Petro DIRECTOR OF PERIODICALS Sue Wuetcher EDITOR Dear Alumni and Friends, Stephanie A. Unger ART DIRECTOR & DESIGN Alan f. Kegler David]. Ri ley N N OVEMBER, I ATTENDED T HE ANNUAL MEETING of the Association of American Medical Colleges (AAMC) in San Francisco. Because the meeting is a forum for discussing topics affecting academic medicine nationwide, it serves as a valuable bellwether for deans and other school leaders whose responsibility it is to prepare as best they can for foreseeable trends, as well as for sudden exigencies. DESIGN ASSISTANT Karen Lichner CONTRIBUTING WRITERS Lois Baker and Ellen Goldbaum PRODUCTION COORDINATOR The financial status of medical schools was a prominent theme at the meeting due to the fact that as many as 70 percent of all schools are having financial concerns. A number of deans l spoke with experienced cuts between 4 and 8 percent in their school's budgets last year and are expecting further cuts of about 4 to 6 percent for the coming year. Cynthia Todd-Flick UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. Michael Bernardino, Dean As a result of the current economic environment, many universities are postponing building projects; others that have built are not sure how they are going to pay for the buildings or maintain them. This reflects a notable difference in how our school operates because the state builds and maintains our buildings. Although we may have smaller cuts in our school's budget, these cuts are in some ways more painful because labor and union laws preclude us from exercising the flexibility that others schools have in implementing them. In general, however, I feel the financial status of our school is currently no worseand no better-than many of our peer institutions. TEACHING HOSPITALS An especially controversial topic at the meeting was physician shortages, which participants spent an entire day debating. As you are aware, the number of residents was capped in 1996 by the Balanced Budget Act, a move that was endorsed by the AAMC and a number of other groups. EDITORIAL BOARD Dr. John Bodkin Dr. Martin Brecher Dr. Harold Brody Dr. Linda f. Corder Elizabeth Volz, Class of 2005 Dr. ]ames Kanski Dr. Elizabeth Olmsted Dr. ]ames R. Olson Dr. Stephen Spaulding Dr. Bradley T. Truax Dr. Franklin Zep lowitz ow, for the first time, the wisdom of this move is being questioned due to the fact that, nationwide, there is a shortage of specialists in a growing number of fields. This is a debate that will directly impact our school, which ten years ago moved sharply toward training primary care physicians and away from training specialists, as did many other schools. l don't know when or how the pendulum is going to swing back to a point that better reflects the needs of our society, and l certainly don't advocate for reversing current trends by instituting equally sharp upward adjustments in specialist training. However, most leaders in our school's administration feel, as I do, that we currently have too many primary Erie County Medical Center Roswell Park Cancer Institute Veterans Affairs Westem New York Healtltcare System KALETD.~ HEALTH: Tlte Buffalo General Hospital Tile Cltildren's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital CATHOLIC HEALTH SYST£\1: Mercy Healtlr System Sisters of Cltarity Hospital Niagara Falls Memorial Medical Center @ IIIYEISITY AT IIFFALI , TIE SliT£ UIHISJTY If lEW Ylll care and internal medicine residents and that it makes increasingly good sense to gradually move some of them into specialties. Letters to the Editor Lastly, a topic that concerned many at the meeting is the amount of debt medical students are assuming upon graduation. (It was reported that the mean average debt for all medical graduates in 2002 was $103,855. When specialty training is factored in, the amount of course rises.) This is an issue that we as educators must address. We must find a way to decrease the significant debt burden of our students. J. R. 4-A .i.:. ,_A-<) ~.BERNARDINO , MD, MBA Dean, School of Medicine and Biomedical Sciences Vice President for Health Affairs Buffalo Pltysicratr is published quarterly by the University at Buffalo School of Medicine and Biomedical Sciences in cooperation with the Office of Communications. Letters to the Editor are welcome and can be sent cfo Buffalo Pltysicimr. 330 Crofts Hall, Unrversity at Buffalo, Buffalo, NY 14260; or via e-mail to bp-notes@buffalo.edu. Telephone: (716) 645-5000, ext. 1387. The staff reserves the right to edit all submissions for clarity and length. T~ ~ University at Buffalo TheStateUniversityofNt:wYork �VOLU M E 37, NU M BER 0 p H y c s A N Features 2 Family Medicine, aGlobal Perspective Refugee Cultural Competency Training Program gives students an opportunity to work with patients from other cultures BY 12 S . A. UNGER ADegree of Latitude Popular biomedical education program helps young scientists make smart career choices May Shogan, left, translating coordinator atthe lnternationallnstitute, and Luis Zayas, PhD, right, a medical/cultural anthropologist and research instructor in the Department of Family Medicine, helptrain medical students and residents in University at Buffalo's new Refugee Cultural Competency TrainingProgram, developed by KimGriswold, MD'94. Turn to page 2 for more. BY NICOLE PERADOTTO 16 On Course A conversation with Margaret Paroski about medical education, curriculum and admissions COV ER PHOTO AB OUT THE 32 Update on Convocation 21 Alpha Omega Alpha Scholars 22 Sung and Medical Alumni Association scholarships Golden Mind and Body Lecture Lawley named Distinguished Medical Alumnus 41 Messages from reunion class chairs 43 Alumni President's column faculty, staff, students and alumni 30 Western ew York Pioneers of Science In Memoriamjohn Edwards work in UB's Center of Excellence in Bioinformatics 34 The Living Anatomy Program 36 Women's Health Initiative spins off new projects BY COVER , RHEA ANNA SEE PA C E 40 The Road Best TraveledKim Griswold's circuitious route tomedical school other alumni 11 ��Family Medi ine: aGlobal I I 1 I �~-~- - - - - - - - · ~-. Despite the presence of interpreters, attention to protocol and the neat stacks of paperwor , the participants were not convened to resolve border disputes, monitor free elections, intercede on behalf of warring parties or debate the merits of armed intervention. Instead they had gathered to welcome new arrivals to America-men, women and children forced to flee their homelands for safety-and to help these refugees learn how to navigate the labyrinthine health-care system that awaits them in their new country. Conspicuous among this group gathered at the Columbus Health Center were two young men and a woman in starched white coats, all first-year students in the University at Buffalo School of Medicine and Biomedical Sciences, who were participating in the meeting as part of an innovative educational program aimed at increasing their cultural competency while improving access to preventive and primary care services for refugees in Western ew York. An Immersion Experience The voluntary program, which is open to all students and primary care residents at UB, was developed by Kim Griswold, MD '94, MPH, an assistant professor of family medicine, who has garnered a three-year, $393,933 grant from the ew York State Department of Health to support its integration into UB's medical school curriculum. A joint sponsor of the program, along with UB's Department of Family Medicine and Kaleida Health's Columbus Health Center, is Jericho Road Family Practice (also located on Buffalo's West Side), which is operated by Myron Glick, MD '93 UB assistant professor of clinical family medicine. Assisting the two clinics with implementing the program are the International Institute of Buffalo and Journey's End Resettlement Services. "Our strategy is to offer a concentrated cultural-immersion l1ffale Hysiciaa W11!t e r 2 003 experience to students and residents at evening clinical sessions that serve only refugee patients," says Griswold. "The students work with people from Rwanda, Sudan, Somalia, Ethiopia, Congo, Kosovo, Bosnia, and Cuba, as well as from a number of Asian countries." All refugees seen in the program are legal immigrants who are being resettled through the federal government, according to Glick. "They receive Medicaid for a year, during which time they are expected to learn English, find a job and provide for their family," he explains. "Some people do incredibly well with that. There are a lot of success stories, but there definitely are those who struggle, and health care is a big part of that struggle because even when they do get jobs, they' re often low-paying and so don't provide health insurance." T he program, formally titled the Refugee Cultural Competency Training Program, builds on a pilot project developed over the past two years by Griswold, UB medical students and volunteers in which medical students conducted health screening of refugees during monthly "health nights" at one of the participating clinics. Clinics for the newly funded program take place from 5:00 to 10:00 p.m. and are dedicated to medically evaluating refugees who have recently entered the country. Prior to seeing patients, the students attend an orientation discussion presented by staff �Pictured, left to right, May Shogan, from one of the resettlement agencies, a cultural/medical anthropologist, a physician, and a case worker from either Journey's End or the International Institute who is informed about the medical, psychosocial, financial, cultural, gender and legal issues of the refugees to be seen. "The orientation focuses on helping the students know what to expect during the clinical session, " explains Griswold, who adds that each session is limited to a maximum of three students to assure that they receive as much one-on-one training as possible. "In particular, they are briefed on what type of psychosocial problems the refugees might present with; for example, traumatic stressors such as torture, mutilation, religious persecution, murder of family members, or loss of home and possessions. They also learn about the medical problems common to the refugees ' homeland, such as parasites and infectious diseases. " In the orientation session, the students also are instructed in how to address the problem of translation and how the translation will be handled during the upcoming session-whether through a telephone translator, physician or health-care translator. Finally, the program's medical/cultural anthropologist, Luis Zayas, PhD, research assistant professor in UB's Department of Family Medicine, teaches the students about basic principles of medical anthropology and introduces them to the concept of "culture," as well as to methods for "taking the role of the other. " In discussing this latter concept, Zayas and a staff member at the International Institute talk to the students about the importance of being open, interested, empathetic and tactful with the patients, attributes that will assist them not only in building trust, but also in gaining meaningful information about the patients' lives. Zayas, an experienced ethnographer who is fluent in Spanish and Portuguese, also briefs the students on the importance of note taking while performing a history, as well as the etiquette for doing this effectively, yet unobtrusively. The Preceptor and the Process After the orientation session, the students spend several hours in the clinic, where they are encouraged to practice their interviewing and listening skills in order to gather knowledge about a patient's life story, as well as facts about his or her health history. Giving the refugees an opportunity to tell their stories serves as a means to help validate the often bewildering and painful experience they have undergone as an immigrant, according to Winter 2003 l 1 fl al• Hysicin 5 �Griswold. "Too, a patient's life story can include important cultural, emotional, sociopolitical and economic events not captured in a standard medical history," she explains. Glick, who leads similar evening sessions at his Jericho Family Practice, recalls an encounter he had with a patient several years ago that reinforced for him the importance of knowing as much about a refugee's past as possible in order to deliver effective care. "I met a woman from Sudan who was especially sad," he says, "and when I heard her story-that she had lost her three older children in a war, and that, basically, they were killed right in front of her and her three younger children-this allowed me to understand her a lot differently than if I didn 't know that part of her story. "But we hear countless stories like this," he continues. "The refugees come with a lot of trauma in the past that can end up causing depression , post-traumatic stress disorder, marital conflict or domestic violence-a lot of psychiatric issues that are hard to put a finger on and are hard to treat, especially if you don't know their stories. " Despite the importance of gathering information about a refugee's life story, Griswold is quick to tell the students that they need to be patient in the interview process and that they don 't need to obtain everything in one visit. "Often the patients are not ready to divulge their histo ry, whatever it is," she says. "For example, torture is a huge issue, and we need to ask about it sensitively. On the first visit, you're not going to say, 'Okay, tell me about your torture.' You can't be that direct; you 6 laffala Hysiciu Winter 2003 have to establish the rapport, the trust. And it may take many visits before a person is comfortable talking about things like that." In addition to taking a medical history and listening to patients' life stories, students also conduct physical exams (depending on their level of training), or assist a resident or attending physician. Further data are collected on health behaviors such as smoking, drinking and the patient's understanding of health in general. 0 nee the exams are completed, the students are taught how to review the patient's story and objective findings, make an assessment and plan with the preceptor forthe patient's continuing medical and psychosocial care. Refugees in need of psychiatric care or mental health services are referred to Lakeshore Mental Health Counseling or to Child and Adolescent Treatment Services, as well as to other agencies and practices collaborating with the program. Attention also is paid to the refugees' oral health, as many have never seen a dentist in their lives and are in urgent need of such care, according to Glick, who is hoping to establish a similar referral network among area dentists. At the close of the clinic session, the students then re-group in the conference room for a half-hour debriefing session that is conducted in a focus-group format by Zayas and the supervising physician. "We ask the students to talk about all aspects of their clinical session with the refugee," says Griswold, "and we pay special �attention to their emotions, especially if they have had few or no experiences with a refugee population." In addition to monitoring the students' emotional responses to their patient encounters, the instructors ask the students to summarize what they learned as it pertains to cultural issues and to talk about hurdles they may have encountered related to translation. They also ask the students to suggest ways they feel the experience could be improved. As part of the program, the students--each of whom must commit to a minimum of two such sessions in order to participate-are asked to keep a diary in which they record all of their encounters with refugees, whether they be within the formal context of the program or in extracurricular activities they undertake on their own, and to complete a written evaluation of their experience in the program. They also are required to write a short paper linking the clinical experience to the lecture aspect of the program and to describe how they feel they benefited from participation in the program. The data obtained during the debriefing sessions are recorded and will be qualitatively analyzed by Zayas at the end of the program in order to assess its success, including how effectively it was integrated into the medical school's curriculum. Life Stories. LiYe The first-year students participating in the late October session at Columbus Health Center were Lynne Learned, Justin Spooner and Brian Eichner. Prior to the start of the session, they were told by Griswold to expect the arrival of two refugee families as the evening progressed: one from Vietnam and the other from Bosnia. They also were reminded that once the refugees and the other participants arrived, introductions would be made and the refugees would be invited to tell the group as much about themselves as they wished. After this discussion, Griswold, Learned and Spooner would escort the refugees down the hall to the clinic to begin the clinical exam sessions. Eichner, who, unlike his two classmates, had not yet attended an orientation session, would remain behind and be briefed by Zayas and a representative from the International Institute, later joining the others in the clinic. As it was the dinner hour, snacks and beverages were passed around the table, and an air of warmth and collegiality filled the small room as others trickled in and introductions were made. Among the first to arrive were the translators from the International Institute: Bong Vu, a Vietnamese man who has been in the United States for 30 years, and Vesna Demirovic, a Bosnian woman who came to the United States five years ago with her husband and 12-year-old daughter. They soon were joined by Barbara Burns, a social worker and a conPictured,leh to right, are sultant on the grant, and Sister Mary Judith, medical students Justin a case worker at the International Institute. May Shogan, an immigrant from Jordan who has been in the United States for 15 years, also arrived and sat with Zayas, with whom she partnered to present the orientation session for Eichner. Fluent in English, French and Arabic, she, too, is a consultant on the grant, with special expertise in cultural issues and refugee assimilation. Rounding out the group were Griswold and two staff members in UB's Department of Family Medicine who work closely with her to administer the day-to-day operations of the grant: Joan Kernan and Christine Wagner, a social worker. A fter about 15 minutes, the first refugee family arrived: a husband and wife and two teenage daughters from Vietnam . The parents were seated next to Vu at the head of the table, while the girls sat to the left of their mother. The girls immediately began interacting with the group, helping themselves to the food and drink that was offered and playfully trying to sound out how to pronounce words printed on the label of a pop bottle. The younger girl, clearly the most outgoing and spontaneous, stood up to offer to pour a cup of soda for the social worker seated across the table from her and engaged in a cheerful pantomime with Kernan, who admired the girl's blouse as she took off her winter coat and settled into her chair. Although Winter 2003 l affal1 Plysiciu 7 �little English was spoken by either girl, clearly they were relishing the encounter and eager to dive headlong into their new life. Their father sat quietly and appeared anxious and withdrawn, the skin on his face deeply creased and worn in contrast to the bright, fuchsia-colored sweatshirt that reached high on his neck, forming the middle layer of several shirts he wore on this chilly evening. The girls' mother also sat quietly, her reserve broken only when Vu drew her into conversation in low tones. Occasionally she cast a quick, guarded look around the room and seemed mildly amused with her daughters' chatter. H aving been informed that the Bosnian family was experiencing-delays in their transportation to the clinic, Griswold decided to move ahead and formally opened the session, asking those in the room to introduce themselves to the family. Once the introductions were completed, Spooner, upon request, briefed the family about what to expect during the clinical exam, after which he and Griswold addressed a few questions from the younger daughter. Zayas then gently encouraged the parents to tell about themselves, if they wished: Where were they from? What was life like in their village? The father, too shy to speak, deferred to his wife. After a brief pause, she began talking rapidly while holding out both hands and repeatedly flashing her fingers to show the numbers "two" and "five," as if convinced her words alone could not convey what she needed to explain. The younger daughter, hearing her mother's sudden outpouring of words, implored her to slow down for the interpreter, tugging on her mother's arm and making a pumping, brakelike motion with her hands. Her distraught mother appeared not to notice and proceeded with her story unabated. When she stopped after a few minutes, Vu paused to collect his thoughts, and then slowly turned to the group and spoke. He explained that she had described how she and her husband had met and married. She also said that they were from a rural province in South Vietnam, about 80 kilometers south of Saigon. When the communists took over, it was very hard because her husband worked for an American company. They gave them all kinds of problems, so it was very difficult to live under the new regime. They didn't think they could survive in Vietnam. Two of their children are here with them; five still are back in Vietnam. Griswold thanked the mother for sharing some of her story and then asked Vu to explain that she and two of the students were going to escort the family down the hall to begin the clinical session. ll•lrli1nlll.••·u. tl!b ...... ..uns .. i1lrtll( 1M R•flt• C•lt•r•P Ce•••t••cr Ti'IIIIIC Prep-. Ill&' • ._ ?lit II ....a; 111· ..............,••, 1111· ucn ... •ret.....IIYII ftnt·,...,ltllll ...lpllltl 1U flc1 tbt ..., II .tlll ..... ltltli. ............. lilllltJU..a.a .r-.m.a.,.llwYIIk.LIIIIil ......,. If w111t lrlinlll calli.., . . . ..... .........-111111 .... II . . - ,_. 111n ,.nJclptlllll ................ iiJIIiti•• !lilt .. . ......... .... ..... 11111 .... till •1 2I 2 I Ill till ...... CIPtlnl c Jl_,,...,.......... ..., ,... . . till..,... ... 8 lulfala PbysiciiR W1n t er Stltll II IIIZ. 2 II I h Cl8flllll . . . . . tUt c-. ,.,._ .................. . &!It .. 2ilfll-.t?ll ... ....... c. . ........... - •I ..... .....,... ...... , I .........., .................. _ . . . .......... ....,.... I ,... ............... , I liM "'IIIC................ ..,........ . . _.... 1 I .....,.. Mtlllil_...._...,._• ............... ......,......., .......................... lriinPII ..... till ....... ...,. ......... . , ............. AJI lilllliiiiMilwlllt . . . . ~tlll .............. ll ....... l?ltull. ...... WntiNIFiiii?J .... . . 2003 �A for now, they communicate by writing letters. fter they left, and before the orientation for Eichner began, The youngest of the two daughters with them attends a local Sister Mary Judith, the caseworker, made a few follow-up high school and the older takes English classes at the Internacomments about the Vietnamese family. She explained that in tional Institute. 1995, immigration policy in the United States changed and, as a They are happy to be in the United States, but the father worresult, children who are over age 18 or who are married cannot ries about finding a good job, although he currently does enough accompany their family. She surmised that the couple's five other piece work for the family to live without public assistance. children remained behind for that reason. Learned, who examined the mother and two daughters, exLater that evening, during the debriefing session, Learned and plained that she was impressed with their closeness. Spooner shared additional information that they had learned "They seemed very loving and concerned for each other," she about the family during the clinical session. said. "They freely discussed sensitive sexuality and gynecological They explained that the parents are in their late 50s and have five adult children in Vietnam. The family had been in the counquestions, even though neither girl is sexually active nor has a boyfriend, something they believe they are try about four months, and they hope that someday the far too young for because, in their culture, it older children also can come to the United States but, Betty Lim, Class of 2003 means marriage." On the whole, Learned concluded, "the entire family was quick to laugh and were very loving toward one another and seemed happy. I found them easy to talk with and was even invited to come to their home. It was sad leaving them in the end." Shortly after Eichner's orientation session with Zayas and Shogan ended, the Bosnian couple arrived and were seated with their interpreter, who introduced them to the others and then talked quietly with the couple for a few moments. B ,.................... ...... .., ...., ................... ............................., ................... .... ........................ ....... ,,,...... u. .............. _ ......,....... .,.....,. ......... _ . ... ........... ,,,6 ....,_ ..................... - .....a,.u. ............... _,.UIIL"'IIIII~)IItlfflrta ............................ ...., ................ ,., .................. ....,_,., a. ................. ....... .. ......_,..,_ t 3 1 oth appeared to be on the brink of exhaustion. The man's thin cheeks, stubbled with whiskers, were sunken in his face, and his eyes were red rimmed and bloodshot, as if he had not slept for days. His wife's pallor was gray and her brown eyes were faded to a lusterless amber. Sturdily built, she sat upright in her chair, tensely dangling her purse over the side of the armrest and staring vacantly around the room, her occasional words to the interpreter revealing broken and missing teeth, similar to her husband's. In a short while, Griswold reappeared to talk briefly with the interpreter and, because the hour was growing late, she and Eichner then escorted the couple to the exam area . Following the clinic sessions, the refugees returned home and the group reconvened in the conference room to debrief the students. In the debriefing session, Eichner, who had Win t er 2003 l tffala Hysieiaa 9 �- ....... ........, __ ............. ... ... ). ....... . . ......... a••• ...., ......., atllllltlll.,. ........... cltll• ............. .................. ..._._,., IJ•IIII•II lltlrlllttutiJ . . . . . . . .... . . - whll ......,., IIIII,_... ... ..., ..... u. ,,... ........., at lllllr.'l ...... lllhlr- IIC ¢1-Jlllillll ........ • ..............., flltll. ,....llltmll1mat••7• • ......... ..-llw -'lillll]lra.... 111111111 F-lllflfa. . . . . . . ........................... ........-. ...... .......................,..... _, .. ......,_ ..., ........... ......................... .. ................ .... lllfrla - - ' .. ........ ~ 1111 . . . . .111MI-'If(•ftnt ............., ....... Jllltlll ..... c•••,.... fir . . . . . . . ~•111 I1Mt.ll 1MI Clfllllr, .................... C111¢1 1111 tr11t111 ,...... w111 all fiiiiiiCIIIII. Tlnl,... .... ..._ ....... _ _ ._..... ........ 111111111 F-•--••~flrl ......................... .... ...... ,... ...... . . . ...................._....... .... ....... ........... ........... _..., ..........., ..., ........................... ... .............. ...,CIIIt. ............. ..... ....................... ................,......_ nni llultll .... .nr1tlll ]11'111'1& llllllrlntlllr,wllllllll . . . . . . . ..... 11111. . . . tllllllnllll 11illlllw111l-111171.tllll...., ....... ~~~u~ .............. -- .... Cllllll't- .... - tllllll I .............. llllllllallll • ..................... Ill E_..._.llftn.,PIIIIIIII IIYIII II lfrlcl lllllllr • ........ ..... \ ...... ,_..lllflr ...... .... ....... JIIIIIC_ ...... ...... . . . . -...... a~~ ... ...................... ,,, . earlier that the remains of her husband had been found in a mass grave in Srebrenica; she had then been asked to describe his personal effects over the phone. The Demographics of Doctoring While the experiences students gain through this intensive program may seem exotic to some, Glick and Griswold both point to the fact that, more than ever, such experiences are increasingly pertinent to the practice of medicine in the United States and will teach students important clinical skills no matter where they eventually practice or whom they choose to serve. In his Jericho Family Practice, Glick estimates that he sees patients from approxiParisima Mirzakazemi. MD mately 50 different countries around the interviewed the Bosnia woman, shared with the world, some 20 to 30 percent of whom are refugees. group more about the family's story. "More and more of our country is becoming increasingly He explained that the couple, in their early 40s, has three sons, diverse," he says. "And whether you end up practicing in rural the oldest of whom was shot in the head but survived. They had been in the United States for four months and speak very little Iowa or on the West Side of Buffalo, you're going to end up dealEnglish, so are taking classes at the International Institute. They ing with folks who are different from you and who come from are Muslim, from a small village in northeastern Bosnia, and the different places, so I think it's wise early on in your training to get husband is an environmental scientist. The wife lost her brothers exposure in a controlled setting such as this program affords." Too often, the first clinical encounters medical students have in the war, and her mother also died recently. She has several with people from other cultures take place in an emergency sisters in the country, one of whom had been notified two weeks 10 lulfalo Hysiciaa W ill t er 2003 �......................... ............................ ................... ,. ••a•am. _. ... ...., .............1. ., 11111111 .. filii ....,. whll .................... .....•••c, ...... ... __....,......,....... ....... _..... _. ...... ......... ......, .. ...... ., • troll I .,._ • fllln•• alii • • 'Y• .... _ .......__ naiL_ 1111 ..,. tllat ......... tllll( ..................... 1..... . . 1111 ....... ..._ tUt ....... c.'t ........... , ......... tnllla( . . ntaMI( 1111 ..... . . . . . . . . . . . .lllllllt- ...... , . . . ........ F-. ...................,.... .......................... ........................... ..................... .. ......................... 1'1111-............,... ..................... ..........._.............. ... ..,.,._.................... .... ............... . .......................... _.,.......................... .................... .., ..... .,......................... .......................... CllllalrJ .... ..., . . . ~ cld- -. Clltanl u ••• ..., ......... ............... naiL _,, ••• r-..t ......... -dllflntCIIIIalrJIIIat ....... ..., ..................... ............. ...., ..... u... llllcwll II "'alll,1 . .'tllana dlllriiiCIII.IIilllllllltwllll..,.. I:III'J................ ., ....,, til. . . . . . . . , - . : . . ,illtllilll'tllana...ay." room, according to Glick. Because of the hectic nature of this setting, the encounter often becomes a source of frustration for the student, instead of a potent learning experience, he feels. "One of the things that this grant does is it allows us to bring students in for an evening that is fairly slow paced," says Glick. "So they get a chance to just go in and talk with the patients, and that gives them a chance to give in a different way than if the visit were just about a medical problem. This is incredibly important because if you don't see people as people, if you don't see them for who they are and where they come from, then you're not going to give them the kind of care that you really should be giving." S pooner couldn't agree ~ore with G~ick's .assessment of the merits of the program. I feel workmg with the refugees IS the most rewarding activity I participate in," he says. "The refugee population needs our help to get acclimated to American culture and lifestyle," he adds. "Each person brings with them a history of family, beliefs and knowledge that varies greatly from my own, and I feel I can learn a great deal from listening to them. Also, interviewing people across a language and cultural barrier is challenging and educational. Prior to this, I really took language for granted!" First-year student Brian Eichner, who previously worked with migrant farm workers from Mexico, says he's interested in learning about the health-care needs of refugees because they are an underrepresented group that has few advocates, and by immersing himself in their lives, he hopes to learn about how to help them. This, he adds, "might also shed some light on aspects of my own family's immigration experience generations ago and so help me to understand my past on a new level." Having met and talked with the Bosnian couple in detail during their clinical visit, he says he was most impressed with their bravery. "The mother spoke to me as openly as she could about her struggles in Bosnia, even though it was clearly difficult for her to do, and she eventually changed the subject," he explains . "However, in that brief time, I felt that I made an emotional connection with her and gained her trust, if for nothing more than a minute; but that was truly a powerful feeling, especially when working with someone who has had to endure so much." Eichner feels it would be valuable for anyone working in health care to be exposed to the type of patient encounters he has experienced through his participation in the program. "It's very easy for us to get caught up in our own daily struggles and to lose sight of how lucky most of us are," he says. "Experiences like this remind me of why I am working so hard in medical school and of how blessed I am to have the opportunities and freedoms that I have in my life." CD Pictured on the cover is the Nzotungicympaye family from Burundi. Left to right. back row: Agnes Musoni , holding five·month·old Nelson Peary Nzo; and Protais Nzotungicympaye, holding Franklin Sijeniyo. age three. In front is She ilia lngabire, age 7. The family immigrated to Buffalo in January ZOOZ via Rwanda. ��Progran1 helps young scientists n1ake smart career choices 0 f-o ~< "' "' p.. "' ...J 0 u z �One of the great advantages of the program is that you get to explore different disciplines and choose the one that you prefer the most. "!thought, 'What a novel idea.' owl don't have to make an uninformed decision about what l want to do for the rest of my life," recalls the Minnesota native, currently a fifth-year IGPBS student in toxicology. "What sold me most on the program was the prospect that interdisciplinary training in biomedical research would open the most doors for my future." Apparently, quite a few students feel the same way. Since the program's inception in 1997, the number- and caliber-of applicants has exceeded the expectations of UB's staff and faculty. "As soon as we set it up, our enrollment increased," notes Suzanne G. Laychock, PhD, senior associate dean for research and biomedical education. "The students have responded extremely well." A ll involved with establishing the program agree that get- ting it off the ground was an incredible undertaking. From developing the curriculum and creating new classes to uniting faculty members and determining the best ways to recruit students, it required participation from dozens of different voices. "We were moving graduate education out of the medical curriculum, and that was revolutionary for us," says Lachock. "There was a lot of dissension on how things would go, and which courses would be given, but we had to get beyond that. The program went forward and now everyone's on board." The faculty's dedication to the program has paid off in more ways than one. With the IGPBS attracting so many applicants, the admissions committee can be more selective in the candidates it chooses. "In the past couple of years we have been competing very well with institutions such as Cornell, University of Rochester and St. Louis University," says Elizabeth Hayden, staff associate for Graduate Biomedical Education. "We have brought students in from as far away as Texas and Utah, and all over the East Coa t." And just what type of student is attracted to the interdisciplinary approach? According to Anthony Campagnari, PhD, former director of recruitment and admissions for the IGPBS and professor in the department of microbiology, the program is geared for students still looking for their research focus. "We attract those individuals interested in multiple disci- 14 laffall Hysician \V inter 2003 plines, and those who are not ready to commit to one single program," he says. "The students are very creative in terms of being able to think about things they would like to do," adds Laychock. "But many of them are unwilling to say they would like to do something specific because their undergraduate programs didn't provide them with the breadth of information to make that decision." Even students with predetermined interests often favor the IGPBS over a traditional departmental program because it provides them such a strong foundation in the sciences. Of those students, Laychock notes, roughly 80 percent are open to the possibility of changing fields. ~e program's first graduate can count himself among that .1_ group. In the summer of 1997 Mohamed R. Mohamed came to UB as part of a training program jointly sponsored by the U.S. Agency for International Development and the Egyptian Ministry of Health. Although he planned to apply to the microbiology department's PhD program, he was encouraged to instead apply to the IGPBS. In June of2001, Mohamed received his PhD-not in microbiology, but in biochemistry instead. "Of course, I would not have been able to change majors ifi wasn't in the IGPBS," says Mohamed, who is conducting postdoctoral research at UB. "One of the great advantages of the program is that you get to explore different disciplines and choose the one that you prefer the most." The program is also popular because it equips students with a knowledge of various fields, which is considered a desirable trait among potential employers, according to Richard Rabin, PhD, director of IGPBS and professor of pharmacology and toxicology. "Gone are the days when the scientists went to their labs by themselves and did their own thing," says Rabin, "That just doesn't happen anymore. There's a lot of interaction across fields. "Of course, students have to specialize; you can't be a jack-of-all-trades. But you have to have an appreciation for the other fields to know what their needs are. Students get a broad experience from the IGPBS rather than immersing themselves immediately in a field and getting myopic." The IGPBS's first-year curriculum includes mandatory lecture courses in cell biology and biochemistry as well as a course on the principles of lab techniques. In the spring semester, students are asked to critique and present papers in a seminar series designed to hone both their analytical and communicative skills. Elective-course options also help �students explore new fields of interest. During the first year, students are required to rotate through at least three labs-and they have the option of working in a fourth-allowing them an opportunity to narrow down their areas of interest and determine their PhD adviser. "These lab rotations are very meaningful experiences," Rabin says. "They're 12 to 20 hours per week and half a semester in length. The students are in there learning new techniques, getting involved to see how they like it and, from the investigator's mind-set, to see how they do. "They are really in the thick of things," he adds. In the spring of the first year, students are asked to rank, in order of preference, the three faculty members with whom they would most like to work. The match is made-with the vast majority of students receiving their first choice of labsonly after it's certain the professor has the funding and space to accommodate the student. In this way, the students differentiate into PhD programs in anatomical science, biochemistry, biological science, biophysical science, microbiology, neuroscience, oral biology, pathology, pharmacology, toxicology, physiology or structural biology. S cott Severance, currently in his fifth year of the program, works in the biochemistry lab of Daniel Kosman, PhD. For Severance, one of the most alluring aspects of the program is the fact that the courses are tailormade to his needs, not those of an aspiring physician. "Although we are associated with a medical school, we do not take medical school classes," says Severance. "Medical school classes are great if you are going to be a doctor, but the instruction, examinations and expectations are different in a graduate school class. "It would be much easier to have the IGPBS students fulfill their course requirements by taking medical school classes, as is the case at many other schools," he adds. "But the directors of the program have done just the opposite." Another bonus of the program comes from an administrative point of view: With the creation of the IGPBS, the recruitment process has been dramatically streamlined. "Previously, each department had to have its own recruitment brochures, and they had to support financially all the recruitment activities," Laychock says. "That was a very expensive and time-consuming undertaking, and we were not necessarily reaching the students we wanted to reach. " ow, with the interdisciplinary program, everything is consolidated, so all the expenses go toward attracting students to this centralized program. We have cut down on expenses and decreased duplicated efforts." "Recruitment involves far more personal contact and follow-up than before," adds Campagnari. "I attempt to contact students as soon as I receive any inquiries or GRE scores and encourage them to fill out an online application." And while the Internet has certainly helped prospective students find out about the program, it's interesting to note that the old-fashioned word of mouth still works wonders. "About three years ago, we did a mailing to PhD alumni informing them of what we were doing and how we were proceeding," Hayden says. "Many of those involved in academic programs have sent us some very qualified candidates. Our alumni are some of our best recruiters, and we welcome their recommendations." Winter 2 00 3 II If Ill rb J SiC iII 15 ��Recently, Paroski agreed to sit down and talk with Buffalo Physician as part of an ongoing series of conversations with leaders of UB's School of Medicine and Biomedical Sciences. (Part I of the interview is published on the pages that follow; Part II will appear in the spring 2003 issue of the magazine.) In addition to this conversation-and an earlier conversation with Dean Michael Bernardino-future issues of Buffalo Physician will publish interviews with Roseanne Berger, MD, senior associate dean for graduate medical education, and Suzanne Laychock, PhD, senior associate dean for research and biomedical education, each of whom will be asked about issues pertinent to her areas of responsibility. The goal in publishing these articles is to inform our readers about the complex economic, political, regulatory and historic considerations school leaders must weigh in making decisions and to provide a larger context within which to understand the many new developments taking place on campus. Comments and questions, as well as suggestions for future topics, are welcome and can be emailed to bp-notes@buffalo.edu or mailed to the address printed on the inside front cover of the magazine, below the heading "Letters to the Editor." -S. A. Unger, editor Q: What are the primary challenges you face in leading the three offices you oversee: medical education, curriculum and admissions? A: Let's start with admissions, since that is the office I started in when I first joined the medical school's administration full time. There, Dr. Bernardino has basically tasked me to do two things: to give the school a better class every year and to give it a class that looks more like the community. In terms of a better class every year, that can be a tough call because I don't think that the "best class" is necessarily the one with the highest grade point averages and MCAT scores. While being bright is certainly a prerequisite for being a doctor, there are many other characteristics that are important in defining what makes a good physician; for example, being personable and professional. So, in the Office of Admissions our primary challenge is to come up with a methodology for finding people who are capable of excelling in their coursework and who possess '' critical non-cognitive attributes. In terms of a class that looks more like the community, we have a great deal of diversity in Buffalo, Western ew York and throughout the state. For example, we have large African-American and Hispanic populations. Our current second-year class of 135 students, however, has only six under-represented minority students in it, which certainly does not reflect the demographics of our community. So, our challenge is to look for ways to recruit more students who will not only be competitive, but also make their class better reflect the community they are going to go out in and serve. In the Office of Medical Education [OME], our primary challenge is twofold: The first is to serve a registrar function-to track students and to produce all the paperwork that enables them to go where they need to go- and secondly, to provide a wide range of guidance and counseling services for our students. With regard to the counseling component, we find that every student who enters our school is truly unique. They all differ widely in the pressures they experience and how they respond to them, whether they be academic, financial or personal. Believe me, these are people who lead widely diverse and exciting lives, and trying to sort out reasonable solutions to their concerns or dilemmas takes up a lot of folks' time! In addition, the students need guidance counseling to help them to decide what area of medicine to choose. This can be a very tough decision. Some of the students have a family full of doctors and they've been exposed to everything, and choosing a career path is not a problem. For other students, they get to the end of their third year and they either love or hate everything and it is truly a crisis for them. ancy Nielsen, who is the dean for the third and fourth years, coaches them through this, and Chuck Severin, who is the dean for the first and second years, helps them through the early years. W int e r 2 003 l 1ffal1 Pbysicial 17 �Debbie Stamm, who is our assistant dean for student services in OME, spends a lot of time taking care of the details of daily life that may not be medicinesuch as financial aid, insurance, clubs, summer internships, special events, and so on-but these are the things that make the medical school experience tick. Some of our students are married and have children; there are just so many facets of life they need help integrating. Again, these may seem like little things, but taken together, they make the difference between a student having a good experience or a bad one. In the curriculum office, our challenge is, obviously, to give the students the education they need to be good practicing physicians, now and in the future. To accomplish this, the curriculum needs to be interesting and stimulating for both the students and the faculty and it needs to have something on the menu for all types of learners. Last year we implemented a new curriculum for the first and second years. In doing so, we switched from a discipline-based curriculum to an organ-based curriculum, where, for example, when you learn the gastrointestinal system, you learn GI physiology, pharmacology, anatomy, microbiology, and so on, because when you go out into the real world and begin practicing medicine, this is how you will need to put information together. When I went to medical school here in the '70s, we sat through lecture hour after lecture hour-a very efficient way for the teacher to stuff as much information into your head as possible, but arguably not the most effective way to learn. Adult learners like to see the relevance of what they are studying; they like to apply it, they like to be active learners. Therefore, in devising the new curriculum, the goals were to have fewer lecture hours and more interactive learning sessions and to teach the students how to go out and find their own information because, again, that's what you do once you get out and begin practicing medicine. Q: In recent years, as you have described, the Office of Medical Education has placed an increased emphasis on providing services to students, and in 1999 the position of director of student services was created. Was that a big change for OME? A: Yes, it sure was. Actually, when I went through school here, the staffing and services in OME were 18 I u II all Pb y sic i 11 Wi nt er 2003 fairly generous, but then they went through a period where they were pretty scant. I think that the staff in the office were very overextended and it was hard for them to be creative because they were running to stay in place with the basic mechanics of: Did the students have grades recorded? Have the dean's letters gone out? As a result, I think a lot of the quality-of-life issues got away from them. Every year the AAMC [Association of American Medical Colleges] has the fourth-year class fill out a graduation survey and they send the results back to the schools. Again and again, it was very clear to us at UB that the students felt they received a good basic education, but that a lot of the support services that made a difference to people weren't there. The school realized that these were not things that could be addressed by somebody as a sideline task ten minutes a day. This was a full-time job. In 1998, therefore, the position of director of student services was created, which was filled by Debbie Stamm. Debbie has done a fantastic job, and the position has assumed such importance that we recently changed the title to assistant dean for student services. Q: How is the success of the new curriculum going to be measured, and when might there begin to be results from these measurements? A: It's always hard to prove that the way you're doing something is better, particularly when the results are so far down the line. You know, who makes the best doctor is going to take time to sort out! However, in the short term, what we can measure is how they do on Step 1 of the national boards, the USMLE. Our first class in the new curriculum is coming through the second year now, so next summer we're going to know how they did on that. We have been told, however, that when schools put a new curriculum in place, they often see a dip in these scores before they see an improvement, so we are aware of that trend. For the type of curriculum we've put in place, where you tend to see the difference is when the students get into their clinical clerkships. Because this year's third-year class is the last class to go through the old pre-clinical curriculum, we're going to survey the clerkship directors to get a handle on how well prepared these students were when they walked in the door. We will be asking such questions as: Did they seem to be able to integrate the basicscience material? Were they able to think on their feet? How good were they at going and getting other resources and information and integrating it? And then we will do this for next year's thirdyear class, which will be the first through the new curriculum, to see if we have a difference. Feedback on the success of the new curriculum will be conveyed to the faculty through the appropriate committee structure-for example, the Curriculum Committee, which reports to the Faculty Council-and through Town Hall meetings. �Q: Are changes planned for the third and fourth years, as well? If so, what is the goal of these changes, and what is the timeline for their implementation? A: We do have changes planned for the curriculum in the third and fourth years, but they are not quite as sweeping. Our goal is to put some elective time into the third year for career exploration. For the students, choosing the direction they will take after graduation is a very pressured decision, and so we want to provide them with a bigger sampling of career options in their third year. Currently, the third-year students have seven-week clerkships in family medicine, psychiatry, OB-GYN and pediatrics and eight-week clerkships in internal medicine and surgery. We are proposing reorganizing the clerkships into four 12-week blocks. One 12-week block would have six weeks of OB-GYN and six weeks of pediatrics; another would have six weeks of family medicine and six weeks of psychiatry. The remaining blocks would be eight weeks of internal medicine or surgery, combined with four weeks of elective time. The four weeks during medicine could be used for any type of elective, and the four weeks during surgery will be used for the advanced-surgery elective previously required in the fourth year. This clerkship design will reduce the number of students per clerkship because, at any given time, approximately 25 students will be taking an elective. This will relieve some of the congestion on the inpatient services and in the clinics. We also plan to give all third-year students two weeks off at at the end of December and over New Year's, as students want to be home with their families during the holidays and the combination of cancelled clinics, few elective surgeries and a decreased inpatient census makes these two weeks a difficult time to teach. We are also proposing that the third year of medical school start earlier than we currently do- in early July rather than mid-August. One of the advantages of starting earlier is that it gives the students more time when they get to their senior year to either take additional electives in things they think they may want to do, or to get things out of the way to give them time to travel when they're on the interview circuit for residency positions. With regard to the timeline for these changes, we propose to partially implement them in 2003 and fully implement them in 2004. We need to phase in the earlier start date for third year to avoid overlap between the incoming and outgoing third-year class and to allow students adequate notice to adjust summer plans and financial aid. We also want to make sure we have faculty buy-in regarding the proposed changes. Q: What is the "continuity series" being developed for third- and fourth-year students, and what is its purpose? A: The continuity series-so called because it will span all 48 weeks of those clerkships we just discussed-is something we are putting in place for two reasons: The first is to keep the third- and fourth-year students connected to the school once they begin their rotations in the hospitals. We have a very decentralized clinical campus; one class can be placed in up to nine different hospitals. Given these logistics, they can lose touch with each other and the school's faculty. This is tough on the class and can be very alienating. It can also make it difficult to provide the students with the counseling they need. So, to that end, the continuity series will bring the students back on campus a couple of times a month in the evenings and will give us an opportunity to talk with them about all the housekeeping details that need to be covered and to keep them connected to one another and to the school. The second reason for starting the series is to provide a forum for introducing the students to topics that don't belong in any one place in the curriculum, but that belong everywhere. These 'orphan topics' can include ethics, professionalism, and some basic-science integration, as well as topics that are suddenly in vogue-for example, bioterrorism. Do you put that in obstetrics or pediatrics? Obviously, it doesn't really fit a particular clerkship. And yet, would you in this era graduate someone from medical school who hadn't been introduced to this topic? o, you wouldn't. So this is the continuity series, and we are piloting it in a limited fashion this year, from 6:00 to 8:00 in the CD evening on some Tuesdays. Editor's note: Part II of this conversation, which will be published in the spring 2003 issue of Buffalo Physician, will include in-depth discussion of admissions procedures and criteria, minority recruitment efforts and the role scholarships play in attracting quality students. Winter 2003 l11fal1 Hysiciu 19 �MEDICAL SCHOOL E W S Honors Convocation Recognizing medical students' achievements HE ANNUAL Ho ORS CoNVOCATION recognizing academic excellence among first- and second-year students at the University at Buffalo School of Medicine and Biomedical Sciences was held in Butler Auditorium on September 21, 2002. The following is a list of award recipients and a description of the awards received. Departmental Awards The departments in the School of Medicine and Biomedical Sciences have established awards to recognize meritorious performance in their courses as well as outstandingachievement in other curriculum-related activities. Garron Solomon, '04, has received the Department of Microbiology's Ernest Witebsky Award for Proficiency in Microbiology, which is given to the secondyear student achieving the highest grade in the microGARRO'I SOLOMO" biology and immunology course. Dr. Witebsky was the founding chair of the Department of Microbiology. Primary Care Summer Externship Program. Dr. Calkins is a former chair of the Department of Medicine. Natalie Shaw, '04, received the Department of Patholo gy's Kornel Terplan Award, presented to the student with the highest combined average in the two second-year pathology courses. Dr. Terplan was a past chair of the department. Shaw also received an Association of Pathology Chairs Honor Society Award. Carmine Grieco, '04, David Block, '04, received the Department D A\' 1[) 20 of Microbiology's Marek Zaleski Award, which is presented to the student who best combines high standards of academic achievement with outstandingservice to the community. The second-year class chooses the recipient. Block also received the BLO< K Evan Calkins Primary Care Achievement Award, which is given to one outstanding student in the laffall nysiciaa W ir1t er 2003 received the Department of Pathology's John Sheffer Award, which is given to the second-year student who has performed at the highest level in CAR\11 "1E GR IECO the laboratory portion of the courses in general and systemic pathology. Dr. John Sheffer practiced pathology in Buffalo for over 35 years and was acting chair of the Department of Pathology from 1972 to 1974. Julie Baker, '04, received The Department of Pathology's American Society of Clinical Pathologists Award for Academic Excellence, J u LIE B AKER which is presented to the second-year student who has demonstrated high academic achievement and outstanding performance in the pathology laboratory. Jennifer Nelson '04, received the Department of Pharmacology and Toxicology's Edward A. Carr, Jr. Clinical Pharmacology Award and the Douglas S. Riggs Award. The former award is given to the student achieving the highest average in the Fundamentals of Pharmacology course. Drs. Carr and Riggs were chairs of the Department of Pharmacology and Toxicology. elson also received an Association of Pathology Chairs Honor Society Award. Other Awards Neeta Chaudhary, James Hereth, Jason Hoffman, Jennifer Maclaughlin, and Eric Ko, Class of 2004, received the AstraZeneka Cardiovascular Drug Monograph Award, which is presented to second-year students by the Department of Pharmacology and Toxicology. They are based on the quality of a monograph written in the form of a package insert. �)EFFREY FEI!'<ER MATTHEW fERNAAYS Jeffrey Feiner and Matthew Fernaays, Class of 2005, received the McGraw-HillLA GE Medical Student Award, which is given to the two highest-ranking students in the first-year curriculum. Discipline Honorary Societies The Association ofPathologyChairs Honor Society awardees were Carmine Grieco, Sandy Kotiah, Jennifer Nelson, Jennifer Nowobiliski, Natalie Shaw, Class of2004. ELIZABETH BOURKE LISA ESLER ]AMES W. BOYLE DAVID LAURA CINSKI DANIELLE DORSANEO Ft ToDD ]ANICKI LY:--<OSAY ]ENNIFER KORZEN WILLMOTT- MELANIE FIORELLA TIMOTHY PARDEE BARTOS BRYAN GARGANO ERIC SCHAEFER DOROTHY STEPHEN LISA ANN DOS TAK HENDRICKS JoYcE ZMt:DA TURKOVICH SANTOS CD Dean's Letters of Commendation Years 1, 2 and 3 Dean's Letters of Commendation recognize exceptional coursework. In years one and two, they are awarded to students who earn honors grades in 75 percent of required courses or achieve 75 percent of available honors points each year. In year three, students who earn at least four honors and two high satisfactory grades are honored. Year One GLENN MILLER MATTHEW ABOUDARA MICHAEL NAZARETH KRISTINE ALGOE RYAN Ross BAUER CHADD SARA BROOKSSIENKIEWICZ CHRISTOPHER BRENNAN SHERIN HUSSAIN KAVITA MICHAEL jORDAN TIMOTHY O'HERRON YALAKONDA LAURA Clt-<SKI MICHELLE CLARK A:-.' LORI BRODERICK MANAS! KADAM KIMBERLY CARNEY JosEPH ]AY PAHADE CATHERINE CASEY ERIC Ko DIANA PRATT EsME Ft:--<LAY KRISTOPHER PAOLINO LEE CHALUPKA SANDY D. KOTIAH MARAT REYZELMAN DAVID FI:-<TAK ALFRED FRO:-.JTERA ELSON ESBIT EETA CHACDHARY KtTA jESSICA PELOW LISA ]ASON PERICAK LtsA EsLER DOS SA:--<TOS ROBERT BUCELLI RoNALD PARSONS CRISTINA LAMPURI KARl SCANTLEBLRY MARK BuRKER BETH PETERSON REBECCA CHUSID MARY LEUNG ELIZABETH ScHNEIDER BRYAN GAR(,ANO SAMANTHA CHEN KEVIN SHILEY SHAWN CIECKO DEANNA LoVALLO CORINE SEBAST }ULIF G.>.\ IN } EFFREY FEINER KEITH SIKORA DAVID CIPOLLA }ENNIFER MATTHEW FERNAAYS DALJIT SINGH GREGORY CONNOLLY ALLISON GRAZIADEI jOANNE SMITH SARA CONNOLLY ICOLE MANN ATALIE SHAW MACLAUGHLIN ICHOLAS 51 LV ESTRI GARRON SoLOMON CHRIST"A GRACZYK DoROTHY HENDRicKs 5TEPHEK HESS THOMAS GRt-BER HoUMAN VosoGHI )EFFREY DAYTON TANIA MARIANI ERIK STEINIGER Tooo ]ANICKI CRAIG HENDLER DAVID WAGNER ANNE DELLES }EFFREY MARTINEZ KEVAN STERNBERG SARA KAPROVE }ACQUELINE }ULIUS STEVEN WATSON }F. 'NIFER KoRnN FAYE ]USTICIA-LINDE THOMAS DUQUIN MEGAN MOORE ]AMES SULZER ANDREW FABIANO BRITTANY MORSE }ILL THOMAN K1>1BERELY LEONARD CAREN GELLIN EvE MoscATO MEGAN TRACY MICHELE 0BROBINA MICHAEL WEII\GARTEN • STEPHEN TL'RKO\'ICH )OHN KARPIE Year Two SAFINA KoREISHI MEGHAN ANDREWS BRIAN GIORDANO )OLENE MusCAT AMANDA KOST CATHERINE ARTMAN CARMINE GRIECO SYED MusTAFA MICHAEL LADRIGAN DANIEL BAER )ASON GuTMAN }ENNIFER MONICA LEE )ASON BARKER CHRISTINA )AMES NITZKORSKI ELIZABETH BoL•RKE ANDREA LUCZKOWSKI )A,1ES R. BOYLE )ENNIFER LYNN )AMES W. BOYLE SAMUEL McCABE HAVERSTOCK ELSON }ENNIFER WILER Year Three Ln..:DSAY WILLMOTT BARTOS )OYCE Z.\1l DA OWOBILISKI W i 11t e r 2 00 3 1 111111 Hysici11 21 �MEDICAL SCHOOL E W S Sung Scholars Named M oLLY M ooRE H ANG K YU P ARK Molly Moore and Hang Kyu Park, Class of2006, are the recipients of this year's John J. and Janet H. Sung Scholarship. Moore, a native ofHamburg, ew York, earned a bachelor of arts degree in biomedical sciences from University at Buffalo. "I wish to express my sincere gratitude to Dr. Sung and Mr. Sung, and I'm honored to be a recipient of their generous gift," says Moore. Park, who was born in Korea and immigrated to the United States in 1994, earned a bachelor of science degree in chemistry from Queens College, CUNY. "I am fortunate to be accepted to UB's medical school," says Park. "Furthermore, I am very honored to be recognized as a Sung scholar. This scholarship enhances and enriches my educational experience at UB and encourages and assists me to be successful academically. I have had the chance to meet many helpful and wonderful people because of the Sung scholarship." The Sung Scholarship is funded by a $1 million gift to the University at Buffalo School of Medicine and Biomedical Sciences by John and Janet Sung, who came to the United States from Korea in 1972 with only $200 to complete their education. At the time, they had two dreams: to attain their educational goals and to establish a renowned clinic in radiology, both of which have been realized. Medical Alumni Association Scholarship Lori-Ann Oliver and Jodi-Ann Oliver, Class of 2006, are recipients of this year's Medical Alumni Association Scholarship. The scholarship is made possible by the generosity of the alumni through their reunion gifts designated to the Medical Association endowment fund. Recipients are selected by the admissions committee according to considerations of financial need and academic merit based on the incoming students' applications. The Olivers, twin sisters, were born in Jamaica and raised in Queens, ew York. They attended Cornell University and earned bachelor of arts degrees in English in 2001. 4D - S. A . UNGER 2 2 11flal1 Hysiciao Wr11ter 2003 �Thomas J. Lawley, MD, an internationally known expert in autoimmune skin disease and Dean and William P. Timmie Professor of Dermatology at Emory University School of Medicine, is the recipient ofthe University at Buffalo's 2002 Distinguished Medical Alumnus Award. Lawley was presented the award on September 19,2002, by Patricia Duffner, MD '72, president of the UB Medical Alumni Association, at a dinner held at the Buffalo Club. fter graduating with honors from UB's school of medicine in 1972, Lawley trained in dermatology at Yale University School of Medicine, UB and the National Institutes of Health (NIH). Following completion of his training, he stayed on at the NIH, where he rose to the rank of senior investigator in the Dermatology Branch of the National Cancer Institute(NCI). In 1988, Lawley left the CI/NIH to become chair of the Department of Dermatology at Emory University School of Medicine. Under his leadership, the faculty grew six-fold and the department went from having no NIH funding to becoming the third highest NIH-funded department in the country. Lawley, whose research interests include the cell biology of endothelial cells and the regulation of cell adhesion molecules and inflammation, has published more than 150 original articles and book chapters. In 1996, Lawley was appointed dean of the Emory University School of Medicine, having served the previous year as interim dean and executive associate dean. In this role, he has focused on creating and implementing two critical strategic plans. Under the research plan, he has recruited more than 80 new scientists and has fostered the establishment of several interdisciplinary centers. He has also established the Dean's Scholar Program, which protects the research time of clinician scientists and Distinguished Medical Alumnus Thomas J. Lawley, MD '72, left, being congratulated for his outstanding contributions to research and education by Patricia Duffner, MD '72, right, president of the Medical Alumni Association. fulfills all 25 goals outlined by his comprehensive plan. During Lawley's tenure as dean, the amount of research space in the Emory University School of Medicine has doubled and the amount of research funding increased by 150 percent. Under the teaching plan, Lawley has increased scholarships, created the Dean's Teaching Awards, expanded the MD/PhD Program and developed plans for a new Medical Education Building. In addition to spearheading these strategic initiatives, Lawley takes a proactive role in overseeing the clinical enterprise at Emory and its affiliated sites and has continued to see patients on a regular basis. As a result of these and other initiatives, the Emory School of Medicine has risen dramatically in rankings to become one of the outstanding medical schools in the nation since Lawley assumed the role of dean in 1996. Over the years, in addition to his academic responsibilities, Lawley has served on many national boards and committees, including NIH study sections and the National Advisory Allergy and Infectious Diseases Council for the National Institute of Allergy and Infectious Diseases of the NIH. He is president of the Emory Medical Care Foundation and chair of the board of directors of the Emory Children's Center. He also serves on the board of directors of the Emory Clinic, Emory Healthcare, and the Emory Children's CD Research Center. -S. A. UNGER Wi11ter 2003 llffal• Pkysicia1 23 �PATHWAYS NEws ABOUT UB's ScHOOL OF MEDICINE AND BIOMEDICAL SciENCEs AND ITS ALUMNI, fACULTY, STUDENTS AND STAFF Velazquez Named Interim Chair VELAZQUEZ 24 laffa le H ys ic i aa Mallory Institute of Pathology and Boston University Medical Center in Boston, Massachusetts. Velazquez is board certified in clinical pathology and is currently enrolled in the Master's in Health Care Administration and Policy Program at Harvard University. Francisco Velazquez, MD, has been named interim chai r of the Department of Pathology and Anatom ical Sciences in the University at Buffalo School of Medicine and Biomedical Sciences. Velazquez has held -S. A. UNGER the rank of clinical associate professor since August 2000 Robotic Surgery Specialist and has also served as pathologist-in-chief Celeste M. Hollands, MD, a at Kaleida Health. pioneer in pediatric robotic Recently, he was surgery, joined Children's appointed division Hospital of Buffalo in commissioner for Western September 2002 as clinical New York for the College director of the of American Pathologists' Miniature Access Laboratory Accreditation Surgery Center Program. (MASC) and Velazquez has held the Miniature academic appointments Access Teaching, at Boston University Training and School of Medicine and Robotic Research H OLLANDS Wayne State University Center (MASTin Michigan. He received TARR), located at the Unihis medical degree from versity at Buffalo School of Universidad Central del Medicine and Biomedical Caribe, Puerto Rico, and Sciences. Hollands, who has served his residency at the also been named associate Wznter 2003 professor of surgery and pediatrics at UB, debuted robotic surgery at the MASC on September 27, 2002, when she operated on two children using this new technology. The procedure was telecast live to UB's School of Medicine and Biomedical Sciences, where twenty-four pediatric surgeons-in-training from various institutions throughout orth America viewed it as part of a two-day advanced training course in pediatric surgery hosted by UB, CHOB, the MASC and the MASTT ARR. "We are very fortunate to have Dr. Hollands as a member of the Children's Hospital staff and the UB medical faculty," says Philip L. Glick, MD, surgeon-inchief at CHOB and professor and interim chair of surgery at UB. "She is one of the few pediatric surgeons in the world to work extensively with robotics. Her work is ground breaking." Hollands earned her medical degree at the �University of South Alabama researchers College of Medicine. She in science, completed her general medicine and surgery training at the engineering Graduate Hospital of the honored at a University of Pennsylvania special dinner and her pediatric surgery held last training at Miami Children's October in TREY! SAN Hospital. Her research Albany. interests include pediatric Trevisan is interim dean of trauma and surgical educathe School of Health Related tion in addition to miniature Professions and professor and access surgery, robotics and chair of the Department of new technologies as they Social and Preventive apply to these fields. Medicine (SPM) in the UB "The work we will be School of Medicine and doing here at Children's will Biomedical Sciences. A UB faculty member since 1985, be paving the way for other types of robotic surgeries," he is director of the Center for says Hollands. "Eventually, Preventive Medicine-part of we will find ways to use this the Women's Health Initiative-as well as SPM chair. technology to help very tiny He has served as interim dean infants and possibly even for of the School of Health surgery in the womb. I am very excited about the Related Professions since prospect of finding new and September 1, 2001, and in better ways to perform that capacity is spearheading surgery on infants." an effort to create a School of The two-day training Public Health and Health program was sponsored by Professions at UB. Ethicon Endo-Surgery, Inc., A prolific researcher, Stryker Corporation, ComTrevisan has authored or puter Motion, Inc., Berchtold, co-authored more than 110 B-K Medical Corporation, articles in scholarly publications and LSI Solutions. and delivered numerous - S. A. UNGER presentations at national and international meetings. A recipient of grants from such Trevisan Receives Chancellors' Award funding entities as the ational Institutes of Health, Maurizio Trevisan, MD, was the American Heart Associaone of three University at tion and the ational Cancer Buffalo faculty members Institute, his current work is selected to receive Chanfocused on cardiovascular cellor's Research Recognition disease epidemiology. Awards for 2002 and was among leading SU Y - SuE WuETCHER Kaiser Named Interim CEOatECMC The Erie County Medical Center (ECMC) Board of Managers has appointed Roger E. Kaiser Jr., MD '79, interim CEO of the ECMC Health care Network. Kaiser, who is an associate professor of clinical anesthesiology in UB's School of KAISER Medicine and Biomedical Sciences, currently serves as ECMC's medical director, as well as clinical director of its Department of Anesthesiology. Kaiser agreed to fill the pos1t1on in ovember 2002 while the ECMC Board of Managers completes its search for a permanent CEO to replace Sheila K. Kee, who stepped down from this role on October 31, 2002. -S. A. UNGER Book on Children's Mental Health David Kaye, MD, associate professor of clinical psychiatry, and Maureen Montgomery, MD, assistant professor of clinical pediatrics at the University at Buffalo, have authored KAYE a text titled W i nte r the Handbook of Child and Adolescent Mental Health, along with Stephen Munson, MD, associate professor of psychiatry and pediatrics at the University of Rochester. Published in October 2002 by Lippincott, Williams and Wilkins as part of its "Core Handbooks in Pediatrics" series, the book is intended to be a practical, handson guide for primary care physicians. Its authors took special care to integrate the perspectives of both mental health professionals and pediatricians, explains Kaye, who adds that the book fills a niche in an area of increasing importance in health care. "There are large numbers of children and adolescents with mental health problems presenting to primary care physicians, and yet there is no single source of treatment information available to guide the practitioner on the front lines," he says. "Pediatricians are increasingly asked to prescribe psychotropic medications, and we hope this book will help them make more informed decisions." In addition to addressing common mental health problems seen frequently in practice, the book explains the various systems involved 20 0 3 I I ffI II Pb J SiC iII 25 �PATHWAYS in children's mental health (i.e., school, social services, the legal system, the mental health system ). By blending the perspectives of child psychiatry and general pediatrics, "the authors present a pragmatic and current approach to issues of office evaluation, assessment, and treatment, including pediatric psychopharmacology," according to the publisher. - S. A . U N G ER .lames Waxmonsky .loins Psychiatry from Cornell University in 1992 and a medical degree, James G. Waxmonsky, MD, summa cum laude, from UB in joined the University 1996. He completed at Buffalo School of residency training in Medicine and adult psychiatry in the Biomedical Sciences UB Medical-Dental in September 2002 as Consortium in 1999. assistant professor of Following residency psychiatry. He is training, he comaffiliated with the pleted a fellowship in Children's Hospital WAXMONSKY child and adolescent of Buffalo, where he psychiatry at serves as the primary psychiaMassachusetts General trist in the Outpatient Hospital (MGH) and a Behavioral Health Unit. psychopharmacology research Waxmonsky earned a fellowship, led by Dr. Joseph bachelor of science degree Biederman, also at MGH. Waxmonsky's primary research interests include the pharmacological treatment of children with bipolar disorder and attention-deficithyperactivity disorder (ADHD) and treatment of adolescent addictions, as well as adults with ADHD. - S. A . UN G ER Ferrick .loins Orthopaedics Michael Ferrick, MD, has joined the pediatric orthopaedic surgery staff at the Children's Hospital of Buffalo and has been appointed When is a house more than a home? ... When it is a Patio Home at Canterbury Woods. Come and learn more about what makes our new Patio Home Community so unique. Informational Seminar Seating is Limited Call 929-5817 To Reserve your Date and Time Episcopal Church Home and /tffiliE.tes 26 l tffllt nysiciiD Winter 2003 $ 705 Renaissance Drive, Williamsville, NY 14221 �clinical assistant professor of orthopaedics at the University at Buffalo School of Medicine and Biomedical Sciences. FERRICK A Buffalo native, Ferrick graduated, summa cum laude, from the University of otre Dame in 1987. He earned a medical degree from the University of Michigan in 1992, after which he returned to Buffalo for residency training in orthopaedic surgery. From 1997 to 2001 Ferrick served as an active-duty orthopaedic surgeon in the United States Army, and in 2002 he completed a fellowship in pediatric orthopaedics and scoliosis at the Texas Scottish Rite Hospital for Children in Dallas, Texas. Ferrick's research and clinical interests include pediatric spinal deformity and childhood lower-extremity disorders. - S. A. UNG ER Stamm Named Assistant Dean Debra L. Stamm has been promoted to assistant dean for student services in the Office of Medical Education (OME) in University at Buffalo's School of Medicine and Biomedical Sciences. She previously served for three years as director of student services in OME. In her new position, Stamm STAMM continues to advocate for students and to act as a liaison between the student body and the school's administration. She also serves as a resource person for student clubs and organizations recognized by Polity, coordinates summer programs for students and assists with the implementation of MedCAREERS, a fouryear career planning program created by the Association of American Medical Colleges to help medical students select a specialty. Stamm earned a bachelor of arts degree in psychology at "We practice law for your peace of mind." Estate Planning - Personal Injury Real Estate - Matrimonial Elder Law One john james Audubon Parkway Amherst, New York 14228 716.636.7600 H oGAN & W ILLIG, PLLC - - - - - Attorneys a t Law - - - - - hoganandwillig.com Winter 2003 l 1ffal1 Pbysicia1 2 7 �PATHWAYS the State University of ew York at Genesee in 1992 and a master of education degree in college counseling and student personnel administration at UB in 1995. Prior to joining the staff in OME in September 1999, she was admissions coordinator in the Offices of Admission and Financial Aid at Harvard Medical School in Boston, Massachusetts. -S. A. UNGER Chief of Thoracic Surgery at RPCI Todd Demmy, MD, has been named chief of the Thoracic Surgery Division at Roswell Park Cancer Institute (RPCI) and associate professor of surgery at the University at Buffalo School of Medicine and Biomedical DEMMY Sciences. Demmy comes to Buffalo from the University of Missouri Hospital and Clinics, Columbia, MO, where he served as chief of thoracic oncology, associate professor of surgery in the Division of Surgical Oncology and Cardiothoracic Surgery and co-director of the Cardiac Transplant Program. He earned his medical degree at Jefferson Medical College, Philadelphia, PA, in 1983, and completed residency training in general surgery 28 llffal1 Hysiciaa (1988) at Baylor College of Medicine, Houston, TX, and in cardiothoracic and cardiovascular surgery (1991) at Allegheny General Hospital, Pittsburgh, PA. Demmy is a Diplomate of the American Board of Thoracic Surgery and the American Board of Surgery. Although he has had laboratory and human research projects in both heart and lung surgery, he is joining RPCI to focus his efforts on thoracic oncology. His research interests include the minimally invasive management of tumors of the lung, esophagus and central portion of the chest. - DEBORAH PETTIBONE Kuvshinoff .Joins Surgery at RPCI Boris W. Kuvshinoffll, MD, has joined the Division of Gastrointestinal Surgery at Roswell Park Cancer Institute and has been named assistant professor of surgery at the University at Buffalo School of Medicine and Biomedical Sciences. Kuvshinoff comes to Buffalo from the Ellis Fischel Cancer Center, Columbia, MO, where he served as chief of the Section of Hepatobiliary and Pancreas Tumors, Division of Surgical KuvSHINOFf Wr11t er 2 00 3 Oncology, and interim chief in the Division of Surgical Oncology, Department of Surgery, at the University of Missouri HealthCare. He earned his medical degree from the University of Maryland (1986) and completed residency training in the Department of Surgery (1993) University of Cincinnati Hospital and a fellowship in Surgical Oncology (1995) at Memorial Sloan-Kettering Cancer Center. Kuvshinoff is boardcertified in general surgery (1995) by the American Board of Surgery. His research interests include radiofrequency ablation of primary and secondary liver tumors and neoadjuvant therapy with sphincter-sparing surgery for low-lying rectal cancers and the surgical treatment of hepatobiliary and pancreatic malignancies. - DEBORAH PETTIBONE Ciovino Receives Doii/Wynder Award Gary Giovino, PhD, a tobacco control specialist in the Department of Cancer Prevention, Epidemiology and Biostatistics at Roswell Park Cancer Institute and a research professor in University at Buffalo's Department of Social and Preventive Medicine, received the Doll/ Wynder Award during the 2002 annual meeting of the Society for Research on icotine and Tobacco (SRNT) in Savannah, Georgia. Giovino is only the second winner of this prestiGIOVINO gious award, which is presented every three years. The award honors scientists who have made ground breaking advances in public health, public policy or epidemiological research, focused on tobacco use and the consequences of smoking on populations of smokers. The award is named after Sir Richard Doll and Dr. Ernst Wynder, whose influential research in the 1950s clearly established the link between smoking and lung cancer. Giovino is recognized internationally for his contributions to the measurement of tobacco use. In April 2002, he received a four-year grant of approximately $3.5 million from the Robert Wood Johnson Foundation to conduct a comprehensive survey to assess youth smoking cessation needs and practices. - DEBORAH PET T IBONE O'Connor and Fakih .Join Medicine Two medical oncologists have received joint appointments to Roswell Park Cancer Institute (RPCI) and to the University at Buffalo School of Medicine and �Biomedical Sciences, where they have been named assistant professors of medicine. Tracey L. O'Conner, MD '97, will serve in the Breast Cancer Division at RPCI, and Marwan G. Fakih, MD, in the Gastrointestinal Cancer Division. After earning her medical degree from UB in O'CONNER 1997, O'Conner completed residency training in internal medicine at Strong ., """ ,.,, Memorial Hospital, University of Rochester Medical Center, in 2000 and a fellowship in medical oncology at RPCI in 2001. She is board certified in internal medicine by the American Board of Internal Medicine and is a member of the American Association of Cancer Research and Alpha Omega Alpha Honor Medical Society. Her research interests focus on novel treatments for breast cancer and supportive care therapies for patients with advanced disease. Fakih comes to Buffalo from the University of Pittsburgh School of Medicine, where he served as assistant professor of medicine. He earned his medical degree at the American University of Beirut, Lebanon, in 1992 and completed residency training in internal medicine at Wayne State University in 1995 and a fellowship in hematology and oncology at the University of FAKIH Pittsburgh in 2001. He is board certified in internal medicine and medical oncology by the American Board of Internal Medicine, and is a member of the American College of Physicians, the American Society of Hematology, the American Society of Clinical Oncology and the European Society of Medical Oncology. His research interests include the development of novel treatments for patients with gastrointestinal malignancies. - DEB O RAH PETTIB O NE GENESEE HEARING SERVICES THE AUDIOLOGY CENTER 61 Wehrle Drive (Near Harlem) Amherst 14225 630 Orchard Park Rd. (Near Ridge Rd.) West Seneca 14224 837-6213 712-2000 • Diagnostic audiometric evaluations (pediatric and adult) • Digital & programmable hearing aid fittings on 60 day trial basis • Tinnitus evaluation and therapy • Vestibular evaluation for patients with dizziness/vertigo • Vestibular therapy • State of the art facilities "The Ear is the Road to the Heart" ( Voltai re) Daniel Schneider, AuD Jennifer Schneider, MA Win t er Jerri Kaplan Joyce, MA 2003 111111 1 Pbysicill 29 �PATHWAYS Western New York Pioneers of Science The inaugural Western ew York Pioneers of Science Educational Conference and Awards Banquet, sponsored by the Hauptman-Woodward Medical Research Institute, was held on October 30, 2002. The purpose of the awards is to focus public awareness on the many significant scientific advancements that have been developed in our region and to recognize those individuals who have achieved prominence through their discoveries. Among those honored at this event were the following members of University at Buffalo's medicalscientific community and affiliated institutions: T. MingChu, PhD, DSc, a research professor at Roswell Park Cancer Institute, developed the PSA (prostate specific antigen) test, which has revolutionized the detection of prostate cancer and become the world standard for early detection. Chu received postdoctoral training at Hauptman-Woodward Medical Research Institute, University at Buffalo and Buffalo General Hospital. Currently, he is engaged in research that focuses on the immunodiagnosis of pancreatic cancer. John A. Edwards, University at Buffalo professor emeritus of medicine and founder of the Alzheimer's Disease Assistance Center of Western New York, died October 28, 2002, in Sisters Hospital. He was 66. Edwards, who retired from UB in 2000, had been acting head of the Division of Geriatrics/ Gerontology in the School of Medicine and Biomedical Sciences. Dr. Wilson Greatbatch is known for inventing the implantable cardiac pacemaker and for introducing the long-life lithium iodine battery into medical usage. He has dedicated his life to studying interdisciplinary areas combining engineering with medical electronics, agricultural genetics and the electrochemistry of pacemaker batteries. He is currently adjunct professor of electrical engineering at the University at Buffalo. Herbert A. Hauptman, PhD, a world-renowned mathematician, received the obel Prize in Chemistry in 1985 for a mathematical formula known as direct methods. His work changed the field of chemistry and began a new era in molecular structure determination of crystallized materials. He is currently president of Hauptman-Woodward Medical Research Institute and a UB Distinguished Professor in the Department of Structural Biology. Anative of Hawarden, Wales, Edwards obtained medical degrees from the University of Liverpool in the United Kingdom in 1959 and trained in internal medicine in the U.K. He came to Buffalo in 1967 and completed atwo·year fellowship in medical genetics at the University at Buffalo School of Medicine and Biomedical Sciences. He joined the UB faculty as aresearch assistant professor of medicine in 1969. Edwards received aNational Institutes of Health Research Career Development Award and was a member of the American Posthumously Lawrence D. Jacobs, MD, was chair of University at Buffalo's Department of Society of Clinical Investigators, eurology and head of the Jacobs eurological Institute at Buffalo General Hospital, which is affiliated with UB. A dedicated physician-scientist, he was world renowned for groundbreaking research on multiple sclerosis and for the development of new treatments for this disease. the American Foundation for Clinical Research and the New York Academy of Sciences. He was medical director of the Episcopal Church Home Long Term Care Facilities and Adult Day Program, and was a member of the Episcopal Church Homes board. He also was president of the Amherst Senior Center advisory board. 30 l ufllil Pbpitill W i n ter 2003 �New Web Index to the Buffalo MedicalJourna1(1845-1919) The Buffalo Medical Journal, published from hospitals and discoveries, 1845 through 1919, contains original submis- • contain obituaries and biographies about Education Services, and linda Lohr, manager of Sharon Gray, former head of Reference and sions by Buffalo and Western New York physi- Western New York physicians and nurses the Robert L. Brown History of Medicine Col- cians, including case studies, editorials and • chronicle the UB medical school and regional lection in the Health Sciences library, Jed the articles, as well as reprints of articles published medical history. in other American and foreign medical journals of the time. project and established criteria for articles. Un- Also included are select editorials by Buffalo der the direction of Corinne Jorgensen, PhD, Medical Journal editors. (The first editor of the students in the UB Department of library and Because indexing for this publication was journal was Austin Flint, MD, a founding faculty Information Studies completed half of the in- inconsistent and sporadic, a comprehensive in- member of the then-University of Buffalo School dexing (nearly 1,200 articles). dex in a single, searchable site on the web has of Medicine. A professor of medicine as well as Funding for the project was provided by the recenUy been compiled, increasing access to the the medical school's first registrar and treasur- Friends of the Health Sciences library and the journal's unique information for those interested er, Flint edited the journal from 1845 to 1855.) Western New York library Resources Council. in the medical history of Western New York. The database includes articles that: The indexing project was a collaborative Mouse Calls is compiled by Pamela M. Rose, effort between the UB Health Sciences library, MLS, Health Sciences Library, University at Buf- • are written by Western New York physicians the UB Department of library and Information falo, 3435 Main St., Buffalo, NY 14214, (716} • describe Western New York heaHh issues, Studies, and the UB University libraries. 829-3900, ext 129; prose@acsu.buffalo.edu. ' · Chofce Employee Benefits G roup LLc THEN GET TO BUFFALO. Pressure at your current pos1t1on JUSt too much to handle? Is your pract1ce giVIng you way too many headaches? If so. then 1t ~ t1me to shuffle off to Buffalo' ? Worned about the snow? No sweat. Buffalo only averages about 25 days of snow a year Snowfalls that would bnng l1fe 1n some Cities to a gnnd1ng halt are no problem here' And our average summer temperature IS a perfect 79 degrees e Here's what we've got! Physicians Ufet1me Health IS a not-for-prof1t complete care prov1der featunng state of the art health centers. We are seeking BC/BE physiCians to JOin our prest1g1ous roster of health care professonals Find out how Ufet1me can f1t your 1fe by send1ng CV to: Physician RecrUitment. Lifetime Health. 205 Park Club Lane. Buffalo. NY 14221 PH 877-217-7465 FAX 310-917-5062 EMAIL: lscreeney@earthllnknet Lifetim e Health (716) 631-3614 • Toll Free: 877-552-1508 w wwfitsyo uri ife.com Equal Opportun1ty Empl ' JP.f m/f/d, e-mail: hs@choice4benefits.com web: www.choice4benefits.com 6633 Main Street • Williamsville, Winter 2003 ew York 14221 1111111 Pbysiciae 31 �era otential outcomes for the newly christened post- The Structure of Proteins genomic era have been widely prophesized and pub- At the UB Center of Excellence in Bioinformatics, one aspect of licized: The development of drugs targeted to an research focuses on predicting the structure of proteins of a individual's genetic profile. The elucidation of ways certain size-below a couple of hundred amino acids-and all biochemical processes interact in the human body. figuring out how they fit into the extremely complex biology of The creation of precise methods of diagnosing condi- both normal function and disease. tions and treating them with minimal side effects. "Ultimately, we' re trying to reduce the lead time for drug Key to translating these theoretical potentials into development, not for one molecule or a few, but for hundreds concrete results is the relatively young science of bio- or even thousands," Skolnick explains. informatics and the ability ofbioinformaticians to acWithout the power of the CCR's supercomputers, this recess and leverage the exponential power of supercomputers. search would not be capable of fulfilling its cutting-edge At the University at Buffalo's Center of Excellence in Biopotential. "Even if each simulation of each protein took informatics, director Jeffrey Skolnick, PhD, UB Distinfive days of computer time, and even if you're looking guished Professor, and his research team have access to BY at just 14,000 protein structures (the small proteins in ELLEN this indispensable computing power and are focusing all the human genome), then you're talking about 70,000 GOLDBAUM their efforts on leveraging it to its maximum capability. days to predict protein structure on a single computer In fact, when describing computing capability at UB processor," says Skolnick. these days, the word that often comes to mind is "staggering." "So if you don't have on the order of several thousand proThat's because in September 2002 a new Dell supercomputer cessors, you just can't reasonably do it. But if you have 4,000 cluster was installed in the university's Center for Computational processors, which we do, then, theoretically, it could take only Research (CCR). 18 days," he predicts. Weighing more than 80,000 pounds, the cluster has a capacity And that's only for one genome. Skolnick and his colleagues in to perform 5.8 trillion operations per second; it contains 4,120 the Department of Structural Biology in the UB School of Pentium processors, more than 2 trillion bytes of random access Medicine and Biomedical Sciences are studying numerous gememory and 160 terabytes of storage. nomes, including those of pathogens and organisms such as the Currently more than 50 scientists at UB are engaged in mouse, the basis for many models of important human diseases. bioinformatics research in the fields of genomics, proteomics, They also are studying less complex genomes, an understandbiophysics, biology, pharmaceutics, chemistry and computer ing of which will provide the basis for better approaches to the science. Many, like Skolnick, will use the supercomputers in the human genome. CCR for their research, which ranges from molecular-structure After important protein structures are determined-a huge determination and computational chemistry to materials sci- undertaking in itself that requires collaboration with experi- �mentalists-comes what Skolnick calls "the hard part," the analysis of each structure to determine its role in biochemical function and how it may both influence, and be influenced by, cellular processes involved in disease. "Ultimately, what we want to do is to relate genotype (what's happening genetically) to phenotype (what's happening clinically)," he says. "What we want to find is, What's the physiological manifestation of this protein structure in this cellular pathway? "The overall goal is to develop personalized medicine, which is based on understanding how a drug affects one person versus how it affects another, " he adds. the interacting proteins that will help scientists discover their role in biochemical pathways. "That's what our method aims to do," he continues. "Using our supercomputer, we can start to see how the path fits together, how this enzyme interacts with that small molecule, or functions in a cascade of cellular processes. "Ultimately, you want to know how the expression of these particular molecules relates to a particular phenotype; for example, whether a particular set of proteins causes a certain kind of cancer," he says. Appetite for Data Connecting the Dots kolnick and his team already are making headway in connecting those dots. In the November 15, 2002 issue of Proteins, the team published results developed while Skolnick was at the Danforth Plant Science Center in St. Louis that provide the first large-scale (genome-based) ability to predict protein-protein interactions. * "With that research, we are now moving toward an understanding of how the whole system works-what's known as systems biology, which is the key revolution in the post-genomic era," he explains. According to Skolnick, the Protein Data Bank, the international "public library" of solved protein structures from which scientists draw data, contains not just isolated molecules but in many instances solved compounds of two or more proteins interacting with each other. "Lots of cellular signals are mediated by these protein-protein interactions," he explains, "but it's a very crowded party, and we want to know exactly who's interacting with whom. Often, the function of one protein can be deduced by studying the proteins with which it interacts." Skolnick conjectures that perhaps there are hundreds of millions of these interactions, a seemingly intractable problem. However, he adds that the process is greatly accelerated if you have a computational method that helps pinpoint the sites on For bioinformaticians like Skolnick, these unprecedented challenges carry with them unprecedented opportunity, for these scientists are getting a first glimpse of the dazzling array of complex cascades of the biochemical activities that make up human life. "Right now, there are only about 500 proteins that are targets of existing drugs, and there are 35,000 genes," explains Skolnick. "The questions we are going to attempt to answer include exploring what makes a drug target a drug target? Can we predict interesting drug targets? Can we suggest cocktails of drug leads? "There is an immense and voracious appetite out there for the kind of data we are generating. " If the post-genomic era lives up to its promise, then experimentalists working in laboratories around the world will eagerly devour these fresh computational results and in the years ahead will translate them into findings that, step by step, will guide the development of medications whose power and precision can today only be imagined. 4D •For a detailed description of the article published in the November 15, 2002. issue of froteins by Skolnick and his team in which they describe a promising new algorithm they have developed that can predict interactions between proteins whose struc· tures are unsolved, visit the University at Buffalo's New Services Web site at http:// www.buffalo.edu/news and enter the keyword "Skolnick" in the search engine. �RESEARCH E W S Virtual Surgery, Virtual Organs Living Anatomy Program takes on a life of its own esearchers at the Uni- if I could learn how to do an versity at Buffalo are operation that poses a high combining 21st-century mortality risk-one I may materials and comput- never see until I'm called to erized sensors to create do it at 3 p.m. on a Tuesdaya simulator for surgical if I can find a way to allow training with "organs" that people to learn surgery techfeel, smell and respond like liv- niques quickly and efficiently, it could save lives."' ing tissue in the human body. That was in 1993. Today The work is being led by David Fineberg, MD, clinical Fineberg is working with UB assistant professor of surgery computer scientists, engineers, and oral and maxillofacial sculptors, materials experts, in the UB School of Medicine pharmaceutical firms, highand Biomedical Sciences, who school curriculum coordinawants to change the way sur- tors and a veterinary school to create a surgical version geons train. In fact, he of a simulator he has also wants to change BY named "The Living LOIS the way content is deBAKER Anatomy Program." livered across many In the process, he has industries and disciplines, including the teaching come to believe that the technology being developed for a of mathematics and science. Fineberg's idea took shape surgical simulator could have nearly 10 years ago when he applications far beyond that was a trauma surgery resident original goal. at Erie County Medical Center. ''I'm interested in creating a A young woman arrived at profound, in-depth immersion the hospital with internal in- into content through a technojuries sustained in an automo- logy platform based on interacbile accident the day before tive physical-virtual models," she was to be married. The im- says Fineberg. "Users will be pact had ripped her liver from able to enter, become immersed its tethering vessels, and her ab- in and manipulate computerdomen was filled with blood. generated content in a very The trauma team worked for natural way by using their three hours in a frantic but fu- hands-a development that tile attempt to save her life. represents a new step in the 'Til never forget that," says evolution of a human-systems Fineberg. "It really affected me. approach to interface developI thought, 'If! had had a model ment. This can be accomplishto practice that procedure on, ed with custom-made physical 34 ltffalo Physician Wi11ter 2003 objects that direct motion of related virtual models." In referring to "a humansystems approach," Fineberg explains that he is collectively describing a myriad of interrelated components that are customized to represent sensory systems of the human body in order to allow, for example, a surgeon-in-training to communicate more effectively with an artificially generated environment. In the case of the Living Anatomy Program, "the sensation of touch and its relationship with vision is the focal point," he explains. Fineberg sees a variety of potential applications, from teaching math and science to high school students, to using simulation to train workers to perform potentially risky tasks, such as operating industrial machinery, without actually putting them in harm's way while they're learning.'Tm looking to change the way content is delivered across all industries and disciplines," he says. The surgical simulator would showcase the technology's potential and function as a prototype for this human/virtual reality interface. Prospective surgeons, like all medical students, learn about the body from a cadaver, which is useful but far from optimal, says Fineberg. "A cadaver is cold, hard and preserved. It bears little resemblance to the living body. "With a surgical simulator, surgeons-in-training could learn, for example, how a ruptured spleen feels or how to locate a torn blood vessel in a blood-filled abdomen." �FINEBERG WILL USE 21ST-CE TURY MATERIALS AND ENDOW THE MODELS WITH COMPUTERIZED SE SORS TO CREATE PSEUDO-ORGANS THAT WILL FEEL, SMELL A D RESPO D LIKE LIVING TISSUE I Fineberg and Thenkurussi Kesavadas, PhD, UB associate professor of mechanical and aerospace engineering and director of UB's Virtual Reality Laboratory, have begun working toward that goal, one organ at a time, with $100,000 in development funds from the ew York State Office of Science Technology and Academic Research (NYSTAR). rgan models, per se, are nothing new, but Fineberg's organs will be unlike anything that exists currently. He will use 21stcentury materials and endow the models with computerized sensors to create pseudoorgans that will feel, smell and respond like living tissue in the body. "This has not been done before," says Fineberg. "You have to have someone who knows what human organs feel like committed to the project to make it work. o one even comes close to our technology of combining these organs with the computer interface." To date he has made molds of the liver and spleen using cadaveric organs as models . He is now working with Polytek, a materials company, to find polymers that feel like living tissue with which to fill the molds. The University of Ottawa Heart Institute's Medical Device Department has also offered engineering assistance and mentoring services on the project. THE BODY. Translating the tactile information into electronic data falls to Kesavadas. He is helping to capture the properties of human tissue using his virtualreality glove, a device that collects data on what the wearer is feeling through sensors located in the glove's fingertips. Kesavadas is creating a database of information that describes the biomechanical properties of soft tissue under various conditions. Just as flight simulation involves more than manipulating instruments on a panel, surgical simulation, to be truly representative of reality, must recreate the sense of urgency and controlled chaos of the surgical suite. "There is a complex atmosphere that exists in a surgical setting that must be reproduced for a realistic simulation," Fineberg says. "That includes sound, people walking around, and algorithms of activities that are occurring. A computer-generated environmentcan capture much of this." Before the project can reach this point, the model organs likely will have a first life as individual teaching tools . Fineberg plans to market them and the technology platform for a number of uses to generate funds to finish the surgical simulator prototype. A firm in Rochester, ew York, is interested in marketing a complete set of organs for teaching biology and anatomy. Veterinary schools also have shown interest in models of dog organs for use in training veterinary surgeons. (Washington State University's College of Veterinary Medicine is currently formalizing a relationship with Fineberg to install a lab to use his models as alternatives to live dogs in the training of veterinary surgeons.) The spleen model will be marketed to physicians who treat bloodrelated diseases. Kesavadas is working on a virtual-reality "overlay" of the spleen, which could make it appear to be injured, inflamed or of a particular age. Fineberg plans next to produce a "liver trainer," for use by anyone who needs to learn the liver's physiology; a pancreas model will follow. "What we are working toward doing is linking spatial position and motion of physical objects with related images in a computer-generated visual scene, so that we can selectively control objects in a virtual world," Fineberg says. "This will allow us to merge the physical with the virtual. We cannot do this without quite a bit of front-end development in both the physical and the virtual area, and that is what we are doing now." <P for every ring purchased a $10 donation will be made to the University at Buffalo alumni fund / February 12th·14th , 10am to 4:00pm place an order call 1.800 .424.1492 or visit www.jostens.com C 2002 Jostens Inc. Printed in U.S.A. 02·0920 Winter 2003 l11fale Pbysiciae 35 �RESEARCH E W S Rich Vein of Data Women's Health Initiative a catalyst for new studies hen researchers in the University at Buffalo School of Medicine and Biomedical Sciences began recruiting women to participate in the three-pronged Women's Health Initiative (WHI) in 1993, the relationship of gum disease to osteoporosis was not one of the questions they were seeking to answer. generation, all of which The goal ofWHI is to BY are direct spin-offs of gather essential clinical LOIS the original initiative. BAKER data on the major disToday, a decade after eases affecting women, the initiative was launched, hun- using women as subjects. With dreds of other spin-off projects that mission in mind, researchare under way at the WHI's 40 ers set out to determine, once clinical sites across the country, and for all, if a woman's risk of catalyzed in whole or in part by developing coronary heart disthe 12-year, $625 million initia- ease,breastandcoloncancer,and tive funded by the ational In- osteoporosis could be lowered stitutes of Health. The WHI is through three interventions: hormone replacement (estrogen alone or with progesterone); vitamin D and calcium supplementation; or a low-fat diet. Meanwhile, myriad ancillary studies have begun addressing questions that weren't even being asked in 1993. "This is one of the legacies of WHI," says Jean WactawskiWende, PhD, co-director with Maurizio Trevisan, MD, ofUB's WHI Vanguard Center. "With comprehensive health data on 162,000 women, we have an invaluable mine of information to use to advance public health. I think we'll be learning from it Jean Wactawski·Wende, PhD, co-director with Maurizio Trevisan, MD, of University for 50 years." at Buffalo's Women's Health Initiative Clinical Vanguard Center UB's interest in the link beIn the "one-thing-leads-to- the largest clinical trial ever un- tween oral health and osteoanother" nature of scientific dertaken in the U.S.; currently, porosis dates to the early 1990s. research, however, investiga- some 162,000 women are en- Researchers in the Department tors in UB's WHI Clinical rolled in it nationwide, includ- of Oral Biology in the School of Vanguard Center have sincere- ing 4,000 in Buffalo. Dental Medicine in 1995 received $3 million in funding to Historically, clinical trials ported results of a pilot study conduct a series of studies on have been conducted only on demonstrating that women with the link between the two condi- men. As a result, treatments increasing levels of periodontal tions. UB also is taking part in tested exclusively on men were disease showed corresponding trials examining the effect of prescribed for women without losses of bone mineral density. estrogen on memory, Alzhei- evidence that they would receive That study, supported in part by mer's disease and macular de- the same benefit. the U.S. Public Health Service, 36 l ulfalo HysicilD Wi11ter 2003 led to a $750,000 grant from the U.S. Army to investigate this link in UB participants enrolled in one arm of the WHI study. Based on those findings, which duplicated the pilot study results, UB received $2 million in the summer of 2001 from the ational Institute of Dental Research to follow the women for four more years and document any gum disease-osteoporosis link. Having a periodontal-disease clinic in place for this WHI spinoff study provided the opportunity for UB researchers to move forward quickly on another major investigation: the link between periodontal disease and heart disease. Trevisan and co-principal investigator Robert J. Genco, DDS, PhD, vice provost and SUNY Distinguished Professor in the Department of Oral Biology, received $7 million from the a tiona! Institute of Dental and Craniofacial Research in October 2001 to plan and conduct a pilot study to determine if treating periodontal disease in patients who have had one heart attack will prevent a second. Genco was one of the first scientists to show a connection between inflammation from periodontal disease and heart disease. He has been working for several years to further elucidate this connection and identify the particular oral pathogens involved in inflammation in the blood vessels. �Inflammation now is considered an important cause of heart disease, and research is progressing in this area on several fronts. Perhaps the richest WHI vein available to be mined is the data bank of blood samples taken from alll62,000 participants at the start ofthe initiative. As various conditions and diseases develop in participants, these blood samples can be scanned for disease "markers," that could form the basis for future screening tests designed to catch diseases in the very early stages. none study, Trevisan and another group of WHI investigators led by Paul Ridker of Harvard University Medical School are analyzing the sam- pies of WHI participants who develop cardiovascular disease, looking for such clues. This research will help detect blood markers that can be used to identify people who are at risk of having a heart attack before any symptoms develop. UB researchers and scientists at additional WHI clinical sites also are studying CA 125, a blood marker for ovarian cancer, using this large database. The collection of blood samples could lead to the discovery of currently unknown disease markers and new methods of early identification for a wide variety of conditions, according to Trevisan. "The fact that we can wait for a disease to show up and then look for clues in the specimens already collected and stored in the WHI blood sample bank will give us better and quicker ways to identify disease markers," he explains. The studies of estrogen replacement and its relationship to Alzheimer's disease and macular degeneration are being carried out at UB and several other WHI clinical centers in participants over the age of 65. Even though the estrogen/ progesterone arm of the trial has been halted, these women will continue to be followed to determine if hormone replacement was beneficial in preventing dementia or vision loss. Women in the estrogen- alone arm of that trial, which was not halted, will continue their participation as scheduled. Results of those trials will begin to be released when the WHI ends in 2005. As the end of the initial WHI trial approaches, UB and other WHI clinical centers will be applying for additional grants to follow participants into the future. "The idea is to keep a data stream going," notes Wactawski-Wende. "The intention is to keep the cohort together. I look at this as a lifespan study. "There'ssomuchdata,people will be analyzing it and learning from it for years." 4D Phillips, Lytle understands that health care providers face unique legal challenges. HIPAA, STARK, compliance issues, DOH regulations, reimbursement, the OPMC, and let's not forget about MFCU audits. These are all hot topics that we are prepared to help you with . Experience • • Breadth Depth Have questions or concerns? Call or e-mail Lisa McDougall, Esq., the health care practice group coordinator, at (716) 847-5478 or lmcdougall@phillipslytle.com. PHILLIPS. LYTLE. HITCHCOCK. A T T 0 BLAINE 8 HUBER LLP R N E Y S est.1834 3400 HSBC Center, Buffalo, NY 14203 (716) 847-8400 website: www.phillipslytle.com BUFFALO • FREDONIA • jAMESTOWN • NEW YORK • ROCHESTER W i nt e r 2 00 3 l1ffalu Pbysician 37 �G u E s T COLUMN MEDICAL B v an STEPHEN W E A p H R , 0 :LH,I C S CUlture ditor's Note: Last summer, Stephen Wear, PhD, associate professor in the Department of Medicine at the University at Buffalo School of Medicine and Biomedical Sciences, and co-director of the UB Center for Clinical Ethics, was invited to be a visiting professor at the Graduate Institute of Philosophy, National Central University, in Chung Li, Republic of China (Taiwan). Wear, who holds adjunct appointments in the gynecology/obstetrics and philosophy departments at UB, sits on various ethics committees in Buffalo, including those at the Veterans Affairs medical center (where the UB Center for Clinical Ethics is located), South Buffalo Mercy Hospital, Erie County Medical Center, Kaleida Health System and Millard Fillmore Hospital. He has published some 40 articles on a wide range of bioethics' topics and has authored a book titled Informed Consent: Patient Autonomy and Clinician Benef'icence within Health Care, which is now in its second edition and has been translated into Italian. At the invitation of Buffalo Physician, Wear has written the following article that encapsulates observations he made during his stay in Taiwan regarding that country's efforts to establish ethical guidelines for health care that incorporate both traditional and modem approaches to treatment. -5. A . Unger f rom July 3 to August 4, 2002, I had the privilege of being a visiting professor at the Graduate Institute of Philosophy at the ational Central University in Chung Li, in the Republic of China (Taiwan). During my month-long stay, I delivered a series oflectures and grand round presentations and participated in a number of case conferences at health-care facilities in the Chung Li and Taipei area. In addition, I collaborated on various research projects that focused on ethics committees and bedside ethics consultation, and consulted with staff at the institute, as well as with physician and nursing faculty at the Yang Ming School of Medicine in Taipei. Technologically, the Taiwanese seem to be about on par with the United States. For example, I was shown medical facilities that boast enormous 200-bed intensive care units, was briefed on very active research efforts in the teaching hospitals, and observed medical student/resident education models that are fairly similar to our own. One notable difference in the educational system, however, is that students begin medical 38 la lf ll t Pb ysicin Wi11ter 2003 school right out of high school and earn their medical degree after a seven-year course of study. As I met and became acquainted with faculty and attendings at various hospitals, I was surprised to discover that a large percentage had been trained in the West, particularly in the United States. Taiwan has what is probably the last large, concentrated population in which traditional Chinese culture abounds, as the communists have done everything they can to eradicate it on the mainland since they took over in 1949 (e.g., the Great Leap Forward, the Cultural Revolution, and the Red Guards). Given that the focus of this ancient tradition is on the family as the basic social unit-not on the individual, as in the West-this produces very different clinical approaches to patient care than what we have become accustomed to in our culture. For example, even when the patient is competent, families are the first to be approached with diagnoses and treatment recommendations by staff. Respect for patient confidentiality is thus not a major ethical principle in �Taiwan, and a family's demand that a patient not be told bad news is usually honored. It was also interesting for me to learn that informed consent for procedures may be obtained by law from either the patient or the family. While the technological level of health care in Taiwan seems in many ways to be as high as ours, the country is about 15 years behind the West in grappling with the issues of medical ethics that inevitably accompany such technology. They are just now beginning to deal with such issues as do-not-resuscitate orders, they have not yet made provision for advanced directives and withdrawal of life support rarely occurs. In this sense, they are behind us; however, their much higher respect for families as surrogates has allowed them to deal with many death and dying issues more comfortably than we have in the West. B efore I left for my visit, I was warned that, in general, Taiwanese health-care professionals are not interested in a rendition of Western individualistic, patient-centered medical ethics. The reason for this sensitivity, I was told, is that this approach would be perceived as just another form of Western imperialism, something the Chinese have certainly had quite enough of over the course of the past two centuries. Given the emphasis on diversity in our own culture, and out of respect for my host country's mores, I was of course prepared to avoid any affront in this regard. Interestingly, however, throughout my visit, my Chinese colleagues consistently wanted to know how a given issue or case would be dealt with in the West. On closer examination, it soon became apparent to me that they were in many ways wrestling with the same sorts of concerns we had wrestled with 25 years ago, when bioethics arose in reaction to the Western tradition of physician paternalism. In particular, they expressed concern that the well-known lack of confidentiality in their medical culture has resulted in a tendency for patients not to be candid when interviewed by physicians. They also report that, for the same reason, people with AIDS come in for treatment much too late. As to truth-telling and patient autonomy, anumber of the cases I was presented with involved patients with treatable malignancies whose families had forbidden the doctors to tell them their diagnosis and took them home for traditional Chinese medical therapy, only to have the patient return a few months later when their disease had metastasized and was untreatable. In response, I found myself wondering if we in the West are being too humble about our progress in medical ethics or too accepting of cultural diversity. In effect, I felt that my hosts were most concerned about the negative, harmful effects of a paternalistic medical ethic, just as we had been a few decades ago. This concern was demonstrated not just in their more general discussions, but over and over again in the cases they chose to present to me in their healthcare institutions. It's not that I feel that the Western individualistic approach to bioethics has the full answer for the Chinese, any more than it does for Western cultures. Often in the West our approach to patients commits the opposite evil of not involving their loved ones at all, an approach that the traditional Chinese practitioner would not allow. As my visit drew to a close, however, it became increasingly apparent to me that cultural diversity only goes so far, and that there may well be a bedrock of desires, expectations and needs common to all patients that any culture and medical establishment must somehow accommodate in order to be successful. Many clinicians in Taiwan are seeing traditional Chinese culture, on its own terms, as challenged by the new technologies and therapies of 21st-century medicine. As a result, I came to understand that they are curious not so much about how we in the West deal with such issues, as about how their own tradition can deal with them as they move forward. 4D Winter 2003 E loffal1 Pbysiciu 39 �DEVELOPMENT E W S The Road Best Traveled By Linda J. Corder, PhD, CFRE UR STUDE TS TRAVEL many paths to reach medical school. One of the most interesting journeys is that of Kim Griswold, MD '94, MPH, whose work with refugees is highlighted in this issue. Kim grew up in San Antonio but moved East to attend Bard College, where she majored in acting. She then took a job in summer stock in Virginia, later moving to Boston to work for the Boston Repertory Company and to be near her parents, who had relocated to Massachusetts. When her mother became ill with breast cancer, Kim moved home to help. Shortly after her mother's death, she spent several weeks in the hospital herself, recovering from injuries sustained in a horseback riding accident. With her acting career on indefinite I I hold, Kim spent many long hours in the hospital bed thinking about what she would like to do with her life. Her primary doctor provided a possible answer: "nursing." She enrolled in a two-year program at Syracuse University and after graduation went to work at Massachusetts General Hospital in neurology. After five years, a neurologist-mentor asked ifshe had ever considered medical school. She said she hadn't because she was sure she "couldn't do it"; but the question led Kim to realize she needed a new challenge. Eventually this same mentor suggested public health, and Kim entered the MPH program at Yale University. Her work at Yale brought to the fore an interest in displaced populations, and a fellowship resulted in her spending ten months at Oxford University, where she studied the delivery of health-care services. After she completed her MPH degree, Kim's father, who had remarried and moved to Buffalo, suggested that Kim consider moving to Buffalo, as well. She did, and took a job writing grant proposals for UB's School of Health Related Professions. Later she worked with the Department of Pediatrics, helping to obtain a grant to study developmental problems of children with severe disabilities. She then began to teach research methods in the Family Medicine Department and approached a 40 l ulf al1 Hysicin Wt11t e r 2 00 3 mentor-supervisor with a request for flexibility so she could pursue a PhD. He said no, but added that he would support her studies if instead she pursued a medical degree. This time she took the suggestion seriously and went back to school to complete prerequisite science courses. As the application deadline approached, her mentors wrote letters acknowledging her nontraditional path, but whole-heartedly endorsing her admission. Once admitted, it wasn't easy. The socialization process was " overwhelming," says Kim, who turned 39 the day of her first anatomy exam, which she failed. But she worked, I I she studied, she cried, and by the end of I her first semester, she had passed everyI thing. It was the turning point Kim needed, and from then on, she knew she would succeed. In deciding on an area of practice, Kim was conflicted until one day she finally "just knew family medicine was it." The field allows her to combine all the elements she encountered on her road to medical school, including public health and research. And, along the way, Buffalo had become home: Her family and friends are here, and she feels she is in her element in the city, whether it be practicing on the west side, teaching medical students or conducting research in the Family Medicine Research Institute. In addition to other ways that Kim gives back, she has initiated two endowments: a scholarship fund to honor Adelaide and Brendan Griswold, who encouraged her to "consider Buffalo"; and the Family Medicine Research Fund, which will eventually underwrite research combining many of the areas of interest reflected in Kim's circuitous journey to medical school. 4D Linda (Ly n) /. Corder is associate dean for alumni affairs and development. She can be contacted via e-mail at ljcorder@buffalo.edu; or by phone at 1-877-826-3246. �Spring Clinical Day and Reunion Weekend Class of' 58 / Mike Genco, MD, '58 and Mickey Stein, MD, '58 Mark your calendars It's not too early to plan for the 2003 Spring Clinical Day and Reunion Weekend. A cocktail reception will be held Friday, April 25, 2003. The 66th Spring Clinical Day and Reunion Dinners will be on Saturday, April 26. For more information, turn to Patty Duffner's message on page 43, or call the Medical Alumni Association office at (716) 829-2778. Our 45th reunion . • • Can you believe it? We have much to be thankful for much to look forward to. We'll see you in April! \Class of '63 Charlie Tyrone, MD, '63 The face of medicine has changed drastically since 1963. Has yours? Make plans now to attend our 40th reunion in Buffalo. Let's get reacquainted and reminisce about the Class of' 43 / good old days. Ralph Behling, MD, '43 Plans are still evolving! There are 37 "old timers" who are contemplating our 60th! I hope to be there and hope you will be there too. Class of' 68 / Tom Cumbo, MD, '68 and Bob Milch, MD, '68 Class of '48 / Dan Fahey, MD, '48 We are putting together a 35th reunion weekend that should prove enjoyable, and we sincerely hope you will make every effort to attend. Plans are well underway to celebrate the 55th anniversary of our graduation from med school. Wouldn't it be great if all 41 surviving alumni of our class could attend? / Class of '73 Arthur Mruczek Sr, MD, '73 and Michael A. Sansone, MD, '73 We have accomplished great things with our degree from '73! Our 30th reunion success depends on your participation ••. Come and share your triumphs with us and see how UB has changed! Class of'53 Bert Portin, MD '53 "Hey everyone, great 50th party planned. Look forward to seeing you!" Class of '78 / David Marchetti, MD, '78 Don't miss a chance to see old friends and get caught up on what they're up to after 25 years. W in ter 2003 l uff 1 l1 Hysici11 41 �D EVE L O PM EN T E W S Class of '83 / Ken Zimmerman, MD '83 1983 ••• 2003 -The more things change the more they stay the same. Come see for yourself. Which can you afford to waste? /Class of '88 Helen Cappuchino, MD, '88 and Andy Cappuchino, MD, '88 1988--We were listening to Michael Jackson sing "The Way You Make Me Feel" and Bobby McFerrin sing "Don't Worry Be Happy." Gorbachev withdrew troops from Afghanistan and the U.S. PeachKeeping Force won the Nobel Peach Prize. The World Series was between two teams from California. Andy still had hair and we had only one child! AND, we all graduated FEATURES BENEFITS • Electronic submission of all major insurance claims • Increase your accounts receivable turnover • Follow-up of all unpaid claims and open patient accounts • Improve collection ratio and reduce bad debts • Advisement on and assistance with insurance carriers and government regulations • Optimize revenue through proper monitoring of charge master • Choice of processing options including on-line or full-service • Eliminate costs associated with computer software and maintenance • Easy start-up or conversion from present billing system • Transition smoothly and quickly while maintaining cash flow • Appointment scheduling software available on request • Improve office efficiency and patient satisfaction from UB med school! Join our classmates on April 26 to reminisce and have fun. We really hope to see you for this great weekend! Class of '93 / Ray Ogra, MD, '93 "Can you believe it's been over 10 years since Renier had his accident with bleach and transformed himself into "Carrot-Top" ? Or since yours truly asked the stupidest question ever (hint: cadaver and wax·injected vessels)? Do you remember the Follies? The H.O.P.E. clinic? The Dive of the Week? The Talent Show? We've all come so far and have so many great memories to share, so come join us this April for our loth year class reunion! • Expertise on existing and new • Assure your patients' rights are corporate compliance guidelines protected • Practice management with • Gain peace of mind from professionally trained staff and knowing that your finances are experienced C.P.A.'s being managed optimally /Class of'98 Thomas A. Maher, C.P.A. President Michael Zionts, MD, '98 Can you believe it's already been five years? Come back and see who is doing MEDICAL BILLING SPECIALISTS what, and where! 42 1111111 Pbysitill Wint e r 2 00 3 50 Alcona Avenue Amherst, NY 14226 Tel: (716) 834-1191 Fax: (716) 834-1382 e-mail: pbs50@aol.com �Dear Fellow Alumni, he highlight of the year thus far for the Medical Alumni Association (MAA ) was the Past President's Dinner, in which we honored our Distinguished Alumnus of 2002, Thomas Lawley, MD '72, dean of the Emory School of Medicine (see article on page 23 ). University at Buffalo has had many alumni who have made significant contributions to the field of medicine, but Tom is really special, and I was honored to be able to present him with this award! As I mentioned in my last message, Spring Clinical Days will be held April25-26, 2003. This year Marty Brecher, program chair, and I would like to highlight the UB Center of Excellence of Bioinformatics and the Buffalo/Niagara Medical Campus (see article on page 32 ). The welcome cocktail party will be held on April 25 (Friday night) at the Jacobs Executive Mansion (the old Butler Mansion ) on Delaware Avenue. The formal program on bioinformatics will be held Saturday morning, April 26, in Hillboe Auditorium at Roswell Park Cancer Institute, and the speakers will include Dr. Jeffrey Skolnick, who will deliver the Stockton Kimball Lecture, Dr. Bruce Holm, Dr. Robert Genco, and Dr. Rob Bakshi. An overview of present and future plans for the Buffalo/ Niagara Medical Campus will also be provided. Following the lectures, a luncheon will be held at the Buffalo Club. This should be an exciting conference, which I know both out-of-town and local alumni will enjoy. In another development regarding one of the MAA's most successful programs-the PhysicianStudent Mentoring Program-! would like to announce that Debra Stamm, assistant dean for student services in the Office of Medical Education (OME), has graciously agreed to assume administrative responsibility for the program, with support from our MAA Governing Board member Marty Mahoney. The program had previously been administered through the Office of Development and Alumni Affairs, which recently underwent staffing changes that limited its ability to continue management of the program. The staff in OME maintain close contacts with the medical students, and we feel they will do an excellent job of matching students with the appropriate mentor. Another important change in the MAA relates to our finances, including dues and expenses, which up until now had been managed by our administrative secretary, who retired last year. After much thought, the Governing Board has decided to enlist the services of the University at Buffalo Foundation (UBF) to collect dues and manage our accounts. UBF has experienced accountants with auditing oversight, and I personally believe these professionals will offer an increased level of financial security for our organization. Finally, the Medical Alumni Scholarship Endowment has grown significantly following a very generous gift from AI Dobrak, MD '39. Our goal is to raise the endowment to 1 million so that we can increase the number of scholarships we give each year (see page 22 for this year's recipients of the scholarship). Please donate generously to your class gift for the scholarship endowment! And please remember to put Spring Clinical Days on your calendar. We're very excited about the program, and know you will enjoy seeing the new campus and hearing about plans for its future. J,b~,:?.~ President, Medical Alumni Association Win t er 2003 llfllll Pbysician 43 �C L A S N 0 T E Cedric M. Smith, MD '52 (started with the Class of '52; graduated with the Class of '53, with an MD/MS degree.) Currently, Smith is a professor emeritus in the Department of Pharma· co logy and Toxicology at the University at Buffalo School of Medicine and Biomedical Sciences, and associate research scientist in UB's Research Institute on Addictions. He also teaches pharmacokinetics and sources of quality drug information to residents in psychiatry. He spends the majority of his time following up on publications he has authored. (Over the past ten years, he has authored 22 scientific/medical articles and edited two pharmacology textbooks and 25 abstracts and book reviews.) 1950s Phoebe Sat uren, MD '52, physical medicine and rehabilitation, lives in Nyack, Y. She writes: "The May 2002 50-year reunion of the Class of 1952 was spectacular, as was our class party and the clinical day. I spoke to the residents in rehab about the growth of pediatric rehabilitation over the years. Dr. Thomas Polisoto hopes to invite more alumni physiatrists to lecture. I also attended a Sunday brunch with some of the students who wanted to meet with alumni. I think this event should continue." E-mail address is: saturendoc@aol.com. He writes: win addition, I have some pet projects such as renewing antique family Ben Celniker, MD '57, ob- photographs, cultivating numerous medicinal stetrics-gynecology, lives in Phoenix, AZ, where he works in a group practice and is on staff at the Maryvale Hospital Medical Center. Favorite medical school memory: "Putting sugar in Harris Kanel's urine in biochemistry class." plants, and studying the yellow bird of the tropics-the Bananaquit and its appetite for sugar and alcoholic beverages. wl am also involved in an active medical/ legal consulting practice specializing in describing the time course of alcohol effects and blood levels and adverse reactions to psychoactive drugs. " My wife, Katerina Kobakof, and I are blessed with five children and nine interesting and active grandchildren. We are challenged to keep up with gardening around our house that over looks the Niagara River. During at least part of the winter you can find us walking/biking the beach of Jekyll Island, GA. Although we are beginners at golf, we fre· quently conclude, along with many others, that golf 'is a good walk ruined. '" E·mail address is: cms23@buffalo.edu. .... la f f al1 Hysici11 Winter 2003 1960s Richard H. Daffner, MD '67, is a di- agnostic radiologist affiliated with Allegheny General Hospital in Pittsburgh, PA. He and his wife, Alva, have two children: Marc, 33, and Scott, 29. Favorite medical school memory: "Summer radiology preceptorship with Dr. George Alker in 1966, which convinced me to become a radiologist." E-mail address is: rhda ffner@netsca pe. net. David Silverstein, MD '72, ophthalmology, lives and works in Saratoga, CA. Favorite medical school memory: "Saturday morning anatomy with 0. P. jones." E-mail address is: dsseyedoc@aol.com. Mark Zlotlow, MD '72, 1970s Sanford J. Holland, MD '72, anesthesiology, lives in Scranton, PA, and is on staff at Moses Taylor HospitaL Favorite medical school memories: "The 'Kent State' year (1970): Erie County K-9 cops on campus; tear gas in Norton Union; no sophomore final exams in pharacology, pathology or microbiology." E-mail address is: sanfordh@mth.org. Joanne Levitan, MD '72, is a diplomate of the American Board of Surgery, and the American Board of Plastic Surgery, with added qualifications in surgery of the hand. She lives and practices in St. Clair Shores, MI. She is in group practice and is affiliated with the Harper Hospital in Detroit and the Cottage Hospital and Bon Secours Hospital in Grosse Pointe. pediatrics, lives in Sacramento, CA, and is on staff at the Kaiser Foundation Hospital in Sacramento and Roseville. His favorite medical school memory: "Buffalo General HospitaL" E-mail address is: mark.zlotlow@kp.org. l ewis R. Groden, MD '77, ophthalmology, lives in Tampa, FL. He is director of the Ophthalmology Residency Program and director of the Cornea Service at the University of South Florida. He is also medical director of Lasikplus Vision Centers in Tampa. E-mail address is: doccornea@aolcom. 1980s Jill Brody, MD '82, internal medicine, lives in Providence, RI, with her husband, R. Nicholas Camp, and their two children, Michael, 16, and Sabrina, 14. Favorite medical school memories: "Biochemistry with Alexander Brownie; neuroanatomy with Harold Brody; medical sub-internship at ECMC; getting done with �Timothy P. Bukowski, MD Paul B. Karas, MD '87, lives '87, FlAP, FACS, has opened in Cheektowaga, NY, with his wife, Donna, and a new office (Pediatric Urology of North Carolina) in Raleigh, NC. Following graduation from UB, Bukowski completed his surgical/urology residency at Wayne State University. After a pediatric urology research fellowship at Cincinnati Children's Medical Center, he returned to Children's Hospital of Michigan to complete his accredited pediatric urology fellowship. From 1995-2001, Bukowski was director of pediatric urol- anatomy." E-mail address is: ralph.camp @verizon. net. Manuel Leonardo Saint Martin, MD '82, lives in Los Angeles, CA, where he has a solo practice in forensic psychiatry. Favorite medical school memory: "All of it. Working with Roberta Pentney, PhD." E-mail address is: cerberus 1113 @hotmail.com. Jessica Rockwell, MD '82, endocrinology, lives in Cooperstown, Y, with her husband, Peter Jederlinic, and their three children: Nicole, 17, their three children: Paul B. (Ben), Jr, 10, Andrew Jay (AJ), 8, and Catherine, 5. He is in a group practice and on staff at Sisters Hospital in Buffalo. Favorite medical school memory: "Getting accepted to the school as a transfer student." E-mail address is: bandofive @aol.com. Adam Ashton, MD '87, psy- chiatry, lives in East Amherst, NY. He and his wife, Cindy, have three children: Evan, 10, Leah, 8, and Alexis, 6. Favorite medical school memory: "Playing drums in the Follies Talent Show bands." E-mail address is: aashton@buffalo medicalgroup.com. ogy at the University of orth Carolina at Chapel Hill, where he received several teaching awards; and from 2001-2002, he was chief of pediatric urology at Children's Hospital of Michigan in Detroit. Bukowski is a Fellow of the American College of Surgeons, F;:i!cw of the Society of Pediatric Urology, and Fellow of the American Academy of Pediatrics, Section on Urology. He has an active interest in laparoscopy and fetal urologic intervention. He and his wife have four children. Sheri Baczkowski, MD '92, is an obstetrician/gynecologist and lives in Williamsville, NY. She Bonnie Orzech, MD '87, is a pediatrician and lives in Finksburg, MD. She and her husband, Bert Nixon, assnotes Alex, 15, and Eric, II. She is board certified in internal medicine and endocrinology and is on staff at Bassett Healthcare. Favorite medical school memory: "Biochemistry classes with Alexander Brownie." and their one-year old daugher Emma. She completed residency training in neurology at the Mayo Clinic in 1996 and is currently on staff at Fairview Southdale. E-mail address is: jald@ dnamail.com. have three children: Bryan, 7, Beth, 4, and Brooke, 2. Favorite medi- and her husband, Jerry Wild, have two-year-old twins, Jenna and Mia. Favorite medical school memories: "Dive of the week, studying in the Study Room, the holiday part and the formal." E-mail address is: wildplace@aol.com. Judine Davis, MD '92, cal school memories: "Friends, parties, snowdrifter!" E-mail address is: bfnbon@aol.com 1990s Janiece Aldinger, MO '92, lives in Edina, MN, with her husband, Tim Clavin, Winter 2003 obstetrics/gynecology, lives in Hamburg, Y, with her husband, Jeffery, and their twoyear-old son Liam Jeffrey Davis. She works in a group practice and is on staff at Sisters Hospital and Kaleida. Favorite medical school memory: "Transition from second to third year, after exams and boards-a really great celebration!" l uff a l• Pb ysiciaa 45 �CLASS Mark Ippolito, MD '92, lives in Davidson, NC, and is on staff at the Northeast Medical Center in Concord. He and his wife, Donna, have two chi!dren: Arielle and Ethan. He completed residency training in neurology at the ational Naval Medical Center in Bethesda, MD, in 1996 and a neurophysiology fellowship at Walter Reed Army Medical Center in Washington, DC, in 1999. He is board certified in neurology, clinical neurophysiology and electro- NOTES diagnostic medicine. E-mail address is: ippolitofour@yahoo.com. lldiko Mikos (Gyimesi), MD '92, plastic surgery, lives in Louisville, KY, with her husband, George, and their two children, Christopher, 4, and Anthony, 3. She completed residency training at UT Southwestern in Dallas, TX, in 1997, and a fellowship in breast reconstruction in Atlanta, GA, in 1997. She is on staff at the Baptist Hospital East. E-mail address is: lldikom@aol.com. Alphonse Daniel Osinski, MD '92, psychiatry, lives in Mount Kisco, Y. Residency training was split between Sheppard Pratt Hospital in Baltimore, MD, and Cornell Medical Center in New York City; completed a fellowship in child psychiatry at the Sheppard Pratt/University of Maryland )oint Program in 1998. "I am on the faculty of Mount Sinai School of Medicine and work at a satellite program at the Elmhurst Hospital of Queens, as a unit chief on an inpatient Keyser Cadillac Upstate NelNYorks only exclusive Cadillac Dealer Keyser Cadillac 4130 Sheridan Drive · Williamsville. 1\lY 634-4100 key ercadillac.com 46 laff al• Hysiciaa Wi11ter 2003 adolescent psychiatric unit. (And I love it!)." Favorite medical school memory: "In some ways I took it all far too seriously, although I remember, with thanks, support I received in various study groups-and some fun, too. Sorry I couldn't make it [to the reunion] E-ma this time guys, but I'll come to one in the future. My best wishes to everyone for success in all aspects of your lives." E-mail address is: alosinski@aol.com. Donna (Sinensky) Ferrero, MD '94, recently moved from Boston, MA, to • • Classnotes can also be submitted by e-mail to: bp-notes@buffalo.edu "Hi, I'm Susan Hunt. I invite you to come to see my Mom's new home ... the Amberleigh Retirement Community. You 'll smile too!" .AB~~nf~~nity 2330 Maple Road, Williamsville For a free brochure or personal tour, call 689-4555 �- ==----------- Rochester, Y, with her husband, Vincent, and their IS-month-old daughter, icole. She works as a physiatrist at Strong Memorial Hospital and is assistant professor in the Department of Orthopedics at the University of Rochester. E-mail address is: vferrero 17@aol.com. Jeffrey W. Kanski, MD '94, has joined the Radiation Oncology Department of the Massachusetts General Hospital and the faculty of the Harvard Medical School. Thomas Burnett, MD '94, and Carol Ann Killian, MD '94, are pleased to an- nounce the birth of their son, Matthew Killian Burnett. He was born March 14, 2002, and weighed 8 pounds, 2.5 ounces and was 21 inches long. Big sisters, Kristen (4 112) and Lauren (3), love their little brother and are enjoying preschool. Tom continues to practice internal medicine in a large multi-specialty group, and Carol Ann practices emergency medicine per diem at two local emergency departments." E-mail address is: tburn @cloud9.net. got married (September 28, 2002) to Todd Wilkerson, who works as a project manager for UPS corporate headquarters. E-mail address is: lesleywilke @aol.com. Lesley (Orman) Wilkerson, completed her residency in internal medicine at the University of Maryland in June 2001. She and her husband, Rajat Bannerji, PhD, MD, subsequently moved to the Seattle area, where she is in her second year of an Rachna Gupta, MD '98, MPH, MD '97, completed her residency in pediatrics at the Childrens' Hospital of the King's Daughters in Norfolk, VA, in 2000, and currently works for Children's Healthcare of Atlanta, GA. She recently infectious disease fellowship at the University of Washington. Her husband is a hematologist/ oncologist at Madigan Army Medical Center. They are also excited to announce the arrival of their daughter, Aradhana Bannerji, born June 16, 2002 (Father's Day). Rachna welcomes e-mails from friends from the classes of 1997 and 1998. E-mail address is: rachnag@u.washington.edu. «D SAVE TIME . •• Order your medical books online at efollett.com Mention this ad and get 5°/o off your next in-store purchase! T..:J... University at Buffalo ~ The State University ofNew 1Vrk UNIVERSITY BOOKSTORE Main Street • Phone:(716)833-7131 www.buffalo-medical.bkstr.com Winter 200 3 I u I I I I D Physic i I D 47 �In Memoriam Orvan Hess, MD '31 when he administered the Health for the State of Orvan Hess, antibiotic to a 33-year old Vermont. During his tenure, MD, '31, died mother who suffered from leopold developed one of on September scarlet fever and a blood the nation's first statewide 6, 2002, infection following a miscar- system of community-based after a brief riage. Her fever broke the mental health services. After illness. He next day and she lived to be a brief stint as an associate was 96. Hess, an obstetrician/ 90 years old. Hess also pioneered the gynecologist by training, was study of healing wounds fol- a medical pioneer who devel- lowing Cesarean sections. oped the first fetal heart "He was a leader in the professor at The Johns Health and Hygiene, he returned to direct patient care, serving in hospital medical community," says settings with the Veterans physician in the United Timothy Norbeck, executive Administration in New York, States to administer penicil- director of the Connecticut Florida and Virginia. lin to treat a life-threatening State Medical Society. "He illness. He spent his 50-year was also one of the friend- at Johns Hopkins, he served career in New Haven, deliver- liest people on earth-pro- as a part-time faculty at UB ing thousands of babies at fessionally and personally." emeritus of obstetrics and .Jonathan Porter A. Leopold, MD '51 gynecology at the Yale Uni- Jonathan Porter Aaron In 1937, while still a resident, Hess began working on a machine that could monitor the heartbeats of In addition to teaching (1957-1965), the University of Vermont (1965-19721 Yale-New Haven Hospital and versity School of Medicine. leopold, MD '51, died on and the University of South Florida at Tampa (19871990). leopold also served on numerous advisory grams at the Brookings huntrealesta te.com September 22, 2002, at his boards and participated in home in Richmond, VA. leadership development pro- leopold retired in 1996 after a distinguished career Institute and the National of more than 45 years as a Institutes of Health. World War II broke out, he physician, public official and leopold is survived by left research to join a U.S. educator. Following gradu- his wife of 21 years, Anita, Army medical team that fol- ation from UB medical and his children: Jonathan lowed General George S. school in 1951, leopold P. A. Jr of Burlington, VT; Patton's Second Armored completed residency train- James S., of West Danville, Division through North Af- ing in internal medicine at VT; Christopher B. of Walter Reed hospital in Shelburne, VT; and Elizabeth After the war he resumed Washington , DC, and A. leopold of Greensboro, his research, and in the served as a captain in the VT. He is also survived by mid-1950s he and another U.S. Army Medical Corps. In his former wife, Barbara, of physician developed a ma- 1954, he joined his father, Shelburne, VT: his brother chine that could pick up and Francis, in private practice David Francis leopold of of internal medicine. After a South Burlington, VT: and record electrical heart signals of a fetus during labor, launching the field of fetal cardiology. In the years that followed , Hess worked to refine the fetal monitor and reduce its size. In 1942, Hess participated in the first clinical use of penicillin in the world residency in psychiatry in his stepchildren Kenneth 1958, he began his public Callahan, Peter Callahan, career as a staff psychiatrist and Patrick Callahan. and, later, as director at we help people move. Call for a free relocation portfolio regarding your destination city. Calll-800-688-1170 or go on-line and visit our web site at unborn children. When rica, Sicily and Normandy. HU. 'T REAL ESTATE ERA Hopkins University of Public monitor, he was also the first becoming clinical professor RELOCATION Totally customized service p ortfolio in cludin g • Nationally trained relocation experts • Complete family needs analysis • Global home sale assistance • Special services for seniors • Full community tour • A complete cost of living analysis • A list of all school systems throughout WNY • Complete spousal placement assistance including resume writing and corporate contacts • 24 hour or less response time • Confidentiality assured In lieu of flowers, Niagara County Mental the family requests that Health Services. In 1964, contributions be made in Governor Philip Hoff ap- leopold's memory to the pointed leopold as the first UB School of Medicine and Commissioner of Mental Biomedical Sciences. Hunt ERA Relocation Center 5570 Marn Street Williamsville, NewYor1< 14221-5410 48 l a ff al1 Plysitill Wi11ter 2003 Email: huntrelocallon@huntrealestate.com �Three i11tercowzected buildi11gs \\Jll make up the Buffalo L1fe Soences Complex on the l3ut1alo- 1agara Medical Campus (l3NMC). 1()() acres bordered by Mam Street. orth Street. Michigan Avenue and Goodell Street. Pictured. abol'c /~ft, is the Umversity at But1alo Center of Excellence in Bioinformatics, and, abtwc r('(ht, Roswell Park Cancer Institute's Center for Genetics and Pharmacolot,'Y· A third building, headquarters for Hauptman-Woodward Medical Research Insntute, not pictured. will be constructed to the left of the Ul3 building. for more information on the BNMC. and \\·ork under way in l3iomformaucs, see article on page 32. ,lt the Ul3 Center of Excellence �p H A R M A c p 0 E I A 0 LB ' 'HISTORY Of 1EDICI ' E ( OLLEC.TIO PRESF TS PHARMA C OPOEIA This illustration was digitally reproduced from offizinellen Cewachse, a four - volume edition of pharmaceutical plants and their medicinal uses, published in German in r863. The pharmacopoeia by Otto Karl Berg (1815-1866) is part of the Robert L. Brown History of Medicme Collection, located in the Abbott Hall Health Sciences Library. Picture here is the Apple, Pyrus malus, one of a series of botanical F images digitally restored as part of an initiative to preserve and highlight X ~ I 0- 1/ / a 0 1' unique resources from a.(/ the library's collection. Reproductions c are available for purchase through the library, and can be viewed online at i Media. buffalo. ed u/art/. Image restoration was performed by iMedia. " the instructwnal media r services department of Computing and Infor mation Technology at the University at Buffalo. 8POOO Ol � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 2003 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2003-Winter Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v37n03-2003-Winter Table Of Contents A list of subunits of the resource. Family Medicine, a Global Perspective A Degree of Latitude On Course Medical School Alumni Pathways Research Development Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v37n03 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2003 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/1f9f80a7249cf0b628331132b008c118.pdf 9268fd1e42601b3a68ca00d9a0a7516d PDF Text Text �l1ffal1 P~ysicial ASSOCIATE VICE PRESIDENT FOR UNIVERSITY CoMMUNICATIONS Dr. Carole Smith Petro DIRECTOR OF PERIODI C ALS Sue Wuetcher Dear Alumni and Friends, EDITOR Stephat~ie A. Ut~ger ART DIRE C TOR & DESIGN Ala"]. Kegler School of Medicine and Biomedical Sciences graduated its ! 56th class, m arking yet another chapter in the histo ry of one of the oldest institutions of m edi cal edu cation in o ur coun tr y. Anyone familiar with o ur school's histo ry knows that its lo ngevi ty is d ue to both an adherence to trad ition and an adaptability to change. While the graduation ceremony fo r the Class of 2002 paid tribute to trad it io n, this year's incoming class paid tribute to change by bei ng the first group of students to complete a year of study in our new curriculum. Th is new curriculum , which is essen tia l to our rem ai ning at th e cutting edge of med ical educatio n, is a change that the students, for the most part, took in str ide, giving DESIGN ASSISTANT Karen Liclwer CONTRIBUTING WRITERS Lois Baker and Ellen Goldbaum PRODUCTION COORDINATOR Cynthia Todd-Flick U NIVER S ITY AT BUFFALO S C HOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. Michael Bernardino, Dean us reason to believe that we have gotten off to a good start in what we EDITORIAL BOARD know will be an o ngo ing process of refi nement. While it is imperative that we immerse our students in the most modern and effective curricul um possible, it is equally important for us to turn our attention to other ways we can support their medical school experience. This support can be demo nstrated in a num ber of different ways, including financia l, ca reer and psychosocial counseling, to name a few. The bottom line is that, as educators, we must establish a relationshi p with our students that assures them we are as interested in their success as they are. Programs that support our students require a financial investment, as well as a moral commitment. In looking to the future, 1 anticipate that our school, like most state-assisted schools, will not receive significantly more money from the state than what it is already receiving, which is about 13 percent annuall y. Therefore, if we are to provide a "value- Dr. john Bodki11 Dr. Martin Brecher Dr. Harold Brody Dr. Linda]. Corder 5 Elizabeth Volz, Class of 200 Dr. ]ames Kanski Dr. Elizabeth Olmsted Dr. ]ames R. Olson Dr. Stephen Spaulding Dr. Bradley T. Truax Dr. Franklin Zep/owitz TEA C HIN G HOSPITALS Erie Cout~ty Medical Center Roswell Park Cat~cer lt~stitute Veteratls Affairs Wester" tetll New York Healthcare Sys . I The Buffalo General Hosplta lo The Children 's Hospital of B4f~ Millard Fillmore Gates Hosplta "tal Millard Fillmore Suburban Hospl KAI.EIOA Ht .\ LT H: added" education to ou r students it is clea r that a major issue we must devote our energy to in the years ahead is development and ph ilanthropy. Currently, our school receives about $200,000 a year from its alumni. I would like to see that fig ure rise to $3 to $5 mill ion. It is important that these funds be used to enhance research efforts, to recruit and retain fac ulty, and to bolster a discretionary fund that supports special projects that arise each year. However, I feel it is equally important that we be in a position to use these fu nds to support programs and services that make our students feel that they are having a positive and worthwh ile experience. Also, because the cost of a medical education is only go ing to increase, it is crucial that we be able to provide scholarships to high-quality students who don't have the wherewithal to attend med ical school without financia l assistance. Sr sTE-"' Mercy Health System Sisters of Charity Hospital CA1Hou c H EAI.TII Niagara Falls Memorial Medical Center @ ONIYEISITY AT IUFFllO. TIE STliE UNIYEISITY OF NEW YOlK If we can do these things, then today's students will be motivated to support tomorrow's students, further ensuring the integrity of a med ical school experience that has Letters to the Editor meant so m uch to so many people over the past century and a half. Buffa lo Physician is published quarterly by the University at Buffalo School o f Medicine and Bio medical Sciences In cooperation wi th the Office of Communications. Letters to the Editor a re welcome and can be sent c/o Buffa lo Physician. 330 Crofts Hall, University at Buffalo, Buffalo, NY 14260; o r via e-mail to bp-no tes@buffalo.edu. Telepho ne: (7 16) 645-5000, ext. 1387. . The staff reserves the right to edit all submissions for clarity and length. As we look to the future, therefore, I hope that you will join me and others at ou r school to not only help define both short- and long-term goals for how we can enhance o ur students' experiences, but to also provide the resources and support needed to see these plans through to fruition. ) _ R.. ~~£4 ./l_;_ y .i) M I CHAEL E . BERNARDINO. MD . MBA Dean, School of Medici ne at~ d Biomedical Sciet~ces Vice Presidetlt for Hea lt h Affairs T...:.:.... University at auffal~rk ~ TI1e State University ofNeW �VOLUME 37, NUMBER t l p H y c s A N Features Sound Science UB scientists advance our understanding of how we hear and what happens when we don't BY LOIS BAKER AChild Abused, but Not Forgotten Stephen Lazoritz, MD '76, brings the lessons of history home to the present by M .K. Kinnamon David Hojnacki, MD '02, pauses to savor the long-awaited moment on stage at this year's commencement, held on May U . For more on the day'scelebration, turn to page 22. COVER 1& Medicine Taken to Heart-John Canty, MD '79, Albert and Elizabeth Rekate Chair in Cardiovascular Disease 18 Match Day Listing 22 Graduation Day, 2002! 24 jeffrey Sko ln ick amed Director of the Buffalo Center of Excellence in Bioinformatics I LLUSTRATION 30 Presidential Assassinatio ns of the 20th Centuryup Close and Medical Honored for Lifetime Achievement SANDRA 35 Find Your Class and All the Familiar Faces from Your Medical School Days OtONISI 42 News from Your UB Classmates and Other Alumni 49 Spring Clinical Day- a Collage 31 Medical Alumni 2& Carl Granger BY Achievement Awards �B I ILLUSTRATIONS SA ND R A D PHOTOGRAPHY KC 2 BY I 0 N IS I BY KRATT laffafo Physicin y L 0 I I s B A K E R �n this multidisciplinary laboratory, specialists in anatomy, audiology, biophysics, engineering, otolaryngology, pediatrics, neurology, physiology, pharmacology and psychology are conducting studies in hair-cell regeneration, drug therapy and ototoxic drugs, noise-induced hearing loss, middle-ear disease, infant hearing loss, central-auditory system plasticity, mechanical transduction (the fundamental process of transferring sound energy to electrical energy), age-related hearing loss, hormonal influence on hearing loss, and central-auditory processing in the brain. Center scientists have generated more than $12 million in research funding, including a highly competitive $5.7 million multidisciplinary program project grant from the National Institutes of Health awarded in 1999, which focuses specifically on the mechanisms underlying acquired hearing loss. Why is a large segment of the population becoming "hard of hearing?" S umm er 2 00 2 luffal1 Pbysician 3 �BOUT 10 MILLION CAN ATTRIBUTE THEIR LOSS OF HEARING TO NOISE EXPOSURE. Listening to music through stereo headphones at top volume, for example, is as damaging to the auditory system as the thunder of a diesel locomotive. Thirty million people in the U.S. are exposed to similarly dangerous noise levels each day. Infections and some cancer chemotherapy drugs also can cause deafness, but the maJor culprit is Father Time. The National Institute on Deafness and Other Communicative Disorders estimates that 30 to 35 percent of people between the ages of 65 and 75 have a hearing loss. The percentage climbs to nearly 50 percent among those over 75. For much of the 20th century, technology to improve hearing had advanced little beyond the ear trumpet, a large cone-shaped megaphone-in-reverse that was intended to amplify sound. That was state-of-the-art for our hard-of-hearing great-grandparents. Salvi, professor of communicative disorders and sciences, neurology and otolaryngology and director of the UB Center for Hearing and Deafness, says that until the past five to eight years, people looked at hearing loss from a descriptive point of view. "They measured loss-how poorly people detected speech and other sounds, and how well they could hear in a background of noise," he says. "That's been the situation for about the last 100 years." Only within the past two decades have hearing researchers begun to understand that hearing depends primarily on the ability of tiny cilia on hair cells of the inner ear to transform sound-wave energy into electrical energy, and on how accurately the brain receives and translates the resulting nerve impulses. "The big change came with advances in biology and our ability to study how inner-ear hair cells develop, live and die," Salvi says. "A huge amount of work is now being done in that area, and our lab was one of the first to get involved. Hearing research has moved from the cellular to the molecular to the genetic level." Tracing the Path of Cell Death Most cases of hearing loss occur when inner-ear hair cells in the cochlea are damaged or killed. Hair cells transfer their neural activity to the auditory nerve, which carries the nerve impulses to the brain's central auditory system. Considerable research in recent years has been devoted to finding compounds that might protect against hearing loss by preventing hair-cell death or by rescuing and repairing damaged cells. Center researchers, collaborating with colleagues at Roswell Park Cancer Institute, were among the first to study the process of hair cell death-specifically programmed cell death called apoptosis- in inner-ear hair cells. Salvi and fellow center scientists are attempting to determine what triggers the cell-death switch of apoptosis by subjecting cultured inner-ear sensory cells and sensory neurons to known ototoxic drugs- the antibiotic gentamicin and cancer therapy drugs cisplatin or carboplatinand tracking the biochemical pathways involved in cell death. 4 luflal1 Pbysici11 S umm e r 2 00 2 Armed with these findings, the researchers now are using certain drugs to try to block these pathways. The primary candidates are a protease inhibitor called leupeptin and an inhibitor of the tumor suppressor gene p53, which acts a "cell executioner" of sorts. "Gentamicin is used in the U.S. to treat infections that arise in persons with muscular dystrophy and cystic fibrosis and is prescribed extensively in other parts of the �world to treat a wide range of bacterial infections," Salvi says. "Unfortunately, gentamicin causes severe deafness, so there is tremendous interest in finding drugs that block hair-cell death. "We have found that leupeptin does a tremendous job of rescuing cells exposed to gentamicin. In inner-ear cultures, we see 70 percent loss of hair cells without it, but with it we can rescue most of those cells. We've also shown that using a p53 inhibitor, we can block cisplatin toxicity in the inner ear." RI HASHINO, PHD, a center research assistant professor and specialist in neuroscience, is studying the cellular mechanism thought to be responsible for the uptake of gentamicin into the hair cells. Her studies suggest that gentamicin is captured and sequestered in lysosomes (cell components that take up external material in the body) for a period of time before it kills hair cells. This finding suggests that lysosomes may be an important factor in the cell-death process and could be targeted for intervention. Hair-cell death due to noise exposure is the primary focus of the work of Donald Henderson, PhD, professor of communicative disorders and sciences and otolaryngology at UB. He and colleagues are conducting investigations into compounds that may protect the auditory system from too much noise. They have identified and are concentrating on a family of enzymes, some of which trigger the death process and some that execute it. "Now we are trying to trace the pathway of these enzymes to following three to six hours of moderate-level noise exposure. Initial studies indicate that even moderate noise exposure stimulates the repair and replacement of proteins in the inner ear, suggesting that if this repair process can be started early enough, it may be possible to condition the ear against hearing loss. Taggart also is investigating the potential of inherited variation in DNA sequences of the inner ear to influence an individual's susceptibility to noise-induced hearing loss. These studies, which involve U.S. Navy personnel who work in high-noise jobs, are assessing the possible role of genetic variation within the specific inner-ear proteins that maintain cellular homeostasis of the inner ear during and after noise exposure. Taggart is targeting a group of functionally related proteins called connexins that maintain normal functioning within the inner ear and are thought to be linked to noise-induced hearing loss. Hearing loss due to aging, responsible for the largest cohort of the hearing impaired, also may have a genetic component, an avenue Robert Burkard, PhD, professor of communicative disorders and sciences and otolaryngology, is pursuing. "Many hearing losses are genetically programmed to show up later in life," says Burkard. "There is quite a bit of evidence to indicate that age-related hearing loss may be a result of a genetic inability to cleanup free radicals. If we know that the gene turns on at, say, 60, we can be poised to do something ''The big change their starting point," says Henderson. "If we can do this, we can rescue, and perhaps prevent, hearing loss due to noise damage." One enzyme being studied as a possible protectant is gluthathione peroxidase, a compound important for maintaining antioxidant activity, which in turn is essential for combating cell damage from free radicals. "We know noise can increase formation of free radicals in the cochlea," Henderson says. "We are investigating how this enzyme would work as a treatment in humans, and how and when to give the drug." The Genetics of Hearing Loss Center researchers led by Tom Taggart, PhD, associate professor of communicative disorders and sciences, are taking center stage in a new avenue of auditory research: the genetics of hearing loss. UB's center is one of the first to conduct gene-expression studies identifying genes within the inner ear that are up-regulated in response to intense sound stimulation. So far they have identified about 100 genes that increase their expression substantially about it. Once we have ideas concerning the causes, we are in a better position to approach a treatment or cure." Tinnitus from the Brain's Perspective UB researchers have done groundbreaking research into tinnitus, the debilitating phantom sounds known as "ringing in the ears" that plague millions of persons, some to the point of disability. Alan Lockwood, PhD, professor of neurology, nuclear medicine and communicative disorders and sciences, a member of the center faculty and director of operations for DBVeteran Affairs' PET Imaging Center, was the first to identify certain sites in the brain where tinnitus originates. Lockwood, Salvi and Burkard now are studying volunteers who can change their tinnitus with certain eye or jaw movements to define further the brain regions that are involved. They also are investigating the effects of the painkiller lidocaine on tinnitus, as the drug is said to reduce the symptoms by up to 30 percent in some sufferers. S u m 111 e r 2 0 0 2 luff al o Ph pici an 5 �"We are trying to determine what is causing tinnitus from the brain's perspective," says Burkard. "Why is the sound being modified? Do different parts of the brain light up? We're looking for areas less and more active that could be helping turn off tinnitus." Burkard, Salvi and Lockwood also are working with an experimental device that can interrupt or mask tinnitus in some subjects through the use of ultrasonic bone conduction. In a related project, center researchers are capitalizing on PET's ability to track brain responses to stimuli to determine if different brain regions are activated during noise and quiet. The Mysterious, Pliable Brain For other center researchers, studies in the field of brain plasticity have more immediate clinical applications. It is known that the neuronal network responsible for hearing reorganizes itself after damage to inner-ear hair cells-in a system may be important for hearing during noisy situations." McFadden also is investigating the potential role of estrogen as a protectant against hearing loss. Hers is the first study to look at the hormone in this context. Working with chinchillas, she found that noise exposure caused less damage in animals receiving estrogen than in those that didn't. These results suggest that estrogen, like gluthathione peroxidase, may act as an antioxidant. "Men get more noise-induced hearing loss than women, and they experience age-induced hearing loss earlier and more severely than women," McFadden says. "In part, this may be because men are exposed to more noise throughout life. But we are seeing some very similar sex differences in chinchillas." In experiments conducted before and after administering estrogen, she found that the females were less susceptible to noise damage at baseline, and that animals receiving estrogen were less likely to develop hearing loss due to noise. She is now measuring natural estrogen levels in the animals and testing their susceptibility to noise. "Now we are trying to trace sense, changing the channel to get better reception. Burkard says one explanation for this phenomenon may be that somewhere in the brain, the inhibition mechanism that protects the central auditory system from too much stimulus develops a lower threshold when less sound reaches the system. The brain's penchant for reorganizing itself may then explain why people who receive hearing aids or implants often have trouble adjusting to the devices. "When people first try a hearing aid, they frequently don't like it," Burkard says. "We think this is because the brain has already compensated for less stimulus, and when the signal is turned up with a hearing aid, it's bothersome; it helps to explain people's distress. This is why it is really important for people to stay with their devices until the brain once again adjusts to the new stimuli." Sandra McFadden, PhD, research assistant professor at the center at UB, and Henderson have found that a poorly understood segment of the auditory organs called the efferent system may play a role in permanent hearing loss. "The efferent system is the appendix of the auditory system," McFadden says. "We don't really know what it does." natomically, the efferent system is a large bundle of fibers running from the brain to the cochlea that functions as a feedback mechanism. "We' re one of the first laboratories to show that if you cut the efferent fibers in one ear, those ears show more damage from noise," McFadden says. "It appears the efferent 6 luffalo Pbysicin S umm e r 2 0 02 Knowledge is power in nearly every endeavor, and this is particularly true in basic scientific research. Understanding how hearing is lost and how hearing loss can be recovered or prevented will make possible the development of new devices and therapies that will brighten the lives of millions of people. The future for understanding and treating hearing loss and other hearing disabilities looks bright, Salvi says. "Drawing from brain imaging, genetics, neuroscience, molecular biology and biochemistry," he says, "we now have a whole arsenal of weapons at our disposal, ranging from those that allow us to look at acquired hearing loss at the molecular level to those that let us look at the whole brain at once." Great-grandmother, with her ear trumpet, would no doubt be a mazed. CD Additional UB scientists who have contributed to the studies described above include Dalian Ding, Wei Sun, Xiangyang Zheng, MD, and Bo-Hua Hu, MD, all of whom are research assistant professors. For more infonnation on the studies described in this article or other major research advances made at the UB Center for Hearing and Deafness, visit the center's web site at http://wings.buffalo.edulfaculty/research/chdl �SENSORY PHYS I CS AND THE SUBSPECIALTY OF Most hearing research and treatment to date has concentrated on the transmitting of auditory signals to the brain-the How Sound, Taste, PSYCHOACOUSTICS "sending" end. It is possible, however, for people to have trouble hearing even when the sending mechanism is in fine shape. One new and promising field of hearing research focuses on how One of the theories she is following is that during hearing loss, these and where the brain receives and deciphers certain signals from the cells may lose their sensitivity due to lack of stimulation. "This leads us auditory nerve. to address a number of questions," she notes. "How plastic is the David Eddins, PhD, and Ann Clock Eddins, PhD, both associate professors in Communicative Disorders and Sciences By Lois Baker (and also husband and wife), are conducting frontline research in this area within University at Buffalo's Center for Hearing and Deafness. brain? Are the cells in the brain being damaged? If we can provide some other type of stimulation, can they recover? Can we stimulate them in a way that will help them respond better?" In another approach to studying the temporal quality of sound, Eddins is conducting PET studies on human volunteers to observe which parts of the brain are active when exposed to auditory signals and what features of sound prompt the brain to shift focus from one part to another. "We are trying to understand why hearing comes easily when listening to certain aspects of sound, while other aspects are more difficuH," she says. "We've found that processing shifts from one side of the brain to the other, depending on whether you are listening globally, such as to general conversation, or locally, such as to a teacher's instructions." This work may help to explain why a problem student "can't hear" even though a hearing test finds no deficit-there may be a glitch in the central processing. David Eddins, PhD, trained in clinical audiology and experimental psychology, studies how the intensity of a sound varies across different frequencies, a concept called spectral processing. "The ability of the ear to identify peaks and valleys of sound is very important in identifying the characteristics of sound," he says. "Every sound has a characteristic spectral pattern, which helps in identifying They work in the field of sensory physics, which is the study of how the source of the sound and in telling the difference between sounds, sound, taste, smell, touch and vision are perceived, and within this but we don't know how the brain processes this information." larger field, in the subspecialty of psychoacoustics. Eddins bases his research on the earlier work of vision researchers. Ann Eddins, a specialist in auditory physiology, studies the brain's These scientists had shown that the brain breaks down an image into temporal processing of sound, or how sound varies over milliseconds of many different parts, then assigns the parts to specific places in the time. "There is a lot we don't know about how the auditory system codes brain's visual center, where specialized cells tuned to certain spatial time," she says. "Most people are able to process temporal variations in frequencies become excited and create a neural representation of sound, but in hearing loss we think people lose some of this proces- the image. sing abilitY." "This discovery brought a revolution in visual science," Eddins says. This results in sounds being smeared together, especially if the "We think there may be a general mechanism for processing features person is listening in an environment with background noise, Eddins of all stimuli. Are cells in the brain tuned to certain spatial frequencies says, which probably contributes to poor understanding of speech in for hearing? We have found strong evidence of "tuning," and we think the hearing impaired. tuning can be explained by the presence of channels-groups of cells Eddins is studying the question of how the temporal aspects of sound devoted to different spatial frequencies of sound. This provides us with are processed in the brain using several approaches, working with an a basic understanding of how sound is interpreted in the brain and how animal model. On a "global" level, she measures the electrical action this tuning changes with hearing loss. created by groups of cells in the brain, called evoked potentials, during "We suspect that the evidence we and others find in this research sound. This identifies the parts of the brain that are activated. She then will completely change the way we think about how the central-auditory measures responses of single neurons in the regions activated to deter- system works." mine which cells respond to sound duration, or to high or low frequency. Summer 2002 l u ffa l1 Pb ysici a a 7 ��BUT NOT FORGOTTE THE WORK OF STEPHEN LAZORITZ, MD '76, PEDIATRICIAN, CHILD ADVOCATE AND AUTHOR WHEN STEPHEN LAZORITZ, MD '76, FIRST "MET" MARY ELLEN WILSON, IT WAS THE LATE 1960s AND HE WAS A UNIVERSITY AT BUFFALO As UNDERGRADUATE. A STUDENT IN SOCIAL WORK 101 HE LEARNED ABOUT THE 10-YEAR- OLD GIRL, A NEW YORK CITY ORPHAN, WHO HAD SUFFERED HORRIFIC ABUSE AT THE HANDS OF HER FOSTER MOTHER FOR ALMOST EIGHT YEARS. S 11 111 m ,. r 2 0 0 2 llflal• nysicia• 9 �Not FORGOTTEN Mary Ellen was not a modern-day child, however. Born in 1864, she was a child from another century, a time when laws accommodated the rescue of abused animals yet made no provision for rescuing abused children. In 1874, her tragic young life became the subject of one of the most celebrated and important legal cases of its time, a case that led to the establishment of the first child protection agency in the United States: the New York Society for the Prevention of Cruelty to Children (NYSPCC). Lazoritz never forgot the little girl whose suffering resulted in a landmark child protection case. Years later, as a pediatrician with expertise in child abuse, he picked up the thread of Mary Ellen's story and embarked on a 15-year quest to find out more. In 1988, his perseverance and a few serendipitous occurrences yielded a book titled Out of the Darkness: The Story ofMary Ellen Wilson, now in its second printing. A Simple Twist of Fate window, along with books and files, and the crowd chanting 'off Today, as vice president for medical affairs at Children's Hospital ROTC.' Eventually, this and other action by vocal students and in Omaha, Nebraska, Lazoritz can look back on a career in which he faculty led to the program being discontinued." has dedicated more than 20 years to abused and neglected children. As a result, Lazoritz, who had been accepted into the Air Force's Despite this remarkably long tenure in a field noted for its quick pilot training program with high honors, had to decide whether burnout, Lazoritz did not enter college at the University at Buffalo in he would transfer to a ROTC program at another university, or 1968 with a driving desire to become a physician. As an undergrad- stay at UB and declare a new major. Eventually, he decided to stay at UB and pursue studies in sociology and pre-medicine. To catch uate in Air Force ROTC at UB, he had pretty much decided on a career as a pilot. However, his experience as a hospital volunteer up with his coursework in these areas, he attended summer while in high school had also sparked an interest in healthcare, school for two years, an effort that paid off when he was admitted which prompted him to take classes in social work. to UB's School of Medicine in 1972. In his third year of medical school, Lazoritz completed his "UB's social work department back then was radical. And there I was, a politically conservative sophomore in my ROTC uniform," Lazoritz recalls. "So, needless to say, I didn't really fit into social work at that time." pediatric rotation at Mercy Hospital in Buffalo, where he met faculty who inspired him to make a lifelong commitment to working with children. "! had some really great preceptors who had a big influence on my life," says Lazoritz. In particular, he remembers UB clinical professors of pediatrics Although he didn't know it in 1987, t return to Buffalo ing more of the Mary Ellen mystory. Upon learning that the child was ventually placed with a family who lived near Rochester, ew York. he made several trips there to investigate. joseph Mattimore, MD, and Chelikani V. Varma, MD. "These physicians and the staff at Mercy showed me that working with kids was a fun thing to do," he recalls. On-the-Job Training Upon graduation in 1976, Lazoritz began a 10-year stint in the United States military, during which time he served in both the Navy and Army. After completing his residency in pediatrics at the Naval Regional Medical Center in Portsmouth, Virginia, in 1979, 10 Ultimately, anti-Vietnam sentiments on campus culminated in events that forced Lazoritz to make a tough decision about his career plans, a decision that put him on a path to becoming a physician. he began his pediatric career at the Naval Regional Medical Center in Orlando, Florida. "One afternoon a crowd looted the ROTC office in Clarke Gym," he recalls. "! remember a Xerox machine flying out the abused children. A turning point in his exposure to these cases laffala Pbysiciaa S umm e r 2 00 2 As a pediatrician, it was inevitable that Lazoritz would encounter came one day while he was working with a group of psychiatrists �and overlooked documents. During his tenure as assistant professor of pediatrics at the Uniformed Services University in Bethesda, Maryland, from 1981 to 1987, he used his free time to search the Library of Congress for information on her case. Finding newspaper articles from 1874 that documented the court trial was easy, he says, but what he really wanted to discover was who her descendants were and how her life later unfolded. On a trip to the National Archives he met a man who gave him a crash course on how to conduct genealogical research, which led to a major breakthrough. performing evaluations of abused kids in Orlando. "On my first day, I got paged to the emergency room to see a child abuse case, and my boss said, 'Oh, by the way, you're also on the child abuse team,"' recalls Lazoritz. "I found out that Mary Ellen had gotten married, and !learned what her husband's name was," recalls Lazoritz. "Then I started looking through years of obituaries to find out when he died so I could get a list of their descendants." In 1987, Lazoritz, his wife, Mary, and their growing family (which "When I saw that first patient, which was a sexual abuse case, I realized that I didn't know what I was doing, and I knew I had to eventually numbered six children, including a daughter named learn," he continues. "Until the late 1970s and early 1980s, we didn't Mary Ellen) returned to Buffalo, where he joined the UB School of know much about sexual abuse. Those of us working in the field at Medicine and Biomedical Sciences as an assistant professor of the time had to teach ourselves and learn in an informal way from pediatrics, a position he held until 1992. During this time, he also other people who knew what they were talking about." Lazoritz soon discovered that the "other people" who knew what they were talking about often were the allied healthcare professionals involved in the abuse cases. "One of the things that intrigued me most about working in the area of child abuse is that you were a member of a team that could include social workers, psychologists, law enforcement officers, lawyers, or prosecutors. And we all had to share information; this is one of the tenets for this field. For example, early in my career I didn't know as much about child abuse as the social workers, nor did I know about the social work aspects of interven- served as director of pediatrics at Erie County Medical Center, where he established the hospital's first child sexual abuse clinic ing in child abuse cases. I had to learn all this in order to be on common ground with them." (sec related article on page 15). Although he didn't know it in 1987, his return to Buffalo moved To this day, teamwork has remained an integral part of Lazoritz' work ethic. Lazoritz literally closer to solving more of the Mary Ellen mystery. History in the Making In 1980, Lazoritz began giving presentations in Orlando to educate the public about child abuse. One day in 1983 while researching a Upon learning that the child was eventually placed with a family who lived near Rochester, New York, he made several trips there to investigate. Not only did he find Mary Ellen's grave, but he also found a school that was named after one of her daughters, florence Brasser, a renowned teacher in the area. lecture, he again encountered the scant, but extremely moving, In talking with the school's principal, Lazoritz was elated to Jearn details of the Mary Ellen Wilson story. "Right then I decided that I had to know as much as I could about that Florence Brasser was still alive and living in a nearby nursing this girl. It became an obsession," recalls Lazoritz. "I kept thinking information that eventually gave him access to the original files from of her as a child, the way she was in 1874, and I believed there were the Mary Ellen case that were stored in a box in the basement of the NYSPCC in Manhattan. real insights and lessons that could be learned from her story." Lazoritz credits "serendipity and divine providence" for helping him painstakingly reconstruct :V1ary Ellen's history from scattered home. He visited the 86-year-old Brasser and was able to gain "My meeting with Florence Brasser basically unlocked all kinds of clues and information," says Lazoritz. S11mmer 2002 lulfa l l npicill 11 �'ot FORGOTTEN 1 A Chance to Finally Tell Her Story In September 1989, eager to share his latest findings on the case, Lazoritz published "Whatever Happened to Mary Ellen?" in the journal Child Abuse and Neglect. A subsequent article about her in American Heritage magazine, which mentioned Lazoritz's research, caught the attention of Eric Shelman, a playwright and fiction writer who lived in Southern California. Shelman had earlier become interested in Mary Ellen's story after reading about her case in a book of little-known facts. In 1991, Shelman contacted Lazoritz via e-mail and the two men began communicating by phone and computer. Eventually they decided to combine their talents to finally tell Mary Ellen's story. "I did most of the research and some of the writing; Eric did the majority of the writing," says Lazoritz. "We were equal partners: I couldn't have done it without him, and he couldn't have done it without me." "Until the late 1970s and early 1980s, didn't know orking in the Milwaukee, where, in 1997, he was appointed associate professor. In 1998, seven years into their collaboration, Lazoritz and Shelman finally met, a year before Out of the Darkness was published. Unique Opportunity to Advocate for Children In the late 1990s, after more than two decades of working on the "front lines" with cases of child abuse, Lazoritz began to feel that his job's high stress level was exacting a toll. "Some people can take a daily dose of the worst that our world has to offer without getting bitter, disillusioned or burned out," he says. "However, I found myself getting bitter, hostile and angrylosing my objectivity and becoming part of the problem. "I like the term 'compassion fatigue,"' he adds. In 2000 Lazoritz left Wisconsin for his current position as vice president for medical affairs at Children's Hospital in Omaha, where he also serves as clinical professor in Creighton University School of Medicine's Department of Pediatrics and as adjunct professor in the University of Nebraska Medical Center's Department of Pediatrics. In his leadership role at Children's Hospital, he feels he has a unique opportunity to advocate for children. "My job is to be a field at the time had to teach ourselves and learn in an facilitator, to provide the medical staff with the tools they need to do informal way from other people who knew what they their work, and to look at the medical needs of the community to see how we can better serve them," he says. were talking about." Collaborating by e-mail, phone and fax, the two created a work of "historical fiction" that is firmly grounded in facts. Initially, Lazoritz was reluctant to include even an iota of fiction; however, Shelman convinced him that a strict reading of court transcripts, dates, and data would not do justice to the story. Having the complete original court transcript of the case was crucial to retelling the story, as it supplied the authors with dialogue in a realistic context. Still, Shelman's storytelling expertise was needed to recreate the settings and thoughts of the characters, as was the assistance of a historian whom the writers employed to review the book for accuracy. For his part, Lazoritz walked the streets of New York and gathered factual information about the neighborhood settings described in the book. In 1992, when his collaboration with Shelman was just beginning to gain momentum, Lazoritz left Buffalo for a position as assistant professor of pediatrics at the Medical College of Wisconsin in "As an administrator at a children's hospital," he continues, "I get a dose of the best that our world has to offer: a team of dedicated professionals working tirelessly to save lives or make children's lives better." While awareness and activism against child abuse has grown tremendously in the past 30 years, the fight to protect children is far from over, says Lazoritz, who points out that an average of three children die from abuse and neglect in the United States every day. One Person Helping One Child During his career Lazoritz has been a keen observer of how the medical profession reacts to child abuse cases, and he hasn't always liked what he's seen. "The issue is not identifying child abuse," he stresses. "For 10 years, every physician licensed in New York State has had to take a course in identifying and reporting child abuse. Unless they were sleeping, they have had the facts. The real issue is taking a stand." Physicians, he says, deny child abuse or don't report it for a number of reasons: "For example, they don't want to get involved, don't want to go to court, don't believe that a family they are well acquainted with I 12 l1ffala Ph ysician Summer 2002 CONTINUED ON PACE 14 �children, Wheeler and Bergh rescued Mary Ellen by relying on laws written to protect animals from inhumane treatment. As a result of the Mary Ellen case, Bergh later went on to found the New York Society for the Prevention of Cruelty to Children INYSPCC). Before the creation of the NYSPCC, child abuse and neglect was considered a family matter; challenging parents or Ellen7 intervening on behaH of a child was unheard of. The land- • mark case of Mary Ellen Wilson forced society to accept a moral responsibility to protect children, even from their parents, and many states followed New York in making child abuse illegal. The Story of Mary Ellen Wilson by In April 1874, Mary Ellen's foster mother, Mary Connolly, was convicted of felonious assault and sentenced to a year in the first child in America to be legally removed from an abusive the penitentiary at hard labor. home. Born in 1864 in the New York City tenements of Hell's In June 1875, Mary Ellen Kitchen, Mary Ellen was only two months old when her father was placed in the care of Etta was killed in the Civil War, leaving her mother destitute. Wheeler's sister, Elizabeth, Unable to care for her daughter, Fanny Wilson was forced and grew up in the country to find others who could. When Fanny later died of consump- outside of Rochester, New tion, Mary Ellen was placed in a home where she was horribly York. She eventually married abused by her adoptive parents. She was beaten with a rawhide and had two daughters who whip almost daily, forced to sleep on a piece of carpet on the are remembered as educated, floor of a closet, burned with an iron, cut with sewing scissors, successful and compassion- and sexually abused by her foster father. Clothed only in a ate women. Mary Ellen Wilson tattered and tom dress she wore in all seasons, she was finally died in 1956 at the age of 92. rescued at age 10. Out of the Darkness, The The two extraordinary people who came to Mary Ellen's Story of Mary Ellen Wilson, is rescue were Etta Wheeler, a social worker who served victims available at online booksell- of poverty in the tenements, and Henry Bergh, who in 1866 ers; or it can be purchased founded the American Society for the Prevention of Cruelty to directly from its publisher, Animals IASPCA). Because there were no laws in 1874 to protect abused Dolphin Moon Publishing, at dolphinmoon.com. Summer 2002 1111111 Pbysicin 13 �FORGOTTEN CONTINUED FROM PACE 12 could be abusive, or they don't want to cause trouble for the family." Lazoritz's hero, C. Henry Kempe, a researcher, teacher, pediatrician and pioneer in the field of child abuse and neglect, was outspoken in what he believed a physician's role should be. "Since 1961, when Kempe said 'physicians have a duty and a responsibility to identify abuse and prevent its likely recurrence,' the medical profession has had this responsibility," says Lazoritz. Child Abuse Resources The Child Abuse Resources page The American Professional Society on the Abuse of Children (APSAC) Another factor that affects the issue of effective intervention is the differing ways a culture views child abuse over time. "Child abuse is defined by society. Some of the things that we now call child abuse would not have been labeled this 100 years ago, or even 20 years ago,'' explains Lazoritz. "As societies advance and become more sophisticated, they identify things as child abuse that other cultures wouldn't. Too, we're identifying abuse more often because we're looking for it." In addition to a rise in child abuse cases due to more strenuous reporting, the incidence of abuse is increasing due to societal changes. The biggest change, Lazoritz feels, is in the increased numbers of single-parent families and teenage pregnancies. "An MARv ELLEN AT AGE 16 art icle titled 'Infanticide' in the October 22, 1998, issue of the New The International Society for Prevention of Child Abuse and Neglect (IPSCANI England journal ofMedicine stated that the highest risk factors for an infant being killed in his or her first year oflife are a maternal age of less than 19 and less than 12 years of education," he explains. "The number of single teenage mothers has gone up, and therefore I think that's why serious child abuse has gone up." Another disturbing risk factor in abuse cases-and the subject of an abstract Lazoritz coauthored-is a boyfriend or husband who is The National Clearinghouse on Child Abuse and Neglect Information not the child's biological father. In the abstract, Lazoritz cites a 1998 study showing that the rate for child physical abuse committed by mothe rs' boyfriends lies somewhere between 16 and 25 percent. Another form of abuse is the subject of Lazoritz's latest book, Shaken Baby Syndrome: A Multidisciplinary Approach, which he coedited with Vincent). Palusci (Haworth Press, November 2001). "! can't say there's a direct cause-and-effect relationship between early childbearing age and infant homicide, but there certainly is a strong correlation,'' he says. "We can tell people never Prevent Child Abuse America to shake a baby, but if we can get teenagers not to have babies, that would be more effective." Ultimately, Lazoritz hopes his work reflects and inspires a passion for helping children. "We are at a point now where each physician who deals with children should ask: 'What more can I do Compiled by Pamela M. Rose, MLS, Health Sciences Library, University at Buffalo, 3435 Main St., Buffalo, NY 14214. (716) 829-3900 x129; pmrose@acsu.buffalo.edu. to prevent abuse? How can I advocate more for this child who has been abused? How can I do more to help this abused child heal?"' Again, he recalls a quote from Kempe: "It is just not possible to worry about all of the needs of all of the children all of the time. There lies frustration and total inaction as well. " What should be learned from the Mary Ellen story? "Each one of us must have our own 'Mary Ellen,"' says Lazoritz. "One person helping one child at a time can make a difference." 1 1 1f al1 Hysicin S u m m er 2002 CD �~Uo.;'JW'"""'tl when a child living in Buffalo or the surrounding area was discovered to be sexually or physically abused, he or she was referred to ·nOur Own ackyar the only physician in town who was providing medical care for these emergent Coyne is paid by Kaleida Health System's Children's Hospital of Buffalo to treat patients through CATS. FURTHERING THE WORK OF STEPHEN LAZORITZ Niagara tor of pediatrics at Erie Country Medical Center and a University at Buffalo assistant professor of pediatrics. "Steve not only would see the children medically, he also would very In addition, he treats children at the CAC of cases: Stephen Lazoritz, MD, then direc- pital; the former is more of a justice model, where children needed to do," says Jack Coyne, MD '85, clinical associate professor of are primarily advocated for through the court system. pediatrics at UB, and medical director of the Child Advocacy Centers of Each week, Coyne treats 10 to 12 children at the Child Advocacy Center of Erie County, or about 600 a year. In 1992 Lazoritz left Buffalo for a position with the Medical College "That's medically speaking," he emphasizes. "From of Wisconsin in Milwaukee (see article opposite), and Coyne stepped there, the children are seen therapeutically, and CATS in to fill the vacancy he left. advocates on behalf of the children for a wide variety of On several occasions in the early 1990s, Coyne traveled to Milwaukee reasons." to train with Lazoritz in how to medically treat children who had been In addition to the efforts of Lee Anthone, Coyne sexually or physically abused, and since then the two physicians have says, "Our community wouldn't be where it is today in maintained a close friendship. this process if it hadn't been for the work Steve Lazoritz "Steve taught me the process for physically examining the children, did while in Buffalo. By educating the community about as well as how to talk to them and how to document what I saw," says the medical exam we can provide for sexually abused Coyne. In addition to treating abused children, Coyne also picked up children-and what we can do with these exams- where Lazoritz left off in attempting to better organize how the chil- Steve showed how we can really help the children." dren's cases were responded to in Buffalo by a multidisciplinary team of Prior to Lazoritz's educational efforts, instead of professionals that included child protective services, police and district abused children being allowed to begin healing after attorneys. At the time, disputes over areas of responsibility were result- intervention, they were often subjected to a series of ing in less than optimal intervention strategies for the children. court-ordered physical exams-sometimes four or five "For two years, we met as a group in an attempt to discover common ground so that the process of evaluating these children and advocating by different individuals and as late as nine months after the initial intake exam. for them wouldn't be one that was detrimental to their well-being," says "Now we have colposcopy and we can document Coyne. "In order to do that, we had to get on the same page and give up with video and still photography for the medical record," things that we in our separate disciplines were doing, and that's exactly says Coyne. "So if a defense attorney contests evidence what happened." that's being presented and wants another opinion, he In 1994, as a result of these meetings, the Child Advocacy Center (CACI of Erie County was established in Buffalo on Delaware Avenue; can get it by having a physician look at the film and not by traumatizing the child with another exam." three years ago, it moved to its current location at 556 Franklin. Since Despite such progress, there is still much work to be that time, more than 300 such centers have been established in the done in the area of child abuse in our region, Coyne United States, including 14 in New York State. stresses. "Right now, the only entity that 'owns' this According to Coyne, much credit for this effort goes to the late Lee whole process is CATS; in many cases, our healthcare Anthone, the wife of Sidney Anthone, MD '50, a Buffalo general surgeon. system is just doing what it needs to do and no more. "Lee Anthone took this work upon herself as a citizen in an effort to Getting the community involved with ownership-that's try and make something happen. She helped facilitate the whole process," says Coyne. The Child Advocacy Center of Erie County is part of the Child and Adolescent Treatment Services (CATS), a local nonprofit social and and according to Coyne, and is affiliated with Niagara Falls Memorial Hos- effectively advocate for them by going to court or doing whatever he Erie, Niagara and Genesee counties. County the CAC of Genesee County. The latter operates along a hospital model, the most important thing now," he says. For more information on the Child Advocacy Center of ~ Erie County, contact Edward Suk, CSW, director, at (716) 886-5437, or e-mail him at sukedward@aol.com. therapeutic agency. Summer 211112 laffale Hysician 15 �ALUMNl MEDICINE, ibernating myocardium i. a condition causec1 by the progressiv£ narrowing of th£ heart arteries, re· suiting in chronic reduction of blood flow tc t-ho hPtJrt M. CANTY MD '79, ALBERT JoHN While contraction of the heart is depressed, the heart tissue remains viable. Since function can improve if blood flow is restored, it is a reversible cause of heart failure. At the University at Buffalo School of Medicine and Biomedical Sciences, John M. Canty Jr., MD '79, and colleagues in the Center for Research in Cardiovascular Medicine are investigating ways in which the heart adapts to chronic reductions in blood flow. Their goal is to discover techniques by which this condition can be diagnosed and to devise new therapies to improve heart function. Canty, a professor in UB's departments of medicine and in physiology and biophysics, recently received a four-year, $700,000 grant from the Department of Veterans Affairs to support a study in which he is using gene transfer by injecting the heart with experimental viruses that contain vascular growth factors in order to try and stimulate development of new or existing blood vessels in the hibernating porcine model. "Over the last several years, there has been intense interest in developing angio- JR., A~D ELIZABETH KATE CHAIR IN .ARDIOVASCULAR DISEASE 16 laffalo Phpiciaa S umm e r H111,r!P 2 00 2 genic gene transfer therapies to stimulate the development of the coronary collateral circulation as an alternate approach to care for patients with inoperable coronary artery diseases," says Canty. "This investigation will identify the ability of different therapeutic strategies to improve collateral perfusion and reverse chronic ischemic left ventricular dysfunction." This study is just one of a number of funded investigations currently being conducted by Canty, who is internationally known for his work in the area of chronic adaptations of the heart to ischemia, according to Robert Klocke, MD, chair of the Department of Medicine in UB's School of Medicine and Biomedical Sciences. In addition to the VA grant, Canty's support includes two grants from the National Heart, Lung and Blood Institute (NHLBI) that total $3.2 million. "At the present time, we have very few options other than cardiac surgery or interventional cardiac catheterization to improve blood supply to compromised cardiac muscle," explains Klocke. "Dr. Canty's work has the promise of providing alternate means of improving cardiac blood flow in all patients with heart disease, not just those who are well enough to tolerate invasive procedures." In recognition of his ongoing contributions to research in cardiovascular medicine, Canty was appointed as the Albert and Elizabeth Rekate Chair in Cardiovascular Disease in UB's School of Medicine and Biomedical Sciences in January 2001 (see article, opposite). "It is a tremendous honor to have been appointed the Rekate Chair," says Canty. �"Since its inception nearly 20 years ago, the Rekate endowment has been instrumental in facilitating a steady expansion of the cardiovascular research programs at UB. It has allowed us to support a number of talented physician/scientists pursuing basic research in cardiovascular medicine in Buffalo." A native of Buffalo, Canty received his bachelor's degree in biomedical engineering from Rensselaer Polytechnic Institute in 1975 and his medical degree from UB in 1979. After training in internal medicine at the University of Rochester, hereturned to UB as a cardiology fellow and joined the full-time faculty in 1983. In 1995 he was named professor of medicine at UB and in 1996, professor of physiology and biophysics. Currently, he also serves as associate chief of the Division of Cardiology and is director of the Cardiac Care Unit at Erie County Medical Center. Canty has received numerous academic awards, including membership in Alpha Omega Alpha, the James A. Gibson Anatomical Society and the Tau Beta Pi Engineering Honorary Society. In 1982 he received the John C. Sable Memorial Fund Award and in 1983 was named a Sinsheimer Scholar. He was also the recipient of a Clinical Investigator Award from the National Institutes of Health's HLBI. In addition, Canty has held numerous memberships on national committees of the American Heart Association and has received consecutive four-year appointments to the Cardiovascular-Renal Study Section of the NHLBI. He has also served on the editorial boards of the American journal of Physiology, Circulation Research and the journal of Cardiovascular Pharmacology and currently reviews manuscripts for numerous other journals, including the New England journal ofMedicine. He is a Fellow of the American College of Cardiology, the American College of Physicians and the American Heart Association. An active teacher and speaker, Canty has mentored over 20 undergraduate students and postdoctoral trainees and has accepted many invitations to speak at recognized centers of cardiovascular excellence worldwide and to chair national and international meetings. 4D 1 he Albert and Elizabeth Rekate was established in 1982 to support and strengthen the educational and research activities of the Division of Cardiology in the University at Buffalo School of Medicine and Biomedical Sciences. Albert C. Rekate, MD '40, has served UB in a number of capacities, including professor of medicine, director and acting chair of the Department of Rehabilitation Medicine, acting dean of the School of Health Related Professions, and associate dean. Since 1995, he has also served as a member of the Dean's Advisory Council for the School of Medicine and Biomedical Sciences. In 1999, the Albert and Elizabeth Rekate Chair in Cardiovascular Disease was augmented by the Willard H. Boardman, M.D., and Jean Boardman Endowment. William Boardman, a retired cardiologist, earned a medical degree from UB in 1944; his wife, Jean, earned a B.A. degree in biological sciences from UB in 1948. 4D CRoss-DisCIPLINARY CoLLABORATIONS m the cent r is their poten estern New c app 1c for Research in Cardiovascular Medicine has a tion to the development of new diagnostics and York Healthcare System. Fallavolhta has re broad interest in integrative cardiovascular bi- therapies for patients w1th chronic coronary ar- ceived a three-year, $390,000 grant from t ology. By combining investigatiOnal stud1es di- tery disease, accordmg to Canty. "In this regard, Department of Veterans Affairs to support a rected at understanding pathophysiological we collaborate closely w1th the UB-VA Center for study he 1 conductmg to determme wh1ch mechanisms m the intact heart with stud1es Positron Em1ss1on Tomography, as well as w1th cardiac tests are most useful in pred1ctmg aimed at tter understandmg the basic bio- bas1c scientists in the School of Med1cine and those patients w th coronary heart d1s ase chemical mechamsms at the molecular level, who w1ll benefit most from surgery. the program emphasizes research that can Biomed1cal Sciences," h says. "The translational nature of the research translated from the laboratory to the beds1de. giVes us the opportunity to test the concepts we the heart improve clmically when blood flow "The central theme of our research is fo- know to be mechanistically involved based on 1s restored by cardiac bypass surgery, accord- cused on understandmg chronic adaptive re- pnor laboratory work with patients who have car- mg to Fallavolhta. "However, m patients w1th sponses of the heart to repetitive ischem1a diovascular d1sease," adds Canty. "Many of the coronary artery d1sease, chromcally dysfunc- ar to that occurring m chronic coronary expenmental approaches that we use are iden- tional myocardium artery d1seases," says John M. Canty Jr., MD, tical to those used m the care of patients w1th coronary revascul rlzation can improve left Albert and Elizabeth Rekate Chair in Cardio- chronic cardiovascular d sease." ventricular function, symptoms and mortal- si vascular D1sease at UB and director of the university's card logy research programs. A key feature of all research projects with- At present, Canty is collaboratmg on myocar- Not all patients wsth poor blood flow to IS frequently v1 le and ity. Therefore, the abihty to identify th1s via· dial hibernation studies with James Fallavolhta, bility m patients, prospectively, is of great MD, assoc1ate professor of medicme at UB, who 1s chnical importance," he says Su mm er 2002 lulfalo Hysiciu 11 �MEDICAL ScHOOL N E w s a This yea National Residency Matching Program (NRMP) results were announced on March 21.2002. Thirty percent of University at Buffalo's graduating medical students will stay in Buffalo to train in the Graduate Medical-Dental Education Consortium, while 46 percent will go out of state. "For the first time, the NRMP has not provided data on choices," says Nancy Nielsen, MD, assistant dean for Student Affairs in DB's Office of Medical Education. "However, polling our students reveals oustanding results, with over 60 percent receiving their first choice and over 90 percent matching in their top three choices." Nationally, match results indicate adecrease in residency positions filled in six primary care specialties: family practice, internal medicine, pediatrics, medicine/pediatrics, internal medicine primary and pediatrics primary. There were 373 fewer U.S. seniors filling these generalist residency positions, with 2051ess positions filled overall. Some specialty areas experienced an increase in match rates compar· ed to last year, including anesthesiology, which had afill rate of 95.1 percent-a 7percent increase over last year; and physical medicine and rehabilitation, for which the fill rate increased from 77.3 percent to 90.4 percent. Diagnostic radiology filled an additional44 PGY-2 positions this year, while there was aslight decrease in U.S. medical school seniors matching to general surgery positions. Overall, 23,459 individuals partici· pated in the match this year. Active U.S. medical school senior applicants enjoyed the highest percentage of matches to first·year residency positions. with a94.1 percent match rate. Nazaneeo Grant learns she is gaing to Geargetown to train 11 surgery. Amodeo, Victoria Blitshteyn, SYetlana U ROCHESTER/STRONG MEM-NY UN i v BuFFALO GRAD MED-N Y Applebee, Garrick UVM/FLETCHER ALLEN-V T Ariyaratana, Suzie lulfal1 Pbysiciaa Summer2002 LOYOLA UN I VERS ITY MEDICAL CTR- I L UN I V NoRTH CAROLINA HosP Brennen, Dnid Auerbach, Marc SAUS H EC/ B ROOKE ARMY NYU SCHOOL OF MED ICINE MED CTR-TX Azodo, Uchendu Brooks, Victoria M OREHOUSE SCHOOL OF MED IC I NE-GA UN I V BUFFALO GRAD MED-NY Beaman, Antoinette Brunetti, Vito r BETH I SRAEL MED CTR- y MERCY H OSP- P ITTSBURGH-PA Beaman, Shawn UN I V H EALTH CTR OF PITTSBURGH- P A UN I V H EALTH CTR OF P I TTSBURGH-PA ALBERT E I NSTE I N COM-NY Bullaro, France sa UN I V H EALTH CTR OF P I TTSBURGH-PA Burke, Mark Beatty, Matthew UNIV BUFFALO GRAD MED-NY UN I V BuFFALO GRAD MED-NY Carlin, Matthew Belani, Shaleen SUN Y H SC-SYRACUSE-NY W I LLS EYE H OSP I TAL-PA Belli, Lily Chang, Jerry LONG I SLAND ) EWISH-NY Choe, Hana LENOX H I LL H OSP ITAL-NY W I NTHROP-UN I V H OSP-NY Binder, DaYid U SouT H ERN CA LI FORN I A Chopra, Liza UN i v BuFFALO GRAD MED-NY CAMBRIDGE H osP/C H A-MA NEW ENGLAND MEDICAL CTR-MA 18 MAYO CLIN IC- ) ACKSONV I LLE BojoYic, Branko �Asuccessful couple'smatch takes Jay Mepani and Rachel Kozower to Case Western University's Metrohealth Medical Center. Francesca Bullaro and friends celebrate news that she will train in pediatrics;Margo McKenna, leh, was aresearch scholar at the NIH last year. Hennon, Mark Chu, Alvina ALLEGHENY GEN H osP-PA UN1v OF CHICAGO HosP- I L DeiBroccolo, Jennifer Fleming, Emily Hinchey, Paul Chung, Jeffrey y STONY BRooK TEAC H H asP- Y Foresta, Christopher Hineman, Ashley NYP HOSP-COLUM PRESBY-NY WAYNE STATE UNIV-M I W I NTHROP-UNIV H osP- Den Haese, Diane Collure, Don UNIV BuFFALO GRAD MED-NY P HOENIX C HI LD/MAR ICOPA-AZ UN I V MARYLAND MED CTR MART I N L K I NG ) R/DREW-CA Dischner, Kurt Conklin, Jeffrey METROHEALTH MED CTR-0H MEM SLOAN- K ETTER I NG-N Y YU SCHOOL OF M ED ICINE Gordon, Kelly THOMAS ) EFFERSON UN I V-PA Domaracki, Beth Connery, Cristine NYU Sc H OOL oF MED I C I NE H ARTFORD H os PI TAL-CT OHIO STATE UN I V MED CTR-O H Grant, Gavin Courtright·Orr, Caryn EMORY UN I V SOM-GA Dwyer·Matzky, Keely UN I V BUFFALO GRAD MED- y UN I V BUFFALO GRAD MED-N Y Horn, Scott B ETH I SRAEL MED CTR-NY NYU SCHOOL OF MED IC I NE U CoLORADO SOM-DENVER Hrycelak, Michael Grant, Nazaneen Cuomo, Linda NYP HosP- CooK CouNTY H oSP ITAL- I L Dufort, Elizabeth UN I V BuFFALO GRAD MED-NY Holder,Amy MARY I MOGENE BASSETT-NY CooK CouNTY H oSPITAL- IL Corvino, Timothy Hoghooghi, Alexander Hojnacki, David Gore, Robert UNIV BuFFALO GRAD MED-NY Hines, Ryan Gittleman, Alicia ST. V I NCENT MERCY MED-O H y Y YU SC H OOL OF MED IC I NE DeSantis, Melissa Cone, Jesse COLUMBIA BASSETT- UN I V BUFFALO GRAD MED- UN1v NoRTH CAROLINA H osP WILSON MEM REG/UHS-NY UN IV H OSPS CLEVELAND-O H U ROC H ESTER/STRONG M EM-NY Y CoRNELL- Y Dayrit, Marivic N SHORE U-MANHASSET-NY De Jolla, Daniel GEORGETOWN UNIV H osP-DC Elliott. Darianne GEORGETOWN UN I V H OSP-DC N S H ORE U-MAN H ASSET-NY Gregory, Charmaine Figueroa, George UN I V BUFFALO GRAD MED- Filipink. Robyn y UNIV BuFFALO GRAD MED-NY STONY BROOK TEACH HosPs-NY UN I V H EALTH CTR OF PITTSBURGH- P A Filsinger, Daren CEDARS-S I NA l MED CTR-CA UN 1v BuFFALO GRAD MED-NY Janis, Gregory DUKE UN I V MED CTR-NC Gupta, Anjeli E1 NSTE I N/MONTEF IORE-NY Kader, Michael UN1v BuFFALO GRAD MED-NY Defazio, Jennifer Huebschmann, John CLEVELAND CL I N IC FOUNDATIONO H U ROCHESTER/STRONG MEM- Y Kam,Steven Hebrank, Jessica £1 NSTE I N/M ONTEF IORE-NY W I LSON MEM R EG/U H S-NY UC SAN FRANCISCO-CA Summer 2002 l 1 f f af • H ys ic iaa 19 �M E C D A L N SCHOOL E w Ab1g sm le for Hana Ch e, who IS on ber way to the Umversity of Southern California to train in general surgery. S Katona, Kyle Lee, Angela Lundgren, Janell N SHORE U-MANHASSET-NY U UNIV HosP CINCINNATI-OH Kenjarski, Brian Lee, Mitchell Pr UNIV BuFFALO GRAD MED-NY IV BuFFALO GRAD MED-NY FLUSHING Maceda, Aimee HOSPITAL MEDICAL U MD-MERCY MED CTR CTR-NY Kerr, Christine U FLORIDA PRoG-SHANDS HosP YU SCHOOL OF MEDICINE Mak, John BROWN U INT MED REs- RI Lerner, Alexander Kim, David ST . LuKE's-RoosEVELT-NY WILSON MEM REG/UHS- Y BARNES-)EWISH HOSP-M0 B I DEACONESS MED CTR-MA EINSTEIN/JACOBI-NY Kozower, Rachel Maim, Brian METROHEALTH MED CTR-OH Lesser, Adam METROHEALTH MED CTR-OH NYP HosP-NY CoRNELL- I WINTHROP-UNIV HosP-NY Krakowski, David Y Mato, Anthony IV Hosr-NY HosP oF THE UNIV oF PA Lin, Peter MT. SINAI HOSPITAL- Mclean, Erika y Lang, Christopher Logue, Christopher Miller, Rebecca UN1v BuFFALO GRAD MED-NY MT. SINAI HOSPITAL-NY WINTHROP-U Mepani,Jay Morcos, Morcos ST. FRANCIS MED CTR-PA UNIV BuFFALO GRAD MED-NY MAIMONIDES MED CTR- NY RIVERSIDE METHODIST- 0H U HLTH Svs E CAROLINA - C ''We practice law for your peace of mind." Estate Planning - Personal Injury Real Estate - Matrimonial Elder Law One John James Audubon Parkway Amherst, New York 14228 716.636.7600 20 laflal1 Hysiciu S umm e r 2 002 HOGAN & WILLIG, PLLC .\ ttorneys at Law - - - - - - hoganandwillig.com �Robert Gore ispleased to be going to Cook County Hospital to train in emergency medicine. Mutty, Christopher Rosella, Peter Sorci, Jonathan UNIV BuFFALO GRAD MED-NY U UNIV BUFFALO GRAD MED-NY UNJV BUFFALO GRAD MED- Weiss, Karen Stanbro, Peter MT AuBURN HosP ITAL- MA y Nguyen, Doan u LA MEDI C AL CENTER-CA Russell, Teresa BOSTON U MED CTR-MA UNIV H EALTH CTR OF Stanislawski, Aimee BosToN U MED CTR-MA I LLINOIS COM-CH ICAGO Weitzman, Steven PITTSBURGH-PA O'Donnell, Kathleen UNIV MAss MED ScHOOL Samson, Gregory LONG I SLAND ) EWISH- Swan, Andrew EMORY UNIV SOM-GA UNIV NoRTH CAROLI Oh, Richard y Whiteside, Michael A HosP H osP OF ST. RAPHAEL- CT Schapiro, Ann MARY I MOGENE BASSETT- NY YALE UN I VERSITY-CT UNIV BuFFALO GRAD MEDMAIMON I DES MED CTR- Y y Osman, Magda UN I V BuFFALO GRAD MED- NY Ostrow, Gregory H ARTFORD H OSP I TAL-CT HLTH PART/REG IONs HosP-M Symons, Andrew Schindler, Kim Wisnoski, Jennifer r UN I V BuFFALO GRAD MED- NY UN I V BUFFALO GRAD MED- y UN I V BuFFALO GRAD MED- NY Tenney, Emily Wolpiuk, Anne CLEVELAND CLINI C FouNDATIONOH UN I V BuFFALO GRAD MED- NY Schwartz, Lainie Teper, Irene UNIV BUFFALO GRAD MED- NY ST . MARY's MED ICAL CTR-CA Seereiter, Phillip Thurlow, Juliane UN I V BUFFALO GRAD MED-NY UN I V B UFFALO GRAD MED- UNIV BuFFALO GRAD MED-NY UNIV BuFFALO GRAD MED-NY Packianathan, Nalini UNIV BuFFALO GRAD MED- NY y ) OHNS HOPKINS H osP- MD Selip, Debra Traugott, Matthew E1 NSTE I N/J ACOB I-NY L ONG I SLAND )EW I S H-NY Selkirk, Stephen Vannelli, Patrick Woo, Junda BAYLOR CoLL MED- H ousTON - TX Yoon, Daniel YU SOM UN I V BuFFALO GRAD MED- Perez, Brenda Y ATLANTI C HEALTH SYs- N J Shahryarinejad, Azin Puchalski, Rebecca BETH I SRAEL MED CTR-NY UN I V BuFFALO GRAD MED- NY Singh, Sandesh Ramsdell, Robert THOMAS ) EFFERSON UNIV - PA UN I V BuFFALO GRAD MED- NY lf'd Yolfson, Alexander CASE WESTERN RESERVE- OH ST. }osEPH ' s-SvRACUSE-NY y UNIV HosP C I NC I NNAT I- OH Pasol, Joshua YU DowNTOWN HosP-NY Wong, Robert UN I V BuFFALO GRAD MED- UN I V BUFFALO GRAD MED- y Siuta, Jonathan Ridgeley, Jamison U NEBRASKA AFFIL HosP NYP H osP-NY CORNELL-NY Zwerling, Brian Walcott, Roger NY H osP/MED CTR QuEENS ST. ELIZABETH ' s MED CTR- MA LONG I S LAND }EWISH MED CTR- NY Weinstein, Jody NAVAL HOSPITAL PENSA C OLA-FL PROGRAM - U H LTH Svs E CAROL I NA- N C UNIV BuFFALO GRAD MED-NY u "' m e r 2 0 0 2 la ffalo Hys i c ian 21 �THE 156TH COMMENCEMENT FOR THE SCHOOL OF MEDICINE AND BIOMEDICAL SciENCES wAs HELD ON MAY 24, 2002, AT THE CENTER FOR THE ARTS ON THE NoRTH CAMPus. THIS YEAR, THE SCHOOL CONFERRED 136 MD DEGREES, 2 MD/PHD DEGREES, 7 MD/MBA DEGREES, 22 PHD DEGREES, 2 MPH DEGREES, AND 27 MASTER'S DEGREES. THE HONORED SPEAKER WAS NEW YORK STATE HEALTH COMMISSIONER DR. ANTONIA NovELLO. CLASS SPEAKER WAS ANTHONY 22 l1ffala Pbysicin MATO. ��PATHWAYS N E ws ABOUT UB' s ScHooL oF M E DICINE AND BIOMEDICAL SCIENCES AND ITS ALUMNI, FACULTY, STUDENTS AND STAF F SUMMER Skolnick t 2002 ad Jeffrey Skolnick, PhD, a worldrenowned scientist in the fields of computational biology and bioinformatics, has been named director of the Buffalo Center of Exce ll ence in Bioinformatics and UB Disting u ished professor of structural biology at the University at Buffalo, the lead research SKOLNI C K partner in the center. Skolnick has served as director of computational and "THIS C OMBI Fl structura l genomics at the Danforth Plant Center in St. Sl PPORT MADE I I Louis, Missouri, since 1999 POSSIBI E FOR US TC' and as an adjunct professor of biochemistry at Washington GO AFIER HIE BfSl University in St. Louis, where ) OF THE. BFST. he has been a member of the faculty since 1982. He has developed algorithms for the prediction of protein structure and folding pathways from protein sequence and has pioneered the use of lattice-based approaches to protein tertiary structure prediction, as well as the simulation of membranes 24 l a lfal e Phy si c iu S t~ m m e r 20 0 2 and membrane peptides. He has also developed structurebased approaches to predict protein function from amino acid sequence, protein-protein interactions and pathways that can be applied to entire genomes. He holds nearly $700,000 in grant support from various agencies, including the National Institutes of Health. Sko lnick earned a bachelor's degree in chemistry from Washington University in St. Louis and master's and doctoral degrees in chemistry from Ya le University. He was a postdoctoral research fellow at Bell Laboratories from 19781979 and an Alfred P. Sloan Foundation Research Fellow from 1983-1987. He is chair of the Scientific Advisory Board on Geneformatics and a member of the Scientific Advisory Board of the Proteome Society and the NIH's Molecular and Cellular Biophysics Study Section. Skolnick is a member of the editorial boards of Biopolymers and Applied Genomics and Proteomics, and also has served on the editorial boards of Proteins, Biophysical Journal and Journal of Chemical Physics. He serves as a referee for professional journals that in cl ude Nature, International Journal of Biological Macromolecules, Journal of Molecular Evolution, Journal of the American Chemical Society and Science. Two accomplished researchers at the Danforth Plant Science Center, Andrzej A. Kolinski, PhD, and Marcos R. Betancourt, PhD, will be joining Skolnick at the Buffalo Center of Excellence in Bioinformatics. Kolinski is a professor at the plant center and heads the biopolymers laboratory at the University of Warsaw 1n Poland. He has won numerous grants and earned several honors, inc! uding the Swietoslawski Award in 1994 and an International Scholar's Award from the Howard H ughes Medical Institute in 1995. Kolinski earned his doctorate in chemistry from the University of Warsaw in 1979, and has taught there and at Washington University in St. 1 I �1 1 Louis, in addition to having worked at the Scripps Research Institute in La Jolla, California. Betancourt has worked in the computational genomics laboratory at the plant center. Prior to that, he held positions at the University of Maryland and at the University of California at San Diego, where he earned his doctorate in physics in 1995. His honors include the Enrico Fermi Award in 1986, a National Defense Science and Engineering Fellowship in 1989 and a National Science Foundation Fellowship in 1996 and 1998. The John R. Oishei Foundation has awarded UB a threeyear, $1,542,000 grant to help support the salaries of Skolnick, Kolinski and Betancourt. "Thanks to the generosity of the John R. Oishei Foundation, in addition to Governor George E. Pataki's strong and visionary financial commitment to this initiative and, at the federal level, the efforts of Congressman Tom Reynolds and Senator Hillary Rodham Clinton, we're delighted to have secured the talents of Jeffrey Skolnick and the world-class team he has assembled for our Buffalo Center of Excellence in Bioinformatics," said President William Greiner at the time of the announcement. " This combined support made it possible for us to go after the best of the best." achsNamed UB Di tinguished Frederick Sachs, PhD, professor of physiology and biophysics was one of 13 University at Buffalo faculty members named in May2002 to the first class of UB Distinguished SA c Hs Professors. The UB Distinguished Professor designation is open to faculty members who have achieved national or international prominence and a distinguished reputation within their field through significant contributions to the research/ scholarly literature or through artistic performance or achievement in the fine arts. Sachs is an authority on cell mechanics and director ofUB's Center for Single Molecule Biophysics. He is also a member of the university's Center for Advanced Molecular Biology and Immunology and its Center for Neurobiology and Vision. His research attempts to understand the electrical processes in cells. Of particular interest are the mechanisms of mechanoreception and the role of ion channels. - SU E W U ET C HER Norton edaiConferred on Jacobs The late Lawrence D. Jacobs, MD, who was professor and chair of the Department of Neurology and a wortd·renowned researcher in the treatment of multiple sclerosis IMSJ, was chosen to receive posthumously University at Buffalo's highest award, the Chancellor Charles P. Norton Medal. The Norton Medal is given annually at the uniYenlty's general commencement ceremony to recocnize someone who has, in Norton's words, "performed some great thing which is identified with Buffalo . · . a civic or political act, a great book, a great work of art, a great scientific achievement, or any other thing which, in itseH, is truly great and enabling and which dignifies the performer and Buffalo in the eyes of the world." "Larry Jacobs was one of our most distinguished faculty mem· ben, and a great Buffalonian-a scholar, researcher and teacher whose groundbreaking research discoveries were exceeclecl only by his compassion and his desire to serve our university, our region and all of humanity," said Presl· dent William R. Greiner. "Throughout his career, Larry brought national and international acclaim to our Depart- ment of Neurology and the UB medical school, as well as to Buffalo-Niagara." Jacobs, who also held the Irvin and Rosemary Smith Chair in Neurology at UB and served as director of the Jacobs Neurological Institute and the William C. Baird Multiple Sclerosis Research Center at Buffalo General Hospital, died of cancer last November at the age of 63. His innovative research, geared toward developing better treatment for relapsing multiple sclerosis-a form of MS that affects 350,000 people in the United States-led to the development of Avonex, which today is the most widely prescribed drug to treat this debilitating form of MS. -SUZASNE CHAMBERLAIN - A RTH U R PA GE Su mm e r 2002 Ia If a I a n y sic ian 25 �PATHWAYS Cranger Pr nted ;t=.n ... i"F..,e Achi vemen Carl Granger, MD, an internationally recognized authority in the field of rehabilitation medicine and professor and chairemeritus of the Department of Physical Medicine and Rehabilitation at the University at Buffalo, received the Lifetime Achievement Award at the third Annual Health Care Heroes Breakfast on April 18, 2002, sponsored by Business First. Granger was honored for his role in developing the Functional Independ e n c e Measure, or FIM™ an easy-to-use rehabilitation assessGRANGER Patrick J Kelly, MD '66, FACS, the Joseph P. Ransohoff Professor and Chainnan of Neurosurgery at New York University (NYU) School of Medicine, received the Olivacrona Award from Karolinska Institute in Stockholm in December 2001 in conjunction with the Nobel ceremonies. Kelly has pioneered computer-assisted stereotactic neurosurgery and minimally invasive surgical techniques for the removal of brain tumors-techniques he is credited with introducing to NYU Medical Center. While a faculty member in the Department of Neurosurgery at UB in the early 1980s-before moving to the Mayo Clinic in 1984-Kelly conducted innovative work in image.guided neurosurgery. To date, he has operated on more than 6,000 patients with brain tumors and is internationally known not only as a brain tumor surgeon but also as an expert in the surgical treatment of movement disorders. In April 2002, Kelly became the only neurosurgeon in history to deliver the William P. Schneider honorary lecture at the American Association of Neurological Surgeons (AANSJ for a second time, having also delivered it in 1996. In this year's lecture he talked about his experiences as a surgeon in Vietnam in 1968-1969. In 1997, Kelly was awarded the Scoville Achievement Award ment tool that allows trained personnel to assign a numerical value-the FIM rating-to a patient's ability to function, based on performance of 18 physical and mental tasks that represent a basic daily routine of personal-care activities. The federal Centers for Medicare and Medicaid Services (CMS), formerly called the Health Care Financing Administration, recently selected the FIM™ as the assessment instrument to be used by rehabilitation hospitals to document requests for prospective payment for rehabilitation treatment. The FIMTM now is used by 1,400 facilities in 50 states and the District of Columbia and has been translated into several languages. In conjunction with the FIM™, Granger established a nonprofit business, the Uniform Data System for Medical Rehabilitation, or UDSMR, to provide reports and store the data for their FIM™ users. That database now holds information on more than 4 million patients, comprising the largest database of medical rehabilitation treatment outcomes in the world. UDSMR is a part of UB Foundation Activities, Inc. -LOIS BAKER art- from the World Federation of Neurological Surgical Societies, marking only the second time in the organization's history that this award has been given. He is also the recipient of The Sir Peter Freyer Medal (Ireland, September 2001), and the Obrador Medal from the Spanish Neurological Association (1996). -S. A. 26 UNGER luffalo Hysician Summer 2002 Ashwani Raj put, MD, has been appointed attending surgeon at Roswell Park Cancer Institute (RPCI) and assistant professor of surgery in the University at Buffalo School of Medicine and Biomedical Sciences. Rajput earned his medical degree (1993) and completed a research fellowship in the DepartmentofSurgery (1997) RAJPUT and residency training in general surgery (2000) at Case Western Reserve University School of Medicine in Cleveland, Ohio. He also completed a fellowship in clinical oncology at RPCI (2002). Rajput's research interests include the molecular genetics of colon cancer and other gastrointestinal malignancies. He is a member of the American College of Surgeons, the Association for Academic Surgery and Society of Surgical Oncology. -DEBORAH PETTIBONE nv tors Recogniz: d School of Medicine and Biomedical Sciences faculty named on United States patents issued to The Research Foundation of the State of New York in 2001 were among those honored by the University at Buffalo at a reception held on May 2, 2002. Among those recognized were Wesley H icks Jr ., DDS, MD '84, associate professor of otolaryngology, who invented the first model of a tracheal lumen that combines epithelial �'V\ R PROl.DTHA A I> IT I M r Y lB W PTTHE<; AWI\RD<;.l8's~CIE CEA D R't Hl( H PRIORIIY I-OR THE l cHI v ME ..,I and mesenchymal elements in a manner that mimics the tracheal lumen surface. Hicks was also honored for his role in developing a method for providing novel surface modified biodegradable polyester polymers that allow small amounts of surface modifiers to be situated on the surface. The research goal for both technologies is the development of wound-healing membranes. Paul }. Kostyniak, PhD, professor of pharmacology and toxicology; Rossman F. Giese Jr. and Joseph A. Syracuse, PhD, co-director of the Toxicology Research Center, were recognized for developing an antimicrobial composition that can impart antimicrobial properties both in, and on, the surface of various household, industrial and medical products. Donald D. Hickey, MD, research assistant professor of physiology and biophysics and clinical assistant professor of neurosurgery, was honored for inventing a device and method to provide a noninvasive estimate of cardiac performance parameters by inserting a catheter and balloon into the esophagus, adjacent to the aortic arch, to sense aortic pressure (part of the previously paten ted Hickey Cardiac Monitoring System). I\ R'\IIY CH UlOGYI<.OF rH 0 ( OMME R( lAllZF fH <;I THLH HI AR AARI rRLLYI tPRESSI\LA I>WI APPR CIAr Stephen Rudin, PhD, professor of radiology and codirector of Radiation Physics Laboratory and Toshiba Stroke Research Center, and Daniel R. Bednarek, PhD, professor of radiology, were recognized for their role in developing a radiographic image apparatus and method for vascular interventions for acquiring veryhigh-resolution radiographic digital images over a small region of interest using a digital solid-state x-ray image detector for the medical imaging application of angiography. Faculty Who Received e Anthony Auerbach, PhD, Physiology and Biophysics; Anthony Campagnari, PhD, Microbiology; Leonard Epstein, PhD, Pediatrics/ Social and Preventive Medicine; Jo Freudenheim, PhD, Social and Preventive Medicine; Paul Knight III, MD, PhD, Anesthesiology/ Microbiology; Mulchand Patel, PhD, Biochemistry; Stanley Schwartz, MD, Medicine; Suzanne Laychock, PhD, Pharmacology and Toxicology. Inventors affiliated with the University at Buffalo were also recognized by the State University of New York as being among the outstanding inventors within the SUNY system at a ceremony held in Albany on May 20, 2002. The UB inventors represented more than one third of the 64 SUNY faculty and staff members from campuses across the system who received awards for their achievements from SUNY Chancellor Robert L. King. Noting this UB Provost Elizabeth D. Capaldi says, "We are proud that UB swept these awards. UB's science and technology is of the highest quality and it is a very high priority for the university to commercialize this intellectual property. Our faculty's achievements in this area are truly impressive and we appreciate SUNY's recognition." The SUNY inventors were honored in four categories: "outstanding inventor," "entrepreneur," "first-time patent" and "first-time invention disclosure." Faculty members were honored as "outstanding inventors," either because they have received multiple patents, their invention has brought in considerable licensing income or their invention is seen as significant in other ways. Faculty in the UB School of Medicine and Biomedical S umm er SG HCH '>TQlALirY. l Al PROPI RTY. YsR coc Ot R 0 • Sciences recognized in this category were: Claes Lundgren, MD, PhD, professor of physiology and director of UB's Center for Research and Education in Special Environments. He has been awarded (with coinventors) more than 120 patents pertaining to, among other areas, human engineering (breathing gear for divers) and the pharmaceutical fields (Nicorette® for smoking withdrawal). Since joining the UB faculty in 1974, Lundgren has submitted six new technology disclosures and has been awarded three patents, two of which are licensed to Sonus Pharmaceuticals and one to a Swiss company, Idiag AG (equipment for respiratory muscle training). Timothy F. Murphy, MD, professor of medicine and microbiology. During his distinguished career at UB, Murphy, who conducts research in the area of vaccine development, has submitted 11 disclosures. Nineteen U.S. and foreign patents have been issued and many more are pending. He is working on a vaccine that targets a bacteria that is the second most common cause ofear infections in children and a leading cause of recurrent infection in patients with chronic obstructive pulmonary disease. 2002 laffale Pbysiciu 27 �PATHWAYS Frederick Sachs, PhD, UB Distinguished Professor of Physiology and Biophysics. Sachs has submitted more than 35 invention disclosures. In a recent study published in Nature, he reported that a protein isolated from the venom of a Chilean tarantula shows promise as a drug to prevent and treat atrial fibrillation, a chaotic beating of the heart that affects 25 million Americans. Several companies are considering the technology for licensing. Those honored as "entrepreneurs" have demonstrated entrepreneurial spirit that enabled them to move their inventions from the research laboratory into wide-scale use. Faculty in the UB School of Medicine and Biomedical Sciences recognized in this category were: EdmundA. Egan, MD, professor of pediatrics and physiology, and Bruce A. Holm, PhD, senior vice provost and professor of pediatrics, pharmacology and toxicology, and gynecology-obstetrics. Egan and Holm developed the commercial surfactant-replacement therapy, INFASURF neonatal, which received new drug approval from the Food and Drug Administration in 1997 as a lifesaving drug that has been demonstrated to reduce the morbidity and mortality of premature newborn infants. INFASURF adult is now in phase II clinical trials. INFASURF drugs are manufactured by ONY, Inc., located in the UB Technology Incubator, part of the university's Office of Science, Technology Transfer and Economic Outreach. Faculty in the UB School of Medicine and Biomedical Sciences recognized for receiving their first patents in 2001 were: Wesley L. Hicks Jr., DDS, MD, associate professor of otolaryngology and attending head and neck surgeon at Roswell Park Cancer Institute, and Frederick Sachs, PhD, UB Distinguished Professor of Physiology and Biophysics. 4D - LORRAINE WAPPMAN AND SUE WUETCHER Choose Canterbury Woods for a lifetime of warmth and fun Set among 63 beautiful acres, Canterbury Woods combines all the best and most meaningful aspects of the way you live now, while addressing your needs and desires for a worry-free future. Call today for your personal tour. Western New York's first Life Care Community. ~nterbury UJoods 1}5) 28 Call7161929-5817 for your personal tour ... laffal1 Physician S umm e r 2 00 2 705 Renaissance Drive Williamsville, New York 14221 �and physiological feedback systems led to the publication of two books on the subject. Dougtas S. Riggs, fonner chair of the Department of Phann· Riggs and his wife of 60 years, Robin Palmer Riggs, acology in University at Buffalo's School of Medicine and shared an uncompromising belief in pacifism. With her help Biomedical Sciences, died on December 22, 2001, at his Riggs was a conscientious objector in World War 11, took in home in Halifax, Canada. He was 87. Hungarian refugees after the 1956 revolution and worked Born in Harpoot, Turkey, of missionary parents, Riggs was educated at Rollins College and at Yale University, where he earned BS and MD degrees. Prior to coming to UB as chair of the Department of Pharmacology in 1954, he pursued an with Physicians for Social Responsibility in the Nuclear Freeze Movement. Riggs is survived by his three children: Timothy A. Riggs of Durham, NC, Virginia P. Riggs, MD (Wendy Lyons) academic career in pharmacology, with teaching positions at of Suffield, CT, and Robin Elizabeth Sagurna of Taufkirchen, Yale and Harvard universities. Gennany; three grandchildren; and a brother, Lorrin A. Riggs was a respected researcher, a gifted teacher and Riggs of Hanover, NH. an enthusiastic mentor. His fascination with mathematics Keyser Cadillac History of Orthopaedic surgery at UB Eugene R. Mindell, MD, chair of the Department of Orthopaedic Surgery at the University at Buffalo School of Medicine and Biomedical Science from 1964 to 1988, has written a history of the department, which is now available for purchase. The book includes an over· view of trends in orthpaedics, both locally and nationally, that impacted on the development of this department, starting in about 1860 and continuing to the present. Complementing this overview are infonnative descriptions of universityhospital affiliations dating from 1848 to the present, and succinct profiles of faculty who contributed to ortho· paedic education at UB over the last 155 years. Also chronicled is Upstate New York's only exclusive Cadillac Dealer the evolution of medical student curriculum and residency training in orthopaedic surgery in Buffalo. Supplementing the 70-page text are 80 photographs, spanning the entire history of the department. The book, titled History of Orlhopaedic Surgery at the University at Buffalo, can be purchased for $25 by sending a check, made payable to the University at Buffalo Foundation, to Michael Quinn, Keyser Cadillac Orthopaedic Surgery Department, University at Buffalo, Hayes 4130Sheridan Drive· Williamsville. Y Annex A, 3435 Main Street, Buffalo, NY 14214. All copies of the 634-4100 key ercadillac.com book and sale proceeds have been donated to UB's School of Medicine and Biomedical Sciences by Dr. Mindell. Summer 2002 4D luffalo Pbysician 29 �BY S. A. UNGER PRESIDENTIAL AssASSINATIONS, Up osean I e c -REEXAMINING THE DEATHS OF KENNEDY AND McKINLEY chair of the Department of Legal Medicine Trauma, presented a talk titled "Trauma Care at Virginia Commonwealth University, Today." He described treatment McKinley Medical College of Virginia, and codirector received in 1901 after he had been shot in of the Virginia Institute of Forensic Science Buffalo and then contrasted this with the and Medicine. Fierro presented a fascinating care a president similarly wounded today look at both the Kennedy and McKinley au- would receive; he also outlined the detailed topsy reports from the perspective of a for- medical-contingency and security plans that ensic pathologist with decades of experience would be put in place wherever the chief executive travels worldwide. studying fatal gunshot wounds of all kinds. After a brief break, the Stockton Kimball In keeping with the lively public debate he University at Buffalo School of Lecture was delivered by Jack C. Fisher, MD, surrounding Kennedy's assassination over Medicine and Biomedical Sciences' emeritus professor of surgery and former the decades, Fierro peppered her talk with 65th Annual Spring Clinical Day was head of the Division of Plastic Surgery at the candid and thought-provoking rebuttals of held on April 27,2002, at the Buffalo/ of California at San Diego. Fisher, University a number of conclusions reached by Becker. Niagara Marriott. The program, sponsored who has authored a book on the McKinley Following Fierro, Roger Seibel, MD '66, by UB's Medical Alumni Association, focused on "Presidential Assassinations in the UB clinical professor of surgery and ortho- assassination titled Stolen Glory, recounted 20th Century." The opening talk was titled "A Surgeon pedics and medical director of the Regional Evaluation for Quality Improvement in how he had become interested in this subject while a medical student at UB. He then pre- Looks at the Assassination of John F. Kennedy" and was delivered by Donald R. Becker, MD, a UB emeritus clinical professor of surgery. Becker provided a riveting description of Kennedy's assassination-his wounds, emergency room treatment and autopsy (the latter of which he characterized as "chaotic"). He also reviewed the criminal investigation that followed, the findings of the Warren Commission and the myriad conspiracy theories that persist to this day. Becker was followed by Marcella Fierro, MD '66, chief medical examiner for the Commonwealth of Virginia, professor and 30 luffall nysician S ummer 2 002 I �sented a well-argued case for why the con- Sullivan, Sharon Murphy, Teresa Vietti and troversy surrounding McKinley's operative the late Brigid Leventhal. His prominence on and postoperative care in Buffalo should finally be laid to rest. At the close of the lectures, the audience the Hodgkin's and non-Hodgkin's lymphoma disease committees of the Pediatric Oncology Group, as well as his role as principal investi- had an opportunity to ask questions of a gator of seminal phase 3 studies of children editor in chief of Vaccine Bulletin. He also serves as a reviewer and editorial board member for many other publications, including Pediatrics. panel made up of the morning's speakers, with these disorders, have Jed to important ad- After leaving Buffalo in 1974, Dantzker after which attendees gathered for a lun- vances in treatment worldwide. In addition to cheon, where Fisher was presented with the Stockton Kimball award by Stephen his scientific and academic credentials, Brecher is known as a devoted, tireless and Pollack, MD '82, on behalf of the UB compassionate pediatrician who exemplifies served as an instructor in the Department of Internal Medicine at the University of California at San Medical Alumni Association. the best qualities of a caring physician. Diego for a year before joining the Each year at Spring Clinical Day, medical of pediatrics at the UniversityofCalifornia at faculty at the Universityof Michigan, where he contrib- alumni achievement awards are presented to Los Angeles and director of pediatric infec- uted greatly to the graduates of UB's School of Medicine and tious diseases and the Pediatric AIDS growth and reputa- Biomedical Sciences. Recipients are nominat- Program at the Cedars-Sinai Medical Center tion of the Depart- ed by their fellow alumni, with final selections made by the governing board of the in Los Angeles. Prior to that, he served for six years as professor and head of the Division ment of Internal Medicine's Pulmo- Medical Alumni Association. This year's re- of Infectious Diseases in the Department of nary Medicine Sec- Pediatrics at the University of Texas Health tion. In 1983, he moved to the University of Science Center at San Antonio, where from Texas Health Science Center in Houston, 1975 to 1981 he was professor and chair of where he served as professor and vice chair of the Department of Internal Medicine atrics at Roswell Park Cancer Institute, chief the Department of Pediatrics. Brunell was a member of the Advisory Committee on Im- of the Division of Pediatric Hematology/ munization Practices Oncology at Kaleida Health's Children's of the Centers for Dis- cine. In 1990, he was nam- Hospital of Buffalo and chief of pediatric ease Control (CDC) ed chair of the Depart- hematology/oncology in the Department of Pediatrics in the University at Buffalo's and the Consultative Group on Vaccine De- ment of Medicine at Long School of Medicine velopment, which is and Biomedical Sci- concerned mainly with medicine at Albert Ein- ences. He is recog- evaluating vaccines for stein College of Medicine nized as a national developing countries. in New York City. He is He has also served as a member and chair of currently a partner in a of childhood lym- the Committee on In- Wheatley Medtech Part- phomas and has fectious Diseases of the MEDICAL ALUMNI Since 1987, Brunell has served as a professor cipients are as follows: Brecher is chair of the Department ofPediat- and international authority in the area and Critical Care Medi- Island Jewish Medical Center and professor of biotechnology company, ners LP. Dantzker has Academy of Pediatrics (the Red Book Committee). In addition to disease and non- serving as a consultant to the World Health Organization, the CDC, the National Insti- textbook Cardiopulmonary Critical Care, Hodgkin's lym - tutes of Health and the Food and Drug Ad- which is the foremost text of its kind. He phoma in children ministration, Brunell has contributed to most of the standard textbooks of pediatrics, med- also established a major investigative jour- icine and infectious diseases in the area of his served on the editorial boards of numerous expertise. Currently, he is chief medical editor of Infectious Diseases in Children and other journals, including The American Review ofRespiratory Diseases. published more than stracts on Hodgkin's and adolescents. Brecher is first author on many papers, published in collaboration with such prominent pediatric oncologists as Margaret :~ 0 and director of the Division of Pulmonary authored more than 100 peer-reviewed papers and several text- 400 articles and ab- c a E books. He is best known for his remarkable nal, The Journal of Critical Care, and has S Limm e r 2002 luffale Physician 31 �A L U M N Spring Clinical Day B rkson M morial Award The RobertS. Berkson, MD, Memorial Award in the Art ofMedicine is presented annually to honor the values and ideals epitomized by Dr. Berkson, who was an esteemed family physician in Buffalo. Patient care was his forte; competence, compassion, patience and dedication to teaching were his virtues. His special expertise in "the art of medicine" is perpetuated in this award. This year, the award was presented to Lawrence Golden, Lawrence Golden a local cardiologist who has served in a number of leadership positions at Millard Fillmore Hospital, including chair of the Department of Medicine (1969-86), chief of cardiology (1967-87) and director of the Cardiology Fellowship Program (1980-92). Throughout his career, Golden has given freely of his time and expertise to a wide variety of services and programs, according to Margaret Paroski, MD, senior associate dean in the School of Medicine and Biomedical Sciences, who nominated him for this award. "In addition to dedicating his life to giving his patients the best care possible and teaching the students and residents how to appreciate the humanism of medicine, Dr. Golden and his wife, Nancy, recently endowed a lectureship series in mind-body medicine at our school," says Paroski. "This generous gift builds upon what his many years of voluntary service have exemplified to our studentsthat physicians who are well versed in mind-body medicine concepts will better provide humanistic care for their patients." D an's Community Service Award Melvin Oyster is the inaugural recipient of the Dean's Community Service award, which recognizes outstanding accomplishments that contribute to making our community a better place to live. "After 50 years in medicine, I can recall only five outstanding physicians, and Dr. Mel Oyster is one of them," says Francis Fote, MD '52, who introduced Oyster at Spring Clinical Day. Oyster is best known for having established the accred- Gentzke & Associates, Inc. Registered Investment Advisor ited Family Practice Residency Program in Niagara Falls, New York, which has graduated 90 residents since 1974. The program grew out of an internship he created in 1952 that was dedicated to preparing students for family practice. "He did this without having Private Portfolio Management President and CEO Glenn Gentzke and Ch1ef Investment Strateg1st Chns King Tax Consulting was one of the first to participate in the internship. "And he earned recognition for the program the hard way. Initially his request for help to support it was turned down by UB's medical school, so he looked Estate Planning instead to the University of Rochester School of Medicine." Fee-Based Asset Management UB Commons 520 Lee Entrance TIAA -CREF Advisor Suite 205 Network Amherst, NY 14228 Tel: (716) 639-0475 had any formal residency training himself," recalled Fote, who Certified QuickBooks Professjonal Advisors www.gentzke.com In addition to founding the residency program, Oyster continues to be "medical director of everything in Niagara Falls that concerns the poor and underprivileged," according to Fote. "He continues to work and teach with the enthusiasm of his youth, long after his contemporaries have retired, and he remains a favorite of the students." Thomas Rosenthal, MD '75, chair ofUB's Department of Family Medicine, says, "Dr. Oyster has been a mentor to me since I was in medical school, and he continues to offer insight into how I, as department chair, can best serve primary care physicians in Western New York. He is an outstanding physician, a leader with energy, an innovator with style, and an educator by example. Dr. Oyster defines community-based primary care." 32 luftal• Hysiciaa Summer 2002 4D �was elected president of · will se"e as treasurer. Kozera is the Medical Alumni Association on April27, 2002, at Spring Clin- the medical director for social services and assistant medical ical Day. Duffner is a UB professor of neurology and pediatrics and administrator for Erie County Health Department. a physician in the Department of Neurology at Kaleida Health's Children's Hospital of Buffalo. will se"e as the new vice president for the association. Pollack is a UB clinical assistant professor of ophthalmology who is in private practice in Williamsville. GENESEE HEARING SERVICES 61 Wehrle Drive (Near Harlem) Amherst 14225 THE AUDIOLOGY CENTER 630 Orchard Park Rd. (Near Ridge Rd.) West Seneca 14224 712-2000 837-6213 • Diagnostic audiometric evaluations (pediatric and adult) • Digital & programmable hearing aid fittings on 60-day trial basis • Tinnitus evaluation and therapy • Vestibular evaluation for patients with dizziness/vertigo • Vestibular therapy • State of the art facilities "The Ear is the Road to the Heart" rvouaireJ Jerri Kaplan Joyce, MA Summ e r 2 00 2 Buffalo Physicin 33 �DEVELOPMENT N E w s The Choice to leave ale ac By Li nda J . Cor de r , PhD. CFRE of my first child and became a member of the "older generation" quite recently, when my last parent, my mom, died. Neither transition was unexpected. We are schooled in this normal course of events from our earliest years. It is, however, our personal experience of these transitions that gives the concept, "Generation to Generation," substance. On this day of transition, we met, a small group of those closest to my mom, with several doctors and a hospital social worker. The lead doctor explained what had happened medically, since Mom's admission several days before. One or two others added some small detail. Altogether, we spent forty minutes discussing the physical aspects of her body's rapid deterioration, in both technical-and very down-to-earthterms. Each ofher children reaffirmed what we had accepted in our hearts the night before around her bed: If there was no hope, life support should be withdrawn. At the end of this discussion, one of Mom's ministers-a woman not many years younger than ! suggested we say the Twenty-third Psalm together, "one of Eva's favorites." Hand spontaneously joined hand around the circle, physicians and children, grandchildren and close friends. Familiar words both comforted and strengthened each of us for our respective roles in the final few minutes of her long, loving life, already irrevocably complete. I was participant and spectator at once. I was grateful for the education and experience of these doctors, that they handled this particular endof-life discussion with such compassion and caring. (I hoped that it was typical.) I was thankful that they were part of the circle that symbolized our contemplation of the mystery of life, and what it meant to walk in the shadow of death. 34 Ia f fa II P b J sic i a1 Summer 2002 This healing and profound transitiOn also made me proud to be a part of one of our nation's medical schools. It made me want to return home and make certain that UB's curriculum included practice in these crucial conversations. It made "The Oath," repeated by each new class of graduating medical doctors, more poignant and imminently real: " ... I will "It made crystal clear tread with care in matters of life that medicine is art as and death. If it be merely within my abilities to help ease suffering well as science, and that at the end of a life, may I face this we must provide our awesome responsibility with humility and awareness of my students with experi· own frailty." It made crystal clear ences along this entire that medicine is art as well as scicontinuum." ence, and that we must provide our students with experiences along this entire continuum. My sibs and I spent the rest of that day of transition making arrangements. Mom's service was a celebration, and memorials were designated for nonprofits in which she was involved for many years. Who can say where her impact will be the greatest? For those who knew my mom, memories, love, values, hope, even her genes, are her most direct legacy. For others, it will be the story of her courage to change and grow, her ideals and career as a teacher. It may also be the scholarship created in her memory that will provide an opportunity for a few more members of the next generation to earn a college degree. When it comes right down to it, such possibilities are why I work in this field, for UB and wholeheartedly through our current campaign-to assist those who, like my mom, choose to leave a legacy that will truly make a difference from "Generation to Generation." Linda (Lyn) Corder, PhD, is associate dean for alumni affairs and development. She can be contacted at 1-877826-3246, or via e-mail at ljcorder@buffalo.edu. CD �SUMMER 2002 1 - - - - - - - -l FI RST ROW, LEFT TO RIGHT' GUEST MARGARET PAROSKI (SENIOR ASSOCIATE DEAN), DANIEL CuRTIN.jOHN SHEFFER. HENRY GARDNER. SECON D ROW: WILLIAM EDGECOMB, PHILIP REITZ, DONALD C. NUWER, ROBERT jAEGER, ANTHONY PREZYNA. HANS f. KIPPING,jAMES STAGG, jAMES PHILLIPS. Summer 2002 l 1ffale Hysiein 35 �, FIRST Row, LEFT TO RIGHT· DONALD H. SPRECKER, 0LIVERj. STEINER, RALPH 0BLER, BERNIE DAVIS, EUGENE W. LOESERjR., ROBERT McDONOUGH WILSON, KURT j. WEGNER, AARON SIMPSON, PHOEBE E. SATUREN, jOSEPH f. CENEWICH, FRANCIS A. FOTE, DONALD F. DOHN, MILTON C. lAPP, ROBERTA. BAUMLER, MELVIN B. DYSTER, jOHN Y. RANCHOFF,jAMES F. ZELLER, DONALDj. KELLY, MELVIN KROHN, NEAL fUHR. , FIRST ROW, LEFT TO RIGHT· BEN CELNIKER, CERMANTE L. BONCALDO, ROBERT B. SuSSMAN, SHERMAN WOLD MAN, jAMES E. lASRY, j. DAVID SCHNATZ. SECOND ROW: fRANKj. CHAFEL, SOL MESSINGER , PHILIP ALFRED BRUNELL, BERNARD WAKEFIELD, jOHN PARKER, ARTHUR L. BECK, PAULL. ARCHAMBEAU. 36 llffall nysiciaa �FIRST Row, LEFT TO RIGHT: DAVID CARLSON, ALAN POHL, GEORGE R. TZETZO. SECOND ROW: RONALD I. DOZORETZ, PHILIP D. MOREY, ROBERTA. KLOCKE, jACK C. fiSHER, PAULj. LOREE, ANTHONY P. MARKELLO, M I CHAEL M . MADDEN, MELVIN j. STEINHART, SEBASTIAN S. fASANELLO. FIRST Row, LEFT TO RIGHT• ROBERT M. BENSON,jOHN RANDALL ANDERSON, RONALD P . jOSEPHSON, DAV I D R. DANTZKER. SECOND Row: jACOB KRITEMAN. T H OMAS P. O'CONNOR, ARTHUR C. SOSIS. GoiNG UP STAIRS ON THE LEFT, BOTTOM TO TOP· jAMES P. GIAMBRONE, THOMAS P. SHEEHAN, RICHARD G. jUDELSOHN, ANTHONY LO GALBO . LAST FOUR BOTTOM TO TOP: T H OMASAUGUSTI NEjR.,j. BRIAN SHEEDY, DONALD E. MILLER, Rocco C. VENUTO. Summer 2002 1111111 Phys ici n 37 �SUMMER FIRST Row, 2002 1 - - - - - - - - ' LEFT TO RIGHT: ROBERT EINHORN, LINDA A. KAM. SECOND Row: RICHARD SAVAGE, MARTIN BRECHER. I FIRST ROW, LEFT TO RIGHT: EuGENE A. PAUL, HOWARD LIPPES, IRA l. SALOM, LINDA SMITH, ALAN S. KURITZKY, RONALD A. VIDAL, CARLj. SCHMITT. SECOND ROW: MARK DE~ARIE,jOSEPH K. BYLEBYL, 0URET S. SMITH, KEVIN C. GREENIDGE, GREG YOUNG. 38 l1ffale Pkysiciae Summer 2002 �FIR.ST ROW, LEFT TO RfGHT: GERALD A. HARSTER, I VAN A. B AUMWELL, NA!'<CY j. PETERS, jESS ICA R OCKWELL, SUSAI'< fiSCHBECK, MARY A. KELLY, ELIZABETH P. BARLOC. SECOND ROW: TI~!OTHY j. CEERING,jO H N S. SANTELLI, ARLENE R. CURRY, DOUGLAS K . PLESKOW, RAND! C. PLESKOW. LINDA C. RABINOWITZ. ROBERT A. CIANFAGNA, jOSEPH P. LEBERER. THIR.D ROW: ANDREW R. HORDES. jOSEPH f. GIOIA, DAVID I. KURSS, jOSEPH WAYNE, RICHARD HEATH, STEPHEN POLLACK PATRICK HURLEY, 1\EIL KLUGER, KEV I N BARLOG, PHILLIP STEGEMAN, ROBERT STERN, jOSEPH CELORMINI. BOTTOM TO TOP: ADA\! K. ASHTON, TIMOTHY BUKOWSKI, DANIELA. BUR!'iS, PATRICKj. SHAUGHNESSY, YUOKO YERACARIS, CARLOS LOPEZ, CAETANO SCUDERI, KATHY LiLLIS. PATRICIA L. KAUFMANN, DOLORES C. LEONARD ]. KEVIN QUINLIVAN. IVAN HARANGOZO, MICHAEL B. WEINBERG. MICHAELS. WATSON. S11mmer ' 2002 llfflll nys i cial 39 �Flli.STROW, LEFT TO RIGHT: jOHN K. CUMMING, KATHARYNE SULLIVAN, DIANE SANFILIPPO,jUDINE C . DAVIS, SHERI BACZKOWSKI ILDIKO MIKOS, PATRICIA A. VORIES, MAUREEN E. DLUGOZIMA, SHARON R. MALLEN, PHILOMENA~. BEHAR, REBECCA HAVERLY, GAYLE FRAZZETTA, ROBERT HAVERLY, KEVIN jACOBSON, MARK IPPOLITO, BRIAN E. J. McGRATH. SECOND ROW: BOB l.AUDICO, MARK PIOTROWSKI, MICHAELA. COLUCCI, GERARD DILLON, EILEEN CRESPO , CYNTHIA JENSON, EvELYN CoGGINS, SUZANNE ROSENBERG, STEPHANIE fRETZ, CATHY YI, VINEET SINGH. FIRST ROW, LEFT TO RIGHT• jEANNIE KAO - KOENIG, SUCHITRA KONERU,jANICE M. LEE, CLAUDIAjARAMILLO LEE, ANDREA TORSONE. SECOND ROW: DAVID NOVAK, WILLIAM WIND, BENJAMIN KOENIG, fRANK M . LEE, RONIKA D. CHOUDHARY, CATHERINE COSTELLO. jARED C. BARLOW JR., PETER ERCOLINO . THIRD ROW: CHARLES SEVERIN, RAVI K. DESAI, M. ANGELA MCLELLAN,jOSEPH 40 11ffal1 Hysiciu L. CHOW, THOMAS R . ELMERjR., ALEXANDER MARCUS. Summer 2002 �Dear Fellow Alumni ' tis with great pleasure that I begin my year as president of the Medical Alumni Association (MAA ). John Bodkin, who served as president for the last two years, ran the organization smoothly and successfully, with insight, intelligence and good humor. I am pleased to announce that he has promised to continue to play an active role as past president. This year's Spring Clinical Day-a fascinating blend of medicine and history-was extremely successful, and I invite you to read about it, starting on page 30 of this issue. Over the past several months, 1 have had the opportunity to serve as a member of the Liaison Committee on Medical Education (LCME) Task Force, a self-study group that reviews all aspects of the medical school in preparation for the accreditation review in October. The last LCME visit was in 1994, and since then there have been a number of significant developments at our school. For example, lecture halls have been renovated and new classrooms and seminar rooms added-all of which are equipped with the latest educational technologies. A new curriculum has been developed for the first- and secondyear students that combines basic science and clinical teaching, with less emphasis on lectures and more on small-group and independent learning. Since 1994, recruitment in the basic sciences has been very successful, and faculty in these areas (including those at Roswell Park Cancer Institute and Hauptman-Woodward Medical Research Institute) have received grants equivalent to the 86th percentile of all medical schools in the country. The clinical faculty has also seen a sizeable increase in research dollars. Under Dr. Bernardino's leadership, an infrastructure for the medical school has been put in place, with clear-cut lines of authority. Direct communication between the medical school administration and faculty has been greatly enhanced by Town Hall meetings that are hosted by Dean Bernardino at each of the clinical sites. As is the case elsewhere in the country, the biggest challenge to medical education in Buffalo is the shortage of hospitalized inpatients for third- and fourth-year medical students. Additional outpatient teaching clinics in hospitals and private offices will be necessary in order to train medical students and residents in the future. As such, the school's administration and faculty are working hard to establish and enhance these venues throughout our community. Finally, following the tragedy of September II, the enormous financial pressures on New York State have directly impacted the medical school. Because our endowment is so limited, money for scholarships, minority student recruitment and funding of resident and medical student research projects is suboptimal. I hope that the medical alumni will take up the challenge to increase donations to the medical school to support these important projects. Medical students are our future and we need to do everything we can to get the brightest and most compassionate to come to Buffalo. In closing, I would like to say that it is a great honor to serve as president of the MAA. If you have concerns or questions that you feel I can address on behalf of the association, please feel free to contact me at any time by calling the MAA office at (7 16) 829-2778. I /_LA- PATRICIA K. DUFFNER, MD •72 President, Medical Alumni Association Summer 2002 luflalo Physiciaa 4 1 �C L A 1950s John W. Richards, MD '52, FACS, writes: "I retired from general surgery in Chicago 1992 and like living in the Ft. Lauderdale area very much. Enjoy opera, symphony and ballet here, plus great weather. " N 0 T E S the antique car hobby. We spend our summer months in Western New York, at our 150-year-old home in Franklinville, NY, and keep up contact with our Meyer Eye Department colleagues." E-mail address is: thelorees@hotmail.com. William Sperling, MD '66, Jacob (Jack) Lemann Jr., MD '54, New Orleans, LA. E-mail address is dr.jack@lemann.net. "In May 2001, I retired from Kaiser Permanente, where I practiced pulmonary and critical care with one office in suburban Williamsville, NY, and the other in midtown, Buffalo, close to the Children's Hospital of Buffalo and the school of medicine. The city office, especially, serves a highly diverse and often clinically challenging population of children and adolescents. Because of my interest in public health and epidemiology, I serve as the medical director of the spending two exciting years traveling nationwide and internationally. I have been a member of the New York State Immunization Advisory Council since its formation by the governor and legislature in I 995. With the rapidly expanding spectrum of vaccines that have been introduced in recent years, I have had a busy schedule teaching and consulting on the subject." care physician with Group Health Cooperative in Spokane, W A. The sun and snow were great, and it is hoped that there will be more trips in the future." E-mail address: schaffer@icehouse.net. Robert Z. Fialkow, MD '72, writes: "My wife, Mikie, and I live in beautiful Owensboro, Kentucky, where we are building a farmhouse on our 22acre farm. We have three Michael S. Bardo, MD '55, writes: "I retired from medical practice on December 31, 2001, because of my wife's illness. My last 11 years of medical practice were with the State of California at the California Correctional Center, where I served as the chief medical officer." 1960s Jack Fisher, MD '62, writes: "In June 2002-at the tender age of 64-I graduated with a master of arts degree in history from the University of California at San Diego as a member of the class of '02-40 years after '62!" E-mail address is: jfishermd@aol.com. medicine. My wife, Barbara, and I are traveling around the U.S. and Canada in our motorhome. We are also enjoying tandem bicycling and playing golf and tennis. " E-mail address is: billsperl@aol.com. James Giambrone, MD '67, is director of the Catholic Health System, Western New York Board of Directors; also chief operating officer for Associated Physicians ofWNY, P.C. Richard Judelsohn, MD '67, writes: "Sally and I are Florida residents (Ft. Lauderdale) and are enjoying retirement, traveling, grandchildren, and writes: "As a practicing pediatrician for over 25 years, I am the managing partner of Buffalo Pediatric Associates. The group has six physicians and two nurse practitioners, luffalo Hysiciaa S umm e r Paul J. Loree, MD '62, 42 assnotes 200 2 Erie Country Department of Health. My responsibilities there cover a broad range, including supervision of programs for school health, chi!dren with special needs, inner-city clinics, STD and TB clinics, outbreak investigation and control and immunizations. Vaccine-preventable diseases-and their eradication-have been of special interest to me since my pediatric training at Cornell Medical Center-New York Hospital (where I volunteered at city vaccination dinics ), followed by appointment to the Epidemic Intelligence Service at the Centers for Disease Control. At the latter, I was an immunization officer, E-mail address is: judelson@bflo.co.erie.ny.us. Donald P. Copley, MD '7D, a cardiologist with Buffalo Medical Group, P.C., was installed as the new president of the Medical Society of the County of Erie on May 7, 2002. Daniel J. Schaffer, MD '7D, and Alan Podosek, MD '7D, reunited this past january in Vail, CO, for a week of skiing. Alan has a private practice in Lynchburg, VA, and Dan is an urgent sons: Dr. Lawrence Fialkow, who lives in Charlottesville, VA; jared, who graduated from medical school in Philadelphia in May and who presented us with our first grandchild in January 2002; and Ethan, who is married to a gorgeous Japanese girl and is a first-year law student at the University of Louisville. I run four dialysis units with my two associates and contemplate retirement in the next few years to enjoy my hobbies of running, tennis, music and video poker. " E-mail address is fialkow@yahoo.com . ��CLASS NOTE Bruce R. Javors, MD '73, received the Award of Merit from the Rochester Academy of Medicine in 2001. A boardcertified surgeon who practices at Rochester General Hospital, as well as a fellow of the American College of Surgeons, Dynski holds numerous faculty positions and finds time to teach surgical, internal medicine and 08-GYN residents. She is also the liaison between the writes: "I was recently named chairman of radiology at St. Vincent's Catholic Medical Center in NY. I was elected to become a Fellow of the American College of Radiology, effective this September. Last year, I was appointed professor of clinical radiology at New York Medical College. I have just completed the manuscript for my second text, to be published this fall by Springer-Verlag. My wife, Susan, and daughter, Alii, continue to light up my life." E-mail address is: bjavors@ saintvincentsnyc.org. Department of 08-GYN and has served as director of the Breast Clinic at the Women's John Marra, MD '74, is a Center since 1992. cardiologist at Good Samaritan Hospital in Baltimore, MD. He is director of cardiac rehabilitation and assistant professor of medicine at johns Hopkins University. He and his wife, Maggie, live in Roland Park and have three children. Dynski, who is a sister of St. Joseph, is involved in numerous community programs and has been a Special Olympics volunteer since 1997. She is a member of a Congregational Committee to evaluate the future of geriatric needs and member of a committee on medical ethics advising the Catholic Diocese of Rochester through the Department of Social Justice and Social Ministries. "Perhaps most admirable and intriguing about Marge," writes her friend Jeanne Grove, DO, "is her courage and continuing accomplishments in spite of being paralyzed from the waist down" as a result of complicated back surgery in 1994. "Through intense rehabilitation and amazing perseverance, Marge has taught herself to walk without gaining sensation in her lower body. "A quote by Willa Cather, I feel, epitomizes Dr. Marguerite Dynski as follows: 'There are some things you learn best in calm and some in a storm."' Larry Altschul, MD '77, writes: "I can't believe it has been 25 years already. My wife, Mercedes, and I live in Dix Hills on Long Island. I am the 'senior' (I can't believe that word actually applies to me) partner in a large cardiology practice. Since April 2000, I have been director of cardiology at Good Samaritan Hospital 44 llffala nysicin Summer 2002 Medical Center. We have five children, ages 15, 17, 19, 21, and 22." E-mail address is: drlarryalt@ aol.com. Andrew S. Ross, MD 'BD, writes: "I have been in practice in Boca Raton, FL, since 1986. I completed my general surgical residency and colon and rectal surgical fellowship. I practice in the largest surgical group in South Florida ( 11 surgeons). I have a busy colorectal practice with a lot of laparoscopy. I remain happily married (26 years) and have three wonderful daughters: Dara, age 23, llana, age \9 and Jordana, 16." E-mail address is arossl7481@aol.com. Adolph Soto Jr. MD '83, writes: "! am still working for Saint Vincent's CMC of New York as a pyschiatrist-Harrison, NY. Adopted a baby, Lucas Enrique, born on january 18, 2001." E-mail address is asoto@ saintvincents.com. Herbert B. Newton, MD 'B4, writes: "My family continues to enjoy Columbus and Ohio State. Alex is into TaeKwonDo, swimming, soccer and riding his bike. Ashley is into ballet, gymnastics, swimming and piano lessons. Cheryl is still the clinical nurse specialist for the neurology/neurosurgery floor at OSU. Work remains busy as I continue my role as the director of neurooncology at OSU and the james Cancer Hospital. I was recently elected vice chairman and chairman elect of the NeuroOncology Section of the American Academy of Neurology. In addition, I am thrilled with the publication of an article entitled "Review of the Molecular Genetics and Chemotherapeutic Treatment of Adult and Pediatric Medulloblastoma" in the December 2001 issue of Expert Opinion on Investigational Drugs. Blackford Middleton, MD '85, writes: "I have re- turned to the world of academic medicine after leaving MedicaLogic/ Medscape (now owned byGE Medical Systems) in early 2001. I have joined the faculty in general medicine at the Brigham and Women's Hospital, Harvard Medical School, and I am director for clinical information systems research and development at Partners HealthCare System, Inc. I'm having fun with students and research, and still building clinical �information systems. Daughters Julia (9) and Lillian (5) are wondering, 'Where is the snow?' Wife Ursula King is making our new home and considering work ... eventually." Laura L. Post, MD '87, writes: "I have been living and working in Saipan, Commonwealth of the Northern Mariana Islands (U.S.) for five years now and am very much enjoying medical practice in a remote, underserved area. I am sorry that I was not able to come to the reunion, but the trip would cost over $2,000 and taken longer than 24 hours. Maybe I will be ble to make the 20th reunion. I spend my days as the correctional psychiatrist at the local prison and commute to the nearby Territory of Guam (U.S.) to serve at their Medication Clinic for seriously mentally ill adults. After hours, I see private clients and on weekends do competency and insanity evaluations for the court, disability and fitness-forduty evaluations in the private sector, and opinions in personal injury civil and sentencing mitigation in criminal matters. My partner, Judith E. Avery, RN, MS (SUNY at Buffalo '87), CNS and I live in a beautiful house overlooking the ocean with our small dog, Max; our medium-sized dog, Sasha, and our large dog, William Palmer Jr. MD. '90, Boris." E-mail address is drlaurapost@hotmail.com. the move again. Stephanie, Janee (12), Jilian (9) and Jayson (2) Pat Shaughnessy, MD '87, and I relocated to Winston-Salem, NC, in june 2002. I have joined another physician in pri- writes: ''I'm in a twoman rehabilitation medicine practice in rural Western Pennsylvania. (I see Dennis Moll ins at conventions.) I am president-elect of the Mercer County Medical Society. My wife, Maggie, and I have three daughters: Colleen, a freshman in high school, Maureen, 12, and Kathleen, 11. All are involved in music. I am cantor and accompany at church. Our "Farmette" is six acres, and we have llamas, sheep, chickens, etc. I'm in Disney World's 20012002 promotional video-biggest accomplishment to date!" Anthony J. Bufo, MD '89, writes: "I am a pediatric surgeon in West Palm Beach, FL." E-mail address is: ajbcrb@ netscape.net. Glen M. Ginsburg, MD '90, pediatric orthopaedic surgeon at the University of Nebraska Medical Center, has been promoted to associate professor. He has been on the staff there si nee 1996. E-mail address is: gi nsy4549@yahoo.com. writes: "We have been on vate practice to work at Whitaker Rehabilitation Center. I have also assumed the outpatient rehabilitation medical directorship. We left Indiana after eight years." Andrew Feinberg, MD '95, and Whitney (Orman) Whitney writes: "Andrew and I got married E-mail address is: wpalmerjr@aol.com. and have a two-year-old son, Ryan, and a Susan J. Littler, MD '91, ophthalmology in a private practice here in PhD, is an attending in Atlanta, and I am working part-time at a OB/GYN at Mt. Sinai Hospital. E-mail address is: suejlittler@aol.com. pediatric urgent care center." on November 2, 1996. We live in Atlanta baby due in June 2002. Andrew is practicing Atif Zafar, BA '89, MD '94, received the George W. Thorn Award from the University at Buffalo Alumni Association during its annual awards dinner held on April19, 2002. The award recognizes graduates under the age of 40 who have made outstanding national or international contributions to their career field or academic area. A medical computer scientist, Zafar is clinical assistant professor in the Department of Medicine at the In diana University (IU) School of Medicine and is on the staff of the Regenstrief Institute, a 25-year-old research foundation located on the IU medical school campus dedicated to the study and improvement of health and health care delivery. Gonzalo Bearman, MD '97, writes: "Regrettably, I was not able to attend the reunion this year. All is well. I am an infectious diseases and public health Fellow at Cornell University in New York City. I will finish the program in july 2003. Currently, I'm dedicating most of my time to clinical research and an MPH degree. Regards to all." Dayo (Wilson) Lanier, MD '97, wrote: ''I'm a pediatrician, living in Albany, NY, with my husband, Rob, and my nine-month old son. I took this past year off from practicing medicine to stay at home with my son, but started back to work parttime this june." Stephen Milback, MD '97, writes: "My wife, Cindi, and I now have three beautiful children ages 5, 3, and 16 months. We've enjoyed living in San Diego these past five years and look forward to a new adventure as we plan our move to Japan." E- mail address is: steve milback@hotmail.com. CONTIN U ED ON PAGE 4 8 Summ e r 20 0 2 luffale Physicia n 45 �• e .John Ambrusko, named in his honor in 1988. 2002 After military service he University of Buffalo School LTJG, he returned to Buffalo of Medicine. He was an All· in private practice. In his 80s, Ambrusko returned to Buffalo and re· John S. Ambrusko, a fonner took on the role of father to sumed his medical career, American basketball player Buffalo surgeon and Florida two grandsons, 4 and 6 serving as chief of the head and captain of the 1940 shaped the rest of Loeser's career occurred in 1953, The defining event that public health official died on years old, after their and neck service at Roswell Dartmouth team that won April 25, 2002. He was 88. mother, his daughter Sara Park Cancer Institute. He the Ivy League title. He when he fell victim to polio The youngest of nine Tokars, was murdered near also maintained a private served in the Anny during during the last major epi- children of Hungarian immi- Atlanta. Eventually her hus· surgical practice in the Buf- World War II, rising to the demic in the Buffalo area. grants, Ambrusko rose from band, Atlanta attorney falo area and served as a rank of captain. According to his brother, humble beginnings to be- Fredric Tokars, was convicted clinical professor in UB's come one of New York of arranging the murder. medical and dental schools. State's most recognized and respected surgeons. Ambrusko's wife, the Marchetta's colleagues After the war, Sullivan Eugene W. Loeser, MD '52, was on the staff of Kenmore he spent agonizing months Mercy Hospital in the Town in an iron lung, and only after further months in re- former Phyllis Eusterman, describe him as a dedicated of Tonawanda, served as died in 1998. He is survived humanitarian and skilled chief of staff and surgery at habilitation was he able to cal degree, Ambrusko be- by six daughters, Therese of surgeon whose career was Sheridan Park Hospital in ambulate sufficiently to After receiving his medicame a surgical fellow at San Francisco, CA; Gretchen marked by quiet service the Town of Tonawanda and work in the UB Respiratory the Mayo Clinic in Roches- Schaeffer of Newport Beach, to his patients. He has operated a private practice and Rehabilitation Center, ter, MN. When World War II CA; Mary Bennett of also been honored by the for many years on Kenmore where he later served as broke out, he enlisted in the Shrewsbury, NJ, Joni of many medical residents Avenue in the Town of medical director. Loeser's Navy, serving for several Bradenton, FL, Karen Wilcox he trained. Tonawanda. A sports enthu- personal experiences led years before returning to the of Buffalo, NY; and Krissy of siast, he was team physician him to introduce improve- Marchetta was a diplo- Mayo Clinic. In 1948, he Woodstock, GA; and 11 mate of the American Board for the Bisons baseball team ments in feeding and joined the surgical faculty at grandchildren. of Surgery, a fellow of the in the 1950s and for the breathing techniques to aid American College of Sur· Bills from 1960 to 1963. patients in weaning from the UB. He also opened a general surgery practice and in rank Marchetta, 1950 helped the Sisters of geons and a member and Survivors include his iron lung. In 1958 Loeser relo- past president of the wife, the fonner Mary Ferguson of Delray Beach cated to Youngstown, Ohio, Mercy found Kenmore Mercy Frank Marchetta, a re- International Head and Neck Surgical Society. Hospital, where he served as spected oncologic surgeon chief of surgery for 20 whose medical career Survivors include his years. From 1954 through spanned more than 50 1978, he was chief medical and Rose Hill, Ont.; a daugh- to become director of medi- ter, Elizabeth S. Bond of cal education for its hospital wife of 53 years, Jean; two Wellesley, MA; a son, Ken· association. During this pe- years, died unexpectedly daughters, Linda Marchetta neth F. of New York City; riod he introduced renal di- consultant to Niagara March 6, 2002, in his home Wild, MD '76, of Williams- and two grandchildren. alysis into the local hospital. Mohawk Power Corporation. on Sanibel Island, FL. He ville, NY, and Joanne was 81. Marchetta of San Francisco, After cataract surgery forced him to give up his Born in Utica, Marchetta Although he never re- 1am • Loeser: CA; a son, Dr. Charles of attended Cornell University East Aurora, NY; and five William D. Loeser, died on moved to Florida, where he prior to earning his med- grandchildren. February 11, 2002, at 79 passed the state's medical ical degree at the then- board exam and began a University of Buffalo Medical new career as public health School. After World War II, years of age. ames Sullivan, Loeser was a native of Buffalo and a graduate of he served James R. Sullivan, a former County Health Department in the U.S. in Bradenton. He also served Medical as an associate medical ex- Corps sity of Buffalo ('41). Follow- cally in his later years, but Buffalo Bills and Buffalo ing graduation from medical his good spirits and humor Bisons, died April 8, 2002, school, he trained in inter- never failed him. with the in Boynton Beach, FL, after nal medicine at Jewish a long illness. He was 85. Hospital of Brooklyn and forces of his career. Post-polio team physician for the occupation under General Douglas who became close friends and colleagues for the rest syndrome slowed him physi- aminer for the State of agency, Ambrusko was re- resume private practice and joined a group of internists Lafayette High and Univer- Florida from 1980 to 1995. As director of the Manatee gained full strength, Loeser felt the calling in 1964 to surgical career, Ambrusko director of the Manatee 46 SUMMER Sullivan graduated from Nichols School, Exeter and Loeser is survived by his wife of 55 years, Annette completed his residency Brown Loeser; a son, David, under John Talbott, MD, at of Needham Heights, MA; sponsible for building a new McArthur, attaining the rank Dartmouth College prior to Buffalo General. After a stint daughters Ellen of West health center, which was of captain. attending the then- as a naval medical officer, Roxbury, MA, and Cynthia luffale Hp i cian Summer 2002 �RELOCATION HU T REAL ESTAT E ERA Loeser Sandoval, of Daly was an Erie County medical where he practiced anesthe- City, CA; and his brother, examiner. He was also clini- siology for two decades. Eugene, of Jupiter, FL. cal instructor emeritus of rehabilitation medicine at UB. er ert S. Wolfe, Mrs. Herbert S. WoHe, RN, Survivors include his For the past 15 years, Potenza had been medical director of the health center wife of 45 years, the former at Geneseo State College. Kathryn "Katie" Siegfried; a He was also a past president writes: "After Dr. WoHe had daughter, Karen Vergo of of the Livingston County open heart surgery and he Kenmore, NY; a son, Robert Medical Society. feH better, we headed for of Santa Barbara, CA; a Texas. We located in Mission, TX, at the Bentsen cal care, often free, to indi- NY; and five grandchildren. gent patients. He received .James mr awards, and July 24, 1984, Grove Trailer Park. We en· joyed all the activities, and many community service the friends we made were was declared Lucien A. wonderful. Each year we James lmre Szabo, of stayed longer, and about Winter Garden, FL, died three years ago, we became Monday, March 18, 2002, permanent residents. "Doctor's heaHh started to fail, and each year he did Potenza provided medi- brother, Nicholas of Buffalo, at age 84. Szabo, a Buffalo native, moved to Central Florida in 1953. He was a less. He was hospitalized member of the American many times and then on Association of Physicians January 26, 2002, he went and Surgeons, American home to be with the Lord he Geriatrics Society, American Potenza Day in Buffalo. Survivors include his wife, the former Susan Baer; a daughter, Evelyn Frank of Lewiston, NY, Michael both of Amherst, NY, Andrew Bellman of loved and served all his life. Gerontologic Society. He is survived by his wife, Nancy; 59 years in June." daughters, Lisa A. Stone of and a sister, Carmello Oviedo, FL, and Nancy J., of .James N. "Bo" Menno of Cheektowaga . Gainesville, FL; son, lmre A., of Winter Garden, FL. former chief of rehabilita- Cheektowaga, NY, and Paul Bellman of Berkeley, CA; ary Miller, MD Lucien A. Gary Miller, died unexpect- Affairs Medical Center in Lucien A. Potenza, died heart attack while jogging. He was a professor of tion medicine at Veterans edly May 25, 2001, of a Batavia, NY, died March 26, April 1, 2002, in Strong 2002, in Town of Tona· Memorial Hospital, pathology and urology at wanda, NY, after a long ill- Rochester, after a brief the University of Colorado ness. He was 73. illness. He was 71. A native of Buffalo, Potenza was born in Buf· HeaHh Sciences Center in Denver, where he was also Schmitt attended Canisius falo and graduated from College and the then- Canisius High School. At the urologic University of Buffalo School University of Buffalo School cancer of Medicine he served as research. as a surgeon and lieutenant president of his class. He was commander in the Navy dur- Following the war, he • • • • • • • Nationally trained relocation experts Complete family needs analysis Global home sale assistance Special services for seniors Full community tour A complete cost of living analysis A list of all school systems throughout W NY • Complete spousal placement assistance including resume writing and corporate contacts • 24 hour o r less response time • Confidentiality assured known For over 30 years both na- Potenza maintained a gen· eral medical practice on Totally customized service portfolio including director of of Medicine prior to serving ing the Korean War. Call for a free relocation portfolio regarding your destination city. Call 1-800-688-1170 or go on-line and visit our web site at huntrealesta te .com Bellman and David Bellman We would have been married James N. "Bo" Schmitt, ...we help people move! Buffalo; six sons, Daniel of Warner, NH, Mark of tionally and internationally headed rehabilitation medi- Buffalo's west side. He was in the field of prostate can- cine at the veterans hospi- also a former president of cer research. tal, and until the mid-1970s Lafayette General Hospital, <D) Hunt ERA Relocation Center 5570 Main Street Williamsville, New York 14221-5410 Email : huntrelocation@huntrealestate.com S 11mmer 2 002 luffalo Pbysician 47 �CLASS I CONTINUED FROM PAGE 45 Kristen Andresen, MD '98, Milford, CT, writes: "After finishing my residency in internal medicine at the University of Rochester and marrying a fellow resident, I've moved to Connecticut, where my husband, Scott, is doing a fellowship at Yale. I'm presently working as a hospitalist and enjoying life with Scott and our two best friends: Shadow (black lab) and Sonner (golden NOTES retriever)!" E-mail is: skskibo@ comcast.net. Lisa E. Heichberger, MD '98, Tacoma, WA, writes: "I completed my family practice residency at Hamot Medical Center in Erie, PA, where I served as chief resident. This past year, I was granted a fellowship in Rural Family Medicine at Tacoma General Hospital in Tacoma, WA. My husband, Mark Peterson, and I presently reside in Tacoma." E-mail address is MPeter32@aol.com. Michael P. Melman, MD '99, Sue Miller, MD '99, writes: writes: "After graduation I spent a year at the NIH completing research in the field of pediatric hematology/oncology. Currently, I am a pediatric resident at Emory University in Atlanta and will be applying for a fellowship in pediatric emergency medicine. Hope all is well with my fellow alumni! E-mail address is: mpmcrew@ aol.com. "Larry and I are excited to be moving to Seattle, WA, in june. I finished my pediatrics residency at Children's Hospital of Buffalo and will be starting my fellowship in CELEBRATE THE SEASONS OF YOUR LIFE AT AMBERLEIGH 48 I u II a II Ph J sic i a 1 Summer 2002 neonatology at the University of Washington. Larry completed his MBA and is currently a consultant with Andersen. We hope everybody is doing well!" E-mail address is: smm4S@hotmail.com. E-mai �Held at the Buffalo/Niagara Marriott, THE 65TH ANNUAL SPRING CLINICAL DAY AND REUNION WEEKEND WAS A TIME FOR OLD FRIENDS AND CLASSMATES TO REUNITE AND REMINISCE ABOUT THEIR MEDICAL SCHOOL YEARS . Dean Michael Bernardino briefing the luncheon crowd on mam of the positive changes taking place at the school, as well as ongoing challenges. ..----- Stephen Pollack, MD '82, vice president for the \!edtcal Alumm Association, was ke} to makmg the day a success. �p H A R M A c 0 p 0 E .I A OF MEDICINE COLLECTION PRESENTS PHARMACOPOEIA This illustration was digitally reproduced from offizinellen Gewachse, a four - volume edition of pharmaceutical plants and their medicinal uses , published in German in 1863. The pharmacopoeia by Otto Karl Berg (18I5I866) is part of the Rob e rt L. Brown History of Medicine Collection , located in the Abbott Hall Health Sciences Library. Pi ctured is the Pomegranate, one of a series of botanical images digi tally restored as part of an initiative to preserve and highlight unique r e sources from the library's collection. Reproductions are available for purchase through the library, and can be viewed online at iMedia. buffalo .edu/ art/ . Image restoration was performed by iMedia , the instructional media se rvices department of Computing and Info rma tion T echnology, University at Buffalo. b, R P 000 3- 02 .E � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 2002 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2002-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v37n01-2002-Summer Table Of Contents A list of subunits of the resource. Sound Science A Child Abused, but Not Forgotten Alumni Medical School Pathways Spring Clinical Day Reunion Photos Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v37n01 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2002 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/b3def877e14766f5a9307dce69790cf0.pdf aea8e1a006e8e9754fc81f41174dba71 PDF Text Text �hffale P~ysician ASSO CIATE VICE PRESIDENT FOR UNIVERSI TY COMMUNICATIO NS Dr. Carole Smith Petro DIRECTOR OF PERIODI CALS Sue Wuetcher Dear Alumni and Friends, EDITOR Stepl1a11ie A. U11ger ART DIRE CT OR & DESIG N Alan f. Kegler AST SPRI ·c, YOL READ ABOVI the pride and excitement we felt when Governor George Pataki p roposed in his "State of the State" address that Buffalo be designated the site for a world-class Center of Excellence in Bioinformatics-a collaborative effort involving the state, industry partners and area academic institutions. In january 2002, this proposa l moved one step closer to rea lity, when Governor Pataki visited Buffalo to announce $200 mi ll ion in state and private-sector funding for the center (see article on page 14 for details on this announcement). The Center of Excellence in Bioinformatics-combined with the establishment of the Strategically Targeted Academic Research (STAR) Center for Disease Modeling and Therapy Discovery in Buffalo-will have a sign ificant influence on the types of basic research we will be conducting at our school in the decades ahead. It will also affect the growth and development of our school's faculty because we will be hiring individuals to fi ll positions that will mesh with the center's goals. Working synerg istically, these two ce n ters-with the aid of supercomputers-will place our school in an excellent position to take a lead role in research that will help provide a better understanding of interactions between molecules and proteins, and disease states and genetics. Ultimately, such studies hold great promise for the timely development of novel drugs, as well as the discovery of new, more viable ways to manage and treat disease. DE SIGNER David f. Riley DESI GN A SS ISTANT Kare11 Lichner Co NTRIB UT ING WRITERS Lois Baker and Elle11 Goldbaum PR ODUCT I ON COO RDI NATO R Cynthia Todd-Flick UNIVERSITY AT BUFFALO S CHOO L OF MEDI CINE AND BIOM EDI CA L S CIE NC ES Dr. Michael Bemardino, D ea 11 E DIT ORIAL BOARD Dr. john Bodkin Dr. Marti11 Brecher Dr. Harold Brody Dr. Linda f. Corder jason Hoffman II, Class of 2004 Dr. james Ka11ski Dr. Eliz abet/1 Olmsted Dr. james R. Olson Dr. Steph e n Spaulding Dr. Bradley T. Truax Dr. Frat1k/in Zeplowitz The establishment of the Buffalo Center of Excellence in Bioinformatics is extremely important to our school, and we will continue to update you on the progress of this exciting venture in the months and years ahead. I am also p leased to announce that Suzanne Laychock, PhD, professor and associate chair of the Department of Pharmacology and Toxicology at UB, has agreed to serve as the T EAC HI NG H OSPITALS Erie County Medical Center Roswell Park Cancer In stitute Veterans Affairs West ern N ew York Healthcnre Syst em K ALE I DA H EAl T JI : significant role in determining what research will be conducted at our school in the future . Th e Buffalo General Hospital Til e Cl1ildren 's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital She will also help deter mine how resources will be allocated for th is research and will C A TH O II C new senior associate dean for research at our school, replacing Bruce Holm, PhD, who has been named a senior vice provost at UB. In her new position Dr. Laychock wi ll have a oversee the recruitment and hiring of new research facu lty. Recent data provided by the Association of American Medical Colleges (AAMC) indicates that our school's performance in basic and clinical research is very good and, as a result, UB has moved up in AAMC rankings in this area. Certainly this improvementalong with the recent steps made toward establishing a center in bioinformatics-gives us H EAcr u S rsrE M: Mercy Health System Siste rs of Clwrity Hospital Niagara Falls Memorial Medical Center @ UNIYEISITY lT IUFFlLO. THE STATE UNIYEISITY II NEW Ylll a positive context within which to work as we strive to conduct research that will help reshape the fie ld of medicine as it enters the new era of proteomics and genomics. Finally, I would like to announce that in the coming year we are planning to recruit new faculty in surgery, pediatrics, neurology and medicine. Currently, we are conducting national searches for chairs of surgery, neurology and rehabilitation medicine, and !look forward to updating you on these once completed. MI C HAEL E. BERNARDINO . MD , MBA Dean, Sclwol of Medicine a n d Biomedica l Sciences Vice President for Hea lt h Affairs Letters to the Editor Buffalo Physician is published quarterly by the University at Buffalo School of Med icine and Biomedical Sciences in cooperation with the Office of Communications. Letters to the Editor are welcome and can be sent c/o Buffalo Physician, 330 Crofts Hall, University at Buffalo, Buffalo, NY 14260; o r via e-mail to bp-notes@buffalo.edu. The staff reserves the right to edit all submissions for length and clarity. T~ ~ University at Buffalo T11e State University ofNew York �V 0 L U M E N U M B E R 36, 0 Features 2 Minimal Access Surgery for Kids Buffalo's pediatric surgeons are leaders in performing and teaching laparoscopic surgery BY 16 24 S. A. UNGER APlace for Business in Medicine A student's perspective on UB's new MD/MBA Program BY Jennifer Wiler, Class of 2003 Imaging and Imagination A look back at a decade of research: Pet Center marks its tenth anniversary The Buffalo Center of Excellence in Bioinformatics receives $200 million in state, federal and private-sector support. Article begins on page 14. BY ALAN LOCKWOOD, MD COVER PHOTOGRAPH, CLOCKWISE, FRONT RIGHT, PEDIATRIC SURGEONS PHILIP GLICK, MARC LEVITT , M I CHAEL CATY , AND GuY BRISSEAU 15 ational Science Foundation grant bolsters computer storage capacity 21 Sung and White scho larship recipients Alpha Omega Alpha scholars inducted 22 Orvan Hess, Class of 1931, a pioneer in fetal-heart monitoring 30 Suzanne Laychock, PhD, named senior assoc iate dean for research 31 Maxine Hayes, 36 Message from MD '73, honored by theAMA 37 james Platt 33 ew faculty at Society Roswell Park 42 News from your UB classmates and other alumni the directorthe cost of medical education then and now White Society 40 Edmund Hayes ~- \ I\ JUN ' 5 ���NE OF THE THINGS THAT IS DIFFERENT ABOUT OUR PROGRAM in Buffalo compared to others around the country is that our entire faculty has embraced the goal of converting over to minimally invasive surgery as a way to think about every operation;' says Glick, who also serves as interim chair of surgery at the University at Buffalo and professor of surgery and pediatrics. "Five years ago, each faculty member made a commitment to this and said, 'I'm on board.' We decided we were going to learn together, sharing both our successes and our mistakes," he adds. ''Although the learning curve was just as steep, I believe we got to the flat part of the curve much quicker than we would have otherwise." At the time they began the transition, the surgeons at CHOB were applying minimally invasive surgical techniques to about 5 percent of their cases; currently, they are up to about 50 percent, and their goal is to eventually reach 100 percent. Convinced that these proven techniques provide a host of benefits to patients and their families, as well as savings in healthcare costs, they now want to do for other pediatric surgery training programs in the country what they've done for their own. "There are some programs out there that are still at 5 percent, so the children in those cities are not benefiting from these great techniques," says Glick. "We'd like to help change that." An Operating Room with a View The new MASC includes two state-of-the-art operating rooms custom-designed for the performance of multidisciplinary, minimally invasive surgery, including laparoscopy, thoracoscopy, endoscopy, arthroscopy and cystoscopy. All equipment in each room is suspended from ceiling booms and is totally automated by a voiceactivated computer controlled by a headset worn by the surgeon. Simply by talking into this headset, he or she can direct all the equipment located on the booms, in cluding flat-screen televisions used to view procedures in real time as transmitted from cameras embedded in the tips of the endoscopes. [n addition, cameras built into the lights above the operating table capture on-screen a bird's-eye view of what the surgeon is seeing with his or her own eyes. Situated unobtrusively in the corner of each room is a "communication control center" that allows images captured by these cameras to be telecast to any location in the world equipped for teleconferencing, which provides the MASC with expansive telesurgery and "telemen to ring" capabilities. I u f fa I o Physician Spri11g 2002 On October 10, 2001, the first live operation from the MASC was broadcast to a meeting of the American College of Surgeons in New Orleans. On March 15, 2002, a second surgery was broadcast from the MASC to a meeting of the Society of American Gastrointestinal Endoscopic Surgeons in New York City. Also located within the MASC are state-of-the-art conference room facilities and an observation room, where medical students or other visitors can view surgical procedures being performed and telecast on a highresolution screen mounted in the room. Surrounding this minimalistic surgical environment are walls and ceilings painted with soft blue clouds and floating teddy bears. Children can select a cartoon movie from a collection of 20 videos donated by Warner Brothers and watch it on the four television screens in the operating room while anesthesia is administered. Or they can choose to play Xbox games donated by Microsoft. "So the kids go off to sleep watching the cartoon or playing the games," says Glick. A New Way to Teach and Train Students I eveloped in tandem with the MASC is the Miniature Access Teaching, Training and Research (MASTTAR) Center, housed in the Biomedical Research Building on the campus of the University at Buffalo School of Medicine and Biomedical Sciences, located five miles from CHOB. This $900,000 center-linked fiberoptically to the MASC- is a component of the Buffalo Center of Excellence in Bioinformatics (see related article on page 14) and is supported by the university for the purpose of teaching medical students, residents, fellows, nurses and technicians about minimally invasive surgery. The idea to make the MASTTAR Center a component of �l the Center ofExceUence in Bioinformatics was championed by Bruce Holm, PhD, former senior associate vice president for health affairs at UB, who was recently named a senior vice provost at the university. "Bruce Holm's efforts have been an essential component of the MASTTAR," explains Marc Levitt, MD, UB assistant professor of surgery and pediatrics and medical director for both the MASC and the MASTTAR Center. "Several years ago, he foresaw how it could be a part of the bioinformatics center, and because of his involvement from the start, the university has been extremely supportive of the MASTTAR Center by providing a significant amount of funding, as well as by encouraging multidisciplinary collaborations with engineers, computer scientists and others on campus." he MASTTAR Center includes an eight-station laboratory that is used to conduct basic-science projects and minimally invasive surgery training courses. Located adjacent to a fully-equipped surgery suite that is used in conjunction with this training, the MASTTAR Center also houses cutting-edge computer facilities, fiberoptic connections and office space available for personal computing needs, including data storage and reduction, statistical analysis and graphic presentation. Also located in the center is an $850,000 Zeus surgical robot donated by Computer Motion. This highly sophisticated robot is an earlier model of one that is located in Buffalo General Hospital's (BGH)* Center for Less Invasive Cardiac Surgery and Robotic Heart Surgery, which is directed by Hratch Karamanoukian, MD, a UB assistant clinical professor of surgery (see page 9 for details on a robotic heart surgery trial currently under way at this center). "Dr. Karamanoukian is one of the premier cardiac surgeons in the country, and he routinely performs coronary anastomoses with the Zeus robot," says Levitt, who adds that Karamanoukian collaborates on a number of projects at the MASTTAR Center. "Basically, Dr. Glick worked out a deal with Computer Motion, where they gave Dr. Karamanoukian a newer model of the robot, and the MASTTAR received the older one he had been using." In the future, surgeons fully expect that robots will merge with minimally invasive surgery to provide surgical applications that could only have been imagined a few years ago. For example, NASA and the military are interested in this technology, which, theoretically, could allow an operation to be performed on an astronaut in space by a surgeon on Earth, or on a soldier on a battlefield by a surgeon located miles away at a secure site, according to Levitt. These scenarios recently took one step closer to becoming a reality when Michel Gagner, MD, a surgeon at Mount Sinai Hospital under whom Levitt trained, performed a Spri11g 2002 Bu If a I o Ph ysi cian 5 �(bottom right) (bottom left) The stmulator was donated to the MASTTAR by Computer Motion. �laparoscopic gallbladder operation on a woman in France from his office in New York City. " In addition to these applications, the reason we're interested in robots is because they can do repetitive motions in very small places, very accurately, and eliminate any tremor a surgeon might have, so you can be incredibly precise," explains Levitt. In pediatric surgery, this instrumentation would be particularly advantageous for such procedures as esophageal repairs on newborns, according to Glick. It would also be a valuable tool for ligating extra blood vessels between the heart and lungs in a procedure called patent ductus arteriosus ligation, and may have some applications to biliary atresia, where surgeons sew extremely small pieces of the intestine to the liver and bile ducts. A t the MASTTAR Center, Glick and his colleagues also are working to develop and test a wide variety of new equipment and technologies related to minimally invasive surgery. Currently, for example, they are collaborating with a multidisciplinary Surgical Simulator Team to develop a next-generation laparoscopic virtual-reality surgery simulator in partnership with two companies: Mentice Corporation, of San Diego; and Silicon Graphics, of Mountain View, California. Members of this team include Christina Bloebaum, PhD, UB Professor for Competitive Product and Process Design and director of the ew York State Center for Engineering Design and Industrial Innovation (NYSCEDII) on UB's orth Campus; and Eliot Winer, PhD, UB research assistant professor of engineering and applied sciences and the associate director ofNYSCEDII; Thenkurussi Kesavadas, PhD, UB assistant professor of mechanical and aerospace engineering and director of the UB Virtual Reality Laboratory; Russ Miller, PhD, UB professor of computer science and engineering and director of the university's Center for Computational Research (CCR); and Thomas Furlani, PhD, associate director of CCR and UB research associate professor of chemistry. Each of the three entities that makes up the Surgical Simulator Team provides specialized expertise that makes this project possible, according to Glick and Levitt. CCR primarily provides the computing power and knowledge; YSCEDII provides advanced virtual-reality technology; and the VR Laboratory is contributing groundbreaking work on hap tics. "Haptics involves, for example, a surgeon using virtual-reality technology to pick up an instrument on the computer screen and being able to feel its weight and consistency with his hand," explains Levitt. The surgical simulator under development at the MASTTAR Center will have two specific applications. The first is preoperative planning, where radiographic images, such as CAT scans or MRis, are burned onto a CD and loaded in a computer, where the images are reconstructed in three dimensions. "If you have a patient with a tumor in his liver, which has a lot of blood vessels around it, you could reconstruct the liver in three dimensions and then remove certain components of the anatomy to see how close the tumor is to the main blood vessels," says Michael Caty, MD, a CHOB pediatric surgeon and UB associate professor of surgery. "This is work we have already done, and it can help the surgeon avoid potential problems and discover safer approaches to take." The second application being developed is one that will enable an individual to simulate an operation on the computer for training purposes. "If you had a surgical resident learning to remove a gallbladder," says Levitt, "she could perform the whole operation before she met her first patient. It's just like the flight simulators used by the airlines, and in both cases it really enhances safety." In addition to these and other research and development projects, Glick has established a clinical laboratory at the MASTTAR Center that focuses exclusively on minimally invasive surgery. He explains that surgeons working with adults have recently begun to examine how minimally invasive surgery affects the physiology of their patients; however, few such studies have been conducted in the pediatric population . "Our goal, therefore, is to explore how this type of surgery impacts on the physiology of children," says Glick. "For example, when you insufflate the abdomen of a fivepound infant with carbon dioxide [in order to create a hollow space so you can perform a minimally invasive Spring 2002 Buffalo Physician 7 �surgical procedure], what exactly is going on in that little baby? This is the type of question we are asking in our research." Stitching in the Curriculum Piece Glick is tremendously enthused about ways in which these research projects and the technologies made available through the MASTTAR Center will affect the training of medical students and surgical residents at UB. He also feels the center can play a role in reversing trends in medical education over the past decade that have resulted in fewer students choosing surgery as a career. "Over the past 10 or more years, because there has been such an emphasis on primary care, students have lost valuable contact time with surgeons and other specialists and, as a result, some of the best students have been turned on to things other than surgery," explains Glick. 0 etermined to do his part to counter this trend, Glick has embarked on an effort to build what he calls "a farm team for the Department of Surgery." To accomplish this, he has begun a surgical interest group (the "SIG") at UB for first- and second-year students, and he is working with administrators to introduce changes in the curriculum that, among other things, will expose students to stimulating new laboratory experiences. Guy Brisseau, MD, CHOB pediatric surgeon and UB assistant professor of surgery and pediatrics, is collaborating with Glick on the details of this new secondyear elective. There are inducements for third-year students, as well. On the first day of their surgery rotation, the students are brought to the MASTTAR Center, where they begin learning basic hands-on skills, such as suturing, the placement of chest tubes and endotracheal intubation. Also, students can test their hand-eye coordination by attempting to take balls from one beaker and place them in another using the laparoscopic virtual reality-surgery simulator/trainer (the same simulator for which the MASTT AR Center researchers are working to develop a next-generation model). "The student's proficiency on this trainer is really amazing," notes Levitt. "If you took a senior surgeon and put him next to a third- or fourth-year medical student on the virtual-reality simulator, the student would do better because they have grown up playing video games and so 8 Bu ff a l o Physicia n Spring 2002 are used to looking at a TV screen while working with their hands. People 50 years and older never did this as children. The computer can record how quickly the students learn these skills, and they are very adept right away." Glick is also developing an entirely new curriculum and training for pediatric surgical residents, a goal he says the MASTTAR Center is "totally suited to support." Recently, he created a teaching program in miniature access surgery for third-year residents aimed at helping them to acquire a clearly defined set of surgical skills prior to being allowed to work in an operating room. "In England, they're very into this kind of'programmed learning,"' notes Glick. "Basically, you have to be credentialed in certain skills before you can operate on humans. In this country, a lot of teaching has been done in the OR, but we're going back to the basics now and our residents are going to have to be credentialed in certain skills before they can progress to the operating room." Alan Posner, MD, UB assistant professor of clinical surgery and chief of laparoendoscopic surgery at Erie County Medical Center (ECMC) and Buffalo General Hospital, will collaborate with Glick and others to help train the residents in acquiring these skills. In addition, ECMC has been fiberoptically linked to the MASTTAR Center, and in February 2002 Posner taught a course on nephrectomy for urologists. For the course, a nephrectomy was performed at ECMC and broadcast live to a conference room on UB's campus. In addition to medical students and residents, practicing surgeons-many of whom attended medical school before minimally invasive surgery was taught-now are being retrained in these techniques utilizing teleconferencing and "telementoring" capabilities at the MASC. In reference to this latter mode of training, Glick explains that there are a number of new operations he and his colleagues have developed and want to teach to others, but they don't have time to travel to locations to be present with surgeons who are performing the operation for the first time on their own. Instead, the surgeons can come to Buffalo to train and when they return home to a facility whose operating rooms are equipped with teleconferenc- �ing capabilities, they can then perform the new procedure while being closely monitored by a CHOB surgeon situated in the MASC conference room. A key to taking the center's teleconferencing capabilities to such an advanced stage is an ongoing collaboration between MASC faculty and Lisa Stephens, associate director for Distance Learning Operations at UB. Due in large part to the technical assistance provided by Stephens and her group, the MASC this year is offering six postgraduate teleconferencing courses, not only to physicians, but to nurses and technicians, as well. The first course, held on January 26, 2002, was attended by 80 operating room nurses and technicians representing 30 hospitals in five different cities in Western New York. f or the past five years, a course has been taught at Miami Children 's Hospital to train pediatric surgery fellows in pediatric laparoscopy. This year, the course moved to Buffalo, where it was taught by the CHOB pediatric team of Glick, Levitt, Caty and Brisseau. Joining this team as v1s1tmg professors were four other leading pediatric surgeons from around the country, including Raleigh Thompson, MD, Steve Rothenberg, MD, Keith Georgeson , MD, and Thorn Lobe, MD. Held in April 2002, the course was attended by more than 20 pediatric surgery fellows from across orth America. In addition, a pediatric laparoscopic fellow, funded by Ethicon Corporation, currently is being trained at CHOB in minimally invasive surgery. The fellow, )oselito Tantoco, MD, is from the Philippines; after two years he will return to his homeland, where he will be the only pediatric surgeon trained in these skills. Another exciting development is the completion of a fiberoptic connection between the MASC and Butler Auditorium in UB's School of Medicine and Biomedical Sciences, which equips that venue with telesurgery capabilities. The new telecommunications system was unveiled on March 19, 2002, for a class on minimally invasive surgery sponsored by UB's Mini Medical School , which seeks to educate the community about science and medicine. More than 300 people attended the class, which was taught by Glick while Levitt simultaneously performed an operation at CHOB, key portions of which were telecast live in Butler Auditorium throughout the lecture. "Our multifaceted approach is the thing that sold our program to our corporate sponsors," Glick says, explaining that the MASC and the MASTTAR Center are supported by grants from the Stryker Corporation; Ethicon Endo-Surgery, a subsidiary of johnson and Johnson; Berchtold Corporation; and Steris Corporation. The MASC has also been supported by the Children's Hospital of Buffalo Foundation, and the MASTT AR, by funds from UB. "There are many people knocking on the doors of corporations, saying they want to be a center of excellence," adds Glick. "But what made us unique is that we were the first pediatric group to approach these sponsors and offer them the clinical excellence, as well as teaching, training and research, in one program. " CD *Children 's Hospital of Buffalo and Buffalo General Hospital are part of the Kale ida Health System. Sp r i11g 2002 luflalo Physician 9 ��inimally invasive surgery is the antithesis of the traditional "open access" approach to surgery in which an operation is performed through an incision in the body large enough to accommodate a surgeon's hands wielding a scalpel, suction tubes or other instruments. Alarge, open wound brings with it collateral tissue damage, risk of infection, pain and alengthy recovery, not to mention permanent, often prominent, scarring. The ability to perform surgery through small "ports," or keyhole incisions, became possible with the invention of the endoscope, a rigid or flexible tube a few centimeters in diameter equipped with a light and camera at one end. By introducing the endoscope and other tiny instruments into small, strategically located incisions via conduits called "trocars," surgeons can complete almost any task. Gynecologists have been performing laparoscopic procedures for several decades; in many ways, they pioneered the field of minimally invasive surgery as we know it today. The first laparoscopic cholecystectomy (gallbladder excision) was performed in 1987, and since then laparoscopy has been applied to many surgical problems, leading some to predict that minimally invasive surgery will make up greater than two-thirds of operating room cases in the near future. Despite its success in adults, however, this form of surgery was rarely used in infants and children until recently. "There was a lot of resistance to minimally invasive surgery in pediatrics, and some was for bad reasons that have taken us a decade to get past," says Philip Glick, MD, surgeon-in-chief at Children's Hospital of Buffalo (CHOB)*, executive director of its new Miniature Access Surgery Center (MASC) and UB professor of surgery and pediatrics and interim chair of the Department of Surgery (see previous article). These reasons include the fact that postoperative pain in children was not well understood and was underestimated, so the need for a more minimal approach was not deemed necessary. Also, because pediatric surgeons prided themselves on making small incisions to begin with, the advantages of Spring 2002 I u If a I o Phy s i ci an 11 �even smaller incisions were not at first recognized, but instead dismissed by early critics of laparoscopy in pediatrics as merely "cosmetic." Other major stumbling blocks were the steep learning curve for minimally invasive surgical techniques and the fact that the equipment was costly and time consuming to set up. Finally, the unavailability of instruments that were small enough in size for infants and children served to effectively stymie those few pediatric surgeons amenable to exploring these innovative surgical procedures. Over the past five years, Glick and his colleagues at CHOB have played a leading role in surmounting many of these barriers, as well as in pioneering new minimally invasive surgery techniques for use in children that, ironically, now are being adapted by surgeons working with adults. A Quest to Move the Field Forward 8 ecause there are 35,000 general surgeons in the United States and only 400 pediatric surgeons, the manufacturers of medical instrumentation were not interested in downsizing their tools for use in pediatrics, claiming that the market was not big enough. "It took a few companies to believe in what we were doing to realize that we were going to push the envelope on this technology, and then they started miniaturizing the equipment for us about five years ago," says Glick. So, instead of 10- to 12-millimeter telescopes-about the size of a chunky pen-pediatric surgeons now can use three- to five-millimeter tools that also have been shortened in length. The new instruments have proven so effective that general surgeons have started using them, especially in adults for whom scarring is a concern. With the new instruments on board, other barriers began tumbling, and minimally invasive surgery in children has taken off at a brisk pace, especially given the obvious benefits to patients and the bottom line for hospitals. "The benefits of minimally invasive surgery for children are significant," says Marc Levitt, MD, UB assistant professor of surgery and pediatrics and medical director for the MASC and the Miniature Access Teaching, Training and Research (MASTTAR) Center at UB. " It leaves little or no scarring, and the risk of pul monary problems is greatly reduced. Also, the chil dren have shorter hospital stays, and once they are discharged they can return to school and normal activities. Essentially, after most of these operations 12 I u If I II P h J s i e i a n S p ri 11 g 2 00 2 there are no restrictions on their activities." Levitt says that evidence is now pointing to a correlation between a decrease in pain due to the smaller incisions and the decrease in pulmonary complications. "Because they have less postoperative pain, they are better able to cough and breathe deeply," he notes. In addition to improved patient care, the equipment and instruments that have been developed are resulting in reductions in healthcare costs. The state-of-the-art operating rooms in the MASC can be readied for surgery with the flip of a switch, in comparison to the lengthy and labor-intensive set-up procedures required for minimally invasive surgery in years past. "We basically have a 'preflight' checklist, where the nurses walk into the OR and in five minutes it's ready to go; all they have to do is set up the sterile equipment," says Levitt. In addition, recent studies have shown that the dollars saved in turnaround time for these operating rooms-where six to eight cases can be done in a day instead of just four- will pay for them in a short time. Leaving No Procedure Unturned By having all the latest equipment and instrumentation at their fingertips, the pediatric surgeons at CHOB have become innovators in their field, challenging themselves and their peers to take a fresh look at all procedures, leaving none overlooked. What they are finding is that many surgeries not only can benefit from the adaptation of minimally invasive techniques, but in some cases can be converted over to these new techniques exclusively. An example of such a surgical procedure involves the treatment of Hirschsprung's disease, a congenital disorder in which the bowel malfunctions, resulting in severe constipation. This condition once required three separate operations during a baby's first six months of life, with each surgery involving a five- to seven-day hospital stay. Using a laparoscopic approach, surgeons at CHOB now perform one three-hour operation that requires no incision. The procedure is done during the first month of life, and the baby can go home in one or two days. "We've done 20 of these operations using telescopes. This gives us a lot better visualization and mobilization from above, which makes the operation safer," says Michael Caty, MD, who, along with Levitt, performed this procedure at the MASC while it was being broadcast live to a group of several hundred surgeons watching it on a screen at the annual meeting of the American College of Surgeons in ew Orleans in October 2001. Caty and Guy Brisseau, MD, along with Glick and Levitt, �make up the pediatric surgery team at CHOB and are the only pediatric surgeons in Western New York. Building on this work, these surgeons have begun using trocar-less surgery in exceptionally small babies in need of minor operations. "Instead of using a trocar, we introduce the surgical instruments directly into the abdominal wall through a three-millimeter incision," says Glick. "This greatly reduces scarring, and it allows you the flexibility of putting the instru- to eight hours to complete. ow, with the assistance of the pediatric surgeons at CHOB, the orthopedists are using thoracoscopic techniques to complete this phase of the surgery, reducing it to a two- to three-hour process and avoiding a large incision. The pediatric surgeons' role is to insert all the trocars and camera instruments for the orthopedic surgeon. Once this is done, they can either go down the hall to the MASC conference room, where they can observe the procedure via telesurgery, or they can go next door to perform their own surgery while still being available to communicate with the orthopedic surgeons should the need arise. ments tn anywhere you want. In the past, we were very rigid about where we placed our trocars, but now we understand that this can be cus- As they eagerly look to the future to explore how other minimally invasive techniques can be incorporated into surgical procedures, the pediatric surgeons at CHOB take pride in the fact that they consider no operation outside the bounds of their scopes. "When we started doing minimally invasive surgery here five years ago, it involved about 60 of the 2,000 cases we complete each year. ow we're up to about 1,000 cases," says Glick. "And the ones we're not doing, we're still asking ourselves, ' Can we do it?' Right now, the answer is, 'We can't,' but we keep asking ourselves that question every day, and as the equipment gets better and we gain more experience, we'll be approaching 100 percent. It's just a matter of time." CD tomized for each operation." The CHOB surgeons also are collaborating with specialists in other fields to develop innovative alterations to surgical procedures that significantly affect quality of life and outcomes for patients. A dramatic example of this is the work they've been doing with orthopedic surgeons to correct spinal deformities resulting from congenital scoliosis. In this procedure, the orthopedic surgeons at CHOB-Robert Galpin, MD, and Douglas Armstrong, MD-must first release the ligaments on the child's anterior spine, after which the patient is turned over and the corrective hardware inserted. In the past, using the traditional open-surgery approach, the surgeon had to make a large incision across the chest or the abdomen to access the spine and release the ligaments, a process that took six *Children's Hospital of Buffalo is part of the Kaleida Health System. Lois Baker, senior editor in News Services at the University at Buffalo, contributed to this story. Sp r i 11 g 2002 l ullala Physician 13 �RESEARCH E W S Bioinformatics Center Receives 8200 Million Bv ELLEN GOLDBAUM -Merging of high·end technologies to foster advances inhealthcare and science n December 6, 2001, ew York State Governor George E. Pataki announced $50 million in state funding and more than $150 million in private-sector funding for the Buffalo Center of Excellence in Bioinformatics, a collaborative effort involving ew York State, industry partners and academic institutions. Building on the emerging discipline of bioinformatics, which uses the power of supercomputers to interpret data in the biological sciences at the molecular level, the new center will merge high-end technology, such as supercomputing and visualization, with expertise in genomics, proteomics and bioimaging to foster advances in healthcare and science. First proposed in January 200 l by Pataki, the Buffalo Center of Excellence in Bioinformatics is an integral part of the governor's plan to develop centers of excellence across the state to harness the strengths of universities and the private sector to create strategically targeted hightechnology centers of innovation, all aimed at spurring economic development and creating jobs. Since that initial announcement, the Buffalo Center of Excellence in Bioinformatics has attracted funding from major national corporations. In December, Pataki acknowledged that efforts to garner such funding were bearing fruit and that the center "will go forward. " In addition to an "initial installment" of $50 million from New York State, he announced the following commitments in software, hardware, venture capital, cash and equipment from the industry partners 14 I u I I a II Physic i a a S prir~ g 2 00 2 to date: Veridian will contribute $62.5 million; Compaq, $42.6 million; Informax, $20.8 million; and a group ofWestern New York businesses is investing 15 million. Stryker Communications is providing $7.2 million to create a communications network for the center (see related article on page 2), and Dell Computer Corporation and Sun Microsystems Inc. together are providing more than $1 million. Other partners include Invitrogen Corporation, Q-Chem, SGI, Amersham Pharmacia Biotech, AT&T, Wyeth Led erie, Human Genome Sciences, Inc. and the Alfred P. Sloan Foundation. The level of the commitment of New York State and the industry and academic partners, Pataki said, will assure that the center will be "the state-of-the-art facility, not just in the United States, but in the world"; and he also predicted that the center "will transform Western ew York into a 21st-century economy." On behalf of the University at Buffalo, which is taking the lead among the center's academic partners, UB president William R. Greiner thanked Pataki for his vision, leadership and continuing commitment to Buffalo- iagara. "It is much appreciated in this region," Greiner said, "and we will work to make you proud." In addition to support from the state, the Buffalo Center of Excellence in Bioinformatics will receive funding from the federal government. On December 7, Representative Thomas Reynolds an nounced that $3 million had been earmarked for the center in the House version of the defense appropriations bill. Senator Hillary Rodham Clinton worked hard to supplement this allocation in the Senate, and on December 21 she and Representative Reynolds announced $3.1 million in funds from two separate Congressional appropriations, providing important start-up costs for the initiative. The Buffalo Center of Excellence in Bioinformatics will be headquartered in a 150,000-square-foot facility to be built on the Buffalo-Niagara Medical Campus (formerly known as the "High Street medical corridor") and will house drug-design and research laboratories, high-performance computational facilities, 3-D visualization capabilities, product commercialization space and workforce training facilities. The center is a natural progression of the pioneering work that the center's major research partners-the University at Buffalo, Roswell Park Cancer Institute and the Hauptman-Woodward Medical Research Institute- have been doing for years in the areas of high-performance computing and visualization, structural biology, genomics, proteomics, pharmaceutical science and �generation of custom gene "chips" through the generation of DNA microarrays. Global link for Bioinformatics Center In a related development, the University at Buffalo has entered into a new hightechnology partnership with Biopharma Ireland, Ireland's new national institute focused on biopharmaceutical research and development, giving the Buffalo Center of Excellence in Bioinformatics an important international connection. UB and Columbia University were named as Biopharma Ireland's first U.S. partners in an announcement made on March 27, 2002, by U.S. Senator Hillary Rodham Clinton. Biopharma Ireland was established by Dublin City University and Athlone Institute of Technology to promote research leading to the discovery of new pharmaceuticals and to the creation of new companies and investments based on that research in Ireland and ew York State. "As a true Center of Excellence we need not only national, but international, connections and recognition," says UB Provost Elizabeth D. Capaldi, PhD. "Ireland has strong computer and pharmaceutical industries and is an ideal partner for our bioinformatics effort. We are pleased to be able to have Biopharma Ireland as a partner." Bruce Holm, PhD, UB senior vice provost and the university's representative at the announcement, notes, "It only makes sense that as a center of excellence, Buffalo's bioinformatics center should be linked with other centers of excellence. "In particular, Ireland has made substantially more of an investment in pharmaceutical research than most other places in the European community," he says. "With our partners in Ireland, as well as with Columbia, this is a natural, complementary partnership for UB." The pharmaceutical companies Elan, Wyeth (a subsidiary of American Home Products) and Schering-Plough recently have made major investments in Ireland. Biopharma Ireland also is putting resources into developing spin-off biotech companies that will benefit both Ireland and New York State. UB's partnership with Biopharma Ireland has its roots in previous research collaborations with Irish institutions facilitated initially by the Atlantic Corridor USA, a Buffalo-based, non-profit alliance created to link the NAFTA and European Union markets. Last semester, UB's Institute for Lasers, Photonics and Biophotonics and the Hauptman-Woodward Medical Research Institute hosted visiting researchers from the University of Galway and the Athlone Institute of Technology. UB has been partnering with Columbia University on the Northeast Structural Genomics Consortium, a $25 million project involving nine institutions to study structural genomics, a new field dedicated to determining gene function by defining the protein structure encoded in a gene's D A sequence. UB's Center for Computational Research, one of the world's leading academic high-performance computing sites, serves as the computational backbone for the ational Institutes of Health-funded project. ( D Sp r i 11 g 20 0 2 Buffalo Physician 15 �16 lallala Hysiciaa Spri11g 2002 �Sprtng 2002 1111111 .. JSICIII 17 �hile the general public may not fully understand how business skills can help today's physicians function more effectively in our complex health care economy, medical students do-and increasingly they are seeking ways to obtain these skills. In response to this growing demand. UB'sSchool of Medicine and Biomedical Sciences teamed up with the School of Management in 1997 to design an innovative program aimed at providing business skills to medical students. This collaboration has since resulted in the formal establishment of an MD/MBA program at UB, which last spring matriculated its first graduate. The new program, one of MBA student Michael Chilungu, Class of neurship, which may help them to open 17 MD/MBA programs in the 2003. " I see a need for physicians who are their own practices, participate in hospital country, was designed to allow medical students to obtain a dual degree in medicine conversant in the business aspects of medi cine to serve as an antidote to this problem. administration, serve as managers in health maintenance organizations, or simply and management in five years, instead of the l t is they who can best reconcile the need for improve their understanding of personal six it would take if the degrees were earned sound financial management with quality finance. independently. Students enrolled in the pro- patient care." gram spend years one and two completing gram is that students are required to complete traditional preclinical medical school also Class of2003, had no previous business a semester of internship training, which helps coursework. They then spend the following experience before entering the MD/MBA ground coursework in the realities of the year as full-time MBA students, after which program. Instead, she credits her clinical market economy. To date, UB students have they return to medical school to complete experience in medical school and intern- completed internships that have involved their third-year medical clerkships and the ships at Independent Health as her primary performing quality assessment research in required fourth-year medical rotations. They conclude the five-year dual-degree motivation to better understand the business of medicine. Erie County Medical Center's Emergency Department; developing and facilitating a "I became interested in the program after course in medical ethics; working as an ac- The reasons students cite for entering the I began working with physicians during my countant; and assisting in product develop- program are as eclectic as the choice of a outpatient experiences as a first-year stu- ment and strategic planning at Cognigen medical specialty. Some report having felt intimidated by financial jargon, others say they have been unsure of what will be dent," says Perez. "I realized that most phy- Corporation, a local firm that performs sta- sicians were overworked, pressured for time and very frustrated with the effect managed care is having on them and their practices. tistical analysis and consulting services for global pharmaceutical organizations. program with a semester of MBA classes. required of them to run a private practice, while still others are drawn to an opportunity to explore a subject other than medicine. Diverse as these motives are, however, one "I feel that the way around this obstacle is to get physicians involved in the decisionmaking processes of HMOs," she adds. l hadeus Grasela, PhD, PharmD, chief executive officer and president of Cognigen, says his company recruits students from the program because their education and training provide them with a students are seeking ways to provide the "In general, I believe that the business aspect of medicine should be understood highest quality of care for their future patients. by all physicians in order to help them de- assets to his organization. theme is echoed by all: Ultimately, these "I have been hearing so much about the changes that are going on in the medical profession with regard to cost-cutting and managed care, and it concerns me that this 18 A notable feature ofUB's MD/MBA pro- Like manyofhercolleagues, Brenda Perez, liver optimal care to their patients." unique skills set-and perspective- that are "The students have a background and Medical students who earn their MBA interest in both science and business, so they have an opportunity to gain exposure to bring a new vision of the future to the table," says Grasela. " In order for Cognigen to be increased emphasis on the business aspect of numerous subjects that are essential to a practicing physician, such as finance, medicine will lead to a disregard for the well - accounting, information technology, man - knowledge for decision making, we must being of the patient, particularly when top agement development and negotiations. also develop paradigms for the use of management consists of individuals with little or no clinical experience," says MD/ Students can also receive training in health - knowledge in strategic planning. luffala Hysiciu Spri11g 2002 care consulting, marketing, and entrepre- successful, we must not only develop new "Society desperately needs individuals �trained in science and the use of knowledge for decision making," he continues. "The obtain a dual degree. "The year of business training between the second and third year directors looked upon his degree favorably when he interviewed. "They were uniformly lack of these individuals will become more of medicine is well-timed," observes Michelle Clark, Class of2003. "Without interrupting impressed and encouraging," he says. apparent as we move into the next phase of increasing productivity based on the efficient use of technology. "The [MD/MBA] students bring an enthusiasm and interest in global affairs that is refreshing and stimulating. It is a pleasure to rotations, we gain business knowledge after having been introduced to medicine. This Some MD/MBA students, however, have received feedback about their participation in the program that reflects deeply felt allows us to begin applying our business experience during our clinical years." schisms in our society regarding the rela- or the most part, students report that Third-year student Perez, for example, has f tionship between medicine and business. responses to their dual degree aspira- been asked questions such as, "Why are you tions have been positive. Daniel Avosso, getting a business degree, only to go work for For students, the opportunity to fluently MD/MBA '01-the UB program 's first an HMO?" And, "If you are interested in transition between two well- integrated professional training environments is viewed graduate-is currently working as an emergency medicine resident at Long Island's as both an efficient and pragmatic way to North Shore Hospital. He says residency business, why not just go to business school? You are taking the spot of someone who is truly interested in practicing medicine." work with such motivated-and motivating-individuals," Grasela adds. I see aneed for physicians who are conversant in the business aspects of medicine to serve as an antidote to this problem. It is they who can best reconcile the need for sound financial management with quality patient care. �The students have abackground and interest in both science and business, so they bring anew vision of the future to the table. In order for Cognigen to be successful, we must not only develop new knowledge for decision making, we must also develop paradigms for the use of knowledge in strategic planning. About the author Jennifer Wiler is a Colorado native who has lived in NewYorkStateforthe past 10 years. After completing her undergraduate education at Colgate University in Hamilton, New York, she worked at Memorial Sloan-Kettering's Harlem Women's Clinic Some have even suggested to her that she is adds. "By now, I feel it has become abun- betraying the profession of medicine, ex- dantly clear that medicine is not practiced in pressing the opinion that "there is no place a vacuum-it must be understood within the context of its environment, part of in medicine for business." Fortunately, many physicians and students which includes our market economy." and then on Wall Street as an assistant securities do appreciate the critical role that business Students in UB's new MD/MBA program analyst. She has now plays in medicine, and they recognize the are delighted with the training they have been an active need for physicians who are both clinicians received thus far and, as a group, we are member of the and managers. "Regardless of whether I later anxious to see where our degrees will lead decide to go into private practice, hospital us. As we look to the future, we have no administration or medical consulting, there- doubts that throughout our careers as medical school community and served as president of the alities of business have a daily and profound physicians, we will strive to increase the medical student body for 1999-2000. Upon impact on how medicine is practiced in any of quality of care delivered to our patients, completion of her MD/MBA degree in 2003, these settings," says MD/MBA student while simultaneously acting as informed she hopes to practice emergency medicine Charlton Byun, Class of2003. patient and physician advocates when busi- "Understanding the basic concepts un- ness issues enter the equation. This is not a derlying the business world will likely be formula for us to "make a lot of money," but very helpful, if not essential, in any attempt to deliver high-quality patient care," he perhaps it is a way to enrich the healthcare experience for our patients. <t) 1501 Ferry Road , Grand Island , NY 14072 773-7063 z0 in New York City l1ffale Pbys i c i u S priu g 200 2 and design programs for victims of domestic violence and sexual assauH. <t) �Alpha Omega Alpha Honor Medical Society White Family Memorial Fund Recipient B Alpha Omega Alpha is a national organization dedicated to supporting academic rittany Lee Morse, Class of 2004, participated in a six-week rural family practice excellence and perpetuating excellence externship in Perry, ew York, with support provided by the White Family in the medical profession. It is the only A native of LeRoy, New York, Morse currently resides in Corfu, New York, a world; students are selected on the basis Memorial Fund. national medical honor society in the rural town in Genesee County. Prior to entering the University at Buffalo's School of Medicine and Biomedical Sciences, she attended SU Y College at Geneseo, where she of scholarship and integrity. Newly nominated Alpha Omega Alpha earned a bachelor of science degree in biology. Lee's goal is to members of the University at Buffalo's practice medicine in an underserved rural community and, to Epsilon Chapter from the Class of 2002 date, she has pursued a strong interest in family medicine. inducted this spring are: The White Family Memorial Fund was established in 2000 to memorialize Deborah A. White, MD '87, and her husband, Christopher, and son, Adam, who died in a car accident in 1999. It supports a summer internship for a firstor second-year student who is interested in pursuing a career Garrick A. Applebee Suzie Ariyaratana Lily M. Belfi linda J. Cuomo Keely E. Dwyer-Matzky in rural medicine. "It was an honor to take part in achieving the goals set forth by the White family, and I look forward to furthering this effort in my career," says Morse. <li) Christopher M. Foresta Anthony R. Mato Christopher E. MuHy Kathleen T. O'Donnell -S. A. UNGER Aimee l. Stanislawski Andrew B. Symons Cra:z:iade Receives Sung Scholarship Juliane M. Thurlow Matthew S. Traugott llison Graziade, Class of2005, is the first recipient of the john J. and janet H. Sung A Karen M. Weiss Scholarship. Graziade, a native ofL1ttle Falls, New York, attended Umon College m Schenectady, New York, where she majored in biology, with a minor in psychology. "!am honored to receive the Sung Scholarship and be chosen out of the first- Students from the Class of 20021nducted Last Spring: year class to be the first recipient," says Graziade. "The Sungs are outstanding people, Shaleen l. Belani and I appreciate that they have provided a scholarship to recognize medical students. Jennifer l. DeFazio "In addition to the honor of receiving this award, the monetary gift is extremely helpful considering the burden of financing a medical education." The Sung Scholarship is funded by a $1 million gift to the University at Buffalo School of Medicine and Biomedical Sciences by John and Janet Sung, who came to the United States from Korea in 1972 with only $200 to complete their education. At the time, they had two dreams: to financially assist other deserving students to attain their educational goals and to establish a renowned clinic in radiology, both of which have <li) been realized. David M. Krakowski Brian J. Maim Caryn E. Orr Andrew P. Swan Students from the Class of 20031nducted This Spring: Esme E. Finlay Alfred T. Frontera Julie A. Gavin Stephen D. Hess Sara I. Kaprove Natasha S. Manes Richard G. Newell �A L U M N BY S.A. UNGER ATribute to Orvan Hess A pioneer in fetal·heart monitoring opment that made it possible to keep a continuous, accurate check on the unborn University at Buffalo School of Medicine and Biomedical Sciences-and certainly one of the most baby's heartbeat even when medical peraccomplished. Over the course of his career, which spanned more than 50 years at Yale-New Haven sonnel were unable to be in the room. Hospital, Hess helped pioneer fetal-heart monitoring, was an early advocate for the return of natural "The fetal cardiac electrical signals childbirth methods and was instrumental in the first use of penicillin. could then be monitored and transmitted While not able to travel from his home in Connecticut to join us for last year's Spring Clinical by radio signal to a distant receiver," Day and his 70th class reunion, Dr. Hess, age 95, was nonetheless with us in spirit. explains Hess. The following article is published as a tribute to Dr. Hess, whose many scientific accomplish· While these early fetal-heart monitors ments not only have earned him world renown in his field, but also a place of pride among his fellow were crude by today's standards and medical school alumni. - John J. Bodkin II, MD '76 Preside11t, Mediml Alumni Association would eventually be replaced by ultrasound, their development by Hess and his colleagues marked the beginning of the field of fetal cardiology. In large part due to his work in this field, Hess received the Scientific AchieveOLLOWI G GRADUATIO from faint and difficult to isolate from the the then-University of Buffalo mother's. As a result, physicians were forc- ment Award from the American Medical School of Medicine in 1931 , ed to employ what he calls the "watch-and- Association in 1979. Contributing to his receipt of this prestiOrvan Hess completed his in- wait-and-pray" method. ternship and residency training Watching and waiting, however, was gious award was the work he did following at the New Haven Hospital in not Hess's style. Upon his return to Yale, World War II to usher in the renaissance of natural childbirth, as well as New Haven, Connecticut. In therefore, he teamed up \VHI LE THESE EARLY pioneering studies he led in 1936, he began a research fel- with Dr. Edward Hon, a FETA L· H EA RT MO l'<I TORS wound healing of the uterlowship at Yale University postdoctoral fellow, to WERE C R t; DE BY TODAY'S us after a Cesarean section. School of Medicine, where he address this problem. In STANDARDS AN D WOULD was named clinical instructor 1957, the two researchers Hess's clinical judgEVENTUA LLY BE REment also proved presm 1937. Five years later, he left the uni- became the first in the PLACED BY uLTRASOuND, cient in 1942, when he versity to serve as a surgeon during World world to monitor fetal THE I R BY was a catalyst for the first War II as part of the evacuation hospital heart activity by continHESS AND H I S COLsuccessful clinical use of attached to General George Patton's 2nd uously detecting and reLEAGUES MARKED THE penicillin. He recalled the cording electrical cardiac Armored Division during the invasions BEG INNING OF THE FIELD circumstances leading to signals indicating the of North Africa, Sicily and ormandy. OF FETAL CARDIOLOGY. this milestone in a 1999 In 1949, Hess returned to Yale Univer- condition of the unborn. interview. "My associate, sity as assistant clinical professor and re- The machine they develsumed work he had begun as a resident on oped was six-and-a-half feet tall and two Dr. A. Nowell Creadick, asked me to go a way to electronically monitor fetal-heart feet wide, far from being portable or com- see Mrs. Anne Miller in the isolation unit of New Haven Hospital. She was one of activity before and during delivery. One of pact in a crowded delivery room. Working in collaboration with Wasil our obstetrical patients, pregnant with her the problems obstetricians faced at that time was the inability to diagnose fetal Litvenko, chief of Yale Medical School's fourth child, when she contracted scarlet distress during the critical period oflabor electronics laboratory in the 1960s, Hess fever from her youngest son and suffered a and delivery. devised a system of telemetering the fetal miscarriage, subsequently developing an "The stethoscope just could not do the electrocardiogram and intrauterine pres- overwhelming bloodstream streptococcus job," says Hess. The fetal heartbeat was sure during pregnancy and labor, a devel- infection. Doctors had done everything Obstetrician/gynecologist and surgeon Orvan Hess, MD '31, is one of the oldest living alumni of the DEVELOP~IEl'<T 22 B u II a I o Physician Spri11g 2002 �possible, both surgically and medically. I went to see her and knew she was dying. " From the hospital I went to the Graduate Club to see her internist, Dr. John Bumstead. I discovered he was upstairs in the library, where he had fallen asleep reading a newspaper. While I was waiting for him to wake up, I sat and read the latest Reader's Digest, in which there was an article called " Germ Killers from Earth, " about the use of a soil bacteria to kill streptococcal infection in animals. "When I spoke to Dr. Bumstead, I asked if anything more could be done for Mrs. Miller, and I said, 'Wouldn't it be wonderful if we had something like this gramicidin mentioned in the Reader's Digest?' This suggestion prompted Dr. Bumstead to talk with his neighbor, John Fulton, a professor of physiology at the Drvan Hess, MD '31, says he is still fascinated with technology and the excitement of medical progress. Yale School of Medicine, who had worked in England with Howard Florey, who was studying penicillin. Dr. Bumstead asked Fulton if he could contact Florey and possibly obtain some of the scarce penicillin. Fulton agreed and Anne Miller received her first injection on March 14, 1942. By the next day, her fever had broken. " Today, Hess says: "I am more convinced than ever that technology can be applied to medical practice without sacrificing humanism or our sacred patientphysician relationship. " (Ji) . 0 ... .,E "We practice law for your peace of mind." Estate Planning - Personal Injury Real Estate - Matrimonial Elder Law HoGAN & WILLIG, PLLC - - - - -- Atto n1 eys ut L nw - - -- - - hoganandwillig.com Proud Sponsor of The Tour de Cure • June 1, 2002 Fundraisirrg event {or tire A m erican Diabetes Association One john james Audubon Parkway • Amherst, New York 14228 • 716.636.7600 Spring 2002 lu ff a l o Phy sici lD 23 �IMAGINATION PET CENTER MARKS TENTH ANNIVERSARY BvALAN H. I LOCKWOOD. MD n November 2001, the University at Buffalo-Veterans Affairs' Positron Emission Tomography (PET) Center celebrated its 1Oth anniversary. In recognition of this milestone-and the notable accomplishments emanating from this center since its inception-we asked Alan Lockwood, MD, director of operations, to write an article highlighting work that has taken place at the facility over the past decade and to preview the direction in which he sees this research moving in the years ahead. Lockwood, a UB professor of neurology, nuclear medicine, and communicative disorders and sciences, has won international acclaim for PET studies he has led in recent years on the origins of tinnitus. These studies-conducted in collaboration with Richard Salvi, PhD, UB professor of communicative disorders and sciences and clinical professor of otolaryngology and neurology, and Robert Burkard, PhD, also a UB professor of communicative disorders and sciences-were the first to show that tinnitus sounds originate in the brain, not in the cochlea, as scientists previously thought. Following the announcement of these findings in January 1998, Lockwood received a steady stream of calls from news reporters around the world. The study was featured on NBC's Today Show and reported on in the New York Times, the Los Angeles Times and Time magazine, among other publications. As Lockwood reports here, a number of other studies conducted at the UB- VA PET Center over the past ten years have uncovered intriguing findings that demonstrate what can be accomplished when talented researchers from a broad range of disciplines combine the science of imaging with the power of imagination. S. A. lJ~GER EDITOR 2 .. Ia f fa I o Physic i aa Spri 11 g 2 00 2 �hat do tinnitus , heart attacks, cancer and the past tense of English verbs all have in common? These seemingly disparate topics have all been the focus of research studies performed in the UB-VA Positron Emission Tomography Center. To mark its first ten years of operation, center investigators described their accomplishments in an Anniversary Symposium held last ovember. Positron emission tomography, better known as PET, is a technique that captures basic life processes in a pictorial format. The PET image is, in essence, a snapshot of how the body functions from a biochemical or physiological perspective. By contrast, X-rays, computerized tomography (CT) scans and magnetic resonance images (MRI) typically portray anatomical information. This ability of PET images to photograph life processes has led to important advances in research and patient care. PET imaging begins with knowledge of how a critical body system works. For example, the brain uses glucose, a sugar, as its only source of energy. Since the brain can't store glucose, it depends on the rest of the body to deliver this vital compound on a second-to-second basis via the bloodstream. In a very real sense, the brain is like the engine of a car-it does lots of work, but it depends on the constant delivery of fuel to be able to function. By measuring how much glucose the brain is using or how much blood is flowing to the brain, it is possible to deduce how hard the brain is working. In other words, measurements of glucose use and blood flow yield impor- ALA" LOCKWOOD, ~D largest medical cyclotrons in the United subject or a patient undergoing a PET scan, inject a tracer (isotope) and take pictures. Behind this fa<yade, however, there is a large team of technicians. Since the isotopes used in PET all have very short half-lives (the time it takes for the activity to fall by 50 percent ), all the tracers the process is deceptively simple. All they are synthesized just before they are used. need do is to lie down with their head in the This step takes place on UB's South Cam- The most commonly used PET tracers camera while members of the PET team pus, in Parker Hall, home of one of the are fluorodeoxyglucose (FDG ) and water. tant information about how normal or healthy a part of the brain might be or how hard it is working. From the perspective of a research States. After the tracer is synthesized, it is whisked over to Buffalo's VA medical center, some 3,000 feet away, via an underground pneumatic transport system. At the VA, images are produced and then analyzed using sophisticated computer software. S pri ng 2002 lullalo Physicin 25 �I111aging and I MAG CONTINUED I NAT I FROM PAGE o N 25 The metabolism of FDG is very similar to glucose metabolism, with one important exception: One of the key enzymes for glucose metabolism can't act on FDG, so the metabolic process stops at this step. This traps the tracer, which allows the PET camera to image its distribution in the body. The amount of trapped FDG is proportional to the amount of glucose that is being metabolized. High amounts of the tracer are an indication of a high glucose metabolic rate, and vice versa. Blood flow is measured in studies that use labeled water as a tracer. These studies are complicated by the fact that the halflife of the water used is only 123 seconds, SO every tWO minutes the amount of jAMES fALLAVOLLITA , MD, left, AND jOHN CANTY, MD tracer is reduced by half. As a result, these studies require close cooperation be- parts of the brain become active or inac- energy to bring this complex projecL tween the cyclotron operators and chem- tive. Thus, a typical brain mapping study to fruition. After securing critical support ists who make the labeled oxygen and includes scans done at rest and scans done from the community in the form of a convert it into water and the technolo- as a subject performs a series of increasingly substantial grant from the James H. Cummings Foundation, Prezio and his associates convinced UB and the VA that the center would become a vital element "THE STUDIES IN THE UB-VA PET in their quest for excellence. Several years CENTER SERVE AS A MODEL FOR INTERDISCIPLINARY COLLABORATION. THE OPPORTUNITY TO WORK WITH COLLEAGUES WITH VASTLY DIFFERENT BACKGROUNDS of planning, construction and recruitment of staff led to the first PET scan in October 1991. Since then, thousands of patients have been scanned and more than HAS BEEN ONE OF THE MOST REWARDING ASPECTS OF MY JOB AS DIRECTOR OF PET OPERATIONS." - ALAN LOCKWOOD, MD $4 million has been awarded to support research in the center. The Anniversary Symposium was planned to highlight major research accomplishments. gists and investigators who use the labeled complex tasks. By subtracting the resting- water in a PET study. state scan from the scan done while the Although blood-flow studies using labeled water are complex, they have been the key to some of the most important work done in the UB- VA PET Center. By comparing the pattern of blood 26 brain is at work, it is possible to identify the parts of the brain that mediate the task. Using this basic strategy, center investigators have made important discoveries that have identified the brain regions that flow at rest with the pattern during the mediate tinnitus and those that we use performance of a specific task, it is pos- when we form the past tense of a verb. sible to identify the regions of the brain The Anniversary Symposium began that perform the task. This strategy works with a brief history of the UB-VA PET because the brain can' t store energy. It Center, which reviewed how joseph Prezio, depends on instantaneous changes in the MD, the then-chair of the UB Department delivery of glucose and oxygen as various of Nuclear Medicine, had the vision and l1ffalo Physician Spri11 g 2 00 2 BETTER CARE FOR HEART DISEASE Heart disease is a major cause of death and disability among Americans and is a particularly serious problem in Western ew York. John Canty, MD, and James Fallavollita, MD, from the UB Department of Medicine, have used FDG PET to define and study "hibernation" in the heart muscle. Hibernating muscle is still alive but does not function properly, causing the heart to pump inefficiently. A better understanding of this process will lead to improved care for patients with coronary artery disease. �Since PET cameras are thesizes that some of these new connec- nearly noiseless, unlike tions are responsible for this false sense of magnetic resonance scan- ringing in the ears. ners, PET is the ideal tool These studies are complemented by for studies of hearing dis- studies of the normal auditory systems orders. A research team performed by the tinnitus team and inves- consisting of myself, Robert tigations of other aspects of the normal Burkard, PhD, and Richard auditory system spearheaded by Ann Salvi, PhD, from the UB Eddins, PhD, associate professor in the UB Departments of Communi- Department of Communicative Disorders cative Disorders and Sci- and Sciences. ences, Neurology and Nuclear Medicine, have identi- L ANG UAG E AND GENDER fied and mapped the brain regions that mediate tinnitus, the false perception of a sound in the absence of an environmental source. This problem plagues millions and is almost always associated with hearing loss. By studying a group of patients who are able to modulate the loudness of their tinnitus, this investigative team was able to pinpoint the auditory cortex as the site ROBERT BURKARD. PHD. front. A~D RICHARD SALVI. PHD DI FFE RENTIATING LESIONS Every year, doctors must tell some of their patients that a routine chest X-ray reveals where tinnitus originates. In related studies, these researchers have found that hearing loss leads to a reorganization of the auditory jeri jaeger, PhD, from the UB Department of Linguistics, directed studies that show how the brain forms the past tense of English verbs. By mapping brain regions activated by forming the past tense of regular verbs (e.g., walk/walked), irregular verbs (run/ran) and clusters of letters that look like words (brep/brepped), jaeger and her colleagues concluded that the brain minimizes word storage needs by using rules to form the regular past tense and a dictionary look-up strategy for irregular verbs. In addition, the brains of men and women perform these tasks differently: Women use both brain hemispheres to form a past tense, whereas men use the left hemisphere. pathways in the brain. The team hypo- a spot or nodule in the lung. Not all of these nodules are cancerous, but that is always the main concern. Since cancerous cells use large amounts of glucose, FDG PET scans can help differentiate the cancers from benign lesions, without the need to perform invasive surgical procedures. Syed Husain, MD, a nuclear medicine physician at the VA, is the Buffalo site investigator in a nationwide cooperative study designed to better characterize the ability of PET to differentiate malignant nodules in the lung from those that are benign. B RA I N R EGIONS AN D T I NN ITUS Studies of the auditory system, particularly investigations of tinnitus, have been a major focus of research in the center. JERI jAEGER. PHD Spring 2002 8 u If a I o Ph JS i ci a n 27 �Jmagin,~ and I M A G I N AT I 0 N anatomy relationships revealed by MRI scans, and brain physiology revealed by PET. CusTOMIZING CANCER CARE Hani Abdel-Nabi, MD, PhD, chair of UB' s Department of uclear Medicine, and his associates from otolaryngology and surgery have made important contributions to the emerging field of PET oncology. In patients with cancer PET often yields information about the extent of a patient's disease with images that are more sensitive and specific than images obtained with other methods. PET scans allow a cancer patient' s physicians to plan treatments RALPH BE!';EDICT, MD THE IMPACT OF MULTIPLE SCLEROSIS ON AUDITORY ATTENTION Attention is a term psychologists use to describe the process of focusing brain resources on a given task. The neural systems that mediate visual attention have been studied extensively in other centers. Ralph Benedict, MD, and his colleagues from the UB Department of Neurology have developed a task that tests auditory attention. Not surprisingly, some of the same regions of the brain are used by both the auditory and the visual systems. In a recent extension of those studies, Benedict and his colleagues have studied attention in patients with multiple sclerosis, They have found that there are changes in the auditory attention pathways that appear to be the consequence of the disease, and they have begun to show how the brains of these patients are reorganized in an attempt to compensate for the lesions in their brains. This team is also collaborating with Rohit Bakshi, MD, from the UB Department of eurology, to study brain that are the most effective while avoiding high-morbidity surgical procedures that would be ineffective. This is a win-win situation that helps the patient, the physician and the healthcare system by reducing costs. Left to right, laflalo Physician S prin g 20 0 2 D THE AUDITORY SYSTEM Salvi and Burkard and I have teamed up with investigators from the University of Rochester to study aging in the auditory system. Studies by this group have shown that aging has an effect on the central auditory system that is independent of the hearing loss common among the elderly. MIGRAI E PHYsiOLOGY AND TREATMENT Headache is one of the most common problems faced by Americans and is a frequent cause of lost time from work. Edward Bednarczyk, PharmD, of the UB Departments of Nuclear Medicine and Pharmacy Practice, and his associates have tackled this problem in a series of studies of spontaneous migraine headaches. They augmented these investigations by using a model of migraine in which tiny amounts of nitroglycerine are given to migraine patients as they are scanned. To complement these studies, the team is evaluating drugs designed to prevent headaches. PET AND EUROPSYCHOLOGY The symposium was rounded out by showing how PET imaging can be integrated with psychological testing. In separate studies that have probed the effects of head injury and the effects of liver failure on brain HA:-11 ABDEL-N'ABI, MD, PHD. EDWARD BEDNARCZYK. PHARMD, AND SYED SAJID HUSAIN. MD 28 AGING A �function, my colleagues and I have shown that specific brain regions are associated with the performance of some of the most common tests used by psychologists. IN ANOTHER STUDY ON THE HORIZON, CENTER INVESTIGATORS WILL BEGIN COLLABORATION WITH COLLEAGUES UB RESEARCH PROJECTS ON THE HORIZON FROM THE DEPARTMENTS OF NEUROLOGY AND The studies in the UB-VA PET Center serve NEUROSURGERY IN A NATIONWIDE EFFORT TO IDENTIFY as a model for interdisciplinary collaboration. The opportunity to work with col- STROKE PATIENTS WHO WOULD BENEFIT FROM SURGERY leagues with vastly different backgrounds DESIGNED TO BYPASS BLOCKED ARTERIES TO THE BRAIN. has been one of the most rewarding aspects of my job as director of PET Operations. Clearly, none of the research conductstudy of multiple sclerosis, where inves- ed in the center would have been possible without grants from sources that are as a nationwide effort to identify stroke patients who would benefit from surgery tigators from the Jacobs diverse as the expertise of the center' s sci- designed to bypass blocked arteries to Institute are studying genetic markers in entists. These include several branches of the brain. these patients. eurological ational Institutes of Health, the Also, Canty and Michael Haka, the For these reasons and more, I believe Department of Veterans Affairs, the De- center's chief radiochemist, have recently that the next decade will be even more partment of Education , the American Heart Association, a number of pharma- teamed up to study the nerve supply to the exciting than the first for the UB- VA heart using a novel PET Center. ceutical companies, Siemens Medical tracer, hydroxy- the Systems, and a variety of foundations, ephedrine. Canty most notably the James H . Cummings suspects that an Foundation of Buffalo. In looking toward the next decade, I abnormal nerve PET Center. Several new initiatives are supply to the heart may be an important factor in sud- under way that will expand its research den cardiac death. program . In a new half- million-dollar grant from I also anticipate that the ini- feel the best is yet to come for the UB-VA the VA Merit Review program, Burkard tiatives growing and I, along with other collaborators, will out of the Buffalo study the effects of background noise on Center of Excel- the auditory system. Merging recordings lence in Bioinfor- of brainwave activity with PET is a cen- matics (see related tral aspect of this research. It takes about a minute for a PET camera to image brain article on page 14) will enable PET activity. This is an eternity, in terms of neural activity, where communications expand their stud- investigators to between nerve cells occur in thousandths of ies and enhance a second. By combining PET images that show where something happens with the value of their PET data by creating links with in- electrophysiological recordings that show 4D when something happens, we hope to improve our ability to probe brain function. In another study on th e hori zon, center vestigators study- investigators will begin collaboration liminary steps in with colleagues from the UB Departments of eurology and Neurosurgery in been taken in the ing genomics and proteomics. Prethis direction have Spri11g 2002 Bu ffalo Physician 29 �PATHWAYS NEws ABOUT UB's ScHooL oF MEDICINE AND BIOMEDICAL SciENCES AND ITS ALUMNI, FACULTY, STUDENTS AND STAFF IN THIS CAPACITY [LAYCHOCK] WILL PLAY A LEAD ROLE IN DETERMINING WHAT RESEARCH WILL BE CONDUCTED AT UB's SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES AND HOW RESOURCES WILL BE ALLOCATED FOR THIS RESEARCH. 30 I u I I a I o Physician logy from Brooklyn College, Laychock to Lead Research Efforts City University of New York, Suzanne G. Laychock, PhD, and a doctorate in pharmacolprofessor and associate chair ogy from the Medical College of the Department of Pharm- of Virginia. In 1990, she was acology and Toxicology in the selected as the outstanding University at Buffalo STAR alumnus at School of Medicine the Medical College and Biomedical Sciof Virginia. ences, has been apLaychock serves pointed senior associas associate editor ate dean for research of Lipids and was and biomedical eduassociate editor of cation at the school. Endocrine Research In this capacity, LAY C HO C K from 1992 to 200 l. she will play a lead She has also served role in determining what re- as field editor for the Journal search will be conducted at of Pharmacology and ExperiUB's School of Medicine and mental Therapeutics, and on Biomedical Sciences and how the editorial board of the resources will be allocated for journal Diabetes. this research. She will also Laychock's research into oversee the recruitment and endocrine pharmacology with hiring of new research faculty. an emphasis on the cellular Laychock, a member of the mechanisms regulating insuUB faculty since 1989, is an lin secretion has been funded accomplished researcher with since 1979. more than 80 publications. In She is a member of several addition to serving as associ- professional societies, includate chair of her department ing the American Diabetes since 1995, she was codirector Association, the American of its Institute for Research Society for Pharmacology and and Education on Women and Experimental Therapeutics Gender. She holds bachelor's and the Endocrine Society. and master's degrees in bio- - LOIS BA K ER S p ri n g 2 00 2 Holm Named Senior Vice Provost Bruce A. Holm, PhD, has been named a senior vice provost at the University at Buffalo, where he will serve as the point person on many of the university's high-technology/ biotechnology projects. In this role, Holm, who formerly served as UB's senior associate vice president for health affairs, will represent Provost Elizabeth D. Capaldi in a variety of capacities. He will be the chief administrator in the provost's office for the Buffalo Center of Excellence in Bioinformatics (see related article on page 14), the Strategically Targeted Academic Research (STAR) Center for Disease Modeling and Therapy Discovery, and the Center for Advanced Biomedical and Bioengineering Tech nologies (CAT). He also will participate in the development of an institute in biomedical engineering at UB and collaborate with administrators in the Office of Science, Technology and Economic Outreach. "Dr. Holm will work closely with our academic partners- �Roswell Park Cancer Institute and the Hauptman-Woodward Medical Research Institute-and with our corporate HOLM partners, the local business community and faculty and deans as these projects move forward," says Capaldi. "He also will work to develop further external relations and scientific and corporate partnerships." Holm holds faculty positions as professor of pediatrics, pharmacology and toxicology, and gynecology-obstetrics, and also serves as associate senior vice president for scientific affairs at Roswell Park. He is principal investigator of the STAR center, as well as several other large awards, including those from the Markey Trust and the Howard Hughes Medical Institute. In addition, he maintains an active research program that has attracted millions of dollars in grant awards to VB. - S U E WUETC HER Mihalko to Direct CAT William M. Mihalko, MD, has been named executive director of the University at Buffalo's Center for Advanced Technology (CAT) by Provost Elizabeth D. Capaldi. Mihalko is an associate professor in the Department of Orthopaedics in UB's School of Medicine and Biomedical Sciences and research director in the Department of Orthopaedic Surgery. Holding both medical and biomechanicalengineering degrees, he serves as the head of arthroplasty at the Erie County Medical Center and is on the medical staffs of Kaleida Health's Millard Fillmore hospitals, Buffalo General Hospital and Children's Hospital of Buffalo. "We are delighted to have someone of Dr. Mihalko's caliber to direct the CAT," Capaldi said in making the announcement. "He is a bioengineer with an active research and clinical program who will provide superb leadership in evaluating and developing biodevices for commercialization in Western New York." Mihalko ' s appointment comes at a time when the CAT- barely three-quarters into its first official year-is already making strides in its main mission: to provide funding to innovations in biopharmaceuticals and in biomedical devices that are close to commercialization. ew York State Governor George E. Pataki announced creation of the CAT and $1 million in funding for its first year of operation last May. "Dr. Mihalko's expertise bioengineering represents an area in which we' re very strong," says Robert Genco, DDS, PhD, a vice provost and head of UB's Office MIHALKO 111 Hayes Honored by the AMA Maxine Hayes, MD '73, assistant secretary of Community and Family Health for the Washington State Department of Health and the recipient of UB's 2000 Stockton Kimball Award, has received the American Medical Association's 2002 Nathan Davis Award in the category of Career Public Servant at the State Level. She was nominated for the award by Mary Selecky, Secretary of Health, Washington State Department of Health. In announcing the award, the AMA stated: "The awards, presented to local, state and federal career and elected government officials, were established by the AMA in 1989 and are truly one of the most prestigious forms of recognition for outstanding public service in the advancement of public health .... The caliber of our nominees [this year) was truly inspiring, and your selection from such an impressive group certainly speaks volumes in recognizing the dedication and diligence of your public service." Hayes, who also holds a master's degree in public health from Harvard University, is a nationally known HAYES pediatrician who, among other things, has strongly advocated for universal health and dental care for children and the elimination of tobacco use among our youth. The award was presented to Hayes on January 29, 2002, at a dinner in Washington, D.C., that was attended by officers of the AMA, as well as by members of Congress and administration officials. <t) -S. A. UNGER Spri11g 20 0 2 I u If a I o Physician 31 �PATHWAYS MIHALKO's APPOINTMENT COMES AT A TIME WHEN THE CAT ... IS ALREADY MAKING STRIDES IN ITS MAIN MISSION: TO PROVIDE FUNDING TO INNOVATIONS IN BIOPHARMACEUTICALS AND IN BIOMEDICAL DEVICES THAT ARE CLOSE TO COMMERCIALIZATION. of Science, Technology and Economic Outreach. Previously director of the CAT, Genco is a SU Y Distinguished Professor and chair of the Department of Oral Biology in the School of Dental Medicine. After completing his residency at the UB Department of Orthopaedic Surgery, Mihalko completed an Adult Reconstructive Surgery Fellowship at the Missouri Bone and Joint Center. He earned his medical degree, as well as a doctorate in biomechanical engineering, from the Medical College of Virginia. He is the recipient of an award from the Buffalo Orthopaedic Research and Education Foundation for Outstanding Orthopaedic Research during Residency, and the American Medical Association's Physician Recognition Award and, with colleagues, the Knee Society's Ranawat Award for research on knee-joint stability. - ELLE N GOLDBAUM Baker and Coldbaum Win Writing Awards Lois Baker and Ellen Goldbaum, senior editors in the University at Buffalo's News Services unit and regular contributors to Buffalo Physician received a Gold Medal in the research, medicine and science writing category in the 200 l Council for the Advancement and Support of Education (CASE) District II Accolades competition. The silver medal in this category was awarded to the University of Toronto and the bronze to Princeton University. Baker ' s submissions included a series of articles on research being conducted by Frederick Sachs, PhD, UB professor of physiology and biophysics, in which he has shown how a protein isolated from the venom of a Chilean tarantula holds promise as the basis for new GOLDB A UM drugs for preventing atrial fibrillation. Also judged to be excellent were articles she wrote on research conducted by Herbert Schue!, PhD, UB professor of pathology and anatomical sciences, that elucidates an internal cannabinoid-signaling system that regulates human sperm fertilization potential; and a study by Ad nan Qureshi, MD, UB assistant professor of neurosurgery, which found a lack of preventive efforts to avert second heart attacks. Goldbaum was singled out for her article on work being conducted at UB by Thenkurussi Kesavadas, PhD, assistant professor of mechanical and BAKER aerospace engineering, who is collaborating with researchers in UB ' s School of Medicine and Biomedical Sciences to develop a virtual palpation glove. Baker and Goldbaum's medical-science reporting also won Bronze Medals in the national 200 l and 2002 CASE Circle of Excellence Awards competitions. -S. A . Rokitka Named to Editorial Post Mary Anne Rokitka, PhD, clinical associate professor of physiology, assistant dean, and director of undergraduate studies in the University at Buffalo's School of Medicine and Biomedical Sciences, has been named an associate editor for Advances in Physiology Education. The peer-reviewed journal, a publication of the American Physiological Society, is dedicated to the improvement of teaching and learning physiology and to the advancement of physiology as a teaching profession. 4D - S. A. 3 2 luttale Physician Spring 2002 UNG ER U NGE R �Roswell Park Cancer Institute IRPCII was founded in 1898 and is the nation's first cancer research, treatment and education center and the only National Cancer Institute-designated comprehensive cancer center in Western New York. The cancer center is a teaching and research affiliate of the UB School of Medicine and Biomedical Sciences, and many faculty at RPCI hold joint appointments at UB. Over the past two years, RPCI has developed and implemented a strategic plan to aggressively recruit new clinical and scientific talent to the cancer center. In January 2002 RPCI president and CEO David Hohn, MD, held a press conference to summarize the successful results of this effort. He also took the opportunity to announce the recent recruitment of two national leaders in the field of oncology, Donald L. Trump, MD, and Candace S. Johnson, PhD. Below are brief profiles of Trump, Johnson and other faculty who have joined RPCI and UB's School of Medicine and Biomedical Sciences in leadership positions since 2000. Donald L. Trump, MD Senwr V>ce President for Clinical Researrh Chazr, Department of Medicim Copnncipnl Jnvestzgator, Cancer Center Support Grant Roswell Pnrk Cancer Institute Donald L. Trump, MD, joined the faculty of RPCI in February 2002 as senior vice president for clinical research, chair of the Department of Medicine, and coprincipal investigator of the Cancer Center Support Grant. Trump earned his medical degree from The Johns Hopkins University School of Medicine, Baltimore, in 1970 . From 1970 to 1975 he completed an internship and resiTR U MP dency training in medicine at The Johns Hopkins Hospital, along with a fellowship in oncology at The Johns Hopkins Oncology Center. Most recently, Trump served as deputy director of clinical investigations at the University of Pittsburgh Cancer Institute (UPCI), where he had primary responsibility for directing the clinical and translational research activities, and as chief of the Division of Hematology and Oncology in the Department of Medicine and professor of medicine and urology at the University of Pittsburgh Medical Center. Trump is a Diplomate of the American Board of Internal Medicine, with subspecialty boards in medical oncology, and a Fellow of the American College of Physicians. His research interests include innovative clinical trials and chemoprevention studies in prostate cancer; antitumor mechanisms and therapeutic effects of vitamin D; and feasibility studies on retinoid treatment in emphysema. He is a member of the Eastern Cooperative Oncology Group and a principal investigator or coprincipal investigator on several National Cancer Institute-funded trials. Trump is the recipient of numerous awards and honors including the 2001 Pittsburgh Science, which recognizes those individuals who dedicate their services to making Pittsburgh a better place to live; multiple citations in Best Doctors in America; and, yearly since 1998, awards from the Association for the Cure of Cancer of the Prostate (CaP CURE) for his research on the role of vitamin D in the treatment of prostate cancer. Trump serves as secretary/ treasurer of the American Society of Clinical Oncology and is a member of many professional societies. He is also reviewer and/or member of the editorial board of several prestigious journals, such as the New England foumal of Medicine, and the Journal ofthe National Cancer Institute. Gentzke & sociates, Inc. Registered Investment Advisor Priva te Po rtfo lio .\ la n age mcnt T a, Co n ~:> uhin g Es tate PI a nn iJ1g President and CEO Glenn Gentzke and Chief Investment Strategist Chris King Fcc- Based 1\ ssrt .\la nagcm cnt UB Commons 520 Lee Entrance Tll\A-C RE F Ackisor Suite 205 ~e t\\·o rk Amherst. NY 14228 Tel: (716) 639-G475 Certified Qflicf.JJooks Profrss iona l Ackiso rs www.gentzke.com Vectors Person of the Year in Sp rin g 2 0 0 2 l alfal1 Physiein 33 �PATHWAYS Candace S . .lohnson, PhD Senior ~'icc Pres1dwt {or Translational Research Semor Member, Department of Pharmacology and Therapeutics Roswell Park Cancer Institute Candace S. Johnson, PhD, joined the faculty of RPCI in February 2002 as senior vice president for translational research and senior faculty member of the Department of Pharmacology and Therapeutics. Johnson earned her doctoral degree in immunology from Ohio State University in 1977. From 1977 to 1981 she completed research and postdoctoral fellowships in immunology/cell biology at the Michigan Cancer Foundation in Detroit. Most recently, Johnson jOHNSON served as deputy director of basic research at the University of Pittsburgh Cancer Institute and as professor of pharmacology and medicine at the University of Pittsburgh School of Medicine. Johnson's research interests include translational research to facilitate the efficient application of promising laboratory findings in clinical studies; preclinical design and development of more effective therapeutic approaches to cancer using highly characterized tumor models; and mechanisms of vitamin D-mediated antiproliferativeeffects either alone or in combination with other cytotoxic agents. 34 luflal1 Pbysiciaa Johnson is a member of the National Institutes of Health Reviewers Reserve and the National Cancer Institute Review Group Subcommittee A-Cancer Center (Parent Committee). She is also a member the editorial board of Oncology Reports, Molecular Cancer Therapeutics, and Molecular PIUlrmacology. Michael C. Brattain, PhD Chair, Department of Phannacology and Therapeutics Basic Science Director, Cancer Center Support Grant Roswell Park Cancer Institute Michael Brattain, PhD, joined RPCI in 2001 as chair of the Department of Pharmacology and Therapeutics and basicscience director of the Cancer Center Support Grant. Brattain, who earned his doctoral degree in biochemistry from Rutgers University in 1974, carne to RPCI from the San Antonio Cancer Institute, a National Cancer Institutedesignated comprehensive cancer center, where he was associate director for basic research. At the same time, he served as professor of surgery at the University of Texas Health Science Center in San Antonio. Over the years, Brattain has held several research, administrative and academic positions, including professor of biochemistry and molecular biology at the Medical College of Ohio; director of the BristolBaylor Laboratory Division, Baylor College of Medicine; and director of molecular and Spring 2002 cellular biology, anticancer research, at BristolM y e r s Squibb, Inc. He serves on BRATTAIN the editorial board of Cancer Research, International Journal of Oncology, and Oncology Research. Brattain is a member of the American Association for Cancer Research, the American Association of Pathologists, and the Metabolic Pathology Study Section of the National Institutes of Health. His research in signal transduction pathways in breast and colon cancer has attracted major funding from the National Cancer Institute, and he has created a broad national network of scientific collaborations. .lohn K. Cowell, PhD, DSC Chmr, Department of Cancer Genetics Roswell Park Cancer Institute Professor, Cellular and Molecular Biology Program Roswell Park Graduate Dll'lsion, University at Buffalo John K. Cowell, PhD, DSc, joined the staff of RPCI in 2000 as chair of the Department of Cancer Genetics. He also is professor of the Cellular and Molecular Biology Program in the Roswell Park Graduate Division, University at Buffalo. Cowell earned his doctoral degree in genetics from Sheffield University (UK) in 1978 and completed research fellowship training in the Department of Cellular Pathology at the Imperial Cancer Research Fund (London, UK) in 1981. He was honored with a doctor of science degree from Sheffield University in 1993. Cowell came to RPCI from the Cleveland Clinic Foundation (CCF), Lerner Research Institute, where he had served as direc- CowELL tor of the Center for Molecular Genetics since 1995. He also had a joint appointment at the CCF Cancer Center and was a CCF professor of clinical chemistry at Cleveland State University. Cowell's research interests include molecular genetics of cancer and cancer predisposition, molecular analysis of neuroblastoma, molecular genetic changes in leukemia, and genetic analysis of brain tumors and breast cancer. Soldano Ferrone, MD, PhD Cha1r, Department of Immunology Roswell Park Cmzcer Institute Professor, Aficrolnology University at BujJalo Soldano Ferrone, MD, PhD, joined the staff of RPCI in 1999 as chair of the Department of Immunology. He also is professor of microbiology at the University at Buffalo. Ferrone earned his medical �degree at the Medical School, University of Milan (Italy) in 1964, and his doctorate in hematology at the University of Milan in 1971. He was a member of the faculty of the Department of Medicine at the University of Milan from 1964 to 1965; the Department of Experimental Pathology at Scripps Clinic and Research Foundation (La Jolla, California) from 1971 to 1981; the Department of Pathology at Columbia University from 1981 to 1983; and chair of the Department of Microbiology and Immuno- logy at New York Medical College (Valhalla, New York) from 1983 to 1999. Ferrone's laboratory research program focuses on developing approaches to counter the multiple mechanisms used by human melanoma cells to escape immune recognition and destruction, and on designing a strategy to target humoral and cellular immunity to malignant lesions in patients with melanoma. Ferrone is a member of the American Association of Immunologists, the American Association for Cancer Re- search, and the Transplantation Society. Currently, he is a member of the Biological Resources Branch Oversight Committee and of Subcommittee F (Manpower and Training) of the National Cancer Institute Initial Review Group. Ferrone has been issued patents on "Anti-idiotypic Monoclonal Antibodies MK223MelanomaAntibody763.74" and on "Anti-idiotypic Monoclonal Antibodies for Treatment of Melanoma." He was honored with the Alexander Von Humboldt Award, Senior Distinguished U.S. Scientist Award, Germany, in 1997. Ferrone has authored or coauthored more FERRONE than 700 journal publications, book chapters and abstracts. He serves on the editorial board of the International Journal of Oncology, Journal of Im111unology, Journal of l111munothernpy, Tissue Antigens, and Vaccine Research. GENESEE HEARING SERVICES THE AUDIOLOGY CENTER 61 Wehrle Drive (Near Harlem) Amherst 14225 630 Orchard Park Rd. (Near Ridge Rd.) West Seneca 14224 837-6213 712-2000 • Diagnostic audiometric evaluations (pediatric and adult) • Digital & programmable hearing aid fittings on 60-day trial basis • Tinnitus evaluation and therapy • Vestibular evaluation for patients with dizziness/vertigo • Vestibular therapy • State of the art facilities "The Ear is the Road to the Heart" rvoJraireJ Daniel Schneider, AuD Jennifer Schneider, MA Spring Jerri Kaplan Joyce, MA 2002 lulfal1 Physician 35 �DEVELOPMENT N E w s Scholarships for Our Students By Li nd a J . Cor d e r , PhD, CFRE OR YEARS, THERE'S BEEN DISCUSSION about the importance of scholarships- "We're losing some of our best 'acceptances' due to higher scholarships elsewhere ... ";or, "If we had even one full scholarship, we might be more competitive ... " Recently, I decided to look into tuition, average student debt and scholarship assistance at UB. What I found begs for additional research and analysis, including correlation of tuition with the number of paid full-time faculty, when medical class size changed and when the school added basic science programs. In the interim, I found that UB's tuition has always been relatively low. Initially, this was due to the short course of study ( 15 weeks) by people who were already, in effect, apprentices to volunteer faculty members who organized the first curriculum. The Class of 1847 paid $80. This included their graduation fee. This situation scarcely changed for 70 years. Although the course of study lengthened, the cost per year remained stable. In 1916, tuition had risen to only $125 a year. In 1928, a mere 12 years later, medical education had in1:-\CREASL 'G creased fourfold to $500 annually. ENDOWMENTS FOR Another period of stability lasted SCHOLARSHIPS WILL through WWII. Then, from 1948 CO, 'TINUE TO BE A to 1955, costs rose from $600 a \IA)OR FOCUS FOR year to $850. During the late 1950s, THF RE,\!AINDER OF tuition decreased and fees increasTHE CA\!PAIG::-.. FOR ed, with the net cost steady. In UB AND BEYO:\'D. 1959, tuition climbed to $1080, but fees declined. Five years later, in 1964, two years after UB's merger with the State University, tuition dropped slightly to $800 for New York residents, remaining at $1,000 for all others, plus a UB fee of $81. This remained constant through the 1970s, increasing somewhat towards the end of the decade. By 1982, residents paid $4,300 a year, when the national average for public medical schools 36 luffalo Physician Spring 2002 was only $2,1 00! By the early 1990s, tuition was $5,600 for New Yorkers, nearly $9,000 for others, with fees still at about $300 a year. We seem to be in another growth mode. Last year was slightly under $12,000. This year we're at $12,840 in-state and $22,940 out-of-state. There is a projected annual increase of $2,000 for the next three years. The above figures might dispel a few myths. Tuition was incredibly low while UB was private. The clinical faculty, high in experience, volunteered their time to teach, which kept costs to students artificially low. The "drop" in tuition and fees when the school merged with SUNY was minor. The largest increases have taken place recently. UB is still a relative bargain, but the fact is that medical and biomedical education and research now cost significantly more than they did for the majority of our graduates. Our students are graduating with an average debt in excess of$80,000. With current scholarship endowments, we were able to award only about $288,000 this academic year m scholarships. The school's Alumni Scholars Endowment got a big boost this year with a generous bequest from AI Dobrak, MD, Class of '39. His gift, in excess of $200,000, increased this endowment by 53 percent, bringing it to about $580,000. Last year, Janet Sung, MD, a Western New York radiologist, and her husband, John, established a scholarship fund with a million-dollar gift. Several alumni have set up smaller named scholarship endowments. Every one of these gifts helps, but the fact is we have a long way to go. Increasing endowments for scholarships will continue to be a major focus for the remainder of the Campaign for UB and beyond. Linda (Lyn) Corder, PhD, is associate dean for alumni affairs and development. She can be contacted at I -877-826-3246, or via e-mail at ljcorder@buffalo.edu. �Lifetime Members When cumulative contributions reach $50,000 or an irrevocable deferred gift is completed for $100,000 or more, a couple or individual is granted lifetime membership in the fames Platt White Society. Combinations of outright and deferred gifts in appropriate proportions may also be the basis of lifetime membership. Names of Founders' Circle members are repeated in an annual category in any year that they make a new gift to the school. UB' s Founders-primarily physicians and attorneysenvisioned a school to train students for service to the community. The Society's Founders help to actualize that vision by providing a generous base of support for programs and activities that enrich the academic environment and enhance medical training. Mrs. Catherine Fix Martinsburg, WV Dr. Thomas F. Frawley '44 Chesterfield, MO Mrs. Christine Gretschel Genner Potomoac, MD Dr. Lawrence Golden '46 & Mrs. Nancy Golden '48 Mrs. Joan W. Alford Mrs. Annette Cravens Buffalo, NY Buffalo, NY Mrs. June M. Alker Mr. Donald l. Davis & Mrs. Esther P. Davis Williamsville, NY Charles D. Bauer, MD '46 & Mrs. Mary A. Bauer Williamsville, NY Dr. Ralph T. Behling '43 Williamsville, NY Dr. S. Max Doubrava Jr. & Mrs. Joan Doubrava Las Vegas, NV Eggertsville, NY Dr. Pasquale A. Greco '41 & Mrs. Lois J. Greco Buffalo, NY Dr. Glen E. Gresham & Mrs. Phyllis K. Gresham '8S Williamsville, NY Dr. Thomas Jr. '60 & Mrs. Barbara l. Guttuso San Mateo, CA Mrs. Marjorie B. Eckhert Dr. Willard H. Boardman '44 & Mrs. Jean E. Boardman '48 Buffalo, NY East Amherst, NY Ms. Rose M. Ellerbrock Dr. Eugene J. Hanavan Jr. '41 Winter Park, FL Williamsville, NY Buffalo, NY Dr. William M. Chardack Dr. George M. Ellis Jr. '4S & Mrs. Kelly Ellis Mrs. Morris Lamer Gulfstream, FL Connersville, IN New York, NY Dr. Joseph A. Chazan '60 & Mrs. Helen Chazan Mrs. Grant T. Fisher Dr. Eugene R. Minden & Mrs. June A. Mindell Providence, RI Palm Beach, FL Buffalo, NY Dr. Phil Morey '62 & Mrs. Colleen Morey Dr. Philip B. Wels '41 & Mrs. Elayne G. Wels Williamsville, NY Williamsville, NY Dr. Richard J. Nagel '53 & Mrs. Florence T. Nagel Dr. John & Mrs. Deanna Wright Orchard Park, NY Williamsville, NY Dr. Richard B. Narins '63 & Mrs. Ellen B. Narins East Aurora, NY Dr. Albert C. Rekate '40 & Mrs. linda H. Rekate '71 Williamsville, NY Dr. Elizabeth P. Olmsted Ross '39 Buffalo, NY Mrs. Mary Cecina Riforgiato Buffalo, NY Dr. Robert J. Smolinski '83 & Dr. Claudia D. Fosket '85 Orchard Park, NY Dr. Albert Somit Carlsbad, CA Dr. Janet H. Sung & Mr. John J. Sung Clarence, NY Spri11g 2002 Annual Memberships All annual donors of $1,000 or more are granted membership in the]ames Platt White Society. Annual membership in the appropriate circle within the society are granted for one year, beginn ing January 1, for the gifts received the prior calendar year. The roster of the fames Platt White Society "Class of 2001" follows. lullalo Phy sic ian 37 �DEVELOPMENT I jAMES PLArr\VHITE. cosT. Dean's Circle The dean is the school's leader. Every leader depends on a small circle of associates who help bring the organization's vision into reality. Individuals or couples qualify as members in the Dean's Circle with generous gifts of $25,000 or more during the calendar year. Professors' Circle A strong faculty is central to a great university. Likewise, central to the future of our school is the dedication of a cadre of supporters whose annual gifts range from $5,000 to $9,999. Charles D. Bauer, MD '46 & Mrs. Mary A. Bauer Williamsville, NY Dr. Melvin B. Oyster '52 Niagara Falls, NY Mrs. Lidia Hreshchyshyn Williamsville, NY Mr. Donald l. Davis & Mrs. Esther P. Davis Williamsville, NY Dr. Max Doubrava Jr. '59 & Mrs. Joan Doubrava Las Vegas, NV Dr. Janet Sung and Mr. John Sung Clarence, NY Dr. Gordon R. lang '62 Chicago, IL Dr. John C. Newman Lewiston, NY Mr. James I. Stovroff Buffalo, NY Dr. Charles S. Tirone '63 & Mrs. Anne R. Tirone '94 Williamsville, NY Chairs' Circle Fellows' Circle Just as a department chair leads a program, donors of leadership gifts In the range of $10,000 to $24,999 are given special recognition. Fellows within the school are recognized for added depth they bring to postgraduate study. Fellows are honored for gifts that total $2,500 to $4,999. Dr. and Mrs. Ernest Beutner Dr. Willard H. Boardman'44 & Mrs. Jean Boardman '48 N E w Dr. Douglas Sinensky Dr. Jay Belsky' 51 Dr. Roman Cham Williamsville, NY San Pedro, CA La Mesa, CA Dr. Robert J. Smolinski '83 & Dr. Claudia D. Fosket '85 Dr. Richard A. Berkson '72 & Mrs. Andrea Berkson Draper, VA Orchard Park, NY Rancho Palos Verdes, CA Dr. Irving Sterman '64 & Mrs. Gail K. Sterman Mr. Sheldon M. Berlow Dr. Isidore S. Edelman New York, NY Dr. lawrence Golden '46 & Mrs. Nancy Golden '48 Eggertsville, NY Philip D. Morey M.D. '62 & Mrs. Colleen Morey Williamsville, NY Dr. John R. Wright & Mrs. Deanna P. Wright Williamsville, NY Winter Park, FL Dr. Melvin M. Brothman '58 Snyder, NY Buffalo, NY Williamsville, NY Dr. Yong Baek Chi Dr. Martin C. Terplan '55 San Francisco, CA Buffalo, NY Dr. Theodore S. Bistany '60 Scholars' Circle One strength of an outstanding institution is the caliber of those who study there. Scholars within the fames Platt White Society have made gifts to the school totaling $1000 to $2,499 during the past year. Those marked with an asterisk (*) are young scholars, graduates of the last decade, who qualify with gifts of $500 to $999. Mrs. Joan W. Alford Buffalo, NY Dr. Kenneth Z. Altshuler '52 & Mrs. Ruth Altshuler I uI I a I o n ys i c i a n West Seneca, NY Dr. lawrence B. Bone '73 Dr. Charles Kwok-Chi Chow & Mrs. Patricia Chow Orchard Park, NY Hong Kong Dr. Jerald Bovino '71 Dr. George H. Christ '56 Aspen, CO Largo, FL Dr. Suzanne F. Bradley '81 Dr. Eugene Cisek Whitmore Lake, MI Buffalo, NY Dr. Martin Brecher '72 & Geri Brecher Dr. Mark Comaratta '85 Amherst, NY East Amherst, NY Dr. Harold Brody '61 Dr. Bernice S. ComfortTyran '58 Getzville, NY Los Altos, CA Dr. James B. Bronk '81 & Mrs. Suzanne Bronk Buffalo, NY Napa, CA Dr. August A. Bruno Sr. '51 Buffalo, NY Dr. linda J. Corder Dr. J. Steven Cramer East Amherst, NY Dr. Julia Cullen '49 Buffalo, NY La jolla, CA Dr. Daniel E. Curtin '47 & Mrs. Elaine Curtin Dr. Stanley Bukowski '81 Orchard Park, NY Buffalo, NY Dr. Stanley J. Cyran Jr. '46 Prospect, KY Dr. William S. Andaloro '45 Chapel Hill, NC Dr. David R. Dantzker '67 & Mrs. Sherrye Dantzker Dr. James P. Burdick '75 Roslyn, NY Caledonia, NY Dr. Mark Anders Dr. Douglas Armstrong Buffalo, NY Dr. J. Bradley Aust Jr. '49 San Antonio, TX Lemoyne, PA Hamburg, NY Dr. Charoen & Dr. Charlearmsee Chotigavanich Dr. Jared C. Barlow Sr. '66 & Mrs. Barbara Barlow Thailand Grand fsland, NY East Amherst, NY Dr. William M. Burleigh '67 Rar1cho Mirage, CA Mrs. John Buyers Little Silver, NY Dr. Roger S. Dayer '60 & Dr. Roberta A. Dayer '72 Williamsville, NY Buffalo, NY Dr. Gerard J. Diesfeld '60 Hamburg, NY Dr. David T. Carboy '63 & Mrs. Jacqueline G. Carboy Lincroft, N] Dr. Nancy H. Nielsen '76 Mrs. Agnes T. Baron Orchard Park, NY Snyder, NY Eden, NY Dr. Thomas P. O'Connor '67 Dr. Michael B. Baron '71 Dr. Nicholas C. Carosella '54 & Mrs. Sandra S. O'Connor Blountville, TN Appleton, NY Dr. Paul D. Barry '71 Dr. leonard S. Danzig '51 Dr. Evan Calkins & Dr. Virginia Calkins Dr. Joseph G. Cardamone '65 & Mrs. Susan G. Cardamone 2002 Dr. Prem Chopra Dr. Timothy Bukowski '87 & Dr. Naomi J. Kagetsu '86 Dr. George Bancroft '81 & Mrs. Susan K. Bancroft '79 Spring Lockport, NY Dallas, TX Arlington, VA 38 Buffalo, NY Dr. Helene E. BuergerPeck'56 Dr. Jennifer l. Cadiz '87 East Amherst, NY Dr. Norman Chassin '45 & Mrs. Charlotte S. Chassin Dr. Michael E. Bernardino & Mrs. Joan Bernardino jacksonville, FL Buffalo, NY Eggertville, NY Dr. Yung C. Chan '73 Arcade, NY Mr. James B. Docherty Orchard Park, NY Ronald I. Dozoretz M.D. '62 Falls Church, VA Dr. Robert Einhorn '72 North Brunswick, Nj Dr. Domonic F. Falsetti '58 & Mrs. Margaret Falsetti Lewiston, NY �Dr. Leon E. Farhi & Mrs. Haya Farhi Eggertsville, NY Dr. Carl V. Granger Buffalo, NY Dr. Bernard J. Feldman '66 Dr. Glen E. Gresham & Mrs. Phyllis K. Gresham '85 Palos Park, IL Williamsville, NY Mr. Kevin Feor '80 & Mrs. Elizabeth A. Feor '78 Dr. Robert T. Guelcher '60 & Mrs. Elizabeth Guelcher Webster, NY Erie, PA Dr. James R. Kanski '60 & Dr. Genevieve W. Kanski '84 Dr. Gerald L. Logue & Mrs. Joelle Logue Eggertsville, NY Williamsville, NY Latrobe, PA Dr. Steven R. Kassman '87 & Mrs. Jeannine Kassman Dr. Thomas A. Lombardo Jr. '73 & Mrs. Donna M. Lombardo Dr. Margaret W. Paroski '80 Glendale, AZ Dr. Kenneth K. Kim '65 & Mrs. Susan W. Kim Clinton, NY East Aurora, NY Dr. Frank A. Luzi '88 & Dr. Lori Luzi '88 Bethlehem, PA Dr. Robert Joseph Hall '48 & Mrs. Dorothy N. Hall Dr. Francis J. Klocke '60 Dr. Helen Marie Findlay '78 Dr. Albert Schlisserman '77 Houston, TX Chicago, JL Dr. Christopher Hamill '89 Dr. Robert A. Klocke '62 & Mrs. Barbara Klocke Dr. Brian McGrath *Dr. Amy E. Ferry '94 Clarence, NY Dr. John M. Marzo '86 Buffalo, NY Eggertsville, NY Buffalo, NY Dr. Donald Hauler '57 and Mrs. Barbara Hauler Williamsville, NY Buffalo, NY Dr. Ludwig R. Koukal '51 Dr. Susan V. McLeer Pensacola, FL Tucson, AZ Buffalo, NY Dr. Mark Heerdt '51 & Mrs. Lois Heerdt Dr. Joseph M. Kowalski '93 Dr. Harry L. Metcalf '60 & Dr. Kaaren Metcalf '78 Dr. Susan Fischbeck '82 & Dr. Patrick T. Hurley '82 East Concord, NY Dr. Jack Fisher '62 La jolla, CA Dr. John Fisher Buffalo, NY Dr. Thomas D. Flanagan '65 & Mrs. Grace Flanagan '70 Williamsville, NY Dr. William A. Fleming '64 & Dr. Beth D. Fleming '67 Greer, SC Dr. Reid R. Heffner Jr. & Mrs. Elenora M. Heffner Buffalo, NY Amherst, NY Dr. Daniel Kozera '59 Lackawanna, NY Dr. Kenneth Krackow Williamsville, NY Dr. Fredric M. Hirsh '73 & Mrs. Donna A. Hirsh Dr. Jacob S. Kriteman '67 Williamsville, NY Danvers, MA Dr. John M. Hodson '56 Dr. Harold Krueger '51 Williamsville, NY Rockford, IL Buffalo, NY Mr. Paul F. Hohenschuh & Dr. Marjorie E. Winkler Dr. Ivan W. Kuhl '45 Dr. Neal W. Fuhr '52 Burlingame, CA Dr. Marie Leyden Kunz '58 & Dr. Joseph L. Kunz '56 Williamsville, NY Ms. Peggy Hong Dr. Robert Galpin Milwaukee, WI Buffalo, NY Wimberley, TX Lockport, NY Dr. Andre D. Lascari '60 Dr. Penny A. Gardner '69 Dr. Waun Ki Hong & Mrs. Mihwa Hong Los Altos, CA Houston, TX Drs. Laura & Michael Garrick Dr. Bradley Hull '41 Brooklyn, NY Getsville, NY Rocky River, OH Dr. Mark J. Lema '76 & Mrs. Suzanne Lema Dr. Ronald F. Garvey '53 Dr. Hilton R. Jacobson '45 Tyler, TX Lakewood, NY Mr. Warren Gelman '70 Robert M. Jaeger, M.D. '47 Buffalo, NY Allentown, PA Dr. George A. Gentner '41 Dr. Charles Alexander Joy '46 Poestenkill, NY Dr. Sanford E. Left '68 East Amherst, NY Dr. Dolores C. Leonard '87 & Mr. Martin Leonard East Amherst, NY Dr. Eugene Leslie '51 & Mrs. Faith Leslie Buffalo, NY Dr. Robert J. Patterson '50 & Mrs. Patricia M. Patterson Snyder, NY Dr. Norman L. Paul '48 Lexington, MA Dr. Marc S. Fineberg Williamsville, NY Dr. John S. Parker '57 & Mrs. Dorris M. Parker Dr. Joel H. Paull '71 &Mrs. Linda Paull Eggertsville, NY Dr. John H. Peterson '55 East Aurora, NY Dr. Harry E. Petzing '46 Hamburg, NY Williamsville, NY Dr. Daniel Phillips '51 & Mrs. Mary Ann Phillips Dr. Merrill L. Miller '71 Reno, NV Hamilton, NY Dr. James F. Phillips '47 & Mrs. Marcella Phillips Ms. Sounghae Min Korea Buffalo, NY Dr. David P. Mindell & Mrs. Margaret H. Mindell Dr. Matthew Phillips '91 Ann Arbor, M I Buffalo, NY Dr. Anthony V. Postoloff '39 Dr. Maynard H. Mires Jr. '46 Georgetown, DE Williamsville, NY Dr. Richard A. Rahner '58 Dr. John A. Moscato '68 & Dr. Beth A. Moscato '96 Orchard Park, NY Erie, PA Dr. John Y. Ranchoff '52 Fairview Park, OH Dr. John D. Mountain '33 Manhasset, NY Dr. Arthur W. Mruczek Sr. '73 Medina, NY Dr. Bert W. Rappole '66 & Mrs. Mary Helen Rappole jamestown, NY Dr. Frederic D. Regan '45 Boca Rator1, FL Dr. Richard L. Munk '71 Sylvania, OH Dr. Robert E. Reisman '56 & Mrs. Rena Reisman Dr. Masao Nakandakari '55 Williamsville, NY Honolulu, HI Dr. Bernhard Rohrbacher '83 Dr. Richard Narins '63 & Mrs. Ellen Narins Getzville, NY Dr. Richard Romanowski '58 Phoenix, AZ Fairview, PA Dr. Allen L. Goldfarb '51 Buffalo, NY Dr. Herbert E. Joyce '45 & Mrs. Ruth Marie Joyce Dr. Elizabeth P. Olmsted Ross '39 Dr. Michael Gold hamer '64 Dr. Harold J. Levy '46 & Mrs. Arlyne Levy Depew, NY Lockport, NY Dr. Tomoe Nishimaki Buffalo, NY San Diego, CA Mr. Arthur H. Judelsohn Amherst, NY japan Ms. Barbara Mcalpine Gong'90 Buffalo, NY Dr. Seymour J. Liberman '61 Dr. Ralph M. Obler '52 & Mrs. June M. Obler '49 Williamsville, NY Dr. Myron Gordon '48 Dr. Jeffrey Kahler '66 Chapel Hill, NC Albany, NY Dr. Wendy A. Kaiser '85 & Dr. Roger E. Kaiser Jr. '79 Dr. Walter Grand Clarwce, NY Williamsville, NY Williamsville, NY Slwker Heights, OH Dr. Hing·Har Lo '74 Blacksburg, VA Dr. Alice Challen LoGrasso '37 Alameda, CA East Aurora, NY Buffalo, NY Dr. John Naughton Dr. Jeffrey S. Ross '70 Los Angeles, CA Lebanon Springs, NY Dr. Albert G. Rowe '46 Tonawanda, NY Dr. Rudolph Oehm '66 Walnut Creek, CA Dr. Joseph F. Ruh '53 Orchard Park, NY Dr. Kathleen O'Leary '88 & Mr. Michael J. Collins '90 Buffalo, NY Spring 2002 B u If a I o P h y s i c i a n 39 �~ -~ -- ---~ - --- DEVELOPMENT I jA\f ES PLATT W HITE CO"\T. Dr. Edwin A. Salsitz ' 72 New York, NY Dr. Iqbal A. Samad & Mrs. Vicar Samad Williamsville, NY Mrs. Elizabeth Ann Schaefer Snyder, NY Dr. David S. Schreiber '69 Westwood, MA Dr. Fred S. Schwarz ' 46 Buffalo, NY Dr. Molly R. Seidenberg '53 Rochester, NY Dr. Elizabeth G. Serrage '64 Cape Elizabeth, ME Mr. Eugene M. Setel Buffalo, NY Dr. Timothy S. Sievenpiper ' 68 & Mrs. Karen S. Sievenpiper 40 Dr. Daniel J. Tutas Washington Grove, MD Dr. Gregory E. Young '77 & Mrs. Diane Young Dr. John J. Squadrito ' 39 Dr. Salvador M. Udagawa & Mrs. Aurora Udagawa Dr. Wende W. Young '61 Lake View, NY Cmw11daigua, NY Dr. Alvin Volkman ' 51 *Ms. Sandra Yu ' 95 Greenville, NC Malden, MA Dr. Coolidge S. Wakai '53 Dr. Franklin Zeplowitz ' 58 & Mrs. Piera Zeplowitz Albany, NY Dr. Philip M. Stegemann '82 Orchard Park, NY Dr. Morton A. Stenchever '56 Mercer Island, WA Dr. William C. Sternfeld '71 Sylvania, OH Mr. Franz T. Stone Clarence, NY Mrs. Gloria Stulberg Buffalo, NY Dr. Michael A. Sullivan '53 Williamsville, NY Dr. Joseph Tannenhaus '45 Homosassa, FL Dr. Michael Taxier '75 Columbus, OH Dr. Wayne C. Templer '45 Dr. Howard C. Smith '53 Mr. Fritz Terplan Huron, OH San Francisco, CA Dr. James A. Smith ' 74 Dr. James C. Tibbetts '64 Orchard Park, NY Sturgeon Bay, W I Dr. Robert G. Smith '49 Dr. Bradley T. Truax '74 Savannah, GA Lewiston, NY internationally renowned designer of bridges who in 1923 bequeathed nearly $390,000 to UB. Through the years, many generous individuals have been inspired by the same conviction and have elected to build on Hayes' foundation of support. Through their commitment to the university, and through their investment in University at Buffalo, benefactors have taken part in shaping the future of UB and securing its legacy into the next century. I u II a I a n ysic ian S Encinitas, CA Corning, NY This society is named after General Edmund Hayes, an W Dr. Albert Somit East Aurora, NY The Edmund Hayes Society E Several of the Medical School's friends and alumni have joined the Edmund Hayes Society, demonstrating their support of our school by including the UB School of Medicine and Biomedical Sciences in their estate plan. If you are interested in becoming a member of the Hayes Society, you can contact our planned giving department at (7 16) 645-3312. Dr. Frances R. Abel Mrs. June M. Alker Dr. Charles A. Bauda Dr. John T. Cangelosi Spri11 g 200 2 Honolulu, HI Dr. Richard D. Wasson '58 & Mrs. Janet Wasson Holland, NY Buffalo, NY Holiday, FL Dr. David C. Ziegler '64 & Mrs. Susan D. Ziegler Dr. Arnold Wax '76 Walnut Creek, CA Henderson, NV Dr. Charlotte C. Weiss '52 & Dr. Hyman Weiss Highland Park, N] Dr. Paul H. Wierzbieniec '74 & Ms. Ellen Wierzbieniec Buffalo, NY Dr. Gary J. Wilcox '73 Carlsbad, CA Special Members A few individuals and couples were gra nted multi-year memberships based on generous gifts made between 1989 and 1993. Dr. Myron E. Williams Jr. ' 46 Batavia, NY Dr. Richard G. Williams '80 Clearfield, PA Mr. Ralph C. Wilson Jr. Orchard Park, NY Dr. Robert Bernot '60 & Mrs. Carol Bernot North Hills, NY Dr. Marvin Z. Kurian '64 & Mrs. Eleanor Kurian Williamsville, NY Dr. Stanley B. Clark Dr. Richard F. Kaine Mrs. Edith Corcelius Dr. J. Walter Knapp Dr. Linda J. Corder Dr. Harold J. levy Dr. Julia Cullen Dr. Sanford H. levy Dr. Thomas G. Cummiskey Dr. Milford C. Maloney & Mrs. Dione E. Maloney Mr. Edward l. Curvish Jr. Dr. leonard S. Danzig Dr. Melvin Oyster Ms. Rose M. Ellerbrock Dr. George M. Ellis, Jr. Mrs. Grant T. Fisher Dr. Jack C. Fisher Dr. lance Fogan Dr. Ronald F. Garvey Dr. Pasquale A. Greco Dr. Glen E. Gresham Dr. Eugene J. Hanavan Jr. Dr. David M. Holden Dr. Hilliard Jason & Dr. Jane Westberg Dr. Kart l. Manders Dr. Benjamin E. Obletz Dr. Richard A. Rahner Dr. Albert C. Rekate Dr. Myron G. Rosenbaum Dr. Elizabeth P. Olmsted Ross Dr. Daniel S. P. Schubert Dr. Albert Somit Dr. Eugene M. Teich Dr. Pierce Weinstein Dr. John R. Wright & Mrs. Deanna Wright Dr. Wende W. Young �Dear Fellow Alumni, nother Spring Clinical Day and Reunion Weekend has comeai1d gone, the success of which will be reported on in detail in the summer issue of Buffalo Physician. As I close out my two-year term as president of the Medical Alumni Association (MAA ), l feel I would be remiss not to thank some of the people who have made my job very easy, including Nancy Druar, our longtime secretary, and Mary Glenn, director of constituency relations and the school's liaison with our association, both of whom have greatly assisted me. I also want to thank all the current and past MAA board members and my fellow officers-Colleen Matti more, MD '91, and Stephen Pollack, MD '82-for the help they have lent toward making the different activities we had throughout the year very successful. I appreciate everything you have done for the association and for the school. In my final message as president, l would like to remind you of the three major awards the MAA bestows on our fellow alumni throughout the year. I think that these awards are very special and that more of our alumni need to know the criteria for nominating individuals to receive them. The Distinguished Alumn us Award, our most prestigious award, is presented each September at the dinner for past presidents. The qualifications for the award are an alumnus who has distinguished himself or herself nationally or internationally among peers and who has made an outstanding contribution to medicine or to the arts and humanities. The Med ical Alumn i Ac hievement Awa rds and the Robert S. Berkso n Memorial Award are the other two awards, which are presented during Spring Clinical Day in April each year. The achievement awards are presented to alumni who have shown conspicuous and outstanding achievement in one of the following areas of medical endeavors: teaching, research, innovation, practice, service, and medical administration. Traditionally, these awards are given to alumni celebrating their reunions that year so that their classmates and friends can join with them in celebrating their success. The RobertS. Berkson Award has been presented since 1988 in memory of Dr. Berkson, a wellknown internist in the Western New York community. It honors a physician who has performed his or her teaching responsibilities in an outstanding manner during five or more years on the volunteer teaching faculty and who combines scholarship and compassion in a way that elevates medicine, in its best sense, from a science to an art. Because I am sure there are many deserving alumni who have not yet been recognized by our association, I encourage you to write to the MAA office to nominate a peer for one of these awards. If you prefer to send your nominations via e-mail, they can be forwarded to Mary Glenn at glenn@acsu.buffalo.edu. In closing, I would also just like to put one more plug in for all eligible candidates-medical school alumni, faculty, PhD graduates and emeritus professors-to join our association and, if you are able, to become a lifetime member. Again, thank you for the honor of allowing me to serve as your alumni association president. 4d14eft4·? BooL,~:~ JoHN J. ' 76 President, Medical Alumni Association S prin g 20 0 2 Buffalo Physician 4 1 �~~- ------- C L A SNOTES 1940s Raymond Bondi, MD '44, writes: "Enjoying salubrious and warm South Florida. I even exercise daily, with a knife and fork." 1950s Joseph F. Ruh, MD '53, writes: "I retired from the office in 1996, but am working at the hospital one day a week doing GI endoscopy." E-mail address is joe@ruh.net. Over the years, Bell has been nationally recognized for his extensive work in promoting women's health issues, particularly familycentered OB care. In 1980, he pioneered the certified nurse mid- University of California, Irvine. Michael I. Weintraub, MD '66, FACP, FAAN, writes: "I am in full-time private practice of neurology and pain medicine. Currently, I am performing clinical research with dia- Medical Center in Anaheim, CA. At that time, betic peripheral neuropathy and carpal tunnel syndrome with alternative modes of therapy; i.e., magnetic therapy and laser therapy. I have over 190 publications, James Youker, MD '54, it was the first such pro- and recently I edited a writes: ''I'm still working gram within the Kaiser book, titled Alternative and chair of radiology at the Medical College of Wisconsin. In March 2002, I finish my two- system and one of the first in the nation. and Complementary Treatment in Neurologic Illness (Churchill Livingstone, 2002). Presently, I am clinical professor of neurology and medicine at New York Medical College and ad- wifery program at Kaiser Jacob (Jack) Lemann Jr., MD '54, New Orleans, LA. E-mail address is dr.jack@lemann.net. year term as president of the American Board of Medical Specialties." E-mail address is: jyouker@mcw.edu. 1960s Kenneth Bell, MD '61. After 33 years as a Kaiser Permanente obstetrician and gynecologist, including the last 14 years as area medical director for the organization in Orange County, CA, Bell retired from the Southern California Permanente Medical Group on December 31, 2001. 42 assnotes luff al a Ph ysici an Pemlallel1te In 1997, he was honored with the prestigious Mentor in Medicine Award from the March of Dimes for his commitment to and leadership in the community and the healthcare industry. While Bell is retiring from Kaiser Permanente, he is not giving up his work as a medical administrator. On January 2, 2002, he stepped into his new role as CalOptima's chief medical officer (Cal-Optima is Orange County's Medi-Cal managed care program). He also serves as clinical professor at the Spri11g 2002 junct clinical professor of neurology at Mount Sinai School of Medicine in ew York City." from 1987 to 1990." E-mail address is andyandcarole@netzero.net. E-mail address is: miwneuro@pol.net. Barry Schultz, MD '&B. John R. Anderson, MD '67, Wyomissing, PA, writes: "After a year at sea, I spent the next year doing Depew, NY, writes: "In 1998, I retired nothing but vasectomies 16/day, 5/day week. Then from Brothers of Mercy Hospital, where I was I went into urology at the University of Connecticut with classmate Bruce Stoesser. I am now chief medical director. From 1999 to 2001, I taught anatomy and physiology and medical terminology at Bryant & Stratton. Currently, I work as a program physician two days a week at UB's Research Institute on Addictions. I had two teaching degrees before earning my medical degree, and would love to teach in the medical school again, as I did of urology at the Reading Hospital and Medical Center in my hometown. I am past president of the Urological Association of Pennsylvania. I may slow down a bit after I get new knees." John Fisk, MD '69, profes- sor of surgery at Southern Illinois University School of Medicine, was �HUNT Since 1911 elected in january 2002 to a two-year term as chair of the board for the U.S. members of the International Society for Prosthetics and Orthotics. Hunt Relocation Center 1970s Donald H. Marcus, MD '71. Northridge, CA, writes: "! have just been reelected to the board of directors of the Southern California Permanente Medical Group for my seventh three-year term. My daughter Elizabeth is in her second year at the University of Southern California School of Medicine." Diane L. Matuszak, MD '74, MPH, was appointed director of Community Health Administration in the Maryland Department of Health and Mental Hygiene, effective December 26, 2001. This administration oversees all local health departments and statewide programs for Epidemiology and Disease Control (including bioterrorism), Food Protection and Consumer Health Services, Environmental Health and Health Planning. E-mail address is dmatuszak@home.com. Greg Antoine, MD '76, writes: "! am the new chairman of plastic surgery at Boston University School of Medicine. I am board certified in plastic surgery and otolaryngology. I specialize in congenital and posttraumatic facial reconstruction. I retired as a colonel from the Army and was formerly on the faculty at Case Western Reserve University School of Medicine. My son Elliott's high school football team won the Ohio State Division I championship. My daughter, Tai, graduated from Dartmouth, and my son Greg got a master's degree from the University of Miami, both in june. I am sad to hear that UB lost its otolaryngology residency program. Jane (King) Dorval. MD '76, was recently elected chair of the Rehabilitation Accreditation Commission's (CARF) board of trustees for the 2002 term. CARF is a private, nonprofit organization that promotes quality rehabilitation services by establishing standards of quality for national and international organizations to use as guidelines in developing and offering their programs or services to consumers. CARF standards are developed with input from consumers, rehabilitation professionals, state and national organizations and those funding the process. There are more than 26,000 medical, behavioral, employment/ community services, adult day services and assistedliving CARF-accredited programs in the U.S., Canada and Europe. As a board-certified physiatrist, Dorval is currently senior vice president of medical affairs and quality oversight at Good Shepherd Rehabilitation Hospital in Allentown, PA. She is also a division chief of rehabilitation medicine at Lehigh Valley Hospital, also in Allentown, and a clinical associate professor on the faculty of Pennsylvania State University School of Medicine in Hershey, PA. Totally customized service portfolio including • Nationally trained relocation experts • Complete family needs analysis • Global home sale assistance • Special services for seniors • Full community tour · A complete cost of living analysis • A list of all school systems and administrators throughout WNY • Complete spousal placement assistance including resume writing and corporate contacts • 24 hour or less response time • Confidentiality assured We don't just move people... We help people move. Call for a free relocation portfolio regarding your destination city. Call 1-800-888-1170 or go on-line and visit our web site at huntrealestate.com Ira Salom, MD '77, has been appointed to the ew York State Board of Medicine, in the Office of the Professions, State Education Department, to serve on license restoration and moral fitness hearing panels. Mary Croglio Corporate Relations Officer Hunt Relocation Center 5570 Main Street Williamsville, NY 14221 -5410 Email: huntrelocation@huntrealestate.com S p r in g 2002 8 u f fa I o Physician 43 �CLASSNOTES Fred H. Geisler, MD '78, publ ished three papers on the natural evolution and treatment of spinal cord injury in the December 200 I issue of the journal Spine. He works in the Chicago Institute of Neurosurgery and Neuroresearch, specializing in spinal instrumentation. E-mail address is: fgeis ler@co ncen tric. net. Leigh Lachman, MD '78, writes: "I live in New Jersey and practice in Manhattan . I am boarded in both otolaryngology and ,;._..;. genera l plastic surgery. I'm married and have three children: two girls, ages 10 and 17, and a boy, age 13. I truly miss those days and parties in medical school. I'd be happy to hear from my friends, who can e-mail me at devilsrul9@aol.com. " Roger E. Kaiser, Jr, MD '79, has been appointed medica l di rector of the Erie County Medical Center (ECMC) Hea lthcare Network. The network encompasses a base of off-campus health centers, an advanced academic medical center with 500 inpatient beds and 156 skilled nursing home beds, and the Erie County Home, a 638-bed skilled nursing facility. Kaiser, who has served as clinical director of the Department of Anesthesia!ogy (1989-present) and as attend ing anesthesio logist ( 1983-present) at ECMC, will continue to It is never less than 94% efficient at trapping particles as small as 0.35 micron. No other whole-house air cleaner can reach more that 70% efficiency on these t 7/EA~lNG BILLS TOO HIGH? Plan ahead and consider updating your heating equipment with a natural gas furnace Just because you have allergies doesn't mean you have to suffer. The Ap rilaire® High Efficiency Air Cleaner is up to 99% efficient at removing allergy-causing sym ptoms from the air in your home. So not only does it relieve your allergies, it also removes airELECTRONIC AIR CLEANERS borne dust and dirt, making your Nobody Makes Clean Air Easier" home Cleaner. e® H & Q HEATING & AIR CONDITIONING " Where Quality Means Quality " • INSTALL HEATING & AIR CONDITIONING SYSTEMS • SERVICE & REPAIR • AIR CLEANERS & HUMIDIFIERS 830 1575 • FREEESTIMATES • FULLYINSURED • • CARBON MONOXIDE TESTING Call George Hoage - References Upon Request NATURAL GAS YOUR BEST ENERGY VALUE 44 Buffalo Phys i cian Spring 2002 practice in these capacities. He also concurrently serves as medical director at the Western New York Center for Ambulatory Surgery (2001present) and is associate professor of clinical anesthesiology (1993present) for the University at Buffalo's School of Medicine and Biomedical Sciences. Kaiser is a member of the American College of Physician Executives, Society of Critical Care Medicine, American Society of Anesthesiologists, and In- ternal Anesthesia Research Society. 1980s Frank W. Sanchez, MD '8D, writes: "I am in my sixteen th year of practice in interventional radiology. l am president of the medical staff at Memorial Hospital in Jacksonville, FL. I had a great time at the 20th reunion in spring 2000." John Claude Krusz, PhD, MD '83, Dallas, TX, was elected vice president of �~-~~--~ the American Board of Electroencephalography and Neurophysiology (ABE ), which administers board certification exams in EEG. Krusz recently cofounded the ational Deaf People's Institute, a nonprofit organization dedicated to providing clinical services to the deaf and hard of hearing. E-mail address is nodynia@ swbell.net. Joseph Carrese, MD '84, MPH, Ellicott City, MD, writes: "I was recently ~- ----- promoted to associate professor of medicine at The johns Hopkins University School of Medicine (November 2001), and am a core faculty member of The johns Hopkins University Bioethics Institute. " E-mail address is: jcarrese@jhmi.edu. - physician assistant. We also expanded our office. John R. Fudyma, MD '85, l continue to enjoy the full spectrum of family ciate medical director of the Erie County Medical care, including obstetrics. My spare time goes into maintenance of home, yard and kids. Rachel ( 16) is hoping to drive soon. jacob (12) is work- work. Fudyma is currently associate professor of clinical medicine in internal medicine ( 1998- Benson Zoghlin, MD '84, ing on preparing for his bar mitzvah. Mindy, my wife, is practicing law Hilton, Y, writes: "Our family practice group expanded again and working on her second-degree belt in lsshin Ryu Karate." E-mail last year to five full-time docs, one part-time (my semi- retired dad) and a address is: drben862 @aol.com. has been appointed asso- Center Healthcare Net- present) and associate ties, including assistant program director of the Internal Medicine Residency Program A ( 1996present) through the University at Buffalo's program director (19951996), assistant clinical professor ( 1991-1998), clinical instructor ( 1989-1991 ) and clinical School of Medicine and Biomedical Sciences. He assistant instructor (1985- 1989). The ECMC has also served in other university faculty capaci- Healthcare Network encompasses a base of Choose Canterbury Woods for a lifetime of warmth and fun Set among 63 beautiful acres, Canterbury Woods combines all the best and most meaningful aspects of the way you live now, while addressing your needs and desires for a worry-free future. Call today for your personal tour. Western New York's first Life Care Community. ~nterbury 1JJoods @l ~~-::.~ Call716/929-5817 for your personal tour.. . 705 Renaissance Drive Williamsville, New York 14221 S prin g 2 0 02 Bu f f a I a Phys i cia n 45 �CLASSNOTE off-campus health centers, an advanced academic medical center with 500 inpatient beds and 156 skilled nursing home beds, and the Erie County Home, a skilled nursing facility. Kathleen O'Leary, MD '88, has been appointed director of the Operating Room at Roswell Park Cancer l nsti tu te (RPCI ). In her new position, O'Leary coordinates the scheduling, staffing and day-today adm I IllStration of the seven operating rooms at RPCI, in which 3,500 procedures are performed annually. O'Leary joined the faculty of the Department of Anesthesiology and Pain Medicine at RPCI in 1992. She has served as medical director of the PostAnesthesia Care Unit (1993-1995); medical director of the Respiratory Therapy Department (1993-1995); director of resident education in the Department of Anesthesiology ( 1994--1997); chief of surgical anesthesia (I 997); and vice chair of the Department of Anesthesia (2000.) Howard Chang, MD '89: Dawn and Howard are pleased to announce the birth of Katherine Mei Chang on December 17, 2001. She weighed in at 5 pounds, 13 ounces, and was 17.5 inches long. Baby Kate is blessed with lots of beautiful, silky black hair and has features similar to that of her sisters, jenny and Marisa, who are thrilled with their new baby sister. town Seattle. Our three girls keep us very busy and sleepless ... (in Seattle!) ." E-mail address is longomc@aol.com. IIana Feinerman, MD '93, writes: "My husband , Cary, and I have settled in Dartmouth, MA. I have just become a partner in my practice. We have a son, jeremy, who is a green belt in tae kwon do. Our daughter, Emily, is two, and our 1990s third baby is on the way. " Marie Christine Longo, MD Lisa F. Keicher, MD '93, '92, writes: "Mike and I are happily transplanted in the Pacific Northwest-great outdoors-and we both have great jobs in down- writes: " Last summer my husband, Steve, and I experienced the greatest and most rewarding adventure of our lives! We In Men1orian1 SPRING 46 traveled halfway around the world to Kazakhs tan, where we adopted our beautiful son, Eli Sergei! He is now a healthy, thriving one year old who is the love of our lives! We continue to live in Verona, NY, where I practice general pediatrics, and my hubby, veterinary medicine. " E-mail address is scneth@dreamscape.com. CONTINUED ON PACE 48 2002 Marvin L. Amdur, MD'36 Buffalo, NY, from early tions. He frequently deliv· two sisters, Adele "Ettie" childhood. Following gradua- ered expert testimony on Brock and Genevieve ing Long Island University, Marvin L. Amdur, MD '36, tion from the then-University and wrote about toxic expo- "Shaney" Cohen of Helfert achieved distinction emeritus professor of Social of Buffalo School of Medi- sure to substances, includ- Rochester, NY, six grand· by graduating from the and Preventive Medicine in cine, he practiced occupa- ing lead and asbestos. In children and two great- then-University of Buffalo the University at Buffalo tiona! medicine and was the mid-1980s, a lifelong grandchildren. Dental School in 1934 and , School of Medicine and Bio- director of the Buffalo interest in art led Amdur medical Sciences, died on Industrial Medical Center back to UB, where he stud- sors, from UB's Medical JanuarY 18, 2000, in San at 755 Tonawanda Street, a ied with the artist Harvey Irving Helfert, DDS,MD'36 Diego, CA. Amdur, 86, was private group practice (with Breverman. In later years he a pioneer in occupational Drs. Robert A. Caputi, also developed his skills on medicine and an expert on Harold L. Graff and John N. the organ and piano. In ad- toxic exposure in the work· Strachan) for 50 years be- dition to his wife, Myra, place who, in his 70s, re· fore retiring. Amdur served Amdur is survived by a turned to college to earn a as a consultant to industrY, daughter, Susan Hayman of degree in fine arts. A native federal and state govern- San Diego, CA; a son, Dr. of Erie, PA, Amdur lived in ment and private organiza- Mark Amdur of Chicago, IL; la ff al1 Physician Spring 2002 Hall High School and attend· by invitation of the profes- Irving Helfert, DDS, MD '36, died on December 10, 2001, at age 90. Born and raised in Brooklyn, NY, Helfert was the son of a well-known New York tailor of fine men's clothing. After graduating with honors from Erasmus School in 1936. Helfert was chief resident in urology at Columbia University and assisted in the advanced development of the well-known Gomco Clamp circumcision tool. He was board certified in urology, a Fellow of the Ameri- �I CONTINUED FROM PAGE 46 can College of Surgeons and a Fellow of the International College of Surgeons. grandson Dylan B. from Niagara Falls High 1930s and later the railway surgeon from 1956 to 1981, Swerdlow; sisters Gertrude School in 1942. He attended mail service. During World with offices in the San Tarnower and Rena Rifkin, the then-University of Buf- War II, he served in the Fernando Valley, CA. He is and former wife Sylvia falo for premedical and Army Corps. Upon discharge survived by his wife, Helen. medical school studies, from the military, Erickson Dinhofer Helfert. Helfert moved to Day· ton, OH, in 1943 and served as chief of staff and chief of Amo John Piccoli, MD'46 surgery at St. Elizabeth and Amo John Piccoli, MD '46, Good Samaritan Hospitals. died February 19, 2000, in Shortly after World War II, Fort Myers, FL. He was 77. at the request of the U.S. Piccoli, originally from Roch- Government, he was one of ester, NY, received his the first doctors to adminis· bachelor's degree from ter penicillin to civilians. If a Cornell University and his patient could not afford life· medical degree from the saving surgery, Helfert was then-University of Buffalo. known to accept homemade He completed his training pies in lieu of payment and and residency at the Roches- was remembered as a ere· ter General Hospital and ative, caring and beloved served as a major in the U.S. doctor who found tremen· Army during World War II. dous satisfaction in helping Piccoli practiced internal people from all walks of life. medicine at Rochester Gen- In 1971, he moved to eral Hospital until retiring in los Angeles, CA, and joined 1990, when he moved to the Sherwood Trimble Medi· Fort Myers. cal Group with the intention He was a member of the of practicing urological Monroe County Medical So- medicine with his son, Cap· ciety, New York State Medi- tain Bruce Stephen Helfert, cal Society, New York State MD, who died in 1972. Society of Internal Medicine, While in practice in Califor· the American College of nia, Helfert trained young Physicians and the Roches- doctors in Mexico and Cen· ter Academy of Medicine. tral America for City of Hope Piccoli is survived by his and donated time to the La· wife, Bess (Gioia), and a guna Beach Free Clinic. In daughter, Julie Margaux 1976, he retired and moved Kelleher. to Laguna Hills, CA, with his second wife, Gertrude Kolbert Helfert, who passed away in 1995. Helfert is survived by his children, Jay Helfert and Carole Helfert Aragon and son-in-law, Audie Aragon; grandchildren Heather Helfert Swerdlow and her husband Aaron Swerdlow and Breanna Helfert; great- graduating in 1948. He entered UB's medical served a general surgery school, after which he in- residency at the former E. J. terned in San Mateo, CA. Meyer Memorial Hospital in Buffalo and completed his training, he opened a gen- training at Veterans Hospital eral practice in Hemet, CA. in Omaha, NE. Graff In 1954, he left his practice enlisted in the Air Force in to work for the Dade County 1952 and was stationed at Public Health Department in Mitchell Air Force Base on Miami, where he remained long Island, where he was untill961. During that chief of surgery. There, he time, Erickson worked in the met Mary Ellen White, a field trials of a then-new registered nurse, and the oral vaccine against polio· couple were married in myelitis and earned an MPH 1955. They returned to degree from Tulane Univer- Buffalo, where he practiced sity. In 1961, he moved to general surgery at Kenmore Crescent City, Fl, where he Mercy Hospital and occupa- practiced for a year before tional medicine at Buffalo moving to De land, where Industrial Medical Center he practiced until his retire· until he retired in 1997. ment in 1977. Erickson is Besides his wife, he is survived by a son, Jonathan, of Madison, WI; a brother, Deborah, of San Clemente, Charles G. Erickson, of CA; and three brothers, Williamsville, NY; and a Sanford and Harry, both of sister, Marie T. Erickson, Amherst, NY, and Herman of of De land, FL. George Erickson, MD'49 died June 12, 2001, of complications related to Alzheimer's disease. He was 70. According to his oncology colleagues at the Uni· versity of Nebraska (UN) Medical Center, Foley strove to provide the best care possible to his patients and to keep up with research; but it was in helping to train future oncologists that he took the most pride. A native of Buffalo, NY, Foley was first in his graduating class at the then-University of Buffalo in 1955. He later earned a doctorate from the University of Minnesota School of Medicine. He joined the UN Medi· cal Center as an assistant professor of internal medicine in 1963 and was named a full professor in 1968. He Hospice Program from 1977 Gertrude Waite DeLaney, MD '50 to 1990. In 1994, he was Gertrude Waite Delaney, among 29 Nebraska physi· George MD '50, died in Tampa, Fl, cians selected for the book Erickson, on April 18, 2001. Best Doctors in America. WilliamS. Glassman, MD '51 wife, Janet; three sons, Harold L. Graff, MD '48, a gust 8, retired general surgeon, 2001, in Foley is survived by his MD '49, died unexpectedly on August De land, Fl, where he lived 27, 2000, at his summer since 1962. He was 90. A home in Rose Hill, Ontario. graduate of South Park High He was 75. in Buffalo and Canisius Col· NY, Graff grew up on Memo· John F. Foley, MD '55, also served the University Niagara Falls. died Au· rial Parkway and graduated survived by a son, Matthew George Erickson, MD, PhD, of Amherst, NY; a daughter, Harold L. Graff, MD'48 Born in Niagara Falls, Upon completion of his John F. Foley, MD'55 lege, Erickson worked in the Bethlehem Steel Works in lackawanna, NY, in the William S. Glassman, MD '51, died November 8, 2001, in las Vegas, NV. Glass- Peter of los Altos Hills, CA, David of Fairview Heights, ll, and James of Petaluma, CA; and three daughters, Sharon of Milwaukee, Judy of Schaumburg, ll, and Susan of los Angeles. man was a general Spri11g 2002 I u f I a I o Phy si ci a n �Which can you afford to waste? BENEFITS FEATURES E-mai I CONTINUED FROM PAGE 46 C. White, MD. DDS '93, writes: "! am practicing emer- gency medicine in Ravenna, OH. I am a partner in PES, Inc. and have been practicing at Robinson Memorial Hospital since 1997." E-mail address is CRW36@aol.com. • Electronic submission of all major insurance claims • Increase your accounts receivable turnover • Follow-up of all unpaid claims and open patient accounts • Improve collection ratio and reduce bad debts are delighted to announce the birth of our daughter, Naomi Hahna Kissel, on April12, 2001. We make Madison, WI, our home and would welcome visitors." E-mail address is: jsbae22@hotmail.com. • Advisement on and assistance with insurance carriers and government regulations • Optimize revenue through proper monitoring of charge master Pamela (Crowell) Grover, MD '98, writes: "Last year I • Choice of processing options including on-line or full-service • Eliminate costs associated with computer software and maintenance • Easy start-up or conversion from present billing system • Transition smoothly and quickly while maintaining cash flow • Appointment scheduling software available on request • Improve office efficiency and patient satisfaction • Expertise on existing and new • Assure your patients' rights are corporate compliance guidelines protected • Gain peace of mind from • Practice management with knowing that your finances are professionally trained staff and being managed optimally experienced C.P.A.'s Thomas A Maher, C.P.A. President MEDICAL BILLING SPECIALISTS 50 Alcona Avenue Amherst, NY 14226 Tel: (716) 834-1191 Fax: (716) 834-1382 e-mail: pbs50@aol.com Gregg Kissel, MD '97, and Jean 8ae, MD '97, write: "We graduated from the University of South Florida/ Morton Plant Mease Family Practice Residency Program and was the recipient of the Outstanding Family Practice Resident Award. I am currently a junior faculty member for the program and will be completing my fellowship in Faculty Development at the Michigan State University Primary Care Faculty Development Fellowship in june, 2002. I am also medical director for the Turley Family Health Center-the outpatient site for our residency program. On May 27,2001, my husband, Will, and I were married at Letchworth State Park, NY." E-mail address is pgrover@tampabay.rr.com. Hannah loon, MD '98, writes: " ! was married to Steven lsserman on November 17, 2001. After a brief honeymoon in Hawaii, I've resumed my duties as chief resident in anesthesia at Massachusetts General Hospital. I am anticipating starting an ICU fellowship at MGH in August 2002." E-mail address is: HToon@massmed.org. 2000s Steve Ambrusko, MD 'DO, writes: "My wife, Amy, and I are doing well and are very excited about our baby on the way, due in June 2002. Otherwise the pediatric residency is going very well." E-mail address is sj_ambrusko@hotmail.com. CD 48 luffalo Physician Spring 2002 �Nineteenth-century shagreen leather lancet case with four tortoise-shell handled blades. Knives such as these were used to bleed patients. After applying a tourniquet, the physician would cut a vessel, usually a vein, with the lancet, which he carried in a case. (Shagreen is a dyed, untanned leather or sharkskin.) The instrument is part of the Edgar R. McGuire Historical Medical Instrument Collection, housed in the Robert L. Brown History of Medicine Collection, Health Sciences Library, Abbott Hall, on the University at Buffalo's South Campus. �~-----------' p H A c. r~rsc CA HY GEAR Y 1E LTH 1 30 ~a )JU T ~ ~==~--~=====- C SCIE~Ct OTT H LL L I~R RY I A C A~PJS PUS M~I L UB's HISTORY Of MEDICINE COLLECTION PRESENTS PHARMACOPOEIA Th is illustration was digita ll y reproduced from offizinellen Gewachse , a four - volume edition of pharmaceutical plants a and their medicinal uses , published in German in I 863. The pharmacopoeia by Otto -Karl Berg (I815 () c ~~afl~ .. ~ I866) is part of the Rob ert L. Brown History of Medicine Collection , located in the Abbott Hall ~ Health Sciences Library. Pi ctured is the Cherry Blossom , one of a series of botanical images digi tally r estored as part of an initiative to preserve a nd highlight unique re sources from the library' s coll ection. R e production s are avail a bl e for purchase through the library , and ca n b e viewed onlin e at iMedia. buffalo. edu/ art/ . Image restoration was performed by iMedia , the instructional media ser vices department of Computing and I nforma tion Techno logy, Univer sity at Buffalo . c BP o no 2- 0 2 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 2002 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2002-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v36n04-2002-Spring Table Of Contents A list of subunits of the resource. Minimal Access Surgery for Kids A Place for Business in Medicine Imaging and Imagination Research Medical School Alumni Pathways Development Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v36n04 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2002 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/69082f9aaa4291d81f3417ec6bf7ea4e.pdf a9e3771f9dabbf968482bef859318bc9 PDF Text Text �AssOCIATE \ ICE PRESIDE"T FOR UN I\ ERSITY Co~n! UNICATIONS Dr. C arole Smit/1 Pe tro DIRECTOR OF PERIODICALS S u e Wu e tcl1 e r EDITOR Dear Alumni and Friends, S t ephanie A. U nge r ART DIRECTOR & OESIG" A lan j. Keg le r OVEMBER, I ATTENDED THE AN UAL MEETING of the Association of American DESIGNER Da v id f. Riley Medical Colleges (AAMC) in Washington, DC, along with other individuals representing our school. An important reason for attending meetings such as this is that they provide a 0ESIG'I ASSISTANT Ka re n Lie/m e r national perspective on challenges faced by medical schools. This, in turn, enables us to understand that many of the day-to-day issues we deal with at UB are not unique but are instead part of larger trends and patterns. For example, we learned that, like UB, most medical schools are having difficulty placing their third- and four-year students in clinical teaching sites because faculty are increasingly situated in outpatient environments. In these environments it is difficult for faculty to take time to teach because of their patient load and paperwork. We also learned that about one-third of all medical schools are experiencing financial difficulties due in large part to the debt being incurred by their hospitals. While we do not have a university hospital and our school is not in debt, we do have pressing issues related to the dispersed nature of our school and its affiliated clinical sites. If we are to address these issues, it is important that we communicate with one another in an open and consistent way. This fall, therefore, the school's senior associate deans and l began hosting a series of Town Hall meetings at our affiliated hospitals and on campus. These meetings, attended by faculty, students, residents and staff, have spurred productive discussions about a wide range of issues. In order to share the content of these discussions with as many people as possible, we have prepared notes from each meeting and distributed them on a listserve. If you would like to be included on this listserve-which distributes other schoolrelated announcements, as well-please send your e-mail address to Mary Glenn, director of constituency relations in the Office of Alumni Affairs, at glenn@acsu.buffalo.edu. Another challenge schools are facing is the introduction of new curricula. At the AAMC CONTRIBUTING WRITER Lo is Ba k e r PRODUCTION CooRDINATOR Cy nthia T o dd - Fli ck UN I\ ERSITY AT BuFFALO SCHOOL OF \1EDICINE AI'D BIOMED ICAL SCIENCES Dr. Mi chael B e rnard i n o , D~oll EDITORIAL BOARD Dr. f o /w Bodk i n Dr. M artin Brech e r Dr. Har old Brody Dr. Linda j. C orde r 04 ja son H offmann , C lass of 20 Dr. jam es Kan ski Dr. Eli z ab e th Olm s t ed Dr. j a m es R . Ol so n Dr. S t eph e n Spauldin g Dr. Bradley T . T ruax Dr. Franklin Z eplowit z TEACHING HOSPITALS Erie Co unty M ed ica l Ce nt er Ros well Pa rk Ca ncer In st itut e \'et eran s Affairs Wes tem New }'~r k Hea lth care Sys tem K :\ll:ID," H t:-\IIH: T il e B uffa lo Ge nera l H ospital . 1 Tir e Clril d ren 's Hospit al of Buffll 0 M ill ard Fillm ore Ga t es Hospital . 1 Millard Fillm o re S ubu rban Hosprta meeting we learned that our peer institutions are finding that it takes anywhere from four to eleven years from the inception of a new curriculum to the time it is solidly in place and well adapted to the school's needs and educational goals. As you know, we introduced a new curriculum at our school this past fall. One thing I assure everyone when talking about this milestone achievement is that the new curriculum is a "work in progress" and one that will be evaluated and improved with as much input as possible from everyone involved. Finally, I would like to announce that according to numbers provided by the AAMC, our CArttotn H f.-tt1H S1srr\f: M ercy Healtlr Sys tem S isters of Clra rit y Hospital N iaga ra Falls Me m orial M edi cal Ce nt er ® UNIYEISITY IT IUFFILI. THE STATE UNIYEISITY If lEW Till school 's basic science faculty produce above the 90 percentile in revenues, per individual, when compared with other medical schools in the United States (specifically, $300,000/ faculty). What this tells us is these faculty are bringing in large amounts of grant dollars in an exceedingly competitive environment and that their work is of the highest quality. This is something I think we should all be very proud of, and it is a strength we will do our best to maintain and build upon in the future. J. R, (LA~; .... -c) ~~- BERNARDINO , MD. MBA Letters to the Editor Buffalo Plly;rcum "published quarterlY h)' the Um,·ersitv at Buffalo School nf ~1cdicine and Biomedical S(ICO(CS Ill cooperation with the Office of (.ommunicatiOns. Letter> to the Editor arc wckoille .md can be sent c/o IJ11(jalo Plr)'srcu"'· 330 Crofts Hall, Univ~r"t' at Bufl,,to, Buffalo, NY t 4260; or vi,J e-nMil to bp-notcs~• bufti1lo.edu. . ·dit ,Jll The >taft re>en·c; the nght to< submissions for length and darity. Dean, School of Medicine and Biomedical Sciences Vice Presiden t for H ea l t l1 Affairs University at Bu ffalo }vrk The State Uui~'Ct'Sity ofNeW �V 0 L U M E 36, Features 2 10 18 Healing in the Aftermath A report on three UB psychiatrists' work at Ground Zero and environs BY S. A. UNGER First Impressions, Lasting Memories Buffalo Physician readers write about September 11, 2001 One Woman's Global Concern Bess Miller, MD '77, a leader in efforts to prevent and treat AIDS and TB worldwide BY BETSY SAWYER COVER Convocation 26 Christiane Northrup, MD, delivers the inaugural Lawrence and a ncy Golden Lectu re EdwardS. Cheslow, MD '81, above, contributes to "First Impressions, Lasting Memories" about September 11, 2001. starting on page 10. Litchman, Class of 1960, ho nored as Distinguished Medical Alumnus 41 Messages from this year's reun ion chairs alumn i 31 Lawrence jacobs, MD, and Gloria Roblin, PhD, remem bered grant to fund study of lin k between periodo ntal d isease and hea rt d isease 34 Program project gra nt to develop vaccine fo r ear and respiratory tract in fections PHOTO OF ANTHONY tori um to the Hospitalthe Third-Year Experience, by Svetlana Bli tshteyn, Class of 2002 No BY 00UC LEVERE other alumni 46 Past Forward, a unique perspective on the Class of 1976 �BY S.A. Areport on three UB psychiatrists' work at Ground Zero and its environs u GER N THE LONG HOURS FOLLOWING THE ATTACK on the World Trade Center on September 11, 2001, many healthcare professionals trained to respond to disasters found themselves in limbo as they awaited a tidal wave of patients that instead arrived at their doors as a wayward trickle. As the days passed and even the trickle dissipated, it became clear that the definition of a worst-case cenario was being reconstructed in this environment of limited activity. Instead of physicians equipped to deal with the most devastating of physical traumas, what was needed were physicians equipped to treat psychic trauma on a scale previously unimaginable in our country. One physician well prepared to galvanize a response to this hastily redefined disaster wasAnthonyT. g, MD '91, who at the time of the attack was treasurer and vice president of operations for Disaster Psychiatry Outreach (DPO), an organization for which he is now medical director. Headquartered in ew York City, DPO comprises volunteer psychiatrists committed to providing on-site disaster mental health services, as well as to producing educational programs, research data and policy statements in support of this mission. �••••••••• ,. c •• �e p The photographs in this a.::» article that depict me- ... morials erected on the E5 e 1 I streets of New York City after the September 11 attack on the World Trade Center were taken by Bruce Jackson, SUNY Distinguished Professor and Samuel P. Capen Professor of American Culture at the University at Buffalo. Sixty of Jackson's photographs-documenting the commemorative candles, photos, flyers, notes, toys and flowers left in New York City's Union Square and Sheridan Square, at St. Vincent's Hospital and on the streets of lower Manhattan-were exhibited October 16--22, 2001, in UB's Center for the Arts. Jackson notes that many of the items displayed originally posed questions as to the whereabouts of thousands of individuals lost in the attack. By September 22, when he took the photographs, however, they had become memorials. "Every place you go in lower Manhattan," he says, "you see sheets of paper taped to walls, fences, kiosks and lampposts. They're all about people who are missing. "Most of the city's firehouses and parks have shrines-things people made or left to try and say something that could not be sail! in words." Buffalo Physician would like to thank Professor Jackson for his generosity in allowing us to include his photographs in this article. We would also like to thank Patricia Donovan, senior editor in UB's News Services, for providing the above information about Jackson's exhibit. -S. A. UNGER AST SUMMER, NG HAD CALLED his former teacher Cynthia Pristach, MD '83, associate professor of clinical psychiatry in the University at Buffalo's School of Medicine and Biomedical Sciences, and asked if she would be interested in not only joining DPO, but also in expanding its membership in Western ew York. Pristach joined the organization and recruited a number of her UB colleagues, including Linda Pessar, MD, associate professor of clinical psychiatry, and Helen Aronoff, MD '92, assistant professor of clinical psychiatry in the Division of Child and Adolescent Psychiatry. Two weeks after the attack on the World Trade Center, g was again on the phone to Pristach, asking if she and other members of DPO in Buffalo would be willing to come to ew York City to work at two sites: the Family Assistance Center and Ground Zero. g said he contacted Pristach because he was confident his former medical school professors would be up to the task. ''I'm biased because I know both Cindy [Pristach] and Linda [Pessar]," Ng admits, "but I also knew they would be very helpful for two reasons: First, they are very experienced, and second, there were a lot of Buffalo folks down here that week, both with the ational Guard and as firefighters, and I thought their having that connection would help us. Too, I knew Linda had previous experience working with firefighters, and that was a nice addition because they are a very tough group to get close to." On September 27, 2001, two days after she had the courage she would need. They assuaged many of these feelings by talking with one another and by confronting what Pessar calls "the imagined chaos of this time." The evening before they departed, which was the eve of Yom Kippur, Pessar and Aronoff went to services together. "We each would have done this anyway," says Pessar, "but I felt like we were preparing to enter another psychic space, and when we ended our final shift in ew York City that following Saturday, we accompanied Cindy to mass at St. Patrick's Cathedral. "So, it occurred to me that, in this time of crisis, we were mobilizing around the values of the important institutions in our lives-that we were bounded by religious, patriotic and vocational values," adds Pessar. Upon their arrival at La Guardia Airport, Pessar and Aronoff, both New York City natives, immediately noticed a dramatic change in the city. "Everything was spooky," says Pessar. "The airport was empty when we arrived, and the taxi dispatcher in Manhattan thanked us for coming! Everything was sort of tumbled about." That same evening, Pristach accompanied g to Ground Zero, where he taught her the protocol for intervention so that she could in turn teach it to Pessar and Aronoff in the days that followed. Pessar and Aronoff did not go directly to Ground Zero, but instead began a 4 p.m. to midnight shift at the Family Assistance Center, located in the cavernous Pier 94 on the Hudson River, which housed a wide array of centralized services for families and survivors. g called, Pristach, Pessar and Aronoff boarded a plane to New York City. In recalling their decision to help, all three psychiatrists say that while they were not ambivalent about going, each did experience some anxiety prior to departing and even questioned whether THE FACES OF TRAGEDY At the Family Assistance Center, Pessar and Aronoff began work at a booth next to another sponsored by the ew York City Department of Mental Health. Thousands of people milled about, �availing themselves of services provided by such almost like what you would see in a painting." Some people needed counseling and referral, organizations as the Red Cross, Salvation Army, Social Security Administration, and Department of while others needed simple advice or an opportuVeterans Affairs, as well as the mayor's office and nity to vent anger, frustration, grief and fear. the city's police and fire departments. Also on site Counseling sessions took place anywhere the psywere groups prepared to provide assistance with chiatrists encountered need, and the need they housing and financial needs, as well as representa- encountered was as diverse as the population. tives from companies formerly located in the World Trade Center. Food was available in cafeterias, and AN FOLD! G OF STORIES places were allotted for children to play and for families to rest. "There were also two long rows of Ten minutes after arriving at the pier, Pessar talked attorneys whose job it was to take data and fill out with a woman referred by a Red Cross worker. The death certificates," recounts Pessar. "Later, we woman lived in an apartment several blocks from learned that the Department of Mental Health had the World Trade Center and, in the aftermath of organized support groups for these lawyers because the attack, was extremely agitated. "She kept repeating, 'I'm not crazy.' She had they had heard some 3,000 stories." At the pier, as well as at Ground Zero, a number of terrible post-traumatic stress disorder," says Pessar. shrines had been spontaneously constructed. Pessar "What we did was talk about the events that had so recalls that along one wall at the pier was a massive upended her life, and what it was she was dwelling collage of photographs of the missing-people of on and worrying about. I reassured her that she every ethnicity, age and appearance. The area was had a well-known and predictable syndrome and roped off, and under the pictures were hundreds of that she would get 'all better' with quick linkage and Teddy Bears sent from families in Oklahoma City. ongoing psychotherapy at a clinic." Helping people identify and name what they "People walked by and looked at this makeshift were experiencing was key to the psychiatrists' shrine, and it was very moving for everyone," says Pessar. "Again, 1 think this was an attempt to use work. "I think the most important advice we gave ritual as a way of containing people's grief and fear." people was that their enormous emotional upUnder the aegis of Disaster Psychiatry Out- heaval was proper and that they didn't need to be reach, the psychiatrists were asked to perform two afraid of their own responses," Pessar notes. If neckinds of services. One was to respond to requests for essary, in addition to talking with people, she and formal evaluation made by the various agencies at the other six or seven psychiatrists working at the the site on behalf of individuals they were assisting, pier also gave medications, but provided only a few and the second was to walk around the pier and talk days' supply so that people wouldn't become comwith people who appeared distressed, with the goal placent about seeking further help. Another encounter at the pier took place in the of providing them with a quick linkage to longladies room, where Pessar and Aronoff struck up a term mental health services. conversation with an African-American woman "What I remember most about the pier are the who appeared outwardly composed. "This wonderfaces, the faces of tragedy," says Pessar. "You knew whom to walk up to, and it was like nothing I had fully dignified woman in her mid-50s talked to us ever seen. The grief had drained and etched them; about her faith, explaining that she was very relithe detail of suffering in their faces was exquisite, gious," says Pessar. u "\VIzat I remember most about the pier are the faces, the faces of tragedy," says Pessar. "You knew whom to walk up to, and it was like nothing I had n•er seen. The grief had drained and etched them; the deta if of suffering in their faces was exquisite, almost like what you would see in a painting." �HE WOMAN ALSO TOLD THEM HER STORY, "There were also two long rows of tJttorneys whose job it was to take data and fill out death certificates," recounts Pessar. "Later, we leamed that the Department of Mental Health lznd organized support groups for these lawyers because they had heard some 3,000 stories." explaining that she was a receptionist for one of the administrators at the World Trade Center and that she had been in the 1993 bombing and had escaped without incident. On September 11, one of the planes hit the tower very close to the floor on which she worked. The ceiling fell in, but she was unscathed. "When she didn't get anything on her from the ceiling, she thought that was a sign from God, that God had created a shield around her to protect her, and that calmed her," recounts Pessar. "One of the secretaries on her floor was not so fortunate and was consumed by a fireball." The woman further explained that when the plane hit, the building's sprinkler system was activated and all the doors in her office automatically locked. She knew of a door that had been kept ajar so people could go down to the level below and smoke. She headed for this exit and proceeded to walk down 73 flights of stairs. "She described water pouring down on these slippery steps and how she just tried to go step by step while the firemen were rushing up," Pessar relates. "And she did escape. But, after telling us her story, she said, 'I'm a religious woman, and my faith is very important to me, but I've been through two bombings, and I need counseling.' So before we parted, Helen provided her with referral information." While working at the pier, Aronoff also recalls going into a television lounge and finding an Ecuadorian woman curled up tightly on a couch, accompanied by her four-year-old son and her sister. Aronoff sat on the floor and talked with them for about half an hour, relying on her limited proficiency in Spanish and the sister's equally limited English to piece together their story. She learned that the mother had recently left behind three other children in her homeland to come to the United States with her husband, who was in the World Trade Center and was missing. When Aronoff asked how the boy was doing, she discovered that the mother was very concerned about him. "She told me he was 'acting like a baby again,"' says Aronoff. "He wanted to sleep in her bed, was clinging to her, was enuretic and was having temper tantrums if he didn't get what he wanted. And she didn ' t know what to do about it because she was barely able to function day to day herself. So I focussed on giving her support, and I think that was very helpful to her. " No E D To THE NEED As intense and draining as these patient encounters were, Aronoff and Pessar found that their work didn ' t end when they left the pier. Each night when their shift was over, they boarded one of the buses provided by the city that stopped at subway stations and other locations in order to facilitate transportation for people traveling to and from the pier to receive services. As it turned out, these bus rides also proved fertile ground for counseling sessions. On one occasion they met a woman on the bus whose fiance worked at the World Trade Center as a carpenters' supervisor. He was called in to work that day and had died in the attack. "The woman told me they had planned to marry and that they had custody of his two small children," recalls Pessar. "She was accompanied by the man's sister, who herself had recently been widowed and had no living relative except her brother. So these sad women had come to the pier only to discover that because the woman was not legally married to the carpenter, she was not entitled to any benefits. "And this was quite common in terms of what we found," continues Pessar. "The pier was populated by people who represented all kinds of domestic catastrophes. These were the families of the janitors, the secretaries, and the cafeteria workers in the World Trade Center. Most had scanty resources to �begin with, and many saw all those resources disappear. They needed to be advised about psychological services and given practical advice." On another bus ride, Aronoff remembers meeting and talking with a husband and wife who had come from south New Jersey because the woman's brother had been killed in the attack. "They were planning a memorial service," says Aronoff, "and they wanted to get as close to Ground Zero as possible just to get a cupful of dirt so they would have something to remember him by." GROU D THAT DEFIES DESCRIPTION On Friday, the second day they were in ew York City, Aronoff worked at Ground Zero in the morning, while Pessar and Pristach worked there in the evening. All three women relate that it is difficult to put into words their first impression of Ground Zero, saying simply that it defies description. Each says she was initially struck by the vastness of the space, approximately 70 acres of dirt and gray mountains of rubble. "On the periphery are cinder-stained buildings with windows blown out and sections of the World Trade Center imbedded in them; and this is Manhattan! " recalls Pessar. Adding to the disorienting effect produced by the obliteration of streets and other directional cues was the fact that at night the site was artificially lighted, which gave it a garish, foggy atmosphere made all the more lurid by the smells that hung in smoke-filled air. Dotting the site, as at the pier, were a number of shrines, where exhausted and dispirited workers stopped to pray. "Everywhere you looked, there was this eerie contrast of the sacred and the profane," says Pessar. "Among the workers, there was a sense of enormous grief, but enormous purpose and patriotism, too. This was a sacred site, sacred to all of us because of the death and because we were Americans and felt we needed to protect it; but then it was a hellish place, too." Along with the grim mood and somber respect evoked by destruction and death, there was a strange, almost carnival-like atmosphere that developed at the site, as well. "Amidst the ruins, there were rows of tents with free food of every kind," says Pessar, "and booths full of new clothes, boots and socks, all free for the taking; heaps of stuffed animals for your children; and places where you could make free calls home. It made me think of Pleasure Island in the Pinocchio movie. And then there was this pile of rubble with 3,000 human remains." MEMORIES OF THE U IMAGINABLE At Ground Zero, the psychiatrists' first task was to meet with the disaster medical assistance teams (DMAT), which are teams of health professionals mobilized by the federal government during emergencies. There were five DMAT teams on the perimeter of the site, and it was their job to respond to any medical emergency, whether it be a cut finger or more serious situations. As was the case at the pier, in addition to responding to formal requests for evaluation, the psychiatrists were expected to approach people at the site-construction workers, firefighters, police, and members of the National Guard-and to provide counseling if needed. A crucial aspect to work at Ground Zero was helping the workers validate their experience, according to Pristach. "Although nobody was saying it officially, during the four days we were there, work at the site was transitioning from rescue to recovery. The workers digging through the rubble needed help validating that they were living through the experience and that what they had been doing was in some way helpful," she says. In one instance, Pristach and Pessar had a lengthy conversation with a high-ranking firefighter who The woman further explained that when the plane hit, the building's sprinkler system was activnted and all the doors in her office automnticnlly locked. She knew of a door that had been kept ajar so people could go down to the level below and smoke. She headed for this exit and proceeded to walk down 73 flights of stairs. �On another occasion, Pristach says she was approached by a firefighter who was concerned about a coworker who had fallen five stories in one of the towers and had survived, but was not coping well in the aftermath. "He told me that his friend was shaking like a leaf at home and that nobody knew what to do for him," she recounts. they said "just needed to vent." He explained how the younger firefighters looked to him for support and guidance but that, as a leader, he had few people to turn to for comfort. He was exhausted by the continuous 12-hour shifts he had been required to work and was concerned about new manpower shortages the fire department was experiencing as a result of the disaster. He explained that, in addition to the many deaths among his ranks, SO new recruits had decided to rethink their career paths, putting pressure on older firefighters not to retire as they had planned. "He was not only grieving the loss of his coworkers and time away from his family, but the fact that everything in his life had been displaced," says Pristach. "And the worst thing was he felt he couldn ' t complain because so many had died." On another occasion, Pristach says she was approached by a firefighter who was concerned about a coworker who had fallen five stories in one of the towers and had survived, but was not coping well in the aftermath. "He told me that his friend was shaking like a leaf at home and that nobody knew what to do for him," she recounts. The firefighter gave Pristach the man's phone number, which she then passed on to a local outreach center for appropriate intervention. Pessar says she found people at Ground Zero more reluctant to talk than at the pier, but that the older firefighters, in general, were more open about their feelings than their younger colleagues. "They had nothing to prove," she says. While working at the site, she recalls being pulled aside by one such older firefighter who said, "Can I speak with you, Doc?" He then began telling her how he had been off duty when he heard the reports of the attack on the radio and had come to the World Trade Center to help. He was in the second tower when it collapsed and was saved by being thrown under a metal table that protected his head. He was rescued from the rubble, given last rites and hospitalized for ten days. '' from the hospital he became preoccupied by the fact that his injuries were not on his face," says Pessar. "He didn't have any legitimate markings of his involvement, and he thought that there were rumors in his neighborhood that he was lying about his experience." Again, Pessar found it important to help the man name what he was experiencing and to be assured that it was normal. "So we talked extensively about survivor guilt, and I tried to help him understand what he was feeling," she says. "We must have talked 4S minutes; it was really a psychotherapy session, and as we finished I asked him to link up with services offered through the fire department and he promised me he would." For Aronoff, one of the most lasting memories of Ground Zero pertains to seeing families of the victims who were brought to the site by Red Cross workers to say their final good-byes. "The first day I was at Ground Zero, the Red Cross began escorting family members by ferry boat from the Family Assistance Center over to Ground Zero in groups of about SO at a time," she explains. FTER HE WAS DISCHARGED "When the first boatload of families came, it was a very moving experience because we were literally standing at the site of the twin towers and all of a sudden from one of the side streets came a group of people who were clearly not rescue workers. They were holding on to each other, holding Teddy Bears, holding flowers, and were absolutely silent as they walked past the towers. Spontaneously, every one of us working at the site took off our hard hats and held them to our hearts," she says. " It was incredibly painful, and it happened three or four times while I was there." �TIME To Go HoME After four days, the remarkable ordeal of these three psychiatrists came to a close and it was time to return to Buffalo and their families, practices and students. In attempting to sum up the enormity of their emotions surrounding this experience, they expect it will take months, perhaps years, to fully absorb what they encountered. All agree that the experience is one they never would have forfeited, and they relate wholeheartedly to Aronoff when she says, "I felt like it was an honor to go, to be called to help. You never really know how much individual help you provided, but I think none of us feels our time was wasted. For me, at least, I was glad to have a chance to be able to give something back." Echoing Aronoffs sentiment, Pessar adds, "I think all three of us-Cindy, Helen and I-are fairly idealistic. And I know that when I went to medical school, I was taught that medicine is a calling. "During the time we were in the city, there was a sense of responding to one's calling. I think this is something all three of us felt; and it was a privilege to respond." CD Drs. Pristach, Pessar and Aronoff would like to thank Dr. Susan McLeer, chair of University at Buffalo's Department of Psychiatry, and other administrators in the School of Medicine and Biomedical Sciences for allowing them to take time away from their normal schedules to travel to New York City to work with Disaster Psychiatry Outreach. .- hllall ,.rslclu I �--- -- Buffalo Physician readers write about September 11 [~itor'snote: J allowing the tcrrorists'attacks zn" 'cw York, \\ ashington, DC, Waiting for Few Patients and Pcnnsylmnia on September 11,2001, "\litlwel Bcmard111o, AID, dean Bv ALEXANDER VoLFSON. CLASS O F 2002 of the Unn·ersity tlt Buffalo School of Medicine and Bio111CdJml Sciences, conl'eycd in 11 letter to alllllllll, flu ulty and students the deep sorrow and disbelief our UB COIII/Illllllt)' felt in the ajtermath oj tillS tragi( day. Dean Bernardino also expressed concern f(Jl· the saJcty of our school's alumni, explaining that some 1,550 lil'c and \\'Orkin the New York Cit)' area, and anaddit1onal600 or more within a 45-minute dnve of\\'ashington, DC At the cl(N o( Ius letter, he inntcd ltllhl'Jduals to contact Buffalo Ph) sician should they lun•e stories they "1shcd to tell about e1 cnts surrounding eptC1nl1cr 11th. Here arc so11zc of tilt' responses \\'e receJ\'cd. n September 11th I was in the fourth week of an anesthesiology elective at ew York Presbyterian Hospital/Weill Cornell Medical Center and spent most of the day in the emergency room. Once I rea lized the scope of what had happened, I felt shocked and scared, but definitely proud to be in a position to help. When the hospital went into emergency mode, there was no panic; everyone just came together and worked calmly. Physicians from all specialties were divided into teams, each assigned to an ER station. There were nurses, students and other staff there as well. Volunteers passed out food and drinks, and we had shifts so that no one would get tired. Unfortunately there weren't too many patients to treat. Cornell has a big burn center, and many patients were directed straight there, bypassing the emergency room. We took care of a few firefighters and police who suffered minor inhalational injuries. Several buses took doctors to the Chelsea Piers, where a triage area was set up. At one point, the discovery of the bodies of two EMT workers brought to tears many of the people in the ER who knew them. But everyone remained calm and continued to work. At the end of the day, a couple of us went to get some pizza at a nearby pizza shop. As we walked in, the customers there began to applaud us. It was a great feeling knowing that you were part of a special group of people who know how and a re ready and willing to help others. CD �SORE SPASMODIC SO ET U SU G VESALIUS EXFOLIA T SUBJECT DESCE DI FREE OF GALILEO A G D EWTON BOTH AT 0 E POI T, THE DISCOVERY OF THE BODIES OF TWO EMT WORKERS BROUGHT TO TEARS MA Y OF THE PEOPLE I WHO K EVERYO A THE ER EW THEM. BUT E REMAINED CALM D CO TI UED TO WORK. �Grey Sonnet Following the Cloud Solace and Inspiration BY EDWARDS. CHESLOW, MD '81 Cataclysmic Convulsions Imploding Laden in grieving horror of chagrin As the initial Witnesses all too complicit in expedient libel begin numbing phase Substitutive Echo of the Enigmatic Hate began to wane, Unpardonable Occurrence action we mistake the psychiatric repercussions of this trauma began to surface. \\'e saw immigmnts with post-trcwnwt1c stress Immediate nearly complete in lethality aftermath unrest Incalculable misery seed to vitiate our unsoiled mighty granite nest Sore spasmodic sonnet unsung Vesalius' exfoliant subject descending disorderfrom war- Free of Galileo and Newton both tom countries who Terminal velocity of neither feather nor weight were rc-tmumatized; Applied accelerant to both Human body and symbol in at least one case I either hope nor solution this encountered, this led Innumerable Particulate to psychotic dcc0111pcnsation requiring Or Clzeslow" a, Ticholas Ra11go Fellow i11 HI\' ,\fedu i11c at the 4IDS Institute, \lowlt Si•m1 S( fwol of A!ed!Wie, m, 1cw York City hospitaliza tio 11. CATHY BUDMAN BY CATHY BuDMAN, MD '84 am an academic psychiatrist on staff at the orth Shore-Long Island Jewish Health System, approximately 20 miles from Manhattan. While our staff remained on alert, anxiously awaiting for what we expected to be the many injured, we could see the smoke from the burning towers from our hospital. To our horror, the patients never arrived. The devastating reality for health-care workers throughout the ew York metropolitan area on September 11 was that there were no large numbers of civilians to be saved. Many, many people perished without tangible remains. Forty to 60 people are missing from my hometown, Manhasset, on Long Island. Some families are missing two siblings, or both parents. In the majority of cases, there are no whole bodies to retrieve, only body parts that were gruesomely dispersed throughout the rubble. The human loss is overwhelming. On a personal level, this catastrophe impacted directly on my sister and her family. They became homeless, the children's elementary school was destroyed, and my sister's office in the American Express building was used as a morgue. And my sister-in-law, who survived the 1993 tower bombing, managed to safely evacuate from the ninth floor of Building 7, which later collapsed. Both witnessed the carnage: the terrifying crashes of both planes into the towers, the desperate people jumping from the upper floors, those killed by falling debris on the streets, and the tidal waves of dust and debris that followed the collapse of the towers. Of course, they have lost neighbors and colleagues. We feel blessed that our immediate family members are alive. For the first few days after the disaster, my office at the hospital was unnaturally quiet. We spent some time counseling emergency medical service personnel from Long Island, many of whom were at Ground Zero but unable to find survivors to help. Many had lost colleagues and friends from the various fire or police departments. �September 11,2001 BY LARRY BEAHA ' .MD '55 t's like On the Beach. What would you like to do As the initial numbing phase began to wane, the ' on the last day of your life?" my wife, Lyn, said. psychiatric repercussions of this trauma began to We were launching our tandem canoe into the surface. We saw immigrants with post-traumatic Erie Barge Canal on our way for apple strudel stress disorder from war-torn countries who were at Omi's Deli across the water. A battered Stars re-traumatized; in at least one case I encountered, this led to psychotic decompensation requiring and Stripes dangled at two-thirds mast as brilliant sun turned a cotton-spattered sky unreal baby blue. hospitalization. "If this is the last day, it will do," I said. We saw families reeling from the unimaginable loss of loved ones, in many cases involving young That morning as I was at work on my computer, people with young children. We saw elderly who Lyn came in breathless: "They just crashed a jet into had survived America's wars overseas and who the World Trade Center." We rushed to the televiwere now heartbroken to experience it on our soil. sion as another plane exploded the second tower in We saw paranoid-schizophrenic patients who were orange flame. It was unbelievable. Like watching delusionally convinced that they had actually King Kong climb the Empire State Building. It lookcaused this disaster. We saw Moslem patients who ed like a trick. The audio portion was Orson Wells were afraid to leave their homes lest they be threat- and his "War of the Worlds" over again but there ened and beaten. We saw angry, depressed adoles- were no disclaimers. cent boys filled with fantasies of rage and retaliOur son, Teck, called from work. "Did you hear ation, as well as many patients with anxiety disor- what happened?" he said. ders and depression who were experiencing severe Yes, we did, and we recalled a pilot with a Kenworsening of symptoms. Many children were pre- more connection who was killed when his B-25 senting with somatization and conversion disor- crashed into the Empire State Building in fog, and ders. We expect the need for psychiatric services will Kennedy's death. Curiously, I remembered the only increase as time goes on. bowl of oyster crackers I ate in a Deco restaurant Being a doctor has provided me with great solace when the Pearl Harbor news came over the radio and inspiration during this crisis. I appreciate more that day my dad had taken us Christmas shopping. than ever the gift of being able to help others. Each Our out-of-town son, Nick, got through on the day brings new challenges and opportunities to phone. "We haven't heard how Pat and Mike are," exert one's humanity, and for this I am so very I said. Our niece and her husband have a tiny rentthankful. 4D controlled apartment they inherited in lower Manhattan. He works in the Financial District. "Thank God you aren't flying today," Lyn said. Nick said, "Isn't Patty's baby just about due?" I remembered the Bay of Pigs. I was in the Air Force on temporary duty in the U.S. Lyn and our kids were on a troop ship sailing from our home base in Japan to meet me in Hawaii. While we were there, Teck and I watched from Waikiki as a hydrogen bomb, tested 600 miles from us, ignited the en tire Pacific sky. As New York rocked in the aftershocks of the World Trade towers, we watched and watched the death and destruction on television. Reports of the Pentagon crash and of another jetliner in Pennsylvania came in. A friend e-mailed, "What if that jet went into the nuclear reactor at Three-Mile Island?" \\'e recalled a pilot with a Kenmore Connection who \\'{IS killed when his B-25 crashed into the Empire State Building in fog, and Kennedy's death. Curiously, I remembered the bowl of oyster crackers I ate in a Deco restaurant when the Pearl Harbor news came over the radio that day my dad had taken us Ch ristmns shopping. -LARRY BEAHAN �That afternoon in the canal and at Omi's, it might fum.' been the last day of our ln·es, so Lyn and I rclJShed the sun, the \Vlltcr and a great blue heron's flight. \\'c paddled our canoe doH 11 the canal and across to the do(k at Omi's little dclzcatesscn. - I f 1• LARRY BEAHAN ~ I 1 f f a f 1 P ys i ei a1 That evening I had two meetings I was planning to attend. Both were cancelled. I argued with one chairman who felt we must mourn rather than meet. I believe it would have been better for our groups to meet and talk and plan joint action, maybe a carpool to the Red Cross to donate blood or to pray. Staying home glued to the one-way communication of the television screen does little for me. That afternoon in the canal and at Omi's, it might have been the last day of our lives, so Lyn and I relished the sun, the water and a great blue heron's flight. We paddled our canoe down the canal and across to the dock at Omi's little delicatessen. Omi, the transplanted German grandmother with her big smile, her bad hip and her full-length apron of pale roses, was flustered. " o, I didn't forget your soup. Who would believe it, how could it happen in this country?" I accepted the hot chocolate she brought instead of the chocolate milk I ordered. "Everything is discombobulated this morning, "she said. An elderly couple arrived by bicycle and took their tea and brownies outside in the sunshine. "I'll pay, you paid last time at Mississippi Mudds," she said. Apparently it was their second date. Omi called, "How do you want your strudel, hot from the oven or cold? "Hot, I love it hot," I called back. Two young women talked, one in a bright red dress with a watermelon-size bulge in front, the other in similar red top and white pants but carrying her newborn in a car seat. "I like to make a big pile of spaghetti with a red meat sauce," one said as the other picked up with her ideas on how to make pickles. Omi, between serving her Transylvanian horseradish soup and delicious flaky, tart-sweet strudel, talked of war: "You tell me how that was possible, in this country. In Germany the airports have soldiers with machine guns. Here we pay inspectors minimum wage. When she interviewed me, Janice Okun loved this soup. I got one granddaughter, lives twenty miles from the Pentagon." One of the mothers peeked at the baby in the basket. "He's nodding. They do that, you know," she said: then, "I just sat and watched an airplane fly into the World Trade Tower. You know how sometimes you can't grasp what you're looking at. IV , , r ,. r 1 oo2 I couldn't believe it. Jt was like something in the Third World." I went to the counter to pay Omi. She was working on a sandwich as she talked on a cell phone tucked under her tilted chin. "Bye, bye Shatzi. I love you too. Goodbye," she said; then to me, "All my kids are calling. I charged you for the lunch special since you had the sandwich and your wife the soup. Was everything okay?" "That strudel, just hot out of the oven, was wonderful." "I know, but some people only like it cold. You have to ask." I tried to tell her about Lyn's On the Beach question- "How would you like to spend your last day?" I don't think I got it through Omi's "discombobulation" that, if this had to be our last day, then a paddle on the canal with Lyn and strudel at Omi's would do fine for me. That evening my sister e-mailed me, "Mike got home covered with dust. He helped rescue workers till there was nothing more he could do. Pat and the baby are okay." CD Dr. Bcaha11 ;, a rcttrcd p:-rclzl<ltn~t mui c111thor o(Mv C.randp.1\ \\'oods, th~ Admmd,1cb. 1-h lives 11ot far from where the Fnc Hargt Canal pa:scs througlz 'orth f'otull\'<lllda, 'ew York. 1-lt• wrote thi.< story 011 the Cl't'lllllg o('\eptl'll!bcr II, 2001. ADay in Downtown Manhattan BY HAROLD BRODY , MD '61, PHD hile on a visit to ew York City to see my cousin on October4, 2001, I took the opportunity to travel into downtown Manhattan to visit the area around what was formerly the World Trade Center. Since my cousin lives on Broadway and West I 1 I th Street, I rode the subway downtown to two station stops before Canal Street and walked the remainder of the way to the site. Leaving the subway, I was immediately struck by how few people were on Broadway. Uptown, there had been about 100 persons per city block, while downtown there were only two to four people per block. �"IT's LIKE ON THE BEACH. WHAT WOULD YOU LIKE TO DO 0 THE LAST DAY OF YOlJR LIFE?" MY WIFE, LY , SAID. WE WERE LAUNCH! DEM CA G OUR TA ERIE BARGE CA AL 0 OE INTO THE OUR WAY FOR APPLE STRUDEL AT 0MI'S DELI ACROSS THE WATER. A BATTER~D STARS A D STRIPES DANGLED AT TWO-THIRDS MAST AS BRILLIANT SUN TUR SPATTERE SKY U ED A COTTO - REAL BABY BLUE. MY ONLY HOPE IS THAT WHAT ALSO LINGERS IS THE RESPECT AND REGARD THAT PEOPLE SHOWED EACH OTHER AT THE SITE. IT SEEMS A PITY THAT WE MUST GO THROUGH AN EXPERIE CE LIKE THIS TO DEVELOP A ATTITUDE OF REGARD AND RESPECT FOR EACH OTHER. BUT PERHAPS THIS PAl FUL LESSO WITH US. WILL REMAI �I went into a hardware store to speak with the owner, who said that the streets had been desolate since the World Trade Center was destroyed and he could not see how he and his family could remain there for very long, given the drop-off in customers to his store. Restaurants were empty, hardly a car passed by, and I saw few police patrolling the area. In short, there was a feeling that everyone had forgotten the existence of this part of the city, where even 24 days after the attack, a cloud of smoke hung in the air. As I neared Canal Street I noticed that store fronts and apartment houses were covered with thick deposits of ash. There was an increase in the number of pedestrians and police, although automobiles, including taxicabs, were virtually absent. Pedestrians were restricted to walkways that had been built on the sidewalks. We could venture as far as one street from the periphery of the damaged area, but no closer. The number of police in this area was very great and they were clearly in charge. Looking toward Ground Zero, the amount of damage I observed was incredible. o buildings were standing in the area; everything had been destroyed. Occasionally, people walking by would wipe tears from their eyes. As we stood observing the work at the site, no one smiled or laughed. There were few young adults in the area, and I saw no children. The area around Wall Street, assau Street, Fulton Street and the former World Trade Center is normally very noisy. Yet while I was there, I was struck by how quiet it was. When people spoke, they kept their voices low. o one shouted, everyone was patient, and there was a total regard for the next person, as well as a gentleness toward complete strangers. In talking with people I encountered, l often sensed confusion in their minds about how to respond to what had happened. While they wanted some form of retribution for those who had created this hell and killed so many thousands without regard, at the same time they were very sad, and several remarked that they wanted to cry as they looked at the broken buildings and debris. Many talked about struggling with the realization that life must go on. You have to leave this area before you can overcome the feeling of dread that envelopes you while you are there. And the feeling does not disappear completely once you've left, but haunts you for hours and days after. My only hope is that what also lingers is the respect and regard that people showed each other at the site. It seems a pity that we must go through an experience like this to develop an attitude of regard and respect for each other. But perhaps this painful lesson will remain with us. 4D Dr. Harold Brody 1sa lh<tmguishcd fcaclung Projl·ssor l;mcntus of anatomical sciences in the Ulllvcrsit)' at Bu{fi1lo School of.\lcdicillc a111f Biomedical Scic11ccs. lhttp://www.sciam.coml attacks are most at risk fo~ post-traumatic stress disorder feel much more vulnerable. Author Sarah Graham discusses wliat events in this article on the Scientific American web site. An internet study lhttp://coping.stanford.edu/J launched on September 22nd attempts to assess responses to the attacks on America. The article also offers a set of do's and don'ts for coping with anxiety and links to other relevant topics. mental heaHh services to those who have survived disasters such also available in print, free of charge, from the Center for Mental �ALUMNI Oistin~ished Medical Alumnus Named Marshall A. Lichtman, MD '60 arshall A. Lichtman, MD '60, received the University at Buffalo's Distinguished Medical Alumnus Award from the Medical Alumni Association at a dinner held on September 20, 2001, at the Buffalo Club. Lichtman is former dean of the University of Rochester School of Medicine and Dentistry and former executive vice president for research and medical affairs for the Leukemia and Lymphoma Society of America. After graduating from Buffalo's Lafayette High School, Lichtman attended Cornell University, where he earned a bachelor of arts degree in zoology. He then entered the thenUniversity ofBuffalo School of Medicine, graduating in 1960. Lichtman spent his entire academic career at the University of Rochester. He completed his residency in internal medicine there in 1963, after which he served in the Public Health Service until1965. He then returned to the University of Rochester to serve as chief resident in medicine. After completing his residency training in 1966, he pursued a strong interest in hematology and was awarded a Special Postdoctoral Research Fellowship from the National Institutes of Health from 1967 to 1969 to conduct studies on the biochemistry and physiology of blood cells and their abnormalities in leukemia. In 1969, he was named a Scholar of the Leukemia Society of America, an honor that was complemented by research support from the National Cancer Institute. In 1968 Lichtman was appointed assistant professor of medicine at the University of Rochester School of Medicine and Dentistry and in 1970, assistant professor ofbiophysics. In 1974, he was appointed professor of medicine and of biophysics, and in 1975 he was named chief of the Hematology Unit. From 1979 to 1989 he served as dean for academic affairs and research at the university, in addition to his responsibilities as a professor, scientist and hematologist. From 1990 to 1995, Lichtman served as dean of the University of Rochester School of Medicine and Dentistry. In 1996, he was named executive vice president for research and medical affairs of the Leukemia Society of America, now the Leukemia and Lymphoma Society. He also retained his appointment as professor of medicine and of biochemistry and biophysics at the University of Rochester. Lichtman has served on the editorial board of five scientific journals and as the editor-in-chief of Blood Cells, Molecules, and Diseases. He has been the editor of two monographs and four textbooks of hematology, one of which is in its sixth edition, and has authored more than 230 scientific articles and book chapters on the physiology, biochemistry and disorders of blood cells. Left to right: John Bodkin II, MD '76, president of the University at Buffalo's Medical Alumni Association, Marshall A. Litchman, MD '60, and his wife, Mary Jo. A Master of the American College of Physicians, Lichtman has been a visiting professor at over 40 medical centers in the United States and Canada. He has served on the Hematology Study Section of the National Institutes of Health and as chair of the U.S. Navy's peer review group of the Division of Biological and Medical Research. He is a past president of the American Society of Hematology and has been chair of the society's advisory board. Lichtman also served on the Council for Graduate Medical Education of the State of New York and on the board of governors of the American Red Cross. CD -S. A. UNGER \V i 11 t er 2002 lulfale Physiciaa 11 ��"There are about eight million new cases of TB worldwide each year, 95 percent of which occur in the developing world," Miller says. "Unless we act aggressively to control and eliminate this treatable and preventable disease, it will continue to take an enormous toll." The World Health Organization (WHO) estimates that without dramatically strengthening public health control and elimination efforts, one billion people will become infected with TB within the next 20 years, 200 million people will become sick and 35 million people will die from TB. Moreover, there are approximately 36 million people living with HIV infection-some 5.3 million of whom became newly infected in 2000 alone. To date, nearly 22 million people worldwide have died from AIDS, and the number of individuals who have been co-infected with this disease and TB-estimated to be about 11 million people-is expected to dramatically increase in the next 10 years. Persons infected with both HIV and TB are 50 to 100 times as likely to develop active TB as those who are not HIV infected. As a result, rates of TB in subSaharan Africa, formerly 10 to 20 times higher than rates of TB in the U.S., have doubled and tripled in the past 10 years. "To prevent HIV infection is to prevent TB, and to treat TB is to treat AIDS," Miller observes. "These two pandemics are intimately linked, and the tactics to control them must be synchronized." 1.1.1 a: TO MAKE A DIFFERENCE u; Born in 1947 in Racine, Wisconsin, and raised in Gary, = 1.1.1 Indiana, Miller was encouraged to pursue her academic interests by her mother, and equally imbued with a strong sense of community and a desire to make a difference in the world by her father, who is a rabbi. A career in public health seemed the logical choice, Miller explains, because of its scientific rigor and its potential to improve conditions for large numbers of people. With this in mind, Miller studied public health nutrition at Harvard University, earning a master's degree in that field in 1970. Three years as a public health nutritionist whetted her appetite for medical knowledge and prompted her to enroll in medical school at the University at Buffalo. C "I loved Buffalo from the beginning," she says. "The \Vi11ter 2002 luffalo Physiciaa 19 �approach there was, and continues to be, very practical and very patient oriented." At UB, she adds, she found further inspiration to work in the area of public health under the tutelage of such mentors as Harry Metcalf, MD, UB associate clinical professor of family medicine, and Robert Dickman, MD '68, then a UB professor of medicine in the Department of Social and Preventive Medicine, who is currently chair of family medicine at Tufts University. Both professors, she says, conveyed a strong concern for and awareness of community-oriented medicine. Her interest in public health was further reinforced when she and a fellow medical student, Benjamin Gitterman, MD '76, established a community board to work with the administration of Buffalo General Hospital to enhance the hospital's responsiveness to the needs of the local community. C PANDEMIC AND OTHER ..... INTERNATIONAL Miller's interest in international health was sparked by another unusual opportunity that came her way during her two-year training with the Epidemic Intelligence Service. This time it was the chance to track down the cause of an illness affecting more than 900 Palestinian schoolgirls on the West Bank of Israel. The illness was characterized by headache, dizziness, abdominal pain and leg weakness, and many of the girls were hospitalized. "I was asked to participate in this outbreak investigation because I had previously worked in the Middle East and because I was a woman," Miller notes. "We visited five hospitals where the girls were receiving care in wards accommodating up to 40 patients, generally two to a bed. Some clearly appeared in distress, but most were full of the bubbling enthusiasm and curiosity of teenage girls. While all were wearing abbayahs and appeared appropriately modest, further examination re- c::t CROSSCURRENTS en After completing her internship and residency in internal e medicine at Washington Hospital Center in Washington, .... DC, Miller moved to Atlanta to join the staff at the CDC as a member of the Epidemic Intelligence Service, a practical training program in public health, emphasizing field work. The year was 1981, a momentous time in public health, as a puzzling affliction (a generalized lymphadenopathy syndrome) had recently emerged among gay men and appeared to be associated with the growing numbers of cases of Kaposi's sarcoma and Pneumocystis carinii pneumonia in the same population. Miller spent months in ew York City investigating the condition. She and her CDC colleagues produced the most complete description of the syndrome, which is now known to be an early manifestation of HJV disease. "The experience was life changing because we were seeing so many vibrant young men in the prime of their lives with an unknown illnes ,"she says. "We conducted extensive interviews, drew blood specimens for the virologists in Atlanta, and reviewed thousands of pathology records to look for a pattern. We found one: There was an increase in generalized lymphadenopathy in ew York C ity among homosexual and bisexual young men between 1977 and 1981. This syndrome appeared to be linked to the illnesses affecting gay men. In a few years, nearly all of the men we had interviewed would be dead." en 20 laffale PhysiciaA \Vi11ter 2002 ..... a: 1111 ..... a: ..... ...:z: w w : �asks, 'What are the major health issues for this community and nation? What causes the greatest burden of disease and loss of productive life? What is the cost to the community and nation in terms of economic development and quality of life? '" a:1!5 BEFORE THE STORM vealed that most were wearing blue jeans and tee shirts beneath their traditional dress. I was filled with feelings of tenderness. "Thankfully, we were able to rule out organic disease and toxic exposures and to rapidly identify possible trigger factors for what turned out to be an epidemic of mass psychogenic illness. Despite the political tensions of the region, the CDC's structured, epidemiologic approach helped calm the situation, and we were able to put a community's concerns over this immediate worry to rest. " Although she found such detective work fascinating, Miller left the CDC in 1983 in favor of a clinical practice as an internist. As much as she enjoyed working with patients, however, she found that she missed the breadth and scope of public health work. After two years, she returned to the CDC, this time taking a position with the Division of TB Elimination, where she could combine her interests in clinical medicine Miller's first years with the Division of TB Elimination in the mid-1980s were .... fairly quiet, she recalls. Because the pub:Z:: lie was not yet aware that the Pandora's .... box of tuberculosis had been reopened, federal funding was sparse. Miller primarily worked in the U.S., consulting with state and local TB control professionals on public health practice. The link between TB and HIV infection was just becoming apparent in the U.S. , and much of Miller's writing and consultation were focused on this connection. As this assignment involved less travel, it gave Miller and her husband, Steve Solomon, an infectious disease specialist who works on patient safety and health-care quality at the CDC, an opportunity to settle in and concentrate on raising their two sons, David and Matthew, now ages 17 and 14. "I like the fieldwork. It's energizing and allows me to learn about the concerns of health-care workers and the people in the community involved," Miller says. "However, when the boys were younger, I felt strongly about not being away from home too much. Now, they beg me to leave!" she jokes. On a more sombre note, she adds that following the September 11 attack on New York City, CDC staff continue to travel and work abroad. However, they closely monitor all State Department warnings regard- and public health. Part of the balance she strives to achieve between practicing clinical medicine and public health comes from her work at a weekly TB clinic in Dekalb County, Georgia, where she has seen patients for the past 12 years. "I like the mixture of the political, analytic and medical features of public health," she says. "At the same time, my clinical work keeps me grounded. " Miller emphasizes, however, that a supervening challenge for everyone working in public health is getting public and private sectors to communicate. "The world of private medicine is geared toward the individual patient, primarily toward illness and cure, although it is becoming more prevention oriented," she says. "The focus of public health, on the other hand, is the entire community. The public health practitioner ing specific destinations. Despite the increasing incidence ofTB, control of the disease remained a low priority throughout most of the 1980s. Late in the decade, however, reports of the spread of multidrug-resistant TB jolted the U.S. public out of complacency. The mounting HIV/ AIDS crisis prompted further concern as epidemics ofTB among AIDS patients were reported in hospitals, prisons and other institutional settings where persons infected with HIV lived or received care. As a result, numerous public and private foundations entered the fray against the disease at both the national and international levels, and Miller soon found herself at the forefront of well-financed efforts to bring TB under control. U ll'i11ter 2002 luflalo Physiciaa .....,;.. E - ·= ........ ...... ........ ..=..._ ... ...... ...... -E -= = co ... co • b.O ·S ... -~ ~ = ... _.,.= -:;; ... ...- I'=co ...... "'... .....: • "' ... ·!:E . ... =-= co ~ ..... >I ... _ ... = ...... =-s_ ·... !J: ·-... .s..... IIIIII :z: 1- z .... > c:; w w 21 �• GLOBAL HEALTH PRIORITY .... So alarming is the modern TB pandemic that WHO declared it a global emergency in 1993. In 1998 the organization C launched the STOP TB Initiative, a global partnership to increase resources and move worldwide TB control higher up on the international public health agenda. Since then, numerous partners have joined this initiative, including United ations agencies, private donors, universities, professional societies and nongovernmental agencies. Miller has represented the CDC on this initiative and strives to promote collaboration between the Global AIDS Program and the efforts of STOP TB. TB control is particularly challenging in developing countries in Africa, Asia and Latin America, where TB and HIV/AIDS are prevalent and health-care infrastructures may be weak. In an effort to improve control in all settings, WHO promotes the Directly Observed Therapy Strategy (DOTS) for TB. "This strategy requires political commitment on the part of the government of each country, a stable supply of anti-TB drugs, direct observation of each patient's therapy for six to nine months, a network of laboratories to perform microscopic examination of sputum, and a recording and reporting system," says Miller. "Political commitment is the key, however, because TB control efforts require perseverance." :Z A major hurdle in the battle against TB is the tendency for patients to discontinue treatment prematurely. "TB is a very slow-growing organism, and it takes six to eight months to treat it," Miller explains. "Because it's time consuming and labor intensive for patients to complete the regimen, it's not surprising that many drop out of treatment after the symptoms go away, even though they still have the disease. " The result may be an increase in drug-resistant disease in the community, Miller notes. When people fail to complete standard treatment regimens, or are given the wrong treatment regimen, the persisting bacilli may include organisms that are res istant to one or more of the anti-TB drugs. These individuals may then transmit these drug-resistant organisms to the people they infect. Multidrug-resistant TB requires up to two years of more toxic, less effective chemotherapy and may be up to 100 times more expensive to treat than drug-susceptible disease. "All of these activities require a strong primary health-care infrastructure, which is critical for the improvement of the health sector in developing countries," Miller explains. "However, these activities are significant challenges for countries where the per capita health expenditure may be less than five dollars a year." There is a great need for new drugs, a shorter treatment regimen, an improved and more effective vaccine than BCG, and "We practice law for your peace of mind." Estate Planning - Personal Injury Real Estate - Matrimonial Elder Law One John James Audubon Parkway Amherst, New York 14228 716.636.7600 22 lull a lu Ph ysi cian IV i 11 I c r 2 0 0 2 H oGAN & W ILLIG, PLLC ------ Attorn e ~· s at Law----- - hoganandwillig.com �...... = ... "i ~ ·= -....... = ... :§ .=CI. -... ... ~ e new tools to make the diagnosis of TB quicker and easier in the field, Miller stresses. "It takes years of research to develop effective new drugs, and large financial commitments to fund that research. Given that TB is a 'poor person's disease'-afflicting homeless people, prison inmates, refugees and people with HIVthe market for TB drugs isn 't very lucrative. This tends to inhibit research in this area," she says. -= ..."' ........ ....:.~e"' =-... -=..,_ ~ -·- .... .,:;c -=~ . e ...... = ...... .,...,. ..."'= ·c::; ...... ...... ,. Cl,. ~a; ... > cn FORHOPE 1::::1 Despite these challenges, Miller is optimistic that c: .... !!§ > "' ,. -=... ...= TB can be brought under control, even in areas c:::» where HIV infection is prevalent. "Though TB is "'-~ :E 1:::1::: --... by far the most common opportunistic infection associated with HIV infection, it is treatable and preventable, provided that treatment is begun early and carried through to completion," she says. The growing collaboration among international agencies, governments and private donors seeking solutions to TB and other health concerns greatly encourages her. In 1998, for example, WHO launched a massive effort toward elimination of "diseases of poverty, " including malaria, HIV/AIDS and TB . ·;:; e .... ::I ... ---== c.::l ... = ... ...... .... ~ :E ·- = z ~ ... .... ... u .... -:'... ~ j 'II 'II Recently, the CDC has also substantially expanded and formalized its efforts in the international arena, a direction that has been supported by Congress. "This past year, as part of the STOP TB initiative, a Global Alliance for Drug Development, spearheaded by the Rockefeller Foundation, has been created to promote new drug development for TB, which is really quite thrilling," Miller points out. Scientific progress offers additional hope. "The genome of the TB bacillus has been sequenced. That's a huge breakthrough that will have a great impact on treatment and vaccine development. All of this makes me optimistic. The TB bacillus is a very complex and tenacious organism, but we have finally moved into the 21st century and are poised to eliminate it." Miller encourages medical students to consider a career in public health as an opportunity to make a difference for entire populations. "When I was in medical school, I don't think many of us looked to public health practitioners as role models. But since then, I've been impressed by the creative, inspiring professionals contributing to this field of medicine. In the arena of TB, with the enormous burden of disease it imposes on world health, the challenge to public health practitioners is tremendous and thoroughly motivating. I feel privileged to be among those responding to that challenge." <TI> Take the Life Care Plunge ... Choose Canterbury Woods for a lifetime of warmth and fun Set among 63 beautiful acres, Canterbury Woods combines all the best and most meaningful aspects of the way you live now, w hile addressing your needs and desires for a w orry-free future . Call today for your personal tour. Westem New York 's first Life Care Commtmity. ~nterbury UJoods ('5) Cal/ 716/929-5817 for your personal tour .. . 705 Renaissance Drive Williamsville, New York 1422 1 ~=·~ \V i 11 t er 2 0 02 luflalo Physician 23 �M E C D A E SCHOOL L W S Honors Convocation Reco nizes first· an Second-Year Achievements ur A \ Hr) rw<; Co ' ·oc \flO recognizing academic excellence among first- and second-year students at the University at Buffalo School of Medicine and Biomedical Sciences was held in Butler in general and systemic pathology. Dr. john Sheffer practiced pathology in Buffalo for over 35 years and was acting chair of the Department of Pathology from 1972 to 1974. Auditorium October 6, 2001. The following is a list of award recipients and a description of the Elizabetb laurke, '03, received The Department of Pathology' s awards received. Departmental Awards CARl- . level in the laboratory portion of the courses the second-year student achieving the highest grade in the microbiology and immunol- American Society of Clinical Pathologists Award for Aca- The departments of the School of Medicine mzd Biomedical Sciences have established awards to recognize meritorious performance in their courses as well as outsta11di11g achievemerzt i11 other curriculum-related activities. Iarin Llrb•anee,'13, outstanding performance in the received the Department pathology laboratory. Carea Cellia, '14, received the Department ofMicrobiology' s Marek of Anatomy and Cell Biology's Gibson -A twell - jones Award, Zaleski Award, which is prese nted to the student ment of Pharmacology and which recognizes the student with the highest combined average in the anatomical sciences courses of gross anatomy, histology, neuroanatomy and embryology. The award is named in honor who best combines high Toxicology's Edward A. Carr Jr. Clinical Pharmacology Award and the DouglasS. Riggs Award. GtLLIN ogy course. Dr. Witebsky was the founding chair of the Department of Microbiology. demic Excellence, which is presented to the second-year student who has demonstrated high academic achievement and ELIZABETH BOURKE ~iaa Lia, '13, received the Depart- standards of academic achievement with outDARius LoGHMANEE standing service to the community. The second-year class chooses The award is given to the student achieving the highest the recipient average in the Fundamentals of of past chairs of the department }IAN LIN Pharmacology course. Drs. Carr Drs. james A. Gibson, Wayne ). Atwell and Laura Ciaski, '13, received and Riggs were chairs of the Department of Oliver P. jones. the Department of Pa- Pharmacology and Toxicology. thology's Kornel Terplan Natalie Sbaw, '14, received the Award, presented to the Department of Biochemistry's student with the highest Lisa Esler, '13, larn Cbaa, '13, an~ IISs Iieber, '13, received the AstraZeneka Car- Edward L Curvish Award, which combined average in the diovascular Drug Monograph Awards, recognizes the student with the two second-year pathology courses. Dr. Terplan which are presented to second-year students highest average in the two first- LHRA C1NSK I year biochemistry courses. was a past chair of the department by the Department of Pharmacology and Toxicology. They are based on the quality of a mono- Timatby Par~ee, '13, NATAUF SHA\\ graph written '13, ceived the Department in the form received the Department of Pathology's john B. of a package Sheffer Award, which is insert Darat~y Hn~ricks, ofMicrobiology's Ernest Witebsky Award for given to the second-year student who has per- Proficiency in Microbiology, which is given to formed at the highest DoROTHY 24 re- laflale Phpician H rNDRICKS \Vi11ter 2002 TIMOTHY PAROFF LISA ESLER Ross RICHER �Je1aifer NIWibilski, '14, received the Department of Physiology and Biophysics' Donald W. Rennie Physiology Prize, which is given to the student with the highest combined average in the l \ two physiology courses in the first year. Dr. Rennie was a former vice president for research at UB and chair of the Department of Physiology AL F R E D FRo NTE RA SARA KAPROVE LYNDS AY ESME FINLAY WILLMOTT-BARTOS Discipline Honorary Societies: Narab Jaaasy, '13, received the and Biophysics. The Association of Pathology Chairs Honor Society awardees were Laara Ciaski, Alfred .leaaifer Naw1bilski, '14, aad Natalie Sbaw, '84, re- and Esllle Fialay, all in the Class of 2003 ( Cinski Evan Calkins Primary Care Achievement Award, which is given to one outstanding student in the Primary Care Summer Externship Program. Dr. Calkins is a former chair of the Fr11tera. Lyadsay Willmatt·lanas, Saralapme. ceived the McGraw-Hill Book Awards, which are given to the two highestranking students in the first -year curriculum. is pictured on page 24.) Department of Medicine. CD NoRAH JANosv NATALI E SHAW Dean's Letters of Commendation Dean's Letters of Commendation recognize exceptional coursework. In years one and two, they are a earn honors grades in 75 percent of required courses or achieve 75 percent of available honors pom three, students who earn at least four honors and two high satisfactory grades are honored. Letters in Yea NICOLE MANN DANIEL BAER )EFFREY MARTI DOROTHY HENDRICKS CHRISTOPHER Ross1 Tooo )ANICKI ELENA SALKOVSKY FORESTO CHRISTINE KERR MEGAN MooRE ADAM COHEN NoRAH )ANOSY ERIC SCHAEFER DAVID KRAKOWSKI CHRISTOPHER SYED MusTAFA DANIEL COTTER SARA KAPROVE DAviD ScHLESINGER BRIAN MALM KIMBERLY CARNEY jENNIFER NELSON KAMALJOT DHINGRA jENNIFER KoRZEN LARISSA STABINSKI ANTHONY MATO jENNIFER DANIELLE DoRSANEO THERESA Kouo jENNIFER TRASK CHRISTOPHER MUTTY LISA DosSANTos KIMBERLEY LEONARD STEPHEN TURKOVICH KATHLEEN REBECCA DWYER )IAN LIN )ULIE VOGEL LISA ESLER )AMES LIN BoBBI WAx ANDREW SWAN LYNDSAY WILLMOTT- ANDREW SYMONS OWOBILSKI ORA CHAN GREGORY Co NOLLY THOMAS DuQUIN SARA GAUGHAN CAREN GELLIN BRIAN GIORDANO DIANA PRATT ATALIE SHAW GARRON SoLOMON ESME FINLAY MARA LINSCOTT STEPHEN VARA DAVID FINTAK NATASHA MANES MICHAEL MELANIE FIORELLA VALERIE MARCHI ZAIR FISHKIN CYNTHIA MARTINEZ- CARMINE "ALEX" l KIT CHENG LAURA CINSKI )AMES BoYLE BRENNAN I EZ WEINGARTEN DAVID FLI T GRIECO )ASON GUTMAN CHRISTINA HAVERSTOCK Lett .arll APRIL BAKER SUNIL BANSAL CAPOLINO BARTOS )OYCE ZMUDA MICHAEL WHITESIDE HEATHER MORGANTI SUZIE ARIYARATANA ALFRED FRONTERA RICHARD LILY BELFI BRYAN GARGA 0 AARON OLDEN LINDA CUOMO jENNIFER DEFAZIO KEELY DWYER- SHERU KANSAL ELIZABETH BouRKE )ULIE GAVIN BRIAN PAGE ERIC Ko )AMES BOYLE LISA GELMAN TIMOTHY PARDEE SANDY KOTIAH BRANDY BRYDEN DAVID GRAY BRENT RISCILI CRISTINA LAM PURl ALBERT CHA G HoWARD HAo KERRYN ROCK )ULIANE THURLOW KAREN WEISS Le ters in ear Ill ANDREW FREEMAN EWELL O'DoNNELL MATZKY CHRISTOPHER Wint e r 20 0 2 l lflall nysieiu 25 �M E D C A L SCHOOL E W S • Bv 10 Engender Health I COLE PERADOTTO Christiane Northrup, MD, delivers inaugural Lawrence and Nancy Golden Lecture hen Christiane orthrup, MD, When it came time to decide began stressing the importance of who would kick off the lectureship, holistic health during the 1980s, it Northrup was an easy choice for the seemed like she was a lone voice in Goldens. A dynamic speaker who the wilderness. The obstetriciangynecologist remembers shutting has hosted four popular specials on PBS, the Ellicottville, ew York, her office door while discussing native, who now lives and practices nutrition with a patient, for fear in Maine, has received international a colleague would hear her dispen- acclaim for advocating that women sing such unconventional advice. tune in to their bodies, take charge of their health and take it easy on What a difference 20 years can make. Today, mainstream news pro- While addressing UB medical stories about healing foods. Ameri- students, she similarly encouraged cans are pending billions of dollars them to listen to their inner wis- in alternative medicine and thera- dom and know their limits. "We all pies. At health clubs, yoga and Pilates have this intuitive ability to know are all the rage. For her part, Northrup doesn't what's the right thing to do for our patients," Northrup said. "What need to whisper behind doors anymore. In fact, so many you need to learn is how to be good surgeons, good people want to hear what she has to say about wellness plumbers. You have to tie the knots right; you have to know this body of work. But that also means that you cannot treat every patient in an ideal way because it and health that her first book, Women's Bodies, Women's Wisdom, sold more than 1.2 million copies. Last year's follow-up, The Wisdom ofMenopause, leaped to first place takes too long. So choose one patient a week with whom among advice books on the New York Times best-seller list you'll interact fully, on whom you'll take a full history. a week after it was released. "You can be St. Francis of Assisi and pretend that "It's really gratifying to see how things have changed," patient is someone you're administering to. Be a physi- Northrup said during a September 24, 2001, lecture at the cian in that way for one person a week who somehow University at Buffalo School of Medicine and Biomedical grabs your soul." Sciences. "As far as I'm concerned, it's a miracle." orthrup warned the group that physicians who orthrup was the featured speaker for the inaugural blame themselves for every patient death simply can't Lawrence and Nancy Golden lecture on mind-body perform effectively in the medical profession. "The medicine. Founded in 2001, the annual lectureship aims reason doctors get burned out is that they begin to think, to teach medical students how the mind and body inter- and you're taught-at least, I was-that if someone dies, act to promote or endanger good health. A clinical professor of medicine at UB, Lawrence Golden, MD '46, was faster than [thinking like] that." chief of medicine and cardiology at the Millard Fillmore Hospital, where he founded the first cardiac rehabilitation program with his \vife, ancy, a family therapist at Child and Family Services for more than 30 years. 26 themselves. grams and magazines abound with lufl a l e Pb Jsician IVi11tcr 2002 it's your fault. othing will take the wind out of your sails When treating patients, orthrup told the physicians- in-training, it's wise to consider factors outside the traditional medical model of cells and genes-factors such as the health of a patient's marriage, her job satisfaction or �\, even incidents of physical abuse lingering in her past. She acknowledged that she makes it a habit to ask patients, one simple question: "What's going on in your life?" From the answers, she's often able to glean important information about situations that may be compromising her patients' health. Although she doesn't minimize the role of molecular biology, orthrup argues that it can't always explain the complex roots of illness and disease. She worries that physicians too often opt for a pill's quick fiX, yet fail to address the circumstances in a patient's environment that may be aggravating the condition. To make matters worse, the so-called magic bullet may even result in a new complication-addiction. As she spoke, orthrup reinforced her points with a slide presentation of advertisements Jeffrey Ross, MD '70, Delivers Terplan Lecture The second annual Kornell. Terplan Memorial Lecture was held October 17, 2001, in Farber Hall at the University at Buffalo School of Medicine and Biomedical Sciences. The lecturer was Jeffrey Ross, MD '70, chair and Cyrus Strong Merrill Professor in the Department of Pathology and Laboratory Medicine at Albany Medical College. He is also vice president for molecular pathology at Millennium Pharmaceuticals of Cambridge, Massachusetts, where he served as a Scientific Fellow during 2000. Ross's lecture was titled "From Gene to Patient: The Emergence of Targeted Therapy and Personalized Medicine in Oncology." The event was made possible by the generlished an endowment to fund the lecture. Terplan's son, Martin Terplan, MD '55, assum- for psychotropic drugs. An ad for Valium showed a woman jogging ed a major role in creating the endowment and down the street, her face a portrait of bliss. A Xanax ad claimed to have unraveled the mystery of depression, pinpointing its origins at a was in Buffalo to attend the lecture and host a particular synaptic site in the brain. "Depression and anxiety in the brain are highly overlapping and r-------..1.....-- osity of the Terplan family, which has estab- reception following it. Kornel Terplan, MD, was professor and chair of UB's Department of Pathology from 1933 to they intercept," she said. "You might have some professors who think 1960 and served for many years as a pathologist that if you get the absolute correct dose of Xanax or Prozac you will cure your patient's life. I wish it were that easy." orthrup added that she's not against prescribing such drugs, if circumstances warrant it. "They all help some people. But what about all the women who are battered in their marriage? We can't get a at Children's Hospital of Buffalo and Buffalo General Hospital. biochemical solution for that." He was internationally recognized for his work in childhood tuberculosis and brain pathology associated with chromosome anomalies of children. "Not only was Dr. Terplan an eminent scholar and one ofthe leading figures at the medical school, he was also a man with great energy and enthusiasm who was known for his personal S umming up her concerns, she read a quote from Max Lerner's warmth," recalls Reid Heffner, MD, chair of UB's Department 1959 book The Unfinished Country: "What. is dangerous about tranquilizers is that whatever peace of mmd they bnng ts a of Pathology and Anatomical Sciences. packaged peace of mind. When you buy a pill and buy peace of mind, you get conditioned to cheap solutions instead of deep ones." Since she began preaching the merits of a mind-body approach to medicine, orthrup has contended that a woman's health is tied to the culture she lives in. She's a harsh critic of the messages that society sends women-destructive messages that make them feel insignificant When the endowment to support this lecture was established by the Terplan family, the long-term goal was for UB to work to expand it by asking former students and colleagues, as well as those who enjoy the lectures, to join in expanding the endowment, according to Heffner. "We would like to be able to fully underwrite one lecturer each year, with a visit lasting for at least one day in order to and self-conscious. Casting an accusing glance at a lingerie ad featuring provide an opportunity for all current medical and graduate a gorgeous woman preparing breakfast while clad only in a bra and students to interact with the guest lecturer," he says. "These panties, she quipped: 'Tm sure that most women make eggs like this- types of visits enhance the curriculum and provide students, you know, before you go into the clinic and get going for the day." When women- and for that matter, men- are made to believe about exciting innovations in pathology research." residents and practicing physicians with an opportunity to hear that they should do it all, they're bound to think they've come up short For information on contributing to the endowment in at the end of the day. The cover of the health magazine Northrup support of the annual Kornel Terplan Memorial Lecture, used to illustrate her point read: "Be loved, think positive, eat right, please contact Lyn Corder, associate dean for alumni affairs stay fit, enrich your life, save the world." "This is the new American dream," she sighed. "It makes you crazy, and development. She may be reached by phone, toll free, at and very stressed out." 1-877·826-3246; or by e-mail at ljcorder@buffalo.edu. CD W in t er 2 00 2 1111111 Pbysiciaa 27 �PATHWAYS NEws ABOUT UB's ScHooL oF MEDICINE AND BIOMEDICAL SCIENCES AND ITS ALUMNI, FACULTY, STUDENTS AND STAFF ((I HAD THE OPPORTU- NITY TO MEET SOME OF MY FELLOW TORCHBEARERS AT A TRAINING EVENT [IN EARLY NOVEMBER], AND I WAS TRULY HUMBLED." TURKOVICH 28 l1flal• Physician \I' i 11 t r r Turkovich Selected as Olympic Torchbearer Steve Turkovich, a third-year student in University at Buffalo's School of Medicine and Biomedical Sciences, was selected to be an Olympic Torchbearer for the 2002 Winter Games in Salt Lake City, Utah. A native of West Seneca, ew York, Turkovich attended Orchard Park High School before coming to UB to complete a major in anthropology. He was nominated for the honor by a relative who, among other things, highlighted his past involvement in the Tar Wars Program, which educates elementary students about the dangers of tobacco use, as well as his work with Hospice's Life Transitions Center, which provides support to children whose parents have a terminal illness. Turkovich was notified of his selection on September 12, 2001, at which time he was 2 0 0 2 told he would be running Because Turkovich will be in two-tenths of a mile at a yet- his medicine clerkship in to-be determined location in February, his near-future plans unfortunately do not include Western New York on December 31 or January 1. attending the Olympics. "This is an unbelievable For more information on honor," says Turkovich about the Olympic Torch relay and his selection. "I had the optorchbearers, visit the 2002 portunity to meet some of Winter Olympics' website at my fellow torchbearers at a www.saltlake2002.com and training event [in early ov- click on Game Programs. ember 2001], and I was truly -S. A. UNCER humbled. Trevisan Named "Many of them have overInterim Dean of HRP come much adversity in their Maurizio Trevisan, MD, prolives and are very inspira- fessor and chair of the Departtional. It's a privilege to carry ment of Social and Preventhe torch with them. tive Medicine in the "Too, this is the University at Buflast time the Olymfalo School ofMedipics will be held on icine and Biomedical American soil for at Sciences, has been least the next ten named interim dean years," he says. of UB's School of "And given the Health Related Proevents of September fessions (HRP). TREVISAN 11, I am especially Trevisan succeeds proud to represent the United Mark Krista!, PhD, professor States in an event that stands of psychology, who has refor peace and unity." turned to the faculty after When asked what he hopes serving as interim dean of his future as a physician will HRP for 18 months. A search hold, Turkovich says, "''d like for a permanent dean has been to pursue a career in either under way since the death of general pediatrics or child Frank Brady in November psychiatry, and perhaps also 1999, just a month after he teach clinical medicine." assumed the dean's position. �l In addition to serving as chair of the Department of Social and Preventive Medicine, Trevisan is diEDGE rector of the Center for Preventive Medicine, part of the Women's Health Initiative. A UB faculty member since 1985, Trevisan's current research is focused on cardiovascular disease epidemiology. He earned a medical degree from the University of aples Medical School in Naples, Italy, and a master's degree in epidemiology from UB. L EV I N E Edge and Levine Named Best Breast Cancer Doctors Two Roswell Park Cancer Institute (RPCI) physicians and University at Buffalo professors were named among the top breast cancer doctors in America in the October 2001 issue of Redbook magazine. Stephen B. Edge, MD, chief of breast surgery at RPCI and an associate professor of surgery at UB, and Ellis Levine, MD, chief of the medical divisions of breast and genitourinary on cology at RPCI and associate professor of medicine at UB, were among the 355 physicians cited by the magazine's "Exclusive List: The Breast Cancer Specialists Rated the Best by Their Peers." "The faculty and staff of Roswell Park congratulate these two outstanding physicians for the recognition given to them by their peers through Redbook magazine," CIAN C IO says David C. Hohn, MD, president and chief executive officer of RPCI. "Drs. Edge and Levine lead a team of caring and compassionate cancer specialists who are dedicated to giving breast cancer patients the best possible care, as well as improving outcomes for the disease." Ciancio Receives Cold Medal from AAP Sebastian G. Ciancio, DDS, SU Y Distinguished Service Professor and chair of the Department of Periodontology, has received the Gold Medal Award from the American Academy of Periodontology (AAP). Ciancio received the award- the AAP ' s highest honor-at the group's 87th annual meeting, held this past fall in Philadelphia. The Gold Medal Award is given annually in recognition of outstanding contributions to the field of periodontology and the diagnosis and treatment of periodontal diseases. A member of the AAP for 35 years, Ciancio is a past president of the association, as well as of the American Academy of Periodontology Foundation. He is a consultant for the Journal of Periodontology and an editor for Biological Therapies in Dentistry and Periodontal Insights. Ciancio received the AAP's Clinical Research Award in 1996, a Special Citation in 1994 and the William]. Gies Award in 1988. A prolific researcher, he has authored more than I 00 scholarly papers. Cinsberg's Earigator Device on the Market The Earigator, an ear-wax removal device invented by Irwin Ginsberg, MD '44, adjunct clinical professor in University at Buffalo's Department of Otolaryngology, is currently being marketed by SURYA Technologies of Amherst, ew York. Ginsberg says he identified the need for an improved method of removing ear wax after observing the discomfort that many patients endured while undergoing the procedure, which traditionally involves irrigating with a syringe that injects water into the external auditory canal. In addition to requiring two-people to complete, the procedure is time-consuming and messy, he explains. The Earigator, on the other hand, delivers a large quantity of irrigating water maintained at 3 7 degrees Celsius and is controlled by a pistol-grip tip equipped with an optically programmed trigger. A large deflector disc uses fiberoptics to illuminate the gently pulsating stream of water and the ear canal. The proce- GINSBERG dure can be done in one-third the time of the syringe method and can be performed by a trained medical professional other than a physician. Currently SURYA Technologies is featuring the device at trade shows and arranging onsite demonstrations for audiologists, otolaryngologists, pediatricians and hearing aid dispensaries. "The response to the product has been very good, and we are quite encouraged," reports "THE RESPONSE TO THE [£ARIGATOR] HAS BEEN VERY GOOD, AND WE ARE QUITE ENCOURAGED," REPORTS RAJ BANSAL OF SURYA TECHNOLOGIES. "WE HAD BEEN FOCUSING ON WESTERN NEW YORK BUT NOW ARE TAKING IT NATIONWIDE." ll' i 11 ter 2002 luffalo Physician 29 �PATHWAYS GET C oNNECTED. • • the exclusive right to all PDT compounds and technologies discovered during the next five years of collaboration between Light Sciences Corporation and the PDT Center of RPCI. This agreement also provides - S . A. UN G ER Light Sciences Corporation with a license to certain novel Global Licensing PDT compounds previously Agreement for discovered at RPCI. In return, Photodynamic Therapy RPCI will receive research Roswell Park Cancer Institute funds, licensing fees and cer(RPCI) and Light Sciences tain milestone payments, in Corporation have entered into addition to royalties on coman exclusive global licensing mercialized products. and research agreement for "Light Sciences brings a the development of future unique perspective to PDT Photodynamic Therapy (PDT) that may well extend its use products. both in cancer and Photodynamic other diseases," exTherapy, pioneered plains Dougherty, at RPCI by Thomas director of the PDT J. Dougherty, PhD, Center at RPCI. "Combined with and colleagues, is a several highly effectwo-step treatment tive new photosenthat uses a light sitizers developed at sensitive drug, called DOUGHERTY RPCI over the past a photosensitizer, and visible light to destroy few years that are activated at cancer cells in solid tumors. deep-tissue penetrating wavePDT using Photofrin, a photo- lengths, this collaboration sensitizer developed in the promises to advance the field PDT Center at RPCI, has been of PDT and, most importantly, approved by the U .S. Food benefit patients," he adds. and Drug Administration Projects to be developed (USFDA) and regulatory under this agreement include agencies worldwide for the preclinical and clinical retreatment of certain types of search on several unique comcancers, including lung and pounds aimed at approval by esophageal cancers. health agencies worldwide, The agreement secures for including the USFDA. CD Light Sciences Corporation - CATHERINE D O NNELLY Raj Bansal of SURYA Technologies. "We had been focusing on Western ew York but now are taking it nationwide." Eventually, the product is expected to make its way into the worldwide market. CARITAS MEDICAL ARTS BUILDING 2625 HARLEM RoAD , CHEEKTOWAGA, NY ADJACENT To S r. JosEPH HosPITAL MARIAN PROFESSIONAL CENTER 515 ABBOTT RoAD , BuFFALO, NY ADJACENT ro MERCY HosPITAL SETON PROFESSIONAL CENTER 2121 MAIN STREET, BUFFALO, NY ADJACENT TO S tsTERS H osPITAL 3 PRIME LOCATIONS (ALL CONNECTED TO AREA HOSPITALS VIA ENCLOSED WALKWAYS) 0 SuiTES N ow AvAILABLE 1000-5000 SQUARE FEET 0 FoR MoRE INFORMATION 716.631.8000 ~ CIMINELLI ' 30 luflall Physician \\' i nt er 2 00 2 • Development Company, Inc. �Lawrence D. Jacobs, MD, world-renowned researcher in the an honorary doctorate from D'Youville College. He also received treatment of multiple sclerosis who was professor and chair of a Dean's Award from the College of Arts and Sciences at Niagara the Department of Neurology in the University at Buffalo School University and the Alumni Merit Award from St. Louis University. of Medicine and Biomedical Sciences, died November 2, 2001, Jacobs served on the board of the International Federation of in Memorial Sloan-Kettering Cancer Center in New Multiple Sclerosis Societies, was past president of the American York City. He was 63. Society of Neuroimaging anti was a founding member and former Jacobs' ground-breaking research, geared toward developing better treatment for relapsing multiple sclerosis, led to the development of the drug Avonex officer of the American Academy of Neurology Education and Research Foundation. Jacobs is survived by his wife, the former Pamela Ryan, a (interferon beta·lal the most widely prescribed drug member of the State University of New York Board of Trustees; used to treat this debilitating form of multiple three sons, Christopher L., Luke T. and Lawrence D. Jr., all of sclerosis. As early as 1981, Jacobs' research showed that early treatment of multiple sclerosis with interferon beta·la, a genetically engineered form of beta inter· feron, significantly reduced the rate of progression and impact Buffalo; two daughters, Jessica H. Enstice of Snyder, NY, and Elizabeth R. of Buffalo; two brothers, Max of Captiva Island, FL, and Jeremy M. of East Aurora, NY, who is chair of the UB Council; two sisters, Michelle of Laguna Beach, CA, and Jennifer of Phoenix; and a granddaughter. of the disease, which often includes brain and nerve damage. Jacobs funded his initial work privately, eventually attracting multi-million dollar grants from the National Institutes for Health. In 2000, the New England Journal of Medicine published the results of a large-scale study, led by Jacobs, of the benefits of beta·la interferon in treating multiple sclerosis, which led to the Harvard Health Letter naming his research as one of the 10 leading health advances for 2000. After earning his medical degree from St. Louis University and completing his residency at Mount Sinai Hospital and School of Medicine in New York City, Jacobs returned to his native Buf· falo, where he began his career in medicine as an attending physician at Millard Fillmore Hospital. He served as chief of research at the Dent Neurological Institute from 1985 to 1989. In 1987, he became director of the William C. Baird Multiple Sclerosis Research Center at Buffalo General Hospital, which was devoted to developing better treatments for the disease and excel· lence in patient education, clinical programs and support services. The Jacobs Neurological Institute, which he also directed, was dedicated in memory of his parents, Genevieve and Louis. Jacobs held the Irvin and Rosemary Smith Chair in Neurology in the School of Medicine and Biomedical Sciences, established in 1998 with a 51.5 million endowment from Biogen, manufac· turer of Avonex. He authored more than 200 publications on neurology and served on numerous medical journal editorial boards. He was the recipient of many awards, including the Stockton Kimball Award from the UB School of Medicine and Biomedical Sciences, the Gloria L. Roblin, PhD, the first non-physician to become a full clinical professor at the University at Buffalo School of Medicine and Biomedical Scie ces, died April25, 2001, in Millard Fillmore Hospital. She was 76. Born Gloria Landsman in New York City, Roblin graduated from Barnard College at age 20 and within two years earned a master's degree and joined the Columbia University faculty. She moved to Buffalo and put her career on hold · after marrying local industrialist and civic leader Daniel A. Roblin Jr., who died in 1986. Once her children completed elementary school, however, Roblin returned to UB and earned a doctorate in psychology in two years, finishing the coursework ROBLIN with distinction. During her years as a clinical professor at UB, she pioneered the medical study of both human sexuality and clinical hypnosis. In particular, she was credited with engendering understanding of sexual orientation. An animated and entertaining speaker, her lectures and speeches drew standing-room-only audiences. In 1980, the medical school's yearbook was dedicated to her. Surviving are her husband, Bennett Friedman of Bradford, PA. her son, Daniel A. Ill of Buffalo, and her daughter, Diane Finlayson of Toronto. Stephen B. Kelley Award from the National Multiple Sclerosis Society of Western New York and Northwest Pennsylvania, and r\ 1 tJ t t~ ... llffaft Hysitill 31 �RESEARCH E W S $7.3 Million Crant to Study the Effects of Periodontal Treatment on Heart Disease he University at Buffalo has received a $7.3 million grant from the National Institute of Dental and Craniofacial Research to plan and conduct a pilot study for a clinical trial of the impact of periodontal disease treatment on prevention of second heart attacks. The three-year effort, involving five centers, will set the stage for a definitive clinical trial on a larger scale of the relationship between periodontal infection, which affects 75 percent of Americans, and cardiovascular disease. Robert }. Genco, DDS, PhD, chair of the Department of Oral Biology in the School of Dental Medicine and a SUNY Distinguished Professor, is principal investigator on the grant. UB is leading the study, which also involves the University of North Carolina, Boston University, Kaiser Permanente/ Oregon Health and Science University and the University of Maryland. DDS, PhD, SUNY Distinguished Professor and chair of the Department of Oral Biology in the University at Buffalo School of Dental Medicine. Recently, Genco A Potential New Weapon Against Heart Disease Genco says the grant "provides an opportunity to bring the basic research we have been doing at UB on periodontal infection and its potential effect on the risk of heart disease and stroke into the real world of the clinic. "If we find through this pilot study that keeping gum disease in check appears to lessen the chances of a second cardiovascular incident," Genco continues, "we will be justified in proposing a large-scale clinical trial that should provide definitive answers on the relationship between these two chronic conditions. If the study is positive, it will give us one more weapon in the battle against heart 32 I u f f II 0 p by sic i I D \1 ' i 11 t er 2 0 0 2 was named a vice provost at UB and appointed head of its new Office of Science and Technology Transfer and Outreach, which replaces the UB Business Alliance. The new office will strengthen the university's existing business partnerships and foster creation of new businesses and commercialization of the university's intellectual property. disease; however, we are a long way from having the data necessary to suggest that treatment of gum disease or any infection will reduce heart disease. " The grant will allow Genco and coinvestigators to assemble a team of cardiologists, periodontists, epidemiologists, infectious-disease specialists, biostatisticians, research nurses in periodontics and cardiology, and data managers necessary to carry out a full-blown periodontal intervention trial. The Question to Be Answered The planning period and pilot study are intended to form the foundation for a definitive trial to answer the question "If periodontal infection is suppressed by an anti-infective intervention , will this result in decreased risk of heart disease?" "It is important to answer this question in a clear and definitive fashion before any clinical decisions are to be made to treat periodontal disease for general health reasons," Genco says. �The pilot clinical trial will begin after a nine-month planning and development period. It will include three groups of subjects: one that will receive antibiotic therapy directed to suppressing the local gum infection; a second that will receive local therapy plus treatment with the systemic antibiotic azithromycin; and a third that will receive standard care. The investigators will assess a risk factor for heart disease, the C-reactive protein, which also may be related to periodontal infection. A total of 900 persons who have periodontal disease and have had one heart attack or are otherwise at high risk for a cardiovascular event will be recruited for the trial by the five centers. The pilot trial will be used to refine the infrastructure and to select or refine an intervention protocol for the definitive trial, Genco says. Growin g Evidence of a Link Epidemiological studies conducted at VB and elsewhere have shown an association between various measures of poor dental health and coronary disease, even after accounting for other risk factors. A 1999 study using data collected nationwide through the Third ational Health and Nutrition Examination Survey, for example, found that people with the most severe periodontal disease were nearly four times more likely to have had a heart attack than people with no periodontal disease. Genco's research team at VB, in one of several studies, assessed the presence of specific oral bacteria in heart-attack patients compared to healthy controls. The researchers found that two periodontal bacteria (Porphyromonas gingiva/is and Bacteroides forsythus) were associated with a 2.5 and 3.0 increase in risk, respectively, of heart attack. Periodontal disease is common in the United States. Seventy-five percent of the population suffers mild forms, while 20-30 percent has more severe forms, according to the most recent statistics from the national health survey. "There is growing evidence of a relationship between infection and atherosclerosis, as well as a specific link between periodontal infection and heart disease," Genco says. "Previous studies have established possible effective treatments of periodontal disease, and it is possible these treatments may lead to fewer subsequent myocardial events in people at high risk for cardiovascular disease. Our study is designed to select the periodontal treatment with the best chance of reducing the risk for heart disease." Co-investigators-all from UB-are Maurizio Trevisan, MD, professor and chair of the Department of Social and Preventive Medicine and interim dean of the School of Health Related Professions; Susan Graham, MD, associate professor of medicine; Sara Grossi, DDS, clinical assistant professor of oral biology; Joseph J. Zambon, DDS, PhD, professor of periodontics and endodontics; and Paola Muti, MD, PhD, associate professor of social and preventive medicine. - Lots BAKER \mce /911 Experience the quality of life our Buffalo Niagara region offers by contacting the AWARD WINNING Hunt Real Estate Relocation Team. HUNT Relocation Center There is so much to think about when considering a transfer. We want you to know what our city offers including housing, cultural attractions, education, entertainment and the truth about our climate. If you have a different destination in mind or moving locally let us know and we'll do the rest. CD We don't just move people... We help people move. Call for a free relocation portfolio regarding your Medical Student Research Training Grant Faculty in the University at Buffalo's School of Medicine and Biomedical Sciences have received a five-year, $231,000 training grant from the National Institutes of Health to support summer research fellowships for medical students. The grant will fund stipends for eight first- and second-year medical students to spend 10 weeks during their summer sessions performing a mentored research project that focuses on infectious destination city. Call l -800-888-1170 or go on-line and visit our web site at huntrealestate.com Hunt Relocation Center 5570 Main Street Williamsville. NY 14221-5410 Email: huntrelocation@huntrealestate.com Wint e r 2 00 2 1111111 nysicill 33 �RESEAR C H E W S earc it funds. Murphy has had a long-standing interest in ear and respiratory tract infections. He holds several patents in volving vaccines, in- - $2 Million Crant · Targets Ear and Lung Infections u Scientists at the University at Buffalo, the Veterans Affairs (VA ) Medical Center in Buffalo and Roswell Park Cancer Institute ( RPCI) have received a 2 million program project grant from the ational Institutes of Health to conduct research aimed at developing vaccines to prevent ear infections in children and respiratory tract infections in adu lts with chronic lung disease. Timothy Murphy, MD , professor of medicine and microbiology and chief of infectious diseases at UB and the VA medical center, is principal investigator for the four-year grant, as well as leader of one of the three research projects 34 luflale Phys ician ll'tll ter cluding one for the P6 protein, which he discovered and has been studying for 15 years. This protein is a promising vaccine candidate for the prevention of recurrent ear and lung infections caused by nonencapsulated strains of the bacterium Haemophilus influenzae, and it is currently being tested in early clinical trials in humans. collection of samples obtained from the long-running VA COPD study, in which 110 veterans have been followed. Yasmin Thanava la, PhD, cancer research scientist at RPCI, and Anthony Campagnari, UB associate professor of microbiology, each will direct one of the remaining projects. Thanavala, an immunologist who has performed innovative research in the develop- Ge11tzke & Associates. Inc. Registered Investment Advisor All three projects include studies of clinical samples emanating from a chronic ob- Prinrte Portfolio/ \\' ca It h \ lanagrmcnt structive pulmonary disease (COPD) study clinic that has been conducted continuously since 1994 at the VA hospital by Murphy and Sanjay Sethi, MD, UB associate professor of medicine. The project Murphy is leading will involve experiments to determine the human antibody response to th e bacterium Moraxella catarrhalis, which is a common cause of ear infections in children and of lung infections in adults with COPD. To accomplish this, he and his team will test a 2002 ment of vaccines for hepatitis, wi ll study the human immune response to specific regions of the P6 molecule. She will introduce human lymphocytes into mice that lack immune systems, creating an animal model with a human immune system. The mice will be immunized with P6 and the researchers will study the antibody response. This is the "next best thing" to immunizing people, according to Murphy, because the mice make human antibodies. As another part the project, researchers will collect lymphocytes from healthy donors and Comprrhrn:,i,·r Planning Financial. C~tale. l?etin'lltenl. Tax Tru:,t Sc 1Yice::, Pre<odent and cro Gleon Gefltzke and Oloef Investment StrategiSt Chris King Concierge ScrYicr::, l UB Commons 520 Lee Entrance Suite 205 Amherst, NY 14228 Tel: (716) 639·0475 Holland Office 10661 Crump Road Holland, NY 14080 Tel: (716) 537·2269 www.gentzke.com ri\\-C.HI.I· \<hi-,or 1'1\\ orl ( .t'rl ifit·< I (JuidJJooks Proft•-,-,ionnl \< h i-,or-, �from adults with COPD and study the response of these cells to P6. Campagnari is a widely recognized authority in studies of the mechanisms of infection and the immune response to the bacterium M. catarrhalis. His project involves studies of an important molecule on the surface of the bacterium called lipooligosaccharide, or LOS. This molecule is critical to the bacterium 's ability to attach to the human mucous membranes and to cause the inflammation seen in the ears of children and the airwa ys of adults with COPD during infection. "Understanding the speci fie mechanisms whereby the LOS molecule does this is the first step in designing novel strategies to prevent these deleterious effects of infection, " notes Murphy. " Dr. Campagnari will clone the genes that are responsible for making LOS and make mutant bacteria with altered LOS molecules. This will allow him to elucidate the role of LOS in infections. " In addition, samples from the COPD study clinic will be used to study the human immune response to the LOS molecule. Campagnari also will collaborate with Howard Faden , MD, UB professor of pediatrics at Children 's Hospital of Buffalo , to study samples obtained from children with ear infections. <Ii) - L O IS B A K ER diseases, microbiology or immunology. Twenty UB faculty members with active, extramurall y funded research programs will serve as a pool of mentors for the students. Principal investigator on the grant is Timothy F. Mur- phy, MD, director of the Division of Infectious Diseases at UB's School of Medicine and Biomedical Sciences and chief of infectious diseases at the Department of Veterans Affairs Medical Center. Coprin cipal investigators are Stanley Schwartz, MD, PhD, director of UB's Division of Allergy/ Immunology and professor of medicine, pediatrics and microbiology; and Charles M . Severin, MD, PhD, assistant dean for years l and 2, and associate professor of pathology and anatomical sciences. <Ii) - S. A. UNGE R C'l 2002 Porsche Cars North Amenca, Inc. Porsche recommends seat belt usage and observance of all traff1c laws at all t1mes. Performance specd 1cat 1ons for companson purposes only. a You dream about it. You decide to get it. Then you enter kindergarten. The more kids you have, the more practical it becomes. Maybe it was the shape. Or the sound. Maybe it was so long ago you can't remember what made you determined to someday drive one. Meanwhile, we put the years to good use, making the 320 horsepower 911 Carrera our best yet. A top that glides elegantly back in seconds. A new, more powerful 2.7 mid-engined flat six that pumps out 217 hp. And exactly two seats. The Boxster. If this isn't a perfectly engineered means of escape, what is? ® CULLIGAN F=ICJ~SC:HE: 8135 Main Street, Williamsville • 716-633-5200 • www.CulliganPorsche.com 1Vi11ter 2002 l •ffale Hysicia1 35 �RESEARCH N E w s average amounts, but who drink together and in their own home, tend to be very satisfied with their marriages. We also have found that couples in which the husband and wife have dramatically different drinking patterns are often the least satisfied with their Impact of Alcohol on Marriage Studied The impact of alcohol on marriage-for better or for worse-is the focus of a study being conducted by a scientist at the University at Buffalo's Research Institute on Addictions (RIA) under a new 1.5 million grant from the ational Institute on Alcohol Abuse and Alcoholism. Kenneth E. Leonard, PhD, a clinical psychologist at RIA who also is a research professor Children's Health and Polluted Fish The Toxicology Research Center at the University at Buffalo School of Medicine and Biomedical Sciences will receive $1.3 million over the next five years as a par- "This study will ment of Psychia- ticipant in a new six-member examine how try in the School of Medicine and Biomedical Sciences, is studying alcohol, the transition to mar- children's environmental health change and adapt their drinking patterns to each other over the early riage, and spouse and peer influ ence on the use of alcohol. "While it seem common sense that drinking problems can cause divorce, there also is evidence that some couples can incorporate heavy drinking into the marriage," Leon- years of marriage." ard says. "Our previous research has found that couples who drink frequently and drink above l alfalt Hysician Wt11ter pal roles in the project are James Olson, PhD, professor of pharma- Researchers will look at the effect cology and toxicology, and Rich- of eating fish from these contami- ard Fitzpatrick, laboratory direc- nated sources on the motor, sen- tor of the Toxicology Research sory and mental development of Center. The University of Illinois at Chi- the refugees' children. The project also will involve educating the cago, Michigan State communities on safe fishing University, the New York sites, safe types of fish and pre- State Department paration methods that reduce the of Health and the risk of contamination. The Toxicology Research Cen- University of Texas Health l--\.1~-::::::;;;:~:;;;:::=:~ "(f ter will serve as the core analytical ScienceCen- toxicology facility for the study. ter also are Paul Kostyniak, PhD, director of membersofthe the center, will head the analytical new consortium. core project. Also playing princi- - CD LOIS BAKER -KATHLEEN WEAVER in the Depart- husbands and wives 36 marriage. "This study," he adds, "will examine how husbands and wives change and adapt their drinking patterns to each other over the early years of marriage, and which couple-drinking patterns can have a deleterious effect on marriage." CD important part of the diet of the two refugee groups being studied. research center formed to study the effects on Laotian and Hmong refugees of eating large quantities of contaminated Great Lakes fish. "I've retired my snow shovel!" A5 a semor, l enJoy my mdependence. That:S why the Amberleigh lifestyle IS appealing. Without mowing the lmm, rakmg the leaYe or shm·eling the snow, I have ume to spend on thincr that I enJoy' My monthly rental lee includes three meals a day m a grac1ous dining room, weekly housekeepmg, scheduled courtCS) transportation, plus a \\ide range of socwl and recreational acmiues. If )'l) 1 think Amberielgh IS what you've been lookmg for, why not call today for a personaltour7 Call 689-4555 ... you'll be glad you did' The project, called the Fox River Environmental and Diet Study, or FRIENDS, is centered at the University of Illinois at Urbana-Champaign. The Fox River, which cuts through Green Bay, fv\onthly rent inc udes. we -oppr m•• d ore and twc.bedrocm oporlm •nl • th _ "leo s served dody • w ,kJy h ,, p1ng and mo•n enonce serv• • 24-hour stoffng • emergency resp< n "' •Y''' m • sc~edu ed tronspo • exercise room • pet w1ng • guest apartments is one of the most heavily PCB· contaminated sites in the Great Retirement living... the way you always dreamed it would be. Lakes Basin and the single largest source of PCBs entering Lake Michigan. Fish from the Fox River and Lake Michigan make up an 2002 -~~~!,. 2330 Maple Road, \\'illiamSYllle For a Jtcc brochure or personal row~ Call (716) 689-4555 �DEVELOPMENT N E w s any Rainbows Yet to find By Li nda J . Cor de r , PhD. CFRE the rainbow ended at Farber Hall. There had been a run of gray days, literally and figuratively, so the ephemeral colors leading right to our school seemed to be a good sign, and I spent the remainder of the semester looking for rainbows. New York was hit hard by the tragedies in September, especially those families who were directly affected by terrorists' actions. Budgets, already tight, became more tentative as legislators struggled to decide among competing priorities, and donors dealt with myriad requests under the shadow of a volatile stock market. Within the school, course coordinators, administrators and students met in different types of ad hoc groups to adjust to change and devise plans for finding resources that make our respective responsibilities possible. You are likely aware of some of our efforts. The first full alumni annual appeal was mailed. We are stili receiving responses from graduates of the school's many programs. Class chairs for spring medical reunions are working to increase class gifts. The Pathology and Anatomical Sciences Department held the second annual Terplan Lecture and added several thousand dollars to that endowment. A bequest, "on the books" for more than twenty years, came in, half designated for scholarships, the remainder for a radiology lecture fund and seed money for radiation research. The school also received proceeds from a charitable trust, again designated for scholarships. As a community, we celebrated the life of, and grieved for, Dr. Lawrence Jacobs, chair of neurology, who died "too soon," yet who accomplished much through his research on multiple sclerosis. A dedicated faculty and staff group began plans to augment the Clinical Skills Development Fund, an extremely important account for those teaching students how best to communicate with patients. Family Medicine, the first department to form an advisory board and hire a development officer, launched a drive to increase their departmental endowment, with an initial goal of $250,000. Members of the Medical Emeritus Faculty Group met regularly throughout the year, and the Medical Alumni Association has extended its membership to them. Dean Bernardino and administrative staff joined those in comparable positions for the Asand sllllnts .et illlffmlt sociation of American Medical ~ Colleges' fall meeting in Washington D.C. These gatherings llljlst t1cllaiCIIIIIIIInisl provide a perspective on where the school is now, relative to peer institutions and to its own progress compared with a year, or res,.sillilities jiiSSillle. several years, before. My personal benchmark is the beginning of the campaign, summer of 1996, essentially the same time I returned to UB. That year, Buffalo Physician had an interim editor. This year, the magazine received highest honors from AAMC's Group on Institutional Advancement. In 1996, we had 169 members in the James Platt White Society and raised slightly over a million dollars from alumni and friends. Today, we have commitments for 85 percent of the school's campaign goal of $50 million. We have several new endowed lectures, many more scholarships, nearly 300 White Society members, a few endowed chairs and many planned gifts in the pipeline. We have an active Dean's Advisory Council extending the network of volunteers and donors-which is fortunate because, in one sense, we have barely begun. Those meetings come around with startling frequency and there are many rainbows yet to find. 4D ....,... Linda (Lyn) Corder, PhD, is associate dean for alumni affairs and development. She can be contacted at 1-877-826-3246, or via e-mail at ljcorder@buffalo.edu. ll'111ter 2002 II If a II Pb J sic i a I 37 �STUDENT C L U M Wisdom Shared and Gained B v SvETLANA Moving from Butler Auditorium to the hospital-the third·year experience BLITSHTEY CLASS 0 or NEVER KNEW what "CCIII" meant until a year ago, when as a third-year medical student I left the safe familiarity of Butler Auditorium and entered the unfamiliar surroundings of the hospital. Suddenly, an intricate and exciting world of clinical practice unfolded before me in a way that had been impossible to anticipate in the sheltered environment of a classroom. It was in the hospital, hidden in the white coat, blue scrubs and progress notes, that I found the meaning of CCIII"clinical clerk of the third year"and came to the realization that I occupied the lowest rank in the hierarchy of hospital titles. After two years of basic science, many students welcomed the third year, while others feared the unknown. Regardless of how anyone felt, we all knew that what lay ahead was printed on a schedule: family medicine, obstetrics/gynecology, medicine, psychiatry, pediatrics and surgery. Looking back, I wonder who could have predicted that becoming a CCIII would turn out to be one of the most memorable and fulfilling experiences in medical education? 38 luffall Physician 1\' i 11 t e r 2 0 0 2 Fam· · edicine: Deep Re elation I opened the door to the room where a patient was waiting anxiously for the doctor. She had been coughing, running a fever and feeling so fatigued that washing dishes had become an ordeal in endurance. She was expecting the doctor to uncover the mystery of her bothersome symptoms and make her feel "all better." This expectation changed abruptly when she noticed a short white coat and the phrase "medical student" in the formal introduction. "How much do you know?" she asked suspiciously. "Certainly not enough to feel confident," I thought to myself. With her permission, I dared to continue asking numerous questions and to complete a physical exam. After analyzing her history and physical findings, I suddenly realized that I was about to embark on a crucial milestone in my medical student career: my first diagnosis, a case of pneumonia. At last, the two years of basic sciences and what had, at the time, seemed like useless memorization of details were merging into a whole. The knowledge of anatomy, physiology and pathology of the respiratory system and the knowledge of microbiology and pharmacology related to pathogenesis and treatment of pneumonia were now necessary to help this patient. And so !left the room with a sense of deep revelation: I was ready. Obs et ics and Gynecolor'" Wha• oTextbook Can Teach T he evenly scheduled outpatient appointments of the family medicine practice were followed by the fast pace of obstetrics and gynecology. For the first time, I was spending more than 24 consecutive hours working in the hospital, realizing that in obstetrics and gynecology, night no longer signified a time for relaxation and sleep. The distinction between day and night was forever lost on the floors oflabor and delivery. It was there, however, that I first witnessed something beautiful, something no textbook was capable of teaching me: the birth of a child. I will never forget �standing anxiously by a woman whom I had known only since the beginning of my shift, surrounded by her family, and by nurses and residents. I, the CClll, was allowed, under the watchful eyes of the residents, to deliver a baby into this world. As I tried to hold on desperately to the small slippery body of the newborn taking its first breath, I thought to myself what a privilege it was to take part in the sanctity of this Medicine: An Introduction to the End of Life I have wondered relentlessly what it takes to become a good physician. If I memorize the names of every muscle and every nerve, if I understand the pathology of every disease, if I learn every pathogen and every medication, will I then have acquired sufficient knowledge to become a physician? While my medicine clerkship taught me the basic skills of reading EKGs, interpreting laboratory tests and recognizing emergency states, working with patients taught me the meaning of the phrase "my patient." For the first time, I felt a tremendous sense of responsibility, obligation and loyalty to those chosen among many on the ward as "the best teaching cases." I knew their every complaint, abnormal physical finding and lab value, their daily vitals and pending diagnostic procedures. I was introduced to their family members, was made aware of their occupation and hobbies, and was contacted by their numerous care providers about the status of their condition. One of my patients, a 50-year-old woman with stage IV adenocarcinoma of the lungs, was planning to undergo an experimental treatment at Roswell Park Cancer Institute. Every day she would tell me "''m a little better today," even though her condition was obviously deteriorating. Then one day during grand rounds, she could no longer contain her emotions and began crying. She knew as well as we did that she would not live to undergo the experimental therapy. Struggling to carry on a conversation, she described her feelings of desperation, hopelessness and fear of impending death. She was already grieving for herself, for her children and for her seven-year-old granddaughter, whose get-well picture posted by the bed served as a subtle reminder of a future stripped of watching her grow. I ;\lE;\lORIZE 1 HI.:. I With her permis· patient is gone." sion.l dared to continue asking Psychiatry. Compassion and Complex Ques ions ompassion in medicine is viewed not as a trait of character; it is emphasized as an essential element that defines the physician as a healer. Compassion is naturally felt toward a patient battling cancer or a severe physical disease. However, to feel this emotion for those suffering from a mental illness requires a willingness to look past the disease, as well as an encounter that may influence how one views mental illness. For me, this encounter occurred when I was asked to evaluate a 50-year-old man with chronic schizophrenia who was accompanied by his sister. Her concern was that "he just wasn' t himself lately": He acted confused and lethargic and appeared physically ill. Although his presentation was less than typical, he exhibited several signs and symptoms suggestive of acute exacerbation of schizophrenia. As a result, he was admitted to the psychiatric unit and placed temporarily in the isolation room. While I tried to convince myself that my limited experience in psychiatry precluded disagreements with the higher authorities, 1felt perplexed. There were certain aspects in the history and presentation of this patient that were inconsistent with a diagnosis of schizophrenia. Could it be that the etiology of his symptoms were rooted in a different disease? I wondered. The answer came with the results of the routine laboratory tests taken upon admission, which, fortunately, I decided to check before leaving the hospital. Printed in bold on the computer screen with the letter "C'' attached for "critical'' was a blood sugar value ten times higher than normal. Instantly, the diagnosis changed from acute exacerbation of schizophrenia to a life- threatening complication from undiagnosed and untreated diabetes mellitus. While the patient was being transported to the intensive care unit for treatment, a psychiatrist on the ward approached me. H e thanked me for A;\lES oF J:\ ER\ J\IuSCLF A. o I-.VER\ • ~::RVE, Ir PATHOLOGY OF EVERY DISEASF, IF \\'ILL her family. The next morning I was approached by one of the nurses, and for the first time I heard the words "Your C family's happiest occasion! IF I later witnessed the final hours of her life as she gasped for air, trying to maintain her strength for I I u. · o~::Rs rA numerous questions and to complete a physical exam. After analyzing her history and physical findings. I suddenly realized that I was about to embark on acrucial milestone in my medical student career: my first diagnosis. acase of pneumonia. n 1 HE lEAR.' bYFRY PATHOGL' A. 'D EVERY ;\1EDICAriO, , THE.' HAVE ACQUIRED SUFFICIE. ' T K. ' 0\\'LFDGE TO BEC0:\1£ A PHYSIUA. •? \\' irrter 2002 luffalt Pbysiciaa 39 �STUDENT COLUMN calling attention to the problem, mentioning that "the patient's life was saved" because I checked his lab results. Although I felt honored by his words, I did not feel proud. If this man had lost his life to diabetic coma, would it be because he also had a mental illness? Who would be to blame for his death? The psychiatrist whose diagnosis was confounded by the past psychiatric history? The primary care physician who never addressed the problem of hyperglycemia, IF YOU ARE A STUDENT although it had been demonstrated several OR RESIDENT INTERESTED times in the past? Or was it the patient's fault IN CONTRIBUTI G TO for being noncompliant with keeping appointTHIS COLUMN , E - MAIL BP - NOTES@BUFFALO. EDU ments and taking medications, for being unTO SUGGEST A TOPIC. able to express or comprehend the nature of his physical symptoms, for being apathetic to his health because he suffered from a mental illness? As I looked at the patients through the window of the locked doors on the psychiatric ward, I thought of others who, by the very nature of their illnesses, are incapable of being actively involved in their healthcare. All they can do is trust the people in white coats and hope that they can find the right treatment and have some compassion for their souls. Your Turn? Pediatrics: No Need for aStethoscope A s we walked through the long hospital corridors during morning rounds, I glanced at a nearby bed where a 15-year-old girl had just received a diagnosis of insulin-dependent diabetes mellitus. She sat alone in her room crying. As the team of residents and students proceeded to discuss her case- presented with an admirable degree of accuracy by a pediatric intern- the verdict was confirmed: a classic manifestation of diabetes. The treatment plan was simple and concise: administer insulin, check blood glucose and urine ketones, enroll in the diabetes teaching program and begin her on a diabetic diet. " othing exciting," the senior resident said, "just a typical case of new-onset diabetes." The team then moved to the next room where another case was waiting to be discussed. At the end of the official rounds, I decided to visit the girl. She had stopped crying and was looking out of the window, perplexed. She told me she dreamt of becoming a dancer and had been taking dance lessons since she was five. "What will my life be like?" she wondered aloud, expecting a reply. "Will I ever become a dancer, now that I have this disease?" 40 IDIIIII rhysiciaa II' 1 11 re r 2 0 0 2 As I thought of my response, I began to realize the complexity of my situation. This girl needed comfort, support and guidance. She was not interested in hearing the pathophysiology of diabetes, or the plan of treatment outlined in her chart. or was she interested in the statistics of long-term complications, or the benefits of tight glucose control. She just wanted to hear from me that she will be all right; that despite the daily insulin injections and glucose checks, despite multiple visits to doctors, emergency rooms, and even intensive care units, she will be able to reach for her dreams and lead the life she desired to have. I sat down next to her, listened to her and reassured her, and for that I did not need a stethoscope. Surgery: AFascinating and Intimidating Close here is something mysterious about the way lights shine on the operating table and the way people ' dressed in blue gowns and masks work diligently in an atmosphere of precision governed by concrete commands. The profession of surgery- and the demands imposed on those who dare to join itboth fascinates and intimidates. Surgery is the clerkship concluding the yearlong journey as CCIII. Its completion brings us to the finish line of the third year and grants us the higher status of CCIV. Six clerkships ago, the third year of medical school seemed as unattainable as a mountain that I had to climb before reaching the next destination. Looking back at the accomplishment, the height of the mountain was merely a product of heightened anticipation. Living it day by day, week by week, clerkship by clerkship was nevertheless difficult and, at times, overwhelming, but a small price to pay given the rewards. ow another class of students joins the ranks of CCI lis, wondering whether the third year will be a positive experience. Like all of us, they will be immersed in the details of rotations, hospitals, grading and exams, while becoming oblivious to the insignificance of each in shaping an overall experience. As I am nearing the completion of the year I realize, in retrospect, that the experience was about more than an education in the clinical practice of medicine and how to function in it. It was also about lessons learned from the lives of the patients, wisdom shared by those who care for them every day, and knowledge gained as a medical student and, above all, as a person. CD �Mark your calendars Sherman Waldman. MD '57 Saturday, April 27. Fo~ more information, call the Medical We're all still here! Carpe diem! We should all enjoy each other while we can. Please consider a glorious 45th reunion. Alumni Association at (7161 829-2778. The reunion classes are 1947, Sebastian S. Fasanello. Sr. MD'&2 1972, 1977, 1982, God bless America. We must maintain our traditions. I'm looking forward to seeing you in April. James F. Phillips. MD ·.n Dear Classmate, I am chairing this year's 55th reunion for our class. Please attend. The dinner will be held at the best restaurant in town: my house at 106 Depew AYenue, with Western New Yoril's best chef, my wife, Marcella. Thomas P. O'Connor. MD '&7 Congregate and celebrate 35 years of the finest profession on earth. Donald (. Miller. MD '&7 The face of medicine has changed drastically since 1967. Has yours? Let's get together and share war stories. Robert I. Baumler. MD "52 There haYe been a lot of changes in medicine during the past half century. Come to our 50-year reunion and let us fill each other In on what has been going on with us and medicine during those years. Linda I. lam. MD "72 Thirty years! Let's get together to celebrate, reminisce and renew friendships. Ileal W. Fuhr. MD '52 Start making your plans now to join those of us who remain for our sr medical school reunion. So much has happened to all of us since graduation. Come and bring us up to date oa your life in and out of medicine! Gregory (. Young. MD '77 Try to make every effort to join us as we celebrate the 'Silver AnniYersary' of our grad· uation from medical school. Come back and see how UB has changed! H • n t e r 2002 I 1 I I I I I P' 1 1 i C i 1 I 41 �Which can you afford to waste? FEATURES BENEFITS • Electronic submission of all major insurance claims • Increase your accounts receivable turnover • Follow-up of all unpaid claims and open patient accounts • Improve collection ratio and reduce bad debts • Advisement on and assistance with insurance carriers and government regulations • Optimize revenue through proper monitoring of charge master • Choice of processing options including on-line or full-service • Eliminate costs associated with computer software and maintenance • Easy start-up or conversion from present billing system • Transition smoothly and quickly while maintaining cash flow • Appointment scheduling software available on request • Improve office efficiency and patient satisfaction • Expertise on existing and new • Assure your patients' rights are corporate compliance guidelines protected • Practice management with • Gain peace of mind from professionally trained staff and knowing that your finances are experienced C.P.A.'s being managed optimally Thomas A. Maher, C.P.A. President 50 Alcona Avenue MEDICAL B ILLING S PECIALISTS Amherst, NY 14226 Tel: (716) 834-1191 Fax: (716) 834-1382 e-mail: pbs50@aol.com �Dear Fellow Alumni, ~e winds of change continue to blow through our medical school. I see these changes as signs of positive growth, and not just change for the sake of change. Following the membership vote on Spring Clinical Day, the Medical Alumni Association (MAA ) is now welcoming as members emeritus faculty, PhD graduates, residents of our affiliated teaching hospitals and postdoctoral fellows. These additions will both broaden and strengthen the interests of the association. Dean Bernardino decided that the informal working relationship between the school's offices of Alumni Affairs and Development should be formalized. Thus, late in the semester, we welcomed Mary Glenn to her first MAA board meeting in her new official role as director of constituency relations. In this capacity, Mary will serve as the school's liaison with our association. Another significant change in our association is the departure of ancy Druar on December 31, 2001. As most of you know, Nancy was secretary in the MAA's office for the past 21 years and was responsible for coordinating its day-to-day operations. In addition, she was instrumental in planning the school 's annual Spring Clinical Day and Reunion Weekend. ancy's presence and singular competence will be missed, and we wish her all the best. As we incorporate these and other changes, our association will stay true to its goal of initiating and supporting social and educational projects related to the school. These projects will no doubt be enhanced by the increased involvement of Lyn Corder, whom Dean Bernardino has named associate dean for development and alumni affairs. We welcome Lyn's interaction with all alumni and know that the merger of these two offices within our school be a "work in progress" throughout this next year. In September, the past presidents of the MAA gathered to toast our newest Distinguished Alumnus, Marshall Lichtman, MD '60. We congratulate Dr. Lichtman on receipt of this award and invite you to read more about his remarkable career and accomplishments on page 17 of this issue of Buffalo Physician. Also this past fall, the Reunion Class Chairs met for dinner to continue the planning for reunions that will be held in conjunction with Spring Clinical Day, April27, 2002. The program will take on a historical flavor this year, with the theme "Presidential Assassinations in the 20th Century." jack Fisher, MD '62, will deliver the Stockton Kimball Address. Finally, I continue to ask for your support of our alma mater through your interest, time, jOH N j. BODKIN!! , MD '7 6 President, Medical Al11mni Association �C L A 1940s Maynard Mires. MD ·46, Georgetown, DE, Preventive Medicine, writes: "! am now retired. I have N 0 T E Herbert Pirson. MD '46. Orchard Park, NY, Diagnostic Radiology, writes: "I am retired. My favorite memory was graduation." E-mail address is hsp-ecp@ worldnet. att.net. Daniel A. Phillips. MD '51. 1950s Carl R. Conrad. MD '51, Clarence, NY, Internal Medicine, writes:"! will never forget my first day with Dr. 0. P. jones." E-mail address is carldocc@cs.com. , Gen- Williamsville, Y, Radiology, writes: "My wife, having fun with special Leslie, and I have five grown children. Who fond memories of the old Medical School at 24 with Harold Levy and Ross lmburgio in the old High Street, where the worn steps, the antiquated amphitheater on High Street." fixtures and the memorials on the walls reminded me that we are all part of an ancient and honorable could forget Doc Leonard's messages to the graduates?" Alvin Volkman, MD '51, Me Cutcheon. Greenville, NC, Pathology, writes:"! have so many favorite memories MD'56. of medical school. Physical diagnosis provided our first clinical experience, but my group was not satisfying our instruc- tor Dr. john Boylan. He demanded more than we seemed capable of doing. Finally, we got it all to- am retired from a pri- McCuTCHEON vate practice in Michi- 1960s ting pretty smart.' We were on our way to being Long Beach, CA, OBI G , writes:"! am chief doctors." E-mail address is alphavic@earthlink.net. of staff at Kaiser Permanente Medical Center in Anaheim, CA. Mark A. Dentinger, MD '56, Carmichael, CA, writes: "!am retired. When I My favorite memory of medical school was carrying anatomic specimens think of medical school, I think fondly of the from Buffalo General Hospital to the medical original school on High Street." school in the trunk of my car in metal pails. I always feared I would Daphne, AL, Otolaryngology, writes:"! and kidneys thrown across the roadway." am on the GACEK 2002 Kenneth E. Bell. MD '61. be in an accident with multiple livers MD'56, IV1111er gan. Friends can e-mail me at wrenwood@ webtv.net." gether, and Dr. Boylan said in his slow stutter, 'You gentlemen are get- Richard Gacek. l uflale Physician Pittsboro, C, Internal Medicine, writes:" I assnotes tradition. My wife, Ruth, and I are pictured here with our family." 44 ries of medical school include the old building on High Street and "Doc" Leonard. Sue A. Eugene Leslie, MD '51, eral Surgery, writes: "My favorite memories include friends, and shooting dice Danny Cordova and Bob Burke." E-mail address is hospital staff at the University of South Alabama. My wife, Elaine, and I have four grown children. My favorite memo- madap@prodigy.net. Fred Schwarz. MD' 46, Williamsville, Reno, , Orthopaedic Surgery, writes: "I am retired. My favorite memories include my marriage to Mary Ann in 1949, the good friends like the late �Harold Brody. MD '61, PhD. Wayne P. Fricke. MD '66, Brody's late wife, Anne, was recently honored as one of 100 outstanding women in the history of Western ew York. A stone was placed on the Women's Walkway- Olcott, Y, Orthopedic Surgery, writes: "I am retired and enjoying life." E-mail address is frickes@attglobal.net. located at the HSBC Arena and the Waterfront-to recognize her work in helping to establish the International Committee of the Women 's Club of the State University of ew York at Buffalo. This committee has helped students, faculty, and families to adjust to living in the United States. Anne Brody also pioneered in establishing the Adult Day Care Program at the Amherst Center for Senior Services. Marino, CA, Hematology/Oncology, writes: "! am on the faculty of the University of Southern James R. Markello, MD '61, Greenville, C, Pediatrics, writes: "I am retired. One of my favorite memories is the evaluation session at the home of Mitchell Rubin, MD, professor and chair of pediatrics." E-mail address is munmark@ earthlink.net. Thomas W. Bradley, MD '66, Tonawanda, Y, Family Practice, writes: "Retired August 1, 1999." E-mail address is tomjan1936@ aol.com. Cary Presant. MD '66, San California School of Medicine as professor of Clinical Medicine and Oncology. One of my most vivid memories was being tested by 0. P jones in gross anatomy on Saturday morning, and I did not have many parties on Friday nights during that course." 1970s Jerald A. Bovino. MD '71, Aspen, CO, Ophthalmology, writes: "!remember Saturday morning anatomy questions from 0. P. jones; Dr. Megahed's kindness and teaching generosity; my good fortune in having wonderful classmates; our great parties to music of the Beatles (Sergeant Pepper's Lonely Hearts Club Ba11d)." Scott A. Kirsch, MD '71, the people in my class, but most of all the UB campus, which is where I met my wife." Richard A. Manch. MD '71. Phoenix, AZ, Internal Medicine, writes: "I am on the staff at the University of Arizona College of Medicine and the Good Samaritan Regional Medical Center. Fondest memories are gross anatomy lab with Robby Kaufman, Henry Milgrom, Mike Armani." 1980s Shirley A. Anain, MD '85, has been elected president of the medical staff at Sisters of Charity Hospital, part of the Catholic Health System, in Buffalo, NY. Anain has been a member of the hospital's medical Young B. Huh, MD '89, staff since 1992. She com- writes: "! completed a pleted her residency in general surgery and plastic surgery at the Cleveland Clinic Foundation and a fellowship in plastic gastroenterology and hepatology fellowship in 1996 at the University of Pittsburgh Medical Cen- surgery at the Hospital for Sick Children in Toronto, Canada. She will serve a one-year term. Mitch lublin. MD '88, and Mary Davitt, MD '88. re- cently moved back to Pittsburgh, PA. Mitch is chief of ultrasound at University of Pittsburgh Medical Center in the Department of Radiology. Mary plans to return to practicing general pediatrics soon. E-mail address is: tublindavitt@msn.com. ter. I have just joined Gastroenterology Associates, P.C., in Quad Cities, !A. My wife, Veronica, and I have two children: Christopher and Hannah." E-mail is kimhuh@aol.com. 1990s Deb (Delozier) D'Souza and John DeSouza. MD '94, write: "We recently celebrated the birth of our second child, john joseph, on june 12, 2001. His older sister, Irene, is four. We also recently moved to Toledo, OH, where john is practicing neuroradiology, and I plan to practice OBI Commack, Y, Family Practice, writes: "My favorite memories include GYN. Chris Wood, MD '94. writes: "! recently married julie Marz, an architect. We're living in a suburb of Chicago and I'm practicing ophthalmology." E-mail address is fenny90@hotmail.com. E-mai CD RICHARD MAN CH AND fAMILY. Wi11ter 2002 l ulfall Physician 45 �A t last year's Spring Clinical Day and Reunion Weekend, we decided to have a little fun with the Class of 1976, which was celebrating its 25th reunion. In addition to asking class member to provide us with an update on their families and careers, we also requested that they have their pictures taken. Little did they know that we also had managed to lay our hands on a 1976 issue of Iris, as evidenced below! \I ~ R Y G L E .• S D I R l C T 0 R 0 F C 0 " ST I C Y R E L A I 0 S S 0 F I C E 0 F \I E D I C A L 6, Dayton, Ohio. Chris is certified in internal 18a top medicine and gastroenterology and is chief of medicine at Dayton VA Medical Center. Susan is a consultant in allergy and respiratory medicine. They have two children, Christian and Andrew. Ch John Bodkin, MD '76, Williamsville, NY, family medicine. Bodkin is the president of Highgate Medical Group and president of the UB Medical Alumni Association. He and his wife, Maria, have four boys, Jack, Michael, Ryan and Andrew. athl n (Can ell) c er an D '76, Bethesda, MD, child psychiatry. Ackerman and her husband, Ronald, have two children, Elizabeth and Jeffrey. Kathleen writes: "My favorite memory of UB is graduating and seeing my father-an MD who graduated from UB's School of Medicine-just beaming." E-mail address is drwireman@aol.com. Christopher Brandy, MD '76, Morristown, Y, general surgery. Brandy and his wife, Linda, have three children, John, Brian and Kathryn. Friends can e-mail him at curtieb@giseo.net. GreggB o man, MD 76, Glenwood, NY, medical management, pediatrics. Broffman is a member of the governing board of the Medical Alumni Association. He and his wife, Denise, have three children, Lauren, Andi and Jake. Gregg writes: "One of my favorite memories of UB is time spent with friends at Don George's family cabin in North Java." E-mail address is lbroffman@aol.com. Paul B. Cotter Jr.. MD '76, Cohasser, MA, ophthalmology, writes: "Who can forget Dan Wild's bachelor party." Paul and his wife, Margaret, have three children, Paul. E-mail address is pbcotter@hotmail.com. lndr w artin Gage, MD. '76, Williamsville, athaniel, John and Y, general and vascular surgeon. Gage is director of the Noninvasive Diagnostic Vascular Lab in Williamsville, NY. He is married to Mary M. Burke. •6 l1ffal• Pbysici11 \V I II t e r 2 0 0 2 A L U ~~ �(married to Patrick Hayes), Dublin, OH, internal medicine, writes: "My favorite memories include study dates with Pat, lunches with special friends at the 'Tiffin Room,' and movie parties at Grant Golden's." E-mail address is karen.glasgow@ mailcity.com. Kare Patrick R. Hayes MD '76 Dublin, OH, emergency medicine, writes: "One of my favorite memories is meeting my future wife in gross anatomy!" Patrick and Karen have a son, Gavin. E-mail address is pathayes@mailcity.com. r S Buffalo, NY, diagnostic radiology. Golden is married to Deborah Goldman, and they have three children, Holly, Geoffrey, and Margaret Curtis. Golden is on the hospital staff St. Joseph's. E-mail address is old-chestnut@hotmail.com. Donald Geor e. MD '76 Jacksonville, FL, pediatrics. George is chief pediatric/nutrition at Nemours Children's Clinic. He and his wife, Linda, have four children, Sarah, Katherine, Christopher, Elizabeth. E-mail address is dgeorge@mediaone.net. n M.levitt, MD' Nashua, H, dermatology. Levitt and his wife, Deborah, have been very busy with their five children, Michelle, David, Tammy, Stephen and Scott. He is in private practice in New Hampshire. Step ShinY liongMD 76. Anaheim Hills, CA, internal medicine. Liong works in Rancho Cucamonga as a clinical physiatrist. Pa · 6. Olean, NY, surgery. Schwach and his wife, Barb, have three children, Davis, Rebecca and Catherine. E-mail address is docschwach@yahoo.com. Michael Smith. MD, '76. Reidsville, NC, family practice. Smith works in a a val Hospital in Camp LeJeune in Jacksonville. Laszlo lomas he , D' 6, Cleveland, OH, ophthalmology. Tomaschek works in Parma, OH, with his wife, Susanne. Linda Wild MD 76. Buffalo, Y, pathology. Linda Wild is an associate professor of clinical pathology at UB's School of Medicine and Biomedical Sciences. E-mail address is wil@buffalo.edu. Linda's husband, Dan Wild, MD '76, is an orthopaedic surgeon in private practice in Buffalo. They have two children, both of whom are in college, Katherine (Katey) and Michael. 4D Wi11ter 2002 l uff1le Physiciu 47 �WINTER Kenneth M. Alford, MD '37 Kenneth Alford, MD '37, a prominent member of the Buffalo medical community and a decorated Army veteran, died October 26, 2001, in his Buffalo home after a long illness. He was 89. A Buffalo native, Alford attended Lafayette High School, where he was an AllHigh basketball playerfor two years. Following graduation, he attended Colgate University, where he also played basketball. After college, he returned to Buffalo to study medicine at the University of Buffalo, graduating in 1937. Alford interned at Buffalo General Hospital and the Hospital for Sick Children in Toronto, where, from 1939to 1940, he was chief resident in to 1982 and a fellow in adolescent medicine at Harvard Medical School and Boston Children's Hospital in 1971 and 1972. He served as trustee of CHOB from 1979 to 1993 and as a director of the Cummings Foundation from 1975 to 1997. Alford is survived by his wife of 61 years, the former Joan Wendt; a son, David H. of Durango, CO; a daughter, Anne Surdam of Buffalo; four grandchildren; and a greatgrandchild. FrankT. Riforgiato, MD'39 Fran T. Rifor& ato, MD '39, died unexpectedly October 26, pediatrics. During that time he was also an instructor in pediatrics at the University of 2001, in Sisters Hospital. He Toronto Medical School. A World War II Army veteran, Alford served five years medicine on Buffalo's West Side for 46 years, was born In Buffalo in 1913 and attended elementary schools in the city. He attended Canisius High School, graduating in 1931, and then went on to Canisius College, earning a bachelor's degree in 1935. Following graduation from the then-University of Buffalo Medical School in 1939, Riforgiato interned at Sisters Hospital and com- in the 4th Medical Battalion. On D-Day, he was part of the landing force on Utah Beach and served as commanding officer at the clearing station hospital, caring for and evacuating the wounded soldiers. For his efforts, he was awarded the Bronze Star. Following the war, Alford joined the pediatric medical staff at Children's Hospital of Buffalo (CHOBI, where he was attending pediatrician from 1977 to 1982. He also was a member of the pediatric staff at Millard Fillmore and Buffalo General hospitals. At Buffalo General, he served as chief pediatrician from 1950 to 1977. 48 Alford was clinical professor of pediatrics at the University at Buffalo from 1973 lllllll Pbysicill was 87. Riforgiato, who practiced pleted his medical residency at the former E.J. Meyer Memorial Hospital in 1941. During World War II, Riforgiato served in the Army, rising to the rank of captain. He was stationed in Surinam, South America, from 1941 to 1943, and also was based at Camp Butner in North Carolina and hospitals and clinics \\ ' 1 11 t e r 2 0 0 2 in Kansas, including the Menninger Clinic. After returning to Buffalo, Riforgiato practiced general family medicine for 46 years on the lower West Side of the city, retiring just a few years ago. "He probably delivered about half the babies in Buffalo during the baby boom," says his son Francis. Besides his wife of 60 years, the former Mary Cecina Gallo, survivors include two daughters, Margaret Mary Rumunno of Conway, NH, and Mary Frances Nagel of Gilmanton, NH; three sons, Leonard of Miami, Philip of Eggertsville and Francis of the Town of Tonawanda; a brother, John of Amherst; and six grandchildren. PaulA. Cline MD'43 Paul A. Cline, MD '43, a retired Kaiser Permanente surgeon, died in Parma, OH, on June 26, 2000, at age 80. A resident of Strongsville, OH, since 1972, Cline began his ten-year tenure as chief of surgery for Kaiser Perrnanente Hospital in Parma a few months after joining the staff in 1973. He retired as a surgeon in 1989, but continued working as a consultant at Kaiser's Musculoskeletal Clinic for a few years. Born in Budapest, Hungary, Cline came to the United States at a young age. Following graduation from US's school of medicine in 1943, he interned at Massachusetts Memorial Hospital in Boston. After a three-year stint in the Army, he served residencies at former E. J. Meyer Memorial Hospital in Buffalo, NY, 2002 and at the Veterans Administration hospitals in Buffalo and Batavia, NY. For 20 years, Cline had a general surgery practice in Buffalo and was also clinical assistant professor at UB and an attending surgeon at Kenmore Mercy Hospital. He is survived by his wife of 28 years, Harriett "Hattie"; daughters, Sandra Schlerf of Columbia, SC, and Barbara Warren of Lawrenceville, GA; son, Clifford of Dallas, TX; stepdaughter, Holly MacMurray of Orchard Park, NY; stepson, Daniel Lewin of Los Altos, CA; two grandchildren; three great-grandchildren; and a brother. Earl K. Cantwell, MD'4S Earl K. Cantwell, MD '45, a former Erie County medical examiner who practiced obstetrics and gynecology for many years, died on April4, 2001, in Kenmore Mercy Hospital, Town of Tonawanda, NY, after a lengthy illness. He was 80. Born in Buffalo, NY, Cantwell graduated from Amherst Central High School in 1938 and completed his undergraduate and medical studies at the then-University of Buffalo, where he received his medical degree in 1945. After interning at the former E. J. Meyer Memorial Hospital, he joined the Army Air Forces, and in 1948 graduated from the School of Aviation Medicine. He was aviation medical examiner at Griffis Air Force Base in Rome, NY, before leaving the service with the rank of captain. After returning to Buffalo, he met Rita J. Roll, whom he married in 1950. Cantwell worked at Deaconess Hospital and maintained a general practice until 1956, when he decided to become an obstetrician-gynecologist and moved his family to Indianapolis to serve a residency at St. Vincent Hospital. After working at the Sault Ste. Marie Clinic in Michigan, Cantwell returned to Buffalo in 1963. He was county medical examiner for 15 years and Amherst town physician for five, as well as a school doctor for the Buffalo Public Schools. He also was a civilian Armed Forces examining officer for 21 years and chief medical officer at the Armed Forces entry station in Buffalo for 10 years. Cantwell maintained an OBI GYN practice in his Amherst, NY, home before retiring in 1984. "By temperament and spirit, he was a physician, and that calling defined his life," says his son, Kevin, of Amherst. "His passion for medicine inspired two of his children to become doctors as well." In addition to his wife and son, Kevin, he is survived by two daughters, Dr. K.C. Ackerman of Bethesda, MD, and Mary Beth of Buffalo, NY; two other sons, Earl K. II of Buffalo, and Dr. Michael of San Francisco, CA; and seven grandchildren. Ansel Robert Martin, MD '48 Ansel Robert Martin, MD '48, who studied dermatology under Dr. Earl Osborne, died on July 17, 2001. <Ii) �Early nineteenth century Italian tourniquet with a brass key and iron-cogged-wheel tightening mechanism. The brass frame is stamped "Giannattasi In Napoli." The tourniquet has many brass and iron decorative flourishes, including the fluting to the screw heads and the iron loop of the catch. In the ear1y 18th century, Jean Louis Petit, a French surgeon, invented the screw tourniquet to control bleeding. The device made thigh amputations possible and reduced risks associated with amputations below the knee. Tourniquets similar to the one pictured here were still in use during the American Civil War. The instrument is part of the Edgar R. McGuire Historical Medical Instrument Collection, housed in the Robert L. Brown History of Medicine Collection, Health Sciences library, Abbott Hall, on the University at Buffalo's South Campus. �CM I SC CATHY GEAqy HE~LTH p H A ] SCIE CE LI~R RY SOUTH C MPU 130 ASEOTT H ll CAr-PUS "'1 IL A UB's HISTORY OF MEDICINE COLLECTION PRESENTS PHARMACOPOEIA. Digitally reproduced prints from a pharma copoeia by Otto Karl Berg (1815 - 1866) were on display last fall in University at Buffalo's Health Sciences Library (HSL), outh Campus. The botanical show was developed by the HSL and the university' s iMedia staff and is the first in a series of "Art in the Library"' exhibits intended to promote the History of Medicine Collection through the display and sale of reproductions of selected works. F1·ed Kwiecien and Don Trainor of iMedia prepared the prints from the original art in the Berg volume, pub lished in Leipzig in 1863. Pictured is Colchicum Autumnale (Autumn Crocus). HP 0001 02 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 2002 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2002-Winter Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v36n03-2002-Winter Table Of Contents A list of subunits of the resource. Healing in the Aftermath First Impressions, Lasting Memories One Woman's Global Concern medical School Alumni Pathways Research Student column Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v36n03 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2002 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/a8125407dc7b423205f6a95c526ca3db.pdf d2631d990ed32d2649e035f8361406c4 PDF Text Text �l1fhh ••ysicial LIB_R_AR_Y_ _ L - -_ _ j ASSOCIATE VICE PRESIDENT FOR UN I VERSITY COMMUN I CAT I ONS Dr. C arole S nrit/1 Petro D I RECTOR OF P ER I OD I CALS Sue Wu e tcher New Dean Named EDITOR S t ephani e A . U n ge r ART DIRECTOR/DESIGNER A lan f . Kegle r N JUNE 28,2001, University at Buffalo Provost Elizabeth D. Capaldi, PhD, announced that CONTR I BUTING W R ITER the positions of vice president for health affairs and dean of medicine would be recombined, Lois Bake r and she named Michael Bernardino, MD, MBA, to the role, effective immediately. Bernardino has been serving as vice president for health affairs at UB since the spring of PRODUCT I ON COORD I NATOR Cy nthia Todd-Flick 1998. As the new dean of the School ofMedicine and Biomedical Sciences, he succeeds John R. Wright, MD, who has served in that capacity since 1998 and as interim dean since 1997. UN I VERS I TY AT B UFFALO ScHOOL OF MED I CINE AND Before assuming that role, Wright was chair ofUB's Department of Pathology for 23 years. In citing reasons for the consolidation, Capaldi explained that "given the current period of rapid change in the field of medicine, the university has decided that leadership for the school can most effectively be provided by one individual who is responsible for its overall educational and research mission, its financial affairs and its relationship with its affiliated teaching hospitals." Capaldi also announced that Wright will continue to serve as professor of pathology in the School of Medicine and Biomedical Sciences. "We all appreciate Dr. Wright's leadership in developing the school's new curriculum and in building a support base for the school with the alumni, students and other constituencies," she said. "These contributions form a strong basis for continued excellence." Prior to coming to UB, Bernardino served as director ()f managed care with the Emory University System of Health Care, in Atlanta, and was a professor of radiology in the Emory University School of Medicine. As vice president for health affairs at UB, he has been responsible for overseeing the clinical and collaborative activities of the university's five health sciences schools: medicine and biomedical sciences, dental medicine, health related professions, nursing and pharmacy and pharmaceutical sciences. He has also been responsible for spearheading the university's relations with its affiliated teaching hospitals and for leading the healthcscience deans in planning and executing joint and cooperative B I OMED I CAL SCIENCES Dr. Mi chael Bernardino, Dcatl EDITOR I AL BOARD Dr. john Bodkin Dr. Martin Brech e r Dr. Harold Brody Dr. Linda f . C orde r Jason Hoffman, C la ss of 2004 Dr. fame s Kan ski Dr. Elizabeth Olm st ed Dr. fames R . Olson Dr. Stephen Spaulding Dr. Bradley T. Truax Dr. Franklin Zeplowitz TEACH I NG H OSPITALS Erie Co unty M edi cal Ce11t er Ros well Park Ca11 ce r In stitut e Ve tera11 s Affairs W es tenr New York Health ca re Sys t em K ALEIDA H EAITII: T he Buffalo Ge11 eral Ho spital Th e CIIildre11 's Ho sp i tal of Buffa lo Mill ard Fillmo re Ga tes Hosp i tal Mi llard Fillm ore S ubu rban H ospit al CA TIIOLI(. H EALTH s )'S1"EM : M ercy Health Sys t em Sis ters of Clwrity Hospit al programs of teaching and research. Earlier this spring, it was announced that Bruce Holm, PhD, senior associate dean for research in the School of Medicine and Biomedical Sciences, has been given the additional N iagara Fa lls M emoria l M edi cal Ce 11t er title of senior associate vice president for health affairs, reporting to Bernardino. @ John Hay, PhD, Grant T. Fisher Chair of Microbiology at UB, has assumed Holm's former administrative responsibilities related to the school's graduate programs in biomedical education. Also, the position of assistant dean for alumni affairs-formerly filled by Bertram Partin, MD '53-has been discontinued, with plans under way to restructure administrative roles in the Medical Alumni Office. UNIYEISIIY l!IUIIILO. THE STilE UNIYEISITY 01 NEW YORK Letters to the Editor Bllffalo Pl1ysician is published quarterly by the University at Buffalo School of Medicine and Biomedical Sciences in cooperation with the Office of Communications. Ongoing developments at the School of Medicine and Biomedical Sciences will be addressed in messages by Dr. Bernardino in upcoming issues of Buffalo Physician, as well as in feature articles and news updates. - S . A. UNGER Letters to the Editor are welcome and can be sent c/o Buffalo Physiciall, 330 Crofts Hall, University at Buffalo, Buffa lo, NY 14260; or via e-mail to bp-notes@buffalo.cdu. The staff reserves the right to ed it a ll submissions for length and clarity. T...:.:... University at B-~~';, 1York ~ The State University OJ �VOLUME 36, NUMBER 0 p H y s c A N Features 2 'A Little Fire in the Belly' Donald Finkel, MD '51, . . p10neenng cancer researcher and founder of the Women, Infants and Children Program BY 10 S. A. UNGER Good Ways to Deliver Bad News New course teaches students how to deliver bad news in a caring, effective way BY M.D. This year'scommencement-held on May 18, 2001-marked the 155th at the University at Buffalo School of Medicine and Biomedical Sciences. Pictured above is new graduate Timothy 8. Curry, MO/PhO. KINNAMON Cov 15 Departments Merge 16 Match Day 20 CAT and NYSTAR programs announced 23 Buffalo-Niagara Medical Campus group formed 24 Graduation 26 Margaret Paroski new director of admissions 27 Beutner and Jordon receive Discovery Award 29 Robert Galpin, MD, heads pediatric orthopaedic surgery 30 Role of statins in heart disease topic of 200 l Stockton Kimball lecture by Antonio Gotto, dean of Weill Medical College, Cornell 31 Medical Alumni Achievement Awards IMAGE BY PAM f-RAN 34 Michael Baron reflects on his medical career after 30 years 35 Class reunion photographs s 38 Gifts of art beautify the school, inspire students jim Dine prints presented to school by AAMC now on display (see back cover) 40 News from your UB classmates and other alumni 43 In MemoriamClassmates remembered and their accomplishments honored �by S. A. Unger Donald Pinkel, MD '51. pioneering cancer researcher and founder ofWIC Program bout the time his Career began tO hit itS peak in the late 1960s, Donald Pinkel, MD '51, found himself at the center of two controversies, the resolution of which would help redefine standards for pediatric care during the latter half of the 20th century. The first of these controversies revolved around the fact that Pinkel insisted on the feasibility of curing childhood leukemia with agents that were then available, a stance that went in direct opposition to prominent pediatricians and hematologists at the time who felt any use of the word "cure" in this context would give false hope to parents whose children had leukemia. By the early 1970s, however, Pinkel and his colleagues had succeeded in silencing these critics by developing the first curative drug treatment for acute lymphocytic leukemia (ALL) in children. The second controversy, which grew out of the first, involved Pinkel's attempt to address the fact that many of the pediatric hematology/oncology patients he and his colleagues were treating also suffered from chronic malnutrition directly related to their socioeconomic status. As a result of this observation, Pinkel led a politically unpopular effort to develop and prove the efficacy of a public-health initiative that later came to be called "Everybody was getting the Special Supplemental Food Program for Women, Infants and Children. upset with us because we Known to health-care professionals today as WIC, this were talking about curing program has since been adopted at the federal level by the Food leukemia and they said, and utrition Service of the United States Department of 'You can't do that,' and Agriculture (USDA), which in its own literature refers to it as "one of the nation's most successful and cost-effective nutrition some people got pretty intervention programs." defensive and angry about How did this native Buffalonian and graduate of the thenthat in the early days," he University of Buffalo School of Medicine find himself on the says. "We were trying to front line of these key battles in oncologic research and publichealth policy? Pinkel-who returned to UB last September to be modest, but still alot of be honored as the 2000 Distinguished Medical Alumnusjournal editors and explains that, in retrospect, his career was stimulated in its course referees didn't like that not so much by clear direction as by disturbing voids in health kind of talk." care for children. 2 laffal1 Physiciaa S umm e r 2 001 ��inkel traces his interest in pediatric hematology/oncologyback to 1949, when, as a second-year medical student, he had the "good fortune" to take an elective in hematology with the renowned clinician David K. Miller, MD, who was head of medicine at E.). Meyer Memorial Hospital (now Erie County Medical Center). "I saw my first child leukemia patient while making rounds with Dr. Miller, and at that point I became very interested in these children. So, by the time I graduated from medical school I was, as you might say, 'into' hematology," he explains. This interest was reinforced during the first few months of Pinkel's internship at Children's Hospital of Buffalo (CHOB). "One of my first patients was a newly admitted child with all the symptoms and signs of leukemia, which I was pretty familiar with by then," he recalls, "so I made the diagnosis and was in the position of having to inform the parents that their child was going to die, because this diagnosis was like a death warrant then. "This was a very disturbing experience for a young person right out of medical school-so disturbing, in fact, that I felt l couldn't run away from it, which might be one's first impulse," he adds. Despite his strong interest in pediatric hematology/oncology, Pinkel had few role models he could look to at that time because the fields of hematology and oncology were still in their infancy, too new to recognize or support individuals with subspecialty interests. In fact, during the time he was a resident at CHOB, the hospital employed only one part-time pediatric hematologist, George Selkirk, MD, whom Pinkel remembers as being very encouraging and supportive. While serving as chief resident during his third year of training, Pinkel received a welcome boost to his aspirations when Selkirk took him aside and asked if he would like to take on a project to develop a tumor clinic at the hospital. "Dr. Selkirk had received funding from the American Cancer Society for a tumor board at Children's, so with those fundsand with the approval of Dr. Mitchell Rubin, chairman of pediatrics-he set me up with an office and a part-time secretary, and I began to review all the patients at Children's who had ever been diagnosed with cancer," he explains. Gradually, because there was no full-time hematologist/oncologist on staff at the hospital, Pinkel began to be called in to see all the children diagnosed with leukemia and other forms of cancer. "You have to understand, no one was doing much then with children who had cancer. Attitudes were negative everywhere," he emphasizes. "It was a very sad situation, so somebody had to get in there and start it." Over the course of his residency, therefore, Pinkel became that "somebody" who stepped in to fill the void. "By the time I finished my residency, I had become the [hospital's] unofficial pediatric oncologist because of my special interest in children with cancer," he says. "I also sensed that much more could be done, at least in terms of pain relief and comfort for the children and their families." lallala Phys iciaa S umm e r 2 001 "Real" Postgra~uate Training in Me~icine Having had the opportunity to see that he could, in fact, "get in there and start it," Pinkel was eager to seek greater exposure to his newly chosen field. Prior to completing his residency in June 1954, therefore, he applied for a fellowship at Memorial Sloan-Kettering Cancer Center in New York City and was accepted. Soon thereafter, however, his plans changed dramatically when he received notification that he had been activated out of his reserve unit at UB, the 338th General Hospital, which he had joined as a commissioned officer following graduation from medical school. In a twist of fate that would change his life in ways he never could have foreseen, Pinkel was assigned as head of pediatrics at the station hospital at Fort Devens, Massachusetts. There, not long after his arrival, he contracted poliomyelitis and became severely disabled, requiring hospitalization for six months at nearby Murphy Army Hospital in Waltham, Massachusetts. "I was extremely ill with it for a while, but after about six weeks I could start raising my head, and after about three or four months, I was able to ambulate some with long leg braces and crutches," Pinkel recalls. Upon discharge from Murphy Army Hospital, the 28year-old Pinkel was retired from the army on full, permanent disability. Still on long leg braces and crutches, �''Th.IS was the first curative treatment of any kind for leukemia and the first time that cancer had been cured primarily with drugs;' he notes. "It was also the first time that people who had generalized cancer were cured, so it was important in three different ways:' ------- he was transferred to a Veteran's Administration hospital outside Boston, where his rehabilitation continued for another year. Referring to this time as his "real postgraduate training in medicine," Pinkel recounts how after a year at the VA, most of which was spent in half-day outpatient physical therapy sessions, he progressed to where he was free of the wheelchair and could rely solely on short leg braces and a cane to walk. "So, after a while, I was able to move along and was very fortunate," he says. As part of his rehabilitation, Pinkel was encouraged to resume working, so the very first day he received his driver's license after relearning how to drive, he headed to Boston Children's Hospital preceded by a letter of introduction from Dr. Rubin at CHOB. The letter was addressed to Dr. Charles Janeway, who referred him to Dr. Sydney Farber, a fellow native Buffalonian and oncologist whose contributions to his field eventually led to Harvard University naming its Dana Farber Cancer Institute in his honor. "When I saw Dr. Farber, he hired me on the spot as a half-time fellow, and I began to work in the Jimmy Fund Clinic at Boston Children's Hospital. In this way I resumed my interest and my activity in hematology and cancer, especially leukemia," explains Pinkel. Back to Buffalo, and Beyond Toward the end of his first year as a fellow with Farber, Pinkel was contacted by Rubin and George Moore, MD, the new director at Roswell Park Cancer Institute (RPCI), who asked him if he would consider returning to Buffalo to establish a pediatric service at RPCI, as well as join the faculty at UB and the staff at CHOB. The answer was yes, and by April 1956, following discharge from the VA hospital, he was on his way back to Buffalo. In the five and a half years of whirlwind activity that followed, Pinkel set about organizing the new pediatric inpatient unit, clinic, laboratory and research programs at Roswell Park, while concurrently conducting his own research, teaching and seeing patients. Then, in 1961, Pinkel was asked to become the first director of St. Jude Children's Research Hospital, which was under construction in Memphis, Tennessee. As envisioned by its founder, entertainer Danny Thomas, the hospital would become the first institution in the United States devoted solely to basic and clinical pediatric research and the first racially integrated institution in that region. Pinkel accepted the offer and began preparing for his move to Memphis in October 1961. As it turned out, however, he didn't leave Buffalo without what would later prove to be a providential encounter in the airport with a former UB medical school professor, John Talbott, MD, who was also on his way out of town, having resigned as head of medicine at Buffalo General Hospital to accept the editorship of the Journal of the American Medical Association (lAMA). While in the airport, the two physicians had an opportunity to talk about their work and Talbott, sensing a future in the drug-intervention studies Pinkel was describing for pediatric malignancies, encouraged him to submit papers on S ummer 200/ l ulfale Physician 5 �his work to ]AMA. In the years ahead, both men recognized this meeting as a catalyst to Talbott's support of Pinkel's innovative studies at a time when other leaders in the medical community were skeptical. ne Controversial Cure Before Pinkel could begin building a world-class research program at St. Jude Hospital, he first had to attend to a few practical details upon his arrival at the hospital, which was still a work in progress. "I was the first person in the building," he recalls with a laugh. "I had a card table and a chair, and we strung a wire out to the telephone pole and another wire out to the electrical pole for my plugged-in heater, and I was in business!" Indeed Pinkel was in business, and over the course of the next few years, he oversaw the hiring of staff, the organization of basic and clinical research programs and the building of inpatient and outpatient clinics, while at the same time he worked to raise money needed to complete construction of the hospital in March 1962. "Shortly after we opened, it occurred to me that we actually ought to be trying to cure ALL, rather than just palliate it," Pinkel recalls. "But no one was talking about trying to cure it at that point because all attempts had been unsuccessful. Scientifically, the pessimism was justifiable because we did not know its cause or mechanism. However, a key feature of St. Jude was the integration of basic and clinical research. And the basic scientists at the hospital were adamant that there was an excellent theoretical basis for curative treatment of ALL with drug combinations." In contrast to the mute resignation that was prevalent at that time, Pinkel and his group moved into action, devising a new plan they called "total therapy," which remains the standard for treatment today. "The idea was that we would use drug combinations: one set for induction of remission, another set for intensive chemotherapy, and another set for continuation," he explains. "Then we used specific therapy aimed at the CNS [central nervous system] based on the observation that children on therapy with normal-appearing bone marrow were coming down with first relapse in the CNS because our drugs weren't getting into the cerebrospinal fluid." For the next five years, the St. Jude researchers conducted pilot studies that, while promising, were very difficult. "We encountered lots of new problems that we had not seen before because of the immunosuppression we were inducing in the children," 6 lu ffale Ph ysicin S11mmer 2001 Pinkel explains. By the time a fifth pilot study had been completed in 1968, however, Pinkel and his colleagues could see that they had something. "As it turned out later, we had reached a point where we were able to cure half the children . This was the first curative treatment of any kind for leukemia and the first time that cancer had been cured primarily with drugs," he notes. "It was also the first time that people who had generalized cancer were cured, so it was important in three different ways." Despite these milestones, Pinkel at first could not win support for the studies from some of his peers and was even "thrown out of' two leading oncology groups whose leadership disagreed with the protocols he was developing and felt strongly that the St. Jude team should not be focusing on trying to cure ALL. "Everybody was getting upset with us because we were talking about curing leukemia and they said, 'You can't do that,' and some people got pretty defensive and angry about that in the early days,'' he says. "We were trying to be modest, but still a lot of journal editors and referees didn't like that kind of talk." Talbott, who had followed Pinkel's work closely over the intervening years since their meeting in the Buffalo Airport, did like that kind of talk, and in 1971 he helped change the field of oncology forever by lending his support to publishing a paper in lAMA on Pinkel's five-year follow-up study. In fact, so confident was Talbott in the merit of the paper, he selected a special cover to highlight it and wrote an accompanying editorial to extol the work being done at St. Jude Children's Research Hospital. In recounting this historic show of support by Talbott, Pinkel says, "That was the first time the phrase 'five-year cure rate' was applied to leukemia in a medical journal. I'm not sure any other journal would have allowed that statement then." A year later, Pinkel won the Albert Lasker Award for Medical Research . Often called "America's Nobel's,'' Lasker Awards are our nation's most distinguished honor for outstanding contributions to basic and clinical medical research. rood as aPrescri~tion While Pinkel and his group could not help but savor seeing children cured of ALL, a problem that had come to light as they were conducting their studies on cancer had thrown a long shadow over their accomplishments. "We found that we were seeing children in that area [Memphis] with leukemia and other forms of cancer who in fact had two diseases: not only cancer, but malnutrition, as well," Pinkel says. "This made it very difficult to treat their �"Actually, we got into a lot of trouble for this [program];' he continues. "You have to remember this was the time of the civil rights movement and most of the youngsters we were seeing were from very poor black families, so people thought WIC was another form of civil rights agitation." cancers because they had such a low tolerance for the chemotherapy due to their poor nutrition." Realizing that the problem of malnutrition was rampant, especially among low-income African-American children in South Memphis, Pinkel began to recognize the need to address this threat to children's health at a community-wide level, not just in terms of how it was impacting those with cancer. In a move that put him well ahead of his time, Pinkel had recruited a full-time MD/PhD nutritionist, Paul Zee, when St. Jude first opened. Together they identified people in the community willing to work with them to establish clinics and a "nutrition warehouse" where food was collected for strategic dissemination to needy women and children. "In this way, we were able to tie in well-child care and prenatal care with the active-feeding program," says Pinkel. "The idea was food as treatment-food as a prescription-and that really hit home and was highly effective. "The food program the St. Jude team carried out was different from other food programs," he adds, "because we conducted a scientific study to test the effectiveness of combining food prescriptions with prenatal and preventive infant and child care. The results of the study documented not only the health-effectiveness, but also the cost-effectiveness of this combined approach to maternal and child health at a community level." As word about the success of the program spread, a local television station became interested and produced a documentary about it that ignited a political firestorm when it first aired. "Many people in Memphis didn't like it at all," Pinkel explains, referring to his nutrition program. So unpopular was it that the city's mayor felt compelled to call Pinkel and assert that he was giving the city a bad image. "When he told me this, I said, 'Wait, maybe you should look at it differently; maybe you should look at it as giving the city a good image because you are recognizing the problem and doing something about it, which is better than what other cities are doing,"' Pinkel explains. "But that didn't go over very well. "Actually, we got into a lot of trouble for this [program]," he continues. "You have to remember this was the time of the civil rights movement and most of the youngsters we were seeing were from very poor black families, so people thought WIC was another form of civil rights agitation. As a matter of fact, some of our St. Jude donors said they wouldn't contribute to the hospital anymore, which got our fund -raisers pretty upset with me." In the meantime, the television station that produced the controversial documentary had been unable to find a sponsor. As a result, they sold it to a national network called DuMont Televi- SLi mm er 200 1 Buffalo Pbysiciaa 7 �"The Ion er that I've been out of school and have taught at other medical schools, the more I appreciate the fact that the medical education we received at UB was really superb:' sion, which ran it as a late-night filler-"You know, one of those shows for insomniacs," says Pinkel. As the story goes, one such insomniac who just happened to tune into the documentary was Senator Hubert Humphrey from Minnesota. Galvanized by what he saw, Humphrey immediately became interested in the St. Jude Nutrition and Health Program and held hearings on Capitol Hill to investigate the problem of malnutrition in the country. "One of our people went to Washington and testified at the hearings," recalls Pinkel. "Senator Humphrey became very involved in this project and was responsible for getting Women, Infants and Children (WIC) legislation passed in the Congress. Before he died, he said he considered this to be his greatest achievement, and the Senate voted unanimous approval of increased funding in his honor." Pinkel, too, considers the WIC program St. Jude' s most noteworthy achievement, surpassing even the curative drug therapy for ALL. "Leukemia is a relatively rare disease, but malnutrition is the most prevalent, fatal and disabling childhood illness worldwide," he says. However, because ofthe tenor of the times and the study's revelation of widespread malnutrition in a high proportion of AfricanAmerican children in a wealthy American city, the St. Jude team was concerned that no journal would accept the study for publication, according to Pinkel. "I suggested to the senior author, Dr. Zee, that it be sent to lAMA because of Dr. Talbott's enlightened attitude and the fact that a student on our team had received an AMA Goldberger scholarship in nutrition," explains Pinkel. "Although peer review was favorable, I am convinced that, again, Dr. Talbott influenced its publication and the subsequent wide dissemination of our results. "It was this publication, plus a follow-up study in the AMA Journal of Diseases of Children, that documented remarkable im8 l uffal1 Pbysiciaa S u m m er 200 1 provement in nutrition and health from our program, convincing even the most conservative [individuals) to support WIC." Building on aProven Track Record In 1974, Pinkelleft St. Jude Hospital and embarked on a stage in his career that involved being recruited to fill a series ofleadership positions at institutions eager to capitalize on his proven track record as a researcher, administrator and teacher. The first stop was in Wisconsin, where he was professor and chair of the Department of Pediatrics at The Medical College of Wisconsin and pediatrician-in-chief at the Milwaukee Children's Hospital, and where he established the Midwest Children's Cancer Center. Fours years later, he accepted a position as chair of the Department of Pediatrics at City of Hope ational Medical Center in Duarte, California, just outside Los Angeles. There, he established pediatric inpatient and outpatient units and research laboratories in the Familian Children's Hospital. In 1982, he again pulled up stakes and moved to Philadelphia, where he assumed the chair of pediatrics at Temple University Medical School and the medical directorship of St. Christopher's Hospital for Children. "!was in Philadelphia long enough to get accomplished what I had wanted to do there, which was to make certain that a new hospital was built in the inner city rather than in a distant suburb," says Pinkel. "Then, I decided it was time to return to my research, so in 1985 I took a position at the University of Texas M. D. Anderson Cancer Center in Houston in an endowed chair in pediatric leukemia research, from which I retired in 1993." Currently, Pinkel continues to work part-time, at Driscoll Children's Hospital in Corpus Christi as a professor of pediatrics at Texas A&M College of Medicine. He also teaches, consults and chairs the Institutional Review Board [at the hospital) and is especially concerned about biomedical ethics. Challenges for the future After devoting more than 50 years of his life to helping define the frontiers of pediatric oncology, Pinkel is crystal clear when asked what he feels the major challenges are for the field today. "First," he says, "we need to find out what causes these cancers and eliminate these causes, because that's the only way to handle any pediatric disease, just as was the case with polio, diphtheria, rickets, scurvyall those terrible diseases." �them. They were also very aware of the 'art' of medicine-of looking at the whole patient, looking straight in the patient's eyes and listening. That's something many of the students today aren't learning." Pausing, he adds: "And I do think medicine is an art, and in order to be successful, it not only takes scientific discipline and integrity and devotion, but it also takes imagination, intuition and passion. You have to have a little fire in your belly." CD He also contends that researchers need to find much simpler ways of treating pediatric malignancies because the therapies being used today are too complex and expensive. "By that I mean, there can be a treatment that's 100 percent effective, but if only 20 percent of the children in need have access to it, then it's only 20 percent effective. "The treatment needs to be simple enough for a 'barefoot doctor' with an eighth-grade education to use," he continues. "One of the big problems we've had in the last 20 years is that we've been moving toward more and more sophisticated treatments that are complex and expensive-like megatherapy and stem cell transplantation. These have been a disaster as far as I'm concerned because they've moved us away from making therapy available to everyone and have separated even more the 'haves' and 'have-nots' in this world." The most promising future for pediatric oncology, Pinkel asserts, is in molecular genetics, "where we can develop therapies that work to block the expression of disease-causing genes or gene products. This is where we need to be putting our energies." Mr. Danny Thomas Paramount TV 5451 Marathon Street Hollywood, CaiHornia 90028 Carrying on the UBlradition When working with students throughout his career-whether in the laboratory, the clinic or the classroom-Pinkel says he has tried to carry on the tradition of teaching from which he benefited while a student at UB's School of Medicine. "I feel sorry for all the medical students I teach who can't go to UB," he says. "The longer that I've been out of school and have taught at other medical schools, the more I appreciate the fact that the medical education we received at UB was really superb. We had very good clinical faculty who were inspiring; they made you want to be a doctor, and they made you want to be good doctors like * Talbott was professor of medicine at the then-University of Buffalo and chief of medicine at Buffalo General Hospital from 1946 to 1959. In 1959 he left UB to assume the editorship of the Journal of the American Medical Association, a position he held unti/1971. Entertainer Danny Thomas founded St. Jude Research Hospital in 1962. 5 II Ill Ill C r 200 I luffala Pbysician 9 �ILLUSTRATION BY RANDY LYHUS �BY M.D. KINNAMON New course helps students learn essential communication skill ........... ..Haw to Bnak Bad module within the school's two· year-lang Clinical Practice of Medicine caursa Summer 2001 �'' ow TO BREAK BAD NEws," a new module within the school's two-year-long Clinical Practice of Medicine course, evolved in part from informal teaching interactions the medical school had with a local Chemotherapy Coach Program. As director of the program, Hillary Ruchlin often gave presentations to UB medical students about how best to communicate with seriously ill patients. To enhance the immediacy of her message, Ruchlin, who is now executive director of the Cancer Wellness Center in Buffalo, always brought along volunteers-«chemo coaches"who were cancer survivors. Her idea to introduce doctors- in-training to the feelings and experiences of cancer patients in a more structured environment evolved from seeing students questioning volunteers after the sessions. "I thought [the new module] would be a wonderful way to of the Standardized Patient Program, who organizes and in- help students understand just what is at stake the moment patients are told they have cancer," says Ruchlin. "It is a life- structs the patients in their real-to-life role-playing scenarios altering moment." Ruchlin approached Alan Baer, MD, UB associate professor of medicine, and they collaborated on the development of the curricular module, now referred to as the "Bad and in how to give feedback to students on the Bad News Checklist (see page 14); Diana R. Anderson, EdM, who assists with the administration of the Standardized Patient Program; and Deborah Waldrop, PhD, assistant professor in UB's School of Social Work. News Project." Their aim was to teach students how to give bad news to patients and to reinforce appropriate methods [motionally Charged Communication Issues by using a format that involves the participation of actual Dennis Nadler, MD, associate dean for academic and cur- cancer patients. ricular affairs in the Office of Medical Education, thinks To develop the curriculum, Baer looked to Dr. Robert "How to Break Bad News" is an idea whose time has come. Buckman's pioneering work on the subject as described in "This is a critical aspect of medical education, one that has his book How to Break Bad News: A Guide for Health Care Professionals (Johns Hopkins University Press, 1992). been left to on-the-job training for much too long," he says. "Actual cancer survivors Buckman, an oncologist at the Toronto-Bayview Regional are uniquely positioned to Cancer Centre (Ontario, Canada) and professor of medicine help young physicians at the University of Toronto, developed a method that learn how to do it right." with, and for me, the stresses the need for physicians to assess the patient's level of Baer thinks students encounter felt abso- understanding of the possible diagnosis. His methodology need help with these emo- lutely real because I also emphasizes the importance of using unambiguous lan- tionally charged communi- could see in their faces guage, presenting information honestly, identifying sources cation issues. "Historical- of emotional support and presenting a clear plan for therapy. ly, physicians have been In addition to Ruchlin, Baer worked to develop the mod- blamed for not doing this well," he explains. "Many ule with UB medical school faculty and staff, including Jack Freer, MD, associate professor of clinical medicine and social and preventive medicine, who teaches the first session of the class and oversees the school's palliative care elective; Karen H. Zinnerstrom, PhD, coordinator for training and evaluation 12 "For the patients I dealt I I f f a I I Pb y s i t i a I Summer 2001 they had gone through this before. One patient told me that it's almost patients have stories of how they first learned like reliving the whole about diagnoses of cancer, and often it's not very tions were authentic." experience. Her emo· �flattering to the medical profession. So now there's a protocol, a step-wise method for teaching students these skills." First taught in January 2000, the four-week-long module begins with two weeks of introductory material that includes lessons on the protocol for how to break bad news; a presentation of Buckman's video, "How to Break Bad News"; and a discussion with a panel of former cancer patients. The panelists describe their experiences, including how they were given their diagnoses, how they handled the information, how they would have preferred to have been told (if it was a bad experience), what they felt upon learning the news, and how they survived their illnesses. In the third and fourth weeks, role-playing begins. During these videotaped sessions, which take place in examination rooms of the Standardized Patient Testing Suite, students present the cancer diagnosis to "patients" using fictional case histories they've learned ahead of time. The patients, who are actual cancer survivors, are then able to give feedback on how effectively their "doctors" communicated the news. Patients complete a written evaluation checklist on the student's performance, and students are given pre- and post-tests to assess their approach to the task before and after their classroom and role-play experiences. Authentic [motions, Authentic Results In its first year the module was conducted as a research project, with Deborah Waldrop from the School of Social Work helping to design the research methodology. In October 2000, Baer presented an abstract on the project's findings at the Association of American Medical Colleges' annual meeting in Chicago. Titled "Breaking Bad News: Use of Cancer Survivors in Role-Play Teaching," the abstract described significant differences in students' approaches to breaking bad news based on the pre- and post-test results. After completing the module, Baer reported students used impersonal and technically specific language less frequently and instead adopted more personal, empathetic and reassuring phrasing. W hile many medical schools use standardized patients (scripted actors) in teaching, the use of actual cancer survivors is what makes UB's program unique. "It feels more real when you're dealing with a person who has been through it," notes Baer. "Students gain confidence and walk away feeling like what they've heard is valid and meaningful." To student Jennifer Payne, role-playing was the most valuable part of the sessions. "It made the biggest impact on all of us," she says. "For the patients I dealt with, and for me, the encounter felt absolutely real because I could see in their faces they had gone through this before. One patient told me that it's almost like reliving the whole experience. Her emotions were authentic." In order for all 140 second-year students to participate in the role-playing, each of the 12 volunteer "patients" had to hear the bad news up to six times a day in a two-hour period. Though these dedicated volunteers were eager to work with the students, it was difficult for them to relive the trauma they experienced upon learning they had cancer. Cancer survivor Ann O'Neil-Merritt, who is fully recovered from a rare cancer she was diagnosed with six years ago, says, "Participating [in the module] this year was a lot easier than last year. I'm one more year removed from the day I found out, but it's very difficult because you're trying to react honestly by putting yourself in the situation you were in and reacting like you did." Ruchlin adds, "We had volunteers 17 years removed from their [cancer diagnosis] who were still having a difficult time." Ultimately, "How to Break Bad News" is about communication and human connection. "The class helped all of us realize that you have to establish a rapport with your patient," Payne reflects. �e s" Chec list for Student reed back On Their Team to Help Them through It The experience was trying for the students as well, although in a different way. Payne explains that her confidence going into the role-playing was shaky, as was that of her peers. "All of us were exceptionally nervous. It was the most difficult thing we've had to do yet in terms of actual patient interaction," she says. "But it made me realize that this is as much a skill as is listening to a heart." Former patient O'Neil-Merritt got involved with the project "to awaken these soon-to-be doctors to the fact that we' re more than bodies. We're a whole organism, not just a set of cells." She also wanted to impart to the students the importance of paying attention. "Listen, watch and pick up clues from your patient and then react to them. Change your agenda and your protocol to meet the patient's needs because every patient will react differently. You have to be aware of what their emotions and body language are telling you," she says. 1. The student introduced him/herself. 2. The student addressed me by my proper name (i.e., did not call me by my first name). 3. The student began our conversation with a question as to my current well-being, health or state of mind. 4. The student asked me what I understood so far; about the symptoms I have been having; about my illness, or the reason for the diagnostic tests that had been performed. 5. The student asked me if I knew the results of the diagnostic tests that were performed. 6. The student asked me how much I would like to know about my illness. 7. The student checked with me several times during his/her explanation to make sure that I understood what was being said. 8. The student told me that the biopsy results were those of "cancer" (and not simply a "tumor" or "growth"). 9. The student described the possible forms of treatment that I might need. 10. The student identified sources of support for me (e.g., family, friends, community, professional). 11. The student outlined a clear plan for the future. A ccording to Baer, the medical education community is becoming increasingly interested in ways to develop the skill of communicating bad news, especially since many experienced doctors did not have this kind of training as students. "We'd love to present this program to physicians as a reminder," says Ruchlin. Associate Dean Nadler agrees, "Every health-care professional should be given this sensitivity training. This is 12. The student ended the interview with an appropriate, polite closure. Standardized patients are asked whether they "agree strongly," "agree," "do not agree or disagree," "disagree," or "disagree strongly" with the following: training that house officers and many faculty could benefit * The student appeared comfortable in his/her communication with me. * The student maintained appropriate eye contact with me throughout from, as well, not just medical students." Ultimately, "How to Break Bad News" is about communication * The student explained the results of the diagnostic test and/or my ill and human connection. "The class helped all of us realize that you have to establish a rapport with your patient," Payne reflects. "! assumed that doctors provided the information to patients and then let them go off and determine how they're going to deal with it from then on. But Dr. Buckman's protocol emphasizes that a physician should take a more active role and should be on their team to help them through it." CD the interview. ness in a language that I could easily understand. * The student facilitated the expression of my concerns and fears (e.g., possibility of impotence, need for mastectomy, fear of pain and death). * The student behaved warmly, but professionally, throughout our encounter. * The student acknowledged and responded em pathetically to my ex pressed fears, crying, tears, or other signs of emotion. * The student guided our dialogue along in a manner which made me feel comfortable. * Overall Rating: The student did an excellent job in presenting me with bad news. According to [Dr. Alan] Baer, the medical education community is becoming increas· ingly interested in ways to develop the skill of communicating bad news, especially since many experienced doctors did not have this kind of training as students. �B v S A. UNGER Department of Pathology and Anatomical Sciences formed N FOLLOW-UP TO A PLAN that was first proposed over four years ago, the Departments of Pathology to give anatomy, which is a pure basic science, a clinical base by linking it with pathology, which is both a and of Anatomy and Cell Biology in the University at clinical and a basic science," accord- Buffalo School of Medicine and Biomedical Sciences ing to Heffner. Heffner explains that yet another officially merged in March 2001 to form the Depart- factor leading to the merger was that ment of Pathology and Anatomical Sciences. The department is chaired by Reid Heffner, MD, formerly both departments had become smaller chair of the Department of Pathology. together a "critical mass" of talent to At the time of the merger, the Department of Anatomy in recent years, and the combining of faculty was viewed as a means to bring foster new research initiatives, especially in the neurosciences. ations, according to Heffner, including the fact that The proposal to merge the two departments was extensively reviewed by the Faculty Council, which established an ad hoc committee chaired by Distinguished Teaching Professor of Physiology and Biophysics Perry basic science departments, in general, are increasingly Hogan, PhD, to study its merits. After meeting with and Cell Biology, which had been without a chair since 1992, was being led by interim chair Frank Mendel, PhD. The merger was prompted by a number of consider- focused on overlapping areas of research, a trend that is particularly accentuated in the anatomical sciences and "THERE'S BEEN A MERGING OF BASIC SCIENCES IN A pathology because both disciplines are historically rooted in morphology. "There's been a merging of basic sciences in a sense that they all are now directly involved in such questions SE SE THAT THEY ALL ARE NOW DIRECTLY INVOLVED I SUCH QUESTIONS AS 'How DO GENES REGULATE CELLS? as 'How do genes regulate cells? How do they manufac- How DO THEY MANUFACTURE PROTEINS, AND HOW DO ture proteins, and how do they regulate growth?'" says Heffner. "Even though [anatomical sciences and pathol- THEY REGULATE GROWTH?'" SAYS HEFFNER. ogy] have morphology in common, we are also like a lot of the other basic science departments in that we are faculty from both departments, the committee wrote a investigating disease and cell and tissue function using report supporting the merger and making several recom - the same techniques, whether it's physiology, pharma- mendations, including that new bylaws and policies and cology, anatomy or pathology. So there's a lot ofblurring between departments; we're not as compartmentalized procedures be written for the department and that addi tional faculty be recruited. Committee members also as we used to be." A related reason for the merger is the planned imple- endorsed formation of a Division of Anatomy within the department, a step that has been taken, according to mentation in fall 200l of a new curriculum in the School Heffner. After two-thirds of the members of the Faculty of Medicine and Biomedical Sciences that will place an Council voted to approve the merger in October 2000, emphasis on the integration of all basic sciences and in the process for consideration of the proposed merger making those sciences clinically relevant to students. was reviewed and approved by the Faculty Senate, con- "One of the goals with this merger, therefore, was cluding two years of faculty input on the decision. <!:) S umm er 200 1 lufl alo Pbysiciaa 15 �MEDICAL SCHOOL N E w S Stacey Blyth, left, will stay in Buffalo and train in family practice, while friend Amy Woolever is headed for Einstein/Montefiore to train in pediatrics. ;; .. ..• L lbdelrazeq, Sonya z SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, y Obstetrics-GYJlecology Adams, Christopher Orthopaedic Surgery HIS YEAR's NATIONAL RESIDENCY MATCHING PROGRAM (NRMP) results Eve Sisser with her husband, ToddSullivan,andtheirsnen· week·old daughter Leeba, celebrate Eve's placement in psychiatryatLonglsland Jewish Hospital. were announced on March 22 by Dennis Nadler, MD, associate dean in University at Buffalo's School of Medicine and Bio· medical Sciences. Of UB's graduating medical students 80 percent of the students received their first, sec~nd or third . . choice of placements. Thirty percent will stay m Buffal~ to tram m the Graduate Medicai·Dental Education Consortium, while 45 percent will go out of state. "Competition for desirable residency positions continues to be intense," says Nadler. "We are very pleased that our students consistently match to some of the best programs in the country." Nationally, match results this year reflected a shift away from trends of recent years where new physicians showed greater interest in family practice programs and less interest for certain specialties, according to the NRMP. This year, the number of individuals entering family practice residency programs decreased by 4.9 percent. Conversely, specialties such as anesthesiology and pathology showed increases of 5.8 and 8.1 percent respectively. Despite the decline in family practice, 51 percent of graduating U.S. medical school seniors matched to a first·year residency position in one of the generalist positions. Among the UB students, 26 were placed in internal medicine, 22 in pediat· rics, 12 in family medicine, 4in medicine-pediatrics and 3in obstetrics-gynecology. Overall, 23,981 individuals participated in the match this year, a decrease from the 25,056 who participated in 2000. Of the total active applicants, 76.5 percent were matched to afirst·year position, a3.1 increase over last year. -S. A. UNGER Mayo Graduate School of Medicine ROCHESTER, MN Adamson, Jennifer Family Practice SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Amoako, Patricia Medicine-Primary North Shore University MANHASSET, NY bosso, Daniel Emergency Medicine orth Shore University MANHASSET, NY Bax·Debiaso, Sarina Ge11eral Surgery SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Bellows, Jason Medicine-Preliminary George Washington University WASHINGTON, DC Emergency Medicine George Washington University WASHINGTON, DC Benedicto, IIberto Surgery-Preliminary SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY 16 l 1llalo Physician S u 111 111 er 2 0 0 1 �Damian and Kristen Compa will train at the University Hospitals of Cleveland; he will pursue internal medicine and she, pediatrics. Azin Shahryarinejad, class of 2002. right, congratulates Eileen Lau, who is pleased to be going to the University of Southern California to train in pediatrics. Terry Thompson, who received his first choice, celebrates with his wife, Melissa, and their 14·month·old daughter, Makayla. Colletti. Richard Bergfeld, Deborah Bravin, Marina Chan. Keith Physical and Rehabilitation Medicine McGaw Medical CenterNorthwestern University CHICAGO, JL Medicine-Primary Columbia Bassett COOPERSTOWN, y Radiology-Diagnostic Bridgeport Hospital BRIDGEPORT, CT Bui. Hieu Chan, Mew Medicir1e-Preliminary Franklin Square Hospital BALTIMORE, MD Pediatrics Baystate Medical Center SPRINGFIELD, MA l11temal Medicine University Hospitals of Cleveland CLEVELAND, OH Buscaglia, Jonathan Cheung, Barbara Compa, Kristen Internal Medicine Einstein/Montefiore BRONX, y Internal Medicine St. Vincent's Hospital NEW YORK, Y Black. Thomas Pediatrics SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Blyth, Stacey Family Practice SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Psychiatry Lama Linda University LOMA LINDA, CA Compa, Damian Pediatrics University Hospitals of Clevela nd CLEVELAND, OH Conboy, Thomas Butsch, Winfield Chou, Richard Internal Medicine SU Y/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY lntemal Medicine Ohio State University Medical Center COLUMBUS, OI-l Campbell. Katrin Chow, Selwyn Transitional Akron General Hospital AKRON, OH Medicine-Preliminary Brown University PROVIDENCE, Rl Botta, Thomas Cancilla. Laura Cicero, Mark Internal Medicine New York Presbyterian Hospital NEw YoRK, Y Internal Medicine University of Rochester/Strong Memorial Hospital ROCHESTER, NY Pediatrics Eastern Virginia Medical School NoRFOLK, VA Borgoy, John Medicine- Preliminary Lankenau Hospital WYNNEWOOD, PA Emory University School of Medicine ATLANTA, GA Bourne, Ryan Internal Medicine SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, Y Bowman, Daniel Orthopaedic Surgery Albany Medical Center ALBANY, Y Braun, Amy Pediatrics SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Clark, Kristin Carrero, Albert Anesthesiology SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Chan, Audrey Medicine- Preliminary Pennsylvania Hospital PH ILADELPHIA, PA Ophthalmology University of Maryland BALTIMORE, MD Medici 11e-Preli m ina ry SU Y/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Radiology- Diagnostic SUNY/Buffa lo Graduate MedicalDental Education Consortium BUFFALO, NY Clementi, Jennifer Pediatrics Long Island jewish Hospital NEW HYDE PARK, NY Psychiatry Duke University Medical Center DUR II AM, c Curry, Timothy Medicine- Prelimi11ary SU Y/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Anesthesiology Mayo Graduate School of Medical ROCHESTER, MN Dalewitz, Jessica Medici11e- Preliminary Beth Israel Medical Center EW YORK, NY Neurology Albert Einstein College of Medicine BRONX, NY Den Haese, Ryan Neurological Surgery University of Maryland BALTIMORE, MD Diamantis, Pamela Pediatrics University of Texas Medical School HousTON, TX Summer 200/ l ulf1ID Physiciu 17 �M E D C A L SCHOOL N w Doran, James Figueroa, Jeanette Kallen, Dianne Family Practice Mercy Hospital PITTSBURGH, PA Family Practice SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Family Practice St. Vincent Health Center ERIE, PA Dull, Michael Dwyer, Cheri Family Practice Atlanta Medical Center ATLANTA, GA Flood, Jeremy lntemal Medicine Thomas jefferson University PHILADELPHIA, PA Kling, Christopher Pediatrics SU ¥/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Medicine-Preliminary SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Derma to logy St Louis University School of Medicine STLOUIS, MO Psychiatry Harvard Longwood BosTON, MA Emerge11cy Medici11e SU ¥/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Obstetrics-Gyr1ecology SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Galas, James Gilmore. Sasha Dwyer, James Kundu, Renita Gould, Milena /ntemal Medicine New England l'vledical Center BosToN, MA Ehrig, Debra Emergency Medicine Yale-New Haven Hospital NEw HAVEN, CT Kurtz, Stacey Pediatrics SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Greenberg, Barbra Psychiatry ew York University School of Medicine EW YoRK, NY Elliott, Frederick Pediatrics New York University School of Medicine EW YORK, y Gross, Kara Erway, Kimberly Guyer, Aaron Psychiatry University Health Center PITTSBURGH, PA Orthopaedic Surgery University of Michigan Hospitals ANN ARBOR, Ml Evanchuk, Darren Hannahoe, Brigid illtemal Medicine McGaw Medical CenterNorthwestern University CHICAGO, IL Pathology Cleveland Clinic Foundation CLEVELAND, OH Pediatrics Einstein/Montefiore BRONX, NY Facer, Jeffery Internal Medicine SU ¥/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Falvo, Mark General Surgery SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Fantuzzo, Joseph Surgery-Prelimirwry SUNY /Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY luffalo Phys i cian Kevin Mullen and his wife, Rachel, celebrate his placement in general surgery at the University of Pittsburgh's University Health Center. Kennedy, Suzette Medici11e Preliminary SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Radiatior1-0ncology University of Minnesota Medical School MINNEAPOLIS, MN 18 E Pediatrics Georgetown University Hospital WASHINGTON, DC Laprairie, Danielle Obstetrics-Gynecology University of Connecticut FARMINGTON, CT Lau, Eileen Pediatrics University of Southern California Los ANGELES, CA Lesh, Charles Lim Sabina Psychiatry Yale-New Haven Hospital NEW HAVEN, CT Maness is, Anastasios Medici11e-Pediatrics St. Vincent's Hospital NEw YoRK, NY Mazzeo, Ramona Psychiatry University of Massachusetts Medical School WoRCESTER, MA McConn, Kara Psychiatry California Pacific Medical Center SAN FRANCISCO, CA lntemal Medicine SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, Y Hughes, Jeffrey Medicine Preliminary SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Radiology-Diagnostic Hospital of St. Raphael NEw HAVEN, CT Family Practice St. joseph's Hospital SYRACUSE, NY Lewin, Sami General Surgery University of Chicago Hospital CHICAGO, IL Pediatrics SU ¥/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Medici11e-Prelimi11ary Winthrop-University Hospital MINEOLA, NY Radiology-Diagnostic Mt. Sinai Hospital NEW YORK, NY Jobes. Gregory Lezama, Jennifer lntemal Medicine SU ¥/Buffalo Graduate MedicalDental Education Consortium BUFFALO, y Psychiatry SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Jobes, Annmarie Summer 2001 McDonald, Amy Mezhir, James Millstein, Leah Medici11e-Pediatrics University Hospitals of Cleveland CLEVELAND, OH Miralog1u, Didem Medici 11e-Preli 111 ina ry Mary Imogene Bassett CooPERSTOwN, Y Physical and Rehabilitive Medicine Eastern Virginia Medical School NORFOLK, VA �Ndegwa Njuguna is headed for the University of Illinois College of Medicine. Ouilikon, Neva lr1temal Medici11e johns Hopkins/Sinai BALTIMORE, MD Paa, Kimberly Mallen, Kevin Gweral Surgery University Health Center PITTSBURGH, PA Morris, Eleazar TrallSitiorwl ew York Hospital/Medical Center Queens FLUSHING, Y A11esthesiology Mt. Sinai Hospital NEW YORK, NY Naik. Dhruti Pediatrics SU Y/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Njuguna, Ndegwa l11temal Medici11e University of Illinois College of Medicine CHICAGO, IL O'Brien, Kristen Family Practice Stonybrook Teaching Hospitals STONY BROOK, NY O'Connor, Thomas Medici11e-Primary University of Rochester/Strong Memorial Hospital RocHESTER, NY Odell, Barbara Medicine-Pediatrics Penn State HERSHEY, PA Ogie. Debra l11temal Medicine University of Illinois College of Medicine CHICAGO , I L Orr.Jeremy Family Practice University of Colorado School of Medicine DENVER, CO A11esthesiology SU Y/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Park, James lrttemal Medicine New York University School of Medicine EW YORK, NY Pasamba, Bernadette Medici11e-Prelimirwry Einstein/Montefiore BRONX, y Anesthesiology ew York Presbyterian Hospital EW YORK, NY Peters, Elyssa Medicine- Prclimirwry Abington Memorial Hospital ABINGTON, PA Ophthalmology Temple University PHILADELPHIA, PA Pfalzer, Aaron Plumpton, Jessica Swiencicki, James Pediatrics Wright Patterson, AFB DAYTON, OH Medicine-Primary Metrohealth Medical Center CLEVELAND, OH Rakhlin, Aleksandr Syed, Sufia Gweral Surgery Westchester Medical Center VALHALLA, NY l11temal Medici11e George Washington Universtiy WASHINGTON, DC Reynolds, Deborah Thompson, Terry l11temal Medici11e Mt. Sinai Hospital NEw YORK, Y Family Practice Lynchburg Family Practice Center LYNCHBURG, VA Salerno, Kilian Trapp, Kathleen Emergwcy Medici11e SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Family Practice SU Y/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Samanich, John Trebb, David Psychiatry Beth Israel Medical Center NEw YoRK, NY Pediatrics Brooke Army Medical Center FoRT SAM HousTON, TX Sarpel, Umut Trojan, Christopher General Surgery Mt. Sinai Hospital NEw YoRK, Y Radiology-Diagrzostic William Beaumont Hospital ROYAL OAK, Ml Medici 11e-Preli111 i 11ary SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, Y Radiology-Diag11ostic SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, y Setlik, Robert Yakani, Rajesh 1111emal Medici11e Brooke Army Medical Center FoRT SAM HousToN, TX Medici ne-Pedia 1rics Albany Medical Center ALBANY, NY Seelagan, Davindra Emerge11cy Medici11e SUNY/Buffalo Graduate MedicalDental Education Consortium BUFFALO, Y Shaposhnikov, Rimma Werth, Christopher l11temal Medici11e University of Southern California Los ANGELES, CA Surgery-Prelimi11ary SUNY/Buffalo Graduate MedicalDental Education Consortium BuFfALO, NY Philip, Joey Sharma, Mudit Medici11e-Prclimirwry SU Y/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Surgery-Prclimirwry Georgetown University Hospital WASHINGTON, DC Neurological Surgery Georgetown University Hospital WASHINGTON, DC Pickhardt, Donald Pediatrics SUNY/Buffalo Graduate MedicalDental Education Consortium BuFFALO, NY Pietryga, Michelle Psychiatry Harbor UCLA Medical Center TORRANCE, CA Pigos, Kevin Family Practice Williamsport Hospital WILLIAMSPORT, PA Sisser. Eve Psychiatry Long Island jewish Hospital NEW HYDE PARK, NY Steiding, Karena Pediatrics Yale- New Haven Hospital NEW HAVFN, CT Woolever, Amy Pediatrics Einstein/Montefiore BRONX, NY Wychowski, Adam Medici11e-Pediatrics Baystate Medical Center SPRINGFIELD, MA Yates, Robin Pediatrics New York University School of Medicine NEw YoRK, NY Zalar, Mona PEDIATRICS New England Medical Center BosTON, MA Summer 2 001 Bu ff 1 I o Physic i 1 n 19 �==, I CAT Program Returns to Buffalo Focus on biomedical and bioengineering technologies f lt.R 1\lF \RIY A DH. A.DF without a New York State Center for programs available to partners of such centers, Advanced Technology (CAT) program that supports industryuniversity collaborations to drive job creation and economic growth, Buffalo is once again home to a CAT, this time a joint venture between the University at Buffalo and Roswell Park explains Holm, adding, "that's why it was so important to get this formal designation." Cancer Institute (RPCI). At a press conference held on April 30, 2001, at RPCI, Governor George E. Pataki announced the new Center for Advanced Technology in Biomedical and Bioengineering Technologies along with $1 million in funding for the center. There are 14 other such centers around the state, each of which receives $1 million in funding annually. Noting that the elimination of Buffalo's CAT in the early 1990s "sent the wrong message" about UB and Western New York, Pataki said that the redesignation of the CAT program will have a tremendous impact on the people of Western New York by fostering the creation of new biotechnology start-up companies and by helping existing biomedical businesses to expand through new or im- v G The Center for Advanced Technology in Biomedical and Bioengineering Technologies will focus on developing new products and creating new jobs in Western New York from biomedical and bioengineering research conducted at UB, RPCI and Western New York companies. Robert]. Genco, DDS, PhD, SUNY Distinguished Professor and chair of the Department of Oral Biology in the School of Dental Medicine, was named director of the center. Genco explains that the Center for Advanced Technology in Biomedical and Bioengineering Technologies will fund projects that are close to the commercialization stage. Particular emphasis will be placed on two areas in which Buffalo researchers have traditionally excelled: the development of biopharmaceuticals, such as the PSA test for prostate cancer, lung-surfactant therapy-for premature infants, photodynamic-cancer therapy and interferon treatment for UB and RPCI by several years, explains Bruce Holm, PhD, senior for multiple sclerosis; and biomedical devices, such as the implantable pacemaker and the platinum coil for inoperable cranial aneurysms. According to Genco, the center will take advances like these and help ensure that they not only are developed in Western New York, but also associate vice president for health affairs. "We assumed we'd have to wait until 2004 to apply formally when the next round of com- produced and manufactured here once they are commercialized. In addition, he says that the Center for Advanced Technology in petition for a CAT becomes available," he says. "The governor's Biomedical and Bioengineering Technologies will function as the science-transfer and accelerator arm of other new centers that are fund- proved product lines. The governor's announcement shortened the formal CAT process announcement shortens the timeline by three years." The announcement also makes UB eligible for any and all state 2 0 B ELLEN 0 L 0 8 Au M 1111111 Pbysiciaa S um me r 2 0 0 1 ed in Western New York, such as the new NYSTAR center (see article, �State companies may compete for two different types of awards, Research Milestone which will be in the range of $100,000 to $200,000 per project. NYSTAR Program announced by governor opposite) and the proposed Center of Excellence in Bioinformatics. Researchers at UB and RPCI, in collaboration with ew York Discovery Awards are made for innovative projects that use a bioinformatics-type approach that allows researchers Particular emphasis will be placed on two areas in which Buffalo researchers have traditionally excelled: to "leapfrog" from a basic-science level to a develop- ~ MA'r 3,200l, GovernorGeorge Bv ment stage. Science Transfer Awards are for research E. Pataki came to the University at ELLEN that is nearly ready for commercialization. Buffalo School of Medicine and Bio- GOLDBAUM "The Discovery Awards typically will fund re- medical Sciences to announce that UB and its research search that uses a genomic or bioinformatics ap- partners have received three peer-reviewed grants total- proach," explains Genco. "Say a researcher has an idea ing $25 million from the New York State Office of Sci- for a diagnostic test or a treatment target. By asking ence, Technology and Academic Research (NYSTAR). a very practical question, and by doing very rapid Calling the funding one of the largest high- the development of throughput screening and analysis with the DNA technology/biotechnology-related investments ever biopharmaceuticals. microarray or on the computer, the scientist can very made by the state in the Buffalo area, Pataki said the quickly come up with some good candidate com- amount constituted one-fourth of the total funding awarded throughout the state under the NYSTAR program . "This new STAR center in Buffalo represents a major milestone and biomedical devices. pounds for drug targets or diagnostic tests." Science Transfer Awards will be made to research- ers who have something in late-stage development that requires additional testing. "This type of award has been the missing link for our researchers," Genco notes. "Government agencies won't fund such projects because they're not true 'discovery research' and often companies want this kind of 'proof-of-concept' work to have already been completed. The Science Transfer Award will facilitate the next step, which could be either solicitation from venture-capital companies or major funding from industry. We're particularly excited because the CAT fills that niche." in our efforts to foster the growth of high-tech and biotechnology research and economic development throughout New York State," Pataki said. "This new center-when combined with our $1 billion Centers of Excellence plan-will generate significant new research funding and spur the establishment of spin-off enterprises, bringing new jobs and economic opportunities to Western New York." The most substantial of the three competitive awards granted was $15.3 million allocated for the establishment of the new Strategically Targeted Academic Research (STAR) Center for Disease For more information on the Center for Advanced Technology Modeling and Therapy Discovery. The center is a partnership between UB, Roswell Park Cancer Institute, Hauptman-Woodward m Biomedical and Bioengineering Technologies, contact Dr. Med ical Research Institute and Ka leida Health. The corporate Genco at (716) 829-2854; or at rjgenco@buffalo.edu. CD . 0 partner is IBM Life Sciences Division, and Bruce Holm, PhD, Summer 2001 l af falt Pbys i c i aa 2 1 �senior associate vice president for health affairs at UB, is principal investigator for the award. The Center for Disease Modeling and Therapy Discovery is designed to make Western New York a world-class player in a broad range of new scientific fields made possible by the sequencing of the ew York." The strategy involves developing an academic-industry colocator facility in the vacant 50,000-square-foot Westwood Squibb Pharmaceutical building at 100 Forest Avenue in Buffalo. The co-locator will facilitate prototyping of new products and human genome. Its ultimate purpose is to discover and develop new drugs and clinical therapies using the tools made possible by the commercialization of research by providing laboratory and busi- genomics revolution and to bring them to the marketplace. An additional $8 million in NYSTAR funding was awarded to from academic and industry, as well as UB Business Alliance staff. UB's Institute for Lasers, Photonics and Biophotonics, under the direction of Paras Prasad, PhD, SUNY Distinguished Professor in locally, but throughout the state- through establishment of a "virtual collaboratory" with the IBM Life Sciences Computational the Department of Chemistry, as part of a $14 million information Biology Division. The virtual collaboratory developed and proto- technology research center awarded to Rochester Institute of typed by UB faculty members is an innovative informatics concept Technology. University at Buffalo researchers led by Robert E. Baier, that makes possible ubiquitous telecommunications between all PhD, professor of oral diagnostic sciences and director of the Industry/University Center on Biosurfaces, and George Lopos, PhD, dean of Millard Fillmore College, also received funding participating institutions. An additional economic engine for Western New York, this concept already has resulted in the forma - totaling $1.5 million as part of the New York Environmental Quality Systems Center established at Syracuse University. ness-incubation space to a multidisciplinary group of scientists The center will forge numerous links with partners-not just tion of a spin-off company, Visual Design Systems. The virtual collaboratory concept means that for the first time "It's a win-win situation for UB, its partners and the entire in Western New York, different institutions will be linked through Internet 2, the high-bandwidth portion of the Internet Western New York community, which will benefit greatly from new job creation in the biomedical field," said }aylan Turkkan, UB reserved for computationally intensive research. Already functioning on and between UB's North and South campuses, vice president for research. "Through our plans for virtual collabora- Internet 2 communications require the installation of so-called tories and academic-industry co-location, our researchers will be "dark fiber" connections, funding for which will be provided by the NYST AR award. integrated with industry in a way they never have been before." Holm noted that the awarding of the grant speaks highly of the quality of science being conducted by UB and its partners. "The fact that this gran t was awarded based on a peer-review process demon- "This will connect not only institutions in Western New York, but all across the state," said Holm. "And our experience in the past six months has been that even strates that the quality of science already being done in Western New just the possibility of having this type of connection has clearly York meets a particularly good standard," he noted. "We are opti- turned heads. To connect not only to faculty in the region, but to mistic that with this funding and with the plan that actually formu- have access to the intellectual capital all across the state has been a very strong draw." 4D lated the funded proposal, we will be able to accelerate both the 22 academic science and the corporate science in Western I u II a I o P b JS i cia n S " 111 111 er 2 0 0 I �Buffalo-Niagara Medical Campus New group formed to coordinate projects HE MAJOR PL \\ ERS IN ~1EDJCAL CARE, research, educa- Bv fruition. "In my 20 years as a volunteer in health care tion and biotechnical innovation concentrated in what has been L 0 Is around the High Street area, this is the best I have ever BAKER seen the institutions communicate and work with one termed the "High Street medical corridor" in Buffalo have formed an entity called the Buffalo-Niagara Medical Campus (B MC) to another," Beecher says. "It is encouraging to see the 'silo mentality' coordinate projects that will serve and enhance the group as a whole. disappear, which in the past has isolated individuals and groups Thomas R. Beecher, chair of the group's board of directors, announced the formation of the BNMC at a press conference held on April 30, 2001, at Roswell Park Cancer Institute (RPCI). from one another, thus making partnerships more difficult." The BNMC has adopted three goals that will drive its work in the future: Create a world-class medical campus that enhances the The members are the University at Buffalo, RPCI, Kaleida Health, already existing clinical, research and teaching excellence of the Hauptman-Woodward Medical Research Institute (HWJ) and the Buffalo Medical Group Foundation. The City ofBuffalo, Erie Coun- member institutions; create economic-development opportunities; and improve and expand the infrastructure of the current campus. ty and the adjoining neighborhoods of Allentown and the Fruit Belt The work is being funded by contributions from the Oshei Founda- are partners in the effort. The entity is governed by a 14-member tion and the five member institutions. Active since December 2000, board of directors composed of representatives from the institutions the group has a project director, Matthew K. Enstice, and has accomplished a number of tasks, including contracting with UB's Center for Computational Research to create a virtual medical campus for use in research collaborations, economic development and faculty recruitment. and partners. UB is represented by President William R. Greiner and Michael E. Bernardino, MD, MBA, vice president for health affairs and dean of the School of Medicine and Biomedical Sciences. Each institution retains its independent governance while collaborating on campus activities. They are being supported in their efforts by a loosely organized Trustee Council composed of corpora- While UB doesn't own land or structures on the medical campus, tions, businesses, government agencies and nonprofit organizations it has a major presence there through its faculty and research. UB's new Department of Structural Biology is located within HWJ, and that are asked to provide volunteer help and consultation as needed. The purpose of the B MC, according to Beecher, is to support the HWI scientists are on the department's faculty. The university and RPCI are joint operators of the DNA microarray facility, many needs of the member institutions as they work to form a world-class RPCI faculty have UB appointments, and UB's cancer research and medical campus that supports centers of excellence in research, teaching is carried out there. Moreover, Kaleida Health is UB's education and clinical care. He praised the synergy and cooperative largest medical-care teaching affiliate, and many members of the spirit of the BNMC members in bringing the collaboration to Buffalo Medical Group serve as UB clinical faculty members. Summer 200 1 . 0 CD Buffalo Physician 23 �MEDI C AL S C H 0 0 L N E w s Commencement 2001 Commencement for the University at Buffalo School of Medicine and Biomedical Sciences was held on May 18, 2001. This year, the school conferred 125 MD degrees, 2 MD/PhD degrees, one MD/MBA degree, 33 PhDs and 42 master's degrees. Pictured (1) Honored Speaker Ronald Dozoretz, MD '62 (2) Kathleen Trapp with children Will, Anne and Joseph (3) Dean John R. Wright, MD (4) Kristen A. O'Brien (5) Jeanette Figueroa and third·year student Pamela Livingston (6) Patricia lmoako (7) Timothy B. Curry, MD, PhD (B) left to right, Mark Cicero, Ndegwa Njuguna and Jennifer Lezama. The following excerpts are from the commencement speech given by this year'shonored speaker Ronald I. Dozoretz, MD '62, chief executive officer, chair and founder of FHC Health Systems. "Set your sights high-be braced and sure-footed on your journey. The possibilities before you in this remarkable time are infinite. With new technologies and understanding from initiatives like the Human Genome Project, you have the capability to make breakthroughs I could only dream of when I was in school." "And I challenge you not only to be bold and take chances in the field of medical science, but in the social sciences as well. Do not leave this very important responsibility to someone else . ... I am sure you are aware of the billions of dollars given to teaching institutions and research projects each year by local, state and especially the federal government. Be involved so you can help influence their decisions." "Few people will ever have such a magnificent opportunity to help society. You have an obligation to do so-seize it. There are many challenges that we face collectively: one in six children live in poverty in this country. There are 44 million Americans without health insurance. Public schools in most cities are in poor repair, and students have no books. AIDS in Africa threatens the future of the entire continent. "We as a nation and as a people must address these challenges. And with your expertise, society will look to you for leadership." "As you embark on your journeys in the world of medicine, research and teaching, please follow your dreams and don't be afraid to fail. Take chances. Be bold. Be passionate. Give back to your community But most important: Never give up. Never give up. Never give up." Summer 2001 ��PATHWAYS N Ews ABOUT UB' s ScHOOL oF M E DICINE AND BIOM EDICAL S c i EN CES AND I TS ALU MNI, F AC U LT Y, S T UD ENTS AND STAFF M Paroski Named Director of Admissions Margaret W. Paroski, MD '80, has been named director of admissions for University at Buffalo's School of Medicine and Biomedical Sciences. She succeeds Thomas Guttuso, MD '60, who served in this capacity at UB for 19 years. Paroski is professor of clinical neurology at UB and medical director for A RGA RE T P A R os KI Erie County Medical Center, a position she will continue to hold. She served as president of UB's Medical Alumni Association in 1996 and is president-elect of the UB Alumni Association. Currently, Paroski is a member of the Dean 's Advisory Council for the School of Medicine and Biomedical Sciences. Guttuso joined the Admissions Committee in 1977 and was named director of admissions in 1982. He has also served as acting chair of the school 's Department of Ophthalmology. - S.A . UNG ER Bojovic Selected for Medical Mission Branko Bojovic, Class of 2002, has been selected as a medical student participant on an international medical mission sponsored by Operation Smile. Medical students are chosen via a competitive application process, and Branko is the first University at Buffalo student ever selected for this prestigious opportunity. Approximately 20 medical missions are sponsored by "Op Smile" each year to over 20 countries, where free facial reconstruc- tive surgery repairs are provided to the medically needy, most of whom are children. - D E BR A STAMM Miller to Head Division of Child and Adolescent Psychiatry Following a national search, Bruce Miller, MD, associate professor of psychiatry and pediatrics in University at Buffalo 's School of Medicine and Biomedical Sciences, has been named director of the Division of Child and Adolescent Psychiatry at UB. He succeeds Gary Cohen, MD, associate professor of clinical psychiatry, who founded the division in 1978 and CA RY CO H EN has served as its director for the past 23 years. Miller, who joined UB 's faculty six years ago, is a national authority on emotional factors impacting on childhood asthma. He received his medical degree from the College of Medicine and Dentistry of New Jersey. He served as an intern in medicine at B RUC E MILLER Long Island Jewish/Hillside Medical Center in New Hyde Park, New York, and completed his residency tra ining in general psychiatry and child and adolescent psychiatry prior to completing a postdoctoral research fellowship in developmental psychobiology at the University of Colorado Health Sciences Center. Miller served MILLER, A NATIONAL AUTHORITY ON EMOTIONAL FACTORS IMPACTING ON CHILDHOOD ASTHMA, SUCCEEDS GARY COHEN, MD, ASSOCIATE PROFESSOR OF CLINICAL PSYCHIATRY, WHO FOUNDED THE DIVISION IN 26 I u If a I a Phy si c i an S umm er 1978 2 001 AND HAS SERVED AS ITS DIRECTOR FOR THE PAST 23 YEARS . �on the faculty of the University of Colorado for nine years before being named director of the Division of Child and Adolescent Psychiatry at the University of Rochester. Prior to his accepting the position of director ofUB's Division of Child and Adolescent Psychiatry, he served as the director of pediatric psychiatry at Children's Hospital of Buffalo, a position he will continue to hold. Since coming to Buffalo, Miller and his research team have been awarded over $2 million in federal grant support for government payers and patients will routinely use to make health-care decisions. "To see ECMC listed as a Top 100 Benchmark Hospital in two out of four specialized areas included in this national study is a proud achievement for our hospital," says Sheila K. Kee, chief executive officer at ECMC. "T his recognition serves as yet another confirmation of the outstanding quality care that is offered by the Western ew York region's medical center." -S.A. UNGER their research. -S.A. UNGER ECMC's Cardiovascular and ICU Services Top 100 Modern Healthcare magazine has cited the Erie County Medical Center (ECMC)-a major teaching facility for University at Buffalo-as one of the 100 top hospitals for cardiovascular and intensive care services in the United States, according to an independent study conducted by Solucient (formerly HCIA-Sachs Institute) healthcare information company. The magazine's February26, 2001, issue features Solucient's 100Top Hospitals program that examines clinical, financial and operational data from hospitals to establish benchmarks for excellence. Clark Bell, editor of Modern Healthcare, noted that the study has evolved into a legitimate tool that employers, CraigVenter Delivers 2001 Cori Lecture J. Craig Venter, PhD, president and chief scientific officer for Cetera Genomics delivered a talk on "Sequencing the Human Genome" at the 24th annual Cori Lecture at Roswell Park Cancer lnstitute (RPCI) held on May 23, 2001. Venter, who was on the faculty at the University at Buffalo School of Medicine and Biomedical Sciences and RPCl from 1982 to 1984, has been widely recognized as the scientist who led the team at Celera Genomics in sequencing the human genome. He has published more than 160 research articles and is one of the most cited scientists in biology and medicine. He has received a number of honorary degrees for his pioneering work and was selected as Man of the Year by the Financial Times. The Cori lecture honors Drs. Carl and Gerty Cori, who served on RPCl's faculty from J. CRAIG VENTER 1922 until 1933. During this time, they initiated work on the chemis- try of the glycogen-glucose cycle, research that earned them the 1947 Nobel Prize in Physiology and Medicine. With this honor, Gerty Cori became the first American woman and the third woman in the world to be awarded the Nobel Prize. -DEBORAH PETTIBONE Ceorge M. Ellis .Jr., MD '45, Receives Samuel P. Capen Award George M. Ellis Jr., MD '45, received the Samuel P. Capen Award-University at Buffalo Alumni Association's most prestigious prize-at a dinner held on April 20, 2001, in the Center for Tomorrow on the north campus. Ellis, a generous and devoted alumnus of the School of Medicine and Biomedical Sciences for half a century was presented the honor for his notable and meritorious contributions to the university and its family. Prior to his retirement, Ellis worked as a physician and surgeon in a small, semi-rural Indiana community. He established the George M. Ellis Jr., S 11 111 111 MD, Endowment Fund for Medicine at UB, and also donated a rare, first edition of De conceptu et generatione homin11s-written by Jacob Rueff and published in Zurich in 1554-to mark the university library's acquisition of its three-millionth volume. Since his graduation from medical school, Ellis has devoted countless hours to organizing annual reunions for the class of 1945 as well as to keeping his classGEORGE M. mates updated and informed about each other. Last year, at the class's 55th reunion, he compiled a book that featured a biographical sketch of each class member. "The book is a treasured piece of memorabilia for each of his classmates and the families of those no longer with us," says Mary Glenn, director of community relations for the School of Medicine and Biomedical Sciences. -S.A . ELLIS UNGER Beutner and .Jordon Honored for Research Ernst Beutner, PhD, professor emeritus of microbiology and dermatology at the University at Buffalo School of Medicine and Biomedical Sciences, and Robert E. Jordon, MD '65, chair e r 200 I ERNST H. BEuTNER Buffalo Physician 27 �PATHWAYS "THE WORK OF DRS. [ERNST H.] BEUTNER AND [ROBERT E .] JORDON ESSENTIALLY BEGAN THE MODERN ERA OF DERMATO-IMMUNOLOGY," SAYS DERMATOLOGY fOUNDATION PRESIDENT JouNI J. UITTO, MD, PHD, IN PRESENTING THE SCIENTISTS WITH THE DISCOVERY AWARD. of the Department of Dermatology at the University of Texas Medical School at Houston, were chosen as corecipients of the Dermatology Foundation's 2000 Discovery Award at the annual meeting of the foundation on March 3, 2001, in Washington. D.C. The Discovery Award was created by the Foundation's Trustees in 1991 as the specialty's highest tribute to those colleagues who embody the essence of scientific and intellectual curiosity that the foundation strives to nurture through its research awards program. Drs. Beutner and Jordon were honored for their seminal recognition of the role of autoantibodies in the pathogenesis of pemphigus vulgaris (PV). Together, they found that PV autoantibodies bind to the surface of keratinocytes in precisely the same suprabasilar location that PV bullae form, suggesting a direct pathogenic role for antibodies. "The work of Drs. Beutner and Jordon essentially began the modern era of DermatoImmunology," says Dermatology Foundation President Jouni J. Uitto, MD, PhD. "The clarity of the relationship between bullous disease manifestations and laboratory findings, first established by [them] has not only permitted important aspects of pemphigus pathogenesis to be deciphered but has helped frame the next set of research challenges." Beutner joined UB's faculty in 1956 and taught microbiology to students of medicine and dentistry until his retirement in 1994. In 1992, he became director of Beutner Laboratories in Buffalo. The UB School of Medicine and Biomedical Sciences is proud that a faculty member and alumnus are corecipients of this prestigious award. -S. A. UNGER Lema Leads State Anesthesiology Society Mark J. Lema, MD, PhD, professor and interim chair of the Department of Anesthesiology at University at Buffalo's School of Medicine and Biomedical Sciences, has been installed as president of the New York State Society of Anesthesiologists (NYSSA), a chapter of the Society of Anesthesi- ologists. Lema is also chair of the Department of Anesthesiology and Pain Management at Roswell Park Cancer Institute (RPCI) and associate research professor in the Experimental Pathology Program at RPCI. As head of NYSSA, Lema leads a community of approximately 3,000 New York State anesthesiologists and works closely with the national organization, which boasts a membership of more that 37,000 anesthesiologists. In addition to his new role with NYSSA, Lema is editor of the journal Regional Anesthesia and Pain Medicine, the American Society ofAnesthesiology Newsletter, special editor of SPHERE and associate editor of the Clinical journal of Pain. He is a member of the Cancer Pain and End -of-Life Care panels of the NationalComprehensive Cancer Network, a MARK J. LEMA member of the Cancer Pain Guidelines Panel of the American Pain Society, and serves on the New York State Commissioner of Health' s Preoperative Policy Panel. - DEB OR AH PETTIB ON E 28 lu lfal a Pb ysicin S umm er 2 001 Bakshi Named Associate Professor Rohit Bakshi, MD, has been named associate professor of neurology with tenure in the clinical-scholar track in the University at Buffalo's School of Medicine and Bio medical Sciences. A native of Buffalo, Bakshi received his medical degree from UB in 1991. As RoHIT BAK SHI an Alpha Omega Alpha scholar, he completed a neuroscience research fellowship with Alan Faden, MD, at the University of California at San Francisco, where he studied neuropharmacology and stroke. Following medical school, he served a one-year internship at the Massachusetts General Hospital and a neurology residency at the University of California at Los Angeles. He then completed a one-year MRI/CT neuro imaging fellowsh ip at the Dent Neurologic Institute in Buffalo, followed by additional training in functional imaging. Bakshi, a staff neurologist and neuroimager with Kaleida Health System, is board certified in neurology and is a diplomat of the American Society ofNeuroimaging. His research �and clinical interests include neuroimaging as it relates to neurologic diseases, especially multiple sclerosis (MS). Recently, he was awarded a threeyear $350,000, research grant from the National Institute of Neurological Disorders and Stroke to study iron deposits and atrophy in the brains of patients with MS using computer analysis of magnetic resonance imaging scans. The project is being conducted at the Buffalo euroimaging Analysis Center, part of the Jacobs Neurological Institute at Buffalo General Hospital and the UB Department of Neurology. Bakshi's previous work suggests that iron deposition is common in MS brains and that the level of iron is related to impairments in physical disability and brain atrophy. Since increased iron levels are known to cause brain injury in other diseases, his work raises the possibility of a new treatment for MS. -S. A. UNGER Robert A. Bermel Receives the C. Milton Shy Award Robert A. Bermel, a secondyear student at the University at Buffalo School of Medicine and Biomedical Sciences, has received the G. ROBERT A. BERMEL Milton Shy Galpin Heads Pediatric Orthopaedic Surgery at Kaleida OBERT D. GALPIN, MD, has been named chief of the Division of Pediatric Orthopaedic Surgery at Kaleida HeaHh System's Children's Hospital of Buffalo, and associate professor in University at Buffalo's Department of Orthopaedic Surgery. Galpin earned his medical degree from the University of Western Ontario, London, Ontario, Canada, where he also completed his orthopaedic surgery residency. Galpin brings with him over 13 years of experience in pediatric orthopaedic surgery. Prior to joining Kaleida HeaHh System and UB, he was clinical assistant professor of orthopaedic surgery and pediatrics at the University of ROBERT D. GALPIN Western Ontario. His clinical interests include the treatment of spinal deformities, limb lengthening, pediatric trauma, sports medicine and hip and foot conditions. Galpin is a diplomat of both the American Board of Orthopaedic Surgery and the National Board of Medical Examiners. He is also a member of Alpha Omega Alpha Honor Medical Society and the Pediatric Orthopaedic Society of North America. Award from the American Academy of eurology. The award, which recognizes the best essay in clinical neurology, was presented to Bermel on May 8, 2001, at the academy's annual meeting in Philadelphia, Pennsylvania. "I am honored to receive this award from the academy and am grateful to my mentors, Rohit Bakshi, MD, and Lawrence Jacobs, MD, for their guidance in my pursuit of a career in academic medicine," said Bermel. "This award is just one recognition of the world-class research which continues to go on in Buffalo in the battle against multiple sclerosis." Bermel is continuing his research on neuroimaging in MS this summer with Bakshi at the Buffalo Neuroimaging Analysis Center in Buffalo General Hospital. His work will be funded by student grants from Alpha Omega Alpha Medical Honor Society and the UB Research Foundation. -S. A. Varma Selected to Participate in Mead'-'ohnson Seminar Chelikani Varma, MD, clinical associate professor of pediatrics at the University at Buffalo School of Medicine and Biomedical Sciences, and an attending at Kaleida Health's Children's Hospital of Buffalo, was nationally selected to participate in the MeadJohnson Clinical Seminar in April2001 in Tucson, Arizona. -S.A. UNGER (I) UNGER Slimmer 200/ 1 111211 Hysiciu 29 �the 64th An (xamination of "The Healthy Heart" Diagnoses and treatment of cardiovascular disease NIVERSITY AT BUFFALO School of BY S Medicine and Biomedical Sciences' 64th A. US G E R Annual Spring Clinical Day was held April 28, 2001, at the Buffalo-Niagara Marriott. The program, sponsored by UB's Medical Alumni Association, focused on "The Healthy Heart" and featured expert speakers who presented state-of-the-art information on the diagnoses and treatment of cardiovascular disease. The program opened with a talk on "Exploring the Power of Cardiac PET in Mainstream Clinical Practice," by Michael E. Merhige, MD, UB clinical associate professor of nuclear medicine and director of the Nuclear Cardiology Fellowship Program in the Department of Nuclear Medicine. "Interventional Cardiology in the Year 2001" was the title of the next talk, delivered by John C. Corbelli, MD '79, FACC, FACP. Corbelli is the Lipid Clinic and Research Director with Buffalo Cardiology and Pulmonary Associates, P .C., and clinical instructor at UB. 30 lalfalo Pbysiciaa S 11mm er 20 0/ Following Corbelli, Paul C. Kerr, DO, FACS, UB clinical instructor in the Department of Cardiothoracic Surgery, spoke on the subject of "Minimally Invasive Heart Surgery." After a brief break, the Stockton Kimball Lecture was delivered by Antonio M. Gotto Jr., MD, DPhil, the Stephen and Suzanne Weiss Dean and Professor of Medicine at Weill Medical College of Cornell University in New York City and provost for medical affairs at Cornell University. Gotto, who is also past president of the American Heart Association, spoke on "Perspective on the Role of Statins in Health and Disease." Prior to becoming dean of the medical college at Cornell, Gotto spent over twenty years at Baylor College of Medicine in Houston, Texas, where he was professor and chair of the Department of Medicine and chief of the Internal Medicine Service �at the Methodist Hospital in Houston . During that time, he was also]. S. Abercrombie Professor Chair for Athero sclerosis and Lipoprotein Research and was the scientific director of the DeBakey Heart Center at Baylor. Gotto and his associates were the first to achieve complete synthesis of a plasma apolipoprotein (apo C-1) and also determined the complete eDNA and amino acid sequence of apo B-100, one of the largest proteins ever sequenced and a key to atherosclerosis and coronary heart disease (CHD). In addition to his research interests, which have brought him worldwide repute as a leading expert on statins, Gotto brought to his lecture his clinical expertise on the pathology of atherosclerosis and CHD. He began his talk with a historical overview of the role of statins in reducing the risk ofCHD, explaining how the drugs were subject to a "backlash" controversy following their approval by the U.S. Food and Drug Administration in 1987. As an example of this backlash, he described a cover story published in the September 1989 issue of the Atlantic Monthly in which it was contended that the prescribing of statins amounted to a "conspiracy theory." Following this introduction, Gotto described the statins currently approved for use in the United States. In addition to explaining their mechanism of action, he outlined data currently available from five major clinical trials on the effect of statin therapy on CHD, which, he said, "show a relative risk reduction over the course of the trials." Results from these trials, he added, are remarkably consistent and provide "overwhelming evidence that statins stabilize plaque," reduce levels of LDL and reduce cardiac events. Gotto also described potential new targets for statin therapy, including diabetes, osteoporosis, stroke and dementia. While the drugs' efficacy in reducing risk for these conditions has not been demonstrated in clinical trials, studies are beginning, he explained. In concluding, Gotto said that, given statins proven effectiveness in reducing risk for CHD, he believes there is a "great underuse" of the drugs. Currently, 10 million Americans take statins, he noted, adding that, in his opinion, "some 25 to 30 million would benefit from them." At the close of Gotto's lecture, the audience had an opportunity to ask questions of a panel made up of all the morning's speakers, after which attendees gathered for a luncheon, where Gotto was presented the Stockton Kimball Award by John ]. Bodkin II, MD '76, president of the UB Medical Alumni Association. Me~ical Alumni Ac~ievement Awar~s Following presentation of the Stockton Kimball Award, Bodkin introduced the four recipients of this year's Medical Alumni Achievement Awards, who were honored for "work Gotto also above and beyond the general described potential practice of medicine, whether new targets for it be teaching, research or statin therapy. national service." including diabetes, Morton A. Stenchever, osteoporosis, stroke MD '56, was professor and and dementia. While chair of the Department of the drugs' efficacy in Obstetrics and Gynecology at the University of Washing- reducing risk for ton's School of Medicine these conditions from 1977 to 1996. Prior to has not been that, he held the same position at the University of Utah demonstrated in from 1970 to 1977. clinical trials, In announcing the award, studies are Bodkin briefly reviewed Stenbeginning, he chever's career, explaining that, after graduating from explained. UB's School of Medicine, he completed his internship and residency training at the Columbia- Presbyterian Medical Center in New York City. In 1962, following two years in the United States Airforce, he joined the faculty of Case Western Reserve University where over the next eight years he served in a S umm e r 2 001 l1f12ID Pbpiciu 31 �ALUMNI number of roles prior to moving to the University of Utah. Stenchever was unable to receive his award in person due to an obligation he was fulfilling in his current capacity as professor emeritus at the University of Washington. Wende W. LoganYoung, MD '61, a Buffalo native, is the founder and director of the Elizabeth Wende Breast Clinic in Rochester, New York, and a clinical professor of diagnostic radiology at the University of Rochester. When it was established in 1976, the Elizabeth Wen de Breast Clinic was the nation's first freestanding mammography and breastimaging facility devoted to breast-disease detection. Today, it is ranked WI just want to say as one of the nation's leading breast-care centers and has that when I opened my clinic 25 years ago, I been given a grant by Blue Cross/Blue Shield to define a was almost laughed Center of Excellence. out of town. For the "Many women from the Buffalo area-patients first five years, we of mine and many doctors didn't make any here-have traveled to money, but then the Rochester to see Dr. Loganpractice took off, and Young because she would tell them right away whether we did very well. And I their mammogram was norattribute that to the mal or not; she has really fact that people born helped to bring mammography to where it is today," and raised in Buffalo said Bodkin. don't know how to Logan-Young is also a take no for an past recipient of The American Cancer Society's (ACS) answer." 3 2 lllfale Hysiciu S umm e r 2001 Hope Award and The Distinguished Alumni Award from the University at Buffalo. She is currently a member of the Medical Advisory Committee for the ACS. Following presentation of the award, Logan-Young commented: "I just want to say that when I opened myelinic 25 years ago, I was almost laughed out of town. For the first five years, we didn't make any money, but then the practice took off, and we did very well. And I attribute that to the fact that people born and raised in Buffalo don't know how to take no for an answer." Currently, she also serves as the speaker of the House of Delegates of the Medical Society of the State of New York. She has served as a trustee of the State University of New York and chief medical officer for the New York State Department of Health's Western Region. Upon receipt of the Medical Alumni Achievement Award, Nielsen stated: "I wore two pins today. One is the UB pin and the other is the emblem they gave me that I'm to wear every time I represent the AMA. I wear that for you because if UB had not given me a chance to come to medical school, I would have been who knows where, and I want to thank all of you who came before me and on whose shoulders I stand. I think of you always and every time I wear this, I honor you." Marcello Fierro, MD '66, is the chief Nancy H. Nielsen, medical examiner for the Commonwealth MD '76, PhD, assis- of Virginia and professor and chair of the tant dean for student affairs at UB's Department of Legal Medicine at the School of Medicine and Biomedical Sci- Medical College of Virginia. Only the ences and clinical associate professor of ninth woman to have been certified by the medicine, has been very American Board of active in the politics of Pathology in forenNielson. PhD. MD '7& medicine throughout her sic pathology, Fierro career, Bodkin explained. today is a Fellow of In 2000, she was elected the American Acadvice speaker of the Ameriemy of Forensic Scican Medical Association's ences and serves as policy-making House of a consultant to the Delegates, which, if tradiFederal Bureau of tion holds, places her in Investigation at the line for the presidency of National Crime Inthe AMA. An internist in vestigation Center. private practice in Buffalo, In addition, she is Nielsen has twice been chair of the Forensic elected to the AMA's Pathology CommitCouncil on Scientific Aftee for the College of fairs and sits on its execuAmerican Patholotive committee and Strategists and serves on gic Planning Task Force. the board of editors Nancy �Marcello Fierro. MD '66 of the American Journal of Forensic Medicine and Pathology. Fierro has also gained renown for inspiring the creation of mystery novelist Patricia Cornwell's protagonist, Dr. Kay Scarpetta. Cornwell has based the character of Scarpetta (the fictional chief medical examiner for Virginia)on her mentor Fierro, whom she first met in the 1980s while working as a technical writer in the Medical Examiner's Office. Cornwell has said of Fierro, "I consider her the best forensic pathologist in the world, and she has been a tremendous inspiration to me." In accepting the Medical Alumni Achievement Award, Fierro said, "Thank you all very much for this award. It's hard to accept an award for work that you love and that you are driven to do." Pausing, she quipped, "And I have one other piece of information to pass along to you: Patricia Cornwell's character is five feet tall, blonde, blue eyed and lOS pounds!" 4D Olmsted Ross Receives lucien Howe Medal Iizabeth Olmsted Ross, MD '39, has received the prestigious the award in recognition of her lifetime accomplishments in Lucien Howe Medal for outstanding achievement in ophthal- teaching, research and community service. mology. The award, presented jointly by the University at Olmsted Ross has been in private practice in Buffalo since Buffalo School of Medicine and Biomedical Sciences and 1944. She began teaching clinical ophthalmology at UB's school the Buffalo Ophthalmologic Society, is named in honor of of medicine in 1955, and in 1974 was named clinical assistant Lucien Howe, MD, who began prac- professor, a position she still holds. She tice in Buffalo in 1874 and founded received a commendation for 50 years of the Buffalo Eye and Ear Infirmary in service at Millard Fillmore Hospital and a 1876. In addition to his private prac- citation for service at Deaconess Hospi- tice, Howe served as professor of tal, where, in 1968, she was named chief ophthalmology at the then-Univer- of the Department of Ophthalmology and sity of Buffalo from 1878-1909. The chair of the residency program. Howe medal, first presented in 1928, Recently, Olmsted Ross was honored was one of a number of awards he by the Buffalo Blind Society, which established to recognize contribu- named their newly renovated area the tions in ophthalmology. Elizabeth Pierce Olmsted Educational Center, and by the Western New York "Past awardees of the Lucien Howe Medal reads like a list of who's Blind Association, which changed its who in ophthalmology," says James name to the Elizabeth Pierce Olmsted, Reynolds, MD, chair of UB's Depart- MD, Center for the Visually Impaired. A ment of Ophthalmology. Olmsted reception in honor of her receipt of the Ross, who is the 23rd recipient of Elizabeth Olmsted Ross, MD, ritflt, and James Lucien Howe Medal was held at the the medal, was selected to receive Reynolds, MD, chair of ophthalmology at UB. center on May 3, 2001. S 11 m 111 e r 2 0 0 I Buffale Physicin 33 �ALUMNI Reflections on aMedical Career Trying to practice the type of medicine UB taught me 30 years ago For all of us, it was very S I SA \1 Ot.- R Spring BY special indeed to see Clinical Day dinner and \1 CHAEI BARO'< him again. listened to my classmates \1 D ' 1 FCCP Our 30th reunion summarize their memories allowed us to rekindle old friendships as of UB and their careers, I felt proud to be their colleague. What well as get to know some of our classhigher praise can I give them mates for the first time. Medical school, except to say that I would entrust residencies and practice have been a blur my life and care (and my family's) at times. It is a treat to have occasions like these to reflect. anyone in that room. It is wonderful to practice It was an honor to be accepted to UB's School of Medicine. We were all medicine. We have the priviyoung and eager then, and with each day lege of seeing miracles unfold that passed-and with every course-the in front of our eyes. In addition enormity of our task became evident. A to witnessing people who have lifelong commitment to study, work and healed and lived when we excellence was what we pledged. By the thought they would die, sadly time we reached our clinical years, the we have seen those who should awesome responsibility of our profession have lived, pass away. MICHAEL had became clear to us. I recount daily the words of The faculty at UB were excellent and, wisdom from the internal medicine director for our class, Dr. M. S. Megahed was the during my residency. He said, "Ladies and best of the best. While he combined his gentlemen, you can't expect your patients vast knowledge of neurology, neuro- to be as concerned about their health as anatomy and internal medicine to teach you are. That's why you are the doctors." us, he taught us far more than facts and I suppose it is human nature, but I still figures with his humanity, deep religious don't understand it. I struggle every day to and family convictions, and friendship. mitigate my patients' suffering and give • was elected to sene a sec:ond tenn as president of the Medical Alu111nl Association on April 28, 2001, at Spring Clnical Day. Bodkin, a 1976 graduate of UB, Is a clinical associate professor of famiiJ medicine and president of the Hllhgate Medical Group In Wllllanmille, New YortL. • class of 1991, becomes Yice president of the Medical Alumni Association. Mattlmore Is a UB clinical Instructor of pediatrics and Is on staff at Kalelda Health's Children's Hospital and Men:, Hospital of Buffalo. 3 4 l llflil Physicin St~mmer 2001 them my best counsel. If medicine has taught me anything, it has been to keep an open mind. As knowledge expands, changes, or goes full circle, we must adapt neither too quickly nor too late. It is my hope that during my career or lifetime I can begin to see and understand the rudiments of the mindbody connection. Whether the keys will be found in biochemistry, physiology, neuroanatomy, or other fields is inconsequential. It will be our ability to harness that great life force for wellness first, and healing second. At the reunion, I sought out Philip Wels, MD '41, who initially interviewed me for a position in the School of Medicine, and I BARON thanked him for the faith he showed in me by accepting me in 1967. I have tried to repay that faith by practicing the type of medicine that UB taught me so 4D many years ago. Michael Baron is a pulmonary and critical care physician who practices with Blue Ridge Medical Specialists in Bristol, Tennessee. • class of 1982, Is the new treasurer for the association. Polack Is a UB clinical assistant professor of ophthalmolou who Is In private practice In WIUianmille, New YortL. �FIRST Row, DOKALD L. BAROI'OE, LUDWIG R. KOUKAL, ELI ENGEL.jONATHAK P. LEOPOLD, BERNARD SMOLENS, MARVII'Oj. PLESKOW, LESTER E. WOLCOTT; SECOSD ROWe AL\'1:-.1 VOLKMAN, LEO!';ARD S. DAI'OZIG, AUGUST A. BRUNO, MARK E. HEERDT, ROBERT E. PLOSS; THIRD ROW, ANTHOSY C. BAROI'OE. WILS0:-.1 W. SHAW. FRA!';Kj. BOLGAS, GERARD E. SCHULTZ; FOURTH ROW, Or> STAIRS, EDWARD :VI. ZEHL.ER.jAY B. BELSKY, EUGE.'E V. LESLIE. CARL R. CO!';RAD, AL.LEK fiRST ROW: ROBERT\\". ED,fONDS.jOSEPH T. L. GOLDFARB. AQUILI. A, :\I.~RY H BOTSFORD. GEORGE ECKH ERT; SECOS D ROW, PASQUALE A. GRECO. PHILIP B. WELS. GEORGE GENT!';ER; THIRD ROW, EUGENE.). HANAVAN. DANIEL.}. MCCUE, BRADLEY HULL. fiRST ROW : IRA \fiLLER, ROBERT E . REISMA:-.i,jOSEPH j . DARLAK, ROBERT B. CORRETORE. HERMA:-.1 R. SCHOEr>E, CARL N. SCHUELER; SECO;-."D ROW, PAUL C. RONCA,JosEPH!.. Ku:-;z.jEAN C. HAAR, ERICK REEBER, HUGH F. Oi:-.:EILL, DEK:-IIS P. IIEIMBACK, HELENE BUERGER. ED,fO:-.ID.). GICEWICZ,jORDAr> S. POPPER, GEORGE H. CHRIST, BERNARD II. SKLAR. FIRST ROW, SEATED : RICHARD \\i. MuNSCHAUER, WILLIAM P. WALSH. HAROLD.). LEVY, As;-."ABEL iRO;-."S, CHARLES D. BAUER; SECO:-.ID RO\L EDWARD F. GuDGEL, LAwRDICE H. GoLDE:-.!, FRED S. ScHWARz. CHARLES A. jOY. HARRY E. PETZI:-.IG, MAY:-.IARD H. MIRES. STANLEY j. CYRAN. CARLj. ]M PELLITIER . jOSEPH R. NAPLES, HERBERT S. PIRSON, EuGENE :\1. \1ARKS . \ummrr 2001 l1ffal1 Hysici11 35 �LEFT TO RIGHT: HAROLD f. GRUNERT. jEFFREY L. KAHLER, jAMES COUGHLIN, CARY A. PRESANT, KENNETH V. KLEMENTOWSKI, VIRGINIA RuBINSTEIN,jOHN RuBINSTEIN.jARED C. BARLOW, THOMAS W. BRADLEY, CHARLES H. MICHALKO, DAVID L. BUCHIN, MARCELLA f. FIERRO, ROGER W. SEIBEL, LOUISj. ANTONUCCI fiRST ROW· TODD A. JACOBSON, THO~IAS LANE, TI!'.IOTHY P. COOLEY, BETTY E. :--,1 EREDITH HARRIS, ROBERTA SzCZUREK; SECO'< D ROW: L. BUKOWSKI. ROBERT E. KAPLA'< \'v.ELLS, STANLEY PATRICK \\1. DIESFELD, GEORGE BANCROFT. DIASA DA.'IELA. CASTELLANI. Ross S. E. ELLIS, SIL\ERSTEIN. fiRST ROW: lLJAj. WEINRIEB, RICHARD A. MANCH, MOHA!'.IED MEGAHED,jOEL H. PAULL, ROY M. 0SWAKS, HARVEY GREENBERG. DONALD H. MARCUS: SECOND ROW: SANFORD S. DAVIDSON, MARTIN N. "JANGO, SCOTT D. KIRSCH, ASKOLD D. MOSIJCZUK. ALLEN BERLINER, NICHOLASj. CAPUA:-iA, MICHAEL B. BARON. jERALD A. BOVINO, jONATHAN S. LEVY. jEFFREY D. fLEIGEL, LEFT ROW BOTTO\! TO TOP· ROSYLN R. RO~IANOWSKI, PAUL C. HOLMWOOD. LANCE A. BESNER. SANFORD H. THOMAS G. DISESSA. l FVY, RIC HARD WILKS: RIGHT ROW THERESA TARTARONE URCIUOLI. STEPHEN URCIUOLI. ANDREW P. GIACOBBE, LEO'<ARD ). PORTOCARRERO, DA!'>iiEL ANDERSON, Wll.LIA!'.I 3& Summer 2001 fl. STEPHAN. E. �FIRST ROW SEATED. LEFT TO RIGHT: t\ILEDi D. CHANG. ROSAI.IND ~OI.AN SuL~I:>.tAN, EussA \1. BoOKNER. JENNIFER). MoM£:>~. \II CHELLE SKRET. ·y SUSCO, KATHYLYNN PIETAK SOUTHARD, LINDA LOR£l>OZANI; SECOND ROW: KATHLEEN£. BETH IN, ADRIANA OROZCO KELLERMEIER, LEliA KIRDANI RYAN, YVETTE M . .JOCKIN , jENSIFER HENKIND FERRARO, MuKESH K.jAtN, Rou.:-~o RODRIGUEZ, PRA!>.IOD K. SHARMA. jOSEPH S. VASILE. \IARY E. BONAFEDE. COLLEEN A. MATTIMORE; THIRD ROW: ERIC SCHUBERT, GREGORY\\' . BRANCH, DwiGHT D. LEWIS, EDWARD PIORTOWSKI, fiRST ROW, LEFT TO RIGHT: THOMAS K. CIESlA, WENDE W. YOU:-iG, SYLVIA R. KENNEDY, j. ANTHONY BROWN; SECOND ROW : KEr-;1\ETH E. BELL, HAROLD BRODY, RICHARD C. HATCH, RONALD H. \IATTHEWj. PHILUPS , ASTHONYR. RICOTTONE , PHlUPj. RADOS, jOHN P.jOHN. MARKj. :\1ANCUSO,jOSEPH P. BONAFEDE. USIAK, EuGENE A. CI~IINO, :'viiCHAEL MADIANOS, ROBERT \1. \10RA!';, GERALD v. ScHWARTZ, ALFRED \lEssoR E. HE. ·RY F. GoLLER, MICHAEL E. COHE .. , HOWARD C. WI LINSKY. FREDERICKS. CIESlAK. SEY~!OURj. LIBERMAN. THE REUNION PHOTOGRAPH FOR THE Cuss OF 1996 WILL BE PUBLISHED IS THE AUTUMK ISSUE OF BUFFALO PH}'S/CHS. Gifts committed to the School by those celebrating reunions this spring totaled over $170,000, the largest class fund drive ever. On behalf of the UB School of Medicine and Biomedical Sciences, I extend a very sincere thank you to the class chairs and their classmates who responded. We are fortunate to have your support and greatly appreciate your generosity. -Lyn Corder, Director of Development FIRST ROW. LEFT TO RIGHT: SUSAN H. BARDE, LINDA \1. WILD, KARE. ·A. Gu.scow, KATHLEEN C. ACKERMA!';: SECOND ROW: STEPHAN LE\ ITT, Do. 'ALD GEORGE, SHINY. l.IONG, MICHAELA. SMITH, CHRISTOPHER). BARDE. DANIEL R. WILD, jOHN.). BOOK!.', PATRICK R. HAYES. CHRISTOPHER F. BRA.'DY, GREGG BROfFMA.', ANDREW \1. GAGE, PAUL P. ScHWACH. LAZLO TOMASCHEK. GRANT GOLDEN. Summrr 2001 llffall nysicial 37 �0 E V E L 0 P M E N T E W S Gifts of Anwork Beautif Our School By Li nda J . Cor de r , Ph0, CFRE we tend to focus on the larger monetary ones of stocks, bonds, charitable unitrusts and estate plans because they have the power to transform the school. As vital as these larger gifts are, however, we also deeply value other contributions; for example, the many volunteers who give of their time. Think about the Dean's Advisory Council, Campaign Steering Committee and National Advisory Group, or the Medical Alumni Association Board, Medical Student Parents' Council and newly formed Medical Faculty Emeritus Group, all of which add to the richness of the fabric that comprises our UB Family. Then, there are the class reunion chairs, alumni who return to talk with students about their specialties, alumni lecturers and the volunteer faculty, a most important group throughout the institution's history. This past year, a group of students became interested in AT PRESENT, WE ARE COMPILING beautifying their school and put A LIST OF ALUMNI ARTISTS AND out a call to alumni for gifts of FRIENDS OF THE SCHOOL WHO artwork that could be displayed in WOULD LIKE TO MOUNT EXHIBITS classrooms, study areas and the OF THEIR WORK OR CONTRIBUTE standardized patient offices, to TO THE SCHOOL'S PERMANENT name a few venues. COLLECTION. PLEASE LET US KNOW As a result, the school is IF YOU WOULD LIKE TO BE ADDED now beautified with works of art TO THIS LIST. such as those presented by one of our alumni who works for the 38 laffal1 Physiciaa Summer 2001 Journal of the American Medical Association and who sent two prints from a show of the journal's cover art. Also, in May of this year, with the help of one of our volunteers, students hung an exhibition of photographs taken by an alumnus. Another alumnus donated a dozen prints on the history of medicine that formerly hung in his office, all of which will be exhibited in a location where they may inspire students. Many others have contributed posters and prints, including Evolution (see below) and the Herd of Buffalo, as well as depictions of plants and flowers. In addition to gifts from alumni, the school has received from the Association of American Medical Colleges a set of five signed prints by Jim Dine (see back cover) . We also have a study of ]ames Scott, Himalayan Survivor signed by both Dr. Scott and the artist, Martin Howard Boscott, a gift from philanthropists in Melbourne, Australia. At present, we are compiling a list of alumni artists and friends of the school who would like to mount exhibits of their work or contribute to the school's permanent collection. Please let us know if you would like to be added to this list. 4D Linda (Lyn) Corder is associate dean and director of development. She may be reached by phone, toll free, at 1-877-826-3246, or by e-mail, at ljcorder@buffalo. edu. �Dear Fellow Alumni, Sl' .. ;S; 0 ·~in; ~"p11e11ed tc •ne on my way to a recent alumni board meeting. Patricia Duffner, MD '72, told me she was not going to be able to serve as incoming president for our Medical Alumni Association. She had a couple of unexpected situations come up that were going to require a great deal of her time. After discussing this with Bertram Partin, MD, '53, former assistant dean for alumni affairs, I decided to offer my services to the board as president for another year. As you all know, I felt very privileged to have served in this role for the past year. I feel I already "know the ropes" and so will be able to help the school even more in my second term in office. As president of our alumni association, I will work alongside Colleen Mattimore, MD '91, and Stephen Pollack, MD '82, who were elected vice president and treasurer, respectively, for the coming year. In the months ahead, I will keep you apprised of changes in the Medical Alumni Office in follow-up to the restructuring plans recently announced for the office, as discussed on the inside front cover. Since these changes were announced as this issue of Buffalo Physician was going to press, I'm unable to provide further details at this time. However, I will do my best to give you as complete an update as possible in the fall issue of the magazine. In other news, a major change in the bylaws of the Medical Alumni Association was approved at the annual meeting held during this past April's Spring Clinical Day and Reunion Weekend. We voted to expand our membership to include emeritus professors, fellows and residents of our graduate medical education programs. These changes will enable us to continue on our course of motivating more people to become interested and involved in "giving back" to our school. Anyone who feels that they might fit into one of these groups and would like information about joining our association, is invited to contact ancy Druar in the Medical Alumni Office, at (7 16 ) 829-2778. Finally, I would be personally remiss if I did not mention our continuing effort to expand the number of alumni who hold lifetime memberships in our association. So, again, please consider supporting our school by becoming a lifetime member of the UB Medical Alumni Association. Thank you for the opportunity to serve another year. jOHN J. BODKIN II , MD President, Medical Alumni Association St~mmer 2001 Buffalo Physician 3 9 �CLASSNOTES Charles J McAllister, MD, '73, writes: "Since July 2000, I have been in the position of chief medical officer of DaVita, the second-largest dialysis company in the world. We have over 430 dialysis units in 34 states. I finally ended clinical practice last year. Very good news is that Diane and I are to be first- time grandparents this year. I maintain offices in Los Angeles, CA, and in New Port Richey, FL." E-mail address is: HKidneydoc@cs.com. Richard J. Goldberg, MD '74, writes: "I am currently professor of psychiatry and medicine at Brown University and psychiatrist-in-chief at Rhode Island Hospital and The Miriam Hospital in Providence. I graduated from the Harvard School of Public Health with a masters of science in Health Care Administration in June 2001." 1980s Michele J. Armenia, MD '86, Barrington, IL, gynecology, writes: "My husband, Robert Aki, MD, and I have three children: Maria, age three, Matthew, age two, and Laura, eight months." 4 0 I u If a I a Amherst, NY, writes: "I completed a lung transplant fellowship in Pittsburgh, PA, in 1991 and currently work in pulmonary and critical care medicine. I am married to James Houck, MD." E-mail address is: lcampbell@kaleidahealth.org. as anyone and writes about them with passion and compassion. This fine, wrenching novel chronicles the addiction of a physician with sensitivity and fearlessness. Dr. Joseph Molea has crafted a wellwritten, important, intensely engaging novel." Karin E. Choy, MD '86, Sean T. O'Brien, MD '86, writes: "Turning 40 has been anything but uneventful! I've finally returned to New York from Connecticut and have taken the position of medical director for Clinical Associates for Rehabilitation and Evaluations, Inc. I also found time to get remarried (to a non-medical UB alum) in April, and we're dividing our time between homes in the city and Long Island. Can't wait to see what's next!" E-mail address is: kcmd@worldnet.att.net. Alpharetta, GA, interventional radiology, writes: "My wife, Sandy, and I have two children: Kasey, age seven, and Jake, age four." E-mail address: styob@aol.com. Lucy A. Campbell, MD '86, 1970s Katrina Guest, MD '86, Waukee, IA, pulmonary medicine, writes: "My husband, Andrew, and I have two children: Adam, ten, and Nathan six." E-mail address is: kaguest@home.com. Joseph Molea, MD '86, will publish his first novel, Duck Blood Soup, this summer. Molea trained as Physic i a a Summer a general surgeon, has a subspecialty in addiction medicine and practices administrative medicine as the executive director of Health Care Connection of Tampa, Inc., a chemical-dependency rehabilitation facility specializing in the treatment of impaired professionals. He lives in St. Petersburg, FL, with his wife, Heidi, a school teacher, and their twin 16month-old daughters, Sophia and Abbegail, whom they adopted from Cen tral Asia last year. Heidi is expecting their third child due this fall. Duck Blood Soup is the first-person account of one physician's struggle to become a surgeon while losing his grip on reality through Demerol 2 0 0 1 addiction. Senior surgical resident Rocky Van Slyke is young, single, living in Philadelphia, at the brink of a brilliant professional career. He should be happy. He's not. Molea skillfully dovetails Rocky's memories into the present-day odyssey of the young physician's own substance abuse, and, through the character of Vincent G. Buddy, the hospital attorney, demonstrates, with alarming accuracy, how the culture of abuse is passed from one generation of physicians to the next. Acclaimed author, Dr. Michael Palmer wrote of this work: "Duck Blood Soup is a powerful, haunting story. Joseph Molea knows the inner workings of addiction as well Deborah Richter, MD '86, Montpe- Sandy and Sean O'Brien lier, VT, family practice, writes: "My husband, Terry Doran, and I have two children: Justin, age 12, and Patrick, age 11. My favorite memory of medical school were the parties at Wally Straus' house." Roslyn R. Romanowski, MD '86, E. Amherst, NY, hematology/oncology, writes; "My husband, Robert Campo, and I have one son, Richard, age three." E-mail address is: rromanow @alum.mit.edu. Alan M. Stein, MD '86, Hooksett, NH, family practice, writes: "My wife, Susan Kunkel, and �I have three children: Sarah, age 15, Kevin, age 13, and Jimmy, age 10. Theresa Tartarone, MD '86, and Stephen Urciuoli, MD'86, Westport, CT, internal medicine, write: "We have three children: Stephanie, Carmine and Anna." Valerie E. Whiteman, MD '86, Hockessin, DE, obstetrics/gynecology, completed a MFM Fellowship at the University of lllinois at Chicago in 1990-1992. E-mail address is: drvwhite @home.com. Kathleen Grisanti Lillis, MD '87, has received the 2001 Catherine McAuley Distinguished Alumna Award from the Alumnae Association of Mount Mercy Academy in Buffalo, NY. The award is presented to an alumna of the academy "who has distinguished herself as a woman of faith, knowledge, integrity and compassion; a woman whose accomplishments in all areas of her life-her family, her community, her career-reflect the legacy and mission of Catherine McAuley, the foundress of the Sisters of Mercy. Lillis is chief of the Division of Emergency Medicine and medical director of the Emergency Department at Children's Hospital of Buffalo. According to Mount Mercy Academy, she has "dedicated her life to enriching the health, safety and well being of infants and children. 1n addition to managing an emergency department that is one of the best pediatric facilities in the country, Kathleen is also the volunteer director of Mercy Flight. She is on call for the helicopter team 24 hours a day, fielding calls and directing care, all for the welfare of children. As a distinguished alumna, Dr. Lillis's life models that of Catherine McAuley in her persistence to improve the quality of life for children, in leading by example and in believing that one life can make a difference." Vasile Chief of Psychiatry at faleahh Care 1990s RohitBakshi, MD '91, neurology and neuroimaging, writes: " My wife, Lori, and I are thrilled to announce the arrival of our first child, Adam. He has added much excitement and joy to our lives. He has been welcomed enthusiastically and lovingly by his four beaming grandparents who also live in the Buf- falo area, including Dr. George Baeumler, MD '59, and Dr. Suraj Bakshi, associate professor of nuclear medicine at UB." ite medical school memories include friends, Dermatones, yearbook staff." E-mail address is: gwmbranch @aol.com. Kathleen 8ethin, MD '91, St. Louis, MO, pediatrics, writes: "I am currently working at St. Louis Hospital in Missouri. E-mail address is: beth in_k@kids. wustl.ed u. Paul A. Brill, MD '91, Anderson, SC, neurology, writes: "My wife, Sandy, and I have a son, Andrew, age nine." E-mail address is: pabrill@viafamily.com. Gregory Branch, MD '91, Baltimore, MD, internal medicine, "I have a son, Byron, age 11. My favor- assnotes Sllmme r 200 1 Aileen Chang, MD '91, Stony Brook, Y, gastroenterology, internal medicine, writes: "My favorite memories of medical school include orientation week." E-mail address is: achang@pol.net. Buff a l o Phy sic i a a 4 1 �CLASSNOTES Robert C. Dukarm, MD '91, neonatology, Buffalo, NY, writes: "My wife, Carolyn Dukarm '89, and I have two sons: Ryan, age four, and Matthew, age two." have three children: Steven, Donovan and Elaina. My favorite memory of medical school was playing pool at Chevy's Bar and Grill." John Gelinas, Jr, MD '91, Ingrid C. Helmer, MD '91, Redding, CT, child and adolescent psychiatry, writes: "My wife, Carole, and I have three children: Andrew, jackson and Emuly. My favorite memories of medical school are times with my friends. UB was a great experience!" E-mail address is: jgjrchbg @gateway. net. Lunenburg, MA, pediatrics, writes: "My husband and I have two children: Natalie and Katherine." Toby D. Goldsmith, MD '91, Gainesville, FL, psychiatry, writes: "We have a new little boy, Reid Mitchell Shapira, born in September of2000." E-mail address is: goldsmith@pol.net. Ronald Hale, MD '91, Victor, Y, public health and general preventive medicine, writes; "My wife, Cynthia, and I have two children: Madeline and Benjamin. Among many other things, I am still under active duty with the Air Force." E-mail address is: erhale@sajx.rr.com. Steven P. Harris, MD '91, Gibsonia, PA, pulmonary, critical care, writes: "My wife, jane, and I 4 2 I u If a I o La jolla, CA, ophthalmology, writes: "We have a son, Erik Willem. My favorite memory of medical school was the Follies." E-mail address is: yvette@jockin.com. Tualatin, OR, anesthesiology, writes: "My favorite memories of medical school include studying in the study hall with my friends and then wandering around campus to find different places to study when it got too crazy in the study hall-and Buffalo wings!" E-mail address is: kubota@teleport.com. Physician Summer Bethesda, MD, pediatric endocrinology, writes: "My husband, Eric Feyer, and I have a daughter, Elyssa, and a new one due in August of 2001." E-mail address is: dmerke@nih.gov. Stephen Lipsky, MD '91, Susan Y. Kubota, MD '91, Amherst, NY, internal medicine, "My wife, Erica, and I have four children, Danitra, Diandrea, Delmarie and Dwight. My favorite memory: 'Rubbish,' or brownies." E-mail address is: dlera@aol.com. Deborah Merke, MD '91, '91, Westford, MA, physical medicine and rehabilitation, writes: "My wife, Kathleen, and I have two children: Marc and Elena. My favorite memories of medical school: friendships, colleagues pulling together to help each other through difficult times; first time on the wards; acceptance and graduation." E-mail address is: pliguori@pol.net. Yvette Jockin, MD '91, Dwight Lewis, MD '91 , Paul Anthony Liguori, MD Dunwoody, GA, pediatric ophthalmology, writes: "I completed a pediatric ophthalmology fellowship in 1996 at Indiana University. My wife, Karen, and I have two children: Harrison and Alexandra." E-mail address is: thelipskys @media.one.net. '91, Loganville, GA, psychiatry, writes: "I work for a community mentalhealth organization at a crisis stabilization inpatient unit." E-mail address is: cbmorgan @medscape.com RichardS. Musialowski Jr., MD '91, Rock Hill, SC, 2 0 0 I rics, writes: "My wife, Kathleen, and I have two children: Connor james and Ryan Elizabeth. I am currently on the hospital staff at Children's Hospital of Philadelphia." E-mai Forest Hills, NY, obstetrics/gynecology, writes: "My favorite memories are brownies, anatomy lab (our group was very funny) and finishing!" E-mail address is: jabram5453@aol.com. Keene, NH, pediatrics, writes: "My husband, Dean, and I have three children: Anna, Maxwell and jonathan." E-mail address is: janmcgonagle@hitchcock.org. Kevin C. Osterhoudt, MD '91, Radnor, PA, pediat- Carol Bradley Morgan, MD Susan J. Littler, MD '91, Jan McGonagle, MD '91, help me out when I had troubles with my classes-that they stuck with me. That support meant much for me." E-mail address is: atn0623@aol.com. cardiology, writes: "My favorite memory of medical school was Friday afternoon anatomy lab that continued on to become chicken wings and darts at a local establishment." E-mail address is: musialor @rjsonline. net. Anthony T. Ng, MD '91, Brooklyn, NY, psychiatry, writes: "My favorite memory of medical school includes having really good friends to Terrence S. Peppy, MD '91, Orlando, FL, obstetrics/ gynecology, writes: "My wife, Renee, and I have three children: Christopher, Stephen and Nicholas. My favorite medical school memories include classmates and rotations." Edward S. Piotrowski, MD '91, Orchard Park, NY, general surgery/trauma/ burns/laparoscopy, writes: "I am a member of the American Burn Association. My wife, judith, and I have two children: Elizabeth and Derek. My favorite CONTINUED ON PAGE 44 �Lloyd A. Clarke, MD'38 Clinical associate professor emeritus in psychiatry Abraham%. Freudenhelm, MD'38 Paul Kendrick McKissock, MD 'SG Renowned plastic surgeon .Jerome.J. Maurlz:l, MD 'S2 Founder of Occupational Health Services Summer 2 0 0 I lllfal• nrsicia• 43 �CLASSNOTES I wife, Donna, and I have two children: Joey and Christopher. My favorite medical school memory: Thursday night Simpsons and get togethers." E-mail address is: joewmd@hotmail.com. CONTINUED FROM PACE 42 Cook at Strong Memorial medical school memories include: ( l) The 'P' dissection group in gross anatomy; and (2) When my partner in secondyear clinical asked an elderly patient, "Do you have a history of subacute bacterial endocarditis?" Residents Arif R. Alam, MD, has been Phil Rados, MD '91, Buffalo, NY, writes: "My wife, Genevieve, and I have a son, Francis ( Frano ), born on january 31, 2001." E-mail address is: amalavinica@hotmail.com. Stephanie Han, MD '96, Susan, and I have two children: )yoti and Ravi." E-mail address is: pramodksharma@aol.com. New York, NY, radiation oncology, writes: "I will join the faculty practice at ew York University Medical Center in July." E-mail address is: stephanie.han@yale.edu. Michelle (Skretny) Susco, MD '91, Clifton, VA, pedi- Eileen Reilly, MD '91, Buffalo, NY, family practice, writes: "I am married to Ray Gomez. My favorite medical school memories include finishing the first year and planning a trip Ray Gomez and across the coutry." Eileen Reilly Vicki L. Seidenberg, MD '91, New York, Y, physical medicine and rehabilitation, writes: "My husband, Mark, and I have two children: early Brooke and Leah Nicole. My favorite memorygraduating!" Pramod K. Sharma, MD '91, Ann Arbor, MI, otolaryngology/head and neck surgery, writes: "I am currently on staff at the University of Michigan. My wife, 4 4 la lf al t atrics, writes: "Among other things, I recently finished a program for 'Physicians Leading Change' at Georgetown University Medical Center." E-mail address is: jmcsusco@erols.com. Rudolph Joseph Schrot, MD '96, Sacramento, CA, Beth MacDonald, MD '96, Portland, OR, internal medicine, writes: "One of my favorite memories of medical school is Karin Selva's cabin party." E-mail address is: sqrmf@aol.com. Joseph A. Zarzour, MD '91, Wichita Falls, TX, pediatric ophthalmology. "My favorite medical school memory: The feeling of relief after a block of exams!" Paul S. Matz, MD '96, Pawtucket, RI, writes: "My primary specialty is general academic pediatrics." E-mail address is: psm9@cornell.edu. Cindy (Repicci) Romanowski, MD '94, and Marcus John S. Pulvino, MD '96, Romanowski, MD '93, Old Orchard Beach, ME, obstetrics/gynecology. E-mail address is: jpulvino@mmicservices.com. write: "We welcomed our second child, Rachel, on April13, 2001. She joins Marcus Jr, age three." Phy si c i aa children: Katherine, Michelle and Rachel. My favorite memorygraduation!" E-mail address is: kmrobillard @aol.com. Kristen Schenk Robillard, neurosurgery, writes: "I remember drawing inspiration from my colleagues during Intro to Clinical MedicineClara K., Eileen K., Brad D.-for their enthusiasm and discipline." E-mail address is: rudolph.schrot @ucdmc.ucdavis.edu. Karen Sneii-Garus, MD '96, Williamsville, NY, obstetrics/gynecology, writes: "My husband and I have two children: Mitchell, age four, and Kyle, almost two. My favorite memories: anatomy, snow, late nights in the CT room at ECMC, the Law library." MD '96, Orchard Park, NY, family medicine, writes: "My husband, Paul, and I have three Summer 2 0 0 I Joseph C. Wittmann, Jr., MD '96, Amherst, NY, pediatrics, writes: "My appointed to the Division of Blood and Marrow Transplantation in the Department of Medicine at Roswell Park Cancer Institute (RPCI). He has also been named an assistant professor of medicine at University at Buffalo's School of Medicine and Biomedical Sciences. Alam joints RPCI and UB from City of Hope National Medical Center in Duarte, California, where he completed a clinical fellowship in bone marrow transplantation. He earned his medical degree from Dow Medical College, Karachi, Pakistan, in 1991, and completed residency training in medicine at UB in 1996. A nutnber flf Clasnotes antYednwewereplag tD press wlllt IIIII Iaue "' ..,.l'llpk#MJ. Plene Witch far them In the autumn 20011aue. �- Based on F/MsM Data ttTheywere ddl sergeantsand cheerleaders~' - Frank Ste/ars/<.j, stroke rehab patient, Harris Hill H.C.F. Why do our patients have better rehab resutts compared to the national average? Maybe it's our staff ''They knew exactly how far to push me:' says Frank Stelarski.' 'But they also encouraged me every little step of the way. When you've been through what I have, that really means a lot.'' To leam more about the nationally recognized McGuire Rehabilitation 11IE ~cfNn~Il9!{ CENTE~ Centers, call 1-888-POSTACUTE or visit www.mcguire-group.com. Recognized for excellence in quality care. AUTUMN VIEW • GARDEN GATE • HARRIS "*****" HILL • NORTH GATE �y H E A R T ARTIST jiM DINE's PRINTS ON DISPLAY Heart is one of five prints by Jim Dine , a well - known modern artist. Astra USA commissioned the prints and made an initial gift of several sets to the Associ ation of American Medical Colleges (AAMC) for dis tribution to its nonproft member institutions. In 1997 , the AAMC gave set 81 / 400 to the University at Buffalo 's School of Medicine and Biomedical Sciences. The prints hang on the second floor of the Biomedical Education Building on UB ' s South Campus. Recently , Heart graced the cover of the brochure for the school's Spring Clinical Day , the theme of which was "The Healthy Heart. " liP 0001 02 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 2001 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2001-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v36n01-2001-Summer Table Of Contents A list of subunits of the resource. A Little Fire in the Belly' Good Ways to Deliver Bad News Medical School Pathways Spring clinical Day Alumni Development Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v36n01 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2001 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/7bcd5093b224d6f9bc61a1aa833431f8.pdf 2289a7794b92d4331b9935dddf071114 PDF Text Text �l1ffale ••ysicial ASSOCIATE VICE PRESIDENT FOR UNIVERSITY COMMUNICATIONS D r. Ca ro le Sm ith Petro DIRECTOR OF PERIODICALS S ue Wuetcher Dear Alumni and Friends, EDITOR S tephanie A. Unger ART D I RECTOR/DESIGNER we anxiously await word from Punxatawney Phil and Dunkirk Dave, those furry little rodents who allegedly predict the end of wintry weather. eedless to say, they had differing messages this year (Phil saw his shadow, Dave did not), Alan f. Kegler CONTRIBUTING WRITER Lois Baker so apparently we now have a choice as to whom we believe. Fortunately, for those on the Campaign Committee, the Dean's Advisory Committee and/or the National Advisory PRODUCTION COORDINATOR Cyn thia Todd-Flick Group, it really didn't matter, as an early February "taste of spring" was experienced in Hilton Head, NC, where we held the annual "winter outing" for these dedicated volunteer groups. The meeting was hosted by Linda and AI Rekate, MD '40, and by Roger Farber UN I VERSITY AT BuFFALO. THE STATE UNIVERSITY OF NEW YORK. SCHOOL OF MEDICINE who, although not a UB alum, has strong family ties to this medical school. Twenty-one of AND BIOMEDICAL SCIENCES these committee/group members attended and a good deal of work was accomplished. Dr. j ohn W right, Dean After much discussion and reflection, the Buffalo Medical-Dental EDITORIAL B OARD Consortium voted to discontinue participation in the "Demonstration Project," a six-year resident-reduction program that was beginning to adversely affect the region's postgraduate educational experience. This action averted the need to reduce the resident quota to final-year levels and provided some needed flexibility to expand the pool, just a bit. The physician work force dynamics have changed dramatically since the Demonstration Project began in 1996, at which time a significant excess of specialists (by the end of the century) had been predicted. The Western ew York region Dr. Bertram Partin, Chair Dr. john Bodkin Dr. Martin Brech e r Dr. Haro ld Brody Dr. Linda f. Corder Dr. Alan f. D rinnan Dr. j a m es Ka nski Dr. Eliz abeth Olmsted Dr. Step /1 e11 Spaulding Dr. Bradley T. Trua x Dr. Franklin Zeplowitz (indeed, the entire country) is now experiencing significant shortages of anesthesiologists, radiologists, and medical oncologists, to name just a few of the specialty areas in short supply. We will continue our commitment to train physicians in the primary care disciplines but this action will allow us to more accurately respond to the real world's needs. A major financial benefit to our ailing hospital systems was yet another reason for with drawing from the project. On February 14, the Hauptman Woodward Institute (HW!) and the university announced an agreement to create a new Structural Biology Department within the School of Medicine and Biomedical Sciences, to be housed within HWI on High Street (see article on page 10). This formalizes the extensive collaboration that has evolved with HWI and Roswell Park (RPC!), and will facilitate even greater collaboration in the future. Indeed, our closer relationships with HWI and RPCI have enabled us to apply for significant new grant funding that would have been well beyond our reach had these collaborative interactions not been in place. This development also marks an important TEACHING HOSP ITALS Erie Co unty Medical Cen ter Roswell Park Cancer Institu te Ve terans Affairs W estern New Yo rk H ealth care System KALEIDA H EALTH: The Buffalo General H osp ita l The Cl1ildren 's Hospital of Buffa lo Millard Fillmore Gates Hosp ital Millard Fillm ore Suburban H ospital CATHOLIC H EALT H SYSTEM: M ercy H ealt /1 System Sisters of Charity Hospital N iagara Falls M em orial Med ical Ce nter @ UNIYEISITY IT 18fllll. THE SUTE UNIVEISIJT IF NEW YOlK step to developing the Buffalo-Niagara-High Street Medical campus, an idea that holds great promise for this community. The return of at least a portion of the medical school to High Street should engender a bit of nostalgia for some of our more "chronologicallyadvantaged" alumni. Although the planning process has generated predictable pockets of opposition and controversy, strong community support and visions of opportunity abound-not an unfamiliar path to progress here on the Niagara Frontier. ---7 ~MD Dean, Schoo l of Medicine and Biomedical Sciences Letters to the Editor Buffalo Physicim1 is published quarterly by the University at Buffalo School of Medicine and Biomedical Sciences in cooperation with the Office of Communications. Letters to the Editor are welcome and can be sent c/o Buffalo Physician, 330 Crofts Hall, University at Buffalo, Buffalo, NY 14260; or via e-mail to bp-notes@buffalo.edu. The staff reserves the right to edit all submissions for length and clarity. % University at auffalo k The State Ut~iversity ofNew Yor �VOLUME 35, NUMBER @ Features 4 Medicine Goes Molecular New fields of proteomics and bioinformatics are spurring multidisciplinary research collaborations in Buffalo BY S . A. UNGER, ELLEN GOLDBAUM AND LOIS BAKER PHOTOGRAPHY BY FRANK MILLER 12 McKinley's Assassination Surgeon and historian Jack Fisher, MD '62, revisits the the medical controversy one hundred years later The Temple of Musicat the 1901 Pan-American Exposition. here pictured at night. was the site of the assassination of President William McKinley inBuffalo, New York. DEPICTS A THREE-DIMENSIONAL STRUCTURE OF MEMBERS OF THE SHORT-CHAIN OEHYDROCENASEIREDUCTASE FAMILY, DETERMINED AT THE HAUPTMAN-WOODWARD MEDICAL RESEARCH INSTITUTE. WORK ON THE STRUCTURE RELATES TO BREAST CANCER AND THE SEARCH FOR MORE EFFECTIVE DRUGS TO TREAT THE DISEASE. 18 John Naughton, honored by AMS of ew York for distinguished service 22 jacobs study named Top 10 for 2000 by Harvard Health Letter 18 Paola Muti Emeritus Faculty Group formed 27 Robert Blake Reeves and james E. Allen remembered named first chair in family medicine at Tuft's University 23 jerome Kassirer honored by American jewish Congress studies breast cancer and the role of hormones and insulin 32 Cocaine use and heart attacks 33 Marjuana use and male infertility 34 Message from the director"Every Gift Vital to School's Future" 35 james Platt White Society 37 Edmund Hayes Society 40 ews from your UB classmates and other alumni 44 Eugene Morhous and George Alex Poda remembered �- Internal Medicine's Man T hank you for the wonderful article on James Nolan, MD, in the autumn 2000 issue of Buffalo Physician. He was an outstanding role model in internal medicine, and I am one of the legions of medical students who followed his lead into academic medicine. It has been a source of pride to watch his leadership of the American College of Physicians and his support of training of more generalists. Finally, during the time I was a minority student in Buffalo in the early 1980s, Dr. Nolan helped to shape a demanding yet inclusive and supportive environment m which excellence was expected. To me, this will be his greatest legacy. 0 - W hile scanning through the newly arrived autumn 2000 issue of Buffalo Physician, I discovered a wonderful group photo on page seven. In it are pictured the Internal Medicine House Staff, 1967, of the Buffalo General Hospital. I think the photo is wonderful because it shows Helmut G. Schrott, MD '66, my husband, in the first row, far right. However, he is identified as "Harold Schrott," an understandable mistake because everyone called him "Hal," but incorrect nevertheless. If you look in your database, I think you will find that he has long been a professor of internal medicine at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Sincerely, DavidS. Kountz, MD '85, FACP .+-J Mara J. Schrott Associate Dean for Postgraduate Education Associate Professor of Medicine Chief, Division of Primary Care UMDN]-Robert Wood Johnson Medical School I just wanted to let you know how wonderful your article on Dr. Nolan was. It was quite a tribute to a man who had an exemplary career. I remember Dr. olan as being an exceptional teacher and legendary clinician. Your superb article certainly brought that out. Congratulations on writing a real "gem." Stephen Lazoritz, MD '76 Vice President, Medical Affairs, Children's Hospital of Omaha I always enjoy reading Buffalo Physician and thought your article about Jim Nolan was very good, but I think you could have done better at identifying the people in the '67 photograph [of the internal medicine house staff]. The two women in the picture are myself-Carol Segal (not Siegel), the third from the left, front rowand Marie (Tony) Verso; I do not see Daphne [Hare] at all. Behind Tony on the end of the second row is Ron Rohe, who became chief resident after Bill [Fleming]. Kenneth Newmark is third from the left in that row. Bob Moskowitz is third &om the right, front row. Joel Schnure is the correct spelling for the resident between Dr. Calkins and Bob. Lou Wertalik is in the back row. Sincerely, Carol Segal, MD 2 luffalo Physician Spring 2001 ~--- �tion (successfully) at the Buffalo General Hospital. As far as I know, the mentoring program was accepted and carried on then for some time in the '50s. From the Buffalo Physician article, I gather that it fell on hard times and then was renewed and now apparently funding is being withdrawn from some other sources. I n regard to the unknown individuals in the photograph [of the internal medicine house staff] on page 7 in the autumn 2000 issue of Buffalo Physician, I believe I can identify the following: 1. SAMUEL ARMSTRONG 2. ORMA BERKOWITZ 3. ARTHUR COHEN 4. DAVID DANTZKER 5. DouGLAS GERSTEIN 6. LIBERATO !ANNO E 7. Ro ALD JosEPHSON 8. JOHN MENCH! I 9. DONALD MILLER 10. DouGLAS RosiNG 11. BRIA 12. JAMES STROSBERG 13. CALVIN TREGER 14. LOUIS W ERTALIK SHEEDY Sincerely yours, Douglas Gerstein, MD San Rafael, CA Primary Care Summer Externship Program I read with interest the article by Debra Stamm in the winter 2001 issue concerning the Primary Care Summer Externship Program ... and I thought you might be interested in the following story of my involvement in primary care training for Buffalo physicians. In the spring of 1950, I approached Dean Stockton Kimball to request that I be allowed to spend time in my junior/ Internal Medicine House Staff, 1967 senior year with a general practitioner, literally living with him or her and observing the practice of medicine and patient care at the level of a capable general practitioner. If I could spend my summer this way, I promised to report to Dean Kimball on my experiences and then, if approved by the faculty, the program could be offered to subsequent classes as an elective. Dean Kimball agreed and with the help of other faculty found a doctor in East Aurora, Dr. Donald E. Donovan, who was willing to be my summer mentor. I spent a fascinating month with Dr. Donovan, living at his home and answering all calls, seeing patients in his office and studying up on the subjects his patients called to my attention. During that time, I helped diagnose a coarctation of the aorta of one patient and helped to arrange for Dr. John Payne to correct that congenital condi- It is interesting how the direct care of patients has suffered in these modern times. The economics of medical care have been the most important factor, as well as the variable "prestige" of specialties. I guess "follow the money" is the American way of life, but there will always be a few romantic and selfless people who want to deal directly with patients' problems and ills. Thanks be for this. Sincerely, Robert E. Ploss, MD '51 Letters to the Editor are welcome and can be sent via e-mail to bp-notes@buffalo.edu; or by post to Buffalo Physician, 330 Crofts Hall, University at Buffalo, Buffalo, NY, 14260. Letters may be edited for length and clarity. Spring 200/ lu flllo Physicin 3 �A<; r YtAR ABOl T Tills TI~ the biomedical community was abuzz with news that the much-vaunted Human Genome By S.A. Unger nd Ellen Goldbaum Project was coming to a climax as rival international groups, both private and government-sponsored, raced toward the finish line in what is arguably one of the most important accomplishments of the 20th century. But what does it mean now that we have sequenced the full complement of DNA in the human genome, and how can these data help scientists develop advanced medical treatments? Much like when a sculptor unveils his prize work of art only to be met with a quizzical, "What is it?" scientists today are now busy explaining to a highly expectant public why the Human Genome Project is indeed a masterpiece. In essence, what they are telling us is that although the Human Genome Project was a Photos By Frank Miller .t luffalo Phys ici aa "race," it was more specifically, a relay race-and only the first leg of it has been run. Spring 2001 �PROTEOMICS A N D The baton-the decoded human genome-is today being . • D .c " handed off to a new set of sprinters who will take it a second lap, bringing scientists just one step closer to what most nonscientists consider the "real" finish line: the translation of basic science into clinical science, where it has practical applications for patients. This second lap in the relay race is today being referred to as the "post-genomic era" because scientists running it are no longer focused on mapping and sequencing genes; instead they have turned their attention to the substances genes produce: proteins. E . . ..• xperts now estimate that we humans have some 30,000 genes that are responsible for churning out thousands of different proteins. The challenge is that, in most cases, the functiOn of these genes and their proteins is a mystery. Toward the goal of unlocking the secrets of proteins, a new scientific field called proteomics has sprung into being, the aim of which is to discover the structure and interactions of all proteins in a given cell. By studying the proteomic landscape of healthy and diseased cells, researchers may better understand the complex ways in which cells communicate at a molecular level, which in turn can lead to a better understanding of our body's metabolic pathways. Once these mysteries are deduced, pharmaceutical companies can collaborate with basic scientists to develop more sophisticated diagnostic devices, as well as new drug targets. In this new world of pharmacogenetics and pharmacodynamics, scientists will attempt to identify which misguided protein needs targeting and design BIOINFORMATICS drugs that bind to it in order to turn it on or off-a form of treatment that, because of its specificity, is predicted to produce few, if any, side effects. Although scientists do not know the details surrounding how proteins function, what they do understand is that a protein's function is often tied to a protein's shape; in other words, the way in which a protein interacts with other molecules is in many cases determined by its three-dimensional architecture. In this post-genomic era, therefore, much attention and tremendous resources are being marshaled toward the goal of modeling the three-dimensional structure of as many proteins as possible. More specifically, scientists who have expertise in structural biology are seeking to devise ways to better understand, and even predict, how a gene's D A directs amino acids to fold in order to create a protein's three-dimensional shape. (Based on current knowledge, scientists estimate that there are several thousand different classes of protein folds.) The quest to sequence proteins and model their shape promises to be as thrilling a race as was the one run to decode the human genome. Over the past few decades, scientists have devised a number of laboriously painstaking techniques to determine the shape of a protein. One of these techniques is crystallography, which involves bombarding single crystals of protein molecules with X-ray beams. The beams are diffracted by the atoms of the protein molecule thereby generating the diffraction pattern. This pattern is then analyzed by computer to define the protein's molecular Spring 2001 lulfale Physician 5 �-~ PROTEOMICS AND structure. A second technique involves nuclear magnetic resonance (NMR) spectroscopy, which uses powerful magnets to determine the chemical shifts of nearly all atoms of the protein. Knowledge of these shifts enables scientists to measure distances between protons, from which protein structure can be calculated. ·ke the Human Genome Project, the success of proteomics ill depend heavily on the ability of scientists to automate [ nd greatly accelerate these and other protein-modeling techniques-as well as protein-sequencing techniquesin order to process phenomenal amounts of information embedded within all the proteins in a given species, or its proteome. Integral to this automation effort will be the tandem development of new generations of supercomputers and robotics systems. Underpinning this entire post-genomic quest is the burgeoning new field of bioinformatics, where computer scientists and biologists work side by side toward the goal of harvesting information produced by the genome and proteome projects in order to provide medical researchers with the knowledge they will need to move forward with discoveries. Center of Excellence in Bioinformatics It was with an understandable sense of pride and accomplishment, therefore, that the University at Buffalo learned in January 200 l that New York State Governor George Pataki, in his "State of the State" address, proposed that Buffalo be designated as the site for a worldclass Center of Excellence in Bioinformatics. 6 lu llale Ph ysician S pring 2 00/ -- - - - - - - -- BIOINFORMATICS In what Bruce Holm, PhD, senior associate dean in UB's School of Medicine and Biomedical Sciences, describes as "one of the biggest announcements made at this university in at least a decade," the governor detailed plans for the center, which he said would be one of three established across the state as part of an ambitious $1 billion high-technology and biotechnology plan aimed at positioning ew York State as a worldwide leader in university-based research, job creation and job development. The other two centers- one of which would be located in Albany for nanoelec- I ... Scientists who HAVE EXPERTISE I • STRUCTURAL BIOLOGY ARE SEEKI:-;'G tronics, and the other TO DEVISE WAYS TO BETTER U . DERSTAND, in Rochester for photonics and optoelec- AND EVE •• PREDICT, HOW A GENE's tronics-would, along DNA DIRECTS AMINO ACIDS TO FOLD IN with the Center of Bioinformatics, serve ORDER TO CREATE A PROTEIN's THREEto link university reDIMENSIONAL SHAPE. searchers directly with private industry as part of what Pataki referred to as "the largest high-tech economic development initiative in our state's history." Making Buffalo a dedicated research site for bioinformatics is a natural progression of the pioneering work that the proposed center's three partner institutions-University at Buffalo, Roswell Park Cancer Institute (RPCI) and Hauptman-Woodward Medical Research Institute (HWI)-have been doing for years. Holm, �PROTEOMICS . . c AND who points out that the majority of the DNA used in the Human Genome Project came from volunteers in Western ew York, courtesy of Roswell Park Cancer Institute's proficiency in creating D A libraries, says Buffalo is uniquely positioned to make a Center of Excellence in Bioinformatics possible because the scientific areas in which it excels will be critical ingredients in the bioinformatics revolution. These ingredients, as outlined by Holm and others who will be involved in the center, include the following: ·Supercomputing. UB's Center for Computational Research (CCR), which is one of the world's leading academic high-performance computing sites, has the large-scale computing and visualization capabilities and the staff expertise necessary for tackling the massive computational problems presented by the data in the human genome. CCR already serves as the computational backbone for research under a $25 million National Institutes of Health (NIH) grant in structural genomics awarded to a consortium of nine institutions, including UB and HWJ (see article on page 9). "CCR provides the computing power that is essential for any successful bioinformatics initiative," says Holm. "Without it, we wouldn't even be in the game." "Proteomics and structural biology require massive supercomputing capabilities," says Jaylan Turkkan, PhD, UB vice president for research. "There are tens of thousands of different ways that proteins can fold, so only with high-end computing are scientists going to be able to model and predict what those folds are going to look like." 8IOINFORMATICS ·Structural Biology, Genomics and Proteomics. Over the past five years, more than $17 million in key scientific awards has been received by UB's School of Medicine and Biomedical Sciences, RPCJ and HWJ to study genomics, proteomics, structural biology and neuroimaging as they pertain to disease modeling and drug discovery. ·Generation of DNA Microarrays. The DNA microarray facility, jointly operated by UB and RPCI, allows scientists to detect thousands of genes simultaneously and analyze their expression. By creating custom gene "chips," each of which can contain thousands of genes, the facility is a boon to researchers investigating which of the 30,000 human genes are active in a given cell or tissue. ·Pharmaceutical Science. Pioneering work in UB's School of Pharmacy and Pharmaceutical Sciences led to the development of the field of pharmacodynamics, and continued work by the same researchers has resulted in new techniques to find markers of pharmacological effect that can be used to optimize new drugs and therapies. A t the same time, HWI and UB are home to the developers of SnB, the molecular structure-determination software based on the algorithm developed by Nobel laureate Herbert Hauptman, PhD, UB Distinguished Professor and president ofHWI, and the Shake-and-Bake algorithm developed by George DeTitta, PhD, professor and chair of the Department of Structural Biology in UB's School of Medicine and Biomedical Sciences and HWI executive director; Charles Weeks, PhD, senior research scientist at HWI; and Russ Spring 200/ l a lla l o Ph ysici an 7 �~--- ~---- PROTEOMICS I . . AND Miller, PhD, director of CCR and professor of computer science and engineering. SnB is the structure-determination software of choice in more than 500 laboratories across the United States. s za on Also at UB is the New York State Center for Engineering Design and Industrial Innovation ( YSCEDII), which has the virtual-reality capabilities to allow scientists to visualize and interact with three-dimensional molecular structures in large, immersive environments. The current arrangement at YSCEDII allows scientists to interact with biological data through visual data-mining techniques. Planned expansion to a fully developed, six-wall (walls, floor and ceiling) "cave"-a capability now available at only one other institution in the nation-will amplify the amount of information that can be displayed by a factor of six at the very least. This new environment will make it possible to 'walk through' a compound, evaluate the fit of a series of drug leads to a particular target protein and suggest changes to drug candidates to maximize their potential efficacy. eR Co ec on We have the right collection of institutions, individuals and facilities to make this [center] happen," says CCR's Miller. "In fact, many of us have been working collaboratively for years." And while it is very early, the business community is already starting to respond. A major firm with strong ties to the area and an interest in bioinformatics has stated that it is considering an additional significant investment in resources in Buffalo, now that a Center of Excellence in Bioinformatics has been proposed. 8 luffa le Physici11 Spring 2001 ·· - - - BIOINFORMATICS olm adds that because Buffalo is a very low-overhead place to locate a business, he expects to see more firms become interested in the area as the center gets going . "Heads are turned by this kind of investment," he says. That's also likely to be the response from federal funding agencies, according to Turkkan. "The federal government wants to see that a state supports a university's activities," she says. "When we can show them that we already have a coherent plan for this center, that we have space identified and major support from Albany, all of these things will make us that much more competitive, especially because they demonstrate to the IH that recruitment of top faculty will be much easier," she adds. In addition, Turkkan notes, the participating institutions have long histories of collaboration that include formal memoranda and faculty with joint appointments, and she emphasizes that it is the nature of those institutions themselves and the capabilities they posses that also make it possible to exploit bioinformatics in its broadest sense. All over the university, and in labs throughout the world, therefore, bioinformatics is driving such collaborations. Buffalo already is making and exploiting those connections, but it is Pataki's announcement that will put the area on the map. "It's time to recognize that Buffalo has some unique strengths," says Holm. "The money for the new Center of Excellence in Bioinformatics will allow us to take those strengths and turn them into an economic engine for this area." - -- �P ROTE OMI CS A N D BI O I NFO RMATI CS ctures -Woodward resonance ( MR) spectros- Medical Research Institute copy to determine protein (HWI) and University at structures.Knowingthemo- Buffalo have received grants lecular structure of proteins totaling $3.13 million to develop new, highB speed methods to determine is essential for designing new drugs to treat, prevent L o the molecular structure of proteins. The funding is part of a y B A $25 million center grant awarded to the Northeast Structural Genomics ( ESG) I K z: 0 .... . and cure diseases. George DeTitta, S E .... .. .... R ~ professor and chair of the Department of Structural Biology in UB's School Consortium composed of researchers of Medicine and Biomedical from UB, HWI, Cornell University, Sciences and HWI executive . ...• • ...•.. Columbia University, Yale University, director and CEO, and Jo- University of Toronto, Ontario Cancer seph Luft, HWI senior re- Institute, Pacific Northwest National Laboratories and Rutgers University, search scientist, will receive $1.75 million over the next home to the principal investigator on five years for their work in crystal- will receive $1.38 million for research the project, Gaetano T. Montelione. growth methods and techniques. The institute will use a newly developed, using NMR spectroscopy to establish The consortium was established in E protein structures. Approximately $1 response to the National Institutes of high-throughput robotics laboratory million was awarded through the Health's (NIH) Protein Structure Ini- center grant for the UB work, with the ational that will allow researchers to obtain crystals for X-ray structural analysis for additional $385,000 contributed by Institute of General Medical Sciences a large number of different proteins in a the National Science Foundation. (NIGMS). The initiative aims to capital- short time. The new laboratory was es- "The center grant supports the pur- tiative, funded through the IH ize on discoveries generated by the tablished with funds from the John R. chase of a cryogenic NMR probe, which Human Genome Project. Oishei Foundation, making Hauptman- The ESG Consortium is one of seven pilot research centers in structural Woodward scientists among the first to use this method of crystal production. will increase the sensitivity of our spectrometer by a factor of three or more, thus reducing measurement time of molecular genomics, a new field dedicated to "It is projects like these that exem- determining gene function by defining plify how critical initial support can be," the protein structure encoded in a gene's DNA sequence. The goal of the NIH initiative is to target proteins from various model organisms, including the fruit fly, yeast, roundworm and certain human proteins. The consortium will use both X-ray crystallography and nuclear magnetic DeTitta says. "The funding from the Oishei Foundation provided the infrastructure for the lab and also gave us another great opportunity to work with talented colleagues, including Tom Szyperski at the University at Buffalo." Thomas Szyperski, PhD, UB associate professor of chemistry, and his team structures about tenfold," Szyperski says. "This will enable us to solve protein structures by MR in an unprecedented rapid fashion. Such investments ensure that our research group, and thus UB's highfield NMR center, will successfully participate in the leading-edge endeavor of structural genomics, which will contribute to lay the foundations of this century's biomedical research," he says. Spri11g 200 1 4D Buffalo Physician 9 �PROTEOMI C S AND 8IOINFORMATICS New Structural Biolo Department Crea ed Univers i ty at Buffalo and Hauptman-Woodward Institute to Collaborate University at Buffalo and HauptmanWoodward Medical Research Institute (HWI) have agreed to establish a UB De- tutions for groundB breaking research in I. 0 structural biology and enables UB's students to have a unique educational opportunity to study both at the research institute and university," said Greiner when the agreement was signed. "It's a win-win situation, not only for UB and HauptmanWoodward, but also for Western New York because the region is now positioned to become a leader in this exciting field," he added. "We're looking forward to a long and fruitful collaboration partment of Structural Biology at HWI, initiating a 10-year collaboration that positions Buffalo to play a lead role in this critical field. Under the agreement, which was formally signed by Christopher T. Greene, chair of the HWI board of directors, and William R. Greiner, president of UB, on February 14, 2001, HWI will remain an independent entity and will continue to conduct with the Hauptmanits own research outside of Woodward Medical projects undertaken by UB de- Research Institute." "It is extremely repartmental faculty members. The new department will be a warding to have been a unit of the UB School of Medi- part of this developing cine and Biomedical Sciences, collaboration," said and Herbert A. Hauptman, PhD, Greene. "This new HWI president and 1985 Nobel department will not laureate in chemistry, joins the only allow Hauptmandepartment as a distinguished Woodward to conprofessor. George T. DeTitta, tinue its rapid growth, PhD, HWI executive director but also adds a new and chief operating officer, is teaching element to the department chair and professor. Main and High Street In addition, 15 other HWI re- medical corridor. It's searchers assume faculty posi- positive for us, the university, the medical tions in the department. " This agreement brings corridor and all of together two outstanding insti- Western ew York." 10 l aff a lo Ph ysician S prin g 2001 In his comments, Hauptman noted that "with l ~ Hauptman- Woodward involved with some of the world's leading scientists in crystallography and structural biology, this new department will provide a unique opportunity for students to learn and train in two different research environments-both an independent research institute and a university setting. "It will allow our scientists to mentor graduate students and v teach them our methods, spurring a greater interest in our work and facilitating the development of new relationships. "It also will encourage the breaking down of walls, which all too often isolate individuals and groups from one another, thus making the diffusion of ideas more difficult. These ideas are needed to stimulate creativity in the individual scientist. Without the combined strengths of the university and Hauptman- Woodward, this Left to right: Christopher Greene, chair of the board at Hauptman· Woodward Medical Research Institute (HWI), George T. DeTitta, professor and chair of the Department of Structural Biology at the University at Buffalo and executive director and chief operating officer of HWI, and Herbert Hauptman, PhD, UB Distinguished Professor and president of HWI. �PROTEOMICS AND 8IOINFORMATICS experience would not be pos- expertise in its midst. "This ini- capabilities, as well as its exper- South Campus to complement sible," Hauptman added. John R. Wright, MD, dean of tiative is also a key element of the larger bioinformatics initia- tise in biology, biochemistry and biophysics. HWJ's facilities. The agreement calls for UB to the School of Medicine and Bio- tive that will help to drive the UB and HWI are already staff the new department imme- medical Sciences, said the new future of the Western New York working closely as members of diately with a minimum of four Department of Structural Biol- economy," he stressed. the recently formed ortheast full-time-equivalent faculty ogy "will strengthen professional interactions that already exist The field of structural biology dates to the 1930s, when scien- Structural Genomics (NESG) Consortium, a collaboration positions. Two of those positions will be filled by six current and greatly expand the opportu- tists discovered it was possible to that has resulted in a total of HWI research scientists and by nities for future collaboration. crystallize proteins and view $3.1 million in grants to scien- them in three dimensions. tists at the two institutions for hired to work exclusively in the obel genomics research. With fund- department. UB and HWI cur- prize for an innovative mathe- ing from the John R. Oishei rently are recruiting those faculty members. The faculty members "In many respects, the science at Hauptman-Woodward Hauptman received a and at the medical school is complementary and this two new faculty members to be is therefore a parti- The department wiLL BE cENTERED AT HAuPTMAN- cularly fortunate align- compensated by HWI, ment for the Western New York community," in addition to DeTitta WooDWARD INSTITuTE [HWI], WITH UB OUTFITTING he further commented. DeTitta noted that are Robert H. Blessing, ADDITIONAL LABORATORY SPACE IN ITS BIOMEDICAL "this is an exciting time for biomedical research in Western and Hauptman, PhD, professor; Vivian Cody, PhD, professor; RESEARCH BurLDING o"N" THE SouTH CAMPus TO ew York. William L. Duax, PhD, professor; and Walter COMPLEMENT HWJ's FACILITIES . Biological scientists at A. Pangborn, PhD, associate professor. UB, Roswell, Kaleida, D'Y ouville and Canisius have Eleven additional HWI sci- matical technique called "direct methods," which has enabled Foundation, HWI recently established a new robotics labora- work-with structural scientists at HWI. Today, we cement a scientists around the world to tory that will allow researchers uncompensated faculty posi- determine the three-dimensional to grow a large number of pro- tions in the department. Hold- relationship that has been 40 structure of molecules rapidly and automatically, using com- tein crystals for X-ray structural ing the rank of professor are analysis in record time. UB has Jeremy A. Bruenn, PhD, D.Y. received $1.38 million through Guo, PhD, and Charles M . worked-and will continue to years in the making. "Out of this relationship, will puter programs. come medically relevant re- The aim of structural biolo- search of importance for its im- ESG for research using Weeks, PhD. Associate profes- gists in the 21st century is to nuclear magnetic resonance sors are Jane F. Griffin, PhD, pact on our health and on our understand the operation of (NMR) spectroscopy to deter- Debashis Ghosh, PhD, David A. local economy," he predicted. biological systems at the subcellular, molecular and atomic mine the structure of proteins, adding to the department 's Langs, PhD, and G. David Smith, PhD. Assistant pro - levels by studying the threedimensional structures of D A, R A and proteins. Knowing the armamentarium. fessors are Chang I. Ban, PhD, Faculty in the new department will perform advanced L. Wayne Schultz, PhD, Yang- structure of specific proteins will research and train scientists in liang Xu, PhD. enable scientists to target new drugs to treat chronic diseases. the methods of modern structural biology. The department will be centered at HWI, with In addition, a number of fac ulty members from UB's graduate school division at Roswell UB outfitting additional labo- Park Cancer Institute and other ruce Holm, PhD, senior associate dean in the School of Medicine and Biomedical Sciences, explained that "structural biology is a scientific cornerstone in the entists are being appointed to zhou Wang, PhD, and Hong- the future of pharmaceutical The collaboration combines HWI's internationally known development, and Buffalo is for- expertise in X- ray crystallography ratory space in its Biomedical UB departments will be affiliated tunate to have such world-class with Research Building on the with the new department. ( D UB's supercomputing Spri11g 2001 Buffalo Physician 11 ��Assassination in Buffalo Time to put the medical controversy to rest? < • • . . -• . •< . .. I ~ B y J A c K F I s H E R , M D '6 2 can still remember an afternoon stroll up High Street from the Buffalo General Hospital, where I was • .•. .. z .• . • assigned as afourth·year clinical clerk in 1962. My destination was asmall bookstore at the corner of Main (I can't recall its name, but someone will likely remind me). What I do remember, however, are the nice people who worked there and my first purchase: awell· preserved copy of Selected Papers, ~ .... . -. < :> Surgical and Scientific, by Roswell Park, MD, an esteemed professor of surgery at the University of Buffalo and one of Western New York's most influential medical professionals at the close of the 19th century. As I sat down to read Park's book, which was published shortly after his death in 1914, my interest was immediately drawn to the chapter titled "Reminiscences of McKinley Week." Spring 2001 I HI IIID PbysitiiD 13 �~ - - ~- ears later, I visited the Buffalo and Erie County Historical Society and took note of a display case featuring artifacts from the events surrounding President William McKinley's assassination in Buffalo at the 1901 Pan-American Exposition. Standing before the display, I viewed the assassin's nickel-plated revolver, the unspent ammunition and a faded typescript. As I leaned closer, I saw that the document was the original draft ofPark's "Reminiscences," made available to the historical society in 1945 by his son, historian Julian Park. Several lines and paragraphs had been penciled out, leading me to wonder what Park had written that he later decided his readers must not read. As I progressed through my surgical training, I never forgot the Pan-American Exposition's Temple of Music, where President ing abdominal trauma, I came to understand what had likely McKinley stood greeting well-wishers. The assassin, 28-year-old happened to our 25th President, and why-after being shot twice Leon Czolgosz (shole-gawz), was an angry, unemployed dissident in the abdomen-his condition deteriorated so rapidly despite the very best efforts of his surgeons. Eventually, I also became aware from Cleveland, Ohio. Although Buffalo police detectives and the of the fallen image of Buffalo and its surgical community due to dent-as were several "special agents," forerunners to the Secret the perception, by laymen and professionals alike, that the Service-no one even managed to spot Czolgosz before he stepped medical treatment the President received was substandard. From a copy of Park's typescript, I learned of his concerns 73rd Coastal Artillery brigade had been assigned to guard the Presi- up, thrust a recently purchased revolver at McKinley's breast and fired twice. ever intending to escape, and fully prepared to con- about the operation that had been hastily performed on President front the inevitable consequences of his act, Czolgosz calmly sub- McKinley by a gynecologist, Matthew Mann, and about his convic- mitted to the violent blows directed at him by a furious mob. tion that abdominal drains would have made a difference in the The President barely wavered and seemed to not know if he had outcome of the case. Implicit in the remarks Park had crossed out was the belief that the President's life could have been saved-and been injured until he saw fresh blood on his shirt. Within moments, the subsequent rebuke of Buffalo's med ical community avoided- where a hastily assembled surgical team decided to operate rather he was transferred to the exposition's modest emergency hospital, if those who were making decisions about his care had waited for than await the arrival of Buffalo's acknowledged expert, Roswell Park to arrive instead of allowing the surgery by Mann to proceed. Park, who at the time was operating in Niagara Falls. Over the years, while researching my book Stolen Glory: The Examination of McKinley's wound revealed that one bullet McKinley Assassination, I have come to recognize that the prevailing had bounced off his sternum, while the other penetrated the left historical opinion of most 20th-century writers is that the surgery was upper quadrant of his abdomen. Laparotomy was performed under considerably disadvantageous conditions in that the patient botched, an opinion that can still be elicited in Buffalo from many who are aware of some of the details of the case. I believe, however, that this is a conviction that is distorted by a century-old conception 14 the sudden, sharp report of gunshots pierced the grand hall of the McKinley assassination story. With accumulated experience treat- was significantly overweight, and lighting and instrumentation were inadequate. of McKinley's injury, as well as by comparisons to modern standards evertheless, two gastric perforations were found and repaired. of how his surgery and aftercare should have been conducted. In Since no other injury was perceived (and the bullet remained undis- contrast, I contend in my book that the available evidence, when covered), the decision was made to conclude the surgery. While the carefully considered in a historical context, supports a different incision was being closed, Roswell Park appeared at the operating conclusion; namely, that members of the surgical team available to room door. He conferred briefly with Mann and then lent his hand serve McKinley's needs acquitted themselves as well as anyone in the to making arrangements for McKinley to recover in the Delaware city or in the nation could have at that time, and that McKinley's Avenue home of exposition President John G. Milburn. wound in 1901 represented a mortal injury from the outset. Stolen Glory begins with the anarchist movement and the climate Meanwhile, the assassin had been transferred to Buffalo's downtown police headquarters before a lynch-minded crowd could assert of terror that led to the assassination of six heads of state worldwide its most fervent wish. Interrogation began at once and lasted between 1894 and 1912; however, for the purpose of brevity, the story can also begin on the afternoon of September 6, 1901, when Czolgosz denied complicity with anyone, he cited as his inspiration luf f a le Ph ys i till Spri11g 2001 through the night, resulting in a signed confession. Although --~ �America's notorious anarchist orator, Emma Goldman, who was then hunted down across the nation and eventually arrested in Chicago. President McKinley awoke the morning after his surgery and asked to see the newspapers. He was not the least bit curious about his assassin; instead, he wanted to know how the world had reacted to the speech he delivered in the exposition's esplanade shortly after arriving in Buffalo. Everyone assured him that his eloquent advocacy of reduced trade barriers in the Western Hemisphere had been greeted with considerable enthusiasm. Each of his surgeons, along with Park, expressed their delight with his quick mental and physical rebound and through periodic bulletins kept reporters informed that the President was destined for a prompt recovery. Wall Street reacted enthusiastically to the news. However, any physician today presented with all the evidence available that morning would have recognized sure signs of trouble: The President's pulse remained high-in the range at 120-and his urinary output following surgery had only been 270 cc. Measurement of the blood pressure and red blood cell concentration were not available in 190 l. Had they been, progressive hypotension and a rising hematocrit would have been observed as the week passed. Instead, all trained eyes were focused on bowel activity, the prevalent fear in that day being " intestinal toxemia." Accordingly, enemas of every known variety were given incessantly. On Thursday morning, the sixth postoperative day, Mr. Charles McBurney of New York City, who had been summoned as a consultant earlier in the week, visited the President again just prior to leaving Buffalo. Meeting reporters afterward, his optimism was apparent to all. When asked about the retained bullet, he jokingly replied that it lay where it couldn't even shorten Methuselah's life .c 0 c . 0 , • by a single day. o sooner had McBurney departed Buffalo's Terrace Street Terminal than the President's condition began to deteriorate. His pulse, then 130, was becoming weaker, his oliguria had persisted, and efforts to administer saline by subcutaneous clysis had been initiated too late. Most physicians today will recognize that McKinley was in shock, not because of hemorrhage, but because of the development of a pathologic third space with several liters of fluid having Spring 2001 Bu ff al o Ph ysician 15 �accumulated deeply within an inflamed retroperitoneum. What While Emma Goldman was still being hunted down as Czolgosz's accomplice, the assassin himself was quietly arraigned in a courtroom while reporters were diverted by the President's funeral service in Buffalo, held a few hundred yards away. In a pace McKinley had needed desperately, and did not receive, was intravenous fluid in significant quantity. Unfortunately, this was a physiologic requirement that would not be defined for many more years. On Friday, a week after McKinley had been shot, the signs of progressive heart failure were apparent to all of his physicians. Every known heart stimulant was used: strychnine, digitalis of justice unimaginable today, a swift trial was followed by electrocution of Czolgosz, all within six weeks of the shooting. ""· During this same period of time, McKinley's surgeons became the targets of stinging criticism from the press as well as from their medical colleagues, whose denunciations were paraphrased by journalists. In response, the sur- and adrenal gland extract. Even brandy was '"'~. '"~~,.~~'{·~~~\\ injected subcutaneously. "''' •''"'~"tS ~ ""1.· ····~~ l\ ~~...;:•:. . More consultants hurried to Buffalo from v~\'5 .... ..: ... r--~·~: turt:,lo ([outicr. -:::_ cities as far away as Philadelphia, Washington, -:".-C\T~A! D.C., and New York. Among them was Charles ~~: .'1lKI.\'LEY IS C\T~AI McBurney, who, upon arriving home had been x:-~.. p ......,.,, -~~~" •r DEAD! ~.::-:::;~ ~Lb. """ " ' IUit ~IS TiltS It~\1\'Q ~ ........... f.'l)r ) ,,,,,,,., ,.,:•;.::;,"llv, dumbfounded to learn of the President's condition and promptly boarded another train bound for Buffalo. Their efforts were all to no avail. William McKinley, "1\11 r h /II k'k)~~;" '"' lttn,vllll. -- lli'~ 25th President of the United States, died at 2:15A.M. on Saturday, September 14, 1901. The American public was stunned, for they had been led to believe that their enormously popular President would recover completely, an outcome many associated with continued economic expansion and prosperity. Instead, Americans were faced with a different kind of leader, Theodore Roosevelt, the unlikely running mate in the 1900 election whom McKinley advisors had called "a damned cowboy!" geons sought counsel from an attorney, and a statement was later issued assuring the public that they had been of one mind throughout the time they cared for the President, a distinct stretch of the truth. Congress meanwhile debated whether or not the surgeons should be paid for their services from the McKinley estate. Eventually they did allow funds to be appropriated from the national treasury because Mann and his chosen assistants had been serving McKinley in his capacity as President. Soon after McKinley died, Roswell Park dictated his recollection of the events surrounding the President's medical care. Once he completed this exercise, he placed the transcription in a desk drawer, where it remained for several years. Shortly before he died in 1914, he edited his comments, and the revised narrative was published true to his wishes. Not until 1945 Advanced Trauma Life Support (ATLSJ protocol. One of the technicians What 11 · McKinley Were Shot Today Secret Service personnel, while another would establish whether the n this, the lOOth anniversary of President William McKinley's other would be in charge of cardiovascular resuscitation of the patient, or nurses would take a history from paramedics or, in this case, from the President's airway and breathing are intact. At the same time still an- death, I have been asked by Buffalo Physician to comment on starting large-bore catheters in each of his anns and initially running how the injured President would be treated today and how approximately two liters of fluid if he showed signs of tachycardia or surgical care has changed since 1901. I have consulted with shock. At this time, we would also perfonn a thorough physical exam- Dr. Fisher on this and am eagerly awaiting his new book. ination, from head to toe, front to back. It should be first emphasized that the care rendered to the President would be no different than that given to any other X-rays to detennine the location of the bullet and its possible course. In patient in the Trauma Center of the Erie County Medical Center; that is, the case of President McKinley-or in the case of this hypothetical the same care is rendered to all patients without regard to their status. An patient-the entrance wound in the abdomen was anterior, and the in-house trauma-call team is present in the hospital 24 hours a day to bullet lodged posteriorly. Approximately 20 to 30 minutes after arrival respond to emergencies, and all trauma team members carry special in the Emergency Room, the patient would be taken to the operating trauma pagers. If we have advance notice, a room for exploration of his abdomen. (Specialized tests such as CT scan team of surgical residents, technicians and ER and MRis are not utilized in penetrating trauma.) The surgeon would personnel is available-gowned, gloved, and make a generous midline incision and perform a thorough and complete ready to go-in the Emergency Department. When treating the patient, we use an approach that follows 16 After we ascertained that the patient was stable, we would take l1ffalo Physiciaa S prin g 20 01 exploration of the abdomen. The incision might also be extended into the chest through the sternum to gain access to the heart and lungs as �was the original draft made available for historical interpretation . A comparison of the two documents reveals an edited version that is soft in tone and reflective of the determined effort made by everyone involved in the tragedy to bring order to the chaotic events that initially surrounded it. Perhaps it also shows a mellowing of Park's estimation of events after the passing of a dozen years. The unedited draft, however, clearly displays considerable angst on the part of Park and perhaps a degree of resentment as well. In it, he raises four issues: First, the haste in which the operation was performed despite the fact that there were no signs of hemorrhage and the President appea red stable; second, the inexperience of the principal surgeon , Matthew Mann, who, although a skilled gynecologist, had no prior experience with gunshot wounds to the abdomen; third, the inadequacy of the facilities used for the surgery (Park recorded that, in h is estimation, the President should have been transferred to the newly c . " , • needed. In an exploration for trauma, the surgeon would follow resect the pancreas using a stapler. Ligation of the splenic artery and vein these priorities: would be done and the whole specimen removed in one piece. The surgeon 1. Control of hemorrhage; would place suction drains, and the abdomen would be closed quickly. 2. Control of contamination; Once the operation was completed-which a senior surgeon would 3. Identify and evaluate all of the injuries; probably do in about two hours-the patient would be taken to the 4. Debride all devitalized tissue and remove all contamination and repair ICU, where a trained team of critical care specialists would monitor his and treat all of the injuries with appropriate surgery; 5. Close the patient. care. This would include urine output, NG output, and other parameters to optimize blood pressure, pulse and fluids. The team would also support the cardiopulmonary and metabolic needs of the patient as needed. In this case, we would debride and close the wounds of the anterior In all likelihood, the President's hospital stay would be approximately and posterior portion of the stomach. If bleeding was encountered, we 7 to 10 days without complications such as pneumonia or a pancreatic would give the patient blood. leak. In all, a total of 100 to 200 physicians, nurses and technicians During surgery, the President would be monitored as if he were in an would have been either directly or indirectly involved in his hospital intensive care unit IICUJ. Using clamps, the surgeon would take down the care. Clearly, the intensity ofthis care and the resources necessary to suc- gastrocolic ligament and omentum between the stomach and colon and cessfully manage such a patient justify the need for a trauma center. explore the underside of the stomach and pancreas. (The bullet that penetrated President McKinley traversed his pancreas to the left of the Dr. Seibel is a clinical professor of surgery at the University at Buffalo School superior mesenteric artery and vein, probably damaging the pancreatic of Medicine and Biomedical Sciences and director of Surgery and Trauma duct.) After the stomach and pancreas were explored, the surgeon would Services at Erie County Medical Center in Buffalo, New York. He wishes to mobilize the spleen and tail of the pancreas towards the midline and thank Dr. john LaDuca for his assistance in editing this article. S p ri n g 2 001 IDIII I O Physiciu 17 �expanded Buffalo General Hospital); and fourth, the omission of inserting abdominal drains. The autopsy revealed that both gastric suture lines were intact and that there was no peritonitis nor any collection of pus, although cultures taken at the postmortem examination grew a mixture of organisms. A large gangrenous cavity behind the stomach was consistent with significant inflammatory damage to the pancreas and adjacent organs. Also, the heart showed severe fatty changes consistent with failure. Unfortunately, McKinley's case preceded by several decades experiments performed by Alfred Blalock and Owen Wangensteen in which they showed that surgically induced ischemia followed by inflammation could result in clinical shock in the absence of hemorrhage. Specifically, they determined that blood volume contracted as fluid was drawn from the plasma and interstitial spaces in order to support a zone of severe inflammation. Without intravenous replacement of that fluid loss, they concluded, death would likely result from a failing heart. By addressing Park's four issues from the perspective of surgery as it was practiced in 1901-together with the hindsight inevitably gained by a century-long interlude-! have drawn the following conclusions about his concerns: In 1901, McKinley appeared clinically stable to his physicians. The standard response to any penetrating injury to the abdomen What attend the event has already been asked by the Secret Service to sub- c . 0 , mit their social security numbers to permit security checks. The ad- McKinley Needed Protection Today vance team inquires about potential public demonstrations involving local or national controversies. If required, a site for these protests will be designated within sight of the President's motorcade. The Secret n 1901, the Secret Service had not been charged with the responsi- Service cannot abridge constitutional rights of assembly or protest. bility of protecting the nation's President. After the McKinley When the President arrives in Buffalo, usually by air, he is driven by assassination, Congress corrected that omission. Today, the the Secret Service to the event. His route is never revealed in advance to Secret Service's capacity and impact far the media as McKinley's itinerary was in 1901. At the Historical Society, exceeds its modest presence a century no person unknown to the Secret Service comes within range of the ago. The following excerpt from Stolen President, with one exception. A space for bystanders has been desig- Glory: The McKinley Assassination, by Jack Fisher, MD '62, (see article on page 121 considers how the Secret Service would prepare today for a presidential visit to Buffalo, New York, and how it would nated and cordoned off behind the television cameras approximately 75 feet to the side of the front entrance. After the President has fulfilled his obligations and bidden farewell to local political leaders attending the event, he departs through the respond if a similar attack were to occur. The President will be attending a series of events in Buffalo that in- Historical Society's front entrance. Surrounded by his protective de- clude an award ceremony at the Historical Society, the former New tail, he stops, turns toward the television cameras, and waves. At that York State Building for the 1901 Pan-American Exposition. The Secret moment, the unthinkable occurs! A young man standing among the Service was informed two weeks in advance of the planned visit. Special bystanders draws a revolver from his pocket, aims, and fires twice at agents in Washington coordinate with their counterparts in Buffalo, the President before he is brought down. The Secret Service agents where one of 116 field offices is located. The Protective Intelligence close in around the President, prepared to take additional bullets if they Section begins its database search of individuals in Western New York come. They quickly pile into the car and depart. who made prior threats to a President or other government official. Police had already halted traffic on Elmwood Avenue, facilitating their Meanwhile, an advance team visits Buffalo and determines the entry onto the Scajaqueda Expressway, a planned emergency departure President's actual motorcade route. The team contacts the Erie route. Inside the vehicle, a still alert President identifies fresh blood on County Highway Department to determine where construction projects his shirt. Seeing this, a special agent alerts the driver to proceed im- might impede movement. Dr. Roger Seibel, or his designate, at Erie mediately to ECMC. Their limousine enters the passing lane and acceler- County Medical Center (ECMCJ will be notified of the visit. [See "What ates. On a closed-communication system, the Trauma Center is notified If McKinley Were Shot Today," on page 16.] of their approach. They exit at Grider Street and arrive at the trauma Planning is coordinated with the Buffalo Police Department; its responsibilities will include traffic and crowd control. At the Historical receiving ramp six minutes after departing the scene of the attack. At that point, Dr. Seibel's team takes over. Society building, all doorways and spaces are checked, with the aid of 18 explosives-sniffing dogs. This will be repeated on the morning of the visit The author is grateful to the Secret Service for their assistance providing and at that time, the building will be secured. Everyone designated to archive documentation from 1901, and for reviewing this descriptio11. laffalo Phys i c i an Spring 2001 • �then-as it is today-was prompt surgical exploration. Waiting would not have helped the President. of. In 1901, gynecologists performed many more laparotomies than did general surgeons, albeit not for gunshot wounds. However, Mann had selected two surgeons to assist him who were experienced with injuries of the kind that McKinley had experienced. + In 1901, elective surgery was often performed in private homes because infection was prevalent in hospitals. + In 1901, the placement of a drain meant use of long rolls of stiffened gauze. Plastic tubes attached to wall suction were not yet imagined. Thus, I conclude that it is extremely unlikely that significant changes in the course of treatment provided to McKinley by his surgeons would have made any difference in the outcome of his case. either is it likely that Roswell Park could have saved President McKinley, as the fate he suffered resulted from errors of omission, not errors of commission. Those errors were unwitting on the part of Mann, Park and their associates, none of whom understood surgical physiology as we know it today. or did they benefit from the capability we have today of monitoring our patients' myriad life functions or from having at our disposal the intravenous fluids and pharmaceutical cornucopia for critical life support. Given a careful and thorough review of historical facts surrounding the medical treatment provided to President McKinley by Matthew Mann, Roswell Park, and their medical colleagues, I believe that events surrounding his care should no longer represent a disparaging chapter in Buffalo's history. Any reconsideration of the McKinley tragedy should be nothing less than a celebration of one hundred years of medical and surgical progress culminating in a century of achievements that Buffalo's surgical community has contributed to significantly. jack Fisher, MD '62, is an emeritus professor of surgery at the University of California at San Diego, where he is currently a master's candidate in United States history. His book, Stolen Glory, The McKinley Assassination, will be available in july 2001 by subscription. For further information, contact Alamar Books at P.O. Box 2876 La jolla, CA, 92037, or by e-mail, at Alamarbooks@aol.com. Dr. Fisher can also be contacted by e-mail at jfishermd@aol.com. �' . - -- --- - PATHWAYS N EWS ABOUT ALUMNI, FACULTY AND STAFF AT THE UNIVERSITY AT UB's School of Medicine and Bio- BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES medical Sciences, in the September 2000 issue of the New Craig Smith, Distinguished Alumnus Visitor Craig Smith, MD '72, chief executive officer of Guilford Pharmaceuticals, recently visited University at Buffalo's School of Medicine and Biomedical Sciences as a Distinguished Alumnus Visitor. During his stay, Smith met with students, members of the Dean's contains ner held on April 26, 2001, at the BCNU, or carmustine, a cancer University Club in New York City. England Journal of Medicine, has been selected by Harvard Health Letter as chemotherapy drug used in the In announcing the award, Gregory one of the top 10 health advances treatment of glioblastoma multi- L. Eastwood, MD, president of of2000. forme, a particularly virulent AMS, told that agency in over 20 years. This cal Schools (AMS) of New York at wafer, which is made of a biode- its annual Deans and Trustees din- gradable polymer, search and graduate deCRAIG SMITH partments to discuss work under way at form of brain cancer. Currently, Deans wish to recognize your long winter 2001 issue of Buffalo Physi- service to the organization, in- trials for a diagnostic test it has cluding your tenure as President, outstanding leadership you have cian, showed that early treatment with one of the drugs used to control multiple sclerosis (MS)interferon beta-1a-reduced the rate of development of clinically definite MS for these high-risk individuals by 44 percent versus provided to the treatment with placebo. developed for Parkinson's disease. during which [time) you spear- -S .A. headed a restructuring of AMS to UNGER strengthen its statewide scope. We also wish to call attention to the Naughton Receives AMS Distinguished Service Award john Naughton, MD, dean of Guilford Pharmaceuticals, which UB's School of Medicine and he helped establish in 1993 to dis- Biomedical cover and develop drugs to diag- Sciences from ew York State Consortium on Graduate Medical jacobs was the first American Education and the many other researcher, beginning in the 1970s, ways in which you have served to test a form of beta interferon, a academic medicine in New York." -S.A. UNGER the body, in the treatment of MS. naturally occurring substance in nose, treat and prevent brain can- 1975 to 1996, cer and other neurological dis- was present- eases. Guilford's leading product, ed a Distin- the GLIADEL wafer, gained Food guished Ser- .Jacob's Study Touted by Harvard Health Letter and Drug Administration approval vice Award A study published by Lawrence of beta interferon. His prior re- in 1996, becoming the first brain by the Associated Medi- jacobs, MD, Irvin and Rosemary search has shown that the drug, Smith Professor of Neurology in approved by the Federal Drug cancer treatment to be cleared by GREC.ORY L. EAsrwo<..m, MD, PREsiDENT 10 (, -,~!{VIC f ro Since that time, he has lead several joHN NAUGHTON m AMS, .ow NALGHTO MS studies using interferon beta1a, a genetically engineered form rHAT "n!E DEA. 'SWISH ro RECOG IZF YOt:R lHE ORC,A I?ATIO , INCLL DING YOCR Tf.Nl RE AS PRESIDE 'T, DURL 'G WHICH [TIME] YOU SPEAR- HEADED A RES.RLC TURI c, Or AMS ro STRENG!HEN ITS STAlFWIDE SCOPE." 20 The study, also reported in the the company is involved in clinical Advisory Council, and faculty in several re- aughton that "the LAWRENCE jAcoss l u fla la Pb ysicin Spring 200/ �Administration in 1996, slows the accumulation of physical disability and decreases the frequency of clinical flare-ups in patients with .Jehle Honored by ACEP for Teach ng Dietrich Jehle, MD, FACEP, clinical director of Emergency Services at the Erie County relapsing forms of MS. - Lots BAKER Medical Center, has received the ational Emergency Medicine Faculty Teaching Award 2000 Holm Named a Top SUNY Researcher Bruce A. Holm, PhD, professor of pediatrics, pharmacology and toxicology, and gynecology/ obstetrics at UB's School of Medicine and Biomedical Sciences, was honored as one of the SU Y system's top research scientists at a dinner held in Albany, New York, on January 22, 2001. Holm, who is also senior associate dean at the School of Medicine and Biomedical Sciences, has conducted internationally recognized research on lung surfactant and oxygen toxicity affecting alveolar cells. In his address to the evening's 21 BR UC E A. HOLM honorees, SU Y Chancellor Robert L. King said, "Each of you has distinguished yourself and our university by the body of your work. Learning of the specifics of [this] work has validated all of my from the American College of Emergency Physicians (ACEP ). Jehle, who is associate professor and vice chair of the Emergency Medicine Program at UB 's School and BiomediDtETRt C H J E HL E plays host to tremendous research initiatives and has, and will, continue to make great contributions to our state, our economy and our society." -Lots BAKER tional Institute of Allergy and ant at RPCI Infectious Diseases, National stnce Institutes of Health. - S.A. U N GER 1999, has also been appointed to BRAHM H. SE GA L the faculty position of assistant sions of Infectious Diseases and Sethi and Berenson Funded to Study Emphysema Allergy, Immunology, and Rheu- Sanjay Sethi, MD, and Charles S. professor of medicine in the Divi- matology at UB's School of Med- Berenson, MD, in the Department icine and Biomedical Sciences. of Medicine at the University at Segal earned his medical de- Buffalo, have been awarded a gree from Albert Einstein College four-year, $750,000 grant from ew York. the National Heart, Lung and He completed residency training Blood Institute of the National ew England Medical Center, Boston, CON TI NU ED ON P ACE 22 cipient of numerous awards, including the Outstanding Mentor/Teaching STUDENTS' ANNOUNCEMENT Award and the Chairman's Teaching Award from UB's Department of Emergency Medicine. Jehle is recognized for devel- tudents for Health and Human Rights (SHHR), a local offshoot of Physicians for Social Responsibility (PSR), has oping the first study of bedside several members who are interested in recycling surplus ultrasonography in abdominal and unused medical supplies from hospitals for use in trauma by emergency physicians developing countries. This type of program was first orth America. He is also co- developed at the Yale-New Haven Hospital several years ago editor of a trauma ultrasound text and has been successfully implemented in hospitals across the that will be used as an instruc- United States. in tional guide for future ACEP The program works as follows: Supplies for patients are often Trauma Ultrasound courses fol- unused, but according to law cannot be reallocated for use with lowing its publication in 200 l. - S.A. UNGER other patients in the United States. Our organization is interested in systematically recycling these supplies and sending them abroad in keeping with the Yale-New Haven Hospital model, and we are we, as a great research institution, proven that the State University in Infectious Diseases at the Na- eases consult- in internal medicine at the cal Sciences, beliefs and my vision for where can go. Your achievements have infectious dis- of Medicine, Bronx, of Medicine is the past re- Massachusetts, and a fellowship has been an interested in finding a local hospital that is willing to participate Segal Named Assistant Professor of ed"c ne in this program. We have several potential recipients in Haiti and other countries in desperate need of supplies. Brahm H. Segal, MD, has been ap- If you know of a hospital or administrator who would be willing pointed director of the Division of to assist us in this endeavor, please e-mail Christina Chang at Infectious Diseases, Department cmcll@buffalo.edu; Betsy Schneider at eas26@buffalo.edu; of Medicine, at Roswell Park or Sarah Gaughan at sgaughan@buffalo.edu. Cancer Institute (RPCI ). Segal, who S prin g 200/ Buffa l o Pb ysi c i an 21 �PATHWAYS Tm A, Iv ~ OF COST EFFECriv~, PREY~ CO I BL HAlo, , F\\ YoRK, cALLS HIMSELF A. " 1A AG£D CARF IDEOLOGuE" \\ HO sEEs "HIGH-QC'ALITY, T fiH-ORIFNTt:D M~DIUNE .•. PRACTICED BY A GROUP Of PROVIDERS \\HOARE WILLI, "G TO ,I LOl SL'I AS~FSS A D IMPROVE THEIR l.)L \lLY OF CARE" AS THE BFSr \\AY ro DELIVER HEALTH CARE . however, the CONTINUED FROM PAGE 21 Institutes of Health to study the precise role that respiratory bacteria (Haemophilus injluenzae) play in regulating immunologic mechanisms of inflammation that lead to chronic obstructive pulmonary disease or emphysema. It has long been known that inflammation is present in the air- critical care medicine-and effective therapies in the future. role that bac- Berenson-an associate professor Both Sethi and Berenson are teria play in of medicine who is board certified affiliated with Veteran Affairs decreasing in infectious diseases-will com- Western New York Health- function has bine care System's Bailey Avenue their clinical and not been ex- research interests in an effort to facility, where the research will plored. In this provide a better understanding be conducted. -S.A. UNGER study, Sethian assistant of the basic causes of emphySANJAY SETHI sema. Such an understanding professor of medicine who is may in turn provide a basis for board certified in pulmonary and designing ways of people with emphysema; novel and more Robert Dickman, MD '68, Named Chair at Tuhs University n April 5, 2001, Robert L. Dickman, MD '68, was installed as the That philosophy was the foundation of his work as director of inaugural holder of the Jaharis Family Chair in Family Medicine ambulatory services at the Buffalo General Hospital, beginning in atTufts University School of Medicine in Boston, Massachusetts. 1972, and as a faculty member at University at Buffalo's School of This is the first endowed chair of Family Medicine in Medicine and Biomedical Sciences, where he earned his New England, and one of approximately 14 others medical degree in 1968. It guided him later him as a faculty member of the in the country. Dickman formerly served as chief of Tufts' Division Family Medicine Center at Case Western University; of Family Medicine, which he came to the university helped his creation, in 1982, of a new Department of to create in 1998. This effort involved strengthening Family Medicine at Cleveland's Mt. Sinai Medical existing family medicine programs and developing Center; and informed his work as a consultant for new ones, including a required third-year clinical Meridia Health Care Systems, as well as in his estab· clerkship. Experienced in shaping new organizations, ROBERT DICKMAN Dickman in 1971 was a founding physician of the Matthew Thornton Health Plan, one of the Northeast's first health maintenance organizations. Throughout his career, Dickman has integrated the principles In 1995, Dickman took the same philosophy to Israel, where he directed managed care programs at Maccabi Health Services, Israel's second largest health fund. of family medicine and managed care in academics, practice and In addition to his interest in managed care, Dickman has pursued management. The native of Buffalo, New York, calls himself a clinical and publishing interests in geriatrics, most recently con- "managed care ideologue" who sees "high-quality, cost-effective, tributing to a major family medicine text; and medical ethics, preventive-oriented medicine ••• practiced by a group of providers especially end-of-life care issues. who are willing to continuously assess and improve their quality of care" as the best way to deliver health care. 22 lishment of a family medicine group practice in Cleveland. laffalo Phys ic ian Spring 2001 Dickman will continue to administer the Tufts' medical school family medicine programs. �Jerome Kassirer Honored by American Jewish Congress Distinguished Community Leadership Award erome Kassirer, MD '57, received the Distinguished referred to as the 'conscience of American medicine.' Kassirer's Community Leadership Award from the American reputation as the 'conscience of American medicine' was furthered Jewish Congress on February 7, 2001, at a ceremony in July 2000, when he stepped down aseditorofthe N£/Minthewake held at the Westin Copley Place Hotel in Boston, of a decision made by the journal's publisher, the Massachusetts Massachusetts. The American Jewish Congress, which Medical Society, to begin adding the tagline "publishers of the New in its own literature refers to itself as the "Attorney England Journal of Medicine" to its other publications. General for the Jewish People," is an 80-year-old After graduating magna cum organization that works around the world to pro· laude from UB's School of Medicine mote religious freedom and diversity, defend the in 1957, Kassirer trained in internal civil rights of minorities, and guarantee the consti· medicine at Buffalo General Hos· tutional rights of all Americans. pital and in nephrology at the New In presenting Kassirer with the award, the Con· England Medical Center in Boston. gress notes that "as editor-in-chief emeritus of the He joined the faculty at Tufts Uni· New England Journal of Medicine {N£/MJ [he] has versity School of Medicine in 1961, made outstanding contributions in the areas of was named professor of medicine in medical care, education, research and health policy. 1974 and was the Sara Murray He has had a distinguished career as a caring physi· Jordan Professor of Medicine from cian, outstanding educator, researcher, innovator in 1987 to 1991. From 1971 to 1991 he was associate physician-in-chief clinical reasoning, and leader in promoting profes· jEROME KAS S JRER sional values. In numerous editorial op-ed pieces and of the New England Medical Center commentaries over the past two decades, he has and vice chair of the Depart- criticized our inadequate medical care delivery system, govern· ment of Medicine at Tufts. In 1991, he became the 38th editor-in· mental interference in medical decision making and the resis· chief of the New England Journal of Medicine. tance of the gun lobby to support reasonable safety measures. Also in 1991, Kassirer was named Distinguished Alumnus of He has tirelessly promoted integrity in patient care and re· University at Buffalo's School of Medicine and Biomedical Sciences search, endorsed a stronger role for patients in medical deci· and received the Distinguished Faculty Award from Tufts University sions and been a careful observer of the role business interests School of Medicine. He now teaches at Tufts, as well as at Yale have played in our American health-care system. During his University School of Medicine. tenure at the New England Journal of Medicine, he was often - S . A. U N c E R Spring 200 1 l uffafo Physician 23 �M B v S U N A G E R E D C A L S C H 0 0 L E W S AWealth of Knowled eand (xperience N e w M e d i c a I E m e r i t u s Fa c u I t y G r o u p Fo r m e d has found its counterpart in lifelong teaching and mentoring through a new group formed at University at Buffalo's School of Medicine and Biomedical Sciences. The group-called the Medical Emeritus Faculty Group (MEFG)-was begun last year in an effort to provide retired faculty with an opportunity to continue viable, interactive relationships with the medical school once their formal academic careers have come to a close. The MEFG got its start in January 2000, when Glen Gresham, MD, emeritus professor and chair of the Department of Rehabilitation Medicine at UB, met with Dean John R. Wright, MD, to discuss the idea of creating a more uniform way in which retired faculty could continue to stay connected with the school should they choose to do so. "In the past, when medical faculty members retired but wanted to stay involved with the school, they worked out informal arrangements with their former departments, but there wasn't a uniform approach to this transition," Gresham explains. "Also, there was no place for us to get together and to feel a part of a peer group. Many of us are in Buffalo for at least part of the year, but our interactions with the school were random-anything from being on the mailing list for Buffalo Physician to being invited to a lecture or some other event. It was kind of'luck of the draw."' ln talking with Dean Wright, Gresham explained that he and a core group of his colleagues felt they were not alone in perceiving that an attempt to establish an emeritus faculty group would be well received by a significant number of their peers. "Dean Wright was very supportive of this idea and suggested that we go ahead and pursue it," says Gresham. "He gave me the names of some people he thought would be interested and to this list we added other names to form an ad hoc steering committee, which began meeting monthly in the summer of 2000." The steering committee has been meeting on an ongoing basis since then and its members have embarked on an outreach effort aimed at inviting as many of their peers as they can locate to join the MEFG. With the assistance of Mary Glenn, from the offices of Alumni and Development, whom the Dean assigned to serve as a liaison with the group, committee members have contacted retired faculty by phone and letters, as well as by word of mouth. Currently, they are preparing to send out a questionnaire to all medical emeritus faculty in the school's database, which has approximately 200 names in it. ..".. ,.. • 0: 24 lulfale Physiciaa Spring 2001 �((Many of the current emeritus faculty have been leaders within the school and have a rich sense of history due to their long tenure here. They will be respected and effective ambassadors for the school." -Dean Gresham says he was pleasantly surprised when he reviewed the database, name by name, and identified 193 emeritus faculty who still list a principal address in Western ew York. "I had no idea there were so many; I thought maybe there would be 50, " he says. "But what I found is that there are a In the long run, lot of us. " Gresham foresees a The response to invitations to join the number of other group has been extraordinary, according to Gresham, who explains that memberinterest groups ship is open to anyone who meets the forming to establish a criterion of being an emeritus professor or faculty member from UB's School of "bank of expertise" Medicine and Biomedical Sciences. that's available to "This is a first-class group, and we'd be anyone who wishes to delighted to have anyone join who ' s interested," he says. draw upon it. Since its formation, the MEFG has accomplished its initial objective, which, according to Gresham, "was to bring us together and see how well we got along and to see what we might be interested in doing. "We all worked together a long time and have much in common, and what we have found is that we do like seeing each other," he continues. "We really are a cohort; we are a group. And this has been very gratifying to confirm. " Another objective the group's members have agreed upon, is that they would like to remain an informal entity. "One of our members was very wise and said we should go slowly and not be in a hurry to become overly organized and have officers and bylaws and such things," Gresham says. "He suggested that we just 'let it grow,' so that's what we're doing." Having reached a consensus that there is indeed a place for such a group, and that its organizational style should remain informal, the MEFG has set to work planning specific events and tasks. Last fall, they began hosting bimonthly roundtable lectures featuring distinguished speakers from the medical school who John R. Wright address topics put forth by the group. In November 2000, for example, Michael Bernardino, MD, MBA, vice president for Health Affairs at UB, spoke on "What Is the Relationship between the School and the Hospitals in Buffalo? " and in January 2001, Dean Wright spoke on "Where Is the School Now and Where Is It Headed?" The roundtable format has proved conducive to discussions between the speaker and members of the group, according to Gresham. In addition to the roundtable luncheons, the MEFG has formed a sub-set of interest groups that draw upon the special expertise of its members. "There's a lot of interest in medical education among our members, particularly with regard to mentoring and tutoring, " says Gresham. "We are a group that has enormous experience in these areas and many still feel they have much to contribute." To date, two such interest groups have been formed: One, headed by jacob Steinhart, MD, an emeritus professor of pediatrics, is aimed at working with physicians-in-training to hone their interactions with patients and to cultivate "clinical wisdom"; and a second group, headed by john Robinson, MD, an emeritus professor of psychiatry, is aimed at providing support to medical students interested in learning more about post-traumatic stress disorder. In the long run, Gresham foresees a number of other interest groups forming to establish a "bank of expertise" that's available to anyone who wishes to draw upon it. "Depending on who comes forward, I anticipate a variety of interest groups that capitalize on the strengths of our members," he says. Another specific task the MEFG has set its sights on is the completion of the emeritus faculty questionnaire, which they hope will help them to better define the group's goals and potential contributions for the future. They also hope to obtain office space for headquarters that would provide them with a place for small CONT I NUE D ON PA GE 26 S prin g 2 001 11111 11 Pbys i c i11 25 �---- M E D ----- - C A L SCHOOL E W S "In the past, when medical faculty members retired but wanted to stay involved with the school, they worked out informal arrangements with their former departments, but there wasn't a uniform approach to this transition," Gresham explains. KNOWLEDGE, CONTINUED FROM PAGE 25 meetings, a phone, fax and computer. "We envision the office being staffed by volunteers who can give of their time to help us accomplish another of our goals, which is to keep a master schedule for all the fascinating medical and scientific lectures at the school and Charles Paganelli, PhD, an emeritus professor of physiology and biophysics who is also a member of the MEFG steering committee, says "It's been a pleasure to see people you've known for years and to work with them in this capacity. This is a group of senior faculty, now retired, whose members have lots of experience around the school and there's no reason why their throughout Buffalo," explains Gresham. "Right now, accumulated knowledge can't be used by the school to these events are spread all over the place and nobody keeps a master calendar that could be made available to our members and whoever else would like to avail themselves of this information." some good purpose." Gresham and his fellow members of the MEFG's steering committee know that to effectively accomplish the goals they have outlined, they must integrate the group's presence into the fabric ofUB's School ofMedi- therefore, view themselves as a resource that not only can be tapped into by others but that can reach out to the school and community. "We've had wonderful careers and we're proud to be emeritus faculty at UB," says Gresham. "Many of us are very busy with volunteer work and some of us continue to practice. So, it's not that people aren't doing things; it's just that we haven't been doing anything as a group with the school. And the response we're getting from the school is very affirming of our goal to interact in this way." "The organization of an active, informed and dedicated emeritus faculty group is good news indeed for the School ofMedicine and Biomedical Sciences and for the university community," says Dean Wright. "Many of the current emeritus faculty have been leaders within the school and have a rich sense of history due to their long tenure here. They will be respected and effective ambassadors for the school." Harold Brody, PhD, MD, emeritus professor of anatomy and cell biology, and member of the MEFG's steering committee, concurs with Wright and Gresham. "A gap has existed because there hasn't been a group like [the MEFG] in the past. Potentially, it could be a very important group because it's made up of people who care very much about the school and understand how it works," he says. 26 lalfal1 Physiciaa Spring 2001 cine and Biomedical Sciences so that when faculty members retire, they see the potential for involvement with the MEFG as just another step in a continuum of interaction with the school. Toward this end, therefore, the MEFG would like to initiate a new stage in the process whereby a faculty member retires from the school. "We now have a faculty meeting where people who are retiring receive a 'diploma' that states he or she has been promoted to the rank of professor emeritus with all its rights and privileges," says Gresham. "In addition, we'd like someone from the MEFG to immediately approach those who have retired to say, 'welcome to the Medical Emeritus Faculty Group.' "In other words, we'd like to make it a seamless and positive transition for those faculty who are interested in continuing their involvement with the school." For more information on the Medical Faculty Emeritus Group, call Mary Glenn at (716) 829-2773; or e-mail her at glenn@acsu.buffalo.edu. �..James E. Allen, assistant professor of surgery Blake Reeves, professor of physiology Sprirrg 2001 l 11fale Hysicin 27 �.... G.> ..... = ....... - ~ -= ... 2. 1111111 Pkysitill Spring 2001 ��Hormones, I n s u I n a n d B r e a s t '> she has been looking at how the blood levels of estrogens and androgens are associated with the risk of developing breast cancer. More recentlywith the support of a two-year, $238,000 grant from the United States Army Medical Research and Materiel Command-she has turned her attention to conducting the first major study of the relationship between breast-cancer risk and levels of insulin in the blood. The Influence of Diet and Exercise When breast-cancer researchers set out to explore questions such as those Muti is pondering, they begin with the recognition that breast-cancer incidence rates are about 25 percent higher in Western countries than in Africa or Asia. "Although both genetic and environmental factors may contribute to explaining this large geographic variation in incidence rates, studies on migrants who moved from countries characterized by low incidence, such as Japan, to countries at higher risk, such as the United States, have shown a significant increase in breast-cancer incidence in individuals that migrate in comparison with their peers who remain in the countries of origin," Muti explains. This evidence has led researchers to surmise that environmental factors, such as diet and lifestyle, play a dominant role in breastcancer incidence, according to Muti. "In countries with high breast-cancer incidence rates, these environmental factors are characterized by an energy-dense diet rich in total and saturated fat and refined carbohydrates, and by low physical activity," she says. In terms of what role genetics plays as a risk factor in the incidence of the disease, Muti reports that "there are connections, but, in absolute terms, genetic predisposition as it has been studied up to now accounts for only 5 percent ofbreast cancer cases. "However, it is possible that the way in which we metabolize components of the environment-metabolize diet or pollutants-may give us a different risk in comparison with people who metabolize in a different way," she adds. 3 0 I u fl a I a Physician Spring 200 1 Cancer Given that genes appear to play a lesser role in the development of the majority of breast-cancer cases, Muti emphasizes that "at this historical moment in research on this cancer, it is very important that we identify the environmental factors that are placing women in our country at such high risk in comparison to women in low-risk populations. Clearly, there are environmental factors, but we really don't understand how they work." One potential explanation of the role environmental factors play in the etiology of breast cancer is that diets rich in total and saturated fat and refined carbohydrates often lead to the development of insulin resistance and hyperinsulimia. Like hormones, insulin is an endogenous substance; in other words, it originates within the body, as opposed to exogenous factors, which arise externally. These endogenous substances, Muti says, are "big mediators between the environment and ourselves." Muti's goal in her current study, therefore, is to test the hypothesis of the linkage between serum insulin and breast cancer. "We know that insulin itself is an important mutagenic factor because it is able to induce proliferation and growth of a cell," she explains. "The mechanistic model we are working with now leads us to hypothesize that because insulin can also increase production of androgens from the ovaries, and because androgens are the precursors of estrogen, insulin is then able to produce both androgens and estrogens, which are important factors for breast-cancer etiology." F"nding Markers of Metabolic Risk To conduct her study on the role of insulin in breast cancer, Muti is building on a series of related studies she has completed over the past decade. The studies are based on data she gathered on almost 11,000 healthy women in Italy between 1987 and 1992 for an initial prospective study on breast cancer, called the HORmones and Diet in the ETiology of Breast Cancer (ORDET) study. Five and a half years after the women were recruited to this original study, 144 were found to have developed breast cancer. In the early 1990s, Muti and her colleagues went back and looked at samples of blood from the women who developed cancer and compared them with samples from women who didn't develop the disease. It was this important study, later replicated all over the world, that first provided scientists with data indicating a definitive link between the presence of high levels of estrogens and androgens in a woman's blood and the subsequent development of breast cancer. In 1998, again relying on analysis of data collected on women who took part in the ORDET study, Muti and her colleagues conducted a study in which they sought to discover whether there was a way they could determine a woman's hormonal (androgen) and insulin levels other than by analyzing her blood-in essence, to �lstrogen Metabolism linked to Breast Cancer Risk and collaborators have Researchers analyzed the found that premenopausal women show a 40 percent lower urine samples from both breast risk of developing breast cancer if their predominant path- cancer cases and controls from way of estrogen metabolism produces by-products with little the ORDET study to determine the biologic activity, rather than by-products that are highly predominant estrogen-metabolism reactive. The research is based on data from 10,786 women pathway. Results showed that the who took part in a prospective study of breast cancer in Italy premenopausal women who devel- called the Hormones and Diet in the Etiology of Breast Cancer oped breast cancer had a higher (ORDETI study (see also article, opposite). Once estrogen has performed its essential hormonal duties, it must be eliminated from the body by undergoing a process called hydroxylation. "Estrogen hydroxylation takes place at two primary sites on the estrogen molecule, designated as the C-2 position and the C-16 percentage of the highly active byproducts of estrogen metabolism (produced by the C-16 pathway), than by-products from the C-2 pathway. Women with predominately C-2 pathway by-products-those with low activity-were 40 position," Muti says. "Earlier research has shown that hydroxyla- percent less likely to have developed breast cancer during those tion at the C-2 position produces metabolites with little or no five years. estrogenic activity and thus might be associated with decreased "The way to change from one pathway to the other is through breast-cancer risk. Conversely, hydroxylation at the C-16 position changes in lifestyle. Physical activity and eating a diet low in fat produces metabolites with high estrogenic activity, and might be and high in cruciferous vegetables can shift estrogen metabolism associated with increased breast-cancer risk. We set out to deter- from high-risk to low-risk," says Muti. mine if there was an association between later development of For more information on this study, refer to the paper published invasive breast cancer and the ratio of C-2 to C-16 by-products in on it in the November 2000 issue of Epidemiology. women before cancer developed." - LOIS BAKER discover whether biological markers exist for these substances other than in the blood . To accomplish this, they assessed the women's sebum production (the output of the skin's oil-andwax-producing sebaceous glands), their body-fat distribution and amount of body hair. (The relation of excess androgen in the blood with sebum production and symptoms of excess body hair, or "hirsutism," has been recognized by researchers for many years, Muti points out. In more recent years, clinical studies on women with established non-insulin-dependent diabetes mellitus and consequent elevated insulin concentration have shown that they have higher abdominal fat.) W hat M uti found in her study was that hair and sebum production were predictors of breast cancer in older, postmenopausal women. Furthermore, the body-fat distribution that fit a more male (pear-shaped) pattern, as opposed to the female (apple-shaped) pattern, was a predictorofbreastcanceronly in premenopausal women, in particular in women who were thinner. "One of the things this told us is that the hypothetical model we have for describing the mechanism of how insulin is able to induce increased production of androgens and estrogens as <!;) precursors to breast cancer is not so simple; it's more complex than we had thought. There are factors that make insulin a relevant risk factor in younger women and there are factors that make androgen and estrogen important risk factors in older women," says Muti. "In my present study on insulin, therefore, what I am looking at is the potential determinant of why insulin is so important in young women, and why androgen and estrogen, and not insulin, is so important in postmenopausal women." To date, the results from Muti's current insulin study are "telling us that insulin and IGF-1 [insulin-like growth factor- I), when measured in the blood, are more important in premenopausal than in postmenopausal women." These findings are leading Muti and her colleagues to hypothesize "that the insulin-resistance theory is stronger, is more valid, for younger women," she reports. "In particular, what we're finding is that glucose in the blood-glycemia-is a risk factor for breast cancer in these women," she notes. Based on these findings, she says, "we are very close at this point in our research to finding markers of metabolic risk that will tell us a little bit more about the potential markers of these environmental factors for breast cancer." Spring 200/ l a fla l a Pbys i c i u 31 �E RESEARCH W S Cocaine Use and Heart Attacks One- uarter of nonfa a heart attacks among persons under the age of 45 in the United I . ..• < States can be attributed to regular cocaine use, scientists at the University at Buffalo's Toshiba Stroke Research Center have reported in a study published in the January 2001 issue of Circulation. Lead author Ad nan I. Qureshi, to Qureshi. "What we do know is that cocaine use increases the levels of the neurotransmitters norepinephrine and dopamine at nerve terminals, which in turn increases heart rate, ventricular contraction and the heart's demand for oxygen. "Cocaine may also constrict blood vessels and increase platelet aggregation. In addition, it has MD, UB assistant professor of been shown to accelerate arter- neurosurgery, and colleagues found an association between frequent cocaine use and heart attacks in this age group, but not between cocaine use and strokes. "These findings "Cocaine may ndicate that changalso constrict blood ng behavior sur- iosclerosis in young patients. Since regular, but not infrequent, use of cocaine was associated with an increased risk in our study, our results seem to support vessels and increase platelet aggregation. In addition, it has been shown to accelerate arteriosclerosis in young patients. Since regular, but not infrequent, use of cocaine was associated with an increased risk in our study, our results seem to support this rounding cocaine use-due to public awareness and education-may reduce the incidence of cardiovascular disease n younger persons," Qureshi says. Previous researchers had reported cases of heart attack and stroke in persons who had sed cocaine within latter mechanism." the previous hour. Given the increase in cocaine use among young adults in the United States, the UB researchers undertook an extensive investigation of the possible relationship. this latter mechanism," he says. In their analysis the researchers used data from the most recent National Health and Nutrition Examination Survey (NHANES 1111, which was conducted between 1988 and 1994 by the Centers for Disease Control to estimate the prevalence of chronic disease in the United States population and identify factors that put people at risk of developing chronic health problems. It involved 40,000 persons two months of age or older. For the first time since these national surveys began, participants ages 18 to 59 were asked about life· time cocaine use. For their analysis of the association with heart attack and luffalo Physician Spring stroke risk, the UB researchers limited their study population to the 18 to 45 age group, which captured all but 25 cocaine users and resulted in a study base of 10,085. The study group was divided into three user groups: never, in· frequent, and frequent. This included anyone reporting using the drug from 10 to more than 100 times. The survey also contained data on prevalence of nonfatal stroke or heart attack. Analysis showed that about one in 20 subjects, 67 percent of whom were males, reported using cocaine regularly. To estimate the impact of the drug on nonfatal heart attack or stroke, the researchers calculated the percent of populationattributable risk-the portion of disease that would be eliminated if the exposure lin this case, use of cocaine) were removed. In general, regular users of cocaine were at nearly seven times the risk of having a nonfatal heart attack than non-users, results showed. The populationattributable risk was 25 percent, indicating that in this age group, one in four nonfatal heart attacks would not have occurred if there had been no cocaine use in the group. There was no relationship between cocaine use and nonfatal stroke. Additional researchers on the study included M. Fareed K. Suri, MD; Lee R. Guterman, PhD, MD; and L. Nelson Hopkins, MD, chair of the UB Department of Neurosurgery and director of the Toshiba Stroke Research Center. lOISBAK R searc Researchers aren't sure how cocaine might increase the chances of having a nonfatal heart attack or stroke, according 32 Adnan 1. Qureshi, MD 2001 �" THESF RESULTS SUGGEST THAT NATURALE DOCA .• ABL OID-SIG"'JALI G REGl.JlArF<; SPER\1 FU CfiONS IN HUMANS, Fl. 'DI. GS WITH :\1EDI< AL IMPLICATIONS FOR HUMAN REPRODUCTIO.' AND DRUG ABUSE," SCHUEL SA Y::i . Marijuana Abuse and Fertility For about the past 40 years, re- concentrations were inhibitory, stance called anandamide was which suggests that localized "In addition, the increased differences in anandamide levels load of cannabinoids in people may regulate sperm swimming who abuse marijuana could flood found to be that chemical. searchers have hypothesized that Regulatory mechanisms that marijuana smoke may affect sperm fertility. A recent study prepare sperm to fertilize eggs in human reproductive tracts remain poorly understood. Human THC inhibit structural altera- adversely impact fertil- scientists provides compelling sperm are bathed in male repro- tions, which are required for ity," he says. "This may "Defects in evidence in support of this ductive tract secretions when they physiological acrosome reactions, explain why men who endocannabinoidsignaling may be responsible for certain headed by University at Buffalo In VIVO. Secondly, both AM-356 and natural endocannabinoid-signal systems in reproductive organs and theory by discovering that a are ejaculated into the female's over the acrosomal cap during smoke the drug have cellular-signaling system that responds to THC (the active sub- vagina, and are not immediately capable of fertilizing eggs. How- capacitation. Thirdly, AM-356 inhibited lower sperm counts than nonsmokers." stance in marijuana), as well as to ever, once removed from the tight binding of sperm to the Collaborating on anandamide (a cannabinoid-like seminal plasma and exposed for egg's zona. "Failure of sperm to the research were Drs. unexplained molecule, or endocannabinoid, several hours to secretions with- bind tightly to zonae is predic- Robert Picone and types of normally produced in the body) in the female reproductive tract, tive of fertilization failure for in Alexandros Makri- may regulate sperm functions re- sperm become "capacitated" quired for fertilization in humans. and can fertilize eggs in vivo, or vitro fertilization," says Burkman. "Defects in endocannabinoid- yannis of the University of Connecticut; The study, led by Herbert by incubation in appropriate culture media in vitro. signaling may be responsible for Jack Lippes of UB; Mary C. Schue!, PhD, professor in pathol- certain currently unexplained Mahony of Eastern Virginia ogy and anatomical sciences, and "We know that sperm capa- Medical School; and Andrea Lani Burkman PhD, assistant professor of gynecology-obstet- citation and fertilizing potential are tightly regulated within types of infertility," Schue! says. "Conversely, endocannabinoidsignaling in reproductive tracts Giuffrida and Daniele Piomelli of the University of California rics, presents the first evidence female reproductive tracts, " that anandamide exists in Burkman says. "We also know may provide potential targets for future development of novel -LO IS BAKER human seminal plasma, mid- that the cannabinoid receptor cycle oviductal fluid and follicu- found in the human brain is ex- lar fluid. Sperm are normally exposed to these fluids as they pressed in the human testis, and that anandamide is produced in travel from the vagina to the site mammalian testes and uteri." of fertilization in the oviduct. Capacitated sperm exhibit a The study also shows that human sperm contain cannabinoid re- characteristic pattern of vigorous swimming called hyperactivated ceptors, and that anandamide motility. After binding to a specific protein in the egg's surface and THC regulate the sperm's "These results suggest that coat (zona pellucida), capacitated sperm undergo the acrosome re- natural endocannabinoid signal- action, a secretory event in sperm ability to fertilize eggs in vitro. ,.' drugs for reproductive medicine. activate these receptors. A sub- ing regulates sperm functions in humans-findings with implications for human reproduction and drug abuse," Schue! says. In 1991, a cannabinoid receptor gene was cloned from a currently infertility," Schuel says. at Irvine. that releases enzymes that enable sperm to penetrate zonae during fertilization. The current study found that an anandamide analog (AM-356) and THC affect the following processes in humans. : i ..• .... First, a low concentration of human brain, which suggested that the body must produce its AM-356 stimulated hyperacti- own chemical version ofTHC to vated motility while slightly higher lani Burkman PhD, and Herbert Schuel, PhD. Spring 2 001 Bu ffalo Physici an 33 �DEVELOPMENT N E w s (ve~ G"ft Vi ato School's future By Li nda J . Co rde r. PhD. CFRE and Biomedical Sciences received $10.8 million in gifts and grants. About two-thirds of the total represented grants awarded competitively by foundations, corporations and nonprofit organizations to outstanding faculty researchers. Members of the James Platt White Society account for the vast majority of the remainder, approximately $3.7 million. This figure represents current gifts, contributions to endowments, bequests and other estate gifts. When I see the tremendous difference that these gifts make to the quality of life for those who study, teach, conduct research and see patients, saying "Thank you" seems hardly enough ... I wish you could walk the halls of our school, our affiliated hospitals, our laboratories and student study areas with me. You would recognize many signs of your philanthropy at work. "Scholarships" is the designation for many gifts. We made proTHIS FUND SUPPLE· gress this year, but increasing both MENTS SCHOLARSHIP the size and number of scholarAWARDS, PAYS ships remain a high priority. CurTRANSPORTATION rently our medical students gradCOSTS FOR STU· uate owing, on average, about DENTS TO PRESENT $80,000 in education loans. For RESEARCH RESULTS the school to enroll its most AND UNDERWRITES promising applicants, it simply RECEPTIONS FOR needs more scholarship funds. DISTINGUISHED Members of the Society underALUMNI WHO RE· wrote several lectures this year. TURN TO TALK WITH The Department of Pathology STUDENTS ABOUT launched a lecture in memory of THEIR CAREERS. Dr. Kornel Terplan. Students heard inspiring lectures dealing with the "art of medicine" during their first- and second-year orientation sessions. Surgery residents participated in the 11 th annual Winfield Butsch Lectureship with an internationally renowned surgeon. The medical student Professionalism Committee finalized the Code of Conduct. It was overwhelmingly approved by students, the Faculty Council and Dean's Executive Committee. A member of this Society underwrote costs for it to be printed on attractive stock, worthy of the content, and distributed without cost to students. The first recipient of the Frawley Resident Research Award received laboratory support for his research in cardiac pathology, cardiac cell biology and integrative physiology. He worked under the guidance of Dr. John Canty, holder of the Rekate Chair in Cardiovascular Disease, an endowed position supported by the Rekate and Boardman Endowments. Many Society members gave to the school's general fund. These contributions provide flexibility to Dean Wright to respond to opportunities that arise serendipitously. This fund supplements scholarship awards, pays transportation costs for students to present research results and underwrites receptions for distinguished alumni who return to talk with students about their careers. Faculty recruitment costs, often not fully covered by budgeted funds, may be supplemented by this fund. A small proportion of overall philanthropy, the general fund remains an important component of the budget. Please help us spread the word regarding the importance of private support. Although state-assisted, the school receives only about 12.5 percent of its budget directly from New York State. Thus, every bit of gift money is vital to our school's future. Development staff members, working in conjunction with alumni, faculty and department chairs, some emeritus faculty members, most importantly, the dean and campaign volunteers who believe in this work, are responsible for encouraging private philanthropy. We want you to know that gifts are used precisely as " DE V EL O PME NT" l 1ffala Pbysician Spring 2001 CON TI NUE D ON P AG E 4 4 �}ANUARY the 1 , 2 0 0 0 - D E c E J\1 B E R 3 1 , 2 0 0 0 Society When cumulative contributions reach $50,000 or an irrevocable deferred gift is completed for $100,000 or more, a couple or individual is granted lifetime membership in the ]ames Platt White Society. Combinations of outright and deferred gifts in appropriate proportions may also be the basis oflifetime membership. Names of Founders' Circle members are repeated in the annual category in any year that they make a new gift to the school. Founders' Circle UB's fo unders-pri maril y physicians and attorneysenvisio ned a school to trai n studen ts for service to the commun ity. The Society's Founders help to actual ize that vision by providi ng a genero us base of support fo r programs and activities that enri ch th e academi c enviro nment and enhance medical training. Dr. Willard H. Boardman '44 & Mrs. Jean E. Boardman '48 Winter Park, FL Dr. William M. Chardack Buffalo, NY Mrs. June M. Alker James Platt White, MD, (1811-18811 was instrumental in founding UB's medical school in 1846. W illiamsville, NY Charles D. Bauer MD '46 & Mrs. Mary Bauer Williamsville, NY Dr. Ralph T. Behling '43 San Mateo, CA Dr. Willard H. Bernhoft '35 & Mrs. Clarice L. Bernhoft Snyder, NY Dr. Thomas F. Frawley '44 & Mrs. Marigrace Frawley Gulfstream, FL Chesterfield, MO Dr. Joseph A. Chazan '60 & Mrs. Helen Chazan Mrs. Christine Gretschel Genner Providence, Rf Potomac, MD Mr. DuVal Cravens (deceased! & Mrs. Annette Cravens Mr. John H. Goodwin Jr. Buffalo, NY Dr. Kenneth M. Alford '37 & Mrs. Joan W. Alford Dr. Richard J. Nagel '53 & Mrs. Florence T. Nagel Mrs. Catherine Fix Martinsburg, WV Mr. Donald L. Davis & Mrs. Esther P. Davis Clarence, N Y Dr. Pasquale A. Greco '41 & Mrs. Lois J. Greco Buffa lo, NY Williamsville, NY Dr. Max Doubrava Jr. W illiamsville, NY Mrs. Marjorie B. Eckhert Dr. Thomas J. '61 and Mrs. Barbara L. Guttuso Buffalo, NY East A m herst, NY Ms. Rose M. Ellerbrock Dr. Eugene J. Hanavan Jr. '41 Willia msville, NY Buffa lo, NY Dr. George M. Ellis Jr. '45 & Mrs. Kelly Ellis Mrs. Morris Lamer Connersville, TN Mrs. Grant T. Fisher Palm Beach, FL East Aurora, NY Dr. Albert C. Rekate '40 & Mrs. Linda H. Rekate '71 William sville, NY Dr. Elizabeth P. Olmsted Ross '39 Buffa lo, NY Ms. Thelma Sanes Dr. Glen E. Gresham & Mrs. Phyllis K. Gresham '85 Las Vegas, NV Orchard Park, NY Dr. Richard B. Narins '63 & Mrs. Ellen B. Narins Williamsville, NY Dr. Robert J. Smolinski '83 & Dr. Claudia D. Fosket '85 O rchard Park, NY Dr. Janet H. Sung & Mr. John J. Sung Clarence, NY Dr. Philip B. Wels '41 & Mrs. Elayne G. Wels Williamsville, NY New York, NY Dr. Eugene R. Mindell & Mrs. June A. Mindell fOUNDERS' C IR CLE, CONT'D Buffa lo, NY Spring 200 1 Buffalo Physiciaa 35 �DEVELOPMENT just as a department chair leads a program, donors of leadership gifts in the range of $10,000 to $24,999 are given special recognition. Mrs. Mollie Holtzman Bergman Hollywood, FL Dr. & Mrs. Ernest Beutner Eggertville, NY Dr. Carl V. Granger Buffalo, NY Philip D. Morey M.D. '62 & Mrs. Colleen Morey Williamsville, NY Dr. Edward Shanbrom '51 & Mrs. Helen Shanbrom Santa Ana, CA The dean is the school's leader. Every leader depends on a small circle of associates who help bring the organization's vision into reality. Individuals or couples qualify as members in the Dean's Circle with generous gifts of $25,000 or more during the calendar year. Mr. Donald L. Davis & Mrs. Esther P. Davis Williamsville, NY Dr. Max Doubrava Jr. '59 Las Vegas, NV Dr. Lawrence Golden '46 & Mrs. Nancy Golden '48 Eggertsville, NY Dr. Albert C. Rekate '40 & Mrs. linda H. Rekate '71 Williamsville, NY Dr. Eugene J. Zygaj '50 Lancaster, NY A strong faculty is central to a great university. Likewise, central to the future of our school is the dedication of a cadre of supporters whose annual gifts range from $5,000 to $9,999. Mrs. June M. Alker Williamsville, NY Charles D. Bauer, MD '46 & Mrs. Mary A. Bauer Williamsville, NY Dr. Joseph G. Cardamone '65 & Mrs. Susan G. Cardamone Eden, NY Dr. Morton A. Stenchever '56 Mercer lsland, WA Drs. Michael and Laura Garrick Getzville, NY Dr. Martin C. Terplan '55 San Francisco, CA Dr. Waun Ki Hong Houston, TX Mr. Fred K. Kurata & Mrs. Lynn W. Kurata Santa Monica, CA 36 I u II a I o Pb ys i c i a n E w Dr. Gordon R. Lang '62 Chicago, IL PLATT SOCIETY, CONT'O Annual donors of $1,000* or more are granted membership in the james Platt White Society. Annual memberships in the appropriate circle within the james Platt White Society are granted for one year, beginning january I (for gifts received the prior calendar year). The roster of the fames Platt White Society "Class of 2000" follows. N Spring 2 0 0 1 Dr. Shedrick H. Moore '55 Costa Mesa, CA Dr. John C. Newman Lewiston, NY Dr. Charles S. Tirone '63 & Mrs. Anne R. Tirone '94 Williamsville, NY Dr. James J. White Jr. '69 Buffalo, NY Scholars· Circle One strength of outstanding institutions is the caliber of those who study there. Scholars within the james Platt White Society have made gifts to the school totaling $1,000 to $2,499 during the past year. Those marked with an asterisk (*) are young scholars, graduates of the last decade, who qualify with gifts of $500 to $999. '"'·c e Fellows within the school are recognized for added depth they bring to postgraduate study. Fellows are honored for gifts that total $2,500 to $4,999. Dr. & Mrs. Charles A. Bauda '42 Boynton Beach, FL Dr. C. John Abeyounis Williamsville, NY Dr. Kenneth M. Alford '37 & Mrs. Joan W. Alford Buffalo, NY Dr. Kenneth Z. Altshuler '52 & Mrs. Ruth Altshuler Dallas, TX Dr. Willard H. Boardman '44 & Mrs. Jean Boardman '48 Winter Park, FL Dr. Lawrence B. Bone '73 Orchard Park, NY Dr. Dennis L. Bordan '70 Port Washington, NY Dr. Suzanne F. Bradley '81 Whitmore Lake, Ml Dr. Martin '72 & Geri Brecher Amherst, NY Dr. Robert A. Brenner '59 Moravia, NY Dr. Harold Brody '61 Getzville, NY Dr. James B. Bronk '81 & Mrs. Suzanne Bronk Napa, CA Dr. August A. Bruno Sr. '51 Buffalo, NY Dr. David P. Buchanan '48 Hillsborough, CA Dr. Hossein Amani Ontario, Canada Dr. William M. Burleigh '67 Rancho Mirage, CA Dr. Melvin M. Brothman '58 Snyder, NY Dr. WilliamS. Andaloro '45 Caledonia, NY Dr. Washington Burns Ill '61 Berkeley, CA Dr. Jennifer L. Cadiz '87 Lemoyne, PA Dr. Mark Anders Buffalo, NY Dr. Charoen & Dr. Charlearmsee Chotigavanich Thailand Dr. Douglas Armstrong Buffalo, NY Dr. Evan Calkins & Dr. Virginia Calkins Hamburg, NY Dr. Robert Gillespie '74 & Mrs. Kathleen Gillespie Buffalo, NY Dr. Hak J. Ko Buffalo, NY Dr. Robert L. Malatesta '60 Warren, N] Dr. Susan V. McLeer Buffalo, NY Dr. Nancy H. Nielsen '76 Orchard Park, NY Dr. Thomas P. O'Connor '67 & Mrs. Sandra S. O'Connor East Amherst, NY Dr. Robert J. Smolinski '83 & Dr. Claudia D. Fosket '85 Orchard Park, NY Dr. J. Bradley Aust Jr. '49 San Antonio, TX Dr. George Bancroft '81 & Mrs. Susan K. Bancroft '79 Hamburg, NY Dr. Elizabeth P. Barlog '82 & Dr. Kevin Barlog '82 Amherst, NY Dr. Jared C. Barlow Sr. '66 & Mrs. Barabara Barlow Grand Island, NY Dr. Paul D. Barry '71 Arlington, VA Dr. Richard A. Berkson '72 & Mrs. Andrea Berkson Rancho Palos Verdes, CA Mr. Sheldon M. Berlow Buffalo, NY Dr. David T. Carboy '63 & Mrs. Jacqueline G. Carboy Lincroft, Nj Dr. Nicholas C. Carosella '54 Appleton, NY Dr. Yung C. Chan '73 Draper, VA Dr. Norman Chassin '45 & Mrs. Charlotte S. Chassin Williamsville, NY Dr. Charles Kwok·Chi Chow & Mrs. Patricia Chow Hong Kong Dr. Bernice S. Comfort·Tyran '58 Los Altos, CA Dr. Donald P. Copley '70 & Mrs. Andrea Copley Amherst, NY Dr. Linda J. Corder Buffalo, NY Dr. Irving Sterman '64 & Mrs. Gail K. Sterman jacksonville, FL Dr. Michael E. Bernardino & Mrs. Joan Bernardino Buffalo, NY Mr. Haskell Stovroff Buffalo, NY Dr. Beverly P. Bishop '58 Snyder, NY Dr. Julia Cullen '49 Buffalo, NY Mr. James I. Stovroff Buffalo, NY Dr. Theodore S. Bistany '60 Buffalo, NY Dr. Daniel E. Curtin '47 & Mrs. Elaine Curtin Orchard Park, NY Dr. J. Steven Cramer East Amherst, NY �E VE R Y LEADE R DEPE DS 0 HELP BR I NG T H E ORGA A SMALL CIRCLE OF ASSOC I ATES W H O I ZAT I ON ' S V I SIO I NTO R EALITY . Dr. David R. Dantzker '67 & Mrs. Sherrye Dantzker Dr. William A. Fleming '64 & Dr. Beth D. Fleming '67 Dr. John H. Hedger '75 & Mrs. Sandra Hedger Dr. Paul B. Karas '87 & Mrs. Donna Karas Dr. Mark J. Lema '76 & Mrs. Suzanne Lema Roslyn, NY Buffalo, NY Salisbury, MD Buffalo, NY East Amherst, NY Dr. Roger S. Dayer '60 & Dr. Roberta A. Dayer '72 Dr. Andrew J. Francis '84 Dr. Reid R. Heffner Jr. & Mrs. Elenora M. Heffner Dr. Julian R. Karelitz '68 & Dr. Mayenne A. Karelitz Dr. Harold J. Levy '46 & Mrs. Arlyne Levy Buffalo, NY Carson City, NV Amherst, NY Dr. William J. Hewett '61 Dr. Mahito Kawashima West Hartford, CT Japan Dr. David C. Lew & Mrs. June K. Lew Dr. Fredric M. Hirsh '73 & Mrs. Donna A. Hirsh Dr. John H. Kent '55 Buffalo, NY Coram, NY Dr. Neal W. Fuhr '52 Dr. Gerard J. Diesfeld '60 Arcade, NY Williamsville, NY Dr. Penny A. Gardner '69 Ronald I. Dozoretz M.D. '62 Falls Church, VA Dr. Robert Einhorn '72 North Brunswick, N] Dr. lillian M. EngasserRowan'45 Chatsworth, CA Dr. Domonic F. Falsetti '58 Lewiston, NY Dr. Leon E. Farhi & Mrs. Haya Farhi Eggertsville, NY Mr. Kevin Feor '80 & Mrs. Elizabeth A. Feor '78 Webster, NY *Dr. Amy E. Ferry '94 Bethlehem, PA Dr. Helen Marie Findlay '78 & Dr. Albert Schlissennan '77 Eggertsville, NY Dr. Marc S. Fineberg Williamsville, NY Dr. Susan Fischbeck '82 & Dr. Patrick T. Hurley '82 East Concord, NY Dr. Jack Fisher '62 La jolla, CA Los Altos, CA Dr. Ronald F. Garvey '53 Tyler, TX Kenneth L. Gayles, M.D. Amherst, NY Dr. Carmen D. Gelormini '50 Syrawse, NY Dr. Michael Goldhamer '64 San Diego, CA Dr. Peter H. Greenman '80 Fairfax Station, VA Dr. Glen E. Gresham & Mrs. Phyllis K. Gresham '85 Williamsville, NY Dr. Robert T. Guelcher '60 & Mrs. Elizabeth Guelcher Erie, PA Dr. Thomas J. Guttuso Sr. '60 & Mrs. Barabara Guttuso East Amherst, NY Dr. Robert Joseph Hall '48 & Mrs. Dorothy N. Hall Houston, TX Dr. Christopher Hamill '89 Buffalo, NY Dr. Donald A. Hammel '60 Ravena, OH Dr. Thomas D. Flanagan '65 & Mrs. Grace Flanagan '70 Williamsville, NY n This society honors Genera l Edmund Hayes, an in ternat io na lly reno wn ed d es igner of bridges who bequea thed nea rly $390,000 to UB in 1923. Over the years, a growing number o f friends a nd alumni o f UB's School of Medicine and Bio medical Sciences have joined the Ed m und H ayes Society by including the school in their estate plan. If you are interested in becomin g a m e m ber of th e Dr. Seymour J. Liberman '61 Buffalo, NY Dr. John M. Hodson '56 Dr. Kenneth K. Kim '65 & Mrs. Susan W. Kim Williamsville, NY Clinton, NY Mr. Paul F. Hohenschuh & Dr. Marjorie E. Winkler Dr. Francis J. Klocke '60 Burlingame, CA Dr. Hilton R. Jacobson '45 Shaker Heights, OH Dr. Marshall A. Lichtman '60 & Mrs. Alice Jo M. Lichtman Rochester, NY Chicago, IL Dr. Hing-Har Lo '74 Dr. Robert A. Klocke '62 & Mrs. Barbara Klocke Dr. Alice Challen Lo Grasso '37 Blacksburg, VA Lakewood, NY Williamsville, NY Alameda, CA Robert M. Jaeger, M.D. '47 Mr. Tetsuri Kondo Allentown, PA Japar1 Dr. Gerald L. Logue & Mrs. Joelle Logue Dr. Herbert E. Joyce '45 & Mrs. Ruth Marie Joyce Dr. Joseph M. Kowalski '93 Lockport, NY Mr. Arthur H. Judelsohn Buffalo, NY Mr. Chan Y. lung & Mrs. Sooja Y. lung East Amherst, NY Dr. Wendy A. Kaiser '85 & Dr. Roger E. Kaiser Jr. '79 Clarence, NY Dr. James R. Kanski '60 & Dr. Genevieve W. Kanski '84 Eggertsville, NY Dr. Robert E. Kaplan '81 Buffalo, NY Williamsville, NY Dr. Thomas A. Lombardo Jr. '73 & Mrs. Donna M. Lombardo East Aurora, NY Amherst, NY Dr. Kenneth Krackow Williamsville, NY Dr. Jacob S. Kriteman '67 Danvers, MA Dr. Robert B. Kroopnick '72 Pikesville, MD *Dr. David R. Ludwig '90 Williamsvillie, NY Dr. Frank A. Luzi '88 & Dr. Lori Luzi '88 Clarence, NY Dr. Ivan W. Kuhl '45 Dr. James R. Markello '61 Wimberley, TX Eden, NY Dr. Marie Leyden Kunz '58 & Dr. Joseph L. Kunz ' 56 Lockport, NY Dr. Weerachai Ladakom '91 Bangkok Dr. Andre D. Lascari '60 Poestenkill, NY Williamsville, NY T Okahumpka, FL Dr. John M. Marzo '86 Buffalo, NY Dr. Conrad May '81 Kensington, MD Dr. Brian McGrath Buffalo, NY Dr. Ronald F. Garvey Dr. Karl L. Manders Dr. John T. Cangelosi Mr. John H. Goodwin, Jr. Dr. Benjamin E. Obletz Dr. Stanley B. Clark Dr. Adele M. Gottschalk Dr. Elizabeth P. Olmsted Ross H ayes Society, you m ay con tact the Planned Giving Office at 716-645-33 12. O r, if you have made similar plans and do not see yo ur na m e o n thi s lis t, please call Mary Glenn in the UB O ffi ce o f Develo pm ent, toll -free, at 1-877826-3246 so that we may in cl ud e yo u in sp ec ia l events d uring the year and honor you in futu re recogn itio n lists. Dr. Charles A. Bauda Dr. Frances R. Abel Mrs. Grant T. Fisher Dr. linda J. Corder Dr. Pasquale A. Greco Dr. Julia Cullen Dr. Glen E. Gresham Dr. Thomas G. Cummiskey Dr. Eugene J. Hanavan, Jr. Dr. Richard A. Rahner Dr. Albert C. Rekate Dr. Myron G. Rosenbaum Mr. Edward L. Curvish, Jr. Dr. David M. Holden Dr. Leonard S. Danzig Dr. Hilliard Jason & Dr. Jane Westberg Dr. Daniel S. P. Schubert Dr. Richard F. Kaine Dr. Albert Somit Dr. J. Walter Knapp Dr. Eugene M. Teich Dr. Melvin B. Oyster Ms. Rose M. Ellerbrock Dr. George M. Ellis, Jr. Dr. Kenneth M. Alford Dr. Jack C. Fisher Mrs. June M. Alker Dr. Lance Fogan Miss Thelma Sanes Dr. Harold J. Levy Dr. Pierce Weinstein Dr. Sanford H. Levy Dr. John R. Wright Dr. Milford & Dione Maloney Dr. Wende W. Young Spring 2001 lulf alo Physiciaa 37 �DEVELOPMENT E w Dr. Margaret W. Paroski '80 Dr. David S. Schreiber '69 Dr. James C. Tibbetts '64 Buffalo, NY Westwood, MA Sturgeon Bay, WI Dr. Harry L. Metcalf '60 & Dr. Kaaren Metcalf '78 Dr. Robert J. Patterson '50 & Mrs. Patricia M. Patterson Dr. Joseph I. Schultz '57 & Mrs. Yolanda Schultz Dr. Bradley T. Truax ' 74 Williamsville, NY Snyder, NY San Pedro, CA Dr. Merrill L. Miller '71 Dr. Norman L. Paul '48 Dr. Fred S. Schwarz '46 Hamilton, NY Lexington, MA Buffalo, NY Dr. David P. Mindell & Mrs. Margaret H. Mindell Dr. John H. Peterson '55 East Aurora, NY Dr. Roy E. Seibel Sr. '39 & Mrs. Ruth Seibel SCHOLARS' CIRCLE, CONT'D Ann Arbor, MI Eggertsville, NY Lewiston, NY Dr. John A. Tuyn '60 Williamsville, NY Dr. Hugh D. VanLiew & Dr. Judith B. Van Liew Dr. Alvin Volkman '51 North Hills, NY Dr. Molly R. Seidenberg '53 Georgetown, DE Buffalo, NY Rochester, NY Dr. Arthur M. Morris '65 Dr. Matthew Phillips '91 Dr. Arthur M. Seigel ' 70 Dr. Richard D. Wasson '58 & Mrs. Janet Wasson River Forest, IL Buffalo, NY Guilford, CT Holiday, FL Dr. John A. Moscato '68 & Dr. Beth A. Moscato '96 Mr. Edwin Polokoff Dr. Elizabeth G. Serrage '64 Dr. Arnold Wax ' 76 Boca Raton, FL Cape Elizabeth, ME Hendersor1, NV Dr. Anthony V. Postoloff '39 Mr. Eugene M. Setel Williamsville, NY Buffalo, NY Dr. Charlotte C. Weiss '52 & Dr. Hyman Weiss Manhasset, NY Dr. Arthur W. Mruczek Sr. '73 Dr. Kenneth John Raczka & Mrs. Rita Raczka Medina, NY Amherst, NY Dr. Richard L. Munk '71 Ms. Katharine B. Rahn Sylvania, OH Arlington, MA Dr. Masao Nakandakari '55 Dr. John Y. Ranchoff '52 Dr. John B. Sheffer '47 Williamsville, NY Dr. Peter E. Shields '79 Tonawanda, NY Dr. Timothy S. Sievenpiper '68 & Mrs. Karen S. Sievenpiper Greenville, NC Highland Park, NJ Carlsbad, CA East Aurora, NY John B. Neeld, M.D.P.C. Dr. Bert W. Rappole '66 & Mrs. Mary Helen Rappole Dr. & Mrs. Edward H. SiiMIOIIS Williamsville, NY Dr. Richard G. Williams '80 jamestown, NY Dr. Frederic D. Regan '45 Dr. Ralph M. Obler '52 & Mrs. June M. Obler '49 Los Angeles, CA Dr. Yasuyo Ohta Japan Dr. Kathleen O'Leary '88 & Mr. Michael J. Collins '90 Buffalo, NY Dr. Albert J. Olszowka '58 & Dr. Janice S. Olszowka Boca Raton, FL Dr. Frank T. Riforgiato '39 & Mrs. Mary Cecina Riforgiato Buffalo, NY Dr. John G. Robinson '45 & Mrs. Pauline H. Robinson '67 Williamsville, NY Dr. Bernhard J. Rohrbacher '83 Getzville, NY Dr. Richard R. Romanowski '58 Buffalo, NY Dr. James M. Orr '53 Dr. Jeffrey S. Ross ' 70 Gallipolis, OH Lebanon Springs, NY Nanuet, NY Dr. Albert Somit Encinitas, CA Dr. John J. Squadrito '39 Albany, NY Dr. Philip M. Stegemann '82 Orchard Park, NY Dr. William C. Sternfeld '71 Sylvania, OH Mrs. Gloria Stulberg Orchard Park, NY Dr. John R. Wright & Mrs. Deanna P. Wright Williamsville, NY *Dr. Shih-Ping Yang '93 Dr. Edwin A. Salsitz '72 Maitland, FL New York, NY Mr. Chun-Sik Park & Mrs. Younghae K. Park Dr. Arthur Schaefer (deceased) Dr. Sylvia W. Sussman '60 Allentown, PA Hideo Suzuki Holland, NY Dr. Wende W. Young '61 Dr. Meyer lllwchun 'XI and Mrs. Ann S. Rlwchun Malden, MA Dr. Warren M. Zapol Boston, MA Dr. Franklin Zeplowitz '58 & Mrs. Piera Zeplowitz Buffalo, NY & Mrs. Elizabeth Ann Schaefer Snyder, NY Dr. Wayne C. Templer '45 Dr. Adolphe J. Schoepflin '45 Mr. Fritz Terplan Ada, OK San Francisco, CA Walnut Creek, CA Dr. Israel Ziv Williamsville, NY Ph ysici an Spring 2001 Mr.WafterMazal *Ms. Sanda Yu '95 Dr. David C. Ziegler '64 & Mrs. Susan D. Ziegler Latrobe, PA Dr. Clan A. March '07 Canandaigua, NY japan Corning, NY Ms. V'll'linia A. lames Mrs. Grace S. Mabie Carmel, IN Tonawanda, NY The following individuals left generous bequests or made arrangements for the school to receive gifts from testamentary trusts. Gifts from the individuals listed below were received during 2000. Miss Ruth v. Hewlett '30 Dr. Michael A. Sullivan '53 Williamsville, NY Williamsville, NY Taiwan Buffalo, NY Williamsville, NY Dr. Marvin Z. Kurian '64 & Mrs. Eleanor Kurian Dr. Gregory E. Young '77 & Mrs. Diane Young Buffalo, NY Dr. Paul A. Palma '73 lul f a le Lewiston, ME Dr. Robert G. Smith '49 Clearfield, PA Mr. Ralph C. Wilson Jr. Dr. Heun Y. Yune & Mrs. Kay K. Yune Dr. Albert G. Rowe '46 Dr. John S. Parker '57 & Mrs. Dorris M. Parker Dr. Richard A. Smith Orlando, FL Mr. James J. Rosso '76 & Mrs. Cheryl Rosso Dr. Charles V. Paganelli Jr. & Mrs. Barbara Paganelli Seoul, Korea Orchard Park, NY Savannah, GA Amherst, NY Dr. Marvin G. Osofsky '59 Dr. James A. Smith ' 74 Dr. John L. Butsch Buffalo, NY Dr. Gary J. Wilcox '73 Fairview Park, OH Dr. Tomoe Nishimaki Ms. Janet F. Butsch Aurora, CO Buffalo, NY Honolulu, HI Japan Dr. David W. Butsch Montpelier, VT Dr. Paul H. Wierzbieniec '74 & Ms. Ellen Wierzbieniec Dr. Charles E. Wiles '45 Atlanta, GA A few individuals and couples were granted multiyear memberships based on generous gifts made between 1989 and 1993. Dr. Robert Bernot '60 & Mrs. Carol Bernot Dr. James F. Phillips '47 & Mrs. Marcella Phillips Orchard Park, NY Special Members Barnstable, MA Dr. Maynard H. Mires Jr. '46 Dr. John D. Mountain '33 38 N Mrs. TModosia H. SlicllneJ '28 Mrs. Ethel Wlmbelty We have made every effort to ensure accuracy in these lists. If you have any questions or corrections, call Mary Glenn tollfree or or e-mail her at glenn@acsu.butfalo.edu. �Dear Fellow Alumni, was held the last weekend in April and 1 Q was a tremendous success, with over 300 University at Buffalo School of Medicine and Biomedical Sciences' alumni attending with their families. Be sure to look for a full report on the weekend's events in the summer issue of Buffalo Physician, which, among other things, will feature the four alumni chosen by the Medical Alumni Association Board to receive this year's achievement awards: Marcella F. Fierro, MD '66, Wendy W. Logan-Young, MD '61, Nancy H. ielsen, MD '76, and Morton A. Stenchever, MD '56. As my year of serving as president of the Medical Alumni Association comes to a close, I can tell you that it has been both a privilege and an honor to serve in this capacity and to have had the opportunity to meet so many interesting and outstanding members of our UB Alumni Association. At this time, I would like to thank a few people who help make this organization run as smoothly and effectively as it does. Bertram Portin, MD '53, our assistant dean for Alumni Affairs, is a tremendous source of support and information, as is Dr. Jack Richert, former associate dean for Alumni Affairs, who has served on the board this year at my request. Jack has also helped with his tremendous knowledge of the history of the organization and the medical school. Mrs. ancy Druar, who serves as our administrative assistant, is certainly the glue that holds this organization together and without Nancy's help, we wouldn't have any of the successful programs that we have today. I also would like to thank some of our fellow Alumni Association board members: Richard Collins, MD '83, who has served as past president, Patricia Duffner, MD '72, who served this year as vice-president, Colleen Mattimore, MD '91, who will be the next vice president, and Stephen Pollack, MD '82, who will be the next treasurer and secretary. I would be remiss if I did not mention one more time that we are still looking for many more lifetime members, and we hope that you, as alumni, will find it in your hearts to support our school in this manner. Once again, I thank you for allowing me to serve as your president. II , MD President, Medical Alumni Association jOHN j . BODKIN Spring 2001 luffal1 Physician 39 �CLASSNOTES 1940s William Herman Bloom, MD '48, has been elected to Who's Who in Medicine and Healthcare, as well as Who's Who in Science and Engineering and Who's Who in the World. He recently published After All, It's Only Brain Surgery (available in bookstores ISB l56167-573-3; publisher, Noble House). Michael Genco, MD '58, writes: "Ann and I are enjoying retirement. We have moved to a condo at 600 Main Street in downtown Buffalo, NY, 14202." E-mail address is: mgencobuf@aol.com. 1960s Dick Eggleston, MD '62, writes, "Hi, I retired from Ford Motors at the end of2000. We just completed a home in Hamilton, MT. I will be hiking, learning to fly fish and using my camera. In addition, I have accepted a parttime position at Marcus Daly Hospital in Hamilton." 1970s Howard R. Goldstein, MD '74, writes: "Judy and I are still living in Cherry Hill, NJ. I'm in an eightman urology practice and am very happy. Our children: Lee is a firstyear surgery resident at the Hospital of University of Pennsylvania (MD, Yale Medical School); Lauren is a the next four years. These included tours of duty in surgery, thanks to a surgi- In 1974, I was in· '46, FPCS, writes from cal residency while in the ducted as a Fellow in the Santa Barbara, CA: Philadelphia, Washington, Navy. Because of being in a Philippine College of Sur- Greetings from - of the members of the DC, the USNAS in the Phil- "goiter belt," I seemed to geons. As the years went ippines, and An- by, my role gradually short-term help to sister class of '46. In lieu of napolis before shifted to that of men· mission hospitals in tiYe Uncoln D. Nelson, MD a healthy body) but lose his soul?' Since retirement we haYe continued to glye my being able to attend discharge from tor for young Filipino foreign countries: the reunion In April, I actiYe duty in doctors. When we re- Bangladesh, Amazonas will write this note about '51. Six months tired from full-time Brazil, Togo, the Gambia our life's work. I say thereafter we duty with our Mission in West Africa and a clinic in the Ukraine. We 'our' since my life's were back in the lthe Association of partner, Lenore Butts PhHipplnes under Baptists for Wortd plan to continue doing Nelson, RN, became my a HeaYenly Com- EYangelism, Inc.) we so as long as the Lord bride in '44 and has re- mander In Chief. malned my closest friend For the next left three of these keeps us in good health. hospitals In the We are grateful for the and colleague in our 35 years, God capable hands of an training years at UB and medical missionary work enabled us to all-Filipino staff thank our mentors there. eYer since our training years In Buffalo. establish three rural major in thryoidectomies continuing the care of the We hnen't piled up mission hospitals and as- and deYeloped a technique total patient: body, soul much of this wortd's and spirit. goods, but the remu- sist in a fourth. These each of doing them under In a ciYIIIan hospital in became general hospitals regional block anesthesia. Hackensack, NJ, in '46- in which we had no choice When I last stopped count- 47, the Navy took charge but to be 'general special- of our appointments for ists,' with a major in After my Internship 4D grandfather, Tom Beahan, an Adirondack Larry Beahan, MD '55, has logger in the early 1900s. published a book, titled, "Larry describes life in a My Grampa's Woods, lumber camp in the the Adirondacks. Beahan, Adirondack woods of a physician active in 1900 in an honest and conservation efforts, intimate way," writes a has assembled a collecreviewer for Amazon. tion of colorful stories com, "so that you hear spanning the 20th centhe noise of the loggers tury. These tales of talking at breakfast, taste tragedy and death, the hot cakes covered humor and family lore with maple syrup, and stem from his family's smell the horses as they encounters in the sweat and strain at Adirondack Mountains pulling the logs across in northeast New York the snow-covered State, beginning with his forest floor." 1950s luffal 1 Phys i c i an Spring 2001 The theme plaque OYer neration is "out of this the door reads, 'For what wortd." We wouldn't ing, we had done OYer does it profit a man to gain switch jobs with any- 1,200 of them. the whole world !including body. �assnotes tion. I enjoy traveling with my wife, Carol, and our three wonderful children." E-mail is Dforster @pol.net. Michael Nancollas, MD, '85, senior at Columbia University and Daniel is a freshman at the University of Pennsylvania, where he is playing catcher for their Division 1 baseball team." E-mail is hrgmd1@home.com. Marguerite Dynski, MD '75, Rochester, Y, general surgery/breast disease, writes: ''I'm a site director of third-year students from the University of Rochester and am on faculty at RIT." E-mail address is marguerite.dynski@ viahealth.org. Claudette Robbins, MD '78, writes: ''I'm no longer at HDH, but am now a full-time radiologist at Olive View Medical Center in Sylmar, CA. E-mails are welcome: claudettemd@yahoo.com." Cavia L. Stanley, MD '78. MDiv, is listed in the 2000 (millennium) edition of Who 's Who in Medicine and Healthcare. He is the district health director of Waccamaw Public H ealth District in South Carolina. The district includes Horry Country (Myrtle Beach), Georgetown and Williamsburg counties. Stanley is a gynecologist in the U.S. Airforce reserves and a lieutenant colonel. 1980s Ellen M. Tedaldi, MD ·so. Philadelphia, PA, internal medicine, is director of the HIV Program at Temple Hospital. E-mail address is etedaldi@ unix.temple.edu. RPCI, where he is also director of the institute's Head and eck Surgical Oncology Fellowship Program. His research interests focus on respiratory epithelial injury-repair and differentiation, and his laboratory is doing novel work in bioengineering large conducting airway devices. David Forster. MD '85, Oak Hill, VA, ophthalmology, writes: ''I'm a clinical associate professor of ophthalmology at Georgetown University. I'm also vice president of the orthern Virginia Academy of Ophthalmology and president of Georgetown Ophthalmology Alumni Associa- Fayetteville, NY, hand surgery/orthopaedic surgery, writes: "I started a clinic for performing artists, so I get to practice a different type of 'sports medicine,' treating musicians in the Central ewYorkarea." E-mail address is hand.doctor@pobox.com. CO N T I NUED ON P AGE 4 2 Wigand's "Secrets through the Smoke" Wesley L. Hicks Jr. DDS, MD '84, associate profes- sor of otolaryngology/ head and neck surgery at the University at Buffalo School of Medicine md Biomedical Sciences, and attending surgeon in the Division of Head and Neck Surgery at Roswell Park Cancer Institute (RPCI ), has been invited by the American Board of Otolaryngology to serve as alternative guest exam iner for its 2001 oral examination and guest examiner for its 2002 oral examination. In 1991, Hicks joined Spri 11 g 200 1 laffala Physician 41 �CLASSNOTES CONTINUED FROM PAGE 41 Roseann Russo, MD '85, Manhasset, Y, pulmonary, critical care medicine, writes: ''I'm medical director of the respiratory care unit at orth Shore University Hospital in Manhasset. Am also the medical director of pulmonary rehabilitation for NSUH/LIJ." Lynda Stidham, MD '85, Glenwood, NY, pediatrics, writes, "Two years ago I returned to Christ the King Seminary where I am studying pastoral ministry, which is enriching my personal and professional life immensely. I'm practicing in a suburban pediatric group." 199 s Gale R. Burstein, MD '9D, Decatur, GA, pediatrics and adolescent medicine, is working as medical epidemiologist at the Centers for Disease Control and Prevention. E-mail address is gib5@cdc.gov. Pamela A. Clark, MD '90, Prospect, KY, pediatric endocrinology, writes: "I am currently chief of the Division of Endocrinology at the University of Louisville." E-mail address is paclark@pol.net. 42 l ulfal1 Pb ysiciaa Mark A. Flanzenbaum, MD Douglas P. Prevost, MD '90, '90, Glen Allen, VA, San Antonio, TX, orthopaedic surgery, writes: "I am an army staff orthopaedic surgeon, chief of joint service." E-mail address is dprevost@ gateway. net. emergency medicine and pediatric emergency medicine, writes: "I am a faculty member at the Medical College of Virginia." E-mail address is mflanz@worldnet.att.net. Eileen Schwartz Saltarelli, Robert J. Leon, MD '90, MD '90, Canton, OH, psy- ew York, NY, writes: "I live on the upper east side of Manhattan. My practice is located in NJ. I enjoy the culture of NYC and solo cardiology practice." E-mail address is rleonmd944@aol.com. chiatry, writes: "I work for a community mental health agency and consult in 12 nursing homes." E-mail address is msaltdoc@aol.com. Laura Nicholson, MD '90, Palo Alto, CA medicine, writes: "I joined Stanford University in 1997 as director of the Medical Consultation Service. I also serve as medical director of Inpatient General Medicine and associate program director of Internal Medicine Residency. On weekends, I enjoy the great outdoors of northern CA and great indoors of San Francisco." E-mail address is lnicho@leland. stanford.edu. Timur Sarac, MD '90, Orange Village, OH, vascular surgery, writes: "I have spent nine years in postgraduate education. Finally it's paying off, as I am working with my residency mentor at the Cleveland Clinic." E-mail address is saract@ccf.org. Valerie Vullo, MD '90, Clarence, NY, physical medicine and rehabilitation. "I am part of the Department of Rehabilitation Medicine at UB and a clinical assistant professor at UB's School of Medicine." Spring 200 1 surgery at the University of California at Davis in Sacramento, CA." E-mail address is rudolph.schrot@ ucdmc. ucdavis.ed u. Cynthia Leberman Jenson, MD '92, writes: ''I'm in Kenneth A. Levey, MD '97, private practice in Bangor, ME, (anesthesiology). My husband, Mark, is a stay-at-home dad with our two daughters, Alexandra, age six, and Erica, three." E-mail address is mcaejenson@ adelphia. net. writes: "I am completing both my residency in OB/GYN and my master's degree in public health this spring at the George Washington University. I will be starting this summer as assistant professor of OB/GYN at the New E-mai Jon Kemp, MD '93, writes: "Meri and I are in Portland, Oregon, and very happy. We have two little girls, Laurel and Sophie. I am practicing ophthalmology and not taking too much call." E-mail address is jkemp899@aol.com. Tara (Sosa) Paolini, MD '95, Lisa M. Nocera, MD '90, Greenville, NC, anesthesiology-pain management. I recently married, moved and started a new job! I'm as happy as I've ever been!" E-mail address is lmnocera@ hotmail.com. cal care at UPMC Passavant in Pittsburgh, PA. I look forward to retiring in 2035." York University School of Medicine." Mark L. Capener, MD '99, writes: "My practice is going very well here in Elko, NV. I also work in Ely, NV, and in Winnamucca on alternative weeks. Who woulda thought? Hello to all the gang in Buffalo!" E-mail is: capeners@elko.net. Steven P. Harris, MD '91, and Raymond V. Paolini, writes: "We are pleased to announce the birth of our third child, Elaina Anne-Marie. She is welcomed by brothers Donovan, age 4, and Steven, age 5. I am currently in private practice in pulmonary and criti- MD '90, write: "We are Thomas A. Cumbo, MD '99, happy to announce the birth of our daughter, Dora Rae, on August 14, 2000." E-mail address is tsosa@ yahoo.com. writes: "I completed my second research expedition to the epa! Himalayas last summer as a PGY-2 resident at The Johns Hopkins Rudolph Schrot, MD '96, writes: "I am currently PGY-3 in neuro - CONTINUED ON PAGE 44 �Erica (Heit) Remer pens amedical thriller Aplan for living. Hospice really is a plan for living. And the sooner you call, the sooner we can help you put that plan into action - with emotional support, pain management, in-home care anything you need to keep enjoying life . Call686-8077. THE CENTER FOR H'lSPICE& PAlllATNE CARE wwtll. hospicebtiffalo. com Spr i ng 200 1 luffalo Physiciaa 43 �C L A CON TI NU ED FR O M P AC E 4 2 University/Sinai Hospital Program in Internal Medicine. I led an eightman team from the Himalayan Rescue Association into the Langtang region of the peaks (just below Tibet) where we gathered data to test a hypothesis regarding the pathogenesis of altitude illness. We studied a Hindu pilgrim population at a sacred high altitude lake at approximately 4,500 meters. The pilgrimage is an annual event in honor of the Vedic Diety Shiva and is performed by approximately 4,000-5,000 individuals. In addition In emo N 0 T E tO COllecting data, We were in charge of providing medical care for the masses in a Third-World environment. It was an exciting mix of basic science, field research, ThirdWorld culture, backcountry medical care and religion. I plan a biannual trek to further refine our numbers and test novel hypotheses. P.S. I have a letter to the editor published about high altitude medicine in the January 2001 issue of Emergency Medicine on page 6. " each donor specifies. The UB Foundation acts as the school's banker and investment manager, charges minimal fees (much less than profitmaking financial institutions) and makes disbursements in accordance with donors' stipulations. It is the Dean, however, who leads the development program. He articulates the vision and the dreams of the school. Our office does assist with details , but it is the donors and volunteer leaders who respond that make the dreams come true. With appreciation to all of those who make philanthropy a high priority, and on behalf of the ultimate beneficiaries , I thank our increasing number of committed james Platt White Society members. You make such a crucial difference to our school. CD mda f. (h 11 Cordu may he reached, toll-j•H at 1-877-826-3246 or mad at ljCOJ derCrobuffalo.edu. CD West Virginia; and Ronald of Buffalo in 1945. A diplo- in White Sulphur Springs, Burbank, California. mate of the National board of trustees for Board of Medical Examin- Aiken County Rescue West Virginia. Morhous was Squad and chair of the Board of Internal Medicine, George Alex Poda, MD '45, died on December ers and the American Eugene J. Morhous, MD '45, died Septem- Board of Preventive Medi- South Carolina Regional was a fellow of the Ameri- 22, 2000, at Aiken Re- cine, he was the author of Blood Bank. Poda orga- gional Medical Center in numerous papers and nized the Sabin Polio certified by the American 44 tal, was a member of the staff at the Greenbrier Hotel ber 11, 2000, at his can College of Physicians home in White Sulphur and served as a member of South Carolina. He was 79. books on nuclear medi- vaccine program in Aiken Springs, West Virginia. the National Board of Medi- A native of Jamestown, NY, cine. He served as an County and Richmond A native of Palmyra, cal Examiners. He was a Poda served as a captain associate professor in the County, GA, and champi- New York, Morhous past president of the Green- in the U.S. Army Medical Department of Community oned the formation of the received his under- brier Valley Medical Society Corps, both on active Medicine at the Medical associate degree nursing graduate degree from and was a member of the duty and reserve status, College of Georgia and program at USC Aiken. St. Lawrence University. West Virginia State Medical from 1941 to 1952, and was a visiting lecturer on He is survived by his wife, Following graduation Society and the American later in the U.S. Navy occupational medicine at Anna Michele Poda; son, from the University of Medical Association. Medical Corps. the Medical University of Steven Michael Poda, Poda was a graduate of Buffalo School of Medi- Morhous, who was pre- South Carolina (USC). He Aiken, South Carolina; cine in 1945, he prac· ceded in death by his wife, Alfred University and Mount served as chair of the and daughter, Deborah ticed medicine for 35 Betty Jane, is survived by Union College and com· board of trustees of Aiken Ann Poda Lyles, Spar· years as a member of two sons: Lawrence, and his pleted his medical degree at Country Hospital and later tanburg, South Carolina. the Greenbrier Clinic wife, Carolyn, of Bluefield, the University of Aiken Community Hospi· I UII aID Ph ySiC iII Spri11g 2001 CD b~ �- Based on F/MsM Data ffTheywere drJl sergeantsand cheerleaders~' - Frank Ste/arski, stroke rehab patien~ Harris Hill H.C.F Why do our patients have better rehab results compared to the national average? Maybe it's our staff ''They knew exactly how far to push me,'' says Frank Stelarski. ''But they also encouraged me every little step of the way. When you've been through what I have, that really means a THE lot:' To leam more about the nationally recognized McGuire Rehabilitation ~~cy}Jf1fl(91'{ CENTE~ Centers, call 1-888-POSTACUTE or visrt www.mcguire-group.com. Recognized for excellence in quabty care. AUTUMN VIEW • GARDEN GATE • HARRIS H*****" HILL • Spring 2001 NORTH GATE Bu f falo Pbysicin 45 �The State University of New York A R A UB's HISTORY OF MEDICINE COLLECTION PRESENTS reproduced prints from a pharmacopoeia by Otto Karl Berg (r8rs-r866) were on display last fall in University at Buffalo's Health Sciences Library (HSL), South Campus. The botanical show was developed by the HSL and the university's iMedia staff and is the first in a series of "Art in the Library" exhibits intended to promote the His tory of Medicine Collection through the display and sale of reproductions of selected works. Fred Kwiecien and Don Trainor of iMedia prepared the prints from the original art in the Berg volume, published in Leipzig in I863. Pictured is Papaver somniferum. BP 0004 01 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 2001 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2001-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v35n04-2001-Spring Table Of Contents A list of subunits of the resource. Medicine Goes Molecular McKinley's Assassination Pathways Medical School Alumni Research Development Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v35n04 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2001 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/0631d26b67e7c195cbebbec314b80cce.pdf a30bb80e02027354cbc75ce5d2d3abd1 PDF Text Text s I c I A N �lullala P~ysicial ASSOC IA TE V I CE P RES I DENT FO R lJ ' I \ ERSITY SER\ I CES Dr. Carole Smith Petro Dear Alumni and Friends, D I R E CTOR Of PERIODICALS Su e Wu etcl1er EDITOR S t ephanie A. Unge r B we will no doubt be in the grips of wi nter, which is supposed to be a bit more bracing here in Buffalo than in recent years. ,\RT DIRECTORIDESIG,;ER A lan]. Kegler evertheless, we do look forward to our predictable changes of seasons and hope CONTR I BUTING \\ RITFR that all of you have had a pleasant holiday break from the routine. The capital campaign "Generation to Generation" kickoff occurred on October 20, Lois Baker COORD I ~ATOR 2000, an event coinciding with UB Homecoming Weekend and the convening of our PRODUCT I ON Dean's Advisory Council. Our own medical school "Family Weekend" took place over the Cy nthia T odd - Fli ck two days that followed. The campaign kickoff was capped by a reception in the Center for the Arts and a marvelous presentation by the American Ballet Theater Company, 111 residence at UB during October. Based on progress to date (during the "quiet phase" of the campaign), ST~TE lJ'dVERSITY OF;\£" 'I ORK AT BurrALO ScHooL 0 F ~~ E D I C I N E A N D BIOMED I C·\L SC I ENCES Dr. j ohn W rig ht , Dean the School of Medicine and Biomedical Sciences' campaign goal has been adjusted upward to $50 million dollars. With Skip Garvey, MD '53, as our campaign committee leader, we not only expect to achieve that goal over the next three years but indeed to surpass it. Endowment means so much to a school such as ours, a fact to which I can personally attest as we manage our way through what have become very challenging times. A healthy endowment will enable many good things for the school, not the least of which will be the ability to attract the very finest student applicants and to provide them with the very best medical education experience. All this would benefit from a significant E.DITOR I AL BOARD Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. D r. Dr. Bertram Portin , Chair Mart in Brech er Har old Brody Linda]. C orde r Alan]. Drinnan ]am es Kan ski Eli za beth Olm sted S teph en Sp a ulding Bradley T. T rua x Franklin Ze plowitz increment in student scholarship availability, which has become so important in the recruitment of excellent students and, through endowed professorships, enabling us to recruit the very best faculty with whom our students can interact, learn and become inspired. As we head into completion of the fall semester, significant progress has been made on developing the new curriculum that we intend to implement in the fall of 2001. Dr. Reid Heffner (assistant dean for curriculum and chair of pathology) is coordinating this effort with the help of a team of dedicated, experienced teaching faculty. The intent is to better integrate course material into a more clinically focused formal in which repetition is intentional rather than accidental, and relevance to basic overarching biologic concepts and clinical application becomes more transparent. The curriculum will also provide more lecture-free time so students can consolidate information on their own and access modern instructional technology; for example, through the use of the computer lab. Since there will be more small-group teaching in the new formal, we arc already planning significant ex- TEACHING HOSPITALS Er ie Co un ty Med ica l Ce nt er Roswell Pa rk Ca n ca l11 stit11 t<' \'e te ra 11 s Affai rs W es te ru New Yo rk H ealt h ca re Syste m K-\11/1)-\ H fo\1 Ill : T h e B uffa lo Ge 11 era l H osp ital T h e Child re 11 's H osp ita l of Buffalo .\ I ill ard Fi llm o re Ga tes H ospilll l . I .\ I ill ard Fillm ore S ubu rba u Hosp tttl H I-\1111 Snrt.u: Me rcy H ea/t/1 Sys t em Sisters of C h ari ty H ospiw l N tagara Fa lls M e m oria l Me d ica l Ce ut er C-\riiOIH ® THE STATE UNIYEISITT Of NEW Ylll IT lUFf ILl pansion of that type of learning space to be ready in time for the implementation date. Although curriculum change is in fact a constant for most schools, this project promises to be more dramatic than any change effected in recent memory. It is unlikely to be perfect at implementation, but we think it will be a significant improvement for our students, nonetheless. Further improvements will be accomplished as experience with the new curriculum evolves. Our goal is to maintain the UB tradition of graduating physicians capable of meeting the challenges of the continually evolving world of medicine. .JOliN R. WRIGHT. MD Dean, School of Medici11e and Biomedical Sciences Letters to the Editor liu(falo l'hp1wm " pubh,hed qu.trterh h' the C nivcr>it\ at Bufl;11o School of ,\kdicinc .md BiomcdiLal Science!-. .111d the Offkc of <:ommunic.ltions. 1 etters to the h.litor arc wckomc and can be sent CIO Buflalo Phplcimz. 330 t rofh II all, L'ni,~;,i1y al Buff;,lo, Buffalo,!'\\ 14260; or ,·ia c·maillo hp-notcs •' butf.tlo.cdu. The 'laff re,crvc' the righl to edil ,,II ... ubmlssiom, for length and daritr . �VOLUME 35, Features 2 Warsaw after the War Morris Unher, MD '43, looks back on his year as a medical officer in post-war Poland PHOTOGRAPHY BY DR. MORRIS UNHER 8 Writing Code Medical students draft first -ever code of conduct for school BY DAVID FLINT. CLASS OF 2003 PHOTOGRAPHY BY FRANK MILLER Emergency medicine resident Ann Marsh competed on the U.S. Fencing Team in the 2000 Summer Olympic Games inSydney. The story of this remarkable physician·athlete begins on page 26. COVER PHOTO BY DR. MORRIS UNHER Medical School 34 Mark your 14 UB medical st udents named HHM I- IH research scholars 16 Frederick Sachs to lead international research project 20 Honors Brunch Awardees named 2000 Distinguished Medical Alumnus 26 Philip Wels selected for 1936 u.s. Olympic fencing team campaign, "Generation to Generation" 31 Lung function associated with longevity 33 Blood vessels reflect future health calendars for April 27-29, 2000, for Spring Clinical Day and Reunion Weekend Messages from Reunion Chairs 39 your UB classmates and other alumni In Memoriam Drs. Henry Morelewicz, Eugene Farber, Arthur Schaefer AP9 2 7 .- J . .J ���ter the nexpectedly, however, the dull routine came to an end when I received orders to report to the Surgeon General's Office in Washington,DC, followed by assignment as medical officer at the U.S. Embassy in Warsaw. Avivid memory 1have of my brief stay in Washington involves avisit from my parents, both native·born Russian, and asomewhat embarrassing moment when my mother asked my superior officer why it had to be hers on who was selected for this assignment. From Washington, I traveled to Camp Kilmer, ew Jersey, then on to the port of embarkation, where I boarded the USS Claymont, a "victory class" transport ship. During the boarding, I learned that I was to serve as transport surgeon for the 900 troops already on board. Fortunately, our voyage was uneventful. Our ship arrived at LeHavre, France, and from there I traveled to Paris where I spent a sleepless 36 hours enjoying the sights and sounds of that beautiful city, which was spared the destruction I was soon to encounter farther east. When it was time to leave Paris I boarded a troop train that carried me to Berlin. Along the way, I began to catch glimpses of burned-out villages. The Berlin I arrived in was a city divided between U.S., French and Russian sectors, all of which were in the throes of reconstruction following nearly complete demolition. From Berlin, I made the 400-mile flight to Warsaw on board a C-47 U.S. army transport plane that departed from Templehof Airport, a busy place with military planes taking off and arriving from many destinations. On our approach to the Warsaw Airport, I saw Russian planes sitting on the field amidst bombed-out buildings and potholed runways. When we landed we were met by a U.S. military attache's car and taken directly to the Hotel Polonia-war scarred, but still standing-and home to the U.S. Embassy while the destroyed embassy building was being reconstructed. The hotel was situated on Aleya )erozolimskie (the "Times Square" of Warsaw), across from tl1e railway station, which had been reduced to a pile of rubble. Arthur Bliss Lane was the U.S. ambassador at the time, and he and his wife and many of the embassy staff lived in the Polonia. Upon my arrival I received a very warm and friendly greeting. Soon I settled into my routine, providing medical care for employees of our embassy-American and Poles-as well as for employees of the British and Italian embassies. Rapid Immersion in "The Polish Problem" Medical facilities at my disposal were primitive. In the hotel, a oneroom dispensary had been established and stocked with medical supplies and equipment from the army medical depot in Berlin and luffale Physician Wint e r ZOO/ with occasional acquisitions from relief agencies in Warsaw. Dr. Fraczek Litwin, the Minister of Health, graciously placed the facilities of the Lecznica Ministertwo Zdrowia at our disposal and, in my year's tour of duty, scarcely a day passed without at least one staff member occupying a hospital bed there. Throughout my stay, I had neither a clerical nor medical assistant and, consequently, it was difficult to maintain adequate records. In all, it would be fair to state that my services as medical officer were utilized to capacity. In the course of performing my duties, I had the privilege of traveling extensively in Warsaw and throughout Poland, visiting many health installations, meeting members of the medical profession and observing the patterns of medical education and practice. Friendships with medical students, practicing physicians and health officials offered me much insight into the "Polish problem" as it was I will never referred to then. By the time I arrived in Warsaw, more than 500,000 Poles had drifted back to the city's ruins to live in what was left of cellars and crumbling attics. I remember observing how, in a burst of ambitious activity, the provisional government had posted one gutted building as the Ministry of Agriculture and another, as the Ministry of Health, and so on. Everywhere the individual and collective will to live and rebuild was strong, but the tasks seemed hopelessly overwhelming in scale. Despite the inevitable manpower shortage incidental to the war and enslavement, Poland was consigning an inordinately large proportion of her remaining men to serve in the armed forces that were being rapidly rebuilt. So, while platoons of singing troops marched through the streets and armed militia patrolled the ruins, old women and young students picked at the rubble. forget a young medical student telling me the harrowing tale of how, during the war, he took his third-year medical examinations by candlelight in an abandoned farmhouse while his fellow students guarded the doors and lonely road. �Warsaw'sdecimated railroad station, situated in the city's"Times Square," as seen from the rooftop of the Hotel Polonia. Physician Population and Hospitals Decimated Among the 10 million people who perished during the German occupation of Poland, 7,000 were doctors, or one-half ofPoland's physician population at the time. In addition, the country lost its most able administrators, educators and public health authorities. As a result of this grievous situation, it was a heroic, but unqualified group that assembled in the Ministry of Health's headquarters in 1945 to begin the Herculean task of rebuilding the country's health-care system. Although he held the position of minister of health, Dr. Litwin, an internist by training, had little formal public health experience. However, he possessed inexhaustible energy and a humanitarian political philosophy. In less than a year, this remarkable man reorganized the public health program in his country, efficiently integrated United Nations Relief Administration (U RA) and Red Cross aid and gave the harassed Polish people respite from the fear of epidemic diseases. In Warsaw, his ministry began the great task of rebuilding the Polish Medical Library; his laboratories began producing vaccines and serums; and his tuberculosis sanitarium began receiving patients. At the same time, Polish peasants once again began benefiting from care provided by their local public health officers. Years later, I learned that Dr. Litwin was purged in the "communist victory" of January 1947. Fearing the rise of epidemics-which fortunately never came-authorities hastily restored water purification and sewage disposal plants. Concurrently, immunization against typhoid fever was made compulsory as a prerequisite to obtaining food ration cards. Without dispute, Poland's worst enemies had by then become tuberculosis, venereal disease, malnutrition and infant mortality, which were overwhelming the resources and ingenuity of the country's health authorities. By the time my tour of duty ended, 1,000 new cases of pulmonary tuberculosis were being reported each week. Compounding the despair was the fact that Polish hospital staffs had been disintegrated, medical equipment looted and buildings destroyed. Fortunately, although there was a shortage of hospital beds immediately after the war, by the time I arrived, the recovery of hospital facilities was well under way and continued at a steady pace while I was working in the country. \V i nt e r 200 1 lulflll Physiciu 5 �--~ --- - - -- - Polish Medical Education, aSurvival Story I . . c The buildings that housed the University of Warsaw's undergraduate and medical schools were not spared in the destruction ofWarsaw. A far more irreparable loss, however, was the teaching staff, which was annihilated by German violence. In effect, the war brought to an end the education of doctors of medicine by official decree; however, I learned that surreptitious education continued in the guise of "schools of sanitation." I will never forget a young medical student telling me the harrowing tale of how, during the war, he took his third-year medical examinations by candlelight in an abandoned farmhouse while his fellow students guarded the doors and lonely road. After the war, despite the fact there were no books and instruments, classes continued to be held. In 1946, large classesthe majority of which were made up of women-were meeting in scattered clinics throughout the city. Strenuous efforts were being made to reorient the Polish clinical methods away from the German model and toward the AngloAmerican model, and the new Ministry of Health Library, which was being generously supported with U. S. contributions, was beginning to be a potent served as an associate clinical professor of force in Poland's medical education. To this day, I feel the survival of Polish medical education must be regarded as a minor miracle. View of Hotel Polonia, home to the U.S. Embassy staff and Dr. Unher while in Warsaw. Professional Integrity amid Crime and Politics In looking back on my experiences in Warsaw, I cannot conceal my unbounded admiration for the Polish physicians among whom I lived and with whom I worked. The caliber of the medical practitioners I met was extremely high and their efforts to bridge the gap of seven terrible years were commendable. Those few who were left to serve the country's 22 million people pooled their meager equipment and books and instinctively sought the urban centers. In the face of the nationalization program that had been instituted, they turned to group practice, and collective clinics comprised of 10 to 20 doctors were becoming common in Warsaw. All the physicians rallied to the task of rebuilding and restaffing hospitals. Eighteen- to 20-hour days were normal for the Polish practitioners, who often were required to walk many miles each day in shell-pocked streets, attending to this task and the many people in dire need of their services. Not surprisingly, counterinfluences sprung up that exploited the chaos surrounding efforts to rebuild the health-care system. For example, drugs were scarce and inequitably distributed; therefore, drug bootleggers who charged exorbitant prices prospered. Also during this time, the terribly reprehensible practice of replenishing the contents of discarded penicillin bottles with burnt sugar and offering them for resale was discovered. In all, I would say that the busy Polish physicians had many distractions during this troubled period. Not the least of which was the fact that the communist-dominated government was making vigorous efforts to recruit medical professionals to its ranks with offers of food and housing privileges. The vast majority resisted all attempts at conversion and so the government had no choice but to tolerate and refrain from molesting these valuable, virtually irreplaceable, members of the Polish population. �I:Jreerpta tre• • Letter He•e Days Gone by, but Never Lost During my tour of duty I traveled widely, both in Warsaw and other areas in Poland. The embassy provided me a car and I spent many hours visiting the square mile that once had been the 'Warsaw Ghetto.' I remember climbing several tall mounds of debris there to gaze in utter disbelief at the charred brick and twisted steel around me. Four hundred thousand people saw life for the last time in that ghetto, and the hot summer sun reminded those of us still alive that all the dead had not yet been buried. I also visited Krakow, Lodz, Zakopane and other places of interest and notoriety, including Auschwitz (or "Oswencin" in Polish). This terrible camp is a place I will never forget. While I was learning firsthand about these atrocities, I also became aware that a new version of the centuries' old tradition of "Jew baiting" was being practiced less than 200 miles from Warsaw, in the ravaged city of Kielce. While this deeply saddened me, it did not surprise me, as throughout my tour of duty I witnessed hundreds of miniature conflicts involving countless bitter, disillusioned and tragic people. Once I had been in Poland long enough to begin to see "the broad picture," it became clear to me that it was a country that had barely begun the long process of healing. In addition to my travels, I also had the privilege of playing host to and providing medical care for visitors to the embassy, some of whom were very memorable individuals. One such person was Dr. Fronczak, health commissioner of Erie County; Harold Stassen, a U.S. senator and then-candidate for president of the United States; Fiorella LaGuardia, former mayor of ew York City; and Franco Autori, conductor of the Buffalo Philharmonic Orchestra. Because of all these remarkable experiences-many of which still profoundly affect me today-it was with mixed feelings that I learned my odyssey in Poland was to come to an end in July 1947, at which time I boarded the Polish luxury liner the MS Batory and set sail for ew York City via Stockholm. While these are memories of a time far in the past, I was reminded just the other day that they are still close to my heart when I recalled an old tune, "Warszawa, Kochana Warszawa.'' "Warsaw, Beloved Warsaw.'' Morris \Vinter 2001 l11fal• Physiciu 1 �~ ------ On the following pages, you will read second-year student David Flint's description of how a Medical Student Code of Professional Conduct was recently developed at the University at Buffalo School of Medicine and Biomedical Sciences. The formulation of the code was largely a student-driven process, and the student participants and document architects are to be congratulated for a job well done. The creation of such a code has been periodically suggested over the years but rejected as "something better left to administration." The classes of 2000-2003 were up to the challenge, however, and the product of their collective labors has won wide, and well-deserved, acclaim. As an elegant finishing touch to this product, the code has been published as a very attractive booklet that will be distributed to each incoming class. This publication was underwritten as part of a generous unrestricted gift to the school from Dr. and Mrs. Edward Shanbrom (Class of'S!). We are indebted to the Shanbroms for this help. One might ask why such a code should be developed by students-or perhaps even developed at all. The first question can be answered in a single word: empowerment. What good is such a code if those who are obliged to follow it are not engaged in its creation? The second question might be paraphrased as "Isn't the Hippocratic Oath good enough?" As venerable as the Hippocratic Oath is, and even though we have modernized it to make it more contemporary, it still falls considerably short both for the present-day medical student and for the practitioner. When UB's medical school was founded in 1846, the states of medical knowledge and technology were such that a physician could probably get by with simply being a good and moral person endowed with a generous amount of common sense. One could occasionally do good, but the What better introduction to the rigors ofbeing a modern physician than a code ofprofessional conduct, created by students for students, which places significant responsi- ability to do harm was quite limited. Mother ature was bility on the students themselves? the great healer. In today's world, the ability to do considerable good is more than balanced by the ability to do considerable harm, with potentially devastating consequences. Decisions about when to intervene, or "merely" support, are critical and often difficult decisions for society, as well as for physicians. Ethical issues that our forefathers (and foremothers) could not have imagined now confront the practicing physician on an almost daily basis. The ability to prolong life is counterbalanced by both the finite nature of resources and the concept of quality of life. Finally, the notion of physicians being responsible for one another's behavior and mode of practice has now become a matter of law; and in jeopardy in most-if not all-states is the physician's right (license) to practice. What better introduction to the rigors ofbeing a modern physician than a code of professional conduct, created by students for students, which places significant responsibility on the students themselves? Our students have taken the challenge seriously, and although the actual code will undergo modification as a function of time and the experience of implementation, it is an excellent starting place. Again, thank you, students, for this extraordinary piece of work. John R. Wright, MD Dean, School of Medicine and Biomedical Sciences �A student's perspective on the year-long process �- - I CoDE - - - OF - -- -- - - - CoNDUCT By Dav d Fl nt, Class of 2003 , the University at Buffalo School of Medicine and Biomedical Sciences-despite its 155-year history-did not have a code of conduct While the university at large does have academic policies, our school did not have a code to address the special social and professional responsibilities of medical students. In an attempt to remedy this, Dr. john R. Wright, dean of the school, organized a committee of second -year students in the spring of 1999 and charged us with the task of drafting such a code. (In the fall , Dr. Charles Severin, assistant dean for students in the Office of Medical Education , expanded the committee by adding members of the class of2003. ) This was the start of a year-long process, the final outcome of which was the development of the first Medical Student Code of Professional Conduct for UB's School of Medicine and Biomedical Sciences. We started at the begin· ning, by asking ourselves, Why do we even need a code? On the first day of orientation to medical school and again at gradua· tion, we take an oath to our patients, peers and medicine. But what does that oath mean? Open Process Key to Consensus We started atthe beginning, by askingourselves, Why do we even need a code? On the first day of orientation to medical school and again at graduation, we take an oath to our patients, peers and medicine. But what does that oath mean? After discussing these and other questions, we decided that our goal in creating a code of professional conduct was to establish a set of common expectations for professional, social and academic behavior, and to provide a framework for discussion about our roles and responsibilities as physicians. To prepare ourselves to accomplish this goal, the committee reviewed journal articles highlighting moral and ethical dilemmas faced by students and physicians. We also reviewed do zens of honor codes from medical schools around the country, which ranged from militaristic to anarchistic, and everywhere in between. From this starting point, we then attempted to create a document that was general enough to have longevity, but specific enough to have practical application . The drafting process itself was eye-opening, as each committee member brought unique skills and perspectives to the ensuing debate about substance and form . Some of the issues raised in our discussion seemed uncontroversial; for example, there was limited disagreement over issues of academic integrity. Other areas resulted in more vigorous debate, such as, When and how is it appropriate to address issues of substance abuse among peers? Where is the line drawn between personal and professional life? In order for a document like this to be supported, there of course needs to be input from more than just eight students and a dean meeting in a conference room. Past attempts at creating a code of conduct at our school had failed , which is understandable because it is a substantial task to reach consensus between students, basic scientists, clinical faculty and administrators. To make the creation of the code an open process, therefore, we did a number of things: We held two 10 lulfalo Physiciaa 11'1 11 1er 2001 �CoDE "town meetings," which were audiotaped for those unable to attend, and we created a webpage that allowed for critiquing of the code, section-by-section. We also made a suggestion box available for anonymous comments and set up an e-mail address to receive input about the code. In addition to distributing hardcopy drafts of the code, we made copies of codes from other medical schools available for comparison. Furthermore, Dean Wright requested comments from the public, as well as from readers of Buffalo Physician. Of all these efforts, the web page was by far the most popular medium through which we received comments on drafts of the code. The page provided an easy way for students, staff and faculty to comment, and also made consolidating and reviewing comments much easier for members of the committee. (The design and maintenance of the webpage was greatly aided by staff in the Office of Medical Computing.) The debate that was made possible through open discussion encompassed a wide spectrum of issues. For example, Is it appropriate to include a portion of the Hippocratic Oath in the preamble? Should the code address the use and care of laboratory animals? Does it adequately address sexual harassment? oF CoNDUCT conflict of interest arise. ) The committee will also consist of two faculty members and one ad hoc administrative member, as chosen by Dean Wright. The dean's faculty representatives will vote, but the administrative member will not. Currently, members of the committee are working to develop a lunchtime speaker series centered around what we hope will be provocative vignettes that will serve as catalysts for debate about ethical issues. Efforts Win National Recognition In the intervening time since the code was finalized and disseminated, our efforts have been recognized by the Association of American Medical Colleges, the Medical Society of the State of ew York, and the assistant dean of Mount Sinai Medical Center, all of whom have expressed an interest in learning how we managed this process. Anyone who has ever served on a committee, whether in academia or in business, understands the hurdles that must be surmounted in order to prevent drifting deadlines and missed opportunities. The Medical Student Code of Professional Conduct for UB's School of Medicine and Biomedical Sciences could It is because the students, faculty and staff dedicated such a significant amount of time to thoughtful discussion of such issues as honor, integrity and professionalism that today we have a Medical Student Code of Professional Conduct that is a very powerful document. In April2000, after more than 1,200 hours of committee time, the student body voted to support the new code by a threefourths majority. Later that same month, the school's Faculty Council unanimously endorsed the student-approved code. It is because the students, faculty and staff dedicated such a significant amount of time to thoughtful discussion of such issues as honor, integrity and professionalism that today we have a Medical Student Code of Professional Conduct that is a very powerful document. Continuing Education and Adjudication In addition to the creation of the code itself, a legacy of this year-long process is the establishment of an institutional body that will have an unprecedented opportunity to take a leadership role in acting not only as an adjudicator, but also as a continuing educator in this area. The Committee of Professional Conduct will consist of two members from each of the four classes, who will be elected early each fall by their peers. First-year students will serve a one-year term, while second-year students will serve for the duration of their medical school careers. (One alternate will also be elected from the first-year class should a not have been created without commitment from the school's administration, most notably Dean Wright. As a committee, we received exceptional support from the Office of Medical Education, especially Dr. Severin. In addition, Dr. Dennis adler, associate dean for academic and curricular affairs, and Dr. Nancy ielsen, assistant dean for student affairs, provided amazing insight into the special issues arising in the clinical years. Finally, credit goes to Junda Woo '02, whose editing expertise helped make the code a much more readable document. D AVID FU I\T IS CURRENTLY A SECOND- YEAR STUDENT AT THE UNIVERSITY AT B UFFALO SCHOOL OF M EDICINE AND BIOMEDICAL SCIE CES. Editor'sNote: The full text of the M edical Student Code of Professional Conduct can be found at http://www. smbs. buffalo. edu/ fianlCPC. htm. Readers who do not have!nternetaccess may request a copy by calling Dr. Charles Severin at (716) 829-2802, or by writing him at the Office ofM edical Education, 40 CPS, 3435 Main St., Buffalo, NY 14214-3013. Beginning September 2000, each firstyear student entering UB's School of M edicine and Biomedical Sciences will be given a copy of the code during orientation. IV i n t e r 2 0 0 1 lulfalu Hysicin 11 �- · - -- - - ~ - ~-~ - -- Thoughts on professionalism and empathy Ro!IERT \1 LCH \ \!D Editor's Note: 011 68 \ugust 1/,2000. Robm \.,\filch,.\/[) '68, rlclnwcd the kcmott 'n rtrt at the lliPl!lal 1\ lute Coat Cercmon~ hdd for the mcolmllg class at the UmiWSlt~ at Buffalo School of ,\fcdtcmc and Biomcdiw/ ~ci<·nns. In the weeks followlllg the ceremony, Buftalo PlwsiLian recei1·ed lllllltewus calls frotll indil'iduals rcqucstmg a copy of .\Ttlch's speech and recommcruli>tg that 11 he reprinted in tht• magaztnt' (or the benefit of readers interested PI furthering dzscusston of profemonalism ilt medrwtc. \s a rc,rdt, his <pccclr i:published her<!, 111 zts e11tircty As medical dirctfor jiJr Hospice Buffalo and the Center for Hospnc a111i Palliatn·e (an in Bul)alo, ,\ttlch Ira; garnered worldwtdc recogm ticm for accomplishments 111 /m fteld. In I 989 he n:n ivd th· British Fmbassv \mhassador's Award for Contnbuttcms to the Intematzonal Hosptce ,\Towmt'ltt, and in }'}'}:; he rtCCli'Cli Cluldrcn'.; Hosptn fllltmational s I tfctllltt \chtn•emt'llt A ward. In a brief illfroductory talk at thc I l'hllt Coat Ceremony, Dean john R. II nght.•\1]), explai11ed that \filch practiced as " general surgeo11for 1;"years prior to dcudmg to pursue-full tune "a passi011 for e11d o(ltft care." He also described how \!ilch went on "to build pwgmms of national and tnterrwtWII<li rellOl\'11." /11 addillon, 1\'nght COIItmended \filch fin Ius e!jorts to l.e/p the medical school integrate the hosptcc program tnto its wmwlum "Bob zs a11 iltcreclthle tndt\'l(lua/ alllla co1•tpassi01wte pln.·sicia•t," he concluded, "and I thmk ;n 'rc l't'ry pril·t!eged to hal'c /u11r as our speahr at tl11s \\'hilt Coat Ccremo 11 - S.A.U. IT IS A PRIVILEGE TO BE PART OF THIS CEREMO Y TODAY, to witness the inception of your professional journey. The moment and the event are rife with symbolism, the temptations of metaphor and allegory irresistible. But I would like to think that we can do better than hackneyed allusions to virginity and ship launchings, and in my attempt to do so I hope that you will forgive me the politically incorrect use of the pronoun "he" in reference to all the sexes. As you know, the White Coat Ceremony is intended to emphasize the importance of both scientific excellence and compassionate care, to help "forge the contract for professionalism and empathy" between the one who wears it and those for whom he cares. In this, it is emblematic of the many dualities that henceforth will be at the center of your lives, like the caduceus with its twin serpents of knowledge and wisdom, the one useless without the other. In your first years, of course, your coats may be little more than functional accoutrements, pale tokens of the ultimate prize, a though "MD" tood for Medical Decolletage. They will become repositories for papers and pens, handbooks and broken slides, redolent of formaldehyde and the splattering of many labs. And they will continue to serve these utilitarian purposes. �These coats are like the doctor's frock coat of old, worn from morning to night in the performance of duty-a coat where he carried his instruments and upon which he wiped his hands and his chin; a coat that spoke to the distances he had traveled and the wounds he had dressed-an ensign of position long before it became a symbol of cleanliness and sterility. But the coat also carries greater symbolism, not the least of which may be that it is shorter than the professor's. Its stains are the medals of struggles against ignorance and illness and suffering. It sets you apart from the bewildering cast that populates hospitals and clinics, from other "health-care professionals" (and, I assume, health-care unprofessionals) . It draws attention to your duty, even in the face of your station. Its color speaks to the purity of your purpose and pursuit. To wear it without a sense of awe is to be a dandy-all style and no substance. It is the badge of entry into the arenas in which you have chosen to labor and to serve. It legitimizes your presence even as the least of learners. It grants you privileged access to the bedside and to the patient, and from this Delphic place the chance to glean things previously unknown. If in your first years you learned about disease, now you can learn about illness. The former occurs in organs; the latter, in people. The oracle is the patient, in all his frailty and unsightliness, whose diagnosis may be common but whose suffering is unique. If you would meet his needs, you must go beyond the mere proficiencies of your training. Listen to what you are hearing, remembering that sometimes the best way to auscultate a heart is to remove the stethoscope from your ears. Feel what you are palpating, see the world with his vision and understand his fears, for his fears are the manifestations of his needs. You must understand his values and goals and make them your own, knowing that cure is not the only legitimate outcome; if it becomes your sole focus, you are destined to be heartbroken. And you must be willing to share the power that is implicitly granted the physician, whose relationship with the patient is inherently one of inequality. Patients come to us because there is something "wrong" with them, and we have the knowledge and the skill they lack to make them whole once again. The coat, which signifies the repository of that knowledge and skill, must never become a barrier to their sharing, nor a cloak that hides beneath it an adroit but tyrannical practitioner. The struggle, then-and from your vantage point today you must accept this on faith-is to stay humane, to continue to fan the embers of compassion and empathy that lie at the heart of the instincts that brought you here. These are fires easily damped by the impetus to acquire knowledge and master skills. But while the aim may be to acquire, the goal should be to dispense, and the demonstration of those qualities of our shared humanity is every bit as valuable, if not more so, than the ability to draw blood or tie a square knot. It is reinforced by the recognition that what happens at the patient's bedside is not just a function of what you know, but of what you are. Still, you will find that the system and the Its color speaks to the process often conspire against this, and, if alpurity of your purpose lowed to, make it difficult to care. You must be and pursuit. To wear it vigilant to this and find ways to renew yourwithout asense of awe is to be adandy-all style selves by nurturing your own body, mind and and no substance. spirit as you would those whom you serve. There is a world ofbeauty outside medicine, and we do neither ourselves nor our patients justice by slighting our involvement with it. Music resonates with our inner harmonies; art gives us fresh views of life. Read uland and Selzer and Schweitzer, as well as the New England Journal ofMedicine. Their science may not be as exact, but their lessons are longer lasting and their contributions probably greater. The physicians truly worth emulating did not have a monochromatic vision of life, and their wisdom was enriched by the arts and their avocations as they gained insight into themselves, as well as into their patients. Let your coats remind you of this, especially when you take them off. Thoughtful men have written that the physician must also be a priest. This is not to confuse him with the gods at whose altars he works, or with the rituals he observes. Rather, it speaks to the summons to heal the soul as he would the body, and, in so doing, find the full richness of his calling. It is fitting, then, that today you don the first metaphorical raiment of priesthood. Today they are those of an acolyte, but other robes await. 4D �- - M B S v A E D C A ------ L E SCHOOL W S Cloister Program Opens New Vistas Three UB medical students selected as Research Scholars t{~ ) BLII \ 0 \ s( 0 () \1 Dll and Biomedical Sciences' students Margo McKenna and janice Sung, Class of 2003, and Charmaine Gregory, Class of 2002, are among 40 medical students selected nationwide for entrance into the prestigious Howard Hughes Medical Institute-National Institutes of Health (HHMI- !H) Research Scholars Program for the 2000-2001 academic year. the direct mentorship of a preceptor whom they select from over 1,100 tenured or tenure-track intramural scientists working on more than 2,600 research projects. In addition to working one-on-one with scientists, the students have an opportunity to meet and talk with accomplished investigators at weekly lectures and can attend national scientific meetings, NIH conferences and workshops. The HHMI-NIH Research Scholars Program, also known as the Cloister Program, was established in 1985 to give outstanding students at U.S. medical schools the Salaries and benefits for the research scholars, as well as administrative costs for the program, are provided opportunity to receive research training at the ational Institutes of Health in Bethesda, Maryland. Those cho- mentors, laboratory space and equipment and supplies for laboratory work. sen to participate in the program spend nine months to a year on the l H campus conducting basic research under by the HHM!. The IH, in turn, provides advisors, The UB medical school students have settled into their year of study and report that their experience in the Cloister Program, to date, is everything .. they had expected it to be. Margo McKenna has selected Leslie Ungerleider, PhD, as her preceptor and is ._,• working on a project titled "Emotion and Attention in the Human Brain: a Functional MRI Study," which is being - conducted in the Laboratory of Brain 30 and Cognition, a division of the National Institute of Mental Health. Specifically, she and her fellow researchers are looking at the amygdala, a region of the brain thought to be involved in the regulation of emotion and social behavior. The lab specializes in using functional magnetic resonance imaging (fMRI) to ask basic questions about how the brain works. "In the study, subjects are asked to perform a task while in the scanner, and the images that we collect can show which areas of the brain are most active and important for doing the task," McKenna explains. Research Scholars,leh to rigbt: Janice Sung, Charmaine Gregory and Margo McKenna. With regard to the Cloister Program, itself, McKenna says "it's an amazing 14 lalfalo Pbysiciu IVtttter 200/ �LIKE McKE. '!\'A A:--JD SU.i\G, GREGORY FEFLS 1HE CLOISTER PROGRA~I GIVES STUDL 'TS A.' EXCELLE!\'T OPPORTGNITI TO GAI:--J EXPOSURE TO BE:--JCH RESI:.ARCH I,' A U0.'IQUE E. 'VIRO. '~IE. '1. " P RES£. I"LY, l A~l • 'OT SURE IF :>!Y CAREER WILL L 'CLUDE BASIC SCIE, 'CE SOLELY OR IF IT \\'ILL SO:>lEHO\\' BE I 'TEGRAfED. H O\\EVER, THERE IS i':"O DOUBT L' :\lY :\II, 'D THAT THIS IS A 0. 'CE- I, ' - A-LifETl:\lE EXPERIL 'CE A, 'D 0. 'E THAT WILL !:>!PACT 0.' :>IY FL., TURE DECIS!O, 'S." opportunity for medical students who are thinking about incorporating research into their careers and an ideal setting for independent thought and creativity in the field of medicine." Janice Sung, who is working with Bar"In the study, subjects bara Bierer, MD, in the National Heart are asked to perform a Lung and Blood Institute on a project task while in the scanner, and the images that we collect can show which areas of the brain are most active and important titled "Effect of Gelsolin on Actin Dynamics in T Cell Signaling," concurs with McKenna. "I think the program is a wonderful opportunity to further our interests and understanding of the basic sciences that we were introduced to during the first two years of medical school," she says. "Also, living with 40 students with remarkably diverse backgrounds provides for doing the task." exposure to bench research in a unique environment. "Presently, I am not sure if my career will include basic science solely or if it will somehow be integrated. However, there is no doubt in my mind that this is a once-in-a-lifetime experience and one that will impact on my future decisions." White Family Memorial Fund Recipient B rian Bennett, Class of 2003, participated in the University at Buffalo School of Medicine and Biomedical Sciences' Primary Care Summer Externship (see article on page 22) as the first a unique environment that is fulfilling both intellectually and emotionally." Charmaine Gregory is working with preceptor Marc Reitman MD, PhD, Molecular Biology and Gene Regulation section chief in the Diabetes Branch of the ational Institute of Diabetes and Digestive and Kidney Diseases. The project they are working on, titled "The Role of PPAR alpha in the Hepatic Steatosis and Insulin Resistance of AZIP/FI Mice," utilizes transgenic mice (AZIP/Fl ), engineered in Reitman's lab, which have recipient of the White Family Memorial Fund. The fund-which memorializes Deborah A. White, MD '87, and her husband, Christopher, and son, Adam, who died in a car accident in 1999supports a summer internship for a firstor second-year student who is interested in pursuing a career in rural medicine. Bennett, who is from Bath, ew York, graduated from SU Y at Binghamton in 1998 with a bachelor a paucity of white adipose tissue and develop an insulinresistant diabetes mellitus. The lack offat cells, according of science degree in biology. "I was very pleased to have had to Gregory, leads to a sequestering of lipids in the liver and muscle. "A remarkable steatosis develops and an impressive diabetic state evolves," she explains. "One of my main goals throughout this past summer was to find out if my image of a small-town physician's life was "Peroxisome proliferator-activated receptor (PPAR) al- day-to-day basis. I am pleased to say that my experience reinforced not only how much I want to be a doctor, but also my selection of a small-town setting for practice. "I can't think of a greater distinction to begin my pha is a transcription factor that stimulates fatty acid oxidation and peroxisome proliferation in mice. I am investigating the effect PPAR alpha has on the steatosis, as well as the insulin resistant diabetes in AZIP/Fl mice." To accomplish this goal, metabolic, physiologic, and molecular studies are being conducted. Like McKenna and Sung, Gregory feels the Cloister my externship placed in Medina with Dr. Madejski," he says. representative of what a real doctor actually experiences on a professional career," he adds, "than to receive a scholarship in memory of the White family and connected with small4D town medicine." -S.A. U!-iGER Program gives students an excellent opportunity to gain IViHt e r 2001 l1ffal• Hysicin 15 �- - M - E - - D C - A . L -- -~ -·. --- - SCHOOL Kornel Terplan Memorial Lecture E W S The inaugural Kornel L. Terplan Memorial lecture was held October Sachs Leads Collaborative Project on Mechanical Sensitivity of Cells 5, 2000, in the lippshutz Room at the University at Buffalo School of !:>clcc t.il·, /ape '>u< IH< a '' I ec 1 ' o~, \fl .s Medicine and Biomedical Sciences. The lecturer was Donald L. Price, MD, professor of pathology, neurology and neurosciences at the Johns Hopkins University and president-elect of the Society of Neuroscience. Price, an internationally renowned scientist who has made major discoveries in the field of neurodegenerative disease, delivered a talk titled "Alzheimer's Disease, lessons from a has established an endowment to fund $500,000 ove r fi ve years, University at Buffa lo and th e Massachu - an annual lecture. Terplan's son, Martin setts Institute of Techn ology are th e only U.S, un ive rsities selected by the japanese Ministry for ongoi ng collabora tive projects, Terplan, MD '55, assumed a major role in falo to aHend the lecture, according to The researchers will stud y the physiological p rocess by which th e mechanical defo rmation of a cell is transfo rm ed in to elect ri cal Reid R. Heffner Jr., MD, professor and and chemi cal respo nses, For exam ple, mechani cal transductio n, chair of UB's Department of Pathology. mo re se nsitive than visio n, occurs when the movement of cells in creating the endowment and was in Buf- TERPLAN japa n Science and Tec hn ology M inistry to collabora te on a $10 m illio n resea rch p roject aimed at understanding th e m ec h- generosity of the Terplan family, which The event was made possible by the L. iop hysics researchers at Uni versity at Buffa lo's School o f Medicine and Bio m edical Sciences have been selected by th e ani ca l sensiti vity of cells, Fred eri ck Sac hs, Ph D, p rofesso r of ph ys iology a nd bi oph ysics, wi ll lead th e UB project, esti mated to in volve abo ut Genetic Approach." KoRNEL B Kornel Terplan, MD, was professor the inner ea r ge nera te nerve im pulses that res ult in th e sense of and chair of UB's Department of Pathol- hea rin g, Sachs and his collabo rato rs at UB discovered the firs t ogy from 1933-1960 and served for mechanical transducers in 1983 and, since th en, their labo ratory many years as a pathologist at Child- has bee n a wo rld ce nter for work o n biological mec han ica l ren's Hospital of Buffalo and Buffalo se nsiti vity. "In add iti o n to providin g the se nse of hearing, me- General Hospital. A 1919 medical cha nica l transdu ctio n also is in vo lved in to uch, th e measurem ent graduate of German University in of jo in t positio n, muscle tensio n, bo ne growth, blood -p ress ure Prague, Terplan was internationally regul atio n, fi lling of th e bladd er and intestines, and the regul atio n recognized for his work in childhood of cell , ti ss ue and orga nism volume an d size," Sachs explai ns. tuberculosis and brain pathology associated with chromosome anomalies of children. Through his work on the pathogenesis of "Altho ugh it is an esse nti al se nso ry process, mec hani cal transdu ctio n also ca n produ ce pa th ology. Ca rd iac fib rill atio n- was a frequent occurrence. In 1936, Terplan recruited Ernest th e un coo rdin ated co ntractio n of th e hea rt- ca n be initiated by m echani cal stress, Witebsky, MD, to the Department of Pathology. In the early 1940s and fai lure of th e Witebsky and Niels Klendshoj isolated the B-antigen found in hea rt is th e most human blood, a discovery that made blood transfusions safer. co mmo n ca use of TB, he proved that a reactivation of past cases of the disease "Dr. Terplan guided the Department of Pathology through d eat h wor ld wide. difficult times prior to and during World War II," says Heffner, U nd erstandin g th e "but his leadership was even more important during the 1950s, m ec h a ni s m s when there was considerable change and unprecedented growth mec hanical trans- in medical schools throughout the country. du cti o n w ill e n - "Not only was Dr. Terplan an eminent scholar and one of the lead- of ab le scie nt ists to rat io nal ing figures at the medical school, he was also a man with great energy deve lo p and enthusiasm who was known for his personal wannth," he adds. th erapies fo r di s- Following his retirement as chair of the Department of Pathology ease." (See related in 1960, Terplan continued a productive career for another 25 articl e o n page 3 1.) years, pursuing his lifelong interest in neuropathology. ., A. i. T he wo rk will be ca r ried o ut in collabora ti o n with 16 laflal1 Pbysiciaa IV1111er 200/ I �Kavinoky & Cook, said "Dr. Riwchun felt it was very important to give back to his alma mater and to provide training to young physicians. This desire to atUB. CD repay culminated years later in -LO IS BAKER his decision to donate part of his estate to the university, a Riwchun Endows desire that was ultimately carProfessorship of ried out by his wife's bequest." Ophthalmology Ann Riwchun was equally he University at Buffalo School of committed to the community Medicine and Biomedical Sciences has and Wisbaum praised her as received a $1 million gift to endow a pro- "a strong woman, a dedicated Masahiro Sokabe, chair of the Department of Physiology at agoya Medical School, who is heading the project and who spent a sabbatical year in Sachs' laboratory l fessorship in memory of internationally known ophthalmologist, eye surgeon and UB alumnus Meyer H. Riwchun, MD '27. mother and wife, and active civic leader." She was the first woman to Hospital and at Children's Hospital of Buf- serve as president of the Buffalo Association falo during the 1960s. Riwchun was attend- for the Blind, and was honored by many ing ophthalmologist at the then-Deaconess organizations for her civic leadership. In B 1979, the Riwchuns were Hospital and attending ophthalmologistin-chief at the former Rosa Coplon Home. The gift-a bequest from Riwchun's wife, Ann S. Riwchun, who died in 1999will fund the Meyer H. Riwchun Professorship of Ophthalmology in the " jointly named Buffalo During World War II, he was a lieutenant News Outstanding Citi- colonel assigned as chief of eye services at zens for their work with the blind. John R. Wright, MD, dean of the School of Medicine and Biomedical Sciences, hailed Riwchun as "a leader in the field of eye Walter Reed Hospital in Washington, DC. l C•~MBE Department of Ophthalmology. Ann Riwchun made the bequest to recognize and continue the work that her husband had pursued as a professor in the medical school, in his private practice and as head of eye services for the U.S. Armed Forces during World War II. "Dr. Riwchun was a highly regarded ophthalmologist and UB graduate who enjoyed a long and distinguished career in medicine, while his wife was equally dedicated to civic activities," President William R. Greiner said at the time the bequest was announced. " During their lives, they made a real difference in the quality of life for Western ew York residents and con- R I A I His patients ranged from enlisted men to such high-ranking officers as General of the Army George C. Marshall, as well as Ameri- care, whether he was using innovative surgical can and foreign diplomats, including Soviet techniques or educating medical students and Foreign Minister Andrei Gromyko. Along with maintaining a private practhe public about the issues of good eye care. tice, Riwchun taught at UB as a clinical proThis gift will allow UB to carry on that legacy fessor in surgery and ophthalmology, was ofleading-edge education in ophthalmology." chair of the Department of Ophthalmology Wright also said he expects the Riwchun and wrote numerous scientific papers on Professor to be named by September 2001. Riwchun, who died in 1998 at the age of eye disorders and eye surgery. The Riwchuns' leadership gift goes to95, earned his medical degree from UB in cialists in Austria before returning to Western ew York for a long career in medicine. wards meeting the School of Medicine and Biomedical Sciences' goal in the campaign for UB: Generation to Generation, a $250 million tinue to do so through this generous gift." The Riwchuns' long-time friend and at- He maintained a private practice from 1929- university campaign. Funds raised will be 1985, also serving as head of the departments torney Wayne Wisbaum, a senior partner at of ophthalmology at The Buffalo General used to enrich academic programs, support students and enhance university life. CD 1927, and then trained under European spe- Wint e r 2 001 l alfalt Hysiciu 17 �- - M E - D C A --- - ---- ---- -. ------- E SCHOOL L Distinguished Medical Alumnus Named Do.wld Ptt .L., ,\[/) .~ •• pct.l£... 1( vllCo!ogts. W S UB Hosts International Epidemiology Conference tures can work to improve the effectiveness of ISEE chapters in latin America , the Caribbean, Central America, Africa, and Univer- The 12th annual meeting of the Central and Eastern Europe," sity Medical School and a renowned specialist in pediatric oncology, \II) International Society for Envi- explains Vena. received the University at Buffalo's Distinguished Medical Alumnus ronmental Epidemiology (ISEE), Conference cochairs, in addi· Award from the Medical Alumni Association at a dinner September hosted by D. John Vena, PhD, of tion to Vena, were John Weiner, 28, 2000, in the Buffalo Club. the Department of Social and DrPH, and Germaine Buck, PhD. I' PROHSSOR OF Pill I ITRICS at Texas A&M A Buffalo native, Pinkel received a bachelor's degree from Preventive Medicine, was held For the full program and ab- Canisius College in 1947 and a medical degree from UB in 195 L He August 18-22, 2000, at the stracts, visit the conference web- served his residency at Children's Hospital of Buffalo, and was a Adams Mark Hotel in Buffalo, site at: http://www.phoenixwork research fellow at the Children's Cancer Research Foundation in New York. group.comlisee2000. Boston, now Dana-Farber Cancer Institute. Pinkel returned to Buffalo in 1956 to start the pediatric department at Roswell Park Cancer Institute. In 1961, he was appointed and 92 students from 45 countries attended the meeting, where the founding director of St. jude Children's Research Hospital in some 350 papers and three poster Memphis, the first institution devoted solely to basic and clinical sessions were presented on the pediatric research. theme of "Environmental Epide- ing members of the Class of miology in Pan America and the 200 I, who were recently in- Since leaving St. jude in 1973, he has accomplished a va- Left to right: Dean John R. Wright, Dr. Donald Pinkel and Dr. John Bodkin World: Building Connections." riety of tasks, including rejuve- "The purpose of the meeting scientists and students from CHRI'> TOP H E R ADA\1'. Midwest Children's Cancer around the world to exchange TH O \IA S BLA C K Center in the city; developing ideas for cutting-edge research in )OHS B O RGO \ pediatric leukemia research the field of environmental health," TH O \IA'o B OTT A programs at City of Hope says Vena, who adds that the event MARIS A BRA \ "IS Medical Center in California and was tremendously successful. The primary goals of the con- in Houston; and, as medical director, taking a key role in ference were to showcase ongoing BARB A RA GR EE SB E R(, interdisciplinary, international AAR O S GL YE R rebuilding St. Christopher's epidemiologic research and to KEI IS M O LLE:\ ELYSSA PE T ER'. facilitate more collaboration in KILl-IS S .H E RS O research and training worldwide. Award for Medical Research, the Kettering Prize for Cancer opportunity for the scientists to Research from the General Motors Cancer Research Foundation, highlight emerging global envi· the Zimmerman Prize for Cancer Research, the Biennial Winder- ronmental health issues, ex- mere Lectureship of the British Pediatric Association and the change the latest scientific Return of the Child Award from the Leukemia Society of America. findings and methodological An upcoming issue of Buffalo Physician will feature an in-depth approaches for a wide spectrum of article on Dr. Pinkel's career, including many fond memories he has environmental exposures and re- of his days in medical school at UB, as well as in training at lated health outcomes, and to talk CD Children 's Hospital of Buffalo. about ways in which organizational and administrative struc· - L O I S BAKER t c r 2 0 0 I SA SHA GIL\I ORE provide a forum to discuss how to "The meeting also provided an \\' 1 11 RYAS DFSHAE SE M.D. Anderson Cancer Center Pinkel has received many honors, including the Albert Lasker y sic i a a Alpha Omega was to bring together distinguished sor of pediatrics at the University of Texas Medical School in Houston. n ducted into Alpha this past fall. nating Milwaukee Children 's In addition to his post at Texas A&M, he currently serves as profes- I a If ale Congratulations to the follow- Hospital and establishing the Hospital for Children in its North Philadelphia neighborhood. 18 CD Approximately 400 scientists Alpha Omega Alpha is the only national medical honor society in the world. Its purpose is to recog11ize wtdergraduate medical school achievement and to perpetuate excellence in the medical profession. �A:z:odo Completes Alpha Omega Alpha Fellowship L \ C 2< 2, is the recipient of an Alpha Omega Alpha Student Research Fellowship, which provided him with $3,000 in support of a research project he completed during the fall of 2000 in the laboratory of Wesley Hicks Jr., MD '84, DDS, at Roswell Park In his research project, Azodo focused on understanding why granulomas form in the airway of cancer patients who undergo radiation therapy or have tumors surgically resected. Specifically, he worked to characterize the role of IL-l, an endogenous cytokine, in the response of tracheal respiratory epithelial cells (RECs) to injury. c I "We were trying to see how blocking IL-l or changing its concentrations affects the growth of porcine tracheal RECs, used as a model for human cells," explains Azodo. "IL-l is known to be an endogenous " result of signal transduction from membrane receptors. It also modi- .... fies the activity of several known mitogens and chemokines. In .. First-year student Diana Pratt is this year's recipient of the Univer- Cancer Institute. .. Medical Alumni Association Scholarship pyrogen and has many effects, both directly on the nucleus and as a particular, it plays a major role in the early attraction of neutrophils to the site of inflammation, which accounts for some of its destructive involvement. This investigation is complicated by the presence of two distinct sub-populations-IL-l alpha, and IL-2 beta-each with different proportions, sites of action and mechanisms of regulations." Originally from igeria, Azodo lived in Rochester, New York, for seven years prior to coming to the University at Buffalo in the fall of 1994 to begin work on a bachelor of arts degree in biology, which he completed in the spring of 1998. Currently, he has a strong interest in pursuing a career in radiology and says he would like to complete a residency somewhere in the southeast or mid-Atlantic, if he does not remain in Buffalo. "As an undergraduate, I had several opportunities to engage my talents and interests outside of the classroom, and I worried that my involvement in these activities would end when I began medical school, but I was wrong," says Azodo. "In my second year, I began a Radiology Interest Group (RIG) that has been recognized by the Polity [the medical student governing body]. The group now serves to introduce medical students in the preclinical years to this innovative and integral part of medicine as it is practiced today." In his second year, Azodo also had an opportunity to serve as vice president of the Student ational Medical Association (S MA). As the junior branch of better-known National sity at Buffalo's Medical Alumni Association Scholarship. The scholarship is made possible by the generosity of alumni through their reunion gifts designated to the Medical Alumni Association endowment fund. Recipients are selected by the admissions committee according to considerations of financial need and academic merit based on the in· coming student's applications. Pratt, a native of Buffalo, New York, graduated from UB in 1999 with a bachelor of science degree in biomedical anthropology. At this point in her education, she is .. interested in pursuing a career in c < family medicine, but plans to remain open to other possibilities, including international medicine. I -5. A. U:-.:GER Medical Association, the S MA provides an avenue for minority medical students to explore the unique contributions they can make to medicine, according to Azodo. "Through collaborative efforts with other groups during the 1999- 2000 school year, we introduced several non - .... minority students to the S MA," he says. "We also provided insight into what minorities could offer the medical community at all levels. In part, we accomplished this by discussing the prevalence of major diseases such as lupus and diabetes in the minority community and by sponsoring lectures, including one by Dr. Paresh Dandona that was well attended. "My work with the RIG and the S MA are just two examples of the kind of overall growth I have experienced and come to value during my time in Buffalo," Azodo continues. "On the whole, UB has been a wonderful place for part of my transition into adulthood." -5. A. 4D U~GER IVi11ter 2001 l 11fale Pbysiciu 19 �- - - M -- E D - C - A ----- ----- ------ SCHOOL L ------ E W S Honors Brunch Recognizes first· and Second·Year Achievements !I F A U-\I HO'\ORS BRc ( H recognizingacademicexcellenceamong Kathleen O'Donnell, '02, first- and second-year students at the University at Buffalo School of Medicine and Biomedical Sciences was held October 22, 2000. The following is a list of award recipients and a description of the awards received. .. c c I ... .. 0 s: The Department of Pathology's American Society of Clinical Pathologists Award for Academic Excellence, which is presented to the second-year student who has demonstrated high academic achievement and outstanding performance in the KATHLEEN o ·oo"<ELL Departmental Awards Kelly Gordon, '02, received The departments of the School of Medicine and Biomedical Sciences have established awards, described below, to recognize merito- the Department of Microbiology's Ernest Witebsky Award for Proficiency in rious performance in courses and outstanding achievement in wrriculum-related activities. Microbiology, which is Pharmacology and Toxicology's Edward A. given to the second-year Carr, Jr. Clinical Pharmacology pathology laboratory. Brian Maim, '02, received the Department of student achieving the Award and the DouglasS. Riggs Award. The former award is of Anatomy and Cell Biology's Gibson- highest grade in the microbiology and immu- Atwell-)ones Award, which recognizes the nology course. Dr. Witebsky was the found - achieving the highest average in student with the highest com- ing chair of the Department of Microbiology. Richard Newell, 'OJ, received the Department L received KELLY GORDO N bined average in the anatomical given to the MD/PhD student the Fundamentals of Pharmacology course, while the latter is sciences courses of gross ana - Christine Kerr, '02, received tomy, histology, neuroanatomy the Department ofMicro- and embryology. The award is presented to the second-year student with the highest average BRIAN MALM biology's Marek Zaleski in the course. Drs. Carr and Riggs were named in honor of past chairs of Award, which is presented chairs of the Department of Pharmacology the department: james A. Gibson, to the student who best Wayne ). Atwell and Oliver P. combines high standards and Toxicology. Maim also received the Department of )ones. ewell also received a McGraw-Hill Book Award, which is given of academic achievement with outstanding service to the two highest-ranking students in the to the community. The second-year class chooses the recipient. RI C HARD NEWELL first-year curriculum. Pathology's john B. Sheffer Award, which is C HRI STil\ E KERR given to the second-year student who has performed at the highest level in the laboratory portion of the courses in general and systemic pathology. Dr. john Sheffer prac- Sara Kaprove, 'OJ, received the Department of Christopher Mutty, '02, ticed pathology in Buffalo for over 35 years Biochemistry's Edward L. Curvish Award, which recognizes the student with received the Department of Pathology's Kornel and was acting chair of the Department of the highest average in the two Terplan Award, presented first-year biochemistry courses. to the student with the Kaprove also McGraw-Hill received a Book Award, in the two second-year pathology courses. Dr. Terplan was a past chair of the department. first -year curriculum. S AR A K A J>ROVE 20 II If Ill H J SiC iII \Vint er 2 001 l highest combined average which is given to the two highest-ranking students in the Pathology from 1972 to 1974. 1 C HRISTOP HER Mt:TTY �the student with the highest combined average in the two physiology courses in the first year. Dr. Rennie was a former vice president for research at UB and chair of the Department of Physiology and Biophysics. Discipline Honorary Societies A:-.; JEll GL:PT A The Association of Pathology Chairs Honor Society awardees were Christopher Mutty, Brian JI LL ALB R EC H T L AL R A C u..:S KJ Anne Wolpiuk , '02, Robyn Filipink, '02, and Maim, Kathleen O'Donnell, Jennifer Defazio, Diane Jill Albrecht '03, and Laura Cinski, '03, received Anjeli Gupta, '02, received the AstraZeneka Den Haese and Linda Cuomo, all the Class of 2002. the Evan Calkins Primary Care Achievement Cardiovascular Drug Monograph Award Award, which is given to one or two given to second-year students by the Depart- outstanding students in the Primary ment of Pharmacology and Toxicology. The Care Summer Externship Program. award is based on the quality of a mono- Calkins is a former chair of the graph written in the form of a package insert. Department of Medicine. 4:D Carlos Cedeno, '03, received the Department of Physiology and Biophysics' Donald W. Rennie Physiology Prize, which is given to J•""" •• DEFAzio Dean'sLetters of Commendation, 1999-2000 M ELII'DA K NOX Class of 2003 T ODD ) AN I C KI The Dean 's Letters of Commendation are awarded to students who D A\'ID K RAKOWSKI ) or'EL B ALLARD SARA K APRO\'E achieve 75 percent of available honors points in each year. Two honors points are earned for each credit hour ofhonors performance C H RI STOPHER A DA~IS M ARll'>A B RA\'1:-1 B ARBRA G REE:-.'BERG Class of 2002 VI CTOR A MODEO G ARRICK A PPLEBEE S L'Z IE A RIY ARATANA E LIZABETH B OLRKE ) E,.N I FER K ORZEN B RI Al'> M AL~! ) AMES B onE ) A~IES LI N ATAS H A M A"ES A "THO" Y M ATO CARLOS CEDEl->0 C H RISTOPHER M LTT\' KI T C HENG RI CH ARD K AT H LEEN O ' D oNNELL C H RI ST INA CLAR K ) EFFREY ) El->NIFER D EF AZ I O CARYN O RR D AN IELLE D oRsA:-.Eo T IMOTHY P ARDEE D IANE D E. · H AESE P HILLIP S EEREI TER L ISA E sLER E LIZABETH P ENDER M ELISSA D ESANTI S S ANDES H S ING H E sME F INLAY E RIC SCHAEFER K EELY D WYER- M ATZ KY ) ON \THAN S IUTA D A\'ID F l"TAK D A\ ID S CHLESINGER M ELANIE FI ORELLA ) ULI E V OGEL while one point is earned per credit for high satisfactory. Class of 2001 CHRI STOPHER L OGUE EWELL ORTH K ARA G ROSS M ARC. A UERBACH R OBYN F IUPI:-.' K AIM EE STA" I SLAWSK I A ARON G uYER SHALEE~ B ELA'! CHRISTOPHER F ORESTO A NDREI\' SWAN D A\'ID F LINT B oBBI W Ax K E\'1' M oLLEt< LI LY B ELFI A LICIA G ITTLEMAN A NDREW Sn1oNs A LFRED F RONTERA L YNDSAY WIL LMOTT- E LYSSA P ETERS S\'ETLAl'>A B LITSHTEY~ K ELLY G oRDON E ~11 LY T ENNEY ) ULIE G A\' I N LI SA G ELMAN KI LIAN SALERNO VI TO B RL'NETTI G REGO RY ) ANIS M ATTHEW T RAUGOTT ) ERR\' CHANG K YLE K ATO~A ) ULIANE T HuRLOW D A\'ID G RAY L INDA CuoMo D A\' I D K IM K ARES W EISS H OWARD H AO B ARTOS R oss Y APLE STEVEN W E I TZ~IA:-.' l l Honors Brune 1V i11 t er 200/ l 1 flal• Hp i c i ll 21 �---- M E D C A L --- SCHOOL -·-- -- E W --~- S The Primary Care Summer [xternship Program " Truly taught me what it takes to be a fine physician " 0 s p I \Is, ( Summer Externship Program has offered first- and second-year students a paid six-week experience during the summer months. Through the program, medical Through the Eyes of Students ... The following comments were made by students who participated in the 2000 Primary Care Summer Externship Program. students are placed in the offices of generalist physicians across Western ew York, where they enjoy varying degrees of interaction with patients, including taking histories and performing physicals. The externship experience clearly has a positive im- .lennifer K. Kor:z:en, Class of 2003 P Rl c F PTO RS: pact on student participants. In reviewing results of the program over the last three years, we found that 96 percent of externs "agreed" or "strongly agreed" that their clinical teachers improved their understanding of clinical "I am now only beginning to grasp all that I really learned practice (such as physical exams, medical decision making, treatment options, etc.). We were also pleased with this summer. Whether it was on the pathophysiology of the results of comparing pre- and post-externship surveys. how limiting HMO drug formularies can be, or how Twenty-seven percent of students felt that prior to the externship they had a broad or very broad much some patients really need reassurance from their doctors, I know my time at Geneva B. Scruggs Health exposure to career opportunities in primary care Care Center has been one of the best learning experiences We found that 96 percent of externs "agreed" or "strongly agreed" that their clinical teachers improved their type II diabetes, how to comfort a patient who has HlV, compared to 64 percent, post-externship. Since of my medical school career thus far. I do not think I will the program's inception in I 993, 67 percent of ever really be able to thank Dr. Gbadamosi, Dr. Lewis, or primary-care externs have entered generalist Susan [Ba ran ] enough for being able to watch them and residency programs, compared to 48 percent of the entire University at Buffalo graduating class work alongside them this past summer, for they have truly taught me what it takes to be a fine physician." during those years. We are grateful for the support of the various understanding of program sponsors, including the clinical practice. tion (whose significant three-year grant ended this past summer) and the Robert Wood Johnson Foun- ulpeper Founda- dation (whose Generalist Physician Initiative grant also ment of Health, the Western .leffrey Conklin, Class of 2002 PRECIPT OR: Fra11k C. Mezzadri, MD "One of the nice things about working for a large group ew York State Depart- practice like Quaker Medical Associates (QMA) was the ew York Rural Area Health chance to see different styles of dealing with patients and ended). Other sponsors include the Education Center and the White Family Memorial Fund. In addition to foundation and institutional support, hearing various perspectives on medical topics ranging from the diagnosis and treatment of patients to managed care. I the Primary Care Summer Externship Program welcomes left each day with at least one new insight that will help me a support from individuals; for example, Evan Calkins, MD, great deal once I get into practice. has established a special endowment fund to develop a confirmed my desire to work in the primary care setting and Externing at QMA more consistent funding source for the program. For more to treat both adults and children, and it also gave me a sense information about the program or giving opportunities, that I would really enjoy working in a group practice, assum- contact the Office of Medical Education at (7 16) 829-2802. ing I have the opportunity to choose my career path." -DFBRA STA~tM, 22 Fatai Gbadamosi, MD, Dwight Lewis, MD, a11d Susn11 Barnn, PA, Geneva B. Scruggs Health Care Center laflal1 Hysiciaa \\'t11tcr 200/ DirectorofStudelll Services �Student Preceptor Speciality MAL'REES GROSSI Drs. Colleen Mattimore & Mary Schamann Pediatrics MARK HAG(,ERTY Dr. Edward). Graber Internal Medicine KESSETH HALLI\\"ELL Dr. Sanford Levy lttternal Medicine CHRIS "CARL" RE\SOLDS Dr. Richard Castaldo Internal Medicine Scon HoRs Dr. Richard Castaldo Internal Medicine STE\"ES KA\1 Dr. Donald Robinson Family Medicine pediatrics and my desire to pursue this field, but also taught me a ILSTIS KA:<ALEY Dr. Raphael Wang Pediatrics wealth of information about how to be a good clinician and communicator with both children and their parents." )EsstFER KoRZE:-< Drs. Dwight Lewis Family Medicine .Justin Kanaley, Class of 2003 PRECEPTOR: Raphael Wang, MD, Williamsville Pediatrics "Beyond the one-on-one teaching that I received from Dr. Wang, I was able to become part of a team of health-care providers who made the office run very smoothly. Every nurse, nurse practitioner, secretary and doctor at Williamsville Pediatrics went out of his or her way to make me feel comfortable in the office. When my sixweek externship was finished, I didn't want to leave, for I truly felt that I had become a part of their team. The experience that I gained from this summer program not only emphasized my love of & Fatai Gbadamosi ROSA'" LASA Dr. Theresita Dolojan OB/GYN ALEXASDER LERSER Dr. john Fudyma Internal Medicine he Primary Care Summer Externship Program wishes to MARA Ltsscon Dr.) . Thomas Reagan Family Medicitte extend a sincere thank you to all the preceptors, listed CrsTHIA MARTISEZ -CAPOLI:-<0 Dr. Ellis Gomez Family Medicitte MATTHE\\ McKES. 'A Dr. Gregory Snyder Family Medicine MORCOS MORCOS Dr. Khalid 1ahran lttternal Medicitte/ Nepltrology HEATHER MoRGASTI Dr. Lawrence Me ally Pediatrics MICHELE 0DROBISA Drs. john Brewer, Roberta Gebhard & Kim Griswold Family Medicine THANK You, PRECEPTORS . . . . T below, who continue to make this program a success. Many of these physicians volunteer their time year after yea r to ensure that students experience the true practice of medicine early in their careers. Student Preceptor )ILL ALBRECHT Dr. M. jane Parmington Pediatrics DA:-<IELLE A:-<<.,LI\1 Drs. Russell Vaughan & Lorie Leonard Pediatrics SL SIL BAS SAL Dr. john Thompson Family Medicine LL'CIA PHROSE-Gtuo Dr. Mark Swetz Family Medicine Dr. Thomas) . Madejski Internal Medicine/ Geriatric Medicine )ES'\IFER PAYSE Dr. Arnold A. Abramo Pediatrics Drs. Thomas R. Gerbasi Pediatrics MICHAEL CHILLSGL' Dr. jack P. Freer Internal Medicine L•LRA Ct:-<SKI Dr. Sharon L. Ziegler Family Medicine )EFFREY CosKus Dr. Frank C. Mezzadri Medicine/Pediatrics LtsDA CL'0\10 Dr. Thomas S. Scanlon Internal Medicine Dr. Howard Sperry Internal Medicine AIRANI SATHASATHA'\ Drs. Catherine O'Neilt & Janet Sundquist Intemal Medicine )E:-<SIFER DEFAZIO BETH DmiARACKI Dr. David james Family Medicilte RACHEL SCH\IITT Dr. William Kuehnling Family Medicine DASIELLE DoRSASEO Dr. Peter Kowalski Family Medicine )OS ATHAN Stl'TA Dr. Peter Winkelstein Pediatrics MOLLY E.nos Dr. Rodney Logan Family Medicine STEPHES TL'RKO\KH Dr. Mark R. Klocke Pediatrics GEOR<,E FtuL"EROA Dr. Anthony C. Sorge Internal Medicine/ Pediatrics SHA\\S VAISIO Dr. Frederick Downs Family Medicine MtCH"\EL WHITESIDE Dr. David Milling Intemal Medicine Dwm Ft:-<TAK Dr. Medicine/Pediatrics Intemal Medicitte Dr. G. jay Bishop l111emal Medicitte LYSDSAY \\'tLL\tOTT -BARTOS Dr. Charles Hershey SEAS GARY!. CHRISTISA GRACZYK Dr. Michael) . Aronica Medicine/Pediatrics Tt:<A WL' Dr. Lorne Campbell Family Medicine Speciality A\tY PLZIO icholas Aquino & Shawn Ferguson )A\IISOS RIDGELEY Dr. Anthony 0. Bartholomew Itttemal Medicine ELENA SALKO\"SKY Dr. Ashok OB!GYN ll'i11ter aik 2001 1 1 11 111 Hysic i aa 23 �- - - --- - - - - M E D C A L -- - -- SCHOOL Mini-Medical School Thrives Gift from Davises supports school and new office . -- - E -- - - W S free to high school students enrolled in the Buffalo, Lockport, West Seneca and Williamsville school districts. Students are presented a curriculum focusing on the real-life applications of the sciences, which they in turn share with lOth graders at their school after completing the semester-long program. Retired business executive and community leader In addition, the Mini-Medical School hosts a Donald L. Davis and his wife, Esther, have made a Mini-Veterinary School, now in its third year, which $600,000 gift to the University at Buffalo's MiniMedical School, a highly popular, public-service medicine and pet health care. Also, in the spring of program presented by B , f D offers a five-week slate of courses in veterinary l \\ the School of Medicine R 5 2000, in collaboration with the UB Law School, a K program based upon a series of medical-legal and Biomedical Sciences. vignettes and specifically targeted to the legal profes- Long-time benefactors of sion was launched. Graduates of both the medical and veterinary the university, the Davises have reached the $1 million mark in their support of UB with their most recent gift. "The Mini-Medical School fits our guidelines for Esther and Donald L. Dnis benefiting the community and the university," says Esther Davis. "It has a very good format, builds on the strengths of the university and extends that knowledge to the community." "The university is the greatest thing that has happened to our area," Don Davis adds. "We wanted to do something that would benefit the entire community." In addition to guaranteeing support for the Mini-Medical School for the next I 0 years, the Davises' donation has also helped fund a new public-access office for the Mini-Medical School at 101 Farber Hall, directly across from Butler Auditorium where the school's programs are conducted. During a ribbon-cutting ceremony held on September 26, 2000, for the new office, Harry Sultz, DDS, MPH, director of the Mini-Medical School, welcomed and thanked the Davises, whom he referred to as "among the most generous, public-spirited citizens we have in Western ew York." The Mini-Medical School- which was started by Sultz and his associate Alan Reynard, PhD, in I997 as "a shoestring operation"- programs are eligible for membership in the MiniMedical School Alumni Association-the first of its kind in the nation-which provides additional science-related programs, clinics and tours, as well as discount enrollment for future programs with the school. Musicians, artists, dancers, actors, athletes, scholars ... we all love Nichols. • State of the art visual and performing arts center • Exceptional college placement record • Challenging curriculum with 17 advanced placement courses has been a highly successful endeavor by all measures. To date, • Comprehensive community service program over 2,000 participants have attended its programs, making it one • More than 60 sports teams of the most popular and far-reaching community services at the • Average class size of 15 • Financial aid available university. In March 2000, the success of the school was formally recognized by Business First, Western ew York's business journal, when it named Sultz a "Health-Care Hero." On!v one invesrment lase; a liferime In its core program, the Mini-Medical School provides a series of lectures dealing with subjects traditionally covered in medical Coeducational grades 5·12 875-8212 school, but geared to helping the public understand the science 1250 Amherst Street Buffalo. NY 14216 www.nicholsnet.net behind the medicine, according to Sultz, who is also dean emeritus of UB's School of Health Related Professions and professor emeritus in the Department of Social and Preventive Medicine. Building on the success of this format, the Mini-Medical School has expanded its offerings to include the High School Science Enrichment Program, which was begun in the fall of 1999 and is 24 c::J:) II f f If I Pb J SiC iII \Vi11t er 2 001 NICHOLS SCHOOL Acceptance granted to qualified students Without regard to race, color, religion or national origm. �D E V E L 0 P M E N T N E w s Gifts for Generations to Come By Li nda J . Cor de r , Ph0, CFRE 0? 1\l l \L 'Cl ) Campaign for DB-Generation to Generation was exciting. The Dean's Advisory Council and Campaign Steering Committee were on hand for special meetings with Dean Wright, a luncheon hosted by President Greiner and a universitywide reception. Our school is poised to top its original goal ($40 million ) shortly, due in part to grants its outstanding faculty receive from nonprofit organizations and private foundations. Thus, the committee agreed to raise the goal to $50 million. Gifts from individuals are increasing as more people realize the small percentage of the budget that comes from state appropriations (about 12 percent). What a tremendous difference philanthropy m akes to an institution like UB! Best of all, there are ways to give that benefit donors as much as their contributions enrich the school. After the kickoff, I was asked several questions regarding charitable trusts. While continuing to respond personally to requests, this column also provides a way to share some quotations about unitrusts that one of our alumni wrote to some of his friends. He warned me that including it here might signal the end of the long-running bull market. However, with the market's constant ups and downs in recent months, neither of us could be blamed for a change in its direction. He begins: "Eat your cake, have more of it and benefit UB Med," and continues: If you are a UB graduate in your fifties or older, there's an excellent chance that your kids are educated to the hilt, off on their own and doing well. There 's also a possibility that you may have bought stock that has gone up tenfold or more. If this applies, read on ... The Charitable Remainder Unitrust is a nifty invention. You not only get out of the tax you would owe if you sold it in value of the original stock purchase. The older y ou are, the larger the deduction , because you have less time left, less time to do something nice. Here's another feature: The winner that you select probably pays a skimpy dividend-or none. The charitable unitrust will pay you five percent [possibly more]. This may come at a time when you GI FTS FROM I:<DIVIDUALS ARE would like to have more money INCREASING AS MORE PEOPLE because of cutting back on your REALIZE TH E S~I ALL PERCENT income-or the inroads of AGE OF THE BUDGET THAT managed care. COMES FRO~t STATE Is a charitable remainder APPROPRIATIONS (ABOUT 12 trust complicated to set up? Will PERCENT) . WH AT A you have to go to a lawyer (which you hate to do )? Heck no. It's DIFF ERENCE PH ILA NTH ROPY pretty much an off-the-shelf, fillMAKES TO A:< INSTITUTI ON in-the-blanks product. UB will LIK E UB! help. So will I, a retired simple B EST O F ALL , TH ERE ARE WAYS country doctor who started on TO GIVE THAT BENEF IT DONORS the path at the noble building AS M uC H AS T HEIR CONTRI BU on High Street . . . TI ONS ENR IC H He ends with: Tell me about T HE SC H OO L. your big winner, brag about your class and I'll brag about mine . .. " I agreed to pass along letters if anyone wants to write to our "Dr. Feelgood. " This campaign provides opportunities for making gifts that will enhance the academic environment for this generation of students and those in the future. If you would like to find out more about the school's dreams or perhaps see an example of how a unitrust, or other charitable trusts, might benefit you and those you love, give me a call. The cam- [the appreciated stock], but you 'll be rewarded with a de- paign will continue through 2003 . Your benefits could last a lifetime; your legacy to the school would last forever. duction for your upcoming income tax return (s). The Linda]. Corder, associate dean, can be reached toll free at amount of the write-off is a generous portion of the increase 1-877-826-3246, or e-mail her at ljcorder@buffalo.edu. W i nt e r 2 00 1 la fl a l1 Hysiciu 25 �OLYMPIC FENCING COMPETITION ~-ent B v S C 0 T T THOMAS UB intern competes on Olympic fencing team NN MARSH WENT TO THE OLYMPICS last September and almost brought back the most rare of souvenirs. An emergency medicine intern in University at Buffalo's Residency Consortium, Marsh was one of three members of the U.S. fencing team that placed fourth in the 2000 Summer Games' team competition in Sydney, Australia. After their comefrom-behind win over fourth-seeded Hungary in the quarterfinals, the Americans lost an oh-so-close bronze-medal match to Germany, 45-42. It was the U.S. team's first-ever medal-round appearance in Olympic competition. "We would really have liked to have won a medal," says Marsh, who was participating in her third Olympic competition. "But we had a very good result. It was a big step for us to beat Hungary-the biggest win we've fitting exit from a sport she has pursued with a passion since the eighth grade in her native Michigan. Fencing's ever had." For the U.S., this win also represented a giant step toward legitimacy in the sport of fencing, which has long been dominated by Europeans. In fact, Marsh and with muscles," though Marsh dismisses that with a laugh-"more like high-speed checkers," she quips. "You're really trying to fake out your opponent," she says of the sport's mental aspects. "Are they really her teammates-sisters Iris and Felicia Zimmerman of Rochester, New York-left Sydney knowing that their going to be smart enough to try that move, or are they just trying to make you think they'll try it?" performance had won the sport new respect in the Fencers wear wire-mesh protective gear and scoring is kept by electronically registering "touches" that are made with the point of the foil. In individual competition, bouts are to I 5 points. United States. Marsh also placed I 6th in the individual foil competition. (The foil, a light, flexible weapon with a rectangular blade, is one of three weapons used in the sport.) If these Olympic games were Marsh's last-as she says they probably were-then she certainly made a 26 laffalo Pbysiciu Wi11t e r 2001 demands are many: quickness, agility, strength, balance and mental dexterity. The sport has been called "chess Team contests, in turn, are relay affairs in which each of the opposing teams' three fencers goes against one another. It can be grueling both physically and �emotionally, and Marsh says she gets sore during competitions from the tension. A competitor who is known for her always-attacking style, Marsh admits to having no patience with the careful parrying of some fencers. ''I'm pretty aggressive," she states. "I kind of overpower people. But I've been working on my defense a lot more, too." The showing in Sydney was even more impressive because Marsh, who had been rather busy adapting to her new life as an intern, didn't do a great deal of train- I .. • .. ing. She lifted weights, did some running and watched videotapes of potential opponents, but there just wasn't time to do the intensive training she's done in past years. "Maybe my attack isn't quite as strong anymore because I haven't had time to train as I once did, due to medical school and residency," she notes, "but I have more strategies and more of a well-rounded game." Once the competition was finally under way in Sydney, however, Marsh's veteran savvy kicked in, making the quarterfinal match against Hungary a drama worthy of its Olympic billing. "We were ahead throughout the beginning of the match," Marsh explains. "But in the middle they had a couple of good bouts, and they started catching up. I was feeling like the tide was turning and they were gaining on us. But our comeback was really dramatic, too. Iris won to get us back ahead, and I was last, against Hungary's top fencer. She's really strongone of the top 10 women in the world- and Acompetitor who is known for her always·attacking style, Marsh admits to having no patience with the careful parrying of some fencers. "I'm pretty aggressive," she states. "I kind of overpower people. But I've been working on my defense alot more, too." I always have trouble with her. But I just tried to focus and not get too nervous. "I felt a lot of pressure initially. She has some moves that always catch me off guard, so I tried to really keep that in mind when I was starting, and it worked for me. I beat her S-2." Match to the Americans. Adding to the piquancy of the victory was the fact that members of the Chinese and Cuban fencing teams watched from the stands, as did Chelsea Clinton, a friend of the Zimmerman sisters at Stanford University. After the foil was put away, the Olympics held other pleasures for Marsh. H er parents redeemed a slew of frequent-flier miles to be there, and the three of them toured the Great Barrier Reef. Also, the fencing team CONTINUED ON P AGE 29 Winter 200 / lulfal1 Hysiciaa 27 �OLYMPI C F E N C ING COMPETITION E PERSO FOLLOW ING Ann Marsh's Olympic efforts with a keen interest was Philip B. Wels, MD '41, professor emeritus in surgery at University at Buffalo School of Medicine and Biomedical Sciences and chair emeritus of the University at Buffalo Council. He had good reason: An outstanding fencer in his youth, Wels was himself once named to the U.S. Olympic team. But fate intervened. The year was 1936, and the Olympics were to be held in Berlin under the oppressive sway of Adolf Hitler. The United States boycotted the games, and Wels' Olympic team never competed. B 5 C then go to tournaments on Saturday and Sunday," he recalls. "I was pretty serious Y 0 T T THOMAS "I was a very, very unorthodox fencer. I didn ' t stick to the positions they taught me. My style was aggressive. 1 tried to use a more decep- Wels says that the missed opportunity was of course disappointing, but adds that the Olympic experience in the 1930s wasn ' t like it is now, with athletes devoting tive type of attack than forceful. J was a bouncing type of guy, all over the place." years entirely to training for the Games. The main focus then was intercollegiate competition, years and even for a time in medical school. After Philip I . Wels. MD '41. professor emeritus in surrery at the University at luflalo was inducted in the Ul Athletic Hall of Fame in 1965 for his fencin£ prowess. Wels pursued the sport through his undergraduate and Wels says he has plenty of great medical school, he served in the Army in the Pacific memories in that arena. In college at UB, he fenced with all three weap- during World War ll and when he returned to UB to complete his residency, he coached the UB team for a ons- a rarity- and placed fourth in couple of years, but "then just kind of faded out of it," the United States in foil. Wels also notes with pride that the he says. "It's a strenuous sport. 1n intercollegiate competitions, r fought both team and individual bouts, and UB fencing team he founded was more I would lose 10 pounds in two day of fencing." successful than most of the school's Wei 's remarkable accomplishments in this rigorous discipline were not forgotten, however, as in I 965 athletic teams, explaining that one year the wrestlers were 0- 6 and the basketball team was 0- 13, while the fencers went 6- 2. "I used to practice five days a week, he became an original inductee into the UB Athletic Hall of Fame. Former fencer Philip Wels, 'MD 41, a knowing observer 28 about it, and it kept me in great shape. l•flalo Hysician Wi11t e r 2 001 �METTLE, CONTINUED FROM PAGE 27 shared a house in Olympic Village with the U.S. women's judo team, giving the athletes a chance to compare notes on their sports. "That was a good opportunity for us; we really enjoyed talking to them and learning about their sport," Marsh says. "Fencing and judo are both martial arts, so there are some interesting similarities." Back in Buffalo after a nine-week leave of absence, Marsh quickly settled into her medical training, refocusing her energy and talents on emergency medicine. She recalls with enthusiasm an opportunity she had to help treat a 19-year-old man with four bullet wounds. "You definitely see people at their worst in the emergency room," she says. "But you have the ability to have a big impact." Since her return, Marsh has also been sharing the story of her Olympic experience with others. Her fellow residents had followed the competition closely and there's little doubt this group of doctors-in-training knows more about fencing than most. (Earlier in the year, in response to numerous requests, Marsh demonstrated the sport in a lecture hall at Buffalo General Hospital, fencing with a friend from Rochester. "People are always so impressed when they see it," she says.) But there's no fencing club in Buffalo and little free time in the life of a medical resident. So lately, for fun, Marsh has been playing tennis and learning the guitar. She says she'd like to eventually get married and have children. And she's realistic about competing against younger, bettertrained fencers. "What I don't want to be is the older woman who's still trying to compete at this level," she says. While her career as an Olympic athlete may be behind her, Marsh can certainly look forward to taking her gifts of agility, strength, balance and mental dexterity into the arena of emergency medicine, where no doubt they will serve her- and her patients- well. 4D Wint e r 20 01 luff1l1 Pbysiciu 29 �R E E A R C E H W Drug Delays Symptoms of Multiple Sclerosis LAURENCEjACOBS, 30 1111111 Physic i 11 Wi11ter 2001 MD �Medicinal Properties of Venom Examined the scientists found that the 20 Biophysicists at the University gan were more than twice as likely at Buffa lo h ave identified a component of venom from a to have died during follow-up C hilean tarantula that blocks tion. Women in the lowest group .... the action of ion channels re- were more than one and a half 0 percent of men with the poorest lung function when the study be· than men with the best lung func- sponsible for cellul ar mechani- times more likely to have died. th e . .. "This observation suggests cal responses-specificall y, the cell 's ability to feel. that those with lower lung- These channels or pores in the cell 0 function levels may need to pay membran e-called mechanics , sa ys Frederick acti vated ch annels also pl ay a causes them to open and close- Sach s, PhD, UB professor of role in th e successful tran sition have been implicated in func- ph ysiology and biophysics, and of newborns from th e placental tions as diverse as the se nses of senior researcher on the project. oxygen suppl y to using their touch and hearing, muscle con- " For example , cells swell traction and coordination, and during congestive heart failure, blood pressure regulation. This is the first report o f a and this peptide interferes with own lungs." The next re sea rch phase , Sachs says, will in vo lve identi - th at process," Sachs explain s. fying other biological actions of substance (in this case, a small " We al so know from earlier protein ) that specificall y blocks work that stretching the heart can initiate fibrillation. If we stretch -activated chann els. Until now, it has been difficult to associate these channels with can block the stretch-activated channels, we ma y be able to particular function s beca use block fibrillation , a cause of there were no chemical com- death following heart attacks." pound s known specificall y to Addressi ng another area , Sachs notes that tumor inva- the peptide and findin g a drug compan y to turn th e peptide into clinically useful drugs. 4D - L O I S BAKER on their lungs, " says Holger Schiinemann, MD, research assistant professor in the Department of Social and Preventive Medicine, who led the investigation. Schiinemann and colleagues analyzed data from the Buffalo Blood Pressure/Erie "It is important to note that the risk of death was increased for participants with moderately impaired lung function, not just those in the lower quintile." County Air PollutionPulmonary Function Study collected during 1960 and 1961. Lung Function Associated with Longevity The original study enrolled 2,273 women and men between the ages of 15 and 96 from whom How well your lungs function may information on lifestyle factors predict how long you live. This and health status , including pul- finding is the result of a nearly monary function , was collected. 30-year follow-up study conducted In 1990, a follow-up study deter- by University at Buffalo research- mined which participants had ers on the association between died and their cause of death. from the Universit y of Vir- sion of brain tissue produces a deformation of the surrounding norm al cells, causing them ginia, Michigan State University to release growth fa ctors that and NPS Ph a rma ce uticalsappears in the May 2000 issue of may fac ilitate or accelerate tumor growth . Stretch-activated th e ]oumal ofG eneraLPhysiology. channels may be the signal for impaired pulmonary function The newl y identified peptide no rm al cells to release growth and all causes of mortality. collaboration with· scientists ative effects, such as smoking, says. "Stretch - cause stretching the membrane block them . Re sults of the research-a particular attention to avoid neg- tumor s," h e stretch- activated channels be- toxin could have several clinical facto rs. "Th is peptide blocks In the study, published in the applic a tions re late d to ce ll those channels and may aid in September 2000 issue of Chest, The purpose of the current study was to investigate the I C O NT IN U ED ON PA G E 3 2 "foR EXAMPLE . CELLS SWELL DURIKG CO:SGESTIVE HEART FAILURE, A:\'D THIS PEPTIDE INTERFERES WITH THAT PROCESS." SACHS EXPLAL'S. F BR d C ~SE \T 0 . IF \1' "V\'E \LSO K 0\1 F~0\1 EARl ER \\ORK C \.BLOCK fHE STRE.Ct:-\Cfi\ATED C lA. H\f STREfU l G fHE HEARI (A l 'lTl-\TE ElS, \IE \1\1 BE \BLE TO BlOCK FIBRIL:..Ar"O A \1 ]OR OF DE \iH FOl:..0\1" (, Ht-\Rf ATTACKS. \Vint e r 2001 l1flal1 Hysician 31 �assistant professor, and between iron levels and risk of Maurizio Trevisan, MD, death from an y cause. professor and chair, De- .... .. public-health recommendations Preventive Medicine; must be based on reasonabl y solid Brydon Grant, MD, pro- evidence that what is being rec- fessor of medicine and ommended is both safe and effec- physiology, and War- tive," says Christopher Sempos, ren Winkelstein, MD, PhD, associate professor of social formerly of UB, now professor emeritus of and preventive medicine and lead author o n the stud y. the School of Public "Currently available data do Health, University of CONT I NUED FROM PAGE 31 Schiinemann says, noting that "Sound clinical guidance and partment of Social and California-Berkeley. not support radical changes in dietary recommendations for increased risk is found in per- The National Heart, lung and iron intake or screening b y association between pulmonary sons who never smoked, as well Blood Institute and the German ph ysician s to detect hi gh- function as among smokers. "The lung is Research Foundation (DFGJ sup- and mortality for periods that extended past 25 a primary defense organism ported the study. years, the limit of previous against environmental toxins. It - LO IS BAKER studies. Schiinemann could be that impaired pulmo- It is surprising and colleagues also nary function could lead to that this simple wanted to determine decreased tolerance against measurement for how long pulmo- these toxins. Researchers also has not nary function is a sig- gained more nificant predictor of mortality. derlie an increase in oxidative importance as a normal levels o f serum ferritin, " states Sempos . " Nor do th ey support the need for large-scale, randomized trials of dietar y Iron, Heart Disease Link Debunked restriction or phlebotom y as a means of lowering iron stores. " There have been more than have speculated that decreased The que stion of wh ether too two dozen studies conducted in pulmonary function could un- much iron increases the risk of dying from heart di sease has received another " no" an - recent years on the association general health- Results showed that stress from free radicals, and we assessment lung function was in know that oxidative stress plays tool. fact a significant pre- a role in the development of dictor of mortality in many diseases." swer via a populationbased, long-term , fol low-up study con - the whole group for the full 29 Schiinemann says the fact that ducted b y Uni- years of follow-up. "It is impor- a relationship does exist between versity at Buffalo tant to note that the risk of death lung function and risk of death researchers. was increased for participants should motivate physicians to The stud y, ap- with moderately impaired lung screen patients for pulmonary pearing in the function, not just those in the function, even if more research is October 2000 issue needed to determine why. "It is of A nnals of Epi- lowest quintile," Schiinemann CD says. "This suggests that increas- surprising that this simple mea- demiology, found no ed risk isn't confined to a small surement has not gained more a ss ociation fraction of the population with importance as a general health- " high-norm al" iron stores severely impaired lung function." assessment tool," he notes. and risk of death due to car- The reasons lung function may Also participating in the re- predict mortality are not clear, search were Joan Dorn, PhD, between diovascular disease, coronary heart disease or heart attack, or "RESULTS FRO\! THIS STUDY ARE CO "SISTE "T WITH OTHERS I:--; SHOWI;-.;G THAT IRO;:o.; DOES. "OT APPEAR TO PLAY A DIRECT ROLE I;:o.; fHE DEVELOP\!E. T OF CORO. ARY HEART DISEASE . ..\10RE RESEARCH STUDY THIS ISSUE I.' V.O\IF..· A."D \11:--;0RITIFS." 32 l1ffale Physicin \Vi11ter 2001 "EEDS TO BE DO;:o.;E TO �Blood Vessels Reflect Future Health Trevisan notes. "These were non- history of myocardial infarction, invasive, direct measurements of was conducted by Trevisan and vessel structure and function. colleagues in Italy. Forty healthy which showed positive findings, Researchers can see the future Our findings showed thickening subjects between ages six and 30 Sempos notes. Still, the subject years with a parental history of between diseases of the heart and circulatory system, and measures of body iron stores, only a few of in the blood vessels of children in the interior layers of the remains controversial. The current study was based with a parent who has had a pre- carotid artery and a malfunction premature heart attack were mature heart attack, and the of the endothelium, the lining of compared with 40 persons with on data collected from partici- picture is not pretty. the vessel. Both these abnor· no family history of heart disease, malities are indicators of 'pre- matched for age and gender. pants in the second National Health and ' utrition Examina- A study published in the New Trevisan says few stud- England Journal of Medicine tion Survey (NHANES II) between 1976 and 1980, and an (Vol. 343, No. 121 ies have looked at by University at the association analysis of death records through Buffalo research- between family December 31 , 1992. The study ers reports that ul- history of heart sample consisted of 1,604 per- trasound images disease and sons-128 men and 100 black showed structural both and functional ab· vessel struc- women; 658 white men and 718 white women- between the ages of45 and 74. "Results from this study are consistent with others in showing that iron does not appear to play a direct role in the development of to lead to atherosclerosis in children as young as was already reflected in Other researchers on the study included Anne C. Looker, .. results could • have important '" be further explored so we can better under- Trevisan, MD, senior author on clinical disease,' disease that the study and professor and chair doesn't yet have symptoms." in the Department of Social and Preventive Medicine. It has been known for some time that persons with a parental stand the causes and disease path of coronary-heart disease and plan early-intervention strategies," he adds. history of premature coronary A team of physicians from pants with a parent who had a disease are themselves at high the A. Cardarelli Hospital, heart attack before the age of 60 risk. This research set out to Federico II University and S. had vessel layers that were 11 determine if it was possible to Maria di Loreto Hospital in Disease Control and Preven - percent thicker and vessels that see structural and functional Naples, Italy; and M. Gene Bond, tion, and Daniel L. McGee of were 55 percent less reactive changes in the arteries of these director of the Division of Vascu- Loyola University Stritch School than blood vessels in children persons at an early age. lar Ultrasound Research at Wake of Medicine. with no parental history of heart The study, which involved re- Forest University Baptist Medi- attack. "This was not a measure- cruitment of children and young cal Center, were major contribu- ment of clinical disease," adults with and without parental tors to this study. Richard F. Gillum, Cuong V. Vuong and Clifford L. johnson, all of the ational Center for Health Statistics, Centers for -LOIS BAKER Results showed that partici· .. tions and need to "The parent's Ml their kids," says Maurizio ; clinical implica- six years. coronary heart disease," Sempos needs to be done to study this issue in women and minorities." ture and tunction. "These normalities known says, adding that " more research blood- CD LOI'i BAK~R searc 1Vi11ter 2001 laflale Hysiciaa 33 �-- ---- - --- --- --- -Mark vour calendars " Edmond J. Gicewicz In nineteen hundred and fifty-six we tried to learn to heal the sick. In the year of two thousand one let's get together and have some fun. Howard C. Wilinsky Here's what your reunion chairs have to sa The 40th reunion approaches. So much to do. So little time. Join the celebration! Louis J. Antonucci let's toast the new millennium together. After Jared C. Barlow all, it's over one·haH a century since we gradu· Thirty-five years-boy, have there been changes ated. See you in Buffalo. in all our lives. Come share and reminisce with your old classmates. Transit Valley Country Club, April 28, 2001. Allen L. Goldfarb Joel H. Paull Thirty years is a long time. let's definitely make sure we get together this year. We'll be in touch Robert E. Ploss let us all get together for our 50th and remi· with the details. nisce about our good years in medicine. looking forward to renewing old friendships and "re-living" some of our most fonnative years. See you there!-R. Ploss Linda Wild Don't put off-now is the time to decide to aHend our 25th reunion. Come back, renew old friendships and catch up on everything new in Buffalo and at the medical school. II f fIll PI J I i C iII i~ 1 n I cr 2 0 f) 1 �Sta•I•J L. l•llewslll £11011111-' ........,. c- ..... ...... _....a ............... ,.. .......... ....... ,.. ...... 15111 ....... ......,, . ., .... ..t I • rs Cell••• I. attl ere .l•••lfer H••lll•ll Ferrare , .............. . _ _ . . . . . . . . . .1... I •• I ...., Ul'. 1............ . . to a...r'IL- ,_.lllllllll,. lta""\1_....._.,..... 11,..._ S.•ferll H. LeYJ , ••• c......... ' -'-.;..);...._j , . . . , . . . . . . . . . . , . . ............. . . . . , . . ... ... ...., .. ......., c- ............... cllldl ., ................. s.e,.. ..... .... ........ - lrla .1. ll•t•l ...... ,....c..,_ ..... ., ...... .......... A plan for living. Hospice really is a plan for living. And the sooner you call, the sooner we can help you put that plan into action - with emotional support, pain management, in-home care anything you need to keep enjoying life. Call 686-8077. T H E CEKTE R FOR H1SPICE& PAlLIATIVE CARE www.hospicebuffulo.com ltffah Urslclu II �- - -- --- - - - ~-- - --- --- . - -- Dear Fellow Alumni, Fl' \ l \K.S AGO, I \PI'ROACHI D DR. JAc K RICHFk (then- associate dean for alumni affairs ) and asked him about my doing some work in the medical school. Jack and I had been friends for a number of years, but even he was curious as to why I needed "another job. " He knew I was very busy with my practice and my wife and four sons at home. I told jack that after years of being on hospital committees and attending insurance company meetings and other medically related events, I needed a change. By joining the Medical Alumni Association, I felt I could learn a little about what was going on in the school and see if I wanted to do more. Indeed, my tenure with the Medical Alumni Association has been a very fulfilling experience. In today's world, especially in New York, most of the medical establishments are in turmoil. It seems almost everyone is loosing money, suing someone or is being bought and sold. There are constantly new rules, new players and outrageous situations with which to deal. The one constant for all UB graduates is the medical school. The Medical Alumni Association is our fraternity; the school, our house; and all the alumni , our "brothers and sisters." Sure, the school has its problems, but it will always be here and it is one place we are alwa ys welcome. With various opportunities in every department, there are many avenues to develop an ongoing relationship with our school, something we all need to do. Anyone wishing for more information, please call the Medical Alumni Association Office at (716) 829-2778. So, remember to support your school. join the Medical Alumni Association; become a lifetime member. Be healthy and happy. jOHN 31 p~ JS i Ci I I 1\!irrter 2 0 0 0 j . BODKIN II . MD President, Medical Alumni Association �C L A S S 0 T E S 1950s 1960s Robert A. Benninger, MD Franklin Glockner, MD '60, '50. Cape Coral, FL, orthopaedic surgery, "I am acting my age; no more flying or sailing. Assistant Pastor at Calvary Wesleyan Church." Truno, MA, orthopaedic surgery. "I retired as chief of orthopaedics, Albany, VA, 1998." E-mail is: glockner @medicine. net. Alfred E. Falcone, MD '50. Francis J. Klocke, MD '60, Jamesville, NY, plastic surgery, "Love you all! Retired!" E-mail is aefalcone@aol.com. Chicago, IL, internal medicine and cardiology, writes: "I work for Northwestern University Medical School, where I am a professor of medicine and director of the Feinberg Cardiov cular Institute. My wife and I have five children ranging from 30 to 39 years of age." E-mail is: fklocke@northwestern.edu. Eugene J. Zygaj, MD '50, Lancaster, Y, OB/GY "I play softball four mornings a week. Our group consists of90-!00 men over 60. Great exercise and fun." Irving Joffe, MD '55, Boynton Beach, FL, radiology. "I am partially retired, working part time for the Palm Beach Health Department, State of Florida. Also doing volunteer work in several clinics." John H. Paterson, MD '55, East Aurora, NY, OBI GYN. "I retired in 1998, and am working part time for a rural hospital in Bath, NY-lowpressure position. I have a cottage on Keuka Lake." Leonard R. Schaer, MD '55, Alamo, CA. "I am retired." E-mail address is nanapop@hotcoco.infi.net. Pathologist Fierro, an Author's Inspiration experiences as the chief of a Statewide Medical Examiner System, the State factual errors. She is also the inspiration behind the fictional medic Kay Scarpetta, characterized in many of Cromwell's books. Andre D. Lascari, MD '60, Poestemkill, NY, pediatric hematology/ oncology. "I retired in Aprill999." Lance Fogan, MD '65, Edwin R. Lamm, MD '60, Lakeland, FL, general surgery, general practice, nursing home care. "I am vice president for Medical Affairs for Genesis Eldercare; my wife, Rosemary, obtained a PhD and teaches nursing. I have certification as a medical director from the American Medical Directors Association and am a member of the board of directors for the Florida Medical Directors Association; president, Central Florida Physicians Alliance," E-mail is: rslamm 1@aol.com Valenc ia, CA, neurology, writes: "I retired in 1997. I'm teaching UCLA neurology residents two months a year. I fill in occasionally when needed at my former med group offices, take classes, travel. I haven't been bored yet!" E-mail is: lfogan@aol.com. Dean Orman, MD '65, Clarence, NY, internal medicine/ gastroen tero 1ogy, writes: "My wife, Donna, graduated from UB medical school in 1984 and practiced with an HMO for II years. Both daughters graduated from UB medical school and are practicing pediatrics. Whitney married a classmate, Andrew Feinberg, whose father and I were also classmates (Mike Feinberg)!" 1970s James M. Baker, MD '70, Poulsbo, WA, family practice, writes: "I worked in small towns all these years but have been forced financially to join a large group where I work less and make more. My youngest is graduating from college this year. My wife and I are active in church and enjoy the childless phase of life." E-mail is: baker poulsbo@pol.net Carl Ellison, MD '70, Tulsa, OK, Pediatrics, writes: "I retired from the U.S. Public Health Service in 1998 after 21 years. I am working for the Cherokee Nation as a primary care pediatrician." Email is: carlellison @gateway.net. Alan J. Fink, MD '70, Wilmington, DE, neurology, writes: "I am still married to Phyllis after 31 years. Our oldest son, Greg, is in his second year of dental school at the University of Pennsylvania, and our younger son is attending I CoNTINUED or.; PAGE 38 assnotes \\'i11ter 2001 I a fla il H J Si c i I I 37 �~-- -- CLASS COr-.iT I~ UED F RO M P AC E 37 Washington and Lee University. " E-mail is drafink@aol.com. John D. Foley. MD ' 70, El Paso, TX, pediatrics, adolescent medicine, writes: " I retired from the U.S. Army with 22 years of active duty in I 995. I am currently on the fu ll -time faculty at Texas Tech University H ealth Science Center, as an asssociate professor of pediatrics and the director of adolescent medicine." E-mail address is john52l6 @aol.com. - -- ----- - --- -------- I NOTES Jan M. Novak. MD '70. Williamsville, Y, gastroenterology, writes: "My son David is a graduate ofUB Medical School ( 1997 ) and son joshua is a UB Medical Student (2003 }. Our daughter judith is a graduate of UB 's English department and is now a graduate student in Health Care Policy at American University in Washington, DC. " Hug11 A. Sampson. MD ' 75. Larchmont, Y, pediatric allergy and Immunology, writes: " My wife, Anne, and I have three children, ranging Terence Chorba, MD '79 from 13 to I 8 years of age. I am currently a professor of pediatrics and biomedical sciences, the chief of ICEP Leaders~ip Award pediatric allergy and immunology, the Kurt Hirshhorn Chair in pediatrics and the director of General Clin ical Research Center at Mount Sinai School of Medicine." E-mail is: hasampson @aol.com. 1980s Christopher S. Walsh. MD '85. medical director of the Cancer Center of Virginia, in Fredericksburg, VA, has developed studying the association between HIV and other opportunistic illnesses. Terence Chorba, MD national Center for HIV, The Project is based in ' 79, writes: "Over the STD, and TB Prevention. the Infectious Diseases years, I have had an Project Retro-CI is an Ward of the Centre enjoyable career in the epidemiologic, labora· Hospitalier Universitaire U.S. Public Health Ser· tory and clinical de Treichville, the larg- vice with several unique research collaboration est public hospital in assignments. We used between the Ministry of Abidjan, and currently to live in Kazakhstan, Health (MOH) of Cote has a full-time staff of where I started an office d' lvoire, the Institute of 140 persons. My wife, for the U.S. Centers for Tropical Medicine in Lindy, is a nurse practi· Disease Control and Pre- Antwerp, and CDC . It tioner working at the vention (CDC) to address serves as CDC's primary U.S. Embassy. Our three infectious disease issues research center for the children are busy learn- in all five Central Asian study of HIV infection in ing French and are pa- Republics of the former Africa. The work is fo· tient with our efforts to Soviet Union. Currently, cused on preventing HIV keep up their Russian. If we live in Abidjan, Cote in uninfected persons; any classmates come to d' lvoire, where I direct preventing HIV disease in West Africa, I would be Project Retro-CI on persons already infected glad to meet them and assignment from the with HIV; assisting the reminisce about old International Activities MOH in monitoring the times." E-mail address is Branch of CDC's HIV/AIDS epidemic; and chorba457@hotmail.com. the VEEBAAT TM System, which debuted at the American Society for Therapeutic Radiology and Oncology 2000 exposition (ASTRO 2000 } in Boston , MA, on October 22-25, 2000 . VEEBAAT-which is an acronym for Verify Event Entries Before and After Task-is a new electronic decision support system designed to he lp reduce the risk of error in the radiation oncology treatment process. Walsh developed the system because he found that the new sophisticated digital technologies susbstantial ly improved automation, but none maintained the human cross-check process in a manner �that enabled efficient manual recovery to safe mode of operation, or what he calls "Symmetric Recovery TM." For more information on the new system, go to www.veebaat.com, or call VEEBAA T Medical Technologies, Inc., at (540) 785-4488. Michael Rokaw, MD '88, writes: "I'm in private practice nephrology in Shreveport, LA. I' m enjoying the change from academic medicine. While at the University of Pittsburgh, I received a National Kidney Foundation Young Investigator grant, a Paul Teschan DC! research grant and a National Institutes of Health First Award for sodium channel regulation. I authored seven papers and over 20 abstracts. My daughter, Sarah, is four years old (in K4) and enjoys swim class, dance class and gymnastics. My wife, Amy (we celebrated our ninth anniversary in April 2000) and I are loving southern living. Miss my classmates, and think of them often." E-mai 1990s Joseph Accurso, MD '92, writes: "! completed a five-year radiology/ nuclear medicine residency at UB after my three years in the U.S. avy. I spent one year in Antarctica, providing medical care to the U.S. researchers. I have been married for almost five years (no children yet) and am now with the Mayo Health System at the Austin Medical Center in Austin, M . E-mail address is: accurso. joseph@mayo.edu. Cynthia L. Jenson, MD '92, writes from Bangor, ME: ''I'm in my second year of private practice in anesthesiology. We are finally settled after a long first year. Alexandra is five and a half and is in kindergarten, and Erica is two and a half. Mark is staying home and loving it." E-mail address is: cjenson@prodigy.net Henry V. Morelewlcz, MD '38 champion of children with dl-bUity \V in t er 200 1 1 111111 Pbpiciaa �Eugene M. Farber, MD '43, Internationally known dermatologist Arthur .,J. Schaefer, MD '47, pioneer In oculoplastlc surgery 1111111 npiciu \\ ' ~J te r 2 00 I �- Based on FIM " Data drill ttTheywere sergeantsand cheerleaders.'' -Frank Stelarski, stroke rehab patient, Harris Hill H.C.F Why do our patients have better rehab resutts compared to the national average? Maybe it's our staff ''They knew exactly how far to push me.'' says Frank Stelarski. ''But they also encouraged me every little step of the way. When you've been through what I have, that really means a THE lot." To leam more about the nationally recognized McGuire Rehabilitation ~cJNn~l(91'{_ CENTE~ Centers, call 1-888-POSTACUTE or visit www.mcguire-group.com. * *" AUTUMN VIEW • GARDEN GATE • HARRIS HILL \\ ' 1 11 1 c • r 200 I NORTH GATE I I I I I I I Pb J s i c i 1 n 4 ~ �p H A R M A c 0 p 0 E I A UB s !IJSfORY 0~ \IEDIC.INE COILECTIO"< PRF~L·rs I'I!ARMACOPOEI \ Digitally reproduced prints from a pharmacopoeia by Otto Karl Bei·g (I8IS· 1866) were on display last fall in University at Buffalo's Health SCiences Librai)' (HSL), South Campus. The botamcal show "as developed by the HSL and the umversity's i \1edia staff and is the fir;t in a senes of "Art in the Libi·ary" exhibits intended to promote the History of \1edicine Collection through the display and sale of reproductions of selected works. Fred Kwiecien and Don Tramoi· of i\1edia prepared the prints from the original art in the Berg volume. pub lished 1n Leipzig 111 1863. Pictured is Picea excel sa. H P OliO\ 0 I � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 2001 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2001- Winter Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v35n03-2001-Winter Table Of Contents A list of subunits of the resource. Warsaw after the War Writing Code Medical School Alumni Development Research Reunion Weekend Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v35n03 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2001 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/bcfff00ba3583dc294146c7b6185cfe0.pdf 52d832f26d014dd5c84fc1dd31f911f0 PDF Text Text �l1ffale P~ysicial ASSOCIATE VICE PRESIDENT FOR UN I \ ERSITY SERVICES Dr. C a role S mi t h Petro Dear Alumni and Friends, DIRECTOR OF PERIODICALS Sue Wue t cher EDITOR S t eplwnie A. Unger )I (, ! , the fi rst of the new millennium (depending, of course, o n how o ne defines the start date of a new millennium). We have just completed another highly successful orientatio n week for inco ming freshmen, which concluded wi th the now-traditio nal White Coat Ceremo ny. Dr. Robert A. Milch, MD '68, ART DIRECTOR/DESIGNER A lan ]. Kegler AssiSTANT DESIGNER Lynda Dona t i directo r of the Center fo r Hospice and Palliati ve Ca re in Buffalo, delivered an inspiring message to the first-year class and their parents, spo uses and friends. Dr. Do n Pachuta, MD '66, addressed the second -yea r students, focusing his comments on the humanistic philosophy that sho uld- must-underpin the physician's approach to learning and to practicing medicine. Do n is in the process of creating an endowmen t that will suppo rt an a nnual lectureship on the "humanism" underpinnings of medici ne. Students also received a copy of the new Code of Professional Conduct, published in an elegant booklet. Printing expenses for the booklets were underwritten by a generous unrestricted gift from Dr. and Mrs. Edward Shanbrom (Ed is an MD '51 alumnus who now resides in California). A special article on the code and how it was developed by our students last year will be presented in the winter issue of Buffalo Physician, which will also feature the complete text of Dr. Milch's talk. All in all, it has been an excellent start to the new academic year. This is the time of year fo r new arrivals to the uni versity. Dr. John Yeh joined us ea rlier in the spring as chair of Gynecology-Obstetrics. Even during this short period of time, the departm ent has undergone remarkable rejuvenatio n. In addition to four new faculty PRODUCTIO!'i COORDINATOR Cynthia Todd-Flick STATE l.JNI\ ERSITY OF NEW YORK AT BuFFALO ScHOOL OF MEDIC INE ~ND BIOMEDICAL SCIENCES Dr. / o lm Wrigh t , Dean EDITORIAL BOARD D r. B e rt ra m Portin, Chair Dr. Martin Brech e r Dr. H a ro ld Brod y Dr. Linda f . Co rde r D r. A lan f . D ri nnan D r. fam es Ka n ski Dr. Eliz abeth Olms t ed D r. S t eph e n Spa ulding Dr. Bradley T . T ru ax M s./ en n ife r Wiler Dr. Franklin Zeplowitz (besides Dr. Yeh}, the teaching programs at both the resident and medical student levels TEACHING HOSPITALS have received new life and there is an air of optimism and enthusiasm in the department. Erie Co unty .\fedica/ Ce nter Roswell Park Cancer In stitute Vetera ns Affairs Western New York Hea lthcare System Dr. Ken Blumenthal arrived in early August to assume the chair of Biochemistry. We are confident that he will grea tly strengthen this department, in terms of bo th its program and its wo rking relationships, and we all look fo rward to wo rking with him as he remolds this esse ntial basic-science department. In ea rly July, Dr. Elizabeth Capaldi joined the university as o ur new provost. For us, in the medical school, this is an extremely impo rtant positio n beca use it represents not o nly overall academic program leadershi p fo r the university, but also for the School of Medicine and Bio medical Sciences. This is a particularly critical period for the medical school as we attempt to remain current in teaching and resea rch yet accomm odate the buffeting fo rces that are all aro und us in the clinical enviro nment. One of the majo r tasks of the fall semester will be to fashion a durable affiliatio n KHHDA HI:A.IIII: T he Buffalo General Hospital Th e Ch ildren's Hospital of Buffalo Millard Fillmore Gates Hospi tal Milla rd Fillmore S ubu rban Hospi tal CATHOliC H fAITif Sr.\TF.\1: Mercy Hea lth System S ist ers of Charity Hospi tal N iagara Fa lls Me m orial M edical Cen ter ® THE STATE INIYUSIIY Of NEW YllliJIUIFlll agreement with Kaleida Health System (the merged Buffa lo General, Child ren's, Millard Fillmo re and DeG raff hospitals) . Central SUNY administratio n and community leadership will be very much involved in the process, which will likely chart the future directio n of o ur school and its clinical programs. No doubt it will be a fea tu red article in an upcoming Buffa lo Physician. We will certainly keep you posted. j OHN R. WRI GHT. MD D ean, Schoo l of M edicin e and Biom edical Scie n ces Buffalo Physician is published quarterly by the State Uni1·ersity of New York at Bujjalo School of Afedicit~e and Biomedical Scieuces and the Office of Pu/JiicatioiiS. It is sent, free of charge, to alumtll, facultj·, students, resiLICtJts, and friends. The staff rcscn'es the right to etfit all ropy aud submissions arrcpted for publiwtwn. T~ at Buffalo -:.:=:s University Tire State University ofNew York �VO L UME 35, p H y c s A Features 2 Internal Medicine's Man James P. alan's extraordinary contributions to his field and UB's Department of Medicine BY S .A . UNGER PHOTOGRAPHY 12 BY FRANK MILLER Eschewing Viewing Obese children learn to replace television with other activities BY S. A. UNGER PHOTOGRAPHY BY MARK DELLAS UB professor of pediatrics and psychology Leonard H. Epstein, PhD, has conducted pioneering research on childhood obesity for the past two decades. On page 12 begins astory about his current work aimed at teaching obese children to choose active behaviors over sedentary ones. COVER 16 Annual Faculty Awards 17 McAloon receives 2000 Humanism Award 18 Nielsen elected AMA's vice speaker 26 "Lonely for a 20 Auerbach wins jacob )avits Award 21 Hypertension redefined 23 Colon polyps unaffected by healthy diet Sciences Career Day a success White Coat Ceremony 25 Professors Albini and Gabrieli remembered Calling of My Own"-Umut Sarpel, class of2001, finds clinical rotations include an exercise in introspection PHOTO 29 Endowments crucial to chool's future 30 Listing of current endowments BY FRANK MILLER your UB classmates and other alumni N ��alkins certainly had this far-reaching goal in mind when he called • ' olan, but what he couldn't haw known at the time was that he was setting in motion a successful recruitment effort that would bring to the L'niversity at Buffalo a future chair of its Department of ~1edicine, and a man, who along with himself, would lead the department for a combined total of 3-l years. :\ot only would :\olan go on to work with Calkins to oYersee the growth of UB's Department of ~lediLine from approximateh- 50 faculty to more than 150, but he would also pia~· a leading role nationalh· in academic medicine, eventually serYing as president of the Association of Professors of ~1edicine and chair of the Board of Regents for the American College of Physicians. \\'ith his "official'' retirement from the State of, ' ew York in July 1999, • 'ohm brought to a dose a career in medicine that would have to be considered exemplary by any standard. Contributing to his stature is the fact that man\' of his colleagues and former students feel strongly that he will be remembered not so much for his long list of accomplishments as for his distinctly artful style of leadership-a stYle that could perhaps serYe as a model for any physician-leader today whose goal is to bring out the best in others under the most difficult of cirwmstanct>s. �The Early Years hen Calkins first approached Nolan about returning to UB, the university was still in the throes of adjusting to the enormous change it had undergone in 1962, when the University of Buffalo-a medium·sized private college founded as a medical school in 1846-was incorporated into the State University of New York (SUNY) system to form SUNY at Buffalo or, more simply, the University at Buffalo. Once the realities of this transition began to take shape, it soon became evident to everyone involved that the state was not just absorbing the buildings, faculty and staff of the University of Buffalo; it was also absorbing its remarkable history and ethos dating back 116 years to when the school was founded by such men as Millard Fillmore, James Platt White, Austin Flint and Frank Hastings Hamilton, all of whom went on to make their mark in the annals of American medicine. Added to this stir of proud history and state incorporation were the sweeping changes taking place in academic medicine at the national level. In large part, these changes were fueled by an unprecedented influx of dollars from the National Institutes of Health into the nation's medical schools, with the goal of promoting the growth and development of academic departments capable of fostering excellence in research. If a medical school were to compete nationally with the lulfalo Hpicin Autum11 2000 rush to develop sound academic departments that boasted the best and brightest in clinical and research faculty, then the best and the brightest it must recruit. At the time Calkins first contacted him, Nolan had just completed a clinical fellowship in medicine in the Liver Study Unit at Yale University's School of Medicine and was finishing up as chief resident in medicine, all the while contemplating the likelihood that he would set up practice in ew Haven, Connecticut. During his internship a few years earlier, he had met Christa, a student from Sweden who was studying microbiology at the university, and the two had married and begun a family. Returning to Buffalo was not in the picture. Calkins himself had come to Buffalo from Harvard University in 1960, when he was chosen to succeed the eminent internist John Talbott, MD, who had left UB to accept the editorship of the journal of the American Medical Association. While at Harvard, Calkins had become acquainted with Dr. Paul Beeson, professor and chair of medicine at Yale, whom he had talked with on several occasions about career opportunities. When Calkins was first offered the job as head of medicine at Buffalo General Hospital, he turned to Beeson for advice about whether or not he should accept the position. "Dr. Beeson had some connection with Buffalo," Calkins recalls. "I think his wife was from here. When I asked him what he thought about my coming here he said, 'Absolutely! It's going to be a great �The establishment of the division of endocrinology marked the stan of abuilding program that would continue for the next 17 years as 13 major divisions were gradually formed within the Oepanment of Medicine. opportunity and challenge. You get up there and get things going and then we'll exchange residents. ' "Well, what more terrific confidence could you give any young man coming into a program by saying on behalf of one of the major departments in the country that the chair would exchange residents?" asks Calkins. CE I B UFFALO, Calkins set to work identifying potential areas of growth and concomitant recruitment needs. At the time, the Department of Medicine for the university was cochaired by the heads of medicine at Buffalo General Hospital and Edward ]. Meyer Memorial Hospital (now the Erie County Medical Center). Calkins's counterpart at E. ]. Meyer Hospital was the legendary clinician David K. Miller, MD, the first full-time faculty member in medicine at UB, who had been head of medicine at the hospital since 1940. For many years, the two hospital-based departments operated largely independently; however, with the arrival of Calkins and the incorporation of UB into the SUNY system, the two heads of medicine began to acknowledge the necessity of working more closely to develop a university-wide department. In 1968, Miller volunteered to step down as cochair of the department. Following a national search, Calkins was chosen to lead the department, with the aim of developing it as a unified entity. From the time of his arrival at UB eight years earlier, Calkins had aggressively taken the lead in recruiting new faculty for his group at Buffalo General Hospital, which had a good base of clinically oriented faculty but a very limited number of research-oriented faculty, as was also the case at the E. ]. Meyer Hospital. "We were in a new era of medicine, where the emphasis was on integrating clinical and basic-science approaches," recalls Calkins. "We identified several areas where we thought if we put all our strength and energy into building in-depth, we would be able to develop programs that could be nationally competitive and attract major funding from the NIH, as well as set the standard for quality of care and for the teaching of students and house staff. " At the time, Calkins estimates that there were only about three or four facult y members in the Department of Medicine who were involved in focused research efforts. The first area that was identified as having a strong basic-science foundation upon which to build was endocrinology. Because the researchers in this group-most notably Dr. John Plager-were located at Roswell Park Cancer Institute, Calkins led an effort to bring them into the Department of Medicine at UB and give them faculty titles. He then recruited Dr. Keith Vance to head the new division. The establishment ofthe division of endocrinology marked the start of a building Alltllmn 2000 luffal1 Physician 5 �- -- - --------------------------------------------~~=---~~- program that would continue for the next 17 years as 13 major divisions were gradually formed within the Department of Medicine. medical school's teaching programs and faculty are disbursed among Buffalo's major community hospitals. For the Department of Medicine, this meant faculty would continue to be located in three hospitals: Buffalo General Hospital, Erie County Medical Center and the Department of Veteran's Affairs Medical Center. "On balance, I think that a university hospital is a tremendous advantage," says Nolan. "And I have always pushed for one, as did Evan Calkins before me. I never made it a secret that I thought that was the way we ought to go. But, early on--in the early 1970s--it was clear it wasn't going to occur, so then one had to accept it and make the best of it, and I think we did." Time to Bring the Talent Home EVERAL YEARS INTO THIS EFFORT, Calkins says he and Vance "got pretty lonely in coordinating the broad teaching responsibilities designed to integrate the basic sciences with clinical medicine." Thinking it time to bring someone on board who could help them with this work, Calkins again turned for advice to Yale's Paul Beeson, who recommended olan, his former chief resident. In the years ahead, olan and Calkins would fondlyand humorously--remember the recruitment effort that ensued. "We didn 't have much money back then and nobody would give us departmental funds for this type of thing, so when Jim came to Buffalo, we took him to a restaurant in the Southtowns where, for something like $3. 75, you stood in line and got your own food. Years later, when Jim and I were actively recruiting somebody and were trying to pull out all the stops, we took the person out for a nice dinner. Later, in an attempt to describe the dinner to someone, Jim joked, 'You know, it was the kind where you get waited on,"' Calkins recalls with a laugh. Smorgasbord dinner aside, Nolan found himself swayed by Calkins and soon he and his family were on their way to Buffalo, where he had accepted a dual position as associate professor of medicine at UB and clinical associate in medicine at Buffalo General Hospital. "Evan Calkins is a very dynamic recruiter," says Nolan, adding that the early 1960s were "very heady times for the university. SUNY at Buffalo was to be the flagship campus--the 'Berkeley of ew York State'--and it was a timeoftremendous growth." olan further explains that one of the great attractions that drew him back to Buffalo was the plan to build a new university/county hospital on the South Campus, at Bailey and Winspear, but recounts how, over the years, that idea--as well as a whole series of plans to relocate the medical school--was scuttled. It wasn't until the early 1970s that administrators finally made the decision not to build a university hospital and instead put into place the still extant affiliated-hospital model whereby the 6 lulfala Physician A 11t11 11111 2000 A Cool Head on the Hot Seat " AKI G TH E BEST OF IT," according to Calkins, involved putting Nolan to work using a special talent he was discovered to have soon after his arrival at UB. "We didn't have the power structure to work with that's in place today; we had to be on the various hospital committees and win by persuasion, by political savvy, in a sense," Calkins explains. And, as luck would have it, he and others soon recognized that olan had a remarkable talent for sitting on these committees and effectively lobbying for the needs of the Department of Medicine. "Jim is easily the best committee man that I have ever, ever seen," Calkins says. "We knew that if we put him on a committee, we could be certain that it would come out exactly the way the Department of Medicine wanted. Jim would sit down with all these senior people and he would represent our position by using his personal interdynamics, by taking a modest, friendly approach, never overemphasizing anything, not getting purple in the face and not pounding the table. This is just who he is and everybody liked and respected him very much and would, in large part, agree with the steps he proposed." As time went on, according to Calkins, olan grew increasingly practiced with committee work, and his skills became invaluable to the department and to the school of medicine. "He of course got better at it because we were always giving him the hot seat," Calkins recalls with a chuckle. "We didn' t waste him on the obvious [committees]. We put him on the ones where the whole future of the department would hinge. He was always much better at this work than I was because I would come in and be much more confrontational, more demanding, more un yielding. "This talent of Jim 's was a lead feature for him throughout his career," he adds, "and I know the dean on several occasions appointed him to chair very tricky committees involving subtle areas of great importance �" Making the best of it," according to Calkins, involved putting Nolan to work using aspecial talent he was discovered to have soon after his arrival at UB. to the school. Also, when he became involved with the American College of Physicians and the Association of Professors of Medicine he was able to do the same kind of work wonderfully well." Building on Buswell Fellowships Y THE LATE 1960s, the Department of Medicine faculty at Buffalo General Hospital had grown out of proportion to the needs or scope of care at the facility. "We were really bulging at the seams. We must have had at least 25 well-established young scientific doctors who had achieved national recognition and were getting major grants," recalls Calkins. At the same time, the county hospital was struggling financially and its faculty in medicine remained primarily clinically focused. Given this situation and the resignation of D. K. Miller as cochair of the department, the time was right, according to Calkins, to begin to bring the county's faculty into the new model for the department. To accomplish this complex transition, Calkins decided it was necessary to move a third of the department's fulltime faculty over to the county hospital. Also at this time, the decision was made to move the department's administrative offices to the hospital, where they remain today. A key factor that made it possible for the Department of Medicine to continue to grow over the next decade was the availability of Buswell Fellowships through the school of medicine. "One of the main reasons why the timing was right for what we were trying to do is that we had about 15 of these faculty fellowships at the assistant professor level, which were given on the condition that the faculty coming in spend 90 percent of their time on research during their first two years," explains Calkins. "So we figured that, in time, the financial support would begin to grow as these scientists became more clinically oriented, got more Autumn 2000 11 flail n y sic i a1 1 �patients coming in, developed as teachers and won recognition for their research activities." The plan, therefore, was to make full use of the Buswell Fellowships to recruit future division heads who would "get their feet on the ground while Jim and I were carrying out the core work of the department," Calkins recalls. In addition to olan, Calkins was working closely with Dr. Thomas Tomasi, who had joined the department in the early 1960s as head of immunology and was instrumental in recruiting key faculty to the department. "Tom Tomasi was a major colleague of ours for eight years. He played a very, very important role in the department during those early years because he helped us identify the key frontiers of scientific medicine and the people we should try to bring into the department," says Calkins. In all, the effort of these and other leaders in the department met with extraordinary success, and today both Calkins and olan proudly point out that of the core group of faculty brought into the department during their combined tenure, some 25 have gone on to chair departments or hold similar appointments elsewhere around the world (see list on page 10). Another area in which great strides were made involved the recruitment of talented residents, according to Calkins. "Dr. olan and Vance and I made a tremendous effort to recruit top-notch house staff in these early years because we recognized that some of the most effective teaching of medical students is carried out by these individuals, who also serve as role models for the students," he explains "So at a time when internal medicine occupied a particularly strong place in the eyes of medical students and house staff, we succeeded in attracting an exceptionally strong group of graduates from UB, as well as from such schools as Harvard, New York University, Temple, johns Hopkins and the University of orth Carolina," he adds. The Heart and Science of Medicine 1969, OLA WAS appointed professor of medicine in the department, and in addition to his growing administrative and teaching duties, he also continued to lead an active research program in liver disease and the effects of endotoxins. In the 1970s, he and his group made key discoveries that led to a better understanding of the role these toxins play in liver disease when the liver is affected by alcoholism and hepatitis. They also determined that antibiotics can worsen some liver diseases by increasing endotoxins. olan had also by this time established a stellar reputation as a teacher and clinician. "Jim is one of the most informed internists I know," say Robert Internal Medicine House Staff, 1976. A complete listing of those pictured here is not available; Klocke, MD '62, current chair of the Department however, the following individuals have been identified: Susan Arbuck, Thomas Avery, Raymond W. Bergenstock Jr., James Cirbus, Richard Curran, Richard Dolinar, Helen Findlay, Geraldine Kelley, of Medicine, who came to UB in 1970 when the Steve Lanse, Alan Leibowitz, Trudy Masters, Nancy Nielsen, James P. Nolan, MaHhew J. O'Brien Jr., department was just beginning to be more inRichard Rosenfield, Marilyn Telon, Henri T. Woodman, AntoineHe Wozniak. volved with the county hospital and who, in 19 78, was named head of the Pulmonary Division there. "He knows a lot about everything, not just his specialty of liver disease, and he is an excellent teacher. "I think the students who really appreciated him the most over the years were the residents, who benefited from his impromptu teaching at the bedside," Klocke adds. "He has such vast knowledge and yet organizes material very well when teaching. Also, because he doesn 't just focus on one thing and then another, he is able to see the big picture." "What's been important to me about teaching, in addition to the content itself," says olan, "is that, hopefully, you can mold individuals into compassionate physicians. And I have always tried to stress this when dealing with patients and with students-the idea of professionalism, of compassion and empathy." olan's gift for teaching both the "heart and science" of medicine resulted in his being twice chosen by residents to receive UB's coveted White Coat Award, which honors "excellence in teaching 8 Buffalo Hpician A utum tz 2 0 00 �and outstanding contributions to the education of house staff." Today, olan says he considers these awards to be among his most prized honors at UB. Creative Funding and Support for Faculty KEEP! G WITH HIS GROW! G stature as a teacher, researcher and administrator, Nolan was named vice chair of the Department of Medicine in 1973 and acting chair in 1978, when Calkins retired from that role. A year later, he was appointed chair of the department, a position he held until1995. "The first few years as chair of a big department like that are tough because you have to prove yourself, but then, over time, you gain confidence," says olan. "But the major thing I had going for me from the start was that I had good division heads and clinical directors, so after a while I was in a position to delegate and to do other things as well. Really, I was blessed with very, very good associates who took on major roles in both the educational and the research aspects of the department." While the department's faculty were exceptional, olan admits that their being housed in three hospitals did pose an ever-present challenge for him. "With the resources of a full-time faculty spread throughout three community hospitals, it's difficult to achieve a critical mass in any one location," he says. "This is especially true for the smaller divisions. It was also difficult to obtain the laboratory space that was needed for the department." An even larger dilemma for Nolan throughout his tenure as chair, however, was the chronic shortage of funds brought about by severe cutbacks from the state and Medicare, in combination with new fiscal austerities imposed by managed care. "Throughout the 1980s and '90s, the hospitals in Buffalo were very badly squeezed-as were hospitals everywhere," explains Nolan, and this directly impacted the medical school and Buffalo's entire health-care community in ways that hadn't been felt before, he contends. "There were times in the '60s and '70s and even into the early '80s, when the hospitals would get into some financial trouble and the university would just pick up their lines, and there were times when the university would get into trouble and the hospitals would step in. Nobody's helping out now; everybody's having to look out for themselves, and over the past 10 years it's become a tremendously competitive environment. "Even though we are a state school, the percentage of our budget that comes from the state for salary purposes is only about 15 percent; that's not a lot," he continues." owadays, over 50 percent of the compensation for the full-time faculty, even in a big department like medicine, comes from practice dollars, and those dollars are increasingly hard to come by." olan explains that these and other funding pressures have in turn "greatly impeded our ability to teach medical students in an ambulatory setting because the practicing physicians, who have always been supportive of teaching students in their offices, are having increasing difficulty doing this because they are under such tremendous pressure to process patients at a rapid rate." Given the pervasive funding shortages olan had to confront as chair, Klocke says it's a tribute to him that the department continued to grow-albeit not at the earlier pace-and that the faculty, for the most part, functioned as a cooperative and cohesive group. "Jim was very creative when it came to finding funding," he says with a smile. "He would go around and sell people on an idea, and then get a piece of funding from here and a piece from there and put together all the little pieces. I was able to recruit an excellent person from Yale-Jamson Lwebuga-Mukasa, who's at Buffalo General now-because Jim helped convince the hospital and the dean to make an investment. He was always very supportive in this way. "Too, Jim has a knack for making people feel wanted, and he is very good at acknowledging people's contributions in a quiet way," Klocke explains. "Actually, everything he does is done in such a low-key, gentlemanly way," he adds. "I have heard people who did not agree with him, but I've never heard anybody say he wasn't a nice person. Even when he had to make tough decisions that somebody didn't like, you knew it was never personal. "So even though there were huge cutbacks from the state and lots of financial and administrative problems when he was chair, he kept everybody going, and our department actually continued to Aut um 11 2000 II f f If I H JS i C iII 9 �grow. And thereally nice thing for me is that I inherited from him a happy and extremely cooperative department." When asked what he consider to be highlights of his tenure as chair, olan says he is in many ways most proud of the research efforts of the department. "At one time, we had more IH dollars than any other department in the four [SUNY] schools," he says, "and that was a source of great pride for our department-that we were able to attract people of that stature. And I think, as such, we developed a very good national reputation for the department as a place for young faculty to work. And during my time, as well as Evan's, we exported some very good people to other very good schools." In addition to this, olan says that he is also proud of the work he did in support of affirmative action during the 17 years he was Former Faculty Members chair. "We were all involved in affirmative action at that time in the sense that we made a real effort to attract medical students from the minority population who were superb," he explains. "Buffalo did extremely well in terms of percentages in this --area~he add,-'' and I'm proud of that." A Mentor and a Model N THE EARLY 1990s NOLA became an increasingly visible leader in academic medicine in his role as president of the Association of Professors of Medicine, a group comprising chairs of medicine across the nation, and as chair of the Board of Regents for the American College of Physicians. Both organizations provided a forum for him to address a central concern he had at that time: the trend toward specialization in internal medicine; in particular, the fact that 70 percent of all medical-school graduates were going into the specialties and only 30 percent into primary care areas. Many people feel that the energy and attention Nolan dedicated to this problem while a leader with both these organizations contributed significantly to the reversal of this trend by the close of the decade. "If you look at his writings from the '90s, you'll see he was writing very frequently in the Annals of Internal Medicine and other journals, talking about the value of the internist," says Klocke. "And as president of the Association of Professors of director, Fogarty Robert A. Murgita, chair and pro· International Center and associate fessor, Department of Microbioi· Gerald Keusch, T HE FOLLOW! G IS A LIST of former fac u lty members in Un iversity at Buffalo's Department of Medicine who hold or have held positions of chair (o r comparable positions). James C. Allen, chair, Department David R. Dantzker, president, Long of Medicine, University of South Island Jewish Medical Center, New Carolina; subsequently, vice presi· Hyde Park, New York director, International Research, ogy and Immunology, McGill Uni· National Institutes of Health, versity, Montreal, Quebec Bethesda, Maryland James P. Nolan, chair, Department Frances J. Klocke, director, of Medicine, State University of New Feinberg Cardiovascular Research York at Buffalo, Buffalo, New York Institute, Northwestern University Medical School, Chicago, Illinois dentfor medical affairs, Roper Hos· Medicine, Albany Medical College, Michael A. Apicella, chair, Depart· Albany, New York ment of Microbiology, University of Iowa College of Medicine, Iowa Robin DeAndrade, ment of Physical Medicine and Re· of Medicine, Atlanta, Georgia president, McMaster University 10 professor of medicine, Tufts-New ment of Medicine, State University England Medical Center, Boston, of New York at Buffalo, Buffalo, Massachusetts Thomas Provost, ment of Medicine, University of HamiHon, Ontario Illinois, Chicago, Illinois A!II!IIIITI 2000 chair, Depart· Albert F. LoBuglio, medical direc· ment of Dermatology, Johns Hopkins tor and professor, Comprehensive University, BaHimore, Maryland Cancer Unit, University of Alabama, Birmingham, Alabama Lawrence Frohman, chair, Depart· fessor, McMaster University, luffllo Hysicin chair, Depart· chair, Depart· habilitation, Emory University School Medical Center; currently, pro· Robert A. Klocke, New York City, Iowa John Bienenstock, dean and vice director, Digestive Disease Research Center and Paul J. Davis, chair, Department of pital, Charleston, South Carolina Andrew Plaut, �Medicine, which is a small but very influential group, he certainly played a major role in shaping the approach that chairs of medicine in this country took in terms of teaching primary care and what roles the departments of medicine were to play in this." Through the American College of Physicians, olan also participated in the national debate taking place in the early 1990s over President Clinton's proposed health-care plan. "This was a very exciting time on several points," he says. "One was the issue of needing to train more general internists, and the other was the whole question of universal health care. And this [latter] issue is one the college has always been in favor of; we believe everyone should be insured, so while I was chair of the Board [of Regents] we had meetings at the White House. I think many of us, myself included, were very disappointed that we didn't get something out of that," he says. Klocke feels that Nolan's national visibility as a leader in academic medicine has been invaluable to UB faculty, not only because it has "opened a lot of doors," but because it has provided a model of public service for others to emulate. "When I was offered the position of editor of the American journal of Respiratory and Critical Care Medicine in 1989, Jim was entirely supportive of my taking on this responsibility, even though it took up an enormous amount of my time for five years," says Klocke. "He felt it was important for my career, as well as for the university, and he was happy for my success, just as he always was for others." Since his retirement from the state in July 1999, Nolan has continued to write and see patients on a consulting basis. At Klocke's request, he is also helping with recruitment for the department and has agreed to continue serving as acting head of the Division of General Medicine until that position-which was vacated two years ago-is filled. Klocke says Nolan has been extremely supportive of him since he became chair of the department but, at the same time, has been careful not to exert his influence on the day-to-day operations of the department. "Jim has been very helpful to me since I became chair, yet he purposely moved his office to another floor so he wouldn't be around, wouldn't be in a position to second-guess me," says Klocke. "However, when I need advice, he's there for me. And on a couple of occasions, he's just stopped by and said to me, 'I know people don't come in to tell you that you're doing a good job, but I just wanted to let you know that things have gone well.' "That's been very heart Special thanks to University warming," says Klocke. Archives, Dr. Evan Calkins But coming from the "best and Dr. \Villiam A. Fleming committee man ever"-and for their assistance in locating a gentleman-certainly not photographs for this article. very surprising. 4D chair, David Schmidt, chair, Department Roswell Park Cancer Institute, This list was compiled by Department of Medicine, of Family Medicine, University of Buffalo, New York, and chair, De· drawi11g on the collective University of California, Connecticut partment of Molecular Medicine, mem ories of current and San Diego. (Dr. Ranney was Farmington, Connecticut State University of New York at former members of UB's Buffalo, Buffalo, New York. Department of Medici11e, mzd Helen M. Ranney, Health Center, the first woman to chair a department of medicine in the John B. Stobo, chair, country.! of Medicine, Johns Hopkins Uni· Philip H. N. Wood, chair, Depart- to ensure its accuracy and versity. Currently, president of Uni· ment of Epidemiology, University completerzess. Corrections or Morris Reichlin, vice president for versity of Texas Medical Branch, of Manchester, England commerzts are welcome and research at Oklahoma Research Galveston, Texas. every attempt has bee11 made Department can be sent John R. Wright, chair, Department Foundation, and George via e-mail to bp-notes@buffalo.edu; or by Lynn Cross Distinguish· Thomas Tomasi, chair, Department of Pathology, State University of writing to editor, Buffa lo ed Professor, University of Immunology, Mayo Clinic/Medi· New York at Buffalo. Currently, Phys icia n, 330 Crofts Hall, of Oklahoma, Norman, cal School, Rochester, Minnesota dean of SUNY at Buffalo's School U11 iversity at Buffalo, Buffalo, Oklahoma (the first department of immunol· of Medicine and Biomedical Sci- NY 14260. ogy in the country I. Subsequently, ences. (Dr. Wright was a Buswell David Sackett, chair, Department director, Cancer Center, University Fellow, working on amyloidosis of Epidemiology, McMaster Univer· of New Mexico; chair, Department with Dr. Evan Calkins from 1965-1967.1 sity, Hamilton, Ontario. Currently, of Cell Biology, University of New chair of the Department of Epide- Mexico, Albuquerque, New Mexico; miology, Oxford University, England. president/chief executive officer, Alllllmll 2000 4D l t ffa le Hys i c i u 11 �ST 0 R Y By S. A . UNGER • Obese children learn to turn off television is helping obese children learn to choose healthy behaviors. �high-calorie foods are red and should be eaten rarely; moderatecalorie foods are yellow and can be eaten in moderation; and low-calorie foods are green and can be eaten freely. According to Epstein, obesity carries the same risks for children as it does for adults: an increase in health problems that include diabetes mellitus, hypertension and high cholesterol. In addition, obese children are at higher risk of remaining so as adults. "Obese children who become obese adults have a very difficult time losing weight and maintaining a normal weight; only a very small percentage are successful over the long run," he says. "So most researchers feel the best hope is to catch kids early and try to prevent them from becoming overweight adults." As part of their ongoing effort to devise ways to "catch kids early," Epstein and his group are currently conducting a study aimed at better understanding how sedentary behaviors can be modified to treat and prevent obesity in children. In work funded by a 1,050,688 grant from the ational Institute of Child Health and Human Development ( ICHHD) of the IH, the researchers are specifically interested in discovering ways to modify a constellation of sedentary behaviors that are especially popular among today's children: watching television, playing video games and surfing the Internet. Sedentary Behaviors Move to the Foreground I n describing the stair-step approach he and his group have taken over the past 20 years to arrive at their current focus on sedentary behaviors, Epstein explains that their first studies- begun in the early 1980s at the University of Pittsburgh-demonstrated the efficacy of treating a child and his or her family together, versus just treating the child separately. From there, Epstein's group focused their attention on trying to understand the role of physical activity in treating obesity. "We started off with a review of the literature on activity, and it suggested that lots of people who begin exercise programs do not maintain them," he says. As a result, his group developed the idea of "lifestyle exercise." Instead of trying to get people to adhere to a very high-intensity exercise program, lifestyle exercise encourages changes in everyday behaviors; for example, parking farther from a store entrance and walking. In the early 1980s, Epstein's group completed the first randomized study done on a lifestyle exercise program and demonstrated that this approach toweightlossworks better than a traditional exercise program. Bythemid-1980s, therefore, Epstein's research had resulted in the establishment of innovative exercise and diet models specifically geared to treating obesity in the pediatric population. "About that time, however, we started to recognize that even though lifestyle exercise and diet were very useful, lots of kids still preferred being sedentary, so then we started to look at the competition-and the competition, of course, was television," recounts Epstein. THE RESEARCHERS ARE SPECIFICALLY INTERESTED IN DISCOVER! TO MODIFY A CONSTELLATIO POPULAR AMO OF SEDE G TODAY'S CHILDRE GAMES A TARY BEHAVIORS THAT ARE ESPECIALLY :WATCH! D SURF! G WAYS G TELEVISION, PLAY! G VIDEO G THE INTERNET. A utum" 2 000 l 1ffal1 Pbysician 13 �This realization was based on pioneering work being conducted at that time by two Harvard researchers, William H. Dietz Jr., MD, PhD, and Steven L. Gortmaker, PhD, who "were the first to effectively argue that sedentary behaviors-television viewing, in particular-were a risk factor in the development of obesity," according to Epstein. They did this, he says, by conducting studies that showed that sedentary behaviors replace high-energy activities while at the same time promoting increased caloric intake in response to commercials for food. B Behavior of Choice ased on Dietz and Gortmaker's studies, Epstein became interested in the idea ofbehavior-choice theory, and in the early 1990s he and his group began a series of studies aimed at better understanding how sedentary behaviors can be modified within the context of this theory to treat and prevent childhood obesity. Again, the sedentary behavior they were particularly interested in studying was television viewing because "it is estimated that by the time children today graduate from high school, they will have spent more time watching television than they spent in class," says Epstein. "Behavioral-choice theory recognizes that kids have a choice between two incompatible behaviors-they can either be active, or they can be sedentary," explains Epstein. "Therefore, we started to look at understanding how people allocate choicehow they decide to do things-and in working with behavioralchoice theory, one of the obvious things suggested by it is that if two things are incompatible, you can either reinforce the one you want, or you can reduce access to it." Subsequently, Epstein set up a study comparing weight loss between three groups: one reinforced for an increase in exercise; 1 .. Buffa a Pbysicia1 A ut11m11 2 000 a second, for a decrease in sedentary activity; and a third, for a combined approach. To reinforce behavior, contracts were set up between the children and their parents that enabled the children to earn points toward rewards that were activity based, as opposed to money or food; for example, going to the zoo with their parents. The results of the study, published in Health Psychology in 1995, showed that the children who were reinforced for being less sedentary- e.g., less television and fewer computer games- had a bigger weight loss than the children who were reinforced for increasing their physical activity. They also had equal fitness changes and a better adherence to the diet prescribed to all study participants. This study, which was the first to manipulate access to television, suggested "that at least this was an alternative approach to trying to work on getting kids to be more active," says Epstein. In an effort to replicate these findings and better understand how the children made their choices, Epstein and his UB group recently completed a study titled "Exercise in the Long-Term Control of Childhood Obesity," which was funded by a $1,073,213 grant from the NICHHD. Participants in this study were randomized to either increase physical activity or reduce sedentary behavior and, in addition to keeping a log on their exercise and food intake, they wore a beeper-size device called an accelerometer that provided the researchers with data about caloric expenditure. "Again, we found that the group that reduced sedentary behavior had substantial decreases in weight loss and improvements in fitness that were maintained over the two years we followed them," reports Epstein. "We also found that in the kids who reduced their sedentary behavior, about one-third of the time they substituted the behavior with physical activity, which �is exactly what we wanted. The other two-thirds of the time, they substituted it with other sedentary behaviors." Epstein emphasizes that the children were not being told what they had to do; instead, they were being rewarded for choices that freed up time for them to fill any way they chose. "Everybody likes to choose what they're going to do, and they are much more likely to change a behavior if they think it's their choice," he says. In 1997, Epstein and his group conducted a laboratory study that confirmed this supposition: "We got much better results for reinforcing children's behavior than restricting it," he says. Two years ago, with these preliminary results in hand, they began their current study, the goal of which is to look at different ways to reduce television that translates into different kinds of outcomes. "We know that reducing a broad constellation of sedentary behaviors-especially TV-is useful in treating obesity," says Epstein. "The study we're currently conducting is designed to identify specific techniques we might use to do that." 4D Musicians, artists, dancers, actors, athletes, scholars ... we all love Nichols. • State of the art visual and performing arts center • Exceptional college placement record • Challenging curriculum with 17 advanced placement courses • Comprehensive community service program • More than 60 sports teams • Average class size of 15 • Financial aid available Only one investment last; a liferirne Coeducational grades 5-12 875-8212 1250 Amherst Street Buffalo, NY 14216 www.nicholsnet.net NICHOLS SCHOOL Acceptance granted to qualified students without regard to race, color, religion or national origin. �PATHWAYS THE Louis A. and Ruth Siegel Teaching Awards FOLLOWING The Louis A. and Ruth Siegel Awards are presented annually in order to AWARDS recognize the importance of superior teaching in the clinical and preclinical were presented years, as well as to encourage or1going teaching excellence. Recipients of the at the Univer- awards are chosen by students through a nomination process, with final input from a committee comprising representatives from each of the sity at Buffalo school's four classes. Louis A. Siegel, MD '23, served as an assistant School of professor in obstetrics and gynecology at the University at Buffalo School of Medicine and Biomedical Sciences for 21 years. In 1977, he and his wife, Medicine and Ruth, erJdowed the Siegel Excellence in Teaching A wards. Biomedical Sciences' Annual Faculty Meeting, held onMay 24, 2000, in Butler oversees and manages the school's House Staff and Special Awards entire research operation and Marsilia Seiwell, MD, GY lOB graduate training program," said Francis Whalen, MD, medicine Dean Wright. "In addition to his Pierre Giglio, MD, neurology many other activities, Bruce is our Gul Dadlani, MD, pediatrics essential liaison with the provost's Dilip Dan, MD, surgery office, as well as with government Dinesh Arab, MD, medicine and industry." Auditorium, Anthony Mato, Class of 2002 Farber Hall. Timothy Pardee, Class of2001 Stockton Kimball Award Dean's Award ors a faculty member for academic The Stockton Kimball Award honThe Dean's Award is given zn accomplishment and worldwide special recognition of extraordinary recop1ition as an investigator and service to the School researcher. Stockton Kimball, MD '29, was dean of the University at MD, professor of medicine and medical Sciences. Buffalo School of Medicine from chief of the Infectious Diseases Wright presented the award to Bruce Holm , PhD, senior associate dean, in recognition l uffall Hysician 1946 to 1958, and his Division at Buffalo Veter- contributions to the ans Affairs Medical Cen- training ofphysicians at ter. Murphy was honored UB spanned more than for being an outstanding a quarter of a cent!lry. scientific investigator in of his many contributions to the The recipient of school. " ot only does Bruce this year's Stockton maintain an extremely well-funded Kimball research program, but he also 16 Autumn 2000 Preclinical Award, Peter T. Ostrow, MD. associate professor of pathology and neurology (left); Volunteer Award, Howard E. Sperry, MD, clinical assistant professor of medicine (right); and Clinical Award, RichardT. Sarkin, MD, associate professor of clinical pediatrics (seated). of Medicine and Bio- This year, Dean H s Timothy Award IS Murphy, the field of microbial pathogenesis who hy has received notable recognition �for his development of vaccine he has developed protocols for antigens for ear and respiratory antibiotic usage and has emerged tract infections. In addition to asaleadingadvocateinNewYork his work at UB, Murphy has for the appropriate management served on numerous national of infections. study sections, review panels and international committees. In recent years, Brass has developed a strong interest in the use of computers in support of Berkson Memorial Award evidence-based medicine and has generously given of his time to The Robert S. Berkson, MD, Memorial Award is presented nn111Wily to honor the values nnd ideals epitomized by Dr. Berkson, who wns nn esteemed family physician in Buffalo. Patient wre wns his forte; competence, compassion, patience nnd dediwtion to teaching were his virwes. His expertise in the "nrtofmedicine" is teach residents how to research information online. For the past 10 years, Dr. in this nwnrd. Margaret McAloon, MD, associate professor of clinical medicine and pediatrics, was presented the University at Buffalo School of Medicine and Biomedical Sciences' Humanism Award at this year's White Coat Ceremony (see also page 24). Nominations for the award are made by directors of the thirdand fourth-year clerkships. McAloon's nominator stated: Robert Kalb has served as a "I cannot think member of the school's volunteer of another faculty faculty, integrating an active member I have private practice with an intensive teaching schedule. Throughout his career, Kalb has demonstrated a remarkable knowledge meant to be perpetuated 2000 Humanism Award worked with who has so gracefully exhibited all the of clinical and investiga- characteristics tive dermatology, which typically demon- The 2000 Berkson he has used to provide strated by the Memorial Award was exceptional patient care. recipients of this presented this year to During the year, he award Corstiaan Brass, MD, generously shares [Dr. McAloon is] lb clinical associate professor of medicine, and this knowledge by conducting week- Robert E. Kalb, MD, clinical asso- ly dermatology conferences, ciate professor of dermatology. supervising residents and students • able to treat people with sincere com- MARGARET MCALOON. MD passion, determine their physical, emotional and social needs, all while Brass has been a model physi- in dermatology clinics and giving cian who willingly volunteers his fourth-year students exposure to teaching a large team of health-care professionals. Her style time to teach at all levels of medi- the practice of dermatology seems effortless and is completely inspiring. She is also a cine, a dedication that has won through his office setting. <Ii) fantastic clinician because she has retained treatment modali- him the respect of students and -NANCY DRUAR ties that may have been forgotten by most, but which consis- colleagues alike. Over the years, tently work for her patients. At the same time, she is completely up to date on the newest proven treatment options. She is one BRASS HAS BEE A ~10DEL PHYSICIAN WHO WILL- INGLY VOLUNTEERS HIS TIME TO TEACH AT ALL LEVELS OF MEDIC INE , A DEDICATION THAT HAS of those special people I hope to emulate as a physician, teacher and mentor." Support for the Humanism Award is provided by the Healthcare Foundation of New Jersey. <Ii) WON HIM THE RESPECT OF STUDENTS AND COLLEAGUES ALIKE . A ll t II Ill tl 2 0 00 luf f al • Phy si c i an 11 �PATHWAY of the board of the ew York State sionary work in Botswana and - LOIS BAKER South Africa. Children's Names CoChiefs for Pediatric Gastroenterology Robert D. Baker, MD, and Susan S. Baker, MD, from Medical University of South Carolina, have been appointed co-chiefs of the Division of Pediatric Gastroenterology, Hepatology and u- trition at the Children's Hospital Chelikani V. P. Varma, MD {leh), has received the 2000 Pediatric Teaching Award from the Pediatric Residents Association of Kaleida Health's Children'sHospital of Buffalo. Varma, aclinical associate professor of pediatrics at the University at Buffalo School of Medicine and Biomedical Sciences, maintains aprivate practiceD.L.C. Pediatrics-in Depew, New York. Pictured with Varma is Dawn M. Simon, MD '98, president of the Pediatric Residents Association at Children'sHospital. of Buffalo and professors of atric gastroenterology and have served as instructors in pediatrics at Harvard Medical School. Among their responsibilities at Children's are the administration and developm of the hospital's Gastroenterol- Buffalo School of Medicine and ogy Laboratory, as well as Biomedical Sciences. The husband-and-wife team earned their medical degrees from Medicine and doctorate degrees elected to the AMA's Council on from Massachusetts Institute of Scientific Affairs and sits on its ex- Technology. They completed in- research on cell gastrointestinal tract in pediatric patients. Their clinical interests include nutrition, dysmotil- ielsen, MD '76, PhD, ecutive committee and Strategic ternships in pediatrics at the assistant dean for student affairs Planning Task Force. She also cur- Children's Hospital of Buffalo in medicine and infec- at the University at Buffalo School rently serves the AMA on the la- 1973, after which they spent three tious disease. of Medicine and Biomedical tional Patient Safety Foundation Sciences and a clinical associate Board of Directors and the Com- professor of medicine, has been mission for the Prevention of elected vice speaker of the Amer- Youth Violence. In the past, she ker has served on the AMA 's Medical Imaging Team Wins Top Pri:ze tion's policy-making Ad Hoc Committee on A University at Buffalo team who received a doctorate in ra- House of Delegates. Structure, Governance won the prestigious Blue diation physics from UB this ican Medical Associa- If tradition holds, the election places and Operations. iel- Currently, ielsen Ribbon Award at the SPIE year. Other members of the International Symposium on team were Stephen Rudin , MD, sen in line for the presi - serves as the speaker of Medical Imaging held in june co-director of the Toshiba dency of the AMA, the House of Delegates 2000. The group received the Stroke Research Center and according to an of the Medical Society of award for a research presenta- director of the Division of AMA spokesper- the State of ew York. tion describing a new medical- Radiation Physics, and Daniel son who explained She has served as a trustee of the imaging technique developed R. Bednarek, PhD, associate that, in the past, State University of ew York at UB that could lead to im- professor of radiology and the vice speaker has assumed and chief medical officer for the proved diagnostic imaging us- research associate professor of ew York State Department of ing lower doses of radiation. neurosurgery and physiology Health's Western Region, and is a Primaryauthorofthestudywas and biophysics. Nielsen, an internist in private fellow of the American College of Parinaz Massoumzadeh, PhD, practice in Buffalo, has twice been Physicians and a former member the speaker's role, and the speaker has been elected president. l•lfal• Hysiciu Alltlllllll 2 000 ker function within the ity, complementary Nancy II. t 8 Both are board certified in pediatrics and pedi- pediatrics at the University at Temple University School of Nielsen Elected Vice Speaker of AMA years performing hospital mis- Society of Internal Medicine. fD j �McKinley Assassination [xamine~ By J a c k C. Fi sher , MD '6 2 VERY PRESIDENTIAL ASSASSINATIO ~ .; = ~ ~ = ~ % .. u r .. ~ - -; . . = ~ ! u c :: m United ballistic advisory, I have relied primarily on my uncle, Jack States history has prompted its own conspiracy theory and led Anthony, a retired engineer with a lifelong interest in historic to public rebuke of the physicians who tried to save their firearms. His theory was a "short load," which means that the patient. Indeed, following President McKinley's murder in 1901 cartridge was deficient of gunpowder and never reached its full the public was skeptical that any individual could act alone to speed or force. His suggestion was to weigh the residual ammuundertake such an anarchical deed, and the late president's nition retrieved from Czolgosz's weapon. Other cartridges might also be short of their gunpowder load . surgeons were eventually censured by CzoLGosz ONLY GOT Two With the cooperation of William Seiner laymen and professionals alike. SHOTS OFF BEFORE HE WAS and William Mayer at the Buffalo and Erie o evidence of a conspiracy was ever SUBDUED. HIS WEAPON County Historical Society, the unexpended found; like so many assassins, Leon Czolgosz WAS DOUBLE ACTION, AND cartridges from the assassin's revolver, acted as a solitary influence on history. HE SHOULD HAVE BEEN together with the two fired cartridge cases Whether or not the surgeons deserved the ABLE TO EMPTY HIS GU:--: IN and the deflected bullet, pictured below, were criticism they received is the principal issue THREE TO FIVE SECONDS. taken to the laboratory of Bruce that I will deal with in a forthcoming book Actual gun used in \NHY DIDN'T HE? Holm, PhD, senior associate dean about the McKinley assassination (Stolen the assassination in the School of Medicine and Glory, due out in the spring of 2001 ). of President Other questions have arisen during my research. Czolgosz Biomedical Sciences. Weights were recorded on a gram McKinley; held in patterned his attack on the 1900 assassination of Italy's King scale accurate to four decimal points. the collection of the The results clearly showed that one of the unused Humbert. He purchased at a Buffalo hardware store a weapon Buffalo and Erie identical to the one used against Humbert, a 5-shot .32-caliber cartridges was short of its full load of gunpowder, lending County Historical Iver-Johnson revolver. Whereas King Humbert's assailant was support to the theory that one of the two spent cartridges Society. able to fire four times, - r I .. Czolgosz got only two shots off before he was subdued. His weapon was double action, and he should have been able to empty his gun in three to five seconds. Why didn 't he? Furthermore, only one of the two bullets penetrated the body; the other bounced off the breastbone, resulting only in a superficial contusion of the skin. A .32-caliber revolver in 1901 could develop a bullet velocity of 700 feet per second and a muzzle force of 100 foot-pounds, more than enough to pierce the sternum and inflict serious damage to the chest cavity. Why didn't that happen? Shortly after the attack, a Buffalo police officer suggested to a reporter that one bullet likely failed because it was defective. For was also defective. Presumably, Czolgosz had purchased ammunition with significant manufacturing variations. One can speculate that if the assassin had emptied his revolver into McKinley's body, only three of five bullets would have penetrated. Why weren't all five shots fired? The best guess of experts I have polled is that the revolver's external hammer became entangled in the handkerchief that Czolgosz used to conceal his weapon. As the assassin went down, his right hand still held the revolver aimed at McKinley, but no more shots were heard. 4D Jack Fisher, MD '62-who will write a more extensive article on this subject for an upcoming issue of Buffalo Physician-is an emeritus professor of surgery at the University of Califomia at San Diego, where he is wrrently a master's candidate in U.S. history. Readers with questions or comments can e-maillzim at jfishermd@aol.com. �R 20 IUffliD E Pbp i c i ln E A R C H Autumr~ N 2000 E w �Hypertension Redefined hypertension is the most prevalent risk factor in heart failure, inversely related to cardiovascular risk." mutations due to exposure to X-ray or to anything potentially joseph Izzo, MD, University at stroke and kidney failure," he Additional authors on the Buffalo professor of medicine and pharmacology and vice chair of explains. "It is clear that lowering systolic pressure is associated with better outcomes in cardiovascu- study were Daniel Levy, director of the Framingham Heart Study carcinogenic that mimics X-ray damage, such as many chemicals research for the Department of Medicine, was lead author of a National Institutes of Healthsponsored clinical advisory statement released in May stating .. that systolic blood pressure is the important factor in lar and renal disease. "Systolic hypertension interacts with other major risk factors, such as high cholesterol and diabetes, which also increase with age, to amplify the age-re- of the National Heart, Lung and Blood Institute, and Henry R. Black, Roberts Professor and chair of the Department of Preventive Medicine, and associate vice president for research at RushPresbyterian-St. Luke's Medical Center in Chicago. 4D -LOIS BAKER BloodTest Measures Radiation Damage determining whether a person has hypertension-not diastolic blood pres- lated risk of cardiovascular events," he adds. Isola ted systolic hyperten- Scientists from the University at Buffalo have developed and patented a simple blood test that can measure accumulated cell sure, as traditionally thought. Making systolic blood pres- sion-defined as systolic pressure damage from ionizing radiation at or above 140 mm/Hg and dias- long before any physical signs sure the major criterion for diag- tolic under 90 mm/Hg-is the are evident. nosis, staging and therapeutic most common form of hypertension and is present in about management of hypertension, particularly in middle-aged and older Americans, represents "a major paradigm shift," the advisory states. It also calls for more vigorous control efforts and for abolishing the use of ageadjusted blood-pressure targets. "This shift affects 25 million people in the United States whose lives can be improved by the change," says Izzo, who adds that much evidence points to systolic pressure as the critical factor in determining the risk of heart disease. "For example, systolic two-thirds of people over the age of 60 with diagnosed high blood pressure, according to Izzo. Using diastolic blood pressure to define hypertension in persons middle-aged and older actually misrepresents the risk of potential heart problems, he notes. "Systolic blood pressure increases steadily with age in industrialized Western societies, whereas diastolic blood pressure increases until about age 55 and then declines. So in older persons, diastolic blood pressure is The testcalled the Transferrin Receptor Red Cell Assay, or "E-Trassay" -was developed by used in the microchip industry. "This test provides a way to measure damage before the first sign of cancer appears," Gong explains. "It also can determine if cell mutations from ionizing radiation are increasing over time. If so, an indi- The test-which vidual can take steps to requires adrop of stop the increase, per- blood and about two hours for analysis-can be taken as often as desired, SO subsequent blood tests can monitor any increase or patients who have redecrease in cell ceived radiation treatdamage. haps through a change in job, diet or environment. It gives people more control over their health." Potentially, the test could also allow cancer ment to reconstruct their past radiation doses, as well as project the amount of residual injury that will exist in the future, Gong adds. It could also be useful for determining exposure to ionizing radia- Joseph K. Gong, PhD, as- tion emitted by cellular phones, sociate professor emeritus of oral diagnostic sciences and chair of UB's Radioisotope Safety Committee. Using a specific biomarker, it reveals the extent of stem cell microwave ovens and computer screens. CONTINUED ON PAGE 22 SCIENTISTS FROM THE UNIVERSITY AT BUFFALO HAVE DEVELOPED AND PATENTED A SIMPLE BLOOD TEST THAT CAN MEASURE ACCUMULATED CELL DAMAGE FROM IONIZING RADIATION LONG BEFORE A Y PHYSICAL SIGNS ARE EVIDENT. Autumn 2000 I u f f al o Physic i a a 21 �RESEAR ~NTIN U ED FR O M PA G E 2 1 Gong and his co-investigator, Chester A. Glomski, MD, PhD, professor of anatomy and cell biology, were able to show that radiation exposure causes stem cells to express an excess of erythrocytes that bear receptors for the protein transferrin on their surface membrane. Knowing this cause and effect, it then became possible to use the number of red blood cells with transferrin receptors as a biomarker for radiation exposure. The test0 .." .. which requ ires a drop of blood and about two hours for analysis-can be taken as often as des ired, so subsequent blood tests can monitor any increase or decrease in cell damage. Also par t icipating in the research was Yuqing Guo, biophysicist and research scientist at Biomira USA, Inc., in Cranbury, ew Jersey. 4D -LOIS BAKER Another Piece to Insulin Pu:z::z:le In addition to enabling cells to absorb sugars, insulin is also known to dilate blood vessels, an action that is a boon to the heart because it allows blood to flow more easily and under less pressure. Precisely how this vasodilation occurs is a puule. But researchers have shown that when insulin comes into con- C N H E w s tact with cells in the blood-vessel lining, it induces the release of rise above baseline in the amount of enzyme. nitric oxide, a known blood- In addition to providing new wider application than previously thought, new research by University at Buffalo faculty has shown. information on the mechanism un- Thomas S. Mang, PhD, UB Endocrinologists from UB have derlying insulin's vasodilatory ef- clinical associate professor of oral vessel dilator. now supplied a new piece to this fect, these findings give insight and maxillofacial surgery, has puule by showing for the first time into the relationship between hard· found that by manipulating the that insulin causes cells in the ening of the arteries and insulin amount of a light-sensitive drug blood-vessel lining to increase se- resistance/diabetes, conditions and the intensity of the laser beam cretion of nitric oxide synthase, that often exist in tandem. "The that activates it, he can successfully the enzyme responsible for nitric oxide produc- lack of insulin or resistance to the action of insu- treat cancer cells deeply embedded lin will cause ing surrounding normal tissue. In tion. "This in the chest wall without damag- the vessel a study recently completed by new ob- constriction Mang and Ronald R. Allison, MD, servation and increase UB associate professor of clinical is impor- aggregation radiation oncology, this low-dose tant be- cause of it platelets PDT approach resulted in com- known to occur plete healing in nearly 90 percent provides in diabetes mel· of 102 recurrent breast-cancer the molecu- litus," Dandona lesions found in nine women who lar basis for the known vasodilatory explains. "Fur- had undergone surgery, fulldose radiation and chemotherapy. effects of insulin," says Paresh thermore, the fact that nitric oxide also may reduce the Dandona, MD, UB professor of expression of adhesion molecules proof of the ability to lower drug concentrat ions and raise light "These results offer further medicine, who conducted the re- on the surface of cells lining blood search in collaboration with gradu- vessels may prevent cells from intensity to successfully treat ate student Ahmad Alijada. adhering to the vessel lining. This certain difficult tumors, " says By introducing insulin into aor- adhesion is one of the initial Man g. " It allows broader applica- tic cell cultures in increasing con- events in arterial hardening tion of this therapy in patients centrations from 25 to 1,000 and blockage." who can truly benefit from it. " microunits per milliliter for a total -LOIS BAKER of six days-amounts similar to what would occur normally and in patients with obesity and type 2 diabetes-the researchers showed that nitric oxide synthase increased as the amount of insulin increased, with the highest concentration of PDT, which was developed at Roswell Park Cancer Institute, the site of UB 's basic cancer research New Light on Cancer Therapy Pho todynamic therapy, or PDT, one of the most promising new cancer treatments, may have much insulin resulting in a 250 percent programs, exploits the propensity of cancer cells to absorb higher than normal concentrations of photosensitive drugs. When exposed to light via lasers, these drugs become toxic and destroy the malignant tissue. Since normal tissue searc 22 luflalo Phys i c i u Autumn 2 000 surrounding tumors also absorbs a certain amount of the drug, the goal of researchers and clinicians is to find a drug-to-light ratio for each tumor type that will kill the �most tumor cells while sparing the Medi- Cancer Center; veys, restaurant-employment most normal tissue. cine ..-:::::::;;;;;;;;ii~~[FI!iljl=::;:;;;;'==-':::~:§::; University of statistics and complaint reports . In the current study involving t h a t Pittsburgh; A review of taxable sales breast-cancer lesions that had there University of showed no effect on sales from "'0 formed on the chest wall, Mang was no dif- Utah; Wake smoking restrictions in restau- ,. lowered the standard 2.0 mglkg ference in there- Forest rants in dozens of communities dose of the photosensitive drug to currence of pol- School in New York, California, Colo- of 0.8 mglkg. "If we used the standard yps between the Medicine; Walter rado, Massachusetts, Arizona, drug dose, we never would have diet intervention group and a con- Reed Army Medical Center; Veterans and Texas, he found. In addition, been able to use a light dose that trol group that didn't change diets. Administration Medical Center (Hines, bar revenues in California in- would reach deep enough to kill Peter Lance, MD, associate Ill; and Kaiser Foundation Research creased 6 percent 12 months the tumor cells without destroying professor of medicine and physiol- Institute (Oakland, CA). normal tissue," he explains. ogy, and principal investigator on -LOIS BAKER "By lowering the drug dose, <D was disappointed but not alto- normal tissue bleaches out before it does any damage, and by gether surprised by the negative results. "The study is consistent after smoking was restricted . Consumer surveys conducted in New York City at five months UB's portion of the trial, says he the small amount of the drug in and 18 months after passage of the Smoke-free Restaurants, Healthy Restaurants delivering more light, we can with the findings of previous reach deeper into tumors where smaller trials and of another large Restricting smoking in restaurants the drug concentration is still trial-the Wheat Bran Fiber has not been a recipe for econo- high enough to kill cancer cells. Study-published in the same mic disaster for the restaurant "These results offer a glimpse of issue. Clearly, dietary change does business, despite predictions to the parameters one might be able not make you less likely to develop the contrary, a University at Buf- to use for treating whole fields of new polyps after you've had all falo epidemiologist has found disease with little normal tissue existing polyps removed. following review of existing data. ew York City Clean Air Act indicated that "Studies showing adverse conse· the vast majority of quences typically consumers dined out are flawed, relying as often after the law on survey data or as before. "Analyses of anecdotal repons. restaurant-employment Our analysis shows statistics indicated that that the restaurant more restaurant jobs business remains were added in New healthy after smoke· York City two years free dining policies after the law went into are implemented." damage," Mang says. "It gives us "What the study does not ad- "Virtually all" published stud- good local control of disease." <D dress-and was not designed to ies on the issue show no adverse address-is what the environment effect in restaurants, hotels and of the colon should be to reduce bars, regardless of the study effect than the rest of ew York State where smoking the likelihood that small, innocent method used, says Andrew was still permitted," Hyland polyps will grow to become can- Hyland, PhD, research assistant reports. In Erie County, cers," he notes. professor of social and preventive per-capita restaurant employ- -LOIS BAKER Polyps Unaffected by Healthy Diet Y, Adopting a diet low in fat and high The researchers also noted medicine, who recently presented ment increased faster than in six in fruits and vegetables may have thatdespitetheirfindings, the idea his findings at the International of seven surrounding counties many health benefits, but lowering that a healthy diet may lower the Society for Environmental Epi- where smoking was permitted, 12 the risk of developing recurrent risk of colon cancer should not be demiology meeting. "Studies months after a county law went colon polyps-precursors of colon entirely discarded. Several fac- showing adverse consequences into effect. "Also, few people are cancer--does not appear to be tors, including study length and one of them. potential reporting errors, could typically are flawed, relying on survey data or anecdotal reports. Our analysis shows that the res- complaining about the law," Hyland notes. taurant business remains healthy after smoke-free dining policies are implemented." public health issue," says Hyland. Investigators from the Univer- have influenced this study's re- sity at Buffalo's School of Medicine sults, Lance says. In addition, such and Biomedical Sciences and the a diet is known to have a favor- seven other centers involved in the able impact on cardiovascular dis- : "Secondhand smoke is a serious "Policymakers need to understand that adverse economic claims five-year national Polyp Prevention ease and other chronic conditions. Hyland examined published Trial reported in the April20, 2000, Other sites involved in the study studies examining taxable sales, tion are unsubstantiated." issue of The New England Journal of were Memorial Sloan-Kettering consumer and restaurateur sur- -LOIS BAKER A11t11mn resulting from smoke-free legisla- 2000 <D l 1ffaf1 Hysiciu 23 �M E D C A L ScHOOL E W S First Biomedical Sciences Career Day G R ADUATE STUDENTS FROM and faculty, as well as from rep- Health, Schering Plough, Ros- the University at Buffalo School resentatives from the law firm well Park Cancer Institute. of Medicine and Biomedical of Hodgson, Ross, Andrews, Sciences, the Departments of The program included a key- an opportunity for one-on-one interactions. Roundtable discussions on specific career paths Woods and Goodyear, the note address by Claire Lathers, were also held with panelists Oral Biology and Pharmaceutics, and Centers for Disease PhD '74, FCP, director of the Ranjana Kadle, PhD, JD; Gary Control, DuPont Office of New Animal Drug Giovino, PhD; Sarita Chauhan, Roswell Park Cancer Central Research Evaluation, Center for Veteri- PhD; John Simich, PhD; Lyn Institute attended and Development, nary Medicine, U.S. Food and Oyster, PhD; Wilson Great- the First Biomedical Erie County Central Drug Administration. Her lec- Sciences Career Day Police Services For- ture was followed by a series of batch; Mark Connors, MA; jacques Berlin, PhD; Michael on May 31, 2000, at ensics Laboratory, the Food and Drug Administration, Gen short talks by Robert Genco, DDS, PhD; Allen Barnett, PhD; Vladutiu, PhD; and james David McCann, PhD; and Hernandez, PhD. The day end- learned about successful strate- Cyte, LLC, the National lnsti- Wade Sigurdson, PhD. During ed with a reception that includ- gies for career development and tute on Drug Abuse, the ew lunch, students were seated ed more networking with the management from UB alumni York State Department of with the invited guests to foster invited presenters. the Buffalo/ iagara Marriott. Students CLAIRE LATHERS Morales, PhD; Georgirene 4D Wh"te Coat Ceremony MEGAN MOORE OF P ITTSFORD, Y, being "cloaked" at this year's White Coat Ceremony by Daniel C. Kozera , MD '59, a board member of the Medical Alumni Association . The annual ceremony-a symbolic rite of passage for beginning medical students to help them establish a ps ychological contract for professionalism and empath y in the pra ctice of . ... . medicine-is sponsored by the Medical Alumni Association a nd The Medical L School Parents' Council. 0 The keynote speaker at the August 11 event was Robert Milch, MD, director for z the Center for Hospice and Palliative Care in Buffalo, whose talk will be featured In the winter issue of Buffalo Physicia11. Following Dr. Milch 's lecture, Margaret McAloon , MD , class is 23 . Their average science grade point average is 3.53 and was presented the " Humanism in Medicine Award " (see page mean MCAT, 9.60. Fifty-seven of the students are male and 79, 17 ) by Charles Severin, MD, PhD, assistant dean for students. female. Ten hold master's degrees and 113 were science majors. Seventy-five are from Western New York. -S. A. Ur-;cE R Thomas Guttuso, MD, assistant dean of admissions, then introduced each of the students while they were being cloaked. 24 For the Class of 2004, there were 1,987 applicants; of those, 463 were interviewed and 136 accepted. The average age of the l a lfa le Ph ysi c i aa Alltllmll 2000 �I AUTUMN 2000 llorls Albini, profe-r of microbiology Elmer ......._11, medical computlntfpl.....r A1<tumn 2000 1111111 ,.pic l u Z5 �S B U S T U y M U T AR P E L D E N C T 0 L U M lonely for aCalling of My Own Clinical r otations i nc l ude an exercise i n int r ospect i on OR MOST MEDICAL stu- dents, the clinical experience of the third year is like a carrot held out to entice them through the heavily didactic first two years. their conviction, I also realized I was lonely for a calling of my own. Gradually, my fear of third year began to mingle with a sense of anticipation for the opportunity I would have to experience each medical field. I decided that the best way to make peace with what lay ahead was to view it as a sort of exercise in introspection. I would fully immerse myself in each of the six rotations: internal medicine, psychiatry, pediatrics, surgery, family medicine, and obstetrics/ gynecology. I would try on every hat and see which one fit. Surely only one would flatter me, and the rest would look obviously ridiculous. But I quietly dreaded the A Possible Cure , but No Patient transition. After all, with almost 20 years of experience sitting behind a de k, I was good at being a student. I had become quite comfortable in Butler Auditorium, twothirds of the way back, slightly left of middle. I loved all the zebra diagnoses and esoteric nuggets of information and could not imagine what lured people from the top of this ivory tower to the bottom of the hospital totem pole. Furthermore, I still wasn't sure which specialty I wanted to pursue, and this ambiguity added to my sense of unease. I envied (and frankly distrusted) those characters who knew they were fated to be urologists or neurosurgeons. As much as I doubted 26 luffall Pbysicill A utumn 2 000 I showed up for the first day of internal medicine dressed sharply, not yet realizing the perils of uncomfortable shoes. My short white coat was brilliantly clean. To give the illusion of experience, I had forced in a few wrinkles and had stuffed the pockets with trusty reference books. My memory of the first week of internal medicine is a disconnected series of flashbacks. There was a lot of wading through lab results- random numbers that I knew were supposed to mean something to me. I couldn't have told you the cause of my patient's microcytic anemia, but I at least made sure that I knew his TIBC by heart. Did medicine really consist of merely juggling consults and labs? This was not the glorious career I had had in mind when I wrote my application essay for medical school. One of my new patients had a concerning set of symptoms: night sweats, weight loss, documented daily fever spikes and anemia. The team was "working him up"-a phrase that, at the time, seemed so aggressive to me. He had already had a history and physical, and although it seemed pointless, I knew I would have to repeat them. I dutifully palpated the thyroid, assessed the trachea for mobility and checked for tactile fremitusjust as I had learned in Butler Auditorium. On and on �fURTHERMORE, I STILL WASN'T SURE WHICH SPECIALTY AMBIGUITY ADDED TO MY SENSE OF UNEASE. I I WANTED TO PURSUE, AND THIS ENVIED (AND FRANKLY DISTRUSTED) THOSE CHARACTERS WHO KNEW THEY WERE FATED TO BE UROLOGISTS OR NEUROSURGEONS. AS I DOUBTED THEIR CONVICTION, I ALSO REALIZED I went with the esoteric details of the physical exam, feeling for epitrochlear lymph nodes and frustrated by the amount of time I was wasting. Then, much to my surprise, I felt something in my patient's axilla. Yikes, a 4 x 5 em axillary lymph node. (At least I thought it was a lymph node, since I had never actually felt one before.) "Sir, you seem to have a lump here. Have you noticed it before?" I proudly reported back to the team that I had found the lymph node-not the attending, not my resident, not my intern, but me, the lowly third-year. So this was medicine! As I arranged for the needle aspiration, I thought about how we were going to get to the bottom of his symptoms, discover his diagnosis and cure him. When we told the patient that we wanted to stick a needle into him, he promptly left the hospital against medical advice. I couldn't believe the team would let a seriously ill person just walk away. "He'll be back," they said. Medicine was not all brilliant diagnosis and glorious cure after all. The Missing Glasses P sychiatry was quite a change. Every day I faithfully rounded up the latest Jab values, but my reports on anemia were always met with statements like, "Yes, yes, but how has he been sleeping?" I was surprised by how much effort it took to detach myself from the numbers and actually pay attention to the patient. When had I gotten so comfortable with labs? What struck me about my psych rotation was the malleability of the human mind. Until I had spent seven weeks in a locked psychiatry wing, I had always assumed that one's personality was a fixed thing. I had friends who were moody, others who were cheery, and that was just how they were. But I was amazed by the phenomenon of the "titrateable" personality and marveled at watching rational minds emerge from once fully psychotic people. I WAS LONELY FOR A CALLING OF I especially remember one of my patients, who arrived in a comatose state. I thought he must have been suffering from a hopeless neurological disability, but we kept on with the medications. One morning I walked in and saw him eating breakfast, and the nurse told me he had been asking for his glasses. For the first time, I saw that some diagnoses take time to emerge and cannot be elicited by strictly objective measurements. As MUCH MY OWN. I would fully immerse myself in each of the six rotations: internal medicine, psychiatry, pediatrics. surgery. An "Old Hand" Draws Blood N ext on the Jist was my pediatrics rotation, where I met a five-year-old boy named Alex (not his real name) who was already in the hospital when I arrived and remained there throughout my inpatient rotation. After a while it seemed totally normal to see Alex playing in the conference area during afternoon rounds, and we all took turns wheeling him around the floor in his wagon. Somehow, the oddity of his continuous presence wore off, and I grew to think he was a normal boy who just happened to live at Children's Hospital. One day, Alex wanted to play a new game. Someone had given him a needleless syringe, and he said, "Let's pretend I'm gonna draw your blood!" A little macabre, I thought, but why not? Alex tied a tourniquet around my arm, and I winced at the squeeze. "It's gotta be tight!" he said in a mock adult voice. Next, uncoached, he expertly wiped down my forearm with an alcohol pad, then began slapping my arm to bring out a vein. "There's a good one!" he said in his doctorvoice, while pressing the syringe up against my arm and directing, "Hold still, I don't have enough yet." I couldn't help but laugh at this parody, but underneath I was horrified by his impression of the medical field. We were trying to heal Alex, but all he knew was that he had been kept away from his family for months, and every day he had blood drawn. It was disillusioning to realize that your most idealistic intentions are not always perceived as such. The last I heard, Alex was still in the hospital. Autum11 2000 family medicine. and obstetrics/gynecology. I would try on every hat and see which one fit. Surely only one would flatter me, and the rest would look obviously ridiculous. l off a le Pb ysician 27 �S l T U D E N T COLUMN WAS IN AWE AS MY ATTENDING SPOKE WITH HER. HIS COMPASSIONATE QUESTIONS ABOUT THE DEATH OF HER HUSBAND AND HER CURRENT FI ANCIAL SITUATIO WERE A TREATME T AS VALID AS ANY PILL OR SCALPEL. History in the Making H y the time I began my surgery rotation, I felt like I had figured out the routine. I had given up carrying references in my pockets, I spent all my time in comfortable scrubs and clogs, and the wrinkles in my white coat were legitimate. I also knew I could take the sleepless nights, the lack of food, and the scut work. Even though I had been duly warned by my classmates about this rotation, I was looking forward to it: Surgery was going to be great. My first days in the OR were indeed thrilling. I loved scrubbing in, and I loved pulling off the mask after we had closed up. This was Your Turn? better than watching ER! If you are a student After a while, however, the physical and emotional demands set in. One case was paror resident interested ticularly arduous: a deep abdominal procedure in contributing to this on an obese patient. I had a large Deaver retraccolumn in future tor in each hand, and my chief still couldn't get issues of Buffalo a clear look at the field. He told the circulating Physician, e·mail nurse to find a St. Mark's retractor. Why did that sound so much like a torture device from the bp·notes@buffalo.edu French Reign of Terror? The nurse handed me to suggest a topic. the oddly shaped tool and warned me that it was notoriously difficult to hold. The operation lasted six hours. As I stood holding the retractors, I tried meditating on whether it was possible to experience a higher level of pain in my arms. It was not. Mostly, I was terrified that I would contaminate the field with the proverbial bead of sweat that was working its way down my brow. At the end of the case, my chief turned to me and said, "That may be the second time in history that a medical student has held a St. Mark's retractor for so long without complaining. The first time was when I did it." Better Than a Pill or a Scalpel M oving on to family medicine after surgery was quite a shock. At first, I admit, I fought the gentle nature of the family practice appointment. It's just not humane to expect medical students to change pace so drastically. One day after I had begun to settle into my new 28 l alfale Hpiciu Autumn 2 000 routine, I went to the door of my next patient and picked up a thick chart, labeled "Volume II." After introducing myself to the patient, I tried to do a review of systems and to assess the state of each one of her many ailments, but I kept meeting with resistance. From my perspective, it seemed like she really didn't want to talk about her physical health at all. When I tried to present this patient to my attending, he smiled and said, "Let's go in and see her together." I had been told about therapeutic touch and the "art" of medicine, but nevertheless I was in awe as my attending spoke with her. His compassionate questions about the death of her husband and her current financial situation were a treatment as valid as any pill or scalpel. After we closed the door behind us, he said, "Sometimes you just have to know your patients." The Totem Pole and the Hat Rack s I write this article, I am completing my final rotation, obstetrics and gynecology. The other day, one of my classmates was talking enthusiastically about his experience in the rotation. "So, have you delivered any babies yet?" I asked. "Oh no," he replied, "but yesterday they let me deliver a placenta!" It's funny how you learn to be content with your place on the totem pole. Much to my surprise, this year that I dreaded is coming to an end. Despite what I've learned, I still don't know which field to pick. All the hats have fit, more or less. o one ever told me the choice would not be obvious, that fate would not present me with the answer as I had expected. There is an active decision-making process, and I can see now that whichever field I choose, it will involve sacrificing what I value in other fields. Lately, I've narrowed down my wardrobe to two hats. Every day I look in the mirror and try to figure out which one looks better on me. 4D A Umut Sarpel is currently a fourth-year student at the Unil'ersity at Buffalo School of Medicine and Biomedical Sciences. �DEVELOPMENT N E w s (ndowments Crucial to School's future By Li nda J . Cor de r • PhD. CFRE -- ( - - c s for the current "Campaign fo r UB: Generation to Generation" is to increase its endowment significantly. Establishing new endowed funds, adding to existing endowments and growing the principal through prudent investing-coupled with a sound spending policy-are all ways to increase the value of the overall endowment and to ensure the future of our school's mission and vision. Some of the School of Medicine and Biomedical Sciences' most cherished traditions germinated from dreams of our forebea rs whose gifts formed the core of its present endowment. With both private and public roots, our school benefits from a combined endowment that generates funds to support, in perpetuity, designated programs of the institution. One of the school's earliest endowments was a gift from Devillo W. Harrington. He was wounded during the Civil War ONE OF THE and brought to Buffalo General SC HOOL 'S EARLl Hospital, where interns from UB ES T E •oQ \VM EN TS treated his wounds. He recovered, WA S A GI FT FROM remained in Buffalo and went to D EV ILL O \V. medical school, graduating in H AR RI:-< GTO !<. H E 1871. In honor of the 25th anniWAS WOU :-<DED versary of his graduation in 1896, DURING THE CIVIL he established an endowment. For \\fAR AND more than a century, the HarringBRO UG HT TO ton Lectureship has brought outBuFF ALo G E =< ERA L standing medical scientists to H o s P 1 T AL, w H E R E Buffalo. Many others added gifts 1 NT ERN s FRoM U B to the school 's endowment, of TR EATED H 1 s which the most significant to date wo uNDs . is the Hochstetter Fund for Medical Research . Mr. Ralph Hochstetter, president of Cliff Petroleum, died in 1955, leaving UB a multimilliondollar bequest for scientific research. This endowment provides annual support for the Bertha H. and Henry Buswell Postdoctoral Fellowships, a program that underwrites up to three years of support for each of several young researchers in the biomedical sciences. Today, that endowment provides over $20 million a year-more than the original bequest. Endowment is crucial to the school's future. Thus, the development team spends a great deal of time facilitating new endowment gifts and providing information to donors of endowed funds about the programs they support and the financial status of the funds. Looking at the school's overall budget, annual gifts and endowment gifts are small, but significant- and increasingsources of income. Endowment income provides perpetual funding for either general unrestricted use by the dean (extremely important) or for specified programs established in accordance with the terms of an endowment gift. It also provides a hedge against downturns in the economy; fluctuations in the political climate in our community, region, state, nation and world; variations in the number of alumni and friends supporting the school's annual appeal; and other changes in the academic environment. Today's students and faculty benefit from the endowment gifts of previous generations. Tomorrow's school is being created by today's endowment gifts. The market value of the school's combined endowment assets was right at $145 million as of June 30, 2000. This represents an increase of nearly 10 percent since 1998, when the school's endowment was $132,161,604. During the "Campaign fo r UB: Generation to Generation," I trust the endowment will continue to show such significant increases. This will require many new endowment gifts designated for the school, in addition to the ongoing wise management of the funds already in the care of the State University of ew York and the UB Foundation. " D EVELOP M EsT" Co s T I ~UEo o s Autumn PAGE 30 2000 l alflll H y sici11 29 �-------- D - E - V E "T'Y J ~ L 0 P M E N T E W CLIN ICAL PREVENTAT I VE MEDICI NE FELLOWSHIp D flit " 'G PAGE, we list the School of Medicine and Biomedical Sciences' endowments held by both the UB Foundation and the state. Those in bold print received one or more gifts during the past fiscal year ( through 6/ 30/00 ) ; an asterisk* indicates a new endowment, established during the same time frame. Those of us who learn , teach a nd conduct research in this unique institution extend our thanks to all alumni and friends who made endowment gifts or finalized endowment agreements in the past year. If you would like information about 1n1t1ating a named endowed fund, or if you have any questions regarding the school's combin ed endowment, please Linda ( Lyn) ]. Corder, associate dean and contact me. director of development, can be reached, toll-free, at 1-877-826-3246, or via e-mail at Ijcorder@buffalo.edu. ALMON H. COOKE CHOLARSHIP PATRICK BRYANT COSTELLO MEMOR I AL CTG ONCOLOGY FUND ) AMES H. EDWARD CUMM I NGS SCHOLARSH I P L. CuRV ISH M.D . AwARD " MA X D OU BRAVA }R. S C HOLARSHIP FUND THE ELIZABETH MED ICAL AWARD DR. RoBERT M. ELLIOT ScHOLARSHIP ELEANOR FITZGERALD FAIRBA I RN ScHOLARSHIP FAMILY MED ICINE ENDOWMENT FEYLER FUND FOR R ESEARCH IN HoDGK I N's D i sEASE DR. GRANT L. T. FISHER FUND WALTER Fix M.D . '42, '43 E DOWED SCHOLARSHIP EDwARD FoGAN MEMOR I AL PRIZE FORD FOUNDAT ION FOR MEDICAL EDUCAT ION THOMAS FRAWLEY M.D . RESIDENCY RESEARCH H.W. ABRAHMMER MEMOR IAL SCHOLARSHIP THOMAS R. BEAM, ) R. MEMORIAL S I DNEY ADDLEMAN MEMORIAL DR. RoBERT BENNINGER FuND I N ORTHOPOED ICs " F uN D FOR CE LEBRATI NG PHI LANTHROPY DR. GEORGE) . ALKER FUND FOR RoBERT BERKSON MEMORIAL AwARD IN THE MARCOS GALLEGO M.D. CLINICAL NEURORADIOLOGY ART OF MEDIC I NE THEODORE & BESSIE G. ALPERT SCHOOL OF MED IC I NE SCHOLARS HI P MusEuM oF NEUROANATOMY FuND LOU IS). BEYER SCHOLARSH I P ExcELLENCE FuND RONALD GARVEY M.D. STUDENT L IFE ENRICHMENT FUND ALPHA OMEGA ALPHA ENDOWMENT PAULK. B I RTCH M.D. FUND )AMES GIBSON ANATOMICAL PR IZE ALP H A OMEGA ALPHA L I BRARY FUND " DR. W I LLARD AN D } EAN BOA RDMA N WALTERS. GOODALE AMER ICAN ACADEMY OF FAMILY PHYS IC I ANS PRESIDENT's AwARD EN DOWM ENT BOOKE FUND ANATOMICAL SCIENCES OF PEDIATR ICS GEORGE GORHAM FUND DR. BERNHARDT ANESTHES IOLOGY DEPARTMENT ENDOWMENT ANNE AND H AROLD BRODY LECTURE FUND CLAYTON MILO BROWN MEMOR IAL L. GEORGE B . BADGERO MEDICAL SCHOOL FUND VIRGIN I A BARNES ENDOWMENT . BuRWELL FuND DR. WINFIELD L. VINCENT CAPRARO LECTURESHIP FUND PH A RM ACOLOG Y - DR. CHARLES A. BAUDA AWARD IN CLAS OF I945 DR. CHARLES CARY MEMOR IAL FAM I LY MED ICINE DR. AND MRS. jOSEPH A. CHAZAN MEDICAL ScHOLARSHIP l uff lll n y sicill BUTSCH MEMORIAL LECTURE IN CLIN ICAL SURGERY * DR. ALL EN BARNET T F ELLO W S H I P I N Autumn 2000 A . CoNGER GooDYEAR PRoFESSORSHIP )AMES H. BORRELL UROLOGY FUND BACCELLI MEDICAL CLUB AWARD WALTER BARNES MEMOR IAL SCHOLARSHIP CHOLARSHIP I RENE P I NNEY GooDWIN ScHOLARSH I P DR. SoLOMON G. BooKE AND RosE YASGUR BERNHOFT- DESANTIS LIBRARY FUND FOR 30 FELLOWSHIP FUND . AND DR. SoPHIE B. GoTTLIEB AWARD * AD E LE M. G o TTSC HALK S c H O LARS HIP F uND CARL GRA GER M.D. ENDOWMENT DR. PASQUALE A. GRECO LOAN FUND THE GLEN E. GRE HAM M.D. VISITING PROFESSORSHIP DR. THOMAS). AND BARBARA ScHOLARSHIP & AwARD L. GuTTuso �GYNECOLOGY-OBSTETRICS DEPARTMENT ENDOWMENT )EAN SARAH HAHL MEMORIAL EuGENE). HANAVAN ScHOLARSHIP FLORENCE M. & SHERMAN R . HANSON FUND FOR MEDICAL EDUCATION DEVJLLO V . HARRINGTON LECTURESHIP THE HEKIMIAN FUND MICROBIOLOGY MEMORIAL FUND ELIZABETH ROSNER FUND DR . DAVID KIMBALL MILLER AWARD IRA G. Ross CHAIR oF MEDICAL INFORMATics EuGENE R. MINDELL M.D. CHAIR IN DR . SHELDON ROTH FLEISCH MEMORIAL FUND HAROLD ORTHOPAEDIC SURGERY G. NORRIS MINER M.D . MEMORIAL AWARD PHILIP D. MoREY ScHOLARSHIP PHILIPP . SANG MEMORIAL FUND RICHARD SARKARIA FAMILY ENDOWED CHAIR IN AGEL M.D . ANESTHESIOLOGY RESEARCH HEWLETT FAMILY ENRICHMENT FUND FOR PSYCHIATRY DR. ANGES RESOURCES FUND DIAGNOSTIC MEDICINE FUND s. NAPLES MEMORIAL SCHOLARSHIP THE DR. S. ROBERT CHARLES GORDON HEYD MEDICAL ARINS MEMORIAL AWARD ATIO ' AL MEDICAL AssociATION, SCHOLARSHIP FUND NAUGHTON AWARD ENDOWMENT DR. ERWIN NETER MEMORIAL * DR. S u K K1 HoN G MEMO RI AL FuN D ANTOINETTE AND LOUIS H. ABRAHAM M. HoROWITZ FuND NEUROLOGY DEPARTMENT ENDOWMENT LUCIEN HowE PRIZE FUND DR . BENJAMIN E. & LILA 0BLETZ PR IZE FUND R. R. HUMPHREY & STUART Nu SIGMA C. L. VAUGHAN u ALUMNI ScHOLARSHIP . )OHNSTON SCHOLARSHIP SUMNER )ONES LIBRARY FUND EUBECK FUND IN ORTHOPAEDIC SuRGERY DR. ELIZABETH P. OLMSTED FUND I SCHOLARSHIP OF THE PROGRESSIVE MEDICAL CLUB oF BuFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES HARRY E. AND LORETTA A . )ORDON FUND VICTOR A . PANARO MEDICAL SCHOOL FUND H. CALVIN KERCHEVAL MEMORIAL FuND F. CARTER PANNIL )R., M . D. AWARD DEAN STOCKTON KIMBALL MEMORIAL ScHOLARSHIP UNRESTRICTED ENDOWMENT FUND LILLIE S. SEEL ScHOLARSHIP IRENE SHEEHAN FuND DEWITT HALSEY SHERMAN AND )ESSICA ANTHONY SHERMAN FuND DR . L01sA . AND RUTH SIEGEL TEACHER's AWARD S . MoucHLY SMALL M.D. AwARD IN BIOCHEMISTRY josEPHINE HoYER ORTON TRUST FuND PSYCHIATRY S. MOUCHLY SMALL M.D. EDUCATION CENTER FUND IRVINE AND ROSEMARY SMITH CHAIR IN ENDOWMENT STEPHEN). PAOLINI M . D. MEMORIAL FUND APLES SARNO SC H OLA RSHIP F UND ScHAFER FuND IN CARDIOVASCULAR DISEASES EPHROLOGY RESEARCH ENDOWMENT RALPH HocHSTETTER MEDICAL RESEARCH FuND )AMES * D R. MA RI A BuFFALo CHAPTER ScHOLARSHIP FuND DR. FRANK WHITEHALL HINKEL s. SANES AND THELMA SANES MEDICAL SCHOLARSHIP NEUROLOGY FUND DR. IRVING M. SNOW FUND DEAN STOCKTON KIMBALL MEMORIAL AWARD PARKINSON RESEARCH FuND MARY RosENBLUM SoMIT ScHOLARSHIP FuND DR. )AMES E. KING POSTGRADUATE FUND )OHN PAROSKI MEMORIAL FUND MORRIS AND SADIE STEIN NEUROANATOMY PRIZE MoRRIS LAMER AND DR. ROBERT BERNOT SCHOLARSHIP DR. CHARLES ALFRED LEE ScHOLARSHIP DR. GARRA K. LESTER STUDENT LOAN RoBERT]. PATTERSON RESIDENT AwARD * j o H N AN D ) ANET SuNG Sc H OLA RSHIP FuND DR. MARK PETTRINO MEMORIAL FUND ]oH PHI CHI MEDICAL FRATERNITY TREVETT SCHOLARSHIP SCHOLARSHIP FUND H. TALBOTT VISITING ScHOLARSHIP FuND * K o R NELL L. TE RPLAN M .D . L ECTURE FuND PRIMARY CARE ACHIEVEMENT FUND RICHARD E. \VAHLE RESEARCH FUND THE LIEBERMAN AWARD PROGRESSIVE MEDICAL CLUB OF BUFFALO FUND MILDRED SLOSBERG WEINBERG ENDOWMENT HA PsYCHIATRY DEPARTMENT ENDOWMENT FuND E.). WEISENHEIMER OPHTHALMOLOGY AWARD LUPUS SCHOLARSHIP FUND DR. HERMAN RAHN MEMORIAL LECTURE DR. MARK WELCH AND BEULAH M . WELCH WILLIAM E. MABIE D . D .S. AND ALBERT AND ELIZABETH REKATE CHAIR IN LLOYD LEVE FUND s LOWENSTEIN AWARD GRACES. MABIE Fu D DR. WILLIAM H. MANSPERGER FuND CLARA MARCH MEDICAL ScHOLARSHIP CARDIOVASCULAR DISEASE ALBERT C. REKATE REHABILITATION MEDICINE LIBRARY FUND MEDICAL ALUMNI ENDOWED ScHOLARSHIP DONALD RENNIE PRIZE IN PHYSIOLOGY ANNUAL PARTICIPATING FUND FOR MEDICAL DouGLAS RIGGs AwARD IN PHARMACOLOGY AND EDUCATION ENDOWMENT THERAPEUTICS ScHOLARSHIP )AMES PLATT WHITE SOCIETY ENDOWME T WILLIAMS/BLOOM MEDICAL RESEARCH FUND DR . MARVIN N . WINER FUND FOR DERMATOLOGICAL RESEARCH WITEBSKY FUND FOR IMMUNOLOGY DR. ERNEST WITEBSKY MEMORIAL FUND MEDICAL SCHOOL LECTURESHIP FUND THE RING MEMORIAL FUND FARNEY R. WuRLJTZER FuND MEDICAL ScHOOL CLASS oF 1957 ScHOLARSHIP MEYER H. RIWCHUN PROFESSORSHIP IN DR . MARK ZALESKI AWARD MEDICAL SCHOOL CLASS OF 1958 SCHOLARSHIP OPHTHALMOLOGY FUND MEDICAL SCHOOL CLASS OF 1963 SCHOLARSHIP EMILE RODENBERG MEMORIAL AWARD MEDICAL SCHOOL CLASS OF 1973 SCHOLARSHIP THOMAS A. RODENBERG AND EMILE DAVIS MARIAN MELLEN FuND HERMAN AND RosE ZINKE MEMORIAL SCHOLARSHIP RODENBERG SCHOLARSHIP FUND Autumn 2000 luffal1 Hysici11 31 �Dear Fellow Alumni, 'GI"\ :-.IY YEAR AS PRESIDE:-\T OF THE MEDICAL ALU\1 ' I AssOCIA'I'lO, ' , I am looking at a well-run, hard-working volunteer organization. Our organization has two major objectives. The first one is to promote and encourage alumni interest and activity in the School ofMedicine and Biomedical Sciences. This is done through our Spring Clinical Day and Reunion Weekend, countrywide meetings, awards dinners, luncheons and various other activities. The second objective is to help the medical students-from orientation through graduation-to assimilate into our profession, to grow as doctors and as human beings and to have some fun in the process. The Medical Alumni Association sponsors events at orientation. Along with the White Coat Ceremony for the incoming students, we have a Physician-Student Mentoring Program, which has received excellent feedback. Our Community Physician Program allows first- and second-year students to meet area doctors and talk about their specialties. We also organize a senior reception and a Match Day luncheon, and entertain requests from the student government. So, what's wrong with the picture? Here's where I start to sound like a guy on public television. Our organization, like most volunteer groups, relies on support from its constituents. Our school has about 6,000 living graduates, but we only average about 1,500 dues-paying members each year. We need your help! I would like to issue a challenge (again, just like public television). A lifetime membership in the Medical Alumni Association costs $750. This is a bargain for younger doctors and a great way for the "mature" doctors to support our school. In order to continue to increase all the association's activities each year for our school, its students and alumni, we need 200 new lifetime members by May 200 I. Anyone who joins the Medical Alumni Association as a new lifetime member between September 2000 and May 2001 will receive a free copy of our new University at Buffalo School ofMedicineand Biomedical Scie11ces Alumni Directory, which will be published in May 2001. As our pulmonary colleagues would say, "Come on, cough it up!" Please help your school-join the Medical Alumni Association now! jOHN I .... j. BODKIN II, MD President, Medical Alumni Association Pbysici11 A11t1111111 2 000 �CLASSNOTES 1940s 1950s Eugene J. Hanavan, MD '41 , Roland Anthone, MD '50, an associate clinical professor of orthopaedic surgery at VB, retired from practice February 29, 2000 and resides in Buffalo, Y. Buffalo, NY, "Did surgery and renal transplantation surgery for 50 years and am now enjoying retirement, although still doing some parttime work with BGH. Spend time with my wife playing tennis and golf." William E. Maloney, MD '41 , writes, "I retired to York Harbor, ME, after years of anesthesia practice in New York. I am married with three children and three grandchildren. My health is not too good. Broken hip, etc. Age 82. Anyone still alive of 194!s? Edward M. Tracy, MD '43, writes: ''I'll be 82 soon, but still practice internal medicine six days a week with a group of physicians I formed last year. I continue to be involved with students at the Medical University here [in South Carolina] and do the same in China. Chick (most of you know her) and I have been married 57 years and have 7 children, 17 grandchildren and 2 great grandchildren. I am in excellent health and enjoy my dog and horse." John G. Allen, MD '46, writes: "I am looking forward to my 55th reunion in spring 2001." E-mail is jallenl391 @aol. Sidney Anthone, MD '50, Buffalo, NY, surgery, "Am currently director ofU YTS." Robert E. Bergner, MD '50, Colden, Y, internal medicine: "Married 50 years and still happy. We have five children and eight grandchildren. I retired after 43 years in private practice. Still playing cello in the Orchard Park Symphony Orchestra and am singing in the church choir." Adelmo P. Dunghe, MD '50, Highland Beach, FL, family medicine: "! recently retired from the U.S. Army; happily retired since 1989; happily married since 1948." James C. Dunn, MD '50, Tucson, AZ, general surgery: "! have been on the faculty at the University of Arizona's College of Representatives of Bernard C. Harris Publishing Company, Inc., will start phoning alumni for the verification phase of our Unirerslty ilf Buffalo School at MedH:ine and BiomedH:al Sciences Alumni Direcfoty project. Much of the information to be verified on each individual's listing will be going into the directory; in particular, this includes current name, academic data, residence address and II"- number (if applicable!. The scope of this information is an indication of the comprehensive quality of the entire volume. The dlrec· tory will sort this data by name In the Medicine since 1978 in the Department of Anatomy. I was on the faculty at SU Y at Buffalo from 1957-1978, in the Department of Anatomy," E-mail is azcacti@acol.com. Yale Solomon, MD '50, Brightwaters, , ophthalmology, recently authored a book for laymen, titled Overcoming Macular Degeneration: A Guide to Seeing Beyond the Clouds, Avon Books. E-mail address is ysolomon@earthlink.net. James Youker, MD '54, was elected president of the alphabetical division, and by class year, and geographical location in separate sections of the book. There will also be a special message from the Alumni Office as well as photos and information about the school. Soon, locating fellow alumni will be as easy as turning a page in the Univer· sity ilf Buffalo School at MedH:ine and BiomedH:al Sciences Alumni Directory. You may resene your personal copy when your Harris representative phones, but don't delay because only pre-publication orders received at that tiRM will be guaranteed. American Board of Medical Specialties (ABMS) in March 2000. In this capacity, he will work closely with Steve Scheiber, MD '64, executive vice president of the American Board of Psychiatry and eurology, who is active on a number of committees of the ABMS. E-mail address is jyouker@mcw.edu Laurence J. Beahan, MD '55, Snyder, NY, psychia- try. "!am chair of the Sierra Club iagara Group 2000 and am publishing a book titled My Grampa's Woods: The Adirondacks. Am on the Public Health Committee Medical Society County of Erie." E-mail address is larry_beahan@adelphia.net. Leonard R. Schaer, MD '55, Alamo, CA. "I am retired." E-mail address is nanapop@hotcoco.infi.net. William J. Sullivan, MD ' 55. writes: "I am practicing half time at the present as the medical director of a group doing forensic psychiatry. I have stopped my psychoanalysis and psychotherapy. I hope and expect to continue to practice for a number of years more." I CONTINUED ON PAGE 34 assnotes Autumn 2000 l uff al1 Physician 33 �~ --- --- - - - -- - - CLASSNOTES CO NTI NU ED FR O M P AC E 33 the hospital will be named in their honor. Barbara YonSchmidt, MD '55, Oakland, CA, pa- thology. "I retired December 31, 1991, after working 35 years at Children 's Hospital of Oakland. " Jacques Lipson, MD '58, and his wife, Dawn, received the john Whitbeck, MD, Medal of Philanthropy for the Year 2000. This was awarded by the Rochester General Hospital Foundation. The newly constructed cancer and blood disorder center at 1960s William E. Abramson, MD '60, writes: "I enjoyed reading the Buffalo Physician summer 2000 issue. Also enjoyed seeing 30 of my classmatesstill vertical-at our reunion dinner on April 29, 2000. How come the Class of 1950 got the attendance trophy with 24 attendees, when we had 31 ?" {Editor's note: In re- sponse to Dr. Abramson's question, the Medical Alumni Association Office '11 who is chai~ explains that the attendallce trophy is determined by proportional represe11tatio11; i.e., the percentage of surviving members who attended. ] of the Department of Oral Diagnostic Sciences in the School of Dental Naomi leiter, MD '60, New York, Y, adult and child psychiatry. " I live near Lincoln Center and would love if my classmates visited with me. My eldest son is a "professor" at the ew School. My youngest son is starting his own theater company called Imbalance as director and artistic director. " E-mail is nl7012 @aol.com. Paullessler, MD '63, has been named director of Pain Management at University of Southern California's orris Comprehensive Cancer Institute in Los Angeles, CA. J. Richard Gunderman, MD '65, writes: " In 1999, I published a book, Raisi11g Your ChildA Love Story, on how to raise children. " E-mail address is: dickgund @aol.com. louis Trachtman, MD '65, writes: "Buffalo Physician is always enjoyable, but I was especially moved by Dr. Bean's article in the spring issue. It reminded me of the teaching methods of our professor of pathology at UB, Dr. Samuel Sanes, who taught the natural course 34 IU II I II rh JS I CI ID A11111mll 2 000 of diseases from the patient's perspective. P. S., I recently .....:t.:....,.L.:...;;;;....J had two articles published in our state medical society's journal, highlighting public health." E-mail: trachman@dhh.sta te.la. us. Andre D. lascari, MD '60, Poestemkill, NY, pediatric hematology/oncology. "I retired in April 1999. William G. Wolff, MD '69, is president of the New York State Radiological Society; councilor of the American College of Radiology; Advisory Committee on Radiological Health to New York State Department of Health. He is chair of the Department of Radiology at The ew York Hospital Medical Center of Queens, Flushing Hospital Medical Center, Coler-Goldwater Memorial Hospital; clinical associate professor of the Weill Medical College of Cornell University; and senior member of the American Institute of Ultrasound in Medicine and member of the Executive Committee of ew York Medical Imaging. 1970s John E. Knipp, MD '72, has been elected chief of medi- cine at St. Luke's Hospital m ewburgh, NY. Eric J. Russell, MD '74, Dr. Russell 's corrected E-mail address is e-russell@nwu.edu. Nancy A. Cunningham, PhD '78 and '80, has been a p- pointed medical library administrator in the Department of Educational Affairs at Roswell Park Cancer Center (RPCI ). In this role, she will supervise and direct personnel, fiscal and budgetary planning and operations of the Dr. Edwin A. Mirand Library and implement and coordinate library marketing and outreach activities. Peter Condro Jr. MD '79. Dr. Condro's corrected E-mail address is crrtfo ra rf@cs. com. 1980s Edward J. Rockwood, MD '80, writes: "My wife, joann Agnello Rockwood, died of breast cancer on july 29, 2000. She worked in the Medical Education Office at Millard Fillmore Hospital from 1977 to 1983, first with Dr. Harry Alvis and then with Dr. Luther Musselman. We have four daughters: Tiffany, 13, Delena, 12, Ashley, �In Memoriam school, Ihrig, who retired attended SUNY at Buffalo, editors of national and professor at Hershey in 1991, was on the staffs where he earned his un- local news media. He is Medical Center from 36 years at 71 North of Buffalo General, dergraduate and medical survived by his wife of 1972-1995. Yahn was Street in Buffalo, NY, died Children's and the former degrees. Klein co-founded over 30 years, the former a native of Olean, NY July 7, 2000, at age 71. A Lafayette General hospi- Williamsville Obstetrics Lois ("Cookie") Joseph and a graduate of St. native of Chicago, Ihrig tals for many years, as and Gynecology, where he Cominsky, three stepchil· Bonaventure University. graduated from the then- well as the Erie County practiced for over 30 dren and three children He was a Navy veteran, University of Buffalo in Medical Center. Survivors years. In addition, he was from his previous mar- a fellow of the Ameri· 1953, with honors. Follow- include his wife, the a clinical assistant pro- riage to Shirley Gerring. ing medical school, he former Jeanette S. Latona; fessor of OB/GYN at UB completed his internship two sons, four daughters, and an active member of Arthur E. Yahn Ill, MD at Bexar County Hospital and a brother. the American Medical As- '65, died at his orne n of Anesthesiology and sociation and the Ameri· Har• sburg, PA, on May the National Board of John J. Ihrig, MD '57, ho practiced dermatology for in San Antonio, TX, and can College of Anesthesiologists, a Diplomate of the American Board served three years in the Morton Paul Klein, MD can College of Obstetrics 15,2000,afteralong Medical Examiners. Air Force, where he rose to '62, died April 5. 2000 and Gynecology. An avid battle with spindle cell Surviving are his wife, the rank of captain. He in Delray Beach, FL, of recreational bicyclist, fibro sarcoma. He was Mary Ann Krastell then returned to Buffalo complications following a world and RV traveler and 60. Yahn had been on Yahn; three daughters, and began his practice in bicycle accident. He was gourmand, Klein was also staff at Harrisburg three sons, his mother, 1965 after completing his 68. A native of Union City, an active supporter of Jew- Hospital since 1971 and two sisters, and a brother. residency in dermatology NY, Klein served in the ish community activities in director of anesthesiology at UB. In addition to serv- U. S. Navy as a medical Western New York and a services there from ing as a volunteer faculty corpsman during the frequently published con- 1975-1977. He was also member at UB's medical Korean War. He then tributor of letters to the an assistant clinical 10, and Amanda, 5. I am a staff ophthalmologist at the Cleveland Clinic Foundation, subspecializing in glaucoma. » E-mail address is: edwardrockwood@aolcom. Steven R. Goodman, MD '84, practices physical and rehabilitation medicine in Federal Way, WA. He is a clinical associate professor at the University of Washington's Multidisciplinary Pain Center, where he teaches intramuscular stimulation for the treatment of neuropathic-myofascial pain syndromes. E-mail address is srgood@home.com. Francis Whalen, MD 'B7, writes: "I have just completed an internal medicine residency and will start a pulmonary critical care fellowship in July at Pittsburgh." E-mail address is fwhalen@adelphia .net. Thomas E. Kowalski. MD 'BB, has been named medical director of gastrointestinal endoscopy in the Division of Gastroenterology and Hepatology, Department of Medicine, at Thomas Jefferson University Hospital in Philadelphia. He is also associate professor of medicine at Jefferson Medical College of Thomas Jefferson University. 1990s Rohit Bakshi, MD '91, has been awarded a threeyear, $300,000 grant from the JH-Nl DS to study MRI findings in multiple sclerosis. The work will be carried out in the Department of eurology at Kaleida Health System's Buffalo General Hospital, where Dr. Bakshi is a neuroimager and MS specialist. E-mail address is rbakshi@buffalo.edu. Mary (Cappuccino) Bonafede and Joseph P. Bonafede, MDs '91. write: "We are happy to announce the arrival of our third child, Andrew Joseph, on February 1, 2000. Andrew joins his big brother, Sam, age 4, and his sister, Ella, age 3. Joe and 1 are both enjoy- A u t u mn 20 00 CD ing private practice (otolaryngology and pedia tries) on the eastern shores of Long Island. E-mail address is Mbon.465050@aol.com." Philomena Mufalli Behar, MD '92, writes: "My hus- band, Jerry, and I would like to announce the birth of our daughter, Julia Fay, on June 25, 2000. She weighed five pounds, 12 ounces, and was 18 inches long." E-mail address is: pmbehar@aol.com. C ON T IN U E D ON P AG E 36 1 1 If al• n ysic ian 35 �CLASS I CON TIN UED FR O \~ ~ 35 Warren Scherer, MD/PhD '92, writes: " I served as the ophthalmic surgeon for a medical mission to El Salvador in August 2000. I am currently in private practice in ew Port Richey, FL." E- mail address is warren scherer@hotmail.com. E-mai NOTES Michael Aronica MD '93, writes: "I am proud to announce the birth of our third child, Marykate. Meghan and Madeline just love their little sister. Mary and I are doing well in Buffalo, NY. I am enjoying my job with the Division of Internal Medicine and Pediatrics at the U Buffalo School of Medicine. My clini- cal duties are based at the Elmwood Health Center and Children's Hospital of Buffalo." Alissa Shulman, MD '93, writes: "I am pleased to announce I have recently joined a wonderful and busy plastic surgery practice- Plastic urgery, P. C.- in South Bend, IN. An additional note: I have continued with my artistic endeavors, both personally and professionally. Life is good!" E-mail address is: doctoral issa@aol.com. Donna (Sinensky) Ferrero, MD '94, writes: "I recently joined a large multispecialty private practice in orth Andover, MA- ew England eurological Associates, P. C. I am practicing physiatry. I am also happy to announce that my husband and I are expecting our first child in March 2001." Babak Parwar, MD '96, and Bobbie Parwar, MD '97. Babak writes: "I am in my fourth year of head and neck surgery at UCLA Medical Center. My wife, Bobbie, is in her second year of ophthalmology at the Jules Stein Eye Institute in Los Angeles." Kristin Larsen, PhD '97, writes: "It's been a good year for me. I got married in September 1999 and was recently promoted to junior faculty in the Department of eurology at Columbia University. My research angle is alternative therapies and preventions for Parkinson's disease." E-mail address is kell4@columbia.edu. A plan for livllg. Hospice really is a plan for living ... one that we can make together. With treatment options from you, plus emotional support, symptom I plan to keep going. management and in-home care from Hospice, we can help your patients make the most of their time with family and friends. Call 686-8077. T H E C E;>.;TER F O R H1)SPICE& PALLIATIVE CARE www.lzospicebtiffo lo. com 36 l•flale Pbysiciaa A utu m" 2000 �- Based on F/Mst-1 Data dnJl ffTheywere sergeantsand cheerleaders:' - Fronk Stelarski, stroke rehab patient Harris Hill H.C.F. Why do our patients have better rehab resuh:s compared to the national average? Maybe ~·s our staff ''They knew exactly how far to push me,'' says Frank Stelarski. ''But they also encouraged me every lfttle step of the way. When you've been through what I have, that really means a lot.'' To leam more about the nationally recognized McGuire THE Rehabil~tion ~~ry}Jfl.I(9!{ Centers, call 1-888-POSTACUTE or vis~ www.mcguire-group.com. Recognized for excellence in quality· care. CEN1E~ tf*****" AUTUMN VIEW • GARDEN GATE • HARRIS HILL • NORTH GATE �p H A R M A c 0 p 0 E I A GB's HISTORY OF MED!Clr-iE COLLECTIO:-i PRF.SE . . TS PHARMACOPOEIA Digitally reproduced prints from a pharma copoeia by Otto Karl Berg (1815-1866) are on display this fall in University at Buffalo's Health Sciences Library (HSL), South Campus. The botanical show was developed by the HSL and the university's iMedia staff and is the first in a series of "Art in the Library" exhibits intended to promote the History of Medicine Collection through the display and sale of reproductions of selected works. Fred Kwiecien and Don Trainor of iMedia prepared the prints from the original art in the Berg volume , published in Leipzig in 1863. Pictu red is Iris Florentina. RP 00 02 01 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 2000 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2000-Autumn Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v35n02-2000-Autumn Table Of Contents A list of subunits of the resource. Internal Medicine's Man Eschewing Viewing Pathways Research Medical School Student column Development Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v35n02 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2000 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/fb8a399d09f5525f5ef63efb48ff9171.pdf c8e4cd065beb7b044517e2ea752b6e79 PDF Text Text �l1ffale P~ysicial A SSOC IATE V I C E PRE S I DE T FO R U NIVERSI T Y SERVI C E S Dr. Ca role Smith Petro Dear Alumni and Friends, DIRE CTO R O F P U BLI C ATI ONS Kathryn A. Sawner EDI TO R Stephanie A. Unger ~\ RITI '(,, nn I·~D 01 Till \( ADF\11( n \R is upon us and both freshme n and sophomores are in the m idst of fina l examinations. Although the newly created study space ART DIRE cT 0 RIDE s I G N E R Alan]. Kegler is as yet un furnished (the furniture is on order), we have made some makeshift arrangements for students du ring their finals and for national board preparation. We hope to have this important student resource fully functional shortly. On another positive note, we hope to upgrade the computer lab during this next year, as the present computers are three years old and their warranties are about to expire. The newer machines (and redistribution of the o lder ones) will be helpful to the new curriculum A SS I STA N T DE S I GN ER Lynda Donati PR O D UCT I O N COO RDIN ATO R Cynthia Todd - Flick STATE UN I V ERSIT Y OF NE W as it begins to u nfold a year from now. Some of the o lder pentium computers will be YORK AT B u FFALO S c H oOL relocated to the Standardized Patient Project, which, as many of you know, is a project OF M E DI C I N E AND through which Buffalo has taken a leadership role in the development of BI O M E DI C A L S C IE NCES Dr. fohn Wright, Dean modules for the national board, as well as in the development of E DI TO RIAL B O ARD standardized testing. In collaboration with the national board, our own computer group, under the leadership of Dr. Ray Dannenhoffer, has devised a system to computerize studen t-"patient" interactions for reporting direct ly to the board. Using industry standard hardware and software wi th customized programming scripts, a pilot project was so successful that we have been asked to provide the computer support for each of the board's present test sites at the University of California at Irvine, Mercer University, Tulane University, the University of Massachusetts, East Carolina University, St. Lou is Un iversity and, of course, UB. We will configure the servers and workstations here and ship them to each of the participating schools. Our staff will then complete hardware and software installation on site and train loca l personnel on program operation. Since the standardized patient will soon be part of national board testing, our school's involvement in the process is something to brag about. Speaking of"bragging rights," our Mini Medical School has a few of its own. Through this innovative progra m , Harry Sultz and Alan Reynard have developed a remarkable community resource. The Mini Medica l School recently received a welcome "shot in the arm" through a generous gift from Esther and Don Davis. This support will provide muchneeded financial stability as the project branches out in both subject area and community coverage. We have already been alerted to a need in the Southtowns, and the facu lty are looking into telemedicine venues in order to reach an even broader community. This, of course, has implications for a range of programs at UB, includ ingCME and GM E possibilities. Finally, Dr. john Yeh, from the University of Minnesota, joined the Department of Dr. Bertram Portin, C hai r Dr. Martin Brecher Dr. Haro ld Brody Dr. Linda f. Corder Dr. Alan]. Drin nan Dr. fames Kanski Dr. Elizabeth O lmste d Dr. Steph e n Spau lding Dr. Bradley T. Tru ax Ms.fennifer Wiler Dr. Franklin Zeplowitz TEA C HIN G H O SPITALS Erie County M edica l Ceuter Roswell Park Cancer Institute Vet erans Affairs Western N ew York Healthcare System K A U :IDA Hf: A l_ J fl: Th e Buffalo General Hospital The Children 's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillm ore Suburban Hospital C ATH OLIC H f. A l TH SY<Tf.\1: Mercy Health System Sisters of Charity Hospital Niagara Falls Mem orial Medical Center ® TIE STITI IIIYIISITY If lEI Till AT II HALO Ob-Gyn as chair on May I. He has recruited four new facu lty and is working on a fifth . And we look forward to the arrival of Dr. Kenneth Blumen thal, from the University of Cincinnati, who will begin leading the Department of Biochemistry around the first of August. Greetings to you all, and best wishes for a very pleasan t and relaxing summer. 7 ( / ~</~ R. WRIGHT, MD Dean, Sch oo l of Medicine and Bio m edica l Scien ces jOHN Buffalo Physician is published quarterly by the State University of N ew York at Buffalo School of M ediciue aud Biomedical Sciences aud the Office of Publications. It is seut, free of charge, to a/umui, faculty, students, restdents, aud frieuds . The staff reserves the rig/It to edit all copy and submissions accepted for publication. T...:l:... University at suffal;rk -:.=:s Tiu>State University ofNew �V 0 L U M E 35, NUMBER 0 H Special 2 group helps first-year students 14 Match Day 18 Graduation N Concussion in sports: new guidelines call for "time-out" BY S.A. UNGER MILLER Wake·up Call Difficult decisions for a gifted young athlete S. A. BY UNGER Carl Lindros, left, father of hockey stars Brett and Eric Lindros, has teamed up with University at Buffalo professor Barry Willer, PhD, right, to institute back·to·play guidelines following concussion in amateur sports. The story of their successful international effort begins on page 2. Baseline Scoring UB professor's neurocognitive test used by FL and NHL BY S. A . UNGER 21 Professor 13 New tutorial A Safe and Sound COVER prospective students an in-depth preview c s eport PHOTOGRAPHY BY FRANK 8 10 y Theodore Bronk remembered 22 New faculty 23 Nancy Druar wins Naughton Award ILLUSTRATION BY WHITNEY SHERMAN 25 Maxine Hayes returns to UB to deliver Stockton Kimball lecture 27 Medical Alum ni Lifetime Achievement Awards 29 Reunion classes traditions begin today your classmates and other UB alum ni 36 First Minority Alumn i Reunion held 40 Medical Alumn i Association officers elected reception October 29 in Chicago 41 Photographs from Spring Clinical Day and Reunion Weekend gatherings �or ort by S. I. Unger Photos by Frank Miller -Carl ,, lin~ros �Due to concussion. Brett Lindros, right, was forced to withdraw from the National Hockey League in 1996 at the age of 19. His injuries served as an impetus for his father, Carl other young athletes from experiencing what his son-former professional hockey player Brett Lindros-experienced that led Carl Lindros four years ago to seek out Barry Willer, PhD, an expert in traumatic brain injury and a professor of psychology at the University at Buffalo School of Medicine and Biomedical Sciences. Since that time- due in large part to Lindros's inspiration- Wilier has become a highly visible leader in international efforts to establish return-to-play guidelines following concussion in amateur sports. The pivotal event that allied Willer and Lindros in their efforts to prevent concussions in sports took place in Buffalo on ovember 24, 1995, during a ational Hockey League (NHL) game between the New York Islanders and the Buffalo Sabres. During that game, while his father watched from the stands, Brett, a second-year player with the Islanders, sustained a concussion that not only changed his life forever but, indirectly, impacted the world of amateur sports, as well. Lindros. to work with University at Buffalo professor Barry "While watching Willer to develop guidelines aimed at keeping young athletes the game, I rememout of sporting events for asafe period of time following a ber seeing Brett check an opposing player in concussion. Pictured with Brett is his older brother Eric. of open ice late in the the Philadelphia Flyers. who today is fighting his own first period," Lindros well·publicized battle with concussion. recalls. "He wasn't hit in the head, but the deceleration from the contact caused him to be concussed." When Brett didn't come back on the ice at the start of the second period, Lindros became concerned and went to the locker room to look for him. There he saw something he says he will never forget. " I found Brett sitting alone, trembling. And right away r could see he wasn't himself," explains Lindros. "He was very disoriented-one moment he was coherent and the next moment, incoherent; he was fading in and out. l could see that it was a serious issue." S 11mm er 2000 Bu ffalo Physician 3 �he next morning, having returned home to Toronto, Lindros went to the public library to discover what he could about concussions. It was through his research in the weeks that followed that he first learned about the Ontario Brain Injury Association (OBIA), an organization that Willer-a native of Canada-has been affiliated with as avolunteer for more than ten years. "In my search of the literature, I found a lot of current " He'd go 'in and out,' and there were noticeable changes in his behavior. He was anxious and jittery-like he had too much papers on severe traumatic brain injury, but hardly anything about repeated mild traumatic brain injury, and it's these caffeine-so he couldn ' t focus on anything for very long." Over several months, Brett's symptoms gradually abated; types of injuries-concussions-that are the most preventable," says Lindros. "What I did find about concussions tended however, in the interim he sought the opinion of three promito be published in the last 10 years, but the theories they nent neurologists, each of whom recommended that he not play discussed were often contradictory, and they confused me hockey again. As a result, on April 15, 1996, at age 19, Brett because I was looking for clear direction," he adds. formally announced his withdrawal from the sport. Despite the dearth of published research on concussions, Knowing what he now knows about concussions, Lindros is Lindros did discover startling statistics about the scope of the thankful that his son was not hurt worse than he was. "Brett's problem, including the fact that an estimated 30 percent of all concussion [in November 1995] was his second in an eight-day youth in the U.S. and Canada will experience a concussion period. What I realize now is that he was probably playing in a before they leave high school and that, of these cases, only concussed mode that night." about one-fourth will be seen by a physician. In hindsight, Lindros also realizes that Brett might have been As long as there is only one minor concussion, the symptoms playing in a concussed mode earlier in the session, as well. are, for the most part, reversible, and the brain recovers within "For example, l remember on one occasion Brett's coach about five days. However, when there are multiple minor conasked him what he was doing during a shift, and he couldn't cussions, particularly if these concussions occur tell him because he couldn't remember. close in time, the probability of irreversible brain damage "Clearly, Brett could have been seriously and permanently rises dramatically. injured in Buffalo. If he had had a significant direct blow to his More worrisome still is the fact that if a young athlete is head that night, there's no telling where he'd be today. There 's allowed to return to play too soon following a concussion and no doubt he was playing when he should not have been. " sustains a second, even minor, blow to the head, he or she can experience a rare, but lethal, condition called secondimpact syndrome. On March 12, 1997, the American AcademyofNeurology (AA The more Lindros learned about concusheld a news conference in New York City for the purpose of sions in the weeks following Brett's injury, announcing return-to-play guidelines it had established. In the more concerned response to an invitation from the AAN, Brett attended the news he became for his son, whose symptoms were debilitating. "He ut of this discussion evolved the guidelines that were adopted in 1998, which, couldn ' t dial a digital phone, he couldn't according to Willer. have been worded in such a way that they "not only make sense read, he couldn't drive, medically. but are presented in a format that enables mom·the·team·trainer to readily and what was really frustrating was that his understand them-mom, that is, whose occupation may be accounting, not medicine." symptoms weren't consistent," says Li ndros. 4 Butt a I o Physician S 11111111 er 20 0 0 �-~ - - - - -- ~~--~-------------------~------------- conference and participated in a panel discussion on the guidelines and their role in attempting to prevent concussion in sports. Soon after this event, the Lindroses were contacted by the OBIA and asked if they would lend their support to the organization's fund-raising efforts, which they agreed to do with the stipulation that a portion of the proceeds raised go to disseminating information about the AAN's guidelines. In response to this request, the president of the OBIA initiated preliminary discussions with the Canadian Hockey Association (CHA) in an attempt to get the association to agree to adapt the AA 's guidelines. It was when these discussions came to an impasse in the summer of 1997 that Lindros asked Wilier-whom he had met at an OBIA event-if he would help get the stalled negotiations with the CHA back on track. W iller agreed to collaborate with Lindros on the project, as well as on a myriad of other preventive strategies aimed at keeping young athletes out of sporting events for a safe period of time following a head injury. On January 1, 1998, their efforts came to fruition when the CHA formally adopted return-to-play guidelines that had been painstakingly crafted by Willer with the assistance of John Leddy, MD, a UB associate professor of clinical orthopaedics and associate director of the university's Sports Medicine Institute. Getting the return-to-play guidelines adopted by the CHA was a very significant step forward, according to Willer, because "the association governs all amateur hockey in Canada, which makes it the first bona fide sports organization to have adopted guidelines regarding concussion." Willer, who has been involved with hockey as a player and coach for most of his life, says he agreed to focus his efforts on hockey not only because he loves the sport, but because he felt it would be an effective conduit for introducing return-to-play guidelines in other amateur sports, which in fact it adopted them on an informal basis, with formal adoption expected to take place sometime this year. When this happens, the guidelines will apply to all international hockey events, including Olympic hockey. Furthermore, if other, alternative guidelines aren't adopted [by the Olympics], the return-to-play guidelines of the International Ice Hockey Federation will apply, by default, to all Olympic events." Willer reiterates that the initial impetus for establishing return-to-play guidelines came from the AA but emphasizes that these guidelines, while groundbreaking, do not translate well to the realities of amateur athletics. " Prior to the AA announcing their guidelines and publishing them in the journal ofNeurology, there were no really authoritative guidelines anywhere. The problem, however, was that the AAN guidelines were basically written for professional sports or other environments where a qualified trainer is on-site and the athletes' histories of concussion are available; in other words, they assume that there is someone on the bench-either a physician or a professional trainer-who can immediately appraise an athlete's condition and determine if he or she can return to play at that time or not." has been. "Hockey was born and bred in Canada, so the international sporting community still looks to Canada and the CHA for leadership," he notes. "Because the CHA adopted the guidelines, the International Ice Hockey Federation also recently S 11 111 111 e r 2 0 0 0 Bu II a I o Physician 5 �when you 'sprain your brain' it's a bigger deal than spraining your knee ing your knee or ankle. If you play on abum knee or live with abum knee, that's one or ankle. If you play on a bum knee or live with a thing. But if you don't come back fully from abrain injury, it's different. You may be bum knee, that's one left with asignificant decline in mental functioning." thing. But if you don't come back fully from a brain injury, it's different. You may be left with a When Lindros suggested to Willer that the UB professor apply functioning." significant decline in mental his expertise and influence toward helping establish guidelines of tell the players. when you 'sprain your brain' it's abigger deal than sprain· a similar nature in amateur sports, Willer and his collaborators began by going to the CHA to meet with the individuals within the association who develop educational programs for trainers. "What ensued was a debate that centered on the questions, 'What can we realistically expect from the volunteer trainer/ coach on the sideline who is just somebody's mom or dad and who has little or no medical background? What kinds of decisions can we expect him or her to make about a player's condition?"' explains Willer. Out of this discussion evolved the guidelines that were adopted in 1998, which, according to Willer, have been worded in such a way that they "not only make sense medically, but are presented in a format that enables mom-the-team-trainer to readily understand them-mom, that is, whose occupation may be accounting, not medicine. " (See guidelines on page 7.) Essentially, the guidelines adopted by the CHA involve three basic modifications to the AAN guidelines. In addition to providing wording that better helps inexperienced trainers identify a concussion when it occurs, they recommend that all concussed athletes be asked to see their physician before they return to play. "Also, given the substantial increase in risk for irreversible damage due to repeated concussions, if an athlete has three concussions in the same year, it is recommended that he or she rest away from the sport for the remainder of the playing season," explains Willer. "These guidelines help make sure nobody goes back to playing sports until they've fully recovered from symptoms of a head injury," emphasizes Leddy, who, as a team physician for intercollegiate athletics at UB, knows firsthand about the dangers of concussive injuries in amateur competition. "I tell the players, 6 8 u f fa I o Physician S llllllll cr 2 000 Despite the apparent simplicity of the modifications made to the AAN guidelines, they required a long series of discussions with the CHA, with final wording changes taking place as late as December of 1999. Lindros feels Willer's role was crucial to making the project a success. "Due to his scientific expertise and credibility, he [Willer] was able to facilitate the whole process and gain the complete support of Canadian amateur hockey through the CHA. He brought order and cohesion to the effort." Physicians' Role aKey to Success Because the guidelines recommend that players see their physician before returning to play, Willer and Leddy have also been working to provide physicians with educational material about concussion in an effort to help them better assess when it's �safe to allow a child to return to playing sports. "Most family doctors, internists and pediatricians probably don 't see enough of these head injuries to really be very comfortable with treating them, and it's not something they' re taught about in medical school," notes Leddy. " 1 think most physicians need more education about how to identify when a concussion has occurred, as well as how to identify and treat symptoms of postconcussive syndrome." F urthermore, he cautions, "These injuries can be difficult to diagnose, at best. There are a lot of symptoms that mimic other things; also, athletes are prone to minimizing symptoms or downright denying them to the doctor. " Toward the goal of educating physicians, Willer is developing an educational package that includes the return-to-play guidelines, information on symptoms of concussion, and assessment procedures for concussed athletes. Through his affiliation with the OBIA, he is also working to organize a medical advisory committee on concussions that, in addition Management e .o eyes; or if eyes open, cannot s Guidelines Following Concussion 1. Remove from the contest. 2. Monitor symptoms (con- Developed by the Ontario Brain Injury Association and approved by the Canadian Hockey Association. fusion, headache, etc.). If they persist longer than 15 minutes from the time of injury, the athlete should be referred to a physician immediately. The injury should then be treated as a Second-Degree/ Complex Concussion. 3. Always check for a possible neck injury. 4. Notify parent or guardian and do not administer any medication. 5. Cannot return to play without approval of a physician and at least 24 hours of symptom-free rest. First-Degree/Simple 1. Confusion, also defined as an altered state of consciousness, that lasts for less than 15 minutes (e.g., asks the same question repeatedly, such as "What happened?" or does not know simple facts, like who the opponent is or what the score is). 2. No loss of consciousness. 3. Dizziness, headaches, nausea, lethargy; may have some memory loss. to establishing a consensus on post-concussive symptoms, will sponsor educational conferences for health-care professionals. " In the long run," he says, " the goal is to help physicians be a little more astute at picking up symptoms and a little more aware of the long-term consequences of concussions themselves." Lindros commends this comprehensive approach to education because he fe els it can lead to protection for all children, not just those involved in sports. "These guidelines, and the awareness they help create, apply to everyone, including parents who see their child fall off the swing set and hit their head. They aren ' t just for sports, but for life in general. What they remind all of us is that the clock doesn't start ticking-a child or an athlete doesn ' t go back to play-until he or she is symptom-free at rest and with exertion for an appropriate period of time. " Essentially what we' re saying is, 'Let's have greater respect for the body and things we do to the head. ' When the body isn ' t treated with respect, a minor concussion can lead to significant, long-lasting problems. " CD Second-Degree/Complex seem to focus, does not answer to name, may be limp). 2. Loss of consciousness may only last seconds but is still serious and must result in removal of the player from the contest. Management ec m aos 1. Always check for injury to the neck. 2. Remove from contest and disallow return that day. 3. If unconscious, or condition deteriorates, stabilize the head and neck and activate the Emergency Action Plan, including transfer by ambulance. 4.Cannot return to play without approval of a physician and at least one week of symptom-free rest. after any concussion requires a physician 's approval. In order to make the most informed decision, the physician must be made aware of the history of concussions and symptoms experienced by the athlete. Another important aspect of these guidelines is that the only known cure for concussion is rest. It takes time for brain cells to recover. When there is more than one concussion in the same season, a physician may recommend a much longer period of rest from sports. If an athlete has three concussions in the same year, the physician may recommend rest away from the sport for the remainder of the playing season. For more information, call 1. Confusion that lasts longer than 15 minutes, or a loss of consciousness (does not open More than One Concussion S· S o An essential aspect of these guidelines is that return to play S 11 mmer the Ontario Brain Injury Association pt 1-800-2635404, or visit their website at www.obia.on.ca. 2000 B u II a I o P h y s i c i a n 7 �by S. I. Unger Wake· Difficult decisions for agifted young athlete ) C) was quite sure hockey would be a big part of his life for as long as he wanted it to be. Today, however, the 17-year-old from Kenmore, New York, isn't quite so certain. That's because Dan recently suffered two debilitating concussions that have left him with a decidedly new appreciation for what it means to have a healthy brain. "Hockey has pretty much been my life. I started playing when I was four, and since the seventh grade I've played on teams yearround," he explains. And Dan hasn't been the only one enjoying the sport. "Hockey is a bonding experience for our family," says his father, Tom. His mother, Bonnie, says, "If you ever get to watch Dan play, the joy is in seeing him skate; he's just such a beautiful skater." john Mickler, Dan's coach at St. joseph's Collegiate Institute, also gives Dan high marks for his prowess on the ice. "Dan has been on the varsity since he was a sophomore. He's a very good player. He's fast and aggressive and plays with great enthusiasm, with a love of life." Dan experienced his first concussion in September 1998, while playing with an independent travel team, the Buffalo Saints, at a tournament in Toronto, Ontario. "I was skating up the middle of the ice and was hit behind with a cross-check," he recalls. "He didn't know where he was. He was disoriented, his eyes were dilated, and we knew he had to come off the ice," explains Tom, who was in the stands when the injury occurred and felt confused himself. "I know what needs to happen when a player breaks his arm, but I didn't have any idea what to do when Dan had his concussion," he says. Despite his initial uncertainty, Tom had the paramedics at the rink look at Dan. "They told us he had a head trauma, and that we needed to watch him pretty carefully," he remembers. The next day, the tournament was in full swing and Dan's team was scheduled to play again. When Dan got up in the morning, his father asked him how he felt, and he said he felt pretty good, that he didn't have a headache and wasn't disoriented anymore. ''I'm not proud of this, but when he asked me if he could play in the game that day, I said yes," explains Tom. In looking back on that decision, Tom now knows how 8 Buffalo Physician S11mmer 2000 fortunate he and his family were that day. "It was a very rough tournament. And while Dan didn't get hurt in the game, his closest friend experienced a concussion in it." The week following the tournament was the first week of school for Dan. "I didn't know why I was there or what I was supposed to be doing," he says. "I figure I'd had concussions before-maybe from playing football in the neighborhoodbut nothing ever stopped me before like this. I was startled." Over the following weeks, Dan's symptoms cleared up and he was again able to immerse himself in the sport he loved. A year went by, and Dan's concussion seemed a thing of the past. Then, on October 24, 1999, at the close of his season with the Buffalo Saints, he suffered a second, even more serious, concussion. The incident occurred at a tournament in Cleveland, Ohio, where Dan had traveled with the parents of a friend on the team. Despite the severity of his injury, no one seems certain about what actually happened. "It was the third game of the tournament, and I remember playing really hard and scoring a goal. After the game, we had free time on the ice, but I remember going over to the bench and just sitting down," says Dan. "I thought maybe I was super tired." Later, in the locker room, Dan's coach came in to talk to the team, but Dan couldn't understand him."[ didn't know what he was saying. I was lightheaded and dizzy, and I began to wonder what I was doing there and where my parents were. I almost got kind of panicky. I didn't even know what day it was." Although scared, Dan didn't tell his coach what he was feeling. ''I'm not a big guy," he explains. 'Tm only about 5' 8", and I didn't want to complain, but I was so tired I couldn't stand up." When his teammates dressed and left the locker room, Dan stayed behind. "The parents of Dan's friend waited in the lobby and became alarmed when he didn't come out," recalls Tom. "When the father finally went to look for him, he found Dan in the locker room alone, sitting on the bench. He didn't know what was going on or what had happened." All Dan remembers about the remainder of that road trip is that he slept in the car during the entire drive back to Buffalo. Bonnie Sanderson called Dan's pediatrician, who told her Dan had to stay off the ice for two weeks. Tryouts for the school �because l wasn't in shape, that maybe I had heat exhaustion," he says. Dan didn't try to skate again until the week ofThanksgiving, at which time he traveled with the team to Detroit and played in a game, the first since his concussion. Again, he felt as though he were suffering from heat exhaustion. "After that, I knew l needed to go to the doctor again; I just wasn't getting better," he says. The following Monday, Bonnie called a friend of theirs who is a neurologist, and he told her to bring her son in immediately. "He gave Dan an MRI and a complete examination and told us he couldn't be on the ice for another two or three weeks, or until his symptoms went away," says Bonnie. On December 15, 1999, Dan returned to play and has not reinjured himself since. "This last concussion was our wake-up call," says Tom, who accepts that Dan's playing days may be numbered. Dan, too, knows there may be difficult decisions to make in the future, but says he no longer looks at hockey in the same way. "Alii have to do is remember those couple of months when I couldn't think in math class and had to ask everyone to repeat things they Normally,l'm agood student, but I couldn't sit still in class for five minutes. I wanted to said to me four times. What's happened to me has brought me down to thinking about what get up and walk out. I just had no ambition to be there," says Dan. "I slept a lot, had a I really want to do. I'm starting to think about headache all the time, was dizzy, and my head felt foggy.l didn't want to do anything." the pros and cons of continuing to play." As he helps his son grapple with the potential long-term implications of his injuries, Tom also ponders whether better Bonnie Sanderson also decisions about Dan's health could have noticed big changes in her been made from the outset. "As parents, I son. "Dan is usually on top think we needed a little more training and of things, both at school guidance. We need more information so we and at home. But many can all be on the same page when a player times when I would talk to gets a concussion. It would have been helpful him, I'd literally have to if we had had more explicit instructions say, 'Dan, are you with me?' about what to look for, what to do." He wasn't himself. He was Bonnie sees the problem in an even larger acting very goofy; that's the "I feel it's really a disservice when you context. best way I can describe it." read in the paper that a pro player has had a While Dan didn' t play concussion on Sunday and then is back at prachockey, he did go to his tice on Thursday and back playing in a game team's practice sessions, that next week. The media treats concussions where he'd watch from the like a broken leg. They make it out to be nobench. "I wanted to stand thing, so it's been hard to know what to think." on the bench to watch, but Like Tom, Bonnie feels different decimy balance wasn't good sions would have been made had she known enough to do that, so I rein September 1998 what she knows today. "I member I had to stand on would never have a child of mine go back out the floor instead." on the ice if I knew it would endanger his On November 17, Dan health," she says. "Yes, hockey is important to played in a scrimmage, but us as a family, but, as I tell Dan, 'I like you didn't feel well afterwards, just the way you are."' 4D he says. "I thought it was team were coming up, but since Dan had made the team the year before, Coach Mickler suggested he take some extra time off in addition to the two weeks. Unlike what happened after his first concussion, however, Dan's symptoms didn't go away, so Bonnie took him to see their pediatrician, who told her Dan couldn't return to play until his headaches subsided. "Normally, I'm a good student, but I couldn't sit still in class for five minutes.! wanted to get up and walkout. I just had no ambition to be there," says Dan. "I slept a lot, had a headache all the time, was dizzy, and my head felt foggy. I didn't want to do anything. "I really began to wonder what was wrong with me, what was happening to me," he adds. "It would have been easier if there had been a clear-cut blow to my head that caused my concussion, but we watched film from the game later, and even though I could see I was hit in the head a few times, nothing stood out as the hit that caused my concussion." 5 " 111 111 er 200 0 Buffalo Physician 9 �I I by S . A. Unger ne of the reasons why many experts feel concussion is such an overlooked problem-even a "hidden epidemic"-is because the affected organ is itself hidden from view. "Yet, when a brain is concussed, if you look at it on a microscopic or cellular level, there's a whole cascade of events taking place, including changes in blood flow and glucose and electrolyte metabolism," explains John Leddy, MD, UB associate professor of clinical orthopaedics and associate director of the university's Sports Medicine Institute. While physicians still don't understand all the physiological changes a brain undergoes when con cussed, what they do know is that concussions cause deficits in neurocognitive abilities, especially when more than one concussion is suffered within a short period of time. Due to recent advances in neuropsychology, neurocognitive tests are now available that measure these deficits more precisely than ever before. When used in conjunction with a standard neurological examination, they become powerful tools for assessing whether an individual has recovered from a concussion. Neurocognitive tests and the data they provide are of particular interest to professional sports organizations, which today are experiencing increased pressure from players' unions and insurance companies to adopt return-to-play guidelines that better protect athletes from preventable, career-ending head injuries. (See article on return-to-play guidelines established in 1997 by the American Academy of Neurology, page 2.) Several years ago, in response to these pressures, both the National Hockey League (NHL) and the National Football League ( FL) began participating in the HL!NFL Players' Association Concussion Testing Project, developed by Mark Lovell, PhD, a neuropsychologist at Henry Ford Hospital, in Detroit, Michigan. (Participation in the project is mandatory for NHL teams and voluntary for NFL teams. Currently, about 85 percent of the FL teams participate, not including the Buffalo Bills.) As part of the project, no athlete can practice or play with a team until he undergoes a baseline neuropsychological examination. In the event of a head injury, he is reexamined and the data are then compared to the "healthy" baseline as a means to measure the severity of his injury and his progress toward recovery. In 1997, Lovell contacted Ralph Benedict, PhD, a neu ropsychologist at the University at Buffalo School of Medicine and Biomedical Sciences, and asked if he could incorporate in the Concussion Testing Project a neurocognitive test Benedict had developed called the BriefVisuospatial Memory Test. As a result, Benedict's test is now a key component in the professional sporting world's attempt to keep players from returning to play too soon following a concussion. Also used in the project is a test called the Hopkins Verbal Learning Test. While completing his postdoctoral training and residency at the Johns Hopkins University, Benedict took a lead role in revising this test, which was originally developed by Dr. Jason Brandt. In addition to providing the Concussion Testing Project with the tools it needs to test the players, Benedict is also serving as a consultant with the project. In this capacity, he is available on an on-call basis should an NHL or NFL player be concussed while playing in Buffalo and require neurocognitive evaluation. Benedict's Brief Visuospatial Memory Test is also widely used outside of professional sports to evaluate cognitive function in individuals affected by brain injuries or disease. 4D �------------------------------------------------------------ ------- UB Selected as Site for High School Pilot Program n a related development, the University at Buffalo was informed in May 2000 that it has been selected as one of three national test sites for a new computer-based neurocognitive assessment program for high school athletes. (The other two sites are the Mayo Clinic and Henry Ford Hospital.) Developed by the same researchers at Henry Ford Hospital who developed the NHL/NFL Players' Association Concussion Testing Project, the new program involves giving high school students an abbreviated version of the professional-level test that can be administered by computer in 15 to 20 minutes. The UB effort--led by Barry Willer, PhD, UB professor of psychology, in collaboration with the Ontario Brain Injury Association and Brock University-will involve high school students in Buffalo, New York, and Niagara, Ontario. Significance of Cong·term ncuss·suotie)effects: "At minimum, parttopating schools are expected to assess every student involved in sports. What would be ideal, however, would be for all students to be assessed, since organized sports-while they do constitute high-risk activities-account for only about 15 percent of all concussions in this population," explains Willer. "Participation in this project to assess the feasibility and validity of the brief assessment procedure could be a major factor in the prevention of cognitive disabilities in young people," he adds. For more information on the HLINFL Players' Association Concussion Testing Project, e-mail Dr. Benedict at benedict@acsu.buffalo.edu. For more information on the new high school testing project, e-mail Dr. Willer at bswiller@ acsu.buffalo.edu. The Impact of Concussions on Youth •:• One-third of youth experience a concussion before the end of high school. •:• One-half of all concussions are accompanied by loss of consciousness. •:• Average age of concussion is age 10. •:• For children who experience more than one concussion, there is an increased likelihood that the problems described above will remain long term. •:• Children with protracted problems stemming from concussion are less likely to attend college. •:• Children who return to play too soon after concussion may experience very serious consequences, including secondimpact syndrome, which can result in death. CD •:• Ringing in the ears •:• Change in appetite •:• Loss of taste/smell Behavioral •:• Irritable/ Agitated •:• Quick temper •:• Can ' t sit still/ ervous •:• Moody/ Depressed/ Tearful •:• Sleep problems Cognitive •:• Mentally "foggy" •:• Memory difficulties •:• Poor concentration/ attention •:• Poor judgment •:• Fatigue •:• Difficulty finding words Physical •:• Headache •:• Dizziness •:• Fatigue/ Drowsiness •:• Blurry/ Double vision •:• Light/Noise sensitivity S 11 m 111 e r 2 0 0 0 Buff a I o Physician . . ~ .. 11 �M B M E D C A L ScHOOL N E w s y Second·look Day D KINNAMON ln · depth preview for prospective students \ 40 ~ D the first spective students could talk to first-year students. One University at Buffalo School of Medicine and popular session was the student question-and-answer l Biomedical Sciences "Second-Look Day" on panel, which included six students in different phases of April 29, 2000. The event was planned to give their medical education at UB. Topics ranged from the accepted students more interaction with cur- MD/MBA dual-degree program to long-distance rela- rent medical students and another chance to tionships, what day-to-day life is like, and opportunities see where they might be spending the next available during the clinical years. For julie Baker, a UB four years. undergraduate, the day was invaluable. "It helped me feel The idea came to first-year students Laura Cinski, )ill Albrecht and Steve more comfortable about my decision to continue at UB." Turkovich as they discussed their Inter- First·year student Lisa Reaves talking with Jim Krygowski, a biology major from Grove City College in Pennsylvannia. view Day experiences. The students felt continued to get acquainted at dinner so focused on interviewing that they and then enjoyed a night on the town weren ' t able to properly evaluate what with their new friends. "I was a bit UB had to offer them. They also thought nervous to meet my future class- Interview Day didn't offer enough mates," says Joe Kita, a St. student contact. Bonaventure student, "but I found Albrecht had attended a similar type that we have the same career goals of event at another school last spring and dreams. l felt like I could connect and felt it would be an ideal model for UB. "Second- to so many people and became excited Look Day lets the school sell itself," she says. "We want about the next four years." people to make an informed decision and to be happy here. The best way to ensure this is to give them lots of information about what UB's medical school is like from a student's perspective." The inaugural SecondLook Day at UB included mini-lectures in anatomy and L physiology presented by . Charles Severin, MD, PhD, z and Perry Hogan, PhD; smallgroup problem-based learning sessions with Murray Ettinger, PhD; student-led tours of facilities; and breakfast and lunch meetings where pro- 12 I u f fa I o Physician Afterwards, a group of the prospective students who had been corresponding by e-mail S 11mm e r 2 000 CD First·year student Joanna Shaw, below left, talks with prospective students. left to right. Joyce Yan Li of Yale University, Julie Baker of the University at Buffalo, and Penny Lawson of the University of Rochester. �The An of New tutor i al group helps first·year students lutorin Science Hi· "l;J , >O " experience gained by some second-year students in the University at Buffalo refer them to a better information source," says Mato. School of Medicine and Biomedical Sciences is now In addition to giving tutors the helping first-year students master their medical school opportunity to serve the school, coursework. The Buffalo Medical Tutorial Group, the tutorial program gives them launched in january 2000, consists of second-year the chance to review for board ex- students who volunteer to share not only their prior ams and to learn how to effectively knowledge of physiology, anatomy, biochemistry and communicate scientific ideas. It's the other first-year subjects, but also their insights on how best to learn them and have a successful first year. and foster camaraderie among The tutorial group is the brainchild of second-year student Anthony Mato, who, while an undergraduate at Cornell University, tutored biochemistry and organic and general chemistry in its Learning Skills Center. Inspired by that program, Mato approached former UB assistant dean Thomas D. Flanagan in October 1999 with the idea of starting a tutorial program at UB. "Our goal is to offer students help during evening hours when professors aren't around," says Mato. "We wanted to create a resource for students studying at night who otherwise couldn't get questions answered until their professor is available." While the group en- ~I K I courages students to consult their professors first, sometimes students are more comfortable talking to their peers, Mato says. "Some first-year students are intimidated by the faculty, and the idea ofcallinga professor at home is a big deal to them. That's why we're here." Four nights a week students can go to Sherman Hall also an excellent way to introduce first- and second-year students. The group, which attracted 22 student volunteers its first year, First·year student Lily Belli, /efr. being tutored by Anthony Mato. enjoys strong faculty support. Mato met with each of the first -yea r professors individually to discuss how the program would work with their courses, and the group communicates regularly with professors about any changes in course material. Each department provided a complete set of their courses' required textbooks, and B y faculty members donated meeting space, a D computer and a teaching microscope. A \I 0 'I Physiology professor james T. Goldinger, PhD, is their faculty advisor. "This [first] year's class is quite successful," says Perry Hogan, PhD, professor of physiology. "They're calmer about their involvement and their progress. The tutorial group could reasonably take credit for their students' imln•eltaH tlllir pncress. De tltlriallfll. CIIN I'IISIII~Iy talll cre~it fer tlllir strints's...tller smoother progress through the medical curriculum." and drop in on a number of sessions that take place in the But the tutorial group's biggest fans are students. "I physiology department conference rooms. These infor- perform better on exams," says Amy Puzio. "Rather than mal get-togethers can take the form of one-on-one meetings, Q -and-A sessions, roundtable discussions or test staring at a textbook, talking about the material solidifies the information for me." Mato's efforts were recently reviews. "Our time is owned by whoever walks in the honored with the school's student-nominated Louis A. room. We' re there to discuss whatever the students want," and Ruth Siegel Award. He is the first student to receive says Mato. Each tutor commits to a minimum of two this award, which is traditionally presented to faculty. hours a week and teaches a subject they did well in and are "A lot of people say they go to medical school because excited about. "We might not know the answer to every they want to help people," says Mato. "This program is a question, but we answer to the best of our knowledge or true test of that." 4D Summer 2000 I u ff a I o Pb y sic ian 13 �MEDICAL ScHOOL N E w s Dorothy Adler Thomas Jefferson University Paul Bogner Pathology, University of Michigan Hospitals PHILADELPHIA, PA ANN ARBOR, Ml Tamara Alberti Anthony Bottiggi Pediatrics, Medical College of Virginia General SLirgery, University of Kentucky Medical Center RICHMOND. VA LEXINGTON, KY Benjamin Alderfer Psychiatry, University of Colorado School of Medicine George Boucher DENVER, CO Graduate Medical-Dental Education Consortium Family Practice, his year's National Residency Matching Program (NRMP) results were announced on March 16 by Dennis Nadler, MD, associate dean in University at Buffalo's School of Medicine and Biomedical Sciences. Of UB's graduating medical students, 58 percent were placed in primary care residencies. Eighty·one percent of the students received their first, second or BUFFALO, Y BUFFALO, Y Mathijs Brentjens Internal Medicine, Emory University School of Medicine ATLANTA, CA third choice of placements. Twenty· nine AkkiiAii Internal Medici11e, Suzanne Burke percent will stay in Buffalo to train in University of Florida Health Science Center Emergency Medicine, SUNY/ the Graduate Medical Dental Education jACKSONVILLE, FL Consortium, while 52 percent will go Steven Ambrusko Pediatrics, SUNY/Buffalo Graduate Medical-Dental Education Consortium out of state. In the primary care specialties, 34 BUFFALO, NY students were placed in internal medicine, 15 in pediatrics, 12 in family medicine, 9in medicine/ pediatrics and 5in obstetrics/gynecology. "Our students do consistently well in the NRMP with placements in some of the top programs in the country," says Nadler. "Our record in 'early' subspecialty match is equally impressive. We are extraordinarily proud of our students' achievements." Nationwide, 51 percent-or 6,931 graduating U.S. medical Jeffrey Amodeo General SLirgery, SUNY/ Buffalo Graduate Medical-Dental Education Consortium Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Anthony Caprio Internal Medicine, University of Rochester/Strong Memorial Hospital ROCHESTER, NY Thomas Caprio Internal Medicine, University of Rochester/Strong Memorial Hospital ROCHESTER, NY BUFFALO, NY Daniel Carl Lisa Apfel Intemal Medicine, General SLirgery, SUNY/Buffalo Medical College of Virginia Graduate Medical-Dental Education Consortium RICHMOND, VA BUFFALO. NY Hope Cawdery Internal Medicine, Duke University Michael Banas Medical Center school seniors-matched to afirst·year residency position in Internal Medicine, SUNY/Buffalo DURHAM, NC one of the generalist disciplines. This is the lowest generalist Graduate Medical-Dental Education Consortium Leslie Chamberlain specialty match rate since 1995, when seniors also matched at BUFFALO, Y AmyBeuler 51 percent. According to the NRMP, 25,056 individuals participated in Family Practice, SUNY/Buffalo Graduate Medical-Dental Education Consortium Medicine/Pediatrics, Ohio State University Medical Center COLUMBUS, OH Julie Cheng Pediatrics, the match this year, aslight decrease from the 26,462 who BUFFALO, NY participated in 1999. Of the total active applicants, 73.4 percent Howard Blumstein Loma Linda University were matched, a4percent increase over last year. Internal Medicine, UMDNJNew Jersey Medical School CA -S.A . UNGER 14 Ramune Alexander Family Practice, SU Y/Buffalo Graduate Medical-Dental Education Consortium Medicine/Physical Medicine and Rehabilitation, SU Y/B uffalo Buffal o Ph ysici an Summer 2000 PISCATAWAY, Nj �James Chevalier Internal Medicine, ew York Presbyterian Hospital-Cornell Christopher Di Maio Internal Medici11e, Thomas jefferson University Michelle Ehrlich Dermatology, Cleveland Clinic Foundation NEw YORK, NY PHILADELPHIA, PA CLEVELAND, OH Frederic Chi Orthopedic Surgery, University of Rochester/ Strong Memorial Hospital Louis Domenico Medicine (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium Catherine Falkner Obstetrics/Gynecology, SU Y Upstate Medical Center ROCHESTER. Y Michael D'Angelo Internal Medicine, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y: Diagnostic nadiology, Penn State Geisinger HERSHEY, PA James Doran Undecided Jaimie De Rosa Surgery (Prelim), Boston Medical Center Holly Drexler Family Practice, Williamsport Hospital BOSTON, MA; WILLIAMSPORT, PA BOSTON, MA Todd Duggan Internal Medicine, Medical College of Virginia James De Santis Surgery (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium Kimberly Dumoff Pathology, University of Pennsylvania BUFFALO, NY PHILADELPHIA, PA Sorabh Dhar Medicine/Pediatrics, SU Y/ Buffalo Graduate MedicalDental Education Consortium Zeynep Ebcioglu lntemal Medicine, Thomas Jefferson University BUFFALO, Margaret Eberl Family Practice, SUNY/Buffalo Graduate Medical-Dental Education Consortium Y Kenneth Harris Pathology, Massachusetts General Hospital SYRACUSE, NY Ani Fleisig Gweral Surgery, Georgetown University Hospital BOSTON, MA Nishi Harvey Medicine (Prelim), St. joseph's Hospital WASHINGTON, DC BUFFALO, NY Otolaryngology, Boston Medical Center Steven Lo. 26. and his fiancee and classmate Reshma Katira, 25. were pleased-and relieved -to discover they will both be going to Chicago. RICHMOND, VA PHILADELPHIA, PA BUFFALO. NY Scott Frank Surgery (Prelim), Mercy Hospital of Pittsburgh ANN ARBOR, Ml PITTSBURGH, PA Bret Gelder Surgery (Prelim), SU Y/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY SumanGona Transitional, St Vincent's Hospital NEW YORK, Y: Ophthalmology, Mt . Sinai School of Medicine Aram Hezel Intemal Medicine, Beth Israel Deaconess Medical Center BOSTON, MA Michael Hochberg Surgery (Prelim), Mt. Sinai School of Medicine NEW YORK, Charles Howarth Medici11e, Columbia Bassett COOPERSTOWN, Y AllysonHowe Family Practice, Travis Air Force Base Fairfield, CA NEW YORK. NY Niels G•thgen General Surgery, Hospital of St. Raphael EW HAVEN, CT Shirley Huang Pediatrics, University of orth Caro lina Hospital Rose Graham Pediatrics, Children's Hospital of Philadelphia c CHAPEL HILL, PHILADELPHIA, PA Madhuri Guntupalli Surgery (Prelim), RushPresbyterian-St. Luke's Hospita l CHICAGO. IL; Ophthalmology, RushPresbyterian-51 Luke's Hospital CHICAGO, IL Alissa Huston lntemal Medicine, University of Rochester/Strong Memo rial Hospital ROCHESTER, NY Adriana Kaczaraj Internal Medicine, Mt. Sinai Hospital NEW YORK, John Hannibal Law School Y Y Kevin Stanley, 25. of Oswego. NY, vociferously shares his results. On his right is Madhuri Guntupalli and to his left. Andrew Stone. . .• L ... z . .c L S 11 111 111 er 2 00 0 Buffalo Ph ysician 15 �M E D C A L N ScHOOL E Second·year student Sandy Singh and his sister. Abhilasha (Abby) Singh, 25. below. await news about her match results. w Jennifer Kam Brian Klagges William Lighthart Medicine (Prelim), SUNY/Buffalo General Surgery, Surgery (Prelim), Graduate Medical-Dental Education Consortium BUFFALO, NY: Diagnostic Radiology, Rochester General Hospital ROCHESTER, NY HeyJooKang Obstetrics/Gynecology, New York Presbyterian Hospital-Cornell NEW YORK, Y Reshma Katira Surgery (Prelim), RushPresbyterian-St. Luke's Hospital CHICAGO, IL: Ophthalmology, RushPresbyterian-St. Luke's Hospital CHICAGO, IL Mark Kenyon Pediatrics, Children's Memorial Hospital CHICAGO, IL ew England Medical Center BALTIMORE, MD Marta Kolthoff Jennifer Lin Obstetrics/Gynecology, University Health Center General Surgery, University of North Carolina Hospital PITTSBURGH, PA CHAPEL HILL, Matthew Krauza Steven Lo Internal Medicine, SU Y/Buffalo Medicine (Prelim), University Graduate Medical-Dental Education Consortium of Illinois College of Medicine BUFFALO, Neurology, University of Chicago CHICAGO, Y CHICAGO, Sharmeela Kuperan Medicine (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY HasitMehta Diagnostic Radiology, University of Texas Southwestern Medical School DALLAS, TX IL; IL Melinda Mesmer Medicine, Yale-New Haven Hospital NEW HAVEN, CT Alka Patel Todd Loftus Psychiatry, New York Presbyterian Hospital-Cornell Medicine/Pediatrics, University Hospital of Cincinnati CINCINNATI, OH Darshan Patel Justin Kwan Michael Logue Family Practice, Pinnacle Health- Medicine (Prelim), Intemal Medicine, New York Harrisburg Hospital Long Island jewish Hospital Presbyterian Hospital-Cornell HARRISBURG, PA NEW HYDE PARK, NY; NEW YORK, Neurology, Baylor College of Medicine General Surgery, SU Y/Buffalo Graduate Medical-Dental Education Consortium HOUSTON, TX Y c EW YORK, NY Eric Kirker BUFFALO, Union Memorial Hospital BOSTON, MA Y Penn State Geisinger DANVILLE, PA BUFFALO, NY Dionysia Mamais Jesenia Peiia Medicine/Pediatrics, Family Practice, SU Y/Buffalo Graduate Medical-Dental Education Consortium Emergency Medicine, Jason Lake Internal Medicine, Walter Reed Army Medical Center WASHINGTON, DC St. Vincent's Hospital Charles Lau NEW YORK, Medicine (Prelim), Brigham & Women's Hospital BOSTON, MA; Diagnostic Radiology, Hospital Y Rosemarie Mannino Everett Porter Medical College of Virginia Internal Medicine, University of Rochester/Strong Memorial Hospital of the University of Pennsylvania Andrew Mayer PHILADELPHIA, PA Internal Medicine, BUFFALO, Y Medicine/ Pedia tries, Mt Sinai Hospital EW YORK, Cedars-Sinai Medical Center Los ANGELES, CA Donald McDonald Y Graduate Medical-Dental Education Consortium y Daniel McKenna Pediatrics, SU Y/Buffalo Graduate Medical-Dental Education Consortium Robert Lewis BUFFALO, Internal Medicine, Talia McNamara Psychiatry, University of California at Los AngelesSan Fernando Valley Lenox Hill Hospital NEw YORK, NY ROCHESTER, Y Erin Reardon Emergency Medicine, Morristown Memorial Hospital MORRISTOWN, NJ Internal Medicine, SUNY/Buffalo BUFFALO, Jennifer Lee BUFFALO, NY Intemal Medicine, RICHMOND, VA Lynn Lawrence Pediatrics, SUNY/ Buffalo Graduate Medical-Dental Education Consortium Donna Peace Family Practice, SU Y/Buffalo Graduate Medical-Dental Education Consortium Jason Lorenc Y SEPULVEDA, CA Tara Reimer Pediatrics, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Gretchen Schueckler. 32, from Buffalo. NY. on the phone to spread the news while receiving ahug from Catherine (Kate) Falkner, 25. �-------------- - - - - - - - - - - - - - - - - - - - -- -- ---------- ----- NehaSheth Richard Telesco Pediatrics, Pediatrics, Priya Wagner Pediatrics, University of Connecticut FARMINGTON, CT University Hospitals of Cleveland Medical College of Virginia CLEVELAND, OH RICHMOND. VA Phaelon Silva Felicia Tenedios Melissa Reyes Obstetrics/Gy!Iecology, lntemal Medicine, New York Hospitals of C leveland Family Leave Madigan Army Medical Center Presbyterian Hospital-Cornell CLEVELAND, OH TACOMA, WA NEW YORK, NY Abhilasha Singh Michael Tinnesz Emergency Medicine, McGaw Medical Center-Northwestern University Emergency Medicine, SUNY/Buffalo Graduate Medical-Dental Education Consortium David Rice lntemal Medicine, Wright Patterson Air Force Base DAYTON. OH CHICAGO, IL Walter Walek Surgery (Prelim), University BUFFALO, NY CamiRiley Intemal Medicine, SU Y/Buffalo Graduate Medical-Dental Education Consortium Graduate Medical-Dental Education Consortium Medicine (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium Medical Center Hospital St. joseph's Hospital Medicine/Pediatrics, Albany ALBANY, NY CHICAGO, IL Y, NY Lirim Tonuzi Graduate Medical-Dental Educatio n Consortium Medicine (Prelim), SU Y/Buffalo BUFFALO, Y Matthew Smith iiiternal Medici11e, SUNY/Buffa lo Graduate Medical-Dental Education Consortium Graduate Medical-Dental Education Consortium BUFFALO, NY; Neurology, SU Y/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, BUFFALO, NY Graduate Medical-Dental Education Consortium BUFFALO. NY MEMPHIS, T Christopher Santangelo Andrew Stone Psychiatry, Internal Medicine, ew England Medical Center WASHINGTON. DC BOSTON, MA Gretchen Schueckler Internal Medicine, Brown University Jason Stopyra Emergency Medicine, Wake Forest University Baptist Medical Center Michelle Watson Surgery (Prelim), SU Y/Buffalo Psychiatry, SU Y/Buffalo Kevin Stanley Orthopedic Surgery, Un iversity of Tennessee College of Medicine Georgetown University Hospital Medical Center Hospital ALBA BUFFALO, NY; Diagnostic Radiology, SUNY/Buffalo Robert Wang Rommel Tolentino BUFFALO, NY Samuel S'doia ANN ARBOR, Ml Transitional, Catholic Health- Beth Smith Family Practice, SUNY/Buffalo Stephen Wampler Family Practice, University of Michigan Hospitals Medici11e/Pediatrics, Albany Igor Sirotkin BUFFALO, NY Lynne Ross y Graduate Medical-Dental Education Consortium BUFFALO, NY Theresa Wendel General Surgery, RushPresbyterian-St. Luke's Hospital CHICAGO, IL Michael White Judith Toski Emerge11cy Medicine, Eastern Virginia Medical School Emergency Medicine, SU Y/Buffalo Graduate Medical-Dental Education Consortium Melissa Wolf BUFFALO, NY Family Practice, University ORFOLK, VA Hospitals of Cleve land Amy Van de Water Medicine/Pediatrics, University of CLEVELAND, OH Minnesota Medical School Emily Wong MINNEAPOLIS, M lntemal Medici11e, University of Michigan Hospitals Rosalia Viterbo General Surgery, SUNY/Buffalo ANN ARBOR, Ml WINSTON-SALEM, NC Graduate Medical-Dental Education Consortium Nora Yip Transitional, Mercy Hospital Marisa Stumpf BUFFALO. NY Un iversity of Connecticut PITTSBURGH, PA Obstetrics/Gy!Iecology, PROVIDENCE. Rl Bryan Scott ew England Medical Center Tracey Shanahan Pediatrics, Ohio State University/Chi ldren 's Hospital COLUMBUS, OH Kathryn Shanks Emergency Medicine, SU Y/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, y -- BOSTON, MA Britta Svoren Pediatrics, Boston Combined Pediatric Residency BOSTON. MA FARMINGTON, CT Roy Vongtama Medici11e (Prelim), Vladimir Zelenko Graduate Hospital Rabbinic Educatio11 PHILADELPHIA, PA; Radiation Oncology, University of California at Los Angeles JamaiZohur LOS ANGELES, CA Buffalo Graduate MedicalDental Education Co nsortium Cheryl Taurassi Eric Waffner Pediatrics, l11temal Medicine, SUNY/Buffa lo Long Island jewish Hospital Graduate Medical-Dental Education Consortium EW HYDE PARK, NY Ge11eral Surgery, BUFFALO, Medicine/Pediatrics, SU Y/ BUFFALO, Y Y S11mmer 2000 luflalo Physician 17 �M E D C A L SCHOOL E W . . ... c L �S ummer 20 00 luffalo Physician 19 �M E C D A L E SCHOOL W S Songs Give S1 Million to School p and his wife, Janet H. Sung, MD, \1 founder and president of four radiological practices in Western New York, including Windsong Radiology, P.C., are giving a $1 million cash scholarship gift to the University at Buffalo's School of Medicine and Biomedical Sciences. "What better way to show our gratitude and appreciad tion," says John Sung, "than to provide scholarships for UB CFO ) \\ Children's Health for Kids medical school students who have good grades, need the money and demonstrate soundness of character, including a genuine, caring attitude, generosity of spirit and leadership potential?" Janet Sung concurs that the gift to the university "has made us very happy because my husband is finally realizing a dream that began when he was a college student in Korea, working his way through "What better way to show our gratitude and appreciation." -John Sung school and depending also on scholarships." The Sungs' story began in Korea, where both were born and attended college. They moved to the United States as a newly married couple in 1972, arriving in New Jersey with only $200. While Janet Sung completed her residency, John Sung earned his MBA from Seton Hall University and completed his CPA training. In 1977, they moved to Buffalo, where janet Sung held positions in radiology with area hospitals. John Sung worked first for the accounting firm Peat Marwick Mitchell, then taught at Daemen College before working full time with his wife. In 1987, the Sungs opened Harlem Radiology, P.C., in a converted Pizza Hut. Today they operate Windsong Radiology, which employs over 120 people and is the only free-standing clinic in Western New York with full diagnostic accreditation from the American College ofRadiology. -SUZANNE CHAMBERLAIN Frawley Establishes Fellowship Award , .\ LJ 1 made the first presentation of the "Frawley Fellowship Award" to V. Uma Valeti, MD, who is currently completing his residency training in internal medicine at the University at Buffalo School of Medicine and Biomedical Sciences. Frawley established the fund this year to support "worthy medical/surgical residents for whom medical research represents a primary personal interest and passion." Valeti, whose goal is to pursue an academic career in cardiology, has completed cardiovascular research in the laboratory of Dr. John Canty. Receipt of the Frawley Fellowship will make it possible for him to continue his research on ischemic cardiomyopathy and hibernating myocardium. Frawley began his own research career with the study of adrenal physiology at UB and then at Harvard University. He continued research on the adrenal cortex and also in carbohydrate metabolism at the National Institute of Arthritis and Metabolic Diseases in Washington, D.C. From there he went on to become professor and chair of I .. internal medicine and director of the first Division of Endocrinology < and Metabolism at St. Louis University School of Medicine. ... 20 -S. luffalo Hysician A. CD UN G ER S umm e r 2 000 Compiled by Pamela M. Rose, MLS, Health Scie11ces Library, U11i1•ersity at Buffalo, 3435 ,\1aill St., Buffalo, .''JY 14214-3002; (716) 829-3900, ext. 129; pmrose@acsu.buffalo.edu. �PATHWAYS Click Appointed to Ped"a r·c Surgery Po t Following a national search, Philip L. Glick, MD, has been In Memoriam appointed surgeon-in-chief at Kaleida Health's Children 's Hospital of Buffalo, clinical director of the Department of Pediatric Surgical Services at Kaleida and division head of pediatric surgery in the Department of General Surgery at the University at Buffalo's School of Medicine and Biomedical Sciences. Glick, a staff member at Children's Hospital since 1988, is a professor of surgery, pediatrics and obstetrics/gynecology at UB, where he also serves as vice chair of surgery for research, and training director for the Pediatric Surgery Residency Program. A Los Angeles native, Glick completed his undergraduate T. BRONK education at the University of California at Berkeley. He graduated from medical school at the University of California at San Francisco, where he also completed residencies in general surgery and fetal surgery and served as chief resident in general surgery. He was a senior resident and chief resident in pediatric surgery at the University of Washington and at the Children 's Hospital and Regional Medical Center in Seattle. - S. A. UNGER Summer 2000 Buffalo Ph ysi ci an 21 �PATHWAYS EDITOR's NOTE: 1 tH;. JVUVH'J.If.g are brief introductions to faculty Scott Coffey, PhD Marc S. Fineberg, MD 1ssi<tatlt Pr.Jte<sc r Amsta•Jt ( timcal Professor Depart•nent of Orthopaedic Surgery c·r.iver<ity at Buffalo Sports \1edi:i JC Institute who have recently joined the Universztv at Buffalo School of Coffey joined UB's faculty in November 1999 as an assistant professor in the Department of Psychiatry and is affiliated with the Community Mental Health Center at Kaleida Health's Buffalo General Hospital. He earned his bachelor of science degree in psychology at Medicine and Arizona State University in 1988, Biomedical his master's degree from the Uni- SCiences. his PhD from the University of versity of North Texas in 1992 and Mississippi in 1996. Coffey completed his training at the National Crime Victims Research and Treatment Center and was a National Institute on Drug Abuse research fellow at the Medical University of South Carolina. Prior to coming to UB, he was a research associate in the Department of Rehabilitation Sciences in the College of Health Professions at the Medical UniversityofSouth Carolina. His research interests include drug craving and impulsivity in substance-dependent individuals and the treatment of trauma victims with a comorbid substance use diagnosis. Fineberg joined UB's faculty as an Fineberg's current research thopaedic surgery in August 1999. interests include procedural He is affiliated with the UB Sports advancements in anterior cruci- Medicine Institute, with active ate ligament reconstruction surgical time spent at Kaleida through the Cadaveric Arthro- Health's Buffalo General Hospi- scopy Teaching Lab; and mag- tal and Millard Ambulatory Sur- netic resonance arthrogram gery Center, and at Erie County active (MRAA), a new test de- Medical Center. Fineberg earned signed to increase diagnostic a bachelor of science degree in sensitivity for occult soft-tissue biology, cum laude, from Syra- injuries of the shoulder. cuse University in 1989, and a medical degree from Northwest- Paola Muti, MD ern University Medica l School in 4ssocia te Professor VepartmetJt of Son a/ and Preventive .\ledicJtJe Senior Associate Research Snentist Research ltJstJtutc 011 4ddJctions 1993. He completed a general surgery internship at New York University/Bellevue Hospital Center in 1994, and a residency in In july 1999, Muti was appointed pediatric orthopaedic surgery at as an associate professor in UB's Shriner's Hospital for Crippled Department of Social and Preven- Children in Tampa, Florida, from tive Medicine, where from 1995 to March to April1995 and january 1999 she had served as a research to February 1997. He was execu- assistant professor. Currently, she tive chief resident in orthopaedic also serves as a senior associate surgery at New York University/ research scientist in UB's Research Hospital for joint Diseases from Institute on Addictions, a position july 1997 to june 1998, and a clini- she has held since 1995. Muti earned a medical degree from Mun wAs APPOL 1TED AS A • A~sociATE PROFESSOR IN 22 l 1 1fa l o Ph ysici an Summer ment of Orthopaedic Surgery from August 1998 to july 1999. assistant clinical professor of or- cal fellow in sports medicine at TIVE MFDICI E, WHFRF FROM Massachusetts General Hospital! Harvard Medical School's Depart- UB's DEPARTMENT oF SociAL AND PREVEN- 1995 TO 1999 SHE HAD SERVED AS A RESEARCH ASS ISTANT PROFESSOR. 2000 �University of Pisa in 1984 and a master of science in epidemiology Druar Named Recipient of Naughton Award Christopher T. Sempos,PhD ship in UB 's Department of Social \ssocrate Professor Director ot Graduate Stud. Department of Sacral and Pn" P>Jt'"p \1 .,, · and Preventive Medicine. Her Sempos joined UB's faculty in No- from UB in 1993. From 1996 to 1999, she served a Buswell Fellow- 5 named the first recipient of the Naughton research interests are in cancer vember 1999 as an associate profes- epidemiology, specifically hor- sor and director of graduate studies monally related cancers, such as in the Department of Social and breast and prostate; and in research Preventive Medicine. He earned a methodology and biomarkers. bachelor of arts degree in anthropology from the University of M. Matthew Phillips, MD Wisconsin, Milwaukee, in 1973, and Cllllrcal Assistant Professor Department of Ortlropocd•cs master of science degrees in nutritional services and preventive med- Phillips joined UB 's facu lty as a icine/epidemiology at the Univer- clinical assistant professor of or- sityofWisconsin, Madison, in 1979 thopaedics in july 1997 and is and 1982, respectively. He completed affiliated with Erie a doctorate in nutrition sciences at County Medical Center and Kaleida Wisconsin in 1982. For more than Health ' s Buffalo Federal Civil Service as a health stat- General Hospital istician, during which time he was (BGH ). He earned project officer for the Framingham his bachelor of sci- and jackson heart studies at the PHILLIPS 15 years, Sempos worked in the ence degree, cum National Heart, Lung and Blood laude, in chemistry Institute. He also served as chief of from St. Lawrence retary for the Medical Alumni Association Nancy Druar, the longitudinal studies branch for University, in Canton, New York, the National Health and in 1987 and his medical degree Examination Surveys, and assistant utrition Award, as announced by dean John R. Wright, MD, on April29, 2000, at this year's Spring Clinical Day and Reunion Week· end. The new award, established by John Naughton, MD, dean of the University at Buffalo School of Medicine and Biomedical Sci· ences from 1976 to 1996, recognizes a nonfaculty individual who has made signifi· cant contribu· tions to the school. Such an individual, the award acknowl· edges, is one who "day in and day out, in his or her NA NC Y DRUAR own quiet way, makes our school, with its affiliated teaching hospitals, a stronger, healthier and happier place for the rest of us to learn, work, conduct research, provide patient care and teach." Druar, who has served in her current role since 1980, is responsible for I . from UB in 1991. He completed to the head for the World Health coordinating the day-to-day operations of the Medical Alumni an internship in general surgery Organization Collaborating Centre Association office, including communications, dues manage- at UB in 1992 and residency for Health and Nutrition Examina- training in orthopaedic surgery tion Surveys. His current research ment, financial reporting and budget preparation. In addi· tion, for the past 19 years she has taken a lead role in planning at the university in 1996. He focuses on the relationship of then served a fellowship in joint body iron stores to risk of cardio- replacement and lower-extrem- vascular disease. "ambassador for the school" and an individual who through Krackow, MD, at BGH from 1996 Barbara Stefanick, MD "kept the vital machinery of the alumni office moving, to 1997. His clinical interests in- \ssistant Professor of Clilllcal Pc,thologr Dcpartmmt of Patholo " advancing the school's mission in ways immeasurable." clude hip and knee replacements, ity reconstruction under Kenneth failed or revised hip and knee Nomination letters on Druar's behalf referred to her as an her "intelligence, pleasantness and diligence to her task" has replacements, lower-extremity deformity and knee orthoscopy. the school's annual Spring Clinical Day and Reunion Weekend. Stefanick, who joined UB 's faculty Druar received the award at the Annual Faculty Meeting on May 26, 2000. Other awards presented at the me be reported on in the fall issue of Buffalo Physiciat CD in july 1999, is an attending pathologist at Kaleida Health 's S umm e r 2 000 Buffalo Pbys i c i an 23 �PATHWAY Buffalo General Hospital. She earned her bachelor of science Bianca WeinstockCuttman,MD degree, magna cum laude, in biology from UB in 1990 and her medical degree, cum laude, from the university in 1994. She then completed her residency training in anatomic and clinical pathology at UB, where she served as cochief resident from 1998 to 1999. Stefanick is board certified in anatomic and clinical pathology, and her clinical interests focus on renal pathology. Weinstock-Guttman joined UB's faculty in November 1998 as an assistant professor of neurology. Her clinical affiliations are with Kaleida Health 's Buffalo General Hospital and Baird Multiple Sclerosis Center at Millard Fillmore Gates Hospital. WeinstockGuttman earned her medical degree at the University of Foundation, where he then served Bucharest in Romania in 1983. She an EEG/epilepsy fellowship from completed a rotating internship at 1996 to 1997. In june I998, he Carmel Hospital in Haifa, Israel, completed a pediatric residency in 1986 and a neurology residency at Rainbow Babies and Children at Sapir Medical Center, Hospital in Cleveland . Wein- Meir General Hospital, stock's primary research interest Kfar-Saba, Tel Aviv Uni- is in epilepsy, EEG and neuro- versity, in Israel, in 1992. physiology. At the Mildred In 1996, she completed a )assoy Long-Term Monitoring three-year Neuroimmun- Unit, he and his colleagues are ology Fellowship at the assessing whether patients could Mellen Center for Mul- benefit from epilepsy surgery. tiple Sclerosis Treatment and Research at the Cleveland Clinic Foundation. At UB, her research and clinical focus continues to be MS. Musicians, artists, dancers, actors, athletes, scholars ... we all love Nichols. • State of the art visual and performing arts center • Exceptional college placement record Prot s >r p a d '\/ ,r 'PI ~' '-'' I a t n Wilkinson, who joined UB's Department of Social and Preventive Medicine in May 1998, also serves as a professor in UB's Department of Oral Diagnostic Sciences, Weinstock joined UB's faculty in in the School of Dental Medicine. August 1998 as an assistant pro- Prior to coming to UB, he was an fessor in neurology and director adjunct professor in the Depart- of pediatric epilepsy and neuro- ment ofEpidem iology at the School physiology. He is affiliated with of Kaleida Health's Children's Hos- at Albany. Wilkinson earned his • Comprehensive community service program pital of Buffalo, where he is bachelor's degree in 1969, his director of the Mildred jassoy master's degree in 1971 and his • More than 60 sports teams Long-Term Monitoring Unit. PhD in 1973, all from UB. He com- • Average class size of 15 Weinstock completed a rotating pleted a postdoctoral research • Financial aid available internship at Carmel Hospital in training fellowship at Duke Uni - Haifa, Israel, in 1986, and a pedi - versity Medical Center in Durham, atric residency at Hasharon North Carolina. At UB, his research Coeducational grades 5·12 875-8212 1250 Amherst Street Buffalo, NY 14216 www.nicholsnet.net Acceptance granted to qualified students without regard to race, color, religion or national origin. laffalo Pbysician \/(flit I r ct r Jfl'ctlu, r1c tp1 rotcs<" JCpartmcllt • Challenging curriculum with 17 advanced placement courses Only one inveslrnenl lasrs a lifetime 24 Arie L. Weinstock, MD Cregg S. Wilkinson, PhD 5 u 111 m e r 2 0 0 0 Public Health, SUNY Hospital and Tel-Aviv interests include the ef- University, from 1987 to fects of low-dose radia- 1992. From 1993 to 1996, tion, and cancer induc- he served a pediatric tion related to environ - neurology fellowship at mental and occupational the Cleveland Clinic exposures. CD �- - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - --~ -- ~- -- the 63rd April29 2000 ACall to Physicians to Lend Their Voices Children's health in the new millennium BY jENNIFER LEWANDOWSKI AND s. A. UNGER Opportunities and Challenges," at the University at Buffalo's 63rd annual Spring Clinical Day held April 29, 2000, at the Buffalo-Niagara Marriott in Amherst, New York. The weekend event, which explored the theme "Children's Health Issues," was sponsored by the UB Medical Alumni Association. Hayes, the assistant secretary of Community and Family Health for the Washington State Department of Health, urged physicians to view the advent of a new decade and new millennium as an auspicious time to more proactively advocate for an improvement in children's health in our country. " It begins with a fresh commitment from each Pictured, letr. Maxine Hayes. MD '73. delivered Stockton Kimball Lecture. of us as individuals, wherever we are stationed, to be willing to move out of our comfort zone and get involved as advocates for children and their families," Hayes implored. "It might start with a small gesture: a telephone call to a powerful political figure, a letter to the editor of a newspaper, a talk at a PTA group, a testimony before a health committee ..• . I MAGINE A NATION in which the child poverty rate is the highest in the industrialized world . Imagine a nation in which social conditions are bringing about a rapid increase in youth depression, a nation in which children as young as preschool-age are being of a state legislature, a contribution to a child advocacy group, or through mentorship of a medical student. "We can all find ways to use the clout we have as physicians and stand up for children," she added, stressing that now is the time to reflect and focus on children, as "they do beautifully symbolize the promise of the 21st century." prescribed such antidepressants as Prozacand such stimulants as Ritalin. Imagine a nation in which youth in the fastest growing segments of the population are at the greatest risk for Hayes began her overview of the status of children's poor health status and care. The nation is the United States, and the challenges are health by presenting a historical survey of the development of medicine over the past millennium, highlight- growing exponentially, according to Maxine Hayes, ing the many strides made in health care, especially in the MD '73, who delivered the keynote lecture titled "The area of public health. From there, she turned her atten- Future of Children's Health in the New Millennium: tion to issues prevalent in the 21st century that threaten S 11mm e r 2 000 I u f fa I o Physician 25 �A L U M N our children, and ways in which physicians can take a leadership role function of America's families are also directly impacting children's in confronting these issues. Because chronic disease has supplanted acute illness as the pri- substantially more likely to have a family income below poverty than health. "Children who live in a household with one parent are mary threat to children's health, physicians who treat children today children with two parents," she reported. "In 1998, nearly 25 percent are faced with different challenges than were their counterparts in of children lived only with their mother and, today, more children the recent past, Hayes explained. Referencing data from the National live in step, blended, sequential or foster families, and many more Health Interview Survey on Disability, she reported that 15 to 18 are homeless." In all, "child poverty in the United States has nearly doubled since the 1960s," she stated. percent of all children today have "ongoing developmental, physical or mental problems that affect their functioning or that require compensatory services for maintenance of a functional level." These To this mix of social changes affecting our children must be added the fact that racial and ethnic diversity has grown dramatically in the conditions, she explained, range from such common diagnoses as United States over the past 30 years, noted Hayes, who predicted that, attention deficit hyperactivity disorder to severe psychiatric disor- after the 2000 census, "we will see a continuation of this trend." ders. "Assuring children's mental health and emotional well-being According to the Children's Defense Fund, Hayes said, minority children now make up 30 percent o f t h e populatiOn . under age 19, will challenge us in the new millennium," she said. Of special concern, she noted, is a rise in the reported incidence and by the year 2020, racial and ethnic minority children will make of depression in children, an increase she attributed to up 40 percent of the population under age 19. "Because minority "fHF BO.rOM the many "rapidly changing social conditions" encoun- chtldren are more likely to be poor than their non-Hispanic, white L,'<E IS "!HAT tered by today's youth. Hayes described a recent study of8,000 Americans 15 counterparts, they are often at risk of poor health status" she said. "And these children ca 11 no t b e ·tgnore d , as t h ey are fast becommg ' . the . PHYSIC lA "''>DO to 54 years of age in which only 2 percent of those age 45 HAVF ( lOl T. to 54 reported symptoms of clinical depression by their emergmg maJ·ority upon wh'IC h th.ts natiOns · , contmumg . . prospenty . and future will rest." late teens, while among 15- to 24-year-olds, 23 percent THE PROBLE~I reported serious depression before age 20. Furthermore, roo she said, teachers and pediatricians are documenting I<; fHAT more depressed youngsters than in the past. MANY 0~ U 1-AI ... lO l <;tIT." Among the "rapidly changing social conditions" that contribute to depression, Hayes said, are alterations in family structure, increased mobility of families and un- stinting exposure to global violence and unrest through television and the Internet. "With the click of a mouse, children can view graphic worldwide calamity and suffering," which causes increased levels of anxiety and Physicians today , Hayes sat·d , can h e1p counter these dtsturbmg . . trends in children's he a lth b Yb ecommg · .mvolved tn . one or more of the following four are nas.. po 1·tcy, practice, . research, and educatton . and training . . · With regard to po 1·tcy, s h e sat'd" strong mvestments 111 . preventton are key to assuring child health," emphasizing that "these mvestments are no 1anger a 1uxury or even a chotce." . . An example of such an mvestment 1·11 preventiOn, · . ts . the Chtldren's . s h e satd, Health Insurance Progran1 , w h.IC h sh e encouraged phystctans .. to become Compounding the problem of overexposure to calamitous news aware of and supp or t tn · t h etr · respecttve . states. In terms of practice and education, Hayes candidly told her audtence that "changt'ngde mograp h.tcs means we must d'tverst·ry our is the fact that many children today aren't provided with "the provider work force. We need practicing providers who are not only depression, she said. "As citizens of a global village, they are far less protected from worrying than children were in years past." anchors, the emotional support, they used to have growing up," tram~d 111 technical skills but culturally competent, as well." ow is divorce currently affects more than 1 million children in the U.S., the time, she said, for us to address the "- isms" in medicine-the "racism and se xtsm · th at create barners . to mutual respect and understand'mg. "Reterencmg c · the February 25 New England Journal and, at any one time in our country, some 500,000 children are in of Medicine editorial that addressed this problem in medicine as it foster homes, circumstances that further erode their emotional relates to gross inequities in the distribution of care, she added, "As support base and contribute significantly to depression. physicians, we need to acknowledge the role we ourselves play in closmg the gap in health disparities." Hayes explained. This is because children aren't spending nearly as much time with their parents as they did three decades ago. Also, Children are less "anchored" not only in a figurative sense, but in a literal sense, as well, because their families are relocating more fre- ln concluding, Hayes reiterated that, "As physicians, we have a quently, according to Hayes. Thirty years ago, children lived in one place umque opportunity today to make a difference for our children and for future gener a t"tons. sorne o f you may say ' I don ' t take care o f for an average of 21 years, a number that today has shrunk to seven. Hayes further explained that rapid changes in the structure and 26 The Badly Needed Clout of Physicians B u If a I o Physician S 11 111 m e r 2 0 0 0 CONTINUED ON PACE 28 �Medical Alumni lifetime Achievement Awards Honoring alumni for their outstand i ng contributions ach year at Spring Clinical Day and Reunion Weekend, medical alumni achievement awards are presented to graduates of the University at Buffalo's School of Med1cme and Biomedical Sciences who have made significant contributions to their fields. Recipients are nominated by their fellow alumni, with final selections made by the governing board of the Medical Alumni Association. This year's recipients are as follow: Richard H. Adler, MD '45 D . ..Jackson Coleman, MD 'GO ISO .. J.:c.ltl~wana ac<"CP _d 1 / Dr GcoriC Ellis For Dr. Richard H. Adler, former director of the Cardiothoracic Surgery Residency Program at UB's School of Medicine and Biomedical Sciences, receiving the Medical Alumni Lifetime Achievement Award represented "a valued gift from this fine medical institution" that launched and helped foster Adler's medical career, said Dr. George Ellis, who spoke of his friend's achievements and character. It was through his education at UB that Adler was given the opportunity to build on his medical knowledge at various institutions throughout the country and world, experience that prepared him for his return in 1949 to UB, where he served on the faculty until 1986, Ellis said. Perhaps the most notable experience for Adler, who also served as head of the Division of Thoracic Surgery at Buffalo General Hospital until 1986, was working in conjunction with his students and house physicians, who continuously stimulated his growth in medicine, Ellis said, adding that it was through his tenure at UB that Adler has been able to influence the next generation of UB students. In 1982-83, this service was recognized at UB, when Adler received the Louis and Ruth A. Siegel Distinguished Teaching Award with Honors. In all his work, he has been a staunch advocate of the clinician fulfilling the role of a caring provider, something he encourages his " Calling Dr. D. jackson Coleman a pioneer in ultrasonography and " ophthalmology, Dr. Thomas). Guttuso credited Coleman with discoveries that have increased the ability of ophthalmologists to ana- • lyze previously undiscovered diseases. "He is now a professor and chairman of ophthalmology at Cornell Medical College," Guttuso said. "He has won nine national awards and fellowships and he is credited with six inventions," he added, including an ultrasonically vibrated surgical knife, an apparatus for medicinally spraying an eyeball and a method for enhancing ultrasonic image data. In addition, Coleman has written some 56 book chapters, as well as a book titled Ultrasonography of the Eye and Orbit. He has also authored 120 publications, in 70 of which he is the first author, Guttuso said. As a visiting professor, Coleman has presented 16lectures throughout the United States and Canada, largely on the subject of ocular trauma. Coleman serves on the editorial boards oftheA11nals ofOphthal- mology and RETINA. In addition to being a diplomate of the American Board of Ophthalmology, he is a fellow of the American College of Surgeons and of the American Academy of Ophthalmol- younger colleagues to emulate, Ellis said. Adler believes wholeheartedly that "being a caring clinician and earning the trust and respect of a patient, is a cherished gift," Ellis concluded. CoNTINUED ON PAGE 2s S u 111 111 er 2 00 0 Buff a I o Physician 21 �A L U M N ogy. He also has served as president of the ew York Hospital Medical Board and on the Executive Faculty Committee at Cornell University Medical College. "He has contributed significantly, not only to his field, but to the knowledge of medicine everywhere," Guttuso said. "He is certainly the star of our class." Anil B. Mukherjee, MD '75 [.... vducec. Wl<. l.Ccep.cJ !J/ Dr. /urw s,ztbenlwrd A friend of Dr. A nil B. Mukherjee's since their early days of medical school in 1972, Dr. john Stubenbord explained that, after graduation from the UniversityofCalcutta in 1962, Mukherjee came to the United States, where he completed master's and doctoral degrees at the University of Utah. He then earned his medical degree from the N . Lynn Eckhert, MD '70 University at Buffalo 1975. After medical school, Mukherjee completed his residency training Jmnd ta t b; her broclnr, Dr. Kenneth H. Eckhert in internal medicine at Georgetown University, and in neonatal and "It's a privilege and honor to present this award to my sister," said Dr. a Kenneth H. Eckhert, who chronicled Dr. N. Lynn • pediatric medicine at the National Institute of Child Health and Human Development and at the ational Insti- Eckhert's achievements as a medical practitioner. After finishing medical school, Dr. Lynn Eckhert tutes of Health's Clinical Center in Bethesda, MD. Serving first as the senior investigator of the In all his work, pregnancy research branch of the NICHD and completed an internship at the Cleveland Clinic, said has been astaunch the NIH, then as chief of the section on molecu- advocate of the clinician lar and developmental genetics in the pregnancy her brother, himself a 1968 fulfilling the role of acaring branch, Mukherjee is currently chief of the sec- provider, something he tion on developmental genetics in the human graduate of UB. Shortly thereafter, she was married "to a wonderful physician encourages his younger genetics branch of the TCHD. Mukherjee, who served a brief stint as an who was studying at colleagues to emulate, Ellis assistant professor of pediatrics and human ge- Children's Hospital of said. Alder believes whole· netics at UB in the late 1960s and early 1970s, has Buffalo" and whose work heartedly that "being a also written hundreds of papers on genetics, with the Peace Corps took them to Oklahoma. "Lynn then took a residency in pediatrics at the University of Oklahoma, and from there she went "most of which I couldn't possibly understand," caring clinician and earning joked Stubenbord. the trust and respect of a Concluding, Stubenbord said he was hon- patient is acherished gift." ored to speak on behalf ofM ukherjee. "Ani! is a on to johns Hopkins University, where she became good friend, and I feel privileged to accept the I a Robert Wood johnson Clinical Scholar and re- award for him," he said. ceived her second master's degree-a master's in public health-in 1973," he said. Seven years later, she completed a doctoral degree in public health from johns Hopkins University. "A CALL TO PHYSICIANS" FROM PAGE 26 In 1984, she was named chair of the Department of Family and children,' or 'I am retired,' or ' I take care of children, but my practice Community Medicine at the University of Massachusetts Medical doesn 't involve children who are disadvantaged.' Others might say, 'I Center and, in 1991, codirector of the MPH Program at the am empathetic ... but I don't think I can do anythingaboutanyofthis.' university's Amherst School of Public Health. In the early 1990s, she served for one year as a visiting professor that too many of us fail to use it. It is true that most children in our "The bottom line is that physicians do have clout. The problem is in the Department of Community Medicine at the University of nation are in good health and have loving parents who tend diligently Zimbabwe and another year as visiting professor in the Department to their physical, intellectual and spiritual needs. But we live in an of Pediatrics at the University of Capetown. In 1994, she was named interdependent world and our destiny ... depends as much on Project HOPE's first William Walsh International Health chair. youngsters who are unhealthy, poor and alienated as on those who are cellor and dean of the International and Public Health Programs at more advantaged. "We can all find ways to use the clout we have and to stand up for the University of Massachusetts Medical Center. children," Hayes concluded. "They are depending on our voices. In 1997, she was appointed to her current position of vice chan- They are depending on us." 28 CONTINUED I u If a I o Ph ysici an Summer 2000 4D �I ----- ~~-- ~ ------------+~~---- FIRST ROW: ROBERT j. PATTERSON. V\ILLIAM S. WEBSTER, LEO ~~~NNING, ADELMO 0UNGHE, HELEN f. SIKORSKI: SECOND ROW: GEORGE TAYLOR, ROY '\<\'.ROBINSON, CARLA. CECILIA, RICHARD.). LEBERER, HY\IA:-1 TETEWSKY. ROBERT BERG.'ER, KARL MANDERS, WILLIA\1 STEIN. YALE SOLO\!ON, ROLAND ANTHONE: THIRD ROW: HENRY L. PECH, SIDNEY ANTHON E. ROBERT,'. Ku.·G. RICHARD LYONS ROBERT BENNINGER, GUYS. ALFANO, EuGENE.). LEFT TO RIGHT: ALBERT C. REKATE lYGAJ. jAMES Du.·N. Do:-~ALD THO\I~S. WARREN R. \!0:-<TGOMERY, jOHN G. 7.0LL, WILLIA\1 HILDEBRAND, j HIES P. SCHAUS. FIRST ROW: WINIFRED MERXA:-1, CLEORA K. KEELEY, jOHN H. PETERSON, C. DANIEL FAGERSTROM: SECOND ROW: S. JOSEPH LA\1ANCUSA, LAWRENCE f. BEAHAN . .)OHX H. KENT, fRANK.). GAZZO, ALBERT A. FRANCO. RAY G. SCHIFERLE, jOHN B. BAKER. FIRST ROW: HERBERT E. JOYCE, A. ARTHUR GRABAU, GE:O.:EVIEVE G. HOWEN. EARL K. CANTWELL ROBINSON, CHARLES E. JOHN G. WILES; SECOND ROW: "lORMAN GHASSIN, JOHN f. HARTMAN. WILLIA'.I S. ANDALORO, WAYNE G. Tn!PLER, IvAN W. KuHL, WILLIAM'\. MciNTOSH: THIRD ROW: K. jOSEPH SHEEDY. GEORGE M. ELLIS. jACOB S1 EINHART: FOURTH ROW: ROBERT l.AGLIA. GEORGE THORNGATE. IV. C. .\1. SCHOPP, \'ITO P. Summer 2000 laffala Physician 29 �SuMMER 2000 FIRST ROW : IRWIN STEINBERG, WILLIAM E. ABRAMSON; SECOND ROW : jOSEPH A. CHAZAN, EDWARDj. GRABER, fRANKLIN GLOCKNER. jAMES R. KANSKI, ROGERS. DAYER, SYLVIA SussMAN, HARRIS C. fAIGEL: THIRD ROW : jOSEPH C. >\NTKOWIAK, DANIEL A. GOLDBERG, H ARR I S ~.KENNER, L. LEITER, MARSHALL A. LICHT\IAN. ANDRE D. LASCAR!, NAOMI ALGIRDAS CAMZIUKAS, DONALDj. DONIUS. WILLIAMj. STEIN, DO!'iALD A. HA\O.IEL, D. jACKSON COLEMAN' GERALD DIESFIELD, EDWIN R. LAMM, EUGENE T. PARTRIDGE; FOURTH ROW : fRANCISj. KLOCKE. HARRY L. METCALF. DANIEL T. GIA!'o<TURCO. THO\I ASj. GUTTUSO, THEODORE S. BISTANY, ROBERT T. GUELCHER. ROBERT L. ~ALATESTA, DAV I D'\. FIRST ROW : SULAH MEGAHED, ALAN M. PODOSEK, STEVEN V. GRAB I EC, ALANj. f i NK, N. LYNN ECKHERT, LAURENCE :-...1. LESSER, WILLIAM f. BALISTRER I , D.H'IDj. ROSSMAN, AGNES \ I ESCHES. V. SZEKERES, DONALD SECOND ROW: HENRY L. P. COPLEY, jOHN D. fOLEY; WHITED, ARTHUR R. GOSHIN. THOMAS A. O'CONNOR, SHAFIC Y . TWAL, WILLIAM j. fiDEN, \ I ICHAEL FIRST ROW : ARTHUR M. L. LIPPMAN!'i, jA:-i ~-NOVAK. MORRIS, LANCE fOGAN, IRA HINDEN, SECOND ROW : jOSEPH G. CARDA~IONE, GEORGE B. ~OORE, GARY H. JEFFERY, GEORGES. STRAUSS, H. ELLIOTT LARSON, BENJAMIN j. WHERLEY. !1-frCHAEL S. FEINBERG. AUGUST J. D'ALESSANDRO. FIRST ROW: DAVID KLUG, LEO R. ~UIDO, \1ARY ELIZABETH ROEHMHOLDT, ~ ARGUERITE DYNSKI, LYKNE HOCHBERG PACE, BRENDAN C. BRADY; SECOND ROW: PAUL D. TRAUTMAN, HENRY P. TOMIAK, DENNIS C. WHITEHEAD, LAWRESCE C. MILLHOFER, WILLIAM I. COHEN, LUDWIG LICCIARDI, jACK CUKIERMAN, ~ARC 30 lullalt Hysician SummL'r 2000 F. P. fREER, jACK COLMA!>, jOHN H. HEDGER, jOHN C. STUBENBORD, jOHN LOVECCHIO. �----- ----- ----~~~~~------------ ---~ - - - - - ~-- FIRST ROW : MATTHEW G . SALTARELLI. MARC K. KLEME~TOWSKI. GALE BURSTEIN BL00\1, ~1ICHAEL B. MARINO, !\'IZA:\1 RAZACK, ANN RIZZO; SECOND ROW : PETER BLOOM. LIDIA V. WENZ, NGOZI 0SUAGWU, EILEEN M. SALTARELLI, VALERIE VULLO SAENGER, MICHAEL LICATA, RAYMOND V. PAOLINI. LAURA PANEBIANCO, jOYCE jANICE E. N. J. NICHOLSON. STEPHEN M. PATERSON, ALICE PIEN MILGROM. ERRICK, SHOBHINA G. CHHEDA. SuzzETTE N. ROBINSO'I, STEVEN j. HOWARD. DENISE ALOISIO, VIRGINIA FIRST ROW : BARRY A. CLARK, ROBERT SHALWITZ. PETER H. GREENMAN. MARK S. BORER, EvA KLO~OWSKI, LYNN \1. E. ROBERTSON; TH IRD ROW : PETER WINKELSTEIN. EDWARD F. KOWALSKI, ROBERT j. LEON. SEAN CAO, RAGHU RAM, l. STEINBRENNER, fRANK W. SANCHEZ, THOMAS DOUGHERTY; HOWARD SECOND ROW: ~! ARGARET W. PAROSK I , CONSTANCE B. LIVERPOOL. GREGORY D. SA:>.!BUCHI . RA:-.:JAN BHAYAI'<A. STOLL, MICHAEL HAYMAN, STEVEN F. LE:-.:Tz, THERESA STEPHAN HAil'S, EDWARDj. ROCKWOOD. LEFT T O RIGH T: KAREN E. DULL, TRACIE DIMARCO, MARTIN C. :v!AHONEY. TARA SOSA PAOLINI. PATRICIA A. KREBS. STEVEN M. FINKELSTEIN, GARY j. 'l!ELAN, DANIELLE NOTEBAERT FEELEY, ARAVIND HERLE, KATE GUERNSEY ACKERMAN. MIROSLAV P. BOBEK. GREGORY A. MCDANIEL. F I RST ROW : ELIZABETH l. MAHER. C. ADRIANA ALVAREZ, LUCIE A. DIMAGG I O, ELIZABETH SPATOLA; SECOND ROW : LOU ANI\ GART:-;ER,jOSEPH A. ZIZZI, RAYMONDj. MEEKS, CAROL HAMMER FORSTER, MARGARET E. REIDY, SHIRLEY V. GALUCKI, BARBARA P. UPPAL. ELAI:o.;E SCHAAF, LAUREL A. \1. STIDHAM; THIRD ROW : THOMAS B. ~1ICHAEL P. NANCOLLAS. CARLj. TURTSS I !\1. PFEIL. LY:\DA COWAN, IRA S. HANDLER, jACK F. COYNE, DAVIDj. FoRSTER. DoNALD TINGLEY. jOHN LEDDY, jAMES M. ESSER. jOHN R. FUDYMAN, M I CHAEL LAHOOD, DALE W. SPONAUGLE. Spri11g 2000 lufl al 1 Physicia n 31 �0 E V E L 0 P M E N T N E s w Tomorrow's Traditions Be ·nToda By Li nda J . Cor de r , Ph0, CFRE of memory and hope. region, joined with the medical school as official spon- extends back through the generations to a small group of sors of the Mini-Medical School for the next ten years. Buffalo citizens, primarily physicians and attorneys, who This is the third year that UB has participated in the founded the University in 1846. Their dreams included White Coat Ceremony. One ofouralumni, Don Pachuta, awarding degrees in all fields, being nonsectarian in governance, and training professionals to serve their region. History of Medicine at the University of Maryland, real- Ourcommunitynowextends to all states and throughout the world, where physicians, surgeons and scientists minds and hearts of future doctors, so initiated an en- institutions-labor in hope, providing tools for lifelong learning, nurturing curiosity and humanity. inaugural lecture himself. Both events reinforce that medicine is an art and that healing often has more to do The mission of the development staff is to serve as a with authentic communication between human beings catalyst to deepen and expand this noble endeavor. Our work complements that of faculty and administrators and than with the latest technology or complex equipment. In the fall, the Pathology Department will initiate a lecture in memory of Dr. Kornel Terplan, who earned an international reputation for his research in the areas professors and to express their appreciation for the educa- of tuberculosis and neonatal neuropathology. •.. \I E ll I C I -.; I much as possible about the dreams and priorities for the sons initiated the endowment, with the reminder that \1 0 R E T 0 ~ T IC B E T \\" E E :\ \\"\T\1 32 0 F T I \: \) 0 school's future. "although educational content and educational tools We listen to will change from century to century, the need to the stories of develop healthy minds, healthy bodies and a healthy alumni and environment will not change. We will always require friends, seeking disciplined scholarship, hard work, honesty, humility, C 0 .\1 \I L '.; I C. AT I 0 I A"\ EST C 0 \t P L E X I u I I a I o Phys ician ~ T II ·\ :"' TEl 11:-:01E Q L I P \I 1- ;-,: T . S11mmer humor and skepticism of the unproven . .. " On a final note, the first annual aughton Award to help the school realize was presented at the annual faculty meeting on its vision. Then, we en- May 24, 2000. This endowed award-established by Dr. john aughton for the "unsung heroes" of our This spring, Dr. Harry RT II A S \1 I T H H U :\t A ;\ B F I ' (, S TilE 0 R ~ I S A :-; H \· A I I :-; <; Dr. Terplan served our school and that department as chair for over three decades, and even those of us who never met him feel his presence in our community. His able them to "just do it." 0 GY Physician." This August, Dr. Pachuta will deliver the and friends an opportunity to "give back," to honor former finding those who want L T H I dowment to ensure that the tradition will be ongoing. He enhances the students' experiences. It also provides alumni common threads, ~ ized the personal importance of this ceremony in the also made provision for a special lecture for returning second-year students, with the theme "Dear and Glorious Development officers are matchmakers. We learn as :-; ll who served for many years as professor of Ethics and the use skills and knowledge they learned in Buffalo. Our immediate community, those who study, conduct research, guide grand rounds, and otherwise work within the school's walls-and in its network of affiliated tion and opportunities they received from the school. .~ known for their support of activities that enrich our Our community transcends both time and distance. It school-is described in detail on page 23. Sultz, founder of our Thus do the values in the school's collective memory Mini-Medical School, become the foundation of its future hope. Together, mem- was honored in a special bers of our unique community facilitate that process. 4D "Health Care Heroes" issue of Business First. At about the same time, Don and Esther Davis, Lyn Corder is associate dean and director of development. Slzemaybereachedbyplwne, tollfree,at l-877-826-3246,or by e-mail at ljcorder@buffalo.edu. 2000 �Dear Fellow Alumni, F\\t>lhiiJT T!H ~ A ""r)r I\ rrn \Jfri)(Af A11 I would first like to thank our outgoing president, Dr. Richard L. Collins, for the outstanding job he has done in leading our organization. Dr. Collins was successful in solidifying two wonderful programs during his tenure: The first was the Physician-Student Mento ring Program, which has become a huge success. The second was the White Coat Ceremony, in which first-year students are given their clinical white coats on the first day of their orientation to medical school; this is done in the presence of their families and many of the faculty members. On April 29, 2000, we held our annual Spring Clinical Day at the BuffaloNiagara Marriott. The program was titled "Children 's Health Issues," and our keynote lecture, delivered by Maxine Hayes, MD '73, addressed the future of children's health in the new millennium. For a report on this insightful and informative lecture, l refer you to page 25 of this issue of Buffalo Physician. This year, we plan on continuing all of the programs that have been offered to both the alumni and the medical students in the past. I would, however, like to focus on membership in the Medical Alumni Association. I know how valuable a physician's time is. Nevertheless, l do feel that as our university continues to make great strides in the medical community, our alumni association should be matching those strides step for step. We need to have a strong base of alumni-not only our older graduates, but also our recent graduates-to support the school in every way possible. We offer a lifetime membership that is very economical, especially for younger doctors who plan on being in the alumni association for the next two to 30 years. Our lifetime membership is also a way for older physicians who are in a more stable situation to support the alumni association and its programs. You 'll be hearing more from me in the fall about increasing our membership and the percentage of alumni who become lifetime members. If any alumni have ideas they wish to share or would like to volunteer their time to help with the association, please contact me at (716) 829-2778. !look forward to this upcoming year as one in which our association will grow and prosper. President, Medical Alumni Association 5 11 111 111 er 2 00 0 Bu If a I o Physician 33 �CLASS 1940s Edward Tracy, MD '43, writes: "I enjoy Buffalo Physician. It's good to hear about classmates, etc. I have been married 57 years to the same "Chick" (that's her nickname!) and we have seven children, all of whom are married. Two graduated from West Point Military Academy and two from The Citadel. Three of my daughters were educated in France. We have 15 grandchildren and one great-grandchild. I am still very active in private practice-internal medicine-and teach, pro bono, at the Medical University of South Carolina. The best to all of you, especially my classmates." 1960s Joseph A.Chazan, MD '&D. received Univer- sity at Buffalo's Distinguished Alumni Award at the Alumni Association's annual awards dinner on April 7, 2000. Chazen is founder of the Rhode Island Di- NOTES active in many civic, religious and arts organizations. He has served for nearly a decade on the UB School of Medicine and Biomedical Sciences alumni board and is a former chairman of UB's general alumni fund drive. Michael E. Cohen, MD '61, received the Samuel Capan Award at UB's annual Alumni Association's awards dinner on April 7, 2000. Cohen is professor of pediatrics and neurology and former chair of the UB's Department of eurology, received the Samuel P. Capen Award-the alumni association's most prestigious prizeon April 7, 2000. The award is presented for notable and meritorious contributions to the university and its family. Director of pediatric neurology at Kaleida Health System's Children's Hospital of Buffalo since 1978, Cohen and his UB colleague, Patricia Duffner, MD, coauthored the alysis Program and medical director of the Rhode Island Artificial Kidney Centers. He has made significant contributions to his community and is 34 lu ffalo Pbysician Wels Receives Chancellor Charles Norton Medal Philip B. Wels, MD '41, visionary and dedicated Biomedical Sciences, received the Chancellor benefactors of time, the Medical Alumni Charles P. Norton energy, ideas and Association's Medal-University at key funding. A uni- Achievement Buffalo's highest versity Founder and Award and the honor-on May 14, trustee of the UB Chancellor Capen Award. In 1997, 2000, during UB's 154th Foundation, Inc., general commencement. Wels has been the he was awarded Wels, who is Professor recipient of many the President's Emeritus of Surgery and awards from UB, Chair Emeritus of the including the Distin- than 60 years of ongo- Medal for more University at Buffalo guished Alumni Award, ing service to the UB Council, has long served the Dean's Award in the community. UB as one of its most School of Medicine and highly regarded textbook Brain Tumors in ties, including chair of the Tissue Committee and Representative of Private Practice to the Executive Committee. He is also a clinical associate professor of surgery at UB's School of Medicine and Western ew York for 25 years and is currently a member of Advanced Cardiac Surgical Associates, PLLC, a Buffalo-based practice group. Biomedical Sciences. 1970s Children: Principles of Diagnosis and Treatment, now in its second edition. A member of the medical-school faculty since I 968, Cohen also serves on the Dean's Advisory Council. Joseph R. Gerbasi, MD '62, was honored by the Erie County Medical Center's (ECMC) Lifeline Foundation at its Springfest 2000 annual black-tie dinner on April 15. Gerbasi has been the surgical director of transplantation at ECMC since 1969 and has served the medical center in many capaci- BP Areta Kowai·Yern, MD '72, Ross L. Guarino, MD '66, was installed as the new president of the Medical Society of the County of Erie on May 9, 2000. Guarino, who succeeds Datta G. Wagle, MD, has practiced cardiovascular and thoracic surgery in writes:"[ have taken a position as burn research director and tissue bank director at Cook County Hospital, Department of Trauma, Burn Center, Chicago, IL." Gordon Avery. MD '74. McLean, VA, Orthopedic Surgery. "I have been an FL team physician for the past five years with the Washington assnotes S " '" m e r 2 0 0 0 �Redskins. I am past president of the County Medical Society." the Community Workshop. Please say 'hi' to everyone for us." John and Kathleen Braico, MD '74, Queensbury, NY, Richard J. Goldberg, MD '74, writes: "I'm cur- Pediatrics. "We have been happily married for nearly 28 years and have built a successful group practice (five pediatricians and two nurse practitioners). John does general pediatrics as well as neurodevelopmental evaluations for kids with learning disabilities and has greatly helped their educational success. We are raising two healthy boys. Besides our prac- rently professor of psychiatry and medicine at Brown University, and psychiatrist-in-chief at Rhode Island Hospital and The Miriam Hospital. Recent new events include starting as editor of the Brown Geriatric Psychopharmacology Update. Also, I'm halfway through a two year master's degree program in medical management at Harvard University." rjgoldberg@lifespan.org E-mai nity Health of the University of Massachusetts Medical School, Worcester, MA. l have a clinical practice at a community health center in Worcester." E-mail address is Lasserd@ummhc.org Eric Russell, MD '74, Chi- cago, !L, Neuroradiology. "I was elected president of the American Society of Neuroradiology, 19992000. I am professor of radiology at orthwestern University Medical School and director of neuroradiology at Northwestern Memorial Hospital. l have published over 100 scientific publications/ book chapters." erussell@nwu.edu ~NTIN U ED ON PAGE 37 J. Manzella, MD '74, York, PA, Internal Medicine. "We take care of approximately 250 HIV patients." lf-jmanzella@ AGenerous Gift of Suppon yorkhospital.edu Diane Matuszak. MD '74, Columbia, MD, Preventive Medicine. "!have served as a local health officer ( 1982-1984) and as a state public health official for the past 14 years in the Maryland Department of Health and Mental Hygiene." Summerr@compuserve.com will provide a renewable tuition scholarship for at least one student in each Sanford Pleskow, MD '74, tice, we are both instructors for neonatal resuscitation. Kathy is a pediatric advanced life support instructor, and for six years she has been medical director of the Hole in the Woods Ranch camp for children with serious and chronic illnesses. She participates in an annual medical mission to Gua temala. John has been on the board of Head Start for 20 years, and Kathy is on the board of Howard Goldstein. MD '74. Cherry Hill, NJ, Adult and Pediatric Urology. "Children: Lee is a junior at Yale Medical School; Lauren is a sophomore at Columbia University; and Daniel is a junior at Cherry Hill High School." Daniel Lasser, MD '74, eedham, MA, Family Practice. "My current position is chair of Department of Family Medicine and Commu- Williamsville, NY, Internal Medicine."! have been happily married for 29 years (same person). Hobbies are travel, hiking, tennis and exercise. I have a daughter who is applying to medical school." says she worked hard to earn John Rowlingson, MD '74, he~ education during a period when state schools awarded scholarships Earlysville, VA, Anesthesiology. "My years of practice have taught me the importance of making pain management a priority. When the case is beyond your skillsget help. Remember, we can't help patients who won't help themselves." Jcr3t@virginia.edu While in medical school, she earned scholarships and summer jobs covering the costs of books and room and board. After completing training, GoHschalk practiced general surgery witli S limm er 200 0 B u If a I o Physician 35 �C L A N 0 T E he first Minority Alumni Reunion of the University at Buffalo School of Medicine and Biomedical Sciences was held April 7-9, 2000, at the University Inn and Conference Center in Amherst, NY. "Coming Together for the New Millennium" was the theme for the event, which included social gatherings and an educational program that focused on advances in the prevention and treatment of common health problems encountered in minority communities. The keynote address for the reunion was delivered by Kevin Greenidge, MD '77, who spoke on "Health Care Access without Health Care: A Minority Dilemma." Greenidge is professor and chair of the Department of Ophthalmology at the SUNY Health Science Center at Brooklyn. The following Classnotes were submit· ted by several attendees of the reunion: JOSEPH OE.JAMES, 36 8 u I I a I o Physician S11mmer 2000 \10 '96 KEV IN GREEN IDGE , \10 '77 �William Sperling, MD '66, Honored William Sperling, MD '66, has been named that meet monthly, bringing together pulmo- the "Dale Daniel, MD, Memorial Partner of nary physicians and thoracic surgeons from the Year" by the Southern California Kaiser Permanente, Balboa Naval Hospital Permanente Medical Group (SCPMG), a and UCSD to learn from one another and to partnership of SOO physicians who care for improve the care of patients. County Pulmonary Society and has worked health maintenance organization. Sperling joined SCPMG in 1974, when Kaiser with the San Diego County Lung Association Permanente was only seven years old in to help establish a Better Breathing Club for San Diego. He is credited with establishing William Sperling, MD '66 an ongoing relationship between SCPMG's chronic pulmonary disease patients. He has also chaired the Tobacco Free 2000 Commit- Internal Medicine Department and the tee for the San Diego County Medical Society and helped to residency program at the University of California at eliminate smoking in the local sports stadium and airport San Diego (UCSD). before state law required it. Sperling is a clinical professor of medicine at UCSD patients, understand their fears, reassure them and give addition to teaching at the university, he has actively them the best care possible," says Maurice Alfaro, a promoted pulmonary medicine educational programs colleague of Sperling's at SCPMG. Wynnewood, PA, Neurology. "I am very involved in a professional organization in the area of headache, and I Inc. I am spending my summers in Zimbabwe, Africa. BonniDutcher, PhD'7B. Amherst, NY, Orthope- Hoffman Estates, IL. "I am working as a medical science liaison for Genentech in Chicago. I set up the clinical trials with antibodies for cancer dies. "I am current chair of Credentials for Kaleida treatment. l would love to hear from old friends. " Health, president of orthtown Orthopedics, Bonnllll@yahoo.com and medical director of the Millard Fillmore Ambulatory Surgery Center. " Bennett Yogelman. MD '78. lecture extensively." Eschul6641 @home.com Paul Wierzbieniec, MD '74, Center for Women's Health and Women's Health Research, as well as the named recipient of the jean Manchester Biddick Professor of Women's Health Research. Their son, Paul, will start as a freshman at the University of Wisconsin this fall, and their daughter, Lindsey, will begin high school. Molly and Bennett have fond memories of medical 4:D trator of Brandeis University's business/ management graduate program from which I graduated in 1995." Magjersam@aol.com Philip Anson, MD '79, Scarborough, ME, Orthopedic Surgery. "After 14 years in a large subspecialty orthopedic practice, I took a twomonth summer sabbatical (as a Teaching Fellow ottingham, England) 111 and Molly Carnes, MD '78. school, where they met and are very grateful to continue to thrive in Leonard Katz, who Madison, WI. Both steered them to UW for are professors in the Department of Medicine their residencies. Phoenix, AZ. "I am retired from medicine and am now a rancher in Arizona, working for at the University of Wisconsin. Bennett is the associate chair for Robin Adair. MD '79, the Bitter Creek Land and Cattle Company, education and Molly is practice for the time (referee) for both men's director of the UW being to be an adminis- and women's lacrosse. Richard Zeschke, MD '76. eedham, MA, Pediatrics. "I've left clinical hotmail.com Snyder, NY, Internal Medicine. "I am currently professor of medicine and associate chief of the Division of Cardiology at UB." Canty@buffalo.edu Allen Carl, MD '79, "Lastly, he's never been too busy to listen to his and has been active in the pulmonary service there. In Elliott Schulman, MD '74, and spine) through AO-ASIF." Psalax@ John Canty Jr., MD '79, Sperling is past president of the San Diego patients in Kaiser Health Plan, a nonprofit I am also an oral examiner for the American Board of Orthopedic Surgery and a lecturer/ instructor (in trauma in I996 and opened a solo private practice on my return. I am team Slingerlands, Y. "I am professor of orthopedic surgery at Albany Medical College. My research involves spinal cord injury and scoliosis. In 1997 I had a traveling fellowship with the Scoliosis Research Society." Alscar@nyca p. rr .com Terence Chorba. MD '79, Atlanta, GA, Internal Medicine. "Buffalo is a great place to go to medical school and you were great classmates to be with." Tlc2@cdc.gov Peter Condro, MD '79, Richmond, VA, Nephrology. "Since 1985 I have lived in Richmond, Virginia, practicing with Richmond Nephrology." E-mail address is: physician for the U.S. Soccer Federation, on the los4441154@::ompuserv.com board of directors of the Margaret Garrisi, MD '79, Maine Lacrosse Foun- Scarsdale, dation and an official ductive Endocrinology S 11 m 111 e r 2 0 0 0 Y, Repro- CONTINUED ON PACE 38 Bu ffa l o Ph ysi c ian 37 �CLASS I CONTINUED FROM PAGE 37 and Infertility. Mjgraf@ mail.med.cornell.edu 98 Subhabrata Chakraborti, PhD '84, Tuscaloosa, AL, "!am working at the University of Alabama in the Department of NOTES Management Science and Statististics and am a professor of statistics. Published over 30 research articles and am associate editor of two statistics journals." Michael Mercado, MD '84, Windermere, FL, Family Medicine. "I've com- pleted 18 marathons since I graduated in 1984. I'm medical director at West Orange Family Medical Care (group practice) and Health Central Park (nursing home); and in-structor in Tang Soo Do Karate at the Traditional Martial Arts Center." A reception for alumni of the University at Buffalo School of Medicine and Biomedical Sciences will be held in conjunction with the Association of American Medical College's annual -.tlng October 27-November 2, 2000, in Chlcaco. Chlcaco MarrioH Kimberly Norris. MD '84, Middleville, Ml, Ophthalmology, and husband, Mike Nosanov, MD '84, Otolaryngology/ Head and Neck Surgery. "We practice together in our own practice, eye and E. .T. specialists, in Hastings, Michigan. l [Kimberly] am actively involved in childhood vision screening research and program development." Mnosanov@voyager.net William Reichman, MD '84, Princeton, N), Psychiatry. "I am director of the Division of Geriatric Psychiatry at the Robert Wood Johnson Medical School and vice chair of the Deptartment of Psychiatry. I am also COO of our university's Behavioral Health System." Reich man@u md nj.ed u Kevin Rosteing, MD '84, Green Bay, WI, Internal Medicine. "We live in Green Bay, a 'cool' beautiful place on the Great Lakes. We own a boat and spend some wonderful time on the water with our children." Kevinr@gbonline.com 38 Buffalo P bysician S 11111111 C r 2 000 Look for more information at the conference, or contact Mary Glenn at I 877) 826-3246; e-mail glenn@acsu.buffalo.cdu. Randall Solomon, MD '84, and Susan Abbott, MD '84, Setauket, NY, Psychiatry. Randall writes, "My wife, Susan, and I are both in private practice of psychiatry. Susan is medical director of]. T Mathe Hospital's adolescent inpatient psychiatric unit." Rsdomon3@bigfoot.com Michelle Stram, MD '84, Chalfont, PA, Internal Medicine. "I've been in a very successful, busy cardiology group practice. I am the managing partner of our office that employs a staff of 25. Michael Kaplan (internal medicine and endocrinology resident and fellow at UB) and I have two wonderful children David, 6, and Sara, 4. Mstram@worldnet.att.net John Oyster, MD '84, Lewiston, NY, Family Medicine. "I am assistant director of Niagara Falls Memorial Medical Center Family Practice Residency and a member of the medical school's Admissions Committee." David Crandell, MD '89, Needham, MA, Physical Medicine and Rehabilitation. " I am team physician for the Ballet Theatre of Boston. Team physician, U.S. Disabled Sports Team, Athletics World Championships, 1994, 1998." Carol DeCosta, MD '89, Brooklyn, NY, Physical Medicine and Rehabili tation. "I worked as a physician for the 1996 Olympic Games in Atlanta. Recently I started a private practice in rehabilitation and sports medicine in Brooklyn Heights, New York. Cdale2810@aol.com �Anna Hart, MD '89, Ports- mouth, VA, Otolaryngology/Head and Neck Surgery. "I was a U.S. aval Flight Surgeon for more than five years, stationed in Florida, then Washington State. I resumed my residency in otolaryngology/head and neck surgery in 1995 and will start as chief this summer. I have presented papers at several meetings, including the Academy of Otolaryngology/Head and eck Surgery and have also wife, Stacey, and l have an 18-month-old son, Ian, and are living in Westchester County, New York. Silberj@ rockvax. rockefeller.ed u Stuart Varon, MD '89, Baltimore, MD, Child Psychiatry. "I am medical director of child psychiatry at Sinai Hospital of Baltimore and an instructor at johns Hopkins University School of Medicine." Svaron@sinai-balt.com In Memoriam Thomas A. March, MD psychology at the VA Cen- South Buffalo for about '31. tral Office in Washington, 50 years and was on the age 96. March D. C., and as the director staff of Mercy Hospital was born in New Castle, of the VA Hospital at for 42 years. From 1957 PA. In 1946, after earn- American Lake, WA, to 1997, he served as ing his medical degree where he retired in 1973. associate medical direc- from UB, he completed In May of that year, in tor and later medical postgraduate training honor of his contributions director fo the Buffalo neurology and psychiatry to psychiatry, March was Chapter of the Blood at Columbia Unaversity. elected a Ufe Fellow by Collection Program of He entered the U.S. Army the American Psychiatric the American Red Cross. Air Force Medical Corps Association. He is sur- He was also a clinical in 1942 and became a vived by his wife, Rorie; instructor at UB for more flight and group surgeon daughter, Peggy Ander· than 40 years. In addition for the 8th Air Force son; son Thomas D. to his wife, Eleanor, he is published three papers. I am on the editorial 1990s Squadron based in En- March; and stepsons survived by five daugh- review panel for our academy's (Oto/H S) journal, which keeps me busy as well." Email is: Toddandkristina@msn.com Lyn M. Oyster, PhD '90, gland. He achieved the Richard and Greg Nace. ters and three sons. received University at Buffalo's Distinguished Alumni Award at the Alumni Association's rank of Lt. Colonel and Elton Rock, MD '59, 1947, March joined the Edward L. Valentine, MD '45, ent died Febru- Veterans Administration ary 25, 2000, at age 80. Alzheimer's Disease. Department of Medicme A World War II veteran, Rock started the Depart- in Pittsburgh, PA. During Valentine served in ment of Gastroenterology his VA career, he served Batavia, New Orleans and at Sisters Hospital in as the director of the VA Asheville/Black Mountain, 1970 and headed It until Hospital at Bedford, MA, NC, as a Navy medical illness forced h Oyster is a founder and as the deputy director of officer. He had private retire in 199 president of GenCyte, LLC, a microbiology company that patents genetic markers for breast cancer. The company will leverage its skill base in molecular biology, microbiology and cell culture to perform biologic laboratory services. It also plans to develop cellculture products for sale psychiatry, neurology and practices in Elma and Andrea Messina, MD '89, Wayzata, M , Obstetrics/Gynecology. "Hugh eeson and I work in the same large multispecialty group with over 350 physicians in Minneapolis. I never thought a neuroradiologist and OB/ Gyn would work for the same group; it's supposedly the shape of things to come." Jeffrey Silberzweig, MD '89, Elmsford, NY, Internal Medicine. "I am currently the medical director of the Rogosin Institute's Queens Dialysis Center annual awards dinner on April?, 2000. Cornell University Medical College. My American Academy of Orthopaedic Surgeons during ceremonies at the academy's 67th annual meeting in Orlando, FL, on March 15, 2000. after a long battle with CD Maxillofacial radiology child. We are moving at Virginia Commonwealth University School into our first home, in Rockville, Maryland. I of Dentistry, MCV campus, effective am presently an assistant clinical professor at George Washington August l, 2000. Elissa (Jaffe) Bookner, MD '91, see Scott Bookner, Richard Safeer, MD '93, writes: "After finishing University and the associate program director of the Family Practice MD '89. my residency in Ba ltimore, I married a won- Residency Program there. I am really enjoying teaching and, in to niche markets. Laurie Carter, DDS '83, PhD Glen M. Ginsburg, MD '90, derful woman. A year '93, has been appointed of Omaha, NE, was in- and a half later, we are associate professor and ducted as a fellow of the pregnant with our first director of oral and and an assistant professor of medicine at served in the Air Force Reserves untii19S3. In 5 11 111 111 e r 2 0 00 I CONTINUED ON PAGE 40 Bullalo Phys i c i an 39 �CLASSNOTES particular, I have had a chance to do some writing and lecturing on the topic of cholesterol management." New Alumni Association Sarah Finnegan, MD/PhD '94, has received a Electe Alumni Association. Duffner is a UB professor of neurology and pediatrics and a physician in the Depart=- John J. Bodkin, II, MD, was elected presi- ment of Neurology at Children's dent of the Medical Alumni Association on Hospital of Buffalo. April 29, 2000, at Spring Clinical Day. $10,300 grant from Fight for Sight, the research division of Prevent Blindness America, to conduct a study titled "Human Photoreceptors in Culture: Growth Factor Requirements and Potential Gene Therapies." <I;) Bodkin, a 1976 graduate of UB, is Colleen Mattimore, MD, class of 1991, is a clinical associate professor of the new treasurer for the association. family medicine and president Mattimore, a UB clinical instructor of of the Highgate Medical Group in pediatrics, is on staff at Williamsville, NY. Kaleida Health's Children's Hospital and Mercy Hospital Patricia K. Duffner, MD, class of 1972, of Buffalo. becomes vice president of the Medical A plan for living. Hospice really is a plan for living. And the sooner you call, the sooner we can help you put that plan into action - with emotional support, pain management, in-home care anythjng you need to keep enjoying life. Ca/1686-8077. TilE CE:-..:TER FOR H"')SPICE& PALLIATIVE CARE www. hospiceb1!{folo. com 40 luffalo Physician S11mmer 2000 ��- Based on FIMsM Data t t They were drJl sergeants- and cheerleaders~' - Frank Stelarski, stroke rehab patient, Harris Hill H.C.F Why do our patients have better rehab resuh:s compared to the national average? Maybe rt's our staff. ''They knew exactly how far to push me,' ' says Frank Stelarski.''But they also encouraged me every little step of the way. When you've been through what I have, that really means a lot.'' To leam more about the nationally recognized McGuire Rehabilrt:ation THE UJ1CGUIRE ~HABILITATll91'{ CENTE~ Centers, call 1-888-POSTACUTE or visrt: www.mcguire-group.com. 1\ccognizcd ror excellence in guality care. AUTUMN BP 000 1 0 1 VIEW • GARDEN GATE • HARRIS "*****" HILL • NORTH GATE � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 2000 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2000-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v35n01-2000-Summer Table Of Contents A list of subunits of the resource. Safe and Sound Wake·up Call Baseline Scoring Medical School Pathways Spring Clinical Day Development Classnotes Alumni Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v35n01 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2000 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/ccab49be147472dcc459717ee4d7dd5e.pdf a6913708f10bcf62f46ae02019168081 PDF Text Text �l1ffale P'ysiciaa ASS OC I ATE V IC E PRESID ENT F OR UNI V ERSITY SERV I C ES Dr. Carole Smith Petro Dear Alumni and Friends, DIRE C T O R OF P U BLI C AT I O N S Kathryn A. Sawner E DI TO R Stephanie A. Unger I l 5° I N 01 :51 - • f" 'Sl 1' At this writing, we have AR T DIRE C TOR/DESI GNE R just returned from our Dean's Advisory Committee meeting in Las Vegas, ably hosted by Alan]. Kegler joan and Max Doubrava (Class of '59). Max also arranged a mini-reunion of the Class of '59, and I am happy to report that class spirit is very much alive and well. Next month ASSISTA NT DESIGNER Lynda Donati we will be in La jolla to meet with another group of alumni. I have good news to report on the recruitment front: On May 1, 2000, Dr. john Yeh will be joining us as chair of the Department of Obstetrics and Gynecology. Also, on August 1, PROD UC TION COORDI N ATOR Cynthia Todd- Flick 2000, Dr. Kenneth Blumenthal will be joining us as chair of the Department ofBiochemistry STATE UN IVER S ITY O F (see pages 26-28 for details). Our next major challenge will be to shore up the Department YORK AT B U FFALO S C HOOL of Surgery, an essential medical school department that urgently needs some help. By now many of you have probably heard of the federal audit under EW OF MEDICINE AND BIOMEDI C A L SCIEN C ES Dr. fohn Wright, Dean way in Buffalo, involving the medical school and a number of its affiliated hospitals. This type of audit has been experienced by almost one-third of the medical schools in the country and has caused considerable concern at each location. In our very distributed system, it has been very difficult to monitor the practice plans as closely as would be ideal. But the bright side is that, once this is all over, we might achieve a more consolidated system. Similar audits are going on at Stony Brook and Downstate, but we don't have too many details yet as to where our own particular audit is headed. I just wanted to let you know firsthand in case you were to hear about it secondhand. Our medical students are putting the finishing touches on a "Professionalism Program," the centerpiece of which will be a student-generated code of conduct and student involvement in implementation. This has been a much hoped-for student-initiative for some time; thankfully-particularly in this increasingly difficult environment-our students have taken on the challenge. If you care to monitor progress, you can visit the students' website at http://www.smbs.buffalo.edu/CPCx.html. I am certain they would welcome your comments and input. We will be instituting several other facets of this important program at the resident and faculty levels, so stay tuned. We also plan to provide opportunities for input at Spring Clinical Day events. The Mini-Med School, directed by Harry Sultz and Alan Reynard, is a continuing success, and ours is the first in the nation to have a full-fledged "Mini-Med School Alumni Association." More than 2,000 participants have attended the program since its inception EDI TO RIAL BOARD Dr. Bertram Partin, Chair Dr. Martin Brecher Dr. Harold Brody Dr. Linda]. Corder Dr. Alan]. Drinnan Dr. ]ames Kanski Dr. Elizabeth Olmsted Dr. Stephen Spaulding Dr. Bradley T . Truax Ms.]ennifer Wiler Dr. Franklin Zeplowitz TEA C HIN G HOSPITALS Erie County Medical Center Roswell Park Cancer Institute Veterans Affa irs Western N ew York Healthcare System K ALEIDA H EAL TH: The Buffalo General Hospital Til e Children 's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital C ATHOLIC H EALT H SYSTEM: Mercy Health System Sisters of Charity Hospital Niagara Falls Memorial M edical Center in 1997, and Harry has received recognition for it from the community on a number of instances. just recently, he was recognized as a "Health Care Hero" by Business First, @TIE STITIINIYEISITJ I I lEI Ylll U lllllLD Western New York's business newspaper. In collaboration with the UB Law School, a program based upon a series of medical-legal vignettes and specifically targeted to the legal profession was launched on March 2, 2000. There is a lot going on here- some of it admittedly bordering on the unpleasant, but much more of it progressive and frankly uplifting. ~ ~C/~ ~ jn~:"N R. WRIGHT , Buffalo Physician is p ublished quarterly by the S tate University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alum ni, facu lty, students, residen ts, and frie nds. The staff reserves the right to edit all copy and submissions accepted for publica tion. MD Dean, School of Medicine and Biomedical Sciences T...=.:.. University at Buffalo -:a=:s The State University ofNt'w York �V 0 L U M E 34 , N U M B E R G) p s y H c A N HEALTH SCIENCES AUG 1 4 2000 Features 2 Rehabbing from Within A doctor's tale of trauma, and the long road back BY jONATHAN BEAN , 8 14 MD ' 89 Little Ears, Big Infections Vaccine developed for treating otitis media and COPD BY S. A. UNGER In 1989, soon after beginning his internship, Jonathan Bean, MD, was severely injured when hit by acar while crllSsing the street. Beginning on page 2, Bean, aphysiatrist, tells of his journey back to health. Brain Drain New clues to how alcohol affects the aging brain BY LOIS BAKER ABOUT THE COVER RODS A~D jONATHAN BEAN HOLDS THE SCREWS IMPLANTED IN HIS PELVIS AND LEG AFTER THE ACCIDENT. CovER 12 Michael White, Class of 2000, returns to his adopted homeland of Brazil to complete an infectious disease rotation 18 Program to help students gain entrance to medical school 20 New institute established 21 Grant supports development of two new centers 26 Kenneth Blumenthal named chair of Biochemistry 28 John Yeh, MD, named chair of Obstetrics and Gynecology 30 A salute to the Class of 1945 31James Platt White Society Annual Listing PHOTO 36 News from your classmates and other UB alumni 39 Stuart Collins and Peter julian remembered BY j o s H LEVINE 41 Deborah, Christopher and Adam White Memorial Fund established �Photos by Josh Levine • ................. W-IIIIIIIHI(ast- aftlrllllltllh.,lar ............. ,llhl. I 1111111 ••r•lcl•• ��IKETHEINCANDESCENTBARRELOF ASHOTGUN, the two headlights bore down. There was no turning back. I took two running steps and dove for the sidewalk. In that instant, I recalled afootball game from my youth. After intercepting apass, I was able to dive over the goal line before the tacklers stopped my momentum. I had the elated sense that I would triumph again. Apiercing crack and the sudden sensation of being forcefully twisted through the air jolted such thoughts away. As I carne to rest, 10 yards down the sidewalk, the smell of concrete dust permeated my nostrils. I instinctively attempted to stand, but it became evident I could not control my legs. Blood and torn flesh covered my right thigh. As I untwisted to lie back down, an exquisite raw pain enveloped my pelvis. I cried out for help. No one answered. I cried out again, but in response heard only the receding sound of screeching wheels in the distance. Eventually, assistance arrived. In the ambulance, with the siren blaring, I considered what would occur next. I could see the paramedic's watch on his wrist. Ironically, I would arrive at work on time. Survey of the Damage Twelve hours later, in a clouded state, I awoke in the surgical intensive care unit. There was a lattice of metal rods screwed into my pelvis and a full-length cast encasing my right leg. Surgery had been lengthy. My pelvis had been fractured in two places and my leg in three. More surgery was scheduled for the coming days. The nurse pointed to a button near my hand, explaining that I could control the morphine dose myself. She suggested that I get some rest. Pain ran up and down my body. I gave a press and fell to sleep. When I next awoke, I was in a private room. Dr. M., one of the • l 1 1f a l e Hysiei11 Spr in g 2 000 most respected members of the medical staff, smiled down at me. He explained that I was under his group's care, that my surgery had been 36 hours earlier and that my anesthesia was still wearing off. With some hesitation, he asked, "You're going into physical medicine and rehabilitation aren't you?" "Yeah," I said, "at Tufts." He shook his head in disbelief and said, "Well, I guess you're going to learn rehab from the inside." He pointed to the morphine pump. "These PCA pumps are new. I'm not so sure they' re a good thing." Turning to leave, he patted my cast and said, "Get some more rest. You'll need it." I looked around the room. A half-eaten sandwich and my sister's coat were lying on the chair at the foot of my bed. Still unable to stay awake, I closed my eyes. Occasionally, I awakened to see the faces of my concerned family or a nurse changing my IV, but each time I sank back into oblivion, my sleep deepening. Finally, I fell into a sleep that was profound; blissful, even. But in the distance I could hear someone calling my name. His voice became louder and increasingly urgent. I was being yanked from the comfort of my dreams. I felt him slapping my arm, and then a sharp stab at my wrist. Opening my eyes, I saw Rick, one of my fellow interns, drawing a blood gas. I had never seen him so frightened. He clamped an oxygen mask on my face and told me I was being transferred to the Intensive Care Unit. Later that day, with the overwhelming sensation that I was breathing through a straw, I underwent the obligatory workup. I had suffered a fat embolism. �Long Road Back Pain Mismanagement After an extensive debate, the physicians decided not to intubate me. Though the respiratory distress was a consequence of emboli released from the fractured bone marrow, they still felt that my use of the morphine pump was to blame. Today, I know better; nevertheless, for the rest of my hospitalization I was labeled as someone for whom narcotics should be minimized. Over the course of the next month, I learned firsthand many of the pain-management principles that would later be a part of my physiatry training. For example, I learned that pain medications with a half-life of four hours should not be prescribed every six, and that it takes 15 minutes for a nurse to deliver a prn medication and an additional half hour before it takes effect. I learned about the difference between bone pain and neuropathic pain, and that narcotics do little to quell the latter. Most notably, for the next nine weeks I came to know the unrelenting tedium, frustration and helplessness of pain mismanaged. An important topic in every physical medicine and rehabilitation text is the medical consequences of bed rest and immobility. Bed rest affects every organ system. As a consultant, I am familiar with the facts: Hemoglobin and blood volume decrease; muscle strength weakens l to 3 percent per day; and heart rate elevates one beat for every two days in bed. Conditions like constipation, postural hypotension and contracture often occur. I experienced these and other complications. Upon discharge from the acute-care hospital, my resting heart rate had elevated from 60 to 85, and my weight had fallen from 155 to lOS pounds. Once I was allowed to bear weight in my eighth week of hospitalization, the postural hypotension was so severe that it took 10 days of tilt-table training before I could stand without passing out. Coupled with the narcotics, the constipation became so bad that enemas and manual disimpaction were commonplace. B Devoted Friendship, the Best Medicine esides all of these issues, lying in bed for nine weeks was both boring and depressing. My concentration was clouded, so reading was very difficult. I became far too acquainted with the emptiness of daytime television. Evenings were the best times because my girlfriend, Melissa, would visit. She brought a VCR and we watched rented movies until visiting hours ended. Nights were very hard. Minus daytime distractions, my pain escalated, and the night nurses were always slower about delivering medications. Lying in the darkness, only partially able to turn side to side, I listened to the sounds of the hospital, wondering ifl would ever walk again. The worst times, however, were the mornings. In my dreams I was always healthy-swimming, climbing mountains or just running with reckless abandon. Waking to the cold truth of the hospital room and my broken body was like being hit by a car all over again. Importantly, for three straight weeks, I was distracted by the sound of snoring. Reclined in the chair at my bedside was Dave Blaustein, a fellow intern and one of my best friends from medical school. After completing his night-float shift, he visited me rather than going home to sleep. Unshaven, with his rumpled lab coat draped askew, he often had a fresh banana peel lying on his -Jonathan Bean today chest. (My family kept the bedside stocked with fresh fruit and juice.) with his wife, Melissa, and long· Upon waking, I'd nudge Dave with time friend and DB alumus my long-handled reacher, and for the next 20 minutes we'd talk like David Blaustein, MD '89, right. we always had, joking about the doctors who took themselves too seriously and cursing the nurses who had given us a hard time. We also talked about sports and politics and shared stories of past escapades. He always left time to hear how I was doing and to validate my frustrations. As much as anything else, he helped me to feel as if things were normal, even if circumstances were not. He taught me about healingthat there are times when devoted friendship is the strongest medicine of all. Spring 2000 l1ffala Pbysic i u 5 �A The Group of Four fter nine weeks of lying in bed fulfilling the typical passive role of a patient in an acute-care hospital, I was transferred to Magee Rehabilitation Hospital. Inpatient rehabilitation requires a patient to function as independently as possible. Patients often wear street clothes, signifying a sense of normal life. For most patients, however, it feels more like boot camp. Given my anxious and disoriented look, it was clear to all those around me that I was a new admission. After having gone through the multiple initial evaluations by nursing, physiatry and social work, I was told to make my way down to the cafeteria for dinner. Now that the external fixeter had been removed from my pelvis, I was able to sit upright and independently propel my loaner wheelchair. Staff helped me when asked, but otherwise tended to those with greater needs. The other patients observed me, though no one initiated conversation and most avoided eye contact. This was particularly true for a group of four youngadult paraplegics of diverse racial background who wore fingerless black leather gloves and were unified by their reliance on lightweight custom wheelchairs. They joked together, darting glances in my direction during pauses in their conversation. Over the next few days, this group of four seemed to follow me around. They often hovered closely, be it in the cafeteria or the therapy gyms. Despite this progress, it took Like a group of adolescent skateboarders, they practiced pulling four more surgeries and five more years wheelies and jumping curbs. of rehabilitation before I considered They observed with knowing curiosity as I strengthened my myself substantially recovered. atrophied arms and shoulders. Though nearby, they never approached or outwardly addressed the fear I felt inside. Then on the fourth day, my physical therapist announced that it was time for me to use the stationary bike. Despite the fractures and nerve injury, the healthcare team agreed that with the return of strength, I would walk again . Initially I was concerned about pain or falling, but I felt more confident with each minute of riding. As my legs became more comfortable, I increased the pace. Closing my eyes, I soaked in the long-missed exhilaration of exercise. Eventually, I became aware that the group of four was parked around me. They had mystified looks on their faces. One spoke, "So, you can use your legs." "Yes," I said with a selfish pride, ''I'll start walking with crutches tomorrow." "Wow, that will be great for you," he said, with a mixture of generosity and sadness. 6 l affal1 Hysicin Spring 2000 I sensed the awkwardness of the moment and struggled with a response. He spared me the discomfort by asking about my injuries. He shared that he had suffered a lower-cervical spinal cord injury as an interscholastic wrestler. The others had suffered injuries from a motor vehicle accident, a gunshot wound and a diving accident. They wished me the best and then slowly wheeled away in separate directions. Framed by wheelchairs, with their narrow legs folded neatly beneath the seats, they suddenly looked young and vulnerable. At that moment, I realized that I had been undergoing a rite of passage, an initiation into the world of spinal cord injury (SCI). Once it was clear that my spinal cord was spared, the process suddenly ended. I became a spectator, not an insider. As a physiatrist, my training has taught me that in SCI almost all body systems are altered. The adjustments to the many social and emotional changes are even more challenging. It can be a very difficult and lonely transition. Throughout the rest of my hospitalization, I rarely saw any of those four again, though they always greeted me with kindness when I did. I Imaginary Finish Line n late January 1990, after three months ofhospitalization, I was discharged to home. In March, I returned to work. Despite this progress, it took four more surgeries and five more years of rehabilitation before I considered myself substantially recovered. Exercise and patience were my daily medications. Most of the feeling has returned in my leg, and every once in a while I go for a long run. At last year's Spring Clinical Day and Reunion Weekend-which included a reunion for the Class of 1989-I returned to one of my favorite places in Buffalo, Delaware Park. Running around the familiar path, my thoughts sifted through the last 10 years. With my asymmetric gait, I sprinted the last half-mile as if it were the end of an important race. As I passed the imaginary finish line, no one cheered or celebrated. The victory was a private one. My experiences did not dramatically change my goals, nor did they lead to some sort of religious epiphany. They have been woven into the fabric of my life. Ultimately, illness is a solitary experience of adjustments that are only partially shared with others. In recognition, as a physiatrist, I lend a hand, assisting my patients to feel intact again. 4D �Spring 2000 luffal1 Hysiciaa 7 �BY s. A. UNGER PHOTO BY K.C. KRATT Little Ears, Big Iiifections vaccines to prevent ear and respiratory tract infections lF YOU WANT TO GET the attention of parents with young children, just tell them that scientists are making significant strides toward developing a vaccine to prevent recurrent ear infections. A leader in this endeavor is Timothy F. Murphy, MD, a University at Buffalo professor of medicine and microbiology whose research is currently funded by a five-year, $1 million grant from the National Institutes of Health (NIH). The vaccine Murphy is developing targets a bacterium called non typeable Haemophilus influenzae (NTHI), which not only is the second most common cause of ear infections (otitis media) in children, but also is a leading cause of recurrent infections in patients with chronic obstructive pulmonary disease, or CO PD. A vaccine against THI is especially promising because it would be effective in both populations of patients. 8 l•ffale Plysicial S p ri n g 2 000 ��I LITTLE EARS, BIG INFECTIONS EDIA and COPD are enormous national health problems in terms of human suffering and cost," rphy, whose work in this area has been continuously funded by the NIH since 1983. "About 80 of children have a least one episode of otitis media by age three, and it is the most common reason £ rvisi s to pediatricians. Recurrent otitis media is painful and because it impairs hearing, it is associated with d lays speech and language development, as well as with learning problems in children as they reach school PD, which includes chronic bronchitis and emphysema, is the fourth leading cause of death in the States, with infections being the most common singie identifiable cause of these deaths." der for a vaccine to be effective against recurrent ear .._........-~,ions, it must work within the first months of a child's life, according to Murphy. This is because if a child's throat becomes colonized with NTHI during his first year of life-even in the absence of an ear infection- he may then be prone to ear infections throughout childhood. "Some vaccines do not induce an immune response in children under age two. It will be critical to develop a vaccine for ear infections that is effective in infancy because it will be important to immunize early to prevent recurrent infections, which are the real problem," he explains. To that end, Murphy's work focuses on two proteins on the outer membrane surface ofNTHI-P2 and P6-each of which has the appealing feature of being able to generate antibodies in infants. "P2 makes up 50 percent of the protein content of the outer membrane and is an immunodominant protein, which means it induces the human host to make antibodies to it," says Murphy. "And what's interesting about it is that if we look at its amino acid sequence among strains, it's different, particularly the parts of it called 'loops' that stick out." It turns out that these heterogeneous loops of P2 were key to answering a crucial question driving vaccine research in this area: Why do children with normal immune systems get recurrent ear infections? Itwas Murphy, working in collaboration with Howard Fadden, MD, at Kaleida Health's Children's Hospital ofBuffalo, who played a leading role in answering this question. "We now have reason to believe that it's because these children with otherwise healthy immune systems are making strain-specific antibodies to these so-called antigenically heterogeneous loops on P2, which leaves them susceptible to reinfection with the heterologous strains," Murphy explains. The fact that the strains are varied "outlines the challenge we face in trying to make a vaccine to prevent these recurrent infec- .. .. .. 10 laffal1 Pbysiciae Sp rin g 2 00 0 tions," he says. "So, the approach we've taken is to try and identify the proteins on the surface of the organism that are the same from strain to strain, or what we call 'antigenically conserved."' In his current study, Murphy has fully explored this approach and he and his team have successfully identified conserved loops on the P2 molecule. "In fact, we can now generate antibodies to these loops, and they kill multiple strains of the organism," he reports. The other protein Murphy is focusing on in tandem with P2 is P6. Since discovering this protein 15 years ago, Murphy has learned much about it, including the fact that Astrategy to present the it is antigenically conserved; in other words, it is identical in amino acid P& molecule for destruction, sequence from strain to strain. In with the goal being to produce addition, he has made several other discoveries that suggest that P6 would a"lethal mutation" in the make a good vaccine antigen. First, he targeted bacterium. determined that the protein is on the surface of the organism, so antibodies can easily bind to it. Second, studies he conducted on human serum-and confirmed by animal studies in other labs-indicate that antibodies to P6 will protect the host by killing the organism. Finally, he has demonstrated that P6 is critical to the viability of the organism; it can't live without it. This latter feature is noteworthy, according to Murphy, because bacteria, like all microbes, can shut off production of surface antigens if they are targeted for destruction, a trick scientists term "phase variation." "P6 is critical to the organism, so it can't shut it off," he says. "In fact we've actually attempted to make a mutant of NTHI that lacks P6 and have been unable to. The organism won't survive without it; it's a lethal mutation." The downside ofP6, however, is that it makes up only 5 percent of the surface of the protein, so in effect it is "hidden" by the organism. "What remains to be determined, therefore, is whether there's enough of a target there for the vaccine to work," Murphy explains. An answer to this question will begin to unfold in the years ahead, as UB has signed a licensing agreement with a pharma- �MURPHY IS ACTIVELY EXPLORING ANOTHER INTRIGUING POSSIBILITY: DEVELOPING A VACCINE THAT CONTAINS MULTIPLE ANTIGENS HOMING IN ON MULTIPLE TARGETS. ceu tical company, Wyeth-Led erie, in Rochester, New York, which is currently testing in humans a P6 vaccine based on Murphy's research. "What my lab has done is identify and characterize vaccine antigens and perform initial studies supporting the potential viability of the vaccine; it's up to the pharmaceutical companies to produce large amounts of the vaccine antigen for testing, which is now happening," says Murphy, who holds multiple patents on the P6 molecule pertaining to its gene and protein sequences and purification and diagnostic methods. C urrently, Murphy is dedicating his research efforts to continuing to learn as much as possible about the P6 molecule and the human response to it. "In particular, I want to know what parts of the molecule they [vaccinated individuals] are making antibodies to. Recently, we've done a lot of work on the antigenic structure of the P6 molecule, looking at how this protein is arranged in the outer membrane. Now we want to identify the specific parts of the molecule that are protective." Murphy is also actively exploring another intriguing possibility: developing a vaccine that contains multiple antigens homing in on multiple targets. Given the fact that P2 is so antigenically appealing, he posits, "Why not splice out its immunodominant loop-loop five, which is very heterogeneous from strain to strain, and people love to make antibodies to it-and put in there an important part ofP6? In other words, why not make P2 a vaccine-delivery system?" By developing a P2-P6 hybrid molecule, he says, "We'd be taking advantage of the immunodominant observation-that humans love to make antibodies to P2. But then we'd manipulate the molecule by putting in the P6 we want the host to make antibodies to. In essence, we'd be using the 'juicy' part ofP2 to rev up the immune system to kill p 6, which SanjaySethi,MD, collaborates will have a bactericidal effect. So we wouldn't be focusing exclusively on either P2 or P6. We'd be taking both routes." CD S p ring 2000 with Murphy on clinical studies. l11fal• Hysiciu 11 �S B MI W C H T U D E N T COLUMN Brazil Redox v HAEL I T E Mi chael White , MD ' 00 , Returns to Hi s Adopted Homeland ERY QUICKLY l REALIZED that my infectious disease rotation in Brazil was going to be a novel experience when, on my very first day at the Hospital Ferreira Machada, our group of 20 medical students was led by our professor into a room where a fouryear-old girl lay suffering on a cot. I .. .. c 12 l•ffal• nysicia• She was feverish and very jaundiced, and her abdomen was distended. As the doctor approached the child to perform an exam, she cried out with anticipatory pain. Very calmly and gently, the physician examined the wary child. It was obvious that every nerve ending was hypersensitive and that each touch sent bolts of pain through her tiny body. To give us further insight, the parents recounted the story of their child's illness. Approximately 10 days earlier, she had complained of abdominal discomfort and fatigue, which had progressed to nausea and vomiting. She then refused to eat, began to look yellowish and developed a fever. The physician took her parents aside to describe the gravity of the situation to them, explaining that their child's liver was not working well, which was why her skin tone was yellow and her abdomen was Spring 2 0 00 enlarged. Of even greater concern, he explained, was the fact that the minerals in her blood were not being maintained at appropriate levels. The child, he added, was also at a high risk of bleeding because her platelets were low. Unfortunately, the parents refused to have her placed in the ICU because their visitation time would be markedly reduced. During this exchange, we also learned that the family was very poor and unable to pay to have a sample of the girl's blood sent to Rio de Janeiro for etiologic determination of hepatitis. As a result, the students decided to pay for the test themselves. The next morning, we learned that the child had died. A week later the lab report arrived, confirming the infectious agent as hepatitis A. This shocking initiation into the Brazilian healthcare system was distressing, yet educational and very beneficial. Compared to the health-care system in the United States, the Brazilian system appears to be much simpler and more direct. As I soon discovered, however, it has an acute yet broad pathology of its own: Despite the fact that many of the country's health-care facilities possess all the amenities of American facilities, the Brazilian public is far too poor to access them. I also learned that in Brazil treatment regimens are frequently engendered without a definitive, formal diagnosis; for example, the child with hepatitis was treated with corticosteroids based solely on history and prior to etiologic delineation of her illness. Furthermore, I was very surprised to discover that clinical impression and physical diagnosis play the primary role in diagnosis and treatment in Brazil, whereas in the United States, a physician's interpretation is used as a startingpointand is characteristically implemented only after diverse and diagnostic laboratory tests are performed. This approach to diagnosis and treatment, although discussed frequently during medical school, had previously struck me as fraught with error and unreliable for practical application. However, my Brazilian experience taught me the merit of a methodical approach to the ill patient that �ALTHOUGH MY FOREIGN LANGUAGE STUDIES CONSISTED ONLY OF A SEMESTER OF EIGHTH-GRADE LATIN, l WAS A BOLD 18-YEAR-OLD WHO JUMPED AT THE CHANCE FOR SUCH AN ADVENTURE. UNDEltSTANI)ABtY, MY PAREN'f-5 WERE ANXIOUS ABOUT THEIR SON MOVING MORE THAN 5,000 MILES AWAY, BUT THEY WERE VERY SUPPORTIVE. includes a thorough and well-planned history and physical examination, as well as a fundamental understanding of disease processes and a faith in one's own medical judgment. In contrast, when working in a health-care system where frequent laboratory studies are the exception, fundamental understanding and application of basic medicine is the rule. In the following years, I often dreamed of returning to Brazil, and once I entered medical school, the idea of setting up a rotation there intrigued me. Not only would such an experience allow me to revisit that beautiful country, it would give me an opportunity to practice the new love of my life, medicine. Just Another Brazilian Medical Student A Homecoming of Sorts 1 hese experiences and powerful impressions were a stimulating introduction to the month-long infectious disease rotation I undertook late in the summer of 1999 as part of my fourth year of medical school. While the rotation was the source of many new and exciting insights, my visit to Brazil itself was not a novel experience; in fact, it was a homecoming of sorts, a sequel to a year-long visit I made to the country in 1990 while a senior at Portville Central School near Olean, New York. While in high school I had met a Brazilian exchange student, and we quickly became friends. As his visit drew to a close, he invited me to return to Brazil with him and live with his family. Although my foreignlanguage studies consisted only of a semester of eighthgrade Latin, I was a bold 18-year-old who jumped at the chance for such an adventure. Understandably, my parents were anxious about their son moving more than 5,000 miles away, but they were very supportive. My first few months in Brazil were among the most challenging of my life. I battled through various illnesses, a completely new diet, an inability to speak the language, and initiation into a very different culture. I attended a local public school, met more Brazilians, joined a basketball league and found a teacher who was willing to tutor me in Portuguese. Slowly, I learned. Through charades and common sense, I began to acquire a vocabulary and an understanding of the culture. My peers taught me how to speak basic Portuguese, including the slang terms, and my teacher taught me formal Portuguese, as well as how to read and write the language. By the time I returned to the United States in 1991, I was very proud of the fact that I could be mistaken for a Brazilian teenager due to my fluency in Portuguese. I n the fall of 1998, I began to contact friends in Brazil.to he.lp me arrange a rotatiOn 1n Campos, a city of 500,000 people located three hours north of Rio de Janeiro. Its economy is dependent upon sugarcane plantations and the factories that produce sugar granules, drinking alcohol and alcohol for use as fuel in cars. As residents of a plantation town, many Campistas are poor and uneducated; few study beyond high school. With the help of my Brazilian friends, I obtained contacts at a private hospital (Hospital Geral Doctor Beda) and a large public hospital (Hospital Ferreira Machada). Through these contacts, arrangements were made for my rotation. Prior to my departure, I spoke with Dr. Nelia Artiles Freitas, head of infectious diseases at Hospital Ferreira Machada. We outlined my responsibilities, agreeing that, throughout my stay, I would be treated as one of the Brazilian students from the local medical school (faculdade de medicina de Campos) studying infectious diseases. As a result, immediately upon my arrival in early August, I assumed the same hospital schedule as the other students; I also researched diseases, attended classes and took exams. Over the course of my rotation, I saw numerous infectious disease cases at various stages, including but not limited to lepromatous leprosy, leptospirosis, herpes encephalitis, tetanus with sorriso sardonicus, pulmonary varicella, ascaris, gonorrheal meningitis, disseminated TB, various fungal infections, HIV and I CONT I NUED ON P AGE While in Brazil, White was hosted by the Fusco family. Pictured above, is 11·year·old Gregory Arenari Fusco Soares, learning how to use a stethoscope by listening to his ownhean. 4 0 S pri ng 2000 luffale Pbpician 13 �14 �BY LOIS BAKER Alcohol' effect on the aging brain PHOTO BY K. KR TT Does drinking really kill brain cells? If not, what oes happen, and h w? Is the damage permanent? oes chronic alcohol abuse in late adulthood increase the deficits caused by aging? For 16 years Roberta J. Pentney, PhD, U professor of anatomy and cell biology, has pondered these basic questions concerning chronic alcohol abuse and brain function. Spri11g 2000 Blff311 Pbysiciu 15 �C ELL MORPHOMETRY-the quantitative study of the form and structure of cells-is Pentney's field, and her painstaking work with neurons in the cerebellum, the control center for movement, coordination and equilibrium, has yielded striking and unexpected answers to difficult questions. For example: Q: Does alcohol kill brain cells in adults? Not in the cerebellum. Q: What does happen? Alcohol damages dendrites, reducing message traffic between neurons. Q: Is the damage permanent? No, it's mostly reversible; however, neuronal structure is changed in the process. Q: Does alcohol abuse make people age faster? No. Age and alcohol appear to act on neurons in different ways. Why is this information important? "It shows that we are moving toward finding out how alcoholism damages the brain , information that eventually could lead to treatments or prevention of the destructive effects of alcohol on brain function in humans," Pentney says. "For a long time, people were looking at cell loss as the real measure of alcohol's effects," she says. "What we've seen through this research is that you don't have to lose entire neurons to disrupt brain function. All you need is damage, and we have developed a model for that kind of change with alcohol. "Damage to the brain caused by alcohol, we now think, is probably similar to the way alcohol affects the liver: There is dam age and repair. Alcohol acts on a 16 1111111 Pbpiciu Sp r ing 2000 number of molecules that interact with each other. Just getting to the point where we can look at a specific part of a cell that is involved is a big step forward. " Identifying that particular part of the neuron affected by alcohol-a structure called the smooth endoplasmic reticulum, or SER-has been accomplished with the aid of $1.4 million in grants from the National Institute on Alcohol Abuse and Alcoholism , including a current grant for $645,000. Pentney's research and that of her coinvestigator, Cynthia A. Dlugos, PhD, UB research scientist in anatomy and cell biology, concentrates on a condition called lateonset alcoholism. "Everybody else has been interested in dealing with alcoholism in the early also bears a striking resemblance stages of life," PenThe Purkinje neuron with full to a tree, and in scientific partney says. ''I'm looklance its branches are called, acing at a span during dendritic arbor; a magnification cordingly, the dendritic arbor. maturity that applies of (A) terminal segments and Pentney and colleagues are to human alcoholism, and at the com(B) loss of a terminal segment. on intimate terms with these arbors . They have examined bined conditions of thousands of light-microscope images aging and alcoholism." The object of her attention is a specific and electron micrographs-photos type of brain cell in the cerebellum called a taken with an electron microscopePurkinje neuron. Pentney considers this looking for changes in shape and signs neuron one of the most spectacular in the of thinning, and counting dendritic brain. Under the microscope it resembles a branches and segments and measuring vast riverine system with branching den- their length s. They have al so determined drites forming the tributaries. The neuron the total number of synapses, the sites �on the ends of branches that receive nerve impulses. Conducting this kind of research with humans is clearly out of the question. Pentney has been working with Fisher 344 rats, whose 22- to 27-month life span has been fully studied and documented. To mimic the neuronal responses of a middleaged human, she begins her interventions with rats that are 11 to 12 months old. In all investigations, Pentney and colleagues used long-term study periods, usually 40 to 48 weeks, to mimic human chronic alcohol intake. One group of middle-aged rats received a liquid diet containing ethanol. A control group of the same age received the same liquid diet with the same number of calories but without the alcohol, and a second age-matched control group received a standard rat-chow-andwater diet. The researchers examined and compared the structure of Purkinje neuron dendritic arbors from aU groups. Over the years a picture emerged of the of synapses. "This was a hopeful note," Pentney says. "Every change we saw was a reversible phenomenon. The brain was repairing itself after alcohol damage." That was good news, but it came with a cautionary note: While the number of terminal segments and synapses had returned to normal, the researchers knew from experience that their placement on the dendritic arbor most likely would be different than before treatment. Pentney's results supported the hypothesis that Purkinje neurons were changed after recovery. "The implications here are clear," she says. "The branching pattern in Purkinje neurons after recovery is not identical to that before recovery; you don't end up with the same arrangement. There is a fair amount of recovery, but the neurons may not function in the same way. A different branching pattern would result in a change in message transmission, which would change the way that part of the brain works. channels, they discovered that the channels were dilated in alcohol-fed rats. This change in neurons, Pentney says, is usually associated with the entry of excess calcium into the cell. o dilation was found in the control animals. "Calcium turns things on in cells," Pentney says. "Too much calcium stimulates too much activity and can kill cells. The SER sequesters calcium within the cell until it is needed. We're thinking that in the case of the Purkinje neuron, localized dilation of the SER is causing the loss of dendritic terminal segments but is not killing the whole cell." Knowing that alcohol-fed rats recouped their synapses after recovery, the researchers expected to see the SER function return to normal also, but it did not. At some point during alcohol recovery, aging began to have its own effect, independently producing dilation of the SER membrane. Finding out when in the life cycle this phenomenon occurs is important, Pentney says, because "THE BRANCHING PATTERN IN PURKINJE NEURONS AFTER RECOVERY IS NOT IDE TICAL TO THAT BEFORE RECOVERY; YOU DON'T END UP WITH THE SAME ARRANGEMENT." effects of alcohol on these neurons. The researchers observed a significant thinning of arbors in alcohol-fed rats, compared to controls. Next, they showed that this thinning resulted from the loss of terminal segments-those at the periphery of the arbors- at the point where they branch from the parent shaft. Because synapses are located on terminal segments, losing some of these segments would result in fewer synapses and, therefore, a reduction in message traffic between neurons in this part of the brain. According to Pentney, these findings may relate to some of the abnormal movements often seen in alcoholics, such as unsteady gait, tremors and Jack of coordination. Turning to examining the damage to Purkinje neurons after recovery from alcohol treatment, the researchers were in for a surprise: Expecting to see thin arbors and a Joss of synapses, they found instead lush dendritic arbors and the normal number "We now had a model that might apply to what is happening in recovering alcoholics," she says. "Most of their motor functioning returns to normal, but some does not." Having determined that parts ofPurkinje neurons disappeared in alcohol-fed rats, the questions now to be answered were, Why and how are these segments being eliminated? Pentney and colleagues considered the possibility that the segments had atrophied from lack of stimulation from interconnecting nerve cells in the cerebellum, which may have been killed by alcohol. That turned out not to be the case. They found instead a completely different mechanism at work. They were able to show that the cellular structure responsible for regulating the flow of calcium within the neuron- the smooth endoplasmic reticulum- was being disrupted in the alcohol-fed rats. Measuring the diameter of these calcium it will help define how alcohol and aging impair brain function-information that is relevant to recovering human alcoholics. "This information tells us that alcohol and aging may act on the brain independently," she says. "It also indicates that these two conditions are disrupting control of calcium in different ways, only one of which leads to deletion of dendritic segments and, by extension, to impairments of normal brain function." Next, the researchers hope to determine exactly what part of the SER membrane is being disrupted. "We are moving toward a mechanism of alcohol's effect on the aging brain," Pentney says. "This research allows us to look at particular components of neurons and understand how their function is related to structure. Maybe if something is missing, we can supply it. Maybe all we need is a single change to prevent these alcohol-induced impairments." <D Spri n g 20 00 lu ffaf• Hysic i aa 17 �MEDICAL B B E SCHOOL N E w s y T s y SAWYER Support for economically and academically disadvantaged students HE AMS PosT-BACCALAUREATE P ROGRAM takes potential medical students who have been impeded by special circumstances in their application to medical school and helps them prepare to try again. Cosponsored by the Associated Medical Schools (AMS) of New York and the University at Buffalo, the program was started in 1991 to promote minority enrollment in the state's medical schools. Currently, it enrolls 14-20 economically disadvantaged or minority students each year. "The Post-Baccalaureate Program is a well-coordinated, structured program of courses, counseling, tutorials and support that provides students with the opportunity to gain requisite skills for entry into medical school," says Carolyn Hamilton, EdD, assistant dean for minority affairs at the University at Buffalo School of Medicine and Biomedical Sciences. "It was designed for applicants who have been denied admission to medical school, to assist them in improving their performance in academic areas where they have shown weakness." Qualities of Character Enrollment in the program is by invitation, with admissions directors at eight participating AMS institutions referring students based on their positive showing during preadmission interviews. Once students gain entrance into the program and successfully complete all of its requirements, they are guaranteed acceptance into the medical school that recommended them . "These applicants represent a diverse cross section of the state's minority population," Hamilton says. "The chief thing they have in common is that they're talented, but they may be lacking in one area or another. The admitting school refers them to the Post-Baccalaureate Program because they show great potential, and because the school recognizes that if they had had that certain 'missing piece,' they would have been accepted." The program allows students to demonstrate abilities that may not be highlighted during a typical medical school admissions interview, says Adrian Jones, PostBaccalaureate Program coordinator at UB. 18 1 1 11111 Pb ysicin Spring 2000 Jones believes that because there are so many highquality applicants vying for a limited number of medical school slots, the interview process is geared to exclude rather than recruit students. This approach, he says, tends to work against economically disadvantaged candidates, who may be highly competent but may not have had exposure to the types of experiences and opportunities available to more affluent applicants. "Every person in th is program has had to deal with difficult circumstances and challenges,'' Jones says. "The fact that they've been able to function and to perform so well academically demonstrates qualities of character that can't always be measured in a one-hour interview." c c .c " �AChance to Thrive ow in his second year at UB's medical school, George Figueroa typifies the sort of person for whom the PostBaccalaureate Program was designed. As the youngest member of a large, close-knit family, Figueroa has carried the primary responsibility of financing his own education. With the aid of vari ous grants and loans, and sometimes two jobs at a time, Figueroa man aged to put him self through school at Rochester Institute of Technology. As undergraduates, he and his wife, Carol, planned a future that would include a family medical practice for him and a network analyst's career for her. Figueroa concentrated on maintaining a record of solid academic achievement while keeping his family afloat financially. Every spare moment was consumed by school, work and the prerequisite hours of community service so necessary to distinguish applicants in the eyes of medical school admissions officials. For the Figueroas, the Second·year student George Figueroa dream was well worth the sacrifice. works with Carolyn Figueroa's first application to mediHamilton, EdD, to cal school was declined because his provide other Medical College Admission Test students with the (MCAT) scores were not competitive. support he knows will Determined to succeed, he enrolled in make adifference. an MCAT preparation course and repeated the test. Although he was able to improve his score, the application period had passed by the time he completed the course, forcing him to wait another year. Figueroa's second attempt was only slightly more successful, garnering interviews by interested admis- sions officials but still no acceptance letters. "They say that every time you apply to medical school and get turned down , your odds of acceptance diminish," he says. "At the time, I was doing customer support for a cellular company and I was miserable. When my second try didn 't pan out, l was very discouraged." Growing increasingly anxious, Figueroa began researching other options, including a year-long graduate program in medical science at Hahnemann University in Philadelphia. While enrollment in the program offered a chance at medical school admission, there were no guarantees. Moreover, financial constraints on the famil y meant that Figueroa would have to leave his wife and two young sons behind in Rochester while he moved to Philadelphia for the year. Despite the drawbacks, he decided to go for it. "Being away from the famil y was the most difficult part," Figueroa says. "Philadelphia was a 14-hour bus trip from Rochester, and I couldn 't go home very often-only about once every four to six weeks. Our youngest wasn't even a year old when I started the program, and every time I'd come home he'd be bigger, taller and heavier. " Though grueling, the experience deepened Figueroa's resolve to achieve his goal. After completing the program in Philadelphia, he was ready to try again. This time he was placed on several medical schools' waiting lists, and most important, although his application was declined by UB, the university invited him to enroll in the Post-Baccalaureate Program. " It was an opportunity I couldn't refuse," Figueroa says. Although the program would require him to spend another year in preparation, he was assured of admission to the UB School ofMedicine and Biomedical Sciences if he successfully completed all program requirements. "The [Post-Baccalaureate] Program helped me immensely," he says, in retrospect. "I can see that if I'd gotten into medical school without the coursework, I'd have been like a guppy in a sea of sharks. All the pre-work gave me a much stronger foundation and has made the current work much easier. For one thing, I don 't have to spend so much time focusing on the minutia, so I can concentrate on some of the more difficult concepts. " In addition to keeping up with his hefty class schedule, family life and part-time job, Figueroa is committed to helping others navigate the path to medical school. CONTINUED ON PAGE ...... ......... "EEIIJ..- --.......... 1'111 ....... .......... ...... mlrllniJ . -.......... ..... 22 Spring 2000 l 1f f al1 Pb ysici a 1 19 �M B E L L E D C A L SCHOOL E w s y E New Institute for lasers, Photonics and Biophotonics N GoLDBAUM he University at Buffalo has established a new multidisciplinary institute to conduct research designed to harness the power oflight in a broad spectrum of applications and potential products, ranging from cancer therapy to telecommunications. The idea behind the formation of the Institute for Lasers, Photonics and Biophotonics is to foster economic growth in Western New York by tapping into UB's strengths in lasers, biotechnology and photonics (the use of photons, instead of electrons, as a medium for processing information). "The medical school is very excited about the institute," says Bruce A. Holm, PhD, the school's senior associate dean, and professor of pharmacology and toxicology and gynecology-obstetrics. "Our interest is twofold, related to the development of new therapeutic modalities for the treatment of conditions ranging from cancer to skin disease, and to the opportunity to use the institute as a mechanism for establishing a true biomedical engineering program that will expand our current activities in other areas." "Nanoclinics" aBillionth of aMeter in Size The Institute for Lasers, Photonics and Biophotonics- which will be headed by Paras Prasad, PhD, SUNY Distinguished Professor in the departments of chemistry and physics and Samuel P. Capen Chair in the Department of Chemistry- has its roots in UB's Photonics Research Laboratory (PRL), established in 1990 and considered one of the most advanced and comprehensive facilities for photonics research in the United States. One of the most promising technologies 20 N l affall nysicial Sprin g 2 000 developed by institute researchers is the nanoclinic, described by Prasad as "the world's smallest clinic." This tiny nanobubble-about a billionth of a meter in size- is designed to perform any one of a number of varied diagnostic or therapeutic tasks by carrying a chemical treatment or diagnostic tool to a specific site in the body. In cell-culture experiments, the group has already developed one formulation of the nanoclinic that selectively destroys cancer cells without the use of chemotherapy. "The entire purpose of this is to take the therapy inside the cancer cell," says E. J. Bergey, PhD, research associate professor of chemistry at UB. "The advantage of the nanoclinic concept is that we can target specific cancers and effect the therapy from within the cancerous tissue or cell, minimizing collateral damage to the healthy cells. The size of the nanoclinic is critical to allowing for efficient distribution throughout the body." The nanoclinics have the potential to be remarkably versatile in carrying optical probes, drugs, genes, inorganic compounds, controlledrelease substances and other diagnostic and therapeutic agents. In addition, hormones, antibodies or other appropriate chemical agents can be attached to the surface to selectively target specific types of cells, according to Bergey. "The nanoclinics can be of SUNY Distinguished Professor Paras Prasad, PhD, heads new institute. 'I tremendous benefit in the noninvasive treatment of early-stage cancer and infectious disease, as well as in gene therapy and oxygenation of damaged tissues," he says. To date, the institute has developed a working prototype and samples of the nanobubble material, both of which are available for testing. The Big Picture In the years ahead, the Institute for Lasers, Photonics and Biophotonics will build on its existing network of partnerships with both industry and research. Within the university, it already has ongoing relationships with other photonics research programs in the School of Dental Medicine, the School of Engineering and Applied Sciences, and the Department of Physics. In addition to I~ NTINUEO ON PAGE 22 • .." < ... �Support for Two New Centers an~ \ $3 . 8 million gr ant from Howard Hughes Medical Institute f B v L o I S four-year, $3.8 million award Medicine and Biomedical from the Howard Hughes Sciences. "It reflects well B A K E R Medical Institute has been not only on the quality of granted to University at Buffalo ' s Bruce Holm's proposal, but also on School of Medicine and Biomedical the university and its reputation. Sciences to speed development of two "In making the award to VB, new research centers. the Howard Hughes Medical InstiThe award will fund research sup- tute reviewers cited a number of port for five new faculty members and strengths," Wright notes. capital equipment for a new Center for "In addition to the quality of the Single-Molecule Biophysics, as well as proposal itself, UB's commitment to facilities for that center and a new Center the two centers was specifically noted, as was the school's recent growth in for Genomics and Proteomics. extramural grant support. The institute In recent years, UB has invested nearly $9 million in building renovations and citing VB as 'an institution rapidly on the equipment purchases that are vital to the two new centers, in addition to providing more than $2 million annually in salary to faculty members associated with the programs. The review of UB's grant request to the institute noted that "the institution has undergone recent growth, and extramural (external ) grant support has increased significantly-evidence that this is an institution rapidly on the rise. " Forty-one medical schools were selected for funding through the institute's Biomedical Research Support Program for Medical Schools from 105 that submitted proposals. UB's award is the second largest in the program. Only UCLA School of Medicine, the University of Michigan Medical School and Yale University School of Medicine-which each received $4 million-were granted more funding. Bruce Holm, PhD, senior associate dean in the medical school and author of the grant proposal, will serve as the project director. "This is no ordinary grant award," says John Wright, MD, dean of the School of rise' are encouraging words, indeed. We congratulate Dr. Holm and the faculty for this outstanding achievement." The Center for Genomics and Proteomics will be a joint effort with senior investigators located at Roswell Park Cancer Institute and at the Hauptman-Woodward Medical Research Institute. This state-of-the-art center will enhance existing expertise in the areas of human , mouse and microbial genomics. Capabilities will include microarray and mass spectroscopic analyses of genes and proteins that will enhance understanding of cancer biology, microbial pathogenesis and human-disease genes. The Center for Single-Molecule Biophysics will emphasize work on computational chemistry, structural biology and molecular biology. Five new faculty members will be hired to further develop this area. The goal, Holm says, is to study proteins and other macromolecules in space and time. Results from such research will provide insights into protein structure-function relationships that can solve clinical problems. ... • L Bruce Holm PhD, senior associate dean in the School of Medicine and Biomedical Sciences, will serve as the project director. Current work in this area is being applied to cardiac function, synaptic transmission, electrolyte secretion and tumor suppression. Anthony Auerbach, PhD, and Frederick Sachs, PhD, both proTHE REVIEW OF UB's fessors of physiology and biophysics, will GRA T REQUEST TO THE codirect this center. INSTITUTE NOTED THAT The work will be "THE INSTITUTION HAS overseen by an adviUNDERGONE RECENT sory board composed GROWTH, AND EXTRAof Holm; Wright; MURAL (EXTERNAL) John Hay, PhD, associate provost for reGRANT SUPPORT HAS search and chair of INCREASED SIGNIFIthe Department of CANTLY-EVIDENCE Microbiology; Harold Strauss, MD , chair of THAT THIS IS AN the Department of INSTITUTION RAPIDLY Physiology and BioON THE RISE." physics; David Hohn, MD, director of the Roswell Park Cancer Institute; as well as the codirectors of the two centers. S prin g 20 0 0 lufl a l 1 H ysi c iu 21 �M E C D A ~uvenile L N SCHOOL Arthritis Study reported on a study being led by Nadine Fisher, EdD, which, to date, has shown that children with juvenile arthritis who take part in an individualized program of resistance exercise experience significant improvement in their ability to function. The article inadvertently omitted Fisher's coinvestigators: Kathleen M. O'Neil, MD, a University at Buffalo associate professor of clinical pediatrics affiliated with Kaleida Health System's Children's Hospital of Buffalo; and Vylma Velazquez, MD, pediatric fellow. Fisher, who designed the exercise program, is an assistant professor of occupational therapy and rehabilitation at UB. 4D OF SU CC E SS, CO NT INUED FROM w s students' previous training and prepare them for the rigors of medical school." Students begin the program with a six-week summer THE W I NTER 2000 ISSUE of Buffalo Physician DE C REE E PA C E 19 Somehow, he finds time to tutor anatomy students enrolled in the Post- Baccalaureate Program and to function as treasurer of the Student National Medical Association. With other members of the association, he is involved in an effort to introduce a peer-mentoring program into UB's medical school. This informal program would link local undergraduates with medical students, who would answer questions and offer insight into various aspects of medical school admission and campus life. enrichment program in math and science. Continuing through the academic year, each student is placed in a 14-credit course of study tailored to meet his or her specific needs. The curriculum also includes daily tutorial sessions and a summer program of prematriculation studies offered on the campuses of each referring school. Participating institutions include Albany Medical College, Albert Einstein College of Medicine, New York Medical College, SUNY at Buffalo School of Medicine and Biomedical Sciences, SUNY Health Science Center at Brooklyn, SUNY Health Science Center at Syracuse, SUNY Health Sciences Center at Stony Brook and the University of Rochester. In most cases, tuition and fees are waived for students accepted into the program. Additionally, students are provided with monthly stipends for room and board and books. "The Post-Baccalaureate Program is proving to be very effective in helping underrepresented students get into medical school," Hamilton says. "Of the 127 to participate during the first eight years of the program, 115 subsequently gained admission. "The program provides the mechanism, but it's really up to the students to benefit from this opportunity. To succeed, they have to be motivated and focused." 4D The AMS Post-Baccalaureate Program is supported by the Josiah Macy ]r. Foundation and the New York State DepartmentofHealth. For additional information, contact Carolyn Hamilton, EdD, director, or Adrian ]ones, coordinator, at (716) 829-2802. Filling in the Gaps The Post-Baccalaureate Program at UB offers a comprehensive curriculum ofbiology, physics, chemistry, mathematics and English, as well as a variety of electives and instruction in organizational and study skills. "Individual coursework varies, depending on the student," says Hamilton. "All of these students are highly qualified, but each needs strengthening in certain areas. One student may need extra attention in chemistry, while another may need to improve performance on the MCAT. Still another may sign up for an elective course on the Greek and Latin roots of scientific terminology. The goal is to fill in gaps in the 22 laffale Plysicin Spring 2000 NEw INSTITUTE , C ONTINUED FROM PACE 2 0 giving its partners access to a broad range of scientific instruments and technologies and world-class testing and research facilities, the institute will offer technical expertise, joint efforts to develop new products, short courses on innovative technologies, and training and recruitment opportunities. For the university, the institute will offer an interdisciplinary graduate program of study, postdoctoral training, visiting-faculty programs, summer programs, and international collaborations and exchange programs. 4J:) �1111111 nraJclu 11 �MEDI C AL S C HOOL N S. Mouchly Small Education Center AN EDUCATION CENTER in honor of S. Mouchly Small, MD, has been opened in the Department of Psychiatry at Erie County Medical Center. Small, who died in 1996, was an internationall y known ps ychiatrist and educator who chaired the Universityat Buffalo's Department of Psychiatry from 1951 to 1978. Under his leadership, the department grew from a handful of faculty members into a major national training and research center of more than 150 profes- sionals. In the early 1950s, Small founded the Muscular Dystrophy Association and served as its national president from 1980 to 1989 and as chair of its executive com mittee until hi s death. In the mid1950s, he wa s in strumental in organizing the Erie County Mental Health Board and was its first director. In this capacity, he helped obtain funding for Buffal o General Hospital's Community Mental Health Center and played an integral role in estab- Musicians, artists, dancers, actors, athletes, scholars ... we all love Nichols. E w s lishing the State Alcoholism Research Center in Buffalo. Small published extensively and was author of A Handbook of Psychiatry, a 1943 book that was widely viewed as an authoritative guide to ps ychiatric theory and practice. In recognition of his outstanding contributions to his field , Small received the E. B. Bowis Gold Medal from the American College of Psychiatrists, the Distinguished Service Citation from the American Psychiatric Association and UB's Stockton Kimball Award. In May 1997, UB 's Medical Alumni Association posthumously presented Small with the Walter P. Cooke Award. The award, given to nonalumn i, recognizes notable and meritorious contributions to the university that influence its growth and improvement. The 3, 000- squa re-foot S. Mouchly Small Education Center includes a conference room and library, administrative offices for the residency-training program and teaching space for clinical services. Included in the center is an area for journals and textbooks, as well as online computer services. The center, which was established through benefactors and donors, was formall y dedicated on October 29, 1999. Speaking at th e ceremon y were Su san McLeer, chair of the Department of Psychiatry, and John Wright, dean of the School of Medicine and Biomedical Sciences. In attendance to cut the ribbon during the ceremony was Small's widow, Mrs. Sophie Small. <:t) Rosenfeld Receives Distinguished Service Award • State of the art visual and performing arts center George Rosenfeld, MD, clinical associate professor of pediatrics at the • Exceptional college placement record University at Buffalo School of Medicine and Biomedical Sciences, has • Challenging curriculum with 17 advanced placement courses at Kaleida Health System's • Comprehensive community ~~~~_.~"'· service program • More than 60 sports teams been presented with a Distinguished Service Award from the medical staff Children's Hospital of Buffalo. Rosenfeld, a member of the staff at Children's for 48 years, has been a stalwart in • Average class size of 15 the hospital's teaching pro- • Financial aid available gram and has served as chair Only one investment lasts a lifetime Coeducational grades 5-12 875-8212 1250 Amherst Street Buffalo, NY 14216 www.nicholsnet.net of its Lab Committee for the past 25 years. In addition, he and his wife established the George and Harriet Rosenfeld ' leh to right: Theodore I. Putnam, MD, George Rosenfeld, MD, Mrs. Harriet Rosenfeld, and Bernard Eisenberg, MD. Award and Grant, which honors the outstanding laboratory accomplishments of an individual on staff at Children's and offers a grant on a competitive basis to physicians interested in research. "George is a fine example of what we would want our resident physi- Acceptance granted to qualified students without regard to race, color, religion or national origin. 24 l1ffal1 Hysicia1 Spring 2000 cians to emulate," says Theodore I. Putnam, MD, chief of the Division of General Pediatrics. "This award is presented to him for his long and faithful service to Children's Hospital." 4D �New Online Catalog for Libraries ONCILL provides integrated access to medical resources medical practitioners at the forefront ofthe digital revolution is the mission of the Library Consortium of Health Institutions in Buffalo (LCHIB). In 1993, electronic access to medical information in our community was forever redefined when the consortium unveiled HUBNET (Hospitals and University at Buffalo Network). Today, an expanded HUB ET delivers such resources as MEDLINE, QMR, selected full-text journals, reference texts, drug information and consumer resources directly to homes, offices and clinical and hospital sites. The newest component of HUBNET is a Today, anyone with a shared electronic online library catalog that web browser and replaces the outdated card catalogs. The sysconnection to the tem-named 0 CALL for the Online Catalog Internet can search of LCHIB Libraries-was first implemented at EEPING WESTERN NEW YORK the library catalogs of any of the LCHIB participating hospital libraries, 24 hours aday, by visiting the ONCILL web site. Kaleida Health System libraries with support provided by a $200,000 grant from the National Library of Medicine (NLM). In 1998, LCHIB received a second grant from the NLM for $298,000 to include the card catalogs of the libraries at Roswell Park Cancer Institute, Erie County Medical Center, Kaleida Health System's Children's Hospital of Buffalo and the Catholic Health System's Sisters of Charity Hospital, Mercy Hospital and Kenmore Mercy Hospital. Today, anyone with a web browser and connection to the Internet can search the library catalogs of any of the LCHIB participating hospital libraries, 24 hours a day, by visiting the ONCALL website at http://oncall.buffalo.edu. The Library Consortium of Health Institutions in Buffalo is comprised of most of the medical libraries in Buffalo, as well as the UB Health Sciences Library. To learn more about the consortium's HUB ET and ONCALL services, contact Martin E. Mutka, director of the LCHIB at (716) 829-3900, ext. 143, or e-mail him at mmutka@acsu.buffalo.edu. -PAT PRIOR �PATHWAYS EDITOR's NOTE: The following are brief introductions to faculty who have recently joined the University at Buffalo School of Medicine and Biomedical Sciences. Additional profiles will be published in future issues ofBuffalo Physician. Chair, Department of Biochemzstry Professor, Department of Social and Prn·entive Medicine .loseph De.lames, MD Donahue joined UB's faculty as a biochemistry in 1974. While Clinical Assistant Professor, Department of Family Medzmze Social and Preventive Medicine in in Florida, he was also on the Dejames joined the University at july 1997. He earned a bachelor of staff of the C.V. Whitney Marine Buffalo's Department of Family science degree in biology from as assistant professor of KennethM. Blumenthal, PhD Richard Donahue, PhD, MPH professor in the Department of Medicine in August 1999. In Providence College, Providence, professor of molecular genetics, Blumenthal became assistant addition to practicing at Niagara RI, in 1976 and a master's in public biochemistry and microbiology professor of biological chemistry Family Health Center, he is work- health from the University of at the University at Cincinnati, Michigan in Ann Arbor, MI, in Kenneth M. Blumenthal, PhD, Research laboratory. at the University of Cincinnati ing with UB's Family Medicine has been named chair College of Medicine in Residency Program, teaching 1981. In 1983, he completed a doc- of the UB Department 1976 and was promot- residents, conducting research torate in epidemiology at the Uni- of Biochemistry, effec- ed to full professor in and serving as associate coordina- versity of Pittsburgh, Pittsburgh, tive August 1, 2000. 1986. While there he tor for the Clinical Practice of PA. Prior to joining the faculty at A specialist in the was honored for out- Medicine course for first-year UB, Donahue was a professor of study of protein struc- standing teaching for medical students. De)ames triple epidemiology and public health tures, Blumenthal is three consecutive years. majored in biology, philosophy at the University of Miami School currently At the time of his de- and African-American Studies at of Medicine in Miami, FL. His parture, he was chair ofthe medical school's Boston College, where he gradu- research interests include the epi- ated in 1990. In 1992, he earned a demiology of insulin resistance, National Institutes of Health Committee on Basic Research and master of arts degree in American/ coronary heart disease and diabe- (NIH) grant to investigate the associate director of the Ohio Puerto Rican Studies at UB. He tes; primary prevention of diabetes interaction of peptide blockers Center for Computer-Aided completed his medical degree at in youth; and coronary heart dis- with gastric chloride channels. Molecular Design, which is UB in 1996 and in 1999 served his ease in people with Type 1 diabetes. Blumenthal earned a bach- housed at the university. He family medicine residency at the elor of science degree in chem- also served three terms on the university, where he was chief istry from the University of university-wide research council. resident in 1998-1999. His clin- Wisconsin in 1967 and a PhD Blumenthal is a member of ical/academic interests include in biochemistry from the Uni- NIH site-visit teams and a past underserved populations, the principal investigator on a K. four-year $596,000 BLUMENTHAL Sarah C. Finnegan, MD, PhD Assistant Researc/z Professor, Department of Neurology Department of Pharmacology and Toxicology versity of Chicago in 1971. He member of three NIH study sec- impact of lower socioeconomic completed a three-year NIH tions. He serves on the editorial status on health, and teaching postdoctoral fellowship in bio- board of the Journal of Biological clinical skills to medical students. logical chemistry at the Univer- Chemistry and has authored July 1999 as an assistant research professor and Buswell Fellowship Finnegan joined UB's faculty in sity of California at los Angles or coauthored 50 papers in School of Medicine before join- refereed journals and five recipient in the Department of ing the faculty of the University book chapters. CD Neurology. She also holds a sec- of Florida College of Medicine L o r s BA K E R ondary appointment in the Department of Pharmacology and JoHN YEH, MD, WILL JOIN UB AS CHAIR OF OBSTETRICS AND GYNECOLOGY oN MAY 1, AND KENNETH BLUMENTHAL, PHD, WILL BEGIN AS CHAIR OF BIOCHEMISTRY ON AUGUST 1. 2 .. 26 1111111 Hysiciu Spring 20 00 �Toxicology, where she works with Psychiatry, Faculty of Medicine Dennis Higgins, PhD . Finnegan since 1971 , joined the Department earned a bachelor of science de- of Family Medicine in Ma y 1999. gree in chemistry at His clinical affiliation is with Erie SU Y at Binghamton County Medical Center' s Divi- in 1984, after which sion of Chemical Dependency. she earned MD/PhD Giordano completed his under- (physiology) degrees graduate premed studies at UB in at UB in 1994. She 1954, after which he earned his Chair, Department of Radiatwn Medicine Roswell Park Cancer lnstit11te interned in internal medical degree from the Univer- Prior to joining the University at human cervical cells by ionizing medicin e at Millard sity of Padua, in Padova, Italy, in Buffalo and Roswell Park Cancer radiation; in vitro screening Fillmore Ho s pital 1960. He completed his residency Institute in August of potential chemo- from 1994-1995 and in psychiatry at Buffalo State Hos- 1999, Kuettel served as preventive completed residency training in pital in 1964. From 1976 to 1991 , associate professor of using human prostate neurology at UB, serving as chief he served as chief of psychiatry at radiation medicine and epithelial cells; and resident in 1998. She then com- Mercy Hospital in Buffalo, and anatomy and cell biol- investigations of a new pleted pediatric residency train- from 1993 until May 1999, as ogy in the Department tumor suppressor gene ing, also at UB, in 1999. Finnegan, medical director of Addiction of Radiation Oncology in prostate cancer. who practices at Kaleida Health 's Medicine at Sisters Hospital, also at Georgetown Univer- Children 's Hospital of Buffalo, is in Buffalo. S . FI NN EGAN Michael R. Kuettel, MD, MBA, PhD of the National Board of Medical Examiners and the Professor and Chair, Department of Radwtion Oncology University at Buffalo American Board of Radiology (radiation oncology). Kuettel's research interests include the molecular mechanisms of neoplastic transformation of human prostate and At Roswell Park Can- interested in caring for children sity in Washington, D.C. M . K u Kuettel received his with neurological disorders, in- medical degree from Northwest· cluding those with developmental disabilities related to perinatal brain injury. Her research inter- Kenneth Hoffman, PhD Associate Professor, Department of Neurosurgery Toshiba Stroke Research Center ests involve elucidation of factors promoting the survival and regeneration of adult human neurons that may hold implications for degenerative disease processes. Hoffman, who joined UB 's faculty in September 1999, earned his bachelor of arts degree in physics, summa cum agents ET T E L cer Institute, Kuettel heads the Department of Radiation Medicine, a referral ern University Medical School in and resource center to health· Chicago, ll, and completed his care facilities across the country residency training in radiation and Canada that offers cancer oncology at The Johns Hopkins patients comprehensive care and Hospital, Baltimore, MD. He then innovative treatments such as the earned a PhD in anatomy and cell gamma knife, photodynamic biology from the Medical College therapy and brachytherapy. <L;) of Wisconsin. He is a Diplomate DEBORAH PETTIBO~E laude, from St. Louis Univer- P•ul B. Qlord•no, MD sity, St. Louis, Assistant Professor, Clinical Family Medicwe Department of Family Medzc111e MO, in 1976, Waltham, MA, in 1984. Prior to tomographic images, or temporal and a PhD in coming to UB, he was an associate 3D data sets, with a focus on vascu - physics from professor in the Department of lar or luminal structures. Specifi- Giordano, a clinical assistant pro- Brandeis Radiology at the University of cally, he is interested in determina- fessor in UB ' s Depa rtment of University in K. H o FFMA N Chicago. Hi s research interests tion of 3D vascular structures include developing ways to ana- from two or more views, quanti - lyze and present radiographic im- tative analysis of these structures age data, either projection images, and alignment of them with their projections. He is al so interested in the segmentation and quantitation of bone, vascular structures and the colon from CT data sets. Currently, he is funded by Spring 2000 lu ffalo Pbysici11 21 �PATHWAY .JohnYeh,MD 1983. Following a residency at research and strategic planning. study the role of growth factors Chair, Department of Obstetrics and Gynecology Beth Israel Hospital in Boston, He also served as executive in human fetal ova development he completed a fellowship in director John Yeh, MD, professor and fertility and reproductive endo- Women's Health Pro- vice-chair of the Department of crinology at Boston's Brigham gram at Regions Hos- Yeh is coauthor of a Obstetrics and Gynecology at the and Women's Hospital. pital in Minneapolis 1991 book, Legal Aspects the and has grants pending for cervical cancer research. University of Minnesota, has In 1987, Yehjoinedthefaculty and was director of of lnferlility, and is writing been named chair of the UB of Harvard Medical School, where the residency pro- a book on growth factors in reproductive medicine. He Department of Gynecology and he spent years conducting re- gram in obstetrics Obstetrics, effective May 1, 2000. search in the field of reproductive and gynecology. Yeh earned an AB degree endocrinology, teaching and from Harvard University in 1979 treating patients. In 1997, he has been funded by and a medical degree from the took the position at the University the National Institutes of Health University of California at San of Minnesota, where he was since 1989. Currently, he is prin- Diego School of Medicine in responsible for the department's cipal investigator on a grant to also has published many Yeh's research J · Y research abstracts, book EH chapters and scientific studies in professional journals. Lo s BAKER ests include the regulation of neu- his PharmD Stanley H. Kim, MD to study methods to improve rotransmitter release and produc- degree at the radiologic colon polyp detection. tion in the nervous system; regula- University of Clinical Asszstant Professor, Department of Neurosurgery tion of cytokine production and Arizona Col- Kim, who practices at Kaleida the National Institutes of Health release from cells of the nervous lege of Phar- Health System's Millard Fil- Tracey Ignatowski, PhD and and macy in Tuc- lmore Gates Hospital, joined interactions among proinflam- son, AZ, in UB's faculty as an assistant Research Assistant Professor, Department of Pathology matory cytokines, adrenergic re- Ignatowski joined UB's Department of Pathology as a research assistant professor in May 1999 and has served in a similar capacity in the Department of Anesthe- immune systems; sponses and opioid responses earned a bachelor of T. I G NATOWSKI M. KALSMAN 1991 and his professor of neurosurgery in medical de- July 1999. A specialist in inter- gree from the ventional neuroradiology, Kim during antidepressant drug ad- University of Arizona College of earned his bachelor of science ministration, providing possible Medicine, also in Tucson, in 1995. degree at the University of mechanisms of action for antide- He completed his family practice Michigan in Ann Arbor, MI, in pressants in the treatment of de- residency in Salt Lake City, UT, at 1986 and his medi- the University of Utah, serving as cal chief resident in 1997-1998. He Wayne State Uni- then completed a rural medicine versity in Detroit in during persistent pain, as well as pression and chronic pain states. siology since 1997. She degree from fellowship in Tacoma, WA, in 1999. 1990. He served his science degree in bio- Michael Kalsman, MD, PharmD logical sciences at UB Clllltcal Associate Professor, Department of Family Medicine His primary interest is in rural residency training medicine with an emphasis on in neurosurgery at obstetrics. He is also interested in Wayne State Uni- researching the use of the Internet versity from 19911993 and at The in 1990 and a PhD in 28 of pathology at the university in Kalsman joined the University at 1995. From 1995-1997 she was a Buffalo's Department of Family postdoctoral fellow at the Univer- Medicine in September 1999. He Ohio sity of Rochester in the Depart- practices at the University Pri- Columbus, OH, from 1995-1999. ment of Pharmacology and Physi- mary Clinic and is affiliated with In addition to interventional ology. Ignatowski's research inter- Olean General Hospital. He earned neuroradiology, Kim's clinical luflale Pbysiciaa Spring 2000 as a medical resource. State STANLEY KIM University in �idency Pro- NewYork,NY. He received a medi- pita!. Her interests include patient complex spine surgery and mini- gram and as- cal degree from George Washing- education and training medical mally invasive spine surgery. sistant professor in the De- ton University School of Medicine students and residents. in Washington, D.C., and com- partment of pleted residency training in sur- Susan Y. Kim, MD Social and gery and plastic surgery at St. Daniel Rifkin, MD Asststant Professor, Departmerzt of Radtation Oncology University at Buffalo Preventive Luke's/Roosevelt Hospital Center. Assistant Professor, Department of Neurology and research interests include Department of Radtation Medicine Roswell Park Cancer Institute Kim rejoined Roswell Park Cancer Institute (RPCI)and UB as an assistant professor of radiation medicine LI He then served a fellowship in Medical Director, Sleep Disorder CerJter of Western New York head and neck oncology and sur- bachelor of science degree in bioi- gery at Memorial Sloan-Kettering ogy, magna cum laude, at the Uni- Cancer Center in New York, NY. versity of Southern California in Loree is board certified by the Los Angeles, CA, in 1979 and American Board of Plastic Surgery his medical degree at St. Louis and the American Board of Sur- University School of Medicine gery. His research interests include in St. Louis, MO, in 1984. He thyroid cancer, microsurgery and then completed a master of pub- in Rifkin joined the UB's faculty in August 1998 and serves as medical directorofthe Sleep Disorder Center of Western lard Fillmore Hospital. Rifkin earned a bachelor of arts degree, free-tissue transfer. cum laude, in religion from Ham- ilton College, Clinton, NY, in 1988, sity of Michigan in Ann Arbor, SUSAN KIM gist, she is a graduate of the University of MI, in 1989. Li's research interests Nilsa M. Martinez:, MD and a medical degree from are preventive medicine, public Clinical Assistant Professor, Department of Family Medictne Dartmouth Medical School, health and chronic disease. Vermont School of Medicine in Burlington, VT. She completed her residency at St. Luke's Medical Center in Chicago, IL, and is board certified by the American Board of Radiology. Most recently, she founded and headed the stereotac- Thom R. Loree, MD C!tief, Divtsion of Head and Neck Surgtcal Oncology/Plastic and Reconstructive Surgery Department of Surgery Roswell Park Cancer Jnstttute Israel Medical Center in New York Assistant Professor, Departmertt of Surgery University at Buffalo City. At RPCI, she is practicing tic radiosurgery program at Beth ew York, located at Kaleida Health System's Mil- lic health degree at the Univer- September 1999. A radiation oncoJo- Medicine. He earned his Hanover, NH, in 1992. He served Martinez joined the his residency in neurology University Buf- at Strong Memorial Hos- falo Family Medicine pital, Rochester, NY, where Faculty Associates in he was chief resident in at She 1996. In 1997, practices at the Univer- he completed a October 1999. sity Primary Clinic in postdoctoral Houghton, NY, and is clinical and re- affiliated with Olean Hospital. General . MARTINEZ search fellowship in sleep Loree was appointed chief of the Martinez earned her bachelor of medicine and clinical neuro-oncology, including gamma Division of Head and Neck Surgi- science degree in neurosciences at neurophysiology at the knife radiosurgery. cal Oncology/Plastic and Recon- the University of Rochester in University of Mich- Rochester, NY, in 1990 and her igan Medical Center Carl LI,MD structive Surgery at Roswell Park Cancer Institute (RPCI) in Janu- medical degree at Boston Univer- in Ann Arbor, MI. His ary 2000. Loree, sity School of Medicine in Bos- clinical research inter- who is also an ton, MA, in 1994. She completed ests include all aspects assistant pro- her family practice residency at of sleep disorders fessor of sur- St. Joseph's Hospital Health Cen- medicine, with a pri- gery Associate Director, General Preventtve Medicine Residency Program Assistant Professor, Department of Social and Preventive Medicine Li joined UB's faculty in March 1999 as associate director of the General Preventive Medicine Res- Rifkin is medical director of the Sleep Disorder Center of Western New York. His clinical research interests include all aspects of sleep disorders medicine, with a primary focus on the effects of hypoxia on the brain. UB, ter in Syracuse, NY, in 1997. Prior mary focus on the ef- came to RPCI to coming to UB, Martinez was fects of hypoxia (often associated from St. Luke's! affiliated with the Hospital Inter- Roosevelt Hos- nists Group at St. Joseph's Hos- with obstructive sleep apnea) on the brain. <!;) at pital Center in T. LoREE Spring 2000 I DIIII O Pbys i c i 10 29 �DEVELOPMENT N E w s Salute to the Class of 194~ By Li nda J . Cor de r , PhD. CFRE \S_ \'1 lN OF r 1, I Sin) \J.G~I 1 11· H 'l\\ \II. Shortly after arriving, I switched on the rental car's radio and heard a narrator describing the USS Arizona in its underwater tomb at Pearl Harbor, barely a mile from Honolulu's airport. Then I realized the date was December 7th. The broadcast, from Washington, D.C., was a retrospective on the 1941 surprise attack that catapulted our nation into the Second World War. For me, that war was just a chapter in my history book, as vague as Vietnam is to our current students. I decided to visit the memorial, to imagine what medical students of that era might have felt as they tried to come to terms with the brutality of war while dedicating themselves to becoming physicians. Members of the Class of 1945 were UB's first to enroll after the U.S. entered the war. Seven months to the day of that bombing-July 7, 1942-they began their medical education at 24 High Street. They were on a fast track-three short years. All their youthful energy was bent toward learning the skills of healing, knowing that their most crucial tests might come under battlefield conditions far from home. The class bonded in a way that, from this vantage point, appears unique in the annals of the school. It may have been due to the attitude prevalent in the nation, or perhaps it was something within the walls of the school. I can't explain it; I 1945 lHE VAST MAJORITY just know it's there. THE SC HOOL's STUDENTS A look through WERE IN UNI~ORM. their 1945 yearbook shows the majority of students in uniform. Most went directly into active duty following graduation and picked up formal residencies following stints in the service. Thus, their paths took a variety of war-influenced turns, both before and following their training. Some became career military doctors. Many returned to Buffalo or practiced in 30 l •ttal• nysiein Spring 2000 small towns fanning out from Western New York into America's heartland and westward. Collectively, they have done a tremendous amount for the school. Some served on the admissions committee, as voluntary faculty members, and as mentors for students and residents. Others are generous with their resources, establishing endowments, supporting scholarships and the school's general fund (many of their names are in this year's Honor Roll, which follows). As a tribute to them and to the interweaving of their lives with World War II, we are working with volunteers to compile a memory book, for them, for the school, for those of us enriched by their stories. Every five years, like clockwork, they reunite in Buffalo to exchange stories and catch up on each other's lives. With each passing cycle, the group gets a bit smaller. Since their 50th anniversary, a hearty core has met every fall "in case they didn't all make it to their 55th." I have a feeling they will extend these annual conclaves as long as there are volunteers to handle the details. In addition to my ruminations on the Class of 1945, what did I learn from my visit to the USS Arizona? That war really is hell. That understanding that particular war simply is not possible for those of us born in its wake. That most people seem to feel genuine sorrow for the inhumanity of it all, when seen from nearly 60 years' perspective. (Flowers sent to mark the anniversary were from groups like the Japanese-American Friendship Association, and most of the visitors on my early-morning sojourn spoke Japanese.) So, I come down on the side of Anne Frank, believing both that most people are good at heart, and also that we need to find better ways to resolve our differences. A war worse than "The Big One" is too awful to contemplate. Or, as our friends in the Class of 1945 would attest, it's better to bind up wounds than to inflict them. Lyn Corder is associate dean and director of develoment. If you would like a copy of the 1945 reunion booklet, call the Development Office toll free, at 1-877-826-3246, or E-mail Lyn at ljcorder@buffalo.edu. �the Lifetime Members When cumulative contributions reach $50,000 or an irrevocable deferred gift is completed for $100,000 or more, a couple or individual is granted lifetime membership in the James Platt White Society. Combinations of outright and deferred gifts in appropriate proportions may also be the basis of lifetime membership. Names of Founders-Lifetime Members-are repeated in an annual category in any year that they make a new gift to the school. ntal in founding UB's medical school in 1846. F nde s' c· le Dr. Joseph Chazan '60 and Mrs. Helene Chazan Dr. Kenneth M. AHord '37 and Mrs. Joan W. AHord Buffalo, NY Williamsville, NY primarily physicians and attorneys, envisioned a school to train students for service to the community. The society's Founders help to actualize that vision by providing a generous base of support for programs and activities that enrich the academic environment and enhance medical training. Dr. Williard Bernhoft '35 and Mrs. Clarice Bemhoft Snyder, NY Dr. Kenneth H. Eckhert '35* and Mrs. Majorie Eckhert Buffalo, NY Ms. Rose Ellerbrock Dr. Willard Boardman ' 44 and Mrs. Jean Boardman '48 Winter Park, FL Amherst, NY Dr. George M. Ellis '45 and Mrs. Kelly Ellis Connersville, IN Dr. William Chardack Gulfstream, FL Spring Mr. DuVal Cravens and Mrs. Annette Cravens Buffalo, NY Mrs. June M. Alker DB's Founders, Providence, RI Mrs. Grant Fisher Lakeview, NY 2000 1111a11 Pkysiciu 31 �DEVELOPMENT fOUNDERS CIRCLE CO!"T·o Mrs. Catherine Fix Martinsburg, WV Dr. Thomas F. Frawley '44 and Mrs. Marigrace Frawley Chesterfield, MO Mrs. Christian Gretschel Genner Potomac, MD Mr. John Goodwin Williamsville, NY Dr. Pasquale A. Greco '41 and Mrs. Joan Greco Buffalo, N Y Dr. Glen E. Gresham and Mrs. Phyllis K. Gresham Snyder, NY Dr. Thomas J. Guttuso '60 and Mrs. Barbara L. Guttuso East Amherst, NY Dr. Eugene J. Hanavan Jr. '41 Buffalo, NY Mrs. Morris Lamer New York, NY Dr. Eugene R. and Mrs. June A. Mindell Buffalo, NY Dr. Richard J. Nagel '53 and Mrs. Forence Nagel E W S Annual Memberships Chairs' Circle Dr. and Mrs. Paul H. Wierzbieniec '74 Scholars' Circle Annual memberships, in the appropriate circle, are granted for one year, beginning January 1, for gifts received during the prior calendar year. The roster of the James Platt White Society "Class of 1999" follows. Just as a department chair leads a program, donors of leadersh ip gifts in this range of $10,000 to $24,999 are given special recognition. Amherst, NY One strength of an outstanding institution is the caliber of students who study there. Scholars in the James Platt White Society h ave made gifts to the school totaling $1,000 to $2,499 during the past year. Those marked with (**) are young scholars, graduates of the last decade, who qualify with gifts of $500 to $999. Dr. Hilliard Jason '61 Boulder, CO Mr. and Mrs. Wilson Greatbatch Dean'sCircle Akron, NY The dean is the school's leader. Every leader depends on a small circle of associates who help bring the organization's vision into reality. Individuals or couples qualify as members in the Dean's Circle with generous gifts of $25,000 or more during the calendar year. Orchard Park, NY Dr. Richard B. Narins '63 and Mrs. Ellen B. Narins Dr. Willard H. Boardman '44 East Aurora, NY Winter Park, FL Dr. Albert C. Rekate '40 and Mrs. Linda Rekate '71 Max Doubrava Jr., M.D. '59 Hilton H ead, N C Anonymous Las Vegas, NV Philip D. Morey M.D. '62 Williamsville, NY Dr. Syeda Fazila Zafar and Dr. lsmaial Zafar East Amherst, NY Fellows' Circle Fellows in the school are recognized for the added depth they bring to postgraduate study. Within the society, Fellows are honored for gifts that total $2,500 to $4,999. Dr. Maria Naples Sarno '34 Syracuse, NY Marie Rose Sarno Syracuse, NY Dr. Charles A. Baud a '42 Boynton Beach, FL Mr. Sheldon M. Berlow Buffalo, NY Buffalo, NY Professors' Circle Dr. and Mrs. Harold Brody '61 Getzville, NY Dr. Kenneth Z. AHshuler '52 and Mrs. Ruth AHshuler A strong faculty is central to a great university. Likewise, central to the future of our school is the dedication of a cadre of supporte rs whose annual gifts ra nge from $5,000 to $9,999. Dr. Melvin M. Brothman '58 Dallas, TX Snyder, NY Darcy Steinhart Amiel and Jack J. Amiel Dr. Allen Barnett '65 Pine Brook, NJ Dr. Elizabeth P. Olmsted Ross'39 Dr. Janet Sung and Mr. John Sung Dr. Charles D. Bauer '46, and Mrs. Mary A. Bauer Buffalo, NY Clarence, NY Williamsville, NY Dr. and Mrs. Robert J. Gillespie Buffalo, NY Caledonia, NY Dr. Philip S. Anson '79 Mr. Arthur H. Judelsohn Scarborough, ME Buffalo, NY Dr. J. Bradley Aust Jr. '49 Dr. Hak J. Ko San Antonio, TX Buffalo, NY Dr. George R. Baeumler '59 Dr. Susan V. Mcleer Kenmore, NY Buffalo, NY Dr. George Bancroft '81 and Mrs. Susan Bancroft '79 Dr. Richard B. Narins '63 and Mrs. Ellen B. Narins East Aurora, NY Dr. Dan Miller '48 Scarsdale, NY Dr. Claudia D. Fosket '85 and Dr. Robert J. Smolinski '83 Dr. John C. Newman Lewiston, NY Dr. John Parker ' 57 and Mrs. Dorris Parker Orchard Park, NY Dr. Charles S. Tirone '63 and Mrs. Anne Tirone '94 Latrobe, PA Williamsville, NY Dr. Edward D. Simmons Jr. Dr. Salvador M. Udagawa Dr. Phillip B. Wels '41 and Mrs. Elayne Wels Lakeview, NY Buffalo, NY Dr. and Mrs. James J. White Jr. '69 *deceased Dr. Nancy H. Nielsen '76 Orchard Park, NY Buffalo, NY Dr. Robert G. Smith '49 32 l1ff al o Hys ici an Sp r i n g 20 00 Drs. Elizabeth and Kevin Barlog'82 Amherst, NY Dr. Jared C. Bartow Sr. '66 and Mrs. Barbara Bartow '64 Grand Island, NY Dr. Paul D. Barry '71 Bethesda, MD Dr. Ralph T. Behling '43 San Mateo, CA Dr. Irving Sterman '64 Dr. Richard A. Berkson '72 and Mrs. Andrea Berkson Boynton Beach, FL THE CALIBER OF STUDENTS WHO STUDY THERE. Hamburg, NY Savannah, GA and Mrs. Gail Sterman ONE STRENGTH OF AN OUTSTANDI, G INSTITUTION I S Dr. WilliamS. Andaloro '45 Bradford, PA Williamsville, NY Clarence, NY Encino, CA Dr. Anita J. Herbert '63 Miss Thelma Sanes Dr. Janet and Mr. John Sung Dr. Kenneth Alford '37 and Mrs. Joan Alford Rancho Palos Verdes, CA Mr. Haskell Stovroff Dr. and Mrs. Michael E. Bernardino Buffalo, NY Buffalo, NY Mr. James I. Stovroff Dr. Joel M. Bernstein '75 Buffalo, NY Williamsville, NY �EVERY LEADER DEPENDS ON A SMALL CIRCLE OF ASSOC I ATES WHO HELP BRI 'G THE ORGANIZATION'S VISION INTO REALITY. Dr. Kathleen O'leary '88 and Mr. Michael J. Collins '90 Dr. Susan Fischbeck '82 and Dr. Patrick Hurley '82 Buffalo, NY East Concord, NY Dr. Suzanne F. Bradley '81 Dr. Mark R. Comaratta '85 and Mrs. Kathleen Comaratta Whitmore Lake, MI East Amherst, NY Dr. Theodore S. Bistany '60 Buffalo, NY Dr. Dennis l. Bordan '70 Port Washington, NY Dr. Martin Brecher '72 and Mrs. Geri Brecher Dr. Bernice S. ComfortTyran '58 Amherst, NY Los Altos, CA Dr. James B. Bronk '81 and Mrs. Suzanne Bronk Napa, CA Dr. linda J. Corder Buffalo, NY Dr. August A. Bruno Sr. '51 Dr. James J. Creighton Jr. '79 Amherst, NY Indianapolis, IN Clarence, NY Dr. Edwin J. Manning '61 Dr. Jack C. Fisher '62 Dr. Herbert E. Joyce '45 and Mrs. Ruth Joyce La Jolla, CA Lockport, NY Dr. Thomas D. Aanagan '65 and Mrs. Grace Flanagan '60 Dr. Wendy Kaiser '85 and Dr. Roger E. Kaiser Jr. '79 Williamsville, NY Clarence, NY Dr. Claudia D. Fosket '85 and Dr. Robert J. Smolinski '83 Orchard Park, NY Dr. Kyoichi Kano Williamsville, NY Tokyo, Japan Dr. Merrilll. Miller '71 Dr. Genievieve Kanski '58 and Dr. James R. Kanski '60 Coram, NY Eggertsville, NY Dr. Reiji Kasukawa Ann Arbor, MI Williamsville, NY Fukushima, Japan Dr. Kenneth Kim '65 and Mrs. Susan Kim Dr. Eugene l. Gaier Buffalo, NY Dr. Daniel E. Curtin '47 and Mrs. Elaine Curtin Dr. Penny A. Gardner '69 Mr. Michael T. Bukowski Orchard Park, NY Los Altos, CA Dr. David R. Dantzker '67 and Sherrye Dantzker Dr. Ronald F. Garvey '53 Roslyn, NY Dr. lawrence Golden '46 and Mrs. Nancy Golden '48 Dr. William M. Burleigh '67 Rancho Mirage, CA Dr. Jennifer l. Cadiz '87 Mechanicsburg, PA Drs. Virginia and Evan Calkins Dr. Roberta Dayer '72 and Dr. RogerS. Dayer '60 Williamsville, NY Tyler, TX Eggertsville, NY Buffalo, NY Dr. Michael Goldhamer '64 Dr. Philip C. Dennen '49 San Diego, CA Southbury, CT Dr. and Mrs. Glen E. Gresham Dr. Gerard J. Diesfeld '60 Arcade, NY Williamsville, NY Hambu rg, NY Dr. Frederick R. Downs '70 Dr. Kim Griswold '94** Dr. David T. Carboy '63 and Mrs. Jacqueline Carboy Attica, NY Buffalo, NY Ronald I. Dozoretz, M.D. '62 Lincroft, NJ Washington, DC Dr. Robert T. Guelcher '60 and Mrs. Elizabeth Guelcher Dr. Joseph G. Cardamone '65 and Mrs. Susan Cardamone Mrs. Ruth H. Dugan '65 Eden, NY Dr. Melvin B. Oyster '52 Dr. Nicholas C. Carosella '54 and Mrs. Mary Carosella Appleton, NY Hamburg, NY Niagara Falls, NY Dr. Robert Einhorn '72 North Brunswick, NJ Erie, PA Mrs. Gilda l. Hansen '44 Williamsville, NY Dr. John H. Hedger '75 and Mrs. Sandra Hedger Salisbury, MD Dr. Yung C. Chan '73 Dr. George M. Erickson '49 Dr. and Mrs. Reid R. Heffner Jr. Draper, VA Deland, FL Buffalo, NY Dr. Norman Chassin '45 and Mrs. Charlotte Chassin Buffalo, NY Dr. Yong Baek Chi Lockport, NY Dr. Prem K. Chopra West Seneca, NY Dr. and Mrs. Charles KwokChi Chow Dr. Joseph M. Failla '82 Dr. William J. Hewett '61 Bloomfield Hills, MI West Hartford, CT Dr. Domonic F. Falsetti '58 Dr. Fredric M. Hirsh '73 and Mrs. Donna Hirsch '75 Lewiston, NY Dr. and Mrs. leon E. Farhi Williamsville, NY Dr. Maynard H. Mires Jr. '46 Georgetown, DE Dr. Joseph F. Monte '59 Clinton, NY Buffalo, NY Dr. Robert A. Klocke '62 and Mrs. Barbara Klocke Williamsville, NY Dr. John F. Montroy '39 and Mrs. Catherine Montroy Bella Vista, AR Dr. Richard Kozak '94** Eugene, OR Dr. Daniel C. Kozera '59 and Mrs. Delphine Kozera Lackawanna, NY Dr. Beth Moscato '96 and Dr. John A. Moscato '68 Orchard Park, NY Dr. John D. Mountain '33 Manhasset, NY Drs. Marie Kunz '58 and Joseph l. Kunz '56 Lockport, NY Dr. Arthur W. Mruczek Sr. '73 Medina, NY Dr. Weerachai ladakom '91 Bangkok, Thailand Dr. Richard l. Munk '71 Sylvania, OH Dr. Andre D. lascari '60 Poestenkill, NY Dr. Masao Nakandakari '55 Honolulu, HI Dr. Thomas J. lawley '72 Atlanta, GA Dr. Tomoe Nishimaki Fukushima, japan Dr. Jack lemann Jr. '54 and Mrs. Mary MacDonaldlemann Dr. Thomas P. O'Connor '67 East Amherst, NY New Orleans, LA Dr. James M. Orr '53 Dr. Eugene V. leslie '51 and Mrs. Faith leslie Dr. Marvin G. Osofsky '59 Gallipolis, OH Williamsville, NY Nanuet, NY Dr. laurence M. lesser '70 Dr. Margaret Paroski '80 Atlanta, GA Buffalo, NY Dr. Harold J. levy '46 and Mrs. Arlene levy Drs. Jacqueline Paroski '49 and Paul A. Paroski DDS '45 Amherst, NY North Tonawanda, NY Eggertsville, NY Dr. John M. Hodson '56 Mr. Kevin Feor '80 and Mrs. Elizabeth Feor '78 Williamsville, NY Alice Jo Lichtman '58 and Marshall A. Lichtman, M.D. '60 Mr. Harold Housler Rochester, NY Webster, NY Rochester, NY Dr. Hing-Har lo '74 Snyder, NY Hong Kong Dr. Amy Ferry '94** Robert M. Jaeger, M.D. '47 Blacksburg, VA Bethlehem, PA Allentown, PA Dr. and Mrs. Gerald l. Logue Dr. Carlos R. Jaen '89** Williamsville, NY Dr. Michael E. Cohen '61 and Mrs. Joan Cohen Dr. Helen Marie Findlay '77 and Dr. Albert Schlisserman '77 Buffalo, NY Williamsville, NY Eggertsville, NY Dr. Thomas A. Lombardo Jr. '73 and Mrs. Donna Lombardo Lexington, MA East Aurora, NY Spring Dr. Robert J. Patterson 'SO and Mrs. Patricia Patterson '48 Dr. Norman l. Paul '48 Dr. Eugene E. Cisek Buffalo, NY Hamilton, NY Dr. Neal W. Fuhr '52 Dr. Julia Cullen '49 Eggertsville, NY Buffalo, NY Dr. Kaaren Metcalf '78 and Dr. Harry l. MetcaH '60 Dr. and Mrs. David P. Mind ell Buffalo, NY Dr. Stanley l. Bukowski '81 and Mrs. Romana Bukowski Buffalo, NY Dr. John Marzo Dr. Andrew J. Francis '84 Mount Dora, FL Washington, DC Dr. Frank A. luzi '88 La Jolla, CA Dr. Paul T. Buerger '49 Ms. Mary J. Bukowski Schutz Irene and Frank Jellinek '40 2000 Dr. Clayton A. Peimer and Mrs. Susan Peimer Eggertsville, NY Mr. Edwin Polokoff Boca Raton, FL laffa l1 Physician 33 �D E V E ~--------- SCHOLARS' CIRCLE, CONT'D Dr. Charles W. Pruet Williamsville, NY L 0 P M E Dr. Hiroshi Yoshida Fukushima, japan Dr. Roy E. Seibel Sr. '39 and Mrs. Ruth Seibel Dr. Wayne C. Templer '45 Dr. Gregory E. Young '77 and Mrs. Diane Young Dr. Molly R. Seidenberg '53 Dr. Arthur M. Seigel '70 Guilford, CT Dr. Bert W. Rappole '66 and Mrs. Mary Helen Rappole '97 Dr. Elizabeth G. Serrage '64 jamestown, NY Mr. Eugene M. Setel Boca Raton, FL Buffalo, NY Dr. Richard R. Romanowski '58 Cape Elizabeth, ME Buffalo, NY Corning, NY Dr. Henry A. Thiede '49 Pittsford, NY Dr. James C. Tibbetts '64 Sturgeon Bay, WI Dr. George Toufexis '76 Williamsville, NY Dr. Bradley T. Truax '74 Lewiston, NY Dr. Edward Shanbrom '51 and Mrs. Helen Shanbrom Santa Ana, CA Dr. John T. Sharp '49 and Mrs. Susan Sharp Lancaster, NY Dr. Thomas F. Varecka '74 Minneapolis, MN Dr. Alvin Volkman '51 Holmes Beach, FL Greenville, NC Dr. John B. Sheffer '47 Dr. Richard D. Wasson '58 and Mrs. Janet Wasson Williamsville, NY Dr. Charles H. Rosenberg '44 Stamford, CT Dr. Peter E. Shields '79 Williamsville, NY Dr. Arnold Wax '76 Dr. Elizabeth P. Olmsted Ross'39 Dr. Timothy S. Sievenpiper '68 and Mrs. Karen Sievenpiper '66 Dr. Pierce Weinstein '49 Dr. Jeffrey S. Ross '70 Holland, NY Dr. Wende W. Young '61 Canandaigua, NY Dr. Franklin Zeplowitz '58 and Mrs. Piera Zeplowitz Buffalo, NY Dr. David Ziegler '64 and Mrs. Susan Ziegler '61 Walnut Creek, CA Mr. James J. Trzaska Buffalo, NY Buffalo, NY East Aurora, NY Holiday, FL Special Members A few individuals and coup les were gra n ted multiyear memberships based on generous gifts made between 1989-1993. Henderson, NV West Palm Beach, FL Drs. Charlotte Weiss '52 and Dr. Hyman Weiss '52 Lebanon Springs, NY Edward H. Simmons, M.D. Mr. James J. Rosso '76 and Mrs. Cheryl Rosso Williamsville, NY Highland Park, Nj Dr. James A. Smith '74 Dr. Gary J. Wilcox '73 Buffalo, NY Orchard Park, NY Carlsbad, CA Dr. Albert G. Rowe '46 Dr. Albert Somit Dr. Charles E. Wiles '45 Tonawanda, NY Aurora, Co Dr. David W. Butsch Montpelier, VT Dr. John l. Butsch Buffalo, NY Dr. Marvin Z. Kurian '64 and Mrs. Eleanor Kurian Carbondale, JL Orlando, FL Dr. John J. Squadrito '39 Dr. Richard G. Williams '80 New York, NY Sarasota, FL Clearfield, PA Buffalo, NY Dr. Pina Sanelli '94** Dr. David D. Stahl '79 Mr. Ralph C. Wilson Jr. M edina, NY Orchard Park, NY Mrs. Marvin (Helen) Winer Boston, MA Dr. William C. Sternfeld '71 Dr. Stuart Alan Wolman '74 Sylvania, OH Beverly Hills, CA Snyder, NY Dr. louise M. Stomierowski '74 Dr. and Mrs. John R. Wright Dr. Stephen C. Scheiber '64 and Ms. Mary Ann Scheiber Garrett Park, MD Glenview, IL Dr. James N. Schmitt '52 Kenmore, NY •• Clln lllrcll •• ..,.. . . . . . '%1 ..... ........... ........ ....... s. Williamsville, NY Dr. John Naughton Sarasota, FL We have made every effort to en ure accuracy tn these hsts If ou ha e questio or corrections, please call Mary Glenn, toll free at Williamsville, NY Dr. Michael A. Sullivan '53 Williamsville, NY Dr. lin-lan Tang '84 Warren, N] Dr. Max A. Schneider ' 49 U B's Orange, CA Robert N. Schnitzler, M.D. '65 f OUNDERS, PRIMARILY PHYSICIANS AND ATTORNEYS, ENVISIONED A SCHOOL TO TRAIN STUDENTS FOR SERVICE TO THE COMMU, 'ITY. San Antonio, TX Dr. Adolphe J. Schoepflin '45 Ada, OK Dr. David S. Schreiber '69 Westwood, MA Dr. Joseph I.SchuHz'57 San Pedro, CA l 1 1f a lo Hys ieia n The following indi viduals left gen erous bequests or made arrangements for the school to recetve gtfts from testamentary trusts Gtfts from those listed were received dunng 1999. . . . . . . . . '15 Ms. Janet Butsch Dr. Edwin A. Salsitz '72 Dr. Arthur J. Schaefer '47 and Mrs. Elizabeth Ann Schaefer 34 w s Columbus, OH Rochester, NY Dr. Frank T. Riforgiato '39 and Mrs. Mary Cecina Riforgiato '37 E Dr. Michael Taxier '75 Amherst, NY Dr. Frederic D. Regan '45 N Dr. Fred S. Schwarz '46 Eggertsville, NY Fairview Park, OH T Buffalo, NY Dr. Kenneth J. Raczka '72 and Mrs. Rita Raczka Dr. John Y. Ranchoff '52 N S prin g 2 000 �Dear Fellow Alumni, NOW! R SUCCESSFUL S PRING C LINICAL D AY has recently come and gone. For those of you who missed this event-organized by Colleen A. Matti more, MD '91, and featuring the theme of "Children's Health"-be sure to look for coverage of it in the summer issue of Buffalo Physician. Prior to Spring Clinical Day, the Medical Alumni Association Board met and chose the following four alumni from reunion classes to receive achievement awards at Spring Clinical Day: Richard H. Alder, MD '45; D. Jackson Coleman, MD '60; N. Lynn Eckhert, PhD, MD '70; and Ani! B. Mukherjee, PhD/MD '75. The board also met to discuss nominations for the Berkson Award, which is given to the outstanding teacher among our faculty, and approved nominations of Robert Kalb, MD, and Corstiaan Brass, MD, to receive this year's honor. In addition to Spring Clinical Day, I am pleased to report that this year's Medical Alumni Association programs have all been successful. The Physician-Student Mentoring Program-in which first-year students are paired up with attending physicians in the Buffalo area-has had enthusiatic reviews from both the students and the physician-mentors. I encourage any of you in the Western New York area who would like to become involved in the program to contact the Medical Alumni Association office at the number listed below so that a student can be paired with you in August. The Community Physicians Program for first- and second-year students continues to meet with success, as well. The Alumni Association, under the chairmanship of Anthony Markello, MD '62, organizes speakers for these noontime meetings, which also include lunch for attendees. On February 2, 2000, Jack Cudmore, MD '62, and Daniel Kozera, MD '59, talked about their careers in medicine. For more information about any of these events, or other matters, please feel free to call the Medical Alumni Association office at (716) 829-2778. RICHARD L. COLLINS , MD President, Medical A lumni Association Spring 2000 luffal e Pb ysici ao 35 �CLASSNOTES 1940s Samuel Cassara, MD '44, writes from Rochester, NY: "I retired in 1997. I am a board certified pediatrician and was in the navy twice. The rest of the time I spent in private practice. I have three children: my oldest, my daugher, works in public relations for a private company; my son is an oral surgeon and my youngest is a social worker. Arthur J. Schaefer, MD '47, attended the American Academy of Ophthalmology's annual meeting in Orlando, FL, where he gave a threehour course on the surgical correction of malpositions of the eyelids. The meeting was held in conjunction with the PanAmerican Society of Ophthalmology and was attended by over 25,000 ophthalmologists from the United States and around the world. 1950s Richard Lyons, MD '50, writes: "I retired july 1, 1999, after 36 years of practice in anesthesiology; assistant clinical professor of anesthesiology at the University of Illinois; director of anesthesiology at Ravenwood Hospital Medical Center in Chicago, IL. Also retired from sailing, skiing and SCUBA. Widowed 36 l 11fala H ysieian since September 1998. Maintain homes in Evanston, IL, and Holmes Beach, FL. Looking forward to our 50th reunion." Ernest H. Meese, MD '54, received the American Cancer Society's (ACS) prestigious National St. George Medal in November 1999 at the Ohio Division's annual state meeting in Columbus, OH. The St. George Medal is presented annually to an outstanding division volunteer. Meese, who practices cardiathoracic surgery in Cincinnati, has been a dedicated volunteer for the ACS for 36 years and has served as president of the board of trustees for both the local Hamilton County Unit and the Ohio Division. He has also given many lectures in support of antismoking ordinance efforts and has seen the positive results of the ACS's work in his region. Currently, Meese serves as a lifetime member of the Hamilton County Unit Board of Trustees and as chair of the Tobacco Committee. Philip Brunell, MD '57, writes: "I retired from NIH a few months ago S prin g 2 000 but I am off to England to Great Ormond Street Children's Hospital as a visiting professor for three months in the spring. I still go into work at the NIH occasionally, edit Infectious Diseases in Children and serve as secretary of the World Society for Pediatric Infectious Diseases. Most of all, I enjoy my four grandchildren." E-mail address is: pbrunell@niaid.nih.gov Jacob Krieger, MD '59, Daniel Kozera, MD '59, Sandra Leininger, MD '59, Lackawanna, NY, Obstetrics/Gynecology. "I have been on the Board of Health for Erie County for over 15 years and have served as president. Due to heart disease, I left private practice of ob-gyn in 1986. Since then, I have worked parttime at the Erie County Health Department as a consultant in ob- gyn. I also consulted for the NYS Health Department and I am past president of Buffalo Gyn-Ob Society and past chief of ob-gyn at Buffalo Mercy and OLV hospitals." Danville, CA, Pediatrics. ''I'm healthy and happy!" Rochester, NY, Anesthesiology. "I was chief of anesthesia at Genesee Hospital in Rochester, NY, from 1969-1977; chief of anesthesia at Rochester General Hospital, Rochester, NY, 1984-1989; clinical assistant professor of anesthesiology at the University of Rochester School of Medicine from 1969-present." E-mail is: j mdkrieger@aol.com Richard Musgnug, MD '59, Medford Lakes, NJ, Dermatology. "I have learned over the years, as I am sure you all have too, life is too short and unpredictable to waste on things that don't have any real meaning in your life. If you can contribute something to a meeting, a committee, a board, etc., do it; if not, move on." E-mail is: Rcmus@aol.com E-mai 1960s Roberta Gilbert, MD '62, writes: "Just published Connecting with Our Children, Guiding Principles for Parents in a Troubled World. Wiley, NY, publishers." Robert W. Hamilton, MD '63, writes, "I was promoted to Professor Emeritus of medicine at the Medical College of Ohio on January 1, 2000. I have retired from the practice of medicine, but still teach parttime. I remain active in my church and with the Ohio Chapter of the American College of Physicians as vice president of the chapter. I am also learning to play the Great Highland bagpipes. E- mail address is: rhamilton@core.com Walter Ceranski, MD '64, Phoenix, AZ, Family Practice. "I became a grandfather six months ago." E-mail address is: 72772.137@compuserve.com Joseph DiPoala Sr, MD '64, Rochester, NY, Internal Medicine. "I am medical director and owner of the Doctor's Wellness Weight Loss Center to assist patients in achieving better health, physical fitness and weight loss. Plus rehabilitation exercise for elderly and those with osteoarthritis." E- mail address is: )dipoalasr@pol.net �__, !"'}' development and Medi· caid managed care, he Thomas C. Rosenthal, practice in the rural MD '75, professor and Western New chair of the Department York community Area Health Educa· of Family Medicine in the of Perry. Over tion Center, which he directs. For his also led efforts to create the New York State thalmology. It's still new and exciting and one of the most fun things in my life, along with hiking and kayaking and learning other 'new' things." University at Buffalo the next eight School of Medicine and years, he re- ongoing efforts in Irving Sterman, MD '64, Biomedical Sciences, has cruited and built the field of rural been named editor of the practice into health services, he The Journal of Rural a stable group was presented with Health, the peer-reviewed model. Boynton Beach, FL. "I was widowed in 1993 and remarried in 1995 and moved to FL. I am now working parttime doing disability evaluations, mostly for worker compensation cases in Syracuse, Y. I am enjoying traveling." E-mail address is: Turkyii@aol.com publication of the Rosenthal returned to National Rural Health his alma mater in 1986, Association INRHAJ. establishing the Office of A longtime contributor to the journal, Rosenthal the NRHA's Distinguished Educator Award in 1992. Rosenthal plans to broaden the journal's Rural Health at UB and audience and impact by leading the New York expanding its traditional focus on health-services has served on the Rural Health Research publication's editorial Center. Committed to research to include more board since 1997. His improving health care in articles on clinical issues interest in rural health underserved rural areas and social issues of rural began in the late 1970s, through research into health. when he opened a solo such issues as health professional workforce Michael Feinstein, MD '64, Scottsdale, AZ. "I retired on July 31, 1998, from my hematology-oncology practice on Long Island after 26 years. I am working parttime in a consultation practice in hematology-oncology in Phoenix." E-mail is: linmic@msn.com John Hazeltine, MD '64, Brainerd, MN, Otolaryngology. "I retired in October 1998. We are planning to live in Jack- sonville, OR, and will move this summer, nearer to our children in San Francisco. Retirement is terrific; I should have done it sooner." Stephen C. Scheiber, MD '64, writes from Deerfield, IL: "I am beginning my 15th year as the executive vice president of the American Board of Psychiatry and Neurology and I am currently - MARY BETH SP I NA for the Advancement of Psychiatry and the treasurer for the American College of Psychiatrists. I continue to be active on a number of committees of the American Board of Medical Specialties and participate in national meetings of many of the psychiatry and neurology specialty and subspecialty organizations." Elizabeth Serrage, MD '64, Cape Elizabeth, ME, Ophthalmology. "I still love practicing medicine C1aS'SiiOteS SPRING 2000 J. Michael Taylor, MD '64, Portland, ME. "I have developed a four-person dermatology practice in Portland, ME. I encounter Liz (Goering) and John Serrage regularly, both professionally and socially." E-mail: m.and. w.taylor@worldnet.att.net James Tibbetts, MD "64, Neurological Surgery. "We retired December 31, 1997, and are enjoying it and each other." Shorepeace@dcwis.com David Ziegler, MD '64, Walnut Creek, CA, Neurology. ''I'm retired and spend March in Phoenix- spring training (baseball)." E-mail is: Davidz@pc-systems. net Stuart H. Shapiro, MD '68. After graduation and board certification in radiology, nuclear medi- Spring 2000 cine, and public health, Shapiro turned his attention to the interface of politics, business and medicine. After staffing the U.S. Senate Health Subcommittee Committee, he became Health Commissioner for the City of Philadelphia and joined the faculty at Wharton School of Business at the University of Pennsylvania. He then moved into the private health-care financing at a large bank, then became senior vice president of a multinational nutrition company. Later he was named CEO of a publicly traded company that provides health care to prisoners across America. In 1997 he was recruited to be CEO of the President's Summit for America's Future with Presidents Clinton and Bush as active honorary chair and General [Colin] Powell as the chair. Shapiro continues to work with General Powell and to do private investing and consulting for for-profit and not-for-profit businesses. He feels he certainly may have the youngest children of anyone in the class- a daughter four and a son 11 months. E-mail'- - - address is: shapirostu@aol.com lu lf1l1 Hysieiu 37 �CLASSNOTES James Cavalieri, MD '69, Williamsville, NY, Pediatrics. "I am past president of the Buffalo Pediatric Society; past member of the board of trustees for Children's Hospital; and past board member of Independent Practice Associates. I am a founding member of Community Pediatric Associates ofWNY LLC. 1994 Pediatrician of the Year." E-mail address is: Jimkatec@aol.com John Fisk, MD '69, Springfield, IL. "I am professor of surgery at Southern Illinois University School of Medicine." E-mail address is: Jfisk@siumed.edu William Major Jr, MD '69, Orchard Park, NY, Thoracic Surgery. "I am executive director, IPA/ WNY, January 1999current." E-mail is: Wmajor@buf.adelphia.net William E. Stempsey, MD '78, SJ, has recently published a book titled Disease and Diagnosis, Value-Dependent Realism. Stempsey, a member of the Jesuit Community, currently is an assistant professor in the Department of Philosophy at the FACP, FAC, writes: "I retired from active solo practice of medicineinternal medicine and cardiology- in March 1999, not by choice but due to health reasons. In College of Holy Cross in Worcester, MA. In 1988, ten years after earning his medical degree at UB, Stempsey completed a master of arts degree in philosophy at Loyola University Chicago, after which he earned a master of divinity degree from the Jesuit School of Theology at the Uni versity of California at Berkeley. In 1996, he completed his doctorate in philosophy at Georgetown University. The book's publishers, Kluwer Academic, state that Stempsey's book "will be of interest to 1111111 Hysici11 Sprin g 1970s Russell P. Massaro, MD '70, lives in Elmhurst, IL, and is currently executive vice president for accreditation operations at JCAHO. Ashesh K. Maulik, MD '72, 38 May 1998, I was discovered to have pituitary macroadenoma. I underwent a craniotomy, followed by radiation therapy. Due to weakness and failing vision, I could not practice. Moved to Las Vegas, NV, to be near family. I miss Western New York and all the CME courses in Buffalo." 2 000 philosophers of medicine, value theorists, bioethicists, and physicians" because it "situates the practice of diagnosis in a new vision of how values permeate the world of disease and medical practice." More information on Disease and Diagnosis can be obtained by calling Kluwer Academic Publishers at (781) 871-6600; E-mail: kluwer@wkap.com Avery It Ellis, MD '77. PhD '79 has been appointed physician executive at the Department of Veterans Affairs Western New York Healthcare System. As clinical head of the veterans' facility, Ellis supervises the operation of both the Buffalo and Batavia sites, as well as community based outpatient clinics in Jamestown, Dunkirk, Niagara Falls, Lockport and Warsaw. Ellis received his undergraduate degree from Cornell University and his medi cal degree from UB, where he also received his PhD in physiology. He completed a medical residency and cardiology fellowship at Stanford University Hospital. In October 1999, he received an MBA from Duke University. At UB, Ellis is an associate professor of medicine and physiology, as well as director of the Cardiology Fellowship Program. A Fellow in the American College of Cardiology, he also holds membership in the American Heart Association, the American Society of Echocardiography and the New York Sate Cardiologic Society. of Andover [Maryland] and is medical director of two nursing facilities in the area and a local college. He has also been a mentor to family practice students and residents. - Terence Chorba, MD '79, writes: "After working on infectious disease issues in Kazakstan and central Asia for the Centers for Disease Control for four years, I am now working in Cote d'Ivoire [Ivory Coast] as director of Project Retro-CI, a collaborative AIDS/TB/ STD research activity of the Ministry of Health and the CDC." 1980s David Bristol, PhD '82, lives in Ann Arbor, MI, and is currently director of biometrics at ParkeDavis Pharmaceutical Research, where he provides guidance for development of treatment for cardiovascular diseases. Wesley L. Hicks, Jr. DDS, MD '84, FACS, has been ap- pointed director of the Fellowship Program in the Division of Head and Neck Surgical Oncology/ Plastic and Reconstructive Surgery at Roswell Park Cancer Institute (RPCI). In this capacity, he is responsible for the national accreditation and development of education and research programs at RPCI through the American Head and Neck Society. He will also continue to serve as associate professor in UB's Department of Otolaryngology. Anthony E. Turiano, MD '83, has been listed in the Guide to Top Doctors, a state-by-state listing of 15,000 doctors in 30 specialties nationwide who are most highly recommended by their peers. Turiano is chief of family practice at Suburban Health Care Andrew M. Knoll, MD '84, FACP, and Maritza Alvarado, MD '85, write: "Andrew has received a chancellor's scholarship at Syracuse University College of Law and graduates in August 2000." �In Memoriam Stuan Y. Collins, MD' 40, died on April 16, 1999. After being discharged from the Army Medical Corp, in 1946, Collins practiced medicine in Elmira, NY. Following his retirement in 1975, he resided in Tequesta, FL, with his wife, Marian, who survives him and who currently resides at 113 Cool View Drive, Noma Roberson, PhD '86, of Amherst, NY, recently published a book, titled Year 2000 and Beyond, which offers information about the potential impact of the year 2000; a checklist for personal information, housing, money, supplies, communications, transportation and personal computers; and spiritual guidance and devotion. Roberson is president/ CEO of a newly formed consulting company, Roberson Consulting Internationa!, the mission of which is to provide consultation to universities, Seneca, SC, 29672-2302. nity Hospital in Julian, named Julian was well known as Collins is also survived by Jersey City, NJ, a diplomate of a chef and culinary advi· three children and four after which he the American sor who frequently grandchildren. returned to But- Board of Ob- cooked in his home for Peter J. Julian, MD '47, falo to complete stetrics and Dallas restaurant chefs. his residency Gynecology in Besides his wife, Ruth Gray Julian, he is a Dallas, TX, obstetrician! training at Dea- 1954, moved gynecologist who practiced coness Hospital to Dallas with survived by a son, in Buffalo from 1951- in 1951. He then his family in nationally-known 1960, died of a heart entered private 1960 to start neoexpressionist artist attack in June 1999 at his practice on his own prac- Peter Julian, of New Dallas home. He was 74. A Humboldt Parkway with tice. He served as a clinical York, NY; a daughter, native of Buffalo, Julian Dr. W. Herbert Burwig, who professor at the University Linda Julian Richie of also completed his under· had the largest obstetrical of Texas Southwestern Dallas; a sister, Mildred graduate studies at UB. practice in Buffalo and Medical Center at Dallas, Nicholas of PA; and Following graduation from developed the city's first from 1960 to his retirement a granddaugbter. medical school, he interned group practice in obstetrics. in 1998. In addition to his at Margaret Hague Mater- (Burwig died in 1992.) reputation as a physician, foundations and government agencies that conduct health research and services for public education. Peggy Stager, MD '88, Dlufowobi Gbadebo, MD '91, writes: "My husband, Dick, and I welcomed our second son, Benjamin, on Superbowl Sunday, January 31 , 2000. Dick is certain that Ben's birthday is a sure sign that he will be a professional football player!" writes: "Buffalo Physician is sure a good way to keep in touch with events and developments within the University at Buffalo and the affiliated hospitals. As an alumnus of the Medical Department, I look forward to each edition of the magazine. Although my practive here in central Wisconsin is busy and rewarding, reading about my colleagues in Buffalo makes me homesick." Anhur Weissman, MD '86, writes: "I am a general surgeon at Tri County Memorial Hospital, in Gowanda, NY, and have a busy solo rural practice. I'm fortunate to be surrounded by excellent nurses and support staff and grateful to be alive and well, working and enjoying operating and office practice. Watching my kids grow up (Katie is 13-going on 35-and Zack is almost 9). Pat and I are planning our 20th anniversary trip to Paris. My best to all." E-mail is: arthursurg@aol.com 1990s Sean Cao, MD '90, was recently appointed associate chief, Division of Transplantation, Department of Surgery, at the University of California at Irvine's Medical Center. His address is UCI Medical Center, Bldg 26, Room 1001, Route 81, Orange, CA 92868-3298; his telephone number is (714) 456-8441. David J. Rodman, MD '91 , writes: "I have received an appointment in SUNY at Buffalo's Department of Chemistry as a research assistant professor and have joined the Biophotonics Institute [see related S prin g 2000 CD article on page 20 ]. I will be working on joint collaborative projects, including solid-state lasers and new drugdelivery systems. " Rosalind Nolan Sulaiman, MD '91, writes: "Rosalind Nolan Sulaiman and Adel Sulaimen are pleased to announce the birth of their second son, Kyle, last spring. Big brother, Cass, is now four." Daniel Pitterman, MD '92, writes: "I am an assistant professor of anesthesiology at Loyola University Medical Center in Chicago. My wife, Corrine, and I are expecting our first child in March." I~NT I NUEO ON PAGE + 0 l affale Pbysician 39 �CLASS NOTES BRAZIL REDUX Do you have a favorite memory, anecdote or inspirational moment that you associate with your medical education? How about a favorite professor, mentor or classmate you'd like to tell about? Buffalo Physician is putting out a call for stories about your past, which we will publish in future issues of the magazine. Here are some ways you can submit your story• •. bp-notes@buffalo.edu 716-645-2313 Editor, Buffalo Physician, 330 Crofts Hall, Buffalo, NY 14260. Be sure to include your name and a phone number or address where you can be reached. Your fellow alumni look forward to reading about your storied past! CONTINUED FROM PA GE 13 toxoplasmosis. Again, most of the diagnoses were based on history and physical exam, and I did learn how to perform a thorough medical examination and how to more efficiently use the history and presentation of the patient. I feel that this experience raised my skills to a new level and certainly deepened my appreciation for medicine. l Day-and Month-To Remember Joseph M. Kowlaksi, MD '93, has been appointed to the medical staff at the Erie County Medical Center (ECMC) Healthcare etwork. An orthopaedic physician/ surgeon, he will join the current team of specialists at ECMC's Spine Center. Kowalski earned his medical degree summa cum laude from UB, where he also completed his residency. He then completed a fellowship in spine surgery at Emory University in Decatur, GA. Prior to medical school, he earned a doctor of chiropractic degree from the National College of Chiropractic in Chicago, IL. Kowalski is a diplomate of both the National Board of Medical Examiners and Chiropractic Examiners. He is a member of the Alpha Omega Alpha Honor Medical Society and the orth American Spine Society. l1flal• Hysiciu Mansour V. Shirbacheh, MD '93, PhD, writes: "After obtaining my MD, I started general surgery training in Long Island, NY. However, in 1996, I decided to leave clinical training and join plastic surgery research in Louisville, KY. My research and many others culminated in the first hand transplant in the U.S. I also applied my research to my PhD dissertation. I received my PhD in physiology last May. I am currently training in plastic and reconstructive surgery in Louisville and will graduate in June 2001." Carollnn Killian, MD '94, Thomas Burnette, MD '94, write: "We are pleased to announce the birth of our second daughter, Lauren Killian Burnette, on November 24, 1999 (7lbs., 11 oz.). Big sister, Kristen, is now 19 months old and is adjusting well! Tom continues to practice internal Spri n g 2000 medicine and Carol Ann, emergency medicine, in NY. Catherine (Costello) Skae, MD '97, writes: "My hus- band, John, and I proudly announce the birth of our daughter, Anya Bernadette, who was born on January 21, 2000-9 pounds, 7 ounces. I am a third-year pediatrics resident at the Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, where I will be the pediatrics chief resident starting in July 2000." Paul Guttuso, MD '97, writes: "I will be starting a fellowship in sports medicine in July 2000. My wife, Trinia, an occupational therapist, just passed licensure for certified hand therapy. We are so proud!" Paul Rosen, MD '97, writes: "I will graduate from Mt. Sinai's Department of Pediatrics and start a fellowship in pediatric rheumatology at Children's Hospital of Cincinnati in July 2000." M y last day at the hospital is one I will always remember, as that's when I completed my most difficult assignment. Weeks earlier, a professor had asked me if I would be interested in giving a talk on hepatitis A. He gave me articles to read, as well as suggestions on what I should cover. He also recommended that I generate a handout for the students. So, on that last day-in front of my classmates, professors, nurses and hospital administrators! gave a 20-minute presentation in Portuguese. Although I was anxious about having to present such technical information in a foreign language, it went very well. I did have difficulty pronouncing certain medical words without a strong accent; however, the audience was responsive and helpful. After I finished, I realized that I had learned a lot about myself, my work ethic and my presentation skills. Having overcome such a challenging situation, I now feel I would be comfortable speaking in front of any group. Looking back on my experience in Campos, I can see that every facet of my education was enhanced, as I learned a tremendous amount about medicine- and myself. In short, I feel that my month in Brazil was a high point in my medical education, to date, and one that further affirmed for me that medicine is my career of choice. CD Michael White is a fourth-year student at the University at Buffalo School of Medicine and Biomedical Sciences. This summer he begins residency training in emergency medicine at Eastern Virginia Medical School, Sentara General Hospital, in Norfolk, Virginia. �HEN DEBORAH A. WHITE, MD '87, her husband, Christopher, and their four-year-old son, Adam, were killed m an automobile accident in February 1999, a number of people at the University at Buffalo School of Medicine and Biomedical Sciences felt a desire to bring together alumni, faculty, staff and friends with the goal of memorializing the Whites. Instrumental in this effort has been Dr. Gail Willsky, associate professor of biochemistry, who knew Deborah as a student and friend and remains close to her family. As a result of the efforts of Dr. Willsky and others over the past year, the medical school's Office of Development has established the Deborah, Christopher and Adam White Memorial Fund. Proceeds from this fund will support a summer internship for a first- or second-year medical student at UB who is interested in pursuing rural medicine as a career. As many of you know, Deborah was a native of Western New York and grew up on a dairy farm in Eden. Three years after earning her medical degree at UB, she joined a busy internal medicine practice in Middleport, a town of approximately 2,000 people several miles west of Medina, where she was on staff at Medina Memorial Hospital. The same year Deborah began her practice in Middleport, Christopher-who earned bachelor's and master's degrees in biology from UB-chose to give up his position as a cellular and molecular biologist at Roswell Park Cancer Institute to become a stay-athome parent. Today, the White's surviving children, Andrew, 10, and Elizabeth, 7, live with Christopher's sister, Mrs. Sue White Chiddy, in Elba. Mrs. Chiddy says the children are doing well and both show an interest in science. (Andrew says he'd like to be a veterinarian.) Friends and colleagues who knew of Deborah's dedication to rural medicine felt that an endowment supporting education and training in this area of health care would be the best way to honor her life as a physician. In the future, a student whose training is supported through the memorial fund will be expected to complete a summer internship in a rural setting, preferably in the Deborah and Medina area. In addition to supporting a rural internship, it is hoped that the fund Christopher White, will provide two additional awards: one to a with Andrew, Adam student graduating in the biological sciand Elizabeth. ences, and another to a student graduating Today, Andrew and in biochemistry, thereby honoring both Elizabeth live with Deborah's and Christopher's accomplishChristopher's ments in these fields. sister, Mrs. Susan For more information about the Chiddy, in Elba, NY. Deborah, Christopher and Adam White Memorial Fund and its support of students interested in pursuing careers in rural medicine and biological sciences, please contact Mary Glenn in the medical school's development office by calling (toll free) 1-877-826-3246; e-mailing glenn@acsu.buffalo.edu; or writing to: Office of Development, School of Medicine and Biomedical Sciences, University at Buffalo, 102 Cary Hall, 3435 Main St., Bldg. 23, Buffalo, NY 14214-3005. �We Get Rehab Results! Our Superior~ Improvement Vs. National and Northeastetn Regional Subacute Facilities Hve Star Care The McGuire Rehabilitation Centers achieve a 34% GREATER FIMsM increase vs. the national average for all admissions. • Pain Management Stroke • Medically Complex • Orthopedic • Infections Cardiac • Cancer • Joint Replacement • Amputee Our facilities were rated outstanding in the community with five stars out of five, according to the Inside Guide to America's Nursing Homes for long-term care. 0 ***** 0 The McGuire learn. ofExperts The McGuire Rehabilitation Centers employ a team of over 30 licensed Physical and Occupational Therapists, specially trained support staff, and an on-staff Physiatrist/ Gerontologist. Together they ensure the highest level of individualized medical and restorative care. Cost Effective! Transfer =Inpatient Admissions I The McGuire Rehabilitation Centers' average charge per case is more than 35% WWER than other facilities in the nation, according to statistics from The Wall Street Journal and the American Health Care Association. To1let Transfer =Inpatient Discharge I =Outpatient Follow-Up Our case mix is consistent with the Northeast and national su bacute region. Our average statistics are: length of stay - 25 days; age - 78; admission FlM score 72.5; discharge FlM score- 97.6; FlM change- 25. 1 points; length of stay efficiency- 1.40; onset time- 17; discharge disposition- 80% to community. Based on 12 months ending March 3 1, 1998. The McGuire Rehabilitation Centers rely on the national The results are in. The McGuire Rehabilitation Centers have leading measurement tool for documenting patients' the clear advantage over other regional facilities based on FIMsM rehabilitative outcomes. This tool is known as FIMsM© improvement, discharge to home, and cost effectiveness. Instrument; Functional Independence Measure, developed ,.,... Our successful rehab program delivers results by the UB School of Medicine along with the Center for ~ ~ because of our superior staff, state-of-the-art equipment, Functional Assessment Research. It's used and specialized rehab facilities. Choose The along with the Uniform Data System for McGuire Rehabilitation Centers for five-star Medical Rehabilitation (UDSMRsM) rehabilitation services. to establish rehab outcomes that DTT ~JI'T""T""J\T Call l-888-POSTACUTE. can be measured and calculated .& ~~ ~\7~ c:MCGUL1?E ""J;'pU Jl W .J.L'1J '-.. -:::::U=Dom-i<MQ}!JJ:!!!j§UBF~--~ ~. Al rifFm =<d. Autumn View • Garden Gate • Harris Hill• Northgate BP 0004-00 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 2000 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2000-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v34n04-2000-Spring Table Of Contents A list of subunits of the resource. Rehabbing from Within Little Ears, Big Infections Brain Drain Student Column Medical School Pathways Development Classnotes Memorial Fund Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-14 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v34n04 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2000 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/cc869a60ddb94d9ea3a6c4035b92b899.pdf d5254410ff1823e31a6597ef6f13dfdf PDF Text Text �1111111 ••rsici•• ASSOCIATE VICE PRESIDE T FOR UNIVERSITY SERVICES Dr. Carole Smith Petro Dear Alumni and Friends, DIRECTOR OF PUBLICATIO Kathryn A. Sawner EDITOR As you can see, the magazine has a new look. With the beginning of the new millennium, its Editorial Board and staff decided now was a good time to update the publication's eight-year-old design and give it a Stephanie A. Unger ART D I RECTOR/DES 1 G N E R Alan]. Kegler "cleaner," more contemporary appearance. Most notable are the new cover masthead, designed to allow more room for the photo image, and the new typefaces inside, chosen ASSISTANT DESIGNER Lynda Harmel for easier readability. Also, the articles themselves are formatted in a more varied way in order to invigorate content and better convey the stories about our medical community. As always, your feedback is important and we hope you will e-mail, call, or write us with your comments. PRODUCTION CooRDINATOR Cindy Todd STATE UNIVERSITY OF One aspect of Buffalo Physician that hasn't changed is its goal of keeping its readers apprised of developments affecting our school. As we enter the new millennium, one topic that will be closely followed is the fact that EW YoRK AT BuFFALO ScHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. john Wright, Dean stewardship of increasingly scarce resources continues to represent our most significant and pressing challenge, a situation that will no doubt extend well into the years ahead. Superimposed upon significantly reduced state financial support (related to negotiated, but as yet unfunded, state salary increases) and significant reductions in hospital support (GME and Part A funding), we are headed for some difficult times indeed. In addition to the effects of managed care and the reduced hospital funding related to the 1997 Balanced Budget Act, we have yet to feel the effects of the pending, much publicized, GME-funding "reform"- a particularly critical issue for New York State. Those of you associated with other academic medical centers around the country are no doubt experiencing similar challenges. Despite all the gloomy financial projections, however, life does go on. A number of positive accomplishments over the past year are beginning to have effects. While work on the new curriculum is still in progress, some physical improvements have already been accomplished. Refurbishing G26 and Butler, our two major lecture halls, has been extremely well received and by late spring we hope to have renovated more appropriate student study space and offices for key student organizations. In addition, planning has begun for the redesign of Farber 144, our most challenging lecture room rehabilitation project thus far. When completed, the physical facilities available for medical education on the South Campus will not only be attractive but more functional and up to date. Finally, through their own initiatives, our students continue to inspire and motivate EDITORIAL BOARD Dr. Bertram Portin, Chair Dr. Martin Brecher Dr. Harold Brody Dr. Linda]. Corder Dr. Alan]. Drinnan Dr. ]ames Kanski Dr. Elizabeth Olmsted Dr. Stephen Spaulding Dr. Bradley T. Truax Ms.]ennifer Wiler Dr. Franklin Zeplowitz TEACHING HOSPITALS Erie County Medical Center KA.L£/OA HEALTH: Tire Buffalo General Hospital The Children's Hospital of Buffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital Roswell Park Cancer Institute Veterans Affairs Western New York Healthcare System CATI-IOLIC HEALTH S'iSTE.\1: Mercy Health System Sisters of Charity Hospital Niagara Falls Memorial Medical Center us all. Of particular note is their willingness (perhaps a more appropriate term would be "eagerness") to help one another. In addition to the Students Offering Support (S.O.S.) Program described in this issue of Buffalo Physician, student-run tutorials have cropped up at a variety of levels, in particular those involving sophomores helping freshmen. Although. faculty supervision is provided, it is really the students who drive these programs.! think you will agree that whatever this new millennium has in store for us, our graduates will continue to play a major role in shaping the future of medicine. 7 ~~ MD Dean, School of Medicine and Biomedical Sciences @TIE SUI£ IIIYIISITT IF 1£11 Tlllllllfflll Buffalo Physician is published quarterly by the State University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It rs sent, free of rharge, to alumni, faculty, students, resitients, and friends. The staff reserves the right to edit all copy and submissions accepted for publicatio11. S �VOLUME 34, NUMBER 0 p H y s c A Features The 'Insider' Steps Out Jeffrey Wigand, PhD '73, takes on the tobacco industry BY NICOLE PERADOTTO Back into Shape Help for osteoporotic compression fractures of vertebrae BY S. A. UNGER The Edge of Possibility Russell Crowe portrays Jeffrey Wigand in a.scene from The Insider. The film dramatizes the UB graduate'slife-shattering ordeal with the tobacco industry. Irwin Ginsberg, MD '44, otologist and inventor BY S. A. UNGER COVER PHOTO 20 New Roles for Dr. Carlos Pato and Dr. Mary Anne Rokitka 21 Dr. Charles Severin and Debra Stamm join OME 22 Students form rock band 25 Melatonin linked to bone growth 26 Research Institute on Addictions joins UB 27 $4.2 million NIH grant to study bipolar disorder 28 Han a Choe, Class of 2002, describes how new S.O.S. peer-support group was formed in response to survey of firstand second-year students 17 Robert E. Alumnus 31 Mark your calendars for Spring Clinical Day and Reunion Weekend 2000! 3D Thomas Frawley, MD '44, recalls faculty support; establishes endowment for research BY WILSON BAKER 35 Saar A. Porrath, MD '61, remembered JAN2 8 LIUuatif N ���First Whiff of Smoke copy of the minutes-one that had been cut down, the scientist says, to "two and a half pages of vanilla." In 1989, Wigand-who earned his doctorate in biochemistry at the University at Buffalo School of Medicine and Biomedical Sciences in 1973-accepted the most lucrative job of his career: a $300,000a-year position as vice president for research and development at Brown & Williamson, a subsidiary of British-American Tobacco. Presiding over 243 employees and a $30 million budget, Wigand was the senior scientist at the world's second-largest tobacco company, manufacturer of Kool, Viceroy and Capri cigarettes. To his former colleagues, it must have seemed like Wigand was sleeping with the enemy. After all, he had spent more than two "Missing were concepts and discussions that were very controversial and contentious-concepts that could prove an embarrassment during litigation. And I had no choice in the matter. I had to [sign off]."(A Brown & Williamson attorney has denied that documents were improperly altered.) Wigand was stunned: A lawyer telling him how to think about science? "That bothered me immensely," he recalls. But things got stranger still. According to Wigand, after the Vancouver conference the company held a "Caution in Writing" seminar, offering decades in health care, working as a director of corporate development for Pfizer, director of WIGAND REFERS TO THIS TIME-CHRONICLED IN THE marketing for Ortho Diagnostics Systems (a division of}ohnson & Johnson) and senior vice MOVIE THE iNSIDER-AS fHE PERIOD WHEN "ALL HELL president of marketing for Technicon, a company that sells blood-analysis equipment. BROKE LOOSE."H IS MARRIAGE WAS FALLING APART, Tobacco? "!thought I was going to be using my skills HE FEARED FOR HIS LIFE, A• D CBS HAD HIRED FORMER to make a difference-to make an intrinsically SECRET SERVICE AGENTS TO ESCORT HIS DAUGHTERS unsafe product safer for those who had to smoke. I thought I could do something that would TO SCHOOL. make a difference socially," says Wigand, who also holds a bachelor's degree in chemistry and a master's degree in biochemistry from UB. Ten months into his tenure at Brown & Williamson, howparticipants advice on "how to write, what not to write, who gets ever, Wigand caught his first whiff of smoke. Attending a meetcopies of what, who communicates with whom. A system was ing in Vancouver, British Columbia, he and other scientists created by which information was controlled and edited and vetted from British-American Tobacco's subsidiaries discussed possiby lawyers," he contends. bilities for safer cigarettes. Following the five-day meeting, At company parties, Wigand began overhearing colleagues Wigand returned to Brown & Williamson's Louisville, Kenusing code words: "Zephyr," for example, meant "cancer"; "Ariel" tucky, headquarters and enthusiastically circulated a 22-page and "Project 16" referred to smoking research Brown & Williamson summary of the meeting's minutes to his colleagues. A few days conducted during the 1970s. "These were documents I couldn't read. later, a company lawyer asked Wigand to sign off on a revised I was the senior scientific officer for the second-largest tobacco !I I l uffal• Pb pici11 W1nter 2000 �company in the world, and I couldn't get access to research documents," he says. By this time, Wigand had grown increasingly unsettled about his company's practices. It wasn't only the fact that his daughters, who learned about the dangers of smoking in school, were asking him, "Why do you do what you do?" He was also starting to grapple with that question himself. And yet, Wigand stayed. He stayed, he says, even after he realized that the company was not committed to a safer cigarette. He stayed even after repeatedly dashing with the company's thenpresident, Thomas Sandefur. The more questions he asked, the more isolated he became. Wigand says he felt like everyone was watching him and describes how his office was moved from a remote section of the building to an area adjoining the offices of the senior executives. Then, in March 1993, Wigand was fired. "I was between a rock and a hard place," he says, explaining why he didn't leave until forced out. "I had relocated my family, and I guess I just didn'twant to create havoc for them. "Don't mistake me," he adds. "I was looking for a job. But leaving the health-care industry to work in the tobacco industry and then trying to get back into health care is not a simple task." Wigand says he was fired after he objected to the use of the additive coumarin in pipe tobacco. After reading a study showing that the vanilla-like flavoring causes tumors in mice, he urged Sandefur to remove it from Brown & Williamson's products. "I felt that was enough to warrant that we take it out immediately. But I was told to mind my own business and to keep searching for another replacement. I took a stand and was fired two months later." (Brown & Williamson spokesmen have said that the company used safe levels of coumarin and that it does not use the additive anymore.) ix months after Wigand was fired, Brown & Williamson sued him for reportedly violating his confidentiality agreement by discussing his salary and health-care benefits with a former colleague. The company interrupted his severance and health-care benefits, which he especially needed for his daughter Rachel, who had been diagnosed with spina bifida. In order to have the suit dropped, Wigand reluctantly agreed to an onerous confidentiality agreement-one he would ultimately break. Couldn't Keep Silent Any Longer Jeffrey Wigand might have gone down as just another former tobacco executive- one of hundreds who leave the industry quietlyand take company secrets to the grave. "All I wanted when I left was what I was entitled to-my severance pay and retirement benefits," Wigand says. But when company executives decided to sue him, "it came back to haunt them," he adds. Winter 2000 l 1flal• Hysicin 5 �In early 1994, Wigand agreed to help Lowell Bergman, a producer for 60 Minutes, analyze documents from Philip Morris about that company's research into fire-safe cigarettes. "They code-named it 'Project Hamlet: To Burn or otto Burn,"' Wigand remembers. As it turns out, Wigand wasn't the only one worried about lawsuits. CBS executives feared that Brown & Williamson would charge them with "tortious interference," claiming that they had induced Wigand to break his confidentiality pact. In an unprecedented and embarrassing move by the network, CBS shelved the interview in the fall of 1995. she poured through the documents, his anger mounted. "The industry has always said [a fire-safe cigarette] was a technical impossibility. And then I read in those papersproduced by Philip Morris in 1985 and 1986-that they had developed a fire-safe cigarette and had tested it against their leading product, Marlboro, and had found it equal to Marlboro. But they elected not to put it into the marketplace because there was no legislation that forced them to." (A Philip Morris spokesman has said in previous published reports that the company has been unsuccessful in creating a fire-safe cigarette, but that research on Wigand refers to this time-chronicled in the movie The Insider-as the period when "all hell broke loose." His marriage was falling apart, he feared for his life. CBS had hired former Secret Service agents to escort his daughters to school. He kept a gun in his house. When he traveled, he used assumed names and unmarked entrances. I it continues.) Bergman quickly came to realize that Wigand had more to offer than his work as a paid scientific consultant. He had a story to tell-one that no one had told before. Unaware that Wigand had signed a confidentiality agreement, Bergman began pushing him to go public. Meanwhile, Wigand's name began making the rounds within the antitobacco crowd. He became an advisor to the Food and Drug Administrationusing the code name "Research"-and served as a witness in several federal inquiries into the Out There. Naked. After the 60 Minutes debacle, Wigand's name was leaked to the press, along with lengthy excerpts from his interview with Mike Wallace. Four days after the story broke, Brown & Williamson sued Wigand, with the company's lawyers instructing him to appear in a Kentucky court for violating his confidentiality agreement. Defying the Kentucky order, Wigand traveled to Mississippi. Facing possible contempt proceedings, he went ahead and testified in that state's massive lawsuit against tobacco companies to recoup Medicaid money paid out for smoking-related illnesses. "I didn't go to jail," Wigand says. "But the threat was very real." «HAD IT NOT BEEN FOR JEFF WIGAND AND tobacco industry. INDIVIDUALS LIKE HIM COMING FORWARD A. D Then, on April 14, 1994, the CEOs of seven BASICALLY DRAWING ATTENTION TO THE TOBACCO tobacco companies sat before the House SubcomINDUSTRY, WE WOULDN ' T HAVE HAD THE TOBACCO mittee on Health and the Environment and testified under oath that they did not believe nicotine SETTLEMENT." -K. MICHAEL CUMMINGS, MD was addictive. As Wigand watched his ex-boss, Sandefur, raise his right hand, something in him snapped. "That's when I knew that if I kept silent any longer I would be just as culpable asanyofthe men on TV. !just After Wigand testified in Mississippi, a reporter with the Wall couldn't live with my conscience anymore. Somebody had to do Street journal obtained the sealed deposition and reproduced excerpts it," he says. from Wigand's allegations of company misdeeds. (It was Within weeks, a man called his house twice, warning Wigand to keep an eye on his daughters. Confidentiality Disagreement In August of 1995, Wigand agreed to a 60 Minutes interview. Yes, he would discuss what he knew of Brown & Williamson's use of coumarin. Yes, he would discuss how the documents about safer cigarettes had been cut. Yes, he would say that he believed Sandefur perjured himself when he said he believed nicotine wasn't addictive-but only if CBS promised to cover his legal costs in the likely event that Brown & Williamson sued him. 6 lulfalt Pbysiciu Winter 2000 only then that CBS aired the interview- a bowdlerized version on the network's evening news and the complete version on 60 Minutes.) Less than a week later, the Wall Street journal reported on another story related to Wigand-a 500-page dossier prepared by his former employer titled "The Misconduct of JeffreyS. Wigand Available in the Public Record." In an attempt to discredit him, investigators working for Brown & Williamson combed through Wigand's past. They read his PhD dissertation for possible plagiarism and searched his resume for misstatements. They even looked into his demands that an airline reimburse him for a cleaning bill after his luggage was returned wet. �is "an American hero." "There have been many people who got out of the industry and have insider information, but very few who have spoken out. He spoke out against the industry, causing great disruption in his life," says Cummings, adding that Wigand is today serving as a consultant on a Roswell Park project to determine a protocol for testing nicotine During production of The Insider, Jeffrey Wigand, left, meets his film counterpart Russell Crowe (second from the left) and lowell Bergman (rigbt) meets AI Pacino (second from the rigbt), who portrays him in the film. delivery devices. "Had it not been for Jeff Wigand and individuals like him coming forward and basically drawing attention to the tobacco industry, we wouldn't have had the tobacco settlement," Cummings points out. " ... .. .. . .• ® .. . . ... ....• In its article on the contents of the dossier, the Wall Street Journal concluded: "A close look at this file, and independent research by this paper into WIGAJ. D WAS STUNNED: A LAWYER TELLING HIM HOW key claims, indicate that many of the serious TO THINK ABOUT science? ((THAT BOTHERED ME allegations against Mr. Wigand are backed by scant or contradictory evidence .... Some of the IMMENSELY." BUT THINGS GOT STRA. •GER STILL. charges ... are demonstrably untrue." I had people inspecting every aspect of my life," Wigand recalls. "And they took it all out of "Jeff Wigand showed just what price you are going to pay if context. Because I went after somebody because my luggage was defect," adds Joe Cherner, president of Smoke-Free you ruined in transit doesn't mean I falsified a claim. In the end, I must Educational Services. say that it backfired on them. But that was a hard place to be. Out Wigand doesn't want to discuss the most severe price he paid by there. aked . speaking out-his marriage, which collapsed under the pressure "It was a terrifying time in my life. This wasn't for the faintof that period. And yet, if he had to do it over again, he says he hearted. Many people would not have given me good odds of wouldn't hesitate. surviving, much less succeeding." "I have no regrets about what I did. I would do it again ifl had to. Hopefully, history will reflect what I did as something that was No Regrets honorable-something others will take as a lesson. ' ' I n June of 1997 the proposed multibillion-dollar settlement "I take no small satisfaction in the role I played-no small of the Medicaid suit that originated in Mississippi was held satisfaction," he adds. "I continue to spread the word. And I will up by one sticking point: Brown & Williamson's lawsuit not stop spreading the word." 4D against Jeffrey Wigand. After a series of closed-door meetings, company executives finally agreed to drop the suit, allowing the settlement to proceed and Wigand to get on with his life . Today he's a high school teacher in Charleston, South Carolina, and the head of Smoke-Free Kids, an organization he founded that educates children about the perils of smoking. "I use actual industry documents and experiments and examples from the silver screen and advertising to help them make healthy and educated choices," he explains. To K. Michael Cummings, MD, director of cancer prevention at Roswell Park Cancer Institute, Wigand Winter 2000 I I If Ill n J SiC iII 7 ��I New treatment for osteoporotic compression fractures of the venebra BY PHOTO BY JosH LEVI S. A . u GER E Winter 2000 ltffal1 Pbrsicial 9 �lee Guterman, PhD, MD THE PAST, when an osteoporotic compression fracture occurred, there wasn't much physicians could do for their patients. More often than not, standard treatment included pain < T medication, bracing and bed rest. Today, however, the outlook for treatment of these fractures is considerably brighter due to the introduction of a new procedure called percutaneous vertebroplasty, the goal of which is to strengthen injured vertebral bodies by filling them with a type of bone cement traditionally used by orthopedic surgeons to affix prosthetic implants. Currently, this investigational procedure is being performed by only a small number of physicians in the United States, one of whom is Lee Guterman, PhD, MD '89, assistant professor of neurosurgery at the University at Buffalo's School of Medicine and Biomedical Sciences. According to Guterman, percutaneous vertebroplasty was developed by a group of physicians in France in the mid-1980s and popularized in the United States in the mid-1990s by colleagues of his at the University ofVirginia in Charlottesville-Jacques Dion, MD, and Mary Lee Jensen, MD-both of whom are radiologists. In the past year, Guterman, who practices at Kaleida Health's Millard Fillmore Gates Hospital, has completed more than 20 percutaneous vertebroplasties. Dedicated to teaching the procedure to other specialists around the country, in May 1999 he taught a course at the American Association of eurological Surgeons in New Orleans, and in October he traveled to Boston, where he taught a course at the Congress of Neurological Surgeons. Recently, he served as a member of a committee that developed standards of practice guidelines for percutaneous vertebroplasty. * Needle Placement with fluoroscopic Guidance Patients undergoing percutaneous vertebroplasty receive local sedation and are awake throughout the procedure. A needle similar to that used for bone marrow biopsies is used to penetrate the injured vertebra. Precise placement of the needle is accomplished using fluoroscopy, a form of real-time X-ray that enables the surgeon to visualize the needle tip and follow its progression in three dimensions. The cement-called methyl methacrylate-is injected via the syringe into the fractured vertebra and must be mixed with carefully timed precision because it begins to harden in minutes. Before the cement is prepared, however, surgeons first must perform vertebral venography, which accomplishes several things: It helps confirm needle placement within the bony trabeculae, 10 lu ff a le Plysici11 Winter 2000 clarifies definition of the fractures in the bony cortex and, most importantly, according to Guterman, outlines the venous drainage pattern. "The vertebral body is made up not only of bone, but it's also made up of veins that drain into the vena cava," he says. "So the first thing we do is inject a contrast medium to see what the venous drainage pattern is. If it is very fast-flowing, there's a chance the cement will enter the vena cava and be carried up to the heart and into the lungs." According to Guterman, if a fistula, or direct connection, is found between the vertebral body and vena cava, the surgeon has several options. "To shut off that connection," he says, "you can take cement that is at a stage where it is ready to solidify and inject it more slowly, which closes off the pathway. Then you can approach from the opposite side and fill up the vertebral body from there. I also sometimes use small sponges made of collagen foam to seal the passageway, then go ahead and insert the cement." Once the venograph has confirmed placement of the Left is an X-ray of a vertebra prior to percutaneous needle and a safe vertebroplasy, and right is an image of the same venous drainage pat- vertebra filled with the methyl methacrylate material. Once the procedure is completed. tern, the surgeons mix patients can ambulate after two hours bed rest. �Vertebral bodies are strengthened by filling them with a quick·setting bone cement. the ingredients of the cement until a "toothpaste" or "cake glaze" consistency is reached, at which time it's ready for insertion. Because the material is not sufficiently radiopaque, chemical compounds containing either barium or tungsten powder are added to it at this time. "By doing this, we opacify the cement, which means it will scatter X-rays, so when we inject the material we can view it much like you would view an angiogram," Guterman says. In general, complications for percutaneous vertebroplasty are rare. One important reason why surgeons need to view the cement as closely as they do, however, is to avoid the procedure's most serious potential complication-epidural overflow with spinal cord compression. ormally, the procedure takes approximately one hour, depending on how many vertebrae are treated. Guterman says he routinely treats two levels per session, and sometimes up to three. Once the vertebroplasty is completed, the patients rest in bed for a minimum of two hours in order to assure that the cement sets properly. After that, they are free to ambulate and resume normal activities. Vertebroplasty'sFuture: AWork in Progress uterman reports that 70-80 percent of the patients he has treated with vertebroplasty have experienced improvement in symptoms; he also notes that Drs. Jensen and Dion at the University of Virginia recently completed a study on 100 patients in which they demonstrated a decrease in pain, a decrease in patients' use of narcotics and improved ambulation. The procedure is currently not approved by the Food and Drug Administration; however, clinical trials are planned, and Guterman anticipates participating in a controlled study at UB in the near future. While percutaneous vertebroplasty has proven to be effective for a growing number of patients, Guterman emphasizes that the procedure is not for everyone and that proper screening of patients is essential to success. "People have back pain for a lot of reasons, and often they have multiple complaints, especially if they are older," he says. "They could have osteoporotic compression fractures, but they could also have degenerative disease or a herniated disc. However, if they can identify one spot in particular that is painful and you take an X-ray and find there's a fracture, then there's a reasonable certainty- maybe 80 percent- that vertebroplasty is going to work. It's not going to cure them of osteoporosis and it's probably not going to take away all their pain, but it will very likely take care of the pain that's due to that fracture. " In looking to the future, Guterman predicts a day when percutaneous vertebroplasty will be used preventively, with significant savings in health-care costs. "I can see the dayand this is conjecture on my part-where imaging technology will be used to identify high-risk patients who are then treated prophylactically with the type of bone cements we are using today or yetto-be developed materials that either regenerate bone or bolster it so fractures don't occur in the first place," he says. "The savings in the area of rehabilitation alone would be huge because patients with multiple osteoporotic compression fractures usually never recover full function. " In addition to osteoporotic compression fractures, percutaneous vertebroplasty is also being used for malignant tumors of the bony portion of the spine, according to Guterman. "This does not cure the tumor, of course, but if a patient is experiencing significant pain and can't ambulate because of structural problems, vertebroplasty is one method for dealing with this limitation." Guterman has already seen notable improvements made to the way vertebroplasty is performed and reports that "a company called Parallax Medical has devised a new method for delivering the cement, which is extremely helpful; it changes the whole procedure and, in my opinion, makes it much easier." Teaching other neurosurgeons about vertebroplasty is a priority for Guterman. " eurosurgeons are very well suited for vertebroplasty because they typically operate on the spine and are able to understand radiographic anatomy of the spine," he says. "Also, they have to use the same trajectory to put the needle in that they would use to introduce a pedicle screw for spine fusion, so it's just another step to instruct them in how to properly insert the cement." While few physicians in the United States are currently trained to perform percutaneous vertebroplasty, Guterman anticipates that this will change as ongoing studies confirm its benefit to patients suffering from osteoporotic compression fracture or malignant spinal tumors. "We're finding this to be a very effective procedure," he concludes. "It works." CD *The standards ofpractice guidelines were developed under the auspices of the American Society of Neuroradiology, the American Society of Interventional and Therapeutic Neuroradiology, and the American Society of Spine Radiology. The committee on which Dr. Guterman served was co-chaired by john D. Barr, MD, and fohn M. Mathis, MD. W i11 t e r 2000 1 111111 nysiciu 11 �p H B y F R A 0 T 0 S S T 0 ~ K R y By S. A. 12 L' �Working at the Despite the fact that his field has developed at such a brisk pace over the course ofhis career, Ginsberg was not a man to be left behind. By the time he retired from active practice in 1997, he was widely regarded as one of Buffalo's finest ear surgeons. A hugely extroverted man with a flair for energetic joke telling, Ginsberg is also known for his warm bedside manner, his generous mentoring of students, his quick mastery of basic science and his downright uncanny ability to understand and engineer biomedical devices and instruments. Given that he is now planning to bring to market a state-of-the-art device he invented for the removal ofear wax, the question perhaps is not whether Irwin Ginsberg has kept up with technology, but whether technology has kept up with Irwin. leci~ilf u lee••• a lutu It was through Ginsberg's love of the automobile that his talent for science and engineering first became evident. Some of his earliest memories are of refusing to go to sleep at night until Otologist Irwin Ginsberg, MD '44-surgeon, educator, researcher and inventor-reflects his mother let him play with a set of toy cars with which he was infatuated. As an adult, this interest translated into a fascination with owning and renovating vintage automobiles, and by mid-career he was full tilt into amassing what was to become one of the best classic-car collections in the world. But it wasn't Ginsberg's innate technical abilities that drew him to medicine and surgery; it was the near death of his mother when he was six years old. "She had a ruptured appendix, was riddled with peritonitis and was admitted to Buffalo General Hospital under the care of Dr. Marshall Clinton," the 78-year-old Ginsberg recalls. ''I'll never forget it. I can still see the room: It was on Michael Corridor on the third floor. Every time I walked down that corridor when I was an intern and a doctor, I remembered the time my mother was a patient in that room." Ginsberg especially remembers going to the hospital one day with his father and overhearing Dr. Clinton say, ''I've done all I can do. All I can tell you is to go home and pray. It doesn't look very good." "I heard that and if affected me deeply," Ginsberg says. "As it turned out, she was on death's door for three weeks and then suddenly went through some sort of crisis and recovered. I remember the day Dr. Clinton put his arm around my dad's shoulder and told him we could take her home in a few days. I knew right then and there that's what I wanted to be-a doctor. on fifty years of change. II r 11 t er 2 0 0 0 1111a11 nrsicin �I just figured you had to be something really great if you could do that for somebody; if you could help a boy get his mom back." T a·ning at Home and Abroad Upon graduation from Bennett High School in 1938, Ginsberg entered premedical studies at the then-University of Buffalo. By 1941 he had earned a degree in chemistry and was admitted to the university's School of Medicine. "We finished in three years at that time because doctors were wanted for the war, so they put us all through an accelerated program, which meant we went to school during the summer, too," Ginsberg says. "I was only 22 when I received my medical degree, and I had gotten married just a year earlier," he adds, explaining that this was a time of great change in his life. Following his graduation in 1944, Ginsberg completed his internship at Buffalo General Hospital, after which he served in the navy for several years. Upon discharge from the service, he moved to ew York City to pursue studies in surgical pathology and research at Columbia Presbyterian Medical Center. He completed his residency in surgery at Mount Sinai Hospital in 1948 and the following year returned to Columbia Presbyterian Medical Center to begin a residency in otolaryngology, training under Edmund Fowler, MD, whom he considers to be one of his foremost mentors. Asked why he chose to specialize in otolaryngology, Ginsberg explains, "When I was rotating through the head and neck department during my general surgery training, I fell in love with the ear, just pure and simple, because of the beauty of it. And I'm still in love with it; it's never tired me out because when you work with the ear, you're often working at the edge of possibility and so that has been a great challenge for me." Ginsberg's appreciation for "working at the edge of possibility" and his aptitude for engineering merged in a fortuitous way while he was completing his residency in otolaryngology and was strapped for funds. During this time, he became aware of a research project at the medical center in which investigators were l alfal1 Plysici11 Wi11ter 2000 measuring the electrical potentials for the stomach in an effort to develop a method for early detection of stomach cancer. In order to do this, they needed to place a silver-silver chloride electrode in one lumen of a Miller-Abbott tube, a task that was proving difficult because the electrode had to be housed in a tiny piece of Lucite machined out of a Lucite rod. "They couldn't get anybody to make those pieces because they were so small, and they drove people mad," Ginsberg recalls with a chuckle. "So I said I could make them. I went down to Canal Street and bought a wrecked jeweler's lathe for eight dollars, put new bearings in it, got a pair of Zeiss twopowered magnifying glasses and developed a technique for making the electrodes," he says. "They worked pretty well, and they helped me get through my residency and support my wife and two children." When Ginsberg completed his training in otolaryngology, his professors declared him "a good technician" and recommended that he go to Europe for further training. "In those days, they'd say they were sending you to Europe to 'get polished,"' Ginsberg recalls. He spent 18 months abroad and completed a fellowship at Guys Hospital in London, where he trained with Robert J. Cann and Sir Victor egus, as well as with other surgeons of repute in Switzerland, Sweden, Scotland and Denmark. The Golden Da so C OS ge Once his training was completed, Ginsberg decided to return to Buffalo, despite having offers to join practices in London and New York City. "I like Buffalo as a city, and my family was here, so I decided to return here to live," he says. "I opened up an office at 333 Linwood, a building that had many E T men in it at the time, and I did very well." So well, in fact, that in 1968 he built his own office building at 897 Delaware Avenue, which today remains one of four locations for the Buffalo Otolaryngology Group. It was during those first years when Ginsberg was in private practice-in the early 1950s-that stapedectomy came to be standard surgical procedure for the treatment of otosclerosis, a �IN ]UNE 198J, DAVID RADLIN, AGE 10, TOOK A RIDE WITH DR. lRWL GINSBERG IN HIS VI 'TAGE PACKARD. DAVID's FATHER, BARRY RADLI ',REMEMBERS THIS RIDE WITH FO 'D. ESS BECAUSE, WHILE E.' ROL'TE, DAVID HAD A TALK WITH DR. GI. 'SBERG A 'D DECIDED HE WOULD WEAR HIS HEARING AIDS AT SCHOOL, DFSPITE THE I-ACT THAT HE WAS BEl TG TEASED BY HIS CLASSMATES. I T 1996 DAVID GRADUATED FROM SYRACUSE UNIVI:.RSITY WITH A DEGREE L' RETAIL AND MANAGE 1E T AND HASSI. TCE EMBARKED ON A CAREFR IN VISUAL DISPLAY. hereditary ear disorder that causes deafness due to growth of excess bone in the middle ear. Ironically, stapedectomy was the first medical procedure in which microsurgery was utilized, and in mastering this technique, Ginsberg couldn't help but recall his early work making electrodes with the aid of Zeiss magnifying glasses. "The golden days for microsurgery were when stapedectomy was perfected," he recalls, "but the most dramatic thing for a surgeon was realizing you could help someone who was deafhear. The operation was done under sedation, so while the patients were still on the operating table, they'd say, 'Oh, it's wonderful, doctor. I can hear!' I tell you, that was a great feeling." ot so great, however, are his memories of the patients no surgical intervention could help. "When a mother would bring her new baby to me and say, 'I wonder if my child can hear or not,' and I knew very quickly he couldn't, sometimes I'd have to walk out of the office to compose myself before I could talk with the mother and tell her her baby was deaf, with all that such a diagnosis entails. It's an awful sentence to give someone." Ginsberg says that children who are deaf or hard of hearing are in special need of support and encouragement. He recalls fondly a case of a 10-year-old boy, David Radlin, who resolutely refused to wear his hearing aids because he was teased mercilessly at school. In desperation, his father, Barry, brought him to see Ginsberg. "I took him for a ride in my Packard with the top down, and afterward he decided he'd wear the hearing aids," Ginsberg remembers with a laugh, adding, "You have to support them all, support them like mad!" P onee ng Coc ea Imp an s In 1968 Ginsberg hired Thomas P. White, MA, MBA, as his audiologist, and the two have worked together ever since. White, who holds a joint appointment as an assistant professor in the Wir~ter 2000 l1ffale Hysiciu 15 �WORKING A T T H E E Department of Communicative Disorders and Sciences at the University at Buffalo, worked with Ginsberg in the early 1980s to develop the first comprehensive cochlear implant program in Buffalo. "Our group always prided itself on being up on state-ofthe-art developments, so we had kept our eye on the implants for a number of years as the procedure was going through its early stages of experimentation," he says. In 1984, Ginsberg decided it was time to move ahead with learning the procedure himself, so he took White to Europe, where they traveled to England, Germany, Switzerland and Austria to talk to and observe surgeons performing the implantations. In Vienna they met with electrical engineers Erwin and Ingeborg Hochmaier, who had designed a cochlear implant called the Vienna Device. "Dr. Ginsberg liked this device best because it had a special application in that the electrode that did the stimulation didn't enter the inner ear," White explains. "And he felt this was an important difference because the inner ear is a very delicate structure, very small, and he didn't want to ram a wire in there. Too, he didn't want to rule out the possibility of future developments." Upon returning to Buffalo, Ginsberg was anxious to begin performing cochlear implantations, but the Vienna Device, which was being manufactured in the U.S. by the 3M Corporation, was still in the process of being tested by the Food and Drug Administration (FDA) and was only available through 10 clinical trial sites, all of which had already been set up. Through persistent efforts and a little good luck, Ginsberg's practice was eventually named a test site when one of the original investigators dropped out of the trial. In 1985, therefore, he began performing the procedure according to the strict FDA guidelines. "We did about 10 patients at the start, and it was a very emotional experience for all of us," White says. "You wait about a month for healing to take place, and then you stimulate the device with the external equipment. When a person tells you that he's hearing something for the first time in his life, it evokes very strong feelings. And often the patients cry." g Researc ing n en g White says Ginsberg contributed greatly to the education of audiologists in Buffalo by teaching at UB and opening his practice to students. "When I was hired, Dr. Ginsberg agreed to make his office accessible to audiology students from the university. Anybody who wanted to could come down to his office and, under supervision, get experience testing in a real environment. And I 16 l1ffaf• Hysicin Wi11ter 2000 D G E 0 F POSSIBILITY think his professional commitment to the emerging field of audiology has been exceptional. It has really made a difference for the students." In addition, Ginsberg volunteered his time to teach a seminar at UB called Clinical Otology for the Audiologist. "Throughout his career, he always treated audiologists as colleagues," says White. "And he always supported our field because he felt audiologists helped him to find better ways to treat patients." In the late 1980s, Ginsberg founded an Ear Research Laboratory to study temporal bone anatomy. Although the laboratory is no longer in existence, scientists at UB today acknowledge that Ginsberg's laboratory was in many ways a precursor to presentday laboratories at the university that focus on basic science inquiries into hearing and deafness. One such scientist is Richard Salvi, PhD, professor of communicative disorders and sciences in the College of Arts and Sciences, clinical professor of otolaryngology and neurology in the School of Medicine and Biomedical Sciences and co-director of UB's Center for Hearing and Deafness. "Dr. Ginsberg has been one of Buffalo's best ear surgeons for many years, and he's made significant contributions to the field of otology in this city. Recently I invited him to come and give a lecture to my students, and he brought along with him a device called the Earigator that he has invented to remove ear wax," says Salvi, who agreed to let Ginsberg demonstrate it on him before the class. "The device is incredibly well designed; he's worked all sorts of clever features into it that are really remarkable, and it works very well." Ginsberg is pleased with his new device, too, and says that it's in the process of being commercialized. But the Earigator is just one of many ongoing projects for this protean ear surgeon, who insists he's only "semi-retired." Recently, he passed an important personal milestone in his life when he auctioned off his beloved classic-car collection. "It was sort of a heartbreak to sell, but what do you do with things like that in my stage oflife?" he asks. "I drove in a Mille Miglia [a 1,000mile race along the coast of California] about six years ago, but that was stretching it. I was in my 70s, and I decided I didn't want to spin out anymore." Ginsberg may not be spinning out in auto races anymore, but he's also not sitting back in the slow lane, watching the world go by. As Salvi observes, "Dr. Ginsberg's at an age when most people would be lying on the beach, relaxing, but he's sharper than ever, and he's still contributing to his field." CD �MEDICAL S C H 0 0 L E W S 1999 Distinguished Medical Alumnus Named Nationally Recognized Allergist and Immunologist RoBERT E. REISMAN, MD '56 clinical pro- and aside from his exceptional professional fessor of medicine and pediatrics, received expertise-for which he is sought after by the Distinguished Medical Alumnus Award physicians and patients all over the Westfrom the University at Buffalo School of ern ewYork area-he is one of the genMedicine and Biomedical Sciences at a din- tlest, kindest and most thoughtful doctors ner held in his honor on September 23, I have ever encountered. He is one of a 1999, at the Buffalo Club. small cadre of physicians who always A 1956 graduate of the medical school, listens to his patients' Reisman is an attending physician and complaints." allergist at Kaleida Health's Buffalo Although Reisman General Hospital (BGH) and Children's has been a full-time Hospital. In addition, he served as co- practitioner throughdirector of the Allergy Research Labora- out his career, he has tory at BGH, in the Department of also managed to Medicine at UB from 1970 to 1990. conduct a superb Over the past four decades, Reisman research program in has integrated into his career the varied allergic diseases, pursuits of clinical medicine, research, according to Kasteaching and dedication to the allergy- sirer. "With Dr. Carl immunology discipline. He has authored Arbesman, he eluciover 200 articles, papers and book chap- dated many fundaters, many of which address clinically mental aspects of allergic diseases, relevant issues in anaphylaxis, asthma, especially the mechanisms of insect drug allergy and stinging insect allergy. He allergies," he explains. is co-editor of the allergy-immunology text Reisman's service to his field includes Expert Guide to Allergy and Immunology, the presidency of the American Academy which was published in 1999 by the of Allergy, Asthma and Immunology; American College of Physicians. In addi- chair of the American Board of Allergy tion, he has played a major role in the and Immunology; a member of the Ameritraining of allergy-immunology specialists, can Board oflnternal Medicine; and chair as well as students, residents and other of the Residency Review Committee of the practicing physicians. American Medical Association for Allergy Jerome P. Kassirer, MD '57, former and Immunology. In 1993, he received the editor-in-chiefofthe New England journal prestigious honor of being awarded the of Medicine, nominated Reisman for the Mastership in the American College of award. "Dr. Reisman was a year ahead of Physicians, one of only 15-20 such awards me in medical school in Buffalo and was bestowed by the college each year. CD my resident at Buffalo General Hospital _ s . A . u N 0 E R when I was an intern there nearly four decades ago," he says. "''ve followed his career closely since that time, and he is one of the most impressive physicians I have known. He has become one of the most highly respected practitioners in Buffalo, Wint e r 2 000 Lett to right: Jerome Kassirer, MD. Rena Reisman. and Hoben Hersman, MD l affale Hysiciu 17 �MEDICAL SCHOOL N E w s he Primary Care Summer bternship Program wishes to extend a heartfelt thank you to all the preceptors who continue to make this program a success. Many of these physicians volunteer their time year after year to ensure that students experience the true practice of medicine early in their careers. The program, which has just concluded its seventh year, offers first- and second-year medical students a paid six-week externship during the summer months. Students are placed in the offices of generalist physicians throughout Western New York, where they enjoy varying degrees of interaction with patients, incl uding taking histories and performing physicals, while participating in the daily operation of an office. Jennifer Paglino Adamson Richard Ruh. MD Mark Swetz, MD Steve Lana, MD Antoinette Alonzo Thomas R. Gerbasi, MD Victoria Amodeo Angela Ferguson, MD Amy Braun Chester Fox. MD Audrey Chan G. Jay lishop, MD Kristin Clark Andrea Manyon. MD Ellen Rich, MD Jennifer Clementi Anthony 0. Jesse Cone Bartholomew, MD Jeffrey Conklin Thomas S. Scanlon. MD John Brewer, MD Neu Daley J. Thomas Reagan, MD Cheri Dwyer Keely Dwyer Dawid Holmes, MD Kimberly Erway Colleen Mattimore. MD Mary Schamann. MD George Figueroa John Thompson. MD James Galas Gaurang Sheth, MD Anjeli Gupta Nicholas Aquino. MD Aaron Guyer Brad Truax. MD Mark Haggerty Ann Marie Hedges Gregory Jobes Michael Kader Steven Kam Brian Kenjarski 18 l l l l al• Hys iciu Family Medicine Pediatrics Pediatrics Family Medicine Internal Medicine Family Medicine Internal Medicine Internal Medicine Internal Medicine Family Medicine Family Medicine Family Medicine Pediatrics Family Medicine Pediatrics Medicine /Pediatrics Independent Health Administration Independent Health Brad Truax. MD Administration Jane M. Parmington. MD Pediatrics Internal Medicine Dnid Milling, MD Internal Medicine Jack P. Freer, MD Independent Health Brad Truax, MD Administration Independent Health lrad Truax. MD Administration Wi11t e r 2 000 The externship program is currently supported by anumber ofsources, including the Charles E. Culpeper Foundation, the Independent Health Foundation, the Lake Plains Community Care etwork, and the New York State Department of Health. There is also an opportunity for individuals to support the program; for example, a special endowment fund has been established by Evan Calkins, MD, to develop a more consistent funding source in this age of decreasing capital. For more information about the Primary Care Summer Externship Program or giving opportunities, please contact Susan Orrange at (716) 829-2917/2012 or e-mail her at sorrange@buffalo.edu. c:D Duid Kim Ellis Gomez. MD John Sauret, MD Danielle LaPrairie Ashok Naik, MD John Jaeger. MD Eileen Lau Chelikani Y.P. Varma, MD G. Lawrence McNally, MD Sabina Lim Frank C. Menadri, MD Leah Millstein Dwight Lewis. MD Morcos Morcos Howard Sperry, MD Dhruti Naik Michael Ndegwa Njuguna Richard Castaldo, MD lrenda Perez lrad Truax. MD Sara Ponkow Rebecca Puchalski Karena Steiding Andrew Swan Juliane Thurlow Steven Weitzman larbara Stouter, MD Catherine O'Neil, MD Janet Sundquist, MD Theodore Putnam. MD Peter Kowalski. MD Harry Metcalf, MD Donald Robinson. MD Charles Hershey, MD Frederick Downs. MD Ashok Naik, MD John Jaeger. MD Peter Winkelstein. MD Sanford Levy, MD Mark R. Klocke, MD Michael J. Aronica. MD Debra Wojtanik Robert Wong Adam Wychowski Dana Yip Jack F. Coyne, MD Raphael Wang, MD Gregory Snyder. MD John Fudyma. MD Robert Ramsdell Laura lendano Teresa Russell Dnindra Seelagan Robert Setlik Jonathan Siuta Kristen Smini Family Medicine 01/GYN Pediatrics Pediatrics Medicine/Pediatrics Family Medicine Internal Medicine Internal Medicine Independent Health Administration Pediatrics Internal Medicine Pediatrics Family Medicine Family Medicine Family Medicine Internal Medicine Family Medicine 01/CYN Pediatrics Internal Medicine Pediatrics Medicine/ Pediatrics Pediatrics Pediatrics Family Medicine Internal Medicine �Through the (yes of aStudent I I I Neva Daley , Class of 2001 Preceptor: John Brewer, MD, Upper West Side Family Health Center Public Heahh \ externship at the Upper WestSide Family Health Center with much anticipation. I was unsure what to expect, but I knew I would enjoy the diversity that family medicine has to offer. As the externship progressed, I began to realize that the benefit of being an extern in this particular clinic went far beyond practicing clinical skills. Yes, I was receiving fine clinical teaching from the various physicians and nurse practitioners, and I was also getting an introduction to the complexities of practicing medicine in an underserved community. The patients were primarily African American and Hispanic of low socioeconomic status. I learned the importance of having just as much respect for patients in poor economic situations as I would for those from a suburban middle class environment. I observed how the physicians addressed the components of the lives of each of their patients with thoroughness and sensitivity. Issues prevalent in this underserved population included affordability of medication or physical therapy if not covered by insurance, transportation costs to a referred physician, lack of compliance for follow-up visits, abuse of (even the sale of) pain medications, poor family planning and contraceptive use, and domestic violence. A significant proportion of the patients also were refugees from Eastern Europe, the Middle East, Vietnam, and Africa. Due to the large number of refugees treated at the clinic, I had to use an AT&T Translator Service with several patients. During the course of the summer, I was able to help deliver care to three members of a family who were among the first wave of refugees from Kosovo. One had been severely beaten by Serbian soldiers before his arrival to the United States. I was humbled to be able to help those who had endured such hardships and brutality. Each of the refugees I saw this summer expressed so much gratitude for the care they were given, and I felt deep satisfaction. It amazed me that I had reached a stage in my medical education where I could help the poor in this manner and have a true impact on the lives of others. !twas as if my childhood dreams of maybe one day serving in an international capacity were slowly unfolding- right here in Buffalo. CD Winter 2000 lallale ••rsiclu 11 �M E D C A L SCHOOL E W S Mary Rosenblum Somit Scholar hip a he Assisting undergraduates in the School of Medicine and Biomedical Sciences UNIVERSITY AT BUFFALO SENIOR Diana Pratt, who volunteered this summer to help deliver needed medical services to villagers in remote areas of the Himalayas, is the first recipient of a Mary Rosenblum Somit Scholarship. The award, made possible by an endowment established by former UB executive vice president Albert Somit, provides Pratt with a $1,800 scholarship for the 1999-2000 academic year. Somit, who served as the university's acting president in 1977, says he established the endowment "to honor my mother, who like so many others of her generation, left family, friends and all that was familiar in Russia to seek a better life for themselves and their children." Widowed when Somit was four, Mary Rosenblum Somit continued to work hard at several low-paying jobs to ensure that her son would be able to attend a good college. Somit initiated the scholarship fund through a $75,000 bequest commitment to benefit "hard-working and deserving undergraduate students" in the UB School of Medicine and Biomedical Science . Deciding he wanted to see immediate results, Somit has given additional gifts so he could activate the fund and meet the needs of students like Pratt, who he says is "precisely the sort of student I had in mind. " Pratt, whose goal is a career in medicine, was part of a group that recently returned from a 28-day trek to India led by UB professor of medicine Richard Lee, MD. Currently, she is pursuing a bachelor of science degree in medical anthropology and special studies and expects to graduate in May 2000. Pratt notes that although her journey to the Himalayas was exhausting and demanding due to precarious trails and high CARLOS P ATO, MD, associate professor of psychiatry and adjunct associate professor of pharmacology and toxicology, has been appointed associate dean for clinical affairs in the School of Medicine and Biomedical Sciences. Pato will work directly with John Wright, MD, dean of the School of Medicine and Biomedical Sciences, and Bruce Holm, PhD, senior associate dean, on matters relating to university faculty and programs within UB's affiliated clinical sites, including clinical research and space allocation issues within all ofUB's health-care affiliates. A UB faculty member since 1996, Pato also serves as codirector of the UB Laboratory of Psychiatric and Molecular Genetics. The lab's research program focuses on the genetics of psychiatric disorders and substance-use disorders. The program is funded by the ational Institute of Mental Health ( IMH ) to study the genetics of schizophrenia and bipolar disorder, and has pilot projects in obsessive compulsive disorder, alcoholism and substance-use disorder. In November 1999, it was announced that Pato and his wife, Michele T. Pato, MD, received a $4.2 million grant from the IMH to search for a gene(s) that may be linked to bipolar disorder (see page 27 for more information. ) Pato has received many awards, including a National Research Service Award and a Young Investigator Award from the ational Alliance for Research on Schizophrenia and Depression. He has also published numerous scholarly articles, conference proceedings and - LOIS BAKER Medical Alumni Association Scholarship altitudes, the knowledge she gained about the health-care challenges faced by the region's villagers gave her newfound "wisdom and on, a -ye· student at he University at Buffalo School of endowment fund. Recipients are selected by the admissions commiHee according to considerations of financial need and academic merit based on the incoming appreciation for both cultural and medical diversity." While at UB, Pratt has been a volunteer tutor with UB's Learning Medicine and Biomedical Sciences, Center and has worked for the past three years in the Office of CD Disability Services. is this year's recipient of the Originally from Lockport, New Medical Alumni Association Schol- York, Eaton is a graduate of Case ATTENTION STUDENTS Look for these upcoming events ... AMA/AMSA Physician-Medical Student Golf Tournament, Spring 2000 AMSllnnual Residency Fair.lpril2000 More information to come! 20 CD book chapters. 1 111111 nysiciu Wi11ter 2000 students' applications. arship. The scholarship is made Western Reserve University, where possible by the she earned a bachelor of science generosity of degree in chemistry. She says her alumni through their reunion long-termgoal is to return to Lockport CD :ticem .. gifts - S. A. desig- nated to the edical Alumni Association UNGER �Sever"n ,Jo"ns 0 E asAss"stant Dean CHARLES SEVERIN, MD '97, PHD, has been named assistant dean of student and curricular affairs for years one and two at the University at Buffalo School of Medicine and Biomedical Sciences. Severin, who is a clinical associate professor of anatomy, came to UB in 1981 to serve as assistant professor of anatomy. Since joining the faculty, he has been consistently recognized for his service to students and teaching excellence, having received the Seigel Award as Outstanding Teacher in Basic Sciences for five years (1982, 1991, 1993, 1994 and 1998). In 1999, he won the award for residency teaching. In 1993, at age 46, Severin decided to enter UB's medical school in addition to maintaining his teaching responsibilities in anatomy. "I went to medical school to improve my teaching. I felt if I had the clinical background I could insert this experience in my lectures," he says. "Also, I was serving on a number of committees in which student issues were being discussed in depth and I wanted to better understand what the students were experiencing-to be able to better relate to them," he adds. "Dr. Severin was chosen for this position because of his extraordinary record as a teacher and as a student advocate," says Dennis adler, MD, associate dean for academic and curricular affairs and head of the Office of Medical Education (OME). "He is enormously respected and loved by students, as evidenced by his having been named recipient of the Seigel Award as many years as he has." Originally from Youngstown, Ohio, Severin earned his AB degree in biology in 1970 from St. Louis University, where he also completed his MSCR degree in anatomy in 1972 and his PhD in 1975. Prior to coming to UB, he was assistant professor of anatomy at the University of Texas Medical Branch at Galveston. 4D Rokitka Named Assistant Dean MARY ANNE ROKITKA, PHD, clinical associate professor of physiology and biophysics, has been appointed assistant dean for biomedical undergraduate education in the School of Medicine and Biomedical Sci- ences. She will continue to have primary responsibility within the school for developing and overseeing education programs for undergraduate students potentially interested in careers in the biomedical sciences. A faculty member since 1975, her research involves comparative environmental, animal and hyperbaric physiology. New Director of Student Services dean for academic and curricular affairs and head of the Office of Medical Education. In particular, of student services in the Office of he adds, "we wanted to designate 'Jiedical Education lOME) in the somebody who is not directly in the School of Medicine and Biomedical promotion pathway to advocate for Sciences. She is the first to hold students and to provide them with his position, which was created to assistance and support." Stamm earned a bachelor of provide improved support and arts degree in psychology at the services to students. In her role, Stamm serves as a State University of New York at student advocate and acts as a Geneseo in 1992 and a master of "aison between the student body education degree in college coun- and administration. She also is avail- seling and student personnel ad- able as a resource person for stu- ministration at UB in 1995. Prior to lent clubs and organizations rec- joining the staff in OME, she was ognized by Polity.In addition, Stamm admissions ill be coordinating the Primary coordinator in Care Externship Program (see re- the Offices of ated article on page 181 and will be Admission orting to implement a new pro- and Financial gram called MedCAREERS, a four- Aid at Har- ear career planning program cre- vard Medical School ated by the Association of American Medical Colleges and the American in Boston, Massachusetts. Medical Association to assist medi- Stamm is available to students cal students in selecting a specialty. on a walk-in or appointment basis. "Our goal in establishing this She can be reached by phone at new position in OME was to upgrade (7161 829-2802; or by e-mail at theservicesweprovidetostudents," says Dennis Nadler, MD, associate In 1993, she received the Chancellor's Award for Excellence in Teaching and has been named an honorary member of the Mortar Board and Golden Key national honor societies. She also received the o.edu. Charles W. Shilling Award from the Undersea and Hyperbaric Medical Society in 1991 and the first annual Dr. Mary Anne Rokitka Award from the Great Lakes Chapter for the Undersea and Hyperbaric Medical Society in 1990. Rokitka, who has an impressive record of university and community service, holds two master's degrees and a doctoral degree from UB. - LO IS \V i 11t er 4D - S . A. U N a E R 2000 BAKER l1ffale Hysici11 21 �M E D C A L SCHOOL B v 5 C 0 T E W S 2002: Sta eOd sse T THOMAS Second·year students form rock band District, they rehearse in the basement of a rented house on Callodine Avenue. There, in a litter of pizza boxes, beer bottles and backpacks-with a wa her and dryer for ambience- the members of the rock band Super-RelateD work out the details of their highenergy contemporary sound. A Marshall amplifier the size of a filing cabinet blasts out the music as lead vocalist Andy Swan lets fly with an original song called "Original Song." You got to see there isn't a need to get excited I'm the least of burdens but I hold on, should move on, That's what I gotta do. This is medical school? Well, no. And for the four University at Buffalo medical school students who make up SuperRelateD, that's the whole point. "Most people in class are completely wrapped up in school," says Mike Campoli, the group's bass player. "I can't deal with that." "You can get involved in the clubs and stuff, but they're still attached to the school," says Rich Oh, the band's lead guitarist. "This is something that's totally unrelated." Which is why these four members of the Class of 2002- the fourth is drummer Dave Krakowski- are manhandling their schedules to make time every Friday afternoon to work on their music. They play cover versions of pop hits originally recorded by the likes of Mathew Sweet and eil Young, but they' re also developing a roster of original songs, actively seeking to play more nightclubs, hoping to release a CD by the end of the academic year- in short, putting a lot of nonmedical energy into the rock-star dream. Yet it was at school that the idea for SuperRelateD was conceived, almost by accident. The band members got together for the first time in January 1998 to perform at the student talent show, which promised to be 22 1 11fal1 Hysitill Wrnt er 2 0 00 a successful debut except for the fact that they didn't have a drummer. Krakowski, a bassist by training but quick to pick up other instruments, was nudged into the breach. "I was elected," he says. "Literally, on the day of the show, Mike and I went to the music store and bought a drum set, and I watched an instructional video that came with it." That night, SuperRelateD closed the show with a brief set of power rock tunes: cover versions of Radiohead's " Bends" and Guns' ' Roses' "Patience." Big dreams were born. Final exams and the summer break separated the band for a while, but this academic year they've taken up the cause with a vengeance. They've recorded a demo tape, shopped it around to various nightclubs, and played a live gig at a newly opened club in iagara Falls. (It wasn' t exactly Madison Square Garden, they discovered: The owners had put a new roof on the building and that evening were testing it by dumping water on it. The roofing job wasn' t great, apparently, as the ceiling sporadically leaked water over the band as they played, inches from megawatts of microphones, amps and speakers. They survived.) For each member of SuperRelateD, their dream requires an investment of scarce time, not to mention money. Besides the $600 drum set, they've spent more than $3,000 on amps and other equipment. "Every time you get something new, you discover something else you need," Swan says. But as an antidote to the rigors of anatomy class and hospital rounds, the band is something they're only too happy to pursue. One of their more pleasant challenges is accommodating each performer's tastes in music, and they're not all that similar. Among their influences, Campoli cites Captain Beefheart, Lynyrd Skynyrd and Led Zeppelin; Krakowski listens to AC/DC, Pearl Jam and modern electronica; Oh is into current British pop like Stone Roses and the Posies; and Swan loves Pink Floyd, Queen and the Black Crowes. SuperRelateD includes, left to right, Rich Oh. Mike Campoli. Andy Swan and Dave Krakowski. Opposite, Andy Swan. normally lead smger on guitar. takes a turn on drums. �The band members As befits a rock band, the musicians are a varied, eclectic bunch. Swan grew up in the Southern Tier of ew York, sang in a small a cappella group at Cornell University, and spent a year after college on the beaches ofVenezuela. Oh, from Buffalo, played in various bands in high school and at the University of Chicago. Krakowski, a ew York City native who'd never played in a band before, graduated from the State University of New York at Geneseo, after which he migrated to Antarctica, where he spent three months doing research. Campoli played in a band called French Toast at Rutgers University in his home state of ew Jersey. But fate brought them together in Buffalo, and only time will tell how far Super RelateD will go. Two people who are working to make as much happen as possible for the band are Charlton Byun, another second-year medical student, who helps out with sound and equipment; and Dan Yoon, a third-year student in UB's joint MD/ MBA program. Yoon, a versatile musician himself who has a studio set up in his Amherst home, is acting as the band's manager and giving advice on technical aspects of performing, as well as how to approach club owners and how to construct a crowd-pleasing set of songs. "They have a very high-energy stage show," Yoon says. "The songs they choose and the way they play them is really exciting. They know how to get people going." Yoon is studying marketing and other management topics this year, which has played right into his efforts to develop the band. "I would base a Jot of their marketability on the fact that they're just excellent musicians," he says, "which, by the way, is actually pretty common among medical professionals. "These guys all love it like I do," he adds, "to the point where we're all finding the time to approach medical school from the perspective that although medicine is going to be our profession, we still need to make time to do other things we love. And I really think they actually have a shot. In my opinion, they're as good as any band I've heard in Buffalo." Oh, yes, and the name? "The current name, SuperRelateD, was thought up by Rich during a class on immunology," Swan says. "And we all agreed it sounded cool. Originally, we were Val Salva, but we switched it because we didn't want it to be a medschool pun." And make no mistake, the band is no joke; its members are proud of what they're doing and are seriously devoted to developing their talent in this creative realm. Says Mike Campoli of their planned CD: "I want it to happen for us so that someday when I have kids and they ask, 'Who's this band?' I can tell them, 'We're the band!"' Winte r 2000 got together for the first time in January 1998 to perform at the student talent show, which promised to be a successful debut except they didn't haye adrummer. l• ff a l • n rsi c i u 23 �RESEARCH ms N E w s the liver than full-term infants. president and chief medical This deficiency could leave them officer of TRC. Robert A. Klocke, MD, susceptible to infection because of the immaturity of their professor and chair of the UB million grant from the Institute immune system." Vivien Carrion, MD, and Department of Medicine, says for Child Health and Human De- Linda Duffy, PhD, both of the the grant "provides a solid base for us to continue and even to UB expand our ongoing research in University at Buffalo pediatric researchers have received a $1.2 Work are collaborating with renal disease." Upstate New York Transplant Services, Inc., (U YTS) on a cal trial of vitamin A's potential to bolster the immune systems of Hospital, Brian M. Murray, MD, UB associate professor of medicine, develop ways to increase organ very premature babies, an action -LOIS BAKER Department of Pediatrics are co-principal investigators on the study. CD antibody response to the hepatitis B vaccine, adminis- who has received early funding donation in the African American community. studying the role of growth fac- The grant is part of a $13 million effort funded by the Rocco C. Venuto, MD, pro- tered to all infants at about three-year, $180,000 grant to through this grant is currently tors in the progression of kidney disease, differentiating between those that are beneficial and toxic. The researchers will use .. Related Professions and Social and Kaleida Health's Children's ational Institutes of that could help prevent poten- .JIIII.if!"!'l'!'!~"'"!'!f'l!'l~~!!!!ll~'--'!lr"!!lii tially deadly infections. 0 The UB Schools of Medicine and Biomedical Sciences, Health Health, to conduct the first clini- velopment, .." .. Organ Donation Among Minorities Studied organ donation across all one month of age, as an indi- fessor cator of vitamin A's immune- second UB researcher who has boosting potential. Mark received TRC grant money, tor of UNYTS, will be principal Ballow, MD, UB professor is conducting ongoing, collab- investigator on the grant. Judith of pediatrics and chief of orative research in the area of Tamburlin, PhD, UB assistant the Division of Allergy and blood-pressure control during research professor of clinical Immunology and Pediatric pregnancy, a topic he has been laboratory sciences and anatomy direct the study. Vitamin A's role as a modula- segments of the population. Mark Simon, executive direc- exploring for nearly 25 years. and cell biology, will be project Nephrology Rese rch Endowe "If we can understand the role of the kidney in controlling blood director and coinvestigator. The UNYTS-UB collabora- Rheumatology at Kaleida Health's Children'sHospital of Buffalo, will of medicine and a National Organ and Tissue Donation Initiative to increase Total Renal Care, Inc., (TRC) has pressure, then we can become tion in the first year of the grant tor of the immune function has donated $500,000 to the Univer- better at avoiding hypertension will be aimed specifically at the been studied in both animals and sity at Buffalo School ofMedicine and perhaps at saving the lives of humans, and results have shown and Biomedical Sciences to es- pregnant women and preventing that it is essential for supporting tablish the Nephrology Research premature births," he says. the immune system against infec- Endowment Fund to partner with Total Renal Care Holdings, Inc., headquartered in Torrance, tion, according to Ballow. UB in the battle against kidney "Despite many improvements in disease. "We are proud to sup- California, is a provider of inte- recent years in treating very-low- port the endeavors of our partner grated dialysis services for patients birthweight preterm infants, institutions like UB, which was suffering from chronic kidney infection remains a major problem," he says. "Preterm infants chosen because of the strength of its academic program and its failure, also known as end-stage CD renal disease. have lower levels of vitamin A in excellent research," says Stan M. - SUZANNE their blood and lower reserves in Lindenfeld , MD, senior vice "IF WF CAN UNDERSTAND THE ROLE OF THE KIDNEY L CHAMBERLAIN CONTROLLING BLOOD PRESSURE, THEN WF CAN BECOME BETTER AT AVOIDING HYPERTENSION AND PERHAPS AT SAVING THE LIVES OF PREGNA ••T WOMEN AND PREVE 'TING PREMATURE BIRTHS." l 1 1f al1 Hysicin Wi11ter 2000 �African American community. years of the grant, the emphasis biology in the UB School of Dental Medicine. By exposing mouse will be on increasing organ pre·osteoblasts and fully During the second and third donation in the Western ew York Hispanic and Native American communities, respectively. Statistics compiled by U YTS show that in Buffalo, 50 percent of patients needing organ transplants are African Americans, while the consent rate for donation from this ethnic group is only 14 percent. This low donation rate poses problems on two accounts: It limits the number of organs available in general to a population in which the need is great; and it decreases the possibility of obtaining a compatible match. Rejection rates for African Americans are higher when the organ is from a donor of another race. 4D -LOIS BAKER Melatonin Linked to Bone Crowth University at Buffalo researchers have shown for the first time that melatonin may play an important role in promoting bone growth. The study was conducted by Jerome A. Roth, PhD, professor of pharmacology and toxicology in the UB School of Medicine and Biomedical Sciences, and Moon·ll Cho, PhD, professor of oral differentiated rat osteoblasts to melatonin, the researchers were able to show that normal body levels of the hormone sped up the transformation of pre-osteoblasts to fully differentiated osteoblasts and induced both types of cells to produce increased amounts of several bone matrix proteins responsible for bone formation. "After binding to its receptor on the cell surface, melatonin signals the cell to produce and mineralize bone matrix proteins," Roth says. ''This has not been shown before, and we are now investigat· ing what cellular events are taking place to make this happen." "We know melatonin decreases with age and that bone loss, which can lead to osteoporosis, is an inevitable part of aging, especially among women," Cho says. "Can melatonin help prevent osteoporosis? Our research indicates it may have that potential." Under standard growth conditions in vitro, mouse pre· osteoblasts undergo cell differentiation to osteoblasts and mineralization in 21 days. Roth and Cho showed that in the presence of melatonin, cell differentiation was completed by day 12 and was Exercise a Cood Workout for ..Ju enile t ew research on the effects of exercise on juvenile arthritis indicates it is OK-advantageous, in fact-for these kids to be kids. Children with juvenile arthritis who took part in an eight-week individualized program of resistance exercise at the University at Buffalo significantly improved their ability to function, some by equivalent or greater at that point than cells grown for 21 days. Most significantly, says Roth further experiments showed that the mouse pre-osteoblasts responded to normal body levels o melatonin, but the cells needed to undergo five to seven days of differentiation before they were capable of responding to melatonin at that level. "These findings place melatonin with a select handful of other agents-includingglucocorticoids, bone morphogenic proteins and vitamin D-that are known to stimulate mineralization in osteoblasts," says Roth. "Because melatonin levels decrease during the aging process, the possibility must be considered that melatonin may have a significant influence on the rate of synthesis and maintenance of bone in the elde ly. -LOIS as much as 200 percent, as shown in preliminary results of the study. Equally important, their pain, disability and use of medications decreased significantly. The research was conducted by adine Fisher, EdD, assistant professor of occupational therapy and rehabilitation medicine, with support from the ational Institute on Disability and Rehabilitation Research. In ovember 1999, she presented results of eexpected to see achange in the disease with exercise, but we didn't expect to ee so much," says Fisher. Everybody showed tremendous hysiological ·mprovement.'' the study in Boston, MA, at a joint meeting of the American College of Rheumatology and the Association of Rheumatology Health Professionals. "We expected to see a change in the disease with exercise, but we didn't expect to see so much," BAKER says Fisher. "Everybody showed tremendous physiological improvement-better strength, endurance and even better aerobic capacity, although these exercises weren't designed for that. Everyone had less pain. ~NTINUED Winter 2000 ON PAGE 26 1111111 Hysicill 25 �N RESEARCH .... .. E w s Res arch Institute on Add"ctions "oins UB sion of hepatitis C. RIA scientist! The Research Institute on Addic- addictive gambling, one involvin tions (RIAl, formerly a component a nationwide survey of gamblin .. I~N TI N UEO behavior and alcohol use, and the Alcoholism and Substance Abuse second evaluating coping skills in Services (OASASI, became part of individuals who have partners who University at Buffalo on November are pathological gamblers. PA G E 25 at the institute at 1021 Main Street in Buffalo, New York. lished at UB in 1968 by the state Department of Mental Hygiene to ally for its research on the develop- conduct research into alcoholisn " Some kids showed 200percent improvement," she adds. "That's pretty exciting." Fisher designed the exercise ment of substance-abuse problems and potential treatments. Cedric and the prevention and treatment Smith, MD, UB professor of phar of substance abuse. The institute macology and toxicology (see be umps $8.1 million a year in exter- low), was RIA's first director, serv program and has shown its al research funding into the local ing unti11979. Through a series of conomy, in addition to expending changes in administration, both at benefits in previous studies of elderly patients with osteoarthritis. However, until now, an individualized resis - The sho examined t nature. prevalenc and consequence of complete memory lapsesso-cane tance exercise program had never been tried with children. a state budget of $3.1 million. other researchers around the country-have found to be a relatively common occurrence. Specifically, Smith was asked to describe the results of studies he has carried out in collaboration with Cynthia Pristach, MD, clinical associate professor in UB's Department of Psychiatry, in which they examined the effects of blackouts on subsequent drinking in both moderate drinkers and alcoholic patients. under the administrative jurisdiction of OASAS, although the two Characteristically, indjviduals ill retain its identity and remain institutions maintained close re- experiencing blackouts don't realize they have had memory loss until hours or days after n its present location. Gerard J. searc c ional ties. 4D - LOIS BAKER research professor of psychology, said of the transition: "We are delighted with our merger with the niversity and are excited about he new opportunities that will re- 20,20 Features Cedric Smith as Exp rt on Alcoholic ultfor both RIA and UB." Connors id the institute will continue to ocus its research on alcohol and other substance use and abuse and that it has expanded it emphasis to include compulsiv inflammatory compounds. infant development in alcoholi - families; ways of reducing DWI rc ambling. Current RIA researcl ·ncludes investigating alcohol us in early marriage; parenting an cidivism; skills training for parent of adolescent drug abusers; an heavydrinking,druguseand blood to-blood transmission betwee1 lllfall nysieiu least 10- 20 percent of the population. The interest in blackouts stems in part from apparent skepticism on the part of the public regarding what Smith and his colleagues-as well as RIA will function as a free-stand- controls at baseline and that the exercise program significantly decreased these cytokines and increased production of anti- LOIS BAKER UB and at the state level, RIA moved particularly interested in establishing that blackouts not only do occur, but are experienced by at ing research institute within UB and onnors, RIA director and UB An accompanying investigation conducted by )aya Venkatraman, PhD, associate profes~blackouts"­ sor of nutrition, found that can occ that children with with alcohol juvenile arthritis had higher concentrations of pro-inflammatory cytokines in their blood than normal 26 The merger brings RIA back to its roots. The institute was estab RIA is recognized intemation· FROM recently began two projects or of the New York State Office of 18, 1999, during ceremonies held • sexual partners in the transmis Wi11t e r 2 000 The October 18, 1999, edition of the ABC television news program 20/20featured Cedric Smith, MD, professor in the Department of Pharmacology and Toxicology, as an expert on memory disturbances produced by alcoholic beverages. The show examined the nature, prevalence and consequences of complete memory lapses- so-called "blackouts"that can occur with alcohol consumption. Smith was interviewed by Cynthia McFadden, who was recovery from the intoxication, according to Smith. Furthermore, although alcoholic patients (approximately 70 percent) often suffer repeatedly from blackouts, the episodes are not limited to alcoholic individuals. "The particularly puzzling and frightening �aspect of blackouts is the fact that a $2.6 million project also funded the individuals appear to have an intact memory and can act 'nor- by the IH, now entering its third year. "Although a genetic linkage has been presumed to underlie bipolar disease in many individu- mally' during the time period that they subsequently can't remember," says Smith. "Fortunately, some individuals appear less susceptible to blackouts than others." Currently, Smith and his colleagues are preparing to publish new data they have gathered from their studies on alcohol-induced blackouts. CD -S.A. UNGER $4.2 Million Crant to Study Cenetics of Bipolar Disorder Carlos . Pato, MD, and Michele T. Pato, MD, associate professors of psychiatry and co-directors of the Laboratory of Psychiatric and Molecular Genetics at the University at Buffalo School of Medicine and Biomedical Sciences, have received a $4.2 million grant from the ational Institutes ofHealth to search for a gene or genes that may be linked . .... .. to bipolar disorder. Identifying the molecular basis of such a linkage could lead to advances in diagnosis and treatmentofthe disorder, which affects millions of people worldwide . The husband-and-wife team are conducting their research with the relatively homogeneous population of the Azores, Portuguese islands located in the North Atlantic about 1,000 miles off the coast of the Iberian Peninsula. This same population forms the study base for their search forgenetic markers for schizophrenia, als, this research promises to reveal the molecular basis of that linkage, and may well lead to important diagnostic and therapeutic advances," says months. Persons in the manic Pato explains. "In addition, the Azores have a centralized health system, and alllO psychiatrists on phase of the disorder can be psy- the islands are collaborating on chotic, are easily distracted, experience exaggerated feelings of well being, exhibit inflated the project." The researchers will look for hereditary pathways of the disease using a variety ofapproaches. "We will select genetic markers be cyclic, with sufferers remaining manic or depressive for self-esteem and may indulge extravagantly in irrational activities. In the depressive phase, persons ex- and look at how the markers behave in well families, compared to a family where the illness shows up several times," Patosays. "We'll perience inertia, loss of self-esteem, withdrawal, also look to see if illness and Biomedical sadness and may even be we'll develop a description of each suspect gene and determine Sciences. Carlos suicidal. Present how often it occurs with illness." An important aspect of the study will be a haplotype relativerisk analysis. Using this approach, researchers John Wright, MD, dean of the School of Medicine and Pato, principal investigator on this research project and associate dean for clinical affairs in the medical school, says bipolar disordercommonly referred to as manic depression-affects about 0. 7 percent of the worldwide population, with a large percentage having a possible genetic component. "The most consistent and signifi- treatments for bipolar disorder focus on managing these symptoms. The Patos say they hope that uncovering the genetic etiology of these disorders will be an important step in developing improved treatments and, possibly, specific cures. Through a pilot study, the researchers already have identified 25 families with 84 affected mem- cant risk for developing bipolar disorder or schizophrenia is bers. That population will be expanded in the newly funded being related to a person suffering from the same illness," he says. "Though it is likely that five-year investigation to include 225 persons with bipolar disorder and their parents. A third study group will be composed of all other Azoreans with the disorder. "The Azores are ideal for a nongenetic factors play an important role in the expression of these illnesses, a significant portion or risk must be genetic." Bipolar disorder is characterized by dramatic mood swings between mania and depression. The mood swings develop and subside spontaneously and may genetic analysis because the islands are geographically isolated and the population has remained relatively homogeneous, with most inhabitants descended from a few families," Winter genetic markers co-exist and analyze genetic patterns from ill person to ill person. In addition, Mllthough a 11enetic linkage as been resumed to derlie bipolar sease in many ividuals, this will analyze the set of esearch promises genes from a patient's oreveal the parents that were not olecular basis of passed on to that that linkage, and patient, with the nonay well lead to inherited set then nponant acting as a control. iagnostic and Both researchers therapeutic hold adjunct appoint- advances." ments with the Center for euroscience at the UniversityofCoimbra in Portugal, which is collaborating on the project. The Whitehead/MIT Center for Genome Research will perform a genome-wide scan and collaboCD rate on all data analysis. -LOIS BAKER 2 000 laffale Hysicin 27 �S T U D E N T COLUMN Sendin Out an S.O.S. BY H A N A C H 0 E Students Offer i ng Support Peer Group Established yet I stared at the clock as if it were alien to me. I just wanted it to stop bothering me so I tried willing it to be silent. Finally, itsincessantnagging forced me to drag myself across the room to turn it off. I had classes. .... 28 l11falt Hysiciu Though the morning sun streamed through the window blinds heralding a new day, I convinced myself that it would probably be too cold, or classes would be boring, or that I could read and study on my own and, oh, that I wasn't feeling too well either. This day was just not a good day. I crawled back into bed, relieved that I had been able to rationalize my way out of going to school. Perhaps I was getting sick; it was winter in Buffalo, ew York, after all. Maybe I had hypothyroidism; hadn't we just learned about Hashimoto's thyroiditis and the concomitant lethargy? Surely, there was a physiological explanation. Yet, in the back of my mind, in my heart of hearts, I knew it was something else: I was depressed. But how could I be? I had always been a proactive, strong, independent soul with high ambitions and strict control over all aspects of my life. While at Columbia University as an undergraduate, I had been vice president of my senior class and felt I had a bright future. Following graduation, I took time off to Winter 2000 prepare for medical school, get some experience in the work force, and earn a master's degree in biology at ew York University, to boot. Accomplishment, scholarship and leadership had not been foreign to me. But now I felt trapped in a futile struggle against apathy towards school, career, life. And in the vicious cycle of life's quirks, the less I cared, the worse I performed in school and the worse the situation progressed. It was as if I had been performing all along and, now, I could not muster the energy or desire to go back on stage anymore. I needed help, but did not know where to turn. Approaching a dean seemed intimidating, and friends seemed to be having some of the same problems. We did not have advisors, and I wondered, "Did UB have counselors specifically for medical students?" Because several of my fellow students had similar questions and concerns, we began a quest to find answers and forge solutions. We decided to get a consensus ofhow many students were suffering doubts, fears and emotional stress. Therefore, in March 1999, we conducted a survey of the classes of 2002 and 2001. Some sobering facts were revealed: 62.1 percent of the 120 students of the class of 2002 and 69.7 percent of the 85 second year students in the class of 2001 who responded said they had experienced a period of significant psychological and emotional distress at least once since attending medical school. These statistics confirm the trend that during medical school training, while students are taught to empathize with, diagnose and treat patients, our own physical, mental and emotional health suffers. We further found that almost a third of the class of 2002 (43 students) and a quarter of the class of2001 (31 students) were distressed enough to need help or counseling. More disturbing is the fact that these medical students-typically characterized as bright and intelligent, motivated and achievement oriented-did not know where to turn for help. What will medicine be like in the next millennium if medical students today cannot obtain help to maintain their own health and happiness? The reality is that �A RECENT ARTICLE IN NEWSWEEK ... TITLED «THE SILENT A1 GUISH OF THE HEALERS" ADDRESSES THIS CYCLE THAT EVENTUALLY MANIFESTS ITSELF IN THI:. DETERIORATION OF THE PHYSICIAN-PATIENT RELATIONSHIP AND, INCREASINGLY, IN MALPRACTICE LITIGATION. the problem stems not from a lack of coping abilities, but because there is often a stigma attached to medical students and physicians who admit they need help; it's as if we were admitting a weakness. The awesome responsibility of caring for the people in our community and the fiduciary expectations placed on physicians can be not only intimidating but debilitating, especially when shouldered by clinically naive medical students. However, to concede that we cannot handle adversity not only forces us to relinquish control of a situation, but exposes a fallibility that is not allowed. Hence, it is safer to assume the pretense of unyielding strength and flawless competency. Moreover, the Marcus Welby phenomenon traps us and transforms us into demigods in the eyes of our families, friends and communities. How then can we possibly admit we need help? It is one thing to cope with the vicissitudes of life in our own personal lives; it is quite another to be defined by our career and to play a role that is immune to doubts, fears and tragedy. Physicians may become captives of the emotional and psychological duress associated with caring for the health of entire communities, which involves confronting pain and death at every step. Ironically, as administrators of health care, we are trained to recognize the signs that a patient's health is compromised, yet we ignore these same signs in ourselves. Would it make us too vulnerable if we remembered that we are in fact only human? If we do not tend to ourselves, we cannot fully and sincerely attend to our patients. A recent article in Newsweek (September 13, 1999) titled "The Silent Anguish of the Healers" addresses this cycle that eventually manifests itself in the deterioration of the physician-patient relationship and, increasingly, in malpractice litigation. My peers and I refuse to accept this state of affairs and are endeavoring to change it. As a result, in April 1999, we established a student-run peer support group called S.O.S., for Students Offering Support. Through sheer determination and dedication we have initiated a program-the first of its kind at UB-that will promote the health of the medical student body. Though our group is still in its infancy, its mission is centuries old and found throughout the animal kingdom: We must take care of our own if we expect to survive. If we medical students and future doctors are to work together on the wards, in teams and in group practices, we must work together to preserve the sanctity of our collective well being. Therefore, S.O.S. reaches out to students by offering education and peer support on four levels. The first level of support includes a resource center that provides information on service agencies in the community and a lecture series that addresses issues such as stress reduction, family planning and seasonal affective disorder. With prevention as the trend in health care for the millennium, our responsibility is to educate not only our patients, but ourselves and our peers. The second level of support is a pager service offered daily for direct and immediate peer support and referrals. As one S.O.S. member states, "I believe that an S.O.S. volunteer can demonstrate the same personal attention and compassion on the phone that a physician would show during a face-to-face visit." It's inspiring that students are concerned enough for fellow students that they will take time out of their busy schedules to be on call for others. The third level of support maximizes the benefits of group discussions to further examine issues like maintaining relationships and exploring spirituality throughout a medical career. Finally, the fourth level is the bridge to professional therapists and psychiatrists. By matching medical students with psychiatrists in the community, we are encouraging them to seek help when they have problems. And now, almost a year has passed since that morning I lay in bed, willing my alarm to cease its noise. I admit I am still anxious about the challenges ahead. However, I do know there is strength in numbers; I will support and be supported by my peers. I encourage 4D you to do the same by sending out an S.O.S. For more information on S.O.S., visit the group's website at http://www.smbs.buffalo.edu/polity/sos. What will medicine be like in the next millennium if medical students today cannot obtain help to maintain their own health an happiness? The reality is that the problem stems not from alack of coping abilities, but because there is often astigma attached to medical students and physicians who admit they need help: it's as if we were admitting aweakness. {ana Choe zs a second-year student at the Uni~erstty at Buffalo School of Medicme and Biomedical Sciences. Wi11ter 2000 1111111 Plysicill 29 �N E w s "Can You B • By Li nda J . Cor de r , PhD, CFRE on my birthday, about a decade ago. His eyes were intense but kind as he welcomed me to his kingdom, the Department of Medicine at St. Louis University's School of Medicine. Obviously a benign monarch, he offered me heartshaped cookies baked by one of the office staff for Valentine's Day. While he went to find coffee, I explored the landscape of his office, noting that the walls were covered with a lifetime of honors. These included a citation of appreciation for his term as president of the American College of Physicians, hung not far from his UB diploma. Tom was also in charge of graduate medical education. On a tour of St. John's Mercy Medical Center, everyone we met grinned in response to his quiet greeting. Along the way, he indulged my obviously nascent knowledge of the field of medicine by explaining the various stages of medical education and training. Tom also fervently extolled the virtues of music, literature, art and "living life." We ended our sojourn in the library, where a large oil painting of him was propped against a set of shelves. "When you next visit," he said shyly, "that will be hanging; the library was recently named for me." Over the intervening years, Tom shared more stories about his life. I learned that he is a spouse, a dad, and a man deeply involved in his community. He also plays the piano, reads widely and enjoys excelling at golf. Driving down Buffalo's "memory lanes" a few years ago, Tom described to me his UB days, which were spent mostly at the hospital because he lived in a house in Allentown where the heat seldom made it to his third-floor room. As a result, the residents dubbed him "that student who hangs around." One night, he recalls, a woman was brought into the ERin a coma and he was encouraged to observe as an "amber-colored fluid" was injected into a vein. The patient immediately awoke and asked where she was. "To a kid, this seemed like magic, or a true miracle," Tom remembers. Later, he learned that the woman had been in Addisonian crisis. 30 l 1 fla l1 H ysi c i11 Winter 2000 Tom was in the hospital that night because his room was freezing, a fortuitous circumstance that changed his life, as he made up his mind then and there to dedicate his energies to the study of Addison's disease. When he completed his residency, Tom's dream was to conduct research with George Thorn, a UB graduate known for his seminal work in endocrinology. After interviewing Tom in Boston, Dr. Thorn decided he would be a welcome addition to his lab; however, due to funding, he had to delay offering him a fellowship for a year. Fearful that a dream deferred would never come to pass, Tom returned to Buffalo broken-hearted. A group of faculty-Jed by Dr. John Talbott-told Tom, "We will finance your first year of research until Thorn can provide fellowship funds." Recalling this offer, Tom asked me with unmitigated awe, "Can you believe that?" The UB faculty encouraged Tom to "learn and return" but didn't hold him to an agreement when he was offered "a rank and salary UB simply couldn't match." His mentor said, "We want what is best for you, so take it." Again Tom said to me, "Can you believe that?" Recently, Dr. and Mrs. Frawley completed funding an endowment that will enable other young physicians interested in research to pursue their dream. This story is not just about the Thomas Frawley, M. D. Residency Research Fellowship Fund, although it will make a difference to the school forever. What strikes me as amazing is the aspect of Tom's story that pertains to his decision to embark upon a career in medical research and how dedicated professors and an outstanding UB alumnus worked together to effect a remarkable outcome. It also shows how "serendipitous" can become "likely" when people and resources are dedicated to students and to creating an academic environment that exceeds expectations. Lyn Corder is associate dean and director of development. She may be reached by phone, toll free, at 1-877-826-3246, or by e-mail at ljcorder@buffalo.edu. �Spring Clinical Day and e nion Weekend 2000 Mark your calendars I Cass of 1955 t's not too early to plan for the 2000 Spring Clinical Day and Reunion Weekend. John H. Peterson A cocktail reception will be held Friday, April28, 2000. The Ray Schiferle 63rd Spring Clinical Day and Reunion Dinners will be on Saturday, April 29. For more information, call the Medical Alumni Association at (7161 829-2778. John H. Peterson The reunion classes are 1945, 1950, 1955, 1960, 1965, 1970, 1975, 1980, 1985, 1990 and 1995. Here's what your reunion chairs have to say . . . Admit it, you've stayed away too long! Come enjoy Spring Clinical Day activities and our 45th reunion. The clock is ticking, so plan to attend. Details very soon. -Ray Class of 1945 Herbert Joyce Herbert Joyce Ray Schiferle We encourage all of those of the Class of' 45 who are still able to come to attend our 55th reunion. The festivities will be the grandest yet for the double nickel on 4/29/2000. Class of 1950 Class of 1960 James Kanski RogerDayer ]ames Kanski Sidney Anthone Save thedatesApri128 and 29,2000. It's our 50-year class reunion and great plans are being made to make it a monumental event. You will be hearing from us about further details. Call your closest classmates and start planning to share the event. Please let us know of any ideas you may have to make the occasion even more special. Plan now for our May 2000 reunion. It's time to renew old friendships, reminisce and share a few laughs. -James Hope everyone will join us for our Can-Am celebration of our 40th. -Roger Bob Patterson Sidney Anthone In '95 we had a great time with 20 classmates. Let's try and double that for our 45th. You wouldn't believe all the tales traded about. Please try and make it. -John Roger Dayer Bob Patterson Wi11ter 2000 1111111 Plysiciu 31 �S P R. I G C IC'AL Ll DAY AND REU 10 WEEKEND c sso 5 2000 985 Beth Maher Joe Cardamone Jack Coyne Joe Cardamone It really has been 35 years since graduation. Let's all get reacquainted. I look forward to seeing you at our reunion weekend April 28-30, 2000. Come and join us in the "City of Light" in the spring of the new millennium. Beth Maher 970 Don Copley Don Copley Be sure to reserve the dates for our 30th medical school reunion in April. Andrea and I look forward to seeing you. If you attended our last reunion, you'll recall the fun we had reminiscing, comparing career twists and reviewing life's little adventures. And don't forget to bring along some belly laughs! Jack Coyne s 990 Ray Paolini Ray Paolini John C. Stubenbord John C. Stubenbord On April 29, 2000, we will be celebrating our ten-year reunion. Please mark your new 2000 calendars now and share with your classmates some fond memories of good times. It's been 25 years since we were all together in Buffalo. Come on home to the place of our medical beginnings. Hope that you all can return for April 29, 2000. 95 Martin Mahoney Tara Sosa Paolini Margaret W. Paroski Martin Mahoney Let's begin the new millennium by renewing old friendships. Margaret W. Paroski Tara Sosa Paolil1i 3 2 l 1ffal1 Hysicin Wtnter 2000 Let's get together to catch up! Plan to join us for our five-year reunion .... Hope you can attend. �Dear Fellow Alumni, I have been privileged to participate in many interesting and exciting events over the past few months. In mid-September, Dr. john Bodkin, vice president of the Medical Alumni Association, chaired the reunion chairs' dinner, held at the Transit Valley Country Club. Dean Wright spoke, and we had a chance to meet with the chairs of the individual reunion classes that will be held in April 2000. It was a welcome opportunity for us to meet these volunteers and show our appreciation for their stepping forward to chair their respective reunion dinners. Later in September, the past presidents' dinner was held at the Buffalo Club in downtown Buffalo. At this event, we were pleased to present the Distinguished Medical Alumnus Award to Dr. Robert Reisman in honor of his many contributions to allergy and immunology and to our medical school. In accepting the award, Dr. Reisman gave a wonderful talk about his career and his thoughts on the past, present and future of medicine. On October 9, 1999, I was privileged to speak before the Parents' Guild during Parents' Week for the first-year medical students. The Parents' Guild is an impressive organization that has been established to try to improve aspects of the medical education experience. This was a well-organized day that gave the parents an opportunity to visit the classrooms, meet the professors and see where their children are learning the basic sciences. The Physician-Student Mentoring Program got off to a rousing start this year under the direction of Dr. Stephen Pollack, who was successful in matching 140 physicians one-on-one with medical students. The goal of this program is to provide students with a nonacademic advisor who can be available on an informal basis to answer any personal or professional questions they may have. Dr. Anthony Markello has volunteered to chair the Community Physicians Speakers Program. In this program, the Medical Alumni Association arranges for physicians in the community to come and speak to first- and second-year classes to help acquaint them with the hours and dedication needed for the various fields of medicine. We have begun to plan our fourth-year medical student reception, held each spring and sponsored by the Medical Alumni Association. The reception, which will be chaired this year by Dr. Bodkin, is a splendid annual event in which the fourth-year students and their significant others come and celebrate the close of their medical school experience. Finally, plans for Spring Clinical Day 2000 are beginning to take shape. The theme for the day will be "Children's Health," and our Stockton Kimball lecturer, as announced in the last issue of Buffalo Physician, will be Maxine Hayes, MD '73, assistant secretary of community and family health for the Washington State Department of Health. Dr. Bruce Rogers, head of the Division of Maternal-Fetal Medicine at Kaleida Health's Children's Hospital, has also accepted Dr. Colleen Mattimore's invitation to participate in the program. Other speakers have been invited, and we are awaiting their response. This is an exciting time to be on the Medical Alumni Association's board. If you are interested in joining our board, please drop me a line through the Medical Alumni Association office at 101 Cary Hall, or call the office at (716) 829-2778. RICHARD L. COLLINS , MD President, Medical Alumni Association Winter 2000 l11fale Hysicin 33 �CLASS 1940s Ralph T. Behling, MD '43, My wife, Rita Clancy Behling, died in July 1998. I remarried in August 1999 to California widow with five children. Jacqueline Paroski, MD '49, North Tonawanda, Y, Pediatrics. "Julie Cullen and I were the first women interns at the Millard Fillmore Hospital. We were also among the first women physicians in the U.S. Navy. I was the first woman president of the medical staff of the DeGraff Memorial Hospital and first woman to be head of pediatrics at DeGraff." John Sharp, MD '49, Holmes Beach, FL, Internal Medicine. "From 1959 to 1987 I was chief of cardiopulmonary medicine at Hines VA Hospital near Chicago, IL. I was also professor of medicine at the University of Illinois and Loyola University in Chicago. I did research in cardiorespiratory physiology and was associate editor of the fota- nal of Applied Physiology in the 1980s for five years." jacksue@gte.net 34 NOTES rics/gynecology at the University of Mississippi from 1967-1974; assistant/associate dean of Academic Affairs at the University of Mississippi from 1970-1974; and chair of obstetrics/ gynecology at the University of Rochester (NY) from 1974-1995. I am now retired." thiede@rochester.rr.com Irma Waldo, MD '49, Hillsdale, NY, Pediatrics/ Primary Care. "I have skied for 40 years and am serving on the ski patrol at the Catamount ski area in Hillsdale, NY. In addition to private solo practice, I have always done school health, and with the County Health Department held well-baby and immunization clinics. In semi-retirement. I was attending MD and medical director of our county nursing home and Twin County Alcohol and Substance Abuse Services of Columbia and Greene counties." 1950s Eugene Beltrami, MD '54, Williamsville, NY, Obstetrics/Gynecology. "I am director of Medical Legal Affairs for the Department ofVeteran's Affairs nationwide." Henry Thiede, MD '49, Jacob Lemann Jr., MD '54, Pittsford, Y, OB/GY "I was chair of obstet- ew Orleans, LA, Internal Medicine. "I was an l tffal• Hysici11 Winter 2000 instructor in medicine at Boston University School of Medicine from 1961-1963; assistant/ associate professor of medicine at Marquette University School of Medicine in Milwaukee, WI, from 1963-1968; associate professor and chief of Nephrology Division at Boston University School of Medicine from 19681970; professor of medicine and chief of nephrology at the Medical College of Wisconsin from 1970-1990; clinical professor of medicine (part-time), Tulane University School of Medicine in New Orleans, LA, from 1995-present." J]emannla@aol.com Ernest Meese, MD '54, Cincinnati, OH, Cardiothoracic Surgery. "My first wife, Marge, was killed in auto accident in 1984 (32 years of marriage). I remarried Rockell Dombar in 1985 and in 1992 had twins Matthew and Donyel, now seven years old. I am still actively practicing thoracic surgery in Cincinnati, where I have lived for 34 years. I am active in state and local American Cancer Society and am a lifetime board member." Thaddeus Reszel, MD '54, Robert Dshrin, MD '54, Buffalo, NY. "I am with Buffalo Amherst Allergy Associates, Department of Internal Medicine, Rheumatology and Hepatology and senior partner of a fivephysician allergy/ immunology practice. Also, president of the ew York State Society of Allergy and Immunology from (1997-1999). orth Tonawanda, NY. "I am in part-time office practice at Reszel Family Practice." John Kent, MD '55, Hackettstown, NJ, Obstetrics/Gynecology. "I have been golfing, traveling, reading, relaxing for the past 13 and a half years of retired life." Joshrin@worldnet.att.net Robert Pletman, MD '54, Schenectedy, NY, Urology. "I am president of Schenectady Urologic Associates. I served 18 years as chief of urology and five years as chief of staff at St. Clares Hospital. I am active as a hospital trustee." E-mail BernardS. Shapiro, MD '57, writes: "I was forced to retire from general surgery due to a knee injury, and moved to ashua, NH, to live closer to our four grandchildren and their parents. I've done some teaching of medical ethics to seniors at an institute of learning in retirement. I also work CONTlNUED ON PAGE 36 �In Memoriam Kenneth H. Eckhert, Sr. MD '35, a member of the School of Medicine and James E. Long, MD '31, a fonner faculty member in the School of Medi· cine and Biomedical Sciences, died November 10, 1999, one day before his 93rd birthday, in Buffalo General Hospi· tal after a brief illness. Long, who joined the UB faculty in 1946, received a bachelor's degree from UB in 1924 and gradu· ated from the UB medi· cal school in 1931. During his career, he established a private general-medicine prac· tice on Parkside Avenue in Buffalo and also was affiliated with Buffalo General Hospital as an associate physician. When he retired in 1977, he was awarded a Citation of Professional Medicine by the UB medical school. A vet· eran of World War II, Biomedical Sciences' clini· cal faculty for more than 40 years, died November 26, 1999, in his Buffalo was boarded in radiology, radiation therapy and can Cancer Society and berg earned bachelor's and nuclear medicine and was working to build a master's degrees from the quality assurance. His network of patient advo· University of Buffalo before passion was for making a cacy centers around the difference in the treat· country. He had been . entering the Anny in 1942. After the war, he briefly ment of breast disease honored by Los Angeles studied psychology at the and, to this end, he County and the cities of Los Angeles and Santa University of Chicago before helped introduce the use He was 88. A native of returning to UB to study of noninvasive needle Monica, among others, Buffalo, Eckhert graduated medicine. He graduated biopsies of the breast and for his contributions to home after a long illness. from the University of Buf· falo in 1931 and from the university's medical school in 1935. He served on the medical school faculty from 1940 to 1981, retiring as a clinical instructor emeritus. He received the Dean's Award from the medical school in 1968. During his long medical career, Eckhert was chief of sur· gery at Deaconess Hospital and senior cancer research surgeon at what is now Roswell Park Cancer lnsti· tute. Among his survivors is his son, Kenneth H. Eckhert, Jr., MD '68, clinical assistant professor of surgery in the UB medical school. Long joined the Anny in 1942 and served as a Committee of the Ameri· Williamsville home. He was 80. A Buffalo native, Stul· Gardner Cox II, MD '48, died major in the 20th Gen· in June 1999 at age 76 in eral Hospital, University Holyoke, MA. from the School of Medicine other organs in the Los health care. He was au· and Biomedical Sciences in Angeles area. In 1975, he thor of a book titled The 1952. After receiving train· opened one of the first Multimodality Approach centers exclusively dedi· to Breast Imaging and . Harvard University and Mas· cated to breast diagnos· consuHed and lectured sachuseHs General Hospital, tics. Called the Women's internationally on breast . ing in child psychiatry at Stulberg returned to disease, patient· Buffalo and entered centered disease private practice. He state management . served as director of and patient advo· · the Child and Adoles· cacy. In addition, he cent Clinic on three worked successfully · occasions and was with national, state : honored by the clinic andlocalheaHhcare policymakers on for 37 years of ser· · vice. He joined the of Pennsylvania, Unit. Breast Center, this facility women under age 50, and : also worked with the psy· became a medical blue· the allocation of tax . chology department, in· print and effective busi· revenues from the sale of cigarettes for use in structing clinical students in ness model for other such group therapy. Stulberg had centers that were estab· breast cancer research. been a life fellow of the lished across the nation Porrath is survived by his American Psychiatric Asso· in the following decades. wife, Toni Bernay, PhD, ciation since 1967. Porrath served as presi· and his three children: Bunna-lndia Theater clinical associate professor and, while stationed in emeritus of psychiatry, died India, was awarded a November 24, 1999, in commendation for Millard Fillmore Hospital research in malaria after becoming ill in his dent of The American So· Mitchell Bernay of Dallas, ciety of Breast Disease, TX, Ellen Lord of Buffalo, The National Consortium NY, Laura Chalfin of Los . at his home in Beverly Hills, of Breast Centers, and Angeles, CA; and his sis· · CA. A pioneer in medical vice president and trea· ter, Hedria Lunken, and . diagnosis and treatment of surer of the International mother, Tibey Porrath, · women's heaHh, Porrath Society of Senology. He both of Buffalo, NY. died September 12, 1999, Burton Stulberg, MD '52, to mammograms for : UB medical school · clinical faculty in 1989. He · Saar l. Porrath, MD '61, He served in the China· legislation pertaining Saar A. Porrath, MD '&1 was a Fellow of the Ameri· was a member of the can College of Radiology AHernative Medicine treatment. Winter 2000 l1ffall Hysitill 35 �CLASSNOTES parttime now at the VAMC in Manchester, NH, doing GI endoscopy and small surgeries two days a week. I would love to hear from my classmates. n bernshap@aol.com Constantine Cretekos, MD '59, Pi ttburgh, PA, Child and Adolescent Psychiatry. "I have worked at the same agency for 30 years and have loved it." James Doyle, MD '59, Dana Point, CA, General Practice-Anesthesiology. "I am now retired. Recently I was visited by Dr. Ron Hoyt and his wife, Susan. He's a retired Air Force colonel. I also had dinner recently with Jay Stevens and Dorothy Rasinski and talked to Bob Wilbee and Larry Way on the phone. All are in good health." Seymour Grauer, MD '59, Syosset, Y, General Surgery. "I am director of surgery at orth Shore University Hospital in Syosset. I am happily married, actively practicing surgery, doing some administrative work and studying for a master's in medical management at ew School University. I am also traveling. Regards to all!" tgrauer@liu.edu 36 1111111 Hpici11 Dorothy Rasinski Gregory, MD '59, Long Beach, CA, Internal Medicine. "I served with the President's Commission on Ethics in Medicine and Biomedical and Behavioral Research and currently am on the VA's National Bioethics Advisory Committee." Eli Isaacs, MD '59, West Bloomfield, MI, Obstetrics/Gynecology. "I am still working, but not out of necessity." Isaacs l23@aol.com 1950s 1960s Barry Weinstein, MD '69, (R-Amherst) Erie County Legislator, 15th District was re-elected in the ovember 1999 elections. He ran unopposed. 970s Allen L. Carl, MD '79, has been elected to the American Orthopaedic Association (AOA), an international organization with a mission to enhance the quality of musculoskeletal health. Membership in AOA is achieved by those who have made a significant contribution to education, research and the practice of orthopaedic surgery. Carl is professor Winter 2000 of surgery and pediatrics in the Division of Orthopaedic Surgery at Albany Medical College. He specializes in the treatment of spinal injuries and disorders in children and adults. 1980s Thomas Pullano, MD '8D, writes: "Since completing my fellowship in neonatal medicine at the University of Colorado, I have been working in Dallas. I am now medical director of the eo natal Intensive Care Unit at Presbyterian Hospital Dallas and a member of Magella Medical Associates. !ina]" article in the Greenville Magazine. Hollins is medical director/administrator for the Roger C. Peace Rehabilitation Hospital, which is part of the Greenville Hospital System. He is the first African American to ever hold such a post in the hospital system. Hollins began practicing in Greenville in 1991, following completion of his residency training in Buffalo in Physical Medicine and Rehabilitation. His wife, Suzette, earned an advanced graduate certificate in information and library sciences from UB in 1988. They are raising their three daughters in Greer, SC. 1990s Tina Marie Gardner, MD '87, Donato Borrillo, writes from Stamford, NY: "I am extremely busy in a hospital-owned outpatient practice. I also teach reading to atrisk kids, serve as a Cub Scout leader and am an attending at a nursing home. In my abundant free time, I camp with my husband, Joe, and our two sons, Jake (9), and Luke ( 4). MS, MD '90, JD, Dennis C. Hollins, MD '87, PhD, was recently selected for inclusion in the annual "Best Doctors in Greenville [South Caro- writes: "! married Christine Wells of Cleveland, OH, and have a ninemonth-old baby girl, Jessica. After graduating from UB medical school, I went on to obtain my law degree from Case Western Reserve University and am licensed to practice law in Ohio. In addition, I completed an aerospace medicine residency at Wright State University (board certified) and have a commercial multi-engine instrument-rated pilot's license. Currently, my family lives in England, where I practice as a flight surgeon for the 352nd Air Force Special Operations squadron at RAF Mildenhall. Cheers! William Palmer, MD '90, and his wife, Stephanie, announce the birth of Jayson William Palmer on September 6, 1999. He joins his sisters, Janee, 9, and Jilian, 7. Palmer is currently in an office-based physical medicine and rehabilitation group practice, Rehabilitation Associates of Indiana, in Indianapolis, I Krista M. ( Prigg) Kozacki, MD '91 , writes: "Life is wonderful in Florence, S.C. We had our third child, Emily Marie, on July 9. She weighed 7 pounds. Her twin brothers Stefan and Jacob (age 6) think she is their little princess. I more than ever advocate breast feeding to my patients now! I am loving my private practice more and more every day. It has been five years. I also get to interact residents. Call if anyone gets this way." EDITOR'S OTE: Due to space limitations, several Classnotes submissions were held for the following issue of Buffalo Physician. �Your stock may pay more dividends than you thought possible You dabbled in the market long before it became a fad and your hunches paid off. But now you need income, and your shares are only producing low annual dividends. so how can you make the most of your securities and still achieve your personal and financial goals? Give your stock to the University at Buffalo. With careful planning, your gift may provide you with income fOr life, a charitable deduction and reduce or eliminate taxes. And fOr UB it can mean more scholarships, research funds or the realization of your own personal vision and goal fOr the University. To learn how your gifts of stock can benefit you and the University at Buffalo, please call the Office of Gift Planning at !716l 645-3312. T~ University at Buffalo ':t=:::l The State University ofNew York University at Buffalo • Office of Gift Planning • 103 Center for Tomorrow • Buffalo, New York 14260-7400 • 716-645-3312 �l•ffale Pllyslcla• State IIIYirslty If lew Yerk at l1ffal1 M35 •ail St. 1111c. zz l1ffale lew Yerk 1U1•·3113 Non Prof I Org U S Postage PAID Buffo o NY Per I No 311 We Get Rehab Results! Our Superior ~M Improvement Vs. National and Northeast-em Regional Subacute Facillties Hve Star Care The McGuire Rehabilitation Centers achieve a 34% GREATER FIM5 M increase vs. the national average for all admissions. • Stroke • Pain Management • Medically Complex • Orthopedic • Infections • Cardiac • Cancer • Joint Replacement Eatll'lg • Amputee Our facilities were rated outstanding in the community with five stars out of five, according to the Inside Guide to America's Nursing Homes for long-term care. **** The McGuire Team ofExperts The McGuire Rehabilitation Centers employ a team of over 30 licensed Physical and Occupational Therapists, specially trained support staff, and an on-staff Physiatrist/ Gerontologist. Together they ensure the highest level of individualized medical and restorative care. Cost Effective! =Inpatient Admissions The McGuire Rehabilitation Centers' average charge per case is more than 35% WWER than other facilities in the nation, according to statistics from The Wall Street Journal and the American Health Care Association. I = Inpatient Discharge I = Outpatient Follow-Up Our case mix is consistent with the Northeas t and national subacute region. Our average s tatistics are: length of stay - 25 days; age - 78; admission FIM score 72.5; discharge F"JM score - 97.6 ; FIM change- 25 .1 points; length of stay efficiency 1.40; onset time - 17; discharge disposition - 80% to community. Based on 12 months ending March 31 , 1998. The McGuire Rehabilitation Centers rely on the national The results are in. The McGuire Rehabilitation Centers have leading measurement tool for documenting patients' the clear advantage over other regional facilities based on F!Ms"' rehabilitative outcomes. This tool is !mown as FIMSM< improvement, discharge to home, and cost effectiveness. lnstJument; Functional Independence Measure, developed Our successful rehab program delivers results by the UB School of Medicine along with the Center for j because of our superior staff, state-of-the-art equipment, Functional Assessment Research. It's used and specialized rehab facilities. Choose The along with the Uniform Data System for McGuire Rehabilitation Centers for five-star Medical Rehabilitation (UDSMRs"') rehabilitation services. to establish rehab outcomes that ~~"DU FJ"'JI'T"T~J\J Call 1-888-POSTACUTE. can be measured and calculated ~.L.U.J. ~\7~ "F"'H£ .1 c:/J'fCGULRE Jl DTT to document successful results. 1' .J.I1J CENTEP<B Copyright 1998 Uniform Data System for Medical Rehabilitation, a divisio: f ~ '-.. U8 Foundation Activities, lnc. All rights reserved. Autumn View • Garden Gate • Banis ffill • Northgate B P 0 003 00 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 2000 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 2000 Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v34n03-2000-Winter Table Of Contents A list of subunits of the resource. The 'Insider' Steps Out Back into Shape The Edge of Possibility Medical School Research News Student Column Alumni Development Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-10 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v34n03 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 2000 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/921ef24ffa18e8c64e5a98f93dc13604.pdf 3e2931c9565d3a095daa32c35adcbc26 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Autumn 1999 �neaP Alumni and FPiends, On the first day of orientation week, incoming students, parents, spouses, family and friends participated in the second BUFFALO PHYSICIAN \10lumc 34 umber 2 annual White Coat Ceremony, held this year in the Center for the Arts. (See article on page l2 of this issue of Buffalo Physician.) This event-based on an idea generated and ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES brought to fruition by Assistant Dean Tom Flanagan-will no doubt represent one of ~mnh the more memorable experiences for our students and, quite frankly , for everyone Dr Ctrolc Petro DIRECTOR OF PUBLICATIONS Kathryn A Sawner EDITOR ~tephame A Unger ART DIRECTOR/DESIGNER \Lm J Kegler PRODUCTION C.mdy lodd STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr john\\ nght Dean EDITORIAL BOARD Dr Benram P<>rtm. Charr Dr Martin Brecher Dr Hawld Brody Dr lmda J Corder Dr Alan J Dnnnan Dr James Kanskt Dr I Iizabeth Olmsted Dr Stephen Spauldmg Dr Bradley f Truax 'vis. Jenmfer \\tier Dr f rankhn Zeplu" nz TEACHING HOSPITALS f-ne County MediCal Center Kaleida Health-Ihc Buffalo General Hospttal fhe Chtldren's llospnalufBuffalo Mtllard ftllmore Gates Hospttal \1tllard hllmore ~uburhan llospnal Ros\\ell Park Cancer lnsUtute \eteransAffatrsWestern. ·e" )ork I kalthcarc S} stem Catholic Health S"tem\1ercy Health System SISters of Chanty Hospttal ·,agara I ails Memorial Medical Center ©The State universny of ew York at Buffalo Buffalo Ph1 sinan is published quarter!} hy the State UniverSI!) of :--:ew York at Buffalo School of \kdicme and Biomedtcal Sciences and the Oil ice of Publications. It ts sent, free of charge. to alumm, facultv students, reSidents. and friend~. rbe staff reserves the nght to edit all copy and submtssions accepted for publication. else involved. This being the second incoming class to have participated in the White Coat Ceremony, it dawned on some of our third-year students that they might have "missed something. " Therefore, at their request, a similar White Coat Ceremony was held a week later, on their first day of classes. Again, this event, like the first, was made possible by the generous support of the Medical Alumni Association, the Parents' Council, the james Platt White Society and our other generous student supporters. Incoming students were also treated to another form of welcome: a completely renovated Butler Auditorium and G26 classroom. During my student lunches last year, one of the most recurrent complaints about the medical student experience here was related to the "dismal" classrooms and the condition of the student lounge. Although Butler has been our best classroom, it lacked the most current educational technology suitable for computer presentations, and the carpet had seen better days. Those renovations, plus a new screen, are now in place. G26 was a slightly different story and over the summer was completely gutted and refurbished. Finally, with help from the Parents' Council and Polity, the student lounge has also been refurbished and now represents a more hospitable refuge for the students. Our plans for the coming year include completely refurbishing Farber 144 and establishing a new, more spacious and suitable student study-space and lockerroom facilities. Other projects are on the drawing board and will be implemented once the necessary planning and funding processes have been completed. It is our conviction that a good learning environment includes physical accouterments as well as all of the more intangible essentials. Our students also experienced another "first" this year as the United States Medical Licensing Examination (formerly the ational Boards) was offered via computer only. (See article on page 8 of this issue of Buffalo Physician .) Although one of the advantages appeared to be almost instantaneous feedback, the "spread out" nature of administration actually delayed the reporting of results. These standardized tests must be subjected to statistical analysis and therefore require completion by all candidates before validation is possible. So much for progress! A final note: Dr. Tom Flanagan really has retired, having completed the initial two years of his planned "retirement" as an assistant dean in the Office of Medical Education. We are all indebted to Tom for making this invaluable contribution to the school and look forward to his continuing participation in school events, even if on a less formal or frequent basis. In the meantime, we wish him and Grace all the best as they enjoy a well-deserved bona fide retirement. John R. Wright, MD Dean, School of Medicine and Biomedical Sciences �VOLUME 34 , NUMBER 2 .-----------------~ AUTUMN 8 On the Trail of Schistosomiasis Electronic Testing Makes Its Mark 2 14 1999 ARevolutionary Look at Medicine SCIENTISTS HUNT FOR MEDICAL LICENSING EXAM .JOSEPH GAGLIARD I GENES IMPLICATED IN NOW TAKEN BY COMPUTER, ASSUMES PERSONA OF THE DEADLY DISEASE REPLACING PAPER- AND- REVOLUTIONARY WAR by S. A. Unger PENCIL COUNTERPART Doc TO TEACH HISTORY photography by Frank Miller by Corrine Streich Hospital News and Philip LoVerde Photography by John Consoli CHANGES COME TO REGION'S VETERANS ADMINISTRATION SYSTEM Research • POTATOES DELIVER Medical School HEPATITIS 8 • • VACCINE Classnotes HARRY L . MOUSE CALLS METCALF , GALLSTONESMD ' 60, RECEIVES • LIFESTYLE LINK "THE SURFACTANT BERKSON AWARD STORY"- -AN UPDATE • GUM DISEASE AND • WHITE COAT CEREMONY STROKE RELATIONSHIP • FACULTY MEMBERS HONORED Alumni • THOMAS FLANAGAN , PHD ' 6 5 , RETIRES AFTER Student Perspective LONG AND DISTINGUISHED HEALTH - CARE POLICY: CAREER AT UNIVERSITY TO TREAT OR NOT TO TREAT-POLITICS Is AN ANSWER by Joseph S. Ross CC'VER ILL T RAT I Bv '> r HA E C~RTER THE (LASs oF 2003--White Coat Ceremony on September 9, 1999, Initiates First-Year Students �The FORGE S IMPLICATED in Schistosonriasis I T's OT DIFFICULT to understand why a sense of urgency underlies The S. monsoni efforts to find a cure for schistosomiasis. Victims of the disease are infected species of schistoso· miasis looms large in with parasitic flatworms that flourish in their blood vessels, discharging Dr. Philip LoVerde's eggs that cause debilitating, often deadly, damage to their tissue and vital life. As coordinator for the World Health organs. Currently, some 200 million people-the majority of whom are Organization's children-have schistosomiasis, making it the world's second most serious Schistosomiasis Genome Project, the University at Buffalo professor and parasitic infection, next to malaria. According to the World Health Organization (WHO), about 10 percent of these cases are severe, resulting in an associate chair of estimated one million deaths each year. Compounding the problem is the microbiology, fact that only one drug is effective in treating schistosomiasis, and the pidured right, is parasite is rapidly developing resistance to it (see article on page 4). determined to out smart the deadly flatworm. PHoros 0 Bl FR:\'\K MILLER Buffoto A . o PHILIP LoVERDE Physician Autumn 1 9 9 9 �GE ETIC EPIDE~liOLOG\ STL D\ T\KES l~B SCIE TISTS TO BY S. A. UNGER BH \ZIL �PHILIP LoVERDE, PHD, professor and associate chair of microbiology at University at Buffalo's School of Medicine and Biomedical Sciences, is a scientist who knows firsthand about the urgent concerns that drive the search to find a cure for schistosomiasis. Widely regarded as a leading international expert on the disease, LoVerde has spent the majority of his career attempting to gain a better understanding of schistosomiasis and ways to treat its victims. Currently, he is coordinator for WHO's Schistosomiasis Genome Project and is a member of the organization's Expert Panel on Parasitic Diseases. In 1998, he completed a term as chair of the ationalinstitutes of Health's Tropical Medicine and Parasitology Study Section and today is president-elect of the American Society of Parisitology. In an effort to move schistosomiasis research in a direction that utilizes the new tools and technologies growing out of the Human Genome Project and other related endeavors, LoVerde has embarked on an ambitious genetic epidemiology study aimed at identifying and localizing specific genes influencing schistosomiasis infection and its clinical course. "Our goal is to improve our understanding of the underlying genetic determinants of resistance to reinfection and disease progression," LoVerde explains. This understanding, in the long term, may contribute to the development of vaccines or other interventions, he adds. In order to complete the study, which is funded by a five-year, $1.25 million grant from the ational Institute for Allergy and Infectious Diseases, LoVerde and his collaborators have traveled to Minas Gerais, a state in Brazil where schistosomiasis is endemic. \11DI<I L \I r111 \lou:ctL\H LL\LL According to LoVerde, there are three components that play a role in the transmission of infectious disease: (l ) the environment where the agent is being transmitted, (2) the �c. c. Om goal is to improve our understanding of the nnderlying genetic detenninants of resista11ce to reinfection and disease progression.·") infectious agent's genes that control its virulence and how it infects an individual, and (3) the host and the host immune system and genes that regulate the immune response to the infectious agent. For years, scientists have studied the environment and the genes of infectious agents (in this case, parasites); however, until recently, they haven't had the sophisticated molecular and mathematical (epidemiological) tools necessary to study the contribution of host genetics to hostparasite interactions. LoVerde and his group are interested in exploring this latter component with the aid of these tools. Specifically, they are interested in what happens to an individual when exposed to the 5. mansoni species of schistosomiasis and , following that exposure, how the immune system responds in terms of eliminating the parasite, something scientists call protective immunity. By studying endemic populations, they are trying to identify phenotypes , combinations of genes in individuals that imbue them with a specific trait. In this case, the scientists are looking for immunologic phenotypes that confer on individuals the ability to: (1) become resistant to schistosomiasis , (2) prevent reinfection, and (3) avoid development of severe hepatosplenetic disease (enlargement of the liver and spleen, which can cause death). Once this phenotype is developed, the scientists will use genetic epidemiology tools (e.g., quantitative genetic analysis , including variance components methods) to discover and test the relative contributions of genes and environment to the variation of a given trait. After the role of host genetics is clarified, they will use a gene-hunting technique called linkage analysis to home in on where the genes implicated ducted. in the phenotype are located on a I B u f f a l o Physician Autumn 1 9 9 9 �c.c. We've been able to show for the first tin1e that inclivicluab \\'ithin the san1e fa1nil~ all respond in a sitnilar fashion to an antigen-they sho\\T the san1e pheno~1)es. in1n1unologically. to the infection. specific chromosome. If specific genes are identified, scientists can then study their complex interactions with the immune system and develop a much clearer understanding of how to devise interventions at the molecular level. completed, involves treating everyone in the village and taking blood samples in order to extract serum, which contains antibodies. (Antibodies are protein molecules produced by the immune system in response to substances called antigens. An antigen is any foreign FII Ll) lh . . , I \ H( II pH()\ II) I . . , K L' D \ 1'\ substance that, when introduced into the body, is recogTo accomplish this complex task, the UB scientists are nized by the immune system and targeted for destrucstudying the population of a village called tion.) The third procedure involves Melquiades, where they have conducted studying the response of antibodies to demographic and genealogic analyses to schistosomiasis antigens , which enables determine who lives there and who is scientists to begin piecing together the related to whom. With the assistance of exact way a person's immune system Brazilian physicians, they have also mounts an attack and then , from that, performed stool exams and completed construct a phenotype. ultrasounds to ascertain who is infected, The immunologic phenotype the UB the level of intensity for infection and the team is interested in identifying pertains clinical stage of disease. "We determine to how T cells respond to antigens by intensity of infection by counting the numreleasing molecules called cytokines. "In ber of worm eggs per gram of feces, " particular, we are interested in a sub-type explains LoVerde. "An infection of 100 ofT cells called Th 1 because they produce interferon gamma, a potent cytokine that eggs per gram and over is pretty severe, marking the point between clinical and promotes the response of macrophages, subclinical. " The results of these tests have which can kill schistosomiasis parasites," revealed that 68 percent of the says LoVerde. Other cytokines village population is infected they are interested in tracking and that the mean egg-perare T F alpha, the overgram feces ratio is over 200. expression of which correlates Once prevalence and with severe hepatosplenetic intensity were determined , the disease, and Th 2-type research team set out cytokines, which produce an to identify phenotypes , a antibody called IgE that has process that involves three been shown to be important procedures. First, they used in protective immunity against their genealogic data to build schistosomiasis. "So these rea family tree called a pedisponses are phenotypes, and gree. " The pedigree in we can measure them, " Melquiades is made up of over 2,000 explains LoVerde. "And if there is in fact a Schistosomiasis is people, of whom 800 are still alive. And it genetic basis for these immunologic phenoendemic in the turns out that the area we're studying is types, we would expect to find familial Brazilian state of one huge pedigree. ow, that's really aggregation of them. As it turns out, this is Minas Gerais. significant because we can perform matches the case. We've been able to show for the first statistically and can look for the identifitime that individuals within the same family cation of genes or associations of traits that result in all respond in a similar fashion to an antigen-they show certain phenotypes we're measuring," explains LoVerde. the same phenotypes, immunologically, to the infection. " The next procedure , which is currently being This is extremely important, LoVerde points out, 0 B u f f a l a Physic i an Autumn 1 9 9 9 �Parasitic flatworms of the Schistoso- person's skin, they can penetrate matidae family are responsible for unbroken tissue and eventually the three main species of schistoso- enter the bloodstream, where they miosis found worldwide (primarily in feed and grow. The worms then Asia, South America, Africa, the migrate to the circulation of the Middle East and the West Indies). intestine or bladder, where they de- Depending on the species of worm, posit eggs that are discharged in the the female flushes out 300 to 3,500 feces or urine. Thus, the cycle begins eggs daily. Eggs that come in contact anew-but often not before the with freshwater hatch, releasing ciliated larvae that go in search of a snail host to infect and grow within. Over time, microscopic worm larvae leave Pictured above is study collaborator Fred Lewis, PhD, of the Biomedical the snail and swim about in fresh-water. If they come in contact with a Research Institute in Rockville, Maryland. "because we know that in people with severe hepatosplenetic disease, the number of parasites is an important indicator of how well they do; yet we also know that in people with the same high number of parasites, some go on to develop severe disease, while others don't. So, it's something besides just the number of parasites, and we think it's host genes." for genes believed to be implicated in the immunologic phenotype. "In humans, there's a major locus on chromosome 5 called q3l-33 , which correlates with resistance to reinfection of schistosomiasis and, lo and behold, what we find is that there are genes that produce cytokines that behave a lot like lL-4, which controls lgE production. This means that the level of expression of lL-4 by T cells is determining in part whether or not somebody is going to be resistant or susceptible to reinfection, and so this major locus seems to be controlling the host-genetic response," explains LoVerde. "Once we identify the genes, this will give us insight, at the molecular level, into the immunological mechanisms that account for either disease resistance or disease progression. And then what we can do is intervene, because we will know what the target is and we will know what we have to focus our vaccines on, as well as ways to manipulate those vaccines." + TIIIIIL IIOHCI L'-, With an immunologic phenotype established, the researchers are using genetic epidemiologic methods described earlier to quantify the relative importance of genes , environment and gene-environment interaction for determining a given phenotype. According to LoVerde, current results point to genetics accounting for as much as 45 percent of the host's response . In the final stage of their study, they are using the powerful statistical technique of variance components analysis combined with linkage analysis to search B parasite has left a trail of devastation within its human host. u f f a l o Physician Autumn 1 9 9 9 0 �BY NICOLE PERADOTTO Medic Ilice • 1111 Cl hat's because last spring, the Class of 200 1-collectively they represent some 17,000 students nationwide-became the first to take the computerized version of the Step One exam. By this fall, all three steps will be offered only on computer, following the decision by the ational Board of Medical Examiners ( BME) to replace the USMLE paper test with its high-tech "e-test" counterpart. That's right: The sharpened No. 2 pencil has at last given way to the mouse. And such a change can trigger exam anxiety even among children of the computer age . "There was definitely a lot of concern about the test-more so than in years past, I'm surebecause the game was changing completely, and we were the first to play by the new rules ," Adams says. In fact, the NBME first began considering a change to computer-assisted testing 22 years ago, although they didn't start working toward that goal until 1996. The new format follows a national trend at century's end that has seen standardized test takers at various educational levels go from shading in ovals in neat rows to pointing and clicking their way 0 B u t t a l o through exams. In addition to the USMLE, such standardized tests as the Graduate Record Examination (taken annually by 400,000 people) and the Graduate Management Admission Test (taken annually by 200,000 people) are now computerized. In most countries, the Test of English as a Foreign Language is also offered electronically. "The biggest reason we went this way was security," explains BME president Tom Bowles, MD. "It's very hard to steal exams that have been administered electronically. " Another improvement over the conventional format is convenience, as the step exams can Physician Autumn • 1 9 9 9 �ILLUSTRATION BY now be taken throughout the year rather than just biannually on set dates. ' omputerizing the exam will allow much greater scheduling flexibility and convenience than in years past," says Frank Schimpfhauser, PhD, assistant dean for educational evaluation and research at UB's School of Medicine and Biomedical Sciences. "Students can arrange to take the test based on their own study needs and academic schedule. Also, those who have had to change their test date-either for illness or for another reason-are finding the new format much more accommodating to their needs." Since it emerged on the scene more than a . B u f f a l o Phys ici an STEPHANIE CARTER decade ago, computerized testing has not received universal passing marks however. One concern has been that with so many test dates available, opportunities for cheating will abound. Other critics worry that the tests are unfair to students who are not computer literate and question whether e-testing is worth the hike in exam fees that typically come as part of the new package. "The computer doesn't magically transform a test into a better test," notes Robert Schaeffer, director of the ational Center for Fair and Open Testing, in Cambridge, Massachusetts. "But it seems inevitable that once you have the technology, people want to use it. So you have these multiple-choice Autumn l 9 9 9 0 �(·Testing "There was definitely a lot of concern about the test-more so than in years past, I'm sure-because the game was changing completely, and we Were the first tO play by the neW rules." - Christopher Adams, Class of 2001 marathons whose existing flaws may only be reinforced on computer." Furthermore, he points out, computer tests end up costing students more on two fronts. First, the price tag for the test increases, which will be the case for medical students starting in 2000. Second, whenever the format of a test is altered, students tend to invest in updated preparatory classes, such as Princeton Review and Kaplan Preparatory Classes. nd then there's the dreaded "black screen of death," when computers craSh beroreor during an exam. That happened to a group of students taking Step One exams thispastsummer, acknowledges Bowles of the BME. However, he adds, the affected students in this case were accommodated with "fairly rapid re-testing. " "With the paper-and-pencil exam, we had disruptions caused by hurricanes, exploding boilers, bomb threats and so forth," he continues. "If you take the total number of examinees who experienced disruptions this time around, it's not a whole lot different from the previous era." 'Tm sure the students who are affected by the glitches think it's not good, but when you look at the total picture, it's been very smooth," says - Alice Wooden Kelly, director of administration at the BME. She feels students will appreciate the many benefits of e-testing, including receiving their results faster, more than they will mind some of the drawbacks to the new format, such as paying a little more for the test. ® B Beyond having been transferred to the computer, other aspects of the step exams have changed dramatically. The Step-One exam, for example, has been reduced from a 700-question, two-day test, to a 350-question, one-day test. The Step Three exam, which will be offered for the first time this fall, incorporates sophisticated case simulations into the 14-hour exam. Test takers will be presented with "virtual" patients, and will be expected to take a history, order lab tests and so forth. As the test progresses, the patient's condition will change based on the student's decisions. "The case ~.J<. simulation is virtually impossible on a paper, , and-pencilexam,"Bowles f• ·~ says. "We think it challenges the examinee to a higher level of clinical reasoning. " As he watched the Class of 2001 ready itself for e-testing, Schimpfhauser, too, noticed severe test dread hitting the student body. "Everyone was extremely nervous because it was a new situation," he says. "For many, the computer testing is perceived as an improvement in the examination procedure, but some students thought that it would compromise their ability to show what they know." Danielle LaPrairie counts herself in the latter group. She excels at standardized tests-the kind that involve filling in hundreds of digitype bubbles with a o. 2 pencil. She worried that staring at a computer screen for seven hours would strain her eyes. She wondered how she would adjust to taking notes with a marker on a dry-erase board rather than working through problems on scratch paper. In short, c u f f a l a she feared that any change in the formula she knew so well might adversely affect her score. Then she practiced for the exam on the CD-ROM she received with her registration materials. "After that, I felt much better about taking the test on the computer. It brought it back down to being worried about what type of questions would be asked," she says. And how did she like the exam? "I had never sat in front of a computer for that long. I was very nervous about that. It was forcing me to change the way I take tests. But looking back on it now, I don't think it had that much of an effect on how I did." Overall, UB students had few complaints about the new Step One exam and tended to prefer it to the paper-andpencil test. While some worried that an abridged exam would mean broader questions (which it didn't), their pretest anxiety was somewhat assuaged by the fact that the exam had been cut back to one day. While taking the USMLE at Sylvan Learning Centers, where the exam is administered locally, Michael Duff didn't miss his o. 2 pencil for a minute. "It was just so simple," he saysreferring to the format; that is, not the questions. And Duff doesn't consider himself among the most computer literate of his generation. He was a physics major as an undergraduate, so his calculator was his best friend. But as an instructor of an MCAT prep course, Duff recognizes that one of the biggest mistakes students make in a paper-and-pencil test is answering questions in the wrong order. "I liked this test because I didn't have to go back and forth between a test booklet and an answer sheet. The questions I Physician E · TESTING CONTINUED ON PAGE 29 Autumn l 9 9 9 �The Smfactant StoiY-An Update INFASURF G_OES TO MARKET WESTERN NEW YORK HEALTH RESOURCES WESTERN NEW YORK HEALTH DATABASE FULL TEXT REPORTS SECTION FACILITIES , ORGANIZATIONS , AND AGENCIES OTHER SOURCES OF INFORMATION HE SPRI G 1999 ISSGE of Buffalo Physician featured a Special Report titled "The Surfactant Story," which chronicled pioneering contributions made to the field of surfactant therapy by University at Buffalo scientists and physicians over the past four decades. Prominent among those profiled in the article was Edmund "Ted" Egan, MD , UB professor of pediatrics and physiology and president and chief operating officer of 0 Y, Inc. , a company he founded in 1985 to manufacture and distribute Infasurf, an exogenous surfactant product that he and his colleagues had developed for the treatment of neonates with respiratory distress syndrome (RDS) . At the time that issue of Buffalo Physician went to press in May, 0 Y, Inc., was unable to commercialize Infasurf due to a legal challenge from one of its competitors, Abbott Laboratories, which in 1994 claimed Infasurf infringed on the patents of its surfactant drug, Survanta. In September 1998, a jury in District Court in Buffalo ruled in favor of Abbott Laboratories, but a final judgment had not been entered. Onjune 23 , 1999,Judge Richard]. Arcara ruled that Abbott Laboratories failed to prove 0 Y, Inc. , had infringed on its paten I.. The judge also issued an "estoppel," which prevents Abbott Laboratories from claiming infringement based on a principle-of-fairness doctrine. "We're jubilant here, " says Egan . "This is the culmination of a 14-year odyssey. That's how long we've been working on this project." The decision will allow 0 Y, Inc., to proceed with manufacturing Infasurf at its facility in the Baird Research Park on Sweet Home Road in Amherst, New York. "We will also be able to hire more employees and to rehire employees who were laid off after the decision that came out last year,"says Egan. In addition to being used a:u~ treatment for neonates with RDS , Infasurf is also currently being studied in clinical trials involving pediatric patients who receive the drug for a wide spectrum of respiratory disorders. In a study published in january 1999 in Critical Care Medicine (Vol. 27, o. 1), it was shown that these patients experienced rapid improvement in oxygenation and , on average, were extubated 32 percent sooner and spent 30 percent less time in the pediatric intensive care unit than control patients. As a result, larger, blinded, controlled studies are planned. + �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] ~ I Lifelong Cultivation of Character WHITE COAT CEREMONY I NITIATES C L ASS OF 2003 '\1 ALGl-ST 9, 1999, the Univer- sity at Buffalo's School of Medicine and Biomedical Sciences welcomed its Class of 2003 at the second annual White Coat Ceremony, held in the Center for the Arts on the orth Campus. The ceremony is now a rite of passage for first-year medical students , who are reminded of their responsibility to "care" as well as "cure" patients by endorsing a psychological contract of professionalism and empathy at the start of their medical careers. To formalize this commitment, they are officially "cloaked" with their first white coats; then, as a group, they recite the Physician's Oath, a modern Sean Garvin, left, and Micheline Lubin, above, proudly "cloaked" with their new white coots. version of the ancient Hippocratic Oath. Opening remarks were made by medical school deanjohn R. Wright, MD, who highlighted the fact that the Class of 2003 is the last class entering the school this millennium. The Physician's Oath, he added, was "specially designed for our school because the ethical basis of medicine is an evolutionary process" and one that requires updating to reflect current issues." Number of applicants: 2,200 (440 of whom were interviewed) The students were Class size: 13B (plus 4 MD/PhD students) then addressed by Where they call home: 69 of the students ore from Western New York, Wesley L Hicks, 21 from the "extended" Western New York region, 13 from upstate New DDS, MD '84, an asYork, 33 from downstate New York, and 2 from out-of-stole. sociate professor of Female-Male ratio: 76 women and 62 men otolaryngology at Undergraduate degree institutions: 2B of the students graduated UB, who implored from the University at Buffalo, 19 from Cornell University, 9 from Conisius them never to forCollege, and Bfrom the University of Rochester; other institutions get that "you are not represented include SUNY at Binghamton, Yale University, Johns Hopkins here only because of University and Rochester Institute of Technology your grade point Average science grade point average: 3.6 (overage overall GPA, 3.6) average and MCAT Average MCAT score: 9.B scores ... but you A"Class" Profile -2003 are here today because your letters of recommendation and your interviews revealed you as having character. "In my view, character is a sense of integrity, noble purpose, thoughtful determination, intellectual curiosity and generosity of spirit," he added. "As I think of my colleagues, teachers and mentors whom I admire and respect, I know this to be true." Hicks also reminded the students that "learning histology is a semester's challenge; it's finite. Integrating honesty, determination and wisdom into your practice of medicine is a lifetime's commitment. If you remember nothing else from our conversation today, remember this: What translates the mechanics of medicine into the art of healing is the character we bring and communicate at our patients' bedsides." In concluding Hicks noted, "But to live your lives and apply to your practice of medicine the highest standards of character requires individual effort, introspection and, at times, emotional angst. Above all, it requires your giving yourselves to something outside of self." + - 5 . A . UNGER ® B u f f a 1 a Physician A. u t u m n 1 9 9 9 �Two Faculty Members Honored MARK YOUR CALENDARS r \CGLT't \1[\,1BERS 1 THE SCHOOL OF MEDICI E and Biomedical Sciences were honored this summer at the school's annual faculty meeting. BRUCE A. HoLM, PHD, professor of pharmacology and toxicology and of gynecology-obstetrics, and associate dean for research and graduate studies, received the George Thorn "Young Investigator" Award. This award recognizes investigators under age 45 who have demonstrated outstanding scientific achievement and the potential for continued contributions to the academic programs and creative environment of the School of Medicine and Biomedical Sciences. Holm, whose work has attracted millions of dollars in grant awards to UB , won the award for his research on lung surfactant and oxygen toxicity affecting alveolar cells. He was also recognized for his exemplary commitment to UB students and academic programs. George Thorn, MD '29, is one ofUB's most distinguished alumni. In 1939, in recognition of his research on Addison's disease , he received the highest honor that can be bestowed upon a medical scientist in the United States-the Gold Medal , awarded by the Bruce A. Holm, PhD American Medical Association. In 194 2, he accepted the Hersey Professor of Theory and Practice of Physics at the Harvard Medical School, which began his long association with that institution. Later in his career, Thorn was named president of the Howard Hughes Medical Institute, and in 1984 he was appointed chair of its board of trustees. ·MAURIZIO TREVISAN, MD, professor and chair of the Department of Social and Preventive Medicine, received the 1999 Stockton Kimball Award, honoring a faculty member for academic accomplishment and worldwide recognition as an investigator and researcher. Trevisan is known internationally for his research into cardiovascular disease risk factors. He is primarily responsible for establishing the Women's Health Initiative at UB through a $10 million grant M . . T . MD aunz1o reviSan, from the ational Institutes of Health. Stockton Kimball, MD '29 , was dean of UB's School of Medicine from 1946 to 1958. Dr. Kimball's contributions to the training of physicians in Buffalo spanned more than a quarter of a century. Under his dedicated leadership as dean , the medical school attained new heights of recognition. + \\0 B u f f a l o Phys i c i an Autumn 1 9 9 Our Health Care Industry at the Crossroads, What Lies in the Future? Location: Date: Time: Keynote Speakers: Adams Mark Hotel Wednesday, November 17, 1999 8 a.m.-5 p.m. Nancy Snyderman, MD Medical Correspondent on ABC's Good Morning America George Will Columnist, Washington Post Present Michael Millenson Author of Demanding Medical Excellence Panel Discussi Physicia Panelists Community and business leaders Health-care provider, CEOs, Insurers l. N. "Nick" Hopkins, MD Irene S. Snow, MD Allyn Michael Norman, DO Registration Fee: $80 For more information, call Independent Health Foundation at 635-4959. @ Minority Alumni Reunion University at Buffalo School of Medicine and Biomedical Sciences "Coming Together in the New Millennium" Date: April 7-9, 2000 Place: University Inn, Buffalo, New York For more information, contact Dr Carolyn Hamilton, assistant dean for Mmonty Affairs. Phone: (716) 829-2802; fax: (716) 829-2798; or e-mail, cah7@acsu.buffalo.edu In the summer issue of Buffalo Physician a graduation picture of Maria LoTempio and John Carter was published in the table of contents. In the photograph, Carter was incorrect~ identified as Patrick D'Abbracci. Match Day /Northwestern University Under the Match Day listings in the same issue, McGaw Medical Center of Northwestern University was incorrectly listed as McGaw Medical Center Northwest or W under the names james Flaherty, Henry Lee and Amy Weinstein. Peak Experience The normal pulse oximetry rate is approximately 96-100 percent, depending on the altitude of the patient. It is not 90-100 percent as stated in the article "Peak Experience," published in the summer 1999 issue of Buffalo Physician. <D 9 �JOSEPH GAGLIARDI' MD '7 9' TEACHES KIDS WHAT PHYSICIANS USED TO DO FOR A LIVI~G SLOUCHED IN CLASSROOM SEATS, the seventh and eighth graders wear the guarded, "what's-this-guy-tryingto-pull?" expression of adolescents when their teacher introduces Dr. Alexander Dobbs. Authentically dressed as a regimental physician and surgeon in General George Washington's army, Dr. Dobbs (aka joseph Gagliardi, MD, Class of 1979, family physician and addictionologist in Columbia, Maryland) jumps directly into his monologue. "Despite the victories at Trenton, Princeton and Saratoga, the war for independence is floundering. The small, poorly fed and ill-equipped Continental Army suffers from many maladies," he says in the present tense, with just a shading of colonial syntax and mannerisms. ��When he [Dr. Dobbs} tells the students that he washes his instruments in plain water between operations, some are appalled and others refute it. Even junior high school students understand the necessity of sterilization, but they have little understanding that there was life before ER and Chicago Hope. welcome lecturer at local schools, historical societies and medical conferences, Gagliardi delights teachers with the unique learning experience he brings to their classrooms. However, media-sophisticated kids who have grown up with Mortal Kombat and MTV music videos are not an easy audience for a serious guy in a funny suit. So Dr. Dobbs starts slowly, commenting on the boys' strange attire , at the rips in their jeans. He asks the girls why they are there (girls often did not have an opportunity to go to school in colonial times). Then he gets all of the children out of their sedentary slouches, and teaches the girls to curtsy and the boys to bow. ow they are amused. He talks about himself. Like Benjamin Franklin , Dr. Dobbs is one of 17 children. He was told at the age of 10 that his father could no longer afford to keep him, and he was apprenticed to a physician. "Before I could begin my medical studies, I had to learn to read ," Dobbs says. ow the kids start asking questions , and he gives them an anecdotal but accurate overview of the rigors of daily life and the social mores of colonial times. After nine years of honing his presentation skills, Gagliardi knows just how gory to make the medical details of his lecture, and when to ask for volunteers. Using reproductions of colonial surgical instruments , he simulates a leg amputation in a military hospital during a Revolutionary War battle. By introducing them to medical practices of the past, Gagliardi hopes to broaden their understanding of modern medicine and to teach students that what happens in a doctor's office today isn't so bad. "Maybe they won ' t scream bloody murder if the doctor wants to take a P throat culture, now that they know that in Dr. Dobbs's day he'd have bled their necks to cure a sore throat. " Gagliardi started speaking publicly in 1990, when his son's social studies teacher asked if there were parents with special interests who would come to class to talk about them. An avid student of the history of medicine, Gagliardiplaying himself- gave an overview of practices from the American Revolution to the Civil War. The students were impressed. Some even told their parents that something of interest had actually happened at school that day and they related grisly details about how legs were once chopped off without anesthesia or the sterilization of instruments. After he had given several more lectures as himself, Gagliardi decided that a more dynamic approach would be to allow students to interact with a physician from the colonial period. The transition, he figured, would "give me a chance to get out of the 20th century completely and play around in the 18th." But he wasn't altogether confident. Lecturing came easily to him , but could he be convincing as Dr. Dobbs? To make his characterization as authentic as possible, Gagliardi read in depth about late-18th century American life, concentrating not only on general history but also on the subjects of dress, social customs, medicine and science. He also traveled repeatedly to colonial Williamsburg to observe the authentically dressed impersonators of aristocracy and tradesmen at work. Although he admired their skill and the physical beauty of the reconstruction , he thought that visitors should be given a truer picture of life in colonial times. hysician Autumn 1 9 9 9 �o emphasize the contrast between the life of a child today and that of one 250 years ago, Gagliardi decided to stress details of Dobbs's own childhood. For Dobbs, not having any schooling was not nearly as bad as having no time to play. To survive, average families worked together from dawn until dark every day except Sunday-which was spent praying in church and doing other "quiet" activities. One Sunday, the young Alexander Dobbs was seen running and playing, which led to Dobbs's father being fined by the church warden. Because the fine was much more than his father could afford, the boy was sent from home to work as a physician's apprentice. On the eve of every public appearance, Gagliardi goes to bed thinking B u f f a l o about these details, as well as other aspects of Dobbs's life. In the morning he puts on his long coat, one-size-fits-all breeches (with a knotted string as a belt), a three-cornered hat, and riding gloves. On the way to school he plays tapes of colonial music on the car stereo. "When I step out of my car, I go into the school office and introduce myself as Dr. Alexander Dobbs," explains Gagliardi. 'Tve never had any acting experience, so this helps keep me in character." The more convincing he is as Dr. Dobbs, the more curious the students become about women's roles, disease causation, and other issues they can learn about from their 18th-century visitor. The combination of medicine and social sciences in Gagliardi's outreach to students is a logical progression of his educational background and interests. Physician Autumn l 9 9 9 As an undergraduate at the University of otre Dame, he studied sociology and education, intending to become a social studies teacher. During his senior year, a course on the sociology of medicine sparked his interest in the science. He entered medical school at the State University of New York at Buffalo in 1975 and completed his family practice residency at the University of Maryland in 1982. While in medical school, Gagliardi started the Mad-Med newspaper and, in conjunction with classmate Peter Condra, MD '79, founded the Mad Med Choir. He also established the Mad-Med Talent Show, the forerunner of the school's current talent show. Today, he practices with Patuxent Medical Group in Columbia, Maryland, where he lives with his wife, Diane, who works in early childhood education, his 17-year-old son, ] oe, and 14-year-old �"May be they won't scream bloody murder if the doctor wants to take a throat culture, now that they know that in Dr. Dobbs's day he'd have bled their necks to cure a sore throat. " daughter, Christine. He also serves as an invited to the Universal Studios in Or- from Vermont to Alabama. associate professor of psychiatry at the lando, Florida, where he appeared on a Predictably, when he speaks before University of Maryland, training third- live show called "Ask the Family youngsters, there are always a few who year medical students in addiction Doctor," which airs on America's Health try to trick Gagliardi into admitting that issues; and as a clinical instructor, work- Network. In addition, he has lectured to he drives a car and gives his patients ing with students who rotate through his numerous medical organizations, aspirin. Once while demonstrating a leg practice in four-week intervals. amputation in a lOth-grade Since first donning the garb history class, he saw a boy slip and persona of Dr. Dobbs, out of his chair onto the floor. "I Gagliardi estimates that he has thought, 'There's a comedian reached more than 10,000 stuhere,' and waited a few seconds dents across Maryland. (All perfor him to get up. When he didn't, formances are done in his free I went over, saw he had fainted, time and without charge to and helped him come around." schools and historical organizaGagliardi later learned that the tions throughout the state.) In boy passes out whenever he hears recent years, he has also spoken discussions about blood and before the American Academy of gore. That was the only time Family Practitioners at its annual Dr. Gagliardi has had to stand in conference in Boston and was Mock amputation elicits strong reaction from a captured audience. for Dr. Dobbs. + ® B u f f a l a Phys i cian Autumn 1 9 9 9 \ I �HIS FALL, THOMAS D. fLA AGAN, PHD, announced his retirement from the University at Buffalo School of Medicine and Biomedical Sciences after a long and distinguished career. As Dean Wright explains in his message in this issue of Buffalo Physician (see inside front cover), Flanagan retired as professor emeritus of microbiology in August 1997, but agreed to remain at the university to serve for two years as assistant dean for student and curricular affairs in the Office of Medical Education (OME). Flanagan, who received the Dean's Award for Distinguished Service this year, came to UB in 1962 to begin work on his PhD. Following graduation, he completed a postdoctoral fellowship in what was then the Department of Bacteriology and Immunology, where he studied under Almen Barron and Ernest Witebsky. In 1966, he was named an instructor in the Department of Microbiology. In 1973-1974, Flanagan was a guest research worker in the Department of Tumor Biology at the Karolinska Institute in Stockholm, Sweden, and visiting professor of microbiology at the University of Linkoping, also in Sweden. Two years after returning to UB, he was named professor in the Department of Microbiology. In 1982, he again took a leave from UB to serve as a guest research worker at the ational Institutes of Health in Bethesda, Maryland. In 1986, Flanagan was appointed acting chair of the Department of Microbiology at UB, and in 1987 he was named chair, a position he held until1990. "Tom served as acting chair of the Department of Microbiology during a tumultuous period in the department's history and served as chair during an equally challenging time," says Wright. "For over two decades he directed the sophomore Medical Microbiology course and, for much of that period, I was his counterpart in Pathology. Through this long relationship , I developed enormous respect for Tom, particularly for his dedication to students." \ I B u f f a I o Phys i c i an According to Wright, Flanagan's major research interest was virology and for much of his career he headed the Virology Laboratory both at Erie County Medical Center and at UB. In addition to many other school-wide activities, he promoted student research and chaired the school's student research fellowship committee for almost 20 years. "When I was appointed Interim Dean and needed someone to help out in the Office of Medical Education-in particular, to address the needs of first- and second-year students-! looked to Tom Flanagan for help," says Wright. "Then·, in September 1997, we took advantage of the fact that he was willing to continue his part-time work in OME, even though he had just assumed emeritus status in the Department of Microbiology." Although the position was officially part-time, according to Wright, "Tom not only exceeded any mythical time commitment limitation previously established, but he brought his wisdom, years of experience with students and his enormous compassion to that office. We are greatly indebted to him, not only for his years of service as a faculty member and leader within the Department of Microbiology, but for the many important contributions he has made to OME over the past two years." In commenting on his years of service at UB, Flanagan says, "One of the things that's been very exciting about working here is that there's been a lot of change, ferment and energy towards growth and increase in stature for the university, and this is something I see continuing." Teaching, he adds, has been an especially rewarding endeavor: "It's been frosting on the cake to be able to teach-to interact everyday with young people who are well motivated in a balanced way, who retain their idealism and who know what they want to accomplish. It's very energizing for everybody involved." Retirement, says Flanagan, will involve "anything that can fit around playing golf. " He adds that he and his wife, Grace, plan to spend about five months each year at their home in South Carolina. + Autumn 1 9 9 9 �s ········· · ········ · ················· · ····· · ···························· · ················· · BY SCOTT THOMAS Change Comes to the Veterans Affairs Healthcare System WESTERN NEW YORK FACILITIES RETOOL AND RESTRUCTURE YO E CASTING A WARY EYE line would have to be pleased with what's been going on within Editor's note: he following the Department of Veterans Affairs (VA) Western New York ltuUt IStlltWS(InQ hrce-pmt senes Healthcare System. highlighting t han~cs 111 the A series of reorganizational moves and the establishment of ealth-t are deliver} ~} ster11.s in Western several community-based clinics are enabling the VA to deliver C\\ health services more conveniently, more effectively and less Yorll. Pre\ to us articles gtl\ C (Ill 0\ ei\IIC\\ on the federal government's bottom expensively than ever before. And because the system has been oj ( hanges that resulted m the retooled to emphasize primary and preventive care, the VA has onnatwn of the Kalc1da become a more well-rounded health-care delivery system, not just lealth S\ stem (Bufblo a place where veterans go for acute and emergency treatment. Ph\ siCian, Summer 1998) c nd in the reconj1guring of rhe Callwlu Health .'>}stem (Buffalo Physician, Spring 1999). 11 ® historic 11-story Buffalo facility on Bailey Avenue was integrated organizationally with the VA's Batavia facility, creating what is now a single management structure that allows more resources to be directed toward patient care. Goals of the integration have included the establishment of patient-privacy projects, purchase of high-tech equipment and upgrades in patient amenities. In addition to patient-care concerns, changes in the VA Western ew York Healthcare System have been spurred by the twin necessities of every healthcare delivery system today: competitive pressures and cost containment. In the 4 7-counties included in the VA Healthcare etwork of Upstate ewYork, the "Often, veterans were coming to us only when they needed emergency services," says Roger Maddigan, who, as manager of medical VA care, is responsible for overseeing the agency's community-based clinics and primarycare services. "Back in 1995-1996, we saw that we needed to change and to start providing general health services that emphasize preventive care and the treatmentofchronicdiseases-things that we see a lot of in our population," he explains. "Since then, there's been a shift to primary care. We've been telling people, 'Don't wait until you're so sick that you have to come to the emergency room."' It was also during this time-in March 1995-that administration of the Buffalo Phys i c i an Autumn 1 9 9 9 �············· · ········ · ·· · ···· · ········ · · ··· ·········· ·· ··· ···· ·········· · · ·· ····· · ······· [ i ] population of veterans is expected to shrink by 22 percent over the next 10 years, according to VA statistics, which means fewer potential patients making use of the system. Also, because many veterans obtain their care outside the VA system, the VA has recognized the need to emphasize patient services and quality of care in order to help it compete with other providers. Additionally, the system faces the challenge of a patient population sig- veterans than ever before. We find an increasing number of veterans who either opt to come here for their care, for which we receive reimbursement from their insurance company, or who come because they have no private health insurance. "We believe we provide superior health care because we concentrate on preventive health care. For example, we look very closely at smoking, hypertension and diabetes, and we have some very aggressive programs to treat these conditions." emphasized outpatient care, to the point where 75 percent of surgeries are done on an outpatient basis. During last year alone, 412,121 outpatient visits were made to VA facilities in the Western ew York system. This turn toward outpatient and clinical care is reflected in changes in the delivery ofservices at the agency's Batavia hospital, as well as in the establishment of community-based VA clinics in Jamestown, Dunkirk, iagara Falls and, most recently, Lockport. "We saw that there are veterans living in outlying areas, and it was very much a disadvantage for them to travel long distances for their primary health care," Maddigan says. "So we established clinics in outlying areas to serve these populations. We're also looking at establishing additional clinics within the City of Buffalo , particularly in South Buffalo and on the East Side. There's a population of veterans who find it difficult to travel to Bailey Avenue, even from a relatively short distance." Operation of the community-based clinics is contracted out through a bidding process. The Niagara Falls clinic, for example, is operated by Horizon Health Services, a private, not-for-profit company, which currently serves 600 to 700 veteran clients at the site, The Bailey Avenue facility is increasing outpatient services to the point where 75 percent of surgeries ore done onon outpatient basis. nificantly older than the general public. In 1998, 47 percent of all patients in the VA's upstate network were over age 65. "Some people feel that the VA is dying and going out of business. That is totally wrong," Maddigan says, adding that 18 percent of eligible veterans in the region currently seek care in VA facilities. "Last year we treated more individual B u f f a l o P hys i ~ ne notable outcome of these recent changes is that the number of beds at the VA's Bailey Avenue facility has been reduced to 167, down from approximately 500 beds a decade ago and a high of 900 when it opened in 1950. With two primary-care clinics located at the Bailey Avenue facility, however , the VA has increasingly cian A utumn 1 9 9 9 according to Jennifer Vogel, MS, Horizon's director of medical services. Before its association with the VA, she says the clinic was best-known for its mental health services, particularly for patients with substance abuse problems. With the addition of the VA contract, Horizon began providing primary care services, which now account for a significant portion of their business. �[1] . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . ... . . . :.: · · Laboratories and PFr Center Accessible to Non-Veteran Patients lung function in patients with such disorders as chronic obstructive lung disease, asthma and interstitial lung disease, as well as damage from asbestos and other irritants. t The Cardiopulmonary Exercise Laboratory, offering exercise studies that measure oxygen uptake, carbon dioxide output, heart rate and cardiac electrical activity during progressive exercise on a bicycle ergometer or treadmill, and measurements useful in a patient experiencing unexplained shortness of breath, for example, or as a training aid to serious athletes. Physicians interested in referring a patient to any of the three labs can call the VA at (716) 862-8635. Physicians may also refer patients, regardless of their veteran status, to the VA's Positron Emission Tomography (PET) Center, which is a joint venture between the Unversity at Buffalo and the VA. The center, which is directed by Alan H. Lockwood, MD, UB professor of neurology, nuclear medicine and communicative disorders and sciences, can be reached at (716) 862-8871. The Veterans AHairs Healthcare System is assigned by law to treat veterans of America's armed forces, but there are circumstances in which it accepts non-veterans as temporary patients. For example, it was recently announced that three specialized laboratories at the VA's Bailey Avenue facility will begin accepting non-veterans by referral, pending final approval. VA physician Brydon Grant, MD, a professor of medicine, physiology and biophysics at UB's School of Medicine and Biomedical Sciences, and head of the school's Division of Pulmonary and Critical Care Medicine, says the labs became accessible to the public because they're operating so efficiently that additional capacity has become available. THE LABORATORIES ARE : t The Sleep Laboratory, providing overnight polysomnography and sleep latency tests, mostly in the diagnosis of sleep apnea . t The' Pulmonary Function Testing Laboratory, using spirometry, oximetry and other measurements to gauge htPLICHIO . S FOR MEDIC \1 EDLCATIO The changes taking place in the VA system are also affecting clinical training programs at the University at Buffalo School of Medicine and Biomedical Sciences. "From the educational point of view, it's technically harder to set up teaching activities for outpatients because they come in, they're seen and they leave," says Gerald Logue, MD, vice chair for education in the school's Department of Medicine. "That's a challenge that the medical school is faced with-not just at the VA , but everywhere. Fewer and fewer numbers of patients are being admitted to the hospital these days. " Logue, who is head of the Division of Hematology in the Department of Medicine, served as chief of staff at the VA until a year ago, so has experienced many of the changes firsthand. Today, as director ofUB's residency program in internal medicine, he's finding it a challenge to give residents the kind of exposure to patients they need while in training. "Ward services have decreased and, formerly, the provision of these services was a very efficient means for teaching. You have captive patients and a team of students and interns taking care of them and making rounds to see them as many times a day as they care to. Because that has obviously changed, we're now having to find ways to get the students involved in specialty clinics and in freestanding or private offices and venues that aren't part of the hospital setting. Teaching that takes place in a clinic, however , is more labor intensive because you do a lot more one-on-one. In a hospital, one attending can work with a resident, a couple of interns and a couple of students. In a clinic you can just teach one person at a time. " D ue to logistics, such as long driving times, the teaching ofUB medical students at the VA currently takes place at the Bailey Avenue B u f f a l o location rather than at the community-based clinics, according to Logue. Many students are assigned to the facility's primary-care clinics, and "virtually all UB medical students will at one time or another have a rotation at the VA, " he says. "For example, in third-year medicine, about one-fourth of the class goes there for training. " With regard to resident training, Maddigan says , "We include the resident clinics in our primary-care services as much as we can. Our goal is to help the residents train in a way that best reflects what the real world is like, so we very strongly emphasize with them the management of chronic disease and preventive health care. "For the veteran , what they're seeing looks seamless because they have the same resident for three years," he adds. "In a way , our primary-care clinics can be thought of as group practices , with each having approxi- Physician Autumn l 9 9 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] mately 8, 000 enrolled veterans. " And as Logue notes, despite the logistical difficulties of matching physiciansin-training with clinic staff and patients, the medicine being practiced in the clinic settings is of the highest caliber. "Generally speaking, the outpatient experiences are evolving and, I think, getting better and better," he says. "When you bring a patient into the hospital, you tend to have data overload with test results and so on. In an outpatient setting, there's much less data. You learn to depend more on the basics, on taking the patient's history, doing a clinical exam. In that sense, it's almost back to basics-it's even better." Whether it be patient care, facilities management or medical education, the challenges faced by Western New York's VA Health care System are in many ways no different from those faced by the region's other health-care systems. While each is driven by its unique mission, history and vision, the end goal for all is to discover ways to maintain the integrity of patient care in as cost-effective a way as possible. For the VA system, this difficult end goal seems best grounded in the "back-to-basics" approach noted by Logue-no doubt, familiar territory for America's veterans. + Drug May Protect Against Hearing Loss esearchers in University at Buffalo's Center for Hearing and Deafness have shown for the first time that a compound called leupeptin may help protect against the noise-induced hearing loss caused by living in noisy industrialized societies. Using an animal model, the researchers found that treating the inner ear with leupeptin before exposure to high-level noise, comparable to a jet engine, reduced the loss of sensory hair cells by 60 percent. Hair cells convert sound waves into electrical impulses that are sent to the brain. Leupeptin, however, did not protect against the damaging effects of the anti-cancer drug carboplatin that can cause deafness in treated patients. "The results are very exciting for two reasons. First, they provide clues to the cellular events that lead to sensory-cell death in the inner ear. Second, they suggest a potential drug-therapy approach to protecting the ear against sound damage," says Richard J. Salvi, PhD, lead investigator, who is a professor of communicative disorders and sciences in the College of Arts and Sciences, clinical professor of otolaryngology and neurology in the School of Medicine and Biomedical Sciences and co-director of the Center for Hearing and Deafness. Salvi and his colleagues at UB have been collaborating with Alfred Stracher and Abraham Shulman, both at the SUNY Health Sciences Center at Brooklyn, to investigate ways to protect the auditory system from damage via noise and ototoxic drugs, common causes of deafness in Western societies. Their current study-which was funded in part by a $14,000 grant from the Martha Entenm~nn Tinnitus B u f f a l o Physician Research Foundation-was based on the knowledge that, in many cases, degeneration of nerve function is caused by a cascade of events, beginning with a trauma that induces an increase of calcium in nerve cells. Excess calcium, in turn, increases the level of enzymes called calpains, which promote the breakdown of proteins and other factors critical to nerve functioning. "Drugs that inhibit the action of calpains, of which leupeptin is one, have been shown to decrease or prevent destruction of nerve functioning that results in neuromuscular atrophy in cases of trauma or genetic disorders," Stracher notes. Salvi and colleagues set out to determine if leupeptin also could protect the sensory hair cells in the ear from noise and ototoxic drugs such as carboplatin-knowing that such insults cause an increase in calpains--and thus prevent hearing loss. The researchers treated the right cochlea of chinchillas with leupeptin for 14 days. On the fifth day, some of the animals were exposed to noise, at 100 decibels or 105 decibels. The left ears of all animals served as controls. Results from the noise exposure study showed massive loss of hair cells in the ears not treated with leupeptin, while only a few hair cells were missing in the treated ear. A similar study, designed to determine if leupeptin would protect against hair-cell loss caused by carboplatin, showed leupeptin offered no protection, Salvi says. Other researchers on the study included Jain Wang and Dalian Ding, research scientists in the Center for Hearing and Deafness. For more information on this study, refer to their recent paper published in NeuroReport (Vol. 10, No. 4). Autumn l 9 9 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 ----~- - - - --- - - - - -~-- -- - -- ' -" . Lifestyle Underpins Gallstones he Western lifestyle of little exercise, lots of saturated fat, lots of refined sugar and little fiber is a major risk factor for the deve lopment of yet another chronic disease- gallstones- a new University at Buffalo study shows. Published in the February 1999 issue of the American journal of Clinical Nutrition, the study is one of the few popu lation-based investigations of factors affecting the development of gallbladder disease over time. Results showed that body mass index and intake of refined sugar and saturated fat were directly associated with the formation of gallstones. The relationship between saturated fat and gallstones was stronger in men than in women . Conversely, physical activity and a diet high in monounsaturated fat, dietary cholesterol and insoluble dietary fiber were protective against gallstones, results showed. "This study confirms that gallbladder disease is one of the diseases of Western civilization ," says epidemiologist Maurizio Trevisan, MD, professor and chair of UB's Department of Social and Preventive Medicine and author of the study. "It's one more message that a diet high in fat and refined sugar and a pattern of low physical activity can get you into all kinds of trouble. " The results are interesting to epidemiologists, he says, because they support the hypothesis that common pathophysiological mechanisms may underlie the chronic diseases afflicting Western populations. Gallbladder disease is increasingly common with age and affects more women than men. Twenty percent of women are ® reported to have gallstones at autopsy. The study was conducted in the small farming community of Castellana in southern Italy. In 1985 and 1986, researchers administered ultrasound scans of the gallbladder and took blood samples from 1,429 men and 1,043 women selected randomly from the population. Persons free of gallstones at that time were reexamined by ultrasound between May 1992 and June 1993; they also completed questionnaires concerning sociodemographic PARTICULARLY INTERESTING WAS THE F I ND I NG THAT SATURATED FAT I NTAKE APPEARS TO HAVE A STRONGER RELATIONSHIP TO GALLSTONE FORMATION I N MEN THAN IN WOMEN , TREVISAN SAYS . status, medical history, dietary habits and physical activity. The 55 men and 49 women who had developed gallstones during the study period then were matched with controls from the study population. To give a B u f f a l a P more complete picture of dietary intake, these participants provided information on how often they ate certain foods. Analysis of the data from new cases and controls showed that age, body mass index (an indication of obesity) and prevalence of diabetes were higher in those who developed gallstones than in those who did not, while physical activity was lower. Dieting, caffeine and smoking appeared to have little effect. Dietary analysis showed that higher monounsaturated fats and calories expended lowered the risk of gallstones, while higher consumption of refined sugars and saturated fat were directly related to gallstone formation. Particularly in- ~ teresting was the finding that saturated fat intake appears to have a stronger relationship to gallstone formation in men than in women, Trevisan says. Women had higher rates of gallstones at the first three quartiles of saturated fat consumption, but theirrisk increased slowly as consumption increased. In men , however, the risk doubled at each quartile of consumption; at the highest quartile, men were at a higher risk of developing gallstones than women. "These findings seem to suggest that other factors , such as hormones or metabolism, may be more powerful risk factors for gallstone formation among women than saturated fat intake," Trevisan says. The research team was headed by Giovanni Misciagna, chief of the laboratory of epidemiology and biostatistics at the Institute S. De Bellis in Castellana. + ~ hysician -LOI S A utumn BA KE R l 9 9 9 0 ~ �·· ···· ······ ·· · · · · ······ · ······ ··· · ·· ····· ·· · · · · · · ···· · ·· · · ··· ·· · ···· · · ··· ···· · · · ··· · · · ··· • ' ' . 0 . Potatoes Deliver Hepatitis BVaccine an eating potatoes protect humans against hepatitis B? Roswell Park Cancer Institute (RPCI) and the Boyce Thompson Institute (BTl) at Cornell University began clinical trials in July I999 at RPCI to test the safety and immunogenicity of the world's first potential oral vaccine against the hepatitis B virus. Subjects will receive the vaccine by eating potatoes genetically engineered to contain it. More than 2 billion people worldwide are affected by the hepatitis B virus , a leading cause of liver cancer and the cause of more than I million deaths annually. Although an effective vaccine is available to prevent hepatitis B, it is too expensive for developing nations to afford . The vaccine must be imported and refrigerated- at a cost of$100 to $150 per personand three injections are required over a six-month period, which prohibits mass immunization in Third World countries. The trial that began in July is the culmination of several years of collaborative preclinical work by Yasmin Thanavala , PhD , UB research assistant professor of microbiology and professor and cancer research scientist in the Department of Immunology at RPCI; Charles Arntzen , PhD , president and CEO of BTl and adjunct professor of biological sciences at Cornell University ; and Hugh Mason , PhD, BTl assistant research scientist and assistant professor of plant biology at Cornell. The program is funded primarily by the ational Institutes of B u f f a l o P hys i Allergy and Infectious Diseases, part of the ationalinstitutes of Health (NIH). In previous pilot studies, researchers inserted DNA extracted from hepatitis B virus into tobacco leaves. An immunologically important protein antigen known as HBsAG was partially purified and injected into mice, where it elicited the same immune responses as those triggered by the commercial vaccine. More recently, the researchers produced this vital protein in potatoes that are edible, making them more suitable for testing oral vaccines. In the current placebo-controlled, double-blind Phase I study, health-care workers who previously responded to a licensed injectable vaccine receive an oral booster dose delivered by a sample of transgenic potato that expresses the hepatitis B surface antigen. BTl generated the potatoes for the clinical trial with financial support provided by Axis Genetics of Cambridge, UK. The clinical trial is coordinated jointly by Thanavala and Martin Mahoney, MD '95 , PhD '88, UB assistant professor of cian Autumn 1 9 9 9 . . family medicine and director of the RPCI Employee Health Clinic, who will be responsible for conducting laboratory testing and clinical assessment. "We are very pleased to be taking the next logical step with this research, " Thanavala says. "The continued support of my basic research by the IH and the World Health Organization, along with the recent collaboration with Axis Genetics , offers us a novel way to impact public health and control hepatitis B worldwide." "This project is a wonderful example of moving research ideas from the laboratory bench to the bedside," adds Mahoney. "We are pleased to participate in this trial to bring this vaccine into a clinical setting. " Research with genetically engineered foods opens up limitless possibilities for delivering vaccines, not only for hepatitis B but also for such diseases as malaria and leprosy. There also may be a market for these "garden variety" vaccines in industrial countries. + - D EBORAH P ETTIBONE AND C ATHERINE D ONNELLY Hodgkin'sSmvivors Face Second-Cancer Risk ersons treated for Hodgkin's disease in childhood are at high risk for developing a second malignancy and should be monitored closely by their physicians throughout their lifetimes , researchers at the University at Buffalo and Roswell Park Cancer Institute (RPCI) have shown in two recent studies. > 0 f- �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 ' / ' Specifically, their findings showed that persons treated for Hodgkin's disease as children were at nine times the risk of developing a second cancer, with risks of developing certain types of cancer much higher than that, compared to patients without Hodgkin's disease. The risk of developing thyroid cancer in males was especially high164 times that of controls. In addition, the relative risk for breast cancer was found to be eight times greater for females; fornon-Hodgkin's lymphoma, 15 times greater for males and 23 times greater for females; and leukemia, 19 times greater for males and 25 times greater for female. "These are big relative risks," says Daniel M. Green, UB professor of pediatrics, a specialist in pediatric oncology at RPCI and senior researcher for the studies. "These findings should alert physicians to the need for careful and continuing screening at a much earlier age than the American Cancer Society recommends for the population at large," he adds. The studies involved 182 patients treated at RPCI for Hodgkin's disease between 1960 and 1989, all of whom were less than 20 years old when their disease was diagnosed. By the time they were 30 years from diagnosis of Hodgkin's disease, 2 7 percent of the patients had developed at least one second cancer, excluding skin cancer. The second of the two studies, which reported on the incidence of skin cancer only, found that the most important variable was combined treatment with radiation and chemotherapy. Of patients who received radiation therapy alone, 3 percent developed skin cancer 20 ® years after the diagnosis of Hodgkin's disease compared to 5 percent of the patients who received combined therapy. + - L OIS BA KE R Gum Disease-Stroke Relationship Found he first national populationbased cohort study of periodontal disease and cerebrovacular disease, conducted by UB researchers, has shown that people with severe gum disease are twice as likely to have the type of stroke caused by blocked arteries than those with good oral health. The relationship of gum disease and stroke was stronger even than the link between gum disease and heart disease, says lead author Tiejian Wu , MD, PhD, research assistant professor in the Department of Social and Preven tive Medicine in the School of Medicine and Biomedical Sciences. "This is the first major study to look at this question," says Wu. "There have been a few other very limited studies, but the number of subjects was small and was drawn from restricted populations. This study also looked at subgroups- men , women , blacks and non-blacks. Periodontal disease was associated with an increased risk for cerebrovascular disease in all groups." The study cohort comprised 9,962 adults between the ages of 25- 75 who took part in the first National Health and Nutrition Examination Survey ( HA ES I) conducted from 1972 to 1974anditsfollow-up, which was completed in 1992. Respondents' oral health THE RELATIONSHIP OF GUM D ISEASE AND STROKE WAS STRONGER EVEN THAN THE LI NK BETWEEN GUM DIS EASE AND HEART DISEASE, SAY S LEAD AUTHOR TIEJ IAN W U , MD , PHD . 0 Buffa l o P hys i cian Autumn 1 9 9 9 �·· ·· · ···· ···· ······ · · ·· ······ · ··· ·· · · ········ · ···· · ······ · ·· ··· ······ · · · ···· · ········· ···· • .. . . was categorized as no periodontal disease , gingivitis, periodontitis, or toothless , based on information collected during HANES I. Cerebrovascular-disease events were confirmed in the follow-up survey through hospital records and death certificates. Results showed that periodontitis was a significant and independent risk factor for developing cerebrovascular events and for non-hemorrhagic stroke- loss of blood flow to the brain due to a blockage rather than a burst vessel. Periodontitis was associated with a twofold increase in non-hemorrhagic stroke risk . The study found no association between periodontal disease and hemorrhagic stroke or TIA. According to Wu, periodontal disease is thought to increase the risk of stroke in much the same way it increases the risk of heart attack. "Bacteria, endotoxins and other bacterial products from gum pockets enter the circulation and may promote an inflammatory response , causing cells to proliferate in the blood vessels and causing the liver to increase production of clotting factors. Bacteria may also attack the vessel lining and damage endothelial cells ," he says. "Further, several periodontal pathogens can induce platelet aggregation and may promote plaque formation that can cause blockages and clotting. " Maurizio Trevisan, MD , professor and chair of the Department of Social and Preventive Medicine and the study's coauthor, says, "While more studies are needed for a conclusive statement about the cause-and-effect association, the consistency of the findings in different gender and racial groups , and the strength of the association between two chronic conditions prevalent in the adult population, may have important implications for individual and public health. " + - B u f f a I o L OI S BA K ER Physic i WOMEN .. w iTH CERTAIN PHYS ICAL CHARACTERISTICS LI NKED TO H IGH LEVELS OF TESTOSTERONE- THE MOST ACT IVE > 0 1- ANDROGEN-MAY HAVE A GREATER 1- R ISK OF DEVELOP I NG BREAST CANCER THAN WOMEN WITHOUT THESE CHARACTER IST ICS . Breast Cancer Risk and Insulin Levels aola Muti, MD , PhD, University at Buffalo epidemiologist and assistant professor of social and preventive medicine, has received a two-year $238,000 grant from the United States Army Medical Research and Materiels Command to conduct the first major study of the relationship between breast cancer risk and levels of insulin in the blood. She also will investigate breastcancer risk and its association with levels of male sexual hormones, or androgens; female sexual hormones; and insulin-like growth factor 1 (IGF-I) , a protein that promotes changes in breast cells. Muti, who has been researching the an A utumn 1 9 9 9 role of hormones in the development of cancer, has shown in an earlier study that women with certain physical characteristics linked to high levels of testosterone- the most active androgen- ma y have a greater risk of developing breast cancer than women without these characteristics. Her current study, which builds on her previous research , aims to show that the risk of developing breast cancer is associated with the hormonal conditions of increased insulin levels in the blood; increased bioavailability of IGF-1 ; increased levels of androgens-specifically, total and free testosterone; and increased levels of estrogens-specifically, total and free estradiol. Finally, Muti hopes to show that the increased bioavailability of IGF-1 and the higher concentrations of the sexual hormones are caused by the higher insulin levels. Teresa Quattrin, MD , UB associate professor of pediatrics and director of the Diabetes Center at Children's Hospital , and the Italian ational Cancer Institute in Milan are collaborating on the study. + -LOIS B AKER ® �~ - · ·· · · · ·········· · ······ · ·· · · · ····· · · ·· · · ··· · ····· · · · ·· · ·· ·· · · ··· · · ·· · · ·· ·· · · ····· · · · ·· · lfij expected as managed-care physicians to be knowledgeable and efficient providers of health care- supplying appropriate medical services, maximizing the utility of patient contact and maintaining quality patient care. And we are expected as physicians in the community POLITICS IS AN ANSWER to be sensible and judicious members of society- remaining nonjudgmental and understanding, being sensitive to every HREE YE-\RS AGO I BEGA to have a gnawing feeling in my person's predicament and valuing the health of the community above all else. stomach. The sensation was not a pain that might lead me to a These expectations are severe by any estimation, but they are reasonable. physician's office for a checkup or to my medical texts for causal "The glory days of American medicine" is a phrase that's come to represent insight. Instead, it was a feeling of disappointment. the era where a Marcus Welby- type At the time, I was living in Tucson , of 20 years ignorant of the status of physician could practice medicine Arizona , and working on an epidemio- health care as a privileged commodity. independently, concerned only with logical project seeking to discern the The son of a pharmacist, I was raised in a the patient's best interests . While relationship between physical activity reasonably wealthy home, where health society's expectations for a primaryand chronic disease in postmenopausal care and medical information were never care or specialty-care physician were Hispanic women. The disappointment wanting. Like everyone else, I had been similar then to what they are today, began one day while I was driving back inundated with statistics detailing the they were different with respect to the from Phoenix, where I had met with the fact that 42 million people in the United community physician. state's project coordinators for the study. States (or 25 percent of the population) Free care, or care at appropriated costs, I should have felt great. I was 22 years are uninsured. Yet what I began to was both a common and anticipated old and living in one of the most beau- realize, as I thought about the women practice many doctors used to ensure tiful regions of our country. I had been enrolled in the Arizona study, was that and improve the health of the commugood health is each person's nity. In addition, prestige was inherent in accepted to medical school at the University at Buffalo greatest need and that health the practice of medicine. Physicians were and would begin classes in professionals are just as respected members of the community. responsible for the health of They were asked to serve as public six months. And I was on vacation (being away from the community as they are officials and were role models for prosschool and working on public health for that of the individual. perity in the United States. projects is certainly a vacation for me) . As medical students, we are challenged Today, however, in the era of manBut all I could think about during to meet the needs of our future patients aged care, a physician's ability to fulfill that 110-mile drive through the desert in spite of the changing U.S. health-care the community's expectations seems were the women enrolled in our study. system. We are expected as primary-care compromised. Gone are the opportuniThey did not agree to participate physicians to be diagnostic and rational ties to provide independent free care, because they were interested in further- at the first moment of patient-physician replaced by utilization review and capiing research or because they had time contact-limiting preventable disease, tation. Gone are the prestige and proson their hands. o. The majority of the reducing unnecessary distress and im- perity of medicine, replaced instead by women participating in the study were proving patient health. We are expected the business and entertainment indusdoing so because it provided them with as specialty-care physicians to be profi- tries . Gone is the physician as a role health-care services for that short span cient and expedient when consulted on model for success, replaced instead by of time. Access to health care, I was cases of advanced disease-assessing the the independent consultant or computer beginning to realize, was a privilege best plan for treatment, working in technologist. But physicians should most of them did not have. cooperation with the primary physician not be discouraged: They are still of Until that time, I had spent upwards and improving patient health. We are considerable importance to the society. Health-Care Policy: To Treat or Not to Treat ® B u f f a l a P hysician Autumn 1 9 9 9 �Last April , I attended a three-day political leadership training workshop in Washington, DC, that prepared medical students to become successful advocates for the public's health. At the Political Leadership Institute, we were taught how to design a political strategy, research an issue, write a position paper or an editorial for submission to an advocacy group or newspaper , speak in public and lobby a public official. The weekend , which was sponsored by the American Medical Student Association , was so bus y that I didn't even have time to see the sights of our nation's capital! Instead, I learned how my actions as a medical student, and eventually as a physician , can affect the health of my community. It may seem insignificant, but the dues paid to a medical organization supplement its office of legislative affairs. That organization may one day be instrumental in convincing a senator Physicians must not diminish the political power that is inherent in their profession by being nonparticipants in, or even apathetic to , health-care policy making. Their patients cannot afford it. Despite the image doctors have of being detached from politics, in reality they have always played a significant role in the political process. Five doctors signed the Declaration of Independence. Before the Civil War , there were about 20 doctors in every Congress; after the war , individual political participation dropped , but physician power stayed strong through the formation of organizations like the American Medical Association , the American Medical Student Association and the Association of American Physicians and Surgeons, all of which represent physicians in the political arena . Why have physicians always continued to participate in politics? Political affairs affect the health of the community. I E-TESTING CONTINUED FROM PAGE 10 popped up right in front of me, I clicked a button and I was done. " When Duff had finished his exam, his study partner, Christopher Adams, still had four days before he sat down to his test. "We had really been pushing each other, and the camaraderie was great," Adams says. "You couldn't sleep in because that person was waiting for you. You couldn't leave the library early because that person was counting on you . After Mike [Duff] took his exam, I felt like I hit a wall. Your jokes just aren't as funny when you're telling them to yourself. " B u f f a l o Physic i an to introduce significant tobacco reform legislation. Participating in a voterregistration drive is time consuming; however , publicizing key political issues and convincing fringe voters to cast their ballots may elect a state representative who supports universal access to health care. Writing a thoughtful and informative editorial on breast cancer for the local paper may help the community better understand, prepare for , or prevent a disease that over 184,000 women are diagnosed with each year. Similarly, lobbying a city council for increased funding for community clinics may help limit the spread of infectious disease. Three years ago, I could see no reason why so many middle-aged women were participating in an epidemiological study except for the express purpose of obtaining health-care services. I can still see no other reason, but I hope that my actions eventually will provide those women with health-care privileges. As an advocate for the public's health , my participation-every physician's participation-in legislative affairs improves the health of the public. As health professionals, we must remember that we are just as responsible for the health of the community as we are for the individual. + josLpli S. Ross is c th . -d-) a su.c L • c:. ••.• L Unhcrsil) at Buffalo ~clwol of \lcdicinc and Bwmcdical SCiences . As e-testing makes its mark on a new generation of students one thing is certain: The new format has profoundly changed the experience of taking a standardized exam. With literally hundreds of exam dates available, gone is the shared misery of hundreds of students huddled over test booklets. Gone, too , is the room monitor telling students when to take a break. Now, the computer does that for them. For his part, Adams isn't the least bit nostalgic about the old days. He'll take the mouse over the pencil any day. But in this brave new world of test taking, he may do well to ensure that his next test date coincides with his study partner's, because there's still no replacement for camaraderie. + Autumn 1 9 9 9 ® �BY L I N D A J . ATrue Story ' "I don't go out much and really can't plan to have dinner with you .... Well I guess you can come see me, so long as you promise not to talk about money ... " I had been at the University at Buffalo for less than a year and was traveling to her city for a professional meeting. I decided to meet some of our past donors and thank them for what their gifts had made possible. In her case, she and her husband (deceased) had established a modest scholarship endowment several years earlier. There was no additional information on file so I checked the current value of the endowment (credible growth), the number of students who had received scholarships, and off I went. She, her cats and I had lemonade by her pool and talked. She told me about her family-"a single and two sets of twins"; her husband and his early practice; and the vacations with five kids and a tent. She also showed me pictureschildren, grandchildren and pets, trips they had taken, and friends. She told me she volunteered at a local senior citizens' center during tax season to help others with their taxes. In her eighties, she expressed amazement that so many of those "old people" didn't know how to fill out their tax forms. When dinnertime rolled around, she smiled and said she would join me after all, if the offer were still open. At a nearby restaurant, we continued the conversation. She talked about the heartbreak of watching her beloved husband lose track of who she was and, then, who he was. She talked about her dream of seeing a day when the mysteries of Alzheimer's Disease were understood and there were options to slow or halt its progress, and preventive measures to keep it at bay. A week or two later, I sent a brochure developed by the chair of nuclear medicine, for he, too, had a dream- using marked neurons to visualize the activity of the brain. A relatively new diagnostic tool at the time, Positron Emission Tomography (PET) was used at only a few centers in the state, to study the secrets of brain physiology and to diagnose various conditions that didn't show up with other types of technology. This crazy dreamer wanted UB to build one. That was nearly ten years ago. In the intervening time, she and I developed a long-distance friendship, a definite fondness and appreciation, each for the other. During one conversation she said, "My husband and I never complained about paying taxes. He earned a good living ® Buffalo C 0 R DE R , PH D, C F R E and that's our country's way of paving the roads and providing schools for children. It was fair and we didn't mind that much. But, I don't want to give away half of our hard-earned resources when I die. My children will share the amount that's excluded from taxes. Now, help me figure out how to arrange the rest so Uncle Sam won't get any." This woman knew she had the means to make an impact "somewhere." She wanted to make a difference in the understanding of Alzheimer's Disease. She believed that UB's proposed center was a way to "light one little candle against the dark." The department chair tirelessly made enthusiastic presentations to anyone who would listen, which painted a picture of what that type of research center could be. Using PET scanners, he explained, researchers might slowly uncover the secrets of how human brains process information and what happens when they lose that ability to function. She became captivated by the convergence of those dreams. Her creative planned gift, a charitable trust that would eventually fund an endowment for the PET Center, his negotiations involving the school's partnership with the Veterans Administration, a combination of other funding sources and additional private gifts made the building of the PET Center possible. The center was completed while she was still able to maneuver easily. She was present at its grand opening, along with her oldest daughter. She helped to unveil a modest plaque commemorating her husband's life and her commitment to this center. After the dedication, her daughter made a rubbing of the plaque. It was copied for all her children and then framed and hung in her living room. Her charitable trust reached maturity this past summer. ow, there is a major endowment bearing their names that will keep her dream alive and similar research moving forward, forever. My friend died peacefully, at age 93, with her oldest daughter again by her side. Her last act of generosity was to have a vital portion of her brain removed immediately following her death and conveyed to a group of Alzheimer's researchers at one ofHarvard's affiliated hospitals. She was then buried next to her husband back home in Buffalo. What is essential lives on, in those of us who knew her and cherish her memory-and in the future research that her endowment will make possible. CONTINUED ON PAGE 31 Physician Autumn 1 9 9 9 �Endowments of the School of Medicine . di al S. 1ome c c1ences HE SCHOOL'S E DO\\.-NlENT IS COMPRISED OF DOZE. S of separate funds, many named for the individual or couple who initiated them. Collectively, they provide valuable resources that enrich the lives and academic experiences of students, faculty and staff, and the wider community in our region. They provide scholarships, annual lectures, underwrite research and travel to present research results. Endowed chairs strengthen individual departments and the school as a whole. Visiting professorships bring the students into contact with nationally known professors who spend a day or several days on campus. We have a strong endowment. We need to expand it. The difference between a great institution and one that is merely adequate is often found in the size and strength of the endowment. Listed below are the school's endowments. Those listed in bold received additional gifts this past fiscal year. Those with an asterisk (*)were established between july 1, 1998, and] une 30, 1999. Those with both an asterisk and bold lettering were initiated and at least partially funded during that time period. Gifts to the school may be designated for any existing endowed fund. New endowments that meet funding guidelines established by the university may be established at any time. Please give me a call if you have questions, notice an inaccuracy or would like to make arrangements for a new endowment in your name or in ' Linda J. Corder (lyn) is the associate dean and director of honor of somedevelopment. She may be reached toll-free at 1 (877) one you admire 826-3246. Her e-mail address is ljcorder@buffalo.edu. or love. I H.W. Abrohmmer Memorial Scholarship Sidney Addleman Memoria l Dr. and Mrs. Joseph A. Chozon Medical Scholarship Dr. George J. Alker Fund for Neurodiology Clinical Preventative Medicine Fellowship Theodore & Bessie G. Alpert School of Medicine Scholarship Almon H. Cooke Scholarship Alpha Omega Alpha Library Fund Patrick Bryant Costello Memorial Alpha Omega Alpha Endowment CTG Oncology Fund American Academy of Family Physicians President's Award James H. Cummings Scholarship Deportment of Anatomical Sciences Library Fund Edward L. Curvish M .D. Award Anesthesiology Deportment Endowment The Elizabeth Medical Award Bocceelli Medical Club Award Dr. Robert M . Elliot Scholarship L.B. Badgero Medical School Fund Eleanor Fitzgerald Fairbairn Scholarship Wolter Barnes Memorial Scholarship Family Medicine Endowment •virginia Barnes Endowment Feyler Fund for Research in Hodgkins Disease Dr. Charles A. Baudo Award in Family Medicine Dr. Grant T. Fisher Fund Thomas R. Beam, Jr. Memorial L. Wolter Fix, M.D. '42/'43 Endowed Scholarship Dr. Robert Benninger Fund in Orthopaedics Edward Fagan Memorial Prize Robert Berkson Memorial Award in the Art of Medicine Ford Foundation for Medical Education Museum of Neuroanotomy Fund (Bernhoft-DeSontis Library Thomas Frawley, M .D. Residency Research Fellowship Fund Marcos Gallego, M.D. Clinical Excellence Fund Fund Anatomy, Cell Biology and Neurobiology) B u f f a Louis J. Beyer Scholarship James G ibson Anatomical Prize Paul K. Birtch M.D. Fund Wolter S. Goodale Scholarship Dr. Solomon G. Booke and Rose Yosgur Booke Fund •trene Pinney Goodwin Scholarship James H. Borrell Urology Fund A. Conger Goodyear Professorship of Pediatrics • Anne and Harold Brody Lecture Fund George Gorham Fund Clayton Milo Memorial Dr. Bernhardt S. and Dr. Sophie B. Gottlieb Award George N . Burwell Fund • carl Granger, M.D. Endowment Dr. Winfield L. Butsch Memorial Lecture in Clinical Surgery Dr. Pasquale A. Greco Loon Fund Vincent Capraro Lectureship Fund-class of 194S The Glen E. Gresham, M.D. V isiting Professorship Dr. Charles Cory Memorial Dr. Thomas J. and Barbaro L. Guttuso Scholarship & Award l a Physic i an A. u t u m n 1 9 9 9 �c ENDOWMENTS CONTINUED FROM PAGE Omega Upsilon Phi Chi Scholarship 31 Josephine Hoyer Orton Trust Fund Victor A. Panaro Medical School Fund F. Corter Ponnil, Jr. , M.D. Award Endowment Gynecology-Obstetrics Department Endowment Stephen J. Paolini, M .D. Memorial Jean Sarah Hohl Memorial •Parkinson Research Fund •Eugene J. Honovon Scholarship John Paroski Memorial Award Florence M. & Sherman R. Hanson Fund for Robert J. Patterson Resident Award Medical Education Dr. Mark Pettrino Memorial DeVille V. Harrington Lectureship Primary Care Achievement Fund The Hekimion Fund Progressive Medical Club of Buffalo Fund Hewlett Family Enrichment Fund for Psychiatry Psychiatry Department Endowment Charles Gordon Heyd Medical Resources Fund Dr. Hermon Rohn Memorial Lecture t Dr. Fronk Whitehall Hinkel Scholarship Albert and Elizabeth Rekote Choir in Cardiovascular Disease Rolph Hochstetler Medical Research Fund Albert C. Rekote Rehabilitation Medicine Library Fund Donald Rennie Prize in Physiology Abraham M. Horowitz Fund R.R. Humphrey & Stuart L. Vaughan Scholarship James N. Johnston Scholarship Douglas Riggs Award in Pharmacology and Therapeutics The Ring Memorial Fund C. Sumner Jones Library Fund Emile Rodenberg Memorial Award Harry E. and Loretto A. Jordon Fund Thomas A. Rodenberg and Emile Davis Rodenberg H. Colvin Kercheval Memorial Scholarship Elizabeth Rosner Fund Dean Stockton Kimball Scholarship Dean Stockton Kimball Memorial Ira G. Ross Chair of Medical Informatics Dr. James E. King Postgraduate Fund Dr. Sheldon Rothfleisch Memorial Fund Morris Lamer and Dr. Robert Bernat Scholarship Harold S. Sones and Thelma Sones Medical Scholarship Dr. Charles Alfred Lee Scholarship Philip P. Song Memorial Fund Dr. Garro K. Lester Student Loon Sorkorio Family Endowed Choir in Diagnostic Medicine Fund Schafer Fund in Cardiovascular Diseases Lloyd Leve Fund The Lieberman Award Hans Lowenstein Award Scholarship of the Progressive Medical Club of Buffalo School of Medicine and Biomedical Sciences Unrestricted Lupus Scholarship Fund Endowment William E. Mabie D.D.S. and Grace S. Mabie Fund Lillie S. Seel Scholarship Dr. William H. Monsperger Fund Irene Sheehan Fund Dewitt Holsey Sherman and Jessica Anthony Sherman Fund Claro March Medical Scholarship Medical Alumni Endowed Scholarship Dr. Lois A. and Ruth Siegel Teacher' s Award Annual Participating Fund for Medical Education Endowment S. Mouchly Small, M.D. Award in Psychiatry Medical School Lectureship •s. Medical School Closs of 1957 Scholarship Mouchly Small Education Center Fund •Irvine and Rosemary Smith Chair in Neurology Fund Medical School Class of 1958 Scholarship Dr. Irving M. Snow Fund Medical School Class of 1963 Scholarship •Mary Rosenblum Somit Scholarship Medical School Closs of 1973 Scholarship Marion Mellen Fund Morris and Sadie Stein Neuroanotomy Prize John H. Talbott Visiting Scholarship •Microbiology Memorial Fund Trevett Scholarship Dr. David Kimball Miller Award Richard E. Wahle Research Fund Eugene R. Mindell, M.D. Choir in Orthopeoedic Surgery G. Norris Miner, M.D. Memorial Award Mildred Slosberg Weinberg Endowment E.J. Weisenheimer Ophthalmology Award • philip D. Morey Scholarship Dr. Mark Welch and Beulah M . Welch Scholarship Richard Nagel, M .D. Anesthesiology Research • James Platt Wh ite Society Endowment Dr. Anges S. Naples Memorial Scholarship Williams /Bloom Medical Research Fund The Dr. S. Robert Narins Memorial Award Dr. Morvin N. Winer Fund for Dermatological Research Notional Medical Association (Buffalo Chapter) Scholarship Witebsky Fund for Immunology Naughton Endowment Dr. Ernest Witebsky Memorial •Nephrology Research Endowment Forney R. Wurlitzer Fund Dr. Erwin Neier Memorial Dr. Mark Zaleski Award Antoinette and Louis H. Neubeck Fund Hermon and Rose Zinke Scholarship Neurology Deportment Endowment Dr. Benjamin E. & Lila Obletz Prize Fund in Orthopaedic Surgery l·udou·mcfztS 1 udoumem, Dr. Elizabeth P. Olmsted Fund in Biochemistry B f f a l a p h 5 c * drc nody cstJblislzcd 111 bold hav< r<"I"CIV<"d a n ~1tis 111 t fis,al year 1998- 1999 u m 9 9 �Dear Fellow Alumni, l T \\AS ~1Y HO'\OR TO SPEAI\. AT THE \.1EDICAL SCHOOL\ ORIL 'T \-:-'0 for the first-year class on October 9, 1999, in Butler Auditorium. During that time, I introduced the class to the Physician-Student Mentoring Program, in which the Medical Alumni Association pairs up each medical student with a community physician in a nonacademic advisory role. We are optimistic about this program and are pleased to announce that we received a sufficient number of physician volunteers this year to match all students. Later that day, I was also pleased to take part in the White Coat Ceremony that was planned by Dr. Tom Flanagan and reported on in this issue of Buffalo Physician (see page 12). It was a wonderful program that will be expanded next year, and I urge anyone interested to feel free to attend. In mid-September the Past Presidents' Dinner of the Medical Alumni Association was given in honor of Robert E. Reisman, MD '56, recipient of the 1999 Distinguished Medical Alumnus Award. Bob's receipt of this award, which will be reported in the next issue of Buffalo Physician, was prompted by a wonderful nomination fromjerome Kassirer, MD '57, former editor-in-chief of the New England journal of Medicine. We on the Governing Board were so pleased to be able to give Bob this award. Spring Clinical Day is being organized by Colleen Mattimore , MD '_9 1, and our Stockton Kimball lecturer will be Maxine Hayes, MD '73. Dr. Hayes is the assistant secretary of community and family health for the Washington State Department of Health, where she oversees a staff of more that 200 and manages an annual budget of over 300 million dollars. Early in the Clinton Administration , Dr. Hayes was on a short list for the Surgeon General post There was an out-of-town reception in San Francisco on October 12, 1999, at the American College of Surgeons' 85th Annual Clinical Congress. The Medical Alumni Association co-sponsored a reception in conjunction with the Department of Surgery at this meeting. All alumni attending this meeting and alumni living in the area were invited to a reception at the Renaissance Park on October 12. The Community Physicians Speakers Program will be starting up this falL This is a very well received program in which the Medical Alumni Association arranges for physicians in the community to come and speak to the first- and second-year classes during lunch to discuss the lifestyles of the various subspecialties. The Medical Alumni Association provides pizza and soft drinks for the talks. The Medical Alumni Association partially sponsored a party held for the first-year class on August 12, 1999, on the USS Little Rock. This event provided a good opportunity for Dr. John Bodkin, Dr. Bertram Portin and me to meet and welcome members of the class. Finally, we are seeking nominations for next year's Distinguished Medical Alumnus Award. (See nomination card inserted in the inside back cover of each Buffalo Physician.) As a reminder, your nominations must be received by March 1, 2000. Richard L Collins, MD President, Medical Alumni Association l 0 Physician Autumn l 9 9 9 ® �• ··········· · · · ····· ·· ··· · ························· · ········· ·· ···························· - ' JOHN E . SH I E L DS JR ., MD '68 , Ham L. Metcalf, MD '60 writes: "Relocated to Hampton Bays, Y. Wife, Bernice, has pro- Receives Berkson Memorial Award gressive MS. Prime Care of Hamptons. FAA consultant. GD consultant. Addiction medicine consultant. " arry L. Metcalf, MD '60, clinical professor Department of Family Medicine, in presenting the of family medicine at the University at award to Metcalf, noted that he has acted as an Buffalo, is the recipient of this year's advocate for continuing and comprehensive patient RobertS. Berkson, MD, Memorial Award careboththroughhispracticeandinthemedicalsystem in the Art of Medicine. Dr. Berkson was that has evolved to serve patient needs. - - - - loved by his patients, respected by colA politically active physician, Metcalf has effecleagues and students, and his special --lively implemented programs and expertise in the "Art of Medicine" is enacted initiatives for the advancement meant to be perpetuated by this award. of medical education and patient care at state and federal decision-making levels. For over thirty years, Metcalf has been committed to educating graduate The award also recognizes that Metcalf "is well respected by his physician and postgraduate students in the art and science of medicine, a commitment that colleagues and medical students and, has been enhanced by his strong role most importantly, by his patients, whom modeling as a physician and the respect he has he continues to serve in a compassionate and caring garnered for his abilities in patient care. manner that indeed elevates his practice of medicine Dr. Thomas C. Rosenthal, professor and chair of the from a science to an art." [ n 1 9 3 0 s HUBBARD K . MEYERS , MD '36 : writes: "I participate in the retired physicians journal Club, which meets biweekly in Green Valley, AZ. The club has 30 members from various states and areas of specialities, including: dermatology, internal medicine, general practice, surgery , orthopedics, anesthesia, neurology and psychiatry. 1 9 5 0 s LEONARD R.SC HAE R , MD , '55 , writes, "Since retirement in 1991, I have been involved in mostly volunteer activities. (!even volunteered for a coronary bypass in 1996.) I have been a docent at science museums, lecture to high ® school senior boys regarding testicular cancer, serve on the advisory board of Emeritus College Division of Diablo Valley College. I have taken many adult education classes as well. Latest hobby: have had supporting roles in a couple of movies, including Bicentennial Man, starring Robin Williams, and SF0-2000, starring Timothy Hutton. Both will be released near the end of the year. Mostly I enjoy my two precious granddaughters, Danielle and Talia , who live 10 minutes away! Send e-mail! nanapop@ hotcoco.infi. net B u f f o I o 1 9 6 0 1 ER IC J . 7 s 0 MD '74 , R U SS ELL, writes: "Elected president of the American Society of Neuroradiology (ASNR) for 1999- 2000; program chair for the AS R annual meeting in San Diego in May 1999, with 3,000 attending; member of the editorial boards for the American Journal of Neuroradiology and Radiology; a member of the executive council for the Society for Cardiovascular and lnterventional Radiology. I also am a regional member of the UB Medical Alumni Association board. My wife , Sandra K. Fernbach, MD, and I have two daughters: Gabrielle Robin, 16, s J OH N . J . L A MAR JR . , MD '63 , and Meredith jean, 12. writes: "Retired as of October 1, 1998. Have 2 1/ 2 grandchildren. Must visit Ft. Hood to see our 1 9 8 s 0 K EVI N FEREN TZ, MD '83 , writes: "I have been awarded the Exemplary Teaching Award for full-time faculty from theAmericanAcademy of current grandchildren and their parents. Doing lots of fishing and gardening." B E RT W . RAPPOL E, MD '66, has been elected to a two-year term as president of the Eighth District Branch of the Medical Society of the State of ew York. Rappole, a surgeon in jamestown, NY, is past officer of the District Branch Family Physicians.! received the award in Orlando, FL, at the Congress of Delegates meeting in September 1999. I've been in Buffalo several times over the last year, giving lectures on smoking cessation to practicing physicians. It's always good to come back." and a past president of the Chautauqua County Medical Society. Physician 9 A. u t u m n 1 9 9 9 �······· · ····································· · ········· · ······ · ······· · · · ············ · · · · · · • • • MARC LEVINE , MD '83, writes: P HI LOMENA MUFALLI BEHAR, "My wife, DEBBIE FELDHEIM Johnson Foundation on a sur- MD '92, writes: ')erryandibought I early 1950s, serving at Thule Air Force Base in Greenland. From [MD '84] and I recently cele- veillancesystem a home in Memphis, TN, in May 1953--1973, he practiced medicine brated our fifteenth wedding for tracking to- 1999. I completed a two-year inl.ockportand was Niagara County anniversary. We live in the bacco control pediatric otolaryngology fellow- health commissioner from 1973 Maryland suburbs of Washing- activities in the ship in Atlanta in June 1999 and until his retirement in 1983. Clifford ton, DC, with our three chil- United States. dren: Sammy,Max and Jeremy, The goal of the initiative is to am currently in private practice. Jerry works for Thomas and Betts was a fellow of the Royal Society of HealthinEnglandandoftheAmeri- age 4, 6 and 8. We both gradu- identify policies that are effective as their director of transportation. can College of Surgeons. ated from the Washington in reducing adolescent tobacco Psychoanalytic Institute several use. Prior to coming to RPCI, years ago and have private Giovino was with the Centers for practices in psychiatry and Disease Control in Atlanta, GA, psychoanalysis. In addition to where he was Chief of the Epide- time spent raising our three busy miology Branch of the Office on boys , we are active in the Smoking and Health. psychoanalytic community and 1 teach in various settings. 9 9 s 0 GALE BURSTEIN AND P ETER ROBERT LASEK AND COLETTE BLOOM , MDs '90. Gale writes: PRUEFER LASEK, MDS '84, write: "Peter and I moved to Atlanta, "We are happy to announce the GA, in June. I am a medical epide- birth of Eric Colin Lasek on April miologist at the Division of Adolescent and School Health at the 7, 1999. We left our practices at Geisinger Medical Center for op- Centers for Disease Control. Peter portunities in Plano, TX, lastJuly. is an assistant professor in the GI Hello to all our friends. Sorry we Division at Emory Medical School. couldn't make the reunion." MICHAEL K. LANDI , MD '94, and his wife, Antonietta, announce Our son, Zachary,just turned one DEBBYAND WALLACE S ALTER, MDs '85, are living in Grand Junction, CO, with their three children, Jeremy, 12, Brittany, 10, and Garrell, 8. They practice family medicine together and have started the area's first multispecialty group with family medicine, internal medicine and OB-GY -Columbine Medical Associates. the birth of their daughter, Lily Marie, on july 21, 1999. She year old in August. WeseeLAURIE BURTO N, MD '90, very fre- weighed 5 pounds, 12 ounces. Mom and baby are doing great! quently. She is a pediatric/ER doc at Egleston Hospital and assistant professor of pediatrics at Emory University." E-mail: gibs@cdc.gov IN MEMORIAM FRANCIS J . CLIFFORD, MD '42, lLANA FEI NERMAN , MD '93, professor emeritus of anatomy at UB's School of Medicine and Bio- writes: "After completing my oto- medical Sciences and a former in iagara County commissioner of Boston, MA, inJune 1998, Cary, health, died May 17, 1999, in laryngology residency Lockport, NY, after a lengthy ill- GARY GIOVINO, PHD '87, has Jeremy and I tried relocating to ew Jersey. However, we soon joined the faculty at Roswell Park realized that Massachusetts was ationfrom UB, Clifford served twice Cancer Institute (RPCI) in the more our speed and are now set- as an Army physician. During Department of Cancer Prevention, tling down in Dartmouth, MA. World War II, he was stationed in Epidemiology and Biostatistics. He is responsible for leading a project Jeremy will be five years old this October and his brother/sister will orthem Europe with the 83rd Infantry Division and was ordered funded by the Robert Wood hopefully arrive in September. to active duty again during the s m B f f a l o p c a ll. u ness. He was 86. Following gradu- n 9 9 THOMAS J. MURPHY, MD '45, died June 1, 1999, in Syracuse, Y, at age 76. Murphy was born in Binghamton, NY, and attended otre Dame University prior to attending UB's medical school. He was an internist for 40 years and a clinical professor for medical students at St. Joseph's Hospital in Syracuse. He was a past physician for Le Moyne College and a consulting staff physician at the Syracuse Developmental Center, Plaza Nursing Home and St. Joseph's Hospital. Survivors include his �• ............................................................................. .. .. . .. . ... . . I his Snyder home after a lengthy illness. He was 85. In addition to conducting a private practice , Link was chief pediatrician at Sisters Hospital, where he also was wife, Theresa M. "Hunnie," six daughters and two sons. SAMUELP . AVERSANO , MD '49 , died on May 16, 1999, in Rochester, Y. Aversano was a native of Rochester, attended Madison High School and Syracuse University, where he graduated with a BS in chemistry. He was in the U.S. Army at Pearl Harbor when president of the staff in 1967-68. Until his retirement in 1987, Link worked extensively with disabled children. He was physician-incharge at the Erie County Health Facility for Children and School it was bombed at the beginning ofWWli and he received an honorable discharge in 1945. Fol- 84, and the new School 84 was dedicated in his honor. He was clinic medical director for the lowing graduation from medical school, he completed his postgraduate training at the then E.J. Meyer Memorial Hospital in Buffa lo. He spent his professional life in Rochester, where he was in solo general practice for 15 years before becoming associate medical director of St. Ann's Home for the Aged, a position from which he retired in 1987. He is survived by his wife, Mary Aversano, and by his son, Thomas, of Baltimore, MD. ROBERT T . DEAN , JR , MD ' 55 , d ied of lung cancer on May 24, 1999. Following graduation from medical school, Dean returned to his home in Phoenix, AZ, where he interned at Good Samaritan Hospital. He practiced general medicine for five years before taking a three-year residency in psychiatry at Colorado Psychopathic Hospital (19611964). He then went into the private practice of psychiatry in Phoenix , retiring in 1995 from active practice. He continued as a consultant until his death. He is survived by his wife, janet, and four children: Patricia Lewis, Robert T. Dean, Ill, j. Richard Class of 1994 during Spring Clinical Day and Reunion Weekend First row, left to right: Ted Szarzanowicz, Michelle Penque, Carol Killian, Patricia Geil, Maya Srivastava, Gloria Delvalle; second row, left to right: Thomas BurneHe, Wendy Snyder, Richard Kozak, Amy Ferry. Dean and Misty Ihrke; and five grandchildren: jesse Lewis, 15 , Carly Lewis, 12, Kelsey Ihrke, 8, and Lindsey and Taylor Ihrke, 2. His wife, janet, says, "He loved the practice of medicine and, especially, psychiatry. It never became routine or mundane for him. " IN MEMORIAM F A C U L T Y ELLIOTT MIDDLETON JR ., MD , a former professor of medicine and pediatrics in the School of Medicine and Biomedical Sciences , died on March 7, 1999, at Maine Medical Center, in Portland, ME, after a brief illness. He was 73.During his 19 years at UB , Middleton served as director of the Division of Allergy and Immunology in the Department of Internal Medicine and co nducted research on the biological effects of natural food substances on health. He was a diplomate of the American Board of Allergy and Im- s f f a l o munology , which Muscular Dystrophy Association of Western ew York at the former E. ] . Meyer Memorial Hospital and at WCA Hospital in jamestown. The Muscular Dystrophy Association presents an annual medical award in his he co- founded , and the American Board of Internal Medicine. name. Link conducted research on cerebral palsy and muscular dystrophy, including clinical tests on several drugs for treatment of the diseases. He was chair of the Middleton was also a past president of the American Academy of Allergy and Immunology, and from 1983 through 1988, he served as editor of the]oumal of Western ew York chapters of the Cerebral Palsy Association and the Muscular Dystrophy Association and for several years was chair of the New York State Cerebral Palsy Advisory Board. He was a member of the board of direc t ors of Special Help for Special Children and the medical advisory committee for the March Allergy and Clinical Immunology. In 1991, he received the Distinguished Service Award from the American Academy of Allergy and Immunology. JOSEPH s K . LINK , who served as a faculty member in the School of Medicine and Biomedical Sciences and as apediatric consultant for chronicdisease research at UB, died April 12, 1999, in MD , p h 5 + of Dimes. c a A u m n 9 9 9 �Your stock may pay more dividends than you thought possible vou dabbled in the market long before it became a fad and your hunches paid off. But now you need income, and your shares are only producing low annual dividends. so how can you make the most of your securities and still achieve your personal and financial goals? Give your stock to the University at Buffalo. With careful planning, your gift may provide you with income for life, a charitable deduction and reduce or eliminate taxes. And for UB it can mean more scholarships, research funds or the realization of your own personal vision and goal for the University. To learn how your gifts of stock can benefit you and the University at Buffalo, please call the Office of Gift Planning at !716! 645-3312. T~ University at Buffalo ~ The State University ofNew York University at Buffalo • Office of Gift Planning • 103 Center for Tomorrow • Buffalo, New York 14260-7400 • 716-645-3312 �BUFFALO PHYSIC IAN Non- Profit Org. STATE UNIVERSITY OF NEW YORK AT BUFFALO U.S. Postage 3 4 35 M AIN ST . PAID B LDG . 22 Buffalo, NY 4 53 BUFFALO NEW YORK 14214-3013 s~R ARY OEPT Permit No. 311 ADDRESS SERVICE R EQUESTE D We Get Rehab Results! Our Superior ~M hnprovement Vs. National and Northeastem Regional Subacute Facilities Five Star Care The McGuire Rehabilitation Centers achieve a 34% GREATER FIMsM increase vs. the national average for all admissions. Stroke • Pain Management • Medically Complex • Orthopedic • Cardiac • Infections • Cancer • Joint Replacement • Amputee Our facilities were rated outstanding in the community with five stars out of five, according to the Inside Guide to America's Nursing Homes for long-term care. 0 ***** The McGuire 1eam. ofExperts The McGuire Rehabilitation Centers employ a team of over 30 licensed Physical and Occupational Therapists, specially trained support staff, and an on-staff Physiatrist/ Gerontologist. Together they ensure the highest level of individualized medical and restorative care. Cost Effective! I = Inpatient Admiss ions I = Inpat ient Discharge I = Out patient Follow-Up Our case mix is consistent with the Northeast and national subacute region. Our average statistics are: length of stay - 25 days; age - 78; admission FlM score 72.5; discharge FIM score 97.6; FlM change - 25.1 points; length of stay efficiency - 1.40; onset time - 17; discharge disposition- 80% to community. Based on 12 months ending March 31, 1998. - The McGuire Rehabilitation Centers' average charge per case is more than 35% WWER than other facilities in the nation, according to statistics from The Wall Street Journal and the American Health Care Association. The McGuire Rehabilitation Centers rely on the national The results are in. The McGuire Rehabilitation Centers have leading measurement tool for documenting patients' the clear advantage over other regional facilities based on FIMSM rehabilitative outcomes. This tool is known as FIMSM<-~ improvement, discharge to home, and cost effectiveness. Instrument; Functional Independence Measure, developed Our successful rehab program delivers results by the UB School of Medicine along with the Center for j because of our superior staff, state-of-the-art equipment, Functional Assessment Research. It's used ~CGUL~ and specialized rehab facilities. Choose The along with the Uniform Data System for McGuire Rehabilitation Centers for five-star Medical Rehabilitation (UDSMRsw) rehabilitation services. to establish rehab outcomes that ~pU J1 Call 1-888-POSTACUTE. can be measured and calculated .& ~~ ~\7.J. ,.,...HE .l. DTT 'M"'JI'T""Tfq]\f .l.I'1I. '-.. IDd~=::::n.m-<~M-G!E!!!!!J§ueeoom.oo.--., '-·~''-""-'"' Autumn View • Gatden Gate • Banis ffill • Northgate � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1999 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1999-Autumn Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v34n02-1999-Autumn Table Of Contents A list of subunits of the resource. On the Trail of Schistosomiasis Electronic Testing Makes Its Mark Medical School A Revolutionary Look at Medicine Alumni Hospital News Research Student Perspective Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-10 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v34n02 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1999 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/7a6733e16c085ba43c1392384baa82b9.pdf 14e5f8eaaf0e8ab3c5a4ce10cc92c3ff PDF Text Text �BUFFALO PHYSICIAN Volume 34, Number 1 ASSOCIATE VICE PRES IDENT FOR UNIVERSITY SERVICES Dr. Carole Smith Petro DIRECTOR OF PUBLICATIONS Dear Alumni and Friends, lr HAS BEET\1 "THAT TIME OF YEAR" -\GAIN - Spring Clinical Day and five-year reunions for alumni; orientation programs for incoming chief residents; achievement awards ceremonies; the pre-finals "follies" presentation by first- and second- Kathryn A. Sawner year students; graduation dinners and, of course, graduation itself. During it all, I ED ITOR endeavored to perfect the art of being in more than one place at one time-with less- Stephanie A. Unger ART DIRECTOR/DESIGNER Alan j. Kegler PRODUCTION than-complete success, but it was fun trying! The good news is that all events were highly successful. The 60th class reunion was organized by Dr. Elizabeth Olmsted Ross, who, with Cindy Todd the able assistance of Mary Glenn from our development office, com- STATE UNIVERSITY OF NEW Y ORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMED ICAL SCIENCES posed a "class book" complete with photographs and an update on Dr. john Wright, Dean virtually every member of the class of 1939. No doubt this will become a much imitated technique for celebrating future class reunions. Ap- ED ITORIAL BOARD Dr. Bertram Partin, Chair proximately, 20 members of the Class of 1939 were able to attend the Dr. Martin Brecher Dr. Harold Brody Dr. Linda j. Corder Dr. Alan j. Drinnan Dr. james Kanski Dr. Elizabeth Olmsted Dr. Stephen Spaulding Dr. Bradley T. Truax Ms.jennifer Wiler Dr. Franklin Zeplowitz reunion events. The 50th reunion class won the prize for TEACHING HOSPITALS [rie County Med1cal Center Kaleida HealthThe Buffalo General Hospital The Children's Hospital ofBuffalo Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital Roswell Park Cancer Institute Veterans Affairs Western New York Healthcare System Catholic Health SystemMercy Health System Sisters of Charity Hospital Niagara Falls Memorial Medical Center ©The State University of ewYork at Buffalo Buffalo Physicia11 is published quarterly by the State University of ew York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alumni, faculty, students, residents, and friends. The staff reserves the right to edit all copy and submissions accepted for publication. the highest attendance rate, with 2l members of that class able to participate in reunion festivities. The Spring Clinical Day program focused on women's issues, specifically breast and ovarian cancer. Ms. Betty Friedan, a founder of the National Organization for Women and the author of the seminal 1963 book The Feminine Mystique, gave the Stockton Kimball lecture. She pointed out that the reasons women tend to live longer than men may not just be due to hormones and/or genetics, but may indeed reflect differences in life-style and, perhaps most importantly, differences in the way men and women handle stress. Graduation ceremonies featured Dr. D. Bruce Johnstone as keynote speaker. Dr. Johnstone, former chancellor of the SUNY system and currently a very active member of the University at Buffalo faculty, presented a powerful message to the students. Having overcome serious illness himself, he could speak with authority on the marvelous challenges and opportunities that await our graduates. The Dean's Advisory Council also met in conjunction with the Spring Clinical Day festivities and the annual] ames Platt White dinner to discuss the variety of issues with which the medical school is currently grappling. The advisory council provides invaluable advice and counsel to me as dean and represents a group of dedicated alumni not only from this geographic region but from other parts of the country, as well. We are all making an earnest attempt to keep in contact with alumni and, with the help of this group and others, we plan to organize more regional alumni events over the next year. Busy as this time of year always is, it marks the culmination of what we are all about-graduating physicians and scientists for the future and preparing for our next group of students, interspersed with occasional alu mni reunions and celebrations. All of these events represent an important cycle and one in which I hope each and every reader of Buffalo Physician will want to participate. I look forward to meeting with as many of you as possible during this next academic year. (--7 ~ ~" R. Wdgh<, MD Dean, Schoo l of Medicine and Biomedical Sciences �V 0 L U ME 3 4 , NUMBER 1 ["SuMMER 1999 L 3 0 1999 2 ASpecial Place loP Women NEWLY ESTABLISHED CENTER FOR WOMEN WITH DISABILITY by Jennifer Gold 8 14 Peak ExpePience HeaPing Loss ReseaPch BolstePed THOMAS CUMBO, U 8 CLASS OF 1 9 9 9 , YEAR, $ 5 . 7 MILLION RECOUNTS MEDICAL PROGRAM PROJECT EXCURSION TO NEPAL GRANT FROM THE RECEIVES FIVE- NATIONAL INSTITUTES photography by Rhea Anna OF HEALTH by Lois Baker Medical School • GRADUATION ARRIVES! • MATCH DAY Student Perspective 1 999 RESULTS TOMORROW'S • PHYSICIANS CONFRONT NEW MOUSE CALLS CHOICE COLUMN • STEP STUDENTS Mission Improbable by Stacey Blyth WIN FIRST PLACE IN SUZANNA GOODYEAR STATEWIDE POSTER ATTENDED MEDICAL Classnotes COMPETITION SCHOOL AT AGE 5 4- A AN UPDATE ON HER WHAT CAN YOU TELL CAREER US ABOUT YOURS? STORI ED PAST- by Betsy Sawyer photography by Gary T. Truman 1999-Maria loTempio and Patrick DiAbbrocci Celebrate Graduation Day, Saturday, May 8 THE (LASS OF Alumni • SPRING CLINICAL DAY; BETTY FRIEDAN DELIVERS STOCKTON KIMBALL Closs of 1990, Knows It's Never Too late to Follow a Dream SuzANNA GooDYEAR, LECTURE • REUNION WEEKEND FESTIVITIES & PHOTOS �: JENNIFER ��I 1997, in an effort to identify and address these barriers, researchers at the University at Buffalo completed one of the first assessments of the health status of women with disabilities. The results of the assessment were so compelling that they spurred formation ofa multidisciplinary Center for Women with Disability, which opened in September 1997 as part of the Western New York Neuroscience Center at Kaleida Health's Buffalo General Hospital (BGH). "The health concerns of many women with disabilities are not met through the traditional health-care delivery system. Often, these women are not treated in the context of wellness but only in terms of their disease," explains Carol Brownscheidle, PhD, UB clinical assistant professor in the Department of Neurology, and director of the new center. The health-needs assessment, which was designed by the Women's Health Collaborative Research Group (WHCRG) under the auspices of the Neuroscience Center, was completed by more than 300 women with multiple sclerosis (MS), stroke or other neurological disorders. The respondents' median age was 45, and half were moderately to severely disabled. More than 20 percent of the women reported a history of gynecological problems, such as uterine fibroids, endometriosis, ovarian cysts, irregular menstrual periods and deterioration of MS during menstruation; a similar percentage reported experiencing reproductive and postmenopausal health problems that were inadequately treated. Forty percent of the women said they were sexually inactive, while 70 percent of those who were postmenopausal indicated they weren't receiving hormone-replacement therapy. 0 MARCH B u f f a l o In sum, the women reported experiencing insensitivity to their special health-care needs; lack of accessible medical equipment, such as examination tables and mammography machines; and difficulty getting to the various facilities for treatment of specific problems, according to Brownscheidle, who chairs and directs the WHCRG and was instrumental in developing the survey. Galvanized by the survey results, Brownscheidle began work on the creation of the Center for Women with Disability. In talking about her involvement with the project, she is quick to acknowledge the ongoing assistance and support she has received from others, including Lawrence jacobs, MD, who is Irvin and Rosemary Smith professor of neurology at UB, head of the Department of Neurology at BGH, and project director for the ew York State Multiple Sclerosis Consortium (NYSMSC), and Dennis Weppner, MD, MBA, UB associate professor of clinical obstetrics and gynecology and clinical director of obstetrics and gynecology at Millard Fillmore Hospital Suburban, both of whom serve as co-medical directors for the center. Today, the Center for Women with Disability is a place where women with special health-care needs receive a variety of services, including social and supportive services that are intended to assuage feelings of isolation and loneliness. For many women with MS, post-stroke impairment, post-polio paralysis, cerebral palsy, spinal-cord injury, spina bifida or movement disorders, such as Parkinson's disease, the neurologist is the gatekeeper for health care, Brownscheidle notes. "We've built on that and formed a kind of one-stop health shopping center. When a woman comes in for stroke treatment Phys l clan Summer 1 9 9 9 �disability; they don't just deal with neurology, but OB-GYN issues, too," notes Elizabeth Roden, who has epilepsy and regularly attends the center. "I really wish something like this had been around when I was first diagnosed." Recently , the center expanded its services to include orne women have limited movement, and urology, with care provided by Philip Aliotta, MD. "Bladder dysfunction is lt can be quite common with this difficult for population and requires them to use the immediate medical attenstirrups on a tion if an infection develconventional pelvic-exam ops," explains Epstein, who table," explains Susan adds that Aliotta provides Epstein, MS, MEd, clinical services at the center twice coordinator for the center, a month and sees approxiwho, along with Weppner, mately 10 to l2 patients developed a pelvic-exam each clinic day. "Dr. Aliotta chair specially adapted for has conducted research on women with disabilities. bladder function in patients (See article below.) "Other with neurological disease, women may not be able to and we are fortunate to have stand upright for mammohim as part of our team," gram screenings or, if they says Brownscheidle. are spastic, may find it difWhile improving access ficult to perform a breast to health care remains the self-exam. In many cases, primary mission of the centhe women simply have a ter, it has begun addressing difficult time getting to the broader, quality-of-life different specialty offices," issues by offering programs she adds. on community-service Although the center has opportunities, networking, been open less than two social services and careers. years, the patients feel that The Outdoor Adventure the access it affords them to Susan Epstein MS MEd and Denms Weppner ~D MBA, developed a pelvicProgram offers wilderness one-stop health care is the exam cho1r specially adapted 1or women with ch~o~1c uisab1ing co•di ons. wheelchair hikes , and the key to its success. "I espeWomen Helping Women Program links women with cially like how the different types of care and services are disabilities to volunteer opportunities in assisted-living consolidated. These are professionals who address all settings and nursing homes. Monthly "focus luncheons" aspects of a woman's life and how it can be affected by or for follow-up visits for multiple sclerosis, she can go to other rooms in the center for a pelvic exam, a Pap test, an ultrasound or to have her blood pressure checked," she explains. ''s G.xnecologic For a woman who has multiple sclerosis (MS), it can be very difficult to transfer from a standard 22 -inch-high wheelchair to a conventional 30-inch-high examination table in a physician's office. For a woman with a neurological disorder that causes spasms, loss of control of lower limbs or pain, transferring to such a table can be impossible. Instead of being a neutral apparatus for the provision of health care-especially gynecological care-the exam table becomes still another barrier, both physically and emotionally. Recognizing that access to examination tables con be a major issue for women with disabilities in need of gynecologicol care, Susan Epstein, MS, MEd, clinical coordinator for the Center for Women with Disability, and Dennis Weppner, MD, MBA, UB associate professor of clinical obstetrics and gynecology, decided to solve the problem. From the start they realized that, to be successful, B u f f a t o Physician they would need to abandon the traditional model for a gynecological exam. The solution came one day while Epstein was at the dentist. lying in a comfortable chair during a long procedure, she thought, "This will work." And it did. Epstein and Weppner immediately contacted PoHerson Dental, which has been in the specialized business of making dental chairs for more than 100 years. They identified a choir that can be lowered to 22 inches to facilitate transfer from a wheelchair. It also had a knee break, which allows positioning for a pelvic exam. Allen stirrups, with a boot-like fit, were aHoched in order to increase comfort and decrease the effects of spasticity. "This sounds like a simple solution, and it is," admits Epstein. "But, until now, there has been nothing that would accommodate the needs of a woman with a chronic disabling condition." Summer 1 9 9 9 0 �feature specialists who come to the center and answer questions on health topics in an informal setting. Some women travel from as far away as Niagara Falls to attend these luncheons, with transportation provided gratis by john Arnet, president of We Care Transportation, a local specialty transportation company. Also, valet parking is available and can be accessed at BGH's main entrance. Other support for the luncheons comes from Biogen, a biotechnology firm that makes the drug Avonex TM, for treatment of MS. A no ther quality-of-life project under way is the development of a Career Center, scheduled to open in fall 1999, which will focus on re-employment of clients by instruction in such areas as resume composition, interview skills, managing home finances and self-esteem building. A fully accessible computer lab will introduce clients to basic PC and Internet skills. Provisions of the Americans with Disabilities Act, job Accommodation Network and opportunities available through vocational education will be presented to clients. Recent statistics show that lack of employment can lead to feelings of loneliness, pessimism, morbid or gloomy thoughts and self-pity in approximately 75 percent of unemployed disabled women, in comparison to 25 percent of employed disabled women, according to Brownscheidle. "Employment is viewed as a productive use of time that improves outlook on life and augments one's contribution to society, whether it involves full-time or part-time work. The Career Center will provide career counseling and aptitude testing, as well as individual and small group sessions to achieve these goals," she says. Carolyn Miller, who regularly visits the center since her diagnosis with MS, says living with a disability can be extremely isolating. "It's a lonely life," she relates, adding that she sometimes feels "vulnerable and depressed" about her inability to enjoy many of the activities she used to, such as volleyball and waterskiing. "It's nice to be involved with the other women," says a u f f a 1 Ilona Tylwalk, who has MS. "There's an interchange of ideas, and we can talk about our problems and different illnesses-because not everyone has MS. "The lunch lectures are great," she adds. "''ve never been disappointed by one." The center's educational goals extend beyond the patient population in an effort to reach health-care professionals, as well. "Women with disabilities are just as susceptible to the three leading causes of death in women in the United States-heart disease, cancer and stroke-and therefore should be screened and counseled accordingly," says Brownscheidle. Unfortunately, the diagnosis of a major disease, such as MS, often overshadows every other aspect of a woman's health, with the results being that broader health-care concerns, including access to primary care, are overlooked. "We listened to our patients and heard the same thing over and over again-that access issues were often ignored and gynecological examinations were demoralizing and impersonal. They just didn't feel comfortable," says Brownscheidle. "Some of the women have even been asked by their gynecologists why they wanted to know about sexually transmitted diseases or birth control. Did they actually have a sex life7" o Physician Summer 1 9 9 9 �Despite such concerns, Brownscheidle states that progress is being made toward better understanding and that "even within the past year in this country, the healthcare profession as a whole has started to focus more closely on specific health issues affecting women with a disabling condition." Weppner emphasizes that the center is not only taking a proactive role in treatment and education, but is also furthering research efforts by ensuring that the women who visit the center are enrolled in the NYSMS registrythe largest population-based cohort of MS patients reported to date. The research implications of this database are enormous, he explains, and the close association with UB's School of Medicine and Biomedical Sciences adds impetus to the center's ability to contribute to the treatment of neurological diseases in general, as well as to the comprehensive care of women, in particular. "By approaching our research from a multidisciplinary perspective, as well as looking at data from the perspective of gender differences for these diseases, we may discover information we might not have otherwise found ," Weppner says. Since its inception, the Center for Women with Disability has attracted the attention of national healthcare organizations, including the New York State Depart- B u f f a 1 o Physician ment of Health, Baylor University and the Mayo Clinic, which last spring sent representatives to Buffalo to visit the center. ln addition, Brownscheidle was invited to present information about the center and the health-care assessment survey at the American College of Obstetricians and Gynecologists 1998 annual meeting in New Orleans and at the Women's Health Issues in Multiple Sclerosis Roundtable in Houston. She also moderated a national conference on women with MS and their healthcare concerns in Amelia Island , Florida, in june 1998. Although the center has not been widely advertised , patients, too , are finding out about it, and their numbers are growing steadily. "Patients are hearing about us ," says Epstein. "Recently, a woman who is an amputee called us to say that she was so thankful for the center because she hadn't had a Pap smear in 10 years. " Exposure and recognition like this is likely to engender continued interest in the growth and development of this unique center for women with disabilities, leading to even more comprehensive services for its patients. However, for Leona lrsh , an Episcopal priest diagnosed with MS, the fact that the center even exists is like an answer to a prayer. "I cannot say enough about what they are trying to do for us. It means so much that they are looking at us as whole people. " + Summer 1 9 9 9 0 ��Class of 1999 B f f a 0 p h y s c a n 5 m m e 9 9 9 0 �started about one year before my actual departure, when I called Dr. Brendan Thomson, whom Dr. Copley had listed as a contact person at the close of his article. Dr. Thomson is a UB alumnus (Class of 1970) who resides in Phoenix and actively runs an ongoing Nepali-American exchange program. He had been the guiding inspiration behind Dr. Copley's decision to travel to Nepal and had accompanied him on his journey When Dr. Thomson returned my call the next day, we realized that we are both graduates of Canisius College and UB medical school and found that our shared jesuit heritage resonated well. He gave me names , numbers and the advice I needed to begin organizing the most daunting task I had ever attempted. Specifically, my goals were to coordinate a medical experience for myself in a location halfway around the world, to complete my residency applications prior to leaving, and to not get killed or lost once I arrived at my destination. The details involved in implementing these goals were tremendous and the obstacles and stresses, extraordinary, but my zeal for adventure and the critical support of my family, girlfriend and several local members of the medical community enabled me to accomplish what I had set out to do. The hardest part of this excursion, I have since realized , was not the trip to Nepal itself, but convincing myself early on that it was worth all the sacrifices and risks I was taking. Having gone and returned, I no longer have any doubt that it was the best thing I could have done , as the trip contributed to my medical education and personal growth in ways I am only now beginning to fully understand. I left for the Far East in September of 1998 not ® B u f f a I o knowing what to expect but strongly motivated by a lifelong interest in biology , travel , wilderness medicine and foreign cultures. My plans to "go it alone " changed for the better at the last minute, when DJ, a good friend of mine from California, decided to come along. Arriving in Bangkok, Thailand, we settled in for a 14-hour layover priorto leaving the next morning for Kathmandu. As the sun was rising, we boarded the plane, which was filled with a motley assortment of colorful passengers, including local Nepali people, trekkers and climbers, and even some celebrities coming from around the world. I met and talked with jon Krakauer, author of Into Thin Air, after which I realized this was going to be a unique experience. Once we took off, I soon received my first dose of the Himalayan mountains , watching as the peaks cut through a thermocline layer of clouds like islands. The jet stream over the Indian subcontinent skims over Mount Everest and a comet-like trail of ice is commonly seen trailing off the peak. We wound through these giants until we approached the emerald green valley of Kathmandu far below. When we finally landed, I was overwhelmed by sensations I had only previously read about in books. The air was muggy from the jungles that surround the city, the sun was extremely hot and masses of people were everywhere, Physician Summer I 9 9 9 �.' Tibetian monks in the village of Pokhara in western Nepal invite Tom, left, and DJ to join them in a pick-up game of hockey sack. Pictured below, a monkey looks on as bodies are cremated on a pyre at Pashupatinath Temple overlooking the Bagmati River. although few seemed to have any real place to go. A loneliness and desperate feeling of emptiness consumed me as I pondered the enormity of spending more than six weeks in such a place. E\\ Co:--;cEPTS ABOL T LIFE, DEATH A\D BAsiC ExiSTE ·cE Once we boarded a epali cab and were under way, I was able to appreciate for the first time both the poverty and the history ofthis ancient place. Looking out my window, I marveled at the small crowded houses, dirt roads, completely disorganized traffic and hordes of people-a mosaic of life that exists under the watchful eyes of the Buddha, which peer from the many temples and stu pas that dot the region. Religion in Nepal is a blend of Buddhism from the north and Hinduism from the south, both mixed with a touch of Animism and Christianity. This blending makes the country a true melting pot and a place where people are very accepting of diverse philosophies and practices. Little did I realize how my perceptions of death, life and basic existence would be challenged and modified during my stay. My mentor during my stay in epa! was Dr. Buddha Basnyat, a local physician who had befriended Dr. Thomson during his first visit to Nepal years before. At the time, Dr. Basnyat had been intent on completing an internal medicine residency in the United States, and Dr. Thomson had helped place him at a Phoenix hospital and had invited him to stay in his home during the three-year fellowship . B u t t a l a Physician When we arrived at Dr. Basnyat's home, I was relieved to finally meet him and his wife and their three children. We were immediately escorted to their family room, where we exchanged "namastes" (a epali greeting meaning "I salute God in you"), after which we were offered tea. DJ and I soon realized that we could not have been blessed with a nicer family to ease our transition. Through the Basnyats, we were introduced to the many facets of Nepali culture, including its festivals, traditions and arts. One such art was the practice of relaxation, which stems from the belief in Nepal that work and leisure time are of equal importance. As a result, hours each day are devoted to relaxation and cultivating a balance between rest and activity. DJ , the Californian, adapted immediately; this medical student, in contrast, had a much harder time with the practice! A MIXTURE OF PEOPLE -\\0 DISEASES FRO\! AROt.; D THE PL.-1.'\ET In arranging for my excursion to Nepal, the plan was that I would "shadow" Dr. Basnyat during his work day at a general medicine clinic, where he is in Summer 1 9 9 9 �private practice with several partners. I would also accompany him on general rounds at the local hospital , conduct research with the Himalayan Rescue Association (HRA) and have some free time to go trekking. I spent the first two weeks in Kathmandu adjusting to my new environment, finding decent $3-aday rooms and struggling daily to maintain perspective. Patients at the clinic were truly a mix from all over the planet, which is to be expected when working roughly 180 degrees oflongitude from Cleveland. A simple fever workup takes on new meaning when a patient has recently been in India, sporadically taken his Lariam (anti-malaria medicine), flown to Lhasa, Tibet (a gain of about 3,200 meters in altitude in one day), cannot remember which vaccines he received, and has come to Kathmandu where he has not been too conscientious of sanitary conditions and has "reveled in the local festivities. " I saw much gastrointestinal illness, ranging from amoebas to cyclospora; sexually transmitted diseases; tuberculosis of all manifestations; rabid dog bites; infected leech bites; a host of dermatology, from psoriasis to cutaneous tuberculosis; and malaria. We also had a good share of common internal medicine problems , but these were often quite advanced. At Patan Hospital I saw untreated malaria , typhus, japanese encephalitis, chronic obstructive pulmonary disorder, anemias, amoebic liver abscesses, rabies and several other exotic maladies. I experienced for the first time the frustration of limited resources, and I developed respect for the local physicians and those whose religious devotion calls them here. While I did have a difficult time adjusting to the poverty of these patients, especially the children, I was impressed by the family presence in the hospital and by how much responsibility the patients' relatives assume. B u f f a l o LHR. L G RESPEC r 1OR \\- JLD PLACES In addition to my experience at the clinic and hospital, I was also very fortunate to work with Dr. Basnyat at the HRA. This organization coordinates rescue missions in the mountains, staffs physicians at strategic trekking and climbing routes, educates trekkers and studies Himalayan climate and biology. Dr. Basnyat's interests lie in high-altitude medicine and extreme environmental physiology. If they live, individuals who are seriously ill at altitude are likely to become patients of Dr. Basnyat's back in Kathmandu. Especially poignant to me in my work with the HRA is a case of a European man who ascended too high, too fast, along the Everest route. He ended up with a horrible case of cerebral edema and was found unresponsive with a pulse-oxygen rate of 38 percent (a rough measure of oxygen saturation in the blood, with the normal rate being about 90 to 100 percent); he never recovered full brain function. More than anything, this furthered my respect for the power of these and other wild places for both the sudden climatic changes that can cause havoc and the subtle insults that can accumulate over time. This firsthand exposure to the field of geographic medicine-which offered me a chance to combine my love of biology with medical work-confirmed for me that this is a discipline I will certainly continue to explore in the years ahead. At the HRA, I had a blast learning the local geography, giving advice to climbers, lecturing about acute mountain sickness (AMS) , designing research projects and, most notably, helping Dr. Basnyat develop theories to explain data he collected from a recent study of his. A theory I developed to help explain one possible component of AMS pathogenesis is currently being tested in the vicinity of Mount Everest, and my frequent daydreams are a testament to how excited I am over the possibility of having conjured a novel idea. I am fascinated by exotic diseases and intrigued by the prevention of such problems, especially when the added complexities of political and cultural differences are factored in. A. U\GUDED TREK L THE WILDER. ESS Soon it was time for DJ and me to leave Kathmandu for a long-planned 10-day trek in the Himalayan wilderness. We went without guides , often resorting to a global positioning system for direction. I had more than my share of leeches, headaches, pain, loneliness, silence and time to think while trudging through the remote terrain. Physician Summer l 9 9 9 �While on o bockcountry trek to Annopurno Sonctuory,Tom Cumbo, leh, come to the oid of o porter who cut his foot with on ox. I learned that this discomfort is the price one pays for the spectacular views normally reserved for IMAX theaters and the wisdom that potentially unveils itself during times of quiet reflection. We were blessed with cloudless mornings, interaction with the natives and time to think about our priorities in life. Dr. Basnyat's father, a devout Hindu, had previously given us lessons on filtering sensations and becoming pleasantly detached from our environment, and the extremes of emotion and physical sensation that characterized our trek provided plentiful fodder for this practice. The Nepal wilderness is harsh, featuring constant avalanches, landfalls, extreme variations in altitude and temperature, wild animals, disease and, at times, mysterious inhabitants. Clouds seem alive as they stream over the high passes. Glaciers creak and moan before unleashing rolling splinters of ice. Sinkholes open in the glacial field, unexpectedly swallowing tons of debris. Small streams become roaring rapids farther down the slopes as they swell with runoff from the icy peaks above. Buddhist prayer flags break the characteristic silence of the open range with crisp flaps, sending constant meditative mantras into the open air. As a final destination, we climbed into Annapurna Sanctuary-a holy land at 5,000 meters that is surrounded by 8,000-meter peaks--where we sat for days, staring in profound awe at the vast panoram;;~ . I also had my share of patients on the trek, which was especially frightening because, for the first time in my medical career, I was working completely alone. I treated climbers who had clear signs of acute mountain sickness and impending complications, others who were maladjusting psychologically and a B u f f a l a Physician local who sliced his foot with an ax and was bleedingprofusely.Itiscomical now to picture myself three days from civilization, using a latex glove with a small hole cut in the finger to irrigate the wound while getting loose translations from the patient's family and shooing curious animals away. Improvisation is often necessary in these circumstances. THE \\ tSDO\t Gu ED FRO\t SLCH AVE. TLRE My time in Nepal was one of the most challenging experiences I have ever had. I spent the majority of the trip adjusting to one tough emotion after another, interspersed with the most tremendous highs. The wisdom gained from such a venture will sei¥e me well for the rest of my life. What did I learn? In essence, I learned about the value of moderation and balance and the importance of family and close friends. I also learned that very rarely does the worst-case scenario in a particular situation actually materialize; that one must practice what one is passionate about; and that life can be cruelly unfair. This year-long project, with all its stresses and rewards, has altered my life dramatically. There were several moments when I felt sensory overload was imminent from the intensity of my experiences. Things I thought were constants have vanished, often painfully. Insights and opportunities have helped fill the void and offer direction. Home again, I thank God for these challenges, the maturation they have spurred and the opportunities they have unleashed. + Summer 1 9 9 9 �Funding Bolsters Research on Hearing Loss UB RECE IVES $5 .7 MILLION PROGRAM PROJECT GRANT FROM NIH he University at Buffalo has received a five-year, $5.7 million program project grant from the National Institu tes of Health (NIH) to expand studies aimed at understanding and treating acquired hearing loss, a condition that affects approximately 28 million people in the United States alone. The grant funds four projects in which investigators are studying the function of the peripheral and central auditory system in an effort to determine how and why noise and certain therapeutic drugs cause loss of hearing. Principal investigator is Richard ]. Salvi, PhD, professor of communicative disorders and sciences in the College of Arts and Sciences, clinical professor of otolaryngology and neurology in the School of Medicine and Biomedical Sciences, and codirector of UB's Center for Hearing and Deafness. In awarding the grant, the IH is supporting UB's efforts to build on significant contributions made over the past 12 years by an internationally recognized research group in the Center for Hearing and Deafness, a multidisciplinary effort involving 30 scientists from eight departments and three schools within UB. "This grant is wonderful news for the university," says UB President William R. Greiner. "It will enable Professor Salvi and his team to expand their pathbreaking research into the causes of acquired hearing loss. The outstanding work conducted by this group is a stellar example of the interdisciplinary research that we foster at UB. Their studies promise not only to advance scientific knowledge about acquired hearing loss, but to benefit millions of people who suffer from this affliction. We are proud that our center received this prestigious NIH grant and look forward to its continued success as a worldwide leader in its field ." UB Provost David]. Triggle notes that program project grants provide funding that makes it possible for scientists to research several related directions simultaneously. FOLR OvERLAPPI"<G RESEARCH THEMES The Center for Hearing and Deafness was established in 1987 by Donald Henderson, PhD, professor of communicative disorders and sciences and otolaryngology, and Salvi, both of whom came to UB that year from the University of Texas at Dallas. They were joined in the mid-1990s by researchers Robert F. Burkard, PhD, associate professor of communicative disorders and sciences and otolaryngology, and Sandra L. McFadden, PhD, research assistant professor of communicative disorders B u f f a l o P and sciences and psychology. Today the center is focusing its research on four overlapping themes that form the basis for the current program project grant. These projects target ( 1) molecular and cellular mechanisms of hearing loss; (2) effects of ototoxic agents and noise on cochlear function ; (3) functional alterations of the central auditory brain regions after partial or temporary hearing loss; and (4) the role of the ears' inner hair cells in the brain's processing of auditory stimuli. "To understand why a patient experiences difficulty in processing hysician Summer 1 9 9 9 �New W. M. Keck Foundation Center for Computational Biology BY complex sounds, we need first to understand how the auditory system processes acoustic information along the entire auditory pathway," explains Salvi. "Damage that originates at the periphery, or inner ear, can cascade through the system, disturbing activity throughout the entire auditory pathway, even spilling over to other sensory, motor, cognitive and emotion centers. This functional reorganization, or plasticity, is poorly understood because of a lack of an integrative research approach to acquired hearing loss. Our project provides such an approach, " he adds. + u f f a l o P hysici CHAMBERLAIN AND EL L E N G OLD BAU M ·D grant from the California-based W.M.Keck Foundation will move the University at Buffalo to the forefront in single-molecule research, an area of investigation so promising that the journal Science recently devoted an entire issue to it. The grant-funding the creation of a new W. M. Keck Foundation Center l for Computational Biology at the University at Buffalo-will allow a team of researchers in the School of Medicine and Biomedical Sciences to purchase high-speed computers that will greatly accelerate their study of the activity of ion channels. Ion channels are protein structures that regulate the flow of electrical currents in cells; when malfunctioning, they can lead to a wide spectrum of diseases. The UB researchers-Frederick Sachs, PhD, and Anthony l. Auerbach, PhD, professors of physiology and biophysics, and Feng Qin, PhD, research assistant professor of physiology and biophysics-have developed software programs that are revolutionizing the way scientists interpret ion-channel activity, which is so complex and timeconsuming that, until recently, many researchers simply gave up on it. With their "QUB" software, researchers around the world are able to discover in minutes how long it takes for an ion channel to change shape, which enables them to understand how it functions, or malfunctions. Previously, such calculations would have taken months. According to Sachs, it was Feng Qin-ot the time a graduate student and someone whom Sachs describes as "brilliant"-who developed the algorithms on which the software is based. "For 20 years, scientists have been collecting data on the random movements of molecules, but they didn't know how to interpret this information," says Auerbach. "Qin made several breakthroughs, and now the analysis is relatively easy." Scientists and software vendors have responded positively to the methods the UB team developed, and the instructional workshops that they hold are well attended. "Our programs are becoming the 'gold standard' for ion-channel research," says Auerbach. "The Keck grant is important to our future because it provides us with computing power that will allow us to push the limits of molecular dynamics," he adds. The Keck Foundation grant supports work that is part of an ongoing structuralbiology initiative at UB; it also builds on other recent corporate grants that are helping to make UB one of the top-1 0 supercomputing sites in the U.S. Founded in 1954 by the late W.M. Keck, founder of the Superior Oil Company, the W. M. Keck Foundation is one of the nation's largest philanthropic organizations. Its grants focus primarily on pioneering efforts in the areas of higher education, medical research, science and engineering. + PROGRAM PROJEa INVESTIGATORS, /eft to right, Sondra l. McFadden, PhD, Donald Henderson, PhD, Richard J. Salvi, PhD, ond Robert F. Burkard, PhD. B SUZANNE a n summer 1 9 9 9 ��···· · ··········· · ·· · ·· · ····· · ··· ·· · · · · ·· · ······· ············· · ···· · ····· · · · ········· · ··· · <· ~ ' ' ® Commencement for the School of Medicine and Biomedical Sciences at the State University of New York ot Buffalo wos held on Moy 8, 1999, ot the Center for the Arts on the North Campus. This year, the school conferred 144 MD degrees, 2 MD/PhD degrees, 35 PhD degrees and 52 master's degrees. Graduates induded students from the Graduate Division of Roswell Pork Cancer Institute. Pictured center, left to right: David Pawlowski, Daniel Perregoux, Stephen Przynosch ond Mary bsePuthiyomodom. Clockwise, from upper left: 1 faculty ond graduating PhOs Tiejon Wu, Or. Germaine Buck, Or. Arthur Michalek, Or. loon Dorn, Enrique Schistermon ond Jeanne Perla 2 Malcolm Heagle II 3 Honored Speaker Or. D. Bruce Johnstone 4 Or. Richard Sorkin, Brian Duffy and Or. Frank Schimpfhauser 5 Mary Rose Puthiyomodom ond family 6 Raquel Tonuzi. 6 u 111 m • r I 9 9 �Wiring Medicine for the Future LA S ARE uNDER VvAY at the University at Buffalo CONTINUING MEDICAL EDUCATION (CME) . CALENDARS OF LOCAL AND REGIONAL PROGRAMS AT UB AND THROUGHOUT WESTERN NEW YORK . CALENDARS OF NATIONAL AND INTERNATIONAL MEETINGS. CATALOGS OF PRODUCERS OF CME PROGRAMS. ONLINE INTERNET CME COURSES. to establish an online medical-information system to serve the educational, research, patient care and administrative needs of UB's dispersed multi-institutional health-care network. Funding in support of this futuristic planning has been provided to the university's Health Sciences Library through a two-year, $283,000 Integrated Advanced Information Management System (!AIMS) grant from the National Library of Medicine ( LM). Gary Byrd, director of the Health Sciences Library and the project's principal investigator, says the system will offer ready access to a virtual, knowledge-based library, as well as clinical-care, research and educational information resources. "The goal is to provide health-information resources that are organized and available across an electronic infrastructure that will enhance the processes by which health-care professionals teach and learn, conduct biomedical research, administer health organizations, provide patient care and offer consumer health information," he says. The Health Sciences Library will collaborate on the project with the Schools of Health Related Professions, ursing, Dental Medicine, Pharmacy, and Medicine and Biomedical Sciences, as well as with affiliated health-care organizations. For participating institutions and organizations, the project is expected to optimize and integrate information-technology goals and strategic priorities; help make effective use of shared expertise and technology; and offer an adaptable, sustainable, high-quality and cost-effective medical-information network with links to many sources of health-care data. The !AIMS grant will also provide programs and tools to help educate and train individuals to use easy-to-navigate, convenient and timely point-and-click workstations. Through these workstations, users will be able to access information independent of time constraints, physical location, organizational affiliation or workplace technology. The lAlMS program was initiated by the NLM, a division of the Nationallnstitutes of Health, in response to a report in the early 1980s by the Association of American Medical Colleges on the role oflibraries in information management. The report recommended that academic medical centers develop information networks to help integrated medical units communicate better. Co-principal investigators for the grant are Bruce Holm, PhD, associate dean for research and graduate studies in UB's School of Medicine and Biomedical Sciences, and Francis Meyer Jr., vice president for information systems and technology for Kaleida Health. + - 18 Buffalo P hysician P ATRICIA Summer D ONOVAN 1 9 9 9 �·········································· · ·········· ·· ···· · ······· · · · · · · · · · · · · · · · · · · ·· · ·. • g I Students Who Are aSTEP Ahead OUR BufFALO->\REA HIGH SCHOOL students participating in the Science and Technology Entry Program (STEP) at the University at Buffalo School of Medicine and Biomedical Sciences were awarded first place in the Natural Science Category I for a poster they presented at the STEP Statewide Student Conference held May 22-23, 1999, in Syracuse, New York. The poster, titled "Heart Health utrition: The Regulation of Homocysteine by Folic Acid, Vitamin B-6 and B-l2Intake," was prepared and presented by Latasha . Evans, a junior at Holy Angels Academy; Lynette A. Gholston, a sophomore at Villa Maria Academy; Nichole M. Gonzales, a sophomore at iagara Wheatfield Senior High School; and Aprile Hollinsworth, a sophomore at Buffalo Traditional School #192. The group received $250 for the first place finish and each member was presented a certificate. The purpose of the STEP Program is to assist underrepresented minority or economically disadvantaged secondary school students in acquiring the prerequisite skills necessary to pursue pre-professional or professional educational programs in scientific, technical or health-related fields, according to Carolyn Hamilton, EdD, assistant dean for Minority Affairs at UB. STEP is open to qualified students in grades 9 through 12. Those who earn entrance to the program complete a two-week orientation, after which they begin the Summer Component, which places them in a university-affiliated hospital where they gain exposure to science and health care through work experience. "This experience is enriched by field trips to the UB South Campus, where the students visit the Neuroanatomy Museum, learn how to conduct research on the Internet in the B u f f a l o I students to the statewide conference, says the four young women researched their winning poster presentation on the Internet and at the Health Sciences Library, as well as contacted a lentil producer in Idaho to obtain dietary information, food samples and recipes. In addition, Murray Ettinger, PhD, Distinguished Teaching Professor of Biochemistry, assisted the students in illustrating a molecular model of homocysteine; and Raymond Dannenhoffer, PhD, in the Department of Anatomy and Cell Biology, provided the students with two heart models. Dennis Nadler, MD, associate dean for Undergraduate Medical Education, andj ohn R. Wright, dean of UB's School of Medicine and Biomedical Sciences, also provided support for the students. "The judges reviewing the posters interviewed the students about their research and each was able to answer a number of questions in a very knowledgeable way," says Coplin. "They were Health Sciences Library, participate in sessions in the Gross Anatomy Laboratory and assist and observe medical students who are examining standardized patients," says Monyuette Y. Coplin, STEP program coordinator in the Office of Minority Affairs. "Many of the students also attend UB's Mini-Med School and Mini-Vet School," she adds. During the academic year, the students attend Saturday classes in biophysics, biochemistry, applied math and computer science that are taught by first- and second-year medical students. "The medical students are good role models and will often informally share information Left to right: Aprile Hollinsworth, lynette Gholston, Nichole Gonzales, latasha Evans with the STEP stu- and Mrs. Monyuette Y. Coplin, STEP's program coordinator at the University at Buffalo. dents about how best to prepare for careers in health care or poised throughout the competition science," says Hamilton. and we are all very proud of their In addition to the hospital experi- accomplishment." + ence, academic instruction and laboratory exercises, students can avail STEP and its activities are supported by a themselves of a Tutorial Program if they grant from the New York State Education are experiencing difficulty with school- Department. For more information on the prorelated subjects. Also, to ensure they gram at UB, contact Monyuette Y. Coplin in have the best possible chance of meeting the Medical STEP Office at (716) 829-2802; their career goals, the students receive or e-mail her at myc@acsu.buffalo.edu. vocational and career counseling. - 5. A. UNGER Coplin, who accompanied the Physician Summer �• ··· · ······· · ··· · ······ ···· · ······· ····· · ······ · ······ ·· · ·· ····· · · · ········· · ·· · ········· ~ I Renee Abderhalden· Friend Internal Medicine, SU Y/Buffalo Graduate Medical-Dental Educauon Consortium BUFFALO, NY Match Day 1999 Bettina Ackermann Pediatrics, Eastern Virginia Stephanie Babcock Pediatrics, Cleveland Clinic CLEVELAto;D, 0 H Lisa Balduf Surgery, Universtty of New Mexico School of Medicine ALBUQUERQUE, M Medtcal School Fayyaz Barodawala Medicine (Prelim), SU Y/Buffalo ORFOLK, VA Daniel Alexander Orthopaedics, Henry Ford Health Science Center Detroit, Ml Graduate Medical-Dental Education Consortium, Buffalo, NY; Diagnostic Radiology, Dartmouth-Hitchcock LEBANON, N H Martha Aliwalas Family Practice, University of Pittsburgh Medical Center, St. Margaret Todd Battaglia Orthopaedics, University of Virginia PITTSBURGH, PA Michael Ament Medicine (Prelim), Renee Baughman Obstetrics/Gynecology, SUNY/Buffalo Graduate Medical-Dental Education Consortium Untversity of Colorado; BUFFALO, CHARLOTTESVILLE, vA Y Neurology, University of Colorado DENVER, CO Lynn-Marie Aronica Obstetrics/Gynecology, SU Y/Buffalo Graduate Medtcai-Dental Education Consortium BIJFFALO, NY Kurt Benham Ophthalmology, SUNY/Buffalo Graduate Medical-Dental EducatiOn Consortium BUFFALO, Y Florence Bero Family Practice, University of Vermont/Fletcher Allen BURLINGTON, VT jorge Arzola Marrero Surgery (Prelim), SU Y/Buffalo Graduate Medical-Dental Education Consortium BuFFALO, Y Jason Borton Emergency Medicine, SU Y/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Tahsina Atiquzzaman Family Practice, Stony Brook Teaching Hospital STONY BROOK, NY ® B u a Y �Amy Breden berg Family Practice, john Peter Smith Hospital FORT WORTH, TX Thomas Cimato Internal Medicine, Hospital of the University of Pennsylvania PHILADELPHIA, PA William Breen Ill Family Practice, Eastern Maine Med1cal Center BANGOR, ME Thomas Cumbo Internal Medicine, johns Hopkins University/Sinai Hospital of Baltimore BALTIMORE, MD Ann De Nardin Family Practice, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Molly Susan Esposito take to the air waves with their news. Andrea deRosas Medicine (Primary), SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Susan Esposito Emergency Medicine, johns Hopkins Hospital BALTIMORE, MD Deidre Brown Family Practice, SUNY/Buffalo Graduate, Medical-Dental Education Consortium BUFFALO, NY joyce Cummings Pediatrics, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y Andre Dick Surgery, Penn State Geisinger HERSHEY, PA Brian Cambi Internal Medicine, Yale-New Haven Hospital EW HAVEN, CT Patrick D' Abbracci Internal Medicine, University of Southern California Los ANGELES, CA Melissa Dilanni Internal Medicine, Brown University PROVIDENCE, Rl Christopher Carlson Internal Medicine, University of Michigan Hospitals ANN ARBOR, M! Chantell Dalpe Obstetrics/Gynecology, State University of ew York Health Center SYRACUSE, y Michael Docherty Internal Medicine, University of Cahforn1a, San Diego Medical Center SAN DIEGO, CA Andrew Fagelman Urology, Maimonides Med1cal Center BROOKLYN, Y John Carter Emergency Medicine, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y Patricia Danaher Family Practice, Washington Hospital WASHI"'GTON, PA Brian Duffy Surgery, Eastern Virginia Medical School ORFOLK, VA Tanya Falkowski Pediatrics, University Maryland Medical Center BALTIMORE, MD Christopher Deakin Psychwtry, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, y David Dugan Surgery (Prelim), SU Y/Buffalo Graduate Med1cai-Dental Education Consortium BUFFALO, Y Barbara Fare Medicine/Pediatrics, Orlando Reg10nal Med1cal Center ORLANDO, FL Barbara DeGuiseppe Psychiatry, SUNY/Buffalo Graduate Medical-Dental EducatiOn Consortium BUFFALO, NY Nadine Duhan Surgery, Rush-PresbyterianSt. Lukes CHICAGO, IL Albert Chu Pathology, Hospital of the University of Pennsylvania PHILADELPHIA, PA Lynn Dunham Pediatrics, SU Y/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y jessica Edwards-Reich Obstetrics/Gynecology, Long Island jewish Hospital NEW HYDE PARK, NY Philip Ehrlich Medicine (Prelim), Alton Ochsner Medical Foundation, New Orleans, LA; Ophthalmology, Louisiana State University Eye Center EW ORLEANS, LA Douglas Evans Surgery (Prelim), SU Y/Buffalo Graduate Medical-Dental Educauon Consortium, BUfFALO, Y; Orthopaedic Surgery, SUNY/ BuFFALO Graduate Medical-Dental Education Consortium BuFFALO, NY Craig Feinberg Internal Medicine, George Washington University wASHINGTON, DC Victor Fila dora II Medicine (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium BuFFALO, NY; Anesthesiology, Brigham & Women's Hospital BOSTON, MA Oren Fix Internal Medicine, Boston University Medical Center BOSTON, MA James Flaherty Internal Medicine, McGaw Medical Center-NW C!liCAGO, !L John Fojtik Emergency Medicine, MCP Hahnemann University PHILADELPHIA, PA Corey Harrison, center, looks to the future. 9 9 �• ·········· · ········ · · · ···· ·· ·· · ······· ·· ~ I Karen Foti Pediatrics, Tulane University School of Medicine, ew Orleans, LA Timothy Fox Emergency Medicine, Maine Medical Center, PORTLAND, ME Medicine (Prelim), University of Utah Affiliated Hospitals SALT LAKE CITY, UT; Radiation Oncology, University of Utah Affiliated Hospitals SALT LAKE Cny, UT Malcolm Heagle II Pediatrics, University of South FLORIDA, TAMPA, FL Elizabeth Francis Medicine (Prelim), Mary Imogene Bassett Hospital, Cooperstown, Y; Dermatology, Penn State Geisinger DANVILLE, PA Brandy Helminiak Emergency Medicine, Ohio State Umverslty Medical Center COLUMBUS, OH Natasha Frangopoulos Surgery (Prelim), Mt. Sinai Hospital, New York, NY; Otolaryngology, Mt. Sinai Hospital EW YORK, NY John Henry Medicine (Prelim), University of Rochester/Strong Memorial Hospital ROCHESTER, NY; Neurology, University of Rochester/ Strong Memorial Hospital ROCHESTER, NY Eric Fung Surgery (Prelim), State Umverslty of ew York Health Center, SYRACUSE, Y; Otolaryngology, State Umversity of New York Health Center SYRACUSE, Y Renee Hernandez Internal Med1cine, Einstein!Montefiore BRONX, NY Karen Gerber·Vecsey Pediatrics, SUNY/Buffalo Graduate Medical-Dental Education Consortium BurrALO, NY jennifer Griffith Surgery, University of Rochester/ Strong Memonal Hospital ROCHESTER, NY Molly Harrington Pediatrics, Maine Med1cal Center PORTLAND, ME Corey Harrison Emergency Medicine, University of Massachusetts WORCESTER, MA Lisa Hazard Maria loTempio Otolaryngology, University of California Los Angeles Medical Center Los ANGELES, CA Stefan lucas Anesthesiology, University of Rochester/Strong Memonal Hospital ROCHESTER, Y Kristine Klein Obstetrics/Gynecology, Albany Medical Center Hospital ALBA~Y. Patricia Lugar Internal Medicine, McGaw Medical Center-Northwest CHICAGO, IL y Mitchell Kolker Surgery (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y; Otolaryngology, SU Y!Buffalo Graduate Medical-Dental Education Consortium, BUFFALO, Y Kelly Holes Family Practice, SUNY/Buffalo Graduate Medical- Dental Education Consortium BUFFALO, NY Brett Mascia Pathology, University of Virginia CHARLOTTESVILLE, v A lucy Mastrandrea Pediatrics, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Margaret lafferty Pediatrics, SUNY/Buffalo Graduate Medical-Dental Educauon Consortium BUFFALO, y Teague Horton Pediatrics, University of Virgima CHARLOTTESVILLE, VA Shannon Howe Pediatrics, SU Y!Buffalo Graduate Medical-Dental Education Consortium BuFFALO, NY Timothy McGrath Surgery (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y; Orthopaedic Surgery, SUNY/Buffalo Graduate Med1cal-Dental Education Consortium BUFFALO, NY Henry lee Medicine (Prelim), McGaw Medical Center-Northwest CHICAGO, IL; Ophthalmology, Wills Eye Hospital, Thomas jefferson University PHILADELPHIA, PA Wayne Hwang Medicine (Prelim), SU Y!Buffalo Graduate Medical-Dental Education Consortium, BUFFALO, N Y; Diagnostic Radiology, Allegheny General Hospital PITTSBURGH, PA Amy jones Internal Medicine, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y a Michael Lipke Surgery (Prelim), New York University Medical Center NEW YORK, NY Won Hee Kim Medicine/Pediatrics, Stony Brook Teaching Hospital $TONY BROOK, NY Keith Herr Psychiatry, Emory University School of Medicine ATLANTA, GA B Ellyn Sellers share in the excitmenl. Edward Kim Internal Medicine, SUNY/Buffalo Graduate Medical-Dental Education Consortium BuFFALO, Y Haruka ltakura Internal Medicme, Hospital of the University of Pennsylvania PHILADELPHIA, PA Group hug said it all this day for Keith Herr, lisa Thebner and lisa Balduf. Left to right: Sandra lee, Edward Kim and Sanjiv Kayastha Plastic Surgery, Spectrum HealthDowntown GRAND RAPIDS, Ml 0 Karen lee Pediatrics, University of Massachusetts WORCESTER, MA Carri·Ann Megargel Internal Medicine, SU Y!Buffalo Graduate Medical- Dental Educauon Consortium BUFFALO, NY Sandra lee Psychiatry, YP Hospital-Cornell NEw YoRK, NY Michael Melman Research Tingting Li Internal Medicine, Barnes-jeWISh Hospital ST LOUIS, MO Daniele Merlis Pediatrics, Albert Einstein College of Medicine, jacobi Medical Center BRONX, NY Michael Lioudis Graduate School MBA, Umversity of orth Carolina CHAPEL HILL, C Susan Miller Pediatrics, SU Y!Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY p y s a 5 m m e 9 9 �··· · ···· · ····· ·· · ·· ············· · ··················· · ············ • · ·. ~ I Charles Roche Medicine (Prelim), SUNY/Buffalo Graduate Medical-Dental Educauon Consortium BUFFALO, NY; Diagnostic Radiology, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Charlie Pan Medicine (Prelim), St. joseph Mercy Hospital ANN ARBOR, Ml; Radiation Oncology, University of Michigan Hospitals ANN ARBOR, Ml Kathryn Montgomery Pediatrics, University of Connecticut FARMINGTON, CT Natesh Parashurama Surgery (Prelim), Boston Universtty BosTON, MA Amy Morrow Pediatrics, University of Michigan Hospitals ANN ARBOR, Ml Parag Parikh Surgery (Prelim), University of California, Irvine Medical Center, IRVINE, CA; Otolaryngology, University of California, Irvine Medical Center IRVI NE, CA Khader Muqtadir Medicine (Prelim), Evanston NW Health Care EVANSTON, IL; Diagnostic Radiology, Cleveland Clinic CLEVELA~D. OH Zulma Rosado Family Practice, Jamaica Hospital Medical Center jAMAI CA, NY Ari Rubenfeld Surgery (Preitm), Georgetown University, WASHINGTON, DC; Otolaryngology, Georgetown University WA SHI GTON, DC Rupal Patel Transitional, Crozer-Chester Medical, SPRINGFIELD, PA ; Ophthalmology, SU Y/Buffalo Graduate MedicalDental Education Consortium BUFFALO, NY Elena Napolitano Medicine (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, Y; Physical Medicine and Rehabiiitation,UMDNJ EWARK, j Frank Salamone Otolaryngology, Umverstty of Cincinnati CINCINNATI, OH Ahlam Saleh Family Practice, University of Massachusetts Medical Center Health Alliance Hospital-Leominster FITCHBURG, MA David Pawlowski Family Practice, Duke University Medical Center DURHAM, NC Daniel Perregaux Emergency Medicine, Mancopa Medical Center PHOENIX, AZ Heidi Narins Emergency Medicine, SUNY/Buffalo Graduate Medical-Dental Educauon Consortium BUFFALO, Y Anthony Santilli Internal Medicine, Brown University PROVIDENCE, Rl Marsilia Seiwell Obstetrics/Gynecology, SUNY/Buffalo Graduate Medtcai-Dental Education Consortium BuFFALO, NY Stephen Przynosch Family Practice, Toledo Hospital TOLEDO, OH Jeffrey Nechleba Orthopaedics, Hamot Medical Center ERIE, PA Mary Rose Puthiyamadam Medicine/Pediatrics, Penn State Geisinger HERSHEY, PA Bretton Newman Family Practice, Columbta St. Marks SALT LAKE CnY, UT Ellyn Sellers Famtiy Practice, Catilion Health Systems ROANOKE, VA Crystal Nicholson -Springer Pediatrics, Nassau County Medical Center EAST MEADOW, NY Michael Rauh Surgery, SUNY/Buffalo Graduate Medical-Dental Educauon Consortium BUFFALO, Y Daniel Nosek Family Practice, Palmetto Richland Memorial Hospital CoLuMBIA, SC James Reuther Psychiatry, University of Texas Medical School HousToN, TX Joy Nwachukwu internal Medicine, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Kevin Robillard Internal Medicine, University of Rochester/Strong Memorial Hospital ROCHESTER, Y Sonia Shah Internal Medicine, Medical College of Vtrgmia Richmond , VA Shams Sheikh Medicine (Prelim), University of Rochester/Strong Memorial Hospital, Roc HESTER, Y; Diagnostic Radiology, Yale-New Haven Hospttal NEW HAVEN, CT Gregory Shipkey Emergency Medicine, Darnal Army Community Hospital FoRT HooD, TX Michael O' Brien Internal Medicine, Brown University PROVIDENCE, Rl Natalie Sikka Pediatrics, Baylor College Medical HousTON, TX Thomas O'Donnell Otolaryngology, Penn State Geisinger DANVILLE, PA B a 0 p h y c a n 5 m m e 9 9 9 I Jenny Speranza Surgery, Stony Brook Teachers Hosptta! STONY BROOK, y Brian Stout Pediatrics, Umversity Hospttals CLEVELAND, OH Michael Stratemeier Emergency Medicine, orth Shore Umverstty MANHASSETT, NY Ivan larkin Surgery (Prelim), Monmouth Medical Center LONG BRA NCH, j lisa Thebner Pediatrics, Emstein!Montefiore BRONX, NY Eric Thierman Medicine/Pediatrics, SU Y/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Katherine Timoszyk Medicine (Prelim), Georgetown University Hospital, WASH I GTON, DC; Neurology, Duke University DuRHAM , NC Racquet Tonuzi Medictne!Pediatrics, SUNY/Buffalo Graduate Medtcai-Dental Educauon Consortium BUFFALO, NY Sylvia Tufano Obstetrics/Gynecology, Untversity of Connecticut FARMINGTON, CT Jayadeep Varanasi Internal Medicine, University of orth Carohna Hospital CHAPEL Ht LL, NC Leonard Vaughan Surgery (Prelim), SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY Amy Weinstein Internal Medicine, McGaw Medical Center-Northwest CHICAGO, IL Ryan White Urology, Albany Medical Center Hospttal ALBANY, NY Judi Wolf Pedtatncs, SUNY/Buffalo Graduate Medical-Dental Education Consortium BUFFALO, NY �Mission Improbable SUZANNA GOODYEAR , 'Z" \ '90, ENTERED US' S MEDICAL SCHOOL AT AGE 54 GooDYfi\R \V\S BOR"< atatimewhenprofessionalcareeroptionsforwomenwerefew and generally considered little more than stopgaps until marriage and children came along. Small wonder, then, that she nearly missed out on fulfilling her girlhood dream of becoming a physician and caring for the poor and needy "It's something that's been in my blood all my life," she says. "My uncle was the medical director of a Quaker mission in Kenya in the 1930s, and it was something I knew I wanted to do. But I didn't know how to get there and I didn't know who to ask." From the age of 14 through her teens, of a pharmaceutical company. A couple Goodyear held tightly to her goal. lt of years later, after taking a position in wasn't until her college years that her the Biochemistry Department at Albany dreambegantofade.Shehadstartedout Medical College in Albany, ew York, as a chemistry major and pre- r - - - - - - - - . she again thought briefly 8 v med student at Earlham about applying for medical 8 E T 5 v College in Richmond , school. But self-doubt won 5 A w v E R out, and she allowed her Indiana, but there were no dream to return to dormancy. strong female role models after whom she could pattern her As the years passed, she immersed career. It was the 1950s, and women herself in her chemistry pursuits. While physicians-especially women in on staff at the New York State Departprivate practice-were not common. ment of Health in Albany, she was honWhile at Earlham , she had an ored in the 1966 edition of Outstanding opportunity to work with a few women Young Women ofAmerica for her work in physicians in the wards of a psychiatric measuring radioactive fallout. Nine years hospital. However, instead of spurring later, she became one of the department's her on, the experience only served to senior radiologic chemists. discourage her. As rewarding as Goodyear's career 'These women were my mother's appeared, deep down she still wasn't generation, and I was not impressed. satisfied . Despite her success-and They were subordinate to the men . imperceptibly to everyone, including Where the men were surgeons, the herself-the seeds of her dream had women took care of coughs and colds. continued to send forth roots. Doubts As I look back today, I admire them, but about the career path she'd chosen l didn't then. l was 21 and l didn't see increased in the 1970s as she met and them as pioneers," she says. began socializing with several women "l think if l'd had a mentor , l might physicians. Unlike those she'd known have gone on. But there was no one to in college, these women were enjoying show me the way, sol gave up. " successful medical careers. After completing a master of science Around that time, circumstances at degree in biochemistry in 1957, she work began to shift, as well. There were went to work in the research laboratory cutbacks and frustrations at the lab, B u f f a l o Physic including increasing problems with the computers . Annoyed with the programmers' inability to correct the problems, Goodyear took a 10-week math application course and began to do some programming on her own. "I also took a course in statistics because the department was reducing staff and l realized these were good skills to have," she says. "But l didn't enjoy it that much , and l knew l didn't want to do it for the rest of my life. l'd work on the computers for an hour or so a day and then head back up to the lab to do something else. That's when l finally sat down and asked myself, 'What would l do ifl could do anything in the world?"' The answer hit her square in the heart: lt was 1983, Goodyear was 52, and she knew she still wanted to be a doctor. "l sat down and cried," she says. Then she set out to change her life. BAcK To ScHooL AT 54 t first, Goodyear was secretive about her decision to apply to medical school. "lt was very difficult to find anybody l felt l could confide in. l didn't need the entire health department lab putting me down. So l'd sneak into the library to get information on medical school and costs. " A i an Summer l 9 9 9 �Today Suzanna Goodyear, MD '90, works for Health Access, a free clinic in rural Clarksburg, West Virginia, where she serves indigent and low-income patients_ One of her surreptitious factgathering efforts netted the study guide for the Medical College Admission Test (MCAT). At the back ofthe booklet she found the information she needed on the application process. "I saw that I needed to do some review work to prepare," she says. "After all, I'd been out of school for more than 30 years. So I started taking courses at Russell Sage College in Troy, New York, and reading textbooks on my own during my lunch hour. " Continuing to work full-time in the B u f f a l a lab, Goodyear spent the next two years studying genetics, organic chemistry, biology and physics. To broaden her experience, she also worked as a volunteer with geriatric patients. She passed the Red Cross Water Safety course and taught swimming lessons. Next, she completed coursesinFirstAidandcardiopulmonary resuscitation and joined an emergency ambulance crew. After being on call every Friday and Saturday night for two years, she completed tests to become a licensed emergency medical technician. The preparation paid off and, at Physician Summer 1 9 9 9 age 54, she passed the MCAT. But scoring well on the test was just one hurdle on the way to gaining acceptance to medical school. She then had to convince an admissions commiHee that she was a good investment, despite being older than most other applicants. "Once I knew what I wanted, assuring other people that I could do it became my greatest barrier to medical school," she says. While interviewing at UB's School of Medicine and Biomedical Sciences, she readilyconcededthatshewasolderthan �the typical student and then pointed out the advantages. "I told them, 'Statistically I may have less time, but you don't really know that about anyone. The average age for a doctor to commit suicide is 45, and I'm past that. I have no children, and I'm past that. I have many years to devote to medicine."' Thomas Guttuso, MD, director of admissions at UB's School of Medicine and Biomedical Sciences, says that although the school does not have an official age policy, Goodyear's application "did raise eyebrows." "In the case of an older student, concerns arise about the appropriateness of spending the money it takes to educate a medical student versus what society will get back," he says. "However, we judged Goodyear's application like everyone else's, on the suitability of her qualifications. " Recalling his interview with her, Guttuso says, "She was very energetic and we felt she would give back to society what she gained from a medical education. And her career certainly bears this out." In April 1986, Goodyear received notice of her acceptance by UB. Her next step was to retire from her job, which, at the time, involved monitoring airborne radioactivity from the Chernobyl disaster. She was ready to become a full-time medical student. AGE G~P A ge has its advantages, Goodyear realized, as she discovered that she was better off financially than many of her fellow students. ''I'd had a good job with the State of New York, and I was eligible for early retirement at half my state salary. I didn't have to scrimp, like so many of my classmates did. Also , I had never married and had no children and my parents had died a few years earlier, so I didn't have family responsibilities. I was entirely free to go my own way." On the other hand, after 30 years in services. In her third year of residency at the professional world, Goodyear had the local hospital, she worked at the developed certain expectations of her clinic several evenings a week. peers. "It irked me when classes started "One night when I was finished with late because people couldn't get up in my shift, I was talking to one of the the morning and be there on time. I felt founding physicians. My excitement the same way as an intern and resident. about the program must have shown I expected things to start on time and for through, because they found the money people to pull their own load. I may to pay me as a full-time staff member. have been slower, but I worked hard so I started in August 1993, following people wouldn't have to do my work." graduation and completion of my Goodyear's social life was affected by family practice boards in july." Today, Goodyear continues at Health the age gap, as well. "My interests were different, and I didn't know how to Access, which is one of about a dozen socialize with my peers," she says. "I free clinics in the state. Supported by attended the Methodist church near cam- state and community funding, the clinic pus. It was an older congregation in what serves patients who meet federal stanhad been a working-class neighborhood. dards for poverty, have no insurance, are not eligible for Medicaid and have no That's where I got my best support." Another problem, Goodyear says, was other source of assistance. West Virginia her inability to stay awake between limits Medicaid to pregnant women, 1 and 3 p.m. "I could study all morning disabled persons and children under age and all evening, but not in the after- 18, leaving a large population of patients noon," she says. "When I went back to eligible for the clinic's assistance. "One of the reasons we use such school, I had no trouble with nightschool work. But afternoon lectures were strict guidelines is so we can access indigent patient programs," she says. dreadful. They still are!" "At this level, the hospital provides 100percent assistance to our patients, and MISSIO'\ TO THE NfED) uring her senior year in medical many major drug companies offer school, Goodyear had an opportu- special pharmacy assistance programs." Health Access provides primary care, nity to experience the mission field. She spent eight weeks at the Presby- as well as referrals to specialties, through terian Mission Hospital in Kikuyu, the volunteer service of medical staff in Kenya. It was rewarding, but enough of the community. All of Clarksburg's phya culture shock to prompt her to seek sicians are on the local hospital staff, charitable opportunities closer to home. and about 90 percent of them donate After her return to the States, she time to the clinic. Additionally, a pharfocused on serving impoverished maceutical company in the area donates many of the products the clinic needs. patients in rural America. For Goodyear, "working part-time "I was fascinated by an article written by a doctor who'd set up a clinic in for the pittance that a charitable healthAppalachia, and I wanted to do some- care organization can pay" represents thing similar. That's why I came to the apex of her career and fulfillment of Clarksburg, West Virginia, for my a lifelong dream. residency," she says. "Caring for people who really need it When a new community clinic for is the most rewarding thing I've ever indigent and low-income patients done," she says. "And to think I almost opened in Clarksburg in October 1992, missed it. Sometimes the highly Goodyear was quick to volunteer her improbable is possible, after all." + D B u f f a l o Physician Summer 1 9 9 9 �B y L 0 I S 8 A K E R Empowerment · and WomenS Health EQUAL OPPORTUNITY FOR A LONG, FULFILLING LIFE Betty Friedan, the first president of the National Organization for Women and the nation's best-known feminist, presented an informal talk on the impact of women's empowerment on their physical and mental health on May 1, 1999, during the 62nd Spring Clinical Day sponsored by the UB Medical Alumni Association, held in the Buffalo-Niagara Marriott in Amherst, New York. clearly brought about this Friedan was the first change, Friedan noted, woman to present the Stockpointing out that this ton Kimball lecture and to change has an important receive the association's impact on women's health, Stockton Kimball Award. as well as on their econoWomen's health was the mic status. theme of this year's Spring She referred to an early Clinical Day, which featured study that found that several presentations on women's mental health breast and ovarian cancer. peaked when they were in Accustomed to speaking their 20s and dropped before gatherings attended dramatically after age 40, almost exclusively by compared to men. "It was women, Friedan opened her thought normal for remarks by joking about the women to go into depresnumber of men in the audision in menopause," ence, a legacy of a profesFriedan said. sion that for many years was Author and feminist Betty Friedon. "It even had a classifialmost exclusively male. She cation: involutional melancholia." contrasted that historical state of affairs with When women were defined only by their the current situation, in which enrollments in feminine role, not as individuals in their own many medical schools are half women. In fact, right, life was over after 40, she noted. "The the class entering the UB School of Medicine love story was the only one that women could and Biomedical Sciences this fall will have a be a hero of. But now, women's mental health majority of women for the first time in the after menopause is better, maybe better even school's 153-year history. than it was in their 20s, 30s and 40s. " The empowerment of women through the women's movement of the 1960s and '70s Buffalo Phys CONT I NUED ON i cian Summer PAGE 1 9 28 9 9 �As women en tered the professions in large num bers, the con cept of the working woman took on a negative tone, Friedan observed. "The hype was 'Women have to have it all,"' she said. "But nobody ever says anything about men having it alL For 30 years people h ave been trying to prove that women's employment is bad for children and they couldn' t do it. Now the newest study sh ows that employment is good for children . .. . Big news! " "Of course women are happier when they aren't living exclusively through their children and they aren't seething with frustrated rage," Friedan said. "There is also less stress and pressure on the man when he isn't solely responsible for providing for the family. That has to be good for children." Friedan said that, while empowerment has had a positive effect on women, th ey historically have lived longer than men, and she suggested this discrepancy as a fertile area for study. "Something about the male role must be a killer. There should be research into the things about women's roles that are good for life," she said, going on to state what she thinks some of those might be. "We carry with us a biological grou nding in a sensitivity to life," Friedan said . "It is part of the socialization of women. We don' t have to suppress our tears and fears. " She offered three characteristics that women who are vital into their 90s have in common: the ability to deal with change, th e ability to deal with loss and the willingness to take risks. Medical Alumni Lifetime Achievement Awards his year's recipients of the School of Medicine and Biomedical Sciences' lifetime Medical Alumni Achievement Awards are as follow: • Elizabeth Olmsted Ross, MD '39, clinical assistant professor of ophthalmology at UBwho has been in private practice in Buffalo since 1944. (See profile on page 39.} then went on to complete fellowships in gastrointestinal physiology at the university's Cardiovascular Research Institute and at the Veterans Administration HospitaL Throughout his career, Way has been recognized for his excellence in teaching and has received numerous commendations and citations for his contributions in this area. From 1991-1992, he was president of the Son Francisco Surgical Society and from 1995-1997, served as chair of the board of trustees lor the Society lor Surgery of the Alimentary Tract. Currently, he is a consultant to the Gastroenterology and Urology Devices Advisory Panel for the FDA. • James E. Youker, MD '54, professor and chair of the Department • Stephen C. Scheiber, MD '64, of Radiology at the Medical College of is professor of psychiatry at NorthwestWisconsin. In recognition of the excelern University and executive vice presilence Youker has brought to his departdent lor the American Board of Psychiament-especially in the areas of patry and Neurology, a position he has tient care and research-he was given held lor 10 years. "However, to all of the Distinguished Service Award by the us-more than anyone else inthe United Medical College of Wisconsin in 1989.1n States-he is someone who is seen as 1997, he was a recipient of a Gold the standard bearer for American psyMedal of the Association of University chiatry and neurology," said Susan Radiologists. Youker has served as a Mcleer, chair of UB's Department of member of the Board of Chancellors Psychiatry, who introduced Scheiber. She and as vice president lor the American added that Scheiber has built a national College of Radiology. He has also served reputation as an educator and scholar STEPHEN c. SCHEIBER, MD on the board of trustees for the Radioconcerned with the health of physicians logical Society of North America. Currently, he is a and the educational process in psychiatry. "But, most member of the executive committee of the American importantly," she said, "Steve has worked tirelessly Board of Medical Specialties and is president-elect of to ensure that residents in psychiatry and neurology the ABMS. access quality training" and noted that his work with • Lawrence W. Way, MD '59, vice chair ofthe the American Boord helps to assure that patients have Department of Surgery at the University of California access to well-trained and skilled professionals." at San Francisco and director of UCSF's Videoscopic Scheiber has served on the editorial boards of numerCenter in the Department of Surgery. Anative of St. ous peer-reviewed journals, has been a reviewer lor Louis, Missouri, Way attended Cornell University be- NIMH grants and has been honored as a visiting guest lore earning his medical degree at UB. He completed professor at over 50 medical schools throughout the his internship and residency training at UCSF, where he nation. New Alumni Association Otficers Elected B u f JOHN f a l o P J . hys BODKIN, i cian II , MD , Summer 1 9 9 9 �Clinical] Madeline and Frederick Szymanski, Closs of 1939, enjoying 60-yeor reunion festivities. Elizabeth Olmsted Ross and John H. Remington, celebrating 60-yeor reunion. Elizabeth Moher, Closs of 1983, with Betty Friedon, this year's recipient of the Stockton Kimball Award. Robert Harvey, Closs of 1950, leh, accepting this year's attendance trophy, which was presented by Richard Collins, Closs of 1983, incoming president of the Medical Alumni Association. Cathy and John Montroy, Closs of 1938, relaxing at dinner. B u f f a l o Ph ysici an Summe r 1 9 9 9 �first row: Frederick]. Szymanski; second row, left to right: Anthony V. Postoloff, Frank T. Riforgiato, john F. Montroy, john). Squadrito, john H. Remington, Elizabeth Pierce Olmsted Ross, Roy E. Seibel, Sr. first row, left to right: jacqueline Paroski, judith Weinstein, julia Cullen; second row, left to right: john Egan, George Erickson, john Sharp, Robert Harvey, Frank Pfalzer, Bradley Aust, Robert Smith, Robert Sanford, Charles Bathrick, Lawrence Carden, Henry Thiede, Irving Lang, Philip Dennen, Richard Schwartz, Paul Buerger, Max Schneider, Pierce Weinstein. first row, left to right: John Kutrybala, Clay Burchell, Sylvia Griva Lizlovs, Allen Lesswing, Donald Wilson; second row, left to right: William Howard, james Youker, Robert Miller, john Conboy, Robert Pletman, Louis Cloutier, Donald Murray, Malcolm Leslie, Robert Oshrin, Edward Wenzlaff, Edward Rayhill, Edward Bockstahler, Richard Mayer, Nicholas Carosella, jack Lemann. ® B u f f a l a Physician Summer 1 9 9 9 �CLASS REUNIONS First row, left to right: Max Doubrava, john McMahon, Daniel Kozera, joseph Monte, David Denzel, Donn Yacht, Sandra Wiltse, William Mangan, George Baeumler, Constantine Cretekos, Charles Anderson, Eli Isaacs. First row, left to right: William Fleming, Frederick Painton, Leo Michalek, Walter Hoffman, Irving Sterman, Elizabeth Serrage, Stephen Scheiber, David Weinstein, james Tibbetts, David Ziegler. First row, left to right: Penny Gardner, Thomas Scanlon, Moira Burke, Mona Milstein, Evelyn Roisman, David Arkin, Hachiro Nakamura, Daniel Levin, Dorothea Downey, Madeline White; second row, left to right: Timothy Harrington, David Schreiber, Michael Pisick, Hanley Horwitz, William Major, Marion Wind, Robert Hartog, james White, james Cavalieri, Gerald Stinziano, David Sherer. B f f a l a p h y s c a 5 m m e 9 9 ® �• · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ··········································· first row, left to right: Anna G. Engel, Sandford Pleskow, Leslie Ford, Thomas Chmielewski, Gordon Avery, Daniel Morelli; second row, left to right: Louise Stomierowski, Bruce Thiers, Daniel Lasser, Hing-Har Lo, Diane Matuszak, Virginia Sybert, Thomas Varecka; third row, left to right: Bruce Middendorf, Richard Buckley, Alan Burstein, john Manzella, jocular Ford, Lawrence Oufiero, james Smith; fourth row, left to right: Paul Wierzbieniec, Roy Seibel, james Pietraszek, Richard Hershcopf, james Budny. First row, left to right: Bruce aughton, Robin Adair, Walter Balon; second row, left to right: Frederick Eames, Richard Irene, Arthur Rosiello, joseph Buran; third row, left to right: john Crofts, john Canty, Peter Shields, Frank Schreck, Charles Francemone; fourth row, left to right: Donald Armenia, Lawrence Sinatra. first row: Thomas Mahl, Karen KimbreliNauschuetz, Kevin Rosteing, Amy Rosteing, Laura Booth Chan, Raymond Chan; second row: Richard Gergelis, Mark Billinson, john Dyster, julie Dessloch, Andrew Knoll, Robert Rattner, Michael McMullen, Herbert Newton. ® B u f f a I o Physician Summer 1 9 9 9 �CLASS REUNIONS First row, left to right: Michael Rosenband, Barbara Bambach Skomra, jeanette Smith, joan MurrayIsaacson, Carol DeCosta, Richard Ruh; second row, left to right: Sharon Zeigler, Amy jeffery, Carolyn Dukarm, Christopher Hamill, Andrea Messina, Christopher Skomra, Lee Guterman, Pamela Reed, Mary Schamann, Paola Seidel, Richard Ferguson, jonathan Bean, David Blaustein, Dawn Gais; third row, left to right: Eric Southard, Paul Lecat, Mark Pundt, Christopher Bartolone, Geoffrey Seidel, Raul Vazquez. 300MHz Pentium II· Processor • 64MB 10 NS SDRAM • 6.0 GB Ultra IDE Hard Drive • Iomega Zip Drive atapi • 17" .27NI SVGA Digital Color Monitor • 8MB AGP Graphic Accelerator • 56K V.90 PCI Fax/Modem • 36x IDE CD-ROM B f a 0 p y • Sound Blaster 128 PCI Stereo Sound Card • Soundimage Subwoofer System • 3.5" High Density Floppy Drive • Microsoff Windows• 98 • Corel Wordperfect Suite 8 (includes; Wordperfect So, Quattro Pro 8•, Presentations 8·) • Zodiac 1000 CD Bundle Complete systems, components, and peripherals, PLUS friendly service and support. All right around the corner! 1·716 ·743 ·0195 T ECHNOLOGY DISTRIBUTION NETWORK www.tdn.net 1000 Young Street . Suite 270. Tonawanda NY 14150 . Fax: (716) 743.0198 s c a n S u m m e 9 9 �r m · · · · · · · · · ·· · · ·· · ······ · · · ········· · ··· · ··· · · ~ Tomorrow's Physicians Confront Choice BY UL \1. rt:' STACEY r nuo r ~A BLYTH on the morning of October 24, 1998, I had no idea how that one call and the events precipitating it would change my experience as a second-year medical student. When I answered the phone, my classmate asked, "Have you heard?" "About what?" I responded. She proceeded to tell me about the murder of Dr. Barnett Slepian. As she spelled out the details , I went a little numb. Despite being safely at home with my husband and daughter, my sense of security was altered. A bullet shattered a window, a man's flesh, and his family's future. That same bullet instilled in me a sense of urgency and a need to evaluate my changing role in the abortion debate. Since that October day I have begun to read about the subject and discuss it with the people around me for the first time. What follows is just some of what I've learned and pondered during these past months. Abortion is a part of human history. Legal or illegal, it has always occurred; legality simply increases its safety and decreases the rates. Maternal mortality and loss of fertility increase exponentially when abortion is illegal, and abortion rates are highest in countries where the procedure is illegal (for instance, Peru's rate is 52 procedures per 1,000 women). That's not to say that our rate in the United States-23 procedures per 1,000-could not be significantly lower. ® Stacey Blyth, a third-year medical student at the University at Buffalo School of Medicine and Biomedical Sciences, is co-coordinator of the local chapter of Medical Students for Choice. MSFC National has over 4,000 student members and assists BO active chapters across the country. just compare that to a rate of 6 procedures per 1,000 women in the etherlands, which has a long history of safe, legal access in combination with reality-based sex education and widely available birth control. This information made me wonder why we are still having this discussion. Whether abortion is legal or illegal, abortion rates will never reach zero due to the imperfect nature of birth control, cases of medical necessity and, more importantly, the imperfection of humanity; however, we could significantly reduce the rates by providing our patients with better options. According to current statistics, 4 3 percent of the women in the U.S. will have an abortion by age 45. Most women who choose to terminate a pregnancy do so only once. Only one unmanageable pregnancy in a reproductive lifetime of roughly 30 years is really quite remarkable. These patients are typically young, and two-thirds plan to have children in the future . They come from every conceivable racial, ethnic, socioeconomic and religious background. During the first year of medical school, we talked a lot about our future role as physicians. We were helped to understand that to be good physicians, we B u f f a 1 a P would need to provide nonjudgmental care to many patients who made life choices with which we were not personally comfortable, such as smoking. Our job will not be to judge our patients' actions and then provide care if we deem them worthy. Yet nowhere in our discussions was any mention made of a woman's right to a safe, legal medical procedure (even if we might not make the same choices for ourselves). When physicians provide care, they are performing important services that save and improve lives; it has nothing to do with validating their patients' actions or lifestyles. To provide high-quality health care over a lifetime, I must forever search my soul for empathy, tolerance and a basic regard for humanity. The rhetoric surrounding abortion is being manipulated to increase intolerance in our culture and drive people to hate. A disturbing trend that is not well understood unless you really pursue it is the growing alliances between extremist hate groups of all sorts and some extremist groups in the anti-abortion movement that advocate violence. During the past 10 years these groups have participated in an hysician Summer 1 9 9 9 �............. . ........................... .. ............. . ............ . ............. . . increasingly violent campaign to shut remove the pro-choice bumper sticker been able to move beyond abortion to down abortion clinics and, as a result, from our truck because she was afraid talk about larger public-health and the number of providers has been the bad people would blow it up. The reproductive-health issues. We are strugsteadily decreasing. Currently, 84 per- idea that I have to choose between being gling to understand how our education cent of the counties in this country do a good doctor and protecting my child and future practice habits can positively not have a single abortion provider, and from the infectious hatred of these people (or negatively) influence our society's roughly 60 percent of the remaining is a constant source of conflict for me. collective well-being. As future physiThe American Medical Association's cians, we are challenging ourselves to providers are at or past retirement age. So what do we do when these brave official position is that the decision of confront intolerance. Given the priviolder physicians retire? These men and whether or not to terminate a pregnancy leged place we will assume in this women remember the carnage and abuse is a private matter between a woman society, it is my belief that we must hold that women suffered as a result of illegal and her physician. This position works ourselves to the highest of standards. abortion; however, the physicians who on paper, but if our current abortion We must find a way to embrace humanhave trained since 1973 do not have this providers are approaching retirement ity in all of its imperfections if we are to horrible experience to help them and we are not training our future establish the trust necessary to provide understand the massive public-health physicians in all aspects of reproductive quality care to our patients. As the anti-abortion movement has imperative of safe, legal access. How services, who will have the skills necesbecome more violent, it has also become can we ask young physicians, just sary to help women make difficult smaller and more out of school rna rgi na lized. and with otherwise I The fear its mempromising futures, TO PROVIDE HIGH-QUALITY HEALTH CARE OVER A LIFETIME, bers instill in us to take on this MUST FOREVER SEARCH MY SOUL FOR EMPATHY, TOLERANCE is real, but the work alone? AND A BASIC REGARD FOR HUMANITY . THE RHETORIC danger our mediJust when I begin cal ins ti tu tions to make my peace SURROUNDING ABORTION IS BEING MANIPULATED TO INCREASE and practitioners with my own loss INTOLERANCE IN OUR CULTURE AND DRIVE PEOPLE TO HATE . will face if they of personal safety, expand student Dr. Slepian's words education and come back to haunt me. He spoke with Medical Students for choices? More than 90 percent of abor- patient services is, in actuality, extremely Choice last year about his training in a tions are currently being performed limited. Terrorism should never be a less volatile time and of his desire to outside of hospitals, yet most medical factor in determining which medical decrease his workload. Unfortunately, students and residents still train in hospi- procedures are available to our patients. The precedent that will be set if the because younger students were not tals. This must be remedied if students anti-choice movement is successful being trained, he felt he could not aban- are to get real exposure to a vital medical don the disadvantaged population to procedure and gain appreciation for how should frighten all of us, regardless of whom he provided care. But what really essential abortion services are for many the choices we might make in our pergot to me was his description ofhow anti- women and families. Unless we find a sonal lives. I for one refuse to let my choice protesters would picket his home way to include abortion training in the morality and future practice habits be and stalk his children. They would standard medical education, it can be dictated to me by an angry minority with guns. I will continue to believe in a accost them at school and at the grocery marginalized and limited by terrorists. here's the surprise ending: So world where we can draw upon the store with violent, threatening rhetoric Despite the bleak tone of most of this diversity of the human community to about their father. My daughter, who will turn eight article, I remain stubbornly optimistic. gain strength, not create fear. + soon, has little more to worry about Faculty support and involvement in right now than what color butterfly clips student efforts to learn about this issue Sources for 111formalion,n tins article incluclr she should wear in her hair, but she have been encouraging. As we've The Alan Guumachcr lnstltuu· c~~ IHL notices things. Even though we have discussed abortion provision, we've agr-usa org) ,\tcdical Students for C.ho1ce tried to shelter her from this violence, come to a much better understanding of www.ms4c.ot g, and the SoutiH'tll Po' crt\ she recently asked my husband to the complexity of this issue. We've even Lcm Center (Win~ Sf1lccnter org). --- - S u f f a I o Physician Summer 1 9 9 9 �8 Y L I N D A J . C 0 R DE R , PH D, C F R E AWord from the Dtrector of Development " development program, over time, is the growth of its endowment. Yet, in the cycle of academic seasons, we have spent very little time discussing this aspect of support for the school. just what is so important about endowment? Endowment is an institution's land, buildings and invested capital resources. In the arena of public higher education, most of the former-land and buildings-are maintained by the state. The latter generates funds to be used, in perpetuity, to support designated programs. One ofUB's earliest endowed funds was a gift from Devillo W. Harrington, who was injured during the Civil War. He was brought to Buffalo, where interns from UB treated his wounds. He recovered, remained in Buffalo, and decided to go to medical school, graduating in 1871. In honor of his twenty-fifth anniversary of graduation, in 1896, he established an endowment. For over a century, the Harrington Lectureship has brought outstanding medical sci en tis ts to Buffalo. Since The endowment is, in a very real sense, the then, many school's security for its future. others have contributed to the school's overall endowment to provide permanent support for designated programs they believe are important to the quality of the academic experience. The endowment is, in a very real sense, the school's security for its future. The school has a variety of funding sources, of which the state's share is relatively small, approximately 12.7 percent. The school's clinical practice plan provides the largest single source of income, while research grants and contracts, annual gifts and endowment gifts comprise small- but significant and increasing-sources of income. Endowment income provides perpetual funding for either the general unrestricted use by the dean (extremely important) or for specified programs established in accordance with the terms of the endowment gift. Endowment income provides a hedge against downturns in the economy; fluctuations in the political climate; variations in the numbers ® Buffalo of alumni and friends supporting the school's annual appeal and other changes in our academic environment. Today's students and faculty benefit from past endowment gifts, while tomorrow's school is being created by today's gifts. I ( '> Additional endowment gifts are the surest way to grow the school's endowment and to protect its mission and vision. Endowment also grows through prudent investment of endowment resources for the long term. A balanced fund, consisting of high-quality, readily marketable stocks, bonds and other assets, is important to meet the goals of growth to outpace inflation and to provide a steady income stream that supports the programs designated by endowment agreements. Several investment advisors, overseen by UB Foundation's (UBF) Investment Committee, manage the school's endowment, and a similar committee oversees the school's state-held endowment. The investment objective is to maximize total return-dividends plus market value-within reasonable risk parameters. Each year the endowment disburses an income stream for current use in accordance with each fund's stated purpose. The percentage disbursed varies slightly between state-held and UBF-held endowments. Generally, between 4 percent and 6 percent of the total endowment's average market value, calculated over the previous three to five years, is made available for spending. The rest of the total return is retained with the endowment principal to secure and even increase its future buying power. The market value of the school'sendowmentassetswas$l32,l61,604,asof]une30, 1998. A year prior, this amount was $111,265,374. Five years ago, in 1993, the school's combined endowment stood at $69,398, 610. The 1998 total represents an increase of over 90 percent in value since 1993. Within the next five years, I trust the endowment will "beat its own record" and at least double in value. This will require many new, significant endowment gifts, in addition to the ongoing wise management of the funds already in the care of the State University and UBF. Watch for additional information about endowments in a future issue of Buffalo Physician. In the interim, if you would like information about initiating a named endowed fund, or have any questions, please contact me by phone, toll free, at 1 (877) 826-3246; or by e-mail at ljcorder@buffalo.edu. Physician Summer I 9 9 9 �Dear Fellow Alumni, As THE E'W PRESIDE T OF THE MEDICAL ALGM I AssociA TIO!\ , I plan to continue the good work started by our previous presidents. Thanks to the leadership and direction from our past president, Elizabeth Maher, and the hard work of Patricia Duffner, this year's Spring Clinical Day, titled "Women's Health," was a tremendous success. The lecture by this year's Stockton Kimball lecturer, Betty Friedan, was interesting, insightful and humorous. Already, plans are under way for next year's event. The Physician- Student Mentoring Program is one of the more tangible ways the Medical Alumni Association demonstrated its commitment to improving the experiences of the students this year. I would like to take this opportunity to salute my medical school mentor as someone who left a very positive mark on my medical career and to whom I am still grateful. Dr. Clayton Peimer and I were paired up in August of 1979. I remember asking Clay, "How in the world do you remember how to treat something like congestive heart failure?" Clay, a hand surgeon, replied, "After you treat something 500 times in medical school and residency, on the 501st time, it begins to sink in." Clay, I have never forgotten that quote and I appreciate all that you did for me and taught me during that period. I hope that I can leave as significant an imprint on the students with whom I come in contact. This is the beauty of the mentoring program. Please consider volunteering for the program by calling the Medical Alumni Office at (716) 829-2778. On August 9, 1999, the Medical Alumni Association will sponsor The White Coat Ceremony at the Center for the Arts on the North Campus. At this ceremony, the first-year students will be given their clinical white coats on the first day of their orientation for medical school. We are proud to take part in this and sponsor such a significant and meaningful event for the first-year students. I look forward to the upcoming year and continued success for the Medical Alumni Association. R ich ar d L. C o ll ins , MD President, Medical Alumni Association CLASS 1 9 3 s 0 writes: "I am a physician on the MediVan, a doctor's office on wheels that gives care to the elderly indigent. This is pro bono publico activity without remuneration. ANG E L O LAP I , MD '37 , 1 9 5 s 0 BERNARD H . SKLAR , MD '56 , writes: I retired November 1, l99l, andam loving it. I saw Dave Ben-Asher ['56] last winter in B u f f a l o P Tucson,AZ. He was looking good. My E-mail address for the computer literate is bsklar l@idt.net. Would love to hear from you. 1 9 6 0 s HARO L D BRODY, PHD , MD '61 , SUNY Distinguished Teaching Professor in the Department of Anatomy and Cell Biology at UB, and his wife, Anne, received the Lynn Millane Community Service Award from the Amherst Senior Citizens Foundation, hysician NOTES Inc., on April 23, 1999. The award is presented to individuals who, through volunteer or professional involvement, have helped maintain and support senior programs that provide socialization, educational and cultural activities, social support and wellness. Anne Brody has been especially dedicated to improving the quality of life for senior citizens and has devoted many years of work toward this goal, according to Dr. Brody. Summer I 9 9 9 R O NALD I. DOZO RETZ, MD '62, was honored April 30, 1999, at the UB Alumni Association's annual awards banquet, which recognizes individuals who have distinguished themselves in their career or in their service to the university. Dozoretz is founder, president, chief executive officer and chair of the board of FHC Health Systems, the largest privately held company providing behavioral health services in the U. S. and Canada, and second �• ·· · ·· · ··················· · · · ········ · ·· ·· · · ···· · ········ ·· ······························ I largest mental-health managedcare company in the nation. of Ophthalmology at Children's Hospital of Pittsburgh. He is the past president of the medical clinical medicine at UB and a frequent lecturer and consultant with the Crohn's and Colitis ROBERTA M . GILBERT , MD '62, staff of the hospital and is president-elect for the American Association for Pediatric Ophthalmology and Strabismus. He also serves as a reviewer for the jour- Foundation of America. writes: "I married joseph Douglass in August 1998, author of Red Cocaine and a new book on progress on the fate of the MIA-POWs. We live in Falls Church, VA. My new book, Connecting with our Children, will be out September 1999 (published by Wiley and Sons). My first book, Extraordinary Relationships, has been in print seven years and continues to do well." nal of Ophthalmology, American journal of Ophthalmology, journal of the American Association for Pediatric Ophthalmology and Strabismus and has served on the editorial board of Binocular Vision. 1 received the Pennsylvania Academy of Ophthalmology's Distinguished Service Award on March 19, 1999, in Pittsburgh. He was honored by Pennsylvania's eye physicians and surgeons for his extraordinary work and for contributions to the specialty of ophthalmology. Biglan is director 7 5 was honored at Springfest '99, the Co u nty Medical Center's (ECMC) annual black-tie dinner dance, which was held this year on April24, 1999, at the Hyatt Regency Buffalo. ovak has been director ofECMC's gastroenterology unit since l980.In addition, he attends in the Hepatology Clinic and recently developed an on-site GI consultative service at the Erie County Home. He is also a professor of B was named to New York Magazine's Uune 7, 1999) Best Doctor "Hall of Fame." For the last 20 years he has had a private practice of orthopaedic surgery in Manhattan, Y. f f a l o 1 9 8 0 5 MD '74, begins a four-year term as a member of the board of directors of the American Academy of Dermatology (AAD). Thiers is professor of dermatology at the Medical University of South Carolina. In addition, he holds clinical appointments as attending physician at Medical University Hospital, Charleston, SC, and chief of the Der- has been named to the board of directors of the American Acad- BRUCE H . THIERS , matology Service at Charleston Veterans Administra- emy of Orthopaedic Surgeons and the American Association of Orthopaedic Surgeons. Toriello is chief of the Department of Orthopaedic Surgery at Wyckoff Heights Medical Center in Brooklyn, Y, and attending orthopaedic surgeon at St. John's Queens Hospital, Catholic Medical Center, Queens, NY. He also currently serves on the board of directors for the New York State tion Medical Center. Thiers has Orthopaedic Society and is a delegate of the House of Del- served the AAD in many leadership positions, in- egates for the Medical Society of the State of ew York. cludingassociateeditorofthejournal of the American Academy of Dermatology. He has also served Be sure to include your name and a phone number or address where you can be reached. Your fellow alum look forward to reading about your storied past! u Experimental Dermatology, journal of the European Academy of Dermatology and Venereology, Current Opinion in Dermatology and Clinical Dermatology. EDWARD A . TOR IELL O , MD '80, Here are some ways you can submit your story.... e·mail: bp-notes@buffalo.edu fax: 716-645-2313 mail: Editor, Buffalo Physician, 136 Crofts Hall, Buffalo, NY 14260 a favorite memory, anecdote or inspirational moment that you associate with your medical education? How about a favorite professor, mentor or classmate you'd like to tell about? Buffalo Physician is putting out a call for stories about your past, which we will publish in future issues of the magazine. ® 0 JAN M . NOVAK , MD '70, Erie ALBERT W . BIGL AN , MD '68, 9 JACOB D . ROZBRUCH , MD '73, as editor of the Year Book of Dermatology and Dermatologic Surgery, consulting editor of Dermatologic Clinics and as a member of the editorial boards of P hysician KENNETH J . ROT H , MD '83, writes: "Havingservedaschairman of the Department of Internal Medicine and vice chief of staff, I will assume the role of chief of staff at Sharp Memorial Hospital in San Diego, CA, on january l, 2000. Sharp Memorial Hospital is the flagship hospital for Sharp Healthcare, which is the largest provider of health care in San Diego County." H E RB N E WTON , MD '84, writes: "I just returned from participating in the 1999 Spring Clinical Day lectures and the 15th Summer 1 9 9 9 �.......... . ... . .. . ............. . ............. . . . .... . . . ..... .. . . . . . . . . ............ .... . ·· ~- -~. ' reunion celebration for our class. The lectures were excellent and focused mainly on breast and ovarian cancer. Although the number of returning classmates was modest, we had an excellent time at the class reunion reception Friday night. Many of us went out afterwards for chicken wings and beer. On Saturday night, the reception dinner was held at the Dakota Grill, which turned out to be an excellent venue. The dinner and service were outstanding. We all had a great time getting reacquainted and caught up on our careers and families. The dinner was organized by Dave and jill Pfalzer, both of whom should be congratulated for all the hard work they put into this great event! From all of us who participated in the dinner reception , l would like to offer a toast to Dave and jill. Thanks guys!! 1 9 9 CHRISTOPHER '91 , has 0 5 MARTIN , MD been appointed medical director of the inpatient child and adolescent psychiatric program at BryLin Hospitals. The 20-bed , short-term program treats children and adolescents with attention deficit!hyperacti vity disorder, dual diagnosis, conduct disorder, depression, suicidaVhomicidal behaviors and other emotional problems. Martin, who is a board certified child and ado lescent psychiatrist, is in private practice with Suburban Psychiatric Associates in Williamsville, NY, and has been on BryLin Hospitals' staff since May 1996. 8 u f f a 1 o P I Elizabeth Olmsted Ross, MD '39, Honored 1999 Recipient of Lifetime Medical Alumna Achievement Award Olmsted Ross has served in ovolunteer capacity with many community organizations, as well as in on official capacity with professional societies. From 1955to 1957, she was president of the Buffalo Ophthalmologic Society; from 1962to 1964, she served as president ofthe New York Stole Women's Medical Society; and from 1964to 1965, she was president of the Women Physician League of Buffalo. During World War II, Olmsted Ross served as a medical officer in the Civil Air Patrol of Buffalo, Tonawanda and Lockport. An avid pilot, she also instructed navigation in the Buffalo Patrol and was a charter member of the "99's", the Notional Women's Flying Organization. For many years, she and her husband Ira G. Ross enjoyed soiling their 38-foot Zeeland Yowl "Tonuki" some 35,000 nautical miles on the Great Lakes and the North Channel and chartering and scuba diving in the Caribbean. In 1991, after her husband's death, Olmsted Ross initiated on endowment for the Ira G. Ross choir in Medical Informatics at the University at Buffalo School of Medicine and Biomedical Sciences. This choir was recently funded and will be implemented during the upcoming academic year. Recently she was honored by the Buffalo Blind Society, which named their newly renovated area the Elizabeth Pierce Olmsted Educational Center and by the Western New York Blind Association, which changed its nome to the Elizabeth Pierce Olmsted, MD, Center for the Visually Impaired. Throughout her active career, Olmsted Ross has also published extensively in professional journals and mode numerous presentations regarding her research in ophthalmology. For these and other contributions to UB and her profession, it was with great pleasure that John R. Wright, dean of the School of Medicine and Biomedical Sciences, presented Dr. Olmsted Ross with the Lifetime Medical Alumna Achievement Award on May 1, 1999. iven that the theme for this year's Spring Clinical Day was "Women's Health," it was only fitting that Elizabeth Olmsted Ross, MD '39, was awarded o Lifetime Medical Alumna Achievement Award (see also page 28). Following graduation from UB, Olmsted Ross completed o rotating internship at the then-E. J. Meyer Memorial Hospital. In 1941, she obtained on externship in ophthalmology at Strong Memorial Hospital, followed by o residency at the University of Illinois Eye and Ear Infirmary. Three years later she become the youngest person on record to become odiplomate of the American Boord of Ophtholmology. ln 1947, she also become a diplomate of the American College of Surgery. Olmsted Ross has been in private practice in Buffalo since 1944 and, over the years has been affiliated with nine hospitals. She received ocommendation for 50 years of service at Millard Fillmore Hospital and o citation for service at Deaconess Hospital, where, in 1968, she was named chief of the Deportment of Ophthalmology and choir of the residency program. In addition to starting her practice in 1944, Olmsted Ross subcontracted with Curtiss Wright Corporation to establish their Safety Goggle Program and industrial lighting standards. Later, working with Cornell Aeronautical Laboratory, she initiated investigation of ocular hazards of high-energy radar on technicians. This led to participation in o research program for the Air Force Medical Center of Griffiths Air Force Bose and Cope Canaveral, research at Tufts University, and o contract with RCA to examine personnel on their radar ship operating at Cope Canaveral. In 1955, Olmsted Ross began teaching clinical ophthalmology at UB's school of medicine and in 1974 was named clinical assistant professor, oposition she still holds. Today, she is also o member of the UB's President's Associates, the James Plott White Society's executive committee and the editorial board of Buffalo Physician. hysician su m mer 1 9 9 9 �• ········· ·· ········ ·· ···································· · ······· · ············ ···· ······ . I GREGORY A. ANDREWS, MD JD , has published a book, titled The Complete Guide to Premedical Success (MedLaw Books Inc. ISBN 0966052501). A re- retired from private practice in 1969 and a year later moved view written about the book states that it is "an all-encompassing guide containing crucial information for premedical students" and concludes: "This 'nuts and to Tequesta, FL. In addition to teaching, Stoesser '93, bolts' guide to achieving the doctor dream covers many of the common issues and questions that arise from students considering medical school. Dr. Andrews, dedicated to the education of young people considering medicine, has created a book that will be an asset on any student's bookshelf. " to Cleveland to complete his surgical residency at St. Luke's Hospital. In 1950, he began his private practice as a surgeon and for 38 years was as- S practiced as a board certified surgeon from 1940-69 at E.). Meyer Memorial Hospital University starting July 1999, to care for the growing population of adults with complex congenital heart disease. IN MEMORIAM FREDERICK G. S TOESSER, MD '29, a longtime Buffalo-area surgeon, died March 8, 1999, in Waterford Health Care Center, Juno Beach, Fl. He was 95. Stoesser served as an associate clinical professor of surgery in UB's School of Medicine and Biomedical Sciences and taught at the university for 32 years. He ® during that time. A past president of the Buffalo Surgical Society, he also served as president of the UB Medical Alumni Association, the Buffalo Academy of Medicine and the Millard Fillmore Hospital staff. Stoesser's research included work on the use of hyperbaric oxygen to treat disease, and he was instrumental in bringing the first hyperbaric chamber to Buffalo. In 1956, he received a patent for a vein stripper, the proceeds from which he gave to the UB medical school for an endowment to support medical students in financial need. KENT L BROWN , MD '42, died April 30, 1999, in St. Vincent's Hospital, Erie, PA, after a brief illness. He was 83. Following graduation from UB, Brown, a native of Westfield, Y, served aboard the USS San Francisco during WWII. In 1946, after discharge from the service, he moved u Amherst after a long battle with cancer. He was 62. Schultz was a clinicial assistant professor in the Department ofMedicine and had Note: Our e-mail address has changed. and Millard Fillmore Hospital, where he was chief of surgery from 1961 - 1967. He also was a consulting surgeon at DeGraff Memorial Hospital B ROBERT SCHULTZ, MD '65,died March 27, 1999, in his home in sociated with and Lafayette General Hospital JOSEPH KAY, MD '94, writes: "I was married on ovember 2, 1996, to Kathryn Fox of Hamburg, NY. After finishing my Med/ Peds residency at the University of Michigan Hospitals, I served one year as pediatric chief resident at that institution. I will be persuing further training in a combined pediatric and adult cardiology fellowship at Duke Karen Brown Johnson of Schenectady, NY; three sons, KentJr. of Honesdale, PA, David of Sherman and Garry of Columbus, OH; a sister, Martha Brown Akin of Chautauqua, NY; and ll grandchildren. f f a l o served on UB's faculty since 1970. He was also a past president of the UB Medical Alumni Association. Schultz maintained a private practice in internal medicine, renal disease and St. Luke's, where he eventually became chief of staff. He also was affiliated with St. Vincent Charity Hospital and Health Center in Cleveland and was named chief hypertension. In addition, he served as chief of nephrology at of staff there in 1980. Following his retirement in 1983, Brown left Cleveland and returned to Millard Fillmore Hospital. He was instrumental in the development of Western New York's first outpatient dialysis center and founded the High Blood Pressure Control Program of Western New York. A past president and board member of the Western New York chapter of the American Heart Association (AHA) , he served on the board of Chautauqua County, where he served as a medical consultant and a member of the board of directors at Westfield Memorial Hospital. Brown was keenly interested in the history of medicine, in medical personalities, in forensic problems related to medicine and in innovations in surgical techniques. Many of his directors of the New York State affiliate of the AHA. In 1984, he was named Man of the Year for the AHA's Western New York observations and information he accumulated went into several books and numerous scientific papers he wrote. In 1946 Brown's chapter for his dedication and support in the fight against heart disease. Schultz was also a member of the National Kidney Foundation, serving on the Western New York board of directors and executive commitee. In 1975, he received the organization's Distinguished Service Award. Survivors include his wife, Sharon, three sons and two daughters. father-in-law and mother-in-law, Garry Cleveland Myers and Caroline Clark Myers, founded Highlights for Children magazine, still a leading periodical for children in America. Brown and his wife, Elizabeth Myers Brown, contributed greatly to the ultimate success of the magazine. Survivors include a daughter, p s I c I a s m m e 9 9 9 �Pubnona•y Rehabilitation Specialized care for: • COPD • Asthma • Emphysema • Pneumonia • Post-Ventilator Therapy • 'fracheostomy Care Garden Gate Health Care Facility is pleased to offer a rehabilitation program specializing in the care of individuals with pulmonary disorders. Patients admitted to the Pulmonary Program have an individual plan of treatment developed by the in-facility clinical team and medical staff in conjunction with the referring p hysician. Fwe Star Care For Your Loved One Rated outstanding in our community with five stars out of five, according to The Inside Guide to America's Nursing Homes. THE UWCGUIRE l{.EHABIL1Tlfl1(9~ CENTEI{ Located at Ganlen Gate Health Care Facility 2365 Union Road in Cheektowaga 1-888-POSil\.CUlE or 929-1715 All major insurances and Medicare payments accepted. �BUFFALO PHYSICIAN Non-Profit Org. STATE UNIVERSITY OF NEW YORK AT B UFFALO U.S. Postage PAID 3 4 35 MAIN ST. BLDG.22 Buffalo, NY BUFFALO NEW YORK 14214-3013 Permit No. 311 ADDRESS SERVICE R EQUESTED Your stock may pay more dividends than you thought possible You dabbled in the market long before it became a fad and your hunches paid off. But now you need income, and your shares are only producing low annual dividends. so how can you make the most of your securities and still achieve your personal and financial goals? Give your stock to the University at Buffalo. With careful planning, your gift may provide you with income for life, a charitable deduction and reduce or eliminate taxes. And for UB it can mean more scholarships, research funds or the realization of your own personal vision and goal for the University. To learn how your gifts of stock can benefit you and the University at Buffalo, please call the Office of Gift Planning at !716l 645-3312. T ~ University at Buffalo ~ State University of New York University at Buffalo • Office of Gift Planning • 103 c enter for Tomorrow • Buffalo. New York 14260-7400 • 716-645-3312 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1999 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1999-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v34n01-1999-Summer Table Of Contents A list of subunits of the resource. A Special Place for Women Peak Experience Hearing Loss Research Bolstered Medical School Mission Improbable Alumni Student Perspective Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-10 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v34n01 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1999 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/efe69a80ce3df399dd1c791c99e45540.pdf 6de97f45c87624fd0643e32c40a70c32 PDF Text Text �BUFFALO PH Y SICIAN Volume 33, Number 3 ASSOCIATE VICE PRESIDENT FOR UNIVERSIT Y SERVICES Dr. Carole Smith Petro DIRECTOR OF PUBLICATIONS Kathryn A. Sawner EDITOR Stephanie A. Unger ART D IRECTOR/ DESIGNER Alan j. Kegler STATE UNIVERSITY OF NEW Y ORK AT BUFFALO SCHOOL OF MEDIC INE AND BIOMEDICA L SCIENCES Dr. john Wright, Dean EDITORIAL BOARD Dr. Bertram Portm, Chai• Dr. 'VIartin Brecher Dr. Harold Brody Dr. Lmda j. Corder Dr. Alan j. Drinnan Dr. james Kanski Dr. Barbara MaJeroni Dr. Elizabeth Olmsted Dr. Stephen Spaulding Dr. Bradley T. Truax Christopher Adams Dr. Franklin Zeplowitz TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospnal Michael Slww The Children's Hospnal of Buffalo Erie County Medical Center Mercy Health System Millard fillmore Gates Hospital Millard fillmore Suburban Hospital Niagara Falls Memorial Medical Center Roswell Park Cancer Institute Sisters of Charity Hospnal Dennis McCarthy Veterans Affairs Western New York Healthcare System Dear Alumni and Friends, Buffalo Physician message, sans the "interim" title. Although I really don't feel much change, it does seem to make a difference to others in terms of moving things ahead, and that is what is important. I know that more than a few of you had been urging for a more permanent solution to the dean's position, and I certainly appreciate the confidence, support and notes of congratulations that have been expressed. The dean's office moved in December, to the second floor of the new medical education building known previously as Cary-Farber-Sherman and now as the Biomedical Education Building (BEB). The office will be located just off the BEB atrium, where it will be much more accessible to students. Being tucked back in the corner of the administrative wing has made it difficult to visit with students on a regular basis. Indeed, I am in the process of setting up regular lunches with small groups of medical students (twice a week, God willing) to track how they are doing, on a more personal level. This move will also bring the dean's office, the Admissions and Medical Education offices into closer proximity. Speaking of medical education, a special task force has been appointed to look at all four years of the curriculum. Although this project is expected to take at least two years to complete, we anticipate some "deliverables" for falll999 implementation and, hopefully, at least, a few "mid-course corrections" this next semester. I talk about these and others changes affecting the medical school in an indepth interview published in this issue of Buffalo Physician (see page 4). Our Dean's Advisory Council (DAC) recently concluded its fall meeting and the input was most helpful. As with any medical school in today's turbulent environment, we face a wide variety of challenges and the DAC has proven to be an invaluable method of reviewing issues and ideas with informed alumni who are dedicated to the mission of the school. We are also interested in obtaining input from other alumni and I am making an effort to visit with alumni groups wherever possible. Indeed, at the recent AAMC meeting in New Orleans, we cohosted a reception (with the other SUNY schools) in an effort to reach out to alumni in that particular region, as well as to attendees at this national meeting. Unfortunately, we did not see many alumni who were not also attending the meeting. We shall keep trying, however. Finally, Dr. Harold Strauss, formerly the Edward 5. Orgain Professor of Cardiology and professor of medicine and pharmacology at the Duke University Medical Center, arrived at UB on ovember l, 1998, to assume the chair of physiology and biophysics (see related announcement on page 27 of this issue). This represents a pivotal recruitment, in my opinion, given the importance and stature of this department within the medical school. Please join me in welcoming Dr. Strauss to our medical school community. You will learn more about his accomplishments and his plans for the department's future in upcoming issues of Buffalo Physician. THIS WILL CONSTITUTE MY FIRST ---; (_ I &~ ~N ~ ~~~~' School of Medicine and Biomedical Sciences R. W "'G"', MD ©The State University of 'lew York at Buffalo Buffalo Physician is published quarterly by the Stale University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alumni, faculty, students, residents and friends. The staff reserves the right to edit all copy and submissions accepted for publication. Dear Fellow Alumni, THIS PAST FALL, the Western New York medical community received much attention due to the murder of Dr. Barnett Slepian. Although I did not know Dr. Slepian personally, he serves as a role model for me and, I am sure, for many other physicians, as well. He was a man of much integrity and compassion who provided a wide range of medical services for women in this area. Regardless of each of our personal opinions regarding abortion, the medical community has a responsibility to provide safe and compassionate care. Medicine has never seemed like a dangerous profession, yet Dr. Slepian's death reminds us of our vulnerability. The Medical Alumni Association has chosen "Women's Health Issues" as the ,-(,::, topic for Spring Clinical Day, May l, 1999 . Mark your calendars now. Thanks to Dr. Patty Duffner, a dynamic event is anticipated. Treatment advances in the areas of breast and ovarian cancers will be highlighted. The author and activist Betty Friedan will be the Stockton Kimball lecturer. Don't miss the opportunity! Congratulations to our dean, john Wright! Moving the offices of dean within the medical school walls in order to be closer to where the students are is indicative of his known talent for and interest in improving the medical school experience here at UB. My confidence in the medical school, and in the quality of our future graduates, is heightened with Dr. Wright at the helm. L. M AHER, MD President, Medical Alumni Association E LIZABETH �33, 3 W - 1 _N _T _E_ R_ NUMBER 1_ 9_ 9 _9 '1 'I FEB 2 2 1999 LlunAHY Steady Leadership in Changing ~mes 2 A CONVERSATION WITH .JOHN R. WRIGHT, 12 Managing Mental Health with Care RONALD I. MD, MD '62, DOZORETZ, DEVELOPS LARGEST Harold Varmus Delivers Cori Lecture IN RECOGNITION OF ROSWELL PARK CANCER NAMED DEAN IN PRIVATE OCTOBER HEALTH SERVICES COMPANY ANNIVERSARY by Scott Thomas by Catherine Donnelly 1 998 photos by K. C. Kratt BEHAVIORAL 18 INSTITUTE'S 1 DOTH Major Health-Care lntitiative U 8 PART OF FEDERAL PROGRAM TO BRING HEALTH-CARE PROVIDERS TO UNDERSERVED AREAS Medical School Town Hall Meeting • DIRECTOR OF NATIONAL • PRIMARY CARE EXTERNSHIP / INSTITUTE ON PRECEPTORS LISTING ADDICTION, ALAN INTERNET ACCESS FOR LESHNER, RURAL COMMUNITIES AStudent's Perspective: Alumni SEXUAL IDENTITY • .JEROME KASSIRER ' 5 7 HONORED CLINICAL PRACTICE SETTING PHD, • by Frank P. Carnevale, MD '95 .JOSEPH A. B ELLANTI ' 5 8 NAMED D ISTIN- GUISHED ALUMNUS • REUNION WEEKEND! I. SPEAKS AT UNIVERSITY AT BUFFALO ISSUES IN A DRUG �zn NGINGTIMES P H 0 T 0 G R A P H Y B Y K. C. K R A T T JOHN R. WRIGHT, MD, INTERIM DEAN FOR THE UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES SINCE JANUARY 1, 1997, AND CHAIR OF ITS DEPARTMENT OF PATHOLOGY FOR 23 YEARS, WAS NAMED DEAN OF THE SCHOOL IN OCTOBER 1998. IN ANNOUNCING THE APPOINTMENT, UB PROVOST THOMAS E. HEADRICK PRAISED WRIGHT'S CONTRIBUTIONS AS INTERIM DEAN, CITING HIS "EXTRAORDINARY PERFORMANCE IN THE MOST CHALLENGING OF TIMES FOR MEDICAL SCHOOLS AND HEALTH CARE IN GENERAL." 0 Buffalo Phy sici an W i n t e r 1999 �JoHN R. WRIGHT, MD, 24TH DEAN OF THE UNIVERSITY AT BuFFALO ScHoOL OF MEDICINE AND BIOMEDICAL SciENCES. Michael E. Bernardino, MD, vice president for health affairs, praised Wright, as well. "john Wright demonstrated his devotion to the medical school by serving as interim dean during a very turbulent time. His wisdom, thoughtfulness, and honest and focused leadership enhanced my transition to the university, and !look forward to working with him as we strive to fulfill the mission of the medical school and the university." • perceptive understanding, openness and resoluteness have made it possible for the university and the medical school to move for\\·ard toward fundamental changes during a difficult period,·· Headrick added, lauding Wright's equanimity, determination and sense of purpose. "I look forward to his continued help and guidance through the thicket of concerns affecting health care and medical schools." B u f f a l o Physician w i n t e r I 9 9 9 �L STEADY - I N LEADERSHIP ---- CHANGING T I M E S ----- A CONVERSATION WITH DEAN JOHN R. WRIGHT s Wright embarks on his tenure as dean, he confronts unprecedented business and fiscal challenges that are inextricably tied to his ability to successfully further the school's primary mission of educating future physicians and research scientists. In early November, he took time out of his busy schedule to talk with Buffalo Physician about some of these challenges and to describe strategies being explored to meet them. With his long history of leadership at UB in many areas of endeavor, from teaching and clinical practice to administration and volunteer service, Dean Wright clearly draws on his deep affection for the school as he strives to provide steady leadership in these changing times. 1In April of last year, Dr. Michael Bernardino assumed the role of vice president for health affairs at UB. What is the scope of his responsibilities in relation to yours as dean of the medical school? SA UNGER with the school's immediate environment, specifically its education and research missions. Obviously, l too am concerned with the practice plan since it affects these two school missions and our overall financial viability. So , there are certain aspects of my job that are very closely intertwined with those of the vice president, and we work together on these issues. Until April of last year, the vice president and dean positions were combined, which is the trend in medical schools today, particularly in those that own their own hospital. Our situation, however, is different and probably more complex than most medical schools. Dr. Bernardino's primary mission will be to work with our affiliated hospital institutions and managed-care organizations to develop productive working relationships with them and- interwoven with that mission-to develop a viable practice plan for the faculty. ln addition , he is also the vice president for the university's four other health-science schools and so he must look after their best interests, as well. The medical school dean, on the other hand, will be more concerned Why is the Clinical Practice Plan as it involves medical school faculty being reorganized? We have a practice plan that has been very difficult to operate and oversee for a reason that is fairly simple: lt was designed as a one-size-fits-all plan for all four of the state's medical schools. However, the other three SU Y schools have their own university hospital, and we do not. And this situation has made it very difficult for Buffalo to develop its own workable practice plan. What has happened is that rather than a single, centralized plan, we have a practice plan within each clinical department, and in some departments there are even additional subdivisions. So we have roughly 22 different practice plans, each with its own separate corporation, business manager, billing system, rules and bylaws and so on. In this milieu, how can the university know what's going on, or negotiate managed-care contracts? How can we monitor the entirety of the practice plan to ensure that we comply with the various regulatory agencies; and if we are asked for an accounting of the plan, how can we respond to that request in a timely and effective way? Surprisingly, despite this lack of central Dean Wright (right) works closely with Michael Bernardino, MD, vice president lor health affairs. organization, the practice plan has worked 0 6 u f f a l a P hysici a n W I n t e r 1 9 9 9 �Ever the professor, Wright lectures on several topics in the General and Systemic Pathology course and says he hopes to continue to be involved in resident education in pathology. measure of accountability, but we should be able to operate in a much more efficient way. In order to be able to contract with the MSO, which is called UB Associates (UBA) , the departments will all have to become not-for-profit, "1412," state corporations. Some already qualify as this kind of entity, but there are other configurations out there that don't conform and so will have to change. rather well over the past decade. But in our particular environment, the departments have had to be entrepreneurial to a degree that has increased plan variability from department to department. And, with managed care, new Medicare regulations, and federal oversight of Medicare dollars, our system has been stressed enormously. So, where it perhaps wasn't necessary before, it now becomes imperative that we develop a more centralized system. Is there a concern that our practice plan could be subjected to a federal audit? What changes are being proposed to the plan? The federal audit that is of most concern to us and to every other medical school in this country is the PATH"physicians at teaching hospitals"audit, which a number of medical schools and medical centers have already undergone. Basically, these audits grew out of issues surrounding Medicare billing for physician services and such questions as who provided the service-residents, who are Medicare supported; or a supervising physician. One of the major issues has been whether or not the supervising physician was physically present when a critical part of the service was rendered. If the physician was not present, then Medicare contends that he or she should not submit a bill for these services since Medicare has already paid for the service through their support of the resident physician. The problem is that, for a long time, Medicare was not at all clear about what "present" actually meant. This has since been clarified, in a way, but PATH audits are retroactive in nature and extend back to when the rules were not clear. Essentially, what is being proposed is the establishment of a medical service organization, an MSO, which will not be involved in the practice of medicinethat's going to be left up to the individual departments and their corporations. What the MSO will do is provide certain services for the departments, such as centralized accounting and, hopefully, over time, centralized billing, although the actual preparation of the bills will probably remain decentralized in the departments. But all the revenues will come in to a central repository so that they can be accounted for and appropriately credited and then redirected back to the departments. The MSO will also provide centralized legal services. Currently, each of the practice plans has its own legal representation, which has been an enormous expense for the overall plan, as have been all the other decentralized services. By forming an MSO, therefore, we will not only be able to provide some B u f f a l o Physician w I n t e r 1 9 9 9 0 �S T E A D Y LE::ADE::RSHIP One of the ways to monitor these patterns of Medicare billing is to have more centralized accountability within the clinical practice plan. In a recent message in Buffalo Physician, you sa id that the medical school' s budget continues to represent a challenge, especially in terms of revenues that are centrally available to operate the school. Could you elaborate on this? This concern is not unique to our medical school. ationwide, managed care has stressed the clinical side of many, if not all, medical schools. In some instances, the financial support of the entire enterprise is challenged. In our case, the state provides roughly l3 percent of our expenditures, and the practice plan between 35 and 40 percent, with research grants and endowments making up much of the remainder. One of the things we have struggled with in our clinical enterprise at UB is the fact that we don't have a university hospital while the other universities in the SUNY system not only have a hospital that they control, but they are also subsidized for this facility. In turn, they control their graduate medical education [GME] dollars, which are significant. The GME dollars in our system go to the affiliated hospitals that participate in the GME consortium. We manage some of these funds through our consortium, but by no means all of them-or even most of them. As a result, one of the things UB is known for is that it costs less for us to educate a medical student than it does for any of the other state schools. The reason for this is simple: We do it with fewer resources. One of the ways the whole thing could be equalized, of course, would be for us to receive a portion of the subsidy that the other state schools receive for their hospitals. If we received just a small fraction of that subsidy and/or had greater control over GME dollars, we would be in a much better, much stronger, position in dealing with our affiliated hospitals and in controlling our educational programs. Is the medical school looking to obtain that subsidy? It's been talked about for a number of years. I don't want to say that we'll never get it, as I'd like to think it's a reasonable request. If we did get that money, I think we could be a model for 0 B u f f a l o As choir of the Deportment of Pathology at the University ol Buffalo for 23 years and immediate post-president of the Association of Pathology Choirs, Dean Wright (pictured here with graduate student Amy Renauld in the pathology laboratory of Robert Spengler, PhD) maintains o strong interest in his area of specialty. the rest of the state-that the state could end up devolving their university hospitals, which is something they've talked about; and for a good deal less money than they're spending now, they could develop a truly excellent medical education system. Are there advantages to our not having a university-owned hospital? ln today's world, it's considered disadvantageous to own one's own hospital, chiefly because of the financial liability involved. Also, as medical education and medical practice become less hospital-bound, the value of a highly specialized tertiary-care facility to a medical school's mission diminishes significantly. The strength of having had, or having come from , a university-owned hospital, however, is the "faculty culture" such arrangements facilitate. Without Physician W I n t e r 1 9 9 9 �S T E A D Y I LEADERSHIP that "culture," the full-time faculty do not tend to practice as a cohesive group and may not identify themselves as readily with "the university. " Well, [laughs] we're working through that. It's a major work in progress and one that's complicated by the fact that we have affiliated institutions in the process of undergoing significant mergers and/or other versions of reorganization. Traditionally, there's been a very competitive spirit among these institutions, and in today's health-care environment, that competition has only intensified. One result is the desire, in some instances, to develop more exclusive relationships with the university. For example, the CFG system has been seeking and in fact has publicly pronounced that it wants a more exclusive relationship with the university, yet we at the university also recognize our other obligations-to Erie County Medical Center, Roswell Park [Cancer Institute], the VA [Veterans Affairs medical center] and the Catholic Health System-which we're not going to walk away from. So, we will have to maintain a delicate balance in terms of exclusivity. That said, however, I think it's a certainty that we're going to have a very strong relationship with CGF, but something short of an exclusive one. Another very important issue we must address with our affiliated hospitals is the university's desire, and indeed need, to control the educational environment for our students and residents. This, of course, presents a challenge because the hospitals have an equally strong desire to control the medical services they provide as well as those who provide them. f a I o Physician w I n I M E S In selecting these centers, we're building on our strengths. In other words, we're looking at the areas in which we already have a national reputation and then proceeding to capitalize on these. The pediatrics and oncology selections clearly fit this stipulation and are areas that we thought, right from the beginning, could be established as Centers of Excellence. As for when the other centers will be named, I anticipate that this will take place once the configuration of the medical school with its affiliated hospitals becomes better defined. What is the state' s new resource allocation methodology, RAM, and how does it affect UB' s research efforts? RAM is a more precise way of allocating resources and reflects upon what you do and how successfully you do it. It's an opportunity for UB to garner more resources from the state, particularly in relationship to new research dollars. There's a sort of premium applied from the state to research dollars . By that l mean, for every new dollar that's brought in to the university, the state has promised to provide us with 20 cents, which is obviously a very attractive proposition. The problem , as I understand it, is that this is a zero-sum game. In For us, a Center of Excellence will be nationally and internationally recognized for its clinical services and research expertise in a specific area of medicine. The medical school, the clinical centers with which we are affiliated, and the entire geographic region will share in this recognition. f T Two of the Centers of Excellence at UB have been determined to be pediatrics and oncology (specifically Roswell Park Cancer Institute). What are the criteria for selecting these centers, and when will the other centers be determined? It has been announced that UB plans to establish four Centers of Excellence. What is a Center of Excellence, and what roles do research, clinical practice and medical education play in these centers? u CHANGING To develop the type of clinical expertise required for a Center of Excellence, you need to recruit physicians and develop programs that have a national reputation and be able to draw patients from well beyond this region. To maintain a Center of Excellence, you have to move forward; you can't simply stand still. You have to generate new ideas and new knowledge, and to do that, you have to be engaged in research, both clinical and basic. From the educational standpoint, nothing stimulates the development of new knowledge better than questions. And anyone working with medical students or residents knows that they make you think about things differently; they keep you from doing something a certain way simply because that's how you've always done it. So, in this way, clinical expertise, research, and medical education all fit into a common purpose when your goal is to develop and maintain a Center of Excellence. How would you describe the present relationship between the medical school and its affiliated hospitals? What changes do you foresee? B N t e r 1 9 9 9 0 �S T E A D Y LEADERSHIP I N CHANGING T I M E S and we need to recognize that these faculty members are absolutely essential to the educational programs of the school. But we also need to energetically protect programs that make us a good medical school. What are some of the issues volunteer faculty have with the university? One of the main issues is that volunteer faculty feel university faculty have an unfair advantage because they are "paid by the university." As I said earlier, only 13 percent of our budget comes from the state, and that is distributed almost equally between the basic sciences and the clinical departments. Because the clinical departments are so large, the money available for salaries is diluted rather rapidly. Also, our fulltime faculty are taxed on their clinical income, which volunteer faculty are not, and our full-time faculty are expected to teach and engage in research. Frankly, I see no such advantage; it's much more of an even playing field than is generally imagined. One advantage that I think the university does have-and, again, this gets back to all of us reading from the same page as far as the clinical practice plan is concerned-is that we represent a significant number of physicians in this community and we should be able to apply that strength to managedcare contract negotiations. If we do get our act together and do function as a group, we'd be a significant presence in this community and we'd be in a position to provide a conduit through which volunteer faculty could also benefit from these contracting relationships. In fact, right now we have a committee of the Governing Board looking at how we might integrate volunteer faculty who wish to be integrated into the system so that they can derive additional benefit from a relationship with the university. As another example, fulltime university faculty can generally obtain malpractice insurance at a much better rate than can the volunteer faculty. This is an advantage that might also be shared. Representatives from the Office of Medicol Educotion meeting recently with Dean Wright include (/eft to right) Fronk Schimpfhouser, PhD, Dennis Nadler, MD, ond Thomas GuHuso, MD. certain respects, RAM is more a shifting of resources than a source of much new money. For example, if our productivity goes up in a certain area and another school's productivity falls , the resources from that declining institution will be transferred to us, and vice versa. If everybody's productivity goes up in a certain area, there might be little shift in funds-or new funding. There' s been some discussion about university-based physicians establishing clinics in the community. Is this being considered and, if so, how do you see this affecting the "towngown " relationship? Part of the concern about the campusbased University Physicians Offices [UPO), of course, revolved around the so-called "towngown" relationship. In some ways, the very existence of physician offices on campus bordered on a tightly held secret; these were not advertised and there was no large signage on campus, presumably to avoid some of the inevitable town-gown issues. But these are issues that are not going to go away; they're part of the territory for our medical school, and for most other medical schools. What we would like to do, however-and I think this is possible-is to collaborate with volunteer faculty in a community effort to better distribute our geographic fulltime faculty. These faculty might have office hours at practice sites that aren't owned by the university, perhaps in rented space where they could make themselves available to patients and to those volunteer faculty members involved in our teaching mission. I feel that this could be a win-win situation for both the university and the town and an arrangement that could mute some of the town-gown tensions. After all, we are a community medical school. We need volunteer faculty 0 B u f f a l How would the university benefit from being in the community? We need to have a more decentralized educational system. The number of hospital beds is shrinking and the push, particularly in primary care, is to have students educated where primary care takes place-and o P hysician w I n I e r l 9 9 9 �5 T E A D Y LEADERSHIP I N CHANGING T I M E 5 Medical informatics is also an important part of modern curriculum development. We have an outstanding new computer lab available to our students, and we need to ensure that they have "free time" available to use it. Currently, we are charging a task force to look at the curriculum for all four years, but with a "deliverable" part that can be implemented next fall . Stan Spurgeon, a faculty member in the Department of Emergency Medicine with a strong commitment to education, is chairing that committee. that isn't in a hospital intensive care unit. We're shifting from a paradigm in which virtually all medical education took place in a hospital environment, which is a very artificial environment for primary care, to a more balanced situation where a good deal of education occurs in the office practice. So there is definitely an advantage for us to have our geographic full-time faculty distributed in the community, with closer working relationships with volunteer faculty. What is the status of the medical school's curriculum? Can faculty and students anticipate changes? Yes, they can. We have a fairly traditional curriculum in this medical school. Recently, we've added some innovations, such as problem-based learning [PBL]-the current rage in medical schools-but our core remains traditional. A number of schools around the country have revised their curriculum to introduce PBL either in toto or in part. We're pretty well convinced that there are some very significant merits to both the PBL approach and the traditional approach, so we're striving to develop a hybrid. A major problem is that by introducing PBL into the first and second years, we now have a very crowded curriculum. This is particularly true for first-year students, who are in class more than they should be. So we need to have a more coordinated/integrated curriculum. Dr. and Mrs. Robert Smolinski, MD, clinical assistant professor of orthopaedics and medical director of UB' Sports Medicine Institute, enjoy an informal moment with Dean Wright. BIOGRAPHICAL BACKGROUND ------ ~----- Monitobo, Conodo, John R. Wright received his medical degree from the University of Monitobo in 1959. He then served his internship ond o resident yeor in internal medicine ot Winnipeg General Hospital ond in pathology of Baltimore City Hospitals. In 1964, he completed his residency in pathology of the Buffalo General Hospital (BGH). Wright olso wos oNotionollnstitutes of Health fellow in endocrinology ot BGH ond in 1965 received o two-yeor Buswell Fellowship, which he spent teaching ond conducting research. From 1967 to 197 4, Wright served os on ossistont professor of pathology ond oncology ot the Johns Hopkins School of Medicine. In 1974, he returned to UB to choir its Deportment of Pathology, o position B u f f a l o Physician w I n he held until being nomed interim deon ot UB in Jonuory 1997. During his 23-yeor tenure os choir of pathology, he olso headed the Deportment of Pathology of BGH. Wright hos olso enjoyed o long offiliotion with Roswell Pork Cancer Institute. From July 1985 through October 1986, he served os interim director of the institute; he wos olso o member ond long-time choir of its boord of visitors until it disbanded in1997. Todoy, he remains on the boord of the Roswell Pork Cancer Institute Alliance Foundation. Notionally, Wright is immediate post-president of the Association of Pathology Choirs ond o former member of the Notional Caucus of Bosic Biomedical Science Choirs ond of the administrative boord of the Council of Academic Societies of the American Association of Medico I Colleges. + t e r l 9 9 9 0 �5 T E A D Y CHANGING T I M E 5 James Plott White Society Executive Committee members hosting o congratulatory dinner. Lehto right ore Or. Charles ond Anne Tirone, Oeon Wright ond his wife, Oeonno. What are some of the attributes you would like to see in a physician who his or her medical education Obviously we would like to make certain that the individual becomes a competent physician with the knowledge base to enter into whatever postgraduate training program he or she chooses and the skills, or sense of curiosity, to continue as a lifetime learner. We would also like to train physicians who think beyond the pure science of medicine, who are imbued with the art of medicine and who view individuals as people first and patients with diseases second. I think our students tend to come to medical school very people oriented but somehow we manage to beat it out of them in the first two years, and maybe in the clinical environment, as well! We need to pay more attention to nurturing the attributes they come to us with and to see that these are not only preserved, but reinforced. whom I knew quite well, I recall that he was a pretty relaxed individual [laughs). There were few of the challenges then that face the deanship today: He was able to go on rounds with students and we would almost never talk about the economics of medicine or fiscal or legal oversight. Those weren't the sorts of things he had to contend with. On the other hand, medicine itself has advanced enormously, and we now enjoy the opportunity to teach students many more exciting things. In my view, one of the most frustrating parts of medicine today is the conflict between having the ability to successfully treat a great number of conditions, yet not having enough resources to provide these treatments to every citizen in need of them. As dean of a medical school, you must ask, How will we apportion these gifts, and how do we fit them into the fabric of our health-care environment and the bureaucracy within which our graduates will need to function? Such ethical considerations were not things that really concerned my dean. Much of this conversation has been about change. What is your overall impression of the health of UB' s medical school and its future? What are the most pressing challenges you face as dean, and do you feel this is a particularly diHicult time to lead a medical school? I'm an optimist. I think we're going to go through some difficult times, though. The construct of the practice plan in Absolutely! When I think about my own medical school days and my dean, a u f f o 1 o Phys ician w 1 n t e r 1 9 9 9 �S T E A 0 Y I LEADERSHIP CHANGING N T I M E S There's going to be a good deal of work ah ead, but we have the matrix here for success. First of all, we are the only medical school in the immediate region, which is not a situation shared by all medical schools. Also, we are a community-based medical school and I think the larger community- not just the hospitals but the business community, as well- recognizes the importance of the university and the medical school to Buffalo. And that's a pretty good asset to have when you're trying to resolve difficult and contentious issues. + this medical school never really fit the environment, and getting that corrected is going to be a challenge. But I believe it's a very do-able goal. The competition that is driving the hospitals to change their configurations is-from the standpoint of progressvery healthy but, on the other hand, we don't want to get caught in the middle of that competition. The medical school needs to pursue its own goals and objectives independently while being aware of and sensitive to the pressures being felt by our affiliated institutions. MICHAEL BERNARDINO , MD , DISCUSSES COPING 1111 CHAOTIC ENVIRONMENT GOALS FOR UB' S MEDICAL SCHOOL • R 0 0 UB'svice president for health affairs, presented areality check on the changes in store for the medical school and its teaching hospitals in the years ahead at the October 13, 1998, "UB at Sunrise" program. The inevitable pain that will accompany the changes, he assured the audience of 170, will be worth the eventual gain. "Ithink if we con get through the next two to three years, the people of this community will look bock at the changes and be very, very proud," Bernardino said. "If we can accomplish even half of our goals, we will hove significantly improved the quality of care in this community." Bernardino, whose topic was "How on Academic Health Center Copes in a Chaotic Environment," took office as vice president for health affairs on April1 , 1998. He come to UB from Atlanta, where he was director of managed core with the Emory University System of Health Care, Inc., and professor of radiology at Emory University School of Medicine. Bernardino said he has set out to achieve three goals lor the UB School of Medicine and Biomedical Sciences: (l) sort out the graduate medical education puzzle with affiliated hospitals to increase benefits to the public and improve residency programs; (2) increase development and research revenue; and (3) stabilize clinical revenue. UB and its teaching hospitals, he added, ore in the process of signing affiliation agreements, the heart of which pertain to residency traininggraduate medical education-and ownership of the reimbursements-from insurance providers that fund the training. As the provider of residents to hospitals and source of a major revenue stream, UB must play a larger role with the hospitals than in the post, Bernardino contended. "In the future, we need to be general partners, not a limited partner," he said. Bernardino predicted that some area hospitals will dose because Western New York has lor too many beds lor the population, and that the closings will hove a sizable economic effect. The imperative during these changes, he stressed, will be to maintain quality of core. L. B IC' 6 u f f a l o P hysici a n w I n "UB should serve as a conscience," he said. In terms of quality of care, he added, "UB physicians should strive to achieve maximal outcomes in 60 to 75 percent of patients, rather than the 50 percent national norm." In an effort to increase revenue from research and development sources, Bernardino said the UB School of Medicine and Biomedical Sciences in the future will locus its clinical and basic research on lour national centers of excellence.Two obvious areas, he said, are pediatrics and cancer; the remaining two are still open for discussion. Noting that stabilizing clinical revenue has been his major locus, Bernor· dina said that government intervention will be on ever-larger force as increasing numbers of patients ore covered by Medicare and Medicaid. Greater government involvement, he added, will bring closer scrutiny, in the form of audits of the medical school's practice plan. The practice plan is the mechanism by which university-affiliated physicians, under contract with the university, agree to return a certain portion of their clinical practice revenues to the university to support essential, but nonrevenue producing, aspects of the medical school, such as basic -science education. In the past, each clinical deportment maintained its own practice plan. "In this environment, we can't operate a practice plan in a decentralized manner with decentralized authority," Bernardino stated. Underscoring the need to introduce sound-business management, he added, "We need a corporate mentality rather than a cottage industry mentality. We must emphasize the group needs rather than individual needs." In the current chaotic health-core environment, Bernardino said, the medical school must constantly question conventional wisdom and determine its own path to a new level of stability and excellence. "I hove no question about our surviving," he said. "I hove no question about our thriving." BY t e r 1 9 9 9 LOIS BAKER - �Managing Mental Health with UB ALUM DEVELOPS LARGEST PR I VATE BEHAVIORAL HEALTH SERVICES COMPANY C r j OR R ONALD l. DOZORETZ, MD, CLASS OF IJ HAPPEN: ~ BECAME THE LARGEST I 1962, IT ALMOST DID 'T OT THE THRIVI G PSYCHIATRY PRACTICE HE FORMED, WHICH VIRGINIA, A D OT THE ME TAL HEALTH MA AGED-CARE COMPA Y HE FOUNDED, WHICH GREW I TO A MULTIMILLIO - DOLLAR ENTERPRISE ACROSS THE In fact, if it weren't for the timely intercession of a caring professor at the University at Buffalo's school of meaicine, Dozoretz might not even have had the privilege of becoming a physician. But that's leaping ahead. To fully appreciate Dozoretz's faltering start to a stellar career in health care, it's important to go back to the beginning, to a little fruit market in Buffalo's Riverside neighborhood. There, as a boy, he worked for his parents-his father, an immigrant from Russia, and his mother, a lifelong Buffalonian-from a very B u f f a 1 a Ph U !TED STATES. young age. Later, he helped out at the small supermarket his family opened off Sheridan Drive. Work was part of the Dozoretz way of life, and that ethic extended to education, as well. Throughout his elementary school years, Dozoretz attended parochial schools and did well; however, when he entered public school, he discovered he was a grade behind. Determined to catch up to his peers, he succeeded in graduating from Bennett High School in three years. He then pursued studies in biology at the Uni- ysician w 1 n t e r 1 9 9 9 �versity at Buffalo, earning his bachelor's degree in 1958. "For kids of that generation who were smart and really fortunate, medical school was the best opportunity," Dozoretz recalls today. "There was dentistry and pharmacy, too, or maybe even law school," he adds, "but nobody talked about going into business. It just wasn't a consideration in those days the way it is now." -lJ ozoretz chose medicine. At about the same time he entered UB's medical school, however, he also chose to get married to Marilyn Bass, and the combined stresses of adjusting to married life and absorbing the enormous amount of material presented to first-year students almost proved too much for him to handle. "With school and marriage, I got stressed out and started falling behind," he says. Finally, at the end of that academic year, three professors-Mouchly Small, Harold Brody and 0. P. Jones- called him in and had a candid talk with him: He would have to get his life in order, they told him, and repeat his first year of studies. "It was a great gift. They could have thrown me out in a second," Dozoretz remembers. "But Dr. Small felt that I was very bright and able to handle the work, so he gave me another chance. As it turned out, I went on to finish, and I think I came out pretty high up in my class. This clearly had a major impact on my life-one that I still remember. " The medical degree Dozoretz earned at UB opened the door to a remarkable transformation from doctor to businessman. First came the clinical studies he conducted with Dr. Julian Ambrose at what was then Roswell Park Memorial Institute in Buffalo. Dozoretz had developed a strong interest in hematology, and at Roswell Park he studied clotting disorders, work that won him a rotating internship at Case Western Reserve University in Cleveland. It was there that he discovered what would become his lifelong calling-psychiatry. B u f f a l o . c c < z m 0 m Ronald I. Dozoretz, MD '62, is chief executive officer, chair and founder of FHC Health Systems. "I loved the medical part of it," he says, "and I felt that with psychiatry I was able to do the medical things that I was interested in, particularly neurology. And the people in the department Physician there were very, very capable. So I switched specialties." After three years as a psychiatric resident at Case Western, Dozoretz served two years as a lieutenant com- DESPITE THE CONTINUING SUCCESS OF FHC HEALTH SYSTEMS, OOZORETZ STILL MANAGES TO FIND TIME TO TURN HIS ATTENTION TO CHARITABLE AND PUBLIC-SERVICE CAUSES . HE'S ESPECIALLY PROUD OF A PROGRAM FOR MINORITY STUDENTS HE HELPED DEVELOP AT NORFOLK STATE UNIVERSITY. W I n t e r 1 9 9 9 �In 1982, he sold the company and began creating what has since become a sprawling, full-service behavioral health-care and managed-care company, FHC Health Systems, headquartered in orfolk, Virginia. Today, FHC-which Dozoretz heads as CEO and chair-is the largest privately held company providing behavioral health services throughout the United States and Canada. With the completion of a recent acquisition , it's also the secondlargest mental health managed-care company in the nation. Injune 1998 the company acquired Value Behavioral Health Inc. and created ValueOptions Inc., which covers more than 20 million people through contracts with over 900 customers and a network of 60,000 providers nationwide. ValueOptions, which operates as a subsidiary of FHC Health Systems, manages behavioral and psychiatric land United States, but to Puerto Rico and the U.S. Virgin Islands, as well. FirstLab is the company's international drug and alcohol testing division, serving corporate clients , state and municipal governments, and even several professional sports teams. RX Innovations is a pharmacy benefits management company with a focus on behavioral health drug management. With the creation of ValueOptions, FHC now employs about 6,000 people. The company's growth record is a source of great satisfaction for Dozoretz, but he prefers to emphasize FHC's goal of becoming better , not necessarily bigger. It's this ongoing emphasis on costr~ omething else he "had" at that effective, quality care that has helped time was the realization that FHC to form alliances with the Univerhis small practice in Portssity of Virginia and the johns Hopkins " Jmouth was hamstrung by a University to conduct outcomes research ........,/ lack of proper facilities for for treatment of psychiatric illnesses. his patients. "We basically had a few "For the past 50 or 60 years, mental health care has been rooms in the basement of one of the provided virtually FOR MANY, THAT WOULD HAVE BEEN THE HAPPY DENOUEMENT hospitals ," he rewithout data ," calls. "There was Dozoretz notes. "It TO A LONG-SOUGHT-AFTER GOAL, BUT FOR DOZORETZ, IT WAS no occupational was conducted in this ONLY THE BEGINNING . THE ROAD LAY AHEAD, AND IT WAS WIDE therapy , no recreoffice or that hospiational therapy, no tal, and maybe thereOPEN. "I'VE ALWAYS HAD AN ENTREPRENEURIAL SPIRIT IN ME. art therapy and no sults were published I JUST THINK YOU EITHER HAVE IT OR YOU DON'T. " group therapy room. in a journal article, It was very difficult but practitioners to treat patients. " rarely spoke with Dozoretz's solution was to broker a health care in two arenas: in the public each other. There was no one who would deal with the developer of a nearby sector, through the federal Medicaid compile the data to find out what really nursing home to establish a psychiatric program and with military contracts; worked in mental health care. unit in the building. The developer built and in the private sector, through indi"At FHC, we have a significant volit, then leased it back to him. From vidual contracts with dozens of compa- ume of data that allows us to define and there , Dozoretz expanded the practice nies , including some of the largest in determine what the best treatment plan to over 125 practitioners in more than the United States. is for certain types of ailments . With While ValueOptions is FHC's newest this data , we can help practitioners 10 offices throughout Virginia and became founder and medical director of initiative, the company's other subsidiar- know how to help patients to get better Portsmouth Psychiatric Center, one of ies have been just as ambitious and just as faster. We also have an extensive inforthe first private psychiatric hospitals in successful. Alternative Behavioral Ser- mation management service division ; vices manages a wide range of programs it forms the basis of what we do, beeastern Virginia. Seeing the potential for providing for troubled young people, including al- cause we pay claims to millions of psychiatric services and facilities , ternative schools, outpatient services, patients and take millions of phone Dozoretz then founded a company called home and community programs, group calls every day. " American Medical Centers Inc., and his homes , alternative living programs, teen By using its vast stores of data to career as a developer was born. "We "boot camps," secure facilities , residen- structure treatment plans that have built and developed more than 30 hos- tial centers and acute inpatient facilities. proven, measurable outcomes, FHC has pitals around the country," he says. Its reach extends not only to the main- been able to sustain its mission of pro- mander at the U.S. aval Hospital in Portsmouth, Virginia , where he treated inpatient and outpatient service members at the height of the Vietnam War. "We had two kids , a rented house and a lot of debt, " he remembers. But he and his family loved Portsmouth, so when his time in the service ended, he established a practice there. For many, that would have been the happy denouement to a long-soughtafter goal, but for Dozoretz, it was only the beginning. The road lay ahead, and it was wide open. "I've always had an entrepreneurial spirit in me. I just think you either have it or you don't. " ® B u f f a L o Physician w I n t e r 1 9 9 9 �viding patient-centered care. "We focus on taking care of patients; this is the most important thing we do," Dozoretz stresses. "We don't look at it as a business as much as a service. We're trying to help people to get better care in a more organized, cost-effective way. "Mental health services today are much more acceptable than they ever were before," he continues. "If a person needs help, or his or her daughter, son, aunt or uncle need it, I think they're very comfortable asking for it. And the new medications, such as Prozac and Clozeril, are extremely effective. They have changed lives and the way mental health care is provided. People spend less time in hospitals now." Despite the continuing success ofFHC Health Systems, Dozoretz still manages to find time to turn his attention to charitable and public-service causes. He's especially proud of a program for minority students that he helped develop at or- folk State University. His theory, he says, is that many minority students are highly capable of succeeding in the sciences at the college level, but they may be put off by the prospect of entering a big college. At orfolk State, for about a dozen years now, the Dozoretz ationallnstitute for Minorities inAppliedSciences has helped support 20 minority students each academic year. "We've graduated many hundreds," hesayswith pride. "About half go into medicine and dentistry, half into other sciences. " Dozoretz also has instituted a mentoring program throughout FHC, in which students at the company's various offices learn about the healthcare business and receive support and encouragement from company employees. The program was featured in President Clinton's recent summit in Philadelphia, with General Colin Powell promoting volunteerism in American life. $1 399 Enterprise Series 300MHz Pentium II• Processor • 64MB 10 NS SDRAM • 6.0 GB Ultra IDE Hard Drive • Iomega Zip Drive atap1 • 17" .27NI SVGA Digital Color Monitor • 8MB AGP Graphic Accelerator • 56K V.90 PCI Fax/Modem • 36x IDE CD-ROM B u f f a I o Physic Dozoretz's public involvement also has included serving on the White House Health Reform Task Force, as vice chair of the Reduction of Bureaucracy Group. He also serves on the board of trustees of the Kennedy Center and is a board member of the National Health Policy Council, where he is active in the restructuring of the nation's health-care policies. Dozoretz's home life is full of hopes and plans for the future, as well. He and his wife, Beth, have two small children: four-year-old Josh, and their newly adopted daughter, Melanne Rose. His two daughters-Shari and Reneefrom his previous marriage both live close by. Acquisitions, outcomes, policies, panels and philanthropy: It all seems like a long way from the family fruit market on the West Side of Buffalo. But Dozoretz still remembers that it almost didn't happen-except for a second chance that turned out to be a first-rate decision. + Complete systems, components, and peripherals, PLUS friendly service and support. All right around the corner! • Sound Blaster 128 PCI Stereo Sound Card • Sound1mage Subwoofer System • 3.5" High Density Floppy Drive • Microsoft Windows• 98 • Corel• Wordperfect Suite 8 (includes; Wordperfect 8•, Quattro Pro 8•, Presentations 8· ) • Zodiac 1000 CD Bundle 1·716 ·'743 ·0195 TECHNOLOGY DI S TRIBUTION NETWORK www.tdn.net 1000 Young Street . Suite 270 . Tonawanda NY 14150 . Fax: (716) 743 .0198 Ia W I n t e r 1 9 9 9 �r \ 11 c~r c. (_ was the focus of the 30th annual Cori Lecture presented at Roswell Park Cancer Institute (RPCI) on0ctober20, 1998, by Harold Varmus, MD, director of the National Institutes of Health. This year's lecture was held in conjunction with an ongoing series of symposia and special events at RPCI in celebration of the institute's lOOth anniversary (see article on pages 18- 19). In discussing the future of cancer care, Varmus predicted that "it's quite likely we will learn HE QCEST FOR! D \ D' AI I T"\ I to tailor cancer therapies to the lesions at the genetic level. Our immediate future will be to create treatments that target the cellular level of cancer and are widely available to all cancer patients." He then talked specifically about research he is currently conducting on gliomas, one of the most common forms of cancer of the central nervous system. seen in patients with the most aggressive form of the cancer. "In the initial study Varmus, who shared the we found that introduc1989 Nobel Prize in ing mutant bFGF inPhysiology and Medicine duced proliferation and with Dr. Michael Bishop migration of glial cells for demonstrating that without the induction of oncogenes can arise from tumors. So, we went back normal cellular genes, exto the beginning and inplained that glioblastoma troduced mutant VEGF. multiforme is of particular ::r Subsequent analysis of interest to him today. This the brain tissue found a poorly differentiated, rapglioma forming in the idly growing tumor is one brain," Varmus said. that occurs most often in The mice with glioNIH DIRECTOR SPEAKS AT adults and was the cause of mas developed hydroROSWELL PARK IN CELEBRATION death for a colleague of his. cephalus ; this proOF INSTITU T E ' S 1 00T H "It has been shown that nounced swelling of the 15 to 20 percent of paANNIV E RSARY head will help identify tients with gliomas reanimals with successful spond to the conventional tumor development. A combination treatment of magnetic resonance imBY CATHERINE DONNELLY surgery, radiotherapy and age (MRI) of the mice chemotherapy. It is not with hydrocephalus clear, however, why some patients respond and the rest also detected the tumor. These clinical observations will do not. We decided to seek the combination of genes allow animals suspected of having a glioma to mature, that control the mutations seen in these cancer pawhich in turn will enable researchers to study more tients," he explained. advanced tumor development. In order to study the gene mutations ofgliomas, Varmus's "Our studies matched some of the clinical progreslaboratory used an avian virus-based retroviral vector sion seen in human patients. It would appear that system to implant suspected genes into mice. Two genes in combinations of oncogenes are necessary to create the particular were studied: basic fibroblast growth factor migratory gliomas, but this is a good first step. We now (bFGF) and vascular endothelial growth factor (VEGF). can move toward the question of where to attack this More than 90 percent of glioma patients have an abnonnal disease and which genes consistently cause this canexpression of these genes, and they are predominantly cer," Varmus reported. Seeking Genes That Control Mutations B u f f a I a Physician w I n t e r I 9 9 9 �. . . LL . < Harold Varmus, MD, director of the Nationallnstitues of Health, at Roswell Park Cancer Institute. Future studies in oncology will not only continue to expand the list of genetic determinants of cancer but also explain the function of these oncogenes and their roles in the process of tumor development. In tum, physicians will be able to identify the gene causing a tumor and treat it appropriately, according to Varmus. "We will continue to build models of human cancer in animals and determine the genetic changes that cause tumors. It is reasonable to expect that we will learn the pattern of mutations and gene expression in cancer and create remedies to cure those tumors," he predicted. For the majority of their careers, Carl and Gerty Cori collaborated on the chemistry of the glycogen-glucose cycle, work that earned them the 1947 Nobel Prize in Physiology and Medicine, which they shared with Dr. Bernardo Houssay of Argentina. With this honor, Dr. Gerty Cori became the first American woman and the third woman in the world to be awarded the Nobel Prize. "The work that Carl and Gerty Cori performed resonates in the scientific community today," Varmus stated. "They helped us to understand sugar metabolism and its effect on tumor development, as well as to elucidate the mystery of diabetes. But, a greater message from their lives is the need to encourage women in the field and the incredible results obtained from collaborative efforts. " Varmus also pointed to an ongoing conflict in the scientific community between clinical researchers who need and want to work together on a project and the tendency in the field to reward independent efforts. "Teamwork," he emphasized, "is the way we need to go." + The Cort Legacy of Collaboration In addition to discussing cancer research, Varmus also stressed the need for collaboration in the scientific field and recognized the exemplary work of Drs. Carl and Gerty Cori, who held positions at Roswell Park Cancer Institute from 1922 to 1933 and for whom the Cori Lecture is named. B u f f a l o Ph ysici an w I n t e r 1 9 9 9 �BY CATHERINE • DONNELLY .. University of Buffalo, so a new building was constructed through fund-raising efforts and the generosity of Mrs. William Gratwick. In 1901 the Gratwick Research laboratory of the University of Buffalo was opened. In 1904, Harvey Gaylord, MD, was named the second director of the institute when Dr. Park stepped down. As part of this transition, Drs. Park and Gaylord determined that the laboratory should be owned and managed by New York State, rather than jointly by the state and the university, as had been the case since its founding. "The laboratory was maintained by an annual grant from New York State, but the state owned neither the land nor the building-these were owned by the University of Buffalo. Dr. Park, Dr. Gaylord and other influential administrators persuaded everyone involved to transform Gratwick Research Laboratory into a state institute," explains Mirand. The legislation to transfer the facility was signed on May 10, 1911. The University of Buffalo's Council subsequently passed a resolution, signed by 14 of its 22 members, agreeing to transfer the Gratwick Research laboratory to the people of ew York State on February 29, 1912. The university received no compensation for the transfer, and the laboratory was renamed the ew York State Institute for the Study of Malignant Diseases. The next step in the evolution of the institute came on March 7, 1912, when a grant of land and monies was provided for construction of a hospital on High and Oak Streets, near the current site of Roswell Park Cancer Institute. "The time has come when the State Cancer laboratory should have hospital facilities for research purposes. All the great modern institutions of medical research are so equipped," stated Gaylord, referring to the fact that the institute had been using the Buffalo General Hospital for its patient care. In 1913, construction was com- world's first institute dedicated to cancer research, is celebrating its lOOth anniversary this year. Since its establishment in 1898 by Dr. Roswell Park, RPCI has maintained a close relationship with the University at Buffalo, which played an integral role in its early development. Park, a world-renowned surgeon, had the prescience to realize that cancer would become one of the most common diseases to plague mankind. To confront this challenge, he proposed the concept of a multidisciplinary institution that would include research, treatment, follow-up care and education. Soon thereafter, he went in search of funds to launch his institute, which was destined to become a prototype for today's comprehensive cancer center. With the help of Buffalo Evening News editor Edward H. Butler Sr., Park began by requesting a $10,000 grant from the New York State legislature. "Dr. Park pioneered the modernday structure of government funding. He believed that New York State should fund biomedical research and cancer investigations, in particular, although monies for biomedical research had never before been received from a government source," explains Edwin A. Mirand, PhD, DSc, emeritus vice president for educational affairs at Roswell Park Cancer Institute and author of The Legacy and History of Roswell Park Cancer Institute. It took two attempts and an election year to pressure Governor Frank S. Black to finally approve the funding from the legislature on April 29, 1898. The facility, which opened shortly thereafter, was named the New York State Pathological laboratory of the University ofBuffalo and was housed on a floor of the University ofBuffalo, then located at High and Elm Streets. Its mission, as stated at the time, was to focus on "defining cancer, its causes and cures." Two years after the laboratory was founded, it outgrew its floor at the B u f f a I o Phys i cian W I n t e r 1 9 9 9 �...... --~ the New York Pathological Laboratory of the University of Buffalo was founded. Its first home wos on the first floor of the university, then located at High and Elm Streets (/eft).ln 1901, a separate facility wos built and named the Gratwick Research Laboratory (below). In 1946, the laboratory was renamed in honor of Dr. Pork. passage of the National Cancer Act of 1971 by testifying at congressional hearings held at the institute to outline the need for significant and continued support of cancer research. Roswell Park Cancer Institute's relationship with the University of Buffalo was strengthened again in 1955 under George Moore, MD , its fifth director, who believed that a comprehensive cancer center should be involved in education, particularly graduate education. Moore was joined in promoting this concept by UB president Clifford Furnas; john Payne, MD, professor of surgery; and Henry Woodburn, PhD, dean of the Graduate School, who helped to found the Roswell Park Graduate Division by charter in 1955. "ln addition, in 1983, RPCI and UB created the Graduate Medical Dental Education Consortium of Buffalo to jointly train residents and fellows interested in oncology. Originally, RPCI had established separate residency and fellow programs, but it later transferred the programs to the university to maintain their quality and consolidate appointments. To date, RPCI has helped to train more than 4,000 residents and fellows who now work throughout the world, and many of the oncologists in ew York learned from this partnership," says Mirand. ln May 1998, RPCI unveiled its new Diagnostic Treatment Center and Inpatient Tower. This facility is the cornerstone of the $241.5 million Major Modernization Project to renovate the institute's 25-acre campus and provide a foundation for state-of-the-art cancer treatment and research into the 21st century. pleted and Cary Pavilion, a 30-bed hospital, opened at the institute. Around the tum of the century, work at the NewYorkState Institute for the Study of Malignant Diseases was recognized worldwide and served as a model for cancer research and treatment across the globe. lts accomplishments influenced President William Taft, who visited the institute in 1910, to urge support of a federal cancer program; however, efforts to .. - establish a federal cancer program did not gain momentum again until President Franklin D. Roosevelt was in the White House. Roosevelt, who understood the goals and programs of the New York State Institute for the Study of Malignant Diseases from his years as New York State governor, signed the first National Cancer Act in 1937, which also established the ational Cancer Institute. Almost a decade later, in 1946, the ew York State Institute for the Study of Malignant Diseases was renamed Roswell Park Memoriallnstitute in honor of Dr. Park. (In the early 1990s, its name was again changed to Roswell Park Cancer Institute.) The institute's influence on national cancer legislation remained strong, and its leaders played an instrumental role in B u f f o l o Physic i an W I n t e r 1 9 9 9 �• · · ··········· · · · ··················· ...... .............. ...... . . . . . ... . .... . ...... . ... Initiative to Bring Health-Care Providers to Underserved Areas UB HEADS FEDERAL EFFORT I N NEW YORK 2 0 ew York State ranks sixth in the nation in the number of people living in areas with fewer than 150 residents per square mile. Unfortunately, only about one in 3,000 of those persons is a physician, and the ratio is worse in the state's inner cities. To help alleviate this shortage of health professionals in the state's underserved communities, the School ofMedicine and Biomedical Sciences at the University at Buffalo is teaming up with the State University of New York Health Science Center at Syracuse and other ew York professional schools. The effort is being aided by a three-year, $3 million grant from the U.S. Department of Health and Human Services that funds the first cycle of a 12-year program with a potential for $22 million in federal funding. With the UB medical school as lead institution, the grant will fund the start-up of an Area Health Education Center (AHEC) program in New York State. The ew York program is part of a nationwide effort launched in 1972, based on the 1970 Carnegie Commission's "Report on Higher • Education and the Nation's Health. " AHEC programs now operate in 41 states. (An earlier effort in ew York State failed due to lack of institutional support.) The goal of the initiative is to bring more health-care providers into the underserved areas by establishing clinical teaching l!Jl~·ml-mlrlJi·mJ•~ . • and practice sites in these outlying communities or B u f f o l o urban settings. Each AHEC site will be managed by a locally appointed director and advisory board and will be linked with a medical school. Through these sites, students from medicine, pharmacy, nursing, allied health, dentistry and social work will get firsthand experience living among and caring for patients in underserved areas. "We urbanize most of our medical students during their training," says Thomas C. Rosenthal, MD, professor and chair of UB's Department of Family Medicine, who will oversee the initiative. "The high-profile urban medical setting is whatyoungphysicians are comfortable with, so that is where they tend to practice. "They cluster in prosperous areas of cities and suburbs for personal reasons, also. Most want to raise families where they will have the greatest opportunities, so it is difficult to retain providers in underserved rural communities, in particular. It requires a person who understands and values rural America. The only way they will see themselves in those communities, is to be in those communities. " During the program's first three years , UB will set up a statewide administrative office in its Department of Family Medicine and help establish regional offices at the SUNY Health Sciences Center at Syracuse and Albany Medical College/State University of ew York at Albany School of Public Health. During subsequent funding cycles, center staff will help establish AHEC regional centers at SUNY at Stony Brook Health Sciences Center and SUNY Health Sciences Center at Brooklyn. Each regional center will be responsible for Physician w 1 n t e r l 9 9 9 \ �······ ·· · · ··· · ·········· ·· ······· · ······· · ··· · · · · · ·· ··· ·· · ··· · · · · · · · ·· · ········ ·· ··· · ··· 2 E , ~~ e I setting up two community-based AHEC sites in underserved areas by the end of the 12-year federal funding cycle. ew York State is required to begin funding the AHEC program in its sixth year and eventually to assume full financial responsibility. Diane G. Schwartz, director of special projects for the UB medical school, will be deputy director of the statewide program office. During the first year, the UB office will establish a communitybasedAHEC site in the 14-countyWestern New York region. According to Rosenthal , each community-based AHEC will function as an arm of a SU Y health sciences center, providing teleconferencing links back to the main campus, a setting for meetings with faculty members, and support services to students and residents living in the rural communities during their rotations. Site directors and community clinicians who will act as preceptors will be trained on-site by UB faculty . "The overall objective is to attract and keep more health-care workers in underserved areas, both by linking medical residents and third- and fourth-year medical students to these communities, and by helping local practitioners feel more connected to the SU Y medical schools," Schwartz says. + Consortium Effort Looks to Improve Family Practice he Department of Family Medicine in the University at Buffalo School of Medicine and Biomedical Sciences is part of a university consortium that has been awarded $900,000 over four years to participate in a new research initiative to change the way primarycare services are delivered and assessed. The grant from the American Academy of Family Physicians was awarded to the Center for the Value of Family Practice, which includes, in addition to UB, Case Western Reserve University in Cleveland, University ofN ebraska Medical Center in Omaha and Lehigh Valley Hospital in Allentown, Pennsylvania. The Center for the Value of Family Practice was one of three centers funded out of 65 applicants. The award is part of an $8 million effort undertaken by the academy to provide a new level of scientific evidence about the importance of an integrated, whole-health approach to the practice of family medicine. "Everyone knows intuitively that family medicine is highly health-effective and cost-effective," stated eil Brooks, MD , president of the academy , in announcing the initiative. "Countless stories from the 85,000 members of the academy confirm that. But a doctor's anecdotes are not enough. " This effort, he adds , will lay the groundwork for evidence-based , outcomes-oriented research in primary care. Carlosjaen, MD , associate professor of family medicine and director of UB's Center for Urban Research in Primary Care, is UB's codirector of the project. "This is very exciting for us ," he says. "The competition was quite stiff. This initiative will give us a chance to help make family practice better for all physicians and patients. " jaen and his fellow codirectors will develop a detailed map of the core structures and processes of family practice. Their center will address five priorities: • Managing chronic diseases within the context of each patient's needs and priorities; • Increasing the ability of family practice to serve as an outlet for applying new technologies; • Integrating mental-health care into comprehensive medical care; • Developing practice-tailored systems to deliver preventive service; • Increasing the community focus of family practice. + Perez Selected to Serve as Liaison to AAFP each medical school in the United States to serve as student membership liaison for his or her campus. The AAFP, a national medical organization for the specialty of family practice, represents 85,000 family physicians, family-practice residents and medical students nationwide. renda L. Perez of Buffalo, a second-year student in the University at Buffalo School of Medicine and Biomedical Sciences, has been selected to serve as student membership liaison for the American Academy of Family Physicians (AAFP) for the 199899 academic year. As the AAFP's official UB representative, Perez is responsible for working directly with other medical students who have an interest in family practice, as well as promoting the specialty of family practice to fellow students. Each year the AAFP selects one student from \ I B u f f c I o Physician W I n t e r 1 9 9 9 I -LOIS B AKER �a · · ······················································································ Physician Preceptors Appreciated SUMMER 1998 PRIMARY CARE EXTERNSHIP PROGRAM is an innovative program that provides real-life clinical learning opportunities for students at the University at Buffalo School of Medicine and Biomedical Sciences who are interested in pursuing careers in primary care. Started in 1993 by the Primary Care Resource Center, the externship is now administered through the Office of Graduate Medical Education. The program is recognized as the largest of its kind in the nation by the American Medical Student Association's Generalist Physician in Training Initiative. The paid six-week externship, completed during the summer months, exposes both first- and second-year medical students to the true continuity of primary care. Placements are arranged in the offices of generalist physicians throughout the Western ewYork area. Students enjoy varying degrees of interaction with patients, including taking histories and performing physicals, while becoming part of the daily operation of an office. In 1998, newly defined goals and objectives, along with more detailed and frequent assessment of the program at various stages, have helped to strengthen the program by providing a consistent set of expectations for everyone involved. The School of Medicine and Biomedical Sciences wishes to extend its thanks to the following physicians who served as preceptors for the Primary Care Externship Program in 1998: STUDENT PRECEPTOR(S) Dorothy Adler Sleven J. Ambrusko Jeffrey L. Amodeo Lynn M. Barnhard David Holmes, MD Jock F. Coyne, MD Mark R. Klocke, MD Anthony Vetrano, MD, lynda S~dhom, MD, & Josey Welliver, MD Amy E. Braun Chelikani V. P. Varma, MD laura E. Cancilla Catherine O'Neil, MD, & Janet Sundquist, MD Anthony J. Caprio Richard Ruh, MD, & Mark Swetz, MD Shawn Cotton, MD Thomas V. Caprio leslie A. Chamberlain Herbert Joyce, MD J. Thomas Reagan, MD Jeffrey Chung Andrea Manyon, MD Kristin L. Clark Timothy F. Corvino Herbert Joyce, MD Jessica L. Dolewilz Charles Hershey, MD Raphael Wang, MD Sorabh Dhar Holly J. Drexler lorne Campbell, MD Ani J. Fleisig Donald Robinson, MD, & Emily Freidan, MD Jeremy J. Flood Brian Connolly, MD Madhuri Guntupalli Gregory Snyder, MD Brigid M. Hannohoe Jock P. Freer, MD Ann Marie Hedges Colleen Mattimore, MD, & Mary E. Schamann, MD Alissa J. Huston Chester Fox, MD Gregory A. Jobes David Milling, MD Christopher W. Kling William Kuehnling, MD ® STUDENT Family Medicine Pediatrics Pediatrics Morto C. Kalthoff Pediatrics Pediatrics Internal Medicine Family Medicine Family Medicine Independent Health Admin. Family Medicine Family Medicine Independent Health Admin. Internal Medicine Pediatrics Family Medicine Family Medicine Family Medicine Family Medicine Internal Medicine Pediatrics Family Medicine Internal Medicine Family Medicine a PRECEPTOR(S) SPECIALTY u f f a 1 o SPECIALTY Ashok Noik, MD, & Suwarna Naik, MD Internal Medicine Pat Collins, MD Family Medicine Eileen W. Lou Jennifer I. Lee Peter Kowalski, MD Family Medicine Peter Winkelstein, MD Sabina lim Pediatrics John Thompson, MD Family Medicine Andrew G. Moyer leah S. Millstein Howard Sperry, MD, MPH, FACP Internal Medicine lorne Campbell, MD Family Medicine Dhruli Naik Nicholas Aquino, MD Debra M. Ogie Medicine/Pediatrics Bernadette J. Pasamba Geraldine Kelley, MD Internal Medicine Peter Kowalski, MD Family Medicine Jesenia Pena Herbert Joyce, MD Independent Health Admin. Brenda L. Perez Elysso R. Peters Ashok Naik, MD, & Suwarna Naik, MD Internal Medicine Gaurong Sheth, MD Joey G. Philip Pediatrics John Brewer, MD Everett F. Porter Family Medicine Gretchen A. Schueckler Jane M. Parmington, MD Pediatrics Davindra Seelagan Thomas S. Scanlan, MD Internal Medicine Tracey C. Shanahan Fronk C. Mezzadri, MD Medicine/Pediatrics Neha N. Sheth Theodore Putnam, MD Pediatrics Kristen A. Smizzi Harry Metcalf, MD Family Medicine Britto M.Svoren John Fudyma, MD Internal Medicine Rommel M.Tolentino G. lawrence McNally, MD Pediatrics Judith A. Toski Herbert Joyce, MD Independent Health Admin. Rosolic Viterbo G. Jay Bishop, MD, FACP, & Anthony 0. Bartholomew, MD Internal Medicine Debra L. Wojtonik Russell Voughon, MD Pediatrics Nora L. Yip Geraldine Kelley, MD Internal Medicine Phys ician w I n t e r 1 9 9 9 �··· ·· · · ·········· · ············· · · · · · ··· ·· ········· ····· · · ·········· · ············· · ··· · · a THROUGH TH E Em oF A STU DE NT . . . "This past summer, as part of my Primary Care Externship, I spent six weeks at a practice, during which time I not only witnessed the bond between my preceptor and his patients, but also formed my own relationships with patients. I learned that sometimes when medicine can't cure things, an understanding and supportive ear can! This was the most exciting time in my medical school career. I experienced many things and was filled with many confusing emotions: happiness and sadness, insecurity and confidence, anger and serenity. This summer I learned what medicine is all about. " Class of 2000 - D oRoTHY A DLER , - P RECEPTOR , D AVID HOLMES , M D Bailey Family Health Center CO NTINU ED SUPPORT NEEDED The Primary Care Externship Program is currently supported by a number of sources, including the Culpeper Foundation, Independent Health Foundation, Lake Plains Community Care etwork, Buffalo General Foundation, and CGF Hospital in jamestown. In order for this unique program to continue, it needs the support of the Buffalo community. A special endowment fund has been established by Evan Calkins, MD , to develop a more consistent funding source for the program in an age of decreasing capital. An accomplished physician and leader in the medical community, with a lifelong commitment to primary-care medicine, Calkins began the fund to encourage young people to explore and pursue the generalist careers. For more information about the Primary Care Extemship Program or giving opportunities, call Susan Orrange at (716) 829-2802; or E-mail her at sorrange@buffalo.edu. B u f f a l a Rural Communities Gain Internet Access to Health Information he University at Buffalo Health Sciences Library has received a $50 ,000 information-access project grant from the ational Institutes of Health and other federal funding agencies. It will be used to help more than 700 publichealth professionals in rural upstate communities connect with the Internet and acquire access to a broad range of health information now available online through the National Library of Medicine ( LM) and its affiliated medical libraries. The UB project will serve the 17 counties of Western and Central New York, their county health departments and the regional office of the state Department of Health. The grant was awarded through a program called "Partners in Information Access" funded by the LM and its National Network of Libraries of Medicine, of which the UB Health Sciences Library is a member. Other funding agencies are the Centers for Disease Control and Prevention, the Health Resources and Services Administration, and the Association of State and Territorial Health Officials. Sharon A. Gray , UB project director, senior assistant librarian and head of reference and education services for the UB Health Sciences Library, says the Physician W I n t e r 1 9 9 9 program is designed to increase awareness of the services offered by the agencies involved. "UB librarians," she says, "will use their expertise to organize Internet resources on public health and to teach health department staff to search these sources effectively. " Gray says the UB project has targeted more than 700 public-health professionals for training through workshops. Also, a Web site linking various information sites will be developed and county health department program managers , county health commissioners and the Western ewYork PubHealth Coalition will collaborate on the • project. L M z director • Donald ~ A. B. Lindberg says the projects funded will make it possible for publichealth agencies to address a variety of community health problems and special populations. They then will be able to respond more effectively to disease outbreaks and environmental health risks that affect the health and well-being of entire communities, he says. The UB project was designed by Gray; Maurizio Trevisan, MD , professor and chair of the UB Department of Social and Preventive Medicine; Robert O'Shea, PhD, emeritus professor of social and preventive medicine; and two of the department's adjunct professors, Erie County Health Commissioner Arnold Lubin and jacques Berlin of the state health department. - P ATRICIA DONOVAN ® �. . . . . . . . . . . .. . . .. . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . . . [1] ~ ~ I Honors Brunch Recognizes Firstand Second-Year Achievements h s B recognizing academic excellence among first- and second-year students was held at the University at Buffalo School of Medicine and Biomedical Sciences on October 11, 1998, in Harriman Hall. The following is a list of award recipients and a description of the awards received: received the Department of Physiology and Biophysics' Donald W. Rennie Physiology Prize, which is given to the student with the highest combined average in the two first-year physiology courses. JAY MORROW DEPARTMENTAL AWAR DS he departments of the School of Medicine and Biomedical Sciences have establish ed awards to recognize meritorious performance in their courses as well as outstanding achievement in other curriculum-related activities. BR'TTA M SVOREN received the Department ofPathology's Komel Terplan Award, presented to the student with the highest combined average in the twosecond-yearpathologycourses. Svorenalso received the Department of Pharmacology and Toxicology's Douglas S. Riggs Award, presented to the secondyear student with the highest average in the Fundamentals ofPharmacology course. received the Department of Pathology's American Society of Clinical Pathologists Award for Academic Excellence, which is presented to the second-year student who has demonstrated high academic achievement and outstanding performance in the pathology laboratory. ALTER WALEK M HORB NSKI received the Department of Pharmacology and Toxicology's Edward A. Carr, Jr., Clinical Pharmacology Award, which is presented to the MD/PhD student who achieves the highest average in the Fundamentals of Pharmacology course. CRAG THOMAS M KEENAN received the Department of Anatomy and Cell Biology's James A. Gibson, Wayne ]. Atwell and Oliver P. Jones Award, which recognizes the student with the highest combined average in the anatomical sciences courses of gross anatomy, histology, neuroanatomy and embryology. CHRISTOPHER ADAMS received the Department of Biochemistry's Edward L. Curvish Award, which recognizes the student with the highest average in the two first -year biochemistry courses. ® HOPE E CAWDERY received the Department of Microbiology's Ernest Witebsky Award for Proficiency in Microbiology, which is presented to the second-year student with the highest grade in the Microbiology and Immunology course. LIN received first prize for the Department of Pharmacology and Toxicology's Astra-Merck Cardiovascular Drug Monograph Awards, which are presented to the second-year students based on the quality of a monograph written in the form of a package insert. Lin also won first prize in the department's 1998 USP Patient Information Competition. JENN FER MELISSA WOLF received the Department of Microbiology's Marek Zaleski Award, which is presented to the student who best combines high standards of academic achievement with outstanding service to the community.Each year's recipient is chosen by members of the second-year class. B u f f a l o Physician w I n t e r 1 9 9 9 �··············· · ··········· · ·················· · ······· · · · ········ · ········ · ········· · · · · E . ~~· e ' ' received second prize for the Astra-Merck Cardiovascular Drug Monograph Award competition. AARON THO J. S GUYER \11 '<EE and received the McGrawHill book awards, which are presented each year to the two highestranking students in the first-year curriculum . SC received the Evan Calkins Primary Care Achievement Award, presented to an outstanding student in the Primary Care Summer Externship Program. s N A PENA received the etter Award, which is presented to a student fellow for outstanding performance in the Primary Care Summer Externship Program. Pena also received third prize for the Astra-Merck Cardiovascular Drug j Monograph Award comj petition, described above. J 1 f r 2000 Jennifer Lin Steven Lo Todd Loftus Michael Logue Beth Lucas Dionysio Momois Andrew Moyer Everett Porter David Rice Christopher Santangelo Tracey Shanahan Andrew Stone Moriso Stumpf Britto Svoren Cheryl Tourossi Felicia Tenedios Rommel Tolentino Amy Vandewater Eric Woffner Wolter Woleck Nora Yip Dorothy Adler Mothijs Brentjens Anthony Caprio Thomas Caprio Daniel Carl Hope Cowdery Leslie Chamberlain Julie Cheng James Chevalier Frederic Chi Joimie DeRosa Christopher DiMaio Kimberly Dumoff Sumo Gono Rose Graham Modhuri Guntupolli Alissa Huston Adriano Koczaroj HeyJoo Kong Brion Klogges Marta Kalthoff Sharmeelo Kuperon Justin Kwon Charles Lou Jennifer Lee ) 1 Christopher Adams John Borgoy Thomas Botto Amy Broun Keith Chon Damian Compo Ryan Den Haese Michael Duff·Roffoele Sosho Gilmore Aaron Guyer Ann Marie Hedges Steven Kom Thomas Keenan Christopher Kling Somi Lewin Kevin Mallen Joy Morrow Barbaro Odell Songito Patel Elysso Peters David Piccioni Kilian Salerno Dovindro Seelogon Robert Setlik Mudit Sharma Koreno Steiding Robin Yates Daniel Yoon Morino Zoydmon Klagges Completes Alpha Omega Alpha Student Research Fellowship :l. rion Klogges, Closs of 2000, was the recipient of on Alpha Omega Alpha Student Research Fellowship, which provided him with $3,000 in support of a research project he completed during the summer of 1998 in the laboratory of laura E.Nikloson, MD, PhD, on instructor of anesthesia at the Massachusetts Gen· era! Hospital in Boston, Massachusetts. Under Nikloson's direction, Klogges used a \"Ideo Motion Analysis System to assist in quantitating the static and dynamic compliance of culture tissue· engineered arterial grafts in vitro. He I 8 R 1 A N K L A G G E 5 e s ,f n n e p n 9 L A (pictured on page 24) GRET DEAN'S lETTERS OF COMMEND ATION he Dean's Letters of Commendation are awarded to students who achieve 75 percent of available honors points each year. Two honors points are earned for each credit hour of honors performance; one point is earned per credit for high satisfactory. B u f f a l o Physician W I n also participated in a preliminary study examining the effects of several pharmaceutical compounds on the functional characteristics of these engi· neered vessels. Klogges graduated cum laude from Providence College in Providence, Rhode Island, where he double majored in biology and psychology. Alter graduation, he worked in the laboratory of William Abbott, MD, chief of vascular surgery at Massachusetts General Hospital. Alpha Omega Alpha is the only notionalhonor medical society inthe world. Its purpose is to recognize undergraduate medical school achievement andto perpetuate excellence in the medical profession. t e r 1 9 9 9 �• ······ · ····· · ························· i, • Multifaceted Approach to Treatment of Addiction D I RECTOR OF NAT IONAL INSTITUTE ON DRUG AB U SE HO L DS TOWN HALL MEET I NG AT UB he ultimate cure for drug addic- he said , while tion will probably involve a com- also emphasizbination of biological, behavioral ing the need to and social considerations, Alan I. make sure these Leshner, PhD , director of the a- findings are distional Institute on Drug Abuse seminated both IDA), announced during a recent visit to the practice to the University at Buffalo. community and Leshner's UB visit was one of several to the general IDA town meetings conducted nation- public. wide during Red Ribbon Week in Contrary to October 1998 to create awareness what most peoabout the realities of drug abuse and ple believe, sciaddiction. ence "says" that In a talk titled "Drug Abuse and drug addiction is a preventable problem Addictions: Myth versus Reality, " and a treatable disease, he maintained. Leshner clarified common misconcep- "The success rates for drug abuse treattions about the nature of drug abuse and ment are comparable to the success rates addiction, focused on scientific advances for any other chronic relapsing illness that have altered researchlike diabetes , hyperteners' fundamental views of sion and cardiovascular the problem and anabnormalities. But we can nounced immediate steps do better. " the NIDA is taking to imLeshner also emphaprove treatment. sized the importance of Citing drug abuse and addiction as distinguishing between two distinct subamong the most complex phenomena groups of people who abuse drugs: facing today's society, Leshner acknowl- One group is made up of those who take edged a tremendous stigma attached to drugs to "feel good, " known as sensadrug addicts and drug addiction. A tion seekers; a second group is made up further hindrance to the search for work- of those who take drugs to "feel better," able treatment approaches, he added, or as a form of self-medication. Essenis the fact that so many misconceptions tially, both groups "like what drugs do abound. to their brains. Although, in the past, a "We have ideologies galore that exist problem has been that we lumped evabout the phenomenon; luckily, how- eryone together both in prevention and ever, we now also have scientific data. " in treatment. " Advances in science over the past 20 Leshner showed slides of functional years have revolutionized fundamental MRI scans depicting increased activity views about drug abuse and addiction, in the brain's reward circuit after drug ® B u f f a l a P use , noting that this area of the brain has traditionally been the focus of studies. Recently , however, researchers have begun to look at how drugs and drugassociated stimuli relate to a wide spectrum of brain functions , such as emotional memory, he reported. Drug addiction is fundamentally a brain disease: Drug use alters the brain state and, over time , actually causes brain changes that result in the compulsion addicts experience, Leshner said. "Compulsion, which is the essence of addiction, occurs because drug use over time changes the brain in ways that persist long after the individual stops using drugs. Treatment needs to attend to those brain changes, both pharmacologically and behaviorally. "Drug addiction is not just about moral weakness and failure , as many people want to believe," he continued. "The final common path for addiction is the brain, but when and how one becomes addicted depends on an intersection of elements, including genetics. " hysician w I n t e r 1 9 9 9 �······ · ···················· · ············· · ····· · ······· · ······· · ··········• ·· ~ t t "COMPULSION, WHICH IS THE ESSENCE OF ADDICTION, OCCURS BECAUSE DRUG USE OVER TIME CHANGES THE BRAIN IN WAYS THAT PERSIST LONG AFTER THE INDIVIDUAL STOPS USING DRUGS. TREATMENT NEEDS TO ATTEND TO THOSE BRAIN CHANGES, BOTH PHARMACOLOGICALLY AND BEHAVIORALLY." Leshner noted that the complexity of addiction is compounded by a chronic relapse rate caused by stress and exposure to drug-associated stimuli. "In the past few years, we have discovered that when an individual is merely exposed to such stimuli, the brain reacts the same way it does when the individual has taken drugs, which shows that addiction is a brain disease that has social and behavioral aspects embedded into it. "Like it or not, we need to acknowledge that when we are dealing with Harold Strauss Named Chair of Physiology and Biophysics arold C. Strauss, MD, former Edward S. Orgain Professor of Cardiology at Duke University Medical Center and a specialist in ion-channel function, has been named chair of the Department of Physiology and Biophysics in the University at Buffalo School of Medicine and Biomedical Sciences. Strauss held appointments in medicine and pharmacology at Duke, and for the past13 years served as director of its multidisciplinary Specialized Center of Research in Ischemic Hearl Disease/Congestive Heart Failure. He brings to UBan extensive research background in the electrophysiology of cardiac cells B u f f a I o addicted individuals, we are dealing with individuals in another brain state. lt was very difficult for people to grasp this 10 years ago, but we have finally come to understand that people are compelled to use drugs because they are in a different brain state, and treatment needs to attend to those brain changes. "The reason we have to care about the nature of the illness, which in this case is biobehavioral, is that it tells us about the nature of the treatment we have to use," he continued. "Treatments need to attend to the biology, the behavior and the social context simultaneously or they will not work as well. " Leshner announced that the NIDA has declared its next major nationwide initiative to be improvement of treatment. Toward this goal, the institute is developing a new ational Drug Treatment Clinical Trial Network to facilitate and is principal investigator on three major federal grants studying the structure and function of potassiumchannels in order to develop safer and more effective antiarrhythmic drugs. Anative of Canada, Strauss earned his medical degree from McGill University in Montreal in 1964 and completed an internship and junior residency at Montreal's Jewish General Hospital. From 1966 to 196B,he was a postdoctoral fellow in pharmacology at Columbia University's College of Physicians and Surgeons. He then completed a one-year residency in medicine at Bronx Municipal Hospital Center, Albert Einstein College of Medicine, and a two-year cardiology residency at New York's Presbyterian Hospital. In recognition of two decades of involvement with the American Heart Association, Strauss Physician W I n t e r I 9 9 9 the dissemination of treatment information. "We are going to use science to improve the quality of existing treatments and look for new treatments." The project will involve a network of interconnected sites around the country, he explained. The hub of each site will be a coordinating center, such as a university or hospital, and each coordinating .. center will be attached to 10 or 15 local < community-based treatment programs "' that will become partners in the research u to be carried out. The research will involve testing scientifically developed " treatments in real-life settings rather than in the laboratory. "People want a simple solution to drug abuse and addiction , but we will never have a handle on the problem until the solutions are as complex as the truly multifaceted problem that we are trying to address," Leshner concluded. + received its Award for Meritorious Achievement in 1996. He has served on various committees and boards of the National Heart, lung and Blood Institute of the National Institutes of Health. He isassociate editor of Circulation Research and is on the editorial board of the Journal of Cardiovascular Electrophysiology. As a researcher, he has published more than 100 articles in peerreviewed journals and authored numerous review articles and book chapters. Amemberoft he New York Academy ofSciences and a diplomate of the American Board of Internal Medicine, he is affiliated with several additional professional organizations. + -LOIS B AKER �rm················································································ · ······· g Sexual Identity Issues in aClinical Office Setting to this is if your life or someone else's life is in danger. Do you have any attraction to members of one~ own gender and is part of the questions?" Right there an atmosphere continuum of sexual expression. Many gay and lesbian youths of trust has been created and the message sent that the adolescent's rights first become aware of and experience their sexuality during will be respected. A similar statement, emphasizing confidentiality, can be adolescence. Therefore, pediatricians who care for teen-agers need to made to adults. How we ask the sexual history is understand the unique medical and psychological issues facing homoimportant. Everyone develops his or sexually oriented youths. her own style with which they are comfortable. The HEADSS model of -from the American Academy of Pediatrics' Policy Statement on interviewing adolescents involves discussing Home, Education, Activities, Homosexuality and Adolescence Drugs, Sex and Suicide. What we don't Most primary care specialties have a hear. We can foster this feeling by want to do is assume heterosexuality similar policy statement concerning ho- having materials in the waiting room: by our questions. To a male, we don't mosexuality. However, few physicians posters depicting same-sex couples want to ask, "Do you have a girlfriend? " feel they have been adequately trained to alongside heterosexual couples; books In doing so, we implicitly communideal with issues of sexual identity. To and pamphlets that discuss issues of cate that it isn't possible he's gay and this end, I presented a Grand Rounds at sexual orientation; or a rainbow sticker it's bad if he is. Consider trying this phrase instead: Children's Hospital ofBuffalo onjuly 24, on a window or wall (the rainbow is the gay pride symbol). "Some of my male patients your age find 1998, titled "Caring for These simple actions themselves attracted to men, some to Your Gay/Lesbian/ BY are profound gestures women, and some to both. How is it for Bisexual Patients and FRANK P . of affirmation for youth you?" This question resonates with paFamilies." Colleagues CARNEVALE. MD starved for images of tients on several levels. It affirms and have since told me of themselves and for normalizes their experience by stating their success in using the places they can turn to they are not alone. It presents their emergapproach I outlined at ing sexual identity in nonthreatening that time. This approach entails three for help. That's what they see. What they hear are the statements true-to-life terms-that they "find themsteps: Safety, Support and "Referral"three simple, brief, inexpensive, yet we make and the questions we ask, selves attracted." (For most people, inteenormously powerful, interventions for both of which speak volumes. For grating their sexual identity into their dealing with sexual identity issues in a example, if it's the first time I've met lives involves first noticing their feelings; the teenager, I like to preface my en- it's a discovery process.) Finally, the quesclinical office setting. tire interview with a statement about tion accepts all points on the Kinsey Scale confidentiality: "Now that you're an by not assuming any identity from the STEP 0 E: SAFET This is the first step for an important adolescent, I will treat you differently outset. And with that we've taken Step reason. It's the basis for creating an than the younger kids. I'll be asking One. We've created an atmosphere oftrust, atmosphere that is conducive to open you questions about many aspects of which opens the door to communication. discussion. Without a sense of safety, your life and it's important for you to none of the remaining steps will take realize that what you tell me is confi- STEP Two: SuPPORT place. Safety is simple to achieve. People dential. I won't talk about it with your What if the patient responds that he perceive a sense of safety from their brothers, sisters or parents, unless or she has feelings of attraction tosenses-what they see and what they you want me to. The only exception ward the same sex? Q,\IOSEXUALI TY IS TP-,:; PERSISTENT SEXuAL and emotional B u f f a l o Physic ian w I n t e r 1 9 9 9 �. . . . •. . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 'llt"!'' ll'!'ll"'i ii'P.II ~, ,.ft'J'I ~ I ll ill This leads us to Step Two of our three-step model: support. The elements of this step are listening, affirming, questioning further, correcting misinformation and assessing risk. In other words, all the normal things we would do with any other issue or concern. LI STEN ! G: This may be the first time they are talking about this. Let them tell you where they are. It's a significant moment in a person's life when he or she shares this with another. A FFI R M ! G: "Many people your age have this experience; it's okay." Q UESTION I NG FU RTHE R: "Tell me more about that." "What do you think?" "What types of sexual experiences have you had?" "Have you been with men, women or both?" C O RR ECTING MI SINFO R MATION: Patien t: "Well, I'm afraid this means I'm gay." Doctor: "What if you were?" Patien t: "No way, then I'd never have kids!" Doctor: "Some gay men and lesbians do have kids. Some choose not to." Patien t: "But if I'm gay I'll get AIDS." What a great chance to discuss STDs and pregnancy prevention. A SSESS ! G RI SK : We can address STD/HIV risk, substance abuse, suicide and physical abuse; B u f f a l o again, we can ask all the questions we would normally ask as part of the adolescent interview. STEP THREE: "REFERRAL" I put referral in quotes because by referral I mean connecting the patient to appropriate resources. Obviously, if appropriate, we can refer to a therapist, a psychiatrist or a substance abuse counselor. More commonly, "referral" involves providing pamphlets, booklets, books and phone numbers of supportive organizations. RESOURCES FOR PHYSICIANS' OFFICES A supportive group of volunteers from PFLAG (Parents Families and Friends of Lesbians and Gays) provided the Children's Hospital Grand Rounds audience with resource packets on this subject. The PFLAG team has sifted through the current literature and distilled, compiled and organized the information into a usable format. The packets can be provided to patients ancl!or their families if the family knows the person is homosexual. If you would be interested in receiving a copy of this packet for your office, simply mail a $3 check (to defray postage and handling costs) to PFLAG, Attention: Resource Folder, P.O. Box 861, Buffalo, Y 14225. + Physician w I n t e r I 9 9 9 f· · "!) Cu '' lc 'D '95 recently completed his pediatric residency at Children's Hospital of Buffalo and, in]anuary 1999, joined the University at Buffalo's Student Health Center. Dr. Carnevale wishes to thank the following individuals and organizations for their support and their roles in the Grand Rounds presentation: Elizabeth B. Conant, PhD, Camille Cox and Curt Gregg,from PFLAG; Mary Alice Boyd, MSW, from the Gay and Lesbian Youth Services (GLYS) of Buffalo; and the teens from GLYS who sat on a panel for the presentation. He would also like to thank Gerald Daigler, MD, from Children's Hospital of Buffalo; and Ross Hewitt, MD, who assisted in obtaining funds from Abbott Laboratories in support of producing the resource folder. 0 �The Evolving Ethics of Medicine JEROME KASSIRER , MD ' 57 , KEYNOTE SPEAKER FOR INSTITUTE OF HUMAN RELAT IONS AWARDS HE \1A. XFv1 "0. 'CE A BUFFALONIAJ'.., always a Buffalonian" was illustrated by the celebration surrounding the return of Buffalo native jerome P. Kassirer, MD, editor-in-chief of the New England]oumal of Medicine, who was in town October 26, 1998, to receive the Institute of Human Relations Award from the American jewish Committee of Western New York (AJC-WNY) . Kassirer, who earned his medical degree from the then- University ofBuffalo in 195 7, was honored for his promotion of medical professionalism, ethical scientific conduct, patient involvement in decision making and reliable approaches to assessment of quality health care. The AJC-WNY, in presenting Kassirer with the award, acknowledged his numerous editorials on these topics, as well as others on professionalism, appropriate use of firearms, the abuses of managed care, and political intrusions into medical decisions. In a keynote address, titled "The Evolving Ethics of Medicine," Kassirer lauded the AJC for battling intolerance for nearly a century and cited the murder of Dr. Barnett Slepian, Buffalo obstetrician/gynecologist and abortionist, as an example of how much farther the world has to go in order to truly be "united as one human race. " Aftpv ar11A Before an audience of more than 200, Kassirer then discussed a number of current controversies in the medical field and outlined their ethical implications. "This is the most tumultuous time in the history of medicine. Technology and scientific advances in providing medical care have overtaken society's willingness to pay for them. rr magna cum laude from the University of Buffalo School of Medicine in 1957, Jerome P. Kassirer trained in internal medicine at Buffalo General Hospital and in nephrology at the New England Medical Center in Boston. He joined the faculty of Tufts University School of Medicine in 1961 , was named professor of medicine in 197 4 and was the Sora Murray Jordon Professor of Medicine from 1987 to 1991 . From 1971 to 1991 he was associate physician-in-chief of the New England Medical Center and B u f f a l o Health-care reforms occur minute by minute. This is not the same field that I entered 40 years ago, but physicians can still influence the course of medicine and maintain quality," he stated. Kassirer is concerned with a marketdriven health-care system in which expansive health maintenance organizations (HMOs), powerful investorowned conglomerates and armies of health-care lawyers and consultants vie for available monetary resources. "We used to have a simpler one-patient and one-doctor system, but now the purchasing power of employers, and the HMO practice of treating populations rather than individuals, drives the industry. Physicians need to take control and get back to the practice of medicine," he emphasized. Currently, physicians are working longer hours and seeing more patients per hour to maintain their incomes, he contended. More and more time is spent processing paperwork, and stress is rampant. As HMOs become dominant in a community, physicians must join them in order to maintain their offices and keep seeing patients. "Capitated care has tempted some doctors to under-test and under-treat their patients and avoid the patients who are seriously ill. The industry today pits the ethical needs of patients against physician income and job security. Physicians can be torn between their patients and their families ," he said. vice choir of the Deportment of Medicine at Tufts.ln 1991 , he become the 38th editor-in-chief of the New England Journal of Medicine. Throughout his career, Kossirer has published numerous original research and clinical studies, textbook chapters and books on nephrology (acid-bose equilibrium, in particular), medical decision making and the diagnostic process. He was o founder and coeditor of Nephrology Forum in the journal Kidney International and of Clinical Problem Solving in Hospital Practice until1991 . Physician w i n t e r 1 9 9 9 �< Kassirer was elected to Alpha Omega Alpha (AOA) as astudent and was named the AOA Distinguished Clinical Teacher of the Year in 1989. He was named Distinguished Alumnus of 1991 by UB's School of Medicine and Biomedical Sciences and received the Distinguished Faculty Award from Tufts University School of Medicine. He has honorary degrees from the University of Massachusetts in Worcester, Thomas Jefferson University in Philadelphia, the SUNY Health Sciences Center in Syracuse, l'Universite Rene Descartes in Paris, Tufts University and the Medical College of Ohio. B u f f a I a Physician W I Kassirer served on the American College of Physicians' board of governors and board of regents and in 1997 received the college's John Phillips Award for his contributions to clinical medicine. He is past chair of the National library of Medicine's Board of Scientific Counselors and past chair of the American Board of Internal Medicine; he is also a member of the Association of American Physicians and the Institute of Medicine of the National Academy of Sciences. n t e r 1 9 9 9 �While admitting that his talk might be interpreted as painting a bleak future for the field, Kassirer counIn Kassirer's view, the greatest threat tered: "We should encourage our to the medical field is loss of integrity, children and our grandchildren to folwhich can be realized when physicians low in our footsteps and enter the under-treat their patients and decide medical field. After all, we are not that "it's for the best"; or, worse, use the selling fake jewelry, we are not makHMO to justify suboptimal care. ing weapons of mass "We have to rememdestruction. ber that the fee-for" THIS IS THE MOST TUMULTUOUS TIME IN THE HISTORY OF We are privileged service method was not MEDICINE . TECHNOLOGY AND SCIENTIFIC ADVANCES IN PROVIDto help people and perfect. The demands make a decent living of HMOs for prevenING MEDICAL CARE HAVE OVERTAKEN SOCIETY'S WILLINGNESS TO while we help them. " tive and cohesive care PAY FOR THEM . HEALTH-CARE REFORMS OCCUR MINUTE BY Crediting UB with have improved mediMINUTE. THIS IS NOT THE SAME FIELD THAT I ENTERED 40 YEARS giving him a superb cine. Managed care has medical education as AGO , BUT PHYSICIANS CAN STILL INFLUENCE THE COURSE OF also forced us to pay well as teaching him more attention to preMEDICINE AND MAINTAIN QUALITY ." how to write, Kassirer ventive medicine, to the closed by strongly enmanagement of chronic diseases, to the quality of care and the cost policies in their region and to deal with dorsing the concept of medical schools of care. I believe that we would not have ethical lapses when they arise. "We need teaching medical ethics as a means of made so much progress in these areas to maintain the public trust or we have helping future physicians learn how to without the prodding of managed care. " nothing. We must remain patient advo- better provide quality care in what is Kassirer outlined ways physicians can cates and fight for their rights and reject sure to be a challenging health-care preserve their integrity, suggesting that attempts to limit care," he emphasized. environment. + CONTINUED OTHER FROM 1998 PAGE RECIPIE 31 the first thing they should do is admit that money isn't everything. Also, they should remain true to themselves, and not bend to pressure from outside sources, including pharmaceutical companies and manufacturers of medical devices. Instead, local physicians should stand together to help create medical TS OF THE INSTITUTE OF HUMAN RELATIONS AWARD OF THE AMERICAN jEWISH Cow~11TTEE OF WESTERN NE\\ YoRK: I. PUTNAM , MD , EVAN CALKINS , MD , LINDA C. DUFFY , PHD , FREDERICK E . THEODORE professor emeritus of medicine and family medicine at the University at Buffalo School of Medicine and Biomedical Sciences; consultant in geriatrics programs, Health Care Plan; and partner, Promedicus Group, was honored for "his long and devoted leadership in medical education and outstanding contributions in the fields of geriatrics/gerontology, rheumatology and general medicine." associate professor of pediatrics at the University at Buffalo School of Medicine and Biomedical Sciences and executive director of the Women and Children's Health Research Foundation, was honored "for designing and developing the Doctor's Pediatric Immunization Program, and expandable Children's Hospital of Buffalo's Expert Software System that monitors and tracks childhood vaccinations." MUNSCHAUER Ill , MD , associate professor of clinical pediatrics at the University at Buffalo School of Medicine and Biomedical Sciences, director of Ambulatory Services and chief of the Division of General Pediatrics, Children's Hospital of Buffalo, was honored "for his tireless effort in the establishment of outreach pediatric centers that provide quality health care to needy children in their own communities." ® B u f f o l o associate professor of clinical neurology and internal medicine at the University at Buffalo School of Medicine and Biomedical Sciences, associate head of the Department of Neurology and head of the Vascular Disease Prevention Research Center, Buffalo General Health Systems, was honored "for his groundbreaking research in multiple sclerosis and the development of a simple selfexamination that can detect atrial fibrillation, a major risk factor for stroke." P hysician w I n t e r l 9 9 9 �BY J . LINDA CORDER . PHD , CFRE The Gift to Know Them Deeply bers, each of whom lighted a candle before I trouped over, with speaking. the Class of 2002 and a few assorted others, Some recited poetry-"Death be not proud ... " to Harriman Hall for a memorial service. I could not stop for death, Death kindly "Because That experience influenced me to change stopped for me ... "-old favorites that have focus, however briefly, from thoughts of helped many of us to accept the death of facilitating philanthropy to another type of someone close. Several gave examples of what gift, that of a person's body, given to facilitate the they learned-about cancer through a tumor education of future physicians. in a woman's lung; from finding an implanted I was struck, initially, with the diversity of pacemaker that had not been "enough" to our newest class-roughly half women and half keep the heart of a man, younger than his dad, men, a rainbow of skin tones , a rich texture of beating; viewing in awe the slack, translucent various ethnic backgrounds and, as I was to skin of a woman who reminded hear, a broad representation of one student of his granny. Anpersonal religious beliefs. Our The service was simple; those memorialized were known other student read a letter from a beautiful children of yesterday, person whose body became "a our healers and health-care givers not by name but by what they had taught. teacher" for a previous class. One of tomorrow ... entreated, "Don't think of this as The service was simple; those my deathbed; rather, think of it as a bed of life," followed by memorialized were known not by name but by what they what each organ might mean if donated, what nerves and other had taught. Though unknown while living, they were rectissues might teach to those with the patience to learn. Several ognized as true friends in their generosity of spirit and their talked about the relationship they experienced with their lasting impact on the lives of the students who had shared cadaver-what they learned always outweighing the frustra"the privilege to cut them and know them deeply .., of not knowing details that will forever remain hidden. tions One of the faculty members told about his mother's end, each speaker lit the candles of those seated nearby, At the decision to leave her body to the medical school where he had bathed in candlelight. Each of us left the until the room was received his education. This past Thanksgiving was his service with a single rose, symbol of memory and hope ... family's first without the smile of his mom across their table. So it was that on one of the year's dark, gloomy days, I He recalled an earlier Thanksgiving when she had first paused in my daily routines to light candles, to celebrate discussed her decision, and the experiences that had led to and remember generous folks I did not know. With those her choice. As an educator, this was one final way she could students, I was thankful for mute teachers who had made influence and teach another group of young people. such a contribution to the understanding of human strength We learned some facts from the chair of the Department and frailty, the diagnosis of disease, the alleviation of pain of Anatomy and Cell Biology. Our school is one of very few and suffering. Standing with those young, idealistic physiin the world with a gross anatomy lab populated entirely by cians of the future, I realized that it is for experiences like those who made a conscious choice of that place as their final these that I chose both my profession and UB's School of destination. We are extremely fortunate that over 7,000 Medicine and Biomedical Sciences. The focus of that memopeople now living in Western New York have made arrangerial service was, indeed, different from my daily routines. ments to join that distinguished company in the future. Our However, the purpose of "anatomical gift" donors is very students are privileged, knowing that those people from much the same-facilitating the education of future physiwhom they learn held medical education and research in the in the best way they know. cians highest esteem. Our school is fortunate to have students who show such reverence and respect for the human spirit and the Linda). Corder, PhD, CFRE, is an associate dean in the School of Medici ne and individual bodies that were animated by that spirit. Biomedical Sciences at the Uni versity at Buffalo. She can be contacted by phone As an onlooker, I gained a sense of their journey of at (71 6) 829-2773, toll free at J-877-826-3246; by fax at (716) 829-3395; or by E- mail al ljcorder@acsu.buffalo.edu. discovery through reflections from at least 15 class mem - B u f f a I o Physician w I n t e r 1 9 9 9 �1998 Distinguished Medical Alumnus Named JOSEPH BELL ANT I, MD '58 MD, director of Georgetown University's International Center for Interdisciplinary Studies oflmmunology, received the Distinguished Medical Alumnus Award from the University at Buffalo School of Medicine and Biomedical Sciences at a dinner held in his honor on September 12, 1998, at the Buffalo Club. Bellanti, an expert in developmental immunology, earned a bachelor's degree from UB in 1954 and a medical degree in 1958. Before beginning his career at Georgetown, he interned at Millard Fillmore Hospital, completed a pediatric residency at Children's Hospital of Buffalo , was a ationalinstitutes of Health trainee in immunology and spent two years as a research virologist at the Walter Reed Army Institute of Research in Washington, DC. Bellanti joined the Georgetown faculty in 1963 as an assistant professor of pediatrics and microbiology, and by 1970 had attained the rank of professor in both fields. He also is director of the Division of Immunology and Virology in the Department of Laboratory Medicine at Georgetown University Hospital. Adopting a multidisciplinary approach to medical research before it was fashionable, Bellanti spearheaded development in 1975 of the International Center for Interdisciplinary Studies of Immunology at Georgetown . The center brought together basic and clinical researchers, allied health professionals, statisticians and health educators. B U f f o l - L OlS B AKER Past presidents of UB's Medical Alumni Associationgather to honor Dr. Bellonti. John R.Wright, MD, dean, UB School of Medicine and Biomedical Sciences; Mrs. Jacqueline Bellonti; Joseph A. Bellanti, MD, Closs of 1958 and this year's recipient of the Distinguished Medical Alumnus Award; Elizabeth l. Maher, MD, president, Medical Alumni Association. ® He has been director of the center since its inception. Bellanti has held many leadership positions in professional societies, including director, and later cochair, of the American Board of Allergy and Immunology; president of the Society for Pediatric Research and of the American College of Allergy and Immunology; member of the board of directors of the National Coalition for Disease Prevention and Environmental Health; and member of the board of regents of the American College of Allergists. An author of more than 200 scientific articles and abstracts and editor of the textbook Immunology, Bellanti served for 10 years as editor-in-chief of Pediatric Research. He also is past editor of Annals of Allergy. + Franklin Zeplowitz, MD '58; Paul H. Wierzbieniec, MD '74; Robert E. Reisman, MD '56. o Physician w I n t e r 1 9 9 9 �Let the Adventure Begin! · - STUDENTS BID A HALE- AND- HARDY BON VOYAGE ON SEPTEMBER 12 , 1998 , AS THEY PREPARE TO EMBARK ON A WHIRLPOOL JET TOUR AT NIAGARA-ON -THE- LAKE , ONTARIO . THE OUTING TOOK THEM THROUGH THE WORLD· FAMOUS RAPIDS AND STONE-WALLED CANYONS AT NIAGARA w{e a mistake. But not from the inside . The roof look." funny, odd, strange, a\'\0 \\'hich means thev can look at more than the bael\ of the D 1e wav we see it, whv build a strai~ht roof when you front seat. ~ l uch more, in fact. can build a perfeetlv ~ood crooked one'' Because the Land Rover DiseO\·erv has more windows It's somethin~ up w se,·en passenl\ers in the Land than anv other -lx-1. Rover DisCO\'Crv will rrulv appreciate. \\'ith the ele,·ated roof and stadiumlil;e sea tin~. • • \\'hv nm take one out for a test drive·~ ~'!'!!!!""~ ,\nd instead of just looking into it , look out of it. passengers in the rear ha\'C ample headroom . DISCOVERY Land Rover Amherst A NOIUHTOWN AIJTOMOTM COMPANY 3560 Sheridan Drive Amherst, New York 14226 • (716) 831-3100 http//www.northtownauto.com B a a p y a n w n e 9 9 �. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1] ~ . -MARK YOUR CALENDARS! t's not too early to plan for the 1999 Spring Saturday, May l. For more information, call the Clinical Day and Reunion Weekend. Medical Alumni Association at (716) 829-2778. A cocktail reception will be held on Friday, The reunion classes are of 1939, 1949, 1954, 1959, April 30, 1999. The 62nd Spring Clinical 1964,1969, 1974,1979,1984, 1989and 1994. Here's Day and Reunion Dinners will be on what your reunion chair has to say to you ... ELIZABETH OLMSTED CLASS O F 1 939 CLASS OF 1954 CLASS O F 1969 Elizabeth Olmsted Ross Mayday! Mayday! Mayday! Last chance to celebrate your 60th May Day '99. Nicholas C. Carosella, Edward A. Rayhill 45 Years! (an you believe it? Come join your friends and classmates in celebration. James White, Hanley M. Horwitz, Gerald D. Stinziano Don't miss our 30th! It should be fun to see how we, the school and Buffalo have changed in 30 years. Let's get reacquainted and renew old friendships. Ross CLASS OF 1949 Richard L Schwartz, Robert (. Harvey It has been 50 years since graduation. Don't miss this chance to get together and celebrate. CLASS OF 1959 William J. Mongan Please come to our 40th reunion. Roam L HARVEY CLAS S OF 1 974 CLASS O F 1 964 J. Frederick Painton Bruce F. Middendorf Looking forward to seeing all of you at our 25th class reunion. Our 35th reunion is imminent. Return to Buffalo to renew old friendships and pleasant memories. J. fREDEIIU PAINTON ® Buffalo BRUCE Phys i F. MIDDENDORF cian w 1 n t e r 1 9 9 9 �························ · ·································································· --··, ' 1 9 4 EDWARD M . TRACY '43 CLASS E. SHIELDS 1 5 0 s and his wife , Elaine, write: We OF 1984 March 1998 and bought our daughter's home. Life in Pensacola is much more laid back. The 1998 summer was unbearable, so we are planning to return to our chalet near Ellicottville, Y, next summer. Ed is involved with a barbershop chorus and quartet. We miss our friends. Our E-mail address is Eohohensee@aol.com. EDWARD CLASS 1 OF 1 989 Barbara J. Bambach, Denise M. Callari Ten years already! Come share memories, laughs and ac· complishments! 9 WILLIAM 6 E . 0 ABRAMSON s text on radiology for medical students. 1 9 7 0 s THOMAS A. LOMBARDO JR . '73 has been elected to the board of trustees at the ichols School of Buffalo for a three-year term. Lombardo, an orthopaedic surgeon and a ichols parent, is director of CGF Health System, secretary of the YS Society of Orthopaedic Surgeons, immediate past-president of the medical staff and current chair of the Department of Orthopaedic Surgery at Millard Fillmore Health System. Lombardo and his wife, Donna, reside in East Aurora, NY, and are the parents of four daughters. ' 60 writes: l have been elected a Life Fellow of the American Psychiatric Association. l'm working part time in a solo private practice of psychiatry and addiction medicine at Sheppard Pratt Hospital in Towson, MD. I'm working less, traveling more and BAMIACH recently had the second edition of his text Clinical Radiology: The Essentials published by Lippincott Williams and Wilkins. This is an introductory RICHARD H . DAFFNER '67 HOHENSEE ' 54 moved to Pensacola, FL , in David F. pfalzer Please come bock to reunite with Herb and the rest of the Class of '84. J. 9 Frank T. Schreck Sex, lies and videotape ... we'll capture it all. Show up! CLASS Bmm is prac- ticing internal medicine in Charleston , SC, and lives on Seabrook Island. He also teaches diabetic care in Beijing, the People's Republic of China. OF 1979 Peter E. Shields Come bock for our 20th reunion and reminisce with your old friends. PETER s 0 I RICHARD 5 . LEE '74 writes: have been appointed western regional medical director for the Sleep etwork, Inc., and Northern evada Sleep Disorders Cen- ter. In April 1998, I became a diplomate of the American Board of Sleep Medicine. enjoying both. HENRY M . BARTKOWSKI retired for the third time on October 14, 1998. He sold his practice of 30 years to Memorial Hospital of Salem County, FL. He travels to Fort Hood , TX , to see his grandkids, Garrett (6) and Skylar (4). He also sees all the Washington Redskin games because his daughter, Stephanie, JOHN J . LAMAR '63 CLASS OF 1 994 Donald M. Slate While following our dreams, we all have disbursed but there will be a party next year an May first! I cannot believe it's been five years, so come bock and we'll share stories, laughs and a couple of beers. B u f f a l o Phys ician is a Redskinette. w I n t e r 1 Q Q Q '76 , a pediatric neurosurgeon, was recently appointed chief of pediatric neurosurgery at Henry Ford Hospital in Detroit, MI, and William Beaumont Hospital in Royal Oak, MI. His special areas of interest are brainandspinalcord tumors,spine instrumentation, and brain and spinal cord injury. Bartkowski's research work involves cerebral ischemia in children. ® �l ll ························································································· HERBERT B. NEWTON '84 writes: My son, Alex (5), has started rics (Amherst, NY), effective but I love it. I came August 1998. I continue to work bus, OH, because of my hus- ogy, was made a fellow of the kindergarten. He is heavily into as a part-time pediatrician at band, Emeka. I have three ch il- American College of Radiology soccer and swim lessons. Ashley the Erie County Health Depart- dren: Chiedu ( 4), Chidi (2), at its annual meeting in Septem- (21J2) is enjoying preschool. ment. My husband , RICHARD E. and Chinenye (9 months). I ber 1998. Fellowships in the college are On the academic front, I have b e e n GERGELIS '84, is an assistant professor in the University at think I keep myself busy. I named Buffalo's Department of Psy- LIVERPOOL '90 . He is well and ANGELO M. DELBALSO '78, chair of UB's Department of Radiol- awarded to members for scientific or clinical re- search in the field of radiology or Classnotes can also be significant contributions to its literature. Criteria for selection also one s significant submitted via E-mail to: bpnotes@pub.buffalo.edu include performance of outstanding service as a teacher of radiology, service to organized medicine and outstanding reputation among colleagues and the local community as a result of long-term superior service. BENSON ZOGHLIN '84 writes: The whirlwind of activity grows ever stronger. In addition to a busy group practice in family medicine, lam president-elect of the Lakeside Hospital medical staff and chief of family medicine at Lakeside. Our group precepts third-year medical students from the University of Rochester and 1 precept at Highland Hospital's Family Medicine Residency Program. I am on the board of directors of the Lakeside Foundation. Mindy is busy with her law practice, and jacob (9) and Rachel (13) have their own hectic pace. has a daughter, Asha, who is my godchild. the top five neu- involved in fore nsic work. We rologists in Central have three children: Kristyn (11), Kimberly (8), and Ohio by an Scott(4). We have remained indepen- loyal to Western dent survey reside in Williamsville. We hope ew York and sponsored and pub- to see you all at our respective reunions, and can't believe it's lished by the Columbus been 15 years! JOEL K. SHUGAR '85: See letter in an exchange program as a member of the International Medical Relief organization of Western ew York. The pro- gram is designed to bring physicians from Third World countries to Buffalo for additional training and to send local physicians overseas to work in countries where sufficient dependent practice associations. molecular biology at the University of Texas at San Antonio. 1 9 9 s 0 Mindy and Icontinueourstudy in ciation with Sheridan Pediat- easy being on call all the time, o BURNETTE THOMAS '94 proudly announce the birth of their daughter, Kristen Killian Burnette. Kristen was born on July ll, 1998, and weighed 6 lbs., 9 1/ 2 oz. She was 19 3/ 4 inches in very well. MARC ROMANOWSKI '93 AND CINDY ROMANOWSKI '94 are proud to announce that they Isshin Ryu karate. l CAROL ANN KILLIAN AND cently took a position in went into solo practice in OBI Gyn one year ago. lt is not a I've gotten married. My wife's doing THOMAS BOYER '89, PHD, re- NGOZI OSUAGWU '90 writes: f cal Group. length . All are experience with managed-care organizations and physician in- tice of general and vascular surgery with the Buffalo Medi- pecting our first child in April. with officials in Tanzania. credentialing at Independent Health. She brings 12 years of first child. I continue my prac- RIYAZ HASSANALI '86 is involved has recently returned to her na- of physician management and the birth of Olivea Marie, our name is Sherry, and we are ex- on page 40. tive Buffalo, NY, with her appointment as assistant director MICHAELA . VASQUEZ '90 writes: Melissa and I have celebrated ATUL KUMAR GUPTA '91 writes: health-care options are not available. Currently, he is working ROCHELLEJ . PLESKOW '85, MS , f keep in touch with STEVEN chiatry, based at the Erie County Medical Center, and is actively Monthly magazine. I was also named to the Central ervous System Panel of the ational Comprehensive Cancer etwork. Also, recently I was informed that I will be listed in the 1998-99 issue of The Best Doctors in America. I remain associate professor of neurology and director of the Division of euro-Oncology at the Ohio State University Hospitals and james Cancer Hospital. B Colum- of ELAINE M. SCHAAF '85 writes: I'd like to announce my asso- ® to p y s c a n had a son, Marcus ] r., born on August 28, 1998. They reside inWilliamsville, Y, where Marc is an orthopedic surgeon and Cindy is practicing rehabilitation medicine. w e 9 9 9 �............... . ...................... . .................... . .............. ..............• ._-·._ • RESIDENTS R AYMOND 0 . S C H ULTZ '95 , a plastic surgeon who specializes in problems of the hand and wrist and in reconstructive surgery, has joined the Center for Plastic Surgery. His main office will beatthecenter's new Orchard Park, NY, facility at 3725 orth Buffalo Road. Schultz completed a general surgery residency at UB from 1991 to 1995. Currently, he is a clinical assistant professor at UB, where he is actively involved in research, having recently made presentations on facial nerve injuries and compression neuropathies. IN MEMORIAM an internationally known ophthalmologist and eye surgeon who ME Y E R H . R IW C H UN '27 , of surgery and chair of ophthalmology at the UB medical school , died at age 95 on October 25, ety, the Maimonides Medical Society and the former Buffalo Eye and Ear Hospital. Active in the 1998, in Buffalo. Riwchun, who maintained a private practice in Buffalo from 1929 to 1985 , Sight Conservation Society, he was a member of the advisory board of the Buffalo Eye Bank. In 1979, he and his wife , Ann , were headed the departments of ophthalmology at Buffalo General Hospital and Children's Hospital , respectively, in the 1960s. He was attending ophthalmologist at the former Deaconess Hospital and ophthalmologist-in-chief at the former Rosa Coplon Home. He was a lieutenant colonel in jointly named Outstanding Citizens of the Year by the Buffalo News for their work with the blind. D ONALD L. E HRENREICH ' 5 3, a clinical professor of neurology at UB School of Medicine and Biomedical Sciences and a neurologist with the Buffalo Medical Group , died ovember 18, 1998 , in Buffalo General the Army Medical Corps during World War ll, serving as chief of eye service at Walter Reed Hospital in Washington , DC. Highly regarded as a teacher in the UB medical school , Riwchun was a Hospital 's Hospice Unit. Ehrenreich , who was 70, suffered from cardiac and other medical problems. He earned a diplomate of the American Board of Ophthalmology and a fellow of the American College of Sur- bachelor's degree from UB in 1949 and a medical degree from the UB medical school in 1953. He became an instructor in the geons and the American Academy of Ophthalmology and Otolaryngology. He served as president of the Buffalo Ophthalmology Soci- Department of Neurology in the I medical school in 1961. Since 1983, he had served as a clinical professor in that department. He was acting head of the neurology department at Buffalo General Hospital for six years in the 1980s, served as president of the hospital's medical staff in 1986 and was a member of the board of trustees for six years. In 1978 he joined the Buffalo Medical Group and later served as chair of its board of directors. Survivors include his wife, Rivona H.; a son , Mark D. of Kenmore; a daughter, Beth E. Lichtenberg of Chicago; a brother, Arthur, of Phoenix; and a sister, Margery Rabow of Sarasota , FL. O SC AR R . OBE RKIRC H ER ' 62 died August 6, 1998. A classmate writes: Oscar, a pediatric nephrologist, retired from the Geisinger Medical Center at Penn State University two years ago. Friends, family and patients will miss this wonderful man. had served as a clinical professor Richard H. Webber, 74, Professor Emeritus of Anatomy, Dies Author of numerous scientific papers, Webber received grants from the National Institutes of Health while at U8to study involuntary nerve pathways to blood vessek in the leg. His major research interests involved the autonomic nervous system and, in later years, neuropeptide changes in gingiva. He retired from UB in 1990. Webber was a member of Phi Rho, a professional and neurological society; the American Association of Anatomists; the Cajal Club, an anatomy organization; Sigma Xi and the American Association of Dental Schools. He was a Fellow of the Human Biology Council. Survivors include his wife, Donna Marie; six daughters, Michaeline Reining and Donna Goss of Grand Island, Margaret Hooper of Ogdensburg, Patricia Majtyka of North Tonawanda, Anne Smith of Pullman, Washington, and Kimberly Marshall of Buffalo; a son, Thomas, of Rochester; and eight grandchildren. ichard H. Webber, professor emeritus of anatomy in the UB School of Medicine and Biomedical Sciences, died November 23, 1998, in Millard Fillmore Suburban Hospital in Amherst, New York. He was 74. Webber was attending Cornell University in 1943 when he joined the Navy. Following his discharge, he completed his bachelor's degree at St. Benedict's College in Atchison, Kansas, then earned his master'sin zoology at the University of Notre Dame in 1949 and a doctorate in anatomy from St. louis University in 1954. From 1954 to 19 59 he was an assistant professor of anatomy at the Creighton University Medical School, where he was principal investigator for several research grants from the U.S. Public Health Service. Prior to coming to UB in 1961 , he was an associate professor at Temple University. B u f f a l a Physician W I n t e r 1 9 9 9 ® �• .............. . ... .. ... . . . .. . .... . ....... . .. . ............ . .............. . . . ............... I 1 9 8 0 s writes: Well , I've been meaning to do this for years, so better late than never. joel K. Shugar '85, checking in for the first time since graduation. I've got a lot to report. After my internship in internal medicine at Millard Fillmore, of which I have especially fond memories, I completed my residency in ophthalmology in Gainesville, at the University of Florida. While in Gainesville, I met my soul mate, Michelle, whom I relentlessly pursued until she agreed to marry me. After seeing a lot of trauma during a rotation in jacksonville, as well as living through the Gainesville murders ordeal, we decided to settle in a rural location and set up practice in Perry, Florida, in 1991. In retrospect, it was the best financial decision we could have made, since rural areas are relatively sheltered from managed care and physician demand exceeds supply. We started as a small "Mom J O EL S HU GAR ' 85 , and Pop, " but the practice experienced growth beyond our wildest expectations. Because of the critical physician shortage in the area, we offered laboratory services and family care in addition to ophthalmology. Havingspent5 ,000 hours moonlighting as an ER physician to pay off my loans in addition to my internal medicine training, I was comfortable to offer those services to fulfill the community need. However the ophthalmology practice grew explosively, and it became obvious the days of the solo practitioner and "Mom and Pop" operations were numbered. What also became obvious is that physicians need to take back more control of health care and that I either needed to hire someone in a suit, or pretty soon I would be working for nonphysician-directed corporate medicine. So I recruited the chief operating and chief financial officer from a 500-bed hospitalnursing home facility to be the COO/CFO of our practice. Together we are evolving a physiciandirected healthcare system. The practice was folded into Nature Coast Health Care , a multi-specialty group practice that currently has 80 employees. We have a couple who are respectively boarded in internal medicine and pediatrics as well as a nurse practitioner specializing in women's health. We are recruiting a family practitioner to complete the primary care group in our Perry location. We are also in the process of establishing several satellite locations and would welcome applications from any colleagues from UB. In addition to the Family Care Center, we just completed construction of ature Coast Regional Surgery Center/Nature Coast Eye Care Institute, which won Medicare approval in October and will undergo JCAHO accreditation in January. We anticipate ENT, general surgery and gastroenterology joining us in the near future as well. In addition to being very busy surgically, our practice has produced significant research, including the first reported use ofTPA for central retinal artery occlusion.! have been fortunate enough to be selected as a peer reviewer for Archives of Ophthalmology and thejoumal of Cataract and Refractive Surgery, and have served as a faculty member of the American College of Eye Surgeons. Other than work, Michelle and I have taken the time to get and stay in very good shape. We lift weights and do yoga together; I run three miles a couple times a week as well. o children in the picture yet, but the negotiations are going on, so stay tuned! Well I promise it won't be another l3 years before you hear from me again! For colleagues who would like to reach me, my office phone number is ( 850) 584-2778 , and my E-mail address is eyeworks@perry.gulfnet.com. Louis Bakay, 81, Retired Professor, Chair of Neurosurgery OUIS BAKAY, a brain surgeon, professor emeritus of the University at Buffalo School of Medicine and Biomedical Sciences, and retired chair of neurosurgery, died on September 10, 199B, in his Buffalo home. Anative of Hungary, Bakay received his medical training at the University of Budapest. He came to the United States in 1948 as a Harvard Research Fellow at the Massachusetts General Hospital, where he remained until 1961 . He was appointed that year as professor and chair of neurosurgery at the UB medical school, where he served for 23 years. Bakay focused his research on the blood-brain barrier and aspects of cerebral edema. He was the author of several books on those topics, as well as chapters in 14 surgical handbooks and more than 100 scientific papers. Several of his books were translated and published in Spanish, Russian and Japanese. After his B u f f a l o retirement in 1984, he wrote amemoir, Gallery of Ghosts, followed by Gastronomic Exotica. Bakay received the Distinguished Alumni Award in 1989 from the Massachusetts General Hospital, an honor given to only five graduates of the hospital's neurosurgical program who had made significant contributions to neurosurgery. He was cited for his pioneering work on brain injuries. In 1997, the Louis Bakay Neuroscience Laboratory was dedicated at Buffalo General Hospital and a fellowship in neurosurgery was established in his name. He is survived by his wife, Nancy; daughter, Stephanie of Boston; son, Nicholas of Los Angeles; and sister, Margitt de Balas-Piry of Budapest. P hysician W I n t e r 1 9 9 9 �No one knows better than medical professionals the importance of teamwork to get things done. That is why most New York physicians and surgeons choose MLMIC as their professional liability insurer. MLMIC's responsive team of underwriters, claims personnel, policyholder services representatives, risk management consultants, medical experts, and defense attorneys provides our insureds with the best liability protection and the highest level of personalized service available. Owned and operated by its policyholders, MLMIC has successfully defended more New York physicians than all other insurers combined. With one of the country's largest and most experienced claims departments, MLMIC also offers the State's only true peer review of claims experience. These are just a few of the reasons why MLMIC is the only medical liability insurer endorsed by the Medical Society of the State of New York. Caii80Q-275-6564 (NY metropolitan area), MLM~C ~ledical ~ Liability :-tutuallnsurancr Company or 800-35~56 (Upstate) for more information and to find out about available premium discounts. Our defense never rests. 2 Park Avenue New Yor k, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11S54 C1998 Medacall,ability Mutual ln~ranu Company �Non-Profit Org. B UFFALO PHYSICIAN STATE UNIVERSIT Y OF NEW YORK AT BUFFALO U.S. Postage 3435 MAI N ST . PAID BLDG. 22 Buffalo, NY BUFFALO NEW YORK 14214-3013 ADDRESS SERVICE Perm it No. 311 CM·IS1-i-" 1' SCIHCES S::Rli'LS DEPT REQUESTED I\39CTT H~LL We Get Rehab Results! Our Superior ~M hnprovement Vs. National and Northeastern. Regional Subacute Facilitles The McGuire Rehabilitation Centers achieve a 34% GREATER FIMsM increase vs. the national average for all admissions. • Stroke • Pain Management • Medically Complex • Orthopedic • Infections • Cardiac • Cancer • Joint Replacement Eat•ng • Amputee ••• Five Star Care ***** Our facilities were rated outstanding in the community with five stars out of five, according to the Inside Guide to America's Nursing Homes for long-term care. The McGuire Team. ofExperts ·rr .. .. • ~ ~~·· .. ;. '" ~·~ The McGuire Rehabilitation Centers employ a team of over 30 licensed Physical and Occupational Therapists, specially trained support staff, and an on-staff Physiatrist/ Gerontologist. Together they ensure the highest level of individualized medical and restorative care. l. I .' h '·~, ···~·'' .~ ,__,.~ . • \y Cost Effective! ... •• • • ~ .. The McGuire Rehabilitation Centers' average charge per case is more than 35% LOWER than other facilities in the nation, according to statistics from The Wall Street Journal and the American Health Care Association. u T_,u I = Inpat ient Admissions I = Inpatient Discharge I = Outpatient Follow-Up Our case mix is consistent with the Northeast and national subacute region. Our average statistics are: length of stay - 25 days; age- 78; admission F1M score 72.5; discharge F1M score- 97.6; F1M change- 25.1 points; length of stay efficiency- 1.40; onset time- 17; discharge disposition- 8(1% to community. Based on 12 months ending March 31, 1998. The McGuire Rehabilitation Centers rely on the national The results are in_The McGuire Rehabilitation Centers have leading measurement tool for documenting patients' the clear advantage over other regional facilities based on FIMsM rehabilitative outcomes. This tool is known as FIMsM<: improvement, discharge to home, and cost effectiveness. Our successful rehab program delivers results Instrument; Functional Independence Measure, developed ~HE by the UB School of Medicine along with the Center for .J j because of our superior staff, state-of-the-art equipment, Functional Assessment Research. . It's used and specialized rehab facilities. Choose The along with the Uniform Data System for McGuire Rehabilitation Centers for five-star Medical Rehabilitation (UDSMR5M) rehabilitation services. to establish rehab outcomes that ~pU Jl DTT ~JI'T"TfqJ\f Call 1-888-POSTACUTE. can be measured and calculated ..& ~.J.U.L .Jr1.l ~\7~ c:/'J.1CGULRE '-. rod~::::u::o.m ~-" .,_C!!!'!!~ '~"'"'"" '"'"'~ UB "'·" '<h" ~. Autwnn View • Garden Gate • Banis Hill • Northgate � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 1999 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1999-Winter Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v33n03-1999-Winter Table Of Contents A list of subunits of the resource. Steady Leadership in Changing Times Managing Mental Health with Care Harold Varmus Delivers Cori Lecture Major Health-Care lntitiative Medical School Town Hall Meeting A Student's Perspective Alumni Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-10 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v33n03 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physicians Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1999 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/b53d99c6138cd19deb31dbe3a690439b.pdf 52e6b38e2dd07f9baeee38b2e0427e88 PDF Text Text AN OPENING TO A NEW PER ECTIVE �Dear Alumni and Friends, BUFFALO PHYSICIAN \'olumc "3"3. '\lumhcr 2 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr Carole Smith Petro DIRECTOR OF PUBLICATIONS Kathryn A. s~1wncr EDITOR Stephanie -\. L'nger ART DIRECTOR/DESIGNER \Ian J Kegler ASSISTANT DESIGNER lynda Harmel PRODUCTION MANAGER \nn Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John R. Wright, /ntmm Dea11 EDITORIAL BOARD Dr Bertram Portin, Chai1 Dr Martin Brecher Dr. Harold Brody Dr lmda J Corder Dr. ,\Jan J Drinnan Dr. Jamc~ Kanski Dr. Barbara \1ajeroni Dr Elt;:abeth Oltmted Dr Charles Paganelli Dr Stephen Spaulding Dr Brad lev T frua., Christoph~r .-\dam ... Dr 1-'rankhn Zeplownz TEACHING HOSPITALS AND LIAISONS The Buffalo General Ho;pital \hcharl H Slum The Children\ Ho,pllal of Buffalo [ne County Medical Center MerC\ Health Svstem \1tlla;·d rillmor~ Gates Hospital t-1IIIard Fillmore Suburban Hosp11al ~Iagara !'alb \lcmorial \ledtcal Center Ro~\vcll Park Cancer In~titutc '>tster- of Chanty Hospital Dnmis .\fcCarth\ \'ctcran'-. Affa1rs v\·cstcrn :'\C\\ York Healthcare System ©The State Lmn·r~nv of '\;cw York at Buffalo ' Buffalo Phnician is puhhshed quarterly by the State LnivcrSity of ~ew York at Buffalo School of Mcdicme and Biomedical Sciences and the Office of Pubhcallons. It one of the best of times for those privileged to be part of the medical teaching profession. New students-be they undergraduate medical students, basic science graduate students, or house officers-serve to energize the faculty. At the end of june, Incoming Residents' Week and a day-long training program for chief residents marked the beginning of the 1998-99 Graduate Medical Education curriculum. Associate Dean Roseanne Berger and her staff organized each of these highly successful and well-received programs. As a practical topic for those destined to be the next chief residents, the program theme was Tools for Leadership. Incoming Residents' \Veek was designed to prepare incoming house staff for the transition from medical student to house officer, and more direct (albeit carefully supervised) responsibility for patient care. In addition to learning more about how the health-care system functions and the various regulations under which it operates (including the infamous NYS "405" variety), the resident's role as teacher was emphasized. Indeed, by the end of the week, each of the incoming residents had been provided with some very basic, small-group teaching principles and an opportunity to apply these skills in a simulated ward-like environment. During a White Coat Ceremony, convened on the first day of their orientation week in mid-August. incoming first-year medical students were welcomed officially into the medical profession (see article on page 22 of this issue). Traditionally, our medical students have taken either the Hippocratic Oatlt. the Charge ofMainwnides, or what is locally referred to as the Physician's Oath at the time of graduation. It occurred to some of our faculty that this might be "a little late" in their evolution as physicians and the suggestion was made to have a ceremony at the vel) beginning of their preparation for the profession. Accordingly, Assistant Dean for Students Dr. Tom Flanagan organized the White Coat Ceremony, the high point of which is reciting the Physician's Oath. At this year's ceremony, introductory remarks described what being a member of the medical profession entails, particularly the obligations that come with the privilege. The fact that some aspects of medical ethics tend to evolve with time was underscored by reference to Jerome Kassirer's (a distinguished UB grad) editorial in the August 6, 1998, issu~ of the New England]oumal of Medicine. On the other hand, it was noted that some ethtcal pnnctples have not changed since the days of Hippocrates, including those embodied in our own Physician's Oath. The students were reminded that when faced with ethical decisions, one's own ingrained value system often becomes invaluable; i.e., "Sometimes one has to set aside principles and do what is 'right."' Following an address by Dr. Margaret Paroski, members of the senior faculty then provided each student with a white coat in what was very much a graduation-like hooding ceremony, foiiO\ved b) group recitation of the Physician's Oath. Smce It may have been some time since any of you attended a graduation ceremony, particularly atUB, yo.u may want to read the oath, which is printed on pages 22 and 23 along w~ a descripuon of Its ongms. Please let us know what you think! f.\11 IILR.\I D'> Tm Blc.l;-.;:--.1;-.;r. Of A NE\\ \L\DI\tK YLAR, IS sent, free of charge, to alumni, faculty, srudents, residents and friends. The staff reserves the right to edit all cop} and submisswns accepted for publication. ~~ hN R. W"G"', MD Interim Dean Sclwol of Mcdicirtc and Biomedical Sciences Dear Fellow Alumni, THE 11 u~t:-<l \\HO YOLL'HFER THEIR Tl\tF to serve on the Governing Board of the Medical Alumni Association do so for a variet; of reasons. One of my main motivations is to improve the medical school experience. )-along with many of my fellow classmates-was one who complained in the early 1980s about a torn-up Main Street, outdated anatomy labs and lectures m a drab G-26 lecture hall with its equally drab "student lounge" across the basement hallway. The present medical student lounge is a far cry from that basement lounge of the past. I am proud to be a part of the Alumni Association's effort to furnish the student lounge (see related article on page 28 of this issue). In the last issue of the Buffalo Physician, I mentioned some recent problems with the Medical Alumni Scholarship Fund. I am happy to announce that the scholarship has been awarded this year and the recipient, chosen by the Admissions Office, is Mr. jesse Cone, a 1998 graduate of the University at Buffalo. Since the Governing Board of the Medical Alumni Association is committed to the future of this scholarship fund, it \\<ill be the subject of an article in a future issue of the Buffalo Physician. I am tremendously grateful and happy to report that more than 150 busy physicians in the Buffalo community have volunteered to serve as mentors for the new Physician-Student Mcntoring Program. The students were equally enthusiastic, and the program is off to a great start. From the profile of the first-yearstudcnts in this issue (sec page 22), I am sure you will agree that despite all the recent changes in medicine, its future IS looking good. ~ E LIZABETH L. MAHER, MD President Medical Alumni Association �VOLUME 33 , NUMBER 2 AUTUMN 1998 4 1 NOV 1 3 1998 2 China Rotation FOURTH-YEAR STUDENTS TAKE A NEW 8 vt APaUrough an 4H Unexplored Field • • EUGENE M. FARBER, The Strengths of Children LUTHER ROBINSON , MD, LOOK AT ANCIENT DERMATOLOGY PIONEER, WORKS IN THE U.S. AND RECEIVES UB ALUMNI AWARD ABROAD TO TREAT AND by S. A. Unger PREVENT FETAL HEALTH-CARE PRACTICES IN BEI..JING ALCOHOL SYDNROME Medical School by Jessica Ancker BIOGEN ENDOWS Research NEUROLOGY CHAIR AT u B-LAWRENCE .JACOBS BODY SHAPE AND NAMED FIRST HOLDER BREAST CANCER by Lois Baker THE ARTFUL DOCTOR - CHARLES V. U 8 PROFESSOR PURSUES 40 AND LOW PREGNANCY PAGANELLI, PASSION FOR PAINTING PHD, SPERM ABNORMALITIES RATES RETIRES AFTER by Lois Baker YEARS OF SERVICE TO UB STUDENT LOUNGE A Class Notes SOCIAL HAVEN FOR MORE CLASS REUNION MEDICAL STUDENTS PHOTOGRAPHS AND by Mara McGinnis MEMORIES Student Perspective SECOND-YEAR STUDENT NEVA DALEY INAUGURAL WHITE COAT CEREMONY FOR INCOMING LEARNS ABOUT THE REALITIES OF CANCER CARE MEDICAL STUDENTS by Mara McGinnis CO\ ER PHOTO B\ jA'>E ELLERY 00PKIKS. Case presentation of two-year-old bor with hypothyroidism. Preventing fetal alcohol syndrome. Story on page 14. �US ' S FAMILY MEDICINE • ROTATION CHINA IN �-- - --- ach spring, fourth-year students at the University at Buffalo School of Medicine and Biomedical Sciences have an opportunity to participate in UB's Cross Cultural Medicine Program, which includes a three-week clinical rotation at various ..--....-• medical facilities in Beijing, China. During their stay in China, students gain knowledge about the structure and financing of the country's health-care system, as well as about its medical education. They also learn about the role of traditional healing practices such as massage, herbs and acupuncture, and have an opportunity to hone their physical-examination skills by taking part in hospital rounds, case presentations and various meetings (see following article by jane Dophins, Class of 1998). The Cross Cultural Medicine Program, which is partially underwritten by Millard Fillmore Hospital, was begun in 1990, when a working relationship between the medical school and Beijing's Capital Medical Hospital was first established. "The goal of the program is for the students to learn about another health-care system and to consider health and illness from a different cultural perspective," explains S. Ramalingam, MD, director of Cross Cultural Medicine and International Health at UB, and clinical assistant professor in the Department of Family Medicine and associate residency director. Ramalingam is convinced that the opportunity for American medical students to collaborate with their peers from another culture and health system fosters an openness to different perspectives on health, education and society. He also believes that by observing a different culture and its medical treatment of patients, students can take an important step in furthering their understanding of the nature of disease. "I want students to understand that medicine is more than just interpreting lab tests. With all of our modern technology, I sometimes think we've forgotten the primary focus of medicine- treating the patient. " A unique aspect of the rotation in China is the exposure students gain to Traditional Chinese Medicine LEFT: PEDIATRIC PHYSICA L (TCM) and the ways in THERAPY SESSION AT A which it is collaboratively integrated with Western, FAMILY MEDICINE HOSPITAL allopathic methods. AlIN BEIJING THAT PROVIDES though this type of colINTEGRATED , HOLISTIC CARE . laboration seldom exiStS between American phy- s u f f 0 l 0 P hysici a n A sicians and alternative medicine practitioners, there are indications that the role of alternative medicine in Western culture is being reconsidered, not only in the clinic, but in the classrooms as welL ationally, the Society of Teachers of Family Medicine has established a Subcommittee on Integrative Medicine charged with developing the first curricular guidelines for the teaching of alternative medicine in U.S. medical schools. (The phrase "integrative medicine" has begun to supplant the phrase "alternative medicine" when describing such studies.) Ramalingam is one of five individuals selected from across the nation to sit on the subcommittee. He reports that after two years' work, the group has completed its recommendations and has submitted the proposed guidelines to the society for consideration, after which they will be presented to the Association of American Medical Colleges. Also, in 1992, the Office of Alternative Medicine (OAM) was established through a Congressional mandate under a ational Institutes of Health appropriations bill to scientifically study the results of TCM. In its first year, the OAM was budgeted $2 million to analyze, interpret and acknowledge what effective therapeutic regimes exist in various alternative practices. By 1997, that figure had risen to $12 million. _" _ Despite governmental encouragement and attempts by such educators as Ramalingam to explore the role of alternative healing methods , the historic lack of scientific rigor-as defined by double-blind studies-is responsible for many of the reservations Western-trained clinicians hold about the efficacy of alternative medicine. A significant benefit medical students enjoy during UB's China rotation, therefore, is the opportunity to observe for themselves the positive results of alternative medicine in a culture where TCM and Western medical practices seem to peacefully coexist. Summarizing what he feels are the benefits of the program, Ramalingam says, "The excitement of a different culture fills students with curiosity and enthusiasm to be inquisitive as well as open-minded- attributes that will serve them well throughout their careers as physicians. " utumn 1 9 9 8 0 �BY JANE ELLERY DOPKINS • cnve THE OST VALU BLE EXPERIENCE OF MY MEDICAL EDUCATION ditor's note: In March 1998,]ane Dophins, afourth-yearstudent at the Universit) at Buffalo's School of Medicine and Biomedical Sciences, participated in the Cross Cultural Medicine Program and its famil_v medicine rotation in China. In the following article, Dophins-n lw is cw rent!) a resident in obstetrics and gynecology at Univcrsil) Hospital in Cincinnati, Ohiogi\ es a fi 1 stlumd account of her unique opportunit) to stuch abroad through L B~'l program The thickly polluted Beijing air was chilly at 6:30a.m. as six of us from the University at Buffalo School of Medicine and Biomedical Sciences assembled in the courtyard of Capital University in Beijing to meet our tai chi instructor for our first lesson. As a participant in UB's three-week Family Medicine rotation in China, I had not expected daily tai chi lessons to be part of the program. To be honest, I had very little knowledge of China prior to participating in this rotation, so I really didn't know what to expect. What I soon realized was that! had been given a remarkable opportunity not only to learn about medicine in China, but also to witness, firsthand, some of the changes the country is experiencing politically, technologically and economically. Beijing, a City of Contrasts Over the course of the rotation, the students and teachers at Capital University of Medical Sciences became wonderful friends to us, and our conversations with them gave us unique insights into Chinese life and culture. The medical studen ts told us about political changes occurring in China and spoke with great excitement about the local elections taking place for the first time. Even though many students we met said they were eager for greater freedoms in China, including greater economic freedom , all but a few were planning to apply for Communist Party 0 membership in order to secure jobs in well-respected hospitals. Without party membership, we were told, a young physician was sure to be sent to a remote rural province after graduation. Many of these young men and women also told us they are in favor of the one-child law as an essential element for China's future success. The economic and technological transitions were apparent in the construction of new apartment buildings to provide better housing for the 11.2 million people who live in Beijing. While shiny skyscrapers funded by rich companies based in Hong Kong were sprouting up, Chinese street workers continued to dig sewer lines and build new roads using hand shovels and pure manpower. We visited several new department stores very much like those in the U.S., but only one of them accepted MasterCard or Visa. BMWs shared the crowded roads with oxen-drawn carts and men riding large tricycles laden with pineapples. During our rotation, we stayed in comfortable hotel-like accommodations on the university grounds, but discovered that young teachers at the university live in small university-owned apartments that have no running water. Beijing is a city of technological contrasts. Modem Tools and Modest Facilities Changes in the economy and advances in technology have influenced the practice of medicine in Beijing. We visited many teachB u f f a l o Phy sician A utumn 1 9 9 8 �ing hospitals in Beijing offering the best tertiary care available in the country. ew technology is a priority for the doctors, but many of the buildings and their grounds are poorly maintained; for example, one day we saw a patient on a stretcher being rolled through rubble to get to a brand-new MRl machine. Although some buildings were modern , most appeared to be very old. ln one hospital, paint was peeling from the walls in a room where we examined patients who were recovering well from kidney transplants. Also, the telephone systems were not elaborate in any of the hospitals we visited. In one facility, we noted that when a surgeon wanted to get results from the pathology lab, he or she would simply walk over to the lab and talk with the staff. Communication, we learned, was often delayed. Case Presentations and Hands-On Learning Attending physicians and residents who spoke near-perfect English escorted us on tours through their wards, stopping at the bedsides of their most interesting patients to give case presentations and teach physical examination. As the weeks passed, we had CLASS OF 1998, DURING an increasing number of ROTATION IN CHINA . excellent hands-on experiences. For example, LEFT: HERBAL we heard the murmur of a mild tetralogy of PRESCRIPTIONS BEING Fallot in a nine-yearPREPARED IN TRADITIONAL old boy. We palpated metastatic cancer in the CHINESE PHARMACY. nodes of a cheerful elderly man who had learned laryngeal speech after his tracheotomy but who had never been told he had cancer. We also saw the butterfly rash on the face of a beautiful 12-year-old girl with Lupus, observed a retinal detachment for the first time, and palpated large spleens. lt was thrilling to have the opportunity to feel with my own hands or hear with my own ears physical findings l had never experienced before as a medical student. After the instruction ABOVE: JANE DOPKINS . ""' z " X u . " 0 < u ~ 0 X ~ �L received in Beijing, l feel much more confident in my examination of the heart and abdomen. We also toured operating rooms where barefooted surgeons routinely perform delicate eye and open-heart surgeries, or relieve bowel obstructions. A world-famous cardiologist showed us his state-of-the art cardiac care unit while lamenting the incredibly high rate of untreated hypertension in China. In talking with obs tetricians, we learned that the cesarean section rate is much higher for boys than for girls, and that infanticide of female babies is uncommon in Beijing. After completing a case presentation and an examination of a patient, we often gathered in a conference room to discuss the case and exchange information. Sometimes the Chinese doctors taught us about a case they were particularly proud of managing; at other times, they asked us for our expertise. Usually the learning was mutual, and we finished our days with a sense that we had exchanged medical knowledge as well as shared our unique cultural perspectives. J Learning about Traditional Chinese Medicine In the U.S., allopathic doctors know very little about herbal medicine , and most herbal preparations are sold as food supplements with very little regulation YANG GUANG DEMONSTRATES or knowledge of their HOW MOXIBUSTION SUCTION , use . In China, the use of herbs in Traditional CREATED WHEN FIRE UNDER Chinese Medicine THE GLASS BALL BURNS OFF (TCM) dates back many millennia. OXYGEN , IS USED FOR During our visit, TREATMENT OF PAIN . we had glimpses of TCM being practiced RIGHT: WILLIAM J . MEDWID , as adjunctive therapy CLASS OF 1996 , PERFORMS to allopathic treatments and were able PERCUSSION EXAM . to observe how herbal prescriptions are used to counteract the side effects of immunosuppressants in transplant patients. At a well-run psychiatric hospital, we learned that TCM is used with great efficacy in preventing the movement disorders produced by antipsychotic medication. Also, at the Children's Hospital we saw the TCM pharmacist mix a treatment for the common cold. One day was entirely devoted to visiting aT raditional Chinese Medicine hospital where TCM is the first-line treatment and 0 B u f f a l o allopathic medicine is used to assist treatment. While we were there, our hosts demonstrated acupuncture on a man with Bell's palsy and on a child with an Erb's palsy. Also, a Traditional Chinese Medicine doctor demonstrated his special method for palpation of the pulse and examination of the tongue. He examined a woman with all the signs and symptoms of hyperthyroidism , and demonstrated that after two weeks of herbal medicine her pulse had fallen from 120 to 85. The patient told us she felt much less anxious and her heart seemed less jumpy. One of the most successful wards in the Traditional Chinese Medicine hospital is the vascular ward, where physicians use salves and systemic medicine to heal diabetic foot ulcers with incredible limb-sparing success. We were awed and amazed by it all. Phys ician A utumn 1 9 9 8 �-- -- - - - Reflecting on Similarities and Differences ln the U.S. , we worry about the politics and controversy surrounding managed-care reimbursement and Medicaid. To our surprise, we found that similar medical coverage problems exist in China. For example, we were told that a person employed by a large company typically has medical coverage, but others pay out of pocket for their care. The friendships l made with our Chinese hosts were one of We also learned that medical care in the country prov- the most meaningful aspects of my experience in Beijing. The inces is difficult to obtain and of very poor quality; often president of Capital University of Medical Sciences, Mr. Shu, patients have advanced disease by the time they are re- hosted us at a welcome banquet and then at a farewell dinner. ferred to the large hospitals in Beijing for treatment. The He was well spoken, entertaining and easy to talk to. We got to philosophy of care for the terminally ill is quite different in know several of the medical students during evening parties China . Few heroics are employed for a terminally ill they arranged for us. On one occasion, the UB physicians patient, and special hospitals, perhaps a bit like Hospice, teamed up against the Chinese medical students in a basketball provide assistance for the dying and their families. game in the center of the university compound. Also , despite At the end of each day spent in the hospitals, we were the unexpected novelty of our first lesson , we enjoyed getting exhausted, both emotionally and physically. Most of the time to know our tai chi instructor during our daily lessons, and we we were impressed with how well patients were cared for , but developed a true fondness for the man who drove our bus to there were a few times when we felt patients were not being the hospitals. treated appropriately. Although we were amazed with the Dai, a 26-year-old science instructor and graduate student modern intensive care units and the great strides being made at the university, served as our facilitator for all our hospital in cardiology, the realities of an overpopulated country with trips and, quite naturally, became our friend. She was eager to very limited resources often weighed heavily on our minds as learn about our life in the U .5. and was willing to tell us of her we rode in our minibus through the crowded streets ofBeijing experiences growing up in China. As we became better back to our luxurious hotel for dinner. acquainted , she told us about her dream of coming to study Over wonderful meals , we had the opportunity to discuss in the U.S. but also helped us understand why she was very among ourselves the many things we had seen and done fond of her life in China. Dai not only talked to us about her life, but shared it with during the day. Because our group of six consisted of two us, as well. She showed us her apartment, took us to the open students, one nurse and three physicians, we often had a great deal to teach each other. We became good friends , shared the Chinese markets and introduced us to her friends. l was very fun of exploring the city of Beijing and helped each other sad to say good-bye to her at the end of our three weeks, but we are keeping in touch through letters. through moments of homesickness. New Sights, Learning and Maturing Our three weeks in Beijing were not spent entirely in hospitals. Our itinerary included several days of structured excursions to such places as the Great Wall and the Summer Palace, as well as a few afternoons of free time for shopping or relaxing. We saw the old-style Beijing Zoo on a Saturday morning, when it was filled with children eager to see the pandas. We spent several evenings getting to know the city of Beijing by hailing a tiny taxi, pointing to where we wanted to go on a map , and then praying the taxi driver would take us where we had asked. As we drove through the city, we saw evidence of the fact that nightclubs and bars are becoming more popular now that there is a little more freedom in China. One evening, we visited Tianamann Square, which was even more impressive by night than during the day. On one of the last days of our visit to China, l sat with two other members of our group, Pam Warner and Carol Chen, in one of the university-run restaurants , eating a delicious dumpling soup that had been boiled over a coal fire. We reflected on all that we had learned of Chinese culture, medicine and human nature. lt had been an exhausting three weeks, with moments of joy and excitement mixed at times with confusion and questioning when we felt that our fundamental values had been profoundly challenged by the way things are done in China compared to the U.S. Each of us learned different lessons and matured in different ways. The three weeks I spent on this rotation in China were thought provoking and mind broadening and were, without a doubt, the most valuable experience of my medical education. + in Different Ways Sounds and Friends B u f f a L a Physician A . u t u m n 1 9 9 8 0 �............................................... .. .... . .. .. . .......... ............. . ... ................. EUGENE M . FARBER , DERMATOLOGY PIONEER , RECEIVES UB ALUMNI AWARD . . . . . .. .. . .. . . . . . . . . . OR EL c,F F M. FARBI R, medicine was more than a calling; it was a fait accompli. By the time he entered medical school at the University at Buffalo in 1939, three of his older brothers-Sidney, Seymour and jason-had preceded him in choosing medicine as a profession and were embarking on careers that, collectively, would make the Farber name one of BY 5 . A . UNGER the more well known in science in the latter half of the 20th century. "I was preconditioned to choosing medicine as a career. Because of my brothers, I was surrounded by medical books at an early age, and I never thought of doing anything else," says Farber, who returned to Buffalo this spring to be honored at the VB Alumni Association's annual awards dinner. . ........ ..... . . .. . .......... ....... . . ........ .......... .... .. .. ........ .. ........... .. ... . . ........ ..... 0 Buffalo Phys ici an Autumn l 9 9 8 �In 1959. when Stanford•s medical school a leader in research to promote lthough he followed of the etiology and understanding in his brothers' foottreatment of psoriasis. steps, Farber was moved to Palo Alto, quick to discover his own path, The Support of choosing in 1946 to pursue what a Close-Knit Family was then an unexplored area of Born the 11th of 14 children, six medicine: diseases of the skin. of whom graduated from the UniThe research contributions he at Buffalo, Farber says versity made over the next four .. . was selected as the first that despite the size of his famdecades-especially with regard chair of lhe school's newly ily, there was always time for to psoriasis-gave significant books and learning-pursuits impetus to the development of formed Department of that were cultivated by his pardermatology as a medical speDermatology. a position ents, Simon and Matilda Farber. cialty. As a professor and chair of "My father came to Buffalo from the Department of Dermatology h e held until 1986. when he was 17. The first Austria at Stanford University's School job he took was as a stevedore on of Medicine from 1959 to 1986, he further contributed to his field as an academic clinician a barge on the Erie Canal, and from that start he went on to build a very successful insurance business," says Farber. and teacher. Today, Farber is president and chief execuDespite the press of maintaining a growing business and tive officer of the Psoriasis Research Institute (which he cofounded in 1986) in Palo Alto, CA, and continues to be raising a large family, both parents spent every spare Farber ••••••••••••••••••••••• e u f f a 1 o • •••• Phys 0 •••••••• ici • 0 an ••••••••••• • •• ••••••• Autumn ••• 1 9 • ••••••••• 9 8 ••••••• • • •••••• ••••••••••• 0 ••• 0 �....................................................................................................... A Path through an Unexplored Field ........ . ........ . ........................................ moment they had reading, so a love of learning came naturally to Farber and his siblings. "My mother was amazing. She had so much work to do all the time around the house, but at night she never rested without her book, and my father read whenever he could, too. Our house was full of books-well over a thousand, I'm sure. There was no TV, so on cold winter nights in Buffalo, there was great pleasure in getting into bed and reading and talking about books, which we would hand down and recommend to each other." sa young teen, Farber was nurtured and strongly influenced by his older brothers d their love of medicine. With their help, he was able to observe operations and tag along on hospital rounds while they were interns. "They liked what they were doing o much and were doing so well, it just seemed natural for me to do it, too. I never thought otherwise," he says. Passing On the Knowledge, One to Another In 1935, Farber departed for Oberlin College in Ohio, where he earned an A.B. degree in premed studies, after which he returned to Buffalo to enter UB's medical . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . school. Several of his brothers had attended Harvard, but Farber decided to return home. "UB was one of the best medical schools in the country, even then, " he says, adding that he has never regretted his decision, as there were a number of professors at the school who not only greatly influenced him as a medical student, but who served as models he would strive to emulate over the course of his career. "Guy Youngburg [then professor and head of the Department of Biological Chemistry] was very inspiring because he gave more than didactic lectures," he recalls. "He was innovative in his teaching and taught by posing problems instead of presenting repetitious lectures from one year to the next. He encouraged me to think of research in relationship to disease. " In his preclinical years, Farber says Oliver P. jones was his very memorable professor of anatomy. "He was a kick. He was an old shoe with the students, who, as a group, were then as they are today-very insecure, very tense and overtired. And 1939 was a desolate year to enter medical school because it was such a stressful time financially; but 0. P. jones had a way with the students that eased some of their burden . . . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . a u f f a 1 a Physician Autumn 1 9 9 8 �"Then there was Earnest Witebsky," he continues, the Compassion respect he had for his professor of immunology still and Commitment evident in his voice. "He was a German-jewish refugee While Professor Osborne may have strongly influenced Farber to consider choosing dermatology as an area of who spoke with a slight accent. He had piercing blue eyes and a kindly way. He's renowned for isolating the Bstudy to focus on in his career, the final push came from antigen found in human blood, his older brother Sidney. Already which made blood transfusions a distinguished pathologist well safer. It was a big lift for the on his way toward making dishis war effort. And what was so coveries in cancer chemotherapy unusual-especially today-was that would result in the Dana preclinical that even though he was a proFarber Cancer Institute in Bosfessor and head of a whole imton being named in his honor, years. Farber says Sidney had words of advice and munology program, he was in encouragement for Eugene once the lab walking around from stuhe had graduated from medical dent to student three afternoons school and was in training, casta week from l p.m. to 5 p.m. " ................... ing about for a direction to take. Another UB professor Farber "Sidney said to me, 'Why don't recalls as clearly as if it were you go into dermatology-there's yesterday is Abraham Aaron, his so much to learn, so much to do; professor of clinical medicine, it's a field that hasn ' t been who "was feared and respected. was his very memorable explored yet. All medical research He asked tough questions at the professor of anatomy. has largely been done on the bedside, and one of his adages ••He was a kick. He was heart, lungs and kidneys, but the that l remember to this day was an old shoe with the skin has been mostly ignored. 'Use a peashooter instead of a students. who. as a There's an opportunity for somecannon with respect to drug group. were then as one with a scientific bent to make therapy. ' In other words, start a contribution."' they are today-very cautiously." With a chuckle, With those words, Farber and Farber adds, "I used that same insecure. very tense and his wife of two years, Ruth Seiffert, quotation with my students for overtired.•• were soon on their way to Minne35 years, and l imagine some of sota. "I was an assistant resident them who are now professors are in medicine at Buffalo General at repeating it." the time and was to be chief medical resident, but I made The UB professor who inOuenced Farber the most is the decision to leave for the Mayo Clinic and to move clearly Earl D. Osborne, who was head of the Departahead with dermatology. " ment of Dermatology and Syphilology. "He was voted While at the Mayo Clinic, the best teacher of the year for Farber pursued his scholastic 30 consecutive years; he was interests, earning a master of scidynamic and exciting," he reence degree at the University of calls with an enthusiasm that Minnesota in 1946. He completed hasn't dampened over the years. a thesis on the blood vessels in "Osborne had received his trainthe skin of the essential hypering in dermatology at the Mayo tensive and immediately made a Clinic, and he inOuenced me to contribution to his newly chosen choose dermatology because I field by being the first to describe was so impressed with how he what is now known as hypertencorrelated clinical changes with sive ischemic leg ulcer. biochemical and immunologiThe four years Farber spent at cal events. That type of apthe Mayo Clinic not only conproach to the largest organ of firmed his desire to pursue academic medicine, but also the body had a great deal of appeal to me." provided him with an opportunity to gain insight into the Pausing, Farber observes, "Teachers, you know, can lives of the patients whose suffering he hoped to someday have a tremendous influence on three or four generations alleviate through his research. by virtue of passing on their knowledge, one to another." In Oliver P. Jones B u f f a l o Physician Autumn 1 9 9 8 �••••••••••••••••••••••• 0 •• •••••••••••• • •• •• •••• ••• •••••••••••••••• 0 ••••••••••••••••••••• 0 ••• 0 •••••••••• A Path through an Unexplored Field ..................... "The Mayo Clinic was the only center in the world found that Stanford Medical School, which at the time where they had a program for the treatment for psoriasis; was in San Francisco, would provide me with a small they called it the Goeckerman treatment. This involved lab for dermatopathology research." covering the patients with black tar from head to foot and So, in 1950, he headed West, with the promise of a keeping them in the hospital for a month, giving them lab , a salary of $2,400 a year and an annual research ultraviolet light every day and special baths. This caused budget totaling $50. " obody had any money in those the disease to go into remission for six months to a year, days , including the schools; you had to get your own," but then it would come back. l was on the hospital service he explains. where we had 30 to 40 psoriatic patients who were But moving west of the Mississippi had its benefits, as suffering terribly-they were at the 'bottom of the barrel' he would soon find out. The post-World War II economy as far as their advanced disease was concerned. When I was picking up steam and the ational Institutes of had that experience of taking care of all those patients who Health ( lH) began to have dollars available to funnel were suffering so badly, I figured this is what I'm going to into dermatology research . "There was no research being do with my research , and that's why I chose to concentrate done in dermatology in the Western United tates," on psoriasis. " he recalls, "so a representative Farber says that while working from the IH came out and with the patients during this time, offered me an opportunity to have mindhe also gained a deep appreciaa very large grant for research in tion for the psychological impact skin dermatology, if we could provide of dermatologic disease. "Visible the labs. " As a result, several thoudisease is the cause of great sufferrelationship is very sand square feet oflab space were ing, and diseases of the skin built and "from then on, we were require great compassion and funded generously, not only by attention to the psyche because of the IH , but by foundations and the mind-skin relationship. The other sources." mind-skin relationship is very ln 1959, when Stanford's medistrong, and the morbidity of most and the morbidity of cal school moved to Palo Alto, skin disease is accentuated when Farber-who had been serving as most skin diseases is acthere is distress-and I say a clinical professor and director of distress , not stress. That is what centuated when there is dermatology since 1950-was the patients experience." selected as the first chair of the Fortunately, Farber was able to school's newly formed Department play a role in mitigating the sufferof Dermatology, a position he ing of patients sooner rather than held until1986. Under his leaderlater. While at Mayo, he had the ship, the department grew to -and I say distress. not opportunity to work with his chief, include 11 full-time faculty memDr. Paul O'Leary, to test the effistress. That is what the bers and achieved international cacy of the first antihistaminerecognition for its research and patients experience. •• Benadryl-for which Parke-Davis innovative treatment. had just received the rights folDuring his long career, Farber lowing its synthesis in Paris. O'Leary and Farber evaluated has published more than 250 papers, the majority of which the compound in acute and chronic urticaria and published focus on elucidating the natural history of psoriasis and the first paper reporting the clinical application of the defining the pathogenesis of the disease. While he was at antihistamine. "It's been a popular treatment for hives ever Stanford, the Department of Dermatology sponsored four since," Farber says. international conferences on psoriasis, each of which attracted 300 to 500 dermatologists and basic Research Opportunities "Out West" scientists from around the world. Also, in 1967, as chair of Once his studies at the Mayo Clinic were completed, the Task Force on Psoriasis for the Academy of DermatolFarber set his sights on winning an academic job in ogy, Farber and his fellow task force members helped dermatology. "I was looking for an opportunity to do standardize treatment of the disease by fulfilling their scholarly work, but there wasn't anything. Finally, I charge to evaluate a wide range of treatment modalities in The strong. distress • • ••••• •••••••••• •••••••••••••••••••••••• B u f f 0 a •••••••••••••••••••••••••• I a 0 ••••••••••••••••••••••••••••••• Physician A. u t u m n 1 9 9 8 �use at the time and to establish criteria for the indications for the different therapies. During his busy and productive years at Stanford, Farber also found time to teach, training over 180 residents and taking pride in the fact that, despite dermatology being an elective, 90 percent of all students signed up to take the class "because we made it interesting and they were able to have a close personal relationship with our faculty," he says. ln looking back on his role as teacher, he acknowledges his good fortune to be in academic medicine at a time when teaching medical students wasn't circumscribed by economic forces like those at work in today's health-care market. "We didn't have any of the pressures on us then that managed care imposes today on faculty , who must see more and more patients, which means they have less and less time for teaching residents and students," he says. "And teaching in medical schools all over the country is suffering because of this. " When he left Stanford in 1986, Farber moved across the street from the school and opened the nonprofit Psoriasis INFINITI Research Institute. Today he maintains a strong interest in ongoing research at the institute, including a large-scale study under way to find the gene(s) that predispose individuals to psoriasis. ever one to retire, he continues to see patients two halfdays a week because, he says, "I still enjoy helping people. " He also enjoys spending time with his grandchildren and following the careers of his three children, Charlotte, an attorney; ancy, a hospital CEO; and Donald, a financial consultant. When he learned that he had been invited to return to UB this spring to be recognized by the university's Alumni Association , Farber says he was "honored and absolutely delighted ," but in recalling his feelings, he is quick to add that this is an honor he cannot accept just for himself: "I have five siblings who graduated from UB. l'm very happy with this honor because I'm thinking of this not so much for me, but for them, as well. I only wish they could have been here to share in this, because they certainly deserved it far more than l." + I ntroducing your way to escape. lnfiniti's luxury sport AUTO PLACE INFINITI Unlike most luxury sport 8129 MAIN ST. , WILLIAMSVILLE escape for the weekend, it has all the comforts and luxuries you East of Transit Rd., Near Eastern Hi lls Mall u f f 0 l 0 MSRD 36,045. 00 utility vehicles, the QX4 not only features everything you need to 633-9585 8 utility vehicle: the QX4. need to escape life's daily stresses. Physician Autumn l 9 QX4 9 8 ��DNG ~OUT THE SSTRENGTHSS OF CHDLDRIEN Luther Knox Robinson'swork to prevent birth defects BY JESSICA ANCKER HEK LUTHER ROBI SO , MD, traveled to South Africa last year to study fetal alcohol syndrome (FAS), he heard local people -.-...-... using the word Ubuntu. They told him it meant "I am because we are," a powerful expression of the vital importance of the community to the individual, and of the individual to the community. The word stuck in his mind because it perfectly conveyed a philosophy that he had long admired. "Each of us has a role to play in meeting societal challenges," explains the associate professor of pediatrics at the University at Buffalo School of Medicine and Biomedical Sciences. "Each of us is successful if the entire group is successful." Buffalo Physician Autumn I 9 9 8 �obinson, who specializes in clinical services for and research on birth defects, !!opes to draw upon the philosophy expressed b) ubwzlu to lower the incidence of preventable birth defects like fetal alcoholS) ndrome. In his view, F AS is not merely a medical condition; it's a sign of trouble at the heart of a community. "FAS calls attention to the real challenges \\e have relative to women's health, and indeed to men's health," Robinson says. "An entire famil) is affected by alcohol abuse. We need to learn ho\\ to strengthen women who are involved in substance abuse, and how to help men to resist substance abuse or rehabilitate themselves." Public education is one of the most important ways to fight preventable birth defects. "One cannot guarantee a perfeel baby, but a beller-informed public can make the types of choices that improve outcomes," he says. "We know that folic acid is a means oflowering the risk of spina bifida, and that avoiding alcohol in pregnancy is a means of preventing FAS. These are public information issues. " But with alcohol, education is not always enough. Society must find ways to prevent and reduce adolescent entry into alcohol use and binge drinking, as research has demonstrated that they are or will be at high risk for alcohol abuse. Resources are needed to provide early intervention counseling, spiritual support or community safe havens to reduce environmental risk factors. "We've known about the dangers of alcohol to the developing fetus for 20 or 30 years now, but the problem of alcohol abuse is so insidious that it's hard to reach the people who are involved," he says. "just telling them something is not going to get them to stop drinking. That's part of the challenge we have to meet in our civic lives. " Robinson tries to put his ideas into practice not only through teaching, but also through community leadership and involvement in local birth-defect infor- ® mation and monitoring projects. "I am a believer that one's intellectual work is enhanced if one can make a link with one's community. ''I'm not unique in that, in any way," he is quick to add. "Most of us at UB feel that way. " native of Ohio, Robinson attended Oberlin College and .._..o;;...,......-...- earned his medical degree from the University of Cincinnati College of Medicine in 1974, after which he completed a residency in pediatrics at the University of California/San Diego (UCSD) Medical Center. It was at UCSD that Robinson met the physician and scientist who would set the course of his future career. Kenneth Lyons jones , MD , professor of pediatrics and dysmorphology, is one of the first researchers to have identified and described fetal alcohol syndrome. jones's 1973 paper in the Lancet, "Recognition of the Fetal Alcohol Syndrome in Early Infancy," described a cohort of high-risk children in Seaule and confirmed long-standing suspicions that alcohol consumed during pregnancy could cause serious problems, including growth retardation and mental deficiencies. (A French physician had published similar findings a short time earlier, but because his paper was not in English, it hadn't been noticed by the worldwide medical community.) Robinson worked with jones for two years as a postdoctoral fellow in dysmorphology. ln addition to learning about and extending the research on FAS , he also studied birth defects linked to genetic factors , nutrition, and chemicals or medications. Following this experience, he returned to general pediatrics during a stint as a general medical officer with the U.S. Public Health Service, and then served as- an associate professor of pediatrics at the University of Texas Medical School in Houston before joining the UB faculty and Children's Hospital of Buffalo in 1987. Robinson , who is board certified in both pediatrics and medical genetics, is director of clinical genetics at Children's Hospital and serves as part of the teamteaching faculty for the first-year genetics course at UB. He also supervises residents and fourth-year medical students doing rotations in the field of genetics and dysmorphology. South African child with fetal alcohol syndrome. Her country has the highest incidence of FAS in the world, according to a NIAAA study. �IfF AS is a tragedy, Robinson is a at least public educahighly regarded tion and other social teacher who has and medical methods earned awards for offer some hope of preteaching both basic venting it. With many science and clinical of the other types of subjects at his birth defects that academic posts in Robinson studies, the Houston and at UB. In path to prevention is 1995, he was given the still uncharted. johnS. ParoskiAward Yet Robinson says for Outstanding Athe does not find his tending Physician work disheartening. Teacher at Children's Luther Robinson, MD, oHrocts o crowd of children during his visit too village ou~ide Cope Town, South Africa. First, he says, there is Hospital. He is a regular attending physician Infant Home in the form of the Father the intellectual challenge of trying to at the Buffalo Institute of Fetal Baker Service to Youth Award in 1991. understand what has happened, a challenge that may someday lead to a cure or Therapy, the Children's Hospitalobinson's expertise in FAS method of prevention. based clinic that specializes in detecearned him a place in the For example, Robinson has been able tion and treatment (where possible) ational Institute on Alcohol show that facial asymmetry in infants to of birth defects in utero. At the instiAbuse and Alcoholism ( IAAA) delis linked to poor facial blood flow durtute, Robinson supervises collection egation that made two trips to South ing development. While it's not yet clear of data for a new birth-defect registry being created in collaboration with Africa last year. The joint South African how to prevent the problem, the finding the federal Centers for Disease Con- and American team was studying a re- suggests further areas of research and trol and Prevention and the ew York gion settled by French wine makers implicates drugs that are known to cause who for the past 200 years have partici- vascular spasms, such as cocaine, toState Department of Health. Robinson also serves as medical pated in the "DOP" system, which pays bacco and nicotine. Robinson also finds director of the Western ew York Tera- their African and "colored" or mixed- satisfaction and inspiration in working tology Information Service, an organi- race workers with both money and alco- with children. "l am impressed time and again with zation he helped found with his wife , hol. The DOP system gives workers wine jan, a nurse who has long-standing in- two to three times a day, five to seven the strength of children and their famiterests in public health, the prevention days a week, from age 14. This practice lies," he marvels. "They sort of develop of birth defects and service to the minor- has resulted in the highest incidence of their own realities in the way they deal ity community. The information service F AS known in the world today, a finding with disability. " Recently, he saw a former patient, a answers the questions of pregnant confirmed by the preliminary results of boy born with limb deficiencies, playing women who suspect they might have the IAAA's study. While in South Africa with the hockey. Some of his other patients, been exposed to a possible teratogen, provides examinations for their babies delegation, Dr. Robinson examined women who went through high-risk pregchildren from the farm communities nancies as teenagers, are pulling their and collects data. The Robinsons founded a similar outside of Cape Town and trained local lives together, caring for their children, information service in Texas during pediatricians on how to use specific working, or returning to school. "My work is personally rewarding and their time in Houston. Both organiza- measurements to identify FAS. "In South of materAfrica, we find the same types intellectually stimulating," Robinson tions are modeled after a California service established by Kenneth Lyons nal risk factors we find anywhere- says. "I often say children don't outgrow jones. The Robinsons' work with the poverty, undereducation, social and their conditions-they outgrow their peWestern New York Teratology Infor- medical problems," he says. "The result diatricians. I look forward to that. I look mation Service won them recognition is that it is the people with the least forward to working with a second generation of children." + from Buffalo's Our Lady of Victory resources who are most affected." �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .. . . . . . [1] ~ I Biogen Endows Chair in Neurology at UB LAWRENCE D . JACOBS , MD , PROFESSOR OF NEUROLOGY , TO BE FIRST HOLDER biotechnology company headquartered in Cambridge, Massachusetts, has established the Irvin and Rosemary Smith Chair in Neurology in the University at Buffalo School of Medicine and Biomedical Sciences through an endowment of 1.5 million. IOC.I \ L r \DI ' G I TER 1 -\TIO 1 A. I The sponsorship of the endowed chair-which is in conjunction with Biogen 's 20th anniversary celebrationwas announced by UB president William R. Greiner at a pres conference at the university in june. Lawrence D. jacobs, MD, UB professor of neurology and an internationally recognized authority on the treatment of multiple sclerosis (MS), will be the first holder of the chair (see article number of MS-related brain lesions and the number of clinical flare-ups. The drug , known by the brand name Avonex®, wa approved by the FDA in 1996 and is now the world's leading treatment for patients with relapsing forms of the disease. In announcing the endowment, Greiner said, "It is especially gratifying to have the breakthrough work of one of our most distinguished faculty memopposite). bers, Dr. Larry jacobs, lead to the Currently, MS affects 250,000 to creation of a chair in neurology that 300,000 people in the U.S., with 200 recognizes and supports his work and new patients diagnosed every week. For provides UB with a permanent legacy. reasons that are not fully understood, "Larry's path breaking research, teachpeople who live between the 38th and ing, service and leadership have elevated 52nd northern latitudes on the globe- significantly the national and internaWestern ew York is located at about tional reputation of our Department of the 43rd northern latitude-a re eurology and the UB medical school. particularly susceptible. We are very grateful to jacob was the first Biogen for recognizing researcher to show that Larry's work through this interferon beta was an generous gift to UB." effective treatment in some james L. Vincent, forms of the disease. Over Biogen's chair of the board, the past two decades, his said, "Biogen is proud to pioneering work has been supported by endow thi chair, which honors three private foundations and the ational individuals who repre ent the fine t Institutes of Health, with funding for ideals of science. l have been closely clinical trials provided by Biogen. associated with lrv and Rosemary mith Ultimately, jacob's research showed for more than 30 years. They demonthat Biogen's genetically engineered strate the highest standards of courage, interferon beta-la slowed the accumu- ethical behavior and integrity-values lation of physical disability in MS pa- that are fundamental to Biogen's corpotients, making it the first treatment ever rate philosophy. to exert such a benefit for this disease. In "We are delighted that Dr. Larry addition, the treatment reduced the jacobs is the first person to hold this B u f f a I o chair," Vincent added. "His belief in the potential of interferon beta-la as a treatment for multiple sclerosis was vital to the successful development of Avonex®, which has brought new hope toMS patients throughout the world." jacobs said he was "very honored" to be selected to hold the new Irvin and Rosemary Smith Chair in eurology. "The endowment demonstrates Biogen's commitment to the work we are doing here, and it's coming at an age when I still have plenty of time left to continue that work. "But the chair isn't forme," he added. "It's for progres in treating patients with multiple sclerosis. It will allow us to do so much, and it will ensure that the work can continue uninterrupted. " john R. Wright, MD, interim dean of the UB medical school, thanked Biogen for its generosity in endowing the chair and termed jacobs' appointment as its first holder "a well-deserved honor. ' ' T h e medical school is proud and pleased that Biogen has chosen to recognize an individual who has contributed so much to the field of neurology and to the community. Dr. jacobs has spent more than 20 years helping people who are living with this debilitating disease. His work is a great credit to himself, the UB medical school and all of the people and organizations who have believed in him and supported his research." Physician Autumn 1 9 9 8 �owrence D. Jacobs, MD, credits his involvement with the treatment and prevention of multiple sclerosis-the interest that has become his life's work-to serendipity. Anative of Buffalo, Jacobs graduated from Niagara University and earned his medical degree from St. louis University. In 1973, he joined the University at Buffalo faculty as a clinical assistant professor of neurology. Through on early affiliation with Roswell Pork Cancer Institute, where he worked as a consultant, Jacobs developed a professional relationship with Arnold Freemon, MD, and several other scientists who were conducting innovative clinical trials of interferon as a possible cancer treatment. It was Freemon who initially urged Jacobs to begin working with natural interferon, suggesting that he test it to determine its antiviral and immune-modifying properties in appropriate neurologic patients. In response to this suggestion, Jacobs decided to concentrate his interferon research on multiple sclerosis. "We asked ourselves, What ore the neurologic diseases of viral and dysimmune etiologies that might be appropriate for trials of interferon therapy?" Jacobs explains. "We first considered lou Gehrig'sdisease, but ultimately we decided on MS because Buffalo happens to be in a geographic region where MS occurs with high frequency and there were so many patients in Western New York with MS. It was just luck. As it turned out, interferon beto was not effective in treating lou Gehrig's disease, but it was effective in MS." Supported by local funding from the Baird Foundation, Delaware North and UB, Jacobs began his research. His early results, published in Science in 1981 , reported that interferon injected into the spinal fluid appeared to stop or reduce MS flare-ups. This led to another, larger multicenter doubleblind study that was supported in port by ogrant from the Notional Institutes of Health (NIH). The positive results of that trial, confirming those of the earlier study, were published in Lancet in 1986. By then Jacobs hod the full attention of the NIH; however, in order to secure funding for on even larger multicenter definitive trial, he knew he hod to show there was o possibility that, in addition to reducing the number of flare-ups, the drug could slow the accumulation of physical disability naturally associated with untreated MS. Jacobs was able to put together o research proposal that satisfied the NIH's stringent requirements regarding disability, and in 1990 he received $4.5 million over four years to conduct a Iorge study of interferon's effectiveness in slowing or reversing the accumulation of physical disability in MS patients. "Biogen then come in to support the Phose Ill trial expenses, as well as the cost of the interferon," Jacobs says. "We developed o wonderful relationship over the years." The company provided substantial monetary support and a supply of genetically engineered interferon called recombinant interferon beta-] o needed to complete the Phose Ill trial. Results of the trial showed that the drug significantly slowed the progression of disability, decreased the relapse rote and reduced the number of MS-reloted brain lesions, compared with the placebo group. Avonex®, Biogen's brand nome for the drug, was approved by the FDA in 1996. Currently, Jacobs is the principal investigator of o$12 million, 50-center study being conducted in the U.S. and Canada on the potential efficacy of the drug in preventing the development of clinical multiple sclerosis in patients who ore at high risk for the disease, such as those with optic neuritis. + -lois Boker ~LVIO.I~ ~~ MD, pioneer in the fight against multiple sderosis In addition to his professorship in neurology , Jacobs holds appointments in the UB Departments of Ophthalmology, Physiology, and Communicative Disorders and Sciences. He is head of neurology at the Buffalo General Hospital and chief of neurology at the William C. Baird Multiple Sclerosis Research Center at Millard Fillmore Hospital. He has won numerous awards and honors for his work, including the Stockton Kimball Award in 1996, and has a lengthy publication record. Irvin Smith, PhD , for whom the chair is named , is a biochemist by trammg whose career in health care and biotechnology spanned nearly 40 years. Prior to his retirement from Biogen in 1996, he served as the company's vice president for development operations and was responsible for managing the Phase Ill trial of Avonex® and for shepherding it through the lengthy FDA approval process. Biogen was established in 1978 by a group of academic researchers, including two obel Prize winners, interested in genetic engineering and its potential to improve health care. Discoveries by Biogen scientists have included the alpha interferon gene and hepati tis B antigens. In addition to Avonex®, the company's discoveries have resulted in the development of Intron® A, a leading treatment for hepatitis Band C and various cancers, and of vaccines for hepatitis B. + B u f f a l a P hysici ' a n A. u t u m n l 9 9 8 �Refiecting on 40 Years of Service CHARLES PAGANELLI, DISTINGUISHED SERVICE PROFESSOR, RETIRES HA.RLES V. P A.GA ELL!, PHD, Distinguished Service Professor, and interim chair of the Department of Physiology since 1991, retired September 1, 1998, after 40 years of service to the University at Buffalo School of Medicine and Biomedical Sciences. "For the past four decades, Charlie has been a consistently productive and extremely dedicated member and leader within this medical school's faculty, " says Interim Dean john R. Wright , MD. "His recent elevation to Distinguished Service Professor rank attests to the many contributions he has made to the university community and to the esteem in which his academic colleagues hold him. As interim chair of the Department of Physiology, and the newly created/merged Department of Physiology and Biophysics since 1997, Charlie has demonstrated extraordinary leadership, patience and vision-qualities we will surely miss as he enters retirement. " leon Farhi, MD, Distinguished Professor of Physiology and Biophysics, says, "Dr. Paganelli's retirement is a great loss for the university. He has been a most faithful servant, and his recently being named a Distinguished Service Professor was longdeserved recognition of his many superb qualities. " Paganelli came to UB in 1958 after completing his PhD in physiology at Harvard University and a two-year postdoctoral fellowship sponsored by the ational Foundation for Infantile Paralysis at the University of Copenhagen in Denmark. In the late 1950s, Hermann Rahn (chair of physiology at UB from 1956 to 1972) was in the process of building a department that was to become internationally recognized for its researchand teaching excellence. Toward this end, he knew he needed to recruit promising young faculty and so contacted friends and colleagues at Harvard and the University of Pennsylvania, including A. K. Solomon, john Pappenheimer and Robert Forster, each of whom recommended Paganelli. Rahn then wrote to Paganelli, offering him a job at the then University of Buffalo. a u f f a 1 o "My wife and I and our two young children were living in Denmark at the time, and l accepted the job sight unseen ," recalls Paganelli, who adds that he had other interesting offers but wanted to return home to ew York. A native of Brooklyn , Paganelli had moved with his family to Albion , Y, when he was 12. In 1958 his parents were still living there , which was one of the factors that turned the tide in his decision to come to UB. The other was his opportunity to join Hermann Rahn in a new and developing department. As a student and fellow , Paganelli had focused his research on examining the permeability properties of red blood cell membranes. "When I got to UB , my research interests shifted somewhat, and I became interested in transport in epithelial cells; for example, in the kidney and in amphibian skin," he says. Later, Rahn interested Paganelli in studying the permeability properties of avian eggshells, which then became his primary focus of research throughout the remainder of his career. This research, much of which was funded by the National Institutes of Health and the ational Science Foundation, provided a model for studying how gases are exchanged by diffusion in the lung. Paganelli credits Rahn with creating a work environment in the Department of Physiology that was conducive to creativity, collegiality and stability-factors, he says, that led him to stay at UB for four decades. "The department Dr. Rahn built here was very lively. It was an interesting Physician Autumn 1 9 9 8 ) �u actually been able to introduce them to something they hadn't thought of before." ln the mid-1960s, Paganelli began his long and notable career of service to the university by participating in a number of medical school committees. By the 1970s he was an active member of several committees for UB's faculty ofhealth sciences, which comprised all five ofUB's medical and health professions schools. Later he began serving on campuswide committees and was a member of the Faculty ) place and he was an extraordinary man. He had a breadth of interests that was remarkable, and because his interests were so broad, he always wanted to share ideas with you. That's how I got involved in research with bird eggs. One day he pulled me aside and said, 'Oh, I have this project l want to talk to you about,' and we went from there. He could get you interested in things." In addition to Rahn, Paganelli speaks fondly of his many colleagues in the department over the years, including Don Rennie, Suk-ki Hong and Leon Farhi. Upon arriving at UB, Paganelli was also given the customary load of teaching responsibilities, something which he says he wasn't quite prepared for at the time. "When l came to UB, I had only done a minimal amount of teaching, so l sort of got thrown into it," he recalls with a smile. Today, with four decades of experience behind him, he says without hesitation that he has very much enjoyed teaching. "What I have liked about it is the idea that you can convey concepts to students and you can see their eyes suddenly open up. It's a very satisfying feeling to think you've 6 u f f a l a Senate , which included a one-year term on the Executive Committee and seven consecutive years on the Budget Committee. He also was a member of the steering committee for the self-study that led to UB's 1982 Middle States accreditation. Paganelli says that perhaps his most memorable campus-wide assignment was his chairing of the President's Review Board on Appointments, Promotions and Tenure (PRB) in the mid1980s. ln a 1997 letter in which he nominated Paganelli to the rank of Distinguished Service Professor, UB president William R. Greiner wrote: Physician Autumn 1 9 9 8 "Service on this board demands an extensive commitment of time, as well as a commitment to the university's highest ideals. One colleague notes that Professor Paganelli was 'an exceedingly effective [PRB] chair who dealt diplomatically but incisively with very sensitive matters."' ln addition to his research, teaching and service responsibilities, Paganelli was also given demanding administrative responsibilities. From 1991 until his retirement, he served as interim chair of physiology, a role he also fulfilled from 1980 to 1982 and again in 1986. He was also associate chair of the department from 1976 to 1980 and again from 1982 to 1991. Paganelli, who is 69, says he and his wife, Barbara, plan to travel in retirement, as well as spend more time with their five children and eight grandchildren. Their eventual plans include living in Italy for an extended period of time and visiting Hawaii to renew friendships they made in 1974 while on sabbatical at the University of Hawaii. When asked what he feels about retiring after 40 years of service to UB, Paganelli says, 'This has been a very good place to work. I've had wonderful colleagues and very good students, and I've been proud to be affiliated with this university. "However, I don't have mixed feelings about retiring," he adds. "It's time." + - 5 . A U N G E R �. . . . .. . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .. . . . . . . [1] ~ I Inaugural White Coat Ceremony CLASS OF 2002 REMINDED THAT THEIR MEDICAL CAREERS HAVE BEGUN swear to fulfill, to the best r recited the Class of 2002 as they began the "Physician's Oath" at the inaugural White Coat Ceremony held in August to welcome the school's newest medical students. tremely competitive academic environments where the element of humanism is often missing, Flanagan adds. p s he expansion of my knowl· edge throughout my life for the benefit of my p The greatest challenge for medical ln the presence of faculty, staff, peers, experienced kidney failure a week bestudents today is that they cannot family and friends, members of the fore finals as a junior at the University of school's l52nd class were "cloaked" with California at los Angeles. anticipate what the their first white coats to mark the begin- He says he was inspired medical field will be like because it is constantly ning of a new UB tradition that empha- to pursue a career in sizes the importance of physicians medicine by the compaschanging and evolving, serving with compassion as well as skill. sion and encouragement according to Flanagan . The Arnold P. Gold Foundation, an shown to him by one of He says that one of the organization dedicated to fostering hu- the doctors during his hospital stay. strengths of this year's manism in medicine , conceptualized the I ri r me e a t e e s o and class is the diversity of their academic ceremony, which reminds new doctors s(e e o die e and cultural backgrounds , which Teaching the more personal, psycho- he feels will contribute in a positive of their responsibility to 'care' as well as 'cure' by endorsing a psychological con- logical aspects of medicine has always way to their ability to adapt to change tract for professionalism and empathy been a challenge for medical educators, and to continue learning throughout at the start of their medical catheir careers. reers. Today, about 85 medical This year UB received " WHEN YOU HAVE THIS COAT ON , WHETHER schools nationwide hold similar 2,500 applications, or about initiation ceremonies for incom19 applicants per slot. YOU ARE A STUDENT OR A PRACTICING ing students. Thomas Guttuso, MD , assisDOCTOR , YOU ARE EXPECTED TO UPHOLD . . . I will respect the scientific gains tant dean and director of CERTAIN IDEALS . THE CEREMONY REMINDED of those physicians and scientists in admissions, says motivation, whose steps Iwallc, and gladly share empathy and social awareness US ALL THAT OUR CAREER STARTS NOW AND such knowledge as is mine with those are the qualities that are most NOT IN FOUR YEARS ." who are to follow ... closely evaluated in the The White Coat Ceremony Class of 2002 applicants. A was an extraordinary way to Guttuso adds that this begin medical school, says firstclass, which has 70 women year student Morcos Morcos. " Reading according to Tom Flanagan, MD , assis- and 65 men , is the first in the school's the oath reminded us that we're not here tant dean for student and curricular history to have a greater number of just to pass a class." Marcos adds that he affairs, who organized the White Coat female students. The students range appreciates the advice he received from Ceremony. "Educators in the medical from age 23 to 35, with the majority a second-year student who told him that field have done a really good job of of the class between 23 and 26 years of it's as important to share knowledge in teaching the technology , science and age. Most students majored in science medical school as it is in medical prac- even the economical aspects of medi- as undergraduates but a substantial4l tice , and who warned him to be wary of cine; teaching the art of medicine , how- students were non-science majors. The overly competitive students. ever, is more difficult. " mean undergraduate grade point Morcos, who recently celebrated his This challenge is compounded by the average of the class is 3.55 overall and th ird anniversary of a kidney transplant, fact that many students come from ex- 3.5 in science courses. a u f f a I a P hysician Autumn 1 9 9 8 �I ----- --- ························································································• · ~ I I ••. I will practice medicine with conscience potential partnership in Georgia at the several times in several ways to accomand d1gn f last minute to pursue her dream of at- modate changes in the medical field, Margaret Paroski, associate profes- tending medical school. explains Flanagan. sor of clinical neurology at UB and the A few years ago Dennis adler, MD, e f my patient featured speaker at the ceremony, told a associate dean of the medical school, the students to be proud of their accomAccording to first-year student requested that a student committee be plishments in making it to medical Antoinette Alonzo, there are very few oc- formed to review several existing verschool, but to be careful not to become cupationswithasmanyrights. "Wehaveto sions of the oath and to decide on their arrogant. "The higher the pedestal you're remember that people are entrusting us. own UB version to reflect the modern on, the harder people try to knock you They are telling us things that they wouldn't world of medicine. The students seoff it," she warned. lected a brief version of an oath by tell anyone else." First-year student Louis Lasagna, MD, Deana Savage felt of Tufts University Paroski's best advice was School of Medicine, to live for today because which was then tomorrow is not promadopted as UB's ised. "Life is today, life "Physician's Oath." is now. Don't feel you ... Most especially I have to wait to start livwill tread with care in matters of life and ing until you have finished medical school," death. If it be merely advised Paroski. "Try to within my abilities to help ease suffering at enjoy these next four the end of a life, may I years and don' t feel face this awesome reguilty if you take time to sponsibility with hudo something you really mility and awareness want to do." of my own frailty ... The mother of a twoyear-old son, Savage can- Peter Ostrow, MD, associate professor of pathology, helps first-year student Jundo Woo of Brooklyn don her white coot. ew student not put life on hold for Steven Weitzman four years. "He is actually going to help Alonzo was in dental school at the Uni- realizes the value of humanism in me," she says about her son. "lf I ever versity of Pennsylvania when she realized medicine after battling lymphoma while think about putting off studying, I will she was trying to make dentistry a substi- pursuing his master's degree in just look at him." tute for her real passion to study medicine. counseling psychology. Throughout Savage, originally from Buffalo, is "It gives me a sense of relief and peace of chemotherapy, Weitzman continued one of 23 UB graduates in this year's mind to be here after having gone through working part-time toward his degree class and proved her loyalty by submit- something that l knew in my heart wasn't and today is in full remission. Although ting only one medical school applica- really for me." he has considered pursuing oncology, tion. "When I read the acceptance letter, For Alonzo , the white coat is a mean- Weitzman thinks he may try child I think everyone in my neighborhood ingful symbol. "When you have this psychiatry since it will not hold such heard me screaming," she laughs. "The coat on, whether you are a student or a personal relevance. practicing doctor, you are expected to excitement still hasn't worn off." The high point of the White Coat Of the 139 new students, four are uphold certain ideals. The ceremony Ceremony for Weitzman, he says, was MD/PhD candidates, three have reminded us all that our career starts when Guttuso read his name and called already earned doctoral degrees and now and not in four years." him 'Dr. ' "It made me feel so privier Ican; for leged to be here." another 14 hold master's degrees in 1e prev I vow always to act to preserve the business administration. finest traditions of my calling and may /long Savage is among those embarking on The ancient Hippocratic Oath no a second career. Previously a resident longer accurately reflects what physi- experience the joy of healing those who podiatrist in Maryland, she gave up a cians do today and has been altered seek my help. + B u f f a l o Physician A. u t u m n 1 9 9 8 �WITH HIS ARTIST AT WORK , SELF-PORTRAIT 24 B u f Q 0 p h w • c a n Jl. u u m n 9 9 8 �························································································• · ~ I The Artful Doctor US PROFESSOR ' S PAINTINGS SELECTED FOR INTERNATIONAL JURIED SHOW E I '> B f R T R \ \! -physician, public health specialist and accomplished scientist at the University at Buffalo-is ready to give it all up for art. Three years ago, the clinical assistant professor in the Department of Social and Preventive Medicine rekindled a love of painting he had abandoned decades earlier. When one of his new works was accepted into an international juried show earlier this year, there was no turning back. "If I could, I would do nothing but paint," says Bertram, sitting in the living room of his tum-ofthe-century orth Buffalo home, where his canvases cover the walls and cluster in the corners. "But I can't afford to." Thus, as with physiciansturned-painters-or - poets throughout history, science subsidizes art. Bertram spends mornings at the School of Medicine and Biomedical Sciences, helping direct the school's new Master of Public Health Program and its preventive-medicine residency. In the afternoons and evenings he takes classes, paints and applies to art shows. "My wife tells me l'm catching up, keeping up and going ahead all at the same time," he notes. Bertram's divergence from art early on is a telling example of environment subverting genetics. "Art is something I wanted to do when I was a kid," he says. "I was the one who did the illustrations for the school newspaper and painted the stage sets in high school. I even won an art contest. s u f f a 1 o "But there was no art education in my grade school or high school. There were no role models and I had no encouragement. I was raised to believe in self-sacrifice, to live life for the betterment of others. To go into art would have seemed selfish. "But there was lots of encouragement to go into science," he says. "Lots of role models, and science offered lots of opportunity. And I was good at it." Consequently, Bertram majored in zoology, no tart, at Indiana University and earned a medical degree from Washington University. He investigatedartschoolsaftergraduating from medical school, but didn't have the courage then to make a major career change, he says. Instead, he went to the johns Hopkins University and earned a master's degree in public health and a doctorate in science. For nine years, he was an assistant professor of social and preventive medicine at UB, conducting health-services research and publishing papers in scien- Physician Autumn 1 9 9 8 I tific journals. Injanuary 1995, he left UB to manage the technical-information program locally for The HMO Group, where he assessed the scientific merit and effectiveness of medical techniques. Bertram's wife, Peggy Brooks-Bertram, assistant to the vice president in the UB Office of Public Service and Urban Affairs, inadvertently pointed him back to art. "It was around Christmas in 1995, and my wife wanted to do something different in the foyer for the holidays, so she dragged out the drawings l did in medical school. I didn't realize they were still around. l looked at them and thought, 'Hey! l wasn't so bad! Let merethink this."' When Bertram left The HMO Group in 1996 to work as a consultant, the less-rigid schedule allowed him time to paint. He enrolled in art classes at Buffalo State College and began to draw and paint again. This time around, there was plenty of encouragement: He submitted works to an amateur art show at the Erie County Fair, winning ribbons and recognition that spurred him on. When his painting "At Ease" (pictured left) was one of 116 pieces out of l ,500 submissions accepted into the ew jersey Center for the Visual Arts' 12th IntemationaljuriedShow, he was thrilled. The show was juried by an Rosentha, consultant in 20th-century art to the Metropolitan Museum of Art, and ran from February 15 through March 29, 1998. Bertram was e pecially pleased that his very traditional piece, influenced by Winslow Homer and Andrew Wyeth, was selected, despite fitting into neither of the two movements Rosentha said characterized most of the selections: collage and assemblage, and surrealism. With his talent affirmed, Bertram now presses on fearlessly. "I no longer have doubts, as I did when I was younger, that lam able to do it," he says." ow all I need is time." + �• . ·········· ··· ······ · ······· · ······················ · ···························· ·· ······· l I "Wimpy"Parents Take Note inconvenience and failure." The results: children who often are inconsiderate, unpleasant, demanding and unhappy. UB PROFESSOR ' S BOOK ON PARENTING GAINS ATTENTION Although the rules and relationships invariably change between parent and child through the stages that lead to adulthood, Condrell says underlying HI- PROC Rf SSI\ f, CHILD-CE TE RED parenting movement, goals should not. "Early on, it's vital that popular during the past two decades, has given rise to a youngsters learn to respect authority, the rights of others and the consequences national epidemic of families in which children are "running" of their actions. " Even the very young can learn the the show, according to child psychologist and family therapist meaning of the word "no" and that misbehavior, lying, cheatKenneth . Condrell, PhD. ing , bullying, whining, Condrell, a clinical assistant professor putting these misobstinance and tantrums in the Department of Psychiatry at the guided, tired, loving parlead to age-appropriate punUniversity at Buffalo, is coauthor with en ts back in charge of ishment. Loss of privileges, Linda Lee Small of a new book, Wimpy their children, their toys , television, trips or Parents, From Toddler to Teen: How NOT families and their lives. games for a predetermined From fodd. r to Teento Raise a Brat, published recently by Wimpy Parents, From HO\\ time carries the message to Rue Warner Books. He notes that parents have Toddler to Teen: How when applied consistently, a Brat been encouraged by the "self-esteem moveOT to Raise a Brat he notes. ment" to not be strict or bossy with their provides parents with Condrell stresses that it's offspring. Instead of being strong family examples and anecalso important to complileaders, he adds, they have become dotes on how to be ment and reward good "wimpy" parents, raising kids who are loving and successful paren ts and behavior so a child gets in the habit of selfish, demanding and disrespectful. enjoy their children into adulthood. behaving at home and elsewhere. The theory followed by these parents The goal of parents should be to teach Bratty behavior, if not altered at some their children a strong point, returns again and again once the sense of responsibility, children become adults. "They are usu• worth and values, which ally the adults who will later inconsiderprepares them for the chal- ately drop off their children with lenge ahead in an often- grandma and grandpa with little or no changing, demanding, warning to baby-sit, borrow money when stressful wor ld , says they find themselves in preventable Condrell. Otherwise, they financial predicaments or expect to will not grow up prepared routinely be bailed out of self-created for the real world, where messes," Condrell observes. proposes that by promoting youngsters' sel [-centered, insensitive, irresponsible Parents, he says, need to teach their self-esteem and turning the family into behavior leads to unhappy relationships, children moral values and responsibila democracy, children will grow up to as well as serious and often grave, life- ity through discipline and example, and be confident, competent, successful threatening consequences. be firm and loving in doing so. "If they adults. "Wimpy parents find it difficult to be don't learn these lessons when they're "The theory looked good on paper, in charge," Condrell emphasizes. "They growing up, they'll learn them later from but in reality, it was awful," says Condrell, are too loving, too patient, take too the real world, which won't be as loving, who founded and directs a large group much abuse and are wishy-washy where forgiving or supportive," he adds. practice specializing in family therapy. discipline and enforcing house rules are Condrell has appeared on national teleow he and other clinical psycholo- concerned because they want to save vision, including CN and BC-TV's gists find themselves spending more time their children from unhappiness, Today show. + Parents . ® B u f f a I o - BY MARY BETH Au tumn SPINA 1 9 9 8 �·····················································································• · ~ . . ~. e I s d 0 g ', s e t s ., r j e s :l f Innovative Partnership Brings Gamma Knife to Buffalo n August 4, 1998, David C. Hahn, MD , president and chief executive officer of Roswell Park Cancer Institute (RPCI), announced the formation of an innovative partnership with Buffalo eurosurgery Group, the University at Buffalo's Department of Neurology and the Roswell Park Alliance Foundation to bring to Western ew York a Leksell Gamma Knife, which he called "one of the most groundbreaking medical advances of recent years. " In announcing acquisition of the gamma knife, which will be operational this fall, RPCI becomes the only facility in Western ew York-and one of only 47 facilities in orth America-to offer this tool for noninvasive brain radiosurgery. The purchase of the gamma knife was made possible through a $3.6 million grant from the Roswell Park Alliance Foundation, chaired by the Han. Nancy aples. "This type of cooperative venture between private practice, university neurosurgeons and Roswell Park Cancer Institute Will be the hallmark of health care in the 21st century," says L. elson Hopkins, MD, professor and chair of neurosurgery, and professor of radiology and director of the Toshiba Stroke Research Center at the University at Buffalo. The gamma knife delivers a single, high dose of ionizing radiation from 20 l intersecting beams to a target previously defined by advanced imaging techniques. It offers the precision of surgery Without a scalpel and without the usual risks associated with surgery, while pro- viding enough radiation to destroy a lesion. This form of radiosurgery has proven successful as a treatment for benign and malignant tumors and vascular malformations located in critical, difficult-to-access areas of the brain. "The gamma knife represents a major technological advance toward noninvasive treatment, which is rapidly becoming the standard of care for some of these conditions," says Douglas B. Moreland, MD , director of Buffalo eurosurgery Group and chief of neurosurgery at Sisters Hospital. For brain tumor patients who are not good surgical candidates due to age, health status , or the inability to tolerate anesthesia , the gamma knife may be an alternative to conventional surgery. For others, it may be used as an adjunct to conventional surgery. Following treatment with this state-ofthe-an radiosurgical tool, patients can usually return to their normal routines within a day, allowing them to maintain good quality of life while eliminating costly hospital stays. Between 1988and 1997, the number of gamma knife sites worldwide has grown from five to 112. Over the same period , the number of patients treated has increased each year from 2,190 in 1988 to 80,000 by 1997. Gary M. Proulx, MD, radiotherapy codirector of the Gamma Knife Center, says, "The gamma knife and other improvements planned for the Brain Tumor Treatment Center at Roswell Park Cancer Institute will make the newest and best treatment modalities available to patients with malignant and certain benign diseases of the central nervous system." + Physician A. u t u m n 1 9 9 8 In Memoriam I �~ -······················································································· ~ Student Lounge aSocial Haven SUPPORT O F MED ICA L A L UMN I A SSO CIATION A PPR ECIATED hile physicians often prescribe rest and relaxation for stressprone patients, future doctors are experiencing the true value of the therapy in the UB medical school's student lounge. Opened in 1993 with the help of the Medical Alumni Association, what was once a medical conference room in 133 Cary Hall is now home to the hustle and bustle of busy medical students who depend on the room's comforting features to accommodate their hectic lifestyle. Visitors to the lounge shouldn't expect to encounter discussions of gross anatomy or cell biology so much as heated foosball games between medical and dental students or a game of pool in which first-year medical students have challenged more experienced 'second-years.' Air-conditioned and furnished with a full-size refrigerator , microwave , VCR, televi ion , copier machine, pool table, two foosball machines , soda machines , couches, and tables and chairs, the lounge provides a recreational retreat for hard-working medical students, who have access to the room 24 hours a day with a 4-digit security access code. Second-year students Tom Zajac and Hugh Bui say they visit the student lounge to work on their foosball skills. "lt helps hand-eye coordination in case you want to go into surgery," jokes Zajac. Bui sums up what he thinks about the lounge in three words: fridge , food and foos. Cheryl Taurassi, a third-year student, frequents the lounge mostly to use the refrigerator and microwave. "The majority of us use it as a place to eat lunch, ® hang out and take a break, or in some cases to nap on the couch," she says. "It's also great in between classes if you only have 15 minutes or a half hour unUlyournext c~ss." The lounge is currently maintained by POLITY, the medical student governing alumni affairs in the medical school. ow retired, Richert recalls when the lounge area also was the Lippschutz conference room, which relocated to the Biomedical Education Building. Before the lounge was created, he remembers , the only place students .. WITH SO MuCH EMPHASIS BEING PLACED ON EDUCA· body, whose -ION IN A STRICT SENSE offices, along -HE LOUNGE IS A SOCIAL with those for the 1ris, HAVEN THAT ENABLES US the medical TO COMPLETE OUR student yearT0GETHER book, are located -CHRIS ADAMS within th e POLJJY P1rsidrnt lounge. The governing board of the UB Medical Alumni Association played a primary role in furnishing the lounge , with the help ofjohn Richert , EdD, former associate dean for Dl'~A~ION B u f f a l o Phys ici could hangout socially was in the atrium in the Biomedical Education Building. "The students felt the atrium area was too public , and they wanted something more private that they could call their own," he recalls. "l agreed, and POLITY submitted budget proposals two years in a row to the governing board of directors. Both yea rs we designated money to help students furnish the lounge. " With the generous donation from the alumni association, students were able to purchase couches, tables , chairs, a television and a VCR. Bertram Portin , MD , current assistant dean for alumni affairs, adds that an A. u t u m n I 9 9 8 �················· · · · ···· · ······························································· ~ the alumni association is studentoriented and supportive of enhancing the quality of student life. "Members of the association have a genuine concern for the students' needs and fee l very strongly that the students should be taken care of. l was glad to play a part in making such resources avai lable," he says. The lounge is especially important to students because it allows them a diversion from the pressures of school. "It gives us an opportunity to get away from school work," says third -year student jason Lake, who was a regular at the pool table his first two years, when he participated in organized lounge pool tournaments. "If we had no escape , life would get pretty dull." To offset the seriousness of their studies with a little humor, other students turn to television. Popular programs include stand-up shows of comedian Chris Rock and reruns of South Parh, says second-year student Charmaine Gregory. Some students, however, use the television as a learning tool. Gregory notes that she has seen students taking advantage of the VCR to study histology slides on videotape. As second-year student Debbie Ogie busily makes copies, she explains the convenience the lounge offers students who want to stay in the building to make a few copies or to look over material. "In the winter, people don't like to have to walk over to Harriman or the library," she says. "It's also really nice because it is a place where I can relax with friends.·· • According to POLITY president Chris Adams, the lounge gives students an opportunity to enjoy each other's company in a relaxed environment. He explains that the friendly atmosphere of the lounge helps foster the development of interpersonal skills, which are important to being a good physician. "I feel that the lounge is an integral part of our experience here at UB. With so much emphasis being placed on education in a strict sense, the lounge is a social haven that enables us to complete our education together .., Adams adds, "It's great to see the dedication of the school's graduates to the needs of current students. I think I speak for all of the students who use the lounge in saying that the efforts of the alumni are greatly appreciated." + \ \}\~c a mistake . But not from the inside . The roof looks funny, odd, strange, n\\~ 1.l1e wa\" IH' sec il. 11 h~· build a >otraight roof 11 hen ~·<nl ean build a perfeetl1· good erooked one'c It·, something up to se1·en passengers in the Land l{o,·er llisem·er1· 11ill trul1· appreeiare. \\"ith the elenlted roof and stadiumlikc sea tin(\. passen(\ers in the rear ha1·e ample headroom. \\' hieh means the~· ean look at more than the hack of the front seal. ~luch more. in fac1. Beeause the Land Ro1·er Dbe01·ery ha>o more 11indows than an1· other 4x4 . \\'h~· no~ take _one out for a test dril·e'c .\nd instead ot just looking into it. look out of i!. 48 DISCOVERY Land Rover Amherst ANORTHTOWN AIJTOMOlM COWAN'f 3560 Sheridan Drive Amherst, New York 14226 • (716) 831-3100 http//www.northtownauto.com L B u f f a l o P hysician Autumn I 9 9 8 �r ! J ··· · ·················· · ····················· · ····· ·· ····················· · ··· · ·· · ······· Learning about the Realities of Cancer Care caring for the patients. My interactions with the patients became close, and my with long hours in the lecture halls and laboratories and late concern for each of them deepened. The nights of study, I eagerly looked forward to summer vacation. Y~t patients' openness with me made me feel even more concern and sympathy my eagerness to see summer arrive was not for the typical for their situations. reasons, since what I was excited about was beginning a clinical Full of optimism for each of them, it shocked me when I would learn from research program at Roswell Park Cancer Institute. the attending that a patient's cancer was The disease of cancer has intrigued Park, my views about quality of life progressing and we had no cure. I would me since my junior year as an under- have been challenged and redefined. think to myself, "How will we tell the graduate, when I worked at Yale Cancer In my formerly naive view, I felt that patient? What do we say? " When I observed Dr. Lawrence Center. Since that time, my apprecia- when patients or physicians Leichman talking with pation for oncology has only deepened, in decided to stop treatment or tients, it was consoling to large part due to my having had an to not undergo experimental see how he would indicate to opportunity to work with two medical therapy at all, they were givthem, either verbally or by oncologists, Dr. Amy Early and Dr. Meir ing up too ea ily or accepting his demeanor, that what he Wetzler, during the past school year. defeat before even trying. owl understand why somewas about to say would not Gradually, the field started to have times it may not be worth much to be easy. In fact, he said that if telling meaning to me beyond the complexities people such bad news ever becomes of cancer biology or the therapeutic "fight" anymore, or even try at all. On most GI clinic days there were easy, it's time to do something else. And regimen : l began to realize that it's the end-of-life issues that pose the greatest between 25 and 30 patients. Although he is right. Patients deserve someone there was a fellow and a resident to who empathizes and is fully supporting challenge to an oncologist. Textbooks and manuals will tell you make preliminary assessments of the them during this time. If therapy does about staging and chemotherapy, but patients, the large number of patients work, the oncologist's care and support how do you tell omeone that there is no meant that I, too, had an opportunity to may be all the medical hope they have. It was a challenging summer to cure for his or her disease? How do you take historic and perform physical exadvise a patient on whether to use ag- aminations. l built confidence and soon face life and death issue so frequently. gressive treatment or to enjoy his or her felt like an important part of the team On one occasion, l watch ed Dr. last months in a Leichman tell a mother that her 23healthier, asymp tomatic state? There year-old son might TEXTBOOKS AND MANUALS WILL TELL YOU ABOUT live only a few more arenorightorwrong answer , nor will it months. The doctor STAGING AND CHEMOTHERAPY, BUT HOW DO YOU TELL told her what she be the same in every SOMEONE THAT THERE IS NO CURE FOR HIS OR HER probabl y already situation. knew, but now it After working for DISEASE? HOW DO YOU ADVISE A PATIENT ON WHETHER TO had been confirmed eight weeks under that things were not the direction of Drs. USE AGGRESSIVE TREATMENT OR TO ENJOY HIS OR HER going to improve. Lawrence and Gail In another case, Leichman in the LAST MONTHS IN A HEALTHIER. ASYMPTOMATIC STATE? a woman who had gastrointestinal received secondservice at Roswell pn1 r" ', r.;mc::,T YEA.R OF MEDICAL SCHOOL filled B u f f a l o Phys i cian Autumn 1 9 9 8 �• • • • • • 0 • 0 • 0 • • • • • • • • • • 0 • 0 • • • • • 0 • • • • • • • • • • • • 0 • 0 • • • 0 • • • • • • • • • 0 • • • • • • • ~~~~~~~~ HURWITZ & RNE, P.C. [ line treatment for her colorectal cancer was told it was not shrinking the tumor and that there were no more reasonable options. Sh e could not appreciate the implications of having failed the second-line regimen, and her response to the poor results was that everything was going to be okay and the physician would just find another type of chemotherapy that would eventually work. But her husband, who was in the hospital room at the time, understood perfectly. As we left the room, he followed us out and asked with uneasiness, "What do I say to my wife when we get home? " He did not know how to cope with the next few days or the next few months. We had no answers for him except that we would try to find another treatment for which she might be eligible, but explained it was B u f f o l o Phy highly unlikely that it would work. It is not common to tell someone how long they have to live, but certain circumstances require it. Patients need to be aware of what is happening to them so they can prepare accordingly. It is usually done out of respect for the patients and their families. However, discussing how long a patient has to live may not be appropriate because one may not know the efficacy of treatment or how fast the cancer will progress to making a significant systemic impact. Also, one may unfairly take away hope for a patient's survival and cause him or her to worsen more quickly due to psychological debilitation. Sometimes l would stand in the clinic and wonder, "What are we accomplishing in oncology? Are we really helping anyone? " But then I remember the many faces we see each day and feel satisfied because I know that regardless of the outcome, we are supporting these patients through what may be the most difficult and scary ordeal that they will encounter. We see the trusting eyes peering at the doctor, who may give a glimmer of hope. We also see the insecurity, not knowing if and when the cancer will come back now that therapy has been successful. Every day may bring smiles of denial, euphoric laughs to cover the hurt, angry outbursts, silent acceptance or slow tears. Although oncology is challenging, we help people to cope. And that may be all that is needed to say that it is worth it in the end. + sician Autumn l 9 9 8 ATTOR EYS AT LAW SERVICI G THE LEGAL NEEDS OF THE H EALTH Scm cEs CoMMU ITY • Managed Care • Purchase & Sale of Practices • Business & Tax Planning • HCFA Safe Harbor Regulations and Physician Self-Referral • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • C redentialing and By-Laws • Hospitai!Medical Staff Issues Please contact Robert P. Fine or Lawrence Mo Ross at 716-849-8900 1300 Liberty Building Buffalo. New York I �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] '' ... ' ' Body Shape May Indicate Increased Risk of Breast Cancer omen who display certain physical characteristics, such as abundant body hair, excessively oily skin and an apple-shaped physique, may have a greater risk of developing breast cancer than other women, researchers at the University at Buffalo have found. Results of the research were presented in june by Paula Muti, MD , UB assistant professor of social and preventive medicine, at the annual meeting of the Society for Epidemiologic Research . The finding comes from an analysis of women who took part in a study in orthern Italy called ORDETHORmone and Diet Etiology of Breast Cancer. Muti says blood levels of male sexual hormones , called androgens , produced in women in small amounts by the ovaries and the adrenal glands, have been positively associated with the risk of developing breast cancer in several prospective studies. The most active androgen is testosterone. The current study sought to determine if external signs of high androgen levels in women could be associated with brea t cancer risk. A positive finding would mean that these traits could be used as a screening tool. "lf these characteristics are linked to an increased risk , women with these traits could be referred for closer screening, or could receive treatment to lower the androgen level," she says. "There are hormone-lowering drugs available, and there are also indications that a diet high in vegetables, fruits and fiber can lower testosterone levels." Muti followed a group of pre- andpostmenopausal women in the Italian study for three years. At the beginning of the study, the women were assigned a score based on an assessment of the amount of body hair. Researchers also assessed sebum production-the output of the skin's oil- and waxproducing sebaceous glands-and body-fat distribution, based on the ratio of waist-to-hip measurements. At the end of three years, 36 premenopausal and 26 postmenopausal women had developed breast cancer. The remaining participants-136 premenopausal and 99 postmenopausal women-served as controls. Analysis of androgenic traits in women with breast cancer and in those free of the disease showed that: • Postmenopausal women with excess body hair had a 33 percent increase in risk of developing breast cancer versus their counterparts with no excess body hair. There was no relationship bet\>\oeen body hair and breast cancer risk in premenopausal women. • Excess sebum production was a significant risk factor for premenopausal women , but not for postmenopausal women. Premenopausal women with the highest levels of sebum production had 2 lf2 times the risk of developing breast cancer compared to those at the lowest level. • Premenopausal women with the stereotypical "apple" shape, in which the waist is bigger than the hips , had a 2112 times greater risk of developing breast cancer than their counterparts with "pear" shapes, in which the hips are bigger than the waist. o signifi- B u f f a l o ., < 0 X . ~ > 0 ~ cant relationship was found between waist-to-hip ratio and breast cancer risk in postmenopausal women. The results, Muti says, provide more evidence that androgens play a role in the development of breast cancer and show that outward signs of high androgen levels could be a useful screening tool for the disease . Martin Stanulla, MD , a visiting researcher from the Medical School of Hannover, Germany, also participated in the study. + Physician - L 0 I 5 Autumn 8 A K E R 1 9 9 8 �··········································· · ·················· · ························· ·· a ' '<~~ . Two Sperm Abnormalities Linked to Low Pregnancy Rates link between specific clinical pregnancies and very low levels of two sperm abnormalities has been found by fertility researchers at the University at Buffalo School of Medicine and Biomedical Sciences. The two abnormalities-premature acrosome reaction and premature chromosomal decondensation-are overlooked in a standard semen analysis and had never been linked to low pregnancy rates, says Lani]. Burkman, PhD, UB assistant professor of gynecology and obstetrics, and urology, and head of the Andrology Section of the UB Department of Gynecology-Obstetrics. By analyzing hundreds of semen samples and comparing them with subsequent pregnancies in the couples studied, Burkman and colleagues determined that samples showing more than 7 percent premature acrosome reaction or more than 14 percent premature chromosomal decondensation had only a slim chance of leading to a pregnancy. "We were surprised to see that these two factors related to pregnancy so clearly," says Burkman, lead researcher on the study. "This is a new finding, and it's impressive because the test is so simple." The acrosome is an enzyme-filled cap covering half the sperm head. Just before fertilization, enzymes from the acrosome, activated at the proper time, soften the egg's covering, or zona, and allow the sperm head with its genetic material to fertilize the egg. If the enzymes are released too soon (a process called premature acrosome reaction) , the sperm is rendered useless. Premature chromosomal decondensation refers to the untimely unraveling of the sperm's tightly packed genetic cargo. lf this begins before the sperm has penetrated the egg, the sperm head swells and fertilization becomes impossible. "ln our study, when pregnancy occurred, we knew that the partner's sperm were capable of fertilizing the egg," Burkman says. "When pregnancy did not occur, the possibility existed that the sperm failed at one or more points in the fertilization process." For this study, the results of which were presented at a meeting of the American Urology Association in June, researchers analyzed semen samples from 250 consecutive patients who came to their andrology laboratory at the Children's Hospital of Buffalo. Samples were rejected if the male did not follow instructions carefully or if the samples were more than one hour old. Each sperm slide was scored for percentage of sperm showing the premature acrosome reaction or evidence of chromosomal decondensation. These scores were then correlated with the couples' pregnancy results, which were grouped as natural pregnancies, intrauterine inseminations and in vitro fertilizations, or no pregnancies. Results showed a very low incidence of acrosome reaction or chromosomal decondensation in the natural pregnancy group, while in the no-pregnancy group, the rates for both errors were significantly higher. Based on these data, the researchers established fertility thresholds of 7 percent premature acrosome reaction and 14 percent chromosomal decondensation, then tested their criteria on sub- e an u f f a 1 o Physic i Autumn 1 9 9 8 ·~ '· ' . sequent new pregnancies. They found that of the 29 couples who later achieved a pregnancy, 82 percent fit the new semen criteria. "Eighty percent of what we guessed would happen, happened," Burkman says. 'This also means that only 20 percent of the problem semen cases could be linked to a pregnancy. So couples with either of these errors have greatly reduced pregnancy potential. "Fifteen years ago, we knew so little about the human sperm that we couldn' t come close to models for predicting pregnancy," she says. "We know much more now." Also participating in the study were Kent Crickard, MD, Frank Gonzalez, MD, and Hemlata Bhakoo, PhD, all ofUB and Children's Hospital, and MaryLou M. Bodziak of Children's Hospital. + -LOIS BAKER ., < 0 '> . 1- 0 1- �BY J . LINDA CORDER . PHD , CFRE AHelpful Guide for Planning ISITS, PHONE CALLS AND MAIL-these provide much of the communication between the development office and those who are interested in contributing money, appreciated stock, real estate or other personal property to the University at Buffalo School of Medicine and Biomedical Sciences. Incoming and outgoing communication is rather even. I enjoy learning from those who love the school as much as providing information for those who request it. Recently, one of the school's generous donors passed along a worksheet on appreciated stock with an example. I had the occasion to share it with others during the summer. Nov,.·, once or twice a week, I receive a nev,. request to send it to someone's friend or classmate, or I am asked for "another copy since I gave mine away." Something with such widespread interest deserves a broader audience, so I decided to share it through this column. What follows is a summary narrative of the procedure, and then a story. It is offered merely as a guide for planning and for your enjoyment. As always, when you are ready to make decisions affecting your taxes, talk with your tax professional. If you would like more details, please contact me at the office. Income tax charitable deductions may be claimed for gifts of intangible capital gain property contributed to the school. The amount claimed is the fair market value on the date the assets arc transferred from the donor to the UB foundation for the school. The overall deduction of such property is limited to 30 percent of the donor's adJUSted gross income for that tax year. To compute an "approximate maximum" deduction, note your adjusted gross income from the prior year (assuming no drastic changes in circumstances), and multiply b) 30 percent ('·x 0.3"). This will give you the maximum allowable deduction for your annual income. To determine the tax benefit of a proposed contribution, multipl) the deduction by your marginal tax rate to compute your tax savings. Marginal rates range from 15 percent for incomes under $41,200 to nearly 40 percent for incomes over $2 71,050. Most ® a u f f a 1 o of the donors with whom I have worked recently have tax rates of 31 percent or 36 percent. If you have a reason to liquidate stock and would like to be philanthropic rather than pay capital gains taxes, you take the amount of tax savings on your gift and multiply it by 5. (The "tax savings" represents the 20 percent figure you would pay in capital gains taxes.) This number will give you the amount of personal gain you can obtain using the tax savings from a gift to offset capital gains taxes you would otherwise pay. Let's look at Dr. G. I. Feelgood's situation. In 1997, he had an adjusted gross income of $270,000. Dr. Feelgood also owns 5,400 shares of stock in Small Biotech Laboratories, Inc., which he acquired over the years with an average cost basis of $3 per share. SBL never paid a dividend. Currently, it sells for $44 per share. Dr. Feelgood's holdings are worth $23 7,600-a potential gainof$221,400. Dr. Fcelgood wouldfeeleven betterifhecould sell the stock and use the proceeds to pay off his condo in Arizona. In addition, Dr. Feelgood would feel terrific if he could use part of the "gains" to benefit good ole' UB medical school, and at the same time reduce his tax burden. Dr. Fcelgood figures that he could give a maximum of $81,000 in stock ($270,000 adjusted gross income x 30 percent) and save $29,160 in taxes ($81,000 x 36 percent). With the tax savings and a capital gains rate of20percent, he could also realize againof$145,800 ($29,160x 5), in essence, tax-free. A gain of $41 per share is equal to 3,556 shares ($145,800 di\i.ded by $41) for $156,484. So, the good doctor gives 1,841 shares to UBF for "alma mater" for a contribution totaling $80,004. He sells 3,556 shares for $156,464 and pays off his condo. He is left with three shares of SBL. He will probably sell them, too, pay Uncle Sam the designated amount and feel ecstatic! If you have a story, pass it along; or if you have any reason to sell some of your highly appreciated stock and would like to contribute an appropriate amount to offset capital gains taxes, let's talk. + Linda] Corcle1, PhD, CFRE, is an associate dean in the School of Medicine and Biomedical Sciences at the Unnerslly at Buffalo She can be contacted b~ phone at (716) 829-2776; toll free at 1-877-826-3246; by fax at (716) 829-3395; or by E-mail, at ljcordcr@acsu.buffalo.cdu. Physician A. u t u m n 1 9 9 8 �........................................................ . ........ ..... . .. ........ 1 LASS OF 9 4 0 s was a guest speaker at the 24th Annual University of Wisconsin Spring Sympo iumsponsored by the Department of Ophthalmology and Visual SciARTHUR J . SCHAEFER '47 1953 REUNION ences April 1718, 1998,inMadison, WI. His lecture, titled "Reflections on the Complications of Ptosis Surgery Yesterday and Today," was given as a tribute to Dr. Richard K. Dortzbach, retiring professor of Cloclmise: Patricia and Harley lindquist, Jack and Maxine Gold, John Handel, Betty and Samuel Galeota ophthalmology and director of the Oculoplastic Service. Dr. Schaefer is a long-time friend and colleague of Dr. Dortzbach. Also, on May 24, 1998, Schaefer was conferred an honorary degree of Doctor of Humane Letters by Canisius College, whence he graduated in 1943. In honoring him at this year's commencement exercises, the college cited Schaefer's "contributions to the field of ophthalmology, his support for aspiring physicians, his contributions to church and community, and his outsta nding Left to right: John B. Fenger, Michael A. Sullivan, Joseph F. Ruh service to his Alma Mater, Canisius College." 1 9 7 0 s • peripheral arterial vascular testing and peripheral venous vascular testing. Gage is a fellow of the American College of Surgeons and serves as a clinical assistant professor at UB. JAMES G . EGNATCHIK '79 has joined Buffalo eurosurgery Group. He is currently clinical assistant professor of neurosurgery at UB and a member of the Executive Committee of the CGF Health System. 1 DANIEL is a gen- eral surgeon and director of the Main Vascular Laboratory in Williamsville, NY, which was recently reaccredited by the lntersocietal Commission for the Accreditation of Vascular Laboratories. Areas included within this accreditation are extra- Left to right: Donald Ehrenreich, James Carlin, Mrs. John Fenger, Thomas Geoghegan, Rivone Ehrenreich cranial cerebrovascular testing, e u f f a l 0 p y 5 c a n A. u t u m 9 8 8 P . 0 SCHAEFER s ' 81 authored three chapters in the textbook Second Edition of Ophthalmic Plastic and RecotJstructive Surge1y, published by C. v. Mosby earlier this year. The textbook, which covers ophthalmic plastic, reconstructive and orbital surgery, is widely read and referenced in the United States, as well as internationally. Schaefer was the primary author of the chapter on enucleation and the solo author of the chapters on evisceration, anophthalmic socket and socket reconstruction. 1 9 9 0 s ' 90 writes: and j would like to announce the birth of our first child, Zachary Alexander Bloom, born on August 4, 1998. GALE ANDREW B . GAGE '76 9 BURSTE IN PETER BLOOM ' 90 Peter is a gastroenterologist at the University ofMaryland. 1am a pediatrician specializing in adolescent medicine atthejohns CONTINUED ON PAGE 36 �• ··········································· · ··· · ······· · ············ ···· ···· · ············· . ' Hopkins School of Hygiene and Public Health. I recent!) had a paper published in )AMA (the lead article, August 12) titled "Incident CIJ/a111ydia traclw111atis infections among inner city adolescent females." I received a great deal of media publicity about the findings of this paper, including national (C , CB ), interna- tional (CBC), and local TV coverage, as we ll as in magazines (Time, cwswee/1) and newspapers (Washington Post, Boston Globe). WILLIAM CHLOSTA '93 will The combined SUNYAB 14th Annual Research Day and Buffalo Otolaryngological Society Meeting was held on June 18, 1998, at the University Inn and Conference Center in Amherst, NY. Pictured ore Buffalo-area physicians honored for their distinguished contributions in the field of otolaryngology over the post 40 years. Standing, left to right: Frederick K. Neuburger, MD; William Hildebrand Jr., MD '40; William Mcintosh, MD '45. Seale~ left to right: Irwin A. Ginsberg, MD '44; Fronk Marchetta, MD '44. begin his fellowship in cardiathoracic urgery at Yale University/ Yale ew Haven Hospital injuly 1999. He can be reached a t chlosta@biomed.med.yale.edu. APRIL CYR '98's husband, Kris , writes: Aidan Campbell was born 10 ounces. He is already living up surgeons, practicing at Buffalo to his name (Aidan means "little General Hospital, CGF Health partner of Buffalo Heart Surgical fiery one" in Irish Gaelic). He System. A grad uate of the Associates in 1983. does tend to sleep quite a bit, so University of the West lndes, we're starting to get some sleep Lewin completed residencies in ourselves and recover. general surgery at Buffalo. He was a founding IN MEMORIAM WALTER L. SYDORIAK '38. on july 1, 1998, at 4:05a.m. April and bravely endured eight hours of thoracic surgery WILLIAM has been and a fellowship August 23, 1998, in St. Mary's elected president of the Buffalo in pcdiatriccardio- Hospital, West Palm Beach, thoracic surgery FL. after a long illness. He at the University was 78. labor at Millard Fillmore Hospital. he i doing fine now. Aidan NORMAN A . LEWIN was pronounced a beautiful baby Heart boy and weighed 7 pounds and specialty of cardiothoracic urgical Associates, a cardiaC . NIESEN '43 died ONLY ONE INVESTMENT LASTS A LIFETIME • Exceptional college placement record • Challenging curriculum with 14 Advanced Placement course • tate of the art visual and performing arts center • More than 60 inter:,cholasnc sports team:, • Comprehensive community service project:, • Average class size i:, 15 • Financial aid available Admissions tests on these Saturdays at 9:00 a.m.: January 24, February ZS To reserve a place for testing or for additional information, pleaoe call: NlCHl1LS MIPPLE CIIOOL, 175 ottmgham Terr., NllHnL~ UrrER SCIIlX1L, 1250 AmheN St. Accepwnce I> gr.mtd to quo~!.heJ >tuJent> without regarJ to race, C<>i<lr, rchgHm nr mnnn.1! nngm. 6 u f f o I o p h c 0 )l, u u m 9 8 �· ········ · ···················································· · ···························• 11 ' I After graduating from UB, iesen served as a major in the Army during WWII. He was chief of urology at Buffalo Veterans Hospital before entering private practice in iagara Falls. Later, he was chief of the medical staff ichard F. Mayer '54, professor of neurology Through I997, Moyer held responsibilities for varied at the University of Maryland School of Medi- lengths of lime as director of the Resident Training Program, cine, was promoted to Professor Emeritus in acting choir, and director of the EMG and Nerve Conduction and Mt. St. Mary's Hospital and I997. On May 9, I998, in celebration of laboratories and Neuromuscular and Myasthenia Gravis served as an assistant clinical Dr. Mayer's long and dedicated career in neurology, Clinics at the University of Maryland Hospital. He has also professor of urology at UB. A member of the Royal Col- the university held a symposium named in his honor. published many papers and articles and has participated in lege of Surgeons of the United After graduating from medical school at the Univer- numerous national and international symposia on neuro- Kingdom, and chief of urology at Falls Memorial Medical Center iesen also main- tained a practice in sity at Buffalo, Mayer completed a summer fellowship muscular disease and neurophysiology. iagara iagara Falls, Ont. He was a past president of the Buffalo Urology with noted neuroanatomist Grant Over the course of his long career, Mayer Rasmussen, PhD, who inspired his growing has been involved in the training of approxi- Society and the Health Association of iagara County. He fascination with the field of neurology. In mately I00 neurology residents and 35 moved Florida 10 years ago. I 954, Mayer made the decision to go to fellows in neuromuscular disease and Survivors include his wife, Boston to serve a medical internship at the research. His leaching responsibilities have jean; a daughter, ancy Eddy of Palm Beach Gardens, FL; and a Boston City Hospital. He remained in brought him great satisfaction, and he enjoys granddaughter. Boston for his training in neurology at the keeping in touch with his former residents Massochusells General Hospital, with the Richard F. Moyer, MD and fellows, who now live and work in locations throughout the United Stales and in exception of a year when he completed a to SIDNEY M. SCHAER '44. WILLIAM M. BUKOWSKI '47 died july 28, 1998, after a long baule fellowship at the Mayo Clinic in Rochester, MN, and many foreign countries. His travels as visiting professor of another year when he served as assistant in neurology have Ioken him to medical centers in Sweden, research at the Notional Hospital at Queen Square Denmark, Germany, Taiwan, Great Britain and Columbia. he had beenastaffmember for44 in london. From I960 through I964, he woso research For the past eight years, he has made annual trips to Japan, years. Bukowski, who was an internist and cardiologist, was along- fellow in neurology at the Harvard Neurological Unit at where he has served as visiting professor in the department time clinical assistant professor the Boston City Hospital and held appointments in of neurology at Nora Medical University and in more recent of medicine at UB. He was 76. neurology ol Harvard Medical School. years in northern Japan at the University of Hokkaido. with amyotrophic lateral sclerosis, in Sisters of Charity Hospital, where After earning his medical degree, Bukowski entered the U.S. In I 966, Moyer accepted a position as associate As Professor Emeritus, Mayer will continue to leach and Army Medical Corps as a captain professor of neurology within the newly organized consult in the University of Maryland's medical school. Department of Neurology at the University of Mary- However, his lighter responsibilities will allow him more lime and served as commanding officer of the 57th Field Hospital land School of Medicine in Baltimore, where he was for his family and for his weekend retreats on the eastern in internal medicine and cardiol- appointed professor of neurology in I 968. shore of Maryland. ogy, establishing a private practice following his military service. in Toul, France. He specialized CONTINUED ON PAGE 38 S u f f a l o Physic i an Autumn l 9 9 8 �• ············ ····· · ·· ·· ·· · ········· ···· ··· I An attending physician in medi- A professor of gynecology and cine and electrocardiography at obstetrics at UB from 1971 to Sisters Hospital, he was president 1979, Nichols left Buffalo in of the medical staff there in the early 1980 to become chair of the 1970sand served on the hospital's Department of Obstetrics and boardofuusteesfromthemid-1970s Gynecology at Brown University to 198l.ln April, he was honored in Providence. He also served as as Man of the Year by the Sisters obstetrician-gynecologist-in-chief Hospital Past Presidents Club. at Women and Infants' Hospital of Survivors include his wife, Rhode Island. ichols is credited Marguerite; five daughters,joan, with building Brown's academic Barbara, Kate, Beth ofWashington, department into a nationally rec- D.C., and Martha Thomson of ognized program and for creal- Devon, PA; two sons, William Jr. of ing an integrated center for Montreal and Peter; two brothers, women's health care throughout Thomas of Alexandria, VA, and Rhode Island and surrounding Stan ley; and eight grandchildren. states. In 1990, he received the Distinguished Medical Alumnus D AVID H . N ICHOLS '47 died in AMANA COLLECTS Comprehensive Cost-Effective Receivables Management ~ Amana Capital Corporation Buffalo, ew York 716-852-3500 800-441-6925 AwardfromUB'sSchoolofMedi- Providence, Rl, on July 15 , CONTINUED ON PAGE 40 1998, of heart failure at age 72. 300MHz Pentium II· Processor • 64MB 10 NS SDRAM • 6.0 GB Ultra IDE Hard Dnve • Iomega Z1p Dnve atap1 • 17" 27NI SVGA D1g1tal Color Mon1tor • 8 MB AGP Graphic Accelerator • 56K V90 PCI Fax/Modem • 36x IDE CD·ROM Complete systems, components, and peripherals, PLUS friendly service and support. All right around the corner! • Sound Blaster 128 PCI Stereo Sound Card • Sound1mage Subwoofer System • 3.5" H1gh Dens1ty Floppy Drive • M1crosoH Wmdows· 98 • Corel Wordperfect SUite 8 (Includes, Word· perfect 8 . Ouanro Pro 8 . Presentations 8•) • Zod1ac 1000 CD Bundle 1·716 ·743 ·0195 TECHNOLOGY DISTRIBUTION NETWORK www.tdn.net 1000 Young Street. Suite 270. Tonawanda NY 14150. Fax: (716) 743.0198 B f 0 0 p h y 5 c o n A u m 9 9 8 �We Get Rehab Results! Cost Effective! Superior FJM1'M hnprovement Vs. National and Northeastem Regional Subacute Facilities 34% GREATER FIM'M increase vs. the nation for all admissions. • Stroke • Pain Management • Orthopedic • Medically Complex • Cardiac • Infections • Joint Replacement • Cancer • Amputee The McGuire Rehabilitation Centers' average charge per case is more than 35% WWER than other facilities in the nation, according to statistics from the Wall Street Journal and the American Health Care Association. - The Ticket Home! A greater percentage of our patients return home vs. the national and northeastern regional Subacute averages. Our goal is to prepare you to return home as soon as possible. Ftve Star Care To<let T"""'u Our case mix is consistent with the Northeast and national subacute region. Our average statistics are: length of stay - 25 days; age - 78; admission FIM score- 72.5; discharge FIM score- 97.6; FlM change25.1 points; length of stay efficiency- 1.40; onset time - 17; discharge disposition - 80% to community. Based on 12 months ending March 31, 1998. The McGuire Rehabilitation Centers rely on the national leading measurement tool for documenting patients rehabilitative outcomes. This tool is lmown as FIM 5 "~ Instrument; Functional independence Measure, developed by the UB School of Medicine along with the Center for Functional Assessment Research. it's used along with the Uniform Data System for Medical Rehabilitation (UDSMR5 " ) to establish rehab outcomes that can be measured and calculated to document successful results. Our facilities were rated outstanding in the community with five stars out of five, according to the Inside Guide to America's Nursing Homes for long-term care. The results are in. The McGuire Rehabilitation Centers have the clear advantage over other regional facilities based on FiM 5 " improvement, discharge to home, and cost effectiveness. Our successful rehab program delivers results because of our superior staff, state-of-the-art equipment, and specialized rehab facilities. Choose The McGuire Rehabilitation Centers for five-star rehabilitation services. THE UJtiCGUIRE llEHABILITATI(9.1\T . Call 1-888-POSTACUTE. .&~ CENT~ c Copyright 1998 Uniform Data System for Medical Rehabilitation, a diVISIOn L -- B u f f a l o Phys ician Autumn ~" . of UB Foundation Act:IVlties, Inc. All rights reseiVed. 1 9 9 8 �• ·························································································· I cine and Biomedical Sciences. director of the cardiovascular MICHAEL MEENAGHAN '71, From 1991 to 1997, Nichols was laboratory at Memorial Hospi- fessor the ing his career at the University a visiting professor of obstetrics- University at Buffalo School of at Buffalo, he served as direc- gynecology at liarvard Medical tal and later became chief of cardiology. Dental Medicine and a dental tor of the dental school's Elec- School and chief of pelvic Kucinski was recognized researcher whose work over two tron Microscope Laboratories as a pio- decades significantly contrib- and professor and chair of the former Department of Stoma- reconstructive surgery emeritus in pro- Oral Diagnostic Sciences. Dur- at neering uted to the use and safety of Massachusetts h ear t implants in the human body, tology and Interdisciplinary surgeon died August 31, 1998, in his Sciences. and in- home in Amherst following a nova tor. lengthy illness. He was 62. s General Hospital , returning to Brown in 1997 as a From 1971to 1989, he served as director of UB's Surface He was While many of Meenaghan's first studies focused on the design of until his retirement he was an cardiologist dental in Colorado Springs to implant a biocompatibility of various materials with oral tissue , he active member of the Council on International Studies and also was involved in evaluating Meenaghan retired in 1996 as pacemaker techniques for "supercleaning" a Lt. Colonel with the U.S. Army and to perform heart various implants for use in the Reserves , 338th General Hospi- human body, as well as the 1998, after a six-month battle tal, Niagara Falls. A graduate of catheterization and balloon long-term effects of umbilical- with lung cancer. He was 61. American International College angioplasty; he also invented a cord vein grafts. in Springfield, MA, he earned professor of obstet- the lies and gynecology. CHESTER 5. KUCINSKI ' 60 died in his Colo- : submitted by E-mail at: bpnates@pub.buffalo.edu. rado prings home on April 5, After completing an internship and residency in internal medicine at the University of Minnesota Hospitals , Kucinski served as a captain in the Army Reserves on active duty France 111 from 1962 to 1964. He then completed his residency in internal medicine at Washington University in St. Louis , MO, in1965 and a fellowship in clinical cardiology at the University of Colorado Medical Center in Denver in 1967. Kucinski then taught for two years at Yale University Medical School before becoming director of cardiology at St. Joseph' Hospital in Orange, heart catheter. implants and Science Center, and from 1991 the Programs. As an educator, he had su- his dental degree and a doctoral In addition, he established pervised postgraduate students degree in anatomical sciences Flight for Life programs for ru- and presented lectures in from UB. ral areas, conducted cardiology anatomy for medical and dental clinics throughout his region students. Meenaghan was a diplomate and past president of the and recruited the first pediatric A former chair of the UB den- American Society of Osseo- cardiologist to Colorado Springs. Kucinski started a vol- tal school's cultural exchange integration, and a member of committee and a member of the the International Congress of unteer service program that u ni ve rsi t y-wide Provost 's Oral Implantologists , as well obtained donations of medical Council on International Stud- as several professional orga- equipment. He also traveled to ies and Programs , Meenaghan nizations. Kenya , Morocco , India and promoted exchange programs In addition, he was a member Guatemala to teach modern with more than 10 foreign den- of the American Dental Associa- cardiology practices to medical tal schools, including those in tion, the American Association personnel there. Thailand, Korea, Japan, China of Anatomists, the International! American Association of Dental Kucinski is survived by and Mexico. During his career, his wife, Doris ; two sons, he was a consultant to more Research and Omicron Kappa Bridger of Denver and than 20 corporate, federal and Upsilon. of Colorado icholas prings; a daugh- university agencies, including Meenaghan is survived by ter, Megan Guiterrez of Gilroy, the U.S. Food and Drug Administration. his wife, Barbara; four sons, CA; his mother, Frances of Buffalo; a brother, Edward Meenaghan joined the john B and Michael of Williamsville , Kevin of Fort of Buffalo; two sisters, Sylvia dental faculty in 1971 in the Mill, Krayna of Buffalo and Audrey lished his practice in Colorado former Department of Oral Pa- Lockport; a sister, Kathleen Tumbarello of thology . He retired last year as Springs, where he served as a Meenaghan of Springfield, MA; and three grandchildren. professor in the Department of and six grandchildren. CA, in 1971. Inl975 , he estab- B ew York City; f f a I a p h 5 c a A C, and joseph m 9 of 9 8 �No one knows better than medical professionals the importance of teamwork to get things done. That is why most New York physicians and surgeons choose MLMIC as their professional liability insurer. MLMIC's responsive team of underwriters, claims personnel, policyholder services representatives, risk management consultants, medical experts, and defense attorneys provides our insureds with the best liability protection and the highest level of personalized service available. Owned and operated by its policyholders, MLMIC has successfully defended more New York physicians than all other insurers combined. With one of t he country's largest and most experienced claims departments, MLMIC also offers the State's only true peer review of claims experience. These are just a few of the reasons why MLMIC is the only medical liability insurer endorsed by the Medical Society of the State of New York. Call 800-275---6564 (NY metropolitan area), MLM~C ~ \ lt'<lical IJabJlitl \lutual Jnsurani>· Company or 800-356-4056 (Upstate) for more information and to find out about available premium discounts. Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11SS4 01998 M~.dical L tri ty Mutual ln~n~nce Compamy �Non-Profit Org. U.S. Postage BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO -.,, 3435 MAIN STREET BUFFALO NEW YORK 14214 :1£ TH 3£~IA L S ,{3G TT PAID 1 773 Buffalo, NY Permit No. 311 · s ~cr: DEPT LL ADDRESS SERVICE REQUESTED To consult with someone truly concerned with your financial health, come to Key. Your Key Private Banker heads a team of KEY PRIVATEBA professionals, who can help you achieve your financial goals with surgical precision. Call Marv Madison at 716-847-2341. It may be one of the most important appointments you make . We know medical professionals' financial needs like the dorsum of our metacarpus. Key. For a new America~ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1998 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1998-Autumn Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v33n02-1998-Autumn Table Of Contents A list of subunits of the resource. China Rotation A Path through an Unexplored Field The Strengths of Children Medical School Student Perspective Research Class Notes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-09 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v33n02 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1998 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/1024134183ada70f0ec4c6c8afd2d9c8.pdf e60f0f944e59001172da7272b38184f0 PDF Text Text �BUFFALO PHYSICIAN Volume 33, Number 1 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr Carole Smnh Petro DIRECTOR OF PUBLICATIONS Kathryn A. Sawner EDITOR StephaniC A. Linger ART DIRECTORIDESIGNER Alan J. Kegler ASSISTANT DESIGNER Lynda IIanne! PRODUCTION MANAGER Ann Raszmann Brov.-n STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John R. Wnght, Intcnm Dean EDITORIAL BOARD Dr Bertram Portm, Chair Dr Martin Brecher Dr Harold Brod\ Dr Linda J. Corder Dr Alan J. Drinnan Dr James Kanskt Dr Barbara MaJCront Dr Eltzabeth Ohmted Dr Chari" Pagancllt Dr Stephen Spauldtng Dr Bradlq T. Tru"' Chr"topher Adams Dr Frankltn Zeplownz TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospnal .\ftdtacl Shaw The Chtldren"s Hospnal of Buffalo Eric Coullly Medical Center \<!ern Health Svstem Mtlla~d Fillmor~ llcahh System franll Sma :-.:iagam Falls Memorial Medical Cemer Ro~wcll Park Cancer Institute Ststers of Chanty Hospnal Dennis .\1rCwcln Veterans Affatr'-. \\'estern :\cw York Hcahhcarc System (()The State Cnt\Crslly of :-.:ew York at Buffalo Buffalo PltyStctan is publtshed quarterly by the State umversit' of "'ew York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publtcatwns. It is >ent, free of charge,toalumnt, faculty, students, resident.<., and friends. The staff reserves the right to edn all cop) and submissions accepted for publtcauon. Letters to the editor, address changes or other correspondence should be addressed to: The Editor, Buffalo Physician, Stale University of New York at Buffalo, Office of Publications, 136 (rafts Hall, Buffalo, NY 14260. We can also be reached by phone at (716) 645-6969; by lax at (716) 645-2313; or by E-mail at bpnoles@pub.buffalo.edu neaP Alumni and FPiends, As "'OTED I'\ THE LAST IS UE OF THE BUFFALO PHYSICIAN, on April1 we welcomed to the university our new vice president for Health Affairs, Dr. Michael Bernardino. Michael's experience in Atlanta in the managed care environment will be invaluable as we face the evolving challenges within the Western New York community. Coupled with the recently consummated merger of Buffalo General Hospital, Children's Hospital of Buffalo and Millard Fillmore Hospital, it is a certainty that these challenges will multiply over the months ahead. Spring Clinical Day has come and gone for another year and, as usual, the event was an unqualified success. On Thursday night, the Dean's Advisory Council joined the james Platt White Society at the society's annual dinner, which, this year, was convened at the Center for Tomorrow. The various reunion class alumni met at several different venues around the city and congregated at a reception Friday evening, and again at the Saturday morning scientific program, The Aging American. On May 22, 1998, we graduated 138 new physicians and 37 new PhD scientists at the Center for the Arts building on the orth Campus. David Hohn, MD, president and CEO of Roswell Park Cancer Center, spoke on the Problems, Solutions and Challenges for clinical practice and medical research. Although many of our graduates will remain in Western ew York, even more will continue their training elsewhere, and no doubt establish their professional "roots" in other places around the country. Included in this issue of the Buffalo Physician is a Match Day 1998 list of where our graduates were placed in their residency programs. I encourage you to review this list and to contact and welcome your fellow UB graduates who are moving into your community. A focused visit from the LCME was completed in April and, although we have yet to hear any official pronouncements, we believe we are on the right track. The LCME has been concerned about implementation of several new small-group course offerings and the density of the curriculum, particularly in the first year. Two other areas of concern were financial aid and general student advisement. Progress has been made on all fronts (except, perhaps, for the first-year curriculum density issue) and the alumni advisement program was recognized as a major advancement for the school. The Alumni Association has agreed to expand the advisement system to encompass all four years. The school budget continues to represent a challenge, particularly as the changing practice environment impacts on revenues centrally available for operating the school. Philanthropy has become even more important to us and you will no doubt have already gotten a sense of this through the various mailings you have been receiving. I hope to continue meeting alumni "on the road,'' as it were, and taking advantage of those opportunities whenever they arise. One purpose of these meetings is to reconnect alumni with the school. This is more than just an effort to increase philanthropy, although many of our alumni are actually looking for opportunities to "reinvest" in the school that gave them so much. We also have a great deal of "expertise" among our alumni, who can be of immense help in providing advice and counsel as we move ahead into the next millennium. 0 t/~?w:"', .i,~~~~m MD Dean School of Medicine and Biomedical Sciences Cover I LLUSTR ·ITIO--: B\ MICHAEL GELEN �Dear Fellow Alumni, A s THE :-.:EW PRESI DE"T O F TH E M EDI CAL A UJ M:-JI A SSOC IA TI O , I plan to continue the good work started by our previous presidents. Thanks to the leadership and direction from our past president, Jared Barlow, and the hard .. work of john Bodkin, this ........ year's Spring Clinical Day, titled The Aging American, was a tremendous success. This issue of the Buffalo Phy sician contains an article on this year's Stockton Kimball lecturer, Edward H. Wagner, MD , '65. Already, plans are under way for next year's event, with . . . . . -. . . -. D.K. M i ller about the death of Dr. David K. Miller (Winter 1998, Buffalo Physician). He was a great teacher and clinician. l would like to relate to you an incident that happened to me as a junior medical student while on my internal medicine rotation at [the E. ]. Meyer] Memorial Hospital in 1965. Dr. Miller was the attending on the medical service at that time. Internal medicine was my second clinical rotation. During one of the first days on the rotation, I was told by the a his and physical on a patient resident to for renal failure (prethe bedside, introduced was going to perform a me that I was about the a history and physical on UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES and none yet had found an d me to proceed. Being a , l performed a complete I WISH TO NOMINATE (print) - - - -- - - - -- - - - - - - - - - - - - - - -- 1ation of the nares l found AS A DISTINGUISHED MEDICAL ALUMNUS/A. septum. With this findi ng had revealed granulomas, COMMENTS (required)-- - - -- -- - -- - - - - - - - - - - - - - - - - - - ent possibly had Wegener's .. WAS SORRY TO READ .. Distinguished Medical Alumnus/a Award Nomination rounds, I told the chief tative diagnosis and that I ained for possible biopsy. 1as ordered, nor did any of patient's nose. ;ervice three weeks, but in YOUR NAME - - -- - - -- - - - - - - -- -DEGREE/YEAR - - - -- - l made weekly attending ~- Miller always treated the SIGNATURE _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ __ _ _ _ _ _ Attach separate sheet if more space is needed fo r comments. medical team. He asked Please respond by March 1 of the current academic year. ominations are rev1ewed annually . tg you think and challeng~ was tough but honest and wa" ~:,c:Hc:• auy uiL<::Ic:,Lc:u 111 u•c. pau.:nt's welfare. During those three weeks, this patien t was never presented to him because the patien t has been presented so many times in the past. Shortly after my third attending round with Dr. Miller, I passed him in the hall and he stopped to talk to me about how my rotation was going. I told him fine and then proceeded to tell Medical Alumni Association him of my findings in the patient with the nasal lesion and my tentative diagnosis. He thanked me for telling him this and proceeded down the hall. Figuring that my comments had again fallen on deaf ears, l felt that I had done about as much as l could do to convey my concerns about this particular patient. Unbeknownst to me, Dr. Miller had immediately proceeded to the ward, demanded the chief resident come with him, took an otoscope and performed a nasal exam. He observed CONTINUED ON PAGE 2 �first year of medical school, in 1976, I attended the graduation ceremonies.! was appalled that the graduates, after four very difficult years of medical school training, wore basic black gowns and the "square hats." I had imagined that the graduates would be attired in very elaborate gowns, befitting their acwhat I had described on my physical exam and he personally complishments-a gown similar to the one the dean wore. called theE T attending and requested an immediate biopsy During my fourth year of medical school, I pursued the of the lesion. A biopsy was performed that day which of a more elaborate graduation gown. The dean's gown idea revealed granulomatous inflammation, with necrosis, comstood out in my mind. After receiving permission from the patible with Wegener's granulomatosis. dean' office to investigate the matter, I contacted several othing more was ever said to me about this, since I had gown companies and obtained several different designs and rotated to a different service. Over two months later I was prices, the most beautiful design being the replica of the asked to attend the Medical Grand Rounds. At the grand dean's gown. The class of 1979 met and voted to make the rounds a case of Wegener's granulomatosis was presented. dean's gown the official gown of graduation. After the presentation, Dr. Miller stood up and stated that The company hired to produce all the necnumerous physical exams had been performed essary gowns, completed the order in time for on this patient over the previous six months Your letters are our graduation. I had fulfilled my dream. The prior to his diagnosis and that the patient had welcome. Please submit excitement and anticipation of wearing these gone undiagnosed until a junior medical student to Editor, Bullalo elaborate gowns permeated the entire class. had made the diagnosis by noting the nasal Physician, 136 Crofts However, the week the gowns were to be lesion. l was then introduced as the person who Hall, University at delivered for our ceremony, the nation's truck had made the diagno is. Buffalo, Buffalo, NY, drivers decided to strike. The gowns were rell did not choose to go into internal medicine, 14260; fax: 716-645egated to a warehouse until the strike ended. although Dr. Miller tried hard to convince me to Ironically, my classmates and I graduated in 2313; or E-mail: choose a career in this discipline. l chose a career the same basic black gowns and "square hats" of bpnotes@pub.buffalo.edu. in surgery and did a general surgery residency and our predecessors. However, the fact that future We reserve the right to then a fellowship in surgical oncology at the classes wear the gown that eluded my classmates University oflllinois Hospital in Chicago, Illinois. edit letters for length and me makes me somewhat envious, but also I cannot tell you what effect this incident had and style. very glad the issue was pursued. It is a gown on my medical career. However, it instilled treof the wearer and the ceremony. worthy mendous confidence and taught me that we should stand by our convictions and not just accept the status quo. As a clinical professor and practicing physician, I have tried to emulate Dr. Miller's skills as a teacher and clinician, and I will never forget him. The medical community has lost a stellar physician and colleague. ROBERT M. BARONE, MD, '66, FAC San Diego, California . jOSEPH GAGLIARDI, MD, MA, '79 Columbia, Maryland Editor's Note The dean's gown described by Dr. Gagliardi was originally designed in 1971 by the late Robert L. Brown, MD, '44, to commemorate the 125tll annivers01y of the founding of the school of medicine. Dr. Brown was associate dean of UB's school of medicine, as well as medical school archivist and associate professor ofmedicine emeritus. Seams from the Past Due to the efforts GRAD ATED FROM the University at Buffalo School of Medicine in 1979. Every year I read with interest your review of the medical school's graduation. l would like to share with you the origin of that very handsome graduation gown. At the conclusion of my of the Class of 1979, all students graduating since 1980 have worn the "dean's gown." Pictured is Joell. Sebastien, Class of 1998. J "' :> "'z ~ z 0 0 �VOLUME 33 , NUMBER 1 SUMMER Elegant Solution to a Complex Problem Merger Final 4 8 NEWLY MERGED HEALTH SYSTEM- 20 1998 Physicians Reaching Out to Students UB ALUM AND PROFESSOR U B MEDICAL ALUM I INVENT LASER TARGETING ASSOCIATION BEGINS SYSTEM USED WORLDWIDE NEW MENTORING PRO- by S. A. Unger GRAM FOR STUDENTS Photo by K. C. Kratt by Nicole Peradotto CHALLENGES AND OPPORTUNITIES FOR UB by S. A. Unger Illustrated by Michael Gelen Alumni Medical School SPRING CLINICAL NATIONAL RESIDENCY DAY , "THE AGING MATCHING PROGRAM AMERICAN" RESULTS LISTED EDWARD H. WAGNER, photos by Frank Cesario Research STOCKTON KIMBALL * REDUCING MULTIPLE LECTURER COMMENCEMENT 1 9 9 8 , A BIRTHS by Scott Thomas TIME TO CELEBRATE * PROSTATE CANCER , photos by Don Heupel ESTROGEN LINK Class Reunions * HYPOXIA STUDIED * TALLER, P HOTO BY NOT HAPP IER �Newly Merged Regional Health System Presents Challenges and Opportunities for UB . - - - - - - . HE LO 'G-A:"\TlC IPATED MERGER OF Buffalo General Health System, Children's Hospital of Buffalo and Millard Fillmore Health System was announced on Aprill, 1998. After nearly two years of extensive study, planning, legal work and governmental reviews, the merger came to fruition, significantly reconfiguring the Western ew York health-care delivery system. Making the announcement was john E. Friedlander, president and chief executive officer of the newly merged regional health system, which has temporarily been named CGF Health System. "Thanks to the efforts, spirit of cooperation and commitment by a great many people in all of the involved organizations, we have made history today because the face of health care in Western ew York has been changed forever in a very positive way," he said. ILLUSTRATION BY MIKE GELEN �BY Friedlander also paid special tribute to the boards, physicians and internal leadership of Millard Fillmore, Children's and Buffalo General for their "extraordinary vision and strong desire to work together to create a dynamic , new , value-driven health-care system for the community and region. " Facilities included in the merger are Buffalo General, Millard Fillmore Gates, Millard Fillmore Suburban, Children's and DeGraff; four longterm care facilities; a number of home care services and approximately 50 service locations in five of Western ew York's eight counties. In all, the merger brings together 2,200 physi- S . A . UNGER cians and 12,000 employees under the CGF Health System. "As an organization, CGF is committed to assuming a leadership role to promote the health of our community and, in doing so, improve the overall quality of life for everyone we serve," said Friedlander, who emphasized that as part of its mission, CGF is committed to excellence not only in service, but in education and research , as well. The UB Connection Because all three of the larger hospitals involved in the merger-Buffalo General, Millard Fillmore and Children 'shave teaching and residency programs with the University at Buffalo's School of Medicine and Biomedical Sciences, the future place of academic medicine within the CGF Health System has been the focus of much attention and concern within the UB community. In addition to ways in which the new merger will affect the school of medicine's primary mission of educating future physicians, there is also a complex financial relationship between the school and the hospitals involved in the merger. As john R. Wright, MD , interim dean for UB's School of Medicine and Biomedical Sciences, explained last winter in a message to Buffalo Physician readers, "The state budget provides only 13 to 14 percent of [the medical school's] annual ex- �Newly Merged Regional Health System penditures, matched by approximately school," he adds. "It would not be in by university administrators, led by the same percentage from extramural- our best interests to be dealing with a Michael Bernardino, MD, the Universponsored research programs. Since weak, floundering, constantly volatile sity at Buffalo's new vice president for hospital support, which also includes delivery system." Health Affairs. the residents' salaries, accounts for apost of these prinThis is a perspective shared by the proximately 23 percent of total expen- business community at-large, Wright ciples are not conditures and the practice plan, an addi- feels. "I think the business community tentious, but reflect tional 41 percent, over 60 percent of sees health care as playing a major role in mutual goals the our funding is derived through the the rebirth of the Western ew York university would health-care delivery system." support, according economy. The University at Buffalo is ln an interview several weeks after arguably the largest employer in the reto Wright. "However, there are some principles that the merger was announced, Wright ex- gion and probably represents--if you may not completely or accurately deplained that while the merger does included faculty, staff and students-the present clear-cut challenges for the uni- largest group of health-care consumers. fine the university's position on what should be included or excluded in an versity and the medical school, it pro- And recently, a number of health-care affiliation agreement. It will be over vides significant opportunities, as well. manufacturing companies have sprung those issues that the agreement, in its In order to effectively balance the up in the region and, although it's not present form, will be subject to negothreat of challenges with the promise often a well-appreciated fact, this is a very tiation as we begin this process," he of opportunities, Wright feels it's im- promising local industry. So, there's an remarks. portant to step back and view the opportunity at this time for the univerWright outlined four benchmark merger in a context that includes as sity, the health-delivery system and priconcerns the medical school will put broad a vision as possible for the future vate industry to work together to improve of health care in our region. forth in its negotiations with CGF. The the economic climate of this region." first, he says, is that "We need to be "I think it could be said that the ln addition, Wright foresees impliable to control the educational envidriving forces behind the formation of cations of the merger that could ronment for our students and resithe CGF Health System have been com- provide other, more specific opportudents, and that level of control clearly munity leaders as much as the individual nities for the medical school. "We will overlaps with CGF's equal desire to hospitals themselves. This merger is an have a chance to consolidate the medihave control over the medical services effort for our community to determine cal school's programs and to develop a it provides and the physicians who its own future bymaintainingsome local more focused, less distributed clinical provide them." programs," he explains. base for these control over the provision of health-care Secondly, he says, "We are a comservices in an environment where com- "There will also be opportunities to munity-based medical school and there mercial enterprises from outside our re- organize our clinical faculty and pracis the desirability, in fact necessity, for gion could come in and determine it for tice plans into a more cohesive, cenus," he says. ew York State is cur"I think the business community sees health care as playing rently not a particularly full-time faculty to work side-by-side hospitable environment for for-profit tralized operation-something that has with volunteer faculty. " As a result, he hospitals, according to Wright, who been missing in the very distributed, adds, "There needs to be different insays that could change. "Clearly, this community-based medical system that reorganization of health care in our has been in place in Buffalo." centives and constructs for each group, community is a proactive commitment and it is critical that CGF be able to to plan for the future and to gain con- Challenges and Obligations create an environment that fosters coltrol over costs and administrativestruc- Following announcement of the laboration among physicians. " ture now. merger, CGF presented the medical Thirdly, the medical school has a And of course what's healthy for the school with a Principles of Affiliation need, as well as an obligation, to concommunity is healthy for the medical Agreement, which is being reviewed tinue its relationship with health- a �delivery systems not included in the CGF system, and the affiliation agreement cannot in anyway jeopardize these long-standing relationships. "We have an important working relationship with Roswell Park [Cancer Institute], Erie County Medical Center, the Veteran's Administration system and the Catholic system that we simply cannot and will not abandon ," Wright states. "We cannot work exclusively with the CGF Health System. That would not be good for us , nor for the community. " And, finally , "The relationship between the university and CGF must be financially sound, " Wright says. "So , it's a symbiotic relationship in which the health and well-being of both entities is absolutely essential to the entire process. " "Roswell Park is clearly one of the centers of excellence that is already established in Buffalo and, therefore, is key to the goal of having other such centers because it already has as its mission the cultivating of a referral base beyond this region, more so than any other facility in our area ," Wright explains. This interest in drawing individuals from outside the region to a center of excellence relates back to the business community's goal of ensuring that health care in Western ew York remains a viable economic force and one that can form a base for revitalization, explains Wright, who emphasizes the integral role academic medicine would play in the development of such centers. "I am convinced, " he says, "that in most, if not all , centers of excellence , an academic presence ensures that the center is going to continue to grow and develop more innovative approaches to treatments compared to a facility that is simply a highly skilled practice site that does not have the constant influx of new information that an academic affiliation provides. " that we have a full-time vice president with expertise in these various areas ," he adds , referring to Bernardino, "we feel dialogue will open up and the faculty's comfort level will increase." Wright emphasizes, too , that how the health-care delivery system in Buffalo takes shape in the months and years ahead will involve choices the community will need to make, as well , and will not be limited to what the university, area hospital systems and physicians determine to be the best course. '·For example," he says, "the question could be asked of the community: 'Do you want a medical school? And if you want a medical school, do you want a good, bad or indifferent school?' I would assume the answer is 'Yes, we want a medical school, and we want it to be an excellent school."' iven the current comCenters of Excellence plexity of Buffalo's The ultimate goal of such a symbiotic health-care delivery sysrelationship between the university and tem, finding a middle CGF is the development of "centers of ground that best repreexcellence" that would not only serve sents the collective needs the Buffalo community, but would result of the population of our in a referral base from outside the region, region-not just the needs of the varaccording to Wright. The idea of estabied entities that provide the care-will lishing a network of centers of excel- Opening up Dialogue be a challenging process but one Wright lence has been repeatedly floated about Wright acknowledges that the prois optimistic about. "Working out how the Buffalo medical community over longed merger process has been very health care will be best delivered in our the past few decades, but has gained stressful for medical school faculty, but community will not be a slam dunk; there is a lot of work to be major role in the rebirth of the Western New York economy... done," heconI cedes. "We're . !. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .~ going to go momentum in recent years as a result of also points out that it has been difficult through some pain, we're going to have market pressures leading to , among for the university to take a proactive differences of opinion, and we will have other things, the CGF merger. Under role in clarifying the ramifications of to work things out over time. For the the centers-of-excellence model , a such a merger until the merger itself long run, we need to look at how we can particular facility would complete a was formally in place. 'The university deliver health care in our community in high volume of specific procedures for couldn't hammer out an affiliation a way that not only helps assure the treatment of defined conditions, such as agreement with a merging system while viability of the medical school, the unicancer or heart disease, in order to con- there was still a possibility it would versity, and area hospitals, but in a way trol costs and assure the highest possible fail ," he explains. "However, now that that helps ensure the viability of our quality due to its focused expertise. the merger has in fact occurred and now entire community." + �MICHAEL K . LANDI , MD , LEFT, AND ROBERT M . LIFESO , MD , WITH DUAL TARGETING RADIATION SYSTEM THEY INVENTED . �8 Y 5. A. U N G E R --------' .L4n UB ALUM AND PROFESSOR INVENT LASER TARGETING SYSTEM �"T ilE 1-1 n r l'llOTIITYI'E ",~ \1 \DE 1 'il\ 1, , .\IIHiw n Fil ii \[ .\ Bllw ,·.\l ;r·: .\\'ll PIPE FHI I\1 \ II \IW\1'\HI: '\TII HE ... L\\ Il l HEI .\LL.' . ".\ :\ [)Til E 'i Et:O \Il Pre \I OilEL \\".\ .' lll"ILT I-.;[\(;.\ FL.\ IILII ;/IT Ifill I\(; .\\'ll \ ll E.\ T\L \llllllOH . Today, the product they developed, called the DRTSTM Platform (for Dual Radiation Targeting System), is being manufactured in Orchard Park, ew York, and sold throughout most of the world. While application for the DRTS Platform was initially aimed at the orthopedic field, other uses for it are rapidly becoming apparent as the innovative tool makes its way into the hands of skilled clinicians in other fields , from oncology to neurology. The system, which received Food and Drug Administration approval in September 1997, is being marketed by Ml RAD Inc. , whose chief executive officer, William Burns, was named Inc. magazine's 1993 Entrepreneur of the Year in ew York State. Fl\lll\1 a research project to find a better way to do this. " This was a project for which Landi was ideally suited. Prior to entering medical school to pursue an interest in biomedical engineering, he had completed a degree in electrical engineering at the University at Buffalo. Before coming to UB , he worked for several years at a company in Los Angeles that developed software for projects requiring advanced radar systems. Earlier, he had served in the U.S. avy, working with guided missile weapon systems on board a destroyer. Lifeso, who is director of the Spinal Cord Injury Unit at Erie County Medical Center and clinical professor of orthopedic surgery at UB's school of medicine, did not have Landi's engineering background; however, he did have a strong interest in laser technology and its potential application to medicine. When Landi approached Lifeso about working on the research project he had proposed, Lifeso was excited to learn of the young medical student's training in engineering and immediately saw the fit. "He talked to me about a concept he had of combining X-ray with laser light and how that might provide a sort of guidance system for surgical procedures," Landi says. After further discussions, Landi decided this was a concept well worth pursuing and he went to work for Lifeso during the summer between his first and second year of medical chool, devoting himself to taking a roughly formulated idea and turning it into a marketable product. "Once I fully understood the problem, I saw that what you needed was a way to mark a surface point of entry that would not interfere with the operant field and give an axial alignment to intersect with a subsurface target. And a laser pointer made the most logical sense," says Landi, who today is a neurosurgery resi- \ BITTI· Ii \\'\)Til Dll Tiii'- The story of how the careers of these three men converged at the point of a laser beam began in the fall of 1990, when Landi was a first-year student at the University at Buffalo School of Medicine and Biomedical Sciences. "I was assigned Dr. Lifeso, an orthopedic surgeon, as a preceptor," he recalls. "The first time I met him was at a morbidity and mortality conference where the previous month's cases and complications were presented. One complication discussed involved a nun who had fallen out of bed and fractured her femur after an intermedullary rod placement in which the distal-locking screws were inserted incorrectly. Dr. Lifeso explained that this was a common problem-that external targeting devices that are supposed to point you toward the region where you need to make the incision and place the screws, weren't that accurate and when done under X-ray imaging required excessive radiation exposure to the patient and surgeon. He then asked if anybody was interested in doing a u f f o 1 o P hysician Summer 1 9 9 8 �I - -- --- ~--~~~ dent and a research instructor in UB's Department of Cn \"II jl B.\ C1111l E Electrical and Computer Engineering. "The most diffiWilliam Bums was the former president and chief execucult problem was developing a way to make the laser rive officer ofMatrx Medical Inc., North America's largest light coincide with the image that you saw from the manufacturer and distributor of emergency medical prodX-ray. Once I figured out how to do that, the device ucts. "Bill Burns provided the entrepreneurial brain came together very rapidly ," he says. power we needed," says Lifeso, who describes his first Figuring out how to do this "just required a lot of few years working with Burns as "a crash MBA course." geometry," according to Landi. "Basically, what I came up Securing the intellectual property rights for the dewith was a system that identifies a line of radiation from vice was obviously a high priority and little time was the X-ray source to the detector; positions a laser beam so wasted. In May 1993, the first patent for the device was that it's co-linear with that line of radiation; and puts a awarded to Lifeso and Landi and assigned to the Reradiopaque target symbol- a cross hair- on that same search Foundation, State University of ew York at line of radiation so that its image on the TV monitor Buffalo. In May 1996, Burns and the two inventors represents a point on the line that the laser indicates." formed a company called MI RAD (minimum radia"Once Mike began building prototypes," Lifeso says, tion) to market the DRTS "it became clear to us that the real problem we were facing Platform and today the was finding the center of the X-ray beam, and that's where BH( l.\ll .\PPLH:.\Tit~~~ company employs 25 his expertise came in. He designed a collator that is key people, including six .\cno~~ jf.\:-~r to the device being able to correlate the flu oro image of engineers, regulatory exthe screw placement site, as viewed on the TV monitor, , 'PECL\LTIE:-perts and two patent with a precise point on the patient's anatomy. '' Throughout the summer, Landi worked on the project at home with materials he and Lifeso were able to obtain using their own resources. "The first prototype was made using a mirror from a bird cage and PVC pipe from a hardware store," Landi recalls. "And the second model was built using a flashlight housing and a dental mirror. " By the end of the summer, Targeting brain tumors during perioperative localization. Landi had designed and built a device that was remarkably sophisticated and someattorneys. In late 1997, thing the two inventors were fairly confident was a the University at valuable innovation if they could get it in the hands of Buffalo invested in someone who knew how to market it. Essentially what MINRAD , taking up the they had developed was a system that would allow a largest equity position it surgeon to use the fluoroscope to visualize and locate a has ever held in a startdeep structure, turn off the X-ray radiation and still have up company. accurate guidance and position information relative to "This was an opporthat deep structure. Using their device, a surgeon would tunity for the universimply place his or her drill tip on a patient at the precise sity to invest in a strong spot indicated by the laser (e. g. , as pointing to the hole start-up company, bein the intermedullary rod) and drill along the axis ing led by an excellent indicated by the beam. entrepreneur with an "Once we had gotten that far with the device, we started exceptionally good to realize how little we truly knew about what to do with technology in a promthe thing," Lifeso says. "Because we were both affiliated ising market, " says with the university, we went to the Office of Technology Daniel Massing, former Transfer, and they put us in touch with Bill Burns." B u f f a I o P hysician Summer 1 9 9 8 �director of UB's Office of Technology Transfer. dent and general manager. "The technology patented In cases where UB has patent rights on a technology, by Drs. Lifeso and Landi is a very elegant solution to the the university traditionally receives an up-front licenscomplex problem of aligning a visible laser guidance ing fee from the company commercializing the techwith a selected portion of the X-ray beam of a fluoronology , according to Massing. In this instance, in lieu scope. The simplicity of the solution they came up with of the licensing fee , the university will receive equity in means that it is inherently less expensive to manufacMI RAD based on its interest, which consists of foundture and less costly and complex to maintain after ing shares and subsequent stock purchases equal to 4. 7 installation. You can't help but feel good about a project percent of the fully diluted interest. In turn, UB's that is this straightforward to design and manufacture," license and patents on the DRTS were beneficial to the Me eirney says. "After 30 years' experience with simicompany as components of the prospectus document lar projects, I've seen both sweet and sour solutions. for raising funds , Massing explains. "The opportunity This is a sweet one. " to take equity in a start-up company that is commerll11 \II\ 1, I\ II\ ~ f.\1 ,\I' I' L II \Till\" cializing research developed in our own laboratories is consistent with a national trend by universities," he Sweet also is the fact that other applications for this notes. "Once the stock is sold, the return to the univerdevice are rapidly developing, which make it more sity of an equity position can be significant, often versatile than its inventors originally intended it to be. exceeding what would result from the license income In oncology, the device is proving to be ideal for generated by royalties. " performing minimally invasive biopsies oflesions than And the return to all investors does indeed look can be visualized with X-rays. This use of the system promising. According to Burns, surgical procedures could also translate into significant improvements in guided by fluoroscopy account for about 10 percent of the accuracy of deep tissue biopsies done on breasts, all operations performed worldwide. "There are about livers or spleens, some 20 percent of which currently 90,000 fluoroscopes currently in use around the world, " produce false negative readings. " ot only will you be he says, "and I think the market potential for the able to improve accuracy, but you will also be able to MI RAD device could reach $130 million, plus anreduce the patient's exposure to radiation as well as his other million for disposable accessories , such as surgior her discomfort because you can hit the target on your cal drapes and biopsy needles. first attempt, without having to manipulate the needle On September 24, 1997, two weeks after it received under fluoro , something that can be especially painful a notice of approval from the FDA for the DRTS, during bone or vertebral biopsies," explains Landi. MI RAD launched Other promisthe device at the ing applications for annual Meeting and the system are in Exhibition of the neurosurgery , ·To! C.\'i.T IIELI' BI'T FEEL mon \Bili"T ,\ l'!lO.JECT TIL\T I. British Orthopaewhich especially dic Association in interests Landi Cardiff, Wales. Earsince this is the lier, the DRTS had field he chose to .\HEll :~1) YL\H< E\I'EHIE'if:E \\ITII SI\IIL.\Ill'llii.Ji':CT:--. I\ E been approved for pursue following sale by Europe 's his graduation 'EE'i BoTH s\\EET \'ill ·,wn 'ilLlllil:\ . Tm·.; '"' .\ s\\"EET ti:\L.". FDA counterpart, from medical and MI RAD has school in 1994. since signed a 10"We're using the year $83 million DRTS to target agreement with Atmos Healthcare, to distribute the intercraniallesions prior to brain surgery. We use it as DRTS in 16 countries in Europe. Recently, a 34 a frameless stereotactic system to localize lesions in a million contract was signed with an Asian distributor. 3-D space, as opposed to the system currently in place," Currently, MINRAD i hoping to produce 400 syshe explains, referring to the standard stereotactic protems a month at its Orchard Park facility, with a sale cedure that involves bolting a rigid frame onto a patient's price of $4,000 for each. The only other systems that head, then placing him in a CT scanner to obtain a come close to competing with the DRTS are priced at three-dimensional picture of a lesion. "What most about $300,000 and are much less accurate than it, neurosurgeons will tell you is 'get me there and I can according to john Me eirney, MI RAD's vice presiCONTINUED ON PAGE 31 6 u f f a I o P hysician Summer 1 9 9 8 �BY LINDA J. CORDER. PHD, CFRE Dreams Woi1h Weaving CREAT I NG A TAPESTRY FOR THE SCHOOL O F MED I C I N E A N D B IOMED ICAL S CIENCES ' HY DEVELOPMENT?" This is a frequent question, especially when I first meet someone unfamiliar with the day-to-day work of a medical school development officer. Weaving is my favorite metaphor for development. In weaving a tapestry or a rug, the details of the background work are invisible, yet a successful outcome is impossible \Vithout careful attention to preparing the loom, securing the strands of the wrap, filling and threading the shuttle and deciding on a general pattern. Similarly, in coordinating development efforts for the School of Medicine and Biomedical Sciences, m; background activities are largely invisible. However, planning, setting priorities and having sufficient resources to support the development program are as important as the loom, which provides the mechanism that makes weaving possible. Maintaining good records and the systematic gathering of additional information on alumni and friends are analogous to the warp, as appropriate research supports all productive development. Consistent and thoughtful communications become the weft, the strands or threads by which all other elements are linked together. In addition, it is necessary for the development officer to review constantly the current dreams and priorities of the institution, always in light of its stated mission. By talking with individuals within the school, who guide key aspects of the academic environment, I can begin to conceptualize proposals. At the same time, I identify prospects who might be interested in contributing to the realization of those dreams. In this manner, general patterns for the desired institutional outcomes are determined; case statements for specific projects can then be written. Patience is paramount. On some days, no visible progress is made. On others, it is necessary to alter the pattern as the fabric takes shape. Occasionally, and with great patience, rows of weft must be carefully undone in order to accommodate changes in the original plan. Colors must be matched and complemented and, at times, a different yarn or thread is necessary, requiring skill in integrating loose ends into the overall design. A development officer's efforts call for the same type of sensitivity and flexibility as specific fund-raising projects evolve. The interests and dreams of individual prospects B u f f a l o Physician need to be melded with institutional priorities. Sometimes, potential donors will have another (or little) philanthropic interest or the timing is not quite right. Some reworking of original designs or finding other donors for a particular purpose then becomes necessary. Picking up and weaving in loose threads- by being aware of prospects' family situations, responsibilities and goals-arc integral to assisting others in their creative gift planning. Both weaving and institutional development involve longterm commitment. Woven fabrics take shape slowly. The matching of donor interests with specific programs or individuals on campus (along with ascertaining '·the best" overall gift planning) is a time-consuming activity. As with all relationships, this type of involvement requires nurturing and the time to grow. In both development and weaving, some motifs may appear repeatedly (i.e., scholarship endowments or endowed chairs, funded by bequests or with trust proceeds). Occasionally, a truly unique design emerges (perhaps a new interdisciplinary research center, complete with "cutting edge" technology). Variations are constrained only by the limits of human imagination and the resources and materials at hand. Not only is considerable time required for the process, but many results are primarily for posterity, lasting long beyond the lifetimes of those from whom the funds and ideas flowed. Thus, in some sense, each completed gift to the school is like a work of art. It is meant to inspire-and to be used and valued by-future generations as well as by those present!) living. As a development officer, 1 remain essentially invisible to the vast majority of people who -..viii ultimately benefit from my work. Nevertheless, I am content to recognize "my mark" in the "final product," just as weavers feel a close affinity with the pieces they have created. It is the "dream become real" that remains long after each item becomes a part of the total fabric of the institution. I chose to be a development officer because it satisfies me to be a weaver of dreams-especially when they come true. 1 chose UB because of its unique history-and because it has dreams worth weaving . . . + Summer Lyn Corder, PhD, CFRE, is associate dean and director of Development. She can be contacted at 716-829-2 773, by fax at 716-829-3395 or on E-mail: ljcordn@buffalo.edu 1 9 9 8 �. . . . . . .. . . . . . . . . . . . . . . . . .. . . .. . .. . . . . . . . . . . . . .. . . .. . .. . . [1] ~ I PH O T O S B Y FRAN K CESARI O Carol Chen lntcma/ Medicine, Loyola Um,·ersit) Medical Center, Maywood, IL Connie H. Chen Internal Medicine, Barnes-jewish Hospital , St. Louis , MO Bonnie Cheng Internal Medicine, Hospital of the Uni\ ersity of Pennsylvania, Philadelphia, PA Peter Cobb Family Practice, Columbus Family Practi ce Cem er, Columbus, GA Seth Cohen Internal Medicine, UMDNj-R.W . johnson , Piscataway, J Jeanine Cooley Pediatrics, Children's Hospital , Philadelphia, PA Pamela Crowell Family Practice, niversity• of Southern Florida , College of Medicine, Tampa, FL Michael Cummings Psycltially , S l\Y/Buffalo Graduate MedicalDental Education Consortium, Buffalo, NY April Cyr Family Practice, Memorial Hospital , Pawtucket, Rl Gul Dadlani Pediatrics, SUNY/ Buffalo Graduate Medical-Dental Education Consortium , Buffalo, f\iY Emily Aguilar Pediatrics, Orlando Region Healthcare System , Orlando. rL Eric Bonenberger Ortltopedics, St. Luke's Medical Center, C leve land, OH Kristen Andresen internal Medicin e, Unt\ ersity of Rochester, Strong Memorial Hospital, Rochester, l'\Y Lori Bowman Pediatrics, SUNY! Buffalo Graduate MedicalDental Education Consortium, Buffalo, ·y Luna D. Bailey Sw·ge•y (Prelim. ), S NY/Buffalo Graduate MedicalDental Education Consortium , Buffalo, NY; O!ola•yngolog) , SUNY/Buffalo Graduate MedicalDental Education Consortium , Buffalo, '\JY Leslie Barr FamiiJ Praclice, SU Y/Buffalo Graduate MedicalDental Education Consortium , Buffalo. :\JY Stephen Bekanich Fami!J Practice, University of lJtah Affiliated Hospnals, Health SCience Center, Salt Lake City , UT Eric Bluman Orllwpedics , Rhode Island Hospital, Brown University, Providence , Rl Yvonne Bobek Pediallics, Medical College of Virginia , Richmond, VA Richard Bremer Internal Medicine, Medical College of Virginia , Richmond , VA Jennifer Bulger Family Praclice, St. Vincent Health Center, Ene , PA Robert Burns Pediatrics, SU Y/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, '\'Y Therese Caligiuri Internal Medicine, S NY/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Jonathan Pediatrics, SU Buffalo Graduate Medical-Dental Education �························································································• · ~ I I .. r Left to right. Jeanine M. Cooley congrotuloted; Christopher P. Schaeffer gets o big hug of support; Nnenno Okereke, Luno D. Bailey, Sophia Streete ond Jonathon Daniels shore results. MaryAnn Dean Psychiatr), SU Y/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Claudia Deyoung Intemal Medicine, orth Shore University Hospital, Manhasset, Y Stacey Dimartino Psychiatry, SUNY/Buffalo Graduate MedicalDental Education Consortium, Buffalo, Y Vamil Divan Internal Medicine, Mt. Sinai Hospital, Elmhurst, Y Jane Dopkins Obstetrics and Gynecolog}, University Hospital, Cincinnati, OH Jason Ehrlich Intenral Medicine, North Shore Universit) Hospital, Manhasset, Y Andrew Esch Internal Medicine (Prelim .), isters of Charity Hospital, Buffalo, NY; Physical Medicine and Rehabilitation, SUNY/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y Timothy Fallon Surge') (Prelim.), SUNY/Buffalo Graduate MedicalDental Education Consortium, Buffalo, Y John Fanton Pediatr-ic Psychiatr) , Rhode Island Hospital, Brown University, Providence, Rl Left to right: Jeffrey Richman, Mei Y. Wong, Jose Macedo, on enthusiastic guest ond Li Zeng celebrate their future. Charles J. Fetterman Internal Medicine (Prelim .), S NY/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y; Ophthalmology, SUNY/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, . Y Donald Flihan urgery (Prelim.) , SUNY/Buffalo Graduate MedicalDental Education Consortium, Buffalo, Y Richard Gayle Psychiatry, Long Island Jewish Medical Center, New Hyde Park, Y Thomas Gergel Famil) Practice, Hinsdale Hospital , Hinsdale, IL Robert E. Gerstenbluth Urology, Case Western Reserve University, Cleveland, OH Youssef Ghaly Family Practice, Mountainside Hospital, Montclair, "lJ Hari Gopal intemal Medicine (Prelim .), Wilson Memorial Regional Medical Center, United Health Services, Binghamton, Y; Diagnostic Radiology, SU Y Syracuse Health Science Center, Syracuse, NY Christine Gordon Pediatrics, St. Luke's-Roosevelt Hospital Center, New York, Y Lisa Green Medicine/Pediatrics, SUNY/Buffalo Graduate MedicalDental Education Consortium, Buffalo,. Y Carrie Greenberg AncsthesiolOg)-, The New York Hospital , ew York, Y Alejandro Gruneiro Surgery , Southern Illinois Uni,·ersity, School of Medicine, Springfield, IL Rachna Gupta Internal Medicine, Uninrsity of Maryland Medical Center, Baltimore, MD Bryan Hanypsiak Orthopedics, George Washington University, Washington, DC Michael Hassett lntemal Medicine, University of Rochester, Strong Memorial Hospital, Rochester, NY Lisa Heichberger Family Practice, Hamot Medical Center, Erie, PA Scott Helsley lntemal Medicine (Prelim.), SU!'\Y/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y; Anesthesiolog_\ , Duke University Medical Center, Durham, C Michael Herbowy Internal Medicine, SU. Y/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Aaron Hoffman urgery , ew York Methodist Hospital , Brooklyn, 'Y Steven Horn Internal Medicine, SU Y/Buffalo Graduate MedicalDental Education Consortium, Buffalo, NY Calogero Ippolito lntenral Medicine, SU 'Y/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Dana Jandzinski Surgery (Prelim) , St. Joseph Hospital, Denver, CO Peter Janes Medicine/Pediatrics, S "JY/Buffalo Graduate MedicalDental Education Consortium, Buffalo, Y Theresa M. Jarmuz Otolar)ngology, Emory University, Atlanta, GA Michael Kane famil) Practice, U Y/Buffalo Graduate MedicalDental Education Consortium, Buffalo, NY Lawrence Kanner Internal Medicine, orth Shore University Hospital, Manhasset, Y ® �. . . [1] " ~ I encourage you to review this list and to contact and welcome your fellow UB Judith Kim Pediatrics, SU Y/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y Paula Kocialski Psychiatry , SU Y/Buffalo Graduate MedicalDental Education Consortium, Buffalo , Y David Montesanti Internal Medicitre (Prelim .), S NY/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y; Ophthalmology , SUNY/Buffalo Graduate Medical-Dental Education Consortium , Buffalo, NY Colin Powers Surgery, SUNY/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Anne Marie Reynolds Pediatrics, S NY/Buffalo Graduate MedicalDental Education Consortium , Buffalo , Y Jennifer Lee lntenwl Medicine, niversity of Rochester, Strong Memorial Hospital , Rochester, Y Bennett Myers lntenwl Medicine (Prelim.), Duke University Medical Center, Durham, NC; eurology , Duke University, Durham , NC Anthony K. Rice Family Practice, Womack Army Medical Center, Ft. Bragg, NC Sandra Leni Internal Medicine, SU Y/Buffalo Graduate MedicalDental Education Consortium , Buffalo , Y Kristin Nesbitt Orthopedics, Henry Ford Health Science Center, Detroit, Ml David Lin Internal Medicine, niversity of Michigan Hospital , Ann Arbor, Ml Neil Lipke Surgery (Prelim .), ew York University Medical Center, New York, Y; Anesthesiology, ew York University Medical Center, ew York , Y Jose Maceda Obstetrics and Gynecology, Thomas jefferson University , Philadelphia, PA Patrick Mahar Medicine/ Pediatrics, S Y/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y Thomas Malinich Medicine/ Pediatrics , outhern Illinois University , chool of Medicine, Springfield, IL Michelle Mang family Practice, Highland Hospital , Rochester, NY Jeffrey Marchant Internal Medicine, Medical College of Virginia , Richmond, VA Michael Markham Family Practice, SUNY/Buffalo Graduate Medical-Dental Education Consortium, Buffalo , Y Amy McGarry Pediatrics, Georgetown Unive rsity Hospital , Washington , DC Thomas McTernan Internal Medicine, SU Y/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Y Sumit Mehta Transitional , Chestnut Hill Hospital, Philadelphia , PA; Diagnostic Radiology , Stonybrook Teaching Hospitals , Stonybrook , Y Mark Oberlies Internal Medicine, Loyola University Medical Center, Maywood , IL moving into your Joseph Rebhan Family Practice, Wausau Family Practice, Wausau, WI George T. Moynihan Otolaryngology , Loyola University Medical Center, Maywood , IL Lori Kwan Internal Medicine, Yale- ew Haven Hospital , New Haven , CT graduates who ore community." John R. Wright, MD INTERIM DEAN Jeffrey Richman lntenwl Medicine (Prelim. ), Mercy Medical Center, Baltimore, MD; Anesthesiology , Johns Hopkins Hospital , Baltimore , MD Joseph Sheehan Pediatrics, University of North Carolina Hospital , Chapel Hill, C A. MacDuff Sheehy lntemal Medicine, Einstein/Montefiore Hospital, Bronx, NY Jenny Oh Internal Medicine, LAC-USC Medical Center, Los Angeles, CA Marc N. Richman Surgery (Prelim .), niversity of orth Carolina Hospital , Chapel Hill, C; Urology , University of North Carolina, Chapel Hill , C Nnenna Okereke Intemal Medicine, Yale-New Haven Hospital , ew Haven , CT Jayson Roland Pediatrics, S Y/ Buffalo Graduate Medical-Dental Education Consortium , Buffalo, Y Dawn Simon Pediatrics, SU Y/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, Tamera Paczos Obstetrics and Gynecology, Temple University Hospital, Philadelphia, PA Neha Sangwan Internal Medicine, Temple University Hospital, Philadelphia, PA Prashant Parashurama Internal Medicine (Prelim .) , Long Island Jewish Medical Center, ew Hyde Park , Y; Diagnostic Radiology, The ew York Hospital , ew York, Y Jennifer Scarozza Medicine/ Pediatrics, SUNY/Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Anand Singh Surgery (Prelim .), SUNY/Buffalo Graduate MedicalDental Education Consortium , Buffalo, Y Kathleen Pastore Emergency Medicine, Brigham and Women's Hospital , Boston , MA a Andrew Stoeckl Surgery (Prelim .), SU Y/Buffalo Graduate MedicalDental Education Consortium, Buffalo, ; Orthopedics, SUNY/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Joel Sebastien Surgery , Westchester County Medical Center, Valhalla , Y Joseph Stowell Transitional, Shadyside Hospital, UPMC, Pittsburgh, PA; Emergency Medicine, Long Island Jewish Medical Center, ew Hyde Park, l\lY Carl Seon Orthopedics, Hamot Medical Center, Erie , PA Clayton Polowy Internal Medicine, Rush-Presbyterian , St. Luke's Hospital , Chicago, IL f Hans Stelmach Psychiatry, niversity of North Carolina Hospital , Chapel Hill , NC Matthew Scozzaro lntenwl Medicine, University of Florida Program , Shands Hospital , Gainesville , FL Christine Pluviose Family Practice, Albany Medical Center Hospital , Albany , NY f Sunil K. Srivastava lntenwl Medi cine (Prelim .), St. Vincent's Hospital, ew York , NY ; Ophthalmology, Emory University , Atlanta , GA Medical-Dental Education Consortium, Buffalo, NY Achini Perera Internal Medicine, University Health Center, Pittsburgh , PA 0 David Serra Obstetrics and Gynecology, SUNY/Buffalo Graduate Sophia Streete Family Practice, Jamaica Hospital Medical Center, Jamaica, Y Medical-Dental Education Consortium, Buffalo, p 5 c o n Y J. William Sparks Transitional, San Diego aval Hospital, San Diego, CA Christopher Schaeffer lntemal Medicine, University of Rochester , Strong Memorial Hospital , Rochester, Y Mary Scott Obstetrics and Gynecology, SUNY/Buffalo Graduate Nicole Pazzaglini Obstetrics and Gynecology , Abington Memorial Hospital , Abington , PA u Lily Snyder Family Practice, Highland Hospital , Rochester, Michael Scharf Psychiatry, University of Rochester, Strong Memorial Hospital , Rochester, Y Viresh Patel Surgery (Prelim .), nion Memorial Hospital , Baltimore, MD ; Orthopedics, SU Y/Buffalo Graduate MedicalDental Education Consortium , Buffalo, Y B Anthony Shih lntemal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 5 m m e 9 9 8 �······· ···················· ·············•g··· I Jeffrey Visco Surgery , SUNY/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Gordon Wingard Emergency Medicin e, Maricopa Medical Center, Phoenix , AZ Keith Volmar Patholog), johns Hopkins Hospital, Baltimore, MD Mei Y. Wong Surgery (Prelim .), SU Y/Buffalo Graduate MedicalDental Education Consortium, Buffalo, NY; Neurosurgery, SUNY/ Buffalo Graduate Medical-Dental Education Consortium, Buffalo, NY Andrew A. Wagner Urology , niversity of Massachusetts, Worcester, MA Jenny S. Oh, left, and Doris Vanderpool share Match Day results. Jennifer Walsh Intemal Medicine, SUNY/Buffalo Graduate MedicalDental Education Consortium, Buffalo, Y Thomas Trevett Obstetrics and Gynecology , University of California at San Diego Medical Center, San Diego , CA Garin Tomaszewski Intenwl Medicine (Prelim .), Loyola University Medical Center, Maywood , IL; Diagnostic Radiolog) , University of Colorado, School of Medicine, Denver, CO Colleen Weber Obstetrics and Gynecology, University of Rochester, Strong Memorial Hospital, Rochester , Y Edna Valdes Surgery , New York Hospital , Medical Center at Queens, Queens, Y Angela Weirich Family Practice, Carilion Health System, Roanoke , VA Doris Vanderpool lntemal Medicine, St. Mary's Medical Center, San Francisco, CA Hannah Toon Intemal Medicine (Prelim ), Mt. Auburn Hospital , Cambridge, MA; Anestllesiolog), Massachusetts General Hospital, Boston , MA Mark Weirich Family Practice, Carilion Health System, Roanoke , VA Anthony Villani Pathology, University Health Center, Pittsburgh , PA Linda Van Intemal Medicin e, Stonybrook Teaching Hospitals , Stonybrook, Y Daniel Yawman Pediatrics, University of Rochester, Strong Memorial Hospital, Rochester, 1Y Li Zeng lntemal Medicin e (Prelim .), Lankenau Hospital , Wynnewood , PA; Anesthesiolog) , Hospital of the University of Pennsylvania, Philadelphia , PA Michael Zionts Family Practice, S NY/Buffalo Graduate Medi calDental Education Consortium , Buffalo, Y 0. \}\~e a mistake. But not from the inside. The roof looks funny, odd, strange, a\~ 'Ilwwa~· we sec it, wh~· build a ~traight roof when can build a perfect!~- ,good crooked one ·~ It's something up to sc,·en passenger~ in the Land Rm·cr Disco,·ery will truly appreciate . \\'ith the clc,·atcd roof and stadiumlike seating. passengers in the rear ha,·e ample headroom. \\'hich means the~· can look at more than the back of the fro nt seat. ~luch more. in fact. Because the Land Ro\'er Disco\·er,· has more \\·indows than an~· other -lx.t. \\'h" not take one out for a test dri\'e ·~ .\nd instead of just lookjng into it. look out of it. YOU Gf* DISCOVERY Land Rover Amherst A NORTHTOWN AIJTOMOTM C~/IM 3560 Sheridan Drive Amherst, New York 14226 • (716) 831-3100 http//www.northtownauto.com B f f a I o p h 5 c a 5 m m e I 9 9 8 �• ···················· · ······ ·· ···················································· · ······ ~ ' �• • • • • • • • • • • • • • • • • • •• • ~ I Commencement for the School of Medicine and Biomedical Sciences at the Stole Unive~ of New York at Buffalo wos held on May 22, 1998, at the Center for the Arts on the North Campus. On that day, the school graduated 138 new physicians and 37 new PhD scientists. Pictured clockwise from below: 1 Therese Caligiuri and one-year-old Willy; 2 Moster's degree candidates; 3 Closs Speaker Sunil K. Srivastava; 4 Nnenno Okereke receiving diploma from UB President William R. Greiner, School of Medicine's Interim Dean John R. Wright, MD, leh, and Vice President for Heohh Affairs Michael Bernardino, MD, center; 5 Rochno Gupta, leh, and Nicole Kerner; 6 Students entering the auditorium; 7 Christopher P. Schaeffer. I �Physicians Reaching Out to Students -NEW PHYSICIAN-STUDENT MENTORING PROGRAM ED! CAL ~CHOOL IS THE TOGGHEST CHALLE'\GE many students have ever faced. The pressure to achieve is intense; the work, grueling. When a problem arises, where do they turn? How do they cope? The University at Buffalo School of Medicine and Biomedical Sciences is offering help in the form of a new Physician-Student Mentoring Program that links first-year students with physician mentors in the community "Medical school is a parochial system, and students can feel so lost in it," says jack Coyne, MD, past president of the UB's Medical Alumni Association, who helped spearhead the program. "You lose contact with the world around you. During the first two years you don't even have time to read the newspaper. When yo u' re they're struggling in a class and don't know where to find help. Maybe they're homesick and could use an empathetic conversation over a hot meal. Perhaps their troubles run deeper. "When I was a student, a number of my classmates had concerns and problems and they didn't know where to go with them ," recalls Coyne, who graduated from UB's school of medicine in "STUDENTS WHO EXPERIENCE STRESSFUL SITUATIONS, WHETHER THEY RESULT FROM REAL-LIFE TRAGEDIES OR THE EVERYDAY CHALLENGES OF LIFE AND MEDICAL SCHOOL, NEED TO FEEL THAT THEY HAVE SOMEONE TO TALK TO, SOMEONE WHO IS INTERESTED IN THEM AND WILL TRY TO HELP." - 1N T E R I M being pushed to the limit in that setting, you can easily feel overwhelmed." In the program, which was begun last fall , the mentoring physicians act as confidantes, friends and sounding boards for students, who can call on them under any circumstances. Maybe ® 0 EA N J 0 HN R.W RIGHT 1985 and today is medical director of child advocacy centers for Erie and iagara counties and for pediatrics at Mercy Hospital. "It can be difficult for a student to share things with people in the administration. With this program, students have an opportunity to B u f f a l o Phys ici meet physicians who can help them or who know people who can help them without having to go 'on the record."' As a student Coyne watched classmates grapple with depression and drug problems. One, overwhelmed by his struggle and unable to talk about his despair, committed suicide, he says. Mentoring may be a way to help, by providing students with a safe haven whenever they need it. "In that case we're talking about a very serious situation , but more often it will be the case of a student who's feeling stress during final exams or who maybe wants a physician to open up his office so he can see the clinical side of things," says Coyne. The new mentoring program is informally structured. At the beginning of the 1997-98 school year, physicians who volunteered to participate received a letter with the name and telephone number of the student with whom they had been matched. Student participants received the physician's name and home and office telephone numbers. Physicians have been encouraged to initiate contact to overcome any hesitations first-year students may have due to shyness, intimidation or worry that they will be a bother. When the program was announced at the beginning of the year, 107 of the medical school's 135 members of the class of 2001 signed up. A survey conducted in early 1998 revealed that of the participants, 29 had been in contact with their mentors, and of that number, 22 described the relationship as helpful. In the survey responses , the program was described by students as "sup portive," "reassuring," "informative" and "friendly, " with several adding that they received "good pointers" from their mentors. an Summer 1 9 9 8 �············ · ·················· · ·············· · · ·· ·· · ··········· · ····· · · · ······· · · · ·····~ Such feedback, says medical school interim dean john R. Wright, MD, indicates that the men to ring program is reaching out to students in need, which is its goal. Wright recalls past situations where he has helped students get through difficult times. One particularly difficult case that stands out in his mind was that of a distraught first-year student whose sibling had been murdered. "There is a real need for this kind of program," Wright emphasizes. "But in the past, attempts to provide such assistance had been somewhat haphazard , so we thought it would be beneficial to the students to have a more organized effort in place. Students who experience stressful situations , whether they result from real-life tragedies or the everyday challenges of life and medical school, need to feel that they have someone to talk to, someone who is interested in them and will try to help. " The idea for the new PhysicianStudent Mentoring Program was brainstormed at an alumni executive committee meeting last year. Once the program was established and an- nounced , area physicians were quick to respond to the call for volunteers , with 75 immediately signing up and a few dozen more coming on board since that time. "Advisement is something that all medical schools struggle with, " Wright says. "Often it's not done particularly successfully. It requires a certain degree of organization because you want to make sure students know these services are available , yet you don't want to meddle in people's lives, and you don't want to be intrusive. From a different perspective, however, it's a good way for medical students to see how a doctor actually practices medicine." But the student isn't the only one who benefits from the rapport. It also allows physicians to reconnect with their past, Coyne says , and to take a look into the future of medicine. "I get a sense of belonging. We as physicians lose touch with what the students are going through. It helps us stay in touch with the system and , more importantly, with the problems students are having as they go through the system ." • PHYSICIANS NEEDED The Physician-Student Menloring Program has met with an overwhelmingly positive response from students; however, more physicians are needed. To volunteer, please call the UB Medical Alumni Association Office at 829-2778. Earlier in the year , Coyne received a call from one of the two students he mentors. Her grandmother died , and she just needed someone to talk to . When he received the call , Coyne realized how useful-and necessarythe program was . Then she told him about a friend of hers who was interested in a mentor. ow he's a mentor to three students . + INFINITI I ntroducing your way to escape . lnfiniti's luxury sport AUTO PLACE INFINITI 8129 MAIN ST . WILLIAMSVILLE ) 1 utility vehicle: the QX4. Unlike most luxury sport MSRD 36,045. 00 utility vehicles, the QX4 not only features everything you need to 633-9585 escape for the weekend, it has all the comforts and luxuries you East of Transit Rd. , Near Eastern Hills Mall a u f f a I o need to escape life's daily stresses. Physician Summer 1 9 QX4 9 8 ® �B Y S COTT T HOM EDWARD H . WAGNER , A S MD '65 , STOCKTON K I MBALL LECTURER The patient wAs A wiDow, ss YEARs oLD . D ESPITE A HALF CENTURY OF CIGARETTE SMOKING, SHE WAS DOING QUITE WELL . Then, from the tiniest hint of trouble, began a slippery slope of debilities. Her legs had been feeling weak; a lifelong walker, she was moving more slowly. Her family physician could detect no pulse in her feet and diagnosed intermittent claudication. Then a series of upperrespiratory infections buffeted her lungs and she began to develop wheezing. The physician searched for a carotid pulse and found none; he prescribed aspirin. He referred her to a vascular surgeon, who examined her and concluded she was not a candidate for surgery. She was at very high risk for stroke, he said, and would benefit from taking it easy. She did, and got weaker. She entered a skilled nursing facility for a while. And B u f f a ! a when she went home, it was, for the first time, with a cane. Now this previously vital womanwho used to take long walks, do her own shopping and maintain an active social life-is largely confined to walking to the bus stop and back. "This is not an uncommon story,'' says Edward H. Wagner, MD '65, MPH, who delivered the Stockton Kimball Memorial Lecture at the University at Buffalo School of Medicine and Biomedical Science's 6lst annual Spring Clinical Day, on April 25. "And it illustrates the difficulties she is faced with in trying to deal not only with these illnesses, but with their impact on her ability to function." The good news, he went on to say, is that Physician Summer 1 9 9 8 �this impact can be managed and mitigatedif the physician intervenes, and if, in the long run, we design a health-care system that goes beyond acute care and supports older people's efforts to take control of their own health. can they communicate and collaborate with their medical providers-often a bevy of specialists in addition to their primary physician-to devise a treatment plan. A STRUGGLE ON BOTH SIDES Wagner says the health-care system, as currently configured, is oriented toward acute care, addressing the presenting complaint without necessarily delving into the underlying health factors in the patienfs life. "But when illness plays itself out over years or decades, the patient's needs change, and a reactive system may not be as relevant as it was in ASTHEAVERAGEAGEOF the past,·· he says. Using the 85-year-old AMERICANS CONTINUES TO CLIMB, widow to illustrate the point, he adds: "She THERE WILL BE MORE DEMAND FOR wanted to walk, to play PHYSICIANS WHO CAN DEAL bridge, to go downtown shopping. The system EFFECTIVELY WITH THE ISSUES OF wanted to know what her presenting complaint was OLDER PATIENTS. that day. This was a clear mismatch between what was important to her and what was important to her health-care provider." The current medical system, he says, focuses on the short term. It pays little attention to delegating health-promoting tasks to the patient, to issuing reminders over months or years that would promote good health and to helping patients educate themselves about their condition. "The older patient," Wagner says, "needs a different system: one that takes a prospective view and looks down the road to next month, next year, a few years from now." A SYSTEM BUILT BACKWARDS Wagner, who spoke to a large luncheon audience at the Buffalo Marriott, has made a career of thinking about the public policy aspects of medicine. A general internist and epidemiologist, he directs the Center for Health Studies and the MacColl Institute for Healthcare Innovation at the Group Health Cooperative of Puget Sound in Seattle, Washington. He also teaches at the University of Washington School of Public Health and Community Medicine, where he is a professor of health services. His research interests include the care of geriatric patients. As part of a Spring Clinical Day focused on '"The Aging American," Wagner pain ted a broad picture of how practitioners tend to treat their older patients-and where they fall short. "The older patient is a struggle for physicians,'· he notes, "but it's also a struggle for the patient to deal with the physician. The patient needs to be an effective, educated manager of his or her own health. So the question becomes, what kind of health-care system do we need to support this?" Wagner says patients themselves must address several issues: what activities can they pursue that would promote good health; what skills can they learn to monitor their illnesses and adapt to changes in their bodies; how can they manage the effects of those illnesses on their ability to function; how can they manage the emotional impact, such as their ability to be a "social animal"; and how a u f f a 1 o Physlclon CONTINUED Summer I ON 9 9 PAGE 8 24 ® �'' THE OLDER PATIENT NEEDS A DIFFERE T SYSTEM: ONE THAT ... LOOKS DO\VNTHEROADTONEXTMONTH,NEXTYEAR,AFEWYEARSFROM TOW. C O N T I NUED FROM PAGE 23 It's not that individual physicians don't recognize these needs and try to meet them, Wagner adds. "But providers are working in a system that doesn't help them do this." The older patient's priorities, he says, generally are twofold: preventing disability and falls, as well as "the potentially devastating impact of the fear of falling"; and managing the chronic illnesses that most older people have. From 75 to 80 percent of older people have at least one chronic illness, he says, and about half struggle with two or more. Do NOT Go GENTLY The encouraging news,Wagner says, is something that has become a fundamental tenet of geriatric medicine: THE PATIENT NEEDS "The deleterious effects of aging may TO BE AN EFFECnot be inevitable." He displayed a TIVE, EDUCATED chart that seemed to prove a piece of common wisdom: Be it MANAGER OF HIS OR pulmonary function or muscle strength, HER OWN HEALTH. oxygen-uptake capacity or endurance, a human being's physiological capacity declines with age. But, Wagner says, that truism applies to the population as a whole; it's a mistake to assume that each individual will follow that path. The challenge for each individual patient is to buck the trend and resist the declines of age-a concept known as "successful aging." ''We're now beginning to understand the factors that lead to successful aging," Wagner says. "Physical activity is probably the most important. Individuals who become sedentary probably will have an increased decline." He points to the concept of"deconditioning" -the idea that with disuse, any physiological system will weaken. "This," he says, "is an enormously powerful tool for understanding decline." SOME PRACTICAL APPROACHES So how can physicians work with their elderly patients to maintain a good quality of life B u f f a l o ' ' despite the chronic conditions that often come \Vith advancing years? Wagner again suggests that we focus on patients' functional abilities and their ability to manage their own health care. For example, to avoid often-debilitating falls, patients might be encouraged to practice tai chi, or pursue endurance and strength training. To reduce incontinence, they can do Kegel exercises or consider pharmaceutical remedies. And to help patients in managing their own care, he says, the key concept is empowerment. "Handing them a book is not useful,"' Wagner says. '·Providing them with organized problem-solving help is"-such as suggesting sources of information, connecting a patient with support organizations, and, in general, treating the patient as an equal partner in health-care decisions that affect his or her life. For the physician trying to better organize his practice, Wagner suggests thinking about how we accomplish six tasks or roles: + Responding effectively to the acute problem. + Making sure the patient's overall status is assessed accurately. + Providing first-class self-management and support. + Finding ways to communicate and coordinate among the primary physician and specialists. + Advocating for patients in the community so that they receive the care they need. + Using data systems and technologies, such as registries and reminder systems, so longterm patient care doesn't depend entirely on the memory of the physician. Physicians don't necessarily have to accomplish all these tasks, Wagner says. They can be delegated to people on their staff or elsewhere who are trained for those roles. As the average age of Americans continues to climb, there will be more demand for physicians who can deal effectively with the issues of older patients. Fortunately, Wagner says, the science of treating older people is starting to come together. "I think this is an exciting time. For the first time we're moving beyond philosophy to evidence," he says. "There's clear evidence out there that we can improve outcomes, and I look forward to working with you on this in the future." + Physician Summer 1 9 9 8 �• ~ --¥" •Sprin~gaClinrcall•Dao/•Gatherimgs........._ Lehto right: Jared C. Barlow, outgoing president of Medical Alumni Association; Bertram A. Portin, assistant dean for Alumni Affairs; and Elizabeth L. Maher, president of Medical Alumni Association . Class of 1973 at Stockton Kimball Lecture. Lehto right:John J. Bodkin and Jared C. Barlow with Edward H. Wagner, Stockton Kimball lecturer. .110 Class of 1948 (pictured) shared the attendance trophy with Class of 1953. Fifty-year reunion doss at Saturday's luncheon. John R. Wright at Saturday's luncheon activities. Class of 1988 at Friday evening reception. B u f f a I o Phys i c i an Summer I 9 9 8 �Medical Alumni Achievement Awards ~FE r!VIE ME Die \l Atl 1 1 Ac HIE\ E \H· I A" on" were presented to the following four University at Buffalo alumni at Spring Clinical Day, April 25, 1998, at the Buffalo Marriott Hotel. RONALD BATT MD CLASS OF 1 958 -Introduced by Dr. Richard Romanowslli "Throughout his career, Dr. Batt has been an innovator in obstetrics and gynecology and an outstanding teacher and superb clinician with special expertise in endometriosis and microsurgery," Romanowski said. "He has been a pioneer in encouraging the use of laparoscopy in his field and, along with his colleague Dr. aples, has been recognized for his research in infertility and for his efforts to find more conservative measures of treating pelvic endometriosis." A prolific writer and medical historian, Batt has published some 20 peerreviewed articles and more than 25 book chapters and monographs. He was a coauthor of Another Era: A Pictotial History of the School of Medicine and Biomedical Sciences, State University of Ne~~ Yorh at Buffalo, published in 1996. In addition, he has also produced a number of audiovisual programs used in teaching. "I see residents and students helped by his work with these programs," Romanowski noted, "and that's very gratifying.'' In recognition of his contribution as a teacher, Batt received the 1995 Chief Residents Teaching Award, which is inscribed: Some men lift the age they inhabit until other men walll on higher ground during that lifetime. A leader in his community, Batt has organized many medical missions overseas to places such as the Ukraine in an effort to help his colleagues in less advantaged countries update their skills. "So for these contributions-for his ongoing patient care, his teaching and his B u f f a l o research, I thank him on behalf of us all for the work he's done throughout his career, day by day," Romanowski concluded. RONALD "SKIP" GARVEY. MD CLASS OF 1953 -Introduced b) Dr.]. Bradley Aust Ronald "Skip" Garvey is an accomplished surgeon, professor and health-care administrator, Aust said. A native of Olean, Garvey was a scholar athlete who attended Harvard College, where he played football. After medical school, Garvey completed his internship and residency at Parkland Memorial Hospital in Dallas, Texas, and a fellowship at the IH. From 1961 to 1983, he was in private practice as a surgeon, and for nine of those years was also team physician for the Dallas Cowboys. "In 1983, he went to Southwestern Medical School as a professor of surgery," Aust said. "Going from practice into an academic medical center is really quite a change and he felt academic medical centers were ill-prepared to deal with the problems that they faced, so he took time out to earn an MBA in Hospital Administration in 1986. At that time, the university was about to build a hospital at Southwestern and they looked around for someone to spearhead the effort and they picked Skip, so he shepherded through the building of the [Zale Lipshy l University Hospital and became its first president and CEO, from 1987 to 1991." Gan•ey then returned to teaching until last year, when the university asked him to accept a position as director and chief administrative officer for its Health Center in Tyler, Texas. "Scholar-athlete, practicing physician, Physician Summer l 9 9 8 �dedicated family man, academic surgeon and administrator-Skip Garvey is truly a 'man for all seasons'," Aust said. MILFORD MALONEY . MD CLASS OF 1 953 -Introduced by Dr. Michael Sullivan "I am honored to be able to present this award to my classmate, Milford, who has led an active career in academic medicine as a teacher, researcher and administrator, while simultaneously maintaining a busy private practice," said Sullivan. After a rotating internship, Maloney completed residencies in both internal medicine and cardiology. Following two years in the U.S. Army Medical Corps., and another two years as a part-time senior cancer research physician at Roswell Park Cancer Institute, he entered into private practice in 1964. In 1968, he was named president of the Western ew York Society of Internal Medicine, and in 1969, became president of the Heart Association of Western New York. Also in 1969, he was appointed chair of the Department of Medicine at Buffalo Mercy Hospital, a position he held until1994. During these years-from 1972 to 1989-he also directed the American Board of Internal Medicine's Medical Residency Training Program affiliated with UB. In 1976, he was named to the Steering Committee for the ational Association of Program Directors in Internal Medicine and a year later, was appointed to the Council of the National Association of Program Directors in Internal Medicine. In 1974, he was named president of the ew York State Society of Internal Medicine and in 1981, served as president of the Medical Society of Erie County. Also in 1981 , he was appointed clinical professor of medicine at UB, after having served as associate clinical professor since 1972. In 1990, Maloney was inaugurated as president of the American Society of Internal Medicine. "I cannot imagine how he managed to do all this in his career," Sullivan noted, "but it's for accomplishments such as these that we present this award." KENNETH R. NISWANDER , MD CLASS OF 1 948 -Introduced by his son Philip N. Niswander, MD "I am honored to introduce my father. It's particularly easy to sing his praises as a colleague because he has so many outstanding achievements, '' said Philip iswander, who gave a brief overview of his father's career. After completing a rotating and a surgical internship and residency training in obstetrics and gynecology, Niswander entered into private practice in Buffalo from 1953 to 1964, during which time he was an assistant clinical professor at UB. In 1964, he was made an assistant professor; and in 1965, an associate professor. From 1963 to 1967, he worked as an obstetrician in the Child Development Program at Children's Hospital in Buffalo, and for three years-from 1966 to 1969-he also served as chief of Obstetrics and Gynecology at the hospitaL In 1969, he accepted a position as professor of Obstetrics and Gynecology at the University of California at Davis, where he also served as chair of Obstetrics and Gynecology from 1969-1982. Speaking of his father's accomplishments, Niswander said, "During this time he published over 150 articles, as well as a textbook on obstetrics, which is currently in its fifth edition. otable among his research accomplishments, in my opinion, is his work showing that obstetric factors have little or nothing to do with brain injury among infants or with the development of cerebral palsy. This research is noteworthy economically as well as medically since it has contributed to the limiting of medical malpractice awards against obstetricians, who were previously found at fault for misconduct for any baby born malformed." In concluding his remarks, Niswander joked that, after consulting with his brothers, it "was difficult to find a single redeeming defect in our father." On a more serious note, he added, "Instead, as time passes, we notice that his reputation is enhanced and that his abilities are sustained, and, for this, we are very proud of him." + New Alumni Association Officers Elected B u f f a l o Physician Summer 1 9 9 8 ® �~············· ··················································· ················· · ······ ltlil CLASS REUNIONS First row: Darwin Moore, Norman Minde, \Villiam Bloom; second row: Raphael Good, Harold Graff, Kenneth 1\Jiswander, Raymond Moffitt, orman Paul, Lester Schiff; third row: Daniel G. Miller, Ansel Martin, Francis Peisel, Vernon Lubs, Daniel Fahey, Michael Dzubaty; fourth row: Robert]. Hall, Alfred Shapiro, S. Paul Zola, Myron Gordon, jasper Van Avery, Richard Proplesch, \Varren Hollis, Glenn Doan. First row: Thomas Geoghegan, Richard Nagel, David Batt, joseph Ruh, Samuel Galeota,W. Ransom Kelley; second row: john Strachan, Donald Ehrenreich, \-til ford \-Ialone\, jack Gold, Herbert Constantine, john Handel, Molly Seidcnbcrg,Jacob Shammash, Thomas Comerford, Ronald Garve}; third row: Marvin Wadler, Bertram Port in, Donald Rachow, Michael Sullivan, Harold ·mulvan, Harle) Lindquist, Herbert Simpkins, Howard Smith, James Orr, James Carlin, John Fenger. First row: ~orton Spivack, Robert Perez, Michael Mazza, William Glazier, jacques Lipson, Carl Contino, Richard Romanowski; second row: joseph Bellanti, Bernice Comfort, john Float, Richard Rahner, Samuel Shatkin, Gary Cohen; third row: jason Reder, Melvin Broth man, Eugene Friedberg, Michael Genco, Alfred Stein, Franklyn Campagna, Richard Wasson, joseph Zizzi, Robert Dickson, Richard Boyle, James Williams, Franklin Zeplowitz, Thomas Cummiske), Marie Leyden Kunz, Harold Zimmerman, jerr) Weisberg. First row: john Schriver, \Villiam Heyden; second row: Stephen joyce, E. Michael ulli\ an, David Malinov, Richard arins, Frank DeLaus,jason Rudisill; third row: john Wadsworth, Thomas Reagan, Joseph Tutton, Ernest Fatta, Robert Hamilton, Charles Tirone, Anthony Foti, George Steiner. First row: Leonard Argentine, Bruce ~toesser, Robert Rosen, Robert \filch, Sara '>trkm, Thomas Cumbo, Ronald Friedman second row: Ehas Rosenblatt, Jonathan Rcynhout, Kenneth \1atasar. Jean Dwyer \\!I hams, Lesbia Fcmande:: mith Le,in, Kenneth Eckhcrt, 1artial Knicser, Harold Kulman, Rtchard Stamile, Barry Shult::. B u f f a l o p h 5 I a n 5 m m e 9 9 8 �CLASS REUNIONS First row: Thomas Dwyer, Charles Anderson, Kenneth Gayles,jeremy Cole, Fredric Hirsh, Robert Lamantia; second row: James Marks, Demetrius Ellis, Paul Kuritzky, Timothy ostrant, Sharon Kuritzky, Reta Floyd, Lynda Sorrenti, Barry Sanders, john Przylucki, Daniel Pietro, Frederick Beck, Michael Haberman; third row: Arthur Mruczek, Patrick O'Connor, Da\·id Breen, Frederick Buchwald, Robert Fugitt, Thomas Lombardo, Michael Sansone, john Klimas, Gary Palys, Daniel First row: :-..1ark Kramer, Barry Rosenberg, :-\elson lsada, Alan Kosk•\\; second row: Louise Barbieri, Clifton Pea), Ronald Somogyi, Cheryl Aldrich, Rondie Emn jones, Linda :-.!orris, Elizabeth Doherty, Iris Buchanan; third row: Paul \\'opperer, Richard Elman, tephen Gawronski, Henry Wilamowski, Dand Sangster, Gregory Bennett, Simon Shaham, Richard Busch, ~!atthe\\ O'Bnen, Angelo DelBalso, David ~!archetti. First row: Catherine Goodfellow, Leslie Doolittle, Younghee Limb, Patricia Flanagan, Suzanne Meyers-Tanbakuchi, Melinda Cameron, Cynthia Pristach; second row: \ u-Fei Wu, Barbara Ostrov, Richard Collins, Charles Niles, Allen Rosen, Neal Smith, Robert Stall, Gah;n Anderson, Robert Rosen, Kenneth Murra), Andrea Man yon-Wild, Renata Wajsman, Mark Schwager; third row: Francis Mezzadri, Peter Accetta, James Wild, Kenneth Zimmerman,Jonathan Graff, Frederick McAdam. First row: Ann Marie LeVine, Margaret Morey-Stager, Stephanie Christensen, Mary Davill, Norah Lincoff, Andv Cappuccino, Lisa Benson, Helen Cappuccino; second row: Sandra Everett, Constance Greene Klocke, janet Flier Sundqmst, Dawn Hrab, Nicole Sasson; third row: Richard Gilbert, Thomas Bellomo, Lori Luzi, Frank Luzi,Jeffrey Steinig, Stephen Hughes, james Schlehr, Charles Everett, David Pochatko,John Dusse, Kathleen O'Leary, Anthony Bartholomew, Mark Klocke, Kevin Kopera, Brad Shumcl, john Barbaccia, janet Williams. First row: Kevin Kelleher ,Jennifer ordby, Paul Fa\·orito, Honora Heffner Favorito, Michael Aronica, Gill Farkash, Richard Hall; second row: Brian Szymanski, jeffrey Senall, Michael Sweeney, Jeffrey Parnell. B u f f a 1 o Physician Summer 1 9 9 8 �Harry Bergman, '34, Special Recognition Award Recipient has received an Award of Special Recognition from the Dean's Advisory Council of the University at Buffalo School of Medicine and Biomedical Sciences for his life's work in urology. When he heard news of the award in April, Bergman, 87, who lives in Hollywood, Florida, said, "I never expected anything like this. My work has been out there for so many years, this is beyond me." The award recognizes that, in 194 7, Bergman devised an instrument capable of obtaining an early neoplastic degeneration inside an apparent benign tumor, an accomplishment for which he received a national award from the American Cancer Society in 1948. lt also acknowledges Bergman's discovery of a radiological sign for ARRY BERGMAN . ' 34, cancer of the ureter, named "Bergman's ign" in his honor by john Emmett, professor of urology at the Mayo Clinic, and first catalogued in Dorland's Medical Dictionary in 1981. Also noted in the award is Bergman's work as a writer and editor of many publications and books, including his highly respected text, The Ureter, which he published in 1960 and revised in 1981. Bergman graduated at the top of his class at UB in 1934 at age 21, making him the youngest graduate of the school. He established a successful practice as a urologist and surgeon in Manhattan and the Bronx. ln 1978, he semi-retired in Florida, where for the next decade he served as a professor of urology at the University of Miami's Medical School and clinical professor at jackson Memorial Hospital in Miami. In presenting Bergman with the award, the Dean's Council states its resolve "to recognize him for his outstanding career contributions to medicine, especially for furthering the knowledge of cancer of the ureter." + Rob Bakshi, '91,Wins National Neuroimaging Award BAKSHI , MD . has been awarded the prestigious Oldendorf Award by the American Society of euroimaging (AS ) . Bakshi was cited for research he did in collaboration with his colleagues at the Lucy Dent Imaging Center and Millard Fillmore Hospital that involved the use of brain positron emission tomography (PET) in the study of multiple sclerosis (MS). The award, named in honor of Dr. William H. Oldendorf, a pioneer in the field of neuroimaging, is presented to a young investigator for outstanding neuroimaging research. Bakshi, a Buffalo native, graduated from UB in 1991 and completed postgraduate training at Harvard and the University of California at Los Angles. He returned to Buffalo in 1995 for a neuroimaging fellowhip and subsequently joined the Dent eurologic Institute and UB's Department of eurology. OB ONLY ONE INVESTMENT LASTS A LIFETIME • Exceptional college placement record • Challenging curriculum with 14 Advanced Placement courses • tate of the art visual and performing arts center • More than 60 interscholastic sports teams • Comprehensive communn:y sel'"\'tce proJects • Average class si:e is IS • Financial atd available Admissions tests on these Saturdays at 9:00 a.m.: January 24, February 2 To resel"'e a place for testmg or for addtttonal mfom1atton, please call: ® B u f f a l o Phys ician Summer l 9 9 8 �Bakshi received the award on February 27, 1998, at the national AS convention, during which time he presented a lecture detailing the findings of his research work. The effect ofMS on brain functioning may play an important role in the progression of the disease , but has previously been poorly understood, he reported. Using fluorodeox yglucose (FDG ) as a tracer to measure brain metabolism by PET, widespread global and specific regional hypometabolism was noted in MS patients as compared to healthy subjects. This effect of reduced metabolism and consequently reduced function was most profound in the frontal and occipital gray matter, and in the white matter. These findings suggest that FDG-PET may be a useful tool to improve the understanding of the pathophysiology ofMS and track the response of these patients to new therapies. Other aspects of brain mapping studying specific clinical MS protocols have been completed and were presented by Bakshi and his Dent colleagues in April 1998 at the annual meeting of the American Academy of eurology. The work presented by Bakshi Rob Bakshi, MD in Orlando was co-authored by RobertS. Miletich, MD , PhD ; Peter R. Kinkel , MD; Mari Emmet and William R. Kinkel , MD , '54. The PET research of the lucy Dent Imaging Center is being supported , in part, by the Dent Family Foundation and is performed in collaboration with UB's Department of uclear Medicine. eurologists at the Dent Institute are also using PET scanning to improve the understanding of other neurologic diseases such as Alzheimer's disease , epilepsy and brain tumors. + B u f f a l o Phys i Nedra J. Harrison, 'Tl,New President Medical Society EDRA J. HARRISON. 77. is the new president of the Medical Society of the County of Erie. A practicing general surgeon with Delaware Surgical Group , P.C. , in Buffalo , Y, Harrison was installed at the society's annual meeting May 12, 1998. A native of Buffalo, she earned her undergraduate degree at Rosary Hill College (now Daemen College) in Amherst, Y. After earning her medical degree, she completed her internship and residency training at Millard Fillmore Hospital in Buffalo. She was in solo practice in general surgery for a number of years following her postgraduate training before joining her present group in 1994. LASER SYSTEM CONTINUED take out the tumor. I don't need an expensive system to help me do that. ' This system is making it much easier and simpler for a physician to find , biopsy or excise a brain tumor," Landi says. Another neurologic procedure DRTS is greatly improving is the percutaneous procedure for trigeminal neuralgia. Treatment of this condition involves placing a needle up through the patient's face via a hole in the bottom of the skull and either burningorinjectingamedicationaround the affected nerve. "What the DRTS system allows you to do is target a neural foramen and place a needle directly into it as opposed to how we do it now, which is walking a needle along the base of the skull until you pop through. This can be very painful for the patients because they need to be awake to tell you if you've hit the right spot in the right part of the nerve," landi explains. In addition , the DRTS has also found a broad application to spine procedures, from guiding the placement of instrumentation to percutaneous procedures for pain relief. cian Summer Harrison, who is a past president of UB's Medical Alumni Association , is also a voluntary clinical assistant professor in general surgery at UB, where she Nedra J. Harrison, MD serves as a preceptor for senior medical students. Harrison is a diplomate of the ational Medical Board and the American Board of Surgery and is a fellow of the American College of Surgeons. Currently, she is a delegate from Erie County to the House of Delegates of the Medical Society of the State of ew York. She is also a member and past president of the Buffalo Surgical Society, where she was the first woman to serve as president. + 1 9 9 8 FROM PAGE 12 Given the success of the DRTS to date , both Landi and lifeso would not be surprised if other, yet-to-be discovered, applications are found for the system they invented. For each physician, it's tremendously rewarding to see how use of the DRTS is contributing to improvements in diagnosis , treatment, pain control and protection from radiation exposure. 'There's no substitute for the satisfaction you get from the people you meet every day when you know you've helped take away some of their pain or contributed to their being treated in a better way," Landi says. lifeso, too, says he derives much satisfaction from seeing the benefits the DRTS brings to his patients, a satisfaction compounded by the work he continues to do with young medical students. "I still do a lot of work with students," he says, "and I encourage them to explore their ideas. If they have something they want to talk about, I tell them to come on in and we'll sketch it out." + Ellt•n liolr/luntuli'OI//rillll!l'll/o this arlitlt•. �· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · IJ ----------------------~- '' - ' / ' Reducing Multiple Births RELI\IINAR't RF'>LARC II by a fertility specialist at the University at Buffalo School of Medicine and Biomedical Sciences shows for the first time that a hormone whose role in fertility was thought to be limited to triggering ovulation may also support growth of a developing egg follicle during fertility treatment. The findings suggest thatlutenizing hormone (LH), a hormone present in the second half of the menstrual cycle, may perform the critical task of ustaining the growth of egg follicles until ovulation, said Michael W. Sullivan, MD, VB assistant professor of gynecology and obstetrics and lead researcher on the study. They have important implications for women undergoing fertility treatments, Sullivan says, because specialists formerly thought the only way to keep a developing egg growing was to administer follicle stimulating hormone (FSH), which also causes multiple eggs to mature. By manipulating LH and FSH, Sullivan says it could be possible to sustain the growth and development of one or two follicles in women undergoing fertility treatment while preventing multiple ovulations, thus decreasing the risk of multiple births. " obody has looked at this before, because it wasn't possible until the development of the recombinant form of the two hormones, which happened very recently," he says. "The finding is very preliminary, but it is promising. " The results are based on a prospective trial involving 24 women that Sullivan ® led while a fellow at the University of Pittsburgh School of Medicine. Successful infertility treatment depends on the ability to manipulate precisely the essential hormones involved, which requires their clear identification. Infertility specialists strive for a single birth; however, a stumbling block to this end has been identifying a way to limit the number of eggs that mature during fertility treatment while keeping at least one egg developing. During a normal menstrual cycle, FSH stimulates egg follicles to develop. At a certain point in the cycle, estrogen signals the pituitary to stop producing FSH, a signal that at least one egg follicle is well and being nurtured. The drop in FSH stops more follicles from developing, all immature follicles die, but the "recruited" follicle lives. " obody knew why the follicle continued to thrive in the face of decreased FSH ," Sullivan says. "We thought that FSH was required all the way along, even at low levels. So stan- B u f f a l o dard procedure during fertility treatment has been to continue FSH, which keeps follicles growing, but also may stimulate too many to develop. "We've now shown that FSH is not essential during the entire first half of the cycle. We've discovered that LH can make up for the deficiency ofFSH as the follicle grows." ullivan and colleagues stopped production of fertility hormones artificially in the study group, and then stimulated follicle development in all the women with recombinant human FSH. When a 14-mm follicle was identified by ultrasound, the women were randomized to one of four groups: continued FSH treatment; FSH replaced with saline; FSH replaced with high dose of recombinant LH, and FSH replaced with low dose of recombinant LH. After two days of treatment, researchers measured blood levels of estrogen, the sign that a follicle is healthy and developing normally. Estrogen levels dropped in the saline group, indicating the maturing follicle had ceased to thrive in the absence of FSH or LH. In all three remaining groups, estrogen levels continued to rise and pregnancies resulted in all three groups. "This suggests that if you administer FSH until one follicle matures, then limit FSH and substitute LH, you can support the growth of the maturing follicle, but won't recruit any more follicles," Sullivan says. Also participating in the study were A. Stewart-Akers, ]. S. Krasnow, S. L. Berga and A.]. Zeleznik of the departments of Obstetrics, Gynecology and Reproductive Sciences at the University of Pittsburgh School of Medicine. Funding came from the IH and TAP Pharmaceuticals. + Physician - LOIS Summer BAKER l 9 9 8 �m ·· ···· · ···· · · · · ·· ······· · ········ ··· · ·· · · ········ · ······ · · · · · ················ · ···· · ······ · m .. . . Blood-Brain Barrier Disruption and Hypoxia HE LA TEST HIGH- TECH GEAR can't protect climbers on Mount Everest from one of the hazards feared most by those who spend time at extreme heightsoxygen deprivation , or hypoxia , resulting in the potentially lethal brain swelling known as high-altitude cerebral edema. Research conducted at the University at Buffalo School of Medicine and Biomedical Sciences suggests that highaltitude cerebral edema is caused by a disruption in the blood-brain barrier. john A. Krasney, PhD , UB professor of physiology and a specialist in hypoxia, presented these findings on April28 , 1998, at the 66th annual meeting of the American Association of eurological Surgeons in Philadelphia. Krasney and colleagues in UB 's Hermann Rahn laboratory of Environmental Physiology have developed an animal model using sheep for studying hypoxia and cerebral edema in an effort to learn more about how and why these conditions develop and their effect on cognitive function. "Brain swelling, and also pulmonary edema, is one of the major problems at high altitude and we don' t really know the cause of either," Krasney says. "It is not lack of oxygen , per se. At high altitude , the brain has an adequate supply of oxygen, because blood flow increases to compensate for the lower concentration of oxygen in the air. Yet people still get sick. " In its mildest form, swelling of the brain brings on the headaches and nausea characteristic of acute mountain sickness. In its most severe form, B u f f a l o unrelieved by retreat to lower elevations , brain swelling advances to highaltitude cerebral edema, which causes disorientation, impaired mental function and death. Information gained from the study of high-altitude cerebral edema and hypoxia is relevant to many people other than those wealthy enough to afford an Everest trek , Krasney notes. "Thirteen million people go to Colorado every year to ski and 65 percent develop at least a headache, " he says . "Twenty-five percent develop acute mountain sickness , and l to 2 percent develop highaltitude cerebral edema. " Hypoxia also is associated with obstructive lung diseases , sleep apnea and other disorders. Krasney's research using sheep has shown that the symptoms of highaltitude cerebral edema are not caused by an inadequate supply of oxygen or glucose to the brain. Rather , it appears that an accumulation of malfunctions creates enough cerebral blood pressure to force apart cells of Physician Summer 1 9 9 8 . . the blood-brain barrier and allow fluids to accumulate in and around brain tissues. They theorize that acute hypoxia may allow a decline in cyclic adenosine monophosphate (cAMP) , a chemical messenger involved in regulating capillary permeability. The decrease in cAMP may allow the cerebral capillaries to leak. In addition , Krasney said, it is possible that , in the presence of hypoxia , another chemical messenger , cyclic guanosine monophosphate (cGMP), acts with nitric oxide , a vasodilator, to promote and sustain permeability of the blood-brain barrier. The combined influence of actions could allow fluid to accumulate in the intracellular spaces, he says. Yet another mechanism that may be at work involves eleva ted levels of leukocytes that may cling to the lining of cerebral blood vessels and cause leaks in the blood-brain barrier. Krasney and colleagues are attempting to clarify further the importance of these mechanisms in the development of acute mountain sickness and highaltitude cerebral edema. Their research is supported by the ational Heart, lung and Blood Institute. + -LOIS BAKER ® �· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · 11 -- ' ------ - - ' / . HURWITZ & RNE, P.C . [ ATTOR Link between Prostate Cancer and Estrogen Studied u f f a l a Ph AT LAW I SERVICI G THE LEGAL NEEDS OF THE HEALTH Scm cEs CoMMU ITY HE FIR<, T 1 \ E~ TIC, -\TIO of the been studied in men , especially in rerole of estrogen metabolism in lation to prostate-cancer risk," Muti the development of prostate can- says. "Yet, men also produce estrogen, cer will begin at the University at and we know that estrogen plays a role Buffalo chool of Medicine and in the development of cancers in Biomedical Sciences in October women. There is evidence also that 1998, funded by a $450,000 grant from androgens are increased in women who the U.S. Army's Medical Research and develop brea t cancer later in life. " Muti's goal is to determine if estroMaterial Command. The 30-month study will determine gen metabolism is influenced by enviif differences in estrogen metabolism ronment and lifestyle in a way that exist between healthy men and men increases prostate-cancer risk. The inwho develop prostate cancer. Infor- crease in prostate-cancer deaths among mation on lifestyle habits also will be men who emigrate from countries with low rates to the collected to deterUnited States, where mine if, as suspected, rates are high , sugthese habits affect "ESTROGEN METABOgests that environwhether estrogen LISM HAS NEVER BEEN mental factors play breaks down into a a dominate role in potent product that STUDIED IN MEN, the disease, she says. may induce prostateESPECIALLY IN RELA"There is evice ll division , or a TION TO PROSTATEdence that a sedenweak version that tary lifestyle and acts to discourage it. CANCER RISK .. . YET , high-fat diet influThis never-beforeMEN ALSO PRODUCE ence estrogen meexamined mechaESTROGEN , AND WE tabolism to produce nism represents a a potent estrogen , potential new avKNOW THAT ESTROGEN while an active lifeenue of s trategies to PLAYS A ROLE IN. THE style and low-fat diet prevent this imporDEVELOPMENT OF induce production tant disease, said of a weak estrogen. Paola Muti , MD, UB CANCERS IN WOMEN ." Potent estrogens assistant professor of may increase prossocia l and preventate cell division and tive medicine and lead investigator on the research. increase cancer risk. It's possible that Prostate cancer is the second lead- the influence of these lifestyle factors ing cause of cancer deaths among men , on hormone metabolism, especially and the American Cancer Society esti- estrogen metabolism, could be the link mates that39,200 men will die of the between environment and prostatecancer risk." + disease in 1998 in the U.S. "Estrogen metabolism has never L OIS BAKER B EYS • Managed Care • Purchase & Sale of Practices • Business & Tax Planning • HCFA Safe Harbor Regulations ysician and Physician Self-Referrals • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence M. Ross at 716-849 -8900 1300 Liberty Building Buffalo. ew York Summer l 9 9 8 �· ···· · ··· ·· ·· ·· ··· · ·· · ·· · · · ·· ··· · · ·· ··· ·· · · ·· · ······· ····· · · ··· · · · · · ··· · ···· · · ···· · ·· ··· ·· m ·~!tl ~. ,;. . Taller, but Not Necessarily Happier con- into changes in quality of life. "If adult quality of life is what we're tinues to presume that height is a measure of personal satisfaction concerned with , then we should probin life, a new study by a team of ably be looking at factors in addition to researchers at the University at height. Maybe we should take into acBuffalo refutes the idea that taller count experiences related to having a is necessarily better. The study, which chronic medical problem in general, compared the quality of life of adults and how this might affect adult adaptawho were treated for growth-hormone tion, " Sandberg says , stressing that the deficiency as children with their healthy findings do not suggest that growthsame-sex siblings who experienced nor- hormone treatment has no benefit mal growth, appears in a recent issue of for patients' quality of life as adults. the journal of Clinical Endocrinology and Metabolism (Vol. 83, pp. 1134-1142.) The researchers, led by UB pediatric psychologist David Sandberg, PhD , a specialist in the psychological aspects of growth-hormone The study involved 140 former deficiency, found that as adults , chil- patients- 117 males and 23 dren who were treated were as well- females- and 53 siblings, all over adjusted as their physically healthy the age of 18. The mean age of the brothers and sisters . They also were treatment group at the time of the study doing much better as adults than previ- was 26. Information on several qualityous studies using non-sibling control of-life measures was collected by telegroups or norms from questionnaires phone interviews. The treatment and follow-up study were conducted at had indicated. Results showed, unexpectedly, that Children's Hospital of Buffalo. there was little or no relationship beBoth the data-gathering method and tween the former patients' adult height the relatively large and complete study or how much they grew over the course population give the findings special of therapy and their reports of psycho- credence , Sandberg says. "Most studies logical and social functioning. An im- use self-administered questionnaires , portant difference that did emerge was which are mailed to patients, giving in marital rates: Siblings were twice as you limited control over the process. likely to be married as former patients. Also , by using same-sex siblings, we "This study questions whether there is account as much as possible for particia direct relationship between how tall pants' genetic and social backgrounds. " The results showed no significant difyou are as an adult and how satisfied you are with your daily life experi- ferences between the formerpatientsand ences," Sandberg says. "Changes in their same-sex siblings in educational height brought about by growth hor- attainment, gainful employment, the likemone do not automatically translate lihood they were living independently, LTHOLGH POPCLAR CCLTLRE a u 1 1 o 1 o P hysic i an Summer 1 9 9 8 '"· .. and social support or adjustment, which involved aspects such as one's network of friends and social activities. There were slight differences between the groups on a measure of general health. Former patients reported more health problems, and those missing other hormones experienced more health and social difficulties , a predictable outcome in light of the fact that some patients still have health problems, notes Sandberg, who adds that he has no explanation for the differences in marital rates. The study places in perspective the relationship between height and happiness . "We shouldn't get caught up in the idea that making someone taller as adults will necessarily improve their quality of life," Sandberg says. "Our goal is to allow each person to reach the normal range so his or her short stature doesn't constitute a physical disability. Maybe beyond that we aren't going to find benefits. Quality oflife is an enormously complex concept. " Also participating in the study were Margaret H. MacGillivray, Richard R. Clopper, Caroline Fung, Linda LeRoux and Dana E. Alliger , all of UB and Children's Hospital of Buffalo . The study was supported in part by grants from Genentech . + - L OIS B AKER �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 ----' / ' - -- ~~~- ' ""' . "It has taken 30 years from the discovery of these animal models to finding out the true cause of these anemias ," comments Michael Garrick. Recent efforts to map the rat genome gave a boost to the anemia research by providing enough markers to enable researchers to begin mapping the Belgrade rat and tists describe as a stunning example of conducting the D A analysis to find the biological conservatism: The same gene that encoded the critical protein. amino-acid change in the same gene in "The publication in 1995 of the rat the same protein is responsible for iron- genome inspired us to get together with deficiency anemia in two different ani- the Harvard group to map the Belgrade mal models. The details of iron metabo- rat, " says Garrick. Meanwhile, the Boslism-particularly the question of which ton Children's Hospital researchers were proteins are responsible for iron attempting to map the microcytic mouse. absorption in the intestine and for iron What the two groups found was akin to traffic within cells-have lightning striking long eluded researchers. twice, he says. "We The UB-Boston team has were looking at two . . . THE PROTEIN concluded that it is different models. We ramp2that actually takes APPEARS TO BE didn't know we'd up iron in the gastrointesfind the same thing. INVOLVED IN NOT tinal tract. Later, when Not only is it the iron is absorbed into cells JUST ONE , BUT same gene encoding in the body, it must be the same protein in SEVERAL CRITICAL delivered to the mitochonboth animals , but it dria. "This protein also is ROLES IN IRON is the same aminothe major one involved in acid change that METABOLISM . this critical, intercellular distinguishes the traffic step," says Garrick. normal animal from The current results, says the mutant. " Laura Garrick, as well as recent research A group at Brigham and Women's conducted elsewhere, suggest that the pro- Hospital in Boston independently found tein also may be implicated in a third the same protein; however, they did not type of iron transport, called nontransferrinhave a mutant animal that could help bound iron transport, which comes into play identify its role. "They did find that when there is excess iron in the body. ramp2 also transports lead, manganese, The findings of the UB and Boston cadmium, zinc, cobalt, nickel and copChildren's Hospital researchers build per. Thus the Belgrade rat could be defion decades of work at UB led by the late cient in some of these metals and thereRobin Bannerman, MD , and colleagues, fore may help us to understand human includingjohn Edwards , MD, that re- variability in response to toxic material," sulted in the characterization of animal Garrick says. models of two types of iron-deficiency "However, this protein doesn't ananemia: the Belgrade rat and the micro- swer all the questions in iron transport, " cytic mouse. Both animals are unable to he cautions. "What's remarkable, absorb iron properly in the gastrointes- though , is that it shows up in so many tinal tract or take it up sufficiently at the ways. It's a fantastic coincidence. " + cellular level. -ELLEN GOLDBAUM Major Step in Understandina Iron Metabolism, Iron-Deficiency cientists at the University at Buffalo and Children's Hospital in Boston (affiliated with Harvard University) have identified and characterized a protein that is the single most critical known element in iron metabolism. The first protein to be identified as essential for normal intestinal iron absorption and the first mammalian iron transporter to be characterized at the molecular level, the protein appears to be involved in not just one, but several critical roles in iron metabolism. The research, supported by the ational Institutes of Health, was published in the February 5, 1998, issue of the Proceedings of the ational Academy of Sciences and highlighted in the March 25 , 1998, issue ofjAMA. 'This finding allows us to take a major step forward in our understanding of iron metabolism," says Michael Garrick, PhD, professor of pediatrics and biochemistry at UB and a coauthor of the paper. Other UB coauthors are Laura M. Garrick , PhD, clinical assistant professor of biochemistry, and Michelle A. Romano, research technician. The discovery of the protein, called ramp2, will allow researchers to increase their understanding of iron-deficiency anemia; it could also lead to improved treatments for hemochromatosis and help manage exposure to toxic metals. For example, the potential role of ramp2 in hemochromatosis was a main topic of discussion in a symposium titled "Molecular Medicine and Hemochromatosis-At the Cro roads ," heldinBethe da , MD,May14-15 , 1998. The work highlights what the scien- e u f f a 1 o Physician Summer 1 9 9 8 �.........................................• • • 1 9 4 s 0 1 9 8 s 0 W ILLI AM MALONEY, '41 , wrties: EDWARD A . TOR IELLO , '80 , Good to read about Ted Ross. I'm glad some of the '41ers are still alive. The war was rough on been named to the board of directors of the American Academy of Orthopaedic Surgeons. our class. I've retired from anes- His election took place at the 65th annual meeting of the academyMarch 19-23,1998, in New thesia and live in Maine, near the shore. My health is fair. I do a little fishing and go to the Carribean most winters. 1 9 7 s 0 has Orleans. Toriello is chief of the Department of Orthopaedic Surgery at Wyckoff Heights Medical Center in Brooklyn, Y, and GLENN L. POST , '72 , writes: "I am currently working and attending orthopaedic surgeon at St. John's Queens Hospital, enjoying life in Kathmandu, Catholic Medical Center, Queens , Y. A member of the Nepal, with my wife , May, a Burmese physician. I am chief of the health E-maJU5 program at the U.S. agency for International Development You've done all you can for your patient. .. now what? I Classnotes tan also be submitted by E-mail at: ew York State Orthopaedic Society, he currently serves on its board of di- rectors. He is also a delegate of the House of Delegates for the Medical So- here. Our program has an anbpnotes@pub.buffalo.edu. nual budget of 17 million for ciety of the activities in maternal and child health, HIV/AIDS, family plan- State of New York. ning and infectious diseases. ROSLY N ROMANOWSK I, '86 , epa! is a wonderful country writes: ''I'm practicing hematolwith a rich and diverse culture, ogy/oncology with Century spectacular countryside and Medical Associates in friendly people. I was a Peace Williamsville, NY. My husband, Corps volunteer here from Bob Campo, and I are enjoying 1977-1979 , during which time our first child, Richard Joseph, I completed a preventive mediborn January 1, 1998." cine residency with a specialty in international health at Johns 1 9 9 0 s Hopkins. Suggest Hospice support and care. Explain how Hospice also helps the whole family. Remind them that you 'II be there with Hospice, still directing care. Tell your patient that you and Hospice together can help make the remaining time more meaningful, more dignified and more comfortable. JONATHAN is now at the University of Florida M ICHAEL J . p~~ 686.8077 5ALZLER ,'79 , at Gainesville, where he works in research. HOSPICE BUFFALO • HOME CARE BUFFALO • KRESGE RESIDENCE LIFE TRANSITIONS CENTER • HOSPICE FOUNDATION WE I NSTEIN , '93 , writes, "I am working in a private pediatrics practice in orthern Virginia, just outside Washington, DC. I got married in August 1997; my wife's name is Sandra. I keep in touch with B u f f a l a p s i c a 5 u m m e 9 8 �I -~-- • ·· · ········· ···· · · · ·· ········· ····· ···· ···· ···· ·· ·· ····· ··· ·· ·· ·· ·· ·· ····· ····· ·· ········· I Edward Math '93 (he was my best man). He will be doing a one-year fellowship in mary for 17 years and completed his career with the ew York thesiologists from 1984-1992. He also served as a certification examiner for the American Board ROBERT J . EHRENREICH , '47 , died on April3, 1998, in a Philadelphia nursing home after suffering a stroke. Ehrenreich, who fought a long battle with State Health Department. Survivors include his wife of 56 years, the former Marjorie Thomas. of Anesthesiology for 25 years. ThisJuly, I will begin my second year of residency in dermatology at SUNY Stony Brook. Also, died March 19 while visiting relatives in Evanston, IL. Ament, January 28, 1998, in Wanakah, Y, at the age of 88. Saab, a surgeon, maintained a practice in a pediatrician, allergist and clinical assistant professor in UB's my wife, Kimberly, and I would like to announce the birth of our who was 79, was a clinical professor of anesthesiology and vice Lackawanna, Y, for more than 50 years. He was also a taff phy- School ofMedicine and Biomedical Sciences. In his 43-year prac- first child, Danielle Leigh, on May 23, 1998. She was one chairman for educational affairs for the anesthesiology resident program at UB. During his long sician at Our Lady ofVictory Hospital and Mercy Hospital in that tice of medicine, he was on the staffs of Children's, Millard community. Survivors include his Fillmore, Sisters, Kenmore Mercy career as an anesthesiologist at Buffalo General Hospital (BGH) wife, the former Jane Daley. and DeGraff Memorial hospitals. Ehrenreich, known as "Dr. Bob," Charlouesville, VA, next year. SCOTT FLUGMAN , '96. writes: month early (surprise!) , but baby and mom are doing well. MARTIN C. MAHONEY , "95, has received the fir t-place award in the 1998 American Academy of Family Physicians Resident JOSEPH R . SAAB , '43, RICHARD AMENT , '42 , and Children's Hospital, Ament introduced new anesthesia techniques and developed the anesthesia resident program at BGH. The author of numerous pub- Scholars Competition. The award was given for his paper, lications, Ament was an expert in "Correlates of Anticipated Infant Feeding in an Urban , Indigent Family Practice Setting." the development of academic anesthesiology in the U.S. and, in recent years, became involved The AAFP respresents nearly 84,000 family physicians, fam- with the Wood Library Museum of the American Society of Anes- ily practice residents and medical students nationwide. thesiologists in Chicago. In 1986, he received the Distinguished Service Award, the most presti- OBITUARIES died December l l , 1997, in his Buf- gious award of the American Society of Ane the iologists, which he had served as president in 1977. Ament also was honored with the dean's award for outstanding service from the UB medical school in 1986, and in falo home after a lengthy illness. He was 81. rban, an internist, 1996, he received the OutstandingAiumnu AwardfromtheUB was a former track star at UB who once ran again Jesse Owens. Alumni Association. A member of many medical In addition to maintaining a private practice in his residence, he was a member of the medical organizations, Ament was president of the ew York Society of CARMELO E . PATTI , '32 , died December 7, 1997, in Hornell, Y. He was 89. STANLEY T . URBAN. '40 , staff of Millard Fillmore Hospital for more than 50 years. He was also medical director of the Erie County Home and lnfir- Anesthesiologists in 1967, a governor of the American College of Anesthesiologists from 197577, and treasurer of the World Federation of Societies of Anes- died on Parkinson's disease, which forced him to retire three years ago, was VINCENT J . CAPRARO , '45 , died continued the practice of house calls long after many physicians had abandoned them, and often on February 2, 1998, in Lorain Community Hospital, Lorain, OH, after a lengthy illness. Capraro, a retired professor and he called his patients if he went out for the night. An early advo- associatechairofthe Department cate of parent-effectivness train- of Gynecology and Obstetrics at UB, was an internationally known specialist in adolescent gynecol- ing, he taught parenting sessions in his office. After traveling to tournaments with his tennis-playing ogy and corrective surgery. He establi hed a private practice in daughter, Amy, Ehrenreich be- 1950 and joined the staff of Millard Fillmore Hospital in 1951, later serving as chair of the hospital's Department of Obstetrics and Gynecology and director of the training program for residents and medical students at UB. He was also chief of the Division of Adolescent and Pediatric Gynecology and Corrective came a chair umpire with the United States Tennis Association and officiated at matches in many locations, including Madison quare Garden and Forest Hills. During those years, he had several encounters with the former tennis "bad boy," John McEnroe. He is survived by his wife, Miriam; his daughter,Amy Haller Surgery at Millard Fillmore Hos- of Penn Valley, PA; two sons, Richard A. of Potomac, MD, and David B. of Wynnewood, PA; a pital and chief of the Division of Adolescent and Pediatric Gynecology at Children's Hospital. In brother, Harold M; a sister, Annette Irwin ofPembroke Pines, 1971 , he received the B Senior Medical tudents' Award for out- FL; and four grandchildren. standing teacher, and in 1990 a lectureship was established in his honor by the UB Medical School JAMES G . ROB I LOTTO , '48 , died November 25, 1997, at age 74, in Orchard Park, NY. After com- Alumni Association class of 1945. He retired in 1976 and moved to pleting his residency at the old Avon Lake, OH, in 1988. 6 f f a I o p s I c a 5 m m e 9 9 �................................................................. . ....... . ... . . . . . . . . . . . . ·· ~ - • E.]. Meyer Memorial Hospital in 1950, Robilotto established a general practice in Williamsville, NY, which he maintained until 1999 Class Reunion Preview I The following is o profile of John H. Remington, MD, Closs of 1939, which will be celebrating its 60th reunion next Moy. 1958. He was on staff of Sisters Hospital and served his anesthesia residency at Veterans Hospital from 1958 to 1960, after JOHN H . REMINGTON , MD After completing his internship at St. Mary's Hospital in president of the American College of Surgeons Upstate which he was a member of St. Joseph Hospital in Cheektowaga, Y, from 1960-1970. He was on Rochester, New York, John H. Remington entered gen- New York Chapter and the American Society of Colon and eral practice for two years with his father, the late Alvah Rectal Surgeons, and was on honorary fellow of the the staff at our Lady of Victory C. Remington, University of Buffalo medical school1897, Royal Society of Medicine of london and Royal Austra- Hospital, Lackawanna, NY, from 1970 to 1974. From 1974, until after which he spent a year in the Pathology Deportment lian College of Surgeons. He served as on examiner for at the University of Rochester, conducting research with the American Boord of Colon and Rectal Surgery and was Nobel Laureate George Hoyt Whipple. He was subse- on American Medical Association program director for quently granted a three-year fellowship in surgery at the the Section on Colon and Rectal Surgery. In addition, he Mayo Clinic, where for one year he was first surgical was founder of the Rochester Surgical Society and presi- his retirement in 1981 , he was a physician for ew York State. Survivors include his wife of 49 years, the former Helen Reyda. EDWARD A . PENN , '51 , died in assistant to Charles W. Mayo. While at Mayo, dent of the Research Society of the he developed and described two new surgi- American Proctological Society. Remington after a brief illness. After gradu- cal procedures and designed on instrument received two awards from the Rochester ating from UB and completing his training in Boston , Penn es- for performing bowel resections. Following Academy of Medicine and was elected to the fellowship, he was assistant surgeon to Sigma Xi, the notional honorary research the staff of the clinic and went on to earn on society. He was also a trustee of the MS degree in surgery from the University of Hochstein Music School and the Allendale Minnesota in 194 7. He then returned to School and was president of the Genesee December 1997 at his home in Yarmouthport, MA, at age 71 , tablished a pediatric practice in Fall River, MA, and served that community for more than 39 years. He moved to Yarmouthport in 1992 and retired from medicine in 1994. Dr. Penn was the former chief of pediatrics at St. Anne's Hospital in Fall River during the early 1970s and was Emeritus Fellow of the American Academy of Pediatrics and past president of the Massachusetts Chapter of the Academy of Pediatrics. He was also an associate professor of Pediatrics at Tufts University School of Medicine and a member of the Health and Finance Committee for the National Academy of Pediatrics. Surviving are his wife , Eileen + (Simon)and three sons. B u f f a l a P Volley Antique Automobile Society. Rochester, where he practiced in his specialty of colon Today, Remington, who retired in 1979, is enjoy- and rectal surgery. During the course of his career, Remington was a ing studying history, reading biographies and travel- clinical associate professor of surgery ott he University of ing with his wife, the former Katherine Weber, RN, who Rochester, choir of the Deportment of Surgery at St. formerly was a surgical nurse at the Buffalo General Mary's Hospital, attending surgeon at Highland Hospital Hospital. There, she worked with the late Marshall and consulting surgeon at Rochester General and Genesee Clinton, Herbert Smith, Thew Wright, Elmer Milch, Hospitals. He has been in all 50 states and in 38 foreign Wallace Hamby and others. The Remingtons (who countries, serving as a lecturer or visiting professor in 14 reside on Old Mill Rood, Rochester, NY 14618), hove of those countries. three children: John Alvah, PhD, University at Buffalo '66, oflucson, AZ; William Frederick, MD, of Pittsford, Remington has published 52 articles, including NY; and Susan Ann, MA, of Ann Arbor, MI. three chapters in surgical texts. He has served as hysician Summer 1 9 9 8 + I �THE ULTIMATE DRIVING MACHINE: AMANA COLLECTS Checkpoint Foreign Car, Inc. Sales and Service 487 Kenmore Avenue Buffalo, NY 14223 Comprehensive Cost-Effective Receivables Management 836-2033 Your WNYLeasing Specialist Serving WNYproudly for 33 years ~ Amana Capital Corporation Buffalo. New York 716-852-3500 800-44 1-6925 WNY's- Exclusive - BMW Retailer THE ULTIMATE DRIVING MACHINE.® THOSE LOOKING FOR MORE CONTROL IN THEIR LIFE CAN NOW FIND IT ON SLIPPERY PAVEMENT. F. G. DOWNING $699 While the road of life may throw you an occasional curve, at least our All Season Traction helps you 1998 BMW 740i handle the particularly slippery ones. FREE SCHEDULED MAINTENANCE 30 mo. Lease Towne BMW 3030 Orchard Park Rd. Orchard Park, New York 14224 Phone: 675-2550 ALL SEASON TRACTION PMT based on 5500 cap cost reduction (or trade). 12.000 miles per year. 15 cents charge per mile for excess miles. First and last PMT. taxes and plate fees due at inception. Residual $43040 Service Loaners Available .•• Minutes From Rich Stadium Bu f fa l o Phys i c i an Summer 1998 �No one knows better than medical professionals the importance of teamwork to get things done. That is why most New York physicians and surgeons choose MLMIC as their professional liability insurer. MLMIC's responsive team of underwriters, claims personnel, policyholder services representatives, risk management consultants, medical experts, and defense attorneys provides our insureds with the best liability protection and the highest level of personalized service available. Owned and operated by its policyholders, MLMIC has successfully defended more New York physicians than all other insurers combined. With one of the country's largest and most experienced claims departments, MLMIC also offers the State's only true peer review of claims experience. These are just a few of the reasons why MLMIC is the only medical liability insurer endorsed by the Medical Society of the State of New York. Caii80Q-275--6564 (NY metropolitan area), MLM~C ~ledicall.iability ~ ~lutuallnsuran~ Company or BOQ-356-4056 (Upstate) for more information and to find out about available premium discounts. Our defense never rests. 2 Park Avenue New Yor k, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Mead ow, NY 11S54 C1998 Medic.alliakril ty Company Mutualln~urance �Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED To consult with someone truly concerned with your financial health, come to Key Your Key Private Banker heads a team of K EY PRIVATEBANK professionals, who can help you achieve your financial goals with surgical precision. Call Marv Madison at 716-847-2341. It may be one of the most important appointments you make. We know medical professionals' financial needs like the dorsum of our metacarpus. Key. For anew America~ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1998 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1998-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v33n01-1998-Summer Table Of Contents A list of subunits of the resource. Merger Final Elegant Solution to a Complex Problem Medical School Physicians Reaching Out to Students Alumni Class Reunions Research Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-09 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v33n01 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1998 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/6ceb59dbd454b2d5b3e613a94a5285ee.pdf 9ea5f35b4b64afd726bc4aa06cfe7a53 PDF Text Text J J ] �BUFFALO PHYSICIAN Volume 32 , Number 2 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr. Carole Sm1th Petro DIRECTOR OF PUBLICATIONS Kathryn A. Sawner EDITOR Stephamc A. Unger ART DIRECTOR/DESIGNER Alan j. Kegler ASSISTANT DESIGNER Lynda Harmel PRODUCTION MANAGER Ann Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. John Wright, Interim Dean EDITORIAL BOARD Dr. Bertram Portm , Chair Dr. Marun Brecher Dr. Harold Brody Dr. Linda j. Corder Dr. Alan J. Dnnnan Dr. James Kansk1 Dr. Barbara Maj eroni Dr. Elizabeth Olmsted Dr. Charles Paganelli Dr. Stephen Spauldong Dr. Bradley T. Truax Roy Vongtama Dr Franklin Zeplowitz TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital M1chael Shaw The Children's Hosp1tal of Buffalo Erie County Medical Center Mercy Health System Mollard Fillmore Health System Frank Sava Niagara Falls Me mona! Medical Center Roswell Park Cancer lnstnute Sisters of Chanty Hosp1tal Dennis McCanhy Veterans AffaiTS Western ew Yo rk Healthcare System © The State Umversity of New York at Buffalo Buffalo Physi cian IS publi s h ed quarterly by the State Umversity of New York at Buffalo School of Medicone and Biomedical Sciences and th e Offoce of Publications. ll1s sent, free of charge, toalumm , faculty , students, res1dents, and fnends . The staff reserves the right to edn all copy and submissiOns accept ed for publication. Dear Alumni and Friends, of our major hospital affiliatesthe Children's Hospital of Buffalo, Buffalo General Health System and Millard Fillmore Health System-is fast approaching. At the same time, the Catholic Hospital System is moving toward a different and more integrated configuration, and the U.S. DepartmentofVeterans Affairs Medical Center is being molded into the evolving VA Integrated Network (VISN#2). Within this flurry of mergers and reorganizations, the Erie County Medical Center is struggling to establish its essential niche in this community's health-care delivery system, and Roswell Park Cancer Institute is experiencing a "rebirth" of sorts. Not only will each of these dynamics significantly change the nature of health care within the greater Western ew York area but, as noted in previous Buffalo Physician messages, they also present a variety of important challenges for the university and, in particular, for the School of Medicine and Biomedical Sciences. My message in the last issue of Buffalo Physician outlined a few of these challenges, and while we cannot report much externally visible progress, some progress has been made, at least in terms of "establishing a direction" as distinct from "arriving at a destination. " I am therefore particularly pleased to report that Dr. Michael Bernardino, from Emory University, accepted the important position of vice president for health affairs and came "on board" Aprill , 1998. Dr. Bernardino, an academic radiologist by training who is well versed in the ways of managed care and practice plans, brings much-needed expertise to the university. The circumstances described above underscore the wisdom of separating the dean of medicine function from that of the vice president for health affairs. Although there will continue to be significant overlap in responsibility, each position is sufficiently different in today's new world of changing education focus , research direction , practice configurations, mergers and managed care that differing skill sets need to be employed-and applied on a full-time , concentrated basis. Mike's arrival should not only herald the development of a more coherent strategy for the medical school-and for the other health science schools-in dealing with the rapidly changing environment, it should also greatly increase the school's "negotiating strength. " The interests of the community, in the broadest sense, represent those of the medical school and of the larger university. Hopefully, your school can serve as a catalyst to bring some rationality to the present turmoil. In the meantime, it is clear that our destiny will be to work side by side, and in collaboration, with our community physicians and volunteer faculty. The commitment is to be inclusive, not exclusive, and to work with the various players in as collaborative a fashion as possible. It won't be easy, but I think you will agree: It's the only logical way for us to go! THE ANTICIPATED MERGER DATE FORTH REE John R. Wright, MD Interim Dean, School of Medicine and Biomedical Sciences Dear Fellow Alumni, lT S EEMS LIKE TH E SC HOOL YEAR IS FLY! G BY. I have the feeling that it just began. However, here we are looking down the homestretch, with Match Day (March 18) and Senior Reception (March 21) behind us, and Alumni Reunion Weekend and Spring Clinical Day (April24-25) upon us. I hope that many of you were/are able to join us for some of these activities. We are happy to announce that Dr. Nancy Nielsen will be joining the Medical Alumni Association Board of Governors. A past recipient of the prestigious Samuel P. Capen Alumni Award, she currently holds the position of assistant dean for thirdand fourth-yearmedicalstudents. We look forward to her participation and counsel. I wish to advise you that the Medical Alumni Association will no longer be able to offer a joint membership with the general University at Buffalo Alumni Association. That association has decided to solicit your membership separately. I will give a more detailed explanation in the next issue of the Buffalo Physician. Dr. john Bodkin has put together an excellent program on the "Aging American" for our Spring Clinical Day, April 25. This year's recipient of the Stockton Kimball Memorial Award , Edward H. Wagner, MD '65, MPH, will deliver a lecture at the annual Medical Alumni Association luncheon tha} day. He is professor of medicine at the University of orth Carolina and at the Umversny o Washington , and also director of the W. A. MacColl Institute for Health Care Innovation, in Seattle. I am looking forward to seeing you at the Alumni Weekend and Spring Clinical Day. With warm regards, ~B"~~.M~~ President, Medical Alumni Association m.o, �------ ~--- ~ -- ~---- ~~ ------ VOLUME 32 , -- ----- NUMBER 2 SPRING The Sounds of Science Focusing AUention on ADHD Northern Exposure RESEARCHERS FIND COMPREHENSIVE A SloE IN BRAIN APPROACH TAKES LEAVE OF RESPONSIBLE TO TREATMENT ABSENCE TO FOR TINNITUS by S. A. Unger WORK IN ALASKA 1998 MEDICAL STUDENT by Bretton Newman by S. A. Unger photos by K.C. Kratt 1 U 8 ALUM THRIVES IN THE BIOTECH INDUSTRY by Betsy Sawyer 1 FDA APPROVES NEW DRUG FOR 2 3 1 COLLABORATIVE EFFORT WITH PRESIDENT UB, THE UNIVERSITY AT NAMED FOR ALBANY AND HEALTH AFFAIRS ROSWELL PARK by Arthur Page by Jessica Ancker Research ews Cl tP. FOUR U 8 A udent's pe spec ive: THE BEGINNING TREATMENT OF OF MY QUEST LUNG CANCER by Pamela Crowell ~--- ALUMNI PRESENTED AMA LEADERSHIP AWARD -- �Sof c1e RESEARCHERS FIND SITE IN BRAIN RESPONSIBLE FOR TINNITUS ICHAEL D EAKI RECALLS the exact moment in his life when he first experienced tinnitus, the constant ringing in the ears that affects an estimated 50 million Americans. "I remember waking up on the morning of Aprill2, 1994, with a high-pitched squealing in my ears. I thought the microwave was going off downstairs but I wasn't able to find the sound anywhere," he says. Recently, For many people who experience tinnitus, the condition represents a nag- Deakin found ging bother in their lives, but one they something else manage to cope with reasonably well. to keep him For others, however, like Deakin, tinni- going: the retus is a debilitating condition because it sults of a study affects them emotionally, to an extent published in Using positron emission tomography, Alan Lockwood, MD, (/eft}, and Richard Salvi, PhD, have that their lives are severely disrupted. "I the january localized the spontaneous neural activity associated with tinnitus to the brain's temporal lobe. went into a state of depression and wasn't 1998 issue of Neurology in which researcheven able to work," says the "Tinnitus will affect 30 to 40 percent ers using positron emission of all people by the time they reach age 56-year-old CPA and BufB y falo businessman. "I have tomography (PET) have for 60, and these numbers are expected to S . A spent the past four years the first time pinpointed the increase as the baby-boomer population looking for help, but I've specific regions of the brain ages," lockwood says. "People with seU N G E R been told this is something l responsible for tinnitus.The vere tinnitus, which is currently about 10 will have to learn to live with study was conducted at the percent of elderly Americans, often sufbecause there is no known treatment. University at Buffalo School of Medicine fer depression, anxiety, sleep disruption "l have friends and know people who and Biomedical Sciences and the U.S. and other symptoms that have a major have tinnitus, and they're not that dis- Department of Veterans Affairs Medical impact on their quality of life. Without tressed by it, but for me, it has seriously Center in Buffalo by lead researchers objective information on how and where affected my life. I can't read, and I can't do Alan Lockwood , MD , and Richard the condition originates, developing efmuch that involves significant concen- Salvi, PhD, who have since received a fective treatments has been difficult. By tration. I have good days and I have bad $1.5 million grant from the IH to identifying the sites in the brain that days; what keeps me going is knowing conduct a major investigation of tinnitus mediate tinnitus, we have taken a critical that I will have some good days. " and hearing loss using PET scanning. step down the road toward a cure 0 B u f f a l a Phys i cian S p r 1 n g 1 9 9 8 �-~ ~~.~---------- ------~ -- ----- TINNITUS . ,_,_ < ~ u ~ for this disabling condition. " Lockwood, a professor of neurology, nuclear medicine and communicative disorders and sciences at UB , is director of the Center for Positron Emission Tomography at the Buffalo VA medical center, a joint venture with UB , where the research was conducted. He and Salvi, who is codirector of the UB Center for Hearing and Deafness, studied tinnitus patients who have the unusual ability to control the loudness of the ringing by clenching their jaws. "We went to a tinnitus support group here in Buffalo," Salvi recounts, "and during conversations with the participants, we learned that some of them could modulate their tinnitus: They could make it louder or quieter by pressing or touching their face around the mouth or jaw, clenching their teeth or sometimes pressing on a tooth. This was a real breakthrough in the project because it meant we could look at the brain in two different states: when the tinnitus was at its normal level and when it was louder or quieter. We used this quite effectively to design the brain-imaging study." The study involved four tinnitus patients, all of whom had mild to severe hearing loss, and six persons with normal hearing and no tinnitus who served as controls. All participants took standard hearing tests before the PET scanning began. By working with these participants , the researchers were able to track fluctuations in cerebral blood flow through PET scans taken while the patients manipulated their symptoms, creating a map of the brain site responsible for tinnitus activity. "We have four major findings in this study," Lockwood says. "The most important is that we were able to localize the spontaneous neural activity associated with tinnitus to the temporal lobe of the brain, which is the most important auditory region of the brain. " The researchers then included another step in the design of their study: They compared the phantom sounds of tinnitus with activity that was produced in the brain by real sounds. In so doing , they narrowed down the population of patients in the study to include only B u f f a l o those people who experienced tinnitus in one ear-and what they found was that most had tinnitus only in their right ear. lt was these two factors-the unilateral expression of the phenomenon and the ability to control the loudness by a voluntary means-Lockwood says, that enabled the researchers to next compare the brain region associated with spontaneous neural activity of tinnitus in the right ear only, with the brain regions activated by playing a real sound in the ear. '' T I hat we found was that the real sounds caused bilateral neural activity, whereas the phantom sounds of tinnitu~ were associated with unilateral "TINNITUS WILL AFFECT 30 THE TIME THEY REACH AGE TO the limbic system, the part of the brain that, among other things, controls emotion. "Our third finding, therefore, was that in tinnitus patients, but not in normal controls, there is this crossover between the auditory system and the limbic system. We now think this is the pathway through which the phantom sounds are conveyed that impact adversely on emotions," Lockwood says. "An important aspect of the clinical manifestation of tinnitus is that it's extraordinarily distressing to many people, and we think this aberrant link between the auditory and the limbic systems is the means by which this information gets transferred. " The fourth finding of the study resulted from a strategy whereby the re- 40 PERCENT OF ALL PEOPLE BY 60, AND THESE NUMBERS ARE EXPECTED TO INCREASE AS THE BABY-BOOMER POPULATION AGES," LOCKWOOD SAYS. activity," says Salvi. "This told us several important things , the most important of which is that the source of this neural activity had to be in the brain. The unilateral delivery of sound to just one ear activates just one cochlea. And if the cochlea had been the site of the spontaneous neural activity that causes tinnitus, we would have seen bilateral activation just as we saw when we played real sounds. So this comparison between phantom sounds and real sounds enabled us to arrive at our second major finding , which was to localize the source of the phantom sounds to the brain, instead of the cochlea, where many investigators have believed tinnitus was originating. " Through comparison of this sound activation in the patients, the researchers made two further significant observations. By playing the sounds into the ears of the patients who also had sensory neural hearing loss , they found activation of the hippocampus region of Physlcia 5 p r I n g 9 9 8 searchers subtracted the areas of activation caused by real sounds in the controls from the areas of activation caused by real sounds in tinnitus patients. What they found was that there is a much larger area of the brain activated in tinnitus patients than in the control group. "This finding indicates that the circuitry of the auditory system has been changed in some way in the patients with tinnitus, " Salvi notes. "It's much larger than in the controls, and we think that's important because we surmise that some of these new connections are the ones responsible for causing the phantomsound sensations. " According to Lockwood and Salvi, other studies have been conducted using functional imaging techniques , such as MRl, in which results have clearly shown that the distress of phantomlimb sensation is associated with the degree to which the brain manifests this TINNITUS CONTINUED ON PAGE 15 0 �William E. Pelham, Jr, PhD, working with a young participant in the Summer Treatment Program. �--- --~-~--------- - - - - - - - - - - - - - - - - - - -- Focusio Atteotion on I n ~ TTE TION DEFICIT HYPERACTIVITY DISORDER (ADHD) is the most commonly diagnosed disorder of childhood. Boys and girls with classic symptoms of ADHD have diffi.culty with attention, impulse control and modulation of activity levels. In recent years, ADHD and its prescribed treatments have swept into the medta spotlight, grabbing the attention of the public with a fervor unrivaled at times by even the most hyperactive of children. At the heart of this national discourse are questions about the number of children being diagnosed with ADHD and the drugs with which they are being medicated-most notably Ritalin, a central nervous system (CNS) stimulant less well known by its generic name methylphenidate. ' At the University at Buffalo, William E. Pelham Jr., PhD, one of the leading ADHD researchers in the United States, is conducting ongoing studies on how best to manage this disorder through a combination of behavioral modification techniques and medication. As a result of his studies and the innovative treatment programs he has developed over the past two decades, Pelham has gained widespread recognition as a researcher who has helped to bring rigorous scientific inquiry to bear on many of the con troverB Y S A . U N G E R siessurrounding the treatment of ADHD. Recently, he was selected as one of a handful of experts to plan and address a ~ational Institutes of Health Consensus Statement Conference on ADHD, to be held in November 1998. CLINICAL TRIALS AIMED AT IMPROVING MEDICATION CoMPLIANCE Medication compliance problems severely hamper treatment of children withADHD, in large part because there currently is no effective long-acting medication available for treatment of the disorder. Ritalin, for example, which has long been considered the "gold standard" for ADHD medicaB u f f a I a tion, lasts only three and a half to four hours so must be given three times a day if it is to be effective. "The schools are then faced with the dilemma of how to give medications to these kids and since there are fewer and fewer school nurses, most schools don't have a person to do that," explains Pelham, who came to UBin 1996asa professor and director of clinical training in the DepartmentofPsychology. "As a result, teachers, secretaries, principals and guidance counselors-people who have lots of other things going on in their workdays-are trying to give the kids their medications during school hours. And some schools are so averse to this that they don't prompt the child, which causes further compliance problems because kids with ADHD have difficulty with organization in the first place, so they don't remember to take their medication." Currently, Pelham is working with coinvestigators at UB's School of Medicine and Biomedical Sciences to conduct two clinical trials, the goals of which are to examine drug delivery systems that would overcome the need for children to take ADHD medications more than once a day. In the first trial, Pelham has received $1.5 million from ALZA Corp. to study the effectiveness of a 12-hour formulation Physician 5 p r I n g 1 9 9 8 of methylphenidate (Ritalin). His coinvestigators on the study are Martin Hoffman, MD, clinical associate professor, and Thomas Lock, MD, assistant professor of clinical pediatrics, in the Department of Pediatrics; and Eugene Morse, professor and chair, Department of Pharmacy Practice, UB School of Pharmacy. In the study, which will conclude in mid-May, participants must already be receiving methylphenidate and responding well to it. Once enrolled, they are randomly assigned to either continuing their normal Ritalin regimen, taking a comparable dose of the new long-acting formula or taking a placebo for one week each in a threeweek period, during which time their regular classroom teachers and their parents rate their behavior. Each Saturday they come to UB and spend the day in a laboratory classroom, participating in recreational activities, schoolwork and meals. Throughout the day, their behavior is observed and measured by researchers viewing them from behind a one-way window and by the teachers in the classroom, with the objective being to track the onset and offset of the medication. "We are measuring the things that you want to know Ritalin affects," 0 �Pelham explains. "For example, in the classroom, we want to see how the drug affects their academic work. So we have them spend lO minutes doing a timed math or reading test and we track their behavior while they work. " Prior to the start of the study, all the families receive psychosocial therapy. Parents attend six training sessions to learn about appropriate behavioral intervention techniques , and the children's teachers attend four similar sessions geared toward classroom interventions. nee this small, tightly controlled study is completed, a second trial with this same design will be conducted by researchers at the University of California at Irvine. Then, in September 1998, UB and 10 other sites across the nation will participate in a large-scale randomized Phase III study of the new longacting version of the drug. Children are currently being accrued for this trial, which will last a year. In a second drug trial, Pelham has received $250,000 from Bristol-Myers Squibb to study the effectiveness of a 24hour skin-patch version of the drug Buspar, an antianxiety agent that has been used for years with adults. His coinvestigators on this study are Helen Aronoff, MD, assistant professor of clinical psychiatry, and Michelle Pato, MD, associate professor of psychiatry, Department of Psychiatry. "Bus par, while not a CNS stimulant, is a drug that preliminary trials show may be efficacious for children who do not respond to Ritalin," Pelham explains. In this multisite trial, the participants-who cannot currently be taking any medication for ADHD-are assigned either a placebo or a lower or higher dose of Buspar in the patch form, which they take for six weeks. The children come to UB once a week to be checked by physicians and research associates; at the end of six weeks their teachers rate their behavior using the Conners Rating Scale. "At the end of the trial, if the doctors think the child is doing well, he is entered into the longer-term safety phase of the study," Pelham says. SUMMER TREATMENT PROGRAM FocusEs oN BEHAVIOR WITH PEERs Pelham's research into ADHD extends beyond drug intervention to include behavior modification, as well. A disadvantage to giving Ritalin is that when children with ADHD stop taking the drug, they revert to former patterns of behavior, and research shows many people affected by this disorder do stop taking the drug when they become teenagers or young adults. "We know that medication, when stopped, has no long-term effect," he says. "Furthermore, research over the past few years suggests that by combining medication and behavioral treatments, significant incremental benefits are gained beyond either treatment alone. Therefore, it's this combined approach that's becoming the treatment of choice for ADHD. " To that end, Pelham has worked since 1980 to develop a Summer Treatment Program that integrates behavior modification therapy with activities normally associated with summer camp. Last summer, the program accommodated 36 children, ages 7 to 12, who stayed together for eight weeks, from 8 a.m. to 5 p.m. each day. The program will be offered at UB again in the summer of 1998. • The activities are largely sports-oriented and provide a highly interactive setting in which behavior problems can easily arise, especially those that pertain to peer relationships, a key area of focus for ADHD researchers. "Negative perception by childhood peers is the single best predictor of adult maladjustment," says Pelham. "This is something we've known in the field of child psychology for years. And surveys show that children with ADHD are often uni- formly disliked by their peers. " Despite knowing that this problem is predictive of poor outcomes in a whole host of measures in children withADHD, researchers have been frustrated in their attempts to find treatment approaches that have proven successful in managing peer relationship difficulties. "Peer relationships are very resistant to change," Pelham says, "and one of the reasons why there has been failure is that it's difficult to work on peer relationships in the office or the classroom, the two locations where standard outpatient treatments are provided. " Overcoming the limitations of these traditional treatment venues is a key objective of the Summer Treatment Program. Another limitation to existing interventions that the program is structured to overcome is the fact that although children are more available for mental health services during the summer months than they are during the school year, most mental health centers and professionals cut back on or eliminate services for children with ADHD during the summer. "A child with ADHD spends as much time awake and interacting with others during the summer months as he or she does in school during the entire rest of the year ," Pelham notes, "yet treatment programs for most children with ADHD are suspended during this time, leaving the kids to engage in what are often unstructured acttvttles. Summers , therefore, represent an untapped time for treatment." In the Summer Treatment Program, children are placed in age-matched groups of l2 children, and treatments are implemented by teams of five clinical �----~---------- staff members who are student interns. Key behavior modification goals of the program pertain to improving the children's social interactions, academic performance and self-esteem, as well as increasing their ability to follow directions and complete tasks. The children spend three hours a day in classroom sessions conducted by special education teachers and aides, who use behavioral modification techniques designed to treat the children's problems in a classroom context. Of these three sessions, one is modeled after an academic special education classroom, a second involves computer-assisted instruction and a third, art therapy. The remainder of the day consists of recreationally based group activities. Treatment throughout the program also includes teaching the children social skills necessary for them to function effectively with their peers in a group setting. These skills are introduced in 10-minute sessions that include role modeling, instruction and practice, after which they are reinforced through the assignment of group tasks designed to promote cooperation. In addition to social skills, an important aspect of peer relationships is a child's performance in group recreational activities, according to Pelham. "In the program, therefore, we strongly emphasize teaching sports skills and knowledge as a way to improve the children's status among their peers and to also improve their own self-esteem." A major component of the program's interventional goals takes the form of a "report card" that is given to the children each day. Points are awarded for appropriate behavior, such as listening and paying attention, following the rules and showing good sportsmanship, or subtracted for inappropriate behavior, such as talking out of turn, aggressiveness, not staying in line and swearing. The children exchange their points for daily and weekly privileges, - - - - - - - --- - social honors and home-based rewards. If the standard interventions provided by the program are insufficient or inappropriate, clinical staff members develop individualized strategies to deal more effectively with a child's behavior. To ensure that what the children learn transfers to their time outside the program, parents receive training one evening a week in how to implement behavioral modification techniques at home, a strategy Pelham says is key to the success of the program. ased on a variety of measuresfrom parent, counselor and teacher improvement ratings, to child self-perception ratings- the Summer Treatment Program has proven to be a very promising form of treatment. In recent years the program has been replicated by the Departments of Psychiatry in the medical schools at Emory University, Case Western Reserve and New York University, as well as by the Department of Pediatrics in the medical school at Vanderbilt University. In addition, the program was adopted as the child-based treatment component of the psychological treatment arms in the National Institute of Mental Health's (NIMH) Multimodal Treatment clinical trial for ADHD and was implemented at seven national medical centers as a part of that trial. However, because treatment programs-even those as intensive at the Summer Treatment Program-have not been shown to have long-term effects without appropriate follow-up, Pelham has developed a Saturday Treatment Program, booster parent training and school interventions. The Saturday Treatment Program, which takes place each Saturday from September to May, places an emphasis on maintenance and generalization -~-­ - --- -------------- of behavior modification. Booster parent training consists of biweekly or monthly sessions to help parents learn how to communicate with their children's teachers and how to continue working on home-based programs. In follow-up interventions, program therapists work with teachers to help them develop detailed classroom management strategies that will provide effective, consistent intervention for children with ADHD. CLINICAL TREATMENT SETTINGS PRO• VIDE BASE FOR ONGOING RESEARCH In addition to providing effective treatment and training, both the Summer Treatment Program and the Saturday Treatment Program are designed to facilitate ongoing clinical research. Over the years, Pelham and his coinvestigators have conducted numerous double-blind, placebo-controlled evaluations of stimulant medications within both these settings. For example, he and his colleagues published a paper in 1990 in Pediatrics (1990. 86, 226-37) in which they described the first study ever done to compare the efficacy oflong-acting drugs for ADHD, including standard methylphenidate, sustained-release methylphenidate, sustained-release dextroamphetamine, and pemoline. "This study resulted in an increase in the number of people using long-acting stimulants because it showed that they all work about as well as Ritalin," says Pelham. "So, despite the fact that there are problems with these drugs, this research showed that they are viable medications, worth using and worth further development for treatment of ADHD. " In another study done in the context of the Summer Treatment Program, Pelham looked at the controversial question of whether Ritalin gives children a sense that they need the drug to solve their problems. In this NIMH-funded study- the first balanced-placebo design study ever done in children-the AOHO CONTINUED ON PAGE 31 �rJ 1 I 1 J .':J ! L! C_. 8 SJ. ! ;:) �-------~ ------ - --- -~- --------- ---------- -~-----~----- Breech babies, blueberries and icebergs TWAS NEARING MIDNIGHT , IT WAS GOING TO SHAPE ME IN A WAY :-.:0 OTHER PLACE HAD BEFORE. -- �U ays later, on August 17, 1997, I began my descent who had been authorized to fly into Nome (by a physician via through thick, gray clouds on an Alaskan Airradio call). She had been thrown from her four-wheeler while lines flight. Having made the decision to take a moose hunting and was medically stable, except that her nose leave of absence from my fourth year of medical was lacerated and separated from her face. It was my job to school at the University at Buffalo, I was ready to stitch it back into place. At home, I thought, a plastic surgeon begin a two-monthstayinNome, working alongwould have been called. Here, I was the person available to do side local physicians and other health-care providers. the job and I went to work. Nome, population 4,500, is situated on the isolated coast of the Bering Sea in the northwest region of Alaska, some 161 miles from Siberia, and is not connected by roads to any outside community. Completely surrounded by water or stretches of unpopulated land in every direction, the region boasts a history rich in Inupiaq and Yupik Eskimo tradition, as well as a Caucasian LEFT TO RIGHT· MOTHER HOLDING BABY influence that has persisted since whaling times. Every fourth DELIVERED BY NEWMAN; RESPECTED VILLAGE orne is also famed for its 1899 gold rush and night, I took inas the terminus for the annualiditarod dogsled ELDER IN NOME FOR A CHECKUP YOUNG BOY FOR house call at the race, held in March, which traverses 1,049 WHOM NEWMAN PERFORMED A SCHOOL PHYSICAL. hospital. After miles offrozen tundra from Anchorage toN orne. 6 p.m. there were I arrived in orne in a drenching downpour and was told that no physicians on duty at the hospital (they were on call from it had been raining for weeks and would likely continue to for home). I took the calls first and had the incredible opportumany more days. The unpaved streets ran thick with mud in nity to see patients in the ER with no residents or attendings front of small, colorful, boxy houses sitting on gravel plots with present to direct me. When I needed help , I called for it, but sparse lawns. This place was very different from any I had ever in the meantime I learned to trust myself, to be calm and to seen before, with severely limited opportunities for dining, think about medical problems on my own for the first time. entertainment or shopping. The focus instead is on the landAfter a few weeks in orne I had the opportunity to fly via the berries in season, the whales and walrus, the salmon runs, bush plane to the tiny Eskimo village of Unalakleet, for a the hours of daylight, the whereabouts of the moose, and the "village visit" with a doctor to see patients who had been simple richness and variety afforded by the changing seasons. waiting for months for medical attention (unless it's an The Seward Peninsula, the great landmass supporting Nome emergency, patients wait for a doctor to visit their village) . and the many smaller surrounding villages, provides a natural The villages are primitive when compared to Nome. Many subsistence harvest rich enough to feed and fully support its residents do not have running water in their homes, and there limited human population. A mixed economy has taken hold, is usually only one store to supply all needs. The schools are split between the influences of "the lower 48" (which has gained well built, and the homes are small and winter-tight. Life here entrance via the telephone, satellite TV and the Internet) and the is even less dollar-driven; instead, it is highly focused on the ever-present, inescapable influence of the bountiful land. hard work of "subsistence living," earning a living from the The town of Nome is the most developed community for land. I treasure memories of the days I walked out into the miles around, and it is clearly the center of medical progress on tundra to pick fat blueberries until my hands were purple the Seward Peninsula. The hospital houses a 21-bed inpatient with the delicious juices. I would return home with a full sack unit, an outpatient clinic and a two-bed emergency room. Norne and can berries as jam, bake fresh pies, and store the juices for provides health care for its own population and for an additional pancake syrup. The pride I felt in collecting my own food was population of 5,000 spread throughout 17 rural villages, accespowerful, and I was blessed to share this experience many sible only by bush plane or boat (the health-care region encomtimes over, thanks to the incredible generosity of those I met. passes an area of some 23,000 square miles). Since the populaOne such kind and generous Eskimo woman was a "health tion is not large enough to support full-time specialty medicine, aide" at the Euksavik Health Clinic in the Unalakleet Village. the physicians who reside in Nome practice as family physiShe invited me and the doctor I was accompanying into her cians. The doctors in this remote area must each be willing and home for dinner with her family, and we shared a "subsistence able to handle the full gamut of medical problems. meal" consisting of a fresh-picked salad from her garden, My first week at the hospital was a busy one. On my first day newly caught salmon from a nearby river, and home-baked I was asked to see a young girl from one of the outlying villages bread served with home-jarred jams. Our hostess , who was 10 �: EXPOSURE raised in the village and is intimately familiar with traditional village life and subsistence living, has taken classes to achieve a minimal level of medical training approximately equivalent to that of an EMT in the lower 48 states. With very little formal training, these brave health aides, as they are called, are responsible for managing the health needs of the entire community: They coordinate prenatal OB care, complete such procedures as blood draws and preventive pap smears, deliver a healthy baby after cutting a fourth-degree episiotomy. This was not the optimal situation: This young woman, who was late in her pregnancy and had had minimal prenatal care, had arrived in Nome on a village Oight that same day. She presented to the clinic in active labor, and at that point our choices were few. We did what we had to do to deliver that baby-and we spent all night repairing that episiotomy. The very next day another woman 35 weeks pregnant with She had been thrown from her four-wheeler while moose hunting and was medically stable, except that her nose was lacerated and separated from her face. It was my job to stitch it back into place. twins was "authorized in" to orne from a village. When she and then radio-call the physicians in Nome with accurate, arrived, we found her four centimeters dilated and opted to pertinent information regarding their patients, on whom they medivac her to Anchorage (500 miles and a few hours by keep updated medical records. medically equipped bush plane). It was clear that this situation This arrangement, unique to Alaska, of health aides procalled for a medivac; however, not all tough situations warviding first-line care to villagers and physicians backing them ranted such an expensive Oight, and we were often faced with up by radio-call from a hub, is important because it allows the difficult decisions about the limits of what we could and could health care of the village to be ministered to by members of not handle safely in Nome. the community. If an emergency arises that is beyond the The system of health care on the Seward Peninsula abilities of the health aides, then a "medivac" is called and the is a fantastic endeavor dictated very much by the expanse patient is retrieved by plane and Oown to orne for care. The and challenge of the land. The isolation between villages is health aides I met are a true inspiration. They embody an extreme, as is the isolation between Nome and Anchorage, institution that has grown out of the special needs arising which adds yet another significant obstacle. I was touched from Alaska's isolation. by the ability of the health aides to take such an active role I returned to orne at an extremely busy time to realize in the care of their community members , and by the that, although health care in Nome was more sophisticated willingness of doctors to give up some autonomy to than village health care, there were still many patients for allow the Alaskan h ealth-care whom we were not able to provide system to exist as it does. appropriate care. For example, at GOLOVIN, A TRADITIONAL ESKIMO VILLAGE ON I was amazed and moved by the THE BERING SEA VISITED BY NEWMAN. orne's hospital, the Norton Sound effect the land had on evRegional Hospital, we had ery aspect oflife in Alaska, a fully-stocked pharmacy, from the gathering of food, an X-ray department with to the establishment of sonogram,and a laboratory; communities, to the prachowever, we had no CT, tice of medicine. I wish all no official OR and inadof us could know the equate space for certain and beauty of napower procedures or emergencies. on a daily basis as I ture Late one night I was did for a while in Alaskacalled in from my stuexperiencing the strength dent apartment in orne of character that is built in because one of my favorstocking a freezer for winite family doctors found ter with salmon, moose himself in the challengand in letting the land meat and hand-gathered blueberries, ing position of delivering a footling breech baby. I had + shape who we are. never seen such a thing, because at home this presentation would have gone to an obstetrician for a cesarean delivery. Bretton Newman returned to the University at Buffalo School of Medicine a nd Biomedica l Sciences in january 1998 and expects to graduate in May 1999. In time, however, my fri end managed to su ccessfully II �Merging Medicine with Business UB ALUMNUS CRAIG SMITH THRIVES N THE B OTECH OLOG c DUSTRY s MD the journey from medical school graduate to founder and leader of a promising new biopharmaceutical company was not as great a leap as one might imagine. In fact, Smith says, his career path has consisted of a progressive series of steps , "each one logically leading to the next and not at all hard to take. " Smith-who spent 16 years junior faculty position there in academic medicine before as an instructor and assistant B y chief of service in the Departstepping into the corporate B E T S Y world-is president and CEO ment of Medicine. He was SAWYER of Guilford Pharmaceuticals, subsequently invited to stay a company he established in on as a faculty member at the university and became an 1993 to discover and develop drugs for the diagnosis, treatment and assistant professor in medicine in 1976. Along the way, Smith says, "I found prevention of brain cancer and other neurological diseases. From his current myself consistently drawn to issues surrounding drugs and vantage point as the therapeutics. Early in leader of a pacesetting my career I won a pharmaceutical busiGUADEL Wafer (polileprosan 20 w1th fellowship that allowed ness, he looks back on carmustine implant) me to complete a yearan unusual and rewardlong sabbatical at the ing career, first in Qohns Hopkins] School academic medicine and Public Health and of then in business. Hygiene , studying Born and reared in Orchard Park, New York, epidemiology and Smith graduated from statistics, and I Nichols School in became interested in Buffalo in 1964. He applying the principles left the area briefly to I learned in those complete undergradufields to the study ate studies in biology at of new drugs." The University of the South in Smith was also beginSewanee, Tenning to realize The GLIADEL®wafer, for treatment of brain cancer. nessee, and then that he had talreturned in 1968 ent as an orgato attend medical school at the Univer- nizer, as well as a flare for building sity at Buffalo School of Medicine and programs and inspiring teamwork. "I've Biomedical Sciences. always gotten enjoyment from the Followinggraduationfrom UBin 1972, process of doing things that perhaps Smith completed an internship and resi- aren't popular, but that are important dency atjohns Hopkins University School for the achievement of a valuable goal ," of Medicine and, in 1975, was offered a he says. "I believe that more is ® a u 1 I a l a accomplished when people work together toward a common purpose ." It was atjohns Hopkins in the mid-1970s that Smith first tasted the satisfaction that comes from building an organization from scratch. Under his direction, the Division of General Internal Medicine grew from a one-man operation-with Smith as its sole member-to the third largest division in the Department of Medicine in terms of National Institutes of Health (NIH) funding, patient care revenues and teaching responsibilities. In 1985, with funding from the Burroughs-Wellcome Foundation , Smith was able to begin his second major building effort-the development of a research program devoted to the thenfledgling field of pharmacoepidemiology. Under his guidance, the program grew to include an interdisciplinary team of two MDs , one PhD epidemiologist and four support staff. Through the program, which still exists atjohns Hopkins, clinical research projects were funded by the Food and Drug Administration (FDA) , the NIH and numerous pharmaceutical companies. In 1988, Smith was courted and eventually hired by Centocor, a biotechnology company in Pennsylvania. As vice president, he led the company's worldwide clinical research programs, initially directing a staff of 24. By 1992 he administered a budget of $30 million, oversaw more than 50 active clinical protocols and supervised a staff that had grown to 126. He was made a corporate officer and as a member of the senior management team, he began to play a key role in the formulation of Centocor's business strategy. Working closely with Centocor's CEO, CFO and legal department, he helped develop the company's partnering strategies. At Centocor, Smith was also charged with identifying key barriers to the company's long-term success. One of Physician S p r I n g 1 9 9 8 �came the first employee of the new corporation. After writing most of the business plan in his home office, Smith moved back to Baltimore from Philadelphia. In September 1993, he hired a secretary, a financial officer, and his wife, Susan, who is now the company's director of project management and, together, the small group formed the core of Guilford Pharmaceuticals. Scios Nova had been working on a drug-delivery system, known as the GLIADEL ®wafer, for treatment ofbrain cancer. Although clinical testing of the product had been completed, the results had not yet been analyzed. Because "I BELIEVE THAT MORE IS ACCOMPLISHED WHEN PEOPLE WORK TOGETHER TOWARD A COMMON PURPOSE ." Craig Smith, MD, president and CEO of Guilford Pharmaceuticals,which develops drug-delivery and neurological products. the problems he identified was that his own role consisted of functions normally carried out by the CEO. Thus, when the company downsized-from almost 1,500 employees to about 500Smith found himself among those looking for other opportunities. In retrospect, Smith says, the dead end at Centocor turned out to be a very good thing, as it cleared the way for his fourth organization-building venture: Guilford Pharmaceuticals. During the last few weeks of his tenure at Centocor, Smith was contacted by a recruiter who was looking for someone to start a new companywithSolomonSnyder, MD , a world-renowned neuroscientist whom Smith had known from his days at 8 u f f a I a Phy johns Hopkins. It was from Snyder that Smith learned of an exceptional opportunity to start a company from scratch with promising intellectual property and technology that was being spun off another company. Originally a small neuroscience company based in Baltimore, Nova had been purchased by the California biotechnology firm Scios, and had its name changed to Scios Nova. The parent companywanted to keep theScios Nova products and research efforts that were complementary to its own efforts, while selling the neuroscience work in progress. Snyder believed the purchase ofScios ova's products and technology would form a sound basis for a new company. Smith agreed and, in July 1993, he be- sician S p r I n g 1 9 9 8 Scios Nova did not want to focus on neurological research or drug delivery, the wafer was included in Guilford Pharmaceuticals' initial capitalization. Smith's team spent their first year of business involved in an intensive search for funding. Much of the company's originally planned financing had fallen through, and instead of the $27.5 million that Smith had expected, Guilford had only $2 million to establish the new company. Adding to this problem was the prevailing financial climate in which investment bankers simply weren't interested in underwriting start-up biotech companies. Consequently, the company remained at four employees, as Snyder and Smith scrambled to find funding. Because Scios Nova owned 80 percent of the company, venture capital firms were not interested in investing: They wanted to own 80 percent of the company. late in 1993 , Smith and Snyder invested their own savings in the company (a combined total of $750,000). This convinced Scios Nova to invest another $1 million in Guilford's future. �Then, in june 1994, the company went public, raising $15 million in an initial public stock offering. This much-needed infusion allowed Guilford to begin to expand its manufacturing capabilities as it filed a new drug application for GLIADEL with the FDA. y 1995, the company was firmly launched. A follow-on public stock offering directed toward institutional investors raised an additional $19.5 million. By the end of the year, the company had increased to nearly 40 employees, whose primary focus was commercializing GLIADEL. A third growth spurt the following year came about as the company evolved from a one-product company (GUADEL) to a company with multiple drug development capabilities. Today, Guilford employs nearly 200 people and is involved in the development of a variety of drugdelivery and neurological products. ministration of chemotherapy drugs . Through a marketing agreement with Rhone-Poulenc Rorer (RPR) , Guilford began marketing GUADEL in February 1997. This event was a major breakthrough for Guilford. No longer considered a development-stage company, Guilford became one of only a handful of biotechnology businesses that have a marketed product. PREPARATION FOR SuccEss ife as a CEO really isn't all that different from life as a physician, says Craig Smith, MD. The founder, [ president and CEO of Guilford Pharmaceuticals recently was asked by a group of Robert Wood Johnson clinical scholars how difficult a transition it was for him to leave academic medicine for the business world. lJ Success in either world, Smith says, is very much a product of good judgment. "Physicians are constantly taking disparate bits of information and synthesizing them into a plan of action, atherapeutic plan. At times, this is simple; at other times, we make decisions in consultation with others whose judgment we trust. With a CEO, it's the same." In medical school, men and women ore trained to work hard and to put in long hours. The some is required of oCEO. Physicians must continually renew their fund of knowledge. likewise, the technical aspects of being o CEO require constant upgrading of skills and acquisition of new information. Guilford's lead product, the GUADEL wafer, gained final federal approval in September 1996, becoming the first brain cancer treatment to be cleared by the FDA for marketing in more than 20 years. The wafer, which is made of a biodegradable polymer, contains BCNU, or carmustine, a cancer chemotherapy drug used in the treatment of glioblastoma multiforme, a particularly virulent form of brain cancer. Approved for patients undergoing surgery for recurrent brain cancer, GLIADEL wafers are packed into the cavity created when a tumor is excised from the brain. Once implanted, the wafers degrade over several months , allowing for the extended delivery of high concentrations of BCNU directly to the tumor site. In addition to permitting site-specific and controlled delivery of the drug, the new product eliminates the toxic and debilitating side effects that accompany systemic ad- ® Under the agreement, RPR holds the rights to market GLIADEL globally, except in Scandinavia; RPR also has the exclusive right of first offer on other polymer oncology products developed by Guilford. In return, Guilford shares in profits from GLIADEL sales and receives other payments from RPR as various regulatory hurdles are cleared in the U.S. and abroad . Additionally, RPR is "Renewing, retooling- these come very naturally to me," Smith says. "We didn't receive training in balance sheets and public stock offerings in medical school, but with the way health-core delivery is changing, that might not be such o bod ideo." Academic medicine is really very entrepreneurial, according to Smith, who compares it to o franchise operation. Faculty and researchers get into business by being accepted by a larger institution with a big nome. Johns Hopkins didn't give himo budget to start o new division in the Deportment of Medicine: it gave him use of its nome. With that nome, he raised funds and leased space in the institution. The institution took 15 percent off the top of his earnings, and he was required to follow the rules of the "franchise." It's up to the choir, program director or principal investigator to keep the franchise running, Smith says. If he or she does poorly, the franchise doses and the space is leased to someone else to develop another research program. Smith was successful of this mode of operation when he was in academic medicine, and he enjoyed the challenge of building his franchise. Today, as a CEO, one of his greatest challenges still is to find the resources to expand the company. Afundamental contrast between business-at leas! business al Guilford-and academic medicine is the emphasis on teamwork versus individual achievement, Smith says. "In the academic setting, the focus is on who's bringing in the mosl money and who's work is being published in which journals. This approach promotes individual achievement that often discourages collaboration," he says. "In a company like Guilford, working in teams for a larger purpose is o way of life." B u f f a l o Physician 5 p r I n g 1 9 9 8 �- - ---~-- --------------- ~ --~- - -~-- ·········· · ·············· · ······························ · ························· · · · · · · [ ! ] IN ANIMAL STUDIES, THE GUILFORD COMPOUNDS HAVE BEEN SHOWN TO REGENERATE NERVE TERMINALS LOST IN PARKINSON'S DISEASE AND TO REVERSE THE FUNCTIONAL ABNORMALITIES ASSOCIATED WITH THIS LOSS. financing clinical studies of GLIADEL for metastatic brain cancer and pediatric brain cancer. Although Smith acknowledges that Guilford has some distance to go before its stockholders can expect the company's products to generate healthy profits, he is excited about Guilford's future. Part of Smith's enthusiasm is based on achievements in the company's neuroscience program, including the completion of Phase II clinical trials of the company's diagnostic test for Parkinson's disease. The new product promises to improve detection and monitoring of the condition, which currently afflicts more than 1.5 million Americans. P arkinson's disease is caused by the loss of dopamine neurons in the area of the brain that controls muscle tone and movement. It is one of the most common of the neurodegenerative conditions affecting older adults, but it is difficult to diagnose in its early stages and impossible to monitor using current methods. Guilford scientists, however, have developed an imaging technique to measure the density of dopamine neurons in the brain. The new product, DOPASCAN Injection, has recently completed a multicenter Phase lib study with the Parkinson's Study Group. Additionally, Guilford's research and development team is concentrating on developing drugs that may someday reverse the effects of Parkinson's disease, as well as those of stroke, spinal cord injury and other serious neurological conditions. Researchers' efforts are centered around the new compounds, called neuroimmunophilin ligands, through B u f f a l o which nerve regrowth can be induced. Building on findings by researchers at johns Hopkins, scientists at Guilford demonstrated in laboratory experiments that low concentrations of certain immunosuppressive drugs can be used to stimulate nerve regrowth. After discovering that the neurotrophic activity of these compounds can be isolated from their immunosuppressive properties, the Guilford team developed a series of compounds with neurotrophic capabilities, but without the immunosuppressive effects. In animal studies, the Guilford compounds have been shown to regenerate nerve terminals lost in Parkinson's disease and to reverse the functional abnormalities associated with this loss. Smith is unaware of any similar studies with such dramatic results. "If anyone had told me 10 years ago that it was possible to make damaged nerves regrow and regenerate, I would have said, 'So what? They won't know what connections to make,"' he says. "But that's what appears to be happening. If the damaged nerves can be stimulated to regrow, they seem to 'know' how to make the right connections on their own." In March 1997, Guilford was granted a U.S. patent covering the neurotrophic applications of neuroimmunophilin ligands, and the company hopes to begin clinical studies of the compounds within the year. Researchers at Guilford are also involved in neuroprotective research, which focuses on preventing nerve cell damage resulting from stroke and head trauma, and in addiction research, which focuses on developing nerve inhibitors to block the pleasure effects of drugs Physician S p r I n g l 9 9 8 such as cocaine, alcohol and nicotine. Smith's ambition for Guilford is to build it into a multibillion dollar concern-an aspiration that is not at all antithetical to his desire to make the world a better place. "Our company does well by doing good," he says. "Our mission is to become a world leader in the discovery and development of drugs to improve human health care and enhance quality of life. We're also in business to build value for our shareholders. While it's true that our industry is competitive, we don't have to conduct business in a way that is at odds with our goal of improving the lives of individuals confronted with life-threatening diseases. " + TINNITUS CONTINUED FROM PAGE 3 plastic transformation of its circuitry. "So we think tinnitus is the auditory system's analog to the phantom-limb sensation experienced by some amputees or people with peripheral nerve damage," explains Lockwood. "This is of much interest to us because we think it provides a target for future research. Understanding the mechanisms that cause plasticity may provide a method for preventing or treating tinnitus in the future." For Michael Deakin, who was a participant in the study, these results and their potential for clinical applications provide him with much hope for a future life in which he can once again enjoy the quiet that normally accompanies times of relaxation, rest or concentrated absorption in a task. "To me," he says, "this study is very, very significant." Seed money for th e research described in this article was provided by the UB Offi ce of Research, with additional f unding from the UB Center for Hearing and Deafness, the American Tinnitus Association, the j ames H. Cummings Foundation of Buffalo and th e National Institute on Deafn ess and Oth er Communication Disorders, of the National Institu tes of Health . �the health sciences at UB. As director of managed care with the Emory University System of Health Care, Bernardino oversaw sales, marketing, contracting, medical management and community relations for a health-care system with net revenues BY A RTHUR P AGE of more than $1 billion. One of the projects he oversaw was the consolidation of multiple system laboratories 1 ( l-f .\ ~ 1 F D t n r ' \If D has been named vice president into a single laboratory system . Prior to for health affairs at the University at Buffalo, effective Aprill, becoming director of managed care, he was associate clinic director in this same as announced by President William R. Greiner. Prior to coming area with the Emory Clinic. Bernardino has been affiliated with to UB, Bernardino served as director of managed care with the the Emory University School of MediEmory University System of Health Care, in Atlanta, and was a cine since 1982. He has served as direcprofessor of radiology in the Emory University School of Medicine. tor of magnetic resonance imaging and director of abdominal radiology at At UB , he has assumed responsibility health sciences," he adds. "Western New Emory University Hospital and as a as the chief officer overseeing the clini- York is very fortunate to have someone of professor in the Winship Cancer Cencal and collaborative activities of the his caliber become a part of our commu- ter. Before joining Emory, he was affiliuniversity's five health sciences nity. His joining us bespeaks the strength ated with the University of Texas Sysschools-medicine and biomedical sci- and potential not only of health sciences tem Cancer Center and ences, dental medicine, health related at UB, but also the excelM. D. Anderson Hospiprofessions, nursing and pharmacy. He lence of the region's healthtal and Tumor Institute is also overseeing the university's rela- care community. " in Houston , and with Provost Thomas E. tions with its affiliated teaching hospiEverett General HospiHeadrick, who tal in Everett, WA. HE WILL BE A FIRM LEADER WITH A CLE"AR headed the A graduate of Case search commitSENSE. OF ~·~E~T'~ ' .-~D TH HE, ' ~u Western Reserve Unitee that recomSCIENCES. - PROVOS T THOMAS E . HEADRICK versity in Cleveland , mended BerBernardino earned his tals and Roswell Park Cancer Institute. nardino , says he "blends an medical degree in 1973 In addition , he is serving as leader for understanding and commitfrom Ohio State Univerthe health-science deans in planning ment to academic medicine sity and completed his and executingjoint and cooperative pro- with health-care business experience. residency in diagnostic radiology at grams of teaching and research and is a He will be a firm leader with a clear George Washington University Hospikey member of the president's cabinet. sense of direction for the health sci- tal in Washington, D.C. In 1996, he John R. Wright, MD , is continuing as ences. His leadership and decision- received an MBA degree from Roberto interim dean of the UB medical school, making styles emphasize listening and C. Goizueta Business School at Emory a position he assumed in january 1997 learning from his faculty members and University. following the resignation of john P. the health and medical community, and Certified by the American Board Naughton, MD. bringing people together for shared goals of Radiology, he is a past president Greiner describes Bernardino's ap- and common benefits." of the Society of Computer Body pointment as "a historic win for UB. " Headrick notes that among Tomography and has been active in "His leadership experience and his Bernardino's charges will be develop- medical organizations, including the vision for the place of medical education ing a five-year academic and financial Society of Magnetic Resonance in the rapidly changing health-care field plan for the medical school and, more in Medicine and the Society of will help bring focus and strength to the generally, guiding the planning for Gastrointestinal Radiologists. + New Vice President Named for Health Affairs ® B u f f a l o P hysician 5 p r I n g 1 9 9 8 �------------------~~---------~- - ----- ····················· · ·································· ·· ······························• · ~ I Nancy Nielsen, MD,PhD,Named Associate Dean for Student Affairs ancy H. Nielsen, MD , PhD, has been named assistant dean for Student Affairs at University at Buffalo School of Medicine and Biomedical Sciences. In this capacity, she will be responsible for overseeing the academic and student affairs of third- and fourth-year medical students. ielsen, who earned her medical degree from UB in 1976, is a clinical associate professor of medicine at UB, with teaching responsibilities at the Buffalo General Hospital. She is also in private practice in internal medicine. Since 1995, ielsen has served as Speaker of the House of Delegates for the Medical Society of the ew York (MSS Y) and has served on MSSNY's state and federal legislation committees and on the Task Force on Health Care System Reform. A frequent lecturer and radio and INFINITI television host on topics relating to health, nutrition, infectious diseases and women's health concerns, ielsen is currently a ew York State delegate to the American Medical Association (AMA) , member of the AMA's Council on Scientific Affairs and a member of the board of directors of the ational Patient Safety Foundation, an AMA initiative formed this year. She is also past president of the Eric County Medical Society and the first woman elected president of The Buffalo General Hospital staff, a position she held from 19961997. In 1996, ielsen was named recipient of the Samuel P. Capen Award, the UB Alumni Association's most prestigious award. + James P. Nolan Receives Alfred Stengel Memorial Award ames P. olan, MD, Distinguished Service Professor and former chair of the Department of Medicine at the University at Buffalo School of Medicine and Biomedical Sciences for 16 years , has been named recipient of the Alfred Stengel Memorial Award for outstanding service to the American College of Physicians. Selection is "based upon unusual loyalty and exceptional contributions to the aims and purposes of the college, as well as the recipient's outstanding influence in maintaining and advancing the best standards of medical education, medical practice and clinical research, " according to information provided by the college. olan, an internationally recognized expert in endotoxins and liver function, disease and injury, is also well known for his leadership in the areas of affirmative action and minority recruitment in medical education. As a Master of the American College of Physicians, he has served the college as governor, regent and chair of the board of regents. olan received the Stengel Award on April20, during the college's 79th annual session in San Diego. + 0~~ f ntroduc;ng your way to escape. \\~ Infiniti's luxury sport AUTO PLACE INFINITI 8129 MAIN ST., WILLIAMSVILLE 633-9585 u f f a l a MSRD 36,045. 00 utility vehicles, the QX4 not on ly features everything you need to escape for the weekend, it has a ll the comforts and luxu ries you East of Transit Rd., Near Eastern Hills Mall B uti lity vehicle: the QX4. Unlike most luxury sport need to escape life's dai ly stresses. Physician 5 p r i n g 1 9 QX4 9 8 I �• ' ··· ····· ············· · ········ · ····· ·········· ·· · ······································· ~ 0 I New, Uniquely Collaborative MPH Degree Program Established BY JESSICA ANCKER OR YI:.ARS PAIRICK A orRs had been thinking about earning a master's degree in public health (MPH), but he never found an opportunity. After he earned his DDS from the University at Buffalo School of Dental Medicine in 1986, he operated a busy private practice and then joined the staff of the Buffalo graduates will be better qualified to respond in a more informed way to changes in health care and to take a more proactive role in helping to define workable solutions to health-care problems. A second advantage, he says, is that "by understanding the determinants of health and disease in our society, practitioners will be better able to help prevent disease and to contribute to the public debate influencing our health policy, making them not only better health-care professionals, but better citizens, too." REFLECTING A NEW REALITY IN THE ECONOMICS OF MEDICAL EDUCATION While the course content for the collaborative MPH program addresses the new economic realities facing medical practices, the administrative structure of the program reflects the new economic realities facing medical educa- General Hospital. His training prepared him well for treating individual patients, but, Anders says, he found himself encountering situations where more knowledge about public health, health policy and healthcare administration would have been helpful. Rapidly changing health-care reimbursement structures and the Buffalo hospital mergers made him want to learn more about administrative and fiscal issues. In addition, Anders developed a subspecialty in treating developmentally disabled patients, a population whose dental needs are not unique but whose cases may pose special management problems. Nevertheless, there was no MPH program in Buffalo where Anders could study the issues that interested him. The closest equivalent was the master of science degree in epidemiology offered by the University at Buffalo School of Medicine and Biomedical Sciences, but Anders felt that the degree was too research oriented for his needs. This year that has changed. Anders has a chance to study for his MPH and he doesn't even have to leave the area. A groundbreaking agreement between the University at Buffalo, the State University of New York at Albany and Roswell Park Cancer Institute, will allow physi- cians and dentists in Buffalo to earn advanced degrees in public health from the University at Albany's School of Public Health. The collaboration is sponsored by the Department of Social "OUR MPH DEGREE IS INTENDED TO GIVE PRACTICAL and Preventive RELEVANCY TO PUBLIC HEALTH-A PROGRAM WHERE Medicine at UB's THE STUDENTS CAN GO OUT AND WALK AROUND AND School of MediSEE HOW EVERYTHING WORKS IN REAL LIFE." cine and Biomedical Sciences and Roswell Park Cancer Institute. tion. After several years of tight state "With the changes in health-care de- budgets, SUNY medical schools generlivery today-including a growing em- ally find it hard to win money for expanphasis on prevention-knowledge ofpub- sion. Instead, they can enter into interlic health issues has become increasingly campus cooperative arrangements to desirable for physicians and other health- share existing resources. care practitioners," says Maurizio Trevisan, "This joint program will benefit both MD, chair of UB's Department of Social of our institutions," says David C. Carand Preventive Medicine. penter, MD, former dean of the Univer"A better understanding of the social, sity at Albany's School of Public Health. public health and policy side of medicine "UB gains access to our nationally acwill greatly benefit physicians and other credited MPH and DrPH programs with health practitioners," he says. "The a minimal investment, while the Uniknowledge acquired in the MPH pro- versity at Albany is able to help set the gram will not only prepare health practi- standard of public health education and tioners for a career in public health and expand its student base." administration, but it will also equip a 'This is a concrete example of collabobroader range of these professionals with ration between SUNY units," Trevisan tools that will enable them to better prac- adds. "It's an example of how things will tice medicine." According to Trevisan, be in the future, with teleconferencing one advantage of the program is that and cross-offerings. This collaboration ® B u f f a l a Physician s p r 1 n g 1 9 9 8 �------------- I - -------------- -- ... . . . ............ .. ........ . ... . . . . ... . . ............... . ........ . . . . . ....... . ----- - -- ........... . ' ~ I represents a significant opportunity in a time of shrinking resources. " W ithout a collaboration with Albany, it's unlikely that UB could have created a new degree-granting program without hiring more faculty, according to Arthur Michalek, PhD, associate director for the Department of Educational Affairs at Roswell Park Cancer Institute and dean of the institute's graduate division, SUNYatBuffalo. "In the present economic climate, we have to be fairly innovative. If we want new programs, we have to fashion them so they aren't going to require a great number of new faculty, " he says. The schools are implementing several innovative teaching techniques to make a success of this joint venture between two campuses that are separated by some 300 miles. UB already offers many relevant courses through the Department of Social and Preventive Medicine and as part of the master of science program in epidemiology. Through teleconferencing, additional instruction will be offered at a special facility at UB. In addition, Roswell Park is expected to have a teleconferencing facility of its own in the near future. Externship opportunities will be provided for students in settings that are expected to range from the Erie County Department of Health to the administrative offices of a health maintenance organization (HMO). Most students will be able to earn credit for B u f f a l o relevant courses they took while earning their primary degrees. UB is implementing the program gradually to ensure a smooth and cohesive transition, and only a few students will be admitted initially, each of whom must already have earned their MD or DDS. Eventually, the MPH program may also be opened to individuals from other health professions. As the program expands, Trevisan hopes to create a dual-degree program that would allow medical students to earn an MD and an MPH simultaneously in a four- or five-year program. THE "BASIC SCIE CE" ARM OF PREVE TIVE MEDICINE The MPH degree integrates well with UB'semphasis on primary care, and it is expected to help UBattract students with a public health perspective. The course requirements for the MPH will be similar to those already in place for the MS in epidemiology; however, MPH students will focus more on public health issues and will not complete a research thesis, but instead will complete internships in the community. "Someone from the 'ivory tower' might get tongue-tied when faced with real public health situations in the field, " Michalek says. "Our MPH degree is intended to give practical relevancy to public health-a program where the students can go out and walk around and see how everything works in real life. " Flexibility has been built in to the Physic/on 5 p r I n g 1 9 9 8 I MPH program to accommodate as many learning needs as possible, so students can focus on specific areas of interest. Citing an example about the importance of this flexibility, Trevisan explains that one of the requirements for completing the three-year residency program in preventive medicine at UB is that students earn an academic degree in either public health or epidemiology. "This is training that is seen as imperative for anyone pursuing a career in preventive medicine. In a sense, public health and epidemiology represent the basic science arm of preventive medicine. Therefore, it's important that we allow students to tailor the MPH program to their specific career goals and interests." Trevisan is already receiving anumber of inquiries about the program. Potential students are interested, he says, because they recognize that public health training will help expand their perspective from individuals to populations, and from treatment to prevention. They also recognize that training in the fiscal and administrative aspects of medicine can enhance their professional careers and their attractiveness to managed care organizations , hospitals and universities. Anders applied for the MPH program as soon as he heard about it, and became the program's first student. He has already begun a course in cancer epidemiology. While in school, he will continue to work nearly full time, so he expects it will take several years to complete his master's degree. "I really think this makes a lot of sense with what I've been doing professionally, " Anders says. Of course, he adds, there are a few disadvantages to being the first: "I have no one to study with!" + For more information on the MPH program, contact Dr. j ohn Vena, acting director of graduate studies, Department of Social and Preventive Medi cin e, Univ ersity at Buffalo, 270 Farber Hall , Buffalo, NY, 14214. Phon e: (716) 829-29 75. �~ · ................ . ..... . ........................................... . . . .. .. .............. ceptional for her maturity and composure. "I was with her when she received a call of congratulations from the Secretary of State and she was very poised. MONICA SPAULDING , MD , A LEAD MED I CAL OFF ICER AT There's something about her; she just NAGANO' S SKATING EVENTS has that little extra spark," she notes. Spaulding spends most days as chief HF T -\;;'-\ LIPI Sl\.1 glided off the ice after her gold medal- of oncology at the U.S. Department of winning figure-skating performance at the 1998 Winter Olym- Veterans Affairs Medical Center in Buffalo , but her avocation takes her to compics in Nagano, japan, she had a mandatory appointment petitions all over the East. In recent months , she supervised drug testing at with Monica Spaulding, MD, professor of medicine at the the World Cup Free Style Skiing team University at Buffalo School of Medicine and Biomedical Sciences. competition in Sugar Loaf, Maine, and the Olympic short-track skating trials in Spaulding, one of four U.S. physi- Olympics in Atlanta, an offer she couldn't Lake Placid. Her venues also have incians in Nagano participating in drug refuse. There she met Carl Lewis,jackie cluded the 1997 Boston Marathon, the testing, was lead medical ofJoyner and Michael] ohnson, 1997 U.S. Track and Field Championficer for the women's figure chatted with 15-year-old ships in Indianapolis and the World B y skating, short-track skating swimming phenomenon Cup water polo competition and the L 0 I S and long-track skating and Brook Bennett, and got to 0 lympic track and field trials , both held 8 A K E R some skiing events. know the entire women's in Atlanta prior to the Olympics. This was Spaulding's secswim team. Those Summer Games-her first ond Olympic experience. She At Nagano, Spaulding Olympic experience-were unquestionwas lead medical officer in Atlanta in worked closely with the American and ably the pinnacle. Spaulding recounts 161996 for two hugely popular competi- Canadian women figure skaters and hour days, subsisting on turkey sandtions: track and field and the aquatic speed skaters. Her impressions of many wiches and the occasional Big Mac, and events, including swimming, diving, of the athletes are memorable, both on loving it. "After the first week, we were all water polo and synchronized swimming. and off the "stage." Spaulding says she exhausted," she says. "I don't think I've The job is a gift from the gods for the very much enjoyed working with worked that hard since I was an intern." avid sports fan and mother of two daugh- Lipinski. "She is a really neat kid. l had agano wasn't much easier, as most of her ters who are competitive athletes. "It's seen her around the games quite a bit events took place in the evening, with the one of the greatest experiences I've ever and she was very easygoing, always mix- athletes often not arriving for testing until ing with people and joking. She had in my life," she says. after midnight. "I usually got back to Nagano is far removed from the lo- seemed to be having a very good my room at two or three in the cal competition in 1990, where time. And in the drug testing morning, sometimes as late as Spaulding's adventure began. She vol- area, she was a delight to work four," she says. unteered to do the drug testing for her with and just so excited to Spaulding's job as lead daughter's swim meet and found the have won the medal," she says. medical ofexperience fascinating. Spaulding reSpaulding adds that she has ficer was to ceived her training and certification in worked with other young make sure time to handle testing for swimming Olympic athletes, all test and track and field for the 1993 World but feels that samples University Games in Buffalo. Lipinski is exwere Because she was certified to conduct drug testing by the U.S. Olympic Committee (USOC) and the National Colle- At the dose of the Olympic;, giate Athletic Association, Spaulding was Spaulding and contacted by the USOC and asked if she Lipinski again would be interested in working at the crossed paths. Keeping the Olympics on Track ® �---------------~--- - --- -- - - -~ --~----- - ---~- ·························································· · ······ ··· ········ ··········· a notified of their secollected and lection and must packaged withsign a form certifyout tampering, ing the time of notiand that each fication. They then athlete certified have an hour to apin writing that pear for testing. If the process was they don't, a posiconducted tive result is autoproperly. The matically registered, ingenuity of usSpaulding says. ers, combined Most competiwith the develtors appear as reopmentof everquested, however , more-advanced and their main task performanceis to produce a urine enhancing drugs , has Spaulding enjoyed the unique cultural events at the Olympics such as this drum performance at the moguls venue in Hakuba. sample while being observed, a predicatransformed what should be a simple matter of letes' safety," she emphasizes, explain- ment that can give even a champion collecting a urine sample into a closely ing that there have been several deaths pause. "Some athletes are around for in cycling in recent years. "The problem hours because they are either dehydrated monitored, painstaking procedure. "No matter what you do with innova- with having a high red blood cell mass is or over-hydrated," Spaulding says. It's tive drug testing, they are one step ahead your viscosity goes up and you can have under these circumstances that she meets the big names who come accomof you," Spaulding says. She tells of a major stroke," she says. Urine is analyzed for evidence of ste- panied by their managers, as well as the athletes using catheters to fill the bladder with "clean " urine, strapping a con- roids, human growth factor and diuret- unheralded , and often more endearing, tainer of urine to the body or hiding a ics, which can mask the presence of champions of lesser-known contests. Once samples are procured, athletes urine bag in the vaginal cavity. Athletes some performance-enhancing drugs , as select a testing kit, certify its pristine selected for testing now are observed well as flush evidence of illegal drugs condition, divide the sample between constantly from start to finish to pre- from the system, Spaulding says. Tests two bottles, label and seal the bottles, also look for stimulants, narcotics and vent such transgressions. The new drug of choice, particularly beta blockers , sometimes taken by place them in the packing kit , seal the kit for distance events, is erythropoietin, marksmen to slow the heartbeat and and testify in writing that all procedures used to stimulate red blood cell produc- gain an extra moment of dead calm in were followed properly. One sample is tested, the other is frozen. If sample A is tion and boost the amount of oxygen which to take aim and shoot. positive, sample B also is tested. If both available to muscles , Spaulding says. Drug testing is conducted on all medal results are positive, appropriate sancNot long ago, this effect was accom- winners and world-record setters, as tions are imposed. Labs were set up in plished more crudely by transfusing red well as randomly selected athletes. Comagano to conduct the testing, which cells, a·process referred to as blood dop- petitors who set a record for their counhad to be completed within 24 hours. ing. "In Nagano, the drug testers weren't try also may ask to be tested to validate Nagano was a very unique experireally confident in their ability to test for their performance. ence for Spaulding when compared to the hormone, so instead they checked hile drug testing was instituted to her other sporting venues, in large part the hematocrit prior to the event and if protect athletes from dangerous due to the unbuffered exposure she had it was past a certain level, the plan was substances as much as to maintain to japanese culture. "I was housed in a to not let the athlete compete because it a level playing field , the process small room, furnished with a tatami was a health risk, " Spaulding explains. This test was only done in the biathlon itself is designed to insure a reliable mat, futon and low table. A communal and cross-country events, and to the result that will withstand legal chal- sink and bathroom were down the hall ," best of Spaulding's knowledge, no one lenges. Athletes selected for testing are O LY MP ICS CONTINUED ON PAGE 22 was excluded. "This test is for the ath- escorted off the field of competition, W f f a l o Physician S p r I n g 1 9 9 8 �• · · ········ · ·· ··· ··· ···················· ·················· Magnificent BUILDING LOTS ~ e I OLYMPICS CONT ' D FROM PAGE 21 she explains, adding that women and men's quarters were completely segregated. "I was surrounded by Japanese women from all walks of life, and it really was a wonderful experience. They helped me improve my Japanese a lot. " Other cultural highlights included a two-day trip to Kyoto with her fellow medical officers and the many hours she spent exploring Nagano on foot. During one such walk, she came upon police officers roping off the street and waited patiently with a gathering crowd to see the emperor and his wife stroll past her. "He was a kindly looking man and his wife was probably one of the loveliest older women I've ever seen," she says. When she wasn't working her events or spending time deciphering the sched- ule for her daily bus rides to the venues, Spaulding made good use of her "Infiniti" pass, which gave her access (not necessarily a seat) to any Olympic event she wished to attend. This enabled her to take in a whirlwind of drama , from Jonny Moseley's gold-medal performance on the moguls, to the U.S.-Canadian men's hockey game, the subsequent Czechoslovakian-Canadian match (with tickets selling for more than $300), and the women's Chinese-Finn hockey match in which the Finns won a bronze medal. Now back into her normal routine of work, Spaulding has had time to reflect on her two-week experience in Nagano and admits to looking forward to an opportunity to participate in future Olympics. "It was an adventure," she says. + TAKE TW ••• AND CALL ME IN THE MORNING! f;'\d ~o~r OW'\ ro(ld: * Fact: Saab owners have a higher education level than any other car owner group. * Saab purchase prices starting low to mid 20's; leases starting at $299 per month. * According to the Insurance Institute for Highway Safety (IIHS), the Saab 9000 has the lowest fatality rate of any production car on the market. As a former president of the University at Buffalo medical school Alumni Association and a practici ng surgeon in Western New York for many years, I've come to understand what members of our profession desire in a home site - privacy, tranquility, fresh air, and pristine surroundings. The Summit at Scherff is a truly extraordinary residential development, unrivaled in Western New York. Nestled in the hills of Orchard Park, this magnificent 81-acres offers 50 estate-sized building lots surrounded by Chestnut Ridge Park and Neuman Creek in a very private enclave. Specifically as an escape from the fast-paced everyday life we lead, it's features include: • Spectacular panoramic views of the Canadian shores, Lake Erie, and the BuiTalo skyline • 11-lature woods and secluded ravines 1 Oversized lots for your dream house • Quick and easy access to the freeway systems leading to BuiTalo and the city's northern suburbs 1 Privacy, seclusion, and exclusivity The Summit promises to be one of the premier areas in Western New York to construct your luxury residence. I invite you to take a stroll through this picturesque setting. For our detailed brochure or a private showing please call (716) 667-2237 or (71 6) 472-3790. Sincerely yours, Edmond J. Gicewicz, M.D. Past President, UB Medical Alumni Association SOUTHTOWNS SAAB 3580 Southwestern Blvd (1 Mile east of Rich Stadium) (716) 662·8008 B u f f a l o THE SUMMIT AT SCHERFF Orchard Park, New York A development by Falcon Land Corp. Physician S p r i n g 1 9 9 8 �-- --------~---------- - --- ~ - -~-- - ~--- ---- ·· · ··· · · · ········ ··· ···· · · · ············ · · · · · ·························· · · · · · ·· · ·········· • ~ ··.· ~ I Laboratory and Fellowship Named in Honor of Louis Bakay, MD he Louis Bakay Neurosciences Laboratory for Surgical Anatomy and Neuropathology at Buffalo General Hospital was opened in December 1997. The lab is named in honor of Dr. Bakay, head of the hospital's Department of Neurosurgery from 1961 until his retirement in 1985 and emeritus professor of neurosurgery at UB. In addition, the Louis Bakay Fellowship has been established in the hospital's Department of Neurosurgery. "Dr. Bakay has done pioneering laboratory research on the specialized nature of the blood-brain barrier and on radioactive nuclear scanning of the brain. He has contributed significantly to various areas of research pertaining to metabolism of the brain," says Walter Grand, MD , clinical head of the Department of Neurosurgery at Buffalo General Hospital (BGH) and clinical professor of neurosurgery at UB, who worked closely with Bakay for more than 10 years. According to Grand, Bakay was the first to introduce electron microscopy to Western New York, having brought the and gentle person and exemplary scholar first such microscope with him when he who is not in the least bit bitter toward came to Buffalo General Hospital in 1961 . his fellowman. These are wonderful qualiIn addition to his medical research ties that came out of his terrible ordeal. accomplishments, Bakay is also known It's for all these reasons, both his pioneeras a medical-history scholar and as an ing research, as well as the stature of the author of several books, one of which is man himself, that we felt it fitting to his autobiography, titled Gallery ofGhosts. dedicate the laboratory and fellowship to "In this book he recounts the trials and him at Buffalo General. " Th e Louis Bakay tribulations he encounLaboratory , which is tered in his homeland of codirected by Grand and Hungary during WWII Peter Ostrow, MD , of the and his escape to Sweden through Nazi- and Department of NeuropaRussian-occupied territhology at BGH, is detory, " says Grand , who voted to training neuroadds that Bakay speaks surgical residents in new five languages and is a surgical techniques usmaster editor in English ing laboratory anatomiDr. Wolter Grand and Dr. louis Bakay and a notably accomcalspecimens. Residents , plished translator of medical archival fellows and attending physicians corredocuments from Latin to English. late surgical anatomy with surgical pro"This is a man who has led a very cedures, and also design and refine new special life," says Grand. "He came to this procedures. The lab is also available for country late in life and had to repeat his use by other surgical subspecialties and entire training at Harvard before he could for training pathology residents. A private dedication for the laboraresume his work. Yet what I find most remarkable about him is that despite all tory was held on December 9, 1997, the horror and deprivation he experi- with Bakay, who is now 80, in attenenced in his life, he grew to be such a kind dance with his wife , Nancy. + ONLY ONE INVESTMENT LASTS A LIFETIME • Exceptional coll ege placement recorJ • Challenging curriculum with I4 Advanced Place ment courses • State of the art visual and performing arts center • More than 60 interscholastic sports teams • Comprehensive community service projects • Average class size is 15 • Financial aid available Ad missions tests on these Saturdays at 9:00 a. m.: January 24, February 28 To reserve a place for testing or for aJJitional information, please call: ICHOLS MI DDLE SCHOOL, 175 Nottingham Terr. , NICHOLS UPPER SCHOOL, I250 Amherst St. Acceptance is granted to qua lified students without regard to race, color, rel!gam or national origin. e u f f a l a P I hysician S p r i n g 1 9 NICHOLS SCHOOL 9 8 �~····· ········ · ······················································ · ····················· Shedding Light on Treatment of Lung Cancer FDA APPROVES NEW PHOTOSENSITIVE DRUG 1 • • • ~ · -, IS R T U S Food and Drug Administra- tion approved the use ofPhotofrin®, a light-activated drug used in photodynamic therapy (PDT), for treatment of patients with early-stage lung cancer. PDT is a multistep process in which a harmless drug absorbed by body tissues is activated by light and releases cytotoxic substances inside tumors. This new modality of cancer treatment has been pioneered over the past three decades by Thomas J. Dougherty, PhD, chief of the Department of Radiation Biology/Photodynamic Therapy at Roswell Park Cancer Institute and professor of radiation oncology at the University at Buffalo School of Medicine and Biomedical Sciences. The use ofPhotofrin in PDT Photofrin is injected intraBY is an option for people diagvenously into the patient, a KEVIN nosed with early-stage lung procedure that is sometimes cancer who are not eligible done in an outpatient setCRAIG for surgery and radiotherapy. ting. Within approximately LOIS "In clinical trials, approxitwo days, the drug concenBAKER & mately three-quarters of the trates in cancer cells, and S .A . patients had a complete rephysicians can then deliver a sponse following treatment of light to the tumor beam UNGER and about half of them are using a fiberoptic and an cancer free in long-term argon-driven laser. When the follow-up," says Stephen Lam, MD, head Photofrin absorbs energy from the light, of the bronchoscopy program at British it produces a molecule called singlet Columbia Cancer Agency ofVancouver, oxygen, an active form of oxygen Canada, and a clinical trial investigator derived from endogenous oxygen. Durfor the new drug. QLT Photo Therapeu- ing its one-millionth-of-a-second life tics, a Canadian biotechnology span, this highly reactive molecule oxicompany, has exclusive license to the dizes anything it touches, killing the Photofrin patent, which is held by cancer cells but sparing surrounding Roswell Park Cancer Institute. tissue. In some cases, necrotic tissue "This is the very first approval for this and exudate are removed through a bronnew therapy in North America for which choscope two days after the initial the intention is to cure the patient. Some procedure. Principal side effects of the patients in the trial are still free of drug include skin sensitivity to light for disease 10 years after PDT treatment," four to six weeks; some patients also says Dougherty. experience inflammation at the treatln photodynamic cancer therapy, ment site, causing varying degrees of ® B u f f a l o shortness of breath and coughing. Lung cancer remains the number-one cause of death by cancer in the United States for both men and women. Currently, the five-year survival rate for Physician 5 p r 1 n g 1 9 9 8 �----~~- -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · a I • ' ~ found out, as early as the 1930s and again in the 1960s, but was discontinued due the unavailability of technically advanced equipment. The big leap in technology came in the 1980s, when lasers that could focus light at precisely correct wavelengths through endoscopes were developed. Since that time, scientists around the world have used PDT successfully on esophageal, bladder, stomach, oral and cervical cancers, and Photofrin-PDT is currently approved for use in Canada, japan and several Euro"TO ME , THE GREATEST VALUE OF PHOTOFRIN IS THAT pean countries. Prior IT HAS THE 'MAGIC BULLET' PROPERTIES THAT HAVE to january of this year, BEEN TALKED ABOUT IN ONCOLOGIC RESEARCH FOR SO Photofrin and the LONG," LIEBOW SAYS . REFERRING TO PDT'S ABILITY TO PDT laser equipment had only been apIMAGE AND TREAT AFFECTED CELLS WITHOUT DAMAGE proved by the FDA for TO SURROUNDING TISSUE. treating late-stage esophageal cancer. Because light doesn't penetrate far Building on the success of Dougherty's into tissue, PDT can only be used on work, Buffalo General Hospital opened a tumors that are on or near the surface of Photodynamic Therapy Center in March organs, accessible by an endoscope or 1995 , under the direction of exposed surgically. Also, because it is a ThomasS. Mang, PhD, former director of local therapy, it is not appropriate to Roswell Park's PDT center and research blood-borne cancers. Although not associate professor of oral and maxillofatherapeutic for all cancers, PDT is less cial surgery at UB. In addition to patient expensive, quicker and safer than many treatment, the Buffalo General center is conventional cancer therapies. Under conducting Phase II and III trials on two Dougherty, Roswell Park's Photody- other photosensitive drugs, tin ethyl namic Therapy Center is continuing to etiopurpurin and Foscan, the latter of develop new and improved PDT drugs, which is being studied for its efficacy in participating in clinical trials of new treating recurrent oral cancers. In the fall of 1997, Mang and his drugs and therapies and investigating the mechanisms that make PDT work. colleagues Ronald Allison, MD, and Dougherty began his innovative work Vitune Vongtama, MD, of the UB Departwith PDT in the early 1970s, following ment of Radiation Oncology, and B. Dale a serendipitous discovery in his lab in- Wilson, MD, of Roswell Park and UB dicating that a chemical being used to Department of Dermatology, announced identify live cells in culture could kill preliminary results from an FDA trial the cells if they were exposed to light. In they were conducting on PDT for use in the years that followed, he and his col- treating Kaposi's sarcoma, as well as leagues began experimenting with pho- external chest-wall lesions from recurthe 178,000 Americans diagnosed with tosensitive chemicals in combination rent breast cancer. Presenting at the lung cancer every year is 14 percent, with conventional lamps to kill tumors European Cancer Conference in Hamaccording to the American Cancer Society. "This new drug approval is particu- that had spread to the skin. Work of this burg, Germany, they announced that 75 larly significant since it is now possible type had been attempted, they later percent of the Kaposi's sarcoma lesions to detect early-stage lung cancer much more successfully than has been the case in the past," says Dougherty. Roswell Park is now planning to combine early detection and appropriate treatment with PDT as a new option for lung cancer patients. This work, according to Dougherty, will be available through Roswell's Division of Surgery under john Urschel, MD, and Timothy Anderson, MD, and through the Division of Medicine under Gregory Loewen, DO. B u f f a l o Physician 5 p r I n g 1 9 9 8 �~·· · · · ········· ······ ············· ······· ·················· ~ HURWITZ & FINE, P.C. I [ATTORNEYS AT LAW were reversed completely and another 19 percent showed partial reversal. Also, 92 percent of the chest-wall lesions associated with breast cancer were completely reversed and the remaining 8 percent showed partial reversal. The only adverse reactions experienced by subjects were due to sun exposure while the photoreactive agent used was still active, a period of several weeks. Mang, who has done extensive research with PDT and is a longtime colleague of Dougherty's, says these results support earlier findings indicating that photodynamic therapy holds great promise for treating cancerous lesions of the skin and that, in general, it appears to be most effective when used to treat small tumors that are discovered early. "Compared to other treatments for Kaposi's sarcomas, PDT is easier on the patient, you can treat large numbers oflesions at one time and the cosmetic results are very good," he says. "Also, PDT doesn't interfere with HIV status and any other treatment patients may be receiving. " Results with recurrent breast cancer of the chest wall were equally exciting, Mang says. "PDT is a very localized treatment that does not interfere with chemotherapy, and there are none of the usual side effects of cancer therapy. Many lesions can be treated in one session, and the therapy is repeatable if the response isn't complete." In yet another research endeavor related to Dougherty's original work, scientists in the Great Lakes Biomedical Laser Institute-a comprehensive, multifacility "laser center without walls," headquartered at US-scientists and clinicians are further exploring the use of the laser as a tool in the diagnosis and treatment of cancers, both alone and in conjunction with drug sensitizers, such as Photofrin. The center is directed by Charles Liebow, DMD, PhD, professor of oral and maxillofacial surgery in the UB School of Dental Medicine, who is na- tionally recognized for his research and treatment of precancerous and malignant lesions of the oral cavity, as well as at other sites, including the pancreas. Liebow, who works closely with Mang, notes that it is only within the past 30 years that lasers have gained acceptance in the medical and dental professions as a means of safely removing lesions from the body. Over the past few years, researchers at several member centers of the laser institute have used the combined laser-Photofrin therapy under special license both experimentally and clinically for other animal and human malignancies. "To me, the greatest value of Photofrin is that it has the 'magic bullet' properties that have been talked about in oncologic research for so long," Liebow says, referring to PDT's ability to image and treat affected cells without damage to surrounding tissue. Liebow further points out that Photofrin combined with PDT is also proving to be a highly precise method for staging cancer. "Photofrin is absorbed by premalignant cells in a way that is directly proportionate to the transformation of the cell from a premalignancy to a malignancy. By taking a fluorescent reading of the cell and measuring the intensity of the fluorescence, we can measure in a very exact way how far the cell has evolved toward cancer, so this has the potential to become a very powerful staging tool," explains Liebow, who, along with Mang, has published studies on this area of research. "Anytime you have a site where there is a transformation of cells going on and you don't know which specific area is further progressed than another, you can find the spot with Photofrin and use it to guide a biopsy. When working with premalignant cells, you then have the ability to provide treatment that is preventive by selectively destroying lesions before they become cancerous. This, to me, is the greatest hope for this new drug and PDT in oncology research." + ® B u f f a l o SERVICING THE LEGAL NEEDS OF THE HEALTH SciENCEs CoMMUNITY • Managed Care • Purchase & Sale of Practices • Business & Tax Planning • HCFA Safe Harbor Regulations Physician and Physician Self-Referrals • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Faci lity Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence M. Ross at 716-849-8900 1300 Liberty Building Buffalo, New York 5 p r I n g 1 9 9 8 �------------~----~-----~-- THE CARITAS MEDICAL ARTS BUILDING A Unique Partnership with St. Joseph Hospital Harlem Road, Cheektowaga (connected via enclosed walkway to St. joseph Hospital) 500 - 8,000 Sq. Ft. Medical Office Suites Now Available For More Information Ciminelli Development Company, Inc. Centerpointe Corporate Park 350 Essjay Road Williamsville, NY 14221 716/631-8000 B uf fa lo P hysici an S p ri ng 1 9 9 8 �~·················· · ············· · ························································· Image of Neural Activity Provides Objective Measure of Attention it takes longer than without the distractions. When the brain is forced to divide its attention, however, as in processing two cocktail-party conypical scenario: You're at a party, versations at once, it flounders. listening to your friend's vaca"The brain can only divide up its tion plans, while straining to over- resources so much," says David hear the gossipy conversation Shucard, PhD, a coinvestigator on the nearby. Your brain, meanwhile, research. Ralph Benedict, PhD, assisis mustering its neuronal re- tant professor of neurology; Alan sources to allow you to concentrate on Lockwood , MD, professor of neurolboth conversations at once. ogy; and Danielle McCabe, psycholeuroscientists at the University ogy graduate student, complete the at Buffalo have been able to produce research team. Results of their work an image of this were presented at neural activity in the Society for one of the few euroscience studies using meeting in New positron emisOrleans in Octosion tomography ber 1997. (PET) and elecKnowledge trophysiology about the neurosimultaneously physiology of atto study brain tention will infunction. Their crease underfindings may standing and improvide new inprove treatment of sight into the basuch attention sis of many_ attendisorders as attention disorders. tion deficits and hyper"WE'RE LEARNING "We're learning how vigilance, a symptom of the brain attends to imposttraumatic stress HOW THE BRAIN portant information disorder in which perand screens out what sons are unable to ATTENDS TO is not important," says screen out irrelevant JanetShucard, PhD, UB stimuli, Janet Shucard IMPORTANT INFORMAassistant professor of says. It also provides neurology and a lead information about the T ION AND SCREENS researcher on the neural demands of any study. "Using electrojob that commands OUT WHAT IS NOT physiology and PET, intense concentration. we can identify how reThe team collected its IMPORTANT." sources are allocated. electrophysiology data What we end up with via electrodes attached is an objective measure to the scalp while study of attention. " subjects wearing earphones identiTheir findings showed that the fied a specific syllable-in this case, brain can successfully complete a the syllable "ba"-from a sequence task requiring focused attention even of syllables . Neural actions generin the presence of distractions, but ated in response to this task, or B u f f a l o event-related potentials, appear on a computer-generated map that reflects the pattern of electrical responses from the brain. The amplitude of a specific point on this wave, called the P300, indicates the acuteness of the brain's response to the relevant stimuli. The P300 was recorded under three conditions: Sustained attention-detecting the target syllable without any auditory interference Focused attention-detecting the target while ignoring distracting stories played simultaneously Divided attention-detecting the target and also paying attention to the content of the stories "We found a huge reduction in the P300 in response to the dividedattention task," says David Shucard. "These findings are relevant to any activity that demands constant attention, such as piloting an aircraft or monitoring sensitive instruments. This is one of the major causes of 'human error'-people get off target. " Simultaneous PET scanning pinpointed areas in the brain responsible for auditory attention tasks by recording the areas of increased cerebral blood flow during the tests. "By combining PET and electrophysiology , we are able to determine the location of major brain areas that are responsible for these different types of attention processes, as well as the time it takes the brain to process information when there are different demands on attention," Janet Shucard says. The researchers are applying their findings to persons with attention deficit disorder and posttraumatic stress disorder, as well as persons with sleep disorders, some of whom have trouble concentrating on tasks. + Physician - 5 p r I LOIS n g BAKER 9 9 8 �~~------- ········· · ······· · · · ······ · ························· · ···· · · · · · · · ·········· · · · ············ · a .. '.·~ . of chemicals obtained from ginkgo leaves-to treat age-related deterioration in brain function. Several human trials there have shown positive reinkgo biloba, prescribed widely in sults, but little research has been done Europe to improve brain function, to replicate these findings in animals, appears to improve learning and according to Winter. memory in rats and prolong their Winter's earlier research with rats life, a study at the University at showed that a set of tasks performed in Buffalo has shown. The unexpected an apparatus called the radial maze could reliably detect positive effect on longevdeficiencies in learning ity has surfaced in re" THAT FINDING and memory related to search to determine age. In the current ginkgo biloba's effect on LEADS US TO study, Winter used 20age-related cognitive SPECULATE THAT deficits, using rats as an month-old rats, which IN ADDITION TO animal model. were assigned a diet "At a certain point in GINKGO BILOBA'S that included either our analysis, we realized ginkgo biloba extract PURPORTED that the rats who were or no extract. Over sevBENEFICIAL EFFECTS receiving ginkgo biloba eral weeks, the animals ON BRAIN FUNCTION , were living substantially performed tasks in the longer than those who radial maze that reTHE EXTRACT were not receiving the quired them to master MAY ALSO HAVE A extract," says Jerrold C. new challenges andrePOSITIVE EFFECT ON Winter, PhD, professor of tain learned informapharmacology and toxition over time. LONGEVITY," Results cology in UB's School showed that rats of Medicine and Bioreceiving ginkgo medical Sciences and biloba extract author of the study. learned more "That finding quickly and made leads us to specufewer errors than late that in addition control animals to ginkgo biloba's and-unexpectpurported beneficial edly-that they effects on brain lived an average function, which our of five months study supports, the longer. Winter extract may also found a significant have a positive effect positive relationship beon longevity. " Results of tween the amount of active ingredient the study appear in the January 1998 and the degree of learning. The standard issue of Physiology and Behavior. dose during most of the study was 50 Ginkgo biloba is available in the U.S. mglkg. However, one subgroup of anias a dietary supplement but is not apmals was assigned to receive EGb 761 in proved by the FDA as a medical treatdoses of 100 mg/kg followed by 200 mgl ment. It is prescribed widely by physikg, interspersed with periods when they cians in Germany and France in the performed tasks while receiving no exform of EGb 761-a complex mixture Ginkgo Biloba Study Indicates Po~tive Effect on Longevity a u f f a l o Physic i an l 9 9 8 ' ' tract. Results showed that at the highest dose, errors declined by 50 percent. "Despite the urgent need to discover drugs able to prevent, delay , ameliorate or cure age-related memory impairment and the degenerative dementias, progress has been slow," Winter states in the article. Two major reasons for this, he notes, are a lack of agreement on appropriate animal models and on their applicability to humans when memory and cognition are concerned, and the absence of a drug proven to work in humans that could serve as a standard in animal tests. "The present demonstration of positive effects of EGb 761 in animals, a substance for which abundant evidence exists of at least a modestly beneficial clinical effect in humans, is encouraging on both points," Winter says. "The challenge now is to identify, from this mix of perhaps 200 chemicals, which chemical or chemicals are producing these pharmacologic effects. " This study was supported in part by Dr. Willmar Schwabe Gmbh & Co. of Karlsruhe, Germany, manufacturer of EGb 761. B A K E R L 0 I 5 Saliva Shown to Be as Reliable as Blood forDNA Screening a!iva appears to be as good as blood as a source of genetic material needed to screen people for inherited diseases, a University at Buffalo oral biologist has shown. The discovery could simplify the screening process enormously, eliminating the risks and complications of handling, storing and transporting blood, including the risk of contact with blood-borne viruses. It also would allow persons who cannot or will not give blood to be screened, and would be a boon to the needle-phobic. �[1] . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . "This is such a clean, reliable, quick, was conducting a major research easy test," says Rob van Schie, PhD, a project involving genetic screening of children for potential UB postdoctoral associrisk factors for juvenile ate in the Department of "SOME PATIENTS periodontal disease, a Oral Biology and lead reMAY BE RELUCTANT particularly aggressive searcher on the discovTO SUBMIT TO form of gum disease that ery. "There are no PHLEBOTOMY tends to run in families. needles. Samples can be PROCEDURES ON Mark Wilson, PhD , forcollected by untrained RELIGIOUS OR merly of the UB School personnel. And it's great CULTURAL GROUNDS, of Dentistry , is the for children, because WHILE OTHERS MAY project leader on that they love to spit." SIMPLY BE APPREHEN· research . Forensic scientists Excited by the possiSIVE; HENCE, AN have used many materibility of having his als as a source for DNA ALTERNATIVE TO THE young research subjects evidence, but blood is USE OF BLOOD FOR spit into a test tube incurrently the most comGENETIC STUDIES MAY stead of being stuck with monly used source of BE DESIRABLE." a needle , van Schie DNA for genetic testing, both for clinitested the salivary :t.. DNA theory using cal use and for basaliva and blood sic research, van from himself and Schie notes. Unforhis wife. Finding tunately, the use of the genetic material blood has many in the blood and sapractical disadvanliva samples indistages and inherent tinguishable , he limitations. collected blood "Blood sampling is invasive and -..~_...,, and saliva samples from 69 adult volpainful, and it inunteers to test the volves a potential theory further. risk of contamination Using polymerase chain reaction, he with hepatitis and the human immunodeficiency virus," he states in his study, was able to show that DNA from saliva published in the October 1997 issue of was as precise as that from blood in revealing polymorphisms in two genes the journal of Immunological Methods. "Some patients may be reluctant to thought to play a role in the developsubmit to phlebotomy procedures on ment of juvenile periodontal disease. The results pertain to only two genes religious or cultural grounds, while others may simply be apprehensive; whose sequence is known, van Schie hence , an alternative to the us e cautions, and although its potential of blood for genetic studies may be appears very promising, the method desirable." has not been proved universally. Like Van Schie was struck with the idea others, he predicts that genetic screenfor the study after hearing a news ing for disease-the subject of a recent report on the Unabomber investiga- editorial in the journal of the American tion telling of successful DNA analy- Medica/Association-will become rousis of dried saliva from a stamp used tine in the near future . by the suspect. At the same time, he Van Schie's findings could increase ~lE~~~~~::;, ® a u I I a t o this momentum, and make genetic testing easily available to populations presently outside the medical mainstream. The research was supported by the ationallnstitute of Dental Research. + -LOIS B AKER Nitric Oxide for Treatment of Aspiration Pneumonia May Do More Harm than Good ohn Belushi, Janis Joplin , Jimi Hendrix and several other pop icons are believed to have died due to regurgitation of stomach contents into the lungs while they were unconscious, an event that precipitates aspiration pneumonia. Aspiration pneumonia also is one of the leading causes of death in pregnant women, who are at risk of developing the condition when they give birth under general anesthesia or undergo other surgery. Researchers in the University at Buffalo's Department of Anesthesiology have found that inhaled nitric oxide, a new therapy being tested to treat serious respiratory ailments, may do more harm than good if used for aspiration pneumonia. They have reported new information about the progression of this potentially fatal form of lung inflammation. Results of their studies were presented recently at the American Society of Anesthesiologists annual meeting in San Diego in November 1997. "We're looking at the mechanisms involved in aspiration-induced lung injury, how we can treat this disease, and how to avoid things that make the injury worse," says Paul Knight, MD, professor and chair of the UB Department of Anesthesiology and senior researcher on the studies. Physician 5 p r I n g 1 9 9 8 �- ~~~ --·---------- --~------ ·----- .................................................................................. -- - - ········ ~ ~ ,,,~WI ' Aspiration of stomach contents oc- synergistically to produce an increase in curs during unconsciousness brought reactive nitrogen species that are toxic on by anesthesia, trauma, drug over- to lung tissue. There was no effect of the dose or other circumstances. When un- combined therapies on lung injury from conscious, a person loses the natural aspiration of gastric particles. Knight reflexes that prevent food particles and! says these two etiologic agents have or stomach juices from entering the been shown to use different pathways in respiratory system. Stomach contents producing inflammatory lung injury. "This observaoften are highly acidic. tion, along with our When acidic matter previous findings comes in contact with of microvascular tissue lining the air and functional passages of the lungs, changes with exa cascade of events reposure to nitric sults that can lead to a oxide and oxygen, decreased ability of the llii!IIIIP:!~~"l suggests that caulungs to transport oxytion should be gen. Even when the taken in using process is internitric oxide in rupted , the initial acute inflammatory damage inflicted may lung injuries that eventually prove fatal also require oxygen due to later-occurring reac"WE'RE LOOKING AT therapy," he says. tions, Knight says. THE MECHANISMS Another study by the One of the newest therasame team centered on pies for treating inflammaINVOLVED IN the relationship of the tory lung injury is inhaled ASPIRATION-INDUCED concentration of food nitric oxide, which can bring LUNG INJURY. HOW particles aspirated to the dramatic improvement in severity of lung damage WE CAN TREAT THIS oxygenation in some paand the progression of tients. Giving supplemental DISEASE. AND HOW the damage. Results oxygen also is a standard TO AVOID THINGS showed that most of the therapy to improve oxidadamage occurred durTHAT MAKE THE tion during lung injury. ing the first five hours Knight and colleagues exINJURY WORSE. " after aspiration and amined administration of remained unchanged oxygen and nitric oxide toafter 15 days. " ot surprisingly," Knight gether in acid-injured and normal lungs, using rats as an animal model. They says, "the higher the concentration of administered nitric oxide at the rate of particles, the greater the damage." Researchers on the studies, in 80 parts per million for five hours to addition to Knight, were ader lung-injured animals, while the animals ader-Djalal, MD, Bruce A. Davidson, also received either 90 percent oxygen or 20 percent oxygen. Lung injury was and J erzy C ios, MD , of th e UB caused either by acidic liquid or gastric Department of Anesthesiology; David particles. A control group with normal Steinhorn, MD, of the UB Department of Pediatrics; and Kent Johnson , MD, lungs also was examined. Results showed that when lung injury of the University of Michigan Departwas caused by aspiration of acidic liq- ment of Pathology. + - uid, nitric oxide and oxygen worked B u f f c l o 5 p r I L n o g 8 l 5 1 A K E R 9 9 8 A D H D c 0 N T '0 F R 0 M ' ' p A G E 7 researchers were able to devise a way to "tease out" what the children expected to happen due to the Ritalin versus how the drug actually affected them. Published last year in Experimental and Clinical Psychopharmacology (1997. Vol. 5, o. l. 3-13), the study took more than five years to complete and involved four consecutive cohorts of 40 children each, with follow-up studies conducted in regular school classes and laboratory settings. "Across all those cohorts, all those settings, all those kids, we found no evidence that expectancy does anything. It makes no difference whether a child with ADHD thinks he took a regular pill or a placebo," reports Pelham. "So all those people arguing over the years, saying that these kids would learn to attribute their successes to taking a pill, turned out to have unfounded concerns." The drug study Pelham is currently conducting on the long-acting version of Ritalin is being done within the context of the Saturday Treatment Program. He is planning other, ongoing studies to take place within the settings of both it and the Summer Treatment Program. Despite the many successes of his programs and studies, Pelham is the first to admit that much work still needs to be done to better understand this complex disorder. "Right now there is no single effective, comprehensive treatment program for ADHD; it hasn't been discovered." But the high societal cost of juvenile delinquency, adult incarceration, alcohol and drug abuse and mental health services reminds him and his colleagues every day how critical it is to continue to search for effective treatments for children with ADHD before their lives spin out of control in ways that even the most organized and focused of individuals would have difficulty overcoming. For more infonnalion on the summe1 treatment program 01 the upcoming clinical oial of long-acting methylphenidate, call (716) 645-3650, ext. 373. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 I I AWord from the Dtrector of Development B Y L I N D A J . C 0 R D E R , P H 0, C F R E to the many people who supported the School of Medicine and Biomedical Sciences a tan exemplary level in 1997.Inso doing, they became members of the Class of 1997 of the school's esteemed james Platt White Society. Since its founding in 1986, the society has grown from a small group of dedicated alumni to an organization of more than 200 alumni and friends, who are generous investors in the future of medical education and training at UB. An executive committee of active society members works with the development staff to increase philanthropy to the school and plan recognition events for members. Publishing this list of the school's most generous donors gives Dr. Wright and the executive committee, as well as all of us who work daily on behalf of the school, an opportunity to show our appreciation. The society currently offers two types of recognition: annual and lifetime. A gift within any year confers an annual membership for the following year. Honorary lifetime society membership is granted when cumulative contributions of a couple or an individual reach $50,000. There are also a few "special" members who received "term memberships"for a specified time frame. Although no new special memberships have been granted since 1992, we honor those earlier commitments. Most special memberships will expire at the end of 1999. Historically, the society held a recognition event in the fall, retroactively compiling a list of those whose gifts had been received from November 1 of the previous year through October 31 of that year. Last year, the society (by a mail vote) decided to migrate to a calendar year. Thus, this year's Honor Roll includes donors of contributions received from November 1, 1996, through December 31 , 1997. For a variety of reasons, the james Platt White Society Class of 1997 is the largest and most prestigious in the history of the organization. These individuals and couples who support the medical school at an outstanding level are seen as its closest friends. They receive additional information throughout the year and invitations to certain medical school and university events. Best of all, this group keeps expanding. It is a welcom- ® B u f f a l o ing and inclusive organization, since the more "best friends" the school has, the more excellent it becomes. Many donors made year-end gifts in both 1996 and 1997; our overall total gift amount is higher than it would have been in twelve months. Others made only one gift during the 14 months. Some made gifts in honor of a class reunion; thus, the current list includes gifts from two sets of reunion classes. There are several individuals and couples who are in the society for the first time, based on two or more gifts made at different times during the 14-month year. Finally, those marked with an asterisk (*) are GOLD members of the societyGraduates of the Last Decade-whose gifts during this time frame totaled between $500 and $999. The lower entry level for more recent graduates was instituted during 1996 to encourage newer alumni to take their place in this society. Most gifts were designated for the school's General Fund, disbursed at the dean's discretion. A few gifts were designated for special projects, such as the Neuroanatomy Museum, or as contributions to departmental funds, which are disbursed at the discretion of the chair for such uses as research seed money or student medical association activities. Donors designated most of the larger gifts for a particular purpose, generally for named endowments. Living donors listed in this Honor Roll collectively contributed $997,429 to theschool.In addition, the school received more than $130,000 from testamentary trusts and bequests during this time frame. We are deeply grateful for all gifts to the medical school, especially those that have the potential to make a transforming difference in the quality of medical education and residency training offered at UB. Read through the roster of members. Thank your friends and colleagues listed here for their outstanding support. If you are not yet in this group, please consider increasing your contributions to the school. The executive committee would like to see this group continue to grow, and increase its significant impact on the academic environment of the UB School of Medicine and Biomedical Sciences. + Linda]. Corder (Ly n) is associate dean and director of development. She may be reac hed by phone at (7 16) 829·2773 or by E- mail at ljcorder@acsu.buffa lo.edu Phys i cian 5 p r I n g 1 9 9 8 �----~= ---~- ------~~ · .~ - - - - - - - - - - - - - - - - - - - - ---- - ~----- ························································································a · '~ I The James Platt White Society I . . '. Lifetime Members When cumulative contributions reach $50,000 or an irrevocable deferred gift is completed for $100,000 or more, a couple or individual is granted lifetime membership in the society. ames of Founders are repeated in an annual category when they make a new gift. Mrs. Catherine Fix Dr. Eugene]. Hanavan] r. Martinsburg, WV Buffalo, NY Dr. JohnS. &: Mrs. Doris M. Parker-Latrobe, PA Dr. Thomas F. Frawley Chesterfield, MO Richard]. agel, M.D.,&: Mrs. Florence Nagel Dr. &: Mrs. Edward Shanbrom Santa Ana, CA Mrs. Christina Gretschel Genner Orchard Park, NY Ms. Pamela F. Skaper Potomac, MD Dr. Elizabeth P. Olmsted Ross Hamburg, NY Dr. &: Mrs. Pasquale A. Greco Buffalo, NY Dr. and Mrs. James]. White] r. Buffalo, NY Buffalo, NY Dr. Glen E. &: Mrs. Phyllis K. Gresham-Snyder, NY Dr. Syeda F. Zafar &: Ms. Mona S. Zafar Dr. Thomas]. & Mrs. Barbara L Guttuso-East Amherst, NY UB's founders envisioned a school to train students for service to the community. The society's Founders help to actualize that vision by providing support for programs that enrich the academic environment and enhance medical training. Dr. Kenneth M. &: Mrs. joan Alford-Buffalo, NY Mrs. June M. Alker Williamsville, NY Buffalo, NY Mrs. Morris Lamer New York, NY Mrs. GraceS. Mabie Orlando, FL Dr. Charles D. Bauer &: Mrs. Mary A. Bauer Dr. Eugene R. &: Mrs. june A. Williamsville, NY Dr. Joseph &: Mrs. Helene Chazan-Providence, RI Richard]. agel, M.D.,&: Mrs. Florence Nagel Dr. Philip D. &: Mrs. Colleen Morey-Williamsville, NY Orchard Park, NY I Professors ' Hilton Head Island, SC Buffalo, NY Miss Thelma Sanes Williamsville, NY Dr. Kenneth M. &: Mrs. Joan Philip B. Wels, M.D.,&: Mrs. Elayne Wets-Buffalo, NY ALford-Buffalo, NY Buffalo, NY Dr. joel M. Bernstein MEMBERS Dr. joseph G. Cardamone Eden, NY I Dean ' s Circle Dr. Thomas F. Frawley Chesterfield, MO Individuals or couples qualify as members in the Dean's Circle with generous gifts of $25,000 or more. Dr. Richard Ament Dr. George MEllis Jr.&: Mrs. Kelly Ellis-Connersville, IN Williamsville, NY Mrs. Grant (Evelyn) Fisher Lakeview, NY Ms. Rose M. Ellerbrock a l o Physician s n East Amherst, NY Dr. Richard B. &: Mrs. Ellen B. Narins-East Aurora, NY Dr. Bernice W. oble Amherst, NY Dr. james&: Mrs. Marcella Phillips-Buffalo, NY Dr. Seth A. Resnicoff Concord, NH Mr. Eugene M. &: Mrs. Susan W . Setel- Buffalo, NY Lewiston, NY I Mr. W. Russell Hurd Sun City, AZ Buffalo, NY r Albany, NY Mr. Arthur H . Judelsohn Dr. John C. Newman p Buffalo, NY Dr. Myron Gordon Tonawanda, ,'JY Dr. Warren R. Montgomery Jr. Amherst, NY Dr. Robert]. Gillespie Dr. Albert G. Rowe Dr. Earl S. Gilbert Buffalo, NY Dr. Willard &: Mrs. Clarice Bemhoft-Snyder, NY f Circle A strong faculty is central to a great university as are the supporters whose annual gifts range from $5,000 to $9,999. Dr. Elizabeth P. Olmsted Ross Buffalo, NY f Dallas, TX Dr. Jack C. &: Mrs. Patricia Fisher-Lajolla, CA Williamsville, NY Dr. Kenneth H. Eckhert Sr. &: Mrs. Marjorie Eckhert Dr. Kenneth Z. Altshuler Dr. Albert C. &: Mrs. Linda Rekate ANNUAL Dr. joseph &: Mrs. Helene Chazan-Providence, RI Fellows within the school bring added depth to postgraduate study. Within the society, Fellows are honored for gifts that total $2,500 to $4,999. Dr. Harold &: Mrs. Anne Brody Amherst, NY Mr. Sheldon Berlow Dr. Willard &: Mrs. Clarice Bemhoft-Snyder, NY Fellows' Circle Dr. Richard B. &: Mrs. Ellen Narins-East Aurora, NY Williamsville, NY u Circle Just as a department chair leads a program , donors of leadership gifts in the range of $10,000 to $24,999 are given special recognition. Dr. Eugene]. Hanavanjr. Dr. Charles D. Bauer&: Mrs. Mary A. Bauer B East Amherst, NY I Chairs ' Mindell-Buffalo, NY Founders' Circle I g 1 9 9 8 Drs. Robert &: Claudia Smolinski-Orchard Park, NY �· · · ·· · · · ·· · · · · · · · · · · · · · · · ·· · · · ·· · ·· · · · · · ·· · · · · · · · · · · · [!] l ~ 0 I Scholars ' Circle Scholars within the society made gifts to the school totaling $1,000 to $2,499 during the past year. Young Scholars (*) are graduates of the last decade who qualified with gifts of $500 to $999. Drs. Evan & Virginia Calkins Dr. Penny A. Gardner Los Altos, CA Hamburg. NY Drs. Andrew & Helen M. Cappuccino*-Lockport, NY Dr. icholas C. Carosella Dr. Arthur C. & Mrs. Klein Los Angeles, CA Dr. Ronald F. Garvey Dr. Robert A. Klocke Dallas, TX Williamsville, NY Dr. Kenneth L. Gayles Dr. & Mrs. Franklyn G. Knox Rochester, MN Appleton, NY Buffalo, NY Dr. Yung C. Chan Dr. Lawrence H. & Mrs. ancy Golden-Eggertsville, NY Dr. Jacob S. Kriteman Draper, VA Dr. William S. Andaloro Dr. & Mrs. Norman Chassin Dr. Peter H. Greenman Dr. Paul S. Kruger Caledonia, NY Williamsville, NY Fairfax Station, VA Watertown, NY Dr. Salvatore Aquilina Dr. Michael E. & Mrs. Joan Cohen-Williamsville, NY Dr. Glen E. & Mrs. Phyllis K. Gresham-Snyder, NY Dr. Thomas]. Kufel Lockport, NY Dr. George & Mrs. Susan Bancroft-Hamburg, NY Dr. Mark & Mrs. Kathleen Comaratta-East Amherst, NY Dr. Robert T. Guelcher Dr. Ivan W . Kuhl Erie, PA Wimberley, TX Drs. Kevin & Elizabeth P. Barlog-Amherst, NY Lyn Corder, Ph.D. Gerard T. Guerinot, M.D., & Mrs. Geri Guerinot Drs. Joseph L. & Marie L. Kunz Buffalo, NY Dr. Charles A. Bauda Dr. & Mrs. Daniel E. Curtin Rochester, NY Boynton Beach, FL Orchard Park, NY Dr. Mala R. Gupta Dr. Ralph T. & Mrs. Rita Behling- San Mateo, CA Richard H. Daffner, M.D., & Mrs. Alva K. Daffner Rochester, NY Dr. Richard A. Berkson Pittsburgh, PA Williamsville, NY Dr. Stanley B. Lewin Rancho Palos Verdes, CA Dr. Nedra]. Harrison Carlisle, PA Dr. Harold Bernhard Dr. David R. & Mrs. Sherrye Dantzker-Ros1yn, NY Buffalo, NY Drs. Roger S. & Roberta A. Dr. Donald R. Hauler Buffalo, NY Dr. Theodore S. Bistany Dayer- Buffalo, NY Pensacola, FL Dr. David L. Marchetti Buffalo, NY Dr. Robert]. Dean Kinston, NC Dr. Reid R. & Mrs. Elenora M. Heffner- Buffalo, NY Dr. Willard H. Boardman Winter Park, FL Danvers, MA Marilla, NY Lockport, NY Dr. Andre D. Lascari Poestenkill, NY Dr. Harold]. & Mrs. Arlyne Levy- Amherst, NY Mrs. Gilda L. Hansen Buffalo, NY Dr. Jack & Mrs. Inez Lippes Buffa lo, NY Dr. Michael A. & Mrs. Glenda Mazza-Spencerport, NY Gerard]. Diesfeld, M.D. Dr. Orvan W. Hess Dr. Dennis L. Bordan Port Washington, NY Arcade, NY North Haven, CT Dr. Melvin B. Oyster Dr. William]. Hewett Harry L. Metcalf, M.D. , & Kaaren]. Metcalf, Ph.D. Dr. Suzanne F . Bradley Niagara Falls, NY West Hartford, CT Williamsville, NY Whitmore Lake, Ml Dr. Robert Einhorn Dr. John M. Hodson Dr. Merrill L. Miller Dr. Martin Brecher North Brunswick, Nj Williamsville, NY Hamilton, NY Amherst, NY Dr. & Mrs. Russell Elwell Dr. James B. Bronk Napa, CA Mayville, NY Dr. Dennis C. & Mrs. Suzette HoUins*-Greer, SC Dr. Maynard H. Mires Jr. Georgetown, DE Dr. Melvin M. Brothman Snyder, NY Dr. Domonic F. & Mrs. Margaret E. Falsetti Lewiston, NY Robert M. Jaeger, M.D. Dean Mitchell , M.D. Allentown, PA Cortland, NY Dr. Kenneth L. & Mrs. Jane Jewel- Mountain Lakes, NY Satellite Beach, FL Dr. Stephen T. & Mrs. Mary Dr. Joseph F. Monte Dr. George H. Mix New York, NY Dr. John A. & Mrs. Karen Feldenzer- Roanoke, VA Dr. August A. Bruno Dr. Helen MarieS. Findlay Joyce-Buffalo, NY Buffalo, NY Buffalo, NY Eggertsville, NY Dr. John D. Mountain Dr. William M. Bukowski Drs. Susan Fischbeck & Patrick T. Hurley- East Concord, NY Drs. James R. KanskiJr., & Genevieve Kanski Eggertsville, NY Dr. Arthur W . Mruczek Sr. Dr. Thomas D. & Mrs. Grace A. Flanagan- Williamsville, NY Dr. Paul B. Karas* Medina, NY Rancho Mirage, CA Buffalo, NY Dr. Dr. Jennifer L. Cadiz Dr. Neal W . Fuhr Getzville, NY Mechanicsburg, PA Williamsville, NY Dr. & Mrs. Kenneth Kim Clinton, NY Dr. Hans F. Kipping Sylvania, OH Ms. Deborah Elliott Brown Buffalo, NY Dr. William M. Burleigh Manhasset, NY irrnala A. Mudaliar Dr. Richard L. Munk Williamsville, NY ® a u f f a 1 a Physician 5 p r I n g 1 9 9 8 �········· · ··············································································a · \ ... I Dr. Masao Nakandakari Honolulu, HI Dr. Edwin A. Salsitz ew York, NY Dr. Charles S. &: Mrs. Anne R. Tirone-Williamsville, NY Dr. &: Mrs. Marvin Z. Kurian Williamsville, NY Dr. Nancy H. Nielsen Orchard Park, NY Dr. Arthur]. &: Mrs. Elizabeth Schaefer- nyder, NY Dr. Bradley Truax Lewiston, NY Dr. Timothy T. &: Mrs. Cynthia ostrant-Saline, Ml Dr. james N. Schmitt Kenmore, NY Dr. joan A. Vivona&: Mr. Robert L. DeiszJr.*-Elma, NY Harry L. Metcalf, M.D., &: Kaaren]. Metcalf, Ph. D. Williamsville, NY Dr. john&: Mrs. Michelle M. O'Brien*-Pinellas Park, FL Dr. Robert . Schnitzler San Antonio, TX Dr. Coolidge S. &: Mrs. Edith Y. Wakai-Honolulu, HI Dr. Thomas P. &: Mrs. Sandy O'Connor-East Amherst, NY Dr. Adolphe].&: Mrs. ancy L. SchoepOin-Tucson, AZ Dr. Arnold Wax Henderson , NV Mrs. Marguerite T. O'Gorman Eden, NY Dr. joseph I. Schultz Harbor City, CA Drs. Charlotte C. &: Hyman Weiss-Highland Park, Nj Dr. Kathleen A. O'Leary &: Mr. Michael]. Collins* Buffalo, NY Roy E. Seibel, M.D. , &: Mrs. Ruth H. Seibel-Eggertsville, NY Dr. Frederick D. Whiting Vestal, NY Dr. Molly R. Seidenberg Rochester, NY Dr. Gary J. Wilcox Carlsbad, CA Dr. Arthur M. eigel Guilford, CT Dr. Richard G. Williams Clearfield, PA Dr. john B. Sheffer Williamsville, NY Dr. John R. &: Mrs. Deanna P. Wright-Williamsville, NY Dr. Timothy S. &: Mrs. Karen S. Sievenpiper-East Aurora, NY Dr. Gregory E. Young Holland, NY Dr. Byron A. Genner Ill Potomac, MD Dr. james A. Smith Orchard Park, NY Dr. Wende W. &: Mr. W illiam]. Young Ill-Canandaigua, NY Dr. Charles D. Kimball Bellevue, WA Dr. Robert G. Smith Savannah, GA Dr. Franklin&: Mrs. Piera Zeplowitz-Buffalo, NY Dr. Clara A. March Buffalo, NY Dr. Donald H. Sprecker Leeds, MA Dr. David C. &: Mrs. Susan D. Ziegler-Walnut Creek, CA Dr. Mark W. Welch Rochester, NY Dr. Ralph M. &: Mrs. june M. Obler-Los Angeles, CA Dr. joseph]. O liver Jr. Rock Springs, WY Drs. Dean E. &: Donna W. Orman-East Amherst, NY Dr. Victor A. &: Mrs. Virginia Panaro-Snyder, Y Dr. Margaret W. Paroski Buffalo, NY Dr. Robert]. &: Mrs. Patricia M. Patterson-Snyder, NY Dr. Norman L. Paul Lexington, MA Dr. Clayton A. &: Mrs. Susan Peimer- Eggertsville, NY Dr. Victor L. Pellicano Niagara Falls, NY john]. Squadrito, M.D. Troy, Y Special Members A few individuals and couples were granted multiyear memberships based on generous gifts made between 1989 and 1993. For most, special recognition will be granted through December 1999. All membersh ips in the society are now made only on an ann ual basis. Dr. james M. &: Mrs. Margo W . Strosberg-Schenectady, NY Dr. Bert W. Rappole jamestown, NY F. T. Riforgiato, M.D.,&: Mrs. Mary-Cecina W. Riforgiato Buffalo, NY Dr. Richard R. Romanowski Williamsville, NY Dr. Burton &: Mrs. Gloria Stulberg-Buffalo, NY Dr. Michael A. Sullivan Williamsville, NY Dr. David W. Butsch Montpelier, VT Dr. MichaelS. Taxier Worthington, OH Dr. Charles H. Rosenberg Stamford, CT Ms. janet F. Butsch Aurora, CO Dr. Wayne C. Templer Corning, NY Dr. Thomas C. &: Mrs. Georgia L. Rosenthal-Orchard Park, NY Mrs. Marvin (Helen) Winer Sarasota, FL In Memoriam The fo llowing individuals left generous bequests or made arrangements for gifts from testamentary trusts to be given to the School of Medicine and Biomedical Sciences during the past year. to ensure accuracy in these Elizabeth A. Storch Middleport, NY Dr. john Y. Ranchoff Fairview Park, OH Dr. john Naughton Buffalo, NY every effort Dr. james F. &: Mrs. Lillian Stagg-Tucson, AZ Dr. William C. Sternfeld Sylvania, OH Dr. Harold Pescovitz Cincinnati, OH Dr. John L. Butsch Buffalo, NY Dr. &: Mrs. James C. Tibbetts Madison, WI lists. Please contact Mrs. Mary Glenn in the Medical School Development Office if we have made an error or if you would like your name(s) to be listed differently in future recognition documents. Send mail to: UB Medical School Development Office, 3435 Main Street, Building #22, Buffalo, NY 14214-3013. Phone: (716) 829-2773. Fax: (716) 829-3395. B u f f a l o P hysician 5 p I r I n g 1 9 9 8 �[5;] . . . . . . .... . . . . . . . . . . . . . . . . . . . . .... ...... . . .... ... . . . . The Beginning of My Ouest BY P A M E L A C R 0 W E L L AST SPRING I HAD THE OPPORTUNITY to hear Dr. Carlos Roberto jaen deliver a lecture on smoking cessation during our third-year clerkship in family medicine. In that 60minute lecture, he opened my eyes to the serious side effects that tobacco use can have on a patient's health and the important role physicians can play in helping a Pam ela Crowell is a fourth -year patient to quit. His lecture was very motivating, and after class I found myself asking him how I could learn more about the topic. He had made me suddenly aware of how little I knew about smoking cessation and how ill prepared I felt as a future family physician. This was the beginning of my quest to become a smoking cessation specialist. I did not want to follow in the footsteps of so many clinicians who ignore the problem of tobacco use because of patient resistance and lack of time. I wanted to learn how to discuss tobacco use with my patients and how to avoid alienating them in the process. In subsequent discussions I had with Dr. jaen, we decided that I would gain the most valuable experience from direct interaction with both the patients and their physicians. As a result, we chose an inner-city primary-care facility, the Deaconess Family Medicine Center, as my primary work site. Our goals at the family medicine center were twofold: (l) to increase the identification of smokers, and (2) to improve the amount and quality of smoking cessation counseling offered to patients at the center. We attacked our first goal by devising a new charting system. We added smoking status to the vital signs and problem list and designed a separate smoking cesstudent at the University at Buffalo School sation progress note that was added to of Mcdicint• and Biomedical Sciences. each smoker's chart. My second role was to provide more intensive smoking cessa- stand my ground instead of running in tion counseling. This sometimes meant the opposite direction. I would inquire as simply talking with the patient about rea- to how much they knew about the effects sons why he or she should consider quit- of smoking on their body. "It's my body. ting. Other times, it entailed assisting the I can do what I want with it," I was told. patient in finding alternative activities to I would try a different angle. "Do you lighting up a cigarette during times of have children?" I asked. I wasn't always stress. Over the course of four weeks, I able to get the patient to admit to the talked with several hundred patients. It importance of cutting back on his or her did not take long to realHE HAD MADE ME SUDDENLY AWARE OF HOW LITTLE I ize that the best way to KNEW ABOUT SMOKING CESSATION AND HOW ILL learn about smoking cesPREPARED I FELT AS A FUTURE FAMILY PHYSICIAN. sation was through the patient's own experiences and attitudes. tobacco use, but I was often surprised at I would often take the opportunity to the number of positive responses I retalk with patients as they sat in the exam ceived from simply initiating an open room waiting patiently to be seen by their conversation. The patients themselves physician. I introduced myself as a medi- began to approach me, saying, "I've been cal student and mentioned that I was trying to cut back on my cigarettes for trying to learn more about smoking. Each years. Do you know anything that may patient reacted in a different way, and I be able to help me?" tried to cater my approach to each one's Whenever I encountered patients who response. Some patients resisted vehe- had successfully quit smoking, I enthusimently. "I'm not interested in quitting," astically asked how they accomplished it. they would tell me. I learned quickly to Some gave credit to their own willpower, ® B u f f a l o Physician 5 p r I n g l 9 9 8 �------- ------------~ -- -----~-- - ------------- --- - ---- ········································································· · ············· a others to a change in daily routine, or hypnosis or prayer. I discovered that the process was a very individual one but also one with great rewards. Another valuable learning experience was my participation in a Stop Smoking Clinic at the Roswell Park Cancer Institute. There was a wide variety of participants, ranging from young to old, first-time quitters to relapsers, and smokers to nonsmokers. The class was taught by Dr. K. Michael Cummings, a nationally recognized tobacco expert. He talked about all aspects of smoking, from the history of the tobacco industry, to the ingredients of cigarettes, to the effects of nicotine on the body, to various behavioral modification techniques. At the end of the sessions, I was thankful to have taken the class and was once again reminded that the best teachers WNY's of all were the participants themselves. One gentleman had returned to smoking after quitting for five years. "The first time I was able to do it cold turkey, right after I was hospitalized for a heart attack. I didn't touch them after that. I didn't even crave them, but then life started to get the best of me. Stress, you know? I was worrying about paying the bills all the time and the next thing you know I was lighting up a cigarette again, not even thinking about how much extra money each pack was costing me," he explained. It was a serious addiction, both physically and psychologically. Dr. Cummings listened to each story intently, then offered his own best anecdotes. One participant said, "I've tried everything: the patch, the gum, walking, drinking water. I just can't stand to go without them. Giving up cigarettes is like losing my best friend." Hearing these words, I wondered, "What could Dr. Cummings possibly say to that?" He always came up with something else that the person could try, a new way to think about the problem or a new behavioral modification technique. One day, at the end of the month , I was talking with Dr. Cummings and sharing with him how impressed I was with his ability to help so many people quit smoking. A smile crept across his face as he peered over his desk and replied, "Pam, I've never been able to make even one patient quit smoking. The patient doesn't quit smoking because of anything I tell her to try. The patient quits smoking because she is ready to quit herself." I walked out of the room adequately mystified, once again humbled by the oft-forgotten role that the patient plays in her own health. + - Exclusive - BMW Retailer THOSE LOOKING FOR MORE CONTROL IN THEIR LIFE CAN NOW FIND IT ON SLIPPERY PAVEMENT. THE ULTIMATE DRIVING MACHINE.e MSRP s64240 F. G. DOWNING s&99 1998 BMW 740i While the road of life may throw you an occasional curve, at least our All Season Traction helps you handle the particularly slippery ones. 30 mo. Lease FREE SCHEDULED MAINTENANCE Towne BMW 3030 Orchard Park Rd. Orchard Park, New York 14224 Phone: 675-2550 ALL SEASON TRACTION PMT based on 5500 cap cost reduction (or trade), 12,000 miles per year. 15 cents charge per mile for excess miles. First and last PMT. taxes and plate fees due at inception. Residual $43040 Service Loaners Available ••. Minutes From Rich Stadium a u f f a 1 o P hysician 5 p r I n g 1 9 9 8 �l!!l. ................................... . ......... . .................... . ..... scrub in on the consummate ousopportunitytoobserveand psychiatrist, part general medical doctor and part law- have been retired 11 years and surgeon's cases. One day , my yer. I am enjoying my work founder, president and CEO of am enjoying it. I'm still active good friend and classmate, Dr. as well as enjoying traveling HealthCare Plan , has been and doing well with my tita- Ferdinand Paolini, and I were and playing tennis. elected board chairman of the nium right hip and post-myocardial infarction, both in 1996. !live one-half mile from Marine co-retractor holders on a thowas non-profit and provider-based on Lesterhill Lake and fish a lot, very slow but meticulous sur- recently certified in medical di- health plans. The December 15, take care of my home and small gery, Dr. Stewart paused and rection for long-term care by 1997, issue of Newsweek maga- garden. My grandson is enter- the American Medical Direc- zine listed the highest rated ing his MD residency this spring. asked," eed to rest your arms 'Dr. Pawlini'7" Ferd replied ,"! don 't know Dr. Stewart, they've tors Association. Rosemarie Santora Lamm, his wife, re- HMOs in the U.S. and THMOG member plans accounted for the writes: been completely numb for the ceived her PhD in Applied top five-scoring health plans, and Thought you'd all like to see last 30 minutes. " The surgical team all relaxed a bit and even Medical Anthropology in De- 11 of the top 18. HealthCare cember 1997. Plan, under Goshin's direction, THEODORE W . BOB COLLINS , Koss , ' 43 , ' 41 , ] three of the class of March ARTHUR EDW I N R. LA MM, ' 60, Stewart "The Superb" chuckled a little. A great man could show a little humanity at times. has MAX A. S C HNEIDER , ' 49 , been elected chair of the a- tiona! Council on Alcoholism 1943. On the left is JOHN M ARA N T Z , ' 65 , of the Pathology Department Center in Corona, CA. Ambulatory and Community effective january 1, 1998. He Ml: In September 1996, I be- has served on the NCADD came corporate chairman of Di- FLET C HER , has been appointed vice-chair of Gardens, Florida; in the middle RICHARD KE N NETH BROMBE R G , ' 75, at Corona Regional Medical and Drug Dependence ( CADD) for a two -year term, iS ' 70 , was a founding member of THMOG. has accepted a new position as chair CA L VI N of Palm Beach Do N oHu E GOS HIN, The HMO Group (THMOG), a national alliance of integrated, racic sympathectomy case. After about 1 and l/2 hours of R . K E NN ET H M A TASAR , Pediatrics at the SUNY Health Sciences Center/Brooklyn (downstate). ' 68 , writes from Bloomfield Hills, Tequesta, Florida; and to his board since 1983. Widely agnostic of William Beaumont right is me, (lOO Waterway Rd, known in the field of alcohol- Hospital, a 930-bed teaching R O BERTS BU R N S, ' 8 3, Apt. 201A, Tequesta, FL ism and other drug addictions hospital , as well as a 190-bed ated from the University of Mem- 33469). I think it is great we as a teacher, author, lecture satellite hospital. We perform phis in December 1997 with a live together, play golf together and film producer, Schneider nearly 400,000 imaging stud- master's degree in playwriting. is the director of education for ies annually and have 35 radi- His play "Zen and the Fear of the Positive Action Center at ologists, 24 residents and 11 Flying" was produced in Pitts- Chapman Medical Center in Orange County, CA. He is a fellows. Judi and I have two sons. Our younger son is in his burgh this year. recipient of UB's Alumni Life second year of medical school and associate together all the time and are well. We go out to dinner all the time, which is great. We would love to hear from any of you and have you come and see us. We will have Achievement Award. attorney in 1 9 5 0 W ILLIAM S ULLI V A N , '55, writes: After 35 years of gen- bad . The best to all. eral psychiatry and psycho' 47 , analysis, I have changed my writes: Another Dr . john Stewart memory. In 1948, I was professional work to forensic psychiatry. I find this new an intern at M.M.H. on the sur- work interesting and demanding . One must be part CHARLES D . ROSS, gical service. l had the marvel- B f f recently, I heard a familiar voice ew York City. His from the past. Looking up, I wife is a third-year medical stu- much medicine has changed. We are glad we are retired. Too a l o SaW PAU L dent at Columbia University College of Physicians and Sur- practice at St. joseph Mercy Hospital in Ann Arbor. (I'm in in orthopedic surgery. PM&R.) As it turns out, Paul and his family live around the corner! Two '85ers on the has been promoted to captain in the U.S. Naval Reserve Medical Corps. p S HIELDS , y s c B E R KOW I TZ, ' 85 , who has joined a nephrology geons who is planning a career J O HN reports: While making the rounds at Harvard. Our older son is an a good time together. Can't believe its been 55 years and how JON WAR D N E R , '85, gradu- ' 68 , a n same block-there goes the neighborhood! 5 p 9 9 �········ ······· · ················ ·········· ····················· ·················· ······ ·[! ] THOMAs P. SMITH , JR. ' 87 , Washington Residency Pro- promoted to assistant profes- Langone, '96, is enjoying her pe- has been appointed medical di- gram in Rehabilitation Medi- sor and am now the director of diatric residency atthe University rector of Erie County Medical cine in 1995. Presently, he is obstetrical anesthesia at the of Texas and will stan in terview- Center's ca rdiac care and telem- an associate medical director University of New Mexico . etryunits. Heisa lsoanassistant professor of medicine, division at Whittier Rehabilitation Hospital in Westborough , MA. of cardiology, at UB. In this ca- He and his wife, Kathleen , pacity, Smith is clinical precep- ing soon for a general pediatric position in ANTHONY LANGONE , ashvi lle, TN. ' 96 , proudly announced the birth writes: I am currently in my second year of my interna l MOR G AN tor for third-y ea r medical of their son, Marc Daniel medicine residency at Baylor alumnus of UBs orthopedic students and lectures exten- Liguori , in july 1997. College of Medicine. After being residency, hand and spine accepted by l2 nephrology fellowship , is back home in Cajun CYNTHIA LEBER MAN JENSON , programs, 1 have accepted a po- country in private practice, hav- writes: Mark and 1 had sition at Vanderbilt University- ing successfully completed two our second child, Erica, on a three-year fellowship with international adoptions (one girl january 16 , 1998. She joins special certification in renal from China and one from Viet- transplantation. My wife, Susan nam) and planning more. sively on topics related to cardiovascular disease. ' 92 , 1 9 9 0 PAUL A . LIGUORI , ' 91 , gradu- ated from the University of Alexandra, now three . 1 was P. LORIO, ' 88 , Four UB Alumni Presented AMA/GlaxoWellcome Leadership Award skills, and the Allegheny Regional resident at the State University of New F Development Corporation, which York at Buffalo School of Medicine and our alumni of the UniHrsity at Buffalo School of Medicine and Biomedical Sc1ences were presented the AMNGlaxo Wellcome Leadership Award at the AMA's interim meeting held in Dallas in December 1997 . The award, which was given to only 40 recipients nationwide this year , acknowledges resident physicians and fellows who have demonstrated a strong commitment to their civic or medical community through volunteer activities. Recipients arc given the opportunity to participate in the Am erican Med1cal Association's policy-making process by attending two meetings of the AMA Resident Physicians Sec tion (AMA-RPS ). The obJeCtive of the program is to encourage involvement among community-oriented physicians 8 u f f a I a P and to develop the skills of potential leaders of orgamzed medicine . Award recipients have their expenses paid to attend one annual and one intenm meeting of the AMARPS and the opening session of the AMA house of delegates. The four UB alumni receiving this award , and their contributions as described b) the AMA, are as follows: Biomedicol Sciences. Stephen J. Kimatian, MD '92, cochaired ofund· raising event for the Children's Hospital of Buffalo during medico\ school. Then while in the U.S. Air Force, he served as ofacilitator for teen and family support groups and coordinated school physico\ examinations and immunization reviews. Kimotion is on anesthesia resident at the Hershey Medico\ Center of the Pennsylvania State University. Kim S. Griswold, MD '94, volunteered os o clinician and on the board of directors of Conoon House, a home for women who ore reconstructing their lives after incarceration, where she developed o program to provide the women with health education and initiated o program to recruit other medico\ residents to volunteer. In 1989, she co-coordinated La Clinico Suyo, o free medico\ clinic for refugees and the uninsured. Griswold is o family medicine hyslcla 5 p r Martin C. Mahoney, PhD, MD '95, serves on the board of directors of the Contolicion Center, which provides health and education services to people with disabilities. He also volunteers with the Niagara Fron~er Vocational Rehobilito~on Center, which helps the disabled acquire and maintain voco~onol I n g I 9 9 8 provides health core to Native Americans with disabilities. Mahoney is a family medicine resident at the State University of New York at Buffalo School of Medicine and Biomedical Sciences. Andrew Sherman, MD '93, volunteers at two local boys and girls clubs in Seattle that serve under· privileged innercity youth. He coaches basketball year-round, providing leadership and o positive role model to 12-14-yeoriJ\d boys. He is ovolunteer physician for o loco\ high school team and provides physicals, game coverage and acute core of injuries. He also provides acute-core coverage for the spinal cord-injured patients at the Veterans Administro~on games. Sherman is o physical medicine and rehabilitation resident at the University of Washington Hospital in Seattle. an �& THE ULTIMATE DRIVING MACHINE: AMANA COLLECTS Checkpoint Foreign Car, Inc. Sales and Service 487 Kenmore Avenue Buffalo, NY 14223 Comprehensive Cost-Effective Receivables Management 836-2033 Your WNY Leasing Specialist Serving WNY proudly tor 33 years The roo f 1ooks funny, o dd , strange, and. \ike a mistake. But not from the inside. The waywe see it, why build a straight roof when you can build a perfectly good crooked one? It's something up to seven passengers in the Land Rover Discovery will truly appreciate. With the elevated roof and stadiumlike seating, passengers in the rear have ample headroom. DISCOVERY Land Rover Amherst A NORTHTOWN AUTOMOTIVE COMPANY 3560 Sheridan Drive Amherst, New York 14226 • (7 16) 831-3100 http//www. northrownauro.com Buffalo P hysic i an 5 p r I n g 1 9 9 8 �Who says there's nothing good on TV? As busy as they are, physicians and other health care providers always take the time to watch MLMIC's top-rated risk management education programs. When they tune into high quality programming broadcast over our satellite network, viewers know what they see will help enhance patient safety and reduce injuries. They also appreciate the policyholder discounts available to participating physicians. MLMIC programming is sponsored by the largest Risk Management Department of any professional liability insurer in the state. Policyholders also enjoy the protection of one of the country's largest and most experienced professional liability Claims Departments. Most importantly, MLMIC has successfully defended more physicians than all other available insurers combined. These are some of the rea sons why MLMIC is the only medical liability insurer approved by the Medical Society of the State of New York. To find out more, call1-800-356-4056 in Upstate New York, MLM~C led~ral ~ or 1-800-ASK- MLMIC in the New York metropolitan area. Ask for free copies of our risk management \ l.i.Jbilill ' lutual In-ur.mrr Company guide for office practices. • Our defense never rests. a u f f a l 0 Ph ys i cia n 5 p r I n g 1 9 9 8 2 Park Avenue New Yor k, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 C1996 Medical lial7ility Mutoallrtf1urance Company �BUFFALO PHYSICIAN Non-Profit Org. STATE UNIVERSITY OF NEW YORK AT BUFFALO U.S. Postage 3435 MAIN ST . PAID Buffalo, NY Permit No. 311 BLDG. 22 BUFFALO NEW YORK 14214-3013 C"t ISC E~IC~L 219t. HISTO !- L ~!­ A3 30TT LI Q~~y SER!~LS ADDRESS SERVICE RY -;:> ... ::. I REQUESTED To consult with someone truly concerned with your financial health, come to Key Your Key Private Banker heads a team of KEY PRIVATEBANK professionals, who can help you achieve your financial goals with surgical precision. Call Marv Madison at 716-847-2341. It may be one of the most important appointments you make. We know medical professionals' financial needs like the dorsum of our metacarpus. Key. For a new America~ BP 1002-98 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1998 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1998-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v32n02-1998-Spring Table Of Contents A list of subunits of the resource. The Sounds of Science Focusing Attention on ADHD Northern Exposure Merging Medicine with Business Medical School MPH Program Established Hospital News Research News A student's perspective Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-09 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v32n02 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1998 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/25d23c235dbdac2e36ce2da1eb43e40f.pdf 6b808860e4c531c12a44d210be2d37cf PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Winter 1998 Out with the Rote, -UNDERGRADUATE CURRICULUM RESTRUCTURED TO INCLUDE PROBLEM-BASED LEARNING in with the ew �BUFFALO PHYSICIAN Volume 32, Number I ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr. Carole Smith Petro DIRECTOR OF PUBLICATIONS Kathryn A. Sawner EDITOR Stephanie A. Lnger ART DIRECTOR/DESIGNER Alanj. Kegler PRODUCTION MANAGER Ann Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr john Wnght, lntcrun Dean and Vice PreSident for Clinical Affairs EDITORIAL BOARD Dr. Bertram Portm, Chait Dr. Manm Brecher Dr. Harold Brody Dr. Lmda j. Corder Dr. Alan j. Dnnnan Dr. james Kanski Dr. Barbara MaJerom Dr. Elizabeth Olmsted Dr. Charles Paganelli Dr. Stephen Spaulding Dr. Bradley T Truax Roy Vongtama Dr. Franklin Zeplowilz TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital Michael Shaw The Children's Hospital of Buffalo Erie County Medical Center Mercy Health System Millard Fillmore Health System Franll Sara Niagara Falls Memonal Medical Center Roswell Park Cancer lnsl!lule Sisters of Charity Hospital Dennis McCarthy Veterans Affairs Western New York Healthcare System ©The Stale University of New York al Buffalo Buffalo Physician is published quarterly by the Stale Universny of ew York al Buffalo School of Medicme and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alumni, faculty, students, residents, and friends. The staff reserves the nght to edit all copy and submissiOns accepted for publication. Dear Alumni and Friends, Nov. THAT 1997 HAS ENDED AND WE BEGIN to contemplate what made this year particularly interesting and challenging, several things come to mind. The rapid changes in the local health-care delivery system represent perhaps the most important of these issues, not only because they affect our primary mission-the education of future physicians-but also because of how the medical school enterprise is currently financed. The state budget provides only 13 tol4 percent of our annual expenditures, matched by approximately the same percentage from extramural-sponsored research programs. Since hospital support, which also includes the residents' salaries, accounts for approximately 23 percent of total expenditures and the practice plan, an additional 41 percent, over 60 percent of our funding is derived through the health-care delivery system. Changes in the financing of this system, together with its overall configuration, are therefore of vital interest to us. As we begin 1998, the merger of Buffalo General, Children's and Millard Fillmore hospitals is poised to occur, yet the consequences of the merger (for us and others) are far from clear. The Catholic system is undergoing similar merger discussions, while Erie County Medical Center and Roswell Park are in the process of determining their respective roles within this rapidly changing environment. As if this were not enough, we are actively engaged in reengineering the residency training programs in response to the well-publicized Medicare Demonstration Project, which calls for a 20 percent reduction in resident training positions over the next five years. This process has been complicated by the fact that most of our programs are dispersed throughout multiple hospital sites and in order to maintain quality (not to mention "accredited") programs, any significant downsizing will undoubtedly require program consolidation to fewer sites. The latter is further complicated by the financial implications to the participating hospitals and the availability of specialized training opportunities for specific program needs. The planning process is moving ahead, but many of the very difficult decisions are yet to come. Against this background, we must continue to develop innovative educational programs for our students, maintain the basic relevance of our curriculum and prepare our students for whatever future medical practice demands. (Fortunately, our students are an adaptable lot and probably better able to manage these changes than some of us older folks.) A number of exciting programs are under development to achieve these goals, some of which are presented in this issue of the Buffalo Physician. Finally, with 1997 having come to a close (and my first year as interim dean), I want to take this opportunity to wish each and every one of you a happy and fulfilling New Year! John R. Wright, MD Interim Dean, School of Medicine and Biomedical Sciences Interim Vice President for Clinical Affairs Dear Fellow Alumni, Change is definitely the key word and it is currently rapid and aggressive. With winter here, I would advise those physicians who ordinarily choose to hibernate, to forego the temptation and stay alert. If not, they could awake to a considerably different medical environment. The steady advancement and influence of managed care, combined with the merging of health systems and HMOs/insurance companies, is creating a sense of stress. With those thoughts in mind, it is refreshing that I have had the opportunity to reflect on the future of medicine through the eyes and perception of members of the younger generation. First-year student Ryan, who is my mentor partner, and my son jerry, a PGYI resident, visualize their medical careers with joy, anticipation and determination. How nice it would be if that vision could be projected to a number of my colleagues. Attitude is obviously the key to handling the stresses of change. Plans for the 1998 reunion weekend and Spring Clinical Day, April25, 1998, are well under way. Dr. John Bodkin is arranging a program on aging, and the reunion chairs are making arrangements and contacting classmates. An article in the autumn 1997 issue of the Buffalo Physician noted that the reunion class commitments in 1997 were increased by 48 percent. Let us keep up the momentum. It is badly needed in this era of rapid decline in state support. Please plan on joining us in celebrating and supporting your excellent medical school. ~B.c:~.M~~ President, Medical Alumni Association �VOL U ME 32 , NUMBER 1 WINTER Out with the Rote, in with the New 2 CURRICULUM 12 Medical Student Exchange to Bosnia 18 EXPERIENCE BRINGS NEW RESTRUCTURED TO PERSPECTIVE TO U B INCLUDE PROBLEM- STUDENTS BASED LEARNING by Michael Beebe 1998 Communication Skills lor Tom~rrow's Physicians NEW PROJECT TO MORE FORMALLY INTEGRATE TEACHING OF EFFECTIVE by S. A. Unger COMMUNICATION SKILL S photos by Frank Cesario by S. A. Unger Heidi DeBlock, MD, PARLAYS HER FASCINA- TION WITH SPACE INTO REGULAR STINT AT HOUSTON'S LB.J SPACE CENTER New Computer Lab by Nicole Peradotto NEW "E-TECH" COMPUTING LAB GIVES STUDENTS ACCESS 3 Medical School DAVID K. MILLER , MD, "A GIANT IN HIS FIELD," TO STATE-OF-THE ART DIES AT AGE 93. LEARNING TOOLS COLLEAGUES AND by Scott Thomas STUDENTS REMEMBER HIM . Astudent's perspective: THE CHALLENGE TO SUSTAIN THE HUMAN - ITY WITHIN US Department Honored AMERICAN .JOURNAL OF 32 Resemh News EPIDEMIOLOGY DEDI- CATES SPECIAL TO UB' S Alumni ISSUE DEPARTMENT REUNION DAY by F. Michael Elliot OF SOCIAL AND PREFESTIVITIES PLANNED VENTIVE by Lois Baker Cover iiiU>Irolion by Wh~ney Shermon. MEDICINE 38 Class notes �PHOTOGRAPHS BY fRANK CESARIO OuT WITH THE ' IN WITHTHE BY S. A. UNGER -UNDERGRADUATE CuRRicULUM REsTRUCTURED TO INCLUDE PROBLEM- BASED LEARNING Changes are currently taking place in medical school curricula that can only be compared in magnitude to changes that took place more than 30 years ago, when curricula were restructured in response to physician shortages in select specialty areas. Ironically, while the changes several decades ago were fostered by a need to include new, specialized knowledge in the curriculum, today's changes are in large part motivated by an admission that the body of knowledge, especially in the basic sciences, has grown so large and complex that no person can be expected to absorb it all-not in four years of medical school, not even in a lifetime. Enter the concept of lifelong learning. Instead of trying to teach medical students everything they could possibly need to know about a seemingly endless number of subjects, educators at the University at Buffalo School of Medicine and Biomedical Sciences and other institutions worldwide are exploring a new concept: What about teaching students to 0 B u f f a l a master processes whereby they can teach themselves how to learn whatever it is they need to learn-using as their base a strong fundamental knowledge of the basic sciences? As in the real world of medical practice, this new form of learning is necessitated when a case is encountered, along with its specific problems. The method being used to foster learning in this way is called problem-based learning; in a larger context, it is also referred to as case-based learning. At UB's medical school, problem-based learning (PBL) is the foundation upon which the undergraduate curriculum for the basic sciences has been dramatically restructured to include a new two-year course called the Scientific Basis of Physician W I n t e r 1 9 9 8 �It is this rethinking of learning methods that has led medical educators to focus on the development of courses that utilize PBL, which emphasizes learning in small, self-directed, s tuden t-een tered groups. A few schoolsincluding Harvard Medic a l School , Small, self -directed, student-centered groups ore through its New integral to problem-based learning. Pictured ore Pathways Program first-year students with facilitator Joan Boizer, PhD. -have devoted their entire curriculum to a PBL format , but at UB , as in most schools, PBL is used to supplement a scaled-back number of core lecture courses. "At UB, what we're looking for is a balance," explains Dennis A. adler, MD, associate dean of the School of Medicine and Biomedical Sciences. "There is material that we believe is core material and is most effectively taught-and certainly more efficiently presented-through didactic lecture. " To effect this balance, therefore , and to accommodate inclusion of the SBM course, lecture time at UB has been reduced by the equivalent of about a day a week. "We did this because we fully expect about 10 to 15 percent of what is learned through SBM to be new material," Nadler adds. Medicine, or SBM. The course was designed by Alan R. Saltzman, MD , MBA, professor of clinical medicine, clinical director of the Department of Medicine at Erie County Medical Center and former chair of UB's Curriculum Committee; and Murray Ettinger, PhD , Distinguished Teaching Professor of biochemistry. Given that SBM in many ways reflects a paradigm shift in medical education, it seems apt that it was launched at the start of the 1996 school year, with the Class of 2000 the first to be enrolled. While implementation of SBM has involved growing pains on the part of both faculty and students, those who have had firsthand experience with this innovative course agree that it merits close attention and support as it continues to develop. lOOKING FOR A BALANCE At the core of the current changes in medical school curricula is the realization that strictly lecture-based formats may not be the most effective way to teach today's medical students, given the ever-expanding body of knowledge that must be considered. Critics of the traditional, lecture-based curricula have called into question its tendency to emphasize rote learning of facts for multiple-choice examinations, its lack of a meaningful context and its purported failure to provide students with the problem-solving skills they will need throughout their careers. They maintain that what students really should be learning is how to analyze and solve problems; in other words , how to identify what needs to be learned, how to find information that can be used to develop a hypothesis and how to test this hypothesis by acquiring additional, more targeted data. B u f f a l o Physician W I n t e r 1 9 9 8 0 �Is A CouRSE FOR ADULTS the group must expand and refine the learning In their first year in the SBM course, students objectives for the case and agree to a schedule for are presented with five clinical cases their first how these objectives will be covered during the semester and seven, their second semester. In two and a half weeks allotted. their second year, they take on six cases each "The goal of SBM is not diagnosis," emphasemester. A case begins in Butler Auditorium, sizes Ettinger, "although the students do like to where the entire class convenes to participate figure out what's wrong. The goal is to underin its presentation, which involves an actual stand the underlying scientific basis of what's patient who sits in front of the auditorium and happening to the patient: What is the cause of the is interviewed by Saltzman, who takes a hisdisease, and what is its clinical course in relationtory. Students are expected to fully participate ship to anatomy, physiology and biochemistry? in the process, which is punctuated by Saltzman In the second year, the emphasis is on the underprodding them to ask questions of the patient. lying microbiology, immunology, pathology and Behind Saltzman and the patient, Ettinger is at pharmacology of the disease." the chalkboard taking notes under the headutside of these small ingsofQuestions, Hypotheses, Tests and Learngroups, students are ing Issues. At the close of this 90-minute sesexpected to find and sion, the students have an opportunity to talk read full-length pawith the patient or the faculty individually. pers about every This marks the start of their case and in the learning issue, not weeks that follow, the class breaks into 17 limiting themselves groups of eight to nine students, joined by a to medical textfaculty member who serves in a clearly defined books, abstracts or scant role as "facilitator" of the group. Each small summaries from Web sites. To that end, students group meets for two 90-minute sessions a week receive training in how to conduct computer for two and a half weeks, for a total of five searches for medical literature and how to idensessions per case. At the start of the first smalltify papers that are appropriate to the learning group meeting, students are given a written issues for each case. summary of the case, prepared by Saltzman, as In the ensuing small-group discussions, the well as laboratory faculty facilitator tests results from serves as a guidethe patient. With not as a teacherthis information expert-to make in hand, the stusure that each memdents and their faber of the group cilitator embark contributes signifion their journey cantly to all aspects into the new of the discussion world ofPBL and that all the Giving struclearning issues are ture to this procovered in depth. cess are clearly Students are encourdelineated objecaged to facilitate tives for each discussion as well. session as defined During its final in the course outmeeting on the case, line. As a result, the group takes an in the first meeting , DESIGNERS OF THE SCIENTIFIC exam, following the same students know it's improcesses used throughout BASIS OF MEDICINE COURSE. perative that they review the earlier discussions. The MuRRAY ETTINGER, PHD, LEFT: the facts of the case and students are free to refer to AND ALAN SALTZMAN , MD. MBA. any clinical data they their notes throughout the have on the patient. Next, exam and conclude by THIS "lT MAKES THE CASE MUCH MORE MEMORABLE TO HAVE A PATIENT THERE," SAYS MElJI,SA WOlf. A SECOND-YEAR STUDENT. "lT CAN BE VERY EMOTIONAL. I REMEMBER ONE CASE WE HAD WHERE THE PATIENT HAD CYSTIC FIBROSIS AND SHE EXPLAINED TO US ITS IMPACT ON HER LIFE. KNOW I I WOULDN'T HAVE FELT THE SAME IF I HAD JUST READ ABOUT HER CASE." B u f f a l o Phys ic ian W I n t e r 1 9 9 8 �turning in one paper that reflects their combined effort. Grades are based 70 percent on participation and 30 percent on content, using the same grade scale that is used in the core lecture courses. "This is a course for adults ," Ettinger emphasizes. "It's not grade oriented in the traditional sense: The biggest part of the 'grade' students receive is a detailed evaluation of how he or she participated in the group. In essence, the 'exams' are closure exercises that continue the learning process." "Basically, what happens in PBL is that education is no longer controlled by the faculty," says Saltzman. "The education process now becomes much more student-focused and student-driven because the students are really the ones who decide what they need to learn to understand the case." A key to making this process work is the fact that the cases are carefully selected in an attempt to integrate them with the overall curriculum. "We meet with faculty to learn what material won 't be covered in detail-or at all-in the lectures and then we pick cases that represent specific common diseases that correlate with these areas. By selecting cases in this way, we know students will choose the right learning objectives," Saltzman explains. NoBODY ELsE IN THE WoRLD DoEs THIS What makes PBL most effective, its proponents contend , is that it lends relevancy to material by presenting the basic sciences within the context of actual clinical problems, a method that has been shown to improve recall. "Problem-based learning is B u f f a l o Physician really a model that comes from education that says you learn and retain better if you do things in context," adler says. "And there's good evidence that it works; that's why it's used in a wide variety of educational settings now, not just in medicine. " Further impetus for the push toward PBL has come from the Association of American Medical Colleges, the accrediting organization for medical schools . "Since the mid-I980s, the AAMC has been on a push to reduce the amount of curricular time in order to get students involved as more active learners," says Saltzman. "Basically, they've bought into the concept of PBL, so when they come around to accredit schools, one of the things they look at is how much time a school devotes to scheduled activities, such as lectures and labs , versus other learning formats. " PBL has also drawn attention as a means of stimulating students to choose careers in primary care in order to meet physician-supply demands resulting from dramatic changes in the delivery of health care nationwide. "There are different ways of teaching and getting students interested in primary care," says Saltzman, "and one of the ways to do that is to introduce them to patients' experiences early in their medical education." A unique way that the SBM course brings clinical relevancy to PBL is its inclusion of the "real" patient at the start of each case, as opposed to presenting the case on paper. "Dr. Ettinger and I had some things we wanted to do when we designed this course," Saltzman says, "and one of the things we wanted to do is introduce each case with an actual patient. We didn't know at the time that nobody else in the world does this, although I know of one school that brings a patient in at the end of a case to wrap it up. " "It makes the case much more memorable to have a patient there," says Melissa Wolf, a second-year student. "It can be very emotional. I remember one case we had where the patient had cystic fibrosis and she explained its impact on her life. I know I wouldn't have felt the same W I n t e r 1 9 9 8 "T HE BEGINNING WAS PRETTY TOUCH AND GO," SAYS SECONDYEAR STUDENT USLif CHAMBtRLAI '\i . " FoR SOME OF THE CASES, T H E FOCUS WASN'T CLEAR AND WE DIDN'T HAVE THE MED ICAL BACKGROUND TO BASE OUR D ISCUSS IONS ON .. . H owEvER, I ATTRI BUTE T H IS TO T H E COURSE BE I NG NEW LAST YEAR; THIS YEAR JT's IMPROVED TREMENDOUSLY." �if I had just read about her case; I wouldn't have known what was going on inside her and I feel the personal aspects of her disease would have been glossed over. With a real patient, I relate to the person, not just the disease. " ope Cawdery, a second-year student, says she was pleasantly surprised when her preceptor for her externship program last summer said to her, "You know a lot for a first-year student. " She says she told him, "It's all SBM." Cawdery says further that one reason she's learning so much from the course is "I get to pick what I'm interested in." Another key to making the course work, Ettinger feels, is that students are expected to do their own literature searches, as opposed to being told what to read. "I have seen that the real power of this course is that students go out and read different things," he says, "and when they come back the typical student doesn't necessarily have a good grasp of anything, and they know it! But what happens in a very relaxed, fun way-and it's a marvel to witness-is that by having read different papers, the students really complement each other's understanding during the small-group meetings and a whole lot crystallizes. It's incredible what can come out of these discussions; they really put it together. Our medical students are awfully good at this." THE Urs -LEARN! AND DowNs G ALO GSIDE FACLLTY Facilitators for the groups are drawn from both clinical and basic science faculty. "This is a very faculty-intensive course," Saltzman says, "and finding people who want to facilitate has turned out to be one of our biggest challenges-to free up one person from a couple of hours of lecturing doesn't help us come up with the 80 facilitators we need a year. And as the pressure on productivity increases for all faculty- in the lab or in the clinic- the time they feel they can allocate for 'optional' activities diminishes." onetheless, faculty have stepped forward and Saltzman and Ettinger hope interest will con tinue to grow. The first group of facilitators was trained in the fall of 1996, when the course began. "They learned alongside the students," says Saltzman, "and the students were exceptionally patient with the process and helped us out a lot. We were trying some things that just weren't working, so we made many changes to the course based on their input." "The beginning was pretty touch and go," says secondyear student Leslie Chamberlain. "For some of the cases, the focus wasn't clear and we didn't have the medical background to base our discussions on. For example, we had a case on sickle cell, but we didn't yet have a basis for the disease given to us in our biochemistry course. However, I attribute this to the course being new last year; this year it's improved tremendously. " Chamberlain says the facilitators were very receptive to criticism, and that has made all the difference. "They made us appreciate the course and made us feel we had some say in it. They didn't just force it on us," she says. Defining what role the facilitator plays in the group has not been without controversy. "We discussed this ad infinitum when we were developing the course," Ettinger recalls. However, he says several groups independently came to the same conclusion: The facilitator is not an expert in the subject area and is not supposed to supply information to the group. ot all the students agree with this conclusion, however, and the role of the facilitator continues to be a point of discussion for both students and faculty. Second-year studen t Andrew Mayer says, "I think facilitators should be sufficiently conversant with the material we're discussing"; however, he does concur that "they shouldn't dominate the discussion." "They're not the classic teacher," says Saltzman, who , along with Ettinger, also serves as a group facilitator. "Rather, "PBL IS SOMETHING OF A CONTRADICTION,'' SAYS CHARLES LAU, A SECOND-YEAR STUDENT. "ON THE ONE HAND, I'M LEARNING TEAMWORK- HOW TO WORK WITH PEOPLE WITH DIFFERENT PERSONALITIES- YET, ON THE OTHER HAND, I'M BEING PREPARED TO BE A VERY INDEPENDENT PHYSICIAN , CAPABLE OF LEARNING THINGS ON MY OWN , AS NEEDED, FOR THE REST OF MY LIFE." 0 B u f f a 1 o P hys i cian w I n t e r 1 9 9 8 �the job of a facilitator is to help make sure that everybody participates all the time; that the group maintains its focus and that the students go into a decent depth about each issue. They're also supposed to routinely foster a period of open discussion by the group about how the group is working." Midway through the course and again at its conclusion, facilitators complete written evaluations of the students; the students also evaluate their own individual performance, as well as that of the facilitator. When students do voice a concern about the role of the facilitators in SBM, Ettinger says, their concerns tend to focus on whether the small-group, PBL format, in general, is conducive to learning for them as individuals. Roy Vongtama, a second-year student, is a case in point: "In a lecture, material is presented in a systematic way by individuals whose knowledge in their field is recognized. As a result, I think I comprehend the material more, and retain more, and I also am more inclined to accept its veracity-as opposed to discussing the material with classmates and a facilitator whose knowledge base may be limited. However, I know I may be biased in this view because of my years of experience with the lecture format." CoNFRONT! needed, for the rest of my life." For first-year student Marina Zaydman, the small-group format has helped her successfully confront a very personal challenge: "I have always had a major problem with being shy, so being in my group has really helped me open up, mostly because we all respect each other. I'm feeling less and less uncomfortable speaking up, and I'm even noticing a change at my preceptorship because I'm able to talk with the patients quite easily. It's the greatest. Being shy used to hang over my head like a ton of bricks." THE GREATEST CHALLENGE REMAI G AND RrsoLVING PROBLEMS As for day-to-day dynamics within the small groups themselves, students and faculty alike agree that, for the most part, the members get along remarkably well. So well, in fact, that groups are purposely disbanded and reformed with different members at the close of each semester-a tactic designed to help prepare them to interact with the multidisciplinary teams they will be a part of as physicians. Problems, when they do occur, often stem from a group member being either too dominating or too quiet; however, facilitators are trained to motivate the students to confront and resolve any interpersonal problems themselves. "PBL is something of a contradiction," says Charles Lau, a secondyear student. "On the one hand, I'm learning teamworkhow to work with people with different personalities-yet, on the other hand, I'm being prepared to be a very independent physician, capable of learning things on my own, as B u f f a l o Physician W I n INC.. "Probably the greatest challenge remaining," says Ettinger, "is for a reformed curriculum to evolve that optimally integrates the core curriculum with the SBM and CPM [Clinical Practice of Medicine] courses. In order for physicians to provide excellent care for their patients, they need scientific knowledge, clinical skills and compassion, as well as consistent approaches for learning, analyzing and solving clinical problems." As SBM continues to take shape in the years ahead, Saltzman and Ettinger are sure they will continue to have lots of input from students, faculty, facilitators and administrators, and they look forward to further improvements that will come from this process. After all, processes geared to solving problems are what these two educators are primarily interested in, and what they find most rewarding in their work is seeing processes such as PBL translate into learning. "The students are really remarkable," Saltzman says. "It's amazing how quickly they learn right from the start what the process is for PBL; they just run through it: facts , questions, hypotheses, mechanisms, t e r 1 9 9 8 0 �'THE EDUCATION PROCESS NOW BECOMES MUCH MORE STU DENT-FOCUSED AND STUDENT-DRIVEN BECAUSE THE STUDENTS ARE REALLY THE ONES WHO DECIDE WHAT THEY NEED TO LEARN TO UNDERSTAND THE CASE." SALTZMA .MD.MBA learning issues .... That's what Dr. Ettinger and I are really interested in. If they learn that process, they are set to learn for the rest of th eir lives." And the students do seem to be learning the process. "The second-year students are into their third semester of this," says Wolf, "and we're getting to be 'old hands' at it. At the beginning, we had no idea where to go with PBL, but now we really go through the routine fast for each caseit almost gets mechan ica l at times. " Who knows, maybe someday Wolf and her Class of 2000 will be making their own brave attempt to take the rote out of learning. + THE GENESIS OF THE SciENTIFIC BAsis OF MEDICINE CouRSE AT UB he Scientific Basis of Medicine (SBM)course is adirect outcome of a report issued in1991by the UB School of Medicine and Biomedical Sciences' Task Force on Undergraduate Medical Education, cochaired by Charles M. Serverin, MD, PhD, associate professor of anatomy and cell biology; and Avery Ellis, MD, PhD, associate professor of medicine and physiology.ln this report-written by the committee's chairs with assistance from Dennis A. Nadler, MD, associate dean in the Office of Medical Education--<hanges to curriculum were recommended to better "prepare students for the practice of medicine inthe 21st century." Akey objective toward meeting this goal was to stimulate 0 B uffalo students' interests in pursuing primary-care careers by introducing them to clinical experiences in their first two years. To accomplish this, the report in part proposed designing a course in which students could "learn basic medical science in a clinical context that illustrates for every student the importance of basic science knowledge for the clinician." Further impetus for the SBM course also came indirectly from athree-year, $600,000 grant the school received in 1994 from the Robert Wood Johnson Foundation to fund UB's Primary Care Practice Initiative. One of the overall goals of this initiative is to revamp the medical school curriculum to more closely link clinical experiences to the basic sciences, as well as to emphasize problem solving and self-learning, explains Nadler, whose Office of Medical Education provides ongoing support for the multidisciplinary SBM course. + Physician w I n t e r 1 9 9 8 �FACUL1Y EXPERIENCING A LEARNING CURVE l:o! n many ways, the move to- facilitator for SBM, but also helps train the discussion in a different direction." ward problem-based learning new facilitators for the course. He and Another aspect of traditional teaching (PBL) in UB's medical education other faculty work closely with Judith that facilitators must leave behind them, curriculum has been as big a tran- Shipengrover, PhD, a medical education according to Shipengrover, is the familsition for faculty as it has been specialist with the Office of Generalist iar practice of dividing up research tasks for students. Stanley Spurgeon, Initiatives in UB's medical school. Both among group members for the sake of MD, clinical assistant profes- educators agree that faculty who serve as efficiency. "In group sessions this apsor at UB and an emergency facilitators in the SBM course are experi- proach only replaces teacher-delivered room physician for the past 20 encing a paradigm shift in teaching lectures with mini-lectures delivered by years, has had experience both methods as much as the students are the students as they report their findings, as a traditional lecturer and, experiencing a shift in learning methods. while the rest of the group listens," she now, as a facilitator for the "It's really difficult letting loose of says. "Although counterintuitive and .) ......, Scientific Basis of Medi- the 'I'm-the-expert' perspective," says seemingly less efficient, the redundancy cine (SBM) course. "Actually, the role Spurgeon. "I have found that the most and scattershot approach of the PBL of facilitator is probably easier for me important thing a facilitator needs to method, in which all group members than for some because in the clinical learn to do is keep his mouth shut." research every learning issue, fosters realsetting, we frequently teach in small Shipengrover says the paradigm shift time discussion and problem solving as groups," he says. "When attending phy- for faculty involves sevstudents work to sift and sicians, interns and residents do rounds eral key changes in persort what they know or "IN THE PAST in a hospital and come across some- spective related to what don't know about each isFACULTY HAVE BEEN thing involving a patient they're not Spurgeon has experisue based on their collecIN CONTROL OF familiar with, in essence that becomes enced. "Part of it is trust," findings." tive THE DELIVERY defined as a learning issue. Everyone is she says. "In the past facSpurgeon has experiOF INFORMATION enced firsthand all these given the assignment to learn about it ulty have been in control NOT NECESSARILY and give a short summary report the of the delivery of infordilemmas; however, he T HE RECEIVING OF is very motivated to connext day. So the small-group, problem- mation-not necessarily IT- BUT CERTAINLY based, student-directed model for learn- the receiving of it-but tinue along his own learnITS DELIVERY. ing has been used in clinical medicine certainly its delivery, ing curve when he sees WHICH ISNTTHE how well the students for many years." which isn't the case with CASE WITH PBL." In the past, though, Spurgeon says, PBL So at some level you progress within the PBL medical students had to "flounder have to trust that the stuformat. "Most of the along," essentially teaching themselves dents can and will do what it takes to time," he says, "if you allow a group to the processes involved in PBL "By our learn-that's the 'Eureka' moment with attack a concept and go at it, they may third year, we did have the basic build- PBL You let the students confront the not go in a straight line, but almost ing blocks for problem-based learning, problem, realize what they don't know, always they get to where they need to be having picked them up from working then go and find out what they need to going; they get it right." with residents and interns," he says. solve it." Shipengrover, too, sees much merit in "But it would have been helpful if we A second area of transition the PBL format, but feels strongly that had been taught these processes in a Shipengrover has identified is that of facilitators should be encouraged to demore formal way earlier on." knowing when to intervene in a group's vote more attention to working with the Spurgeon says he became interested discussion. "It's a judgment call that students to more clearly define what exin teaching when he was a fourth-year takes a lot of practice," she says. "As an actly the process is that they are experistudent at Indiana University School of expert-turned-facilitator, there's a con- encing in the group. "I feel there should Medicine. "I began teaching the third- stant push and pull about when, for always be a learning objective related to year students," he says, "because I re- example, to speak up and tell the stu- the group process itself," she says. "I membered how helpful the students were dents the answer to an issue they've think we're missing a lot if we don't make who had made the transition ahead of me been struggling with and when to sim- it part of the facilitator's role to help the and I wanted to help in the same way." ply point them toward the solution students see and understand the larger Today, Spurgeon not only serves as a through strategic questions that move framework they're working within." B u f f a 1 o Physician W I n t e r 1 9 9 8 0 J. . . . . . . . . . . . . . . . . . . . . . . . . ._____________________. �APhysician Whose Dreams -and Work-Are WHE her family's home in Elmira, New York , staring up at the stars, as her father discussed the constellations. A pilot during World War II, he was the one who told her about Apollo l3's mishaps after the now-famous warning, "Houston , we have a problem," was uttered from the spacecraft. At an age when many girls are into dolls , DeBlock was caught up with the space race. But back then, the world hadn't met Christa McAuliffe. "The Right Stuff' meant, in no small part, testosterone. Yet no one tried telling DeBlock the stars were no place for a woman. "We didn't have sexual barriers growing up ," she says. "I have an older sister who graduated from college in 1968-she was a dorm-mate of Hillary Clinton at Wellesley-and I thought that she was one of these women who was forging the way for me. So we were talking this summer about that, and I asked her if she found that difficult. Her comment was that she never noticed anything. "There were four girls and one boy in my family, and our parents allowed us to make our mistakes and choose what we wanted to do. And that changed our mind-set 100 percent. "Yes , I notice that I'm the only woman sitting in the room [at the space center]. But I don't let that affect my behavior. " As a teenager, DeBlock's initial exposure to the world of medicine didn't leave her as starry-eyed as space. When she was in high school, her next-door neighbor, a physician, got her a job performing electrocardiograms at the local hospital. "At first I really hated it," she recalls. SHE WAS SIX WEEKS OLD , Heidi DeBlock took her first ride in a glider. When she was six years old, she marveled as Neil Armstrong took "one small step for man, one giant leap for mankind." Her research there focuses on how As a physician, she has parlayed her zero gravity affects astronauts' hearts. fascination with the final frontier into a regular stint at Houston's Lyndon B. The results of her biggest project, in johnson Space Center. "Space is fasci- which she examined the heart rates of nating because it is so vast, and so little seven astronauts who had gone on space is known about it," says DeBlock, Class walks between 1990 and 1993 , were of 1990, a visiting scientist at the center's published in the Apri.l1997 issue of the cardiovascular lab. "I love science, and American]oumal of Cardiology. the science involved in this is And that's just the beginso rich. " ning . Construction of the BY Ironically, DeBlock's NASA space station is scheduled to NICOLE begin next year, and her findconnection with the great unPERADOTTO known began far from it: in the ings will be crucial once it is basement of UB's medical in operation. "The arrhythschool. There, a visiting professor giving mia research is important because we a lecture on a heart drug briefly discussed want to make sure there are no ill her sabbatical at the space center. After effects on the astronauts' heart rhythms the talk, DeBlock, then a second-year when they're up there ," she says. "We student, approached the teacher and have to make absolutely sure that it's asked for names of people she could safe for them. " For now, in-flight data is as close as contact in Houston. She made the calls, had good credentials and, in her fourth DeBlock gets to the launchpad. She was year, was invited for a month-long once invited to watch a liftoff-but she had to scrub when she couldn't find a internship. baby-sitter for her three daughters . "Lo and behold, everything clicked This year she was among close to there," she says. "They just kept inviting me back, and I kept going back." For one 3,000 candidates vying for one of the month every year and a half, DeBlock most elite callings in the world: astrofrees herself of her duties at Albany Medi- naut. Although she didn't get an intercal Center, where she is an intensivist in view, she plans to try again next year. the surgical intensive care unit, and at And if it happens, she would be fulfillAlbany Medical College, where she is ing the dream of a lifetime. director of the second-year cardiovascuAs a chi.ld, DeBlock-then Heidi lar rotation, and travels to Houston. Frutchy-would sit on the front steps of ® B u f f a l o Physic i an w I n t e r 1 9 9 8 �"The environment was scary to me. 1 just didn't like being in a hospital." The next summer she warmed up to the job. And then, a turning point: "l watched open-heart surgery and thought that was the greatest thing." At the University of Rochester, she majored in astrophysics, paying for her education by reading Holter monitors at Strong Memorial Hospital. Both disciplines, huge and unknown in their own ways, intrigued her curious mind. During her senior year, she and a PhD student published an article in an international physics journal on a discovery they had made in the field of chaos. "By that time, I had learned to love medicine more and more. 1 didn't like astrophysics less and less. But after [the article was published] 1 felt 1 had accomplished something in physics, and now it was time to move on to medicine." In the two years before starting medical school, DeBlock worked at Strong as an intensive care unit technician and got married. She entered UB in the fall of 1986. ln space history, it was a signifi- B u f f o l o "lt was very Heidi DeBlock, MD, vying to become on astronaut dramatic. I think everyone held their breath until they heard that the shuttle was into a safe configuration"meaning it was safe for the astronauts to disembark. "And then everyone started hemming and hawing and AT THE UNIVERSITY OF ROCHESTER , SHE MAJORED wondering how long IN ASTROPHYSICS , PAYING FOR HER EDUCATION it was going to be BY READING HOLTER MONITORS AT STRONG delayed. It's only MEMORIAL HOSPITAL. BOTH DISCIPLINES, HUGE then you realize how much of these AND UNKNOWN , INTRIGUED HER CURIOUS MIND . people's lives are on While the world's interest in space that space shuttle, and how much goes has waxed and waned, DeBlock's into it. You can't really realize that until has only grown with her increased you're there. " DeBlock's next trip to Houston is in involvement. She knows that every blastoff means a potential scientific February. Until then, the scientist and breakthrough. "l was in a conference her minister-husband are sure to have room during a launch once, and many an intriguing dinner-table conthere must have been 75 [scientists] versation about the world "out there." "That's always interesting," she notes, watching it on a closed-circuit TV. laughing. "We never argue, though. " Two of the three engines ignited and Between her hectic schedule and varithe one did not. So they had to shut down the shuttle and abort the ous professional duties, DeBlock relies on her family to keep her grounded. + mission immediately. cant year. Early in it-on january 28the Challenger burst into Games 73 seconds after liftoff. "1 was 23," she remembers with the instant recall you would expect of a space buff. "I had just moved from Rochester to Holland, Michigan, where my husband, Scott, was starting seminary." Physician w I n t e r l 9 9 8 ��MEDICAL STUDENT EXCHANGE TO BY MICHAEL BEEBE BRINGS NEW PERSPECTIVE VERY PHYSICIAN HAS A HORROR STORY about getting through medical school. Few ring as true as those of Maida Secerbegovic, MD , a 1997 graduate of the University of Tuzla Clinical Medical Center. That's Tuzla, as in Bosnia, the war-torn former Yugoslav Republic whose people-let alone its medical care-have been turned upside down by ethnic fighting. Secerbegovic, whose medical studies took seven years to complete due to the constant shelling of her city and hospital by Bosnian Serbs, just completed a five-week exchange at Children's Hospital of Buffalo as part of a medical partnership between Buffalo and the Bosnian city. Earlier last summer, three students from the University at Buffalo's When they first arrived at the hospital. the UB students were shocked by the damage they saw, which had b een caused by hundreds of shells landing on the hospital grounds. School of Medicine and Biomedical Sciences made the journey to Tuzla, where they saw how a hospital staff missing one-third of its physicians has been handling the medical care of a city whose population more than doubled to nearly one million during the war. This was the first time it was deemed safe enough for an exchange of medical students through a partnership called International Medical Relief of Western New York. Begun by jacob Bergsland, MD, a Buffalo General Hospital heart surgeon who went to Bosnia in 1994 to work in a United Nations field hospital, the alliance is the first hospital partnership in Bosnia supported by the American International Health Association. It was honored by First Lady Hillary Rodham Clinton in a October 1996 White House ceremony. P H 0 6 u f f 0 l 0 Physician T 0 w B y G R A P H S 1 n t e r 1 9 9 8 L I S A A P F E L �T he exchange of medical students almost never happened. The relief organization did not want to dilute any of its already scarce resources, which were needed to help Tuzla's physicians rebuild their medical system. The immensity of the job and the dearth of available funding seemed to make an exchange of students a costly extra. But after hearing how their professors were helping people who truly needed it, and after becoming acquainted with some of the Bosnian physicians and nurses who have come to Buffalo for training, the students didn't think so.(Recently, the U.S. government renewed a $2 million grant that, along with local contributions and donations from the medical school and Buffalo hospitals, will be used to assist Bosnia.) "This program was generated by the students," says Dennis A. adler, MD, associate dean at the UB medical school and a clinical assistant professor of pediatrics. "They decided to do their own fund-raising. Without that kind of initiative, we could not have done it. " The only restriction the medical school put on the students was that the program would have to be a true exchange program, with Tuzla students coming to Buffalo to study as well as UB medical school students spending time in Bosnia. The student exchange started last summer when the first group from UB-Lisa Apfel, a second-year student from Hyde Park, NY; Daniel Avosso , a second-year student from Long Island, Y; and Won Hee Kim, a thirdyear student from New York City- traveled to Tuzla. A Muslim-held industrial community about 50 miles north of Sarajevo, Tuzla suffered considerably during the war, when it served as a key distribution center for humanitarian aid. To bring in even more supplies, the United Nations wanted to open the city's airport. The Serbs responded by shelling the city. 6 u f f 0 l 0 When they first arrived at the hospital, the UB students were shocked by the damage they saw, which had been caused by hundreds of shells landing on the hospital grounds during the war. Clinic walls are still pockmarked by shrapnel. Less immediately obvious was the effect that years of fighting and treating war victims had had on the hospital staff and on the community it served. During the worst of the fighting in 1992, there was power only two hours a day, no telephone service, little or no pay for doctors for their long hours and no public transportation. urses sometimes had to walk three hours just to start their shifts. Some of the doctors who were able to leave did; others were pressed into service in field hospitals at the front. During the interruption in her studies, Secerbegovic helped give immunizations in the war zone and was nearly hit by artillery shells. A medical-surgical resident at the hospital suddenly became the hospital's chief of surgery when the chief left. There was no more heart surgery, let alone elective surgery. When they ran out of supplies and drugs or equipment, the staff had to make do . Apfel experienced a telling example of this the first time she walked into the hospital and saw the long line of patients waiting outside a clinic. There are no longer any hospital gowns in Tuzla, so men and women alike stood outside the clinic stripped to the waist. o one complained. It was just part oflife. At least they had some hope of treatment now. Riyaz Hassanali, MD, a Buffalo physician specializing in reconstructive plastic surgery and an advisor to the program, was stunned when he first went to Bosnia. Because everyone in the medical community had to concentrate on treating war injuries, no one was caring for the health needs of the civilian population. "Minor problems became major problems because they had not been treated," he says. "One of the national journals published the pictures we took of patients with untreated tumors because they could not believe the tumors had progressed to that point." Apfel and her fellow students were shocked at how little equipment was left. The nearest MRI machine was in Budapest, Hungary. There was a CT scanner at the hospital, but it was Physician W 1 n t e r 1 9 9 8 �thousands of hours past its intended lifetime. Last summer a Buffalo physician packed a neonatal ventilator into three suitcases and took it to the Tuzla hospital, where 7,000 babies a year were being delivered with no ventilator available. Contrast that with the experience Secerbegovic had coming to the Children's Hospital of Buffalo. In one of the most advanced pediatric hospitals in the country, she spent a majority of her time helping administer gastrointestinal tests with equipment not available in her homeland. She says she asked as often as she could how the American physicians would handle procedures if they didn't have the benefit of such advanced technology and equipment. "This was a great experience. I feel like I can help our younger students now," she says, in nearly flawless English. (She did not need tutoring from the UB English professors who go to Bosnia to help physicians with their language prior to their coming to the United States.) Hassanali says that Bosnia's lack of resources brings an interesting twist to the medical education of the American students who visit: "The students who go there learn more about the practice of medicine than about the practice of technology." They also learn how difficult-and potentially costlyit can be to practice medicine without even the rudiments of technology. Apfel notes, for example, how Bosnian physicians looking for blood in stool samples sometimes miss it because they have to rely on visual examinations, while American doctors use a simple chemical strip costing a few cents, with near-perfect results. "The resources are severely limited in Bosnia," she says. "It was amazing to see how the staff dealt with it; how they would devise things while a physician here would order several tests." Students from both countries also spent time together outside the hospitals. 1 Secerbegovic, whose parent? took Apfel into their home in Bosnia, visited her host's home in Hyde Park and made a trip to Niagara Falls during her time in the rotations at the Tuzla hospital-pediatrics, surgery or internal medicine-and spent their off-hours exploring the city and countryside. They included a trip to Sarajevo, a once breathtakingingly beautiful city that was heavily damaged during the war. The medical student exchange program, once thought to be an expensive extra, is bringing unforeseen benefits, as the students are bringing to their studies a different perspective from their visits, viewing the problems and challenges in both countries with fresh eyes. ew approaches are going to be needed, notes Hassanali, since Bosnia is being forced to not only rebuild its health system, but also to abolish the former centrally controlled economy of communist Yugoslavia. Every specialty in the Tuzla Clinic, for example, was once its own fiefdom , with everything separate-from medical journals to operating theaters. Daniel Avosso, who, like most Americans, followed the war on television and in newspapers, began to see Bosnia in a different light after his stay there. As he walked through Tuzla, he saw numerous churches, temples and synagogues as evidence ofa diversity far wider than the media's portrayal of only three groups: Serbs, Croats and Muslims. "I was impressed by the diversity in Tuzla, the various religions and cultures," he says. "It was something I thought only existed in America, not in a country that I thought was not accepting of other cultures." Hassanali, himselfa refugee from Uganda, believes other UB medical students who travel to Bosnia will come to the same conclusions he has about his practice here: "I realizes how lucky I am to be in the United States, practicing in Buffalo, with the tremendous resources we have available." + u.s. Apfel, Avosso and Kim were given their choice of B u f f a l o Physician w I n t e r 1 9 9 8 �Communication E for Tomorrow's Physicians stablishing a pattern of open and trusting communication between physician and patient is more than a perfunctory gesture of goodwill at the outset of a professional relationship; it's the foundation for every measure of success in a clinical practice. How well a physician communicates with patients affects accuracy of diagnosis, adherence to treatment plans, patient and physician satisfaction and-increasingly-incidence of malpractice suits. Despite this fact, a focus on technology in medicine over the past four decades and a subsequent drive to train "scientific physicians" have tended to erode awareness of the need for clinicians to have and cultivate effective interpersonal skills. In more recent years, however, the emphasis on technological innovation has been eclipsed by managed care and its focus on cost effectiveness, which has dramatically changed how health care is delivered. This, in turn, has provoked unprecedented criticism from patients about how they perceive they are being treated. More often than not, the focus of their attention-or contention-is on how well they feel their doctor communicates with them. In an effort to ensure that medical students acquire the communication skills they will need in their future practices-and to help bring the "art" of medicine back into balance with the science-a new project is under way at ® the University at Buffalo to more formally integrate the teaching of effective communication skills into the medical school's curriculum. The projectwhich will complement existing efforts at the undergraduate and residency levels at UB-is being led by Frank Schimpfhauser, PhD, assistant dean for educational evaluation and research. Funding for the project is being provided by a $50,000 grant from the Medical Liability Mutual Insurance Company and the Medical Society of the State of New York. L!STE lNG AND RESPONDING TO CALLS FOR CHANGE The new communication project is a direct outgrowth of the Standardized a u f f a 1 o BY 5 . A . UNGER Patient Clinical Competency Program established at UB's medical school in 1992 with grants from the Macy Foundation and the National Board of Medical Examiners. In large part, this program was begun in response to concerns that thirdand fourth-year students and faculty expressed about the curriculum, which they felt did little to ensure that students had minimal competencies in a wide range of clinical practice areas, according to Schimpfhauser. More than 90 percent of the students surveyed over two classes felt their opportunities to observe or be observed in a standard way were less than adequate. Students felt that they had not observed enough physician-patient interactions, that they did not have enough structured feedback on their own interactions and that their clinical skills training lacked consistency and quality. This sentiment was paralleled by faculty interest at the national and local level to develop more effective and consistent approaches to assessing students' progress and performance in areas of history taking, physical examination and patient communication. "We realized that we could no longer just assume that over the course of their first two or three years in medical school, students will uniformly acquire basic clinical practice skills, and we saw that we needed to develop more consistent ways to teach and objectively assess the skills relevant to these Physician W I n t e r 1 9 9 8 �instructors who will demonstrate positive modeling, continued practice with and feedback from standardized patients and, finally, application of the acquired skills in a clinical setting. Performance reports will be given to students, summarizing their attainment of skill, and plans for the future include making communication skills a part of UB's annual " I ALWAYS TELL MY STUDENTS THAT NO PATIENT WILL EVER competency exams. COME TO YOUR OFFICE WITH A WRITTEN TEST SAYING . 'I SEE "Working with standardized patients YOU PASSED THIS TEST, SO YOU CAN BE MY DOCTOR ,' INwill provide stuSTEAD, THEY ARE GOING TO JUDGE YOU BY SUCH THINGS AS dents with an opporYOUR EYE CONTACT, HOW WELL YOU LISTEN AND WHAT tunity to perfect their communicaQUESTIONS YOU ASK . PATIENTS WILL MAKE THESE TYPES OF tions skills without JUDGMENTS ABOUT YOU EVERY DAY" - JAMES HASSETT, MD embarrassment a wide range of clinical procedures and about their lack of experience and withprovide structured feedback in years out consequence to patients," explains two, three and four, using "report cards" Harry Sultz, DDS, MPH, professor of and faculty presentations. Expectations Social and Preventive Medicine, and and performance scoring are based on coinvestigator for the project. faculty-developed criteria. "Rather than focus on history tak- WoRKING TO OvERCOME ing, the physical exam or other specific "PROBLEMS OF PERCEP'fi0:\1" clinical problems, this project is in- The foremost goal of the new project is to tended to place a primary focus on give students the interpersonal skills they students' communication skills within will need to deal sensitively and effecthe context of common, yet sensitive tivelywitha wide range of situations they and difficult clinical topics and issues," will encounter in their everyday practices, especially situations that can be says Schimpfhauser. Currently, Schimpfhauser and his value laden, such as teen pregnancy, coinvestigators on the project are work- alcoholism or risk of HIV infection. ing with faculty teams to identify and Studies have consistently shown that develop appropriate problems and patients' criticisms of physicians-and checklists, as well as clinical scenarios approximately 75 percent of all medical that will be implemented using stan- malpractice suits-can be traced to probdardized patients. Topics and issues will lems of perception about how well painclude, but not be limited to, advanced tients feel their doctors communicate directives; informed consent; HIV risk; with them, not how well they feel their Do ot Resuscitate orders; the presen- illness was treated. Specifically, these tation of bad news; sexually transmitted studies show that patients focus on such disease; obesity and nutrition; substance concerns as how comfortable the physiabuse; and domestic violence. cian made them feel, whether they unThe training-set to begin in the spring derstood their treatment options, whether of 1998-will initially involve medical the physician gave the impression that he students and residents in the depart- or she listened and truly cared, and ments of Surgery and Medicine. Their whether the physician explained things interactions with the standardized pa- in a way that gave them hope. James Hassett, MD, also a project tients will be videotaped and critiqued. If deficiencies are identified, the students coinvestigator, is associate program diwill participate in a five-step remedial rector for residency training in the Deprocess that will include working with partment of Surgery at UB and chair of areas- including communication skills," says Schimpfhauser. Through the program, "standardized patients"-persons trained to portray patients and specific scenarios-are first used to complement preceptor instruction in the Clinical Practice of Medicine Program for first- and second-year medical students. They are also used to assess 6 u f f a l o Physician W I n t e r 9 9 8 the Program Director's Committee, a consortium of committees for all of the medical school's residency programs. He works every day with residents as they learn to interact with patients, and he feels strongly that communication skills are the single-most important determinant of success at this level of training. "For residents in training," he says, "how well they do depends on how well they communicate with their peers, with other professional staff, with patients and with attending staff. Communication in those four areas becomes the most crucial factor in whether or not they're going to do well in a residency program. "Residents are almost never stressed by knowledge limitations; rarely does anything happen to their patients where just pure knowledge will make a difference," he adds. "There's not that kind of urgency in the work. However, what does matter is how well the students can talk with a patient and find out what's wrong and how well they can talk with the patient's family and explain treatment options. I always tell my students that no patient will ever come to your office with a written test saying, 'I see you passed this test, so you can be my doctor.' Instead, they are going to judge you by such things as your eye contact, CONTINUED ON PAGE 19 COMMUNICATION SKILLS [oinvestigotors working to develop the new communications skills training program and to plan the conference ore: LISA BENSON, MD, clinical assistant professor of medicine and consultant; TIMOTHY GABRYEL, MD, clinical assistant professor of medicine and director of the Internal Medicine Residency Program at Millard Fillmore Hospital; JAMES HASSETT, MD, professor of surgery and associate director of the Surgical Residency Program; DENNIS A. NADLER, MD, associate dean for curriculum and student affairs, Office of Medical Education; STANLEY SPURGEON, MD, clinical assistant professor of emergency medicine and medical director for the Standardized Patient Clinical Competency Program; HARRY Sum, DDS, MPH, professor of social and preventive medicine and director of Health Services Research; KAREN ZINNER STROM, PHD, trainer/ evaluator, for the Standardized Patient Clinical Competency Program. �The Challenge to Sustain the Humanity Within Us BY F . MICHAEL ELLIOT last June gave me a sense of accomplishment and brought closure to a period of exploration and growth. The transition to medical school represented a deliberate and refreshing step into a world of new experiences, ideas and people. RADUATI G FROM COLLEGE The past few months have been a period of intellectual discovery and personal introspection. The adjustment to the faster pace and greater expectations of medical school has been difficult, as I believe it has been for many. What is most challenging, however, is the confrontation each of us must undergo with our own limitations despite our desire for perfection. The pressure to master knowledge becomes the crucible through which our perseverance is tested, strained and strengthened. Although tedious and consuming, the process of learning inscribes within us the vocabulary through which we will communicate as future teachers, scholars and healers. As we prepare to become witnesses to the suffering of people, students must also confront and accept the limitations of medicine. Our knowledge of the human body and the causes of its pathologies has always been, and will certainly continue to be, incomplete. As science provides medicine with new routes of observing and deconstructing the mechanisms within our cells and organs , new questions will overshadow the past discoveries. Advances in biotechnology conquer yesterday's diseases only to be rendered impotent by the ® emergent pathogens of tomorrow. The search for the breakthrough is over: Victories over disease are now measured in cautious, incremental steps. Bold efforts to cure cancer and AIDS are now directed toward attempts to manage these diseases as chronic, long-term conditions. Economic forces now significantly influence the direction of biomedical research and public health policy. Escalating health-care costs have invited and indefinitely ensured the fu- spite these obstacles, the art of medicine perseveres as the means through which human suffering is understood and alleviated. Because those who suffer most acutely are often the least spoken for and soonest forgotten, it is often the physician who must act as sole witness , advocate and healer. Although the progression of a disease and the inevitability of death may be beyond a physician's THE INTERACTION BETWEEN DOCTOR AND PATIENT IS MORE FRAGILE AND INTIMATE THAN I HAD IMAGINED : IT IS A PRECIOUS FORM OF COMMUNICATION THAT SELDOM OCCURS BETWEEN HUMAN BEINGS . ture dominance of managed care. The consequent loss of physician autonomy has forced doctors to reexamine and possibly redefine the relationships they share with their patients. It is what the field of medicine aspires to accomplish that continues to compel students to become doctors in this increasingly arduous social landscape. De- B u f f a l a control, his capacity to address pain may not. What seems to distinguish the physician from other vocations is his consciousness of this pain and his willingness to alleviate the consequent suffering. It is through communication that this healing occurs, as the patient's vulnerability and uncertainty is abated by an understanding of what afflicts him. Physician W i n t e r 1 9 9 8 �The clinical experiences during this first semester have been a fulfilling opportunity for me to experience medicine beyond the basic sciences. The very act of taking a history with a patient is profound for a student, now entrusted with the private pain and frailties of others. The interaction between doctor and patient is more fragile and intimate than I had imagined: It is a precious form of communication that seldom occurs between human beings. While shadowing a doctor during a preceptorship, I found myself an observer of two worlds, remembering myself once as a patient but now projecting myself as a future doctor. Before I am fully equipped with this new medical education, these few visits have allowed me to see patients from the uncomfortable perspective of someone who is helpless to heal them. Although I cannot discern them yet, these patients have symptoms I will soon recognize and diseases I will one day diagnose. Until then, however, I am grateful for their kind patience as I fumble with my stethoscope. The frenetic pace of this first semester has increased my appreciation for the occasional moment of casual diversion or personal introspection. I have looked forward to seeing my family during the holidays and breaks, more acutely aware of the brisk passage of time. It is paradoxical that this education through which we seek the ability to heal others requires that we devote so much time away from people, immersed in study. We have chosen to devote our lives to the rigorous study of medicine, a pursuit demanding personal sacrifice for what we believe is a noble end. The challenge is to accomplish this task while nurturing and sustaining the humanity within us that has compelled us from the beginning. + COMMUNICATION SKILLS (FROM PG 17) how well you listen and what questions you ask. Patients will make these types of judgments about you every day. " The only way students are going to learn these skills, Hassett says, is through practice and appropriate feedback. "This is what Dr. Schimpfhauser is doing with standardized patients. The reiteration of a format in a standardized way is critical to training; it's the concept of 'practice makes perfect."' TooLs FOR ToMORRow In addition to training students, the methods developed in this project will provide faculty with objective and systematic means of assessing performance in the area of interpersonal skills. "In medical school you have a variety of very good evaluation tools to test cognitive competencies," Hassett says. "However, there are few tools to evaluate skills. You have a history of how well the student performed in college, but we are finding that these records are not always predictive, so really there currently are no methods of testing how well students will be able to interact with patients. With this project, Dr. Schimpfhauser is working to develop this type of tool. Once it's completed, it will be very helpful for faculty because it will allow us to train against a precise standard, a standard that will help us make sure students are acquiring the skills they will need to become better doctors-and better people." + A final outcome of the projecl ru•i/1 be to hold a bes/pmclices confermce in Buffalo in the fall of / 998 in '"'-'hich teaching techniques, diniml simulation packages and assessment tools developedfor the project rmd in use at other medical school.r u::iH br.rhored 11:irh eiluca7orsinvitedfrom mediml schools throughout Nt'"'-• Yori.'Siale. O NLY O NE INVESTMENT LASTS A LIFETIME • Exceptional college placement record • Challenging curriculum with 14 Advanced Placement courses • tate of the art visual and performing arts center • More than 60 interscholastic sports team • Comprehensive community service projects • Average class size is 15 • Financial aid avai lable Admissions tests on these Saturdays at 9:00 a. m.: January 24, February 28 To reserve a place for testing or for additional information, please call: ICHOLS MIDDLESCHOOL, 175 Nottingham Terr., NICHOLS UPPER SCHOOL, 1250 Amherst St. 875--8212 Acceptance 1s granted to qualified students w1thout regard to race, color, rehg1on or nanonal ongm. B u f f a l a Physician w I n t e r 1 9 9 8 NICHOLS SCHOOL �New Medical Computing Lab Opens medical student peers intently at the computer screen, working her way through a histology tutorial program. Layer by layer, the structure of a tissue section reveals itself-accompanied by review questions, gentle corrections and the kind of patience only a machine can muster. In a thousand variations, that's the worked to each other and ready to go scene being replayed in the new Medical to work with quick Internet connecComputing Lab that opened in August tions and access to Medline, Hubnet 1997 at the University at Buffalo's School and other medical databases. of Medicine and Biomedical The lab is open 8 a.m. to BY Sciences. Combining a new age 10 p .m. , weekdays, and dayof computer technology with light hours on the weekSCOTT the accumulated knowledge of ends-plenty of time for harTHO AS centuries of study, the lab is ried students to fit in one last making medical education Internet search for a missing more accessible to the first generation of citation, or to type that paper that's due students who've grown up with the desk- tomorrow. top computer. Primarily, however, the lab is a place From such mundane necessities as for teaching and for learning. word processing to exciting advances in Dannenhoffer refers to it as an "e-tech" database searching, all the possibilities classroom, in which a professor can work of computer-assisted learning (and even- at a central station and direct computer, tually medical practice) are being played VCR and other electronic images to apout in the Cary Hall lab. pear on students' individual monitors, or "This has been in the planning for project them on a screen using one of two three or four years, " says Ray projectors and an audio system. The arDannenhoffer, PhD, director of the rangement allows the professor the flexschool's Office of Medical Computing ibility to move back and forth in his and faculty member in the Department presentation at the click of a mouse, for of Anatomy and Cell Biology. "I under- example, or the ability to quickly access estimated how much the students would appreciate it: The feeling is, 'The school has really invested something in my education. They've put up an infrastructure I can really use."' The project involved major renovations to the second floor of Cary Hall, including the removal of walls to create a wide-open room, then a series of improvements-carpeting, paint, new furnishings, such as comfortable ergonomic chairs and computer desks and Laser]et printers-and about 70 Gateway 200 MHz computers, all net- e u f f a 1 o a related image when a class discussion takes an unexpected turn. What's different about the e-tech classroom is that the students, too , are given the tools and the responsibility for managing their own learning. This is especially evident in a series of tutorials, such as the histology tutorialdeveloped by John Cotter , PhD , professor of anatomical sciences and opthalmology at UB's medical schoolthat allow students to immerse themselves in a body of information until they're satisfied that they've mastered it. There's also a computer sound system with headphones- useful in a cardiology session, for example, in which the student learns to identify normal and abnormal heart sounds by listening in a controlled environment. The medical school's new focus on problem-based learning, as in the Scientific Basis of Medicine course for firstand second-year students, would be much more difficult to carry out without this computer support. For one thing, problem-based learning demands that students search out, sort and evaluate information on their own- something that computers make exponentially more efficient than walking through a labyrinth of library stacks. "It saves a tremendous amount of time," says Amy Van de Water, a second-year student who's now taking her third semester of Scientific Basis of Medicine. "Because we're first- and second-year medical students, our medical background Physician W I n t e r 1 9 9 8 �\ I is very limited, so you really have no idea and the students can search those for a interactive teachers of diagnostics, even sometimes what to make of the symptoms particular article and either save it or as general-reference textbooks. [presented by the class's designated pa- print it out." "These students are either working tient]. There are a number of medical This sort of information manage- directly with the diagnostic programs, textbooks on-line, so that's a good starting ment is crucial to the emerging field of or logging onto the World Wide Web point. In some programs you can get a medical informatics, a field that the and looking at particular sites, or logwhole article on-line, rather than trying to next generation of physicians will find ging onto the university library facilifind it in the literature in the library-if themselves encountering every day. ties, looking at papers with regard to you can find it at all on new findings .... Many of the shelves." the students have had a THE EMERGENCE OF PRACTICAL APPLICATIONS IN First-year student great deal of computer exRob Collard agrees: perience through the colMEDICAL INFORMATICS MAKES . .. FAMILIARITY "Here you can go off lege years. But surpris[WITH COMPUTERS] CRUCIAL TO THE STUDENTS" and find reliable ingly, there's a section of sources of information the class that is fairly naSUCCESS AS PHYSICIANS. to attempt to bring ive as far as computer usdepth to the issues age is concerned. It's very raised in class. It's a team approach, and From computerized patient records important that they be given the opporhopefully it leads to a synthesis of is- and billing, to new ways of presenting tunity to begin to use this technology sues." and sharing data about patients, to keep- and get some idea of how it all works As for the amenities of the new com- ing current with the tremendous growth and to overcome their fears. " puter lab, Van de Water says it's a sig- of medical knowledge, physicians will The emergence of practical applicanificant improvement over the previous increasingly find the keyboard as tions in medical informatics makes that lab. "There are more computers avail- necessary as the stethoscope. familiarity crucial to the students' sucThat's the focus of a course in medi- cess as physicians. As an example, able to students, so you don't have to wait," she says. "There are faster and cal informatics for second-year students Spangler points to the Visual Chart, a better printers here. And the old lab was taught by Robert A. Spangler, MD, an method of presenting patient informanot temperature-controlled, so we were associate professor and director of gradu- tion visually that was developed by always opening the windows because it ate studies in the Department of Physi- former UB medical school professorjohn was sweltering." ology and Biophysics. "We go through Loonsk, now at the University of North "Because the computer lab is in the things like the structure of databases Carolina. "It's a Windows-based probuilding where teaching takes place, and how to conduct effective searches, a gram that tackles individual patient data students don't have to go to the library little bit about the Internet as a resource, and displays it in a graphical fashion , so if they need to do a search in between and then we talk about expert systems," one can, at a glance, get a feeling for the classes and have only a little bit of time," he says. Those systems include such nature of the problem," Spangler says of Dannenhoffer says. "And besides the programs as QMR and Iliad, which can the program, which is undergoing field medical databases that are available, a act as consultants in diagnosing a condi- tests. "It's not just a chart hanging on lot of the medical journals are on-line tion based on a set of symptoms, as the end of the bed anymore." + B u f f a l o Physician W I n t e r 1 9 9 8 �Journal Celebrates Innovative UB Research acuity in the Department of Social and Preventive Medicine at t "Consumption ofPCB-Contaminated Fresh Water Fish and Shortened Menthe University at Buffalo School of Medicine and Biomedical strual Cycle Length"- Pauline Mendola, Sciences have trained some of the most respected epidemiolo- PhD, formerly of UB, now of the EPA t "Gender Differences in the Relationgists in the United States and produced significant and innova- ship Between Depressive Symptoms and tive research in cancer, occupational, environmental, nutritional, Alcohol Problems: A Longitudinal Perspective"-Beth Steger Moscato, PhD, reproductive and cardiovascular epidemiology. research assistant professor tionship of alcohol and breast cancer, In recognition of the department's t "Physical Activity, Obesity and Diabecontributions to the field , the December and relationship of gum disease and tes"-Timothy D. Dye, PhD, a 1990 2, 1997, issue of the American journal of heart disease. graduate of the department, now BY Epidemiology is dedicated to research by t Trevisan was the first to show at the University of Rochester. the beneficial dietary effects of its faculty members and graduates. The issue begins with hisLOIS "The publication of this issue cel- olive oil in population-based torical overviews of the UB ebrates the rich legacy of the depart- studies. medical school (which marked ment and the School of Medicine and t John Vena, PhD, professor its sesquicentennial in 1996), Biomedical Sciences," says Maurizio and associate chair, has defined several the department, as well as epidemiolTrevisan, MD, professor and chair of the nutritional and environmental factors ogy in Western ew York, dating back department. "It affirms the important that influence the risk of bladder to 1843. Graduate Philip C. asca, PhD, contribution that our training programs cancer. professor of epidemiology at the Unihave made to the field of epidemiology t Germaine M. Buck, PhD, associate versity of Massachusetts at Amherst, and prevention." professor and one of the nation's most writes on current problems and future Saxon Graham, PhD, one of the pio- respected specialists in epidemiology of opportunities in the field and graduate neers in the study of the relationship of infertility, in 1994 received one of two Christine B. Ambrosone, PhD, discdiet and disease, spent his career at UB, research fellowships awarded in the usses the new field of mol ecular where he conducted some of the earliest United States by the Merck Company epidemiology. studies in the United States on the health foundation and the Society for EpidemiThe final two studies concern the benefits of a diet high in vegetables ology Research. She is conducting a reliability of study participants' reports containing beta carotene, now shown to long-term study of tubal ligation. of lifetime drinking histories (by Marcia The issue's lead article, "Body Mass Russell, PhD, clinical professor) and of lower the risk of certain cancers. Jo L. Freudenheim, PhD, associate Index and Mortality in a General Popu- reports of pap smears, breast exams and professor, has continued that research lation Sample of Men and Women," mammograms (by Richard B. Warnecke, and in the past decade has earned a written by Joan M. Dorn, PhD, assistant PhD, formerly ofUB, now of the Univerreputation as one of the nation's leading professor, reports that being overweight sity of Illinois at Chicago). is a significant mortality risk factor for nutritional epidemiologists. Graduates of the department include women and men less than 65 years old. top officials and/or researchers at the Other research highlights follow: Other articles and lead authors int The department was designated as one ational Cancer Institute, Monsanto of 15 vanguard centers for the ational clude: Company, the ational Center for Institutes of Health's Women's Health t "Lactation History and Breast Cancer Toxicological Research, ewYorkState Department of Health, Roswell Park Initiative, one of the largest clinical tri- Risk"-Jo L. Freudenheim, PhD t "OxidativeStressandLungFunction"als ever assembled, focusing on diseases Cancer Institute, Centers for Disease Holger ]. Schunemann, MD , research Control and Prevention, Illinois Despecific to women. t More than $12 million in funded re- assistant professor partment of Public Health , University search is currently under way, includ- t "Consumption of Contaminated Sport of Massachusetts at Amherst, Univering studies of the effects of lifestyle on Fish from Lake Ontario and Time-to- sity of Iowa and orthern California lung cancer and heart disease, health Pregnancy, ewYorkAnglerCohort"Cancer Center. + effects of eating Lake Ontario fish , rela- Germaine M. Buck, PhD ® s u f f a l o Phys i cian w I n t e r 1 9 9 8 �Magnificent BUILDING LOTS l Dear Colleague: As a former president of the University at Buffalo medical school Alumni Association and a practicing surgeon in Western New York for many years, I've come to understand what members of our profession desire in a home site - privacy, tranquility, fresh air, and pristine surroundings. THE CARJTAS The Summit at Scherff is a truly extraordinary residential development, unrivaled in Western New York. Nestled in the hills of Orchard Park, this magnificent 81-acres offers 50 estate-sized building lots surrounded by Chestnut Ridge Park and Neuman Creek in a very private enclave. MEDICAL AitTS BUILDING Specifically as an escape from the fast-paced everyday life we lead, it's features include: • Spectacular panoramic views of the Canadian shores, Lake Erie, and the BuiTalo skyline A Unique Partnership with St. Joseph Hospital • Mature woods and secluded ravines • Oversized lots for your dream house • Quick and easy access to the freeway systems leading to BuiTalo and the city's northern suburbs • Privacy, seclusion, and exclusivity Harlem Road, Cheektowaga The Summit promises to be one of the premier areas in Western New York to construct your luxury residence. I invite you to take a stroll through this picturesque setting. For our detailed brochure or a private showing please call (716) 667-2237 or (716) 472-3790. (connected via enclosed walkway to St. Joseph Hospital) 500- 8,000 Sq. Ft. Medical Office Suites Now Available Sincerely yours, For More Information Edmond J. Gicewicz, M.D. Past President, UB Medical Alumni Association Ciminelli Development Company, Inc. Centerpointe Corporate Park 350 Essjay Road Williamsville, NY 14221 _j 716/631-8000 B u f f a l a Physician W I n t e SUMMIT AT SCHERFF Orchard Park, New York A development by Falcon Land Corp. - --- THE r 1 9 9 8 ® �~ ········· · ·············································· · ··················· · · ······· · ·· El the world. Later, in 1963 , he was a senior member of the team that performed the first kidney transplant at that same institution. After his training was completed, Aust stayed on the faculty as a scholar of the American Cancer Society, beginning in J. BRADLEY AUST LOOKS BACK 1957. "At the University of Minnesota ," he recalls , "I worked for Dr. Owen Harding Wangensteen, who, over the Bradley Aust, MD, was recognized as University at course of his career, trained 30 chairs of Buffalo Distinguished Medical Alumnus at a dinner held surgery around the country, including Dr. Randolph Paine, cochair of surgery in his honor on September 25, 1997, in Buffalo . A 1949 at UB. " Discussing trends in medicine that I graduate of the UB medical school, Aust retired in 1996 influenced career options for physicians as chair of the Department of Surgery at the University of starting out in the 1950s, Austsays, "My whole generation went into cardiac surTexas Health Science Center at San Antonio, a position he gery. " However, his plans to do just this held for 30 years. In a recent interview from his home in changed suddenly one day, when his mentor and "boss ," Dr. Wangensteen , Texas, he shared highlights of his long and eventful career, stopped him in the hallway and engaged attributing much of his success to exceptional mentoring, him in a conversation in which he strongly encouraged the young surgeon collegial teamwork and simply "being in the right place at to pursue oncologic surgery. "It was clear that if I wanted a job on the right time ." staff, I should become a cancer "The 1950s were a very intersurgeon," Aust says with a esting time to enter medicine ," chuckle. As is often the case, this Aust says. Indeed, as his career unexpected change was positook shape, the young Buffalo native found he had the good tive and over time led to new and unexpected opportunities. fortune of being able to play an active-sometimes pioneeringIn 1966, Aust was selected to role in the unfolding of medical be the first chair of the Department of Surgery at the Univerhistory. After finishing his studies at UB, Aust went to the Unisity of Texas Health Science Center at San Antonio. Earlier versity of Minnesota to serve his surgical residency, during which in his career, while at the University of Minnesota , he time he discovered an interest in research and an academic caconducted research related to studies on endotoxin shock and reer. His surgical training was interrupted by two years of ser- J. Bradley Aust, MD, left, receiving Distinguished Medical Alumnus award fromJohn the application of immune R.Wright, MD, interim dean, UBSchool of Medicine and Biomedical Sciences, center, tolerance to transplantation. vice as a surgeon during the Koand Jared C. Barlow, MD, president, Medical Alumni Association. Later, he began to gain national rean War. Returning to school in In 1955 , Aust had his first brush recognition through his pioneering clini1952, Aust completed his residency and fellowships in physiology, oncology and with medical history , when he served cal work in oncologic, vascular and transsurgery, and earned an MS degree in as a junior member of the team at the plantation surgery. Once in Texas, he physiology and a PhD in surgery as part University ofMinnesota that performed concentrated his efforts on the many one of the first open-heart surgeries in challenges inherent in building a new of his research training. 1997 UB Distinguished Medical Alumnus Named ® B u f f o l o P hysician w I n t e r 1 9 9 8 �···· ·· · ·· · ··· · ···· · ··· ····· ···· · department, the practice of oncologic surgery and the development of improved ways to administer adjuvant chemotherapy. Aust's move to San Antonio was literally a "ground floor" opportunity, as the school was in the process of being established. Looking back, he feels this time and the years that followed were the most rewarding of his career. "just the germination of the idea that I could run a department of surgery was very exciting," he says. "These were heady times. I had an opportunity to help design the curriculum, establish a new department in a new school and train surgeons according to my own model. " In addition to his administrative responsibilities at the Health Science Center, Aust continued to explore his clinical research interests and pioneered isolated perfusion, the administering of ·· · · · ········ · · · ······ · ··· · · ·· ············ ·· ····· high doses of chemotherapy locally as a means to overcome systemic toxicities. He also found time to serve as president of a number of medical and surgical societies, including the Society of Surgical Oncology, and the Association for Cancer Education, and served as chair of the Board of Governors of the American College of Surgeons. Aust is reflective about progress in the field of oncology, having spent the last several decades of his career treating cancer patients. "People often ask me where I think we stand now in our attempts to treat cancer more effectively, " he says. "I often compare the conquest of cancer to the conquest of the atom bomb. When we developed the atom bomb, we knew all we needed to know to develop it; we just had to do the engineering. When we started out to conquer cancer, we didn't have the basic · ·· · · · · ~ • understanding to do the engineering; we didn't have the basic science. " Today, progress is being made in our understanding of the basic biological processes underlying the genesis of cancer; that's the understanding from which progress in the future will stem, he adds. In retirement, Aust is avidly pursuing one of his favorite hobbies-surgical history-and is hard at work writing a chronicle of the Health Science Center at San Antonio. He also remains dedicated to his alma mater by volunteering his time to serve as a member of the Dean's Advisory Council for the UB medical school, traveling to Buffalo three times a year to meet with the group. He says being named UB's Distinguished Medical Alumnus is something he didn't anticipate and states simply, ''I'm really honored. " + -S.A . UNGER If you come looking for a car, you'll be awfully disappointed. HOWEVER, there's little chance you'llleave that way. BECAUSE at the Land Rover Centre, we have the world's most impressive 4x4s. AND people who answer any of your questions about driving. A4x4, of course. &JjS Amherst A NORTHTOWN AUTOMOTIVE COMPANY 3560 Sheridan Drive Amherst, New York 14226 (716) 831-3100 • (716) 835 FAXX (3299) Buffalo Physician w i n t e r 1 9 9 8 ® �• ···· ·· ········ · · · ······························································· ······· · ~ I Primary Care Extemsbip Program Receives $150,000 Grant n innovative program providing real-life clinical learning opportunities in primary care for University at Buffalo medical students has received a three-year, $150,237 grant from the Charles E. Culpeper Foundation of Stamford, Connecticut. Physician in Training Initiative. The paid externship exposes first- and second-year medical students to the practice of primary care medicine in community-based settings throughout Western New York. Administered by UB's Primary Care Resource Center, the six-week Medical Student Summer Externship Program is recognized as the largest of its kind in the nation by the American Medical Student Association 's Generalist Diane Schwartz, executive director of the Primary Care Resource Center, says the Culpeper Foundation grant will help fund an assessment of ways to retain UB medical students to practice primary care in Western New York. "Our numbers are showing that 50 percent of UB medical school graduates are entering primary care ," Schwartz says. "However , the significant issue is retention. With more analysis and evaluation of the primary care externship program, we will have valuable information on how we can retain the medical students entering primary care in Buffalo and the surrounding areas." Gathering this information, explains Schwartz, could have a significant impact in areas with a health-care shortage designation , a federal term to identify areas with too few medical THE SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES WISHES TO EXTEND ITS THANKS TO THE FOLLOWING PHYSICIANS WHO SERVED AS PRECEPTORS FOR THE PRIMARY (ARE SUMMER EXTERN SHIP PROGRAM IN 1997. EXTERN PRECEPTOR FIELD EXTERN PRECEPTOR FI ELD Renee Abderhalden Bettina Ackerman Tomaro Alberti Ben Alderfer Romone Alexander Steve Ambruski Jell Amodeo Joyce Anderson Lynn-Marie Aronico Stephanie Babcock Lynn Barnhard Florence Bero Anthony J. Caprio Thomas V. Caprio Hope Cowdery Patrick D'Abbracci Ann DeNordin Porn Diomontis Melissa Dilanni Melissa Dilonni Louis Domenico Jr. Holly Drexler Notosho Frongopolous Jennifer Griffith Molly Harrington Chuck Howorth Shannon Howe Shirley Huang Rashma Katira Thomas S. Scanlon, MD Evelyn Hurvitz, MD, FAAP Ganesh N. Deshponde, MD Thomas F. Cozza, MD David Holmes, MD G. Lawrence McNally, MD Mork R. Klocke, MD lone M. Pormington, MD Nicholas Aquino, MD Chelikoni VP Varma, MD Geoffrey Markowski, MD Geoffrey Markowski, MD Pat Collins, MD Donald Robinson, MD Richard Schifeling, MD John Fudymo, MD Geraldine Kelley, MD Sanford Levy, MD Anthony 0. Bartholomew, MD G. Joy Bishop, MD Shawn Cotton, MD Mork Swetz, MD Geoffrey Markowski, MD Paul Lecat, MD Theodore Putnam, MD Richard Schifeling, MD Margo Krasnoff, MD Gregory Synder, MD S. T. Pavon, MD Internal Medicine Pediatrics Pediatrics Pediatrics Family Medicine Pediatrics Pediatrics Pediatrics Medicine/Pediatrics Pediatrics Family Medicine Family Medicine Family Medicine Family Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine Internal Medicine Family Medicine Family Medicine Family Medicine Medicine/Pediatrics Pediatrics Internal Medicine Internal Medicine Family Medicine Family Medicine Margaret Lafferty Charles Lou Karen Lee Judy Lettmon Jason Lorenc Rosemarie Mannino Andrew Moyer Kara McCunn Hasit Mehta Donna J. Peace Jesenia Pena Stephen Przynosch Mory Rose Puthiyomodam Kevin Robillard Gretchen Schueckler Morsilio Seiwell Tracey Shanahan Natalie Sikka Marissa Stumpf Britto Svoren Priyo Tahilioni Roque! Thomas Judith Toski Amy Van de Water Rosalia Viterbo Michelle Watson Ryan White Melissa Wolf Nora Yip Barbara Stouter, MD David Milling, MD Raphael Wang, MD Dona Drummond, MD James Wild, MD Ellen Rich, MD Timothy F. Gabryel, MD Thomas R. Gerbasi, MD Harry Metcalf, MD Ellis Gomez, MD Peter Kowalski, MD Fronk C. Mezzadri, MD Colin McMahon, MD David Thomas, MD Jack P. Freer, MD Brian Connolly, MD Emily Frieden, MD Jack F. Coyne, MD Deborah Richter, MD Peter Kowalski, MD Colleen Mattimore, MD Anthony F. Oliva, DO Leonard Katz, MD Robert Berke, MD Peter Winkelstein, MD Geraldine Kelley, MD Howard Sperry, MD, MPH Leonard Katz, MD Anthony Vetrano, MD Pediatrics Medicine Pediatrics Family Medicine Family Medicine Internal Medicine Internal Medicine Pediatrics Family Medicine Family Medicine Family Medicine Medicine/Pediatrics Medicine/Pediatrics Family Medicine Internal Medicine Family Medicine Pediatrics Pediatrics Family Medicine Family Medicine Pediatrics Family Medicine Medicine Family Medicine Pediatrics Internal Medicine Internal Medicine Medicine Pediatrics B u f f a l o Phys i cian w I n t e r 9 9 8 �professionals available. "It is important to attract students to practice primary care in these areas," Schwartz says. "Developing long-term relationships with patients and the community through the externship program, we believe, provides the impetus for the medical students to continue practicing medicine here." The Culpeper Foundation grant also will fund stipends for 20 medical students per year to participate in the externship program, as well as provide partial funding for an associate director of the program. The Charles E. Culpeper Foundation is a private, nonprofit charitable foundation established by the late Charles E. Culpeper, one of the early pioneers in the bottling and marketing of Coca-Cola. The foundation provides approximately $7 million per year in support of activities in health, education, arts and culture, and the administration of justice. + Journal Dedicated to Dr. Helm he ovember 1997 issueoftheDer- matologic Surgery journal has been dedicated to Frederick Helm, MD, emeritus professor and former chair, Department of Dermatology, UB School of Medicine and Biomedical Sciences, on the occasion of his 70th birthday. In an editorial comment, Robert A. Schwartz, MD, of The University of Medicine and Dentistry of ew jersey, says of Dr. Helm: "His work since the early 1960s with professors Edmund Klein, Halina Milgram and Howard L. Stoll Jr. on skin cancer and its immunotherapy is of extraordinary merit. His book, Cancer Dermatology, is a first-rate accomplishment, as are the large number of book chapters and articles he has written .... The work of Professor Helm and his colleagues has led to the present era of unprecedented advances in the study of etiology, recognition and management of skin cancer symbolized by the superb articles in this Special Issue." + inda Duffy, PhD, associate professor ters, insurance providers and school and of pediatrics, and scientific director public health officials," she says. "I look of the Women and Children's Health forward to serving the children of ew Research Foundation (WCHRF) at York State and intend to promote public the University at Buffalo School of policy that supports initiatives that help Medicine and Biomedical Sciences us achieve Health 2000 objectives for and the Children's Hospital of Buffalo, immunizations." + has been appointed to New York State Governor George Pataki's Advisory Council on Immunizations. According to Duffy, the appointment provides a vital opportunity to impact immunization compliance for the children of Western ewYorkand ewYork State. "Immunization surveillance depends on integrated, cooperaLinda Duffy, PhD, associate professor of pediatrics and scientific tive efforts between primary-care director of the Women and Children's Health Research Foundation physicians, regional referral cen- u f f a l o Physician W I n t e Buffalo Physician ~Uff"tj f "~ s \ t \ " " Giv e us a call: (716) 645-6933 Michael J. Baranski Marketing Representative Linda Duffy,PhD,Named to Governor'sAdvisory Council B Advertise in one of the finest publications in Western New York ... r 1 9 9 8 BARANSKI ADVERTISING 146 Stepping Stone Lane Orchard Park, NY 1412 7 �• ································· · ··············································· · ······ . I fallacy .... Everyone has a will. The real question is "Who wrote it? " If an individual, for whatever reason, doesn't take the time to write a personal will, the author becomes "the politicians." All states, as well as the m Co•o•• PHD " ' " ' federal government, have laws that govern what happens to a person's ast fall, I had the opportunity to represent the School of Medicine assets if he or she dies without a valid will or other estate plan. One reason and Biomedical Sciences at the 17th International Fund Raising there are so few "public service" proWorkshop. It was held near Amsterdam, outside the village of grams promoting the writing of wills may stem from the government's inNoordwijkerhout, on the North Sea, in a former monastery. terest in the resources of those who die intestate. Some people are also Thirty-four countries were represented by a total of 689 delegates. content with this arrangement. (I once There were 18 of us from the United States. What a novel experience heard of an immigrant and naturalized citizen of the United States who to be in such a distinct minority-and yet at the same time, to feel was so happy with the life he had made here that he wanted his accumulated totally at home among my peers. wealth to go to our government.) Most Participating in this workshop was laws therein. The overwhelming mes- of us, however, prefer to have a more an adventure I will treasure all my life. sage was that those who included edu- active voice in how our hard-earned It reinforced my commitment to this cational and charitable organizations resources are used after we are finnoble vocation of institutional advance- in their estate plans did so more for the ished with them. Recently, I had the privilege of readment, and at least equally important, love of their families and their organimy decision to work on behalf of this zations than for tax benefits. To pro- ing an expertly crafted will. It was excellent medical school. Together with vide for their families and to direct beautiful, thoughtful and complete. It fully utilized the gift exDr. Wright, the departclusion amount of ment chairs and fac" WHERE THERE' S A WILL , YOU HAVE A SAY ." YOU MAY HAVE $600,000, currently in ulty, with alumni and effect, as legacies to friends of this instituHEARD IT REPORTED THAT ONLY FOUR IN TEN OF ADULT children and grandchiltion, I am delighted to dren. The remainder be involved in helping AMERICANS HAVE VALID AND UP-TO- DATE WILLS. FROM ONE was divided among to weave the future of educational and charithis school. It is alPERSPECTIVE . THAT STATEMENT IS A FALLACY . . . . EVERYONE table organizations, ready outstanding; fuHAS A WILL. THE REAL QUESTION IS " WHO WROTE IT?" leaving no taxes of any ture philanthropy sort to "Uncle Sam" or holds the potential to "Cousin Gov." One of enhance and expand the opportunities available to students, resources to nonprofit organizations, the beneficiaries was the University at alumni, fellows, faculty and friends. there has to be an official document Buffalo. The six-figure gift will initiate Three of the small-group sessions in that governmental authorities recog- a scholarship endowment in memory which I participated focused on lega- nize. In this country, the document of the individual's daughter. Forever after, outstanding students at UB will cies, and how, at their deaths, indi- is a will. viduals in many different countries "Where there's a will, you have a benefit from the thoughtful foresight make gifts to their favorite organiza- say." You may have heard it reported of this individual and those who helped tions. There are, of course, more simi- that only four in ten of adult Americans to structure the will to meet his wide larities than differences in these have valid and up-to-date wills. From variety of objectives. In our office, we frequently receive prgrams, regardless of country or tax one perspective, that statement is a AWord from the Director of Development "' ® B u f f a 1 o Physician w I n t e r 1 9 9 8 �requests for assistance in crafting wills and other estate plans . For general questions, I have a variety of booklets that present overviews of ways to give, what is essential to include in a will and what types of gifts bring with them lifetime benefits to donors. One even focuses on "Estate Planning for Today's Woman." All of them include information regarding the changes made in the tax laws during the 1997 Congressional Session. The school is also fortunate to be a part of a university-wide development operation, with a planned giving staff available to assist in specific aspects of planning one's estate. Each situation is different; each plan becomes a tapestry, the design of which rests with the individual and what he or she wants to accomplish with the resources available. lf you have questions , our conversations are confidential. Give me a call. Linda]. (Lyn ) Corder is th e associate dean and direc tor of development for the School of Medicin e and Bi omedical Sciences. She previously serv ed the sc hool as maj or gifts coordinator and assi stant dean . + INFINITI tal in Little Rock and served as assistant professor and associate professor of ophthalmology at the University of Arkansas for Medical Sciences. Reynolds returned to Buffalo in 1988, when he was named chief of pediatric ophthalmology at Children's Hospital. Currently, Reynolds is the recipient of a two-year, $436,000 grant from the National Eye Institute to investigate a treatment that could prevent retinopathy of prematurity. Characterized by excessive growth of retinal blood vessels in extremely premature infants, the condition can cause vision degeneration and blindness. + James Reynolds,MD, Named Interim Chair, UB'sDepartment of Ophthalmology ames Reynolds, MD , has been appointed interim chair of the Department of Ophthalmology at the University at Buffalo School of Medicine and Biomedical Sciences. Reynolds, who is an associate professor at the medical school, also serves as chief of pediatric ophthalmology at the Children's Hospital of Buffalo. A graduate ofUB's school of medicine, Class of1978, Reynolds completed his ophthalmology residency in Buffalo and fellowship training in Pittsburgh, after which he became a clinical instructor and staff surgeon at the Eye and Ear Hospital, the Children's Hospital of Pittsburgh and the University of Pittsburgh SchoolofMedicine.ln 1983, he became the chief of pediatric ophthalmology at the Arkansas Children's Hospi- James Reynolds, MD I ntroducing your way to escape. lnfiniti's luxury sport AUTO PLACE INFINITI Unlike most luxury sport 8129 MAIN ST. , WILLIAMSVILLE escape for the weekend, it has all the comforts and luxuries you East of Transit Rd. , Near Eastern Hills Mall u f f a I o MSRD 36,045. 00 utility vehicles, the QX4 not only features everything you need to 633-9585 B utility vehicle : the QX4. need to escape life's daily stresses. Physician W i n t e r 1 9 QX4 9 8 �• ··········· · ··········· · ············ · ······················· · ··· · ······················ · ~ . I He Was aGiant in His Field -DAVID KIMBALL MILLER , MD , DIES AT AGE 93 avid Kimball Miller, MD, professor emeritus at University at Buffalo School of Medicine and Biomedical Sciences, died in his sleep at age 93 on October 25, 1997, at the home of his son, David Rush Miller, in Hilo , Hawaii, where he had lived since 1993. A native of Bloomington, Il, Miller graduated from Illinois Wesleyan University in 1925 and Harvard Medical School in 1929. He then served a twoyear internship at Boston City Hospital, after which he completed a residency at Rockefeller Institute for Medical Research in ew York City from 1931-1937. Miller came to Buffalo's Edward ] . Meyer Memorial Hospital (now Erie County Medical Center) in 1937 as director of laboratories, and two years later he became director of the Department of Medicine at the hospital , a position he held until1967. Also in 1937, he accepted a teaching position at the University at Buffalo medical school, becoming the first full-time faculty member in medicine at the school. "Because he was the first full-time faculty member in the department, which had a very strong clinical faculty , it was critical that he be a master clinician, and this was a role Dr. Miller fulfilled in a very amazing way," says james olan, MD, professor of medicine at UB's School of Medicine and Biomedical Sciences and chair of its Department ofMedicine from 1978 to 1995. "Dr. Miller was recognized by both academic and volunteer faculty as being the most superb bedside clinician and teacher in Western ew York," olan adds. "He had an encyclopedic knowledge of medicine , but more importantly, he could assemble small clues about a patient's illness and arrive at an accurate diagnosis and effective management plan. Dr. Miller trained a generation of internists who are among the best clinicians in this region and throughout the nation. To this day, many of these physicians still revere him as the greatest clinician they've ever encountered. " From 193 7 to 1968, Miller also served as cochair of the Department of Medicine at UB 's medical school, a responsibility that was shared with the chief of medicine at the Buffalo General Hospital. For many years, the two hospital-based departments operated largely independently; however, with the arrival of Evan Calkins, MD , in 1961 , as head of medicine at the Buffalo General Hospital, and the incorporation of the then-University of Buffalo into the State University of New York system, he and Miller began to work together closely to develop a university-wide department. In 1968, Miller volunteered to step down as cochair of the department in order for the university to further develop the concept of a single department, according to Calkins. "Dr. Miller realized the importance of combining the two departments into a single, unified department and was very supportive of me," says Calkins, who , following a national search, was selected to serve as its chair. "Dr. Miller was 100 percent supportive of this transition," he adds. "He was a very generous man and had a great capacity for seeing the whole picture." Miller remained active as a professor of medicine at UB until his retirement in 1974, at which time the university hon- ® a u f t a l o ored him with the title of emeritus professor of medicine. In 1984, in further recognition of his skill as a medical diagnostician and for his commitment to patient care and clinical instruction in medicine, he was honored on his 80th birthday with the dedication of the David K. Miller Wing of the Erie County Medical Center. orman Chassin, MD , completed his residency training with Miller in 1951 and remained a lifelong colleague and friend. "Dr. Miller was not only a teacher, but he was an example for us, " Chassin says. "He was known as a counselor to his trainees. I still see some of these physicians at meetings and they tell me the most important time they spent in their professional life was the three to five years they spent with Dr. Miller. " "He was a tremendous clinician who ran a very tight ship and really challenged young people," Calkins recalls. "He had a wonderful way with those he trained and they, in turn, loved him tenaciously. " "The thing I remember most about Dr. Miller," Chassin says, "is that, as a teacher, he never stopped taking care of patients. He never turned down a referral from a colleague. If you had a tough case, you'd tell him you needed his help and he was there, even if it meant making a house call along with you. Sometimes he'd add an important but subtle observation; other times, he just gave you and the patient confidence by being there because he was a giant in his field, and his greatness touched the patients. " + Amemorial service will be held for Or. Miller on Friday, April 24, 1998, at 1 p.m. at the Bernard Smith Amphitheater, Erie County Medical Center, in conjunction with Spring Clinical Day. Physician W ; n t e r l 9 9 8 �When w-as the last tin1e you w-ere rew-arded for being you? Don't you think it's tin1e ... D IS C 0 U N T P R 0 G RA M S You're a doctor. You're committed to helping people. The last thing you should have to worry about is liability insurance. Nobody knows that better than we do. We're MedPro/Frontier, a recognized leader in Professional Liability Insurance. We reward doctors with comprehensive plans and discounts including part-time and new doctor discounts, and risk management credits. And doctors reward us: 18,000 practitioners are protected by MedPro/Frontier. We've also earned the exclusive Part Time 50% Nevv Doctor 50% Annual Pre-payment 3% Risk Management 5% endorsements of many medical societies including the New York State Society of Internal Medicine. MedPro/Frontier has an (A-) rating by A.M. Best Company, and an (A+) by Standard & Poor's. Our in-house claims department plus a staff of insurance, legal and medical professionals are readily available to answer any questions you may have. Call now. Don't you think it's time? 1-800-822-8260, Ext. 616. MedPro. Protecting You and Your Future B u f f a 1 o Physician w I n t e r 1 9 9 8 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] '' ' " . Noise-Induced Hearing Loss Partially Rescued sensory cells express a rush of glutathione, an antioxidant that absorbs free radicals. R-PIA was found to increase the activity of glutathione, thus oise-induced hearing loss may be providing enhanced protection from caused partly by free-radical oxi- free-radical damage. dative damage to sensory cells in To test the effect of the drug on hearthe inner ear, and laboratory stud- ing loss, researchers applied R-PIA topiies of a drug called R-PIA have cally to the inner-ear membrane of one shown that it can lessen the ex- group of animals and applied a saline solution as a control in a tent of damage by ensecond group. The anihancing antioxidant activity, researchers at mals then were exposed to mid-frequency noise the University at for four hours at levels Buffalo's Center for high enough to cause Hearing and Deafness temporary deafness . have found. Donald Henderson, The loss of hearing was verified by monitoring PhD, UB professor of brain waves in the hearcommunicative disoring center in the cortex. ders and sciences, says The lack of brain activthe action of R-PIA " IN THE FUTURE, WE MAY likely would be similar ity in response to normal BE ABLE TO RESCUE THE in the human ear. "In the sound indicated complete hearing loss. HEARING LOSS OF future, we may be able to Brain-wave activity rescue the hearing loss PERSONS INADVERTENTLY was measured again at one of persons inadvertently EXPOSED TO LARGE day, four days, and 20 days exposed to large amounts AMOUNTS OF NOISE. " following noise exposure. of n'"'ic;e, such as those Results showed that the near an explosion, for example, through the use of this drug. " animals treated with R-PIA recovered Noise-induced hearing loss, a major their hearing faster and more completely health problem in industrialized societ- than those treated with saline. "The R-PIA-treated animals also ies, is a primary research focus of UB's Center for Hearing and Deafness, which showed less damage and loss of senHenderson codirects with fellow scientist sory cells than control animals," Henderson says. + Richard]. Salvi, PhD. The new study, conducted by L 0 I S B A K E R Henderson and colleagues Sandra Mcfadden, PhD, and Bo-Hua Hu, PhD, along with Richard Kopke, PhD, of the U.S. Army, documents the action of R-PIA on noise-induced hearing loss in chinchillas, a mammal with an auditory husband-and-wife team of psychiarange similar to that of humans. trists at the University at Buffalo In earlier work, the researchers has received a $2.6 million grant showed that the stress of loud noises from the National Institute ofMencauses an increase in free radicals in the tal Health to conduct one of the inner ear, which can damage or kill first major population-based studsensory cells. To defend themselves, Searching for Genes Linked to Schizophrenia ® B u f f a I o ies aimed at finding the gene or genes that may be linked to schizophrenia. Carlos N. Pato, MD, and Michele T. Pato, MD, UB associate professors of psychiatry, are principal and coprincipal investigators, respectively, on the project. They have been building the project for seven years in the Azores, a group of nine islands located off the coast of Portugal that make up a Portuguese state and where most inhabitants are descended from a few families. "Psychosis is a complex syndrome, the most common form of which is schizophrenia," Carlos Pato says. "In at least 20 percent of cases of schizophrenia, other family members are also affected with the illness, but genetics may play a role in an even greater percentage. Our study will try to determine how often the illness and a particular gene, or genes, are seen together. If we can find the gene that causes the illness and then find the product of that gene, we can begin to design more effective treatment." About one percent of the world's population is afflicted with schizophrenia, a mental illness characterized by symptoms such as deterioration of personality, disordered thinking, delusions, hallucinations, paranoia or catatonia. The main form of treatment is antipsychotic drugs, which must be taken regularly and continually to control symptoms. The five-year study will be carried out in the Azores and in a population group on the Portuguese mainland. "The Azores are ideal for a genetic analysis," Pato says, "because the country is small and its population has been relatively genetically isolated, with most inhabitants descended from a few families. The Azores have a centralized health system, and all 10 psychiatrists on the islands are collaborating on the project." The researchers will look for genetic links using a variety of approaches. "We will select genetic markers and look at how the markers behave in well families compared to a family where the illness Physician W I n t e r I 9 9 8 �······· · · ·· · · ········· · ···· · ·· · ···· ·· ···· ···· ···· · ·· ·· ········ ·· · · · · ····· · ·· ·· ···· ·· · ·· ··· m ·'S~ '· ..~.. '-· . Why Are Blacks More Prone to shows up several times ," Pato says. "We'll look to see if illness and genetic markers exist together, and we'll analyze genetic patterns from ill person to cardiology researcher at the Uniill person. We'll develop a description versity at Buffalo may have found of each suspect gene and determine one answer to the question of why how often it occurs with illness. " more blacks than whites have high An important aspect of the study will blood pressure. be a Haplotype Relative Risk analysis. The answer appears to lie in the Using this approach , researchers will way the lining of blood vessels , the analyze the set of genes from a patient's parents that were not passed on to that endothelium, responds to certain sigpatient, Pato explains. The noninherited nals telling it to dilate. Bong Hee Sung, PhD, UB associate professor of mediset then acts as a control. A field team is already in place in the cine, has shown that in some blacks, Azores. The UB researchers travel there blood vessels didn't relax and widen as frequently to maintain close ties with the they should in response to a normal project. Meanwhile, they are setting up a blood-vessel dilator. Dilation of blood genetics research program and labora- vessels is one of the body's natural tory at UB that ultimately will be mechanisms for easing blood flow , thus lowering prescapable of performing sure. genetic analyses of any Sung prepotentially inheritable disthe sen ted ease, the researchers say. study results Both Carlos and Michele recently at the Pato hold adjunct appoint12th Internaments with the Center for tional InterNeuroscience at the disciplinar y University of Coimbra in Conference on Portugal, which is collaboHypertension rating on the project. Also in Blacks in involved are james L. London. Kennedy, MD , head of the THE FINDING REIN · Why the blood neurogenetics section at Clark FORCES THE RELATION · vessels don't relax Institute of Psychiatry, UniverSHIP BETWEEN and widen as exsity of Toronto , who is a pected remains unHYPERTENSION AND coprincipal investigator, and clear, Sung says. Eric Lander, PhD , of the WhiteDIABETES , TWO "Th ese are all head/MIT Center for Genome DISEASES THAT ARE healthy people, " Research, who will perform a MORE PREVALENT she adds. "They genome-wide scan and collaboAMONG BLACKS THAN had normal glurate on all data analyses. WHITES . cose and cholesM. Helena Azevedo , MD , proterollevels, and are fessor of psychiatry at the University of Coimbra, is the principal in- not obese.There was no apparent reavestigator for the Portuguese team, and son for them to have endothelium dysCarlos Paz Ferreira, MD , director of psy- function . Where this comes from , we chiatry at Psychiatric HospitalS. Miguel, don't know . We can't really say what the pathway is yet. " Azores, is directing the fieldwork. + Sung and colleagues studied the High Blood Pressure Than Whites? - B u f f a L I 0 o I S 8 A K E R Physician w I n t e r 1 9 9 8 ' . blood-vessel response in a group of l2 healthy African-Americans and l l Caucasians, all of whom had normal blood pressure. They also showed normal fasting cholesterol levels, glucose levels and other parameters known to affect blood pressure. The researchers measured the diameter of a vein in the left hand of all participants and then introduced the vasoconstrictor norepinephrine into the vein to cause it to narrow. Veins of participants in both groups narrowed similarly. Insulin, a vasodilator that acts on the endothelium in addition to regulating blood glucose, was added to the norepinephrine, and the vein diameter was measured again. Results showed that veins remained narrowed in five , or 42 percent, of the l2 African-Americans, indicating they did not respond normally to insulin as a vasodilator. Sung says the blunted response may be one of the mechanisms underlying the increased prevalence of hypertension in some blacks. "This subgroup of African-Americans was resistant to the vasodilatory action of insulin. Nothing happened to their blood pressure when insulin was infused." Sung said the finding reinforces the relationship between hypertension and diabetes , two diseases that are more prevalent among blacks than whites. Insulin resistance is a risk factor for adult-onset, or type II , diabetes. The question Sung and colleagues now are trying to answer is why an apparently healthy subgroup of blacks is not responding normally to insulin. She said the condition has important health consequences, and that once scientists know what causes it, they can work to prevent it. Additional researchers on the study were Marilou Ching, MD; Surendra G. Gudapati , MD ; and Michael F. Wilson , MD , all of the UB Department of Medicine. + L 0 I S 8 A K E R �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . [1] ' , ' "' . lesser-known functions include activating the immune system in response to stress; it also plays a role in fertility. It is another of prolactin's lesserUniversity at Buffalo neuroendo- known effects-its role in regulating crinologist is providing new in- the seasonal molting cycle in such anisights into the cause of changes in mals as the Siberian hamster-thatdrives blood levels of the hormone Badura's research. Siberian hamsters prolactin, which plays a role in turn from brown to white in winter and regulating many vital human experience a corresponding drop in prolactin levels. Badura is attempting to physiological functions. Supported by a grant from the Na- identify the brain chemical that triggers tional Science Foundation (NSF), Lori this change. Once identified, the chemiBadura, PhD, assistant professor of psy- cal could be manipulated to correct an chology, is attempting to identify the existing hormonal imbalance. The Siberian hamster is a convenient neurotransmitter that signals those model for studying prolactin regulation changes. If successful, her research could lead to interventions to keep the because its hormonal variation is photosensitive-triggered naturally by seasonal hormone at optimum levels. "Some medications-ones that in- changes in amount of daylight- and crease dopamine, for example- requires no chemical manipulation. "A number of faccan cause prolactin tors can affect prolevels to be low," she lactin release," says. "Too much or Badurasays. "Ifthere too little prolactin are big changes, a can cause infertility. number of factors It is important to may be involved. At know what neurothe basal level, the chemicals are affectchanges are small ing any system and easier to because a change in control." one causes a change One of the neusomewhere else. rotransmitters that "We already know "TOO MUCH OR TOO Badura and colleagues prolactin's effects, but we are looking at is norepiLITTLE PROLACTIN CAN don't know what causes nephrine because its levthe brain to regulate its CAUSE INFERTILITY. els also appear to change production. If we can find IT'S IMPORTANT TO under different light conthe chemical signals that KNOW WHAT ditions and it is known cause these changes, we NEUROCHEMICAL$ ARE to be involved in prolaccan design a drug to reguAFFECTING ANY SYSTEM tin release. late them. Knowing the BECAUSE A CHANGE IN "We don't know if this chemical neurotransmitis coincidental, if other ONE CAUSES A CHANGE ters that underlie each factors are involved or if system would allow us to SOMEWHERE ELSE. " there is a real cause and compensate for problems effect," she says. "Once in any of them." we establish a relationship, we can maProlactin is perhaps best known as the hormone responsible for stimulat- nipulate norepinephrine and see ifprolacing mammalian milk production. Its tin changes. No one has done that yet." Study Seeks to Identify Brain Chemical Regulating Prolactin ® B u f f a l o Before Badura can move into that realm ofdiscovery, however, she and her graduate students must master the delicate and difficult technique of implanting the necessary microinstruments in the mousesized hamsters so that any physiological changes can be measured. "If this technique becomes viable," she says, "it would permit a new direction in research that is very attractive to granting agencies. This will allow us to document any kind of physiological activity and physical state minute by minute. We will be able to answer many questions that we haven't been able to answer before." Badura's work has been funded by the NSF since 1993, when she was a postdoctoral fellow at the University of Connecticut. + - L 0 I B A K E 5 R Link between Heart Disease and Gum Disease trange as it may seem, taking care of your teeth and gums may also protect your heart. Funded by a $1.2 million grant from the National Institutes of Health, University at Buffalo dental researchers and preventive medicine specialists are beginning a fiveyear study of the relationship between periodontal disease and heart attacks. The study and the size of the award reflect a growing interest in new evidence suggesting that infections in the oral cavity may trigger disease elsewhere in the body. UB dental researchers are in the forefront of this field, with several preliminary studies showing that persons with gum disease are at high risk of developing heart disease. The oral bacteria that cause gum disease appear to be the culprit, says Robert Genco, DDS, PhD, SUNY Dis- Physician w I n t e r 1 9 9 8 �••••••••••••••• • • 0 •••• 0 •••••••••••••• 0 •••• 0 •••• 0 •••• 0 •• 0 . 0 •• 0. 0 •••• - ~~~~~~~~ HURWITZ & FiNE, P.C. [ATTORNEYS AT LAW tinguished Professor, chair of the UB problems, eliminating the influence of Department of Oral Biology and princi- other factors that contribute to heart disease, such as smoking or obesity, to pal investigator on the new study. "Oral bacteria enter the bloodstream determine the extent to which gum via small ulcers that develop in the gum disease is an independent risk factor for heart disease in tissue of persons with both men and periodontal disease. women. These bacteria conThe participants tribute to plaque forwill be followed to mation and increase determine the incithe chance of clots dence of second forming. Clots can heart attacks among also accumulate the heart patients around damaged tiswith and withou t sue, such as a lesion periodontal disease. in the blood vessel or Researchers also a replaced heart valve. will collect data on These accumulations UB DEN T AL the number of first heart can narrow blood vessels. attacks in a control The bacteria also cause RESEARC HERS ARE IN group and assess their platelets to aggregate and THE F O REFRONT OF can increase the chances relationship to periof clots forming. Clots in a odontal disease. TH IS FI ELD, W ITH If periodontal disease narrowed blood vessel can S E V E RAL PRE LIMINARY is found to be a true risk cause a myocardial infarcfactor for heart attack, tion, or heart attack. STUDI ES SHOWING "We've known for the next step will be to THAT PERSONS WITH find out if treating the some time that oral bacteria can precipitate these disease reduces that GUM DISEASE ARE AT kinds of reactions," risk, Genco says. BeHIGH RI S K OF cause cardiovascular Genco says. "We just redisease remains a leadcently put these findings DEV ELOPING H E ART ing cause of death in together as a possible most developed counexplanation of how D I SEASE. tries, the answer to that bacteria that cause gum question could have a disease can also increase major impact on public health. the risk for heart disease. " "Although we know much about the The new study will involve 1,000 people who have survived a first heart risk factors for heart disease, there is attack, and 2,250 people who have not still much unexplained risk to be ashad a heart attack. A complete health sessed," he notes. Coinvestigators on the study are history will be compiled on all particiMaurizio Trevisan, MD, and Karen pants, and all will be given a dental exam with X-rays to determine the ex- Falkner, of the UB Department of Soistence and extent of periodontal dis- cial and Preventive Medicine; and Sara ease. Blood samples also will be taken Grossi, DDS, Ernest Hausmann, DMD, PhD ,Juan Loza, DDS, PhD, andjoseph and cholesterol profiles determined. Researchers then will analyze rates Zambon, DDS, PhD, all of the UB School of periodontal disease among heart- of Dental Medicine. + attack patients and those with no heart L 0 I S 8 A K E R B u f f a L o Physician w I n t e r 1 9 9 8 S ERVICING T HE L EGAL N EEDS OF THE H EALTH S ciENCEs CoMMUNITY • Managed Care • Purchase & Sale of Practice • Business & Tax Planning • HCFA Safe Harbor Regulations and Physician Self-Referrals • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence Mo Ross at 716-849-8900 1300 Liberty Building Buffalo, New York I �~ -······················································································· El CLASS OF 1 958 Reunion Chairs Prepare for Reunion Weekend Festivities Allred M. Stein (pictured) Dear Classmate-Fifty Eight-Can you believe it? Forty years since you became an MD. Our reunion will take place on April 25. Save the date. We have the place. We will celebrate. Michael Genco t's not too early to plan for the 1998 Spring Clinical Day and Reunion Weekend. A cocktail reception will be held on Friday, April24, 1998. The 61st Spring Clinical Day andReunion Dinners will be on Saturday, April25. For more information, call the Medical Alumni Association at (716)829-2778. The reunion classes are of 1948, 1953, 1958, 1963, 1968, 1973, 1978, 1983, 1988, and 1993. Here's what your reunion chair has to say to you! Mickey Stein and l are putting together the usual celebration. lt won't be the same unless you are there! CLASS OF 1 963 Anthony M. Foti We traveled life's path together for a meaningful period. lt would be fun to see how we, the school and Buffalo have changed in 35 years. Please plan to attend our reunion. We hope to see you there. CLASS OF 1948 CLASS OF 1968 Harold l. Graff Daniel J. Fahey It's hard to believe that it has been 50 years since graduation. Please reserve Reunion Weekend of April 24-26. Hope everyone will be here. Great expectations! Looking forward to renewed friendships of the Class of '48. Thomas J. (umbo Robert A. Milch Dear Classmates, lt's 30 years for us. Please come back on April25 to celebrate and reminisce together. We are all looking forward to seeing you again for our 30th. CLASS OF 1 973 CLASS OF 1953 Michael A. Sullivan Arthur W. Mruczek (pidurec/) Next April 25, imagine you're at our 45th reunion. Like Marv Levy says, "Where would you rather be than right here, right now?" We are looking forward to seeing you at the 25th-Year Reunion Weekend. Please plan to join your classmates for this special quarter century of memories. Michael A. Sansone Come back to your roots for the 25th reunion. We need you to make it a success! ® B u f f a l o Physician w I n t e r 1 9 9 8 �··················· · · · · · ···· · ··· ·· ······· · ···· ······ ··· ·· ····························· ·· ~ • CLASS OF 1 988 CLASS OF 1978 Helen (Hess) and Andy Cappuccino David L. Marchetti The clock is ticking! Our 20th reunion (our "Distant Replay"). Please find the time to attend. "Collagen Superstar"; "Insulin Superstar"; Who really ca res? Who really remembers? But memory of the parties will last forever. Come celebrate lOyears out of med school. April25. Save the date! CLASS OF 1 993 CLASS OF 1 983 Michael J. Aronico Richard L. Collins Dear Class of 1993, Can you believe it's been five yea rs since med school graduation? Why don't you book April 24 for our five-year reunion weekend and Spring Clinical days. Look forward to partying and catching up with all of you . Let's ge t together and have some fun at our 15th. & THE ULTIMATEDRIVINGMACHINE: AMANA COLLECTS Checkpoint Foreign Car, Inc. Sales and Service Comprehensive Cost-Effective Receivables Management 487 Kenmore Avenue Buffalo, NY 14223 836-2033 Your WNY Leasing Specialist Serving WNY proudly tor 33 years ~ . ' Amana Capital Corporation Buffalo, New York 716-852-3500 800-441-6925 B u f f a I o Phys ici an w I n t e r I 9 9 8 �• ........ . ........... . ... .. ... . ........ . . . . .. .. . ...... . ..... . .......... . ..... . . .. . . ........ I 1 9 4 0 5 writes from her home in Hillsdale, NY: "At age 72 , I'm still working. Retired from my solo family practice after 35 years , but the retirement didn't take , so I'm doing school health. I'm the medical director of Columbia and also of Green Counties' outpatient Alcohol and Drug IRMA M . WALDO , ' 49 , Treatment Services. And after years of seeing young'uns and their families , I now am seeing the pathology of medical school days , as an attending at the Pine Haven Nursing Home for 40 of my dear little old folks! John is retired , and we both ski all winter. " 1 9 6 0 5 JOHN J . LAMAR , JR ., '63 , retired in September 1997 after 30 years of solo pediatric practice. He now spends much of his time visiting his grandchildren, Garrett, age five , and Skyler, age three, in Ft. Hood, TX. IRA H I NDEN , '65 , says, "I'm very pleased to announce that the Wooster Clinic, a 31-physician multispecialty group, of which I am a member, has merged with the Cleveland Clinic. I will continue to practice in the Family Practice Department of the Cleveland Clinic's Division of Regional Medical Services. BARRY A . WEINSTE I N , ' 69 , has been elected to the Erie County Legislature, representing most of Amherst, NY. His twoyear term began January 1, 1998. He continues in family practice in Amherst, in his 24th year. 1 9 7 0 5 V . SZEKERES , '71 , AGNES writes , "I was selected Internist of the Year" in 1997 in our Kaiser Facility in Bellflower, CA. I was proud to be the only lady to be honored by my colleagues after six years of well-deserving male internists. We have 65 internists in our group. " of Toledo , OH , has been honored by the Vitreous Society, the world's largest organization of vitro-retinal surgeons , with a named lecture in recognition of his contributions to the society and to the advancement of vi.treoretinal surgery. The "Founder's Lecture" award wi.ll fund internationally renowned speakers and support vision research for the society, which Dr. Bovino cofounded and of which he is past president. JERALD A . BOVINO , '71 , has accepted a position as associate professor in the Department of Otolaryngology at Case Western Reserve School of Medicine and Metro Health Medical Center in Cleveland, OH. GREGORY ANTOINE , '76 , ® MELINDA AQU I NO , '92 , says , "I finished my pain management fellowship at Montefiore Medical Center and joined the faculty there as a full-time attending in both anesthesiology and pain management. I am currently studying to become a licensed acupuncturist to enhance my pain management practice. " KRISTINE TENEBRUSO , '93 , of Honeoye Falls, Y, and Todd Blalock announce the birth of their first baby, Lauren Marisa Blalock, on July 14, 1997. Kristine is an attending physician in emergency medicine at Rochester General Hospital, Rochester, NY. of ew Orleans , LA, has begun his residency in ophthalmology at the Ochner Medical Foundation and Louisiana State University Hospital in ew Orleans. "Ever the boater," he writes, "I have chosen to live and spend what little free time I have on my 3 7foot sailboat, Yank ee." THOMAS R . ELMER , '97 , OBITUARIES COL. HERBERT BERWALD , '27 , of Napa , CA , died on Octo- JOHN R . ANDERSON , '67 , writes from DePew, NY: "I retired as medical director at Brothers of Mercy Nursing and Rehabilitation Center on December 31 , 1997." 1997. Mary writes, "Our son , Sam, is now two. Joe has joined a group of otolaryngologists in Bayshore, Y, after completing a head and neck and microvascular surgery fellowship . I completed a fellowship in pediatric infectious diseases and am in private practice. " 1 MARY 9 9 0 5 ( CAPPUCCINO) AND BONAFEDE , ' 91 , announce the birth of their second child , Ella , on June 30, JOE B f f a l o ber 10, 1997. Following graduation from UB, Dr. Berwald was commissioned in the U.S. Army and received his surgical training at Walter Reed General Hos- p h s c a n pita!. During World War II, he was commanding officer of the 217th General Hospital in England and France , the largest general hospital in the European theater. Following the war, he was chief of the surgical service at Percy Jones General Hospital in Battle Creek, MI , and at the 343rd General Hospital in Osaka, Japan . During the Korean War, he was surgical consultant to the Republic of Korea , after which he served as chief of the Departm ent of Surgery at Letterman General Hospital in San Francisco, where he retired from the Army in 1957. Following his military retirement, Dr. Berwald became chief of surgery at the Veterans Home in Yountville, CA , retiring from the state in 1972. He then joined Kaiser Permanen te Medical Group , retiring from medical practice in 1982. He is survived by his wife of 67 years, Victorine Cherney Berwald; his daughter, Arley Hulstrand, of Denton, TX; and his son, Col. Herbert T. Berwald,Jr. , of Fairfax, VA ; and eight grandchildren and two great-grandchildren. PATR ICIA A . MEYER , '50 , died on August 27 , 1997. CARL LOUIS EVANS GRANT , '83 , chair of the medical staff at Sheehan Memorial Hospital and clinical instructor in medicine at University at Buffalo School of Medicine and Biomedical Sciences, died Sunday, October 5, 1997, after a brief illness. He was 46 . Born in Manhattan , Grant attended Marist College and completed his pre-med studies at Harvard University prior to w n I e 8 �........................... ............. • TAKE TWO ... AND CALL ME IN THE MORNING! ~'\d ~014r OW'\ earning his medical degree at UB. In addition to Sheehan Memorial rottd: * Fact:Saabownershavea higher education level than anyothercarownergroup. * Saab purchase prices starting low to mid 20's; leases starting at $299 per month. * According to the Insurance Institute for Highway Safety (IIHS), the Saab 9000 has the lowest fatality rate of any production car on the market. Hospital, he practiced internal medicine at Buffalo General Hos- Millard Fillmore Hospital's Resident Physician Program 1950-52 and a former research staff physician of the Millard Research Insti- pital and Erie County Medical Center. In 1992, he received the UB Biomedical Sciences Commendation for Teaching Excellence. cochair of an International Study on Toxic Inhalation Programs of the National Toxic Inhalation Surviving are his wife, the former Lachele Clemons; four sons, Khori Group, headquartered in Milwaukee, WI, and Cleveland, OH. At ofBuffalo and CarlJr., Adrian and Trevor, of Grand Island; and six present, Dr. Cordasco is affiliated with the St. Luke's Hospital Medical Center and affiliate clinical professor of medicine at Case Western Reserve University. He is also an emeritus (retired) of the Cleveland Clinic Foundation and presently works in the Department of uclear Medicine as a research associate. daughters, Christian of New Britian, CT, Kahlia and Lauran, of Buffalo; and Maria, LaShae and SOUTHTOWNS SAAB Cheynae, of Grand Island. 3580 Southwestern Blvd RESIDENTS (1 Mile east of Rich Stadium) EDWARD M . CORDASCO ' 50, (716) 662·8008 WNY's of Cleveland, OH, an alumnus of tute 1970-75, has been appointed - Exclusive - BMW Retailer THOSE LOOKING FOR MORE CONTROL IN THEIR LIFE CAN NOW FIND IT ON SLIPPERY PAVEMENT. THE ULTIMATE DRIVING MACHINE.e MSRP s64240 F. G. DOWNING s&99 1998 BMW 740i 30 mo. Lease Towne BMW 3030 Orchard Park Rd. Orchard Park, New York 14224 Phone: 675-2550 While the road of life may throw you an occasional curve, at least our All Season Traction helps you handle the particularly slippery ones. FREE SCHEDU LED MAI NTENANCE ALL SEASON TRACTION PMT based on 5500 cap cost reduction (or trade), 12,000 miles per year. 15 cents charge per mile for excess miles. First and last PMT. taxes and plate fees due at inception. Residual $43040 Service Loaners Available •.• Minutes From Rich Stadium B u f f a I 0 P hysician W I n t e r 1 9 9 8 �Planned Giving to UB. A tax deduction and income lor life are two of the benefits you may receive with planned giving to the UB School of Medicine and Biomedical Sciences. You needn't be wealthy, or a financial genius. All you need to do is make a gilt- and hove a desire to help today's budding geniuses make the world a better place in 50 years. For more information, contact Lyn Corder, Ph.D, CFRE, at (716) 829-2773, or via e-mail at ljcorder@acsu.buflalo.edu UNIVERSITY AT BUFFALO State Universiry ifNew York http: // www . buffalo .e du �Who says there's nothing good on TV? As busy as they are, physicians and other health care providers always take the time to watch MLMIC's top-rated risk management education programs. • When they tune into high quality programming broadcast over our satellite network, viewers know what they see will help enhance patient safety and reduce injuries. They also appreciate the policyholder discounts available to participating physicians. MLMIC programming is sponsored by the largest Risk Management Department of any professional liability insurer in the state. Policyholders also enjoy the protection of one of the country's largest and most experienced professional liabi lity Claims Departments. Most importantly, MLMIC has successfully defended more physicians than all other available insurers combined. These are some of the reasons why MLMIC is the only medical liability insurer approved by the Medical Society of the State of New York. To find out more, call1-800-356-4056 in Upstate New York, or 1-800- ASK-MLMIC in the New York metropolitan area. Ask for free copies of our risk management MLM~C ~ :.ledteal Liability \lutuaJ ln,urance Company guide for office practices. • Our defense never rests. 2 Park Avenue New Yor k, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 C>l996 Me,J cal LIB~• ity Mutual ln5Urana C )mpany �BUFFALO PHYSICIAN Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED To consult with someone truly concerned with your financial health, come to Key Your Key Private Banker heads a team of KEY PRIVATEBANK professionals, who can help you achieve your financial goals with surgical precision. Call Marv Madison at 716-847-2341. It may be one of the most important appointments you make. We know medical professionals' financial needs like the dorsum of our metacarpus. Key. For anew America~ f � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 1998 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1998-Winter Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v32n01-1988-Winter Table Of Contents A list of subunits of the resource. Out with the Rote, in with the New Heidi DeBlock, MD Medical Student Exchange to Bosnia Communication Skills for Tomorrow's Physicians A student's perspective New Computer Lab Department Honored Medical School Research News Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-09 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v32n01 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1998 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/b3edc60af2be48ce4d345841489ead09.pdf 90507d817819483b3b40c9aa2f51766f PDF Text Text --- - --------- - -- - State University of New York at Buffalo School of Medicine and Biomedical Sciences, Autumn 1997 �BUFFALO PHYSICIAN \ olume 31, Number 4 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr Carole ~m1th Petro DIRECTOR OF PUBLICATIONS Kathryn .-\ Sa\mer EDITOR Judson \1ead (lntenm) ART DIRECTOR/DESIGNER AlanJ Kegler PRODUCTION MANAGER \nn Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John \\'nght, /ntcmn Dean and V1<r P•cllllrntfor Climwl A{fw11 EDITORIAL BOARD Dr Bertram Partin, Chail Dr \t1artm Brecher Dr llarold Brodv Dr Lmda J . Corder Dr Alan J . Drmnan Dr james Kanski Dr Barbara Majerom Dr Elizabeth Olmsted Dr Charles Paganelli Dr Stephen ~pauldmg Dr Bradley T Trua' Roy Vongtama Dr Frankhn Zeplow 1tz TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospnal .\1iclwcl Sha" The Chlidren·s llospnal of Buffalo Eric County 'Vted1cal Center Mercy Health System Mlila~d Fillmore Health '>ystem Frcmll Sm·a Niagara falls Memonal Med1cal Center Roswell Park Cancer lnsutute ~!Sters of Chanty llospnal Dl'mm .\1cCw thy Veterans Affairs Western New York Heahhcare System The Stale vni\'CrSil\' of New York at Buffalo If) Buf{tdo Pl11 sician IS published quarter\) b\' the State UmverSil)' of Ne" York at Buffalo School of Medicine and Biomedical Sciences and the Office of Pubhcauons. It IS ~cnt , free of charge , to alumni , faculty . students, reSidents, ami fnends . The staff resenes the nghtto ed1t all cop\ and submissions accepted for pubhcauon Address qucsuons. comments , and submisswns to: The Ednor, Buffalo Plnsiciwt, State Lmvcrsity of Nc\\ Y~rk at Buffalo, Office of Publi cations , 136 Crofts Hall , Buffalo, m 14260 Send address changes to: Buffalo Physician , 146 B10med1cal Educauon BuHdmg, H 35 'Vtam ~lreel, Buffalo , NY 14214. Dear Alumni and Friends, As I POI>..;TED OUT TO THIS YEAR's INC0\11NG \1EDICAL STL>DENT'>, these are rapidly changing times, and the task of meshing the art with the science of medicine is becoming ever more challenging. Voltaire is said to have observed, "The art of medicine consists of amusing the patient while nature cures the disease"; yet the scientific basis of medicine continues to expand and now offers glimpses of disease mechanisms and body function that provide new and exciting vistas for the healing arts. But as Victor McKusick noted on a visit to Buffalo, "There is a widening gap between how to diagnose and how to treat, and between what we think we know and what we really know." I suspect that this statement is as valid today as it was just five years ago. We can take solace, however, in the fact that the quality of our entering class has not only been maintained but-no offense, alumni!-actually improved. Our curriculum has also changed: While it still has many of the traditional features familiar to most of our alumni, the new Clinical Practice of Medicine (CPM) and Scientific Basis of Medicine (SBM) courses introduce the art of clinical problem solving through the mechanism of self-directed learning. This should not only add a little excitement to the curriculum but also better equip our students to become "lifelong learners." Finally, we look forward to welcoming Stephanie Unger as the new editor of Buffalo Physician. A senior editor and writer with the City of Hope ational Medical Center/ Beckman Research Institute, in Duarte, CA, Ms. Unger will come on board in October. In the meantime, a very special thanks to Judson Mead, editorial manager of the UB Publications Office, for serving as interim editor. / ~ .127_/ ~f/L~ c:;7' JInterim Wright, M.D. 1~~~;R. Dean, School of Medicine and Biomedical Sciences Interim Vice President for Clinical Affairs Dear Fellow Alumni, THE CLASS OF 2001, CONSIST\ G OF 135 FRESH\1.\"1 medical students, has embarked on an exciting journey. It is a bit shocking to realize that they will complete their basic medical school education in the next millennium. I'm sure I speak for all alumni in expressing my appreciation for the extensive skills and energy of interim dean Dr.john Wright. I look forward to his continued participation, counsel, and guidance as he works to maintain and improve the quality and status this medical school has achieved over the past two decades under the leadership of former dean Dr. john Naughton. This year we are excited about a new mentoring program, conceived by Dr. Wright, in which interested freshmen will be matched with alumni volunteers who will act as a friend and mentor, as well as serve as a source of information, advice, and assistance. I can't think of a better way for students to get to know the alumni and our association. We already have more than 100 students from the freshman class, and judging by the numbers of alumni volunteers, they seem to be equally enthusiastic. If any alumni who have not been contacted would be interested in participating in the mentoring program, please contact the Medical Alumni Association office. The mentoring program committee is being chaired by past Medical Alumni Association president Dr. jack Coyne. ~.,;;w, ~D~ President, Medical Alumni Association �V OLUME 3 1, N UM B E R 4 A UTUMN 4 Dr. Mahoney Becomes Dr. Mahoney 8 DNA on Ice ROSWELL PARK ' S DNA LIBRARIES-FROM G IVING UP A SILKWORMS TO PLASMODIUM VIVAX. by Jessica Ancker CAREER IN 1 997 "The Woman's Way of Seeing and Doing" 12 PUBLIC HEALTH FOR REFLECTIONS ON MEDICINE. PIONEERING WOMEN I N by Michael Beebe MEDICINE AT UB. by Christopher Densmore Research GAIT-RELATED PROBLEMS. PESTICIDES AND BREAST CANCER. HIGH CHOLES- TEROL AND STRESS . Orientation '97 LET THE HARD WORK BEGIN! Development Medical School News MEDICAL SCHOOL REUNION A Student's Perspective LESSONS FROM THE GIVING PROGRAM. MINI MED SCHOOL. LATE MIDDLE AGES. P AG ANELLI HONORED . PET CENTER GRANT. MAGGIE Alumni News WRIGHT RETIRES. TONE .JOHNSON .JR . DEAN'S ADVISORY COUNCIL. UB COMPLETE S WHI E NROLLMENT . by Judith Toski, Class of 2000 '75 AWARDED BRONZE STAR. 1 9 9 8 SPRING CLINICAL DAY PLAN S. Classnotes �mr· ................................................................................. UB researchers study gait-related problems ALTERED STRIDE MECHANICS MAY LEAD TO SECONDARY INJURIES sing a force-measuring treadmill called the Gaitway, developed by the Kistler Instrument Corp. of Amherst, Y, in conjunction with the UB biomechanics laboratory , UB researchers are looking at two distinct kinds of gait mechanics: running after a leg injury , and walking after hip-replacement surgery. RLN"'ING INJLRIES One area of interest is the relationship between initial and secondary injuries in runne rs . Harold Burton, Ph.D. , UB associate professor of physica l therapy and nutri- ~ tion and exercise science, and his : coinvestigator on the study ,john Leddy, "' M.D., associate director of the UB Sports Medicine Institute, have been able to show that runners who develop a muscle injury in the lower extremities alter their running pallerns unconsciously after an injury. This change in running mechanics causes a deviation in the foot's normal impact and push-off force , which can be measured on the treadmill. A change in running mechanics may affect the way that force is dissipated. As a result , the added or altered forces are absorbed by joints and/or muscles unaccustomed to this stress, which may lead to a secondary injury in areas such as the knee , hip , or lower back. "By getting an idea of how a person with a particular problem changes running strategy, we hope to eventually identify a pattern and predict the risk and location of a secondary injury," 0 Burton says. "If we can predict what's going to happen , intervention with corrective measures , such as an orthotic, can prevent the secondary injury from occurring." The study, which involved 10 male recreational runners , examined the effect of injury to the thigh muscles. After coll ecting baseline measurements during level treadmill running, researchers had the participants induce muscle "injury" by running downhill for two 20minute sessions. Downhill running can cause microscopic muscle-fiber tears. For four consecutive days following the injury session, researchers recorded the walking pallern a patient has developed to cope with the pain of arthritis. According to Scott White , Ph.D., associate professor of physical therapy and nutrition and exercise science, relearning a proper walking pallern helps to prevent injuries after surgery and speeds rehabilitation . White is using a Kistler treadmill equipped with a computer that displays measurements of force for patients to read as they walk. When reinforced by verbal coaching from a physical therapist, the visual aids can help patients see the problems with their gait and get immediate feedback on improvements. vertical foot-ground reaction force generated by each runner during level treadmill running. Results showed that the runners who got sore, or "injured ," after running downhill produced altered forces during the next running session, indicating alterations in running mechanics. "These altered mechanics may predispose the individual to secondary injuries of other structures, such as joints, ligaments, and tendons ," Burton says. Among runners , this is no small problem. According to Burton, 50 percent of the people who run regularly experience some type of injury during any one year and need more education about what can happen as a result. A patient with a pronounced limp , for example, can be shown two rectangles that represent the relative lengths of the strides he makes with his right foot and with his left foot. By trying to make the two rectangles match in size as he walks, the patient learns what the correct, symmetrical walking pattern feels like. The Gaitway system's software also lets researchers record the data and perform a number of different analyses. In a three-year study funded by the Arthritis Foundation, White is testing the technique on a prototype Gaitway machine , working in collaboration with Robert Lifeso , M.D., clinical professor in the Department of Orthopedic Surgery, who performs hipreplacement surgery and often refers his patients to White's group for postoperative therapy. + HlP REPLACEMEt\TS Hip-replacement surgery can take care of the pain and immobility associated with arthritis, but many times it fails to correct a related problem-the cramped B u f f a l o - L OtS physician B AKER AND JESSICA A NCKER Autumn 1 9 9 7 �· · · ···· · · · · · ···· · · · ···· · . ... . . .. . . . . . . . . . ... .. ..... . . .. . m .... . ················· [(1~--~ .. . Study questions breast-cancer High cholesterol boosts blood risk trom pesticides and PCBs for pressure in high-stress situations women who breast-feed eople with normal blood pressure n research involving 154 postmenopausal women with breast cancer and ] 92 healthy \\Omen of similar age selected randomly from the general population, Kirsten Moy ich, Ph.D., research instructor in the UB Department of Social and Prcvcnti,·c Medicine and chief investigator on the study, has found no link between breastcancer risk and exposure to pesticides and PCBs in \Yomcn who breast-fed. Researchers measured blood levels of certain organochlorines-DOE, HCB, mircx, and PCBs. Since these compounds arc stored in body fat and arc not easily broken dm.,n , they accumulate in the body over time. Some of these chemicals ha\ c been shown to increase estrogen activity in animals and consequently have been linked to breast-cancer risk. \\'hen separated into groups according to histor) of breast-feeding, .,.,-omen '" ith breast cancer who had never breastfed had significantly higher levels of organochlorines than healthy women who had nc,·cr breast-fed. "These chemicals arc stored in fatty tissue, including breast tissue ," Moysich savs. "The chief mechanism for climin;ting them from breast tissue is lactation , .,, hich Oushcs them from the svstem." She adds that even though tl1c nursing baby is exposed to these substances, the beneficial effects ofbrcastfccding appear to outw cigh potential risks associated '' ith these organochlorines. The study was p rcsc n ted at the International Socict} for Environmental Epidemiology in Taiwan in August. + --- B u f f 0 I 0 can experience greater increases in blood pressure during stressful situations if they have high cholesterol, according to a study published by Bong Hce Sung, Ph.D., UB associate professor of medicine, in the june issue of the American journal of Hypertension. Conversely , the study found that lowering cholesterol with drugs and diet also lowers stress-related increases in blood pressure. It is the first study showing a link between cholesterol levels and hypertension. "We don't know the cause of high blood pressure in 90 percent of hypertensives," Sung says. "These findings shed some light on the mechanisms that cause high blood pressure, opening up possible new avenues for treatment and prevention. "Our results indicate that lowering cholesterol may have the added benefit of controlling blood pressure better during stress, which will lower the chances of developing hypertension and heart disease." The effect of cholesterol on vasoconstriction has been well documented in isolated peripheral vessels, but until now the o,·erall effect of cholesterol on blood pressure has not been studied. To assess the relationship between high cholesterol and blood pressure, ung and colleagues established a study group composed of 70 people with normal blood pressure, 33 of whom had normal cholesterol and 37 with high cholesterol. Blood pressure was monitored in both groups while they took a mental arithmetic test , a standard method to simulate psychological stress. Physician Autumn 1 9 9 7 ~ Researchers added stress to the equation, Sung says, because a dramatic increase in blood pressure during physical or mental challenges has been shown to be a risk factor for later development of hypertension and cardiovascular disease. Recent evidence also shows that the damage to organs caused by hypertension is more closely linked to blood-pressure response to stress than to "casual" blood pressure. Results showed that during the stress test, systolic blood pressure increased to the hypertension range (greater than 140 mm Hg) in 46 percent of the high-cholesterol group, compared to 18 percent of the normalcholesterol group. Sung says that high cholesterol appears to impair the ability of the endothelium (blood-vessel lining) to relax and constrict normally. The study's second phase was designed to determine if lowering cholesterol lowers blood-pressure response to stress. ln a double-blind design, half of 26 members of the high-cholesterol group took a cholesterol-lowering drug for six weeks, while the other half received a placebo; the protocol were then re,·ersed. Total cholesterol fell 26 percent during drug treatment. Participants repeated the mental arithmetic stress test after both the drug period and the placebo period. Results showed that peak systolic blood pressure during stress dropped from 141 mm Hg without treatment to 133 mm Hg after treatment. Sung's coauthor on the study were joseph L. lzzojr., M.D., UB professor of medicine and professor of pharmacology and toxicology, and Michael F. Wilson, M.D., UB professor of medicine. + L o 5 8 A K E R �~f~HI[~ ~f~f~H~ are key to progress in genetics research If DNA is the book of life , the laboratory of Pieter dejong , Ph.D. , is the printing press . BY JESSICA PHOTOS 0 B u f BY f a K l o He and his colleagues in the Human Genetics Department at Roswell Park Cancer Institute are the world's leading suppliers of the DNA libraries that make genetics research possible. They have supplied the gene libraries in which the two breast-cancer genes (BRCA1 and BRCA2) were identified in 1994 and 1995, as well as a host of less ANCKER famous genes involved in such illnesses as C . KRATT spinal muscular atrophy , pancreatic tumors, and Wilm's tumor. More than 40 research centers in 10 countries are using dejong's libraries to hunt for specific genes , create gene maps , or sequence large stretches of human D A. Their work makes them a crucial participant in the Human Genome Project. They're also applying their methods to a wide variety of other organisms, building libraries of the DNA of mice , rats , baboons , silkworms , the Legionnaire's disease organism Legionella, and the malaria parasite Plasmodi um vivax. They're even working with genetic material from a Doberman pinscher that suffers p hysician A u t v m n 1 9 9 7 �library and its copies occupy three tightly packed seven-foot freezers. "So, clearly, you can see that one of the things we need is technical improvements so the libraries will take up less space," de j ong says. The libraries are shipped to researchers all over the world. One of the biggest advantages of using a standardized library is that it provides a common reference system. lf, for example, a scientist identifies a disease gene made up of several fragments from de jong's DNA library, other researchers anywhere in the world can verify the work by placing an order with de jong for copies of those bacterial colonies. A LTER from narcolepsy, supported in part by a grant from the American Kennel Club. "ln this lab, you get calls from the strangest places," de jong says. CR EAT ING LIBRA RIES ln de jong's lab, human chromosomes are cut into pieces between 100 and 300 kilobases long, and the pieces are linked to fragments of artificially produced bacterial D A. The resulting circular chromosomes are made up of mostly human D A but also include important elements that allow them to "pass" as bacterial chromosomes when they are inserted into bacteria. One of these is a D A sequence that ensures that whenever the bacterium divides, it will produce copies of the artificial chromosome for the daughter bacteria. These bacterial artificial chromosomes, or BACs, are inserted into specially bred strains of the common bacteria E. coli. When the bacteria are properly cultured and separated, the result is an array of hundreds of thousands of separate bacterial colonies. Each colony, which is tagged with a unique identifying number, contains hundreds of copies of a unique fragment of human D A. Together, all the colonies are known as a library. Building the library is tricky work. At each step, many of the bacteria die from the unusual stresses imposed upon them. For example, electric shocks are used to punch holes in bacterial membranes so the BACs can enter-and the shocks are strong enough to kill a substantial portion of the bacteria. "At each step, we have a rather narrow window of opportunity," dejong points out. The library can be stored indefinitely by freezing in glycerol, or it can be copied by a "printing press" that dips a tiny metal spike into each colony, picks up bacteria, and touches a clean well of agar where the bacteria will grow and form a new colony of clones genetically identical to the mother colony. Dejong's lab makes 12 copies of each DNA library in order to accommodate requests from future researchers; a single ATE SYSTE MS IN v ENTED Although there are many ways to build aD A library, most have serious drawbacks. Some techniques package the human D A fragments into viruses, which then infect bacterial cells. But to fit in the viruses, the human DNA has to be cut into very tiny pieces; and since human genes may be as long as 1,000 kilobases, it's not very useful to have to cut the D A into fragments of only 15 kilobases or so. The invention of the yeast artificial chromosome, or YAC, overcame the size problem, but introduced other difficulties. YACs, which are grown in yeast, can be used for fragments of several hundred kilobases-large enough to contain an entire gene, or at least a substantial portion of one. However, up to 60 percent of these fragments are altered in unpredictable ways in the yeast. Sometimes, two or more pieces of human D A become inserted in the same YAC, making unrelated human D A sequences appear to be neighbors. Other times, the YAC D A gets rearranged or combines with other YACs inside the yeast. �~(~[ll[~ ~(~(~H~ Today, de Jong and many other scientists usc a system based on the bacterial artificial chromosome, or BAC. ABA can accept large fragments of human D A, and bacteria faith full} reproduce them without confusing rcarrangemcn ts or recombinations. Dejong also uses a libra[} system he invented several years ago, a variation upon the BAC called a PAC because it uses some fragments from an organism called the rl bacteriophage. His PAC librar) is being used b) researchers all o<.er the world, including the world's largest gene- equencing center, the Wellcome Trust Centre for Human Genetics, in England. "They sequence more than all the other centers put together, and they use our PAC libra[} exclusively," dejong says. ETHICAL TROUBLES RESOLVED The Human Genome Project was in full swing, with research APPLICATIONS I CA CER RESEARCH delving into four major D A libraries (including dejong's), Libraries from Roswell Park haw already been instrumental when an international dispute broke out about ethical probin Identifying the t\\o known breast-cancer genes and in lems involved in the collection of the D A samples. It was studying man} other cancers. discovered that the samples in the libraries were not taken In an example from Roswell Park , dcjong's PAC library is from a cross section of the population, but from a few donors helping to pin down precise information about the chromowho worked in the laboratories, and that these donors had somaltranslocations that cause leukemia. never signed informed-consent releases. Also, no measures Peter D. Aplan, M.D., a member of the Ros\\cll Park had been taken to safeguard their anonymity, leading to the faculty and a B assistant professor of pediatrics and of possibility that they could run into trouble obtaining health microbiology and immunology, says that many research insurance if any genetic anomalies were discovered. methods can provide some information about these transloThese problems arose when the researchers who were cations, but only molecular biology can pinpoint the exact building the libraries treated places where chromosomes the human samples as they break and rejoin. "We want to Some ethicists fear that genetic would samples from other ornarrO\> it down to the precise information will lead to the temptation ganisms. "The focus was not base pair ," he says. on the individual. It was on the Aplan and his colleagues to tinker with the human genome. species," de Jong says. compare D A from leukemia cicntists involved with the patients \l-ith DNA from de Human Genome Project also worried that they would be accused jong's PAC library. B} subjecting both to digestion \\Ith of elitism for studying only the genes of fellow scientists. restriction enzymes , and then comparing the patterns of In response to the findings, the ational Institutes of resulting fragments , the researchers can narro\\ down the Health awarded grants to build a new set of libraries that location of the break-point to a region of less than l ,000 base comply with strict guidelines. Dejong's group was awarded pairs. This region is small enough to be sequenced in an $1 million to build two new libraries, one of DNA from a automatic D A sequencer. woman's white blood cells, the other from a man's. Dozens of "Pieter' Pl clones provide a framework that we usc to volunteer rc ponded to an advertisement in the Buffalo map our findings onto ," Aplan sa)S. cws, and after screening by Roswell Park's genetic counseUsing methods like these, Aplan has identified and charlor, 20 men and20 women were selected as potential donors. acterized a nm·el gene that , when disrupted by translocaThe final selection of blood samples was made on a doubletions, apparently helps to cause T-cell acute lymphoblastic blind basis, so neither the volunteers nor the scientist know leukemia. He has also studied the mechanisms of action of whose genes are in the new library. distorted gene products im olvcd in other leukemias and has The male D A library hasjust been completed; the female proposed an explanation for ho\\ chemotherapy for a prione is next. Meanwhile, the old libraric may still be used mary cancer can trigger therapy-related acute myeloid leukemia many } cars later. because the donors signed consent form , de jong says. 0 B u f f a L 0 Physician A u t u m n 1 9 9 7 I �TH E PROMISE Cancer is not the only target. By studying inheritance patterns in an extended family, researchers at ew York University have narrowed down the location of a potential epilepsy gene to a region of aboutSOO,OOO base pairs on one chromosome. They can go no further with gene mapping, so they have approached dejong about making aD A library from a particular patient thought to have the gene. And many of the world's most prominent genetics research centers, including the Wellcome, the Whitehead Institute/MIT Center for Genome Research, and the Sanger Centre in England, are using dejong's libraries to sequence human D A as part of the Human Genome Project. Each segment of human D A is subdivided until it is small enough to be analyzed by an automated D A sequencer. Some 16,000 of the estimated 50,000 to 100,000 human genes have been mapped, but the function of many of these genes is still unknown. A comprehensive sequence of the human genome will reveal many more unknown genes, so the next step must be to investigate their function through such techniques as comparing them with homologous genes from other organisms. There are many questions about the best uses of the new genetic information. Some ethicists fear that it will lead to the temptation to tinker with the human genome for trivial or monetary reasons. But Thomas Shows, Ph.D., chair of the Department of Human Genetics at Roswell Park, is optimistic that complete information about human genes will focus medicine on what he calls "preventive maintenance." "We could become predictors of disease," he says. "Preventive medicine is so much less expensive than treating disease after the fact. " Prenatal testing can already identify more than 200 genetic disorders. Ultimately, Shows hopes, physicians will be able not only to identify potential problems but to prevent them. "Genetic testing might allow DNA library plates are stored us to find out what cards we're at -85 degrees Celsius. dealt with in the game of life," he says. "Do we have a royal flush , or a couple of two's? Whichever, we need this information to play the game." + For more informoHon obout BACs ond PACs, visit Pieter de Jong's Web site ot http/ jbocpoc.med.buffolo.edu. j essica Ancl1er, a Cleveland-based freelan ce writer, is tlte fann er editor of Buffa lo Physician. 1. Extract DNA Human white blood cells are embedded in agarose, then digested with enzymes, leaving the DNA behind in the agarose gel. How to Build a DNA Library: THE RECIPE 2. Cut up DNA The DNA is incubated with a dilute solution of restriction enzymes, which cut the chromosomes at specific nucleotide sequences, producing a pool of DNA fragments of different lengths. 3. Select fragments In gel electrophoresis, small DNA fragments embedded in a gel move through an electric field at speeds proportional to their size. In order to separate large fragments, the orientation of the electric field is changed every few seconds in a process known as pulsed-field gel electrophoresis. Fragments of the desired size-] 00 to 200 kilobases-can be isolated using this process. 4. Build artificial chromosomes The DNA fragments are linked with the vector DNA to make circular bacterial artificial chromosomes, or BACs. Naturally occurring enzymes are used to seal the pieces of DNA together. S. Insert into bacteria Ashock of a few thousand volts of electricity creates a hole in a bacterium's membrane that lasts long enough for a BAC to squeeze inside, a procedure called electroporation.ln order to create enough holes in enough membranes, the jolt must be strong enough to kill a substantial fraction of the cells. 6. Weed out failures Only a few of the surviving cells will have successfully taken up BACs. Each BAC has been constructed with agene that confers resistance to a particular antibiotic. By exposing the E. coli to that antibiotic, the researchers can kill off any cells that don't have a BAC inside. 7. Grow colonies of clones The surviving bacteria are spread thinly over plates of growing medium and allowed to reproduce. Each colony will be made up of the genetically identical descendants of a single bacterium. 8. Plant colonies Arobot identifies the round white colonies, picks asample from each, and plants the samples in the library plates. Each library plate, which is about the size of a large index card, has 384 tiny wells filled with growing medium and thus can support 384 clones. Each well is identified with a unique address, and each plate is labeled with a bar code. An entire human genome library will contain more than 500,000 clones and fill some l ,500 plates. 9. Store or reproduce The plates can be stored indefinitely at -85 degrees Celsius. The colony-picking robot can also act as a "printing press" to make copies of the plates. �MARTIN MAHOI\L\ \\'.\~ON Ill.,\\;\\ to a stellar career in the field of public health as an epidemiologist whose doctoral dissertation revealed higher-than-expected cancer rates among Seneca Indians and as director of ew York's cancer-surveillance program-all before he reached the age of 30. He also had teaching appointments in the School of Public Health at the State University of ew York at Albany and in the Roswell Park Cancer Institute's graduate division. Arthur Michalek, Ph.D., a leading cancer researcher at Roswell Park who first had Mahoney as a student, then later conducted groundbreaking research with him, recalls that he had the makings of "a leader in the field." So what is Mahoney, now 35, doing with a stethoscope around his neck, checking a youngster's sore throat, asking an elderly patient how that new medication is working, and seeing anyone who comes in the door of the family practice clinic at the relatively low-profile DeGraff Memorial Hospital in orth Tonawanda, ew York? Mahoney, who still carries the oversized shoulders of a competitive swimmer from his undergraduate days at Canisius College, smiles at the question. "It's something I always wanted to do," he says. He obviously wanted to do it pretty badly. 0 e u f f a 1 o phys ici an Autumn 1 9 9 7 �PHOTOS BY FRANK CESARIO �- FROM PUBLIC HEALTH TO PRIMARY CARE ~--------------------------------------~ WHEN HE FIRST APPLIED to the University at Buffalo medical school in 1983, after graduating with honors in history from Canisius, he was not accepted (true of about 90 percent of those who apply). His grades were good, his board scores were okay, and he had taken the necessary science courses despite his history degree. He just wasn't close enough to the front of the line. David Valai k , Ph.D., his history professor as well as his swim coach at Canisius, doesn't think much of a medical school admission committee that would reject Mahoney. Valaik couldn't have asked for a better student or swimmer. Last year Mahoney was the first swimmer since Canisius started its swimming program in the 1960s to be inducted into the college's sports hall of fame. "Martin never needed the lecture 1 give to some students," Valaik says. "He had it. " Without the option of attending medical school, Mahoney decided to study epidemiology, earning both a master of science degree and a doctorate at UB before going to work with the ew York State Health Department in Albany. As director of the state's cancer-surveillance programs, Mahoney found both rewards and frustrations in public health. He suddenly had access to millions of health records and powerful computers to analyze the data . He traveled throughout the state, looking at clusters of cancer and trying to find relationships . But as he discovered in May 1989 , there are limits to what an epidemiologist can do . Mahoney came from Albany to orth Tonawanda with the results of his latest study, a look at cancer cases near a plastics factory. A nine-year survey of local medical records showed cancer was not on the increase. lt was not what the hostile audience wanted to hear . "We are not going to buy that ," said the city's mayor at the time , Elizabeth C. Hoffman , who had ovarian cancer herself. " ot when people see house after house with people with cancer." Mahoney felt the call of medicine and its more immediate results even more strongly after he first gained the confidence of the Seneca Indians and then published his study showing that cancer rates were much higher among that ative American population than expected. The study, and later work by Mahoney , Michalek, and others, showed that while cancer deaths increased by 4 percent in the general population, they jumped by 10 percent among ative Americans, who have the poorest cancer survival rates in the United States. Yet health-care providers to these Indian populations gave cancer a lower priority behind alcoholism, diabetes , injuries , and cardiovascular disease. "As a researcher," Mahoney says, "l thought it would be easy to implement. But I didn't see anyone jumping on it. " So in 1990, Mahoney again applied to medical school and this time , armed with credentials that most medical schools would die for, was easily accepted. B u f f a l a Mahoney's first rejection was reall y not unusual, says Roseanne Berger, M.D., associate dean for graduate medical education at the UB Medical School. "Despite the questions in the press about whether we're training too many physicians or whether income is going down , the number of applications to medical schools continues to increase. The talent pool is really remarkable ." But going to medical school and interrupting a successful career to do so is difficult, as Mahoney found out. He and his wife, Ellen, were expecting their first child (their daughter Christine is now 6), and they had to sell their home in Albany and go apartment hunting in Buffalo. Mahoney also had to give up a good income with the state and face stiff tuition bills again. His wife was behind him all the way. "Why not do it? " he says. "I figured this was always going to haunt me if I didn't." To put it mildly , Mahoney was not your typical medical student. He kept his teaching appointments at SU Y/Albany and Roswell , continued his research with his mentor Michalek, and picked up a part-time job as a medical epidemologist with the Buffalo Otolaryngology Group. "T hey were sitting on a large amount of data from their patients over the years, and I helped set up a database," he recalls. Mahoney, who received one of the public-health industry's most prestigious honors in 1992-thejay S. Drotman Memorial Award-for his pioneering research with the Senecas, also started making a name for himself in national medical circles. He was elected first as a student representative, then later as a resident representative, to the American Academy of Family Physicians' Commission on Public Health. Then this past spring, he received the American Medical Association's Glaxo Wellcome Leadership Award, the resident's award from the ew York State Academy of Family Physicians, and the MeadjohnsonAward for graduate education in family practice. Described by those who know him as soft spoken but vocal when he needs to be , Mahoney seems almost embarrassed by the attention . "I guess I've just been fortunate to be recognized for some of my accomplishments," he says. Mahoney feels that his public-health background is invaluable when searching for the cause of a patient's illness in the clinic. Like epidemiology, he reasons , medicine is a case of examining a problem thoroughly and then reducing the odds. If it's not this, it could be that; if you eliminate this , it might be that. Physician Autumn 1 9 9 7 �FROM PUBLIC HEALTH TO PRIMARY CARE - ~--------------------------------------~ Practicing medicine, in the same way, is helping him with his research. While serving part of his residency in the Deaconess Hospital, where he saw a mostly minority, low-income population, Mahoney noticed that many of the new mothers were not nursing their babies. "Physicians are naturally inquisitive, and would probably notice this and say something about it to their fellow physicians or spouses," says Berger, the associate dean and Mahoney's ultimate boss during his residency. But Mahoney's public-health background gave him the expertise and confidence to follow his curiosity and develop a questionnaire and a database to further study the reasons behind this phenomenon, she says. Noting that the results are still coming in, Mahoney says that it appears that breast-feeding in these women is not something that is passed down from one generation to another, perhaps because they have children at such an early age and the generations pass so quickly. His work at Roswell Park Cancer Institute, where his research partners include Michael Cummings, Ph.D., one of the nation's preeminent antismoking experts, has led him to what he feels is one of his most exciting projects: Tar Wars. Conceived by two Denver physicians and run in past years on a shoestring budget, Tar Wars has been adopted and funded by the American Academy of Family Physicians. Mahoney serves on the Tar Wars board of directors and is its coordinator in Western ew York. ''I've really bought into this," Mahoney says. "I think it's a terrific program. "You can't tell kids that smoking is going to shorten their life and that they may die when they are 40, 50, or 60 years old," he said. "When they're l l or 12, they think they're going to live forever. So we mention the negative effectsbad breath , yellow teeth, smelly clothes. Plus smoking costs a lot of money. It begins to get them to focus on how advertisers set them up. You never see these effects of smoking, or ashtrays or burns in the clothes in the ads. We get them to figure out how much smoking costs, about 60 or $70 a month. That's a small fortune for a kid-that's three CDs and a in tendo game." Mahoney intends to hit the road this year to spread the message of the Tars Wars campaign in classrooms. It's not that he has a lot of free time. In addition to his work , Mahoney and his wife now have two other children, icholas (5) and Madeline (15 months). He also is the medical director for the Cantalician Center for Learning; a board member of the Allegany Regional Development Corporation, which helps serve the Seneca ation of Indians in Salamanca, Y; and a board member for the iagara Frontier Vocational Rehabilitation Services, a group that trains and finds jobs for disabled people. And for the past year, he has served as vice chair of the residents section s u f f a l a Physician representing family physicians on the national Council on Medical Specialty ocieties. He is a founding member and on the steering committee for the etwork for Cancer Control Research in American Indian and Alaska Native Populations. In addition, he serves as a referee for five professional journals, including the Intcmationaljou rnal of Epidemiology, and he i an author, coauthor, or contributor to 57 research projects. "My wife understands my work," he says. "She knows this makes me happy. I'm one of the luckiest people in the world." Mahoney has just completed his residency-he also was chief resident-and signed a contract with the medical school, one that allows him to practice medicine, teach medical students, and continue his research. 'Ttl spend 60 percent of my time in clinical work, supervising residents and seeing patients. Twenty percent of the time I'll teach, 10 percent for administration, and 10 percent for research. That doesn't sound like a lot of research, but right now I'm doing all my research on my own time." It would have been simpler, of course, had Mahoney gotten into medical school the first time. But now that he's completed the training for his dual careers, he wouldn't have it any other way. His former mentor, Michalek, who has developed a deep friendship with Mahoney, says his medical degree helps Mahoney bring a fresh perspective to the public-health field . "I think he'll have the best of both worlds," Michalek says. "An M.D. has a real appreciation for the clinical approach. Most people in public health may have a Ph.D., but they don't have an appreciation for disease. That clinical training gives him the ability to better evaluate the research ." It also has a beneficial side effect for Michalek: After all these years of teaching medical students, Michalek has finally chosen one to serve as his own personal primary-care physician-Or. Martin C. Mahoney, Ph.D., M.D. + .\1ichacl Beebe is a reporter for the Buffalo Autumn l 9 9 7 ews. �MEDICAL STUDENTS �"DOES THE WOMAN'S WAY OF SEEING AND DOING EVER HANDICAP HER?" BY CHRISTOPHER DENSMORE , 'E HtJNDRED YE-\RS> AGO , - on April 27, 1897, Dr. Maude j. Frye addressed the graduating class of the University of Buffalo School of Medicine on the subject of "The Woman's Place in Medicine." An 1892 graduate of the medical school, in 1897 Dr. Frye was on the faculty as a clinical instructor in the diseases of children. I am going to use Dr. Frye's address, along with the recollections of UB's first female medical school graduate, Dr. Mary Blair-Moody, and editorials of Dr. Austin Flint that appeared in the Buffalo Medical]oumal, to illuminate the experience of these pioneering ._. women medical students. I will use, as much as possible, their own words. First, Dr. Frye: "I WISH TO PRESENT to you tonight some thoughts concerning woman's place in medicine; the limit of her work, [and) the line which she will oftenest follow. "Whether we like to confess it or not, woman's physical organization necessarily sets a limitto her achievements ... [Here Dr. Frye refers to the proposal that women serve in the National Guard. She is a bit skeptical.] In reckoning the chances of woman's success when she comes into competition with man, the physical factor has always to be taken into account. That medical work which makes the least demand on woman's physique is, other things being equal, that in which she will best succeed." In looking at the past, it is sometimes apparent that beliefs can change. One of the hot topics of the medical literature of the 1890s was whether women should ride bicycles: Would the exertion harm them? Of possible relevance here is an illustration in the first UB yearbook (the Iris), in 1898, of a woman with a bicycle waving a UB pennant. ow back to Dr. Frye: "IT IS, HOWEVER, concerning a feature of woman's mental equipment for work in medicine that I wish especially to speak. I do not expect many of you to agree with me, yet I ask you to think on these things. We must acknowledge between the average man and the average woman an unlikeness of mental capacity comparable to their physical unlikeness, a sex in mind, if I may use the term. This is not equivalent to saying that man is superior to woman. There is equality with diversity. The elm is not better than the oak, nor the oak than the elm, but each is B u f f a l o Physician good of its kind. There are mental processes which are identical in the sexes, there are others which may oftentimes give advantage to the woman in the work of the physician. Does the woman's way of seeing and doing ever handicap her? Let us try to answer the question." lt was this last sentence that first got my attention. A gendered way of "seeing and doing?" Sounds like Men Are from Mars, Women Are from Venus, and other books of that ilk. The debate about whether men and women are essentially the same, or essentially different, has been going on for some time, with, so far as I can see, little chance of final resolution. But to return to Dr. Frye: "IN THE EARLY DAYS when the woman who began the study of medicine was of heroic type, her success was assured from the beginning, for the courage which dared to commence the struggle was equal to any hardship or any emergency which arose later. She has opened the way for the woman of average ability, the woman who but for her pioneer work would be teacher or nurse. The average woman has not, as a rule, the daring of an Elizabeth Blackwell." Dr. Frye is speaking to us from a century ago, 1897. Fifty years earlier, in the fall of 1847, Elizabeth Blackwell had become the first woman to study medicine in the United States when she entered Geneva Medical College. Or rather, she became the first woman to be recognized by the Autumn 1 9 9 7 �medical profession as a physician. Women have been studying and practicing medicine for a lot longer than 150 years. We are in fact talking about the institutional recognition of women as physicians by the medical profession. Elizabeth Blackwell's story is not unconnected with the history of the University of Buffalo. In 1847, many of the people who taught at Geneva in the fall came to Buffalo in the spring to lecture at the VB medical school. All of the teachers at Geneva mentioned by Elizabeth Blackwell in her autobiography were also on the faculty here at UB. One member of our faculty (who did not teach at Geneva) was Austin Flint, after whom Flint Road on the university's North Campus is named. Dr. Flint was the editor of the Buffalo Medical journal and an early supporter of what was then the novel experiment of educating women to be physicians. ln an editorial published in January 1848, Flint looked forward to seeing women as physicians, even though he also stated that "We should regret to see any innovations tending to lead woman from her appropriate sphere-the domestic hearth and the social circle-but we can perceive no good reasons why females whose duties are not prescribed by domestic or social relation should be denied ... exercising usefully their faculties in the capacity of medical practitioners, under proper limitations." To modern sensibilities, this may seem rather lukewarm support, but Flint did, in my e LimaLion, provide important upport to Blackwell by publishing her dissertation in the pages of the Buffalo Medical journal and by writing approvingly of her progress in the medical profession. But advances are not always sustained. Flint's successor as editor of the Buffalo Medicaljoumal was emphatically opposed to women doctors, and when Elizabeth Blackwell's sister Emily applied for admission to the VB medical school in ovember 1851, her application was rejected by the faculty. Women continued to be educated as physicians, but only in such institutions as the Female Medical College of Philadelphia and the ew England Female Medical College, not at the older male institutions. UB's true pioneer woman medical student was Mary Blair-Moody, whose application for admission to the medical school was accepted in 1874. In 1896 Dr. Blair-Moody's reOections on her own experiences were published in the Buffalo Medicaljoumal: "EARLY IN THE AUTUMN of 1874 the majority of the faculty of the medical department of the University of Buffalo decided to favorably consider an application made some years before by a woman resident of their ® B u f f a I o own city, to pursue the study of medicine in their classes on the same footing as the male students. Sex was to be left out of the question as much as possible. The minority, finding it difficult to wholly approve, yielded with true American spirit and also welcomed the innovator with what grace they could command. My youngest brother, then about passing out of his teens, having just previously decided to pursue the study of medicine in that institution, became a member of my family, and together we went into the search for the precious possibilities of the healing art. Every day we measured our work, not by what was required, but by what was possible to be done, making that also include the required. The personnel of the faculty at that time always recurs to my memory as being of a somewhat unusually high order. There was a keen love of truth among them for its own sake. "Two of them said to me, at different times in the course, 'Do not believe what we tell you in medicine or what anybody says until you prove it.' All did not teach in that way for obvious reasons, especially the demonstrator in anatomy.ltwould be impossible. Professor Hadley's classes in chemistry had been and continued always to be open to women. Not only so, women were cordially welcomed and encouraged to do the best work of which they were capable. Dr. Mason frequently had women visitors in his physiology classes and delighted in enlightening them on such practical points as choice of good respiratory mechanism, effects of certain nervous lesions, and similar branches of the subject. "After being well started in my work, and having become quite enthusiastic over the clearness and elegance with which the professor of surgery, Dr. Moore, instructed his classes, I chanced to be in one of the other professor's rooms when he entered without noticing me and exclaimed: 'How is it that we have a woman here?' Dr. Potter entered at that moment and replied: 'J assume the responsibility.' He was dean at the time, and one of them-1 do not remember whom-remarked: 'If we do not like it when she gets through, we can close the doors.' They have never been closed; but, nevertheless, it is my impression that it is liable to remain what it was in the beginning, a man's college, courteously conceding as a privilege to women advantages not taken into account by its charter members. "This has its uses; chivalry on one side and gratitude on the other are encouraged. It is like a bit of the romance of the Middle Ages dropped into the life of a wide-awake, not to say prosaic, American city. Some of the professors said when they decided to leave the doors open to women: 'It shall never be a woman's college. If they wish to study as the men do, well and good. We shall not advertise it as a college admitting women, nor make special arrangements for them, nor consult their convenience.' One of the professors who took this stand and maintained it expressed at one time a thought which is shared by too many and is Physician Autumn 1 9 9 7 �I = - - - - - -- - - -- - - - ------ - -~~-------~ ~ ~ -- --~----- --- mentioned for that reason: 'No lady will wish to study medicine, with the emphasis on lady.' "It was a question in my mind soon after entering how to manage ... I soon felt that there was a majority of the students that would intelligently sustain fair play in the matter. That was a great help to me. What I would have done had that sentiment not prevailed in the class Ido not know.! am sure that this sentiment also prevailed among the professors. There were a few rough fellows in the class who occasionally called my attention to themselves by cat-calls when I entered, excessive smoking at recess, close to my seat, and other manifestations of ill breeding. The class endured it for a while in silence, simply attempting to frown it down. It happened, however, one day that one of the ringleaders of this movement was discovered in some such trick, I do not know just what, and was doubled up and handed over the tops of the iron seats from one man to another from the back row right down to the desk and rolled over that in no gentle manner to the lecturer's usual place. The quietest, most scholarly, and most gentlemanly men in the class took hold with a will and received him with open arms as he was handed along too rapidly to help himself, starting as he did doubled up like a jackknife. This happened just before lecture time.lt was done quite sternly, almost silently, and ---- = and "Of course," recalled Dr. Blair-Moody, "he would not be just ready when I wanted to go home." " ... At graduation the announcement was received with rather more than the usual cheers and congratulations, six little pairs of hands in the gallery joining in the applause." By the time Dr. Blair-Moody penned her recollections, and when Dr. Frye gave her lecLUre, women medical students at UB were no longer an experiment. In the 1880s and 1890s, women made up as much as 15 percent of the graduating classes. Women would remain a minority until the 1970s, but their fitness to swdy medicine was no longer seriously questioned. On October 17, 1889, the women students at the University of Buffalo met to consider "the advisability of fonning a society of women students of the university." Since the time the college admiued women, and Mrs. Moody became a student, the effort of coeducation had been a success, and the time was now ripe for women to bind themselves to support one another to work, not as a few timorous individuals upon whom the world should frown disapprovingly, but as a sisterhood whose object should be mutual encouragement, support, and aid in matters social, educational, and professional. The organization founded , known only by the initials S.E.V., sponsored lectures, study sessions, and social events. Women were to some degree accepted, but continued to feel the need to create separate organizations for mutual support. Organizations by and for women at the university have now been functioning for more than a century. Returning to the remarks of Dr. Maude Frye in 1897: iiiiiiiiiiiiiiiiiiiiiiiiiiiiii must have noforce, small amount ofrequired muscular as he was not a slight fellow to whom this dose was administered. It amused me greatly, as the man seemed to shrink from attracting attention to himself in any way afterward ... "... John, the janitor, was my faithful friend through it all. He was always interested in my work, kind and helpful. Among the boys he had the reputation of being afraid of nothing, living or dead. He, too, liked to see fair play, at least so far as I was concerned, and occasionally so expressed himself to the students in his own inimitable way. 'She pays her money like the rest,' he said to one rough student one day. 'She has just as good a right here as anyone.' "But there were limits, by common consent apparently, to my privileges. It was to be fair play but no favor on account of sex. Our professor in medicine ... once overstepped the bounds, according to class sentiment. We were studying diseases of the chest under his instruction. A prize had been ... offered for the best report on a certain set of lectures on this subject. Perhaps to try the temper ofthe men and their opinions on the subject, he called me out at several successive clinics to make the chest examination, which was a coveted privilege and could not well be accorded to everyone. About the third time a hiss of disapproval was sufficiently expressive to convey the class sentiment of fair play and no favor ... " Mary Blair-Moody was what we now think of as a "nontraditional" swde nt~older, married , and with children of her own. When she entered the medical school, she was in her late 30s with six children. She doesn't mention her child-care arr;ngcments or support network, but occasionally at the end of a long lecture day her family came down to pick her up, and the children would sit with her in the upper seats of the lecture hall. One of her boys would take off his shoes and stockings, B u f f a 1 a Physician "THERE IS ONE quality which more than any other makes for success in certain lines of medical work. It is the type of courage more or less common to all men, rarely found in women-the courage which dares. It is the courage of the soldier, and the explorer. It is the courage which makes possible the great surgeon." ote here that Dr. Frye is talking about two forms of diversity in the mind: a diversity among women, between the heroic pioneers in the mold of an Elizabeth Blackwell and most women; and a generalized diversity between men and women. "ON THE OTHER HAND, through all time woman's genius has given this character to her work. It has not turned to great deeds but has contented itself with the humbler, often holier, tasks of the home, the school-room, and the sick chamber ... It is the courage whose other name is patient endurance ... "The lack of daring does not make a physician less trustworthy, nay rather she may be more worthy of trust, but the lack does not work to her material advantage. There are departments of medicine, notably bacteriology, for which not only woman's type of courage, but her whole manner of training, from her youth up, should eminently fit her, Autumn l 9 9 7 �and in such work as this I believe she will excel. But the woman who gains wealth and fame in the practice of general medicine or of surgery will be the woman who possesses, without necessarily losing anything of her outward womanliness, the masculine type of courage. She will be the woman who would rather be wrong than not try. The average woman would rather not try than risk being wrong. "There is a special message which I wish to give to the young women receiving their diplomas tonight. It is concerning your work among women. Whether you intend to be a gynecologist or not, every woman who enters your office expects you to be. Setting aside your right to do whatever you can and desire to do, the fact that women wish women physicians is the only reason for your being such. You will come to feel later the great power for good-not altogether in a professional way, but as friend and counselor-which is yours, for the good woman who is a good physician has before her, in teaching to her sex right ways of living and true views of life, a work which will bring satisfaction to herself and blessing to others. "... Except for the woman of unusual talent, wifehood and motherhood are of themselves a vocation. Because of this and because other occupations demanding less of her physically and mentally and offering quicker success are open to woman, the number of women physicians will always be few . Yet whether we ever occupy a great place in medicine or not, a place is ours. We are better women for the knowledge of humanity which our work has given us. May we not hope that humankind will be the better too, for our having wrought!" Dr. Elizabeth Blackwell continued as a pioneer in medical education for women in the United States and also in Britain, where in 1859 she was the first woman to "have her name entered on the Medical Register of the United Kingdom." She died in 1910. Dr. Mary Blair-Moody became the fir t woma n member of the Erie County Medica l Society, a fellow of th e America n Association for th e Advancement of Science, and a fo under of the [Buffalo] Women's Educational and Industrial Union. The union later (in 1916) gave their building to house the new College of Arts and Sciences and provided an endowment for the university. When asked for her opinion about th e uses of the endowment, Dr. BlairMoody recomm ended the establishment of a Departm ent of Preventive Medicine, "wi th a yo ung, able, gifted , and enthusiastic person as leader. Sex should not bar anyo ne fro m this chair. " She died in 1919. Dr. Maude Frye taught briefly at UB, then went on to a large and successful medical practice in Buffa lo. From 1922 to 1940 she also served as Medi ca l Adviso r for Women at th e Uni versity of Buffalo. She died in 1946. Change is so metim es slow. In the co urse of co ll ecting materials for this paper, I checked th e Medentian, a magazine published by the students of medicine and dentistry at UB in the 1940s. I was looking to see if it might have carried an article on Dr. Frye's retirement. Though I didn't find one, there was a regular monthly column written by women in the medical school under the ti tie "Hen-Med. " The first issue of the 1939- 40 school yea r, some 50 yea rs after Dr. Frye ente red the medi cal school, ended with the following observation : "THE SLIGHTING FACT that none of the physical diagnosis instructors at a hospital (quote) wants a woman in his group (unquote) ... The unflattering fact that women are politely excused from certain clinical procedures. The unsurmountable fact that too many hospitals have doors closed to women interns. Take all this, give it a quick glance, and pretend to forget about it. "Pretend. But do your share to prove your worth. Remember that the emancipation of women is still a thing of the future. And here in this school, as liberal and open-minded in its attitude toward women as any school in the country, among a group of genuine good fellows who are learning to accept you in spite of the remnants of their traditional distrust of you, is your chance to play a part in the great emancipation." + Magnificent BUILDING LOTS Dear Colleague: As a former president of the University at Buffalo medical school Alumni Association and a practicing surgeon in Western ew York for many years, I've come to understand what members of our profession desire in a home site - privacy, tranquility, fresh air, and pristine surroundi ngs. The Summit at Scherff is a truly extraordinary residential developme nt, un rivaled in Weste rn New York. Nestled in the hills of Orchard Park, this magni fice nt 81-acres has been subdivided into 50 estate-sized buildi ng lots surrounded by Chestnut Ridge Park and euman Creek in a very private enclave. Specifical ly as an escape from the fast- paced everyday life we lead, it's features include: ' Spectacular panoramic views of the Canadian shores, Lake Erie, and the Bulialo skyline ' Mature woods and secluded ravines • Oversized lots for your dream bouse ' Quick and easy access to the freeway systems leading to Bulialo and the city's northern suburbs ' Privacy, seclusion, and exclusivity The Summit promises to be one of the premier areas in Western ew York to construct your luxu ry residence. I invi te you to take a stroll through this picturesq ue setting. For ou r detailed brochure or a private showi ng please call (716) 667-2237 or (716) 472-3790. Sincerely yours, Ed mond J. Gicewicz, M. D. Past President, UB Medical Alumni Association THE Orchard Park, New York CIJristoplt e1 Densmore is tlte University at Buffa lo arcll ivi .st. B u f f a l o Phy si SUMMIT AT SCHERFF c i an Autumn I 9 9 7 �ou and Community Blue - a partnership based on a mutual goal of excellence. Our commitment includes finding solutions to the challenges that we all face in the ever-changing health care arena, and listening to the needs of those we work with and serve. For members, Community Blue offers innovative health coverage that gives members more choices and more flexibility, plus greater and more affordable access to the care they need. PARTNERED FOR EXCELLENCE. Providers benefit from Community Blue's growing enrollment and from the streamlined systems and procedures we're introducing. For employers, we provide a 12-month rate lock that gives rate stability and coverage that matches their business cycle. At Community Blue, we're proud of all we stand for in health care ... our innovative programs, our quality coverage and our financial stability. Most of all, we're proud of the long-standing partnership of excellence we have with the Western ew York medical HMO community. Blue Cross & Blue Shield of Western New York For information, call 887-7921. E .... An loderxn<km LKtnstt of 1he Blue Cross and Blue "'htekl Assoo:.auon The HMO that gives you more Buffalo Phys icia n A utumn 1 9 9 7 ���. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . .. . . . . . . . . . . . [1] ~ I Mini med school ahit LAYPERSONS LEARN HOW EX C ITING AND UNDERSTANDABLE SCIENCE AND MEDICINE CAN BE tis 6:30 on an exquisitely beautiful summer evening in late july, and Butler Auditorium is already starting to fill. By 7:00, Alan Reynard, Ph.D., professor of pharmacology and toxicology, is well launched into his description of how R A polymerase forms mR A in order to copy D A. He is squeezing in the last few minutes of a lecture he began two weeks before, working his way to the consequences of mutation" ow, is a protein with an incorrectly placed amino acid a mutation? No." He presents clearly but quickly because Jerrold Winter, Ph.D., professor of pham1acology and toxicology, is waiting to present his scheduled lecture on the chemistry of the brain. Every UB medical school class for the past 30 years has sat in these seats and heard these lectures, although they have usually been given in more detail. But tonight the students are a retired electrician and his wife , a systems analyst, an office manager, a lawyer, 16-year-old Brandon Palumbo, whose grandfather wants him to get a taste of what studying medicine would be like, and 200 other men and women as unlike in their age and backgrounds as traditional medical school students are alike in theirs. This is the final night of the second six-week session of UB's Mini Medical School, developed by Harry Sultz, D.D .S., M.P.H., professor of social and preventive medicine and director of the medical school's Health Services Research Program. When he applied to UB's Office of Public Service and Urban Affairs for a start-up grant, Sultz knew that such programs had been successful elsewhere. The first was offered by the University of Colorado Health Sciences Center in Denver in 1990; since then, more than two dozen institutions have offered similar programs, including a four-week session for members of Congress sponsored by the ational Institutes of Health's Office of Science Education Policy. "The real question in our minds ," Sultz said recently, "was whether Buffalo , with its reputation for blue-collar interests, would respond the way other cities had. " a u f f a 1 o Buffalo and its environs responded. otice of the spring program consisted of one announcement on UB's FM radio station and an article in the Buffalo ews. More than 1,000 people called for the 287 seats. A second program was arranged for June and July to accommodate some of the overflow. A third program will run in September and October, supplemented by additional lectures-on alternative medicine, women's health , preventive medicine , and how to navigate the health-care system, among other topics-for those who have been through the basic course and want more. The curriculum for the basic course consists of two lectures each on the subjects of cardiology, neuroanatomy and neurosurgery , microbiology and infectious diseases , oncology, immunology, and pharmacological therapeutics of the mind. Sultz, who readily characterized the program as "pa rt lecture, part theater, " recruited a luminous faculty of volunteer lecturers . On the night of the last summer session, as Jerrold Winter describes Otto Loewi's discovery of the chemical transmission of impulses in the nerves, the Butler auditorium quiets to a dead hush . "The thing that surprises me the most," Sultz says, "is the interest the people have in pure science. They're fascinated by science, even if it doesn't have immediate practical application to their own health." Sultz set three goals when he proposed the program: to promote good relations between the community and the medical school, to make science and medicine more understandable and exciting to laypersons, and to increase participants' knowledge of health and disease so they could be more competent health-care consumers. Continued demand for the basic course and the interest of"graduates" in additional lectures suggests that he has Physician Autumn 1 9 9 7 �····································· ···· ·······.························· · ··· · ··········• · tM I I THE THING THAT SURPRISES ME THE MOST IS THE INTEREST THE PEOPLE HAVE IN PURE SCIENCE. THEY'RE FASCINATED BY SCIENCE , EVEN IF IT DOESN' T HAVE IMMEDIATE PRACTICAL APPLICATION TO THEIR OWN HEALTH. " met the first goal. "We have a number of science teachers taking the course," Sultz says, "and they've wanted to know if they can bring their students. So we're talking about creating a mini med school for science teachers and their students on a model developed by the University of orth Carolina." For Charles Gorder, a retired electrician from Clarence, NY, the evenings have been a taste of what might have been: "When I was a youngster, I worked as an assistant to a pharmacist. When I got drafted during the war, I hoped to be a corpsman but the avy made me an electrician. I've been an electrician all my life-and that's been good, don't get B u f f a l o me wrong. But I've always had the interest. I've learned more here in six hours than I did in my entire life in school. Look at tonight. Now I know that someone who's depressed may be suffering a chemical imbalance." Bill Kilinskas, a systems analyst from Amherst, Y, came because "at my age you start thinking about health. The knowledge of what a heart attack really is, what a stroke really is, is useful. " And the 16-year-old? "I think it's pretty interesting." During intermission, after Winter has finished diagramming receptors and explaining acetylcholinesterase, serotonin, dopamine, gamma-aminobutyric, and other features Physician Autumn 9 9 7 of brain chemistry, Palumbo buttonholes him at the back of the hall. After the first session, Sultz was approached by a local cable television system with an offer to tape and broadcast the lecture series, but he turned them down. "I don't want people to take this sitting in their living rooms. I want them to go to medical school." And he rounds out the experience with a mini graduation. Led by the traditional bagpiper, the robed faculty march to the well in Bu tier to close the sessions. Participants receive a certificate attesting to the completion of 12 hours of instruction in the medical sciences. + - J U D 5 0 N M E A D �• ·········································· · ···································· · ········ ~ I Paganelli named Distinguished Service Professor harles V. Paganelli, Ph.D., professor of physiology at the University at Buffalo, has been named a SU Y Distinguished Service Professor. A member of the UB faculty since 1958, Paganelli has served as interim chair of physiology since 1991, a position he also held from 1980 to 1982 and in 1986. In addition, he was associate chair of the department from 1976 to 1980 and from 1982 to 1991. Starting in 1970, Paganelli was named to several committees ofUB's Faculty of Health Sciences (made up of all five of the university's medical and health professions schools), in which capacity he helped shape the role of those schools in the university's mission. An active researcher, throughout his career Paganelli has brought more than $5.7 million in awards to the university. His research has taken him to locations that include the Marshall Islands , the Midway Islands , Alaska , and Hawaii. He has presented lectures in Denmark , France , Switzerland, Italy , Israel , Taiwan, Korea , and japan , as well as throughout the United State . Paganelli has published more than 70 articles in professional journals and is coeditor of the book Physiology Function in Special Environments. His professional memberships include the American Physiological Society and the Undersea Medical ociety. In 1995, he received the dean's award of the School of Medicine and Biomedical Sciences and the Student ational Medical Association Award. + try , and Rehabilitation Medicine, and the faculty of Social Sciences. Also participating is the Department of Veterans Affairs through the VA Western ew York Healthcare ystem. "T his award by the Cummings Foundation will allow us to continue mapping the critical pathways by which humans understand language ," says Lockwood. "By studying the links between sound and emotion centers in the brain , we may also be able to better understand hearing loss and disorders such as tinnitus or ringing in the ears, which is associated with adverse psychological symptoms like depression , ~ anxiety, and insomnia." a In addition, the study will examine ~ auditory attention systerns that require ~ more complex processing of aural information and will analyze how the brain handles language , including studies of reading, grammar, and syntax. Such tests have already proved useful in monitoring recovery from concussive brain injuries like the one suffered by former Buffalo Sabres player Pat LaFontaine. Using newly installed M Rl equipment and powerful computers in Buffalo's VA medical center, the researchers will combine the MRI and PET images to map the functions observed in the PET scans onto precise locations in the body indicated by the MRI images. Part of the funds provided by the Cummings Foundation grant will be used to upgrade the computer equipment and software to include this sophisticated image-fusion capability. The james H. Cummings Foundation , located in Buffalo, was established in 1962 through a bequest by james H. Cummings, who was a prominent manufacturer of pharmaceuticals with operations in Buffalo and Toronto, Ontario. The foundation has distributed more than $ 15 million in grants to further medical science, research, and education. + ~ UB medical school receives $107,000 grant from James H. Cummings Foundation he University at Buffalo has received a $107,000 grant from the james H. Cummings Foundation of Buffalo to fund a pioneering research project that will look at how the brain transforms the sounds we hear into information. This three-year study will combine images of brain activity formed using positron emission tomography (PET) scans with images of structures in the brain acquired through magnetic resonance imaging (MRI) to create a unique image that links neural activities to specific brain sites. Through the combined images, researchers hope to gain new insights into how sound relayed by the auditory system are understood. Directed by Alan Lockwood , M.D. , UB professor of neurology , the multidisciplinary project will involve the Departments of uclear Medicine and eurology, Communicative Disorders and Sciences, Linguistics , Psychia- - B u f f a I a Physician PAULA WITHERELL Autumn I 9 9 7 �HURWITZ & RNE, P.C. [ATTORNEYS AT LAW Put the best seat in the fwuse myourgarage. I Maggie Wright med school assistant dean,retires SERYICI G THE LEGAL aggie Saxon Wright, assistant dean for student affairs and director of minority affairs, retired in August 1997. She had served in the medical school's administration since 1981. Wright oversaw the academic and student affairs concerns of first- and second-year medical students and administered the core basic science program, including medical electives, the HLBI Summer Research Program, and the ational Medical Fellowship Program. She also provided support services to all medical student organizations and was advisor to the Minority Undergraduate Pre-health Organization. Active as director or advisor to many local and national programs, Wright has been honored both by medical educators and by the community as the recipient of, among other awards, the State of New York's United University Professions Excellence Award, the ational Medical Association Award, and the NAACP Medgar Evers Award. + NEEDS OF THE HEALTH Scm cEs COMMU ITY • Managed Care • Purchase & Sale of Practices • Business & Tax Planning • HCFA Safe Harbor Regulations and Physician Self-Referrals • Contracts with Private & Public Entities 1997 Buick Riviera • Employee Relations Please contact Robert P. Fine or Lawrence M. Ross at 716-849-8900 Riviera: the most sophisticated personal luxury car Buick has ever offered. It is designed to stir the spirit and excite the soul. We at Paul Batt Buick are proud to serve the people of Buffalo and its surrounding communities. For the last 43 years, we have offered the lowest prices possible, along with the very best in service. We value the professional and the hard working labor force in our community and will continue our efforts to maintain their loyalty. When you enter our showroom you will find helpful people, not pressure-so when you think of Buick sales and service, we know you'll think of us! Joseph R. Pera Paul V. Batt, Jr. 1300 Liberty Building 1717 Walden Ave. , Buffalo, NY Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues 'ldut'!Jall7Jlliti Buffalo, 6 u f f a 1 o ew York Physician 891-5595 Autumn 1 9 9 7 �• ······························································· · ······ · ················· ~ I Key issues include relations between the medical school and the local medical community, relations between the BY ANDREW DANZO school and the university as a whole, and changes in patterns of medical practice and teaching. Underlying it all are the economic factors driving much of hey don't do it for the glory-the Dean's Advisory Council is the change-the decline of government a relatively unheralded group that prefers to meet outside the support, the rise of managed care. To preserve an atmosphere in which memspotlight. They certainly don't do it for the money-members bers speak freely, Wright hesitates to relate details of Advisory Council dispay their own way, even if they must take a cross-country cussions, but he will say that recent sessions have touched on such subjects flight to participate. as the importance to the school of its What they do for the chool of Medi- the council after having spent 24 years volunteer faculty and the planned mergcine and Biomedical Sciences, however, as chair of orthopedic surgery at UB. ers among institutions in Buffalo's teachis becoming increasingly valuable. With Bradley Aust, M.D., founding chair ing hospital consortium. a roster of senior alumni and faculty of the Department of Surgery at the Some Advisory Council members members, the Dean's Advisory Council University of Texas at San Antonio have already been through similar issues is helping the school position itself to and a member of the elsewhere. "They can maintain leadership in medical educa- UB Class of 1949, provide us with some DEAN 'S ADVISORY COUNCIL tion, biomedical research , and health- agrees: "We're happy of the scenarios and some of the things we care policy during a period of profound to try and be supJ. Bradley Aust, M.D. national change. need to pay allention Charles D. Bauer, M.D. portive in giving adMichael E. Cohen, M.D. "The Dean's Advisory Council is a vice. One of the to from the perspecS. Max Doubrava, M .D. tive of the medical forum to put forth provocative, poten- advantages of outJock C. Fisher, M.D. schoo I," Wright says. tially controversial ideas; to get a reac- side participation is James R. Konski Jr., M.D. "Experience is a wontion from individuals both inside and that we're at other Jerome P. Kossirer, M.D. outside this community," says interim universities and derful teacher. " (Con sultant ) dean and vice president for clinical af- medical schools: In February of Harry l. Metcalf, M.D. fairs John R. Wright, M.D. "I articulate There are some this year, the group Eugene R. Mindell, M.D. current issues facing the school, warts generic problems met in Boston at the Richard B. Norins, M.D. and all. I don't think I hold anything that cut across uniHoward Hughes Margaret W. Poroski, M.D. back ... and the Advisory Council is not versity boundaries, Medical Institute, Dorothy C. Rosinski-Gregory, M.D. reticent about providing advice." and we can tell [the where the Advisory Albert C. Rekote, M.D. Established two years ago by former dean] about our Robert N. Schnitzler, M.D. Council's honorary George W. Thorn, M.D. dean John P. a ugh ton, M.D., the coun- problems and how chair , UB Class (I lonon11y Clw ir) cil represents a broad range of experi- we solve them. " of 1929 member Philip B. Wels, M.D. ence. Members from the Buffalo area George W. Thorn, Wright sees the Franklin Zeplowitz, M.D. include faculty who are heavily involved council, M.D ., has served as which in the UB medical school and alumni meets three times a research director. who are active in the local medical com- year, as a combina"He talked about his munity. Other council members, many tion of expert panel and sounding board life," recalls Mindel!. "He gave us of whom hold distinguished academic to help the school grow stronger in an some suggestions about how our and research positions, are scallered unpredictable but rapidly evolving en- school can attract outstanding facaround the country. vironment. "It's a given that we're not ulty and how to pursue funding for "We would like to help the UB School going to stand still," he adds. "We're activities we're interested in. " of Medicine to move ahead," says Eu- going to have to think of different ways ext February council members will gene R. Mindel!, M.D., who serves on of doing things." travel to San Diego, where they will be Dean's Advisory Council ® B u f f o l o Physician .A. u t u m n I 9 9 7 �····················· · ·· · ··············· · ··· · ······· · ················· · ···· · ······ · ····· • I • ~ . I hosted by jack C. Fisher, M.D., a UB Class of 1962 member who is among the group's most active participants. A noted professor of surgery at the University of California at San Diego and former head of that school's Division of Plastic and Reconstructive Surgery, Fisher hopes to provide insight for developing strategies in Buffalo. "There are contrasts to what's happening in Buffalo with what I've experienced here in California," Fisher says. ''I'm planning to give [council members] the opportunity to meet with some of the administration from our medical chool and medical center to discuss how managed care has inOuenced our own graduate and undergraduate medical education. It's been hard. " Fisher, who devotes at least several days a year to Advisory Council meetings and preparation , sees it as a way of giving back to his alma mater. "Basically, I'm a graduate, and Buffalo is my home. I was honored to be asked, and I find it interesting." + Andrew Danzo , a Buffalo -based freelan ce writer, is a frcc1uent contributor to Buffalo Phys ician . INFINITI AUTO PLACE INFINITI 8129 MAIN ST., WILLIAMSVILLE 633-9585 East of Transit Rd., Near Eastern Hills Mall s u f f a 1 o UB first to complete Women's Health Initiative enrollment he University at Buffalo is the first of 40 sites in the nation to meet all its recruitment goals for the $625 million Women's Health Initiative (WHI), the largest clinical trial ever undertaken in the U.S. UB's Department of Social and Preventive Medicine was selected in 1993 to be one of the initiative's 16 Vanguard Clinical Centers. These sites established the study's design and developed the operating procedures for the remaining centers. A total of 4,000 women in Western ew York have volunteered to take part in this landmark study. The WHI's goal is to arrive at definitive answers concerning the relationship of hormone-replacement therapy and various aspects of diet on women's long-term health. A third aspect of the project, the observational study, involves tracking women over the 12year study period to determine lifestyle habits that are beneficial or harmful. Specifically, the study will seek to determine risk factors for heart disease, the largest killer of women; breast, colon, and endometrial cancers; osteoporosis; and Alzheimer's disease. The WHI eventually will involve 163,000 women nationally between the ages of 50 and 79. Karen Falkner, Ph.D., recruitment director for UB's Vanguard Clinical Center, says that being the first to reach its recruitment goals is a significant accomplishment for UB and a testament to the generosity and insight of the women in Western New York. "These volunteers are willing to devote a part of their lives for the next decade to helping improve the health of women for generations to come," she says. "They are part of a history-making adventure." The university's share of the grant forthe WHI study is $11 million spread over l2 years. Co-principal investigators on the trial are Maurizio Trevisan, M.D., professor and chair of the UB Department of Social and Preventive Medicine, andjean Wactawski-Wende, Ph .D. , UB assistant professor of gynecology and obstetrics. The university's recruitment success in this clinical trial will help make it a prime site for future investigations, Falkner says. + When the engineers at lnfiniti set out to create the new flagship Q45, they didn't ask each other, "What does a luxury car owner desire most in a luxury car?" They asked the luxury car owners themselves. In countless interviews, Infiniti asked questions like, "What catches your eye?", "What tickles your fancy?" and "What makes your heart pound?" The result? Styling that's the perfect blend of elegance and sportiness. Physician QX4 Autumn 1 9 9 7 I �• ························································································ Aword from the director of development BY LINDA J . CORDER. PH 0 .. C hanks to many generous medical graduates who celebrated a class reunion this past spring, the Medical School Reunion Giving Program for 1997 received a prestigious award from the SU Y Council on Advancement and Development. I had the felicitous responsibility of accepting this] udges' Citation on behalf of the school during the annual SU Y/CUAD Conference, held in Corning, Y, this pastjune. The entry of the School of Medicine and Biomedical ciences was one of 113 submitted for evaluation of excellence and improvement by a panel of experts. Of the programs or publications evaluated, there were eight recognized as "Best of Category" and 11 that received a "judges' Citation." Our program received a judges' Citation. Last fall , we analyzed the Medical chool Reunion Giving Program by the results it had obtained over the previous six years. The amount of reunion gifts given to the school during that time period wa slightly more than $575,000an average of 92,500 a year, or under $10,000 per class, per year. With the assistance of former dean Dr. john aughton, we recruited reunion gift cochairs for most of the classes celebrating reunions. As far as I have been able to a certain, this year was the first in which most class reunion chairs had a cochair to assist with their class gifts. We extended the definition of "reunion class" to include all living alumni who graduated in years ending in "2" and "7." This added four reunion classes within the "jubilee Emeritus" group. Two-the 55th and 60th year classes-took active roles in this year's reunion celebrations. ® We encouraged class members to make gifts to any fund that would benefit the School of Medicine and Biomedical Sciences. In the past, class members were asked to contribute to a specific reunion account, for a purpose decided by someone else. We also included a one-page survey in the initial mailing. This provided each class member with an opportunity to update the information on file in our office and that of the Medical Alumni Association, to rate their perceptions on various aspects of medical practice, and to s hare per onal information with their classmates. (A t press time, we are still working on the "class booklets" based on these survey . They will be finalized and mailed to each person who made a reunion gift, ca me to reunion weekend, B u f f o 1 o F . R E or took the time to complete and return the survey even if they could not come to the reunion or did not make a reunion gift.) These four program enhancements likely resulted in the increased reunion giving upon which the award was based. Several people made gifts based on Dr. aughton's suggestion of $100 for each year since graduation, and many additional individuals gave contributions of 1,000 or more that will result in their recognition as members of the james Platt White Society for 1997. Overall, reunion class members committed more than $136,000 to the school, with a participation rate of 33 percent. This amount is more than double the total of reunion gifts made in 1996 and it surpasses the average of the previous six years by $44,000-that's an increase of 48 percent!! Twelve additional reunion class members made pledges of unspecified amounts. Depending on the magnitude of these gifts, the percentage of increase may be even more significant. The reunion class with the highest gift total-more than $30,000-was the Class of 1942. This successful effort was led by Richard Ament, who established a Charitable Remainder Unitrust in honor of his 55th reunion . He designated the remainder amount for the Department of Anesthesiology. Two classes shared honors for the highest percentage of participation: More than half-58 percent--of the living class members of the Class of 1937 and the Class of 1947 made a reunion contribution. Above 40 percent were the Classes ofl967 and 1952, with 42 percent and 41 percent participation, respectively. Physician Autumn 1 9 9 7 �··· ··· ··· · ············· · · · ··· · · · ··· · ···· ·· · · · · ··· : ···· ··· ······ · · ···· ··········· · ·· ·· ··· · · · ~ I How does this compare with other academic medical centers? From one perspective, not very well. My evidence is anecdotal , primarily from UB graduates who completed their residencies elsewhere and receive anoth e r institution's alumni publications. A UB alumnus in Arizona told me of a friend from residency whose medical class made reunion gifts totaling more than a million dollars. nearly twice as much as all of our classes combined, over a sixyear period' However, that was a private institution, with a development program that is more than 100 years old. A California surgery professor, also a B alumnus , described a multimillion dollar annual philanthropic program at his university, of which the reunion gifts made up a significant percentage. Like UB , this is a publicly assisted institution , but with a much shorter history than UB's 150+ years. Yet that medical school was established with the knowledge of the need for-and expectation of-significant private contributions. So, what is the "right" perspective by which to assess our program7 For now, l come down on the side of the panel of judges for the SU Y/CUAD awards. We provide our own standard of comparison. In this first year of increased efforts and generosity, the classes celebrating reunions in 1997 made significant progress over previous results . Our improvement earned us a citation of merit. Our efforts this year will provide benchmarks for future years of this program. Over time, reunion gifts have the potential to transform the academic and clinical opportunities currently available to UB's medical students. Over time, more classmates will want to participate and to contribute at levels that will bring them increased personal recognition and enhance their alma mater in significant ways. Who knows? Within the next few years, the certificate earned this past spring may have a companion piecean award of excellence for best program in the development category! + Liuda j. Cordc1 is assist aut dcau aud dirccto1 of dcvclopmcuL Medical School Reunion Giving Program 1997 Class Year 6 u f Number in Class Number Who Gave Gift Amount Number Who Pledged Pledge Amount Total Number of Gifts and Pledges Total Dollar Amount 1937 '42 '47 12 32 48 6 9 26 $6,331 1,910 17,684 1 2 2 (l nspecijied) $28,625 550 7 11 28 $6,331 30,535 18,234 58% 34 58 '52 '57 49 56 19 17 13,735 3,400 1 4 1,650 700 20 21 15,385 4,100 41 38 '62 '67 58 95 20 31 11,343 9,830 2 9 8,650 1,645 22 40 19,993 11,475 38 42 '72 121 26 9,073 7 3,817 33 12,890 27 '77 125 28 5,830 10 1 245 38 7,075 30 '82 121 26 3,950 7 660 33 4,610 27 '87 111 21 3,172 12 1,900 33 5,072 30 '92 119 19 675 7 295 26 970 22 f a l o Phys i cian Class Participation Percentage (I inspecified) (2 Cnspecifled) (2 Cnspecijied) (2 lnspecifled) (2 { nspeci}ied) (I lnspecifled) (I lnspecifled) (I Cmpecijied) Autumn 1 9 9 7 I �.,, ,ar.l"'mllllll':'l '' l711 ~ 11 11~~ · · · · · · • · · · · · · · · • · · · · · · · · · • · · · · · · · · · · · • · · · · · · · · • · · · · · · · · · · · · • · · · · · · · · · · · · • · · • · • · • · • · · · · • · Mandeville's suggested transition-tointerview statement isn't terribly different from the one Dr. Manyon asked us to use in our preceptors' clinics: "So, what brings you to see the doctor today? " While Mandeville certainly doesn't give the patient room to expound upon his BY JUDITH TOSKI . CLASS OF 2 0 0 0 condition (Dr. Manyon would reprimand him for not using an open-ended question), it is noble that Mandeville tis the year 1300, and you are a provincial lord in France. You have and his contemporaries would even been coughing for days, ever since you somehow stumbled into speak to patients. There was little patient-doctor interaction in the earlier, some bad air while hunting your grounds. You send for the local pre-university Middle Ages. Prior to the physician. Along with your messenger you send a flask of your rise of the university system, physicians would instead receive the patient's urine, a you expect the doctor to have formulated an opinion urine and make a diagnosis from it alone, without ever seeing or speaking to regarding your prognosis before he arrives at your bedside. the patient. In medieval European iconography, versibly altered by the innovations of Other aspects of doctor-patient inthe urine flask was the universal science and technology, there is one teraction have also been retained symbol of medicine. It implied element of medical care that has not through the ages. The idea that the great understanding, much like changed quite as drastically: the art patient's trust in the physician is parathe long white coat suggests of doctor-patient interaction. mount is a concept that has been alive Henry de Mandeville, a physi- in some form since antiquity, when the medical expertise of A~~~!!~~ today's attending phycian and surgeon who Greek believers sought healing from sician. While the symwrote around 1315, de- the god Aesculapias. During the 14th bot has changed, the scribed a proper method century, Arabic texts from the early connotation has ofquestioningapatient- Middle Ages came into vogue in not. What imparted onewhich,inmanyways, Europe-including one by Qusta ibn power to the repremirrors the paradigm my Luqa, a writer on psychosomatic medisentation, both in the class was taught in cine. This treatise explained that magic Middle Ages and today, is Clinical Practice of spells and incantations cure illnesses the patient's belief that Medicine during our because patients want to believe in "this doctor is a person first year at UB. In them , and th e mind controls the body who can heal me. " The a descrip- to effect the remedy. The medical intion of the novators of 14th-century Europe took remedies of both eras refleet the scientific underp r o p e r this concep t one step further, indicatstanding of the time, and thus protocol for ing that physicians have the power to would be completely differentbringing in a cure because patients accept that they the provincial doctor would have consultant on have such power. In the absence of applied poultices of mustard and an ongoing case, extensive pharmacopoeia or advanced other materia medica to the lord's M o n d e vi I I e surgical techniques , the patient's beche t, while today's primary-care specified the lief in the ability of the physician to phy ician would most likely language that heal was essentially the only tool that auscultate his lungs and chashould be used with the doctors had available to them. Today, tise the lord for keeping up a patient. He recom- in spite of improvements in medical three-pack-a-day smoking habit. AI- mended that the patient be interviewed, technology and the wide range of drugs though aspects of the treatment and first saying: "Sir, I hope it will not offend available to physicians to help ameliophysical examination have been irre- you if I ask when your illness began?" rate disease, not every illness has been Doctor-Patient Interaction: Lessons from the Late Middle Ages ® B u f f a I o Physician A u t u m n I 9 9 7 �' =-----=---- ~-- --- ------- - ---- -- ----- --~ ------ ··············-·······························-········································· ~:m il Medicine has changed because the world around it has. Advances in scientific thought and innovations in technology have transformed how care is delivered in so many ways that it is inconceivable to us moderns that anything could have remained the same about it. And yet, some similarities do exist between our culture of physicianpatient interactions and that of the Middle Ages. The desire of the patient to have faith in the doctor and his cures has not been modified all that much, and the necessity of open communication between physician and patient is a concept that even today is being taught and reinforced in UB's medical curriculum-to our advantage as future physicians, and to the benefit of our current and future patients. + Details on medieval medical practices taken cured. In such cases we have the same tool available to us that Henry de Mandeville and h is contemporaries had: that is , our patient's belief that we will try to save him if it is at all within our power to do so. This is a skill that transcends wearing a white coat or schlepping a pager around. My mentor, Dr. julian Ambrus , taught me that trust must be earned and reinforced in each encounter with every patient. A physician can only obtain trust when he treats the patients with the honor he would accord a superior. from McVaugh, Michael R. "Bedside Manners in the Middle Ages." Bulletin of the History of Medicine, val. 71, no. 2, johns Hopkins UP, Baltimore, MD. judi tit Toshi It as a B.A. in history of medicine from Thcjoltns Hopllins University. NICHOLS MIDDLE SCHOOL • Challengi ng, innovative curriculum • Outstanding preparation for high school • Average class size of 14 students • Interscholastic sports • Comprehensive visual and performing arts program • Dedicated, caring faculty • Financial aid available For further information, call: HOOL, 175 Nornngham Terr. B u f f a l a Physi NICHOLS UPPER SCHOOL, 1250 Amher>t ci an A utumn L 875,8212 1 9 9 7 NICHOLS SCHOOL --~ �Tone Johnson J[ '75: Alum earns belated decoration for bravery "When 1 got back, the very people I thought 1 was defending didn't like me very well. And that had nothing to do with being black-it was any soldier who was in Vietnam." Johnson said he dealt with the adjustment by disappearing into the colBY VIVIENNE HEINES lege environment. After graduating from Grambling College, earning his M.D. from UB, and completing his residency, uring a three-day period in 1965, a 19-year-old U.S. Army he served two more years in the military private named Tonejohnson found himself in a Vietnam jungle, and two years with the U .. Public Health Service before entering civilian life as a surrounded by dead or dying companions and hostile orth family practitioner. ow married and the father of five, Vietnamese regulars. Johnson runs his own practice and has that it is not uncommon for soldiers to recently opened two drug treatment As the American came under inreceive awards many years after they centers. As a lieutenant colonel in the creasingly heavy mortar fire, they ran out of ammunition and nearly lost any served. Congress also expanded the U.S. Army Reserve Medical Corps, he eligibility hope of surviving. Most didn't. Of the 35 runs a comrules for commen in his unit,Johnson was one of five bat medical ""IT WOULD HAVE BEEN EASY TO JUST bat veterans who lived through what became one of training proGIVE UP. BUT ABOVE ALL. I BELIEVED the worst battles of the Vietnam Warto receive gram to teach THAT MY FELLOW TROOPS WERE GOING TO decorations la Drang Valley, ovember 14- 17, 1965. ordinary solCOME . AND THEY DID ."" in 1996. "We ran out of ammunition at about diers prin one in the morning. We were only saved Johnson ciples of first by what we fondly called 'Puff the Magic attributes the award to the research of war aid and emergency medical care in the Dragon' [rapid-firing gun hip aircraft] correspondentJoseph L. Galloway, who field of combat. and the Air Force," John on recalled. described the horrors of Ia Drang in We ln the la Drang Valley battle,Johnson An American plane arrived, fired nearly Were Soldiers Once ... and Young, the was wounded in several places. An exatop the soldiers, and dropped napalm 1992 book he coauthored with retired plosion gave him a concussion and around them. Lt. Gen. Harold G. Moore . knocked him unconscious. He woke up "That really cleared them out. l was Johnson , now a family practice doc- in the middle of the shooting to find a close enough that 1 could feel the heat tor in Corpus Christi, aid the award is orth Vietnamese soldier sitting on his significant to him. from the names, but it wasn't close chest and eating his C-rations, he once enough to actually burn me," Johnson "lt means my country cares. Above told an interviewer from the ueces all things, it means my country cares," Valley Medical Society newsletter. said. "Frankly, I was glad they did [drop he said. the napalm], because a little longer and "This ticked me off," he said. we would have been goners." Like many Vietnam veterans , WhenJohnson moved, he startled the In ovcmber 1996, the 51-year-old John on returned to an American pub- soldier, who jumped up and shot him in Johnson received the Bronze Star for lic that was neither appreciative nor the armpit before being killed in the meritorious achievement in recognition accepting of the horrors he had experi- intense fire that ensued. Johnson also of his efforts to repulse the enemy durenced. Because of his race, he felt the suffered injuries to the face and knee. ing the bloody battle at la Drang Valley. adjustment even more keen!)'· The scar on his face is barely visible The award was pre en ted at a ce remony "As a black person in the war, it was today, but shrapnel wounds cost him in the ational Guard Armory in Corkind of tortuous. At home , we were the peripheral vision in his right eye. pus Chri ti, T . undergoing racial conOict. Then , in the "As I took care of the other soldiers war, we were undergoing that kind of during the night, a few of them said, A spokeswoman for the Army Personnel Agency, in Alexandria, VA, said armed conOict," Johnson recalled . 'Let's just give up. We're all worn out, B u f f a I a Physician Autumn 1 9 9 7 �we don 't ha\c an\ thing. ' The) had been wounded , and some were blccchng quite badl) and were ma) be a liulc bit delirious," johnson recalled . johnson got through the night b) maimaining his faith in God and in his fellow soldiers. '"A ll I could thmk was, 'The} 'll be here. ' And through the night, as we prayed about it, I knC\\ the) 'cl be here . It would ha\ e been caS) to just give up . But aboYe all, I believed that 111) fcllO\\ troops \\ere going to come. And the) did. " johnson said he has goucn past his nightmares about the \\ar, but it has changed him in other ways. " People ~a) , ''r ou 're so calm.' I sa), 'If you\e been through hell once, it's easy B u f f a I o to li-,:c in America .' Lillie things don't bother me nO\\. " Reprinted b) pctnih>ionfmmtlicCotpus CI111Sli (Tnm) Caller- Times. + ~ 1998 SCD plans I Plans for the 1998 Reunion Weekend and Spring Clinical Day (April25, 1998) are already well under way. This year's program is chaired by Dr. John Bodkin. The following reunion chairs held their organizational meeting September 11 : the 50th Year Class of '48, Dr. Daniel Fahey and Dr. Harold Graff; the Class of '53, Dr. Michael Sullivan; the Class of '58, Dr. Alfred Stein and Dr. Michael Genco; the Class of '63, Dr. Anthony M. Foti; the Class of '68, Dr. Robert Milch and Dr. Thomas Cumbo; the 25th Year Class of '73, Dr. Michael Sansone and Dr. Arthur Mruczek; the Class of '78, Dr. David Marchetti; the Class of '83, Dr. Richard Collins; the Class of '88, Drs. Andrew and Helen Cappuccino; and the 5th Year Class of '93, Dr. Michael Aronica. Physician Autumn 1 9 9 7 0 �• ···· ·· ······· · ·· ·········· ········ ····· ···························· · ······················ I 1 9 4 0 s daring surgery. The idea was to increase the collateral circula- bany, Pensacola, FL, writes: "There's tion to the ischemic cardiac from chair of Dept. of ObGyn, nothing like a sentimental enco- muscle. After a couple of hours Albany Medical Center, after 16 mium to stir fond memories. So of holding retractors, one be- years. iL was when I read of the death of came lax. Dr. Stewart always had and chair the board of Maternal JOSEPH H. MELANT '43 , of M Y R ON G O R DO N '48 , of AI- the same poignant question: Infant etwork of the Capital Re- 4, 1996) in Buffalo Physician. 'Doctor, are you holding those gion, and chair the Committee on Fifty-five years ago I had the retractors, or are those retrac- Medical Schools and Graduate good fortune to assist this gifted tors holding you?' He was the Medical Education of MSS Y. man in the first open-heart sur- embodiment of integrity and the Looking forward to 50th next year. gery performed in Buffalo, at sui generis of his time. " Skip Zola, Bill Bloom , and Dan a senior in medica l school, thus I had the honor of being his fourth assistant (there wasn't room at the table for any more!). It was a period when opening the pericardia! sac and dusting some talcum powder into it was SAMUE L CASSARA Rochester, '44 , of versity of California at Irvine. 1 ow teach, office practice, Dr. John D. Stewart (September Meyer Memorial Hospital. I was (addiction medicine) at the Uni- Y, writes: "Stepped down 9 LANCE 6 s 0 FOGAN ' 65 , of Valencia, CA, writes: "!took full early retirement from the Southern California Permanente Medical Group on July 31, 1997. I spent my entire practice career at the Kaiser Permanente Medical Center in Panorama City, Miller were here in Albany in April CA, beginning in july 1971. My for our son Seta's bar mitzvah. " last 16 years I served as chief of Y, writes that he the eurology Department. I ex- retired May 30, 1997, after 48 MAX A . SCHNE I DER '49 , years of pediatric practice, at the Orange, CA, has been elected pect to pursue my many inter- chair of the board of the ests happily and full time." age of 78 years. ext? "I will of a- write an autobiography of my tiona! Council on Alcoholism life and times. " and Drug Dependence. He is a IRVING S . KOLIN '65 , recently appeared on Channel9 in Miami, clinical professor of psychiatry If you come loolting for a car, you'll be a\vfully disappointed. HOWEVER, there's little chance you'llleave tl1at way. BECAUSE at tl1e Land •, Rover Centre, we have tl1e world's most impressive 4x4s. AND people who can answer any of your questions about driving. A4x4, of course . Amherst A NORTHTOWN AUTOMOTIVE COMPANY 3560 Sheridan Drive Amherst, New York 14226 (716) 831-3100 • (716) 835 FAXX (3299) ® B u f f a l o P hysician A utumn 1 9 9 7 �-- ··················· · · ····· ··· ······· ·········· · ·········· · ···· · ············ ·· ········· ·· ··• • I FL, to discuss psychological trauma in victims of child kid- the Southern California Kaiser publications are Sexual Investi- Permanente Health Care Pro- gation (NYU Press, 1996); Sex, who joins jacqueline (7), Alex (5), and Eric (3). Marc is direc- napping, and ADHD and the Ritalin controversy. gram. The department has a staff Love, and Friendship (Rodop, 1997) ; The Philosophy of Sex thalmology at Florida Health ( Rowman, 1997); and The Pili- Care Plans in Daytona Beach, FL. JOHN E . SHIELDS '68, of Delhi, Y, writes that his son john JOHN E . KNIPP '72 , of Washingtonville, Y, is presi- losoph) of Sex and Love (Paragon House, 1997). JENNIFER L. CADIZ '87 writes: M. Shields has ajD/MBA degree dent and chief of staff of the with honors, and Gregory P. Cornwall Hospital, Cornwall, hields is a freshman at Univer- Y, and president-elect of the of 80 MDs and ER As. sity of Arizona. He adds that he is Orange County Medical Soci- at Russell Sage College in Albany. ety, Orange County, Y. He is in the private practice of internal 1 9 7 0 5 DONALD H . MARCUS '71 , of Sepulveda, CA, has been appointed chief of anesthesiology at the Kaiser Foundation Hospital in Los Angeles. The L.A. Hospital is the tertiary hospital for WNY's medicine and gastroenterology. ALAN S OBLE '72 (M.A. Pharmacology), of ew Orleans, LA, writes: "l have recently been promoted to full professor ( 1990) and to research professor (1994). Among my latest tor of the Department of Oph- ''I've moved to Harrisburg, PA, 1 9 8 0 5 to begin life as a civilian. I'll be practicing with one of the local KEVIN S . F ERENTZ '83 , of hematology/oncology groups." the Pikesville section ofBaltimore, MD, has been installed as the LA URA POST '87, of Saipan, 49th president of the Maryland has been appointed chair of the Academy of Family Physicians (MAFP). Department of Psyc hiatry at Commonwealth Health Center, in Saipan. Her first book, Back- MARC J . KOBLICK '84. of Ormond Beach, FL, and his wife, Helene, announce the birth of stage Pass: Interviews with Women in Music, has just been published by ew Victoria Publishers. their fourth c hild, Reid Jayson , - Exclusive - BMW Retailer THOSE LOOKING FOR MORE CONTROL IN THEIR LIFE CAN NOW FIND IT ON SLIPPERY PAVEMENT. THE ULTIMATE DRIVING MACHINE.® MSRP s64240 F. G. DOWNING Towne BMW 3030 Orchard Park Rd. Orchard Park, New York 14224 Phone: 675-2550 s&99 1998 BMW 740i While the road of life may throw you an occasional curve, at least our All Season Traction helps you handle the particularly slippery ones. 30 mo. Lease FREE SCHEDULED MAINTENANCE ALL SEASON TRACTION PMT based on 5500 cap cost reduction (or trade). 12,000 miles per year. 15 cents charge per mile lor excess miles. First and last PMT, taxes and plate fees due at inception Residual $43040 Service Loaners Available..• Minutes From Rich Stadium s u f f a l o Physician Autumn 1 9 9 7 ® �• ····························· · ···· ·· ····· . I THE ULTIMATE DRIVING MACHINE. JOHN AKER '88 , oflndianapo- ANTH ONY R . RICOTTONE lis, I . writes: "I finally finished '91 , of Cheektowaga. my plastic surgcl) fellowship at " "vly wife, Deborah, and I arc YU, and am now in private practice in Indianapolis. ) . \Hites: pleased to announce the birth of our daughter. Marisa. Our son Kathleen and I were recently Dommie recent!) turned 2. I ha\ e blessed by our second child, recently joined KeY in Barloc, Rt- Zachery Alexander." charJ Gilbcrt,andJohn Gri~wold at Buffalo Medical Group tn the of DEBRA M . OMIATEK '89 , Lewiston, practice of urolog\." Y, is celebrating her first year in private solo prac- CAROL ANN KILLIAN '94 ti ce. She is president of the THOMAS M . BURNETTE '94 , iagara County Chapter of Family Practice (AArP). of Sleep; Hollo"', 9 9 0 5 and GALE of Baltimore, PETEF<BLOOM '90 emergenc\ 111 MD, write that Peter has recently Westchester Count} , ni- Ann has accepted a JOb as an rD versity of Maryland; he i working on research on infectious County Medical Center and Tom dysentery at the Center for Vac- has begun working as an inter- 111 the \ Vestchcstcr cine Development in Baltimore. nist in the Mount Kisco Medtcal Gale just received her master's in Group. The; keep in close con- public health from The Johns tact with Barb Kearnq, \\ ho Hopkins School of Hygiene and married Paul Stcfantck tn '>ep- Johns Hopkins in a CD -funded is finishmg her patholog\ resi- sexuall y transmitted diseases. Gale spent this past spring in tiful bah) girl named South Africa, where she consulted rebruar) 1997. health services. atalt e low to mid 20's; leases starting at $299 per month. MIKE J . PELECHAGY JR . ' 94 , of Orchard Park, ) , \Hites: * According to the Insurance "\\ c've .Just accepted a fellowship position at Roswell Park 111 hema- GULATI '92 announce the birth tology/oncology , starting Juh l , of their son Suneel S. Ram on 1997. Also, '' e had another bah) Feb. 21 , 1997. Ragh u has joined girl, OliYia Paige. We're glad to he Kenmore Family Medicine, a back in the Buffalo area. r or those new group practice in Kenmore, on the Internet, look up m) nc\\ Y. Neeva is completing her rP [-mail address either at ..,,,Itch- niversity at board or 411. Institute for Highway Safety (IIHS), the Saab 9000 has the lowest fatality rate of any production car on the market. SOUTHTOWNS SAAB 3580 Southwestern Blvd (1 Mile east of Rich Stadium) 716) 662·8008 Buffalo this year. ® higher education level than any other car owner group. * Saab purchase prices starting NEEVA re idency at the f;'\d ~01.1r OW'\ road. * Fact: Saab owners have a 111 and RAGHU RAM '90 AND CALL ME IN THE MORNING! tember 1994. Thev continue to dency. Barb and Paul had a beau- develop ado lescent- friend!) TAKE TWO ... reside in Tonawanda while Barb position to conduct research on for a rural district to help them Your WNY Leasing Specialist Serving WNY proudly tor 33 years ) . Carol attending Public Health and is working at 836-2033 respccti\cly, at the L.,niYersit\ of joined the faculty of the Division of Gastroenterology at the 487 Kenmore Avenue Buffalo, NY 14223 medicine and mternalnu·dtctnc, Pittsburgh. The} hm·c mo,·ed back close to thetr families to BURSTEIN '90 , Sales and Service nte that the) ha,·e completed thetr three) car res1denctcs 1 '\J), ' ' and Checkpoint Foreign Car, Inc. B u f f o l o Physician Autumn 1 9 9 7 �... . ..... UBMICRO COMPUTER SALES www.ubmicro.buHalo.edu Call 645· 554 t ..............• 11 . g Out A Non-Profit University at Buffalo Se ice Program - ' OBITUARIES MARTI N A . ANGELO '36 , of Fort Lauder- dale, FL, died May 28, 1997. The retired Advertise in one of the finest publications in Western New York ... Buffalo neurosurgeon was 85. He was on the staff of most area hospitals until retiring in 1976 and moving to Florida. Born in Buffalo, he sold newspapers and shined shoes during the Depression to help support his Buffalo Physician family and pay for his education. In World War II, he was commanding officer of an ~ u~ ~ ~ l~ Army hospital train unit stationed in France. He was a member of the American Medical f" ~ ~ \ t \ "~ Association, the Harvey Cushing Society, the Congress of Neurological Surgeons, and the Baccelli Club of Buffalo. Angelo is sur- YOU ARE ELIGIBLE vived by hi wife of 55 years, Marie Ruth for academic pricing on••. SanFilippo Angelo; a daughter; two sons; a sister; and nine grandchildren. Acer • Adobe • Apple • Corel • Dell • Hewlett Packard • Microsoft • Texas Instruments &much more ... Delivery & Setup in your home or office available! HAROLD Williamsville, BERNHARD ' 49 , of Y, former chief of service and medical director for gastroenterology at Millard Fillmore Health System, died june 19, 1997, at his home. He was 70. He Give us a call: practiced gastroenterology for the past 45 (716) 645-6933 Computer Workshops years and was one of the first physicians here to introduce the technique of gas- Michael J. Baranski trointestinal endoscopy; he was also a clini- Marketms Representative cal associate professor of medicine at UB. Call 645-3560 to have a brochure mailed to you. He recently was named Master of the American College of Gastroenterology, one of the most prestigious awards in his field, in • On-Site Private Training available. • Scheduled workshops start at $59. • 1/2 day miniclasses target specialized topics. recognition of his medical expertise and service to the professional group. He served as a trustee and secretary of the American College of Gastroenterology, governor of the college's orthern ew York chapter, and president of both the GastrointestinalLiver Society of Western Western ew York and the ew York Society for Gastrointes- tinal Endoscopy. Bernhard is survived by his wife of 48 years, the former G loria Summer hours: Mon thru Fri I 1-5 ~~~-·~~.[111'[+] BARANSKI u f f a l o grandchildren. ADVERTISING A non-profit University program tor students_ faculty & staff The commons . North Campus • (1t6) 645· 3554 • Fox: 645-3884 B Grossman; two daughters; and three Physician Due to space collstmillts, some Class11otes recei\ eel forth is issue ofBuffalo Physician will appear i11the next issue. -Eel. 146 Stepping Stone Lane Orchard Park, NY 14127 Autumn 1 9 9 7 �To consult with someone truly concerned with your financial come to KEY PRIVATEBANK Key. Your Key Private Banker heads a team of professionals, who can help you achieve your financial goals with surgical precision. Call Marv Madison at 84 7-2341. It may be one of the most important appointments you make. We know medical professionals' financial needs like the dorsum of our metacarpus. <>-w Key. For a new America~ ® Buffalo Physician Autumn 1 9 9 7 �Who says there's nothing good on TV? As busy as they are, physicians and other health care providers always take the time to watch MLMIC's top-rated risk management education programs. • When they tune into high quality programming broadcast over our satellite network, viewers know what they see will help enhance patient safety and reduce injuries. They also appreciate the policyholder discounts available to participating physicians. MLMIC programming is sponsored by the largest Risk Management Department of any professional liability insurer in the state. Policyholders also enjoy the protection of one of the country's largest and most experienced professional liability Claims Departments. Most importantly, MLMIC has successfully defended more physicians than all other available insurers combined. These are some of the reasons why MLMIC is the only medical liability insurer approved by the Medical Society of the State of New York. • To find out more, call1-800-356-4056 in Upstate New York, or 1-800- ASK-MLMIC in the New York metropolitan area. Ask for free copies of our risk management MLM~C ~ \lt'IKal Uahtlil; \fuluallnsurani,. (ompany guide for office practices. • Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 C1996 MM ca .aPi ty 1nsursnu: Ccmpsny Mutua l �BUFFALO PHYSICIAN Non-Profit Org. STATE UNIVERSITY OF NEW YORK AT BUFFALO U.S. Postage PAID 3435 MAIN STREET Buffalo, NY B UFFALO NEW YORK 14214 Permit No. 311 ADDRESS CORRECTION REQUESTED Planned Giving to UB. Tax deduct,ons and on 1ncome for fe ore on'y port ;Jf the benefits you con recetve w th planned g1v1ng to the LB and B omediCOI sc,ences weo 1thy o a School of Med c ne Yot.. needn I be norc1o ger uo All you need s to make a gft And hove o de~ to he1p today s budd,ng gen ses mo e the wor o a better p oc.e n 50 years. For mo e nf Corder PhD mot or contact Ly~ CFRE of 716 8292773 or vo e-mo' of I]C.Order@ocsu buf a o.ed UNIVERSITY AT BUFFALO S!alt l "niz·eni{J' qf . \ i•zt· JiJd, � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1997 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1997-Autumn Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v31n04-1997-Autumn Table Of Contents A list of subunits of the resource. Research DNA on Ice Dr. Mahoney Becomes Dr. Mahoney "The Woman's Way of Seeing and Doing" Orientation '97 Medical School News Development A Student's Perspective Alumni News Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-09 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v31n04 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1997 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/04b0e3e59d8eb9c6dc6dd52b05eddd9f.pdf 878a086bb473a87802435ea1299cf63e PDF Text Text �Dear Alumni and Friends, BUFFALO PHYSICIAN \ olumr 31 '\umhcr 3 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr ( ;.uolt "'mlth Pt•tro DIRECTOR OF PUBLICATIONS h.athn n \."a\\ ncr EDITOR Jr ...... ila \n<.:krr ART DIRECTOR \l,m J 1-;egkr PRODUCTION MANAGER \nn Ras::mann Bn)\\ n STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John R. \\ nght lntt:l rru Dnm wul 1·;" Prnulnli{<H Clu1iwl \ffw" EDITORIAL BOARD Dr Bcnram Portm Cha1r Dr Dr Dr Dr Dr Dr Dr Dr Dr Dr Dr \larun Brecher Harold Brod1 R1chard L Coll11" Lmda J. Corder .I ian J Dnnnan James Kansk1 Barhara \laJrrom Llizahrth Ohmtrd Ch.trlrs Paganelli Stephen Spauldmg BradiC\ T Trua"' Roy \ 'ongtama Dr I ranklm Zcplo11 liz THIS I''L r or Bt FHW P11n1c 1.\\ marks a significant change for the school. After nearly two years as editor of Buffalo Phvsician, jessica Ancker has accepted a new opportunity elsewhere. \\"e all wish her well and thank her for her many outstanding contributions to this publication. During our search for her successor. judson Mead, editorial manager of the lJB Publications Office. will sene as interim editor. On May 11 , 1997, we celebrated the medical school's l5lst commencement, graduating l-+6 men and women as doctors of medicine and 37 as doctors of philosophy; four received bo th degrees simultaneously. At the ceremon), an honorary doctor of science degree was awarded to Dr. james Holland. a distinguished former member of the Roswell Park Cancer Institute and of the university. Our incoming medical student class is now complete, and we look forward to greeting this group a few short months hence. \\"e are also welcoming new house officers. many of them our own recent graduates. The new chief residents also begin their final year of residency and, along with the ne\\ residents. will participate in comprehensive orientation programs orgamzed by the Graduate Medical Dental Education Consortium, a legacy of former dean john Naughton ably directed b) associate dean Dr. Roseanne Berger. The introductory programs pro\·ide incoming residents with the latest medical, legal, and administrative updates and teaching! evaluation skills, as well as basic and advanced life-support training. Much credit is due to Dr. Berger for her commitment and dedication to this effort. As we continue to struggle through the fiscal maze so commonplace in today's medical schools and universities, we arc deeply grateful to you, the alumni and friends of this uniwrsity·. for your generous sharing of time, energy, and yes, worldly goods, to this noble cause. Please accept this sincere thank-you for your help. /f John R. Wright, M.D. /ntaim Dean, School of .\lcdic111c and Biomedical Sncncrs lntnim Vice President for Clinical A/fails TEACHING HOSPITALS AND LI A ISONS The Buffalo (,rnrral llospllal \fulwd ~~~"'' The Children's llospnal of Buffalo Ene Counl\ \lrdtcal Center \lerCI llralth ''stem \Iiiiard 1 Hlmore llealth ~ystrm l·ranlz S£1HI '\iagara l·alls \lrmonal \lcd!cal Center Ro~wcll Park ( <.lnccr ln-,ttlutc Sisters of Charll\ llospllal Dntnis \frCatth\ \'eteran!-, .\.ff..l irs \\·estern ~ew York Hcahhcare '-,ystcm ([)The ~tate UniH·rslly of :'\e\\ York at Buffalo Buffalo PI"'""'" IS published quanerh h) the State Lmversilv of ~e" \ork at Buffalo School of \1cdicinc and Biomedical Sucnccs and the Off<ce of Puhhcat10ns. It " sent, free of charge, 10alumni. facultY . students. residents. and friends. The staff reserves the nghtto cdll all cop) and submtssiono.; accepted for publication . .:\ddress questions, comments. and subnu,;10ns to The E:dllor, Bt<{falo Phrskian, State Lmvcrsny of !'Jew York at Buffalo, Office of Puhhcat!Ons. 136 Crofts Hall. Buffalo. '\\ 1-+260 Send address changes Ia: Buffalo Plll\«i<lll 1-+6 CFS .\dduwn H35 Mam Street Buffalo,"' 1-+21-t Greetings! A., THL ~EI\ t 1 LUCTED PRE,IDE"'f of the Medical Alumni Association, I am honored, proud, and humbled when I consider the quality of the individuals this organization represents. The 60th annual alumni weekend and Spring Clinical Day was a resounding success, thanks in no small part to Richard L. Collins, M.D., who put together an outstanding program. New York State commissioner of health Barbara DeBuono, M.D., M.P.H., updated attendees on the political and legislative aspects of managed care in New York State. john Friedlander, president and CEO of CGF Health System, presented the case for mergers. Steven R. Peskin, M.D. , talked about the evolution of managed care across the country. Irene S. Snow, M.D., spoke about practicing medicine under managed care. As a recent past president of the Eric County Medical Society, she has a unique perspective. She emphasized her personal involvement with patients, associates, and local, state, and national medical and specialty societies. Highlighting the program was the induction of two honorary medical alumni-john '\Iaughton, M.D., our recently retired dean of 22 years, and john Richert, Ed. D., our recently retired associate dean for medical alumni affairs. Each of them played a major role in making the school and the alumni association what they are today. There are some special people who deserve recognition for their support of this association: Nancy Druar, our administrative assistant; Bertram Portin, M.D. , our new associate dean of medical alumni affairs; and jack F. Coyne, M.D., our past president. We also wish to thank our interim dean, john R. Wright, M.D., for his support and participation. With the continuing support of these individuals, I am looking forward to a successful and enjoyable year. Sincerely, ~,d::Mf'~ Pres1dcnt, \lediwl Alumni Assocwtion �- --- - -~- -~- -- - ---- - -- -----.--- - VOLUME - - 31, NUMBER 3 S UMMER 1 i i i j Sp~ing 2 Clinical Day THREE PRESENTATIONS LOOK AT DIFFERENT ASPECTS OF CHANGE IN HEALTH CARE. 8 UB's New Specialty Dental Clinics DENTAL MEDICINE AND MEDICINE OFTEN CONVERGE IN St;IUIRE HALL . 10 D~. Cong~essman DAVE WELDON ' 8 1 IN THE HOUSE I S SAYS LIFE LIKE BEING AN INTERN YEAR-ROUND. by Clare O'Shea by Rosemary E. Frei Medical School News MATCH DAY . TWO FORMER FACULTY REMEMBERED. NEW CHA I R OF PEDIATRICS. t-1AMES PLATT WHITE HONOR ROLL. Commencement '97 PIONEERIN G THE Alumni News CLINICAL CURRICULUM. THE PICTURES SAY IT ALL! NEW ALUMNI ASSOCIATION RESIDENCY SLOTS. OFFICERS. HONORS FO R AStudent's Perspective LE ARNING ABOUT ASTHMA FO UR. 60TH ALUMN I WEEKEND. AT STREET LEVEL. by Michael Kane, Class of 1998 Classnotes THE QUOTE ON THE <OVER is hom ·APhysicion'sOoth; odoptedfromonewrittenby louislnsogno, M.D., deon of the Sockler School of Groduote Biomedical Sciences ond deon for ocodemic offoirs of the Tufts University School of Medicine. As port of commencement exerc~es eoch yeor, groduotes of the UB School of Medicine ond Biomedical Sciences rise ond formally sweor to fulfill, to the best of their ability ond judgment, this covenant. In oddiHon, three yeors ogo onew tradition wos born ot the UB medicoIschool: On the first doy of orientoHon eoch yeor, the ooth is reod ond discussed with students os omeons of impressing upon them the full significance of the program they ore obout to undertake. The complete text of the ooth is featured in the Autumn 1996 issue of Buffalo Physician. s 5 J':J~l ~ �SPRING SI X T ANNUAL I ETH ALUMNI WEEKEND CLINICAL DAY'97 Health commissioner discusses state P9licy in B y JESSICA Stockton Kimball Lecture ANCKER are creating tensions between private conscience and public policy, and nowhere are those tensions more obvious than in the office of New York State commissioner of health Barbara A. DeBuono, M.D., M.PH. CHANGES IN AMERICA HEALTH CARE DeBuono, who delivered the annual Stockton Kimball Lecture as part of the 60th Spring Clinical Day on April26 at the Buffalo Marriott hotel , plays a pivotal role in the development of the state's health policy. That often puts her in a tough position, as she illustrated by describing a case that recently reached her desk in Albany, Y. A patient received a diagnosis that indicated a Whipple procedure (pancreaticoduodenectomy), DeBuono said. His insurer, a managed care organization, supplied the names of three surgeons in his city qualified to do the procedure. But the patient, seeking what he felt would be the best possible treatment , underwent surgery at Memorial SloanKettering Cancer Center. His HMO refused to pay the bill or even to cover what the approved doctors would have charged. The patient appealed to the state health commissioner. On the one hand , DeBuono points out, the patient broke the agreement he made when he enrolled in his HMO. That agreement allowed the insurer to control its costs (and his premiums) by controlling where he could seek medical care. On the other, the patient wanted the best possible care. "And why shouldn't he get the best? " DeBuono asked. But there's no concrete evidence that the procedure performed at Sloan-Kettering was of substantially better quality than what the local surgeon would have done. While it is PHOTOGRAPHY 0 universally accepted that surgeons who perform high volumes of cardiac surgery have better outcomes, there is no comparable body of research on Whipples. When it comes, DeBuono's decision may have broad economic and political ramifications. If she decides in the patient's favor , will millions of ew Yorkers get the message that they can go out of plan whenever they want? But if she decides in favor of the insurer, could that lead to further restrictions on care? And how will the patient at the core of the case pay his bill? This case was one of the manypublidprivate health-care issues DeBuono discussed at Spring Clinical Day. DeBuono received her M.D. at the University of Rochester and completed her residency at the ew England Deaconess Hospital in Boston. She then earned a master's degree in public health from Harvard University and served as a fellow in infectious diseases at Brown University Medical School before becoming director of health for the State of Rhode Island. DeBuono was named New York State commissioner of health by Governor George Pataki in 1995 , becoming the first woman to hold the job. During her address at Spring Clinical Day, DeBuono said that the state had balanced cost-cutting with social responsibility in its Health-Care Reform Act of 1996, which deregulated BY DON HEUPEL ---------------------------------------------------------------------------------------B u f f a 1 a Physician Summer 1 9 9 7 �----------------~----- SIXTIETH A NNUAL __ ---- -.-- - - - ALUMNI hospital rates and created unique funding pools for graduate medical education and charity care. However, she noted, there's a lot more for state government to accomplish. As a member of a Republican administration that is in principle dedicated to reducing state regulation, DeBuono sounded reluctant to draft legislation to deal with minute details of health-care delivery. But legislation to cope with the "growing pains" of managed care, such as denials of care and physicians being deselected from networks without good reason, seems inevitable, she said. DeBuono also cited examples of insurers delaying reimbursing hospitals for service worth millions of dollars until the Department of Health intervened. "I don't want to have to legislate that," she added. "I wish the industry would do it voluntarily." The goal is to make sure that medical decisions are made for medical reasons, not economic ones. "The more managed care and indemnity insurance take decisions out of the hands of providers, the more frustrating it is for doctors and patients," DeBuono said. "We've got to fix that problem." An important step, she said, was the state Managed Care Omnibus Act of 1996, which has been praised by the American Medical Association for protecting providers and patients. It bans gag orders; ensures that managed care plans disclose their coverage, referral, and emergency care policies; allows doctors to appeal deselection; and establishes a patient grievance procedure. Legislation alone is unlikely to solve all the problems. DeBuono's story about the Whipple procedure grievance shows that some of the toughest deci ions may continue to be made on a case-by-case basis. "I still haven't decided what to do ," DeBuono confessed about the case. "If anyone has any ideas, let me know." + B u f f a l o Physician summer , 9 9 7 0 ~ �SIXTIETH ANNUAL ALUMNI Practicing medicine under anaged he thoughts I share with you today are mainly personal, and are geared toward our responsibility in patient advocacy and the preservation of our profession in managed care. The failure of managed care When managed care first came into being, it is my understanding that it was supposed to give less expensive care to people who couldn't afford conventional insurance. It is hard to argue that the first goalless expensive care-has indeed been achieved. Health-care premiums have risen at or below the inflation rate for two years, but most industry experts predict more increases. The multifactorial reasons for this include: 1. the need ofHMOs to satisfy stockholders after delivery of low profits last year; 1. the consolidation of HMOs into fewer and larger entities, eliminating competition and allowing prices to rise; 3. more expensive technology and an aging population; 4. demand from consumers for more access to specialists and point-of-service plans; and S. federal and state legislation that make it difficult for managed care to control costs. Managed care has also been a resounding failure in providing coverage to the uninsured and the underinsured. It is estimated that by the year 2002, the number of uninsured will reach 45.6 million, up from 39.5 million in 1995. The health-care reform agenda empowered managed care, and managed care failed to deliver the goods. What is quality care? The most abused and misused phrase of the '90s, in my opinion, has been "quality care." What exactly is quality care? Ask any of the four players in health care-employers, insurers, providers, or patients. Instantly, we have a problem. Patients and health professionals tend to think differently about what constitutes quality of care. Patients judge quality by very personal experiences, such as how long their proBY 0 IRENE B u f 5 f a . l care vider spends with them, how easy it is to access specialty care, and the range of health benefits provided. Professionals, on the other hand, tend to rely on populationbased performance measures, such as outcomes of cancer treatment over time. Employers concern themselves with such data as cost, time lost from work, and employee satisfaction as demonstrated by complaints to their human resources departments. Insurers declare their own quality measures. The ational Committee for Quality Assurance ( CQA) , the organization set up to measure quality of care given by managed care plans, has come under attack for not being independent enough. As of 1996, CQA got 40 percent of its funding from HMOs. The Health Plan Employer Data and Information Set (HEDIS) that CQA uses has been widely criticized by physicians for tallying up easy-to-administer tests rather than getting at core issues of what constitutes quality medical care. HEDIS doesn't measure quality: It measures the number of Pap smears or immunizations given. To confuse this picture even further, the development of quality measures has proven to be philosophically contentious, technically difficult, and politically delicate. Physicians must act Finally, some answers. This is a perfect place for physicians to take a leading-edge position by demanding relevance, objective research, and appropriate application. Physicians and managed care organizations need to work together to establish treatment guidelines patients can trust. Wide-ranging collaborative efforts led by academic researchers would be the most promising in outcomes research and treatment guidelines. And we must be at the table either individually or through our subspecialty societies when outcomes data is analyzed and implemented. just as we must be willing to accept report cards on our performance, we must demand more in-depth surveys of HMOs. Physicians should push for public disclosure and comparisons of HMOs regarding their performance in treating serious or chronic illnesses, how often and why out-ofplan referrals are denied, and ease of access to specialty care, among other things. SNOW o WEEKEND . Phys M . D ici . " 80 an Summer 1 9 9 7 �-~-- - - ----- - - - - - - - -- - - - SIXTIETH ANNUAL --- - --- -- ALUMNI I must admit that when I think of managed care, I feel like Albert Finney in the movie Network when he opens his window and shouts out, "I'm mad as hell and I'm not going to take it anymore!" In my more rational moments, however, I do believe that doctors who fight managed care at every turn will find themselves in a losing battle. We should take the lead in health-care delivery by admitting that we are dealing with finite resources. But physicians need to be a blaring trumpet section in our argument that we are better at making medical decisions and more compassionate than utilization review clerks. Doctors must take a stand against economics driving ethics and insist that ethics drive the economics. While accepting the principlesofpracticingcosteffective medicine , we must be able to challenge certain managed care rules that we feel compromise patient care. While on the topic of ethics and economics, I am philosophically opposed to the concept of capitated agreements. Simply stated, I just wasn't raised to be rewarded for work I haven't done. Under capitation, if you manage patients efficiently and effectively you stand to gain. The potential abuse of this system is glaringly obvious and extremely frightening. As patient advocates, we should not allow a system that poses this kind of potential threat to patient care to gain momentum. Capitation places providers-already in need of tort reform-in legally indefensible positions. In potential errors of omission, it will not take a Perry Mason to ask, "So, Dr. X, did you stand to gain financially by not ordering testY? " Yet capitation is here, thriving, and soon I will find myself practicing within it. However, I hope its prognosis is poor! Capitation in its pure form, without adequate oversight and regulation, is a consumer activist's next cause, and in my opinion, rightfully so. Hold HMOs responsible We must encourage regulators, employers, and consumers to insist on greater public disclosure of HMO financial results. - - - WEEKEND George Anders, a Wall Street journal reporter, said it better than I can in his book Health Against Wealth: HMOs and the Breakdown of Medical Trust. Anders commented that the big profits and compensation packages of some HMO industry executives can be seen as "uncomfortable hypocrisy for an industry that publicly preaches the virtues of austerity." o discussion of how physicians practice in any environment would be complete without mentioning the need for tort reform. In this regard, I mean that HMOs need to be held accountable for their mistakes. HMOs need to be "I question how long I will be able in good conscience o practtce economically driven me 1c1ne." subjected to the same malpractice restitution methods that physicians and other professionals face. Perhaps it is time for us to renew our commitment to the professional oath, ethical principles, and ongoing education process of a vocation that has always been dedicated to the betterment of mankind. The practice of medicine is in a state of unrest, which has the potential to bring out the best or worst in our profession. We must have the courage to speak out against any system that jeopardizes our legal right and moral obligation to practice good medicine. When historians record how we responded to these challenging times, it is my hope that we will be remembered for our commitment to our patients, our colleagues, and our principles. + ~------------------------------------------------------------------------------------------------------~ B u f f a t o P hysician summer 1 9 9 7 0 ~ ��with all of tne diseases of. dentistry, bexond dental caries and tne cracl<s oetween aentistry ommunities extenaing Pennsylvania Alfredo Aaulrre of the Orel Madlall .. Cllnlo (top lettll ......_..A. utlunen of the TeiiiP......,._n......,.Dieor...,.. end OICifacaMI Pain Cllnlo (bottol8 lettll Leurle c.re.r of . . . Orel ..... Me Mai&DIIII Dl&gnaetlo . . . . . . . Cllnlo , ........... ,.,.,,. A d&ld81 X ...... {G&IIIIarltllat •U lllla..e atena&la ln . . . oa:o8d,_D ......... . ., a &Ia , ............ , arrtWWj. in the ��Specia cinic takes haitosis senousy "Some people have joked, 'Maybe you could sell gift certificates,"' says Mirdza Neiders, D.D.S., M.S., head of the Breath Disorders Clinic in UB's Department of Oral Diagnostic Sciences. "Because most of our patients are referred by another person, like their spouse." The Breath Disorders Clinic is one " The best of six Special Care Clinics that specialdetector ize in diagnosing and treating dental or medical difficulties that most pracis still the titioners don't usually treat. They fill human in the gray areas between medicine nose." and dentistry, including psychological and social concerns that affect many Americans. All kidding aside, halitosis is one such serious social problem, as evidenced by the millions of dollars spent in the U.S. and Canada on breath mints, toothpastes, and mouthwashes. Some people are so concerned about their breath that they build their lifestyles around avoiding people. They may be referred to the clinic by someone close to them, or else a physician or dentist. While some cases of halitosis are truly medical, many can be alleviated relatively easily. The first step for patients coming to the Breath Disorders Clinic is for the clinician to determine whether the person truly has bad breath and, if so, to track down the origin of the problem. "The best detector is still the human nose," admits eiders. "If the person does have bad breath, treatments can then be designed to tackle it. If they don't, I sometimes refer them to Dr. Gale to help them overcome their social inhibition." In most cases, bad breath is caused by anaerobic bacteria on the surface of the tongue; these bacteria can simply be scraped away with a flexible, dull object, such as the edge of a plastic spoon. Prescription antiseptic mouthwash can also be helpful in some cases. If the odor is being emitted by an infection under an old crown or between teeth, repair of these defects is the best medicine. + 1 9 9 7 0 �43-year-old physician takes leave for his other calling by CLARE O ' SHEA "Can you hold on a second? " DAVE WELDO '81 PUTS THE PHO E DOW and rushes off again. We had been discussing his neuroanatomy professor at UB, the intense summer he spent immersed in microbiology and pharmacology, the way the snow would settle on the evergreen outside his tiny apartment off Hertel Avenue. But those memories are 15 years old, and right now Weldon doesn't have much more than 15 minutes for nostalgia. Voices on the other end of the line are calling him to the floor of the U.S. House of Representatives. It's time to vote on public housing. ® Buffalo Physician Summer 1 9 9 7 �unruffled, quietly picking up where he left off and continuing his train of thought from the House cloakroom, his refuge between votes. In many ways he sounds less like a doctor than, well, a politicianbut Weldon finds a lot of similarities between the two vocations. "The general skills a physician has transfer well into the political arena," he says. "My background gave me a lot of experience in relating to people, solving problems, and explaining complex issues to people in terms they can understand." While Weldon has become comfortable on Capitol Hill, he remains committed to his first calling. "I don't see myself as a career politician," he says. When he was elected in 1994, he pledged to honor an eight-year term limit. "I definitely identify myself as a doctor-a doctor temporarily on leave to serve Congress." Being on leave has only meant shifting to a higher gear, however. life in Congress, says - - - - - - - - - - - - - - - - - - - - --t"lm--- Weldon, is "like These days Weldon is better known as "Honorable" than "Doctor." For the being an intern "The general skills a physician past three years Weldon, a 1981 graduyear-round." In a has transfer well into the political ate of the UB School of Medicine and sense, Weldon Biomedical Sciences, has been serving arena. My background gave me a lot of has been running as a Republican representative. Instead at that pace since experience in relating to people, oflooking after patients, he's been lookhe left his home ing after the needs of Florida's 15th on long Island solving problems, and explaining Congressional District. Instead of mediand enrolled in complex issues to people in cal cases, he's been caught up in welfare the accelerated reform, balancing the federal budget, terms they can understand." medical program and school-choice legislation. at UB. He had "Okay, now where was I? I was in the accelerated program planned to work his way through medical school, but when at UB, and ... ." We'll be interrupted five times by the end of he realized how demanding the program would be he applied our conversation, but the 43-year-old congressman remains for an Army Health Professions scholarship. Then he got s u f f a l a Physician Summer 1 9 9 7 �''I'm not expecting heaven on earth-there will still be a lot more worl< to do when I leave.'' Weldon also serves on the House Science Committee and engaged to ancy, whom he'd met when they were both the House Banking and Financial Services Committee. And students at the State University of New York at Stony Brook. his commitment to health-care issues has not been forgotten. "l went through this grueling summer curriculum, took my finals, then ran back to Long Island, got married , and went on "We did pass important health insurance reform in the last Congress that will restrict the ability of insurance companies my honeymoon, " he says. "It was a whirlwind, but those were wonderful years. I was newly married , studying like crazy, and to exclude people because of preexisting conditions," Weldon notes. "I was very pleased with that. But I think there's a lot working with some of the finest people I've ever known. " Weldon graduated from UB in 1981 and spent the next more that can be done to make insurance more accessible and three years at the Letterman Army Medical Center in San affordable. l'd also like to see medical malpractice reform, Francisco, where he completed his internship and residency although the President has been an adamant opponent of it. " Because Weldon in internal medicine. He and his family spend was then assigned to a part of every month three-year tour of duty at "I began to become concerned with what I in Washington , it is Winn Army Community saw as a bad direction that we were impossible for him to Hospital in Fort Stewart, GA. The highlight? Workhave regular patients. heading in as a nation. I was particularly ing with General orman But he continues to disturbed by the high degree of family Schwarzkopf. see patients at the "He was the division Melbourne medical breakdown and the general erosion commander when I got group 's Saturday of traditional values." there ," Weldon recalls , walk-in clinic. He "and I was his wife's also is on call on occasional weekends at a community hospital in Melbourne. doctor and a good friend of his aide-de-camp. " "l really did like practicing medicine, and I had reservaBy the end of his army duty in 1987, Weldon and his wife tions about giving it up. That played a strong role in my were in love with the South. They moved to Melbourne , FL, decision to serve only eight years. My plan is to return to where Weldon was in private practice only a few years when he started thinking seriously about getting involved in politics. private practice in 2002. !look forward to that. The pace is so "I began to become concerned with what I saw as a bad much slower than this-can you hold on a second'" direction that we were heading in as a nation ," he explains. "I Weldon puts the phone down again and goes off to cast his was particularly disturbed by the high degree of family breakvote against an amendment (proposed by Rep. joseph down and the general erosion of traditional values. And I Kennedy, D-Mass .) to a bill to repeal the United States thought it was terrible that our congressional leaders in WashHousing Act of 1937 and deregulate the public housing ington were just borrowing money year in and year out. " program. "These are amendments that usually just make it easier for people to get public housing, " Weldon says. "That's First he threw his support behind local candidates whose generally the trend. Mr. Kennedy has a vision that's very vision he shared. Then one day in 1993, a colleague suggested that Weldon would make a better congressman than any of much opposite to what the Republican majority vision is. " the candidates running for election the next year. Coupled Welfare reform and a savings of $50 billion in government with his concern about the Clinton health-care plan-like spending are among the initiatives that Weldon sees as signals of positive change since he went to Washington. ln the next many physicians, Weldon is skeptical about the federal five years, he hopes to contribute to a crackdown on crime and government's ability to run the health-care system drug abuse and to continue to push for a smaller federal efficiently-that suggestion "pushed me over the edge," government and lower levels of taxes. "The process of change he says. Weldon won the election in 1994 and was reelected has been slow," he says, "but I think we're making headway. " to a second term in 1996. And if the world hasn't changed enough by 2002, will Since his district includes the Kennedy Space Center, Weldon be able to give up politics? Weldon devotes substantial time to space issues. His medical ''I'm not expecting heaven on earth-there will still be a lot expertise has proved useful here, as well. "''m a big supporter more work to do when I leave," Weldon says. "But l don't of the space program," he says, "and there's a lot of exciting think l could totally walk away from politics after this. lt's science research that is performed on the shuttle, like gotten into my blood." + microgravity research. " B u f f a 1 a Physician Summer 1 9 9 7 �Sandra A. Block Internal Medicine, UB Graduate Medical Dental Education Consortium, Buffalo , Y Match Day 1997 Adrienne D. Bonham Obstetrics and Gynecology, University of wo-thirds ofUB's graduating medical students were placed Rochester/Strong Memorial Hospital , Rochester, Y in primary care residencies in this spring's Match Day. The Timothy P. Braatz Internal Medicine (prelim ), University of Maryland , Baltimore, MD; Radiology-Diagnostic , University of Maryland , Baltimore, MD ational Residency Matching Program results were announced March 19 by associate dean Dennis Angela M. Camasto Pediatrics, University Hospitals of Cleveland, ' Cleveland, OH adler. Eighty-six percent of the students got their first, second, or third choice of placements. Almost one-third will stay in Buffalo to train in the Graduate Medical Dental Education Consortium, while 48 percent will go out of state. In the primary care specialties, 28 students were placed in internal medicine, 2 7 in pediatrics, 21 in family medicine, and 7 in medicine-pediatrics. This is the first year that ew York State has considered obstetrics-gynecology one of the primary care specialties. Fourteen students were matched to OB-GY residencies. "We're very pleased with the outcome of the match, especially with respect to the number of students who chose residencies in primary care," adler said. "We've worked very hard to achieve this goal." Jared C. Barlow lntemal Medtcine (prelim ), ew Rochelle Hospital , New Rochelle , NY; Anesthesiology, Mount Sinai Hospital , ew York , NY Drew H. Barzman Psychiatry, Duke University Medical Center, Durham , NC Juan P. Abonla Pediatrics , UB Graduate Medical Dental Education Consortium, Buffalo, NY B u f f a l o p h y s c a S u m Edward L. Chan Pediatrics, UB Graduate Medical Dental Education Consortium, Buffalo, y Alexander W. Chen Medicine/ Pediatrics, Duke University Medical Center, Durham, C Kristen M. Chimileskl Pediatrics, University of Chicago Hospital, Chicago, IL Ronlka D. Choudhary Family Practi ce, Highland Hospital of Rochester, Rochester, NY Joseph L. Chow Family Practice, Highland Hospital of Rochester, Rochester, NY Gonzalo M. Bearman Intemal Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, Y Ravl K. Desai Internal Medicine, UB Graduate Medical Dental Education Consortium , Buffalo, NY Terl Beers Obstetrics and Gyn ecology, UB Graduate Medical Gregory DIFrancesco Emergency Medicine, UB Graduate Medical Dental Education Consortium , Buffalo, Y Cassann N. Blake Surgery , SU Y Health Science Center, Brooklyn, y m Patricia A. Cawley Pediatrics, Morristown Memorial Hospital , Morristown , J Catherine C. Costello Pediatrics , Albert Einstein College of Medicine!Montefiore Medical Center, Bronx, NY Altagrace Belmar Pediatrics (primary), Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY Sharon Baratz Internal Medicine, George Washington University, Washington , DC Jason M. Andrus Psychiatry, University of Hawaii , Honolulu , HI y Kathleen M. Batt Family Practice, Halifax Medical Center, Daytona, FL Dental Education Consortium , Buffalo, NY Jean S. Bae Psychiatry, University of Wisconsin Hospital and Clinics, Madison , WI Jeffrey A. Cassidy Surgery (prelim), UB Graduate Medical Dental Education Consortium , Buffalo, Y; Orthopedics, UB Graduate Medical Dental Education Consortium, Buffalo, e 9 9 Andrew Dmytrljuk lttternal Medicine, George Washington University, Washington , DC Jacqueline A. Dombrowski Medicine/Pediatrics , UB Graduate Medical Dental Education Consortium, Buffalo, Y �Morris P. Elevado Internal Medicine, University of Massachusetts Medical Center, Worcester, MA Clarlsa R. Gracia Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA Paul J. Kerner Orthopedics, Allegheny University, Central City, PA Thomas R. Elmer Internal Matthew J. Gutierrez Internal Medicine (prelim), Alton Ochsner Medical Foundation, New Orleans, LA; Ophthalmology, Louisiana tate University Eye Center, ew Orleans, LA Medicine, University of Vermont! Fletcher Allen Health Care, Burlington, VT (prelim), University Hospital, Stony Brook, Y; Radiology-Diagnostic, SU Y Health Science Center, Brooklyn, Y Paul A. Guttuso Family Practice, Peter W . Kim Internal Medicine, St. Mary Hospital, Lubbock, TX Simone P. Elvey Internal Medicine Taj A. Hadee Pediatrics, Medical College of Virginia, Richmond, VA (prelim), UB Graduate Medical Dental Education Consortium, Buffalo, NY; Radiology-Diagnostic, University of Rochester/Strong Memorial Hospital, Rochester, NY Children's Memorial Hospital, Chicago, IL Peter S. Ercollno Pediatrics, Asra Khan Internal Medicine Randy S. Fagin Surgery (prelim), UB Graduate Medical Dental Education Consortium, Buffalo, Y Pamela R. Haefner Pediatrics, Electra C. Martin Emergency Mediciue, SUNY Health Science Center, yracuse, Y and Gynecology, UB Graduate Medical Dental Education Consortium, Buffalo, Y Andrew Klapper Plastic Surgery, Paul J. Mason Orthopedics, Henry Eric J. Hanauer Internal Medicine Benjamin 0 . Koenig Emergency Medicine, William Beaumont Hospital , Royal Oak, Ml Janine M. McAssy Internal Suchltra Koneru Family Practice, M. Angela Mclellan Obstetrics and Gynecology, UB Graduate Medical Dental Education Consortium, Buffalo, Y ew York University Medial Center, New York, Y Jennifer T. Hanauer Obstetrics (prelim), Albert Einstein College of Medicine!Montefiore Medical Center, Bronx, Y; eurosurgery, Albert Einstein College of Medicine!Montefiore Medical Center, Bronx, NY and Gynecology, Rochester General Hospital, Rochester, NY James B. Gaul Medicine/Pediatrics, University of Minnesota Hospital and Clinic, Minneapolis, M Agnes A. Gelder Family Practice, iagara Falls Memorial Medical Center, Niagara Falls, Y Jennifer P. Gennuso Pediatrics, Kathleen P. Gillan-Lundgren Pediatrics, Children's National Medical Center, Washington, DC Louisiana State University School of Medicine, Shreveport, LA Armond M. Lapine Internal Medicine, niversity of Utah Affiliated Hospitals, Salt Lake City, T Peter M. McNeela Family Practice, Hamot Medical Center, Erie, PA Peter S. McQulller Anesthesiology UB Graduate Medical Dental Education Consortium, Buffalo, NY Manal Hegazy Surgery, ew ew Rochelle, y Research, Buffalo, NY Lisa M . Mendonza Family Practice, UB Graduate Medical Dental Education Consortium Buffalo, NY Janice M . Lee Internal Medicine, Wenchun Hsu Emergency Mediciue, Emory University chool of Medicine, Atlanta, GA t. Louis University School of Medicine, t. Louis, MO Michael D. Merrill Internal Jeffrey M . Legrett Internal Medicine (primary), UB Graduate Medical Dental Education Consortium, Buffalo, NY Mediciue, UB Graduate Medical Dental Education Consortium, Buffalo, NY Daniel C. Metrick lntemal Medicine, Mount Auburn Ho pita!, Cambridge, MA Kenneth A. Levey Obstetrics and Gynecology, George Washington University, Washington, DC Claudia Jaramillo luternal Medicine (primary) , UB Graduate Medical Dental Education Consortium, Buffalo, Y Jennifer A. Meyer Pediatrics, Timothy N. Llesching Internal y Akron General Medical Center/ EOUCOM, Akron , OH; Ophthalmology, Case Western Reserve University, Cleveland, OH Joseph F. Lopes Surgery (prelim), Dartmouth-Hitchcock, Lebanon, NH; Urology, DartmouthHitchcock, Lebanon , NH Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, NY Loren S. Kane Internal Medicine, Andre L. Lopez Family Practice, University of Medicine East Carolina-Pitt County Memorial Hospital , Greenville, C Stephan J. Mllback Family Practice, aval Hospital, Camp Pendleton , CA Medical University of South Carolina, Charleston, SC Jeannie Kao Physical Medicil1e and Rehabilitation, William Beaumont Hospital, Royal Oak, Ml 0 Alex Mompoint Internal Medicin e (prelim) , Sisters of Charity Hospital , Buffalo, Y; Physical Medicine and Rehabilitation, University of Texas outhwestern Medical Center, Dallas, TX UB Graduate Medical Dental Education Consortium, Buffalo, y Iuternal Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, Y B Lori A . Michael Emergency Andrew J. Luisi Internal Mediciue, Brian M . Karaszewski B Graduate Medical Dental Education Consortium, Buffalo, Medicine, Deaconess Hospital, Boston, MA Thomas J. Joly Transitional, Y Mediciue, University Health Center, Pittsburgh, PA Frank M . Lee Emergency Medicine, Obstetrics and Gynecolog) , Our Lady of Mercy Medical Center, Bronx, NY (prelim), UB Graduate Medical Dental Education Consortium, Buffalo, NY UB Graduate Medical Dental Education Consortium, Buffalo, Thomas E. Hansen Orthopedics, Rochelle Hospital, Ford Health Science Center, Detroit, Ml University of Maryland, Baltimore, MD Ayanna Angela L. James Jennifer L. Geiger Surgery Pathology, UB Graduate Medical Dental Education Consortium, Buffalo, Y University of Wisconsin/St. Mary's Medical Center, Madison, WI Eric I. Finkelstein Surgery University of Rochester/Strong Memorial Hospital, Rochester, NY Dori R. Marshaii-Hobika Gregg E. Kissel Family Practice, Lorna Linda University, Lorna Linda, CA Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, NY David R. Frels Internal Medicine, Pediatrics, University Health Center, Pittsburgh, PA Akron City HospitaVNEO COM, Akron, OH (prelim), University of Rochester/ Strong Memorial Hospital , Rochester, Y; Neurology, niversity of Rochester/Strong Memorial Hospital, Rochester, Y Michael A. Filice Emergency Alexander Marcus Regina Y. Kim Family Practice, Sabrina R. Hammett Obstetrics University of orth Carolina Hospital, Chapel Hill , C Paul M. Maggio Surgery, Rhode Island Hospi tall Brown University, Providence, Rl Cozzette Lyons Internal Medicine, University Hospitals of Cleveland, Cleveland, OH 0 p y 5 c o n 5 m m e 9 9 �Jonathan A. Morgan Internal Medicine (prelim), Long Island jewish Medical Center, ew Hyde Park, NY; Radiology-Diagnostic, Thomas jefferson University, Philadelphia, PA Christopher M. Pieczonka Surgery (prelim) , UB Graduate Medical Dental Education Consortium, Buffalo, NY; Urology, UB Graduate Medical Dental Education Consortium, Buffalo, Shrini T. Mukkamala Surgery (prelim), B Graduate Medical Dental Education Consortium, Buffalo, Y David M. Pllati Surgery, University of North Carolina Hospital, Chapel Hill , C Tracey L. O'Connor Intemal Medicine, University of Rochester/ Strong Memorial Hospital, Rochester, NY Mount Sinai, Flushing, NY Gina L. Parlato Family Practice, orth Colorado Medical Center, Greeley, CO Emmanuella Paul Family Practice, Emory University School of Medicine, Atlanta, GA Christian W. Rochoii intemal Medicine (prelim), niversity of Vermont/Fletcher Allen Health Care, Burlington, VT Philip S. Piasecki Intemal Medicine (prelim), Sisters of Paul Rosen Pediatrics (pri mmy), Mount Sinai Hospital, ew York, a a Y p Matthew Smith, D.D.S. Surgery (prelim), B Graduate Medical Dental Education Consortium, Buffalo, Y Gavin N. Somersel Obstetrics and Gynecology, Albany Medical Center y 5 c a n s u m Matthew Taberski Internal Medicine, Hospital of the niversity of Pennsylvania, Philadelphia, PA Evan S. Taragano Pediatrics, University Health Center, Pittsburgh, PA Andrea L. Torsone Obstetrics and Gynecolog), University of North Carolina Hospital, Chapel Hill, NC Meryl Y. Tucker Obstetrics and Gynecology, UB Graduate Medical Dental Education Consortium, Buffalo, NY Usha Vaidyanathan Internal Medicine, University Hospitals of Cleveland, Cleveland, OH Joseph H. Wandass Ill Medicine/ Pediatrics, UB Graduate Medical Dental Education Consortium, Buffalo, Y John J. Welch Pediatrics, Georgetown University Hospital, Washington, DC Dayo N. Wilson Medicine/ Pediatrics, B Graduate Medical Dental Education Consortium, Buffalo, Y Noelle M. Stevens Family Practice, SU Y Health Science Danielle A. Woodall Internal Medicine, Albert Einstein College of Center at Syracuse/St. joseph's Hospital Health Center, Syracuse, y Sarah K. Storm Pediatrics, North Shore University Hospital, Manhasset, Y Gary A. Styn Family Practice, B Graduate Medical Dental Education Consortium, Buffalo, NY m Julie A. Szumigala Obstetrics and Gynecology, UB Graduate Medical Dental Education Consortium, Buffalo, NY louise Z. Spierre Pediatrics, University of Cincinnati Hospital , Cincinnati, OH Y y h Nicole L. Symons Family Practice, University of Medicine East Carolina-Pitt County Memorial Hospital , Greenville, C William M. Wind StJrgery (prelim), UB Graduate Medical Dental Education Consortium, Buffalo, Y; Orthopedics, UB Graduate Medical Dental Education Consortium, Buffalo, Y Hospital, Albany, Vitaly Raykhman Surgery (preli m), UB Graduate Medical Dental Education Consortium, Buffalo, Y; Umlog), B Graduate Medical Dental Education Consortium, Buffalo, Y Maryann M. Parietti-Scharf Family Practice, Highland Hospital of Rochester, Rochester, Y u Monica J. Simons Obstetrics and Gynecology, Queens Hospital! Pamela P. Rath Transitional, Hennepin County Medical Center, Minneapolis, M ; Ophthalmology, University of Minnesota, Minneapolis, M John Panagiotopoulos Intemal Medicine, Winthrop-University Hospital , Mineola, Y B Jimmy Y. Sim Pediatrics, Thomas jefferson University/Dupont Institute, Philadelphia, PA Jennifer M. Ragi Intemal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA lesley A. Orman Pediatrics, Eastern Virginia Medical School, orfolk, VA Charity Hospital , Buffalo, Charles M. Severin, Ph.D. faculty, Department of Anatomy and Cell Biology, UB Graduate Medical Dental Education Consortium, Buffalo, Y John C. Radford Emergency Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, NY Medical Center, Merced , CA Jennifer F. Sussal, M.P.H. Pediatric Psychiatry, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, Y Craig M. Senzon Intenwl Medicine (prelim), Beth Israel Medical Center, New York, Y; Neurology, Albert Emstein Medical Center, Bronx, NY Bobbie l . Pustelny Surgery (preli m), University of California at Los Angeles, Los Angeles, CA Christopher M. Occhino Family Practice, Merced Community Noah D. Sabin Surgery (prelim), Abington Memorial Hospital, Abington, PA; RadiologyDiagnostic, Albert Einstein College of Medicine(Jacobi Medical Center, Bronx, Y y Catherine F. Przystal Medicine/ Pediatrics, University of Rochester/ Strong Memorial Hospital, Rochester, Y David J. Novak Internal Medicine (prelim), Georgetown University Hospital , Washington, DC Paniti Sukumvanich Obstetrics and Gynecology, niversity Health Center, Pittsburgh, PA Tami S. Seaman Family Practice, UB Graduate Medical Dental Education Consortium, Buffalo, Aisha K. Prim Pediatrics, Children's ational Medical Center, Washington, DC Manyan Ng Pediatrics, Thomas jefferson University/Dupont Institute, Philadelphia, PA James J. Runfola Family Practice, West jersey Health System, Trenton, J Patrick V. Scott, D.D.S. Surgery (prelim), UB G•aduate Medical Dental Education Consortium, Buffalo, Y V. Chowdry Pinnameneni Intemal Medicine (prelim), New York Methodist Hospital , Brooklyn. Y Gerardo Negron Internal Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, Y Lisa S. Sufrin Pediatrics, University of Cincinnati Hospital , Cincinnati, OH Thomas E. Schenk Pediatrics, UB Graduate Medical Dental Education Consortium, Buffalo, Y y James P. Murray Medicine/ Pediatrics, University of Texas Medical School, Houston , TX Mary E. Ross Pediatrics, St. Louis Children's Hospital , St. Louis, MO e 9 9 7 Medicine(Jacobi Medical Center, Bronx, NY Denise C. Woodall Pediatrics, Eastern Virginia Medical School, orfolk , VA Carolyn M. Young Psychiatry, UB Graduate Medical Dental Education Consortium, Buffalo, Y �.. . . .. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. . . . . . . . . . . [1] ~ I Rettred surgery professor dies BY WORTHINGTON G . SCHENK n September 4, 1996, surgery lost an outstanding leader with the death of john D. Stewart, M.D. Stewart earned a B.A. from the University of Virginia and graduated cum laude from Harvard Medical School in 1928. He and Henrietta Rhees were married in 1937 and had two daughters and one son. Their son, David, became a surgeon, but tragically, died quite young of undiagnosed overwhelming sepsis. Stewart completed an internship at the Huntington Memorial Hospital and a residency at Massachusetts General Hospital. He did research and further JR . , M . D . work at Massachusetts General and Harvard before being appointed professor of surgery at UB and chief of surgery at the E. ]. Meyer Hospital (now Erie County Medical Center). In 1943, he was commissioned a major in the U.S. Army Medical Corps and a year later was promoted to lieutenant colonel. He served on several national research committees, including the surgery section of the ationa! Institutes of Health. After serving a term on the American Board of Surgery, he became its chair in 1956. Stewart also Nobelist dies at 94 ir john Carew Eccles, a abel Prize-winning neuro- physiologist and a former member of the UB faculty, died in May at his home in Switzerland, the ew York Times has reported. He was 94. In 1963, Eccles shared the obel Prize for Medicine or Physiology with Alan Hodgkin and Andrew Huxley for describing the electrochemical communication system between nerve cells. Eccles showed that excited nerve cells release a substance (acetylcholine) that enlarges pores in a neighboring cell's membrane, allowing positively charged sodium ions to enter the cell, reverse the polarity of the electric charge in the cell, and transmit the nerve impulse. He also found that in other types of synapses, the excited nerve cell induces the neighboring cell to discharge potas- sium ions, which reinforces its existing polarity and inhibits the transmission of the nerve impulse. Eccles was the author of a number of books, including The Physiology of erve Cells (1957), The Inhibitory Pathways of the Central ervous System (1969) , The Understanding of the Brain (1973), and The Human Psyche (1980). Born in Melbourne, Australia , Eccles earned his bachelor's and medical degrees from Melbourne University, and his master's and doctorate from Oxford University under a Rhodes scholarship. B u f f a l o Phys i served as president of the American Surgical Association and was active in many other professional groups. His interests were not limited to surgery. The family kept cattle and working horses on ranches in South Carolina and Florida. In 1965,john retired from his medical school and hospital positions and moved to Boca Raton, Fl. During his professional career, he trained 20 surgeons, most of whom became chief surgeon at their institutions. Few surgeons made the breadth of contributions to the profession as did john D. Stewart. + Worthmgwn G. Schenh jr., trai ned with Dr. Stewart and later succeeded him as ch1ej of surgery at E.). Meyer Hosp1tal. He conducted the research that led to the obel in the 1950s while at the john Curtin School of Medical Research of the Australian ational University in Canberra. Eccles was knighted by Queen Elizabeth II in 1958. Other honors included membership in the Pontifical Academy of Sciences and a four-year term as president of the Australian Academy of Science. He and his first wife, Irene, had nine children. In 1966, Eccles came to the U.S. to head the American Medical Association's Institute for Biomedical Research in Chicago. Two years later, he moved to Buffalo to direct UB's Center for theStudyof eurobiology. He was named a SU Y Distinguished Professor in 1975. After his retirement in 1975, Eccles and his second wife, Helena, settled in Switzerland. + cian Summer 1 9 9 7 �- - - ------ -~-----~-~ ---- - ~~~- - -= ························································································•· Mlfl I I Morin appointed chair of pediatrics rederick C. Morin III, M.D., has been appointed chair of UB's Department of Pediatrics after serving as interim chair for a year. A UB professor of both pediatrics and physiology, Morin was also appointed pediatrician-in-chief at Children's Hospital of Buffalo. He has been chief of the hospital's Division ofNeonatalogy, which is internationally recognized for its research on treatments for lung failure, including surfactant replacement therapy, inhaled nitric oxide, and liquid ventilation. Morin succeeds F. Bruder Stapleton, M.D., who is now chair of pediatrics at the University of Washington. After earning his M.D. at Yale University, Morin completed his residency at Stanford University and held a research FREDERICK C MORIN Ill fellowship in neonatalogy at the Cardiovascular Research Institute of the University of California at San Francisco. He directed the Intensive Care ursery at the University of Rochester before joining the UB faculty in 1986. He is board certified in both pediatrics and peri nata 1/neona ta 1 medicine. + WNY's Largest Volume BMW Dealer THE ULTIMATE DRIVING MACHINE~ THOSE LOOKING FOR MORE CONTROL IN THEIR LIFE CAN NOW FIND IT ON SLIPPERY PAVEMENT. F. G. DOWNING s&99 1997 BMW 740i 27 mo. Lease Towne BMW 3030 Orchard Park Rd. Orchard Park, New York 14224 Phone: 675-2550 While the road of life may throw you an occasional curve, at least our All Season Traction helps you handle the particularly slippery ones. FREE SCHEDULED MAINTENANCE ALL SEASON TRACTION PMT based on 5000 cap cost reduction or trade, 10,000 miles per year. 15 cents charge per mile for excess miles. First and last PMT, taxes and plate fees due at inception. Service Loaners Available ... Minutes From Rich Stadium B u f f a 1 o Physician summer 1 9 9 7 �COMMENI 1 9 9 7 Commencement ceremony honors cancer researcher Internationally hnown cancer researcher James F. Holland, M.D., was awarded a State University of ew York honorary doctorate in science at the 151st commencement of the UB School of Medicine and Biomedical Sciences on May 11. Holland , whose work helped shape modern treatments for leukemia and other cancers , also delivered the annual D. W. Harrington Lecture on May 12, on the topic of "The Search for HMTV, Human Mammary Tumor Virus." Commencement ceremonies were held in the Center for the Arts on the UB orth Campus. SUNY Trustee Edward . elson conferred the honorary degree on Holland. One hundred forty-six students received their M.D.s during the ceremony, and 37 received Ph.D.s. Four received M.D./Ph.D.s. The ceremony served as the conclusion of the university's 18-month sesquicentennial celebration. Holland, CU Y Distinguished Professor and chief of the Division of eoplastic Diseases at Mount Sinai School of Medicine , served as chief of medicine at Roswell Park Cancer Institute for more than 20 years. A graduate of Princeton University and Columbia University College of Physicians and Surgeons, he spent a year at the ational Cancer Institute before coming to UB and Roswell Park Cancer Institute in 1954. He was named chief of medicine at Roswell in 1956, serving until 1973. During much of that time , he also served as director of Roswell's Cancer Clinical Research Center and became a research professor of medicine at UB. In 1972, Holland received the prestigious Lasker Award for his work in chemotherapy. + ® B u f f a l o p h y �-----~-- ---~- - -------- - -~-....--- - - liCE ME NT On with joy to new challenges: Twin sisters Drs. Danielle and Denise Woodall (center); Dr. joseph Lopes with daughter Olivia (top, page 18); UB President William Greiner hooding, then congratulating, Dr. james Holland (below, page 18); Interim Dean john Wright, presiding (top, page 19); Dr. Lisa Mendonza with family friends (above); Dr. Regina Kim signing the Book of Physicians (immediate left); and Class Speaker Dr. Charles Severin (below). ~ �• ··················································· · ···································· ~ I Aword from the director of development BY LINDA J . CORDER. PH . D. , C.F.R.E . n this issue of the Buffalo Physician, the school honors and thanks members of the james Platt White Society. Several times since becoming a development officer in the School of Medicine and Biomedical Sciences, I have been asked about the history and evolution of this honorary recognition organization. The short answer is, it provides a vehicle to thank those who generously contribute their personal resources to enhance and advance the School of Medicine and Biomedical Sciences. Each donor decides where his or her gift will go. Many give to the school's General Fund, which is disbursed at the discretion of the dean. It is not an exaggeration to say that the General Fund is the most important current gift fund. The caliber of our faculty continues to increase, in part, because of the flexibility this fund provides in support of searches and faculty dt.velopment. Other uses for the fund include recruiting promising students, supporting the minority high school research apprentice program, and underwriting the Medical Scientist Training Program seminar series. Some donors choose to designate their gifts for endowed funds, including endowed scholarships and endowed faculty chairs. Others make gifts to special projects, such as UB's euroanatomy Museum, or to departmental funds, which are disbursed at the discretion of the department chair for such uses as research seed money or student medical association activities. Gifts to any of these funds-as well as annuities, charitable trusts, or bequestsqualify a donor for membership in the james Platt White Society. The society offers two types of recognition: annual and lifetime. An annual gift of $1,000 or more results in a year's membership in the society. An individual or a couple is granted lifetime membership in the Founders' Circle of the society when cumulative contributions reach $50,000. Recognition in the james Platt White Society confers recognition in the University's President's Associates (annual) and University Founders (lifetime) honorary organizations. When the james Platt White Society was established in 1986, memberships went to ® B u f f a l o those who donated $10,000 payable over a period of ten years to any fund that benefited the school. Larger gifts guaranteed recognition for a specified number of years. A few "special members" are still recognized, due to those early agreements. Several years ago, the recognition categories were changed to the current annual and lifetime memberships. The category "Special Membership" is no longer offered, and will expire for current members at the end of 1999. The recognition category "In Memoriam" was added to recognize those whose thoughtful foresight included arranging major bequests or gifts from testamentary trusts for the school's enhancement. Individuals and couples who support the medical school at an outstanding level are seen as its closest friends, and so they receive additional information throughout the year, invitations to certain medical school and university events, and special recognition by the school. Best of all, this is an open and expanding group. The more "best friends" the school has, the more excellent it becomes. All are welcome to contribute and be recognized for their support. The entry level for the society has never been raised. In fact, it has actually been lowered for recent graduates. "Graduates of the Last Decade" (GOLD) are recognized for annual contributions of only $500 or more. The Executive Committee wants to encourage all medical alumni, and especially the GOLD graduates, to support their school at a level commensurate with their resources. We are deeply appreciative of all gifts to the medical school, especially those that have the potential to make a transforming difference in the quality of medical education and residency training offered at UB. I invite you to read through the roster of members that follows, and to thank your friends and colleagues listed there for their outstanding support. If you are not yet in this group, please consider increasing your contributions to the school. The executive committee would like to see this honorary group double in size by the end of the century.+ Linda). Corder became the direcror of development for the School of Med1cine and Biomedical Sciences this year. She had previously sen·cd the school as major gifts coordinaror. Physician Summer 1 9 9 7 �- -- --~-----~~~~-- -- - - ---- - - ~~-~ -- -= ·············· · ·········································································• · ~ I Dean ' s Circle james Generous gifts of $25,000 to $49,999 qualify individuals or couples as members of the Dean's Circle. Platt White Society Dr. Kenneth M. and Mrs. joan Alford Chair Buffalo, NY Dr. Charles D. and Mrs. Mary Bauer Byron A. Genner Ill, M.D. Williamsville, NY Potomac, MD I Founders ' Circle Individuals or couples whose cumulative lifetime contributions total $50,000, or whose irrevocable deferred gifts total $100,000 or more, are honored as permanent members of the Founders' Circle. Their names are also repeated in an annual category, at the appropriate level, in any year that they make a new gift to the School of Medicine and Biomedical Sciences. Dr. Elizabeth P. Olmsted Ross Buffalo, I Y Cheste1jield, MO Orchard Park, NY Dr. Orvan W. Hess Dr. Richard B. and Mrs. Ellen Narins North Haven, CT Dr. Richard B. and Mrs. Ellen B. arins Williamsville, NY Philip B. Wels, M.D., and Mrs. Elayne Wels Eggertsville, NY Buffalo, NY I Dr. George M. Ellis Jr. and Mrs. Kelly Ellis Connersville, IN Lakeview, NY Mrs. Catherine Fix Martinsburg, WV Dr. Thomas F. Frawley Chesterfield, MO p h Annual Members Individuals or couples whose annual gifts total $1,000 or more are honored in the year the gift is made, at the level indicated by the total amount of contributions made during the period specified. The following lists recognize this year's annual members, some of whom are also honored as members of the Founders' Circle. Mrs. Grant (Evelyn) Fisher y 5 c I a n 5 m Circle Gifts of $5,000 to $9,999 are given due recognition in the Professors' Circle. Central to a great university is a strong faculty. Likewise, central to the future of our school is the dedication of a cadre of supporters within the Professors' Circle. Miss Thelma Sanes Dr. Kenneth H. Eckhert Sr. and Mrs. Marjorie Eckhert Dr. Thomas]. Kufel Marilla, Y Dr. Charles]. McAllister Clearwater, FL Buffalo, NY I Scholars ' Circle One strength of an outstanding institution is the caliber of those who study there. Scholars within the james Platt White Society have made gifts to the school totaling $1,000 to $2,499 during the past year. These marked with an asterisk(*) are young scholars, graduates of the past decade who qualified with gifts of $500 to $999. Dr. Bruce M. Abramowitz Glenview, IL Dr. Kenneth Z. Altshuler Dallas, TX Dr. Richard Ament I Professors ' Buffalo, NY Providence, R1 o Longboat, FL Dr. Elizabeth P. Olmsted Ross Snyder, NY l Dr. Benjamin E. Obletz Hilton Head Island, SC Dr. Willard and Mrs. Clarice Bernhoft a East Aurora, NY Dr. Albert C. and Mrs. Linda Rekate Y Chairs ' Circle Dr. Thomas F. Frawley Richard]. Nagel, M.D. and Mrs. Florence Nagel Dr. joseph and Mrs. Helene Chazan Y just as a department chair earns recognition for leadership of an academic program, donors who make leadership gifts in the range of $10,000 to $24,999 are given special recognition by the james Platt White Society. East Aurora, NY Williamsville, Dr. joel M. Bernstein Dr. Richard W. Munschauer Dr. Eugene R. and Mrs. june A. Mindel! Dr. Charles D. and Mrs. Mary Bauer f Dr. Thomas]. and Mrs. Barbara L. Guttuso Mrs. GraceS. Mabie Orlando, FL Buffalo, NY f Buffalo, NY New York, NY Dr. Kenneth M. and Mrs. joan Alford u Buffalo, NY Mrs. Morris Lamer Williamsville, NY B Dr. Eugene R. and Mrs. June A. Mindel! East Amherst, NY Mrs. june M. Alker Circle Fellows within the school are recognized for the added depth they bring to postgraduate study. Within the james Platt White Society, fellows are honored for gifts made during any one year that total $2,500 to $4,999. Williamsville , NY Dr. and Mrs. Pasquale A. Greco Buffalo, I Fellows ' I Dr. William S. Andaloro Caledonia, NY Dr. George Bancroft Hamburg, NY Drs. Kevin and Elizabeth P. Barlog Dr. Willard H. and Mrs. Clarice Bernhoft Amherst, NY Snyder, NY Dr. jared C. and Mrs. Barbara A. Barlow Dr. Harold]. and Mrs. Arlyne Levy Grand Island, NY Amherst, NY Dr. Robert M. Barone Dr. Edward Shanbrom Santa Ana, CA Buffalo, NY e 9 La]olla, CA Dr. Paul D. Barry Dr. and Mrs. james]. White Jr. m Williamsville, NY 9 7 Aiea, HI �• ························································································ Dr. Ronald E. and Mrs. Kathleen Batt Lancaster, NY Dr. Mark and Mrs. Kathleen Comaratta East Amhnsl, ry Gerard T. Guerinot, M.D. , and Mrs. Geri Guerinot Dr. Edwin j. and Mrs. Phyllis E. Manning Rochester, Snyder, NY Y Dr. Ralph T . Behling Dr. Lyn Corder Dr. Eugene J. Hanavan Jr. Dr. Michelle j. Marinello San Mateo, CA Buffalo,, Y Blljfalo, 'Y Williamsville, Y Dr. Richard A. Berkson Dr. and Mrs. Daniel E. Curtin Mrs. Gilda L. Hansen Dr. William L. Marsh Rancho Palos Verdes, CA Orchmd Park, NY Williamsville, NY Bethesda, MD Dr. Theodore . Bistany Mrs. Joan D'A rrigo, in memory of Dr. Pete r . D'A rrigo Dr. Reid R. and Mrs. Elenora M. Heffner Dr. Don L. Maunz Buffalo, NY Dr. john . Bivona Jr. Newbu rgh, NY Dr. Willard H. Boardman Buffalo, Buffalo,, Y Bangor, ME Y Dr. Merrill L. Miller Dr. William j. Hewett Richard H. Daffncr, M.D., and Mrs. Alva K. Daffne r Hamilton, NY West Hartford, CT Mrs. Edwina Mincks in memory of Dr. Charles B. Mincks Jr. Robert M.jaeger, M.D. Winter Park, FL Ptllsbwgh, PA Dr. Dennis L. Bordan Port Washmgton, NY Dr. David R. and Mrs. Sherrye Dantzkcr Dr. Suzanne F. Bradley Roslyn, NY Whitmore Lake, ,\1/ Dr. RogerS . and Mrs. Roberta Dayer Dr. Charles A. joy Dean Mitchell , M.D. Bt;Jfalo, NY fairview, PA Cortla nd, Y Gerard]. Diesfeld , M.D. Dr. Stephen T. Joyce Dr. joseph F. Monte Arcade, NY Buffalo, \JY Buffalo, Dr. Thomas A. Donohue Dr. and Mrs. James R. KanskiJr. Dr. james]. Moran Lexington, KY Eggertsville, Santa Monica, CA Dr. Ronald l. Dozo retz Drs. Julian R. and Mayenne A. Karelitz Dr. Thomas W. Bradley Tonawanda, NY Dr. Martin Brecher Amherst, Y Dr. Harold and Mrs. Anne Brody Amherst, Y Dr. James B. Bronk Napa,CA Dr. Melvin M. and Mrs. Elaine S. Broth man Snyder, NY Dr. August A. Bruno Amherst, NY Dr. William M. Burleigh Rancho Mtrage, CA Dr. Washington Burns Ill Berkeley, CA Drs. Evan and Virginia Calkins Hamburg, l\Y icholas J. Capuana New Hartford, Y Dr. Dr. Nicholas C. Carosella Appleton, Y Dr. Yung C. C han Drapc1, VA Dr. Michael E. Cohen Williammlle, NY Dr. D. Jackson Coleman Ha worth, Nj Allenl01vn, PA Dr. Maynard H. MiresJr. Moun/am Lakes, Nj Norfolk, VA Georgetown, DE Y Dr. Thomas W . Morgan Dr. Robert B. Kaufman North Brunswick, Nj Ontano, Potomac, \tiD Dr. and Mrs. Kenneth K. Kim Roanoke, VA Clinton, Dr. jack C. Fisher Dr. Arthur C. Klein Lajolla, CA Los Angeles, CA Dr. Penny A. Gardner Dr. Robert A. Klocke Los Altos, CA Williamsville, NY Dr. Kenneth L. Gayles Dr. Paul S. Kruger Manhasset , , Y Y Dr. Arthur W Mruczek Sr. Medina, NY Dr. Richard L. Munk Sylvania, OH Dennis A. Dr. Lawrence H. Golden Dr. Paul A. C. Greenberg Y Dr. Kim Griswold Lockport, NY Ri chard]. agel, M.D. and Mrs. Florence agel Dr. Gordon R. Lang Orchard Park, Poestenkill, Dr. Masao 1 Y Eric, PA f f a l o akandakari Drs. Robert G. and Lillian V. jamestown, Carlisle, PA Dr. Robe rt T. Guelcher Y Honolulu, HI Dr. Stanley B. Lewin Fort Myns, FL adler, M.D.* Velvedccr- Tiburo, CA Dr. Andre D. Lascari Dr. Edward F. Gudgel a PaulL. Drs. joseph L. and Marie L. Kunz Chicago, IL Btiffalo, \'Y adler, M.D. East Amherst, NY Watertown, NY Eggertsville, NY Y Dr. John D. Mountain Dr. John A. and Mrs. Karen Feldcnzer Buffalo, NY Y Dr. Philip D. Morey Williams1·illc, Y Los Angeles, CA Dr. Robert Einhorn New York, Mukilteo, WA Dr. Kenneth L. and Mrs. Jane Jewel ey Y Dr. jack and Inez Lippes Dr. Thomas P. and Mrs. Sandy O'Connor Buffalo, Y East Amherst, Y p h y c a n S u m m e 9 9 7 �······················· · ······ · ································· · ······················· · ·' ~ I Mrs. Marguerite T. O'Gorman Dr. Joseph I. Schultz Dr. Bradley Truax Dr. Myron E. Williamsjr. Eden, NY San Pedro, CA Lewiston, Y Batavia, XY Dr. Rudolph Oehm Fred and Peggy Schwarz Dr. Alvin Volkman Dr. Richard G. Williams Walnut Creek, CA Williamsville, NY Greenville, NC Clearfield, PA Drs. Dean E. and Donna W. Orman Roy E. Seibel, M.D. and Mrs. Ruth H. Seibel Dr. Arnold Wax Dr. Lester E. Wolcott Henderson , V Lt1bbock, TX East Amherst, NY Eggertsville, NY Dr. JohnS. and Mrs. Dorris Parker Dr. Molly R. Seidenberg Dr. Harold J. Weinstein Gregory E. Young, M.D. Van Nuys, CA Holland, NY Dr. Arthur M. Seigel Drs. Charlotte C. and Hyman Weiss Ca nandaigua, NY Guilford, CT Highland Park, Dr. Elizabeth G. Serrage Dr. Paul H. Wierzbieniec Dr. Franklin and Mrs. Piera Zeplowitz Portland, ME Amherst, NY Buffalo, NY Dr. John B. Sheffer Dr. Gary J. Wilcox Williamsville, Carlsbad, CA Dr. David C. and Mrs. Susan D. Ziegler Rochester, NY Latrobe, PA Dr. Robert J. Patterson Snyder, NY Dr. Norman L. Paul Lexington, MA Dr. joel H. Paull Buffalo, NY Dr. Victor L. Pellicano Niagara Falls, NY Y Dr. Timothy S. Sievenpiper Dr. Charles E. Wiles East Aurora, NY Ha111es City, FL Dr. A. john Piccoli Drs. RobertJ. Smolinski and Claudia Fosket Fort Myers , FL Orchard Park, NY Dr. and Mrs. Herbert S. Pirson Dr. William L. Sperling Orchard Park, NY San Diego, CA Dr. Cary A. Presant Dr. John E. Spoor San Marino, CA Laurens, NY Dr. Bert W. Rappole JohnJ. Squadrito, M.D. jamestown, NY Troy, NY Dr. Frederic D. Regan Dr. William C. Sternfeld Staten Island, Y Sylvania, OH F. T. Riforgiato, M.D., and Mrs. Mary-Cecina W. Riforgiato Middleport, NY 8 Dr. David W. Butsch Montpelier, VT Eugene M. Sullivan Jr. , M.D. Dr. Richard R. Romanowski Ms. Janet F. Butsch Aurora, CO Boston, NY Williamsville, NY Dr. Michael A. Sullivan Dr. Charles H. Rosenberg Buffalo, NY Mr. Barry Swartz Dr. and Mrs. JeffreyS. Ross Dr. and Mrs. Marvin Z. Kurian Amherst, NY Albany, NY Willtamsville, NY Wayne C. Templer, M.D. Dr. Albert G. Rowe Harry L. Metcalf, M.D. , and KaarenJ. Metcalf, Ph.D. Corning, NY Tonawanda , NY Dr. David M. Rowland Dr. and Mrs. James C. Tibbetts Jr. East Aurora, Y Madison, WI Dr. Eric J. Russell Dr. Charles S. Tirone Chicago, IL Williamsville, NY Dr. Adolphe J. and Mrs. L. SchoepiTin Green Valley , AZ a l o Williamsville, Y Dr. john Naughton Buffalo, Y Mrs. Marvin (Helen) Winer Sarasota, FL Dr. George Toufexis ancy Williamsville, NY p h y 5 a n s In Memoriam - The following individuals left generous bequests or made arrangements for gifts from testamentary trusts to be given to the School of Medicine and Biomedical Sciences during the past year. Dr. Russell F. Brace Randolph, Y Dr. Richard J. Kenline Tonawanda, NY Dr. Thomas A. Rodenberg Hollywood, FL Dr. Mark W. Welch Rochester, :-JY Dr. John L. Butsch Williamsville, NY Stamford, CT ecial Members A few individuals and couples were granted multiyear memberships based on generous gifts made between 1989 and 1993. They will receive special recognition through December 1999. At that time all memberships in the society will be made on an annual basis, including ongoing recognition for Founders' Circle members as they reach 550,000 in cumulative gifts. Elizabeth A. Storch Buffalo, NY f Wa lnut Creek, CA Las Vegas, NV Hamburg, NY f ~ Dr. Wende W. Young Dr. Roger M. Simon Dr. Harry Petzing B I u m m e 9 9 We have made every effort to ensure accuracy in these lists. Please contact Dr. Linda) . Corder, Ms. Catherine Williams, or Mrs. janet Parker in the Medical School Development Office if we have made an error or if you would like your name(s) to be listed differently in fut ure recognition documents. Send mail to: Room 141 Biomedical Education Building, UB School of Medicine and Biomedical Sciences, 3435 Main Street, Buffalo, NY 14214-3013. Phone: (716) 829-2773. Fax: ( 716) 829-3395. E-mail: <ljcorder@acsu.buffalo.ed u>. �• ········· · · · ··················································· · · ·· ···· · ··············· Clinical curriculum traces its roots to Buffalo BY S COTT T HOM A S t was half a lifetime ago, at the beginning of their careers . But for five pioneering medica l educators who came together once again to reminisce, the memories remain as sharp as a new scalpel. A "Celebration of Medical Education" honored the five former UB faculty members who created the Project in Medical Education, an innovative effort from 1955 to 1959 to expose beginning medical students to clinical experience and small-group teaching. The project was revolutionary for its time, and not without controversy. Previously, medical students had spent almost all of their first two years in the lecture hall. The Project "we should bring together medical educators and professional educators to see if there was something we could learn from them-and perhaps even they could learn from us." The idea evolved, Miller said, into a series of courses taught jointly by professors in medicine and education, and programs for visiting professors to spend time in both the School of Education and the medical school. 'The colonization began there, but in the course of the next few decades it has spread worldwide," he said. "All these schools have to acknowledge that the seeds of this movement began at the [then] University of Buffalo." Stephen Abrahamson, Ph.D., Ed.D., was on the School of Education faculty at the time; his career has since taken him to the University of Southern CaliLeft to right: Miller, Abrahamson, Rosinski, Jason, and Becker fornia, where he is now professor emeritus. He said he had one proviso when agreeing in Medical Education got them into hospitals and working with patients, an approach that to co-direct the Project in Medical Education: has become the standard for medical educa- " o gross anatomy, and no operating room. " Abrahamson noted the rise of "a bottomtion in the United States. At an April 24 presentation, the five pio- line mentality" with the advent of managed neers shared thoughts on why the project care; he also pointed with hope to the enorsucceeded so thoroughly, and where medical mous amounts of material now widely education might be going in the years ahead. available through the Internet. "In my 35 years of medical education," George E. Miller, M .D., co-director of the project, went on to the University of he added, "''ve tried to learn not a damn Illinois Medical School and is now professor thing about medicine. And the little I have learned has made me pray for health. " emeritus there. Edwin F. Rosinski, Ed.D., earned his docHe spoke of how Stockton Kimball, dean ofUB's medical school at the time, agreed that torate at UB while working on the project. B u f f a l o P Since then, his career has taken him to the Medical College of Virginia; the U.S. Department of Health, Education, and Welfare; the University of Connecticut; and the University of California at San Francisco, where he is now professor emeritus. Rosinski predicted a greater emphasis on outpatient and primary care-the latter a strength ofUB's medical school curriculum, which has become a national model. Hilliard Jason, M .D., Ed.D., earned his medical degree and his doctorate in education from UB. He now directs the Center for Instructional Support, in Boulder, CO, and is clinical professor of family medicine at the University of Colorado Medical School. jason recalled an initial disillusionment with medicine, due to a histology professor who "insisted that we spend hours peering through a microscope at tissues and putting dots on paper to match the shading of what we saw. " That changed with the Project in Medical Education. "I was so excited that there was somebody here who was challenging the status quo. There was this other side of the school that was enormously exciting and enriching." jason sees a plus side to managed care. "The arrival of the bottom-line mentality brings with it the notion of accountability. We have not had that in medical education. " Donald Raymond Becker, M.D., taught surgery at UB until1980, then went to the University of Connecticut at Hartford. ow emeritus there, he teaches at the University of California at Davis. "There have been so many changes in medicine in the past 40 years," he said. "Humanism courses and biomedical ethics committees; AIDS; more women and minorities in the profession. Some say medicine has become too cold, too remote, too impersonal, too unavailable, too money-hungry. "But when students today ask me if I would do it all over again, my answer is still: 'In a flash! ' Why should it matter to me who pays me or how much paperwork I have to do? There will always be the sick who need healing. " hysician + Summer l 9 9 7 B �Put tfze best seat in tfze fwuse myourgarage. ·······················································•· ~ I Residencyslotstobecut by 20 percent overfive years 1997 Buick Riviera Riviera: the most sophisticated personal luxury car Buick has ever offered. It is designed to stir the spirit and excite the soul. We at Paul Batt Buick are proud to serve the people of Buffalo and its surrounding communities. For the last 43 years, we have offered the lowest prices possible, along with the very best in service. We value the professional and the hard working labor force in our community and will continue our efforts to maintain their loyalty. When you enter our showroom you will find helpful people, not pressure-so when you think of Buick sales and service, we know you'll think of us! Joseph R. Pera Paul V. Batt, Jr. 'ldat'JJaff7lllll1 1717 Walden Ave., Buffalo, NY 891-5595 B u f f a l o he number of medical residents trained in Buffalo will be reduced by about 20 percent over the next five years in response to a Medicaid incentive program and cuts at the Veterans Administration. The Graduate Medical Dental Education Consortium of Buffalo had 687 Medicaid-funded residents in training in 1996. That number will be reduced to about 545 by the year 2001 , said Roseanne Berger, M.D., UB associate dean for graduate medical education. The cuts are part of an incentive program for ew York State hospitals offered by the federal Health Care Financing Administration, which runs Medicaid. During the five years of the cuts, HCFA will ease the transition by paying the participating hospitals a percentage of the money they would have received had they continued to train residents at 1996 levels. At the same time, the Veterans Administration is also cutting back on residency training. The Buffalo consortium now trains about 101 VA-funded residents; over five years, this figure will be cut to about 89, according to Gerald Logue, M.D., chief of staff at the Veterans Affairs Western ew York Healthcare System at Buffalo. The result will be a reduction in the number of Buffalo-area medical residents from 788 to 634. Also, a larger percentage of the remaining residencies will be in primary care areas. "Residencies are paid for with public money, so the numbers and types of residents should be driven by what the country needs," Logue said. Nationally, there is a concern that schools are training too many doctors, and specifically, too many specialists. There's also concern about the high cost of medical education, which contrib- Physician summer 1 9 9 7 I utes to the overall expense of health care. For example, federal budget officials have predicted that the Medicare Trust Fund, which is the source of much of the country's GME funding, will have a $600 billion deficit by 2002. As long as residency training provided income for hospitals, there was a strong incentive to create more residency positions and use the residents to take care of indigent patients. Sometimes, residents found themselves performing procedures not because they were required for board certification but because the hospital had no one else to do them. The trend has resulted in many more residency positions than can be filled by graduates of American medical schools, leading hospitals to recruit international medical graduates (IMGs). The changes are likely to start reducing the number of IMGs in the U.S., and Roseanne Berger residents may soon be able to select the types of hospital work they need in order to meet their own educational priorities rather than doing what is needed to care for patients. In addition to the changes in the two federal sources of GME funding, more changes are afoot at the state level due to the ew York State Health-Care Reform Act of 1996. Details remain to be worked out. However, Berger said these changes probably won't result in deeper cuts in Buffalo's programs. The changes provoke a variety of reactions at UB. Some feel that residents will end up better off: "I think this has the potential to strengthen many of our residency programs, " Berger said. "Many of our faculty see it as an opportunity." + - JESSICA ANCKER �_, ............ . . . .................................. . ..................................... . lEI Asthma in the urban community BY MICHAEL CLASS KANE , OF 1998 NOW I KNOW IT'S NOT THAT SIMPLE lenty of studies show that asthma is a growing concern of the inner city. The challenge that I am seeing early in my medical career is making the transition from textbooks, algorithms, and studies to actually helping people with asthma manage their condition outside the physician's office. Over the past two years, I have had the chance to see up close the environIn addition, I learned the importance the opportunity to work with Carlos ments in which Lower West Side asth- of being sensitive to the financial rejaen, M.D., and the Center for Urban matics live. sources of patients. Physicians often tell Research and Primary Care (CURE PC) Of the asthmatics we studied, 80 per- asthmatics to vacuum frequently to reon a comprehensive asthma study done cent were Hispanic, two-thirds received duce the level of dust, or to get rid of in Buffalo's Lower West Side. We iden- public assistance, and more than half cockroaches. But some patients can't tified asthmatics in the community and were exposed directly or indirectly to afford a vacuum cleaner, and they may gathered information about their medi- environmental tobacco smoke. Fewer have no choice but to live in cockroachcal management and knowledge of than half of the adults had a high school infested subsidized housing. asthma, their home environment, their education. More effort has to be put into smokexposure to environmental tobacco My eyes have been opened to many of ing prevention/cessation programs. smoke, and their socioeconomic status. the problems physicians face I joined the research team in per- when treating a chronic disease forming more than 800 home inter- in an urban community. One views in this poor, urban community. I of the most obvious problems became aware of the many sociopolitical was communication. I speak problems of this area, and of many asth- very little Spanish. Sitting in matics' poor understanding and man- patient interviews with a biagement of their condition. lingual researcher, I imagined The a tiona! Asthma Education Pro- what it must be like for a gram publishes guidelines for managing panish-speaking patient who asthma, ranging from the use of corti- enters an emergency room and costeroids, bronchodilators, and peak gets maybe 30 seconds of inflow meters, to the elimination of envi- struction for preventing the ronmental irritants, such as dust, pets, next acute asthma attack- in or tobacco smoke. English. When l first read those guidelines, I gained a better appreciathe management of asthma seemed easy tion of explaining things in enough. I thought that there was noth- plain language. Before I studied ing about asthma that couldn't be ex- asthma, I had no idea what a plained and brought under control after " nocturnal exacerbation " a few 15-minute visits to the clinic. was- it just sounded ow I know it's not that simple. Dr. serious. But that's the kind of term a Almost all the people we interviewed jaen tells his medical students, "In order doctor is Iikely to use when describing a knew that tobacco smoke can make to practice good medicine, you must night-time asthma attack. It's no won- asthma worse , but many still lived in a know the community in which you prac- der some patients-whether they speak smoke-filled environment. One home tice." My experience with him gave me English or not- don't understand. we visited had four children under the ® B u f f a 1 o Physician Summer 1 9 9 7 �UBMICRO COMPUTER SALES A Non-Profit University at Buffalo Se ice Program age of seven with asthma. one of the children were on any sort of treatment plan, and each of the parents smoked two packs of cigarettes a day. I asked what they did when their children had trouble breathing. The parents replied , "Take them to the emergency roomwhat else? " Besides the asthmatics who had no medications to take , there were others who took potentially harmful medications incorrectly. In one home , I interviewed a girl and her grandmother, both with asthma. During the interview , the girl began wheezing. She took an albuterol nebulizer treatment, and when that brought only partial relief, she went to her grandmother's medicine tray and took one of her grandmother's prescription 300 mg theophylline tablets. When I asked about it , the granddaughter explained that she some- Letter to the Editor times had to take her grandmother's medication because it was stronger. I took the opportunity to tell her that these medications-and others-can be dangerous iftaken inappropriately. I urged her to talk to their physician about a medicine review. But even though we both were speaking English , I suddenly got the feeling that I was speaking a foreign language. It is very easy to feel that these sorts of problems are out of the physician's hands, and that people will do whatever they want. However , after working on the CURE PC project, I know that I am going to try my best to confront many of these problems and work with patients for a better quality of life. That, after all , is what the patients really want. + Mi chael Kan e, who wi ll sLa rl hisfatmh yem of medi cal school this f all, is C0 11 sideri11g el!l cringfamil) medi cin e. Buffalo Phys ician received this letter in respo nse to Mike Merrill's www.ubmicro.l)uHalo.edu Call 645· 554 YOU ARE ELIGIBLE for academic pricing on... Acer • Adobe • Apple • Corel • Dell • Hewlett Packard • Microsoft • Texas Instruments & much more ... Delivery &Setup in your home or office available! "A Student's Perspective" column in our Winter 1997 issue. Computer Workshops May 6 , 1997 Call 645-3560 to have a brochure mailed to you. Dear Mike, • On-Site Private Training available. • Scheduled workshops start at $59. • 1/2 day miniclasses target specialized topics. 1 thought you 'd be interested that a guy as far away as Oklahoma really enjoyed your article "Medicine is a Game of Power" in Buffalo Physician. Thirty years ago, I took a watered-down version of the Oath of Hippocrates, which I suppose you will soon do. But keep in mind the spirit of the original . And the violations of it. In my opinion, in spite of "powerful enemies, " the intrinsic value of a good physician is tremendous and will prevail. Water finds its level. Third-party pay is inherently corrupt. You will be more valuable than you think. r Cordially, Summer hours: Mon thru Fri I 1-S Ed Ellis , M . D . Rowland Ellis Flatt Clinic Antlers, Oklahoma A non-profit UnivefSIIy program for students, faculty & staff The Commons • North Campus • (716) 645-3554 • Fax : 645-3884 B u f f a I o P hysician Summer 1 9 9 7 �• · · ··· · · · ·············· · ········ ··· ·· · ······· · ·· · · · ···· · ········ ·· ··· · ·· · ··· · · · ·········· New Alumni Association ollicers elected ared C. Barlow, M.D. , was elected president of the Medical Alumni Association at Spring Clinical Day on April 26. Barlow, an anesthesiologist, is medical director and administrator of the Millard Fillmore Surgery Center in Williamsville, Y, and serves as chair of anesthesiology for the Millard Fillmore Health System. A UB clinical associate professor of anes- Jared C. Barlow thesiology, he graduated from the medical school in 1966. Barlow was recently appointed to a three-year term on the New York State Committee on Quality Measurement, which develops quality measures and promotes research on clinical practice guidelines. He succeeds Jack F. Coyne, M.D ., as president of the Medical Alumni Association. Elizabeth L. Maher, M.D., becomes vice president of the Medical Alumni Association. Maher is a 1985 graduate of the medical school and a UB clinical instructor of medicine. A specialist in family medicine , she is an emergency department Elizabeth L. Moher attending physician at Medina Memorial Hospital. Richard Collins, M.D. , a primary care physician with the Buffalo Medical Group, is the new treasurer of the Medical Alumni Association. He also served as program director for Ri(hord Collins Spring Clinical Day. + Alumni Association honors four our prominent alumni were honored with Lifetime Achievement Awards from the Medical Alumni Association at Spring Clinical Day. Pictured below, from left to right, they are Jack Lippes '4 7, Eugene Marvin Sigman '52, Ross Markello '57, and Richard Ament '42. Of Lippes' research into reproduc- Left to right: Lippes, Sigmon, Morkello, and Ament tion and contraception, his best known work is the invention of the S-shaped intrauterine device known as the Lippes Loop. His biochemical studies of oviductal fluids have also been instrumental in developing treatments for infertility. A UB professor of gynecology and obstet- ® rics , Lippes has served as an international family-planning consultant to the World Health Organization, as well as numerous countries. He serves on the IUD committee of the International Planned Parenthood Federation. Sigman held positions in the Departments of Urology and Surgery at UB, Buffalo General Hospital, and Roswell Park Cancer Institute before moving to the University of Connecticut as professor of surgery and chair of urology. In 1985 , he became dean of the University of Connecticut School of Medicine, a position from which he recently retired. Markello , a former chair of anesthesiology at UB and E. J. Meyer Hospital (now Erie County Medical Center), recently retired as associate medical director of Independent Health of B u f f a I a Western ew York. He served UB as assistant dean for graduate medical education from 1978 to 1981. Markello has held a Sloan Fellowship through the Massachusetts Institute of Technology School of Management's Health Executive Development Program. Among numerous other professional honors and activities , Markello served from 1980 to 1981 as associate project director of the Love Canal Cooperative Health Study for the Centers for Disease Control and Prevention . Ament , a clinical professor of anesthesiology at UB , is a past president of both the American College of Anesthesiologists and the ew York State Society of Anesthesiologists. He also served on the executive committee of the World Federation of Societies of Anesthesiologists and as secretary of the Council of Medical Specialty Societies. An active member of the American Medical Association , he has testified on medical issues before Congress and the U.S. Justice Department. + -J.A. Physician Summer 1 9 9 7 �Reunions at 60th annual Alumni Weekend 1 9 4 7 First row (left to right): Ferdinand Paohm, Hallie Buchanan Mont, Peter Juhan, Robert Ehrenreich Second row (left to right): james Philhps, james Stagg, Arthur Schaefer, Daniel Curtin, Phihp ReitZ, Donald Nuwer, Ste\'en Cline, William Baker, Harold Pescovitz, David ichols, Elbert Hubbard Ill Third row (left to right): Robert jaeger, Robert Segal, Robert Dean, john Sheffer, Hans Kipping, Frederick Whiting, john Waite, john Weiksnar First row (left to right): Oli\·er Steiner, Burton tulberg, Bern1e Dm•1s, Phoebe aturen, Kurt Wegner, james Szabo Second row (left to right): eil Fuhr, Eugene Sigman, Donald Dohn, Victor Panaro, Ralph Obler, joseph Gene\~ich, Melvin Oyster, Alfred Lazarus, Wilbur Schwanz, S. Aaron Simpson, Robert Baumler, Donald Sprecker 1 9 5 7 First row: Roberta Gilbert Second row (left to right): George R. Tzetzo, David Carlson, Anthony Markello, joseph Armenia, Arnold Lubin Third row (left to right): jack Fisher, Sebastian Fasanello, Paul Loree, Owen Bossman, Robert Klocke, john Cudmore, Philip Morey First row (left to right): Charles O'Connor, Gregory Thorsell, Ben Celniker, Bronson Berghorn, Ross Markello, Richard Miller, Hilliard jason Second row (left to right): Bernard Wakefield, james Lasry, Robert Carpenter, Germante Boncaldo, john Parker B u f f a l o p y s c a n 5 u m m e 9 9 7 �[ll 1 9 6 7 First row (left to right): Thomas Augustine, Laird Quenzler, John Treanor Second row (left to right): Margaret Brown, Thomas Sheehan, John Menchini, Douglas Sirkin, Adele Gottschalk, Linda Young, Richard Young, John Anderson, Ronald Josephson, Barry Epstein Third row (left to right): Frank Perlroth, Rocco Venuto, Michael Phillips, William Burleigh, Trevor Robinson, Jonathan Ehrlich, Harvey Schwartz, Alan Saltzman, Arthur Sosis, Donald Miller, Thomas O'Connor, James Giambrone, David Fugazzotto, Anthony LoGalbo First row (left to right): Dennis Gross, Virginia Hawley, Robert Einhorn, Linda Kam, Joseph Oliver Second row (left to right): Alan Ast, Stuart Rubin, Robert Folman, Ian Frankfort, Martin Brecher, Murray Morphy, Richard Rivers, Russell Elwell First row (left to right): Eugene Paul, Thelma Caison-Sorey, lldiko Kondray, Antoinette Wozniak Second row (left to right): Alan Kuritzky, Howard Lippes, Albert Schlisserman, Steven Stone, Helen Marie Findlay, Kevin Greenidge, Nedra Harrison, Gregory Young, Janice Williams, John Norlund, Richard Terry, Michael Kressner First row (left to right): Gerald Harster, Michael Cesar, Joseph Leberer Second row (left to right): Timothy Gee ring, Joseph Gelormini, Mary ® B u a 0 Kelly, Elizabeth Barlog, Kevin Barlog, David Kurss, Michael Bartlett Third row (left to right): Joseph Gioia, R. Scott Crandall, Philip Stegeman, Benjamin Contessa, Joseph Wayne p y a s m m e 9 �First row (left to right): Beth Wutz, Elizabeth Conroy, Katharyne Sullivan, jack Hsrao, Patricia Reddin Vories, Marie Longo, E\·elyn Coggins, Stephanie Fretz Second row (left to right): Randall Loftus, Mark Swetz, Cynthia jensen, George Pancio, Mrchael Longo, Paul Paterson, Atle Skattebol (Identification not ava ilable befo re publication) If you come loolting for a car, you'll be a~vfully disappointed. HoWEVER, there's little chance you'llleave that way. BECAUSE at the Land Rover Centre, we have the world's most impressive 4x4s. AND people who can answer anyof your questions about driving. A4x4, of course . •, Amherst A NORTHTOWN AUTOMOTIVE COMPANY 3560 Sheridan Drive Amherst, New York 14226 (716) 831-3100 • (716) 835 FAXX (3299) B u f f a l o P hysic i an summer 1 9 9 7 �• ......................................... . THE ULTIMATEDRIVING MACHINE: • 9 1 3 0 5 ogy and was named McAllen's of "1996 Honoree. " Kuhl moved Y, writes, "From the to south Texas after complet- forgotten '30s: Last time 1 ing his residency in dermatol- HENRY H . Snyder, HAIN ES ' 33 , checked, there were ten M.D.s ogy and serving in the U .. from 1933. 1 sent a letter to all and was immediately informed Army and the Public Health Service. In addition to his prac- there were nine still alive. Some tice, Kuhl helped found a clinic are still healthy, one with a for Hansen 's disease and Checkpoint Foreign Car, Inc. Sales and Service 487 Kenmore Avenue Buffalo, NY 14223 stroke, me with two bypas es worked in the county venereal and cataracts, but still ambula- disease clinic. A past president tory. I'm still registered, for of the Texas Dermatological Society and a member of the 836-2033 etc.), but retired. 1 turned 90 City Health Authority, he year old on May 4." served as clinical associate pro- Your WNY Leasing Specialist Serving WNY proudly for 33 years convenience (prescriptions, fessor at the University of Texas 1 9 IV A N W. 4 0 K UHL ' 45 , 5 of McAllen , TX, recently retired from his practice of dermatol- Science Center for 17 years. With his wife, Ruth , he raised nine children, two of whom have become physicians. TAKE TWO~ -.. AND CALL ME IN THE MORNING! f;'\d )o ... r OW'\ roaE * Fact: Saab owners have a higher education level than any other car owner group. * Saab purchase prices starting low to mid 20's; leases starting at $299 per month. * According to the Insurance Institute for Highway Safety (IIHS), the Saab 9000 has the lowest fatality rate of any production car on the marl<et. ''The best m a de line in America" since 1913" 300 CRESCENT STREET • JAMESTOWN, N.Y. 716 664-5260 SOUTHTOWNS SAAB -Our Only Location- 3580 Southwestern Blvd (1 Mile east of Rich Stadium) Open Monday - Saturday 10-4 • MasterCard & Visa Accepted Take Thruway Exit 59, then Rt. 60 south to Jamestown. In Jamestown follow Rt. 394 east to Winsor Street; turn left on Crescent. Buy direct from our factory at wholesale prices. Save at least 50%. (?16) 662·800~ 8® 8 u f f 0 l 0 Physician Summer 1 9 9 7 �······································· · ··················································• HI ' 1 9 5 0 5 JAMES E . YOUKER '5 4 , of FRANKLIN ZEPLOWITZ '58 , in May. His new bride, of Buffalo, Margarita (whom he met in medicine.Iwillbeteachingstudents and residents in the ambulatory setting. Y, is the new Hartland, WI, received the president of the Bogota on Project World Gold Medal of the Association Medical Society Health), graduated in 1996. of University Radiologists at its of the County of They matched in Seattle for 45th annual meeting in Dallas, Erie. He suc- neurosurgery and family practice, respectively. David Sherer system chair of pediatrics for Atlantic Health System in annually to an outstanding ceeds Russell Bessette '76. '69 has been hospitality king radiologist for long-term Zeplowitz during the interviews." contributions to education, the TX. The honor is awarded is 1 9 7 0 cago, IL, has been elected vice and is chair of the radiology as a clinical instructor of sur- president of the American Soci- ERIC RUSSELL '74 , gery at UB. Lackawanna, classmate Rasinski julius Jr. '59, of Durango, CO, retired early in 1996 as a family practitioner. He had he will be re- of Chi- Sandra Fernbach, M.D., was el- Victor system chair, sponsible for merging all pediatric care un- ety of euroradiology. His wife, College of Wisconsin. 9 of ], has been named 5 director and chief of staff at 1 FELD '79 , J. As the first Our Lady of Victory Hospital in Lackawanna, NY, and serves of Y, writes: "Our Randolph, medical research, and patient care. DANIEL C . KOZERA '59 , LEONARD G . Florham Park, Youker practices at Froedtert Memorial Lutheran Hospital department at the Medical 6 0 5 evated to the executive council of the American Roentgen Ray WILLIAM E . ABRAMSON '60 , of Baltimore, MD, recently Society. KAREN tification in addiction medicine from the American Society of Addiction Medicine. der one department for the hospitals and the outpatient facilities. Atlantic Health System serves as a major teaching affiliate for both passed the examination forcer- been the team physician for GLASGOW '76 , of ew jersey Medical School and Co- Columbus, OH, writes, '·Re- lumbia University. Feld has been cently, I left a multidisciplinary chief of pediatric nephrology, director of the Children's Kid- group practice to become the the California Angels ever MOIRA J . of assistant program director of ney Center, and professor and since the team was founded. Tampa, FL, writes: "Two new internal medicine at Riverside vice chair of pediatrics at UB and He also served as team physi- physicians have been added to Methodist Hospital in Colum- the Children's Hospital of Buf- bus, where my husband, Pat Hayes '76, practices emergency falo since 1983. cian for the L.A. Rams." BURK E '69 , my family. My son, Brendan, graduates from medical school NICHOLS MIDDLE SCHOOL • Challenging, innovative curriculum • Outstanding preparation for high school • Average class si:e of 14 students • Interscholastic sports • Comprehensi,·e visual and performing arts program • Dedicated, caring faculty • Financial aid available For further information, call: 875--8212 B I u f f a l a p 1 c i a n 5 m m e �• •••••••••••••••••••••••• . HURWITZ & FINE, P.C. I [ 1 EDWARD 9 A. 8 TORIELLO 0 ATTOR EYS AT LAW I I N F I N IT I 5 S ERVICING '80, of Brooklyn, THE L EGAL NY, was appointed to the board of directors of the American Academy of Orthopaedic Surgeons at the organization's 64th annual N EEDS OF THE meeting in February in San Francisco. He is H EALTH S cm cEs chieJ of the Department of Orthopaedic Surgery at Wyckoff Heights Medical Center in Brooklyn, and is attending orthopaedic surgeon at St.john's Queens Hospital , Catholic C OMMU ITY Medical Center, in Queens. Toriello also serves on the board of directors of the New York State Orthopaedic Society and as a • Purchase & Sale of Practices The f ront-wheel Jrive lnj initi® 130n 1 • Managed Care • Business & Tax Planning delegate for the Medical Society of the State of ew York. An titterior more .•paciotM than a Roll• Royce Sil<•er Spur 11!. An e:rceptionally gmmllt.J li.<t of .<fanJard lu.-rury feature,<. A 190-hp V6 mpable 4 out-acceleratin,q many lu.mry v&•. AnJ of cour.<e, the ,</andard-,<elling performance and ,<erl'ict of lnfiniti. • HCFA Safe Harbor Regulations SJ99 mo. 56 mo. lean $999.00 dOII'n and Physician Self-Referrals LYNDA KARIG HOHMANN '81 , of Albany, Y, writes that she joined the Capital Dis- • Contracts with Private trict Physicians Health Plan as associate medical director. Prior to that, she had been & Public Entities medical director of a local addictions pro- • Employee Relations gram for four years. "Heather, my daughter, turns 21th is year and plans to go to medical Counseling school in another year." JANET • Fringe Benefit Programs '84 and JOHN '84 , of Morgantown, WV, WILL I AMS BARBACCIA • Representation Before Government Agencies on announce the birth of their fourth child, Nicholas Andrew. He joins Katie (5), Matthew (3), and Thomas (1).john is residency Audit & Business Issues • Facility Finance director for the Department of Anesthesiology at West Virginia University; janet is research director in the university's Department of Emergency Medicine. and Construction • Credentialing and By-Laws MARTHA PAVLAKIS ln t r ouu cing tbe a ll n ew 97' QX4® f r om SJ5,550. 00 in an lnfiniti® QX-1®, one of tbe fit-.<1 !bing.< you'll e,<cape 1~1 tbe mtmdane. Becau.1e !be QX-1 i.1 not your typical lu.-rury .<portuttlity l'tbicle. lflbi/.e it 1!{/erd all tbe l'tr.latility you e:rpect from a l'ebicle of it.< kint), tbe QX-1 offer.~ .Jome/ bin.9 you Jon 't e.~flecl: tbe lu.~·ury of an lnfiniti. '88 , of Stanford, CA, • Hospital/Medica l Staff Issues is an assistant professor of medicine (nephrology) at Stanford niversity Medical Center. "My clinical work is in kidney and pancreas transplantation, and my research Please contact Robert P. Fine or Lawrence M. Ross at 716-849-8900 interests are acute rejection and gene expression in transplant dysfunction. " I N F I N IT I AUTO PLACE INFINITI 8129 MAIN ST. , WILLIAMSVILLE 633-9585 '88 and MARY DAVITT Y, write, "We are proud to M ITCHELL TUB LIN '88 , of Albany, East of Transit Rd., Near Eastern Hills Mall announce the birth of our third son, Andrew james Tublin , on October 15 , 1996. Andrew joins Daniel (4) andjoshua (18 months) in ® 1300 Liberty Building Buffalo, New York B u f f a L o ( 130-$450). Bank fee + tax and license due at mception. 12,000 annual mileage. $.15 per m1le in excess. Physician Summer 1 9 9 7 �.........................................................• 11 ' Advertise in one of the finest publications in Western New York ... the Tublin gang! Mitch is assistant professor of radiology at Albany Medical Center; Mary state, and national levels." He had served for four years as the student representative to is practicing pediatrics, also at Albany Medical Center." the medical society's advisory council, and as student councillor to the ew York State Medical Society's governing council. He is CAROL V. R . DECOS T A ' 89 , of Brooklyn, NY, writes, "I was recently promoted to associate director of outpatient rehabilitation at the Staten Island Univer- Buffalo Physician sity Hospital. My practice also includes sports medicine. I was one of the physicians who covered the volleyball players during the Centennial Olympic Games in Atlanta last summer. " RUff"tU f"~S\[\"" 9 9 0 5 MARY RITA MURPHY '90, ofMarshalltown, lA, has moved from Tucson, AZ, to Iowa and will be in private practice with a partner starting in October. She writes that she is happily married and has three sons, ages 5112, Jih, and 18 months. (716) 645-6933 Michael J. Baranski Marketing Representative ADVERTISING 146 Stepping Stone Lane Orchard Park, NY 1412 7 a u t f o 1 o P hysic Levey is starting a residency in obstetrics and gynecology at George Washington University. RESIDENTS A . SWIANTEK ('73-'76), of Williamsville, Y, is in the process of pat- enting an instrument for prostate surgery called the ortech Sled. The instrument allows surgeons to perform electro-surgical vaporization for soft-tissue resection and desiccation. He writes that the procedure resects through soft tissue, prevents postoperative bleeding, and yields high-quality of Vienna, VA, tissue samples for pathological analysis. writes: "I have been appointed to one of the chief resident positions in the Georgetown OBITUARIES CRAIG CHEI FETZ ' 95 , Internal Medicine Program. I have recently won an award as a finalist at the Washington Regional American College of Physicians meeting for a poster presentation on Rhodococcus equi pulmonary infections. I have been elected to serve on the ACP Washington, DC, Regional Associates Council." REGINA Y. K I M '97 . of Akron, OH, is starting her family medicine residency program at Akron City Hospital!NEOUCOM . "I got married on October 12, 1996, in Rochester, NY, to Edward B. Yoon , M.D. , who is a fourth-year OB-GY resident at Akron City Hospital. We have a new yellow Labrador pup named Scout." BARANSKI also an alternate delegate from the AMA Medical Student Section to the American Medical Association's House of Delegates. PHILIP 1 Give us a call : I K E NN ETH L E V E Y '97 , ofBuffalo, Y, was honored by the Medical Society of the County of Erie at its annual meeting in May. He was recognized for "being an enthusiastic representative of organized medicine at the local, o n 5 m m e 9 9 7 ROBERT OEH L ER ' 38 , of Amherst, NY, died May 23 , 1997, after a long illness. The retired surgeon and veteran of World War II was 82. Born in Buffalo, he attended School 53 and was a graduate of East High School. After earning his medical degree, he completed his residency at Buffalo General Hospital. He entered the U.. Army in 1941 , serving until1946. His assignments during the war included duty on the Aleutian islands off Alaska. Oehler returned to Buffalo after the war to open his surgical practice and was on staff at Buffalo General Hospital and Children's Hospital until his retirement in 1979. He was a member of the American College of Surgeons, the American Medical Association, the Buffalo Surgical Society, and the Gross Medical Club. An avid fisherman and hunter, he was also a member of the Buffalo Athletic Club. He is survived by his wife of 4 7 years, the former jean Yeo. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] Magnificent BUILDING LOTS . I of Williamsville, Y, died March 23, 1997. A pioneer in alcohol rehabilitation, he helped the American Urologic Association. Among his honors were election to fellowship in both the American and the Royal Canadian publicize the concept of alcoholi m as a di ease and a public health problem. In Colleges of urgery. He served as president of the iagara County Medical Society and 1948, he started and directed the first alcohol rehabilitation center in ew York State. He also worked with Alcoholics Anonymous in treating patients. Born in Buffalo, the Buffalo Urological Society, and was an enthusiastic teacher as an assistant profes- KENNETH GOLDSTEIN ' 39 , Goldstein was the 1932 Buffalo Evening ews city tennis champion and state doubles champion. After earning his M.D. , he completed a residency at the former E. j. Meyer Memorial Hospital , and served as a major in the Army Medical Corps during World War II. Goldstein practiced internal medicine and gastroenterology in Buffalo, teaching at UB as a clinical professor and serving on the staffs of Millard Fillmore Hospital and E.]. to Tucson . He was hired by THMEP to serve as chief of urology and director of the urology training program at the County and Kino Community Hospitals from 1975 to 1983. After a brief retirement, Baer served eight years as the first urologist of the Salt Lake City FHP Medical Group before re- Medical Alumni Association. He is survived oughly enjoyed his full life with his family, by his wife, Loraine, and a son, Harvey R. his varied medical practice experiences, and his love of golf, traveling, sailing, and skiing. He is survived by his wife of 50 years, Babette; his three children, David (of Pied- BAI SC H '45 , of La jolla, CA, died last year at the age of 74. A surgeon, he was certified by the American Board of Surgery and the American Board of Thoracic Surgery. The Summit at &herff is a truly extraordinary residential development, unrivaled in Western New York. estled in the hills of Orchard Park, this magnificent 81-acres has been subdivided into 50 estate-sized building lots surrounded by Chestnut Ridge Park and Neuman Creek in a very private enclave. turning again to Tucson to retire. ever the type to consider retirement an all-ornothing event, Baer then served as a cruise physician for Society Expeditions. He thor- BRUCE F O RDIN G As a former president of the University at Buffalo medical school Alumni Association and a practicing surgeon in Western ew York for many years, I've come to understand what members of our profession desire in a home site · privacy, tranquility, fresh air, and pristine surroundings. sor of surgery and urology at the University at Buffalo. In 1975 Baer and his wife moved Meyer. He was a past president of the UB Goldstein, M.D., UB Class of'77. Dear Colleague: Specifically as an escape from the fast-paced everyday life we lead, it's features include: • Spectacular panoramic views of the Canadian shores, Lake Erie, and the Buffalo skyline mont, CA), Laurence (of Laurel, MD), and janet Elisabeth (of Brookline, MA); and his • Mature woods and secluded ravines ten grandchildren; as well as by his brother, Howard (of Plant City, FL). • Quick and easy access to the freeway systems leading to Buffalo and the city's northern suburbs • Oversized lots for your dream house • Privacy, seclusion, and exclusivity R ICHARD A . BAE R '46 , of Saddlebrook, AZ, died March 26, 1997. He was born in iagara Falls, Y, on August 5, 1921. After graduating from the University of Michigan and the University at Buffalo medical school, he served a year's internship at Sisters of Charity Hospital in Buffalo before joining the U.S. Navy. He spent two years on the medical staff of the Great Lakes Training Center Hospital and then completed further training in surgery and urology at Mt. Sinai Hospital , Metropolitan Hospital, and Western Reserve University in Cleveland, OH. Baer then returned to iagara Falls, where he practiced urology for 22 years. He was a diplomate of the American Board ofUrology and a member of ® of Orlando, FL, died injanuary of cancer. Born in J O HN L AWR E N CE MU SSER ' 51 , The Summit promises to be one of the premier areas in Western New York to construct your ltLxury residence. 1 invite you to take a stroll through this picturesque setting. For our detailed brochure or a private shmving please call (716) 667-2237 or Buffalo, Musser served as a sergeant in the .S. Army from 1941 to 1945 in the orth African campaign of World War II before going to medical school. In 1958, he and his family moved to Hawaii , where he practiced (716) 472-3790. at the Hawaiian State Hospital in Paavilo Sincerely yours, and served as chief of psychiatry for Hilo Hospital and Institution of Mental Health. Musser also served in the Peace Corps. After returning to Western ew York in 1965, he Edmond J. Cicewicz, ~1.0. Past President, UB Nl.edical Alumni Association practiced psychiatry in Mayville, Y. He moved to central Florida in 1986 and worked for the Seminole County Public Health Department. He is survived by his wife, orma, THE SUMMIT AT SCHERFF and three daughters. 6 f f 0 l 0 O rcha rd Pa rk, New York p h y s I o n S u m m e 9 9 7 �Who says there's nothing good on TV? As busy as they are, physicians and other health care providers always take the time to watch MLMIC's top-rated risk management education programs. • When they tune into high quality programming broadcast over our satellite network, viewers know what they see will help enhance patient safety and reduce injuries. They also appreciate the policyholder discounts available to participating physicians. • MLMIC programming is sponsored by the largest Risk Management Department of any professional liability insurer in the state. Policyholders also enjoy the protection of one of the country's largest and most experienced professional liability Claims Departments. Most importantly, MLMIC has successfully defended more physicians than all other available insurers combined. • These are some of the reasons why MLMIC is the only medical liability insurer approved by the Medical Society of the State of New York. • To find out more, call1-800-356-4056 in Upstate New York, or 1- 800-ASK- MLMIC in the New York metropolitan area. Ask for free copies of our risk management MLM~C ~ledical ~ Uabinl\ \lutuallnsur.mi't> Company guide for office practices. • Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 @1996 Me :::.tl abi ty M tual M'!M.Inlr!G'- ..omp•ny �Non-Profit Org. BUFFALO PHYSICIAN U.S. Postage STATE UNIVERSITY OF NEW YORK AT BUFFALO PAID Buffalo, NY 3435 MAIN STREET BUFFALO NEW YORK 14214 Permit No. 311 ADDRESS CORRECTION REQUESTED Planned Giving to UB. Tax deductions and on ncome for l·fe ore only port of the benefits you con receive with planned g;v;ng to the UB School of Medic ne and Biomed·col Sciences. You needn't be wealthy, or a financial genius. All you need is to make a gift. And hove a desire to help today s budding geniuses make the wor 1d o beller place in 50 years For more information, contact Lyn Corder Ph D., CFRE, at (716) 829-2773, or v1o e-mail ot ljcorder@ocsu buffolo.edu. UNIVERSITY AT BUFFALO tate L"niwsity rf.\ ew l iJ1k � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1997 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1997-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v31n03-1997-Summer Table Of Contents A list of subunits of the resource. Spring Clinical Day UB's New Specialty Dental Clinics Dr. Congressman Medical School News Commencement '97 A Student's Perspective Alumni News Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-09 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v31n03 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LB_HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1997 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/abe8d2d36bce3f6b3ca187a1f61c17d8.pdf cb90bb359762e6121c6a816e3fd32b20 PDF Text Text L �BUFFALO PHYS I CIAN Volume 31, Number 2 ASSOCIATE V ICE PRESIDENT FOR UN IVERSITY SERVICES Dr Carole Smith Petro DIRECTOR OF PUBLICATIONS Kathryn A. Sawner EDITOR jessica Ancker ART DIRECTOR/DESIGNER Alan]. Kegler PRODUCTION MANAGER Ann Raszmann Brown STATE UN IVERSITY OF NEW YORK A T BUFFAL O SCHOOL OF MEDIC INE AND B IOMEDICAL SC IENCES Dr john Wright, lntenm Dean, V1cc President for Clinical Affcurs EDITORIAL BOARD Dr Bertram Portin Dr Martin Brecher Dr. Harold Brody Dr. Richard L. Colhns Dr. Jack F. Coyne Dr. AlanJ Drinnan Brian Duffy Dr James Kanski Dr Barbara MaJeroni Dr. Ehzabeth Olmsted Dr. Charles Paganelh Dr. Stephen Spaulding Dr Bradley T. Truax Dr. Franklin Zeplowitz TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital .\1icharl Shaw The Children's Hospttal of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Health System Franh Sam Niagara Falls Memorial Medtcal Center Roswell Park Cancer Institute Sisters of Charity Hospital Dear Alumni and Friends, THIS REPRESENTS MY FIRST OPPORTL,NITY as interim dean to communicate with you through the medium of the Buffalo Physician. During my tenure in this position, we will be presented with opportunities to build upon the many accomplishments fashioned in thejohn Naughton era, but we will also need to break new ground as we address new challenges. Managed care will, in whatever form it ultimately takes in Western New York, require significant changes and adaptations not only for the medical school but for the entire health-care delivery system in the Western New York region. Most of you are aware of the merger discussions between the Buffalo General, Children's, and Millard Fillmore Hospitals (see the Winter 1997 Buffalo Physician). As the reorganization unfolds, we may be presented with unique opportunities to reconfigure our programs at these institutions and elsewhere, and, in the process, maximize the distribution of faculty in a way that will enhance not only efficiency but also academic creativity. There is probably no single model that will address these needs. The process will not only be complex but likely driven by considerations beyond our control, and, in some instances, completely unanticipated. Provost Thomas Headrick recently circulated a major discussion document, "Planning UB's Academic Future: A Report to the UB Community," which outlines a number of bold new considerations for the university at large. The document is actually a "work in progress," and during the next few months, the provost and president William Greiner will be meeting with the faculties to discuss some of the concepts and proposals contained therein. Some of the suggestions for the medical school are new to this geographic region, but most are being considered or implemented in many other parts of the country. One of the most challenging ideas involves rethinking the traditional departmental structure and possibly reorganizing at least some of the faculty around interrelated disciplines. UB boasts 28 departments, significantly more than many other schools, including such icons of medical progress as johns Hopkins. Whether other configurations are right for Buffalo remains to be seen, but at the least, they merit our serious consideration and study. All in all, these will be challenging and exciting times. We will keep you updated through the Bllffalo Physician and through our meetings with faculty, alumni, and friends of the university through the months ahead . ~ W right, M.D. lntenm Dean, School of Medicine and Biomedical Sciences Interim Vice President for Clinical Affairs Dennis ivtcCarthy Veterans Affairs Western New York Healthcare System ©The State Uniwrsity of New York at Buffalo Buffalo Physician is published quarterly by the State Unl\-ersny of New York at Buffalo School of Medtcine and Biomedical Sciences and the Office of Puhhcations. It ts sent, free of charge. to alumni, faculty, students, residents and friends. The staff reserves the right to edn all copy and subm<ssions accepted for publication. Address questtons, comments and submisstons to: The Ednor, Buffalo Physician, State Lmversny of New York at Buffalo, Office of Publtcations. 136 Crofts Hall, Buffalo. N) H260 Send address changes to: Buffalo Physician, H6 CFS '\ddttion, 34 35 Main Street. Buffalo NY l42H Dear Fellow Alumni, As THE SNOW MELTS and the crocuses try to bloom, we find ourselves with new leadership at UB. A towering, gentle man, john Wright, M.D., serves as the interim dean of the School of Medicine and Biomedical Sciences. He is not only blessed with administrative skills, but is also an outstanding teacher. I met him when I was a second-year medical student, and found that he was one of the few teachers who could make medicine come alive. Like many in our class, I was rejuvenated. I wanted to get out there and cure the world, or at least, learn as much as possible now so we could someday make a difference. john generated this enthusiasm in many of us. It's because of role models such as john that UB offers outstanding programs like the Master Clinical Teaching Fellowship, developed by Diane G. Schwartz, Sheila Brodnick, and Richard Sarkin , M.D. As a graduate of this fellowship program, I am excited to share it with you in the pages of Buffalo Physician. l found it an immensely valuable experience for teaching students in my clinical practice. And thank you, Dr. Wright, for your inspiration as a teacher, researcher, and individual. We have exciting, challenging times before us, and no one better to lead us. Sincerely, ~y~DC'~ /'?~ President Med1ca/ Alumn1 Assooat:10n �VOLUME 31 , NUMBER 2 SPRING 8 Teaching on the Fly: US HELPS DOCTORS COMBINE TEACHING WITH 14 OB-GYN today PHYLLIS LEPPERT , M . D ., R . N. , PH . D ., IS THE PRACTICE DEPARTMENT'S INTERDISCI- by Nicole Peradotto PLINARY NEW CHAIR photos by Frank Cesario by Jessica Ancker 18 97 Amedical mission to Kathmandu by Donald P. Copley, M.D. '70 08-GYN yesterday RANDALL AND WINKLER REUNITED A DI V IDED DEPARTMENT New faculty by Ronald E. Batt, M.D. '58 VICTOR .JAMES HERNANDEZ , PH.D ., AND MARIA LAURA A V ANTAGGIATI , M.D. Research news TOSHIBA FOUNDS Astudent's perspective: STROKE RESEARCH MEDICINE IS A CENTER. MILD CONCUS - OF POWER SIONS CAUSE LASTING BY MICHAEL MERRILL , PROBLEMS . SURGERY REMAINS AN OPTION FOR GAME CLASS OF Medical school Alumni WPW SYNDROME. PARENTS ' 1 997 COUNCIL FRANKLYN KNOX SUPPORTS STUDENTS . Hospital news ROSWELL PARK FACES CHANGE. PAROSKI BECOMES ECMC MEDICAL DIRECTOR . HCP REORGANIZES. COMBINES RESEARCH BUCK AND WRIGHT WITH LEADERSHIP. RECEIVE HONORS. TWO HARRINGTON LECTURE ALUMNI GIFTS. NEW FOCUSES ON DEGREE OFFERED. MEL PHYSIOLOGY . DIEDRICK DIES . Classnotes �World-class stroke research center established at UB with $3.6 million gift of Toshiba imaging equipment esearchers are getting down to work in a new world-class stroke research center established at UB with a $3.6 million gift of equipment and services from Toshiba America Medical Systems. Toshiba has donated its most advanced cerebral angiography equipment to help researchers study stroke and perfect new minimally invasive neurovascular surgery techniques. "What's exciting about this center is that it provides researchers with the same kind of super-high-tech equipment that we're using in the hospitals," says L. Nelson Hopkins, M.D., director of the new center and chair of UB's Department of Neurosurgery. "So the research we're doing is only months away from use on patients-not years." Phase one of the project was completed in December with the installation of one of Toshiba's top-of-the-line angiographic x-ray machines in the center on the fourth floor of UB's Biomedical Research Building. The Toshiba machine can show blood vessels as small as a half a millimeter across, and can make video images at a rate of thirty frames per second (about the same speed as a standard video camera). In phase two, Toshiba will donate a model of its next generation of angiographic equipment, which will have three-dimensional capabilities and be able to take even faster images. "We'll have the first one in the world," says Hopkins. That means that UB researchers will be developing the techniques that will be used by physicians around the globe. Such equipment is necessary for some of the newest endovascular surgery techniques, which depend on maneuvering flexible microcatheters through the maze of cerebral blood vessels. The donated angiographic equipment includes positioners and focus tubes, cameras, digital video recorders and interfaces, generators, computer software, and workstations. "Minimally invasive procedures will dominate surgery in the 21st century," Hopkins says. "Tomorrow's neurovascular technology will be developed, tested, and perfected here. We know of no other research center with comparable equipment and capabilities." Installation of the equipment was aided by a grant from the Wendt Foundation, which helped offset the cost of essential structural alterations. Another grant from an anonymous donor will help cover operating expenses. A pioneer in endovascular surgery and chief of neurosurgery for the Millard Fillmore Health System, Hopkins was instrumental in developing the new partnership with Toshiba. He was recently a lead researcher in clinical trials of the Guglielmi Detachable Coil, the first product to receive approval from the U.S. Food and Drug B u f f a l a Phys i Administration for treating intracranial aneurysms considered too high risk for traditional surgery. UB'sstroke researchers at the Toshiba center will have three priorities. One, under the guidance of radiologist Stephen Rudin, Ph.D., is to achieve even better imaging with the lowest possible x-ray dosage. Rudin's new procedures should increase resolution capabilities from half a millimeter to a tenth of a millimeter, Hopkins says. In an unusual collaboration, Barry Lieber, Ph.D., an aerospace engineer who specializes in the dynamics of air cian S p r I n g l 9 9 7 �- ---- - ~-~- - ,~------ ······································ · ····· ·· ············ · ············ · ···· · ········· ··· · m . flow, is working with neurosurgeon Ajay Wakhloo, M.D. , Ph.D. The two scientists are combining their expertise to investigate the dynamics of blood flow, using full-scale models of cerebral blood vessels. Finally, Lee Guterman, M.D., Ph.D., is researching new techniques and de- viding funding to support graduate student stipends and an exchange program between japanese and American researchers. "Further, since any area of the body can be accessed through the vascular system, other departments, such as cardiology, surgery, and radiology, will have the option of conducting studies using the Toshiba angiographic equipment," u.w~ ..... . , . .................... Hopkins says. In addition to research, the center will provide unique educational opportunities. "We currently offer working courses in endovascular techniques for treatment of experimental aneurysms. The Toshiba Stroke Research Center will enable us to expand and diversify our offerings, attracting course participants from around the globe," Hopkins says. "The flow of personnel and information between the center and other international research centers in the U.S. and Asia will offer unique educational opportunities to UB students and faculty and the Western vices to treat and prevent stroke, espe- New York research comcially minimally invasive endovascular munity at large." Toshiba selected UB surgical procedures. Techniques used by UB 's neurosurgeons include because of "the clinical microcatheter injection of thrombolytic expertise, commitment, drugs to break up clots and stents to and research" of Hopprovide permanent support for nar- kins and his colleagues, says Jeffrey T. Dillon, rowed vessels. The Toshiba research facility will sales manager with also be used by researchers developing Toshiba America Medi new treatments for conditions other cal Systems. Toshiba America than stroke, and will serve as an educaMedical Systems, based tional center for students from UB and around the globe. Toshiba is also pro- in Tustin, California, is . _........" / B u f f a 1 a Physician 5 p r I n g 1 9 9 7 .. . .. a subsidiary of the international Toshiba Corp., one of the world's largest manufacturers of electrical and electronic equipment, with annual sales of more than $48 billion. Toshiba America Medical Systems' line of medical imaging systems includes diagnostic x-ray, xray computed tomography, diagnostic ultrasound, and magnetic resonance imaging. "This new stroke research center will capitalize on all the best strengths of UB's School of Medicine and Biomedical Sciences-pioneering research, outstanding clinical care, and exceptional teaching," says UB president William R. Greiner. "We are absolutely delighted to have Toshiba as a partner in this center. With an international corporate leader like Toshiba generously supporting the work of a first-class researcher and surgeon like Dr. Hopkins, we think that's a recipe for success. Most importantly, the creation of this center promises better health and fuller recovery for millions of people. And we think that's the real success." + - LOIS BAKER AND JESSICA ANCKER 0 �11 ............................................................... . . . . . . . . . .. . . . . . . . . . . . . . . . . ' I Surgery remains an option for some with WPW syndrome hree catheter ablations failed to correct Clayton Broussard's WolffParkinson-White syndrome, and he continued to suffer debilitating attacks of tachycardia. So his family brought fourteenyear-old Clayton from Louisiana to Buffalo where he could be operated on by Gerard M. Guiraudon, M.D., a pioneer in the treatment of cardiac arrhythmias and one of the few surgeons in the world who has remained an expert in epicardial surgery for Wolff-Parkinson-White syndrome. The operation was a complete success. "Even the best horse-drawn wagon had to be replaced with a motor car," Guiraudon says. "But once in a while, the horse still works better." In Guiraudon's metaphor, his epicardial surgical approach to arrhythmia is the horse cart, while the newer catheter ablation techniques are the motor cars. Surgery for Wolff-Parkinson-White syndrome was pioneered in 1968. But in the early 1980s, while at the University ofWestern Ontario in London, Ontario, way for a change in technology. By relying on Guiraudon's techniques to pinpoint the accessory pathways, surgeons were able to use catheter radio frequency ablation to fix most Wolff-ParkinsonWhite cases. Guiraudon himself helped train the new generation of catheter surgeons. Since 1990, catheter ablation has become the method of choice for treating Wolff-Parkinson-White syndrome. "I went from 120 of these patients a year to just five or ten," Guiraudon says. Today, he performs the surgery on patients like Clayton, who have undergone catheter ablations without success, or on patients who are scheduled to undergo open-heart surgery for other reasons. In a 1994 review article in the Annals of Thoracic Surgery, Guiraudon lightGuiraudon led an international team of heartedly focused a "retrospectroscope" surgeons in developing safer epicardial on the surgical treatment of Wolffsurgical techniques. Avoiding cardioParkinson-White syndrome. He conpulmonary bypass, they worked on the cluded that "a large body of scientific beating heart using surgical dissection, knowledge and skill was brought to cryoablation, or lasers. light by this experience and, of even For nearly ten years, Guiraudon's apmore importance, passed on for best use proach was the first choice for Wolffto the catheter surgeons." Parkinson-White patients. "Everybody But Guiraudon is not ready to retire visited this man and learned from him, yet. Born and trained in France, he was and everybody sent patients to see him," a professor of surgery in Paris before says Tomas Salerno, M.D., the director accepting a position at the University of of cardiothoracic surgery at the Buffalo Western Ontario and University HospiGeneral Hospital. "Getting Gerard tal in London, Ontario, at age fifty. Now, Guiraudon to come to Buffalo was like at sixty-five, he has become an immiputting a little hook in the ocean and grant again, moving to Buffalo to becatching a huge fish." An accomplished valve surgeon who come UB 's associate chief of developed what has become the stan- cardiothoracic surgery and the chief of dard approach to the mitral valve, cardiovascular and thoracic surgery at Guiraudon has also authored classic pa- Millard Fillmore Health System. His wife, pers on cardiac arrhythmias that are Corette M. Guiraudon, M.D. , remains referenced in such texts as Harrison's in London, Ontario, as the hospital's chief of pathology. Principles of Internal Medicine. "If you move, you do better," he says. Guiraudon and his colleagues also "You look at things in a new way, not in did extensive work in mapping the aca preconceived way. I moved to London cessory pathways that cause Wolffbecause I thought I could have a fruitful Parkinson-White syndrome. "Our goal collaboration with my colleagues there, was not just to do the surgery, but also and I did. Now, I hope I can do someto understand the pathophysiology." That new understanding paved the thing new here." + JESSICA 0 B u f f a l a Physician S p r I n ANCKER g l 9 9 7 �m ·························································································· m .. . ' . Mild concussions can cause lasting abnormalities in brain esearchers at UB have shown that a concussion results in abnormal brain activity that can last for months. This activity correlates with patient complaints of physical and emotional discomfort early on, and with various cognitive impairments later, the researchers found. Richard Linn, Ph.D., assistant professor of rehabilitation medicine, led a multidisciplinary research team which uncovered the abnormal brain activity in a small group of patients with recent concussions, using PET scans taken at the PET Center in the Buffalo Veterans Affairs medical center. The abnormalities were invisible to MRI. "In the first few weeks post-injury, some of these patients may experience headache, irritability, dizziness, or fuzzy thinking," Linn says. "They may have an MRI scan, which typically shows no abnormalities. Many may come away still feeling that their thinking isn't right, but they don't know why. "We now are able to show that these symptoms are related to a definite change in brain activity, and that these patients are not merely imagining their symptoms. The abnormalities in the brain reflected how well patients performed on cognitive tests. The greater the abnormality, the worse the patient's performance." Linn, program director of the UB T raumatic Brain Injury Rehabilitation System, is one of only a few researchers in the country who are using PET to study mild traumatic brain injury. Linn's research is funded by the National Institute of Disability and Rehabilitation Research. PET scans were administered to six victims of concussion two to three weeks after the injury and again three to four months later. The scans revealed small B u f f a I a but significant areas of increased glucose metabolism in the anterior cingulate, more pronounced in the right hemisphere than the left. All the patients had had normal MRis and showed few signs of injury. The increased use of glucose may be a sign that the cells are repairing themselves after injury, or that their ability to function is diminished and they need more energy to perform the same work, Linn says. In the early stages after injury, this abnormal activity correlated with patient complaints, such as headache, irritability, anxiety, depression, dizziness, and lack of concentration-symptoms collectively dubbed post-concussive syndrome. physician 5 p r I n g 9 9 7 ' . The studies showed that after three to four months, the areas of abnormal activity had enlarged somewhat and were correlated with impaired attention span, verbal memory, motor function, and information processing, but not with post-concussion symptoms. "Patients need to know they aren't going crazy, and that what they are experiencing may be a normal part of the recovery process," says Linn, who is now recruiting patients for a larger study. According to Linn, the only treatment for mild traumatic brain injury is patience. "People just have to wait it out. More than 50 percent of them are back to normal by six months; more than 95 percent are fully recovered in a year." + L o 5 B A K E R 0 �~············· · · · ····· · ······· · ···· · ······················ · ··· · ···························· ~ Roswell Park Cancer Institute faces change BY ANDREW DANZO s managed care's relentless expansion forces medical institutions to behave more like businesses, adaptation has become the watchword. At Buffalo's venerable Roswell Park Cancer Institute, however, change doesn't come easily. The 99-year-old institute is part of state government, and that, according to many people inside and outside the institution, has hobbled its ability to compete in the new healthcare marketplace. New York State officials have proposed spinning Roswell Park off as an independent non-profit entity. The plan is greeted enthusiastically by those who believe the institution will benefit from increased flexibility, but it has others worried that Roswell Park may jeopardize its tradition of groundbreaking cancer research in its rush to become self-supporting. Robert Hinckley, public affairs director for the state Health Department, points out that being a part of the state hampers Roswell Park in some of its everyday activities. "They can't develop networks, partnerships, mergers, et cetera, and react quickly to this changing health care environment," Hinkley says. "They can't do a lot of things that the Buffalo General Hospital can do. To get a $5,000 contract approved they have to go through this department, the Division ofBudget, and the Comptroller's Office. 0 CHANGE IF IT IS TO Buffalo General doesn't have to do that." Anderson Cancer Center at the UniverGov. George Pataki this year proposed sity of Texas in Houston. For example, that Roswell Park be allowed to change he would like greater flexibility to creits governance structure, possibly be- ate new types of positions. "We need coming a not-for-profit enterprise or af- managedcare specialists and case manfiliating with another health-care institu- agers," he explains. "The current systion. Approval is required from the state tem takes an enormous amount of time Legislature, and details remain to be and effort when we need to move worked out. One strong supporter of the quickly. This is an institution that needs plan is the institute's new president, David to reinvent itself." C. Hohn, M.D. He succeeds Thomas B. But Pataki's proposal for a governance Tomasi, M.D., who left last year after change has been greeted skeptically by running the institute for a decade. unions. "We think some of the cost "I think Roswell must change if it is to issues can be addressed within the conthrive and survive," says Hohn, who text of a public institution," says Richarrived in February from the M. D. ard E. Casagrande, executive director of B u f f a l a 5 p r I n g 1 9 9 7 �~ ---~== '~-~--- - - - ·································· · ······ · ··········································· · ···· [I I ] ' ' Lll] the Public Employees Federation, which represents 845 physicians, research scientists, nurses, and technicians at Roswell. "We see privatization as being really radical surgery. I think the primary gain, when you cut through the fluff and the sweet talk, is that they think that the public employees make too much." Hinckley says the plan is not an attempt to void state union contracts. "We've told them that we will abide by the collective bargaining agreements they have," he says. "Certainly, because of their expertise, any not-for-profit would need the vast majority of the employees." Some staff members worry nevertheless that Roswell could lose itself in the transition. "Roswell is not simply another hospital," says a senior scientist who asked not to be named. Without financial support from the state, he fears that Roswell will begin to lose research grants and become trapped in a downward spiral. "Roswell was never supposed to compete with a normal hospital, because it doesn't offer the same product," the researcher says. "You don't go to Roswell Park to get the same care as at Buffalo General. You go to Roswell Park because that's where we're developing new treatments that no one in their right mind is paying for." Through the Graduate Medical Dental Education Consortium, Roswell Park trains 26 UB residents. In its capacity as a UB graduate division, the institute also trains about 300 graduate students. The 25-acre Roswell Park campus is in the midst of a $245 million construction project. The institute's fortunes, however, have been slipping in the increasingly competitive health-care industry. Despite its National Cancer Institute designation as one of only 28 comprehensive cancer centers in the nation, Roswell has seen insurers steer many patients B u f f a l o elsewhere, and Buffalo General now handles a greater portion of the region's cancer cases. The institute's deficit is put at about $70 million, and it has been unable to join hospital systems being formed by Buffalo General, Millard Fillmore Health System, and other Western New York institutions. For his part, Hohn says he is dedicated to maintaining Roswell's status as a premier center for research and teaching, as well as for treatment and prevention. "I think acquisition is unlikely and probably not desirable," he adds. "This is not about unloading Roswell on someone else. I would not have come here if that was the intent. It is about the ability to affiliate, because health care is organizing into networks and systems. But the exact governance that would be put into effect has not been established." The governor's proposal also includes an additional $70 million for Roswell Park in each of the next three years. Some of that would be used to begin a 20-year plan to repay the state for the institute's deficit. Roswell Park's new president expects to become a familiar face in Albany over the coming months. ''I'm absolutely committed to building the case for ongoing state support for education and research," Hohn says. He also plans to step up the pursuit of grants and philanthropic support. "My vision of Roswell is for a growing and thriving institution," he adds. "I think we're really talking about building a brighter future." + HealthCarePlan reorganizes ealthCarePlan, Western New York's oldest HMO , is moving away from its roots as a staffmodel HMO. The 90 doctors who work for HealthCarePlan are leaving the HMO to form their own group, Medi- Physician 5 p r I n g 1 9 9 7 cal Partners of Western New York, which will continue to care for HCP's patients as a contractor. Patients will notice little or no change. The decision has been described by both sides as mutually amicable. Richard Battaglia, M.D., who will become medical director of Medical Partners, said the move will benefit the physicians because they will be able to accept payment from other insurers as well as from HCP. Medical Partners, which will be largely primary care doctors, is also exploring the possibility of merging with practices that contain more specialists, including the Buffalo Medical Group, he said. + UB alum appointed ECMC medical director argaret Paroski M.D . '80, of Buffalo, NY, has been appointed medical director of Erie County Medical Center. In this position, she oversees the medical operations of the ECMC Healthcare Network. The network includes the medical center, the Erie County Home, and a growing group of community health centers. Paroski is the former clinical director of ECMCs Department of Neurology. She is also a past president of the UB Medical Alumni Association. In addition to maintaining her Margaret Paroski, M.D. medical practice and her administrative roles, she continues to be an active researcher. + 0 �BY NICOLE PERADOTTO • In e UB HELPS DOCTORS COMBINE TEACHING WITH PRACTICE c E s "Teaching is about being a good role model. Inspiring people is a part of teaching." A R 0 - Pediatrician Richard Sarkin, M.D. 0 B uff al o P hy si cian Spring 1997 �IN THE MIDDLE AGES, teachers were known as "doctors ," a word derived from the Latin verb docere, to teach. By definition, then, a doctor is a teacher. And at clinics, offices, and hospitals around the world, many doctors take that definition very seriously B Take, for example, Kerryann Broderick, M.D., site residency director for emergency medicine at Erie County Medical Center. At 9:00a.m. one weekday, Broderick and fourth-year UB medical student jacqueline Dombrowski interpret a patient's chest x-rays for signs of tuberculosis. At and Biomedical Sciences. Ask students why, in addition to clinical courses, they shadow physicians in their scant free time , and they respond that there's no such thing as too much clinical exposure. Such learning allows them to leave the lecture hall, to leap 9:30, Broderick asks Dombrowski to help document a ninetynine-year-old woman's death, and then ushers her off to the quiet room to watch a resident break the news to the family . Half an hour later, the physician offers the student tips on how to debride a chemical burn and how to present a diabetic patient to the patient's primary care physician. Then Broderick listens to Dombrowski's presentation of a man complaining of intense pain in his left foot. Upon seeing the patient herself, Broderick congratulates her student for correctly diagnosing that the man did not in fact suffer from an infected toe naiL Welcome to "Teaching on the Fly 101 "-clinical instruction. Physicians find many ways of folding the education of students into their own practice of medicine. Under a physician's supervision, students can take histories , diagnose, and even treat patients. Clinical instruction represents more than half of the coursework at UB's School of Medicine from the hypothetical textbook case to a patient on a gurney. For many students, clinical experience helps determine specialties and build confidence. For the preceptors-many of whom volunteer their timethe benefits of teaching may not seem so obvious. Teaching takes time. Balancing patient care with student instruction can be exhausting. Being a preceptor can be demanding in other ways , too; students often expect teachers to serve as career counselors and personal advisors in addition to fulfilling their role as instructors. Yet those who teach insist that its rewards offset its demands. Teaching is as enlightening an experience for them as it is for their charges, and it makes them finer physicians. "Students require a lot of energy," says Broderick, assistant professor of emergency medicine. "They ask tons of questions and need a lot of supervision, especially early on. u f f a I a P hySICia n 5 p r I n g 1 9 9 7 0 �"More and more schools have been expanding their But I get challenged by them, and they're just so eager to learn clinical medicine offerings over the last couple of years and do small things. "They keep me really fresh, particularly at the basic because it is necessary," explains Dennis Nadler, M.D., science level. They'll ofassistant professor of ten ask, 'Why did you do clinical pediatrics and something that way?' associate dean at the "Spending a lot of time in lecture halls and That makes me question medical school. "Spendlaboratories can bring students down. Its why I chose that way and ing a lotoftimein lecture wonder, 'Is there another halls and laboratories can helpful for them to have (clinical) way? Is there a better bring students down. It's way?'" helpful for them to have exposure, to see whats coming down the In the emergency dethis exposure , to see partment, where time is what's coming down the line and to maintain their enthusiasm. " of the essence and line and to maintain their unpredictability is the - UB Associate Dean Dennis Nadler, M.D. enthusiasm." norm, Broderick is well At the clinical level, UB aware that persistent incounts 1,512 volunteer • quisitiveness can be too much of a good thing. In such instances she arms herself with options for students who threaten to slow the pace of operations. "Sometimes I try to sneak in to see a patient before a student does. Then I can come out and set things up that need to be done, like drawing blood. Sometimes, if I don't think they're quite ready to do a certain procedure, I say, 'You have to back off and watch what I do,' or I give them less acute tasks to perform." "You really have to learn how to switch gears very quickly. You have to assess a student's level, get to it, and then explain things at that level." faculty and 807 geographic, full-time faculty. Ehsan Afshani, M.D., clinical associate professor of radiology, falls intaA..he second category.In 1990 and again in 1996, Afshani received a louis A. and Ruth Siegel Teaching Award, an honor based on student nominations. Among the teaching duties Afshani considers most important is fostering critical thought. It's a skill that some students, dazzled by high-tech diagnostic tools and insecure of their own abilities, have a tendency to neglect. "In medicine you don't deal with x-rays alone , and students in radiology must be reminded of that. Sometimes students prefer just looking at x-rays and taking tests instead of what's so important: Talking with patients. Whenever they want to order a test, I say, 'Is it worth doing because it's going to help you come up with a diagnosisor because protocol tells you to do it? '" It's not just that Afshani appreciates the Socratic method. He wants his students to appreciate health-care costs, too. Clinical experience in the curriculum New to UB's curriculum this year is a two-year introductory clinical block that begins during the freshman year. Among the skills taught are history taking, diagnosing, cardiopulmonary recuscitation, and infection control. ® B u f f a l o Physician 5 p r 1 n g 1 9 9 7 �and throat. He organized his fourth-year schedule with a rotation in pediatrics at year's end, recognizing that it would provide him with ample opportunity to examine a host of sore throats, runny noses, and aching ears. "That four-week experience absolutely turned my life around. I had the most wonderful teacher (Mary Cruise, M.D., who is now retired), and she helped me realize that pediatrics was for me. There is no question in my mind that she, more than anybody else, was responsible for my decision. " And that's something preceptors must consider, as well, Nadler emphasizes . "Students take extra time, and at teaching sites, extra time is provided. But managed-care organizations don't want to pay a physician to see twenty patients a day when he or she can see thirty patients a day for the same amount of money. This is something we have to think about, and we'll be discussing it more in the future . And it's not just managed care. If there's a guy in a solo practice, his entire base is the number of patients he sees. But I don't know anyone who has made a conscious decision not to teach because of economics." That's often the case because physicians remember the teachers who nurtured them when they were students and residents, and they want to continue the tradition. When he was a medical student in 1970, Nadler planned to do a residency in surgery followed by one in ear, nose, 0 Consider you r goals and objectives, and communicate them to your learner. 0 Discover enthusiasm for your subject and for you r lea rners. 0 B u f 0 0 Take you r teach ing and their learning seri ously- plan, teach, reflect. 0 0 a l a 0 Get to know your learners as people, not just as learners. @ Promote self-directed learning. Provide frequent, timely, constructive feedback. Consider how you know if your learners are learn ing what you want them to be learning. Make your teaching and their learning fun . From "Sharpeni ng the Saw: Improving Preceptor Teac hing 0 Make you r learners as active as possible. f Becoming a good teacher Not every doctor is a good teacher. Even the best doctors can make simple mistakes when they start teaching. They may be disorganized. They may fail to give students feedback, or be unable to give clear descriptions of protocols and procedures. Some may take students' physician Skills," a handout written by Admit your own limitations. Re-learn how to say, " I don 't know." S p r I n g 1 9 Richard Sarkin, M.D. 9 7 �"The more approachable you are as a teacher, the more abilities for granted; others may underestimate students. comfortable students will be around you, and that's a positive As one doctor puts it, "There are a number of physicians them to learn in," says Sarkin. "I think there's atmosphere for I would want to treat my kid-but not to teach him. " In a very thin line beother words, even a tween a demanding physician esteemed teacher and a teacher by colleagues and "You really have to learn how to switch who intimidates, and liked by patients the latter model is may lack essential gears very quickly. You have to assess a pervasive in medical teaching skills. schools. UB has initiated student~ level, get to it, and then explain "Another problem several programs through the Priis that most people mary Care Resource think that when things at that level." Center to help docthey' re teaching , tors become better they're telling some- Emergency physician Kerryann Broderick, M.D. teachers. The cenbody something. But ter, directed by Riit's questionable chard Sarkin, M.D. , is a joint program of the Departments of Internal Medicine, Family Medicine, Pediatrics, Social and Preventive Medicine, and Obstetrics/Gynecology. One of the center's programs, the Master Clinical Teaching Fellowships, offers selected community physicians a stipend to attend an eight-month workshop series on clinical teaching. A second, the Teaching Effectiveness Program, offers faculty a choice of workshops on specific practical questions, such as, How does a preceptor handle a bright but condescending student? What's the best way to introduce students to patients? How can a preceptor criticize students without disheartening them? Sarkin, a clinical associate professor of pediatrics, teaches many of the workshops. A movie buff, he shows clips from such films as Footloose, Mr. Holland's Opus, and The Paper Chase when discussing the qualities of a capable teacher. ® B u f f a l o whether the person they're talking to is learning or not. We're trying to expand the whole notion that teaching is providing information. Teaching is about being a good role model. Inspiring people is a part of teaching. So is promoting self-directed learning, where students aren't so much provided information but motivated to learn on their own. " At the Children's Hospital Ambulatory Pediatric Clinic, doctors wear animal toys wrapped around stethoscopes, and patients stop by a drawer filled with stickers at the end of their visit. Here, Sarkin practices what he preaches. One afternoon he discusses a hypothetical patient suffering from persistent headaches with a handful of residents and a third-year medical student. Then the group turns their attention to a dozen or so real patients- youngsters sitting in the waiting room suffering from the flu , runny noses, or other winter ailments. After seeing his first patient of the day, medical student Phys icia n 5 p r I n 9 1 9 9 7 �Anand Singh talks with Sarkin. "His mother says he has cold symptoms that are coming and going. The cough is not producing anything, and he's tugging on his ears. I tried looking in his ears, but he started crying." "So, he looked sick and uncooperative?" "Yeah. He stuck his fingers in his ears when I tried to look in them." "Did you make him say 'Ah ?"' "Well, by that time he was crying." "That's an 'Ah,' isn't it?" Doctor and student discuss potential diagnoses and treatments before they walk down the brightly lit hall to room 7. There, a boy no taller than a kitchen stool sits glumly in his mother's lap. As Sarkin turns to address the toddler, his voice changes. Suddenly the fast-talking pediatrician paces his words extra slowly. His tone mellows; the pitch of his voice rises. He sounds like a narrator for a children's movie. "Are these your hands, Taylor? Oh, these are very nice hands. Can the nice doctor see your tummy?" At first the two-year-old doesn't protest when Sarkin pulls up his sweatshirt. When he starts whining, Sarkin encourages him to touch the stethoscope. This holds the boy's interest for a few seconds. Now it's time for the ears. "If I promise not to hurt your ears, can I look at them?" Taylor shakes his head. "OK," Sarkin says as he gently tugs the boy's fingers from his ears, peers inside them, and spots signs of a middle-ear infection. Singh raises his eyebrows and grins. He has learned a skill that no textbook-no matter how comprehensive-can teach. + UB provides support for clinical teaching Because more medical education today takes place in community physicians' offices, UB is placing a greater emphasis on helping doctors become good teachers. UB's Primary Care Resource Center offers a number of programs that promote effective teaching in different ways. Master Clinical Teaching Fellowships pay selected community physicians a stipend to attend an eight-month series of seminars on effective teaching practices. The program carries Category I Continuing Medical Education credits. The next "class" of fellows will start the program in September. The Teaching Effectiveness Program sponsors workshops to provide formal training in effective teaching techniques. These workshops, which generally attract UB's regular clinical faculty and residents, focus on specific teaching issues and carry Category I CME credits. The Master's Degree in Health Professions Education, designed for clinical instructors, combines Graduate School of Education courses with independent study. Community Academic Practice grants support independent medical practices that participate in graduate medical education. Among the activities eligible for funding by the grants: renovations to provide space for students, or the purchase ofjoumals or equipment for students. The program also provides each site with computers and access to electronic resources, such as Medline. For more information about any of these programs, contact the Primary Care Resource Center at (716) 829-3176. B u f f a l o physician S p r I n g l 9 9 7 + �Interdisciplinary Phyllis Leppe rt , R.N ., M.D., Ph.D., is the new department chair BY JESSICA ANCKER PHYLLIS LEPPERT FIGHTS a many-fronted war on behalf of maternal and child health. In the course of the battle, she has acquired an impressive array of academic credentials, published unique research, and worked to build a new ethic of collaboration among different types of health-care professionals. Mecca Cranley, Ph.D., dean of UB's School of Nursing, served on the search committee that recruited Leppert as the new chair of UB's Department of Gynecology and Obstetrics. "My agenda was to get someone committed to interdisciplinary education and practice," Cranley says. "I didn't realize we were going to find someone who was herself so interdisciplinary! That was a bonus." Leppert first trained as a nurse and then became a doctor. But instead of abandoning her first profession in favor of her more prestigious second one, she has worked to break down cultural barriers between the two. Leppert loves lab research and earned a Ph.D. while studying the physiology of the cervix. While committed to what she calls "bench research," she has also continued to work on such medical practice issues as raising health professionals' awareness of cultural differences. "It all comes together when you think that our goal is to reduce the number of low-birthweight babies and problems in pregnancy," Leppert says of her varied career. "We have to work on a number of fronts--biochemical, obstetrical, socialall at the same time." An interdisciplinary career Leppert earned her master's in nursing from Columbia University and practiced as a public health nurse in Harlem before receiving her midwifery certification in 1964. She studied at the Maternity Center Association in New York City, which offers one of the nation's oldest midwifery training programs. ® "I had wanted to be a physician since fifth grade, but it was a time when women weren't encouraged to do that," Leppert recalls. "But when I was in my thirties, I took a look at what I was doing and said, 'Why don't I just go to medical school?"' She did just that, earning her M.D. from Duke University School of Medicine in 1973. Leppert completed residencies in pediatrics and in obstetrics and gynecology and was a Robert Wood johnson Clinical Scholar at Duke before accepting a fellowship in maternal-fetal medicine at Columbia University's College of Physicians and Surgeons. She taught at Columbia for ten years. Though Leppert chose to pursue medicine, she has remained involved with midwifery training and practice and continues to value the knowledge and attitudes she learned as a midwife. For instance, she says, in normal births midwives favor a "high-touch" approach with minimal medical or surgical intervention. Obstetric education focuses on problems in pregnancy and delivery, an essential field of knowledge, but one which sometimes can bias obstetricians to favor a more high-tech, interventionist approach than is necessary for a given situation. "Both approaches are needed, but we're not always very good at figuring out which woman fits in which category," Leppert says. "We need to approach the question scientifically, deter- B u f f a I o mine who needs the interventions, and then make sure they get them." Firm grounding in research Leppert believes that all medical care must be firmly grounded in science-in both laboratory and epidemiological research. Her own love affair with research began in medical school. After a course in immunology, she worked in Duke's Laboratory of Pediatric Endocrinology under Stuart Handwerger. "That is something that really influenced my career," she says. She took advantage of her years at Columbia to do research on the role of cervical elastin in gestation and parturition, obtaining a Ph.D. from the Department of Pathology. She has continued to publish research on the physiology and endocrinology of the cervix and uterus. "It's essential that everyone in medi- Physician S p r I n g I 9 9 7 �cine have a strong grounding in science," Leppert says. "But in this country we have tended to put bench research on a pedestal and pooh-pooh community medicine. My experience has taught me that all of it is important. You can't break these areas apart-you have to be excellent in all areas. "That's one reason I think UB is such a good school-it has shown that primary care is important without neglecting research. " In Rochester, New York, Leppert held positions in obstetrics-gynecology, nursing, and community and preventive medicine at the University of Rochester, and was chief of obstetrics and gynecology at Rochester General Hospital. She has also served as a consultant to the federal Women's Health Initiative and recently completed a Robert Woodjohnson Foundation study aimed at reducing sociocultural barriers to health care. She co-edited a textbook, Primary Care for Women, published this year by Lippincott-Raven Publishers. ("I just had time to call them and change my title on the frontispiece from professor at Rochester to chair of the department at Buffalo! " she says.) The text is designed to provide information for any primary care practitioners who take care of women, including nurse-practitioners, physician-assistants, and physicians in different specialties. The book covers a variety of women's health issues, such as reproductive health, pregnancy and delivery , and menopause. It also provides an introduction to a wide range of primary care issues, such as cardiovascular disease, derma to logic disorders , and psychiatric problems, and describes how these conditions manifest in women and what impact they may have on pregnancy. Other chapters cover social issues, such as "cultural competency," the working knowledge of other cultures needed to care for a broad spectrum of patients. ing that way while they're in training, it might be easier to start working that way in practice. " There are other changes she would like to make. "We have to rethink residency education so it's not so rigid, and incorporate principles of adult learning. We have to do more animal labs and computer simulations and telecommunication. That way, by the time they get to the patient the residents are more polished and prepared." New ideas for medical education Collaborative practice While at Rochester General, Leppert brought together medical and midwifery education by putting student midwives in the same learning situations as medical students and residents. She also helped integrate midwives into the hospital's obstetrics practice. She has similar plans for Buffalo. She is bringing Children's Hospital's four nurse-midwives into University Gynecologists and Obstetricians, the UB practice plan incorporated last year. With Dean Cranley's support, she is also hoping to integrate the education of nursing students and medical students, and to award some of the midwives faculty appointments in the School of Nursing. LuAnne Brown, R.N., believes both doctors and nurses will benefit from Leppert's program. "Her idea is very good," says Brown, the nursing coordinator for maternalneonatal services at Children's Hospital. "It fosters the idea of teamwork. If you get doctors and nurses to start think- Leppert once worked in a neurology rehabilitation unit that provided what she calls an ideal example of collaborative practice. Each patient was cared for by a team of doctors, nurses, nutritionists, occupational therapists, and physical therapists. "The neurologist was about to discharge one patient when the occupational therapist pointed out that the man was still having trouble doing the kinds of everyday activities he would need to live independently. And the physician listened. " Building on this model, Leppert has been involved in collaborative obstetrical practices in which different professionals cooperate to supervise cases, and follow the leadership of whoever is most qualified for each case. High-risk situations may be supervised by a physician; lower-risk ones by a nurse-midwife. "It's sometimes hard for physicians to work this way. We've been taught that we're the king of the hill," she says. "That's an attitude I would like to see changed. We have to respect each other. "+ ...THE CHILDBEARING EXPERIENCE Is an intense, memorable event that lasts at least nine months. The health· care team must provide a nourishing relationship during this time, and because of complex knowledge and the different skills of various professions, a health-care team works best.... 1 believe that no one person should be the "captain" of the team. Leadership is dynamic and fluid and is based on expertise. For instance, in the case of a pregnant woman with Class C diabetes, the matemallfetal medicine specialist is the team leader; in a case of straightforward moderate preeclampsia, the leader might be a family practitioner; In the term twin delivery, the team would be led by an obstetrician; while in a normal birth the team leader could be the nurse-midwife. In the area of discharge planning, the social worker and family are the leaders. Different geographic regions of the U.S.A. could and should develop unique matemlty care Excerpt from "Developteams, just as women and their families should have the right to a team of their choice.... ing sound team relation1believe that the future of matemity care is in a team approach. It will succeed to the extent ships among maternity that we emphasize the positive aspects of the health-care team. Developing sound relation· care professionals," in Prelude to Action II: ships calls for mutual respect, openness, and an absolute refusal to carve out territory. The Reforming Maternity most important feature in the development of sound team relationships on the matemity care Care, 1995, a publication team is a focus on the patient. We always need to ask, "What is best for this particular woman the Maternity Center of and her family?" Only then are team relationships sound and the team approach a success. Association. B u f f a l o Physician 5 P r I n g 1 9 9 7 �OB-GYN yesterday RANDALL AND WINKLER REUNITED A DIVIDED DEPARTMENT AT BY R ON A L D E . BA TT , UB M . D . ' 58 N THE YEARS BEFORE WORLD WAR II, the University of Buffalo's Department of Gynecology and Obstetrics had become divided into an obstetrics department chaired by Francis Goldsborough and a gynecology department headed by James King. This academic division reflected tensions both within the department and within the medical community. But when the two rival chairmen stepped down in 1942, they left heirs who ushered in a new era of cooperation. Clyde L Randall and Edward G. Winkler served as ideal cochairmen of the Department of Gynecology and Obstetrics for eighteen years. They respected each other, and their interests were complementary, benefiting both the department and the practice of obstetrics and gynecology in Buffalo and Western New York. Winkler brings new surgical techniques Edward Godfrey Winkler (1901-1960) went to Georgetown Medical School and did residency training in obstetrics, gynecology, urology, breast surgery, and gynecologic oncology. After returning to his hometown, he honed his skills as a chief resident in obstetrics, gynecology, and urology for two years at the Buffalo City Hospital, under Goldsborough. The two became very close, almost like father and son. Winkler entered practice in 1932 at the depth of the Depression. He ® went to Chicago to learn the Heany technique of vaginal hysterectomy directly from H. P . Heany. He and Robert O'Connor worked night and day to build the obstetric-gynecologic service at Buffalo City Hospital. Winkler introduced low forceps and episiotomy for routine deliveries, and extraperitoneal cesarean section to replace classic cesarean section. Later, he introduced a low-flap- transverse procedure to replace extra peritoneal section, and finally low-segment-vertical cesarean section to reduce the chance of injury to the uterine vessels. Winkler was the first in Buffalo to do total abdominal hysterectomy and introduced the Heany technique of vaginal hysterectomy and repair. In contrast to the teachings of one of their influential predecessors (Irving W. Potter), Winkler and O'Connor taught that no internal podalic version and extraction should be performed until the cervix was fully dilated. 6 u f f 0 l 0 Recognizing the value of breast milk to the survival of premature infants, they introduced frozen breast milk. The breast milk was put into little cake tins, set on dry ice to freeze, and then stored in the refrigerator for use. They reduced premature infant loss from 60 to 10 percent. Randall focuses on research Clyde Lamb Randall (1905-1990) graduated from the University of Kansas Medical School and did residency training in gynecology, general surgery, and pathology. While working together in Buffalo, King and Randall formed a close relationship. Physician 5 p r I n g 1 9 9 7 �THE N "I think that the most important thing I learned from King was to try to be decent to people," Randall said. "He was exceedingly kind to his patients. He liked his patients and he treated them accordingly." However, King's insistence on strict routine irritated Randall. In 194 2, Winkler and Randall declined offers of full-time positions at Buffalo City Hospital and Buffalo General Hospital, respectively. Winkler succeeded Goldsborough as UB professor of obstetrics and gynecology, and Randall succeeded King as professor of gynecology. As co-chairs of the department, they alternated responsibilities on an annual basis. They developed similar but separate three-year residency programs which rotated through the gynecology, gastrointestinal surgery, and breast services at Roswell Park Memorial Institute. Both Randall and Winkler were excellent surgeons, with remarkable respect for tissues. City-wide cooperation During World War II , many physicians were called into the armed forces , and Winkler and Randall experienced huge growth in their clinical practices. They frequently met, often in the middle of the night, while attend- B u f f a I o A N D w _N 0 ing patients in labor. They also met socially in each other's homes to discuss academic matters and curriculum, but never once did they go to each other's hospitals. Out of these meetings they began to hold monthly combined meetings of their residents and attending surgeons at the Park Lane Restaurant on Gates Circle. Soon they added Herbert Burwig's service from the Deaconess Hospital and Louis Mclean's from the Millard Fillmore Hospital. Such collegiality greatly ameliorated the extremes that had marked recent obstetric practice (e.g., the conservative management of natural delivery promoted by Goldsborough, and the routine internal podalic version and extraction practiced by Potter) . The city-wide meetings led directly to the formation of the Buffalo Gynecologic and Obstetric Society in 1946. Different teaching styles Winkler gave medical students and interns a firm grounding in obstetrics and gynecology to prepare them for general practice. Robert Patterson observed: "Dr. Winkler was very demanding of the medical students. We had to sit with the patient during labor with our hand on the abdomen, and we really learned about labor. " Winkler trained his residents as general obstetrician-gynecologists, able to treat all problems encountered , including breast cancer. The large clinics that he and O'Connor had built up at Buffalo City Hospital during the Depression were invaluable for this education. The program was highly structured; residents learned one surgical technique to treat each condition encountered . After mastering the techniques , the residents were encouraged to broaden their experience. Winkler was directly responsible for training ___Q]:)stetrician-gynecologists and then physician 5 p r I n g I 9 9 7 placing the work in their hands by drawing up regulations to limit the privileges of general practitioners doing obstetrics. Randall's residency program was loosely structured. He allegedly never performed an operation the same way twice and encouraged individualized training of his residents so that they could develop and expand their special interests and talents. Complementary interests During the tenure of these men as co-chairmen of the department, the quality of medical education in obstetrics and gynecology for medical students, interns, and residents reached an extremely high level. For example, in the late 1950s, outside examiners of the residency program thought that the medical students were residents. During this period, the University of Buffalo graduated a higher percentage of students into obstetrics and gynecology training programs than most other nonsectarian medical schools in the country. Winkler concentrated on medical student education, standardized resident training, and local medical politics, whereas Randall focused on individualized resident training, the development of subspecialists, and leadership in the National Board of Obstetrics and Gynecology and the American College of Obstetricians and Gynecologists. Together they combined community and university resources for optimal patient care and teaching. When Winkler died in February 1960, Randall became UB's first full-time chairman of obstetrics and gynecology. He later served as the medical school's vice president for health sciences, acting dean, and executive officer, before moving to Maryland as director of education of the johns Hopkins Program in International Education for GynecologyObstetrics. + ® �" BACK IN FAMILIAR SURROUNDINGS, I'M STILL SEElNG THINGS THROUGH A NEPALI TINT ... I CATCH MYSELF PESTERING MY FRIENDS ABOUT HOW LUCKY WE ALL ARE, IN AND OUT OF MEDICINE, WITH SUCH A WEALTHY AND EFFICIENT CIVILIZATION TO GIVE US MORE THAN JUST SURVIVAL." Rmedical mission to BY DONALD P. COPLEY , M.D . ' 70 J l �T MY TWENTY-FIFTH medical school reunion last year, while trading boasts about conquests and crises, I wondered what, after all, is truly meaningful in this life. I turned to a favorite classmate, Brendan Thomson, now a pulmonologist in Phoenix, Arizona, and asked, "What is the most worthwhile thing you've done since graduation?" Without hesitation he answered, "NepaL" Of course I knew that Mount Everest is in Nepal-I'd even day-dreamed of someday seeing the world's tallest mountain-but beyond that I drew a blank. Brendan had traveled to Nepal six times since 1985 on a variety of medical missions. The country, which is the size and population of New York State, is strikingly beautiful from jungle to grand peak, mostly agrarian, and painfully poor. With an average yearly income of only $250 and a literacy rate of about one-third, Nepal needed lots of help, Brendan told me. On his first visit there, Brendan met a young Nepali physician named Buddha Basnyat who was intent on an internal medicine fellowship in the United States. Brendan placed Buddha at a Phoenix hospital and invited the young man to stay at his home during the three-year fellowship. The two have remained close, exchanging visits almost yearly. Since then, Brendan has acted as a travel agent for American students and doctors going to Nepal to study or teach, and he has helped Nepali doctors come to America to take board exams. And when Brendan visits Nepal, he takes other physicians along to teach and practice. ''I'd love to do something like that," I said , with visions of trekking in the Himalayas. "You know what?" said Brendan. "You can!" He needed a cardiologist for an advanced life-support course planned for the next visit. It wasn't long before I was dashing off a check for airfare to the other side of the world. Getting there It took thirty grueling hours for my wife, Andrea , and me to fly from Buffalo to Hong Kong, where we linked up with Brendan's small contingent of American doctors and nurses. After two days of orientation, we flew on to the burgeoning city of Kathmandu, 500,000 people nestled into a story-book valley turned deep green by the recent rainy season. As our jet banked over a shrine to land, I caught a glimpse of a giant figure of Buddha with its life-like tempera eyes squinting through the smog created by cheap Indian gasoline. We headed off in eighty-degree weather on a kamikaze taxi ride into the city, careening crazily on the British side of the road. We passed big-wheeled bicycles piled high with produce, smoky motorcycles buzzing by like mechanized mosquitoes, and little blue vans stuffed with people, like fraternity Volkswagens. The sweet smell of this sewerless city was intermittently obscured by clouds of dense diesel exhaust. At a roadside gutter, a woman washed her family's clothes near an array of fresh vegetables piled on the ground for sale. We were greeted everywhere with the Nepali gesture of "hamaste" (pronounced "hom-a-STAY"), palms together in a prayerful and humble pose, the height of the hands indicating the level of respect. A Nepali hospital About the size of a small community hospital in the U.S., Kathmandu's Patan Hospital was built a decade ago entirely from church donations , and it is still run by missionaries. Chief of Medicine Mark Zimmerman has been there since the day the hospital opened, when he arrived fresh from his U.S. residency. His work has been subsidized every year by a Methodist church in Syracuse, New York. He relishes what would be intolerable to most of us: a smothering rush of seriously ill patients who often arrive too late to be cured, sometimes even dying on the hospital's doorstep. He loves the challenge of functioning with ludicrously limited resources, for next to no pay, with little distinction between work and rest. Smiling and joking gently, he always looked calm and content amidst the hubbub. People, sometimes a thousand in a single day, walk for miles to queue up at an outpatient window. The sickest patients stay in one of Patan's 150 ward beds. We toured the hospital through corridors darkened by J �power outages. Although the hospital was fairly clean, the doors and windows were often left open, without screens, to let the breeze take care of necessary ventilation. Through a door open to an operating room, a smiling patient waved to me as his inguinal hernia was being repaired. Latex gloves , considered disposable in the U.S., were being washed and hung to dry on a large wooden rack, evidence that the Patan staff wastes nothing. The hospital survives on donated medical equipment. Much of it, such as the EKG machines and resuscitation equipment, came from Brendan and his colleagues. As we walked by one of Brendan's old cardiac defribrillators, he whispered, "Think of the lives we've saved by sending this over!" The medical wards bustled with patients and their relatives , the latter providing constant nursing care while the R.N.s attended to technical work. At Patan, the patient's family must purchase all drugs and supplies themselves from a nearby pharmacy. Tuberculosis is the number-one killer in Nepal; pollutioninduced lung disease is the most common non-infectious problem. Exotic infectious diseases abound: leishmaniasis, leprosy, rabies. Many Nepalis smoke-especially the youngsters , who idolize the American Marlboro image-which gives the cigarette industry a chance to "make a killing. " I saw more patients with rheumatic heart disease than with heart attacks , ® B u f f a l a but Nepali physicians expect that increased levels of smoking and urban stress will soon cause a coronary epidemic. Our students, twenty Nepali resident doctors and thirty nurses, were hungry for the critical-care knowledge we taught. We caused some consternation when we challenged traditional Nepali gender roles by putting male doctors and female nurses together in the same room and having them listen to our female nurse lecturers. We taught basic and advanced life support, the mechanics of chest compression and the Heimlich maneuver , cardiac diagnosis and EKG analysis, defibrillation, and drug treatment. Our students asked perceptive questions, the kind that come from people who have seen a lot. They beamed with pride when we handed out diplomas on the last day. Time for touring e made brief excursions into the countryside to learn about its beauty-and its poverty. On a 2,500-foot hike into the foothills of the Himalayas, we puffed like choo-choos while young children hurried past us up the paths, carrying cinder blocks in backpacks supported by forehead straps. Other youngsters begged us for American ballpoint pens to use at school. Finally, Mount Everest! A chartered plane took us northwest from Kathmandu , playing hide and seek with lowhanging clouds. Suddenly, there it was , fully visible from its tropical base at 2,500 feet to its snow-capped peak at 29,000 Physician S p r i n g 1 9 9 7 �The si&fttof a man perusing a newspaper 1s not common, as only about a durd of the Nepali population can read ThiS set of donated equipment 111 a fishing tackle box at Patan Hospital is not fancy, but it IS adequate to handle most emergencies. A father gneves at a child's funeral pyre. Doctors in Singapore work mostly in solo practice, without managed-care headaches, yet they still feel cost-containment pressures directly from their patients. For example, angioplasty is favored over coronary bypass surgery because it's cheaper, and patients are willing to return two or three times a year for repeat procedures. "For my patients, it's like going to the dentist," said one local cardiologist. I found Singapore doctors busy and independent, wealthy and content, with a touch of arrogance-similar in many respects to American doctors of a generation ago. Back in familiar surroundings, I'm still seeing things through a Nepali tint, or what's called "perspective." I catch myself pestering my friends about how lucky we all are, in and out of medicine, with such a wealthy and efficient civilization to give us more than just survival. Now I understand why Brendan keeps going back. He and I are sure to talk about Nepal at our next reunion dinner as we contrive another excuse to return. + ' feet. Microscopic villages were scattered at its toes like the patterns of a fine Tibetan rug. My cherished unlikely dream had become a reality, thanks to Brendan's perseverance. On the way home, we stopped in Singapore, an Oz-like city with gleaming skyscrapers and spotless, antiseptic streets. We had received an invitation from the U.S. Ambassador to Singapore, Timothy Chorba, whose younger brother, Terence, is a 1979 alumnus of UB's School of Medicine and Biomedical Sciences. In Singapore, per-capita income exceeds $16,000, and there is no unemployment. We lectured at Mount Elizabeth Hospital, which is about the same age as Patan Hospital but ages apart in appearance and technology. About the size of the Buffalo General Hospital, Mount Elizabeth sparkles from yearly renovations and is blinking with the latest medical machines and computers. Most patients pay out-of-pocket for their medical services, while those few with limited resources get a lesser level of care at a subsidized government facility. B u f f a l a physician 5 p r Donald P. Copley, M.D., practices cardiology and cardiac rehabilitation in Kenmore, New York. Brendan Thomson, M.D., practices pulmonary care in Phoenix, Arizona. Both are members of UB's Class of 1970. For more information about participating in a Nepal exchange, contact Thomson at 5251 West Campbell, Phoenix, Arizona 85031, (602) 247-7725. I n 9 9 9 7 �............. .. . .. ............. . . . ........ . ................ . ............... Tumor viruses and stressed-out bacterta B Y A N D R E W 0 A N Z 0 or the UB School of Medicine and for a pair of promising researchers at the National Institutes of Health, 1995 was a pivotal year. It was the year that the Lucille P. Markey Charitable Trust awarded $1 million to expand UB's young but already internationally recognized Center for Microbial Pathogenesis. And it was the year that Victor James Hernandez, Ph.D ., and Maria Laura Avantaggiati, M.D., crossed the Atlantic to take their wedding vows in Rome. This year, UB is using part of the Markey grant to bring the couple to Buffalo. "This is, from our point of view, a perfect package," says Microbiology chair Ian Hay, Ph.D. "They both bring to the group expertise that we need, and they're both superb. We consider ourselves very fortunate to have them here." The Center for Microbial Pathogenesis is an interdisciplinary unit with some two dozen investigators who come from both clinical and basic science backgrounds. Formed several years ago out of collaborative efforts that began in the early 1980s, the center has garnered widespread attention for its work in such areas as molecular parasitology, sexually transmitted diseases, and pediatric infectious diseases. Avantaggiati and Hernandez arrived in early February and promptly set up shop in UB's recently opened Biomedical Research Building, where they will continue work they were pursuing at the NIH. Avantaggiati is interested in tumor viruses and cell growth; Hernandez is studying stress response and adaptation in bacteria. "There is no drug that will work against bacteria forever. They will all become ineffective, " says Hernandez. "So our hope is to now find the next generation of antibiotics that will sustain us for the next fifty years. It's my premise that these stressresponse systems within bacteria will be very potent targets for future antibacterial chemotherapeutics." Hernandez, a native ofEl Paso, Texas, received his Ph.D. in cell and molecular biology from the University of Texas at Dallas in 1991. For the next five years, he worked as a postdoctoral fellow in the Laboratory of Molecular Genetics at the National Institute of Child Health and Human Development. Nearby, in the NIH's Laboratory of DNA Replication, Repair, and Mutagenesis, Avantaggiati was studying interactions between viral and cellular proteins. Born in Naples, Italy, she had come to Bethesda after three years as a postdoctoral fellow at the University of Rome, where she had already earned her M.D. "I wanted to do research, " she recalls. "In Italy, it's very good, but it's not the center. Certainly the most important things are going on here." For about three years, Avantaggiati and Hernandez would pass in the hall, exchange a polite hello, and go on to their respective labs. "It had always been a very formal relationship until one day I made a conscious choice to go in and talk to herandget to know her," recounts Hernandez. "We got to know each other better and began dating. It was a whirlwind romance." Onjune 1, 1995, they were married in Italy. "We had a grand party in Rome," Hernandez says. That same year, Avantaggiati moved to the National Cancer Institute, where she focused her work on cellular interactions that appear to have a role in tumor development. Hernandez pressed ahead with efforts to disrupt the ability of bacteria to adapt to stresses. UB, meanwhile, had already begun using the Markey grant to recruit new faculty to the Center for Microbial Pathogenesis. When UB used the grant to make an offer to the pair, they had already received other offers. But they selected UB because they were impressed by both the university and the city. "For us, things like crime are important, because we want to start a family," Hernandez says. Avantagiatti agrees. "The city's very nice. The people are very kind," she says. "The weather I still have to adjust to!" + Physician s p r I n g 1 9 9 7 , �.. . . ...... .. . .. ... .. . . . .. . .. . . . . . .. ... ... . .. . . . . . ......... ... .. . . . ... . ......... • ••••••• •• ~ I Germaine Buck, R.N., Ph.D. Epidemiologist appointed to board of national research agency , ermaine Buck, R.N ., Ph.D., associate professor of social and preventive medicine, has been appointed to a three-year term on the board of the Institute of Medicine's Medical Follow-up Agency, an arm of the National Academy of Sciences. The agency conducts epidemiologic research on the health status of veterans. Founded shortly after World War II to conduct follow-up studies of the wartime experience, the agency now bases its studies on records from the military and the Department of Veterans Affairs . The agency's board is composed of fourteen physicians and researchers from universities and research centers across the country. Buck has won national recognition for her epidemiologic research in human reproduction and fetal and earlychildhood health. In 1995 , she was appointed to a three-year term on the B u f f a 1 o National Research Council Committee on Toxicology , which provides expert advice to government agencies on toxicologic issues and problems. A prolific researcher, she holds a three-year fellowship from the Merck Company Foundation and the Society for Epidemiology Research to conduct a long-term study of the safety and effectiveness of tubal ligation. She holds master's and doctoral degrees in epidemiology from UB. She is a member of the American College of Epidemiology, the Society for Epidemiologic Research , and the Society for Pediatric Epidemiologic Research , and is a fellow of the American Academy of Cerebral Palsy and Developmental Medicine . + Wrtght honored for minortty education achievements aggieS. Wright, Ph.D., assistant dean for minority affairs , has received the Outstanding Contribution to Medical Education Award for 1996 from the National Association of Minority Medical Educators. Wright was assistant Physician 5 p r I n g 1 9 9 7 I dean for student affairs and director of minority programs for the medical school before assuming her current position. During her tenure, she has been director of the Minority High School Research Apprentice Program, the Science and Technology Enrichment Program for talented minority college students, and the Health Careers Opportunity Program. A former teacher, Wright earned master's and doctoral degrees in counseling from UB and worked at the University Counseling Center before taking her position at the medical school. Her recent honors include the Sojourner Truth Award from the National Association of Negro Business and Professional Women's Clubs; the award for leadership in meeting the challenges of children with special needs from the Robert Warner Rehabilitation Center Division of Human Genetics; the award from the Buffalo chapter of the National Medical Association for leadership, commitment, and service; and the award for outstanding contributions to medical minority education from the northeast region of the National Association of Minority Medical Education. + �,. In honor of John Naughton, M.D., the university has installed a bronze bust of the former dean in the Biomedi(al Researth Building. Shown here on the O((asion of its unveiling; UB President William Greiner, Houghton, S(ulptor Jeff Slomba, University Coundl (hair Philip B. Wels, and Provost Thomas E. Headri(k. Museum receives $50,000 gift $50,000 gift from an alumnus will help support UB's Neuroanatomy Museum. Willard H. Bernhoft, M.D. '35, and his wife, Clarice L. Bernhoft, made the gift in honor of Harold Brody, M.D., Ph.D., SUNY Distinguished Teaching Professor in the Department of Anatomy and Cell Biology, who helped establish the museum. "Dr. Brody is a sincere, hardworking gentleman who has been an inspiration to a lot of medical students and colleagues at UB," says Bernhoft, UB emeritus professor of colo rectal surgery. "He devoted much time to this project and even traveled to Denmark to learn how to create a neuroanatomy museum. " After earning his bachelor's and M.D. ® from UB, Bernhoft served from 1942 to will join him in supporting UB. 1946 as a neurosurgeon in the U.S. Army, "New York State doesn't provide the and traveled to the Philippines and Ja- financial resources needed by the unipan. When he returned to Buffalo, he versity. With the right impetus-that opened a private practice in colorectal being support from UB alumni and surgery, from which he retired last year. friends-the university can continue to The Bernhofts hope their gift will be one of the best in the country." + attract similar contributions by other medical alumni to help establish an endowed chair in anatomy in honor of Brody. Bernhoft, who has also been a strong supporter of UB's Willard Bernhoft and Carlo DeSantis Library of Anatomy, Cell Biology, and Neuroanatomy, says he hopes other alumni Clari(e L. Bernhoft and Willard H. Bernhoft, M.D. '35 B u f f a l o P hysician 5 p r I n g l 9 9 7 r �····· · ····· · ····· · ·········· ·· ····· · · · · ··· ················ · ··· ·· ····· · ········ · ··· · ····· • · ~ I ,. r Anesthesiology research to be funded by gift from alumnus Mefford Diedrick UB'sfirst medical illustrator, dies $50,000 gift from Richard]. Nagel, M.D. '53, has established the first endowed fund to support research in UB's Department of Anesthesiology. "Although the university offers excellent clinical experiences for its medical students studying anesthesiology, research in this area is something that I believe requires more attention," says Nagel, UB emeritus professor of anesthesiology. "Supporting research now will allow me to see some results from new UB studies, and it opens up many opportunities for students to Jearn from these experiences. I also hope my gift will encourage others to offer their support to this fund." Nagel joined the medical school faculty in 1955 and retired in 1995 . He also served for four years on the medical school admissions committee. He was chair of the Department of Anesthesiology at Mercy Hospital for fifteen years, and served as chair of anesthesiology at Our Lady of Victory Hospital in Lackawanna, New York. A retired lieutenant colonel of the U.S. Army Reserves, Nagel is the president of the South Towns Tennis Center in Orchard Park, New York. + elford D. Diedrick, UB's first trained medical illustrator , died on January 24, 1997, in Queenstown, Maryland, where he had lived since 1982. He was eighty-four. Diedrick, who was profiled in the fall1996 issue of Buffalo Physician, was the first director ofUB's Department of Medical Illustration. A native of Buffalo , he studied art at the Rochester Athenaeum and Mechanics Institute (now the Rochester Institute ofTechnology) in the early 1930s. Later , he studied at Johns Hopkins University under Max Broedel, who is considered the father of medical illustration in the United States. Upon returning to Buffalo, Diedrick worked in various capacities at area hospitals and at the B u f f a l o Physician 5 p r i n g 1 9 9 7 I medical school until he was hired by UB as a full-time illustrator. With his training in both art and anatomy, Diedrick produced innumerable illustrations for publications and teaching. He also illustrated medical stories for newspapers and television. Among his larger projects~e three surgical atlases. His last major project was the 11lustration o Surgery , by former UB faculty members David H. Nichols, M.D., and Clyde L. Randall , M.D., a text that is now in its fourth edition. Diedrick helped found the nationa l Association of Medical Illustrators in 1945, and served as its president in 1963. The association recently honored him with a Life time Achievement Award. Diedrick, whose wife, Bertha, died in 1995, is survived by his two sons, five grandchildren, and one great-grandson . His remains were donated for medical research. + �• ········································ · ······ · ···· · ·· · ····· · ··········· · ·· · ···· · ·· ···· ~ I Parents'Council aids medical students BY hey drove their children to Little League, checked their homework, and kept them in line. Now that their children have grown, some parents are still finding ways to remain active in their children's lives through the Medical Students Parents' Council, which raises money and provides unique support services to UB's medical students. Robert and Elaine Heichberger, the parents of third-year student Lisa Heichberger, are the council's copresidents. "We both have been teachers all our lives. When teaching is in your blood, this type of thing is a natural progression," Elaine Heichberger says. "We are interested in medical education, have a great deal of pride in UB, and have an interest in our daughter's education." They view the council as a support post for the students. "The support your children feel when you are involved with their medical education, even when they are married, means a great deal to them," Elaine Heichberger says. "That is discussed at the meeting on many occasions, and the students are very appreciative." The council has provided many things to make students' experiences at UB more pleasurable. The parents helped to renovate and furnish the student lounge, supplied the hardware for the electronic mail system, donated a fax machine and a copy machine, and created an annual grant of $5,000 for the computer laboratory. But their assistance is not limited to tangible items. According to associate dean Dennis Nadler, M.D., "the Parents' Council also VICTOR FILADORA provides support for educational missions and activities which benefit the student body as a whole." For example, the group sponsors student travel to national meetings, which Nadler believes has a ripple effect that strengthens the entire class. Also, during every holiday season, council members invite UB students who can't be with their own families into their homes for support and companionship. The council, which is unique among medical schools, was founded ten years ago by former dean john Naughton, M.D., as a way for parents to get involved in their children's education. One of the group's most popular activities is the annual Gala Dinner Dance for the graduating seniors on the evening before graduation. The council pays for dinner, dancing, a boutonniere or corsage, and a gift for each graduate. Parents are recruited during Parents' Weekend, and they receive a directory describing the responsibilities and priorities of the council. During the spring session, the school solicits donations from the members. Between $15,000 and $20,000 is donated annually; these funds go directly to student support. "Reinforcement from the home front gives students the backing they need so that they know they are not alone," says Elaine Heichberger. "The parents realize that it is the little things they can do which provide extras that students would otherwise have to do without. " Although correcting homework and carpooling to sports practices are no longer required, the emotional, educational, and financial support of parents still enriches each medical student's experience and makes medical school at UB much more enjoyable. + Victor Filadora is a fourth-year student at the School of Medicine and Biomedical Sciences. ROBERT AND ELAINE HEICHBERGER, THE PARENTS OF STUDENT LISA HEICHBERGER, ARE THE CQPRESIDENTS OF A UNIQUE PARENTS' GROUP AT UB. B u f f a I o S p r I n g 1 9 9 7 �.......... . .. . . .. ..... ............... ...................... ...... . ..... .. . . . .. . ..... . .. get in the way. But that periphery is made up of human souls, which have a bunch of that subterranean anger, and an agenda. And they are the people who BY M IKE M ERRILL , CLASS OF 1 9 97 pay us . They are trying to get into the examination room, trying to tell us that the ower, says the I Ching, must be fused with justice. same patients who want us to heal them "When one understands this," the 3,000-year-old Chi- also don't want their families hobbled by huge insurance premiums. These nese book says, "one understands the meaning of people are trying to tell us that we need to change the way we do things . everything that happens in heaven and on earth." We ignore them , or fight them , at It's quite a point for contemplation: worker bee in times of layoffs. our peril. They will shape our future , Then I went to medical school, or they will , I think, find someone else power exercised without justice can only lead to instability, in a government or a plunged into an environment of entitle- to do our work. business or a family . It leads in the ment and ego and suffering. The excesses and injustices of the powerless to a subterranean anger that I kept working partadministrative and may build to a destructive explosion. time at HCP, and I noinsurance systems, These thoughts bring a new light to ticed a change, a subtle "LITTLE ACTIONS just like those of evthe hospitals and clinics. It's easy to distance between me erything else, eventuAND WORDS CAN underestimate one's power: watch the and some of my old ally will be blunted patients at Erie County Medical Center acquaintances. I have and balanced. They RESONATE DOWN A deferentially get out of the way of the become one of the obare unstable and so white coats. Little actions and words jects that the anxiety will not last, as the I CHANNEL OF TIME IN can resonate down a channel of time in fixes upon. Ching says. UNFORESEEN WAYS. " But l think the unforeseen ways: one elderly patient I don't like it, but I physician's role will refused CTs because a doctor once said can't undo it. only remain powerful it would "make slices of the stomach." As a doctor, it might to the extent that we In a way, the I Ching is right. What we be easy to forget the learn to incorporate, see going on here in all of human life is fear of losing my job, in a dignified manner, the working out of the correct way to the worry about how the indirect financial to pay for groceries, the exercise power among humans. concerns of the paof unemhorrible maw Nowhere have I seen this so clearly as and the contients , at HealthCarePlan, where I have worked ployment, the anxiety cerns of the adminisof being without for six years. trative environs. I started there in 1991 as, basically, a health insurance. But Medicine now has high-level secretary, continuing as are- these are the fears of powerful enemies. my co-workers. When search assistant for a year, then entering It's the latest incartheir bosses get angry, medical school in 1993. nation of the same old and their world shakes I was of low rank in the Guaranty cycle: power concentrembles. When a secBuilding in downtown Buffalo that around justice, trates retary is fired, it breaks houses HCP's headquarters. I didn't even justice dissipates , and the leg of her family. need to wear a suit; it would have been I know the world of power leaves. + silly. The secretaries and clerks looked the patient will call me. on me as something of an equal, When I'm in the examination room, Mih e Merrill, afonnerj ournali sl, is a fourth-year though a bit of an anomaly. I made a wherever I end up, support staff and medical st udent at UB wlwsecolumns appear regulot of friends , heard the gossip , and insurance companies will seem merely larly in the Buffa lo News. He will begin a resishared the helpless anxiety of the peripheral entities that had better not dency in internal medicin e in Buffalo next year. Medicine is agame of power 8 u f f a 1 o P hysician 5 p r I n g 1 9 9 7 �Aleader in research and in academic administration FRANKLYN KNOX or many academics, stepping into administration means abandoning research. Not for Franklyn Knox. Internationally known for research on the physiology of the kidney (work that he began thirty-five years ago while still a graduate student in UB's Department of Physiology), Knox has also helped lead one of the nation's most highly respected medical institutions through a period of expansion and change. He is a recipient ofUB's Distinguished Medical Alumnus Award, and this February Knox was awarded an honorary degree from UB during the "Kidney Performs Under Pressure" symposium on renal physiology. A native of Rochester, New York, Knox earned his bachelor's degree in pharmacy from UB in 1959. In 1965, he became the first UB student to earn an M.D. and a Ph.D. concurrently. "I had entered medical school with the idea of a career in research and teaching, and it became evident to me that I needed further training in research, so I embarked on the Ph.D.," he recalls. "My decision to pursue renal physiology had more to do with my mentor, Don Rennie, M.D., than with the kidney itself. I first met him when he taught the medical school physiology course, and then I did research in his laboratory in the summers. "One of his many research interests was kidne y function . But under Hermann Rahn's leadership, the Department of Physiology largely focused on respiratory physiology. As a result, we studied respiration of the kidney." Knox worked for three years at the ® ,.. '65 , DISTINGUISHED INVESTIGATOR AT THE MAYO FOUNDATION accomplishment I point to with the greatest degree of pride," Knox says. Before 1982, the Mayo's medical and Ph.D. degrees were granted through the University of Minnesota. Under Knox's leadership, the Mayo became accredited to take full responsibility for both degree programs. "In some sense, the change was a 'truth-in-labeling' issue, because all the medical curriculum was being taught here at the Mayo anyway, " Knox points out. "The decision for us to independently grant Ph.D . degrees, as well as M.D.s, has resulted in much stronger basic science education here." He has also been involved in other major changes at the Mayo. The Mayo established full clinics in jacksonville, Florida, and Scottsdale, Arizona , in order to make its service and reputation more national in scope. It has also instituted a series of changes in response to National Heart Institute's Laboratory of Kidney and Electrolyte Metabolism, moving to the Department of Physiology at the University of Missouri School of Medicine in 1968. Two years later, he joined the Mayo Clinic and entered its Department of Physiology and Biophysics, which he later chaired. He was then appointed Dean of •= the Mayo Medical • School as well as director for education of the Mayo Foundation, with huuu hu responsibility for supervising undergraduate and resident medical education, the Ph.D. programs, and the health-related science programs, as well as continuing medical education. "The establishment of the Mayo as a degree-granting institution in its own right is the Interim medical school dean John Wright, M.D., with Franklyn Knox . B u f f a l a Physician 5 p r I n g 1 9 9 7 �················· · ······································································• James E. Springate; joey P. Granger, of the University ofMississippi; University of Alabama professor james A. Schafer, the president of the American Physiology Society; and the society's president-elect, Allen W. Cowley Jr., of the Medical College of Wisconsin. Knox spoke about his recent research on the kidney's natriuretic response to increased blood pressure. Two observations-that patients who take non-steroidal anti-inflammatory drugs ( SAIDs) over a long time increase their risk of hypertension, and that NSAIDs block prostaglandin synthesis-raised the question of how prostaglandin is involved in natriuresis, Knox said. He traced the sequence of events through which, in healthy individuals, increased blood pressure is reflected in increased renal interstitial pressure, which triggers pressure natriuresis to help lower blood pressure. In hypertension, a number of factors can interfere with this cascade. Knox's experiments showed that lanJESSICA ANCKER thanum ions crossed the epithelium of the proximal tubule via the tight junctions between the epithelial cells. Knox used these findings to argue that prostaglandin helps maintain the permeability of the tight junctions, and D. that this permeability accounts for a he kidney's regulation of blood substantial fraction of the transepithelial pressure relies on the paracellular transport of water and electrolytes. Thus, transport of water and sodium in he said, prostaglandin synthesis amplithe proximal tubules, Franklyn fies the natriuretic effect of increased Knox argued in February's D. W. blood pressure. The D.W. Harrington Lecture series Harrington Lecture. brings distinguished scientific speakers Knox's lecture was the cornerstone UB twice a year. The series is funded to of the "Kidney Performs Under Presendowment created by Harrington, by an sure" renal physiology symposium at a member of UB's class of 1871. + UB's Center for the Arts in February. -].A. The other speakers included UB's managed-care pressures, including developing its primary care network and affiliating with a network of hospitals and clinics. Knox credits the Mayo's strong administrative support structure with allowing him to continue being an active researcher throughout his administrative career. "Also, there's an expectation that administrative responsibilities will rotate, so people are encouraged to maintain their professional research roles throughout different administrative jobs." He now holds the title of Mayo Foundation Distinguished Investigator and Head of the Nephrology Research Unit of the Mayo Clinic and Foundation. He has served on numerous national and international editorial and advisory boards, and is a past president of the American Physiological Society and of the Federation of American Societies for Experimental Biology. His recent research focuses on the regulation of phosphate metabolism and the role of blood pressure in controlling electrolyte and water excretion. + 1kw Y• S Hwl COIIIIIIISSIOII 8arltara A. De8uono, H.D wl be the keylole speaker at DB's 60dl Annual $pMg OilicaJ Day OD April 26, ID a pni&IUI eatided "1lle blienillg of llealdl Care.. The pregnll at tile Buftalo Marriott IS designed to Dlfer physicials ilsigllts and answers to the prolllems ucl epportunltleS of medial practKe, aCtOnllng to program chair Richard Collins. H.D '83. 8 a.m. Welcome and Introduction Jadt f Coyle. H.D '85, presideat. "edial Alumni Association ~ L Wright. M.D., 111ten11 dean. Schoel of ltediCIIe ud lioiiHal Scieltes ' lidtanl L Colas. "0 '83, prop~ dlair Paracellular transport in the kidney: the W. Hanington Lecture B u f f o I o physic i an S p r I n g I 9 9 7 Fw more ln(onnotlon about Sprinc ClniaJI OCiy Gild ocher Alumni Weeltend Cldlwflies, , . _ coneoct die Medical AUnnl Alsodar.ton CJt 7111-129-2778 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] . HURWITZ & RNE, P.C. [ATTORNEYS AT LAW I I 1 S ERVICING T HE L EGAL N EEDS OF THE H EALTH S CIENCES C OMMUNITY • Managed Care 9 JOHN D. 4 s 0 WHITE '40 , of]acksonville, 1 FL, has moved with his wife, Dorothy, to Cypress Village, a retirement community next to the Mayo Clinic. He continues to be active in low-vision counseling and community affairs. He writes: "I would like to know why we don't have news of the '40s classes. I can't believe that they are all dormant. If you get to Florida, I'd like to see any of you!" • Purchase & Sale of Practices THEODORE W . KOSS '41 , of Smithville, • Business & Tax Planning • HCFA Safe Harbor Regulations and Physician Self-Referrals TN, has had a good recovery from both a total hip replacement and a coronary occlusion last fall. ''I'm doing exceptionally well, fishing and following the market." 9 6 s 0 MORTON PAUL KLEIN '62 , of Boynton Beach, FL, is retiring from ob/gyn after 28 years. He plans to travel through the United States and Canada in his new motor home. HARVEY LIEBESKIND '63 , of Jackson- ville, FL, writes: "Although I continue to practice psychiatry part-time in Jacksonville, most of my time over the past 20 years has been devoted to the thoroughbred horseracing and breeding industry as an owner. I attend all the major thoroughbred auctions and race principally in New York, Kentucky, and Florida. Two of my three sons are in the business with me. I'm looking forward to our 35-year reunion in 1998." • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence M. Ross at 716- 849- 8900 HAROLD PESCOVITZ '47 , of Cincinnati, OH, has retired from his practice of surgical oncology. "I winter in Boyton Beach, FL, and summer in Cincinnati, so 1see no snow." of Buffalo, NY, received the Senior Honor Award Cer- ARTHUR J . SCHAEFER '47 , tificate for his many years of service to the American Academy of Ophthalmology and its scientific and continuing education programs. The award was granted at the academy's 100th Anniversary Meeting in Chicago on Oct. 25, 1996. At the meeting, Schaefer was one of five past presidents of the American Society of Ophthalmic Plastic and Reconstructive Surgery who gave a three-hour instruction course, "Refinements in Surgical Techniques in the Treatment of Ptosis, Entropion, and Ectropion of the Eyelids." STEPHEN C . SCHEIBER ' 64 , MARC COEL '68 , of Kailua, HI, is chair of nuclear medicine at the University of Hawaii School of Medicine and director of nuclear medicine at Queens Medical Center. He writes: "I have had a nuclear medicine text (atlas) published by Saunders. 1 would be interested in hearing from members of the class of'68living in Hawaii. I live in Kailua, across the mountains from Honolulu, where I work ... a bit warmer than Buffalo this time of year." s . K. Bosu '69, of Anaheim, CA, has been C .J . PARKER '58, writes that he has moved from Detroit, MI, where he was an associate professor of biochemistry, to Hayes, VA. 1300 Liberty Building Buffalo, New York appointed director of the N.I.C.U. and clinical chief of pediatrics at Southern California Permanente Medical Group in Orange County. He was also recently elected to a two-year term as president of the Association of Nigerian Physicians in the Americas, a 2,000-member professional association. ® of Deerfield, lL, was elected chair of the Committee of Board Executives and Representatives of the American Board of Medical Specialties. He was also approved for membership in the Benjamin Rush Society and the University Club. Scheiber is secretary of the Group for the Advancement of Psychiatry and treasurer of the American College of Psychiatrists. B u a a p 5 c a 5 p n g 9 �.................................................................. I N FIN I T I 1 9 s 0 7 ARTHUR R . GOSH IN THOMAS ARNO '70, of Buffalo, NY, was selected by the Academy for International Health Studies to travel to jerusalem for a '78, of Meadville, PA, was awarded the 1996 D'Angelo Excellence in Heart Care Award by Hamot Medical Center. Arno is medical director and chief of cardiology at Meadville Medical Center. He was honored for improving cardiac care and week of study of the Israeli health-care system. He joined a delegation of 18 American health-care leaders that met with Israeli raising public awareness about heart disease. Among his accomplishments were adding new services at the hospital, writing medical columns for the local newspaper, Minister of Health joseph Matza; members of the Brookdale Institute; the mayor of Jerusalem; and the chair of the board of Israel's largest HMO, which has 3.4 million members. Goshin is president and CEO of Buffalo's oldest HMO, HealthCarePlan. He is also board chair and appearing on the radio to raise awareness of heart disease, and helping in the annual Heart Fund Drive. 1 9 8 s 0 '82, of Los Alamitos, CA, was recently advanced to fellowhip in the American College of Physicians and continues to practice pulmonary and critical care medicine in Orange County, CA. Having '74 , of Seattle, WA, writes: been promoted to the rank of commander in the Navy Reserve Medical Corps, he has attained qualification in surface warfare medicine on the U.S.S. Kitty Hawk and was recently awarded the Navy Commendation Medal. He and his wife, Pina Wong, M.D., have one daughter, Christen Marie, who is experiencing the 'terrible two's. ' "I have joined the Richmond Clinic and am starting an internal medicine practice. I will be living in North Seattle with my wife, Claudia, my daughter, Nicole, and my granddaughter, Samantha." RICHARD AL TESMAN '76 , of White Plains, NY, writes: "After 10 years in the private sector, I've returned to academia as director of the acute division of New York Hospital-Cornell Medical Center in Westchester County. I still maintain my psychiatric consulting practice." TAWNI ANN FRANK '76 ,ofCharlesCity, VA, writes: "After eight years working as a general practitioner and ER doc, I found my true calling in psychiatry. I am now an assistant professor in the Department of Child Psychiatry at the Medical College of Virginia in Richmond." MIKE NEANDER '76 , of Oneonta, NY, is practicing child, adolescent, and adult psychiatry in rural upstate New York, and works monthly in Washington, DC. He works with families with multiply behaviorally challenged children. e 0 0 p y c An interior more Jpaciou,l than a Ro//.1 Royce Silo•er Spur Ill. An e.-cceptionaffy generow liA of ,1tandard Lu.-wry featured. A 190-hp V6 capahle of out-acceleraltizg many Lnxury V8J. And of courJe, !he Jtandard-Jetting performance and Jervice oflnfiniti. $599 mo. 36 mo. LeaJe $999.00 down MARK CHUNG CEO of Vytra Healthcare, a HealthCarePlan subsidiary on Long Island. JOHN J . FIN A The fro nt-wheel drive I nfiniti® /50™ '82, of Grand Island, NY, is director of laboratories and chief of pathology at the Niagara Falls Memorial Medical Center. He has been granted voluntary recertification by the American Board of Pathology. Gioia is board-certified in anatomic and clinical pathology and is a clinical assistant professor at UB. JOSEPH F . GIOIA '83, of Memphis, TN, writes: "After a decade in academic medicine, including the last two years as chief of the division of geriatrics at the University of Tennessee at Memphis, I will begin a new adventure this year. I am joining St.j oseph's Hospital in Memphis to become the medical director of a MedWise Center. MedWise is run by GeriMed of America, a national company providing primary care for older adults throughout the continuum of care. " ROBERT BURNS o n 5 p n 9 9 9 I ntrouucing the all neov 9 7' QX4® from Sj5,550.00 In an ln/inili® QX4®, one of the firJt lhingJ you 'If eJcape iJ the mundane. Beca11Je the QX4 iJ not your typical La.xury .1porl utility l'e!Jicle. While it offet~' all the verJatility you e.-..:pect from a l'ehicle of it,, kino, I he QX4 offeN .wmething you don't e.-..:pect: the Lu.-..:ury of an infiniti. I N F I N IT I AUTO PLACE INFINITI 8129 MAIN ST. , WILLIAMSVILLE 633-9585 East of Transit Rd., Near Eastern Hills Mall ( 130-$450). Bank fee + tax and license due at inception. 12,000 annual mileage . $.15 per mile in excess. �& WILLIAM J . MAYER '83 , of Portage, MI, was recently appointed president and gen- THE ULTIMATE DRIVING MACHINE= eral manager of the Functional Foods Divi- Advertise in one of the finest publications in Western New York ... Buffalo Physician ~ Uf\"tj v"~ s \ [ \ "" Checkpoint Foreign Car, Inc. sion of Kellogg Company. He also served on an Institute of Medicine study committee that published Improving Health in the Community. He and his wife, Annie Fainsinger, have two sons, joshua (5) and Adam (2). EDWARD A . ZANE '84 , of ew Milford, CT, writes: "After serving as chairman of the Department of Anesthesiology, I have been elected to serve as president of the medical staff of ew Milford Hospital. Our three children-Alexandra (8), Erica (6) , and Mauhew (4)-bring endless joy to Debbie and me." OONNICA L. MOORE '86 , of Sales and Service eshanic Station, NJ, has been elected vice president for membership of the • American Medical Women 's Association. 487 Kenmore Avenue Buffalo, NY 14223 Moore, a gynecologist, has Give us a call: 836-2033 (716) 645-6933 • Michael J. Baranski Marketing Representative also been named president of Sapphire Women 's Health Group, which provides consulting services to companies and organizations interested in enhancing their position in women's Your WNY Leasing Specialist Serving WNY proudly for 33 years health. She will also serve as the program chair for the Fifth Annual Congress on Women's Health in Washington, DC, in june. She writes, "I hope to see many alumni there! " JOHN BARBACCIA '88 and JANET WILLIAMS '88, ofMorgantown, WV, announce the birth of their son, icholas Andrew, on Dec. 31, 1996. He joins three older siblings: Katie (5), Matthew (3), and Thomas (1). 1 BARANSKI ADVERTISING 146 Stepping Stone Lane Orchard Park, NY 14127 ® s u f f a l o P 9 9 s 0 PAMELA A . CLARKE '90, of Prospect, KY, writes: "I finished my pediatric endocrinology fellowship in june 1996 and accepted a position as assistant professor at the University of Louisville in the Division hysician 5 p r I n g 9 9 7 �················ · ······································ · · · ········ · ······················ • II ' of Pediatric Endocrinology. My husband, begin a two-year fellowship in pediatric oto- Mike, and I have been keeping busy build- laryngology at Emory University in Atlanta ing our dream home." this July. GLEN M . GINSBURG '90 , of Omaha, JONATHAN WEINSTEIN I '93, of Alexan- NE, was appointed assistant professor of dria, VA, writes: "I have finished my resi- pediatric orthopedic surgery and clinical dency in pediatrics at Children's director of the Motion Analysis Laboratory Medical Center in Washington, DC, and ational at the University of Nebraska Medical Cen- have joined a large practice in Fairfax ter after completing a fellowship in pediatric County, VA. I love living in this area and orthopedics at the University of Southern California. take advantage of the many sights and activities. I just finished my second Marine Corps Marathon-with my father! Ed Math LINDA D . LORENZANI - FRANCIS '91 , of Washington, NC, writes: "I finished my and I keep in touch frequently and occasionally I hear from Andy Corsello. " psychiatry residency at Sheppart Prall Hospital in Baltimore in 1995, and I've joined RESIDENTS the faculty at East Carolina University School of Medicine's Department of Psychiatric Medicine in Greenville, NC. " W I LLIAM A . PULLEN ( 1982- 85) , of Los Angeles, CA, was chosen as one of the best physicians in Los Angeles by Los-Ange- MATTHEW J . PHILLIPS '91 , of Snyder, NY, writes: "My wife, Toula, and I are proud les Magazine. Pullen is married to JoAnn C. Pullen '83. to announce the birth of our son, Mauhew John Phillips Jr., on Nov. 9, 1996. He joins his brothers James (3) and Michael (2). " of Amherst, NY, is completing the last year of her otolaryngology residency at UB and will PHILOMENA MUFALLI BEHAR '92 , MANDEEP KAUR RAI ( 1992-95), of Chagrin Falls, OH, was awarded an educational grant from the National Foundation for Infectious Diseases to attend the 1996 lnterscience Conference on Antimicrobial Agents and Chemotherapy last fall in ew Orleans. Rai is a fellow in infectious diseases at Prompt Care and the Cleveland Clinic Foundation. NICHOLS MIDDLE SCHOOL • Challenging, mnovative curriculum • Outstanding preparation for high school • Average class size of 14 students • Interscholastic sports • Comprehensive visual and performing arts program • Dedicated, caring faculty • Financial aid available For further information, call: NICHOLS MI DDLE SCHOOL, 175 Nottingham Terr. B f f 0 0 p h y s NICHOLS UPPER SCHOOL, 1250 Amherst St. c 0 5 p 9 875~8212 9 9 ® �• ·············· · ···· · ········· · ····· · ··········· · · · ···· · ············ · ·· · ········ · ······ · ··· I OBITUARIES STEVEN PIERI '36, of Fort Myers, FL, died on Dec. 18, 1996, after a long illness. After graduating from UB, he received further training from the People's Hospital in Akron, OH, and the Belmont Hospital in Chicago. In 1939, he started a group practice in Corning, Y, and worked there until his retirement in 1981. He was also a member of the staff at the Corning Hospital and was active in the Steuben County Medical Society. He is survived by his wife and classmate from UB, Doris Pieri '36. JOHN L. MUSSER '51 , of Orlando, FL, diedjan. 19. He had been battling cancer. He is survived by his wife, Norma. JEFFREY J . SEYMOUR '93 , of Ilion, NY, died jan. 6 as a result of injuries sus- tained in a car accident. He was 31. Seymour was completing his residency in emergency medicine at Albany Medical Center, where he had become chief resident. He earned his bachelor's degree from Cornell University after attending Herkimer County Community College. He graduated from UB School of Medicine and Biomedical Sciences with honors. In 1995, he married Pina Sanelli, UB Class of '94, who is now a resident in radiology at Albany Medi- This photo of Jeffrey Seymour and Pina Sanelli appeared in the 1993 Iris, UB' s medical student yearbook. cal Center. If you come loolring for a car, you'll be awfully disappointed. HoWEVER, there's little chance you'llleave that way. BECAUSE at the Land Rover Centre, we have the world's most impressive 4x4s. AND people who can answer anyof your questions about driving. A4x4, of course. 3560 Sheridan Drive Amherst, New York 14226 (716) 831-3100 • (716) 835 FAXX (3299) ® a f f a l a P h y s I a n 5 p n 9 9 9 �Put tfte best seat in tfte fwuse myourgarage. UBMICRO CD:MPUIERSAIES ANon-Profit UNIVERSITY AT BUFFAIDS YF PROGRAM Call 645-3554 I •, il"r•,' YOUAREEIIGIBIE HEWIEITBIQ(ARD - MICROSOFf•CDRa•AOOBFANDMUO-I M:ml 1997 Buick Riviera Riviera: the most sophisticated personal luxury car Buick has ever offered. It is designed to stir the spirit and excite the soul. We at Paul Batt Buick are proud to serve the people of Buffalo and its surrounding communities. For the last 43 years, we have offered the lowest prices possible, along with the very best in service. We value the professional and the hard working labor force in our community and will continue our efforts to maintain their loyalty. When you enter our showroom you will find helpful people, not pressure-so when you think of Buick sales and service, we know you'll think of us! Joseph R. Pera Paul V. Batt, Jr. Purchase any qualifying Macintosh desktop computer, Apple display (if sold separately), and Apple printer through 1119197 and receive a $150 mail·in rebate. APPLE ScHOOL REwARDS Purchase any qualifymg Macmtosh desktop computer, Apple dtsplay (if sold separately), and Apple printer through 1119197 and earn pom~ for any school of your choice (to be redeemed for Apple products) !OMEGA REBATE OFFER Purcha~e an Iomega Zip OM.,, and rerei"' by mail either a $50 rebate, OR more than a $150 value "Game Pack-to-Go" Purcha~e an Iomega Zip D~k 10-pack and recei"' by mail either a $20 rebate, OR more than a $60 value "Net Stuff Organizer" See Iomega mail-in certificate at UBMicro for details. Rebate through 1/31/97. $50 HP DESKjET 340 SERIES REBJITEOFFER through 3131/97. See HP mat!-in certificate at UBMicro for detai~. CoMPUTER WoRKSHOPS Call 645-3560 to have a brochure mailed to you. 7Jai' J Jaff 7Jalc1 1717 Walden Ave. , Buffalo, NY Open Mon thru Fri 11-5; Wed & Thurs 11-6:30 Celli for currr:nt pricmg and aw.ulablllll·, Priers subji'CI to chon!{t' ~·ahout notfU 11m • •11[+] 891-5595 A non-profit UnivetS!ty program for students, tocuhy & staff The Comm ons • North Campus • (7 16)645-3554 • Fox: 645-3884 B u f f a l o Phy s i c i an s p r I n g l 9 9 7 NAME (please pnnt) DAYTIME PHONE VISA MASTERCARD SIGNATURE MedtcaVDental diploma frame (fits 20"x 16" diplomas) U.S. shtpptng charges per frame (allow 6-8 weeks) TOTAL $ S e nd your order with pa yme nt t o: USAB Dtploma Frames c/o Office of Alumm Relat1ons UniverSity at Buffalo 3435 Main Street, 109 Allen Hall Buffalo, NY 14214-3003 Fax: 716-829-390 I Phone: 716-829-2608 or 1-800-BUILD UB �TAKE TWO ... TheDollar AND CALL ME IN THE MORNING! Doctor... f;'\d ~O<tr Information Insights Opinions Finances Stocks & Bonds Call in Listen In OW'\ ro(l[ * Fact: Saab owners have a higher education level than any other car owner group. * Saab purchase prices starting low to mid 20's; leases starting at $299 per month. * According to the Insurance Institute for Highway Safety (IIHS), the Saab 9000 has the lowest fatality rate of any production car on the market. WWKB, 1520 Saturdays 9:05 to 10:00 am SOUTHTOWNS SAAB @~P!2~~~11 3580 Southwestern Blvd (1 Mile east of Rich Stadium) Member: American Stock Exchange, NASD, SIPC (716) 662·8008 237 MAIN STREET Tel: 854-7541 WNY's Largest Volume BMW Dealer THE ULTIMATE DRIVING THOSE LOOKING FOR MORE CONTROL IN THEIR LIFE CAN NOW FIND IT ON SLIPPERY PAVEMENT. MACHINE~ F. G. DOWNING Sfi99 While the road of life may throw you an occasional curve, at least our All Season Traction 1997 BMW 740i helps you handle the particularly slippery ones. 27 mo. Lease Towne BMW 3030 Orchard Park Rd. Orchard Park, New York 14224 Phone: 675-2550 FREE SCHEDULED MAINTENANCE ALL SEASON TRACTION PMT based on 5000 cap cost reduction or trade, 10,000 miles per year. 15 cents charge per m1le for excess miles. First and last PMT, taxes and plate fees due at inception. Service Loaners Available ... Minutes From Rich Stadium Buffa l o Phy si c i a n Spr i ng 1997 �Who says there's nothing good on TV? As busy as they are, physicians and other health care providers always take the time to watch MLMIC's top-rated risk management education programs. • When they tune into high quality programming broadcast over our satellite network, viewers know what they see will help enhance patient safety and reduce injuries. They also appreciate the policyholder discounts available to participating physicians. MLMIC programming is sponsored by the largest Risk Management Department of any professional liability insurer in the state. Policyholders also enjoy the protection of one of the country's largest and most experienced professional liability Claims Departments. Most importantly, MLMIC has successfully defended more physicians than all other available insurers combined. • These are some of the reasons why MLMIC is the only medical liability insurer approved by the Medical Society of the State of New York. • To find out more, call1-800-356-4056 in Upstate New York, or 1-800-ASK-MLMIC in the New York metropolitan area. Ask for free copies of our risk management MLM~C ~ \ledJCal uabilit\ \lutual Ins=ie Compan) guide for office practices. • Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 115S4 Ci1''96M~d allab 1ty M~.Jtuallnt~urance Company �Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED PLAN'l'ING A TREE UNDER WHICH You WILL NEVER Srr DR. DEVILLO W. HARRINGTON, class of 1871, knew how to make his money grow. In fact, this man who in 1905 provided $5,000 through his will for the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. THIS PERMANENT endowment in Dr. Harrington's name has grown to over $300,000 and today it supports the famous Harrington lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed funds at the school. They enable UB to provide scholarships ·to outstanding students, enhance scientific research, support excellence in teaching and meet the ever-changing needs of the school. YOU TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you develop a smart financial plan. Acharitable bequest provides the satisfaction that comes from planting a tree under which you will never sit, but which will bear fruit for generations to come. FOR ACONfiDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact STEPHEN A. EBSARY, JR. I Assistant Dean and Director of Development, School of Medicine and Biomedical Sciences UNIVERSITY AT BUFFALO (716) 829-2773 UNIVI!ASITY AT BUFP'ALO SCHOOL OF MI£DICINII!: l50 I 5 0 Y £ A R S 18415-1998 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1997 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1997-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v31n02-1997-Spring Table Of Contents A list of subunits of the resource. Teaching on the Fly OB-GYN today OB-GYN yesterday A medical mission to Kathmandu Research news Hospital news Medical school New faculty A student's perspective Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-09 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v31n02 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1997 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/036b61aa5ed92170adcc2621130b772d.pdf 6e9fd3da5c49d53bd021792690850f6a PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Winter 1997 �BUFFALO PHYSICIAN Volume 31, umber l ASSOCIATE VICE PRESIDENT FOR UN IVERSITY SERVICES Dr. Carole Smith Petro DIRECTOR OF PUBLICAT IONS Kathryn A. Sawner EDITOR jessica Ancker ART DIRECTOR/DES IGNER Alan j. Kegler PRODUCTION MANAGER Ann Raszman n Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MED IC I NE AND BIOMEDICAL SCIENCES Dr. john Wright, Interim Dean , Vice President for Clinical Affairs EDITORIAL BOARD Dr. Bertram Portin Dr. Martin Brecher Dr. Harold Brody Dr. Richard L. Collins Dr. jack F. Coyne Dr. Alanj. Drinnan Brian Duffy Dr. james Kanski Dr. Barbara Majeroni Dr. Elizabeth Olmsted Dr. Charles Paganelli Dr. Stephen Spaulding Dr. Bradley T. Truax Dr. Franklin Zeplowitz Dear Alumni and Friends, UB's SESQUICENTENNIAL EVENTS WILL END with the award by the SUNY Board of Trustees of an honorary doctor of science degree to Dr. james Holland at commencement on May 11, 1997. Dr. Holland, the Distinguished Professor of eo plastic Diseases and the director of the Cancer Center at the Mount Sinai School of Medicine and Hospital will also participate in teaching students in medicine, and will present a Harrington Lecture during the course of the weekend. Between now and the closing events of May 11, two additional special activities are planned. The first, on Feb. 21-22, 1997, will be held in connection with University Founders Day. Franklyn Knox, M.D. '65, Ph .D. '65, formerly dean of the Mayo Medical School and director for education of the Mayo Foundation, will be honored by a special symposium coordinated by the UB Department of Physiology. He will present a Harrington Lecture, entitled "The Kidney Performs Under Pressure." The SUNY Board of Trustees will also confer the honorary doctorate of science degree upon him as part of the sesquicentennial festivities. A very special event will focus on advances in medical education. It will be held on April25, 1997, the day before the annual Spring Clinical Day meeting. Four major leaders in medical education who had their roots at UB will return to join other faculty with whom they had worked, in addition to the current generation of medical education leaders at the medical school, to discuss the past, present, and future of medical education. The four are Dr. George Miller, Dr. Steven Abrahamson, Dr. Edwin Rosinski (Ed.D. '58), and Dr. Hilliardjason (M .D. '58, Ed.D. '62) . As the sesquicentennial activities draw to a close, it is my observation that each served to reconfirm the medical school's commitments to the intent of its founders and to provide excellence and leadership in education, research, patient care, and community service. As medical education and health care enter into a new, challenging era, UB stands ready to maintain its professional integrity, while preparing to make its contribution to the necessary growth in knowledge and needed advances that lie ahead. ~·'~.~ TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital Michael Shaw The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Health System John Naughton , M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Frank Sava Niagara Falls Memorial Medical Center Roswell Park Cancer Institute Sisters of Charity Hospital Dennis McCarthy Veterans Affairs Western Healthcare System ew York ©The State University of New York at Buffalo Buffalo Physician is published quarterly by the State University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alumni, faculty, students, residents and friends. The staff reserves the right to edit all copy and submissions accepted for publication. Address questions, comments and submissions to: The Editor, Buffalo Physician, State University of New York at Buffalo, Office of Publications, 136 Crofts Hall , Buffalo, NY 14260 Send address changes Ia: Buffalo Physician, 146 CFS Addition, 3435 Main Street, Buffalo, NY 14214 Dear Fellow Alumni, WELL, IT'S WI TER IN BUFFALO ONCE AGAIN. We brace ourselves for the cold weather ahead, and follow our Bills. But something is different. Things are not the same. Someone is not here. It is the individual who has directed and guided our medical school for the past 21 years, Dean john Naughton, M.D. When I was talking with him about some of his accomplishments, he quickly turned the discussion to one of h is favorite interestssearching his family tree. As he speaks of his travels through Ireland and the Northeast, you see a glimpse of the passion with which he engineered this medical school into the 21st century. He follows no model, but creates innovative ways to reach his goals. Hence, the reason why the Robert Woodjohnson Foundation has provided UBgrants fo r primary care, and why he currently chairs the New York State Council on Graduate Medical Education. His medical education interests have centered on reform of graduate medical education, medical student education, and collaborative and regionalized models of health care and education. It's hard to envision our future without Dr. aughton's leadership. He will be tru ly missed, but his legacy will live on in the students he has touched. Today's health care system has certainly benefited and will continue to benefit from his vision, passion, and dedication. Thank you, Dr. aughton! Cover photo by K.C. Krall Sincerely, ~cf2C'~~D Jack F. Coyne, M.D. President, Medical Alumni Association �VOLUME 31 , NUMBER 1 WINTER 4~~~~ ~,~~~~~~~"~.0. 8 C~unch ~me THE MANAGED CARE NAUGHTON DISCUSSES HIS REVOLUTION GOES INTO CAREER FROM SPORTS HIGH GEAR IN BUFFALO WRITER TO CARDIAC by Jessica Ancker 12 97 Making histo~y in the histo~y of medicine U 8'S TREASURES ON DISPLAY photos by K.C. Kratt RESEARCHER TO DEAN. II ..JOHN R. WRIGHT, M.D. NAMED INTERIM DEAN 2 Then and Now WHEN THE GERM THEORY WAS STILL A THEORY by George F. Haddad, M.D. '94 3 Research Alumni RADIOLOGIST WENDE W. LOGAN-YOUNG , GRANTS FOR BREAST GENOME RESEARCH. LIJ:¥UID VENTILATION . 2 Medical School News Astudent's perspective NEW BOSNIA PARTNERSHIP • A ..JOHN BORDER, M.D. IDEALISM INTO PRACTICE PRIMARY CARE EXTERNSHIPS. by Christopher J. DiMaio, Class ..JOHN KOLEGA, of 2000 PH.D. THE NPR CAREER OF US's MIRIAM SHUCHMAN, '61. ..JACK RICHERT RETIRES. CANCER AND HUMAN POLICE SUICIDES. M.D. M.D. CHANCE TO PUT 3 Classnotes �. . . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . . . . . . .. . . . . . .. . . . . [1] I ' I " . $1.6 million funds study of alcohol and breast cancer an drinking alcoholic beverages increase the risk of developing breast cancer? If the answer is "yes," as many scientists suspect, what are the mechanisms involved, and are some women genetically more susceptible to the risk than others? University at Buffalo scientists will attempt to answer these and other questions about alcohol through a $1.6 million grant from the U.S. Army's special program for breast cancer research . The study was led by] o Freudenheim, Ph.D., UB associate professor of social and preventive medicine. "There is a fair amount of evidence that alcohol may be related to breast cancer, but most research has used inadequate measures of alcohol intake," Freudenheim explains. "We will be making careful measures of lifetime alcohol consumption, as well as collecting data on diet, physical activity, and reproductive history. The researchers also will assess genetic differences in the way individuals metabolize alcohol, and will compare breast cancer rates among "fast " and "slow" metabolizers . A specimen bank will be created to store blood samples for current and future research . The study group will be composed of 1 ,350 women from western New York with breast cancer and 2,030 randomly selected Jo Freudenheim, Ph.D 0 healthy women to serve as controls. Participants will be between the ages of 35 and 79. Researchers theorize that alcohol may influence the development of breast cancer by changing the body's steroid hormone levels or by increasing oxidation. These mechanisms are among those that will be investigated in subgroups of the study population. The research is an offshoot of an $8 million investigation of alcohol and its relationship to chronic diseases being carried out jointly by UB's Center for Preventive Medicine and the Research Institute on Addictions in Buffalo. + L o 5 B A K E R UB liquid ventilation study proves eiTectiveness artial liquid ventilation is safe and effective for premature infants, according to research from UB that appeared as the lead article in theSept.l2 , 1996, issue of the New England journal of Medicine . A five-center trial of partial liquid ventilation to treat lifethreatening respiratory distress syndrome in extremely premature infants has shown that the procedure is safe and effective , and that it improves lung function in some children who failed to respond to conventional treatment, increasing their chances of survival. Corrine Leach, M.D., UB assistant professor of pediatrics , headed the multi-center investiga- a u t t a t a P tion of the procedure, which was developed by Bradley Fuhrman, M.D ., UB professor of pediatrics. Both practice at Children's Hospital of Buffalo. Respiratory distress syndrome , the leading cause of death in premature infants, develops when the lungs of these tiny babies are unable to secrete surfactant to prevent the air sacs from collapsing. Partial liquid ventilation (PLV) involves introducing an oxygen-rich liquid called perflubron into the baby's lungs . The liquid allows the lungs to inflate and permits oxygen and carbon dioxide to pass through the air sacs and into the blood stream more easily and efficiently. "The successful introduction of liquid into the lung and the ability of infants to breathe with liquid allow us to ventilate the lung at lower pressure , which causes less damage ," Leach explains. "If we can decrease the amount of lung injury , we can greatly improve the patient's outcome and perhaps prevent chronic lung disease." The pilot study involved 13 infants born between 24 and 34 weeks of gestation. All had failed to respond to conventional therapy and were at risk of death . Carbon dioxide levels improved in all patients while on PL V; lung functioning improved in 11 infants. Seven of the 13 critically ill infants survived. Of those who died , three succumbed to their acute lung disease, and one to bronchopulmonary dysplasia. Two patients died of nonrespiratory complications of prematurity. Clinical trials using PL V to treat children and adults with severe respiratory distress syndrome are now under way. Results are promising, Leach says. + hysician o L W 5 1 n t 8 e r K A 1 E 9 R 9 7 �- - . - ~ -~ - - . ~. ~ --- ~- - - . .. - - - - -- - - Reorganizing the Human Genome Project Former trooper studies police suicide rates a pretty good indicator of what's going on out there ." Results appeared in the American]our- s part of a nationwide project to combat ethical and image problems with the Human Genome Project, the federal government has given Roswell Park Cancer Institute researchers a grant to build a new human gene library. The same Roswell Park research group , which is led by Pieter Dejong, Ph.D. , also won a grant to begin gene sequencing. They will share the $2 million Department of Energy pilot grant with a team at the University of TexasSouthwestern. The National Center for Human Genome Research decided there was a need for new gene libraries after finding problems with the way researchers had obtained DNA samples in the older libraries. The federal administrators found that most of the DNA in the four best gene libraries (including Dejong's) came from only four people, rather than from a diverse group of donors. They also found that some of the subjects may not have been fully informed of what their donation would be used for, and that several of the donors were known to the researchers and so were not anonymous. Under new ethics guidelines, researchers will recruit a larger pool of donors and follow procedures to ensure donors' anonymity and to obtain their informed consent. They will also follow additional rules to combat image problems. For instance, researchers may not donate their own DNA (because it might appear "elitist") or ask junior lab members to do so . They must also recruit a substantial number of women donors. According to Dejong, a UB associate research professor, sequencers will continue working on the old libraries during the two years it will take to create the new ones. + olice officers are eight times more likely to die by their own hand than by homicide, a study by University at Buffalo epidemiologists has shown. They also take their own lives at a much higher rate than other municipal employees, the findings indicated. The study is one of the few empirical analyses of police officers' risk of suicide, homicide , and accidental death, and the only study to compare their risk to that of other workers. "We are hoping this study will make the police community aware that suicide is a problem, not a myth , not something that should be shrugged aside, " says lead author john M. Violanti, Ph.D., a UB assistant clinical professor who is himself a 23-year veteran of the New York State Police. Violanti, along with john E. Vena , Ph.D. , and other colleagues from the UB Department of Social and Preventive Medicine, analyzed mortality data for the 138 Buffalo police officers and other municipal workers who died between 1950 and 1990 of external causes. According to Violanti, the Buffalo statistics mirror those of police departments around the country. "We looked at five other cities, and all five departments were higher in suicide than other occupations . I think this is The researchers identified a number of potential factors in the police suicide rate, including continuous exposure to human misery, an overbearing police bureaucracy, shift work, social strain, marital difficulties , inconsistencies in the criminal justice system, alcohol problems, physical illness, impending retirement, and lack of control over work and personal life. Easy access to handguns and the lack of confidential counseling may also be factors , says Violanti. "Police officers are even more hesitant than the average citizen to get help for emotional problems," he notes. "Because of their role and their job, they mistrust many things , and they especially mistrust mental health professionals. The other half of the problem is , confidential help isn't always readily available. "Departments should include some sort of suicide awareness training in their stress management program," Violanti adds. "The New York City Police Department has such a program and suicides went down after it was instituted. The Buffalo department now also has a program in place. " The research was supported by a grant from the National Institute of Mental Health. + -JESSICA B u f f a l a ANCKER Physician w 1 n t e r 1 9 9 nal of Industrial Medicine. - 7 L o s B A K E R 0 �Naughton discusses his career from sports writer to cardiac researcher to dean at UB As]OHN NAUGHTON, M.D., 63,stepsdownafter21 eventful years as dean of the medical school, he can be certain he's secured his place in UB history. Conversely, UB can be sure it has secured its place in Naughton's own eventful history, which began far from Buffalo or any other academic center. John Naughton grew up about 80 miles from Oklahoma City in Lawton, OK, at the time a town of 14,000 people. Lawton's business community, including the Naughton family's restaurants, depended on servicemen visiting from the nearby Fort Sill military post and training center. Young jack, as he was called, did well in school and also worked hard at a number of different jobs. Helping out at his father's restaurants , the Chuckwagon and jack's White House Cafe, "taught me just about everything there was to know in the restaurant business." He also worked part time as a sports and news writer for the Lawton Constitution. "I was a good writer-my strong point was writing lead sentences," he remembers with pride. Naughton earned an associate's degree from Cameron State College, a two-year school in Lawton where he was the editor of the student newspaper. But he had higher aspirations: he went on to St. Louis University to earn a B.S. in preparation for medical school. "My interest in medicine, I think, came from my mother. She had been a nurse before she was married, and always wanted to have a doctor in the family," Naughton says. "At the same time , my father , as an independent businessman who was very active in each community he lived in , gave me an appreciation of the importance of community service. That's something I consider to be part of medicine, too. " When he entered college, Naughton found that he was far behind some of his contemporaries in basic science education. "Lawton was a very small community, and we didn't have a lot of kids who went into academic fields. "Looking back on it, I appreciate Lawton, because I grew up among real people who sometimes academics and medical students don't have a chance to know," he says. bx !essica Ancker 0 B u f f o l o P Naughton earned his M.D. from the University of Oklahoma, did a mixed medical internship at George Washington University, and completed a residency and post-doctoral work at the University of Oklahoma Medical Center where he remained until 1968 as an assistant professor. While his early research interest was the effect of emotional stress on the heart, he soon began investigating the effects of physical stress and ways to rehabilitate patients after heart attacks. "In a time of national emphasis on fitness during John F. Kennedy's presidency, we were looking at broad national questions , not just the effects of hysician w I n t e r l 9 9 7 �-- --- tests on individuals. Our question was , in an unfit society, could unfit people be reconditioned and would it improve the quality of life? " a ugh ton then moved to the University of Illinois, where he became an associate professor and the director of the school's Rehabilitation Center. Later, at the George Washington University Medical Center, he became director of both the Division of Rehabilitation Medicine and the Regional Rehabilitation and Training Center. He also directed the ational Exercise and Heart Disease Project, a national study that he continued to head until its final report in 1983. It was at George Washington that B u f f a I a Phys i c - -- - --- Naughton got his first taste of administrative life , becoming dean of academic affairs in 1973. "Even though I loved being a researcher, I had also always been interested in teaching and in broader areas of medical education," he explains. Heremembers being trained to be a first-rate internist, with only secondary emphasis on developing a specialty. By the time he joined the University of Illinois, emphasis on the core of medical education was already disappearing in favor of training specialists. "That alerted me that there were interesting issues in medical education. My interest was in providing a medical Ia w I n t e r 1 9 9 7 - - �''I am lool<ing forward to education that served a broader need in society." Naughton accepted the deanship of UB's School of Medicine and Biomedical Sciences in 1975 at the age of 42. He was eager for the chance to lead a school, and he describes a mix of other reasons that made UB's offer intriguing. First, he says, he wanted to join a public university, with its commitment 0 to serving the people of its state. He also liked the fact that UB was an integral part of the Buffalo community. "Medical education should be serving the community in some way." Also, Naughton said he immediately felt that UB had never taken full advantage of the resources at its fingertips. For example, UB's outstanding faculty weren't getting recognition at the national level, and they were rarely invited to join state Health Department committees. "Things other people saw as disadvantages, I saw as opportunities. That probably comes from my rehabilitation career!" Coming on board at a time of sagging morale, low prestige, limited research funding, and uncertain priorities in the wake of the merger with SUNY, Naughton helped raise the school to national stature. One achievement that will always be linked with Naughton's name is the creation of the Graduate Medical Dental Education Consortium of Buffalo. More than just coordinating resident education, the consortium has become a symbol of the cooperation among the hospitals, which have reduced duplication, saved money, and concentrated their expertise by designating certain hospitals to develop into regional centers of specialty services. Interestingly, Naughton also counts as a success his hospital consolidation study, which stirred public controversy and was never implemented. He had been invited by Buffalo General Hospital, Children's Hospital of Buffalo, and the former E. ] . Meyer and Deaconess hospitals to head a study on the feasibility of mergers. The resulting report recommended a series of consolidations to cut down on unused beds and costly duplication of services. The plan failed by one vote to pass in the Erie County legislature, due to opposition from community groups, politicians, and some parts of the medical community. "However, that study served to create the image of the medical school as a B u f f a l a leader in Buffalo's medical community. It was also the first opportunity to bring people from the different hospitals together in a more cooperative way. It set the stage to found the consortium." Naughton is credited with many other accomplishments at UB, including beginning the Primary Care Resource Center, winning the Robert Wood johnson Generalist Physician Initiative grant, building and renovating university buildings, and establishing a strong affirmative-action policy. The dean is looking forward to returning to research, teaching, and men to ring new generations of students and doctors. "The things I came to UB to accomplish, I think I have accomplished. You get a certain thrill and high out of that," he says. "We now have a sense of institution. We have stature as a medical school, and it's not just dependent on one or two outstanding individuals. "I am looking forward to the next few years as an academic." + Physician w I n t e r 1 9 9 7 �INTERIM DEAN APPOINTED ohn Wright, M.D., will serve as interim dean and vice president for clinical affairs until a new dean is appointed. Wright, the chair of the Departments of Pathology at UB and Buffalo General Hospital, earned his M.D. at the University ofManitoba in 1959. He completed a residency at the Buffalo General Hospital and then held a National Institutes of Health fellowship in endocrinology there. Between 1965 and 1967 he held a Buswell Fellowship at UB. Wright taught at johns Hopkins University School of Medicine before joining the UB faculty in 1974. Among many other appointments, Wright has served as interim director of Roswell Park Cancer Institute and as director of the university pathology residency program. Wright says he hopes to continue john Naughton's initiatives in reorganizing the Faculty Practice Plan, reorienting medical education toward a primary care perspective, and providing support for the student body. He also hopes to keep the medical school involved in the merger negotiations between the Buffalo General, Children's, and Millard Fillmore hospitals. + B u f f o l o Physician w I n t e r 1 9 9 7 �BY JESSICA The managed care revolution goes into high gear in Buffalo lue Cross and Blue Shield of Western New York set off a firestorm of criticism last year when it introduced Community Blue Advantage, a plan that lets patients opt for lower copays and more services in return for a more limited selection of hospitals and doctors. In another city, this might have been accepted as just another insurance option. In Buffalo, it was considered outrageous. One state legislator accused the company of a "callousness" that was "frightening," and the county medical society at one point demanded an immediate halt to the plan's marketing campaign. Reaction might not have been so strong if doctors and hospitals hadn't already been feeling squeezed by fastmoving changes in Buffalo's health-care economy. Two factors here are compressing and accelerating a market evolution that is familiar to much of the rest of the country. First, a statewide Health-Care Reform Act is changing the playing field for New York State hospitals in 1997. New York had been one of two holdout states that still set hospital reimbursement rates for most insurers; now, all 0 insurers are free to negotiate these rates . Second, managed care is rapidly coming of age in Western New York. While about 30 percent of New York State's population is enrolled in managed care plans, the rate is almost 50 percent in Buffalo. The figures will increase, particularly because state officials hope to enroll 2.5 million Medicaid recipients in managed care in the second step of health-care reform. So the state has stripped hospitals of some protected rates at the same time that managed care is driving down hos- Buffalo ANCKER • pitalization rates. And looking ahead, both insurers and providers fear that for-profit companies will soon move into Western New York. These converging forces have produced a burst of competition in the health-care field . Patient care is rapidly moving out of the relatively expensive hospital setting, hospitals are facing low occupancy rates, and insurers are finding new ways to manage care and to share financial risk with doctors. "It took southern California 20 years to be changed by managed care. It took about eight years for Boston. We're going to do it in 18 months ," predicts jack M. Sieber, a health-care consultant at Ernst&: Young, LLP. "I think we're going to leapfrog some of the steps that other regions went through," agrees Robert V. Stanek, chief executive officer of Mercy Health System of Western New York. "That's a double-edged sword. On one hand, we learn from what's happened elsewhere. On the other, the rapidity of the change will be difficult. " These are some of the changes Buffalo will see in the near future : of? A wave of hospital mergers that could consolidate nearly half of the region's hospital beds into two systems; of? Reimbursement systems that split risks between insurers and providers; Physician W 1 n t e r 1 9 9 7 �-- - - - - - - - - - -- - - -- - - 7 Less money for residency training, which may translate into fewer residency slots; t" More interest by doctors in group practices and other sorts of cooperative arrangements that help them provide patient advocacy and negotiate better deals from payers. Stages of economic change The national health-care economy is changing in fits and starts, and it's different in every city. William L. Kissick, M.D., Dr.P.H. , has a unique perspective on the issue. The author of Medicine's Dilemmas: Infinite Needs versus Finite Resources, Kissick is a professor in the University of Pennsylvania Medical Center as well as Penn's Wharton School of Business. In the 1960s, he served as a staff member to the federal task force that created Medicare. In a recent lecture in Buffalo, Kissick outlined four stages of evolution in the health-care market. The first stage is the traditional system as many doctors fondly remember it. Doctors practiced independently or in small groups and were paid by insurers. There was not much push for lower costs on the part of employers. Kissick cites Syracuse, NY, as an example of a community that is still in this early stage of development. The second stage of market evolution begins when managed-care plans attract more enrollment, and hospitals therefore find themselves contending with lower rates of admission. Providers begin affiliating in loose networks, but are often still reimbursed on a discounted fee-for-service basis. According to Kissick, Buffalo is rushing into stage three. Managed-care providers have become larger, hospitals are merging, and integrated systems are beginning to link health-care financing with health-care delivery. Stage four , he predicts, will feature more highly managed care, fully integrated health-care delivery and finance systems, a high demand for primary care doctors, and leaner times for specialists. B u f f a 1 o - - - - ----- - - ---- Merging to save money Western New York's seven Catholic hospitals are well on their way to becoming an integrated system. They are likely to include Niagara Falls Memorial Hospital as an affiliate. In addition, Millard Fillmore Health System, the Buffalo General Hospital, and Children's Hospital of Buffalo are continuing talks toward a merger. They have released few details about the negotiations except to announce that john Friedlander has stepped down from his position as Buffalo General CEO in preparation for leading the new merged entity. "The health-care industry is going down the same path as the banking, railroads, and airline industries-we're undergoing consolidation to provide a better product from cost and quality standpoints," says Stanek, the Mercy Health System CEO. The mergers offer the potential to save money through consolidations and economies of scale. All the players agree that a considerable fraction of the 4,700 hospital beds in the Buffalo area are unnecessary, although estimates of the figure range from 15 to 35 percent. The mergers could also put hospitals in a stronger negotiating position with payers because insurers won't be able pit one hospital against another or ignore a system that serves a crucial geographic region. Erie County Medical Center is pursuing another strategy, expanding to form its own system with a network of community primary-care facilities to attract more insured patients. Creating a system (through mergers or through expansion into the community) puts hospitals in a better position because they can offer payers a full range of services, better geographic coverage, Physician w 1 n t e r 1 9 9 7 -- and more direct control of costs, according to Sieber. Some health-care experts also say that in the future, full-service healthcare systems may contract directly with large employers, bypassing insurers altogether. A more immediate incentive for mergers is a fear that New York State will drop its longstanding ban on for-profit hospitals. "There's a concern that if the law is changed, a big national provider could come in and scoop up whoever's not involved in a system," says Sieber. "Most people here would rather see community involvement and community control of the health-care system." In addition, for-profit insurers from New York City and from other states have been putting out feelers in the region. Increased competition on top of the state deregulation ofhospital rates would have prompted mergers in any case. The process is being speeded up by the fact that managed care in Buffalo is already so strong. "It's a big change, to take away that protection for hospitals at the same time that managed care is mature," says Arthur Goshin , M.D., president of Buffalo's oldest managed care group, HealthCarePlan. "In other states, either there was no regulated reimbursement, or managed care grew slowly." State law changes the rules New York's health-care reform package does more than just deregulate hospital rates. Among other things, it creates new funding pools for graduate medical education (GME) and for charity care. The changes are intended to stop the 0 �common practice of using GME dollars to help support a hospital's charity care and bad debt. They are also an attempt to reduce the number of residents trained in New York and bring the number closer to the national average of30 to 35 residents per 100,000 population. As a result, Western New York hospitals , which train 40 to 45 residents per 100,000 people, will face a $13.9 million loss in GME dollars, according to] ohn P. Naughton, M.D., who recently retired from his position as dean of the School of Medicine and Biomedical Sciences. While there is concern about how the reforms will affect the future of medical education, doctors are welcoming other parts of the health-care reform law that protect patients and doctors . Among the law's provisions: an absolute ban on "gag rules;" guarantees that qualified doctors will be involved in decisions about whether to cover specific procedures; and grievance procedures for patients denied care and for doctors dropped from insurance plans. Doctors share risk in new payment schemes Buffalo's managed care entities-mostly Independent Health Association , HealthCarePlan, and Community Bluetogether enroll almost 50 percent of the area's population (80 percent of the commercially insured population) . But until quite recently, Sieber says, most managed care companies in New York State have operated through discounted fee-for-service systems, so they weren't that different from indemnity companies. "We called it 'managed care lite."' "It's really been 'indemnity in drag,"' agrees UB's chair of family medicine, Thomas Rosenthal, M.D. As the market grows more competitive, managed care groups are altering theirreimbursement plans. For example, Independent Health Association, an independent practitioner association/managed care organization, has introduced a new system of modified capitation (prepayment on a per-patient basis). HealthCarePlan continues to reimburse physicians on a 'withhold' system, in which the insurer prepays doctors up ® to 85 percent of agreed-upon fees , but withholds the remaining 15 percent until the end of the fiscal year. Doctors who worked within their budgets then get the entire 15 percent; higher costs are deducted out of the withheld money. As an additional incentive, says president Arthur Goshin, physicians will be told the rates charged by hospitals. That will give doctors a reason to prefer hospitals where HCP has negotiated low rates. Blue Cross and Blue Shield negotiates different types of reimbursement with different providers, says Nora McGuire, the executive director of Community Blue, the insurer's HMO. Sieber says there is room for a variety of reimbursement systems. "Capitation is the buzz word today, but it's only one form of sharing risk. It's quite possible that no single method will dominate the market. " Companies are also creating new types of plans. HealthCarePlan, originally a staff-model HMO, recently added a preferred-provider network called Choice Care. But for many physicians, it was Blue Cross and Blue Shield's new HMO product that came to symbolize a threatening level of change. In essence, the company divided its HMO, Community Blue, into two parts. One is the traditional HMO in which patients are responsible for copays for a range of services. The alternative, Community Blue Advantage, offers additional dental, optical, and other services, lower copays, and medical care from a subset of the plan's doctors and hospitals. Patients can go to doctors outside the network for an additional fee . McGuire , the plan's executive director, says hospitals were chosen to participate in Advantage based on the rates they negotiated with the plan. The plan selected doctors based on factors that included cost, geographic distribution, and hospital affiliation. The plan resulted in complaints from hospitals and doctors not included in this abridged roster, although Community Blue managed to soften the criticism after adding ECMC to the Advantage plan and holding talks with the Medical Society of Erie County. B u 1 I a l o Best practices Insurers are also doing more to manage care by trying to standardize the way different doctors practice. In part, they do this by providing outcomes data and other research . Doctors and insurers both agree that doctors are eager to help set best-practice guidelines, and that, if they are convinced of the value of the guidelines, they willingly comply. The desire to better serve patients, as well as peer pressure from fellow doctors, can both play a role. "Doctors want to know the data because they want to use it in their decision making," says Gosh in, president of HealthCarePlan. "Physicians are scientists, and if we direct those energies into getting the best practices, we'll get the best outcomes," says Buffalo Medical Group medical director Richard M. Peer, M.D. "If it's imposed upon them, they will rebel. If they understand the process, and have input, they get enthused." But that doesn't mean that insurers and doctors will agree on what the best practices are. Doctors are concerned that insurance companies' business goals will win out over quality concerns. Insurers suspect that doctors don't appreciate the importance of controlling costs. In some cases, physician organizations can give doctors a greater say in how insurers regulate practice. And physician groups can also help doctors negotiate better deals . As a result, Buffalo's doctors are becoming more interested in cooperative arrangements, such as group practices , physicianhospital organizations, and independent practitioner associations. "Physicians in New York haven't been very organized, but we're starting to see more of that," Sieber says. One of the area's largest and oldest multi-specialty group practices is the Buffalo Medical Group. It was formed in 1946 as a way to pool resources and practice in an atmosphere of professional cooperation, but gradually its business role has become more important. The group now handles all billing, negotiates contracts with insurers, and scrutinizes contract language. Physician W I n t e r 1 9 9 7 �- - -~ ---- - -~-- - - ~- -- --~ - - "If we feel it is to our benefit and to care doctors and giving them a strong economy by realizing the possibility of our patients' advantage, we will partici- financial incentive not to use specialty cost savings in insurances. pate in an insurers' plan as an entire care, money is budgeted for primary In 1984, there were 33 hospitals in group," says Peer, a vascular surgeon care and for different types of specialty the Twin Cities. Within four years, eight who serves as the medical director. care based on usage of specialty services hospitals closed and most of the others A different type of physicians' orga- in past years. Additional financial and had merged into three systems. HMOs nization is the University Medical Group, professional incentives are intended to also merged and consolidated, and phyformed to organize UB's 400-plus physi- encourage specialists to follow certain sician groups grew larger in reaction. cian faculty members. Its chief adminis- practice guidelines and to underspend The result is a variety of networks of trative officer, Greg Brodnick, came to their pool's budget. physicians, HMOs, and clinics that have UB after a career with several Blue Cross ''I'm not suggesting this is the perfect shifted the provision of health care from and Blue Shield plans in New York and way to pay doctors, but we also know hospitals into community-based offices Pennsylvania. the pitfalls of the fee-for-service sysand clinics. A new state program, "I certainly know the other side's phi- tem," Tronolone says. "At this point in MinnesotaCare, provides coverage for losophy," says Brodnick. "That's what the health-care system, there is going to the uninsured. makes me valuable in this situation." be an economic policeman. The patients Buffalo may evolve along similar lines, The group's bargaining strength would be best served by having people or it may find its own solutions, Kissick comes from its diversity of generalists with medical knowledge do that, rather says. One of the critical factors is how and specialists. Also, many of the fac- than the 'bean counters."' doctors engage in the process. ulty practice in the downtown hospitals lawrence McCullough, Ph.D., a Baylor that care for most of Buffalo's Medicaid What nowt College ofMedicine professor who spoke patients. This makes the doctors more Minneapolis was one of the first regions at UB's symposium on ethics and values attractive to insurers who enter the Med- where the health-care economy began in health care, urged doctors to be more icaid managed care market, because the to change, and it's one of the few that has assertive in their response to managed insurers have to enroll enough doctors reached Kissick's fourth stage of ecocare. "I refuse to accept the victimology to care for their new subscribers. nomic evolution, managed competition. language. Physicians are the most pow"Whenever you have big numbers, The area has some similarities to erful, well-organized profession in the you have strength," Brodnick says. "Our Buffalo. Like New York State, Minnecountry. It's time to stop complaining goal is to get our doctors signed on with sota prohibits for-profit hospitals. Minand start acting." all the third-party payers. We can say, neapolis' population of 2.6 million is He told doctors to accept the fact that 'Either you take all of us, or you get none about twice that of the Buffalo-Niagara all payment schemes would include fiof us."' County region. However, unlike Bufnancial incentives, but urged them to Another sort of physician group is the falo, Minneapolis has a core of powerful fight to ensure that the incentives do not Independent Practitioners Association of Fortune 500 companies, which spurred cripple clinical judgment, that ethical Western ewYork, which comprises the much of the change in the health-care components are included in quality indoctors who work for Indicators, and that patients dependent Health. The are fully informed about IPA is so integrally contheir insurance plans. nected with Independent Kissick urges providHealth that the insurer ers and insurers to work essentially pays capitatogether to ensure such Carrie B. Frank has been appointed intion money to the docsocietal goods as conterim president and chief executive officer tors' organization, which sumer choice, low-cost of the Buffalo General Health System. then pays physicians. The care, and organized She succeeds John E. Friedlander, who IPA's president, Michael practice. has stepped down to lead the developTronolone, M.D.,says the "To manage or be ment of a merged health care system that IPA gives doctors a strong managed, that is the quesmay include Buffalo General, Children's voice in the plan. tion," he says. "Whether Hospital of Buffalo, and Millard Fillmore Tronolone says the 'tis nobler in the mind to Health System. doctors' group negotisuffer the slings and arFrank had been Buffalo General's exated a form of capitation rows of outrageous forecutive vice president and chief operating Carrie B. Frank that spreads financial tune, or to take up arms officer since March 1993. Before that, she risk among all types of against a sea of troubles, had served in a number of financial roles, including vice president practitioners. Instead of and by opposing end of finance and chief financial officer. capitating the primary them." + New CEO named for the Buffalo General Hospital a u f f a l a Physician w 1 n t e r t 9 9 7 �by Jess ca Ancker B photos u f f a l o P hysici by a n K.C. W Kratt I n t e r 1 9 9 7 �-- - - -- ----- ~ - - - - ·- -- - - - • ____n • the isto~ of medicine In UB\ RoBERT L. BROW\! HISTORY OF MEDICINE COLLECTION HAS BECO:YIE A LITTLE RICHER. A first edition of a 16th-century obstetrical text donated to the collection this fall became the University Libraries' 3 millionth volume. And a $500,000 endowment by the History of Medicine Collection's strongest supporter will enable the library to expand its unique collection. Volume number 3,000,000 is a 1554 first edition of Jakob Rueffs De GALEN PERGAMUM, 0 one of the most famous physicians of antiquity, practiced in Rome in the second century of the Christian era. His texts dominated medicine in Europe , Byzantium, and the Arab countries for more than 1,000 years. This book, Galeni Pergameni omnia, quae extant, in latinum sermonem con versa (The surviving writings of Galen ofPergamum, translated into Latin), is a compilation of his writings published in Basel in 1561. The detailed hand-coloring of the frontispiece evinces the respect accorded to Galen's name even at this date. B u f f a l o conceptu et generatione hominis. The Rueff book was presented to the University Libraries by George M. Ellis, M.D., class of 1945. It builds on the strengths of the collection, which was started by james Platt White, M.D. (1811-1881), a founder of the UB medical school and its first professor of obstetrics. White's collection of more than l ,000 medical texts was bequeathed to the university and became the nucleus of the History of Medicine Collection. The late Robert L. Brown, M.D. '44, was a strong supporter of the History of Medicine Collection throughout his 25-year career in the medical school. Brown, who at one point served as acting dean and later became the school's first associate dean, supervised the merger with the State University of New York. He also served as the medical school archivist, locating and preserving historical records that otherwise would have been lost. In 1985, the year of his retirement, the History of Medicine Collection was named after him. Brown's $500,000 endowment to the collection is one of the largest ever received by the library system. The 12,000-volume History of Medicine Collection already houses a trove of unique books, the oldest dating to 1493. In this issue of Buffalo Physician, we introduce a few of them to readers. Physician W I n t e r 1 9 9 7 �MAKING ANDREAS HISTORY THE HISTORY OF M E D ICI E VESALIUS of Brussels revolutionized the study of anatomy in the 16th century with detailed descriptions and illustrations drawn from his own dissections. He generally suspended his specimens from a pulley, so the organs and tissues in his illustrations often appear to be dangling from the cadaver. Because his observations updated and sometimes contradicted those of the ancient authority Galen, Vesalius came under fire from some critics who accused him of disregarding tradition. While the original sketches may have been made by Vesalius himself, the woodcuts, some of the most famous images in medical history, are thought to have been carved by assistants to the artist Titian. Two hundred seventy-seven wood blocks were created for the 1543 first edition of De Humani Corporis Fabrica (Of the structure of the human body) and an accompanying abridged edition called the Epitome. Some of the original illustrations were replaced by copies in later editions. UB's History of Medicine Collection owns one of these, a fourth edition (the closed book shown above). The original blocks were lost and rediscovered several times over the next few centuries as they passed through the hands of collectors , artists, and librarians. The New York Academy of Medicine and the Library of the University of Munich printed what would become the book' s fin al edition in 1934, a copy of which is shown above and at right. The blocks were destroyed in the Allied bombing of Munich in World War II. B u f f a l o Physi c la W I n t e r 1 9 9 7 �-- - - -- MAKI ~-- ~ - ~ THE G HISTORY DE c 0 N c E PT U ET GENERAT I 0 N E -- ~ ~- - - -- HISTORY OF MEDICI - E H 0 MIN Is (Of the conception and generation of men) was published by Swiss obstetrician Jakob Rueff in 1554. The book's Latin text covers contemporary knowledge about conception, fetal development, uterine anatomy, birth, and care of mother and infant. Rueff is believed to be the first author to recommend the use offorceps in live births . The woodcuts, although in many cases derived from illustrations by Andreas Vesalius, also correct some flaws in Vesalius' representations of the fema le reproductive organs. The woodcuts were carved by Jost Amman, who was also noted for his Biblical scenes. Shown here are depictions of abnormal presentations of the fetus. Presented to UB this year by George M. Ellis, M.D., UB class of 1945, De conceptu became UB 's 3 mill ionth library volume. B u f f o 0 p h y c o n w e 9 9 �MAKING THE HISTORY HISTORY OF MEDICINE SURGEON BRITISH William Cowper published the first edition of his popular Myotomia reformata, or an anatomical treatise on the muscles of the human body only three years after he entered the practice of medicine. The 1724 edition shown here, with its beautiful copperplate illustrations and capital letters, was published posthumously. During his career, Cowper identif ied the bulbourethral gland and the fascia pectinea ligament, both of which are now named after him . He also published other works on hardening of the arteries and surgery of the maxillar sinus. One of Cowper's publications, The Anatomy of Humane Bodies, became the focus of a plagiarism scandal. Scholars believe he bought the copperplates to Anatomia Humani Corporis, published in Amsterdam by Govert Bidloo, and republ ished them with his own English text and a new appendix. Lacking modern copyright protect ions, Bidloo retaliated by publishing a scathing attack calling Cowper a literary crimina l. ® B u f f o l o Phys i cian w I n t e r 1 9 9 7 �- -- -- - MAKI --- - -- G HISTORY WILLIAM HUNTER'S TheAnatomyof - -- - - -- - - - - TH E O F MED I C I erus ex eHum 1 - E ite! in figures reveals both his expertise in medicine and the value he placed on art. Hunter and his artists and engravers worked for 30 years to create this book, which was published in 177 4 by John Baskerville. Born in Scotland , Hunter practiced obstetrics and surgery in London . He opened his own School of Anatomy and lived on its premises , teaching and building his collections of anatomical specimens, rare books , coins , and paintings . B u f f a t o Phys l c l a W I n t e r 9 9 7 �MAKING "LET THERE BE A THE HISTORY T t STD UT ASS I STA HISTORY OF MEDICINE hold the pa ient's head firmly, and let others put their hands on his arms and knees." Such practical advice for surgery before the advent of anesthesia is found in Bell's Great Operations of Surgery, published in 1821 by the British surgeon Sir Charles Bell , who made a special study of the nervous system and was the first to describe Bell 's palsy. In his Great Operations, Bell detailed the tools and procedures used in such operations as trephining the skull, correcting hernias, amputating limbs, and removing bladder stones. An accomplished artist, he also illustrated his own book. In his advice to young surgeons, Bell draws on the experience he earned during his career in London and Edinburgh: "The extraction of the [bladder] stone most requires patience, and a disregard to what spectators are thinking of you, especially fools with watches in their hands." According to an inscription on the flyleaf, this copy of Bell was given to Roswell Park, M.D., in 1882 as a Christmas present. Park's own signature also appears on the title page. ~ I ® 6 u f f 0 l 0 Physlclo w I n t e r 1 9 9 7 �- --- - - ---- - - MAKI -- ~-- -- - - --- ~ G HISTORY - --- - a stonemason , was admitted to the hospital on March 20 , 1854, with debilitating faintness and lack of appetite. He died the next day. This hand-colored lithograph portrait of lveson in Thomas Addison 's 1855 book On the Constitutional and Local Effects of Disease of the Supra-Renal Capsule, illustrates the patient's overall pallor and some smoky skin discolorations on his face and chest. Addison was the first to link the discolorations, the faintness, and the weak pulse with autopsy findings of diseased supra-renal capsules (the adrenal glands). The disorder, called Addison's disease , is now known to occur when tuberculosis or autoimmune problems destroy the adrenal cortex and result in deficiencies of aldosterone and cortisol. This edition of Addison is exceptionally valuable because it was presented to the History of Medicine Collection by George M. Thorn, M.D. , UBclass of1929, who was one of the developers of the treatment for Addison 's disease. The book is inscribed to Thorn by " a grateful patient. " u f f a l a Physician -- - - ~ TH E HISTORY O F ME DI C I IVESDN, e - W i n t e r 9 9 7 - E �• ····· ·· ···························· ···· ······················ · ················ · ········· . I New faculty member is a regular voice on NPR hroughout her career, Miriam Shuchman, M.D., has drawn on her medical expertise to write articles for the popular press and to create broadcast commentaries and documentaries. Today Shuchman, a member of the psychiatry departments at UB and the Erie County Medical Center, is also a regular medical commentator on NPR's "Medical Rounds." A graduate of the University of Connecticut Medical School, she completed her residency in psychiatry at Massachusetts General Hospital and Harvard Medical School. Fellowships at Dartmouth-Hitchcock Medical Center inN ew Hampshire and the Robert Wood johnson Clinical Scholars Program at the University of California at San Francisco allowed her to pursue her interests in consultation psychiatry and medical ethics. She has also worked as a psychiatrist at San Francisco General Hospital. Since moving to Buffalo in 1995, Shuchman has been spending three days a week at ECMC and the rest of the week in Toronto with her husband, Don Redelmeier, a physician on the faculty of the University of Toronto, and their son, 2-year-old Daniel. Some of Shuchman's work for the popular media has been in collaboration with Michael Wilkes, M.D., Ph.D., one of her classmates from both high school and medical school who now teaches at University of California at Los Angeles Medical School. In their first collaboration, an article for the Hartford Courant newspaper written while they were in medical school, they discussed the medical school socialization process that helps turn a student into a doctor. Later, in regular columns for the Los Angeles Times and the New York Times, Shuchman and Wilkes educated readers about such medical issues as clinical depression, back pain, smoking cessation, and vaccines. Their writing caught the attention of a National Public Radio executive, who invited them to create their monthly program for Weekend Edition Sunday. Their close professional relationship shows in the smoothness of their fastpaced discussions on the radio program. One of them may begin an explanation of the day's topic, and hand it over to the other to complete, as in a well-rehearsed duet. They translate medical terms into simpler language that will be familiar to a lay audience. When they disagree, they do so politely but unapologetically. In the week before each broadcast, Shuchman, Wilkes, and NPR host Liane Hansen hold a telephone meeting to choose a headline-grabbing topic. Shuchman then prepares herself with a blitz of research. She combs through professional journals and news clippings and interviews experts around the country. She may ask professional societies, such as the American Psychi- B u f f a I o atricAssociation, to provide background material, or seek the help ofNPRstaffin collecting relevant news articles. On a recent "Medical Rounds ," Wilkes and Shuchman discussed nonsteroidal anti-inflammatory drugs such as Aleve. They pointed out that these drugs can cause serious side-effects, including ulcers. Hansen asked whether self-medication was dangerous. ''I'm not sure that medicating oneself when it's a matter of having pain is such a bad idea," Shuchman said. "You don't want to always have to call your doctor and say, 'I have this pain again, what do you think I should do?' It does make it easier for people that they can walk into the drug store and talk to the pharmacist and say, 'I know that there are a number of these drugs which are over the counter. What do you suggest?"' "I think I've got to disagree, Miriam," Wilkes responded. "I think that few people talk to the pharmacist when they buy over-the-counter drugs. I'm worried about how many people end up in the hospital with serious complications like ulcer disease, etc., and even death, as a result of taking too many of these drugs. " The pair said later that the issue was one on which they have long disagreed. "Michael tends to wear a public health hat, and I tend to wear an individual patient hat," Shuchman said. "I really think there's a limit to how much people want to be protected from thingswhether it's in medicine or in something else, like the speed limit on the highway. We know that a 55 mile-perhour speed limit is safer, but people want to drive faster. " Much of Shuchman's media work focuses on mental health, including such topics as the impact of violence on children who witness it and the value of talk therapy and medication in the treatment of depression. She is working on a radio documentary on schizophrenia for the Canadian Broadcasting Corporation to be aired in spring 1997. Physician W I n t e r 1 9 9 7 �Why Jtay home for the holUJayJ? Tbefront-wbeel orive Infinitt-® /30TM Miriam Shuchman, M.D. Shuchman won the 1996 Media Award from the Northern California Psychiatric Society. It's unusual to get such praise for her journalism work, Shuchman says. "Far more often, you get a letter from someone who disagrees with you or is offended by something you said." But, she says, she appreciates even these letters. She recalls one example, a "Medical Rounds" program on a Supreme Court ruling that protected patient-psychotherapist confidentiality. "It's a stigma for people to find out you've been in therapy. It can often prevent you from being promoted at your job," Shuchmansaid on the air. "So the court was recognizing that people have to know that what they say to a therapist will be confidential in order to feel that they can even go into therapy." Shuchman also pointed out that religious confessions are generally considered privileged, and she described the public outcry over an Oregon case in which prison officials secretly recorded a murder suspect's confession to a priest. Within hours of the broadcast, Weekend Edition Sunday received an e-mail from an Oregonian. "Dr. Shuchman pronounced the name of this beautiful state, Ore-gawn," he wrote. "As every Oregonian knows, and as every easterner who's never been here seems never to know, IT IS PRONOU CED ORYGUN!!! as in 'He may have a knife OR A GUN!! ' Incidentally, people in Eugene are often B u f f a 1 a offended when people say YOU-gene rather than the correct pronunciation: you-GE E. So, let's all say together, 'The taped Catholic confession happened in you-GE E, Orygun."' Although the letter may have been a bit embarrassing, it did turn out to be a learning experience. In a later "Medical Rounds," Shuchman discussed state measures on managed care, including a proposition on the Oregon ballot. "Listeners might not have agreed with me, but at least I pronounced the name of the state correctly! " She adds, "If I get letters that are very moving, where people share their personal stories or have been offended or hurt by something I said, I'll often call back or e-maiL" In one case, after a program on mastectomies and lumpectomies, she spent several hours on the phone with a listener who had lost his wife to breast cancer. Shuchman sees her two careers, medicine and journalism, as closely intertwined. Being a physician gives her the credibility to influence the public's understanding of medical issues. "I keep getting grabbed by stories, coming from my patients, or my students, or the ideas that come up in practice." + "Medical Rounds" is broadcast once a month as part of NPR's Weekend Edition Sunday, which is heard in Buffalo on Sundays from 8 a.m. to noon on WBFO-FM. Physician w I n t e r 1 9 9 7 An interior /TUJre Jpaciou.J than a Rnli.J Royce Sif.,er Spur Ill. An exceptionally genermu lut of JtaniJariJ fu:r:ury featuru A 190-hp V6 capable of out-accelerating mo.ny lu:r:ury V&l. AniJ of courJe, the JtaniJaru-utting performo.na and Javia of 1nfiniti. SJ99 mo. ]6 mo. feaJe 1999.00 dou•n Intro ducing tbe all n ew 97' QX4® f rom 1]5,550.00 In an lnfiniti® QX4®, one of the firJt thingJ you 'll eJcape i.J the mundane. BecaUJe the QX4 i.J not your typical lu.:-cury Jporl utiliiy vehicle. Whdt: it o/ferJ all the verJatility you e:r:pect from a vehicle of itJ l::iniJ, the QX4 offerJ Jomething you IJon 't e.:r:pect: the lu:r:ury of an I nfiniti. I N FIN IT I AUTO PLACE INFINITI 8129 MAIN ST., WILLIAMSVILLE 633-9585 East of Transit Rd ., Near Eastern Hills Mall ( 130-$450). Bank fee + tax and license due at inception. 12,000 annual mileage. s.15 per mile' in excess. �Trauma surgeon John R. Border dies ohn R. Border, M.D., an internationally known researcher whose pioneering work continues to save thousands of accident and injury victims from multiple-system organ failure, died on Monday, ov. 11, of a heart attack at his South Wales, NY, home. He was 70. Border, who joined the UB faculty in 1965 as a member of the Department of Surgery, was director of the trauma service at Erie County Medical Center and director of UB's Trauma Research Program from 1968 until his retirement in 1991. In the early I970s, he led nized and treated as soon as a team of UB researchers in possible after the original developing treatment plans trauma," he emphasized. to prevent the stress of seMuch of the lifesaving vere, multiple trauma from research over the years was producing a chain of biofunded through grants chemical events that, if not from the National Institreated with combination tute of General Medical protein and glucose therapy, Services. could lead to death. Although officially retired, Ina 1982 interview, BorBorder continued his work, both locally and internationder explained that when the John R. Border, MD . . body does not receive adally, to improve the treatequate amounts of protein to meet in- ment of trauma patients. Wearing his creased demands to maintain function trademark fire-engine-red suspenders, and begin repair of damaged tissue, it white shirt and tan slacks, he regularly draws on its own resources from muscle visited his office at ECMC. and other vital organs. The modest, soft-spoken Border "The fatal sequence-multiple- trained hundreds of UB medical stusystem organ failure-must be recog- dents and residents during his career, WNY's Largest Volume BMW Dealer THE ULTIMATE DRIVING IF BEING STARED AT MAKES YOU BLUSH, PLEASE CONSIDER YOUR CHOICE OF COLORS ACCORDINGLY. MACHINE~ F. G. DOWNING Towne BMW 3030 Orchard Park Rd . Orchard Park, New York 14224 Phone: 675-2550 $29 320 ' 1996BMWZ3 With a plethora of colors to choose from, you'll want to pick a roadster that goes with the crimson hue you 'll be sporting each time you take it for a spin . Service Loaners Available ... Minutes From Rich Stadium a u f f a l a Physician W I n t e r 1 9 9 7 �- - - --- -----~~- - - --~-- --- - - - HURWITZ & RNE, P.C. [ ATTOR EYS AT LAW I inspiring them by his example to not only be good surgeons, but to practice the art of the profession. It was not unusual for him to sleep overnight in his office at ECMC in case a patient he was especially concerned about needed him during the night. A 1956 graduate of Harvard Medical School, he did his undergraduate work at Harvard College and Indiana University. He served in the U.S. Navy Submarine Service from 1944-48. He and his wife, the former Donna Orvedahl, traveled on the Great Lakes and down the East Coast on their sailboat, Don]on II. + SERVICING THE LEGAL NEEDS OF THE HEALTH SCIENCES C OMMU ITY • Managed Care • Purchase & Sale of Practices • Business & Tax Planning • HCFA Safe Harbor Regulations and Physician Self-Referrals • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs "It's ok to ploy!" said Ringling Bros. clown John Lynch. Lynch, the son of on endocrinologist, discussed humor in medicine with students in Butler Auditorium while the circus was visiting Buffalo in November. • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence M. Ross at 716-849-8900 Fourteen physicians have completed UB's first Master's Teaching Fellowships, which offer training in clinical teaching and precepting. Bock row: Thomas Scanlon; Michael Terranova; Jock Coyne; Richard Carlson; Joe Lanigan; Sanford Levy; Anthony Vetrano. Front row: Tim Siepel; Donald Robinson; Colleen Mottimore; C.V.P. Varma; David Novelli; Thomas Gerbasi. Not pictured: Richard Ruh. 6 u f f a l o Phys ician w I n t e r 1 9 9 1300 Liberty Building Buffalo, New York 7 �TAKE TWO. I I AND CALL ME IN THE MORNING! f;"\d ~o..,r OW"\ ro(l[ * Fact: Saab owners have a elebrate the higher education level than any other car owner group. * Saab purchase prices starting low to mid 20's; leases starting at $299 per month. • * According to the Insurance . lfl Marrtott Institute for Highway Safety {IIHS), the Saab 9000 has the lowest fatality rate of any production car on the market. SOUTHTOWNS SAAB tyle! 3580 Southwestern Blvd (1 Mile east of Rich Stadium) (716) 662·8008 From elegant parties to informal get-togethers, let the Buffalo Marriott host a celebration filled with warm fellowship and gracious hospitality. TheDollar Doctor... For Exceptional Entertaining ... Banquet rooms accommodating 10 to 1000 Superb catering with choice of packages Expert planning assistance For Your Office Festivities . .. Enjoy a special holiday luncheon or dinner with Panache Restaurant's delicious steaks, seafood and pasta. Information Insights Opinions Finances Stocks & Bonds Call in Listen In For Anytime Holiday Cheer! Stop in The Night Club Lounge for dancing and socializing with old friends and new! Book your holiday party today! Call the Catering Office at 689-6900 Ext. 61. BUFFALO.,\\arnott. 1340 Millersport Highway Amherst, NY 14221 (7 16) 689-6900 (800) 334-4040 FAX (7 16) 689-0483 WWKB, 1520 Saturdays 9:05 to 10:00 am ~~P!:,!:~~IJ Member: American Stock Exchange, NASD, SIPC 237 MAIN STREET Tel: 854 -7541 ® 6 u f f 0 l 0 Phys ici an W I n t e r 1 9 9 7 �·--- - - --~ ~ - - TRACING THE MOVEMENTS OF CELLS When walls between research disciplines break down, the change opens up new opportunities and new ways of looking at old problems, according to cell biologistjohn Kolega, Ph.D. B u f f a 1 o muscle cells; specifically, the migration of the endothelial cells that line blood vessels. These cells migrate during normal development when blood vessels are formed, and also during wound healing, tumor growth, and diabetic blindness caused by blood vessels forming in the retina. Kolega is attempting to establish how and when cells organize and distribute the motor protein myosin II, and how cells regulate the function of the protein. To watch cells move in three dimensions, Kolega places them in a collagen gel. Careful observations of moving cells are revealing how this molecule might act to move different parts of a cell as it crawls. A related project that examines how electrical stimuli affect the permeability of a sheet of cells may shed more light on cellular mechanisms of blood vessel leakage. Although some of the molecular structure and mechanisms are beginning to be understood, it's not known how they all work together. Visual imaging may provide some of the answers, Kolega says. For example, he uses fluorescent imaging to examine spe- Physician W I n t e r ~ cific proteins within living cells as they move. "One of the things that is exploding in my field is the imaging technology-the whole battery of different forms of microscopywhich is allowing us to visualize things in the cells that we could never see before. Things that were worked out by biochemists in test tubes are starting to be seen within the living cells. That is going to take the tremendous advances in molecular biology and translate them into real biological behaviors. We can now start to watch these things happening." New discoveries in the field are likely to be applicable to all cells, Kolega says. "I happen to be working on endothelial cells, in part because it's easier to get funding for something with clinical applications, but I like to think that my work will help answer the basic question of how non-muscle cells migrate." + John Kolega, Ph.D. Cell Biologist "It's no longer good enough to know everything about molecules or cells or organisms," he says. "The really interesting things are going on at the interfaces between the old disciplines, where you have people with different expertise looking at a system from different levels." Thanks to this new interdisciplinary emphasis in research and education, Kolega is now delivering human anatomy lectures to firstyear medical students, in addition to working with endothelial cells in the lab. Kolega, 38, earned his doctorate at Yale and held post-doctorate positions at the National Institutes of Health, New York University Medical Center, and Carnegie-Mellon University. Upon joining the Department of Anatomy and Cell Biology at UB, Kolega took a crash course in human anatomy so that he could share the responsibility of teaching basic preclinical courses. He spent virtually every day of his first year at UB in the anatomy lab. "I was just one step ahead of the students," he groans. When not lecturing or supervising dissections, Kolega continues his research into cell migration. His field is the locomotion of non- - - -JESSICA 1 9 9 7 ANCKER �• ............... . ... . ................ . . . ....... ~ I Extemships provide a taste of the real thing ven with today's emphasis on clinical experience in medical education , it's not every second-year student who gets to do an abdominal paracentesis or a flexible sigmoidoscopy. Clayton Polowy did. "I had some serious hands-on experience as far as procedures went," Polowy recalled of his 1996 experience in UB 's Primary Care Summer Externship program. "It's basically primary care medicine and preventive medicine at its highest degree ." Polowy, now a third-year student, was one of 7l first- and second-year students in the program last summer. The externship, which pays students to spend the summer working with a primary care doctor, was developed in 1993. Of the 55 externship participants who have graduated from medical school, more than two-thirds have gone on to residencies in primary care. "It's designed to give students a taste of reality in Geraldine Kelly, M.D., supervises as student extern Mark Oberlies terms of primary care mediexamines a patient. cine," said Kim Crooks, who coordinates the program at UB's Primary Care Resource Center. "A certain. The current budget comes from lot of programs are modeled after this one. a variety of sources, including the mediI get calls from all around the country." cal school, the Robert Wood johnson The six-week externship remains un- Foundation, and the state Department usual in the large number of students it of Health. The Independent Health enrolls and in the stipend it pays: $1 ,200 Foundation has also provided support for first-year students and $2,000 for since 1995, and it recently decided to those in their second year. That helps make a significant contribution for 1997. push the annual cost to $125 ,000, but it "The goal of the foundation is to immakes it possible for more students to prove the quality of health in the combenefit from the full-time externship ex- munity, and we feel strongly that if perience. ''I'm maxing out my loans," there is a large pool of primary care said Polowy. "It was nice to feel that I physicians in the area, we're going to be didn't have to work on top of doing that. " able to accomplish that," said joanne Because it has no guaranteed source Way, the executive director of the founof funding , the program's future is un- dation, which is connected with the ADMISSIONS TEST January 11 and February 8, Upper and Middle Schools March 8 and April 26, Middle School • Exceptional college placement record • Challenging curriculum with the most Advanced Placement courses in Western New York • Average class size of 14 students • More than 60 athletic teams • Comprehensive visual and performing arts program • Financial aid available For further information, call: 875~8212 ICHOLS MIDDLE SCHOOL, 175 Nott ingham Terr. NICHOLS SCHOOL NICHOLS UPPER SCHOOL, 1250 Amherst St. B u f f a l o P hysician w I n t e r 1 9 9 7 �- - - -- ~~-- -· - managed care company Independent Health Association. In addition, the Millard Fillmore Health System, the Millard Fillmore medical staff, and the Howard Wilding Memorial Fund of the Millard Fillmore Health Education and Research Foundation have made donations totaling $30,000. The externship is a way of introducing students to clinical medicine and the Buffalo medical community, said TimothyGabryel, M.D., vicechairmanofmedicine at Millard Fillmore. "It helps them to see that what they went to medical school for really exists," he explained. "The best feedback for us is when we see the enthusiasm in the students," said TonyBarthalomew, M.D., who with his partner, jay Bishop, M.D., has been an externship preceptor since the program started. It was at their Fredonia practice that Polowy got his experience. "In six weeks you really get to see a lot," Polowy said. "One time, I did a joint injection." He recalled how his preceptors would take the time to pull a book off the shelf before discussing a procedure, or would provide an immediate critique of the way he interviewed a patient or made a presentation. "I was always treated by the staff and the physicians as a colleague," the student said. Emily Calkins, another third-year student, was inspired by her 1996 externship with Deborah Richter, M.D. , in Buffalo's Geneva Scruggs and Mercy health centers. "She was just a great role model for me , which I needed during medical school," said Calkins. "You see so many social problems , and she handled them so well. For many of these patients she was the only place they could turn for help. I keep her in the back of my head at all times , wondering, 'What would Dr. Richter do? "' Mark Oberlies, a third-year student who has had two summer externship experiences, said he was already interested in primary care, but he had a nagging uncertainty about whether any B uffalo - - - physician could truly master the scope of practice encountered by generalists. "As a medical student you feel so utterly clueless when there's so much coming at you, " he said. "You just think, 'I've got to get to my little area of medicine and learn everything I can about it. ' At the same time you've got people telling you to be a famil y doc and take care of everything. I needed to see if I could do that. " Oberlies spent the first summer working with geriatric patients under June Chang, M.D., and the second summer with Geraldine Kelley, M.D., at Mercy Hospital. "I take a lot of comfort from the examples of these people," Oberlies concluded. "I have a lot of respect for the people I've met in both externships. The greatest success of the program for me was that it showed me that primary care is doable. People can do it, and do it well. " + - AN DREW D A N Z 0 - & THE ULTIMATE DRIVING MACHINE ~ Checkpoint Foreign Car, Inc. Sales and Service • 487 Kenmore Avenue Buffalo, NY 14223 UB and Buffalo General announce new partnership with Bosnia 836-2033 fficials from UB met at the White House on Oct. 2l for a ceremony to announce a partnership to help Bosnia rebuild its health-care system after years of war. Leaders from UB, the Buffalo General Hospital, and the city of Buffalo were guests of Hillary Rodham Clinton. Buffalo General has had an informal relationship with Tuzla Clinical Center for two years, through the efforts o[Jacob Bergsland, M.D. , a cardiothoracic surgeon and UB associate professor of surgery. The new project, funded by $2 million from the United States Agency for International Development, will offer educational programs and the exchange of clinical personnel. Nearly 120 healthcare professionals have already enrolled in the program at the clinical center in Bosnia-Herzogovina. + Your WNY Leasing Specialist Serving WNY proudly for 33 years Physician W I n t e r 1 9 9 7 • - • ~AR ® �THEN ~~AND~ N 0 W When the germ theory was still atheory BY GEORGE HADDAD, eorge Haddad, M.D. '94, is pursuing a doctorate in the Department of the History of Science and Medicine at Yale University. In his paper "Germ Theories, Scientific Medicine, and the Buffalo Medical Community," Haddad argues that there were numerous kinds of germ theories before Robert Koch's discovery of the tuberculosis bacillus, and that much of the local scientific debate was actually a "fixing of the meaning" of the phrase "germ theory." He also shows that scientific advances did not move, ready packaged,from European and American academic centers to peripheral communities like Buffalo. Instead, these smaller communities underwent their own periods of debate and upheaval before reaching consensus. The following excerpts from Haddad's work focus on the writings of one outspoken opponent to the germ theory. Haddad's full paper, along with other articles on western New York medical history, is being published in Medical History in Buffalo 1846-1996: Collected Essays, by the Friends of the Health Sciences Library and the University at Buffalo School of Medicine and Biomedical Sciences. Copies are available from History of Medicine curator Lilli Sentz at (716) 829-3024. Fighting the new theory F rederick R. Campbell was born in Niagara County in 1860. He graduated from the Buffalo Medical College at age 24 and later joined the medical department of Niagara University, where he taught "Hygiene" and "Materia Medica and Therapeutics." In addition to medical acumen, he had literary and historical interests, and his schol- M D arly output included a book entitled The into a certain lineage of medical theories, Campbell opened the germ theory Language of Medicine. In june of 1885, Campbell wrote an to criticism that other theories also faced. Two years after Robert Koch's discovarticle entitled "Chemical vs. Germ Theories of Disease" in which he offered ery of the tubercle bacillus, Campbell a historical account of the dialectic be- realized that the role of doctors in the new tween the "chemical-humoral" and germ theory world was about to change. "germ-parasitic" theories of disease. just "When the germ theory becomes an esas the history of philosophy had experi- tablished fact," he scoffed, "the true phyenced a dialectic between idealism and sician will become a mere manipulator of materialism, Campbell believed that germicides, and the pathologist a student of microscopic medicine, too , had botany." a specific sort of This did not dialectic between mean Campbell different theories of was opposed to an disease. He wrote: "There was a huideal of scientific progress in medimoral pathology of cine. On the conthe Ancients, estrary, he saw sentially a chemichemical theories cal theory of disof disease and orease, replaced by ganic chemistry as the vegetable parathe legitimate heirs sitic hypothesis of to the scientific traVallisneri, dition. He claimed Hauptmann, and that there were Linaeus. Then "many honest sciStahl proposed a entific men who purely chemical are unwilling to theory of disease, accept, in their but this has been Frederick R. Campbell, M.D., in a portrait present state, the followed by the published posthumously in the BuHalo Medical views of the germ theory, sug- and Surgical Journal. 'bacteriologists.'" gested by the revIn his comparison of chemical and elations of the microscope, and brought to its present stage of development by germ theories, Campbell exploited the such men as Virchow, Pasteur, Tyndall, optical limits of microscopy and offered and Koch. " a large number of well-articulated obBy placing the germ theory within a jections to a germ theory. For example, genealogy of medical theories, Campbell microscopes of the time could not disstressed the contingency and contro- tinguish between bacteria associated versial nature of a germ theory of dis- with very different diseases, and so, as ease. Moreover, by placing a germ theory far as Campbell knew, they were identi- B u f f a 1 o Phys ician w 1 n t e r 1 9 9 7 �- ~ -- - - ~--------, -- - - - - -- T H E N ..A'NDII N 0 w cal to each other. However, Campbell and antisepsis were mediated through thought it was nonsensical to blame chemical processes. The germ theo"identical" bacteria for varying diseases. rists, according to Campbell, had He also asserted that "bacteria and serendipitously, through erroneous theories, fallen micrococci are always found on the upon the proper surfaces of mucous methods of surmembranes and gical antisepsis. these organisms In a translation differ in no respect and commentary from those found in upon a French ardiseases." Moreticle published in over, he denied the the Buffalo Medical clayo al<l, •llowiloc 'I" ...... contagiousness of and Surgical jourtuberculosis and in- This laboratory sketch of cholera germs under the nal, Campbell exsisted that tubercu- microscope was published in the BuHalo Medical pressed his concern losis could be and Surgical Journal by George W. Lewis, M.D., about the social caused by a number a contemporary of Campbell's who defended costs of accepting of different, non- Koch's germ theory. At the time, it was rare for the germ theory of bacterial "irritating the journal to print any drawings or visual aids. disease: substances." "As to the social Campbell's "chemical theory," on the consequences, they have been seen in the other hand, explained infectious dis- recent epidemics in Italy and the south of ease by insisting that the introduction of France, where scenes of barbarism befit"some chemical substance" can result in ting another age were enacted. In Italy, it disease. He believed that chemical poi- appears proprietors demand that persons, just like drugs or bacteria, could sons suspected of having phthisis [tuberhave "selective powers." Moreover, culosis] shall vacate their property." In this piece, Campbell asserted that Campbell believed that chemical theories offered a "more rational basis of laboratory scientists do not do as much treatment than germ theories." Ulti- for practical medicine as "those who mately, Campbell believed that a chemi- pass their lives surrounded by diseases." cal theory of disease would be estab- Campbell's belief that he and the other lished as fact once scientists studied opponents of a germ theory were depathological chemistry as well as patho- fenders of "true clinical medicine" reflects the cleavage in medical identity logical anatomy. Campbell ended his diatribe against that the germ theory controversy progerm theories by rhetorically equating duced. Campbell drew a clear line bebacteriologists with alchemists. Bacteri- tween the practice of traditional bedside ologists "have already given the world medicine and the laboratory dabblings many valuable discoveries," he began. of the new medical scientists. In another Buffalo Medical and Surgi"] ust as the alchemists of old, while seeking the philosopher's stone and the elixir cal journal contribution, Campbell vitae, brought forth what was even more scoffed at bacteriologists for claiming valuable to mankind, modern chemistry, that they had discovered the true nature so the microscopists have paved the way of disease and reminded them that they, for the greatest discovery of modern medi- just as past believers in systems of medicine, were susceptible to new discovercine, surgical antisepsis." By this, Campbell did not suggest ies and revisions: "Were not the astrologists, the that antisepsis relied on a germ theory of disease. He firmly believed that sepsis humoralists, and the solidists of old ----...... ... ...................._ ""'..._·_ B u f f a 1 o PhUSICian W I n I e r 1 9 9 7 equally as certain as the modern bacteriologists, that they had discovered the true nature of diseases? Who can say that some writer in years to come will not ridicule those 19th century doctors who believed that microorganisms, like the demons of old, produced diseases in man?" A laudatory obituary of Campbell appeared in the same issue of the journal. His life ended at age 28. "He fell victim to typhoid fever, after a sickness of over a month," wrote the editors, who then tactfully commented, "Indeed it may be said that his death was the result of overwork enfeebling a physical system not robust and making it an easy prey to disease." Through modern hindsight, Campbell may appear hopelessly unprogressive, but he can also be cast in a sympathetic light. He did not study in Europe, and he, like most other American medical school graduates, did not have extensive training in microbiologic techniques. He saw a germ theory as a threat both to traditional medical practice and to his own sense of professional identity. His opinions did not fall along expected generational lines, nor did his opposition to a germ theory mean that he was against a scientific ideal in medicine. In fact, Campbell repeatedly made the claim that his "chemical theory" was the true heir to the scientific tradition. In addition to his theoretical and practical objections, Campbell saw a germ theory as a threat to traditional sources of professional identity. Campbell believed that true doctors spend their lives surrounded by the sick rather than peering into a microscope. His turn to the analysis of medical history may just have been an idiosyncrasy of his personality. However, it may reflect a greater tendency of physicians to make sense of changing values and meanings by turning to the study of medical history. + �I Achilllce to put idealism into practice BY CHRISTOPHER J. DIMAIO have wanted to become a doctor since I was a child. I did not have any life-altering experiences that led me to choose this career. I simply loved science and wanted to indulge myself in the highest level of science possible- human medicine. Thus I find myself in the middle of my first year of medical school, and I am loving it. But let's face it. My life is not as rosy as I may make it out to be. Ask any medical student, myself included, a seemingly harmless question like, "How's it going? " and you will find that you have just set yourself up for a formidable avalanche of complaints and frustrations about "how much work I have ," "how far behind I am, " and the ever-popular, "I need more sleep! " I can only compare the experience to trying to finish a plate of food only to have the waiter bring out another serving. just when you're wiping your mouth clean with the napkin, two more plates come out. And just when you thought you couldn't eat another crumb, the waiter decides to bring out the main course. Not hungry? Well , too bad, because the chef is just getting started. To be honest, I feel that all of the hard work and sacrifice is worth the effort. My experiences in the past four months have been unlike any others. Every day I get to ask the question , "How does the body work? " and every ® day I get another answer. My experiences go way beyond those in the classroom, though. I will never forget the rush of adrenaline I experienced when I made my first incision on a cadaver, or when I was firs tasked to do a physical examination on a patient. new cases, and how we should learn from the cases we have seen in the past. Most important, we are beginning to learn how to feel like doctors: how, when we are presented with a new case, we realize that this isn't simply patient #6578463, but rather Mr. Thomas O'Donnell who lives around the corner, has a wife and three children, and one day hopes to retire to Florida. The knowledge and information I will have gained from my years at UB will be with me for the rest of my life, and will allow me to carry on a tradition of treating those who are ill, and protecting those who are not. It is a dedication that will allow me to realize my noble thoughts of what a career in medicine should be. In each issue, Buffalo Physician invites a medical student to write a column about a topic of his or her own choice. A member of the Class of 2000, Christopher]. DiMaio is in the middle of his first year of medical school. It is exciting to know that this is only the beginning of my medical career, and that a lifetime of similar experiences awaits me. I stated my idealistic views of medicine in my application essay: "I truly enjoy helping people, and would like to have a career that allows me to make a difference in the lives of those who seek it." Today, my visions are being realized. We are learning how to think like physicians, how we should approach B u f f a l a Physician W I n t e r 1 9 9 7 I �Put tfze.best seat in tfze fwuse myourgarage. UB:MICRO CDMPUIERSALES A Non-Profit UNIVERSnY AT BUFFAIDS Yl PRoGRAM Advertise in one of the finest publications in Western New York ... Call 645-3554 www .computer-store. ubmicro.buffalo.edu Buffalo Physician YOUAREEUCJBTE ~Uff"lj for educationalpricing f " ~ s\ t \ " " DflL•COMPAQ•ZfNIIH APPlE•ACffi llXASINSIRUME\Tf Cl:l!:!!~ HEWIEIT9I(J(ARD - MICROSOFf•CORFl•ADOBFAND MUQI i\Om 1997 Buick Riviera Riviera: the most sophisticated personal luxury car Buick has ever offered. It is designed to stir the spirit and excite the soul. We at Paul Batt Buick are proud to serve the people of Buffalo and its surrounding communities. For the last 43 years, we have offered the lowest prices possible, along with the very best in service. We value the professional and the hard working labor force in our community and will continue our efforts to maintain their loyalty. When you enter our showroom you will find helpful people, not pressure-so when you think of Buick sales and service, we know you'll think of us! Joseph R. Pera Paul V. Batt, Jr. 'ldut7Jau-7Jtdd 1717 Walden Ave., Buffalo, NY Give us a call: (716) 645-6933 Phys APPLE ScHOOL REwARDS Michael J. Baranski Marketing Representative Pun:hase any qualifymg \lacintosh desktop computer, Apple display (if sold separately), and Apple printer through 1119/97 and earn poin~ for any school or your choice (to be redeemed for Apple products) IOMEGA REBATE OFFER Purchase an Iomega Zip Ori\'e, and recei\'e by mail either a $50 rebate, OR more than a $ISO >'alue "Game Pack-to-Go" Pun:hase an Iomega Zip Disk Ill-pack, and =i>< by mail eother a $20 rebaie, OR more than a $6o value "M Stuff Orpnizer". See Iomega maol-m renoCicate at l'BMocro for details. Rebate through 1/31/97. $so HP DEsK}ET 340 sERIEs REBA1EOFFER through 3/31197 See HP mail-on rertiOcaie at UB\Iocro for details CoMPUTER WORKSHOPS Call 645-3560 to have a brochure mailed to you. BARANSKI Open Mon thru Fri 11-5; Wed & T hurs 11-6:30 Coli for curr~nr priCin~ and Q\'(jifabilm·, Pnas subJ~Ct to dmnR~ witlwut noiiCt' ADVERTISING 891-5595 Buffalo Pun:hase any qualifymg Macintosh desktop computer. Apple display (if sold separately), and Apple printer through 1/19197 and rereire a $150 mail-in rebate. ician 146 Stepping Stone Lane Orchard Park, NY 1412 7 W I n I e r 1 9 A non-profit University program for students, faculty & staff The Commons • North Campus • (716) 645· 3554 • Fax: 645-3&84 9 7 �Aman who touched aenerations of students JACK RICHERT , ASSOC IATE DEAN FOR ALUMN I AFFAIRS , RETIRES ack Richert left many in the UB community with fond memories when he retired Nov. l from his position as associate dean for alumni affairs. It's no wonder, because he has touched the lives of hundreds of students- doing everything from helping them finance their education to keeping in touch after graduation. "I've met wonderful people in all my sions, student affairs , curriculum, medidifferentpositionsatUB," he says. "Now, cal school publications, and financial I can go to any major city and look in the aid. He also served as coordinator of Medical Alumni Directory and find post-graduate advisement and director people I know. It's a great feeling ." of the U.S. Foreign Medical Graduate He first came to UB to earn a master's program. In the latter capacity, he won in counseling psychology and a doctor- a $226,000 grant from the U.S . Departate in academic administration. The ment of Health, Education, and Welfare medical school hired him in 1970 as to create a pilot program for these transfer students. registrar and assistant to the dean. Former associate dean Leonard Katz, It was a time of rapid transitions. The dean who had hired him, Leroy A. Pesch, M.D., worked with Richert to bring stuM.D., left in 1971. Clyde L Randall, dent affairs and curriculum together in M.D., and F. CarterPannill, M.D. , served the new Office of Medical Education in as acting deans in quick succession. It 1975. "jack took the lead in student affairs ," Katz rewasnotuntil1975, members . "He with the arrival of was also extrajohn. P. Naughton, " IT'S BEEN GREAT TO SEE ordinary at arM.D ., that the SO MANY STUDENTS WHO school had a perranging events . CAME INTO MY OFFICE ON manent dean. For example, at Naughton credgraduation he THE FIRST DAY OF CLASS its Richert with added color with GROW AND MATURE AND BE helping to shore up a huge UB banthe administration ner , arranged for SUCCESSFUL ." music, and added during this period. other touches to "It was a very tough make ita wonderfew years, and jack was one of three ful pageant and a people who served as the 'glue' to hold great celebration." He took over the alumni affairs office services together for the students," he in 1984, and soon became associate dean says. In 1972, he was promoted to assis- and director of medical alumni affairs. tant dean. At various times in the folHe has had a profound impact on the lowing years , he led the offices of admis- Medical Alumni Association. When he B u f f a l a first became involved with the group , it sponsored only a few activities a year. I oday, as a result of innovations he introduced or facilitated , it is active yearround, offering events, lectures, awards , and educational programs for alumni and current students. He also helped expand the annual Spring Clinical Day program into an entire reunion weekend. The new Distinguished Alumni Awards and Alumni Achievement Awards recognize outstanding accomplishment. Receptions at national medical meetings make UB alumni feel welcome everywhere. The Medical Alumni Association has also become much more active in student life. The association donated money to furnish the medical student lounge, and it participates in student and resident orientations. It also sponsors scholarships, student travel to scientific meetings, and travel to work in developing countries. The association's Community Physician Program invites doctors to give luncheon talks to medical students about career choices, types of practice, and lifestyles. Richert also chaired the Buffalo Physician editorial board, where he helped the dean choose board members that represented the entire UB community, and was sensitive to readers' desires about the look of the magazine , according to fellow board member Bradley Truax, M.D. '74. "jack wanted to make this magazine something that the alumni would enjoy and look forward to getting rather than just throw in the wastebasket," Truax says. One of Richert's accomplishments was the creation of the james Platt White Society, which honors alumni who make annual gifts to the school of $1 ,000 or more. Philanthropy was not the only Physician w I n t e r l 9 9 7 �..L_ - -- - - - -- - - - - - - - - - . . .. .. . . . . . . . . . . . . . . .. -~ • goal of the organization. "My goal in creating the society was to help our alumni reconnect with UB ," he explains. "There had been something of a breach between the people who graduated from the private University of Buffalo and those who graduated from the public University at Buffalo (after the 1962 merger of the university with the SUNY system). We had graduates who lived nearby and had never been back to the school. We needed to bring them back, reconnect them with the school, and show them that they were still part of our community." "None of these good ideas would have come to fruition without jack," says alumni association past president Margaret Paroski, M.D. '80, who met Richert when she was a student and he was assistant dean for student affairs. "He has a real knack for persuading people to participate, take on responsibilities, and get things done, and he's always understood how important volunteerism is to the school and to medical teaching in general. " Richert's engaging manner , good memory for names and faces , and gift for B u f f a l o building friendships have been key to his success at UB---and will make him missed. "I was accepted just four days before school started, so I showed up with no idea about where to stay," recalls jack Coyne, M.D. '85 , Medical Alumni Association president. "jack put together a whole list of possibilities, and found ways for me to fund my education, too. Physician w I n t e r 1 9 9 7 He took a personal interest-it was more than just a job. " In retirement, Richert plans to catch up on reading and research ("There are a lot of libraries I have neglected for too long! ") , get involved with volunteer activities, work on his century-old house in Buffalo, and spend more time with his wife and their daughter. "As I retire, I think what a nice time it was. There were obviously peaks and valleys , but I think the peaks outnumbered the valleys ," he says. "It has been wonderful to watch the school move into national prominence. "I also think about the pleasure I've had in meeting so many fine people who have become my personal friends. And it's been great to see so many students who came into my office on the first day of class grow and mature and achieve and be successful." Recruited by admissions director Thomas]. Guttuso, M.D., Richert will also serve as a volunteer member of the medical admissions committee. And so , even in retirement, he will continue making connections with new members of the UB medical school community.+ -JESSICA A NCKER �Wende W. Logan-Young, M.D. '61 FOUNDER AND DIRECTOR OF THE ELIZABETH WENDE BREAST CLINIC BY ANDREW DANZO ack in the mid-l970s, a diagnostic radiologist had a radical idea. Armed with emerging breakthroughs in imaging technology, Wende W Logan-Young, M.D., felt that radiologists should move out from behind their x-ray viewboxes to play a more central role in the fight against breast cancer. In pursuit of this vision, Logan-Young founded the Elizabeth Wende Breast Clinic in Rochester, NY. Now radiologists at her clinic and similar ones in other cities are giving women more timely and compassionate answers to some of their most fearful questions and reducing the need for surgical biopsies. "Ours was the first clinic where the radiologist intervened and started doing more of what the surgeon did ," ® Logan-Young recalls. "Before, the traditional role of the radiologist was to sit down at the end of the day and look at the image made earlier by a technician. There was no patient contact. " Logan-Young named the clinic after her mother, who taught her the kind of compassion she tries to bring to her own work with patients. "She was my role model , just a fabulous person," Logan-Young says. B u f f a I o P Logan-Young has been a pioneer in the use of a multiprocedural approach that stresses the importance of taking a good patient history and conducting a thorough breast examination, in addition to utilizing ultrasound and 14-gauge needle gun biopsies. With her associate , Nancy Yanes Hoffman , M.S., she published Breast Cancer: A Practical Guide to Diagnosis in 1994. The book is to be the first ofthree volumes; she is currently working on the second. "The book is a distillation of 20 years of what worked best," Logan-Young says. Those years represent a second, perhaps third , career for Logan-Young, who is one of a long line of Buffalo physicians and UB alumni. During her time at UB, she was married to classmate] onathan Logan, M.D. '61, and was called Wende Logan. "It was a hell of a good school," Logan-Young recalls. "I still have very good feelings about the university. " She originally entered internal medicine. After having four children, however, she couldn't keep up with the demands of the practice and switched to radiology. She joined the University of Rochester School of Medicine faculty and got involved in testing new lowdose x-ray films. If it could be perfected, she realized, low-dose mammography could open new doors in breast cancer screening and diagnosis. She also noticed how grateful women were when she told them their results on the same day. "This was considered heresy in 1975," she said. At the time, and not uncommonly even today, radiologists were supposed to report only to the referring physician, a protocol that she said caused delay and anxiety. "It sounds like a small point, but it isn't, " she says. She became convinced that there was a need for radiological practices devoted to breast cancer. "I went around to every group in Rochester and begged them to take me hysician W I n t e r 1 9 9 7 �--- ----- - - - - - -- - - - -- -- - - - -- - "O~RS~IWAS~~ili HE!!IIF.IRSli C l.!! INIC!J,,W8ERE:!!,~ili 8E RADIOI!OGISlijiiiNliERVENED AND STARli ED)~DOING~IMORE O F.: WHAli il'~ili HE S~RGEONn EIDE W. loau·YOUIG, with that concept," she says. "They all said I was crazy. So I opened my own office." As she was setting up, she read an article about using an ophthalmic ultrasound scanner for breast exams. Researchers had reported promising results with ultrasound breast imaging since the 1950s, and by the mid-1970s several physicians around the country were using ultrasound for breast exams, but there was still no commercially available machine designed explicitly for that purpose. Logan-Young bought one of the ophthalmic units. "At that point," she says, "there wasn't a radiologist in the country who was combining ultrasound and radiology." By bringing the best tools for breast cancer detection- clinical examination, ultrasound, and mammography-under one roof, Logan-Young felt that the techniques could complement one another to more accurately identify real cancers and to reduce the number of surgical biopsies on masses that proved benign. But there were problems to be resolved with the low-dose film. LoganYoung organized national meetings on that and related issues at Roswell Park Cancer Institute in 1977 and 1979. "A lot of the equipment changes that came out resulted from those meetings," she recalls. Logan-Young continued publishing her results with low-dose mammography and ultrasound. She also traveled the country demonstrating techniques for clinical breast cancer diagnosis. Her practice, however, was slow to take off. "We spent a lot of time modifying the equipment," she says. B u f f o l o IDID ." M.D. Eventually it paid off. The Elizabeth Wende Breast Clinic now has a staff of 80 and sees 50,000 patients a year, some from as far as Watertown and Binghamton, NY. "They like the ambiance of the office and they like having the results the same day," explains Logan-Young, who took her current name after remarrying six years ago. A major part of her quest to expand the radiologist's role was fulfilled in 1993 when she acquired the first 14gauge needle biopsy unit in western New York. The needle biopsy technique was developed years earlier in Sweden, but it was only recently perfected by a Colorado radiologist who added a new - needle design and computerized guidance that yielded results comparable to surgical biopsy. "The development of the 14-gauge needle was the last step that the radiologist needed to prevent unnecessary surgery, to keep us from doing too many biopsies," Logan-Young says. Nationally, she added, only one out of every five surgical breast biopsies confirms a cancer, while the rate for her patients is one out of 1.3. Equipment and technique are not the entire equation. "This sounds real corny, but from the beginning we tried to make the office look more like a home than an office," Logan-Young says. "I always hated the sterile white jackets. We put in antique chairs and flowered wallpaper. " Three of the 14 chapters in her 1994 book are devoted to interacting with patients. "Once you become the one to make the diagnosis, you do a lot of the counseling that the surgeons would have done." + Grover Wende, Class of 1889 Wende Logan- Young's great-grandfather's brother wrote an early text on dermatology George H. Westinghouse, Class of 1896 Logan- Young's grandfather Walter David Westinghouse, Class of 1931 George Westinghouse's son was Logan- Young's fath er Wende Westinghouse Logan-Young, Class of 1961 Physician Walter David Westinghouse, Class of 1964 Her brother is a San Diego cardiologist Andrea Westinghouse, Class of 1989 Her sister entered medicine as a second career and is now a pediatrician in Eden, NY w I n t e r 1 9 9 7 �• · ··· ·· ···· · · ····· ··· · · · ·· · · · ·· ······ · · ·· ··· ·· · · ·· · ·· ······· ·· ··· · ···· · ···· · · ·· ···· ·· · · · · ·· I 1 9 5 0 s DONALD R . HAULER '57 , of Pensacola, FL, has retired from the U.S. Navy after more than 36 years of active duty. His rank at retirement was captain. He was awarded the Legion of Merit at a Washington Navy Yard retirement ceremony. He moved from McLean, VA, to Pensacola in In April 1997, Jason, along with Edwin Rosinski (Ed.D. '58) and former UB faculty members Stephen Abrahamson and George Miller, will be honored by the UB medical school for their pioneering work in medical education, which began while they were all at UB together. September. 1 JEROME P . KASSIRER '57 , of Weston, MA, was named Distinguished Internist of 1996 by the American Society oflnternal Medicine for contributions to the social and economic environment of the practice of medicine. A kidney specialist at the Tufts University School of Medicine and the New England Medical Center, Kassirer is the editor-in-chief of the New England journal of Medicine. HILLIARD JASON ' 58 , 9 6 s 0 RICHARD H . DAFFNER '67 , of Pittsburgh, PA, writes: "I have just published my fifth textbook, the second edition of Imaging Strong Memorial Hospital in Rochester, NY. He and his wife are both clinical professors of family medicine at the University of Colorado School ofMedicine.Jason is also co-director of the Center for Instructional Support and co-director for education for the Society of Laparoendoscopic Surgeons. ® also serves on the board of the New York State Department of Health's Office of Professional Medical Conduct. He and his wife, Sharon, have two daughters, Gretchen and Julie 1 of Vertebral Trauma . I am currently professor of radiologic sciences at MCP-Hahnemann School of Medicine at Allegheny University. I am based at Allegheny General Hospital in Pittsburgh." ED .D . '62, of Boulder, CO , and his wife, Jane Westberg, Ph.D ., recently published their sixth book, Fostering Learning in Small Groups. It is part of both the Springer Series on Medical Education and the Springer Series on Nursing Education. Jason earned his education doctorate while completing medical school and his residency at director of anesthesia services at Millard Fillmore Suburban Hospital in Buffalo. He is a member of the Millard Fillmore Health System board of directors and president-elect of the system's medical staff. A UB assistant professor, he is also chair of the school's quality assurance committee for anesthesia. Burdick 9 8 s 0 DAVID S . KOUNTZ '85 , of New Brunswick, NJ , has been named associate dean for postgraduate education and chief of the division of primary care at UMDNJ-Robert Wood Johnson Medical School. PEGGY ( MOREY) STAGER of Cleveland Heights, OH, writes that she and her husband, Richard, "announce the birth of our beautiful boy, Samuel Robert, on April 1, 1996." She is practicing adolescent medicine at MetroHealth Medical Center in Cleveland. '88 , 1 9 7 s 0 MICHAEL BARON '71 , of Bristol, TN , writes: "I have relocated to private practice in Bristol in pulmonary critical care medicine. The hospital is two and a half years old and is state of the art, and managed care is just beginning. I am an assistant clinical professor of medicine at East Tennessee State University School of Medicine." JAMES P . BURDICK '75 , of East Amherst, NY, was installed as president of the New York State Society of Anesthesiologists in December. Burdick is B u f f a l o U.S. ArmyinfantryinApril194l. On Dec. 7, when the Japanese attacked Pearl Harbor, Secrist was on guard duty on the island of Oahu, five miles away. In combat duty in Europe, Secrist was wounded in action and received the Purple Heart. He left the Army with the rank of first lieutenant after five years of service. Secrist returned to school on the GI Bill, earning a bachelor of arts degree from Columbia University in 1947 and his M.D. from UB in 1951. Secrist made house calls to patients all over Buffalo and developed a reputation for treating patients regardless of their ability to pay. A member of the Erie County and New York State Medical Societies and the American Medical Association, he was board-certified in internal medicine. He was a member of the American College of Chest Physicians. OBITUARY ROBERT SECRIST '51 , clini- cal associate professor emeritus at the School of Medicine and Biomedical Sciences, died Nov. 5 in his hometown of Lockport. He was 78. Secrist attended Cornell University for three years before leaving to work at Bethlehem Steel. He was drafted into the p h y 9 e a n w n I e 9 9 7 �Who says there's nothing good on TV? As busy as they are, physicians and other health care providers always take the time to watch MLMIC's top-rated risk management education programs. • When they tune into high quality programming broadcast over our satellite network, viewers know what they see will help enhance patient safety and reduce injuries. They also appreciate the policyholder discounts available to participating physicians. • MLMIC programming is sponsored by the largest Risk Management Department of any professional liability insurer in the state. Policyholders also enjoy the protection of one of the country's largest and most experienced professional liability Claims Departments. Most importantly, MLMIC has successfully defended more physicians than all other available insurers combined. These are some of the reasons why MLMIC is the only medical liability insurer approved by the Medical Society of the State of New York. • To find out more, call1-800-356- 4056 in Upstate New York, or 1- 800- ASK- MLMIC in the New York metropolitan area. Ask for free copies of our risk management MLM~C ~ledical ~ Liab1lity :-lutuallnsurance Company guide for office practices. • Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracuse. NY 13202 90 Merrick Avenue E. Meadow, NY 11554 el996 Ml"..d ..:.1 L at> ity Mutua! ln~r,gnc~ Company �BUFFALO PHYSICIAN Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No . 311 STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 21 4 'fED.LC L HISTO. IC~ ADDRESS CORRECTION REQUESTED PLAN'fiNG A \3 JT T LldR ~y TREE UNDER WHICH Ll w-~IHLS A Y D-~T You WILL NEVER SIT DR. DEVILLO W. HARRINGTON, class of 1871, knew how to make his money grow. In fact, this man who in 1905 provided $5,000 through his will for the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. THIS PERMANENT endowment in Dr. Harrington's name has grown to over $300,000 and today it supports the famous Harrington Lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed funds at the school. They enable UB to provide scholarships to outstanding students, enhance scientific research, support excellence in teaching and meet the ever-changing needs of the school. YOU TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you develop a smart financial plan. Acharitable bequest provides the satisfaction that comes from planting a tree under which you will never sit, but which will bear fruit for generations to come. FOR ACONFIDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact: STEPHEN A. ESSARY, JR. I Assistant Dean and Director of Development, School of Medicine and Biomedical Sciences UNIVERSITY AT BUFFALO U N IVIE: R S I TY AT I!I UFFAl.O SC H OOL O F M ED I CI N E l5~ 1 5 0 YEARS (716) 829-2773 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 1997 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1997-Winter Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v31n01-1997-Winter Table Of Contents A list of subunits of the resource. John P. Naughton, M.D. Crunch Time Making history in the history of medicine Research Medical School News Then and Now A student's perspective Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2019-01-09 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v31n01 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1997 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/0f398d8e93b4093e754ecd5a751e5e2b.pdf fd716ff75fda5971dc3bbf631ad69b56 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Summer 1996 oes me 1c1ne deal with death? �BUFFALO PHYSICIAN \olume 30. Number 3 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr Carole '>nuth Petro ACTING DIRECTOR OF PUBLICATIONS Kathryn \ Sawner EDITOR Je>SICa Ancker ART DIRECTOR \ian J Kegler ASSISTANT DESIGNER Julie Gmten PRODUCTION MANAGER \nn Raszm~1nn Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John Naughton, Dean , \ ·"c Ptcsidcrll fo• Cliniwl A{f<111 s EDITORIAL BOARD Dr John A RIChert . Cluurmmt Dr Martm Brecher Dr llarold Brod) Dr. Rtchard L. Collms Dr. Jack f Co) ne Dr. Alan J Dnnnan Brian Dufh Dr James Kanskt Dr Barbara MaJerom Dr Elizabeth Olmsted Dr Charles Paganelli Dr Stephen Spaulding Dr BradiC\· T. Truax Dr r rankltn Zcplowttz Dear Alumni and Friends, THE SESQviCENTE:-o'\IAL E\E'\TS during the first two weeks of May truly rel1ected the commitment of the school's alumni, faculty, and friends to its missions and accomplishments. A major highlight was the opportunity to have Helen Ranney, M.D., deliver a stellar Harrington Lecture, receive an honorary Doctor of Science degree, and give very warm, well-directed remarks to the 1996 graduates. The commencement was also highlighted by the attendance of 29 members of the class of 1946, gowned and hooded and sitting on the stage with other faculty and distinguished guests. Spring Clinical Day was a resounding success in its own right. It drew probably the largest gathering of medical school alumni ever to attend this annual event. The session focused on issues related to preparation for death, the theme of this issue of Buffalo Physician. For me, it was amazing to experience the warmth and humaneness exhibited by a UB alumnus, Robert Milch, M.D., the medical director of Hospice Buffalo and an organizer of the session. He, with Ms. judith Skretny, set a tone which served to galvanize the audience into a cohesive, concerned, attentive group which ensured a successful learning experience for the entire day. The program was further highlighted and enriched by a singularly gifted presentation by the Stockton Kimball lecturer, Sherwin Nuland, M.D. As I rel1ect on the school's focus on its 150-year history, it is indeed rewarding and a pleasure to see a renewed awareness ofUB's successes and its willingness to commit itself to another 150 years of dedication to educate outstanding physicians and biomedical scientists. Sincerely, ~~. John Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences TEACHING HOSPITALS AND LIAISONS fhe Buffalo (,eneral llospttal \ftdwd )lww I he Chtldren·s Hospttal of Buffalo [ne Count\· Medtcal Center Mercy llospttal 'vltllard fillmore llealth System Dear Distinguished Alumni, fnmll.Sa\'a Ntagara Falb Memonal Medtcal Center Ro"sell Park Cancer lnstilllte St>te" of Chanty lio>pnal DCillll\ \f<Cmllt) \eterans Aff.m> Western '-Oew York lleahhcare sy,tem © The State L·rmnSit) of '\ess York at Buffalo Buff<~lo Phnrcwn " publtshed quarterly b\ the !>late Lmve"nv of Ness York at Buffalo School of \.1cchunc and Biomcd1c.:al Science~ and the Offtle of Publtcallons It rs sent , free of charge.toalumm , faculty , student; , re;tdents and fnends. fhe staff r._enes the nghtto edn all cop) and submi.,c,lons accepted for puhltcallon. 4\ddrcss questions , comments and >ubmisstOns to: The [dnor, Buf{lllo Ph)-\itian. '-,tate Uni\·cr'-tll\. of r\e\\ York at Buffalo . Office ·o r Publt callon; , 136 (rafts I tall , Buffalo, '\1) 14260 Send address changes to: Buff<~ln Phl;t<illn, 1-!6 CFS Addnton , H35 \lam Street , Buffalo, 1\Y 1-!2 H (over Image: Scala/Art Re;ource. 1\Y Fdsard \lunch , Thr Dc<tth Chwnbcr , Munch Museum , Oc,lo, r\orway. THA'\K YOL FOR the opportunity to serve as the president of the Medical Alumni Board of Directors. Much gratitude is due to Margaret Paroski, M.D., whose shoes I need to fill-a task that will be hard to accomplish. She served with vision and commitment, and was an example to our students of a caring, effective teacher and clinician. Also, congratulations to Beth Maher, M.D., for an outstanding Spring Clinical Day program, "The End of Life: The QualityofDeath." The program attracted more than 300 physicians and was one of the best attended Spring Clinical Days ever. 1 It is with great pleasure that we continue the celebration of the sesquicentennial anniversary of our medical school with the Distinguished Medical Alumni Award, to be presented this Septemberto Elliott C. Lasser, M.D., class of 1946. Dr. Lasser's research in radiology has been the cornerstone of some of our present-day diagnostic techniques. This recognition is a source of pride for all our alumni. Plans for the 1997 Spring Clinical Day are already under way. Richard Collins, M.D. , is planning a program addressing the impact of managed care on the physician and the patient. The Alumni Association will also continue to sponsor a wide range of activities for medical students, including the community physician program, the senior reception, orientation events, and receptions at national medical meetings. As your new Alumni Association president, I look forward to this year, and I ask for your support and any ideas to better serve you and our future physicians. Sincerely, ~if C'~ /W:J Jack F. Coyne, M.D. President, Medical Alumni Association �V OL UME 30 , 3 NUMBER SUMMER Buffalo Hospice 5 A TEAM THAT CARES FOR DYING P ATIENTS TAKES ON A NEW ROLE: EDUCAT- 10 Physician-Assisted Suicide How FAR SHOUL D DOCTORS GO? by Jessica Ancker lNG YOUNG DOCTORS. 18 1996 The End of Life and the Quality of Death U S 'S S PRING CLINICAL DAY OPENS DISCUSSION ON CARING FOR THE by Andy Danzo TERMINALLY ILL. by Scott Thomas Research Medical School News BUFFALO GENERAL DISTINGUISHED GETS KUDOS. ALIENS AND ASTHMA . HELPER DOGS . PROFESSORS . ROBERT N. SPENGLER . EUGENE MINOELL. MATCH DAY . GIFTS TO UB . Alumni News LYNNETTE NIEMAN ' 7 8 OF THE History of Medicine NATIONAL INSTITUTES OF NATIONAL MEETINGS HELD HEALTH. THREE GENERA- IN TIONS AT UB . BUFFALO . AStudent's Perspective " I HAD NEVER KNOWN SO MUCH ABOUT ANYBODY. " BY CHRIS SCHAEFFER, CLASS OF 1 998 . Classnotes �! l··· ·· · ·· ······· · ········· · ·· · ··· · · ··· ······· · ··· ··· ········· · ·· ·················· · ········ Dogs can help people with impaired mobility ervice dogs promote independence and high self-esteem among individuals with impaired mobility, and they can also save money, according to UB researcher Karen Allen, Ph.D. The research by Allen and her colleague,Jim Blascovich, Ph.D., found specially trained dogs more cost-effective and useful at performing certain tasks for people with severe mobility problems than human helpers. They reported their findings in the April 3 issue of thejoumal of the American Medical Association. The ubjectsofthestudy suffered from muscular dystrophy, muscular sclerosis, spinal cord injury, or traumatic brain injury, and had used wheelchairs for mobility for at least two years before the study. The dogs were trained to pull wheelchairs, carry parcels, help with daily dressing, open and close doors, assist in getting in and out of cars, and pull people up from lying or sitting positions. They were even trained to pull their owner to safety in an emergency. Some canines have learned to assist with as many as 100 tasks, Allen said. Twenty-four of the individuals were given the trained animals one month after the study began. The other 24 received their canine helpers 13 months later. In both groups , the dogs' assistance cut the amount of time required by human helpers by approximately one half within six months. Also , the subjects' self-esteem scores nearly doubled in six months, and tripled by the end of the two-year study. The 0 individuals reported newfound independence, increased psychological well-being, and positive effects in other areas of their lives. At the end of the study, 40 out of the 48 subjects were able to get pan-time employment, and 18 of the subjects started school. A service dog costs about 5,000 to train and about $1 ,100 to maintain annually, far less than the cost of home health aides or other assistants , Allen said. While seeing-eye dogs are well-accepted and covered by many insurers, other types of service dogs are often not covered. However, the state of Montana is providing Medicaid coverage on a trial basis as a result of this study, Allen said. Allen , a member of the psychology department, is the former assistant director of UB's Center for Behavioral and Social Aspects of Health. + H E R 5 C H E L E M E L 5 0 N Buffalo General honored by national accreditation group he Buffalo General Hospital has been awarded a three-year accreditation with commendation by the joint Commission on Accreditation of Health Care Organizations for the first time in its history. Accreditation with commendation recognizes excellence and places Buffalo General in the top 12 percent of the 5,200 accredited hospitals in the country. joint Commission members reached their conclusion after spending about three weeks last December conducting surveys at Buffalo General, its Community a u f f o t o Mental Health Center, and its long-term care facility at the Deaconess Center. "Buffalo General is to be commended for its commitment to providing quality care to the people in its community and region," said Dennis S. O'Leary, M.D. , president of the joint Commission. "You have a lotto be proud of: superb people, excellent staff really doing a great job. It's clear they really care," said joint Commission surveyor Robert eher. "The quality of the programs really stands out. " + Aliens and asthma n innovative experiment involving a popular children's movie may have pinned down the neurological pathway by which unpleasant emotions constrict airways in asthmatic children. UB pediatric psychiatry researchers Bruce Miller, M.D., and Beatrice Wood, Ph.D. , reported their results at the annual meeting of the American Psychosomatic Society, March 7-10 , in Williamsburg, VA. The researchers invited 24 asthmatic children ages 8 to 18 to watch the video of "E.T.- The Extraterrestrial," while their heart rates , respiration rates , and blood oxygen saturation were monitored . Airway reactivity and pulmonary function were tested before and after the movie by spiro metry and methacholine challenge tests. The researchers were particularly interested in the children's physiological responses during a highly emotional scene in which the young hero , Eliot, talks to what appears to be the dead body of his friend , E.T. -then discovers that E.T. is alive. The mood shifts suddenly from hopelessness to relief and joy. Results showed that during the sad scene, heart rate and oxygen saturation became unstable, reflecting airway con- Physician Summer t 9 9 6 �··· · ···· · ······· · ······· · ·· · ··· · ····· · ··· · · · ·········· · · · ······· · ········ · ··· ·· ···· · · · ···· • . striction. During the happy scene, heart rate and blood oxygen stabilized , indicating open airways. In addition , the researchers noted that changes in activity of the vagus nerve , known to influence both heart rate and airway constriction, correlated closely with changes in the children's emotional responses . They believe the finding points to the vagus nerve as one pathway by which emotions affect asthma symptoms. "These findings are clinically important because they suggest that emotional conditions, such as depression and hopelessness, may be important triggers of airway constriction in asthmatic patients," Miller said. "Knowing that the vagus nerve is a specific pathway for inducing these psychophysiologic responses, we can now target this pathway for treatment intervention. " Miller suggested that antidepressant medications with strong anticholinergic properties may be the best choice for treating depression in asthmatic children. "These medications may have the dual effect of treating depression, while at the same time lessening vagal responsivity , which would directly improve asthmatic symptoms, " he said. "We need to point out to physicians that treating the depression can improve asthma symptoms , as well as mood. " The "E.T ." study is part of a long-term collaborative effort by Miller, the director of pediatric psychiatry at Children 's Hospital and a UB associate professor of psychiatry and pediatrics , and s u f f 0 l 0 P hys i Wood , the assistant director of the pediatric psychiatry department and a UB assistant professor. The two came to UB last year from the University of Rochester. An earlier study published by the two colleagues in 1994 found that children who experienced more intense physiological reactions and described their emotional experiences in more intense terms also experienced decreased pulmonary function and heightened airway reactivity. Miller and Wood believe that in this subgroup of asthmatic children, strong emotions activate a specific pathway in the autonomic nervous system that causes or aggravates asthma. In the long run, Miller and Wood hope their work will help bring the study of the body a little closer to the study of the mind. "We believe that's where medical education needs to go . It's stilted and artificial to practice psychiatry in a vacuum , or to practice medicine in a cian 1 9 9 6 '. vacuum ," Miller said. Wood adds that health care professionals must also include a concern for the patient's family and social setting. "It's no good to treat the child individually. It's important to engage the family , and see how that impacts the child's physiological functioning. " She hopes , too, to begin to develop a model for health , not just for illness. "We need to look more at the positive ways families impact on physiology, not just the negative ways. " Miller established his reputation in the field with a benchmark 1987 study on the links between depression and fatalities from asthma. He conducted in-depth interviews with families of asthmatic children who had died from their disease and with the families of others who had survived near-death experiences. He found that the children who had died were much more likely to have experienced psychological stress and family turmoil , such as a divorce or an impending separation . Also, around the time of their death , they were much more likely to have experienced feelings of despair and wishes to die. "My clinical practice had suggested this link long before, but this was the best-designed study to establish the link ," says Miller, who practiced family medicine for several years before specializing in psychiatry. Wood joined Miller's research after studying the impact of family stress on children with Crohn's disease . + -LOIS Summer .. . B AKER �nt How does medicine deal with death? DoES MEDICAL SCHOOL ADEQUATELY PREPARE DOCTORS to treat dying patients? Is it always possible .. .. to control pain, or to facilitate a dignified death? What should the law say about a dying patient who asks a doctor for a lethal dose of drugs? These are some of the topics brought up for discussion at UB's Spring C lin ical Day, held May I I on the topic of "The end of life: The quality of death." This issue of Buffalo Physician further explores these questions in several re lated articles. The first, "Hospice Buffalo," follows medical students and young doctors as they leam about palliative care in UB's new hospice education program. "Physician-assisted suicide: How far should doctors go?" explains recent developments in the legal and social debate about assisted suicide, and tries to put them in ethical perspective. Our Spring Clinical Day coverage includes excerpts from a panel discussion about dying patients, their families, and their doctors, and a story about the Stockton Kimball Lecture delivered by Sherwin Nuland, M.D., author of How We Die. In our new student column, third-year student Chris Schaeffer reflects on how death robbed him forever of the chance to know one fascinating and mysterious patient. We hope that this special issue will invite discussion and reflection on these difficult questions. -The Ed ito r 0 B uffalo P hysician Summer l 9 9 6 �• ICe by Andrew Danzo Photos by K.C. Kratt A team that cares for the dying takes on a new role: educating young doctors 0 CAR PIEDAD, M.D., was still getting used to people calling him "doctor" when he visited some old friends at Hospice Buffalo in late spring. At the nurse's station there were hugs for the young bear of a physician, freshly graduated and preparing to leave for a residency down south. Here he was still Oscar. Piedad looked at the Family Room, decorated with soothing pastels and simple, comfortable furnishings . He recalled the Christmas party there. The family pets that came for visits. The meetings with spouses and children to discuss final arrangements. He seemed "IT OPE:\lED M\ EYES TO Buffalo Physician A to miss it. \\'HOLE NE\\ C0:'KEPT OF MEDICINE," he explained. Summer l 9 9 6 0 �HOSPICE BUFFALO lN THC 18 'v10 HIS Physicians have a since Hospice Buffalo hard time saying became a clinical "enough," according training site for the UB to Thomas Raab, School of Medicine M.D., clinical assoand the Graduate ciate professor of Medical Dental EdumedicineatUB. "We cation Consortium of are trained to treat, Buffalo, some 70 residiagnose, and evalu- ____dent and lJ) medical ate; and if we don't students have shared know what's going an exposure to palliaon, we treat, diagtive medicine that is nose, and evaluate still relatively unsome more," he said. usual. They have "We must compaslearned about pain management, symptom sionately communicate to the dying patient management, and working in interdiscipliand the family when medical technology "You learn a nary teams. They have comforted dying padoesn't have any more to offer them and it's tients-some calm, some haunted by nighttime to stop. So many times, doctors don't lot of loving mares. They have made house calls. Overall, do that. " they have learned something about accepting the inevitability of death , and maximizHospice as Education and caring ing the quality of the life remaining. "Doctors just don't get good trammg in "There are a lot of life issue you have to caring for patients at the end of their lives," that before address," said Piedad. "For the family memsaid Raab. "It's sad what we do to some bers, too. The spouses and the children. people at the end of their lives. " They have to go through the dying process, The hospice educational program began you might too ... You learn a lot of loving and caring under the state-funded Indirect Medical Eduthat before you might only have shown to cation Demonstration Project. It now inonly have your own family." cludes lectures at the medical school and Advances in medical techniques and techconsortium hospitals by Hospice Buffalo nology have raised troubling questions about medical director Robert Milch, M.D., and shown to when efforts to save a life merely prolong a short- and long-term rotations for residents and medical students. painful death. The Robert Wood Johnson your own Foundation recently funded a study to deRotations include rounds of the inpatient termine whether better prognostic informaunit and home visits with a social worker or tion and patient-physician communication a clergy member. Students also work with family." would prevent overtreatment and pain at the the bereavement staff, who keep up with end of life. families for l3 months after a loved one's Dishearteningly, the "SUPPORT" study, reported death in order to provide support for the first-and in the ov. 22/29, 1995 issue of the Journal of the hardest-year of loss. American Medical Association, found that the interThe official hospice training program began in late ventions did little or nothing to improve care or 1994, but two students paved the way more than a year outcomes. The study documented that fewer than earlier. The first was Piedad, whose father , also named half of physic ians knew when their patients did not Oscar, is a retired general surgeon in Buffalo. want CPR,-cand half of conscio us patients were in The other was Maria Bruno, M.D., then a secondmoderate to severe pain before they died. The article year student. states that physicians "p rovide more extensive treat"I had some family members with cancer and bad ment to seriou ly ill patients than they would choose illnesses, and I knew people who just weren't satisfied for themselves." with the way they were treated. I wasn't sure if it was the 0 a u f f a 1 o Physician Summer 1 9 9 6 �HOSPICE physicians, or the system in general," said Bruno, who has just finished her internship in internal medicine in Buffalo. " ow I think it's the system in general." Bruno remembered her grandmother's death in the 1970s. "It was one of those situations where they opened her up , found cancer and closed her up without telling her ," she said. She thinks the doctors didn't want to upset her grandmother, but the result was sending her home without preparing her for the pain that would come. Bruno did a summer fellowship at Hospice Buffalo between her second and third years. Once the training program was up and running, Bruno returned for an elective rotation in her fourth year. She also researched the literature on physician-patient communication , and assembled a presentation that is still given to students and residents at the beginning of their hospice rotations. The presentation is entitled "Talking about Difficult Subjects: A Survival Guide for Giving and Getting Bad News. " "Medicine isn't all about science," Bruno said. "Hospice medicine is about the art of medicine as well as the science of medicine. " The training program got into full swing when Hospice Buffalo opened its Mitchell Campus, a complex of low cream-colored buildings in the Buffalo suburb of Cheektowaga. The campus includes a lObed unit for hospice patients in the final stage of disease, a lO-bed nursing unit for AIDS patients, and a 30-bed skilled-nursing residence for both hospice and non-hospice patients with advanced illness. It also includes a 220-seat auditorium for conferences and educational activities. UB residents in family medicine , internal medicine , and geriatrics now routinely visit Hospice Buffalo as part of their training, ac- B u f f a l o Physician BUFFALO "We must cording to Liora Ziv, R. ., Ed. D. , the organization's director of education. For other residents, the hospice rotation is available as an elective. Medical students can also choose hospice rotations as third- or fourthyear electives. compassionately communicate to the F r o m T h eo ry to P ra c ti ce Medical student oelle M. Stevens spent a week at Hospice Buffalo last summer. She remembers visiting a woman who had no family. The woman had put off seeing a doctor about the growing hardness in her breast, and by the time she did, the cancer had spread. "She wasn't going to benefit from chemotherapy, " Stevens recalled. "She was living alone in her apartment and wasn't even able to get up and go to the kitchen." The hospice team brought her back to the Mitchell Campus. Before the woman died, she confided to the student her surprise at the warmth of the Hospice staff. "She was one of the reasons why I would like to go into geriatrics, and why I would also like to continue working with Hospice in the future, " Stevens said. The opportunity came sooner than she had expected. During a hospital clerkship later in the year, Stevens became friendly with an elderly woman who had been admitted after a seizure. A CT scan and an MRI revealed that a cancer had metastasized to the brain, but its origin wasn't clear. "The medical team was really set on trying to figure out what the cancer was, " Stevens said. "They had a surgical consult coming in , and they were focused on trying to cure her. But they were not focused on what her wishes were." The woman, a retired nurse, insisted that she didn't want surgery or chemotherapy, and the family agreed. Stevens became the interme- dying patient and the family when medical technology doesn't have any more to offer them and it's time to stop. So many times, doctors don't do that." Summer 1 9 9 6 0 �HOSPICE BUFFALO diary between the patient and the medical team. Stevens advised the family to make their wishes known to the oncologist, and gave them the Hospice phone number. The woman ended up spending her last days at Buffalo Hospice. "I won't forget this lady," Stevens said. unsettling. You don't know where to sit ... You find yourself looking at disease in a totally different way. You look at the faded pictures on the wall. At the things on the coffee table. At the picture in the wedding dress. And then you see the patient in bed, and you see what the disease has done. " The Life Students are Hesitant Qua lit y of When the hospice lessons click, medical stuStudents and residents aren't exactly breakdents and residents no longer feel a sense of "When you go ing down the doors for hospice electives. futility in the face of serious illness. Instead, They often call for information, then call they have the skills and the desire to improve into a patient's back and say they've changed their mind. the quality of the life that remains. "In hosLauren Michalakes, M.D., isn't surprised. pice you don't have the expectation that people She remembers being an internal medicine are going to get better, so you don't have that home, you're resident a decade ago, intrigued by the techsense of failure that you have in a hospital," nology and intellectual challenge of the hossaid Robert Patterson, M.D. , who heads the on their turf. It pital. "We used to love intensive care," she lO-bed inpatient unit. recalled. "You'd feel like you were doing a Pain management is a key component of lot, and you'd write up these wonderful can be the hospice training. At the start of rotations, three-page reports. Being so busy technostudents and residents complete a 39-queslogically, you really didn't have to talk with tion test to assess knowledge and attitudes unsettling... the patient." about pain, drugs, and addiction. Clinical During five years of private practice, howpractice guidelines are also distributed. "In You find ever, her views changed. medical school you talk about 15 milligrams "In the hospital, people die in double of morphine as a therapeutic dose," said blaring rooms with strangers and with C Patterson. "Sometimes we use up to 4,000 yourself lookon the other TV," she said. "They die with milligrams of morphine a day to control pain, their clothes pulled off and hooked up to and the patients are still responsive; they can ing at disease things and all alone." talk. " Michalakes remembers sitting with an A former professor and associate chair of elderly woman at her home when she died. in a totally the OB/G department at UB, Patterson has "I just watched her in her big post bed with been volunteering at Hospice since retiring all her Ouffy pillows and her daughter and from obstetrical practice three years ago at age different way." husband and her poodle," Michalakes re70. Some days, after putting ina morning at the called. "What's wrong with that? I felt like I hospice inpatient unit, he goes home and spared her something. I felt a sense of accomplishment babysits his grandchildren and great-grandchildren. that I hadn't felt in medicine before. " "In my practice as an obstetrician, I dealt a lot with She now works full-time at Hospice Buffalo. families, " he said. "That was one of the joys of mediMichalakes thinks it's important for students to visit cine. Surprisingly, I feel the same about this .. .. It's two patients at home. "When you go into a patient's home, things that happen to all of us-we're born, and we die. you're on their turf," Michalakes explained. "It can be Hopefully, we can help at both ends." B u f f o l o Phys ician Summer 1 9 9 6 �HOSPICE BUFFALO A Sp iri t ual P la ce "You hydrate a healthy patient, you don't do it for a Buffalo Hospice medical director Robert Milch started dying patient," explained Ziv, the education director. "You his career as a general surgeon with a philosophical bent can really cause more suffering and pain in exchange for and a nagging discomfort about modern medicine. He's maybe prolonging for a few hours the life of the patient." been increasingly involved in Hospice Buffalo since it Tchernov said this aspect of hospice went against his original training. "In my Russian medical school, the started in 1978, and he gave up private practice several years ago to serve as its first full-time medical director. preserving of life as long as possible was the philosophy. We would never let a patient dehydrate." "There's something that hearkens to why you became a physician in doing this kind of work," Milch said. "It's Stude n ts F i nd Men t o r s not about dying. It's about how we live." During his recent visit to Hospice Buffalo, Piedad spotted Life and death are tightly interwoven at the hospice Patterson down the hall. He campus. After traversing a remembered the older brick walkway dotted with mephysician's manner, the way morial stones to former pahe touched and talked with tients, visitors arrive at an inis as much a philosophy as a facility gravely ill patients. "just his formation desk, where they voice, you could see them right can buy shirts, baseball caps, HosPICE BuFFALO ISBASED at the Mitchell Campus, a away calming down," Piedad and other souvenirs with the $6 m Ilion complex on 20 wooded acres, part of a hospice logo. There's a sunlit recalled. "I remember one pnvate nature preserve in Cheektowaga. chapel, usually the scene of time, a patient was very close But Hospice IS as much a philosophy as a facility. memorial services, but also the to the end. He went into the More than three-quarters of hospice pat1ents are place where a patient's daughand held her by the hand. room cared for 1n the1r own homes. Medical, nurstng, ter had her wedding this year. He told her not to be afraid." counseling, and pastoral serv1ces are prov1ded Then there's the bulletin board In a letter to the hospice through Hospice Buffalo and a networl< of affiliated outside Milch's office, where non-profrt agenoes under the umbrella of the Hosstaff after his rotation, Piedad someone has tacked up a dyp1ce Assooat1on. Serv1ces are also prov1ded in area wrote: "I was introduced to an nurs1ng homes and hosp1tals. ing patient's joke. aspect of patient care I had Medicare, Medica1d and maJor nsurance plans "They say the hearing is the never seen before. Pet therapy, will pay for hosp1ce care, and Hosp1ce Buffalo last thing to go. It's not. It's the music therapy, birthday paroffers a sliding payment scale for the uninsured. sex," the woman quipped. A ties, Christmas gifts, family According to med1cal director Robert Milch, dinners, decorated rooms, and few days later, she revised her M.D., bereavement serv1ces are an important part evaluation: "You know what I the list goes on. I began to of hospice care. "It doesn't stop when the mon1tor realize that the facility treated was saying about the hearing. stops. It goes on, and you've got to take care ofthe more than pain; their treatI think maybe I was wrong. " surv1vors." Bereavement care, wh1ch lasts 13 months Death itself, however, is ment involved quality of life, after a death, includes counseling and support groups. resolution of life, family innot trivialized. "It's a very spiritual place," said Andrei volvement, staff involvement, G. Tchernov, M.D. , who bereligious beliefs, personal life decisions, and bereavement ... I have never seen a team on lieves the hospice rotation he completed as a resident will help him in his family medicine practice. His a unit work so cohesively and with so much heart." experience also forced him to change his views on Piedad is now doing his residency in family medicine and sports medicine at Richland Memorial Hospital in practicing medicine. Columbia, SC. Shortly after his visit, Liora Ziv reflected For example, he learned that hospice professionals are on the impact of the educational program. "I don't think willing to withhold interventions that would postpone we can say yet that we've made a big difference," she an inevitable death. A hospice patient who suffered a concluded. "But I think we have made a dent in the stroke, for example, might use the physical therapy room surface if people like Oscar come back and say they'll at the Mitchell Campus to regain the ability to lift a fork. take what they learned here into their practice." + But patients near death and with no hope of recovery Buffalo j ournalist Andrew Danza, a frequent contributor to Buffa lo Physiwould be unlikely to receive antibiotics if they develop cian, also works as a writer for UB's Department of Family Medici ne and the pneumonia, or water if they become dehydrated. L_ _ _ _ _ _ __J ew Yorh Ru ral Health Research Center. e u t t a l o Physic i an Summer l 9 9 6 0 �Choices at the end o f Ii f e • • 1an Sl SSI How far shouldsdoctors go? COURT DECISIO S, SE SATIO AL CASES, STATE REFERENDA, and one-cause crusaders are dragging the intensely controversial issue of physician-assisted suicide out of the closet and into the public arena . ... Whether or not the nation's legal landscape is irrevocably altered as a result of the controversy, the public mind has already changed. A topic once taboo is now dissected on editorial pages and joked about on talk shows. Polls demonstrate increasing support for the idea of physician-assisted suicide during a terminal or unbearable illness. The new openness about DNR orders, health-care proxy appointments, and withdrawal of life-sustaining technologies may also be making it easier to discuss all sorts of end-of-life decisions. For the majority of Americans, the figure who has done more than any other to turn assisted suicide into a public issue is retired pathologist jack Kevorkian. By May of this year, Kevorkian had admitted auending 28 deaths, and had been acquiued in his third trial for assisting in a suicide. At about the same time, a nationwide Gallup poll showed that 75 percent of respondents favored allowing a doctor to end an incurably ill patient's life at the patient's request. "Public relations-wise, Kevorkian's done a tremendous job-he's converted a huge egment of the public," said rightto-die activist Derek Humphry, author of the how-to suicide book Final Exit. It's the kind of public relations most of the medical community would rather not have. Many doctors-even those who support physician-assisted suicide-believe Kevorkian is not qualified to perform it. They object that he had no experience treating patients during his career as a pathologist, and that he does not know BY P H 0 T 0 his clients well, does not try to manage their pain, and does not adequately screen them for clinical depression. In the end, what many doctors, nurses, and ethicists dislike the most about Kevorkian is that he does not appear to reflect at all about his individual cases. Because he believes so strongly that assisted suicide should be available, they say, he distributes his treatment without seeming to ask himself if this option is the right one for this person at this moment. "Physician-assisted suicide shouldn't be easy. It should always be a hard decision," said Timothy Quill, M.D., the Rochester, Y internist who opened a professional dialog on the subject in 1991 with an admission in the ew England journal of Medicine that he had prescribed a lethal dose of barbiturates to a dying patient. In his account of his eight-year relationship with "Diane," Quill described diagnosing her leukemia, discussing her desire for suicide, and asking her to consult her psychologist. Only when he was convinced that she was acting rationally on the basis of an unwavering wish, and only after wrestling with his own emotions, did he prescribe the drugs she requested. There is no consensus on the morality of physician-assisted suicide. While activists like Kevorkian and Humphry want to make the practice widely available on compassionate grounds, opponents argue that it is wrong under any circumstances to take a life. Many doctors also believe that their very mission prohibits assisting in death. "It's absolutely appalling that a doctor would take deliber- .JESSICA 8 S B u f y f F a l R o A ANCKER N K Phys CESARIO ici an Summer 1 9 9 6 �"A SUICIDE THREAT IS A CRY FOR HELP. OUR ANSWER MUST BE TO PROVIDE THAT HELP, NOT TO HELP THEM COMMIT SUICIDE. " Denise Hanlon, R.N., member, NYS Task Force on Life and the Law ate steps to end someone's life," said Evan Calkins, M.D., a member of the Buffalo Medical Group and UB professor emeritus. "It violates the Hippocratic oath to do no harm , and it weakens the ethical standing of the medical profession. We are a healing profession, not a killing profession." Other doctors take a middle view. They feel that before the American medical establishment considers assisted suicide , it should learn how to provide good end-of-life care for all dying patients. If assisted suicide is to be an option, they say, it should be decided as Quill and "Diane" decided it; not in the courts or on the editorial pages, but one case at a timecarefully, deliberately, and with anguish. Even some opponents respect Quill. "If all doctors were like Quill , then this wouldn't be a great concern," said Denise Hanlon, R.N. , an opponent of physician-assisted suicide who serves on the ew York State Task Force on Life and the Law. "Or if all patients were like 'Diane.' But they're not. " The l aw The courts and state legislatures are the current forums for debate about physician-assisted suicide. The 1994 Oregon "Death with Dignity" law is the first in the country to explicitly condone physician-assisted suicide, although legal challenges have so far prevented it from going into effect. In March 1996, the Ninth Circuit Court of Appeals, a federal court in San Francisco, overturned a State ofWashington law that banned assisting in a suicide. The plaintiffs were four physicians, three terminally ill patients who died before the ruling, and a non-profit organi- B u f f a l o P hysician zation called Compassion In Dying. The court broke new ground by determining that the U.S. Constitution guarantees a "right to die;" that is, to choose the manner and time of one's own death. Depriving patients of that right therefore violates the due process clause of the 14th Amendment. The court wrote that doctors should be able to prescribe life-ending medication for terminally ill, competent adult patients who want to hasten their own deaths. The judges said that their decision , in essence, removed them from the issue. "We are following the constitutional mandate to take such decisions out of the hands of the government, both state and federal , and to put them where they rightly belong, in the hands of the people. " The ruling has the potential to affect California , Washington , and Oregon, which all fall under the jurisdiction of the Ninth Circuit Court. In a similar ruling on April 2, the Second Circuit Court of Appeals, with jurisdiction over ew York, Vermont, and Connecticut, struck down part of ew York's ban on assisted suicide. The case was brought by three terminally ill patients and three doctors, one of whom was Quill. The patients all died before the ruling. The judges ruled that a doctor can prescribe drugs to hasten the death of a competent, terminally ill patient at the patient's request. They explained their decision in commonsense language: "What interest can the state possibly have in requiring the prolongation of a life that is all but ended? And what business is it of the state to require the continuation of agony when the result is imminent and inevitable?" legally, the rationale was more complicated. It was de- Summer 1 9 9 6 �"IF WE DON'T HAVE ANY LEGAL WAY TO DO TH I S, THEN IT TURNS INTO ONE DOCTOR MAKING THE HARDEST TREATMENT DECISION POSSIBLE IN A VACUUM - WITHOUT CONSULT I NG ANYBODY , WITH- OUT DISCUSSING IT . THAT TO ME IS NOT GOOD MEDICINE. " Timothy Quill , M.D., plaintiff in Quill v. Vacca cided that the ban violated the equal protection clause of the 14th Amendment. All patients already have the right to hasten their own death by refusing medical treatment. However, the argument goes , terminally ill patients who were not being kept alive through medical intervention had no comparable way to hasten their own death . lf patients can essentially commit suicide by refusing treatment,Justice Roger]. Miner wrote, "they should be free to do so by requesting appropriate medication to terminate life during the final stages of terminal illness. " Stil l a crime While these rulings are being appealed to the U.S. Supreme Court, and while Oregon's law remains entangled in the courts, it remains a crime for doctors to assist in suicides. Yet it's clear that they are doing it anyway. An anonymous survey recently published in the journal of the American Medical Assodation found that a small percentage of doctors in Washington state had helped terminal patients who wanted to die. A survey of Oregon doctors published in the N E]M in February showed that 7 percent of respondents had assisted in a suicide. Forty-six percent of the respondents said they might be willing to assist in suicides if the practice were legal, and 31 percent said they would refuse on moral grounds. "l think the issue at this point is how to respond to physician-assisted suicide , not whether it's going to happen ," said Stephen Wear, Ph.D ., co-director of UB's Center for Clinical Ethics and Humanities in Medicine. "Whether or not the legal situation allows it, it's happening, and in some jurisdictions it's likely to become legal. " B u f f a l a Does the law matter? Timothy Quill firmly believes that liberalizing the law is necessary to protect doctors like himself who choose to help patients die. But jack Freer, M.D. , chair of Millard Fillmore Hospital's ethics committee, uses Quill's case to prove that the law is already practically powerless to touch doctors. After Quill's E]M letter, prosecutors referred the matter to a grand jury, which refused to indict him. "They couldn't indict Quill. Kevorkian is unconvictable," Freer said. "lf that's the case, if you can't be convicted, then [the legal decisions] don't matter because you don't need extra protection. If a doctor acts in good faith, if it is clear that someone is suffering and asks for help, then that physician is unlikely to be prosecuted, anyway. "There would have to be a compelling need in order to justify such a sweeping change in the status quo. l don't see that need, especially when the change would jeopardize so many vulnerable people who have not availed themselves of good palliative treatment," Freer added. P u b lic debate? Quill and some other activists argue that since the practice is happening, it is important to discuss it. His purpose in writing the NE)M letter and joining the Second Circuit Court lawsuit was to open up discussion on what he felt was a widespread practice. "lf we don't have any legal way to do this, then it turns into one doctor making the hardest treatment decision possible in a vacuum-without consulting anybody, without discussing it. That to me is not good medicine," Quill said in a recent interview with the Buffalo Physician. Physician Summer 1 9 9 6 �Choices at the end o f "IT'S ABSOLUTELY APPALLING THAT A DOCTOR WOULD TAKE DELIBERATE STEPS TO END SOMEONE'S LIFE. WE ARE A PROFESSION, NOT A Iif e HEALING KILLING PROFESSION." Evan Calkins, M.D., UB professor emeritus ew Yo rk State Attorney General Dennis Vacco (UB Law School class of 1978) is leading the appeal because he feels allowing doctors to take life is wrong, and that vulnerable patients could be pressured into suicide for economic or other reasons. He also fears that ew York could become home to a sort of cottage industry of commercial death clinics. But even if he succeeds in getting the U.S. Supreme Court to uphold the ban on assisted suicide, Vacco does not plan to launch a drive to prosecute doctors- such as Quill- who have admitted doing it. "I don't think we need to change the prosecutorial scheme," he told this magazine. "No law can eliminate proscribed behavior, but the deterrent would discourage a sufficient number of professionals from engaging in this conduct. "I think that the system we had until this decision was working well. " Public po li cy Doctors, nurses , lawyers, ethicists, and members of the clergy from around ew York State meet once a month as part of the ew York State Task Force on Life and the Law to wrestle with some of the hardest questions in health care. Some of the task force's recommendations have led to ew York's health-care proxy law and the Family Care Bill, which has not yet been passed into law. The group's 1994 report When Death is Sought recommended against decriminalizing physician-assisted suicide. Some members of the task force felt that it was inherently wrong to take a life. Others felt that it was unethical for a doctor to do so. A third group felt that in some cases, providing a quick death for a terminal patient who asked for help would be B u f f a 1 o P hysici a n S compassionate and ethical. The task force was in agreement, however, in concluding that legalizing physician-assisted suicide would be dangerous public policy. The cost of health care and the perceived value of the patient could come to bear on who ends up committing suicide , they cautioned. They were also concerned that patients would not be properly referred for psychiatric or palliative care, and that attitudes about assisted suicide might become casual. "Over time, as the practices are incorporated into the standard arsenal of medical treatments, th e sense of gravity abo u t the practices would dissipate," the task force warned. Also opposed to physician-assisted suicide are professional medical societies, including the American Medical Association, which say that it violates a doctor's mission, and some religious groups. "It's a non-negotiable with us," said Sister Sally Maloney, a vice president at Mercy Health System of Western ew York, a Catholic hospital group. "It's completely opposed to our commitment to life. The ethical directives by the Catholic bishops are very clear on that. " Good end-of-l i fe care Since 1978, Hospice Buffalo has cared for more than 13 ,000 dying patients. Only one has committed suicide, according to medical director Robert Milch, M.D. "It's not unusual for us to go into a patient's home and hear that patient say, 'Look, doc, if things get too bad, I've got the ummer 1 9 9 6 �Choices at the end o f Ii f e usually they're looking forreassuram:e on rwo-points: one, that you can take care of their symptoms and their pain; two, that they will not be alone." "These fears are what drive people to consider suicide. lf you support patients and families, if you address their needs and fears, then the urge to do self-harm essentially disappears," he said. However, study after study has shown that doctors often fail to control patients' pain. "lf l make someone uncomfortable enough, put them in enough pain, l can convince them of anything," Milch said. "That is the principle of torture. "l would rather establish as a standard that the presence of unassessed, unmanaged pain is prima facie evidence of incompetence on the part of the physician," Milch continued. "lf physicians can't manage physical suffering, why would we give them the ability to do omething even bigger-end a life? " For Milch, and many other , physician-assisted suicide is at best a glamorous distraction from discussion of the real needs of terminal patients, and at worst a quick fix that society finds easier than spending the time, money, and emotional energy necessary for good care of the dying. "A suicide threat is a cry for help," said Hanlon, an adjunct professor at the UB School of ursing. "These people are in an impo iblesituation and they don't know what to do. They fear the unknown, and they fear that they won't get the help they need. Our answer must be to provide that help, not to help them commit suicide." But for Stephen Wear, the lack of good palliative care itself becomes an argument in favor of legalizing assisted suicide. "lf we can make people feel that they won't be needlessly overtreated and that their pain will be managed-and right now that is nota reasonable expectation, and people know it-then we should agree with Milch. lf we can't, then for compassion's sake we should be with Kevorkian and Humphry-and I loathe saying that," Wear said. "But it isn't enough to make philosophical arguments against assisted suicide. Doctors have to change their practice so assisted suicide is no longer the compassionate alternative." Even in the best scenario, where palliative care eases symptoms of terminal disease and hospice-type programs support patients and their families, many people believe that there will still be patients who cannot be helped by medicine. "ln most patients we can relieve their suffering, and we have to get better at doing that," Freer said. "But l also think it's clear- and most doctors agree-that there are people whose suffering cannot be relieved. There are people whose suffering can only be relieved by ending their lives." A s l i ppe r y slope The recent legal decisions on assisted suicide have made a distinction between helping a patient take his or her own life, and actively taking the life of a patient through euthanasia. But many fear that condoning one will lead to the otherand worse, to euthanasia of patients who are incapable of consent. ln the etherlands, euthanasia is illegal, but is not prosecuted if doctors demonstrate that the patient explicitly requested euthanasia, document their actions, and stay within other guidelines established by the national medical society. "IF PHYSICIANS CAN'T MANAGE PHYSICAL SUFFERING, WHY WOULD WE GIVE THEM THE ABILITY TO DO SOMETHING EVEN BIGGER-END A LIFE?" Robert Milch, M.D., med1cal director, Hospice Buffalo ® B u f f a l o Physician Summer 1 9 9 6 �"THE PROBLEM WITH THE PHYSICIAN-ASSISTED SUICIDE QUESTION IS THAT IT DISTRACTS FROM REAL ETHICAL DILEMMAS IN MEDICINE, AND COMPASSIONATE CARE OF DYING PEOPLE. " jack Freer, M.D., ethics committee chairman, M illard Fillmore Hospital Law might be the group that could provide leadership on the issue ," said Quill. Hanlon responded, "We will investigate any topic the governor tells us to, but we have already looked at this topic and come up with recommendations on it. " The task force's report warned that it would be impossible to draw up guidelines that could not be bent or broken. However, at least one study there has shown that more than one-fourth of euthanasia deaths occurred without a specific request from the patient. Many argue that this proves legalizing assisted death for consenting patients can lead to officially sanctioned euthanasia of patients who are incapable of consent. Also, Milch points out, "Nothing in medicine is a sure-fire bet. " If some physician-assisted suicide attempts fail to kill the patient, he asks, would that lead to sanctioned euthanasia? "Whose responsibility will it be to administer the coup de grace? " W h o w ill dec i de ? For the moment, the courts are making the decisions. If they decide to decriminalize physician-assisted suicide , the resulting legal void could open up more questions than it answers. The medical profession and American society as a whole will then have to decide how to handle the new freedom-to use it, abuse it, or reject it. "We're a complex society , a society of tensions, and there are not very many things that have a clear 'yes' or 'no' answer anymore, " Wear said. Also remaining to be solved is the issue of giving the proper care to dying patients-educating doctors and allocating resources. Whatever their opinion on physician-assisted suicide, observers believe that improving end-of-life care would drastically reduce the number of patients who find life so unbearable that they would choose suicide. "The problem with the physician-assisted suicide question is that it distracts from real ethical dilemmas in medicine , and compassionate care of dying people ," said Freer. "It's just such a simplistic way of dealing with such a small number of people, when the focus should be on the vast majority whose pain we just are not treating. " + jessica Andur is the editor of Buffalo Phy sician . T i me for gu i de li nes ? Some believe that the potential loosening of assisted-suicide laws means that it is time for medical professionals and patient advocacy organizations to cooperate in setting up guidelines to provide direction and protection for both groups. "We need guidelines and rules so people know that if they dot their i's and cross their t's, they can do this out in the open ," Quill said. His recommendations for safeguards include ensuring that a patient who elects suicide is terminally ill and not clinically depressed; that the patient is not pressured into the decision; that the wish to die is not a transient one; that there is proper access to palliative care; and that a second opinion is sought from an independent practitioner who has expertise in caring for dying patients. Quill's first concern is that palliative treatment and hospice care be extended to all who need it. "Hospice care must have failed , or not be acceptable to patients , before they should be able to choose assisted suicide. " He suggests that safeguards would have to be passed into law at the state level. "The state Task Force on Life and the B u f f a l a p h y c a 5 m m e 6 �Shades ofGr by Scott Thomas Four Buffalo doctors discuss the care of the dying BLACK A D WHITE aren't options for the physician caring for a patient in the final stage of life. All decisions are made in the gray zone in between. These shades of gray were the topics of a panel discussion, "Confronting Difficult Emotional and Ethical Issues in the Care of the Dying" at the 59th annual Spring Clinical Day, moderated by Elizabeth L. Maher, M.D. '85. The panelists were: Martin Brecher, M.D. '72, chairman of pediatrics at Roswell Park Cancer Institute and chief of hematology oncology at Children's Hospital. Jack P. Freer, M.D. '75, an internist and ethicist at Millard Fillmore Hospital who teaches at UB Medical School. Ross G. Hewitt, M.D., medical director and principal investigator for Erie County Medical Center's immunodeficiency services. Robert A. Milch, M.D. '68, medical director of Hospice Buffalo. Case No. I: A 36-year-old HIVpositive homosexual man. Following complications of AlDS, he began to develop memory loss . He made his partner his health care proxy and told his family in Wisconsin of his illness . When he was hospitalized for PCP pneumonia, his mother demanded that he be intubated for respiratory distress over the proxy 's objections. Hewitt: When the family is not aware of the diagnosis until much Buffalo Physician Summer 1 9 9 6 �Care of the dying later in the course of the disease, it puts patients and perhaps their significant others literally years ahead in terms of acceptance of the situation, coming to grips with their loss, the realities of having AIDS. They've gone through that process and are probably at a better stage to make health care proxy-related decisions on CPR and life support. So now the family is faced with going through all of those same processes that the patient has already been through years earlier. That very often leads to conOicts regarding care at the end of life. I think it's very possible in this particular case that the mother is still in shock and not able to listen to the facts that we might present in terms of what the prognosis is. Freer: This also points out the importance of a health care proxy, particularly in situations where there may be a number of different friends and family who may have conOicting views about what is best for the patient. This is in part because of the legal climate and the popular culture both presuming that people would want everything done to keep them alive as long as possible unless they've said otherwise . With that presumption, if you had somebody like the parent coming in and saying 'yes , you'd better intubate that person,' that is in keeping with this predominant view within the hospital culture and the courts, and there- B u f f o l 0 Physician fore it's important to have somebody who has the legal authorization to make decisions like this. Milch: Sometimes it's helpful to word things just a little bit differently. I've always been uncomfortable with defining ventilation and things like that as "life support." I think the connotation of discontinuing "life support" weighs heavily down the road, and if we redefine them as "function supports"-that's what we're doing with the ventilator is supporting the failed function-then perhaps that could be part of the first step over the bridge. Case No. 2: A 4-year-old boy with Stage 4 neuroblastoma. After chemotherapy, he had remission until age 6, and with a bone marrow transplant did well for another 18 months. At this point the mother requested no aggressive therapy. He was hospitalized for seizures, and required progressively larger doses of Phenobarbital to control them; hospital staff objected to giving such massive doses, and reported the case to administrators. Brecher: When a family faces potential loss of a child, perhaps this is the greatest tragedy that one can face in life. The family is really never the same thereafter. The parents are faced with this overwhelming tragedy in their lives; the siblings, who are sometimes forgotten elements in all of this , are profoundly affected by the parents' full attention on the sick child. The grandparents sometimes feel left out of the loop, and of course they're heavily emotionally involved. There's a tremendous impact on all the family. After the child dies , this family is going to have to live with what went on for many years to come and hopefully feel comfortable, not with the death of the child, but with what went on, that everything that should have been done was done correctly. There is such a loss of control when something dreadful happens to your child. After all, these are parents who used to decide what their kid would wear in the morning, what they would eat at lunch, Summer 1 9 9 6 �and suddenly it seems like everything has spun out of control and they have no impact at all on the course of their child's life. And to be able to bring that into the care-giving aspect of things , to have the child at home with as much support as they need , makes them feel that they have an important pan in this and gives them more comfort about a terminal situation. tain level , we relieve some of their bone pain, we improve their exercise tolerance or what have you. Brecher: The issue of the emotional impact on the care-givers is an important one. The longer you work with a child and a family , and the more you get to know them , the more they become a part of your life and the more difficult it is if there's suddenly a bad turn of events. Freer: Cases like thi also raise an important point for l think the after is important, too , sticking with the people involved in medical education. These are very family. I've had families tell me that not only was losing complex, difficult cases in terms of medical managethe child difficult, but they ment, in terms of commuhad devoted so much of their nication, in terms of settime and so much of their ting where the patient is life energies for months or going to be cared for. And years to the care of this child yet there is still that rem"I'VE HAD FAMILIES TELL ME that suddenly there was this nant of the old medical incredible void , when even education system where THAT NOT ONLY WAS LOSING though they might have cases like this are not inthree other kids, they didn't teresting, they're not good know what to get up for in teaching cases. l still get THE CHILD DIFFICULT , BUT the morning. infuriated when l see patients drop off the teach Milch: Even our choice of THEY HAD DEVOTED SO MUCH ing curve when they go to words is significant. On the hospice or a palliative care one hand we have "do not plan. These are very comOF THEIR TIME AND SO MUCH resuscitate, " on the other plicated management ishand we have "aggressive. " sues, and maybe we have Why would we refer to it as to emphasize this in trainOF THEIR LIFE ENERGIES FOR an aggression, rather than ing. trying to examine it as someMONTHS OR YEARS TO THE Milch: The issue of whether thing that may or may not a patient does or does not be appropriate to a certain have a do-not-resuscitate clinical setting7 l am as CARE OF THIS CHILD THAT order is but a small commuch troubled by standing orders of daily blood draws . ponent in his overall plan To what end? lt doesn' t imfor care, and should really SUDDENLY THERE WAS THIS pact our therapies. Then be kept to the side of deciperhaps it's appropriate to sion-making. The plan of INCREDIBLE VOID. " examine that. CAT scans, care is daily reassessed , MRls, other procedures ofeven hourly reassessed . ten do little more than docuYes , we would transfuse Martin Brecher, M.D. ment the natural progrespatients with metastatic sion of disease and do not prostate cancer, for example , if in getting their affect our decision-making hemoglobin up to a cerprocess. + e u f f a l o Physi c ian Summer l 9 9 6 �Care of the dying se in uland explains how we die by Scott Thomas OTHI G E~E," said Sherwin B. uland, M.D., "we should teach them that they must never let their patients lose hope." Hope-an elusive concept, and one that might seem to have more to do with poetry than with the science of medicine. Yet uland, who delivered the Stockton Kimball Memorial Lecture at the 59th annual Spring Clinical Day on May 11, told a large luncheon audience that hope is a most critical component of care at the end of a patient's life. As death approaches, he said, the role of healer and counselor is most important, not the science of T-cells and high-tech machines. Nuland, a clinical professor of surgery at the Yale University School of Medicine, is best known for his 1994 book How We Die, a frank and anecdotal account of life's last chapter as he has seen it played out in his family and his patients. The book won the ational Book Award for nonfiction and the Book Critics Circle Award, and was a finalist for the Pulitzer Prize. Though the ideas of hope and approaching death may seem irreconcilable, uland offered three ways in which a dying patient can be given the gift of hope. He was once asked, "What is the worst way to die?" His response was, "Alone"-whether physically alone or emotionally isolated. "Hope becomes a promise," he said, "that we will let no one die alone." Second, uland said, hope is the promise that no extraordinary measures will be taken that will make things worse. And finally, he said, physicians can impart the hope for immortality. "I don't believe in an afterlife," he said, "but I do believe in immortality. There are, for each of us, maybe one, maybe five people whose lives are dependent on what we are. We can share with them what their existence means for us. That's the kind of immortality that I would cherish." A person's actions and life affect loved ones for years and perhaps generations. Thus, a life well lived confers immortality. uland also quoted Czech President Vaclav Havel: "Hope is not the belief that things will turn out well. It is the belief '"lr \\ E TE \CH a u f f a 1 OLR qt_,DE TS o Physician that things will make some sense however they turn out." Nuland recounted the circumstances that led him to write How We Die-a persistent literary agent, a family history touched by many early deaths. "Death had been part of the lore of my family," he said. "Going to medical school meant learning to understand, to take part of the mystery away." In his practice he realized that most of his patients had no concept of what life's final stage was like, medically or emotionally. Romanticized Hollywood images of the family patriarch dispensing pithy wisdom from his deathbed, or the beautiful young woman going peacefully into that good night, are all we have to go on, he said. Hence his unflinching collection of stories about how real people die, sometimes easily and quietly, sometimes in pain or unable to resolve their life's unfinished business. uland pleaded for his fellow physicians to pay close attention to comfort care for their dying patients. "How did physicians forget that even more important than saving life is the duty to relieve pain?" he asked. "When did we begin converting every ethical and moral decision into a clinical decision? How have we begun to value triumphs of technique over triumphs of reason?" He traced the genesis of that attitude to the entrance of molecular biology into medicine. "We began teaching our students that one can learn more about a patient through the proper tests than by developing a real relationship with the patient. We moved farther and farther away from the fellow human beings who came to us for help, and before we knew it, we no longer knew who they were." But, uland argued, it benefits the practitioner as well as the patient to embrace a more human connection. "Among the greatest rewards we derive from medicine," he said, "are those we derive when we get emotionally involved with the people who come to us for healing." + Thomas, a frequent contributor to Buffalo Physician, is an editor and freelance writer with specialties in medicine, the arts, and religion. Summer l 9 9 6 �The historic context ot medicine Nationwide history of m edicine meetings draw scholars to Buffalo B Y JESSICA ANCKER for thousands of years, but in every age societal prejudices have colored their interpretations of th ose observations. H EALERS HAVE MADE ACCURATE MEDICAL OBSERVATIO S This lesson was a recurrent theme at the national meeting of the American Association for the History of Medicine, which was held in Buffalo May 9-12 in honor of UB's sesquicentennial. The event drew more than 400 scholars from around the country to the Hyatt Regency Buffalo. In the keynote address, Thomas Benedek, M.D., a rheumatologist and the president of the a sociation, discussed medical theories on the occurrence of gout in women. "The story of gouty women is an example of the interaction of science and the society in which it is practiced. It should not be considered unique," Benedek cautioned. "Despite our tremendous advances in science and technology, an unexpected stress makes us retreat to moralizing." Gout is caused by high levels of uric acid, which is produced by the metabolism of purine. The disease is characterized by sudden attacks of pain, swelling, and stiffness of the joints, often in the feet and legs. Inheritance, overeating, and alcohol can play a role in triggering the illness. Because estrogen help women excrete uric acid more efficiently than men, premenopausal women rarely suffer from gout. Ever since the 4th century B.C., Benedek said, healers have noticed that gout is rare among women. The earliest known pronouncement on the disease"A woman does not take the gout unless her menses be stopped"-is attributed to Hippocrates himself. The Roman writer Seneca blamed the disease on licentious and intemperate lifestyles. While these activities may have been regrettable in men, Benedek said, they were considered despicable in ® women. "Because of their vices, women have ceased to deserve the privilege of their sex; they have put off their womanly nature and are condemned to suffer the diseases of men ," Seneca wrote in a passage echoed by doctors for centuries. An 18th-century comic poem played on the alleged connection with lechery: "Where does one see a wife irate Because her spouse suffers gouty feet? In hot passion's embrace, as e\·e1yone /mows, Tl1 e gouty most often arc mighty heroes!" Doctors trying to explain gout in apparently blameless men and women offered alternate explanations. A few speculated that gout could be inherited from ancestors. Others held that gouty symptoms were not always gout. One doctor wrote that slender women with symptoms of gout were really suffering from hysteria. In the 18th century, the prestigious Philadelphia doctor Benjamin Rush absolved a respectable woman patient of the imputation of indelicate behavior by calling her gout rheumatism. "The cultural response to gout meant that women with gout were scorned: doctors often believed it was due to their unacceptable behavior," Benedek said. "The same thing happened when AIDS appeared. That shows how helpful it is for doctors to know something about the history of medicine-it helps them better analyze new problems that they encounter." The 69th annual meeting of the American Association for the History of Medicine drew 66 papers. The Society for Ancient Medicine, the AIDS History Group, the American Veterinary History Society, the American Association for the History of ursing, and seven other affiliated history societies also held their meetings in Buffalo the same weekend. Papers covered a multitude of topics, including fetal alcohol syndrome, the treatment of insanity in the 19th century, medical scholars in medieval Paris, traditional Korean medicine, the polio vaccine and public health policy, and dissections in the paintings of Rembrandt. + UB history professor Jomes Bono, Ph.D. (left), coordinated local affairs for the national meeting of the American Association for the History of Medicine, May 9-12 in Buffalo. Thomas Benedek, M.D. (right), of Pittsburgh, PA, is the association president. B u f f a l o Phys ici an Summer 1 9 9 6 �.......... . ............ . ............ . ........... . . . .. . .... . ...... .. .. . ... . ... •••••••••• ••• ~ I Dean Naughton to stay for additional six months ohn P. aughton, M.D. , the dean of the medical school and vice president for clinical affairs, has agreed to keep his current posts until the end of the year. aughton said he had planned to retire in June, but agreed to stay on for an additional ix months while the search for his successor continues. "As always, I appreciate your everwillingness to respond to the needs of the university," Provost Thomas Headrick told the dean. "UB greatly appreciates John's dedication and willingness to serve the university," UB President William Greiner said. After his retirement, aughton will John Naughton likely be as busy as ever. He plans to teach, do research in cardiology, and get involved in other educational projects. "''ve begun my transition by teaching a course in health care organization, and I'm continuing my activities in graduate medical education reform, and immunology and heart disease," he said. + Endowment established for scholarships and awards \ J director of admissions and the scholarship committee, I see the tremendous financial need of nearly 50 percent of the school's medical students. It made me realize how crucial financial assistance is to these students. " + ophthalmology. Recipients will be chosen on the basis of academic standing and financial need. "1 owe my success in medicine to UB, and 1 appreciate the opportunities I received when 1 was a student," saidGuttuso " ow, as Thomas Guttuso Registrar Dick Jones organizes the 1996 graduates in the Center for the Arts atrium. Twenty-nine members of the doss of 1946-who graduated during UB's centennial-returned to help the school celebrate its sesquicentennial. scholarship and award fund for UB medical students has been established through a gift of residential property from Thomas]. Guttuso, M.D. '60, the medical school's director of admissions, and his wife, Barbara. The Dr. Thomas ]. and Barbara L. Guttuso Scholarship and Award Fund will provide an annual scholarship for four medical students, as well as an award for a senior with an interest in B u f f a l a Physician Timothy Y. Jordon, M.D., was the class speaker at commencement. Summer 1 9 9 I 6 �• ································································ . I Match Day 1996 UST U DER HALF ofUB's graduatin g class ( 49 percent) were placed in primary care residencies in this spring's Match Day, putting the university within a hair of its 50 percent goal. The ational Residency Matching Program results were announced March 20 by associate dean Dennis adler at the Lord Amherst Motor Hotel. Eighty-two percent of the 136 graduating UB students got their first, second, or third choice of residency. Thirty-one percent will remain in Bu ffalo to train in UB's Graduate Medical Dental Education Consortium, while 53 percent will go out of state. JOHN l. BUTSCH, Stngfl), Rush- Presbyterian-St. Luke's Medical Center, Chicago, IL LAWRENCE R. CANFIELD, Famil) Practice, niversity of ew Mexico, School of Medicine, Albuquerque, M RICHARD E. CHARLES, lnccmal Medicine, The list below includes fou r additional students who were matched on UB Graduate Medical Dental Education Consortium, Buffalo, NY KATHERINE B. CHATIGNY, Psychiauy, Umversity of ew Mexico, School of Medicine, Albuquerque, NM Match Day but were not graduating seniors. Of the primary care specialties, 15 students went into internal medicine and four chose internal medicine-primary care. Twenty-two students chose BASIL CHERPELIS, Internal Medicine (P1clim.), orth Shore Universit) Hospital, Manhasset, Y KRISTEN M. CHRISTIAN, Pediatrics, S Y Y Health Science Center, Syracuse, pediatrics, 21 went into family medicine, and seven chose med!peds. EILEEN (Primal) Ca1c), Emory Universit)' School of Medicine, Atlanta, GA Universi ty of Michigan Hospitals, Ann Arbor, Ml SARAH BALLOW, Pediatrics, KIMBERLY M. BONISCH, Pediatrics, Graduate Medical Dental Education Consortium, Buffalo, NY Jo ANNE ARNOLD, Obstetrics & Gynecology, UB Graduate Medical Dental Education Consortium , Buffalo, NY PETER AUGUSTINOS, Surgery, St. Elizabeth's Medical Center, Boston, MA UB Graduate Medical Dental Educauon Consortium, Buffalo, Y JOHN P. BARRETT, Obstetrics & Education Consortium, Buffalo. Gynecology, Womens and Infants Hospital, Providence, Rl MARY(. BOPP, Pcdiauics, UB Graduate Medical Dental Education Consortium, Buffalo, Y RENIER J. BRENTJENS, lntcmal Medicine, University of Virginia, Charlouesville, VA MICHAEL BEECHER, Medicine/Pediatrics , UB Graduate Medical Dental Education Consortium, Buffalo, NY SUSAN E. BEHR, Pediatrics, Univer it)' of B u f f a l o TIMOTHY M. ComR, Diagnostic Radiology, Univcrsit) of Chicago Hospital, Chicago, IL HOLLY H. CROMWELL, TlansJtional, Cook County Hospital, Chicago, IL F. DAVIS, Internal Medicine, LOS Hospllal, Salt Lake Cit)', UT ALLEN GINA R. BRESCIA, lntcnwl Medicine, BRADLEY R. DAVIS, SurgCI), University of Yale- ew Haven Hospital, New Ha,·en, CT (P1immy Care), University of Rochester, Strong Memorial Medical Center, Rochester, NY SALVATORE BIANCO, Family Practice, Spartanburg Regional Medical Center, Spartanburg, SC Y Yale- ew Haven Hospital, ew Haven, CT PAUL C. BURNS, lntcnwl Medicine Texas Medical chool. Houston, TX Radiolog), Universit) of Rochester, Strong Memorial Hospital, Rochester, Y STEPHEN R. COOK, ,\fcdicinc/PcdJatrics, UB Graduate Medical Dental MATIHEW f. BARTELS, Pediatrics, DAVID ANDERSON, Surgery (P1elim.), UB M. BOBEK, Emergency MediciltC, ONEIL BAINS, lntcmal ,'1-fcdicine mversity Health Center, Piusburgh, PA JOSEPH E. CHRUSCICKI, Diagnostic Phys ici an Cincinnati Hospital, Cincinnati, OH JOSEPH S. DEJAMES, Family P1actice, UB Graduate Medical Dental Education Consortium, Buffalo. NY MANNY A. DELUCCA, Pediatrics, Medical College of Virginia, Richmond, VA Summe r 1 9 9 6 �········································•~ ··· I I ;; :.•> u ~ z Rhode Island Hospital, Prolidence, Rl (LARA E. KIM, lntemal Medicine, University of Nonh Carolina Hospital, Chapel Hill, NC MEEGHAN A. HART, Pediatrics, UB Graduate Medical Dental Education Consortium, Buffalo, Y ANDREW B. KLAFTER, Psychiatry, Thomas jefferson University, Philadelphia, PA STEVEN G. HEINTZ, Family Practice, ANTHONY J. LANGONE, lntemal Medicine, University of Vermont, College of Medicine, Milton, VI Baylor College of Medicine, Houston, IX JASON K. Ho, Family Practice, KEUNG W. LEE, In/ental Medicine, Yale- Glendale Adventist Medical Center, Glendale, CA MATTHIAS K. LEE, Psychiatry, Stanford BRIAN HANLON, lntemal Medicine, ROB L. DEMURO, lntmwl Medicine Dermatology, Stony Brook Teaching Hospitals, Stony Brook, NY (Primar) Care), Bassett Healthcare, Cooperstown, 'Y JAMES W. FOIT, Family Practice, UB DAVID J. D'SOUZA, Diagnostic Graduate Medical Dental Education Consortium, Buffalo, NY RadwlogJ, UniYersity of Texas Medical School, Houston, IX KATHLEEN M. DYSON, Pediatncs, UB RICHARD A. EDWARDS, Obstetncs & Gynecolog_1, UB Graduate Medical Dental Education Consoruum, Buffalo, NY LLEWELLYN A. FOULKE, Patlrologj, Hospital of the University of Pennsyh·ania, Philadelphia, PA UniYersity of Cincinnau Hospital, Cincinnati, OH MICHAEL J. ENDL, /rue mal ?lfedrcinc (Prelim.), Sisters of Charity Hospital, Buffalo, NY; and Dwgnostic Radiolog) , Duke Uniwrsil) Medical Center, Durham, C JOSHUA J. FISCHER, /ntemal Medicine, Universit) of Virgmia, Charlonesnlle, VA SAMUEL GOODLOE, Surgery• (Prelim.), UB Graduate Medical Dental Education Consortium, Buffalo, Y Gynecology, SU Y Health Science Center, Syracuse, NY THOMAS J. GUTTUSO, lntemal Medicine Einstein College of Medicine, Montefiore Medical Center, Bronx, y ERIK J. JENSEN, lntemal Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, NY PATTI A. HAMERNIK, Pediatrics, UB TIMOTHY JORDEN, General Surger), GINA l. FLORES, Far111/; Practice, New STEPHANIE C. HAN, lrllcntal Medicine Hampshire-Dartmouth Famll) Practice, Hanover, H (Prelim.), UB Graduate Medical Dental Education Consortium, Buffalo, Y; and Radiation Oncolog), Yale- e\\ Haven Hospital, New HaYen, CT (Prelim.), Ston) Brook Teachmg Hospitals, Ston) Brook, Y; and B a 0 p y PAULY. JEE, lmemal Medicine, Alben (Prelim.), University of Rochester, trong Memorial Hospital, Rochester, NY; and 1 curolog), University of Rochester, trong Memorial Hospital, Rochester, Y Hospital at Queens, Flushing, NY SCOTT L. FLUGMAN, lmernal Med1cine BABAK JAHAN-PARWAR, Research Fellowship, Swgical Pa!holog), Roswell Park Cancer Institute, Buffalo, Y CHRISTOPHER JAYNE, Obstetrics & Graduate Medical Dental Education Consortium, Buffalo, 1Y DORNA E. FLASH, Transitional, New York Graduate Medical Dental Education Consortium, Buffalo, NY Graduate Medical Dental Education Consortium, Buffalo, NY Universil) of Virginia, Charlonesville, VA DAVID J. FIORELLA, lntcmal Medicine THOMAS F. HUGHES, Family Practice, UB MARK JAJKOWSKI, Surgery, UB THOMAS J. GENNOSA, Family Practice, (Prelim.), UB Graduate Medical Dental Education Consortium, Buffalo, NY; and Oplttlralrrwlog_\, Louisiana tate niYersity Eye Center, Ne" Orleans, LA MICHAEL S. LEONARD, Pediatrics, UB RAJIV K. JAIN, Medicine/Pediatrics, Duke UniYersity Medical Center, Durham, NC TIFFANY B. GENEWICK, Obstetrics (.-. Gy necoiOg)', UB Graduate Medical Dental Education Consortium, Buffalo, Y GARY J. ELKIN, /ntcnwl Medrcrne, Health Service, Stanford, CA Gynecologj, Temple University Hospital, Philadelphia, PA Louis University School of Medicine, St. Louis, MO (Prelim.), i ter of Charity Hospital, Buffalo, Y; and Diagnostic RadiologJ, johns Hopkins Hospnal, Baltimore, MD Graduate Medical Dental Education Consortium, Buffalo, NY JEAN(. HSIAO-WANG, Obstetrics c~ Yu-LUEN Hsu, lntenwl Medicine, St. BRIAN J. FORTMAN, /ntcnwl Medicine c a 5 m (Prelim.) Madigan Army Medical Center, Tacoma, WA WALTER J. KANTOR, Emergency Medicine, University Health Center, Pittsburgh, PA DAVID KAUFMAN, Pathology, Mt. Sinai Hospital, m New Haven Hospital, New Haven, CT e ew York, 9 9 Y Graduate Medical Dental Education Consortium, Buffalo, NY KWOK Ll, lntenwl Medicine (Prelim.), UB Graduate Medical Dental Education Consortium. Buffalo, Y; and Ophthalmology, Louisiana State University Eye Center, ew Orleans, LA DOMINIC R. LIPOME, ln!enwl Medicine (Primary Care), UB Graduate Medical Dental Education Consortillln, Buffalo, NY HAROLD I. LITT, lrHemal Medicine (Prelim.), Mt. Auburn Hospital, Cambridge, MA; and Diagnostic Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA CHENG H. Lo, Surgery, Stony Brook Teaching Hospital, Stony Brook, Y JIADE J. Lu, Internal Medicine (Prelim.), Sisters of Charity Hospital, Buffalo, Y; and Radiation Oncolog), jackson Memorial Hospital, Miami, FL BETH M. MACDONALD, Family Practice, Southwest Washington Medical Center, Bush Prairie, WA MICHAEL A. MANKA, Emergency Medich1e, UB Graduate Medical Dental Education Consortium, Buffalo, NY DEBORAH J. MANN, Emergency Medicine, UB Graduate Medical Dental Education Consortium, Buffalo, NY CHRISTOPHER (. MASCIA, Pediatrics, Medical College of Virginia, Richmond, VA �• ·········· ·· ··············· · ············ ~ I L. WALK, Family Practice, Highland Hospital Program, Rochester, NY PAULS. MAll, Pcdiatncs, Children's JOHN P. PATTI, \1rdiclllc/Pediatrics, UB KARIN A. SELVA, Graduate Medical Dental Education Consortium, Buffalo, NY Pcdtatrics, Uni,·ersity of ew Mexoco, School of Medocine, Albuquerque, M LISA Hospital of Pholadelphoa, Philadelphia, PA L. MCNALLY, Surgery (Prelim.), University of Rochester, Strong Memorial Hospital, Rochester, NY: and Urology, niversity of Rochester, Strong Mcmonal Hospital, Rochester, N'r OSCAR E. PIEDAD, Family PracL!cc, Richland Memorial Hospital, Columboa, SC EDWARD SILVERMAN, Obstctncs & G_\IICcolog_\, Mamwnodes Medical Center, Brooklyn, N'r JAMES G. WAXMONSKY, FREDERICK J. PIWKO, Fanlll) PnJctice, \\ olllamsport Hospital and Medocal Center, Wolliamsport, PA INDRANI SINHA, Pedtatrics, Unovers1ty of Florida, Shands Hospital, GameS\ille, rL KEE Y. WEE, KATHRYN A. MCVICAR, Pcdwtrics, JONATHAN W. SIRKIN, Psychiatl}, UB NAOMI D. WEINSTEIN, f.,Gynecology, Unl\erslt) of Rochester, Strong Memonal Hospotal, Rochester, NY STEVEN R. POSNER, urger\, Unoversit) of Michigan Hospitals, Ann Arbor, Ml JOHNS. PULVINO, Obstetrio & G) necology, Mmne Medical Center, KAREN A. SNELL, Obstetrics f.,Gynecology , Ba)'State Medical Center, Springfield, MA WILLIAM J. MEDWID, KAVITHA T. RAM, Obs!Cims MELANIE Presbytenan Ho pita!, Ne" York, Y THOMAS P. MEAD, Obslrtms Family Practice, Beverly Hospital, Danvers, MA PracL!ce, t.;B Graduate Medocal Dental Education Consortium, Buffalo, NY KIMBERLY E. METZ, Fanuly DAVID T. MILLER, Surge'} (Prclun.), UB Graduate Medocal Dental Education Consortium, Buffalo, Y: and Orthopedtcs, B Graduate Medocal Dental Education Consoruum, Buffalo, Y Emergency Medicine, Long Island jew1sh Medical Center, Long Island, NY PINAKI MUKHERJI, DWAYNE A. NARAYAN, Psychiatry, noverslty of Virgmia, Roanoke,\ A Obstru 1c; f_,Gynecology, noverslty of Texas Southwestern Medocal School, Dallas, TX EMMEKUNLA K. NYLANDER, NAYOMI E. OMURA, Internal Medicine (Prclun.), George Washmgton University, Washmgton, DC J. 0STEMPOWSKI, Orthopedics, Universit)' of Cincinnati Hospital, Cincinnati, OH MICHAEL CHRISTOPHER PACE, Urology, Unoversit) of Texas Southwestern Medical School, Dallas, TX Emngency Medtchtc, UB Graduate Med1cal Dental Education onsortlum, Buffalo, 'r PARAS PANDYA, Medtwoc, Unoversoty of Connecticut, Farmington, CT NEIL N. PATEl. Internal ® C" G\IICcolog_v, LB Graduate Medocal Dental Education Consortium, Buffalo, Y SUNG Y. SoN, Fwmlv TranstL!ollal, Evanston Hospital, Ch1cago, IL Graduate Medical Dental Education Consortium, Buffalo, Y J. RIEGEL, llllernal \trdicine, St. Elizabeth's Medical Center, Boston, MA KRISTIN A. STIEVATER, Psychiatt) , UB Fwnily Practice, UB Graduate Medocal Dental Education Consortium, Buffalo, N'r MICHAEL(. STONER, H. WILLIS, JR., i\eurosurgery, CleYeland Clinic Foundation, Cleveland, OH BYRON MARY M. WILSCH, Obstetrics & Gynecology, University of Rochester, Strong Memorial Hospital, Rochester, Y Graduate Medical Dental Education Consortium, Buffalo, NY KRISTEN M. ROBILLARD, ARLENE S. ROGACHEFSKY, Dw11a!Oiogy. Cle,·eland Clinic Foundation, Cleveland, OH JOSEPH(. WITIMANN, Pediatrics, UB Surgcty, Medical College of VIrginta, Richmond, VA Graduate Medical Dental Education Consoruum, Buffalo, Y Obstcutcs & G\nrcology, Albany Medical Center Hospital, Albany, NY TOVA R. STRAM, l. WRAZEN, Pedialt ICS, Oregon Health Sciences ni\-ersity, Portland, OR JENNIFER Medicine! Pechatms, Baystate Medical Center, pnngfield, MA SUSAN M. SZIMONISZ, Practice, LB Graduate \ted1cal Dental Education Consortium, Buffalo, Y MARY A. RYKERT, Fanul_1 Practice, Niagara Falls Memorial Hospital, Ntagara Falls, Y CHARLES YATES, FamilJ Pedtautcs, B Graduate Medical Dental Education Consortium, Buffalo, Y MAXINE E. SZUMIGALA, STARLEEN (. SCHAFFER, \lcdicine/ Pediatncs, Jackson Memonal Hosp1tal, Moamo, FL MARK R. ZAMBRON, Medicinc/Pediallics, UB Graduate Medical Dental Education Consortium, Buffalo, NY Emergency Mcdicme, UB Graduate Medical Dental Educauon Consortium, Buffalo, ) RENATE TREADWAY, DAVID F. SCHMITZ, Fcuml) Practice, Famoly Practice ResidenC) of Boise, Boise, ID Fanuly Practice, Niagara Falls Memonal Hospital, iagara Falls, Y DANIEL W. ZORICH, Obs!CIIics f., Gynecology, UB Graduate Medical Dental Education Consortium, Buffalo, NY MILLICENT H. TREVETT, J. SCHROT, Surget) (Prelim.), t. Louis niverslty chool of Medicine, St. Louis, MO RUDOLPH J. SCHUECKLER, Orthopedics, McGaw Medical Center, orthwestern Uni,·ersity, Chicago, IL JON UDWADIA, Pccliatr tcs, UB Graduate Med1cal Dental Education Consortium, Buffalo, N) EROL VEZNEDAROGLU, Surgcl) (Prelun .), Thomas jefferson UmverSll), Philadelphia, PA: and 1\eurosurget) , Thoma jefferson UmverS!l), Philadelphia, PA DOUGLAS A. SCHULTZ, 0 + Pediatrics, UB Graduate Medical Dental Education Consortium, Buffalo, NY OTTO 0 lntetnal Medicine (Prelim.), St. Mary's Medical Center, Long Beach, CA: and Radiation Oncology, Stanford University Hospital, tanford, CA Scan S. WILLIAMS, PATRICK J. STEIN, Psychiatl), UB BRIAN f Pediatrics, University of South Florida, College of Medicme, Tampa, FL Ptactice, Lancaster General Hospnal, Lancaster, PA EILEEN B. REILLY, u Dtagnostic Radiolog_\, Uni\·ersll\ Hospitals of Cleveland, Cleveland, OH Graduate Medocal Dental Education Consortmm, Buffalo, NY Portland, ME B Psychiall), UB Graduate Medical Dental Education Consortium, Buffalo, NY p s o n S u m m e 9 9 6 �··················································· ·· ···································• · · ~ •• New UB Chair honors professor HE U IVERSITY HAS HONORED a respected faculty member, Eugene R. Mindell, M.D., with the establishment of the Eugene R. Mindell M.D. Chair in orthopedic surgery. Mindell, UB professor emeritus and chair of the department of orthopedics from 1964 to 1988, conducts research in orthopedic oncology and bone pathology. Eugene Mindell He is particularly interested in new treatments that avoid total amputation. For example, Mindell takes pride in saving the arm of a 19-year-old woman with osteogenic sarcoma just above her wrist. After the cancer was removed, along with part of the radius, the patient's bone was reconstructed with bone from a bank. Ten years later, the patient has a good arm with an excellent grip, and no recurrence of disease. After interning at the Cincinnati General Hospital, Mindel! was stationed as a naval officer at the Veteran's Hospital in Columbia, SC. He completed his residency at the University of Chicago Clinics. Mindell met his wife of 50 years, june A. Mindell, while he was a medical student and she was an undergraduate at the University of Chicago. They have four children and three grandchildren. Robert Gillespie, M.D., chair of UB's Department of Orthopedic Surgery, said of Mindell: "He is a man of great charm and obvious integrity and leadership qualities. His greatest accomplishments are his dedication to the residency program and his work as a teacher. He is a true academic surgeon." The chair is funded by a charitable remainder trust commitment from Byron A. Genner III, M.D., UB class of 1954. Further gifts toward the chair are being sought. Genner's gift places $825,000 in real estate in trust for the medical school, while still generating income for Genner during his lifetime. The school will seek more money to bring the total funding for the chair to between $1 million and $1.5 million. "UB provided me with an outstanding undergraduate and medical education," said Genner. "This became evident during my internship and orthopedic surgery residency. It was satisfying being as well or better prepared than my peers in my academic endeavors." Genner spent 15 years on active duty in the U.S. Air Force, retiring as a lieutenant colonel. His career includes posts as associate clinical professor at George Washington University and assistant clinical professor at Georgetown University. He continues a part-time orthopedics practice, along with an active + medical-legal consulting service. -8 Y P A U L A W I T H E R E L L As part of UB's sesquicentennial celebration, these plaques were installed in downtown Buffalo to commemorate the first three homes of the medical school. B u f f a I a Physician Summer 1 9 9 6 �Robert N. Spengler, Ph.D. Neuroimmunologist WORKING AT THE INTERSECTION OF IMMUNOLOGY AND NEUROBIOLOGY IT' 5 o sEcRET that the mind has a profound effect on healing. Quantifying that relationship and examining it at the molecular level is the work of Robert Q) sity of Michigan, where he also did postdoctoral work in pathology. He joined UB as an assistant professor of pathology in 1989. His primary area of interest is cytokines, a class of immune system hom10nes that serve as cellto-cell communication signals. Once thought to be active only in the immune system, cytokines have been found to have many functions in the nervous system, as well. This has led researchers to believe that cytokines participate "We're looking for a better understanding of how the brain controls body functions , and the other way around-how cells associated with the immune system control neuronal functions," says Spengler, assistant professor of pathology. "Each system is interdependent on the other. " Spengler, 4l,isparticularlywell qualified to explore the fruitful intersection of immunology and _Eeurobiology. He earned his Ph.D. in pharmacology from the Univer- B U f f o . Spengler, Ph.D. l o Physician in neuro-immune communication and may even act as neurotransmitters in certain situations. Spengler is particularly interested in tumor necrosis factor. Like many other cytokines, it was first identified and named for its connection with an immune function (killing tumor cells). ow researchers believe it also has neurologic functions. Because the concentration of tumor necrosis factor often governs how it functions in different disease states, much of Spengler's work focuses on investigating how the body regulates the release of the substance. Another of Spengler's research areas is psychotropic drugs. He has investigated the biochemical activity of antidepressant drugs and how cytokines may be linked to depression. He also studies the use of antidepressant drugs to alleviate neurological pain, which occurs when a disorder such as arthritis causes chronic pain that creates a continuous circuit in the brain, causing the sensation of pain even without any further stimulus from the site of the disorder. Drugs that affect neural behavior may do so by regulating cytokine expression or sensitivity, according to Spengler. "We use drugs as a tool to understand a disease, " he explains. "Drugs are used because they work, not because we know how they work." Spengler is also beginning experiments on a second group of cytokines, the interleukins, which seem to perform many of the same functions as tumor necrosis factor. This redundancy, he theorizes, shows how important these functions are. "It's clearly the body's way of backing itself up," he says. + Summer 1 9 9 6 �·· · ··· · ········· · · · ·········· · ·········· · ··· ·· · · ···· · ··· · ········· ··· ·· · ···· · ···· · ··· · · ·• · · ~ I Two D~tinguished Professors named wo members of UB's medical fac- a department-wide commitment to upulty have been named to the rank holding the policy. It is largely through of Distinguished Professor, the his work that UB has been recognized highest rank in the State University as a national leader in recruiting and of ew York system, by the SU Y retaining students and facBoard of Trustees. ulty from traditionally James P. olan, M.D. , was named underrepresented groups. Distinguished Service Professor, awarded olan has been a memin recognition of extraordinary service to ber of the Governor's the community, state, or nation. Council on Graduate Perry Hogan, Ph.D., was named Perry Hogan Medical Education, and Distinguished Teaching Professor , has served as president of the ew York an equivalent honor that recognizes State chapter of the American College of outstanding teaching competence. Physicians. olan, who recently stepped down Hogan teaches cardiovascular physiafter 16 years as chairman of the Depart- ology, cell membrane phenomena, and ment of Medicine, is an internationally the electrophysiology of excitable cells. recognized expert in For many years he has taught cardiac liver function, liver and circulatory physiology to first-year disease and injury, medical and graduate students. and endotoxins. Hogan received the Louis A. and Ruth His efforts in the Siegel Award for Outstanding I eacher in 1970s led to a the Preclinical Sciences five times during full and fair affirma- a 16-year period. The award is given by tive action policy and medical students and fellow faculty. + James Nolan I UB microbiology professor dies at 76 ugene A. Gorzynski, Ph .D. '68, of Homburg, NY, a professor of microbiology and pathology at UB and chief of the microbiology section at the Buffalo VA Medical Center, died May 16 after a lengthy battle with cancer. He was 76. In 19 55, Gorzynski and the late Erwin Neier, an internationally known bacteriologist, were the first to describe enteropathogenic f. coli bacteria as a toxin producer that could cause severe diarrhea in infants and young children. Aveteran of World War II, Gorzynski served as director of bacteriology with the Army General Hospital in England. While there, he met his future wife, Ruth Repp, an Army nurse and Missouri native. She died in 1992. At different times, Gorzynski worked at the VA, Children's Hospital, and Roswell Pork Cancer Nielsen and Nolan Win Alumni Association Awards Institute, and served as an assistant director oft he ancy H. ielsen, M.D., a 1976 and serves as regional medical director graduate of the medical school for the Board of Professional Medical and a former member of the SU Y Conduct in the ew York State DepartBoard of Trustees, has been given ment of Health. A specialist in internal medicine the Samuel P. Capen Award , the and infectious disUB Alumni Association's most ease, she is a clinical prestigious award. assistant professor of The award recognizes alumni who medicine at UB. have made "notable and meritorious The Alumni Ascontributions to the university and its sociation also gave family ... influencing growth and imthe Walter P. Cooke provement of UB and stimulating othAward to James P. ers to give their active interest and olan , M.D. The material support to the university. " honor recognizes ielsen was the first woman to be exceptional service elected president ofThe Buffalo General to UB by a nonHospital medical staff. She is past presialumnus . + dent of the Erie County Medical Society Nancy Nielsen B u f f a I o P hysici a n Summer 1 9 9 6 Erie County Health Department. He hod taught at the UB School of Nursing and Erie Community College as well as at the UBmedical school. Amember of the UB-based Ernest Witebsky Center for Immunology, he served on the admissions committee of the School of Medicine and Biomedical Sciences. An amateur violinist, Gorzynski performed with the Amherst and Orchard Park Symphony orchestras for more than 30 years. He also was commanding officer of the 365th General Hospital for the U.S. Army Reserves in Amherst from 1966-69. He retired as a colonel in 1979. + ® �••••••••• • • 0 •••••••••• • ••••••••••••••• •• •• • • 0 ••••••••••••••• "I had never known so much about someone " ••• BY CHR I S SCHAEFFER , UB MEDICAL SCHOO L C LASS OF 1998 n the summer of 1995, after my first year of medical school, I spent six weeks at The Buffalo General Hospital's Outpatient Clinic. The story of that externship is the story of the 100 people I saw. I was fascinated by their stories, by their problems, by the factthatl was sitting in the room with them, wearing a white coat and writing it all down. Of all the stories that I came across that summer, one will always stay with me. Mr. R was a 54-year-old man, divorced, with one son. His face had the look of worn shoe leather. He was gaunt, with uncut white hair and skinny legs inside cowboy boots. In our first interview, during a checkup, Mr. R gave me the gist of his complaints. But what fascinated me was that his life had been so different from mine. He was poor, he had grown up without any of my advantages, and he had taken pleasure where he could find it. Later, my preceptor, Dr. Richard Schifeling, explained alcoholic cirrhosis and the attendant problems Mr. R was having-ascites and hemorrhoids, to name two. Mr. R returned the next week, before his scheduled appointment, complaining of pain and worsening ascites. I waved to him in the hall, oddly glad to see a familiar face in the crowd. ext week Mr. R was back. This time I asked to see him. In the sea of everchanging, ever-similar complaints, Mr. R seemed like a rock of certainty- ! already knew what was wrong with him. I talked to Mr. R about his belly and how things were going at home. Frankly, I was curious about how his life had come to this point. He could barely move himself around the examining room. I wanted to know, 'Who is this person who has done this to himself?' I put all of my empathy and listening skills to work, and for my efforts learned only that he lived with "a woman friend" and had just decided to give up drinking. Mr. R asked me to take off his boots becau e it hurt too much to bend over. That day, Dr. Schifeling recommended a transjugular intrahepatic ponosys-temic shunt, or TIPS, to bypass his failing liver. Mr. R looked at us, then looked away, and consented by saying, "Whatever you got to do.l just want to get this over with." When Mr. R was admitted, I thought, "Hah! He'll be here all the time-now he'll have to talk to me. " My increasing familiarity with his medical condition made my complete lack of understanding of him bother me more and more. When I visited, we chatted about nothing-the nurses, the food, the TVs remote control. What I really wanted to know was if he was nervous about the surgery, if he really had kept drinking even with his liver destroyed. I left without answers. Mr. R went from poor to worse. His kidneys began to fail , so he couldn't • •••••••••••••••••• • •••••••• have the surgery after all. Over the next two weeks I saw a myriad of people in the outpatient clinic, but every morning and evening I visited Mr. R. We tried everything we could to help, including multiple abdominal taps to relieve his ascites. One memorable day I stood with an attending, a resident, an intern, and a fourth-year student as the intern began an abdominal tap. After the initial excitement, everyone left except the intern and myself. The intern looked at me, considered his aching arms, and asked ifl would like to finish the tap. The next thing I knew, the intern had left, I was holding a needle somewhere inside Mr. R's belly, and Mr. R was talking on the telephone. All I could think was, "What is going on?? I hope nothing goes wrong! " Every day he was in the hospital, I saw his complete medical report, from his blood and urine to how he had slept the night before. I had never known so much about someone. In the final weeks of my externship it became clear to me (long after it had become clear to everyone else) that Mr. R was going to die, and die soon. Whenever I saw him, I waited quietly so he could bring up anything he wanted to talk about. I asked how he felt, I joked with him. Nothing changed. He still complained about his roommate, his girlfriend, his son. I never got to know Mr. Rduring our talks. He stayed private and separate from me. Knowing his prognosis, Mr. R decided to go home. He tried to cheer our blank faces by joking that he'd come to the clinic, "just like before." He left on Friday. When I got to work on Monday, Dr. Schifeling took me aside and told me that Mr. R had died over the weekend. + Chr-is Schaeffer, l-..ho will enrcr h1s !hird year a! L'B School of \.fed1cme and Biomedical Sciences 1h1s fall, is the secretan- of tht' \.1edical Studen! Polit\ s u f f a I o Phys i cian Summer t 9 9 6 �1996 reunion portraits en classes were honored at this year's Reunion Weekend festivities as they gathered in Buffalo to remember old times and renew acquaintances. FIRST ROW:john Crissey, Raymond Trudnowski, Stanley Cyran, William Walsh, Myron Williams, john Allen, Annabel Irons, Edward Gudgel, Donato Carbone. SECOND ROW:Lawrence Golden, William Marsh, orman om of, Harry Petzing, Fred Schwarz, Charles Bauer, Harold Levy, Herbert Pirson, Ross Imburgia, Thomas Morgan, R. joseph aples, Maynard Mires, Albert Rowe, Eugene Marks. THIRD ROW: Raymond Osgood, Richard Munschauer, Bernard Groh, Carllmpellitier, Willis Allen, Guy Hartman, Charles joy, W. William Tornow, Amo Piccoli, Frederick Musser. B u f f a l o P hysician FIRST ROW: Lester Wolcott, August Bruno, Donald Pinkel, Leonard Danzig. SECOND ROW: Alvin Volkman, james LoVerde, Allen Goldfarb, Milton Robinson, Eugene Leslie, Marvin Pleskow, Eugene Teich, Carl Conrad, Edward Shanbrom, Harold Krueger. Reunion Classes Continued on page 30 Summer l 9 9 6 �~ -········· ··· ·· · · · · · ························ · · ··· · · ··························· · ········· lEI FIRST ROW: Peter Goergen, Bernard Sklar, Helene Buerger, Sue McCutcheon,john Bartels, Robert Reisman, Fred Lee, Herman Schoene. SECOND ROW:john Hodson, joseph Kunz, Fred uessle, Robert Corretore, Paul Ronca, john Walters, Hugh 0' eill, Carl Schueler, jean Haar. THIRD ROW:Edmond Gicewicz, Mark Dentinger, Fred GoldsteinGretan, Erick Reeber, Dennis Heimback, George Christ. FIRST ROW: Eugene Cimino, Harold Brody, Michael Cohen, james Markello. SECOND ROW:joel Bernstein, William Hewett, A. Thomas Pulvino, Thomas Ciesla, Washington Burns Ill, Sylvia Kennedy, ]. Anthony Brown, Wende Young, Henry Goller, Edwin Manning,Jonathan Logan,joseph Fermaglich, Howard Wilinsky. FIRST ROW: Edwin jenis, Murray Yost, Robert Barone, jared Barlow, Cary Presant. SECOND ROW: Roger Seibel, jeffrey Kahler, Virginia Rubinstein, David Buchin, Rudolph Oehm, Ross Guarino , William Sperling, Frank Barbarossa, james Cuffe. THIRD ROW:Harold Grunert, David Wallack, Eugene Spiritus, H. john Rubinstein, Michael Weintraub, Louis Antonucci, Thomas Bradley, Wayne Fricke, Marcella Fierro, james Moran, john LaDuca. FIRST ROW: Colleen Livingston, Annie Terry English. SECOND ROW: Marvin Stein, Askold Mosijczuk, Dennis adler, Scott Kirsch, David Rowland, David Bloom, Sigmund Gould, Roy Oswaks, Allen Berliner, Robert Kaufman, Richard Manch, joel Paull. THIRD ROW:jay Harolds, Donald Marcus, David Hoffman, Martin Mango. FOURTH ROW:Manny Christakos,] ames McCoy,] ohnAntkowiak. FIFTH ROW: Charles Yeagle. B u f f a l o Physician Summer 1 9 9 6 �FIRST ROW: Gregg Broffman, Arnold Wax, Linda Wild, Susan Barde, Robin Lazar-Miller, Patrick Hayes, Karen Glasgow, Louise Isenberg-Dallaire, Stephan Levitt, Hartwig Boepple, Paul Schwach. SECOND ROW: Martin Barron, Grant Golden, Daniel Wild, Jon Yerby, Christopher Barde, Melvin Pohl. THIRD ROW: David Myers, Christopher Brandy, William Bishop, Dennis Pyszczynski, John Bodkin. FIRST ROW: Suzanne Bradley, Beth Heitzman Donahue, Betty Wells. SECOND ROW:George Bancroft, ToddJacobson, Pablo Rodriguez, Stanley Bukowski, Daniel Castellani, Pano Yeracaris. FIRST ROW (KNEELING AND SITTING): Carmen Todoro, Katrina Guest, Donnica Moore, Sanford Levy, Molly 0'6-orman, Paul Holmwood, Deborah Puckhaber, Mary Bennett. SECOND ROW: Megan Farrell, Shirley Anain, William Beneke, Andrew Giacobbe, Edward Stulik, Lance Besner, Riyaz Hassanali, Leonard Portocarrero, Karin Choy, Sean O'Brien, Mark Vickers, Deborah Richter. FIRST ROW: Alison Koehler, Kathylynn Southard, Susan Littler, Grace Alessi, Mary Bonafede, Rosalind Nolan Sulaiman, Elissa Bookner. SECOND ROW: Kinga Tibold, Joseph Barrocas, Joseph Bonafede, Steven Abbey, Richard Alessi, Jennifer Ferraro. B u f f a l o P hysician Summer 1 9 9 6 �Treating children from around the world LYNNETTE NIEMAN , '78, CLINICAL DIRECTOR OF THE NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT ynnette Kaye Nieman, M.D., values the knowledge and practical experience she carried from UB to her career at the National Institutes of Health (NIH). However, one thing she hasn't found a use for was an adage she was taught here: in medicine, if you hear hooves, it's more likely a horse than a zebra. "Around here, that just isn't true: hooves mean it's probably a zebra," explained ieman, 43, clinical director of the ational Institute of Child Health and Human Development, one of 16 component institutes at NIH. Nieman encounters the exotic and uncommon every day as she studies and treats afflicted children who come from throughout the world to the Institute's Bethesda, MD, clinic for treatment of rare endocrinological disorders. "Simply put," ieman explained, "we get to see weird things from all over the world." ieman oversee patient care, protocols, credentialing and medical education at the Institute , administering a 36bed inpatient unit and large outpatient clinic. More than 70 physicians, from fellows and trainees to experienced, board-certified experts , provide direct care through affiliation with the Institute. Young doctors who complete fellowships at the Institute are frequently recruited into academic medicine, the pharmaceutical industry or regulatory posts, including the Food and Drug Administration, A Buffalo native, ieman is board-certified in endocrinology and internal medicine. She obtained her undergraduate degree in molecular and cellular biology at Smith College and attended UB School of Medicine and Biomedical Sciences between 1974-78. She performed her residency in Buffalo as well , rotating between Buffalo General, the VA hospital, and what is now ECMC. She rose to chief resident during her third residency year. ieman served as an endocrine fellow in Buffalo for a year before joining IH explains ieman. Although the federal government has tightened its belt in recent years, ieman says that IH still enjoys relatively stable funding. Independence from constant grant-garnering enables IH clinicians and researchers to pursue "more high-risk research where there might not be a clear-cut payoff," explains ieman . Some of the work the Institute does in vaccine development is "really cutting edge," she added. Field trials take place all over the world , including current projects in Vietnam, Egypt and Israel. in 1982. ieman has authored more than 100 major journal articles and book chapters, most on Cushing's Syndrome or female reproductive anatomy. Cushing's Syndrome is a rather uncommon disease which ieman has researched , written about , and spoken on extensively. A natural overproduction of cortisone by the adrenal system, Cushing's comes in varying degrees of severity. Although relatively treatable, early Cushing's symptoms can be difficult to distinguish from more com- ® B u f f o l o Physician summer l 9 9 6 �Cushing's. In addition, she has examined other potential uses for the drug, which the FDA is now examining. "The drug seems to have potential for reducing fibroids and stalling endometriosis ," she explained. Thirty million women a year experience these problems, which are the most common reasons for hysterectomies, according to ieman. Dr. "Pepper" Davis, ieman's first attending physician in Buffalo, deserves credit for steering her toward endocrinology, she recalled. "I was mon ailments, ieman explains. "The early signs, such as weight gain, hypertension and interested in gynecology, but we talked a lot and he mood swings, are frequent even among the general popula- introduced me to the idea of medical endocrinology." ieman also credits UB medical school for showing tion," she said, "so we do a lot of work teaching clinicians how her how to examine philosophical and bio-ethical conto distinguish Cushing's from more common ailments." siderations during her training, tools Later stages of Cushing's, however, are which she has now revisited in dealing unmistakable. Patients will develop round, 11 with the RU 486 research. Simply put1 we reddened faces and weight gain in the center ieman, her husband and their two of the body, with purple stretch marks around children live in Bethesda. After years the midsection. Fully developed Cushing's get to see weird dedicated to the study of endocrinologican be fatal. Generally, victims succumb to cal change , ieman is occasionally ancillary problems including hypertension, tempted to "treat" her 13-year-old son infection, or adrenal cancer. things from all for puberty. "His mouth definitely went ieman's research into Cushing's has into puberty before the rest of him," says brought unique opportunities to study potenNieman. "There are those days, when I tial uses for RU 486, the controversial drug over the world." tell my husband , 'You know, I could used in other countries as an "abortion pill." cure this!"' ieman has found that RU 486 is an + effective cortisone blocker in treating B u f f a l a Physician Lynn ette Nieman, M.D. Summer 1 - 9 9 6 STEVE COX �SURF THE NET! Three generations of UB doctors he University at Buffalo's sesquicentennial celebration serves as a special milestone for the Levy family. It will mark the 50th anniversary of the graduation from B of Harold]. Levy, M.D., and the lOth anniversary of the graduation of his son, Sanford H. Levy, M.D. It will also be the Slst anniversary of the graduation of Harold's father, Sidney H. Levy, M.D., a radiologist who started the Levy line of UB physicians. Sidney, who died in 1945, received his M.D. in 1915 from the then-private nivcrsity of Buffalo, interned at the old Eric County Hospital, and then served as aU .. Army medical officcrduringWorld War 1. When idncy opened his practice in diagnostic radiology, he was only the second physician to render such services in post-World War I Buffalo. "When he started his practice, some hospital did not have radiologic equipment, o the patients were brought to my father's office in ambulances for such ser- vices," said Harold, a Buffalo psychiatrist. Harold graduated with honors from the UB medical school in 1946 at the young age of 21, and served for a short time in the U.S. Army Medical Corps. ln 1948, Harold was recalled to active duty and served as chief of psychiatry at army hospitals in Korea and Hawaii. Later, Harold entered the growing field of psychosomatic medicine. ow, at age 71, Harold, a life fellow of the American Psychiatric Association, continues his private practice at Psychiatric Associates of Western ew York and serves as a clinical associate professor at UB. Exactly 40 years after Harold received his medical degree, he watched his son, anford, graduate with highest honors. 'Tve wanted to be a doctor for as long as I can remember," recalled Sanford, an internist at Sisters Amherst Health Center. "Seeing my father working in medicine and the strong relationship he had with patient had a positive influence on me. Even today, my father continues to teach me." A fellow in the American College of Physicians, an ford is also an authority on alternative and complementary medicine. Following his father's lead, Sanford also teaches and mentors UB medical students and residents at Sisters Hospital. Harold is a member of the james Platt White ociety, a past president of the Medical Alumni Association , and reunion co-chair for the class of 1946. "I have an extreme sense of pride both as an alumnus ofUB and as a physician," he said. "Medicine is the highest calling and i one of the most commendable professions to enter. There is no greater sense of satisfaction and gratification than to serve your fellow man and improve his + quality of life. " The Levys ® • INTERNET SOFTWARE Many Titles!! PC Anywhere ENOR10N IOCANYWIIIll£ DOS ... 67 Windows... $69 • America Online \ lac & \\'indows...S21.-l9 • lnlcrncl Starter Kit Windo"~...$3-t49 \lac... 3-4.95 • Prodig) \lac & Windo"s... 15.95 • ~ctscar>e "~I' igator for \\ indows...$32 Can '1connect from home ll'ithout one! INTERNAL STARTING AT $84.95 EXTERNAL STARTING AT $94.95 Many Brands-' • Supra • US Robotics • Boca Modems • Practical Peripheral • Global Villiage BOOKS 20 % off Retail Using the Internet.............$15 The User-Friendly Reference Easy Internet................ $18.95 Using the Internet.............$29 Special Second Edition INTERNET WORKSHOP Learn How to Use the Internet! Feb 7 & 8 ......$99 CUSTOMIZED WORKSHOPS These private workshops are tailored to your needs. They are available and very affordable. Call 645-3560 for information! Prices sllmw1 iuclude a 2l1 discounl for cash payments Open .\1011. Tues, Fri 1/am-Spm. ned & Tlwrs llam-6pm (ij': l"". . . II~tel M .. . . .. A non-profit UnwefSJfy program for students faculty & staff The Commons • North Campus • (716) 645·3554 • Fax: 645-3884 P B u A f U f L a A l W o ITHERELL Phys i cian Summer 1 9 9 6 �........ . .. Reunion classes support UB his year's reunion classes made generous donations to the medical school during the annual Spring Clinical Day and Reunion Weekend festivities. In all, $130,030 was pledged to the medical school to be used for scholarships for worthy students. Following is a list of participating class members and class totals. Dr. Thomas]. Murphy Dr. Edward A. Penn CLASS OF 1946-$58,900 Dr. john G. Allen Dr. Charles D. Bauer Dr. Robert A. Brown Dr. Donald P. Pinkel Dr. Marvin j. Plcskow Dr. john T. Crissey Dr. Robert E. Ploss Dr. Stanley j. Cyran , Jr. Dr. Milton Robinson Dr. Maier M. Driver Dr. Lawrence H. Golden Dr. Gerard E. Schultz Dr. Edward Shanbrom Dr. Bernard F. Groh Dr. Edward F. Gudgel Dr. Eugene M. Teich Dr. Alvin Volkman Dr. Guy L. Hartman Dr. Lester E. Wolcott Dr. Charles A. joy CLASS OF 1956-$3,050 Dr. Elliott C. Lasser Dr. M. David Ben-Asher Dr. Harold J . Le,·y Dr. Robert B. Corretore Dr. Eugene M. Marks Dr. Joseph j. Darlak Dr. Dennis P. Heimback Dr. William L. Marsh Dr. Arthur T. Skarin Dr. Lawrence D. Lubow Dr. Donald H. Marcus Dr. Merrill L. Miller Dr. Elizabeth Donahue Dr. Paul D. Fadale Dr. jonathan Gewirtz Dr. Wende W . Young Dr. Richard L. Munk Dr. joanne G. Gutliph Dr. Denms A. Nadler Dr. LyndaM. KarigHohmann Dr. Todd A. jacobson CLASS OF 1966-$13,825 Dr. Paul M. Ness Dr. Louis]. Antonucci Dr. joel H. Paull Dr. Robert E. Kaplan Dr. Frank j. Barbarossa Dr. Dadd W. Potts Dr. Girard E. Robinson Dr. jared C. Barlow Dr. Douglas S. Richardson Dr. Daniel P. Schaefer Dr. Robert M. Barone Dr. Da,·id M. Rowland Dr. Anne Shain Dr. Thomas \V. Bradley Dr. Richard I. Staiman Dr. Evan B. Shap1ro Dr. james j. Cuffe . Jr. Dr. William C. Sternfeld Dr. Ross A. Sih erstein Dr. james D. Felsen Dr. Melvin f'ox Dr. Annie Terry-English Dr. Da,·id Small Dr. Harold Trief Dr. Lloyd D. Stahl Dr. Harold F. Grunert . Jr. Dr. Edwin H. jenis Dr. Francis j. Twarog Dr. Roberta C. Szczurek Dr. Stephen . . Vogel Dr. David M. Thomas Dr. jeffrey L. Kahler Dr. Bennett G. Zier Dr. Frederick L. Williams Dr. Georgianne ZigarowiCz Dr. KcnnethV. Klementowski CLASS OF 1976-$6,300 Dr. ~tichael L. Aaron Dr. Serafin C. Anderson CLASS OF 1986-$4,920 Dr. Laurel A. Bauer Dr. William j. Beneke Dr. Donald M. Pachuta Dr. Cary A. Presant Dr. Dr. Dr. Dr. Dr. Ben W. Rappole Dr. james F. Shaffer Dr. Michael R. Bye Dr. Anthony Camilli Dr. William L. Sperling Dr. John E. Spoor Dr. David Wallack Dr. Michael !. Weintraub Dr. Paul B. Cotter. Jr. Dr. David A. Della Porta Dr. Geraldme K. Kelley Dr. james Kern Dr. Sean T. O'Bnen Dr. Dr. Dr. Dr. R1chard j. Lederman Charles H. Michalko james]. Moran john j. O'Connor Dr. joseph L. Kunz Dr. Maynard H. Mires, Jr. Dr. Thomas W. Morgan • Dr. Paul Stanger Dr. Ronald H. Usiak, Sr. Dr. Martin E. Leber Dr. Annabel M. Irons - ~ Deborah Beller Marlene Bluestein Christopher f' . Brandy Soma Y. Burgher Dr. Michele]. Armenia Dr. Mary K. Bennett Dr. john H. Bloor Dr. Marsha E. Brooks Dr. Lucy A. Campbell Dr. Timothy E. Frey Dr. Katrina A. Guest Dr. Camille Hemlock Dr. Thomas]. Kufel Dr. Sanford H. Le,·y CLASS OF 1971-$17,225 Dr. Richard W . Munschauer Dr. Fred Lee Dr. Sue A. McCutcheon Dr. jennifer S. Kriegler Dr. john Y. Lambert Ill Dr. Micha Abeles Dr. Stephan M. Ledtt Dr. janice j. Pegels Dr. R. joseph Naples Dr. Frederick C. Dr. john M. Antkowiak Dr. Nancy H. Nielsen Dr. Roslyn R. Romanowski Dr. Norman Nomof Dr. Jordon S. Popper Dr. Michael B. Baron Dr. Christine Privitera Dr. Mark E. Schweitzer Dr. Raymond W . Osgood Dr. Paul D. Barry Dr. Denms R. Pyszczynski Dr. Rita R. Sloan Dr. Harry Petzing Dr. Paul C. Ronca Dr. Herman R. Schoene Dr. Allen I. Berliner Dr. Thomas L. Ritter Dr. joy D. Steinfeld Dr. Amo j. Piccoli Dr. Matthew W. Szawlowski Dr. David A. Bloom Dr. Paul Schwach Dr. William H. Stephan uessle Dr. Herbert S. Pi rson Dr. jerald A. Bovino Dr. Carole Shear Dr. Edward j. Stulik Dr. Alben G. Rowe CLASS OF 1961-$9,250 Dr. Barry G. Brotman Dr. \Varren Thau Dr. Carmen M. Todoro Dr. Fred S. Schwarz Dr. Richard H. Baker Dr. Kenneth A. Burling Dr. George Toufexis Dr. Michael \V . Wood Dr. W. William Tornow Dr. Nicholas j. Capuana Dr. Bernard M. Wagman Dr. Richard j. Valone Dr. Harold Brody Dr. Washington Burns Ill Dr. Kenneth j. Clark , Jr. Dr. Arnold Wax Dr. William P. Walsh Dr. Michael E. Cohen Dr. Manny E. Cristakos Dr. Linda Wild Dr. Myron E. Williams. Jr. Dr. H. Howard Goldstein Dr. Arthur C. Cronen Dr. Herbert S. Wolfe Dr. Henry F. Goller Dr. Lawrence]. DeAngelis CLASS OF 1981-$5,915 Dr. Paul L. Nadler Dr. Thomas G. DiSessa Dr. George Bancroft Dr. Anthony T. CLASS OF 1951-$9,645 Dr. William j. Hewett Dr. Howard M. Hochberg Dr. Pasquale D. Baratta Dr. Michael D. Plager CLASS OF 1991-$1,000 Dr. jennifer f. Hen kind Ferraro Dr. Colleen A. Mattimore g Dr. Carl R. Conrad Dr. Leonard S. Danzig Dr. Sylvia R. Kennedy Dr. Sigmund S. Gould Dr. Harvey Greenberg Dr. Andrea C. Bracikowski Dr. Philip j. Rados Dr. Seymour j. Liberman Dr. jay A. Harolds Dr. Suzanne F. Bradley Dr. Barry D. Shaktman Dr. Allen L. Goldfarb Dr. jonathan Logan Dr. Barbara I. Karpel Dr. james B. Bronk Dr. Mitchell K. Spinnell Dr. Mark E. Heerdt Dr. Edwin j. Manning Dr. Robert B. Kaufman Dr. Stanley L. Bukowski Dr. Harold P. Krueger Dr. Dave B. Olim Dr. Scott D. Kirsch Dr. Daniel A. Castellani Dr. Eugene V. Leslie Dr. Saar A. Porrath Dr. Stanley B. Lewin Dr. James j. Czymy Dr. james V. LoVerde Dr. A. Thomas Pulvino B a 0 p h y c a 5 u m m e 6 �~ -··································· · · · ··· · ············· · Why c~tay home for lEI the holiiJayc~ ? Medical Alumni Awards The front-wheel urive Infinitt-® I 50"' An interuw more .•paciow thana Rolf,, RL>yce Silm· Spur 11/. An e:>:ceptionally .fJetzerOild IL:•t of dtanJarJ lu.."l.·wy feat/ire.•. A 190-hp V6 capah!e ofout-acceleratin.lJ many lll.Ylli:J V&•. tlnd of cour.•e, the ,ltandarJ-,,etting pet:formance anJ .•erl'ice of lnfiniti. The Medical School Alumni Association presented three Lifetime Career Achievement Awards at Spring Clinical Day on May ll. The awards are given to alumni/alumnae in honor of lifelong achievements in important areas of medical Like e<'ery lnfiniti, llu G20 come.• ll'ith an e;t:/en,lil'e liA of .•tanJard !u.-wry feature,•; tl -1-year/ 60,000 mile Ba.•ic Nell' Vehicle Wtzrranty; 2-1-hour RoaJ.Jitle tl.•.•t:ttance Program Trip interruption Benefit.•; anJ our Free Serl'ti:e Loan Car Pro_qram. $3 ]9 mo. endeavor, such as teaching, research, 50 mo. !ea.Je $0 down practice, or community service. Michael E. Cohen, M.D. '61 (top left), is a neurology professor at UB. IN FIN IT I Robert E. Reisman, M.D. '56 (top right), is an allergist in Buffalo. Edward Shanbrom, M.D. '51 (bottom), is retired from his internal medicine AUTO PLACE INFINITI 8129 MAIN ST., WILLIAMSVILLE 633-9585 practice in Santa Ana, CA. All are pictured with Margaret Paroski, M.D., East of Transit Rd. , Near Eastern Hills Mall the outgoing president of the Medical Alumni Association. G20 42 moJ130 42 mo. lease with cash or trade equity down. (G20-$495) (130-$450). Bank fee + tax and license due at inception. 12,000 annual mileage. $.12 per mile 1n excess. ® B u f f a l a Phys ician Summer 1 9 9 6 �--~- -~ ---~- - - Spring Clinical Day and Reunion Weekend '96 SALE OR LEASE CONTEMPORARY MEDICAL OFFICES Spring Clinical Day (May 11) kicked off a lively reunion weekend. Alumni from the past SO years attended the Stockton Kimball lecture, CME panel discussions, and poster exhibits at the Buffalo Marriott. But the weekend's social events, receptions, and dinners also provided plenty of time for meeting old friends and making new ones. 4800 sq. ft. onNiagam.PallsBlv4.inAmhent Close to l-290 • Ample Parking • Handicapped Accessible Competitive Rent 3,000 sq.ft.Delaware Awnue a: \'irginillStreet Plenty of Parking • Can be divided or expanded ALANT.HASTINGS • 847-1100 • HXT.286 ~ ?~\~t?~ B u f f a t o P hysician Summer 1 9 9 6 �• ·························································· ; HURWITZ & RNE, PC. I I 1 9 3 0 5 CARLJ . STREICHER '35 , of Lake Havasu City, AZ, ha retired from his ophthalmology-otolaryngology practice. He writes, "After a direct experience with insertion of a stent into a coronary artery, I am now as active as a golrer rive days a week can be, and hope to continue in this career for some tune! " BERNARDS . STELL '36 , FRANKL. TABRAH '43, SERVICI G in the Department of Physiology at the Uni- THE LEGAL versity of Hawaii's School of Medicine, and H EALTH Straub Clinic and Hospital. recognized with a plaque from the Hidalgo• Managed Care Starr County Medical Alliance for his lifetime dedication to the citizen ofHidalgo and Starr • Purcha e & Sale of Practices • Business & Tax Planning 1 9 5 0 WILLIAM J . SULLIVAN '55 , 5 of los Angeles, CA, is self-employed in forensic psychiatry. will be memorable: in May will be the 60th anniversary of the granting of my M.D. de- He is president ofW.j. Sullivan, M.D., Inc. gree; the 50th anniversary of my having earned an Cd.M. degree from the Millard . of Buffalo; the 50th • HCFA Safe H arbor Regulations 1 9 6 HARRIS FAIGEL '60 , 0 5 of Waltham, MA, anniversary of my induction into Phi Delta Kappa, honorary education fraternity; and pediatrics at Tufts School of Medicine and the 50th anniversary of my membership in was elected to the boards of the American the American Psychiatric Association." College Health Foundation and the American College Health Association. One son, 9 4 5 Douglas, is Hnishing a GI fellowship and taking a position at the Portland (OR) VA '40, ofjacksonville, FL, was Hospital and Oregon Medical School; Faigel's awarded a special citation by the American other son, jordan, is a vice president at Association of Retired Persons in appreciation Paine Webber in New York City. JOHN D . WHITE 0 and Phys ician Self-Referrals • Contracts with Private was appointed associate clinical professor of 1 Scm CES CoMMU ITY of McAllen , TX, was ciety of America. Stell adds, "The year 1996 Fillmore College at N EEDS OF THE director of th e Baromedicine Center at the IVAN W . KUHL '45 , I of Honolulu, HI , of Sun Cit), AZ, the tereo Division of the Photographic So- AT LAW is emeritus professor of community health Counties through his medical practice. won the Master Stereographer Award from ATTORNEYS & Public Entities • Employee Relation Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Bus iness Issues • Facility Finance and Construction of outstanding service to the community. of Pittsburgh , PA, was elected president of the Pennsylva- • Credentialing Hills, Ml , received the second annual Grad iva Award from the ational Association for the nia Academy of Ophthalmology at its an- and By-Laws Advancement of Psychoanalysis and the Biglan is director of ophthalmology at ALBERT W . BIGLAN '68 , ALEXANDER GRINSTEIN '42 , of Beverly nual meeting in Pittsburgh March 29-30. American Board of Accreditation in Psycho- Children's Hospital of Pittsburgh, and con- analysis for his book The Rcmwlwblc Bcatrix sults for the Neonatal Intensive Care Potter. The Gradiva Award, named for igmund Freud's 1907 work, Delusions and Dreams in jensen's "Gradiva," honors poets, ery at Magee-Women's Hospital , the Veteran'sAdministration Hospital , the West- artists, writers, and others who create works Rehabilitation Institute of Pittsburgh. urs- ern PA School for Blind Children, and the • H ospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence M. Ross at 716-849 -8900 that advance psychoanalysis. Grinstein's of Orchard book won in the category of childhood- BERNARD C . MUSCATO '69 , related books. He was presented with the Park, NY, has been appointed chair of Mercy award on Apri l 20 at the annual Hospital's Department of Obstetrics and Gy- conference in ew York City. AAP necology. He is past president of Mercy 1300 Liberty Building Buffalo, New York Hospital's medical staff and is serving a six- ® B u f f a l o Ph ysician Summer 1 9 9 6 �••••••••••••••••••••••••• II 0 BARANSKI ADVERTISING • I THE ULTIMATE DRIVING MACHINE= year term on the hospital's board of directors. Since 1974, he has been in private p ractice at Hambu rg Gynecological and Obstetrical Group. 1 9 WILLIAM J. 7 0 5 was appointed FIDEN '70 , clinical director of Erie Countr Medical Center's Department of Familr Medicine. He also serves a clinical assistant professor at UB. A colonel in the ew York Air a- tiona! Guard, he is clinic commander of the 107th Medical Squadron in iagara Falls, Checkpoint Foreign Car, Inc. NY. He and his wife, Susan, live in Buffalo. Sales and Service Medical College of Wisconsin . His daughter Lisa, a sophomore at Duke University, will Your advertising presents your c o mp a ny image t o the public .. . and to prospective cli ents a nd c ust o me rs. At Baranski A dvertising, we are proud to represent some of the finest publications in Western ew York, publications where your advertising message is sure to reach a quality audience. LAURENCE J . POHL '72 , of San Diego, CA, recently received an M.P.H. from the be taking herMCATin August1996, follow- • ing in her father's foots teps. Pohl writes that his classmate, Michael Gordon '72, is the 487 Kenmore Avenue Buffalo, NY 14223 most successful ophthalmology physician in San Diego, do ing radial keratotomy. 836-2033 ERIC J . RUSSELL '74 , of Chicago, ll, currently serves as acting chair of the Department of Radiology at • orthwestern Univer- sity Medical School and was elected treasurer of the American Society of Neuroradiology. Your WNY Leasing Specialist Serving WNY proudly for 33 years His wife, Sandra K. Fern bach, M.D., recently completed her term as president of the Chicago Radiological Society. CALL US TODAY REBECCA JACKSON SCHEITERLE '79 , (716) 645·6933 of Olean, Y, is doing full-time emergency medicine and is ER director at Olean General Hospital. She has four children: Stacy (18), Zachary (10), Jonathan (8), and MICHAEL J. BARANSKI Kathryn (7). She was remarried injuly 1995 to Rick Scheiterle. Marketing Representative 1 9 8 0 SU S AN STEPH E NS-GROFF '82 , P. S. We did this book! 5 of Phoe- nix, AZ, pediatrician for Maricopa County (AZ) Regional Schools, was honored as an outstanding healer by the YWCA ofMaricopa County at its third annual Tribute to Women B u f f o l 0 P hysician summer l 9 9 6 ® �• ···· · ··· · ······························· · ; Ifyou thought you knew us... do J.OU know I luncheon. She was chosen for her extensive efforts to provide medical services to the poor, especially her work running the clinic at the Thomas j. Pappas Regional counseled their parents about the limitations and possibilities of their children's conditions. She was the widow of RussellS. Kidder, M.D. Center for homeless children. ROBERT C . BAHN '4 7 diedApril 1 9 9 0 s 30, 1995,at his home in Rochester, M . He was 69. He was emeritus ROBERT P . P ITERA '90 , of Holbrook, Y, recently com- consultant in pathology and anatomy at the Mayo Clinic. He earned a Ph.D. in pathology from pleted a lecture series at the Beijing Hospital in the People's the University of Minnesota in 1953. He had a longterm interest Repub lic of China for the hospital's 75th anniversary. "My in the application of computers to medicine and belonged to the lectures focused on sports medicine with emphasis on diagnosis and treatment." The series drew over 100 physiatrists from all parts of China. Interested alumni Mathematics Association of America and the Association for Computing Machinery. Bahn also played trombone and tuba with local groups, including the Rochester can contact him at the Empire State Building, 350 Fifth Ave., Civic Music Concert Band and Suite 6606, New York, Y 10018 (212-293-7800), or at his home, what's NE.W? ~"~~ ., s~"s 'loJ· ._;;.~""'os"<'" • 14,000 sq. ft . of flexible ~~"~~ ~<:• 'b-~ e'-' meeung space on property ~ ~ 'o"<:PLUS direct access to an .,;::.f) {"~0 additional 250,000 sq. ft . 'r>" { 0~~ with state-of-the-art capabilities. "~(('X ;;."s;;. • Superb catering and innovative <1$"s~'~{ 'Q~s' theme dinners PLUS expert ~\'l ~ ~'l 0~ planning assistance from .,;::.f) ._~{;;.'<:pre-event through closing. <.0 Trombones Anonymous. His wife, Miriam Ruth Huer, died in 1992. 405 Sadd le Rock Road, Holbrook, NY 11741 (516-5638346). "It was great seeing everyoneatourfifth reunion. Keep in touch and keep smiling." And Your Choice To Stay In WNY! Buffalo Physician is on e-mail! OBITUARIES RUTH F . KRAUSS-KIDDER '4 3 , a respected member of the Children's Hospital staff and the UB faculty, died March 29, 1996, at the iagara Lutheran Home. She was 75. Before • A first-class hotel with outstanding amenities, comforts and conveniences - centrally located at the University at Buffalo Complex. Our new address for classnotes is Rooms bpnotes@pub.buHalo.edu. associate professor of pediatrics in UB's department of neurology. After graduation from UB's medical school, she interned at the former news about your fife, career, or famay. Don't forget to include your name, your home BUFFALO~affiOft address, and the year you E.]. Meyer Memorial Hospital. She joined Children's medical staff in earned your MD from UB. 1340 Millersport Highway, Amherst, Y 14221 (7 16) 689-6900 or (800) 334-4040 At the University at Buffalo Complex 1945. As a pediatric neurologist, she not only treated patients but ® B u f f a li.1r Congrarulations to The University at Buffalo School ofMedicine & Biomedical Studies on celebrating I 50years ofteaching, healing and research.' FromTN'f-~ Please send us the latest her retirement, she was director of electroencephalography at Children's Hospital and clinical ,t\'ail.tbl~: lJ B Alumni W~:~:k~:nd Oc.tob~:r ·1-6, I 'J'J6 l a P hysician Summer 1 9 9 6 �The jury is out. Your practice and assets are on the line. This is not the time to be second-guessing your choice of professional liability insurance companies. In a similar situation, a MLMIC policyholder remains confident, knowing he or she is protected by a company that already has successfully defended more physicians than all other available insurers combined. Adding to the value of your MLMIC policy is one of the country's largest and most experienced professional liability Claims Departments, as well as the largest Risk Management Department of any professional liability insurer in the state. MLMIC also offers New York's only true peer review of claims experience. Only physician-owned and controlled MLMIC offers this high level of quality assurance and service. MLMIC also is the only medical liability insurer approved by the Medical Society of the State of New York. Find out more about the protection you'll receive from the largest and most successful company of its kind in America. Call1-800- 356--4056 in Upstate New York, or MLM~C ~ \ledical IJability \lutual Insur.mce Company 1-800- ASK- MLMIC in the New York metropolitan area. Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 0 :4M..-. Mtwo �BUFFALO PHYSICIAN Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED 1 77 3 ri £ 1-1L l H ~C E CE S St:R LS Dt:PT B TT ti l I.,. r - PLANT'ING A TREE 'Z'S' ·= UNDER WHICH You WILL NEVER SIT OR. OEVILLO W. HARRINGTON, class of 1871, knew how to make his money grow. In fact, this man who in 1905 provided $5,000 through his will for the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. THIS PERMANENT endowment in Or. Harrington's name has grown to over $300,000 and today it supports the famous Harrington Lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed funds at the school. They enable UB to provide scholarships to outstanding students, enhance scientific research, support excellence in teaching and meet the ever-changing needs of the school. YOU TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you develop a smart fi nancial plan. A charitable bequest provides the satisfaction that comes from planting a tree under which you will never sit, but which will bear fruit for generations to come. FOR A CONFIDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact: STEPHEN A. EBSARY, JR. Assistant Dean and Director of Development, School of Medicine and Biomedical Sciences UNIVERSITY AT BUFFALO (716) 829-2773 U N I V I!:IIISITV AT .UFFALO SCHOOL 01" MEDI C INI!: I li 0 1848 Y ll · A R 5 1998 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1996 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1996-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v30n03-1996-Summer Table Of Contents A list of subunits of the resource. Buffalo Hospice Physician-Assisted Suicide The End of Life and the Quality of Death Research Medical School News History of Medicine A Student's Perspective Alumni News Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v30n03 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1996 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/f4209f935ca3475fdb4248c5ca161ddc.pdf f8f3e3241eb62160d7d97da33858a740 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Spring 1996 8 4 6 9 9 6 �BUFFALO PHYSICIAN Volume JO , Number 2 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dear Fellow Alumni, Dr C uole 5rnth Petro ACTING DIRECTOR OF PUBLICATIONS Kathryn A. ~"''ncr AS WI: CELEBRATE the University at Buffalo s sesqUiccntenmal this EDITOR many talented physicians and scientists who have contributed to that year, we reflect on the rich history of our med1cal school and the jesSica Ancker history. These indi\'Iduals were visionaries in their own era, lookmg ART DIRECTOR co~ld Alan J. Kegler into a future that others ASSOCIATE DESIGNER sesqlllcentenmal celebrate not only our school's past, but also our julrr c.rerten not sec. So it is fittmg that the vision for the future PRODUCTION MANAGER We have a tendency to thmk that the past was somehow a Ann Raszm;.mn Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. john :-.jaughton, \'icc PreSident for Clmrcal Affarrs. Dccm kinder, simpler time, when doctors were unburdened by the complicated issues we face today, and inspiration and dedication were all that , \vas needed It seems unfair, somehow. Roswell Park did not have to spend two hours on the phone arguing to get an MRI approved . James Platt \Vhite did not have to pay outrageous malpractice premiums. Matthew Ma.nn did not have the quality-assurance police hounding hun about his C-scction rate. Austin flint EDITORIAL BOARD Dr John A RKhcn , Chairman Dr. Martrn Brecher Dr. Harold Brody Dr. Richard L. Collms Dr. Alan J. Drinnan Dr james Kanski Dr Barbara Marjcroni Dr, Elizabeth Olmsted Dr. Charles Pagand, Dr. Margaret W . Parosk1 Dr. Thomas Raab Dr. Stephen Spauldmg Dr. Bradley T Truax TEACHING HOSPITALS AND LIAISONS The Buffalo (,encralllosprtal ,\.ticlwd Shu11 The Children's llosprtal of Buffalo Erie Count\' Medrcal Center Mercy Hospital Jl,llllard fillmore llosprtals rrani~ Sm·a • N ragara ralls Memorial \1cdrcal Center Roswell Park Cancer lnsmute Sisters of Charity llosprtal Dnmis MrCcuthv \'rterans Affairs \Vrstcrn New York Hcalthcan· Svo.,tem did not have to worry about a \1edicaid audit. They didn't have to get CMI: credits, write triplicate scripts, or attend endless hospital committee meetings Things were so simple back then-if you call operatmg wnhout electric lights or antibiotics simple In real It}, each generation has its own umque problems to face Our common denominator is that we overcome the challenges and learn ways to solve our problems. Despite all the woes of modern medical practice, you?g people are applymg to our school in record numbers. \\'hy? One reason is that despite the stresses It bnngs, medicine still offers the intrinsic satisfaction of t._uring illness or helpmg people cope with what we cannot cure. The other reason is that we have a ternfic medical school. I may sound like a proud mother offering a somewhat biased opinion about how good-looking her children are but our med1cal school offers an excellent education at a reasonable cost hy any objective standards Our school has been acknowledged as an outstanding primary care/comprehensin' medical school by a national magazine (which arrived at that conclusion \V nhout any mput from me)! So how do we keep our medical school top notch m tough tunesl _Our Medical Alumni Association is a key player in that mission Since its mceptwn m 1875, the Medical Alumni Association has served to better the school in many ways. It allows us to stay in touch giving us the opportunity to network and exchange Ideas. A casual conversation at an alumni ©The State t niwrsrty of New York at Buffalo reception ca"n lead to a major project for the Medical Alumm Association. C.cneral class Buffalo Phv"rrun rs publrshcd students choose what field of medicine they want to pursue. quarterly by the State UnrvcrSlt)' of New York at Buffalo School of Medicine and BiomcdJCal 'icit:nu.·s and the Olfrce ol Publicatrons. It rs sent free of charge. toalumnr , fanrltv , students, rcsrdrnts and frrends. I he staff resn\'l's the rrght to edrt all copy and suhmisstons accepted for publicauon Address question.._, comments and submisSions to: The Edrtor Bu{julo Physificm, Statr l~ nivcrslt)' or New York at Buffalo , Offit-c of Puhlr callons 136 Crofts llall , Buffalo , New York 14260 Send address (hanges to: Buffalo Physician. 146 Cl'~ Addrtron , H35 Miun Street, Buffalo, New York 14 214 reunion gifts fund much-needed scholarships. The Coi~munity•Physi<.ians Program helps In treating a patient, any physician can tell you the difference a supportive familr makes family serves ro motivate, comfort, guide, and care for the patient. As medical alumni, we are the family of our school. As a family, we are proud of the 150 years of tradition this yearlong sesquicentennial celebratiOn marks, and the MediCal Alumm Association looks to its . , members for a \ tsion of the next 150 years. We also plan to have fun in the process. \Vannest regards, ~~ W. ?OA.o~, MD Margaret W . Paroski, MD. Prrsidcnt, l\.1cdical Alumni Association �v 0 5 p L . R 3 N 0 , o . N G 9 2 9 6 150 Preparing for the 21st Century -by john Naughton, M.D. UB's MEDICAL ScHOOL AT THE fOUNDlNG OF THE U 1\'ERSITY OF BUFFALO The stories of three of UB's founding father -by judson Mead BUFFALO's U !QUE NETWORK OF TEACHING HOSPITALS How the unusual relationship between the University at Buffalo and its teaching hospitals evolved. -by Ann Whitcher PHOTO ESSA'r: LIFE AT THE MEDICAL SCHOOL Two students bring us along during their daily routine. -photos by Don Heupel, story by jessica Ancker The medi cal faculty of the Uni versity of Buffa lo in 1861. PHOTO: UNIVE R SITY A RCHIVES . UNIVERS ITY AT BU FFALO _.J CoNTINuiNG A TRADITION or ExcELLENCE Profiles of some of UB's young faculty . m m MEDJCI'\J E or THE F UTURE Members of the UB community speculate on what is to come. C LASSNOTES �• ICa Preparing for the 21st Century This special issue of the Buffalo Physician celebrates UB's Sesquicentennial. The school's birthday is May 11, 1846, when New York State granted the charter to form the University ofBuffalo. Our Sesquicentennial Celebration parallels the events from early 1846 through mid-184 7, when the first class was graduated. The medical school was founded with strong community ties and a dedication to preparing excellent physicians committed to the highest quality of patient care and community service. At least three ofUB's first seven faculty members were unquestioned giants in medicine. Dr. james Platt White, one of UB's founders and a gynecologist-obstetrician, extended clinical teaching to include the demonstration of live birthing. Dr. Austin Flint was a peripatetic teacher, expert diagnostician, prolific writer, and editor. Dr. Frank Hastings Hamilton, a surgeon, introduced the use of ether as an anesthetic in BY JOHN the iagara Frontier. These three set the course for UB's medical school, consistent with Chancellor Millard Fillmore's dream that UB should be "eminently useful" to the citizens of Buffalo and western ew York. Like all institutions in the young nation, UB had its ups and its downs. A few of the high points: • The recruitment of Dr. Roswell Park from Chicago to head the Departments of Surgery in both UB and Buffalo General Hospital was a major accomplishment. Park was an internationally recognized surgeon with a broad range of interests and tremendous energy and foresight. His NAUGHTON , M . D . DEAN , SCHOOL OF MEDICINE AND BIOMEDICAL S CIENCES VICE PRESIDENT FOR CLINICAL AFFAIRS ••• a u a 0 p h y 5 c a n s p n g 9 9 �Buswell, and a UB alumnus, Dr. Harry Laforge, helped secure this bequest, which was shared between UB and the University of Rochester Medical School. • A group of local physicians (alumni and non-alumni) formed a fund-raising organization, the Annual Participating Fund for Medical Education (APFME). The first funds were used to recruit Dr. Hermann Rahn to become chairman of the Department of Physiology. Today, the funds are endowed and the revenues support Continuing Medical Education programs. Barbara Mierzwa serves as the APFME Director for CME. • The Medical Alumni Association supports the professional development of medical students, residents, and its other members. A major new initiative is the annual recognition of a Distinguished Medical Alumnus. • UB and its teaching hospitals established a nationally recognized model for graduate medical education. The Graduate Medical Dental Education Consortium of Buffalo has demonstrated the importance of shared gover- memory is honored through the cancer institute and the local society of surgeons that bear his name. • During the troubled years around UB's centennial, a leader emerged who served as dean for 12 years, Dr. Stockton Kimball. 1 regret that we never met. He is reputed to have been a warm person with a great deal of foresight, tenacity and fortitude who provided the leadership to broaden the medical school's missions and to relocate the school to the University Campus. • During World War 11, the school added two strongwilled, well established educators and scientists to its basic science faculty , Dr. Ernest Witebsky and Dr. Oliver P .Jones. These two , who helped establish UB's strength in fundamental biomedical research , were named Distinguished Professors by the SU Y Board of Trustees. • The school received its largest endowment from a Buffalo industrialist, Ralph Hochstetler, after his death in 1955. The revenues support physicians as they prepare to become clinical scientists and faculty committed to biomedical research. Hochstetler's brother-in-law, Dr. Henry s a 0 p h y 5 c CONTINUED a s p 9 9 ON PAGE 9 6 54 e �"For a long time the defects in the system of medical instruction in the neighboring colleges at Fairfield, Geneva, and Willoughby had been the subject of remark among my medical associates and myself It was on all hands agreed that the great desideratum, clinical instruction, could not be supplied in these rural schools. Without an opportunity to apply at the bedside the precepts inculcated in the lecture-room, the system of teaching by lectures can never be successful in making good practitioners. "Moved by these considerations, and influenced partly, no doubt, by the hope of personal professional advancement, ifthey could show they merited it, two or three young men, after careful deliberation, set about procuring a charter for a medical college. In this enterprise the older practitioners not only declined to participate but tried to discourage its undertaking. Nothing daunted by this opposition, aided by a few laymen, we proceeded in the winter of I 845-6 to procure a charter for a University. In the latter part of the same year we organized a medical department and appointed a corps of professors."- from remarks by Professor James P. White, M.D., at the inaugural dinner of the Alumni Association on Feb. 23, 1875. The "two or three young men" were White himself, Austin Flint, and Frank Hastings Hamilton, all then in their early or mid-30s, and all destined to make their marks on medicine and medical education in the United States. By B judson a Mead 0 p y s c a n 5 p g 9 6 �6 JAMES PLATT WHITE A pioneer in American obstet- rooms and laboratories for les- rics and gynecology and in the sons in practical anatomy and teaching of clinical obstetrics, chemistry. The faculty con- James Platt White may rightly be sisted of White, Flint, Hamil- considered first among equals in ton, Charles A. Lee, James Webster, Charles B. Coventry, the founding of the University of and George Hadley. Hamilton was Buffalo School of Medicine. a faculty member of the Geneva Of the three principal founders, Medical College but had taken up resi- White had lived in Buffalo longer than dence in Buffalo two years before; he re- Austin Flint and Frank Hastings Hamilton. cruited Lee, Webster, Coventry, and Hadley from White's father had moved the family from Austerlitz, Geneva. Y (near Albany), to the Buffalo area when White was five White cooperated in the founding of the city's first years old. He was educated in local schools and at hospital, the Buffalo Hospital of the Sisters of Charity, as Middlebury Academy in Vermont. White began his medical education in Buffalo in the well as in the establishment of Buffalo General and the office ofDr.Josiah Trowbridge in 1830 and then spent three Providence Asylum for the Insane. He was also instrumen- years attending medical lectures at the Fairfield Medical tal in the establishment of Buffalo State Hospital. College in Fairfield, Y. After receiving his medical degree On Jan. 18, 1850, White wrote a new chapter in Ameri- from Jefferson Medical College in Philadelphia in 1834 at can medical education when he conducted a clinical dem- the age of23, White set up a practice in Buffalo specializing onstration in obstetrics before 20 students in the new in the diseases of women and children. He also traveled to facility the university had built the previous year. The Europe to further his studies in Edinburgh, Paris, and students were permitted to perform a vaginal examination Vienna. According to one biographer, "he possessed of a woman in labor and then to witness her delivery. White, boundless physical energy which gave him a forceful , who knew this teaching method to be accepted in many aggressive personality." European medical schools, and who believed that medical students should witness a delivery before entering general The first class of the new University ofBuffalo met in the practice, called it "demonstrative midwifery." spring of 1847. The facility , a renovated Baptist church, included an amphitheater that could accommodate 200 The demonstration became a topic for vociferous public students and also served as a dispensary, as well as lecture discussion. Physicians who had opposed the founding of 8 a 0 p y c a 5 p n g 9 �the medical school were quick to attack White, while his nal of the Medical Sciences, published in Philadelphia, but students passed a resolution congratulating and thanking White was supported by medical journals in Louisville and him. The Buffalo Commercial Advertiser editorialized in Cincinnati. The Committee on Education of the American favor of his demonstration, but a few days later the Buffalo Medical Association reponed in 1851 that demonstrative Courier carried a highly charged editorial, signed "L," midwifery was entirely unnecessary. stating that "a precedent had been set for outrage indis- Clinical teaching in obstetrics was soon well established, criminate." In a letter to the Buffalo Medical journal, 17 nonetheless. Twenty-five years later White was pleased to Buffalo physicians called demonstrative midwifery unnec- remind an audience of medical school alumni that "this essary and "grossly offensive." When Dr. Horatio Loomis method of teaching has now been introduced, in some form had additional copies of the Courier editorial printed and or other, into all the leading institutions of the land, and in distributed, White sued him for libel. White was supported many, is made a prerequisite to graduation." at the trial by the testimony of Dr. Chandler Gilman, james Platt White was the only one of the three principal professor of obstetrics and disease of women and children founders of the medical school to spend his entire career in at the College ofPhysicians and Surgeons in New York City. Buffalo; however, he was far from parochial in his associations. Gilman stated that he had performed similar examinations He was a founder of the American Gynecological Society and, in while two or three students observed, and that he hoped to 1877, chairman of the section on obstetrics and gynecology and emulate White's demonstration of an actual delivery. vice president of the American Medical Association that had Loomis was acquitted, primarily inveighed against his clinical teaching because the jury ignored the judge's a quarter of a century before. He was Physicians who had charge; however, White felt that demonstrative midwifery had been also extremely active locally and was one of the founders of the Young opposed the founding of Men's Association, the Academy of vindicated. White's demonstration and Fine Arts, the Buffalo Historical Soci- the medical school were ety, and the Buffalo Club. At the time Gilman's testimony on his behalf quick to attack White, were the target of a vehement editorial by the influential American jour- of his death, he was for the second lime dean of the medical school he while his students passed a had brought into the world. resolution congratulating and thanking him. 0 B u a a p h c a n s p n g 9 �AUSTIN FLINT G In 1836, 24-year-old Austin Flint, during his eight-hour visit was with his wife and baby son, arrived enough to generate three papers, in Buffalo from published in 1845, 1852, and 1875 orthampton, MA, to set up a medical practice. (presented in 1873), on the com- Within five years he had pub- municability of typhoid. lished papers on rubeola, sudden The illness had struck 28 of the death, the use of quinine in intermit- 4 3 inhabitants of the village, killing 10 ting fever, and the connection between of them, a few weeks after a traveler from dyspepsia and the mind. By the time of his Massachusetts had fallen ill and died at the death in 1886, Flint had published more than 240 village inn. Flint discovered through correspon- articles on almost every aspect of internal medicine, as dence that the traveler had probably "left home with the well as several books and a widely adopted medical germicidal principal of typhoid in his body"; he con- textbook. He had also made significant contributions to cluded that "the subsequent cases were due to infection or the fields of physical diagnosis and epidemiology, served contagion introduced into the closely congregated com- as president of the American Medical Association, helped munity. " Although he noticed that three families who did found the University of Buffalo and another medical not drink from the village well escaped the disease, he college, and been a faculty member at four other schools. attributed their health to better nutrition because they Flint was the fourth generation in his family to practice were also wealthier. After diagnosing the disease and medicine (and he was followed in the profession by a son testing the well water, Flint dismissed an accusation from and grandson). He was educated at Amherst College and villagers that the epidemic had been caused by deliberate received his medical degree from Harvard College in poisoning of the well. 1833. Although he did not study abroad, Flint was well Flint's early papers on contagion were quoted by john acquainted through his Harvard teacher with the statis- Snow, a pioneer in epidemiology, in a famous oration in tical case recording methods advocated by the Parisian 1853. After that speech, Snow succeeded in stopping an clinician Pierre C. A. Louis. In 1843, Flint, who had been outbreak of cholera in London by taking the handle off a appointed health officer in Buffalo the year before, was pump to prevent people from drinking the contaminated called to the village of water. onh Boston, 18 miles away, to investigate an outbreak of severe illness. He diagnosed the Years later, after the transmission of typhoid fever illness as typhoid fever. The information he collected through contaminated water had been demonstrated, u a 0 p h y s c a n 5 p n g 9 9 6 0 �Flint revisited his North Boston findings and found that natural gift, nor does it accompany as a matter of course there had been a privy close enough to the public well to the acquisition of knowledge one acquires from reading or contaminate it with infected excreta from the first victim. didactic lectures. It is an art to be acquired." Flint was In his 1873 presentation to the American Public Health described as "a large man, with a full voice," always Association, Flint said, "It is perhaps the most remarkable solicitous of the comfort and feelings of his patients. experience on record as embracing a combination of In 1852 he left Buffalo to take a position at the University circumstances proving, in the first place, the communica- of Louisville. That year he received an American Medical bility of typhoid fever and, in the second place, rendering Association prize for his essay "Variations in Percussion vastly probable, if not certain, the communication by and Respiratory Sounds." Four years later Flint returned to means of a contagium contained in drinking water. " He Buffalo as professor of pathology and clinical medicine. His recommended sanitation precautions that, unfortunately, work on heart sounds resulted in a second AMA prize in went unheeded for another half-century. 1859. In 1862 he published a paper describing the particu- The reputation Flint had established through his early lar heart murmur that still bears his name. publications prompted an invitation in 1844 to teach at The characterization of the "Flint murmur" occurred at Rush Medical School in Chicago. He accepted, but soon Charity Hospital in New Orleans. The peripatetic Flint realized that he preferred living in Buffalo. Once resettled was by then dividing his time between Buffalo in the in Buffalo, he founded the Buffalo Medical]ournal, which summer and he edited for the next decade. ew Orleans in the winter. Flint left Buffalo permanently in 1860 to become professor In 1845, Flint attended the ational Medical Conven- of pathology and practical medicine at Long Island College tion in New York City as the delegate from the Buffalo Hospital. He helped establish Bellevue Hospital Medical Col- Medical Association. He was appointed to a committee lege and spent the rest of his life in New York City. charged with studying the requirements for granting medi- Flint's son Austin Flint Jr. described the variety of cal degrees. The committee's recommendations ultimately experiences that had made his father one of the great included extending the year's lecture period from four to six clinicians and teachers of his age: "During his professional months; requiring attendance for two years of lectures; career he encountered soldiers in camp and in barracks; requiring a total of three years of study, including three the rich and the poor; those afflicted with diseases inci- months of dissection; and requiring that all medical facul- dent to lives of ease and luxury and paupers in hospitals; ties have at least seven professors. the pioneers of western New York After helping to found the Uni- and the inhabitants of the metropo"The ability to observe versity of Buffalo, which held its first classes in 1847, Flint served as lis ... cases observed in the experience of a quarter century as a gen- is not a natural gift," the school's professor of medical eral practitioner, and of more than theory and practice for six years. He another quarter century as a con- Flint said. "It is an art shared james Platt White's belief in sulting physician, including epito be acquired." the utility of clinical teaching, say- demics which have occurred in this ing, "The ability to observe is not a 0 B a 0 country within the last 50 years." p h 5 a 5 p g 9 9 6 �FRANK HASTINGS HAMILTON 1813-1886 5 1 e Something of the single- growing city of Buffalo in or- mindedness of Frank Hastings der to have greater access to Hamilton, who once wrote (about surgical cases. He continued himselO that "a man whose busi- to teach at Geneva untill848. ness is in information rather than When the medical de- pleasure does best to travel alone," partment of the University of is evident in what he accomplished Buffalo enrolled its first class, r very early in his life. Entering Union e College as a sophomore at 14, he earned Hamilton was professor of principles and practice of surgery and his bachelor's degree three years later, then clinical surgery, a chair he held until studied anatomy in the office of Dr. John G. 1860. He was also the school's first dean. A contemporary described Hamilton as "rather cool and Morgan in Auburn, NY, for a year before attending medical .t lectures at the Fairfield Medical College in Fairfield, NY. He reserved to strangers, but open-hearted to trusted friends . 11 was licensed in 1833 by the Cayuga County Medical He could not conceal his utter abhorrence of the arro- ,, Censors; he earned a medical degree from the University gant. " .- of Pennsylvania in 1835. By then he was 22. ., Before the advent of anesthesia, surgery was performed As surgeon for the Auburn State Prison, Morgan could as rapidly as possible and the surgeon depended on a k obtain the bodies of prisoners who had died. Hamilton thorough knowledge of anatomy. In his first lecture at ,_ Was his demonstrator in anatomy untill834, when Mor- Geneva in 1840, Hamilton told his students, "You must gan was called to the faculty of the Geneva Medical persevere in penetrating and threading the windings of College. Hamilton returned to Auburn after his study in anatomy, and you must obtain complete mastery over 11 Philadelphia and taught anatomy and surgery in his pri- your nervous cords, that ... the keenest cry of suffering 1- vate office, mainly to students from the Theological Semi- shall not cause a thread to vibrate. " 1- nary at Auburn. In 1839, Hamilton was appointed profes- Hamilton was a preeminently skillful and inventive s sor of surgery at Fairfield Medical College; not quite two surgeon. In The History of Surge1y in the United States years later he succeeded his former teacher at Geneva 1775-1900, Ira M. Rutkow, M.D., calls him "one of the when Morgan left the schooL Hamilton traveled and most versatile of 19th-century American surgeons. " A studied in Europe during 1843-44, then moved natural mechanic, Hamilton invented a variety of surgical 6 9 u 0 0 p h 5 to c the 0 5 p n 9 9 9 �instruments, according to an article by Oliver P. Jones, the first battle of Manassas, he rapidly gained a wider Ph.D., M.D., for the 1973 Buffalo Physician. Jones also scope of responsibility as brigade surgeon, medical direc- said Hamilton was one of the first surgeons to excise the tor of a division, medical director of an army corps, and metatarsophalangeal joint for bunions and to remove the finally, in 1863, Medical Inspector of the United Stares central portion of the thyroid. To make joint amputations Army. He had published A Practical Treatise on Military more precise, Hamilton described what he called 'keys Surgery in 1861 and brought out a second, enlarged and guides' to the articulations. edition in 1865. During the war , he wrote to his wife that At the Buffalo Hospital of the Sisters of Mercy, in 1854, "it is no uncommon thing for a surgeon in the field to be Hamilton demonstrated the efficacy of closing old ulcers compelled to change his position once or twice during an by skin graft when he successfully transplanted a 7" x 4" operation, on account of a change in the direction or range flap of skin from the left leg of a patient to close an ulcer of the shots. " on the right leg. It was also in Buffalo that Hamilton wrote Hamilton resigned his commission late in 1863 and the preface to his influential book A Practical Treatise on returned to teaching at Bellevue. He was made professor Fractures and Dislocations , published in 1860. The first of the principles and practice of surgery and surgical American text to deal in depth with fractures , it was used pathology there in 1868. Four years later he published The throughout the country and appeared in seven editions, Principles and Practice of Surgery. He described its purpose the last in 1884. as "to supply within the compass of a single volume of Frank Hamilton and Austin Flint were both members moderate size, the instruction necessary to a full under- of the Long Island College Hospital's first faculty. Here standing of all the subjects belonging properly and exclu- Hamilton realized an ambition in clinical instruction that sively to surgery. " The volume went through three edi- he had harbored for 20 years: at the new college in tions , the last published shortly before Hamilton died in Brooklyn , students were able to 1886. In an address to the graduates pass directly from the lecture hall Hamilton was a surgeon in to the hospital wards for bedside of the University ofBuffalo in 1853, Hamilton gave them his final ad- teaching. the 3 I st Regiment of the A year after moving to Brooklyn, Hamilton became professor of monition as a teacher , urging them to study advances in medicine New York Volunteers in military surgery, fractures, and dis- during their careers. He warned the Civil War. His two sons locations, and professor of clinical that those who did not would , as surgery at Bellevue Medical Col- old men, " ... discover in their cruwere in the regiment and, lege. He volunteered as surgeon for the 31st Regiment of the New cibles some few scanty facts which , if they had looked to the experi- he wrote, "I wanted to be York Volunteers immediately after ence of others, they might have near my dear children in the outbreak of hostilities in the known at 30. It is quite as often, Civil War. His two sons had joined we fear , that they die wholly uncase they were wounded." the regiment and , he wrote , "I conscious that the science which wanted to be near my dear children they faithfully intended to prac- in case they were wounded. " In tice all their lives is a century or charge of a general field hospital at more ahead of them." B 0 0 p y 5 c a 5 p g + 9 9 �r i In 1953, the medical and dental school moved to this new building from its old High Street home next to Buffalo General Hospital. Samuel P. Capen Hall (renamed Sidney Farber Hall in 1974) became the nucleus of UB's South Campus. PHOTOS : UNIVERSITY ARCHIVES , UNIVERSITY AT BUFFALO ��BY ANN WHITCHER When the University of Buffalo opened in 1846, medicine was about to begin a half-century of dramatic advances, and the hospital Was about to change from a charity service for the poor to a pivOtalcommunityinStitution. ln the mid-19th century, mostmedicalpractitioners had little ~BUFFALO GENERAL HOSPITAL BEFORE THE TURN OF or no formal education; such primitive opened in 1858, it, too, became an affilimethods of therapy as bleeding, blister- a ted teaching hospital for the medical school. Medical school faculty had twice ing, and purging were still in use. Clinical training for physicians, too, been part of unsuccessful efforts to found Was extremely limited, owing to the a city hospital, in 1846 and 1854; with state of hospital care. A sojourn at even the establishment of Buffalo General, the best endowed of hospitals was sta- they finally succeeded. The association tistical!y riskier than home care, due to between the school and the birth of the the hygienic horrors of the time. Surgi- hospital inextricably linked the two in cal anesthesia was gradually introduced the public mind. When Buffalo General appointed its only after the late 1840s; asepsis was not Practiced until much later in the cen- first medical staff, most of the physitury. cians were associated with the univerNonetheless, hospitals were valuable sity, a pattern that still holds true today. Places for young doctors to see a variety By 1869, the medical school could asof patients and gain the kind of ex peri- sert that Buffalo General "will be open for clinical instruction . . . o hospital ence they would need in practice. . The University of Buffalo established fees are required; the Faculty having lts first relationship with a hospital when made arrangement for the admission of Sisters Hospital was opened in 1848 by all the members of the class without the Sisters of Charity. Frank Hastings charge." liamilton and Austin Flint, both faculty A rapid acceleration in medical unmembers at the medical school (then derstanding followed the introduction located a block away from the hospital of antisepsis in the 1870s and asepsis in at Main and Virginia streets) became, the 1880s. When the renowned German respectively, Sisters' attending surgeon surgeon Ernest Von Bergmann was asked and physician. When Niagara Univer- in 1882, "What's new in surgery?" he is Sity formed a medical school in 1883, said to have replied, "We wash our hands Sisters switched its primary affiliation; before we operate ratherthan afterward." however, Niagara's medical school was Actually, the surgeon of the 1880s iissolved 15 years later, and the UB- was likely to give a cursory wipe on the lsters connection was restored, al- sleeve to a dropped instrument, then though probably not with the intensity sanguinelycontinuewiththeprocedure. lt had once enjoyed. By the 1890s, however, aseptic surgery When Buffalo General Hospital became a more and more common hos- 0 0 p h 5 c 0 5 p pita! practice; there were now autoclaves, sterilized dressings, and rubber gloves. Knowledge of pathogenic microorganisms also played a major role in increasing ~ the public's trust in ~ hospital surgery be- --~ tween 1875 and ~ World War I. ~ When the ~ medical school re- 9 ~ cruited Roswell al THE CENTURY . Park from Chicago in 1883 to become professor of surgery, he quickly took on additional duties as attending surgeon at Buffalo General. A man of wide culture who had studied in Europe, Park "taught the value ofLister's approach, as well as aseptic methods," Evelyn Hawes wrote in her history of Buffalo General. "The faculty of the medical school was virtually the same as the attending staff of The Buffalo Genera! Hospital; medical students attended the hospital clinics, and observed procedures of their university professors at close hand." "The growth of the whole idea of residency-hospital training after medical school-really evolved from the mid1800s," says Roseanne Berger, M.D., UB associate dean for graduate medical education. "People graduated from medical school and didn't have sufficient medical training, so they sought apprenticeships in hospitals, but these experiences were highly variable." By 1890, the johns Hopkins Hospital had coined the term "resident" to describe individuals who had completed one year of hospital training, followed by specialized training provided by the medical school faculty. "What made it unique was that, up to then, such training was under the auspices of various hospitals," Berger says. "A teacher of residents may or may not have been affiliated with a medical school, or hold n 9 9 9 �Research Laboratory (forerunner of today's Roswell Park Cancer Institute) to be built on High Street, neighbor to both Buffalo General and the medical school, which had moved to a new building on High Street in 1893. In 1911, Gratwick became a state facility, initially known as the Institute for the Study of Malignant Diseases. A number of new hospitals and smaller clinics were established in Buffalo between 1870 and 1920, some run by specialists in rival schools of medicine. According to Another Era, thesesquicentennial pictorial history of the medical school , "competition among regular, homeopathic, and eclectic physicians intensified, culminating in the founding of the Buffalo Homeopathic Hospital (later Millard Fillmore) and Pierce's Invalids' Hotel. Ethnic and religious groups started their own hospitals, some of which became affiliated with the medical school while others have since closed or consolidated." Mercy Hospital, now one of the nine teaching hospitals, was opened by the Sisters of Mercy in 1904. A more clinically oriented medical education evolved throughout the country after 1910, when the Carnegie Foundation for the Advancement of Teaching published a harshly critical evalua- a faculty appointment. radical at the time to introduce this concept of organizing residency training-as opposed to medical school training-under the auspices of a medical school." By the 1890s, Buffalo General's medical staff included many distinguished practitioners; the close connection between the hospital and the university helped their efforts to integrate scientific medicine and hospital care. When Roswell Park became ill with diphtheria in 1893, he chose to recover in Kimberly Cottage, Buffalo General's facility for contagious patients-a clear endorsement of the therapeutic standards that had been achieved. The gesture must have been appreciated by the house staff and ward nurses. This was an age, after all, when those running the hospital were not often its patients, and when those with financial means usually preferred treatment at home. Forging another link in Buffalo's health-care network, Roswell Park and Buffalo Evening News publisher Edward H. Butler Sr. secured legislative funding in 1898 for a cancer research laboratory in the medical school. By 1900 the institute had outgrown its lab spac: of just a few rooms. A gift from the Gratwick family enabled the Gratwick a u 0 0 p 5 c o n tion of medical education, the Flexner Report. Charles E. Rosenberg says in his book, The Care of Strangers: The Rise of America's Hospital System , "That evolution grew out of an intricate symbiosis between hospitals constantly in search of staff, on the one hand, and on the other, physicians who sought clinical training and status. " By 1914, more than 75 percent of medical graduates in the country were taking an internship. "One of the things that grew out of the Flexner Report," says UB medical school dean John Naughton, "was that more and more medical schools did have an identifiable hospital or two that were, by perception anyway, controlled by them. That has never existed in Buffalo." By the time the Flexner Report came out, a number of other hospitals were also loosely affiliated with UB. One was the Children's Hospital of Buffalo, which had opened in 1892. Another was an institution devoted to tuberculosis that evolved into City Hospitalin 1918. Later renamed E.j. Meyer Hospital, the institution in 1946 became a county hospital that was the forerunner of Erie County Medical Center. UB's affiliations with Children's and City Hospital were informal by today's standards, but they made possible the variety of clinical settings enjoyed by medical students of the period. 5 p g 9 6 �A 1934 evaluation report from the C_ouncil on Medical Education and HosPitals lists clinical facilities for teaching ~t Buffalo City Hospital, Children's and . uffalo General. Heads of depanO.:ents In the me d'ICa] school held equivalent Positions m · t h e Bu ffalo City Hospital. Staff · appomtments, however, were reserved for the hospital's board of managers. Buffalo General and the medical school h d ha a no formal agreement, perps because of their long history of Wok' r mg together. "All visiting men are llJ.emb ers o f the faculty " the report noted A « · f , . · n m ormal agreement" also existed b Ch· etween the medical school and Ildren's. had lobbied for a new building on High Street. The Buffalo General Hospital had offered a block ofland on High Street for the new building; others saw what is now the university's South Campus as a more logical site. Some feared that put- l . By 1945, most of the medical school's k c Inical Wor was done at E.J. Meyer. All THE HOUSE STAFF OF MILLARD casesent . h FILLMORE HOSP ITA L, 1 93 1. enng t e hospital, including out. Pallent . ' were available for teaching. Buf- ting the new medical-dental facility near f 1 a o Gen l era treated all types of patients except" , Buffalo General would allow the hospi. mental, contagious and tubercu- tal to dominate it. In the end, the counIosis" . to an evaluation report cil approved the South Campus plan, rrollJ.' thaccordmg A , . c . e MAs Council on Medical Edu- and Samuel P. Capen Hall was opened allon and H . l ospita s and the Association in 1953 (it was renamed Sidney Farber of Am . encan Medical Colleges. Hall in 1974);Sherman followed in 1958. According to council minutes, UB P The relationship with Children's apeared t b h 194 . 0 e t e most solid, the AMA's Chancellor Samuel P. Capen displayed ·· h epresenceof his customary judiciousness and vision a 1. 5snetea msa1·d ,citmgt . laJson · th h commntee representing both in weighing the thorny matter. "He cited ""e ospital and the school that deter- the advantage of cooperation in every .,,Inect t ff w sa appointments. Although there possible way, not only with all the hosas still f th no ormal agreement between pitals with which the medical school llJ.ed· I e h lea sc h ool and the two general now cooperates, but probably also, as b ospitals, the report noted that "mem- time goes on, with a number of others. ers of th ff llJ. ct· e sta are also members of the As he saw it, medical education is just at e leal h 1 "" sc oo and the heads of depart- this moment at the beginning of a large '"ents at h h . te t e ospnal are on the commit- expansion into somethmg distinctly dif! es Which head the din ical departments. " ferent and more popular than it has n 1948 y , ground was broken for a new been in the past. There is an intensive eterans Ad .. Pin mmistration hospital, cap- drive in public interest in better and fo gByears of effort to secure a VA facility more extended medical care." r uffalo. ~~~~~~~~if.~ t What must have been a ense m . eetmg of the UniVersity C on J ounciltook place · une 10 , 1948 , [o IIowlog ct· a period of contentious lscuss· of h Ion on the location . ,s new h t e uni·versny d OllJ.e for its medical and ental schools which had l on · ' lii ~ smce outgrown the · g Street facility Many TH E ST AF F OF B UF F ALO GENERAL IN In the d. . me leal community B UI L DIN G AMPHITH E A TE R , C . 19 38. Medical school dean Stockton Kimball echoed these thoughts. No one hospital would be sufficient for the teaching needs of the university, he contended. Indeed, it was his view that the strength of the medical school lay in the large amount and variety of clinical material available at all the hospitals. By 1950, the medical school had teaching agreements with E.J Meyer, Buffalo General, Millard Fillmore Hospital, and Children's. While there was no formal agreement with Roswell Park, the two institutions were affiliated for teaching purposes. By 1956, extensive clinical facilities were available through agreements-now written-with Buffalo General, E.J Meyer, Children's, and Millard Fillmore, plus an "understanding" with Roswell Park. A 1965 report from a visiting team representing the AMA and the Association of American Medical Colleges noted that the school had since been given full accreditation, but repeated past concerns about "the basic hospital domination of the medical school and the need for strengthening the basic science areas." Following the university's merger with the State UniversityofNewYorkin 1962, there were new layers of complexity to be considered. For one thing, faculty communication was hampered, partly by "the geographic separation of clinical facilities," the 1965 evaluators commented. "''m sure the state did not have an understanding of all these relationships between the medical school and the hospitals," Naughton says. "There was the assumption, at least locally, that the state would build a medical center for UB." Various studies ensued "and a lot of money was spent on the planning ... Somewhere along the line, as I understand it, (UB) President (Martin) Meyerson and Governor Nelson Rockefeller decided that ~ the better place for this <~ medical center would be ~ i: the Amherst Campus and ~ not on the old campus." In g 196 7, plans were an- & g nounced to construct a ~ university hospital on the ~ Amherst Campus, but ll a 0 p y s a 5 p n g 9 �g ,~ . "0 these plans never materialized. "By the time I came here in 1975," Naughton says, "it was pretty clear that the state wasn't going to put another hospital in Buffalo, and therefore that if we were going to survive as a medical school in a teaching community, we needed to develop a different strategy." Paving the way to the modern hospital network were several key reports in the 1960s that urged institutional responsibility for graduate medical education. The 1966 Millis report of the AMA's Citizens Commission on Graduate Education ofPhysicians, for instance, said that teaching hospitals must demonstrate responsibility for medical education through the creation of a medical education committee. They also recommended that an agency be authorized to plan, review, and coordinate standards for graduate medical education. "The formation of the Graduate Medical Dental Education Consortium ofBuffalo in 1983 was really the culmination of an arrangement that had existed in Buffalo for a long time," UB's Roseanne Berger states. "Residency programs were based in hospitals throughout the city, because there was no single university hospitaL A single program actually shared the resources of multiple hospitals, and the oversight of that single residency program would be charged to a particular educator, a program director, but the financial arrangement-as to who would be responsible for supporting the program-became very complicated." By the early 1980s, there were new B u a 0 p requirements for accreditation under the auspices of the Accreditation Council for Graduate Medical Education. "That organization accredits the various residency programs and the various specialties and ensures that each program meets a set of standards that are established by a specialty-specific residency review committee," Berger explains. "In 1982, it required that each program identify a single sponsoring institution. In Buffalo-since the majority of programs were located at multiple hospitals-just deciding who that single sponsoring institution was became a problem. 'This became an opportunity to establish the consortium, and in so doing it pulled the hospitals together around one mission: graduate medical education. A governing structure was then established to create a formal process for the hospitals to work collaboratively for structur- Today'steaching hospitals: The Buffalo General Hospital The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Hospitals Niagara Falls Memorial Medical Center Roswell Park Cancer Institute Sisters of Charity Hospital The Veterans Affairs Western New York Healthcare System y 5 c a s ing, reviewing, and thinking about issuE of resident training in the region." Today, the consortium plans and di rects all Accreditation Council residenc and fellowship training in Buffalo aill Western New York. Resident salarie and benefits are equal for each training year level throughout the region and ar paid by the consortium. A second initia tive, the Western New York Health Sci ences Consortium, formed in 1987, i directed toward improving the area' health-care delivery system. Michael Noe, M.D., vice presiden for professional affairs at Buffalo Gen eral, provided key leadership in orga nizing the consortium. "From the be ginning," Naughton says, "Mike and th1 residency training directors furthere1 the understanding of the strength, eco nomics, and improved training qualitj that could come from a single, coordi nated organization committed to share governance." Today, the Graduate Medical Denta Education Consortium coincides wit separate university agreements with th teaching hospitals. Resulting joint en terprises have produced more resideD cies in primary care, regional centers fo organ transplants and positron emi5 sion tomography imaging, and a rura health initiative. Medical school an consortium initiatives are flourishing i biomedicine, epidemiology, and clini cal trials, and the school has receive major funding to expand its generaliS medical education programs. Throughout its history, the medici! school has drawn on a network of affih' ated hospitals to advance its missiofl according to a ugh ton and joyce Vana Ph.D., clinical assistant professor of so cial and preventive medicine. The tW0 collaborated on a recent article in the: American Journal of Public Health. 'This arrangement," they wrote, "ha5 been sometimes divisive and always challenging, with conflicting loyalties an~ allegiances occasionally placing hosp1til service needs before medical educati011. However, mutual tolerance and depefl' dence have also developed. In Buffalo rhC need for collaboration in education, re' search, and service has proved stronger than the drive for autonomy." + p n 9 9 9 �These students were some of the last to study at the High Street university building. By 1949, when this picture was taken, the decision had already been made to move UB to Main Street. PHOTO: UNIVERSITY ARCHIVES , UNIVERSITY AT BUFFALO Old Alumni Hall was the lecture room in the High Street building. TIAN YEARBOOK, PHOTO : t947 MEDEN ERSITY AT BUFFALO L E R S I T Y ARCHIVES . UNIV �BY .JESSICA ANCKER THE PHOTOS BY DON LONG THING HOURS ELSE EVOLVES ABOUT NEVER CHANGE, MEDICAL CONSTANTLY TO BUT EDUCATION KEEP EVERY- UB AT ABREAST HEUPEL OF NEW TECHNOLOGIES, TREATMENTS AND ATTITUDES. TWO CUR- STUDENTS TYPICAL DAY TO KRISTEN BROUGHT PROVIDE A ANDRESEN, A US GLIMPSE 24-YEAR-OLO ALONG INTO WITH LIFE SECOND-YEAR AT THEM ON UB TODAY. STUDENT, WANTS PRIMARY CARE DOCTOR IN EITHER GENERAL MEDICINE OR PEDIATRICS . WHO GREW UP ON A LONG ISLAND FARM, WILLIAMSVILLE THAT OVERLOOKS A HAS RENTED A A TO BECOME A KRISTEN, SMALL HOUSE IN NEIGHBOR'S PASTURE, COMPLETE WITH HORSES. SHE DOESN'T HAVE MUCH TIME TO ADMIRE THE VIEW, THOUGH . ANY FREE TIME SHE CAN SNATCH FROM HER COURSES IS SPENT PREPARING FOR HER FIRST NATIONAL BOARD EXAMS IN ..JUNE. MOST OF KRISTEN'S DAYS ARE SPENT IN THE LECTURE HALL, AS HAS LONG BEEN TRADITIONAL FOR FIRST- AND SECOND - YEAR STUDENTS. BUT US IS INTRODUCING CLINICAL MATERIAL EARLIER AND EARLIER IN THE T H E �CURRICULUM. KRISTEN'S PATHOLOGY LECTURES, CORRELATIONS DISEASES IN WHICH STUDENTS ARE PRACTICING PHYSICIANS PRESENT RECENT EXAM. IN THE IT'S PROBLEM-SOLVING. THAT ILLUSTRATE THE CHANCE TO LEARN ABOUT PATIENT CARE BY SEEING PATIENTS AT BUFFALO 1 960S AND 1 970S, THIS "INTRODUCTION TO ONE-SEMESTER COURSE THAT TAUGHT STUDENTS HOW TO TAKE A PHYSICAL CASES BY CLINICAL LEARNING ABOUT. SHE'S ALSO GETTING A GENERAL HOSPITAL. FOR EXAMPLE, ARE ROUTINELY FOLLOWED NOW A INSTEAD PRECEPTOR FULL OF YEAR JUST COURSE, WITH LECTURING CHALLENGES HER TO HER TRY AN ON TO HISTORY AND ADMINISTER A EMPHASIS THE MEDICIN~ CLINfCA- c ON CASE-BASED PATIENTS EXPLAIN THEIR SHE COMPLETE LEARNING EXAMINES, SYMPTOMS WAS - A - AND KRISTEN'S AND ILLNESSES. HER EARLY EXPERIENCE WITH CASE-BASED LEARNING AND PROBLEM-SOLVING IS INTENDED TO INTRODUCE HER TO THE SKILLS SHE'LL BE DEPENDING ON IN HER THIRD AND FOURTH YEARS, TRADITIONALLY KNOWN AS THE "CLINICAL YEARS." KEN LEVEY, 24, A THIRD-YEAR STUDENT WHO PLANS TO GO INTO OBSTETRICS, INTRODUCES US TO A TYPICAL DAY IN THOSE "CLINICAL YEARS." KEN, IN THE MIDDLE OF A CLERKSHIP AT THE LUCKY TO HAVE FOUND CHILDREN'S A HOSPITAL OF BUFFALO, FIRST-FLOOR APARTMENT ON COUNTS HODGE HIMSELF STREET, WITHIN STROLLING DISTANCE OF THE HOSPITAL. HIS CLERKSHIP CONSISTS OF THE TRADITIONAL FOUR WEEKS ON A WARD. IN A RECENT INNOVATION, THE CLERKSHIP INCLUDES TWO ADDITIONAL WEEKS IN CHILDREN'S OUTPATIENT CLINIC. KEN IS ALSO PART OF ONLY THE THIRD CLASS WHO WILL SERVE A CLERKSHIP IN FAMILY MEDICINE. HEALTH PRIMARY CARE NOW INCLUDE CARE AND SOME COMMUNITY HEALTH OF THE FUTURE AMBULATORY PROBABLY SETTINGS, EXPERIENCE IN CENTERS. WILL CLINICS, SO DEPEND MOST PRIVATE OF US'S HEAVILY ON CLERKSHIPS DOCTORS' OFFICES OR KEN'S TIME IN THESE SETTINGS WILL PREPARE HIM TO WORK WITH RELATIVELY HEALTHY PATIENTS, IDENTIFY DISEASES EARLIER, AND EMPHASIZE PREVENTIVE HEALTH CARE. IN HIS FOURTH YEAR, AT LEAST ONE OF HIS ROTATIONS WILL BE SERVED ENTIRELY IN AN AMBULATORY SETTING. THESE NEW ASPECTS OF KEN AND KRISTEN'S EDUCATION ARE PART OF U B'S GENERAL PRACTICE INITIATIVE . THE SCHOOL IS IMPLEMENTING A NUMBER OF CURRICULUM CHANGES AS IT STRIVES TO GUIDE AT LEAST 50 PERCENT OF ITS GRADUATES INTO PRIMARY CARE FIELDS. "THE IDEAL FOUR-YEAR CURRICULUM INTEGRATES ALL ASPECTS OF MEDI- CINE, INSTEAD OF TEACHING THEM M.D., ASSOCIATE DEAN TO TEACH PROBLEMS, WANT TO STUDENTS INSTEAD PREPARE IN ISOLATION," SAID DENNIS A. FOR CURRICULAR AND ACADEMIC AFFAIRS. HOW OF TO MERELY STUDENTS ACCESS HOW TO FOR THE KNOWLEDGE MEMORIZE NATURE AND HOW "WE WANT TO INFORMATION. OF PRACTICE AS NADLER, WE IT IS SOLVE ALSO INFLU- ENCED BY AMBULATORY CARE AND MANAGED CARE. THESE ARE THE KINDS OF THINGS THEY'LL NEED TO KNOW AS r~ 0 DOCTORS." + w --------------------~ a 0 p y c a 5 p n g 9 6 �+- B: 1 1 A.M. KRISTEN ANDRESEN PACKS HER LUNCH BEFORE TAKING OFF FOR A FULL DAY OF LECTURES AND CLINICAL CLASSES. ~ 9 A.M. 1 1 :30 A.M. TODAY'S PHARMACOLOGY LECTURER , ..JERROLD WINTER , PH . D., COVERS A WIDE ARRAY OF TOPICS, INCLUDING NEUROLEPTICS AND THEIR SIDE EFFECTS, AND DRUG DEPENDENCE, TOLERANCE AND WITHDRAWAL. WINTER ALSO WARNS THEM ABOUT ILLICIT RECREATIONAL USE OF THE THERAPEUTIC DRUGS THEY WILL HAVE EASY ACCESS TO I N THEIR PROFESSIONAL LIVES. HE CITES THE CASE OF A DOCTOR WHO DIED AFTER A LOCAL SELF-ADMINISTERED OVERDOSE OF ANESTHETIC. "DOCTORS ARE MORE LIKELY TO GET IN TROUBLE WITH THESE KINDS OF DRUGS," HE SAYS. �i- l 1 :40 A.M. "iHe: ME:DICAL STUDE:NTS' COMPUTER ROOM IS C:ROWDe:D DURING THE LUNCH BREAK. FINDING A ~'"Re:e: TERMINAL, PRINTs OUT A KRISTEN QUICKLY EDITS AND REPORT ON THE HISTORY AND PHySICAL OF A PATIENT SHE EXAMINED LAST We:e:K. THE PAPER IS DUE TO BE HANDED IN THIS "'-~'"TE:RNOON. ~'"e:w HER WORK FINISHED, SHE TAKES A MINUTES TO SURF THROUGH HER E-MAIL. t 1 2 P.M. KRISTEN MEETS A GROUP OF OTHER SECOND-YEAR STUDENTS IN THE ATRIUM OF THE NEW BIOMEDICAL RESEARCH BUILDING TO PLAN BOARD REVIEW SESSIONS. THEY ARE CHECKING THROUGH A LIST OF PROFESSORS WHO MIGHT BE WILLING TO GIVE EVENING REVIEW LECTURES. "IT'S KIND OF TOUGH ON THEMTHEY HAVE TO TAKE THE STUFF WE'VE BEEN STUDYING OVER THE PAST YEAR AND SQUEEZE IT ALL INTO A TWO-HOUR LECTURE," KRISTEN POINTS OUT. t 1 2:30 P.M. KRISTEN TAKES HER LUNCH TO A QUIET CARREL AND EATS WHILE STUDYING FOR AN UPCOMING EXAM IN HUMAN BEHAVIOR. �t 3:35 P.M. -+ KRISTEN AND THREE CLASSMATES ARRIVE AT BUFFALO GENERAL HOSPITAL. IN THE OFFICE OF THEIR PRECEPTOR, TALAL BAKI, M.D., THEY DON THE SHORT WHITE COATS THAT MARK THEM AS STUDENTS. BAKI DESCRIBES ONE OF HIS CARDIAC PATIENTS, AND KRISTEN HAZARDS AN EXPLANATION OF WHAT THE PATIENT'S SYMPTOMS COULD MEAN AND HOW THE HEART TROUBLE MIGHT SHOW UP IN VARIOUS TESTS. "YOU HAVE 90 PER- CENT OF THE ANSWER. KEEP GOING, TELL ME THE REST," BAKI SAYS, ENCOURAGING HER TO COMPLETE HER IDEAS. �4:40 P.M. KRISTEN READS ALOUD THE CASE HISTORY SHE PRINTED OUT DURING HER LUNCH BREAK AND DISCUSSES IT WITH BAKI. EVERY TWO WEEKS, KRISTEN GETS A CHANCE TO TAKE A HISTORY AND PERFORM A ON A PHYSICAL BUFFALO GENERAL PATIENT WHo AGREES TO MEET WITH A MEDICAL STUDENT. ON ALTERNATE WEEKS, SHE PRESENTS THE CASE HISTORY TO BAKI, WHO SUGGESTS ~UESTIONS SHE MIGHT HAVE ASKED THE PATIENT, THEORIES ABOUT WHAT IS WRONG, OR BETTER WAYS TO WRITE UP THE REPORT . _, 6:40 P.M. KRISTEN HAS FINALLY ARRIVED HOME , WHERE SHE TAKES A MINUTES TO PLAY WITH HER BLACK LABRADOR , SHADOW, AND FIX DINNER. THEN SHE HEADS TO HER DESK FOR A STUDYING. SON I'M "I PREFER TO STUDY AT HOME. I'M A FEW NIGHT OF BOOK PER- I NEED TO HAVE ALL MY TEXTBOOKS AROUND ME WHEN STUDYING SO I CAN LOOK THINGS UP." + �+- :20 A.M. KEN LEVEY RISES EARLY DURING HIS CLERKSHIP AT CHILDREN'S HOSPITAL. "I GIVE MYSELF A MINIMUM OF FOUR HOURS OF SLEEP. I THINK THAT'S THE ABSOLUTE LEAST YOU CAN GET BY ON. WHEN GET SIX I FEEL GREAT." �6:50 A.M. -+ EARLY MORNING MIST WAFTS BY LEVEY THIS THURSDAY IN FEBRUARY AS HE WALKS TO THE HOSPITAL . HE'S ON HIS WAY TO ONE OF THE INFANT WARDS, WHERE HE'S SERVING A WEEK CLERKSHIP . FOUR- LATER, HE'LL SPEND ANOTHER TWO WEEKS IN ONE OF THE HOSPITAL'S CLINICS TO GET TRAINING IN AMBULATORY SETTINGS. 1 0:00 A.M. -+ MANY DOCTORS AT CHILDREN'S HANG TOYS FROM THEIR STETHOSCOPES OR WEAR GOOFY TIES WHEN THEY ' RE TREATING CHILDREN. "WE'RE TRYING TO DISTRACT THE KIDS FROM THE THINGS WE MIGHT HAVE TO DO TO THEM," ONE PHYSICIAN SAYS. �• • 0 •.40 AM -+ KEN ASKS INTERN THERESA WEGMAN, M.D., FOR SOME ADVICE. THERE'S ALWAYS THE SOUND OF ONE OR TWO BABIES WAILING ON THIS FLOOR, AS DOCTORS AND NURSES CATCH UP ON PAPERWORK AND ORDERLIES PUSH BROOMS AND LAUNDRY HAMPERS. ~ 1 1 A.M. ATTENDING PHYSICIAN FERDINAND YATES, M .D ., HOLDS AN IMPROMPTU LESSON ON DOWN'S SYNDROME FOR KEN AND HIS FELLOW STUDENTS, TIM LIESCHING AND LISA MENDONZA. AFTER CROWDING AROUND THE BED OF A SMALL DOWN'S SYNDROME PATIENT SUFFERING FROM A RESPIRA- TORY INFECTION, THEY RETREAT TO THE HALLWAY WHERE YATES TALKS ABOUT THE MEDICAL PROSLEMS OFTEN ASSOCIATED WITH DOWN'S. ~1 1:20 A.M. KEN TAKES A FINAL LOOK AT PATIENTS, BRITTNEY MOREY, lNG FROM RESPIRATORY ONE OF HIS TINY WHO IS RECOVER- SYNCYTIAL VIRUS !RSV) PNEUMONIA, ONE OF THE AILMENTS ON THE FLOOR. MOST COMMON BRITTNEY IS DOING FINE, AND CHECKS OUT LATER NOON. "WE WANT TO GET HER BEFORE SHE CATCHES OUT OF HERE SOMETHING REALLY BAD FROM ONE OF THE OTHER TO BRITTNEY'S MOM, THAT AFTER· KIDS," KEN EXPLAINS DAWN SMITH. �1 2:00 P.M. ~ KEN JOINS OTHER STUDENTS AND RESIDENTS IN A CONFERENCE ROOM OFF THE CAFETERIA FOR A LUNCHTIME LEC- TURE BY JEFFREY TUCKER, M.D., THE MEDICAL DIRECTOR OF THE HOSPITAL'S POISON CENTER. TUCKER APOLOGIZES FOR THE SUBJECT-INGESTION OF CAUSTIC SUBSTANCES. "IT PROBABLY ISN'T THE BEST LUNCH TOPIC!" BUT HIS LECTURE DOESN'T SEEM TO DULL ANYONE'S APPETITE. �/ 3:00 P.M. -+ A .., 7:1 s P.M. RADIOLOGY CONFERENCE GIVES "USUALLY I TAKE THURSDAY JAMES BACKSTROM , M.D . , THE NIGHT OFF TO WATCH 'FRIENDS,' DIRECTOR OF M Rl, THE OPPOR'ER,' AND 'SEINFELD,' BUT TUNITY TO SHOW STUDENTS HOW TOMORROW I HAVE TO DO A TO MAKE DIAGNOSES FROM PRESENTATION ON VARIOUS IMAGES . 'FAILURE TO HE SLAPS A THRIVE,"' KEN SAYS. HE CHEST X-RAY ON THE LIGHT SPENDS THE EVENING AT THE TABLE AND CALLS KEN TO THE HEALTH SCIENCES LIBRARY. + FRONT OF THE ROOM TO QUIZ HIM . KEN SCRUTINIZES THE IMAGE AND CAN'T FIND ANY PATHOLOGY . "ARE YOU TELLING ME I'D SHOW YOU A CHEST X-RAY? " NORMAL BACKSTROM ASKS . " NO, YOU WOULDN'T DO THAT ," KEN ANSWERS , PUZZLED . BUT THAT'S WHAT IT TURNS OUT TO BE. AFTER THE OTHER STUDENTS LAUGH , BACKSTROM POINTS OUT, "THAT ' S THE HARDEST THING OF ALL , TO HAVE THE CONFIDENCE TO SAY , 'THERE'S NOTHING WRONG WITH THIS PICTURE.' " �1916, WHEN HAROLD REIST WaS finishing his final year at the University of Buffalo, students were required to take one year of arts and sciences courses before entering medical school. Reist would have spent his first two years performing dissections and studying such standard scientific subjects as organic chemistry, physiology and bacteriology. In his third and fourth years, he would also have studied at Buffalo General and other hospitals. This photo was taken by a classmate, Victor Reinstein. BY PHOTO: DR. VICTOR REINSTEIN ALBUM , UNIVERSITY ARCHIVES . UNIVERSITY AT BUFFALO �WITHOUT ITS FACULTY, a school would be nothing more than an assemblage of buildings and labs~ microscopes and machines. The quality of UB's School of Medicine and Biomedical Sciences ultimately resides in the quality of the people who work, teach, and learn here. It was the innovative, forward-thinking doctors and scientists of the past, such as Austin Flint, Roswell Park, and ErnestWitebsky,who made UB a leader in medicine and research today. And it is the young doctors and scientists joining UB and its affiliated hospitals who will continue that tradition well into the 21st century. I. ~. .:.:I /.. _f;gJ . ••::1 we showcase a number of the ·~-- ~B uffalo In this issue of Buffalo Physician, lJlJ\ out~ standing young professionals on our Phys ician Spring 199 6 �faculty Some are practitioners who are turning their everyday experiences in treating disease into research that will benefit thousands of patients lg they will never see. Others are lab scientists whose patience at the bench may Pay off with undreamed-of drugs and therapies. Some are working on such )S, high-profile diseases as AIDS; others focus on problems that rarely touch )'s Americans, such as trypanosomiasis. In this issue, we can profile only a few of the e. innovative young men and women who have Joined our faculty in recent years. We plan to continue the series in future Issues with articles on new faculty to keep our readers in touch with the ever-changing medical school. We hope the articles on the next few ts Pages and in coming issues will demonstrate the range of talent and wide array of specialties that \!viii continue to provide UB's students with the best in medical education n, t~ for years to come. * Photographs J( by e K.C. Kratt 1 " f f a 1 o Physician 9 9 6 ED �in emergency medicine at the Medical College of Pennsylvania. Abrams is now an assistant professor ofemergency medicine at UB and the associate residency director at ECMC. Abrams helps train emergency department residents in fluoroscopy for quick diagnosis of injured extremities, and in telemedicine for long-distance communication. "Ultrasound and fluoroscopy aren't the kinds of things you'd use in every situation. But in some cases they can help you weed out what's serious from what's not," she says. "You take a look at an ultrasound and, boom! you find the bellyache iS caused by gallstones. That's not an emergency situation-you tell h1m he can go home. You st1ck someone's finger under a fluoroJ. scope and f1nd out it's not broken. Fine! That person can go home instead of waiting around for hours while you take care of all the gunshot wounds first." Abrams, who vollltlteered as an EMT while she was in medical school, continues to feel strongly A MAN WALKS INTO an emergency department complaining of about community service. She haS established a clinic for the homea vague back pain. Hours of tests reveal nothing, and soon the less at Buffalo's Friends of the N1ght pain itself disappears. As he dresses to go home, he collapses People shelter. A volunteer teafl'1 and dies of a ruptured aortic aneurysm. of nurses, medical students and doctors visits the shelter two eve"The suspicions we had weren't Ultrasounds are non-invasive, nings a month, providing routine high enough to bring in the radioloquick, cheap and portable, and have medical care to 15-20 people a gists and order up an ultrasound. no side effects. They night. Abrams But if we'd had an ultrasound maare particularly good hopes to enroll chine available in the emergency at picturing fluid build"If we'd had an more volunteers so department this wouldn't have hapup. All these factors she can offer the pened. That's unconscionable that ultrasound make them ideal for services more frehe died," says Barbara J. Abrams, quick diagnoses in quently. "It's a great machine available M.D. (known as Bobbie), as she certain life-threatenopportunity for the recalls the crisis from her residency ing situations, such as in the emergency medical students that led to her cunrent career as aneurysms, ectopic because they get 3 director of ultrasound education in department, this pregnancies, and carchance to take hisErie County Medical Center's emerdiac tamponades. tories and do physiwouldn't have gency department. Her latest research cal exams and start Abrams, 34, is bringing ultrashows that tilting a happened. That's doing some cofl'1sound technology into emergency trauma patient backmunity service. The departments around the country. In unconscionable wards in the T renpatients are also Incourses for the American College delenburg position credibly appreciathat he died." of Emergency Physicians, she trains can help doctors ditive." emergency physicians in ultrasound agnose injuries that Abrams orgause, develops protocols to help involve intraperitonized a similar cliniC them decide when the procedure is neal fluid build-up. atherlastpostin Philadelphia "I saidt0 appropriate, and tailors diagnostic Abrams received her M.D. from myselfthat wherever I go, ifthey need techniques for traumas. Brown University and did a residency a homeless clinic, I'll do it" -:J.A Barba r a Ab r ams , M. D . Adding to the ER's Diagnostic Arsenal * e s u a 0 p c a n s p g 9 �Bumpers , l . Harvey M. D . Ji~s :rJ- doctors and patients are slow to recognize the waming signs of cancer when they appear in younger patients, so the disease in these patients progresses further before it Creating New Models of Cancer in Mice HARVEY l. BUMPERS, M.D., HAS BEEN SO BUSY making breakthroughs Vvith animal models of cancer that he hasn't had time to begin a set of experiments he has been imagining for years-experiments ;e ~s :'s IS. ,d is Hl rn :k that he believes may hold the key to cancer. U .Bumpers, 40, a graduate of the n1versity of Rochester School of Medicine, completed his surgical Internship and residency at SUNY Stonybrook, where he was chief ~esident. He held surgical oncology ellowships at SUNY Stonybrook and Roswell Park Cancer Institute. An · U ass1stant prefessor of surgery at EB, he is an attending surgeon at [; CMe, the VA medical center, Bufpalo General Hospital, and Roswell ark as al ;ly 3.5 e- ;0 e Bumpers has succeeded in growIng human colon polyps in severe combined immunodeficient (SCI D) l'l'1lce. He has also implanted cancerous tissue in such a way that it con· p Slstently metastasizes to the liver. revious researchers treated cancerou s t.1ssue w1th . enzymes or chem·leas I 1n . order to get it to grow lf'lb sites under the skin or in the ae do men. Bumpers found, howVer, that pieces of solid tumor no special manipulation to needed g row· In the mice's gonad fat pads1 ~ fact, he believes that the tumors · ••etastas1ze · because their natural st n ructure and cell components are ot altered. perfonm genetic studies to compare precancerous polyps with cancer, and premetastatic cancers with metastatic ones. He also hopes to evaluate treatments in the mice with cancer. "This is all working so well, I haven't had time to get started on what I I 00 percent believe is the answer to cancer," Bumpers says. "I think the answer will be found in the adhesion proteins in cell membranes. But I have some other work to do before I can look into that." Bumpers has also done epidemiological studies of fisk factors in colo rectal cancer and breast cancer. In both, he found that younger patients had worse survival rates than older ones. He believes that both is diagnosed. A major in the U.S. Anmy Reserves, Bumpers recently created a unique reservist training program at the Buffalo VA medical center. He and several nurses in the Reserves arranged to perfonm surgery on Saturdays at the VA to fulfill the requirements of their drill duty. The arrangement allows reservists who are surgical scrub technicians to maintain their training by regularly helping in the surgery. It has also helped the VA reduce the length of time patients wait for non-emergency surgery. Bumpers also participates in public education on cancer through radio shows, workshops, and mailings organized by churches. "I feel strongly that if there is a possible solution, you should do your best to tell people what it is," he says. "Otherwise, they hear something on the news about cancer, and don't do anything about it." -J.A. * L. (I) u c: 8 In another breakthrough, t Umpers has used similartechniques a- s~lgow human breast cancer in able t mice. "No one has ever been 0 grow human breast cancer lf'l ,•. any animal before" he says "and •ve d ' ' ' th on t know exactly what it is that prevents it from growing. I lf'lklt'sb Call ecause breast cancertypi" y has a lot of fibrous tissue and ••Ot V ery many cells." · new exPe .His sue cess ·1n creat1ng ca nmental models for two kinds of Ofncer has provided him with a lot Pr · OJects to work on. He plans to 0 0 p h ctS u 5 c 0 5 p g 9 9 �A. M chaeI Ca I M. D . g ur Boosting the Immune System with lnterleukin-2 MICHAEL A CALIGIURI, M.D ., is researching new approaches to preventing cancer and controlling AIDS via the immune system. He is also part of an unusual team that develops treatments from the concept stage all the way through the laboratory bench to the patient's bedside. "It's incredibly satisfying to see our own observations translated into a treatment for a patient," says Caligiuri, 40, who is based at Roswell Park Cancer Institute. Caligiuri holds an M.D. from Stanford University and did his internship and residency at Harvard Medical School in Brigham and Women's Hospital in Boston. He did a fellowship in medicine at Harvard, and fellowships in oncology and bone marrow transplantation at the Dana-Farber Cancer Institute. Now a tenured associate professor of medicine at UB, he is a member of the department of hematologic oncology and bone marrow transplants. Caligiuri and colleagues including Zale Bernstein, M.D., recently studied a small sample ofHIV-positive patients and found that daily injections of interleukin-2 substantially boosted levels of natural killer cells, one of the types of immune cells that is decimated by the virus. As a result, none of the I 0 patients suffered opportunistic infections during the 90-day treatment period. The interleukins are part of a class of honmones called cytokines that regulate the growth of certain immune cells. According to Caligiuri, this was the first cytokine trial in AIDS patients. The findings raise the possibility that AIDS could be controlled with daily self-administered injections. The injections would boost the immune system to fight off fatal opportunistic infections, such as pneumonia and Kaposi's sarcoma. "Like diabetes, this would be hormone replacement therapy," says ED B u a 0 p Caligiuri, "but instead of sex hormones, we're working with the honmones of the immune system." Caligiuri is also studying the relationship between compromised immune systems and cancer. People with AIDS and other immune system problems suffer I 00 to I ,000 times as many lymphomas and sarcomas as the general population does. In research on severe combined immunodeficient (SCID) mice, Caligiuri and his colleagues have found that low doses ofinterleukin2 prevent certain lymphomas. The mice are bred to have severely inadequate immune systems, and h 5 c a s can be induced to develop a human-like immune system with injections of lymphocytes from human donors. Humans who are seropositive for Epstein-Barr virus are at high risk of a certain fatal lymphoma; mice who are injected with samples from these humans will be at risk for the same cancer. But with surprisingly small daily doses of interleukin-2, Caligiuri says, the mice were protected from the cancer. Caligiuri also led an international team that recently discovered a genetic defect linked with one common fonm of leukemia, acute myeloid leukemia. The defect was discovered on chromosome I I , and it was already known that many patients with acute myeloid leukem1a have three copies of chromosome I I. The researchers, who include UB oncology division chief Clara Bloomfield, M.D., say it is the first known molecular defect associated with a trisomy. Caligiuri predicts that more molecular defects will be identified and linked with different cancers, opening the way to gene therapies. Much of the research on leukemia. he says, may be performed at Roswell Park, which runs the world's largest leukemia bank. -J.A. * p n 9 9 �J1- J- ·e JS al ,d ~s Michael G. Ca t y' M. D. al a l- ysit ala 1e le Teaching Generalists as a Specialist ra st ~d tDUCATING GENERAL PRACTITIONERS IS A CHALLENGE for special- ists like Michael G . Caty, M. D ., a pediatric surgeon at the Children's Hospital of Buffalo . -s. ~s. a. at l's t.... "To provide them w1th a rTieaningful education, we apply our day-to-day work to their needs," Caty says. . Some of his students are pediatnc surgery fellows who have already ~eceived general surgerytraining and ave chosen pediatric surgery as thew subspecialty. These students need to be taught very specific details of pediatric surgery that will enable them to sue~eed in their newfield. Ut Caty also teaches general surgery residents, the majority of 'Nhom aren't likely to go on to pediatric sur~ery. These students, e explains, need to 1 earn basic surgery Pnnoples and only as much about pediatric surgery techn1ques . th as eymayneed in their Practice. th As the director of C eclin1cal clerkship at hildren's Hospital Caty also trains med 1 ~ cal h students who aven't yet decided on a 0 p h their future. They will leam enough about pediatric surgery to help them decide when to refer a patient to a specialist, and may also spend time in the division's clinic, where they'll see a variety of patients. "You can be a role model and a mentor even being in a different field," Caty says. Caty, 37, earned his M.D. from the University of Massachusetts, and did a general surgery residency at University of Michigan Hospitals, where he served as admlnistrative chief resident. He was a clinical fellow in surgery at Harvard Medical School in the Chiidren's Hospital of Boston. H1s field of pediatric surgery has given Caty a chance to develop a wide range of expertise, because although he specializes in one population, he doesn't limit himself 5 0 5 p to a single type of surgery. One of his specialties is laparoscopic splenectomies, performed on patients with spherocytosis. Because the disorder is hereditary. many of his patients' parents also underwent splenectomy operations when they were young. "The parents vividly recall having big incisions and being in the hospital for a month, and they're very appreciative when their children can have it done with laparoscopy," Caty says. Caty's research has centered on understanding and preventing organ damage caused by ischemia and reperfusion. lschemia/reperfusion damage is often linked with necrotizing enterocolitis, an intestinal infection among premature newborns. lschemia/reperfusion research can also be applied to transplant surgery, because organs can easily be damaged by the interruption in blood flow that occurs during a transplant. Caty's recent experiments on the intestine indicate that histamine produced by the body during ischemia/reperfusion events may contribute to organ damage. His research suggests that drug therapy against histamine could be an effective treatment to help prevent the -J.A. damage. * g 9 9 �Ke v n G b b n s 0 M D Going after Brain Tumors from a New Direction KEVIN GiBBONS , M.D., IS TAKING NEW APPROACHES to neurosurgery and head-injury management. Gibbons, 35, is the director of Millard Fillmore's neurosurgical intensive care unit. He holds an M.D. from Albany Medical College and did his internship and residency at UB. He also did a fellowship in surgical critical care at UB. Gibbons specializes in skull-base neurosurgery, particularly in novel exposure techniques for internal aneurysms, blood vessel malformations, and tumors once thought to be unresectable. These are often benign tumors; that is, in a different part of the body their slow growth and lack of metastases would pose few problems for the patient. But when they are situated deep within the brain, or in bone separating the brain from the face, their pressure on the brain, the cranial nerves, or the cerebrospinal fluid leads to debilitating symptoms or death. Traditionally, surgeons would open up a section of the cranium and push or pull aside the healthy brain to reach at least part of the tumor. But Gibbons says this procedure is often not successful in exposing the entire tumor and can injure healthy tissue, leading to complications such as hemorrhage. infection, stroke, and spinal fluid leakage. Instead, he and colleagues at Millard Fillmore and Roswell Park are entering the brain at the base of the skull or through the face. Using these newer approaches, surgeons are more likely to reach the entire tumor without disturbing or injuring the healthy parts of the brain. Gibbons twice a year teaches 3 . I national course on neurosurglca critical care sponsored by the American Association of Neurological Surgeons. He is working to popularize a change in treatment of traumatiC head injuries and aneurysms. Doctors typically treat strokes and an. ve eurysms by working to 1mpro blood flow to the brain. However. after a traumatic head injury, they' focus on controlling brain swelling by administering diuretics or other medications. According to Gibbons. these measures don't work for very" long, forcing repeated treatment after a day or so. The new guidelines recornmend increasing blood flow and perfusion to the injured brain: regardless of what caused the InJury'· Gibbons recommends ventilating · patients and increasmg cardiaC output through drugs to ·lncrea se blood flow. "The swelling problems may' be worse in the short term, but 1n the long term, they improve more rapidly," he explains. "It's the sarne experience with other organs whefl they are inJ·ured-they do better · st with better blood flow. It has JU taken us a while to realize that the brain should be treated the sarne way." 11 Gibbons was also a part of team that pioneered a new pal~ treatment in surgery for rupture discs. He and his colleagues lrl' serted a naturally degradable mor. 1 s ite phine sponge into the surglca and found that it provided longterm pain control. -J.A· * a 0 p y 5 c a s p n 9 9 9 �e r Carlos Jaen Roberto M.D., Ph.D. ' '/ g :r s. 1 ,t laking the Pulse of a Whole Community ''F AMILY PRACTICE IS LIKE TAKING CARE OF FRIENDS," says Carlos 1\oberto Jaen, M.D., Ph.D. "You have a chance to be close to People at so many important times in their lives. You form a Partnership with them to improve their health or their function . It's a challenge intellectually and at the level of your heart." fil ain -ed inor;ite ngJ.A· th Jaen has made many friends in l e Poor communities of Buffalo's tower West Side, where he prac~ces at the Niagara Family Health lJ enter and directs UB's Center for J ~an Research in Primary Care. ~n, 39, earned . his M.D. and a .D. 1n ep1dem1ology from UB, . ~,amlly . pract'and did h.IS res1.d ency 1n ~~e at University Hospitals of feveland. An assistant professor 0 both family medicine and social :nd preventive medicine, Jaen Perves on the New York State t' Ubi'IC Health Council and the na~onal Agency for Health Care ohcy and Research. Jaen has gained special insight 0 0 p h into the largely Puerto Rican community of the Lower West Side by supervising a comprehensive health survey of the area. The survey, conducted in 1993 and 1994, found high levels of asthma, diabetes, heart disease, hypertension, and other chronic conditions. The researchers also found high numbers ofsmokers-47 percent of the men and 32 percent of the women, compared with a national average of about 23 percent. In addition, they found that barriers such as language, distance, and lack of health insurance often prevented families from getting adequate health care. The researchers also y 5 c o n s p charted beliefs about HIV, use of preventive services, drug use, and experiences with crime. "One reason we were able to get such a high response rate is that our people were very persistent. They wouldn't take 'no' for an answer," he says. His group shared the research with community groups, who in turn shared their own insights and joined the efforts to solve the problems. "The community became empowered," he says. The survey has also spun off new projects for jaen and many of his students. Jaen has won a grant to reinterview the asthmatics in the study population. "Mortality from asthma has been increasing in poor urban communities over the past I0 years. Is it environmental exposure? Is it tobacco smoke? Is it lack of knowledge? Is it poverty? What is it that is causing this problem?" he asks. Jaen also writes columns for Panorama Hispano, a Spanish-language monthly that circulates in western New York. "I pride myself on my ability to make things that are very complex simple. I do that when I do direct patient education in my office, but also in a more public way when I do it in print," he says. "It makes me feel good when a patient comes into my office and says, 'I read your article about smoking.' It's a way of reaching more people than just the ones I can see in my office." One ofhis anti-smoking projects is a survey of how cigarette advertising and promotions are tailored to the inner city. Jaen says that although tobacco companies spent $6 billion on advertising last year, he is not intimidated by their strength. "I follow in the tradition of Don Quixote, I suppose. I have a picture of some windmills in my office that my mother got me when she went to Holland, and they inspire me. I just keep working in my circle of influence and see what happens. I think we have -J.A. right on our side.'' * n g 9 9 6 0 • !.. LL bO c: • �D a v d J a m e s M D task than they may have been Jed to believe." t In Canada, James points ou ' about 50 percent of me d .ICa1 stu- Specializing in Everything DAVID jAMES, M.D., is working to reintroduce a concept as old as professional medicine, and as new as 1990s health-care reform: the family doctor. "My father's family doctor took out his tonsils on the kitchen table, and amputated mygreat-uncle'sanm on that same kitchen table," James says. "The family doctor looked after you from birth and the cradle to the grave." A Toronto native, James, 37, earned his M.D. from the University ofToronto. In the Canadian system, James says, family practitioners are trained in all primary care areasobstetrics, pediatrics, and emergency and internal medicine. In his solo practice in a Toronto suburb, he saw patients in his office for about 44 hours a week, spent another 25 hours in emergency practice, and delivered two to four babies a week. "You're expected to have almost specialist knowledge in every area," James says. As an assistant professor of fam- dents become family practloners· d 11 Underthe country's publicly funde . health plans, pat1ents can 't get free . I.1st un less theY care from a spec1a are referred by their fam1 IYd0 ctor. . es "The family doctor superviS their care, acts as a curator. The . amount of money .It sav es iS remarkable," he says. d James welcomes the pu brIC an . private pressures t hat are driving d this country towar . eon agreaterre I1anc . general practl'tiO' ily medicine and the new medical director of Deaconess Center's family medicine center, James hopes to train a new generation of U.S. doctors in the same wide range of knowledge. He teaches family medicine, low-risk obstetrics, pediatrics, In Canada, about emergency medicine, and a wide range of other procedures. 50 percent of James is also an attending physician at medical students Deaconess and in Buffalo General's emergency and obbecome family stetrics departments. "Part of my job is to practitioners. show students that being a family physician is a much more broad, demanding ners. "General prac~ tice is not seen a being glamorous, the hours are irregular. and you don't rnak~ the same kind o dough, so students tend to go into sp ecialties. But I ber1e ve0 that in five to 1. years everybody iS going to earn a bout the same amounpS the health-care rn ar- ------ - -- ~-~--- e B a 0 p y s a s p n ket changes." * A - J.. g 9 �c. Shahrokh Ph. D. M. D., Khan Fighting Blindness through Surgery and Research SHAHROKH C. KHANI, M.D., PH.D., woRKS ON RETINAL degenerative disorders on two levels- the operating table and the laboratory bench. His primary research interest is in retinal gene therapy; currently, he is engaged in a search for the key to retinitis pigmentosa. Khani, 33, eamed his M.D. and a Ph.D. 1n biological chemistry from the University of Michigan. He was an · 1ntem at Saint Joseph Mercy Nosp1tal in Ann Arbor, Mich., and ~ a residency in ophthalmology at ash1ngton University. He also did fellowships at Harvard Medical ~hool and the Medical College of ISconsin before coming to UB. An assistant professor of ophthalmology and biochemistry, Khani teaches residents and biochemistry graduate students and is UB's director of retina services. Retinitis pigmentosa is a congenital disorder that interferes with the eye's ability to adaptto light and da.L . . Ioss o f '"' caus1ng progress1ve vision that can range from night blindness to total blindness. In young patients, whose only symptom may be night blindness, an electroretinogram can detect the functional problems that signal more severe problems to come. The disorder is also characterized by, and named for, the presence of extra, clumped pigmentation in the ret1na. Because the enzyme rhodopsin kinase helps photoreceptors to adapt to light by catalyzing the phosphorylation of the visual pigment rhodopsin, Khani believes that a mutation in rhodopsin kinase may be responsible for retinitis pigmentosa. As an initial, but substantial, step toward identifying the defect, Khani has succeeded in isolating and cloning the gene and identifying several mutations. Next, Khani's research team w ill try to express the mutant proteins in bacteria or cell cultures and analyze them, then introduce the mutation into a mouse and perform electroretinograms to see what effect it has on retinal response. "Retinal gene therapy is in its infancy. 1 th ink that more and more work wi ll be done in this area," says Khani. Although retinitis pigmentosa affects only a small number of people , Khani believes that the techniques he is establishing will have widespread applications. ''I'd like to find more genes responsible fo r retinal degenerative disorders-particularly age-related macular degeneration, which is the cause of blindness in about 2.2 percent of the population," he says. Even after genetic defects are identified In retinal degenerative disorders, the re are many hurd les that need to be overcome before gene therapy can be establ ished as routine, Khani explams. Unlike the cornea, the retina is re latively difficu lt to infect with the viruses that could be used to transfer genes, he says. Also, when researchers have succeeded In transferring genes to the retina, they have been d isappointed to find that the new genes are not functionally expressed. Because functional gene therapy is so far in the future, there is still plenty of demand for the retinal repairs Khani performs In the operating rooms at Erie County Med1cal Center and Millard Fillmore Hospital. As a vitreoretinal surgeon, Khani uses Iase r treatment to correct diabetic . retinopathy. He is also engaged In clinical trials on the use of high-density periluorocarbon liquids to reattach detached retinas in complex cases. Khani's trials compare the usefulness oftwo ofthe fluids, periluoron-octane and periluoro-n-octyl bromide. The high-density liquids are injected into the eye, where they settle under the fluid in the eye and gently press the retina into its proper place, stabilizing it while scar tissue is removed by lasers. The liquids can easily be removed after the opera- J.A. tion. * a 0 p h 5 c a n 5 p n g 9 9 6 i) �Ro b n S t e nhorn, H. M. D . neonatology department Nitric oxide, which is naturally produced in endothelial cells, was being used for the first time to relax the smooth muscle layer around the blood vessel, and enable an oxygen-deprived baby to breathe. For infants that do not respond to medication, she brought her expertise in heart-lung bypass surgery, which she calls a "safety net" and a "last-ditch effort." The complicated procedure of handing an infant's respiratory and cardiac functions over to machines for five to seven days requires 24-hour vigilance from two professionals, but gets positive results. Saving Newborns Who Can't Breathe RoBIN H. STEINHORN, M.D., HAs MADE A CAREER out of saving newborn infants who are literally blue from lack of oxygen. The window sill in her office at the Children's Hospital of Buffalo is filled with pictures of her now-thriving patients. Steinhom is fascinated by the moment when a baby takes its first breath of air. "Never at any time in anybody's life is there such a dramatic change with such rapidity," she says. In more than I in I,000 live births, that first breath can't oxygenate the baby's blood, and the infant is diagnosed with persistent pulmonary hypertension. These are the babies who are sick enough to qualify for the specialized treatment Steinhom can offer as medical director of Extracorporeal Life Support Services at Children's Hospital. Babies with persistent pulmonary hypertension are brought to Children's via helicopter from all over the state for treatment. Steinhom, 39, got her M.D. from Washington University and did a residency in obstetrics and gynecology at the Bames Hospital Group. She then swrtched fields, completing a resrdency rn pediatrics at the University of Minnesota, where she became an assistant professor of pediatrics. Steinhom also helped develop a program to train doctors, nurses, and technicians in heart-lung bypass while she was at the Variety Club Children's Hospital at the University ofMinnesota Hospital and Clinic in 1986. She brought the program to Children's Hospital of Buffalo. Her current area of research is cyclic guanosine monophosphate (cyclic GMP), a naturally occurring substance that relaxes blood vessels and works in concert with nitric oxide. She hopes that an understanding of how the cyclic GMP system develops naturally will help explain why it fails in some babies. Steinhom came to Buffalo four years ago because she was interested in the pioneering work being done wrth nrtnc oxide in the hospital's Steinhom prescribes passion for one's work. "Have some real excitement about what you are doing," she advises medical students. "I never go to the nursery without thinking about what I am doing in the lab, and I never go to the lab without thinking about the nursery." • She recalls her false start in obstetrics. ''After my first year of training I realized that I was more interested in the babies than the mothers." She was particularly intrigued by the blood vessels in infants' lungs. which can be manipulated in anumber of ways after they are bom. "It aroused the scientist in me," she says. Steinhom calls the examination of blood vessels and cyclic GMP her main contribution to medicine, and hopes the future holds not only a cure for persistent pulmonary hypertension but also a way to prevent it LL (]) .c. 1- * -BT a 0 p h c o n s p E !rN g I T. joHN 9 K ELL 1 9 �>(- Stephen in T e ach, J . M. D. Jr :h s!d lo Diagnosing Bacteremia in Febrile Children UP TO ·e IS PERCENT OF THE CHILDREN who come to a pediatric emergency department present with nothing more than a fever. But their diagnosis can be as innocuous as a cold, or as serious as meningitis. '0 ·e •P S, ;s b ric n ;- h n IC ill e )- s. 1t n b )- 1- 1- d 5, 1:' It e ,- c t J Polymerase chain reaction (PCR) technology, which has been used for years in laboratories to replicate DNA and create samples large enough to identify, will soon move into the hospital and become a speedy alternative to cultures, Teach predicts. PCR could identify a disease in 3 to 6 hours. "It will begin the molecular triage of sepsis," he says. PCR diagnosis will improve treatment by Doctors must quickly determine Which of the feverish children are suffenng from occult bacteremia, the bacterial infection in the blood that precedes and can blossom into a full-fiedged disease, such as a urinary tract infection or meningitis. Current culture techniques, wh1ch rely on watching the growth of bacterial colonies from a blood sample, can take from I 2 to 72 hours to diagnose bacteremia. Children who appear to be at risk are not only started on antibiotics but often hospitalized for the entire time 1t takes for the culture to Prov1de an answer. "The approach to that complaint hasn't really Changed in years, and I believe it is about to change," says pediatrician Stephen Teach, M.D., a clinical asSistant 1n pediatrics who specializes 1n ped1atric emergency medicine at the Children's Hospital of Buffalo. Teach, 40, earned an M.D. from Narvard University and a master's degree in public health from the University of California at Berkeley. l-ie did a residency in pediatrics at Children's Hospital of Boston, and Vvas a clinical fellow in pediatrics at Narvard Medical School before com1ngto UB as an assistant professor of pediatrics and emergency mediCine. accurately identifying the small percentage of feverish children who are suffering from a serious illness. It will also help hospitals cut down on costs by shortening the length of inpatient stay. Many hospitals are already building "short-stay" units designed for treatment ranging from a few hours to a full day. PCR will be particularly valuable in identifying bacteremia because the various organisms that cause bacteremia are well known. "You can't just screen for everything. You have to know what infections are epidemiologically likely to be present in this patient, and for bacteremia those bacteria are well described." PCR is already used at Children's Hospital to identify herpes, pertussis, HIV, Lyme disease, and some other diseases, Teach notes. "This will just be an expansion of an existing technology," he says. 'k - J.A. Teach's research into fever among children has shown how ~ifficult bacteremia is to identify. or example, in a 1995 paper, he demonstrated that one of the standard observation scales for classifying fevers 1s not very useful for children under three years old. "This is where I think we're go 1ng to see the world of molecular d1agn ost1cs · enter 1nto . the world of ambulatory pediatrics," Teach says. a 0 p h y s c o n 5 p g 9 6 6) • �their livestock, so that even if people do settle there, they can't support themselves. And then it kills the people as well," Williams says. T rypanosomes have a number of unique adaptations that make them particularly tough to kill or immunize against. They easily elude the human immune system because they change the glycoproteins. in their coat as antibodies recogntze them. The constantly changing coat makes it next to impossible for the immune system to recognize them as invaders. w No reen I I T rypanosomes also have an unusual genetic structure. The organism's genes are shorter than needed, so in order to express functional proteins, the trypanosome edits its own genes, spltctng togetherthe necessary components. a ms , p h. D. Williamsisfocusingherresteabr~ SLEEPING SICKNESS IS A DEVASTATING DISEASE endemic to Africa and on the organism's energy me a . Iism, which is also unusual. Leamtng more about what distinguishes trypanosomes' biochemistry from that of the cattle and humans it infects could lead to a drug that will target · h no efand kill the protozoan wtt Battling Parasites with Molecular Biology South America that saps strength and induces fatal comas in people and cattle. The key to fighting it may be to block the metabolism of the tricky parasite that causes it, according to microbiologist Noreen Williams, Ph.D. "It gives me some satisfaction to be working on this disease," she says. "It's a disease of developing countries, and so it hasn't been the focus of much research. The countries where it's endemic don't have many resources, but that doesn't make them any less cycle in the tsetse fly. It infects the insect's salivary glands and is injected into cows, antelope, or people as the fly bites them. The trypanosome thrives first in the bloodstream, then-over months or years-invades the lymph nodes, the heart, and the central nervous system. If important." Williams, 40, holds a Ph.D. in biochemistry and molecular bioiogy from New York University. She did postdoctoral work at The johns Hopkins University and was an assistant professorwith the Uniformed Services University of the Health Sciences before coming to UB in 1992. An assistant professor of microbiology, Williams is also the di- quickly identified, the disease can be cured by drugs. If not treated before it reaches the central nervous system, sleeping sickness leads to headaches, confusion, lassitude, coma, and death. An East African strain moves more quickly, often killing through congestiveheartfailurewithinweeks or months. A closely related illness in South and Central America is called Chagas' disease. rector for microbial genetics and "It's a severe problem in devel- physiology. The parasite that causes sleeping sickness, trypanosoma brucei, is a protozoan that lives part of its life oping countries. The tsetse fly breeds in water, meaning it lives in the parts of a country that would be good places for people to live. But it kills G B a 0 p 5 c a n 5 feet on the host. .. 1 "We're looking at the cnttca 't to enzymes that are necessary ~,or 1 survive. If you knock them out, you 'd knock out the organism," she says. Williams is particularly interested tn an ATP synthase that helps the trypanosome generate A TP for.''tS energy requirements. Compltcattng the research is the fact that trypa. rn nosomes change their metabo 1IS as they move between their insect and mammalian hosts. In a recent paper, Williams and her colleague~ identified an inhibitor pepttde tho apparently helps regulate ATPase function. "Modern biochemical approaches are new to parasitolog}'• · 1tg ht and they've helped .1t JUmp years in the past I 0 years," she says~ "It's a microcosm of what '.: hap pening in science in general. . Williams is also entering into t~ new collaboration to study plan that are chosen-apparently for medicinal purposes- by animals like chimpanzees and gonl.I as. Sh e Plans to help test substances firom thef plants on the "tryps" in the hopes 0 finding new leads to a cure. * -J.A· p n 9 9 �"The real lady is as much out of place in the practice of medicine as in a regiment of dragoons. " So ran an editorial in the Buffalo Medicaljournal in 1857. But by 1880, l3 regular medical colleges around the country admitted women. The University of Buffalo was one of them, having graduated its first woman, Mary Blair Moody, i.n 1876. By 1912, when these medical students were photographed in the library, it was not uncommon for women to make up about 10 percent ofUniversity ofBuffalo's graduating class. PHOTO : UNIVERSITY ARCHIVES , UNIVERSITY AT BUFFALO /cfcf:?l The university was also progressive in admitting black students. Early records do not list race, but a number of black students are known to have graduated in the 19th century. joseph Robert Love, class of 1880, is believed to have been the first. The second, Cornelius Nathaniel Dorsette, was rejected by the University Medical College of New York City because of his race before being accepted to the University of Buffalo. Pictured here wi.th his class in 1882, Dorsette became Booker T. Washington's doctor and a founder of the National Medical Association. PHOTO: UNIVERSITY ARCHIVES , UNIVERSITY AT BUFFALO �Medicine o t WHAT DOES THE FUTURE HOLD FOR MEDICINE? A procedure to lengthen life indefinitely?The eradication of disease? Genetic manipulation to create the perfect human being? Members of the UB community don't think so. Instead, they believe the next 50 years will bring little change in disease, and continuous progress in technology and treatments. What will change quickly and dramatically, they predict, is the profession of medicine as it is buffeted by social, political, and economic forces. Their speculations, which are presented on the following pages, were summed up by Gerald Logue, M.D., chief of staff at the Buffalo VA medical center. "If you look at the last 50 years in medicine, we've made enormous advances that you couldn't possibly have predicted. That's probably going to happen in the next 50 years as well. "Nevertheless, the diseases will always be there. We may alter . . . . some presentations, and there may be a few new viruses. But people 0 have a finite life span. Even if we eliminated cancer, it wouldn't extend 0 life span very much.There are factors that are age-related that aren't disease-related. m z < > ,0 ~ "Violence and war will probably still cause trauma and longlasting effects," he concluded."We're much more likely to look back in 50 years and be impressed with man's inhumanity to man than with nature's inhumanity to man." The top worry for all our respondents was the economy of health care-how it will be affected by spiraling costs, managed care, changes in Medicaid and Medicare, and politically driven systemic reform. Almost all of our experts predicted some type of universal health-care system, either public or private, in the near fui:tJre.Thomas Rosenthal, M.D., chairman of UB's Department of Family Medicine, 1 9 9 6 �uture ( PHOTOS BY FRANK CESARIO ) was optimistic that economic pressures would result in some improvements in care-a return to family medicine, for instance. But many of our respondents had more worries than hopes, fearing losses in doctors' traditional autonomy and in quality of care. Susan Regan, a prominent health-care attorney, summed up the topic of health-care financing for us, also touching on issues of market competition and tax reform. Another topic of concern was drug resistance in disease-causing organisms. jerome Schentag, Pharm. D., provided hope for the future in his discussion of the issue, pointing out that while discovering new drugs will help, changing the way doctors use existing drugs may do even more to fight the problem. Two bright views of the future were provided by David Ellis, M.D., who discussed the burgeoning field oftelemedicine,andAian Lockwood, M.D., who talked about the emerging possibilities of modern imaging technology. Both felt that their specialties have the potential to bring progress to medicine: imaging by discovering new information, and telemedicine by disseminating information. james Nolan, M.D., speculating on the future of medical training,thought that greater demand for primary care physicians may lead to a new system in which almost all medical school graduates enter generalist residencies. He also speculated that the cost of residency training may in the future be shouldered by the public sector: f Medical ethics specialist Stephen Wear, Ph.D., offered a thoughtful look at the moral ., aspects of medicine. He believes that it is poor communication between doctors and patients that causes many of today's ethical tussles. Although these may melt away as doctors change their attitudes, he anticipates that there will always be new problems. Finally, 5 Wear wasn't the only member of our panel who was concerned that cost considerations, rather than medical ones, might begin to constrain care. e u 1 1 a 1 o Ph ys l cla n 5 p r I n g l 9 9 6 �---- T ( H u T u - R 0 GERALD L . LOGUE , M . D . , ON MEDICINE . M D ----··- -- c - N ) The future will change how • practiced IS DISEASES OF THE FUTURE WON'T BE appreciably different from today's, but the practice of medicine will change radically, accordingto Dr. Gerald L. Logue's peek into the crystal ball. Logue says that because recent research has brought breakthroughs in understanding the genetic basis of cancer. breakthroughs in cancer therapy may be only a few years away. "We're going to see a tremendous reaping of benefits ofthat research in the next five to I 0 years.'' However, advances in treating other problems, such as cardiovascular disease, substance abuse, and environmentally triggered illnesses, will probably be incremental ratherthan revolutionary. 'We'll just keep chipping away." says Logue, chief of staff at the Buffalo VA medical center. What will change more radically. Logue predicts, is the way medicine is practiced. Burgeoning health-care costs and politically driven systemic reform will change how doctors pract1ce mediCine, and who pays for it. Obvious changes surround1ng the advent of managed care include more ambulatory care, and more control by payers and less by doctors. Logue also predicts greater cooperation between doctors and other health professionals, such as nurse practitioners, nurse-midwives, and physician assistants. primary care can be delivered by these other professionals, he notes. He also predicts a change in the way doctors use the tools of their trade. "We are slaves to our technology. Our technology is way beyond our ethics, or our methods of using it," he says. Because life-prolongmg technology IS available, doctors and families tend to use it on patients even when the patient's uality of life is poor and there's no hope of recovery. "It isn't !e right thing to do," Logue insists. "We're at the mercy of our ·::ome technology-we love it, we idolize it, we worship it." Logue hopes that this will change as doctors become more educated, and as more patients are urged to appoint health-care proxies and make advance-care directives. The change will be driven not only by concern for skyrocketing costs but also by a desire for better and more rational health care. "We will have to tum around our technology-driven health-care system," he says. "But we'll also have to be careful that we don't head back into a dark age of medicine where we don't offer that care to anyone." Even with federal aid, training residents drives up costs at hospitals. In an increasingly competitive market, hospitals may . . become unwilling to continue foot1ng the bill. In other countries, graduate medical education can be funded through a tax on health care, but America's political cl1mate makes that approach unlikely here. ''I'm not sure who 1s going to end up pay1ng for it," Logue admits. . Logue sees future research funding coming more from the pnvate sector and less from public sources. He also says that there's ~goo~ chance ther~.will be fewer students going into pure research. They re not dumb, he po1nts out. 'They look and they see that in the future, there's not going to be as much money." The "baby boom" demographic increase in the number of the elderly, plus rising costs and continuing fragmentation and mobility ~f fam11ies, ~ill cause a crisis in care for the elderly, Logue predicts. Everybody s go1ng to want to go into nursing homes and no body's going to want to pay for it," he states. "This is not really a medical problem, but s1nce 1t gets paid for out of the same pot, it will end up be1ng a problem for medicine." _ J.A . s p n g 9 9 6 �T u H T 0 R M N D DAVID G. ELLIS, M.D., ASSOCIATE DIRECTOR of the emergency department at Erie County Medical Center, is at the vanguard of sharing med1cal data, expertise, and protocols using personal computers and videoconferencing-an emerging technology called medical informatics, ortelemedicine. "Every specialty is going to look at this and apply it," he predicts. Computer- ( DAVID G. ELLIS, M.D., ON MEDICAL INFORMATION TECHNOLOGY ) ized protocols and video link-ups are the future as surely as managed care is, he believes; in fact, telemedicine will be inextri- Com put e r s w iII cably linked with managed care in the name of efficiency. The goal of informatics is to organize information so it can be shared by doctors and other medical staff in numerous, widely separated locations. The system will enable professionals to share information about specific patients, as well as protocols concerning entire classes of patients. Ellis hopes it will make treatment as efficient and uniform as possible in a manner cons1stent with the latest literature and practice, and in keeping w1th the goals of managed care. "The goal of the new medicine IS to keep people 1n the best health at the lowest cost, preferably at home," he says. Videoconferencing helps doctors and hospitals make scarce expertise and resources available over a larger geographic area. With a v1deo camera wired to a personal computer, doctors can examine a pat1ent and consult with each other even if they are miles apart. As an example of the possibilities, a new distance education room 1n the Health Sciences Library at UB's medical school allows nurse-practitioner students in the town of Olean to attend class in Buffalo without physically making the trip. Ellis is also pioneering the use oftelemedicine at the Erie County Holding Center and the Attica Conrectional Facility. T elemedicine makes its possible for doctors at ECMC to examine prisoners at Attica and consult with nurses at the prison without any of the financial, security, or time concerns that anse when prisoners are transported. The telemedical examination at the prison takes a few minutes, while the round trip from the hosp1tal would take several hours. And because the patient isn't taken out of the prison, there's no security risk. Even the prisoners like the new arrangement. Ellis has found that prisoners would rather get qu1ck emergency care in the prison than be taken to a public hosp1tal in shackles. Ellis's vision of the future includes doctors connecting to a medical Internet through their personal computers, or joining doctors from the community on virtual grand rounds without leaving thew respective hospitals. T elemedicine will keep doctors cunrent, curb feelings of isolation, and aid in the development of consistent clinical pathways and protocols, he believes. In his own field of emergency medicine, Ellis dreams of ultimately eliminating the Waiting room altogether, instead collecting registration and medical information through portable computers at the patients' bedsides While they are being treated. Ellis stresses that while technology will help establish consistency in practice, it willnever eliminatetne art of medicine. Medicine will always require flexibility because patients, diseases, and computers are not completely predictable. However, protocols can shorten e 0 0 p y 5 0 medical communication length of stay, reduce costs, and improve survival rates. Doctors should considertelemedicine a tool "just like a stethoscope," he says. "This technology is no longer a big deal. The real challenge now is relationships. This presents new ways for people to deal with each other." Technology will not replace primary care physrcians, either, he notes. It will merely enhance their capabilities. Consequently, Ellis is not worried that medical students win resist informatics. As an assistant professor at UB, he has found this generation of students computer-literate and cognizant of the value of technology. "Even doctors trained before the advent of personal computers are learning more about computers and reaping the rewards of more efficient practices," he says. - BY ERIN ST. jOHN KE L LY 5 p g 9 9 6 �u H T T u ( D M 0 R N Medical imaging will bring to medicine ALAN H. LOCKWOOD, M . D . , ON MEDICAL IMAGING NEW WAYS OF iNTEGRATING INFORMATION will make medica\ imaging nd new technologies will make 1t cheaper and more morepowe rfiul . a . 'bl d'cts Alan H Lockwood M.D., director of Pos1tron access1 e, pre I · ' Emission Tomography (PET) Operations for UB and the Buffalo VA medical center. . . . PET , one of the newest imaging technologies,. will be Invaluable .h in studying diseases and abnormalities-espeoally ones w1t out · tom·1cal manifestations-because 1t measures chang1ng 0 bV\OUS ana . · 1 · 1 processes such as blood flow and glucose metabolism. phys1o og1ca · f . ood explains in some cases o Intractable For exampIe, Lockw .' . ·1 magnetic resonance 1magmg (MRI) and computed ep1epsy, · · B 'd ·fy· reveal no anatomical abnormalitieS. y 1 ent1 1ng tomograp hY(CT) underactive regions of the brain, however, PET scans can find the locus without the hazards of more invasive methods. PET will also lead to steady progress 1n leam1ng about normal, · 1 av he believes Because 1t can measure blood flow I hy phys1o heat obt' · to various sections of the brain, PET is an ideal tool for finding out how the brain performs everyday yet still mysterious tasks, such as thinking and talking. Lockwood and his colleagues have already begun PET studies of people as they process language. "We'll begin to see the neuroanatomy of language production," he predicts. "One of the future developments in PET technolo'6f is going to be the fusion of physiological information with other sources of data," Lockwood says. Computer programs to integrate and superimpose PET scan information with MR\s already help doctors locate the site of a physiological abnormality with precision, he says. Further progress will be made by combining PET, which records events lasting about one minute, with electrophysiological methods that work on a fraction of that time scale. The combination will show how various brain regions work together to perform tasks such as talking and reading. Lockwood says it's unlikely that PET imaging itself will change much. ''I'd say we're pretty close to optimal in that technolo'6f." Instead, he believes, the invention of new radiopharmaceuticals will expand how PET is used and make PET technology more widely available. New tracers to study the brain, the heart, and the origin and spread of cancer are on the horizon. Lockwood also says less expensive tracers will be developed that will be widely distributed and used in existing primary care facilities. For example, a new generation of tracers can be used in Single Proton Emission Computed Tomography (SPECT) machines. These machines are often available in community hospitals and outpatient facilities that cannot afford PET systems. Regulatory barriers will also fall as a consequence of the work done in PET centers like the one in Buffalo, Lockwood predicts. Currently, the U.S. Food and Drug Administration classifies PET radiopharmaceuticals as experimental because their short half-life makes it impossible to subject them to the kinds of testing required for most drugs. Although PET studies are expensive, they are far less costly and hazardous than other alternatives such as exploratory surgery. That means PET can be used to help physicians decide on treatment options. Buffalo is the home of a unique committee made up of physioans. hospital administrators, and insurance companies that is establishing guidelines for the use of PET in the clinical setting. According to Lockwood, this makes Buffalo a leader in facing the challenge of determining how to use PET and other imaging technologies in ways that are sound both medically and economically. - J·A · B U a 0 p h y 5 a n 5 p n g 9 9 6 �T u H u T H 0 R D ( N ( JAMES P. NOLAN, M.D ., ON RESIDENCY EDUCATION ) Residency training will create more :1 tt s. s, tg .0 :Jf ys \. RESIDENCY MIGHT CHANGE SUBSTANTIALLY in the future, with most residents heading for a generalist education and a small number choosing super-specialties, according to James P. Nolan, M.D., immediate past chairman of the Department of Medicine. Residency training will need to reflect the medical community's increasing emphasis on primary care, says Nolan. Primary care skills will need to be taught from the first year of medical school, and residency training will need to develop into more of a continuation of medical training. It could even be that most young doctors will go through one generalist residency, instead of selecting specialties. T rain1ng will be very different for the m1nority who choose specialties, Nolan believes. "Those who do choose to enter the more technical aspects of med1cine probably will see their education differentiate in the third year of medical school, and they will go on to a highly specialized residency after that. he says. Specialist residencies will become much more focused and narrow, he believes. For example, radiologists could become wedded to one imaging technology. "We also will see changes in managed care and the way we've originated that system," says Nolan, who expects to see a universal health-care system like Great Britain's. Inpatient care will decrease as hospitals focus on the sickest patients. Most health care, Nolan predicts, will take place in ambulatory settings. And while there still will be a need for critical care doctors, Nolan said, residency training in the future will become more heavily oriented toward preventive care and wellness. "I think we also will see norms of treatment become similar for all physicians, and variations from treatment guidelines will have to be justified," he says. These care guidelines will be implemented to 8 0 0 p h 5 c a achieve efficiency, cost-effectiveness, and universality of care. The downside, he wams, is that physicians may have less discretion in terms of treatment. The roles of different types of health-care professionals will be undergoing a change, Nolan believes. "I think we will see a blurring of the roles of physicians, nurses, pharmacists and other health-care providers. I think we will see more working as a team, and blending certain aspects. For example, prevention and counseling will be emphasized across the board for all practitioners," he says. UB already is working to meet the needs Nolan sees developing. ''Moregeneralistskillswill be taught to students earlier, and that's what we're doing now," he notes. But medical educators will need to do even more to facilitate the changes he sees on the horizon. Medical schools, Nolan says, need to develop more ambulatory sites and clinics throughout the community that are staffed by university and clinical faculty. "We have not been able to use physicians' offices as much as we'd like. We still find that most tra1ning is in the inpatient setting. We've got to find the resources to move out into the community." Residency will likely become more a period of education and less a term of work. "The service component is decreasing now. Residents are not providing the same amount of service that they once were required to. The education of residents is being stressed much more than it has been in the past." That may lead to a change in the way residency training is funded. Residents are now generally on hospital payrolls, so their training is paid for by patients and thirdparty payers. If residency becomes more education-oriented, that cost may be picked up by the government, Nolan explains. - BY CHRISTINE VIDAL n 5 p n g 9 9 6 �~~~~~-- I u H T u -~·-·----~- - R 0 M D N the family doctor, a narrowing of the salary gap between specialists and generalists, and a smaller role for the hospital as more routine care is performed in ambulatory or home settings. Although she believes that managed care can bring new efficiency, she does not think it will miraculously erase the high cost of care. "Medicine is always going to be labor-intensive, and it's always going to take a long time to train doctors and other professionals,'' she explains. "And it's always going to take time for patients to respond to treatment ( SUSAN G. REGAN ON HEALTH CARE FINANCING ) Competition, not regulation, will and get better. No matter how much you pay the cellist, it takes the same amount of time to play the string quartet. "We will have to develop a better sense of distributive justice," Regan says, pointing to the current lack of service to the poor and to people in rural areas. "It's a form of rationing, but it's not based on any legitimate reasoning~ it's either how much you can pay, or the cost of health care THE COMING REVOLUTION IN AMERICAN health care will create a system that is vastly more efficient and, ideally, more fair than today's, says Susan G . Regan , a member of the New York State Public Health · · E · Council. Regan, who is also a member of UB's Center for Clin1cal th1cs and Humanities in Health Care, is an attorney who regularly lectures at the medical school. She heads the health law department at her firm of Magavern, Magavern & Grimm, which serves as counsel to a number of hospitals and health care prov1ders. . R Pred icts that the country will reshape 1ts health-care egan k "I h system through market forces, not government ta eover. n t e next 1 0 to 1 S years, we'll have a strong, deliberate movement toward competition in health care," she says, po1nt1ng out that a New York State government task force recently recommended that ·t 1 begin to negotiate reimbursement rates w1th all payers. h osp1 as · · b 11 Under this plan, not only health maintenance organ1zat1ons, ut a third-party payers~including Medicaid~would negot1ate payment rather than follow rates set by the state. These are the k1nds of measures that will likely begin to bring costs down, Regan bel1eves. "This will undoubtedly cause some problems, but overall 1t will lead us to greater efficiency. The days of the planned economy in health care are gone," Regan says. She does believe, however, that the nation'straditions of consumer protection will probably lead to some government supervision ofthe emerging system. "We may well dec1de that we need regulation a~ a balancing force, just as we discovered the need for ant1trust laws, she notes. "In the future, we will also reexamine how our tax policy contributes to our problems," she predicts. For example, current law subsidizes employer-provided health care by allowing employers to deduct the insurance they provide their workers; yet it does not force all employers to provide health insurance. The result is that people who get no insurance from their jobs indirectly subsidize those who do~the government collects the full amount of taxes from the uninsured, and uses that money, in part, to give a tax break to companies that provide health insurance for their workers. Regan agrees with the many observers who forecast a return to B 0 0 p h s whether in your town there happens to be an orthopedic surgeon." At the other end of the scale, she observes, a few people at the end of life receive far more care than they want or can benefit from. Concerns about cost and about good medical care will necessitate a more rational system of distributing care to those who need it. There is a serious risk that managers may try to save money by cutting back on needed services, or that doctors will be overly constrained by cost considerations. We have not yet found ways of avoiding those dangers, according to Regan, but it is essential to do so ifhealth-care reform is to succeed and make Americans better off "Our country is unique in that we have enormously creative thinking in the insurance industry and among health-care providers, so I can't help but think we'll come out of it with a better system," she states. ~J.A. c 0 5 p 9 9 9 �T u H T u 0 R M c 0 N ( THOMAS ROSENTHAL, M. D ., ON FAMILY MEDICINE ) M.D .. CHAIR oF UB's Department of Family MediCine, believes that the future of primary care is the future of medicine. "Primary care is going to reemerge as the base around which we build our health-care system, the same as it is now in every developed country with national health insurance," he states. "Family doctors have been managing the care of the family for centuries." Rosenthal himself practiced for eight years as a family physician in the farming community of Perry, NY. He became medical director of Buffalo General Hospital's Department of Family Medicine in 1986. He helped establish UB's DIVISIOn of Rural Health in Cuba, NY, and its residency program in rural health. Rosenthal was also the founding director of UB's Primary Care Resource Center. Managed care and the need to control costs are strong incentives to return to the model of the family doctor, Rosenthal explains. He expects to see health care move toward some sort of national insurance system within five years. As primary care becomes more important, Rosenthal says, schools will have to produce more generalists. "Medical schools will have to focus on producing 50 percent oftheir graduates who go into primary care careers. We will have to model primary care as the exc1t1ng career it can be." Rosenthal also predicts a move toward decentralization. "More medical education will have to occur in the communities, and less in hospitals,'' he says. Decentralization will make care more accessible. People will be able to see doctors in nearby clinics, or have phone consultations, or even receive home visits. The result will be earlier detection of disease, and better prevention and management of chronic illness. Hospitals will care foronlythe sickest patients. "If we improve the access to quality primary care, we'll see fewer admissions because THOMAS RosENTHAL, they will have their illnesses better managed in an outpatient setting. This has already been proven." Hospitals will therefore specialize in caring for advanced and complex disease processes, and incurable, terminal illnesses. Doctors will have to receive better training in pain management and end-of-life decisions, he says. "These are issues thatfamily practice residencies have always stressed,'' he adds. "We'll need at least as many hospital beds as there are today because the population will be larger, but we will need fewer beds per thousand people,'' he predicts. "However, the cost per day will probably go up." It is possible, Rosenthal says, to provide better and cheaper care without cutting back on the amount of care. "Managed care gets around rationing health care because you make wise decisions and treat people appropriately,'' he explains. "You make a decision based on a history and knowledge of a patient and their values, saving the lives of people with the potential to return to a reasonable state of well ness rather than prolonging the lives of people for more suffering." Technology presents its own set of problems, Rosenthal observes. Medical practitioners will have to decide whether technological advances are saving lives or merely prolonging suffering. "That's a real tricky, difficult question that we've put off answering." For example, imaging and advanced tests have made it possible to detect prostate cancer earlier than ever, but there's still no consensus on what to do with that knowledge. Surgery and other aggressive treatments may save some lives, but sometimes the treatment causes unwelcome side effects and does not prolong life. A second stage of research is needed to determine how best to treat prostate cancer, says Rosenthal. -BY CHRISTINE VIDAL The future . . of medicine IS In care B a 0 p h y c a 5 p g 9 9 6 �T u H u T R 0 M D ( N JEROME J. SCHENTAG , PHARM . D ., ON PHARMACEUTICS DISEASE ORGANISMS ARE BECOMING RESISTANT to drugs faster than drugs are being developed. In the next five to _1 0 years, doctors will see increasing numbers of patients dying from 1nfect1ous diseases such as pneumonia. But pharmaceutics professor Jerome j. Schentag, Pharm. D., he d oes n't believe this crisis spells the end of med1c1ne. .Instead, . believes that doctors will find better ways of using ex1stmg drugs, d that research will focus on boosting the immune system to an . . .. take over the fight against disease. "It's not a hopeless SJtuatJon, bugs were laying their strategy. They came back in force." Although the imminent crisis has spurred new research, experience shows that it takes an average of seven years for new drugs to progress from the test tube to the patient. 'There isn't anything in the pipeline now that looks like a miracle drug. We are getting new drugs, but they're mostly knock-offs of things we already have," Schentag says. Two classes of powerful broad-spectrum drugs developed in the 1980s together make up 50 percent of the antibiotics sold today. The third-generation cephalosporins attack bacteria by inhibiting key reactions in the cell walls, while the advanced fluoroquinolones interfere directly with bacterial DNA. "What we need, frankly, is another one of those advances," Schentag says. he says. . . "Five years ago, it looked like we were w1nn1ng. The bugs were on the run," says Schentag, who is also the director of Millard Fillmore's clinical pharmacokinetics lab. "The pharmaceutical industry pulled back a little, started investing in other areas. Meanwhile, the Hospitals are beginning to address the problem by finding better ways to use the antibiotics they have. Most hospitals save money by buying drugs in bulk and then using up their supply, but according to Schentag, using the same antibiotic over and over in the same setting helps breed resistant strains even more quickly. Instead, Millard Fillmore and other hospitals are beginning to rotate antibiotics every few months. They are also paying closer attention to dosing by testing patient cultures for resistance and boosting dosages in some cases to kill slightly resistant strains before they have a chance to develop higher resistance. In the long term, medical research will concentrate more on active and passive immunity, Schentag believes. That may include attempts to create immunoglobulins that are specific to certain diseases instead of the general ones in use now, as well as bacterial vaccines like the one against Hoemophilus in~uenzoe that helps prevent pneumonia and meningitis. In the short term, however, only changes in drug use can slow the development of drug-resistant bacteria. A simple thing like instant diagnostic tests could allow doctors to determine bacterial strains and prescribe very narrow-range drugs. More important, according to Schentag, is getting doctors to be more restrained in their use of drugs. "If we ever get to the point where we stop giving antibiotics to everybody with a cold, it would be the most revolutionary thing of all," he says. - J. A . The diseases are the drugs B u a 0 p h y s c a 5 p 9 9 �u H T u T H 0 R D ( N New ethical are on the horizon TouGH CHOICES IN MEDICINE will always involve ethical questions, but better communication between doctors and patients could someday resolve many of the day-to-day problems that require the intervention of ethicists like Stephen W ear, Ph.D. "I hope people who do what I do at the bedside won't be needed," says Wear, the co-director of UB's Center for Clinical Eth1cs and Humanities in Health Care. The author ofthe 199 3 book Informed Consent Patient Autonomy and Physician Beneficence in Clinical Med1one, Wear holds joint appointments in the departments of Medicine, Gynecology and Obstetrics, and Philosophy. He heads the ethics consultation team at the Buffalo VA medical center, where he is on call 24 hours a day, seven days a week. He is also a member of ethics committees at Hosp1ce Buffalo, Buffalo Mercy, Millard Fillmore, Children's Hospital, and the Erie County Medical Center. Wear is most often called to a hospital to resolve disputes between families, patients, and doctors on issues of clinical ethics such as informed consent. end-of-life decisions, and aggressiveness of treatment. Frequently, he says. the debates are caused by misunderstandings between doctors and families. He often clears up problems by simply helping physicians explain diseases and treatments, and by translat1ng "doctorese." Many of the issues around end-of-life decisions have already been charted out conceptually, says Wear, whose doctorate is in philosophy. What will hapSTEPHEN WEAR , PH . D . , ON MEDICAL ET HICS ) pen 1n the future, he predicts, is that doctors will do a better job of putting the theories there will be little need for bedside dispute resolution, Wear into practice by clearly informing patients about their disease, prognopredicts. However, new ethical questions are always cropping up. SIS, and choices. ·'One ofthe reasons people like me are around is that "We'll be going through a very ugly phase as issues of health care the profession has resisted internalizing these issues. financing are worked out," Wear believes. "We have to have this "A great deal of conceptual progress has been made in biomedicrisis because we have only so many resources to go around." cal eth1cs in the last 20 years," explains Wear. For example, at one Concern for cost may force insurers to limit treatment. Health point. refusing aggressive treatment was considered a suicidal act. maintenance organizations may prohibit doctors from prescribing Now, the concepts of informed consent and the right to refuse expensive dnugs or discussing effective treatments outside the treatment are widely accepted and have changed the terms of the network. ''I'm very nervous about that. My guess is, society w ill make debate. some poor choices along the way. I am hopeful that the right choices Wear says that institutions will probably be pressured to change will have been made in 50 years." as well. Hospitals now concentrate on trying to cure diseases, rather The emerging technologies of gene mapping and manipulation than on managing death. Each death is discussed in detail in hospitals' will raise new issues. The Human Genome Project, when completed, morbidity and mortality meetings. "Deaths have to be defended, could provide information about an individual's risk of illnessbecause there's always a suspicion that somebody m1ssed the boat. information that. in t he best case could be used to prevent disease, But 1n many cases, death is the only realistic outcome of a disease. or in the worst case to cut off insurance. Parents may get the power Why not focus the discussion on how the patient was treated, to select the qualities of their offspring. "It's a way of making choices whether pain was alleviated? Hospice has a lot to teach us," he says. regarding another individual," Wear cautions, "and whenever you As doctors and patients become better informed about ethical do that. you raise ethical questions." - J.A . questions of health care-and communicate better about them- c e u a a p h s c a s p n 9 9 9 �CONTINUED FROM PAGE 3 nance in resident and fellowship training. • The merger of the University at Buffalo with the SUNY system in 1962, of course, was the most significant event of these 150 years. The merger was traumatic but important, bringing an infusion of resources to make UB a major public institution. The period between 1962 and 1975 was characterized by confusion, instability, diminished institutional self-esteem, disillusionment, an uncertain direction, and little cohesion. The UB faculty had spent much effort in defining its dreams for a medical center comparable to those at Rochester, Stonybrook, and Syracuse, but found that those dreams were not shared in Albany. When the bubble burst, poor morale pervaded the school. This was reflected in critical accreditation reports in 1962, 1966, and 1972, a decline in academic productivity, and deterios v J OHN NA ration of the physical facilities. The situation improved in 1973 with the recruitment ofUB's first full-time vice president for health sciences, Dr. Fitzhugh Carter Pannill. I was recruited as UB's first full-time dean in 1975, and am forever grateful to Carter and to UB's president at that time, Dr. Robert Ketter, for offering me this exciting opportunity. Certain facts were apparent when I came: •UB and the community possessed a wealth of resources which included capable personnel, diverse hospitals, and a large population base. Those could provide the cohesiveness, ethos, and energy to develop a mature medical school. •Many of UB's best faculty had not received the national recognition they deserved. Now that UB's ability to compete with the best is established, this should never occur again. • Continued achievement of excellence required the acceptance that UB and the community were interdependent, and that meaningful programs were more likely to flourish through cooperation than competition. UB's medical school of 1996 is far different from thatof 1946. It has experienced five successful accreditation visits between 1976 and 1995. It has developed a core academic center with a world-class Health Science Library, magnificent educational facilities , a modem vivarium and biomedical research complex, and the schools of dental medicine, nursing and allied health professions. UB and its affiliated hospitals have defined both their individual missions and their shared ones. A strong volunteer faculty supplements UB's academic faculty. Most importantly, the medical school attracts academically competitive students, residents, and biomedical graduate students. Enough of the past and present. What of the next 150 years? In my opinion, the faculty, the university leadership, and the hospital and community leadership have positioned UB well for the future. For UB and all institutions of higher education, the new economy and social order will encourage sharing, collaboration, and interdisciplinary activity. There will be B a 0 p s increased emphasis on independent learning, increased use of technology, less classroom experience, and more attention to outcomes rather than to process and regimentation. Such change is already occurring at UB . Continued transformation will take another generation. But by building on past achievements and today's optimism, UB's medical school and its community partners will provide the best in education, health care and leadership. These assets will help us meet the challenges ahead: • The medical school has a core of educational and research facilities to sustain its mission well into the next century. • The new fiber optic network linking the campus and hospitals with other places in the state provides the infrastructure for distance learning, transmission of library information, and the continued development of the region's health system informaUGHTON , M . D . tion superhighway. • UB's biomedical research program generates more than $30 million annually. Together with a faculty practice plan that generates almost $80 million dollars a year and the complementary resources provided by New York State and the hospitals , the school will be able to educate physicians for the future. Two projects are planned in the next five years to help the school meet its obligations to its students andiacult.y: •The Comprehensive Health Education Center will be built in the old dental school building at the north end of Farber Hall. It is envisioned as an interdisciplinary center for community health education research, problem-based education, and the teaching of interview skills and physical diagnosis. The center will provide a modicum of patient care shared by the various health science faculties , and, we hope, a centralized autopsy facility coordinated among the teaching hospitals. •The second and third floors of historic Harriman Hall will become the locus of the medical school's administrative offices while its first floor continues to provide student support services. The building is connected to the Biomedical Research Building at the second floor level, uniting the South Campus health sciences core. As we celebrate UB's Sesquicentennial, there are many reasons for optimism. Future research, education and patient care will be interdisciplinary. Biomedical research will become more cooperative and collaborative. Education will be interdisciplinary, combined with more independent learning. Patient care will become more integrated and comprehensive. My dream for the year 2146 is that UB's leaders of the past, present, and future will meet in the great unknown to evaluate how each generation has remained faithful to the dreams of Millard Fillmore and UB's founders . Happy 150th B ir t h da y UB ! + c a n s p g 9 9 �\ ', - l HE UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES has a long and distinguished history-and you ore port of it_ In celebration of its Sesquicentennial, a beautifully illustrated pictorial history of the Medical School is available for your personal library or office_ This hardcover, 192-poge keepsake, Another Ero, contains 250 photos, including rare, historical photographs that will transport you to a time when___ Medical School tuition was $65 a year and "good board, with room, fuel and lights" could be found for $4_50 a week_ UB medical students were the first in the United States to witness a clinical demonstration of a live birth-which caused an outcry in newspapers nationwide! Retrace 150 years of achievement, trials and tribulations in this special limited volume, and toke pride in the Medical School's vision for its future_ To order Another Era by credit card call Wadsworth Publishing Company at 1-800-369-2646 exL 3339 $39_95 including shipping and handling. Gift cards available upon request. Charges will appear on your statement as Wadsworth Publishing. B u a 0 p y s c a n 5 p g 9 �• ······················································ I 9 0 3 5 ARTHURT . SKARIN ' 61 , ofNeedham,MA, E . GORMAN ' 36, of Hilton Head, SC, published the second edition of his Atlas of has been active at the Volunteers in Medicine Clinical Onco logy. Skarin is the chief of the Clinic on Hilton Head Island since 1993. The hematology laboratory and the medical di- FRED organization provides free medical service to rector of the thoracic oncology program at 6,000 to 8,000 people who have no other Dana-Farber Cancer Institute, and teaches at medical care. Harvard Medical School. The book is the first The State University of New York at Buffalo Department of Family Medicine is continuing to grow and expand. We are seeking BE/BC Family Practitioners to join us in varied urban and suburban settings throughout Buffalo and Western New York. The candidates we seek must have interest in OBI GYN and assume teaching responsibility for medical students and residents. Benefits include competitive salary, ample vacation, sick time, CME time, and licensure/board fees. If any of these opportunities sound of interest, your colleagues here at Family Medicine would welcome the chance to speak to you. of its kind to cover all aspects of oncologic 9 0 4 ALEXANDER GRINSTEIN '42 , tumors and malignancies. About half the 5 photos in the atlas come from Skarin's teach- of Beverly ing collection, gathered as part of his hobby Hills, MI, announces his most recent publi- of photography. Skarin's post-UB career be- cation, The Remarkable Beatrix Potter. His gan with a fellowship at Boston City Hospi- previous publications include Freud's Dreams, tal. Near the end of the Vietnam War, Skarin Freud at Crossroads, Conrad Ferdinand Meyer was drafted and spent two years in the U.S. and Freud, and Freud's Rules of Dream Inter- Air Force. After returning to Boston, he helped pretation. Alexander is president of the Dr. Sidney Farber develop a medical oncology Sigmund Freud archives. 9 program at the Children's Cancer Research 0 5 Foundation, which later became the Dana- 5 Farber Cancer Institute. Skarin says he some- of Dallas, TX, times reminisces about Buffalo with friend while chairman of psychiatry at the Univer- who is a daughter of longtime UB professor sity of Texas Southwestern Medical Center at Oliver P. Jones, Ph.D., M.D. KENNETH ALTSHULER ' 52 , Dallas, was named 1995 Professional of the E. of Delhi, NY, was Year by the Dallas Alliance for the Mentally JOHN Ill. The group honored Altshuler for helping selected a fellow of the American College of establish Mental Health Connections, a co- Physicians. He recently completed health- operative program ofUT Southwestern's De- care management training at the Kenan partment ofPsychiatry and the Dallas Mental Flagler School of Business, University of Health and Mental Retardation Center. North Carolina at Chapel Hill. SHIELDS '68, Altshuler, who holds the Stanton Sharp Dis- 9 tinguished Chair in Psychiatry at UT Southwestern, recently assumed the presidency of 7 0 JAMES J . MCCOY JR . '71 , 5 of Charleston, sc, is medical director of the Charleston the American BoardofPsychiatristsand Neurologists. Please contact Rebecca Brierley, Professional Affairs, Department of Family Medicine, 462 Grider Street, Buffalo, NY 14215 (716) 898-4797; Fax (716) 8984750. EOE/AA Surgery Center and a member of the Arthroscopy Association of North America, 9 6 0 5 and was recently installed as president of the of Waltham, MA, was South Carolina Orthopedic Association. He elected to the executive committee of the has seven children and soon will be a grandfather. HARRIS FAIGEL ' 60 , section on Ado lescent Health of the American Academy of Pediatrics and was appointed STEVE TUCKER '72 , chair of the finance committee of the Society of Anchorage, AK, is in solo practice in nephrology. He is gover- for Adolescent Medicine. His third grandchild (first grandson) arrived last June. His nor-elect of the ACP in Alaska and serves as wife, Frayda, is enrolled in the psychiatric director of the Alaska/Northern Alaska Kid- nursing track for a M.S.N. at Northeastern ney Center and chairman of the pharmacy University. and therapeutics committee. He has two We encourage the inquiries of women and minorities. adopted children, Jacob Ian, 5, who skates, B a 0 p h y s c a n s p n 9 9 9 6 �\ ......................................• II Ifyou thought ' you knew us... do J.OU know what's NE.W? ..;,~ ~ '<' skis, and plays soccer and hockey; jackie (5 1/2), Alex ( 4), and Eric and Alanna Elizabeth, 15 months. (19 months). JAMES P . o""e'( \ of BU R DICK '75, is the director of anesthesia ser- for an essay about lesbian battering entitled Strike One. Apractic- ban Hospital in Buffalo and a ing psychiatrist, she ha also pub- member of the board of directors and president-elect for the medi- lished features , es ays, fiction, and poetry in the U.S., Canada, cal staff of Millard Fillmore the United Kingdom, and Aus- Health System. He also serves on tralia. Her first book, a collection the board of the ew York State of interviews with female musi- Department of Health's Office of cians-including Marianne Professional Medical Conduct. Faithfull, joan Osborne, Laurie Lewis, and Grammy-winnerjanis of ment. He was also promoted to lieutenant colonel in the medical Ian-will be published this year. Post lives with her long-term partner, judith Avery, a psychiatric nurse. corps of the U.S. Air Force Re- 9 serves at Langley Air Force Base, where he serves as a gynecologist in the Women's Health Center. s 0 9 M ICHELLE SKRETNY SUSCO '91 , of Clifton, VA, is a board- certified pediatrician in a small of group practice in Manassas, VA. Washington, D.C. , has spent the She married joel Susco on Sept. 2, 1995. T ER EN C E CHORBA , '79 , past year helping improve disease surveillance systems in five OBITUARIES central Asian nations as a CDC epidemiologist in Kazakhstan. MARVIN N . W I NER , '39, of Sarasota, FL, died Dec. 27, 1995. Rooms .1vailahlc for UB Alumni Weekend October 4-6, 1996 9 Congrarularions to The University at Buffalo School ofMedicine & Biomedical Studies on celebrating I 50years ofteaching, healing and research! FromnNf-~ 8 0 S He was born in Buffalo, and after MAR K 5. B O R E R '80, of Dover, earni ng his M.D. , served three DE, was rated a "Top Doc" in the years in the U.S. Army Air Corps. state by 200 medical colleagues in the ovem ber 1995 issue of He practiced dermatology in Buf- Delaware Today. Mark is board- an instructor at UB. A Fellow of falo from 1946 to 1981 and was certified in psychiatry and child the American College of Physi- psychiatry. cians and of the American Medical Association, he was also a MARC BUFFALO~arrtoft 1340 Millersport Highway, Amherst, NY 14221 (716) 689-6900 or (800) 334-4040 At the Univers1ty at Buffalo Complex 0 STANLEY '78, of the Richmond Health Depart- • A first-class hotel with outstanding amenities, comforts and conveniences - centrally located at the University at Buffal o Complex. u L . Richmond, VA, is acting director And Your Choice To Stay In WNY! B CA, won first prize in the Ari- vices at Millard Fillmore Subur- COVIA ~ .("~ ~;:. ~ s~ of Oakland, zona Authors' Association ationa! Literary Contest in 1995 ;:.S· • 14,000 sq . ft. of flexible ~'b~~~ ~;:. . "/)~ e"\ meeung space on property ~ ~ 'o~;:. PLUS direct access to an -0-fJ ~~ ~0 additional 250,000 sq. ft. 'o~ 0~e;r. with state-of- the-art capabilities. ~ ~~~~~s~· s'~ .;;s' . and mnovauve . . • Super b catenng ~~s ~ 'o theme dinners PLUS expert ~\~ ~ 'b~o" planning assistance from -0-fJ ~~;:.';:. pre-event through closing. ~0 ~ LA U RA POS T '87, East Amherst, NY, is the president-elect of the ew York State Society of Anesthesiologists. He \ Oo ~~,o See Why ,:~'~~ ~;:.O~ e,C.\.~ \~ '( We're Your Ideal _,~~ s~~,,o<:'> ~~~~ . Fact·1·tty... \~ <i>'1~~s J. M eeung ~s ~o I 0 p h y J . K O B LICK '84, of Ormond Beach, FL, became a form er pre ident of the Central tales Dermatologic Society. He fellow of the American College was a member of the Landings of Surgeons. He and his wife, Racquet Club. He moved to Helene, have three children : Sarasota 10 years ago. He is sur- 0 n s p n g 9 9 6 �• •• • ••••••••••• • • • •• • • • HUR\VITZ & FINE, P.C. I I ATTO R NEYS AT LAW I THE ULTIMATE DRIVING MACHINE: S ERVICING THE L EGAL vived by his wife, Helen M.; his daughters, Beth Berenson of New York City, and Ellen N EEDS OF THE Litman of San Francisco; and four grandchildren. Memorial donations may be made to University of S. Florida Allergy Research, Account #25040, care of the Division of H EALTH S CIENCES COMMUNITY Allergy and Immunology, University of S. Florida College of Medicine, VA Hospital, 13000 Bruce B. Downs Blvd., Tampa, FL 33612. PAUL ROBERT MOYCE, • Managed Care • Purchase & Sale of Practices • Business & Tax Planning '70, of Mountain Checkpoint Foreign Car, Inc. View, CA, died peacefully Oct. 19, 1995 as the result of a severe head injury. He was surrounded by his loving family. Born in Buffalo, he graduated from the University of San Francisco in 1966. After earning his • HCFA Safe Harbor Regulations and Physician Self-Referrals Sales and Service • Contracts with Private • • Employee Relations & Public Entities M.D., he served in the U.S. Air Force as a flight surgeon. He was board-certified in anesthesia in 1977 and began his practice at Dominican Hospital in Santa Cruz. He vol- Counseling 487 Kenmore Avenue Buffalo, NY 14223 836-2033 unteered for the Santa Cruz Suicide Prevention program and Hospice. A growing interest in mental health led him to enter a residency in psychiatry at the University of California at Davis in Sacramento. He obtained his second board certification and began a private practice in psychiatry in Menlo Park, CA., in 1990. He enjoyed literature, travel, music, and the exploration of the spirit. An accomplished pianist and vocalist, he sang bass with the Cabrillo College • Fringe Benefit Programs • Representation Before Government Agencies on • Audit & Business Issues • Facility Finance Your WNY Leasing Specialist Serving WNY proudly for 33 years and Construction • Credentialing and By-Laws Slavonic Chorus and toured the Soviet Union with them in 1987. He is survived by his • Hospital/Medical Staff Issues wife, Kaki; his daughter, Audrey; and his son, Gregory, of Seattle, WA. Donations Please contact Robert P. Fine or Lawrence M. Ross at 716-849-8900 may be made to the Audrey Saxon Moyce Education Fund, care of David Moyce, trustee, P.O. Box 1883, El Grenada, CA 94018. We have more class notes than we could fit into this special issue. They will appear in the Summer 1996 issue.-The Editor 1300 Liberty Building Buffalo, New York ' j B a 0 p y 5 c o n s p g 9 9 6 �The jury is out. Your practice and assets are on the line. This is not the time to be second-guessing your choice of professional liability insurance companies. In a similar s ituation, a MLMI C policyholder remains confident, knowing he or she is protected by a company that already has successfully defended more physicians than all other available insurers combined. Adding to the value of your MLMIC policy is one of the country's largest and most experienced professional liability Claims Departments, as well as the largest Risk Management Department of any professional liability insurer in the state. MLMIC also offers New York's only true peer review of claims experience. Only physician-owned and controlled MLMIC offers this high level of quality assurance and service. MLMIC also is the only medical liability insurer approved by the Medical Society of the State of New York. Find out more about the protection you'll receive from the largest and most successful company of its kind in 2 Park Avenue MLM~C ~ledical ~ America. Call1-800-356-4056 in Upstate New York, or New York, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 liability ~lutual Insur.mce Company 1- 800-ASK- MLMIC in the New York metropolitan area. 01994 Med.c.l Lab ty Our defense never rests. B u a a p s c a 5 p M~ n g lneuranu Cc-nparry 6 �I SURF THE NET! • B L cl ADVERTISING INTERNET SOFTWARE Many Titles!! DOS ...$67 Windows...$69 A F BARANSKI PC Anywhere tc A Why Jtay home for the holidayJ? • America Online Mac & Windows ...$21.49 • Internet Starter Kit Windows...$34.49 Mac...$34.95 • Prodigy Mac & Windows...$t5.95 • Netscape Navigator for \Vindows ... $43 l The front-wheel drive lnfinitt"® I 30'M A,_, interior more .1paciou.J tl>an a Ro!/.1 /?i,yce 3. Stiver Spur /fl. An e.weptiona!ly 9Werou.J li.Jt of -•tanoard lu.-.:ury fealure.J. !90-hp 6 A p v capahle ofoul-accelerating many lu.r:ury V&. v And of cour.Je, il>e .J/andard-.Jel/ing performance and .Jervice of lnfiiritt: tr Sl S399mo. 59 mo. fea.1e SO down 81 5; M flj ar D Ut ti< es Can't connect from home without one! INTERNAL STARTING AT $84.95 EXTERNAL STARTING AT $94.95 Your advertising presents your company image to the public ... and to prospective cl ients and customers. At Baranski Advertising, we are proud to represent some of the finest publications in Westeri1 New York, publications where your advertising message is sure to reach a quality audience. Many Brands! • Supra • US Robotics • Boca Modems • Practical Peripheral • Global Villiage re ta BOOKS 20% off Retail be Using the Internet.............$15 M The User-Friendly Reference tu th Easy Internet................$18.95 Using the Internet.............$29 ca Special Second Edition c S[; wi wi so m: INTERNET WORKSHOP Connecting to and Using the Internet! June 12 & 13 ..... $119 Ec CUSTOMIZED WORKSHOPS tn These private workshops are tailored to your needs. They are available and very affordable. Call645-3560 for information! 94 w. thi Su Prices shown i11clude a 2% discount for cash payments Open Mo11, Tues, Fri 1lam-Spm, Wed & Thurs flam-6pm .-~-·:-JiiUiti A non-prolil University program for sludents. faculty & staff The Commons • North Campus • (716) 645-3554 • Fox: 645-3834 s Thefront-wheel drive lnfinitt"® G20'M Lifce every lnfinit~ the G20 come.J ll'ilh an e.r:ten.Jive lilt of Jlandard lu.r:ury fealw·e.J; A 4-year/60,000 mile BaJic Ne"' Vehicle Warranty; 24-hour Roao.Jide A.J.JUiance Program Trip lnterruplion Benefit.J; and our Free Service Loan Car Pm_9 ram. S3J9 mo. 50 mo. fea.Je SO down CALL US TODAY (71 ~) 645·6933 IN FIN IT 1 MICHAEL J. BARANSKI AUTO PLACE INFINITI 8129 MAIN ST., WILLIAMSVILLE Marketing Representative 633-9585 East of Transit Rd Near Eastern Hills M'all P.S. We did this book! ~20 42(mo./130 42 mo. lease with cash or trade equity . own. G20-$495) (130-$450). Bank fee + tax and hcense due at •nception. 12,000 annual mileage $12 per mtle m excess. · · a 5 p g 9 9 �.I • PLANTING A TREE UNDER WHICH You WILL NEVER SIT DR. DEVILLO W. HARRINGTON, class of 1871, knew how to make his money ' grow. In fact, this man who in 1905 provided $5,000 through his will for. the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. THIS PERMANENT endowll)ent in Dr. Harrington's name has grown to over $300,000 and today it supports the famous Harrington Lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. ) Uf he DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed funds at the school. They enable UB to prov1de scholarships to outstanding students, .ve At enhance scientific research, support excellence in teaching and meet the ever-changing needs of the scho,ol. YOU TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you deve I0 P a smart financ1al . plan. Acharitable bequest prov1des . the. sat1sfact1on . . that comes from PIantmg . a tree ere ure under which you will never sit, but which will bear fruit for generations to come. FOR ACONFIDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact: r STEPHEN A~EBSARY, JR. ~ - - - -- ~ Assistant Dean and Director of Development, School of Medicine and B1omedical Sciences UNIVERSITY AT BUFFALO (716) 829-2773 UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE ISO YEARS •e•e · •••e a 0 'p h y 5 c o n 5 p n g 9 9 �·--- BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT"BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED -11 . .>.~.: l .,)TJ .!C ·- L Y .;TT L.i. .~ ><Y ,L, ... _ T ~ -- ~-- - Non-Profit Org. US Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1996 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1996-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v30n02-1996-Spring Table Of Contents A list of subunits of the resource. UB's Medical School at 150 The Founding of the University of Buffalo Buffalo's Unique Network of Teaching Hospitals Photo Essay: Life at the Medical School Continuing a Tradition or Excellence Medicine of the Future Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-20 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v30n02 Extent The size or duration of the resource. 64 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1996 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/334b5777f1ce947055f51673d3f1b7f0.pdf acc839f8ffcd24c4660cac3bc145a771 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Winter 1996 �BUFFALO PHYSIC I AN \olumc 30. '\umhcr I ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr Carole ~mnh Petro DIRECTOR OF PUBLICATIONS Timoth) j Conro\ INTERIM EDITOR judson \lead ART DIRECTOR \Ian j hcglcr ASSOCIATE ART DIRECTOR "'cott l:ri<.:kcr PRODUCTION MANAGER -\nn Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John '\:aughton \tee Pre>tdcnt for Clmical \[fat". Dean EDITORIAL BOARD Dr John \ Richert Chatrman Dr. \1artm Brecher Dr. Harold Brod\ Dr. Richard l Colltns Dr. Alan J Dnnnan Dr Timoth' Gabrwl Dr. James Kanskt · Dr. Charles \1a,;aro Dr. Charles Pagancllt Dr. Robert L. Rct>man Dr. Thomas Rosenthal Dr. Stephen ~pauldmg Dr Bradley T Truax Dear Alumni and Friends, N ineteen ninety-six has arrived; thanks to the dedication and hard work of the school's History CommiLLee, everything is in order to celebrate UB's and its medical school's sesquicentennial. The committee, chaired by Dr. Ronald Batt and Dr. Harold Brod) and ably assisted and supported by Dr. joyce Vana, has orchestrated a fine program of events. The initial opening activities will be held on February 22, 1996, when the newly completed Biomedical Research Building will be dedicated and the formerly undesignated Cary-Farber- herman Addition will be named the Biomedical Educatio n Building. These acth·ities will be conducted from 10:00 a.m. till noon. That afternoon, an academic convocation will be held in the elegant Austin Flint Reading Room of the Health Sciences Library. Thanks to the help of its director, Dr. Gary Byrd, and its excellent staff, the room will be available from 3:30 to 6:00p.m. The uNY Trustees and UB's president will confer an Honorary Doctor of Science degree on Dr. Saxon Graham, Professor Emeritus of Social and Preventive Medicine and the department's former chairman. This will be followed by a major Harrington Lecture by Dr. Steven A. Schroeder, president of the Robert Wood johnson Foundation. These activities are already complemented by the publication of the Medical Alumni Directory and by the publication of a special supplement in Business First dedicated to the medical school's sesquicentennial. In early April, the pictorial history compiled by all members of the History Committee and edited by Dr. Brody, Dr. Vana, and Dr. Richard Lee will be available for purchase. Thanks to the efforts of Ms. joyce Buchnowski, an im pressive flyer describing the book has been widely circulated. A series of other events are programmed throughout 1996 and up to mid-year 1997. We hope you will be able to participate in as many of the e,·ents as possible. \-tore important, all of us who have worked on preparing the sesquicentennial hope you will take the time to reflect on the significance of the school's past, its influence on you, and the pcomi>e' >nd '"P""'ibili''" 'h" will "~' <n ~"~ ' ....._, TEACHING HOSPITALS AND LIAISONS Batana \.\ \1edtcal Center Adem· Kclh The Buffalo (,cneral il<"pnal .\ ltdwd Slta" Buffalo \ .\ \1cdical Ccmcr The Children\ Hospnal of Buffalo Lric Count\ \1eclical Center \!ern Hospttal \1tllard Fillmore Hospnals fnmh Sma Roswell Park Cancer lnstnute '-,i~tCr"t or Charity llo~pital Dnuu~ \fc'Cwtln <0 The ~tate L 111\·crsll\. of :\cw York at Buffalo Bt4ffalo Ph\ \1(1<111 IS publtshcd quarterly b~ the State Lni\·cr..,it~· of :\e" York at Buffalo ~chool of \tcdtunc and Biomcdi<:al St:icnccs and the Office of PublicatiOns. It ts .,t.:nt free of charge. toalumm , facultY, students, re>tdents and fnends. The staff reserves the nghtto cdtt all COl" and ..,uhmi-,"otons at:ccptcd for puhliGttiOn . \ddrcss quc ... tions, comments and Eduor Bu(fcllo Ph)\icicm, State Lnin:-rsuy of '\"n, ... ubmission.., to : )ork at lluflalo . Unl\crstt\ Puhltcatll>t". I 3{> ( rofts llall,lluffal<i, '\c" York 1-+loO Send address thanges Ia: Buffalo Pin siw111. Ho (I~ \ddt! ton . 34 35 \lam ~treel. Buffalo. '\e" York 142 1-+ j ohn aughton, M. D. \!icc President for Clinical Affairs Dean, Sclwol of Medicine and Biomedical Sciences Dear Fellow Alumni: T he medical school's sesquicentennial celebration is well under way! We will keep you posted regarding the various e\'ents marking this historic m ilestone (there is a rou ndup on page 22). On February 22, 1996, we will ha\"C dedication ceremonies for the opening of the Biomedical Research Building and the designation of the CaryFarber-Sherman Addition as the Biomedical Education Building. In the ncar fu tu re, you wi ll be receiving a brief alumni sun-cy. The Board ofGo\'ernors tries hard to represent the alumni at large, but wedon'tgettosee many of you regularly, and we'd like to knO\\ what you're thinking. A variety of topics will be covered and we really hope that you'll find a few minutes to reply. If there arc any questions or topics you'd like covered in the survey, please let me kno\\. \Vhen I introduced Dr. 'laney Nielsen as a speaker at Spring Clinical Day in 1993, I was O\-cmhelmed by the list of her accomplishmenLs. Well, get ready for another line on her C.V. I Dr. :\!ielsen has been selected as this year·s recipient of the State University of New York at Buffalo's most prestigious alumni award, the Samuel P. Capen Award. Congratulations are also in order for Dr. james olan, who rcceml) retired as chairman of the Department of Medicine! Dr. "lolan will recci,·e the Walter P. Cooke Award, the university's award for notable and meritorious contributions to the uniYersity by a non-alumnus. I'm looking forward to seeing many of you at Spring Clinical Day in May. Warmest regards, ~... a. ~ . - ()a.JtJZX w. T ~sJt.,;. , MD Margaret W. Paroski, M. D. �V 0 w 3 L N T N 0 E R o 9 9 6 IJ Research II Hospital News II Treating Violence e ECMC's Trauma Center isn't finished working with the victims of violence when they are healed. The doctor's in. Page 26. m Sleep Without Rest e At the Sleep Disorder Center of Western ew York, patients may discover that what ails them during the day is the result of what they don' t know about their nights. Medical School · Then and Now , A Spoonful of Humor Alumni Treating violence with more than sutures. Page 6. 1 Classnotes *James ffiar~s. m.~. '?l ta~es t~e ~elm at What happens once you go to sleep? Poge 12. t~e ~~~~r~. rage{~. �weight-loss treatment programs showed that at 10 years, more than 20 percent of the children had maintained a 20 percent decrease in overweight, compared to fewer than 1 percent of the adults. "These results suggest that as a public health policy issue, it may be a better use of limited resources to focus on preventing obesity in children, instead of trying to reduce obesity after it is well established in adults," says lead researcher Leonard H. Epstein, professor of psychology, social and preventive medicine, and nutrition at the University at Buffalo. The study appeared in the September 1995 issue of Obesity Research. Epstein, who heads B's Behavioral Medicine Laboratory and has studied childhood obesity for more than 20 years, is now working with overweight children who participate in a four-month comprehensive, family-based weight-control program called the Stoplight Diet. The Stoplight Diet teaches children to ea t a nutritionally balanced diet by linking foods to the three signals on a traffic light: "red " high-calorie foods should be eaten rarely; "yellow" moderate-calorie foods can be ea ten in moderation; and "green" low-calo rie foods can be eaten freely. The program combines diet with exercise, behavior modification , and a maintenance program and is the only Dorn receives NIH "FIRST"grant treatment program in the country to document success in children over an extended period. In the current study, Epstein compared treatment results of children and parents from 113 families who had participated in behavioral weight-control programs conducted by his group. Children and parents in these programs were given similar diet, exercise, and behavior-change recommendations. At six months, about 40 percent of children and 20 percent of adults showed at least a 20 percent decrease in pounds overweight. While both children and parents regained weight after this initial drop, children's weight gain at five years stabilized at about 7 percent below baseline and remained there at10 years. But adults returned to their baseline weight by five years, and at10 years they weighed about 7 percent more than they did at the beginning of the study, results showed. Epstein cited several factors that could explain these results, including the nature of most adult treatment programs. "Typically, adults are treated by themselves, while children are treated within the family, which provides important support for habit changes and maintenance." Other reasons include the natural tendency of children to be more active, a difference in motivation in children and adults, children's fewer number of fat cells, and the fact that children's habits aren't as deeply ingrained. Epstein calls for more studies to replicate these findings and to better understand the mechanisms that may be responsible for the differences in effectiveness. The research was supported by grants from the ational Institutes ofHealth. + Leonard H. Epstein, Ph.D. (right}, meets with a CBS reporter. LOIS BAKER oan Dorn, Ph.D. , research instructor of social and preventive medicine at the University at Buffalo, has received a $350,000 five-year First Independent Research Support and Transition (FIRST) Award from the ational Institutes of Health. The FIRST award is given to new researchers to support their first independent research project and help them become competitive for traditional IH grants. Dorn's award is based on a research proposal to investigate the role of physical activity in disease prevention. he will conduct long-term follow-up and analysis of two epidemiological studies relating to this issue: a general population study conducted in Buffalo in the 1960s containing detailed health and lifestyle information collected from residents of that city; and a multi-center, randomized clinical trial conducted in Western ew York in the late 1970s as part of the ational Exercise and Heart Disease Project that was designed to study the effects of a regular, medically prescribed, supervised exercise program on the rehabilitation of survivors of a myocardial infarction. Dorn will determine the current status of all original participants and the cause of death of those who have died , and will analyze various health factors determined at one and three years and their relationship to long-term survival. + Kids better losers than parents he first study to compare weight loss and weight-loss maintenance in children and adults enrolled in the same treatment program ha shown that obese children take pounds off easier and keep them off longer than their obese parents. The follow-up study of participants in B 0 0 p h y o n w n e 9 9 6 �..•. .. . • . . . . . . . • . . . . . . . . . . . . . . . . . . . . • . . • . . . . • . . . . . . . . . • . . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . . . . • m . !lj , . ' . . '. Study points to new treatment for recurring UTis in women ings held even when several months tant professor of nuclear medicine and passed between recurrences. pharmacy, says about 10 percent of the "If our results are confirmed in fu- U.S. population experiences migraines , ture studies, they may have significant with women suffering the headaches n a study of 23 women with recur- therapeutic implicarent urinary tract infections , re- tions for women with searchers at the University at Buffalo recurrent UTis ," have found that most patients were Russo states. "Data being reinfected by the same strain from at least two preof E. coli bacteria that caused their vious treatment studinitial infection and not by different ies suggest that longstrains each time, as reponed previ- term remission can be ously. In addition , they found that the achieved with antimibacteria causing recurrences in most of crobials in some the women were harbored in the patient's women. We also own intestinal tract. know that certain anResults of the study were reported in tibiotics can eradicate the August 1995 issue of]ournal oflnfec- bacteria in the fecal tious Diseases. flora better than oth"These findings give us a new under- ers. Given these constanding of the mechanism of recurrent siderations, further urinary-tract infections," says Thomas data on the impact of A. Russo , M.D. , University at Buffalo different treatment Women suffer migraines three times more often than men. assistant professor of medicine and lead regimens on longinvestigator on the study. "It's possible term cure clearly are needed. " three times more often than men. that alternative approaches aimed at Migraines are thought to start with A specialist in infectious diseases , eradicating a persisting strain from the Russo began the research while with the a narrowing of blood vessels in the intestinal flora, and not just the urinary Bacterial Pathogenesis Unit of the NIH's brain , which decreases blood flow and tract , would result in a long-lasting, ational Institute of Allergy and Infec- can cause the flashes of light and dark permanent cure," Russo says. tious Disease. Also participating in the bar-like visual aura some migraine Urinary-tract infections in women ac- study were Ann Stapleton, M.D., Tho- sufferers experience, Bednarczyk says. count for an estimated 7 million office mas M. Hooton, M.D. , and Walter E. This vasoconstriction is thought to visits a year, at a cost of more than $1 Stamm, M.D. , of the UniversityofWash- be followed by a widening of the blood billion. About 20 percent of women ington-Seattle, and Suzanne Wenderoth vessels in the brain, or vasodilation , with an initial infection will develop of the ational Institutes of Health. + which causes the characteristic recurrences , some as many as 20 a year. pounding pain. B A K E R L 0 5 Previous studies concluded that o consistent relationship has been more than 75 percent of the recurestablished between migraine symptoms ring infections were caused by a new and cerebral blood flow , however , acstrain of bacteria from an outside cording to Bednarczyk. source. Using a genomic-analysis University at Buffalo researcher His study will attempt to show such a technique similar to D A fingerhas received a $114,000 two-year relationship by measuring cerebral blood printing unavailable to earlier regrant to study the mechanism flow at three intervals-during a headsearchers , Russo 's group found that underlying migraine headaches. ache episode, following treatment with 68 percent of recurring infections in The research is funded by the De- sumatriptan, and during a headachethe 23 young women were caused by partment of Defense, with funds free period-using positron emission the same strain of bacteria that made available through the Women's tomography, or PET scans, which are caused their first infection. The fig- Health Initiative. extremely sensitive and allow researchure was 76 percent among women Principal investigator Edward M. ers to monitor biological processes as with the most recurrences. The find- Bednarczyk, Pharm.D. , research assis- they occur. + Migraine study funded B a 0 p c a n w e 9 9 6 e �r r . : n · · · · · · · · · · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · t!JJ UB dental school helps set up clinic for underserved children First pediatric heart transplant performed at Children's he School ofDental Medicine at UB is joining forces with Mercy Hospital and The Children's Hospital of Buffalo to establish a pediatric dental clinic expected to serve 4,0006,000 children who currently receive little or no dental care. The new clinic is expected to open in February in Mercy Hospital's Marian Professional Building. UB dentists project that they will serve 1,500 children covered by Medicaid the first year. "This project is a prime example of how a successful health consortium can work ," says Louis]. Goldberg, D.D.S. , Ph.D. , dean of the UB dental schooL The new pediatric dentistry clinic will be a six-chair expandable facility , managed jointly by the three participating institutions. The cost of the project (approximately $375,000, including equipment, computers, and furnishings) will be shared by the two hospitals. Dental students and residents will rotate through the clinic, with UB dental school faculty serving as attendings. Initially, only basic pediatric dentistry services will be offered; oral surgery and orthodontic services will be added as resources become available. "The Children's Hospital of Buffalo is very excited about the new partnership between Mercy , Children's, and the UB dental school," says Mary M. Ward, Ph. D. , vice president of clinical services at Children's Hospital. "O ur joint-venture pediatric dental clinic on the Mercy Hospital campus allows us to ensure that the children of our community have access to a pediatric dental network that is responsive to their unique needs. " Several other UB dental school outreach initiatives for underserved residents of Erie County and the Southern Tier are currently under way. + he Children's Hospital of Buffalo was designated the Upstate New York Regional Referral Center for Pediatric Heart and Lung Transplantation in june 1995 by the New York State Department of Health. Three months later, on September 27, CHOB successfully performed its first pediatric heart transplant. The patient , ten-week-old Evan Kentile , son of Mark and judy Kentile of Claysville, ew York (near Utica), was born in Syracuse on july 6 with a severe congenital cardiomyopathy. Immediately after birth he was transferred to CHOB's Level Ill eonatalintensive Care Unit, where his case was managed by neonatal and pediatric intensive care teams. Once his condition stabilized, he was approved for heart transplantation and his name was placed on the national organ donor list. A donor became available at The Children's Hospital of Buffalo on September 26. The heart was matched to Evan's specifications , and with the assistance of Upstate ew York Transplant Services, the donor's liver was sent to The Children's Hospital of Philadelphia for transplantation . Evan's heart transplant operation was -LUCY GARDNER CARSON performed by Eliot Rosenkranz , M.D., chief of the Division of Cardiovascular Surgery at The Children's Hospital ofBuffalo, with the assistance of orman Lewin , M.D. , a cardiothoracic surgeon from the Department of Surgery at Buffalo General Hospital. (T he transplantation program at Children's was developed in coopera- Eliot Rosenkranz, M.D., holds young transplant patient Evan Kentile. o L 0 B 5 8 A 0 K E 0 R p h o n tion with the adult-based transplant program at BGH .) "This initial transplant procedure demonstrated the benefit of having a transplant program at Children's Hospital equipped to deal with the most critically ill newborns, " says Rosenkranz. "This patient truly benefitted from the availability of all aspects of high-intensity care and teamwork that have been put together here ." Evan was discharged from The Children's Hospital of Buffalo on October 27. After remaining in the area for several weeks to allow for continued monitoring and regular follow-up examinations, he and his family returned home to Claysville. They visited Buffalo in December for a Christmas celebration at the Ronald McDonald House. "Evan is doing very well after receiving his new heart, and has not experienced any significant complications," Rosenkranz says. "His parents can now look forward to the opportunity to enjoy a long, healthy life together. " Before CHOB's designation as the Upstate ew York Regional Referral Center for Pediatric Heart and Lung Transplantation, such transplants in ew York State were primarily provided at adult healthcare systems in ew York City, or at out-ofarea pediatric medical centers in Boston, Pittsburgh, and Cleveland. + w n e 9 9 6 �······ · ············· · ···· · ···· · ··········· · · ·· · · ······························ · ········· · · [ i ] Western New York VA medical centers complete merger significant new partnership between the Veterans Affairs medical centers in Buffalo, Batavia, and Rochester became official in january, when the management structures of the three health care facilities completed their merger into one organizational unit. The Veterans Affairs medical centers are being integrated into a single healthcare system called the Department of Veterans Affairs Western ew York Healthcare System (YAW YHS) . Richard S. Droske, present director of the Veterans Affairs medical center in Buffalo, will serve as director of the new VAWNYHS. "Our goal is to make the best use of resources to give veterans the best health care possible," he says. Other goals of integration include providing a full continuum of care to patients, including primary care to every patient, expanded clinic hours, additional points of access for care, and decreased waiting times; better coordinating patient transfers and referrals; processing admissions in a more timely fashion; establishing one telephone number that veterans can call for care, information , and appointments; mak- B u 0 0 p ing patients' medical files available at any of the facilities in the integration; and reducing travel for veterans by transporting staff to provide specialized care at the facility closest to the veteran. The VAW YHS at Buffalo will continue to serve as the tertiary referral center for patients from throughout Upstate ew York and northern Pennsylvania, offering complete inpatient/ outpatient services and acute care. The VAW YHS at Batavia will specialize in comprehensive geriatric and long-term care, but will continue to offer limited outpatient and primary care services. Patients in need of acute care and hospitalization will be treated in Buffalo. Perhaps the greatest change will take place at the VAW YHS at Rochester, which presently consists of a small clinic in the downtown federal building whose space limitations preclude anything other than providing the most basic mental health and general medical outpatient services-to only 9 percent of Monroe County's 64,000 veterans. The Rochester outpatient clinic will soon be relocating to a new building dedicated solely to providing the area's veterans with more complete health care services. The goal of the VAW YHS at Rochester is to double its annual patient visits to 55,000 within the first year. Following national trends, all three medical centers (plus the VA's satellite center in Jamestown) will emphasize more ambulatory surgical procedures and outpatient care, and will expand the use of physician assistants and nurse 5 c 0 w practitioners whenever possible, in order to cut costs and streamline service. Cost savings realized through these measures, and through integrating the three medical centers into one management structure, will be reinvested into patient care and making more services accessible to more veterans. + - L UCY G A R D N ER CARSON Dawidson named transplantation services director at BGH he Buffalo General Hospital has named Ingemar Dawidson, M.D. , Ph.D., F.A.C.S., DirectorofTransplantation Services. Dawidson, whose clinical expertise is in kidney and pancreas transplantation and vascular access surgeries, earned his medical degree at the University of Gothenburg , in Gothenburg, Sweden. After completing his surgical residency at Sahlgren's Hospital in Gothenburg and his research fellowship in surgery at Tulane University, Dawidson underwent renal transplant training at the University of Gothenburg and earned his Ph.D. in surgical physiology at the University of Gothenburg Medical School. He then underwent liver transplant training at the University of ebraska Medical Center and pancreas transplant training at the University of Minnesota Medical Center. A prolific contributor to research and education (he has authored 123 abstracts and has been the selected speaker at more than 30 international lectures and symposia), Dawidson is a fellow in the American College of Surgeons, and a member of the American Society of Transplant Physicians, the American SocietyofTransplantSurgery, the American Council on Transplantation, and the Association of Academic Surgery. + n e 9 9 6 �BY JESSICA ANCKER Beepers sound in the corridors of Erie County Medical Center's trauma center. A paramedic is signaling to the doctors, nurses, and staff that his ambulance is bringing in a patient with stab wounds. Minutes later, the doors swing open and a young man is wheeled in, bleeding from scratches on his cheek and shoulder and from a third deceptively small spot in the left side of his chest. The two paramedics brief the doctors (" He says it was a six-inch knife"). The patient writhes and asks if he can get anything for the pain. "If we gave you something now, you'd just throw it up when you go into surgery," a resident says. PHOTOGRAPHY e u ffa lo BY Physic ROBERT 1 an WALION wInter 19 9 6 ��An unceasing thread of blood The program has its roots in the research of Simpkins, who found thatas he and other doctors had long suspected-assault victims were likely to come back to the hospital many times. "I kept noticing that I was operating on the same individuals," Simpkins says. His research in Washington , D.C. , and Baltimore found that 35 percent of the victims of violence in the emergency room had been to the hospital at least once before. Within five years , Simpkins found, 44 percent of these patients would return to the hospital after other violent episodes-and even worse, 20 percent would wind up dead. "I realized operating on them wasn't getting to the root of the problem," Simpkins says. In Buffalo , ECMC head of surgery Roger Seibel was noticing the same thing. During one two-year period, the number of gunshot wounds, stab wounds, and other violence injuries skyrocketed by 50 percent. Many patients were repeat victims. "It's a feeling of hopelessness just to patch them up and send them back out," Seibel says. >\T \1A~'t HO~PITAL':J , that would be the end of the Simpkins and Seibel teamed up with Karen Romano and story. But at Erie County Medical Center, it's where a new eville Francis to create the Violence and Victimization story begins. Prevention Program in March 1994. Before the patient leaves the hospital , social worker eville Their first step is to take advantage of the patient's pain Francis and surgeon Cuthbert Simpkins might come to chat. and confusion to urge him to rethink his life. And after the patient goes home, Francis will probably call to "The best time to intervene check in, and maybe suggest a is when that person is in the meeting. hospital ," Simpkins states . Those simple human con•PEOPI.£ T£ND TO B£ • "They've got a tube in their tacts are the beginning of the chest-that hurts. They've got hospital's aggressive follow-up a colostomy. They're scared. I for assault victims , called the try to make sure they're scared. Violence and Victimization PreI tell them 'You almost died ,' or vention Program. More than just 'You almost lost your leg."' stitching up wounds and set"People tend to be a little ting bones, ECMC's staff tries to more insightful when they realize they came close to dying," rescue patients from the kinds of violent lifestyles that could Francis agrees. "Coming close to death gives you a greater land them right back in the emergency room. "let's think of this as a demographic problem , rather appreciation for life. " They hope the pain and fear might be enough to make than something that just happens ," says Karen Romano , even the toughest young man or meekest woman wake up. ECMC's trauma nurse coordinator. winds down along his ribs as he is stripped, x-rayed , catheterized, questioned , reassured. An anesthesiologist takes the young man's hand and explains that the surgeons want to see if the knife has nicked his heart. "We're going to put you under and do what we call a pericardia! window, " she tells him. "How long will I be out' " he asks nervously. "It depends on what they find. More than likely it will be less than two hours, " she says. "But I'm asking your opinion," he insists. "lf there's something wrong, how long will it take? " She answers , "It's different for every person." He asks to make a call to his mother, and a young nurse takes the phone number and relays his message. An operating room is cleared, and the flock of doctors and nurses whisk the patient in. The operation finds no damage to the heart, and in a few hours he is stitched up and recovering from the anesthetic. 0 B u a 0 p h s a n w e 9 �If it does, they're ready to suggest help. For a drug dealer wounded in a street battle, that might mean substance abuse treatment, a trip to the welfare office, and job training. For a battered wife, it might mean shelter, and the emotional and legal assistance to help her get protection from her spouse. For many patients, it means help getting or keeping a job. "Unemployment is one of the risk factors for violence ," says Simpkins. That's when he began to lean on Francis for help in finding a new job , and sometimes just for comfort. "He's the best friend I have. Sometimes I feel like he's the only friend I have ,'' Truitt says. "He's got an understanding of me." With Truitt's good job history and six years of Army service, he was able to land another machining job. But after a few days , Truitt said, he couldn't handle the heavy pieces of steel with his weakened arm. His employer told him he could come back after his arm regained its strength, but when Truitt called after weeks of physical therapy, he found the job had been filled. ''I'm still looking, I don't give up. But it's tough. Whatever color you are ," says Truitt, who is black, "it's tough ." A natural optimist, Truitt will probably only need counseling and physical therapy to become one of eville Francis' success stories. But Francis deals with tougher cases every day, people who could spiral into poverty and end up as more grim statistics in ECMC's emergency room. The social worker's challenge is to find options for even the toughest cases: the young drug dealers who don't want to let down their macho street image, the battered women who are too scared to leave their spouses, the people who haven't held a steady job in years. Francis draws on his own varied experiences to connect with his clients. A native of Jamaica who emigrated to Toronto as a teenager , he worked in a factory for 12 years until the plant closed down and laid him off. "It was scary , and that's how I know how some of these people feel , " says Francis , a tall man who wears dreadlocks pulled into a ponytail above a casual jacket and tie . "I do identify with struggling people . I know the frustrations of being there. I know what it's like being on the outside looking in. " But he also knows that it's possible to take advantage of misfortune , a lesson he tries to impart to his clients. When he Bt.,FFA.LO RESIDE T GREG TRLITT was barely conscious under a turban of bandages when Francis first visited him. Two robbers had smashed his head with a board and grabbed his knapsack and wallet as he was walking home from a Fourth of July picnic. "I didn't even have any money in that wallet," says Truitt. At first, Truitt didn't think he had anything to talk to a social worker about. As soon as his head felt better, he was planning to go back to his good job, his girlfriend, and his two little children. But the next month, the manufacturing facility where Truitt had been doing lathe work went bankrupt. Also, Truitt realized his injury was worse than he had thought when he self-confidently checked out of the hospital against his doctor's advice. The head injury had left lasting nerve damage in his right arm and hand that robbed him of strength and made his hand clench up unexpectedly during work. He was also pursued by unexplained fears. "I was getting ready to cross the street and go between the cars, and I couldn't do it. My buddies were across the street, saying, 'Come on, man ,' and I just couldn't cross the street," recalls Truitt, a small, energetic 32-year-old who talks about his problems with a kind of exasperated wonder. "It's like being a kid all over again. Completely helpless." B u a 0 p h y 5 c a w e 9 �was laid off, Francis went to school, earning first a bachelor's degree and then a master's in social work from the University of Toronto. He conducted street workshops on AIDS and worked with the boys who accompanied their mothers to a battered women's shelter before joining ECMC in March 1995. Francis tries to approach every one of the 500 ECMC patients each year who are victims of violence, and tailor a unique approach for each. Some just need jobs, and the hospital's fledglingjob bank has provided housekeeping and cafeteria work at the hospital and at the University at Buffalo. But for someone who has been without work for a long time , job placement isn't enough. The social worker will talk about the responsibilities that work entails, such as showing up every day, and calling in sick rather than just staying home. Sometimes he even drives his clients to work. Francis recalls driving one client to her first day on a new job. She became very quiet in the car, and finally admitted that she was Cuthbert Simpkins. M.D. so nervous that she might never have made it alone. "We're talking about people doubting that they can live up to the experiences and responsibilities of working," Francis says. "But she ended up doing very well. " His job might also include visiting clients' homes and getting to know their families, visiting the welfare or unemployment office with them , or persuading an employer to hire someone with a prison record. lt also includes being patient. One man recovering from a drug-related shooting said he had no interest in talking to Franci . But two weeks later, he called and said, "What was that program you were talking about? " Francis was able to get him involved in drug rehabilitation , and hopes that he might be ready for a job soon. he tells how bigots bombed his family home when he was a child because his father was helping to register blacks to vote. Even before that horrific moment , which forced the family to leave their Louisiana hometown , he recalls that the library wouldn't let him in because he was black. These experiences , as well as his experiences with his patients, have helped convince him that American society is deeply violent. "There's a willingness at all levels of our society to use the tools of violence that are advantageous to them-whether it's the pen or the sword," he says. Middle-class families , he believes, are likely to express violence by sniping at their spouses, criticizing their children, or firing their employees. The poor tend to use guns, knives , and fists instead of just words , so they are more likely to land in the emergency room. Furthermore , Simpkins says, generations of oppression have forced disproportionate numbers of blacks into poverty and the violent lifestyles it can engender. As a first step to their overhaul of society, the staff of the violence prevention program created a videotape aimed at children. Filmed with the help of a local television station, the video traces four patients as they enter the emergency room, bloodied and battered; watches surgery in gory detail; and listens to the patients afterward as they talk about the violence and wish they had led different lives. Karen Romano and eville Francis, who take the film to the city's classrooms every week, say the patient that makes the biggest impression on kids is a young man who was crippled by a bullet and now must use a wheelchair. ln the long run, Simpkins wants the violence prevention program to launch the same type of peaceful revolution his father sought through voter registration. "l'd like to see the community organize itself. Register people to vote , take their fate in their own hands. Then l think we can see the community solve some of its own problems," he says quietly. "l don' t think we can really solve this problem until our entire country has a differ- r------------------------, THf C.RC\TORS OF THE \!OLE CL PRE\ E TIO program share a conviction that their work should be part of a greater overhaul of society. Simpkins, who is also black, doesn' t sound bitter when B 0 0 p h y s c o n w n e �FRANCIS TRIES • en t sense of interpersonal relations . I think we need a higher moral and ethical plane." eville Francis puts it more simply. "The problem is in the community, but the solution is also in the community." For now, the program's staff is taking it one patient at a time. "Let's say you get 400 patients who come in to the emergency room injured because of violence or a violent lifestyle. If you can getlO patients out of your 400 to change, that's something to start with," Karen Romano says. + Trauma Center - Life-saving teamwork The violence prevention program is just one example ofthe smoothly running support structure that underpins ECMC's trauma center. "We have a commitment from generalists and specialists to come in any time of the day or night to take care of trauma patients," says Karen Romano, the hospital's trauma nurse coordinator. The planning begins well before a patient is admitted. Paramedics or emergency medical technicians decide whether to bring a patient to ECMC based on state guidelines, including severity of injuries, extent of damage to the car in a car accident, and minutes away from the hospital. They then dial a number that reaches a network of beepers throughout ECMC. The beepers can display a simple message of what the injury is and how soon the patient will arrive. Incoming patients are brought to one of the trauma rooms, directly inside the emergency wing's doors. Each trauma room is equipped with portable x-rays and sonograms, lights, and surgical equipment. Once patients are diagnosed and stabilized, they con be sent to one of the operating rooms, intensive care units, radiology rooms, or other facilities clustered in the immediate area. Asurgical "pod," a corridor with nine small rooms branching off it, is available for patients whose injuries aren't as severe, and doctors in a similar medicol"pod" care for non-emergency illnesses. The emergency wing is designed to make it easy to get patients from one specialty area to another. Dr. Roger Seibel, who worked with the architects who built it, says it is being redesigned to make B u 0 0 p h s c movement even easier, and to add more space for outpatients and their families. The trauma system also provides services for recovering patients. Special outpatient rehabilitation areas provide such services as specialty dressings, water tub rehab, counseling, and occupational and physical therapy. Crucial to the center's work is its staff. All nurses have advanced training in trauma care and cardiac life-support. Residents receive onthe-job training from senior doctors, including many who have been in trauma care their entire careers. The staff evaluates cases in weekly and monthly morbidity and mortality meetings. Equally important, Karen Romano says, is the fact that they receive emotional support from one another. The ecstatic high of saving a life and the crushing disappointment of losing a patient create an atmosphere of both tension and camaraderie, she says. "It's very physically demanding and emotionally demanding to see, for instance, ayoung person permanently disabled," says Romano, who practiced critical care nursing before taking over as nurse coordinator. "It really does toke a special breed to practice in trauma." ECMC's 1,600 trauma patients come from all walks of life and have every conceivable injury and illness. The average age is 31 ; 75percent are men. While car accidents cause the greatest number of injuries (538 in 1994 ), assaults with guns, knives, fists, and other weapons come in a strong second with a total of 419. --::JA 0 w n e 9 9 6 �B u a a p h II 5 c a n w n e 9 9 6 �b y J u d s o n M e a THE HYPOTHETICAL truck driver, taking micro-naps at 65 miles per hour and headed for disaster, has thousands of very real counterparts on the road who are excessively sleepy because sleepdisordered breathing is waking them up hundreds of times every night-and they don't even know it. The ew England]ournal of Medicine editorial was prompted by publication in the same issue of findings from the largest population-based study of obstructive sleep apnea that had ever been conducted. Sleep studies of 602 employed men and women between the ages of 30 and 60 revealed that 4 percent of the women and 9 percent of the men in the group had a level of breathingrelated sleep disturbance that would warrant treatment. Edwin Manning, M.D., clinical professor of neurology and director of the Sleep Disorder Center of Western New York, says that sleep problems are still misdiagnosed or under-diagnosed, although awareness of them has increased greatly in the past 15 years. "There was a survey done at Stanford recently that found that in 1980 something like 80 percent of persons presenting a certain set of symptoms were diagnosed as depressed ," Manning says. "By 1985, physicians considered 50 percent of the persons presenting the same symptoms were depressed and 50 percent had some kind of sleep disorder. By 1990, it was recognized that only 5 percent of this population was actually depressed. " On a ovember afternoon, Manning explains obstructive sleep apnea in a small observation room as a technician monitors a patient sleeping in an adjacent bedroom. The patient is an overweight middle-aged man; the sleep study is run during the day because he is a shift worker. As far as the patient is concerned, he is asleep. But there are a number of signs that the sleep is not peaceful. The EEG readout crawling across the tee h n ician 's computer screen shows the tight amplitude of stage 2 sleep. His heart rate , audible from the EKG , is slowing noticeably; his blood oxygen level is dropping rapidly toward less than 70 per- d Anyone who sees a long-haul tractor-trailer driver nodding over the wheel as he barrels down the Interstate after ten years without a single restful night's sleep would call his situation , at the least, potentially catastrophic. But as Eliot Phillipson, M.D., pointed out in a 1993 editorial in the New England Journal of Medicine, "Ten to fifteen years ago, obstructive sleep apnea was considered to be a medical curiosity that was of little importance, and snoring was more a subject of humor than one of serious scientific curiosity. " Images B a 0 b y p h K . C . s K r a t t a w n e 9 6 �Sleep has an architecture that was only discovered beginning in the 1950s when a University of Chicago graduate student started running EEG tests on his eight-year-old son and found brain-wave activity that resembled a waking state during certain periods of sleep. These periods, coinciding with the eyes darting rapidly from side to side beneath closed lids, we now know are dreams; the sleep stage is REM, for rapid eye movement. The normal sleeper passes through four stages of increasingly deep non-REM sleep: stage 1 being a barely sleeping state of drowsiness, stage 4 being a profoundly deep sleep characterized by delta waves. During these four stages, the sleeper maintains muscle tone. After an hour to an hour and a half, the sleeper moves back to stage 2 and enters a first episode of REM sleep: brain activity increases dramatically; heart rate, respiration, and blood pressure all go up; but the muscular system is effectively paralyzed. As the night proceeds, the sleeper cycles through stages 2, 3, and 4 and REM sleep, with the lengths of REM sleep increasing while delta sleep decreases. Persons who suffer repeated arousals throughout the night never achieve stage The patient is in the sleep center cent. He is not breathing, but the instrumentation on his chest and abdomen because he reported to his physician that he is leepy all the time during record that he is trying to . Then a loud snort is broadcast into the day. Indeed , excessive daytime the observation room from a micro- sleepiness is one of the most comphone on the headboard. The EEG bursts mon presenting complaints related into activity, the heart rate shoots up to to sleep disorders. And such a com80, and the blood oxygen level begins to plaint is far from a triOing inconverise. The readout from a thermistor at- nience: a report prepared for the ational Commission on Sleep Distached under his nose shows that he is orders Research and published in breathing again. "He's awake now, but he doesn't know Sleep, in 1994, estimates that for the year 1988, the total cost of accidents it," Manning says. On the video monitor, the patient is lying on his side, head on an outstretched arm, his other hand tucked under his chin, apparently soun d asleep. Hi EEG quiet back to the relatively uneventful trail of stage 2 sleep. Then, after a few seconds, he stops breathing again. His heart rate and blood oxygen level start to drop. The cycle of arousal and return to sleep repea ts regularly about every 30 seconds. "His upper airway relaxes until it collapses completely after a few seconds of normal breathing. Then he tries unsuccessfully to breathe until the effort arouses him ," Man- Edwin Manning, M.D. ning says, watching another sudden related to sleepiness in the United burst of brain activity. "He may be States was between 43.1 billion and $56.02 billion. waking up 300 times a night. " "Wherefore to some, on being abed, they be taken to sleep, presently in arms and legs leapings and contractions of the tendons , and so great a restlessness and tossings of their members ensue that the diseased are no more able to sleep than if they were in a place of greatest tortu re. " B a a p h y 5 c a w n e 9 9 6 �"His upper a ir way relaxes until it collapses completely after a fe w seconds of normal breathing. Then he tries unsuccessful ly to brea t he until the effort arouses him, " Manning says, watching another sudden burst of brain activity. "He may be waking up 300 times a night. " 4 sleep. This deprivation is associated not only with sleepiness during the day, but also with diminished cognitive functioning and memory loss. "Obstructive sleep apnea is primarily a mechanical problem, so we use mechanical interventions to treat it, " Manning says. "Conservative treatment includes such things as weight loss, correcting posture, and smoking cessation. " A more aggressive intervention , for those who can tolerate it, is to splint the upper airway by the application of continuous positive airway pressure (CPAP) through a mask or nasal splint. A small com- Francis Gengo, Pharm.D. pressor is used to supply air at between 4 and 20 cc of pressure. located While such a device (which produces in the Dent eurologic Institute at the sensation of being slightly inflated) Millard Fillmore Hospital, runs approximight well bother a person not suffering mately 1,000 sleep studies a year, operobstructive sleep apnea, Manning says ating 24 hours a day with a technical that it can produce dramatic results for staff of eight. The center has four sleepsome of the patients he sees at the sleep ing rooms , outfitted with double beds and other furniture to be more homecenter. ''I've had patients who have been than hospital-like. Patients bring their chronically sleepy and lethargic for years own sleepwear. It is, naturally, a quiet wake up here after one night with CPAP work environment. For a typical overnight sleep study, intervention bursting with energy ," he says. "They tell me they've had their first the patient arrives in the evening, gives good night's sleep in years. " Surgery is a a brief history, changes into sleepwear, treatment option for a small group of and then is fitted with an array of electrodes on the scalp , beside each eye, and patients. The sleep center, B a 0 p s a n w on the chin, the chest, and both legs; a thermistor under the nose ; an oxymeter on one finger ; and belts around the chest and abdomen-these produce what is called a polysomnographic record. Although sleeping in a strange place and so thoroughly instrumented can cause what center technical director Thomas Maurer refers to as "first night effect, " getting patients to sleep is not a significant problem: after all, the reason most patients are there is that they are too sleepy . In the morning , patients complete a questionnaire that asks about such things as how long it took to get to sleep and the quality and duration of the night's sleep. "Some people have poor perception of their own sleep," Maurer says. "Some patients will report that it took two hours to get to sleep when the sleep study shows that it only took 10 minutes. " Technicians can monitor two studies simultaneously, watching data on a split computer screen and the sleepers on two video monitors. Data from a sleep study is scored later, with technicians paging through computer screens, each one of which shows 30 seconds of the study, to record arousals, oxygen levels , heart rate , and other pertinent condi- e 9 9 6 �"We ' r e one of j u s t a h and f u I of centers 1 n the co u ntry- and the on Iy one in New York-where the pharmacological studies look at both sleep a nd daytime effects , the real-world end-points of drugs that suppress the central nervous system, " Gengo says. tions; screens that show significant events can be printed out. The days of turning pages through thick sheaves of pen tracings ended when the center computerized its data management in 1992 after running both ystems in parallel for six months. ManningsaySthatsleepdis- (The sleep center has conducted clinical studies of the drug's effect on both sleep and next-day psychomotor performance-see box , facing page.) As for melatonin , which is enjoying a vogue as a sleep-inducer, Manning says that there is evidence that it has a role in directing the time relationships in sleep and that it can be of some help in controlling sleep problems related to jet lag orders fall into four broad categories: not being able to get to sleep or stay asleep, excessive daytime sleepiness, sleep-wake schedule disorders, and abnormal behavior and activity during sleep. Because everyone, at one time or another, has trouble falling asleep or staying asleep, a popular poll would probably name insomnia as the nation's number-one sleep problem. The aggre sive advertisement of overthe-counter sleep-inducing medications reinforces the belief. But the medical approach to insomnia is changing. "U ntil fairly recently, 15 percent of all prescriptions written were for Polysomnographic technician Pam sleeping pills," Manning says, "but Farina scores the digital record of a that's beginning to decline." sleep center patient's night. Manning, who lectures on sleep to first-year medical students at UB, tells them that 70 percent of insomnia prob- and other sleep phase disorders. But lems can be solved without medication Manning would discourage long-term by a regime of proper sleep hygiene. use of melatonin because its other acManning's first commandment for get- tivities in the body may interfere with ting to Jeep: "If you can't get to sleep, get reproduction and complicate heart disout of the bedroom." For transient ea e; another problem with the unreguinsomnias that need medication, Man- lated nostrum is that consumers can't ning favors the relatively new, rapid- be sure what they are buying. Excessive daytime sleepiness may be acting non-benzodiazepine zolpidem. 8 a 0 p h 5 a n w caused by various disturbances of a person's sleep, by chronic insufficient sleep, or by narcolepsy, the condition that causes a person to drop off to sleep suddenly during the day, sometimes directly into REM sleep; these episodes are often coincident with the experience of a strong emotion. A patient being tested for narcolepsy will spend a night at the sleep center for a regular sleep study, and then the following day undergo a Multiple Sleep Latency Test (MSLT) . This test consists of taking four or five 20-minute naps , two hours apart, to determine how quickly the patient goes to sleep and how quickly he or she moves into REM sleep. Achieving REM sleep during two of five naps indicates that the patient suffers from narcolepsy. The MSL T can show that a person is excessively sleepy-rapidly achieving stage 2 sleep in all four nap sessions but never REM sleep-indicating some factor other than narcolepsy. The abnormal behavior during sleep-or parasomnia-that Manning sees most frequently at the sleep center is sleep myoclonus, or periodic movements in sleep. In this disorder, the sleeper's legs jerk periodically during non-REM sleep, causing brief arousals from sleep and disturbing the normal sleep architecture by decreasing stage 4 sleep. The movements stop during REM sleep. Periodic movements in sleep are as- n e 9 9 6 l J �l 1 sociated in some cases with a condition called restless legs that particularly bedevils some persons before and during the onset of sleep. Manning likes to cite a description of the condition written in 1685 by the London physician Thomas Willis: "Wherefore to some, on being abed , they be taken themselves to sleep, presently in the arms and legs leapings and contractions of the tendons, and so great a restlessness and tossings of their members ensue that the diseased are no more able to sleep than if they were in a place of the greatest torture." Fortunately for its sufferers, the condition of restless legs responds to treatment with dopamine. The key to treating any of the many sleep disorders-from the sleep that won't come , to the sleep that gives no rest-is discovering that the problem exists. "There are many, many people suffering from sleep disorders who don't feel they can discuss them with their physicians, " Manning says. "People spend about one third of their lives asleep and for those who have problems with sleep there is often a remediable underlying cause. Physicians should be aware of sleep disorders and aware of the public health consquences of sleep disorders. " + Sleep Center Drug Research Cows mooing and dogs barking are not something one would expect to hear in the usually quiet corridor of the Sleep Disorder Center of Western New York. But they do occasionally disturb the center's morning peace as road hazards that test the alertness of volunteer subjects negotiating a virtual highway on a driving simulator. Gengo, who is the author of Drug Effects on Human In addition to diagnosing sleep disorders, the center maintains an active program of pharmacological research Functioning and numerous papers, has pioneered an ap- under the direction of Francis Gengo, Pharm.D. , associate proach to clinical studies that uses one drug as a marker professor in the departments of pharmacology and neurol- for evaluating another. Alcohol is an obvious marker for ogy and director of neuropharmacology at the Dent Neuro- comparative assessments of psychomotor impairment, logic Institute. Gengo's group is as interested in their and Genge's group has done extensive testing to establish subjects' waking state as in the contours of their sleep. the magnitude of effect of different blood alcohol levels. "We're one of just a handful of centers in the country- B "We can now say that the effects of a certain amount of and the only one in New York-where the ..,.....,.,..,._ benadryl are equivalent to the effects of a pharmacological studies look at both sleep certain amount of alcohol," he says. and daytime effects, the real-world end-points In current studies, Gengo is comparing the of drugs that suppress the central nervous effects of Zolpidem, Tamazepam, an over-the- system," Gengo says. counter antihistamine-based sleeping aid, and During sleep studies, Gengo 's research a placebo. Because the effects ofTamazepam group uses polysomnography to look at the have been fairly well studied, it serves as the effects of different drugs on such things as the time of sleep onset and the character of -·~------'- two nights, the first at home and the second in marker for Zolpidem. Subjects are treated for the ensuing sleep. In the morning, psychomotor tests the sleep center, and then undergo a battery of waking- reveal the subject's ability to think clearly and react state psychomotor tests. The over-the-counter sleep aid quickly. One such testing device is the driving simulator. causes the greatest morning-after impairment. Gengo has used it to establish baseline data that helps For studies of the effects of certain drugs not intended to to determine the relevance of psychomotor impairment. promote sleep--such as muscle relaxants or deconges- "There has been a lot of research that looked at the tants- Gengo' s group uses the Multiple Sleep Latency Test effect of a new drug against a placebo," Gengo says. "You (MSLT) and psychomotor assessments during a regime of find a statistical difference, but what is the functional scheduled naps for subjects taking regular doses of the significance or relevance of the difference?" medication (or placebo). u 0 0 p h s c a w n + e 9 9 �· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · [I] ~ ' tial for those types of resources to grow. We are considered a resource library, regionally and nationally, and we provide materials to other libraries for a fee. The fees actually cover the cost of those services and even generate a little bit of extra income that we can use to supplement other services and resources. "T he last initial impression I'd like to mention is the very strong support from the faculty community here on campus ....._....__ _ _ _....;..J From bound volumes to HUBNET GARY BYRD REFLECTS ON HIS FIRST YEAR AS DIRECTOR OF US'S HEALTH SCIENCES LIBRARY ary D. Byrd, director of the University at Buffalo's Health Sciences Library since january 1995 , came to Buffalo after nearly 12 years at the Health Sciences Library at the University of orth Carolina at Chapel Hill as Associate Director (198387) and Assistant Director for Finance, Planning, and Research (1987-94). He completed his doctorate in library science at that university in 1994. His first year at the helm ofUB's H L has confirmed his initial positive impressions. "First, this is a beautiful facility-it's one of the nicest facilities on the orth or outh Campus, in my estimation. This was the original Lockwood Library at the old private UB, and the main reading roomthe Austin Flint Reading Room-is a showplace for both campuses. "We have a very knowledgeable, service-oriented staff. They've gotten well-deserved service excellence awards from the university administration; they're well respected on campus and in the region and nationally , and that was one of the real attractions to me in this job-being able to work with such a highly motivated , competent staff. "Another obvious thing that impressed me right away was the information resources that have been gathered and made available under the heading of HUB ET [Hospital and University at Buffalo library resource ETwork]. B u a 0 p HUB ET is an array of bibliographic and full-text electronic information resources that have been gathered and made accessible over a wide-area network, so that health sciences faculty , students, and practitioners at the university and its affiliated teaching hospitals , as well as at other practice and teaching sites throughout Western ew York, can easily log on to this array of databases and search the medical literature-including full texts of many journals-and get an impressive amount of other information resources at their fingertips. This is a wonderful array of for this library, and the Friends of the information resources, and a model for Library organization that we have. Also, the way in which electronic inforI sensed in meetings with the deans , mation resources can and before l took this job, that they were also should be provided in very supportive of this library and that this kind of a setting. they were eager to support our resources "The gem of our and services. One demonstration of their collection is our commitment is that this year the deans History ofMedicine all agreed to help support the ongoing Collection, which I costs of the HUB NET system from their would call a worldown budget, as well as from the hospiclass history of tals' and the library budget, so that's a medicine collection. new source of support." It includes not only loByrd first became interested in inforcal medical history, but a mation resource management through very impressive assortment his work for Ship Hope in Tunisia in the of other historical materials illustrating late 1960s, when he was in the Peace the history of medicine and the health Corps. The mission of Ship Hope , a sciences. The School of Medicine is the volunteer project of American health oldest part of the university , and the professionals who refitted a World War sesquicentennial will be drawing pretty ll vessel as a floating hospital , was to significantly from those collections. dock at ports of developing countries "I was also impressed by the potenfor nine months to a year at a time, tial to strengthen resources in the seroffering modern medical services and vices despite budget constraints. Some training for local doctors. Byrd credits of our services actually generate income his experience as a volunteer assisting that helps us support those and other the ship's chief of staff with inspiring services, and I think we have the potenhim to pursue a fellowship in biomedi- h 5 c a n w e 9 6 �··················· · ······ · ············ · · · ·· · ······ · ·········· · ··· · ················· · ··· · · ~. ~ I future , we may not have a separate circulation department, for instance. We may be providing reference services in new locations and in different ways, and providing an increased array of reference services , such as more in-depth consulting." Byrd hopes to make better use of limited resources by restructuring the HSL and granting greater flexibility to the staff. He praises the experience and HSL director Gary Byrd in the library's Austin Flint Reading Room. dedication of not cal library science at the University of only the library's faculty and profesMinnesota in Minneapolis. sional employees but also the support One of Byrd's first projects upon ar- staff and clerical workers, and he pledges riving at UB was to work with his staff to to use these most valuable human recreate a vision statement of the long- sources more effectively: "We've got term goals and guiding principles of the many people with many years of service HSL. He would like to see the library to the university and to this library, and become more flexible and better able to my feeling is that we need to find ways respond to the health information needs to use their energy and creativity, and of both local and remote users. give them opportunities to use their "This library has had a fairly tradi- skills in new ways." tional organizational structure," he says, Byrd notes that the evolution of per"with public service units and technical sonal computers and the Internet has services units-cataloging, acquisitions , changed the way information resources and management of all our serial collec- are managed. "An increasing number of tions. ow we're in the process of re- our resources are available electronistructuring, somewhat. We're consoli- cally from computer terminals all over dating our technical services units into a campus, and at remote sites in our affilisingle collection management services ated hospitals and practice sites all over unit, and we're looking at possible new Western ew York, and even from models for organizing our public service people's homes. We have an increasing units and consolidating the way in which need for telephone support for remote we provide services from all of our public users. We need to use staff more flexibly service points-the places where the in ways that will allow them to go out public can approach the staff and ask for and work directly with users in their help or information, such as the circula- offices, or in their labs, or in classrooms. tion desk, or the reference desk. In the We need to strengthen the library's in- B u a a p h y 5 c a w I ternal computer and telecommunications infrastructure and its links to campus, regional, and worldwide electronic information networks. "The library is organized in many ways like an academic department: We have library faculty as well as professional and support staff. Our library faculty not only provide reference and other services, but they help instruct students, faculty, and staff on the effective use of information resources. And not only do we provide classes that we teach here in the library, but our faculty also go out and serve as guest lecturers and instructors in courses that are taught by other faculty. "I personally think there will be an increasing need in the future for courses that are actually taught by library faculty as part of the regular university curriculum. In some areas of the health sciences, especially, courses may really be needed on how best to manage information resources; how to use appropriate computer hardware and software to manage information, to browse the Internet, to use library resources, to understand the concept of effective search strategies, to understand how to use controlled vocabularies or Boolian logic or other strategies that make for effective use of the literature. "We still have a ways to go to strengthen and build on the resources that we have, but I think that we've gotten a strong commitment from everyone to work together to help make that possible. We don't have any magic bullets. I think the ammunition that we do have is our ability to demonstrate the value of the resources and services that we provide to the community, and then work collaboratively with the other parts of the university and with our affiliated hospitals to pull together the resources to turn those things into reality." + -LUCY e GARDNER CARSON 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] ~ I BARANSKI ADVERTISING Your advertising presents your company image to the public ... and to prospective clients and cu tamers. At Baranski Advertising, we are proud to represent some of the finest publication in Western ew York, publications where your advertising message is sure to reach a quality audience. Medical students enjoy new lounge tudents in the School of Medicine and Biomedical Sciences have a new place to prop up their feet, thanks to the generosity of the Medical Alumni Association. Over the past two years the alumni group has donated approximately $4,000 to refurbish a former conference room in Cary Hall, which recently was outfitted with couches and a coffee table; a conference table; electronic equipment, including a television and VCR, a photocopier, and a microwave; a foosball table; and artwork. The purpose was to make the free time medical students have at lunch and between classes more CALL US TODAY enjoyable, according to Neha Sangwan, president of Medical School Polity. (716) 645·6933 "We wanted a little more of a social place than a study area. We wanted to get students to start to interact and to get to know people in different years, and to give them something to do," she said. "We greatly appreciate all the efforts and support of MICHAEL J. BARANSKI the Medical Alumni Association because it's helped to Marketing Representative bridge the gap between the first· and second·year students. This has provided a really comfortable P.S. We did this book! B u a atmosphere so we can get to know each other." 0 p y c a w e + 9 6 �················· · ································ · ·····································• ·· ~ •• ::» Percent and number of graduates from 1989-91 entering primary-care specialties-45th and 23rd, respectively; first among SU Y medical schools. (UB's total graduates for the three years, at 4 3 7, is larger than that of 70 percent of U.S. medical schools, a factor which lowers its percentage ranking compared "All medical schools share the broad to schools with fewer graduates. Also, and essential missions of education, re- the rankings in this category do not search, and patient care," Cohen said. reflect the success of the medical school's "However, within this context, individual Primary Care Initiative, begun in 1990, schools have different priorities and goals. which has raised the percentage of UB Because of this, a single ranking of medi- graduates entering primary care from cal schools is inappropriate and mislead- an average of 28 percent for 1989-91 to ing. The Institutional Goals Ranking 40 percent for the class of 1995. [In the Report is designed to provide medical AAMC survey, schools with 40 percent schools and the public with several scales of their 1989-91 graduates entering primary-care specialties by which they can mark ranked 5th.]) an institution's achievements in various areas." ::» Percent and numUB received its highest ber of 1995 graduates marks in the category of planning to practice inpercent and number of state-58th and 42nd, 1981-90 graduates who respectively; fourth are faculty, ranking 14th among SU Y schools in and 18th, respectively. percent, second in numAmongSU Yschools, UB bers. ranked first in percentage ::» Federal research and second in numbers. grants and contracts in aughton said UB's 1993-94-67th overall; second among SUNY high ranking in this category reflects the emphaschools. sis the school's faculty John P. Naughton, M.D. Naughton noted that places on teaching and education in its UB's listing doesn't include research fundbasic-science and clinical-training pro- ing administered by its affiliated cancer grams. research center, Roswell Park Cancer "Our graduates learn that as faculty Institute. Research funds attributable to members, they can play an important UB faculty working at Roswell Park torole in guiding the future of students taled $21,771,842. If these funds had and residents, can influence the future been included with those administered of medicine, and can enrich their per- directly by SU Y, UB's ranking would sonal and professional lives," he said. have been 36th instead of 67th. UB's rankings in the remaining cataughton said the report, prepared egories were: since 1990 but released to the public for ::»Percent and number of thefirsttimeinl995, isusefulforgaugunderrepresented minority graduates ing the medical school's progress in during 1990-94-27th and 23rd, re- important areas and for judging its perspectively; second in both listings among formance in comparison to medical SU Y schools. schools of similar size and scope. + UB ranks high as contributor to medical school faculties he University at Buffalo School of Medicine and Biomedical Sciences received high marks from the Association of American Medical Colleges (AAMC) in its 1995 Institutional Goals Ranking Report, released in late December. UB received its highest ranking14th among the nation's 125 U.S. medical schools-in the category of percent of graduates who are on the faculty of a medical school. UB was one of only two public universities in the top 15. In the remaining categories, UB placed in the top fifth to the top half in all listings but one, and was first or second among the State University of ew York's four medical centers in all listings but one. john P. aughton, M.D., UB vice president for clinical affairs and dean of the medical school, said he was very gratified by the results of the report. "These rankings indicate we have been able to achieve a successful balance between academic excellence and clinical relevance ," he noted. The AAM C report assessed the success of the nation's medical schools in meeting five goals considered important in today's medical climate: graduates entering primary-care specialties; graduates planning to practice in-state; graduates who are medical-school faculty; graduates who are underrepresented minorities; and total research grants and contracts. jordanj. Cohen, M.D., AAMC president, said the report is not intended to determine which medical school is "best," but should be used by medical schools and the public to evaluate these institutions in selected categories. B u a 0 p h y c a n w n e 9 6 �. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . .. . . . . [1] t, I sociation of the History of Medicine in Buffalo in honor of the medical school sesquicentennial (May 9-12 , 1996) >- Bestowal of honorary degrees at commencement in 1996 and 1997 >- Symposium on Epidemiology and Preventive Medicine (September 20-21 , Exhibits to highlight medical school's sesquicentennial year 1996) three-day national symposium on Ethics and Values in Medicine, the national meeting of the American Association of the History of Medicine, and a special opera performance will highlight the celebration of the 150th birthday of the University at Buffalo School of Medicine and Biomedical Sciences. Founded in 1846, the medical school was the first component of what is now the niversityatBuffalo, which is marking its sesquicentennial during an 18month period in 1996 and 1997. A 24-member commiuee composed of physicians, historians , archivists, scientists, and representatives from UB's teaching hospitals has spent the past three years planning special events to commemorate the medical school's century-and-a-half record of excellence in education, research, and service. Ronald E. Ball, M.D., clinical associate professor of gynecology and obstetrics, and Harold Brody, M.D., Ph.D., SU Y Distinguished Teaching Professor in the Department of Anatomy and Cell Biology, co-chair the committee. joyce Vana , Ph.D., clinical assistant professor of social and preventive medicine, serves as its coordinator and liaison to the dean of the medical school. For residents of Western ew York, the most visible sign of the medical school's sesquicentennial celebration will appear in january 1996, when 50 blue-and-gold commemorative banners will be installed along Main Street and Bailey Avenue on UB's South Campus, home of the medical school. The celebration will begin officially on February 22 , 1996-University Day-with the dedication of the medical chool's new $33 million biomedical research building, the awarding of an honorary degree, and the presentation of the 1996 D.W. Harrington Lecture. Events planned for 1996 and 1997 include: >- Publication of a pictorial history of the medical school (February 1996) >- ational symposium on Ethics and Values in Medicine (November 1416, 1996) >- One-day scientific colloquium and bestowal of an honorary degree (February 1997) >- Special performance by the Greater Buffalo Opera Company (Februwy 1997) >- Special exhibits at the Buffalo and Erie County Historical Society and the medical school's affiliated teaching hospitals + "How We Die"Author to Deliver Stockton-Kimball Lecture in May Dr. Sherwin B. Nuland, the author of National Book Award winner How We Die, will deliver the annual Stockton·Kimball Lecture at Spring Clinical Day on May 11. The tiNe of his talk will be "Death, the Doctor, and Hope." Nuland earned his M.D. from Yale University in 1955 and trained at Yale in general, cardiothoracic, and cardiovascular sur· >-Mounting of memorial plaques marking the three original medical school buildings in downtown Buffalo (May gery. Anoted speaker on medical topics, he has also written monographs on historical figures in medicine, such as Hippocrates and Napoleon's surgeon, Dominique Jean Larrey. In his 1994 book, How We Die: Reflections on Life's Final Chapter, he discusses haw modern doctors too 1996) often try desperately to save life, abandoning an >ational meeting of the American As- older mission to help people die with dignity. Sesqui(entennial banners now festoon the medi(al S(hool (ampus. a u 0 0 p y 5 c o n w e 9 9 �······································ ~ ~ I UB medical faculty appointed to national panels l 59th Annual Spring Clinical Day Cedric M. Smith, M.D., professor of pharmacology and toxi- Saturday, May 11, 1996 Buffalo Marriott cology at the University at Buffalo, has been appointed to a five-year term on the Expert Advisory Panel on Drug Information Science of the United States Pharmacopeia (USP) . The USP, founded in 1820, is a non-profit organization responsible for establishing public standards of strength, quality, purity, packaging, and labeling for drugs, medicines, and other healthcare devices and services. The standards are published in the USP- ational Formulary and are enforced by the U.S. Food and Drug Administration. The Expert Advisory Panel on Drug Information Science will be concerned primarily with expanding the USP drug and therapeutic-information database, which recently combined with the AMA Drug Evaluations database. Germaine Buck, Ph.D., associate professor of social and preventive medicine at the University at Buffalo, has been appointed to a three-year term on the ational Research Council's ( RC) Committee on Toxicology. The Committee on Toxicology, a component of the RC's Commission on Life Sciences, provides expert advice to government agencies on a broad spectrum of toxicologic issues and problems. Buck has won national recognition for her epidemiologic research in human reproduction and fetal and early-childhood health. + Medical Alumni Association State University of ew Yorh at Buffalo Continuing Medical Education End of Life/Quality of Death Death and the dying process hove traditionally been ignored by the treatment· and technologyoriented medical profession. Medical schools hove only recently begun to offer any curriculum in palliative medicine or death and dying. For many physicians the death of opatient is seen as opersonal failure. As oresult, dying patients and their families ohen feel shunned by and distanced from the physician at this critical moment. The advent of odvonced-<ore directives and heolthcore proxies has mode issues of dying o necessary topic for discussion between physician and patient. The objective of this conference is to help physicians become more comfortable with death and thereby be better equipped to help patients and their families through the dying process. Participants will be exposed to the basic concepts of palliative medicine, learn about end· of·life core resources in Western New York, and discover strategies for easing the transition from curative to palliative core. Principal Presentations "Dying Healed-The Nature of Care at the End of Life" Robert A. Milch, M.D. '68 "Delivering Bad News with Compassion and Hope" Judith Skretny, M.A. "Confronting Difficulr Emotional and Ethical Issues in the Care of the Dying" (panel discussion with case presentations) Martin Brecher, M.D. , )ach P. Freer, M.D., Ross G. Hewitt, M.D., Robert A. Milch, M.D. "Death, the Doctor, and Hope" Stockton-Kimball Memorial Lecture Sherwin, uland, M.D., F.A.C.S., author of How We Die The 1996 Spring Clinical Day will begin with registration at 7:30a.m. and welcoming remarks at 8:00 and conclude with the annual Medical Alumni Luncheon at noon, followed by the Stockton·Kimboll Memorial Lecture. UB chemistry professor Philip Coppens (right)was honored by the HauptmanWoodward Medical Research Institute with its first David Harker Award for outstanding contributions to the field of crystallography. Coppens received the prize at the dinner commemorating the 1Oth anniversary of the awarding of the Nobel Prize to Herbert Hauptman (left), institute president and UB research professor of computer science. B u a a p 5 The Accreditation Counci l for Continuing Medical Education designates this program for up to 4 hours of Catcgor) I credit toward the Physician's Recognition Award of the American Medical Association. This program has been reviewed and is acceptable for 4 prescribed hours by the American Academy of Family Physicians. a w n e 9 9 6 �Afriend called him "idealistic in apractical way" DR. ROSWELL PARK WAS A PIONEERING CANCER RESEARCHER AND " LIVING ENCYCLOPEDIA" WHOSE LEGACY LIVES ON IN TWO GREAT LAKES CITIES country, and was led by a well-known and well-respected his many achievements, founding the world's medical faculty. Park also relished the challenge of establishfirst cancer research institute in Buffalo in 1898 ing himself in a new city-and he was challenged. A piece is the one for which Dr. Roswell Park is probably published in the Buffalo Medicaljoumal commented on the best remembered. Rechristened the Roswell Park acquisition of Park by the university, questioning why a Memorial Institute in 1946 and known today as Buffalonian couldn't be found to fill the vacancy: "We fail to the Roswell Park Cancer Institute , this vital research and educational center was born out of Park's ascertain , after repeated inquiries in surgical circles, that the conviction that the increasing incidence of cancer around new appointee brings to this responsible position any ex tenthe turn of the century called for more immediate and sive experience or reputation. " It wasn't long, however, constant attention. Although the severity of his claims was before Park's indisputable character and aptitude won over the disgruntled columnist and the two achieved a friendly originally contested, he even went so far as to predict in 1904 that cancer deaths would one day outnumber deaths from relationship. tuberculosis. Park's concern about the increase of cancer In 1891, Rush Medical College tried to recapture Park by cases was as humane as it was scientific: He realized offering him the post of chairmanship of surgery-a that both professional and public attitudes toward tempting invitation that would have been an errorcancer patients during the nineteenth century mous promotion for Park. But a local group of were harsh, primitive, and counterproductive to influential medical professionals and public infinding a cure for the disease. dividuals coordinated a campaign to convince Park to stay in Buffalo, countering the Chicago Roswell Park was born in 1852 in Pomfret, offer with an offer of its own: Would Park be Connecticut, into the ninth generation of a prominent family that had arrived in America interested in a third building for the medical on the Mayflower (and had entered England school, on High Street, to be constructed to Park's specifications? Yes , Park would. with William the Conqueror). The first generation of Parks to venture from the East Coast, Park worked diligently and, aided by his many government and professional contacts, Roswell's family relocated to the Midwest when his father founded Racine College in Racine , Wislaunched an ambitious campaign to secure canconsin. After completing his B.A. and M.A. lr-=o=--R-= R-o_s _w_ E_L_L---:P:-A - R- K --,1 cer-research funding. In 1898, he and Edward degrees at Racine , Roswell Park earned his H. Butler Sr. , publisher of the Buffalo Evening M.D. at orthwestern University in 1876. After three years ews, won the world's first public-fund appropriation for cancer study. This 7,500 from the ew York State legislaas adjunct professor of anatomy at his alma mater, Park left to pursue his medical studies in Germany, France, and ture helped establish the ew York State Pathological LaboAustria. Indicative of his growing reputation , he was apratory of the University of Buffalo, the first lab in the world pointed lecturer of surgery at Chicago's Rush Medical Coldevoted exclusively to the full-time study of cancer. Within lege and an attending surgeon at Chicago's Michael Reese two years , the three small rooms the medical school had Hospital while still in Europe. Park did soon move to designated for laboratory use could no longer meet the Chicago, and it was there that he began what was to be a long demands of Park's research. Public donations and private and successful medical career in two Great Lakes cities. giving from Mrs. William Gratwick made it possible for land In 1883 Park left Chicago for the medical department at to be purchased for construction of the Gratwick Research the niversity of Buffalo, where he became professor of Laboratory at the University of Buffalo. Completed in 1901, surgery and later joined the new dentistry department. He it was , this time, the first lab in the world to be built and also worked as a surgeon at the Buffalo General Hospital. equipped solely for cancer research. Several things about the niversity of Buffalo appealed to Although by 1904 a ew York State grant annually Park: It had one of the oldest and best medical schools in the allotted the lab 15,000 for maintenance, it was not a state B a a p y a n w n e 9 6 �sidered among his most influential publications are the facility; that is , until19ll-thanks to the concerted efforts Mutter Lectures on Surgery, given in Philadelphia; the Lecof Park, along with the support of government officials and tures on Surgical Pathology; the Epitome of the History of the public. It was renamed the ew York State Institute for Medicine; Surgery by American Authors; and the Practice of the Study of Malignant Diseases, a title it retained until1946, Surgery, deemed when it was reby many his finest named after its iniwork. As a musitiator. cian , he was reFor thirty-one ported to be highly years until his skilled; he prideath, Park served vately published as a UB professor his musical pieces of surgery and Bufin a collection he falo General modestly titled A Hospital's chief Little Music. surgeon. Both inIt is not surprisstitutions would ing that one of feel Park's influPark's admirers ence for another called him a "livthirty-one years ing encyclopedia. " after his demise, as "When others each was led by his sought rest in novformer students. elty, gaiety, and Park's medical change," the friend expertise and reexplained , "Park assuring profescould be found sionalism earned Roswell Park (lacing the camera) operates before medical students and faculty, c. 1895-98. storing his splenhim the presidid mind with dency of the American Surgical Society, as well as American fresh material. " membership in the International Congress of Surgeons. As one ofBuffalo's most trusted and well-known surgeons, Park Rarely did Park slow down, even was appointed medical director of the Pan-American ExpoFrom its meoger three-room beginning in 1898, the as he got older sition of 1901, held in the city, and he was among the team Roswell Pork Concer Institute today spans twenty-five and intermitof physicians who attempted without success to save the life acres in downtown Buffalo, maintains osatellite tentlyill. Uncharof assassinated President William McKinley. acteristically, he research facility in Springville, New York, ond includes Park's achievements in medicine alone would guarantee made plans to go him a place among Buffalo's most successful citizens; howamong its fifteen buildings in Buffalo o 218-bed away and simply ever, he did not rest at the borders of his own profession. As hospital. The institute is currently undergoing o $241 relax in 1914, but a dedicated member ofUB's University Council, Park fought million renovation ond modernization of its facilities, died two days for the expansion of the university into the arts and sciences, slated to be completed in 1998, its centennial year. later on February prompting one colleague to describe him as "idealistic in a Cancer survival rates hove increased dramatically 15-almost cerpractical way. " His desire to be involved in creating a comfrom Pork's day, when being diagnosed with cancer tainly of heart plete university led to the establishment of the College of was virtually equivalent to odeath sentence. Only one failure-emArts and Sciences shortly before his death-and his son Dr. in five people survived the disease in the 1930s, one bodying perhaps julian Park would become its first dean, a position he would in four in the 1940s, and one in three oscore later. his favorite and hold for forty years. In men's social circles, Park was called Equally impressive is the fact that survival rates for often-quoted a "notorious mixer"; he held the presidencies of both the aphorism: "The those stricken with leukemia tripled between 19 50 Buffalo Club and the Liberal Club. As a scholar, he wrote 167 future reserves textbooks , articles , and monographs dealing not only with and 19 60- thanks, in no small port, to the for us repose medicine, but also with thanatology, student life in the early pioneering efforts of Dr. Roswell Pork. enough. " + Middle Ages, and sixteenth-century Italian philosophy. Con- Roswell Park'sButfalo Legacy s 0 0 p h 5 c o n w e 6 �A ,, Spoon f u I of Humor© gotten sick and they've called out over the P .A. for a doctor. There I am, resting comfortably in the middle seat with my knees in my eyes (I believe they call it the "chiropractor position"), when I hear the announcement: "If there is a doctor ACTUALLY , THE FIRST TIME I ANSWERED A CALL FOR on board, please make yourself known HELP , THIS PAST SUMMER , IT WAS A S ICK CHILD to the flight attendant." My first thought is, maybe they are looking for a date, or they have an Amway 111•111 his summer I made the deci- (Stamford, to be exact, but I still prefer on the side and are looking to business sion to move from the prom- to think of it as the ew York Metro ised land (California) to the area). Things are different here: obody bring doctors fleeing managed care into homeland ( ew York Metro has a sense of humor. For instance, the their group. The scary thing is, at this area). Perhaps it was the trickle- woman at the rental agency's name was point I might even be interested-espedown effect of managed care. I Anita Head. When I laughingly asked if cially if I begin as a Double-Diamond believe I reached my low point that was her real name, she retorted, Attending. Sometimes I am reluctant to respond when I was moonlighting in an occupa- "What's so funny about that?" I thought to these mid-air announcements. What tional medicine clinic (despite my train- to myself, "You not only need a head , if it's a situation I can't handle? This ing in pediatrics) and examining an but you need a sense of humor. " When I moved back East I needed to time, however, I literally jumped at the employee of Federal Express. The patient, a graduate student in finance , was fly one way, and there was only one opportunity, since l was trapped in the explaining the wonderful benefits pack- airline that would sell a one-way ticket. middle seat between two guys named Barry who were taking turns age offered to Fed Ex employpicking their teeth while disees who work as few as 20 cussing their favorite episode hours a week-a benefits of the Carney Wilson talk package that includes free I CHOSE THE SAME AIRLINE WHEN show ("Good-Samaritan Docflights to anywhere they fly. RETURNED TO CALIFORNIA FOR tors Who Get Sued While The only catch, he noted, i Helping Transsexual Patients that you have to be willing to VACATION DURING CHRISTMAS BREAK , with Kleinfelters"). You can sit in the "jump seat." ow, ON A " MANAGED-CARE VISA" (YOU see why I welcomed this opI'm not even sure what a jump portunity to get up and seat is, but I figure any seat KNOW , JUST ONE HOUR AND NOT A "work. " Anything to escape that includes the word the "dueling teethpickers." "jump" sounds like it has MINUTE LONGER ). Another reason l am usumore room than the average ally reluctant to get up and coach cage-! mean seat. assist in these situations is, I I even went so far as to jot down the name of the person in charge I don't want to name the airline, but let am a pediatrician. It's not very often that of personnel at FedEx (I still have her me just say it sounds like "terror air" kids get sick on planes, although l have number, in ca e l ever decide to move and leave it at that. lt is also the only considered supplementing my income back to California). Then it occurred to airline that has no frequent-flyer pro- by offering an impromptu pharmacy me that I may be overqualified: After all, gram (probably because it doesn't have service specializing in Benadryl and other I've written a book, and I am a pediatri- any frequent flyers-except me, that benign sedatives for children in the back cian ... maybe I could specialize in lift- is). I chose the same airline when l of the plane (I could make a killing on ing crates filled with children's books? returned to California for vacation dur- flights to Orlando and Anaheim). Actually, the first time I answered a As I said, that wa the low point. o ing Christmas break, on a "managedcall for help, this past summer, it was a care visa" (you know, just one hour and now l find myself in Connecticut, in the child-one who had had corrective sick middle of the "Blizzard of '96"-not not a minute longer). surgery for cyanotic heart disease two For some reason, every time l have unlike the Blizzard of '77 in Buffalo ('nuff said). I am living in Connecticut flown this airline (twice) someone has years earlier. A little oxygen did the ...adoctor on board?" B u a 0 p h y 5 c a n w n e 9 9 6 �Stu S i Ivers t e in, trick, and I was an instant hero. The second time it was a very un-pediatric problem: a 38-year-old with tingling and numbness down his arms and legs. He was only a couple of years older than me, so 1 knew there was no way he could in the back, I had to prove I was a doctor. Like somebody is going to try to take on that responsibility just to impress people: "Stand back! 1 am a doctor ... okay, I have a Ph.D. in political science, but you did ask for a doctor. " be suffering from a stroke or heart attack (could he?!). I quickly asked the usual questions: What did you eat? Do you have a past medical history? Taking any meds' (Are you a lawyer?) ow, believe it or not, before they would even let me touch this guy or open up the bag of equipment they keep As soon as I got over there and identified myself as an M.D., you could see the guy felt better right away, which just goes to show the importance of touch in medicine-and let's face it: touch is about all you can do on a plane. There is no CBC, no enzymes to measure, and no pulse oximeter. The guy's blood pressure B u a 0 p y 5 c a w M.D. and vitals were stable, and he improved with a little reassurance, so I concluded that he was most likely suffering from hypoxia coupled with flu symptoms. But just to be on the safe side, I decided to radio an internist on the ground, which meant that I got to take a trip to the cockpit. When I got there the pilot, co-pilot, and flight engineer all turned around to talk to me-and I'm thinking, "Who the hell is flying the plane?!" Automatic pilot or no automatic pilot, I want to tell you it is unnerving in the extreme to see these guys all looking backward while the plane is moving forwardkind of like riding in a ewYork City cab and having the driver climb into the back seat to chat while the car is going down Fifth Avenue at 45 miles an hour. (Come to think of it, that's probably not so unusual, ew York City cabbies being what they are.) Anyway, the pilot gave me his card (first time that's happened to me) and promised he would put in a word for me so I could get a free flight. So wouldn't you know it? I'm headed back to the East Coast from California (trip number three on "Terror Air"), minding my own business, and I hear that call for help on the P.A. again. This time it's a 33-year-old woman who has fainted in the back of the plane. I get up to answer the call to duty and the flight attendant says, " ot you again," which is precisely what I was thinking. So now I am three for three. Well, by now I am even ready to consider working for this airline instead of Federal Express, provided the benefits package is better. In these days of economic uncertainty, you have to find work wherever you can- even on cross-country flights. + Stu Silverstein, M.D., president of Standup Medicine Seminars of Son Francisco, California, and Stamford, Connecticut, lectures nationwide on humor in medicine. e 9 6 �~ -················································· · ······ · ·················· · ··········· lEI Promoting prevention at the CDC JAMES MARKS '73 IS THE NEW DIRECTOR OF THE NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION same pragmatic approach to the agency's long list of target issues: eeing one patient at a time isn't enough for James S. cancer, diabetes, heart disease, adolescent behavior, nutrition, Marks, M.D. '73: He prefers to take them in batches of physical exercise, community health, oral health, teen pregnancy, hundreds of thousands. family planning, reproductive health, infant mortality, and smokMarks is the new director of the ational Center for ing. Some current projects include monitoring mammogram rates, Chronic Disease Prevention and Health Promotion, a expanding state cancer registries , and helping redesign principal unit of the federal Centers for Disease Control school health curricula to emphasize prevention. The agency also and Prevention. puts out several hundred publications a year, including its famous "People don't realize that chronic disease causes 70 perSurgeon General's Report on Tobacco, an annual summary of cent of the deaths in the United States and 60 percent of the research on smoking and health. healthcare costs. We're having trouble paying for it already. "Our responsibility is to see that the findings of research That means either we are going to have to curtail care, or we'll about prevention are disseminated widely so that people have to reduce the incidence of these problems through know what to do to avoid chronic disease," Marks says. prevention. And we believe prevention is the only humane That entails distributing most of the agency's $400 milsolution," Marks says. lion budget in grants to state health departments , universiMarks was appointed director of the 550-person agency ties, schools, and other organizations to fund education, by CDCP Director David Satcher in June 1995, but long monitoring, and research programs. before that he had made a name for himself as an outspoken Marks grew up in Alden , near Buffalo, and majored in advocate of preventive health. His numerous publications psychology as an undergraduate at Williams College in include editorials for the journal of the American Medical Massachusetts. He earned his M.D. from UB in 1973 (where Association in which he applies science to social problems his father, Eugene, had earned his M.D. in 1946), and to come up with non-ideological, although not necessarily completed his internship and resinon-controversial, solutions. dency in pediatrics at the UniverIn a 1985 JAMA commentary, " THAT' S WHEN HABITS BEGIN , IN sity of California at San Francisco, he recommended creating a desigADOLESCENCE . WE' VE GOT TO SHOW where he also worked in a Planned nation called "fetal tobacco synTHEM THAT GOOD HEALTH HABITS Parenthood Teen Clinic. drome" to call attention to the "I realized while I was pracARE TO THEIR OWN BENEFIT , AND well-known correlations between ticing in San Francisco that the smoking and low birth weight and THAT THEY' RE NOT JUST problems I was seeing were pregnancy complications. An ediACCEPTABLE , BUT COOL. " broader problems than just the torial in 1987 advocated commuclinical ones," he says. Dispensnity-based sex education that ing antibiotics and vaccinations did nothing to remedy the would teach teens not only how to say "no " to sex-but also poor nutrition , teen motherhood, and other societal probhow to protect themselves if they said "yes." lems he saw day after day. "l got interested in the broader "Sexual messages pervade our lives-at home, in schools, community issues. " in media, in shopping centers, on airplanes , and even in He was hired by the Centers for Disease Control as an physicians' offices," began another JAMA editorial urging Epidemic Intelligence Service Officer in Ohio. On his universal sex education. His next sentence no doubt surfirst day at work, he was sent to Pennsylvania to help prised readers expecting disapproval of our sex-obsessed investigate what would become known as Legionnaires' society: "Rightly so, since being sexual is part of being Disease. "It was tremendously exciting, my first day on human." the job! " Marks remembers. He also investigated outAs head of the preventive health agency, Marks is applying the B a 0 p h y s c a w e 9 6 �························································································ ra~ . • breaks of measles and diarrhea , as well as complications from the swine flu vaccine, and was sent to Hawaii to monitor an outbreak of German measles in adults. With a growing conviction of the importance of epidemiology and public health, Marks left the CDC to earn a master's d eg re e in public health from Yale University, winning a Robert Wood Johnson Clinical Scholars fellowship. Toward the end of his studies, Marks served James Marks, M.D. '73, on the Centers for Disease Control and Prevention campus near Atlanta, Georgia. six months as "It's the leading cause of preventable mortality in this Connecticut's acting state epidemiologist. He also returned country," he says. "The tobacco companies have to deny to pediatric practice. "I just wasn't sure l wanted to stop what science is most clear on-the links between toseeing patients," he remembers. bacco and cancer and heart disease-every time we Marks rejoined the CDC in 1981. Since then, he has held publish the Surgeon General's Report on Tobacco. They a number of science policy appointments in various departhave to have 3,000 children start smoking every day ments, including the Birth Defects Branch and the utrition because 400,000 of their best customers die each year Division of the Epidemiology and Research Branch. Most and 600,000 quit." recently, he served for four years as the director of the However, the same issue has provided the most encourDivision of Reproductive Health, a subunit of the agency he aging example of the success of public health education, currently heads. Marks also teaches at Emory University he says. School of Public Health and has served as a consultant to the "When the Surgeon General's Report of 1964 came out, World Bank and the World Health Organization. which was the first to publicly state the risk of smoking, One of his goals for his agency in the coming years is to try nearly 50 percent of the adult population was smoking. Now harder to reach adolescents with the messages of preventive it's down to the low 20s. That's an incredible change and an health. "That's when habits begin, in adolescence. We've got incredible success." to show them that good health habits are to their own benefit, Marks, 47, lives in Atlanta with his wife, Judy (a 1968 and that they're not just acceptable, but cool." graduate of UB, where she was named "Outstanding FreshHe also hopes to begin attacking Americans' sedentary man Woman" and served as president of the Honor Society), way of life by promoting physical exercise, and to continue and his 16-year-old son, Adam. His 19-year-old daughter, to monitor the health problems of the uninsured. "We are the Amy, is at college, where she is tentatively pre-med. Alonly industrialized country that doesn't cover our entire though he has enjoyed living in Atlanta for many years, population. When we're designing programs for HMOs and Marks retains fond memories of his alma mater. insurers , we can't lose sight of the fact that they don't cover "l still miss the snow and the Bills," he says. + 20 percent of the population." One topic that never fails to get Marks' juices flowing is E 5 5 c A A N K J c E R tobacco. B u a a p h 5 c a n w e 9 9 6 �• ······························ · ······························· ·· · · · ·· ············ · ········ I BERNARD 5 . STELL '36 , of un City, Arizona, had l l slides-ofhis30 acceptedexhibited in imernational stereo photography exhibitions in 1994. 1 9 5 s 0 MORTON A . STENCH EVER '56, of Merler Island, Washington, continues to teach and practice after resigning as chair of the niversit)' ofWashingwn's DepanmenL of Obstetrics and Gynecology, a position he held for 19 years. He also serves as associate editor of Obstetrics and Gy necolog} , and has coauthored Comprehensive Gynecology and authored three books. He serves as treasurer of the American Board of Obstetrics and Thomas March '31 (arrow} at the 1966 reunion. Gynecology, and is a member of the OB/ GY 1 9 3 s 0 Residem Review Commiuee. He won the 1995 Wyeth/Association of Professional Gynecology and Obstetrics Annual Recog- THOMAS A . MARCH '31 , of Tacoma, Washington, writes: "As an ancient alumnus of the medical school class of '31, I am perplexed at the silence of other alumni from the class of'31. Perhaps it is because they feel 'too old.' nition Award. He and his wife, Diane, recently celebrated their fortieth wedding anniversary, and enjoy their three children and four grandchildren. 1 "A slwrt biography is perhaps indicated at this point: 9 WILLI AM "After internship at Toledo Hospital (Ohio), I attempted general practice in 6 s 0 E. ABRAMSON '60, of Baltimore, Maryland, teaches aCME course on substance-abuse education for primary care physicians at Maryland-area hospitals, four different locations in ew York State during the Depression of the '30s. sponsored by the state medical society. He "Economics forced me to tahe a staff appointment at Harlem Valley State Hospital. Before I knew it I became eligible for Psychiatric Boards, after continues his private psychiatry and addiction medicine practice at Sheppard PraLL Hospital in Townson, Maryland. I R V I N G 5 . KOLIN '61 , ofWinterPark, postgraduate courses at Columbia University. Florida, appeared as a guest of Ted David on "After service overseas in the Army Air Force in 1942 (as a Lieutenant Colonel; I resigned in 1945), I joined the staff of a VA Hospital. I became a recent edition of C BC-TV's Money/inc LO discuss the economic costs of substanceabuse disorders. The program was televised nationally. Hospital Director in VA, then continued in Veterans Administration as a J OH N J . LAMAR JR . '63, of Salem, director in two different locations. I retired in 1973 and had a private ew jersey, is happy to announce that he neuropsychiatric practice for about a year. will be retiring in 1996. His youngest daughter, Danine M. LaMar, who married Glendon "And now I am enjoying complete rest and retirement." grade at Quinton Elementary School. Lodge in 1994, will be teaching the third a a 0 p h y s c a n w n e 9 9 6 �...................................................... . .......... Orange, Connecticut, coedited with Hal ange County Medical Society. He and his wife, Colleen Mulligan (B.S.N . '79 , B. Jenson and 50 contributors a 1,600- D'Youville) , are raising their two "big boys": page text this summer entitled Pediatric Todd , 8 , and Trevor, 3. ROBERT 5 . BALTIMORE '68, of SURF THE NET! INTERNET SOFTWARE Many Titles!! Infectious Diseases: Principles and Practice, PABLO RODRiGUEZ '81 , ofWarwick, published by Appleton and Lauge. He is professor of pediatrics and epidemiology at Yale University School of Medicine, where his E-mail address PC Anywhere Rhode Island, has been appointed associate chief of OB/GY DOS ... $67 Windo"s... $69 at Women and Infants • .\merica Online ~lac & \Yindows...$11.-49 • Internet Starter Kit \Vindo\\s...$3-'.49 \lac...$3-'.95 • Prodig_' \lac & \\ indo\\s...$15.95 • '\etscapc :\a,·igator for\\ indows...$32 Hospital, the teaching hospital of Brown is University in Providence, Rhode Island. He baltimorrs®maspo3. mas. yale.ed u. has two children: Rafi, 6 , and Kika, -1-. 1 9 7 s 0 ROSLYN '86 , of ROMANOWSKI SUSAN A. BARDE '76, of Dayton, Snyder, Ohio, who is in private practice in allergy, Western wrote in to announce that her husband, Millard Fillmore Ho pita!. She returned to Christopher A. Barde '76, is chief of medi- the area in 199-t, and assumed her latest ew York, is thrilled to be back in ew York doing heme/one at cine at the Dayton VA Medical Center and position after working one year at Buffalo chair of gastroenterology at Wright State General Hospital. Can 't connect from home ll'ithout one' INTERNAL STARTING AT $84.95 EXTERNAL STARTING AT $94.95 niversity. They have two sons: Christian, ANNA KRISTINA ELISE HART '89, 13, and Andrew, ll. of Portsmouth, Virginia, has completed a 1 9 8 second tour of duty as flight surgeon in the s 0 Florida, is chief of the Department of Plastic cared for four squadrons and was head of Surgery at Florida Hospital in Orlando and a legislative committee member of the Or- UNIVERSITY AT BUFFALO S C HOOL OF M EDI C INE 150 I SO 1846 Y E - A RS 19 9 ManY Brands! • Supra • US Robotics • Boca Modems • Practical Peripheral • Global Villiage nited States avy, most recently at AS Whidbey Island, Washington, where she WALTER SIEMIAN '80,ofWindermere, CONTINUED ON PAGE 32 BOOKS 20% off Retail 150 Years of Medical School History Using the Internet............. $15 The User-Friendly Reference Easy Internet. ............... $18.95 Using the Internet............. $29 Special Second Edition INTERNET WORKSHOP In celebration of its sesquicentennial year, the School of Medicine and 6 Biomedical Sciences has published a 192-page history chronicling its accom- Learn How to Use the Internet! plishments and its everyday life over the past century and a half. This Feb 7 & 8...... $99 CUSTOMIZED WORKSHOPS handsome hard cover volume is beautifully illustrated with 250 photographs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . These private workshops are tailored to your needs. They are available and very affordable. Call 645-3560 for information! . $39.95 includes shipping and handling $59.95 for a numbered, leather-bound, special collector's edition . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Prices slro•n• include a l et discoum for caslr paymems Open .\fou. Tues. Fri 1/am-Spm. ned & Thurs /lam-6pm C Order your copy today for delivery in March 1996. •r rrt n an r awlul'" Pnl'•• ·hJtltooiuo,f(l'"lll t 11<•tll' To place credit orders, call Walsworth Publishing Company at 1-800-369-2646, ext. 3339 A non-profit Umversity program for students faculty & staff The Commons • North Campus • (716) 645-3554 • Fox: 645-3884 6 u a 0 p h y 5 a w n e 9 6 �• ·························································· Why dtay home for the holidayd? I J e nni fe r (Broman) Moman, who is practicing pediatrics in Beaver, Pennsylvania, and is happily married to Dr. Moe Moman, a dentist. STEVEN P. HARRIS '91 ,ofPittsburgh, Pennsylvania, and his wife, jane, announce the birth oftheirson teven Phillip Jr., born September 1, 1995. The front-wheel drive lnfiniti®130"' MICHELLE PI ETZAK '92 , of Los An- ing her residency at Children's Hospital of Eln int~rt;>r 11/0t'l' ,•pact;>u,• than a Rolf,, Rove~ Si!..o· 5purlll. An ~.\-ceptulttal~v.tJm~mu,• o/ ,•tandard lu.rw:v f~atur~.•. 1! /90-hp 1'6 mpaM~ o/out-acal~ratti'.tJ many !u.\·w:v Jl<l:•. Elntl o/ <'tl/11".'~• th~ ,•tantlartl-,•ettin.tJ Los Angeles. Currently, she is in the first p~tj;>rlllilll<'~ anti ,•~r<'lt"e geles, California, married a fellow pediatrician, Derek Wong, in june 1995 after finish- year of a fellowship in gastroenterology at the niversity of outhern California. it;,, t>/ ln!i'niti. S.J 79 mo. -12 IIIli. lea.•e SO£11111'11 OBITUARY DONALD HALL '41 , of Buffalo, died Michelle Pietzak ' 92 january 7, 1996, after a brief illne s. He was a past presidentofthe Medical School Alumni the Aviation Medicine Department at the Association. After service in the Army during World War !I and residency at Buffalo hospital. During her two years at Whidbey Island, she spent much of the time traveling General Hospital and The Children's Hospi- and participating in training exercises both tal of Buffalo, Dr. Hall entered private prac- in the area and as far away as the East Coast. tice in obstetric and gynecology. He was an he attained the distinction of being the first assistant clinical profe sor at the medical female assigned to two aircraft carriers, and Achievement Medals for her accomplish- Blood Services and the Deaconess Center of Buffalo General Ho pita! Family Planning. Pro_qram. cine, working with several area medical or- ments while on her assignment. She reports ganizations, including American Red Cross that she mi se the days of nying while a night surgeon, but is enjoying being a resident in the world's largest and busiest naval 9 9 s 0 MICHELLE SKRETNY SUSCO '91 , Correction of Clifton, Virginia, is a board-certified pediatrician practicing in a four-pediatrician ELLEN GIAMPOLI '90 AND group practice in Manassas, Virginia, after CRAIG NARINS '90 were wed in completing three years of residency training Tarrytown, ewYork,onjune 10,1995. at Children's National Medical Center in Readers of the Autumn 1995 issue who Washington, D.C. She and her hu band , arc friends of the couple have noted joel, a CPA, who married in cptcmbcr 1995, will be living in their new home in The editors regret their error. ~.\·t~n.•il'~ a a -12 1110. !ea,•e SO tiown I N F I N IT I AUTOPLACE INFINITI 8129 MAIN ST., WILLIAMSVILLE 633-9585 East of Transit Rd., Near Eastern Hills Mall that we mi identified Dr. Giampoli. G20 42 mo. '130 42 mo. lease W<th cash or trade eqUity dawn. (G20-$495) (130-$450). Bank fee + tax and license due almcepbon. 12,000 annual m<leage. $.12 Clifton. Susco also provided an update on a an S2 79 IIIli. hospital. 1 Lit..-~ ~"ay !t~/i'nitl·, th~ (;]{!com~, , "•ith li.•t o/ ,•tandarti /u.\'111"1/ f~atur~.•: a -l-ymr/60,0£/0 mil~ Ba,•ic x~:,. l '~hic/~ ll'~u·ranty; 2-1- hour Roal/,,itl~ JJ.,,,[,•tana Pro_qram Trtp Interruption B~n~fi't,•; and our Fra Sal'ia f_,oan Car school until his retirement in 1983. After his retirement, Dr. Hall remained active in medi- most recently was awarded two Navy The front-wheel drive lnfiniti® G20'" per m1le p 5 a n w 1n excess. e 9 �The jury is out. Your practice and assets are on the line. This is not the time to be second-guessing your choice of professional liability insurance companies. In a similar situation, a MLMIC policyholder remains confident, knowing he or she is protected by a company that already has successfully defended more physicians than all other available insurers combined. Adding to the value of your MLMIC policy is one of the country's largest and most experienced professioral liability Claims Departments, as well as the largest Risk Management Department of any professional liability insurer in the state. MLMIC also offers New York's only true peer review of claims experience. Only physician-owned and controlled MLMIC offers this high level of quality assurance and service. MLMIC also is the only medical liability insurer approved by the Medical Society of the State of New York. • Find out more about the protection you'll receive from the largest and most successfu l company of its kind in America. Calll-800-356-4056 in Upstate New York, or 1-800-ASK-MLMIC in the New York metropolitan area. MLM~C ~ \l<'li!Cal ljabilit) \lntuallnsuranct' Compan) Our defense never rests. 2 Park Avenue New York. NY 10 016 2 Cl'nton Square Syrac"e>e. NY 13202 9() Merrd Avenue E. Meadow. NY 11554 �BUFFALO PHYSICIAN Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED PLANTING A TREE UNDER WHICH You WILL NEVER SIT DR. DEVILLO W. HARRINGTON, class of 1871, knew how to make his money grow. In fact, this man who in 1905 provided $5,000 through his will for the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. THIS PERMANENT endowment in Dr. Harrington's name has grown to over $300,000 and today it supports the famous Harrington Lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed fu nds at the school. They enable UB to provide scholarships to outstanding students, enhance scientific research, support excellence in teaching and meet the ever-changing needs of the school. YOU TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you develop a smart financial plan. A charitable bequest provides the satisfaction that comes from planting a tree under which you will never sit, but which will bear fruit for generations to come. FOR A CONFIDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact: STEPHEN A. EBSARY, JR. Assistant Dean and Director of Development, School of Medicine and Biomedical Sciences UNIVERSITY AT BUFFALO (716) 829-2773 UNIVII!RSITY AT aUFFALO SCHOOL 0,. ME:DICINII! t5~ 150 YEARS � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 1996 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1996-Winter Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v30n01-1996-Winter Table Of Contents A list of subunits of the resource. Research Hospital News Treating Violence Sleep Without Rest Medical School Then and Now A Spoonful of Humor Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v30n01 Extent The size or duration of the resource. 36 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1996 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/6ad5c5c491ee4c72591c41beb85f0f08.pdf 5ad80e3fc2f2a5f1d081bbd5f459504f PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Autumn 1995 FROM DARI<NESS TO DAYLIGHT UB's Traumatic Brain Injury Rehabilitation System repairs broken lives �BUFFALO PH Y S I CIAN Volume 29, umber 4 ASSOCI ATE VI C E PRESIDENT FOR UN IVERSITY SE RVICES Dr. Carole Smith Petro DIRECTOR OF PUBLICATIONS Timothy j. Conroy ED ITOR Nanette Tramont, R.N. ART DIRECTOR Alan J Kegler ASSOCIATE ART DIRECTOR Dav1d R1ley E DITO RIAL MANAGER judson Mead PRODUCTION MANAGER Ann Raszmann Brown Dear Alumni and Friends, T his issue of Buffalo Physician describes the Traumatic Brain Injury Rehabilitation System that has proven so successful in Buffalo. The story provides yet another example of how collaborative efforts among institutions can facilitate patient care, enhance the education of health professionals and promote meaningful clinical opportunities that can utilize the resources of other institutions to positive advantage. As importantly, the system has ensured that patients can be treated in Western New York rather than be transferred to service delivery sites in other parts of New York, or in other states. The latter actually provides an economic savings for the citizens of Western New York since such services are more costly, as well as inconvenient, when patients with head injury are treated in other states. We congratulate the medical, hospital and other leadership that worked to make this system a reality and a success. Sincerely, STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. john Naughton Vice PreSt den! for Cluucal Affairs j ohn Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Dean EDITORIAL BOARD Dr. john A. Richert, Chairman Dr. Marttn Brecher Dr. Harold Brody Dr. R1chard L. Collins Dr. Alanj. Dnnnan Dr. James Kanski Dr. Barbara Marjeroni Dr. Dr. Dr. Dr. Dr. Dr. Elizabeth Olmsted Charles Paganelli Margaret W. Paroski Thomas Raab Stephen Spauldtng Bradley T. Truax TEACH ING HOSPITALS AND LIAISONS The Buffalo General Hospital Michael Shaw Buffalo VA Medical Center Arlene Kelly The Children's Hospital of Buffalo Ene County Medical Center Mercy Hospital M1llard ftllmore Hosp1tals Frank Sava Roswell Park Cancer Institute Sisters of Chanty Hosp1tal Dennis McCarthy ©The State Umversity of New York at Buffalo Buffalo PhySician IS publtshed quarterly by the State University of New York at Buffalo School of Medicine and Bwmed1cal Sciences and the Office of Publications. It IS sent, free of charge, toalumm, faculty , students, residents and friends. The staff reserves the right to ed1t all copy and submissions accepted ror publicatiOn. Address questions, comments and subm1ssions to: Editor, Buffalo Physietatt, State Universny of New York at Buffalo , Universuy Publications, 136 Crofts Hall, Buffalo , New York 14260 Send address 1hanges Ia: Buffalo Physiciatt, 147 CFS Addition, 3435 Matn Street, Buffalo, New York 14 214 Dear Fellow Alumni, T his year is Oying by, and we are rapidly approaching the beginning of our Sesquicentennial. Numerous events have been planned to celebrate the 150th anniversary of our medical school, and we hope you will be able to join us for some or all of the festivities. As you know, this past year the Medical Alumni Association purchased furnishings for the medical student lounge. The students were most appreciative, and acknowledged our efforts with a reception and commemorative plaque. Our Alumni Association was also honored with representation on the newly formed Dean's Advisory Council, which held its first meeting October 25-26, 1995. The Council has broad geographic representation, and alumni traveled from as far as California to attend the meeting. The group toured the new Biomedical Research Building, which is a spectacular addition to our medical campus. Dr. Beth Maher informs me that plans for Spring Clinical Day are shaping up nicely. Dr. Sherwin Nuland, author of How We Die, will be the Stockton Kimball lecturer. His topic will be "Death, the Doctor and Hope." He wrote to Dr. Maher, "Your school is a place I have long admired, and the feeling is always enhanced by my visits." We hope you will enhance Spring Clinical Day with your presence, and I'll look forward to seeing you there on May ll, 1996. Enjoy, ~~ W. ?~~J Ml) Ma rga ret W. Paroski, M. D. '80 President, Medical Alumni Association �V A 0 2 L U T U M o N 9 9 N 4 9 5 II Resear(h II Hospital News GME Maelstrom e UB's graduate medical educaII The tion consortium girds itself for fundamental changes in financial support system. m Putting Ba(k the Pie(es e UB's Traumatic Brain Injury Rehabilitation System repairs broken lives. IIJ Medi(al S(hool EiJ Then and Now m m ASpoonful of Humor Flying the friendly skies. Page 21. Alumni m Classnotes * l~e meuical sc~ool' slon~ ~istor~ of e~ual o~~ortu­ UB' s teaching hospitals plan for the worst. Page 6. nit~. ra~e ~~. �.... . ......... . .................. . ....... . ............................. . ... . .............. UB biologists build better mouse model for Duchenne MD research mark absence of dystrophin and increased mast cell activity characteristic of the disease, it doesn't exhibit the progressive weakness that is a symptom of Duchenne muscular dystrophy. He said the mice exhibit a degree of muscle weakness and degeneration , but only after they are physically stressed by running on treadmills for periods of time or are injected with chemicals that induce mast cell activity. "We wanted a model that would express the full symptoms of the human disease ," Hudecki said. He and his colleagues bred mice with the dystrophin deficiency and the exaggerated activity of mast cells throughout the body. The findings show that not only does d ys trop hin-deficien t muscle contain a greater number of mast cells, but the muscle tissue also appears to be hypersensitive to mast cell products, he added. niversity at Buffalo biologists have developed a new mouse model of Duchenne muscular dystrophy that may more accurately simulate the progression of the disease than current models. The research, which should also provide an enhanced understanding of the - formed about pain management, and that this lack of knowledge interfered with the nurses' ability to provide adequate treatment. The study, which appeared in the May issue of the journal of Pain and Symptom Management, points to a problem with nursing and medical school curricula, according to lead author Kathleen G. Wallace, Ph.D., assistant professor of nursing and postdoctoral nurse fellow at Buffalo's Department of Veterans Affairs Medical Center. "Nurses and physicians are not taught enough about pain management," she said. "Schools have not made the commitment to teach it. ln the meantime, the knowledge base of pain management is exploding. " The pilot study involved 108 staff nurses selected from a random sample of hospitals in Georgia, Louisiana, ew York and Washington , D.C. Since staff nurses are usually the first on the scene when a patient is in pain, their sensitivity to, and skill in dealing with, pain problems is critical for effective pain management, Wallace said . Study participants were asked to rate themselves in several areas related to pain management-educational preparation, practice skills and knowledge of legal, financial, political and ethical issues - and to rate the importance of each area. They also listed the three most important problems of pain management in their facility. Undermedication surfaced as the most significant problem of pain management. This finding is a step forward , Wallace said, because previous reports have shown nurses and physicians generally did not believe patients were being undermedicated. The researchers found that most of the nurses interviewed thought their pain management skills were adequate, even though other studies repeatedly had found the opposite to be true. B Y ELLEN GOLDBAUM The new mouse could provide enhanced understanding of the disease. role mast cells play in the disease, was published in the july issue of the journal of Neurological Sciences. Michael S. Hudecki, Ph.D. , research associate professor ofbiological sciences, ndermedication is the most signifiis the senior author. Coauthors are jocant problem of pain management seph A. Granchelli, postdoctoral fellow , in hospitals, one of the first studies and Catherine M. Pollina, research asto investigate how nurses assess sociate. The work was funded by the their knowledge of pain and their Muscular Dystrophy Association. skill in alleviating it has shown. "There has not been a good model for The pilot study, conducted by UniDuchenne muscular dystrophy ," versity at Buffalo nursing researchHudecki said. "This specially bred mouse ers , also revealed that nurses think gives us a very good handle on studying they are adequately informed about the Duchenne disease. " managing pain, despite research Hudecki explained that while the pre- showing they aren' t. vailing animal model, a mouse deficient But the nurses interviewed believed it in dystrophin, closely simulates the hall- was the physicians who were ill-in- Nurses see undermedication as major pain management problem e B a 0 p 5 0 B A Y LOIS m B AKER 9 9 5 �···· · ·························· · ·········· · ················· · · · ·· · ··· · ·········· · ········· · · s . " ' '~ ..~.. . Rural AIDS cases increasing three Improved survival seen with new times faster than in urban areas head and neck cancer treatment IDS cases in rural areas appear to be increasing at a rate three times faster than in metropolitan areas, where health care facilities are better equipped to deal with the problem. Rural AIDS cases increased 9.4 percent from 1991 to 1992 - the last period for which comparable statistics are available- compared with 3.1 percent in major metropolitan areas , according to a review of scientific literature focusing on rural HIV/AIDS conducted by UB's ew York Rural Health Research Center. The review also found that unlike the typical urban AIDS patient, likely to be homosexual males, rural AIDS patients are more likely to be heterosexual females. "In terms of both total cases and research, rural AIDS remains dwarfed by the urban epidemic," said Robin Graham, Ph.D. , senior research scientist at the center and lead author of the study. "But our literature review indicates that AIDS is a serious rural problem, with growing numbers of patients requiring services from illequipped local health care systems." The studies reviewed revealed several distinct characteristics of the rural epidemic: <§> The rate of increase of AIDS cases in proportion to the population is much greater in rural areas. ©> Rural AIDS is distributed unevenly, with 30 percent of cases concentrated in the South Atlantic states. ©> Rates are particularly high among black women , adolescents , ative Americans and migrant workers. ©> A substantial portion of rural HlV patients have migrated to metropolitan areas , returning home to family exhibiting advanced cases of the disease. <§> Intravenous drug use and heterosexual contact are becoming significant modes of transmission of rural HlV. BY B u LOIS c p h .. chemotherapy shrunk it to 1/2 centimeter, we still took it out as if it were two centimeters," Lore states. Significantly, all the patients in the study were evaluated and treated by Lore , who resected the tumors to .5 to 2 centimeters beyond the point at which they had been marked by tattoos following diagrams , anatomical stamps and photographs. new treatment regimen for head and neck cancer developed at the Head and eck Center at Sisters of Charity Hospital could hold promise for some of the estimated 30,000 Americans who are diagnosed with the disease yearly. The new regimen, which combines preoperative chemotherapy with an innovative surgical technique , was pioesearchers and clinicians from neered by John M. Lore, M.D. , medical several UB departments are orgadirector of the center. Lore presented nizing a Group for Advanced Vihis research , scheduled for publication sion Research to bring together in the American journal of Surgery, at people working in the field to the annual meeting of the Society of collaborate on research , coordiHead and eck Surgeons last May. Lore demonstrated a five-year sur- nate funding efforts, share resources vival rate of 76 percent in one group of and enhance teaching. 93 patients with advanced squamous William Coles, M.D. , professor and cell carcinoma of the head and neck he chair of ophthalmology, is the group's treated over 15 years with one of two executive director. Malcolm Slaughter, preoperative chemotherapy protocols. Ph.D., associate professor of biophysical Previous survival rates , as demonstrated sciences and ophthalmology, has been by the ational Cancer Institute's 1987 named director of basic research , with Head and eck Contracts Program, av- James Reidy , M.D. , assistant professor of eraged 35 percent. ophthalmology, serving as director of The Head and eck Center's dramatic clinical research. 76 percent survival rate was seen in the 40 Researchers from the UB Departments patients who received cisplatin and 5-0uo- of Clinical Laboratory Science, Anatomy, rouracil preoperatively. Another 48 who Pediatrics, Biochemistry and Social and received preoperative Preventive Medicine have alcisplatin and bleomycin ready affiliated with the group. posted a five-year surCurrent members are conducting funded research 1n- - vival rate of 43 percent. (Five patients were diabetic retinopathy, noncompliant.) retinopathy of prematurity, The crux of Lore's age-related macular degenregimen is the strict aderation, corneal inOammaherence to preoperative tion, neuro-ophthalmology chemotherapy planand outcomes of surgical proning of ablative cedures in the developmenuncompromised surtally disabled. gery regardless of a fa- Angiogram displaying abnormal The group is organizing a vorable response to the retinal vascular pattern. research conference for 1996. chemotherapy. "If the tumor was 2 cen- Periodic grand rounds and continuing edutimeters prior to chemotherapy, and the cation seminars are also planned. UB researchers,clinicians form advanced vision research group BAKER 0 '· y c c m �Buffalo General and Buffalo Columbus finalize merger plans merger plan involving Buffalo Columbus Hospital; its parent organization, Buffalo Healthcare Corp.; and The Buffalo General Hospital has been finalized, hospital officials announced recently. The merger agreement, according to BHC board chair Vincent]. Muffoletto , represents "a major step toward providing vastly expanded services to our medically underserved community. " The Honorable joseph S. Mattina, chair of the board at Buffalo Columbus Hospital, observed that board members had "agonized" over the future of the institu- john E. Friedlander, Buffalo General's president and CEO , praised judge Mattina, Muffoletto , Garcia and members of the BC/BHC boards for exhibiting "extraordinary vision and determination. "Columbus represents a critical service provider for the community and specific patient populations, including the indigent, people who are HIV-positive , substance abusers, the chronically ill and people noting that Buffalo Columbus has a work force of 290 and Waterfront 200. "With approximately 500 staff, the campus will be a major employer on the WestSide." Sisters Hospital fights domestic ~olence with Crtsis Services he Safe Passage Program, Sisters of Charity Hospital's domestic violence program, has implemented an innovative working relationship with Crisis Services, a nonprofit human services agency that specializes in crisis response. The pilot collaborative effort between Sisters and Crisis Services will provide for the training of both crisis advocates from the agency and hospital staff, beginning with social workers , to serve as victim advocates. "We are training staff who will respond to victims' needs on a 24-hour basis," said Kathleen Slammon, M.S.W. , coordinator of the Safe Passage Program. Approximately 50 volunteers from Crisis Services' Advocate Program previously experienced in working with rape victims will receive additional training specific to domestic violence, including the dynamics of abusive relationships, standards of care for victims and community resources. The volunteers will supplement the services provided by Sisters Hospital social workers, who will also receive training specific to domestic violence. "The intent of this collaborative effort is to provide victims with consistent and comprehensive care," Slammon noted. Physicians, nurses and other hospital staff will be trained in domestic violence identification and intervention following the first phase of instruction for social workers and advocates. f tion for several years. "This agreement with Buffalo General will allow ~ us to mamtam our presence on the Lower West Side, provide better services than ever before, proceed with construction of a diagnostic and treatment center, and preserve as many jobs at this facility as humanly possible," Mattina explained. Earlier this year, the hospitals and BHC announced that discussions were under way to develop a merger plan in an effort to preserve, enhance and expand health care services for the city's West Side. Under the plan, the current Buffalo Columbus facility will be replaced with a diagnostic and treatment center. "Throughout the negotiations, the good of the community always came first ," remarked Andres Garcia , president and chief executive officer of Buffalo Columbus Hospital. "Our foremost responsibility is to the people of the Lower West Side, and our goal is to make this work so that they will have a community health care facility they can be proud of. " ?) with special needs ," Friedlander said. According to Friedlander, the merger plans include "the extension of new and existing services, while moving ahead with the process of developing a health care campus, including a diagnostic and treatment center at the site. " The 160-bed Waterfront Health Care Center, a residential health care facility operated by General Care Corp. , parent organization ofBuffalo General , has also been mentioned in the plans to create a health care campus. "Currently, we are exploring ways in which Waterfront and Buffalo Columbus can work together to create a West Side health care campus," Friedlander said, ;o. u m 9 9 �. . . . . . . ... . . . . . . . . ... . . . . . ... .. ... ... . ... .. ... ... . . ... . ... [1 "The entire hospital staff will be required to receive training. The extent of that training will depend on a person's position," Slammon added. The Safe Passage Program recently received a $10,000 Legislative Local Initiative Award from the New York State Department of Social Services. Funds from the award will be used to further develop the domestic violence program in the areas of intervention, advocacy and counseling services. Medical staff reappointments announced at Mercy Hospital hree UB physicians have been reappointed to key medical staff positions at Mercy Hospital of Buffalo. Saleela Suresh, M.D. , clinical assistant professor of rehabilitation medicine , has been reappointed as chair of rehabilitation medicine, a post she has held since 1979. She earned her bachelor's degree from the University of Calcutta, India , and her medical degree from the R. G. Kar Medical College in Calcutta. She served rotating internships in Calcutta and at the D.C. General Hospital in Washington, D.C. Suresh holds membership in the American Academy of Physical Medicine and Rehabilitation, the Medical Society of the County of Erie, the Medical Society of the State of New York and the American Association ofElectromyography and Electrodiagnosis. Noel Chiantella, M.D. , clinical assistant professor of radiology, has been reappointed as chair of Mercy's radiology department. He earned his bachelor's degree from Mount St. Mary's College in Emmitsburg, Md., and his medical degree from the University of Maryland Hospital. He served as a lieutenant, general medical officer, in the U.S. avy. John Fanelli, M.D. , has been appointed chief ofMercy's division of family practice, department of internal B u 0 0 p medicine. He earned his bachelor's degree from Niagara University and was an Army ROTC Distinguished Military Graduate. Fanelli earned his medical degree from UB , and served a rotating internship at the Ireland Army Hospital in Fort Knox , Ky. CHOB wins approval for acute pediatric inpatient rehab unit he ew York State Department of Health has approved The Children's Hospital of Buffalo's certificate of need to develop an acute pediatric inpatient rehabilitation unit. "There are no certified inpatient beds for acute pediatric rehabilitation in the Western ew York area, " said Joseph A. Ruffolo, president and CEO of Children's Hospital. "The acute needs of these patients are being met usually via transfer to acute inpatient rehab units outside of Western ew York and often outside of New York State. The gap in health care delivery results in fragmented and duplicative care for patients who require intensive rehabilitation services. Patient relocation forces temporary relocation for the family, which creates inconveniences and increased cost and stress," Ruffolo said. The inpatient rehabilitation unit will provide a multidisciplinary team approach for the treatment of brain dysfunction, traumatic spinal cord dysfunction, stroke, amputation of limbs, congenital deformities , neurological conditions , arthritis and other conditions. The treatment team will consist of the following medical disciplines: developmental pediatrics, education, occupational and physical therapy, social work, psychology, nutrition, rehabilitation nursing and speech therapy. "With a strong outpatient rehabilitation unit in place and numerous inpatient services providing referrals and direct clinical expertise, Children's Hospital demon- s c a A strates a strong commitment to provide a comprehensive continuum of care for this special population. A dedicated rehabilitation inpatient unit will ensure focus on functional outcome, so as to return each patient to the most independent setting possible," Ruffulo added. The Robert Warner Rehabilitation Center is the outpatient rehabilitation component of Children's Hospital. Grant named chief of pulmonary and critical care at VA center rydon Grant , M.D., has been named chief of pulmonary and critical care medicine at the Buffalo Department of Veterans Affairs Medical Center. A graduate of Charing Cross Hospital Medical School, London, Grant became interested in research during his residency and became a research fellow at the Royal Postgraduate Medical School in London. He continued his clinical training at Middlesex Hospital Medical School in London. ln 1977, Grant continued his research in pulmonary gas exchange and mathematical modeling at the University of California at San Diego. In 1979, he joined the faculty Brydon Grant, M.D. at the University of Michigan. He has been in Buffalo since 1983 as an attending physician at Erie County Medical Center in the pulmonary and critical care division, and as director ofECMC's pulmonary function lab since 1990. Grant has served on the editorial board of Respiratory Physiology and the American Review of Respiratory Disease. He recently completed a term as an associate editor of the American]oumal of Respiratory and Critical Care Medicine. u m n 5 0 �n interestin_ times THE ONLY CERTAINTY FOR ACADEMIC MEDICINE IS FUNDAMENTAL CHANGE t portrait photo s by Robert Walion EVERY ASPECT OF ACADEMIC MEDICINE WILL BE AFFECTED BY THE FlNA CIAL REFORMS BEING PLANNED FOR THE MEDICARE A D MEDICAID SYSTEMS - FROM THE NUMBER OF RESIDE CY SPOTS AVAILABLE TO NEW PHYSICIANS TO THE PRODUCTIVITY OF THE PROFESSORS WHO TEACH THEM . AT UB A D ITS AFFILIATED TEACHING HOSPITALS , THE MOOD IS OT HOPEFUL �by Andrew Danzo THE Fl A CIAL U DERPl Naughton describes the forces at work: the need for costtion are undergoing a fundamental reorganization. Medicontainment and a more rational approach to medical work care is being cut back and restructured. Medicaid, too. force policy; political promises of tax cuts; widening accepGrants are getting harder tance of business notions and harder to come by. of productivity. "These And in ew York, it's forces are going to collide anyone's guess what will here very shortly," happen when the system Naughton predicts, leanthat has regulated hospital ing forward during a disreimbursements for more cussion in the wedgethan a decade comes up shaped office that he will for renewal in several soon leave. He suggests a months. label: "Call it the GME "It's all under attack, evmaelstrom. " ery bit of it," says john Graduate medical eduaughton, M.D. , UB vice cation cost $3 billion in president for clinical afNew York State in 1994. fairs and dean of the School About a third of that came of Medicine and Biomedifrom Medicare hospital recal Sciences. imbursements, with most o one is sure exactly of the remainder from how it will play out. The Medicaid and non-governonly certainty is that ment insurers. The fundthings will be different , ing scheme is complex, to starting with teaching put it mildly. Medicare rehospitals and rippling outward. imbursements are driven by costs Among the hospital members in base years updated for inOa.JOHN NAUGHTON, M.D. tion, calculations of overhead atof the Graduate Medical Dental tributable to education, estimates Education Consortium of Bufof illness severity among teachfalo, there is talk of "integraing hospital patients and various tion " and "downsizing. " Fewer other factors. Reimbursements residency slots, perhaps. A testfrom Medicaid and other insuring of relationships among coners are determined by the New sortium members. Pressure on York Prospective Hospital Reimfaculty to find time for more bursement Methodology ( YPHRM), which adheres to clinical service. some parts of the Medicare formulas . "The CEOs know what's going on and know that something will have to give, but they are really unsure ," says Paul The average reimbursement per resident in 1994 ranged Candino, chief executive officer of Erie County Medical from more than $200,000 in the ew York metropolitan Center. "Once we see what the damage is, we'll be positionarea to about $149,000 in Western New York, a differing for redirecting our strategic initiatives. " ence that at least partly reOects regional variations in It may all end up producing something that is more health care costs. With 788 residents and fellows in the collaborative and attuned to the needs of a reorganized GMDECB, it is easy to see how changes in GME reimhealth care system, but the transition will not be painless. bursement could quickly translate into huge losses for ult' s all under attacl<, every bit B u 0 0 p c 0 of it. " A u u m 5 0 �ACADEMIC MEDICINE FINDS ITSELF IN INTERESTING TIMES affect medical education, but they are preparing for a individual hospitals. That could be compounded by major challenge. Asked what's at stake , Candino reother changes in Medicare, which covers nearly half the plies , "Everything. " patients in GMDECB institutions, and Medicaid. One obvious response would be reducing the number of Meanwhile, growing proportions of publicly and privately insured patients are residency slots, and some in managed care. HMO hospital executives say that can't be ruled out. "I penetration among those with non-government inthink the decisions will have to be what can we all surance in the metropoliafford from an educational tan Buffalo area is now about 60 percent, accordperspective as well as an ing to William D. Pike, operational one," says Ripresident of the Western chard Braun, vice presiew York Healthcare Asdent for finance and chief sociation. HMOs in Buffinancial officer of The falo have generally been Buffalo General Hospital. following the prevailing He says the consortium reimbursement rates set might also have to conunder NYPHRM, even sider consolidating some though they' re not reprograms, such as interquired to, Pike says. But nal medicine, which is the HMOs are beginning now split into two parts. to get more aggressive, he Naughton agrees that adds , pointing to one the government must get plan's recent exclusion of residencies under control hospital labs from a contract for nationally. In the three decades outpatient work. since Medicare began, training P A U L CANCINO programs and slots have prolifAs YPHRM approaches its june 30 renewal deadline , all erated. The knocks on the system are well known: public bets may be off. It is YPHRM funds helping to subsidize a surthat controls the bulk of hospiplus of specialists; geographic tal reimbursement for such maldistribution encouraged by "public goods " as graduate concentration of residencies in medical education and indigent a handful of states- New York care, and the insurance industry is already pushing to be realone has one-sixth of the leased from the dictates of diagnation's total; far more residents nosis-related groups , according than there are new American to jeannie H. Cross of the M.D.s , with programs sucking Healthcare Association of ew up young doctors from counn York State. "We're moving in tries where they are needed and the direction of a more marketmedical schools stymied in their oriented system ," Cross says. "The question is how fast. " efforts to rebalance the physician work force . GMDECB officials warn that there are still too "Obviously, the feds have a big job to do ," aughton many unknowns to predict exactly how all this will says. But Buffalo , he quickly adds , is not the place to do it. uThe CEOs l<now what's going on and l<now that something will have to give, but they are _really unsure. c a n m n 9 9 5 �ACADEMIC: MEDICINE FINDS ITSELF The GMDECB has been a national model since it adopted a self-imposed cap on residency slots several years ago. "We only have a few programs where we could say in the most rational sense of the word that we have a few excess residents," Naughton says. "We'd rather not lose any because we think the size is about right. " Final decisions on residency slots will be inOuenced by a variety of factors. For instance, disincentives for training graduates of foreign medical schools would be felt in the consortium, where about 45 percent of the slots are filled by international graduates. And even though the GMDECB is committed to training half of its residents in primary care (it's now at 43 percent), new disincentives for specialist training could pose difficulties. "We have a high surgical component at Buffalo WILLIAM General," says Braun, "and as you start to cut at that, you tear away at the whole system." To some degree, hospitals have already begun weaning themselves from their reliance on residents because the programs have been putting greater emphasis on the educational component of resident training. "They're not the slaves that they had been," says Roseanne C. Berger, M.D., associate dean for graduate medical education. Nevertheless, residents are still important. "Of our 21 clinical departments, 19 of them have relationships with graduate medical programs," says Michael F. Noe, executive vice president and medical IN INTERESTING TIMES director at Buffalo General. On average, the hospital has about 150 residents. "They are very much involved in patient care in the course of their learning experiences," Noe says. "Once they reach a certain level of competency, they directly provide patient care, particularly in urgent situations. If we did not have them here in the hospital, it would be very difficult to replace them. " Eventually, fewer residents could also mean fewer physicians in Western New York , Noe adds. "As there are fewer people in training, there will be fewer individuals familiar with the area who have developed a preference for this area as a place to practice ," he says. "lt could have an impact on the availability of people who go into practice. " Even if hospitals did cut back D. P I K E on residents, it wouldn't solve their problems. GME reimbursements have become intricately woven into teaching hospital budgets, supporting things that will continue to run up bills whether or not the residents are there. The largest part of the Medicare reimbursement goes not to direct costs - resident salaries and benefits range from about $20,000 to $60,000 in New York- but to compensate hospitals for the indirect, and somen what abstract, cost of being a teaching institution. Based on the ratio of residents and interns to beds, the indirect component is designed to pay for such educational costs as the greater number of tests that aWe have a very lean machine as far as health care delivery in Western New Yorl~. But we can do better, and we can do better by collaborating for shared services. B a a p h y s a n A u m 9 0 �ACADEMIC MEDICINE FINDS ITSELF residents tend to order, as well as for things like greater illness severity among teaching hospital patients. It is sometimes called an "add-on " to the direct Medicare reimbursement, which is paid according to diagnosis related group. "Our add-on is gigantic," says ECMC's Candino, who administers a hospital that is not only a major academic affiliate, but also has regional trauma and burn units and provides more than $20 million a year in indigent care. In New York, hospitals also receive indirect education reimbursements from Medicaid and nongovernment insurers through NYPHRM, which uses a formula that is similar to Medicare's but adjusted to encourage primary care residencies. The total indirect component is about 57 percent of the $3 billion in GME reimbursements in ew York. "A lot of it goes to the bottom line of the hospitals," says James RICHARD olan, M.D., director of medicine at ECMC and former chairman of medicine at UB. Likewise, other reimbursement streams help to indirectly support the educational mission of teaching hospitals. GMDECB officials say they will have to consider the potential revenue losses posed by overall changes in Medicare and Medicaid as they reassess their teaching activities. "If education stayed the same and you cut out $20 million of other funds , it's hard to say it would have no impact," says BGH's Braun. "The reality is, if someone cuts your budget by 10 or l3 percent, you have to react to it. The reaction IN INTERESTING TIMES has to be, what programs can we afford? " Teachers as well as residents are likely to feel the pinch. "This , of course, comes at a difficult time for faculty ," says Nolan. "There's been a decrease in state funding and hospital funding even without these cuts," he adds. "The hospitals have had to decrease the support they can give faculty. And grant support also has been decreasing." The combined effects of various revenue losses "are going to make it more difficult for full-time faculty to be financially supported," says oe. "In New York State in particular, our hospitals have operated very close to the margin. We have worked in a very heavily regulated environment for many years. The impact in New York State is going to be significantly greater than in other states." Berger sees that leading to some tough choices for adminisBRAUN trators and faculty. "I think there will be an increase in pressure for clinical activity, which may take them away more from the teaching endeavor," she says. That pressure had been growing already in recent years, and clinical practice now accounts forabout$75 million in UB medical school gross income. Berger says faculty could also be affected by financial pressure in the practice environn ment. "As managers begin observing the clinical productivity of faculty more closely, if there are no allowances for teaching time built in there , the standard will be maintained, whatever level is set for uTh e reality is, if someone cuts your budget by 10 or 13 percent, you have to react. The reaction has to be, what programs can _we afford? B u a a p y 5 c a A u u m 9 9 �ACADEMIC MEDICINE FINDS ITSELF seeing patients," she says. "You're not going to be able to teach as much while you're seeing patients if you're expected to see more patients." The coming year will be a crucial one for the GMDECB as it reacts not only to the federal changes, but to those at the state level as well. In addition to NYPHRM, New York's Medicaid managed care program is still taking shape, and another round of state budget cuts looms. "People are saying that next year is going to be a health care Super Bowl in New York," says Cross, the Healthcare Association spokesperson. "NYPHRM is a playoff game by itself." The situation could present some opportunities. For instance, the current system of GME reimbursement does not pay as much for ambulatory residencies as those in hospitals. Within the GMDECB, the salaries and benefits of ambulatory residents are covered, but RO SE ANN E C. there is no mechanism to pay the overhead costs. "Until there is real reform of financing, it's going to be hard to make the changes that are needed, shifting the locus from the hospital to the ambulatory setting," says Leonard A. Katz, M.D., director of research and education programs at Health Care Plan, which trains two internal medicine residents a year in the primary care: group practice!HMO track. The debate over such issues and the ongoing evolution of health care delivery are likely to put stress on relationships within the GMDECB. With managed care expanding and a continued push to replace DRGs with negotiated fees , hospitals that make teaching a part of their mission will IN INTERESTING TIMES have trouble competing unless there are adequate mechanisms to compensate them for their higher costs. "You have people at the consortium table collaborating for graduate medical education, but at the same time, these collaborators are competitors for patients," says Pike, of the Western New York Healthcare Association. "As competition heats up more and more, it's hard to sit down and say, 'let's work together."' But Pike and others say they expect the consortium toweatherthestorm. Ifanything, cooperative efforts will become more important. "The consortium is a good example of how the market is reacting in general," Pike says. "We have a very lean machine as far as health care delivery in Western ew York. But we can do better, and we can do better by collaborating for shared services." Examples of new partnerships are already emerging as hospitals form networks that unite B E R GER, M.D. a variety of providers and facilities to offer patients a "continuum of care" through a single organization. "l think you're going to see tremendous changes from a standalone hospital system to an integrated delivery systems environment," says Robert V. Stanek, chief operating officer of Mercy Health System, the network that now occupies the Mercy Hospital chair at the GMDECB table. Stanek says the n ew environment will pose challenges for clinical education . "Will it strain the mission? Sure it will," he says. "But in the long term, we're going to continue to provide services to the community, and as part of that, an educational mission needs to be maintained. " uYou' re not going to be able to teach as much while you're seeing patients if you're expected to see more patients." B u a 0 p h y 5 c a n A u m n 9 9 �PUTTING BACK THE PIECES US'S TRAUMATIC BRAIN INJURY REHA I ITATION SYSTEM REPAIRS BROKEN LIVES BY PHOTOS B u a BY SCOTT THOMAS COLLIGNON/JAROSZ 0 p h c a n ;o. u m n �-------- - HE ACCIDE T ITSELF, Anthony DeLabio doesn't much remember. He and a couple of friends were just fooling around. Too young to drink in ewYork State, they had walked across the Rainbow Bridge into Canada and spent the evening hitting the bars. Then they had walked back and were hanging around in the parking lot of the Rainbow Center mall. "We started horsing around by the edge of the parking lot," DeLabio, now 22, says of that fateful September night in 1992. "I leaned over ... and I fell. The next thing I knew, when I got percent of traumatic brain injuries are motor-vehicle-related. If you add in pedestrians who are hit by cars, it's closer to 60 or 70 percent. "And now, in some cities (though not Buffalo) , gunshot wounds are coming close to those numbers. " The medical school's Traumatic Brain Injury Rehabilitation System is a regional consortium that operates at three levels: ECMC, with its Level I trauma unit and acute-level rehabilitation; Our Lady of Victory Hospital in South Buffalo, for intermediate-term rehabilitation; and, until recently, the Deaconess Center ofBuffalo General Hospital, for long-term in-patient rehab. Labi says she and her colleagues are working with patients who , had they sustained such injuries 20 years ago , never would have survived - people with multiple body traumas Each year, an estimated half million people nationwide suffer a head injury; a significant proportion of them will require a course of rehabilitation. The medical school's Traumatic Brain Injury Rehabilitation System is a regional consortium that operates at three levels: acute-level, intermediate term and long-term, in-patient. from crashes, or horrific gunshot wounds. "In the past," she says, "most of them would have died of complications from their injuries. Now the emergency medical services are so much better. With the use of helicopters, patients are getting to trauma centers much more quickly. And the earlier we can treat them, the better. " But reckless drivers and trigger-happy gunmen aren't the only risks to gray matter. "just about anything can result in a head injury," Labi says, and she ticks off some examples: industrial accidents; falls , particularly among older people; blunt trauma , such as assault with a baseball bat. All can damage the brain and its delicate neural pathways - and forever alter the life of the victim. Anthony DeLabio says of his time on the eighth floor of ECMC, the head injury rehab unit: "I was totally confused. I had no idea what was going on. I remember that a couple my senses back, I was on the rehab floor (of the Erie County Medical Center)." He had been in a coma for five days before he opened his eyes. "The strangest thing was, for a while after the accident I had these dreams of people falling. ever me, always other people. And I'd say to them in the dream, 'Don't worry, you won't remember it."' DeLabio's story is in some ways typical of the events that conspire to injure the human brain. Each year, an estimated half-million people nationwide suffer a head injury; a significant proportion of them will require a course of rehabilitation. Most such patients are young, male - and have been around alcohol, automobiles or both. "We live in a fast world," says Maria L. C. Labi, M.D. , Ph.D., medical director of the University at Buffalo Traumatic Brain Injury Rehabilitation System. "More than 50 B u a 0 p y a u m 9 9 5 �of my friends came to see me; other than that, it was just very confusing. "But all the people, the doctors and nurses, were very nice to me. They calmed me down a lot of times, because I felt like I was caught in a whirlwind. I didn't know why I was in the hospital. They told me day after day that I fell, but I just couldn't make the association. I couldn't remember going out that night. " But slowly, in the nine-and-a-half weeks he was in the hospital , and throughout a long course of outpatient rehabilitation, Delabio made the connection. He worked with physical therapists to learn to walk again. Occupational therapists helped him relearn "the day-to-day things" showering, getting dressed. Speech therapists helped him learn to organize his thoughts and taught him strategies to course. The brain is a delicate and complex instrument, and damage may forever wipe out a lifetime of accumulated skills and memories. Labi, who is an assistant professor in UB medical school's department of rehabilitation medicine , makes the distinction between functional and neurologic recovery. It's not necessarily true , she says , that the central nervous system can 't regenerate itself: severed nerves sometimes reconnect through a process called sprouting. "lt's not always as efficient as it was before ," she says, "but even if the injured area does not recover , the brain has a lot of redundancy in it. Other parts can take over the function of the injured part. " Failing that, though, the goal is functional recovery. A patient may be paralyzed, for example, but if he can learn to PHYSICAL THERAPIST LESLIE MOREDOCK ASSISTS ROGER HOUSER. improve his memory. They also worked with him to relearn how to swallow and eat and talk. He worked painfully to regain coordination in his left hand that was impaired by the fall. He tried cooking. He passed his driver's test. Eventually, he got his life back. "I think that's one of the finest rehab centers around, " Delabio says now about the Buffalo TBl system. "Besides being great physicians and therapists, they have an empathy for the patient. They try to understand what the patient is going through. That's important." Delabio's remarkable recovery is the kind of outcome the rehabilitation teams hope for. It's not always possible, of B u a 0 p s live independently with the help of a wheelchair and maybe a part-time aide, he has made a functional recovery. "The system," Labi says, "is intended to make people as functional as they can be through excellent and cost-effective care. "It's very rewarding work," she says. "The perception of most people is that these patients are hopeless, that if they don't come out of it right away, they're never going to get better. But with good, appropriate, timely care, they do get better." Such as: {i;l The man in his 40s who was hit on the head by an 800pound weight at work. He was back on the job in six months. {i;l The patient in his late 30s who was run over by a train. 0 u m n 5 �"He pretty much broke every bone in his head," Labi notes. He, too, was recovered well enough to consider returning to work in six months. @ The lawyer in his late 20s who was in a car crash in California- back practicing law in a year-and-a-half. These cases, Labi says, are different from stroke, the other assault on the brain, because with trauma, the damage to the body is generally much more widespread. Patients come with fractures, blood clots, multiple traumas. Treating them, and rehabilitating them, means intervening early so their injuries don't snowball. "These cases are not typically one little problem you're working on," says Carolyn Teter, who administers the head trauma rehabilitation unit at Our Lady of Victory Hospital. "We're working on many problems at a time." they hadn't bargained for; they may have trouble accepting this changed person. One thing is for sure: The family will never be the same again. Richard T. Linn, Ph.D., an assistant professor in the department of rehabilitation medicine and program director of the UB Traumatic Brain Injury Rehabilitation System, says accepting what they've lost can be the most difficult part for head injury patients. "Most of these folks , when they're on the inpatient unit, are very confused and still showing quite a bit of disorientation," Linn says. "Many of them are not really ready for intensive supportive therapy. It's only when they get better and realize something of what they've lost that it really starts to sink in." Linn performs neuropsychological assessments of pa- "It's veryrewardingwork.The perception of most people 1s that these patients are hopeless, that if they don't come out of it right away, they're never going to get better. But with good, appropriate, timely care, they do get better." tients with head trauma, trying to establish a baseline level of functioning and then, later, to assess the patient's progress six months to a year after the injury. He also does some psychotherapy with these patients. "There aren't many psychologists in town who will do psychotherapy or supportive therapy for people with a brain injury," he says. "They may have memory problems, for example, and how can you do psychotherapy when they have to be reminded each time where we had progressed to? The answer is, you adapt your therapy to work more on reintegration issues: How do you get back to work? Isn't it frustrating not making as much money as you're used to? Maybe you can't drive, and that's dehumanizing. " Labi says the TBl system was conceived as a continuum of care- from the trauma intensive-care unit, through levels of in-patient rehabilitation, from acute to long-term and on to outpatient rehab. It's a system that makes sense economically as well as medically, says Glen Gresham, M.D. , professor and chairman of the medical school's department of rehabilitation medicine, and director of rehabilitation at ECMC. "For years patients were being sent out of state, all over the place, because there wasn't any coordinated system close For example, Teter says, if a patient is immobilized by his injuries, his joints can become tight and bent with muscle contractures, requiring surgery. And the whole range of skills that often is lost to a head injury takes time to relearn. That's why the TBI system employs a panoply of therapists, working as a team to decide how to work most effectively with a particular patient. They include occupational therapists, physical therapists, speech pathologists, recreational therapists , neuropsychologists, social workers, case managers and the attending physiatrist. And their work doesn't end at the hospital doors. "The shortest piece of a rehabilitation is the in-patient program," Labi says. That typically is followed by continuing outpatient therapy and monitoring. And the patient's family becomes deeply involved, whether or not he ends up living with them. Head injury happens not just to an individual, but to the family as well. The person they knew and loved may be irrevocably altered. They may have new care-giving duties B 0 0 p h s 0 u m 9 �OCCUPATIONAL THERAPIST SANDRA SEILER HELPS CHAD STUDLE Y IN THE K I TCHEN . to home," Gresham says. "It was just sort of a chaotic situation." with a lot less care on the outside. " The TBI rehabilitation system, he says, "put it all on the "We're working with the insurance companies and the basis of cooperation, so everyone could win. Particular hospigovernment to make this as efficient as possible," Labi adds. tals are guaranteed of a role; the health department (which "The financial climate in medicine with patients like this is very pays for many patients' head-injury rehab) is pleased because precarious. But our philosophy is that every patient deserves a patients are not sent out of state, which is much more costly; trial of rehabilitation regardless of their insurance source." and private insurers are pleased because they feel they can Sometimes that rehabilitation takes a turn even the best depend on the cost-effectiveness of the care, that this consortium is interested in good "The financial climate in medicine with patients like this care and not just interested in a big profit. "This is a model of regional 1s very precanous. But our philosophy 1s that every care that we're very proud of and that we think can be a model for the whole country." patient deserves a trial of rehabilitation regardless of their james A. Phillips, clinical instructor and administrator for the medical school's department of rehabilitation insurance source. " medicine, says having the Department of Health and private insurance carriers represented on the system's board of directors brings unity of therapist couldn't have predicted. Anthony Delabio, whose purpose instead of squabbling over fees. parking-lot fall put him into a coma, is back to the books at the "That's the cosmic glue that keeps things together," Phillips University at Buffalo. He had been studying environmental says. "At least we have reasons to communicate, which is not science, but now he wants to get into a different field: medicine. necessarily what's been happening elsewhere in health care. " Delabio, who lives with his parents in Niagara Falls, still He also notes , "The amount of money that we're spending has some impairment. "I get distracted easily," he says. "And in the hospital is only 20 percent of (a head-injury patient's) memory is a problem. " lifetime care cost. The real burden of care is when they leave But he's in great physical shape, having taken up body the hospital. The amount of care that the family has to give , building. He doesn't drink anymore: "I've been working so or an aide has to give , is really more substantial. We're trying hard on my rehab, I don't want to jeopardize it. " And the to make the community aware of alternatives: assisted living whole experience has changed him, not entirely for the worse. centers, for example. lf we can improve a patient's function"It's made me grow up a lot," he says. " ow I have ing by just a little bit, sometimes that means he can get by direction in my life .... I know what I want to do ." B u 0 0 p c o n u m 9 9 �TRAUMATIC BRAIN INJURY RESEARCH FOCUSES ON FUNCTIONAL OUTCOMES much care patients will need after they leave the hospital. " THE CLOSE ASSOCIATION between the medical school's Labi will report preliminary results from the study at a Department of Rehabilitation Medicine and the rehab proUB-sponsored international conference on head injury rehagrams in the Traumatic Brain Injury Rehabilitation System bilitation, to be held at iagaramakes possible some important reon-the-Lake, Ontario, in july 1996. search into an epidemic problem. • RichardT. Linn, Ph.D. , under a Two academic studies in grant from the ational Institute progress: on Disability and Rehabilitation • Dr. Maria Labi has a grant from Research , an ann of the U.S. Dethe federal Centers for Disease Conpartment of Education, is studying trol and Prevention, now entering individuals who have sustained its fourth year, to study head-injury mild head traumafor example, patients as they progress through who have lost consciousness those the rehabilitation system. Labi is for less than 30 minutes after a looking at the functional outcomes blow to the head. About 5 percent of head injury over a long period of of the people who suffer such ::1 follow-up care, and trying to idenconcussion, he says, continue to tify risk factors for complications have problems- attention deficit, from such injuries. headache, fatigue, depression , anxi"By having this regional system, etya year after the injury. by identifying all the patients comNow in the third year of the ing into the system, we've been able project, Linn is seeking a way to to collect data from the point of DR . MARIA LABI , JAMES PHILLIPS (LEFT) AND predict who will have such probimpact and follow them out for the RICHARD LINN , PH . D . (RIGHT). lems and who won't. Patients who rest of their lives," says james A. agree to participate undergo a positron emission tomography Phillips, clinical instructor and administrator for the mediscan within a couple of weeks of their injury, and Linn will cal school's Department of Rehabilitation Medicine. "That try to correlate the amount and areas of change in brain study will be a benchmark for the rest of the country. lt will function with later problems. also give back to insurance carriers information on how CUTHBERT SIMPKINS II , M.D . , {LEFT) ASSOCIATE PROFESSOR OF SURGERY AND DIRECTOR OF THE VIOLENCE AND VICTIMIZATION PROGRAM , WITH RESPIRATORY THERAPIST JOHN GUAGLIARDI . B u a 0 p h c a u m 9 9 �Michael Msall,M.D, receives 1995 Sir James Carreras Medical Award in care, clinical research, education and advocacy for children with neurodevelopmental disabilities. His efforts include team approaches, family supports and developmental interventions for children with Down's syndrome, cerebral palsy, spina bifida, congenital malformations, prematurity and related neurodevelopmental disabilities. His work was recently published in Clinical Pediatrics and the journal of Perinatology. Msall is a member of the Society for Pediatric Research. The Robert Warner Rehabilitation Center is a cooperative effort of families , rehabilitators and professional and voluntary not-for-profit community agencies, including Variety Club of Buffalo Tent #7 and The Children's Guild. The Sir james Carreras Award was established in 1986 and honors the name of Sir james Carreras, MBE, a former president of Variety Club International who still serves on its board. ichael E. Msall, M.D. , associate professor of pediatrics and rehabilitation medicine, has received the 1995 Sir james Carreras Medical Award. The award and an accompanying $10,000 prize are presented annually by Variety Club International to the physician who has done outstanding work in the field of pediatric medicine during the previous year. Msall was chosen to receive the award from among 60 physicians nominated from around the world. He is chief of the division of developmental disabilities and medical director of the Robert Warner Rehabilitation Center at The Children's Hospital of Buffalo. A UB faculty member since 1987, Msall received the award for his efforts UB medical student named to academic medicine fellowship niversity at Buffalo medical student Aisha Prim has been named an Academic Medicine Fellow by National Medical Fellowships, Inc. Prim is one of 35 minority medical students selected for the honor, funded by Bristol-Myers Squibb Co. , and established by The Commonwealth Fund, from among 90 students nominated by 58 medical schools. The $6,000 fellowship funded her participation in a summer research project at Roswell Park Cancer Institute to study how certain components of the immune response may help kill tumor cells. She worked with her mentor, Richard Bankert, V.M.D. , Ph.D., associate chief of Roswell's department of molecular immunology and professor of microbiology. Prim will present her research findings at a threeday symposium in january. Prim has received the Buffalo Urban League Youth Award and the medical school's Dean's Commendation Award for Academic Excellence. ln addition, she has received the Buffalo Foundation Award and the Special Merit Fellowship for 1993 to 1995, and is copresident of the UB Chapter of the Student ational Medical Association. Two former UB medical students , Andrea Williams, M.D. , and Yvette Vinson , M.D. , are previous recipients of the national award. -!11'1'"'--...,..------...... Michael E. Msall, M.D. B u a a p 5 c a ... u m n 9 9 �SUNY trustees namelJrouy-and-- -versrty~erecei~ed a doctorate from the , , , Umversny of Mmnesota. Hong distmgmshed professors suk Ki Hong, M.D. , Ph.D., uB professor of physiology, was named a distinguished professor in january in recognition of his reputation and contributions to research. A UB faculty member since 1975, Hong also serves as director of graduate studies in the department of physiology. Before coming to UB, he was professor and chair of physiology at the University of Hawaii. Hong's research interests lie in the areas of renal and environmental physiology. He has authored or co-authored wo School of Medicine and Biomedical Sciences faculty members have been awarded the rank of distinguished professor, the highest in the State University of ew York system, by the SUNY Board of Trustees. The rank is an order above full professorship and has three co-equal designations: distinguished professor, distinguished service professor and distinguished teaching professor. The rank of distinguished teaching professor was conferred upon Harold Brody, Ph.D., M.D., professor of anatomy and cell biology. The designation is awarded to persons who have demonstrated outstanding teaching competence at the graduate, undergraduate or professional level. Brody is a 1961 graduate of the medical school, and has been a faculty member for 40 years, serving for half of that time as chair of the department. He has done research and published widely in the field of neuroanatomy, and has served on several editorial boards, including that of Buffalo Physician. As a Fulbright scholar to Denmark in 1963, he helped establish that country's first cadaver donor program. He was one of the founding members of UB's Center for Aging and is past president of the Gerontological Society of America. He received the society's Robert W. Kleemeier Memorial Research Award for Outstanding Research in Gerontology in 1978. Brody left the anatomy department chairmanship in 1991 to continue teaching, do research and to fulfill a lifelong dream of establishing a MuseumofNeuroanatomy at UB. The museum, dedicated in january, has received national attention and is being used actively for education and research. A graduate of Western Reserve University, now Case Western Reserve Uni- B a a p nearly 190 articles for scholarly publications and more than 40 textbooks, monographs and book chapters He has earned numerous academic awards, including the Stockton Kimball Award from the medical school for excellence in research, education and service, and a special citation for distinguished service from the japanese Panel on Diving Physiology and Technology of the U.S.-japan Cooperative Program in Natural Resources. Hong received a medical degree from Yonsei University in Korea and a doctorate in physiology from the University of Rochester. 1995 Spring Clinical Day Awards given for research presentations T HIS YEAR'S FIRST- PLACE SPRING CLINICAL D AY AWARD WENT TO HANI ABDEL-NABI , M . D. , AND HIS TEAM FOR " CLINICAL APPLICA- TIONS OF W HOLE BODY PET FOG IN CANCER PATIENTS" ( R IGHT) ; SECOND PLACE WAS WON BY B IRGIT JURLANDER, M . D . AND HER TEAM FOR " CORON ARY A NGIOGRAPHY AND B IOCHEMICAL MARKERS IN UNSTABLE A NGINA PATIENTS" (BELOW) ; AND T H IRD PLACE WAS AWARDED TO H RATCH L. K ARAMANOUKIAN , M . D ., AND HIS TEAM FOR " D ECREASED P ULMONARY N ITRIC O XIDE S YNT H ASE A CTIVITY IN THE R AT M ODEL OF C DH" (R IG H T) . y 5 c a n A u u m 9 9 5 �THEN . . . . NOW Medical school enjoys rtch African-Amellcan herttage RECENT FOCUS ON UNDERREPRESENTED MINORITIES BUlL T ON A HISTORY OF_ " COLOR-BLIND" ADMISSIONS AND EDUCATION POLICIES FOR MEDICAL STUDENTS !though early records do not indicate race , it is University of Buffalo and completed his degree . clear that black students attended the University of Dorsette helped organize the ational Medical AssociaBuffalo School of Medicine before the turn tion for black physicians and was a trustee at Tuskegee of the century. Institute in Alabama, which Booker T. Washjoseph Robert Love was described ington built from a small normal school in a newspaper article about the into a nationally known institution with school's 1880 commencement as an 1,500 students. Episcopal clergyman who studied Other early black medical school medicine as "an auxiliary to his graduates include Frank L. ministerial calling," and was Watkins , who came to the Uniidentified then as the Univerversity of Buffalo from Montsity of Buffalo's first black gomery, Ala., graduated from graduate. His intention was the medical school in 1891 and "to undertake under Bishop died in Buffalo in 1921. Henry Holly of the island of Hayti, Harrison Lewis, who graduWest Indies, the introducated in 1918, was a member tions of the church in San of the university's first class Domingo ," according to in the College of Arts and the commencement arSciences before he transticle. Love's later writing ferred to the medical school. exerted an important inPerhaps best known locally was W. Yerby jones , a fluence on jamaican history, it was indicated. graduate of the medical Cornelius athaniel school's class of 1924, who Dorsette, a member of the lived in Buffalo for 50 years. class of 1882, was the second A prominent ophthalmologist, jones served as chief of African-American to receive a medical degree from UB. He was staff of the former E. ] . Meyer Memorial Hospital. BookerT. Washington's physician, and often was mentioned by WashMary B. Talbert, for whom the ington in speeches as an example of university's Talbert Hall is named , black perseverance and initiative. was a native of Ohio who graduated Born into slavery in onh Carolina , from Oberlin College in 1885 , married a Dorsette was separated from his mother at Buffalo bookkeeper and spent most of her life two months of age. He was raised by his grandin Buffalo. Active in local and national organizamother and graduated from the Hampton Institute in tions, she was chairman of the executive board and then 1878. Failing health forced him to president of the ational Association resign from the Medical College at of Colored Women , and vice president JOSEPH ROBERT LOVE Syracuse. After regaining his health of the ational Association of Colored and being rejected by the University Medical College of People. In 1922, a year before her death, she received the New York City because of his race , he came to the Springarn Medal from the AACP. 8 a 0 p c c u m n 9 �A Spoonful of he airline industry is in trouble. With utilization down , and many airlines cutting back on both personnel and flights , airline executives have looked to successful industries as models for their reorganization. Here's what might happen if airlines were run like the medical profession. Humor © Stu S i lverste i n , MANAGED CARE AIRLINES The terminal is neat and clean, the attendants courteous, the pilots capable. In the event of an emergency landing, M . D . HMO AIRLINES Passengers arrive eight hours before their flight after calling an "advice reservation desk" and then carry their seats out on the tarmac. They then take seats to the middle of the plane and flap their arms and hum "Anchors Aweigh. " Film: "Any Which Way But Up. " MEDICARE AIRLINES PEDIATRIC AIR They have the largest budget. Nobody can find the airport. There are three committees working around the clock to figure out how to make the airport more accessible. Problem is, the committee can't find the airport either. All seats will be first class, as soon as the seats are installed. Passengers walk out onto the runway, a short man with a bow tie hands them stickers in between answering advice calls and running to the back to help deliver the food . Every first-class seat is next to a colicky infant and breastfeeding mother. The movie: "Sophie's Choice: Augmentim" Complimentary drink : Pediatri c cocktail: amoxicillin and jack Daniels. PSYCHIATRY AIR First-class seats are couches. Coach passengers break up into small discussion groups. Flight destination is "wherever you want to go." Midway through the flight the pilot announces "I am experiencing some turbulence, but we aren't here to discuss me." The movie: "julia Child: Cooking with Lithium." SURGERY AIRWAYS The cashiers, flight attendants and pilots all wear shower caps and shoecovers, even though the flight isn't a sterile environment. Midwa y through the flight a steering wheel and earphone piece are thrown out of the cockpit, and you hear the pilot admonishing the crew, that "these aren't the ones I iike to use. " Th e movie: "A Broviac Runs Through It" The meal: Nobody has ever eaten it. B a a p h the pilot has to call an 800 number to get approval to lower the oxygen masks. They also have a fleet of Lear jets for the CEO of the airline. The crews receive lucrative incentives for talking passengers out of flying at all. s c a Stu Silverstein , M.D., pres ident of Standup Medicine Seminars of San Francisco, California, and Stamford, Connecticut , lect ures nationwide on humor and medicin e. He is also co-author of What About Me?, a booh on growing up with a develop- mentally di sabled sibling. u m n 5 �Fierro '66, inspiration for fictional, best seller M.E. AS THE REAL-LIFE VIRGINIA CHIEF MEDICAL EXAMINER , MARCELLA FARINELLI FIERRO SEES HER ROLE IN THE " KAY SCARPETTA" MYSTERIES AS "GREAT FUN" r. Kay Scarpetta and Dr. Marcella modest about her role as the model for Farinelli Fierro '66 are both bril- Kay Scarpetta. She is also quick to liant medical detectives, forensic point out that she doesn't physically pathologists who are among the resemble the fictional medical exambest in the business at unlocking iner. ''I'm definitely not 105 pounds the secrets of the dead and letting and five feet tall with blue eyes," she them tell the tales of how they lived and died. The fictional Dr. Scarpetta has gained worldwide fame as the heroine of Patricia Cornwell's best-selling mysteries. The latest, From Potter's Field, follows Scarpetta from Virginia, where she is chief medical examiner for the Commonwealth of Virginia, to ew York, where she confronts her principal adversary, psychopathic killer Temple Gault. While Scarpetta is fictional , she is, according to Cornwell, based on her mentor, Marcella Fierro, who is the real-life Virginia chief medical examiner. "1 consider her the best forensic pathologist in the world, and she has been a tremendous inspiration to me. " During an interview promoting her new book, Cornwell told a national audience how sur- Dr. Marcella Farinelli Fierro '66 prised she had been to discover a woman serving as a medical examiner says with a laugh. when she walked into the M.E.'s office She also doesn' t followthe lifestyle 10 years ago. Cornwell, a former news- of Scarpetta, who is divorced and enpaper reporter, ended up spending five joys affairs with FBI agents. Fierro and years working as a technical writer in her physician husband have two chilFierro's office and researching the op- dren , neither of whom is following erations of a real-life morgue for her their parents' medical career path, almurder mysteries. though their son is in law school and Fierro considers her role in the best- is interested in criminal law. Their selling mystery books "great fun" and is daughter is a legislative assistant to a s u 0 0 p h 5 o n A orth Carolina congresswoman. Fierro and Cornwell have become close friends, and she remains one of Cornwell's chief advisors, reading every manuscript for factual errors. Growing up in Buffalo, where she attended D'Youville College and the University of Buffalo School of Medicine and Biomedical Sciences, Fierro never dreamed of serving as a mystery book heroine , or even working as a pathologist. "While in medical school 1 was very interested in internal medicine, but once I did my pathology rotation I found this area of medicine fascinating," she recalls. "I was also inspired by the late Dr. Judith Lehotay (formerly Erie County's chief medical examiner), who was one of the first female forensic medical examiners." After medical school graduation in 1966, Fierro did her internship and additional training in Ottawa, Canada's capital, where her husband , Robert, was in training as an obstetrician-gynecologist. She had two more years of pathology training at the Cleveland Clinic, and another year of forensic pathology training at the Medical College of Virginia. She was certified in fo rensic pathology by the American Board of Pathology in 1975, becoming just the ninth woman certified by the ABP in forensic pathology. She served as Deputy Chief Medical Examiner for Central Virginia u m n 9 �············································· · ·········································· ~ for 17 years, followed by 18 months association's board of directors and as professor of pathology at East the executive committee. Fierro is a Carolina University School of Medi- fellow of the pathology-biology seccine, where she taught general and tion of the American Academy of Foforensic pathology. In 1994, Fierro rensic Sciences. She has also served as returned to Virginia to assume her a consultant to the FBI and on a panel current positions as chief medical studying gunshot wounds. She has examiner and chair of the depart- been published in professional jourment of legal medicine for the Com- nals and contributed chapters to sevmonwealth of Virginia, and profes- eral books, and is currently editing sor of pathology at the Medical Col- the second edition of a text on identification for the College lege of Virginia. of American "Forensic Patholopathologists. gists are reAlthough ally medical detectives an~M~nr a l1 o f who are helpcases ining the living volve dead by uncoverpeople, she is ing the causes philosophical of death," she about her work. explained. "lt all "There are a depends on million ways your focus. to look at difWithout the ferent cases, information and this field we have requires crelearn ed your focus. Without the ative thinkthrough paing and is information we have learned thology , for never borinstance, we ing." for through pathology, would never Testifying know what in criminal instance, we would never we know tocases is an day about important know what we know today child abuse part of a foand how to rensic about child abuse and how to recognize pathologthe signs of ist's job, and recognize the signs of abuse." abuse. We Fierro enjoys are saving the experi1 i v e s ence. through our work and that helps "I regard the court time as an opporus. We also owe it to the dead tunity to teach, to instruct the court," to find the cause of death and she explained. discover the killer in case of She is past president of the National Association of Medical Examin- homicide . " ers and presently serves on the - s v o E a o R A H w 1 L L 1 A M s B a 0 p h y s c a n A • Stephen Kimatian '92,is 1994 Air Force Flight Surgeon of the Year tephen]. Kimatian, M.D. '92, has been named 1994 Air Force Flight Surgeon of the Year. Kimatian, a flight surgeon with the 16th Operations Medical Flight, 16th Operations Group, at Hurlburt Field, Florida, competed against representatives from nine other major air commands to win the annual competition for the Malcolm C. Grow Award. Last year, Kimatian spent 189 days supporting joint special and national security operations in Bosnia, Somalia and Haiti. Kimatian was the first medical officer to reach the scene when an Air Force AC-l30H gunship crashed in the Indian Ocean in March. After triagingand treating the survivors, and transporting them to a avy vessel for further treatment, Kimatian returned to the crash site to coordinate mortuary affairs and collect information as part of the interim accident investigation board. Before activation of the 16th Operations Medical Flight, Kimatian evaluated the contents of medical rucksacks and medical Rapid Response Development Kits used during deployments. He served as a clinical instructor for medical technicians, advanced cardiac life support instructor and clinical advisor to joint medical planners preparing for training. Kimatian entered the Air Force after his graduation from the School of Medicine and Biomedical Sciences in 1992. He completed his internship at Wilford Hall Medical Center, Lack land Air Force Base, Texas; the USAF Hyperbaric Medicine Course, Global Medicine Course, Brooks Air Force Base; and Combat Casualty Care Course, Camp Bullis, Texas. He served with the 55th Special Operations Squadron at Hurlburt Field until activation of the 16th Medical Operations Flight in October 1994. u m n 9 �Arthur J. Schaefer, M.D. '47,wins Lucien Howe Award from 1954 to 1956 as chief of ophthalmology at hospitals in Korea and japan. He was named technical advisor to japan's first eye bank in 1955. A specialist in ophthalmic plastic and reconstructive surgery, Schaefer has maintained a private practice in Snyder since 1959. He has been a member of the medical school's teaching staff since 1952, and is a clinical professor of ophthalmology and a clinical assistant professor of otolaryngology. Schaefer has published widely in professional journals, and has been an invited guest lecturer in the United States and abroad. Active in professional organizations, he is past president of the American Society of Ophthalmic Plastic and Reconstructive Surgery. He is a fellow of the American College of Surgeons, the American Society of Ophthalmic Plastic and Reconstructive Surgery, the American Academy of Ophthalmology and the European Society of Ophthalmic Plastic and Reconstructive Surgery. In 1989, he was elected chairman of the advisory board of the American Society of Ophthalmic Plastic and Reconstructive Surgery. He has been a member of the editorial board of the journal Ophthalmic Plastic and Reconstructive Surgery since 1985. rthur J Schaefer, M.D. '47, anationally known ophthalmic plastic and reconstructive surgeon, has received the Lucien Howe Award for contributions to the field of ophthalmology. The award is presented jointly by the School of Medicine and Biomedical Sciences and the Buffalo Ophthalmology Society. Recipients are selected by a national committee. The award was first made in 1928 to Dr. Edmund B. Spaeth, director of ophthalmology at the Wills Eye Institute in Philadelphia. Schaefer is the 22nd recipient of the prestigious award, and the first Buffalonian. He received the award, a specially cast gold medal, in ceremonies held this past spring. Howe was a pioneering oph- Arthur J. Schaefer, M.D. thalmologist and researcher who practiced in Buffalo in the late 19th and early 20th centuries, and was a member of the UB medical school faculty. In 1926, he founded the Howe Laboratory of Ophthalmology at Harvard Medical School, known worldwide for its research. Schaefer graduated from Canisius College, took his medical internship and ophthalmology residency in Buffalo hospitals, and has spent most of his career in Western New York. He started the oculoplastic, lacrimal, orbital and reconstructive surgical clinic and service at the former E. j. Meyer Memorial Hospital in 1961. The service was the medical school's first subspecialty clinic. Schaefer served in the U.S. Army B u a a Paulette Smart '92,wins AMAI Burroughs-Welcome award aulette A. Smart, M.D. '92, has received the 1995 American Medical Association/Burroughs-Welcome Leadership Award for leadership in community service. A third-year resident in physical medicine at Ohio State University Medical Center when the award was made, she was one of 40 residents and fellows selected for the honor that allows them to participate in the Ameri- p h y s c a n ll. can Medical Association meetings for resident physicians. One of Smart's goals is to be a mentor to young people. She was active in the Big Brother/Big Sister program when she was a student at Pace University in Pleasantville, N.Y. , where she received her bachelor's degree in 1988. While in medical school, she taught physics on weekends to gifted high school students, and participated in musical groups that performed in nursing homes and children's units. She also spent five weeks in jamaica, West Indies, providing medical services to the less fortunate. Smart joined other resident physicians in session at the AMA's annual meeting in Chicago last june. She will also attend the group's interim meeting in Washington, D.C., in December. Seibel '66,honored for years of work at ECMC'strauma center he Erie County Medical Center Lifeline Foundation recently honored Roger W . Seibel, M.D. '66, at the foundation's annual black tie dinner dance. Seibel is ECMC's clinical director for the department of surgery and also serves as director of trauma services and the burn treatment center. Seibel, affiliated with the medical center since 1973, was influential in the establishment of one of the first trauma units in the country there. In 1989, the New York State Department of Health recognized the unit as the regional adult trauma center for the eight-county Western New York area. The unit treats over 1,600 trauma cases annually. Since 1989, Seibel has also been director of Western New York's regional burn treatment center at ECMC- the only one of its kind between Pittsburgh and Rochester. Seibel is a clinical professor of surgery u u m n 9 9 5 �and clinical associateprofessor of orthopaedics. He has published chapters in several books and authored articles in refereed journals. His article, "Blunt Multiple Roger W. Seibel, M.D. Trauma, Femur Traction and the Pulmonary Failure-Septic State," changed the way trauma patients are cared for. A 1966 graduate of the School of Medicine and Biomedical Sciences, Seibel began his residency program at the former E.j. Meyer Memorial Hospital in 1967, and was drafted by the United States Air Force in 1968. After a year in Texas and a year in Vietnam, he returned to Buffalo in 1970 to complete his residency. Franklin Zeplowitz '58, chief of staff and medical director of Our Lady of Victory Hospital, was honored recently for his distinguished service by hospital president and CEO Albert Candino (far left), chairman of the board, and retired Bishop of the Catholic Diocese of WNY Edward Head (center) and Bishop Robert C. Wurtz (far right). Irene Snow '80,among alumni elected to medical society posts The third woman physician to head the were Russell W. Bessette , M.D. , D.D.S. organization since its founding in 1821, ' 76 , president-elect; Franklin she succeeds David Scamurra, M.D. Zeplowitz , M.D. '58 , vice president; edraj. Harrison, M.D. '77 , secretaryeveral alumni of the School ofMedi- Snow is a diplomate of the American cine and Biomedical Sciences have Board of Internal Medicine, and is cer- treasurer. been elected officers of the Medical tified by the National Board of Medical Examiners. Society of the County of Erie. As a member of the county medical Irene S. Snow, M.D. '80 , clinisociety, she has served as president cal associate professor and chief elect, vice president, secretary-treaof general medicine for Buffalo Medical Group , was installed as president at the surer and as chair of the group's pubargaret Paroski , M.D. '80 , society's annual meeting held in June. lic health committee. She is also a president of the Medical member of the Alumni Association, has been Medical Society of elected a vice president of the State of ew Erie County Medical Center's York, the American lifeline Foundation , a notMedical Association, the American for-profit corporation that raises e sure to set aside time to celebrate the Sesquicentennial at Spring Clinical Day, May College of Physi- funds to develop programs and encians and the hance patient care at the medical 11 , 1996. Sherwin B. uland , M.D., author of "How Women Physicians center. Paroski is clinical director ofECMC's We Die ," will deliver the annual StocktonAssociation. department of neurology and an associAlso elected to Kimball lecture. ate professor of neurology. one-year terms Paroski '80,named vice president of ECMC'sLifeline Foundation Mark Your Calendars B a 0 p y s c a 1>. u m n �• ······ · · ····· ·········· ···· · · ····· ··· ··················· ····· · ··· ·· ····· ······· ···· ····· Sesquicentennial Reunion Weekend set EXT YEAR 'S REUNION WEEKEND AND SPRING CLINICAL DAY WILL COINCIDE WITH THE CELEBRATION OF THE MEDICAL SCHOOL'S SESQUICENTENNIAL ANNIVERSARY , WITH REUNION CELEBRATIONS ON FRIDAY , MAY 10 , AND THE STOCKTON KIMBALL LECTURE ON FOUNDERS' DAY , SATURDAY , MAY 11 . HAROLD J. LEVY, M.D. '46 Al ROWE, M.D. '46 MARVIN PLESKOW, M.D. '51 AllEN GOLDFARB, M.D. '51 JOSEPH KUNZ, M.D. '56 JOHN HODSON, M.D. '56 ROBERT REISMAN, M.D. '56 MIKE COHEN, M.D. '61 JARED BARLOW, M.D. '66 JOEL PAUll, M.D. '71 DENNIS NADLER, M.D. '71 JOHN BODKIN, M.D. '7 6 STANLEY BUKOWSKI, M.D. '81 BRIAN SAME, M.D. '81 PANO YERACARIS, M.D. '81 SANFORD LEVY, M.D. '86 PAUL HOLMWOOD, M.D. '86 SUSAN llnLER, M.D. '91 B 0 0 p h s o n m 9 9 �CLASS OF 1 946 CLASS OF 1981 CLASS OF 1 966 "Fifty years and still going strong! join us and celebrate. So many memories to share! " Harold J. levy "We would like to see you all back for the 30th reunion. Looking forward to reminiscing, renewing friendships and the fellowship. Please join us. " Chairman Jerry Barlow AI Rowe Chairman "It's been a rapid 15 years. Let's get together and try to catch up. Hope to see you in May '96! " CLASS OF 1 971 CLASS OF 1 951 Morv Pleskow Chairman AI Goldfarb Co-Chairman CLASS OF 1956 Stanley Bukowski Co-Chairman Co-Chairman "Can you believe it? Forty-five years! Our class reunion- May l l , 1996. Please, reserve this weekend! It's too important to pass up. It will be great fun to become reacquainted , renew old friendships, and enjoy the warm companionship we shared in the past. Do your best to join together for this very special celebration! " "Why wait five more years7 Come to Buffalo in the spring and relax with a few choice classmates! " "After 25 years it will be great to see one another. Looking forward to our Silver Reunion! " Brion Some Co-Chairman "Enough time has passed so that at least some of us will have grown up! Hope that as many as possible will be able to come and that all are well. " Joel Poull Co-Chairman Dennis Nadler Co-Chairman Pono Yerocoris Co-Chairman CLASS OF 1 976 "Class of 1976- can you believe 20 years have gone by?! Come back to your medical beginnings. There will be only one 20th-year reunion. Don't miss it! " "Come back and see how the medical school has changed and how all of us have changed in 10 years. " John Bodkin Sanford Levy Chairman Co-Chairman CLASS OF 1 986 "Forty years! It is time to celebrate! " Andrew Gage Paul Holmwood Joseph Kunz Co-Chairman Co-Chairman Co-Chairman John Hodson CLASS OF 1 991 Co-Chairman Robert Reisman "It's hard to believe that five years have passed since medical school and that some of us are still residents! I am looking forward to seeing all of you for a little wine , a few stories, laughs and baby pictures. " Co-Chairman CLASS OF 1961 "Set aside the time and help us celebrate the Sesquicentennial at the school and our 35th reunion in Buffalo, the weekend of May 10, 1996. " Susan littler Chairperson Mike Cohen Chairman Ed Manning Co-Chairman B u 0 0 p 5 a A u m �1995 Alumni Achievement Awards made IVE MEDICAL SCHOOL ALUMNI WERE THE RECIPIENTS OF THIS YEAR ' S ALUMNI ACHIEVEMENT AWARDS . ALL PICTURED WITH OUTGOING ALUMNI ASSOCIATION PRESIDENT RUSSELL BESSETTE '76 ARE : AT TOP LEFT , HARRY METCALF ' 60 ; AT BOTTOM LEFT , THOMAS GUTTUSO ' 60 ; AT TOP RIGHT , ROLAND AND SIDNEY ANTHONE '50 ; AND AT BOTTOM RIGHT , NORMAN CHASSIN ' 45 . HURWITZ & FiNE, P.C. I ATTORNEYS AT LAW I SERVICING THE LEGAL NEEDS OF THE HEALTH SCIENCES COMMUNITY Managed Care • Purchase&SaleofPractices • Business&Tax.Planning • HCFASafeHarborRegulations and Physician Self-Referrals • Contracts with Private & Public Entities • Employee Relations Counseling • Fringe Benefit Programs • Representation Before Government Agencies on Audit & Business Issues • Facility Finance and Construction • Credentialing and By-Laws • Hospital/Medical Staff Issues Please contact Robert P. Fine or Lawrence M. Ross at 716-849-8900 1300 Liberty Building • Buffalo, New York B 0 0 p h s c 0 m �Harold Brody, M.D. '61, professor of anatomy and cell biology and former chair of the department, received the 199S Distinguished Medical Alumnus Award from John Naughton, M.D., vice president of clinical affairs and dean of the School of Medicine and Biomedical Sciences. The award, a specially designed crystal bison, was presented at a dinner honoring Brody in October. ~niuersit~ at ~uffalo meaical ~lumni ~irector~ UNIVERSITY AT BUFFALO 1 B-MONTH SES~UICENTENNIAL C: DESK CALENDAR TIIE 1996 Universily al Buffalo Medical elebrate 150 years of tradition with the University at Buffalo 18-Month esguicentennial Desk Calendar, an elegantly designed calendar featuring illustrations culled fi·om University Archives. Each month's images-selected for their Alumni Directory has officially been released! character and umguenesschronicle UB's history. The calendar comes with a custommade lucite holder and stand, and is gift boxed. Medical Alumni. Dislribulion has already begun for Since Lhis is our Sesquicenlennial Edilion, you won'L want Lo miss oui. It is not too late to order your own copy of the directory. This comprehensive new volume is a compJation of tbe mosl current data avaJable on over 5,300 Lhose who reserved dreir copies early. If you wish to place an order or have any queslions about tbe directory, please contact our publisber directly at the (allowing address: CUSTOMER SERVIC E D E PARTMENT B E RN A RD C . HARRIS PUBLISHING Co., INC. 22 KO GE R C E NT E R NOR F OLK , VA To order, please call Stella Ryndak at (716) 645-6969. B u a a 23502 Or call t/1e Customer Service Department toll /ree at 1-800-877-6554 p h y 5 a n A u m n 9 �SPRING CLINICAL DAY Spring Clinical Day and Reunion Weekend '95 EDICAL SCHOOL ALUMNI AND OFFICIALS GATHERED AT THE BUFFALO MARRIOTT FOR THIS YEAR' S SUCCESSFUL SPRING CLINICAL DAY , FEATURING STOCKTON KIMBALL LECTURER RICHARD KRUGMAN , M . D . �AND REUNION WEEKEND REUNION CLASSES FROM THE PAST 50 YEARS CELEBRATED IN GRAND STYLE AS THESE PICTURES CLEARLY DEPICT . �• ················ · ·········· · ········ · ··· · ·········· · ······················ · ··········· · ··· . I November. In ad- 19505 E D W A R D of SHANBROM '51 , Santa Ana, California, received an honorary doctor of science degree from Allegheny College. THOMAS HAMILTON elected president of the Buffalo on March 8, 1995. He joins his Surgical Society and secretary- sister, Leah, 4 , and brother Paul, establishing an an- treasurer of the Medical Society 2 1/2. nual award in his name to honor fu- of the County of Erie. She also recently became a partner in the ture leaders in the formation of Delaware Surgical field of palliative Group, P.C.,agroupoffivegen- pain and symptom eral surgeons working at Millard WILBUR '69 , South and South west and Who's Who in the World. 6 9 IRVING KOLIN '65 , 0 5 of Winter Park, Florida, was invited to the and named professor of pediatrics and radiology and interim chair of radiology at the University of Iowa. He has six children and one grandchild. Governor's Institute in North Carolina to present recent re- 7 9 0 5 naltrexone in the treatment of alcoholism. Dr. Kolin also spoke at Duke University's department of psychiatry, where he addressed the topic of neurotransmitter systems and the use of medication in the treatment of alcoholism. JOAN G lAM POLl '90 and CRAI G were recently wed NARINS '90, in Scarsdale, New York. Or. Giampoli completed her resi- 8 9 0 DAVIDS . K OU NTZ '81 , 5 ofPhila- Strong Memorial Hospital, in ew York, where she Rochester, delphia, has moved from was chief resident in pathology. Hahnemann University Hospital to Temple University as asso- She is a fellow in surgical pathology and cytology at Strong. Dr. ciate professor of medicine and arins completed his residency director of ambulatory care at Duke University Hospital in there. He has two sons, David, 4, Durham, and Matthew, 18 months. cardiology fellow at Strong. SH I RA R UBINSTEIN '85 , search findings on the use of 5 dency at Vanderbilt Medical Center in ashville, Tennessee, and of Iowa City, tion of University Radiologists, 0 Fillmore Health System and St. SM I TH elected president of the Associa- 9 9 joseph Hospital. Iowa, has been new edition of Who's Who in the third child, Michael Nicholas, oring Dr. Milch by II ' 57 , oflasVegas,Nevada, Marvin A. McMillen '75 has been listed in the has been dition, CHI is hon- management. P . NEDRA HARR ISON '77 , directs orth Carolina. He is a R OSALIND N OLAN S U LAIMAN married of the Child and Adolescent Out- '91 , Wrentham, Massachusetts, has patient Psychiatry Clinic at M . D ., been appointed chief of internal Georgetown University, Wash- cember 1994. She is expecting a medicine at the Rehabilitation ington , D.C. She will present a baby this December. She is com- Hospital of Rhode Island. Or. paper at the American Academy pleting her med-peds residency at Sgalia currently practices inter- of Child and Ado- Baylor this year; her nal medicine and cardiology in lescent Psychiatry's husband is finish- Hopedale, Massachusetts. He has annual meeting in ing his ID fellow- A RTH UR C . S G A LI A '73 , A D E L S U LAIMAN , (Georgetown '90) in De- medical served on the faculty of the Uni- ew Orleans. She ship. They plan to director ofHospice Buffalo, clini- versity of Massachusetts Medi- cal professor of surgery and ad- cal School since 1978. writes that she and her husband love where his father is ROBERT A . M I LCH '68 , Washington, D.C. Elaine Ziavras '85, ambassador, for a has been named chief of surgery of she adds, is in the settling, probably Michael Reese Hospital in Chi- Georgetown on the East Coast. cago, Illinois, and professor of ophthalmology surgery and physiology at the department. junct clinical professor of family medicine at UB's School ofMedicine and Biomedical Sciences, has recently been named therecipient of the prestigious Award for Lifetime Achievement from Children's Hospice Interna- practice in Oman, MAR V IN A . M C M ILLE N '75, University of Illinois at Chicago. few years before NAVY L T. PAUL D . Rosalind Nolan Sulaiman '91 S EE MAN '93 , is currently halfway He has been program director in J EFFREY surgery at the Yale Affiliated Pro- STEI NIG '88 , commitment to children's hospice care. The award will be pre- gram at Bridgeport Hospital, director of the surgical intensive York, has completed a surgery ment to the Mediterranean and residency in Savannah , Georgia, Adriatic seas and has been serv- sented at a banquet during the care unit at the West Haven and is now a partner with ing off the coast of Bosnia- tional. Dr. Milch was recognized for his personal contribution and P . of Lancaster , New through a six-month deploy- 1995 CHI National Conference OVAMC and clinical associate South towns Surgical Associates. Herzegovina aboard the dock held in Washington, D.C. , in professor of surgery at Yale for He and his wife, Maria, had their landing ship USS Gunston Hall. the past eight years. B u a 0 p y a n m n 9 �The jury is out. Your practice and assets are on the line. This is not the time to be second-guessing your choice of professional liability insurance companies. In a similar situation, a MLMIC policyholder remains confident, knowing he or she is protected by a company that already has successfully defended more physicians than all other available insurers combined. Adding t,o the value of your MLMIC policy is one of the country's largest and most experienced professional liability Claims Departments, as well as the largest Risk Management Department of any professional liability insurer in the state. MLMIC also offers New York's only true peer review of claims experience. Only physician-owned and controlled MLMIC offers this high level of quality assurance and service. MLMIC also is the only medical liability insurer approved by the Medical Society of the State of New York. Find out more about the protection you'll receive from the 2 Park Avenue New York. NY 10016 2 Clinton Square Syracuse. NY 13202 90 Merrick Avenue E. Meadow. NY 11554 largest and most successful company of its kind in America. Call1-800-356-4056 in Upstate New York, or 1-800-ASK-MLMIC in the New York metropolitan area. Our defense never rests. Cl1994 M.-:d1call ab ty Mutulll lt1!:11Jrance Company �Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No . 311 BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED PLANTING A TREE UNDER WHICH You WILL NEVER Srr DR. DEVILLO W. HARRINGTON, class of 1871, knew how to make his money grow. In fact, this man who in 1905 provided $5,000 through his will for the University at Buffalo School of Medicine, is still supporting UB today through the endowment his bequest created. THIS PERMANENT endowment in Dr. Harrington's name has grown to over $300,000 and today it supports the famous Harrington Lecture Series, which twice a year brings distinguished scientific speakers to the School of Medicine and Biomedical Sciences. DR. HARRINGTON'S LEGACY to UB is just one of many bequests which have established permanent and important endowed funds at the school. They enable UB to provide scholarships to outstanding students, enhance scientific research, support excellence in teaching and meet the ever-changing needs of the school. YOU TOO can provide the School of Medicine with a measure of permanence through a bequest. Proper estate planning helps you develop a smart financial plan. A charitable bequest provides the satisfaction that comes from planting a tree under which you will never sit, but which will bear fruit for generations to come. FOR A CONFIDENTIAL consultation on making a bequest to the UB School of Medicine and Biomedical Sciences, or to receive materials to share with your attorney or estate planning advisor, please contact: STEPHEN A. EBSARY, JR. Assistant Dean and Director of Development, School of Medicine and Biomedical Sciences UNIVERSITY AT BUFFALO UNIVERSITY AT BUFFALO SCHOOL OF MEDICINE 150 V£AAS (716) 829-2773 ��SCHOOL OF BUFFALO MEDICINE AND PHYSICIAN CLASS OF 1 999 · BIOMEDICAL • �RENEE ABDERHALDEN BETTINA ACKERMANN DANIEL ALEXANDER MARTHA ALIWALAS University of New Hmnpshire Biochemistry Johns Hopkins University Biology University at Buffalo English Cornell University Biology MICHAEL AMENT .JOYCE ANDERSON LYNN-MARIE ARONICA .JORGE ARZOLA, .JR. Princeton University English University at Buffalo Anthrop:Jlogy University of Pennsylvania Biological Basis of Behavior University of Rochester Biology/ Psychology ROBERT BAIOCCHI LISA BALDUF FAYYAZ BARODAWALA University at Buffalo Biology Case Western Reserve University Colgate University Molecular Biology/ Economics STEPHANIE BABCOCK Hamilton College Biology Biomedical Engineering TODD BATTAGLIA KURT BENHAM ROBERT BENSON FLORENCE BERO Amherst College Psychology Rochester Institute of Technology Electrical Engineering Brighmn Young University Japanese Oarkson University Chemical Engineering ... 3 �SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES THOMAS BLACK .JASON BORTON WILLIAM BREEN DEIORE BROWN University of Michigan Cellular and Molecular Biology Niagara University Biology University at Buffalo Biology Canisius College Psychology SUZANNE BURKE BRIAN CAMBI CHRISTOPHER CARLSON ALBERT CHU St. John's University William and Mary College Biology SUNY College at Geneseo Biology Johns Hopkins University PATRICK D'ABBRACCI CHANTELL DALPE PATRICIA DANAHER Carusius College Biology Cornell University Industrial and Labor Relations Dartmouth College Psychology St. John Fisher College Biology ANN DENARDIN ANDREA DE ROSAS MELISSA DIIANNI ANDRE DICK Marist College University of Rochester Physics/Astronomy University at Buffalo Biology University at Buffalo Biochemical Pharmacology Medicine Public Health THOMAS CUMBO Biology ... 4 s �OF 1999 MICHAEL DOCHERTY BRIAN DUFFY NADINE DUHAN PHILIP EHRLICH Cornell University Biology Johns Hopkins University Biology University of Notre Dame Biology Duke University B1ology SUSAN ESPOSITO DOUGLAS EVANS ANDREW FAGELMAN TANYA FALKOWSKI Brown University Brain and Behavior SUNY at Binghamton Biology Muhlenberg College Natural Science Canisius College Biology BARBARA FARE VICTOR FILADORA II OREN FIX JAMES FLAHERTY SUNY at Binghamton Psychobiology Cornell University Biological Sciences University of Notre Dame JOHN FO.JTIK KAREN FOTI NATASHA FRANGOPOULOS ERIC FUNG Rensselaer Polytechnic Institute Biology Rochester Institute of TechnologyI University at Buffalo Photography/ Social Science Cornell University Hwnan Development; Family Studies Harvard University Biochemistry Cornell University Biology and Society • 5 Mathematics �SCHOOL OF MEDICINE KAREN GERBER .JENNIFER GRIFFITH Rochester Institute of Technology Biotechnology Cornell University Nutrition AND BIOMEDICAL .JOHN HANNIBAL IV University at Buffalo Biology SCIENCES s MOLLY HARRINGTON Cornell University Biochemistry , COREY HARRISON Allegheny College Chemistry MALCOLM HEAGLE LISA HAZARD II St. Lawrence University Biology Dartmouth College Biology BRANDY HELMINIAK SUNY College at Genesee Biology \ .J. CRAIG HENRY RENEE HERNANDEZ KEITH HERR .JONATHAN HERSHBERGER Houghton College Humanities Fordham University Chemistry University at Buffalo Biochemistry University of Rochester Biology/ Philosophy STEPHEN HESS ARAM HEZEL KELLY HOLES SHANNON HOWE Wake Forest University Biology Vassar College English Niagara University Biology University at Buffalo Biochemistry .... 6 �OF 1999 HARUKA ITAKURA AMY .JONES Cornell Uruversity Biology Stanford University Biology University of Rochester Neuroscience EDWARD KIM WON HEE KIM KRISTINE KLEIN MARGARET LAFFERTY SUNY at Cortland History/ Biology University ay Buffalo CheiTilStry St. Lawrence College Biology St. John Fisher College Biology WAYNE HWANG Johns Hopkins Biology LEENA ISAC \ Du LAM KAREN LEE HENRY LEE Harvard University Psychology SANDRA LEE Barnard College Psychology Columbia College Mathematics Uruvers1ty at Buffalo Biology .JUDI LETTMAN .JONATHAN LEVINE TINGTING Ll MICHAEL LIOUDIS Cornell University B1ology New York University Biology University of Rochester B1ology University at Buffalo Biology ... 7 �OF SCHOOL MEDICINE AND BIOMEDICAL SCIENCES I MICHAEL LIPKE STEFAN LUCAS PATRICIA LUGAR KELLY MARONEY SUNY at Binghamton Biology University of Michigan/ University at Buffalo Chemical Engineering/ Biophysics University at Buffalo Anthropology University of Rochester Health and Society BRETT MASCIA TALIA MCNAMARA CARRI - ANN MEGARGEL MICHAEL MELMAN University at Buffalo Biochemistry University at Buffalo Biology Lehigh University Behavioral Neuroscience Cornell University Biology DANIELE MERLIS SUSAN MILLER KATHRYN MONTGOMERY AMY MORROW Bowdoin College Biochemistry University at Buffalo Psychology Boston University Mathematics Smith College Chemistry KHADER MUl:;)TADIR ELANA NAPOLITANO HEIDI NARINS .JEFFREY NECHLEBA University at Buffalo Biological Sciences St. Johns Uruversity Biology Williams College Chemistry Yale University Economics A 8 s �OF 1999 DANIEL NOSEK University of Rochester Electrical Engineering .JOY NWACHUKWU Canisius College Biology MICHAEL O'BRIEN CHARLIE PAN Stonehill College Biology Massachusetts Institute of Technology Electrical Engineering/ Biology NATESH PARASHURAMA PARAG PARIKH RUPAL PATEL DAVID PAWLOWSKI Massachusetts Institute University at Buffalo Biology/ Political Science University at Buffalo Anthropology University at Buffalo Biochemistry ELIZABETH PELTON DANIEL PERREGAUX STEPHEN PRZYNOSCH Wheaton College Chemistry Middlebury College Biology/ Psychology Cornell University Biology MARY ROSE PUTHIYAMADAM MICHAEL RAUH MICHAEL REMINGTON KEVIN ROBILLARD University at Buffalo Early Childhood/ Health Sciences St. Bonaventure University Biochemistry University at Buffalo Biochemical Pharmacology Cornell University Natural Resources of Technology Chemical Engineering AMY PECK Wheaton College Biology ... g �SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES CHARLES ROCHE ARI RUBENFELD SAMUEL S' DOIA AHLAM SALEH University at Buffalo Biochemistry/ Pharmacology Cornell University Biological Sciences University at Buffalo Biophysics Ccmisius College Biology ANTHONY SANTILLI KIM SCHINDLER MARSILIA SEIWELL STEPHEN SELKIRK SUNY at Allxmy Mathematics Cornell University Biochemistry SUNY at Binghamton Biology Boston University Psychology ELLYN SELLERS SONIA SHAH SHAMS SHEIKH GREGORY SHIPKEY Hartwick College Biology Williams College Biology University of Rochester Chemical Engineering Canisius College Biology NATALIE SIKKA .JENNY SPERANZA BRIAN STOUT RENEE TAEFI Cornell University Human Development and Family Studies Rochester Institute of Technology Biology University at Buffalo Biological Sciences Ithaca College Physical Therapy .A 10 s �9 IVAI University at Buffalo Biology KA~HERINE TIMOSZ Cornell University Biology Lt EBNER ER A ~A. E A~ MYW AS Cornell University BiologJcal Sciences Boston University B1ology v T Uruversity at Buffalo Pharmacy and Pharmaceutics Tufts University International Relations z Hofstra University Cherrustry Individuals Not Pictured University of Pennsylvania History • H -Y Brown University Blomedical Engineering R C UE 0 1A Cornell University Anthmpology R AN University at Buffalo Biology �:c - . . ~ _L . - _A - S - -_ . - S . . - ~. , 0 .. -· - -- . - - - F . -__ ·_ _ --- - -- -_, . - - -· .....,.___ "- ~ ---- -------- - -. ...-~ ---- __.,.,.. :-_:-9=_-_:-__:~--=-~-9_::-_- ~; __-=:~_:g_-_-: ·: -------- ..... - · - -- ~-- ------ -~J � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1995 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1995-Autumn Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v29n04-1995-Autumn Table Of Contents A list of subunits of the resource. Research Hospital News The GME Maelstrom Putting Back the Pieces Medical School Then and Now A Spoonful of Humor Alumni Classnotes Class of 1999 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v29n04 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1995 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/1282444b30b5d092a8b57c3090a58fe9.pdf 19699087ba777d50ec61ac236db76802 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Spring 1995 �BUFFALO PHYSICIAN Volume 29, Number 2 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr_ Carole ~milh Pctrl, Dear Alumni cnl Friends, I DIRECTOR OF PUBLICATIONS TunOih) ). Conroy EDITOR Nant'tlc Tramont. R. ART DIRECTOR Alan J. Kegler ASSOCIATE ART DIRECTOR D.mdj. Riley PUBLICATIONS MANAGER )ud,on Mead PRODUCTION MANAGER t\nn Raszm.,mn Brov.n STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. John augh1on. Vice President f"r Chnit:al Affa~rs. Drm1 EDITORIAL BOARD Dr. john A Richert, Chairman Dr. Rus.sdl Besseuc Dr. Martin Brecher Dr. Harold Brod) Dr. Richard L. CoUnts Mr. Ra,; Desai Dr. Alan]. Drinnan Dr. james Kanski Dr. Elizalxth Olmsted Or. Barbara Majeroni Or Charles Paganelli Da·. Thomas Raab Dr. Stephm Spauldmg Dr. Bradley T. Truax t's a tremendous pleasure to inform you that UB's medical school was among those institutions to receive one of the last gram awards to be funded by the Lucille P. Markey Foundation. The faculty leadershtp who led thts successful effort, Dr. lam Hay and Dr. Philip LoVerde in particular, deserve the institution's gratitude for the quality of the grant proposal submitted to compete successfully in this national arena. The timing of the award and its announcement could not be better. For example, this issue of Buffalo Ph~ ~ician emphasizes research activity in the school; the new biomedical research building opens this ~pring; and the Sesquicentennial activities are upon t•s. Although scientific merit was the primary criterion on which the I~ Foundation based its judgment. the school was certainly benefitted by ' . ~the enthusiastic support and hard work of the University's administrative officers; many of our alumni, especially Dr. Thomas Frawley, Dr. Virginia Weldon and Dr. Eugene Farber; and the many faculty who helped make this multidisciplinary effort a success. The funds from this award will be used to develop further the school's commitment to the area of molei:ular parasitology. It is a tremendous tribute to the school that the core of this program will be administered bv a basic science department that has had significant historical import to the school, Mi~robiology. Thus. the Center will serve to perpetuate the memory of Dr. Ernest Witebsky, the founder of the department at UB, and his protege who served the school so well, Dr. Felix Milgrom. Both of these outstanding scientists provide the ideal role models for their successors to emulate. All in all, the Markey Award designation to UB was a great event and marks UB's further commitment to pursue its scientific missions in the years ahead. ~·4-.~ john Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital Michael Shaw Buffalo VA Medtcal Center ArlawKclly The Children's Hospital or Buffalo Erie County Medical Center Mercy Hospital Millard Ftllmore Health System friDIItSava Roswell Park Cancer Institute Sisters or Charity Hospital Dennis McCardt.Y () The State Unlverllry of New York at Bullalo IJuffalo Physiclo is pu!Jhshed quanerly by the State Un.iverslry of ew York at Buffalo School of Medictne and Blomedial Sciences and ~ Office of Publications. It is sent, fret: ofcharge. to alumni, fill:ulty, students, tcildrnts and l'rlendi.. The staff reserves~ ri&htto edit aD. copy and •ubmisslons accepted for publication. Address questions. commmts and submisstons 10. Eduor. Bllffl&lo Physician, State Umversuy of New York at Buffalo, University Publicauons, 136 Crofts Hall, Buffalo. New York 14260; or by e-mail to notes@pub.buffalo.edu. s.-. ....., ..... tc Buffalo Physician, 147 CfS Addition, <05 MainStrttt.BulTalo,NewYork Iilli 0. Felew Alanlli, A s winter begins to fade and the first suggestions of spring appear, our attention can tum to the upcoming Spring Clinical Day. By this time, we on the Board sincerely hope that you have responded to the AlumniOfficeandarernakingplanstorenewfriendshipsandparticipateintheSpring Clinical Day program. The sub-committee of the Board has been reviewing files and several members from the class reunion years will be chosen for Achievement Awards. The senior medical student class will be honored at an upcoming cocktail reception and we look forward to officially recognizing these new members into the Alumni Association. Once again, we look forward to seeing you at Spring Clinical ay. If there are any matters which we can assist you with, do not hesitate to contact the Alumni Office. Russell W. Bessette, D.D.S., M.D. '76 Prnident. Medical Alumni Association �V 0 s 2 L p R 9 N N G 2 0 9 9 5 Research FDA chief David Kessler delivers Harrington Lecture. Page 20. Hospital News Building the Future of Research UB's new research building brings together researchers in a way designed to produce results far beyond what they can accomplish alone. Restructuring Research at UB The reorganization of scientists and clinicians promises synergistic results. Medical School Then and Now ASpoonful of Humor Alumni Classnotes Garden Spots ECMC' s roots. Then and Now. Page 24. �E J ·························································································· Landmark UB study shows major illness in West Side population esidents of Bqffalo's low-income, largely Hispanic Lower West Side are twice as sick as the U.S. population living in poverty, and face major barriers to receiving adequate health care, according to a comprehensive health survey conducted by the UB Center for Urban Research in Primary Care. The study is one of the first of the health status of a pocket of the urban poor in general, and of an urban Puerto Rican population in particular. The study is also one of the first of Puerto Ricans, who account for threefourths of Buffalo's Hispanics and comprise the major portion of Hispanic populations in ortheastern cities. "Most existing studies of Hispanics have been done with Mexican-Americans in the Southwest and West," said Carlos Roberto jaen, M.D., Ph.D., study project director and UB assistant professor of family medicine and social and preventive medicine. Demographics from the study show the population to be 54 percent Hispanic (three-quarters Puerto Ricanborn) , 29 percent non-Hispanic white and 17 percent African American. The number of men and women are nearly equal. Seventy percent are under 40. Smoking, alcohol consumption, asthma and diabetes are major problems in this population in which conventional written health information isn't very useful because more than a third of the residents did not complete high school. And when members of the Hispanic population go to a hospital or doctor's office in Buffalo, they often can't communicate with the English-speaking staff and physicians, the study noted. The results also indicate that, contrary to early assumptions, most residents of this low-income neighborhood have access to health care and are cov6 u 0 0 p Carlos Roberto Jaim, M.D., Ph.D., UB assistant professor and West Side study director. ered by some type of health insurance. Bilingual interviewers went door-todoor to gather data for the study, completing interviews at 826 households representing 1,873 individuals, for a response rate of about 78 percent. UB-Roswell researchers win $8.9 million in grants from NCI rants totaling $8,914,038 have been awarded by the ational Cancer Institute to UB and Roswell Park Cancer Institute researchers. john A. Blessing, Ph.D., UB adjunct assistant professor of statistics of the statistical office of the gynecology oncology group at Roswell, won a five-year $7,514,692 grant to fund that group's ongoing work of collecting and correlating data. Margot M. Ip, Ph.D., UB research professor in Roswell's department of experimental therapeutics, won a fouryear, 734,752 grant to investigate gene expression in normal mammary cells and try to determine the way this expression is disrupted by malignancy. h y s c 0 5 Enrico Mihich, M.D., of Roswell's department of experimental therapeutics, won a three-year, $342,763 grant to study cancer chemotherapy and immunologic effects. The research will expand previous in vitro work on Adriamycin and examine its effects in vivo. Thomas Shows, Ph.D., UB research professor from Roswell's department of human genetics, won a three-year, $321,831 grant to clone chromosome 11 genes. Questions raised about use of growth hormone for short stature ost short children are well-adjusted and have no serious social or emotional problems, despite assumptions by some physicians and parents, a study by researchers at UB and The Children's Hospital of Buffalo shows. The research hits at the heart of the controversy over whether to treat short children who are not deficient in humangrowth honnone. One rationale to treat was to improve psychosocial functioning. p n g 9 �······ · ····· ··· ····· ·· ········· · ····· · ·· ·········· · ····· · ······· ·· ······ · ··· · · ········· · ·· E : J "Shorter-than-normal children may be teased, and they may be treated as if they are younger than they are, but, despite that, they are doing pretty well," said David E. Sandberg, Ph.D. , assistant professor of psychiatry and pediatrics, B has won a new three-year, and lead study investigator. "Previous 600,000 grant from ASA to reports had led us to believe these chilstudy the physiological mechadren were quite bad off." nisms behind observed cardiovasThe study, published in last cular regulatory phenomenon in December's issue of Pediatrics, is based zero-gravity. on data from 258 children referred to a The award is based on research conpediatric endocrine clinic because of ducted on cardiovascular functioning shorter-than-normal stature. Parents and deconditioning in microgravity on completed a Child Behavior Checklist; two ASA Space Lab flights that found children 12 years of age and older com- blood pressure in flight is regulated by a pleted a comparable questionnaire them- decrease in vascular resistance in reselves. Responses were compared with sponse to an increase in cardiac output those from normal children and chil- induced by microgravity. dren referred for mental-health services. This phenomenon was first observed Earlier studies reported problems in UB research among children with moderate to severe short stature, including socialization based on height rather than age, stigmatization because of appearance, poor social skills, social isolation, low self-esteem and poor academic achievement. But these data were primarily from short children with conditions such as underactive pituitary or chromosomal anomalies. The UB study showed that parents rated boys somewhat less socially competent with somewhat more behavior problems than the normal sample, but without major ·~ psychosocial problems. The short boys ."~ were rated as functioning disor tinctly better than the group referred for mental-health services. Boys' ratings of themselves mirrored their parents on social activ: -~ ity, but they didn't report having more behavior problems. Short adolescent boys rated themselves better athletically than conducted on Space Lab l. Findings in the second study, conother boys their age. Short girls showed little difference in social functioning, be- ducted on Space Lab 2, also showed that havior problems and self-esteem and re- the ability of astronauts to perform work ported being better at athletics than the when they returned to Earth, as meacomparison group. UB wins $600,000 NASA grant to study BP regulation in space B a 0 p y 5 c 0 5 p sured by performance on a specific physical-exercise regimen, was decreased, and that there was a relationship between the ability to perform work and time spent in space. Astronauts on Space Lab 2, who were in flight for 15 days, performed less well upon their return to Earth and remained limited longer than their counterparts on Space Lab 1, in flight for nine days. Both in zero gravity and in readjusting to Earth's gravity, the astronauts' bodies regulated blood pressure by expanding or constricting blood vessels in the presence of increased cardiac output, the results showed, a phenomenon not observed prior to the two UB Space Lab experiments. The experiments and equipment used on both Space Lab experiments were designed by Leon E. Farhi, M.D., UB dis tin- · guished professor of physiology. The new experiments, Farhi said, will be conducted in simulated zerogravity environments. "If we find something interesting through these Earth-bound experiments," he added, "we will go back to ASA for another in-flight experiment." UB researchers involved in the project, in addition to Farhi were Barbara E. Shykoff, Ph.D.; Christopher Eisenhart; Richard Morin; Albert]. Olszowka, M.D.; David R. Pendergast, Ph.D., and Mary Ann Rokitka, Ph.D. n 9 0 �a ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · said, "john has demonstrated a remarkable ability to keep Buffalo General in a leadership position in today's increasingly complex health care scene. "With the advent of health care reform Kinnard and the need to develop integrated health care systems, John's business acumen and creativity will serve General Care Corp. and the hospital well in the years to come." Butfalo General'sKinnard and Friedlander assume new roles fter serving as president and chief executive officer of General Care Corporation since its founding in 1985, William V. Kinnard, M.D., has stepped down to devote more time to his role as president and chief executive officer of The Buffalo General Foundation. Succeeding Kinnard is john E. Friedlander, president and chief executive officer of The Buffalo General Hospital, the main entity within General Care. ln making the announcement, Thomas R. Beecher, Jr., chairman of the General Care Corp. board of directors said that Friedlander, a BGH executive since 1984, will maintain his responsibilities as the hospital's president and CEO. Beecher described Kinnard and Friedlander as "exceptional leaders whose vision and achievements have earned them the respect and admiration of their peers in the health care industry." Kinnard, who relinquished his General Care Corp. responsibilities last September, noted that the move had been planned for some time. Kinnard had served as BGH president and CEO from September 1975 until March 1990 when he was named the hospital's first fulltime board of trustees vice chairman. He will continue as chairman of the board of directors of Friedlander WestLink Corporation, a for-profit joint venture involving General Care and several other Western ew York health care providers. Commenting on Friedlander's appointment to lead General Care, Beecher B u a 0 work more closely with the most visible and respected provider of health care services in the West Side community. "This merger will enable Buffalo Columbus and Buffalo General to jointly develop a strategic direction toward providing a comprehensive array of primary ambulatory care services to address the major health problems in the Hispanic and non-Hispanic communities of the West Side," he added. BGH first WNY hospital to oiTer endoscopic ultrasonography he Buffalo General Hospital now performs endoscopic ultrasonography (EUS), a new diagnostic technique that detects Gl tract tumors with greater accuracy. The technique provides higher resolution images of tumors within the Gl tract and its adjacent structures. Buffalo General is the only hospital in Western ew York to offer the new technique, according to Siddhartha Shah, M.D. , UB clinical assistant professor of medicine. "With EUS , a detailed five-layer structure of the gastrointestinal tract wall can be easily visualized," Shah said. "GI tract tumors distort this normal five-layer structure and can be detected by this new technique , in detail. It allows us to visualize with great accuracy how far the tumor extends through and beyond the wall and whether it involves lymph nodes and adjacent structures. Shah said EUS is superior to CT scanning in staging GI malignancies, with EUS accurate in more than 85 to 90 percent of cases and CT accurate in about 50 percent. The procedure takes one to two hours and is performed in BGH's GI Laboratory, usually on an outpatient basis. Buffalo General and Columbus Hospital begin merger talks n a move designed to improve the delivery and expand the scope of health care services to Buffalo's West Side, the Buffalo Columbus Hospital, its parent organization, Buffalo Healthcare Corp., and The Buffalo General Hospital have agreed to engage in discussions that will result in a plan to merge. Buffalo Columbus president and chief executive officer Andres Garcia described the discussions as a "dynamic opportunity" for the hospital to strengthen its position as the "pre-eminent provider of primary, ambulatory care and substance abuse services for the Lower West Side. "Our aging facility and equipment have made it increasingly difficult for Buffalo Columbus and Buffalo Healthcare Corp. to provide the Hispanic community and all people on the Lower West Side with the health care services they expect and deserve," Garcia said. john E. Friedlander, Buffalo General president and chief executive officer, said BGH "welcomes the opportunity to p y 5 c a 5 p n g 9 9 �- · ·· ·· · -- - -~- - - ···· · ··············· · ····· · ·· · ········· · ·· · · · ·· · ····· · · ·· · · ····· · · · ········· · ECMC officials hope the new facility will provide simpler and faster services for outpatients using the hospital, including dedicated parking, decentralized, "point-of-service" registration and improved patient flow from one service to another. The facility would be funded through the sale of general obligation bonds, with ECMC contributing about $2 million, based on the level of surplus hospital officials expect for 1994. The twostory structure will be the first construction project at the medical center since it was built in 1978. Patients are given intravenous sedation. Routine endoscopy locates the tumor and the dedicated ultrasound endoscope examines the area. Feeley named associate director at Buffalo VA Medical Center illiam F. Feeley has been named associate director at the Buffalo VA Medical Center. He will be responsible for all administrative support services at the facility , including human resources, medical ad- .---------. ministration , fiscal and acquisition and rna teriel management. The position reports to medical center director Richard S. Droske. Prior to coming to Buffalo, Feeley held associate director positions at the VA Medical Centers in orthampton, Massachusetts, and Grand Junction, Colorado. Hospice Buffalo receives training grant to support its CHILD Project fficials at the Erie County Medical Center have announced plans to build a $14 million ambulatory care center r.ext to the hospital. The 80,000-square-foot building will house primary care, diagnostic and specialty outpatient services including family and internal medicine, OB-GYN , pediatrics, chronic dialysis, laboratory specimen collection stations and X-ray facilities. The hospital submitted a CO last December. a 0 p h ·· ···· · ~ ~ they support families in their communities. The CHILD Project team will define conditions of infants at risk and teach others to recognize these risk factors in order to appropriately refer or care for the infant. Project training will include the medical and psychosocial aspects of the problems of prematurity, cocaine exposure, HIV/AIDS, sickle cell anemia, developmental disabilities and failure to thrive. Buffalo General announces ED renovation and expansion project he Buffalo General Hospital has unveiled plans for a $5.6 million renovation and expansion of its he ew York State Department of department of emergency mediSocial Services has awarded Hoscine. pice Buffalo a $42,000 grant to John Friedlander, BGH presiprovide informational and educa- dent and chief executive officer, detional programs designed to im- scribed the project as the "most signifiprove the provision of services to cant construction program" for the hosdisabled infants with life-threatening pital since the mid-1980s when the new conditions. Hospice Buffalo is one of 16-story medical tower building was only two organizations in ew York completed. State to receive grant funding for this The project, to be accomplished in program. phases so as not to disrupt ED operaThe grant was awarded to Hospice's tions, is expected to be completed about CHILD Project, a special program intro- mid-1996 . duced in 1994 as part of a ew York The initial phase will involve conState Department of Social Service spon- struction of a two-story addition on the sored initiative to improve services to Ellicott Street side of the ED , including medically frail infants who are at risk of a new elevator to operate between the medical neglect. The grant will be ad- ground floor and the first floor of the ministered by The Life Transitions Cen- main hospital building. ter, an agency affiliated with Hospice Renovation of the first floor , previBuffalo that provides education, counously occupied by same day surgery, seling and support groups for children, will occur during the project's initial adults and families concerned about phase. In June or July of this year, ED grief, death and living with a serious or operations will move from the ground life-threatening illness. The program, floor to the first floor until renovations which began this month, will continue are complete. through February 1996. Temporary relocation will ensure The CHILD Project will assist and uninterrupted service for the more than support social services professionals as 3,000 patients who use the ED. ECMC submits CON to build $14 million outpatient care center B - - · - -·- - =-- - y s c a s p 9 9 �• • PHOTOS BY K.C . KRATT �UB's new research building brings together researchers in away designed to produce results far beyond what they can accomplish alone BY SCOTT THOMAS It looks sharp. It's built for speed -everything within ready reach, all the amenities for comfort and efficiency. It's roomier than you'd expect from the outside. You might say the new research building of the School of Medicine and Biomedical Sciences is a luxury vehicle perfect for the next stretch of the scientific highway. The new laboratories combine functionality with beauty in a classical design. �The new building features standard. institutional-quality materials used in an innovative and visually pleasing way. Light-reflective materials open up the interiors: maple casework makes the workspace bright and inviting. THE RESEARCH BUILD! G is in the final stages of completion, culminating a project more than five years in the making. The building provides for 60 wet laboratory units , each consisting of a main lab and two auxiliary labs; support facilities such as equipment rooms , utility rooms, darkrooms and "environmental chambers" for heated or chilled materials ; 60 offices for investigators; and six spacious conference areas. It's a significant advance for a school whose progress in research- one of the most significant factors in attracting and keeping high-quality faculty members - had been squeezed by a severe shortage of laboratory space. "It was essential that we make a sizable space readily accessible and functional very quickly ," says Bruce A. Holm, dean for research and graduate studies at the medical school. A faculty member throughout the time the building was being planned, Holm moved to the dean's office in 1993. joseph T. Spence , Ph.D. , Holm's predecessor as dean for research and graduate studies, was heavily involved in helping researchers, administrators and building planners reach a consensus on just what form the new structure should take. "We very much saw the building as a tool , just as any piece of equipment in the laboratories is a tool, " said Spence, who left UB in january 1993 to become head of the Beltsville Human utrition Research Center, a division of the U.S. Department of Agriculture's Agricultural Research Service. "We tried to be one step ahead of where we were today," Spence said. "We asked ourselves what people would be 0 B u 0 0 p 5 doing five, 10, 20 years down the road. And we were particularly interested in coming up with some design concepts that would make it as flexible as possible. " The existing labs in the Cary-Farber-Sherman (CFS) complex, Holm said , not only were inadequate for the number of researchers working , they needed major renovations to bring them up to state-of-the-art standards. "The problem with that," he says, "was that with the laws concerning asbestos abatement, it was incredibly costly to renovate those labs. We actually found that it was cheaper to build the new building. " The old labs will stay, he added , and "we will renovate them , but now we can do it in more of a piecemeal process. " After a competitive bidding procedure, the architectural firm Helmuth Obata Kassebaum was commissioned to design the building and supervise its construction. HOK is well-known in architectural circles - primarily for its sports facilities , including Baltimore's baseball stadium, Oriole Park at Camden Yards, Buffalo's Pilot Field and UB's University Stadium. Andy Wong, a principal at the ew York City office of HOK , served as the firm's project manager for the research building, leading a core team of three architects. He says the job involved drawing people out on what they wanted just as much as it did drawing lines on blueprints. "We understood that the mission of this project was to create more research space," Wong says. "The ability of the institution to attract research grants and talent is really tied c o n 5 p n g 9 �Maintenance-free materials were used to provide longevity as well as workability. Amenities include special flooring. Corian countertops. vinyl wall coverings and granite flooring and sculptured steel walls inthe main elevators. "Ultima tely, a lab bui lding is about the environment in into that. But that doesn't begin to define the goals of the the lab ," he says. "It's about the research environment that project, everything that's wrapped up in the warm fuzzy surrounds the investigator. It doesn't work from the outside stuff, the qualitative issues that need to be addressed. " in, it works from the inside out: how the benching works, In a series of dialogues with investigators and other how much wet space there is , how that relates to service faculty , school and campus administrators and State Univerrequirements ... sity of ew York representatives, the planners defined "We began to get a sense of the some of those qualitative issues. Says academic day there (among Wong: "They ranged from the researchers) , what the global - 'We have X numculture is there. We ber of dollars , get us the "THE MISSION of this project was to create more research discovered that most laboratories posspace. The ability of the institution to attract research grants and talent is really tied to people don' t really sible' - to the more spewant to hang around cific- 'We don't have a that But that doesn't begin to define the goals of the project. everything that's wrapped in a public space sq front door to this acaup in the warm fuzzy stuff. the qualitative issues that need to be addressed." much as have convedemic complex, and we nient access to their serwould like to create that. ' vice areas. They tend to spend "The end product, the building, more time in their research environthe attributes of the building- its modument than in the public rooms. The culture of research is larity, its flexibility- you just can't take that off the shelf and more that they need to be in their own spaces. But we built say, 'Here it is.' You have to tailor those generic approaches, and that includes siting, circulation , connectivity to the it to encourage interaction. For example, the conference existing campus, landscape issues, future connectivity. The rooms are in an area where there's a lot of circulation. " CFS complex is a pretty Byzantine maze of things. We didn't That kind of thinking is evident in the design of the want to aggravate the circulation issues, we wanted to clarify completed building. It's eight stories, including a ground them. " floor , six floors that house laboratory and office space, and a And primarily, Wong said , they talked about how to make penthouse floor with mechanical equipment for the buildthe building work best for the people whose work it was ing. The laboratory floors are laid out identically to each intended to further: the researchers themselves. other- labs , offices, support rooms and conference rooms a 0 0 p y 5 c o n 5 p 9 0 �Outside the laboratories, the floors are built for convenience and easy functionality. Support rooms and equipment rooms hold excess materials and equipment, freeing up space in the labs. Each floor has two darkrooms for developing photos and X-rays; the darkrooms are at one end of a long corridor, but an indicator light in the center of the hall shows whether the darkrooms are in use- saving busy researchers the long walk to find that out. In addition, dozens of small touches make the research building a comfortable place to work. "We had to use very maintenance-free materials, materials that have longevity," says architect Wong. "We were really challenged, because normally that grade of material is not one that the (construction materials) industry features or focuses on to try to come up with a lot of new colors or patterns. Our challenge was to use it in as innovative and visually pleasant a way as possible. "We did that by choosing very pleasing patterns on the floor, in the tiles. We took the standard, institutional-quality things and used them in a different way. We introduced daylight into the corridors by the placement of the windows. We chose to use as light-reflective materials as possible to all located in the same place, making it easy to find one's way around and easy to service the heating/cooling, electrical, water, waste, fiber optic and other supply and disposal lines. The labs themselves combine functionality with a large degree of beauty. Each laboratory unit consists of a large lab space (some with a center island) and two smaller adjacent labs where auxiliary or preparatory work can be done. There are the usual assortments of taps for purified water, natural gas and air. The countertops are a black epoxy resin, built to simulate the old slate tops that researchers have used for centuries. Fume hoods allow for work with materials that need to be vented to the outside. (ln addition, positive air pressure is maintained in the corridors, and negative in the rooms themselves, to prevent potentially hazardous airborne materials from escaping into common areas.) Solid maple cabinetry inset with glass windows gives a classical feeling to the rooms. Across the hall from each lab unit is an office space of about 14 by 15 feet; every office has a window, recessed over the attractive maple veneer that conceals the room's heating! cooling unit. The building completes a circuit with the Cary-Farber-Sherman complex and connects Squire and Harriman halls through tunnels and overhead walkways. The buildings now enclose a quadrangle of grass. ringed by sidewalks and crisscrossed with lights. B a a p h s c a n 5 p g 9 9 �- --- working with microbes or hazardous chemicals, but it can be open up the interiors. ln the labs, the maple casework was to costly in terms of heat loss. make it as bright and as inviting a space to be in as possible, To alleviate that costly loss, exhaust air passes over a because people spend a great part of their day there." series of pipes containing glycol; the heated glycol is then Thus, such amenities as chalkboards scattered throughrecirculated from the top floor down to the out the corridors for impromptu brainstormbasement, where it heats the incoming sessions, Corian countertops ing fresh air. "lt probably traps in the restrooms, vinyl wall one-third to half of the heat covering in a pattern of that would otherwise be "Ultimately. alab building is about the environment in the lab. It's about the tiny squares, special lost," Krygier says. flooring in the first-floor research environment that surrounds the investigator.lt doesn't work from the In addition , to save animal holding areas beelectricity, lights in the outside in. it works from the inside out how the benching works. how much cause it's continually building are controlled being washed down and wet space there is. how that relates to service requirements." motion sensors - no by beautiful granite flooring need to remember to flick and sculptured steel walls in the switch off when you leave. And the two main elevators add a sense of a sophisticated reverse osmosis water purification comfort and beauty as well as functionality. system treats tap water to remove sediments and bacteria by just as notable is the environmental consciousness that forcing it through a screen at high pressure, running it went into the building's design. through a charcoal filter and submitting it to ultraviolet rays. The air in the building is renewed nine times per hour, On the outside, the building completes a circuit with says Theodore R. Krygier, project coordinator for the the Cary-Farber-Sherman complex and connects Squire University's Office of Design and Construction. That's necand Harriman halls through tunnels and overhead walkessary for safety, in a building where investigators might be ways. (A passkey card system will secure the laboratory floors against intrusion from the common pedestrian corridor. ) The buildings now enclose a quadrangle of grass, ringed by sidewalks and crisscrossed with lights. Andback to the "warm, fuzzy" goals that were estabSchool of Medicine and Biomedical Sciences Research Building lished at the outset- serve as a front door to the medical school complex. Laboratory units ................................................. 60 "The materials that we chose were very quiet, so we attempted to give a lot of interest to the pattern and shapes" Equipment rooms ........ ............... .... .............. ...... 12 of the exterior, Wong says. "We chose the glass to be very harmonious with the brick. We attempted to create a diaUtility rooms ............................................... .. ...... 12 logue. The most prominent windows are for the office areas, and there are areas of large glass, such as the big vertical element at the corner of the building near the front entrance. Common work rooms .. .......... ......... .... ...... .. ......... 6 "In everything we did on the exterior, there was a very conscious effort to create an articulation of the exterior Darkrooms .. ... ... ... ...... .. .. .... ... ........ .... ... .... .. .... .. ... 12 walls. Shadow and play give this building a sense of scale. We chose to use as many of the given elements in as artistic a way Environmental chambers ................................. .. . 18 as possible. "We tried to create a sense of balance and harmony with Conference areas ............ ........... ................. .. ......... 6 the other elements that were pre-existing. The CFS complex had a fairly warm tone, and we attempted to borrow from that. The dental school had a palette that was a little more Offices ................................ .......... .. ..................... 60 rich. We tried to create a sense of harmony that would bridge all the elements that were there and at the same time create Laboratory space ....... .............. 110,000 square feet an identity distinctive to the medical school." An identity - but as yet, no name. Building .. .................... ... .. ... ... . 210,000 square feet "We do hope to name it," Bruce Holm says. "There have been some ideas. There are lots of people you can name About $54 million, funded by the State COST buildings after. " For the research building's new tenants, at least, the name University of ew Yorl? Construction Fund is excitement. B a a p h y c a n 5 p 9 9 9 �Rror~anization of scientists anrf rlinicians 111lomises srner~islic results t ��"The building is more than just a building," Holm said. "It's really meant to be a catalyst to put into effect an overall plan that's part of our mission for the next decade or two. It's allowed us to bring together people who wouldn't otherwise have come together. I'm very excited about it." Much of the school's research is performed at the hospitals of the Graduate Medical Dental Education Consortium of Buffalo, where many of the medical school's faculty both teach and practice. That hospital-based research will continue , Holm said ; the new research centers, or "affinity groups" as they are known, each comprising from 10 to 30 people, will do their work in the new building, and in renovated dry-lab space in the Cary-Farber-Sherman complex. "What we're moving are highly productive, highly thematic research groups, " he said. "They've actually in large measure self-formed. We left it to the investigators to find their own affinities, and some people are members of more than one group. " It's hoped that the new alignments will help continue a decade-long trend that has greatly strengthened the medical school's position among major medical research universities. Holm estimated that during the 199394 academic year, the school's faculty members brought in $30 million in grant money- excluding the approximately 200 faculty on the staff of Roswell Park Cancer Institute. Add in the grants to those Roswell Park researchers , and the figure climbs to $58 million. "It's dramatically on the increase ," Holm said. "My guess is that, 10 years ago , we were lucky if we were talking $10 million. "We've recruited new faculty members and initiated some new programs, and it's taken off in a big way. It's been a concerted effort to build up the research program in the school of medicine," he added. A thriving research program has two major benefits. Foremost, of course, it advances the frontiers of scientific knowledge and medical treatment. But it also gets the medical school's name out in front of the national scientific audience, making it much easier to attract the top-quality investigators and teachers who , in turn, create the best education for future physicians. Holm points out a third advantage, one that directly benefits medical students: "We have a variety of programs for the medical students centered around these research activities, that in fact teach them how to think. "When they go out into a world of medicine which is constantly changing, their education will be continuing for the next 30 or 40 years. "They need to be able to look at the literature and to be able to critically read journal articles and determine what is the best type of treatment for their patient. Having a strong research program means that we're imparting that creative thinking quality. " A comprehensive survey of research at the medical school would fill a book. But a quick overview gives a snapshot of the variety of projects being undertaken , both in basic medical science and in the clinical application of that science. Here, then , are some highlights of the medical school's research activity: Thomas]. Langan , M.D., associate professor of neurology and pediatrics and an attending neurologist at The Children's Hospital of Buffalo , coordinates an affinity group in Neurosciences focusing on the provocative idea that the brain, long thought to be unable to repair itself, "doesn't simply age and deteriorate but has a potential for a positive kind of change. " The eight members of the group , he says, are looking into such areas as how the visual system changes over time, and how it can regenerate and repair itself. Research on the cellular level, into such mechanisms as ion channels and protein secretions, seeks to discover how the nervous system changes with time and how clinicians might manipulate that. One member, a neurosurgeon , is investigating transplantation strategies to address conditions such as Parkinson's disease. Langan , whose own research concentrates on the plentiful brain cells called astrocytes , says formation of the new affinity groups can only help researchers' collaborations. "We don't talk enough to each other," he said of investigators in general. "The kind of exchange that most people find most productive is running into each other in the hall and talking things over. This will enhance that kind of day-to-day collaboration. " And Langan, who sees young patients with such brain insults as cerebral palsy, mental retardation and epilepsy, welcomes the alliances between basic scientists and clinicians. "Scientific illumination has to come before any attempt at treatment," he said. "The draw really was to try to understand some of these terrible brain syndromes, and by understanding them better, find out how to change things. " Robert Hard , Ph.D. , and his colleagues in the Imaging Center are accomplishing what was unimaginable before the invention of the microchip. Using powerful new technologies of video microscopy and computer methodology, they study tissues , cells- even individual molecules within cells. They accomplish that by using fluorescent markers to The new alignments continue adecade-long trend that has greatly strengthened the medical school's position among major medical research universities. B u a 0 p h c a 5 p n 9 9 �Bruce A. Holm. Ph.D. Associate Dean for Research and Graduate Studies Associate Professor of Neurology and Pediatrics �John A. Krasney. Ph.D. Professor of Physiology target molecules , attaching them covalently in a way that doesn't disturb the molecules' function , and then following them at low-light levels. The group has 16 members from five teaching departments. "There are people doing the same kinds of research in these different departments , and these interdisciplinary programs afford an opportunity for them to interact on a more formal basis than usually occurs," Hard , associate professor of anatomical sciences, said. Other sophisticated technology that the Imaging Center has in place or hopes to install: confocal microscopy , which enables the researcher to collect information in three dimensions and make 3-D computer models of cells; atomic force micro copy, so incredibly sensitive that it can measure forces between molecules; and laser tweezers , which use a laser beam to move parts of an individual cell around, even slicing chromosomes off a mitotic spindle. "The idea is to get everybody on a common Ooor and use (the Imaging Center) as a resource for the whole medical school, as well as promote more interactions on applying this technology to a variety of medical problems," Hard said. The Cardiopulmonary Center was initiated in 1990 to build on the medical school's diverse faculty interests in cardiovascular and pulmonary physiology. About 40 investigators are working in three major subgroups- cardiovascular medicine, pulmonary medicine and developmental biology. B u a 0 p h "Over the years here at Buffalo, one of the great research strengths of this university has been in cardiovascular and pulmonary research ," saidjohn A. Krasney, Ph.D., professor of physiology and liaison for the group. "The problem has been that we've been geographically separated. Many of the labs are at Erie County Medical Center and at other hospitals , and some of us who are doing basic science are here on the Main Street campus." ow, bringing together the affinity group can result in much more convenient and frequent interaction. "We're interested in the physiologic mechanisms that regulate and control the circulation in various situations," Krasney said. He gives as examples the problems of coronary artery disease, pulmonary disease , high blood pressure and changes in circulation that occur at birth. Cardiopulmonary Center investigators also are exploring how nutrients are carried in the blood to the body's organs and cells, and how that nutrient transfer is accomplished. One high-profile project under way is a ASA-supported study of how elevated carbon dioxide affects circulation to the brain. ln both the U.S. space shuttle and the Russian Mir space station, carbon dioxide levels have approached a very high 3 percent. "This can lead to problems in the ability of the astronauts and the cosmonauts to function, " Krasney said. One part of this study is being done in Cologne, Germany, in collaboration with scientists of that nation. c a 5 p n g 9 9 �---- -- - Robert Hard. Ph.D. Associate Professor of Anatomy and Cell Biology At the Center for Microbial Pathogenesis, researchers are looking at parasitic, bacterial and viral pathogens involving such projects as vaccine delivery systems and vaccine development, host-parasite interactions, the body's immune response to bacteria and how various viruses work in cells. One development being tested: a vac- .----.-------cine to prevent middle-ear infections in infants. The researchers point to four prevalent infectious diseases that have arisen in the past 15 years - AIDS, Lyme disease, Legionnaire's disease and toxic shock syndrome - as evidence of how much work remains to be done. This center in january announced that it has received a $1 million grant from the Lucille P. Markey Charitable Trust, which will be used primarily to hire additional researchers. Medical school officials hope that funds from this leading grant-giving organization for fundamental biological and medical research will contribute to the school's ability to attract new investigators. In announcing the award , UB President William R. Greiner said, "This important award indicates the Markey Trust's confidence in, and support for , UB's work in crucial areas of biomedical research. It will be the critical ingredient that supports major progress in the study of infectious disease." 'The Markey Trust's award will play a crucial role in the university's ability to seek matching funds for infectious disease research from other private and public foundations and agencies," said john aughton, M.D., vice president for clinical affairs and dean of the medical school. john Hay, Ph.D., professor and chair of the medical school's microbiology department and a principal investigator for the Markey award, noted, "This award will allow a marked expansion of the center's important disease investigations. It also will give a substantial boost to the national and international reputation of the center and UB. " Holm , also a principal investigator for the award, says the center developed from a collaboration initiated in 1981 by three scientists in different departments in the medical school. The center now includes 15 senior investigators , as well as support staff, and input from five departments. The pmgmms for the medical students centered around the school's research activities, in fact teach them how to think. B u a a p h y 5 c a n 5 p n g 9 9 5 �Other research efforts involve basic scientists and clinician scientists: The Metabolic Regulation Group studies how cells regulate their metabolism by hormones and other mechanisms. Investigators are looking at how cells use copper, the regulation of insulin secretion, the mechanisms governing obesity and the use of surfactants in treating lung disease in newborns. In the Molecular Mechanisms of Cell Regulation Center, researchers are investigating how proteins work in regulating cell processes and metabolic pathways, in addition to their function in such diseases as cancer, endocrine disorders and skin diseases. An overall goal of the group is to understand how these proteins affect expression of the genetic code in the body's development and aging, as well as its pathologies. Discovering the physical configuration of cells and their component molecules is the focus of the Structural Biology Center. Its investigators use X-ray crystallography and nuclear magnetic resonance imaging to discern molecular structures, including those of proteins, D A and RNA, carbohydrate and membranes. The Toxicology Research Center is in its seventh year of operation. Its focuses include developing in vitro methods of studying the body's reaction to foreign substances, in contrast to toxicology's traditional in vivo animal-based research. For example, in a study funded by the ational Institute of Environmental Health Sciences, researchers are seeking to develop biological markers that would indicate exposure to a particular substance. "The goal," says james Olson, M.D. , associate professor of pharmacology and liaison for the group, "is a simple test, like a blood test, to determine whether someone has been exposed to a substance or is susceptible to damage from exposure. " The investigators, he said, are looking for changes in molecules or cells, such as levels of enzymes or messenger R A. The group's other main focus, Olson says, is measuring levels of the chemicals themselves in the blood. For example, toxicologists have monitored the health of people who live along the Great Lakes and eat fish that may expose them to such contaminants as PCBs, dioxin and myrex. Excessive exposure may lead to reproductive and developmental problems. Initiatives in outcomes research and primary care constitute another major area of medical school investigation. Several new projects of the Rural Health Initiative study health policy and practice in the nation's rural areas. One, funded by the federal Office of Rural Health Policy, looks at the impact of managed care on rural communities throughout the United States, and the impact nurse practitioners have had on health care in rural areas. Another explores how the spread of AIDS has affected rural health care systems. A companion study looks at why immunization rates vary John Hay. Ph.D. Professor and chair of Microbiology �~~~- ~- -- -- ~ James Olson. M.D. Associate Professor of Pharmacology fighting coronary artery disease , osteoporosis and endometrial cancer; studying how a low-fat diet affects risk of cardiovascular disease and breast and colo rectal cancer; and investigating whether calcium and vitamin D supplements reduce the risk of osteoporosis, colorectal cancer, high blood pressure and breast cancer. Initiatives in Rehabilitation Medicine include the Uniform Data System, which is being developed into one of the largest databases in the world on issues in medicine , pediatrics and gynecology. "They're able to provide different subsets of this data to different people who need it for generating policy decisions, in the clinical management of patients, or to do outcomes research ," says Holm. Again , a brief survey only hits the highlights of the wideranging and growing research program at the medical school. Holm , for one, expects research to remain a strong part of the school's activity. "Our IH funding is growing, and it's as high as it's ever been," he said. "Realistically we're not going to be able to keep up this level of growth in the current (political) climate. But even if we were to plateau at the current level, I would not be unhappy. "I think it's a very exciting time ." greatly from county to county. Thomas Rosenthal, M.D. , chair of family medicine, says a new Department of Health grant will enable researchers to study how rural primary care physicians use the government's medical guidelines in treating the fast-growing illness of congestive heart failure. "We'll look how closely physicians in rural ew York State follow those guidelines, and if not, why not; and what kinds of things could be done to increase the use of those guidelines, if that's appropriate ," Rosenthal said. That's not specifically a rural issue, he acknowledged. "But there are differences in how medicine is organized in rural communities and in urban areas. We've developed a reputation for being able to look at these things in a rural environment. " Another initiative in outcomes research and primary care involve UB as one of 16 vanguard clinical centers nationwide that are part of the $635 million Women's Health Initiative , the largest clinical trial ever undertaken in the United States. Investigators are recruiting as many as 3,500 women from Western New York, and the study will include both clinical and observational components. Among the investigations: testing how effective hormone replacement therapy is in B a a p y s a 5 p n g 9 9 5 �a ······································ · ···· · ········· · ······················ · ··········· FDA chief David Kessler, M.D, J.D, delivers 1995 Harrington Lecture SAYS AGENCY HAS A RESPONSIBILITY TO DETERMINE THE POTENTIAL BENEFITS NEW DRUGS CAN BRING AS WELL AS THE POTENTIAL HARM THEY CAN BRING esponding to recent public criticisms that his agency moves too slowly in approving new drugs , Food and Drug Administration Commissioner David Kessler , M.D. , ].D. , told a standing-room only crowd at the medical school that the FDA has dramatically increased the access that patients with life-threatening diseases have to promising new drugs. Kessler delivered the D.W. Harrington Lecture February 9. He said the FDA has sped up the approval process for new drugs and increased patients' accessibility to new drugs that are still in the clinical stages of testing. Kessler, who was appointed by President George Bush in 1990, said the AIDS epidemic changed the way the FDA handles the approval process for B u 0 0 p new drugs offering potential treatments for patients with terminal diseases. He said in today's world , it is important for these patients to have the right to take a chance on a new drug when seemingly all other treatments have failed. "Experimental sources of therapy, such as new drugs , represent a rare source of hope for those people with conditions that have seemed to outsmart medical science," Kessler said. He said he realizes the FDA must address the unique problems facing those patients who have nothing to lose by trying experimental treatments. "In urgent cases where people are dying and no effective therapy exists, something more is required of the FDA," he added. The FDA has come under sharp criticism recently from conservative groups y s c o n 5 that believe the government over-regulates the pharmaceutical industry and hurts its ability to compete globally, as well as causes unnecessary deaths to people who could be helped by therapies awaiting FDA approval. Full-page ads in national newspapers trumpet, "If a murderer kills you, it's homicide. If the FDA kills you , it's just being cautious. " But Kessler points to widespread misconceptions about the length of time it takes for the FDA to approve a new drug. "For most drugs , the average approval length is l3 months, " he said, "not seven years or 10 years like most people think. " Sometimes the agency moves even quicker. Kessler, a graduate of Harvard Medical School and the University of Chicago Law School, said that in the past few years four new drugs- most notably the potential AIDS treatment, DDI - received approval in less then seven months. Kessler said this kind of fast-track approval is one of the best ways the FDA can address the needs of patients afflicted with life-threatening diseases. In 1992, he noted, the FDA also began granting conditional approval to certain drugs before final confirmation of direct evidence of their effectiveness is made. Drug manufacturers now can p g 9 �I ~- --- - ~- ---- -- · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ·a I ' I I "The riskiest thing we can do is to not take risks. Especially since patients have said that they are willing to take the risks." said it is "not enough for the FDA just to get new potential therapies to people who need them. " lt is also its responsibility to "get answers" about the potential benefits a drug may bring as well as the potential harm it can cause. "The challenge," he said, "is to strike the right balance between access and answers. "One day we're going to make a mistake ," he said. "But the riskiest thing we can do is to not take risks. Especially since patients have said that they are willing to take the risks." The magnitude of these risks depends on the precision of the FDA approval process, which Kessler said "is only as good as the scientific research on which it is based. " Participation in the clinical trials phase of that research, he said, was closed to the most seriously ill patients - ironically, those who might benefit most from the experimental drugs being tested - until 1987 when the FDA opened the doors for tens of thousands of seriously ill people, mostly AIDS patients, to receive drugs free of charge while the drugs are in clinical trials Kessler said the FDA had to realize that while diseases such as AIDS "have no geographical boundaries, access to cuLLing-edge medical technology often does. " ln 1992, this program was expanded "Experimental sources of therapy, such as new drugs, represent a rare source of hope for those people with conditions that have seemed to outsmart medical science." apply for conditional approval if they prove a drug is "reasonably likely" to successfully treat a disease. Kessler said drugs receiving conditional approval are still held to the same standards as drugs receiving full approval and that manufacturers must conduct post-marketing studies to ensure efficacy. But, he said, "the less time a drug is in clinical trials, the less we will know about it and the more risks we will take when we make it available." Kessler B u a 0 p h y 5 a n 5 p to include even more patients. "Today, drugs that show promise are being made available to patients before they have received final approval from the FDA and before they are marketed to the public," said Kessler. The D.W. Harrington Lecture Series was established in 1896 by Devillo White Harrington, an 1861 graduate of the UB medical school and a professor of genitourinary and venereal diseases from 1886 to 1905. BY CHRIS SHEA Hershey appointed to Veterans Affairs Neurology AdrtsoryGroup inda A. Hershey, M.D., Ph.D., associate professor of neurology and chief of neurology service at the Buffalo VA Medical Center, has been appointed to membership on the Department of Veterans Affairs eurology Advisory Group. The appointment was made by john Booss, M.D., VA's director of neurology service for the 171-medical center system. The 11-member advisory group, composed of both VA and non-VA physicians, will serve as a policy advisory body for the nation's largest health care system. g 9 5 �a ························································································ Hauptman-Woodward Institute honors Kanski and Tomasi Nolan granted mastership in Amencan College of Physicians he Hauptman-Woodward Medical Research Institute, Inc. (HWl) honored two local physicians during its Fourth Annual Awards Luncheon held in january. james R. Kanski, M.D., clinical associate professor of medicine and a practicing physician with The Buffalo Medical Group, received the Helen Woodward Rivas Award for service to HWl. Thomas B. Tomasi, M.D., Ph.D., president and chief executive officer of Roswell Park Cancer Institute, received James Kanski, M.D. the George F. Koepf, M.D. Award for his contributions to the advancement of biomedical research. The awards were instituted in 1992 to honor the founders of HWl. Kanski received his medical degree in 1960 from UB's School of Medicine and Biomedical Sciences. A member of the HWI board of directors since 1975, he served as vice president and chairman of the nominating committee for most of his tenure. Kanski stepped down from the board in january after 20 years of service. He has also served as chief of the endocrine clinic of The Buffalo General HosThomas B. Tomasi, M.D. pital. Tomasi received his medical degree from the University of Vermont Medical School and his Ph.D. from Rockefeller University. The author of more than 300 publications and abstracts, he also serves as chairman of Roswell's department of molecular medicine. B a 0 p ames Nolan, M.D., professor and chair of medicine, has been granted mastership in the American College of Physicians by that body's board of regents. Masterships are given to fellows who have made distinguished contributions to the medical profession because of personal character, positions of honor and inOuence, eminence in practice or in medical research or other attainments in science or the art of medicine. olan received the award at the College's 76th Annual Session in Atlanta this month. Naughton receives honorary degree from Kosin University ohn aughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences, received an honorary degree of doctor of medicine from the Kosin University in Pusan, Korea, last month. Naughton, dean of the school since 1975, is an acknowledged authority in the areas of exerci e physiology, exercise testing , cardiac rehabilitation, graduate medical education and regionalization of health care. His professional training is in internal medicine, cardiology and psychosomatic medicine. He holds fellowship status in the American College of Physicians, the American College of Cardiology and the American College of Sports Medicine. He has authored or co-authored over 120 peer-reviewed articles and two textbooks. He formerly directed the rehabilitation center at the University of Illinois School of Medicine in Chicago, h y a n 5 the Division of Rehabilitation Research and Training Center at the George Washington University Medical Center, Washington, D.C., and the ational Exercise and Heart Disease Project. Hui elected to fellowship by American Physical Society ek Wen Hui, Ph.D., research professor in the department of biophysics at Roswell Park Cancer Institute, as been elected a fellow by the American Physical Society. Each year the society's council elects members whose distinguished efforts have advanced physical science or its applications. Election to fellowship is limited to no more than half of one percent of the membership, or one in 200. Hui, a specialist in electron optics, was honored for his "innovative application of electron diffraction and other physical methods to elucidate membrane and liquid crystal structures, phase transition and membrane diffuse mechanisms." Sarkin named to chair pediatric association'seducation panel ichard Sarkin, M.D., clinical associate professor of pediatrics and attending physician at The Children's Hospital ofBuffalo, has been elected to the position of chair of the Ambulatory Pediatric Association's Special Interest Group on Medical Student Education. As chair, Sarkin is responsible for making recommendations on curricular structure and teaching methodologies for medical students across the country during their pediatric rotations. Sarkin is also a member of the executive committee of the council. p g 9 5 �I - -----~-~-- - ~-- - ~.- · · · · · · · · · · · · · · · · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · o March Foundation'ssupport to school approaches $1 million loan fund to ensure help is available for students when unanticipated needs arise. lara March graduated from the University of Buffalo School of Medicine in 1907 and never treated a single patient. But she helped thousands of sick and injured people through her generous support of education for generations of physicians. At her death in 1967, the assets from March's estate were used to create a foundation for the medical school's benefit. Each year for nearly a quarter of a century, the Clara March Foundation has provided significant support for the school's students. Last year the foundation presented another generous gift of $65,000 for loans and scholarships, brining its total support to nearly $1 million. The foundation's annual gifts to the medical school provide 20 to 39 scholarships a year, in amounts from $1 ,000 to $10,000. A portion of the foundation's support is also set aside in an emergency illS elects RPCI researcher Joel Huberman,Ph.D, to rank of fellow oel Huberman, Ph.D., rese~rch professor at Roswell Park Cancer Institute and one of the nation's leading experts on D A replication, has been elected to the rank of fellow by the American Association for the Advancement of Science. Huberman, a cancer research scientist in the department of cellular and molecular biology at Roswell , was honored by the AAAS for his "pioneering studies of D A replication, particularly for his discovery and characterization of eukaryotic DNA replications origins. " Each year the AAAS elects members whose "efforts on behalf of the advancement of science or its applications are scientifically or socially distinguished. " Brodsky first woman officer of pediatric otolaryngology society inda S. Brodsy, M.D. , UB associate professor of otolaryngology and director of the pediatric otolaryngology department at The Children's Hospital of Buffalo, has been elected treasurer of the American Society ofPediatric Otolaryngology. She is the first woman officer elected to the organization. She has also been elected to the board of directors of the Society for Ear, ose and Throat Advances in Children, as well as the American Academy of Pediatrics, Section on Otolaryngology and Bronchoesophagology. At a reception for Clara March Foundation staff, trustees and recipients: from left, medical student and scholarship recipient, Aisha Prim; Foundation accountant M. Jane Dickman, C.P.A.; Foundation trustee Carmella DiPasquale; vice president of clinical affairs and dean of The School of Medicine and Biomedical Sciences John Naughton, M.D.; Foundation trustee Frank W. Warhus and his wife; and medical student and scholarship recipient James Murray Jr. B u a 0 p y 5 c o n s p n 9 9 9 - �One of the many gardens at the Buffalo City Hospital. Circa 1930. EtM~ built ~m ~e~ t~ peoJ~e mf its commmmity MEDICAL CENTER'S ROOTS DATE BACK TO AN OLD SCHOOL BUILDING REQUISITIONED IN 1909 TO DEAL WITH SCARLET FEVER EPIDEMIC rie County Medical Center had its roots in two Buffalo hospitals and an old , school building requisitioned in 1909 as a temporary contagious disease hospital by the then-commissioner of health Ernest Wende, M.D., and the mayor of the City of Buffalo,]. N. Adam. ~ B 1 ~ a 0 p y 5 a n 5 p n 9 9 5 �I -- - --- - -- - - - - THEN a 0 p A N D ~ N0 W In 1918, the new Buffalo City Hospital and opened in 1951. It was later named opened its doors; it was one of only 12 in the Donald C. O'Connor Memorial Wing the country that accepted all diseases for in honor of the hospital's third superintreatment. Later that year, the Erie County tendent. The last building added to the hosAlmshouse and Infirmary, located on the pital was the new School present site of the Univer84 for crippled children, sity at Buffalo's Main Street renamed the ComprehenCampus, burned to the sive Care Center for Chilground. Patients from the dren, which opened in Almshouse were moved to 1971. the new Buffalo City HospiGround was broken tal - abruptly and unexfor the present Erie County pectedly turning the new Medical Center on Octotuberculosis hospital into a ber 27, 1971, culminating public general hospital. 10 years of meetings, disThe original buildings of cussions, consultations the Buffalo City Hospital and planning. housed administrative ofThe new hospital fices and patient beds. In on Grider Street building 1922, more patient care became a reality because of the untiring space and the original urses Home were efforts of a group of civic-minded citiopened. One year later, communicable dis- zens led by then-county executive B. john Tutuska; Mrs. ease space was opened. And Mildred Campbell, chairin 1924, the Crippled woman of the Meyer HosChildren's School84, a day pital Advisory Board; and school for children with the Dr. Kenneth Eckert, presiresidual handicaps of polio dent of the Comprehenand other crippling diseases, sive Health Planning was opened. Council of Western ew The name of the Buffalo York. City Hospital was changed Designed by Gordon to the Edward J. Meyer MeFriesen Associates of morial Hospital in April Washington, D.C., the 1939 in honor of Edward]. new Erie County Medical Meyer, M.D., a prominent Above, Alpine Sun Lamps Center was one of the most were used in the treatment Buffalo surgeon who served of tuberculosis, rickets, modern and inefficient, as president of its board of scurvy and some skin novative hospital buildmanagers for 20 years. A diseases. Below, ings in the country when member of the University of fluoroscopy. Both pictures it opened its doors on july Buffalo School ofMedicine's circa 1930 from "Views of 9, 1978. class of 1891, Meyer also the Buffalo City Hospital." Today, it serves as one served as an instructor in of the medical school's afsurgery and adjunct profesfiliated teaching and resor of clinical surgery. Editor's note: Special thanks to Ed Leisner of Erie County In 1946, control of the search sites, as well as the Medical (enter's medica/library Edward]. Meyer Memorial area's designated Level I for his help in compiling this Hospital was transferred Trauma Center, burn article. from the City of Buffalo to treatment center, AIDS the County of Erie. unit and a host of other The last addition to the acute care and ambulatory Grider Street hospital was services available to the built for psychiatric patients community. n the winter of 1909, Buffalo was gripped by an epidemic of scarlet fever. With some 3,000 reponed cases and no contagious disease hospital facilities in the area, Wende and Adam, on February 19, 1909, urgently converted an abandoned school building on the corner ofBroadway and Spring streets into a temporary contagious disease hospital. The only other public hospital facility in Buffalo at the time was the Municipal Hospital at 770 East Ferry Street. Frequently referred to as the "pest house," it was operated by the Buffalo Health Department exclusively for the care of smallpox patients. In 1910, the city saw an alarming increase in the incidence of tuberculosis. That year, 561 tuberculosis deaths were reported, prompting the city fathers to plan a hospital for the treatment of tuberculosis patients. The 70-acre West Farm on Grider Street was purchased for $200,000 as the site of the new Buffalo City Hospital. It would cost another $3 million to build and equip it. In 1913, due to the rapid decline in the incidence of smallpox as a result of the gradual acceptance of the smallpox vaccine, Municipal Hospital was converted into a tuberculosis hospital to be used until the new hospital was erected on the Grider Street site. The high rate of tuberculosis in the city and the total lack of facilities to care for children with the disease attracted the attention of Edward H. Butler, Sr., the founder and publisher of the Buffalo Evening ews. As a result of Butler's efforts, a temporary tent hospital, large enough to accommodate 50 children, was erected on the Municipal Hospital grounds adjoining the original building. With the onset of a typically frigid Buffalo winter, the children were moved inside. Before the Buffalo City Hospital was completed, three separate units were added to the Municipal Hospital for the care of patients suffering from venereal diseases, alcoholism and psychiatric problems. B ------- y 5 a 5 p n 9 9 9 �A Spoonful of Humor© Stu Silverstein, ( BUT NOT QUITE AS MODEST AS SOME ithin the next few months we will once again have to face the ugly specter of the health care debate in the " ew Congress." As a physician, l feel it is my duty to give my congressman (whoever he is) my thoughts on the matter. l plan on making my own proposals. Here in California we witnessed the passing of Prop 187, "the illegal alien initiative. " lam currently collecting signatures in anticipation of getting the "Silverstein" initiative on the ballot: anyone in California who tries to start up another HMO or managed care company automatically qualifies as an illegal alien. Recycling is important in California, so my health care package will respect this by taking the 1,000-page plan that Clinton came up with and cuLLing it into 16th's to use as prescription pads. We can use half of them to prescribe sedatives for ewt Gingrich. (You know, if Elvis were alive today he'd be 60, and probably look something like ewt.) The guy is going wild , on the first day Congress was in session he climbed into Tom Foley's seat screaming like some kind of a rodeo clown running away from Richard Simmons. ewt is calling for us to sign on with his "contract with America. " Look , Democrat or Republican, you have to wonder about a guy who is willing to solve all your problems if you sign a contract with him. l suggest we shave his head and see if he's got three 6s tattooed on his skull. That might even explain the election results. "Network marketing" is big these days, especially among physicians try- B u a a p OF NEWT'S !) ing to augment their incomes to pay malpractice premiums. l think we should apply the concept to health care reform. For instance, if you are a patient having a spinal tap, you've still got your hands free , so you'd have the option of doing a spinal tap on the person in the next bed. Then you can bill him for your services, thus reducing your health care costs. He works on the person next to him and so on. The last person out just files for bankruptcy and even..-.--=~ tually nobody pays, and (almost) body gets hurt. My plan would inc I u de thing from warehouses. The Clinton plan requires that states set up large consumer groups called health alliances to collect premiums and bargain with health care providers. All companies with 5 ,000 emplo yees or fewer would have to buy coverage through an aliiLook, why don't they just hand over the job to WalMart? Pretty soon everyone will be employed by them anyway . We could call it "The Slice Club." You walk in to the shop, pick up a bag of Almond Joys, leg warmers and pick a urologist off the shelf to fine-tune your prostate. We could even have a driv ethrough out p a tientwindow .... that's where Ross Perot gets his hair cut and look what it's done for him. ... just to make sure it gets approved in the House and Senate, the definition of therapy will include chiropractic adjustments at clinics that charge $7 a drink. These days everyone is buying everyh 5 c a n M.D. Slll Si /rcrstci11, p•csidc111 of Sta11dup Mcdici11c Scmi11ars of Sa11 Fra11cisco, lect ures 11aliollwidc 0 11 5 humor ill mcdici11c. p 9 9 9 5 �- - -- . . . . . . . . . . .... ·. . . . . ... . . . . .... . . . ..... . ..... . . . ... E!j -- - -- - -- Stockton Kimball talk highlights annual symposium MEDICAL A L UMNI ASSOC IATION ' S 1995 SPR I NG CLINICAL DAY PRESENTATIONS FOCUS ON "THE PHYSIC IAN - hysicians are men and women of commitment, conscience and skill who face some of society's most challenging problems on a daily basis. Indeed , life and death issues are at the heart of medical practice , and so even private domestic relationships become part of a history and physical. The School ofMedicine and Biomedical Science's 58th Annual Spring Clinical Day, Saturday, April 29 , at the Buffalo Marriott, will address a variety of subjects encountered by physicians and other professionals concerned with the field of child sexual abuse, neglect, adolescent trauma and violence to the elderly. The conference, entitled , "The Physician- Healing the Abuse in Our F amily ," is intended to increase professional skills in prevention , recognition , assessment and treatment of all forms of maltreatment in the family system. The pres en lations will emphasize the awareness physicians need to recognize abuse in their patients and to encourage their roles as advocates for their patients. Specific approaches to these issues will be offered by the experts who have been carefully selected to speak at this year's program , designed to touch both the heart and the mind. The program has been designated for up to four hours of Category I Credit toward the Physician's Recognition Award of the American Medical Association and four prescribed hours by the American Academy of Family Physicians. B a 0 p h HEALING THE ABUSE I N OUR FAMILY" Faculty of this year's program inIntroduction clude: john F. Coyne, M.D. '85 "Amy" - Outreach Coordinator, Program Chairman PACT Clinic ofThe Children's Hospital of Buffalo Richard David Krugman, M.D. Landmarks in the Field of Child Abuse Dean and Professor of Pediatrics, School Stephen Lazoritz , M.D. of Medicine, University of Colorado , Denver, Colorado Stephen Lazoritz, M.D.- Medical Post Traumatic Stress in Abused Director , Child Advocacy Center , Children and Adolescents Children's Hospital of Wisconsin ; As- Susan V. McLeer, M.D . sistant Professor of Pediatrics, Section Head , Medical College of Wisconsin , Milwaukee, Wisconsin HIV: The Physician Can Make the Susan V. McLeer, M.D.- Professor Difference and Chairman, Department of Psychia- "A1ny" try, School of Medicine and Biomedical Sciences, University at Buffalo Kathleen G. Pharris, M.S.W. Coffee Break - Exhibit Reviews Director of Senior Day Center and Family Focus Program, Catholic Charities of Buffalo The Physician's Role as the Child Robert M. Reece , M.D.- Director, Advocate Institute for Professional Education , Robert M. Reece , M.D. Massachusetts Society for the Prevention of Cruelty to Children, Boston, Massachusetts The Tragedy That May Be Overlooked The agenda follows : Kathleen G. Pharris, M.S.W. Registration Business Meeting Welcoming Remarks Russell W. Besette, M.D. '76 President, Medical Alumni Association john aughton, M.D. Vice President for Clinical Affairs Dean, School of Medicin e and Biomedical Sciences 5 a n 5 p Annual Medical Alumni Luncheon and Stockton Kimball Memorial Lecture Child Abuse Prevention: Is It Too Little Too Late? Or Is It the Light at the End of the Tunnel? Richard D. Krugman , M.D. + g �~ ·········································· · ············································· Alumna dedicated her life to helping othe~ LISA BECHTEL '86 , PRACTICED WHAT SHE SAW AS THE IDEAL OF MEDICINE: A PATH OF SACRIFICE TO HELP THOSE WHO NEEDED IT MOST he lesson of Lisa Bechtel, M.D. '86, is one of humility. She died May 10, 1994, in Las Vegas, evada, where she made her home, conducted a private practice, managed a clinic and was in the process of raising three children. She and I palled around in medschool. What drew us together was what we saw as the ideal of medicine: a path of sacrifice to help those who needed it most. She went to Pittsburgh to do her family practice residency at Shadyside Hospital and I went to Rochester's Highland Hospital to do mine. Pressures of residency ate up time for both of us, and we drifted apart, losing touch. I married, adopted a child, and- the old storygot pregnant and had a second child. The majority of my family medical practice centered on inner city clinics in Buffalo. What I didn't know at the time was that in significant ways, Lisa's life was paralleling mine. She found a spouse, they adopted three children, and true to our ideals, she worked where people needed her most. From a alive American reservation in northern evada, she moved back to her home town, Las Vegas. By this time-Ilearned later, almost too late - her life and work had begun a new phase. This phase as much as anything defined the ideal of self-sacrifice - going beyond anything we had talked over so ardently back in med school, and the truth is, surpassing anything l had imagined for her or myself. Lisa was lesbian, so she was well B u a 0 p Lisa Bechtel, M.D. 5 c a 5 p n 9 9 9 5 �- --- - ---- . --- ························································ ~ ACADEMIC H ALTH PROFESSIO ALS I Insuring care for those who care Subscriber Owned • Organized • Governed PHYSICIANS • DE TISTS HEALTH PROFESSIONALS NURSES • RESIDENTS acquainted with the gay subculture, by then ravaged and haunted by the AIDS epidemic. She began working with AIDS patients, partly because of her innate sympathies, but largely because they weren't on top of doctors' lists. In fact, the Las Vegas AIDS clinic was unable to attract a medical director - low pay, very long hours, draining work, emotionally costly. The position was offered to Lisa. She took it. At once she became an indispensable figure of hope, charity, comfort and support, as well as medical attention. And it went further. Pediatricians asked her if she would see HIV -positive children who weren't getting the attention they needed. Way too few physicians knew how to treat them. She agreed. Her partner, Ann, a nurse practitioner who also worked at the AIDS clinic, was well aware of the need. Together they took another step. First they adopted an HIV-exposed baby, naming her Mariah. A year later she tested negative. Then they took in another unwanted baby - HIV-exposed in utero , plus various teratogens such as crack and alcohol. They not only kept her alive, but she thrived with them , and continues to as of this writing. Then a third baby, ate, was adopted. He was a year old last December. His HIV results are still inconclusive. Then, the wretched misstep occurred. Cleaning up in the clinic, depositing syringes in the dirty needle box, Lisa nicked herself. She filed a report and promptly forgot about it. That was in Aprill993. Six weeks later she developed a raging fever and viral syndrome. Her T cells fell so rapidly that within a few months she was diagnosed with full-blown AIDS. She grew too weak to carry on in medicine. In a little more than a year, she died. But not before the gay community rallied around her. By this time, we had renewed our contact after so many years, finding our friendship intact, reaffirming our beliefs. At a large, astonishing benefit in Las Vegas, the kind of celebration that snubs death , Lisa was honored . I attended and I don't think I've seen such an outpouring of gratitude and sympathy for one person. All good physicians dream of making a difference. Lisa Bechtel made a difference- a very, very big difference. Her example continues to make a difference in me, an object lesson that in this one profession whatever we think is enough, is never enough. All good physicians Superior policies for academic full-time and voluntary clinical faculty dream of making a ~ Competitive premiums ~ Rewarding educational programs ~ difference. Lisa Complete legal seiVice ~ Comprehensive coverage ~ Dividend opportunities Bechtel made a difference- a very, Academic Health Professionals Insurance Association is a subscriber owned and organized reciprocal licensed by the Insurance Department ofNew York State. Policy and programs ofthe Association are determined by a representative Board ofGovernors elected by subscribers at SUNY Health Science Centers. Enrollment open at all times. Transfers arranged \vithout loss. AcADEMIC HEALTH PROFESSIONALS INSURANCE AssociATION Empire State Building 350 Fifth Avenue, Suite #1512 ewYork, ewYork 10118 Ph. 212-947-4541 Fax 212-947-4572 B u a 0 p h very big difference. 5 c a n 5 p - BY n DEBORAH 9 9 RICHTER 9 5 �E ; ] ···················································· ·· ·· Four receive 1994 Lifetime Career Achievement Awards ifetime Career A hievement Awards were presented to four alumni last year. Andrew A. Gage , M.D ., '76, William R. Kinkel , M.D ., '5 4 , James F. Mohn, M.D. , '44 and Max A. Schneider , M.D., ' 49 , received the Medical Alumni Association's 1994 Lifetime Career Achievement Awards at last year 's pring Clinical Day and Reunion Weekend celebration. The awards are presented in recognition of conspicuous and outstanding career achievement. y ft \1~; Andrew A. Gage, M.D. William R. Kinkel, M.D. James F. Mohn, M.D. ~ Max A. Schneider, M.D. \.hi OFFICH uestionnaires for the special Sesquicentennial edition of the alumni directory have been sent out by the Harris Publishing Company. Please be sure to complete and return your directory Call UB questionnaire before the deadline indicated. cro to nqu~re' • Apple • IBM • Dell • Compaq • Panasonic • Hewlett Packard • TI • Sony • Software • Supplies • Accessories • Audio • Hands-on Workshops Prior to the publication date, the Harris Company will contact you after the data have been compiled to verify the information in your listing. B a 0 p 5 c a n s p n g 9 5 �"EJ ... .... ................. .. ......... ... .. . ........ . .................................. became board certified in critiof Johns Island, South Carolina, writes that after interning at Buffalo's Deaconess Hospital and HAROLD J . ELLIOTT '38 , cal care medicine in addition to internal medicine and pulmonary diseases. He is director of respiratory service and associ- orthern Westchester Hospital, he practiced medicine for six years in the mountains of Kentucky, eight years at orthern ate director of the sleep disor- igeria Mission Hospital, 18 years in southeast Minnesota and and living in Chicago. for the past 23 years in Johns Island, Charleston County, South Carolina, in a poor people's clinic in a church building. At age 80, he's still active ders lab - still actively practicing medicine, skiing and !ly fishing. His son, George, is married board certified examiner of the American Board of Forensic Examiners. '65 , of STANLEY L. OLINICK '40 , Winter Park, Florida, was certified in forensic psychiatry by points out a crowning irony of The American Board of Psychia- his career. In what may be his final (or nearly so) year of private practice of psychoanalysis, try and eurology after successfully completing the first exam given in the field last October. He has previous certification he has been included in the second edition of "Best Doctors in America." He continues to write papers for psychoanalytic journals, teach and enjoy his family, tennis, music and reading. LEONARD WOLIN '41 , of was appointed president and to professor of radiology at Northwestern University Medical School. He is director of chief executive officer of the Long neuroradiology and a member of Island Jewish Medical Center. the strategic planning committee -AS R. His is a senior partner at Kenmore Pedi- was atric Associates, P.C.; medical director for ight Call, an afterhours telephone triage service for elected president of the Chi- of JAN ARTHUR SCHWARTZ Westwood, Massachusetts, was elected president of the Massachusetts Academy of Dermatol- '75, is a pediatric anesthesiolo- ROBERT A . KUWIK '72 , of Johnson City, Tennessee, left private practice to accept a position as assistant professor of psychiatry at East Tennessee State University Quillen College of Medicine. His oldest son, Brian, is a Fulbright scholar in Cameroon, Africa, until October 1995; middle son, ick, is a junior at Florida State University. psychiatry since 1992 and is certified by the American Society of Addiction Medicine and the American Board of Quality Assurance and Utilization Review. Rhode Island. He wrote that he and his wife were expecting their Marrow and Blood Stem Cell Severin-Salzman. third child, a son, in January 1995. JOHN R . AND E R SON '67, RICHARD ofDepew, ewYork, was named medical director of the Brothers Sparks, PFOERTNER '60, of Boise, Idaho, recently B u a 0 BARNETT SALZMAN '65 , of Mercy ursing and Rehabilitation Center in Clarence, New p ARTHUR C . SGALIA '73 , of Wrentham, Massachusetts, was named chief of internal medicine at Rehabilitation Hospital of S. LEE '74 , of evada, was appointed chief of neurology and director of neurosciences of orthern Nevada Medical Center. 0 Society. 12; and Meredith, 7. of Bowling Green, Kentucky, was appointed medical director of the adult unit of Riverdell Psychiatric Hospital as well as a new member of the American Board of Forensic Examiners. He recently married Stacy Jean B. cal can Academy of Pediatrics. he's now "retired" but keeps up with his computer and the latest news, including the very latest from the Los Angeles Times, about his son, MAURICE J . WOLIN '84 , of Westlake Village, California, and his work for the Westlake Medical Center's Bone GEORGE cago RadiologiThey have two children: Gabrielle, ogy. He has two daughters. with added qualifications in geriatric psychiatry and addiction recently New York Chapter 1 of the Ameri- ALLEN BERLINGER '71 , Amherst, New York, writes that Transplant Center. K. Fernbach, physicians; and vice president of three days a week. KOLIN DAVID R. OANTZKER '67 , ROGER A . FORDEN '70, '65 , of Newton, Connecticut, recently became a diplomate and S. ERIC J . RUSSELL '74 , of Chicago, Illinois, was promoted wife, Dr. Sandra AUGUST J . D 'ALESSANDRO IRVING York, where he has been a staff physician for two years. 5 p gist at the Geisinger Clinic, in Danville, Pennsylvania. She recently spent three months as a visiting professor of pediatric anesthesiology at the department of anesthesia of Soroka Medical Center, Ben Gurian University of the egev, Beer-Sheva, Israel. DENNIS WHITEHEAD '75 , chief of emergency services for Dickinson County Memorial Hospital in Iron Mountain, Michigan, is serving a two-year term as speaker of the council of the American College of Emergency Physicians. He recently became the 36th person (and second physician) to climb the highest point in each of the 50 states. He writes that he's looking forward to his 20-year class reunion this spring. B E NNETT VOG E LMAN '78 , was appointed to the University of Wisconsin Teaching Academy and promoted to professor in 1994. g 9 9 5 �~ -··· ····· ··· ········· ······· ····· ·· ········· ······· ···· ······························ · ···· 1 9 8 KATHERINE DECARIA '80 , s 0 VINCENT JASNOSZ - of Murrysville, Pennsylvania , is a staff pathqlogist at Allegheny General Hospital in Pittsburgh. She has two children: Daniel, 5; and Anna, 4. of LOIS M . MCNALLY '82 , ew York City, was appointed director of medical student education for the ophthalmology department of the ew York Eye and Ear Infirmary where she JOSEPH 1 FASA - '86 , and his wife, NE LL O Donna, announce the birth of their second child, Diana Christine, on December 20, 1994. JESSIE JEAN -RUSH '86 , 9 9 s 0 of Cleveland Heights, Ohio, write ship at Naval Hospital in Jacksonville, Florida. He is now serv- that joe is currently a fourth-year ing as a general medical officer E T resident at the Cleveland Clinic. Mary completed her pe- on board the amphibious dock BONAFEDE '91 , MARY CAPPUCCINO '91 , Tucson, Arizona, is a general pediatrician and major in the U.S. Air Force at Davis MonthanAir Force Base. She has three diatrics residency at Children's landing ship the U.S.S. Gunston Hall, currently deployed to the Hospital of Philadelphia in 1994 Mediterranean Sea. and is currently doing a pediatric infectious disease fellowship at beautiful children: Kira, 10; Rainbow Babies Hospital in Eddie Jr., 8; and Kesha, 6. OBITUARIES BENNIE MECKLIN '35 , practiced family medicine in the Thousand Islands T I NA MARIE GARDNER '87 , practices ocular oncology and of Malone, attended by many classmates. A Watertown, ophthalmic pathology. ''I'm a family physician working great time was had by all. 46 years, died MARC KOBLICK '84 , and his wife, Helene, proudly announce the birth of their third child, EricJordan, born June 21, 1994. ern New York. We are teaching .P. students in our practice. My son jake is 4 of outdoorsman, with a strong in- Westlake Village, California, is terest in plants and trees and co-director of the Westlake gardening. I'm expecting my sec- Medical Center's Bone Marrow ond child next month. " of Stamford, Connecticut, joined ROBERT HESS a private practice group of six '37 , died ovember 8, 1994 in pediatricians there. She writes Oceanside, California. He was an assistant plant physician and and sends news about "lots of surgeon at Bethlehem Steel in babies Lackawanna, to our classmates: a baby girl, Ilana; has INGRID ew York, for 38 years before his retirement in 1972. has a baby girl, Natalie; PATRICK E . RYAN , JR . '87 , CRUSE is an associate professor at the COLLEEN of Bal- University Hospital in Syracuse, ZITTEL timore, Maryland, is director of KINGA the EMG Laboratory at Johns ew York, where he's been an in physician attending girl, Alexa. Hopkins Bayview Medical Cen- cardiothoracic surgery since last but a new house desperately in ter and an assistant professor of july. His \vife Denise, he writes, need of a new roof and paint job, neurology at Johns Hopkins is staying at home for now, tend- so lots to keep Joe and me busy." School of Medicine. Her son ing to their children: Sean, 5; Alexander was born March 6, Erin, 3; and Kieran james, 18 1994. She writes that classmates months. ROB I N CONWIT '85 , MEHNERT that she "is really enjoying it!" ELISSA JAFFE BOOKER and Blood Stem Cell Transplant Center. ovember 14, JENNIFER F . HENKIND '91 , years old and is quite an MAURICE J . WOLIN '84 , and ew York, area for 1994, at age 83. for the Mohawk Tribe in Northmedical, P.A. and who Cleveland. They were married on November 19, 1994 at a ceremony ew York, writes, com- and JOE of PAUL D . SEEMAN '93 , pleted his family practice intern- AND GREG have a boy, George; and TIBOLD has a baby o babies for me yet, MAT THEW J . PHILLIPS '91 , died july 14, 1992. CHARLES TANNER ~3 , a Buffalo cardiovascular surgeon and former president of Mercy Hospital, died December 7, 1994 after a long illness. WALTER A . OLZEWSKI '54 , ew York, and his assistant professor of neurology wife, Toula, announce the birth and clinical associate professor of of their second son, Michael of anatomy and cell biology, died Ventura, California, has been Nicholas, born December 12, February 23, 1994. and practicing internal medicine 1994. He joins his brother , are there since August 1992. She james, who turns 2 on April 7. expecting second babies this and her husband Thomas Alfano, AMY MILLER O 'DONNE LL had her third son, Michael , in February RE ICHARD of Snyder, VINCENT J . PARLANTE '42 , 1994; A L I S ON PETERSO N SARAH MURRAY WH ITE YASMIN PANAHY '89 , STEPHEN J . KIMATIAN '92 , who were married in December spring. ANDRE MIDGETTE ' 79 , drowned in Brazil in june 1994 of Navarre, Florida, writes that 1991, welcomed a son born September 15, 1994. while on vacation with his wife and daughter. he is a [light surgeon for the U.S. Air Force in Special Operations at Hurlburt field , Florida. a a 0 p h 5 c a n 5 p n g 9 5 �The jury is out. Your practice and assets are on the line. This is not the time to be second-guessing your choice of professional liability insurance companies. • In a similar situation, a MLMIC policyholder remains confident, knowing he or she is protected by a company that already has successfully defended more physicians than all other available insurers combined. • Adding t..o the value of your MLMIC policy is one of the country's largest and most experienced professional liability Claims Departments, as well as the largest Risk Management Department of any professional liability insurer in the state. MLMIC also offers New York's only true peer review of claims experience. • Only physician-owned and controlled MLMIC offers this high level of quality assurance and service. MLMIC also is the only medical liability insurer approved by the Medical Society of the State of New York. • Find out more about the protection you'll receive from the largest and most successful company of its kind in America. Call1-800- 356-4056 in Upstate New York, or 1-800-ASK-MLMIC in the New York metropolitan area.• MLM~C ~1edical ~ u ab1litr ~lutuallnsuranl't' Company Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracu5e, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 �BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1995 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1995-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v29n02-1995-Spring Table Of Contents A list of subunits of the resource. Research Hospital News Building the Future of Research Restructuring Research at UB Medical School Then and Now A Spoonful of Humor Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v29n02 Extent The size or duration of the resource. 36 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1995 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/2ebb0c0f48bdf05c396319ecd4f13792.pdf 1343078c3383bbf7f71de62773f2f9c7 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Summer 1995 �BUFFALO PHYSICIAN Volume 29, Number 3 STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr. john a ugh ton, Vice President for Clinical AffalfS, Dean ASSOCIATE VICE PRESIDENT FOR UNIVERSITY SERVICES Dr. Carole Smtth Petro DIRECTOR OF PUBLICATIONS Timothy j. Conroy EDITOR Nanette Tramont, R. ART DIRECTOR Alan j. Kegler ASSOCIATE ART DIRECTOR DaVId j. Riley PUBLICATIONS MANAGER Dear Alumni and Friends, T his issue of Buffalo Physician highlights selected efforts in the national and international arena of volunteerism in which many faculty and students engage. You are probably already aware that foreign exchanges designed to enhance research and educational endeavors have long been a tradition for the school's faculty. Humanitarian efforts toward aiding the citizens of the global community take that tradition one step further. As the world becomes "smaller," it is even more important for UB's faculty to develop meaningful relationships that serve to enhance humanitarian efforts throughout the world. UB obviously offers a fine environment in which to train physicians and scientists from here and abroad, and its faculty and students have endeavored to "give back"- both to their local and global communities - a measure of what they have received. In all the exchanges, both the giver and the rec1pient benefit. We have many examples of successful exchanges in Europe and Asia, as well as in our own community. lam sure these will continue in the years ahead and that more will be added as national and international collaborations increase, and more physicians become aware of the needs for such humanitarian efforts. Sincerely, judson Mead PRODUCTION MANAGER Ann Raszmann Bro\vn EDITORIAL BOARD Dr. john A. Rtchert, Chairman Dr. Marttn Brecher Dr. Harold Brody Dr. Rtchard L Collins john aughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Mr. Ravi Desai Dr. Alanj. Drinnan Dr. james Kanskt Dr. Elizabeth Olmsted Dr. Barbara MaJeront Dr. Charles Paganelli Dr. Margaret W. Paroski Dr. Thomas Raab Dr. Robert E. ReiSman Dr. Stephen Spauldmg Dr. Bradley T. Truax TEACHING HOSPITALS AND LIAISONS The Buffalo General llospttal \fichael Shaw Buffalo VA Medical Center Arlene Kelly The Chtldren's Hospttal of Buffalo [ne County Medtcal Center Mercy Hospttal Mtllard Fillmore Hospttals Franll Sa\·a Roswell Park Cancer lnstttute Sisters of Charity llospttal Demus McCar·thy ©The State Umvcrstty of New York at Buffalo Bufftdo Physician is publtshed quarterly by the State University of 'lew York at Buffalo School of Medicme and BIOmedical Sctences and the Office of PublicatiOns. It is sent, free of charge, to alumni, faculty, students, residents and friends. The staff reserves the right to edtt all copy and submiSSIOns accepted for publication. Address questions, comments and submiSsions to: Editor, Buffalo Phystcian, State University of New York at Buffalo, UniverSity Publications, 136 CroftS Hall, Buffalo, cw York 14260 Send address changes to: Buffalo PltysiCian, 147 CFS Addttion, 3435 Matn Street, Buffalo, New York 14214 Dear Fellow Alumni, T hank you for the opportunity to serve as President of your Medical Alumni Board of Directors. My predecessor, Dr. Russell Bessette, did an outstanding job and will be a tough act to follow. This coming year, 1996, will mark the Sesquicentennial Anniversary of the medical school. Celebration of this event has already begun, with the conferral of an honorary degree to Dr. Gregory Thorn, one of our most distinguished alumni, at the medical school commencement this year. We will also be publishing an updated Medical Alumni Directory, which will include a brief history of our medical school. We hope you will take advantage of this directory to keep in touch with o ld friends. Plans for the 1996 Spring Clinical Day are already under way. Dr. Beth Maher is planning a promising program addressing issues on death and dying. The Alumni Association will continue to sponsor a wid e range of activities for the medical students, including the Community Physician Program, the Senior Reception and orientation events. This past year we donated funds to furnish the medical student lounge. We look forward to a busy and enjoyable year, and hope we can count on your support. We're always looking for new ways to serve our alumni and welcome your suggestions. Sincerely, Margaret W. Paroski , M.D. '80 �8 v 0 5 u 2 L . M M E 9 . o . N 9 R AUG 3 3 9 5 1 95 Research Hospital News Partial liquid ventilation. Page 12. Giving Back e UB's doctors volunteer their skills and themselves to communities throughout the world - including their own. m Breathing Life Through Liquid e The new technique of partial liquid ventilation developed at UB has the potential to revolutionize the treatment of respiratory failure. Medical School Then and Now , Alumni ASpoonful of Humor Classnotes * l~e ~lass of 1~~~. ra~e ~l Robert L. Brown, M.D. '44, dies after brief illness. Page 23. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 / ' ' / . Study shows no increased breast cancer-electric blanket use risk re-menopausal women who sleep under electric blankets do not significantly increase their risk of developing breast cancer, a study conducted by UB researchers has shown. The research is a follow-up to an earlier UB study involving post-menopausal women that also found no increased risk of breast cancer as a result of electric blanket use. It was published in the December 1994 issue of the American journal of Epidemiology. In the current study, a team of researchers led by john Vena, Ph.D., professor of social and preventive medicine, investigated a possible breast cancer-electric blanket association by comparing electric blanket use in 290 premenopausal women who were newly diagnosed with breast cancer with a control group of 289 age-matched women without cancer. Results showed that among those who used electric blankets the most, the percentage of women with cancer and without was identical. In both groups, 8.3 percent said they had used a blanket daily in season and continuously throughout the night for the previous 10 years. "The bottom line," Vena said, "is if there is an effect, it is likely a weak one. Some researchers now think that the pineal-melatonin mechanism [one of the mechanisms suspected to increase breast cancer risk] may only operate for certain types of cancer tumors- those that are estrogen-receptor positive. The next phase in our research will be to look at electric blanket use and certain types of breast cancer." Also participating in the study werejo L. Freudenheim, Ph.D.; james R. Marshall, Ph.D.; Rosemary Laughlin, Ph.D.; Mya Swanson; and Saxon Graham, Ph.D., all of the department of social and preventive medicine. + B u a a p weren't recommending the back position despite the AAP recommendation. Parents were getting conflicting advice from nurses and doctors." Hudak designed the study to determine how physicians feltabout the issue and how their attitudes influenced what they told parents. The AAP recommends the tummy-up or side position. Reasons given most often for having reservations about the recommendation were the lack of published data on the connection between sleep position and SIDS in the U.S., and past experience. Also menUB study has shown that physi- tioned often was the possibility of aspiracians are reluctant to follow the tion after gastroesophageal reflux. + recommendation of the American Academy ofPediatrics and tell parents to put newborn babies on their backs to sleep to reduce the risk of Sudden Infant Death Syndrome. The recommendation, promulgated by the Academy in 1992, broke with University at Buffalo study- the what had been tradition since the 1930s first ever to assess the use of and abandoned the practice of placing assistive devices by elderly perinfants on their stomachs after studies sons with Alzheimer's disease and from Europe, Australia and ew Zealand other cognitive impairments- has showed a significant decline in SIDS found most existing devices for after physicians there urged parents to patients with dementia aren't designed put their infants to bed on their backs or to remain useful as mental health detesides. riorates. The UB study, reported in the january Results of the study, conducted by 1995 issue of Pediatrics, involved 121 researchers in UB's Rehabilitation Engiprimary care physicians. Only 24.4 per- neering Research Center on Aging, cent of them said they strongly agreed showed that elderly persons with cogniwith the AAP recommendation and only tive impairments living at home were 42 percent said they recommended the using fewer devices after one year than supine position to new parents. at the beginning of the study, even Principal author Bonnie B. Hudak, though their need for helpful devices M.D. , assistant professor of pediatrics, had increased due to declining health undertook the project as a result of her and cognitive status. own experience with her new daughter. "Obviously we are not making de"When I had my baby in 1993, no- vices that are as useful as they should body talked to me about sleep posi- be," said William C. Mann, Ph.D., direction," she said. "I began talking to other tor of the center, professor and chair of parents and learned that pediatricians the department of occupational therapy Physicians reluctant to heed ill adrtce about infant sleep position Alzheimer'simpairment outpaces dertces designed to aid patients y 5 a n 5 u m m e 9 9 �m ···· · · · · · · · · · · · · · · · · · ·· · · · · · · · · · ···· · ·· · ···· · · · · · · · · · · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · · m ' . . . and lead researcher of the study. "We need to develop more 'smart' devices and devices that will remain useful longer, as cognitive health declines. " Baseline data from the study, reported at a recent Gerontology Society of America meeting, came from a Consumer Assessments Study by center researchers that analyzed the types of assistive devices used by 90 elderly people and their caregivers. Mann and his colleagues based their current findings on a 31-person subset- all with cognitive impairments living in a home setting. Twenty-five of the 31 were diagnosed with Alzheimer's disease; the remainder were cognitively impaired. The researchers intend to follow this group for five years to provide direction for new device development and improvement of existing devices. + researchers say fractal geom- l etry may hold the key to ear- ~l lier detection of osteoporosis. The computational technique that tests and characa. Ill terizes bone deterioration more accurately than methods currently in use was developed by Raj S. Acharya, Ph.D. , associate professor of electrical and computer engineering. He explained that clinicians who look at X-ray images of bones have only been able to track deterioration in bone mass; deterioration in the honeycomb structure has been too subtle to see. But Acharya and his colleagues found a way to examine the fragile interconnections in this tissue , and to determine the level of deterioration. The technique lets them home in on each pixel in an X-ray or MRl and assign it a specific value called a fractal dimension. "With fractal dimensions , we can compute structural information," Acharya B u 0 0 p Genetic evidence of smoking and cancer rtsk shown by UB study said. "Together, mass and structural information give a much better indicator of bone condition. " Working with animal data obtained from Merck Corp. , Acharya and colleagues from the School ofDental Medicine used fractals to compare the trabecular tissue of the bones of normal rats with those of rats with osteoporosis induced through estrogen depletion or the immobilization of limbs. "ln both cases, when we computed the fractal dimension in these data, we found there was a significant difference between the values for normal bones and the values for bones with osteoporosis," he said. In the early stages of osteoporosis, Acharya said, "the honeycomb structure might actually be broken, which would weaken the bone, but because the mass might still be the same, a bone density test would not show anything abnormal. "The advantage of our approach is that if you can pick up signs of disintegration before the bone starts massive deterioration, then you can start therapy ," he said. "And if you can catch it at an early stage, there's a good chance that a deeper osteoporosis will not develop. " + Fractal geometry may aid in earlier detection of osteoporosis - B Y ELLEN esearch has yielded further evidence of a genetic link between cigarette smoking and breast cancer risk in humans. A study conducted by UB scientists has shown that female smokers who have the slow-acting genotype for -acetyl-transferase ( AT2) , an enzyme that detoxifies carcinogenic compounds in cigarette smoke, could have eight times the risk of developing breast cancer as women with the fast-acting NAT2 gene. The research provides new insight into why previous epidemiologic studies may have failed to show a consistent association between cigarette smoking and breast cancer in the face of evidence that tobacco smoke is a cancer risk factor at many other organ sites. Other research has shown that smokers with the slow-acetylation genotype for NA T2 had higher levels of tobacco's carcinogenic compounds in their bloodstream and were at increased risk of developing bladder cancer. The UB researchers - led by postdoctoral fellow Christine Ambrosone, Ph.D., of the department of social and preventive medicine - analyzed the characteristics of the AT2 gene in the DNA of 159 post-menopausal women with breast cancer and 203 cancer-free women in a control group. A strong association between smoking and breast cancer in slow acetylators was shown, with women who began smoking before age 18 at highest risk. Intensity of smoking at two, 10 and 20 years prior to the interview appeared more significant than duration of smoking. Slow acetylators showed a fivefold increase in risk. No significant associations between breast cancer risk and total years smoked, packs-per-average year or pack-years smoked were demonstrated among rapid acetylators. + GOLDBAUM Fractal dimension (FD) graphed for spine (above). e I'Moftsl FD " '-tWill 1.95 1.90 1.85 • 1.80 •••• • •••• 11 1.70 .., 1.65 1.60 1 - - - ' - - - ' - - - - - - _ ; _ - - - - 1 1 3 4 5 6 7 8 9 10 11 11 13 14 15 lime May 30, 1991 y 5 June6, 1991 a B Sept.16, 1991 n s '' m m Y e LOIS B AKER �The nation's first integrated hospice campus combines inpatient care facilities with a 40-bed residential facility containing a 10-bed AIDS unit. The lO-bed inpatient unit, which replaces Hospice Buffalo's former Alden facility, provides care for pain and symptom control, respite , and patients in the final stages of their disease process. The unit includes accommodations for family members to spend the night. Mitchell Campus also serves as a training site for medical and nursing students and allied health professionals and offers community programs on grief, loss and living with a life-threatening illness. + Hospice opens unique integrated residential-inpatient facility he nation's first integrated hospice campus combining residential and inpatient care facilities opened in Western New York last April. Located in Cheektowaga, Hospice Buffalo's Mitchell Campus was designed by the Hospice Association of Western New York to meet the growing need for services to help individuals and families facing advanced illness. The innovative campus includes Kresge Residence - the nation's first hospice-operated skilled nursing facility-a lO-bed inpatient unit, a 200-seat multidimensional educational center, non-denominational pastoral care facilities and centralized offices for Hospice home care and administrative staff. The 40-bed residential S F provides advanced care to those who have a skilled nursing need but a limited caregiving system, or no home in which to receive care. lt includes a lO-bed unit for AIDS patients - the only one in ew York State outside the ew York City metropolitan area. Kresge Residence features a comprehensive activities and recreation program, as well as physical therapy, occupational therapy, speech therapy, mental health services and pastoral care. Hospice support services include medical social work, volunteer support and bereavement counseling. 0 B u a 0 New book names Roswell one of North America'sbest hospitals oswell Park Cancer Institute is one of the "top-rated medical facilities in the United States and Canada," according to The Best Hospitals in America, a new book published by Visible lnk Press. Written by john Wright and Linda Sunshine, the book is a comprehensive guide to the services offered by the most prestigious medical institutions in orth America. Based on physician recommendations, and supported by information from government sources , professional and lay publications, patient satisfaction surveys and interviews with hospital officials, the book identifies for the public those hospitals whose reputation, personnel , basic and clinical research, treatment modalities and other special qualities have earned p h y s c a 5 them the highest standing in the medical community. According to the authors, "these are places to which physicians in other hospitals send their sickest patients - and with good reason." Roswell is the only facility in Western ew York and one of only 27 nationwide to hold the designation of comprehensive cancer center, awarded by the ational Cancer Institute. "We are pleased and proud that Roswell Park has once again been recognized for its exemplary leadership role in setting the national standards for cancer care, research and education," said Thomas B. Tomasi, M.D., Ph.D., president and CEO of Roswell Park. + Roswell opens dedicated HIVrelated malignancy center oswell Park Cancer Institute has opened its Center for HIV -Related Malignancies to meet the needs of patients who have cancer as a result of human immunodeficiency virus infection. The new center affords patients access to unique therapies, several of which have been pioneered at Roswell, said Zale Bernstein, M.D. , center director. "These patients require specialized care and unique approaches to help prevent and treat malignancies and opportunistic infections," Bernstein said. "As a major cancer center, Roswell Park m m e 5 �. . . . .... . . . . . . . . . . . . . . . .... . . .·. . . . . ... . . . . . . . . . ... . [1] has the facilities, resources and expertise to provide the intensive care these patients need. " A 1994 survey by U.S. News and World Report ranked Roswell among the best hospitals in the U.S. specializing in treating HIV-infected patients, based in part on the design , availability and preliminary successes of innovative treatment protocols the cancer center offers. Several current protocols use photodynamic therapy, pioneered at Roswell in the early 1970s. Others use Interleukin-2 in self-administered doses to attempt to ameliorate patients compromised immune systems. "We have recently completed a study which indicates that this therapy is easily administered with good comfort and compliance by the patient," explained Bernstein. In the patients studied to date, there have been no opportunistic infections reponed in over 40 months of accumulated observation. Bernstein added that Roswell is one of only three centers in the nation using monoclonal antibody therapy to treat malignant lymphoma in HIV-infected patients. "We have treated over 15 individuals with this therapy and have witnessed good results, " he said. "We encourage physicians and HIVinfected individuals to look to our treatment protocols as viable approaches to cancer care," Bernstein said. For more information on these and other protocols, call the centerat1-800-685-6825. + the ew York State Department of Health. The heart-lung transplant program completes and complements the alreadyestablished adult cardiac transplantation program in place at The Buffalo General Hospital, and is supported by the School of Medicine and Biomedical Sciences, as is BGH's. Buffalo General was designated the area's regional adult heart transplant center in 1986; its lung transplant program was developed in the early 1990s. Children's has maintained a working relationship with the adult program in an ad hoc role . Children's has had an active cardiac program for more than 30 years. The recent recruitment of Eliot Rosenkranz , M.D., from the Cleveland Clinic to head Children's division of cardiovascular surgery, has intensified the hospital's program. "The designation marks a new milestone in Children's Hospital's more than 103-year history," said joseph A. Ruffolo, president and CEO of Children's. "It's about saving lives ... providing the finest pediatric health care services well below the national cost level ... tapping new research doors that enable us to continue looking for better treatments and cures to heal our children ... and helping to establish new referral patterns from throughout New York State for other specialty pediatric services Children's offers. "One of the most pleasing aspects of this approval process was that Western ew York area hospitals, health insurers, civic leaders and health care stakeholders showed unconditional favor for our effort and participated as supporters," Ruffulo said. Children's filed its CON injuly 1994. At that time, pediatric heart and lung transplantation in New York State was primarily provided at adult health care systems in New York City, or at outof-area pediatric medical centers in Boston, Pittsburgh and Cleveland. + Children'swins DOH approval for heart-lung transplant center he Children's Hospital of Buffalo announced it has been designated Western ew York's regional center for pediatric heart-lung transplants with the approval of its certificate of need application by B 0 0 p y 5 c 0 S u BGH names Salerno chief of its division of cardiothoracic surgery he Buffalo General Hospital has named Tomas A. Salerno, M.D. , chief of the division of cardiothoracic surgery. Salerno is internationally known for his research and the development of the technique of warm heart surgery. He has been a visiting professor worldwide , including at BGH several times in the past. Salerno earned his medical degree at McGill University in Montreal, Quebec. He received his specia lty training at Montreal ' s Royal Victoria Hospital , where he became chief resident in general surgery and then chief resident in cardiovascular and thoracic surgery. Salerno served as professor and chairman of cardiothoracic surgery at the University of Toronto, Ontario, from 1987 until 1992, and head of the division of cardiovascular and thoracic surgery at St. Michael's Hospital in Toronto until1993. He was an honorary professor of cardiac surgery at the University of Chieti, Chieti, Italy, from 1993 until1994. ln addition, he has been on the surgical staffs of Kingston General Hospital, Kingston, Ontario; St. Mary's of the Lake Hospital, Kingston; Montreal Chest Hospital; Montreal Children's Hospital; The Toronto Hospital; and Sunnybrook Health Science Hospital, Toronto. He is a member of many national and international societies, and has published more than 500 papers and abstracts. He is the author of an upcoming book, Warm Heart Surgery. + m m e �-------------------------------------------------------------- . T II () \I .\ "IT IS BETTER TO LIGHT ONE CANDLE," says an old proverb, "than to curse the darkness." Peter, Paul and Mary made a song of that sentiment back in the glory days of social activism. But 1 volunteer service isn't consigned to the memory of the 1960s. Far from it. As dozens of University at 1 Buffalo medical school alumni, faculty and students demonstrate every day, pitching in with talent and energy always makes a real difference in people's lives. From the war-ravaged survivors of the Bosnian civil war, to the rebuilding economies of Vietnam : and the Ukraine, to the mean streets of our own poorest neighborhoods, volunteerism works. The darkness around us does seem deep, and there are many who would curse it. For these physicians, though, there just isn't time to lament the state of the world. There's work to be done. -------------------------------------------------------------- .. 0 B a 0 p h 5 a S u m m e 9 9 �-------------------------------------------------------------- .. From our own baekyard. to loealrs halfway around thr world. tlw nrrd for mrdieal hrlp is strong. 1 [B·s physieians proridr both din'<·t nwdieal earr for palirnts. and training. rrlirf and supplit>s for llH'<Ii<·al prrsomwl. IN TilE MIDST OF WAR some of whom, Hassanali notes, hadn't had a break in two years. Fifteen doctors were ready to make the trip in May 1994, but the on-again, off-again war broke out anew in Sarajevo. "The State Department strongly discouraged us from going," Hassanali said. "It became a dangerous situation to bring a big delegation." Hassanali decided to go alone. He went to Zagreb, Croatia, and joined the United Nations force there as part of a group of medics. But the fighting in Sarajevo was too fierce; the UN could get him into the city, but couldn't guarantee he'd ever make it out. He stayed in Zagreb, treating some of the nearly half-million refugees who fled to Croatia. Meanwhile, Bergs land, who holds dual orwegian and American citizenship, was able to enter Sarajevo with a medical company of the orwegian army. He was in Bosnia for three months, and spent four days in Sarajevo just after a major shelling of the city's central fruit market left 120 dead and scores injured . "To a large extent those patients had been treated already," Bergsland said. "We basically did more for the evacuation. President Clinton had sent a plane to take out Television images of the vicious civil war in the former Yugoslavia have horrified the world and sparked compassion for the innocent victims of the fighting. An initial effort in Buffalo to treat some of the wounds of war now has blossomed into a large-scale initiative for relief medicine and medical training for Bosnia's physicians. Called International Medical Relief of Western ew York Inc., the organization includes about 250 volunteer physicians and has a corporate office and a warehouse for supplies. Its president is jacob Bergsland, M.D., an assistant professor of surgery at UB medical school; its vice president is dermatologist Riyaz Hassanali , M.D. '86. Several other UB-connected physicians serve as officers or on an advisory board. The group began after Hassanali was introduced to the wife of Bosnia's vice president, herself a dermatologist, who was living in Buffalo with her children. After hearing her talk about the situation in her country, Hassanali organized a meeting of local physicians who wanted to find some way to help. They decided to solicit medical supplies and organize a trip to relieve the Bosnian doctors, ______________________________________________________________ .. B a a p h y c a n S u m m e 9 5 0 �r--------------------------------------------------------------., G [ I N I 1 B A 1 1 G K 1 1 1 1 lntt:>rnational Mt:>dital Rt:>lit:>f of Wt:>stt:>rn ~l:'w York providt:>s lwlp for war-torn Bosnia and Zagrt:>b. Croatia. some of the victims, and we had to get them from the hospital to the airport. " That was accomplished , he said, in armored ambulances accompanied by armed guards. He also practiced in his specialty, thoracic surgery, in the north-central Bosnian city ofTuzla. Now the contacts that both Bergsland and Hassanali made have grown into a continuing relationship with physicians at the Tuzla Medical Center. "We had decided that bringing humanitarian supplies was one thing, but the one group that has been completely ignored is the doctors and nurses, " Hassanali said. "Every other organization was helping the victims (of the war) . But we decided that our efforts would go toward the medical personnel. These are people who are really making sacrifices .... We started corresponding with some of the doctors , and found that they were hungry for knowledge. " So International Medical Relief started sending medical textbooks and journals, and put together a shipment of medical instruments. The group also began an exchange program, sponsoring Bosnian doctors and nurses to come to Buffalo for intensive training. The first group includes a cardiologist and a vascular surgeon, as well as three nurses , all training at The Buffalo General Hospital. "Bosnia is not a Third World country by any means ," Hassanali said. "But because of the war situation, they have been completely deprived of outside information and money to continue their research. You have a very educated group of individuals who are now just starving intellectually. " ln addition , teams of Buffalo physicians - one this summer, one in the fall- are heading for Tuzla to treat patients and conduct seminars. ln the past year, Hassanali said, about $100,000 in cash has been raised through two dinners and two medical conferences, and about $500 ,000 in equipment has been donated. "Our long-term goal," he said, "is to set up a 1 cardiac surgery center in Tuzla. " For Bergsland, pitching in is a matter of supporting what's right. "The legal government of Bosnia," he said, "has a policy that's similar to what we have in the United States: that people should be recognized as individuals and not as members of some ethnic or religious group. The Serbs have this terrible policy of ethnic cleansing and destruction of other people. Fifty years after the Nazis had similar policies in Germany, now we have it 400 miles to the south. This is something that we must do something about. " "l can completely identify with what they're going through ," said Hassanali, himself a refugee from Uganda. "Somebody was there to help me, to lend me a hand, and now it's my turn to pay back. ... I don't profess changing humanity. My goal is to make a difference for one person in this world. lf we all thought that way, the world would be so much better. " SEEING ACR<SS BORDERS lt was a bit of volunteer work on the Caribbean island of St. Lucia, back in 1976, that set Yale Solomon, M.D. '50, to thinking about the rest of the world. Said Solomon, an ophthalmologist in Bay Shore, .Y.: "Ophthalmology is the type of work that one can do on kind of a one-shot basis. l realized that you can go in , operate and see patients, and leave, and you don't leave a trail of half-finished work as you might, for example, in internal medicine. " A decade later, Solomon was inspired by a friend who had done similar work in India to go there. "I met the doctor in charge, and he was very happy to have the help ," Solomon said. "I realized that this could be some sort of ongoing arrangement, that they could use help beyond just me for a month. " That realization has grown into Volunteer Eye Surgeons International Ltd. (VESI) , a group of ophthalmologists who volunteer their expertise to serve month-long ______________________________________________________________ .. 0 B a a p h 5 a n 5 u m m e 9 9 5 �r··----------------------------------------------------------·-• I In Virtnam. tlw Voluntwr EyrSurwons Jntrrnational Ltd .. trains physitiansand pnwidPSsuppliPSand updatro nwditallitrratml'. 1 I Scott D. Perrapato , M.D., didn't know what to expect when he went to Vietnam for three weeks in February. What he found was both totally foreign - and oddly familiar. The Ho Chi Minh Medical School, he said, was built in the late 1960s by the American Medical Association, when that city was called Saigon. "It hasn't changed a bit since then," said Perrapato, who serves as an assistant professor of urology at the University at Buffalo medical school. "It was like being in a Southern U.S. medical school in that time. It's a neat place." Through the Friendship Foundation of American Vietnamese, an Ohio-based group, Perrapato joined a team of seven physicians on the trip. They made rounds from 7 a.m. to noon each day , then lectured to medical students all afternoon. "They have a 200-bed, 350-patient urology hospital," he said. "To work in that kind of environment is kind of a dream." The group also traveled to the provincial city of Nah Trang, where Perrapato worked with the staff urologists and saw patients. "''d never been in a place so destitute, " he said, "but the people showed no animosity (toward the Americans). From the street people to the government people, they were just gracious. I'm told the Vietnamese and Asian people have always been very open, and they're certainly not materialistic. . .. There, the families help give care in the hospitals; they're expected to, and they love doing it. And really , it's a big advantage to the patient." Now Perrapato is on the designing board for a new hospital in ah Trang, making suggestions for what the facility should include. He's making a return trip in February, this time with his wife, Tracy, who did her residency in family practice at UB. The hard part, Perrapato said, was the re-entry into American life. "The quality of the doctors and nurses was exceptional (in Vietnam) , but the constraints weren't B A I a 0 p h 5 c a 5 m m e 9 5 c K 1 1 -------------------------------------------------------------- .. u ~ 'KIND OF A DREAM' residencies in India, Thailand, Java, Liberia, the East African nation of Djibouti- and now Vietnam, to which the group has sent eight doctors in the past year, to see patients and train the staff physicians there. "We do not go for volume," Solomon said. "I learned in India that the doctors there are perfectly capable surgeons and physicians, and do an extraordinary amount of work. India has 6 million people with cataracts. "If we send a doctor there every six months , he's not going to make a dent in it. We teach some basic material and do operate, but primarily for demonstration purposes. "It's amazing how many ophthalmologists- both the young ones before they really start their practices and the ones in their later years - have an altruistic sense that they want to go and do something other than sit in their office and work for money," he said. "They feel they want to help and use their unique abilities , and here's an opportunity. " The Vietnam project includes bringing a young ophthalmologist from that country, a professor at Hanoi Medical School , to the New York Eye and Ear Infirmary for training. "He'll go back with books, supplies, and an awareness of new techniques that they just don't have ," Solomon said. "We're sending him back with a lot of books which he is going to translate into Vietnamese. They do not have any medical literature that dates after 1970." VESI makes it easy to volunteer, making all travel and living arrangements for ophthalmologists who agree to a month's service overseas. And the benefits work both ways. "It's very rewarding for the doctor who does the work ," said Solomon, who has cut his own practice in half to manage the organization. "You see cases and see things that you would never have experienced otherwise. The culture, the way people react to their physician - the whole atmosphere is so different. In a sense, this is really fun. " B (1 0 �r - - - - - • • • • • • • - - - • - - - - • - - • • • • - - • - - - • • - - - • • • • - - - - - - • - • - • - • • • • - • • - ., The program also involves bringing Ukrainian physicians to Buffalo for training, as well as an initiative to translate medical textbooks into Ukrainian. Organizers also are seeking to install a computer system in the central medical library in L'Viv, which would make it possible for physicians to teleconference with their colleagues worldwide. Sirkin's first trip to L'Viv was in june 1994; she took with her some donated diagnostic and surgical equipment and supplies. She taught techniques of anesthesia , cataract surgery and lens implant surgery, as well as such basics as how to use a microscope. In March of this year she returned to L'Viv. "They seem to be doing fairly well," she said. "They're starting to adopt some of the techniques and some of the equipment. "But it's very difficult, because you're fighting the political system within the hospital hierarchy , which is very patriarchal and hierarchical. Ophthalmology is almost entirely a female specialty there. But the administrators are all male, and the ophthalmologists don't always get their needs met. " there. There wasn't the paperwork and all the insurance overtures. I'd never been in that environment, where you could just practice medicine. " 1 X I (; I 8 A c K niiTI'IN(l CKRAINE GPTO DATE There's nothing wrong with Ukrainian medicine that about 25 years of scientific progress won't cure. That's what Sara R. Sirkin, M.D. '68, an adjunct professor of ophthalmology at the UB medical school, has found on two trips to the city of L'Viv in that former Soviet republic . "They're very competent people," the ophthalmologist said of her colleagues there. "The difficulty is , their medicine is still back in the late '60s. The facilities were built in the '50s and '60s and are very antiquated. They don't have access to modern medication or equipment, and they don't have the money to buy these things. "Much of their medical care, although adequate , is still very much Third World. We're trying the best we can to teach them modern techniques in surgery- in my case, cataract surgery and lens implants. And we're trying to upgrade their infectious disease control. "They're very eager to learn, and there's certainly nothing wrong with their intelligence. It's just that, under the Soviet system, they haven't had the opportunity to learn. " Sirkin went to L'Viv, an ancient city of 1.5 million people, as part of the American International Health Alliance, a joint U.S.-Ukraine effort to improve the medical conditions in the former Soviet republics. "There are churches that go back to the 13th century," she said. "It's a beautiful city. " The Buffalo connection was engineered by Myroslaw Hreshchyshyn, M.D. , chair of gynecology and obstetrics at UB medical school, through the Millard Fillmore Health System, for which Sirkin is chairman of the department of ophthalmology. ON TilE HOME FRONT It's not only in far-flung locales that the need for quality medical care is great. In Buffalo , two initiatives are directed at addressing the health needs of the city's poorest residents. At Friends of the Night People, a new medical clinic is open on alternate Tuesday nights for clients of the soup kitchen . Its proprietors are M. Steven Piver, M.D., clinical professor of gynecology and obstetrics and a longtime supporter of the organization, and Bobby]. Abrams, M.D. , an emergency physician who serves as a UB clinical assistant professor at Erie County Medical Center. The clinic sees about 20 patients a night, said Abrams , who had run a similar clinic in Philadelphia, where she Tlw eity of L'Vir in tlw l'krairw is plagu~l with antiquat~l fatilitit>s and latk of aeet>ss to tll(XIPrn nr~lieation and ~1uipnwnt. -------------------------------------------------------------B u 0 0 p c c n s u m m e 5 �r•••••••••••••••••••••••••••·-------------------------------·-·• morning clinic for men at Buffalo's City Mission. It's staffed by physicians from Sheehan Hospital, supported by volunteer medical students and nurses from the ursing Center for the Homeless, a project of the UB School of ursing. "We get a wide range of problems," she said. "In the winter there are a lot of colds and infections. Overall there are a lot of foot problems, a lot of athlete's foot, really poor hygiene. A lot of them are on their feet a lot and don't have good shoes." Bonham said about 60 medical students are involved on a rotating basis, doing initial intake, taking histories and vital signs. They also solicit donations of supplies from pharmaceutical companies. She said the clinic sees 15 or 20 people on an average winter morning, fewer in the summer. The clients, she said, are just people for whom life has taken a bad turn. "We had one man who came in, he told me he had a four-year degree. He was an accountant or something like that. He said he had been promised a job in Buffalo, but the job didn't pan out and he had gotten his wallet stolen. He had no ID, and he found himself on the street with no job and no place to live. He was very intelligent and well-spoken, and had all this luggage with him that he had to carry everywhere. "A lot of times you find people who've just had bad luck. The patients generally are quite grateful and very polite. It's actually surprising to some people. There are a lot of misconceptions about this population. For the most part, they're not what you might expect. They're younger than I had expected, for example. Some of the stories you hear will break your heart. "We may not have a lot of skills yet, but we do have time, so we talk to the patients. Often in an office setting you're on a time limit, but we tell them if they want to talk, we'll listen. Sometimes what they need most is a good listener." + served an emergency medicine residency. "As a physician you have to give back something to the community, and probably the best thing you can give back is your skills," Abrams said. "The minute I started this clinic, I can't tell you how many physicians came, asking if they could be a part of it. And the medical students are very eager to volunteer. We can offer them one-on-one teaching there, and it also exposes students to working in the community." Abrams and Piver, with the assistance of medical students, physician assistants and sometimes volunteer paramedics, see patients with such complaints as infections, coughs or colds, and perform routine physical exams. "We don't do anything invasive," she notes- no needles or scalpels - and they refer plenty of cases to hospital emergency departments. "There are whole families that are homeless," Abrams said. "A lot of my patients are a mother, a father and three kids. They have no way to get to a doctor and have basic things done. The kid may have a wound that's almost infected, but many of them are working people. To sit in the emergency room for three hours for a kid to be seenthey can't do it." Part of the job is building trust with patients. Abrams tells of one man who suffers with a seizure disorder that began when his father hit him in the head - with a hammer. The man was institutionalized for 40 years, she said, and "he was terrified, just terrified. Every time I saw him, his question was , 'Are you going to put me back in?' But now he'll come to me voluntarily, looking for help. "These people are really going out of their way to be good patients and help themselves," Abrams said. "And many of them have said: 'We know you don't have to be here. Thank you."' Adrienne D. Bonham is a second-year student at UB medical school who coordinates Hope Clinic, a Saturday HPrP in Buffalo. llw JXXlr and llw honwiPss swk medital altPntion at FriPnds of llw ~ight PP<lpiP and llw City Mission. -------------------------------------------------------------B u a 0 p h y 5 c a 5 m m e 9 v B A c K �DIA E ZwiREKI • lll • • 1 Ul PHoTOGRAPHY BY RoBERT CoLLIGNO THE EW TECHNIQUE VENTILATION DEVELOPED POTENTIAL TO TREATMENT OF 6 a 0 p 5 c OF a n 5 PARTIAL AT UB REVOLUTIO LIQUID HAS THE IZE THE RESPIRATORY FAILURE. m m e 9 9 �CORINNE LEACH, M . D ., PH.D., HOLDS FOUR-MONTH OLD KENNETH LA BARGE, ONE OF T H E BABIES WHOSE LIVES WERE SAVED BY PARTIAL LIQUID VENTILATION. B a 0 p y s c a 5 u m m e 5 �DuRING THE PAST DECADE, the University at Buffalo has grown strong among major medical research centers. Funding has increased, a state-of-the-art research center has recently been built, and the reputation of UB investigators continues to develop. But all this pales by comparison with the thousands of lives that will be saved as the work of these researchers becomes clinical reality. From the tiniest of premature infants to elderly victims of accidents and illness, society will reap the rewards as studies that originated in Buffalo reach fruition and are developed into clinical practice throughout the country, and the world. At UB and The Children's Hospital of Buffalo , along with four other centers nationwide, l3 premature babies who teetered on the brink of death from respiratory failure earlier this year were treated in the first clinical trial using partial liquid ventilation led by Corinne L. Leach, M.D. , Ph .D., assistant professor of pediatrics and attending neonatologist at Children's. This revolutionary technique was first described by Bradley P. Fuhrman, M.D., chief of pediatric critip LA T "THE I cal care at the hospital and a professor of pediatrics at UB. All of the infants responded with I S FUTURE TO improvement in their lung function, and seven ultimately survived . Known also as A CHILDREN perfluorocarbon-associated gas exchange, or PAGE, partial liquid ventilation could significantly enhance treatment for not only newborns, but older children and adults who suffer from lung disease. "Treatment is a way of taking advantage ofliquid to make a collapsed lung available for use ," explains Fuhrman. "It will be especially effective in situations where there is generalized lung collapse, such as acute respiratory distress syndrome and hyaline membrane disease . It showed very good effectiveness in the trial involving the l3 babies, all of B a 0 p h c whom were expected to die and had failed with all conventional forms of treatment, including surfactant. " PAGE also has been used to treat children with viral pneumonia and in patients with bacterial infections that cause lung collapse. "The plan in the near future is to do this in children and adults," as well as newborn babies, notes Fuhrman. "PAGE is a potentially major breakthrough," according to NEAR N THE Bruce A. Holm, Ph .D., dean for research and graduate studies at UB. "Its history lies in anD 0 I N T HI S other development: the development of surfactant. " The results of the D ADULTS " first clinical trials showing the efficacy of surfactant were published in Buffalo in 1985. A combination of phospholipids and proteins, surfactant is normally produced in the alveoli and secreted into the lung, where it is responsible for lowering surface tension. The initial production of surfactant in the laboratory, and later by commercial firms, has changed the standard of care for the treatment of respiratory distress syndrome. PAGE carries the basic concept behind surfactant a giant step forward. a 5 m m e 9 9 5 �R oge r Kais e r , M.D. in back g round , and Bhup e ndra Mepani , M . D. , view X-r ays from th e first clini ca l tri a ls . "It takes a patient who is unstable and poorly oxygenated and offers a more stable course," says Fuhrman. "We think we'll reduce the risk of having this kind of lung disease. " Leach, who collaborates with Fuhrman, and developed this technique in the treatment of respiratory distress syndrome, reported the results of the pioneer clinical trial at the May 10, 1995 meeting of the Society for Pediatric Research in California. Leach came to UB in 1988 from the University of Pennsylvania and the Children's Hospital of Philadelphia , having worked with Thomas Shaffer, Ph.D. , of Temple University, who designed an early liquid ventilator, and is considered the modern-day father of total liquid ventilation. In addition to Fuhrman and Leach , Erie County Medical Center's Roger Kaiser, M.D., clinical associate professor of anesthesiology and clinical assistant professor of surgery, has been instrumentally involved in studies using PAGE on adults . "Brad Fuhrman simplified the entire process of partial liquid ventilation and launched it into the clinical arena ," according to Leach. "While he was in Pittsburgh, he figured out that partial liquid ventilation could work; at the same time I was doing total liquid ventilation research here at UB. We got together, and I modified it to work in the sick premature lung. Since then , our team at UB , including Drs. Michelle Papo, David Steinhorn, Lynn Herman and Roger Kaiser, has developed PLV in the treatment of many dis- B a a p y 5 c eases, which has led to subsequent pediatric and adult clinical trials of PAGE. " And, as the landmark study of the l3 infants proves, it does work. Reaching this milestone took approximately 30 years, during which time one of the major barriers to clinical application was the fact that liquid breathing required a highly specialized ventilator. Fuhrman successfully leapt this hurdle. "PAGE requires the standard ventilator already used in hospitals ," he explains. "It doesn't require a shift in the way we do ventilation. It just makes existing methods work better. "We think it will make the lung more uniform and therefore more available for ventilation," he continues. "The spin-off could be quite large. There are 150,000 ARDS (Adult Respiratory Distress Syndrome) cases in the United States. In addition, many patients develop lung disease as a component of other problems. PAGE actually contributes to the treatment of many different diseases." Describing his role in the development of PAGE, Kaiser notes , "my role has been supportive of Fuhrman. Most of my work has been in sheep, utilizing an acid aspiration lung injury model. " Kaiser used sheep in his laboratory trials because initial work had been done on smaller animals. As a prelude to human adult trials , large animal trials were conducted. Much research has been funded by the Alliance Pharmaceutical Corporation, San Diego , which holds the patent on medicalgrade perflubron, the fluorocarbon commonly used in PAGE. a s u m m e 9 9 5 �"Brad Fuhrman first discussed PAGE in the july 1991 issue of Critical Care Medicine. Alliance contacted him immediately and matched Fuhrman with our chemical, perflubron," according to Hal W. DeLong, executive vice president of business development/marketing at Alliance. "One of the pleasant surprises has been that humans responded so similarly to animal models, which indicated the efficacy of the technique in treatment," adds DeLong. Kaiser notes that three human trials for PAGE- in neonates, pediatric patients and adults- have been initiated since 1993. "We are starting Phase II of trials in adults this summer," Kaiser says. "This will be a controlled study of two separate groups, one treated with PAGE and a control group treated with standard therapy. We will look at a number of different parameters to see how effective this therapy really is, whether it lowers the number of days spent on a ventilator, and whether it affects outcomes regarding mortality. Then, Phase Ill trials, which will be more broad, will be done. " Sites for this summer's adult trials include ECMC and BGH. Kaiser predicts that ifinvestigators' data work and the PAGE technique are shown to be of value, actual clinical application in adult patients could be implemented within the next two years. Perfluorocarbon is much less expensive to manufacture than its predecessor, surfactant. Other potential benefits to the patient include a shorter hospital stay and lower morbidity. And in years to come, the ultimate achieveBR AD L EY P. F u H R M AN, M.D. ment of PAGE researchers could be to prevent ARDS entirely. "Once we demonstrate that this is working the kinks effective therapy for out on that," says " I T TAKeS A PATIENT WHO IS UNSTABLE ARDS, the next step Leach. "Partial liqwould be to look uid ventilation will into its use prophybe one of the theralactically," predicts pies available in the AND POORLY OXYGENATED AND OFFERS Kaiser. "Preliminary '90s and in the fudata show that ture for the treatperfluorocarbon ment of lung dismay also minimize ease. We have a lot A MORE STABLE COURSE. " inflammatory reof data to show that sponse; therefore, other state-of-thewe could actually art therapies such as minimize lung damsurfactant have been shown to combine well with PAGE. This age before it happens. " gives us every reason to suspect we will use them in combinaCombining surfactant and partial liquid ventilation to comtion in the years to come," she concludes. + bat lung damage is also being investigated, although "we're still 6 u a 0 p y 5 a n S u m m e 5 �FuNDING CUTS RESEARCH IMPERIL look at research sites or the opportunity for investigators to visit Washington , D.C. , to present their cases. Furthermore, the effect of federal budget cuts is discouraging for researchers - new and experienced alike- whose applications are turned down by agencies such as NIH. "Because we have a larger number of investigators and a smaller number of grants being funded, more investigators tend to reapply. The work load on their part is tripled. This is demoralizing for young scientists. It has discouraged people from academic research," says Holm. "And , we're seeing senior investigators with 25 or more years' experience being turned down. The statistics are not flattering for anyone." UB , however, seems to be an exception to this national trend . During the past three years the university has seen a 20 percent growth in extramural grant funding into the School of Medicine and Biomedical Sciences. "We've managed to buck the system," concludes + Holm, "but how long can we keep it going? " Thrilling new developments in medical research have moved major centers like UB into the international limelight as the wombs , birthplaces and cradles of cure and prevention for such life-threatening conditions as lung disease . But how will federal funding cuts threaten to nip these pioneer efforts in the bud? The outlook is ominous, according to Bruce A. Holm, Ph.D. , UB dean for research and graduate studies. "The rate of growth for funding is not matching the rate of growth of the body of knowledge or the number of researchers ," notes Holm. The future work of the ational Institutes of Health, foremost agency among research funding in the United States, is severely jeopardized. "There have been dramatic cuts in-house at the IH. It's a matter of time before this impacts on productivity," says Holm. For instance, the NIH has completely eliminated research-related site visits as a means of cutting expenses. Review of applications for funding is now based solely on the written word, without a first-hand RESEARCH THAT CHANGES LIVES: A CHILDREN's HERITAGE with PKU in 19 58- one year before Guthrie discovered the test that screened Thirty-six years ago, Children's Hospital was the site of another life-saving for the disease and 10 years before newborn screening became standard research breakthrough when Robert Guthrie, M.D., who died this year on hospital practice. June 24 alter a long illness, changed the nature of newborn screening for mental PKU babies are born with normal intelligence, but become retarded if they retardation with his heel-prick blood test lor the presence of phenylketonuria follow a normal diet. Early detection and treatment with a specialized formula (PKU). are essential- and must become a lifelong habit. Today, efforts are focused Infants born with the disorder are unable to metabolize the essential amino on caring for older children and adults, as well as acid phenylaline, which builds to toxic levels and newborns, affected by PKU. "It's important to treat leads to mental retardation. If detected at birth, infants as early as possible to lower the level of children can lead normal lives if they follow a phenylketonuria. Within 10days to two weeks alter special diet that excludes foods containing large a child is born, the diet begins," notes Georgirene amounts of protein. Vladutiu, Ph.D., associate professor of pediatrics Guthrie's PKU test is now standard for newand neurology at UB and director of the Guthrie borns in all 50 states and 25 countries, and is laboratory. estimated to have spared 30,000 people worldwide At the laboratory, all PKU patients in from mental retardation. In Buffalo, his legacy Western New York- atleast1 00 at any given time continues through the efforts of the Robert Guthrie - ore monitored, and a nutritionist studies and Biochemical Genetics laboratory, located at modifies their diets as needed. Monitoring for paChildren's Hospital, the site of his original work. 5 Hospital in 1982 • Dr. Robert Guthrie at Children' tienls in North Dakota and parts of Ohio is also done Guthrie credited his son, John, and his niece, there. Margaret Doll, with being the inspiration for his research and campaign to get newborn testing widely accepted. John Guthrie, "Whenever a patient is pregnant, we monitor her PKU level weekly during who had non-PKU mental retardation, died earlier this year at age 47. Margaret the entire pregnancy. We also test the baby, of course. Most of the time, if the Doll is profoundly retarded and lives in a Minneapolis group home. She was born mother has followed her diet, the baby is line," Vladutiu says.+ B u 0 0 p y 0 5 u m m e 9 9 �• ... . ........................................... .. .......... ... .. . ....................... ~ I Naughton to step down as dean after 20 years WILL PURSUE TEACHING AND RESEARCH AT THE MEDICAL SCHOOL ohn P. augh ton, M.D., vice presi- the academic side, clinical practice and among the hospitals loosely affiliated dent for clinical affairs and dean of research . All three activities have devel- with the medical school; residency prothe school of medicine and bio- oped in a very significant way, testi- grams were administered and run by medical sciences for the last 20 mony to the fact that the medical school them , with little cohesion and consishas risen to become one of the top tency from hospital to hospital. years , will resign july 1, 1996. The community's health care sufaughton made the announce- medical schools in the country. " Naughton said he plans to stay at UB, fered for it, with competition between ment to a stunned group of colleagues and well-wishers gathered March 1 in the teaching undergraduate· and graduate the over-bedded hospitals resulting in atrium of Cary-Farber-Sherman to cel- medical students, pursuing his research splintered services, rising health care ebrate his 20th anniversary at the medical specialty- cardiac disease exercise re- costs and fiscal woes for all of them. aughton, in his role as vice president school. His retirement date coincides with habilitation - and working with the the school's sesquicentennial celebration. school's faculty on the evolution of an for clinical affairs, is widely credited with Naughton said he came to his decision interdisciplinary curriculum. Another helping to tum the situation around by to step down, "by realizing that 20 years is project, he adds, will be capturing his bringing the hospitals together in a coopa long time to be dean. The erative rather than comthings I'd planned to accompetitive arrangement that "For 20 years, he's demonstrated a unique and uncanny ability to get parties to the plish have been accomsaw them enter into a plished. It's time for the uniconsortia! agreement in table and work at consensus-building strategies among parties that otherwise would 1983 to respond to guideversity to evaluate the leadership of the school. " He lines promulgated by the credited the university for Liaison Committee on not. His ability to do this in this environment is going to be greatly missed." Graduate Medical Eduits continued "support for cation. the clinical changes made at - John E. Friedlander, president and CEO of The Buffalo General Hospital The Graduate Medithe medical school and its primary care initiatives." cal Dental Education William Greiner, president of UB, "unique experience in Buffalo of col- Consortium of Buffalo has served as a said, "john has led his school into the laboration and health care change." model for the nation and achieved sigAnd in his 20 years as dean of the nificant accomplishments , among them ranks of the nation's top 10 comprehensive medical schools. He has also re- medical school-12 of them also as vice the designation of The Buffalo General shaped the medical school's connec- president for clinical affairs for the univer- Hospital as the regional heart-lung transtions with the Western New York medi- sity- Naughton has seen a lot of change. plant center; the establishment of a single A nationally prominent cardiologist, division of neonatology in pediatrics to cal community at large. He helped to create extraordinary new relationships he came to UB as dean and professor of coordinate neonatal care, research and with UB's affiliated teaching hospitals, medicine from George Washington education; the establishment of a PET relying on a consortia! model that has University School of Medicine and center at the Buffalo VA Medical Center garnered national attention as a new ap- Health Sciences, where he served as and Millard Fillmore Hospital; and the proach to medical education." dean for academic affairs , in 1975. At designation of the regional Trauma-Bum john E. Friedlander, president and that time , UB's medical school was beset Center at Erie County Medical Center. CEO of The Buffalo General Hospital, by a lack of direction and leadership , The consortium also governs all resisaid, "He's dedicated himself to con- with both morale and research funding dency programs in Western ew York, tinuing in an outstanding way the medi- support low after the 1962 merger be- serving as the "institution of record" for cal mission here. Dr. aughton has a tween the once private University of graduate medical education, and is regreat deal of understanding of the three Buffalo and the public State University sponsible for standardizing residents' important aspects of medical school- ofN ew York. Clinical teaching was split salaries and managing their credentialing. B u a 0 p h 5 a 5 m m e 5 1 J �······················································ · ····· · ············· · ·············• · ~' ' 1 J medical staff president] ames P. alan, M.D., BGH president William V. Kinnard, M.D., and the immediate past president of the hospital's board of trustees, Robert S. Scheu, all of whom helped draft the plan with Naughton. Scheu and alan served as associate directors of the project; Kinnard chaired a task force that investigated the business and legal aspects of the proposed merger. The plan was eventually killed in the county legislature when that body failed to establish the nonprofit management corporation that would run the consolidated hospitals by one vote- l3 in favor, 7 against. Perhaps, ironically, many of the recommendations made in the report have been borne out by time - from the closing of the nursing schools, to the conJohn P. Naughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences. version of the former Deaconess aughton was appointed vice presi- recommended that Children's be phased Hospital to a skilled nursing facility and dent of clinical affairs in 1984 after serving into a new nonprofit corporation that the area's decreased inpatient bed capacity. in that capacity as acting vice president of would manage it along with BGH, Deaa ugh ton accomplished much in his health sciences for a year. The position coness and Meyer in the county facility 20-year tenure, for both the medical gave him greater authority over clinical that was under construction at the time. school and its teaching hospitals. His teaching areas- at UB, without its own The merger plan proposed that acute watch saw the school garner significant medical center, the affiliated teaching care would be provided by the new research funding and prestigious grants, hospitals sites- and graduate as well as county hospital and BGH, with the em- among them the Robert Woodjohnson undergraduate medical education. phasis at BGH shifted from inpatient to Generalist Physician Initiative, the But aughton's tenure was not with- outpatient services. It also recommended Women's Health Initiative and the out controversy. Two years after com- that Deaconess Hospital be converted Markey Trust award. He was instruing to Buffalo, he was asked by officials into a nursing care facility, that the mental in making the School of Mediof The Buffalo General Hospital, The nursing schools at BGH and the county cine and Biomedical Sciences a leader in Children's Hospital of Buffalo and the be closed and that Columbus and the the push for primary care, and is also former E. ] . Meyer Memorial and Dea- now defunct lafayette General Hospital credited with unifying the-school's camconess hospitals to head a study into the move into the Children's facility. pus with the construction of the new Bolstered by support from a "Citizen's medical research building and the Caryfeasibility of merging those hospitals. The resulting report- portions of which Committee to Save Children's Hospital" Farber-Sherman complex, as well as inleaked to newspapers months before its that garnered over 200,000 signatures on stituting a consolidated computer netofficial release - set off a storm of a petition to keep the facility open and work among the hospitals and medical protest within both the medical com- independent, the hospital's medical staff school, now operated by the Health Sciand board of directors voted against the ences library and known as HUB ET. munity and the community at large. The report - citing the area's l3 consolidation, as did the medical staff at percent underutilized bed capacity Buffalo General in a sharp rebuke to Con~nued on page 20 6 a 0 p 5 c a n s m m e 9 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . [1] ~ I Richard Krugman M.D~ delivers 1995 Stockton Kimball Lecture Naughton, Continued from page 19 Naughton also instituted UB's medical scientist training program for M.D.Ph.D. students and its successful early assurance program. His tenure saw steep increases in the quality of the university's medical students and an added focus on CHARGES MEDICAL PROFESSION TO MAKE CHILD minority medical education. He also ABUSE A PUBLIC HEALTH PROBLEM FOR PHYSICIANS spearheaded increased parental involvement in undergraduate medical education at UB with the formation of a parichard Krugman , M.D. , is a man nation's top childhood diseases. Child ents council and other programs. with a mission: to reinvent the abuse affects more than 2.5 percent of Naughton says, "the job for my suctreatment delivery system for vic- children nationwide each year. As a cessor will be to help provide creative tims of child abuse in our society. University of Colorado Medical School leadership in an ever difficult, con"We must change the focus of intern more than 30 years ago, Krugman strained environment" anticipated by child abuse from a social services worked with Dr. Henry Kemp , who conboth federal and state budget cuts. and law enforcement "There's an awful lot of uncertainty ," he mode to a public health remarks , "and we haven't seen all the approach concerned with fallout yet. preventive treatment ," "We've been done dirty in a way. We said Krugman, who shared were moving on pathways that looked his mission with a crowd more at regulation and coordination. of hundreds of UB mediAnd now we're caught in a social whirl cal school alumni on Sat- or maybe whirlpool - where we're urday, April 29 . uncertain of the changes fostered by Krugman delivered the competition and withdrawal of support. " keynote address at the Add to that, he says, the "reductions Medical Alumni Associafrom the hospitals in practice income tion 's Spring Clinical and research, and medical schools Day, held at the Marriott throughout the country will have to try Inn in Amherst. Although to re-sort things. We hope to maintain he is now dean of the Unithe emphasis on what we're all abou t - versity of Colorado Mediquality patient care, education and re- cal School in Denver , search. " Krugman still spends 10 At a Medical School Executive Com- to 20 percent of his time mittee meeting he attended last spring, speaking on and researchGreiner stated he intends to pursue the ing child abuse and neselection of a new dean and to separate glect, his passion since he that position from the post of vice presi- was a medical student. He dent of health sciences. A search com- is a former practicing pemittee will be formed soon to search the diatrician and worked vice president position. briefly as an advisor on In discussing his tenure, Naughton health care issues to Richard Krugman, M.D. said, "I think my biggest accomplishment former U.S. Senator David has to be bringing the hospitals and medi- Durenberger of Minnesota. ducted a pioneering study on battered cal school together to see that they could Krugman explained that child abuse children. "In 1960, we thought we had work for mutually cooperative goals." + is more prevalent than congenital heart uncovered the scope of the problem B Y NANETTE TRAM ONT defects or asthma, making it one of the when we found evidence of a few hun- B u a 0 p h y 5 c a s u m m e 9 9 �........................................................................................• .. · ~ I dred cases in Colorado," Krugman recalled, "and we thought it would be relatively easy to take care of." Today, more than three million reports of child abuse are filed each year. And 15 percent of all men, and 27 percent of all women now report some form of sexual abuse during their childhood, Krugman explained. Child abuse is finally recognized as a problem, said Krugman, but its root causes are not being adequately addressed. "As a society, we have attention deficit disorder," said Krugman. "We are quick to recognize a problem but long to cure it. We simply move on to another problem." Increased childhood and family stress, brought on by a lack of quality time as a nuclear family and events like divorce and out-of-wedlock births (both up 400% since the 1960s, Krugman points out), contribute to the high incidence of child abuse in our society, according to Krugman. "Kids face increasing isolation and stress," he said. "What we have is an emergency. We spend billions of dollars on the downstream effects of not treating child abuse early," he said, "but it is really quite extraordinary that, as a society, we are still in a basic stage of denial regarding this issue. " The impact of childhood abuse is lifelong, linked to an unusually high suicide rate among pre-pubertal children and contributing to such teenage and adult complications as eating disorders, developmental disabilities, even chronic headaches and moderate to severe chronic physical shaking, according to Krugman. To solve the dilemma, Krugman advocates a system of home health visits to sufferers of child abuse by trained medical professionals. Currently, abuse victims are dealt with by social service professionals , who, according to Krugman, are woefully overworked and undertrained to deal with the problem. "Many parts of the country require only B a a p means a system that makes it easy for a potential abuser to pick up the phone, reach a trained professional and say 'I need help ,"' said Krugman. Physician advocacy and market forces will create the environment needed for real reform in child abuse treatment, believes Krugman. The downstream costs of these medical issues will force the health care delivery market to begin making the types of adjustments it needs in order to provide preventive care to children and potential abusers, Krugman predicts. "Health care reform," he added, "is happening already. It is a market-driven force moving, like the weather, from west to east across the country." Krugman is not the first in his family to make a medical name for himself. His father, now retired in Florida, conducted extensive research which led to the first vaccine for hepatitis B. Seated next to UB's long-tenured medical school dean, john Naughton, M.D. , Krugman observed that being dean of his medical school is "not a unique opportunity. l am the ninth dean in twelve years." Looking over the list of past Stockton Kimball speakers, Krugman even noted that he was not even the first dean from the University of Colorado to be featured. Krugman also joked that, being from Denver, he shared Buffalo's pain each football season. Despite four appearances each, neither the Bills nor the Denver Broncos have ever won a Super Bowl. The luncheon's namesake, Stockton Kimball, served as dean of the University of Buffalo's School of Medicine from 1946 until his untimely death in 1958 at the age of 55. Kimball's tenure saw the medical school moved from its old home at Main and High Streets downtown to its current location at Main and Bailey, on the southeast corner of the South Campus. The move poised the medical school, which was still private, for its later merger with + the University ofBuffalo and SUNY. a high school diploma to become a case worker," said Krugman, "and their lack of knowledge is striking." Krugman believes money to finance the shift in emphasis in treating child abuse can be "squeezed out of the already shrinking health care delivery system. " He made an example of two friends of his from Denver, both doctors who owned their own HMOs and decided to merge. "Then another, larger HMO came in and bought them out. othing changed as far as service delivery was concerned, but my two friends split more than $6 million. "If the health care delivery field has enough money out there to make my two friends millionaires, there is money out there to fund child abuse treatment," chastised Krugman. He added that his home health visitation system would also reduce the number of inappropriate visits to emergency rooms, the most costly way to deliver public health services. Krugman praised the recent opening of a multidisciplinary Child Advocacy Center on Delaware Avenue in Buffalo. Though becoming more common in the west, it is the first center of its type in New York State, with the second due to open soon in Niagara County. The Child Advocacy Center is a cooperative effort of representatives from various area social service agencies designed to offer a single outlet for investigation, support, advocacy and medical treatment for sexually abused children and their families. The atmosphere is designed to minimize the amount of trauma involved to the children and perpetrators of abuse in seeking treatment. "Abusive parents love their children very much,just not very well," explained Krugman. Abuse is compounded because today's perpetrators were often abused as children, he added. Early intervention by trained professionals is the best treatment, he explained. "That's why I say that preventive treatment 5 c a 5 I BY m m e STEVE 9 COX �Sisters of Charity Hospital history reflects its mission BUFFALO'S FIRST HOSPITAL BUlLT ON SERVICE TO THE LEAST FORTUNATE he roots of Buffalo's first hospital Humboldt streets. The 30-acre site was to its present location, absorbing St. can be traced to the mid-19th cen- purchased from Austin Flint, M.D., the Louise de Marillac Maternity Hospital tury when the diocese's Bishop, first medical staff chief at Sisters Hospital. into its maternity unit and thus consolijohn Timon, traveled to Baltimore Land was also purchased at Main and dating all the Sisters of Charity health to request the services of the Sis- Delavan streets to help meet the grow- care services. ters of Charity to establish a hospi- ing medical needs of the city. A new Over the years, Sisters Hospital has tal for the Queen City of the Lakes, a hospital, accommodating 300 patients, undergone extensive additions, renovagrowing frontier on its way to becoming was completed in 1876. From 1877 to tion and modernization. The first addia major transportation center. 1882, some 4,420 patients were treated tion, built in 1948, housed the emergency Bishop Timon had purchased a brick there at a total expense of$19,000. About department, family health center, patient school house and adjoining cottage on half the patients were charity cases. rooms and outpatient treatment centers. Pearl Place in the city. The property, By 1884, four distinct Daughters of A five-story building added in 1965 which he turned over to the changed the face of the hossix sisters who traveled to pital, encompassing its adBuffalo to start the hospital, ministrative offices and rnabecame the first site of the ternity service, as well as Sisters of Charity Hospital in patient rooms, conference 1848. The Sisters of Charity areas, the medical records in America became known department and physician two years later as the Daughlounge. Another addition ters of Charity of St. Vincent constructed two years later \"JEW OF TUE llEDlC..!.L COLLEGE, ASD TUE llll:~~~~ll~S~_;-~~F::,T~~-~.o:=u:.:~._._ housed the pharmacy, cende Paul, officially joining with the order established in France in 1633. Charity hospitals filled specific needs in tral supply, diagnostic imaging and purWithin a year of its opening, Sisters the community - the newly opened chasing departments. Hospital was faced with its first test with Emergency Hospital at Pine and Eagle Inl974,theSetonProfessionalBuildthe outbreak of four cholera epidemics streets, Sisters Hospital for the sick at ing and St. Catherine Laboure Health in Western New York. Patients jammed Main and Delavan, St. Mary's Infant Center additions were completed- the the hospital; many recovered, but the Asylum and Maternity Hospital for or- Seton Building housing medical and epidemic would claim 900 lives before it phans and unwed mothers at Elmwood commercial offices along with hospital subsided. and Edward and Providence Retreat for extension offices, and the St. Catherine ln 1854, the Daughters of Charity the mentally ill at Main and Humboldt. facility housing a concentration of rehaexpanded their services to the City of Established originally as a downtown bilitative services including physical and Buffalo with the establishment of St. branch of Sisters Hospital, Emergency occupational therapy, social work and a Mary's Infant Asylum and Maternity Hospital was taken over by the Diocese skilled nursing facility. Hospital. The facility, which remained of Buffalo in 1954. lt is now known as Re-Vision 2000, Sisters Hospital's open for nearly a century at Elmwood Sheehan Memorial Hospital. major modernization project completed and Edward streets, cared for orphans Providence Retreat was closed in last year, added two more stories to the and unwed mothers. 1940. Two years later, Sisters Hospital main structure as well as new surgery, In 1860, Bishop Timon felt the dio- opened the St. Louise de Marillac Mater- coronary and intensive care units. The cese needed an institution dedicated to nity Hospital, which merged with St. project also included the construction the care of the mentally ill. The Daugh- Mary's Hospital in the Providence Re- of a new building named after Sr. Mary ters of Charity opened Providence Re- treat building. Charles Dever, former hospital presitreat the following year on the site of the Sisters Hospital remained at Main dent, to house the information systems present Sisters Hospital at Main and and Delavan untill948 when it moved and finance departments. a u a 0 p y 5 c a s m m e 9 9 5 �························································································• ·· · ~ I baton were designed served as director of the and constructed by Dr. Visiting Nurses AssociaBrown, as well as the tion from 1975 to 1978 case in which they are and was a member of the medical honor society, displayed, and he also Alpha Omega Alpha, the designed the school's Medical Foundation of academic gown, a Buffalo , the Faculty chandelier and doors Club, the Medical Hisin the complex to torical Society, the which he devoted his Albright-Knox Art Gallife. lery, the Museum of SciIn recognition of his ence, the Buffalo and Erie strong support of the County Historical Society Health Sciences Li- Robert L. Brown, M.D. , 44 and the Friends of the brary for 26 years, the historical and rare book collection was School of Architecture. He was also a long named the Robert L Brown History of standing member of the Buffalo Club. He is survived by his sister-in-law, Medicine Collection in 1985. Upon his retirement that same year, he was ap- Mrs. Donald (Virginia) Brown; a niece, pointed consultant to the University Li- LauraMehl;a nephew, Kenneth P. Brown; braries and continued his close associa- and his good friend , Donald]. Savage. tion with the History of Medicine Collec- Contributions may be made to the University at Buffalo Foundation, P.O. Box tion until his death. Dr. Brown received the Dean's Award 590, Buffalo, New York 14231-0590 for + in 1967 and 1973, and the Distinguished the History of Medicine Fund. Medical Alumni Award in 1974. He - B y L I L L I S E N T Z In addition to the facilities located on the hospital campus, Sisters has continually expanded its off-campus sites. In 1981, it opened the Alden Medical Center; in 1989, it opened an outpatient chemical dependency STAR unit in Amherst followed by a second a year later in West Seneca. In 1992, the hospital opened the St. Vincent Health Center on Buffalo's East Side and the St. Louise Health Center on the city's West Side. Sisters moved into the north suburbs with the opening two years ago of its Amherst Health Center. From its humble beginnings nearly 150 years ago, the history of Sisters Hospital is reflected in its services to Buffalo's poor, mentally ill and orphaned. The hospital has grown tremendously from its one-building roots to a network of health care facilities encompassing a full range of acute and long-term care as well as inpatient and outpatient services. + Robert L. Brown, M.D, former associate and acting dean,dies GRADUATION DAY 1995 It was a day for celebration and obert L. Brown, M.D. '44, former associate dean and acting dean of the University of Buffalo's School of Medicine, died April 5, 1995 after a brief illness. Dr. Brown's accomplishments and contributions to the medical school weremanyand varied. He was appointed assistant dean in 1959 and acting dean in 1960, when he directed the intensive planning for the university's merger into the State University of ew York system two years later. He was the first associate dean appointed to the School ofMedicine. In 1974, Brown became the medical school's archivist, beginning a systematic search for the historical records of the school that led to the categorization and preservation of many original records from the early years of the school. The medical school's mace and marshal's B a a p h I festivities as the School of Medicine and Biomedical Sciences graduated its 149th class of physicians and medical scientists this past May. y c a s m m e 9 9 �.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . [1] ~ I Match Day 1995: Success and Celebration UB'S GRADUATE MEDICAL DENTAL EDUCATION CONSORTIUM RESIDENCIES DRAW 35 PERCENT OF ITS GRADUATING MEDICAL STUDENTS THIS YEAR his year's doss of graduating medical students did well on the National Resident Matching Program, with 67 percent getting their first choice and 83 percent getting one of their first three choices. Of the 140 UB students participating in the NRMP, 35 percent will remain in Buffalo in Graduate Medical Dental Education Consortium residencies; 11 percent will stay in New York State, but outside Buffalo; and 51 percent will do their residencies out of state. Seven students were unmatched. Primary care residencies drew 40 percent of UB's graduating physicians, down from last year's 44.1 percent. Nationally, the program matched 17,858 of the nearly 23,000 students who competed for the 20,751 first-year residency positions available. More than half were matched in generalist residencies, including family practice (15.4 percent), internal medicine (24.5 percent) and pediatrics (11.1 percent). Omolora J. Akinbomi, Pediatncs, Children's Nauonal Medical Center, Washington, DC George J. Burnett, Psychiatry, Graduate Medtcal Dental Education Consortium, Buffalo, NY Mory J. Ciotoli, Emergency MediCine, Umverstty of Rochester/Strong Memorial Hospllal, Rochester, Y Trine B. Allen, Psychiatry, Duke Umverstty Medical Center, Durham, NC Timothy R. Byrnes, Internal MediCine (Prehm.), Ststers of Chanty Hospllal, Buffalo, NY Lori A. Cohen, Internal Medicine, Long Island jewish Medtcal Center, ew Hyde Park, NY Darren M. Coparoso, Family Pracuce, Graduate Medtcal Dental Educauon Consoruum, Buffalo, Y Richard J. DeAsla, Surgery, University of Rochester/Strong Memorial Hospllal, Rochester, NY Michael J. Carlson, Internal Medicine, Medtcal College of Virginia, Rtchmond, VA Tracie l. DiMarco, Family Practice, New York Medical College Mtd-Hudson Family Pracuce Serv1ces lnsmute, Kingston, NY lhuoma U. Alozie, Internal Medtcine (Prelim.), Hospllal of St. Raphael, New Haven, CT Andrew l. Altman, Urology, Case Western Reserve Umversity, Cleveland, OH Barry R. Armondi, Internal Medicine (Pnmary Care), Long Island jewish Medical Center, New Hyde Park, NY Brett D. Arnoldo, Surgery, Graduate Medical Dental Education Consorl!um, Buffalo, NY Robert A. Borroli, Emergency Medicine, Maricopa Medtcal Center, Phoemx, AZ Katherine A. Blum, Obstetncs and Gynecology, Graduate Medtcal Dental Educal!on Consortium, Buffalo, NY Miroslav P. Bobek, eurologtcal Surgery, Universlly of Mtchtgan Hospllals at Ann Arbor, Ann Arbor, Ml Maurits S. Boon, Surgery (Prelim.). Thomas jefferson UmverSily, Philadelphia, PA Otolaryngology, Thomas jefferson Umverslly, Philadelphia, PA Anthony J. Bartkowiak, Internal Medicine (Pnmary Care), Graduate Medical Dental Educauon Consortium, Buffalo, NY Maria D. Bruno, Internal Medicine (Prelim.), Graduate Medtcal Dental Educauon Consortium, Buffalo, NY Ophthalmology, Graduate Medical Dental Educauon Consortium, Buffalo, NY Ross J. Bellavia, RadiOlogy- Dtagnosuc, Umverslly Hospllals of Cleveland, Cleveland, OH Cheryl D. Buck, Medicine!Pedtatncs, Umverslly of Cincinnal! Hospital, Cincinnau, OH Scott J. Belote, Emergency Medicine, Graduate Medical Dental Educauon Consoruum, Buffalo, NY Tony T. Bui, Transitional Year, Wilson Memonal RegiOnal Medtcal Center (Unlled Health Services), johnson Clly, NY Physical Medicine and Rehabilllal!on, Universlly of Texas Southwestern Medical School, Dallas, TX Kathleen E. Bethin, Pediatrics. St. Loms Children's Hospllal, St. Louts, MO B u a Frank P. Carnevale, Pediatrics, Graduate Medical Dental Educauon Consoruum, Buffalo, NY 0 p h liang R. Chang, Obstetrics and Gynecology, Graduate Medical Dental Educauon Consorl!um, Buffalo, NY Craig E. Cheiltez, Internal Medicine, Georgetown UmverSily Hospllal, Washington, DC J~eph C. Dipirro, Pathology, Graduate Medtcal Dental Educauon Consoruum, Buffalo, NY Anthony M. Dirubbo, Medicine!Pediatncs, Umverstty of Rochester/Strong Memonal Hospllal, Rochester, NY Therese M. Duane, Surgery (Prehm.), Eastern Virginia Graduate School of Medicine, Norfolk, VA Karen A. Chojnacki, Surgery, Thomas jefferson Umverstty, Philadelphia, PA Karen E. Dull, Pediatrics, Umverstty Health Center of Plllsburgh, Plllsburgh, PA Christine M. Chruscicki, Psychiatry, Duke Umversity Medical Center, Durham, NC Christopher J. East, Internal Medicine (Prelim.), Ststers of Chanty Hospllal, Sebastian J. Ciancio, Surgery (Prehm.), Baylor Buffalo, Y College of Medicine at Houston, Anesthesiology, Duke Umverslly Houston, TX Medical Center, Durham, NC Urology, Baylor College of Medicine Affiliated Urology Program, Houston, TX Daryl R. Ehlenlield, Pediatrics, Graduate Medical Dental Education Consortium, Buffalo, Y c a 5 u m m e 9 5 �·········· · · · · · ·· · · · · ···· ··· · · · ······· · · · ·· · ·· · · ·· ·········· · ········ · · · ··· ··· ·· · ····· · ·• · tm I lynelle M. Emery, Famtly Pracuce, Famtly Practice Residency of Southwest Washtngton Medtcal Center, Vancouver, WA Cynthia E. Epstein, Pedtatncs, Medtcal College of Virgmta, Rtchmond, VA AndrewS. Feinberg, Transitional Year, Georgia Bapust Medtcal Center. Atlanta, GA Ophthalmology, Emol)' Umverslty School of Medtcme, Atlanta, GA Carole Y.Fenton, Emergency Medtcme, Graduate Medtcal Dental Educauon Consortium, Buffalo, NY Faith A. Heavens, Pediatrics, North Shore Umversity Hospital, ew York, NY Andrew D. Henry, Internal Medicine, Umverslty of South Flonda College of Medtcme at Tampa, Tampa, FL Nigel I. Henry, Obstetncs and Gynecology, Brooklyn Hospttal Center, Brooklyn, Y Aravind Herle, Internal Medtcme, The Umverslty of Chtcago Hospttals, Chicago, IL Huiiung Kim, Radiology- Dtagnosuc, George Washmgton Umverslty, Washmgton, DC Donielle S. Noteboert, Emergency Medtcine, Graduate Medtcal Dental Educauon Consoruum, Buffalo, NY Eric H. Kossoll, Pedtatrics, Eastern Virgtma Graduate School of Medtcine, Norfolk, VA David M. Odell, Famtly Pracuce, St. Joseph Hospttal, Denver, CO Shone C. Ferguson, Pedtatncs, Graduate Medtcal Dental Educauon Consoruum, Buffalo, Y Shown P. Ferguson, Pedtatncs, Graduate Medtcal Dental Educauon Consoruum, Buffalo, NY Peter Hertz, Surgery (Prehm.), Graduate Medical Dental Educauon Consoruum, Buffalo, NY Dono lim, Obstetrics and Gynecolog}', Universtty of Rochester/Strong Memorial Hospttal, Rochester, :-.JY Tyrone D. Fillyow, Psychiatry, Sheppard Prall Hospital, Baltimore, MD Douglas J. Hickox, Surgery (Prehm ), Graduate Medical Dental Educauon Consortium, Buffalo. NY Arlene D. lobo, Internal Medtcme, Cleveland Clmic Foundauon, Cleveland, OH Meghon A. Higman, Pedtatncs, Unl\·erslty Health Center at Pmsburgh, Ptusburgh, PA Martin C. Moloney, Famtly Medtcme, Graduate Medtcal Dental Educauon Consoruum, Buffalo, Y Evon Hirsch, Family Practice, University of Cahfornia at San Franctsco, Fresno, CA Michele M. Manko, Pedtatncs, Graduate Medtcal Dental Educauon Consoruum, Buffalo, NY Jeanne C. Fitzsimmons, Emergency Medicme, Graduate Medical Dental Education Consortium, Buffalo, NY Michelle Game, Pedtatncs, Eastern Virgtma Graduate School of Medtcme, Norfolk, VA Kathy M. Golding, Famtly Pracuce, Graduate Medtcal Dental Educauon Consortium, Buffalo, Y Randy J. Goldstein, Pedtatncs, Medtcal College of Virgmia, Richmond, VA JeffreyS. Grant, Internal Medicine (Prehm.), Ststers of Chanty Hospital, Buffalo, NY Physical Medtcme and Rehabtlltauon, SUNY Health Sciences Center, Syracuse, NY James C. Ho, Internal Medtcme (Pnmary Care), Long Island Jewish Medical Center, New Hyde Park, NY Toreq S. Horb, Internal :vtedtcine, Vanderbtlt Umverslty Medical School, Nashville, TN B a 0 c a Michele A. Potempa, Famtly Practice, Graduate Medtcal Dental Educauon Consoruum, Buffalo, NY Susan E. Potts, Pedtatncs, Duke Umverslty Medical Center, Durham, NC Kirk Puttlitz, Pathology, Emory Umversity School of Medicine, Atlanta, GA lrm R. Roio, Psychiatry, Umverslty Hospitals of Cle,·eland, Cleveland, OH Peter D. Roy, Surgery, Umverslty of Alabama Hospital, Montgomery, AL Susan M. Noselli, Internal Medtcme (Prehm.), Jewish Hospttal of St. Louts, St. LOUIS, MO Neurology, Washtngton Umverslty, St. Louis, MO Helen M. Kim, Psychtatry, Massachusetts General Hospital, Boston, MA y Natalie Poppito, Pathology, DartmouthHitchcock Medtcal Center, Lebanon, NH James G. Nalbone, Psychtatry, Albany Medtcal Center Hospital, Albany, NY Marie I. Kessler, Pedtatrics, Graduate Medtcal Dental Educauon Consortium, Buffalo, NY p Jesslyn l. Perry, Internal Medicme, Graduate Medical Dental Educauon Consortium, Buffalo, NY Brenden M. Miner, Surgery (Prehm.), Umverslty of Vermont, Burhngton. VT Heather M. Keene, Obstetncs and Gynecology, Provtdence Hospital, Southfield, Ml James S. Killius, Radiology- Dtagnosuc, Duke Unl\·erstty Medical Center, Durham, "iC Nancy Perez, Pedtatncs, Graduate Medtcal Dental Educauon Consortium, Buffalo, NY Gregory A. McDaniel, Medtcine/Pedtatrics, Western Reserve Care System/ NEOUCOM,Youngstown, OH Christina M. Keaney, Pathology, Graduate Medtcal Dental Educauon Consoruum. Buffalo, NY Thomas A. Honno, Famtly Pracuce, Guthrie/Robert Packer. Guthne, PA Tushar Patel, Ophthalmology, Scheie Eye Institute, Unl\·erslty of Pennsylvania, Phtladelphta, PA Madhulika Mathur, Pedtatncs, Graduate Medtcal Dental Education Consoruum, Buffalo, NY Jeoneo R. Hundley, Emergency Medtcme, Graduate Medtcal Dental Educauon Consoruum, Buffalo, NY Somir Khonior, Obstetncs and Gynecology, New Hanover Regwnal Medtcal Center, Wtlmmgton, NC Margaret E. Partridge, Pedtatncs, Umverslty of Rochester/Strong Memonal Hospital, Rochester, NY Philip l. Monzonero, Medtcme (Prelim.), St. Elizabeth's Hospital of Boston, Boston, MA Anesthesiology, Oregon Health SCience Umversity, Portland, OR David P. Hughes, Emergency Medtcme, Bowman Gray/North Carohna Bapust Hospital, Wmston-Salem, NC Kate l. Guernsey, Pediatrics. Umverslty of Colorado School of Medtcme at Denver, Denver, CO Thomas A. Owens, Medtcme/Pedtatncs. Duke UniverSit}' :vtedtcal Center, Durham, NC Patricio A. Krebs, Pathology, Baystate Medtcal Center, Spnngfield, MA Bryon R. lotzmon, Internal Medicme (Prehm,), Wmthrop-Umversity Hospttal, Mmeola, KY Neurology, Mt. Sinat School of Medtcme, New York, NY Albert B. Fiorello, Emergency Medtcme, University of Anzona Affthated Hospitals, Tucson, AZ Whitney l. Orman, Pedtatncs,Emory Unl\·ersity School of Medicme, Atlanta, GA Dovid P. Kowalski, Famtly Practice, Graduate Medical Dental Educauon Consoruum, Buffalo, NY Mitchell J. Herr, Internal Medtcme (Prehm.), Graduate Medtcal Dental Educauon Consoruum, Buffalo, Y Anestheswlogy. Umverslty of Cahforma at San Otego Medtcal Center, San Otego, CA Steven M. Finkelstein, Internal Medtcme (Prehm.), New England Medical Center, Boston, MA Anesthesiology, Brigham and Women's Hospital, Boston, MA I Neal T. Reich, Internal Medicme (Prehm ), Graduate Medtcal Dental Educauon Consoruum, Buffalo, Y AnesthesiOlogy, Graduate Medtcal Dental Educauon Consortium, Buffalo, NY Koren M. Roll, Pedtatrics, Hahnemann UmverSit)-, Phtladelphia, PA Renee F. Neely, Psychtatry, Graduate Medtcal Dental Education Consoruum, Buffalo, NY Germaine N. Rowe, Internal Medtcine (Prehm ), Graduate Medtcal Dental Education Consorttum, Buffalo, NY Physical Medtcme and Rehabthtation, Presbyterian Hospital, New York, NY Gory J. Nielan, Pedtalncs, Baystate Medical Center, Spnngfield, MA Amitobh P. Soha, Surgery, Flushmg Hospttal Medtcal Center, Flushmg, NY 5 m m e 9 �~ - . . . ... .. . . . . . . . . . . . . . El Theresa M. Sarafin, Pediatncs, Dartmouth-Hitchcock Medical Center, Lebanon, H Jeffrey Tessier, Internal Medicine, Portsmouth Naval Hospital, Portsmouth, VA Eva H. Sotell, Internal Medicine, Umversny Health Center at Pittsburgh, Pmsburgh, PA Edouord J. Trobulsi, Surgery (Prehm.), Thomas Jefferson Umversity, Pmsburgh, PA Urology, Thomas Jefferson Umversny, Pittsburgh, PA Philip Sauvageau, Medicine!Pediatncs, Graduate Medical Dental Education Consortium, Buffalo, NY Bertram Portin '53,to serve on Sisters Hospital board of directors Rolph P. Tufano, Otolaryngology, Umversny of Pennsylvama, Philadelphia, PA Bethonn Sthober, Pathology, Harbor-University of Cahforma at los Angeles Medical Center. los Angeles, CA Paul F. Updike , Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH Joel A. Shapiro, Orthopedics, McGaw Medical Center of Northwestern Umversity, Chicago, ll Felice Vobnitk, AnesthesiOlogy. Umversity of North Carolina Hospitals, Chapel Hill, NC Chondresh A. Shelot, Emergency Medicine, Mt. Sinai Medical Center, Cleveland, OH Timothy E. VanDuzer, Emergency Medicine, Graduate Medical Dental Education Consortium, Buffalo, NY Fronk Sindoni, Surgery (Prehm ), Graduate Medical Dental Education Consortium, Buffalo, NY Eileen Velez, Pathology, Graduate Medical Dental Education Consortium, Buffalo, NY Michael J. Singh, Surgery, Graduate Medical Dental Education Consortium, Buffalo, NY Andrew W. Worner, Internal Medicine, Graduate Medical Dental Education Consortium, Buffalo, Y Erik D. Skoog, Ophthalmology, Medical University of South Carohna, Charleston, SC Theresa M. Wegman, Pediatrics, Graduate Medical Dental Education C..onsorl!um, Buffalo, Y Romuold Sluyters, Surgery (Prehm.), Graduate Medical Dental Education Consortium, Buffalo, Y Orthopedics, Graduate Medical Dental Education Consortium, Buffalo, Y Dennis D. Weimer, Psychiatry, Umversity of Anzona Affiliated Hospitals, Tucson, AZ Denise K. Sokolofsky, Pediatrics, Graduate Medical Dental Education Consortium, Buffalo, NY Wendy l. Weinstein, Psychiatry, Graduate Medical Dental Education Consoruum, Buffalo, NY Stephen P. Sorrentino, Internal Medicine (Pnmary Care), North Shore University Hospnal, New York, NY Timothy P. Whelan, Internal Medicine, University of Colorado School of Medicine, Denver, CO Taro A. Soso, Internal MediCine (Prehm.), Graduate Medical Dental Education Consortium, Buffalo, Y Anesthesiology, Graduate Medical Dental Education Consortium, Buffalo, NY Ellen M. Whyte, Psychiatry, Umversity Hospnals of Cleveland, Cleveland, OH Attending Physicians Matthew Withiom-leitth, Obstetrics and Gynecology, Graduate Medical Dental Education Consortium, Buffalo, NY Peter F. Stengel, Internal Medicine, Umversny of Maryland, Baltimore, MD ertram A. Portin, M.D. '53, has been named to the Sisters Hospital board of directors . Certified by the American Board of Surgery and the American Board of Colon and Rectal Surgery, Portin is chairman of the hospital's division of colon/rectal surgery and a past president of the Sisters Hospital medical staff. "We are fortunate to have someone of Dr. Portin's leadership ability and insight join our board of directors ," said John] . Maher, president of Sisters Hospital. "Dr. Portin's presence on the board is important to further integrate physician expertise into governance and leadership at Sisters Hospital. " Portin is a member of the American College of Surgeons, the American Society of Colon and Rectal Surgeons, the American Medical Association and the Accreditation Council for Graduate Medical Education. + The award far best reunion class atten- William J. Wnuk, Medicine/Pediatrics, Graduate Medical Dental Education Consortium, Buffalo, Y dance this year goes to the 50-year Class Andrew N. Young, Pathology, Emory Umversity School of MediCine, Atlanta, GA of '45, which, under the stewardship of Thomas W. Stone, Internal Medicine (Prehm.), Graduate Medical Dental Education Consortium, Buffalo, NY Ophthalmology, Duke Umversity Medical Center, Durham, NC Brion K. Zebrowski, Surgery, Bridgeport Hospital, Bndgeport, CT class reunion choir Herbert Joyce, posted Erik J. Stumpf, Family Practice, Hahfax Medical Center, Daytona Beach, Fl Jeffrey l. Zondermon, Transmonal Year, Carney Hospnal, Boston, MA Ophthalmology, Tufts New England Eye Center, Boston, MA an approximate Royte R. Syracuse, Internal Medicine (Prehm.), Umversity of Maryland at Baltimore, Baltimore, MD Ophthalmology, Graduate Medical Dental Education Consortium, Buffalo, Y Jennifer M. Zubler, Pediatrics, Graduate Medical Dental Educauon Consortium, Buffalo, NY dance. Congratula- Keith A. Zu!!olo, Surgery. St. Elizabeth Hospital Medical tions to all on a job lisa l. Stephens, Obstetrics/Gynecology, Baystate Medical Center, Spnngfield, MA Eva M. Tokots-Dilorenzo, Obstetrics and Gynecology, Graduate Medical Dental Education Consortium, Buffalo, NY B a 0 Center/NEOUCOM, Youngstown, OH 78 percent atten- + + well done! p h y 5 a s m m e 5 �1995 reunion portraits: 50 years of medicine recalled en classes were honored at this year's Reunion Weekend celebration, and gathered in Buffalo to reminisce, remember old friends and good times, and renew acquaintances. CLASS OF 1945 CLASS OF 1950 FROM lEFT TO RIGHT: FIRST ROW: Richard Adler, Edward Forgrave , john FROM lEFT TO RIGHT: FIRST ROW: William Webster, Alfred Falcone, Robinson , Herbertjoyce,jacob Steinhart, Gilbert Tybring, Earl Robert Bergner , Roland Anthone SECOND ROW: Henry Pech, Sidney Anthone, Karl Manders, james Cantwell, Theodore jewett SECOND ROW: Paul Cotter, Eugene Morhous, William Andaloro, Dunn , Richard Leberer, Leo Manning, Roy Robinson Raymond Barry, Genevieve Howen, Vincent Capraro, Ivan Kuhl, THIRD ROW: Adelmo Dunghe, Eugene Zygaj , joseph Sheedy, William Loeser, William Mcintosh Robert Patterson THIRD ROW: Charles Wiles, john Fairbairn, Edward Valentine, john Hartman, Victor Lazarus, Hilton jacobson, john Long, orman Chassin, George George Ellis, Richard Greenwald, Thorngate, Vito Laglia , Adolphe Schoepflin, Leslie Osborn, Robert Schopp, Peter Terzian, joseph Tannenhaus, A. Arthur Grabau , Wayne Templer B a Reunion Classes Continued on page 28 0 p y c 0 5 m m e �~ ························ · ·· · ·········· •••••••••••••• • ••••• 0 •• • • • ••••••••••• • ••• w~ There· Med Eva H Cen Phili! Den Beth• Cal An! Joel No Chm Me fra1 CLASS OF 1955 CLASS OF 1965 De FROM lEFT TO RIGHT: FIRST ROW: Milton Alter, John Peterson, Leonard Mic Schaer, joseph LaMancusa Ed SECOND ROW: Bertrand Bell, Ray Schiferle, john Foley, john Baker, Eril Frank Gazzo, james unn, Michael Gianturco, Robert Dean, Robert Pittell, john Kent, james Stengel , john LeValley, Shedrick Moore Sc FROM lEFT TO RIGHT: FIRST ROW: Louis Trachtman, Kenneth Kim, joseph Cardamone, George Strauss SECOND ROW: Gary jeffery, W. Scott Walls, Elliott Larson, Antonio Catanzaro, George Moore, Robert Schuder Ro D• 0 c 01 E St 1'- CLASS OF 1960 CLASS OF 1970 FROM lEFT TO RIGHT: FIRST ROW: Harris Faigel, Edward Graber, Algirdas FROM lEFT TO RIGHT: FIRST ROW: Bruce Prenner, Michael Lippman, jeffrey Rothman, Bruce Sobin, Laurence Lesser SECOND ROW: Mary Clemens, Marilyn Kassirer, Roger Forden , William Balistreri, Allan Winzer, Arthur Goshin, Lynn Eckhert THIRD ROW: Dennis DuBois, Seth Craig, Donald Copley, Harold Vandersea, Brenden Thomson, Thomas O'Connor, Sebastian Conti, Allen Davidoff, Donald Gabel, Steven Weinstein, jan Novak, Alan Fink, Arthur Seigel, Shafic Twa!, Elliott Brender Gamziukas, joseph Antkowiak, Sylvia Sussman, Andre Lascari, William Abramson, Charles Riggio, Eugene Partridge SECOND ROW: Marshall Lichtman , Donald Hammel, joseph Chazan, Harry Metcalf, Donald Donius THIRD ROW: Harold Brody, james Kanski, Daniel Gianturco, William Stein, Franklin Glockner, Robert Malatesta, Harris Kenner, Gerard Diesfeld, Daniel Goldberg, Roger Dayer, Theodore Bistany, Thomas Guttuso B u 0 0 p h s c 0 5 m m e 9 9 5 �CLASS OF 1975 CLASS OF 1985 FROMLEFT TO RIGHT: FIRST ROW: Shirley Galucki , Barbara Brar , Elaine Schaaf, Erica Heit Remer, Lynda Stidham , Margaret Reidy, Roberta Moss, Elizabeth Maher, Lucie DiMaggio , Darlene Eldredge Fairchild, Amy Miller O'Donnell , C. Adrianna Alvarez, Donald Tingley, Graciela Desemone , Thomas Cowan SECOND ROW: David Forster, Carol Hammer Forster, Sabino Torre, Raymond Meeks, jack Coyne,jacques Hajjar, Susan Bates, Kenneth Romano, Thomas Szalkowski , jon Wardner, Victor Marino THIRD ROW: Michael Lahood , Michael ancollas, joseph Zizzi , john Leddy, Ira Handler, Blackford Middleton FROM LEFT TO RIGHT: FIRST ROW: Marvin McMillen , Sylvia Regalia, Leo liO Muido , Marguerite Dynski, Ben Echols, Lynne Hochberg-Pace, Alan Calhoun SECOND ROW: Marc Colman , Kenneth Anolik, William Cohen , Dennis Witehead, William Novak, Thomas Rosenthal , Henry Tomiak , jack Cukierman , Paul Trautman , john Stubenbord, Craig Blum, john Hedger, Michael Rade, Peter eumann , jack Freer, Eugene Hirsh CLASS OF 1980 CLASS OF 1990 FROM LEFTTO RIGHT: FIRST ROW: janice Errick , Alicia Stanton, Steven Howard , Suzzette Robinson , Stephen Panebianco , Valerie Vullo, Harriette Feier, Kimberly Blake, Dianne Jaeger Sutter SECOND ROW: Marc Klementowski, joseph Murphy, Mary Rita Murphy, Raymond Paolini , Robert Pitera , Mark agy , joyce Paterson FROM LEFT TO RIGHT: FIRST ROW: Thomas Dougherty, Archimedes Thomas, Edward Rockwood, john Shayne, Constance Lentz , Coral Surgeon, Theresa Stephan- Hains, Mary George, Lynn Steinbrenner SECONDROW: james Twist, Margaret Paroski , Gaspere Geraci , Mark Borer B 0 0 p s c 0 5 u m m e 9 9 �Porrath '61, pioneers integrated care for breast disease STUDY SHOWS THAT HIS MAMMOGRAPHY CENTERS FIND BREAST CANCERS EARLIER THAN THE AVERAGE FOR LOS ANGELES PATIENTS aar A. Porrath, M.D., has known since he was about four years old that he wanted to be a physician. "It was probably the influence of traveling with my father when he visited sick members of his congregation that influenced my early career choice," Porrath explained. His father was Rabbi Samuel Porrath, a long-time rabbi in iagara Falls and Amherst. Ironically, his inital decision to specialize in radiology was made because he thought he didn't want direct contact with patients. After graduating from the University of Buffalo's School of Medicine in 1961 , he served his internship and residency at Mt. Sinai Hospital in Cleveland. Following his military service as the chief of radiology service at Kenner Army Hospital in Fort lee, Virginia, he moved to California. "It was while I was in los Angeles that I started doing more and more mammograms and I found that I liked the patient contact," he recalled. By 1983, his transformation to direct patient clinical service was completed when he founded the Women's Breast Center in Santa Monica , which has pioneered an integrated care approach to breast disease and management. In 1990, he joined the Mammography Center in Burbank. Both centers are operated under the umbrella of the Women's Breast Center Group, which also operates the Mobile Mammography Center in the los Angeles area . Porrath also organized the Foundation for the Study and Prevention of Breast Disease, which sponsored a multitude of county-wide health fairs , attracting more than B u a 0 p 250,000 people over the two-year period from 1985 to 1987. The two breast centers are the largest providers of indigent breast health care outside of county facilities in los Angeles; the foundation has received grants to help cover the costs of treating indigent patients. "My book, A Multimodality Approach to Breast Imaging, published in 1986, was panned by some for being what was considered too clinical," explained Porrath, who is obviously in opposition to these critics. "Breast cancer is definitely increasing - basically for two reasons. About 60 percent of the increase is due to the aging of the population and the other explanation is that we are simply detecting a lot more cancers," Porrath said. He believes the current national controversy over the issue of mammogram screening guidelines for women under age 50 is largely related to cost issues. Porrath points out that of the approximately 180,000 women who will c a n S get breast cancer this year in the United States, nearly 30,000 will be in the 40 to 49-year-old age group. A total of 40,000 will be under age 50. "If we send a message to the American woman that screening has no validity, we will virtually wipe out the detection of all Stage 0 and Stage 1 breast cancers almost 20,000 women. There will be at least 6,000 women who would have lost the chance to prove that breast cancer is a curable disease. That is not including the vast number of people who will automatically jump at the chance of not having a mammogram because of their innate fears of breast cancer. " Porrath acknowledges that detection is more difficult in women under age 50, but points out that the lead time between detection and the spread of cancer is also less- making early detection all the more important. He stresses that breast cancer in the younger woman is a much more aggressive disease. u m m e 9 5 �"Breast centers such as ours are actually quite cost-effective because our statistics from more than 40,000 patients have demonstrated a significant reduction in unnecessary surgical biopsies. Of course this reduction also means less trauma for the patients." Five hundred of the center's approximately 40,000 patients have been diagnosed with breast cancer. But a study demonstrated that the cancers found at the center were smaller and were found earlier than those in other Los Angeles breast cancer patients. For all of Los Angeles County, 62 percent of the patients are Stage 1, I and II, compared to 90 percent of the Women's Breast Center cancer patients who were Stage 0, I and II. While he encourages breast self-examination, Porrath isn't optimistic that its usage will increase greatly. "Self-examination is based on a psychologically wrong principal- it offers a negative reward for a positive action by telling women that they can possibly find breast cancer by examining themselves," he explains. Porrath is well aware of the significant emotional issues involved in breast examination, mammography and breast cancer. His wife, Toni Bernay, Ph.D., is a psychologist and a consultant to the Women's Breast Center and the Mammography Center. Porrath has been elected a fellow of the American College of Radiology and is past president of The American Branch of the International Society for Study of Breast Disease, The National Consortium of Breast Centers and current vice president of the World Federation of Ultrasound. He has taught radiology technology training courses throughout the country, including Buffalo, and has lectured widely on breast cancer and detection issues throughout the U.S. and the world, including Canada, Mexico , Germany, Argentina, Brazil, Greece and Austria. + · B BY u DEBORAH a W a ILLIAMS p cated last September, has received national attention and is being used actively for education and research. A graduate of Western Reserve University, now Case Western Reserve University, he received a doctorate from the University of Minnesota. In receiving his Distinguished Medical Alumnus honor, Brody joins a list of renown School of Medicine and Biomedical Sciences graduates. He will receive the award at a dinner in his honor this October. The SUNY Board of Trustees also named Suk Ki Hong, M.D., Ph.D., UB professor of physiology, distinguished professor in january in recognition of his reputation and contributions to research. A UB faculty member since 1975, Hong also serves as director of graduate studies in the department of physiology. His research interests lie in the areas Harold Brody '61,garners two distinguished UB honors arold Brody, M.D., Ph.D., has been awarded the rank of distinguished professor - the highest in the State University of ew York system- and elected 1995 Distinguished Medical Alumnus. The designation of distinguished professor, made by theSU YBoardofTrustees, is an order above full professorship and has three co-equal designations: distinguished professor, distinguished service professor and distinguished teaching professor. Brody, professor of anatomy and cell biology, was named distinguished teachingprofessor. Thedesignationisawarded to persons who have demonstrated outstanding teaching competence at the graduate, undergraduate or professional level. Brody, who joined the ------·- =~ faculty in 1954, earned an M.D. from the medical school in 1961; for half of his 41 years at UB, he served as chair of the department. He has done research and published widely in the field of neuroanatomy, and has served on several editorial boards, including that of BufHarold Brody, M.D., Ph.D. falo Physician. As a Fulbright scholar to Denmark in 1963, he helped establish of renal and environmental physiology. Hong has authored or co-authored that country's first cadaver donor pronearly 190 articles for scholarly publigram. He was one of the founding members ofUB's Center for Aging and is past cations and more than 40 textbooks, president of the Gerontological Society monographs and book chapters, earned of America. He received the society's numerous academic awards, including Robert W. Kleemeier Memorial Research the Stockton Kimball Award from the Award for Outstanding Research in Ger- medical school for excellence in reontology in 1978. search, education and service, and a Brody left the anatomy department special citation for distinguished serchairmanship in 1992 to continue teach- vice from the japanese Panel on Diving ing, do research and to fulfill a lifelong Physiology and Technology of the U.S.dream of establishing a Museum ofNeu- Japan Cooperative Program in atural roanatomy at UB. The museum, dedi- Resources. + ...., 5 a n 5 u m m e 9 9 �A Spoonful of Humor© Stu Silverstein, M.D. e've all heard the old joke about the man who calls in a plumber and gets presented with a bill for $400. The customer says, "That's outrageous! What is your hourly rate?" "$200 an hour, plus travel And let's face it, men don't like calling for help to begin with, but when you are calling a plumber in, you are not only admitting that you are asking for help, but you are essentially saying that your intestines need to attend a 12-step group. That's not easy to admit to anyone, let alone a guy who shows up in overalls, no socks and asks to use your phone while spinning a monkey wrench around his pinkie (no l don't mean an orthopedist). Why are all plumbers overweight? Why do they all wear blue overalls. And even if they aren't overweight they always wear double extra large overalls. After jiggling the handle for 20 minutes time," answers the plumber. "$200 an hour!" the man replies, aghast. ''I'm a urologist. I went to medical school, residency, did a fellowship and I only charge $75 an hour." The plumber just shrugs his shoulders and says, "Hey, that's all I charged when I was a urologist." The disparity is even worse for pediatricians, and I went look. nobody hkes their job. That's why through a similar experience recently when I had to call in they call it a"'job." If they loved it, a plumber. Since I became a they'd call it something else, like "fun." homeowner, I can no longer just "I love my fun." But if It was fun call the landlord and order him you wouldn't get paid for it. over to the house when the bowl is stuffed up. B u a a p h s a 5 (billed through a lawyer's office) he tells me l will need to replace the toilet. A new toilet? ow that is something you never think about. How many folks have bought a new toilet- ever? And it's not that easy. The plumber doesn't just say, "Okay, just fetch me a toilet!" You have to choose one from a catalogue that he hauls in from his truck. A catalogue of toilets, now that's what l call bathroom reading. So now l have to choose between the flashy, efficient model, and the standard, family one. There you are having dinner with another couple, and the woman says, "You know, Myron and l are thinking about trading in our Lexus LS for a sporty LS 200. " "Yeah, l know what you mean. My wife and I are thinking about trading in our toilet for an intestinal evacuation system. You won't believe what they're showing in the catalogue." Of course everyone always complains that plumbers make too much. Even doctors complain. lf you break it down by the hour, the average plumber m m e �charges more than the average therapist. If I was a therapist and spent all those years in school, I would just go an extra six weeks and become a plumber. What the heck! Combine your fields! Put an ad in the yellow pages: "Purge your drain and your psyche for one low price. We'll even throw in the kitchen sink." "Copper pipes and crackpots - we fix 'em all. " "Whether you're anal-retentive or your toilet is- no job is too small. " "Unclog your drains and your brains - aH our plumbers are also licensed clinical psychologists. " It would be great the plumber shows up with a couch and you get to stretch out and free-associate. "So, how do you feel when your husband ignores you? ... hold on a second, damned tank won't release." I suppose that being a plumber isn't the greatest job in the world, but then again what job is? Everyone wants a job that they will like, so they go to school for 200 years, borrow $200,000 and then they realize that every morni'1g they still have to go to "work. " You can always tell when people hate their jobs, because theygooutoftheirway to tell you how much they like it. Look, nobody likes their job. That's why they call it a "job." If they loved it, they'd call it something else, like "fun ." "I love my fun. " But if it was fun you wouldn't get paid for it. "Sorry Mr. Yakman. You're enjoying your job too much. I'm afraid we're B a 0 p h AcADEMIC HEALTH PROFESSIONALS INSURANCE AssociATION gonna have to stop paying you. " When I tell people I am a pediatrician and they say it must be "fun " getting to "play with kids all day. " o! I don't get to play with kids all day. If you consider holding a kid down while he screams, spits and sees you as a human rest room with a white coat, then, come along - it's play time. Nobody gets to play with kids all day except other kids, and if you paid them Insuring care for those who care Subscriber Owned • Organized • Governed PHYSICIANS • DENTISTS HEALTH PROFESSIONALS NURSES • RESIDE TS Superior policies for academic full-time and voluntaty clinical faculty ~a. Competitive premiums ~ Rewarding educational progran1s ~ Complete legal service ~ Comprehensive coverage Dividend opportunities Academic Health Professionals Insurance Association is a subscriber owned and organized reciprocal licensed by the Insurance Department ofNew York State. Policy and programs ofthe Association are determined by a representative Board ofGovernors elected by subscribers at SUNY Health Science Centers. Enrollment open at all times. Transfers arranged without loss. AcADEMIC HEALTH PROFESSIONALS INSURANCE AssociATION to do it, eight hours a day and told them they can't leave, they would hate it too. In fact they would insist on going to work. + Empire State Building 350 Fifth Avenue, Suite #1512 New York, ew York 10118 Ph. 212-947-4541 Fax 212-947-4572 Stu Silverstein, M.D., president of Stondup Medkine Seminars of Son froncisw, Colifomio, lectures nationwide on humor inmedkine. He ~also c!Xluthor of What About Me?, o book oboot growing up with odeveklpmentol~ disabled ~bling. 5 a n s m m e 9 9 �[ IJ························································································· 1 9 THOMAS 3 MARCH s 0 ' 31 , of Tacoma, Washington, has, in his 43 years of practice, tried pri- vate practice in four locations in New York State. He also worked for ew York State and the VA before his retirement in 1973 at age 70. With eight grandchildren and 10 great grandchildren, he tells us he, at age 92, and his wife, at age 75, are well (relatively!). He'd love to hear more of his classmates from 1931. white photography since he was at 5 Country Club Lane, Route medicine in addition to internal 14. He got involved in stereo 11, photography about 22 years ago shire 03257. medicine and pulmonary diseases. He is director of respira- ew London, ew Hamp- and began specializing in pho- tory therapy services and associ- 1 tographic techniques that involve high-speed (l/50,000'h of 9 5 s 0 has been lab. Still actively practicing medi- a second) electronic flash as well as electronic sensors and elec- a professor of pediatrics at ortheastern Ohio Universities Col- cine, he enjoys skiing and fly fishing. He writes that his son, tronic components two years lege of Medicine since 1985. He George, is married and living in ago. Dr. Stell uses two single- KURT J . W E G N ER ' 52 , is director of the residency pro- Chicago and has blessed him lens cameras for his stereo work, gram in pediatrics at Tod with two grandchildren. rather than the Stereo Realist Children's Hospital in Youngstown, Ohio. Still active in pedi- camera produced some 40 years ago for that purpose. His spe- atric consultations in neonatol- cialization has paid off; he has ogy and genetics, he has three of Hol- won numerous awards for his sons, including one who is an lywood , Florida, is understand- stereograms, including the Best orthopedist, and two grand- HAR RY BERG MAN '34 , daughters. Ann B. Matasar, Amoco Distin- of Show medal from the Chicago Lighthouse International guished Professor of Interna- Exhibition of Stereo Photogra- WILLIAM ably proud of his daughter, Dr. ate director of a sleep disorders J. S U LLIVAN ' 55 , IRVI NG S . K OLI N '65 , of Winter Park, Florida, participated in a national meeting of clinical investigators working with Revia (naltrexone HCL) in the treatment of alcoholism. Revia is now approved by the FDA for the of treatment of alcohol dependence. Dr. Kolin served as co- tional Business at Roosevelt phy for his strobed photograph Los Angeles, California, is still University, Chicago, who has of a hummingbird at a feeder, working full-time in forensic investigator in the national been elected American treasurer the PSA Best Coniemporary psychiatry, focusing on medical study. He has also been ap- of the International Federation ofUniversityWomen Professors. medal from the Wichita International Exhibition of Photog- malpractice cases. He recently became a member of the execu- pointed to the advisory board of Dupont Pharmaceuticals for fur- She is that group's financial vice raphy for his high-speed stereo tive board, head of the psychia- ther study of the drug's use president, as well. Dr. Matasar slide of a golf ball landing in try section, of the American in the treatment of alcohol de- will visit Yokohama, japan, for water, and the Best of Show Board of Forensic Examiners. installation before visiting the group's official office in Geneva, Salon for his stereogram portrait Switzerland. Recently, the Uni- of a young woman. Dr. Stell re- versity of Paris- Sorbo nne, in- members that during his medi- an Innovation in Medical Man- creased her yearly tenure from cal school years, he and Ed agementaward from The Ameri- six weeks as professor of Eschner were the only photog- four to finance, and she received an invitation to serve as a visiting professor of finance at the University of Kiev, Ukraine, as well as one to lecture at the University of Vienna, Austria. medal from the Cordova Stereo Apter served as a resident ad- tography. Stell, who retired from junct professor at the oceano- private psychiatric practice in Eggertsville, New York, in 1975, graphic center of ova University in Ft. Lauderdale, Florida. has had an interest in black and He has now taken a well-de- has won ies of the entire record of their visit, which resulted in a reduction of health care costs due to a substantial and sustained drop cago and as a resource psychia- ous awards for his stereo pho- s patients were given written cop- turer at the University of Chi- City, Arizona, has won numer- 0 Health Services program. In it, practice, as a professorial lec- Center. From 1984 to 1995, Dr. 6 can College of Physician Executives for his Brandeis University tired in early 1984 from private trist at Michael Reese Medical 9 HARRIS C . FAIGEL '60, re- of Sun B ER NAR D S . S TELL '36 , 1 raphers in the class. N ATHANI E L S . APT ER '38 , u a a p h y 5 American College of Psychiatrists. The American College of Psychiatrists includes only 550 members elected from the 40,000 members of the American Psychiatric Association. Election to the College is based on peer recognition of accomplishments; elevation to fellowship - further recognition of work in psychiatry- is achieved by less than half of College members. in utilization of clinic services despite increases in student en- S AMUEL C . A RMSTRO N G ' 67 , rollment. is serving as chief of staff of GEO R GE B . P FO ERTNER ' 60 , Providence General Medical Center in Everett, Washington. of Boise, Idaho, was recently board certified in critical care served retirement and is living B pendence, and was recently elevated to fellowship in the c a n 5 m An internist, hematologist and oncologist, he has been with the m e 9 9 �··········· · ···· · ········· ·· ·· ········· ···················································• • ' Everell Clinic there for 21 years. JAMES L. CAVALIERI II '69 , was recently awarded the Buffalo Pediatric Society's "Pediatrician of the Year" award. He's Emory University. His son josh, Medicine in the Bronx, 16, is getting ready to apply to York. falo Pediatric Society, he is a member of the board of trustees of The Children's Hospital of Buffalo. in private practice in physical medicine and rehabilitation in is l2 and his daughter julie is 10. 1 1972. Past president of the Buf- 9 8 Annapolis, Maryland. She and her husband celebrated the birth s 0 of their second child, Margot of Dover, Leigh White, on April12, 1995. Delaware, was recently elected LiLLie Margot joins her older to a fellowship in the American brother, Cameron, who is 5. MARKS . BORER '80 , Psychiatric Association. MARITZA COTT0 '87 , of Dover, IAN M . SCHORR '69 , ew jersey, writes that his twoyear-old grandson, who lives in Chicago, forces him to take much-needed short vacations! 1 9 7 s 0 she is practicing cardiology at that he is moving back East to take a position in Columbus, Rochester Park Medical Group and Park Ridge Hospital in Roch- Ohio with Ross Products Division - Abbott Laboratories, as director of clinical research. ester, ewYork. She tells us that ANTHEA WOODLEY '87 , is also practicing card iology and CAMILLE BUONOCORE '87 , is KEVIN FERENTZ '83 , of Balti- more, Maryland, has a national Brookline, Massachusetts, was radio show heard on W EDAM in Buffalo and on 125 stations around the country. He also has a new son, number three, J. TWAROG '71 , listed in Best Doctors in America, 1994-95. He was also honored by the Asthma and Allergy Foundation of America ew England Chapter- for his contributions to asthma care in 1995. married and practicing endocrinology, and is the proud mother of daughter Corinne. GRETCHEN EBERHART '87 , Noah Samuel, born january 25, of Clearwater, Florida, has been appointed medical director of clinical affairs for Community Dialysis Center. He writes that although he has joined the ranks of physician executives, he still is able to enjoy a busy clinical practice. Community Dialysis Center operates 165 dialysis centers throughout the country. EUGENE HIRSH '75 , is a prac- ticinggastroenteroJogist in north Atlanta. Elected chief of the Gl section at St. joseph's Hospital there for 1995-96, he is an associate clinical professor of medi- 1994. is in private practice with Tri-City cine in digestive disorders at Anesthesiologists in Tempe, Arizona, where he enjoys his busy practice. He was recently board certified in pain management. He and his wife, jennifer, have 1 ' 84 , 9 9 finished his residency in psychiatry at Yale University and is now happily working in the Boca Raton Psychiatric Group in South Florida. His wife finished her Ph.D. in psychology at the University at Buffalo in 1993 and gave birth to their wonderful son , Mitchell , on january 14, of Westchester, ew York, is assistant director of psychiatric emergency services at Mon tefiore Hospital, the teaching hospital 0 0 p h y 5 c 0 n Claire Anita, on December 3, 1994. She joins her two brothers, Ryan, 2 1/2 and Connor, 1 1/2. KRISTA M . ( PRIGG) KOZACKI '91 , of Florence, South Caro- lina, wonders how everyone is doing in Buffalo. She writes that after she finished her fami ly medicine residency, she opened a private practice with another physician she went through residen cy with. They call the practice, "Pee Dee Regional Family Medicine." Business is great, she says, and the art and thrill of join them in September. Her family is doing wonderfully: her husband continues to practice with the same law firm , and their twins, Stefan and jacob, turned two February 18. They talk nonstop, climb the five-foot fence, play in the dirt and give wonderful hugs. Unique to her practice is a nursery built into the office of daughter, with a private nanny to care for the children. "It's the ew York and his wife, best part of medicine and moth- DOUGLAS P . PREVOST '90, of the Albert Einstein College of B Anita, had their third child , for her boys and her partner's 1995. Snyder, Stefan and Jacob Kozacki, 2 family medicine are even more fulfilling. A third physician will s 0 BRIAN FELDMAN '90, for a girl?? " jennifer sends her best regards to Dr. aughton. She was his secretary in 1983 and 1984. WEINST E IN is doing a fel- on january 27, 1995. four boys: Matthew, 7; Brendan, 5 1/2; justin, 4; and joey Jr., l. "Anyone have the secret formula CAROL PANKOW lowship in endocrino logy at Massachusells General Hospital in Boston. She and her husband celebrated the birth of their first child , Lindsay Grace Eberhart, JOSEPH D . CURLETTA '84 , CHARLES J. MCALLISTER '73 , writes that writes ROBERT SHALWITZ '80 , of FRANK is SARAH MURRAY WHITE '85, coaches basketball. His son Ben been in private practice in Williamsville, ew York, since I ew colleges and is in his third year of varsity swimming. He also . s m m e �• ....................................... . BACK TO SCHOOL SALE I erhood," Krista says. "Finally, it's very exciting to hear and read all about the growth and changes at UB med." CYNTHIA ( LEBER MAN) JENSON of Pittsburgh, Pennsylvania, writes that she and Mark '92 , had a baby girl, Alexandra Nicole, on March 8, 1995. She also tells us that jim and Laura Krug had a baby girl, Sarah Eliza- R ICHARD WARREN BR ITT ' 36 , died last ovember 4, in Deer Isle, Maine. Dr. Britt, a Tonawanda, ew York, native, was the son of Dr. W. Warren Britt. He began his medical career in practice with his father and brother, DR . ROBERT C . BRIT T ' 42 , in Tonawanda, and practiced there for 29 years, where he was a member of the medical staff of DeGraff Memo- beth. CATHY K . NAUGHTON '93 , and MICHAEL J . NAUGHTON '93 , are now second-year residents in the general surgery and internal medicine programs at Washington University/Barnes Hospital. Michael will pursue a fellowship in hematology/oncology and Cathy will continue at Washington University in the division of urological surgery. Cathy and Michael were married September 3, 1994, in St. Louis, Missouri, at the inth Street Abbey in historic Soulard. T O DD S C H LES ING E R ' 94 , is completing an internship in internal medicine and beginning one in dermatology this summer. J O HN OBITUARIES TIM OTHY SH E RWOO D recently completed an internship in internal medicine at johns Hopkins Hospital. He plans on making a career change to general surgery and will start an internship at University Hospitals of Cleveland, Ohio, this '94 , summer. He and classmate Debra Tarantino '94, will be married Performa 5200 CD Performa 636 CD rial Hospital, before moving to Maine in 1966. IRVI NG WEINER '37 , died May 6, 1994, at age 82. He had been in private practice in ewburgh, ew York, since 1938, before he retired after 50 years of practice. L EON A RD WOLIN ' 41 , PowerBook 520 of Buf- Power Macintosh 7100CD $1379 Performa 636 CD falo, died May8,1995. Dr. Wolin was the father of DR . MAU R ICE 8MB RAM, 500MB hard drive, CO-ROM drive, 15" color monitor, keyboard, mouse and lots of software. Performa 5200 CD $1819 8MB RAM, 800MB hard drive, CO-ROM drive, 15" color monitor, keyboard, mouse and lots of software. W OLI N '84 . Power Macintosh 71 00 CD $2029 8MB RAM, 700MB hard drive, CD-ROM dnve, 15" color monitor, keyboard, and mouse. died unexpectedly on Christmas Day while visiting his daughter in Colorado. THOMAS J . ENR IGHT '48 , WA L TER A. PowerBook 520 $1469 4MB RAM, 240MB hard drive. PENTIUM NOTEBOOK DELL Pentium NoteBook $4089 OLSZEWSK I ' 54 , died February 23, 1995. An assistant professor of neurology and clinical associate professor of anatomy and pathology at UB, Dr. Olszewski was board certified in neurology by the American Board of Psychiatry and eurology and neuropathology by the American Board of Pathology. He was a fellow of the Stroke Council of the American Heart Association and the American Academy of eurology. 16MB RAM, 810MB hard drive, 75MHz, 10.4" Dual Scan Color Display , Li ion extended life battery. BEST PRICE ON MICROSOFT OFFICE Microsoft Office is an integrated packal)e including Word, Excel, PowerPoint, a workstation l1cense for Mail & Access (professional version only}. $126 $134 $139 $158 • Microsoft Office for Macintosh Standard CD • Microsoft Office for Windows Standard • Microsoft Office for Macintosh Standard • Microsoft Office for Windows Professional .. ~ ,, \!~L ill.\\ - OFFICEI September 16. A non-profit University program for students, faculty & staff The Commons • North Campus • (716) 645-3554 • Fax: 645-3884 B u 0 0 p c a n 5 m m e �The jury is out. Your practice and assets are on the line. This is not the time to be second-guessing your choice of professional liability insurance companies. In a similar situation, a MLMIC policyholder remains confident, knowing he or she is protected by a company that already has successfully defended more physicians than all other available insurers combined. • Adding to the value of your MLMIC policy is one of the country's largest and most experienced professional liability Claims Departments, as well as the largest Risk Management Department of any professional liability insurer in the state. MLMIC also offers New York's only true peer review of claims experience. • Only physician-owned and controlled MLMIC offers this high level of quality assurance and service. MLMIC also is the only medical liability insurer approved by the Medical Society of the State of New York. Find out more about the protection you'll receive from the largest and most successful company of its kind in America. Ca111-::800-356-4056 in Upstate New York, or 1-800-ASK-MLMIC in the New York metropolitan area.• MLM~C ~ledical ~ Uability ~lutualln.<Urallef Company Our defense never rests. 2 Park Avenue New York, NY 10016 2 Clinton Square Syracuse, NY 13202 90 Merrick Avenue E. Meadow, NY 11554 01994 Med,cal Ual:111ty Mut.c.u~! ~ra11ee CompZiny �BUFFALO PHYSICIAN Non-Profit Org . U.S. Postage PAID Buffalo, NY Permit No. 311 STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED PLANTING TREE UNI)ER WI-ncH Yc)l WILIJ NE ER 7 Srt DR. Dr:Vn.LO W lhRRI <.IU • dass of 1871, knew how to make his monc) grow. In fact, this man who in 1905 prO\idcd $5.000 through his \\ill for Assrs n at Buffalo S<:hc r 150 y I • E <6 a A • I S ••• of \lcdicinc. is still supporting l'B � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1995 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1995-Summer Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v29n03-1995-Summer Table Of Contents A list of subunits of the resource. Research Hospital News Giving Back Breathing Life Through Liquid Medical School Then and Now Alumni A Spoonful of Humor Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v29n03 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1995 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/61b2df99f11fd06ae6710c62febd72c6.pdf 18a2e61b4e50fe33e72286625e664e26 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Autumn 1994 UB'S FACULTY PRACTICE MANAGEMENT PLAN MAKES SENSE FOR ITS FACULTY MEMBERS AND THE PATIENTS AND STU DENTS THEY SERVE �BUFFALO PHYSICIAN Dear Alumni and Friends, \olume .!8, \iumber 4 T ASSOCIATE VICE PRESIDENT FOR UNIVERSITY ADVANCEMENT Dr C" ole ~m!lh Petro DIRECTOR OF PUBLICATIONS flmothv ). C mwv EDITOR ..1ne·te Ird.:-::.c~,: R l\1 ART DIRECTOR Ala,., I. Kcglr• ASSOCIATE ART DIRECTOR xonl rl(l er PRODUCTION MANAGER Ann R~\slm~mn Br..>wn STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES l'r 'vim aug; t.m. V 1ce Presd•nt for C •• meal Affd: cs. Dean EDITORIAL BOARD Dr john \ Riche t l h~"nn" Dr Russell \\ Bessette Dr \hnm Bul.bc: Dr ll n ld D:--)c.h· Dr \lr Dr Dr Dr Dr Dr Dr Dr 1 Rich.:d L ( .Ji ms Ra' i DrsJi \Ian : Dr""··m l.tmes Kntskt ~I 1zabet h Olmsted Ll·arlrs Pa~•. clli i ho"'as Ra.;~ hts tssuc of Buffalo Phvstcian reviews t\vO activllies of singular importance ~o L B\ medical ~chool- the proposed Academic Medtcal ( ollegmm and the lOth ann!\ ersarv of the operation vf the ~Lhool sF acuhy Practice Management Plan (F PMP, The latter was m:mdated b) the state legtslature to ensure that full-time and geographical full time chmca: faculty members met <.ducauonal and research responsibtliues to Slt Y ,md to dewlop a mechanism to employ talented fa<.ult) at competiuve compensatwn :evels. Such organizations are alwavs dtfficult to implement, It IL'ok t.B almost l 0) ears to wmplv with the legislauve in illative and the '>l ''t Trustees" pohc1es. But the FP\IIP has proven its potenual to cement the tnstltutional rclauon'>hip of a clmi...a' fa<.ulty dispersed throughout \\estern "\e\\ York The 1991 audn mdkates this decentralized plan ts functionmg well Of a tot.1l revenue ha'>t of approximately $70 mtlhon, almost half went 10 support f<~cult\ sala!"ics and $2 9 millio~t .md '>2.7 mil11on respeLt:\el) \\tre returned to the hospitals for overhead and to the school for academtc program developrrent. The \cad(:m1c MedKal (ollegmm represents a broader umverSil\ -cL>mmunlt) effort to mvolve the school, tea<.hiPg hospllals, cimical fac ultv ,md hospital ph\ st.:ian staffs m more cooper<~ the plannmg and work .ts the needs to meet the extgcnnes related to health care an<l medt<.al edu<.atlon reform becomt reality fhts orgamzatwn 1s working to defme its prmuples of orgamzation and w tll follow"' tth more speulk orgamzatlonal planmng. Gtvtn the su<.cec;s ol some ol l B sand the community s <.on~orual expenenees. this new c>rgamzauon could lorm a model from whkh !le\\ c:ooperatl\ e ventures de\ clop m \Ve'itern "le\\ 'r ork, and on-.e o.~g.:~in, .tn orgamzauon that wuld sene as a model for those vther aL.:~demicallv onented medtcal<vmmunmes that are struggling to deal with the c..omplex tssuec, of health care ard health edu<.ation refvrm. Smcerd), ~4---.~ ~lef!-c" <.pau'dt~(. J:c;~dlc) T ; r ax john "\aughton, \1.0. for Chmull \jfa:r~ Own ';c hool of \Jcdrcinr and Biomedtcal -'>ucnLn \'1< c Prc~ident TEACHING HOSPITALS AND LIAISONS fhc r 1iliO (.Je""IC'r"-. Hospll.ll \fi, had ~haw Buffa!<'\\ Vdi"" Center Dear Fellow Alumni, \~knr kt!~v Y The U1: ld:e:o s H•>Si>" !I of Buff. Ene Cvuntr ''~dh.~. Ccntc· "'er,) H"s"l:-Jl ~!tllarJ f til more llospuals frunl' 5m~ Ros\\elll'c.~t~t. Cc.JiiCt..r lnst.:~tc <.tstf'S of Chant~ Hosf>ttll D•.:nms Vc( ar•hv Tite "10:111... l mvers1rv uf "\ie\\ Y.... : k "' Buff,:c• C:uff,;lo PhvSidan i< pcbhs'>cJ qu:~rtc1~y b,· thr ..,Ute l nh~ r;:'"' ·>f !'.rw )ctk Jt Bulf.,Io School ct \1c<i.~ont:: anti F10medacal <;ocf\C("S and the Ltft h r ef i 'uf"'.l,cJtlons. h 1:::. SLnt free vi (hargc w.Ilumni, :.tt ultv Stude:1h, Tt.:.SilkntS .md fn·~"nJs. fhc 5taP rescn.ec;. the nJI'-t t.)edatall ... op) Jnd SlibtnJSstons a.ccpteJ fc.r publa.. Jta_ 11 \ddrcc;s q:~C">Ilons, ~o..cmmc~lh and s.ubmiSS~<)nS to: [d .. tor L:uf(ult, Ph)'')tl~un, ")LJ.tc l mvcrsuy of "l'"w )c•rk Jl Buflalo L'nl\crsttv PuhlcJtHll:S.I ~{>( r.·'t,llJll,U;.:!IJ:u. "'cv. )Jrk 142o(' orb~ .•. r-o~JI Jt notesu-'; >t: h. bu ff~lo.eue>. Send address <hanges to: flu/Jul.• Ph}llc>an. 14 ( l"> \ddittc•o l41j Mam ~t: ec! f.uffJic· "'cw h·rk d 2 I I our alumni board recently held tb mtd-<.ummer me~ting ..1nd pLm<. are well undt:rwav for the upLc'mt.ng medical <>chool year \Vekommg rec ~puons were held for !re'ihm.m and junior students ro1l0w mg form:d pre<;entaticms, the \lumm \s.,ouauon sponsort:d a c;octal event for stud~n•s I he SULLC~sful < ommumty Phv-.toans' Progr.tm w 11l be contmued fhe \t:Jr<. aclt\ 1· ues, '' hKh mclude mtroducing <>tudents to the dJtl) praw,e ol d1ffermt mediul-.peualt.e'>. '' :P be <.o-<.haired bv Dr<;. Roger Daver 'oO, .tnd Beth \tah.:r '85. fhe board arranged for the p""esident of the Mcdicai ">tudent Pol:t) h.> .:mend se\er.tl mectmgs, allowing for mort .:arrfulh C\aluated requesb and opponunitt.:s forLooperauon betwet:n the student bod\ and A.lumm AssL'Uatwn Plans for '>pnng (. hmcal Da) and Reumon Weektnd ,tre begmnmg to sohdify under the dtre.:tk>n of c hJtrperson Dr. j.:~ck ( m ne 8) ln '>epttmbu, \\ e pre~ented the D snnguished \kdical J\lumnus A'' ard to Dr '\Joel Rose '64 Hts achtevementc, are -nHmati<'nalh recognized: 11 IS an honor to have pre.,ented thts award to him ln'-.: ,tgain 'our '\lumm Assocuuon seeks to provide \\ays to a<.si<.t bt>th th nc.:nt and <ocnivr members. II you ha\ e <IllY 1dea<. that' ou \Hsh to sh..1re, plea~c d~' not hestt.tte to LOntact me Smcerelv. ~ c::::: Russell \V Be<;~ette, D D '>, \1 D. '76 P,-esrdmt, \lcdical Alumm As~L'< iatwn �V 0 u A II II II Where's the beef? Page 2. 2 L T u 8 M o N 9 N 4 9 4 Research Hospital News Practice Makes Perfect e After 10 years, UB's Faculty Practice Management Plan makes sense for its faculty members and the patients and students they serve. m Equal Time e The new Academic Medical Collegium gives its members an equal say in the future of health care in Buffalo. m m Medical School Then and Now m m Alumni Then and Now. Page 26. ASpoonful of Humor m Classnotes * l~e new ~cafiemic ffiefiical [ollegium ta~es s~a~e. rage lt �· · · · · · · · · · · · · · · · · · · · · · · ·· · · ·· · · · · · · · · · · · · · · · · · · · il] '' ' / 0 Roswell researchers arrest human cancer xenograft in scid mice B and Roswell Park Cancer Institute scientists have been able to arrest the growth of human lung cancer xenograft in severe combined immunodeficient (scid) mice by administering a long-circulating liposome formulation of doxorubicin known as Doxil. By doing so, Richard B. Bankert, Ph.D., D.V.M., associate research professor and principal investigator on the study, and colleagues, have reported the first direct evidence that antitumor drugs delivered in sterically stabilized liposomes are more effective at halting the growth of human tumors than more conventional systems. Bankert's research also establishes the scid mouse as a viable model in which to study novel chemotherapeutic approaches to treating human solid tumors. "The scid mouse appears to be an excellent model for in vivo testing the activity of anticancer agents on solid tumors due to its ability to produce tumors that retain the histological characteristics and metastatic potential of the original human specimen," Bankert said. Administering drugs in liposomes to reduce toxicity and target the drug to the tumor has been under investigation at Roswell for 20 years. The effectiveness of conventionalliposome preparations has been limited by their brief circulation time, as well as their susceptibility to uptake and clearance by the liver and spleen, and the binding of plasma components to their surface, causing the liposomes to break down and leak before reaching the tumor. Bankert and his team used sterically stabilized liposomes, which exhibit an enhanced ability to accumulate within B u a 0 p The fatty acid found in meats and dairy products may offer some protection against breast cancer. solid tumors in vivo. The researchers investigated the antitumor effects of Doxil, doxorubicin encapsulated in conventional liposomes ( C-DOX) and free doxorubicin against a human squamous cell carcinoma of the lung grown in scid mice. "Doxil completely arrested tumor growth in all of the mice tested , while free doxorubicin only slightly delayed tumor growth and C-DOX was ineffective at arresting tumor growth , although some decrease in growth rate was observed," Bankert said. Clinical trials for patients with lung cancer res is tan t to first -line chemotherapy are underway. + Where'sthe beef? esearchers at Roswell Park Cancer Institute have found that conjugated linoleic acid (CLA), a minor fatty acid found preferentially in meats and dairy products , offers some protection against breast cancer in animal models. "Unlike most fatty acids , CLA prevents rather than stimulates cancer development," said Clement Ip, Ph.D., UB assistant research professor from h c a A Roswell's division of breast surgery. Meat from ruminants contains more CLA than meat from other animals; bacteria from the ruminant's stomach can convert linoleic acid, an essential polyunsaturated fat, into CLA. "Dairy products and cheeses are also good sources of CLA," explained Ip, whose two recent studies provide strong evidence of the fatty acid's anticancer properties. Ip found that rats whose diets contained 0.1 percent CLA by weight - the equivalent of about four times the amount consumed in the everyday diet of the typical American- developed just twothirds as many breast cancers as rats given no CLA. In his paper published recently in Cancer Research, Ip further suggests that CLA may reduce the susceptibility of breast tissue to malignant changes. Of the large number of naturally occurring substances that have demonstrated anticancer activity, all but a handful are plant-derived. CLA is unique because it is present in food derived from animals, and its effectiveness is seen at dietary concentrations that are close to the levels consumed by humans. "We just do not know the impact that CLA alone has in the context of a high fat u m n 9 4 �·························· · ································ · ·············· · ·· · · · ·········· g] . ·~" '· ..• . illegal cigarette sales net state, federal governments big revenues orty-six states garnered $71 million in taxes from the illegal sale of cigarettes to minors in 1991, and the federal government took in an additional $51 million, according to a study led by UB researchers. California topped the states in illgotten tobacco revenues with an estimated $10.2 million, the data show, followed by Texas at $8.2 million, ew York at $7.2 million and Florida at $4.1 million. Louisiana, Missouri, Montana and ew Mexico were not included in the illegal tax-revenue statistics because these states had no law restricting the sale of tobacco to minors as of 1991. Since then, all 50 states and the District of Columbia have passed laws banning the sale of cigarettes to minors. The report, recently published in Are babies who are nursed protected later in life? Women breast-fed as infants may have lower risk of breast cancer ew research from UB indicates that women who were breast-fed as infants may experience a measure of protection against breast cancer later in life. The UB study, involving 1,130 women from two counties in Western ew York, indicated that women who were breast-fed had a 25 percent lower risk for developing breast cancer than women who were bottle-fed as babies. The study appeared in the May issue of Epidemiology. "There is growing interest in exposures in early life, including diet, and their relationship to breast cancer risk," said jo Freudenheim, Ph.D., associate professor of social and preventive medicine and the study's principal investigator. "There has to be some sort of environmental component to explain the geographical variation in breast cancer rates. American journal of Public Health, tracked the illegal sale of cigarettes to minors , by state, using a variety of national reports and studies. It was authored by K. Michael Cummings, Ph.D., associate research professor and senior research scientist at Roswell Park Cancer Institute; Terry Pachacek, Ph.D., associate research professor of social and preventive medicine; and Donald Shopland of the ational Cancer Institute. Other findings included: ~ Approximately 2. 7 million teenagu a 0 p .. ers smoked an estimated 516 million packs of cigarettes in 1991. ~ Federal and state governments collected a total of more than $240 million on the sale of cigarettes to teens 12-18 years old. ~ Cigarette companies earned $190 million in profit from sales to teenagers 94.8 million of it from illegal sales to minors. Cummings said the report was intended to send a message to state governments. "Despite laws prohibiting the sale of tobacco products to minors, it's clear teenage smokers can still buy cigarettes easily. Studies show that when these laws are enforced, illegal sales to minors can be reduced dramatically," Cummings said. + intake in humans," said Ip, who added that the challenge of future research will be to define the potential benefits of CLA in the human diet, to characterize its anticancer activities, to elucidate its mechanism of action at the subcellular level and to design new strategies for enriching foods with CLA. + B '· y 5 a n Risk factors relating to exposures in adulthood don't explain all the variation we see. This finding of a possible protective effect from having been breast-fed could be significant, and it is certainly worth looking at further. " Freudenheim and a team of researchers collected data on an array of potential risk factors from 528 women newly diagnosed with breast cancer and 602 women with no cancer who were randomly selected from the same population and matched for age. The women were between the ages of 40 and 85 during the time of the study, from 1986 to 1991. After controlling for age, education, age at menarche, age at first pregnancy, number of months they nursed their own children, number of pregnancies, family history of breast cancer, history of benign breast disease and body-mass index and height, the researchers found that one aspect of early nutrition - whether a woman had been breast-fed- was asso+ ciated with a decrease in risk. BY u m LOIS n BAKER 9 4 e �Buffalo General initiates third state lung transplant program he Buffalo General Hospital, in cooperation with the School of Medicine and Biomedical Sciences, has become the third hospital in ew York State to initiate a lung transplantation program. "This new service is an extension of our heart transplant program and its primary focus will be patients with endstage lung disease who reside in Upstate New York (west and north of Albany)," saidJoginder N. Bhayana, M.D., associate professor of surgery and director of BGH's Heart/Lung Transplant Program. In ew York State, only Columbia Presbyterian Medical Center and The Mount Sinai Medical Center in ew York City offer lung transplantation in addition to Buffalo General. oting that more than 80 heart transplants have been performed by BGH surgeons since 1984, Bhayana observed, "Our team has extensive transplantation experience and is well-prepared to perform lung transplants. " According to Bhayana, by late April , 28 people had already received preliminary evaluations for lung transplantation, and six were on the United etwork for Organ Sharing (U OS) list of patients awaiting donor organs. Bhayana said his transplant team hopes to perform six to eight procedures annually. "Obtaining lungs is more difficult than hearts because many potential donors are on respirators for several days prior to dying," he noted, adding that the chances of lung infection increase after a patient has been on a respirator for 48 hours. Unlike heart transplants, where organ rejection is the most critical postoperative factor, infection is the most 0 B u a 0 p serious concern after lung transplantation, he said. Bhayana observed that a multi-disciplinary team was developed to manage the evaluation, transplant surgery and post-transplant care in cooperation with the patient's primary care physician. The team consists of representatives in cardiothoracic surgery, pulmonary medicine, cardiology, infectious disease, psychiatry, nursing, pharmacy, pathology, rehabilitation medicine, nutritional + services and social work. edge and technology of genome science. "This very generous gift from the Palisano family will allow Roswell Park to endow its new program in cancer genetics and to use the interest the funds generate to support the research activities of its laboratory," said Thomas B. Tomasi, M.D. , Ph.D. , president and CEO ofRPCl. Roswell now houses several hereditary cancer registries, including the Gilda Radner Familial Ovarian Cancer Registry and the Familial Cancer Syndrome Registry, and has plans to add three new ones. + $1 million gift to Roswell will fund new cancer genetics laboratory Medical/Dental staff officers Buffalo family who lost six of its elected atteaching hospitals members to cancer has pledged $1 million to Roswell Park Cancer edical and dental staff officers Institute to establish a cancer gewere elected recently at several netics research laboratory. DB-affiliated teaching hospitals. The laboratory will be dedicated At Sisters Hospital, Daniel A. to the memory of John and Santa Castellani, M.D., clinical instrucPalisano, whose first born, Vincent, at tor in neurology, was elected age l3 started a delivery business with a president. Also elected were Edward horse and wagon that later spawned a Bartels, M.D., clinical instructor in gynumber of highly successful transporta- necology and obstetrics, president-elect; tion companies, including Boss Linco Kenneth]. Eckhert, Jr., M.D. , clinical Lines. assistant professor of surgery, secretary; Roswell received the gift from the and Nady Shehata, M.D. , treasurer. Charles and Charlotte Palisano family At The Buffalo General Hospital, Scott and from the Vincent and Harriet A. Tulman, M.D. , clinical assistant proPalisano Foundation. fessor of surgery, was elected president. "lt is both a privilege and an honor to Also elected were Daniel A. Mariniello, have a cancer research laboratory at M.D. , clinical associate professor of gyRoswell Park carry the name of my fam- necology and obstetrics, president-elect; ily, said Charles ]. Palisano, whose Nancy Nielsen , M.D., SUNY trustee and mother, Santa, three of his brothers, clinical assistant professor of microbiolVincent, Victor and Samuel, a sister, ogy and medicine, vice president; Daniel Virginia, and niece, Diane, died of can- S. Camara, M.D., secretary; and john cer. DeBerry, M.D. , assistant professor of The laboratory will be located within urology, treasurer. Roswell's new Cancer Genetics and Gene At The Children's Hospital of Buffalo, Therapy Program, established to capi- Daniel Peroni, M.D. , professor of peditalize on the explosive growth in know!- atrics, was elected president; Russell S. y 5 c a n A u m 9 9 4 �························ ··········· ···················································· ·· ·~ liJJ Vaughan, M.D., clinical assistant professor of pediatrics, was elected vice president; and Ehsan Afshani, M.D., professor of radiology and pediatrics, was elected secretary-treasurer. At Millard Fillmore Health System, Thomas Cumbo, M.D., clinical associate professor of medicine, was elected president. Also elected were Thomas Lombardo, M.D., clinical instructor in orthopaedics, president-elect; james Burdick, M.D., clinical instructor in anesthesiology, secretary; and Evan Evans, M.D., clinical instructor and Buswell fellow in surgery, treasurer. + Children'srecruits nationally renowned heart surgeon Eliot Rosenkronz, M.D. liot Rosenkranz, M.D., has joined The Children's Hospital of Buffalo to head its division of cardiovascular surgery. Rosenkranz, who was recruited from The Cleveland Clinic, holds the position ofUB associate professor of surgery. He will participate in clinical and laboratory cardiovascular research at both the medical school and Children's. "The successful recruitment of Eliot Rosenkranz is a coup for Children's Hospital," said joseph A. Ruffolo, the hospital's president and chief executive officer. "By leaving The Cleveland Clinic and joining the staff at Children's Hospital, Dr. Rosenkranz is making a strong statement as to his future investment and commitment to the success of the hospital." A native of Glen Clove, ew York, Rosenkranz is a graduate of the University of California at San Diego School of Medicine. He completed his general residency at the University of California and Los Angeles Medical Center. 6 0 0 p h Rosenkranz was the head of the section of congenital heart surgery at The Cleveland Clinic, responsible for pediatric and adult congenital heart surgery, pediatric heart transplants and arrhythmia surgery, as well as clinical and laboratory research. + NFMMC wins Preferred Prtmary Care Provider DOH designation iagara Falls Memorial Medical Center has recently been designated a Preferred Primary Care Provider by the ew York State Department of Health. lt is one of only two hospitals in the eight county Western ew York area Erie County Medical Center is the other- to have won the designation. Criteria to qualify for a Preferred Primary Care Provider include provisions for preventive and interventive health services, including immunizations and c 0 A cervicaVbreast/colon cancer screening, in addition to standard services such as radiology, pharmacy and clinical laboratory. The designation carries with it enhanced Medicaid reimbursement rates. DOH also mandates that each Preferred Primary Care Provider hospital establish a quality assurance program to determine patient satisfaction and continuity of care. The program includes development of an in-depth patient tracking and referral system, a 24-houra-day telephone service for patient health care inquiries and extended operational hours. The hospital 's primary care resources include its Hamilton B. Mizer Primary Care Center, which houses 18 programs, including Memorial Pediatrics, its family practice residency program, prenatal care assistance program and numerous specialty care clinics; the Summit Immediate Treatment Center; and the Tuscarora Health Center. + m n 9 9 �0 B a 0 p h y 5 0 n A u m 9 9 4 �,-------------------------------------~ I I I I I I I I PRACTICE MAKES PERFECT AFTER 10YEARS, US'S FACULTY PRACTICE MANAGEMENT PLAN MAKES SENSE FOR ITS FACULTY MEMBERS AND THE PATIENTS AND STUDENTS THEY SERVE I I I I I I I I y M A R w K A L L c A E I L _________ __ __________________________ Buff a loP h y sIc i an A u t u m n 1 9 9 4 ~ 0 �,------------------- - ------ - - ----------- Because so many different groups and individuals were involved, and because negotiations were so complex, it has taken a long time, much hard work and a great deal of cooperation to make the University at Buffalo Faculty Practice Management Plan into the efficient, cutting-edge system its proponents believed it could be. But a decade after its implementation, that's what the plan has become. Mandated be ew York State legislature in the midl970s and implemented on january l , 1984, the practice plan manages the income ofUB's widely varied and expert medical and dental faculty in 20 different departments, many of whom are widely dispersed at the school's affiliated teaching hospitals. "The plan has been extremely important to the development of the School ofMedicine and Biomedical Sciences," says] ohn aughton, M.D., vice president for clinical affairs, dean of the School of Medicine and Biomedical Sciences and chief administrative officer of the UB practice plan. PAUL C. HOLMWOOD, M.D., ASSISTANT PROFESSOR OF OPTHALMOLOGY , AT LEFT, WITH MEDICAL STUDENTS JOEL SHAPIRO (SITTING) AND ANDREW FEINBERG , AT MILLARD FILLMORE HEALTH SYSTEM ' S GATES CIRCLE EYE CENTER. AT RIGHT, I I I WITH RESIDENT ESTHER SANTOS, I I I M.D., DEMONSTRATING A PROCEDURE. L _______ __ _____________________ _ _________ _ 0 B u a a p y s c a n u m 9 9 4 �------ - ---- - - - -- - ---- - ---- - --------- ----, the medical school together. Given where we are in medicine right now, without the plan we would be completely disorganized , not knowing how to respond to many concerns," aughton says. The practice plan better defines the role of departmental chairs, creates common ground rules for faculty and provides funds both for the medical school and for hospital overhead, aughton says. "The practice plan brings about a more fairly shared enterprise," he says. The practice plan organizes, limits and audits the amount of money faculty physicians earn from clinical practice. Earning limits are based on faculty rank. Under the plan, physicians are allowed to earn no more than 250 percent, or in some cases 275 percent, of the maximum base salary allowed to a professor of their rank. Physicians also contribute to the fund of the chief administrative officer of the plan. SUNY Central sets a new salary cap every year. "The cap presents different concerns for different types of physicians," says ancy Glieco, assistant vice president of clinical affairs and administrative staff person to the plan since its implementation. "For instance, a family medicine doctor is not going to reach the salary cap, whereas for an orthopedic surgeon the cap may be an issue. " At the time of its implementation, the plan was highly controversial because it controlled physician incomes , Glieco says. o one is more aware of the complexity of the plan's history than William Dillon, M.D., an associate professor of gynecology/a bs tetrics located at The Children's Hospital of Buffalo . President UB's practice plan is its application of the State University of New York (SU Y) Faculty Practice Management Plan. Covered by Article 16 of the policies of the board of trustees of SU Y and negotiated by contract between the Union of University Professors and the Office of Employee Relations , the SU Y-wide plan includes all of the medical schools and dental schools in the SUNY system, as well as the School of Optometry. The plan mandates that all full-time and geographic full-time SU Y faculty (those based at affiliated hospitals) must be members. The plan is not required for volunteer or part-time faculty. At each SUNY institution with a medical faculty, the plan is administered by a governing board of that faculty . The fact that UB faculty do not work at only one nearby hospital, such as at SU Y-Stonybrook, but are dispersed among eight area hospitals, makes the management of UB's practice plan more complex than others in the SU Y system. "Without a centralized clinical faculty, and existing in various places in the Western ew York community as we do , the plan defined and brought together those who make up the full-time faculty ofUB.lt's the glue that holds I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1 I I I I I I I I I I I I I ------ -- ----------------------------------~ a a 0 p h y 5 a A u m n 9 �~-------- -- -- --- ---- ------ -- -- ----- - ------ 1 I I I I I I to have the honors and accolades associated with fulltime appointment to a medical school and the time to gain professionally and in administrative ability." According to Glieco, the plan has evolved significantly over the 10 years it has been operating at UB. "When we first started, we almost didn't know who all the people involved were," she says. "The organization was very loose - we collected money and patients however we could. "We've gone from being disorganized to being a department-centralized system with 20 departments and very few compliance problems," Glieco says. "The plan forces a member to have an organized practice, so we know who's doing what and where they're based," Glieco says. "Financing medical education has become a much more important issue in the last 10 years, and medical schools have changed from an unstructured environment to becoming a real business. We negotiate with teaching hospitals and each department, and this is the fifth year of the department-by-department audit. Here in the dean's office we think it's one of the best things to happen in medicine in the last decade. " of UB's Faculty Practice Management Plan governing board since 1986, Dillon has been on the board from its inception. "In the beginning, it took a lot of work by the governing board to educate faculty as to exactly what the practice plan was, to answer their concerns and objections and to work towards full compliance with the plan," Dillon says. "It was a learning process for the board also," Dillon says. "We needed to develop policies and procedures, certain guidelines under which the departments would function, and have the departments develop their own plans for the management of clinical income while seeing to it that those plans were consistent both with the overall UB plan and with Article 16. It was not an easy feat, and took a lot of talk and education over several years. " For Dillon, all the work has been necessary and significant because of the plan's importance. "As state employees in a university system, there must be an accounting of our income to the public," he says. "It's important that some limits are placed on the amount of income generated by one's private practice within the plan. Just as there are benefits for being a faculty member of the SUNY system, some of those benefits must be referred back to the school, and back to individual departments also. "The plan tries to allow SU Y faculty members to make competitive earning with other peers and yet do all the things a faculty member does which are not income generating," Dillon says. Although he admits that perceptions of the importance of being a UB faculty member may vary among physicians, for Dillon that importance seems clear. "I view my employment as a teacher, researcher and administrator of a medical school as a privilege," he says. "It's a profound responsibility - the privilege of seeing to it that a new generation of physicians are properly trained. With it comes the chance to be at the cutting edge of one's profession, L ________________________________________ _ B a 0 p h s c a ll. u u m 9 4 �-----------------------------------------, manner," he says. Currently, the plan gets good cooperation from the departments, Dillon says. There's more centralization within departments of their own finances , with reporting on a monthly basis to the office of clinical affairs flowing more freely and in a timely manner. The dean's tax computation, which provides money for the chief administrative officer of the plan, is done on a uniform basis, as is the computation for hospital overhead payment. Com- Beginning with a 1990 audit of 1989 earnings, audits have been done each year on a department-by-department basis by the accounting firm Levin and Associates. As the plan geared up for that first audit in 1990, there was a lot of concern about the cost of the audit procedure, and more effort and education needed to be provided to the departments, Dillon says. "Since that time , what we've seen is that the yearly audit process has become standardized, moves easily and is completed in a timely LEONARD FELD , ASSOCIATE M.D. , PROFESSOR OF PEDIATRICS , AT LEFT , WITH RESIDENTS ROB- ERT WORONIECKI , M.D ., ( LEFT ) AND RANDY CAN- TOS , M.D. , AT AN OUTPA- TIENT CLINICS CHILDREN ' S OF AT HOSPITAL BUFFALO, RIGHT, WITH I I I I I I I THE AND AT PATIENT ANI BAL LARACUENTE AT I I THE CLINIC. I I ---------- -- --- - ------------- - -- --- -- -- ---~ B u a a p h y 5 c a A u m n 9 �, ----- ----- ----- ------- ------- -------- ---- I I I I I I I pliance problems have decreased, and the vast majority of faculty now fund their retirement plans directly through the practice plan. Dean aughton says that the practice plan has defined much more clearly the role of department chairs from the standpoint of operating the various clinical sites of the medical school. "It gives department chairs the ability to manage their faculty," aughton says. "Before the plan, department chairs tended to have responsibility without much authority. The practice plan has helped them organize their faculty, and makes their position as department chair more secure." The plan has led to the formation of a number of facilitating organizations and legal entities to ensure its proper functioning. One such organization is University Medical Physicians Services (UMPS), which is the facilitator for the University Physician's Office, an ambulatory multi-group practice site that operates at two campus locations- the ground floor of the Cary-Farber-Sherman Annex and a sports medicine site in Farber Hall- as well as out of various offices in the teaching hospitals. Currently about 30 practice plan members see patients at the University Physicians Office. The office also provides UB medical students the opportunity to work directly with patients. UMPS received not-for-profit status in 1993, saving UB a great deal of money in state taxes. Most UB departments have become more formalized in their operations and have formed professional corporations, Dillon says. "Many of the more informal agreements between the hospitals and various departments or individuals have been done away with," he says. One department that has formed a professional corporation is the department of medicine, which currently has faculty at five affiliated teaching hospitals. The University Medicine Services Professional Corporation (UMSPC) is a departmentally centralized plan, with the same rules and goals for department faculty at all hospitals. Members of all hospitals, as well as representatives of all specialties, are represented on the department's practice plan governing board. The corporation is governed by the overall umbrella of the UB-wide and SU Y Faculty Practice Management Plan governing boards. The corporation has a ceiling less than the 250 percent mandated by the overall plan. With the exception of a small group of on-campus faculty, faculty in the department of medicine tend to be hospital-based at one area hospital, according to james olan, M.D. , president of the UMSPC, chair ofthe department of medicine and director of medicine at Erie County Medical Center. "Since I took over as chair of the department in 1978, an increasingly large percentage of salary dollars have needed to come from practice," olan says. L _________________________________________ · B u a 0 p y s c a n A u u m n 9 4 �-- --------------- - ------ -------- -----------~ want to say he had to be limited. If there's someone we can recruit who is going to help patients in Buffalo, we should work together to make sure the cap is not a stumbling block. I think people are coming to understand that. " Despite such issues, Feld agrees with Dillon that on the whole the plan has been a great success. "It's appropriate to have a plan that covers all departments, and this plan is individually tailored to meet the needs of various departments ," he says. "For all practical purposes it's worked pretty well. People will always have complaints, and no document is perfect for everyone. But if a majority like it, then it's been successful. "The practice plan provides a system that allows faculty members to supplement their incomes in the academic environment so we can be competitive and keep the people we want," Feld says. "In a university environment there have to be rules so that people can better work together. The practice plan gives UB a team approach , and that's what has made us so successful. " aughton agrees with Nolan that the issue of managed care will be a key challenge for the practice plan in the next decade. "As we experience changes in health care reform and financing, we will have to become more group-oriented," aughton says. "We will have to think as a group about how we interface with the changing financial environment. "We want to make sure the practice plan serves our mission of education and research , and generates the needed patient care activity," a ugh ton says. "The plan is in place, has matured and is functioning well. There are some real challenges out there , no doubt about it, but I + believe we can-face them. " "This has made it necessary for faculty to do a lot more practice, and has often put them in competition with the larger community for patients. "It's important to recognize that the practice plan only organizes income, and is not a plan for organizing the clinical practice of UB faculty, " olan says. "We do not have a university-wide group clinical practice. But having such a practice will be very important as we get into managed care, in which people will want to work with total care and not just particular departments. "Since UB faculty work at so many area hospitals, we have to be very attentive to the practice of our various hospitals , each of which has its own clinical culture ," olan sa y s. " Our department's faculty is spread out between competing institutions , and our faculty have to support the goals of their hospitals as well as [those] of UB." Although Dillon admits that a number of critically important issues still need to be dealt with, he believes the practice plan has come a long way. "Continuing issues will come up ," he says. "But we have a very good track record , and a responsive system that can deal with those issues. " Leonard Feld, M.D ., a member of the governing board from 1987 to 1990 and vice president of the board and chair of finance and policy from 1989 to 1990, says one of those key issues is how income limits will affect UB's ability to be competitive in recruiting physicians in certain fields . "There does need to be some flexibility on the limit," says Feld, who is an associate professor of pediatrics and physiology. "If UB wants to recruit certain individuals, income limits should not be a factor ," Feld says. "For instance, if we wanted to recruit a top transplant surgeon, we wouldn't I I I I I I I I I I I I -- - ------------ -- - -- - - ------- ---------- - - ~ B u a 0 p h y 5 c a A u m 9 9 4 �II THE NEW ACADEMIC MEDICAL COLLEGIUM GIVES ITS MEMBERS AN EQlJAL SAY IN THE FUTURE OF HEALTH CARE IN BUFFALO ANDREW T'S MORE THAN JUST ANOTHER institutional name. To people like Charles B. VanVorst, President of the Millard Fillmore Health System, "Academic Medical Collegium" * says a lot. "If you go back and look at Webster, the definition of 'collegium' is people sharing power on an equal basis." G) a u f f a l o P h y s I c I a n A u t u m n 1 9 9 4 �W LE IT'S STILL A WORK IN PROGRESS, the proposed Academic Medical Collegium holds the promise of creating a strong but flexible alliance among the University at Buffalo, its schools of Medicine and Biomedical Sciences and Dental Medicine and the eight area hospitals already affiliated with the university for graduate medical and dental education. There's also a seat at the table for medical staff and faculty in the novel organization, which proponents see as a vehicle for taking the region's health care and medical education systems into the next millennium. "We're trying to get up a step and do more for the community in a collaborative way," said Thomas R. Beecher Jr. , former Buffalo General Hospital chairman and a key player in the effort. Medical school dean john Naughton, M.D. , a prime mover behind the nascent organization, is optimistic. "There's been a broad foundation of principles to which most people have agreed," he said. "The good news," aughton added , "is everybody sees the appropriateness of moving toward cooperative interfaces in an era of reform directed at health care and health education that can be an overwhelming challenge to existing programs of quality." By incorporating broad representation from the university, hospitals and physicians, the Academic Medical Collegium hopes to build on the success of the existing Graduate Medical Dental Education Consortium, but to overcome the tensions that plagued a previous cooperative project, the Western ew York Health Sciences Consortium . If successful , the Collegium would enhance the region's medical education and health care systems to a point where Buffalo could become a national center of medical excellence. At the moment, the Collegium is more concept than concrete, but the concept is bold and its architects hope to move from artist's rendering to actual blueprints this autumn. The resulting structure would be something of a meeting hall from which members could launch collaborative efforts to enhance their academic and health care missions. "The question ," said VanVorst, "has got to be, how do you develop that forum with institutions that are not merged or economically linked to one another? I don't think it's a problem. I think it's a challenge. " Dean John Naughton, M.D., a prime mover behind the nascent organization, is optimistic it is •moving toward cooperative interfaces in an era of reform directed at health care and health education." B 0 0 p h s c o n u m 9 9 4 �Thomas R. Beecher, former Buffalo General Hospital chairman and a key player in the effort to build the Collegium, believes the organization could harness "a powerful force in the community" to meet the challenges that health core reform will bring. CCORDING TO THE Collegium's statement of m1sswn and principles, its focus would include everything from training and research to quality, cost and access to care. "There's a powerful force in the community if you take these eight institutions and the university medical complex to solve problems," Beecher said. It's too early for the Collegium to be planning any specific projects, but Beecher said there's no lack of possibilities. "If you put the weight of the university and all these hospitals into preventive medicine," he suggested, "a lot could be accomplished. " The Collegium would also serve as a communication forum for member institutions and practitioners, whether they be academic or community-based. And organizers want to keep the doors open for non-member institutions and practitioners to collaborate, too. "It's a very positive, almost ecumenical concept," said Gerald Sufrin, M.D., professor and chairman of urology and chairman of the medical school's Council of Clinical Department Chairpersons. "It's to improve health care delivery in a broader sense. Packed into that goes education and research, making young people the best they can be. " The organization would include the same institutions that make up UB's Graduate Medical Dental Education Consortium: the medical and dental schools, The Buffalo General Hospital, The Children's Hospital of Buffalo, Erie County Medical Center, Mercy Hospital, Millard Fillmore Health System, Roswell Park Cancer Institute, Sisters of Charity Hospital and the Buffalo VA Medical Center. aughton said plans call for the Collegium's board to include three people from each institution, including the chief executive officer or equivalent, the chief operating officer or designee and a medical staff or faculty representative. UB will be represented by its president and vice president for clinical affairs and chairman of the clinical council. Some see the Collegium as a natural next step in the development of cooperative efforts that began more than a B u 0 0 p h 5 c a n m n 9 4 �Charles B. Van Vorst, president of Millard Fillmore Health System, sees the Collegium as a forum from which member "institutions that are not merged or economically linked to one another" can launch collaborative efforts to enhance their academic and health care missions. decade ago with formation of the graduate medical education consortium, the organization that serves as the sponsoring institution for the numerous residency programs spread among UB's affiliated hospitals. While many had once viewed Buffalo's lack of a single university medical center as a drawback, the consortium has come to be seen as a model for other communities and a promising arrangement for implementing graduate medical education reforms , such as greater numbers of primary care slots. "It has drawn national attention," said William D. Pike, president of the Western ew York Hospital Association. The graduate consortium also got the university and the region's traditionally competitive hospitals used to working more closely together. In 1987, they formed a second alliance, the Western ew York Health Sciences Consortium. Its goal was to enhance the quality of health care in the region, and it was soon credited with several high-profile successes, including establishment of the Bone Marrow Transplant Center at Roswell Park, the Heart-Lung Transplant Center at Buffalo General and the Positron Emission Tomography center shared initially by UB and the Buffalo VA Medical Center, and now the Millard Fillmore Health System. Unlike the graduate consortium, the health sciences consortium was incorporated, giving it a more formal structure. And the Buffalo business community, interested in keeping health costs under control, played an important role in its formation and operation, so much so that the organization was headed by a bank executive. Despite its successes, the consortium ran into trouble. "There was always tension about how much involvement the business community should have in decisionmaking," recalled aughton. To make matters worse, physicians felt excluded. And hospitals, ever mindful of their own autonomy, were edgy about being absorbed into a de facto university medical center. Former UB President Steven B. Sample suggested that the consortium could solve some of its problems by putting the university in a stronger leadership position. The idea was seriously considered, but it didn't make nervous consortium members any more comfortable. "Eventually that organization went on the back burner," aughton said. "It hasn't been formally dissolved. But by gentleman's agreement, we decided to strike out in new directions to form a more mutually compatible organization." B a a p h c a n m 9 �LKS TOWARD THAT END have been going on at various levels for four years. UB's new president, William Greiner, also became involved, and by this summer the Collegium reached the point where everyone was preparing to sign off on a statement of mission and principles. It's an ambitious document that targets four areas: medical education; health care delivery; biomedical research; and the region's national standing. The document states that the Collegium would "Enhance the ability of its members to fulfill their respective academic roles, including those related to education of health care professionals .... " While it goes on to indicate that the Collegium would absorb the graduate education consortium, Beecher said that issue will remain uncertain until members get to work on specific operating plans. As for health care, the statement charges the Collegium with developing "organized approaches to meeting community health needs that strike a balance between collaboration and competition in addressing major health care issues, including quality, access and cost of care." Among other things, it says the Collegiu m would: facilitate availability of the best preventive, diagnostic and treatment modalities; foster efficient resource use and avoid unnecessary duplications; promote primary care access for underserved groups in the region; and encourage, where appropriate, resource sharing and joint support of activities. "I think this complements wherever health care reform takes us," said Robert Stanek, chief executive of Mercy Hospital. "But more importantly, it's good for the community." The mission and principles statement also says the Collegium would bolster biomedical research, partly by creating alliances of common interest that would "gain from clinical and organizational diversity among programs, departments and institutions." Such efforts might not only advance the body of health sciences knowledge, but could also help the area compete more successfully for research funds and establish it as a national biomedical research leader. The document also says the Collegium would encourage health services research into issues of quality, 6 u a 0 p h y 5 access, cost and appropriateness. In addition, the organization would develop collaborative information systems, which could also serve educational and administrative needs. "We can do very collaborative research among institutions," said Edwin Mirand, M.D., Roswell Park's vice president for educational affairs and dean of its graduate division of the UB medical school. "We can get greater numbers into the treatment schedules. You're always looking for patients to come into protocols, and one institution may not have one type of patient, but a group of institutions might. " Finally, the Collegium would work to advance the regional and national reputation of not only its members, but of the entire local health care community. In particular, it would identify collaborative opportunities to retain patients within the region and encourage "services of excellence." To answer physician concerns, Collegium planners added a section to the mission and principles statement in May that provides for proportional representation among institutions, medical and dental staff and UB faculty. "I think some of the nervousness between the volunteer faculty and the full-time faculty has been diminished because a representative voice has been assured," aughton said. Sufrin said the medical school's clinical department chairpersons were among the first to endorse the Collegium document. "In a sense, the faculty at large could be considered another institution," he said. "From our standpoint, we look upon the Collegium as an extraordinary opportunity to work with the other health care institutions in the system." The mission and principles statement also says, among c a n A u m 9 9 4 �Gerold Sufrin, M.D., professor and chairman of urology and chairman of the Council of Clinical Deportment Chairpersons, describes the Collegium as "a very positive, almost ecumenical concept" that will "improve health core delivery in a brooder sense." other things, that faculty appointments will not be universally required for medical and dental staff appointments to all teaching hospitals, and that the Collegium itself will not enter arrangements to provide patient care or other services unless all members and their staffs agree. "Keeping the physicians involved helps to round out the system," said Stanek. With Collegium participants concerned about their autonomy and everyone uncertain about the direction of health care reform, it hasn't been easy getting to this point. But many are optimistic. "I think it's good and it'll help health care delivery, research, education," said Mirand. "Yes, you'll lose some independence. But it'll also give us more opportunities. " "There's no question that people are looking out for their turf," said VanVorst. "But I do sense a broader winwin, a broader sense of community. I see a broader vision or need emerging. I think it's good, and I hope we find a way to build on that." If all goes according to expectations, Collegium organizers will work this fall on an organizational structure to carry out the lofty generalities of the mission and principles statement. Will the Collegium be incorporated? Will it absorb the graduate education consortium? What exactly will it do , and who will do it? It will probably be the most difficult part of the process, Beecher said. B u a 0 p h y s c VanVorst said he thinks the Collegium can avoid the tensions that troubled the Health Sciences Consortium. "I think it's a lesson," he said. "Also, that was several years ago .... The environment has changed, the leadership of most of the hospitals has changed. I see that as an opportunity. " The trick, he added, will be to move as quickly as possible "without fracturing the process or creating mistrust." Stanek said member institutions shouldn't feel threatened as long as the Collegium takes a "planned, rational approach." The organization may eventually try to reduce service duplications and encourage specialization among hospitals, but some of that is happening already, he said, pointing to developments like ECMC's traumaburn unit. Collegium or not, he added, downsizing is occurring, and the Collegium could help member institutions cope with it better. a ugh ton said he doesn't expect the Collegium to be finalized overnight. "We're in a preparatory phase," he said. "The actual formal organization may take another year or two. We're in a process of evolution." Still, he said, he sees the organization as being on the leading edge of a trend that will grow, especially if the basis of the Clinton health care plan is adopted. "I don't think there is any doubt that the managed competition theme will push every community to do more to develop + cooperative strategies for survival," he said. a n ll. u m n 9 9 4 �. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . .. . . . . . [1] I/ ;;;::::::_lJ 0 I Moncada gives Harrington Lecture INTERNATIONALLY RENOWN RESEARCHER FOCUSES ON CLINICAL APPLICATIONS OF NITRIC OXIDE RESEARCH alvador Moncada, M.D., who is internationally known for his pioneering studies of nitric oxide and its clinical applications, delivered the D.W. Harrington lecture, " itric Oxide: Physiology, Pathophysiology and Therapeutic Implications," discussing the history of nitric oxide research and some recent research on nitric oxide that suggests significant clinical possibilities. Paresh Dandona, M.D., UB professor of medicine, introduced Moncada, research director for the Wellcome Research laboratories in England since 1986. Dandona praised Moncada as "one of the most unique and creative minds of our time," saying his work "has inspired generations." While nitric oxide research was initially focused only on prostacyclin and related issues, Moncada helped expand nitric oxide research to all areas of the body, Dandona said. Moncada, a member of England's prestigious Royal Society who has received their gold medal, is credited with the discovery that nitric oxide is the endothelium-derived relaxing factor. The author of more than 550 publications on vascular physiology and pharmacology, including seminal work on modulation of prostaglandin release and action by blood vessels, platelets and endothelium, he is also a member of this country's ational Academy of the Sciences. Moncada said the determination that vascular endothelial cells generated nitric oxide was made in 1987. A year B a a p later, researchers determined brain synapses also generated nitric oxide, leading to the suggestion that the formation of nitric oxide from l-arginine, the synthetic precursor to nitric oxide, was a widespread pathway for the regulation of cell function and communication. It was determined that nitric oxide acts as MONCADA , A MEMBER O F ENGLAND'S PRESTIGIOUS ROY AL S OC IETY , IS CRED ITED W ITH THE DISC OVERY T HAT N ITRI C O XI DE IS T H E ENDOTHELIUM· DERIVED R ELA X ING FACTOR . h c a n an intermediary in such functions. The discovery that l-M A (methyl nitroso arginine - a derivative of larginine) was a selective and competitive inhibitor of the generation of nitric oxide proved the most important tool for the investigation of nitric oxide, Moncada said. l-MNA produces a longlasting hypertensive response and causes such effects as significant loss of blood flow. Such effects can be immediately reverted by the injection of larginine, Moncada said. The most interesting part of such a finding, Moncada said, is that l-M A does not increase blood pressure by inducing vascular construction, but by blocking the production of nitric oxide. Thus, in its normal physiological state, the cardiovascular system is in a state of active vasodilation, and a balanced system tends toward normal vasodilation. Such research shows nitric oxide is the endogenous dilator in the system, Moncada said. itro-vasodilators act the way they do because they are transformed into nitric oxide. itric oxide, he said, performs numerous functions within the body, interacting with prostacyclin and inhibiting platelet aggregation and white cell activation to regulate platelet and white cell activity within the vessel wall. Evidence is also growing to suggest that nitric oxide modulates vascular smooth muscle cell proliferation via a cyclic GMP-related mechanism , Moncada said. " itric oxide is a general regulator that plays many different roles, " Moncada said. "An interesting question is whether we can make compounds that might be different from normal vasodilators, which can lead to our selectively targeting specific vasodilators." itric oxide is widely distributed in u m 9 ] �. .. . . . .. .. ........... . . . . . ..... . ... .. .. . ... . .. . .... . .............. .. ......... .... .. ··· · ·~-· I in biological fluids may serve as a general marker of disease , Moncada said. "All these functions of nitric oxide are being established," Moncada said. "How could we have understood blood pressure before knowing this? Itnc oxide, which in the atmosphere is known as a pollutant, is also the first known gas to act as a biological mediator. Could it be that other gases also play a role in the nervous system, he said, where neurons are highly interconnected, and nitric oxide neurons are very resistant to processes of neurodegeneration. Moncada said this further suggests that nitric oxide may play a role in longterm potentiation - a major factor in memory. itric oxide may play many other roles in the central nervous system as well , Moncada suggested, including the regulation of cerebral spinal fluid. Research has discovered that white cells also release nitric oxide, Moncada said. Thus, while nitric oxide acts as a biological mediator for physiological purposes, when released by white cells it has defensive purposes. Nitric oxide is cytostatic and cytotoxic for tumor cells, bacteria, fungal cells and protozoan parasites, Moncada said, adding that activated white cells release nitric oxide for a very long time. At the moment, clinical applications of nitric oxide research are focused on the vessel wall area , Moncada said, where nitric oxide-mediated vascular relaxation can help regulate blood pressure. Also, it is clear that excessive nitric oxide production can produce hypertension in cases of septic shock. itric oxide synthase inhibitors can potentially manage such shock , Moncada said. "Whoever has been in an intensive care unit trying to reverse the effects of septic shock will agree this is very important," he said. Recent research has found an increase in nitric oxide production in all parts of the body during pregnancy, Moncada said. Such increased production could cause the decrease in vascular tone in pregnancy and other effects, as well as help prevent heart disease in pre-menopausal women. Other research has suggested that the breakdown products of nitric oxide a u a 0 p h I animal systems? " The Harrington Lecture is sponsored by the School of Medicine and Biomedical Sciences. The D. W. Harrington Lecture Fund was established in 1886 by Devillo White Harrington, M.D. , an 1861 graduate of the UB medical school and a professor genito-urinary and venereal diseases from 1886 to 1905. + B Y MARK WALLACE z Q ~ 3: . § 0 ~ Shirley Sampson, deputy director of Health Systems Agency, and Herbert Hauptman, Ph.D., president and scientific director of The Medical Foundation of Buffalo, speak at a health care reform forum sponsored by Rep. Jack Quinn, R-Hamburg, held at the medical school in May. Ebsary appointed assistant dean and director of development tephen Ebsary, Jr. , has been appointed assistant dean and director of development for the School of Medicine and Biomedical Sciences. He has served the university in various capacities since 1988, including as director of planned giving for the University at Buffalo Foundation, Inc. "Steve will help us continue to build on our y c a n strong base of philanthropic support," said john aughton, M.D. , vice president for clinical affairs and dean of the medical school. "We want to increase the school's endowments and unrestricted support so that we can continue to provide the excellent education for medical and graduate students that has earned us national prominence." Ebsary, a graduate ofMuskingum College in ew Concord, Ohio, is a native of East Aurora, ew York. Active in numerous fund-raising organizations, he is president of the Western ew York Planned Giving Consortium and chairman of the SUNY Task Force on Planned Giving. + m 9 9 4 �- • - ------ · · ··········· · ··· · ·· · ··· ·· ·········· · ·· · · · ····· · ········ ··· · · ············ ·· ··· ·· ·· · ····· z I 32 medical students receive awards at commencement don S. Ehrlich Award, the Mark S. Petrino Award and the American Academy of Family Physicians President's Award hirty-two UB medical students • Thomas Burnette, of Briarcliff were honored during the school's Manor: the Baccelli Award and the Bercommencement held on May 15. nard H. Smith Memorial Award in CliniAmong the recipients were cal eurology eight multiple award winners: • Karen Houck, of Snyder: the Dr. • Sean Perini, of Buffalo: the Cyrenius Chapin Award and the Hans Dr. George Alker Award, the Robin M. ]. Lowenstein Award in Obstetrics Bannerman Memorial Research Award, • Christopher Wood of Williamsthe Dr. Cyrenius Chapin Award and the ville: the Dr. Thomas]. Guttuso Award Upjohn Award and the E.]. Weisenheimer Award • Martha Bennett, of Cleveland, Ohio: Other graduates receiving awards the Charles Bauda Award, the Dr. were: Cyrenius Chapin Award and the Stephen • Diana Sanderson, of Tonawanda: ]. Paolini Award the Gilbert M. Beck Memorial Prize in • Steven Hammel, of Tonawanda: Psychiatry the Buffalo Pediatric Society Award, the • Katherine O'Donnell, of Buffalo: David K. Miller Prize in Medicine and the Buffalo Surgical Society Prize in the Morris and Sadie Stein Neuurgery roanatomy Award • joel Brenner, of Williamsville: the • Andrea Williams, of Buffalo: the Children's Hospital Prize Dean's Award, the orman Haber Me• Richard Kozak, of Buffalo: the Somorial Award and the ational Medical ciety for Academic Emergency MediAssociation Award cine Award • Kim Griswold, of Buffalo: the Gor• Todd Schlesinger, of Cleveland, B u 0 0 p h 5 c 0 n A Ohio: the Dr. Austin Flint Award • joseph Kay , of Amherst: the Bernhardt and Sophie B. Gottlieb Award • Michael Krabak, of Buffalo: the Francis]. Klocke Award • Debra Tarantino, ofBuffalo: the Dr. Heinrich Leonhardt Prize in Surgery • Elizabeth McClintick, of Buffalo: the Lierberman Award •j ennifer Tufariello, ofWilliamsville: the Maimonides Medical Society Award • joseph Valenti, ofBuffalo: the Medical Society of the State of New York Award • Michael Landi, ofBuffalo: the Medical Alumni Association Award • William Cecere, of Kenmore: the S. Robert arins Memorial Award • Douglas Golding, of Kenmore: the G. orris Miner Memorial Award • Glen Feltham, of Amherst: the Benjamin E. Obletz, M.D., Award • john Pryor, of Buffalo: thejohn R. Paine Award in Surgery • Madonna Tomani, of West Seneca: the Clyde L. Randall Society Award in Gynecology-Obstetrics • Mark Sheldon, ofBuffalo: the Emilie u u m n 9 �··························· · ··············· · · · ······· · ····· · ·························· · ·• · ~ I Lambert retires as Red Cross Blood Services principal officer nize those who donate six or more times per year. Under Lambert's direction, the Red Cross' Buffalo laboratory consistently eginald Lambert, Ph.D., has re- extracted the highest number of prodtired his position as principal of- ucts per donated unit of blood in the ficer of Blood Services, Buffalo Red Cross system. In 1993, the national Region after 21 years of service to component production average was 2.6 products per donated unit. The Buffalo the American Red Cross. Lambert, professor emeritus of Region amassed 3.6 products per unit microbiology, achieved many accom- average- enabling one unit of donated plishments during his tenure- among blood to assist up to four patients and them, the establishment of seven fixed fully maximizing each blood donor's blood collection sites throughout West- time and efforts. Also under Lambert's stewardship, ern New York. As a result, the Buffalo Region has consistently had the highest Buffalo was an early leader in the collecratio of donor per 100,000 population tion of platelets, pheresis in the early of any large region in the Red Cross 1970s and was the first Red Cross blood region to utilize a blood product irradiasystem. One of Lambert's proudest moments tor. Donald Dudley, an 18-year veteran came in the early 1970s when he led the Red Cross to adopt a "community re- of the American Red Cross, has been sponsibility" philosophy rather than the named Interim Principal Officer for the former "credit" system of blood dona- Buffalo Region. Dudley, who has served tion. Lambert also fully understood the in a variety of positions at both the strong personal commitment blood do- regional and national level, is currently nors feel to the program, and in 1986 he serving as Interim Principal Officer for established the "Sixer Club," to recog- the Rochester Blood Region as well. + Davis Rodenberg Memorial Award • Donna Stawasz, of Cheektowaga: the PhilipP. Sang Memorial Award • john Sherwood, of Buffalo: the john Watson Award in Medicine • john McArdle, ofYonkers: the john Watson Award in Medicine • Geoffrey Hobika, of Grand Island: the james Platt White Society Award • Michelle Penque, of Grand Island: the Frederick B. Wilkes Pediatric Award • Antonio Bird, ofBuffalo: the Farney R. Wurlitzer Award + SMILES ABOUND AS THE MEDICAL S C HOOL HELD ITS 148T H C OM· MENCEMENT I N MAY. FROM LEFT TO RIGHT , JEFFREY SEYMOUR , M . D ., ' 93 , CONGRATULATES NEW GRAD P I NA C . SANELLI , M . D .; J O S E PH J . FA LSON E. M . D ., MAKES HI S MOT HER MARYANNE PROUD ; AND BEHZAD TABIBIAN ( STANDING) AND MICHAEL LANDI ENJOY THE CEREMONIES . B u c 0 p h I y c c u m n 9 9 4 �• ·· · · · ····· · · · · · ···················· · ·· · ······· ·· ····· ·· ·············· · ··· · ·············· z I Kristen Schenck-Robillard Med student takes first place honors in AAFP research forum B medical student Kristen SchenckRobillard was the recipient of the First Place Research Forum Award at the ew York State Academy of Family Practice's annual meeting May 8, 1994, in Saratoga Springs, ew York. The title of Schenck-Robillard's research paper was "Predictors of First Contact Care in a Poor Urban Census Tract. " She competed against other medical and biomedical sciences students, as well as residents and attending physicians for the award. Carlosjaen, M.D., senior clinical investigator and clinical assistant professor of family medicine, is SchenckRobillard's research faculty leader, supervising her research endeavors. "If Kristen has expressed interest in becoming a family doctor, the specialty would be lucky to have her," jaen said. Schenck-Robillard, a native Buffalonian who attended Canisius College for her undergraduate education, is a member of the Class of 1996. She is expecting her first child in October. Schenck-Robillard will also present her paper to a national audience at the B a 0 p American Academy of Famil y Practice's scientific assembly held in September in Boston , Massachusetts. Two other UB medical students presented papers at the Saratoga Springs conference. jennifer Zubler, Class of 1995 , presented "Use of Ultrasonography." Patricia Krebs , also a member of the Class of 1995, presented "Violent Acts in Rural Settings. " Krebs will also present at the AAFP's scientific assembly in Boston. + - B Y R EBECCA B RIERLEY Rosenthal named chairman of family medicine department homas C. Rosenthal , M.D., associate professor of family medicine and a 1975 UB medical school graduate, has been named chair of the department of family medicine. Rosenthal has served as interim chair for the past year. A member of the department since 1978, he was instrumental in establishing the division of rural health, the medical school's rural health campus in Cuba , ew York, and its residency program in rural health, one of four in the country. Through his initiative, UB was named a ew York Rural Health Research Center in 1992, and one of five universities in the U.S. designated as national rural health research centers. He received the 1992 Distinguished Educator Award from the ational Rural Health Associah y 5 c a A tion for his work in expanding and improving rural health care. Rosenthal also is founding director ofUB's Primary Care Resource Center, headquarters for projects implemented through the school's primary-care initiative, a cooperative effort begun in 1992 to increase the number of medical school graduates entering primary-care practice. Rosenthal is project director of the Generalist Physician Initiative grant from the Robert Wood johnson Foundation. + Sarkin elected chair of pediatric association education group ichard Sarkin, M.D., clinical assistant professor of pediatrics, has been elected chair of the Ambulatory Pediatric Association's Special Interest Group for Medical Student Education. Sarkin also is a member of the executive committee of the council on medical student education in pediatrics. + Departmental name changes better reflect academic disciplines o better reflect the scope of their disciplines and missions , two medical school departments have recently undergone name changes. The department of pharmacology and therapeutics is now officially the department of pharmacology and toxicology, and the department of anatomical sciences is now officially the department of anatomy and cell biology. + u m 9 4 �ity, cost-effective, efficient care to all of the country's citizens in a larger variety of community-sited environments. This can be done only if more physicians are prepared to work in new settings and to focus on our many unmet needs. "UB is proud to be included among the schools that will provide the needed leadership for change in the years ahead," he added. The grant will support the following activities: • Recruiting underserved and rural students • Pairing promising high school students with primary care faculty during the summer • Restructuring some courses to include more emphasis on primary care clinical approaches, as well as developing new courses • Teaching information management skills to medical students • Training medical student in multidisciplinary teams with nurse practitioners, physician's assistants, therapists and social workers • Moving primary care medical clerkships out of hospitals and into clinics and doctors' offices in the community • Hiring a director of education development to help design new courses and programs, and a medical education specialist to train faculty to implement the initiatives "The Robert Wood johnson granl offers us a tremendous opportunity to unite the goals of the primary care departments and to produce high-quality clinical graduates who will be more likely to enter primary care," said Thomas Rosenthal, M.D., chair of the department of family medicine and the grant's project director. "Those who don't enter primary care will have a better understanding of the challenges patients face in our health care system." The medical school has set a goal of UB wins $60,000 Robert Wood Johnson Foundation grant he School of Medicine and Biomedical Sciences will receive approximately $600,000 over three years from the Robert Wood johnson Foundation to support the medical school's efforts to redesign its medical education curriculum and to increase the number of primary care physicians it graduates. In three years, after a successful evaluation, the foundation will continue to support UB's primary care education efforts through a non-competitive threeyear grant. UB is one of 14 U.S. schools to receive a Generalist Physician Initiative implementation grant. The money will allow the university to carry out recommendations developed during an 18month planning period, funded in 1992 through a $150,000 award from the foundation. The Generalist Physician Initiative grant will enable the medical school to begin its primary care recruitment efforts in high school, and to develop projects and programs that will give medical school students early hands-on experience in primary care. Studies have shown that early positive exposure can influence students to choose careers in primary care medicine . "The faculty and I are elated by the designation from the Robert Wood johnson Foundation to participate further in the Generalist Physician Initiative," saidjohn P. aughton, M.D., dean of the medical school and vice president for clinical affairs. "Medical schools and their teaching hospitals have done much since World War II to improve the quality of patient care and to eradicate curable diseases. Today, the challenge is to provide qual- B u 0 0 p h y c o n A u having 50 percent of its graduates eventually practicing in primary care fields. In September 1992, the school launched its own primary care initiative devoted to graduate medical education when it unveiled a $5 million demonstration project involving six Buffalo teaching hospitals, Medicaid, four private health care insurers and the ew York State Department of Health. That effort concentrates on recruiting medical school graduates into primary care residencies, improving faculty and resident teaching, setting up community academic practice sites and developing primary care research opportunities. The Robert Wood johnson Foundation, headquartered in Princeton, New jersey, is the nation's largest philanthropic organization devoted to improv+ ing health care. BY LOIS BAKER Ginsberg receives Triological Society Presidential Citation rwinA. Ginsberg, M.D. ,adjunctclinical professor, has been awarded the Presidential Citation of the American Laryngological, Rhinological and Otological Society. The founder and president of the Buffalo Oto laryngology Group received the award for his internationally recognized contributions to the research, diagnosis and treatment of hearing disorders. The Society, also known as the Triological Society, presented the citation at its annual conference in West Palm Beach, Florida. Ginsberg received the award for his pioneering research and practice in middle ear microsurgery and cochlear implants, as well as his work in the education of the deaf. + u m n 9 9 4 �Roswell Park Cancer Institute founded as part of UB NATIONAL CANCER INSTITUTE-DESIGNATED COMPREHENSIVE CANCER CENTER HAD ITS ROOTS AS A THREE-ROOM LABORATORY AT 24 HIGH STREET he first government-supported get into the business of disease research. cancer research laboratory in the But a year later when the bill was world had its beginnings in three passed a second time, he changed his rooms of the old University of mind and signed it. The state continued Buffalo building at 24 High Street. to support the laboratory until 1903 The laboratory, then known as when another governor, Benjamin B. the ew York State Pathological LaboOdell, faced with a shortage of funds, ratory of the University of Buffalo, had threatened to veto the appropriation. been set up under a grant of $7,500 from the state legislature in 1898. The enabling legislation specified that the money was to provide for "the equipment and maintenance of a laboratory devoted to an investigation into the causes, nature, mortality rate and treatment of cancer." Today, it is Roswell Park Cancer Institute, named for the UB professor who fought for its creation and served as Roswell Park Cancer Institute, circa 1935 its director for its first six years. Again, Butler exerted his considerable Park had come to Buffalo as profesinfluence until the bill was signed. State sor of surgery at the 4 7-year-old unisupport was never in doubt again, though the amount was sometimes in question. versity. One of the first things he noted In two years the laboratory outgrew was the greater incidence of cancer here than in Illinois, where he previously the medical school space. With money publicly raised, land was purchased on practiced and taught. He called the disease "the pathological mystery of the High Street across from The Buffalo ages. " Despite that, the University of General Hospital, and the first building in the world constructed solely for canBuffalo had no funds for cancer research, so Park turned to the state. cerresearch was opened in mid-1901.It He enlisted the support of Edward was named the Gratwick Research Laboratory of the University of Buffalo in H. Butler, editor and publisher of The Buffalo ews, who wielded consider- recognition of Mrs. William Gratwick, who underwrote it with a $25,000 grant. able influence with the legislature. In 1911, Roswell Park, no longer The legislature approved a grant, but Governor FrankS. Black vetoed the director but still actively interested in bill,questioningwhetherthestateshould the laboratory, led a move to have it B u a a p h y s c a A taken over by the state and it became the ew York State Institute for the Study of Malignant Diseases. In 1946, its name was changed to the Roswell Park Memorial Institute, in honor of its founder. During its early UB years, the laboratory had a staff of l 2 - five of them professionals. In 1903, they published five scientific papers. The laboratory maintaineda colonyof3,000 mice and 300 rats for research in spontaneous and transplantable tumors, and studied antibodies in mice recovering from experimental tumors. George ] . A. Clowes, M.D. , a member of the early staff, introduced experimental drugs in the treatment of cancer for the first time in the U.S. Later, working for Eli Lilly & Co., he helped develop methods for the commercial manufacture and use of insulin, for which he received the Banting Medal of the American Diabetes Association. Because of his work, four of his former faculty associates at UB were among the first to get insulin for their patients. Today, Roswell Park Cancer Institute is no longer officially a part of UB, although they are both ew York State public institutions. The institute serves as a teaching arm of the university the RPCI Graduate Division; students rotate through it for experience in treating patients with cancer. It was recently designated a Comprehensive Cancer Center by the ational Cancer Institute. + - BY u MILDRED u m n SANES 9 �Spring Clinical Day and Reunion Weekend held April29 and 30 At left, University at Buffalo president William R. Greiner, and below, John M. Canty, M.D., ' 79, associate professor of medicine, address the gathering. his year's Spring Clinical Day and Reunion Weekend, held April29 and 30, was a resounding success that saw friends and colleagues come together to reminisce and renew friendships. As these photographs of the events attest, a good time was had by all! + At left, this year's Reunion Classes enjoying the festivities. Above, outgoing Medical Alumni Association president Robert Reisman, M.D.,' 56, presents an Alumni Achievement Award to James F. Mohn, M.D., '44, as Jerome P. Kassirer, M.D.' 57, editor of the New England Journal of Medicine, looks on. Other Alumni Achievement Award winners were Andrew A. Gage, M.D., '44; William R. Kinkel, M.D., '54; and Max Schneider, M.D., '49. At right, Paula L. Stillman, M.D., former provost and dean of Eastern Virginia Medical School, speaks to participants at the program. e u a a p h y c a u m 9 9 �Reunion Portraits: Pictures of 55 Years of Success ere, Buffalo Physician presents the 10 classes that were honored at this year's Reunion Weekend, including the Class of 1939, which met informally to celebrate + 55 years of medicine. LEFT TORIGHT- FIRST ROW: Frank T. Riforgiato, Elizabeth Olmsted Ross SECONDROW: Anthony V. Postoloff, Roy E. eibel, George C. Brady, john H. Geckler LEFTTO RIGHT- FIRST ROW: Richard Egan, Paul Weygandt, Sidney chaer,james F. Mohn , Irwin Ginsberg SECOND ROW: Anthony Aquilina, Willard Boardman, Raymond Hudson, Frank H. Long, Jr. , Herman Edelberg, Howard Barnett, Helmut Mueller, Sam Cassara, Newland Fountain, Francis Marchetta, Casimir Pietraczek THIRD ROW: Clinton Strong, Raymond Bondi, Frank T. Frost, james Sullivan, Robert G. Wilkinson, Jr. , Theodore Prentice, William Potts, Thomas Frawley, Andrew A. Gage, Edmund Collins, William Nowill LEFT TO RIGHT- FIRST ROW: Carmelo Armenia, jacqueline Paroski, julia M. Cullen, joseph Bradley Aust, Jr. SECONDROW: Ralph S. Canter, Richard Schwanz, james Werick, George Erickson, Paul T. Buerger,john T. Sharp, Pierce Weinstein, Max Schneider, Harold Bernhard THIRD ROW: Charles Bathrick, Philip C. Dennen B u a 0 p y 5 c 0 A u m 9 9 �I - ~ --~ _-- ········· · · ························· · ···· · ············· ~ • lEFT TO RIGHT- FIRST ROW: Edward Wenzlaff, Charles Marino, Allen Lesswing, Paul Weinmann, Robert M. Oshrin, icholas Carosella, Donald Murray SECOND ROW: jacob Lemann, Jr., Donald Wilson, Byron Genner, William Howard, orbert Kuberka, john L. Conboy, Robert Miller THIRD ROW: Richard Mayer, William Kinkel, Edward Rayhill , Alfred Wolfsohn lEFT TO RIGHT - FIRST ROW: Daniel Kozera, Elton M. Rock, andra Wilt e Leininger, Eli M. Isaacs SECOND ROW: Constantine]. G. Cretekos,johnj. McMahon, William Blaisdell, joseph F. Monte, George Baeumler, Thomas Doeblin, james M. Cole, Richard A. Falls, Daniel Ninburg lEFT TO RIGHT- FIRSTROW: joseph DiPoala, Anthony Ferrari SECOND ROW: james Tibbetts, Jr., David Weinstein, john A. Manzari, Elizabeth Serrage, Michael Goldhamer, Charles LaDoulis, Gerald Goldstein THIRD ROW: George Glowacki, Stephen P. Katz, Irving Sterman,]. Frederick Painton, Jr. , Marvin Z. Kurian , Richard Wolin , Bela F. Ballo, David A. Leff, Michael Feinstein, Lawrence Casazza B u a 0 p h s c a n A u m n 9 4 �~- - LEFT TO RIGHT- FIRST ROW: Dorothea Downey, Penny A. Gardner, Moira J. Burke, Marion Wind-Pisick, David M. Sherer, Evelyn Hirschorn Roisman, Madeline White, Barry Weinstein SECOND ROW: Joel B. Bowers, Robert]. Gibson, Michael Pugliese, Michael Pisick, Hachiro akamura, Robert Hartog, louis Hevizy, Gerald Stinziano, James Cavalieri, Samuel Weissman, Bernard Muscato THIRD ROW: David F. Hayes, Timothy Harrington, Daniel Mandelbaum, Hanley Horwitz, James Patterson, Douglas Roberts, Thomas Scanlon,James White LEFT TO RIGHT- FIRST ROW: Lawrence Oufiero, Diane Matuszak SECOND ROW:James A. Smith, Paul Wierzbieniec, Stephen Yerkovich,John H. Clark, Richard]. Buckley, Jr., James l. Budny, Joseph P. Lemmer, Bruce Middendorf, Bradley T. Truax, Roy E. Seibel,Jr. , Thomas l. Walsh, Edward Valentine LEFTTO RIGHT- FIRST ROW: Peter E. Shields, Sonia L. Wornum, Ivonne Cellino, Robin H. Adair SECOND ROW;John Canry, Donald Armenia, Joh n Corbelli , Arth ur Rosiello, joseph Buran, Jr., Michael Cellino, Charles Francemone, Walter A. Balon, Ramon]. Pabalan, Andrew ]. Majka, John W . Crofts B u a 0 f' h c 0 n u u m n 9 9 4 �··· ·· · ·· ·· ·· ·· · ···· ·· ······· ·· ·· · · ··· ·· ·· ·· · ·· · · ··· · ··· · · ···· ·· · · · · ····· · ··· ·· ······ · ··· • ij LEFT TO RIGHT- FIRST ROW: Benson Zoghlin. Michael McMullen, Andrew LEnTO RIGHT -FIRSTROW: Amy R. Jeffery, KaraM. Kelly, Diane M. Cicatello, Knoll, David Pfalzer, Laurajo Booth, Raymond Chan SECOND ROW: Susan Rodney j. Voisine, Mary Schamann, LoriAnn Fraas-Burns, Richard E. Abbott, Evelyn Hurvitz, MoritzaAlvarado, Amy Schueckler, Mark Billinson Ferguson, Debra M. Omiatek, Carolyn]. Piver, Lee R. Guterman SECOND THIRD ROW: Fitzroy Dawkins,john McLaughlin,julie Dressloch, Mina Ohm, ROW: David R. Bloom , Kristina E. Han, Andrea L. Messina, Douglas Sillart, ora Meaney-Elman, Madeline Lalia, Kevin Rosteing, Paul Greenberg, Pamela D. Reed, Dawn A. Gais, Mark Pundt, Thomas Grimald i THIRD Seth Matarasso, William Healy FOURTH ROW: Thomas Mahl, Douglas Bates, ROW:Kevin M. Senn, Raul Vazquez, Michael Licata, Wayne A. Forde, Leonid Kenton Forte, Marc ]. Kublick,John A. Brach , Herbert Shkolnik, Paul]. Lecat, Eric R. Southard, Henry M. Stachura ewton,John G. Dyster,john Lupiano, Paul Misthos, And rew Tanner, Randall A. Solomon Donate $20 to Ronald McDonald House®and Get a Free Phone* From Cellular One® A vailable to all State, RF, UBF and FSA employees. Special airtime rates $12 Monthly fee and 22¢ per minute. I f you've been wondering if or when you'll buy a cellular phone... here's an offer that'll make you feel good about owning one. The program is called Hear The Call, Help The Children, and here's how it works. Your contribution of at least $20 helps fund Pl iO phone from Cellular One. Simple as that. ow, owning a cellular phone from Cellular One never felt so good. To contribute to the Ronald McDonald House* and get your free cellular phone, visit any Cellular One store or participating dealer or call 861-9680. But hurry, Buffalo's Ronald McDonald though. This offer expires September 30, 1994. '-l.~ff.~;;;;~~o..1J House*, one of 160 facilitie CELLUlAR ONE. around the world, each providing a seriously ill children being treated at local hospitals. At the same time, your donation also gets you a free NEC 861--9680 contact Paula Omicioli Make your check payable to: Ronald McDonald House• • Offer conun,amt upon new acovauon, equtpmmt contract and cm:ltt approval w1th Cellular~ m the aevm-county Westttn Nc.- Yorit area. Cellular c::>nt reserves the rteht to substitute equ1pmem. A one-t~ acovaoon fee apphes. EqUipment conmcu and rate plans vary. Certam temu and c.ondiUON apply. �~ -· · · ······· · · · ··· · ········ ·· ····· · ······· · ··· · ···· · ······ · · ·· ·· ·· · · ······ · ·············· 1181 Eugene Farber '43, focused his career on integrating clinical specialty of dermatology with basic science B UFFALO NATIVE SPENT 37 YEARS AT STANFORD AS A C LI NICIAN , EDUCATOR AND ADMINISTRATOR , AND FOUNDED T HE PSORIASIS R ESEARCH INSTIT UTE uring a guest lecture at the Central Research Institute of Dermatology in Soviet Georgia in 1977, Eugene Farber, M.D., attempted to inject some humor into his presentation by projecting pictures of California, his adopted home. One by one, Farber held up pictures of famous West Coast attractions: Fishermen's Wharf, Chinatown, the giant redwood trees. "My interpreter repeated that the redwood trees are so tall that when Sputnik flew over it almost hit the top of the trees," Farber recalled. " obody laughed." It was probably the only "bomb" dropped in Cold War history. Although Eugene Farber may not ever be recognized for his stage presence, the accomplished physician-researcher can be credited with helping to transform dermatology from a clinical specialty to a discipline with a close integration with basic science. A native of Buffalo, ew York, Farber received a B.A. degree from Oberlin College in 1939, his M.D. degree from the University ofBuffalo in March, 1943, his M.S. degree from the University of Minnesota in 1946 and served his residency at the Mayo Clinic from 1944 to 1948. From 1949 to 1986, Farber served at the Stanford University School of Medicine as a clinician, educator, research investigator and administrator. He completed his career at Stanford as a profesB u a 0 p sor of dermatology and chairman of the department of dermatology, a position he held from 1959 to 1986. It was at Stanford where Farber began to pioneer independent departmental status for dermatology. "In order for dermatology to grow as a specialty, with its own individuality and greater room for development, I believed it was necessary to have equal status with other clinical disciplines," Farber said. This desire for independence can be considered the landmark in the evolution of dermatologic research on both the basic science and applied levels, specifically in the study of psoriasis. Until well into the 20th century, published knowledge of this disease was almost entirely descriptive. From the genesis of his career, Farber linked clinical observations with laboratory studies. "I enjoyed teaching the longer I was in it. My professorship at Stanford included teaching combined with patient care and research. When I visited my patients, I would always have three or four students with me. It was important for them to actually see patients and to get first-hand experience with different maladies," Farber said. "The research part occupied my nights and weekends. I worked at least 60 hours per week during my career, but I enjoyed it." It was his desire for expanded knowledge and increased research that led to the First International Symposium on Psoriasis, held in 1971. Three more were h w " c a n A to follow at five-year intervals. Throughout his career, Farber has lectured in 44 different countries and has received honorary memberships and awards from more than 26 foreign dermatology societies. He is the author of several hundred scientific publications and four books. He recalls that one of his most memorable collaborations was in ewfoundland, British Columbia, where Farber teamed up with Dr. Wayne Gulliver, a professor of dermatology at St. John's University. Farber and Gulliver were investigating a five percent prevalence of psoriasis in a population that was considered to be a closed community. "There was a very low rate of divorce and most of the people living there are married within the community," Farber said. "We had an excellent opportunity to undertake genetic analysis of entire families," Farber said. "Evidence pointed to the sixth and seventeenth chromosomes, which demonstrated linkages in the family studies." Upon his "retirement" from Stanford, Farber co-founded the Psoriasis Research Institute, a non-profit foundation in Palo Alto. Originally established with a skin biology unit specializing in psoriasis, the institute expanded in 1989, adding a clinical-pharmacology division and a psoriasis medical treatment center. Although the main emphasis of the institute's work is research, Farber said that patients receive treatment daily at the facility. u u m n 9 9 4 �---------- - --~----=----=-=--~~~---_--- ···· ··· ··· · ··· ··· · ·· ···· · ······ · ················· · ·· · ·· · ······················ ·· · ·······~ • "We have a large program in Farber also recalled Abraham Aaron, psychoneuroimmunology, a field of M.D. , a professor of gastro-neurological great pertinence to people who have medicine, whose strict style of teaching diseases of the skin," Farber said. "We was respected and admired by the stuare investigating biochemical and im- dents. munological mechanisms which account "We were afraid of him, but his discifor the so-called mind-body relation- pline as a physician was exemplary," ships. Farber added. "Seventy-five percent of psoriasis is In 1993, Farber returned to Buffalo stress-related. We are, therefore, look- to attend his 50th class reunion. "I could ing at the sensory nervous system of the hardly believe how old we had become," skin with particular attention to neu- he quipped. ropeptides," Farber said. Theresearch, he said, is aimed at identifying antagonists to the neuropeptides, the suspected trigger of psoriasis and other skin diseases, in an effort to block their release and prevent the occurrence of the skin condition. The Institute also provides a total care program to individuals suffering from skin disorders. Farber believes it is important for patients and family members to learn about their disease. The total care concept includes access to educational materials and conventional and non-traditional Eugene Farber, M.D. treatment, such as auto-hypnosis, re"I was pleased to know what fine careers my classmates had. When I laxation techniques and diet. "After a period of total care, the need graduated from Buffalo and went to the for aggressive skin treatment is less- Mayo Clinic, I found that what Buffalo ened," Farber said. taught allowed me to compete successThroughout his career Farber has fully with students from the top medical assumedleadershippositionsinnumer- schools in the country," Farber said. ous dermatologic societies and organiLooking back to his early days as a zations. He is past president of the Soci- medical student, Farber observed draety for Investigative Dermatology, the matic changes in the way medicine is Pacific Dermatology Association and the taught today. "Medical school faculties Association of University Professors. He have advanced beyond having their stuis an honorary member of the Buffalo dentssimply memorizeGray'sAnatomy, for example." Chapter of AOA. Farber credits his initial interest in "There is much more practical applidermatology to Earl Osborne, M.D., a cation in the teaching of medicine toUniversity ofBuffaloprofessor, who was day," he said. Yet for all the progress in "dynamic and exciting in his teaching of medicine and medical schools, Farber dermatology." laments the "tough choices" facing the B u a a p h y s c a n " u medical students of today. "Medical students are faced with paying off huge debt. This shortens their career expectations because they can't hang on to specializing. It's just too expensive," Farber said. "The coming government requirements on how many specialists can be permitted to enter any particular field will also affect career choices and the possibly the quality of medical care. "The government wants medical schools to produce more family doctors, but medicine is too complicated today, and we need specialists. You can't be a jackof-all-trades," Farber said. Many UB stude nts and alumni will recognize Farber Hall on the University's South Campus. The building, however, is named after the late Dr. Sydney Farber, the noted dermatologist's brother, who, after graduating from the University of Buffalo, taught at the Harvard University School of Medicine for 4 1 years and founded the Dana Farber Cancer Center. There is a long association between the Farber family and UB.Jason Farber, M.D., was clinical researcher of chest medicine at University of Buffalo, while Marvin Farber, Ph.D., headed the university's philosophy department. Another brother, Seymour Farber, served as vice president for graduate education at the University of California in San Francisco. These days, Eugene Farber has reduced his work schedule to five days a week, devoting more time to leisurely reading and other pursuits. "I will take early retirement when I am 100," Farber said. However, there's no sign of the + good doctor slowing down. - BY u m PETER n SIGURDSON 9 9 4 �~ ·········· · ·· ·· · ·· ·············· · ········ · · ·· ·· · ·· ··· ··· ·· ·············· · ···· · ·· ········ ml 48 UB alumni listed in "Best Doctors in Amertca" orty-eight alumni from the School of Medicine and Biomedical Sciences have been named in the second edition of The Best Doctors in America, a directory of the best in the profession as chosen by their peers. Best Doctors lists 7,200 physicians in more than 50 specialties - approximately 2 percent of the nation's 350,000 practicing physicians. UB has 28 faculty members in the listing, compiled from interviews with thousands o f specialis ts throughout the country who were asked to rate the clinical ability of their peers. UB alumni included in Best Doctors are: Bernard S. Alpert, M.D. , ' 74 , Reco n structive and Microsurgery, San Francisco, Ca.; Kenneth Z. Altshuler, M.D., '52, General Psychiatry/Psychoanalysis, Dallas, Tx.; Joel M. Andres, M.D., '68 , Pediatric Gastroenterology, Gainesville, Fl.; William Balistreri, M.D., '70, Pediatric Gastroenterology, Cincinnati, Oh.; Karl R. Beutner, M.D. , '79, Dermatology/Herpes Virus Infections, Vallejo, Ca.; DavidA. Bloom, M.D., '71 , Pediatric Urology, Ann Arbor , Mi. ; Marlene Bluestein, M.D., '76, Geriatric Medicine, Tucson,Az.; Philip A. Brunell, M.D., '57, Pedatric Infectious Disease, Los Angeles, Ca. ;Joseph Caprioli, M.D., '79, Ophthalmology/Glaucoma, ew Haven, Ct.; Antonino Catanzaro, M.D., '65, Pulmonary and Critical Care Medicine, San Diego, Ca.; Carl I. Cohen, M.D., '71 , Geriatric Psychiatry, Brooklyn , .Y.; David Cohen, M.D., '89, ephrology, ew York, .Y.; Michael B u a 0 p E. Cohen, M.D., '61, Pediatric eurooncology, Buffalo, .Y.; D. ]. Coleman, M.D., '60, OphthalmologyNitreo-Retinal Surgery, Haworth, .]. ; Bruce F. Connell, M.D., '52, Facial Aesthetic Surgery, Santa Ana, Ca.; David R. Dantzker, M.D. , '67, Pulmonary and Critical Care Medicine, Roslyn, .Y. Also, Raymond]. Dattwyler, M.D. , '73, Infectious Diseases/Clinical Immunology, Stony Brook, .Y.; Patricia Duffner, M.D., '72, Pediatric eurooncology, Buffalo, .Y.; Demetrius Ellis, M.D., '73, Pediatric ephrology, Pittsburgh, Pa.; Eugene S. Flamm, M.D., '62, Vascular eurosurgery, Philadelphia, Pa.; John F . Foley, M.D. , ' 55 , Medical Oncology/Hematology, Omaha, e.; Richard R. Gacek, M.D. , '56, Otology/ eurotology, Syracuse, .Y.; Robert E.Jordon, M.D., '65, Dermatology/Cutaneous Immunology, Houston, Tx.; Louis Kavoussi , M.D ., '83 , U rology/ Endourology, Baltimore, Md.; Douglas W . Klotch , M.D. , '71 , Head and eck Surgery, Tampa, Fl. ; Thomas ]. Lawley, M.D., '72, Dermatology/Cutaneous Immunology, Atlanta, Ga.; Richard ]. Lederman, M.D., '66, eurology/Electromyography, Cleveland, Oh.; Stephen R. Marder, M.D., '71 , Psychiatry/Psychopharmacology, Los Angeles, Ca.; James R. Miller, M.D., '79, eurology/ Infectious and Demyelinating Diseases, Skaneateles, .Y. Also, Stan ley L. Olinick, M.D., '40, Psychiatry/Psychoanalysis, Washington, D.C. ; Linda Paradowski, M.D., '80, Pulmonary and Critical Care Medicine, Chapel Hill, .C.; Donald Pinkel, M.D. , '51 , Pediatric Hematology/Oncology, Houston, Tx.;Anthony A. Portale, M.D., '74, Pediatric ephrology, San Fran- h ~ " c a n A cisco, Ca.; Cary Amet Present, M.D. , '66, Medical Oncology/Hematology, Los Angeles, Ca.; Linda Rabinowitz, M.D., '82, Pediatric Dermatology, Milwaukee, Wi.; Robert E. Reisman, M.D., '56, Allergy and Immunology, Williamsville, .Y.; Hugh A. Sampson, M.D. , '75, Allergy and Immunology, Baltimore, Md.; elson B. Schiller, M.D., '66, Cardiology, San Francisco, Ca.; John B. Schlaerth, M .D. , '68, Gynecologic Oncology, Los Angeles, Ca.; Max A. Schneider, M.D., '49, Addiction Medicine, Orange, Ca.; Arthur Skarin, M.D., '61 , Medical Oncology/Hematology , Boston, Ma.; Kenneth Solomon, M.D. , '71 , (deceased), Geriatric Psychiatry, St. Louis, Mo.; Paul Stanger, M.D. , '61 , Pediatric Cardiology, San Francisco, Ca.; Morton A. Stenchever, M.D. , '56, Reproductive Surgery, Seattle, W a.; Robert C. Stern, M .D., '82, Pediatric Pulmonology, Cleveland, Oh.; Virginia P. Sybert, M.D., '74, Pediatric Dermatology, Seattle, Wa.; Stanley]. Szefler, M.D., '75, Allergy and Immunology, Denver, Co. ; and Lawrence W . Way, M.D. , '59, Gastroenterologic Surgery, San Francisco, Ca. + Medical school receives gift to create student scholarship fund he School of Medicine and Biomedical Sciences has received a $508,000 gift from a trust created by Helen Hekimian. The gift will be used to fund scholarships for students demonstrating academic merit and financial need. Helen Hekimian was the daughter of the late W illiam Crosby, a prominent Buffalo businessman active in university affairs earlier in this century. She married Ivan Hekimian, M.D., a 1927 u u m n 9 9 4 �..... .... .. ...... .... .. .. .. .. .... ..... ..... ... ... .. ... ... .... .... . r-------------. NEW OPPORTUNITIES FOR FAMILY PRACTITIONERS Hassanali, who practices dermatologic cosmetic surgery, originally had planned to fly to Sarajevo, Bosnia/ Hercegovina, but was turned back. Instead, his group traveled to Zagreb, visiting the main hospitals and rehabilitation centers that house many refugees and war-injured patients. Hassanali, himself a refugee from Uganda, donated $30,000 worth of medical supplies to the Zagreb hospitals and rehabilitation centers. Hassanali plans to bring one 17-yearold patient to Buffalo for reconstructive surgery. The girl, injured in an explosion in which she lost both parents, suffered severe burns on her face and hands. + graduate of the medical school who founded the local Red Cross Regional Blood Program, taught at the medical school and maintained an active practice in Buffalo. + Time to renew James Platt White Society memberships r, he Jomes Plott While Society - ooiSiinguished leodersh~ orgonizotion bosed on the values ond principo~ of the former deon ond founder of the School of Medicine ond Biomedicol Sciences4 ~ is oleoding suppporter of the school'smission of providing the highest quorlly educofion, reseorch ond ~ lient core. Through its membels' generous, choritoble member· ship pledges, the School of Medicine ond BiomeOICol Sciences confinues its leodel5hip role os one of the premier medico! schoo~ in the counhy-one poised to reoctto the dxJIIenges of heolth core refonn ond the burgeoning technology revolution through the use of innovative educooonol ond orgonizofionol progroms !hot benefit the next generotion of both physicions ond their potients. nyou hoven'tolreody, pleose renew your membership pledge for this yeor.And fyou oren'tolreody omember, but would like to join the medico! school'sprincipol supporting orgonizotion, pleose coli Michoel E. Benzin, Director of the Annuol Appeol, ot (716) 64 5-3312. + ynette ieman, M.D., ' 78, has been appointed clinical director of the ational Institute of Child Health and Human Development. She has served as deputy clinical director of the agency since 1990, and more recently as acting clinical director. Board certified in internal medicine , endocrinology and metabolism, Nieman has served on the institute's IRB since 1988 and on a number of clinical center committees focused on issues of patient care. She has been an invited speaker at many symposia and grand rounds , and has offered testimony concerning RU 486 to Congress on a number of occasions. Nieman's research has focused on attempts to improve diagnostic precision in Cushing's syndrome , the evaluation ofluteal function and the uses of antiprogestins in the reproductive cycle. + iyaz Hassanali, M.D., '86, recently returned from a humanitarian mission to Zagreb, Croatia, he coordinated to bring medical supplies and drugs to refugees of the war in Bosnia. u 0 0 p h W e provide everything you need to build a successful practice, as well as an enriching work environment. Salary is highly competitive. Benefits include retirement plan , license fees, health and malpractice insurance, ample vacation and CME time, and research opportunities. Area is eligible for loan forgiveness programs. Call coverage is very good and is managed effectively. Managed care programs are already in place. Lynette Nieman '78,appointed clinical director of NICHD ftiyazHassanali '86,spearbeads humanitarian mission to Zagreb B BEIBC family practitioners needed to staff new family care sites to be opened by ECMC and SUNY at Buffalo Department of Family Medicine. y 5 c o n A u Responsibilities include clinical work and teaching of residents and medical students. Administrative duties are flexible. Physicians must be willing to perform obstetrics. (With in-house OB back-up.) Please contact Rebecca Brierley, Family Medicine Recruitment Coordinator, Erie County Medical Center, 462 Grider Street, Buffalo, NY 14215, (7 16) 898-4797, fax (716) 898-4750. ERIE COUNTY ~fMEDICAL CENTER • u m n . A 9 9 " �A Spoon f u I MUSINGS ON THE WAY TO of © Humor L.A . finally bought myself a new car. First time! I had always avoided it for fear of having to bargain with the salespeople. But first, of course, you have to deal with the receptionist. I called and said, ''I'm looking for Michael," and she asked, "Is that a two-door or a four-door?" The salespeople always want to know your last name, so they can repeat it over and over to lure you into a feeling of false security. When I was looking I always told them my last name was" o Sale Today." "Will you be buying the car today, Mr. o Sale Today?" " o! And that's Dr. o Sale Today." That's not true. I would never tell these guys I'm a doctor. Then they'd see me as a six-foot chicken on a rotisserie. I decided to take a trip down to L.A. to break the car in and visit a friend . I had a lot of time during the drive to think about things, not the least of which were the present inhabitants of the White House - two lawyers. I liked it better when we had an actor, a diet pill addict and Frank Sinatra doing naked pushups in the Lincoln Bedroom. At least you knew what you were dealing with and they entertained you all the time. As I got closer to L.A. (you can always tell from the lovely red haze in the air) I called ahead to let my friend know that I would be there in a half hour. I was only two miles away, but this was L.A. B u a 0 p Great times we live in- to be able to make calls from the highway - and I'm thinking, "Wow! I'vegotacellularphone in the car," which means I no longer have to stop at a gas station to make phone calls. ow if they could come up with a cellular toilet, that would be great. Cellular phones are still somewhat affordable - especially if you only use them on weekends. I try to avoid the "airphones," though. On a recent flight they announced a contest: make a call on the airphone using your credit card, and you have a chance to win $50,000 -or spend $50,000 if you stay on more than 10 minutes. Before arriving at my friend's house I decided to pick up a bottle of wine. I handed the clerk a 20 bill and he placed it under the drawer. I thought, "Why do they place the $20 under the drawer?" That's the first place a hold-up artist is going to look ... unless he's stupid. What are we dealing with here - remedial criminals? "Gee, all I see are ones and pennies . . . where could the big bills possibly be?" h ~ 5 c a n A u u m n 9 9 4 �Stu S i Ivers t e in , M.D . I also glanced through People magaThat day, the headline of the newspaper (well not the newspaper - USA zine. They had a quiz titled "Are you a Today) said that Congress was hoping genius?" You can pretty much be sure to pass a bill that would ban all assault that if you're reading People magazine weapons. I thought, "well let's see, we've and taking that test - you're not ... got Uzis, AK 4 7s, HMOs and grenades." although I did score pretty high. When l finally got to LA. , one of the Kaiser Permanente is big in Sou them first things my friend and his wife asked California. I believe one-third of the me was how to choose the right doctor. insured population there is with Kaiser. This, in fact, is the model the govern- With the new government health plan ment is following. In order to keep pace looming on the horizon, many people, I heard that Kaiser is thinking of install- including your friends and relatives, ing an outpatient drive-thru window. will be asking you for the same advice. Having recently faced this many times First in the country, in fact. myself, I never know what to say, but do offer to tell people how not to choose the "wrong" doctor. I've even prepared a little handout. Feel free to copy it and do the same. Tips on Choosing Your Doctor • Do not choose a doctor whose office is on a Greyhound bus. • It is probably not a good sign if for every prescription of Prozac your docThe sports page announced that tor writes, he gets 100 frequent flyer Darryl Strawberry signed with the Gimiles. ants. Yeah, I suppose if he gets in shape • If he says, "OK, up on the table and he can lead the league in free-basing. take off my clothes." Stay away! !! And for you real couch potatoes who • Watch out if he keeps referring to his can't program a VCR, now there's a new stethoscope as Hector. device that allows you to command • Ladies, it is not good if there is a sign your VCR. You just lie there on the on the wall that reads, " o Shoes. No couch and say, "Tape Seinfeld. Channel Shirt. No Cervix." 4. 8:30." and it will do it for you. The • Be careful if the fish tank in the waitdeluxe version has an additional feature ing room is labeled "Exhibit A." that lets you say the words, "I have no • Most importantly, leave his office life," and it lifts your skull off and sucks immediately if he asks you to turn your out your brain and you become a huhead and pull his finger. + man futon. And apparently Bill Clinton cel- Stu Silverstein, M.D., president of Stondup Medicine Seminofl ci Son fmncisco, ebrated his SOOth day in office by gain- Colifomio, ledures notioowide on hun101 in med"Kine. He recently published his first book, What About Me?, about growing up with a developmentnDy ing his SOOth pound . tfiSObled sibling, c~H~Uthored with BfYTKI Siegel, Ph.D. B u a 0 p h y 5 c a n A u u m n 9 9 4 �• •• • • • • • • • • • • •• • • • • • •• • The Perfect AcADEMIC HEALTH PROFESSIONALS INSURANCE AssociATION I Prescription For Your Conference Needs Insuring care for those who care 1 9 4 s 0 Subscriber Owned • Organized • Governed teaches diabetic management in Beijing and anjing, Ch ina for two months each year. He is in private practice in South Carolina. EDWARD M . TRACY '43, GEORGE THORNGATE PHYSICIANS • DENTISTS HEALTH PROFESSIONALS NURSES • RESIDENTS IV, '44, of Pebble Beach, California , writes, "During the trimester break in June 1944, there was a significant number of my classma tes wh o became wedding bound. This was especially true for those of us in the Navy Y-12 program. ine months later our daughter was the first offspring, we think, to be born to the class. With our five daughters, eight Superior policies for academic full-time and voluntary clinical faculty ~ Competitive premiums 0 . LOESER Conference Planning Professionals 'i' Convenient Downtown Location Dividend opportunities 'i' Quick Metro R ide to Main Street Campus and Medical School 'i' Close to Buffalo G eneral, Roswell, ECMC and Children's Hospitals 'i' Y our Guests Can W alk to Theatre, Shops, Pilot Field, Restaurants, Entertainment Academic Health Professionals Insurance Association is a subscriber owned and organized reciprocal licensed by the Insurance Department ofNew York State. Policy and programs ofthe Association are determined by a representative Board ofGovernors elected by subscribers at SUNY Health Science Centers. ' 45 , 'i' CME Friendly 'i' Great Banquet Food Please Talk To Us AbDUt Preparing A Proposal So YDU Can Bring YDUr GrDUp's Next Convention To Buffalo Enrollment open at all times. Tran fers arranged \vithout loss. (71 6) 856-1234 EXTENSION 6142 ACADEMIC HEALTH PROFESSIONALS INsURANCE AssociATION has been elected president of the William A. Little Obstetrical and Gynecological ociety, the association of faculty and alumni of the Department of OB-GYN at the University of Miami(Jackson Memorial Medical Center. It is of a 'i' Complete legal service ~ RAPHAEL 5 . GOOD '48, u of Meeting Space ~ ~ writes, "Five years after closing my private practice, I am again retiring, this time as medical director of a preferred provider organization. Our plans are to spend more time with children and grandchildren, distributed on the east and west coasts, but Youngstown, ew York remains our home." B 18,000 Square F eet Comprehensive coverage grandchildren and one greatgrandchild, Helen (Tweet) and I are looking forward to celebrating our Golden Wedding Anniversary, both of us in good health. We hope the other newlyweds of June 1944 will celebrate their anniversary with joy also." WILLIAM ~ Rewarding educational programs HYATT. WE'VE THOUGHT OF EVERYTHING~ Empire State Building 350 Fifth Avenue, Suite #1512 ew York, ew York 10118 Ph. 212-947-4541 Fax 212-947-4572 0 p h ~ 5 c o n A u u m n 9 9 4 �······· ·· ·· · · · · · ······· · · · · ··· · ·· ·· · ···· ··· · · ·· ····· ···· · ··· · · · ·· · ·· · · · ··· ·· · · ·· ·· · · ·· · · · · · ~- -~- ' particular note that Dr. Good is a past president of the South He is a fellow of the American Florida Psychiatric Society. president of the Georgia Psychi- I Psychiatric Association and past atric Physicians Association. Dr. 9 5 0 '51 , Haberman is clinical associate professor of psychiatry at Emory received the degree of Doctor of Science, Honoris Causa on May and Morehouse University 1 EDWARD SHANBROM 5 University School of Medicine School of Medicine. 22, 1994, from Allegheny College. Dr. Shanbrom has published over 100 scientific articles D IANE and is the author or co-author of over 20 patents. In the 1960s he collaborated with Dr. Kenneth Brinkhous to establish a technique that allowed concentration and purification of factor VIII. Besides funding scientific endeavors, Dr. Shanbrom and his wife, Helen, have also been supporters of the arts and education in their Orange County, California community. HILLIARD JASON ' 58 , has hosted, co-written, and produced more than 50 educational videos in the field of medical education for national distribution. Springer Publishing Company has recently released a new book written by Dr. Jason and his wife (Jane Westberg, Ph.D.) titled: Teaching Creatively with Video: Fostering Reflection, Communication and Other Clinical Skills. Both this new book and a prior book, Collaborative Clinical Education: The Foundation of Eff ective Health Care, are part of the Springer Series on Medical Education. is now retired, after practicing general surgery in ew Mexico since deputy director, Community Health Surveillance within the Maryland Department of Health and Mental Hygiene. Earned my MPH at Johns Hopkins University School of Hygiene and Public Health and am board certified in general preventive medi- Hilt.ard Jason '58 1971. Dr. Wilbee was recently appointed to membership on the State Board of Medical Examiners. He is a former president of the State Medical Society and past president of the ew Mexico chapter of the American College of Surgeons. 1 9 JOHN 6 0 JOHN C . S T UBENBORD '75, has been practicing internal medicine and family medicine in East Aurora for 10 years. He 5 was appointed a fellow of the Royal Society of Medicine, London, in July 1992. He has three boys, Derek, 6, jess, 3 and Wesley, l. SHIELDS '68, of ew York, is medical E. Delphi, director of Bassett Health Care of Stamford-Delhi. Dr. Shields is a member of the American College of Physician Executives. 1 7 9 0 5 GEORGE Y . LOHMANN , JR. '72 , is listed in Compton- Connally Guide to Best Doctors in ew York Metro Area, Who's Who in the East, Science and Engineering and World, Business and Finance. His daughter, orelle Christa Victoria, was born October 15, 1991. u a 0 MICHAE L A . HABERMAN 73, u 5 c a 9 8 0 5 ROBERT J . BRACO '80, of Springfield, Missouri, has joined the Springfield Clinic to do in- PAB LO RODR I G UEZ ' 81 , writes, "I have been awarded the 'Community Service Award' by the AMA young physician section for my work with the Minority Health Advisory Committee to the Rhode Island Department of Health. I have two boys, ages 3 and 5; my wife and I have become avid windsurfers." University and is practicing with term. His 7-year-old son, Keith, Kaiser in Fontana, California. She won first place in the National Radiant Peace Foundation's essay contest for the Midwest region. Besides a cash award, his is an associate GI fellowship director and assistant clinical professor of medicine at Lorna linda University. She and her husband, essay will be considered for publication in a book about children and their contribution to world peace. Chiayu Chen, have a daughter, Katherine, born January 17, 1993. Medical Association of Atlanta. h 1 RONALD A . V IDAL 77, was elected president of the medical staff of Samaritan Health System of Clinton, Iowa, for the '94-'95 was installed as president of the p Ronald A. Vidal '77 dustrial consulting. cine and public health." ROBERT H . WILBEE '59, B L. MAT USZAK '74 , writes, "Recently appointed n u u m PAT RICIA HSIA '85, completed a GI fellowship at Georgetown NIC HOLAS D 'A V ANZ O '86, is practicing pediatrics in a [ourman group in Raleigh, orth n 9 9 4 �• . .. .. . ... . ... . .......................... . ....... . ... .. .... I Peggy Morey Stager '88, was married October 30th to Richard Stager. Carolina. He and his wife have two children, Stephen icholas, 10 months and a 3 V2-year-old daughter. 1 9 9 s 0 FAITH F R ANK E L '91 , completed apediatric residency at Georgetown University Hospital and is now in private practice in Virgm ta. She and her husband, Douglas '88, was married October 30th to Richard Stager. Friends PEGGY MOREY STAGER Power Mac 7100 includes: • 15" Color Monitor • ClarisWorks • CD ROM Bonus: Microsoft Bookshelf Frankel, M.D., have a 1-year-old son, Maxwell Shane Frankel. from near and far joined the special celebration at the Buffalo Hyatt Regency. Mary Davitt and Mitch Tublin arrived from Pittsburgh, Nancy Lisch cruised in from Cleveland, and Cindy and Tom Bellomo road tripped from Milwaukee. The local attendees included Lori and Frank Luzi, Lisa Benson and Lee Guterman ('89) and Helen and Andy Cappucino. A fantastic time was had by all! The newlyweds reside in Cleveland Heights, Ohio. Peggy is an adolescent medicine attending at MetroHealth Medical Center. C Y N T H I A 66 MHz, PowerPC 601 RISC-based processor, 8MB RAM, 250MB hard drive. Macintosh Color 15" display, AppleDesign keyboard, built-in Ethernet, at:ive ClarisWorks 2.1, and the Apple Student Resoun:e Set which includes: The Macintosh Writing Companion; Student Assist; The Internet; Microsoft Bookshelf; The Voyager Offer (a coupon offer to pun:hase interactive CD ROM discs for just $9.95 (normally sold for $24.95 to $79.95)). ( LEBER MAN ) JENSON ' 92 , writes, "Curren tly co mple ting fi rst year of anesthesiology residency at the University of Pittsburgh . Mark and I are celebrating our one year anniversary, May 15, 1994." MI.L. $2358 • 15" Color Monitor • Pentium Upgradeable THOMA S GRIMAL DI '89, writes, ''I'm com- OBITUARIES pleting urology training at the University of Michigan and plan on joining the UB Urology faculty at the Buffalo VA Medical Center. My 1-year-old daughter, Sarah, and I are coping with the death of my wife, Ester Ponce Grimaldi '89. Thank you classmates for all the support. Ester died suddenly in an automobile accident injanuary 1994. A medical school graduation award is being established in her name, to recognize a compassionate and positive approach to clinical medicine." 8 u a 0 66 MHz 486DX processor, 8MB RAM, 340MB hard drive, SVGA 15" color monitor, 3.5" floppy drive, full size keyboard, DELL System mouse, DOS 6.2 . Windows 3.1, and 1 year next business day on-site service. died on March 23, 1994, in Buffalo. Before retiring in 1985, he practiced internal medicine and was associated with Millard Fillmore Hospital. After retiring, he and his wife, Lois, spent winters in Florida, where he enjoyed fishing and golfing. RUSSELLS. K I DDER '41 , KENNET H SOLOMON '7 1 , • Apple • IBM • Dell • Compaq • Panasonic • Hewlett Packard • TI • Sony • Software • Supplies • Accessories • Audio • Hands-on Workshops died unex- pectedly last spring. p h " c a n A u u m n 9 9 4 �BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 ADDRESS CORRECTI O N REQUESTED 1773 EALTH SCIE CES SE LS DEPT ABBOTT HALL CAMPUS IL 4 The only liability coverage with this seal of approvaL Medical Liability Mutual Insurance Company (MLMIC) is the only professional liability insurer approved by the Medical Society of the State of ew York. Since its founding in 1975, the phy icianowned and managed company has successfully defended more physicians than all other available insurers combined. Additionally, MLMIC has the largest and most experienced professional liability claims department in the country, the large t risk management department of any ew York State professional liability insurer, and the state's only true peer review of claims experience. Call1-800-ASK-MLMIC (metro) or 1-800-356-4056 (upstate) for more information and an application. MLM~C ~ Medical Liability Mutual Insurance Company Our defense never rests. 2 Park Ave., New York, NY 10016 2 Clinton Sq., Syracuse, NY 13202 90 Merrick Ave., East Meadow, NY 11554 tO 1993 Medical Liability Mutual Insurance Company --Oo<- M--Oo< ��\ \ �/ / I ~ach I I / I I I I / year, the University at Buffalo School of Medicine and Biomedical Sciences ad, mits 135 new students. I Over the next four years, I I I I I 1 I 1 I they will learn both the art and science of medicine as they realize their calling and form lasting relationships that will enrich their lives. J I I Here, Buffalo Physician pre, I I I I I \ I \ sents the Class of 1998 and wishes them well on this, the beginning of their four,year journey to become physicians. \ \ \ \ \ \ \ �nHOOl Of MfOI[INf ANO ~IOUfOI[Al ~WNtf~ KRISTEN ANDRESON C 'rnelllJnt\·erslt\ Ammal Sczences LUNA BAilEY LESliE BARR Duke Uniwrsity L:nn·ersity 1t Bufralo Bzology/Chemmry Psychology Bwlo~· LORI BOWMAN SU. 'r J.t Geneseo RICHARD BREMER Clarkson UniversitY Bwlogy BwloJf.i YVONNE BOBEK Cornell Uni\·ersit~ • · · · ·· · · · · · ·· ·· · · · · · · · ·· · · · · ·· · · ERIC BONENBERGER orth Carolma State University Bzology :oology STEPHEN BEKANICH ,j Scranton Lnn·Lrsit~ ~' / ll'·:·. · ···' ,\- "'• JENNIFER BUlGER lJ I at Fred, ma Biology ROBERT BURNS TERRI CAliGIURI EMilY CAlKINS Gannon Umver>~t\ Gannon lJmveut~ UniversitY at Buffalo Biology Biology Anthropology APRil CAMPBEll JOHN CARTER CAROl CHEN Princeton Lmversity SU Y at Plattsburgh Johns Hopkim University CONNIE CHEN Cooper Union History Biology Biology Elecmcal Engmeering 3 �BONNIE CHENG ew York Universtty PETER COBB Davidson College SETH COHEN Yeshiva Umversity JEANINE COOLEY Umversity at Buffalo Biology Biology Biology Health Sc1ences PAM CROWELL Mercyhurst College Sports Med1cme MICHAEL CUMMINGS Cornell Umversity GUL DADLANI Umversity at Buffalo JONATHAN DANIELS University at Buffalo Nurririon Biology Psychology CHRIS DEAKIN Umversity at Buffalo MARYANN DEAN West Liberty State College BARBARA DEGUISEPPE Saint Francis College CLAUOIA DEYOUNG Northeastern University Busmess Art/Psychology Biology Mechanical Engineering = = = = ' PAMELA DIAMANTIS New York Umversity STACEY DIMARTINO Universit} of Rochetser VAMIL DIVAN University of Pennsylvania JANE DOPKINS Harvard-Radel iffe Policies Bwlogy Health Care Management and Policy Women's Studies 4 �HHOOl Of MfOI~INl ANO ~IOMfOI~Al ~WUf~ • · · · · ·· · · · · · · ·· ·· · · · ·· · · ·· · · · ·· · lYNN DUNHAM CRYSTAL DYER JASON EHRLICH ANDREW ESCH Colgate University CUNY City College Umvemty at Buffalo Universitv at Buffalo Bwlogy History Busmess Admmistranon eurosCience JOHN FANTON TODD FEHNIGER CHARLES FETTERMAN MELISSA GARDNER SU Y at Binghamton Uni,·ers1ty at Buffalo Cams1us College Hartwick College Philosophy and Bwlogy Bwlogy Biology Psychology RICHARD GAYlE JENNIFER GEORGE THOMAS GERGEL ROBERT GERSTENBLUTH Cams1us College Fordham Univer ity University at Buffalo Biology Chemistry Biology U Y at Binghamton Bwlogy YOUSSEF GHAL Y HARI GOPAL CHRISTINE GORDON LISA GREEN CU Y Queens College Cornell Umvemty CUNY Lehman UniverSlty of Rochester Bwlogy B1ology Anthropology Cell and Developmental Biology 5 �AlEJANDRO GRUNEIRD L verstt) at Butt:.tlo Btochenust') BRYAN HANYPSIAK LniH:rsi \ MICHAEl HASSETT 01 cr •. :1 C. I qe Bwlogy Flu t o Bwlogy liSA HEICHBERGER U. Y ~t Fred mia Bwlogy/Medtcal Technolog) = = = MICHAEl HERBDWY AARON HOFFMAN Umn:rsny at Buttalo lJni• n College Bwlogtcal Sc~ences Hi.I!OT) = STEVEN HORN UNY 1t Bin,!h~mton Bwlogy ARIEl HOTCHKISS Weslq: n lJnin:rslt\ Psycholoif.i CAlOGERO IPPOliTO PETER JANES THERESA JARMUZ LAWRENCE KANNER ( m1 IUs College SL. ·y ·n Genesco Bost<•n Lmtversit) Bwloi(}/Ps..,cholo!;} Bwchemistn Psychology Han .1rJ universtty Bwlog)' SANJIV KA YASTHA JUDY KIM Ydie Univcrsit) Bwlogy PAUlA KOCIAlSKI LORI KWAN Camstus (., lkgt Lniverstty at BuHalo Biolo10 Btology· c •rnell untn:rsttv A>tan Sttultes 6 �HHOOl Of UfOit!Nf ANO ~IOUfOitAl HlfHf~ • · ·· · · · · · · ·· ··· ·· · · ·· ·· · · · · ·· · ·· • ~JENNIFER lEE DAVID liN NEIL LIPKE CornelllJmn:rslty Cornell Lmvemty Umverstty at Bufhlo Cell Bwlog-y Bwlog) Spwal Studtes PATRICK MAHAR 't Bonaventure lJmvcrsity Bwlug-y TOM MALINICH MICHELLE MANG Bucknell University H·umlton College Mechamcal E"'lgtnee-rmg Bwlug)" AMY MCGARRY H, h Cwss Rus>tan JOSE MACEOA U1 tversi\ RuL 'lLskr Bwlug> JEFFREY MARCHANT lJn H:TSI •t Bu(fal l Health Sctences \ ) 7 J MICHAEl MARKAM PENELOPE MARTIN SlJ"JY at Plattsburgh Untvcrstty ot Rochester Ps,-cholog-y • euroscience THOMAS MCTERNAN Buth<L :->t· L C liege Bwlog-y SUMIT MEHTA GEORGE MOYNIHAN BENNETT MYERS BRETTON NEWMAN ) ale l.Jni\·ermv Ltberal Studtes \ illanova University Economtcs Cornell UntnNt\ Colgate University BwlogJ 7 J eurosLrence �= = = = MARK 0BERLIES JENNY OH lYlE OSTROW TAMERA PACZOS Univers1ty or Notre Dame Tufts University Johns Hopkms Umverstty University at Buffalo Business Administranon Psychology Biology Physical Anthropology PRASHANT PARASHURAMA Cornell Umvers1ty Phys1cs VIRESH PATEl Umvers1ty at Buffalo NICOlE PAZZAGLINI Umvemty at Buffalo Anthropology Johns Hopkms Un1versity Chemical Engineering ACHINI PERERA Biology ClAYTON POlOWY COLIN POWERS JOSEPH REBHAN JAMES REUTHER M1am1 Univer-ity of Ohw Cams1u College SU Y at Plattsburgh M1ch1gan State Biology Biology Biochemistry Physwlogy/ Anthropology ANNE MARIE REYNOlDS t. Lawrence University Biology ANTHONY RICE JEFFREY RICHMAN MARK RICHMAN Cams1us College Worcester Polytechmc Institute Wesleyan Umverstty Bwchem1stry Biology Chemistry B �~~H~~l ~f Ml~I~IU AN~ ~I~Ml~I~Al nllNtl~ • · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · JAYSON ROLAND Queen's University ZULMA ROSADO UniYersity at Buffalo Boston Umverstty Life Sctences Biology Biomedical Engineering JENNIFER SCAROZZA Canisius College Biochemistry CHRISTOPHER SCHAEFFER Harvard Umversity Psychology University at Buffalo ANGELA SCHOEP St. Olaf College Psychology Bwlogy MARY SCOTT Miami University ofOhw Mtchtgan tate Univer ity JOEL SEBASTIEN D'Youville College CARL SEON Umverslty of Mtchtgan Zoology Physiology Biology Classical Archeology DAVID SERRA University at Buffalo MACDUFF SHEEHY Brown Umverstty Umversity of Rochester ANAND SINGH Lehigh University Psychology Aquanc Biology Biology Biology MATTHEW SCOZZARO FRANK SALAMONE MICHAEL SCHARF DAWN SIMON NEHA SANGWAN Michigan State Untverslty Engmeenng �KENNETH SNYDER Cath iL L n vt s1tv , AmcnL B10med1cal Engrnemr. > JOSEPH STOWEll lt Bin {h ,unton Biology SGN! = J. WILLIAM SPARKS .3nl.! Bwlogy Un;ver It\ ut \L SUNIL SRIVASTAVA HANS STELMACH C rrell Ln \t:Nty k.t:ub College Economics Pswhology SOPHIA STREETE GARIN TOMASZEWSKI HANNAH lOON Bufr.1lo '>tate College Unt\'f.Tstt\ at Buftalo Rochestu Institute of Techno log~ Bwlogy Chemmn and Anthropology Btology THOMAS TREVETT CHRISTOPHER TROJAN DORIS VANDERPOOL ANTHONY VILLANI 11, >lv Cn"' C ollc,;e Cnrndl Umverstt\ U'1tverstt' at Butfalo How 1rd University BwloRY Bwchemtstry Health and Human Sciences Btology MICHELE WATSON New Y )Tk Universtty Psychology JEFFREY VISCO KEITH VOLMAR ANDREW WAGNER C ·ndl Untverslt~ Bwlogy lth, c.1 C liege Bostun University Phystcs Biomedtcal Engmeenn~; 10 �~[~OOl Of M!OI[IU UO ~IOM!OitAl ni!H!~ • · 0 0 • • • • • • • • • • • • • • • • • • • • • • t;.{ •.· ·-_ .:~---~ ~---/_ ? ~~-:-:_...:, .·:' . ·, . . ' ......, • r . ' . COllEEN WEBER L nin~r,lt\· '. Rc•Lhestu MARK WEIRICH lmn:r'lt\ c ~I d En~;h.lh/Bwlogy 1\ lrcrtJhwlog:y TAHSINA YASMIN liNDA VAN Y.1le LmvcrsltV Bwlogy m L 111 St John ' L GORDON WINGARD er,,t~ 't R(lLhL 't.:r (ell Bwlog) DANIEl YAWMAN 11\ erslt~ Ln1ver'lt\ Jl ,)tre Oame Hiswn/Prc-~1t?d Bl(,/( .If\ MICHAEl ZIONTS C.uneglv:-..1ell< •n L 111Hrs1ty \kchamcal Engmeenn~ Photographs by S tmon Tong OttJCe of Publ1cau n-., Dln~H.> n of Uni\er Augu•t 1994 C 1037 94 lt'l Sen ICC!l>. . '.·-~'., -.- MEl Yo WONG (_ Pr'1ell L ntYLr,ity Biology lY ZENG Buftalo Broluf!:'IPs)cholol:) Unl\-er>~tv lt 0 0 • • • • �� Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1994 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1994-Autumn Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v28n04-1994-Autumn Table Of Contents A list of subunits of the resource. Research Hospital News Practice Makes Perfect Equal Time Medical School Then and Now Alumni A Spoonful of Humor Classnotes Class of 1998 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo physician, Autumn 1994 Buffalo medical review Buffalo physician and biomedical scientist Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v28n04 Extent The size or duration of the resource. 56 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB_HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1994 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/21b95c23bbdc6cd130acca62600fe6d3.pdf 1d066aa11bc0b3e94864028a5fe62997 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Summer 1994 �BUFFALO PHYSIC I AN Volume 28, Number 3 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY ADVANCEMENT Dr Carole Smith Petro DIRECTOR OF PUBLICATIONS Timothy j Conroy EDITOR Nanette Tramont, R.N. ART DIRECTOR Alan j. Kegler ASSOCIATE ART D IRECTOR Scott Fricker PRODUCTION MANAGER Ann Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MED ICINE AND B IOMEDICAL SCIENCES Dr. john Naughton, Vice President for Clinical Affairs, Dean EDITORIAL BOARD Dr. john A. Richert, Chairman Dr. Martin Brecher Dr. Harold Brody Dr. Richard L. Collins Dr. Alan J. Drinnan Dr Timothy Gabryel Dr. james Kanski Dr. Charles Massaro Ms. Melanie McNally Dr. Charles Paganelli Dr. Robert E. Reisman Dr. Thomas Rosenthal Dr. Stephen Spaulding Dr Bradley T. Truax TEACHING HOSPITALS AND LIAISONS The Buffalo General Hospital Michael Shaw Buffalo VA Medical Center The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Hospitals Frank Sava Roswell Park Cancer Institute Sisters of Charity Hospital Dennis McCarthy ©The State University of New York at Buffalo Buffalo Physician is published quarterly by the State Umversity of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge, to alumni, faculty, students, residents and friends. The staff reserves the right to edit all copy and submissions accepted for publication. Address questions, comments and submisstons to· Editor, Buffalo Physician, State Universtty of New York at Buffalo , University Publications, l36 Crofts Hall, Buffalo, New York 14260 Dear Alumni and Friends, C oncerns about the cost of health care in the United States also must include concerns about the cost of educating medical students. The SUNY system has sought to maintain tuitions that ensure students from all socioeconomic backgrounds access. Despite this, the base annual tuition for New York State residents exceeds $8,000, and most students require, seek and obtain major levels of financial assistance. UB's medical school has addressed its commitment to alleviate students' financial pressures by encouragingscholarship support for meritorious and needy students. Thanks to the generosity of many alumni. and friends, direct scholarship support approximates $200,000 each year. But these funds provide only 3 percent of the financial support required by UB's medical students. For example, in the 1992-93 academic year, 88 percent of UB's 555 medical students received some level of financial support from scholarships, grants or loans. Total financial aid from all sources approximated$ 7.5 million. In the 1993 graduating class, 25 students had amassed accumulated debts of $50,000 or higher and one amassed a debt that exceeded $80,000. The average debt for the class neared $30,000. This year's Class Reunion Campaign dedicated its donations to the Medical Alumni Scholarship Fund, as will the next three campaigns. It is anticipated that over five years, a principal of $500,000 will exist; its annual revenues will be used to enrich existing scholarship support. The 1993 campaign provided a fine beginning to this goal with total contributions of about $90,000. These funds not only recognize academic merit and financial need, but reduce our students' debt burdens considerably. The students, faculty and I are thankful for your continued interest in UB and in the well-being of its medical student body. ~ Sincerely, (. J 0 ~, ~ j ohn Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Dear Fellow Alumni, W ith the beginning of a new academic year, your Medical Alumni Board looks forward to providing experiences that enrich our medical students, house officers and alumni. Recently, we welcomed the incoming residents and the freshman medical class. During the year, we hope to impart to these physicians and physicians-in-training a sense of camaraderie and a feeling of trust for one another that will help the profession go forward. Activities such as the community physician program and career presentations to freshman and sophomore students offer guidance by established physicians in the difficult choice of career planning. We plan another January reception for senior students, as well as a Match Day celebration for seniors, along with out-of-town receptions for alumni in other cities and at major medical meetings. The 1994 Distinguished Alumnus Award will be presented in September to Dr. Noel Rose. Dr. Rose's achievements in immunology have been the cornerstone of many techniques and developments utilized in daily clinical practice. His recognition is a source of pride for all our alumni. The flagship event of our alumni year is Spring Clinical Day and your board is busy putting together another informative event that will also give us an opportunity to renew old friendships. Again on this day, Alumni Achievement Awards will be presented. As your new Alumni Association president, I look forward to this year and I ask for your support in our endeavors. Please feel free to contact me with any of your suggestions. Sincerely, ~ Send address changes to: Buffalo Physrcian, 146 CFS Addiuon, 3435 Main Street, Buffalo, New York l4214 < ===- Russell W. Bessette '76 �V s 0 u a 2 L M M E N o 9 R 3 9 4 Research Hospital News II An Investment in the Future • UB's medical scholarships benefit the students, their benefactors and the profession. m Going Beyond the Curriculum e Today's medical students focus their free time on research and community service. E!J ASpoonful of Humor Using spare time wisely. Page 14. m Alumni EZJ Medical School IJ Classnotes * ~n t~e ~ouer: ffiilnren ~anes ann t~e first ~anes ~c~olar. ~arnara ~earne~. Mat'h Day '94: It was a very gaad year! Page 38. �.. . . . . . . .. . . .. . . . . . . .. . . . . . .. . .. . . .. . . . .. . . .. . . . . . . . . . .. . . . . . . [1] , ' _. I . Buffalo General Hospital to join in national stroke research study he Buffalo General Hospital's neurology department is participating in nationwide research comparing the effectiveness of aspirin with the anticoagulant Coumadin in preventing strokes among patients who have already suffered them. "The data should give doctors clearer scientific guidance about which treatment will best protect patients from a second stroke," said Patrick Pullicino, M.D., the study's principal investigator. The study will last two years and will enroll 2,000 patients in more than 30 centers throughout the United States. The Buffalo General Hospital study team, which includes collaborating investigator Frederick Munschauer, M.D., and study coordinator Margaret Hens , R.N., Buffalo General stroke projects coordinator, hopes to enroll about 60 patients. Patients eligible for the study must have had a stroke within 30 days and be between the ages of 30 and 85. Patients with cerebral hemorrhage, or who are unable to take Coumadin, are not eligible to participate. For further information, contact Pullicino at 845-3703. + New anesthesia regime reduces high-rtsk cardiac complications hanging the type and method of administering anesthesia and pain medication to high-risk surgery patients can dramatically reduce the risk of postoperative cardiac abnormalities and possibly lessen the chance of a heart attack, University at Buffalo researchers have found . A team of anesthesiologists led by Oscar de Leon-Casasola, M.D., UB asB u 0 0 p The study will compare the effectiveness of aspirin with Coumadin to prevent second strokes. sistant professor of anesthesiology, followed the surgery and early recovery of 198 patients admitted during one year to Roswell Park Cancer Institute for upper abdominal cancer surgery. One group of 88 patients received standard general anesthesia during surgery and morphine for pain after surgery, self-administered through an intravenous line. Another group of 110 patients received combined anesthesia therapy using bupivacaine and morphine via epidural. After the operation, the same two drugs, adjusted to pain control, continued to be administered by epidural. All patients had an electrocardiogram every 12 hours for three days following surgery to detect cardiac abnormalities. Results showed that patients in the epidural group had 51 percent fewer incidents of tachycardia (15 versus 58) , 12 percent fewer episodes of ischemia (five versus 15) and suffered no heart attacks. Three heart attacks were reh s c a n 5 ported in the general group; none was fatal. De Leon-Casasola said about 40 percent ofhigh-risk patients suffer ischemia after surgery; 8 to 20 percent suffer heart attacks. When surgeons at Roswell reported a significant drop in heart attacks following major cancer surgeries, a team of anesthesiologists began to investigate why. "We had been using combination therapy for about five years ," de LeonCasasola said, "and there was much data suggesting that patients receiving a combination of anesthesia agents via epidural had better outcomes. So we decided to take a look at that issue." Researchers theorize that the epidural anesthesia dilates the coronary blood vessels to help prevent ischemia and the morphine better controls pain to prevent nervous system stimulation. + B Y LOIS BAKER Smokers at rtsk for pertodontal disease,separate UB studies find making may be a key risk factor in periodontal disease , University at Buffalo researchers have concluded. Results of separate studies by Joseph Zambon, D.D.S. , Ph.D ., and Robert ]. Genco , D.D .S., Ph.D ., found that smokers experienced less attachment of tooth to bone and more bone loss around teeth than non-smokers. In a study of 1,426 adults ages 25 to 74, Zambon found that the loss offiber attachment of tooth to bone was three times greater among current smokers - 12.03 percent vs. 4.28 percent compared to non-smokers. Zambon, professor of periodontics, also reported a 120 percent increased risk of infection with bacteria that cause periodontal disease for every step in levels u m m e 9 9 4 �··· · · · · · ········· ·· ··· ·· · · · · ··················································· · ········· · • .. . . from light to heavy smoking. He reported current smokers had higher levels of Actinomyces actinomy-cetemcomitans, Bacteriodes forsythus and Porphyromonas gingival is- all of which cause periodontal disease- than non-smokers. Genco, chair of oral biology, studied 1,361 adults ages 25 to 74. He found that smoking increased bone loss around teeth, a risk that increased from 3.34 to 7.35 times from light to heavy smokers. Researchers included Sara Grossi, D.D.S., senior research scientist; E. E. Machtei, D.M.D., visiting associate professor; Alex W. Ho, research support specialist; Robert Dunford, senior scientific programmer; and Ernest Hausmann, D.M.D., Ph.D., all with the + department of oral biology. - B Y M ARY BET H S "We are making new versions of human hemoglobin by growing the pro- _ tein in bacteria and doing site-directed mutagenesis," he explained. "We can change any amino acid in a protein into any other amino acid we choose. In this way, we hope ultimately to design a molecule that will function optimally as a blood substitute." + - BY a l. o p h II l The grant will allow UB researchers to continue developing a synthetic form of hemoglobin. that will function outside a red cell, explained that when hemoglobin is removed from red cells it binds oxygen so tightly "a person could have a generous supply of oxygen and still suffocate because the oxygen wouldn't be released to the tissues." Noble's approach involves manipulating the amino acid sequence of the hemoglobin molecule and observing how its structure affects its function . y 5 BAKER multi-center study in which UB researchers from The Children's Hospital of Buffalo participated, has found that high-dose intravenous respiratory syncytial virus immune globulin is a safe and effective means to reduce the severity of the disease in children. The three-year study involved 249 highrisk children in Buffalo, Rochester, Boston, Washington, D.C. and Denver. Debra A. Tristram, M.D., and Robert C. Welliver, M.D., of the center for infectious diseases at Children's, were supporting investigators for the study, published late last year in The New England journal of Medicine. Tristram said between 35 and 40 children have been treated with RSV immune globulin at Children's. "Overall, the treatments had good benefits for the children in the study. They had less respiratory ailments and were less likely to acquire severe RSV," Tristram said. The new treatment compound uses antibodies extracted from the blood of volunteers such as pediatric nurses who have been exposed to RSV and have high RSV antibody levels. "Children were hospitalized less often and required less intensive care treatment than· children without the infusions," Welliver added. + UB receives $1.1 million grant to continue hemoglobin research B LOIS New treatment compound found eiTective in reducing RSV severity PINA esearchers at UB have received a $1.1 million grant to continue developing a synthetic form of hemoglobin, joining researchers from five other institutions participating in the $6 million, fiveyear study funded by theN ational Heart, Lung and Blood Institution. Robert Noble, Ph.D., professor of medicine and chief of the laboratory of protein chemistry at the Buffalo VA Medical Center, is principal investigator on the UB project. The new funding will allow the team to continue research begun with a $1.3 million grant in 1988. "We are trying to obtain the fundamental knowledge that will enable us to design a molecule that will serve better as a blood substitute than normal hemoglobin," Noble said. Noble, whose team is concentrating on developing a form of hemoglobin ' . c a S u m m e 9 9 4 0 �"Chemo Coach"program begins in Western New York hospitals RPCI opens area'sfirst regional Brain Tumor Treatment Center he American Cancer Society's "Chemo Coach" program, which matches chemotherapy patients with one-year post-chemo patients for support, has begun in Western New York hospitals. The program, developed by ACS's Erie County Unit, recently won the society's award for being the most innovative program in the nation. "The program is based on the belief that someone who has 'been there' will encourage and empower the patient. Healing and wellness is promoted by motivation, encouragement , caring and support," said Hillary Ruchlin, director of patient services for the Erie County Unit of the ACS. All coaches are trained not to dispense any medical information or advice and have completed volunteer training. The program, begun last August after nearly two and a half years of development , has served 275 patients to date. It will be introduced nationwide this year. "We match patients and coaches according to age and type and location of cancer. The coaches then meet the needs of the patients by providing information and support and showing them that there is life after chemo," Ruchlin added. Seventy-five chemo coaches have been trained and are available through the Erie County ACS office. The program is available through patient or physician referral. For more information, call689-6981. + n recognition of the somewhat higher incidence of brain tumors in Western New York than in the nation, Roswell Park Cancer Institute has opened a Brain Tumor Treatment Center- the area's first major regional referral center for the multidisciplinary management of patients with brain tumors. B u a 0 p national Chemo Coach program was developed by the ACS' s Erie County Unit. "The Brain Tumor Treatment Center will provide for comprehensive treatment of all types of brain tumors in adults at one centralized location in Western New York," said Kyu H. Shin, M.D., professor and chairman of radiation oncology at UB and chairman of the department of radiation medicine at Roswell. Shin is one of the founders of the new center. h y 5 c a S The center - headed by neurooncologist Laszlo Mechtler, M.D. , clinical assistant instructor and assistant professor of neurology- is a collaborative effort between Roswell, The Buffalo General Hospital, The Children's Hospital of Buffalo, Millard Fillmore Health System and Erie County Medical Center. "By combining these resources and expertise, the scope of care provided goes far beyond what is available in community hospitals and at other regional teaching centers," noted Shin. The center provides diagnostic, treatment and surgical services in multi-specialty areas. In neuro-oncology, under the direction of Mechtler, neuroimaging, chemotherapy (including intra-arterial and intrathecal), neuro-oncological care and neurooncologic pain management are offered. In neurology and neuroimmunology, under the direction of Steven Greenberg, M.D., assistant professor of neurology, microbiology and immunology and chairman of the department of neurology at Roswell, services offered include neurological care, molecular diagnosis and a tumor tissue repository. In neurosurgery, under the direction of Walter Grand, M.D., clinical professor of neurosurgery, and Charles R. West, associate professor of neurosurgery and chairman of neurosurgery at Roswell, services offered include stereotactic biopsy and surgery, both invasive and superselective neuroradiology and photodynamic therapy. In radiation medicine, under the direction of Shin, services offered include radiosurgery, interstitial brachytherapy of brain tumors, photodynamic therapy, u m m e 9 9 4 �intracavitary radiation therapy and cerebral spinal axis radiation. Patients may be referred to the Brain Tumor Treatment Center by calling the Patient Referral Office at 1-800ROSWELL. + must be screened and cleared by their physicians," Ward noted. Since the startup of Western New York's only lithotripsy service in December 1986, urologists have performed nearly 7,000 non-invasive treatments on kidney stone patients at The Buffalo + General Hospital. Memorial Pediatrics provides wellchild care, sick care, immunizations, sports and school physicals, lead testing, birth control, teenage counseling, supportive services for physical and sexual abuse and 24-hour emergency coverage. + iagara Falls Memorial Medical Center has opened a pediatric primary care center. Formerly known as the "Kid's Clinic," Memorial Pediatrics, at 501 TenthStreetinNiagaraFalls, has evolved from a part-time clinic to a full-time pediatric service to improve the quality and continuity of care for families living in the Niagara Falls area. "Our goal is to serve the people in this community who don't currently have physicians," saidjack Coyne, M.D., the program's medical director. "We're here to offer comprehensive, quality health care for families in a pleasant, sensitive atmosphere." appointed president of the medicaVdental staff at Buffalo Columbus Hospital. A native of Cuba, Perez-Bode earned his doctorate of dental surgery at the University of Havana's School of Dentistry. After coming to the United States as a refugee in 1968, he received his New York State dental degree from the University at Buffalo School of Dentistry. He has been on the staff of Columbus Hospital since 1989. A member of the Cuban Dental Association in Exile, he served as vice president of the medicaV dental staff at Columbus before his appointment as president. + Buffalo General introduces new "waterless"lithotripsy technology Niagara Falls Memorial Medical Perez-Bode named president of Columbus Hospital medical staff he Buffalo General Hospital, which Center opens Memorial Pediatrics pioneered the use of extra-corpoene Perez-Bode, D.D.S. , has been real shock wave lithotripsy in Western ew York, has added waterless technology to the water bath lithrotripsy it introduced more than seven years ago. The move is expected to reduce a patient's length of stay to less than one day in most cases and minimize the pain associated with the procedure. During a "dry" lithotripsy procedure, a gel-like substance is applied to the patient's back, which is then positioned against a small water-filled cushion. "Because there is less pain associated with the new technology, the need for general anesthesia is eliminated in most cases. An intravenous sedation is used instead, allowing the patient to return home the same day," said Phyllis Ward, nurse coordinator of lithotripsy services at BGH. "Since the patient is no longer immersed in water, the visualization of the kidney stone by X-ray equipment is dramatically improved and the length of time to localize the stone also is decreased," Ward added. Ward also said that a patient's sizean important consideration in water bath lithotripsy - is no longer an issue. Even with the new technology, she noted, some of the previous eligibility criteria still apply. "Pregnant women still are not candidates for the procedure, and people with cardiac problems e u a 0 p h Memorial Pediatrics will provide full-time pediatric services to families in the Niagara Falls area. y s c a n s m m e 9 9 4 �Investing in the U:U'8 med:ieft;I 8ehoift;:r8h:ip8 p8;y d:i-v:ideii.d8 :ro:r ~he 8~-...deii.~8, ~he:i:r beii.e:rft;e~o:r8 ft;II.d ~he p:ro:re88:iOII. In the 0 ffices of the University at Buffalo Foundation, there is a list. On the list are a couple of dozen names. And on those names hangs the educational fate of a great many future physicians. O 6 u ffo lo Ph ~stcton S u m m e r I 9 9 4 �Pho"to8 b y Do-..g;Ia-8 Le-vere B u a 0 p s c a n s m m e 9 9 4 �~~Themo. .e y ~O-S a-ya-i_In-b i e ft-II_di -tho-..g;h-t;, ~ha--t's -the bes-t; -..se i_-t;!' I o~ deei_ded -t;hn--t;, 0--t; ~o:r Ien-s-t pa-:r-t; I -the gn-Ye -t;o -the medi_en-I sehooi, I ~a-.._-ted -t;o hn-Ye some-t;hi_.._g pe:rmn-.._e.._-t;. EYe.._ a-:1:-t;e:r I ' m go.._e i_-t; ~••• s-t;i_II b e -there.'' 'T'I•cl ma, ~a..-.e~ .~ 0 B u f f a 0 p h y 5 c a n 5 m m e 9 9 4 �It's the listofpeople who have made a commitment to the next generation of healers: they've endowed scholarships for students learning their craft at the UB School of Medicine and Biomedical Sciences. Some are alumni of the medical school, giving back a token of what their education has made it possible for them to earn. Some are former faculty members who've seen firsthand the bright, committed young people who continue to enter the profession. Some are just interested citizens who know that, despite UB's relatively reasonable tuition costs, some students would not be able to make their dreams happen without significant financial aid. And some who have endowed these scholarships, it must be said, are no longer with us. It's an irony of charitable giving that so often a gift is made in the form of a bequest - a provision in one's will. Such support, of course, can be vitally important in building up the endowment funds that are the basis for the medical school's scholarship programs. But other donors have found that there's nothing so satisfying as actually watching your money go to work, seeing the good that you can do in individual lives. Ask Thelma Sanes. A handful of years ago, Sanes established the Harold Sanes and Thelma Sanes Medical Scholarship with a major donation to the school. The scholarship- named for Thelma and her late brother Harold- was in recognition and memory of their late brother Samuel, professor of pathology at the medical school for many years and head of pathology at the former Meyer Memorial Hospital (now Erie County Medical Center). B 0 0 p 0 5 m m e 9 9 0 �Harold Sanes had passed away in 1986. ButThelmaSanes can watch with pride the results of their living gift to the future of the medical profession their brother loved so much and gave so much to . This year, the first of the "Sanes Scholars" graduated from the medical school; at any one time, four such students receive aid from the Sanes B u a 0 p grant. The scholarships, which nearly cover the school's $8 ,450 annual tuition, are renewable for each year of a student's education. "I had written up how I wanted the scholarships to be paid," Sanes said. "They're given every year, but the students who get them, get them for four years. I felt that anybody who met the criteria of the scholarship is someone 5 c a S who is in need , and I didn't want to dump them after freshman year. " The scholars have a genuine affection for their benefactress. "Most of the winners have written me letters of appreciation," Sanes said. "Occasionally I even get a Christmas card from one of them. They're very nice people. " There's an annual luncheon as well, she said, at which donors and scholar- u m m e 9 9 4 �ship winners can meet. Sanes said she has made provision in her will, as well, for an additional donation- "to cover inflation." "I figured, there's going to be enough left. Part of it should go where it will do some good." That it has. The first Sanes Scholar, Barbara P. Kearney, graduated on May 15, having had the scholarship for all four years of her medical education. "It was wonderful," Kearney said of the day she learned she had won the scholarship. By invitation, she had written a brief essay about her accomplishments and stated the case for her financial needs. The good news came in a phone call from Thomas ] . Guttuso, M.D., assistant dean for admissions. Between then and graduation, of course, were the strenuous four years that begin to turn scholars into physicians. But through all the work that those years entailed, Kearney said, she knew that the endowed scholarship - in her case, $5,500 annually -was there to help make it possible. A lot of her fellow students, she pointed out, will leave UB medical school with crushing debt burdens. "I still have some loans that I've taken out," she said. "I had to buy a car, and there are the books. But it's only about half of what I would have had to take out." What that means, she said, is flexibility in choosing a field of practice. (New residents who are tens of thousands of dollars in debt can feel pushed into a high-paying specialization.) Kearney began her residency in pathology with the Graduate Medical Dental Education Consortium of Buffalo onjune 12. "A lot of my friends have parents and relatives who've helped them along through school," she said. "But that's not possible for everyone. 8 0 0 p "Any scholarship or any kind of grant that can be made available, I strongly encourage (potential donors) to do that." Even gifts of smaller scope can make a significant difference in the scholarship aid the school can distribute, said Guttuso. By pooling smaller gifts, the medical school can assemble scholarships for those in need. Right now, he said, about 35 students are benefiting from scholarships that total around $60,000 annually. "It's our hope," Guttuso said, "that we can build a scholarship fund that will enable us to help close to half the class each year." Each class of the medical school has 135 students. Guttuso said students are considered for aid based both on their academic promise and on their financial need. Twenty "scholar incentive awards" are given to applicants solely on their academic promise, he said"we're trying to attract the most intelligent students to come to our institution." But for all other scholarships, need is a factor in the decision. Each spring, Guttuso said, his five-person scholarship committee sits down and sifts through the applicants for aid. It's a wrenching process. "It's kind of tough sometimes, when you get down to 50 or 45 students," he said. "To eliminate some is hard, because they all really need it. That's why we're hoping that we can expand the program to help a greater proportion of the students." Except for the minimal Regents Scholarships, New York State provides no money for scholarships, notedjohn A. Richert, Ed.D. , associate dean for alumni affairs at the medical school. "Monies are few and far between," he said. One major initiative to expand scholarship assistance is the establish- 5 a 5 scope cn..IJ.. d i ffe:reiJ..ce schoo1 cn..IJ.. ASSISTANT DEAN FOR ADMISSIONS m m e 9 9 4 �ment of Medical Alumni Scholarships, to be funded by those who know best how expensive it can be to go through medical school - the alumni themselves. Dr. Donald P. Copley, a cardiologist who was president of the Medical Alumni Association last year when this plan took shape, explains. "Last vear when we began organizing for the reunion class spring session, I brought this idea up to all the (class reunion) chairmen at the same time," he said. "The question I posed was, if we pull together and all of the classes got together quite a few thousand dollars, and the (Medical) Alumni Association promised to retain an identity for everybody involved- that is, identify particular students and maybe associate them with particular classes and link up person-to-person - would the chairmen and their constituencies be interested? "It turned out there was a pretty universal enthusiasm for the idea." So for the '93 class reunions, again this year and for the next three years, alumni class gifts to the school will be funneled into what promises to become a major scholarship endowment. (The five-year cycle was established to give members of every class the opportunity to contribute. Some individual classes, notably the Classes of 1957 and 1973, already have established scholarship funds; but this is the first time all the classes together have the opportunity to contribute to a combined fund.) Class gifts to the school have averaged around $100,000 each year, Copley said, and planners of the Medi- B a 0 p cal Alumni Scholarships hope to ex- books," says Claudia Jaramillo, anpand on those figures . "We're shoot- other alumni scholarship recipient. ing for $1 million," he said, "but at "That's usually what it comes to for a this point it's awfully hard to tell year (of books). (whether that goal is attainable). If we "The budget usually fora (UB) medigot to $500,000 or $600,000, we'd cal student is about $20,000 a year, still be quite happy about it." especially if you're not living at home. There was some controversy, he But still, anything you can get, espenoted, over whether recipients of the cially $1,000, is definitely helpful." scholarships should be chosen on acaFellow recipient] eannie Kao notes demic merit or simply on need. "Half that her student loan was reduced by the people I talked to thought that the amount of the alumni scholarneed should be a major consideration, ship, "and to have that be $1,000 less so that people who had no resources is really nice." With interest, of course, or very little resources would be the loan repayment can be much greater ones who were offered the scholar- than the principal borrowed, so a ships," Copley said. "An equal num- $4,000 reduction (the scholarships ber of my constituency thought that are for all four years) is a major benefit merit should be the only criterion." down the road. The outcome: a time-honored com"As a medical student," says scholpromise, in which academic merit arship recipient Frank M. Lee, "you will be the primary focus in half the really don't have the time to take on a scholarships, financial need the de- job except in the summertime. The termining factor in the other half. scholarship does cover my books at "The idea," Copley said, "is to carry least, which is nice. each of these individuals through four "Since UB is not really that expenyears of school." He noted that john sive to start off with, you do come out P. aughton, M.D., dean of the medi- with a debt, it's not in the hundreds of cal school, has supported the alumni thousands but still it's something you initiative with some discretionary have to think about. The scholarship money he has available. "Dean makes more of a difference in a school Naughton was particularly enthusi- like ours," because it represents a astic and helpful," Copley said. greater portion of the cost of medical Already the Medical Alumni Schol- education. For those with the means to make arships are providing significant support to first-year students. "It's a great a major gift of scholarship money, UB feeling to pick up that $500 check at offers two possibilities: an annual the start of each semester," says one scholarship or an endowed scholarsuch student,]ason M. Andrus. "It's a ship, both of which can be established couple months' rent. It's a terrific through the Office of University Defeeling to think that your school thinks velopment. An annual scholarship is a gift of that you're unique and they're going out of their way to assist you like about $8,000 or more for one year, or that. " annually for several years, to support "Definitely it helps, especially with a student's educational expenses for s c o n 5 m m e 9 �those years. By contrast, an endowed scholarship is a gift of at least $150,000 that is then permanently invested and the income used as scholarship assistance. It's a gift that continues beyond the donor's lifetime. Michael E. Benzin, associate director of special, annual and regional giving for the University at Buffalo Foundation, noted that the foundation has experience in handling gifts of all sizes. The endowment managed by the foundation for the university is now $40 million. (Donations earmarked for the medical school are managed by the B 0 0 p h foundation, but the school itself decides who is to receive the scholarship money they generate.) Unrestricted gifts are encouraged, because they afford the most flexibility in meeting students' scholarship needs. But major donors , Benzin said, can structure their gifts in any number of ways. For example, if a surgeon wants to endow a scholarship that would go only to students who aspire to surgery, that's entirely possible. Or, he said, "if (the donor) worked his way through medical school and would like to assist a student who's in that situation, you can do that, too ." s c a S u Benzin said endowment money is invested conservatively and that a part of the interest is channeled back into the principal so that its "buying power" isn't eroded by inflation. And he reminded potential donors about the james Platt White Society, founded in 1986 to honor donors to the medical school of$1,000 or more. Named after a founder of the school, the society has about 200 members. As Barbara Kearney , the new pathology resident, said of her Sanes scholarship: "There's just so many people out there who could benefit from something like this. " + m m e 9 4 ��o ree time is a scarce commodity for medical students. But one Saturday morning this spring, Amy Ferry was spending some of hers with a homeless man in Buffalo's City Mission. The pain in his feet and knees had gotten so bad he was having trouble walking. And he was feeling run down and depressed. "Any drugs?" asked Ferry, who was completing her fourth year at the UB School of Medicine and Biomedical Sciences. Not any mor_e, the man said, but he still drank. "Do you see your drinking as a problem?" Ferry asked. "I see me as a problem, period," the man replied. After the man had been referred for further treatment, Ferry reflected on why she was devoting this morning to Project Hope, the weekly City Mission clinic run by student volunteers from the UB medical school. "Doctors are expected to be involved in the community," she said simply It's the same reason she spent last summer on Capitol Hill, lobbying over tobacco and mammographies. "It's part of learning to be a doctor," she added. Ferry is among the large number of medical students who take it upon themselves to extend their educations beyond the curriculum requirements. Some work in clinics with underserved populations. Some teach health lessons to school children. Others spend long hours in the laboratory helping to carry out research. They do it to varying degrees and for a variety of reasons: a sense of social responsibility, intellectual curiosity, clinical experience, diversion, career advancement or just the challenge. e a 0 p h y 5 c a n S u m m e 9 9 4 �~ ~ese are talented kids in many respects, and they do a lot of things, " said Richard] ones, Ph.D., medical school registrar . No one keeps tabs on exactly how many students take part in activities that aren't required but are professionally relevant. Thomas Flanagan, Ph.D ., chairman of the Student Research Committee, said that at last count, several years ago , more than 300 UB medical students were involved in research. Recent projects include investigations into DNA, the epidemiology of neuroblastoma in New York State, alcohol-related injuries in children and adolescents and the exposure of medical students to blood and body fluids . And student leaders estimate that half to three-quarters of their classmates get involved in some type of voluntary service activity, from medical clubs to clinic work. Among the larger student initiatives are Project Hope and a pair of programs that put medical students into the schools to teach children about AIDS and healthy diet. "Most students will get involved even at a peripheral level in something," said Melanie McNally, 1993-94 president of Polity, the medical school's student government council. Those who do get involved may spend less than an hour a week on outside activities. Research, however, can easily take several hours a week. And some students find themselves with the equivalent of a part-time job. "I think a lot of it depends on how you handle your own stresses," said Eileen Killackey, a Project Hope volunteer who is going into her third year. "I think it depends on what you're most concerned about doing while you're in medical school. .. . In a way, it's something to keep you going. It gets you out of the classroom and in touch with what you're actually going to be doing at the end of four years. It's like light at the end of the tunnel. " But getting involved at more than a peripheral level can force students to make tough choices. "Your grades can reflect it," said B u a 0 ence on match day. "If you're visible , it does go down in your dean's letter," said McNally. "Right now, that's the only non-personal benefit you get out of it. " But it's the personal benefits that often matter most. It's not uncommon for students to describe their volunteer work in terms of social and professional responsibility. Many see the work as a way of helping others while preparing themselves to become better physicians. "It's definitely a two-way street," said Sarah Ballow, a Project Hope volunteer going into her third year. "Most of the people who get involved in these activities have a desire to do something," said McNally. "That's why they got into medical school in the first place - because they wanted to do something for their community." Flanagan said that while many student researchers take on their projects with an eye toward honors and residencies, a good number do it out of simple intellectual curiosity. "Some have a specific disease interest that they want to pursue," he said. "Some kids have had no research experience and just want to see what it is. " The research projects cover a broad spectrum, from laboratory "bench" research, to clinical investigations and even health policy work. Every year, the medical school supports about 20 students in its 10-week Summer Research Fellowship program. Applicants must submit detailed proposals, and only about half are accepted, said Flanagan. But in most cases, student researchers get started simply by talking to a professor and signing on to projects already under way. Many do it in the summer after their first or second year, when there's a little more time. And if there's a grant supporting the project and some money to spare, there may be a stipend in it for the student. Tom Guttuso,jr. , said that when he started medical school he didn't plan to become a researcher, but he became engrossed in the laboratory after his first year and the experience has "completely changed" his medical education. Guttuso received a summer research fellowship in 1992 to work with physi- Michael Landi, M.D., a Class of 1994 member who conducted several research projects. "I know my first-year and second-year grades were probably a little bit lower because of the time I put into research ." McNally said her student government work has forced her to manage time better - to a degree. "You make the time, you really do ," she said. "Then you go and beg your professors to have mercy. " Dennis A. Nadler, M.D., associate dean for academic and curricular affairs, said UB encourages students to go beyond the classroom. "Our university," he said, "stands on a three-legged stool -academics, research and service." Official encouragement, however, has been somewhat uneven. Some students who participate in research can garner extra points toward Latin graduation honors . But no points are awarded for those who participate in community or university service, such as volunteering at a clinic or serving as a student representative on a university committee. That may be changing. Nadler recommended last year that service activities be rewarded with graduation honors, and as early as this fall- depending on the outcome of a faculty council meeting in late May- a revised honors system could take effect. Under it, new categories of diploma honors would be created for research and volunteer service. Latin honors would revert to the traditional system, in which they are bestowed strictly for academic achievement. "We really feel that we have a commitment to serve the community as a medical school, and that extends all the way down to the students," said Nadler. "What we haven't had in the past was an adequate way of rewarding the students." Even without honors, extracurricular work can mean career benefits. "So many residency programs are interested in whether students have done any research," said Flanagan, a microbiology professor who oversees the medical school's Research Forum and Summer Research Fellowship programs. In some cases, community and university service could also make a differ- p h 6 c a n 5 u m m e 9 9 4 �ology professor Susan Udin, Ph.D., on visual plasticity in frogs. "We were working on basically trying to get the visual nervous system to reorganize and heal after it's been damaged and I just kind of fell in love with it. "I ended up really digging it so much that I did it through the second year of medical school - before classes, after classes, during some of the more boring classes." Then he took off the 1993-94 academic year, which would have been his third, for full-time study of the hormone melatonin with a $23,000 grant from the Howard Hughes Medical Institute. Guttuso was unable to prove an effect on frog visual systems, so he switched gears to pursue his theory that melatonin could prevent or slow the development of Parkinson's Disease. "It's been a lot of work to get this model up and running," he said. But, he added, the results could be much more clinically relevant than his original line of inquiry. His results, unfortunately, have been "inconclusive," but because of a design flaw in the experiment rather than his theory. Guttuso "hopes to do it again this summer." Ultimately, Guttuso said he would like to make research part of his career, mixing it with clinical practice, possibly in neurology. "It's put the thought into my head that I'm going to do something that I never expected to do when I entered medical school," he said. "Once a student gets involved in research, they very frequently will continue," said Flanagan. "They will do it in B u 0 0 f' h gery residency at Mercy Hospital in Buffalo this year, has been involved in several research projects, including a study into the exposure of medical students to patient blood and body fluids. He said he found that about 30 percent ofUB's class of 1993 was exposed through needle sticks, mucous membrane splashes and other means during third-year rotations. "That's pretty consistent with the class of 1994, too," he added. The study began when Landi read a letter in the medical school newspaper from a former student who had contracted hepatitis during her rotations. A snafu left the woman unaware for several weeks that she had tested positive for hepatitis, prompting Landi to look into student exposure rates and the policies for dealing with such cases. "It was just because I was kind of offended," he said. Landi, who is submitting the UB study for publication, is still reviewing results from a larger subsequent survey he conducted with another UB student of exposure rates at seven medical schools across New York State. He also helped develop a comprehensive policy for UB's consortium of teaching hospitals to handle student exposure cases. Previously, there was no consortium-wide policy. Landi never calculated how much time he put into his research, but he remembers spending a lot of evenings and weekends with it. "I wouldsayit'sagood parttime job," he said. "It gets kind of labor intensive when paper writing comes around. " Students who take on significant extracurricular responsibilities say it forces their free time during the school year. They don't have a lot of time, but they make time." Under the graduation honors policy in effect in recent years, students could earn Latin honors points if their work was accepted for presentation at the annual Research Forum, and their supervisor approved. "A lot of the work is very good and leads to publication," Flanagan added. The medical school encourages re- search, partly to make students aware of the career possibilities, but also to turn out more rounded clinical physicians. "It's one thing to read the outcome of research and another thing to actually conduct it, to confront the solving of problems, to be frustrated by things that don't come out the way you expect them to," Flanagan said. Landi, who is beginning a neurosur- y s c o n S u m m e 9 9 4 �them to set prionttes. "Some people manage to pull off the top grades even with this, but most of us are in the B range," said McNally, the Polity leader. Many students describe their extracurricular activities as a good way to experience a broader world that will be relevant to their professional futures. McNally said that in being responsible for the $88,000 in student activity funds distributed by Polity, she's learned something about accounting. "I have become very interested in the administrative side of medicine," she added. "I've found that I'm very good at this, and I'm hoping to make it part of my career." At Project Hope, students deal with unteers how to take histories and talk with the homeless patients. "I've always been interested in serving underserved populations ," said Ballow, who worked in a soup kitchen during her high school years in Connecticut. This summer, she will conduct US-sponsored research at a Navaho reservation in Arizona. She has also managed to keep up a relationship with her boyfriend, who lives four hours away in Pittsburgh. ''I'm a very organized person," she said with a smile. Project Hope began several years ago as an outgrowth of a City Mission clinic run by the School of Nursing. "We just wanted to do more outside the classroom, to use what we were learning," said Joe Kay, M.D., who graduated this year to begin a residency in internal medicine and pediatrics. Kay said he enjoyed his time with the clinic. "You're doing it because you want to, rather than being evaluated all the time," he said. "It's a different atmosphere than the hospital. It gives you an idea of the problems with the health care system, too ." Many students involved with Project Hope agree that the experience has affected them. "I always find that talking to the patient is a very humbling experience," said Killackey. "Medically speaking right now, I don't know how best to help people because I don't have the clinical skills. But with situations they might not see on hospi- these community projects, you find out that your just being attentive and listental wards. "If someone comes in with a simple ing to these men and women can make foot fungus, you tell them to clean their a big difference." There are limits, howfoot and change their socks," said Cook. ever, to how much students can take on. "Then you find out they only have Ferry, who will begin her residency this one pair of socks." year in obstetrics and gynecology, served About 60 students are involved in two years as regional student co-coordiProject Hope, according to Ballow, who nator for the American Medical Women's helps administer the program. Each of Association. "They wanted me to run those students spends at least one Satur- for national co-coordinator," she reday morning at the clinic. Ballow is called. "I said not while I'm an internthere once a month, showing new vol- no way, no how." + "0 think there is definitely a trade-off," said Stephen Cook, who in his first two years has been involved in Project Hope, a pair of Buffalo pediatric clinics and the Primary Care Club. Recently, he also initiated an undergraduate clinic for Niagara University students interested in medicine. "I enjoy doing these things," he said. "It's time I could spend learning gross anatomy or biochemistry, but that's the type of person I am. I'm a more humanistic person. I like dealing with people." Noah Sabin, a 30-yearold attorney who just finished his first year at UB medical school, has been adding to his list of responsibilities. During his first year, Sabin was elected vice president of the American Medical StudentAssociation chapter. He also signed on to a national AMSA task force on tort reform, and will work on environmental health issues with Rep. David Obey, DWisconsin, in Washington this summer as an AMSA fellow. In addition, Sabin said he tries making time to exercise and keep up on his nonmedical reading and current affairs. He described time management as something that's subject to amendment as exam results come back. "I sort of have a sense from looking back at law school of how much those grades really meant in the long run," he added. "They meant a lot if you're looking for a certain amount of prestige in a certain field . ... (But) the people defining what's most prestigious have spent their entire lives in those environments, and they don't really know what else is out there." B u a 0 p h 5 c a n 5 m m e 9 4 �M edical school makes a lot of demands, but it doesn't demand that students volunteer their time for research or public service. Yet many do . Here are some of the things they're involved with: RESEARCH "The student research at UB takes a number of faces, " said Luther Robinson , M.D. , assistant dean of student affairs. Student work ranges from basic biology to the genetic basis of cancer. "The spectrum of research in medicine contributes to the intellectual climate in medical school," Robinson added. Students most frequently get involved by approaching a professor already carrying out a research project. Some departments have grants to sponsor research opportunities, as well. And each year the university supports about 20 students in its Summer Research Fellowship program. Applicants must submit detailed proposals to a faculty committee for the full-time, IO-week program. In addition, student researchers can apply to present their work at the annual Research Forum. At the last forum, in December, more than 70 students made presentations. "This is not the science fair ," said Thomas Flanagan, Ph.D. , chairman of the Student Research Committee. "This is real research. " PROJECT HOPE About 60 students are involved in this Buffalo City Mission clinic, a u 0 0 p American Medical Student Association, the AIDS-prevention program began at UB last year. Since then it's reached nearly 10,000 students in Buffalo-area junior high and high schools. About 55 first- and second-year medical students take part. "We talk about the biological aspects of AIDS- transmission and prevention," said Beth MacDonald, who just finished her second year and is STATS coordinator. "The questions are usually very specific and very explicit," she added. "The questions show that the kids obviously need to learn." which is an expansion of a clinic started earlier by UB's School of Nursing. Each Saturday morning, four or five first- , second- and fourthyear medical students attend. They are joined by a nurse and physician. The first- and second-year students take histories and vital signs, then observe as the fourth-year student conducts an examination. They present their findings to the physician, who then conducts a final examination. Among the administrative problems faced by student organizers has been a lack of insurance for physicians who volunteered to attend. Recently, Project Hope became affiliated with Sheehan Memorial Hospital, which has been rotating physicians to the clinic every other week. "The credit goes to the medical students," said Raul Vazquez, M.D., of Sheehan's Family Care Center, who was attending the clinic one day this spring. Vazquez, a member ofUB's Class of 1989, said that while students were interested in such volunteer work when he was in medical school , programs like Project Hope didn't yet exist. GET HEART SMART In this four-year-old program, medical students visit local fifthgrade classes in teams of four or five to deliver presentations on avoiding heart disease. The 70 participating students, mostly in their first year, reach several thousand 10and 11-year-olds annually. "That's the age to get them, when they're still impressionable and don't have any heart disease," said Brad Davis, who ran the program i.n 199293. "We really consider it the purest form of preventive medicine." PEDIATRIC CLINICS STATS Teen-agers don't like listening to those they see as adults. But if they're told something by another student, particularly if that student is wearing jeans and a t-shirt, the message might get through. That's the theory behind Students Teaching AIDS To Students. Launched several years ago by the s c a S u About 20 to 30 students per semester attend pediatric clinics at the Roberto Clemente and jesse E. Nash health centers in Buffalo. They're mostly in their first and second years, and they help the health center staff with growth charts and sometimes with immunizations. + m m e 9 9 �A Spoon f u I of Humor© ADVICE FROM SOMEONE WHO ' S BEEN THERE ince this issue of Buffalo Phy sician features topics on medical school, I started thinking back to those days. Despite their complications, intricacies, similarities and differences, professors can basically be divided into five categories: tf . MIGHTY FAMOUS BIG SHOT ~ - THE DISDAINFUl EGGHEAD Advantages: His course includes attach- Advantages: Draws in grant money B u a 0 p and monolith residents to the department. Disadvantages: Speaks with a difficult-tounderstand South African accent, despite having spent all his life in a suburb of Cleveland. Choice in clothing qualifies him as legally blind. Warning: May be hazardous to your health. ing state-of-the-art electrodes to the lacrimal glands of domestically raised coyotes, making for interesting chit-chat at family gatherings. Disadvantages: Hates M.D.s and considers them technicians. Warning: Sit in the back row and avoid making eye contact. A ·THE NOVICE DRONER Advantages: Meticulously organized ~.PROFESSOR IN TRUCK DRIVER OUTFIT Advantages: Chain-smoking genius. Car- handouts make going to class very unnecessary. Disadvantages: Includes material that nobody ever heard of, including the people she is citing. Includes material nobody cares about. Warning: This is what the boards and cocktail parties are like. ries lecture notes in a Metallica lunchpail. Disadvantages: Cyanotic mouth breather, occasionally desaturates while lecturing. 5 c a n s /!; . PSYCHIATRIST FROM liCHTENSTEIN Advantages: His three lectures can be u m m e 9 9 4 · �Stu S i Ivers t e in M . D. ~ The social worker making rounds spontaneously combusts from boredom. ~ The patient loses patience and presents hmself to the housestaff. ~ The attending asks you to pull his finger. ~ Alfred Hitchcock walks through the group. ~ The team breaks up into small discussion groups in the stairwell. + FOR THOSE OF YOU who have friends or relatives about to attend medical school, here are some basic rules for success: summed up in one sentence: People who are terminally ill often get depressed. Disadvantages: See above. Warning: When you get depressed you will wait in line with your classmates to see him. , ~ Avoid lecture halls. on rounds, start each sentence with "According to the literature, occurs in 5% (or 95%) of the cases." ~ ever say, "I didn't get the lab results." It's always, "They're not back yet." ~ Begin rounds by handing out articles , nobody will read them anyway, so just randomly photocopy them. ~ Grow a beard with no mustache and nod your head up and down like a toy dog. (Males only please.) ~ Keep repeating, "great case, good pathology," until somebody notices you're naked from the waist up. ~ Offer to look at the smear several times during rounds while staring at the lab reports. ~ ~eep referring to your stethoscope as your pal Hector. ~ When Stu Silverstein, M.D., president of Standup Medicine Seminars of San Francisco, California, lectures nationwide on humor in SIGNS THATYOU ARE BORING ON ROUNDS: ~ You are a medical student. ~ Twenty minutes into your presentation the attending says, "how old was that patient? " ~ The patient asks you to leave the bedside because everyone else left for GI rounds 20 minutes ago. ~ When you present the lab results, the intern punches a bunch of numbers into his pocket calculator, looks up and asks if you also get expensive phone bills. ~ The chief resident pulls you aside to tell you you're too intense, relax or he'll give you a wedgie. B a 0 p h ~ 9 c a n 5 m m e 9 9 4 �Mixing medicine and business VIRGINIA WELDON '62, USES BOTH HER MEDICAL EDUCATION AND CORPORATE EXPERIENCE AS SENIOR VP FOR PUBLIC POLICY FOR MONSANTO COMPANY fter listening to a description of her assignments at the Monsanto Company, one of the nation's largest multi-billion dollar enterprises, you might think Virginia V. Weldon possesses degrees in chemical engineering, international diplomacy and marketing rather than a doctorate in medicine from UB. "I'm expecting a phone call from the FDA during the interview. If the call comes, I've got to take it, but I will call you right back." Indeed, Virginia Weldon is a busy person. As senior vice president, public policy, for the St. Louis-based company, the class of '62 alumna is responsible for corporate communications and government affairs, devoting most of her hectic schedule to opening new markets and winning government approval and public acceptance for emerging technologies and products. "Monsanto markets its products worldwide, and I have the responsibility to help sell our products and to get new products approved for sale by the government," Weldon explains. The Monsanto Company manufactures and markets agricultural and chemical products and pharmaceutical and food ingredients. Some of its best known products include Roundup herbicide, Ortho lawn and garden products and NutraSweet. Weldon never saw herself abandoning the operating room for the corporate boardroom. "When I went to medical B u a 0 school, I was thinking about being a practicing physician. I loved surgery. I really enjoyed surgery in my junior year at the E.]. Meyer Memorial Hospital," Weldon said. "And we had wonderful people teaching physiology. I remember going to parties and on picnics with Dr. john Boylan and with other faculty and students. It was a wonderful time. The four best years of my life," she adds. Following an internship and residencyin pediatrics at The johns Hopkins Hospital in Baltimore, Weldon completed a three-year fellowship in pediatric endocrinology at The johns Hopkins University School of Medicine. Shortly thereafter, Weldon joined the faculty of the School of Medicine at Washington University in the department of pediatrics. It was there that her interests in medicine began to shift to matters of public policy. "I became involved with public affairs as a member of the Endocrine Society and the Society for Pediatric Research with issues concerning funding for research and the ethical treatment of human subjects," Weldon says. After serving as co-director of the division of pediatric endocrinology and metabolism, Weldon was appointed assistant to the vice chancellor of medical affairs. The metamorphosis from physician to businesswoman was well underway. Weldon was named deputy vice chancellor for medical affairs and vice president of the medical center at Washington University School of Medicine and p s c a n S Medical Center in 1967. She joined Monsanto as vice president, scientific affairs and was quickly promoted to vice president, public policy, serving in that capacity from August 1989 to October 22, 1993, when she began her present position with Monsanto. One of the greatest challenges facing Monsanto, Weldon says, is to build public trust. "Science-based companies like Monsanto have a responsibility to assure the public that the science on which new products are based is of the highest caliber. It is imperative that our science and assessment procedures are beyond reproach in order to be credible and trusted." Weldon's education and experience as both a physician and corporate executive have helped shape her views regarding health care and, in particular, with the congressional debate regarding health care reform. "It's a very complicated subject, partly because of the size and complexity of the health care system, the entrepreneurial spirit of our country and the public's expectation for continual improvement of medical care." It will be very hard, she adds, to reform the nation's health care system in "one fell swoop." Instead, Weldon said attention should be paid to aspects of the system that are "broken." "We need portability of insurance coverage and we need to provide insurance for those who don't have coverage. And it must be affordable," she maintains. u m m e 9 9 4 J J �l J 1 J "One of the issues being overlooked in this debate is the jobs involved with health care services. No one is considering the consequences to the academic medical centers, pharmaceutical companies and insurance companies," Weldon says. When asked specifically about regulatory delays that affect the timely approval of new pharmaceuticals, Weldon said, "One way to help this country maintain its competitive edge in pharmaceutical discovery is to provide the FDA with enough funds to work efficiently and effectively, to give them resources to hire the scientists they need to evaluate new drug petitions, and to make sure the agency is free from political influence." But, she added, "Our congressional leaders have not seen fit to provide the additional funds the FDA needs. There are numerous, geographically separate facilities for the FDA in Washington, many of them antiquated. There is certainly a need for more resources." As a spokesperson and policymaker for a major international company, Weldon has become, by default and not by design, a high profile example of a successful businesswoman and she has strong opinions regarding opportunities afforded to all individuals within corporate America and within her own company. "What happens to you, whether you succeed or fail, depends upon you as an individual. "I don't believe that women who become militant about their role can contribute effectively. Women who make positive contributions make it easier for other women who will come after them," Weldon said. "My guess is that women who employ 'sharp elbows' in an attempt to further their careers actually make B a 0 p " SCIENCE-BASED COMPANIES LIKE MONSANTO HAVE A RESPONSIBILITY TO ASSURE THE PUBLIC THAT THE SCIENCE ON WHICH NEW PRODUCTS ARE BASED IS VIRGINIA WELDON OF THE HIGHEST CALIBER. " that was purposeful- it happened because, historically, medicine was dominated for so long by men." ot surprisingly, Weldon has taken an active role in promoting the national effort on women's health issues and, in 1993, was appointed by the National Institutes of Health to serve as Chairman of the Women's Health Initiative Program Advisory Committee. UB is one of 16 vanguard clinical centers participating in NIH's landmark things harder ," Weldon continued. "Monsanto is trying to find qualified women and minorities in order to achieve a diverse work force and to provide an opportunity for everyone to succeed. Monsanto is very serious about diversity. " But Weldon also acknowledged the difficult role many women face in advancing their careers. " ... probably every woman in any kind of job that is viewed as non-traditional has felt marginalized or overlooked .. .. we must work very hard to change the culture in our (nation's) businesses and institutions, but it takes a long time." An area in which Weldon sees steady progress, however, is in women's health initiatives. "Women's health has been neglected for a long time. I don't think 5 c a n s studyofwomen~h~hh . As for the future, Weldon says she is constantly challenged in her job at Monsanto and is not thinking about any more career changes. "Someday," she said wistfully, "''d like a little more time + for golf and travel. " - m BY m PETER H . SIGURDSON �~-··········· · ··········································································· IE Kasstrer '53, delivers Stockton Kimball Lecture 1991 DISTINGUISHED MEDICAL ALUMNUS RETURNS FOR SPRING CLINICAL DAY TO SPEAK ON " CLINICAL REASONING : TEACH I NG I T AND LEARN I NG IT" " espite or perhaps because of all sorts of technological advancements, our cognitive skills remain the preeminent part of our work as physicians,"] erome P. Kassirer, M.D., editor-in-chief of The New England journal of Medicine, told the audience gathered to hear him give the annual Stockton Kimball Memorial Lecture at this year's Spring Clinical Day, held April 30 at the Buffalo Marriott. "But despite the importance of the diagnostic process, we spend precious little time trying to understand it," he said. Kassirer's talk, "Clinical Reasoning: Teaching It and Learning It," focused on what he called "the mental process that physicians use when they perform the task of diagnosis." Robert Reisman, M.D., president of the UB Medical Alumni Association and a longtime friend and schoolmate of Kassirer, introduced Kassirer and praised him as "everything a physician should be- a clinician, teacher and researcher who is dedicated to medicine. He's an excellent physician, often referred to in those most admirable of terms as a 'physician's physician,"' Reisman told the more than 300 people, including UB B u 0 0 President William Greiner, who attended. Kassirer, a 1953 UB alumnus who earned his medical degree from the UB School of Medicine and Biomedical Sciences in 1957, began by pointing out that he felt it was a great privilege to be giving the Stockton Kimball Memorial Lecture partly because Kimball was dean of UB's medical school when Kassirer had been a student there. Kassirer praised UB and the Buffalo area, saying "I treasured my experience in medical school and the two years I spent at Buffalo General Hospital." Regarding the diagnostic process, Kassirer said, "The more we study it, the less likely we are to make errors. I want to explain how the process goes, as well as the faults that affect even the best of us." Kassirer pointed out that while phy- p h 5 c o n s sicians often think of themselves as the only people who use diagnosis, nothing could be further from the truth. Diagnosis is a process used by all sorts of people, from politicians to mechanics, Kassirer said. The diagnostic process involves, first of all, inferences that are made from observable facts about the nature of a system malfunction, Kassirer said. Such inferences yield "a series of provisional approximations that are revised continually," he said. But he added that it was important to pay attention to the distinction between a perception and an inference, and to note how much inference goes on in any act of perception. "As an example, if you see a ball bounce into the street, that perception may cause you to immediately slow down your car because of your inference that the ball could be followed by a child," Kassirer said. Kassirer pointed out that there are two basic types of problem-solving methods, which he termed "weak" methods and "strong" methods. Weak methods are general problem-solving methods that do not depend on a particular domain of expertise, are widely applicable across different problem areas and m m e 9 9 4 �·· ····················· ···· ·············· · ················ · ········ · ·· ·· ····· · ···· ·· · · ·· • are characteristic of novice rather than normal and abnormal findings. The com- ciples for teaching clinical problem-solvexpert behavior, Kassirer said. Strong peting hypotheses also have to be proved ing, which included using case presenmethods, he said, are methods used by false at this stage, Kassirer said. tations and giving students data in domain experts and involve rapid recResearch on the diagnostic process "chunks" that allows them to particiognition of patterns and efficient for- has a number of important uses in edu- pate in the diagnostic process. Kassirer mulation of problems in "semantically cation, Kassirer said. It enables better stressed the importance of using real meaningful chunks." Such methods go teaching of that process, and helps stu- cases in order to reflect what he called directly toward the solution of particu- dents learn how to recognize clusters of "the messiness of clinical medicine." lar problems and are domain-depen- cues at the beginning of the process. Other basic principles included stressdent and narrowly applicable, Kassirer Research on diagnostics also helps ex- ing causal relations when possible, and said. plain the rationale behind the tradi- identifying for students the reasoning Kassirer said four basic components tional routine "workup" with which strategies employed, as well as potential comprise the diagnostic process: hy- physicians prepare for every diagnosis, errors in reasoning. pothesis generation, context formula- Kassirer said. It is essential, Kassirer said, to teach tion, hypothesis refinement and hypothBut research on diagnostics also helps by example. Students learn reasoning esis verification. teach students that in certain cases it by seeing others reason, he said. Generating the initial hypotheses and may be appropriate to skip around, to The clinical reasoning process can formulating a context for those hypoth- start from laboratory data, or, in the help minimize errors at all points in eses provide a model for gathering more case of urgent problems, to interrupt diagnosis, and can help avoid such coninformation about the problem, Kassirer normal processes of information, sequences of error as delays in treatsaid. Often based on minimal cues that Kassirer said. ment, unnecessary exposure of patients come in clusters, these initial hypothFurther, students can be taught to to various tests, inappropriate treatment eses "can range from the general to the avoid certain heuristics that can lead to and the anxiety that results from each of specific," Kassirer said. "At this stage, error. Teaching the quantitative ap- these consequences, Kassirer said. hypotheses are intermingled in a pecu- proach to combining clinical data, as "All this will hopefully lead us to a liar sort of way." well as the use of pre-compiled, condi- general model of problem-solving that After developing a context for un- tion-action pairs, can also be improved can help us identify good or bad reasonderstanding why one has come to these by research on diagnostics, Kassirer said. ing," Kassirer said. + initial hypotheses, the problem solver Kassirer listed a number of basic prinBY MARK W ALLACE enters the stage of hypothesis refinement, Kassirer said. At this stage, various hypotheses are deleted, added or made more specific. This phase is dominated by probabilistic reasoning as the problem solver tries to determine which of the generating hypotheses are most likely correct, Kassirer said. By using pre-compiled rules and information about the source of various problems, the problem solver tries to achieve a hypothesis that has near certainty, he said. When one hypothesis clearly begins to dominate, the problem solver has reached the stage of hypothesis verificaThis year's senior medical students were honored by the Alumni Association and President and tion, Kassirer said. The hypothesis has Mrs. William Greiner at the annual Senior Reception last february 26 at the Buffalo Hilton. to be tested for coherence and accuracy, and to see whether it explains both B u a 0 p h y s c a n s m m e 9 9 4 �• ·············· · ······························· · ············ ····· ··········· · ·· · ·· · ······ . I • A test of the effectiveness of hormone-replacement therapy in reducing the risk of heart disease and osteoporosis. • A study of the effect of a low-fat diet on the risk of cardiovascular disease and breast and colorectal cancer. • An investigation of the effectiveness of calcium and vitamin D supplements in reducing osteoporosis and colorectal cancer. In Western New York, 14,000women will be recruited over three years to take part in the clinical trials. The observational study will follow women over eight to 12 years to try to determine physiological and lifestyle factors that can affect health. Participants in this phase - about 2,200 of them in Western New York - initially will give detailed medical histories and then will be contacted every three years to update their information. Women interested in volunteering for the study should call the Women's Health Initiative clinical center at (716)829-3128. + Women's Health Initiative begins MEDICAL SCHOOL AMONG 16 VANGUARD CENTERS TO PARTICIPATE IN LANDMARK STUDY OF WOMEN Trevisan. "We will be taking part in a history-making study that will answer very important questions regarding the well-being of women. "In addition, information we gain from the central study will be the seed for other studies that will contribute to the knowledge of women's health. It is also creating a number of new jobs, and more jobs will be created as other studies are generated. "This is a massive undertaking," he added, "and we will need the cooperation of many people, particularly the women volunteers, to make the study a success." The study itself will be conducted in two parts- clinical and observational. The clinical component will involve three investigations: esearchers at UB kicked off the major recruitment drive for the Buffalo portion of the $625 million Women's Health Initiative with the February 25 grand opening of the new women's clinical center. The Women's Health Initiative, funded by the National Institutes of Health, is the largest clinical health study ever undertaken in the United States. Approximately 160,000 women between the ages of 50 and 79 at 45 centers will take part in identical studies designed to investigate the causes of heart disease, breast and colorectal cancers and osteoporosis in older women and test the effectiveness of various treatments. UB, selected as one of the 16 lead research centers in the 12-year study, will receive $11 million over the life of the project. Headquarters for the UB clinical trials is a newly renovated 5,700-squarefoot clinical center in Farber Hall on the South Campus. The grand opening featured a ribbon-cutting ceremony with UB provost Aaron N. Bloch; John Naughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences; Mauriz\_9 Trevisan, M.D., principal investigator for the UB portion of the study ana chair of the Department of Social and Preventive Medicine; Jean Wactawski-Wende, Ph.D., professor of social and preventive medicine and one of the UB investigators; and Congressman Jack Quinn, R-Hamburg. "This is a wonderful opportunity for Western New York and UB," said B a a B Y LOIS B AKER Women's Health Initiative MaurizioTrevisan,M.D.,andJeanWadawski-Wende,Ph.D.,atthenewdinicalcenter. p h y 5 a n S u m m e 9 9 4 �. . . . . .. .. . . ... . .. . .. . . .... ...... .. .. . . . . ... . ... . ... . ..... . .. .... .... . . . . • • • • • • • • • • • • • • • •• ~ I Dean honored by Asian Amertcan Physicians'Association recently avid C. Dean, M.D., clinical professor of medicine , received the Asian American Physicians' Association's first "Friend of the Asian American Physicians' Association" award at a dinner held last fall. Dean, who is also chief of cardiac rehabilitationatBuffalo VA Medical Center and co-medical director of the cardiac rehabilitation unit at The Buffalo General Hospital, is a fellow of the American College of Physicians, the American College of Cardiology and the College of Chest Physicians. + Lockwood assumes new PSR post he board of directors of Physicians for Social Responsibility (PSR) has named Alan H. Lockwood, M.D., UB professor of neurology and director of the Buffalo VA Medical Center's Center for Positron Emission Tomography, its 1994 president. Founded in 1961, PSR is a leading national organization of more than 20,000 health professionals and supporters working in 90 chapters across the country for the elimination of nuclear and other weapons of mass destruction, the achievement of a sustainable environment and the reduction of violence and its causes. PSR is the U.S. affiliate of International Physicians for the Prevention of Nuclear War, recipient of the 1985 Nobel Peace Prize. B u 0 0 p h I Lockwood has been a member of PSR for over a decade , serving in its house of delegates from 1986 to 1989, and as chair of that body from 1987 to 1989. He was elected to the national board of directors in 1989 and served as its treasurer for two years before being selected as president-elect in 1993 . Lockwood also serves on the editorial board of The journal of Medicine and Global Survival. Lockwood has been a leading PSR spokesman against the Strategic Defense Initiative. He has also been instrumental in the development of PSR's programs to address environmental health + threats. Curtis Mettlin, Ph.D., (left) receives award fram Irvin Fleming, M.D., ACS president. Curtis Mettlin receives prestigious ACS Volunteer Leadership Award urtis ]. Mettlin, Ph.D., chief of epidemiologic research and director of the department of cancer control at Roswell Park Cancer Institute, received the National Volunteer Leadership Award from the American Cancer Society (ACS) . The award is given annually to ACS volunteers whose service to the national organization has been long and distinguished. Mettlin has written more than 180 articles, chapters and books on cancer. He was the principal investigator of the ACS's multi-institutional study that found the use of ultrasound and the prostate-specific antigen blood test in conjunction with digital rectal exam significantly increases the detection rate for prostate cancer. Mettlin has served on many national ACS committees and task forces dealing with issues as diverse as cancer detection and treatment, public and professional cancer education and developing strategies for all Americans to gain access to + cancer treatment and prevention. Carl Granger wins Frank Krusen Award for rehabilitation medicine arl V. Granger , M.D., associate chairman of the department of rehabilitation medicine, has been awarded the Frank H. Krusen Award for outstanding contribution to the field of rehabilitation medicine by the American Academy of Physical Medicine and Rehabilitation. Granger, who is also director ofUB's Center for Functional Assessment Research and co-director of the Multiple Sclerosis Center, was presented the award at the academy's annual meeting last November. The award was established nearly 25 years ago to honor one of the academy's founding fathers. Granger served as president of the academy from 1975 to 1976. He is the author of more than 90 publications and co-developer of the Functional Independence Measure and the Uniform Data System for Medical Rehabilita+ tion. 5 c a n S u m m e 9 9 4 �developed a powerful system that mimics many types of brain damage ." Langan observes that the close resemblance of the cultures to damaged $534 ,000 WILL FUND RESEARCH INTO ASTROCYTE brain was "a fortunate surprise. " GROWTH AND RECOVERY FROM BRAIN DAMAGE But his lab's efforts to sort out the biochemical controls were even more niversity at Buffalo neurologist percent of all approved grants, resulting surprising. Studying a class of cell-signaling proteins known as G proteins, Thomas]. Langan, M.D., has re- in five years of funding. The NIH reviewers described the researchers discovered that the modiceived a $534,000 National Institutes of Health grant to explore Langan's application as a "very strong fication of these proteins by by-prodthe link between astrocyte growth proposal which emphasizes a very im- ucts of cholesterol metabolism deterand recovery from brain damage. portant aspect of astrocyte cell biology. " mines whether the astrocytes divide or Studies by others have shown that differentiate. "One of the most satisfying (and rare) "We showed that this modification, things that can happen in biomedical newborn astrocytes in culture divide on called isoprenylation, determines research is for a focused area of labora- the normal developmental schedule, whether the astrocytes commit to divide tory work to rapidly provide clues to which in the intact brain is the main several important clinical problems," reason for the growth of the brain after or assume a more differentiated shape. In other words, there seems to be a Langan, associate professor of neurol- birth. common biochemical control mechaLangan discovered that the cultured ogy and pediatrics and an attending nism for these two critineurologist at The cal aspects of astrocyte Children's Hospital of function. " Buffalo , said. The NIH grant will Langan's research foallow Langan and felcuses on astrocytes, the low UB researchers star-like brain cells that Commitment RPoint Ronald Berezney, Ph.D. , "are by far the most nuStart Glls professorofbiology,and merous cells in the brain, Robert]. Plunkett, M.D. , even though their funcassistant professor of Flat, tions were mysterious Stellate, Proliferating Arrested neurosurgery , to study Astrocyte until around 20 years Astrocyte this mechanism and to ago. Modification of the cell-signaling proteins determines whether the astrocytes divide. determine how it ap"During the last deplies to the problem of cade in particular ," brain injury and recovery. Langan explains, "there has been in- astrocytes further resemble their counThe significance of the apparent link creasing evidence that astrocytes may terparts in the intact brain by maintainbetween the role of isoprenylation in be involved in controlling the fate of ing the capacity to divide again for many and differentiation , cell division control neurons , both in terms of normal devel- months. Langan says, "lies in the potential to opment and response to injury. " He also found that when the cultured But, he notes, very little is known astrocytes are stimulated to divide later, manipulate the astrocyte responses once about what coordinates the complex they act exactly as cells that respond to the control mechanisms have been defined. behaviors of astrocytes themselves many types of brain injury. "Since astrocytes play a key role in an area where Langan's recent findings "When stimulated," Langan says, responses of human brain to many types lie that has drawn interest from the "these cultured astrocytes express the of injury, ranging from trauma and mulationalinstitute of eurologic Disor- same proteins on the same time schedtiple sclerosis to Parkinson's Disease, the ders and Stroke. At a review meeting last ule as the cells in intact brain that are autumn , the NIH branch ranked involved in reactive gliosis, the hall- ability to control their actions could + Langan's grant application in the top 4 mark of brain injury. Therefore, we have have immense practical benefit." UB neurologist wins NIH grant B a 0 p h y 5 a n 5 m m e 9 4 �························································································• ·· ~ I I UB has 28 faculty physicians listed in this year'sedition of "Best Doctors in America" wenty-eight faculty members at the School of Medicine and Biomedical Sciences have been included in the second edition of The Best Doctors in America, a directory of the "best and brightest" in the medical profession. Best Doctors lists 7,200 physicians in more than 50 specialties - approximately 2 percent of the nation's 350,000 practicing physicians. The listing is compiled from interviews with thousands of specialists throughout the country who were asked to rate the clinical ability of their peers. UB faculty members who are included in Best Doctors are Mark Ballow, M.D., professor of pediatrics and chief of the division of allergy and immunology; David W. Bentley, M.D., former professor of medicine, director of the Multidisciplinary Center on Aging and director of the division of geriatrics; Clara D. Bloomfield, M.D., professor of medicine; Lawrence B. Bone, M.D., associate professor of orthopaedic surgery; Edward L Bradley, Ill, M.D., professor and vice chair of surgery; Linda S. Brodsky, M.D., associate professor of otolaryngology and pediatrics; Michael E. Cohen, M.D. , professor and chair of neurology; Patrick Creaven, M.D., associate research professor of pharmacology; Patricia Kresse! Duffner, M.D. , professor of neurology and pediatrics; Bradley P. Fuhrman, M.D., professor of pediatrics. Also, Robert Gillespie, M.D. , professor and chair of orthopaedic surgery; Marion Zucker Goldstein, M.D., clinical associate professor of psychiatry; Daniel Green, M.D., professor of pediat- B 0 0 p h Bone Bradley Brodsky Duffner Fuhrman Gillespie Goldstein Greenfield Herzig Hopkins Jacobs Middleton Min dell Nemoto Pincus Reisman Rossi Stapleton Voorhess Ballow Bentley Cohen Creaven Green MacGillivray orthopaedics; Takuma emoto, M.D., research associate professor of surgery; Stephanie Pincus, M.D., professor and chair of dermatology; Derek Raghavan, M.D., professor of medicine; Robert Reisman, M.D., clinical professor of medicine and pediatrics; Thomas M. Rossi, M.D., associate professor of pediatrics; F. Bruder Stapleton, M.D., A. Conger Goodyear professor and chair of pediatrics; and Mary Louise Voorhess, M.D., + professor emeritus of pediatrics. rics; Saul P. Greenfield, M.D. , associate professor of urology; Geoffrey P. Herzig, M.D., professor of medicine; L elson Hopkins, M.D., professor and chair of neurosurgery; Lawrence D.jacobs, M.D., professor of neurology; Kenneth A. Krackow, M.D., professor of orthopaedics; Margaret MacGillivray, M.D., professor of pediatrics. Also, Elliott Middleton, Jr., M.D., professor of medicine and pediatrics; Eugene R. Mindel!, M.D., professor of s o n 5 Raghavan m m e 9 9 �• ··· ··· ······ · ·· · ············ ·· · ·· ·· · ·· ···· ··· · ··· · ········· ·· ······· · · · ···· · ··· ··· ······ . I Judah Folkman, M.D, delivers 1994 Harrington Lecture NOTED RESEARCHER DISCUSSES GROUNDBREAKING THEORY OF ANGIOGENESIS AS WELL AS CLINICAL BREAKTHROUGHS USING ANGIOGENESIS INHIBITORS udah Folkman, M.D. , whose research led to the development of the theory of angiogenesis, delivered the 1994 D.W. Harrington Lecture, "Clinical Applications of Angiogenesis Research," discussing the history of his work with angiogenesis, as well as some recent clinical breakthroughs that saved the lives of children with tumors which, in the past, would have been fatal. Charles Paganelli, Ph.D., interim chair of the UB Department of Physiology, introduced Folkman, who is the julia Dyckman Andrus professor of pediatric surgery at Harvard Med1cal School. Paganelli praised Folkman's interest and achievement in a wide range of areas, including not only the theory of angiogenesis but also development of the contraceptive Norplant and of implantable cardiac pacemakers. Paganelli further praised Folkman for offering fundamental insights into the growth of capillary networks. Folkman, who is also professor of anatomy and cell biology at Harvard, is credited with discovering the mechanisms of angiogenesis, a concept that holds that solid tumor cancers may develop as a result of chemical signals released by tumor cells that cause the blood vessels in surrounding tissue to grow. Research is under way worldwide investigating angiogenesis and its relation to cancer and many other diseases. The theory of angiogenesis has been guided by two central questions , Folkman said. "First is the question of how angiogenesis, or blood vessel growth, is turned off in many physi- B u a 0 Judah Folkman, M.D. ological states," he said. "Then there's the opposite question: why is it not turned off in many pathological states, and why does it persist to the detriment of its host?" In attempting to answer these questions, angiogenesis research has focused on three basic areas, Folkman said: what cancer would be like in the absence of angiogenesis, what would human tissue be like without it and what would happen if all communication between tumor cells in the human body could be stopped, Folkman said. Folkman began his research into angiogenesis in the 1960s while serving a two-year term in the U.S. Navy at the Bethesda National Naval Medical Center. After completing an experiment to study hemoglobin solutions by infusing the thyroid glands of rabbits with those solutions and then measuring thyroid function, Folkman and his colleagues began to ask whether isolated glands p h y 5 c o n S could support growth, he said. That research led Folkman and his colleagues to publish the hypothesis that tumor growth was angiogenesisdependant, Folkman said. In simplest terms, he said, that hypothesis stated that after a tumor exists, every further increase in tumor mass must be preceded by the proliferation of new capillary blood vessels that converge upon the tumor. "Our hypothesis led to many experiments, and the field has now moved in a number of basic directions," Folkman said. In the 1970s, Folkman began to work on isolating a variety of angiogenesis factors. After some years of failed work, Folkman finally managed to compile a list of those basic factors . "The list had great transformative pow ers for angiogenesis research," Folkman said. "It transformed my critics into my competitors." But it wasn't until1990 that researchers finally gained direct evidence that tumor growth was angiogenesisdependant, Folkman said. "Only four years ago did our many years of lab research begin to be translated to clinical trials," he said. Recent clinical trials have fallen into three basic categories, Folkman said: trials of angiogenic peptides that accelerate angiogenesis, the administration of angiogenesis inhibitors for patients with tumors and trials that attempt to understand the principles of prognostic tests in cancer. The discovery of angiogenesis inhibitors has taken place "primarily under weird circumstances," Folkman said, u m m e 9 9 4 �· ····· · ···· ·· · ·· ···· ··· ·· · ·· ·· · · · ·· ···· ··· ··· ·· ··· ···· · · ··· · · · · · · · · ·· · ···· ··· · · · · · ·· · ···[ i ] , ~ I - B BY u M A R K a WA 0 tion is a not-for-profit organization that brings together medical education and research, health care providers, health care manufacturers and health care-related businesses to explore issues facing the industry. + Health Care Industries Association presents Awards for Excellence suggesting that many inhibitors were discovered by accident rather than by controlled experiment. 1989 saw the first successful treatment of universally fatal pulmonary hemangioma by the angiogenesis inhibitor alpha-interferon. On hearing the news, Folkman and others were understandably skeptical, he said, but further investigation proved the treatment was valid. The administration of alpha-interferon has already saved 53 people, mostly children, who otherwise would have died of their tumors , Folkman said. "A whole series of tumors can now be held to dormancy by angiogenesis inhibitors," he said. "We're beginning to think that in the near future cancer patients, on their first biopsy, will have angiogenesis profiles perfomed," Folkman said. "They will also have long-term angiogenesis treatment to extend the dormancy of their cancer. " Folkman served as surgeon-in-chief at Children's Medical Center in Boston for 14 years before resigning in 1981 to conduct research full- time after his 1980 appointment to Harvard. A member of the National Academy of Sciences, Folkman counts among his many honors a 10-year Merit Award from the National Cancer Institute in 1989, the American Cancer Society's Medal of Honor for basic science, Israel's Wolf Prize in Medicine and the Christopher Columbus Award in Biomedical Research from the National Institutes of Health. The Harrington Lecture is sponsored by the School of Medicine and Biomedical Sciences. The D.W. Harrington Lecture Fund was established in 1886 by Devillo White Harrington, M.D., an 1861 graduate of the UB medical school and a professor of genito-urinary and vene+ real diseases from 1886 to 1905. oswell Park Cancer Institute , Herbert Hauptman, Ph.D., and Wilson Greatbatch were among the individuals and institutions recognized by the Health Care Industries Association's first Annual Awards for Excellence. The Economic Impact Award for Excellence was awarded to Roswell Park Cancer Institute. The award was cosponsored by the Western New York Economic Development Corporation. Special President's Awards were presented to Nobel Laureate Hauptman, UB research professor of biophysical sciences, and Greatbatch, adjunct professor of electrical and computer engineering, for their dedication to the Health Care Industries Association and their overall contributions to the health care industries of Western New York. UB President William Greiner delivered the keynote address. The Health Care Industries Associa- Nolan named chair of College of Physicians Board of Regents ames P. Nolan , M.D. , professor and chair of the Department of Medicine has been elected to a one-year term as chair of the American College ofPhysicians Board of Regents. Nolan has served on the 26member board since 1989 and was vice chair in 1993. Prior to joining the board, he was the society's governor for New York State for four years , winning the Governor of the Year Award in 1988. He also served as president of the New York State chapter from 1987 through 1988. In addition to his UB appointments, Nolan serves as director of medicine at Erie County Medical School. + At left, Herbert Hauptman, Ph.D., and Wilson Greatbatch receive Health Care Industries awards. LLACE p h y 5 c a n S u I m m e 9 9 4 �• ··················································································· · ···· . I UB signs unique clinical psychiatry agreement BUFFALO PSYCHIATRIC CENTER , WESTERN NEW YORK CHILDREN'S PSYCHIATRIC CENTER JOIN THE UNIVERSITY'S MULTIDISCIPLINARY CLINICAL TEACHING SITES the state Office of Mental Health; john Naughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences; George Molnar, M.D., UB associate professor of psychiatry and executive director of the Buffalo Psychiatric Center; and Allen R. Morganstein, M.D., clinical director of the Western ew York Children's Psychiatric Center. UB, ~rimarily through its department of psychiatry, has used the two facilities to train students and residents for some time, but never had a formal working agreement with them. As a result of the agreement, a 10-member committee from the three institutions will be formed to oversee the educational and research programs the facilities operate. he Buffalo Psychiatric Center and the Western New York Children's Psychiatric Center became formal UB clinical teaching sites in a contract-signing ceremony held in March. The five-year renewable agreement between UB and the New York State Office of Mental Health opens new teaching and multidisciplinary research opportunities at the centers for UB faculty, students and medical residents, and provides the centers' physicians and staff access to UB's faculty and research facilities. Participating in the signing were UB President William R. Greiner; Philip B. Wels, M.D., chair of the UB Council; Richard Surles, Ph.D., commissioner of From left: William Greiner; Ri(hard Surles, Ph.D.; John Naughton, M.D.; Philip Wels, M.D.; Allen Morganstein, M.D.; and George Molnar, M.D., at the March signing (eremony. B a a p h s c a n s The new contract opens the centers' doors to the UB schools of dental medicine, nursing, pharmacy and health related professions, as well as to faculty and graduate and undergraduate students in clinical psychology and social work. The centers will provide equipment, lecture rooms and laboratories, in addition to faculty, for teaching and joint clinical research activities. "Collaboration with local providers has already proven to be an outstanding model for clinical training in UB's School of Medicine and Biomedical Sciences," Greiner stated. "We are delighted that the Buffalo Psychiatric Center and the Western New York Children's Psychiatric Center will join UB's group of clinical affiliates. Greiner praised Surles for his support, adding, "This sort of joint effort of the state, local providers and the university can do much both to enrich UB's education and training programs and to enhance care delivery for our fellow Western New Yorkers." Naughton, who will be UB's primary liaison with the centers and was instrumental in negotiating the agreement, said the relationship is a welcome step in the university's efforts to expand opportunities for clinical teaching and research for its students and faculty. "This contract confirms that these two psychiatric centers are very important facilities in our community," Naughton said. "The opportunities the agreement presents for interdisciplinary research and innovative learning are enormous. The inclusion of these facilities in the university family will add u m m e 9 9 �The images assist in pre-operative planning of the implant site, direct visualization of how well the implant will fit and ascertain the need for building up bone tissue before implantation. DelBalso is currently president of the American Board of Oral and Maxillofacial Radiology. He is the only physician in the U.S. who is board certified in both medical diagnostic radiology and oral maxillofacial radiology. + significantly to our educational opportunities, particularly in the areas of pediatric psychiatry and in the care of the chronically ill. " The affiliation offers a model that deserves replication in other areas of the state, Surles noted. "This agreement not only creates outstanding educational and research opportunities for university students and the psychiatric centers' staffs, it provides the agency with a formal role in academic training - a first for the state Office ofMental Health." Molnar praised the mutually beneficial agreement. "Our expectations are high ," he said, "and our enthusiasm is great. We look forward to many new opportunities for joint teaching andresearch activities , and to increased collaboration with the university's schools and departments. " Morganstein said, "The agreement will be beneficial to the university, as well as to the Western New York Children's Psychiatric Center, in providing opportunities for professional growth of staff. Ultimately, this will filter down to the community by providing enhanced clinical services." + B Y L OIS B AKE - 0 0 p 'i( Convenient Downtown Location Quick Metro Ride to Main Street Campus and Medical School 'i( Close to Buffalo General, Roswell, ECMC and Children's Hospitals tephen B. Edge, M.D. , chief of the breast division of the department of surgical oncology at Roswell Park Cancer Institute , has been appointed to a panel of health care experts and consumers to evaluate breast cancer treatment in New York State. The new Breast Cancer Treatment Quality Advisory Panel will gather data on treatment strategies, measure the quality of breast cancer treatment in New York and recommend ways to improve its effectiveness. Edge, the only Western New Yorker appointed to the advisory panel, has served as chief of RPCI's breast division since 1992. He is an investigator with the National Surgical Adjuvant Breast and Bowel Project. A fellow of the American College of Surgeons, Edge is a member of the American Society of Clinical Oncology and the Society of Surgical Oncology. + R h 'i( Conference Planning Professionals Stephen Edge named to state breast cancer advisory panel ngelo M. DelBalso, M.D., D.D.S. , interim chairman of the department of radiology, recently addressed the Third International Congress of the Dutch Society of Oralimplantology. DelBalso, clinical director of Erie County Medical Center's department of radiology, explained how readily available computer software can be used for three dimensional imaging in connection with permanent tooth replacements. u 18,000 Square Feet of Meeting Space 'i( DelBalso addresses Dutch Society of Oral lmplantology Congress B The Perfect Prescription For Your Conference Needs y s o n S u 'i( Your Guests Can Walk to Theatre, Shops, Pilot Field, Restaurants, Entertainment 'i( CME Friendly 'i( Great Banquet Food Please Talk T o Us A bou t Preparing A Proposal So You Can Bring Your Group's Next Convention To Buffalo (716) 856-1234 6142 EXTENSION HYATI. WE'VE THOUGHT OF EVERYTHING ~M H~Y--A--T"T REGENCY BUFFALO m m e 9 9 4 �• ··················· · ·· · ···················· · ················ ·· · · ··········· ·· ····· · ····· . I UB wins federal rehabilitation research grant $2 .4 MILLION WILL FUND NATION'S FIRST CENTER TO DEVELOP OBJECTIVE STANDARDS TO MEASURE DISABILITY AND ITS EFFECTS he University at Buffalo has received a $2.4 million federal grant to establish the nation's first center charged with developing objective standards to measure disability and its effects, and to assess the effectiveness of rehabilitation programs designed to treat disabilities and improve function. The new Rehabilitation Research and Training Center on Functional Assessment and Evaluation of Rehabilitation Outcomes will fund seven research projects over the next four years. The work will involve faculty from UB's department of rehabilitation medicine and its schools of nursing, health related professions and architecture and planning. The new center will also collaborate with five other academic rehabilitation centers - Craig Hospital in Englewood, Colorado; Rehabilitation Institute of Chicago; Kessler Institute for Rehabilitation, Inc., West Orange, New jersey; The Ohio State University; and Brown University. D'Youville College in Buffalo will work with the UB center to develop a curriculum in functional assessment studies. "Our charge is to introduce a more scientific approach to measuring the abilities and limitations of people living with handicaps," said Glen E. Gresham, M.D., professor and chair of the department of rehabilitation medicine and the grant's project director. "We hope to develop uniform standards for measuring disability and the methods disabled people use to adapt that everyone accepts and understands." B u 0 0 Glen Gresham, M.D. Currently, there is no system to classify disabilities according to severity, or to a standard rehabilitation regimen based on severity, Gresham said. "In this era of health care reform," he noted, "the field of rehabilitation medicine must be able to prove the value of its services. Research conducted through this new center will enable us to define disabilities clearly, tell which rehabilitation approaches are most valuable and will allow rehabilitation workers across the country to use a common language to describe patients and their problems." The center's seven research projects and the academic rehabilitation centers involved are: • Handicap assessment - to improve the classification of handicaps (UB and p h y 5 c 0 S Craig Hospital). • Relationship of treatment to outcomes- to determine how much rehabilitation programs help patients (UB, Rehabilitation Institute of Chicago and Kessler Institute for Rehabilitation) . • Measuring handicapping environments - to identify barriers that produce handicaps and measure the extent of their effect (UB). • Characteristics of effective, efficient medical rehabilitation programs - to determine why one program works better than another (UB, Rehabilitation Institute of Chicago and Kessler Institute for Rehabilitation). • Determining which functional assessment measure can best be applied to persons with traumatic brain injury (UB u m m e 9 9 4 �Msall elected to membership in Society for Pediatric Research and The Ohio State University). • Validity of telephone interview versus personal interview for completing the Functional Independence Measure, a score used to follow a patient's progress and measure the outcomes of a rehabilitation program (UB). • Determining whether social support enhances rehabilitation outcomes (UB , Kessler Institute for Rehabilitation and Brown University) . The grant also calls for developing a curriculum in functional assessment studies, which will be offered initially by UB and D'Youville College; writing a training manual on using functional assessment instruments; and hosting a national conference on functional assessment to be held in conjunction with the International Rehabilitation Medicine Association's annual meeting. UB has been in the forefront of medical rehabilitation for the past decade. UB researchers have led a national effort to develop the Uniform Data System for Medical Rehabilitation that includes the Functional Assessment Measure - a standard now employed nationally and internationally by facilities treating severely disabled people to define ability to perform common tasks. UB's department of rehabilitation medicine also established a national database that currently holds more than 400,000 patient records. Byron Hamilton, M.D., clinical associate professor of rehabilitation medicine, is principal investigator on the grant. Nadine Fisher, Ed.D., clinical assistant professor, is program coordinator and james A. Phillips, clinical instructor, is fiscal manager. The new research and training center will function within the framework of the UB Center on Functional Assessment Research, directed by Carl Granger, M.D., professor of rehabilitation medicine. + B B u Y L OIS a B 0 ichael Msall , M.D. , associate professor of pediatrics and rehabilitation medicine, has been elected to membership in the Society for Pediatric Research. Membership in the national organization is based on research record, sponsorship by members in one's specialty area and a vote by the full membership. Msall's research has focused on the problems and consequences of extreme prematurity and functional independence in children with Down 's syndrome, cerebral palsy and neurodevelopmental disabilities. His work was published recently in Clinical Pediatrics and appeared in the February issue of the journal of Perinatology. + • Apple • IBM • Dell • Insight • Panasonic • Canon • TI • Software • Supplies • Accessories • Audio • Hands-on Workshops ATeam Effort -In March, New York State Assemblyman Sam Hoyt presented Dean Naughton with the pen Governor Mario Cuomo used to execute legislation Hoyt co-sponsored that enabled the University Medical Practice Services to be classified as not-for-profit, and therefore, tax-exempt in New York State. lml ,Dllltlri A non-profit University program for students. faculty & The Commons • North Campus • (7 16) 645 -3554 • Fa x: AKER p h y 5 c a n 5 m m e 9 9 �THEN&IiiiiNOW Traditions and training varied for first med students TWO LECTURE COURSES REQUIRED FOR GRADUATION FROM FIRST CLASS OF UNIVERSITY OF BUFFALO SCHOOL OF MEDICINE • ' first medical students differed from their counterparts of today in just about every way: I their demographics , ._ 1i their age , their premedical school training and their medical school training. Sixty-seven students comprised the first class of the University of Buffalo School of Medicine. Students then were required to be at least 15 years old, although the majority of the class were 18 to 21. All 67 students were white males and many were already apprenticed to a "competent physician licensed by a county medical society." Three years of such apprenticeship were required before the degree of doctor of medicine was awarded. Like students now, students then paid fees-$2 for matriculation, $5 for graduation and $10 each to six of the seven professors who gave lectures or demonstrations. The professor of chemistry was paid $12 from each student because they used his equipment. But unlike today, UB had "no provision for gratuitous aid" - no scholarships. The school's first classes were held in a wooden building (formerly the First Baptist Church) on the corner of Seneca and Washington Streets in downtown Buffalo. Sold by the church in 1836, the building was used successively since then as a customs house, post office and police court. The university paid $700 to renovate the church for its use. The yearly rent came to $300. A library of 519 volumes ~ J B ~ a 0 The school's first classes were held in a wooden building (formerly the First Baptist Church) on the corner of Seneca and Washington Streets in downtown Buffalo. was valued at $829.96; its museum of anatomical, pathological and surgical preparations and drawings cost $250. An amphitheater accommodated 200. Instruction nearly 150 years ago was primarily by "lectures, demonstrations , clinical illustrations and recitations." Students weren't required to take notes , but that method of learning was highly recommended. Lecture courses lasted 16 weeks. Two such courses were required for graduation. Students often audited the same course twice. Most clinical experience was gained through apprenticeships in the dispensary of the school and the county p h y s c a S u m m e 9 4 �THENI!IiEIN 0 W .............................. r:_-· .. ./":,·~········· -~· .----on ..._ free to indigent patients and others willing to be observed by students. Students were allowed into the wards of the almshouse at no charge "at such hour of each day as the several medical officers are in attendance." And students then not only had to meet the school's academic standards, they had to be "of good moral character" to qualify for a diploma. The council of the university's first report to the Regents of the State of New York notes that the faculty can "exercise the power of expulsion for crimes of immoral conduct." But, it added, "no occasion for the exercise of this power occurred during the last year." Three weeks before the close of the lecture term, students in the university's first class delivered to the dean or registrar a dissertation "on some medical subject which must be examined and approved by the faculty previous to the examination for the degree" before they could receive their diplomas. Diplomas then were licenses to practice. It was required, however, that they were deposited on file with the Erie County Clerk. Specialists, of course, didn't exist nearly 150 years ago and most students set up their own offices or went into joint practice with an older, experienced physician. Surgery then was confined largely to emergency procedures. In his centennial address in 1946, George W. Thorn, M.D., a UB alumnus, pointed out that 100 years earlier only seven specific medications existed for disease - digitalis or foxglove for heart disease, quinine for malaria, cowpox vaccination for smallpox, vermifuges for intestinal parasites, mercury for syphilis, iron for hypochromic anemia and iodine, which had proved important in preventing goiter. + I ·~;t1 Ill 01 \tf •. ~·- :.·#. ­ :-: -- ......... --- -~ e -u a a p h 5 c a - n 5 u m BY m e MILDRED 9 SANES 9 4 �• ···················· · ······ · · · ········· · ········· · ···· ·· ···· ·· · · ·· · ······· · ····· · ·· · ··· · . I Francis P. Alcedo , Internal Medicine, Yale-New Haven Hospital, New Haven, Connecticut Class of '94 wins big in Match Day Robin] . Arent, Pediatrics, Eastern Virginia Graduate School of Medicine, Norfolk, Virginia 87 PERCENT OF US'S GRADUATING MEDICAL SCHOOL Kenneth] . Baker , Obstetrics and Gynecology, St. Barnabas Medical Center, Livingston, New jersey SENIORS GET ONE OF THEIR FIRST THREE CHOICES Daniel] . Barbero, Medicine/Pediatrics, Ohio State University Hospitals, Columbus, Ohio raduating seniors from UB's medical school fared well in this year's national match for residencies. A full 87 percent of the students who participated in the program were matched with one of their first three choices for residency programs, and 67 percent of them got their first choice, according to Dennis Nadler, associate dean for curricular and academic affairs. Forty-four percent of the class will pursue a residency in one of the primary care specialties: 10 in family practice, 32 in internal medicine, 18 in pediatrics and seven in combined medicine/pediatrics. Thirty-four percent of UB's graduating seniors will stay in the Buffalo area and 14 percent will remain elsewhere in the state to pursue their residencies. Fifty-two percent will pursue residencies out of state. Following is a list of students from the Class of '94 and their matches. p T 0 H 0 y B 5 5 M 0 T N N 0 Chad L. Beatty, Surgery (Prelim), University at Buffalo Graduate Medical Dental Consortium Martha I. Bennett, Family Practice, University Hospitals of Cleveland, Cleveland, Ohio Paula A. Bennett, Family Practice, University of Maryland-Baltimore, Baltimore, Maryland Jennifer J . Bergoine, Pathology, Medical College of Virginia, Richmond, Virginia Antonio M. Bird, Psychiatry, University of North Carolina Hospital, Chapel Hill, North Carolina Joel S. Brenner, Pediatrics, Eastern Virginia Graduate School of Medicine, Norfo lk, Virginia G Brian P. Brett, Medicine/Pediatrics , Morristown Memorial Hospital , Morristown , New jersey Tracy L. Brobyn, Family Practice, Mountainside Hospital , Verona, New jersey Daphine A. Brown, Internal Medicine, Oakwood Hospital , Dearborn, Michigan Gregory M. Bugaj , Internal Medicine, Mt. Zion Medical Center of the University of California at San Francisco, San Francisco, California Thomas M. Burnette, Internal Medicine, University Health Center-Pittsburgh, Pittsburgh, Pennsylvania Enrico Caiola, Medicine/Pediatrics, Baystate Medical Center, Springfield, Massachusetts Maria T. Cartagena, Surgery (Prelim), University at Buffalo Graduate Medical Dental Consortium, Uro logy, University at Buffalo Graduate Medical Dental Consortium William L. Cecere, Surgery (Prelim), University at Buffalo Graduate Medical Denta l Consortium james F. Chmiel, Surgery (Prelim), University Hospitals of Cleveland, Cleveland, Ohio Scott P. Cholewinski, Internal Medicine (Preli m), University at Buffalo Graduate Medical Denta l Consortium , Radiology - Diagnostic, Strong Memorial Hospital, Rochester, New York James Chmiel is congratulated by assistant dean Frank Schimpfhauser. B u a 0 p h y s c a n 5 u m m e 9 9 4 �................................ Below, Charles Rocci looks on as Christian DeFazio and his fiancee, Elizabeth Olson, open his match. Left, DeFazio, who will study emergency medicine at the University of Illinois, is congratulated by Olson and Falsone. Dennis B. Chugh, Internal Medicine, St. joseph's Hospital and Medical Center, Phoenix, Arizona Lynn M. Cieslak, Internal Medicine, St. joseph's Hospital and Medical Center, Phoenix, Arizona Kelli A. Cooney, Pediatrics, All Children's Hospital, St. Petersburg, Florida Devin A. Coppola, Family Practice, St. joseph's Hospital Health Center, Syracuse, New York Edwardj. Cosgrove, Internal Medicine University at Buffalo Graduate Medical ~ental Consortium Kirsta Leale Craig, Family Practice, Southside Hospital, Bay Shore, New York Joseph P. Cronin, Medicine/Pediatrics University at Buffalo Graduate Medical,Dental Consortium Ketan C. Dave, Surgery, Providence Hospital, Southfield, Michigan Maria L. Davis, Emergency Medicine, HarborUniversity of California at Los Angeles Medical Center, Los Angeles, California Christian R. DeFazio, Emergency Medicine, University of Illinois College of Medicine at Chicago, Chicago, Illinois Glen T. Feltham, Orthopaedic Surgery, University Hospitals of Cleveland, Cleveland, Tracey I. Demino, Surgery (Prelim), North Shore University Hospital, Manhasset, New York Ohio Nita K. Divan, Physical Medicine and Rehabilitation, University at Buffalo Graduate Medical Dental Consortium Amy E. Ferry, Obstetrics and Gynecology, St. Luke's Hospital of Bethlehem, Bethlehem, Pennsylvania Todd A. Dorfman, Surgery, Maine Medical Sarah G. Finnegan-Sloan, Internal Medicine (Prelim) , University at Buffalo Graduate Medical Dental Consortium, Neurology, University at Buffalo Graduate Medical Dental Consortium Center, Portland, Maine Winston G. Douglas, Internal Medicine, University at Buffalo Graduate Medical Dental Consortium Mark D. Fisher, Internal Medicine (Prelim), University at Buffalo Graduate Medical Dental Consortium , Anesthesiology, University at Buffalo Graduate Medical Dental Consortium Brian C. Dowdell, Internal Medicine (Prelim), Sisters of Charity Hospital, Buffalo, New York, Physical Medicine and Rehabilitation, Stanford University Hospital, Palo Alto, California Lorna K. Fitzpatrick, Pediatrics, St. Louis Children's Hospital at Washington University Medical Center, St. Louis, Missouri john L. D'Souza, Internal Medicine (Preli m), Strong Memorial Hospital, Rochester, New York, Radiology- Diagnostic, Rochester General David S. Foley, Surgery, Bowman Gray School of Medicine/North Carolina Baptist Hospital, Winston-Salem, North Carolina Hospital, Rochester, New York Darlene A. Durkin, Pediatrics, University at Buffalo Graduate Medica l Dental Consortium Maura P. Foley, Internal Medicine, University of Virginia, Charlottesville, Virginia joseph M. Falsone, Internal Medicine, University at Buffalo Graduate Medical Dental Deborah L. Delozier, Obstetrics and Gynecology, Strong Memorial Hospital, Rochester, New York Patricia A. Geil, Pediatrics, University at Buffalo Graduate Medical Dental Consortium Consortium Maureen A. Fay, Internal Medicine, University of Connecticut, Farmington, Connecticut Petros Ghermay, Psychiatry, University of California at San Francisco, Fresno, California Gloria M. del Valle, Pediatrics, University at Buffalo Graduate Medical Dental Consortium e u a a p h 5 c a n 5 u m m e 9 9 4 �Michael T. Giovanniello, Physical Medicine Presbyterian-St. Luke's Medical Center, Denver, Albany Medical Center Hospital , Albany, New and Rehabilitation, Ohio State University Colorado, Radiology- Diagnostic, University of York , Radiology- Diagnostic, Albany Medical Hospitals , Columbus, Ohio Co lorado, School of Medicine, Denver, Colorado Center Hospital , Albany, New York Douglas J. Golding, Family Practice, University Horacio Gutierrez, Internal Medicine (Prelim), Diane R. Heimback Morrison, Obstetrics and at Buffalo Graduate Medical Dental Consortium Sisters of Charity Hospital, Buffalo, New York, Radiology - Diagnostic, University of Colorado Gynecology, University at Buffalo Graduate Mabel P. Gong, Obstetrics and Gynecology, New Medical Dental Consortium School of Medicine, Denver, Colorado York Downtown Hospital , New York, New York Idalia M. Gonzalez, Pediatrics, University at Buffalo Graduate Medical Dental Consortium james D. Gould, Internal Medicine (Pre lim), Geoffrey G. Hobika , Internal Medicine, Sandra M. Gutierrez, Surgery , The Brooklyn University at Buffalo Graduate Medical Dental Hospital Center, Brooklyn, New York Consortium George E. Haddad , Internal Medicine, Karen L. Houck, Obstetrics and Gynecology, University at Buffalo Graduate Medical Dental Consortium, Anesthesiology, Duke University University at Buffalo Graduate Medical Dental University at Buffalo Graduate Medical Dental Consortium Consortium Medical Center, Durham, North Carolina Tegest F. Hailu, Family Practice, University of Carline T. Hyppolite, Internal Medicine Theodore S. Grabow, Transitional Year, California at San Francisco, Fresno, California (Prelim), North Shore University Hospital, Manhasset, New York Hennepin County Medical Center, Minneapolis, Minnesota, Anesthesiology, The University of Medical Center of Eastern Carolina, Greenville, Patricia E. Allen Iheke, Obstetrics and Chicago Hospitals, Chicago, Illinois North Ca roli na Gynecology, University at Buffalo Graduate Kim S. Griswold , Family Practice, University at Christian H. Hansen, Pathology, Georgetown Buffalo G raduate Medical Dental Consortium University Hospital, Washington, D.C. Geoffrey M. Gullo, Tra nsitional Year, George]. Hatsios, Interna l Medicine (Pre lim), Steven D. Hammel, Pediatrics, University Medical Dental Consorti um Gregory T. jehrio, Internal Medicine, Mary Imogene Bassett Hospital, Cooperstown , New York B a a p h 5 c a 5 m m e 9 9 4 �.. . ...... . . .. .... . . . ..... . .. .. . . ...... . . .. ..... . ... .. .. . . . .. . . . ....... . ... . ...... . ... • ~ Above, Todd Schlesinger, left, and Atif Zafar get the good news. At left, Charles Rocci, Stephen Machnicki, Michael Giovaniello, Joseph Falsone and Glen Feltham celebrate. Andrew D. jenis, Surgery, University at Buffalo Graduate Medical Dental Consortium Jeffrey W . Kanski, Internal Medicine (Prelim), Roger Williams Hospital, Providence, Rhode Island Joseph D. Kay, Medicine/Pediatrics, University of Michigan Hospitals, Ann Arbor, Michigan Barbara P. Kearney, Pathology, University at Buffalo Graduate Medical Dental Consortium Glenn E. Kershen, Surgery (Prelim), Temple University Hospital, Philadelphia, Pennsylvania, Urology, Temple University, Philadelphia, Pennsylvania Carol Ann Killian, Emergency Medicine, University Health Center of Pittsburgh, Pittsburgh, Pennsylvania Richardj . Kozak, Emergency Medicine, Oregon Health Sciences University , Portland, Oregon Michaelj . Krabak, Internal Medicine, Barnes Hospital, St. Louis, Missouri David G. Kupkowski, Internal Medicine, United States Naval Medical Center, Portsmouth, Virginia Michael K. Landi, Surgery (Prelim), University at Buffalo Graduate Medical Dental Consortium , Neurological Surgery , University at Buffalo Graduate Medical Dental Consortium Timothy J. Larosa, Psychiatry, University Hospitals of Cleveland, Cleveland, Ohio Christian D. Lates, Pathology, University at Buffalo Graduate Medical Dental Consortium s u a 0 p janet M. Lawrence, Medicine/Pediatrics, University at Buffalo Graduate Medical Dental Lauraj. Nicholson, Internal Medicine, Strong Memorial Hospital, Rochester, New York Consortium Paulj . Lee, Internal Medicine, Albert Einstein Affiliated Hospitals, Bronx, New York Michael P. O'Neill, Radiology- Diagnostic, University of South Florida College of Medicine, Tampa, Florida Wendy L. Leffel, Family Practice, Forbes Health System , Pittsburgh, Pennsylvania juliana S. Paik, Pediatrics, University of California at San Fra ncisco, Fresno, California Chien H. Lin , Surgery, Nassau County Medical Center, East Meadow, New York Michaelj. Pelechaty, Jr. , Internal Medicine, Guthrie Healthcare System/Robert Packer Hospital, Sayre, Pennsylvania Stephen C. Machnicki, Internal Medicine (Prelim) , Winthrop-University Hospital, Mineola , New York, Radiology- Diagnostic, Lenox Hill Hospital , New York, New York Michelle D. Penque, Pediatrics, University at Buffalo Graduate Medical Dental Consortium Sean Perini, Internal Medicine (Prelim), University of Washington, Seattle, Was hington, Radiology - Diagnostic, University of California at San Francisco, San Francisco, California Andres M. Madissoo , Surgery (Prelim) , University at Buffalo Graduate Medical Dental Consortium , Urology , University at Buffalo Graduate Medical Dental Consortium Richard G. Pinckney, Internal Medicine, Medical Center Hospital of Vermont, Burlington, Stacey A. Madoff, Obstetrics and Gynecology, George Washington University, Washington, D.C. Vermont john Pollina, Surgery , University at Buffa lo Graduate Medical Dental Consorti um Rita M. Malvaso , Internal Medicine (Prelim) , Baylor University Medical Center, Dallas, Texas, Physical Medicine and Rehabilitation, University of Texas Southwestern Medical School , Dallas, Ulka Prakash, Internal Medici ne (Prelim), University of Mary land School of Medicine, Baltimore, Mary land, Anesthesiology, johns Hopkins Hospital , Baltimore, Mary land Texas Frankj . Mascaro, Internal Medicine, University at Buffalo Graduate Medical Dental Consortium john Pryor, Surgery, University at Buffa lo Graduate Medical Dental Consorti um john R. McArdle, Internal Medicine, Yale-New Haven Hospital , New Haven, Connecticut Nasser Razack, Surgery (Preli m), No rth Shore University Hospita l, Manhasset , New York Elizabeth A. McClintick, Internal Medicine (Prelim), University at Buffalo Graduate Medical Dental Consortium , Anesthesiology, University at Buffalo Graduate Medical Dental Consortium Edward D. Reidy, Internal Medici ne (Preli m), Sisters of Charity Hospital, Physical Medicine and Rehabilitation , New England Med ical Center, Boston, Massachusetts Lisa L. Miller, Pediatrics, Rhode Is land Hospital , Providence, Rhode Island Stephanie C. Mitchell, Internal Medicine, Overlook Hospital, Summit, New jersey Cindy D. Repicci, Physical Medicine and Rehabili tation, Univers ity at Buffalo Graduate Medical Dental Consortium Paulj . Mus tacchia, Internal Medicine (Prelim), Presbyterian Hospital, New York, New York Charles A. Rocci, Emergency Medici ne, Albany Medical Center Hospi tal, Albany, New York Erns t Nanor, Internal Medicine (Preli m), Norwalk Hospital , Norwalk , Connecticut, Anesthesiology, Tula ne University School of Medicine, New Orleans, Louisiana Thomas Romanelli, Internal Medici ne (Preli m), University Hospitals, SUNY at Stony Brook, Stony Brook, New York , Anesthesio logy, University at Buffalo Graduate Medical Dental Consortium Michael A. Nasiak, Internal Medicine, University at Buffalo Graduate Medica l Dental Consortium Paul J. Sagerman, Pediatrics, St. joseph's Hospital, Phoenix, Arizona Tung V. Nguyen, Internal Medicine, Kaiser Foundation Hospital, San Francisco, California Diana R. Sanderson, Psychiatry, University at Buffa lo Graduate Medical Denta l Conso rtium 5 c a n s u m m e 9 9 4 �• ·············· · ····· · ············ ·· ················ · ··········· · ··· · ········ · ···· ·· ····· ~ I jennifer M. Thompson, Obstetrics and Gynecology,]ersey Shore Medical Center, Neptune, New jersey Gregory V. Tobias, Internal Medicine (Prelim), University at Buffalo Graduate Medical Dental Consortium, Anesthesiology, University at Buffalo Graduate Medical Dental Consortium Madonna R. Tomani, Obstetrics and Gynecology, University at Buffalo Graduate Medical Dental Consortium jennifer M. Tufariello, Obstetrics and Gynecology, Ohio State University Hospitals, Columbus, Ohio joseph S. Valenti, Obstetrics and Gynecology, University at Buffalo Graduate Medical Dental Consortium Yvette M. Vinson, Surgery (Prelim), Strong Memorial Hospital, Rochester, New York, Otolaryngology, University of Rochester, Rochester, New York From left, Carhne Hyppohte, Paula Bennett, Andrea Withams, Gloria Del Valle, Jennifer Thompson and Patrida lheke share their joy. Pina C. Sanelli, Anesthesiology, Albany Medical Center Hospitals, Albany, New York james W. Spain, Radiology -Diagnostic, Milton S. Hershey Medical Center of Pennsylvania State University, Hershey, Pennsylvania Paul Sansone, Internal Medicine, DartmouthHitchcock Medical Center, Lebanon, New Hampshire Michael Stanton, Internal Medicine, University of Michigan Hospitals, Ann Arbor, Michigan, Neurology, University of Michigan Hospitals, Ann Arbor, Michigan Mark W. Sheldon, Internal Medicine, Hospital of the University of Pennsy lvania, Philadelphia, Pennsy lvania Donna M. Stawasz, Medicine/Pediatrics, University at Buffalo Graduate Medical Dental Consortium john T. Sherwood, Internal Medicine, johns Hopkins Hospital, Baltimore, Maryland Donna G. Sinensky, Transitional, Mercy Catholic Medical Center, Darby, Pennsy lvania, Physical Medicine and Rehabilitation, New England Medical Center, Boston, Massachusetts Gregory H. Stiller, Surgery (Prelim), University of Colorado School of Medicine, Denver, Colorado Mary E. Stock, Internal Medicine, University at Buffalo Graduate Medical Dental Consortium Donald M. Slate, Pathology, University at Buffalo Graduate Medical Dental Consortium Sisters of Charity Hospital, Buffalo, New York, Anesthesiology, McGaw Medical Center of Northwestern University, Chicago, Illinois Sharon A. Szukala, Pathology, Duke University Medical Center, Durham, North Carolina Wendy I. Snyder , Pediatrics, University at Buffalo Graduate Medical Dental Consortium Behzad Tabibian,Internal Medicine, CedarsSinai Medical Center, Los Angeles, California Kenneth A. Sobel, Pediatrics, University at Buffalo Graduate Medical Dental Consortium a a h • c a n Amy L White, Pediatrics, University at Buffalo Graduate Medical Dental Consortium Andrea M. Williams, Surgery, University at Buffalo Graduate Medical Dental Consortium Douglas W. Wisor, Transitional, Reading Hospital and Medical Center, Reading, Pennsylvania, Physical Medicine and Rehabilitation, Medical College of Virginia, Richmond, Virginia Theodros Yohannes, Surgery, University of Louisville School of Medicine, Louisville, Kentucky, Urology, University of Louisville School of Medicine, Louisville, Kentucky Atif Zafar, Internal Medicine, University of + Cincinnati Hospital, Cincinnati, Ohio Debra R. Tarantino, Surgery, University Hospitals of Cleveland, Cleveland, Ohio p Christina G. Weston, Psychiatry, United States Air Force Medical Center (Wright-Patterson), Dayton, Ohio Christopher F. Wood, Internal Medicine (Prelim), Strong Memorial Hospital, Rochester, New York, Ophthalmology, Loyola University Hines VA Hospital, Maywood, Illinois Thaddeus E. Szarzanowicz, Surgery (Prelim), University at Buffalo Graduate Medical Dental Consortium, Orthopaedic Surgery, University at Buffalo Graduate Medical Dental Consortium J. Paul Sla venas,Internal Medicine (Prelim), u jennifer C. Wargula, Pediatrics, University Health Center of Pittsburgh, Pittsburgh, Pennsylvania Maya D. Srivastava, Pediatrics, Cleveland Clinic Foundation, Cleveland, Ohio Todd E. Schlesinger, Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio B lauren j . Vriesenga, Family Practice, Riverside Regional Medical Center, Newport News, Virginia 6 u m m e 9 9 4 �········ ··· ··· · · ·· ······ ·· · ······ ···· · ·· · · ·· · · · · ·· ··· · · · ·· ·· ··· ··· ··· · · ··· · ··· ··· ·· ····· · ·• 11 ' is free from Boehringer Ingelheim Pharmaceutical representatives. Dr. Bianco and his wife, Joan, have a new addition, Regina-Marie, born August 1, 1993. She joins David, 12, and John-Michael, 8. "We're all fantastic!! " tinguished Alumnus Award in 1989, received the award as part of the Sixteenth Annual Meeting of the St. Louis Metropolitan Medical Society. 1 9 5 0 s was reelected treasurer of the Minnesota Medical Association last September. ERICK REESER '56, MICHAEL A . SANSONE '73, JOHN R . ANDERSON '57, was Thomas F. Frawley '44 1 9 s 0 4 gives seminars on "Living With Low Vision" as part of the Mariners Hospital Community Lecture Series. Dr. White has low vision and his experience provides the visually impaired with techniques to increase their independence. His program includes a presentation on closed caption TV enlargers and talking books. In March Dr. White received certificates of appreciation from Florida's Department of Elder Affairs and the Alliance for Aging for his volunteer service. named medical director of the Brothers of Mercy Nursing and Rehabilitation Center, Clarence, New York. Frankhn Zeplowitz '58 by the Buffalo News in its 45th Annual Awards for Outstanding Community Service. JOHN WHITE '40, THOMAS F. FRAWLEY '44, chairman of graduate medical education at St. John's Mercy Medical Center, St. Louis, Missouri, was awarded the Robert E. Schlueter Award for "demonstrating excellence in clinical practice, promoting advocacy for patient care in socioeconomic and political matters and for representing the medical profession in community service." Dr. Frawley, who received UB's Dis- B u a 0 FRANKLIN ZEPLOWITZ '58, was elected chief of staff of Our Lady of Victory Hospital, for 1994-96. He is an attending surgeon at the Lackawanna hospital and a past president of its medical staff. He is a UB clinical instructor of surgery. 1 9 6 1 HARVEY LIEBESKIND '63, writes, "Hoping to retire this year, move to California, travel with my mate, buy and sell thoroughbred horses for a living. My oldest son, Louis, trains horses, middle son, Neil re- • c 5 LAWRENCE ZEROLNICK '72, atrics to join Kaiser Permanente in Baltimore. He and his wife, Barbara, announce the birth of their son, Matthew, on November 8, 1993. of Washington, D.C. , just completed a book for patients with arrhythmia entitled, You Can Live With It! This 66-page book ROBERT DIBIANCO '72, cal director of Hospice Buffalo, was named a Citizen of the Year II 0 has left private practice in pedi- ROBERT A. MILCH '68, medi- h 7 recently was honored by theN ew York State Ophthalmological Society for "leadership and commitment to organized ophthalmology in New York State." He is a past president of the state society and has been a member of the Federal Economic Committee, which advises Medicare on health-care reform. Sansone is chairman of the New York State Managed Care Committee. JOHN KEYES '75, is secretary- treasurer of the medical staff at Lake Shore Hospital in Irving, New York. married attorney Carol Siravo in Cranston, Rhode Island, in April. ALAN PERL '77, 1 9 8 0 s JOSEPHT. WAYNE'82, is pro- searches horse pedigrees, youngest son, Stuart, is a movie stuntman and bartender. Lee Baumel '63, moved to Hawaii in 1993. Paul Lessler '63 retired and is doing financial consulting work." p 9 MICHAEL BARON '71 , writes, "I have recently had two positive events occur in my career which I would like to share with the Alumni. I received the Inpatient Teacher-of-the-Year Award, 1992-1993, from the Family Practice Residency Program of the University of Massachusetts Medical Center. In addition, I am now a diplomate in critical care medicine." s 0 I a n 9 u m m e gram director of the combined internal medicine-pediatrics training program at St. Louis University. He announces the birth of his son, Gregory Joseph, on January 9 , 1994. HERBERT NEWTON '84, is assistant professor of neurology and director of the division of neuro-oncology, Department of Neurology at Ohio State University Medical Center. 9 9 4 �• ······· · ······ · ··· · · · ···· · ··· · ···· ··· ············ ··· ··············· · ···· · ···· ·· ···· · ······ I my general surgery internship in Denver, I spent two years as a brigade surgeon at Ft. Bragg, North Carolina, 82nd Airborne Division. We moved back to Buffalo,july 1993, at which time I started my orthopaedic residency. I married Anita Pantera in August 1991. We were introduced by our fellow classmate Virginia Beerel Campion '90. She and my wife went to high school together. We have two beautiful sons, Ryan Douglas, 20 months, and Connor Matthew, 6 months. MICHAELS. WATSON'87,an anesthesiologist, is vice president of the medical staff at Lake Shore Hospital in Irving, New York. Brian Moore Bernard ROBIN CONWIT '85, has moved to Baltimore and is now an assistant professor at johns Hopkins and director of the EMG Lab at the Francis Scott Key Medical Center. MICHAEL SANSANO JR. '85, has opened his own practice in ophthalmology at 515 Abbott Road, Buffalo, New York. He and his wife, Claudia, have four daughters. HELEN CAPPUCCINO '88, has opened an office in Lockport, New York for the practice of general, thoracic and laparo-scopic surgery. Andrew Cappuccino '88, is completing a spine fellowship with Paul McAfee at johns Hopkins and will be practicing in Amherst and Lockport injuly. The Cappuccinos are the proud parents of four children: Jacqueline, 13; Mac, 5;jake, 2; and Nicholas, 1. M DAVID I. KOLE '90, of Santa Maria, California is in private prac- tice and is chief of pediatrics at DAVID R. BLOOM '89, is now a partner of Beach Physicians and Surgeons Medical Group, Inc., Huntington Beach, California. He is also the team physician at Orange Coast College. "Doug Sillart '89, is a travelling anesthesiologist extraordinaire. Marian Medical Center. He has two children, Ben, 6, and Emily, 4. KRISTA M. (PRIGG) KOZACKI '91 of Florence, South Carolina, is finishing a family medicine residency in 1994 and is considering private practice or a faculty position opportunity. She is the recipient of the McLeod Regional Medical Center Merit Award. Her twin sons, Stefan jerome and jacob Scott, were born on February 18, 1993. M DONNICA L. MOORE '86, and her husband, Stan Bernard, M.D., M.B.A., are delighted to announce the birth of their son, Brian Moore Bernard, on Labor Day, 1993. As is obvious from this photo, he is eager to follow in Mommy's and Daddy's footsteps, although with the directions their careers have takenDonnica is associate director, professional relations at Sandoz Pharmaceuticals and Stan is director, pharmacoeconomics at Bristol Myers Squibb Company - a briefcase might be a more appropriate prop! B u a 1 9 9 0 5 MARK A. FLANZENBAUM '90, is completing a residency in combined internal medicine and pediatrics at the Medical College ofVirginia. He has accepted a position as attending physician in emergency medicine beginning in August 1994. Flanzenbaum is engaged to be married inN ovember to Christie R. Boyd, a neonatal intensive care nurse at the Medical College of Virginia. RICHARD G. BENNETT '92, is a second-year psychiatry resident at Case Western University Hospitals. He married Dawna Lynch on july 9, 1993. p h II • CURZON CADY FERRIS, JR . '46, died in july, 1993. He was 71 years old. Dr. Ferris retired from the Hendrick Medical Center in Abilene, Texas, in 1988. LINDA SHRIRO SCHENCK '77, an adjunct professor at the University of Minnesota's School of Public Health, died of complications from an autoimmune disease in December 1993. ESTER MARIE PONCE GRIMALDI '89, was killed on January 18, 1994, when the car she was driving hit a patch of ice, and slid over an embankment. She was six months pregnant with her second child. Dr. Grimaldi had just completed her residency in pediatrics and was working for a health maintenance organization in Michigan. Besides her husband Thomas Grimaldi '89, she is survived by her daughter, Sarah Marie. Buffalo Physician Goes Electronic Now you use the Internet to send classnotes or other information to Buffalo Physician. Our address is: OBITUARIES HOWARD CRAIG KEYES '28, died in Bellingham, Washington, July 8, 1993, three days short of his ninetieth birthday. Until his retirement in 1974, DoUGLAS PATRICK PREVOST '90, writes, "After completing a Dr. Keyes practiced at the Keyes Clinic, consisting of a father and three sons, all of whom graduated from the University of Buffalo Medical School- William Chauncey Keyes in 1896, Roswell Park Keyes in 1926 and Donald Keyes in 1928. c a n 5 u m Notes@pub.buffalo.edu We'd love to hear from you via e-mail or snail mail! m e 9 9 4 ��BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 2194 ADDRESS CORRECTION REQUESTED ME DICAL HISTORICAL LI 3RARY ABBOTT LI BRARY SERIALS DEPT CA PUS MAil. The only liability coverage with this seal of approval. Medical Liability Mutual Insurance Company (MLMIC) is the only professional liability insurer approved by the Medical Society of the State of New York. Since its founding in 1975, the physicianowned and managed company has successfully defended more physicians than all other available insurers combined. Additionally, MLMIC has the largest and most experienced professional liability claims department in the country, the largest risk management department of any New York State professional liability insurer, and the state's only true peer review of claims experience. Call1-800-ASK-MLMIC (metro) or 1-800-356-4056 (upstate) for more information and an application. MLM~C ~ Medical liability Mutual Insurance Company Our defense never rests. 2 Park Ave., New York, NY 10016 2 Clinton Sq., Syracuse, NY 13202 90 Merrick Ave., East Meadow, NY 11554 «:> 1993 Medical liability Mutual Insurance Company Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1994 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1994-Summer Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v28n03-1994-Summer Table Of Contents A list of subunits of the resource. Research Hospital News An Investment in the Future Going Beyond the Curriculum A Spoonful of Humor Alumni Medical School Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo physician, Summer 1994 Buffalo medical review Buffalo physician and biomedical scientist Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v28n03 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1994 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/f36d4d89e97460e54f336abca2038b2d.pdf d32ef53a42634df70763d2048e2a4b00 PDF Text Text I I I State' Unive!sity, of New York at . Buffal~ School of Medicine and Biomedi~al Sciences, Spri.ng 199.4 �BUFFALO PHYSICIAN Volume 28, Number 2 ASSOC IATE VICE PRES I DENT FOR UN IVERS ITY ADVANCEMENT Dr. Carole Smith Petro DIRECTOR OF PUBLICATIONS Timothy j Conroy EDITOR Nanette Tramont Kollig, R.N. ART DIRECTOR Alan j Kegler ASSOCIATE ART DIRECTOR Scott Fricker PRODUCTION MANAGER Ann Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDIC I NE AND B IOMED ICAL SCIENCES Dr john Kaughton , Vice President for Clinical Affairs, Dean EDITORIAL BOARD Dr. john A. Rtchert, Chairman Dr. Martm Brecher Dr. Harold Brody Dr. Richard L. Collins Dr. Alan j. Dnnnan Dr. Timothy Gabryel Dr. james Kanski Dr. Charles Massaro Dr. Charles Paganelli Dr. Robert E. Reisman Dr. Thomas Rosenthal Dr. Stephen Spaulding Dr. Bradley T Truax Dear Friends, C hanges in medical education and health care are occurring at breakneck speed! UB's medical school and its affiliated teaching hospitals fortunately began developing a strategy for coping with the anticipated adaptations in the mid-l980s. Some of the required efforts were made possible through the development of a demonstration project that served to modify the priorities and directions of the graduate medical education programs. This has been largely accomplished through the Graduate Medical Dental Education Consortium of Buffalo. In the late 1980s, the school's faculty agreed to pilot a comprehensive two-month ambulatory clerkship in the fourth year. During the past two years, the Curriculum Committee has begun its re-evaluation of course offerings to ensure that future graduates will be properly prepared for national health care reform. This effort has been enhanced by the planning grant received from the Robert Wood Johnson Foundation and the school has submitted its final proposal to the foundation in the hope that UB will be among the l2 finalists to receive its support over the course of the next five years. These funds will be directed to assist the faculty in making the required changes in curriculum offerings and to assist in the adaptations in educational technique and support that must be forthcoming. Already, some significant changes are occurring. For example, beginning this fall, a formal clerkship will be offered in family medicine; the departments of medicine and surgery will modify their clerkships so that each department will offer new one-month courses in the fourth year. The Curriculum Committee, faculty and students have initiated their evaluation of years one and two, and obviously new innovations and designs should be forthcoming for these academic calendars in the years ahead. We hope to be able to position the school and its affiliates so they can respond positively to the changes that lie ahead and to maintain our commitment to excellence in teaching, research and patient care. Sincerely, John aughton , M. D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences TEACHING HOSPITALS AND LIAISONS Batavia VA Medical Center Arlene Kelly The Buffalo General Hospital Michael Shaw Buffalo VA Medical Center The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Health System Frank Sava Roswell Park Cancer Institute Sisters of Charity Hospital Dennis McCarthy «:>The State University of New York at Buffalo Buffalo Physician is published quarterly by the State University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications . It is sent, free of charge, to alumni , faculty , students, residents and friends. The staff reserves the right to edit all copy and submissions accepted for publication. Address questions, comments and submissions to: Editor, Buffalo Physician, State University of New York at Buffalo, University Publications, 136 Crofts Hall, Buffalo , New York 14260 Dear Fellow Alumni, T he 57th Annual Spring Clinical Day, the traditional highlight of the Medical Alumni Association's activities, will take place on April30 at the Buffalo Marriott Hotel. The general reception for all Reunion Classes will be held on Friday evening, April 29, at the Center for Tomorrow. The five-year class reunion chairs have planned their Saturday evening receptions, a unique and ever more meaningful time to renew "old" close acquaintances and rehash unforgettable memories. This year, we have a most exciting and innovative program, addressing current and future issues in medical education- a subject that should be interesting and appealing to all attendees. The complete program can be found on the Alumni Section pages of this issue. The morning presentations set the basis for the Stockton Kimball Lecture, which will be presented by Jerome P. Kassirer, M.D., '57 , editor of The New England journal of Medicine, and a premier medical teacher and educator. His topic will be "Clinical Reasoning: Teaching it and Learning it. " As a personal note, I thank Dr. Kassirer for accepting this invitation. He is a past recipient of our Distinguished Alumnus Award and holds one of the most prestigious positions in American medicine. Thi• •hou\d b• '" ou~<anding w"~ Send address thanges to: Buffalo Physician, 147 CFS Addition , 3435 Main Street, Buffalo, New York 14214 Robert E. Reisman, M.D., '56 �v 5 2 L 0 p R 8 N N G 2 0 9 9 4 ~n tne [ouef: Five of the six new Consortium hospital CEOs. From left, Robert V. Stanek, Charles Van Vorst, Lynn Brown, Joseph Ruffolo and Paul Candino. Research Hospital News Leading Buffalo's Changing Health Care Scene e Six Dr. Roswell Park performs surgery. From The Pictorial History of the Medical School collection. Page 25. of the nine affiliated teaching hospitals have new CEOs. What will the changes mean? Changing the Face of Medical Education e The School of Medicine and Biomedical Sciences is moving steadily toward a new way of teaching that stresses analysis over memorization and patient interaction over crowded lectures. Medical School Alumni ASpoonful of Humor Graduate Education Classnotes Going home. Page 34. Alum Jack Coyne blends two callings. Page 30. �.... . .. . . .. . .. . .. . .. .. .. . . . ... . . ... . .. . ..... . . .. ... ... . .. ... . .. .. . . ...... ... .. . . ... .. . .. . . .' . UB research continues on NASA's Spacelab Life Sciences 2mission B research done on the first Spacelab Life Sciences mission that showed the body regulates the cardiovascular system in a novel way, continued on last October's Spacelab life Sciences 2 mission with three more astronauts over a longer period of time. The research was designed by a team of scientists headed by leon E. Farhi, M.D., distinguished professor of physiology. Results from the first mission showed that during space flight the cardiovascular system adjusts vascular tone to maintain blood pressure in the face of elevated cardiac output. "This type of regulation ofblood pressure was completely unexpected, " Far hi says. "The system's failure to reduce cardiac output surprised us." Earthbound research in simulated weightlessness has shown that when gravity is eliminated, the heart pumps more blood initially, but the body eventually reduces total blood volume by eliminating blood plasma through urine to maintain normal blood pressure. Astronauts on the Spacelab missions used special equipment designed by UB technicians to determine how the heart and lungs perform in and adapt to the weightless environment of space during exercise and at rest and how that adaptation affects the astronauts' readjustment to gravity. Results from the initial study found that astronauts did not regain normal cardiovascular balance and could not perform the experiment's exercises fully for at least seven days. UB researchers speculate that even five more days of weightlessness in space could cause more pronounced and longer-lasting effects on the heart and lungs. The experiment was one of three studies conducted during the mission that focused on the astronauts' cardiovascular functioning in zero gravity. Astronauts David Wolf, M.D. , Shannon lucid, Ph.D., and Martin Fettman, Ph.D. , trained for more thana year a tUB and the johnson Space Center in Houston to learn how to conduct the experimets in the confines of the Space Shuttle Columbia. - B y L 0 I 5 B A K E R Highest sepsis mortality rates found from respiratory infections lderly patients who develop sepsis from respiratory infections while hospitalized have higher mortality rates than patients who develop sepsis from all other infection groups , according to a study by UB's Center for Pharmacoepidemiology Research. Sepsis is the most common cause of death in intensive care units, according to Thaddeus H. Grasela , Pharm. D., assistant professor of pharmacy and director of the Center. Grasela was the principal investigator on the I, 758-patient study that revealed mortality rates that varied widely depending on the source of the sepsis infection. Patients with sepsis acquired from respiratory tract infections had the highest mortality rate at 59.3 percent. The lowest mortality rate was reported in patients who developed sepsis from a community-acquired urinary tract infection. Mortality rates for patients who acquired sepsis from other infections were: • 46.4 percent for hospital-acquired urinary tract infections. • 45 .8 percent for patients with abdominal infections. • 36.7 percent for patients with skin infections. • 35 .9 percent for gram-negative bacteremia inclusive of all sources. • 28.3 percent for respiratory tract infections acquired in a nursing home. • 24.6 percent for urinary tract infections acquired in a nursing home . The multi-center study followed patients receiving antibiotics for suspected or documented cases of gram negative infections that can lead to sepsis from the beginning of their treatment until their discharge from the hospital or death. + - B Y E LLEN G OLD B AUM Liposomes curb taxol's toxicity sing liposomes to deliver taxol has allowed researchers to control resistant tumor growth in animals with doses of the drug that would be lethal if delivered traditionally. UB and Roswell Park Cancer Institute scientists reported in the December 15, I993 issue of Cancer Research that the liposome delivery system may overcome some of the major obstacles to the more effective use of taxol in fighting cancer. "Taxol has two problems," said Robert Straubinger, Ph.D., assistant professor of pharmaceutics and lead author of the study, "The drug itself is toxic and �·············· · ············································· · · · ······················ · ····~ the solvent in which it is administered is also toxic." Straubinger's experiments showed that the use of liposomes to deliver taxol allowed it to be administered rapidly and in doses between two and seven times larger than those the animals would have been able to tolerate as free drug. "We're quite encouraged, " said Straubinger. "By encapsulating taxol in liposomes, we have caused a marked decrease in toxicity and increased the drug's potency. "Right now," he added, "patients who take taxol have to be treated heavily with antihistamines and steroids. That controls the side effects, but some of these supplementary drugs may interfere with the same systems that transport or metabolize taxol within the body." Liposomes, he explained, although they are essentially fat-soluble, are also very stable in water and thus provide a way to dissolve fat-soluble drugs such as taxol in the body. "Liposomes are particles with an oily core, and a fat-soluble drug like taxol tends to stay with them," Straubinger said. "As a result, we have reduced the massive wave of free drug that causes some of the side effects." The UB researchers compared the conventional delivery of taxol against taxol in liposomes in animals with colon cancer, even though the drug has not shown to be effective in controlling colon cancer growth. "We were able to see control of tumor growth in animals given multiple injections of liposomes containing 40 milligrams of taxol per kilogram of body weight," Straubinger said. "If you gave that amount as free drug, it would have killed the animals. But in liposomes, it didn't. It just controlled the tumors nicely." - B B Y ELLEN a GOLDBAUM 0 p UB'sDrug Surveillance Network tracks drug reactions nationwide he University at Buffalo's Drug Surveillance Network (DS ) is the only network of hospital pharmacists in the U.S. designed to rapidly track and share information about how patients react to drugs. Established by UB's Center for Pharmacoepidemiology Research with grants from pharmaceutical companies, and supported with a grant from the Food and Drug Administration, the DS includes more than 1,100 clinical pharmacists in 522 acute-care hospitals. "We have the unique ability to get a peek at what goes on in hospitals across the country," said Thaddeus H. Grasela, Pharm. D., director of the center and assistant professor of pharmacy. The network places Grasela virtually at the bedside of patients in hospitals from ~ :• -• The network of hospital pharmacists tracks and shares information about adverse drug reactions. 5 c a n s p Miami, Florida, to Anchorage, Alaska. Currently, clinical pharmacists from six UB teaching hospitals- Mercy Hospital, The Children's Hospital of Buffalo, Erie County Medical Center, Roswell Park Cancer Institute, The Buffalo General Hospital and Millard Fillmore Suburban Hospital- participate in the network. According to Grasela, one or two cases of adverse effects from a drug over a period of months or years in a single hospital may not attract concern. By combining information from hundreds of hospitals, however, the DSN provides a much faster way to spot problems with specific pharmaceuticals. - BY ELLEN GOLDBAUM UB scientists awarded $1.5 million in Veterans Affairs grant funding our UB researchers at the Buffalo VA Medical Center have received Department of Veterans Affairs grants totaling $1.5 million. John Canty, M.D., associate professor of medicine , received $606,600 to explore how nitric oxide affects coronary artery blood flow in conditions of underperfusion. Alan Lesse, M.D., assistant professor of medicine and pharmacology, received $174,100 to explore how changes in a surface protein on Haemophilus influenzae affect its virulence. Jeffrey Mador, M.D., assistant professor of medicine, received $175,600 to investigate the causes of respiratory fatigue. Timothy Murphy, M.D., professor of medicine and microbiology, received $533,700 to explore the causes of exacerbations of chronic obstructive pulmonary disease. He will also establish a Chronic Bronchitis Study Clinic to follow patients before, during and after exacerbations. n g 9 9 4 �~ -··· · ··· · · · ···· · ·· ·· · · ·· · · · ···· · ···· · ······ · ··· ···· ········ · ··· · ·· · ········· · · · ···· · ···· · · ~ Holmlund treats about 60 patients in Western ew York. The treatment, done on an outpatient basis, involves injecting the toxin directly into the overactive muscle , Holmlund says. The toxin, he explains, blocks the nerve impulse to effectively relax the muscle. "The nice thing about it," he notes, "is that we can grade the weakness" to tailor the response to each patient. The effects ofbotulinum toxin are transient, lasting several months - about three each in laryngeal dysphonia and spasmodic torticollis treatments and about six months for blepharospasms , Holmlund adds. "It has been a truly wonderful experience to help patients with disorders we previously could not help. We can finally do something positive for them," he says. In addition to facilities in Albany, Rochester and New York City, the treatment is only available at about 20 to 30 centers nationwide, Holmlund says. vices there. She holds a master's degree in health systems administration from the University ofLouisville in Kentucky, as well as both bachelor's and master's wo new CEOs have been ap- degrees in English from orth Texas pointed at University at Buffalo State University in Denton, Texas, and a medical school affiliated teaching bachelor's degree in nursing from Spalding hospitals. College in Louisville, Kentucky. Joseph A. Ruffolo has been appointed president and chief executive officer of The Children's Hospital of Buffalo and Evelynn G. Brown has been appointed as the new vice president and chief executive officer for hysicians at Millard Fillmore Millard Fillmore Suburban Hospital. Health System's Dent Neurologic (For more changes at the teaching hospiGroup are one of only four groups tals, see the cover story on Page 6.) in New York State using botuliRuffolo previously served as vice presinum toxin to treat patients with dent of corporate finance for Millard dystonias. Fillmore Hospitals, where he was reTomas Holmlund, M.D. , assistantprosponsible for financial leadership of fessor of neurology and an attending Millard and its affiliated health care subat the Dent, has been using physician sidiaries, including corporate restructuring, medical staff development, merg- botulinum toxin successfully in patients ers and acquisitions, programmatic de- with blepharospasms , spasmodic velopment and expansion as well as torticollis and laryngeal dysphonia since 1991. fiscal operations. New CEOs appointed to head two UB affiliated teaching hospitals Dent physicians use botulinum toxin successfully for dystonias Ruffolo was credited with playing a significant role in Millard's financial turnaround. The organization had lost over $20 million in operations over 13 years before Ruffolo joined it in 1984 and enjoyed operating surpluses in nine consecutive years after that. Brown most recently held the position of senior vice president and senior administrator for Eastern Maine Medical Center in Bangor, Maine. She also served as senior vice president for corporate services at North Colorado Medical Center, Inc., in Greeley, Colorado as well as director of professional and technical services and director of nursing and patient care ser- B a Mercy Hospital'striplehead nuclear camera is first in WNY area ercy Hospital of Buffalo has recently acquired Western New York's first triple-head nuclear imaging camera. The new camera provides superior quality images in shorter scan times and offers enhanced computer capabilities to address difficult processing demands. Compared to single-head, conventional nuclear medicine cameras, Botulinum toxin, injeded diredly into the muscle, blocks the nerve impulse. the triple-head is more effi- 0 p h y 5 c a n s p n g 9 9 4 �·· ······· · · ·· · · ·· ···· ··· ···· · ·· · · · ··· ·· ·· · · ······ ········ ···· · · · · · ··· ·· · ···· · ·· ······ ·· ·· · a cient, acquires three times the amount of information in the same amount of time and offers superior image resolution. "The recent acquisition of the triple-head camera will allow Mercy Hospital to provide our patients with the latest in nuclear medicine imaging techniques, " said Fazalur C. Rehman, M.B.B.S., clinical associate professor and chairman of Mercy's department of nuclear medicine. The flexibility of the triple-head camera allows it to handle all types of planar and SPECT studies as well. Suburban completes Suburban's new additions will add approximatelylOO,OOO square feet of space to the ISO,OOO-square-foot facility. phase one of its $60 will feature a dedicated X-ray room , two cystography rooms and an exam code room and 20 exam rooms when room . An additional six ambulatory surmillion modernization project illard Fillmore Suburban Hospital has completed the first phase of its $60 million modernization project, which broke ground in September 1992, with the opening of its orth and East additions. The new additions, which add approximately 100,000 square feet to the 150,000-square-foot facility, house a 20bed critical care unit, a 32-bed medicalsurgical unit, expanded emergency and radiology departments , new cardiology and respiratory therapy services and a new medical library, medical records and medical staff lounge. Suburban's new emergency department - with 50 percent more space than its busy 30,000-plus-visit ER - B a 0 p h renovation of the original, adjacent ER space is complete. The 151-bed hospital's radiology department, now doubled in size, accommodates nuclear medicine, fluoroscopy and the addition of angiography. The department features two dedicated mammography units, two ultrasound rooms and two SPECT cameras. The 20-bed critical care unit, with 10 each CCU and ICU beds, consolidates the hospital's four intensive care beds, four coronary care beds, a satellite pharmacy and a satellite laboratory. The new 32-bed medical-surgical unit includes 16-patient telemetry capabilities. The new construction also adds an additional OR room to Suburban's four , and three more recovery beds to its original six. The OR suite also features s c a s p gery beds have also been added to Suburban's original six. "The expansion and renovation project will help Suburban Hospital to meet the health care needs of Williamsville, Amherst, Clarence and surrounding communities well into the future . This also provides our physicians, nurses and other medical professionals with state-of-the-art facilities to care for their patients," said Lynn G. Brown, vice president and chief executive officer of Millard Fillmore Suburban Hospital. Renovation work continues on the original building, constructed in 1974. The $60 million project is the most extensive modernization project in Millard Fillmore Health System's 121-year history. n g 9 4 0 �--------------------------------------------------------------------. B y 5 0 C T T T H 0 M A S LEADING ' NOTHING IS CERTAIN BUT CHANGE- ESPECIALLY, IT SEEMS, IN HEALTH CARE. IN THESE TIMES OF SHIFTING POLITICAL SANDS AND AN EXPLOSION OF KNOWLEDGE ABOUT THE HUMAN BODY AND ITS SYSTEMS, THE EDUCATION OF FUTURE PHYSICIANS IS NEVER STATIC. THAT'S TRUE, TOO, OF THE INSTITUTIONS WHERE THOSE FUTURE PHYSICIANS PUT INTO PRACTICE THEIR RIGOROUS EDUCATION. SIX OF THE NINE HOSPITALS THAT ARE PART OF THE GRADUATE MEDICAL DENTAL EDUCATION CONSORTIUM OF BUFFALO - THE TRAINING GROUND FOR ABOUT 700 MEDICAL RESIDENTS - HAVE NEW CHI EF EXECUTIVE OFFICERS, ALL WITHIN THE PAST 15 MONTHS. P H 0 T 0 S E' v M A K R D ~ L L A s --------------------------------------------------------------------. 0 B u a 0 p h y 5 c a n 5 p g 9 9 4 �·-------------------------------------------------------------------~ • -- B a 0 p h y 5 c a n s p g 9 4 0 �e're living in an era where both medical education and health care will change considerably," said John P. Naughton, M.D., vice president for clinical affairs and dean of the University at Buffalo School ofMedicine and Biomedical Sciences. "The people coming in new will bring some new ideas, and if those ideas are worth testing, we'll probably test them.I think they'll contribute to positive change." The new CEOs have come to Buffalo from areas as diverse as Virginia and Indiana, Texas and Maine. Their backgrounds as businesspeople and health care administrators provide a wealth of experience that becomes a further resource for the education consortium. "It's something of an added learning curve for them," Dean Naughton said. "After all , they came here primarily to manage their hospitals, and now they find out that they have to work with each other. .. . It's been a learning process in the past six months, but I think it's been going very well. " Buffalo Physician caught up with these six newly appointed chief executives to ask about medical education, running a hospital and the unique demands that New York State places on the challenge of providing medical care. To a person, they were enthusiastic about the consortium's work in training medical residents. And they see more change ahead as the hospitals and the school - cope with a new era in health care. sity hospital , but that structure may turn out to be a long-term positive. The key to it is how well we work together. There's a tremendous give-and-take. ''I'm extremely supportive of the affiliation and want to continue to strengthen it. It's a real opportunity for practicing physicians, hospitals and the university to continue to come together in a cooperative way." VanVorst sees Millard Fillmore as a hospital system in a good position to adapt to the trend toward decentralized and outpatient care. "We need to continue to position Millard as an integrated delivery system," he said. "If you want to cling to the anchor of the past, this is a very troubling time. If you see it as a bridge into transforming our industry into even more of a positive force for society, it's a very exciting time. It's white-knuckle at times, but you just have to have faith that it will all come out appropriately." with sparking a dramatic turnaround in Buffalo's second-largest hospital system. Under his leadership , the formerly money-losing system ran consistently in the black. In addition, jennings formalized the hospitals' relationship with the university and many of the residency programs it operates. He left Buffalo last year to become president of the Children's Memorial Medical Center in Chicago. VanVorst came to Millard Fillmore in May from San Antonio, Texas, where he headed the multi-hospital Santa Rosa Health Care Corp. At Santa Rosa , he developed a long-range strategic plan and a quality management plan. His previous positions included president and CEO of the Carle Foundation, in Illinois, a not-for-profit health care holding company with hospitals and other facilities, and vice president of operations at Methodist Hospital of Indiana. Van Vorst has received the World Health Organization Fellowship and was appointed to the National Advisory Council on Public Health Training. His master's of business administration in health care administration is from George Washington University, in Washington, D.C. "New York is a much more regulated state" than hts previous locations, Van Vorst said. "It has unique nuances in terms of how health care is delivered." And the medical school's relationship with its consortium of hospitals, he said, also is unusual in American health care. "What is exciting and, frankly, I think is avant-garde about Buffalo, is the fact that there is a pluralistic approach many hospitals working with the university, a joining together of community resources. I think it may be a structure that's ahead of its time. "It starts from a level of collaboration and coordination that we have to do, because there is no (single) univer- Charles B. Van Vorst is the new president and chief executive officer of the Millard Fillmore Health System, which comprises the 443-bed Gates Circle and 151-bed Millard Fillmore Suburban hospitals. His predecessor,] an] ennings, served for a decade starting in 1983. Active in the community, Jennings is credited Lynn G. Brown joined Millard Fillmore Suburban Hospital on Nov. 3 as vice president and chief executive officer. She succeeds Albert L. Fritz, whose two years at the Amherst hospital ended when he returned to his hometown Baltimore to establish a health care consulting firm. During Fritz's tenure, the suburban hospital embarked on a major expansion necessitated by its burgeoning business in delivering babies as well as increased services, patient visits and occupancy that consistently approaches 100 percent. Millard Fillmore Suburban handles more than 3,000 obstetrical cases each year, reflecting its location in the youthful and populous Town of Amherst. Fritz redefined the hospital's approach to providing a "quality life experience" to couples at the birth of -------------------------------------------------------------------0 B u 0 0 p y s 0 s p g 9 4 �-------------------------------------------------------------------· B a 0 p y s c a 5 p g 9 9 4 �------------------------ --------------------------------------------- practice residency programs are the core of Millard Fillmore Suburban's role in the consortium, Brown said. The coordination of several teaching hospitals , she said, "certainly adds a layer of complexity. On the other hand , I believe there is tremendous value for a hospital to be affiliated with the medical school. It kind of forces everybody to stay on the cutting edge. "If you're there teaching residents and have residents in the building, it says that everybody there has to stay on their toes. It's a very positive growth experience, and really sets the stage for people to stay current in the field. " Brown said Eastern Maine Medical Center has affiliations with Tufts University, for the teaching of pediatric medicine, and the University of New England, an osteopathic program. "It's a very similar situation here ," she said. "Obviously, the more residencies you have, the more complicated it gets. "It's verymucha balancing act, too, " their children, instituting a wider spectrum of before- and after-delivery educational classes for new parents. Lynn G. Brown comes to the hospital from Eastern Maine Medical Center in Bangor, Maine, where she was senior vice president and senior administrator. During four years there, she implemented a total quality management program , brought 17 patient response teams on line and established a management development program. Previously, Brown worked for eight years at North Colorado Medical Center in Greeley, Colorado, serving as senior vice president for corporate services as well as director of professional and technical services and director of nursing and patient care services. Her master's degree in health systems administration is from the University of Louisville, Kentucky. She also holds a bachelor's degree in nursing from Spalding College in Louisville. Obstetrics/gynecology and family she said. "When you commit to being a teaching hospital, it is more work. A lot of times it would be faster to just do (some procedure) yourself rather than teaching someone. But it's really the questions, the answers and the interaction that helps us to grow. The patient, in the long run , will benefit because they are the recipient of having a well-attuned medical staff." Recognizing the hospital's "very attractive" suburban location, Brown says, "We're all looking toward becoming a more integrated health care system. As health care changes and evolves, a lot more emphasis is being placed on primary care. Family practice and obstetrics are both generally regarded as primary care practices. "We have a very strong focus on the health care of the future . Basically, we're a full-service community hospital. We want to look at more preventive medicine and the community's health in general. " -------------------------------------------------------------------- · B 0 0 p y 5 c 0 n s p n g 9 9 4 �-- --------------------------- ---------------------------------------- last October ,Joseph A. Ruffolo simply altered his daily commute. He had served as vice president of corporate finance at Millard Fillmore Hospitals since 1984. His predecessor at Children's, john P. Davanzo, saw the hospital come increasingly to handle high-risk deliveries; it also dominates the Buffalo market in pediatrics. During his two years at the helm of the West Side hospital, he grappled with a decrease in Children's patient load attributed to the population shift to the suburbs and severe competition for the obstetric market from other hospitals - most notably, Sisters and Millard Suburban. The resulting financial problems forced the layoffs of about 60 employees in 1992. At Millard Fillmore, Ruffolo played a significant role in that system's return to profitability. He also worked with the medical school to establish a Department of Rehabilitative Medicine. His previous health care administration experience includes positions at Sheehan Emergency Hospital and iagara Falls Memorial Medical Center. In 1990 he won the Cain, Shattuck Co. Award, a prestigious national award that provides the winner a fellowship in corporate financial management at Harvard University. Now, Children's financial picture has improved, and Ruffolo says the hospital's 125 residents in all specialties of pediatric medicine are keeping physicians up on the latest methods of caring for the tiniest of patients. "What (the consortium) enables us to do is to really stay on the cutting edge of new technologies and treatment modalities," he said. "Participating in these teaching programs allows you to develop protocols that can monitor behaviors much more effectively than if you were trying to do that using When he became president and chief community hospital physicians. " executive officer of Children's Hospital Ruffolo says he wants Children's Hos- regulated health care environment challenging. Here, "providers operate under a much more regulated environment," Maher said. "The options on what you can strategically do tend to be much more limited." He also cited the difficulties an administrator faces in a state that tightly regulates the fees hospitals can charge. "It's created a system where hospitals have a difficult time maintaining financial solvency," he said. "It makes it much more difficult for hospitals to have the capital to restructure and retool for the future. " About the medical school consortium, though, the new CEO is nothing but positive. "For a hospital like Sisters, it really opens up a lot of avenues for being able to work with the university," he said. "If you think about hospitals that are outside the opportunities a consortium provides, they're not able to access the educational resources that we're able to access. The consortium, for us, provides that opportunity, that avenue to benefit from resources that, without the consortium, frankly, we wouldn't have. " Sisters has about 48 residents in such programs as internal medicine, obstetrics/gynecology, otolaryngology and family practice. The Main Street hospital's future , Maher said, will be "very much involved in trying to not simply take care of the patients that arrive at our front door, but rather reaching out to the community and enhancing the health status of the community. It's something we can't do by ourselves, but only by working collaborativelywith other providers. " john]. Maher, Sisters Hospital president and chief executive officer, last April became the first lay president in the hospital's 145-year history. The hospital, part of the Daughters of Charity ational Health System, had been administered for the six years before that by Sister Angela Bontempo. Taking office at a time when the hospital needed renovation and was facing pressing financial problems, Sister Bontempo helped increase the hospital foundation's assets to more than $3 million, and directed the establishment of new women's services, chemical dependency centers and satellite primary care offices throughout Buffalo. She also was the force behind the hospital's $42 million modernization project. Sister Bontempo left to take on other duties in her religious order, the Daughters of Charity of St. Vincent de Paul. Maher previously was executive vice president of the St. Vincent Hospital and Health Care Center, in Indianapolis, also a part of the Daughters of Charity hospital system. There he was responsible for day-to-day operations at the hospital's three acute-care facilities, a regional referral center, a smaller community hospital and a mental health facility. He also managed a $100 million construction program and helped institute a program in which nurses and other staff members play a more active role in defining their care units - a program that cut costs, increased satisfaction among patients, physicians and staff and improved patient outcomes. Prior to his six years in Indianapolis, Maher worked in health care administration in Tacoma, Washington; Richmond, Virginia; and Chicago. He has master's degrees in business and in hospital administration from Ohio State University. He, too, finds NewYorkState's highly - ••••••••••••••••••••••••••••••••••••• B u a 0 p ., y s c 1 1 1 --------------------------------~ I a n s p n g 9 9 4 �--------------------------------------------------------------------· ficulties occasioned by stiff competition, fewer admissions and an increase in the average length of time patients stayed in the hospital. Mercy's financial picture improved after 81 positions were eliminated late in 1991. In Virginia, Stanek was responsible for all hospital operations, including finance and marketing. His previous experience included serving as executive vice president and chief operating officer of Good Samaritan Hospital, in Pottsville, Pennsylvania. His master's in business administration and administrative management is from St. joseph's University, in Philadelphia. His original training was in pharmacy, at the Philadelphia College of Pharmacy and Science, and in chemistry, at East Stroudsburg University, East Stroudsburg, Pennsylvania. Stanek says Eastern Virginia Medical School worked with DePaul Medical Center in much the same way the UB Medical School works with the hospitals in its teaching consortium. "It really is a major medical school," he said of UB. "The residents have the ability to experi~nce different environments. They pital to reach out to the community, "moving toward ambulatory settings so that residents have more exposure to ambulatory medicine. And we are beginning to develop more outreach initiatives in preventive medicine." Ruffolo says Children's seeks to encourage residents to choose primary care as a specialization, recognizing that primary care is increasingly essential to an integrated health care system. "I want to build Children's Hospital as more of a regional and statewide tertiary center for cardiovascular, thoracic and neurosurgery, hematology and oncology," he said. MERCY HOSPITAL Robert V. Stanek comes to Buffalo from orfolk, Virginia, where he was executive vice president and chief operating officer at DePaul Medical Center. He succeeds Sister Sheila Marie Walsh, who had been administrator of the South Buffalo hospital since 1976. Sister Walsh, like many local hospital executives, struggled with financial dif- also have exposure to not only full-time faculty members, but also with volunteer and part-time faculty members (at the hospitals). There's a richness and diversity there, and that's a major advantage that this type of consortium approach brings to the table." About34 residents, Stanek said, serve in the internal medicine, physical medicine and pediatrics programs at Mercy Hospital. ew York, he agreed, is a unique environment for the health care administrator. "It's driven to a large degree by this being a very regulated state health care environment. In Virginia it was very deregulated. Here, reimbursement rates are very regulated by the State of New York; in Virginia, it's much more a competitive situation, similar to the Clinton managed care environment. "I find the hospital providers in Buffalo to be very collaborative in nature, and I find that very helpful. The level of collaboration can help achieve a better quality of care for the people we serve. It becomes more cost-effective over time." In South Buffalo, Stanek said, "our -------------------------------------------------------------------- ~ B a 0 p h s c a n s p n g 9 9 4 �~ -------------------------------------------------------------------~ overall direction is to make sure that we are meeting the needs of the community. We try to make a commitment to servicing employees, patients, physicians-- we look at all of those as people whose needs we are challenged to meet." He points to gall bladder surgery as an example of how new technology is radically changing the way hospitals do business. "A few years back, you'd be in the hospital10 days to two weeks. Now it's laparoscopic; patients stay for a day or two. "We're watching the transition from care being provided in an inpatient setting evolving to outpatient settings. It's less expensive that way. "And there's a very strong evolution in the health care environment to really deal very heavily with preventive medicine rather than just the traditional delivery of health care. We want to develop an integrated, seamless delivery system. We want you to have the ability to get into the system and have your health care needs met." Wyoming County Community Hospital , where as CEO he guided the 102bed hospital to its first years in the black since its founding. Hired in 1990 - a year in which the hospital lost $2.3 million- he led it to profitable years in 1991, 1992 and 1993, with no financial assistance from the county. At ECMC, Candino said, his mission will be to bring the medical center into similar financial stability, while at the same time developing long-range plans for the way it delivers health care. "I think that ECMC and all the consortium hospitals have to begin looking at the overall delivery system and the health care community in the Buffalo and Western ew York area, " Candino said. "It's difficult to do, because there are all sorts of pressures on hospitals right now- reimbursement pressures, health care reform pressures. "It would be very easy for the CEO to continually focus on what's going on within the internal operations of the hospital he's in charge of, but if that's all the CEO does, then the overall world will change, and where the medical center fits into that will be up to someone other than the CEO. He has to make decisions for what makes sense for the community. "I think we have to work together and start making some decisions , not only what makes sense for our particular hospital, but what makes sense for the community." The appointment of ECMC's new chief executive officer was fraught with political controversy as the hospital's board rejected County Executive Dennis Gorski's candidate. The board has the sole authority to hire the county hospital's chief executive officer, but since the county executive appoints 10 of the board's l3 members, Gorski had argued he should have a voice in the selection process. With the selection process narrowed to three candidates, Gorski had sup- Paul Candino began work on February 14 as chief executive officer of the Erie County Medical Center, succeeding George H. McCoy, who had led the Grider Street facility since 1986. McCoy resigned effective April 1 to take a position with the government of St. Croix, in the U.S. Virgin Islands. As chief executive officer of St. Croix Hospital, he will oversee the rebuilding of the hospital, severely damaged by Hurricane Hugo in 1989. During his tenure, ECMC was named a regional center for the care of trauma, burns and AIDS. McCoy also is credited with buttressing the hospital's troubled cardiovascular surgery service and finances as it entered the 1990s. Nevertheless, it remains beset by financial and political troubles. Candino comes to ECMC from the ported Sushil C. Sharma, head of Buffalo's Columbus Hospital, over the other two, one from Washington, D.C., and one from Ohio . The board rejected Sharma, saying his experience at the helm of tiny Columbus Hospital didn't qualify him to lead giant ECMC. That decision set off a firestorm of protest, as supporters of Sharma pointed to his exemplary record at Columbus and his strong credentials. Candino maintains a firmer financial footing for ECMC will ease some of its political pressures. "We have to gain, as an institution, any efficiencies we can gain," he said. "Once we do that, a lot happens and a lot of opportunities will be presented. All of a sudden government is not as interested in the day-to-day operations of the medical center. As long as government is footing the bill in terms of a large subsidy, then they're going to want to have a say. That's their job. They're elected to serve the taxpayers' interests. "But once we can get beyond that, once we can generate a gain or a breakeven situation without a county subsidy, then we'll be able to look at the long-term picture of delivery of health care in the Western New York area , and work in more of a collegial environment with the other hospitals, work toward some mutual goals." OfECMC's part in graduate medical education, Candino said that's "a part of our overall mission. "In addition to providing high-quality care at the lowest cost possible, it's also a medical center that has the responsibility to provide teaching and research for the overall good of medicine," he said. "Somebody has to supply physicians to the community, especially the Western ew York community and especially primary care physicians, in the future. And somebody has to do the research and look into cures for the future. "I look at it as a challenge. " + -·------------------------------------------------------------------B u 0 0 p y s c o n 5 p n g 9 4 �HANGING FACE THE OF ED I CAL DUCATION UB'S REVAMPED CURRICULUM WITH THE BY BLENDS BEST ANDREW OF THE THE BEST OF THE OLD NEW DANZO It used to be fairly cut and dried. Two years of basic science. Two years of clinical experience. Then the M.D. Those days are over. The UB School of Medicine and Biomedical Sciences is moving steadily toward a new way of teaching -one that stresses analysis over memorization and patient interaction over crowded lectures. Proponents hope it will bring the art and science of medicine into more meaningful focus, providing future physicians with cutting-edge computer skills while re-emphasizing the people skills of old-fashioned doctoring. Many changes are being implemented or planned, but the central ones involve a problem-solving emphasis in basic science courses, earlier introduction to clinical skills, the creation of a clerkship in family medicine and a shift to ambulatory settings for other clerkships. B a a p 5 c a n s p g 9 9 4 �PHOTOS BY ROBERT basic science faculty, which he described as "excellent." "It's a difficult line we're walking here," said Loonsk, a 1986 UB medical school graduate. "By no means are we trying to imply that what they're doing is not superior." The proposals not only would make changes in the way the basic sciences are taught, but they would also establish a closer link to the clinical training that is the core of the second two years. "One of the ideas put forward is to focus the curriculum in the first two years around clinical education and experiences," said Dennis A. Nadler, M.D., associate dean for curricular and academic affairs. adler declined to predict the final outcome. He did say, however, that the ideas under discussion would "drastically" change the way medicine is taught at UB. Bone said it would be a "significantly" different education than the one he received when he attended the medical school more than 20 years ago. "We had no clinical correlation," said Bone, who graduated in 1973. "We had no interdisciplinary approach and we didn't see patients , except for an occasional visit with a preceptor, until the third year." The new proposals include an earlier introduction to clinical courses and improvements to the first-year preceptorship program. "The experiences the students had with the preceptor program vary, and that's a concern," said Loonsk, explaining that some students haven't had enough contact with their preceptor. One idea is to have students follow a single patient or family all the way through medical school. "That's a difficult one," Loonsk admitted. Nadler said the second-year family medicine course might The new approach is not so much a single effort as a group of ideas that have evolved independently in recent years. But many of those ideas are now coalescing under the umbrella of the medical school's primary care initiative. "The reason is that the forces of health care reform and national need are such that we don't need larger numbers of specialists, we need larger numbers of generalist physicians," said dean and vice president for clinical affairs john aughton, M.D. The medical school hopes to be chosen by the Robert Wood johnson Foundation in late spring for a $3 million grant to help implement the changes. If it wins the grant, and administration officials are optimistic, the funds could speed the changes, though no one has yet put a precise timetable on them. Naughton said UB isn't the only school making such efforts, but it's at the forefront. "We've moved a little faster than certainly most of the eastern schools have," he said. UB already has made some of the changes. It has started moving medical clerkships, for instance, from hospital bedsides to ambulatory settings, such as physician offices and clinics. It also has introduced a family medicine clerkship for third-year students. And some basic science classes have begun introducing problem-solving and clinical-correlation approaches. "The whole idea of medical school is to become a doctor and take care of patients," said Lawrence Bone, M.D., cochairman of the school's Curriculum Committee. "That's what we're trying to do , make doctors." Many of the changes that are still in the proposal stage focus on the first two years, where students traditionally have been immersed in basic sciences. john Loonsk, M.D. , the other Curriculum Committee cochairman, said that while the changes are significant, they are meant simply as improvements, not criticism of UB's B a 0 p s c WA LI ON 0 5 p g 9 9 4 �CHANGING THE FACE OF u a 0 p h 5 EDUCATION techniques almost to the exclusion of traditional didactic teaching. UB doesn't intend to go that far. "We hope to strive for a balance ," he said. "We believe both are important teaching tools , and we hope to achieve a balance. " Rosenthal said the techniques already have been introduced as a "clinical correlations " component in some courses, particularly microbiology and biochemistry. The teaching often is done in a team , with a clinical faculty member on hand to present the case, say, of a patient who has walked into a doctor's office with fever and chills. What might have been a purely scientific discourse on bacteria is transformed into a give-and-take exercise. Instead of- or in addition to - simply listening to a lecture, the students find themselves pondering the patient's chest X-ray. "What we hope to do is give the student the opportunity to recognize the relevance of what's being taught and give them the discipline to ask their own questions ," Rosenthal said. The teaching techniques would most likely take final shape around an "interdisciplinary medicine" course, a twoyear track that would integrate related aspects of basic science courses now taught separately. Among the many details still to be resolved are just which course components to move , and where. Rosenthal said there is no single model for what UB wants to do with its curriculum, but medical school officials have been exchanging ideas for several years with representatives of five other schools, including Harvard. "This has been an evolutionary process that comes into focus in 1994 with the Robert Wood johnson Initiative," he said. be expanded into the first year , using many of the same sites, as well as some additional ones, now used in the second-year preceptorships. Students might spend one or two half-days a week at the same site, following patients and seeing how a generalist practices, Nadler said. The second-year clinical introduction course also might be shifted to teach first-year students interviewing and diagnostic skills , said Thomas Rosenthal , M.D. , project director of the Robert Wood ] ohnson Generalist Initiative. Ideally, said Rosenthal, "by the time they hit the third year, they have some of these basic clinical skills developed and are able to take better advantage of the clinical experiences." While clinical experience would be accelerated and expanded under the proposals, the approach to teaching basic sciences also is in for some revision. Nadler said the catch-all phrase for the change is "self-directed learning," a central element of Harvard's New Pathway program. Essentially, it makes the student a more active participant. "The traditional curriculum at this school is a very didactic one," Nadler said. "Students go to lectures and laboratories and are taught." Self-directed learning is based on two techniques , casebased and problem-based teaching, which are similar. In problem-based teaching, basic science students are presented with a question that relates to a common medical problem, such as diabetes or cerebral palsy. The students break up into groups, decide what they must do, research the issue, discuss it, then present their findings . It's similar to a seminar. In case-based teaching, the process is about the same, but instead of being presented with an abstract problem, students are faced with a patient case. Nadler said Harvard's New Pathway program uses the B MEDICAL c a s p n g 9 9 4 �CHANGING THE FACE OF MEDICAL EDUCATION find the1r own UB was one of 18 medical schools that received answers rather Robert Wood johnson grants several years ago to than be told . search for ways of turning out more primary care Smith, who physicians. attends many Rosenthal said that the original Robert Wood Curriculum johnson grant of $150,000 expires in May. If UB is Committee among the l2 medical schools that win new $3 meetings but is million grants from the foundation~ , U~B~w~ou~ld!!h!av~e:._~~~~~.J._L___ 1w~..,.; not a member, "the resources to accomplish said the combiin a couple years what would nation of stu(otherwise) take us a much dent-based longer time ." learning and earlier clinical It would also elevate UB's exposure should give stunational stature, dents a greater appreciation not only among for what medicine is all schools emphaabout. "The students will sizing primary perceive from early in their care, but among careers the relevance of what those breaking they're learning to medical new ground in care," he said. "Some stumedical curricudents always understood lum innovation. why they were learning what While the package of prothey were learning. Other posed changes has come unstudents did not. " der the primary care umpart of the apA key brella, there's a broader raproach is research, not the tionale as well. scientific laboratory kind, "What is being proposed but the sort that's traditionwill be good for all doctors ," ally done in libraries. Exsaid Cedric Smith, M.D ., a cept now it's done more readily by computer and it's often professor in the department of pharmacology and therapeureferred to as "accessing information." tics . Bone sees it in terms of fostering a "lifelong pursuit of "There are many reasons ," said Nadler. "But maybe the knowledge. most important reason is we have discovered that students "As a physician, you don't stop learning the day you who know how to think, how to solve problems and access graduate from medical school," he said. "It's the obligation of information are more effective physicians than the ones who the school of medicine to help students develop those skills just memorize." ... in this day and age , the use of computers as a tool as well Murray Ettinger, Ph.D. and distinguished teaching proas an instrument for learning is very important." fessor of biochemistry, agreed. Already, vast amounts of information are available in "One goal is to try to give students a chance to learn more computer data bases, many of which can be tapped through on their own and to tie things together more on their own," said Ettinger, a member of the Curriculum Committee. "Up the HUBNET system operated by the medical school and its consortium hospitals. And electronic medical records will to now, a lot of medical school education in this school and most schools is an awful lot like undergraduate education, become more common, replacing traditional written records . "The electronic medical record is going to have terrific where people just go to lectures and take exams." The new curriculum may be more like traditional graduramifications in patient care," said Loonsk, who is the medical school's director of medical computing. ate education, where students are expected to conduct their Some proponents envision storing a patient's full medical own research , then present their findings and argue their history, right down to the X-rays , in computer data bases conclusions in seminar discussions. In short, students would B u a 0 p y 5 c a n 5 p g 9 9 4 �CHANGING T HE FACE OF from which the information can be easily retrieved and transferred. That could also have tremendous implications for clinical researchers, who currently must go to hospital record rooms and wade through stacks of patient charts. UB has been trying to familiarize medical students with computers and make them aware of the machines' potential since 1986, Loonsk said. It is one of the few schools that require computer training, though that's done now as a component of biophysics in the second year. One of the curriculum proposals now under discussion would create a first year, first semester course devoted to medical computing. "Actually, here at Buffalo, we're way ahead of the game compared to many schools because of the HUB NET system," said Loonsk. Through HUBNET, students and faculty can get into data bases like MEDLINE, where they will find information pertinent to both clinical care and research. Many of the data bases contain complete articles, and even textbooks are available on-line. "One of the problems with medicine for a long time was that it was becoming increasingly specialized, partly because there is so much information, it was difficult for the generalist physician to stay current in all these areas," Loonsk noted. Not any longer. "The implication to medical school," added Loonsk, "is that we should teach people how to access the information well." Specialists, of course, will always be needed. And physicians will always have to carry a lot around in their heads. But with medical knowledge expanding daily, some medical educators have come to the conclusion that it's better to stress thinking over memorization, because physicians who are well-versed in the principles can now more readily look up the detailed information they need for a specific case. And B u a 0 p h y 5 M EDICAL E DUCATION that information will be more current than something they learned years ago. "In the past we taught students much more to memorize," said Susan Schwartz, M.D., a Curriculum Committeemember. "Butit'simpossible to define anymore a body of knowledge they should have by the time they leave medical school." With problem-solving and research skills, she said, "they can become experts." The 25-member Curriculum Committee has been discussing many of the changes for several years and is just beginning to take the broad themes to the faculty at large. Before implementation, proposals must be approved by the Faculty Council, then go to course coordinators for more detailed development. Loonsk said they probably would not take effect until the 1995-96 academic year, at the earliest. Some significant related changes already have occurred, however. The biggest is the family medicine clerkship for third-year students. A major part of the Robert Wood johnson Generalist Initiative, it was approved by the Faculty Council in 1993 and will be instituted with the 1994-95 academic year. At the same time, the traditional clerkships are shifting away from hospitals toward ambulatory settings. "In medicine, the big change that we introduced over the past year was a four-week block of ambulatory medicine," said Schwartz, who is clerkship director for medicine. There are related goals. As medicine in general has shifted toward more ambulatory care, the educational experience for students in hospitals has narrowed. They've been meeting only the sickest patients, limiting their bedside interactions with patient and physician alike. c a n s p n g 9 9 4 �CHANGING THE FACE OF u a 0 p 5 c EDUCATION solution, she added , means that many students will take part two of their boards in senior year before finishing the full medicine and surgery clerkships. "That may be a problem," she said. The shift to ambulatory settings also has some students worried. "It's not a concern on my part, but for the students I think it seems a lot more intensive in the hospital setting, and they need to be reassured that they're learning as much in the ambulatory setting," Schwartz said. When the first group of students in the new ambulatory medicine rotation took their exam last fall, they did as well as previous groups, she noted . The ambulatory emphasis also means lining up new training sites and more community-based volunteer faculty . "That type of educational experience is basically one-onone," said Rosenthal. "It does represent a challenge to the departments of pediatrics and medicine to develop that volunteer faculty. " Other challenges lie ahead. For one thing, curriculum planners must decide which components of basic science courses should be integrated into the new interdisciplinary and problem-based approaches, and which should be left separate. There is consensus on the concepts - "We're trying to teach the science basic to medicine, rather than teaching basic science," said adler- but the devil is in the details. Also, some faculty members are uneasy with the uncertainty of the whole situation and the implication that the old ways were a failure . Naughton said that while UB is at the forefront of medical curriculum innovation, "most medical schools are going to make these same kinds of changes in the next few years ." "It will require a lot of faculty cooperation," he added. It is possible the new teaching approaches could take time from faculty who already are stretched between classes and their own research. Then again, the approaches could be easier to teach, since they delegate more of the responsibility for learning to the students. Either way, things are changing. "It will put a lot more stress on the primary care facultythey'll have to participate in courses they never thought about participating in before," said Rosenthal. "It will put the basic science faculty in a position where they'll have to interact more with clinical faculty ... it'll require change on both our parts, and change is stress." Ettinger agreed that faculty will be affected. "It's a different kind of teaching," he said. But, he added , "I think it may be less painful than people think." "The student wasn't getting a chance to do their own personal history and physical the way they were supposed to," said Schwartz. In a doctor's office or a clinic, Rosenthal said, students encounter patients "who present earlier in the disease process and with a condition that is not acutely life-threatening. So your diagnostic work-up is done not only at a different pace, but it's done with a different approach." Besides encouraging more students to choose primary care, he added, it will give future specialists more exposure to generalist physicians, which can only help interactions between the two groups. As faculty members ponder curriculum, some administrators have been thinking about the admissions side of things . adler said there have been efforts to identify demographic characteristics of medical school applicants most likely to choose primary care careers. "There is some literature on the subject, though it's pretty scarce," he said. "There is a sense that people from rural backgrounds are more likely to choose generalist medicine and return to rural areas ." But Thomas]. Guttuso, M.D., assistant dean for admissions, said the effort is limited. "We're looking for those people who have the personal qualities that we think will make them become outstanding practicing physicians," he said. "If it fits primary care, fine. But it doesn't have to be primary care." Meanwhile, said Guttuso , the number of applicants has increased from a low of about 2,250 in 1988 and 1989 to about 3 ,600 for the 1994-95 class. "There's definitely been an increase in the number of people applying who don't have pure scientific backgrounds," he said. "But still, the vast majority of the pool is scientifically oriented." While there is a sense of enthusiasm about all the changes, a lot of dust is still to settle. "These things come at a price, and they don't come easily," said Naughton, noting that introduction of the new family medicine clerkship resulted in scaled back third-year clerkships for medicine and surgery. The family medicine clerkship will be seven weeks, while medicine and surgery are being reduced to eight weeks from the previous 11 weeks. To compensate, students will take four weeks of a new Medicine 2 and Surgery 2 in the fourth year . "I was not happy about it," said Schwartz. "Not at all." She said planners considered a "screw everyone" solution that would have cut a week off all clerkships, but that would have disrupted the system of teaming students up with residents and interns on four-week rotations . "It was really a fierce battle for a year," Schwartz said. The B MEDICAL a 5 p n g 9 9 4 �a ············ · ··· · ·············· · · · ···· · ········· · ·· ·· ···· · · ·· · · · ··· ····· · ······ ·· · · · · · · · $7.5 million establishes new center ENTERPRISE WILL CONCENTRATE ON DEVELOPING AND MANUFACTURING REHABILITATIVE ASSISTIVE DEVICES he University at Buffalo has re- ogy Evaluation and Transfer "expands Assistive Technology and project direcceived a five-year, $7.5 million significantly the capabilities of the Cen- tor of the new initiative. The co-direcgrant from the National Institute ter for Assistive Technology, already a tors of the project are William C. Mann, on Disabilities and Rehabilitation visible leader in the field. professor and chair of the UB DepartResearch to establish the first na"It promises to increase our collabo- ment of Occupational Therapy and ditional center for advancing new ration with consumer-based agencies rector of the Center for Assistive Techassistive devices from the inventor's and private businesses in the commu- nology, and Kenneth ]. Ottenbacher, workshop to the manufacturer's assem- nity and nationally. It offers a promising professor of occupational therapy and new model of cooperation between uni- associate dean of the School of Health bly line. The Rehabilitation Engineering Re- versity, business and public interests." Related Professions. search Center on Technology EvaluaThe new center will help close the Five to 10 devices per year- items tion and Transfer is a collaboration be- - supply-demand gap in assistive devices that likely would not reach the public tween the Independent Living Center of existing nationwide, notes joseph Lane, otherwise - are expected to become Western New York, an agency that as- associate director of the Center for available to people with disabilities as a sists people with disabilities; result of the center's work. the Western New York Tech"We plan to bring into the nology Development Center, marketplace products that Inc. (TDC), a corporation that will make a difference in helps create, expand and dipeople's lives," Lane adds. versify technology-related "We hope to reach the inbusiness in Western New ventor working in the family York; and UB's Center for garage, as well as the estabAssistive Technology, a lished designer. multidisciplinary group that "Really helpful products provides research, education often never see the light of and service in the field of day because many designers assistive technology. and inventors don't have reThe center, which began sources to develop their ideas operating last fall, screens and make them marketable, prototypes for new assistive Above, Steve Bauer, director of research and development for the center, and don't know how to link works on an electronic data acquisition system. Below, Dale Johnson, design devices from across the up with the manufacturer," engineer associate, works on a powered mobility simulator. United States, selects those he said. "On the other hand, with the most market potential, evalumanufacturers often lack knowledge ates and refines them and establishes about consumer needs and product repartnerships with commercial firms to quirements. Our new center will promanufacture and market the products. vide the resources and become that missG. Alan Stull, dean of the UB School ing link." of Health Related Professions, in which Lane notes that the "military research the Center for Assistive Technology is and development of the past decade housed, says the Rehabilitation Engigenerated a wealth of new technologies neering Research Center on Techno!that are pending declassification. They B u 0 0 p s c o n 5 p n g 9 9 4 J } �············································ ····· ················ ·· ·········· · ·········· a · ~ I hold great promise for assistive technology applications. "The facilities now at UB, along with resources in Toronto, Rochester, Pittsburgh and Cleveland, make this region uniquely positioned to become the national center for research and manufacturing in assistive technology. We are definitely the leading region in the field." The Center for Assistive Technology currently houses the national Rehabilitation Engineering Research Center on Aging, which develops and evaluates assistive devices for disabled older adults. The Center for Assistive Technology also encompasses the Developmental Disabilities Assistive Technology Institute, which designs and produces lowdemand assistive products; Project LINK, a national clearinghouse that connects consumers who need assistive products with appropriate device manufacturers; Rehabilitation Technology Services, which designs and builds customized seating and positioning devices, plus a wide array of services for people with sensory, physical and cognitive impairments. The new center uses a five-stage evaluation process to ensure resources are expended on products with market value. Prototypes are analyzed by technical, user and marketing groups at each stage, and are either withdrawn or advanced, depending on the results of the collaborative evaluations. Organizers expect the center to be self-sufficient within five years, generating future operating funds through a percentage of the revenues from sales of devices licensed to manufacturers, partial ownership of some patents and fees for services charged to some inventors and corporations. A new not-for-profit company will eventually take over the center's technology evaluation and transfer functions. B a 0 p h I Above, Johnson welding in a lab at the center. The UB Center for Assistive Technology will continue new device research and development as well as grant procurement to fund the manufacture of "orphan" products- devices that would substantially enhance the lives of those who could use them, but that have little y 5 c a n 5 p commercial value to manufacturers. A 10-member board of directors with representatives from national consumer associations, private corporations, research centers and technology-transfer agencies oversees the work of the new center. - B v n L g 0 I 8 5 9 A 9 K 4 E R �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 l I UB begins joint study of addiction that 75 to 90 percent of the alcoholic population never enter an alcohol treatment program," Blane explains. "Thus, UB JOINS WITH RESEARCH INSTITUTE ON ADDICTIONS there is a strong need for populationbased studies like the ones we will conTO ESTABLISH ALCOHOL RESEARCH CENTER duct." RIA will conduct a study of why he School of Medicine and BioThe grant will create approximately some alcoholics seek treatment while others do not, and why some alcoholics medical Sciences and the Buffalo- 30 new jobs. "This is the first NIAAA Alcohol Re- appear to recover without treatment. based Research Institute on AdTrevisan notes the grant offers a dictions (RIA) have received a joint search Center dedicated to studying the $8 million grant from the National clinical and medical epidemiology of unique opportunity for alcohol researchInstitute on Alcohol Abuse and alcoholism. The new center adds an ers and clinical epidemiologists to work Alcoholism to establish the nation's first important, substantive direction to al- together to conduct research into Center for the Clinical and Medical Epi- cohol research in this country," Blane alcohol's relationship to chronic dissays. "These studies will significantly ease. demiology of Alcohol. "The study concentrating on coroHoward T. Blane, Ph.D., RIA direc- expand our knowledge of the natural tor, will direct the new center and Marcia history of alcoholism and the relation- nary heart disease will look in detail at Russell, Ph.D., RIA senior research sci- ship between alcohol use and health drinking patterns- not just the amount, but the way people consume alcohol entist, will serve as scientific director. disorders. "Most of what we know about alco- as possible risk factors," he adds. "We Maurizio Trevisan, M.D., chair of social and preventive medicine, will direct re- holism is based on studies of alcoholics will also look at the interaction between in treatment, but it has been estimated alcohol and other nutritional factors." search conducted at UB. The UB study on alcohol and The grant will fund three major ~!l!!fJ~IF~~;;;~II!I'I-,~Itll!!~ lung cancer will be the first to conresearch studies and one pilot protrol for possible confounders such as gram that will run concurrently over the next five years. The renutritional status and passive smoking - a particularly important facsearch programs will study the epitor to consider, Trevisan notes, since demiology oftreated and untreated alcoholism, the epidemiology of a great deal of alcohol is consumed alcohol and coronary heart disease in smoky bars. and the epidemiology of alcohol Other UB researchers involved in and lung cancer. The pilot prothe project includejo Freudenheim, gram will involve the development Ph .D.; james Marshall, Ph.D .; of a computer-based geographic inManavela M. Desu, Ph.D.; jeffrey S. formation system on alcohol conSchwartz, M.D.; Donald Armstrong, Ph.D.; Elisa V. Bandera, M.D.; Terry sumption to serve as a basis for Pechacek, Ph.D.;johnE. Vena, Ph.D.; further epidemiological study. The Lucy Campbell, Ph.D., and Paula grant also provides funds for a naMuti, M.D. tional conference on alcohol epiAdditional RIA researchers indemiology to be held in its fourth year and the establishment ofa blood cludeGerardj. Connors, Ph.D.; Kenand specimen bank that will allow neth E. Leonard, Ph.D., and Michael ~ ~ future researchers to explore the role R. Frone, Ph.D. ~ j of genetic markers and individual RIA is a research institute affiliated ~ susceptibility and to assess the interwith the New York State Office of u action between alcohol consump- The NIAAA Alcohol Research Center will be the first to study Alcoholism and Substance Abuse Sertion and these markers. vices. the clinical and medical epidemiology of alcoholism. B u a 0 p h s c a s p n 9 9 9 4 �···-·--·-·--·---·-------------·----------------·-·---------- ----··----·-·-·············· a · ~ I 1993 is strongest yeM ever for school's James Platt White Society he James Platt White Society capped its strongest membership drive ever last October with a special reception at the Park Country Club. Membership in the organization, which recognizes donors to the School ofMedicine and Biomedical Sciences of $1,000 or more, rose to more than 180 alumni, faculty and friends. Organized in 1986 on the medical school's 140th anniversary, theJames Platt White Society is a distinguished leadership organization based on the values and principles of James Platt White, M.D., one of the founders and a former dean of the medical school and a pioneer in the field of obstetrics. White's vision, intellectual vigor and moral courage represent the qualities of the society's membership and leaders. Gifts to the medical school by members of the society have helped fund biomedical and clinical research, provide scholarships, purchase stateof-the-art laboratory equipment and maintain innovative programming. Members of theJames Platt White Society for 1993 include: Dr. Bruce Abramowitz Dr. Kenneth Alford B a 0 Dr. Kenneth Z. Altshuler Dr. Richard Ament Dr. William S. Andaloro Drs. Kevin and Elizabeth Barlog Dr. jared C. Barlow Dr. Ronald E. Batt Dr. Ralph T. Behling Dr. David A. Berkson Dr. Richard A. Berkson Dr. and Mrs. Willard H. Bernhoft Dr. Theodore Bistany Dr. john C. Bivona, Jr. Dr. Willard H. Boardman Dr. Martin Brecher Dr. and Mrs. Harold Brody Dr. Melvin M. Brothman Dr. Robert L. Brown Dr. August A. Bruno Dr. Elaine M. Bukowski Dr. Ivan L. Bunnell Dr. David W. Butsch Ms. janet F. Butsch Dr. john L. Butsch Mr. David N. Campbell Dr. icholas]. Capuana Dr. Peter A. Casagrande (deceased) Dr. and Mrs. Norman Chassin Dr. and Mrs. joseph A. Chazan Dr. Michael E. Cohen Dr. Robert]. Collins Dr. Donald P. Copley Dr. and Mrs. William R. Cromwell Dr. Daniel E. Curtin Dr. Richard Daffner Dr. Peter S. D'Arrigo Dr. Roger S. Dayer Mrs. Carlo E. DeSantis Dr. Edward Diao Dr. Stuart L. Dorfman Dr. Sterling M. Doubrava Dr. Ronald I. Dozoretz Dr. George L. Druger Dr. Kenneth H. Eckhert Dr. Robert Einhorn Dr. and Mrs. George M. Ellis Dr. Alfred S. Evans Dr. john A. Feldenzer Dr. Donald M. Fisher Dr. jack C. Fisher Dr. john W . Float Dr. Thomas F. Frawley Dr. Vincent]. Fuselli Dr. Richard R. Gacek Dr. B. joseph Galdys Dr. Ronald F. Garvey Dr. john W . Gibbs Dr. Gerard Guerinot Dr. Thomas]. Guttuso Dr. Ralph R. Hallac Dr. joseph V. Hammel Mrs. Gilda L. Hansen Dr. Reid R. Heffner, Jr. Dr. Orvan W. Hess Dr. William J. Hewett Dr. joseph M. Hill p y 5 c Dr. Fredric Hirsh Dr. john M. Hodson Dr. Robert M. jaeger Dr. Kenneth L. jewel Dr. Stephen T. joyce Dr. james R. Kanski, Jr. Dr. julian R. Karelitz Dr. john P. Kelly Dr. Kenneth Kim Dr. and Mrs. Paul S. Kruger Dr. Marie Leyden Kunz Dr. and Mrs. Marvin Z. Kurlan Dr. Francis]. La Luna Dr. RobertS. LaMantia Dr. Gordon R. Lang Dr. Andre D. Lascari Dr. Dana P. Launer Dr. Won Yub Lee Dr. Sanford Leff Dr. Eugene V. Leslie Dr. Laurence M. Lesser Dr. Paul A. Lessler Dr. and Mrs. Harold]. Levy Dr. jack Lippes Dr. Hing-Har Lo Dr. Thomas A. Lombardo, Jr. Mrs. GraceS. Mabie Dr. Milford S. Maloney Dr. David L. Marchetti Dr. Don L. Maunz Dr. Michael A. Mazza Dr. Margaret McAloon Dr. Charles]. McAllister Dr. Margaret P. McDonnell Dr. Harry L. Metcalf Dr. Francis C. Mezzadri Dr. Merrill L. Miller Dr. Eugene R. Mindel! Dr. joseph F. Monte Dr. john D. Mountain Dr. Arthur W. Mruczek, Sr. Dr. Richard L. Munk Dr. Richard]. Nagel Dr. Masao Nakandakari Dr. Richard B. Narins Dr. john Naughton Drs. Robert and Lillian Ney Dr. Charles R. Niles Dr. john D. Norlund Dr. Benjamin E. Obletz Dr. Patrick L. O'Connor Dr. Thomas P. O'Connor Dr. Carrie P. Ogorek Dr. Yasuyo Ohta Dr. Elizabeth Olmsted Drs. Dean and Donna Orman Dr. johnS. Parker Dr. and Mrs. Robert]. Patterson Dr. orman L. Paul Dr. Clayton A. Peimer Dr. Victor L. Pellicano Dr. james F. Phillips Dr. Daniel A. Pietro Mr. R. Willis Post Dr. Richard A. Rahner a s p I Dr. Bert W. Rappole Dr. Albert C. Rekate Dr. Frank R. Riforgiato Dr. Charles j . Riggio Dr. Richard R. Romanowski Dr. and Mrs. Charles H. Rosenberg Drs. Robert Smolinski and Claudia Fosket Dr. Albert G. Rowe Dr. jacob D. Rozbruch Dr. Eric]. Russell Miss Thelma Sanes Dr. Michael A. Sansone Dr. Robert N. Schnitzler Dr. David S. Schreiber Dr. joseph I. Schultz Dr. Roy E. Seibel Dr. Molly Seidenberg Dr. Elizabeth G. Serrage Dr. john B. Sheffer Dr. john E. Shields Dr. Timothy S. Sievenpiper Dr. Roger M. Simon Miss Alice Simpson Dr. Arthur C. Sgalia, Jr. Dr. Raymond M. Smith, Jr. Dr. Morton Spivak Dr. john E. Spoor Dr. john]. Squadrito Dr. Richard J . Sternberg Dr. William Sternfeld Dr. Eugene M. Sullivan Dr. Michael A. Sullivan Dr. MichaelS. Taxier Dr. Charles S. Tirone Dr. john P. Visco Dr. Franklin E. Waters The estate of Mrs. Pauline E. Watson Dr. and Mrs. Arnold Wax Dr. and Mrs. Harold F. Wherley Dr. james]. White, Jr. Dr. Gary]. Wilcox Dr. james S. Williams Dr. Richard G. Williams Dr. and Mrs. Marvin Winer Dr. john R. Wright Dr. Gregory E. Young Dr. Wende W . Logan-Young Dr. Syeda F. Zafar Dr. Franklin Zeplowitz Dr. and Mrs. David C. Ziegler Editor's Note: While every effort is made to ensure the accuracy of this listing, omissions and misprints may occur. This report lists all members between October 24, 1992 and October 22, 1993. If you have any questions, comments or concerns, please call Michael E. Benzin, Acting Director of Annual Giving, at (716) 645-3312. Thank you. 9 9 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 ~ I Sesquicentennial committee begins events planning MEDICAL SCHOOL FOUNDING ALMOST 150 YEARS AGO MARKS UNIVERSITY AT BUFFALO'S BEGINNING ith a little more than two years before the University at Buffalo and its School of Medicine and Biomedical Sciences celebrate the 150th anniversary of its founding, the History of the Medical School Committee is already busy planning celebrations and events to commemorate the historic occasion. Composed of representatives from both the medical school and the university at large, the committee meets monthly as a whole; its task forces focus on specific aspects of the Sesquicentennial Celebration. In the planning stages are a symposium series, the medical school's annual Spring Clinical Day, various medical school and community-wide exhibits featuring medical school memorabilia, a special sesquicentennial logo and the Annual Meeting of the American Association for the History of Medicine, scheduled from May 8 to May 12, 1996. The group is also working on anumber of special publications, including A Medical History in Buffalo 1846-1996: Collected Essays, A Pictorial History of the Medical School, Selected Writings of Austin Flint and an alumni directory. Douglas Bacon, M.D. SCHOOL OF MEDICINE a 0 E y 8 Committee members include: Harold Brody, Ph.D., M.D., Co-chair Professor, Department of Anatomical Sciences Ronald E. Batt, M.D., Co-chair Clinical Associate Professor, Department of Gynecology-Obstetrics joyce Vana, Ph.D., Secretary Clinical Assistant Professor, Social and Preventive Medicine B Assistant Professor, Department of Anesthesiology James Bono, Ph.D. Assistant Professor, Department of History Ivan Bunnell, M.D. Clinical Professor Emeritus, Department of Medicine Leon Farhi, M.D. Distinguished Professor, Department of Physiology Shonnie Finnegan University Archivist David Gerber, Ph.D. Professor, Department of History Nanette Tramont Kollig Editor, Buffalo Physician Richard Lee, M.D. UNIVERSITY AT BUFFALO 4 A 6 R S 9 9 6 Professor of Medicine, Pediatrics and Obstetrics john Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Carole Smith Petro, Ph.D. Associate Vice President for University Advancement Office of the Vice President for University Advancement and Development jack Richert, Ph.D. Associate Dean for Alumni Affairs Mildred Sanes Lilli Sentz Curator, History of Medicine Collection Library of Anatomy and Cell Biology Dedicated -John Naughton, M.D., vice president of clinical affairs and dean of the School of Medicine and Biomedical Sciences, speaks at the dedication of the school's anatomy and cell biology library last October. At left, Irene DeSantis, widow of Carlo DeSantis, Clarice Bernhoft and Dr. Willard Bernhoft, after whom the library is dedicated, look on. p 5 c a n s p g 9 9 • �............................................................ . . · · · · ··· · · · · · · · ·a Medical school memorabilia sought for pictorial history o celebrate the l50th anniversary ofits founding, the medical school will publish a pictorial history. Already being compiled, the history will feature articles and memorabilia about the school, its students and the historical events that have made it what it is. Connie Oswald Stofko, former Buffalo Physician editor, who will edit and compile the publication, asks for help from anyone who might have a contribution to it: "We need pictures, lots and lots of pictures, to make our pictorial history shine. We're looking for anything visual: photos, paintings, drawings, commencement programs, award certificates, perhaps even an antique that we could photograph. We need pictures from every time period , but we expect we'll have the hardest time finding things from the 1800s. Don't send any original! We'd hate for an heirloom to get lost in the mail. Describe to us what you have, or perhaps photocopy it. Please include the names of people in the picture, the date, wh ere it was taken and any other information you have. If you can't identify the picture, maybe we can help. Send the information about your picture to: Connie Oswald Stofko Editor, Pictorial History of the Medical School History of Medicine Collection Health Sciences Library South Campus 3435 Main Street Buffalo, New York 14214 Please remember to include your name, address and telephone number so we can contact you . B u a 0 p h Items already from the Pictorial History of Medicine Collection, to be published for the Sesquicentennial Celebration in 1996. Above, Dr. Roswell Park performing surgery, circa 1898. At left, the University of Buffalo's 1894 football team. Pictu re guidelines: Photographs: Any size, color and shape is fine. We can have a print made from a slide. Photos from programs and other publications could be copied. Photos from old newspapers might work. Paintings, drawings: Oil paintings, charcoal sketches, pen and ink drawings, pastels and other artwork are all possibilities. Maybe you have artwork 5 c a n 5 p of an old building or a sketch of a piece of equipment or the readout of some pioneering piece of equipment. Other: Look for programs from lectures, commencements or other ceremonies; award certificates; pins or buttons, or perhaps early items used in your field. Thanks, but we don't need yearbooks. We've got those." g 9 9 4 �THEN-NOW Anesthesiology at the University at Butfalo: FROM ITS ROOTS IN 1913 TO TODAY , US'S DEPARTMENT OF ANESTHESIOLOGY HAS MADE NOTEWORTHY CONTRIBUTIONS TO THE SPECIALTY was a pivotal year in the history of medicine both locally and nationally. On May l l , 1846 the University of Buffalo School of Medicine was founded. Almost five months later, on October 14, 1846, William Thomas Green Morton used the vapors of sulfuric ether to anesthetize Gilbert Abbott for the removal of a jaw tumor in the first public demonstration of surgical anesthesia. One hundred forty-eight years later, Paul R. Knight, Ill , M.D. , Ph.D., chairman ofUB's Department of Anesthesiology, oversees a branch of the medical school with more than 80 faculty members. The anesthesiology department supports 52 residents and fellows in six clinical sites scattered across the Buffalo metropolitan area, administers anesthetics , cares for patients with pain and manages critical care. Its anesthesiologists actively investigate problems in basic science and clinical and historical research, as well as give lectures in basic science and clinical demonstrations for the medical students. The Department of Anesthesiology has not always been so substantial. It originally was part of the Department of Surgery; its first appointment, John Henry Evans , was nominated in 1913 by the world renowned surgeon, Roswell Park, as an assistant in anesthetics. Over the next 40 years, Evans would bring anesthesiology in Western New York and the University of Buffalo to international prominence as he developed the country's first department and residency B a a training program . While remaining in active clinical practice all his professionallife, Evans also published 29 papers over the length of his career in the leading journals of his day . John Henry Evans was born on September 24, 1876 to Welsh immigrant parents in the Southern Tier community of Freedom, New York. He learned English at the age of 10 when his family moved to Machias and his father established a general store. He attended the Ten Broek Academy in Franklinville and graduated from Ithaca High School. Evans spent six years in the Merchant Marine before resettling in Western New York and enrolling in the University of Buffalo School of Medicine. After graduating with honors in 1908 at the "advanced" age of 32, Evans spent four years at The Buffalo General Hospital as a house officer, giving anesthetics as part of his duties . Evans returned to Machias in 1912 to set up a general practice. But he returned to Buffalo within a year after his brother was killed in a train accident. Evans' interest in the administration of anesthetics and his work with Roswell Park during his days as a house officer led to his faculty appointment. From then until the First World War, he was paid $2 per student for teaching anesthesiology. On May 15, 1917, the chairman of surgery promoted Evans to instructor in anesthetics. p y s c a n The First World War interrupted his academic career, when he was commissioned as a captain in the United States Army Medical Corp . He returned to Buffalo after his discharge in 1919 and began to resurrect both his academic and political career by becoming active in the organizations of the specialty. During the 1920s, Evans helped establish two societies devoted to advancing the then-fledgling specialty of anesthesiology. In 1922, he was elected president of the Board of Governors of the International Anesthesia Research Society, an organization over which he would preside for the next 20 years. The group's mission was to promote scientific inquiry into anesthesiology across the world. In 1923, the Eastern Society of Anesthetists was founded by Evans and two nationally prominent ew York City anesthesiologists,] ames Gwathmey and Adolf Erdmann , to promote anesthesiology along the Eastern seaboard. Evans presented a paper at the ftrst meeting of the society entitled "Blood Pressure Guides and Safety in Anesthesia. " In 1927, he was elected president of the Associated Anesthetists of the United States and Canada, the only national anesthesiology organization at the time . The July 1927 issueoftheBritishjoumal of Anesthesia was dedicated to Evans and listed his many accomplishments. In 1928, Evans was elected as the Eastern Society's president and helped present a bust of Morton commemorating the first public demonstration of ether anesthesia to the Massachusetts General Hospital. Photographs of the event were published in Current Re- 5 p 9 9 4 �THEN-NOW his career. Convinced that oxygen injected subcutaneously could improve wound healing and eliminate arthritic pain and improve function, Evans spent long hours testing his theories. Years after, former medical students still remember Evans' demonstration of the technique. In addition to pain management, Evans was embroiled in a scientific debate over how much oxygen could safely be used to treat pneumonia. Evans advocated the use of a high enough inspired oxygen concentration to abolish cyanosis - a radical thought for the day. Many others felt that permanent lung damage would occur when oxygen was inspired in concentrations greater than 60 percent. Evans clearly demonstrated this was not the case, and developed an apparatus for oxygen administration by face mask that today would be recognized as continuous positive airway pressure ( CP AP). When Boston's Coconut Grove Night Club burned in 1942, Evans was called in as a consultant to administer supplemental oxygen to the victims of that fire. The University of Buffalo should be proud of its long tradition in anesthesiology and its first chairman,] ohn Henry Evans. His attitude and his efforts have made possible much of what has become routine academic practice in the 81 years since Roswell Park made his initial appointment. Above, Evans, shown ot left ot his office in Mochios, New York. Below, the University of Buffalo medical school classes of 1907 through 1911. Evans is the first person in the second row at left. - searches in Anesthesia and Analgesia, the Department of Anesthesia; full recognition of anesthesiology as a medical specialty had materialized in Buffalo. Residency training in the field was initiated that year when Rose Lenahan accepted a position as hospital assistant in anesthetics (the equivalent of resident today) at The Buffalo General Hospital. Research into the effects of oxygen captivated Evans for the last 20 years of only American medical journal devoted to the field at the time, and Evans was pictured among the leaders in the field . In 1932, he was appointed professor of anesthetics. Four years later, a publication of Evans' originated at the Department of Anesthesia. The 1938 edition of the University of Buffalo Bulletin cited Evans as professor and head of the B u a 0 p y 5 c a 5 p BY DOUGLAS BACON , M.D . About the author: Douglas Bacon, M.D., is an assistant professor in the department of anesthesiology and director of resident education at Roswell Park Cancer Institute. The author would like to thank Chris Densmore and Shonnie Finnegan of the University at Buffalo Archives, Alfred S. Evans, M.D. and Ann Stewart (Dr. Evans' children), Richard N. Terry and Patrick Sim of the Wood Library-Museum of Anesthesiology fo r their help in preparing this manuscript. n g 9 4 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 ' I I Members of the IH study sections are selected on the basis of their demonstrated competence and achievements within their scientific fields. Achievements taken into consideration include the quality of research accomplishments, publications in scientific journals, achievements and honors. UB professor authors several sections for the Merck Manual ames B. Lee, M.D., UB professor of medicine has updated the prostaglandins, thromboxanes and leukotrienes sections for the recently published 16th edition of The Merck Manual of Diagnosis and Therapy. Lee, who is an alumnus of]efferson Medical College in Philadelphia, is director of the Erie County Medical Center's hypertension program. Lee is one of 300 scholars and specialists who have contributed to The Merck Manual. Schimpthauser elected to head medical education research group rank Schimpfhauser, Ph.D., UB assistant dean and director of educational evaluation and research, has been elected president-elect of the Society of Directors of Research in Medical Education. The Society of Directors of Research in Medical Education, which conducts and promotes medical education research and acts as liaison and consultant to other medical groups, is composed of professionals in the field from U.S. and Canadian medical schools. Schimpfhauser, a 1965 UB graduate, has been active in the society for nearly two decades, serving as membership committee chair in 1991 and treasurer in 1992. Schimpfhauser's research in medical education has included topics on Frank Schimpfhauser, Ph.D. Murphy chairs NIH subcommittee imothy F. Murphy, M.D., professor of medicine and microbiology, has been appointed chair of the Bacteriology and Mycology Study Section, Subcommittee 2, Division of Research Grants for the National Institutes of Health. Murphy is chief of the infectious diseases divisions of the medical school, the Buffalo VA Medical School and Erie County Medical Center. He co-developed a vaccine with the potential to provide immunity against middle ear infections and was recognized as Niagara Frontier Inventor of the Year for 1992 by the Technical Societies Council of the Niagara and iagara Frontier Patent Law Association. Director of the UB microbial pathogenesis graduate group, Murphy heads two five-year projects totaling $2.5 million in funding from the National Institute of Allergy and Infectious Diseases to study organisms that cause childhood middle ear infections and adult lung infections. B u 0 0 p h y 5 c o n s cancer education, student career choice and decision making and most recently, on the use of standardized patients for the assessment of clinical competence. An associate professor of social and preventive medicine, he holds master's and doctoral degrees from Ohio State University. He administers program evaluation activities for the School of Medicine and Biomedical Sciences and is the coordinator of the third and fourth year academic programs. He also chairs the Association of American Medical Colleges' mini-workshop program and is a member of that organization's national planning committee. He has published more than two dozen articles in professional journals and has made presentations at more than 30 conferences in the U.S. and abroad. p n g 9 9 4 �...... . ................. ····················· · ················ · ··· · ·····················[!] lii'J Spring Clinical Day agenda set AGENDA he Medical Alumni Association has set the agenda for its 57th Annual Spring Clinical Day, to be held Saturday, April 30, at the Buffalo Marriott. This year's program - Medical Education Into the Next Centuryfeatures Jerome P. Kassirer, M.D., '57, as its keynote speaker. Kassirer, who received the Distinguished Medical Alumnus Award in 1992, is editor-in-chief of The New England journal of Medicine and professor of medicine at Tufts University School of Medicine. He also lectures at Harvard University. Kassirer will deliver the Stockton Kimball Memorial Lecture, "Clinical Reasoning: Teaching It and Learning It." The program, designated for up to 3.5 hours of category credit toward the Physician's Recognition Award of the American Medical Association and 3.5 prescribed hours by the American Academy of Family Practice, will present new approaches to the teaching of medicine. Faculty will explore ways to improve patient-physician communication and investigate its impact on the practice of medicine. Medical informatics and its effect on medical education will also be discussed, as well as the use of standardized patients in medical education. In addition to Kassirer, the faculty includes John W. Loonsk, M.D., '86, UB's director of the office of medical computing and assistant professor of biophysical sciences; RichardT. Sarkin, M.D., coordinator of UB's teaching effectiveness program and director of pediatric medical student education; and Paul::; L. Stillman, M.D., provost and dean of the Medical College of Hampton Roads, Eastern Virginia Medical School, Norfolk, Virginia. B 0 0 p h 7:30a.m. Registration and continental breakfast 8:15a.m. Welcoming Remarks Robert Reisman, M.D., '56 President, Medical Alumni Association John Naughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences 8:25 a.m. Introduction to the day's interactive program Frank T. Schreck, M.D. '79 Program Chairman 8:30 a.m. "The Science of Listening" RichardT. Sarkin, M.D. 9:15a.m. "Information at Clinical Fingertips: Moving Beyond the Promise of Medical Informatics" John W. Loonsk, M.D. , '86 10 a.m. Coffee break and exhibit review 10:30 a.m. "The Use of Standardized Patients for Teaching and Assessment" Paula L. Stillman, M.D. 11:30 a.m. Business meeting Noon Annual Medical Alumni Luncheon and Stockton Kimball Memorial Lecture "Clinical Reasoning: Teaching It and Learning It" Jerome P. Kassirer, M.D. , '57 Andersen '47,and Zizzi '58, lauded by UB and ECMC urray N. Andersen, M.D., '47, and Joseph A. Zizzi, M.D ., '58, were honored for their long-time work at Erie County Medical Center. Officials from the School of Medicine and Biomedical Sciences as well as county and hospital officials, cited the physicians last year at the hospital's annual Springfest dinner dance. The event is held to benefit employee education. Andersen is former chief of thoracic 5 c 0 5 p and cardiovascular surgery at ECMC. He also served two years as president of the medical-dental staff at the former E.]. Meyer Memorial Hospital. Zizzi is director of clinical cardiology. He has also served as assistant medical director, acting medical director, medical director and deputy medical director at the hospital. Celebri-tees- Stephan Commins '74, and Jan Nathanson '74, at last October's Walt Disney World's Pro-Am Golf Classic. LincoiT '88,authors JAMA article orah Lincoff, M.D. , is one of the co-authors of a "Letter from Havana - 'Outbreak' of Optic and Peripheral Neuropathy in Cuba?" published in the July 28, 1993 edition of the journal ofthe American Medical Association. The article concerns a disorder first recorded by Cuban physicians in January 1992 and subsequently spread throughout Cuba. Lincoff and fellow authors Jeffrey G. Odel, M.D. , and Michio Hiano , M.D., of the College of Physicians and Surgeons of Columbia University, studied 20 patients ranging in age from 19 to 63 years afflicted by the disorder, the symptoms of which include decreased vision and sensory symptoms (paresthesia, burning and dysesthesia) predominantly in the feet. Lincoff currently is a neuro-ophthalmologist at Buffalo General Hospital. g 9 9 4 �~ ····························································· _ ····· _ ······_ ······· _ ······_ ··· Q to Grenada and then I got accepted to UB," he says. Deciding to pursue pediatrics, he trained at The Children's Hospital of Buffalo and eventually accepted the position of medical director of the hospital's Roberto Clemente Health Center on Buffalo's West Side. Prior to his arrival, a physician would spend three hours a day seeing patients at the center. "My idea was to offer continuity in a full-time position there and set up a system where we could have a nutritionist and social worker and build up the community so that our kids could stay out of the hospital emergency room," Coyne explains. The effort was a success. When he started at the center in 1988, patient visits averaged 4,000 per year. By the time he left last September, the annual total had grown to 22,000. Last fall, Coyne accepted a position with Niagara Falls Memorial Medical Center, taking on much the same challenge he did at Clemente. He was put in charge of the Kids Clinic at the Hamilton B. Mizer Primary Care Center- a place where a physician came in three or four days a week for three hours at a time. Coyne quickly added two full-time physicians, a nurse practitioner and a social worker. He credits Memorial Medical Center President Timothy J. Finan for taking the initiative in extending continuity of care at the primary care site that has just opened 10 new pediatric rooms and has since been renamed Memorial Pediatrics. "Forty-seven percent of the community in Niagara Falls is on public assistance. Most of those children do not have a physician. Tim Finan felt that was not appropriate and that we needed to do something different," explains Coyne. Services provided by Memorial Pedi- Prtest doctor, advocate for the poor FROM NORTHERN KENYA TO NIAGARA FALLS , JACK COYNE '85 , TREATS THE UNDERPRIVILEGED ost people follow one vocation at a time. Not Jack F. Coyne, M.D. He is both pediatrician and priest. The 1985 graduate of the School ofMedicine and Biomedical Sciences, however, considers himself primarily in social work. "There are those who feel that the priesthood is more sacramental. I honestly believe that the role of the priest is to be a social worker," he says. This view proved to be a renegade attitude with the Church in St. Louis where he was a graduate student in the late 1960s. So Coyne became part of a small group of fellow seminarians who decided to start a new religious community. "There was a full-page article in Newsweek when we made the break in 1968 for doing things differently- not dealing with the liturgy so much as dealing with inner city problems," Coyne recalls. Coyne added another vocation at the time as the group used music to express its work in the inner city, forming a folk-rock quintet known as "The Mission" that made appearances on national TV talk shows hosted by Dick Cavett, Steve Allen and Mike Douglas. The quintet also made an album for Warner Brothers Records with Mary Travers of "Peter, Paul and Mary." In 1981 - 10 years after he was ordained a priest- experiences in Cambodia, Haiti and Borneo convinced Coyne that he needed a knowledge of medicine to continue his work with the poor. "Because of those experiences, I applied to medical school and I got lucky. I had my airplane ticket set to go Jatk Cayne, M.D., and two very satisfied patients, Jeremy and Harvey Brundidge. B u a 0 p 5 c a 5 p 9 9 9 4 �· · · · · · · ·· · · · · ······ · · ·· ·············· ·· · · · · ······ · ··········· · ··· · · · ····· · · · ··· ··· ······ ~ ~ In 1984, Coyne switched from the Roman to Eastern rites, joining the Greek Orthodox Church. Coyne observes, adding, "To get the right mental health services, to get the right counseling, to get a child who's eight or nine through the system now and get the help he or she needs will help prevent them from becoming a painful survivor at 30. This is really a goal of mine and something that child advocacy is dedicated to as well. " Coyne added yet another vocation in 1987 when he became a husband and then a father. Having a continuing problem with the church law of celibacy, he switched from the Roman to Eastern rites in 1984, joining the Greek Orthodox church, which allows priests to be married. "There is no relationship in my mind between priesthood, service and celi- atrics include well child care, sick care, immunizations, sports and school physicals, lead testing, birth control, teenage counseling, 24-hour emergency coverage and supportive services for physical and sexual abuse. In fact , Coyne is the medical director of child advocacy teams in Erie and Niagara counties that investigate sexual abuse. "We see about three children a week who are sexually abused ," he says. He is pleased with Erie County's commitment to revamp a floor of the Prudential Building at Delaware Avenue and Allen Street as an advocacy center for young sexual abuse victims. "I find that a real expression of pediatrics because many of these children are forgotten - not just medically," B 0 0 p y s c o n 5 p bacy. I still think that might change in the Catholic church but I'll probably be long gone when that happens. That brought me to where I am today - to keep my priesthood but be able to get married and have a family," he states. Two years ago , Coyne fulfilled a lifelong dream and journeyed to Africa to set up a clinic in the bush of Northern Kenya for the nomads . "We did some HIV testing and worked with the (missionary) nuns there to create some medical services that could be performed on a regular basis ," he explains. It was a brief visit before his return to Buffalo. "I always thought I would eventually stay in Africa to work but as I grew up and had more responsibilities, such as a family , going to Africa wasn't as easy. My way of expressing the same need was to work in the inner city here, " Coyne declares . It has truly been a multi-vocational road for this Long Island native with a lifelong commitment to working with the poor. "I always wanted to be a priest but I didn't want to be in a parish," he concludes. Instead of administering in a parish, jack Coyne has acted as a shepherd of health care continuity in communities where such enrichment has been rare. And that's good for both the body and soul. - B y j I M B I S C CORRECTION In the last issue of Buffalo Physician, Dr. Franklin Zeplowitz' name was inadvertently omitted from the 1993 Reunion Class donors. Dr. Zeplowitz should have been included with his 1958 graduating class. Our sincerest apologies! n g 9 9 4 0 �! l ······················· . .................. .......... . . . . it is about the only occupation for the people. A coffee picker may earn 11 quetzales ($1.70) a day," Schaefer said. Approximately 2,500 people live in the village, with about 25,000 more in surrounding villages and coffee plantations, Schaefer said. Transportation is difficult in the mountainous region. "Patients often have to walk many hours or days to reach the hospital," he added. The Hospital de la Familia receives surgical patients from all parts of Guatemala and the surrounding areas of southern Mexico, El Salvador and Honduras. Schaefer said the most prevalent diseases there are malnutrition, respiratory ailments, gastrointestinal infections, congenital malformations and traumatic injuries. The region's infant mortality rate is approximately 80 percent, although a substantial improvement in that figure has been reported over the past five to 10 years in the area served by the Hospital de la Familia. Schaefer was accompanied by operating room nurse Karen Kumar and operating room technician Geraldine McGuire. During their two-week stay in Nuevo Progresso, they performed 140 eye surgeries. The ophthalmology team was part of a larger medical group that covered a variety of specialists, including otolaryngologists, general surgeons, OBI GYN and general plastic surgeons. This was Schaefer's second visit. Carolyn Bessette, M.D., in NASA's zero-gravity simulator. surgeries as well as defibrillation and mechanical ventilation. Bessette has completed a flight surgeon's training course offered at the johnson Space Center and is currently pursuing an aerospace medicine residency. Carolyn Bessette completes NASA aerospace medicine fellowship arolyn Bessette, M.D., a recent medical school graduate, recently completed a NASA aerospace medicine fellowship at the johnson Space Center in Houston. She was one of four senior medical students selected to participate. The four-week intensive program included lectures on topics such as cardiovascular reflex responses to microgravity, pharmacodynamics in zero-gravity, controlled ecological life support systems aboard a space station, the mechanisms of decompression sickness, vestibular adaptation to space flight and muscular atrophy and adaptation to microgravity. The fellowship also included zerogravity simulation flights as well as visits to NASA's Space Station Freedom mock-up's medical operations module. The unit is equipped to perform minor B u a 0 Daniel Schaefer '81, volunteers in Guatemala with medical team aniel P. Schaefer, M.D., '81, director of the ophthalmology section at St. joseph Hospital, was a member of a volunteer medical team that traveled to the Hospital de la Familia in Guatemala last spring to administer services to the poor. About 2,500 people live in the Nuevo Progresso, a mountain village about 170 miles northwest of Guatemala City. "The town lies at an altitude of about 2,500 feet in a nearly impenetrable rain forest. This is a coffee growing area and p h s c a . . . ...................... . ..... The Strasenburgh Planetarium, in Rochester, New York, was the site for a recent Medical Alumni Association reception. s p n 9 9 9 4 �Dear Colleague, Donnica Moore '86, honored by Amertcan medical women'sgroup he American Medical Women's Association (AMW A) honored Donnica L. Moore, M.D., '86, at last year's 78th annual meeting, "Women Promoting Women's Health: Prevention Through Research and Education." Moore was presented with the Calcium Education Nutrition Award, sponsored by Proctor and Gamble Pharmaceutical Company. The award is presented annually to the AMWA member who has done the most to educate physicians , medical students and the lay public about the importance of osteoporosis and treatment. Moore is currently the director of medical education at Sandoz Pharmaceuticals. She has spearheaded development of the Sandoz osteoporosis computer education program, a comprehensive, state-of-the-art, multimedia self-directed learning program designed for medical students. She has also been involved in developing AMWA's master faculty training program in osteoporosis and in establishing the Sandoz postdoctoral fellowship in bone metabolism. The AMWA event also marked the first time the association featured a UB School of Medicine and Biomedical Sciences alumni reception at its annual meeting. Moore, who is also AMWA regional governor for New York and New] ersey, organized the reception. B u a 0 p h The Perfect Prescription For Your Conference Needs We are pleased to inform you of your eligibility to purchase microcomputer and information technology products at special educational prices at UBMicro, the University at Buffalo's non-profit computer resale program. Consulting and pricing information is available weekdays 9:30am to 5pm, and until 7pm on Wednesdays and Thursdays. UBMicro is located in The Commons on the north campus at 645-3554. 18,000 Square Feet of Meeting Space "i' Conference Planning Professionals "i' Convenient Downtown Location "i' Quick Metro R ide to Main Street Campus and Medical School "i' __ Close to Buffalo General, Roswell, ECMC and Children's Hospitals "i' Your Guests Can Walk to Theatre, Shops, Pilot Field, Restaurants, Entertainment _.__ "i' CME Friendly "i' Great Banquet Food Please Talk To Us About Preparing A Proposal So You Can Bring Your Group's Next Convention To Buffalo (716) 856-1234 6142 • Apple • IBM • Dell • Insight • Panasonic • Canon • Tl • Software • Supplies • Accessories • Audio • Hands-on Workshops ml Dllllr+l EXTENSION HYATT. WE'VE THOUGHT OF EVERYTHING~M H~Y--A--T,T RE A non·profit University program for students. faculty & staff The Commons • North Campus • (7T6)645·3554 • Fox: 645·3884 c a n 5 p B n U 9 G f E"' C Y A , 0 • 9 9 �----A---- S P-, o o . ·.;n f . u , I" f o H u m o r; THEY SAY YOU NEVER CAN - B U T IT'S STILL FUN TO TRY sis my tradition, I returned to my roots in New York City for New Year's. I never enjoy the ew Year's rituals, since traditionally by 12:45 a.m., you've been asleep for 10 minutes with a pointy noisemaker protruding from your pocket. For the past 10 years, my friends from med school and I have always celebrated the "Third Alternative" party (the first alternative is the usual New Year activity and the second is to stay home or go camping in Central Park) . At this particular party , watches are checked at the door and we have random countdowns on the dance floor and show a video loop of the ball dropping throughout the evening (from 1961, of course, since Dick Clark had the same formaldehyde look then he has today). The goal is to avoid the mechanized rituals of the holiday and still have fun . A trip toN ew York is never complete without a trip to the old neighborhood. People there still know me because I went to medical school. The first person I see is the man B 0 0 across the street with the clever mustache and stretch pants with bass and treble control. "Hi, how's it going in CaliF AWNYA? Are you still interning?" He doesn't ask if I'm an intern, but if I'm still interning. I believe the verb In thi.s old, entrenched, working-class jewish neighborhood, everyone has a doctor who is the ,,best" in their field. "intern" means to confine or impound, especially during a war- which, come to think of it, is not unlike what it feels like to be an intern and go three and a half years without sleep. This guy (for the life of me I have no idea who he is or how he knows me) p h 5 c o n 5 next says to me, "Tell me something ... " (Already I know I'm in trouble.) "My wife sprained her ankle. What's good for it? Dr. Marvin Schanker on the radio says milk is good for this sort of thing. " I'm thinking Dr. Schanker certainly should know since he learned so much about medicine while earning his Ph.D. in communications. Against my better judgment, I continued this conversation and told him milk will help a broken bone but not a sprain. He broke in with, "Oh, what do you know. Dr. Schanker has been around a long time- you're young yet." Dr. Schanker may have been around a long time, but so has Charles Manson and I don't usually ask him for advice on ethics cases. Maybe it's time for Dr. Schanker to be interned. In order to gain brownie points with me , everyone from the old neighborhood tells me about the doctors they know. "My daughter-in-law's brother is married to a doctor. He is doing very well as a plumonologist"- which I believe is either a French expert on ball-point pens or an author- p n g 9 9 4 �jewish neighborhood, everyone has a doctor who is the "best" in their field. When pressed as to why their doctor is the best, they tell you, "everyone says so," and, "he's so busy you have to make an appointment to make an appointment. He's the best 'eye man' in Brooklyn. " The truth is, nobody knows how well their doctor did in medical school. How many even look to see where the doctor went to school. Does anybody actually know how well their doctor did in biochemistry? obody looks! I have a friend, a podiatrist, who actually hangs his dog's pedigree on the wall. For his patients, he's the best "foot man" in Bensonhurst. I even went back to the hospital where 10 years ago I spent my first days on the ward. I recalled my first time in the hospital wearing my white coat that came out of the package five minutes earlier with eight other things, including two stethoscopes, an eye chart and a rectal thermometer key chain. I looked more like a roofer on the way to an insurance inspection. At this point, I don't know anyone who carries that much equipment. But when you're a student and you don't feel like a doctor, you need to at least look like one (orTrapperjohn). I recall standing there with all this equipment on while residents whirled by picking off stethoscopes and eye charts saying 'can I borrow this , can I borrow that?' I felt like a gingerbread man Christmas morning. Of course they never returned any of the equipment, so after a half hour I was picked clean down to my boxer shorts ready to see my first patient. I felt so awkward. I was 22 years old. I wasn't shaving yet, and here I was doing procedures on people, examining patients. You can never say touching or feeling in the medical profession; they teach you very early on it is always "examining, probing, palpating," never "touching." That's too offensive. But it felt good to see old friends and colleagues and to see that I'm not the only one unbuttoning my pants while sitting down to dinner because my pants are shrinking. Happy ew Year. Stu Silverstein, M.D., president of Stondup Medicine Seminars of Son Francisco, California, lectures nationwide on humor in medicine. ILLUSTRATION BY JAY LINCOLN B u a 0 p c a 5 p g 9 9 �a · ····· ····· · ··· · · · · · ············· · · · ···· · ······· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ········ · · search fellow at the Buffalo Institute of Fetal Therapy. Karamanoukian received the award , presented last summer at the society's annual international meeting in Washington, D.C. , for his research combining nitric oxide and surfactant for the treatment of diaphragmatic hernias in newborns. Last year marked the first time ever the Society of Pediatric Research presented the award to a surgeon. Karamanoukian's research suggests combining nitric oxide with surfactant may lower the mortality of newborns with diaphragmatic hernias and significantly decrease morbidity. Further prospective clinical trials to examine the effect of the combined modality are planned. Karamanoukian is working in the laboratory of Philip Glick, M.D., assistant professor of surgery and Children's pediatric surgeon. Frances Nesti, M.D. Children'sfellow wins crttical care medicine research training award he Society of Critical Care Medicine In Training Award has been awarded to Frances Nesti, M.D., a fellow in critical care medicine at The Children's Hospital of Buffalo and UB's department of pediatrics. The award recognizes excellence in critical care research. Nesti was chosen specifically for her research presentation in the area of perfluorcarbon liquid ventilation. Nesti received an engraved plaque and $2,000. Annual Incoming Residents Week set for June 13 -18 The School of Medicine and Biomedical Sciences will hold its annual Incoming Residents Week Monday through Saturday, June 13- 18. Approximately 150 residents will participate in the program about communication skills, teaching skills and issues in medicine such as advanced directives , documentation and medical records. The residents will also receive life support and advanced life support training. Nitric oxide/surtactant research garners national research award he 1993 National Residency Research Award , presented by the Society of Pediatric Research, has been awarded to Hratch Karamanoukian, M.D ., a general surgical resident of the department of pediatric surgery at UB and The Children's Hospital of Buffalo and re- B a 0 p h y s c a n 5 Lalley,Ph.D~ '74,tapped to head HIT student center for the deaf eter Lalley, Ph.D., has been selected to head the Center for Baccalaureate and Graduate Studies at the ational Technical Institute for the Deaf ( TID), a college of Rochester Institute of Technology in Rochester, New York. Lalley, a 1974 graduate of the school of medicine's doctoral program in human genetics, was named to the position last]une. The recently established center is a comprehensive, student-oriented service that offers such programs and services as academic advising, tutoring, notetaking and interpreting as well as pre-baccalaureate discipline-related courses. A geneticist, Lalley has achieved national and international prominence. From 1985 to 1991, he was chairperson of the International Committee on Comparative Gene Mapping. He has served on numerous national and international advisory panels and has written more than 80 research journal articles. He is on the editorial board of Clinical Biotechnology and has been subject area editor of Genomics. He is a former editorial board member of the journal of Experimental Zoology and Cytogenetics and Cell Genetics as well as a reviewer for numerous other publications. The NTID is the world's largest technological college for deaf students. It was created by Congress and is funded primarily by the U.S. Department of Education. NTID represents the first effort to educate large numbers of deaf students within a college campus planned principally for hearing students. More than 1,100 deaf students from across the United States and other countries study and live there. p n g 9 9 4 �·························································································[! ] Rehabilitation Center in Clarence, New York, where he served as medical director. His portrait will be displayed in the center to honor his many years of dedicated service. Dr. Paolini was instrumental in the creation of the Broth- ROSARIE BENDER ' 20, is retired and living in Fort Lauderdale, Florida. Dr. Bender, who was one of the first women plastic surgeons, practiced plastic and reconstructive surgery for 50 years. She is the only living member of her class. ers of Mercy's 40-bed rehabilitation unit. He plans to enjoy retirement with his wife, Emily, eight children and three grandsons. writes, "Surviving: two bypasses, cataracts. Keeping busy, would like to see more entries from my class. Where are you? How are you?" David S. Ba[hman '47 BERNARD S . STELL '46, of Sun City, Arizona, informs us retired surgeon, is a columnist for several newspapers, and the author of a recently published book, Thoughts and Musings of an Arkansas Country Doctor. He also co-authored the book , MAX A. SCHNEIDER '49, received the Silver Key Award from the National Council on Alcoholism and Drug Dependence for "outstanding service in the field of addiction medicine." HENRY H . HAINES '33, that his article "Stereomacrography - The Water Droplet Lens" appeared in the December 1993 issue of Stereoscopy, published by the International Stereoscopic Union. DAVID S . BACHMAN '47 , a with his family and three little grandsons. HERBERT W . SiMPK INS ' 53 , of West Orange, New jersey, retired from practice in December. PAUL L. of Tarzana, California, retired last]uly after 38 years of practice in internal medicine. Breaking the Smoking Habit. informs us he is now fully retired and plans on spending more time BURTON STULBERG ' 52 , FERDINAND A. PAOLINI '47, retired in December from the Brothers of Mercy Nursing and HERBERT A . '55 , LEONHARDT of Florham Park, New jer- sey, informs us that he retired in 1993. He has six grandchildren. J . SULLIVAN '55 , writes, "Still working full time with my practice restricted to forensic psychiatry. My wife, Carol, and I recently purchased a new, large motor home; we are enjoying traveling throughout the West, Canada and Mexico in it." Finally, a Real Retirement Planning Breakthrough for Doctors, Attorneys, and Professional Entrepreneurs... The Tax-Free "Private" Pension V 100% Tax-Free Compounding of All Interest, Dividends and Capital Gains V No Income Tax or Tax Consequences on Withdrawals V Unlimited Contributions V 100% Tax-Free Fund Transfer and Switching V 100% Income Tax and Probate-Free Life Insurance Benefit V o 10% IRS Penalty On Withdrawals Before Age 59-1/2 V o Forced Distributions At Age 70- 112 V Flexibility To Fit Your Changing eeds B a 0 p s c a 5 p ' 54 , lished in the Fall1993 PHAROS (the AO medical honor society magazine). His paper explains the 10 biblical plagues. WILLIAM DAVID HERTZ '52 , WEINMANN wrote a paper, "The Tenth Plague -Deathofthe ewborn? " pub- g 9 9 4 �l! l· ···· ··················· ·· ········· ······· ·· ·· ··········· ····· ······ ···· ······· ······· ··· was re- CAPTAIN ELIAS ROSENBLATT director of clinical services in elected to a second term as treasurer of the Minnesota Medical Association. '68 , writes , "I have been living the department of radiology at the University of Iowa. He has six children and one grandchild. ERICK REESER ' 56 , in Potomac, Maryland for almost 10 years now, long enough to appreciate some of the better parts of the Washington, D.C. , area, and to avoid all the rest. My wife, Ruth, is administrative director of physical medicine and orthopaedics at Suburban Hospital in Bethesda. Our son , Jeremy, is in his junior year at the Bullis School. Our daughter , Alison, graduated from there a year ago and is a sophomore at Kenyon College. Their brother, Michael, graduated from Cornell in 1991 and is now working in the hotel appraisal business in Miami. I'm a captain in the Navy medical corps , currently assigned as the director of the Naval Medical Doctrine Center on the Marine Corps Base at Quantico, Virginia. This assignment followed my graduating from the Naval War College. The center develops, analyzes and tests the doctrine of the utilization of medical assets in support of Naval, joint and combined (i.e., NATO) operations. It's very WILLIAM E . ABRAMSON '60 , writes, "On July 31 , 1992, Iretired after 28 years as a staff psychiatrist at Sheppard Pratt Hospital in Towson , Maryland. I have remained in private practice , with my office in the hospital , and on the courtesy staff. I love my new boss !" presented papers on attention deficit disorder in young adults at the University of Massachusetts MediHARRIS FAIGEL '60 , cal Center, American College Health Association. He is president-elect of the New England Chapter of the Society for Adolescent Medicine. His granddaughter, Madeline, was born January 10, 1993. RONALD S . MUKAMAL '64 , retired from private practice and moved to Baltimore, where he works part time. writes, "Although I returned to Ghana in 1968, I have tried to keep in touch with a few classmates over the years. Notable among these are Charles Ladoulis , Michael Taylor and Steve Scheib~r. From 1968 to 1978, I taught epidemiology and control of tropical endemic diseases in the Department of Community Health of the Ghana Medical School. I joined the World Health Organization in 1978 and served as a senior epidemiologist at the FRED K . WURAPA ' 64 , B u a Irving S. Kolin '65 Tropical Disease Research and Training Centre in Ndola, Zambia. Since 1986, I have been reassigned to the WHO Regional Office as the Regional Adviser on Control of Parasitic Diseases." AUGUST J . D ' ALESSANDRO ' 65 , retired in 1992 from the state of Connecticut after 25 years. He is medical director of Catholic Family Services in Danbury, Connecticut, and a psychiatrist with the New York State Department of Mental Retardation . IRVING S . KOLIN ' 65 , successfully completed the examination of the American Board of Adolescent Psychiatry for certification in adolescent psychiatry last May 20. Dr. Kolin is board certified by the American Board of Psychiatry and eurology and in the past year has also successfully completed examination for added qualifications in geriatric and addiction psychiatry. He is also certified by the American Society of Addiction Medicine and the American Board of Quality Assurance and Utilization Review. 0 p h 5 exciting work. Not only are my clinical and operational experiences utilized , but so are the academic and communication skills learned in undergraduate and prep school years. " IAN M . SCHORR ' 69 , of Englewood , New Jersey , announces a new grandson , born February 4, 1993. is professor of radiology and pediatrics and vice chairperson and WILBUR L. SMITH ' 69 , c a 5 p RONALD H. BLUM '70, was appointed deputy director of NYU's Kaplan Cancer Center. His wife, Diane, is executive director of Cancer Care , Inc. ROBERT DIBIANCO '72 , and his wife, Joan, announce a new addition, Regina Marie DiBianco, born August 1, 1993. The family now consists of David , l2;JohnMichael, 8; Regina Marie, 1/2! DR . ROBERT KROOPNICK was elected a fellow of the American College of Physicians in January 1993. Board certified in both internal medicine and '72 , geriatric medicine, he practices in Randallstown , Maryland. is director of the Englewood Hospital hemodialysis unit. He has a 12-year-old son and two collegeage sons; one attends the University of Vermont and one attends the University of Arizona. RALPH R . HALLAC '73 , RICHARD LEE '74 , writes he has been named medical director of Sierra Summit Rehabilitation, an outpatient facility in Reno, Nevada. A fellow of the American Academy of Neurology and certified by the American Academy of Pain Management, he was recently appointed a fellow of the Royal Society of Medicine, London , U.K. Dr. Lee has also been involved in locum tenens work for the past three years in clinical neurology. g 9 4 �····················· ·· ···································································l ! - ! n ' ton and his wife, Katie, are the R ICHARD I A. WOLF '82 , writes, proud parents of a son, James "still in cardiology at Grand Cody, born in October 1992. Forks Clinic in Grand Forks, North Dakota." He wonders if anyone knows where Rob MARK 5 . BORER '80 , is presi- Dudek, Roger Beneitone and dent of the Psychiatric Society of Ivan Baumel! are? Delaware and co-founder and PATRICK E . RYAN , JR ., '83 , medical director ofMeadowwood is currently in fellowship in Intensive Treatment Options. GASPERE Barlow Lynch '77 C . cardiothoracic surgery at SUNY GERAC I '80 , Syracuse. He is married with writes that he is currently em- three children: 4 l/2 years, 21 ployed by Capital Health Sys- months and 4 months. tem as medical director of pri- NORA MEANEY-ELMAN '84 , mary and urgent care. He reBARLOW LY N CH '77 , is presi- dent-elect of the Washington Urological Society. Dr. Lynch is a clinical assistant professor of urology at Georgetown and cently received board certification in medical management in addition to board certifications in family practice and emergency medicine. George Washington University. He lives in Silver Spring, Mary- JAMES B . BRONK '81 , has land, with his wife, Pauline, and been installed as the 67th presi- son, jason. dent of the Solano County Medical Society. He is a partner in a ORESTES G . ROSABAL '77 , is the Southern Medical Association's state councilor for and Vacaville, California. Florida. In October, he attended the association's 87th Annual Scientific Assembly in New Orleans. Dr. Rosabal maintains a private practice in orthopaedic surgery in Hialeah, Florida. TERENCE CHORBA ' 79 , writes, "I received an M.P.A. from Harvard's JFK School of Government in June before returning to the National Center ' 81 , an had a great time in Cambridge. " BRUCE J . NA U GHTON '79 , is returning to Buffalo as chief of the division of geriatrics at The Buffalo General Hospital. Dr. Naugh- B u a 0 Electrodiagnostic Medicine Megan Elizabeth, on June 25 , meeting. Robin is a neurologist 1993. She continually amazes us, as well as her brothers, Daniel in Pittsburgh; Sarah, Maria and I and Ryan." Arbor, respectively. " is as- practice-in D.C.,Buffalo,and Ann DE I DRE GREENE '86 , writes , sistant director of psychiatric "Accepted a part -time faculty po- emergency services at Montefiore Hospital, Bronx, New York. sition with Egleston Children's was Atlanta. We celebrated the birth elected chairperson of the Chesa- of our third child, Timothy Elvis peake Bay Alcohol and Substance Dixon, in August 1993. " Abuse Program Advisory Board. CARLOS M . ophthalmologist in Amherst, Hospital at Emory University in ISADA '86 , re- com- cently joined the staff of the Cleve- new company, Energy Systems Associates, specializing in elec- pleted a five-year general surgery residency at St. Luke's- land Clinic Foundation in the de- tromagnetic medicine and bio- Roosevelt Hospital in Manhat- His wife, Loretta Isada, is in pri- FRANK New York, recently founded a LACQUA '85 , partment of infectious diseases. logical hazards consultations. He tan and a one-year colon-rectal vate practice in Akron, Ohio, as and his wife, Diane, announce the surgical fellowship in Houston, a noninvasive cardiologist. birth of their son, Michael) oseph, Texas. He is in private practice GLENN on May 29, 1993. He joins proud in Brooklyn and Staten Island, Lithonia, Georgia, and his wife, sisters, Erica and Sarah. New York. He has married Eva Carla Hackett Paris, announce for Injury Prevention and Control at CDC. My family came and at the American Association of DENISE M . DAVIS '85 , ology group based in Fairfield DAV ID J . RODMA N writes, "My husband, Richard Elman '78, and I had a daughter, CAROL W E INSTE IN '84 , private practice diagnostic radi- James B. Bronk '81 GERALD HARSTER '82 , was PARRIS '87 , of Acosta and resides in Brooklyn. the birth of a daughter, Stephanie writes , Delyse Parris, on September 17, JON M . WARDNER '85 , appointed director of laborato- R. ries at jeannette District Memo- "There was an impromptu Class 1993. Dr. Parris is a rheuma- rial Hospital, near Pittsburgh, of '85 mini-reunion in Pennsylvania. He has two sons, leans this October. I enjoyed run- tologist in private practice at the Gwinett Arthritis Center; his Ryan, 10, and jesse, 6. ning into Maria Labi, Robin wife is administrator at Grady Con wit and Sarah Murray White Hospital. p h y s c a 5 p ew Or- n g 9 9 4 �[! ] ·············································· ····································· · ···· and his wife, Marcia, announce the birth of a daughter, Rachel, in DAVID ROSENBLUM '87 , December 1993. She joins her brother, Daniel, 4. Dr. Rosenblum is chief of medical staff at Gaylord Hospital in Connecticut and codirector of its spinal cord injury unit. Active in clinical research, including clinical trials in multiple sclerosis, he also holds appointments at Yale and Columbia-Presbyterian Medical Center. will R ICHARD GILBERT '88, M ICHAEL HALLETT '89 , was recently appointed associate medical director for adult psy- CARLOS C . ALDE N '39, died January 14, 1994. The Army's most decorated surgeon, he was a senior psychiatrist at Buffalo Psychiatric Center for more than a decade before his retirement in 1976. chiatry at Brylin Hospitals. Dr. Hallett completed his psychiatric residency at Erie County Medical Center. He also maintains consulting privileges with Millard Fillmore Health Systems and has established a private practice. In addition to general adult psychiatry, his interests include obsessive/compulsive disorders, mood disorders, anxi- NAT HAN I EL J . P U LVER '48 , Lidia Palcan '90 join the Buffalo Medical Group after completing a urology residency at Georgetown Medical ety disorders, dual diagnosis and schizophrenia. Center in June. He has three children: Ricky, 4; Chelsea, 3; and Alexis, 2 months. pleting a residency in otolaryngology at the University of Pennsylvania. He and his wife, Michelle, WILLIAM PALM ER , JR ., '90, completed a residency at Duke University in proudly announce the birth of a son, Michaeljoseph, on April22, 1993. They have a daughter, Molly Bess, born May 19, 1991. was appointed chief resident of physical medicine and rehabilitation at the University of Pittsburgh. DAVID KATZ '88 , neurology and a fellowship in neuro-ophthalmology at the University of Michigan at Ann Arbor. In july 1993, he joined a group of neurologists in private practice as a junior partner with the subspecialty of neuro-ophthalmology. an ophthalmologist, is a member of the medical staff at ColumbiaGreene Medical Center in Hudson, New York. Dr. Kraus has joined the practice ofSanford Ullman '38. WAYN E Z I MMER ' 89 , Hopkins Hospital. Her husband is an orthopaedic surgery resident, also atjohns Hopkins Hospital. is com- is a third-year resident pursuing a dual certification in internal medicine and pediatrics at University and Children's Hospitals, Cincinnati, Ohio. JOSEPH BARROCAS , ' 91 , finished residency at The Children's Hospital of Buffalo and joined the Delaware Pediatric Group in Buffalo. HARR IET TE F EIE R ' 90 , writes, "I am completing a residency in neurology at UCLA with an eye toward an academic career in neuroimaging. I married Lorain DIANE KRAU S '88 , ANT H O NY L. CAPOCELLI, JR., completed a neurosurgery fellowship at Long Island jewish Memorial Hospital in june 1992. He and his wife, Christy, announce the birth of a son, Bryce Anthony, born September 14, 1992. ' 89 , B a ROHIT BA K S HI '91 , JONAT HAN O ' BRIEN ' 90 , completed internal medicine residency and started a gastroenterology fellowship at Albany Medical Center in july 1993. He has five children: Nathana, 5; William, 4; Shoshana 3; Rebecca, 2; and Eli, born july 21. Baeumler, R.N., daughter ofUB med school alumnus George R. Baeumler '59, on july 17, 1993 in Delaware Park - what a catch! " LI DIA PALCAN '90, announces her marriage to james Wenz, M.D., in Baltimore, Maryland, on June 5, 1993. Lidia is currently a fellow in child and adolescent psychiatry at johns 0 p h y s JOSE P H M . ACCURSO ' 92 , recently reported for duty with Naval Support Force Antarctica in Port Hueneme, California. c a 5 p died last March in Cincinnati, Ohio, of coronary heart disease. Dr. Pulver was in the private practice of pediatrics in White Plains, ew York, for 20 years before moving to Israel, where he managed the health care of children in the development town of Hazor. He practiced pediatrics with the Group Health Cooperative in Madison, Wisconsin after returning to the U .5. A long-standing member of the Academy of Pediatrics, he retired in 1989. R OY J . THURN ' 52 , died on September 12, 1993. His wife writes, "Roy loved medicine and finally retired at age 71 so we could do some traveling, etc., that his commitment to medi- cine postponed. He retired on April 2 as medical director at Bethesda Hospital, St. Paul, Minnesota, and on April 7 was diagnosed with inoperable small cell cancer of the left lung. We attended his class reunions and were looking forward to the next one." D EAN ALLE N LES HER ~2 , of Newark, died oflungand heart failure on August 12, 1993. Before retiring in 1992, he was a researcher at the Ciba-Geigy Corporation where he spearheaded the development of Lopressor. g 9 9 4 ��BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS COR~ECTIOf'j R The only with thi~ Medical Lial Company (ML liability insurer Society of the S Since its fou owned and mar fully defended 1 other available Additionally, and most exper ity claims depaJ largest risk rna: any ew York~ insurer, and th( review of claim Calll-800-A 1-800-356-4056 mation and an < Our def€ 2 Park Ave., Nev. 2 Clinton Sq., S~ 90 Merrick Ave. © 1993 Medical Liabili~ �Non-Profit Org . U.S. Postage PAID Buffalo, NY Permit No. 311 ' REQUESTED S C I EI'; C E~ ri.\L L ~: L ly liability coverage is seal of approval. jability Mutual Insurance [LMIC) is the only professional rer approved by the Medical eState of New York. :ounding in 1975, the physicianaanaged company has success~d more physicians than all 1le insurers combined. lly, MLMIC has the largest perienced professionalliabilpartment in the country, the nanagement department of ·k State professional liability the state's only true peer .ims experience. )-ASK-MLMIC (metro) or )56 (upstate) for more inforn application. MLM~C ~ Medical Liability Mutua! Insurance Company fense never rests. few York, Y 10016 , Syracuse, NY 13202 we., East Meadow, NY 11554 bility Mutual insurance Company �B U FFALO PHYS ICIAN STATE UN IV E RS ITY OF NEW YORK AT BUFFALO 3435 MAI N STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED The only liability coverage with this seal of approval. Medical Liability Mutual Insurance Company (MLMIC) is the only professional liability insurer approved by the Medical Society of the State of ew York. Since its founding in 1975, the physicianowned and managed company has successfully defended more physicians than all other available insurers combined. Additionally, MLMIC has the largest and most experienced professional liability claims department in the country, the largest risk management department of any New York State professional liability insurer, and the state's only true peer review of claims experience. Call1-800-ASK-MLMIC (metro) or 1-800-356-4056 (upstate) for more information and an application. MLM~C ~ Medical Liability Mutual Insurance Company Our defense never rests. 2 Park Ave., New York, NY 10016 2 Clinton Sq., Syracuse, NY 13202 90 Merrick Ave., East Meadow, NY 11554 © 1993 Medical Liability Mutual Insurance Company Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 31 1 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1994 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1994-Spring Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v28n02-1994-Spring Table Of Contents A list of subunits of the resource. Research Hospital News Leading Buffalo's Changing Health Care Scene Changing the Face of Medical Education Medical School Alumni A Spoonful of Humor Graduate Education Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo physician, Spring 1994 Buffalo medical review Buffalo physician and biomedical scientist Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v28n02 Extent The size or duration of the resource. 46 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1994 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/4268a956ed09e8732e83b20afff9bf8c.pdf f8f9e2c3529adfe0820340d25c3b8491 PDF Text Text Biomedical Sciences, Autumn 1993 �BUFFALO PHYSICIAN Volume 27, Number 4 ASSOCIATE VICE PRESIDENT FOR UNIVERSITY ADVANCEMENT Dr Carole Smith Petro DIRECTOR OF PUBLICATIONS Timothy J Conroy EDITOR anette Tramont Kollig, R.N. ART DIRECTOR Alan J. Kegler ASSOCIATE ART DIRECTOR Scoll Fncker PRODUCTION MANAGER Ann Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr John Naughton, Vice President for Clinical Affairs, Dean EDITORIAL BOARD Dr John A. Richert, Chairman Dr Martin Brecher Dr. Harold Brody Dr Richard L. Collins Dr. AlanJ. Drinnan Dr. Timothy Gabryel Dr. James Kanski Dr. Charles Massaro Dr Charles Paganelli Dr Robert E. Retsman Dr Thomas Rosenthal Dr Stephen Spauldmg Dr Bradley T Truax Dear Friends, T wo major milestones are reported in this issue of Buffalo Physician. The first relates to the dedication of the Center for Positron Emission Tomography that occurred m mid-May. That dedication served to culminate several years of effort between the Department of Veterans Affairs and UB with the installation of the area's first PET camera. The Buffalo VAMC and the Cummings Foundation were included in the activities. The latter provided a $1 million grant that served to ensure the success of the project. Dr. Joseph Prezio provided exemplary leadership for this project and organized an outstanding scientific symposium. The second event was the celebration of the lOth anniversary of the Graduate Medical Dental Education Consortium of Buffalo (GMDECB). The organization has become the institution for governance of graduate medical education in Western ew York and it is membered by ll participating institutions- the medical and dental schools and nine affiliated teaching hospitals. The GMDECB has been instrumental in providing stronger training programs and in developing new direction and new emphasis for graduate medical education. The organization has committed to achieve a 50 percent distribution of trainees to the primary care specialties of family medicine, internal medicine and pediatrics over the next few years. It has also become a model that might serve to provide some guidance to national health care leaders as new initiatives in health care reform develop. Dr. Michael oe, executive vice president and medical director at The Buffalo General Hospital and program director of the preventive medicine training program, in particular, has provided extraordinary leadership to the GMDECB effort. Sincerely, John aughton, M.D. Vice President for Clinical Affairs TEACHING HOSPITALS AND LIAISONS Batavia VA Medical Center Arlene Kelly The Buffalo General Hospaal Michael Shaw Buffalo VA Medical Center The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Millard Fillmore Hospitals Fran I• Sava Roswell Park Cancer Institute Sisters of Charity Hospital Dennis McCarthy ~ The State University of ew York at Buffalo Buffalo Physician IS published quarterly by the State University of New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It 1ssent, free of charge, to alumm, faculty, students, residents and friends. The staff reserves the nght to edit all copy and submissions accepted for publication. Address questions, comments and submissions to : Editor, Buffalo Physician, State University of ewYork at Buffalo, Umversity Pubhcauons, 136 Crofts Hall, Buffalo, New York 14260 Send address changes to: Buffalo Physician, 146 CFS Addition, 3435 Mam Street, Buffalo, New York 14214 Dear Fellow Alumni, T he beginning of anew academic year brings another cycle of activities for the Medical Alumm AssocJatwn, with the goal of enriching the experiences of medical students, house officers and alumni. We have greeted the incoming house staff and will shortly sponsor another one-day session on "Prep for Practice," a practical practice management introduction (recognizing the current uncertainties of future practice). We have welcomed the entering freshman medical class and during the academic year will continue our support for a variety of student projects. In particular, the Alumm Association will continue to organize three sessions, with presentations by community physicians devoted to differing types of medical practice. In September, the annual award honoring an outstanding alumnus was presented to Dr. William Balistreri, Class of 1970. Dr. Balistreri is professor of pediatrics and medicine at the University of Cincinnati College of Medicine and is an internationally recognized pediatric hepatologist. We are especially pleased that Dr. Balistreri participated in the teaching program at Children's Hospital; his participation provided a wonderful opportunity for our medical students, house officers and faculty to benefit from his presence. Alumni receptions have been planned in neighboring Rochester and at several national medical meetings. Local alumni again will be guests at our annual reception. Your support for these most worthwhile activities is needed and appreciated. .,,,,,.,,d,, ~ (aver: The photograph of Dr. Joseph Prez10 was created by Collignot0arosz LTD. Robert E. Reisman, M.D. '5 6 �V 0 u A 2 L T u N 7 M N o 9 4 9 3 H OCT 1993 IJ Research IJ Hospital News IJ The Center for Positron Emission Tomography e "Then and Now" heralds the Sesquicentennial. Page 29. Dedicated to patient care, research and education. m 10 Years of Cooperation over Competition e The Graduate Medical Dental Education Consortium of Buffalo celebrates a decade of progress. m m m m m Alumni Graduate Education Medical School Classnotes ASpoonful of Humor 11 Shake and Bake." Page 3. * [~il~ren' s ~ospital ~egins ~W uaccine trials. ~agel. 11 ln Sickness and in Health." Page 28. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 ' .... ' Study subjects must have well-documented HIV infection but no symptoms of HIV disease other than swollen lymph glands or a mildly swollen liver or spleen. Subjects also cannot have received any anti-retroviral or immune-regulating drugs within one month before their entry into the study. The Centers for Disease Control and Prevention estimates 10,000 children in the U .5. are infected with HIV. By the end of the decade, the World Health Organization projects 10 million children will be infected worldwide. For more information about trial sites or eligibility for enrollment, call the AID Clinical Trials Information Service at 1800-TRIALSA, or call the PACT program + at Children's Hospital at 878-7908. Children'sHospital selected for experimental HIV vaccine trials he Parents and Children's Together (PACT) program at The Children's Hospital of Buffalo is one of 12 sites nationwide coordinating the ationallnstitutes' of Health first trial of experimental HlV vaccines for children. "This trial is the first step in developing a vaccine thatmaypreventordelaydisease progression in children with HIV," notes Cynthia zelc Kelly, M.D., director of the pediatric AIDS program at Children's. The study, which will compare the safety of three experimental vaccines in 90 children, will enroll children between the ages of one month and 12 years. At least half of the children in the nationwide trial will be two years of age or younger to enable a comparison of the immune responses of the younger and older participants. Tying cholesterol testing to being overweight may miss many at risk Children's Hospital will help (Oordinate HIV va((ine trials. B u 0 0 p electing patients for cholesterol testing merely because they are overweight is a poor practice and may cause primary care physicians to miss many high-risk people, a University at Buffalo study has found. Neither weight nor body mass index is associated with high cholesterol levels, suggesting that screening should be offered without regard to weight, the study by Barbara A. Majeroni,M.D., UBclinical assistant professor of family medicine, determined. The study was reported in The journal of Family Practice. Majeroni reviewed the charts of 604 patients selected randomly from her group practice; 196 of the patients had had their cholesterol levels determined. Results showed a trend toward less screening of people with a low y 5 c 0 A Neither weight nor body mass index is assodated with high (holesterol, the study found. body mass index and more screening of persons with a higher body mass index. But the overweight people were no more likely to have high cholesterol levels than + patients who weren't overweight. BY LOIS BAKER Nitric oxide treatment used for persistent pulmonary hypertension esearch at The Children's Hospital of Buffalo with nitric oxide ( 0) may pave the way for breakthroughs in the treatment of persistent pulmonary hypertension in newborns. " itric oxide research and therapy may be the biggest step yet in the treatment of persistent pulmonary hypertension," said Frederick Morin, M.D., UB associate professor of pediatrics and division chief of neonatology at Children's Hospital. Treatment with 0 selectively dilates the vessels to the lungs-increasing blood u m 9 3 �............... .. ......... . ........... .. ................................... ........ m m ~~ ' flow to the lungs and oxygen in the blood within minutes - to stabilize the newborn. Preliminary indications show that 0 treatment may be a much less expensive and less risky treatment than extracorporeal membrane oxygenation - a fairly new treatment form itself. itric oxide treatment is being conducted on a trial basis for persistent pulmonary hypertension at Children's Hospital and four other medical centers across + the country. New software will allow rapid solution of complex molecules cientists who design new drugs will soon have at their disposal an extremely fast software package that solves complex molecular structures on a workstation, sometimes in minutes or hours. The new software, called "Shake and Bake," was developed by researchers at the University at Buffalo and the Medical Foundation ofBuffalo, and has developed from basic research to viable product in less than one year. Led by obel Laureate Herbert Hauptman, the research team invited researchers doing rational drug design and other work involving complex molecular structures to sign up for an initial test phase of the package during the summer. General distribution is scheduled for the fall. "'Shake and Bake' will solve structures that no one's been able to solve,'' said Russ Miller, Ph.D., UB computer science professor and a member of the research team. The software is the first that can routinely solve structures of up to 300 to 400 atoms if high-quality X-ray data are available. The user-friendly, menu-driven package has taken only hours or days to solve B u a 0 p h Bake" can solve complex molecular structures in minutes or hours. very complicated structures, including structures that previously took more than a decade to solve using other methods, and others that had previously been unsolved. Two versions of the software are available: one that runs on aU IX workstation and one on a massively parallel Thinking Machines CM-5 supercomputer. + - B Y ELLEN G OLDBAUM Method for synthesizing promising new cancer treatment developed niversity at Buffalo scientists have removed a major obstacle to the synthesis of an extremely promising cancer treatment that would inhibit uncontrolled cell division. A paper that describes the new approach to synthesizing potential protein kinase inhibitors, which is orders of magnitude faster than previous ones, was published in the May issue of The journal of Biological Chemistry. s c a '' "This will allow scientists to survey a much wider range of candidate inhibitors in a much shorter amount of time, including compounds that were just not synthetically accessible before," said David Lawrence, Ph.D., UB associate professor of chemistry, who led the research team. Protein kinase inhibitors, which inhibit the formation of the enzyme kinase that signals cells to divide, are generally recognized as potentially "a very novel family of chemotherapeutic agents," Lawrence said. Synthesizing such compounds in the lab, however, has been a difficult hurdle for scientists to overcome. Because of this, the UB scientists focused on developing protein kinase substrates rather than inhibitors. Both substances bind to their target enzymes substrates temporarily and inhibitors permanently - to inactivate the enzyme. Lawrence explained that focusing on substrates enabled the team to rapidly determine the types of chemical structures the enzyme would recognize. Lawrence said that both substrates and inhibitors must contain a specific amino acid within a peptide- a string of amino acids - that is recognized by the target enzyme, to be effective. He added it was generally accepted that the key amino acid had to be contained within the string, rather than on the end because this was observed in natural proteins. "Because the critical component is often very chemically sensitive, the process of attaching other amino acids to it often triggers unwanted chemical reactions which can ruin the critical compound,'; Lawrence said. In what he described as "an act of desperation," the UB team attached the key component at the very end of the chain of amino acids. "To our amazement, we found that such compounds served as extremely efficient substrates for enzymes,'' he said. + - BY u m ELLEN GOLDBAUM 9 3 0 �[ll . . . ............. .. ......... . . . ..... . .. . .............. . ....... . ....... . .... . able, as well. The program is closely affiliated with Roswell Park Cancer Institute and The Children's Hospital of Buffalo as well as other area health care facilities that offer pediatric services. It is one of only a few pediatric z hospice programs in 3 ~ the country that main§ tains swing beds in an ~ acute care hospital. Hospice Buffalo begins its home-based, comprehensive pediatric service. For more information or patient referral, call838-4438, Ext. 219. + . Comprehensive pediatric service established by Hospice Buffalo ECMC achieves lowest trauma mortality in New York State ECMC had 3,386 trauma admissions over the past 18 months with a total mortality rate under 2 percent- the lowest mortality rate in the state for a regional trauma center. For treatment of adolescents 10 to 15 years old admitted for trauma, the hospital achieved a 0 percent mortality rate. " o one component of the trauma system, whether it be police, fire, medical care or pre-hospital community care, can exist separately," said ECMC administrator Thomas Faith. "The truly regional and comprehensive nature of theW estern ew York Trauma System is a model that everyone who is associated with it can be proud of." + Buffalo General'sLancaster Alcoholism Clinic extends hours ospice Buffalo has established "The Carousel Program for Children and Families," a comprehensive pediatrie County Medical Center's Regional he Buffalo General Hospital's ric service for children and adolesTrauma Center has the lowest reLancaster outpatient alcoholism cents with life-threatening illnesses gional mortality statistics in the state, clinic has extended its hours of opand their families. and with the exception of the region eration. The interdisciplinary home-based prothat encompasses ew York City Alcoholism Outpatient Services, gram provides coordinated, comprehenand Long Island, the most trauma 11 West Main Street, Lancaster, is sive care under the direction of the child's patients. open from 9 a.m. to 8 p.m., Monday physician, according to Eva Rubinstein, According to statistics compiled by the through Thursday, and from 9 a.m. to 5 R. . , J.D., director of pediatrics for Hosew York State Department of Health, p.m. on Friday. pice Buffalo. Caregivers work closely with Services include Robert Milch, M.D., Hospice medical di- ~ assessment to derector, other area physicians, nurses and ~ termine if an alcoallied health care professionals to meet the * hol or drug probphysical, psycho-social and emotional ~ lem exists; indineeds of children and their families. Chilvidual, group and dren are not required to give up curative family counseling; therapy or have a limited prognosis to be education and readmitted into the program. lapse intervention The Carousel Program offers homecounseling, as well based pediatric skilled nurses, medical as services for adult social workers, child life specialists, art children ofalcoholspecialists, music therapists, speech theraics. pists, occupational therapists, pastoral For more inforcaregivers, volunteers, bereavement counmation, call 681selors, dietitians and home health aides. 4957. + High-tech home care services are avail- ECMC's Trauma Center mortality rate was less than 2 percent. 0 B a a p h 5 c a u m n 9 �. . . . . . . . . . . . . ... . ... . . . . . . . . . . .... .. . . . .. . . . ... . . .. [1] I . Buffalo General opens East Side adult ambulatmy care program Amsterdam named director of laboratory medicine at ECMC aniel Amsterdam, Ph.D., professor of microbiology and associate professor of medicine, has been appointed director of the department oflaboratorymedicineat Erie County Medical Center. Previously, he was director of clinical microbiolgy and im..... munology there. Amsterdam earned his doctorate ,.,,;)!'• .. .. ·.'...:·' from ewYorkUni"'~ versity. Before joiningECMC,heheaded the human cell biology program at the euroscience Center of the Kingsbrook jewish Medical Center and was on the faculties of Long Island University and the Mount Sinai School of Medicine. Amsterdam is a member of the American Association for the Advancement of Science, the American Association of Pathologists, the American Society for Cell Biology, the American Society for Microbiology and a fellow of the American Academy of Microbiology, the American Association for the Advancement of Science and the Infectious Diseases Society of America. + Children'sHospital appoints new director of pediatric surgery ~ ,. ~ ichard Azizkhan, M.D., has been appointed surgeon-in-chief and director of the department of pediatric surgery at The Children's Hospital of Buffalo and professor of surgery and pediatrics at the School of Medicine and Biomedical Sciences. Azizkhan was formerly associate professor of surgery and chief of pediatric surgery at the University of orth Carolina at Chapel Hill School of Medicine. He earned his medical degree from the Milton S. Hershey Center of Pennsylvania State University College of Medicine and completed a residency in general surgery at the University of Virginia Medical Center. Azizkhan did his pediatric surgical training at johns Hopkins University. Board certified by the American Board of Surgery in general surgery, pediatric surgery and surgical critical care, Azizkhan is a member of the American College of B u a 0 p h ~ ~-'!fl'~ 0 y 5 ' [IJ Surgeons, the American Pediatric Surgical Association, the Association for Academic Surgery, the Society of University Surgeons, the American Association for Surgery of Trauma, the American Medical Association and the American Academy of Pediatrics. + he Buffalo General Hospital has opened an adult primary care center on Buffalo's East Side. The 1490 jefferson Health Services at 1490 jefferson Avenue will offer general medical care, health screenings, podiatry care, nutritional counseling, health education and wellness programs and social work counseling for people who require referrals to social and human service agencies. The new facility includes five examination rooms on the first l1oor of the 1490 Enterprises Community Center, where it is housed. All private insurance as well as Medicaid and Medicare are accepted. + • c a A Chairman of pathology appointed at Roswell Park Cancer Institute ohn]. Brooks, M.D., has been appointed chairman of the department of pathology at Roswell Park Cancer Institute and professor and vice chairman of the department of pathology at UB. A graduate of jefferson Medical College, Thomas jefferson University, Philadelphia, Brooks completed his residency in pathology at the Hospital of the University of _Pennsylvania School of Medicine, where he was chief resident and assistant instructor of pathology. He was associate director of the section of surgical pathology, director of the immunohistochemistry laboratory and professor of pathology and laboratory medicine at the Hospital and School of Medicine at the University ofPennsylvania, Philadelphia. In 1987, he served as a visiting professor with honorary clinical status at the Royal Marsden Hospital and Institute for Cancer Research, London and Surrey, England. Brooks also has subspecialty training in hematopathology, soft tissue pathology, immunohistochemistry, in situ hybridization and the ultrastructure, cytogenetics and growth of soft tissue tumors. The author of more than 100 original scientific papers and 50 scientific abstracts, editorials, reviews, book chapters and letters, Brooks holds editorial positions on the journals Surgical Pathology, Modem Pathology and Applied Immunohistopathology. He is a reviewer for the journals Cancer, Ameri- can journal of Pathology, Cancer Research and the European journal of Cancer Research and Clinical Oncology. + u m n 9 9 3 0 �. Cooperative efforts between UB and the Department of Veterans Affairs become a reality O au tfa I a Ph y sl c 1 an A u t u m n 1 9 9 3 �On May 14, 1993, the University at Buffalo joined a select group not awarded its $3.4 million federal funding package until1988. "We didn't get it in the first round, but we did in the second," of nuclear medicine centers of excellence when it formally dedicated its $12 million Center for Positron Emission aughton says of the VA grants awarded on an annual basis. The Tomography- one of the most advanced in the country and grant was one of only four high-technology projects the federal one of the few with clinical, research and educational applicabody awarded that fiscal year. But with minimum PET startup costs estimated at between tions. The multidisciplinary center, which integrates medical spe$7 and $10 million, the federal grant was only a start for UB's cialties and subspecialties within its three functions , has been ambitious project. the result of collaborative efforts between the federal and state Funding ultimately came from diverse sources: $1.6 million governments and private foundations and corporations since its from UB itself, 6 million from ew York State, $1 million from the james H. Cummings Foundation in the form of a contribuinception. Indeed, even physically, the center consists of two distinct entities- UB's Parker Hall, the site of the cyclotron, and tion to the University at Buffalo Foundation's "Pathways to Greatness Campaign" and the VA award. the Buffalo VA Medical Center, 3,000 feet across the street, PET technology is considered one of the most advanced in where the PET scanner itself is housed - connected by an underground pneumatic tube system. medical imaging, distilled from a number of scientific disciThe center's origins date back to the mid-1980s, \l ucE sMA plines. It enables the visualization and quantification VI 11 LL . . . when congressional legislation made it possible c:, \\\ Q(J.f of complex physwlogiCal processes on a chemifor certain grants to be used to fund both ...,~'\ -+')'/'l cal level. The technology uses short-lived Department ofVeterans Affairs facilities and ,$'• ~ physiologically compatible positron-emitthe communities they serve to develop and ~ ~.,., ting radionuclides synthesized into phar~ maceutical drugs that are administered share scarce medical resources. The UB- ~ VA PET center accepts both veterans and : ~ to patients and read by a scanner. The non-veterans. ~ ~ infonnation the scanner reads is then "The VA was instrumental in the de- "' ~ fed into a computer to produce three%! velopment of this technology," says john ~ ~ dimensional images of physiological proaughton, M.D., vice president for clini- ~ cesses. cal affairs and dean ofUB's School ofMedi- ~ ~ PET technology uses radioactive nu?' cine and Biomedical Sciences. "There are ,; c, elides of elements commonly found in the several PETS in the country located in VAs. " body, such as oxygen, nitrogen and carbon, The PET center now serves four to six patients that are administered to the patient. Because they each week. "A fair number of those referrals are from are physiologically compatible, the PET radionuclides Rochester," aughton says. actually follow true physiological and metabolic processes, Cooperation between the different entities that comprise rather than mimic biological pathways as other nuclear mediUB's PET center has been the byword from the start of the cine imaging technology tracers do. PET imaging produces images of the functioning of the body, project. augh ton praised the joint relationship between the univerrather than its structure, as more traditional forms of medical sity and the Buffalo VAMC in both the ownership and manageimaging technology- CT scanning, for instance- do. The technology, which can afford physicians a cellular view ment of the PET facility. "The cooperative venture allows the VA to do something it of biochemical processes, shows promise in a number of disciplines and applications, among them, cardiology, neurology, couldn't do itself and the SU Y system to do something it couldn't do by itself," says Alan Lockwood, M.D. , director of psychiatry and oncology. The key to UB's successful PET center, according to aughton, PET center operations for the VA and UB professor of neurology and nuclear medicine. "This is a very rich intellectual environwas "developing the cyclotron"- the specially designed electromagnetic device that accelerates charged particles or ionized ment for something like this to take place in. UB is the flagship atoms to very high velocities. The high-speed particles then institution of the SU Y system and the Buffalo VA Medical collide into targets - physiologic elements- to produce the Center is one of the major VA hospitals in the country." radionuclides. "There was no space at the VA for the cyclotron," aughton says of the arrangement. "So we used a bay in Parker Hall to UB's cyclotron is one of the more advanced in the country. Manufactured by the Belgian firm , Ion Beams Application, it is house it. "Parker Hall not only houses the cyclotron now, but it serves the largest and most powerful of its type manufactured today. as a base for the nuclear medicine department. The arrangement From its specially designed bay in Parker Hall, it manufactures has enabled us to centralize that department. " radionuclides that are converted to radiopharmaceuticals by the UB entered the competition for PET grants in 1987, but was chemistry function of the nuclear medicine department in $ B u a 0 p s c a m n 9 9 8 �Parker and then transported via pneumatic tubes to the PET scanner suite at the VA. It takes the radio pharmaceuticals- many with a half-life of slightly more than two minutes, according to Lockwood- 80 to 90 seconds to travel the 3,000-foot distance. The scanner portion of the center has been in operation since October 1991; before UB's cyclotron went on-line during the summer, the center purchased radionuclides from Hamilton, Ontario, a ugh ton says. ow, the university is in a position to supply some of the "longer" short-lived radionuclides to other PET centers, he adds. UB's PET center is the only one within a 150-mile radius; it is one of only four in the state and one of two approved for use in patient care. PET technology has been in existence since the mid-1970s, according to joseph Prezio, M.D., chair of UB's department of nuclear medicine, director of the PET center and one of the driving forces behind the university's entree into PET technology. "But it was so technically poor and cumbersome and atrociously expensive, no one could get involved except for a few well-financed research centers," he explains. "As the equipment matured," he continues, "the cost, though still prohibitive, got a little better. "And," he explains, "there were clinical reasons to continue." Those clinical reasons include hopes for improved treatment outcomes and better understanding of a number of diseases and conditions, including epilepsy, coronary artery disease, schizophrenia, Alzheimer's disease, Parkinsonism, brain tumors and cancer. PET imaging in cardiology detects coronary artery disease earlier and with greater sensitivity than more traditional diagnostic procedures, often precluding the need for cardiac catheterization and other procedures that involve patient risk. At the VA Medical Center, patients with ischemic coronary artery diseases- about 100 so far- are scanned to determine whether an area of the heart with poor blood flow is still alive and capable of benefiting from certain treatments or dead and not capable, Lockwood says. "Current tests available primarily measure flow . We help sort out the difference between low-flow live muscle and low-flow An underground pneumatic tube connects the cyclotron boy in Porker Hall to the PET scanner suite at the Buffalo VA Medical Center. The tube system provides high-speed transfer of rodiophormoceuticols for use in medical imaging. The rodiophormoceuticols- some with a half-life of just over two minutes - travel the 3,000-foot route in 80 to 90 seconds. PET Scanner Suite Buffalo VA Medical Center 0 B u c 0 p h y s c n A u m 9 9 3 �dead muscle to determine the best candidates for bypass or angioplasty and to avoid expensive and risky procedures," he adds. The technology is revolutionizing the way patients are chosen for angioplasty and coronary bypass surgery or medical treatment. The technology is also revolutionizing oncology treatment decisions-enablingphysicians to evaluate the effectiveness of chemotherapy within a matter of days rather than months. At the VA, it is also being used to successfully pinpoint the site of electrical outbursts in the brains of epileptics as part of presurgical evaluations to determine whether seizures emanate from a single spot in the brain. "Around half the patients are seizure-free after surgery," Lockwood says. "And a substantial portion of the other half get substantial improvement. lt makes an enormous positive impact on the patient's life. " And although there are no clinical applications in psychiatry yet, UB's center already has garnered research awards with strong clinical applications, among them , grants to look at brain injury after minimal trauma and study brain pattern abnormalities after severe liver disease. The minimal brain trauma study, Lockwood says, involves collaborative work between the VA and UB's departments of psychiatry, neurology, internal medicine, nuclear medicine and emergency medicine at Erie County Medical Center. Lockwood says the PET center is beginning clinical studies of patients with colorectal cancer to detect recurrences. Other research involves collaborations with the university's linguistics department to try to determine which areas of the brain are involved with specific functions of speech. In addition to its clinical and research applications, UB's PET center is the first comprehensive training center for PET imaging in the United States, thanks to a three-year, $450,000 grant from Siemens H. G. , a major supplier of nuclear imaging equipment. The center is equipped to train the range of personnel needed to operate a fully functioning PET center - from the technicians who assist the chemists to the physicians who specialize in nuclear medicine. It is organized around four Winspear Ave. ~I Cyclotron Facility Porker Hall University at Buffalo South Com us I. B 0 0 p h y s c Buffalo VA Medical Center Parker Hall .,; > < University at Buffalo South Campus >- ~ ·;:; = 0 A u m n 3 0 �J~~~~~ ~r~li~. m.L ~~~~~~ ~~~~rtm~~t ~f ~~~ ~~r m~~~~~~~ w~ ~~~~r~~~~ r~ ~ major training groups: technicians, radiochemists, nuclear physicists and physicians. "The problem throughout the U.S. and, probably the world," Prezio says, "is that training for PET has not been organized appropriately, or in enough depth, so that you can end someone to one site and have them come back seasoned and trained. Siemens liked what we were doing here. They were looking for someone willing to put the effort into it. "Our goal from the beginning, in addition to establishing the PET imaging center for research and clinical use, was to set up a national educational program that would be unrivaled in the United States." In addition to that Siemens grant, the Buffalo VA Medical Center will receive more than $150,000 from the corporation to develop computer software for the PET scanner. Two new software modules will be developed: one, with both research and clinical care applications, will compute blood flow; the other will describe metabolism in the brain using mathematical modeling of biochemical reactions. "Right now there is no software in our computer system that enables a user to measure blood flow ," says Lockwood. 'This will expand the capability for existing and future PET systems," he adds. The grant was developed through a Cooperative Research and Development Agreement. The agreement, which falls under the auspices of the federal Technology Transfer Act of 1986, allows both federal and private corporations to work together to develop new technology.It is only the second time in VA history such an agreement has been reached. "This is an example of a new trend in funding of medical research where there's cooperation between public and private sectors," Lockwood says. "This will be an increasingly important aspect to funding future research of all types. " On the downside, "PET studies are expensive [currently running over $2,000 per procedure] and not generally covered by health insurance in this country. In Buffalo, however," aughton says, "payment arrangements are made on a case-bycase basis. Many of the area's major third-party payers have negotiated rates to cover the studies." To ensure coverage, Lockwood says that patients at the PET center are carefully screened to meet certain criteria. "We study patients only with specific indications for the procedure, rather than as an open-ended diagnostic procedure. "This is a very deliberate step we've taken because of our commiunent to provide cost-effective services to the public," he notes. "We request reimbursements only for procedures judged likely to be cost-effective. And because of this, we've had good relationships with insurers in this area. "After all, insurance companies will want to pay $2,400 for a study if it will save them $40,000 down the road." And although neither Medicaid nor Medicare reimburse for PET scans, national efforts are underway to change that. + B u a 0 p h y PET center dedication culminates two decades of planning and development for the future oe Prezio, M.D.'s singular vision of making the University at Buffalo a major force in nuclear imaging became a reality on May 14, 1993, when the University formally dedicated its Center for Positron Emission Tomography (PET) that is one of the most advanced in the country. It was a vision that began in the mid-1960s and took root two decades later when congressional legislation made it possible to award grants that would aid both federal Veterans Affairs hospitals and the local communities they served. And it was a vision that Prezio -as both chairman since 1985 and professor of nuclear medicine - is largely responsible for nurturing. According to john Naughton, M.D. , vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences, Prezio has helped build a department "always strong in the research arena and with a fine clinical presence." Prezio came to UB first as an internal medicine resident in 1959 and then as a clinical assistant professor and assistant director for medical education at Mercy Hospital in 1964. Over the next nearly 30 years he has served the university, he has seen both the department of nuclear medicine and the specialty itself grow and expand at the undergraduate and graduate levels as well as in its clinical and research functions. Prezio's love of nuclear medicine and the city in which he's realized his dream began rather circuitously with a rotating internship in internal medicine at Mercy Hospital. The Georgetown University Medical School cum laude graduate's strong interest in endocrinology- he eventually completed both a clinical and research fellowship in the field at Georgetown - developed into an even stronger interest in nuclear medicine as Prezio used radioactive iodine to treat thyroid patients. c a m n 9 �programs filled by international medical school graduates is about 60. Since 1985, UB's national graduate enrollment average has been greater than 90 percent. Part of what makes UB's nuclear medicine residency programs so attractive is that some combine nuclear medicine with another specialty- such as internal medicine and radiology- to allow graduates to get both boards in a shorter period of time than they would if they completed two separate residencies. "The programs are so successful," Prezio says, "that we're now offering a five-year program with the PET and neurology and psychiatry. That's five years versus six or seven years. And both the job market potential and academic career potential are outstanding. "We're the only university in the country offering the combined programs- except for a smaller, not-as-mature program at the University of orth Carolina." Prezio has also focused on major educational programs to increase community awareness and extend the university's concerns about the quality of nuclear medicine. "We want to expand our educational services beyond Western New York to become a national training site- not only for conventional nuclear medicine, but especially for PET training. "We've just completed a training program for endocrinologists to familiarize themselves with radiation safety techniques in their practice. We want to expand on that. " The PET center figures heavily in Prezio's plans for the future- he wants to establish it as a major research center, and is well on the way to accomplishing that goal already with the acquisition of grants to use PET technology to look at brain injury after minimal trauma and brain pattern abnormalities with severe liver disease. Prezio also wants to develop and enhance the department's attractiveness to industry. "I want to use the PET center and department as a resource and evaluation site for new drugs. " Taward this end, Prezio is recruiting an expert in nuclear pharmacokinetics. Prezio's final goal- at least for the present- is to further expand the multidisciplinary approach the department of nuclear medicine has taken in the past 10 years. "We want to continue to work closely with neurology and psychiatry to assist in research where PET technology can be applied. We want to bring all these research activities into this department. " Prezio credits Michael Cohen, M.D. and Murray Morphy, M.D. -chairs of neurology and psychiatry respectivelyfor spearheading the effort and for the successes they have already achieved. "They took a 'what's good for everybody' attitude rather than 'what's good for me' attitude and they deserve a lot of credit. + "We led the way in these jawboning techniques,'' he says. "That's how it all started," he relates. In fact , Prezio merged those interests when he started the clinical radioisotope program at the South Buffalo hospital nearly three decades ago. At that time, nuclear medicine was in its infancy- its first identification as a specialty, in fact, was in the late 1950sbefore the technology revolution that saw its knowledge base expand almost exponentially. "As the field became more complex, with the development of new imaging technology and new radiopharmaceuticals, it came into its own," Prezio said. "The idea to start a separate specialty," he adds, "was born in Buffalo, with Dr. Merrill Beader at Roswell Park Cancer Institute. He worked feverishly and with considerable aplomb to establish a forn1al residency program in 1971. It was the first in the country. In 1972 the boards were offered for the first time. " In 1972, nuclear medicine's technology consisted pretty much of a "scanner device and early scintillation gamma camera,'' according to Prezio. Applications consisted of lung, bone, thyroid and brain- the cardiac applications that are a mainstay today had not yet become a reality. And at the time, both the technology and its applications were directed at in1aging. "The direction today,'' Prezio explains, "is not just imaging, but the functional analysis of actual biochemical processes. "The next step is the cellular processes. We can look at these with the PET." And with UB's sophisticated new PET center- one of the few in the country with the capacity for both patient care and research- the department of nuclear medicine is positioned to become a national leader in both. Under Prezio's stewardship, the department has accomplished several goals. "The major thing," Prezio says, "is the centralization of the department from Diefendorf Annex. " Its recent consolidation to Parker Hall "is the first time in its history that it is totally centralized in one place. "All major educational activities for training medical students, technicians, nuclear medicine residents , are all here in Parker Hall. "Our grand rounds," he adds, "draw 90 people. They are always very well attended. We draw physicians and technicians from Rochester, Hamilton- the whole Western ew York area. It [the centralization and resulting consolidation] is an outstanding success. "And psychologically, it's better," he says, noting "neutral territory. " Making the nuclear medicine programs more attractive to American graduates has been another accomplishment. ationally, the percentage of nuclear medicine residency NANETTE B u a 0 p h y 5 a n u TRAMONT m KOLLI 9 9 3 G �.. B a 0 p a u m 9 9 �The Consortium's structure emphasizes the goal of improving educational quality, not meddling in the member hospitals' operations, and giving the members on equal voice in decisions. B u f f a l o P h ys icI an A u t u m n 1 9 9 3 �c 0 0 p ITED BY COMMO E R A NECESSITY, THE UNIVER- SITY AT BUFFALO MEDICAL SCHOOL A D ITS TEACH I G HOSPITALS ARE Fl A WELL AS CELEBRATE THE lOTH AI ATIO AL RECOG DI G STRE GTH lTJO AS THEY JVERSARY OF THEIR I STITUTIONAL ALLIANCE. Through the Graduate Medical Dental tion of American Medical Colleges. "People are coming and looking at Education Consortium of Buffalo, the assortment of residency programs scattered what we're doing with the Consortium," among area hospitals has been brought said William D. Pike, president of the under an organizational umbrella, giving Western ew York Hospital Association. the university greater control over gradu- "It is unique and something we should be ate medical education without threaten- proud of." aughton is ing hospital auclearly proud of the tonomy. The arrangeconsortium he was ment has fostered instrumental in greater cooperation at "If I had to describe it in forming 10 years a time of increasingly ago. "We're probstrained finances, and a word, I'd say ably the most soit has taken on some phisticated and of the thornier policy 'consensusbuilding .' I complex consorquestions in health tium that exists in care, such as the need would say no one has lost the country," he to tum out more prisaid. "I don't know mary care physicians. "There have been that we necessarily any autonomy." a lot of positive are the model, but outcomes ," john we are a model." Richard Braun, vice aughton , M.D. , asSitting back in sociate vice president shirt-sleeves behind president of finance and for clinical services his wide desk, and dean of the mediaughton recalled chief financial officer of cal school, said simthat it wasn't always ply. easy. Some resiAnd witl1 the nadencyprograms had The Buffalo General tion bracing for major to be reorganized, upheavals in health with responsibilHospital care and medical eduities and resources cation, the Consorshifted among diftium is also being ferent hospitals. viewed as a model. And, he notes, bu"When people talk about GME con- reaucratic turf battles haven't been comsortia, they all talk about Buffalo," said pletely relegated to history. joyce Kelly, Ph.D., associate vice presi"It'll lead to some testiness from time to dent for clinical services with the Associa- time," he said. "It'll lead to some issues. T 0 N But it works out." In fact, Naughton said, he was surprised there weren't more problems in bringing the university's teaching hospitals together. "Amazingly enough, given the magnitude of it, the difficulties were relatively modest," he said. "The main difficulties were in visualizing the needs and in bringing everybody into it so they filled their proper roles. " The goals behind the Consortium are better education for residents and better coordination among the participating institutions. "Most university medical centers are single centers that report back to one university," said Richard Braun, vice president of finance and chief financial officer of The Buffalo General Hospital. "What we have is a consortium of eight hospitals that divvy up the teaching." The idea for the Consortium came in the early 1980s when the Accreditation Council for Graduate Medical Education issued new guidelines requiring greater institutional management of residency programs. At the time there was little coordination between the Buffalo programs, with some controlled by the university and some by the hospitals - The Buffalo General Hospital, The Children's Hospital ofBuffalo, Millard Fillmore Hospitals, Erie County Medical Center, Sisters of Charity Hospital, Buffalo VA Medical Center, Mercy Hospital and Roswell Park Cancer Institute. UB was not the only medical school in the nation without its own medical center. But even among schools relying on community hospitals, the UB-affiliated residency programs were notably scattered, said Michael F. oe, M.D. ,BGH executive vice president and medical director. "We did not have the university or a university hospital identified as the sponsor of the programs," recalled oe, who worked with Naughton to forn1 the Consortium. "We had multiple hospitals identified as the sponsor of individual programs." . C 0 0 P E R A T I 0 N ti �.. oe described the situation as "fragmentation to the extreme." In some cases, he said, program directors found themselvesjuggling the conflicting interests of several hospitals involved in the same program. "The hospitals each had their own house staff, their own payroll and benefit package for the residents. There was no uniformityeveninthatarea," headded. " ordid we have any common operating policies that applied across the entire system." David M. Crossland, M.D. , chairman of the Consortium's residents committee, agreed. "There was no organization. They competed with one another and didn't trust one another," he said of the hospitals. "Residency programs were as good or as bad as the institution had them be." Said aughton: "We had had prior to that time a fair amount of problems with the various accrediting bodies." When the new ACGMErulescamealong, "We had to respond," aughton said. One of the first signs that the Consortium would workcameearlyon, during seemingly mundane discussions about designing a letterhead for Consortium stationery. "There was always a little tension in the communityaboutownershipoftheseresidencies," aughton recalled. "The question was, having made that bigjump, how would we identify ourselves." The dean said he was sure the hospitals would balk at putting the medical school's name anywhere prominent. He was happily mistaken. "It was pretty clear that the hospital directors thought the university should have the lead in it," he said. aughton credits several factors for the Consortium's success, including its design as a voluntary membership organization rather than a formal entity like a corporation. The structure emphasized the goal of improving educational quality, not meddling in the member hospitals' operations, and giving the members an equal voice in decisions. "We weren't merging anything," aughton said. "Ev- ery institution was going to maintain its integrity." oe agreed. "I think our success in establishment, as well as in the continued operation of the [organizational] model we decided upon, was first of all that it was a fully participatory governance process," he said. "You still have the individual tension, obviously," Naughton said. "But the decisions are made collaboratively, not by any single institution." Members meet regularly and lines of communication are kept open. The Consortium has three committees: administration, which includes deans, hospital �heads and hospital medical directors; program directors, which includes university department heads as well as the directors of each residency program, and residents, composed of elected representatives from each program. In addition, each committee elects a representative to sit on the other two C 0 0 committees. "All of our dealings are public within the organization," oe said. Program directors retain responsibility over the residencies, and medical school graduates still apply to individual residencies rather than the Consortium. But the Consortium is the sponsoring institution, and application forms and many other PER facets of the programs are now standardized. "What we did was to externalize the governance of all those programs from all those hospitals to a central body," oe said. Buffalo General CFO Braun said that while the Consortium's course is clearly set by aughton and the chief executive officers of the member hospitals, its decisions are group efforts. "If I had to describe it in a word, I'd say 'consensusbuilding,"' he said. "I would say no one has lost any autonomy. " Consortium members point to a number of achievements, including: • Centralized record-keeping Resident records were previously kept by the individual teaching hospitals. Bringing them under one roof is more efficient and has saved money, aughton said. • Resident salaries In the past, residents received different salaries and benefits depending on which program and hospital they were in. "Before there were different arrangements between hospitals ," aughton said. Even residents in the same program could receive different salaries if the program was spread over more than one hospital, oe said. Consortium members spent a number of years working on the problem. Along the way they encountered complications caused by the fact that some member hospitals- the VA and Erie County Medical Center - are run by government, oe said. "There were also union issues," he added. Two years ago the Consortium finally succeeded in forming two independent corporations to administer compensation packages for medical and dental residents. The corporations pool funds from the member hospitals and have eliminated most of the variations in resident salaries and benefits. • Orientation There is now a single week-long orientation program for residents, which in- AT I 0 l N ! �eludes training in bedside manner and certification in advanced life support. • Grievance procedure The establishment of a Consortium procedure for appealing disciplinary actions has been a major stride for residents, according to Crossland. "We've got much better due process in place now," he said. • Program reviews The Consortium itself reviews residency programs for potential accreditation problems before the ACGME arrives for its triennial checkup. "They do just as good a job as the outside body," said M. Luther Musselman, M.D., director of medical education at Millard Fillmore Hospitals. any of the Consortium's initiatives, such as pooling salaries and creating a combined orientation program, represent efficiency gains, said Diane Linskey-Hauser, executive director of the New York State Council on Graduate Medical Education. "There are lots of economic reasons for doing this," she said. Crossland said the Consortium also has worked to improve residency programs. Residents traditionally have been burdened with heavy workloads that cut into their time for study and research, he said, adding, "That's beginning to change and I'm impressed that they're serious about it." But some feel the Consortium's greatest achievement has been its willingness to tackle wider medical issues, such as the need for more primary care physicians. "It's really seeking to address some of these broader policy goals, well beyond these day-to-day operational issues," said Kelly. The emphasis on turning out more primary care physicians has become one of the Consortium's top priorities. It has set a goal of increasing the proportion of 13,000 residents, more than any other residents in primary care specialties to half state and nearly double the number in the total number of residents, and it has California. Buffalo itself has slightly more also pledged to cap the resident popula- residents than does all of Kansas. Buffalo's is neither the only nor the first tion at 750 medical and 32 dental, roughly teaching hospital consortium in the nathe present number. "That probably would be much more tion. The Association of American Medidifficult without some sort of consortia! cal Colleges tried to find out more about them this year by sending questionnaires effort," Braun said. Any proposal to start a new residency to about 400 teaching hospitals, accordprogram in a field outside primary care is ing to Kelly. The survey identified about met with heated debate at Consortium 40 different consortia around the country, though Kelly said meetings, he added. there are more, exMembers of the plaining that the Consortium are survey's purpose was presently involved to learn about the orin a demonstration "We're probably the most not to ganizations, project aimed at count them. boosting the numsophisticated and complex "Our preliminary ber of residents in findings suggest that the primary care spefor the most part the consortium that exists in cialties, the number consortia outside New of minority physiYork State do not share cians and the numthe country. of producing the goal ber of physicians in more generalist phyunderserved geoI don't know that w e sicians, more minorgraphic areas. ity physicians and Because of its efnecessarily ore more physicians servforts, the Buffalo ing underserved arConsortium is ateas," Kelly said. the model, but tracting national atThose other contention. "There are a sortia are geared more lot of organizations we ore a model." toward issues like resithat are interested in dent recruitment and trying to reform John Naughton, M.D., coordinating benefits, medical education," she said. "Buffalo is said Kelly. "Right vice president fo r clinical way ahead of everynowit'skindofheatbodyelse," she added. ing up because as The Buffalo Conaffairs and dean of the folks are thinking of sortium has taken its medical reform , cue on the broader they're also thinking School of Medicine and social issues from the ofmedical education state, which has been reform." Biomedical Sciences advocating greater use ew York State of consortia to implays a unique role prove medical trainin graduate medical ing since the report of education because the state Commission it has more than L �c 0 0 p E R A on Graduate Medical care, underserved Education in 1986. populations and miThe Commission's nority recruitment. "We did not hove the work led to creation Another consorof the state Council tium has been on Graduate Medical university or o university formed around AlEducation, which has bany Medical Colcontinued to push the lege and Albany hospital identified as the consortium idea. Medical Center, but "The advantages while its plan was apsponsor of the [residency] would be that it alproved by the state lows the opportunity Council on GME programs. We hod multiple for regional planning three years ago, the and looking at sociorganization has hospitals identified as the etal needs rather than been hampered by fiwhat the department nancial problems of medicine needs in and it continues to sponsor of individual tenns ofstaffing," said exist mostly on paLinskey-Hauser. per. programs. It was In its Fourth AnAs time goes on, nual Report, the Counhowever, and there fragmentation to the cil states: "Through is more pressure for consortia, medical changes in medical extreme. In some cases, schools, their affilieducation and the ated hospitals, and health care system, other teaching sites there will be more program directors found can jointly define the need for consortia. educational needs of "The point is that themselves juggling the residents and coordimedical schools and nate the development their teaching hospiconflicting interests of of core curricula, tals are going to have placement of resito network better," several hospitals involved dents and allocation said aughton. of educational re"A lot of coordisources in a way that nation is going to be in the some program." is both efficient and required among the responsive to the medical schools and Mi(hael F. Noe, M.D., needs of society." the affiliated hospiSo far , the only tals," agreed Linskeyexecutive vice president other operating conHauser. "Right now, sortium in the tate is Buffalo is a very clear and medical director of The one organized by model for how conew York Medical sortia might be modCollege and nine afeled." Buffalo General Hospital filiated hospitals in Kelly said there the late 1980s. In adhave been consortia dition to fostering around since the quality education, that consortium's goals 1960s and '70s, but now "they are being also include more emphasis on primary created at an increasing rate." C 0 0 PER T I 0 "The most common model for consortia is not the way it operates in Buffalo," she added. Most consortia now follow the "integrated program" model, Kelly said. These consortia are typically corporations set up to take over the residency programs. The member institutions give up their right to sponsor programs, and instead, the corporation becomes the sponsor. Kelly pointed to McGaw Medical Center at the orthwestern University School of Medicine. Contrary to what the name implies, McGraw Medical Center is not itself a hospital, but a consortium covering several member hospitals. Buffalo's consortium is an "independent" model, a less rigidly structured umbrella organization that lets member institutions retain a significant role in the residency programs. "There is no dominant hospital," said Musselman. "That's probably the biggest difference between Buffalo and other consortia." elly said that neither structure is particularly better suited than the other to pursue the widersocietalgoals for which consortia will be needed, but the Buffalo model makes it easier to get hospitals together in the first place. "It means you can maintain your independence," she said. One manifestation of that independence is in internal medicine, which is split into two programs within the Consortium. "Program A," with about 140 positions, is based at Buffalo General Hospital, Erie County Medical Center and the Buffalo VA Medical Center. The smaller "Program B," with about 40 slots, is based at Millard Fillmore. Even though Millard Fillmore was a Consortium member, it was reluctant to give up its own internal medicine pro- AT I 0 N �gram. "We didn't think it was good for residents to have two months in five different hospitals," Musselman said. "They finally agreed with us and allowed us to keep our program." Crossland said the Consortium's voluntary nature can be a disadvantage, limiting its ability to make changes. "It takes a lot of time and persuasion," he said. In general, however, the Consortium has fostered greater cooperation among its members. "I think we generally feel now that in a sense we have equal input into a decisionmaking process, that the unilateral decision-making that is sometimes not in the best interest of the educational objectives isnolongeraproblem," said oe. "Weare equal participants in a planning process that helps us assure the stability of our educational relationships. There is no question that sometimes decisions that are made don't go the way of one or more hospitals, but on balance I think everyone would agree the procedures set up have brought more advantages than disadvantages, more wins than losses." The primary care demonstration project i one of the more notable examples of cooperation through the Consortium. Under the project- initiated by the Consortium and the medical school, six of the 1 Consortium hospitals, the ew York State Department of Health, four private insurers and Medicaid- the hospitals involved pool about 15 percent of the indirect medical education reimbursements they receive from the government and insurers. The reimbursements are meant to help , compensate the hospitals for the costs of their teaching programs, and the 15 percent they are pooling is money that would otherwise have gone into the hospitals' general budgets, Braun said. The Consortium redistributes the pooled funds , which amounted to about 750,000 last year, to the hospitals for use in primary care training and other programs consistent with the demonstration c 0 project's goals. The Consortium also makes it easier for member institutions to respond to changes, as they did several years ago with a new state requirement involving resident credentialing. The Consortium brought the proper people together to establish a credentialing process, which now includes a system for forwarding records from one hospital to the next as residents rotate, aughton said. Crossland said that from the perspective of the residents themselves, the Consortium has been a "mixed bag." He said it has helped by making salaries and benefits more unifom1, but he adds quickly �c c o E 1 v c c that salaries should be higher. "Overall in the ortheast, we're in the lower 25 percent," he said. l n general, however,Crossland said he is pleased with the Consortium's goals and believes its members are making a good faith effort to improve educational programs. But he said he worries that financial problem could be an obstacle. "The hospitals, I can't overemphasize how much pressure they're under," he said. Last year wasn't a good one for the Consortium's hospitals. "ln total, the six hospitals that reported unaudited numbers showed a substantial loss, $8 million, I think," Braun said. "It's indicative of the environment and the problems we read about in the papers every day. It has nothing to do in a direct sense with the Consortium, but it influences people's ability to participate and the needs that they have." Braun said it hasn't kept the consortium from undertaking any new programs so far, but, "It's a consideration every time we sit around the table and talk about what new and innovative programs can be tried." Crossland said the hospitals are hampered by low reimbursement rates for graduate education. "Some of the reimbursement is going to have to be improved," he said. aughton agrees that the financial situation is serious. But he remains optimistic about the Consortium . "I think the threat is less if we continue to share resources as we do," he said. "l think the Consortium is a pretty good response to the economic climate." + f c c C 0 0 0 0 p E A R T I 0 "There is no dominant hospital. That's probably the biggest difference between Buffalo and other consortia." PER Luther Musselman, M.D., director of medical education for Millard Fillmore Hospitals AT I 0 N �-PAYING OFF FOR THE FUTURE, TOO Y ears ago, hospitals in Buffalo and less serious now," said Andrew J. Rudnick, president ''There's always been a little bit of disquiet elsewhere tended to look on other of the local business group called the Greater Buffalo Partnership. about it," he added. Now work is underway to form a new organi- health care institutions as rivals. They were motivated more by their own selfinterest than by what was best for the region. While the Graduate Medical Dental Education The business community pushed for creation of zation to replace the WNYHSC with a consortium the WNYHSC because it was concerned that local more directly under the control of the university hospitals were duplicating services and spreading and local medical community. The new consortium Consortium of Buffalo didn't set out to solve that some specialties too thinly over multiple institutions. would include the GMDECB, which would continue problem directly, it did help set the stage for anew As a result, there were inefficiencies and some pa- to operate without significant changes. After several years of the WNYHSC, Rudnick way of thinking and a new era of cooperation. tients were traveling to other cities for treatment they said, cooperative efforts have become institution"It helped to provide the mechanism for an should have been able to get in Buffalo. Through the WNYHSC, UB and the area hospitals alized and business leaders no longer feel a need evaluation," said medical school Dean John Naughton, M.D. now engage in more joint planning. Among other to be involved in the process. "We're not academic "Getting the parties to the table served as a things, Naughton and others credit the Consortium medical people," he said. ''We're not clinicians. springboard toward dealing with alarger agenda," with bringing a Trauma-Burn Center to Erie County We're not researchers. Ultimately it's got to be agreed Michael F. Noe, M.D., executive vice president and medical director at The Buffalo General Hospital. "Out of that, in 1987, the Western New Medical Center, a Heart-lung Transplant Center to turned over to them." In addition to encouraging cooperation, the The Buffalo General Hospital and a Bone Marrow Transplant Center to Roswell Park Cancer Institute. new consortium will also focus on issues such as York Health Sciences Consortium was formed." Forming the WNYHSC proved more difficult than new information systems and closer collaboration The Health Sciences Consortium took the the GMDECB because medical people were uneasy betweentheuniversityandcommunityphysicians, GMDECB concept one step further, going beyond with the central role played by the business commu- Noe said. the focus on training to look at the broader issue nity. "It was a little bit more controversial because it of providing quality care at low cost. was threatening to physicians and faculty as well," will be in place by the end of the year. Traditional hospital rivalries "seem to be far Naughton said. Naughton said he hopes the new consortium -A NDREW + DANZO �., ~·· ·· ······· ·· · · ··· · ······· · ··· · ················· · ····· · ······ ··· ··· · ·· ·· ·· · · · ············· · · · ··· Spring Clinical Day and Reunion Weekend '93 successfully staged his year's Spring Clinical Day and Reunion Weekend, held on April 30 and May 1, marked a time to reminisce, renew friendships and review health care practices today. lt was, as always, a rousing + success. From left to right- First row: Ronald E. Martin, Victor Guarneri, Richard]. Buckley, r. , Gertrude Swarthout Second row: Walter R. Peterson, Kenneth Bone, Alfred S. Evans, Duncan K. Macleod, Eugene M. Farber, athan P. egel From left to right- First row: Thomas Grayson, Morris Unher, Anthony Marano Second row: Thomas Heineman, B. joseph Galdys, Marvin Bloom, Harold Feldman, jane Freiberg, George Heus, William Keenan, Paul Wolfgruber, Ivan Bunnell, Ralph Behling, Edward Crohn, Richard jones Third row: Louis Ciola, Edward Tracy, Charles Tanner,john Ninfo From left to right- First row: Harold Graff, Daniel Fahey, Vernon Lubs Second row: Edward Heckman, Raphael Good, Myron Gordon , Daniel Miller, Robert Hall CLASS OF B a 0 p y 5 c a n A u 1948 u m 9 9 3 �CLASS OF 1 953 From left to right- First row: David Batt, jacob Shammash, Richard agel, joseph Ruh, Marvin Wadler, Donald Ehrenreich, Thomas Geoghegan Second row: Herbert Constantine, john Strachan, Reinhold Ullrich, james Coleman, Molly Seidenberg Panner, Thomas Comerford, Howard Smith, john Volunan, Milford Maloney, james Orr, Ronald Garvey Third row: Harley Lindquist, Curtis johnson, Stanley Cohen, Donald Rachow, john Handel, Bertram Portin, Raymond Smith, Michael Sullivan, Sander Fogel, Herbert Simpkins,john Fenger CLASS OF 1 958 From left to right- First row: Melvin Brothman, Richard Rahner, Thomas Cummiskey, Richard Wasson Second row: Richard Romanowski , John Armenia, Marie Leyden Kunz , Lucien Potenza, Michael Mazza,joseph Bellanti, jason Reder Third row: William Glazier,john Float, Michael Genco, Carl Contino, Donald Ginsberg, jacques Lipson , Domonic Falsetti, Robert Dickson, Bernice Comfort, Ronald Batt, Franklin Zeplowitz, Franklyn Campagna, Joseph Zizzi, Samuel Shatkin, Alfred Stein, Eugene Friedberg, Leo Kane, Richard Boyle, Robert Perez, Gerard Guerinot Fourth row:David Koretz, Morton Spivack, William Deverell, Gary Cohen, Gaspare Alfano , Reinhardt Wende,John Giardino, Elroy Anderson CLASS OF 1963 8 u a a p h c a A u m 9 3 �CLASS OF 1 968 i From left to right- First row: john hields, Gary Karch, jeffrey Stoff Second row: Bruce Gesson, Katherine Dowling Schlaerth, Barbara Blase Sayres, Sara Gerstman Sirkin, Thomas Cumbo, Ronald Friedman, Morris Stambler, Leonard Argentine Third row: Lawrence Baker, Gerald Daigler, Robert Baltimore, Albert Biglan, Robert White, Lesbia Fernandez Smith, Robert Rodner, john chlaerth, Geoffrey Clark, Elias Rosenblatt, Harold Kulman Fourth row: Bruce Rabin, jonathan Reynhout, Brianjoseph, Lawrence Dobmeier, julian Karelitz,john Bivona, Robert Rosen,julian Offsay, Robert Milch, Paul Murphy, Robert Dickman, William Clack From left to right- First row: David Breen, Frederic Buchwald, Robert Lamantia, Lynda Young, Sharon Kuritsky, Paul Kuritsky, Thomas Wasser, William Ackerman Second row: Frederick Beck, Michael Haberman, john Klimas, Michael Sansone, Charles McAllister, Arthur Mruczek Third row: jacob Rozbruch, john Przylucki, Dana Launer, Daniel McMahon, Andre Raszynski, Charles Wiles, Raymond Dattwyler, Arnold Scherz, Demetrius Ellis, Thomas Dwyer CLASS OF 1973 From left to right- First row: Michael Blume, Ronald Somogyi, Elizabeth Doherty,judith Baron-Stone, Richard Elman Second row: Stuart Dorfman, Kenneth Glick, Matthew O'Brien, Stephen Gawronski Third row: teven Kaplan, Paul Wopperer, Stewart Altmayer B u a 0 p h s c a " u m 9 9 3 �CLASS OF 1 983 From left to right - First row: Robert Smolinski, eal Smith, Richard Collins Second row: Melinda Cameron, Mary Lee, Suzzanne Tanbakuchi, Deborah Korwin, Younghee Limb, Gwen ichols, Andrea Manyon-Wild, Patricia Flanagan Third row: Ephraim Back, Kenneth Zimmerman, James Koness, Daniel Murak, Robert Rosen,jonathan Graff, Gregory Zuccaro, Borys Loza, Michael Chaskes, Kenneth Roth, Victor Chehebar, Therese Giglia , Peter Accetta Fourth row: Ross Greenberg, Lonny Behar, Robert Stall, Carl Grant, James Corasanti, Galvin Anderson, William Hanavan, Kevin Ferentz, Mark Schwager Fifth row: Charles iles, icholas Aquino, Frank Mezzadri, Frederick McAdam, James Wild, Mark Venditti, Allen Rosen SPRING CLINICAL DAY From left to right - First row: Judith Hays, Lisa Benson-Guterman, Stephanie Christenson, Ellen Adler-Weinberg, Janet Williams-Barbaccia, Norah Lincoff, Ann Marie Levine, Margaret Morey Second row: Kathleen O'Leary, Robert Mennella, Paul Shields, Helen HessCappuccino, Lori Guttuso-Luzi,John Barbaccia, Constance Greene-Klocke, Lisette D'Eon , Ralph Pothel, Thomas Bellomo Third row: Charles Everett, Lisa Guttuso-Klenk, Stephen Hughes, Andrew Cappuccino, Wayne Waz , Frank Luzi, Dawn Hrab, Mark Klocke Winners of the class with the highest percentage of attendees pose for a picture. The AMA's Dr. James Todd lectures on health care reform. Orvan Hess '31, wins an Alumni Achievement award. B u c 0 p y s a n A u m n 9 �~·· · ········································· · ············· · ·· · ··················· · ············ · · lEI Kathleen A. Lillis, M.D. Lillis '87,appointed attending physician in emergency medicine athleen A. Lillis, M.D. , '87, was recently appointed attending physician to the division of emergency medicine at The Children's Hospital of Buffalo. Her responsibilities include supervising resident and medical student teaching in addition to overseeing all incoming patients. Lillis is also medical director of the stabilization and transport team, as well as a child abuse and toxicology consultant for the hospital and medical director of Mercy Flight. + Frawley establishes endowment for residency research fellowship homas F. Frawley, M.D., '44, chairman of Graduate Medical Education at St. John's Medical Center and Emeritus Professor of Medicine at St. Louis University School ofMedicine, has established a charitable remainder unitrust through a gift of securities valued at $50,000 to the University at Buffalo. The unitrust will establish the Thomas F. Frawley, M.D. Residency Research Fellowship in the School of Medicine and Biomedical Sciences. The endowment will B a a p provide a stipend for a resident to perform r search for one year before deciding to follow primarily a medical re earch career or elect to go into clinical practice. Frawley received the Distinguished Medical Alumnus Award in 1989 and served as chairman of the medical school's annual fund drive in 1992. He served as president of the American College of Physicians from 1981 to 1982 and recently was the 1993 recipient of the Alfred Stengel Memorial Award presented to a Master of the College who has exhibited "unusual loyalty and exceptional contributions to the aims and purposes of the College as well as outstanding influence in maintaining and advancing the best standards of medical education, medical practice and clinical research." + Two annual awards endowed for graduating medical students enjamin E. Obletz, M.D. , '32, retired Buffalo surgeon, and his wife, Lila, have established the Dr. Benjamin and Lila Obletz Fund to support a prize in orthopaedic surgery to be awarded annually to a graduating senior. Obletz received both his undergraduate and medical degrees from the University at Buffalo and has served as a clinical professor of orthopaedic surgery from 1956 until the present. Mrs. june Alker has endowed a fund in memory of her husband, George]. Alker, M.D., '56, chairman of the department of radiology at UB from 1985 to 1991. The fund will provide an annual award at commencement to an outstanding student in the area of neuroradiology. Dr. Alker, who died December 31, 1991, was born in Budapest, Hungary, and immigrated to the United States in 1949 as a refugee. He was director of radiology at y 5 c a n A Erie County Medical Center and a member of the American Society of euroradiology. + Lillian Ney'64,named diplomate of medical management board illian Vitanza ey, M.D., '64, vice president for medical affairs and medical director ofW.C.A. Hospital in jamestown, ew York, has been designated a diplomate of the American Board of Medical Management, the national certifying agency for physician executives. ey, who has been with W.C.A. Hospital for 19 years, is board certified in internal medicine and cardiovascular disease. She is a fellow with the American College of Physicians, the American College of Cardiology and the Council of Clinical Cardiology of the American Heart Association. She is also a member of the American College of Physician Executives. + Reisman '56,named master in American College of Physicians obert Reisman, M.D. , '56, has been named a master in the AmericanCollege of Physicians. Reisman, UB clinical professor of pediatrics, is currently President of the Medical Alumni Association. + u m 9 3 �··· · ···· ······ ·· ···· · · ·· · ··· ····· · ·· · ·· · ····· ···· ··· ··· ·· ·· · ·· · ··· · · ·········· ·· ·········· ·· ····· · 1 ·. . II I • I Innovative palliative care training program begins at Hospice Buffalo or the first time, fellows from the Graduate Medical Dental Education Consortium of Buffalo are receiving training in palliative care at Hospice Buffalo. The eight-week rotation, under the auspices ofUB and the ational Institutes of Health Summer Program, emphasizes attitude, knowledge and skill. Under the leadership of Robert Milch, M.D ., medical director of Hospice Buffalo, the fellows examine the interdisciplinary approach of palliative care and how the therapeutic process involves more than diagnosing and attempting to revert advanced disease. Emphasis is placed on interventions as they relate to the patient's needs , desires and beliefs, and assuring patients have as much control as possible over decisions that affect them. The fellows are also involved in discussions on the ethical aspects of caregiving, including euthanasia , resuscitation , paternalism, aggressive versus palliative interventional therapy, incompetent patients, fairness in the health care system and strategies for resolving ethical issues. The curriculum covers common symptoms in patients with advanced chronic disease along with suggestions of appropriate techniques to combat them. Elements of grief reactions and preventive techniques for adverse reactions are also addressed. The rotation identifies various organizational arrangements for the delivery of palliative care and their relationship to the health care system, including community resources available to patients with advanced illnesses and their families . The fellows rotate through each clinical discipline of hospice care, examine methods used in nursing homes and accompany counselors on social work and bereavement visits. + B 0 0 p h The training follows an interdisciplinary approa(h to palliative (Ore that re(o.gnizes the therapeuti( pro(ess involves more than diagnosing and attempting to revert advan(ed d1sease. Pediatrtc fellow receives research award from national association elawati Yuwono , M.D., a fellow in the division of pediatric gastroenterology/nutrition at The Children's Hospital of Buffalo has received a Glaxo Fellow award for her abstract, the "Role of Promoter and Suppressor Genes During Adnomidis Polyp Development in Familial Polyposis Coli." Yuwono presented her data at the annual meeting of the American Gastroenterological + Association. "Membership in the consortium strenothens and improves the quality of b Memorial's family practice residency program through increased coordination with the State University of ew York at Buffalo's medical and dental schools and other area teaching hospitals," Memorial president Timothy]. Finan said. "Our participation will cement an effective working relationship and improve communication to the benefit of our resident physicians, the hospital and the community. " + Niagara Falls Memortal Medical Center joins Buffalo Consortium iagara Falls Memorial Medical Center has joined the Graduate Medical Dental Education Consortium of Buffalo to strengthen and enhance its family practice residency program. y c 0 n Resident training at Niagara Falls Memorial Medi(al Center will be enhan(ed. m n 9 9 �• ················· · ··· · ······························· ·· ·········· · ···················· · ··· · ····· ~ I "In Sickness and in Health" chronicles the plight of Alzheimer's disease victims he Western ew York Chapter of Alzheimer's Disease and Related Disorders Association has found an unusual way to raise money for its support services and promote awareness of the disease. lt has hired Buffalo Ensemble Theatre, a downtown professional company, to produce In Sickness and in Health, a new play about a family struggling to cope with the advancement of the disease. The play, by Donna Marie Vaughan, will be presented ovember 4, 5, 6 and 7 at Lancaster Opera House. All proceeds will benefit the local chapter. In Sickness and In Health, which is expected to receive national coverage, opens with Cecilia, a mother of four now in her late 50s, rummaging for her mislaid checkbook, which her husband, Emmet, eventually finds in the icebox. As the play progresses, Cecilia's condition steadily deteriorates, and Emmet alternates between shielding the severity of the disease from the children and visitors and grappling with the temptation to give his wife up to professional care. "Losing a person so gradually is more painful than death," said Marion Goldstein, M.D. , UB principal investigator of psychiatry who sits on the Alzheimer's Disease Association's Board ofDirectors. ''I've known a lot of people [who have] run away from it. But living to the fullest with a partial mind is something we should all know and share in - it enriches us." In Siclmess and In Health throws an unusual and sensitive spotlight on the other victims of the disease that afflicts four million Americans: their families. lt is the hope of the Alzheimer's Disease s u a 0 p Association's Western ew York chapter that the play will heighten awareness of both the severity of the disease and of the day-to-day struggles of the husbands, wives, children and friends- "caregivers" -who also live with it. "Donna came to us with the script in 1991 and consulted with our education director," said Sharon Ross, the chapter's executive director. "We've been looking for ways to produce it ever since. "What we're excited about is the opportunity for an innovative way of entertaining and educating people about Alzheimer's through the medium of theatre. " Ross said that she would be bringing the actors into contact with Alzheimer's sufferers so that they could stud) the symptoms o the disease. The local Alzheimer's Disease Association is one of 215 chapters working to alleviate the burden of the disease on victims and their families. Western New York's Chapter is armed by 100 volunteers who serve Allegany, Chautauqua, Erie, Genesee, iagara, Orleans and Wyoming counties. h s 0 A The support groups reflect a national web of interest and research that provides assistance for both those suffering from the disease and the next of kin who must continue to provide care as the disease takes its confusing and frequently devastating toll on daily life. The Western ew York Chapter's newsletter, for example, carries the advice, "You never win an argument with an Alzheimer's patient," from the Association's San Francisco chapter; the Greater Washington chapter offers tips "On Hiding Things." The association has also developed a program called "Safe Return," which helps locate patients who have wandered off alone (59 percent of sufferers are afflicted with what can be life-threatening wandering, and 70 percent of patients surveyed indicated wandering was a frightening factor in their lives.) The program, the impetus for which was the death of a wandering Buffalo patient in October of last year, enrolls patients in a national database and issues identity tags and brace- u m 9 9 3 �······ ··· ········ ·· ··· · ·· ·· · · ····· · · · ········ · ····· ·· ····················· ·· ··· ·· ············ r g l§JJ lets for a small fee. It also trains those who may not have had contact with the disease - and especially police and emergency crew members - in recognizing and responding to its symptoms. Information on Alzheimer's Association Western ew York support groups and its "Safe Return" program may be obtained by calling (716) 873-1335 or 1800-273-6737; information on purchasing tickets for In Siclmess and In Health may be obtained by calling (716) 8731335 or (716) 855-2225 . + - B Y R O B ERT W AT ERH OU SE PranikoiT elected asecretary of Amertcan Urological Association "Then and Now"will chronicle 150 years of medical school history evin Pranikoff, M.D., associate professor and vice chair of urology, has been elected secretary of the Northeastern Section of the American Urological Association for a five-year term. As secretary to the association, Pranikoff will coordinate its affairs as well as sit on its executive committee. He is the first urologist from the Buffalo area to be elected to the position. + n 1996, the University at Buffalo- and its founding School of Medicine and Biomedical Sciences- will celebrate 150 years of service. Beginning with its next issue, Buffalo Physician will commemorate the Sesquicentennial with the inauguration of o special series called "Then and Now," which will look at various aspects of what the medical school was like over the post 150 years. The series will toke both o historical perspective and o personal one with articles about what life was like for early medical students, clinicol "firsts," personol "firsts" and the history of the affiliated hospitals. In addition, Buffalo Physicianwill excerpt articles from The Buffalo Medical Journal, first published in 1845, and keep its readers abreast of the various events and exhibits scheduled to celebrate the Sesquicentennial. Stapleton appointed chair of pediattic nephrology sub-board Bruder Stapleton, M.D. , A. Conger Goodyear professor and chair of the Department of Pediatrics, has been named chair of the sub-board of pediatric nephrology of the Ameri1can Board of Pediatrics for 1993. The six-member board is responsible for certifying pediatric kidney specialists in the United States. Pediatrician-in-chief at The Children's B u a 0 p h Examiners, a member of the American Pediatric Society and sits on the executive councils of the Eastern Society for Pediatric Research and the American Society of Pediat+ ric Nephrology. Hospital ofBuffalo, Stapleton recently was named assistant secretary general of the International Pediatric ephrology Association. A fellow of the American Academy of Pediatrics, he is certified by the American Board of Pediatrics and its sub-board of pediatric nephrology. He is also a diplomate of the American Board of Medical y 5 a n A m n 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] ~ I Two UB professors elected to Amertcan Pediatric Society aniel Green, M.D., and Bradley Fuhrman, M.D., UB professors of pediatrics, have been elected to the American Pediatric ociety for outstanding contributions to the field of pediatrics. Green, professor of pediatrics in the division of hematology/oncology, is chief of the oncology section in the department of pediatrics at Roswell Park Cancer Institute. He is also a member of the Scientific Committee of the International Society of Pediatric Oncology and the Society of Pediatric Research. Fuhrman heads the divisions of critical care medicine at The Children's Hospital of Buffalo and in the department of pediatrics at the medical school. He is a member of theNorthwestPecliatricSociety, the American Academy ofPediatrics and the Society of + Critical Care Medicine. Congratulations abounded as the S(hool of Medidne and Biomedkal Sden(es' Class of 199 3 attended its (Ommen(e· ment (eremonies in May. editorial board of thejoumal of Urology. Mark Ballow, M.D., professor of pediatrics and chief of the division of allergy/ immunology at The Children's Hospital of Buffalo, has been appointed to the editorial board of the ]oumal of Clinical Immunology. Donald Opila, M.D. , clinical assistant professor of medicine, received the "Young Internist of the Year" award from the American Society of Internal Medicine at + their recent national meeting. chair of medicine and microbiology and chief of the division of infectious diseases at UB untillastjanuary. The vaccine was judged the most promising invention among 40 entrants selected from more than 300 inventions receiving patents in 1992 in Western ew York. If it proves effective in humans, the vaccine will be a major medical breakthrough in the treatment of ear infections. The vaccine may also be effective against + lung infections in adults. B UB researcher Murphy named Inventor of the Year for 1992 wo researchers who developed a vaccine with the potential to provide immunity against middle ear infections were selected iagara Frontier Inventor of the Year for 1992 by the Technical ocieties Council of the iagara Frontier and the iagara Frontier Patent Law Association. Timothy Murphy, M.D. , UB professor of medicine and microbiology and director of its microbial pathogenesis graduate group, and Michael Apicella, M.D., professor and chair of the department of microbiology at the University of Iowa College of Medicine, were honored for their work. Apicella was professor and Bradley Fuhrman, M.D. UB physicians honored by award and journal board appointments hree UB physicians have been honored for their expertise in their repective fields. Gerald Sufrin, M D., professor and chairman of the department of urology, has been appointed to the B u a 0 p c a A Y LOIS B AKER Life Technologies donates labware for use in cell culture research abware valued at $45,000 for use in cell culture research recently was donated to the medical school b y GIBCO Life Technologies, Inc. Life Technologies, headquartered in Niagara Falls, ew York, develops, manufactures and sells molecular biology products and cell culture products under the BRL and GIBCO brand + names. u u m 9 3 �··························································································• II . - ' 1 9 4 0 director of the Delhi and Stam- structive pelvic surgery. George A. Gentner '41, of Phoe- '85, is presently a fellow in neonatology at the SU Y HSC. ford offices of the Mary Imogene nix, Arizona writes, "I have been retired for several years now and enjoy coastal cruising on a sailboat off southern California." John E. Shields '68, is medical particularly in the field of recon- s I Raymond Moffitt '48, retired in Bassett Hospital of Cooperstown, 1989 as chief emeritus of gastroenterologyatSt.Joseph's Hospital New York. Jeffrey G. Straus '84, writes, "I am a contributing author to the text Ophthalmic Anesthesia (Slack, in Providence, Rhode Island. He Sogba K. Bosu '69, is a pediatri- Inc., 1993); thechapterisonStraus William D. Loeser '45, of Young- now enjoys golf and working part- cian/neonatologist with the Retrobulbar stown, Ohio, closed his practice time elderly in Southern California Permanente nique, U.S. Patent#4,759,746." arragansett, Rhode Island, and Medical Group, Orange County, in 1989; he is currently medical director of a preferred provider with the California, assistant chief of pediatrics and director ofNicu-Kaiser Sarasota, Florida. organization. 1 9 5 0 Hospital, Anaheim, and chairman s Robert A. Benninger '50, of Cape of the pediatrics department, West Coral, Florida, informs us that he Anaheim Medical Center. Allyn, are expecting a second child in September. Paula Rothman '85, has joined a 1 9 7 0 s orthopaedic surgery and is cur- Maxine Hayes '73, is assistant rently helping to build a church. secretary of health for Washington State. She is president elect for tice in Birmingham, Alabama. Michael]. Bartiss '87, has joined the Carolina Eye Associates in the Association of Maternal Child Southern Pines/Pinehurst, of radiology at the Medical Col- Health Programs. Hayes received her MPH from Harvard Univer- Carolina, as a pediatric ophthal- lege ofWisconsin, has been elected sity School of Public Health in to the board of trustees of the American Board ofRadiology. His 1977. James E. Youker '54, professor and chairman of the department six-yearterm beganJuly l. Youker practices at the Milwaukee County 1 Medical Complex and Froedtert Memorial Lutheran Hospital, ichols '47, chief of where he specializes in chest radi- gynecologic pelvic surgery at Mas- ology, cardiac radiology and sachusetts General Hospital, was mammography. David H. Kevin M. Miller '85, ofWoodland Hills, California, and his wife, reproductive endocrinology prac- sold his airplane but still has a sailing sloop. He retired from David H. Ni(hols eedle and Tech- 1 9 6 0 mologist. MarkS. Courey '87, has joined the faculty of Vanderbilt Univer- 9 8 0 s sity, ashville, Tennessee, after completing a fellowship in voice George C. Geraci '80, is now board disorders and care of the profes- certified in medical management, sional voice. emergency medicine and family named Outstanding Surgeon of the Year at the annual meeting of orth s practice. Geraci is medical direc- Robert H. Goldklang'87, received tor of primary and urgent care for Capital Health System in Harris- a Clinical Research Award from burg, Pennsylvania. Health in 1992 and was selected the Glaxo Institute of Digestive to receive a renewal of the grant in the Society of Gynecologic Sur- Alan L. Pohl '62, informs us that Andrew M. Knoll '84, having suc- 1993. Goldklang is a junior fac- geons, held in PhoenLx. his son, Andrew, graduated from cessfully delayed his residency ulty member in the department of internal medicine at the Univer- ichols, formerly a professor and chair- the University ofWisconsin Medi- until the enactment of Section man of obstetrics and gynecology cal School and is a radiology resi- 405, is completing his final year of sity of California at San Diego at Brown University, is currently a dent at Michael Reese Hospital in training as chief resident in inter- School of Medicine/San Diego VA visiting professor at Harvard Medi- Chicago. nal medicine at the SUNY HSC in Medical Center. Currently, he is a cal School and Massachusetts Syracuse. He has accepted a posi- General Hospital. He is known for William M. Burleigh '67, of tion as attending physician in the his innovative surgical contribu- Rancho Mirage, California, in- Emergency Department at St. tions to the health care of women, forms us his daughter, Jennifer, Joseph's Medical Center in Syra- was born March 11, 1992. cuse. His wife, Maritza Alvarado 6 u 0 0 p y 0 n m trainee member of the American Gastroenterological Association and a member of the American College of Physicians. �• ····························· ······ ········ ··· · ········ ·· ································· . ' Deborah Shalder '87, writes, "I won a fir t place in watercolor at the annual exhibit of the American Physician AnA ociation held in San Antonio, ovember 1992." joseph Aferzon '89, announces the birth ofRacheljessicaAferzon onjanuary 11 , 1993. Aferzon is a third year neurosurgery resident at Hartford Hospital, University Stephanie is now Child Care Director at the YMCA." Scott Svitek '90, is chief resident in pediatrics at Long Island jew- of Connecticut. Ronald A. Alberico '90, was picked as one of the 40 best sec- ish Hospital. Debra M. Omiatek '89, is currently employed as clinical director at the Tuscarora Indian Health Center. ond-year radiology residents in the country. He has two children: Zachary Ryan, two, and Karissa icole, 11 months. Matthew]. Phillips '91, and his wife, Toula, announce the birth of Stuart Varon '89, has been appointed chief resident of child and Ronald Palazzo and Ellis Gomez Palazzo '90, announce "our new Richard G. Bennett '92, is cur- adolescent psychiatry at the West- addition, Ana-Maria Elaina, was psychiatry at Case Western Re- born September 17, 1992. Both of serve University Hospitals in Cleveland, Ohio. David]. Pochatko '88, completed an orthopaedic surgery re idency injune and began a foot and ankle fellowship at Emory Univer ity. Pochatko plans on practicing in us completed family practice residencies in june." very helpful bigsisterjanee.Janee was three years old in February. theirson,JamesMatthew,onApril 7, 1993. Buffalo. Helen Cappuccino '88, a general surgeon, and Andrew Cappuccino '88, an orthopaedic surgeon, proudly announce the birth of their fourth child, Nicholas An- em Psychiatric Institute and Clinic of the University of Pittsburgh, Pennsylvania, for 1993-1994. rently in the residency program in thony. 1 9 9 0 Ranjan Bhayana '90, announces the birth of his second daughter, Brittney Paulina, on March 4, 1993. Bhayana has relocated to the Buffalo area. Daniel F. Klee '90, began a cardiology residency at Good Samaritan Hospital in Phoenix in july. Pierre]. Moeser '90, of Chesterfield, Missouri, writes, "I will be in the citizen ambassador program rheumatology delegation to Russia and the Czech Republic in October 1993." Anna Kristina E. Hart Anna Kri tina E. Hart '89, writes, "I am still on active duty in the navy as a flight surgeon, currently in Pensacola, Florida. In earlyJune I'll be transferred to Whidbey Is- land, Washington , for one additional year before resuming re idency." B a William F. Balistreri '70, has been named the recipient of the Distinguished Medical Alumnus Award for 1993. 5 Ronald Alberico '90, is chief resident in radiology at Long Island 0 BIT U ARIES Evelyn Heath Jacobsen '24, died April 12, 1993, after a long illness. She worked for almost 50 years at The Children's Hospital of Buffalo, both full-time and part-time, until her retirement at age 70. The jacobsen Ambulatory Care Center at Children's Hospital was named for her and her husband, the late A. Wilmotjacobsen, M.D. Arthur C. Hassenfratz '28, died December 13, 1992. Hassenfratz was in private practice in Buffalo for 52 years. Rutherford S. Gilfallan '41, died in Dillon Beach, California, ovember 27, 1992, after a long illness. jewish Hospital. john F. Perry'S!, died December 25,1992, in Gilroy, California. William Palmer, Jr., '90, writes, James M. Garvey '55, died of emphysema at his home in Olean, "My wife, Stephanie, and I an- New York, March 8, 1993. nounce the birth of our second daughter, jilian, on October 11, 1992. She joins her proud and a p y 5 james]. Freeman '74, of Medford, New York, died of a heart attack April 18, 1993. Dr. Freeman worked for the assau County Health Department. a n A u u m n 9 9 �A Spoonful of Humor © Stu Silverstein , M.D . Future Perfect? THE TIMES THEY ARE A 'CHANGIN FOR HEALTH CARE eligious friends of mine tell me that we are living in the Messianic Era. With the scores of changes occurring recently, I remain open to this possibility, for these are indeed strange times. It's either that, or virtual reality scientists are playing a clever trick on all of us. Recently, we have seen the almost unthinkable - the death of Superman, and over the summer Charlie Brown finally hit that elusive home run after years ~f striking out. A colleague of mine just informed me that john Bradshawemperor of the dysfunctional family, admiral of the good ship healthy functioning- is getting a divorce (which sort of begs the question, "who gets custody of his inner child?"). The changes are particularly frightening for those of us in health care. And if all these changes aren't enough, we are facing the specter of two lawyers determining the economics of health care for the coming century -one lawyer who spent $200 at~~=-~~Z airport for a haircut and one, it seems, who spent 2 at the supercut drive-thru window. I am waiting for Hillary to actually bill us for 35,064 hours of service in 1996. Indeed, I am hoping that she doesn't expand the concept to "drive-thru" short-stay surgery to cut down on health care costs. When I decided to become a pediatrician, I did so despite warnings that I Would end up standing at the entrance to U.S. l 0 l holding a "Will do LPs for food" sign to make ends meet and pay off my student loans. At times I've thought about it, but resisted the temptation (primarily because there is barely room with all those unem~loyed lawyers holding up signs expresstug their willingness to litigate for the same). ow it seems that those who decried my going into primary care - my colleagues who chose careers in radiology and dermatology Will soon find that the real prestige will rest with those of us who chose primary care. According to Hillary Rodham Clinton, we're going to be the darlings of the new health care plan they're generating. At last I'll never again be asked to sit at the kiddie table during staff meetings, or play miniature golf to match my miniature salary. The possibilities are excitmg. We could soon see orthopaedists ordering "total" malleus, incus and stapes replacements to treat chronic otitis media, or perhaps general surgeons performing below-the-cochlea amputations for the same ... call it the van Gogh procedure- CPT code number 9990. Pathologists will prove what most of us suspected all along -that they know it all and this time they won't arrive when it is too late. Yet, this is perhaps what is awaiting us under the "managed competition" now being proposed by the Clinton administratio::,n~.-~~"" Managed competition is one of those oxymorons we've seen over the years, like "military intelligence," "government help" and "Super Bowl champion Buffalo Bills." What is managed competition anyway? I envision patients comparison-shopping from city to city, and hospitals setting up cubicles like those seen at car dealers. "OK Mr. Goodname. We'll throw in the epidural and the appendectomy, but the vasectomy will take me below cost - might have to call in a urologist, or even a plumber if you're willing to pay the difference. Let me check with my manager first!" President Clinton has promised us universal health coverage with acceptable quality, but he didn't mention that he will be using virtual reality technology to do it. This may not be such a bad idea, and actually may be the way to obtain not only universal health care coverage, but universal satisfac' tion in life-disgruntled postal workers could express their dissatisfaction while firingvirtualreality guns, Ross Perot could fulfill his megalomaniacal fantasies and actually become CEO of the country if not the universe in the privacy of his own home while leaving the rest of us alone. And maybe through the wonders of virtual reality technology, we can even see the unthinkable- the Bills winning a Super Bowl. Well, some things even in these times remain virtually + unrealistic. Stu Silve~tem, M.D., president of Stoooup Medicine Semino~ of Son fmocill:o, Colifom~. lectures nationwide on humor rn medi<ine. �BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO Non-Profit Org. U.S. Postage 3435 MAIN STREET PA ID BUFFALO NEW YORK 14214 Buffalo, NY Perm it No. 311 ADDRESS CORRECTION REQUESTED The only liability coverage with this seal of approval. Medical Liability Mutual Insurance Company (MLMIC) is the only professional liability insurer approved by the Medical Society of the State of ew York. Since its founding in 1975, the physicianowned and managed company has successfully defended more physician than all other available insurers combined. Additionally, MLMIC has the large t and most experienced professional liability claim department in the country, the largest risk management department of any ew York tate professional liability insurer, and the state's only true peer review of claims experience. Call1-800-ASK-MLMIC (metro) or 1-800-356-4056 (upstate) for more information and an application. MLM~C ~ Medical Liability Mutual Insurance Company Our defense never rests. 2 Park Ave., ew York, NY 10016 250 Harrison St., Syracuse, NY 13202 90 Merrick Ave., East Meadow, NY 11554 ' 1993 ~l edical Uability Mutual Insurance Company �I C s AND s B•OME... 0 9 1 F S C f [ N c.; E.G 9 7 I N L. �\ ~ 9 s > 0 1/J Ul EACH YEAR, THE UNIVERSITY AT BUFFALO'S SCHOOL OF IOMEDICAL SCIEN MEDICAL STU RS, THEY WILJ ES ADMITS ENTS. IN THE REALIZE THEIR :Y: WILL ENRICH FULFILLING YEARS OF THEIR LIVES. �s s J. Pablo Abonia I Jared Barlow ...,t h ' I II n \t:r [[!"1 9 > I l 1 Gonzalo Bearman Kathleen Batt tf B d • Angela Camasto l. orndl l n crs1t Timothy Braatz rf 1'1 l 1 \) Jeffrey Cassidy \, R Sandra Block Cassann Blake u t 9 Jean Bae Jason Andrus n ornu B 1 • Drew Barzman ri\ l ... F Mana! Abu Hegazy !u vc 0 c f, I B Edward Chan Alexander Chen ,, \u tf.mul 2 13'""' 111 lo llopk n' l lr 1 1\l Kristen Chimileski r tv R ,! c ter r;,, ,. �A \.. 0 5 5 F 1 9 9 > Joseph Chow l Catherine Costello Adrienne Deyo I FI II R Gregory DiFrancesco Bt f I Jacqueline Dombrowski \; !1 f I -., F Thomas Elmer. Jr. Eric Finkelstein 1 B 1 falo Ronika Dua Morris Elevado ~ <{ u rll I) r c otr , I Peter Ercolino otrc I J rrc 111 II ~ t Randy Fagin Bt f d' Michael Filicl! B ,tf ( n cr 1t t 1-{L I' B !. " David Fries ,, R k ' James Gaul Jennifer Geiger l IIV 3 t 1\ b!. </ f ) lk �A \.. 1 F 1 • : 9 9 > Carrie Greenberg Clarisa Gracia Kathleen Gillan Jennifer Gennuso l 0 5 5 II l B Matthew Gutierrez Rachna Gupta Taj Hadee Paul Guttuso 1 v b Pamela Haefner Sabrina Hammett I ::-l 't B, B I ) t B 1 1- l Bn 1 F F 4 1 n 't 1 Jennifer Hensen Scott Helsley Orlando Hayle Thomas Hansen Eric Hanauer , 11 Donald Higgs '! on l I t r 'o, �A \.. s s II \1r 1 r lie 9 9 > Claudia Jaramillo l Jeannie Kao 1 Brian Karaszewski ~ I 'I p I ll 1 l Michael Kane I Loren Kane F Dana Jandzinski Angela-Ayanna James Wen Hsu I 0 Peter Kim Asra Khan Paul Kerner Regina Kim r 1 , c F Gregg Kissel r B 1 Benjamin Koenig l Suchitra Koneru 1 I 5 Armond LaPine �\.. J 1 Frank Lee A s s 0 F f 9 9 > Janice Lee Jeffrey LeGrett Sandra Leni Timothy Liesching Joseph Lopes Andre Lopez Alexander Marcus Paul Mason Janine McAssey Lisa Mendonza Daniel Metrick B Kenneth Levey ! \ J Andrew Luisi. Jr. l. r H J I Angela Mclellan Peter McNeela 6 �A 1\ s 0 PI 1 I Manny Ng Christopher Occhino 9 9 > r David Novak David Nielsen 1 I 1 rf l E b Gregory Nagel F Jonathan Morgan Stephen Milback Jennifer Meyer l s B f I '-' t I I Tracey O'Connor I, Molly Parietti lesley Orman th II r Gina Parlato Emmanuella Paul Alka Patel 1 0 r ~ t 8 Philip Piasecki l I t a fl faio 1 " 7 f11 �A \.. Christopher Pieczonka 0 5 5 loll l 1.." c F 'IU '" l !. JU Noah Sabin t Btf ) 9 > Christine Pluviose 1\l l'\\'1 Pamela Paczan Rath Jennifer Ragi 1.. omclll n t\l It <1 r-it li., B· m,J, /[ n'", ' I'Nll"!il) Psy.f r "~IT Vitaly Raykhman 9 F I Bobbie Pustelny Aisha Prim ' V. Chowdry Pinnamaneni l I B I David Pilati P. I F Christian Rocholl Sd 11"1 I p, B /,1 1 "l ) fiiLJ ex, I t l n , h tgh.l nt 1 f or :htt 1 l , v r 1lv t ,/. ,.,.,, Thomas Schenk Tami Seaman Craig Senzon 1.. l (. \f rL] l 11 \ Nit b''"" 8 t "FU James Runfola Paul Rosen v I'd pm:. 1 >r1l \( k �5 0 5 F f \.. lily Snyder Monica Simons Jimmy Sim 9 9 > Gavin Somersel ! Noelle Stevens lisa Sufrin Gary Styn, Jr. Sarah Storm l l 0 lie l I Paniti Sukumvanich Jennifer Sussal Nicole Symons Matthew Taberski l It Evan Taragano ) I fl p Andrea Torsone ! 9 B' B '"' Usha Vaidyanathan Andrea Walter �A \.. ~..-r ( Ill th .. F f I H P .. 1 "/c.l l 1 1 P t:f Il 1 Carolyn Young Louise Zador 1/ \u' h .. • H I I .. ' ' I 1 l jf, Denise Woodall orPdll 1 cr 1t ~,.n, fulo p l f Lt111 9 Danielle Woodall William Wind Dayo Wilson f Lf "/l 9 > Joseph Wandass 1 0 5 5 0 by SimonTon~ . Pholo~raph,- of metli..:al instmments by Robert \Y' a! ion. J l\1 ... ,.. \ 9 f ;, l ~ Photo~raph,- of ,-tmlenb lL 11 u 1/) Ul d. > ..) 9 > �UN IV E R ~, f T BUFF-ALO L A s s 0 F 9 ENCE"S 9 7 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1993 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1993-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v27n04-1993-Autumn Table Of Contents A list of subunits of the resource. Research Hospital News The Center for Positron Emission Tomography 10 Years of Cooperation over Competition Alumni Graduate Education Medical School Classnotes A Spoonful of Humor Class of 1997 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v27n04 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1993 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/5100bb6f7d6df56d3ae4d288f1f6f4c0.pdf 6d18a66fe9ae26c576d782d37b48e9bd PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Summer 1993 �Dear Friends, BUFFALO PHYSICIAN Volume 27, Number 3 ASSOC I ATE V ICE PRESIDENT FOR UNIVERSITY ADVANCEMENT Dr Carole mtth Petro D IRECTOR OF PUBLICATIONS Timothy J. Conro) EDITOR anette Tramont Kollig, R.N. ART D IRECTOR Alan J. Kegler ASSOC IATE ART D l RECTOR Scott Fricker PRODUCT ION MANAGER Ann Raszmann Brown STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND B IOMEDICAL SCIENCES Dr john Naughton, Vice Prestdent for Chmcal Affans, Dean EDITORIAL BOARD Dr. john A Rtchert, Chatnnan Dr. Martm Brecher Dr Harold Brody Dr. Rtchard L. Collins Dr. Alan j. Dnnnan Dr Timothy Gabryel Dr james Kanskt Dr Charles Massaro Dr. Charles Paganelh Dr Robert E. Retsman Dr Thomas Rosenthal Dr Stephen Spauldmg Dr Bradley T Truax TEACHING HOSP ITALS AND LIAISONS Batavia VA Medtcal Center Arlene Kelly Buffalo General Hospttal Mtchacl Shaw Buffalo VA Medtcal Center Chtldren's Hospttal of Buffalo Ene County Medtcal Center Mercy Hospttal Mtllard Fillmore Hospttals Franl1 Sava Roswell Park Cancer Institute Ststers of Chanty Hospnal Dennis McCarthy ©The State Umversity ofr\ew York at Buffalo Buffalo Phys1c1an IS published quarterly b)' the State Umverstty of f\,;ew York at Buffalo School of Med1cmc and BiomediCal SCiences and the Orfice of Publications. It is sent, free of charge, to alumni, faculty , students, resadents and fnends. The staff reserves the right to edit all copy and submissaons accepted for publication. Address quesuons , comments and I n july, a very concrete example of the benefits of Buffalo's consortia! efforts will be realized. The University, its Health Sciences Schools, the Health Sciences Library, and seven of the eight teaching hospitals will upgrade the availability of reference materials for students, residents and physicians who are based in or who use these faClhlles. This project will be jointly funded by UB and the hospitals and will bring the total MEDline reference system plus other biological reference systems directly to each hospital. In addition, a large number of actual text materials and graphics can be transmitted to the end-users or consumers. Because it is a joint venture of all of these partners, common equipment will be used across the educational system and the costs of adding to existing computer information capacities, while not insignificant, are much less than if developed in another manner. The services will improve education and information availability at all levels - undergraduate, graduate and continuing medical education. My office is grateful for the leadership provided by individuals such as john Hammond,john Loonsk and jerry Wilson, to name just a few of the many people involved, and for the cooperative input among the many units of UB and the teaching hospital system, which helped make this important project a reality. Literally everyone involved in medical and health education in all these institutions will benefit directly from this effort. At this time, l would like to take this opportunity to announce that Buffalo Physician magazine will begin accepting advertisements in our next issue. We are pleased to be able to offer our readers this additional benefit of informing them of various services and products that might be useful to them. Sincerely, john Naughton , M. D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Dear Fellow Alumni, T he Medical Alumni Association had a most successful1992-1993 year. Congratulations and sincere thanks to Don Copley, who guided the organization with wisdom, tact and boundless energy. The basic goals were met- addressing many of the needs of the medical students, alumni and medical school. In addition, the Medical Alumni Board, under Don's leadership, established new alumni recognition awards, first presented at the 1993 Spring Clinical Day, and a new medical school scholarship fund, which should serve as an acceptable and appropriate conduit for reunion class contributions to the medical school. Spring Clinical Day, as usual, was educationally enlightening and socially, a warm pleasurable event particularly for those celebrating five-year reunions. We are indebted to Margaret Paroski, Class of 1980, for her direction and organization of this superb program. With the help of an enthusiastic, dedicated Medical Alumni Governing Board, I hope to continue to support the standards set by my predecessors. I hope you will continue to support the Medical Alumni Association which provides very special services, particularly to the medical students. Best regards, submtss10ns 10 Editor , Buffalo Physician, Stale Umversity o[New York at Buffalo, Umversity Publications, 136 Crofts Hall, Buffalo, ew York 14260 Send address changes to: Buffalo Physician, 146 CFS Add1t1on , 3435 Mam Street, Buffalo, l'ew York 14214 Robert E. Reisman, M. D., '56 �v 5 2 L 0 u M M N 7 E R 3 0 9 9 3 II Research II Hospital News He captured my heart in a way that patients aren't D supposed to." • Doctors affect patients every 11 Health care reform it's no joke. Page 42. day. But sometimes, patients profoundly affect their physicians. IIJ Managed Care e Containing health care costs or physicians' autonomy? EJ Medical School ~~ Graduate Education Social and Preventive Medicine's Maurizio Trevisan studies dietary habits. Page 22. IJ Alumni IIJ ASpoonful of Humor m Classnotes *managing rnanageo care. rage lt Med student Andrea Williams wins National Medical Fellowships award. Page 33. �11 ............................................ . ..... . ......... ... .... . ............ . ......... § " ~ ~ • :t u Skin cancer is the target of NIH's $5 million grant to Roswell Park Cancer Institute. Roswell gets $5 million NIH grant to study photodynamic therapy esearchers at Roswell Park Cancer Institute have received a $5 million grant from the ational Institutes of Health to conduct in-depth clinical and basic science studies of photodynamic therapy and skin cancer. Pioneered at RPCI in the 1970s by chemist Thomas Dougherty, Ph.D., photodynamic therapy (PDT) has been shown in clinical trials conducted in the United States and abroad to shrink or eradicate certain solid tumors, especially those of the bladder, breast, brain, lung and head and neck. PDT has also become an option for thousands ofcancer patients for whom surgery is not possible or who cannot tolerate additional chemotherapy and radiation. A large percentage ofPDT "cures" have been skin cancer patients. "An epidemic of 600,000 new cases of skin cancer are reported in the United States each year," said Allan R. Oseroff, M.D., chief of Roswell's Department of B u 0 0 p Dermatology and principal investigator of the IH study. "For large skin tumors, especially those appearing on the face, surgical removal may result in extensive reconstruction and in some cases, disfigurement. Chemotherapy and radiation may have a cumulative toxic effect." PDT virtually eliminates the drawbacks associated with more conventional treatments, without toppling the cure rates. Over the next five years, the Roswell researchers will assess the effectiveness of PDT against the most common type of skin cancer and scrutinize the mechanisms and dynamics of PDT as they explore strategies to perfect the treatment. + Selenium-enriched garlic is just one of the "designer foods" being tested as a cancer preventative by Clement Ip, Ph.D., a breast cancer researcher in Roswell Park Cancer Institute's Division of Breast Surgery. These days, Ip's laboratory smells like an Italian restaurant. In one recent study, Ip discovered that garlic- enriched by the anticancer agent selenium - protected animals against breast tumors. Selenium - a non-metallic element that resembles sulfur - has been Ip's major research interest for the last 15 years. "My studies and those of others, have shown that selenium protects against breast cancer. My goal has been to find the best ways to incorporate sufficient quantities of selenium safely into foods. " His choice of garlic is a natural, since the vegetable is abundantly rich in sulfur and has moderate anticancer activity. "Plants convert inorganic selenium in soil to organic selenium analogs of naturally occurring sulfur compounds," Ip said. "By substituting sulfur with selenium, we had hoped to produce more powerful anticancer agents in garlic." Ip compared garlic grown in seleniumenriched soil to garlic grown in normal soil. The selenium-enriched garlic was far superior to regular garlic in suppressing breast cancer in experimental rats treated with a carcinogen to induce breast tumors. "Designer foods"being tested as cancer preventatives at RPCI picures may call it the "stinking rose," but garlic by any other name will still carry that heady aroma potent enough to keep vampires, and perhaps even a disease or two, at bay. h s c o n s Garlic by any other name will still carry that heady aroma. u m m e 9 9 3 �m ····· · ·· · ··· · ································ ··· · · ·· ·· ··· ·· · · ··· ·· ··········· · ····· ·· ····· • .. . ' "Our research shows that by incorporating selenium into a plant that is already rich in sulfur, the potential for cancer protection is significantly enhanced," lp said. + Agrowing population of children may be at risk for long-term school problems. Half of veiY premature infants need special education services alf of extremely premature infants who survive into childhood may need special education services when they enter kindergarten. Another 15 percent are on the verge of needing special help, a study conducted by UB researchers has found. And children whose families had limited resources were seven times more likely to need help than those in more affluent households. Being non-white or male each increased the risk two and onehalf times. The study, headed by Michael E. Msall, M.D., associate professor of pediatrics and rehabilitation medicine, was published in the American journal of Diseases of Children. The research constitutes one of the first school-readiness studies of children born extremely prematurely during the 1980s and treated with calf-lung surfactant extract to prevent respiratory distress syn- B u a 0 p h The study, headed by Carl V. Granger, M.D. , professor of rehabilitation medicine, appeared in the journal Stroke. Granger speculated that older patients may be discharged from rehabilitation earlier because they reach a plateau sooner or because other medical problems may limit their ability to participate vigorously in rehabilitation. He also raised the possibility of a bias against older patients on the part ofyounger care providers, who may speed up discharge because they feel older patients + have less potential to benefit. drome. The treatment has dramatically increased the survival rates of extremely low birth weight infants. With more children surviving prematurely, especially those weighing under three pounds, Msall said, researchers have speculated there is a growing population of children at risk for long-term physical problems and school difficulty. Msall and his research team set out to assess the kindergarten readiness of children who survived extremely premature births to determine factors that identify children who might need extra help. The cohort of 149 children born at 23 to 28 weeks gestation were between four and five years old at the time of the study. Of the 149 children, 35 percent were observed to be ready for regular public school kindergarten. Fifteen percent were considered at risk of requiring special education resources, 4 2 percent were classified as requiring modified classrooms and 9 percent as needing extensive rehabilitative therapies and special education resources. Low socioeconomic status was the most significant predictor of the need for special education help among the children studied, followed by being non-white or male. + B Y L OIS BA ' ' KER Older stroke patients fare worse than younger ones,UB study finds lder stroke patients don't recover as well as younger ones and spend less time in rehabilitation than do the younger patients, according to a UB study of the rehabilitation history of 7,905 stroke patients. 5 c a 5 u Other health problems may limit the recovery of older stroke patients. m m e 9 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . [1 '' ' "' . aspirin bind to the same receptor in the platelet. "But aspirin can't produce its effects if ibuprofen is already there," Gengo said. "If both drugs are taken together, the patient will get the temporary effect of the ibuprofen, rather than the permanent effect of the aspirin. " The researchers are now expanding their study to include older subjects taking both aspirin and ibuprofen for several + weeks. - B Y ELLEN G OLDBAUM Ibuprofen and aspirin don't mix. UB team uses DNA to recreate key Ibuprofen may diminish aspirtn's proteins to prevent tooth decay beneficial eftects on platelets B scientists have used recombinant eople who take aspirin regularly to prevent stroke and heart attack may need to be careful about how- and especially when - they take ibuprofen, according to a UB study. Published in the journal of Clinical Phannacology, the study demonstrated that in healthy, young volunteers who took a single dose of ibuprofen and then took an aspirin an hour later, the ibuprofen markedly shortened the duration of aspirin's effect on blood platelets. But the ibuprofen did not have the same effect on blood platelets if taken after the aspirin. "Both ibuprofen and aspirin inhibit platelet activity," said Terence Fullerton, Pharm. D., UB clinical instructor of pharmacy and director of the study conducted at Millard Fillmore Hospital. "But aspirin does so irreversibly for the life of a platelet - about seven to 10 days - while ibuprofen does so for only four or five hours." According to Francis M. Gengo, Pharm. D., UB associate professor of pharmacy, director of neuropharmacology at Millard Fillmore and co-director of the study, the working hypothesis is that ibuprofen and 0 B u a 0 p called mucins, that lubricate the mouth and tooth surfaces, minimize the abrasion of enamel and provide a moisture-rich environment that discourages the proliferation of harmful bacteria and fungi. Histatin possesses antifungal and antibacterial properties, Levine said, attacking the outer membrane of fungi or bacteria. While Levine said the mechanism of cystatin is not yet clear, it also possesses antibacterial and antiviral properties and halts the proliferation of microorganisms. Both proteins can help prevent the decay of tooth enamel, as well as infections that eat away at soft tissue and bone. Although future mou thrinses and toothpastes containing these proteins will not replace chemical antibacterial drugs, which, in tandem with the body's immune system, attack colonies of several types of microorganisms, "they'll be important in preventing or fighting the growth of these + microorganisms," Levine said. D A techniques to recreate key proteins in human saliva that help fight bacteria, possibly paving the way for over-the-counter products that - B Y would help prevent tooth decay. "Inexpensive products containing these salivary proteins will be used in toothpastes, mouthrinses and oral sprays by the turn of the century," predicted Michael j . Levine, D.D.S. , UB professor of periodontics. The two proteins in saliva recreated by the UB team - cystatin and histatin - inhibit the reproduction of microbes or interfere with their activity, which contributes to oral diseases. The team also is working to recreate two glycoproteins, Using DNA to fight tooth de<ay. h 5 c a 5 m MARY BETH S PINA ,z ~ " m e 9 9 3 �. . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . ... . . ... . . . . [1] Tucker appointed director of WNY Regional Poison Control Center r effrey R. Tucker, M.D., has been appointed medical director of theWestem ew York Regional Poison Control Center at The Children's Hospital of Buffalo. Tucker is a staff member at CHOB in its emergency medicine department and has been the associatedirector for the Poison Control Center. Tucker's responsibilities include providing medical advice to the poison specialists at the Center and educating residents and medical students about toxicology. Tucker is currently involved in several research projects, including a study of Albuterol- the medicine commonly used to relieve wheezing in children. Tucker graduated from Boston University School of Medicine and completed his residency at Boston City Hospital. He completed fellowship training in pediatric emergency medicine in Brown University's program at Rhode Island Hospital. + radiation over a 40- to 60-hour time period. Radiation from the pellets remains essentially confined to the tumor area, sparing the surrounding healthy tissue. Roswell Park's first patient to receive low-dose radiation using the new remote afterloading system was diagnosed with stage IlA cervical cancer. She had been treated with conventional external radiation prior to this treatment. Conventional intracavitary brachy~ therapy- the use of which was pioneered "'~ for gynecological cancers at Roswell to achieve the highest cure rate in the country following hysterectomy- carries with it certain risks for those treating the paLast year's record loss exceeded $29 million. tient. "Any persons having contact with the patient during treatment are exposed to be the most difficult in recent years, the - although briefly - to the radiation report said. The overall operating loss of source," said Kyu Shin, M.D., chairman of $7.9 million was posted in 1989; that loss the Department of Radiation Medicine. grew by 68 percent to $13.3 million in "The risk," he added, "is minimal, almost 1990 and increased by 30 percent to $17.3 inconsequential, but our new method million in 1991. eliminates any potential risk of exposure." The current loss of $29 million repreA computer-controlled robotic system sents an increase of 68 percent over the loads and unloads the radiation sources. previous year. Proposed ew York State "Before a person enters the patient's room, budget cuts for 1993 would mean an addi- the robot will remove the radiation imtional revenue loss of$41.4 million, while plant and place it into a vault. When the proposed Medicare cuts would result in a visitor leaves the room , the radiation further revenue loss of over $20 million to sources are replaced in the patient." Western New York hospitals. Combined Shin and his colleagues are currently with the 1992 operating loss, the pro- using the new procedure on patients with posed Medicare and Medicaid cuts could gynecologic cancers. account for a collective loss of$93 million For more information on brachytherapy in 1993. + or to refer a patient, call Roswell Park Cancer Institute's Department of Radiation Medicine at 845-3172. + Western New York hospitals post record-high operating loss for '92 RPCI oiTers computer-controlled estern ew York Hospital Asso- low-dose radiation therapy ciation member hospitals posted a record-high operating loss of $29,023,000 for 1992, resulting in 759layoffs in 1992, according to a report by the Western ew York Hospital Association. The financial performance of Western ew York's hospitals has been declining over the past four years, and 1992 appears B u a 0 p h oswell Park Cancer Institute is now offering computer-controlled lowdose brachytherapy - a safer, more efficient way to deliver low-dose radiation directly to tumors. The procedure uses robotics to implant radioactive pellets directly on or near the tumor to deliver low doses of y s c a 5 z ..: Asafer way to deliver low-dose radiation. m m e 9 3 0 �. .. ................ . . . ..................... . ........................ . ........ . ... . ........ psychiatric beds at BGH to 107, including 4 7 in the main hospital building and 60 in the hospital's Community Mental Health Center (CMHC). Buffalo General now operates 74 2 beds. Philip C. oe, assistant vice president and CMHC administrator, said the hospital has also opened two new specialty units, one for senior adults and the other for mentally ill chemical abuse patients. Each unit contains 20 beds. "Putting the 22 psychiatric beds in the tower will help maintain a close affiliation with medical units in the hospital," oe said. Additional multidisciplinary staff have been hired, including nurses, social workers and occupational and recreational therapists. Opening of the new units completes the final phase of a project begun in 1989. The first phase, a lO-bed medical psychiatric acute care unit, was completed in 1990; the second phase, a 15-bed affective disor+ ders unit, was opened in 1991. Sisters Hospital opens new lobby and 10-unit surgical department isters of Charity Hospital is heading for the three-quarter mark of its 28month, $42 million modernization project with the opening of its new operating rooms and lobby. The new 10-suite surgical department, which opened in March, is located on the hospital's fifth floor next to its recently opened intensive care unit. "It's quite an exciting change from the old area, which was built in 1948," said Gino Pazzaglini, executive vice president at Sisters. "The new space provides us with a modern, efficient area which will allow our surgeons and nurses to offer the best and safest possible care to our surgical patients." The new rooms are larger and equipped with the latest in surgical support systems. The new lobby, with its heavy emphasis on glass architecture and natural lighting, features stained glass artwork, high ceilings and banners carrying pastoral themes of hope, peace and joy. "From the beginning we felt the lobby should be seen as a special place to greet the general public, a place where they will be made to feel comfortable and at ease," + Pazzaglini said. 0 B a 0 Van Vorst named new Millard Fillmore Hospitals president Sisters Hospital nears <ampletion of its $4 2 million modernization proje<t. BGH opens 22 psychiatric beds to complete $1.6 million project he Buffalo General Hospital has completed the final phase of a $1.6 million project with the opening of 22 psychiatric beds in its medicaVsurgical tower. The new beds increase the total of p h y 5 a n S illard Fillmore Hospitals' ChairmanoftheBoard, Edward T. Hunt, announced that Charles B. Van Vorst has been appointed the new hospital president and chief executive officer. He succeeds jan R. jennings, who was recently named president and chief executive officer of the Chicago Children's Memorial Medical Center. VanVorst most recently held the position of president and chief executive officer of the Santa Rosa Health Care Corporation of San Antonio, Texas. The corporation is a regional, notfor-profitmulti-hospi- u m m e 9 3 �. . . . . . . . . . . . . . ... . . . . . . ...... . ... . ... . . . . . . . . . . . .... [1] tal system consisting of seven hospitals with 1,166 licensed beds. During his tenure at Santa Rosa, Van Vorst's accomplishments included the development of a new long-range strategic plan and the implementation of a total quality management structure. "We are extremely pleased that Mr. Van Vorst will be leading our hospitals and look forward to his contributions toward the continued success of our health care delivery system," Hunt said. "While his philosophies are very similar to those of the hospitals' board, we anticipate that he will add a new dimension which can only serve to further enhance the level of care we currently provide," he added. Prior to his position at Santa Rosa, Van Vorstspent l l yearsaspresidentandchief executive officer of The Carle Foundation in Urbana, Illinois, a not-for-profit health care-related holding company that owns and manages a number of health care entities including two hospitals, a nursing home and retirement center. Additionally, he held the position of vice president for operations for Methodist Hospital of Indiana for seven years. "I look forward to the opportunity to continue the momentum set forth by Mr. jennings and lead Millard Fillmore Hospitals to even greater heights and national prominence," VanVorst said. + MFH' s Hertel-Elmwood Internal Medicine Center. diagnostic services. Thomas Small, M.D., has been appointed medical director of the center. The center will operate under a preventive medicine philosophy, administering immunizations and vaccinations and providing information on health maintenance. A major goal of the center is to avoid major health problems in its patients through + early and ongoing intervention. New technique for liquid breathing discovered by UB research team simplified technique for liquid breathing discovered by a team ofUB researchers could significantly improve treatment of premature infants, children and adults with lung diseases. It could also help cut this country's annual $5 billion price tag for treating adult respiratory distress syndrome. Bradley P. Fuhrman, M.D., UB professor ofpediatrics and the team's chiefinvestigator, has pioneered an inexpensive way to enable the body to "breathe" perfluorocarbon. The technique is known as perfluorocarbon-associated gas exchange, or PAGE. Liquid ventilation shows great promise for treating premature babies with hyaline membrane disease and other patients with adult respiratory syndrome. Widespread testing of liquid breathing in humans has been impossible in the past, Fuhrman said, because a suitable, high-purity, me- he medically underserved community of Black Rock/Riverside is the location of a new primary care center run by Millard Fillmore Hospitals in conjunction with UB's School of Medicine and Biomedical Sciences. The Hertel-Elmwood Internal Medicine Center offers patients 16 years and older convenient access to medical care and a 0 p + ~ns. B MFH opens primary care center in medically underserved community 6 dicinal grade of perfluorocarbon did not exist and the procedure required special equipment. Fuhrman's technique uses a standard respirator, rather than a specially designed liquid ventilator. In PAGE , the perfluorocarbon remains in the lung while the respirator delivers breaths of oxygen. In standard liquid ventilation , perfluorocarbon is cycled into and out of the lungs using a specially designed liquid ventilator, which oxygenates the liquid and purges it of carbon dioxide. When his liquid ventilator broke down in the midst of research on piglets, Fuhrman decided to hook up an animal with a perfluorocarbon-filled lung to a standard respirator. "When I saw it worked," Fuhrman said, "I was exhilarated." PAGE is significantly less expensive than other methods of liquid ventilation since it uses readily available equipment. It is also kinder to damaged lungs because it is effective at lower pressure and may allow the use of lower oxygen concentra- y s c a n 5 m Y LOIS B AKER re nhalation halation Liquid breathing technique holds great promise for treating children and adults with lung disease. m e 9 9 3 0 �"He captu my heart in a way that patients aren t SUptxJSed to." • 1 tors affect patients every day. But sometimes, patients profoundly affect their physicians. Here are their stories. 0 Buffalo Ph y sl c I a n summer 1993 �Illustrations by Glyn B u a a p h y s c a s Sweeney 5 u m m e 9 3 0 �11 -rII remember my patientstheir grace, dignity and humor and triumph over adversity. Their stories are legion and what we have to do is train ourselves to listen and see. They're all out there and each has a moral of its own." -r- __e ,s - ... and they couldn't come to visit him. He was all by himself. "So the nurses and physicians who took care of him became his parents. "The barriers of how I was going to deal with this little boy were quickly broken. He captured my heart in a way that patients aren't supposed to. "He always wanted people to stay with him and although he was in a lot of pain, he rarely, if ever, cried. "We were constantly trying to figure out ways to try to relieve Rodney's pain. We tried everything. "We used to just carry him around. He always wanted to be carried, so we would just take turns carrying him. "Once he wanted to know why I had to leave- I remember this very vividly. "He finally died and we all cried together about his death. "That child made a very big impression on me. He was always upbeat, always happy to see you and always asking to go on a trip around the ward. And he could always con one of us into carrying him around. "He's probably the first patient who I knew intimately who died. And I did grieve for him. I have lost other patients, and I think I remember the names of all of them - a little bit of you dies with them each time- but this boy taught me there are ways you can comfort patients and make their time more meaningful." probably the first patient vvho I k.ne\v intimately Bob Milch, M.D., '68, was talking about his patients who have changed him. "You know what the definition of a minor procedure is?" he asked. "It's a procedure that's done on someone else. "Stories not memorable to the physician are to the patient. That's what it's all about - minor procedures and memorable stories." The physician-patient relationship is a complex one -and by its very nature, one in which it is the patient whose life is most affected. But sometimes, it is the physician who is changed by a patient who shows remarkable courage, or humor, or strength, or spirit, or pure force of will in the face of illness and adversity. And different patients affect their physicians in different ways- changing the way they see or practice medicine, or changing the way they see themselves. These are the patients whose stories are chronicled here. \vho died. And I did grieve for him. I have lost other patients, and I think I remember the names of all of them - a little bit of you dies \vith them each tin1e -but this boy taught n'1e there are vvays you can Virginia Weldon, M.D., '62, con1fort patients and make their vice president for public pol icy at Monsanto. "He was a little boy about two. I was an intern atjohns Hopkins Hospital. He had a neuroblastoma and it had metastasized to his orbits and his face had become deformed. "I knew I was going to be on the service he was on and i was worried about how I was going to take care of this little boy. "His parents lived in rural Maryland B u a 0 p Donald P. Copley, M.D., '70, past president ofUB's Medical Alumni Board of Directors. "I first saw KathyFreerin May ofl989. The last time I saw her was April 13. She was a young teacher who had had an extremely bad heart attack in May of '89. I never thought she'd leave the hospital, let alone go back to teaching. We did an echocardiogram on her which showed an ejection fraction of 15 percent, which is about as low as I've ever seen in anyone time more rneaningfu l. " h y s c a n S u m m e 9 3 �who's alive. "She had a prolonged hospitalization -at least 10 days - and I sent her home with trepidation. Her echo was slightly improved when she went home but still very bad. "We did a stress test, at least we tried, and she did poorly - she couldn't walk very far at all. "She had been a busy, active teacher, with no prior medical findings - no smoking, a family history of coronary disease, but not remarkably bad. "But she may be the type that goes with blood clots rather than atherosclerosis. We did an angiogram just before she went home and found a single occluded artery. My best guess is she had an atherosclerotic plaque that produced a clot that closed the vessel rather abruptly. "She went home and went into a rehab program that lasted a long time- at least six months. She started slowly and we weren't optimistic. "I had thought she was close to dying in the hospital - maybe a 50-50 risk - and I had told her husband things were grim. "But she is a very positive, jocular, bubbly person. In fact, she's been accused of being kind of cavalier- cracking jokes about dying early. People who don't know her accuse her of being flip. "She has what I would call an extreme form of an optimistic attitude. Whenever I would describe to her the possible outcomes, she would focus on the positive. She always passed over the negative. "And that's the way she was in rehab, too. She was very helpful to the other patients. She was even ready to get on with her life, without going back to work, which was always very important to her. And she was always very well-liked by the kidsshe taught middle school- and also very highly regarded by her peers. "She is very energetic- a Type A, an intense coronary factor- but with none of the hostility you associate with Type As. B u a 0 p "It was a full year before she could consider going back to work full time. And her echo is not normal now, it still shows the scar clearly. Her ejection fraction is doubled what it was when she was in the hospital and she still has a rather dilated heart. But she's found ways to cope with the disability." one had ever done exercise testing after a John aughton, M .D., vicepresident for clinical affairs and dean of UB's School ofMedicine and Biomedical Sciences. "I had one patient, Mr. Douglas Cordon, during my residency and fellowship training at the University of Oklahoma, who was the first to undergo exercise testing and training after a heart attack. It was because of him that we [Bruno Balke, Francis agle, Michael Lategola and aughton] developed a strategy for exercise testing and physical reconditioning for cardiac patients. "In 1964, Mr. Cordon indicated to me he wanted to get into some physical activity after his heart attack. He was 54 at the time. Two months earlier he had wanted to enter a physical therapy program- he had high blood pressure-and was one of a group of healthy volunteers we were studying. So we had the data on him before his MI. And so two weeks post-MI we first did an exercise test and measured the loss. We put him on a training program. He had a higher capacity after the training program. His work capacity increased. "He lived another 15 years after that and always kept fit. " o one had ever done exercise testing after a heart attack. We had him walking on a treadmill, and as we got more comfortable with him, we increased to 50 patients. It's an example of how you make a change by studying one individual patient, and then adding groups of patients. "My efforts grew from studying Mr. Cordon well to the development of group programs for heart attack patients and heart attack. vVe had him \·valking on a treadmilt and as vve got n1ore comfortable \ vith him , \veincreased to 50 patients. It's an exan1ple ofho\v you make a change by studying one individual patient, and then adding groups of patients." y s c a n 5 m m e 9 9 3 �then to the development , implementation and completion of the ational Exercise and Heart Disease Project. ln essence, he because l don't think she looks at it as changed my whole world. " terminal. "She faces the future with a realistic, yet Roseanne Berger, M.D., associ- optimistic point of view. She's very calm ate dean for graduate medical education. and brave and even at times when she is "Her name is Frieda Bair, and l remem- uncomfortable or in the hospital. ber her for a number of reasons. She is an "l have to feel her attitude is certainly accomplished poet. She is an elegant, ar- contributing in a lot of ways to the way she ticulate, very attractive elderly woman is coping with a very serious illness . who has a terminal disease ... rather, Even when she is in the hospital, she cancer ... l don't want to say terminal, has the ability to reach out to other B u a 0 p h y s c a n 5 people e v e n though she has a very good reason to be introspective and self-centered. But despite all that she's interested in and concerned with other people. Whenever l see her, before l even have a chance to say a word, she asks me how I am. And it's not just me- she's like that with other people. "She's always been an observer of life. She has these inspirations, or muses ... "l first saw her about two years ago. She was diagnosed with cancer [pancreatic] that first visit. But her illness is only a small part of this woman - her creativity and u m m e 9 9 3 �11 -relegance are central to her. "She has always been a teacher, formally, and she has allowed me to share her story with fourth-year medical students, so her case has been examined in detail by several seminars of medical students and she has been more than willing to allow me to do that- and has always been very gracious about allowing them to examine her and ask her about what she was feeling and what was happening with her life. "Her poetry has given me an insight into this person. She writes about very tangible things that people can relate to easily, like home. And she has a lovely little poem about red mittens ... the Buffalo Blizzard ... pollution ... and this one that I use for the medical students. "She is very much at peace with herself, and has that calm and confidence that comes from having led a full life. She is at ease and peaceful with what is happening. She is ready to accept death if it happens, but she's not just going to give up. She wants to live every day as well as she can." Ji first sa\v her about t\vo years ago. She \vas diagnosed \ vith cancer [pancreatic] that first "risit. But her illness is Robert Milch, M.D., '68, medical director of Hospice Buffalo. "There are so many patients in my line of work who are recollected for different reasons. And it's good that we try to recollect as many as possible - each of them is part of the fabric of us. "I remember a patient with cancer of the pancreas who was referred to us after discharge from one of our teaching hospitals. His wife was given a prescription for demerol and syringes to inject him with. "And we were told that he was a 'troubled patient' because at the height of one of his pain episodes, he bent the siderails ofa bed. We got him offinjectables to a more appropriate medication and he lived a comfortable and pain-free life for the remainder of his five months. "His gratitude was matched only by ours. "I remember seeing patients who point B a 0 p out just how fallible all the things we learned in medical school are regarding the use of pain medication. "I remembera39-year-old woman with cancer of the pancreas. As her disease progressed, she would take four grams of morphine every four hours. Do you know what the normal dose is? "We brought her into the hospital and gave her an epidural of morphine of just four milligrams. And all her pain disappeared. "We had to actually convince her to take small amounts of morphine to prevent withdrawal. "All the things we learned about addiction and dosing are not always applicable. "I remember a young man of 28 who was dying of Hodgkin's. Every day I came in to see him he was wearing a different t-shirt- whether it was U2, Jefferson Airplane, The Who - he always had some t -shirt from a rock group. As he got thinner and thinner, one day he was wearing one that said 'Hoots and the Geraltones.' So I said, 'Who are these guys?' "And he said, 'We got you!' He was Hoots and his wife was Geraldine and they just had one made up because they finally ran out. "I remember a man who was 50 and dying of cancer of the thyroid. When he and his wife had gotten married they had been very poor together for a long time. By dint of hard work, their marriage had worked out successfully - their children were healthy, they had sacrificed a lot in their early years. "The one thing she had wanted, but never had got, was a pair of diamond earrings. He was going to die before their next anniversary, and did, in fact, die about six months before. "But on the day before that anniversary, he had delivered to her a pair of diamond earrings." + only a small part of this \voman - her creativity and elegance are central to her. " y s c 0 5 u m m e 9 9 3 �By 0 Andrew an z o There was a time when organized medicine didn't think much of managed care. In fact, it tried desperately to stamp out, or at least contain, the health maintenance organizations that were spreadingfrom the west coast. Managed care won. 4D a u f f a I a P h y s I c I a n 5 u m m e r 1 9 9 3 ��ne in five insuredAmericans now belongs to an HMO . At least half the nation's physicians are believed to be affiliated with HMOs and related entities, and the majority at some point encounter utilization review, part of managed care's widening spectrum. The American Medical Association last year went so far as to acknowledge the "legitimacy" of HMOs. ow, organized medicine is even getting into the game- the Medical Society of the State of ew York is forming a statewide physician network to compete on the managed care field as early as this year. Health care reform will only accelerate the trend. While details remain to be hammered out in Congress, the Clinton administration's reform plan relies heavily on managed care to deliver health services. In New York State, Gov. Mario Cuomo is also pushing a reform initiative emphasizing managed care principles. Once the dust settles, several trends are obvious: greater demand for primary-care physicians, the backbone of managed care plans; a continued erosion of the solo practice as more physicians are pushed into groups, and further diminution of the ~~FOR THE autonomy physicians have traditionally enjoyed. "For the individual physician, I think it's a very disquieting time," said UB School ofMedicine and Biomedical Sciences Dean john aughton,M.D. "We'vehadthroughout the history of medicine in the United States the fee-for-service system and the solo practice. Clearly the forces are to encourage physicians to practice more in groups than in the past." In 1980, 4 7 percent of ew York State physicians were in solo practice. By 1988, the latest year for which figures were available, the percentage had dropped to 41 percent overall and to only 27 percent of doctors under 40 years old. Only 2 percent of New York doctors listed HMOs as their primary practice in 1988. But many more are affiliated with non-staff HMOs and similar plans, the fastest-growing segment of the managed care sector. o one knows exactly how many, but nationally it's estimated to be at least half of practicing physicians. "In some communities, every doctor is involved," said Kathryn Allen, executive director of the New York State HMO Council. And HMOs are scooping up more and more patients. During the 1980s, national HMO enrollment nearly quadrupled to 40 million. In ew York State it tripled and now stands at about 3.5 million. Health care reforms are expected to drive the numbers up dramatically, though ew York State Health Commissioner Mark Chassin, M.D., said that if federal rules permit, he favors a flexible approach based on the needs and resources of different regions of the state. " etworksandhealthplansandHMOs are part of the solution, but forcing consumers into one of the health plans, forcing physicians and hospitals into one of the health plans is not what we want to do," he said. However reforms play out, there will be greater emphasis on primary care physicians. "It can't be successful unless there is a larger pool of generalists available," said UB's Naughton. About one-third of the approximately 56,700 practicing doctors in New York are in primary care. It's the same proportion nationally, and the exact opposite of the generalist-specialist ratio in most other nations. Since managed care programs rely on primary care physicians to coordinate and control patient treatment, it's estimated that at least half of all physicians should practice the primary care specialties to make the programs work effectively. In ew York's inner cities and rural areas, there aren't enough physicians now, said Richard Kirsch, chairman of the ew York State Health Care Campaign, a coalition of groups pushing reform. "The INDIVIDUAL PHYSICIAN, I THINK IT'S A VERY DISQUIETING TIME." 6 u 0 Dean John Naughton, M.D. 0 p h s c 0 5 u m m e 9 9 3 �said aughton. Last year UB, in consultation with its consortium of teaching hospitals, set a goal of getting half its residents into primary care by 1995. However, aughton noted, even if all the nation's residency programs went to the 50 percent goal, the proportion of practicing generalists wouldn't reach 50 percent until the year 2035. In the meantime, some specialists might find themselves in the same boat as the laid-off factory worker. "People for the first time in recent months have been talking about the issue of retraining," said Edward Salsberg, director of the ew York State Department of Health's Bureau of Health Resources Development. "If you have a large supply of specialists and managed care comes into place and the use of specialists is decreased, then the demand and need for specialists should be dropping. In a specialist-rich state like New York, there's the question of what they will do. " Psychiatrists are already feeling the managed care crunch. Faced with premium complaints from employers, the Blue Cross and Blue Shield HMO in Buffalo , Community Blue, last year hired an outside health management company to oversee its mental health-substance abuse benefits. The company revised Community Blue's provider list, cutting the number of psychiatrists from 99 to 31. lt also reduced the number of Ph.D. psychologists from 141 to 93. The number of master's-level psychologists, social workers, psychiatric nurses and addiction counselors rose from 94 to 166. "They cover a broader range and there is not as heavy a concentration of psychiatrists," said Lynn Sidare, Community Blue spokeswoman. "We felt there were other specialties in mental health that could provide good, effective treatment." She said anyone who was seeing a psychiatrist removed from the list was given a grace period to wrap up treatment main thing New York needs to be doing is building up its capacity to provide primary care to its citizens," he said. Cuomo's initiative acknowledges that -proposing incentives to steer more medical students to primary care and financial help to open primary care practices. "l think we're a school that has been looking at the problem for quite some time, " B a 0 p h 5 c a n 5 m m e 9 9 3 �and make the switch. "The medical community obviously thinks this is very wrong," said H. John Rubinstein, M.D., president of the Medical Society of the County of Erie and a 1966 UB medical graduate. The society protested to the state, which ruled that Community Blue was within its rights. The tate, in fact, did the same thing last year with its own insurance plan, farming out management ofmental healthsubstance abuse benefits for 395,000 state and local government employees. "On an annualized basis, the program has saved us $30 million," said Priscilla Feinberg of the governor's Office of Employee Relations. any physicians are frustrated and angry, feeling that while the profession bears some responsibility, they've been made the scapegoat for a health care system that is far too expensive and far too inequitable. They agree that some kind of change is needed, but worry about the details. "My fear is we'll be left with even more administration and more micromanagement than we have now," said Amy P. Early, M.D., an associate clinical professor in UB's oncology division. The Medical Society of the State of ew York is hoping to maintain more control for physicians by taking a lesson from the labor movement and organizing, not as a union, but as a network of doctors who can negotiate from a position of strength in the expanding world of managed care. "Like it or not, the pressures faced by private practicing physicians in their efforts to compete effectively in the health care arena will be overwhelming and many physicians will lose the struggle to main- a u a 0 p tain their private practices," ancy H. Nielsen, M.D., SU Ytrusteeand the plan's coordinator, wrote in a report to the medical society's house of delegates this year. "When these challenges are added to the growing problems of a crushing bureaucracy and significantly decreased payments, it is evident that for the physicians of ew York State, 'business as usual' is no longer possible." The MSSNY Physician Network would provide medical services for insurers, employers and HMOs, with the state medical society negotiating statewide contracts and local medical societies handling local contracts. The network, which would have its own utilization review and quality assurance programs, would require an unspecified financial commitment from members. "It is clear that if these initiatives are uniformly implemented, physicians will gain immeasurably in their ability to compete effectively in the future managed care market," ielsen wrote. The medical society is also fonning a second network to compete in New York's Medicaid Managed Care Program, which seeks to get half the state Medicaid population into managed care by 1996. By and large, physicians have come to accept HMOs and managed care arrangements as part of the health care landscape. Early, an oncologist with the Buffalo Medical Group, said she has had occasional problems getting HMO approval for specialized cancer treatments in facilities outside the area. But overall, she feels she has a good relationship with her group's HMOs. "If I, as the primary doctor, have a problem or recognize that my patient has a special need, I can call someone," she said. "I may not always get approval, but I have a line of communication open." The real hassles, she said, are with the long-distance utilization reviewers. "For me to call an 800 number to someone in Indiana whose credentials I don't have a s c a S clue about to seek hospital admission for my desperately ill patient is ludicrous," she said. Chassin, who was most recently senior vice president of a utilization review company before becoming New York's health commissioner, agreed that there is both good and bad under the managed care umbrella. "In its best incarnation it can be a very effective way to maintain quality or improve quality at the same time costs are being controlled," he said. "But it's not always implemented that way. In other implementations it is micromanagement and throwing obstacles in the way of physicians trying to provide quality care for their patients." Chassin favors a flexible approach to reform in ew York, one that allows a variety of arrangements for health care delivery and compensation. He wants the state's rate-setting power expanded to physicians so there will be more uniformity and fewer inequities, like Medicaid reimbursements that discourage doctors from serving poor neighborhoods. But he would like different cities and regions to use the payment system that works best for them, whether it be salary, capitation or fee-for-service. "We want to have a statewide approach that encourages diversity," he said. John Rodat, an Albany health care consultant who has served in a variety of state positions, said perhaps the biggest trick in reform will be finding a way to accommodate the organizational impulses of the reformers and the independent nature of medicine. "The knowledge and skills and temperament and perspective that good physicians can and should have are ones which cause them to focus totally on the individual patient and not to see the organizational context around them," Rodat said. "These are not folks in gray flannel suits, and they should not be." u m m e 9 9 3 �But those traits, he said, have made the medical community slow to deal with restructuring, to see it as someone else's problem. "My very strong fear is that those who are going to impose reform, because they've B y nan age when care is "managed" and physicians are "providers," everyone complains about the bureaucracy. But to Robert A. Milch, M.D., it was something a little more unsettling. It was the feeling that medicine was surrendering its humanity to a cold ethic of efficiency. He wanted out. Unlike many frustrated physicians, the 1968 UB medical graduate didn't retire early. But he did give up his surgical practice to become medical director of Hospice Buffalo on january l. He's much happier now. "What I found was, I think, a microcosm of the best that medicine has to offer, which is humane, appropriate, cost-effective care," Milch said. It's unclear how many physicians are fed up and making a change. "At this point it's still primarily anecdotal," said Edward Salsberg, director of the ew York State Department of Health's Bureau of Health Resources Development. In 1990, the latest year for which figures were available, only 52,722 of ew York's 70,080 licensed physicians were active in patient care, but B u a 0 p h make things worse for many folks .... To do it right, it seems to me we have to have some kind of common language for solving the problem." Will that happen? "I think it's possible," he said. + grown impatient and the public has grown impatient, have a completely different set of perspectives," he added. "Even though they also may be perfectly wellintentioned, it is my great fear that their organizational perspectives are going to A N D R E D W A N Z 0 to specialized treatment. "What a terrible word," Rodat said. "What's terrible about it is that it is, in fact, descriptive of what the role is.. .. This is somebody whose primary role is to decide whether or not you go on, and if so, what price you pay. Wait a minute! " For Milch it was seemingly small things that added up. Like the surgery schedules that left residents little time to interact with patients, to gain some understanding of their hopes and fears before the anesthesiologist arrived. "This system conspires against humanity in the name of perceived efficiency," he said. He blames insurance companies. But he also blames medicine itself. "You've got to recognize truth when it's staring you in the eye," he said. "We have so many problems with health care delivery. So many of them are societal and the practitioner is the convenient whipping boy. But so mu.c h of the criticism is well-deserved. We have abdicated so many of our responsibilities. We have closed our eyes to questionable practices. Once you lose your deserved stance of moral rectitude, you can't be surprised when those who you should be serving tum on you." + the proportion doesn't seem notably different from past years, Salsberg said. Still, everyone seems to know someone who couldn't take it anymore. "I have seen some people who have just gotten out of practice and taken administrative jobs because the bureaucratic morass has gotten so bad," said H. john Rubinstein, president of the Erie County medical society. "I think it's fair to say that practicing medicine is probably not as much fun as it once was, when there wasn't a lot of regulation," said john aughton, M.D., UB medical school dean. "I think most physicians are very well motivated and committed to providing good care and dedicated to the needs of patients. But the emphasis on more external review and documentation of what we do, those are hard habits to take on. It does create a climate of distrust between physicians and patients, and vice versa. " john Rodat, a health care consultant in Albany, thinks the lexicon of contemporary health care tells a lot about it. Take, for instance, "gatekeeper," the term managed care plans use for primary care physicians, who control their patients' access s c a n S u m m e 9 9 �• ········· · ··················· · · ····· · ·· ··············· ·· ·· ·· ····· · ·· · ··· · · · ····· ·· ·· · · ··· ···· ··· ~ I tiative. "In addition to benefiting women living in Western ew York," he said, "this program will accelerate the role of the school's Department of Social and Preventive Medicine in epidemiology, preventive medicine and community medicine. Italso will complement the medical school's efforts to train a larger number of primary care providers." The UB Women's Health Initiative will be headquartered in Farber Hall on the UB South Campus. A 24-hour hot line will be established later this summer to answer questions about the study and to take the names of women who wish to participate. Trevisan said he is convinced that one of the major reasons UB was selected to participate in the study is because the UB selected as vanguard center for national Women's Health Initiative Maurizio Trevisan, M.D ., chair of sohe University at Buffalo has been selected to be a lead research center cial and preventive medicine, is UB's primary investigator. in the $635 million Women's Health "This is a wonderful occasion for UB Initiative- the largest clinical trial and Western ew York," Trevisan said. ever undertaken in the United States. "This was a very tough competition and UB will aetas one of 16 vanguard clinical centers; its share of the project will UB fared very well. " john P. aughton, UB vice president total about $11 million over 12 years. The Women's Health Initiative is being for clinical affairs and dean of the medical undertaken to learn how to reduce the risk school, said, "UB is very pleased to be of coronary heart disease , breast and among the institutions selected to be vancolo rectal cancers and osteoporosis in older guard centers in the Women's Health Iniwomen. Approximately 160 ,000 postmenopausal women between the ages of 50 and 79 will be recruited by the 45 research centers throughout the country participating in the study. A pproxi rna tel y 3,500 women will be recruited from Western ewYork. As a vanguard center, UB will help design the study and establish operating procedures that other centers will follow . Clinical trials are expected to begin at the vanguard centers this fall. The remaining 39 clinical centers are expected to be anJean Wactawski-Wende, M.D., dinical assistant prafessar of Gynecology and Obstetrics, and Maurizio Trevisan, M.D., chair of nounced this fall. Social and Preventive Medicine, at a news conference announcing UB' s vanguard center designation. B a a p h y 5 c a n 5 u m m e �··········································································· ··············· · ····· • ·· ~ I entire community supports the effort. Ph.D. , and Terry Pechacek, Ph.D., all from "We were able to offer a package not the UB Department of Social and Prevenmany institutions could match," he said. tive Medicine. "This effort involved the departments of Also participating are Myroslaw gynecology and obstetrics, medicine and Hreshchyshyn, M.D., chair, and jean medical technology. We had the support Wactawski-Wende, M.D., from the Deof the deans of the medical school and the partment of Gynecology and Obstetrics; School of Health Related Professions and Robert Kohn, M.D., Susan Graham, M.D., the UB provost. We had the support of the June Chang, M.D. and Paresh Dandona, medical community, the political commu- M.D., from the Department of Medicine, nity, the health-care providers and civic and Donald Armstrong, Ed. D., chair of the and religious organizations. Department of Medical Technology. + "This is a very complex study, involvB Y LOIS B AKER ing recruiting volunteers, retaining them and arranging for reimbursement," Trevisan said. "Because everyone was behind us, we were able to address all of these issues." The study itself will be conducted in two parts - clinical and observational. he United State's first comprehenThe clinical component will involve three sive training center for nuclear iminvestigations: aging has been established • A test of the effectiveness of hormone at the Univerreplacement therapy in reducing the risk sity at Buffalo, of coronary heart disease, osteoporosis funded by a and endometrial cancer. • A study of the effect of a low-fat diet $450,000, three-year on the risk of cardiovascular disease and grant from Siemens H.G. breast and colorectal cancer. The grant is the re• An investigation of the effectiveness of calcium and vitamin D supplements in sult of two years of reducing osteoporosis, colorectal cancer, discussions between UB and Siemens, an blood pressure and breast cancer. The trials will begin in August or Sep- international contember in Western New York. The obser- glomerate headquarvational study will follow about 2,200 tered in Germany and a women from 12 to 17 years of age to try to major supplier of determine physiological and lifestyle fac- nuclear imaging equiptors that can affect the health of women. ment worldwide. Under the grant, Participants in this phase initially will give detailed medical histories and then will be the training center- to be headquartered contacted every three years to update their in the medical school's department of nuclear medicine- will concentrate on information. Co-principal investigator on the study positron emission tomography (PET). "We're in the process of organizing a is james Marshall, Ph.D., UB professor of core curriculum to train everyone from social and preventive medicine. Otherinvestigatorsarejo Freudenheim, the PET technician who assists the chemPh.D.; Alma Blake, Ph.D.; Diane Hayes, ists, through all of the higher levels of science right up to a director of PET operations," said joseph A. Prezio, M.D., UB chair of nuclear medicine. " o one is doing that anywhere in the United States. " Siemens needed a center that could train its people in depth in this new field, Prezio said, and UB already had a wellregarded program in nuclear medicine and is establishing a major PET facility in conjunction with the Buffalo VA Medical Center. The new facility will be one of the most advanced PET imaging centers in the world. 'The problem throughout the U.S. and, probably the world, is that training for PET has not been organized appropriately, or in enough depth, so that you can send someone to one site and have them come back seasoned and trained," Prezio said. "Siemens liked what we were doing here. They were looking for someone willing to put the effort into it. "Our goal from the beginning," he added, "in addition UB establishes comprehensive nuclear imaging training center B u 0 0 p y s c 0 S u I valed in the United States," Preziostated. The center will be organized around four major training groups -technicians, radiochemists, nuclear physicists and physicians, according to Prezio. Training of PET technicians began this spring. Other programs will accept enrollees when curriculums are finalized. Training periods will vary from a month for technicians to two years for physicians being trained to + interpret PET images. B m m Y e LOIS B 9 AKER 9 3 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] ~ I Maurizio Trevisan is poised to expand SPM's role in both scope and breadth he first thing that struck Maurizio Trevisan, M.D. about this country after he came here from his native aples, Italy, was Americans' penchant for eating large breakfasts with meat every day. "My parents used to have a cup of coffee- maybe toast and jelly- but no meat," he recalls. ow, the chair ofUB's Department of Social and Preventive Medicine (SPM) is putting that observation - and many more about the American lifestyle - to work, studying dietary habits with an eye toward reducing the incidence of the number one and two killers of Americans, cardiovascular disease and cancer. Trevisan believes that the key to changing the bad habits that contribute to the deaths of over 1.2 million Americans each year is "to focus more on societal problems. The largest impact will come not so much from focusing on the individual, but by influencing the market for foodby lowering fat, eating leaner meats. "And the market," he notes, "has responded to consumer demand. The largest impact will be the change in labeling," soon to be phased in by the Food and Drug Administration. "Increased awareness has created a change in consumer awareness that has resulted in producers changing their packaging." Trevisan, who originally came to this country in 1979 to study at orthwestern University, talks about his former boss in Chicago, a leading authority on diet and heart disease. "He shows slides of two meat cows - one from years ago and one from now. There is a huge difference in B a 0 p the sizes. And now the one that wins the competitions is leaner. People used to look for the steak with all the marbling. ow they're looking for the leaner meat. "We tend to consume what's available," he notes, adding, "I was lucky enough to grow up in a place where you didn't use butter on your bread and you didn't eat meat every day. We would only eat meat once a week. "Lunch was the major meal, and always with pasta. I'm still not used to a cold lunch," even after eight years. In 1982, Trevisan returned to the University of aples, where he obtained his medical degree, before coming to UB as an assistant professor in 1985. He notes that since he's lived in the United States, "dietary habits have changed tremendously," resulting in decreased incidence since 1970 in heart disease and stroke. "And they're still changing for the better." And that is his ultimate goal, of course - to be able to influence peoples' habits and lifestyles to improve the quality of their lives. To that end, Trevisan and Social and Preventive Medicine are carrying on the work of Saxon Graham, emeritus professor and former chair of the department. Graham and his groundbreaking work in epidemiology and diet and disease were key to Trevisan's decision to come to UB. He was, at the time, being wooed by two other institutions. "One of the reasons I came here," he recalls, "was I fell in love with Saxon Graham. I thought he had tremendous vision for the department. 'Td like to continue what Saxon started. I want to maintain and continue to strengthen the department in the field of diet and chronic disease. And I'd like to expand it and continue to include environmental and occupational research. " Another ofTrevisan's goals is to make SPM more clinical. "My background," he explains, "is in internal medicine. Trevisan moved closer to this goal last March when UB was named a vanguard center in the ationalinstitutes' ofHealth landmark Women's Health Initiative. UB, under the auspices of SPM, along with the Departments of Obstetrics and Gynecology and Medicine, will look at a number of factors affecting women's health. Among those to be investigated in the observational study that will look at over 100,000 postmenopausal women are diet, physical activity, smoking, estrogen replacement therapy, alcohol use and psychosocial factors, including social networks, personality, depression and role satisfaction. "At some time, I'd like to expand our definition of Social and Preventive Medicine by being more closely in contact with the community I don't want to be an Ivory Tower scientist. We need to participate more and be more aware of the needs of the community" h y 5 c a n 5 m m e 9 �········· · ··· · ·············· · ················· · · · ············ · ·············· · ··············· · ···• · ~ I I ) J Maurizio Trevisan, M.D. UB will also participate in the initiative's clinical trials to determine whether ERT for postmenopausal women is ultimately beneficial or not. [See the previous story in this section for more information on the Women's Health Initiative.] Trevisan acknowledges the chairs of the other departments involved for their support and involvement in obtaining the prestigious IH designation, as well as that of john Naughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences. "The IH people said, 'It's the first time we've ever seen a dean so involved.' If we 8 a 0 p h his department is relatively small, it is thriving under the medical school's primary care recruitment and women's health initiatives and poised to enjoy an even larger role in the future. "At some time, I'd like to expand our definition of Social and Preventive Medicine by being more closely in contact with the community. The medical school has a responsibility for the health of its community. "I don't want to be an Ivory Tower scientist. We need to participate more and be more aware of the needs of the community." + make it, it's a great end to the efforts of many people involved," Trevisan said, referring to one of the IH's last site visits before awarding the vanguard clinical center designation to UB. Naughton has similar praise for Trevisan. "Maurizio is a very broad thinker. He is committed to epidemiologic and clinical research, and is a good leader of the faculty. His strong leadership, particularly in the area of primary care and interaction with other departments, make us fortunate to have him here." Trevisan officially took over SPM on january l after serving as interim chair after Saxon Graham retired. And although y 5 a n S u - m BY N ANETTE TRAMONT m e KOLLIG �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] ~ I Suraj A. Acharya Family Practice, UniversityofCalifornia-San Diego Medical Center, San Diego, California Match Day '93 aresounding success for UB'sgraduating medical students Shabi na Ahmad Gynecology/Obstetrics, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew York atch Day went well for UB's medical students this year- with 84 percent of the graduating seniors accepted into one of their top three residency program choices. Dennis Nadler, M.D., associate deanfor curricular and academic affairs, said that this year saw 63 percent of UB's medical students accepted by their first choice of residency programs, 11 percent by their second choice and 10 percent by their third choice. In the highly competitive surgical specialties, 10 of 11 UB students who applied were accepted. "The usual match in these specialties is 50 percent," Nadler said. "So to get 10 out of 11 is excellent." Nearly one-third of the students will remain in Buffalo to continue their training- an increase of7 percent over last year. Twenty percent will go to other New York State programs, while about half were matched with out-ofFollowing is a list of the medical school's Class of '93 matches. u 0 0 ancy A. Allen Gynecology/Obstetrics, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew York Jewel D. Alleyne Surgery, University at Buffalo Graduate Medical/ Dental Consortium, Buffalo, ew York Matthew E. Alter Surgery, University at Buffalo Graduate Medical/ Dental Consortium, Buffalo, ew Yorlz Pavan Anand Anesthesiology, Albany Medical Center, Albany, ew York Gregory A. Andrews Obstetrics/Gynecology, Sisters ofCharity Hospital, Buffalo, ew York Michael]. Aronica Med!Peds, University at Buffalo Graduate Medical/ Dental Consortium, Buffalo, ew York Behnam Asgharian Surgery (Prelim), University of Louisville, Louisville, KentucJzy Hisla A. Bates Intemal Medicine (Primary), Yale-New Haven Hospital, ew Haven, Connecticut Ophthalmology, Yale University, ew Haven, Connecticut Andrew J. Bauer Pediatrics, Madigan Army Medical Center, Tacoma, Washington Elyssa A. Blissenbach Intemal Medicine, Medical University of South Carolina, Charleston, South Carolina John S. Brebbia Surgery, University at Buffalo Graduate Medical! Dental Consortium, Buffalo, ew York state residency programs. B Elizabeth A. Allen Gynecology/Obstetrics, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew York p h s c 0 5 Jon M. Bruce Surgery, University at Buffalo Graduate Medical! Dental Consortium, Buffalo, ew York m m e 9 9 �................................................ .... ............................ . . . . ... . . . . . . . . .•. ·. ' ~ ' ' AnneM. Comi Pediatrics, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, New York Thomas A. Coppola Internal Medicine, University at Buffalo Graduate MedicaVDental Consortium, Buffalo, New York Andrew C. Corsello Internal Medicine, Strong Memorial Hospital, Rochester, New York Vanessa L. Crothers Obstetrics/Gynecology, Ohio State University Hospitals, Columbus, Ohio Joan C. Davis Obstetrics/Gynecology, Baystate Medical Center, Springfield, Massachusetts Michael L. DuBartell Family Practice, Middlesex Hospital, Middletown, Connecticut Karen M. Duguid Obstetrics/Gynecology, Strong Memorial Hospital, Rochester, ew York John A. Dzik Pediatrics, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, New York Congratulations abound as over 60 percent of the class members are accepted into their top choice. Tricia L. Eisenstein Surgery (Prelim), Mt. Sinai Hospital, New York, ew York Julene 0. Evansmurage Obstetrics/Gynecology, Maimonides Medical Center, ew York, New York Lisa A. Cardamone Surgery (Prelim), University at Buffalo Graduate ALL PHOTOS BY SIM ON TONG Thomas G. Burke Internal Medicine (Prelim), St. joseph Hospital, Denver, Colorado Emergency Medicine, Denver General Hospital, Denver, Colorado Craig]. Burrows Family Practice, St. Vincent Health Center, Erie, Pennsylvania Heather R. Campbell Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Jean M. Cange Family Medicine, University at Buffalo Graduate MedicaVDental Consortium, Buffalo, ew York Rodney Capiro Obstetrics/Gynecology, Harlem Hospital, ew York, New York B a 0 p h MedicaVDental Consortium, Buffalo, ew York Orthopaedic Surgery, University at Buffalo Graduate MedicaVDental Consortium, Buffalo, ew York Gil M. Farkash Obstetrics/Gynecology, University at Buffalo Graduate MedicaVDental Consortium, Buffalo, ew York Richard M. Chemelli Pediatrics, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, New York Paul Favorito Surgery (Prelim), UniversityofMinnesota Hospital and Clinic, Minneapolis, Minnesota Elaine H. Cheon Obstetrics/Gynecology, Strong Memorial Hospital, Rochester, ew Yorl1 Ilana L. Feinerman Otolaryngology, Tufts ew England Medical Center, Boston, Massachusetts William F. Chlosta Surgery, St. Mary's Hospital, Waterbury , Michael S. Ferguson Emergency Medicine, University of Massachusetts Coordinated Programs, Worcester, Massachusetts Connecticut Josephine Cho Internal Medicine (Prelim), Staten Island University Hospital, New York, New York Radiology - Diagnostic, Einstein Affiliated Hospital, ew York, New York David M. Fisher Surgery, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, ew York David K. Frey Psychiatry, SUNY Health Science Center at Syracuse, Syracuse, ew York Judine C. Coggins Obstetrics/Gynecology, Sisters ofCharity Hospital, Buffalo, ew York 5 c a n s m m e 9 9 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] ~ I Allen Friedland Med!Peds, University of Cincinnati Hospital, Cincinnati, Ohio Timothy D. Haley Surgery, Medical College of Pennsylvania, Philadelphia, Pennsylvania Wallace E. Johnson Internal Medicine, Strong Memorial Hospital, Rochester, ew York Myron L. Glick Family Practice, Lancaster General Hospital, Lancaster, Pennsylvania John D. Hall Obstetrics/Gynecology, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, New York Saidat T. Kashimawo Psychiatry, Beth Israel Medical Center, New Yorh, ew Yorh Charles R. Gray Psycl1iatry, Thomas jefferson Philadelphia, Pennsylvania Hospital , Betty B. Gregoire Psychiatry, University at Buffalo Graduate Medical! Dental Consortium, Buffalo, ew York Kathleen T. Grimm Med!Peds, University at Buffalo Graduate Medical! Dental Consortium, Buffalo, New York B u 0 0 p Richard E. Hall Surgery (Prelim), University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew York Honora M. Heffner Patholog,, University of Minnesota Hospital and Clinic, Minneapolis, Minnesota James M. lsemia Internal Medicine, Healtheast Teaching Hospital, Allen10wn, Pennsylvania h y 5 c 0 n 5 Robin M. Kass Internal Medicine (Prelim), Faulhner Hospital, Boswn, Massachuseus eurology, Columbia University, New York, ew York Lisa F. Keicher Pediatrics, Hershey, Pennsylvania State, Hershey, Pennsylvania Kevin J. Kelleher Family Practice, Franklin Square Hospital, Baltimore, Maryland m m e �· ········ ··· ···················· ·· ······· ············· · ···· ····· · ······· ········· ········· ······• · · ~ I I Theodore J. Kolias Internal Medicine, Hershey, Pennsylvania State, Hershey, Pennsylvania Joseph M. Kowalski Surge1y (Prelim), University at Buffalo Graduate MedicaUDental Consortium, Buffalo, New York Paul M. Kozlowski Surgery (Prelim), Strong Memorial Hospital, Rochester, New Yorlz Urology, Strong Memorial Hospital ofthe University of Rochester, Rochester, ew York UB' s graduating medical students getting the good news: 84 percent were accepted into one of their top three choices for residency programs in this year's Match Day. Brian J. Krabak Internal Medicine (Prelim), Sinai Hospital, Baltimore, Maryland Physical Medicine and Rehabilitation, New England Medical Center, Boston, Massachusetts Jonathan R. Kemp Internal Medicine (Prelim), University at Buffalo Graduate MedicaUDental Consortium, Buffalo, ew York Ophthalmology, Louisiana State University Eye Center, ew Orleans, Louisiana J . Christopher Kuhn Pediatrics, University at Buffalo Graduate MedicaU Dental Consortium, Buffalo, New Yorlz Cathy Kim Surgery (Prelim), Barnes Hospital, St. Louis, Missouri Urology, Washington University, St. Louis, Missouri Tracy]. Lathrop Internal Medicine (Prelim), Einstein Affiliated Hospitals, New York, ew Yorlz Elizabeth H. Kim Internal Medicine (Preli m), St. Vincent's Hospital, ew Yorlz, ew York Anesthesiology, Brigham and Women's Hospital, Boston, Massachusetts David]. Lee Transitional Year, Presbyterian/St. Luke's Medical Center, Denver, Colorado Anesthesiology, Dartmouth-Hitchcoclz, Lebanon, New Hampshire Jeffrey 5. Kingsbury Surgery (Prelim), University at Buffalo Graduate MedicaUDental Consortium, Buffalo, ew York Kewjung Lee Family Practice, orthwestern University/St. joseph Hospital, Chicago, Illinois Ricardo A. Knight Physical Medicine and Rehabilitation, Temple University Hospital, Philadelphia, Pennsylvania B u 0 0 p s c 0 n 5 Charles H. Lieu Internal Medicine, Barnes Hospital, St. Louis, Missouri m m e 9 9 3 �• ··············································· .................... .... .... ...... .......... ..... An ebullient Jon Brute reteives tongratulations from his tolleagues. Jeffrey R. Parnell Internal Medicine (Primary), University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew Yorh Ophthalmology, University of California-Los Angeles, Los Angeles, California Vikram . Patel Surgery (Prelim), McGaw Medical Center, orthwestern University, Chicago, Illinois Otolaryngology, orthwestern University, Chicago, Illinois Francis R. Pallerson Orthopaedic Surgery, SUNY Health Science Center at Syracuse, Syracuse, ew York Kristen L. Paulus Internal Medicine, Georgetown University Hospital, Washington, D.C. Randall J. Loftus uclear Medicine, University at Buffalo Graduate MedicaVDental Consortium, Buffalo, ew York Andrew C. Michel Emergency Medicine, Geisinger Medical Center, Danville, Pennsylvania Karen M. Maier Family Practice, Harrisburg Hospital, Harrisburg, Pennsylvania Rogena L. Miller Pediatrics, Emory University School of Medicine, Atlanta, Georgia James K. Mantone Orthopaedic Surgery, Grace Hospital, Detroit, Michigan David A. Milling Internal Medicine, University at Buffalo Graduate MedicaVDental Consortittm, Buffalo, ew York Gina M. Marrero Pediatrics, Yale- ew Haven Hospital, ew Haven, Connecticut Lomelle B. Mills Internal Medicine, George Washington University, Washington, D.C. Bruce B. Marshall Emergency Medicine, Carolinas Medical Center, Charlotte, orth Carolina Daniel]. Mollin Internal Medicine, University of orth Carolina, Chapel Hill, orth Carolina Christina L. Master Pediatrics, Children's Hospital , Philadelphia, Pennsylvania Michael]. a ugh ton Internal Medicine, Barnes Hospital, St. Louis, Edward F. Math Internal Medicine (Prelim), University of California-Irvine, Irvine, California Radiology-Diagnostic, Duke University Medical Center, Durham, orth Carolina Jennifer A. ordby Pediatrics, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, ew York Fiona A. McConnell Pediatrics, University of Colorado, School of Medicine, Denver, Colorado Kevin C. McMahon Family Practice, St. Vincent Health Center, Erie, Pennsylvania Claudia F. Michalek Psychiatry, University at Buffalo Graduate MedicaV Dental Cons01iium, Buffalo, ew York B u 0 0 p Missouri Katherine A. O'Donnell Surgery, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, ew York Sanjay R. Ogra Internal Medicine (Primary), University at Buffalo Graduate MedicaVDental Consortium, Buffalo, ew Yorh William E. Ottowitz Internal Medicine (Prelim), University at Buffalo Graduate Medical/Dental Consortium, Buffalo, New York h y s 0 n s Laura]. Pierce Med!Peds, Strong Memorial Hospital, Rochester, ew York James D. Pile Obstetrics/Gynecology, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew Yorh Michael D. Rabice Pediatrics, University at Buffalo Graduate MedicaV Dental Consortium, Buffalo, New York Arlene E. Ricardo Surgery, University of Texas Medical School, Houston, Texas Gloria Richards Internal Medicine C., Georgia Baptist Medical Center, Atlanta, Georgia Marcus R. Romanowski Surgery (Prelim), University at Buffalo Graduate MedicaVDental Consortium, Buffalo, New Yorh Orthopaedic Surgery, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew York Leon Ronen Family Practice, aval Hospital Charleston, Charleston, South Carolina Paul B. Rosenthal Family Practice, UniversityofCalifornia-San Diego Medical Center, San Diego, California Mark A. Runfola Surgery, Good Samaritan Regional Medical Center, Phoenix, Arizona Richard S. Safeer Family Practice, Franklin Square Hospital Center, Baltimore, Maryland u m m e 9 9 �······························································· ···· ·········· ··· ········· ·· ····· • ·· · ~ I Diane M. Sanfilippo Obstetrics/Gynecology, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, New York Frank M. Scappaticci Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania Eric]. Schneider Family Practice, University of VirginiaCharlottesville, Charlottesville, Virginia Jeffrey A. Senall Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan Jeffrey Seymour Surgery (Prelim), University at Buffalo Graduate Medical/Dental Consortium, Buffalo, New York Peter U. Shen Internal Medicine, The York, ew York 1 ew Yorh Hospital, ew Andrew L. Sherman Physical Medicine and Rehabilitation, University of Washington Affiliated Hospitals, Seattle, Washington Julie M. Sicilia Transitional Year, Mary Imogene Bassett Hospital, Cooperstown, New York Patricia Sticca Pediatrics, University at Buffalo Graduate Medical! Dental Consortium, Buffalo, 1 ew York Michel E. Wild Obstetrics/Gynecology, ew Yorh Downtown Hospital, ew Yorh, ew Yorh Michael F. Sweeney Obstetrics/Gynecology, Akron City Hospital, Akron, Ohio Kelly A. Wood Internal Medicine, Barnes Hospital, St. Louis, Missouri Brian Szymanski Physical Medicine and Rehabilitation, University at Buffalo Graduate Medical/Dental Consortium, Buffalo, New York Thomas]. Yacovella Medicine C, University of Minnesota Hospital and avy + Clinic, Minneapolis, Minnesota aval Heather Campbell phones home. Courtenay C. Watt Emergency Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania Samiris Sostre Psychiatry, Einstein Affiliated Hospitals, ew York, ew York Michelle A. Webb Internal Medicine, Medical College of Virginia, Richmond, Virginia Anthony M. Spina Surgery (Prelim), University at Buffalo Graduate Medical/Dental Consortium, Buffalo, New York h Edward R. Stephenson Surgery, Hershey, Pennsylvania State, Philadelphia, Pennsylvania Christopher R. White Internal Medicine (Prelim), Sisters of Charity Hospital, Buffalo, New Yorl1 Radiology-Diagnostic, University Health Center of Pittsburgh, Pittsburgh, Pennsylvania Anil K. Vaidian Internal Medicine, Montefiore Medical Center, Bronx, ew York Michael K Soeder Med!Peds, Baystate Medical Center, Springfield, Massachusetts p Thomas C. Wheatley Pediatrics, University Hospital of Cleveland, Cleveland, Ohio Mary C. Totten Otolaryngology, Loyola University, Chicago, Illinois Christina A. Smith Psychiatry, University Health CenterofPittsburgh, Pittsburgh, Pennsylvania 0 Judy A. Wesolowski Obstetrics/Gynecology, SU Y Health Science Center at Syracuse, Syracuse, ew Yorh Kristine L. Tenebruso Internal Medicine (Primary), Rhode Island Hospital, Providence, Rhode Island Gail H. Smallen Pediatrics, University at Buffalo Graduate Medical! Dental Consortium, Buffalo, ew York a icho\as A. Stathopoulos Internal Medicine (Prelim), St. Mary's Hospital, Rochester, ew York Ophthalmology, Pennsylvania State University, Hershey, Pennsylvania Guy A. Taylor Internal Medicine (Prelim), University at Buffalo Graduate Medical/Dental Consortium, Buffalo, ew York Anesthesiology, Presbyterian Hospital, New York, New Yorh Alissa M. Shulman Surgery, University of Texas Medical School, Houston, Texas u Jonathan I. Weinstein Pediatrics, Children's Hospital National Medical Center, Washington, D.C. Robert W . Tahara Family Medicine, United States Hospital, jacksonville, Florida Mansour V. Shirbacheh Surgery, assau County Medical Center, East Meadow, ew York e Christopher D. Sprowl Family Practice, St. joseph Hospital, Denver, Colorado Irwin C. Steinberg Obstetrics/Gynecology, Winthrop Universi ty Hospital, Mineola, New York Paul D. Seeman Family Practice, United States avy aval Hospital, jacksonville, Florida y I s a 5 u m m e 9 9 �- - ········· ··· · ······· ········· ····· ··· ··· ·· ······· ······· . . .. . .. ... .. .. . ... ..... ......... ... • Maria New, M.D~ thanks her patients as she delivers 1993 D. WHarrington Lecture common symptom of the disorder) aggravated by stress. In her study of this disorder, ew identified its "nonclassical" form- a late onset hyperplasia in which the patient acquires the symptoms of the disease after HLA-TYPING LED TO DISCOVERY OF NONCLASSICAL birth, rather than in utero. ew became FORM OF CONGENITAL ADRENAL HYPERPLASIA aware of this form using HLA-typing to identify carriers in a specific family. Up to this point in herresearch, HLA-typing had en owned pediatric endocrinologist and then a male until adulthood, when the predicted every outcome in her patients. Maria I. ew, M.D., delivered the victim fell in love with and tried to marry "It was all fine until we hit this family, " 1993 D. W. Harrington Lecture, a maid. "The maid was dismayed and ran where ew noted that the deficiency wasn't away," when the unfortunate patient pro"Congenital Adrenal Hyperplasia: being passed on the way it was predicted From the Laboratory to the Bed- duced a birth certificate that was for a baby to . girl rather than a boy. Although it was ' ~ side," recounting her research on "We were very disappointed in the believed "he died of a broken heart," in the nonclassical form of the disorder. nonconcordance of the HLA prediction." Alexander Brownie, Ph.D., UB profes- fact, she said, he died of salt-wasting (a ew discovered one particular family sor and research professor in pathology, member - a male with a mild deficiency introduced ew, chair of pediatrics at on one of the sixth chromosome pair and Cornell Medical College. A friend of ew's a major deficiency on the other. She defor over 20 years, Brownie described her scribed the man's son "like no patient I dedication to the field of pediatric endohave ever seen," noting that the son should crinology, recounting how she always have had the deficiency at birth but in fact wanted to have a positive impact on childid not, nor did his sister who had the dren suffering from endocrine disorders. same HLA gene type. ew thanked many for their help in her Symptoms of the nonclassical form inresearch , but she made a special point to clude infertility and rapid growth. One of 100 thank her patients, "some of whom I have the most common symptoms is frontal followed from the time they were born hair loss. Treatment can help eliminate until they were parents." many of these symptoms. Pediatrician-in-chief and director of Statistics show that the severe classical the pediatric metabolism clinic at The disorder occurs in one in 14 ,554live births, ew York Hospital, ew has concenalthough there are some geographic variatrated her studies on the 21-hydroxylase tions; Alaska's Yupik Eskimos show the deficiency, which along with the 11-hyhighest frequency of the classical form. droxylase defect, is one of the most comew described how she "never exmon forms. The deficiency causes an inpected what I got" when she tested the creased secretion from the adrenal gland genetic axiom that mild disorders occur of cortisol precursors and androgens, remore frequent than severe ones. She said sulting in masculinization of the female she expected the frequency of the mild external genitalia during intrauterine life. deficiency of congenital adrenal First described in 1854, the disorder hyperplasia to be somewhere around one can lead to female infants being sexually in 13,000 live births, and was shocked misassigned at birth, as well as precocious when she realized it was much higher. A sexual maturation in boys. New told the 11 test on Eastern Europeanjewsshowed the story of that case, in which an Italian frequency to be one in 27 and a test on patient- raised as a female until age four, Hispanics in New York showed a fre- ~I Overall, the frequency average of congenital adrenal hyperplasia is one in who shows symptoms, while one in seven is a carrier, making it the most common autosomal recessive defect. New called for universal testing, but lamented the fact that only states have mandated it thus Jar. a a a p s c a n 5 u m m e 9 �quency of one in 40. Overall the frequency average of congenital adrenal hyperplasia is one in 100 who shows symptoms, while one in seven is a carrier, making it "the most common autosomal recessive defect. " ew called for universal testing, but lamented the fact that only 11 states have mandated it thus far. Treatment begins in the womb as fetal cells are Hl.A-typed. "When you get a diagnosis by amniocentesis, it's already too late," ew said. Dexamethasone is used to treat the fetus at risk even before the gender has been determined. If it is later found the fetus is a male, treatment is ended; females are treated until term. ew said treatment can lead to recovered fertility and the lessening of other symptoms "without causing complications. "It's still a very experimental procedure," explained ew, "but I am very respectful of human life." The author of more than 400 research papers on abnormalities of the adrenal gland, New is immediate past presidentof the Endocrine Society. In 1988, she received the society's Robert H. Williams Distinguished leadership Award in Endocrinology. She has received the New YorkAcademyofMedicineMedalofAward and the Due Case award from the Office of the Governor of ew York. She was elected a fellow of the American Academy of Arts and Sciences in 1991. The Harrington lecture is sponsored by the School of Medicine and Biomedical Sciences. As Harrington visiting professor, ew spent two days meeting with faculty and medical students in hospital grand rounds, at clinics and in informal discussion groups. The D. W. Harrington lecture Fund was established in 1886 by Devillo White Harrington, M.D. , an 1861 graduate of the UB medical school and a professor of genito-urinary and venereal diseases from 1886 to 1905. + r' Maria New, M.D. B s 0 0 p h y s c 0 5 u m m Y e M ARK P 9 OLLIO �• ································································································ ~ I The aim of both initiatives is to provide cooperative patient care networks for diverse specialty services to residents of the West Side close to their homes as well as to develop cost-effective access to University-affiliated tertiary care services to medically underserved communities. Prenatal services will be provided at the Buffalo Columbus' Family Care Center by clinical faculty of the department of gynecology and obstetrics. Women receiving prenatal care at the Buffalo Columbus facility will be referred primarily to CHOB for deliveries, as well as for any specialized pregnancy-related care. Additionally, women seen for gynecological services at the Family Care Center will be referred to either Children's or Erie County Medical Center. The agreement was forged through the joint efforts of john P. BlFFALO COL.lMIUS HOSPITAL UB-Columbus agreement provides cooperative patient-care services for West Side residents. UB-Columbus Hospital linkage to provide prenatal care services new agreement to enhance access to women's health and AIDS services to residents of Buffalo's West Side community has been inked between the School of Medicine and Biomedical Sciences, The Children's Hospital of Buffalo, Erie County Medical Center and the Buffalo Columbus Hospital. The agreement, which establishes a primary-tertiary care network to provide comprehensive women's services, includes provisions for delivering early prenatal care to an area with some of New York State's highest infant mortality rates. The agreement also provides for the training of local medical and nursing staff by specialists ofECMCS AIDS program to administer routine primary medical and specialized ambulatory care to AIDS and HIVpositive patients. B u 0 0 p president for clinical affairs and dean of the medical school, and the hospitals. At a press conference and luncheon announcing its es- II h c 0 UB oiTers GRATEFUL MED through National Library of Medicine grant B's Health Sciences Library has been awarded a 15-month outreach contract to promote library services to 75,000 health care professionals throughout Western and Central ew York. The library will do this through its Western New York Outreach Program, which began in August1992 and will run through this October, funded by a $159,699 ational Library of Medicine (NLM) contract awarded through the ew York Academy of Medicine. The program will introduce its audience to GRATEFUL MED, a software package that offers desktop access to biomedical information and will link unaffiliated health professionals to library services. Cynthia Bertuca, head of information dissemination services for the Health Sciences Library, said the program currently targets more than 10,000 pharmacists and dentists in a 25-county area. The counties involved are the eight counties ofWestern ew York, plus Steuben, Livingston, Mon- GRATEFUL MED reaches out. 5 tablishment, Naughton was lauded by Columbus Hospital board members for his community service and efforts on behalf + of Buffalo's West Side. 5 u m m e 9 3 �. .. . . . .. ... ..... .... . .. .... . . . .... . .... ... ...... .... ......... . . ..... . ... . ..... ... . . . . .. .... ••• ••~ ••• • I roe, Ontario, Wayne, Cayuga, Yates, Seneca, Schuyler, Chemung, Tompkins, + Cortland and Tioga. New plan turns private practices into formal classrooms in WNY the memory of the associate professor of medicine at New York University School of Medicine who served as a member of MF's board from 195 2 until his death in 1979. + The Graef Memorial Scholarship was established by the ational Medical Fellowships (NMF) board of directors and endowed through a gift from the Irving Graef Medical Fund. The award honors our doctors' offices, an inner-city health clinic and an HMO in Western ew York are becoming the nation's first private medical practices to function as formal training sites for medical students and resident physicians studying to become primary care physicians. The program is called the Community Action Practice (CAP) project, a cooperativeventure of the Graduate Medical Dental Education Consortium ofBuffalo. CAP is part of a $5 million primary care initiative unveiled by the Consortium last fall , designed to increase the number of resident physicians training in primary care from 35 to 50 percent by 1994. The new program will allow aspiring doctors to study primary care medicine where it is practiced- in doctors' private offices and walk-in clinics rather than in hospitals, the traditional training ground for all fields of medicine. Computer software and hardware will also be provided on-site as part of the new program. + UB medical student wins Irving Graef Memorial National Medical Fellowships scholar award ndrea Williams, a University at Buffalo medical student, has been chosen as the 1992-93 Irving Graef Memorial Scholar. As the Graef Scholar, Williams will receive $2,000 during her senior year. B u a 0 p h Andrea Williams 5 a n 5 I m m e 9 �. . . . . • ••••••••••••••••• •••••••••• . . . . .... . . . . . . . . . . . . . . . .. . . . UB'sOffice of Graduate Medical Education is key to excellence in Consortium residency training oseanne Berger, M.D., UB's new associate dean for graduate medical education has her capable hands full. Her office - the Office of Graduate Medical Education and House Staff Affairs - is charged with overseeing not only the education of over 700 resident physicians, but the many functions associated with coordinating their education through the school's Graduate Medical Dental Education Consortium of Buffalo (GMDECB). Founded 10 years ago in an effort to respond to new guidelines issued by the Liaison Committee on Graduate Medical Education, the GMDECB consists of the School of Dental Medicine, the School of Medicine and Biomedical Sciences and its nine affiliated teaching hospitals, all residency training program directors and one resident from each program. Before her office was established last October, Berger says "graduate medical education was spread among the hospitals, with some residents sent to multiple hospitals without any coordination between them. One resident may have gotten a salary from one hospital and rotated to three hospitals and his or her colleague might have received a different salary from another hospital and essentially do the same thing. And benefits were a problem, too." In addition, Berger adds, the accrediting body for graduate medical education "required an institution of record to hold responsible for ensuring the quality of the programs. In Buffalo, we had eight hospitals - and who was responsible for the quality? "That function is now focused out of this office." B a 0 p Roseanne Berger, M.D. The office also serves as a clearinghouse for Consortium residency program directors to learn about accreditation information and other issues affectinggraduate medical education. "For example," Berger explains, "the impact health care reform being anticipated from Washington will have on graduate medical education- that type of effort comes out of this office." Issues common to all residency programs are coordinated through the medical school's graduate medical education department. "Because there are multiple residency programs, there are certain issues common to all programs that are managed more efficiently if coordinated through one office," Berger says, and cites the Consortium's one-week residency program orientation as an example. 'The residents learn about communication skills, teaching skills, issues in medicine such as advanced directives, documentation, medical records, and also receive training in life support and advanced life support- all issues common y s c a n s .................................... to all programs and important for the new house staff to know. " As the medical school's chief liaison to the Consortium, Berger's office is poised to take an even broader role, given the current climate of health care reform that is likely to touch not only practicing physicians, but both graduate and undergraduate medical education as well. That climate, Berger notes, will probably result in striking changes in the way physicians- particularly resident physicians- are trained in this country. And UB and its Consortium- having committed to achieving 50 percent of its residency positions in primary care "are on the forefront of change because we are a Consortium and in the future graduate medical education will look toward developing more. We are the oldest and we are looked at as a model for the nation, having worked collaboratively with the hospitals. " The 50 percent primary care residency goal is only one objective of a three-year ew York State Department of Health demonstration project Berger's office also has responsibility for. That demonstration project is aimed at easing the nation's current and projected shortage of primary care physicians. "We've made a commitment to make changes in graduate medical education in exchange for more favorable reimbursement rates. This is a key reason why this office was established," Berger said. "We have to demonstrate we're making the changes we've committed to making. And these are exactly the kind of changes the government and health care planners feel need to be made in this country in terms of health care delivery and medical education. "We have a leg up on things because we've already committed to making these kinds of changes." + - BY m NANETTE m e TRAMONT KOLLIG 9 9 3 �. .... . ... . ....................... ... ...... .... ........ ... ...................... . ............... II lell Listing of Consortium residency programs demonstrates expanded specialty scope as well as focus on primary care he Graduate Medical Dental Education Consortium of Buffalo is responsible for the education of over 700 resident physicians. Following is a listing of the programs the Consortium runs, including the affiliated hospitals, program directors and number of positions in each program. ALLERGY AND IMMUNOLOGY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Erie County Medical Center Program Director Dr. Mark Ballow umber of Positions - 4 ANESTHESIOLOGY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Erie County Medical Center Millard Fillmore Hospitals Roswell Park Cancer Institute VA Medical Center Program Director Dr. Richard Ament Number of Positions - 52 VA Medical Center Program Director Dr. Clara Bloomfield E DOCRINOLOGY AND METABOLISM Hospital Erie County Medical Center Program Director Dr. Stephen Spaulding EPHROLOGY Hospital Erie County Medical Center Program Director Dr. Rocco Venuto GASTROENTEROLOGY Hospital Erie County Medical Center Program Director Dr. Milton M. Weiser INTERNAL MEDICINE PROGRAM A Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Erie County Medical Center VA Medical Center Program Director Dr. Robert Scheig Number of Positions- 156 (iJicludi,gfellowships ) Programs CARDIOVASCUlAR DISEASE Hospital Erie County Medical Center Program Director Dr. Avery K. Ellis PULMONARY DISEASES Hospital Erie County Medical Center Program Director Dr. Alan R. Saltzman HEMATOLOGY-MEDICI E Hospital Erie County Medical Center Program Director Dr. Gerald Logue RHEUMATOLOGY Hospital Erie County Medical Center Program Director Dr. Floyd A. Green INFECTIOUS DISEASES Hospital Erie County Medical Center Program Director Dr. Timothy Murphy INTERNAL MEDICINEPROGRAM B MEDICAL ONCOLOGY Hospitals Buffalo General Hospital Roswell Park Cancer Institute Hospital Millard Fillmore Hospitals Program Director Dr. joseph lzzo umber of Positions- 3 7 DERMATOLOGY Hospitals Buffalo General Hospital The Children's Hospi tal of Buffalo Erie County Medical Center Roswell Park Cancer Institute VA Medical Center Program Director Dr. Stephanie Pincus umber of Positions- 10 FAMILY PRACTICE Hospitals Buffalo General Hospital Cuba Memorial Hospital Erie County Medical Center Millard Fillmore Hospitals Olean General Hospital Program Director Dr. Daniel Morelli umber of Positions - 52 B a a p h y s c a n 5 m m e 9 9 �• ••••••••••• I VA Medical Center Program Director Dr. George Simpson Number of Positions - PSYCHIATRY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Ene County Medical Center VA Medical Center Program Director Dr. Seung-Kyoon Park Number of Positions - 26 12 PATHOLOGYANATOMICAL CLINICAL Hospitals Buffalo General Hospital Erie County Medical Center Roswell Park Cancer lnslllute VA Medical Center Program Director Dr. Reid Heffner umber of Positions - 19 CHILD PSYCHIATRY PEDIATRICS NEUROLOGICAL SURGERY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Erie County Medical Center Program Director Dr. L. Nick Hopkm Number of Positions - 7 NEUROLOGY Hospitals The Children's Hospnal of Buffalo Buffalo General Hospnal Erie County Medical Center Millard Fillmore Hospnals VA Medical Center Program Director Dr. Michael Cohen Number of Positions- 16 CHILD NEUROLOGY Hospitals The Children's Ho pnal of Buffalo Erie County Medical Center VA Medical Center Program Director Dr. Michael Cohen NUCLEAR MEDICINE Hospitals Buffalo General Hospnal Mercy Hospital Roswell Park Cancer lnslllute VA Medical Center Program Director Dr. joseph Prez10 umber of Positions - 6 Program Director Dr. Myroslaw Hreshchyshyn umber of Positions - 40 OPHTHALMOLOGY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Ene County Medical Center VA Medical Center Program Director Dr. William Coles umber of Positions - 12 ORTHOPAEDIC SURGERY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Ene County Medical Center Mercy Hospital VA Medical Center Program Director Dr. Lawrence Bone umber of Positions - 16 Programs HA D SURGERY Hospitals Millard Fillmore Hospitals Erie County Medical Center Program Director Dr. Clayton Peimer umber of Po it ions 3 PEDIATRIC ORTHOPAEDICS Hospital The Children's Hospital of Buffalo Program Director Dr. Robert Gillespie umber of Positions- 1 GYNECOLOGY AND OBSTETRICS Hospitals Buffalo General Hospnal The Children's Hospnal of Buffalo Erie County Medical Center Millard Fillmore Hospitals Roswell Park Cancer Institute 6 u a OTOLARYNGOLOGY Hospitals The Children's Hospital of Buffalo Ene County Medical Center SISters of Charity Hospital 0 p h y 5 Hospitals The Children's Hospital of Buffalo Erie County Medical Center Mercy Hospital Roswell Park Cancer lnslllute Program Director Dr. Gerald Daigler Number of Positions - 71 (includi ngfellowships) Programs EO ATAUPERJ ATAL MEDICI E Hospital The Children's Hospital ofBuffalo Program Director Dr. Frederick Morin PEDIATRIC EPHROLOGY Hospital The Children's Hospital ofBuffalo Program Director Dr. Leonard Feld PEDIATRIC HEMATOLOGYONCOLOGY Hospitals The Children's Hospital ofBuffalo Roswell Park Cancer Institute Program Director Dr. Martin Brecher PEDIATRIC ENDOCRINOLOGY Hospital The Children's Hospital ofBuffalo Program Director Dr. Margaret MacGillivray PHYSICAL MEDICINE AND REHABILITATION Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Ene County Medical Center Mercy Hospital Sisters of Charity Hospital VA Medical Center Program Director Dr. Kyu Ha Lee Number of Positions - 13 a n 5 u m Hospitals The Children's Hospital of Buffalo Western New York Children's Psychiatric Center Program Director Dr. David Kaye umber of Positions - 6 RADIOLOGY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Erie County Medical Center Millard Fillmore Hospitals VA Medical Center Program Director Dr. Angelo De!Balso umber of Positions- 18 Programs PEDIATRIC RADIOLOGY Hospital The Children's Hospital of Buffalo Program Director Dr. jerald Kuhn SOCIAL AND PREVENTIVE MEDICINE Hospitals Buffalo General Hospital Program Director Dr. Michael oe Number of Positions - 7 SURGERY Hospitals Buffalo General Hospital Erie County Medical Center Millard Fillmore Hospitals VA Medical Center Program Director Dr. Eddie Hoover Number of Positions - 72 Programs COLO AND RECTAL SURGERY Hospital Buffalo General Hospital Program Director Dr. Bertram Portin umber of Positions - 1 PEDIATRIC SURGERY Hospital The Children's Hospital of Buffalo m e 9 9 �··············· ····························•··· Bl I Program Director Dr. james Allen Number of Positions - 2 Erie Count)' Medical Center VA Medical Center Program Director Dr. joseph Margarone Number of Positions - 8 VASCUlAR SURGERY Hospitals Buffalo General Hospital Millard Fillmore Hospitals VA Medical Center Number of Positions - 2 PEDODO TICS Hospital The Children's Hospital of Buffalo Program Director Dr. joseph Bernat umber of Positions- 4 THORACIC SURGERY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Millard Fillmore Hospitals Roswell Park Cancer Institute VA Medical Center Program Director Dr. Eddie Hoover umber of Positions - 4 UROLOGY Hospitals Buffalo General Hospital The Children's Hospital of Buffalo Millard Fillmore Hospitals Roswell Park Cancer Institute VA Medical Center Program Director Dr. Gerald Sufrin umber of Positions - 9 AFFILIATED PROGRAMS MERCY HOSPITAL Program Internal Medicine Program Director Dr. Thomas Raab umber of Positions - 23 NIAGARA FALLS MEMORIAL HOSPITAL Program Family Practice Program Director Dr. M. Oyster umber of Positions - 12 Program Gynecology and Obstetrics Program Director Dr. Michael Ray umber of Positions- 8 SISTERS OF CHARITY HOSPITAL Program Internal Medicine Program Director Dr. elson Torre Number of Positions- 20 DENTAL PROGRAMS GENERALPRACTICE DE TISTRY Hospital Buffalo General Hospital Program Director Dr. Alan Drinnan umber of Positions - 6 GENERALPRACTICE DE TISTRY Hospital Erie County Medical Center Program Director Dr. Stuart Fischman umber of Positions - 6 GENERALPRACTICEDE TISTRY Hospital VA Medical Center Program Director Dr. Gene lnneo Number of Positions- 5 GE ERALPRACTICEDENTISTRY Hospital Millard Fillmore Hospital Program Director Dr. Sanford usbaum umber of Positions - 3 ORAL AND MAXILLOFACIAL SURGERY Hospitals Buffalo General Hospital B 0 0 • p h y 5 c 0 s m m e 9 9 I �"The Name of the Game" in health care reform today is reasonable change JAMES TODD , M .D. , GIVES STOCKTON KIMBALL LECTURE s he spoke in sports analogies and anecdotes,] ames Todd, M.D.'s message was clear: any change in the American health care system will have to be "slow and reasonable. " Executive vice president of the American Medical Association, Todd delivered the Stockton Kimball Memorial Lecture- "The arne of the Game" - at this year's Spring Clinical Day, held May 1. Margaret Paroski, M.D. , '80, assistant professor of neurology and Spring Clinical Day chairperson, introduced Todd to an audience of about 300. "If you read Time or Newsweek , I don't need to introduce you to Dr. Todd, because every time you hear anything about Hillary Clinton dealing with theAMA,you'llsee Dr. Todd's name." Todd explained how he sees health care as a game, with "rules, regulations, goals, winners and losers. Meanwhile, we and our patients are out on the playing court, fighting our way to a goal that sometimes seems only we continue to see. But unlike any other endeavor, there are also some rules, in this case called antitrust, that prevent doctors from working out their own team game plan. " Todd called UB "a grand example of how you can coordinate the education of students, the needs of the community and become a very cooperative activity to teach and advance the art and science of medicine." He lauded Stockton Kimball by saying, "Dr. Kimball was noted for many different achievements: for his knowledge of tropical disease, for his dedication to improving the physical facilities of your campus, for his concern for the people and commuB u 0 0 p nity of ew York State. "His involvement, his brand of humanitarianism, his genuine caring, personify the characteristics, the kind of personal concern which draws us all when we think about going to medical school." Todd said he saw a connection between Kimball's work and the theme of this year's Spring Clinical Day lecture, noting that in 1950 Kimball chaired a special AMA committee to study medical training in times of war and crisis called the joint Committee on Medical Educa- y s c 0 s tion at the Time of National Emergency. "How appropriate that is. And how very germane that is to my being with you this afternoon. Because if there was ever a time of national emergency in health care, we're facing it today. " The crisis is so compelling, Todd said, that "Mrs. Clinton has assembled a committee of 500 to find a solution. I'm not telling you it's a professional emergency -although it is that- nor is it a patient emergency- but it is that, too. The state of health care in this country is a national emergency-one that touches every single citizen of the United States," Todd said. "It touches the 87 percent for whom the current system has essentially been working pretty well. And it especially touches the 3 7 million people who are denied access to the system because of insurance regulations, loss of jobs or a dozen other quirks and loopholes. "These have rendered the basics of health care out of reach for too many for too long. And it is not a secret to anyone anymore that the present system is unsustainable. " either patients nor doctors can stand too much more of our present system. " Todd explained how he thought that the "future in the medical sciences will be limited only by our imaginations. Indeed, if the Clinton administration does the job that all of America hopes they'll do, I think we will have a lot to look forward to as far as returning to the goals that motivated us as physicians. " Todd warned of the dangers of mixing politics and medicine. "If Clinton and Clinton get stuck in the thicket m m e 9 �of political and practical miscalculations, we will all suffer-especially our patients. "The stakes are even higher than our own professional standing. And the name of the game I am talking about is patient care. Rules are being written even as we speak," Todd said. "Well, I'm no slam-dunker myself, but I do know this: there's not a coach in the world who doesn't try to improve on player performance." Todd noted that various strategies for rescuing the American health care system have already been proposed, adding that the AMA was one of the first organizations to put forth a plan. "We put a plan on the table known as Health Access America. It is the American way to reform the health care system. It seeks to bring to patients an essential set of benefits, universal access, cost containment, equity - while at the same time working to bring doctors relief from regulations." Todd believes the key to reforming the health care system is "not just change, but reasonable change. "Responsible change is the winning strategy. Today, patients are sent into a system so wrapped up in red tape they can hardly maneuver. Doctors half the time are playing with one hand tied behind our backs. We are coming under scrutiny that seeks to punish and not to educate, sending us racing full-tilt into the shelter of defensive medicine, so we don't get sued or worse," Todd said. ''I'm sure all of you would welcome a world in which you could follow your best clinical judgment and return the profession to the ability to discipline itself." But change will not occur, Todd said, unless "we show restraint in our behavior in what's going on around us. We have to focus on responsibility to our nation. We cannot afford to think of medicine as a spectator sport. We have to have active participation." + BY B u CARRIE a Calls for membership in the James Platt White Society went out from medical ~chool ~lumni during a special membership drive held last April. From left are: Albert G. Rowe, M.D., 61; R1chard R. Romanowski, M.D., '58; Michael A. Sansone, M.D., '85; Angelo M. DeiBalso, M.D., '78; Lawr~nce E. Mervine, assistant dean and senior development officer with the University at Buffalo Foundation; Arthur W. Mruczek, Sr., M.D., '73, and Elizabeth P. Olmsted, M.D., '39. Frawley '44 receives prestigious Alfred Stengel Memorial award homas F. Frawley, M.D., '44, has been awarded the 1993 Alfred Stengel Memorial Award. The American College of Physicians award, established in 1947, is given to a Master of the College who has exhibited "unusual loyalty and exceptional contributions to the aims and purposes of the College as well as outstanding influence in maintaining and advancing the best standards of medical education, medical practice and clinical research." Frawley, the 1989 recipient of UB's Distinguished Medical Alumnus Award, is a professor emeritus and chairman of the Department of Graduate Medical Education of St.john's Mercy Medical Center, St. Louis, Missouri. A governor of the American College of Physicians, he served as that group's president from 1981 to 1982. Frawley , who has been active on research and evaluation committees of the ationallnstitutes ofHealth, the ational Academy of Sciences and the American Medical Association, received his award in March at the American College of Physicians' Convocation held in + Washington, D.C. LIBERANTE 0 p h y 5 c a 5 m m e 9 9 3 �hkhert Kenneth Eckhert M.D~ Sr~ lauded by Niagara Lutheran Home he iagara Lutheran Home Foundation presented Dr. Kenneth Eckert, M.D., '35, with its 1993 Humanitarian Award at a special dinner in his honor last April. Eckhert, a lifelong Buffalo resident, played a key role in the establishment of the Health Service Agency- the first of its kind in Buffalo and the first to receive federal funding. Eckhen served as president of that agency, which was a forerunner of today's Health Systems Agency. Eckhert and his long-time friend, the Reverend Dr. Ralph Loew, were instrumental in the establishment of Trinity Tower, a senior citizen residence developed in conjunction with Holy Trinity Lutheran Church. Eckhert is a member of the board of trustees of the Niagara Lutheran Home Foundation and currently serves on a number of boards and medically related associations. He served as chiefof surgery, chief of staff and president of the executive committee of the fomer Deaconess Hospital. + B u 0 0 p American Academy of Family Physicians honors UB physician Harrts Directory begins survey of UB medical school alumni arlos Roberto jaen, M.D., '89, UB assistant professor of family medicine, was one of eight physicians honored recently by the American Academy of Family Physicians for their contributions to medicine and public health. Jaen received the Academy's McNeil Clinical Research Award for his work, "Symptoms Associated with Middle Ear Effusion in Children: A Basis for Quantifying Clinical]udgment." jaen came to the University at Buffalo in October 1992 after completing a fellowship and residency in family practice at University Hospitals of Cleveland, affiliated with Case Western Reserve University. He holds a doctorate in epidemiology and a medical degree from the UB School of Medicineand Biomedical Sciences. He completed his undergraduate and master's degree work at iagara University. jaen's research on tobacco dependence and bladder and colorectal cancer has been published in various scientific journals. + Carlos Roberto Jaen, M.D. s preparation for publishing an extensive medical school alumni directory, the Harris Company will begin sending questionnaires to all alumni with current addresses. Please be sure to complete and return your directory questionnaire as soon as possible to help make the School of Medicine and Biomedical Sciences' new directory as complete as possible. Alumni who fail to return their questionnaires may be inadvertently omitted from the directory. + y 5 c o n s m m e 9 9 3 �A Spoonful of Humor © Stu Silverstein, M.D. Health Care Reform It's No Joke • • • Stu Sil\'erswn, M.D., prrs1drnl of Slandup Med1c1ne Unless You Make It One Srm1nars of San Franmco, Califorma, lee lures nal!onw1de on humor in medicine In the previous issue of Buffalo Physician we talked about the technique of revamping old jokes with medical themes for appropriate use when addressing medical audiences. Here are a few jokes and anecdotes about an issue that seems to be appearing everywhere- in the news, on these pages, in our nation~ capital, and maybe even in our practices-the managed care movement in health care reform. • Recently, I was sitting in the doctors' lounge, reading the AMA ews and Buffalo Physician. I spotted a friend reading a government report on health care reform. I asked him why he was wasting his time reading that crap. He looked at the AMA News I was reading and said, "What are you reading about in there? How medicine is changing for the worse- managed care is placing unrealistic restrictions on us, our incomes will be going down, we won't be able to practice the way we used to. "You read that and get all depressed. I read this and find out we're all millionaires, play golf on Wednesdays and will continue to get rich despite health care reform." • I'm not sure ifl feel so good about two lawyers revamping the health care system in this country. Do you get the feeling that after four years in office we're going to get a bill for 35,000 hours for Hillary's services? B a a p h ''Asking the government for advice on how to run health care is like asking Sylvester Stallone for acting lessons.'' • Asking the governmentforadviceonhow to run health care is like asking Sylvester Stallone for acting lessons. • Hillary Clinton reminds me of someone who takes your watch off to tell you what time it is. • I told my son that I wanted him to be a partner in my practice, but it seems the government will beat him to it. • When I played hockey in high school, I spent most of the time sitting on the bench. In the last game of the season, we were down by one goal with one minute to go and no time outs left. The coach called my name to send me in. I turned around to get my instructions and he said, "We're out of time outs and can't stop the clock. Go in there and get hurt. " As a doctor facing health care reform, I feel as if I'm reliving that experience. + 5 c a n 5 u m m e 9 9 �• . ........... ... ... ..... . .................... ... .. . . .. . .. . ......... . ......... . ......... medical practice, and clinical re- governor to the American College search ." Frawley served as presi- of Surgeons for North Carolina. dent of the College from 1981to EUGENE A . PAUL '77 , writes, 1982. "My time is divided between a 1 9 6 0 full-time position as chief of the 5 medical clinic at Harlem Hospital ROBERTA GILBERT '62 , in- and a private general internal forms us that the first printing of medicine practice in Jamaica, ew her new book, Extraordinary Re- York. " lationships: A ew Way of Thinking About Human Interaction, sold out; the publisher is already be- ORESETES G . ROSABAL '77 , Southern Medical Association's ginning the second printing. Bernard S. Stell 1 9 3 State Councilor for Florida, reScientific Assembly of the Asso- laboratory dire ctor at Coastal 0 5 BERNARD 5 . STELL '36, of cently attended the 86th Annual Mi(hael Rowland CALVIN MARANTZ '65 , is now ROBERT B . KROOPNICK '72 , Communities Hospital in Santa Ana, California. Sun City, Arizona, has received was elected to fellowship in the Rosabal, a specialist in orthopaedic American College of Physicians. and traumatic surgery, is in private practice in Hialeah, Florida. the Diamond Star Award in the DONALD J . WALDOWSKI '65 , Kroopnick is board certified in Stereo Division of The Photo- has a solo private pediatric prac- internal medicine with additional graphic Society of America. tice at850 West High Street, Lima, qualifications in geriatric medi- Ohio. cine. pediatrics in Troy, ew York. " 1 9 4 0 5 THOMAS F . FRAWLEY '44 , DOUGLAS H . MOFFAT '79 , recently assumed the position of chief of medicine at Buffalo Psy- WALTER Z. SCHWEBEL '83 , writes, "I am still in the practice of ciation held in San Antonio, Texas. ANTHONY B . SERFUSTINI '66 , RETA D. FLOYD'73,announces chiatric Center. is chairman of the department of the opening of a new office at 924 orthopaedic surgery at the Uni- Buena Vista, Suite 204, Duarte, versity Medical Center in Las Ve- California 91010. Outside of work, EDWARD ROCKWOOD '80 , gas, evada. Floyd is active in her church where practices ophthalmology at Cleve- she is a Sunday school teacher. land Clinic Foundation. He and 1 9 8 0 5 chairman of graduate medical JOHN E . SPOOR '66 , writes, "I She also is active in the Pasadena! education at St. John's Mercy his wife Joan (former Millard have been named the editor of the Altadena chapter of Links - Medical Center and emeritus pro- Fillmore Medical Education sec- Section on Rural Emergency Medi- women's civic organization. Floyd fessor of medicine at St. Louis cine Newsletter- ACEP." lives in Altadena with her hus- University School of Medicine, was the 1993 recipient of the Alfred Stengel Memorial Award presented by the American College of Physicians. The award is given periodically to a Master of the College who has exhibited "unusual loyalty and exceptional con- a DANIEL P . SCHAEFER '81 , a band and two children. 1 9 7 0 retary) have three daughters. UB clinical assistant professor, 5 ELLIOTT SCHULMAN '74, has RONALD H . BLUM '70 , has been appointed deputy director of the Kaplan Comprehensive Cancer Center at New York University Medical Center. been elected a fellow of the Ameri- attended the American Society of Ophthalmic and Plastic Recon- can College of Physicians. In ad- structive Surgery meeting in Dal- dition to lecturing extensively on las, Texas. A member of the Edu- headaches, he is co-director of the cation Committee, he assisted in Comprehensive Headache Cen- giving written and oral examina- tributions to the aims and pur- BRUCE M . PRENNER '70 , was ter at the Germantown Hospital tions to the candidates for mem- poses of the College as well as in Philadelphia, Pennsylvania. bership in the society. outstanding influences in main- invited to present clinical research on asthma before the European taining and advancing the best standards of medical education, Respiratory Society in Vienna , Austria, in August. MICHAEL ROWLAND '75 , of Pinehurst, orth Carolina, was elected to a three-year term as B 0 0 p h 5 c 0 n s u m m e �····· · ················· ··· ··························· ·· ················· · ·················• II • DEIRDRE GREENE '86 , Elliott Schulman writes, JEFFREY WASSERMAN '82 , writes, "Vickie and I now reside in doing pediatrics. My husband, Rob Dixon, and I now have two kids - Patrick,3, andAurora, 16 Rochester, ew York, with our two sons, Robb, age 6, and Steven, age 4. After my residency in anes- months." thesiology, I spent one year as an MICHAEL S . academic anesthesiologist at the University of Rochester's Strong MILLER '86 , writes, "I am an assistant profes- Memorial Hospital. I am now in sor of psychiatry and a full-time faculty member of the University private practice at Rochester General Hospital." of Texas Health Science Center at San Antonio. My wife, Pamela, MARGARET and I have two beautiful children writes, "I completed my pediatric - Laura L. Post Matthew, age 3, and Jeffrey, D . JENKINS a senior fellow in the Robert TINA GARDNER '87 , ROSLYN '86 , R. ROMANOWSKI sion of hematology/oncology and Washington, will receive her MPH in Epidemiology in June 1993. Harvard Medical School instructor, received a five-year Clinical SARAH MURRAY WHITE '85 , Investigator Development Award (CIDA) totaling $385,000 from the National Heart, Lung and writes, "I have recently joined an Washington, D.C., where I practice rehabilitation medicine and perform electrodiagnosis. We are at the Washington Hospital Center. My husband, Bill, son Cameron, two and one-half years old and I live in Annapolis, Maryland. I recently spoke with Gretchen Pankow '87, who will be doing an endocrine fellowship at Massachusetts General (unless she changes her mind)." KARIN E . CHOYS '86 , writes, ''I'm a practicing pediatrician with the Kaiser Permanente HMO in the Hartford, Connecticut area. I am also happily divorced and enjoying 'flying solo!"' address is St. Regis Mohawk Tribe Health Services, do Community Building, Hogansburg, ew York. LAURA L. POST '87 , SHAUGHNESSY '86 , writes, "I have moved back to Boston with my partner, Rick, and combine private practice, mental health center work and a teaching appointment at Harvard Medical School and McLean Hospital." RAY 800RADY '87, has been medical director of Operation Concern, a lesbian/gay community mental health and services agency in San Francisco. She is active in research on lesbian mental health in addition to having a prolific writing career in women's music and culture. Post and her partner, Judith Avery, R.N.C. , have two sons and one grandchild, Karen, who is 18 months Blood Institute to investigate the erythropoietin receptor - how red blood cells are produced. JAM E S writes, "I have moved to northern ew York and am working for the Mohawks. It's beautiful up here! " Her new a staff physician in the divi- Wood Johnson Clinical Scholars Program at the University of orthopaedic surgery group in old. currently chief of the psychiatry clinic at Massachusetts General Hospital, completed four years in youth psychiatry and will finish a two-year STEPH E N C . SORENSON '87 , informs us that he completed an emergency medicine residency in Louisville, Kentucky, and is pres- fellowship in psychiatry in June. He has accepted a two-year staff position at Harvard. Boorady re- ently in private practice. He marriedJudith Bellville on September 19, 1992, in Louisville. cently attended an international A . MOREY '88, residency at Rainbow Babies and Children's Hospital, Cleveland. After a much-needed hiking trip in New Zealand, I'm beginning a fellowship in adolescent and young adult medicine at the Children's Hospital in Boston." is now director of clinical and regulatory organogenesis in CamM ICHAE L SABOLI NSK I '88 , bridge, Massachusetts. PAUL SHIELDS '88, u a 0 p h y 5 c has a pri- vate practice in internal medicine in Naples, Florida. In October he joined the aples Medical Center, specializing in internal medicine. CHARLES S . P . J E N KI NS '89 , of Chapel Hill, North Carolina, informs us, "Got married. Doing well. Will be hearing the pitterpatteroflittle feet soon. Seeya'll." KENN ETH P . SUN '89 , is cur- rently an anesthesiology resident at St. Luke's Roosevelt Hospital Center, ew York. TRAC I TROUP '89 , has joined the department of family practice convention in Paris. e '87 , "Still in Allentown, Pennsylvania, age 17 months." LAURACINNIE I a 5 m m e 9 9 �• .. . . . . . ................................................................................... I at Group Health , Inc.'s St. Paul Medical &: Dental Center, in St. Paul , Minnesota. 1 9 9 0 ELI Z ABETH CONROY 5 '92 , and her husband jeff, announce the birth of their son, Dylan Reid, on january 8, 1993. She is currently in a dermatology residency at the Cleveland Clinic Foundation . OBITUARIES RUTHERFORD FORD 5 . RUTHER · '41 , died in Dillon Beach, California, ovember 27, 1992, after a long illness. Rutherford was chief of staff and founder of Marin General Hospital in 1955; founder of Marin Organ Bank and Marin County Heart Association. He was the author of over 100 scientific and medical papers. L L OYD M. LEHRER '79 , died February 22, 1993, due to the effects of Behcet's Syndrome. In Beginning with our Autumn 1993 issue, our readers will hove the opportunity to learn more about products and services of interest to them. We ore happy to provide advertisers the opportunity to shore their product information with our unique readership who number more than 10,000. For additional information, please contact our Advertising Manager. addition to his private practice in Houston , he served as an assistant clinical instructor of medicine at Baylor College of Medicine , chair- • man of the department of medicine at Bellaire General Hospital and chairman for public education for the American Cancer So- University ot Buffalo Publications Deportment ciety, where he was honored for his work by the State of Texas. He 136 Crofts Hall is survived by his wife, Susan, and his sons, Benjamin and Michael , Buffalo, New York 14260 of whom he was so proud. Phone: (716) 645-2626 FAX: (716) 645-2313 B a a p h s a n s m m e 9 9 3 ��BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED Non-Profit Org . U.S. Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1993 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1993-Summer Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v27n03-1993-Summer Table Of Contents A list of subunits of the resource. Research Hospital News "He captured my heart in a way that patients aren't supposed to." Managed Care Medical School Graduate Education Alumni A Spoonful of Humor Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v27n03 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1993 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/d780fd2a03a80c9fed4f5662cb58735f.pdf 3aa09c9c1329e25bce74f2157eff2cd7 PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Spring 1993 . '• B~~a~·se of it, 7,367 .Americans will die this year. �Dear Alumni and Supporters of the UB Medical School, BUFFALO PHYSICIAN \ olume ~7 1\ -be- T DIRECTOR OF PUBLICATIONS (ACTING! )- C m 'e ~m1th Pet o he facultv of the Department of Social and PreYentn·e \ledKme and Gynecolog) and Obstetri~s are pursuing the possihilit\· of bemg designated a \'anguard Center for the EDITOR -..anette Tramo;- r_, g, R ART DIRECTOR \!an ] Kegler ASSOCIATE ART DIRECTOR Soa R f rich. STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES 1 John "\~mg',~ );--. \ L ~: Prcslc ~nt fc r Climcal -\ffz s, D.· Jlt EDITORIAL BOARD )r )0hn \ Rich t C r• ..,.." • Wvmen s Health Initiati,·e Clinical Trial sponsored b' the :\atioroal Institutes of Health. This m1tiat1Ye ''as approYed by Congress and is designed to eYaluate the health status vf women and the effect of a selected number of interYentions important to the health of women. Dr. \laurizio Tre\isan and Dr. \lyrosla\\ Hreshchyshyn haw proYided excellent leadership for this important multidisciplinaf\ effort TwentY-four organi::ations are being site-Yisited and it is expected that 15 wtll recciYe the designation of a Vanguard Center UB 1s wn excited about th1s possibdn' because clinical trials arc an important component of our research portfoho, and thts trial in particular, serws to complement our other inil!al!Yes re:.ned to pnman health care, health promotion and d1sease preHntion The staff of the Buffalo Physic tan and 1 keep you abreast of our progress in this Important area ''ill Sincere!~, ~~- R charc de Asia Dr \lo t - r ec ·or !.)r HOl old Bn""~d\ D• R charL Lolhns !), Donald P (.>:>lev '"lr I !an J Dnnnan L>1 fi -"'C'l \ ual-rvc Dr Glen ( res',J-, ]a -es Kd. 1s"'i john ;'>.aughton, ~!.D. \'ice Prcstdcnt for Cli111cal 4.ffairs Dean, Sdwol of \fcdiCIIIL cwd Bio111cdical Sciences L)r harles \lassar ..l ( harles Poganelh L utrc Rc bnson T cmas Rcse ·hal "" Ia ~Lrc ,r Bra<llrv fP'lX s, phen Snaul<ung jerome\ •• .:s !)r ( ): ): ), · 11 ::Jr Dr Dr Dear Fellow Alumni, TEACHING HOSPITALS AND LIAISONS Bato\ ia \ \ \le~ ul (enter Buffa'o C.e •er~. • >Sf nal ~\fh. harl '\rlt n. Buffo o \ \ \le~ c II ( enter t .<lo Pcd'"' C hildren s Ho;m 1! vf Buffale> E'IC c uUnt\ V,Jical ( e ·t.r Me C\ tms;1u,tl Mill. d FIll more t. "rlt.IIs Fr..,"11l '\a\· RC'..,we \ .... k (ancer ns.Hute SISt"rs of C harm • "• nal Dcnn.s \~. ( arriJ, c: fhl ~tJte a· >1 "IIo l m,·cro;;it\ ,. '\._w \ )f c. ,{Ja'o P11, s •• In 1s pu~l sh d quanerh "' t .. State l mvers v < f ew \ ork a• f ff 1lc Sc ..lol of \teL c~ne ., d Dl~:ncc... c 11 '>lllnccs '" c. ·~e '-'f:- c~ vi Pubu... lt c ns. I • ) ~nt free vic Jtg". 1o::~ .,...ni, 1'li uh} 't .:tc --s. r,si<.~nts anc. fnends. frc stalfr~srrve<t e r ght t· e~ .allccp' 11 Jnc Sl. b ni<;.c;Jo 1!...t. hcai.IOn. S lCCe 'ted f H \ddr>ss <JU stions, wmments and submis'i<.."- ~ ~o F c! tor b.IJJ.l'~ Pin s.(.UHl State l nivercoih of t\,;.c'' ' ' k Jt BuffJIJ l nners;t. Pu.>i"cc...:io""'"' ~6\.. oftsHall,b1 J Jlu "C\\ \ 1: k l4l6ll Send address changes to: BuJ ,• PII) '" an 14f ( FS \J<.htwn. l h \1ain~t eet Puffalo,"'cw\or' 1+21+ Cover llluslrolion by Ted Pitts T he excitement mounts as we approach the focal pomt of our -\lumni war- our 56th annual Spring Clinical Day on \lay 1, 1993 at the Buffalo \Iamott. \\'e are expLcting ~arucularly good att.endance this ,·ear for our C\-cle of class reumons going back o\'er )0 years. As) ou h.n e come to expect, we w11l also be presentmg another proYocatl\ e and challengmg cducauonal program that this Year is entitled "Doctor Watchers." This program will highlight the Yarious agencies that monitor physiuan performance and suggest \\a\·s to aYoid unwarranted scrutin). Our energetic ch:urpcrson, Dr. \largaret Paroski, has obtained commitments from an outstanding group of knowledgeable speakers. From Rochester comes Dr. Charles\ acanti, who is presentlY ser\'lng as Chairman of the '\Je\\ York State Board of Professwnal Conduct. Another speaker wlll be '\Janq ' iclsen, \\ell-known Buffalo internist and currenth the Regional ~led !Cal Coordinator of the Office of Professional Conduct. Other local speakers will include Dr Ross Hewitt from the AIDS ser\'lce at Erie Count\ \ledical Center and Dr. \lichael Horan clinical mstructor in pediatrics at The Children's Hospital of Buffalo Our d,stinguished Stockton Kimball lecturer thisyearwill he the American Medical -\ssociation's Dr James Todd, talking about "The '-Jame of the Gaml" As alwaYs, thts program carries four hours of Category 1 C\IE credit. Be sure to look a gam this year at the full Yaricty of Spring Clinical Day poster displavs summari::ing much of the current medical research being done at the UniYersity. \\ e are also Yen· pleased this year to be presentmg for the first time a group of Alumm Achie\·ement Awards at the afternoon luncheon honoring alumni who haYe made outstandmg contnbutions in partJCular fields of medical endeaYor or communit) sCf\"lce And don't forget our popular fridav night reception April 30th at the Center 'or Tomorrow thM th1s year wdl recognize our Reunion Chamnen as thev present for the first time our \lumni Scholarship awards to desen·ing medical students. This Year"s Spring Clinical Da\ \\ill certain I) be memorable and I urge you all to attend. 'I ours truh, Don Caple). \I D .. '70 �0 L p 2 R N G 9 9 3 IJ Research IJ Hospital News II Cluster lllnessese UB med student wins American Public Health Association award. Page 22. Sorting through one of the most vexing phenomena in medicine. m The Waiting Game e Despite advances in transplant technology, one-fourth of the people waiting for organs will die because of a shortage of donors. Leaving them laughing using humor in talks and presentations. Page 25. m Medical School ASpoonful of Humor , Alumni Classnotes ~tanoaro antibiotic therap~ for ear infections calleo ineffectiue. rage ~. New Roswell Park testing helps ensure safety of donated tissue. Page 20. �· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · IJ ' / . girls, he points out, and bottle feeding blood flow, " said Alan Lockwood, M.D., appears to be associated with increased UB professor of neurology and nuclear medicine and director of PET operaotitis media with effusion. In addition, the earlier in life children tions at the Buffalo VA. "This will octors know that ear infections in develop ear infections, the greater their expand the capability for existing and children rise as the temperature falls. risk of suffering recurring infections future PET system," he added. + But what they don't know, says a UB throughout childhood. Other factors such researcher and physician, is how to as family history, allergic conditions and a effectively treat the condition, de- mother's cigarette smoking might increase spite decades of antibiotic use. the risk of otitis media. 'The very fact that otitis media ... in the The standard treatment for ear infecantibiotic era, has emerged as a disease of tions is successive doses of antibiotics, an overwhelming, epidemiologic importance, approach that has resulted in increasing he National Cancer Institute has awarded five multi-year grants totalmust indicate that the treatment of this populations of resistant bacteria, Bernstein ling$1,566,723, to UB-Roswell Park condition has been somewhat of a fail- notes. + BY LOIS BAKER Cancer Institute researchers. ure," saidjoel M. Bernstein, M.D., clinical Richard Bankert, an associate reassistant professor of otolaryngology and search professor from Roswell's depediatrics. Otitis media accounts for more pediatpartment of molecular immunology, received a fourric visits to doctors' offices than any other year, $572,764 infectious disease and is the most common cause of hearing loss in children, grant to assess he Buffalo VA Medical Center will Epstein-Barr ViBernstein writes in Hospital Formulary. receive more than $I50,000 to de- rus (EBV) vacciSome children have ear infections more velop software for its new Positron nation strategies than others- a result, he says, of characEmission Tomography (PET) scan- to determine their teristics or conditions that seem to predisner through a grant developed un- ability to induce pose certain children to the condition. der a cooperative research and de- immunity in laboBoys tend to be more susceptible than velopment agreement ratory mice from between the VA and SieEBV-induced disseminated lymphopromens Medical Systems. liferation. The three-year reBonnie B. Asch, Ph.D., an assistant research project, formed search professor from Roswell's experiunder the auspices of the mental pathology department, received a four-year, $421,795 grant to investigate federal Technology Transfer Act, will allow mammary cell markers in different stages the development of two of progression to malignancy. Carleton C. Stewart, Ph.D., a UB renew software modulesone to compute blood search assistant professor, received a fourflow and one to describe year, $239,499 grant to conduct a multiparameter flow cytometric analysis of metabolism in the brain solid tumors. Stewart, from Roswell's flow using mathematical cytometry facility, also received a threemodeling of biochemiyear, $158,574 grant to study the role of cal reactions. flow cytometryin molecularphenotyping. "Right now there is Thomas S. Mang, Ph.D., a research assono software in our computer system that enciate professor from Roswell's radiation ables a user to measure medicine department, received a three- Standard antibiotic treatment for ear infections labeled ineiTective NCI awards $1.5 million in grant money to UB-Roswell researchers VAMC receives cooperative grant to develop new PET software B a 0 p a n 5 p g 9 �····························································· · ·········· ·· ··············· · m ·~!lj '·' ~~"· '· , . women and 239 Italian women with relation to 16 symptoms during three phases- premenstrual (defined as the week before menstruation), menstrual and the remainder. Results showed that omen from different cultures, livAmerican and Italian ing vastly different lives, experiwomen experienced ence many of the same menstrual nearly the same amount and premenstrual symptoms, a of symptoms overall, State University of New York at while Bahrainian women Buffalo researcher has found. reported fewer symptoms. The study is the first large-scale, popuWomen's experiences lation-based comparison of menstrual across cultures were most cycle distress across cultures. similar during the men"Margaret Mead suggested cramps are strual phase, and least trans-cultural symptoms," said Lisa A. similar during the remainder phase. Monagle, Ph.D., clinical assistant profesSymptoms reported during the premensor of social and preventive medicine and strual phase were revealing, Monaglesaid, lead investigator in the research. "Our because they show that the condition study confirms this, and also suggests that known as premenstrual syndrome (PMS) other symptoms, such as water retention, is not, as some people have suggested, a emotional distress and decreased activity, media-created phenomenon. Premenare experienced trans-culturally as well." strual symptoms common to all three The study compares the experiences of cultures were fatigue, anxiety and cramps. 179 American women, 172 Bahrainian Generally, Monagle found as many differences as similarities between cultures in the prevalence ofindividualsymptoms, but found consistent symptom groups + across all three cultures. . ' . year, $174,091 grant to investigate the use of photodynamic therapy in the treatment of pancreatic cancer. + Menstrual symptoms experienced across cultures,UB study shows BY LOIS BAKER Tacrine found to reduce some early Alzheimer'ssymptoms UB researcher is one of six authors of a study published in the ovember 11, 1992 issue of the journal of theAmericanMedicalAssociation that shows the drug tacrine is effective in reducing some of the symptoms of early Alzheimer's disease. Linda A. Hershey, M.D., associate pro- B u a a p s c a n s p fessor of neurology and chiefof the Buffalo VA's neurology service, performed the study at the Buffalo VA Medical Center with Kerry Donnelly, Ph.D., assistant professor of psychology, and Karen Burch, R.N., clinical nurse specialist. The 20 patients in the Buffalo component of the study were among 468 Alzheimer's patients at 23 outpatient centers nationwide enrolled in the trial. The study involved men and women over 50 who were mildly to moderately impaired due to probable Alzheimer's disease, but otherwise in good health. During the 12-week trial, patients received either a placebo or a daily dose of tacrine. Tacrine-treated patients showed significantly more improvement in memory and language than those receiving a placebo. Physicians and caregivers also noted greater improvement in behavior in the tacrine-treated patients than those on placebo. Patients taking tacrine should be closely monitored for side effects, including liver toxicity, nausea and vomiting, diarrhea, abdominal pain, dyspepsia and rash, Hershey cautioned. + BY n LO 9 I S BAKER 9 9 0 �----- Deaconess establishes area'sfirst pediatrtc long-term care unit v a 0 - couraged to participate in formulating care plans, as appropriate. The 21 pediatric S F beds are being filledinstages,withoccupancyofthefirst two-thirds already completed and the last third anticipated by June. Jan Valencourt, R. ., is the unit coordinator. + he only long-term pediatric care unlt m upstate ew York opened late last year at The Deaconess Center, a division of The Buffalo General Hospital. The 21-bed unit will care for children with congenital defects, specialized medical problems and head trauma. It is the seventh such facility in ew York State. The pediatric unit is the final link in an $8 million renovation and construction project at Deaconess that began in 1989. An earlierphaseoftheprojectadded 38 geriatric beds to the facility, which now has 200 geriatric skilled nursing beds, 21 adult long-term care head trauma beds and the pediatric unit. "A serious shortage of skilled nursing beds for children in the state prompted Buffalo General to develop this specialized unit," said Marilyn ]. Gibbin, BGH vice president for long-term care. "Because of this scarcity, we anticipate referrals from local agencies, as well as downstate and out-ofstate," she added. Gibbin noted that The Children's Hospital of Buffalo served as an early catalyst for the project and trained the unit's nursing staff. Linda A. Kam, M.D., medical director for the new unit, has privileges at both hospitals. In addition to physicians and nurses, the unit's multidisciplinary team includes social workers, audiologists, leisure time activities and educational personnel, nutritional services staff and occupational, speech and respiratory therapists. Families, and the children themselves, are en- B -- sliding glass door to allow for both continuousobservationandquietprivacywhen desired. Each patient room also has a large window to allow for ample natural lighting." The new ICU connects directly to Sisters' new surgical unit, slated to open in March. A new on-call physician room adjacent to the unit has also been added. The renovated units feature time-elapse clocks in patient rooms and nursing stations to facilitate code and drug administration record-keeping, air mattresses with pumps, scales mounted directly onto the beds and hemodialysis hookups at each bed. + Edge appointed chief of Roswell Park breast surgery division tephen B. Edge, M.D., has been appointed head of the Division of Breast Surgery, Department of Surgica I Oncology, at Roswell Park Cancer Institute. Before assuming his position at Roswell last summer, Edge served as assistant professor of surgery at the University of Virginia at Charlottesville since 1986. He is a graduate of Case Western Reserve University Medical School and completed his internship and residency in general surgery at the University Hospitals of Cleveland. He served a threeyear fellowship in surgicaloncologyatthe ationa! Cancer Institute, Surgery Branch. Edge is a principal investigator with the a- Sisters of Chanty Hospital opens renovated critical care units s part of its $42 million renovation project, Sisters Hospital has opened its newly modernized 16-bed intensive care and eight-bed coronary care units. "Both new critical care units offer patients and staff a much larger area," said Sister Mary Kelley, vice president for asset management. " ursing observation stations with recessed lighting and large counter areas overlook generous patient care rooms. Each patient room has a p y s a 5 p g 9 9 3 �. . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .[1] 0 0 p h 111: II!Otlill~ Tue M :'l], Dec 15 l'.l'lZ ................ ... . ,.. _ ......,.,,..... ?& •• _ ?1.8 .. ?1.1_ ,."' .... 18, ';0 1?. 8 17.8_ fS + :~:~- s_ '"··12 .5_ u.8_ s_ ,. ..... ... ..."·'.. """ "'·' ,,. -tZ r• tteftt. 1.11 • ll"ltb't Wed 11 .51 . ...... 1993 , ,8_ BtUi_ 88. 5_ :n.s 39.5_ Jf>.5_ JS. O "'·' ~:1 ..... 2:1.8_ 21 . 8 ' Dlt:rTI:Jil:t .' A topographic corneal scan, showing (at right) an essentially normal eye with mild astigmatism and (at left) an eye with keratoconus (pre-corneal transplant). assigned to a certain power range to produce a color-coded contour map of the cornea. One of the main diagnostic advantages of the new analyzer, Reidy said, is its ability to confirm the presence of certain conditions that previously could only be speculated, such as early corneal abnormalities. Special software added to the $30,000 analyzer allows operators to produce computerized spheric or aspheric contact lens fittings for difficult-to-fit patients. Millard's Eye Department, which has been doing five to 10 exams a week since it obtained the analyzer about a year ago, takes referrals from eye care professionals throughout Western New York, Reidy added. + illard Fillmore Hospitals' Gates Circle facility has become the only facility in Western New York to offer topographic corneal scans using newly developed computerized technology. The hospital's corneal analyzer uses concentric rings of light focused on the cornea to map its shape. Used to determine the presence of certain corneal conditions such as keratoconus, astigmatism and post-corneal transplant torsion, as well as for contact lens fittings and preradial keratotomy mapping, the analyzer uses video technology to capture the rings of light reflected off the cornea and then digitizes the image to produce a full-color print out, according to James]. Reidy, M.D. , assistant professor of ophthalmology and director of the cornea service at Erie County Medical Center. A mathematical formula translates the distance between the individual rings and transforms those distances into corneal power. "The rings are traced by computer, as well as each space between each of the 15 rings along 270 different meridians, and translated into the corneal curvature," Reidy said. The results, he added, are u r.ueon. 050 Millard oiTers first topographic corneal scans in WNY area B .. .,._"' .·-·-_ tiona! Surgical Adjuvant Breast and Bowel Project- a group of cancer researchers that receives support from the ational Cancer Institute. A leader in breast cancer research, the group was a dominant force behind the widespread use of less extensive surgical procedures for breast cancer. A fellow of the American College of Surgeons, Edge is also a member of the American Society of Clinical Oncology, the American Federation of Clinical Research and the Southeastern Surgical Congress. + - B Y N ANETTE T RAMONT KOLLIG Buffalo General Hospital names new head of orthopaedic surgery enneth A. Krackow, M.D. , an orthopaedic surgeon who specializes in hip and knee replacements, has been named head of the Department of Orthopaedic Surgery at The Buffalo General Hospital. Krackow, also named professor of orthopaedic surgery at the University at Buffalo, succeeds Edward H. Simmons, y 5 c 0 n s p M.D. , who had served as head of BGH's orthopaedic surgery department since 1983 before retiring from the position late last year. He remains an active member of the orthopaedic surgery staff. Immediately prior to accepting his new position at BGH, Krackow was a professor, full-time faculty, Department of Orthopaedic Surgery at Johns Hopkins University Medical School. He was also a member of the active orthopaedic surgery staff at Good Samaritan Hospital, Children's Hospital and Union Memorial Hospital, all in Baltimore. Krackow has authored numerous journal articles for peer and non-peer review publications, written four books and chapters for many others. His 1990 book, The Technique of Total Knee Arthroplasty, is used by most of the nation's orthopaedic surgery residents. A member of the American Orthopaedic Association, he is also a diplomate of the ational Board of Medical Examiners, a member of the American Academy of Orthopaedic Surgery, the Orthopaedic Research Society, the Knee Society and the American Medical Association. He is board certified by the American Board of Orthopaedic Surgery. + n g 9 3 0 �() B a 0 p 5 c 0 5 p g 9 3 �Buffo Ia Phy sIcIanS p rl n g 19 9 3 0 �- ~ - --- -- , a British sur~Oil co es across a b~arre ildlioo tumor ilien tindS at ·t stri es wi in a o- e a e It Belt." Since the childhood diabetes cases a decade ago in Poland, researchers have found other outbreaks, and the World Health Organization now hopes that further study can identify environmental agents at work in the disease. But cluster investigations aren't easy, and for every one that adds to medical understanding, many, many more raise unanswered questions, hit dead ends or simply prove to be matters of coincidence. "The cluster phenomenon is very difficult to evaluate," said Alfred S. Evans, M.D. , a 1943 graduate of the UB medical school, winner of the school's 1992 Distinguished Medical Alumnus Award and Yale University professor emeritus of epidemiology. In the UB incident, there were 15 Hodgkin's disease cases among 5,708 faculty, staff and students who once used a building at 4230 Ridge lea Road in Amherst. The New York State health department labeled it a true cluster, noting that the cases occurred at more than four times the national rate. But it also found that the people with Hodgkin's had a number of demographic and medical char- ln midwest Poland, physicians notice an upsurge in childhood diabetes so striking that it looks for all the world like a communicable epidemic. In a building once used by the University at Buffalo, worried faculty and staff members tally the number of Hodgkin's disease cases among their colleagues, then call in the state Department of Health. Clusters of chronic disease are among the most vexing phenomena in medicine. Communicable diseases are by definition subject to outbreaks. But tumors? Multiple sclerosis? What is the small-town pediatrician to make of the third patient this month to be diagnosed with childhood leukemia? Chronic disease clusters are rare, but hardly unheard of. And in some cases, they can yield significant medical insights. After dogged field study, some good hunches and a little luck, the strange jaw tumors noticed in Africa by Denis P. Burkitt, M.D. , in the late 1950s contributed not only to the discovery of the Epstein-Barr virus, but also to theories on relationships between the virus , immunodepression and cancer. 0 B a 0 e Lvmp oma 7 ......... p y c a acteristics closely associated with the disease. ln essence, investigators said the cluster was one of risk factors and probably would have occurred if the same group of people came together anywhere. Unusual? Yes. Reason for alarm? o. ot everyone is satisfied. "I think it was kind of a pat on the head, you know, 'Don't worry,"' said Joel S. Rose, who once worked at 4 230 Ridge lea. "I have colleagues who worked in that building, and I'm concerned about their welfare. " The public in general has grown more concerned about clusters in recent years. Hardly a day goes by at many large public health agencies without a call from someone who's noticed that there's an awful lot of cancer in the neighborhood lately. Many in public health think people have every right to be concerned, and government has been devoting more resources to cluster investigations. But physicians and policymakersstillgrapple with how much to spend in light of other needs. "It's a very important question because the past experience has been that they (cluster investigations) tend to be 5 p g 9 3 �unrewarding," said Curtis Mettlin, Ph.D. , UB research associate professor and director of cancer control and epidemiology at Roswell Park Cancer Institute in Buffalo. "There have been very few instances where a cluster aha lysis has led to disease prevention or control. More often they end up unexplained. There are some cases historically, though, which turned out to be so rewarding. " Cluster investigations are nothing new to medicine. In fact, since john Snow noticed 139 years ago that a London cholera outbreak was concentrated suspiciouslyarounda public-water pump, clusters have been at the heart of epidemiology. And just as that case contributed to the understanding of infectious disease, researchers have long hoped cluster investigations could shed light on diseases like cancer. As far back as the late 19th century there was a cancer-cluster study in Buffalo; a map from it remains on display in the Roswell Park library, Mettlin said. Over the last two decades, cluster cases have jumped from the medical journals to newspapers and television. After the ational Cancer Institute showed with maps in the 1970s that clusters were present in the Northeast, the ew jersey Turnpike would forever be known as "Cancer Alley." In 1978, the ew York State health department found that people living next to iagara Falls' Love Canal appeared to be at heightened risk for miscarriages and birth defects and sent panic through the community when it recommended pregnant women and children under two years leave the area directly adjacent to the site. Residents subsequently did their own health surveys, and under the glare of network television lights successfully pushed for evacuation of the wider neighborhood. john E. Vena, Ph.D. , associate professor in the UB medical school's Department of Social and Preventive Medicine, began his epidemiological work at Love Canal. "It made people aware that there are problems out there that aren't figments of their imagination," he said. B u a 0 p h ." he anyone gets ow e reason or it;' saidK llyAnnBarixa 1v1. ., w o ~tu 1e Ri eLea ortheNew "Yc r S De arttnen Environme~ta a w11e ge s.o many c~ . . e enVIrol)ment 1S 1n e news lot. Rather an thin itS n act Of Go , 1 e ip .e old a, s, ey In .It '' I 5 a s p g 9 3 0 �cause, and the exposures are often high. In neighborhoods, however, the number of cases tends to be relatively small, people move in and out and exposure levels are much lower. "We feel people do have a right to know what's going on in their communities," said Philip C. asca, Ph.D. , director of the New York State health department's Bureau of Cancer Epidemiology. "But I will say this up front- it's very difficult with these methodologies to pinpoint an exposure. " With a five-decade-old cancer registry and cluster investigation units dating to the 1970s, New York is considered one of the leaders in the field. But efforts have been growing nationally.In 1989 the Centers for Disease Control and Prevention, the Association of State and Territorial Health Officials and the Agency for Toxic Substances and Disease Registry held a two-day conference on clusters. They followed up with a set of guidelines for health agencies, published in the CDC's july 27, 1990, Morbidity and Mortality Weekly Report supplement. According to the guidelines, clusters that might yield important findings share several characteristics: "Usually such a cluster has a definable health outcome, either new or rare; a potential exposure or agent is suspected, along with a connection between the exposure and the health event; the situation is highly unusual, and statistical testing confirms the investigator's impression; and the short-term public health impact is immediate and self-evident. " Few clusters make the grade. "More clusters are due to a chance occurrence of rare events, what I've heard some people call the 'expected unexpected,"' said Ward Cates, M.D., M.P.H. , director of training in the CDC's Epidemiology Program Office. "just by chance alone, these things are going to occur." Some initial cluster reports come from Frequently it is related to the environment, or at least to where people live. Many chronic diseases do follow geographic patterns. Multiple sclerosis is more common in temperate climes. So is Hodgkin's disease. But why? Is it something in the air? Better diagnosis and reporting of cases? Or something else? Burkitt found that his jaw tumors occurred only below a certain altitude, later realizing that temperature was the critical factor. He also found correlations with rainfall. Then someone suggested he compare his maps of tumor incidence with maps of intense malaria cases. Bingo. Eventually Burkitt came to believe that the Epstein-Barr virus, in the presence of immunodepression brought on by longterm malaria, could cause "Burkitt's lymphoma." Today, the relatively frequent clustering of diseases like multiple sclerosis and Hodgkin's have bolstered theories that viral agents are at work there, too. In many cluster cases, pollution is also a suspect. Animal tests have linked anumber of chemicals to cancer. And some studies have found a correlation between high cancer rates and proximity to chemical plants, hazardous waste sites or ground water contamination. "There's no question that clusters could occur with an appropriate exposure," Evans said. Proving it is another matter. To document an environmental connection to a cluster, he said investigators should show a relationship between incidence and the duration of and proximity to the suspected cause. They should also study a large, comparable area that is free of the suspected cause. All in all, he said, it's a daunting task. In occupational cases, particularly industrial ones, investigators can at least document how long a person has worked and been exposed to a suspected disease B u 0 0 p s c 0 n physicians, but the vast bulk are made by the general public. In New York State last year, the health department's Bureau of Cancer Epidemiology received 328 phone inquiries. "We've always sworn that right around Christmas time, when people get together at parties, we tend to get a lot," said Nasca, who earned his Ph.D. in epidemiology from UB's Department of Social and Preventive Medicine. Of the hundreds of cluster reports annually, asca said about three-quarters go no further than the initial call. The department has an ombudsman to handle the reports, many of which involve a variety of cancers. After asking some questions, the ombudsman is usually able to tell the caller that there's nothing unusual going on. "Lay people have the idea that no matterwhat the disease is, it must all be caused by the same thing," said Brix. "We have to do health education and explain to people that first of all, cancer is very common, unfortunately. One-third of Americans will get cancer at some point in their lives and one-fourth will die of cancer." If there does seem to be something unusual, the department will check its cancer registry, and that often resolves the issue. For instance, asca said, a report of four brain tumors on one block will raise eyebrows, but on checking the registry investigators may find that the tumors all metastasized from different sites, greatly reducing the likelihood of a true cluster. If the registry confirms the report and sometimes it reveals even more cases -the department calculates whether the number of cases really are more than would be expected. Nasca said investigators work with local citizens and health officials to draw boundaries for the study area, taking local concerns and scientific needs into consideration. "If it looks like nothing is going on, we write up a long report as well as a simpler 5 p g 9 �executive summary," he said. The reports go to local health officials and concerned citizens. When a study confirms there are more cases that expected, investigators interview the patients, asking about medical history as well as lifestyle, occupation and where else they have lived. In eight cases last year the department went at least as far as checking whether the observed cases were more than expected, and as of early this yearthere were 19 other such studies under way. "In some cases we have confirmed some excess," asca said. "The real problem is trying to confirm some etiology." Given that, resource allocation is one of the biggest issues facing cluster investigators. asca feels that as long as clusterinvestigation units carefully target their studies and help educate the public in cases that don't merit investigation, their cost is well worth it. But he notes that the state is also working on cancer research, intervention and prevention. "I would not want to see cluster investigations draw staff from those other important areas," he said. + B 0 0 p y 5 c 0 5 p n g 9 9 �- --- ---~- - ~----- ' I Questions still remain I B y a 0 N 0 R E W 0 A N Z 0 relations aspects of their task as well as the and indicators of pre-existing immunological problems, also risk factors. And scientific issues. At Ridge Lea, things got off to a bad several had family members with start. The investigation officially began in Hodgkin's. All were at risk for the disease 1989, but after two years little had hap- before ever setting foot in the building. pened. Two people with Hodgkin's died "We don't think there's anything in without being interviewed by the health that building that would make it unfit for department, Hastrup said. And people human occupancy," Brix said. "These who had used the building were not alerted people had a very high prevalence ofknown to seek early treatment if they had risk factors associated with Hodgkin's disease. I'll be honest, I was surprised at how Hodgkin's symptoms. After a letter from 50 faculty, staff and well they fit the pattern. " students and some pressure from the adHastrup doesn't buy it. 1f you had a ministration, the health department as- group with an unusually high rate ofbreast signed Brix to the case in 1991. cancer, she asks, would you be satisfied She documented 15 Hodgkin's cases simply to know that the victims were among the 5,708 faculty, staff and stu- women? She said the cluster can't be exdents who used the building the most plained by risk factors without knowing while it was part ofUB's temporary Amherst how common those factors were among campus from 1969 to 1986. The incidence everyone who used 4230 Ridge Lea. "I don't think the health department's was more than four times the rate for the nation as a whole and more than three explanation is sufficient," she said. "What they're basically asking us to do times the rate for upstate New York, where Hodgkin's is more prevalent than it is is a 45-minute interview on over 5,000 people," responded Brix. "It's an enornationally. The health department tested the build- mous use of state resources, and there's no ing for chemicals, ionizing radiation and scientific reason for it whatsoever. " Clifford B. Wilson, UB associate vice magnetic fields. It found nothing unusual. But, Brix said, she did find something president for student affairs, said he acunusual among the people with Hodgkin's. cepts Brix's conclusion. He said he would They were of higher than average socio- rest easier if there were something more economic status, which previous studies concrete than risk factors to explain the have found to be common in people with cluster. But, he added, ''I'm not sure what + the disease. Many had had mononucleosis more one does. " Overtheyears,janicel. Hastrup, Ph.D., sensed that something was wrong. In talking with other UB faculty, staff and students who used the temporary building at 4230 Ridge Lea Road in Amherst, Hastrup heard about four with Hodgkin's disease. It seemed like a lot. Then, in 1989, there were two more cases. Hastrup, an associate professor of psychology, called the ew York State Department of Health. Last summer the health department confirmed that there indeed had been a Hodgkin's disease cluster at 4230 Ridge Lea. But it said the cluster had more to do with the backgrounds of those who were sick than with the building they shared. UB accepts the findings. Hastrup and several others who used the building don't. "It's better to say you don't know than to say you've explained it when you haven't," she said. "We did a very thorough investigation both on the health side and the environmental side," countered Kelley Ann Brix, M.D. , of the health department's Bureau of Environmental and Occupational Epidemiology. Cluster investigations frequently fail to satisfy the people who requested them. Cover-up charges are so common that guidelines published by the Centers for Disease Control and Prevention suggest investigators be sensitive to the public B A p 5 a s p 9 9 �B u f f a l a P h y s I c I a n 5 p r 1 n g 1 9 9 3 6) �y I B I 5 c i r D u 0 s t 5 p n i a n g e 0 9 s �z r w y b T e e c i p d i k t s t It will be a deadly one for 7,3&7 of the 29,4&9 Americans waiting for organ transplants. B u a 0 p y s c a �odern medicine has come a long wa~ Docto~ but in this day of xe- nograft transplants from baboons and microscopic cookie cutters for replacing human corneas) a frustrating dichotomy exists. Under its end-stage renal disease program, the federal government spends $3.5 billion a year to treat patients who could be taken off dialysis if donor kidneys could be found. And, the average ICU patient awaiting a liver transplant runs up costs of between $1 ,000 and $2,000 a day. The donor shortage, according to kidney transplant surgeon Sidney Anthone, M.D., needs to be addressed from both an educational and a legislative point of view. Anthone chairs an ad hoc committee for the United etwork of Organ Sharing (U OS) - made up of the country's 75 regional organ sharing centers and their computer networks- which has among its goals the integration of the organ donation process into medical school curriculums. "Curriculums are crammed already," notes Anthone, professor of surgery at UB. "But a curriculum has been written by U OS for nurses, medical students and neurosurgeons. It is now a matter of putting it into the schools and promoting it, having somebody who will go around and stampede for it." Indeed, the organ procurement movement needs a P.R. boost. It's a life-anddeath matter for the 22,415 Americans who, as of]anuary 1993, were waiting for Tremendous diagnostic, surgical and treatment advances have brought organ transplantation into a new era. But the single biggest obstacle to hope for the nearly 30,000 Americans awaiting organ transplants is a shortage of healthy individuals willing to make the vital choice to donate such organs when they or their loved ones die. In the laboratory, enhanced tissue preservation media and immunosuppressive drugs are developed. Dramatic methodologies for accurately matching donor and recipient cells are devised. Twenty-first century surgical instruments and techniques are mastered. But in hospital intensive care and hemodialysis units, the number of patients whose survival depends on new organs swells by 5 percent each year. All the milestones and medical advances in the world simply don't work without organ donors. Transplant surgeons and organ procurement officials agree that despite required request laws and similar recentlyenacted measures, a critical donor shortage remains. The average wait for a kidney transplant increased from 126 days in 1988 to more than a year in 1991. Some potential kidney recipients wait more than five years for the right donor to surface. B u 0 0 p s 0 s donor kidneys, the 2,321 awaiting liver transplants and the 2,686 who needed new hearts. Add to these statistics 127 patients in need of a pancreas, 775 who needed joint kidney/pancreas procedures, 964 awaiting lung transplants and 181 who needed heart/lung procedures. The numbers are sobering, even more so when one considers that 25 percent of these patients will not live to realize a second chance at life. "The waiting lists are so long because individuals are being diagnosed more rapidly with end-stage organ disease," according to Elizabeth A. Me amara, R.N. , M.S.N. , director of procurement at The Upstate ew York Transplant Services, Inc. "More patients are coming in sicker and being diagnosed quicker. "Individuals waiting for heart, lung, liver and heart/lung transplants usually end up becoming very ill before their transplant. Sometimes, they're too ill to undergo the surgery," she adds. jacob Bergsland, M.D., assistant professor of surgery at UB, is a cardiac transplant surgeon affiliated with the Buffalo Heart Surgical Associates. He echoes Anthone's concerns about the donor shortage and elaborates on an added wrinkle for patients awaiting hearts instead of kidneys. p n 9 9 9 3 ' �; "The nature of the .. problem for cardiac patients is that, unlike dialysis for kidney patients, we don't really haveaback-upsystem, except for mechanical devices which are not perfected. Our patients tend to die within one or two years unless they're transplanted. Also, each donor has only one heart, versus two kidneys," says Bergsland. While Bergsland sees a "stagnation" in the number of potential heart donors, he adds that "the number on the waiting list slowly goes up, though it is limited due to the nature of heart disease." Further contributing to the problem, according to the cardiacsurgeon, has been the recent explosion in the number of heart transplant centers nationwide. Of the approximately 2,000 cardiac transplants perfomedannually, about 75 percent are done in the United States. As of December 1987, there were 114 heart transplant centers in the country, according to U OS. By 1988, the year the first ew York State-certified center was established at The Buffalo General Hospital, this number had grown to 135. Today, there are 158 cardiac transplant centers. "There are too many centers," emphasizes Bergsland. "Fifteen hundred transplants ... is not enough [per center] to keep people in shape to perform these operations. Also, the cost goes up with B 0 0 p fewer numbers, and it's more difficult to answer key scientific questions. For a successful clinical study, you need more patients per center. It is society's responsibility to make sure this is handled properly. Transplant centers can't be used for advertising or prestige purposes." The cloud hanging over progress in transplantation does, however, have a silver lining. Several of them, in fact, as illustrated by recent technological breakthroughs in such areas as tissue matching, surgical procedures, tissue and bone preservation and immunosuppressive y s c 0 5 p agents to battle organ rejection. Kathleen Polanski, a Buffalo-area school bus driver, was diagnosed with systemic Iu pus erythematosus at the age of 16. Within six years, her disease had caused kidney damage so severe that dialysis was the only answer. Standing in the way of a successful transplant was the fact that her lupus produced various antibodies that reacted not only with potential donor tissue, but with her own as well. Three times, positive crossmatches between Polanski and potential donors ruled out transplant surgery. Crossmatch procedures to manually and visually measure antibodyreactivity failed to distinguish between antibodies related to the patient's lupus and · those which could have caused rejection of a donor organ. The answer to this dilemma and an increasing number of perplexing cases-lies in flow cytometry, a process of tissue matching that uses laser beams to measure the light properties of various types of tissue cells. Only 12 facilities nationwide are accredited by the American Society for Histocompatibility and Immunogenetics to use flow cytometry as a predictive index in transplantation. One is at Buffalo's Erie County Medical Center and directed by Thomas C. Shanahan, Ph.D., associate professor of microbiology at UB. In addition to lupus patients in need of n 9 9 �ecause it offers this heightened degree of sensitivity in detecting immune responses and helps eliminate some candidates from unfair exclusion from organ transplants) flow cytometry is a giant step in addressing the organ donor shortage. techniques for pancreas implantation as the most promising area of development in his field. Utilizing a process known as the bladder drainage technique, in which the duodenum is anastomosed to the bladder, surgeons are now able to implant the pancreas along with a section of the duodenum. This has resulted in reduced rates of post-operative complications and improved chances of detecting early organ rejection. Kidney/pancreas transplants, performed routinely for only the past five years, are vital to approximately 4,000 Americans each year, most of whom have been diabetic since their youth. Breakthroughs in surgical technology have led to new promise for patients who need cornea transplants, as well. Transplant surgeon james]. Reidy, M.D., cites the example of the surgical microscope and the trephine blade, the latter of which is now used in 75 percent of cornea transplant cases. "The trephine blade is basically a hightech cookie cutter," explains Reidy, assistant professor of ophthalmology at UB. "It looks like a small, round cutter with a razor-blade edge, and it cuts a circular transplants, flow cytometry is effective in cases ofindividuals who take certain drugs, such as hydralazine for hypertension and procainamide for heart disease, which produce antibodies similar to those lupus patients produce. "Old methods [of tissue matching] couldn't distinguish between harmful and non-harmful antibodies. Therefore, some patients were unfairly excluded," explains Shanahan. "In some cases, patients' antibodies may react against tissue, but this may not rule out a transplant. These patients may produce antibodies which mimic rejection." Because it offers this heightened degree of sensitivity in detecting immune responses and helps eliminate some candidates from unfair exclusion from organ transplants, flow cytometry is a giant step forward in addressing the organ donor shortage. In Polanski's case, it allowed her surgeons to perform a successful kidney transplant in 1989. Rabie Stephan, M.D. , a transplant surgeon and clinical assistant instructor who is working to establish a kidney/pancreas center based at UB, sees new surgical B u a 0 p 5 c a n 5 hole in the cornea. It is used to cut out damaged corneas and replace them with donor corneas, which are sewn in with stitches one-third the diameter of a human hair. " The story of a patient who literally has a brighter outlook on life as the result of these amazing instruments is perhaps their best testimonial. Marilyn Foit, a suburban Buffalo woman in her mid-40s who is working toward a masters degree in special education, literally couldn't see to read the blackboard before Reidy transplanted her left cornea in 1987. Five years later, she underwent a transplant in her right eye. She had suffered since her childhood from keratoconus, a cornea disease that causes progressive astigmatism and had rendered her legally blind. Following the success of her first transplant, Foit returned to school. "I started school 20 years ago and I've finally been able to return," she says triumphantly. A year after the first transplant, when her cornea had sufficiently healed, Foit was fitted with a standard contact lens to replace the cumbersome, uncomfortable p n g 9 �"The donor situalens she had been tion is pretty good in forced to wear to corBuffalo," says Edward rect her vision. "I H. Simmons, M.D., UB looked in the mirror professor of orthopedic and started laughing surgery. "Thesupplyis and said to the techniapproaching the decian, 'I've aged 20 mand, within reason. years!' I could finally Once bone is tested, culsee! It was the same tured and frozen, it can What this country needs is more of a "can-do" attitude about feeling l had when getbe kept indefinitely. " tingglasses at age nine. organ and tissue donations. Misconceptions such as these are Bone allografts are typiAll of a sudden, life cally either frozen or a big part of the reason why nearly 30,000 Americans can only became easier," she freeze-dried, depending recalls. wait - and hope for a second chance at life: on whether or not the Fait's right eye is accompanying cartilage still healing; in her left MYTH: ''I'm too old to be a donor. " must be preserved. eye, she enjoys 20/20 FACT: Organ and tissue donors range in age from newborn to 70 Bone grafting is vision with a standard years. probably the oldest contact lens. form of transplantation, MYTH: "My loved one's body will be disfigured. " Compared to the according to Simmons. FACT: Skilled surgeons harvest organs and tissues in such a way that dire shortage of organs He notes that autothe body is in no way visually marred by the surgery. such as kidneys and genous spine fusion hearts, donor corneas MYTH: "He never signed a donor card, so we can't agree to give up his procedures were perare relatively easy to organs." formed in the United find. Because tissue FACT: Signing a donor card is important, but not necessary. ext of States as early as 1911. matching generally is kin have the final say regarding organ and tissue donation. "When bone graftnot required because ing was first being done, the cornea is avascuMYTH: "It's against my religion. " all grafts were autoglar and corneas may FACT: Today, every major U.S. religion supports the concept of organ enous, and a patient's be preserved for up to and tissue donation. own bone continues to two weeks after harbe the gold standard vesting, a generous MYTH: "Organ donation is expensive." against which all others number of eligible FACT: A donor bears no financial responsibility for the costs related are judged," notes Euto transplant surgery. -Diane Zwirecki donors exists. Each gene R. Mindell, M.D. , year, 40,000 corneas professor of orthoare transplanted in the plant patients is the fact that, although 10 paedics and director of UB's division of United States. "Corneas may be harvested up to six to 20 percent of patients suffer rejection orthopaedic oncology. "However, 20 to hours after death," Reidy says. He sees the episodes, 90 percent of these can be treated 30 years ago , it was discovered that the development of specialized preservation with topical eye drops that are not only sites from which grafts were taken somemedia as a milestone and describes this effective but inexpensive. The drops cost times had residual disease symptoms. And, media as "similar to that used by scientists between $5 and $30 for a month's supply there were situations oflarge defect where - compared, for instance, to immuno- much bone was needed. Then, surgeons to grow cells outside the body." Unlike organs that derive their nutri- suppressive agents for renal patients that began to use bone allografts. " Allografts are common in cases oflimb tion from the body's blood supply, cor- may cost in excess of$100 for 100 tablets. cancer, severe trauma and total joint failSupply and demand come close to a neas derive oxygen from the atmosphere balance for patients who need bone graft ure. "In order to save a tumorous limb, and glucose from inside the eye itself. It is this difference in makeup that makes this procedures to treat cancer, trauma, failed surgeons dissect 10 to l2 inches of that joints or similar orthopaedic problems, limb and fill the defect with cadaverous type of preservation possible. bone," explains Mindel!. "If a total hip or Also working in favor of cornea trans- according to UB surgeons in this field. Organ Donations ~e~un~ln~ t~e m~t~s B a a p s c a n 5 p g 9 �knee which has been in place for 10 to 15 years fails, reconstruction is done to avoid a shortened leg after joint removal. The use of allografts in these cases is increasingly common." Fresh-frozen grafts are necessary in cases where cartilage as well as bone must be preserved to ensure a successful transplant. lf cartilage is not needed, freezedried bone is sufficient. Approximately 25 bone banks nationwide provide both large bone and bone/ cartilage allografts. In Buffalo, Mindell performs a bone graft every one to two weeks, includingseverallimb-sparing procedures each year. Transplant surgeons in various disciplines agree that improved immunosuppressive agents, several of which have become available only during the past few years, have led to great strides in the success of organ transplantation procedures. Kidney recipients usually rely on one of three kinds of immunosuppressants: cyclosporine, steroids or imuran. A new weapon in the arsenal is known as OKT3 . "OKT3 is directed against cytotoxic lymphocytes, as opposed to other immunosuppressive agents which are non-specific to the lymphocytes that cause rejection," says Anthone. In the realm of cardiac transplants, a new drug known as FK 506 bears some similarity to cyclosporine, according to Bergsland, who notes "most patients have some type of rejection, usually during the early phases following a transplant." A single donor can help as many as 200 people in need of new organs and tissue. Technological history is made over and over via the introduction of new equipment, new drugs, new talent and new techniques. But for those who are waiting, the numbers and the scientific breakthroughs often don't add up to a healthy, hopeful future. Unless more people are willing to donate organs and promote the concept of organ donation, the waiting game for many potential organ and tissue recipients will be lost. + B a a p h y s a 5 p 9 9 9 3 �Roswell Park uses PCR diagnosis to help ensure the safety of potential organ donations n a first-of-its-kind agreement in New York State designed to ensure that transplanted organs and tissues are HIV-free, Roswell Park Cancer Institute has recently been commissioned by Upstate New York Transplant Services (U YTS) to perform polymerase chain reaction (PCR) diagnosis on all potential donor specimens. "Concerns about undisclosed HIV infection were underscored earher this year in reports published in the New England journal of Medicine and the journal Lancet, which documented cases of HIV -infected individuals who had tested negative on serological examination and who were inadvertently used as tissue or organ donors," according to Steven]. Greenberg, M.D., UB assistant professor of neurology and chairman of the Roswell's neurology department. Greenberg, who came to UB two years ago from the National Institutes ofHealth, says that with PCR testing, "basically, we can ask, 'Is there a retrovirus present?' Unfortunately, if an individual is HIVinfected, it can take up to six weeks before an antibody level can be detected by normal serological techniques. This is a more sensitive test which can be done rapidly with a turnaround time of only about eight hours." Steven J. Greenberg, M.D., in his lab at Buffalo's Roswell Park Cancer Center. B u 0 0 p h Greenberg attributes the relatively recent capability to test potential donor tissues and organs not on the PCR technique itself- which already existed and, in fact, is routinely used in forensic science to type blood products and semen - but rather, on "a rather ingenious application of existing methodologies and an existing understanding of how molecular engineers put things together. "What has helped to automate the process and make it more widespread," he adds, "have been the more recent developments. The technology had to play catch up. " Greenberg credited the development of the automated DNA thermal cyclerwhich runs the PCR based on a software program the investigator downloads and the cloning and production-scale availability of a thermal-stable polymerase enzyme. Consisting of three separate reactions "repeated ad nauseum ," according to Greenberg, PCR "allows one to take a needle in a haystackandamplifyit to make a haystack full of needles." The "haystack full of needles" is the amplified genetic material- be it virus, bacteria, fungus or protozoa- of whatever the investigators are testing for. In the first step of the reaction, performed at high temperatures , duplex strands of DNA are melted apart. The second - or annealing step - "allows primers to anneal with either strand of the DNA to , therefore, frame the genetic tar- 5 a n 5 p get of interest," according to Greenberg. The final step is the polymerization step, in which DNA is synthesized for the ends of both primers, using DNA as a template. The reaction doubles the amount of existing material, which then is synthesized exponentially. The amount of material- of "haystacks full of needles" depends on the amount of cycles the reaction is programmed for. For 30 cycles, for instance, the material- synthesized exponentially - is multiplied by one billion. "There are two main reasons for using this," Greenberg explains. "It is excruciatingly sensitive, and independent of a host immune response. " That independence from the host immune response will help eliminate the "window of vulnerability" between the time a person is actually infected and his immune response is activated that often exists in the screening process for donor organs and tissues. According to Eugene R. Mindel!, M.D. , director of UB's division of orthopaedic oncology, "the number-one question I hear from patients is 'will I get AIDS from my allograft?"' And though the safety of this and other transplant procedures has greatly increased, the AIDS question continues to permeate all aspects of medicine - transplantation being no exception. Answering this query can only help to enhance the overall success rate of organ and tissue donation. + - N AN ET TE TRAM O N T 9 9 9 K O LLIG �I - • ---------------- ·· ·· ··· ····· ····· ··· ··········· ······· ·· ····· ·· · ········ · ·· ······ ······ ······ · ············ ······ ~ I lie health professionals. Mahoney wrote his doctoral dissertation on temporal mortalitypattemsamong the Seneca Nation oflndians, the first such study to have been done wi.th the Senecas. The study compares the mortality rates among specific age groups within the Seneca Nation to the mortality rates of other New York State residents in the same age groups. The research found unusually high mortality rates among the Senecas, especially due to cancer. The study has lead to a refinement and refocusing of the Seneca ation's public health programs, pinpointing specific areas, such as cancer, which wi.ll receive Med student winsAmerican PublicHealth research award artin C. Mahoney, Ph.D. , has won the 1992JayS. DrotmanMemorial Award from the American Public Health Association for his work in public health. Mahoney, a member of the class ofl995, received the award and presented his research at the APHA's annual meeting last ovember in Washington, D.C. The award, established in 1979 by Peter Drotman in memory of his late brother, recognizes promising young pub- B a 0 p y a n 5 more attention and further research. Mahoney earned his master's and doctoral degrees from UB. He has been a research scientist with the New York State Department of Health Bureau of Cancer Epidemiology and director of the bureau's Cancer Surveillance Program. He is a founder and member of the steering committee of the ational Cancer Institute's Network for Cancer Control Research in American Indian and Alaska ative Populations, and has initiated a survey of state public health agencies' sponsorships of cancer prevention and control services for Native Americans. + p n g 9 9 �Donald Rennie,M.D, senior UB counselor and vice presideni dies onaldW. Rennie,M.D.,67, a former UB vice president and vice provost, died December 28, 1992, in Myrtle Beach, South Carolina, while on vacation. A senior counselor to UB President William R. Greiner, Rennie had served as a faculty member in the department of physiology at the medical school for 34 years. He was named vice president for research in 1980 and assumed the additional responsibilities of vice provost for research from 1990 until last December, when he was named a senior counselor in the areas of research and sponsored programs, a position of cabinet rank. Greiner described Rennie as "a wonderful, sensitive and wise person; a man who all of us really admired. Don was our senior counselor for the last 10 years, someone Steve Sample and I wanted at the table for his wisdom." Rennie joined the UB faculty as an assistant professor of physiology in 1958. He was promoted to associate professor in 1962 and named a professor in 1966. Rennie was a visiting professor at Laboratorio di Fisiologia at the University of Milan, Italy, from 1966 to 1967. In 1968, Rennie assumed the responsibilities of associate chairman of the UB physiology department, was named acting chairman in 1971 and served as department chairman from 1973 to 1980. While serving as a vice president and vice provost, Rennie continued to teach physiology. Rennie received his medical degree and a master's degree in physiology from the University e u 0 0 p h of Oregon School of Medicine. He did a postdoctoral fellowship there as well as at Harvard Medical School. A member of the editorial boards of the American journal of Physiology and journal of Applied Physiology, Rennie had served on the Porter Fellowship Committee of the American Physiological Society, Test Committee for Physiology of the ational Board of Medical Examiners and as an ex-officio member of the Educational Committee of the American Physiological Society. Donations in his memory can be made to the Donald W. Rennie Memorial Fund, in care of the University at Buffalo Foundation, and sent to the Department of Physiology, University at Buffalo, 122 Sherman Hall, Buffalo, NY 14214. + B Y ARTHUR PAGE needed for optimal function. A member of the American Institute of Nutrition, the American Association of Cancer Research and the American Heart Association's Basic Science Council, Spence joined the UB faculty in 1980. He was appointed associate dean in 1988 and held a joint appointment as research asso+ ciate professor of nutrition. Above, about 50 physicians attended the second annual "Prep for Practice," held last October. Below, about 200 students, staff and alumni attended this year's senior reception at the Marine Midland (enter. Spence leaves UB to head USDA research center in Maryland oseph T. Spence, Ph.D., former associate dean for research and graduate studies, has become the new director of the U.S. Department ofAgriculture's Beltsville, Maryland, Human utrition Research Center. Below, faculty and staff view the exhibits entered in the 12th annual Medical Student Research Forum. ter - one of five nutrition research centers operated by the USDA's Agriculture Research Service. He oversees nutrition studies ranging from how many calories are burned in today's lifestyle to how much of the ultra-trace elements chromium and selenium are y s c 0 s p n 9 9 �· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ll 1/ ~iJ ~ I UB wins Robert Wood Johnson Foundation planning grant B's School of Medicine and Biomedical Sciences has received a $150,000 grant from the Robert Woodjohnson Foundation to plan new ways to select and train students to become primary care physicians. UB is one of 18 medical schools, selected from 83 applicants, participating in the first phase of the foundation's Generalist Physician Initiative to increase the number of pediatricians, general internists and family practice specialists. As a recipient of a planning grant, UB is in a strong position to secure a $2.5 million implementation grant from the foundation. "UB's medical school and teaching hospital system are honored to be numbered among the 18 recipients of a Robert Wood johnson Generalist Physicians Grant," said B a a others about their use. joseph L. lzzo, Jr. , M.D., professor of medicine and pharmacology and program director, said specialists with a knowledge of drugs and drug interactions are in critically short supply. "The shortage of clinical pharmacologists is occurring at a time when the number of new drugs under development and the need for drug-related education are at an all-time high," lzzo said. The program - one of four nationwide - is expected to grant two or three fellowships for the first year. The fellowships are aimed primarily at physicians who would choose clinical pharmacology as a subspecialty, but qualified doctoral candidates also will be considered, lzzo said. The UB program offers two avenues of entry: a two-year certification program following a residency or other postdoctoral training, or a unique four-year program combining a residency in internal medicine with a clinical pharmacology + fellowship. john P. aughton, M.D., vice president for clinical affairs, dean of the medical school and director of the project. "The faculty is committed to developing an outstanding educational experience to help correct a major manpower deficiency in American health care. This grant will help develop throughout our region those programs necessary to encourage future medical students to become generalist physicians." The medical school launched its own primary care initiative in graduate medical education last September, unveiling a $5 million demonstration project involving six Buffalo teaching hospitals, Medicaid and four private health care insurers. The Robert Wood johnson initiative aims to reach students even earlier, starting at the high school, undergraduate and medical school levels. One project involves working with the 14 area hospitals to identify promising high school students to work during the summer with community physicians. Projects are also underway to increase the emphasis on primary care in the medical school curriculum and add more out-ofhospital teaching sites. The Robert Wood johnson Foundation, headquartered in Princeton, ew Jersey, is the nation's largest philanthropic organization dedicated to improving health + care in the United States. B Y L o 5 B Y LOIS B AKER BAKER UB receives clinical pharmacology grant to launch pilot program he University at Buffalo has received a $3 million grant from the U.S. Food and Drug Administration to establish a pilot program in clinical pharmacology aimed at relieving the shortage of specialists trained to develop and test new drugs and teach p s c a 5 p n 9 9 �A Spoonful of Humor © Stu Silverstein, M.D . Leaving them laughing Think back to the last conference you attended. That first lecturer, he watss~t~h~e;::::;::;::;:;;::;::::=; obel Laureate from ew Zealand .. you came to hear. His CV is recited in a British accent by the chairman of neurology (who was raised in Brooklyn) . This world-renowned speaker approaches the podium and begins to speak. You become intrigued by the stain on his jacket and obsessed with the phone bill you forgot to pay, or did you pay it ... or didn't you? The lights go out, the slides go up. You close your eyes for "just a second" because of the lead in your eyelids. It's now 11:30; the lecture ended 45 minutes ago. All you remember is his bowtie and your drool-covered collar. What went wrong? Why do some people grab the audience's attention from the start? Chances are they use humor in the form of appropriate, wellplaced jokes, anecdotes and asides. But most people claim they can't use humor in their talks for a number of reasons. Theoneihearmostis, ''I'm not funny ," or, "Ican'tcomeupwithmaterial." While it's true most people are not naturally funny, most don't know how to ice skate erence becomes naturally either (including members of How do you the Buffalo Sabres), but it is something make a small fortune in medical practice? that can be learned. And coming up with Start with a large one. the material is not as hard as you think. The same can be done with anecdotes. One of the easiest ways is to "switch" an Here is a switched joke to a medical theme. old joke and replace the details with mediAt the circus, a strongman takes a lemon cal references. The result is a new joke that and squeezes it. At first, the juice dribbles is essentially original. Comedy writers did out quickly, then slows down until not a this during the past four years, when Pol- single drop comes out. The ringmaster ish jokes were switched to Dan Quayle offers $200 to anyone who can squeeze jokes. Andbytheway, virtually all "ortho- even one more drop from the lemon. Two paedic" jokes are restructured Polish jokes. pumped-up bouncer types step up and Suppose you want to comment on the squeeze until they're red in the face. otheconomic hard times of medical practice ing comes out. "Does anyone else wish to today. Followingisanexampleofaswitched try," says the ringmaster. joke. The originalis from jewish Humor by A frail-looking man steps forward. The joseph Telushkin (Morrow 1992). crowd begins to snicker. He picks up the How do you make a small fortune in lemon, squeezes it and a cup ofjuice pours Israel? Come up with a large one ... with out. Stunned, the ringmaster asks, "Who B a 0 p y 5 c a n s p are you? What do you do? " "Arnold Mills, Blue Cross claims department. " If you were using this joke to begin a talk on collecting from third party payers, you could add, "Billing and collecting from third party payers is difficult and sometimes you have to be a little like Arnold Mills to make it in practice. Making it in medical practice in the '90s is what I'll talk about today. " When using a "funny story," it's best not to begin by saying, "Here's a joke." It's better to say, ''I'd like to start with a story." The joke you start with should relate to your topic. Following is a joke derived from old jokes and how to use this to lead into a serious talk. A young man walks into an internist's office, rushes up to the receptionist's desk and says, "I understand my father has owed you for an office visit for three years now. " The receptionist replies, "Yes, have you come to settle the account? " "No," says the man. "I've come to get health care on the same plan he has. " "The cost of health care- and paying for it - are uppermost on the minds of most Americans. Today, I'd like to discuss ways we can make it more affordable ... " Here's another joke with a medical theme. In hospitals in heaven, internists order the fluids , orthopods set the fractures, psychiatrists do the talking, gynecologists do the pelvics. In hospitals in hell, orthopods order the fluids , gynecologists set the fractures, internists do the talking, psychiatrists do the pelvics. If you look at every joke as an opportunity to come up with a funnier one with a better theme, you will soon have more jokes than you know what to do with. + References: A Funny Thing Happened on th e Way to th e Boardroom, Michaellapoce (Wiley 1988) Us ing Hum or f or Eff ecti ve Business Spealling, Ge ne Perrell (Sterling 1989) Stu Silverstein , M.D., president of Standup Medicine Seminars of San Francisco , California , lectures nationwide on humor in medicine. g 9 �Gianturco named chair of St Joseph department of surgery ichael]. Gianturco, M.D., a 1955 graduate of the School of Medicine and Biomedical Sciences, has been appointed Chairman of the St.Joseph Hospital Department of Surgery. A board certified general surgeon, Gianturco has been on staff at St. Joseph Hospital for 29 years and is currently medical staff president. He is a member of the Buffalo Surgical Society, Western New York Vascular Society, Baccelli Medical Club, Erie County Medical Society, ew York State Medical Society and American + Medical Association. Michael J. Gianturco, M.D.,'SS, in his Amherst restaurant, Michael's Plum. Wels, a clinical professor of surgery at UB and distinguished alumnus, was recently appointed chair of the University at Buffalo Council by Governor Mario M. Cuomo. Chairman of the department of surgery at Millard Fillmore Hospitals from 1987 until1989, Wels completed his residency in surgery at the former E.]. Meyer Memorial Hospital, Buffalo, New York. He received the Distinguished Alumnus Award in 1979 and the Samuel P. Capen Award in 1981. A trustee of the University from 1972 to 1976, he has been a trustee emeritus since 1979. Hess, director of the Perinatal Monitoring Program at Yale- ew Haven Hospital (Y NH), Yale University School of Medicine, completed his residency in surgery, gynecology and obstetrics at New Haven Hospital, ew Haven, Conn ecticut. He is also co-director of the Y HH Fetal Heart Institute and Fetal Cardio-Vascular Center. Hess is a diplomate of the ational Board of the American Medical Association, past-president and a member of the Connecticut State Medical Society, a fellow of the Ameri- Alumni Association announces first Achievement Award winners our UB physicians will receive the first annual Alumni Achievement Awards - one of them posthumously- at this year's Spring Clinical Day luncheon. The awards, which recognize a select group of UB medical alumni who have made their mark in a particular area of medical endeavor, will be given to Philip Wels, M.D., '41; Orvan Hess, M.D., '31; Kenneth Altshuler, M.D., '52, and posthumously to 0. P. Jones, M.D. ,'56. In establishing the awards, the Alumni Association wants to laud alumni who have distinguished themselves in areas such as research, teaching, technical innovation, private practice, community service and school administration, according to Donald P. Copley, M.D., '70, Alumni Association president. In each case this year, he added, the recipients have made outstanding contributions in one or more fields. B 0 0 p c o n 5 can Board of Obstetrics and Gynecology and the American College of Surgeons and a fellow of the American College of Obstetrics and Gynecology and pastchairman of that organization's Committee on Anesthesia and Analgesia. Altshuler, professor and chairman of the department of psychiatry at the University of Texas Southwestern Medical Center, completed residencies in psychiatry at the Bronx Veterans Administration Hospital, Bronx, New York, and the ew York Psychiatric Institute. A fellow of the American Association for the Advancement of Science, the American College of Psychoanalysts and the American College of Psychiatrists, Altshuler is also a member of the American Medical Association and a life fellow of the American Psychiatric Association. 0. P. Jones, UB professor emeritus of anatomyandassistantmedicalschooldean who died in 1989, was recognized as one of the world's experts on the morphology of red blood cells. He also received the Distinguished Research Award from the Buffalo Chapter of Sigma Chi for pioneer- p 9 9 �ing the use of advanced microscopic techniques in hematology. The awards will be given prior to the Stockton Kimball lecture on Saturday, + May l. Alumni Association establishes scholarship endowment fund o help further the medical school's goal to seek students of all means, the Medical Alumni Association has announced it is establishing an Alumni Scholars Endowment Fund out of donations received from reunion classes at Spring Clinical Day and Reunion Weekend. "This year's donations will be pooled together in one fund," explained Alumni Association President Donald P. Copley, M.D., '70. A goal of $1 million, to be collected over five years, has been set, Copley added; the interest would be used to fund 10 scholarship awards one made for each of the 10 reunion classes. "The size of the award would likely be $1,000 per year for four years," Copley said. "There would be 40 such awards at any one time- and we hope to continue them indefinitely," he added. The first awards will be given April30 at the Reunion Class Cocktail Receptions + held at the Center for Tommorow. Spring Clinical Day and Reunion Weekend set for April30, May 1 he Medical Alumni Assocation has set Saturday, May 1 for the 56th annual Spring Clinical Day. Mark your calendars and plan to attend! jamesS. Todd, M.D., executive vice president of the American Medical Association will deliver the keynote address, "The Name of the Game." Reunion classes of 1943, 1948, 1953, 1958,1963,1968,1973,1978, 1983and 1988 will meet for Cocktail Receptions on Friday, April 30, at UB's Center for Tomorrow, and on Saturday, May 1 for Reunion Dinners. Those classes will be vying for the Best Attendance Trophy, won last year by the Class of 1952. + 1992 Reunion Class Donations New med school alumni directory to be published in June 1994 Donations from last year's Reunion Classes totaled nearly $80,000. Following is a summary of the gifts. he Bernard C. Harris Publishing Company, Inc., will produce a new medical alumni directory. Scheduled for publication in june 1994, the directory will contain facts on over 5,200 medical school graduates, including their current names, addresses and telephone numbers as well as academic and career information. The Harris Company will begin mailing questionnaires to alumni in the near future; if you prefer not to be listed in the directory, please contact the Alumni Affairs Office in writing as soon as possible. + Class Year .. #in Class .. #of Dooors ...... Total Gifts 1942 .........41 ........... 18 ................. $8,077.13 1947 ......... 52 ........... 12 ................. $5,850.00 1952 ......... 54 ........... 26 ............... SI 0,225.25 1957 ......... 61 ........... 22 ................ $ 5,925.00 1962 ......... 66 ........... 19 ............... $13,875.00 1967 ......... 92 ........... 42 ............... S14,525.00 1972 ......... 117 ......... 31 ................ $ 9,425.00 1977 ......... 134 ......... II ................ $ 3,925.00 1982 ......... 138 ......... 18 ................ $ 4,625.00 s 1987 ········· 144 ......... 27 ................ 2,050.00 B u 0 0 p h y o n 5 p James S. Todd, M.D. AMA executive to deliver Spring Clinical Day keynote address ames S. Todd, M.D., executive vice president of the American Medical Association, will deliver the keynote address for this year's Spring Clinical Day lecture. A general surgeon from Ridgewood, New jersey, Todd joined the AMA in 1985. Before that, he was a member of the organization's board of trustees as well as a commissioner to the joint Commission on Accreditation of Hospitals. Todd graduated cum laude from Harvard Medical School and interned and served his residency at Columbia Presbyterian Medical Center. A diplomate of the American Board of Surgery and a fellow of the American College of Surgeons, he has been a director of the Institute of Society, Ethics, and the Life Sciences (Hastings Center) and has published numerous articles dealing with health care and professional liability. On May 1, he will talk about 'The Name of the Game" at Spring Clinical + Day. 9 9 3 �• ·························································································· I 1 9 3 s 0 won the APA's Newsletter of the Year in 1992. CARLJ . STREICHER '35 , is enjoying retirement in Lake Havasu City, Arizona. He plays golf five times a week and has a new home built on a golf course. BERNARDS . STELL '36 , a retired psychiatrist writes, "In three international photo salons sponsored by the Photographic Society of America, my stereo slides won awards. Because most of my photographs are close-ups, ARTHUR J . tion of the various mal positions of the eyelids. tronic flash units that I use are also synchronized at speeds up to DONALD practice in thoracic and cardiovascular surgery in Cincinnati, 1 9 5 s 0 F. DOHN '52 , reports that he is busy with coastal cruising (sailboat) , camping and travel after retiring from the practice of neurosurgery in july 1991. EDWARD W. HOHENSEE '54 , retired in June from the have a Diamond Star in PSA Competitions. ow I am accumulat- ogy. After a total hip replacement private practice of ophthalmol- HILLIARD 1 9 4 s 0 THEODOREW . KOSS '4 1 , writes, "I am comfortably retired nearCenterhillLake,Tennessee. " GILBERT B . TYBRING '45 ,edits the Wisconsin Psychia- trist, the Wisconsin Psychiatric Association's newsletter, which B a ' 58 , book co-authored with his wife, Jane Westberg, Ph.D., Collaborative Clinical Education: The Foun- died December 1, 1992. A tuberculosis researcher after his graduation from medical school, he did private practice in Buffalo for nearly half a century, retiring in the early 1980s. dation of Effective Health Care, published by Stringer Publishing Company in 1992. Jason is currently executive director of the died October 3, 1992. Slocum Center for Instructional Support (a non-profit educational service) system. Heleft Texas in 1952 and in September, he reports that he is enjoying retirement and visiting and clinical professor of family medicine at the UniversityofColo- his eight offspring. rado School of Medicine. ERNEST H . MEESE '54 , retired three years ago after 50 years of practice and is keeping busy sculpting and writing books. JASON announced the release of a new Stereographer I. " IRVING PERLSTEIN '39 , OBITUARIES CLYDE W . GEORGE '29 , Ohio. some out-of-the-way place to get unusual pictures. At present, I ing credits for the next PSA Stereo Division Award, Master Hilliard Jason '58 Ernest H. Meese '54 physiology and surgical correc- I do not use a stereo camera; I use two 35 mm single lens reflex cameras whose shutters are synchronized electronically. The elec- 1/SO,OOOofasecond. Iamover80 years old, so I find it easier to set up my photo equipment on our backyard patio than to travel to SCHAEFER '4 7 , a UB clinical associate professor, attended the Advisory Board meetings of the American Society of Ophthalmic, Plastic and Reconstructive Surgery and the American Academy of Ophthalmology, in Dallas, Texas, as a member of a team of physicians who gave a lecture on the patho- 1 was presented the 1993 Swords- 9 6 s 0 HARVEY C . SLOCUM '32 , was the first professor of anesthesiology in the University of Texas spent approximately 10 years in military service at Walter Reed Army Medical Center. Upon retirement from military service, he returned to the University of Texas; in 1979 he was named Professor Emeritus. man Award given by the American Cancer Society at the Annual Beverly Hills, California, writes, Swordsman Ball on January 16, "My associate in practice and I 1993. This prestigious award recognizes his outstanding service and leadership in the field of can- have scheduled 17 radiology technology courses for mammography EDMUND M . TEDEROUS techs around the country. " '43 , died December 19, 1992. SAAR PORRATH '61 , of cer for the past 30 years. He has beenontheBoardofTrusteesof the Ohio Division of the Ameri- STEPHEN can Cancer Society since 1979 and served as the Board's president in 1990. Meese has a private 0 p y 5 E . RICHARDJ . MILAZZ0 '42 , died October 26, 1992. LANGER GEORGE BISGEIER '50 , '67 , of Berkeley, California, has recently been named medical director of the Wellness International etwork. died of a brain tumor on ovember 5, 1992. DANIEL A . RAKOWSKI '60 , died December 8, 1992. c a 5 p g 9 ��BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO Non-Profit Org. U.S. Postage 3435 MAIN STREET PAID BUFFALO NEW YORK 14214 Buffalo, NY Permit No. 311 ADDRESS CORRECTION REQUESTED .. .. •' • . .. .• .. ;.. . ... . ... .~ .· . .. .. .. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1993 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1993-Spring Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v27n02-1993-Spring Table Of Contents A list of subunits of the resource. Research Hospital News Cluster lllnesses The Waiting Game Medical School A Spoonful of Humor Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v27n02 Extent The size or duration of the resource. 32 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1993 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/e7c663ad05ea016a079396c1be013372.pdf 898cc1e3821d4eef7f43acda9552b44b PDF Text Text State University of New York at Buffalo School of Medicine and Biomedical Sciences, Winter 1993 Problem Patients 8 'A Thorny Issue �THE BUFFALO PHYSICIAN AND BIOMED I CAL SCIENT I ST \olume 27 -.;umber I DIRECTOR OF PUBLICAT IONS (A CT ING) Dr Carole Smith Petro EDITOR -.;anelte Tramont Kolhg. R.:\ ART D I RECTOR ~Ian J Kegler ASSOCIATE ART DIRECTOR Scott Fricker STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr john -.;aughton \ice President for Chntcal Affa'"· Dran EDITORIAL BOARD Dr john ·\ Richert Chairman \lr Richard de Asia Dr \!arlin Brecher Dr Harold Brad\ Dr. RIChard L Colhns Dr. Donald P Copley Dr. Alan j . Dnnnan Dr. Ttmoth,· Gabryel Dr. Glen Gresham Dr. james Kanskt Dr. Charles \lassaro Dr. Charles Paganelli Dr. Luther Robmson Dr. Thomas Rosenthal Dr. Saleela Suresh Dr Bradlev T. Truax Dr Steph~n Spauldmg Dr jerome Yates TEACHING HOSPITALS AND LIAISONS Bata\la \A \ledtcal Center Buffalo General Hospital \fichacl Shah Buffalo\',\ \led teal Center Paula Prdmr Children's Hospital of Buffalo Ene Count\ \lediCal Center \lerC\· Hospital \hllard Fillmore Hospitals franl1 Sam Roswell Park Cancer Institute Sisters of Charity Hospttal Dmnis .\ lcCartln 'c The State Lnt,·erstty of""' York at Buffalo Buffalo PlnSICian IS published quarterly b' the State Lni,·ersity of -.;ew York at Buffalo School of \ledtcme and BIOmediCal Sctences and the Office of Publications. It IS sent free of charge, toalumnt, faculty, students, reSidents and fnends. The staff resen-cs the nghtto edtt all copy and subm1ssion~ accepted for pubhcauon \ddrcss quesuono; , comments and submiSSions to · Editor. Buffalo Physician. State Lni,·ersitv of "\c,, York at Buffalo, C~i\'CrSll\ Publications. 136 Crofts Hall, Buffa!~ , "o;ew York 1-+260 Send address changes to: Dear Alumni and Friends, D r. Elizabeth Olmstead, an alumna, class of '39, has established a significant endowment designed to support the school's educational efforts m the area of medical informatics. The endowment principal of$1.5 million will generate an annual income to support the continued development of computer-assisted learning for medical students and to deliver ongoing educational information to residents, faculty and practicing physicians in Western New York. We believe this is the first such endowment of its kind in the United States. Dr. Olmstead has been a loyal, dedicated volunteer faculty member of the school for man} years. She established this important gift to memorialize the memory of her late husband, Dr. Ira Ross, who was an engineer at Calspan and who served as its administrative leader from 1958 until his retirement in 1969. The medical school is committed to expanding Its role in this important area as part of its commitment to keeping all of its constituencies involved in ongoing, life-long learning. Under the capable leadership of Dr. John Loonsk, UB is on the cutting edge of this Important educational technology. Thanks to Dr. Olmstead, this program will be enriched and we will all benefit from her generosity and kindness. On behalf of the administration, faculty and alumni, I am pleased to express our heartfelt gratitude to Dr. Olmstead. Sincerely, J ohn aughton , M. D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Dear Fellow Alumni: W e're all excited about a high profile idea that should put your Alumm AssoCiation in the spotlight again. We have begun accepting contributions to a $1 million Alumni Scholars Fund to support worthy medical school applicants. This is a way to consolidate our class gifts so we can all pull together for a highly visible objective. Dean Naughton has expressed his full support for this major endowment fund that will accumulate principal over a five-year cycle so that each class has a chance to participate. The admissions department will assist us in picking two or three students each year. The awards will be presented at our Spring Clinical Day reception. We intend to follow our Alumni Scholars through the school year and keep you informed of their progress. Another major innovation for 1993 will be our new Alumm Achievement Awards, to be presented to a select group ofUB medical alumni who, although perhaps not universally famous, have nevertheless made their mark in a particular area of medical endeavor such as research, teachmg, technical innovation, private practice, community service and school administration. We are soliciting nominations from all over the country including both rural and urban locales. These Achievement Awards will be presented at our Spring Clinical Day luncheon. We are also sponsoring a Visiting Alumni Lecture Program to encourage the return of qualified alumni to lecture to peers, residents and students. We will contribute an honorarium to defray travel expenses. We also plan informal receptions to allo"" the lecturers a chance to meet old and new friends. Yours truly, Buffalo Plnsician. 146 CF~ \ddnion, 3435 \lamStreet , Buffalo, :\c" York 14214 Don Copley, M. D., '70 �- 0 ...........r - :;,r- w N 2 ~ ., _ N 0 1 f 3 ' 7/. I T( E R 9 9 Hospital News I Problem'Patients e T:Pe experts sa managing them takes a :mu self- Xami ation as patient-exami ati9n. Taking the Stand e As the need for medical experts In courtrooms grows, and in the absence o( stand,ardiz-ed pro(essional guidelines-, testifying in court can be a contro ers~al practtce. ASpoonful of Humor Medi,al s,hool People Alumni NCI' s Breast Cancer Prevention Trial still open to area women. Poge 2. Classnotes fflillarn ann ~r~lin forge joint seruice agreement. New findings on electric blanket use and breast cancer. Page 2. rage~- �l~l .................................................................................... Overall, electric blanket use did not increase the risk of breast cancer, the study found. But there was a slightly elevated, although not statistically significant, risk associated with sleeping with the blanket on all night throughout the season, suggesting the need for further study. Vena continues to investigate the risks of electric blanket use among premenopausal women. Electric blankets do not increase breast cancer risk urling up under an electric blanket ward off winter's chill may not pose an increased cancer risk , according to UB researchers. john Vena, Ph.D., and colleagues in the Department of Social and Preventive Medicine have shown that using an electric blanket does not increase the risk of breast cancer in post-menopausal women, the population group most likely to develop the disease. The study was published in the Americanjournal of Epidemiology. The breast cancer investigation compared electric blanket use over 10 years in 382 post-menopausal women with the disease and 439 with no known cancer. Scientists have hypothesized that chronic exposure to electromagnetic fields , such as those produced by electric blankets, increase breast cancer risk by suppressing the normal nighttime rise in the level of . the hormone melatonin. Melatonin regulates the hormone prolactin , known to influence breast cell growth. to 6 u a 0 BY LOIS The study is designed to determine whether the drug tamoxifen is effective in preventing breast cancer in women at a high risk of developing it. Tamoxifen has been used for 20 years to treat patients with advanced breast cancer. Since 1985, it has also been recommended as an adjuvant therapy for early-stage breast cancer. "With the latest statistics showing that one in eight women will develop breast cancer at some time in her lifetime, the BAKER Breast cancer study open to WNY area women he Breast Cancer Prevention Trial announced last April by the ational Cancer Institute's ational Surgical Adjuvant Breast and Bowel Project is still accepting women in Western New York. p y 5 c a n w e 9 9 3 �... . .... . ................................................................. . .............. tamoxifen study could potentially mean the reversal of this frightening trend and the saving of thousands of women's lives," said Stephen Edge, M.D., chief of breast surgery at Roswell Park Cancer Institute's Breast Center. The study will involve 16,000 women who will be randomly assigned to either tamoxifen or a placebo. Women 60 years and older are eligible to participate in the study based on age alone. Women aged 35 to 59 arc eligible to participate if they have an increased risk for developing breast cancer based on certain factors. Western ew York women interested in participating in the study or obtaining further information should contact Roswell Park Cancer Institute at845-7667. opinion turned up first on the list. \ ommunities trying to attract family physicians may get better results if they woo the doctors' spouses rather than the doctors themselves, a UB researcher has found. ln a survey designed to determine the factors that influence a doctor's decision concerning where to practice, the spouse's u 0 0 p Personal income , on the other hand, ranked lOth . Results of the survey cond uctcd by Thomas Rosenthal , M.D. , associate professor of family medicine, were reported in the journal of the American Board of Family Spouse's opinion means most in practice location B ' ' h Practice. Family practice is one of the most heavily recruited specialties due to existing and projected shortages of primary care physicians, a diminishing number of medical school graduates entering these fields and a high turnover rate among those who do. To better understand why a family physician selects one community over an- y c a w .[! other , Rosenthal surveyed physicians who graduated from family practice residencies between 1970 and 1989. Data were analyzed collectively, as well a by year of graduation , community size and in-state versus out-of-state location. The survey asked respondents to rank 24 factors known to influence a physician's decision about where to practice. Spouse's opinion was rated "most important" or "important" by 86 percent, with little change across year of graduation, community size or other variables. "Public policies and medical school experiences can have an impact on physician specialty and distribution ," Rosenthal said , "but the ability of an individual community to attract physicians will rely on how well it can confront problems and take action." The next three factors receiving the highest percentage of importance were hospital-related - hospital consultants (73 percent), hospital services (71 percent) and colleague interaction (70 percent). umber five on the list was afterhours coverage with 70 percent. Other factors rated important or most important by a majority of doctors were: quality of schools (67 percent), proximity to hospital (6J percent), family health and education need (60 percent), personal income (59 percent), employment for spouse (56 percent) and cultural opportunities (53 percent). BY e LOIS BAKER 9 9 0 �a ··························································· · ······· · ··············· · · · ··· the hospital's ties with the School of Medicine and Biomedical Sciences, and forging an agreement that made Millard Fillmore Hospitals one of the medical school's major teaching affiliates, with 16 residency programs based there. jennings was also instrumental in establishing in 1987 the Western ew York Health Sciences Consortium - an association of representatives from the medical school and its affiliated teaching hospitals, business and government designed to emphasize the need for cooperation and enhance the quality ofhealth care in Westem ewYork. "One of the most rewarding aspects of my experience in Buffalo," jennings said, "has been working with the University at Buffalo School of Medicine and Biomedical Sciences in the formation of the Western ew York Health Sciences Consortium. "One of the best secrets in Western ew York is the quiet but measurable leadership of Dr. john Naughton. He has in this tenure taken the University's medical school to the top quartile of all U.S. medical schools. In several key areas of measurement, the UB medical school is clearly within the top lOin thecountry,"jennings said. "This achievement is directly related to Dean aughton's commitment to excellence and perseverance," he added. Under jennings' stewardship, Millard Fillmore Hospitals established five primary care sites in medically underserved areas, established its successful Sleep Disorders and Hand Center specialty services, forged an agreement between its 3,342-birth Suburban Hospital maternity service and The Children's Hospital of Buffalo for neonatal coverage, established its $4.5 million Baird MS research center and developed the nation's largest freestanding ambulatory care center. The hospital also recently broke ground for a $60-million expansion and renovation project. The project, one of the Jennings leaves Mnlard post for Chicago ChUdren's an R. jennings, president and chief executive officerofMillard Fillmore Hospitals for the last 10 years, was recently named president and chief executive officer of the Chicago Children's Memorial Medical Center. He took over his new post january 15, 1993. "Having securely positioned Millard Fillmore Hospitals to meet the health care needs of this community for many generations, the climate was appropriate to accept the position at the Chicago Children's Memorial Medical Center, considered the 'crown jewel' of the U.S. child advocacy movement," jennings said. "During my nine years as president of Millard Fillmore, we have achieved every strategic objective charted. Millard Fillmore Hospitals has become one of the leading health care facilities in ew York State," he said. "The numerous successes achieved by Millard Fillmore during these nine years could not have been accomplished without the cooperation and dedication of the hospitals' board of directors, medical and nursing staffs, administration, employees and volunteers," jennings added. jennings took over as president ofMillard Fillmore Hospitals in 1983. The twohospital system had, at the time, lost $20 million over the previous l3 years. With several additions to a newly built administrative team, jennings turned Millard's finances around, with it emerging as the only major teaching hospital in the state to have maintained a positive bottom line for the past eight consecutive years. jennings is credited with strengthening 0 B u a 0 p 5 c a largest in its history, includes the addition of 43 beds to Millard Fillmore Suburban Hospital and major renovations to both the Gates Circle and Suburban facilities. The Chicago Children's Memorial Medical Center, founded in 1882 for poor children and affiliated with orthwestem University Medical School, is a multicorporate entity with its 265-bed facility as its centerpiece. A national search to find a new presidentand chief executive officer for Millard Fillmore Hospitals is already underway. New surgery chief named at VA Medical Center illiam Lynn Weaver, M.D., has been appointed clinical associate professor of surgery and chief of surgery at Buffalo VA Medical Center. A native ofKnoxville, Tennessee, Weaver graduated from Howard University in Washington, D.C. , with a degree in pharmacy. He attended Me harry Medical College in ashville and completed his internship, residency and nine years in the Army. "I think this is a tremendous challenge because of the history of the surgical department of this VA and all it stands for ," Weaver said. "The important name that the Buffalo VA and University at Buffalo medical school have developed in the national medical community gives me the opportunity to work with some of the brightest minds in the country," he added. Weaver hopes to increase the visibility of the surgery department by highlighting some of its past accomplishments, including its leading role in the development of cardiovascular technology. w e 9 �.... . ................................................ Sisters Hospital announces change in leadership isters of Charity Hospital has announced that Sister Angela Bontempo, hospital president and chief executive officer, is leaving Sisters Hospital for other duties within her religious order, the Daughters of Charity of St. Vincent De Paul. With the change in Sister Bontempo's status effective in October, a search process for a new chief executive officer is now underway under the direction of the regional office of the Daughters of Charity National Health System. "Being missioned is part of life in our religious community," Sister Bontempo said. "I've been at Sisters Hospital for six years and that's probably about an average stay for sisters in our order. But whether it's six, 16 or 60, moving on is never easy," Sister Bontempo said. "I will carry Buffalo and its people in my heart, always. Like so many others who have come to this beautiful area, Buffalo has captured me and I'll always be a Buffalo booster." Sister Bontempo took over Sisters Hospital in December 1986. "When I came here," she said, "the hospital needed major work. We had an old facility that begged for attention and was dangerously close to slipping into financial disaster. " Sister Bontempo brought in a new administrative team and the hospital has finished every year of her tenure with a positive bottom line while its fund balance has doubled. Among her accomplishments have been the establishment of new women's services, satellite primary care and chemical B u a 0 p ························· ···········a In 1990, Gov. Mario Cuomo named Sister Bontempo to the ew York State Pubic Health Council. She was also named to the Board of Trustees of the Western ew York Public Broadcasting Association. dependency centers and the hospital's $42 million modernization project, slated for completion in 1994. The project includes a new emergency department, family care center, operating rooms, intensive and ----- I Mnlard and BryUn announce ioint service agreement illard Fillmore Hospitals and Brylin Hospitals recently announced the establishment ofa formal medical ser- vices exchange agreement and the appointment of a jointly recruited physician to head Millard's psychiatry department and serve as associate medical director at BryLin. The agreement provides psychiatric consultation services for all emergency room and inpatients at Millard's Gates Circle and Suburban facilities and inservice educational programs for the nursing and support staffs. It also will foster a more coordinated care effort for inpatients at Brylin who need acute medical care and treatment. Under th e agreement, Ellen S. Dickinson, M.D., clinical assistant professor of psychiatry, was named chairperson of Millard's psychiatry department and associate medical director at BryLin. Board certified in psychiatry and neurology, Dickinson was an assistant professor of psychiatry at Albert Einstein College ofMedicine, Yeshiva University, ew York. She also served as the unit chief of psychiatry at North Central Bronx Hospital in ew York. coronary care units, head and neck center, urology and ambulatory care areas as well as a new entrance way and lobby. Sister Bontempo was the first woman to serve on the board of directors of M&:T Bank and currently sits on the board of the bank's parent company, First Empire State Corporation. In 1987, she received the Clifton C. Thorne Award for outstanding achievement in health care and human services. She received the 1989 Brotherhood! Sisterhood Award in health care by the National Conference of Christians and jews. 5 c a w n e 9 0 �~ 1 \ L 0 L B u 5 T R a A T 0 0 N p h 5 B y w H a T n N w E y 5 H e E R M A 9 9 N �B Y S C 0 T T T H 0 M A S Problem Patients Every physician has themhere's how he patient, a some doctors woman, came to Suzanne K.W. Anderson, M.D., with a complaint beyond the l<en of any diagnostician. deal "I feel with "I just feel so empty." empty inside," she said. them. Then she came again. And again. Soon, the patient was seeing Anderson every couple of days. "She really glommed onto me," says Anderson, now a family phy~ician and a clinical assistant professor of family medicine at the UB medical school. "She told me I was the only doctor who would ever tal<e care of her, who would ever love her." Buff a loP h y s i c ion WIn I e r 19 9 3 0 �Anderson tried to set limits- and the young woman turned violent. She cut herself with razor blades, showing the doctor her scars as punishment for her "rejection. " She invented a wild story about being kidnapped and raped, saying the rapist had carved an obscenity into her abdomen. The word was there, all right, but it was the woman's own knife that had done the carving. "Over time we did manage to establish some limits and got her into counseling," Anderson says. "And she actually ended up having astable relationship with a man after a couple of years." Problem solved. But for physicians struggling to treat difficult patients, rarely is the solution so neat. From dependent, fawning persons to the hostile and delusional , problem patients are a continual source of frustration for the caring doctor. Treating them means negotiating a fine line between empathy and effectiveness. And, perhaps most difficult to acknowledge, problem patients can point up a physician's own subconscious prejudices and shortcomings. "In a way, every patient is potentially a problem patient," Anderson says. "If their problems aren't treated respectfully, they can be a problem." "Compassionate objectivity" is how Jamie Shiffner defines that line between getting too involved with a patient and staying too distant. Too close, he says, and the physician can get caught up in the patient's emotions and stresses. Too far , and it's impossible to treat a patient with the empathy essential to proper diagnosis. Shiffner, a psychologist with a doctoral degree, teaches a Behavioral Sciences Seminar in the medical school's Department of Family Medicine. As part of that seminar, he delivers an annual lecture on problem patients- who they are and how to cope with them. There are no easy answers; the lecture consists of a series of video clips of patients, followed by students' discussion 0 B u a a hysician A might have no problem with a patient Physician B finds highly annoying- a difference that's rooted in the doctor's own subconscious. "There are certain kinds of personalities that we have trouble with, just because they remind us of people we've had bad experiences with in our own lives. You can use your own response as a diagnostic tool." of how they might handle the situation. One thing he has discovered, Shiffner says, is that "Know thyselr' is the first rule for dealing with problem patients. "Rather than being focused outwardly, pay attention to yourself," he says. "Know when you need to excuse yourself and get a cup of coffee, then come back. ... Give yourself time and space. Often it feels like, 'I've got to do this now, in my office, this second.' But there are very few things other than a code that you have to do right people who are excessively concerned about why I'm prescribing this drug, and does it have side effects. I also have a problem with excessively dependent people, and I can use my own annoyance as a signal that this is a dependent person. You can use your own response as a diagnostic tool." One place where problem patients congregate is hospital emergency departments. Close to the street, often serving as primary care providers for people without a regular physician, ERs play host every day to a wide-ranging drama of human misery. "There are hundreds of different reasons that people have stress that may ultimately result in a visit to the emergency department," says Steve Lakomy, M.D., who practices in three Western ew York ERs - at St. joseph and Sisters hospitals and the Erie County Medical Center-and is a clinical assistant professor of emergency medicine at UB . "There now. " Anderson notes that Physician A might have no problem with a patient whom Physician B finds highly annoying - a difference, she says, that's roo ted in the doctor's own subconscious. "There are certain kinds of personalities that we have trouble with,just because they remind us of people we've had bad experiences wi th in ou r own lives," she says. "I tend to have a problem wi th people who challenge authority a lot - p y s c a w n e 9 �are people who come to the emergency department because they're depressed and have a physical manifestation. Or they have a lot of stress at home or on the job, and they come in with an ulcer or high blood pressure. "There are people who just have emotional insecurity and can't deal with their problems; they don't have the coping mechanisms. It's a very wide range of people, and a wide range of problems. We kind of lump all these people together as hypochondriacs, when in fact there are all sorts of reasons. " One problem endemic to emergency rooms is the drug-seeking person. 'Tve had a patient come in and complain of a crushing chest pain, and gave him morphine for what could have been heart attack pain," Lakomy says. "It turned out he was faking it. "Or you have people from out of town who present with pain and say they need Demerol. But most area little more tactful. They have a whole list of drugs they can't take because (they say) they have an allergic reaction. Basically, it narrows down to one or two narcotics that they can take. "Sometimes they walk out of the department when they realize you're not just going to give them medication. "Butl always try to err on the side of the patient. l would rather be fooled several times, and actually give narcotics to a patient who's not being honest, than send somebody home in pain." Then there are the characters - not too sick, not too crazy,just enough of both - who keep life in the ER interesting. Lakomy tells of one patient, an asthmatic man in his late 40s, who sometimes shows up every day for two weeks with an exacerbation of his condition. While he's being treated, he regales the staff with his intentions to marry famous exMouseketeer Annette Funicello - who, of course, knows nothing of the sort. But he has this plan, see ... The patient has refused psychiatric counseling, Lakomy says, "but he's still a very functional individual." B a 0 p " here~ a reporting system for doctors - if we commit a violation or have a lawsuit against us, it gets recorded and gets reported to the physician registry. But patients who have seen doctors multiple times or who have had multiple surgeries, and never had any positive findings - we don't know about those patients. We become their victims." Anxiety, in all its forms, surfaces again and again as an underlying cause of patients' problem behaviors. Anderson, the family physician, tells of a recent patient who imagined that his head was Ooating up to the ceiling, and that electric shocks were shooting from his head to his toes and out his anns. Such symptoms, she noted , don't correlate with any known organic illness. So she spent some time talking with the patient. lt turned out that he had recently emigrated from Cuba, had a big family to support, had no job and no health insurance. "The symptoms were all related to this tremendous anxiety he had," Anderson says. "The thing is, he had been to an internist who had put him through a whole lot of tests, and spent a lot of his personal money, without result. " ln such cases, she says, "it's really a challenge to get them to see they don't have a physical illness. You have to bring this on very slowly and carefully, not too abruptly. "Often, just the awareness (that the symptoms are anxiety-related) makes the symptoms disappear or become a nonconcern to the patient." a n w Dentists, especially, find fear and anxiety epidemic among their patients- often stemming from fear of the dentist himself. The effects can be crippling. SanfordL. Nusbaum, D.D.S. ,a l960graduate of the UB dental school, tells of one patient. "Open, please," Nusbaum said to the patient, who would not. "We talked about it. l said, 'Can you open7' '"Yes.' "'Do you want me to examine you and see what the problem is?' '"Yes.' '"Well , open.' '"I can't."' 'Tve seen patients that, when you start explaining to them what has to be done, they'll pass out just listening to it. There's all this psychological, emotional baggage they're carrying with them that makes it a problem.'' Despite the time pressures on every physician, Howard Lippes, M.D. , '77, a clinical assistant professor of medicine at B, says the doctor's time is what fearful patients need most. "If you can possibly spend the time to e 0 �ot all problem patients are in the wrong. There are " many problem patients who ought to be problem patients, because they're not given the information that the patient should be receiving." [I i I I II B II "If you can't find something physically patient on, you're almost acknowledging wrong with them, they're almost angry at the wrongs of the prior physician." you . And they'll go to another doctor. All this is moot, he says, if the patient is "There's a reporting system for doctors not physically ill. Abandonment is rarely - if we commit a violation or have a charged, he says, "but physicians worry lawsuit against us, it gets recorded and anyway." gets reported to the physician registry. But Also , Albert notes, "Not all problem patients who have seen doctors multiple patients are in the wrong. There are many times or who have had multiple admis- problem patients who ought to be probsions and multiple surgeries, and never lem patients, because they're not given the had any positive findings - we don't information that the patient should be know about those patients. We become receiving. " their victims. " And just because a patient presents sympCan a physician who finds a patient toms that have grown in the mind, endocriunbearable sever their professional rela- nologist Lippes notes that doesn't mean he tionship? The answer is yes, but the isn't sick in body anyway. He tells of a patient legalities can be dicey. he saw while an intern- "an elderly woman UB Law School Professor Lee A. Albert, who complained of chest pain on a daily a specialist in medical-related legal issues, basis. All the physicians who took care of her says ending a doctor-patient relationship were rather exasperated; her pains were atis legally risky when the patient is ill and tributed to depression. has nowhere else to go. "But one day she explained that her "A doctor may not deny services to that chest pain was really due to a heart attack. patient without being sure the patient has And it really was. The attending physician access to a substitute physician," Albert told me, 'Even the crocks get sick somesays. "If she does refuse services after a times.' The lesson being that even the patient-physician relationship is estab- hypochondriacal patients can get real illlished, without reasonable assurance that nesses. You really have to be tuned in." a substitute physician is available, that's Despite the frustrations , Campagna and called abandonment, and it's tortious con- other physicians say dealing with problem duct. The patient can sue for damages. " patients is just part of the territory in a But,Aibertsays, "reasonable assurance" human science like medicine. "If you is a gray area. "It's often not very easy to conquer the challenge and ultimately find a substitute. When you go to a new things turn out well for them , it's a victory doctor, he asks whom you've been treated and it's a wonderful feeling," she says. by and what happened. There's a kind of "But sometimes the pain of getting there is collegiality that says if you do take that more than you want to bear." sit down and explain to the patient what it is you're doing or what it is you think the patient has, you're most of the way there," Lippes says. "The more suspicious and anxious the person is, the more time it takes." But the physician can talk until he's three shades of blue, and he won't talk some patients into doing what's best for themselves. on-compliance, or nonadherence, is one of the thorniest issues confronting physicians with a sincere interest in their patients' well-being. Ida M. Campagna, M.D ., '79, apracticing OB/GYN who is a clinical assistant professor in UB medical school's Department of Gynecology and Obstetrics, cites the case of a young patient she has now: pregnant, diabetic, but who refuses to take insulin. "We're going to try to do some outreach to this girl," Campagna says. "Get on the horn, call her, see if we can convince her how serious this is. A lot of things can happen with this baby. You have to pull at the heartstrings of the mother and say, This is what's best for your baby.' "Sometimes you have to do what your mother did, which is to administer an oldfashioned dose of guilt." Campagna also says she is troubled by "doctor-shopping," where patients go to one physician after another in search of a diagnosis that fits their own idea of what's wrong. "There are people who are really delusional about their ailments," she says. u a 0 p h y 5 a n w e 9 3 �'A roster of difficult patients Jamie Shiffner, a psychologist with a doctoral degree who teaches a Behavioral Sciences Seminar in the UB medical school's Department of Family Medicine, delivers an annual lecture on problem patients- who they are and how to cope with them. Shiffner has summarized the range of problem patients - a range as broad as humanity itself - into a dozen categories. They're a laundry list of the people who can ruin a physician's day. Perhaps you've encountered: Overly dependent people who have trouble making decisions . "They're the ones who call up at 3 in the morning and say, Tve got a runny nose, do you think I should take an antihistamine?'" Shiffner says. Seductive patients, both those who approach a physician sexually and patients who wheedle and flatter the physician in order to obtain narcotics. Aggressive patients. "Some get B 0 0 p h downright nasty," Shiffner says. Threatening people, who know what they want- for the doctor to sign disability papers, for example - and threaten force to get it. Suicidal or self-mutilating patients. Antisocial personalities, whose problem behaviors include lying, cheating and stealing. One antisocial patient is the one who never pays his bill. Patients who withhold necessary information, out of distrust or shyness. "Sometimes," Shiffner says, "people expect that doctors should be magical, and figure out what's going on without any information." Those with psychotic delusions. Arguing logic with them gets the physician nowhere. Passive-aggressive persons - tho e who say yes but mean no. Into this category fall all those patients who say they'll take their medication , lose weight, whatever, but don't follow up. People who are disgusting for some reason. Their appearance may just pro- y s a n w voke strong emotion in the physician -or they may not have showered in weeks. "They can be lovely people," Shiffnersays, "but it's really hard if you can't sit there without passing out from the aroma." Extremely attractive people. "Feelings don't just go away because you're a doctor," Shiffner says. And finally, patients suffering from a borderline personality disorder, generally people who have been abused as children. These patients, Shiffner says, are both dependent and standoffish - a contradictory set of behaviors difficult to resolve. In addition, Shiffner mentions a seemingly innocuous behavior that can turn into a problem: the patient who's exceedingly nice. "Maybe they talk and talk," he says; "maybe it's hard to deliver difficult news to them. What if you have to talk to them about their drinking too much? That can be as difficult as the person who comes in and yells at you." n e 9 9 3 ��BY ANDREW DANZO he said he raped her. He said she consented. The physical evidence couldn't say who was telling the truth. Thats where Raphael S. Good, M.D., came in. "My testimony was that the way she described the event, rape was not possible - or at least entry was not possible," recalled the University at Buffalo medical school graduate. "That was the bottom line. " He never said in so many words that William Kennedy Smiths accuser was lying, but Good gave the jury in West Palm Beach, Florida, reason to doubt her. And in December 1991 , thefourwomenandtwomen found Smith innocent. I)hysicians (L' I ILLUSTRATION Buff a loP h y sic JJ( rt BY ian Witnt sscs TED w PITTS i n t e r 1 9 9 3 �Lastly, taking the stand isn't always fun. "It's very intimidating to be a witness," said Brian S. joseph, M.D., a psychiatrist who graduated from the UB medical school in 1968. "You're playing by different rules, and while they're always respectful, they don't always treat you like you know everything." But the American College of Physicians maintains testifying in court is part and parcel of a higher calling. In its 1990 statement, which accompanies guidelines for medical expert witnesses, the college said: "Physicians, as members of society and as professionals, have a duty to testify in court as expert witnesses . . .. Nonpartisan and scientifically valid expert testimony not only assists the deliberations in a particular case, but also can establish for the record applicable standards of care." Some physicians say an occasional court date can be a gratifying teaching experience that helps keep them sharp. Others say there are personal rewards, especially in medical malpractice cases where they can help weed out incompetents or come to the aid of a wrongfully accused colleague. And, while it's not for everyone, cross- be to get more physicians into the courtroom. "Small numbers of physicians should not spend disproportionate amounts of time testifying; rather, more physicians should try to be available to serve as experts as a component of their professional activities," the American College ofPhysicians proclaimed in a 1990 statement. How can practitioners obliger "They might make it known to their local medical societies," said Lois Snyder, ].D., manager of health and medical-legal policy development for the college. "Some societies are becoming interested in pulling together an information bank of people who could be experts." But, she added, "I don't know who is doing this with regularity. " Physicians have plenty of reasons for avoiding the courts. Many cite the time it takes from their already busy schedules. And things can get messy if arrangements with the lawyer aren't spelled out. In Buffalo, so many disputes over issues like fees and canceled court dates have arisen that the county medical society has been working with the local bar association to develop a model witness agreement for members. ood is among the large number of physicians who go into the courtroom as expert witnesses. Many more serve as experts in cases that never reach court, either because the cases are settled beforehand or because the physicians convince the lawyers that there really isn't a case. Many lawyers say their need for medical experts has grown, and with that growth has come controversy. Court rules for the use of medical experts are vague, and professional guidelines vary among different medical organizations. Some physicians turn up so frequently on the witness stand that they have little or no time to actually practice. Some of their colleagues refer to them as "hired guns," the medical equivalent of the ambulancechasing lawyer. The best way to reduce the reliance on experts with questionable expertise may "THE PEOPLE WHO TESTIFY FREQUENTLY, MANY OF US THINK OF THEM AS WHOREs.•• Rapna I(, t>d \1 D. B a a p h c a n w e 9 l �"YOU'RE PLAYING BY DIFFERENT RULES, AND WHILE THEY'RE ALWAYS RESPECTFUL,THEY DON'T ALWAYS TREAT YOU LIKE YOU KNOW EVERYTHING." -Bnanjoseplt, M.D. examination can be as invigorating as a good game of tennis. "Listen," said Good. "I don't do anything I don't enjoy. I've been around too long." Good, a member of the UB medical school's Class of 1948, said he was brought into the William Kennedy Smith case by defense attorneys seeking a rape expert. Board certified in OB-GY and psychiatry, both of which he teaches as a clinical professor at the University ofMiami medical school, Good helped establish one of the nation's first rape-treatment centers in Miami in the early 1970s. He also is coauthor of a book chapter on rape. But Good's testimony ended up centering on the physiology of sexual response, and for that he was also qualified as a former vice president of the American Association of Sex Educators, Counselors and Therapists, and as the organizer of a human sexuality course at the University of Miami. He also maintains a psychiatric practice in Miami. Before trial, he reviewed voluminous records, including the depositions, police statements and polygraph tests of Patricia Bowman, the woman who accused Smith. "I would guess the stack was close to two B u 0 0 p h feet high ," Good said. On the witness stand, he said, he was given a hypothetical situation mirroring the alleged circumstances- that the rape occurred even though the victim was fighting off the attacker, the victim was not sexually aroused and the attacker had only a partial erection. Good said it didn't add up. Under cross-examination, he said, the prosecuting attorney kept hammering away at the fact that there was semen in the woman's vagina, so there had to have been intercourse. "I kept saying that under the conditions described, she could not have had intercourse," Good said. "The prosecutor said intercourse did occur. 1 said, 'Well, there must be some discrepancy."' The physician said he enjoyed verbally dueling with the assistant prosecutor who questioned him. "She tried to downplay my clinical experience, saying 1 was busy reviewing journals and giving talks around the country, implying I was not clinically involved with patients," Good said. "1answered by saying, 'Yes, it's true I am a very busy doctor.' She was very frustrated. " For all his cool, Good had been on a y a w witness stand only twice before. Once he testified about behavioral responses to pornography in an obscenity trial, and another time about marital relationships in a case involving an abortion law's spousal-notification clause. Like many medical experts, Good has worked with attorneys much more frequentlyoutside the courtroom. He said he is often called upon to review records in medical malpractice and personal injury cases, but the cases are usually settled or dropped before court, based on his conclusions. Good emphasized, however, that it's only a sideline. "The people who testify frequently, many of us think of them as whores," he said. "It's not an unusual experience, the same people are testifying all the time. I'm not sure they are dishonest, but they may see things a little differently." Few formal restrictions, however, govern the use of expert medical witnesses. "Generally, the relevant guidelines are the federal rules that govern court proceedings, and they are very broad about who can testify," said the American College of Physicians' Snyder. "Physicians sometimes see that as a problem." e �Various medical organizations have their own guidelines. The American Association of eurological Surgeons, for instance, says members who testify should be practicing surgeons or those who "can demonstrate enough familiarity with present practices as warrant designation as an expert." The American College of Physicians suggests that witnesses "should be actively involved in the clinical practice of the specialty or the subject matter of the case for three of the previous five years at the time of the testimony." The Medical Society of the State of ew York says witnesses should be practicing in the specialty at issue, but if they are already retired, it shouldn't be for more than five years. Not only do guidelines vary, but there are also gaps. For example, one pediatrician wrote in a letter to the journal Pediatrics last year that he would like better criteria for testifying in medical malprac- "YOU CAN'T SURVIVE FOR VERY LONG AS AN EXPERT WITNESS IF YOU'RE A HIRED GUN, BECAUSE YOU'D BE EXPOSED." They don't teach "Expert Testimony" in medical school. Yet some believe more physicians should lend their expertise to the legal system as a matter of professional duty Here are some tips for those who get involved: GET IT IN WRITING Many physicians become expert witnesses on the basis of little more than a phone conversation. That's a mistake, because there is ample room for misunderstanding. The Medical Society of Erie County and the Erie County Bar Association have been working on a model document to use in drafting expert witness agreements. For more information on the model, contact the medical society at (716) 8521810. WHAT To CHARGE A general rule of thumb is, charge whatever the value of the time taken from your practice. B u a 0 p Keep in mind, the American College of Physicians and others consider it unethical for experts to take a fee contingent on the case's outcome. One physician, however, has proposed an interesting twist on the contingency fee. In a letter in the May 20, 1992, journal of the American Medical Association ,]. Terrence Coyle, M.D. , a physician who practices at the Eye Clinic ofBellevue, Washington, writes that when he is asked to review a medical malpractice case and finds no merit to it, he asks no payment as long as the case is dropped. That, he writes, "has saved several physicians unnecessary stress from unfounded malpractice suits." h s a w PRACTICE WHAT YOU PREACH One of the top criteria for a medical expert is clinical experience in the subject. The American College of Physicians, for instance, suggests active clinical practice for three of the previous five years. Consult your state medical society and your specialty organization -there's a good chance they also have guidelines. And once you take the stand: DON' T SPECULATE ln the William Kennedy Smith rape trial, Raphael S. Good, M.D. , testified that sexual intercourse could not have occurred under the circumstances de- e 9 9 3 �Lice cases. lt is unclear how many different professional guidelines have been issued. Only late last year did the American Medical Association survey specialty societies to get a handle on the patchwork of rules. ln the meantime, the classified pages of law journals are filled with ads for medical experts seeking work. One ad in a recent issue of the National Law joumal states: "Neurologist. On faculty of prestigious university. Head injury and other expertise. " The ad lists a Boston-area telephone number. There are also services that provide medical experts. ln another National Law ]oumal ad, the Medsearch etwork lnc. offers "Prompt initial case assessment$495" for medical malpractice attorneys. Medsearch advertises that "Our expert panel consists of 15,000 board certified medical specialists nationwide" who provide reports, depositions and testimony. scribed by the accuser. Good says the prosecuting attorney kept asking how that could be, since physical evidence showed that intercourse had occurred. "The prosecutor would have liked me to say she (the woman) must have been lying. Butthat's a trap. Once you say that, they ask you how do you know someone is lying," Good recounts. "When they asked how do you explain it, l said, 'Hey, there's some discrepancy."' \ ATTITUDE IS EVERYTHING "You can't be arrogant and you must understand where you are," advises Franklin Zcplowitz, M.D. "Many times they (lawyers) get after physicians that come into the courtroom with a hostile B u 0 0 p manner." A past president of the UB medical school alumni association (Class of'58), Zeplowitz is a Buffalo surgeon who has testified in the past as an expert and now testifies regularly as the treating physician when his patients pursue personal injury cases. BE CLEAR "lt's not unlike giving a lecture to a class, to the extent they can understand what you're saying," says psychiatrist Brian S. joseph, M.D., '68. "You'vegota lay jury," addsZeplowitz. "You've got to answer questions at their level so they can understand what you're talking about." s o n w o one suggests that such witnesses will say anything for a price. But some question the expertise of physicians who spend more time in court than at the bedside. Others point out that in court, it's not always what you say but how you say it, and some experts might be more willing than others to tailor the way they answer questions. Good said a close friend of his is an attorney who handles personal injury cases. Years ago the lawyer had Good review a worker's compensation case. "I told him my opinion," Good recalled. "He thought I could say ita different way. I did not feell could say it another way." The two have remained friends, but the lawyer has never again sought Good's medical expertise. Many attorneys, however, say the only thing they want from an expert is an honest, unslanted assessment. Lawyers are becoming more thorough in research- COACHING Lawyers won't tell you what to say (at least they shouldn't). But they may want you to emphasize some things and downplay others. The best way to deal with the gray areas is to stick to your notes. "You just bring the facts out as you see them," says Zeplowitz. DON ' T BE FOOLED Advises joseph: "When you go to court and the opposing attorney says, 'Good morning, doctor,' it's important to know he doesn't mean it. " - n A N 0 e R E W 0 9 A N Z 0 9 �-----------------~--~- ••H .. "OFTEN YOU ARE CONTACTED BY ATTORNEYS BY VIRTUE OF THE PAPERS YOU HAVE WRITTEN." -]ach Fisher, M.D. ing the history of their opponent's expert witnesses, and they will seize on anything that helps them paint the witness as a hired gun. A lawyer can raise questions in jurors' minds about a psychiatrist who always finds criminal defendants insane or an obstetrician who always testifies for malpractice plaintiffs but never for defendants. "You can't survive for very long as an expert witness if you're a hired gun, because you'd be exposed," said Charles P. Ewing, J.D. and Ph.D. , a UB professor of law and psychology who has testified as a forensic psychologist. "You want someone who is rigorous and fair," said Gregory Stamm, j.D., a Buffalo-area attorney who frequently represents physicians before government agencies and sometimes represents medical malpractice plaintiffs. "If you have a doctor who's willing to testify about gynecology one day and psychology the next day and internal medicine the next day, he's going to be exposed, so you haven't done yourself any favors hiring him," said Stamm, a 1971 UB law school graduate. Lawyers usually can find experts without resorting to the full-time professionals. B a 0 "Often you are contacted by attorneys by virtue of the papers you have written," said jack C. Fisher, M.D., head of the division of plastic surgery at the University of California, San Diego, Medical Center. Fisher, a 1962 UB medicalschoolgraduate, served as chairman of a Plastic Surgery Educational Foundation committee on silicone implants in the late 1980s. He later wrote about the issue in the New England journal of Medicine. ow he is working with several attorneys defending physicians against silicone breast implant lawsuits. "So when you put a summary of an issue in the New Englandjoumal of Medicine, there are a lot more eyes on that summary than just the subscribers to the journal," Fisher said. In cases involving quality of care, Stamm said lawyers first look for experts within the community who can address local standards. "If you're representing the physician, it's very easy to find someone," he said. It's much harder to find local experts willing to testify for plaintiffs against physicians, he added. lf no local physicians will testify, Stamm said a lawyer will look to nearby communities. "What you're looking for is an p y a n expert who at least practices in the same state as the defendant," he said. After a while, attorneys develop their own lists of experts who are willing to testify, though they try to avoid using the same ones over and over. Lawyers will occasionally give a colleague the name of one of their own experts as a professional favor. In the William Kennedy Smith case, Good said defense lawyers first enlisted a friend of his, a pathologist, in their search for a rape expert. The pathologist called around the country, unaware that his friend had a reputation in the field. "People said, 'Hey, there's somebody there in Miami,"' Good recalled. In the end, Good said, he felt his testimony carried a lot of weight with the jury. But, he added, "There were many other aspects of the case that resulted in the not guilty verdict, l'm sure." And Stamm noted that as important as experts are, they usually don't make or break a case by themselves. "Good cases will tend to win regardless of experts and bad cases will tend to lose regardless of experts," he said. "I've had jurors tell me they didn't listen to the experts." w e 9 9 �A Spoonful of Humor © Stu Silverstein, M.D . hou hts on avisit to our nation's ca ital Before addressing the physicians of the D.C. Medical Society, l got to see the happenings of Washington first hand. l was welcomed to the D.C. area by all of the soon-to-be-unemployed Republicans at the exit ramp holding their "Will forge passports for food" signs. After living the past few years in California and growing accustomed to its casual ew Age attire, like tie-dyed lab coats, l was overwhelmed by the sea of blue and gray suits - more than I saw during the entire 15 days of the PBS series on the Civil War. Aides say they are concerned with how Bush will adjust to just sitting around with no defined job or agenda doing nothing during the next few months. Cmonhe's been doing that for the past four years. Bush is getting ready to move out. Barbara is out house-hunting for a nice place in George's hometown ... just as soon as they figure out which state it is in. Secretary of State james Baker, who has always bolstered his career by associating with winners,justsigned on as the mascot of the '49ers (sorry, Bills fans!). The Democrats are taking over the city, and with President-elect Clinton's drive for ethics in government, startingjanuary 20th you could easily get pulled over for driving under the influence of a lobbyist. ow, Arkansas "chic" is in. (An oxymoron, like congressional ethics.) l caught an early sign of this when I saw a young civil servant drive by in a Chevy pickup with a wine rack on the back. Clinton says he will involve Americans from all sectors of society in his administration. He's considering giving Gennifer Flowers a position . .. as First Bimbo. Bill and Hillary's daughter, Chelsea, is back at school. Her principal said she will 6 u a 0 p be treated "just like any other student" ... ow that the Church of England is yeah, any student who has the bomb squad allowing female priests, l guess it's only a matter of time before we start seeing male opening her Cheese Doodles! AI Gore will supposedly have a more nuns at the airport. active role than he did at their first press And, of course, baseball player Steve conference where he looked like a cadaver Howe, who was thrown out ofbaseball18 on line at the ATM machine. times for using drugs, just signed with the Yankees. A spokesman for the We now have two women senaYankees said that despite his probtors from California. they were introduced to the Q~[~t\ !ems and difficulties, "gram for senate floor, Senator Bob gram" he's still one of the best PackwoodlMMEDIpitchers in baseball. ATELY Seems like someone forgot to tell Bill Clinton that he won the election because he's still on the campaign trail. Responding to the death of Superman, he claimed it could have been avoided if Bush had implemented humane health care reform . The election year brought some interesting issues to the ballot. ln Northern California there was the controversial "Doctor-Assisted Suicide" Bill and in Southern California, the "Police-Assisted Suicide" Bill. But most of all , we are probably going to face some kind of government-mandated health care reform , leaving a lot of doubt and uncertainty in the medical community. Many wish we could just run things involveour way. In this spirit, I would like to leave ment! To get some relief from politics, last you with the Top 10 Current Movies- if week l watched the Frank Sinatra and the AMA were in charge of Hollywood. Michael jackson specials back-to-back. l Malcolm XXY soon realized that they actually do have a In House Alone 2 lot in common - they both grab their A Broviac Runs Through lL crotches and are willing to have their Beauty and the Plastic Surgeon noses broken to further their careers! Th e Last of the Meconiwm Back home, I discovered that the City Bram Stol?er's Dracula's lnservice of San Francisco is now being sued by on Exchange Transfusions Tampa Bay because they didn't get the Of Murine and Men Giants. Several local law firms are going to Informed Consenting Adults donate $3 million worth of legal services, A La Leche League of Their Own which works out to about three hours of Three Ninjas On Rounds work. s a n w n e �a ································································································ "For his many scholarly contributions in genetics in general and to medical genetics in particular and for his many personal contributions through generations and generations of geneticists, young physicians and others, we honor today Victor A. McKusick with the bestowing of the D.W. Harrington Award. " McKusick was founding president of The Human Genome Organisation from 1988 to 1990 and a founding member of the American Board of Medical Genetics. "Through his writings, courses, conferences and his personal example through his relentless activities, he has organized and called attention to important genetic disorders that result from alterations in fundamental biological processes. He has been a major contributor to making possible the more recent applications of powerful molecular genetic technique to the human disorders," Erbe said. Editor-in-chief of Medicine and founding editor of Genomics, McKusick talked about the international effort to map and sequence the human genome. "Thegoalofthe human genome project is to locate all of these genes, to identify them and to discover upon which chromosome they are situated and where on that chromosome, and to determine the full sequence of nucleotides from one end of genome to the other," McKusick explained. "There was an influential editorial in Science in March of 1986 suggesting that the way to solve the problems of cancer is to complete the sequence of the human genome," he said in regard to the significance of the study of the genome. The ational Academy of Science committee recommended that a special project was warranted and that it should have add-on funding so there would be no "robbing of Peter to pay Paul." Estimates of funding necessary to complete the project approximate $200 billion The Human Genome Proiect: unraveling its implications VICTOR MCKUSICK DELIVERS HARRINGTON LECTURE he ~ddcning gap bt.>t~H.'etl Hhat ph_';si( ians kno1-v h(nv to diagnose and H· hat thn hnov~. haw to tnat ""'ill he inten~ified b1r the luto""' ledg£ gleaned front tlu I Iuntan (,enome Ptoject. ptedic ted 1enowned geneticist\ idot A. tvkKusic h. ~1.IJ., '>c. D., cL~ he delhCJrd the 1992 I).\\. Ilanington I ccttoe. "I he llunu.ut C1enonte PJV)CCt: Bachgnntnd, ~tat us, Ptosp£ cts and bnplic ations. ·· members , quickly and unanimously, reached a decision to give the award today to Victor A. McKusick." Erbe, who is director of the Division of Genetics at The Children's Hospital in Buffalo, chairs the study group that reviews all grant applications for proposals to study social and policy issues of the Human Genome Project. The massive project to codify the sequence of nucleotide bases that makes up the genes in each of the 23 chromosome pairs in the human body has allocated a generous 3 percent of its budget to fund the study of the ethical, legal and social implications of its results. Erbe lauded McKusick by saying, "Dr. McKusick is a name really synonymous with clinical genetics and ... a major figure in American medicine. McKusick referred to subjecting D A to study as the diagnostic biopsy of the gene- an approach that will be increasingly used to identify specific neoplasms and their dispositions. But the knowledge that comes from this study raises "ethical and social issues" such as privacy and confidentiality that are being given a great deal of attention, he said. And although some may try to make connections between the genome's "constitution" and issues such as criminality, McKusick said many of these associations will be "spurious." Richard Erbe M.D., UB professor of pediatrics and medicine and chair of the Harrington Lecture selection committee, introduced McKusick, saying that although few geneticists have been chosen for the Harrington award, "the committee B 0 0 p h 5 c o n w n e 9 9 3 �·········· · ··································································· ·· ················ a · I (m 1988 dollars). I Also codtfted ts a growing hst of dtseases anatomy. He explained that while three categories of genetic disorders ~~-~t~r' /,I feet. The first of these diseases, McKusick related, was Huntington's disease , which was f mapped on the short arm o Chro~'1.~~~., mosome 4 in 1983. "This type of mapping is useful because once one knows where the gene is on the chromosome, one can hope to design a diagnostic test," McKusick explained. Of the 2 million plus genes in the human genome - 2,600 have been mapped. The genes for diseases such as cystic fibrosis , one form of Alzheimer's and Duchenne muscular dystrophy have been identified. McKusick said genes express disease ·: · f> . B a a p h s a n w A graduate of Tufts University and johns Hopkins' School ofMedicine where he received his M.D. in 1946, McKusick is a professor of medical genetics at The johns Hopkins University. - s v c A R R 1E A . L 1a E R A N T E e 9 �a ·············································· Dean Naughton receives Distinguished Service Award from Sickle Cell Disease Association School of Medicine and Biomedical Sciences, the School of Social Work and the Institute for CBO Education and Training. ohn P. Naughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences received a Distinguished Service Award along with the medical school from the iagara Frontier Association for Sickle Cell Disease at its twenty-fifth Anniversary Dinner held last September. Naughton was cited for "his notable contributions to, and support of, the agency's unique health service to promote and ensure the well-being of the sickle cell affected and at-risk populations ofWestern New York from 1981 to 1992." During that time, a ugh ton provided a quality of material assistance that substantially contributed to the association's survival, according to the citation he received. He was also lauded for his active involvement in the creation of the Sickle Cell Center of Western ew York at The Children's Hospital of Buffalo, as well as his "always available advice and counsel on programs and problems." The University was cited for "its invaluable contributions to, and support of, the agency's unique community service work." Individual units of the University that provided singular contributions were also cited. They include: the Student ational Medical Association, the Black Student Union, the Equal Opportunity Program, the Office of Urban Affairs, the B a a ........ . ................. . ........... . .. . ........ idly growing field of medical information into its curriculum, according to John aughton, M.D., vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences. "Ira was a visionary - always looking two decades ahead," Olmsted, his wife of 39 years, said. "With medical informatics the wave of the future, this chair, one of the first of its kind in the country, represents an appropriate tribute to him." The use of medical informatics is not far off for UB's teaching hospitals, which are working with the medical school to develop an Information Systems etwork to link health care facilities and physicians in Western ew York. The network will provide a national and international prototype for medical education and health care delivery, according to Thomas A. Riemenschneider, M.D. , chair of the Western ew York Health Sciences Consortium Information Systems Council and associate vice president for clinical affairs and associate dean of the medical school. "The new Information Systems Network will place Western ew York on the cutting edge of this medical technology. The Ross chair in Medical Informatics adds significantly to that impetus," said Dr. Riemenschneider. Medical informatics chair to be estabhshed with gift in honor of Ira Ross ne of the nation's first professorships in medical informatics has been established at the School ofMedicine and Biomedical Sciences through a $1.5 million gift in honor of the late Ira G. Ross by his widow Elizabeth Pierce Olmsted Ross, M.D., '39. Olmsted is a practicing ophthalmologist and UB clinical professor of ophthalmology. The endowed chair will be known as the Ira G. and Elizabeth Olmsted Ross Chair in Medical Informatics. Ross, a distinguished aeronautical engineer, former president of Cornell Aeronautical Laboratories (later known as Calspan) and a dedicated Buffalo community leader, died january 3, 1991. The chair in medical informatics will help the medical school integrate the rap- p h y s c a Correction Our sincerest apologies to Robert A. Klocke, M.D., for printing a photograph of Francis Klocke, M.D., (instead of Robert) in an article about the medical school's annual faculty meeting in the Summer 1992 issue. Robert Klocke, a professor of medicine and physiology and chief of the pulmonary division, received the Stockton Kimball Award for excellence in academic achievement. w n e 9 9 �····· ········ ············· ············· ·· ···· ··········· ········ ····························· ·· ·[ ! ] Lore honored for oncologic surgery contributions project progress reports, Fish received the 1985 Outstanding Teacher Award and the 1987 Francis V. Hanavan Outstanding Teacher Award from the SchoolofHealth Related Professions. In 1985 , 1987 and 1988 he received the Faculty Recognition Award from the University's physical therapy program. Fish is a member of the American Physical Therapy Association, a manuscript reviewer for Physical Therapy and Physical Therapy Practice and a member of the MedicaVProfessional Advisory Committee of the Visiting Nurses Association of Western New York ohn M. Lore , Jr. , M.D., professor and former chair of the Department of Otolaryngology, has received the Presidential Award of the American Society for Head and Neck Surgery, for "his leadership in raising the quality and measurement of fellowship training in Head and eck Oncology ... " He is also the recipient of a Special Recognition Award from The Society of Head and eck Surgeons for his "untiring service as chairman of the joint council for approval of advanced training in head and neck oncologic surgery." Lore, the author of An Atlas of Head and Nech Surgery, is a senior member of the Commission on Cancer and a fellow of the American College of Surgeons. He holds dual certification by the American Board of Otolaryngology and the American Board of Surgery. Bissonette re-elected head of UCPA of WNY board aymond P. Bissonette, Ph.D. , associate professor of family medicine at UB, has been re-elected president of the board of directors of the United Cerebral Palsy Association ofWestern ew York. Also re-elected to the board was Kathryn A. Sawner as vice president, executive assistant in the Office of the President and G. Alan Stull, dean ofHealth Related Professions at the University at Buffalo. The UCPA of W Y volunteer board of directors governs the policies and procedures of the agency which provides a comprehensive range of services locally to 1,200 adults and children with disabilities. Fish wUI head physical therapy/exercise science ale R. Fish, associate professor of physical therapy and exercise science, has been named to a threeyear term as chair of the Department of Physical Therapy and Exercise Science in the School of Health Related Professions. Fish has been a UB faculty member since 1974. He is also a clinical assistant professor in the Department of Anatomical Sciences. Author or co-author of numerous abstracts, book chapters,journal articles and B 0 0 p h y s o n w Roswell doctors named 11 best" cancer specio6sts ive physicians from UB and Roswell Park Cancer Institute were selected as among the 419 "best cancer specialists in the United States" in a survey conducted by Good Househeeping magazine. The results were published in the magazine's October 1992 issue. Over 350 department heads and section chiefs at 110 major hospitals and comprehensive cancer centers nationwide were asked to name doctors they considered "outstanding" in treating the most prevalent cancers. Cited by their peers were Roswell Park surgeon and research associate professor of surgery Harold Douglass, Jr. , M.D., for gastrointestinal cancer; surgeon and clinical professor of surgery Constantine Karakousis, M.D. , for melanoma; surgeon and clinical professor of gynecology and obstetrics M. Steven Piver, M.D. , for gynecologic cancer; medical oncologist/hematologist, chairman of Roswell's Department of Medicine and professor of medicine Clara D. Bloomfield, M.D. , for leukemia, and medical oncologist/hematologist and professor of medicine Geoffrey P. Herzig, M.D. GYN and OB managers nome local editor oni Canazzi has been named editor in chief of AMGO News - the newsletter of the Association of Managers of Gynecology and Obstetrics. Canazzi is a senior staff assistant in the Department of Gynecology and Obstetrics at The Children's Hospital of Buffalo. e 9 3 �~ - · ····· ······· ······ ············ · ··············· ·· ··· · ·· · ·········· · ··· · ················· · ······ Q Evans receives Distinguished Medical Alumnus Award cation that l got at the University at Buffalo and that my father got." He said he would have liked the award to have been given to his late father, a graduate of UB's medical school and professor of anesthesiology, whom he described as a "pioneer" who established the first anesthesia training program in the country. After graduating from UB medical school in 1943, Evans interned at Philadelphia University Hospitals, Philadelphia and Goldwater Hospital in New York City. He then served two tours of duty in the U.S. Army- the first as a post-World War 11 public health officer in japan and the second as chief of the Hepatitis Research Center in Munich, Germany. Evans was appointed deputy chief of preventive medicine and consultant in epidemiology to the Army Surgeon General after his discharge from the Army. In 1987, he received the john R. Seal Award from the Society of Medical Consultants to Armed Forces, that organization's highest tribute. In 1977, Evans, who majored in English as an undergraduate at the University of Michigan, received the Best Book award from the American Medical Writers Association for his textbook Viral Infections of Humans. The book is currently in its third printing. Evans has published more than 200 articles in professional journals and spent his 43-year career studying the relationship of viruses to cancer and other chronic diseases, focusing his interests on infectious mononucleosis and the Epstein-Barr virus. About80 people attended the dinnerto see Evans receive his award, a specially designed crystal bison, from Donald Copley M.D., president of the Medical Alumni Association. LAUDS HIS LATE FATHER IN ACCEPTING AWARD lfredS. Evans M.D., '43, consultant to ASA's Manned Space Program and an infectious diseases expert, received the School of Medicine and Biomedical Sciences' 1992 Distinguished Medical Alumnus Award on September 24 at a dinner in his honor at the Buffalo Club. "I am very proud to be the recipient of this distinguished award," Evans said. "You have a very distinguished group of medical alumni. I am happy to be among them. I am happy to be a member who has been trained by this fine medical school." Evans,john Rodman Paul professor of epidemiology at Yale University for 20 years, was professor and chair of the Department of Preventative Medicine at the University ofWisconsin until he retired in 1988. A fellow and past president of the American College of Epidemiology and past president of the American Epidemiology Society, Evans served as editor in chief of the Yale journal of Biology and Medicine for three years. On accepting his award, Evans said, "I appreciate very much the wonderful edu- - BY CARRIE A . LIBERANTE Alfred S. Evans, M.D., '43, (center) receives the 1992 Distinguished Medical Alumnus Aword, a specially designed crystal bison, from Donald P. Copley, M.D., '70 (left) and Dean John Naughton, M.D. B u a 0 p h y 5 c a n w e 9 9 3 �....................................................... . . . . . . . Annual James Platt White meeting held he james Piau White Societyof the School ofMedicine and Biomedical Sciences held its seventh annual meeting October 23. The event included a talk by joseph Prezio, Chairman of the Department of uclear Medicine, on the introduction of the medical school's new Positron Emission Tomography Center as well as a tour of the facility and the new cyclotron. A reception and dinner dance were held later that evening at The Saturn Club. The event honors members of the society, who make annual contributions of $1,000 or more to the medical school. The membersofthejames Piau White Society for 1992 are: Dr. Kenneth Z. Altshuler Dr. Richard Ament Dr. WilliamS. Andaloro Dr. jared S. Barlow Dr. Horace L. Banaglia Dr. Charles A. Bauda Dr. Barry Benisch Dr. Richard A. Berkson Dr. Willard Bcrnhoft Dr. Paul K. Birtch Dr. Theodore S. Bistany Dr. Dennis L. Bordan Dr. Willard H. Boardman Dr. Martin Brecher Dr. Harold Brody Dr. james B. Bronk Dr. Robert L. Brown Dr. Melvin M. Brothman Dr. August A. Bruno Dr. Elaine M. Bukowski Dr. Thomas S. Bumbalo Dr. William M. Burleigh Dr. David W. Butsch Ms. Janel F. Butsch Dr. john L. Butsch Mr. David N. Campbell Dr. Nicholas j. Capuana Dr. Ben Celniker Dr. and Mrs. joseph A. Chazan Dr. Michael E. Cohen Dr. Donald P. Copley Dr. Daniel E. Curtin Dr. Edward Diao Dr. PeterS. D'Arrigo Dr. Richard Daffner Dr. RogerS. Dayer Dr. Alfred H. Dobrak Dr. Stuart L. Dorfman Dr. Sterling M. Doubrava B u a a Dr. Ronald I. Dozorctz Dr. Patricia K. Duffner Dr. Kenneth H. Eckhen Dr. Robert Einhorn Dr. and Mrs. George M. Ellis Dr. Alfred S. Evans Dr. john A. Feldenzer Dr. Donald M. Fisher Dr. jack C. Fisher Dr. Eugene S. Flamm Dr. Thomas F. Frawley Dr. Richard Gacek Dr. Man A. Gajewski Dr. Penny A. Gardner Dr. Robert A. G1anfagna Dr. john W. Gibbs Dr. Mala Gupta Dr. Thomas Gunuso Dr. Theodore R. Hall Dr. Eugene Hanavan,jr. Mr. Edward Hansen Mrs. Edythe T. Harris Dr. Re1d R. Heffner,jr. Dr. Orvan W. Hess Dr. Williamj. Hewell Dr. joseph M. Hill Dr. Annabel M. Irons Dr. Stephen joyce Dr. james R. Kanski,jr. Dr. john P. Kelly Dr. Richard j. Ken line Dr. Kenneth Kim Dr. Hans F. Kipping Dr. Arthur C. Klein Mrs. jean L. Klein Dr. Monon P. Klein Dr. jacobS. Kriteman Dr. joseph L. Kunz Dr. Marvin Z. Kurian Dr. Gordon R. Lang Dr. Andre Lascari Dr. Eugene V. Leslie Dr. Lawrence M. Lesser Dr. Harold Levy Dr. Stanley B. Lewin Dr. jack Lippes Dr. Hing-Har Lo Dr. Gary H. Lyman Mrs. GraceS. Mabie Dr. Michael M. Madden Dr. Milford C. Maloney Dr. Boris L. Marmolya Dr. Don L. Maunz Dr. Robert C. McCormick Dr. Harry Metcalf Dr. Merrill L. M1ller Dr. Eugene R. Mindcll Dr. joseph F. Monte Dr. john D. Mounlam Dr. Arthur W. Mruczek, Sr. Dr. Richard L. Munk Dr. Richard j. Nagel Dr. Masao akandari Dr. Richard B. Narins Dr. and Mrs. john a ugh ton Dr. Robert ey Dr. john D. orlund Dr. Timolh)' T. Nostrant Dr. Ralph M. Obler Dr. Benpmin E. Obletz Dr. john j. O'Connor Dr. Thomas P. O'Connor Dr. Yasuyo Ohta Dr. Carrie P. Ogorek Dr. Elizabeth P. Olmsted p h y s . . . . . . ... . . ...... n w .. . . . . [!] Mrs. Rose Marie L. Wong Dr. john Wright Dr. HaJIIlla Yamabarashi Dr. Gregory [. Young Dr. Wende W. Young Dr. Syedc r. Zafar Dr. franklin Zeplowuz Dr. and Mr;. David C. Z1egler Dr. Dean E. Orman Dr. johnS. Parker Dr. Gerald E. Pancrson Dr. and Mrs. Robenj. Pallcrson Dr. Clayton A. Primer Dr. Victor L. Pellicano Dr. james F. Phillips Mr. R. Willis Post Dr. Linda Rabinowitz Dr. Ben Rappole Dr. Alben C. Rekate Dr. Frank T. RiforgialO Dr. Charles Riggio Dr. Richard R. Romanowski Dr. Charles Rosenberg Dr. Alben G. Rowe Dr. Eric j. Russell Miss Thelma Sanes Dr. DavidS. Schreiber Dr. joseph I. Schultz Dr. Roy E. Seibel Dr. Elizabeth Serrage Dr. Arthur j. Schaefer Dr. Robert N. Schnitzler Dr. Edward Shanbrom Dr. john B. Sheffer Miss Alice Simpson Dr. john [. Spoor Dr. William C. Sternfeld Dr. Eugene M. Sullivan, Jr. Dr. Michael A. Sulivan Dr. MichaelS. Taxier Dr. Charles S. Tirone Dr. Edward A. Toriello Dr. Anthony C. Trippi Mrs. johnnie Vinson Mrs. Yvelle Vinson Dr. john P. Visco Dr. Barbara Von Schmidt Dr. Franklin Waters Dr. Harold j. Weinstein Dr. Virginia Weldon Dr. Philip B. Wels Dr. and Mrs. llarold F. Wherley Dr. james j. While, j r. Dr. Gary j. Wilcox Dr. james S. Williams Dr. Richard G. Williams a . . . 1993 Spring Clinical Day and Reunion Weekend Set Mark your calendars and make plans to attend the 56th Annual Spring Clinical Day and Reunion Weekend. The program features cocktai I receptions for reunion classes on Friday, Apri130, and james S. Todd, M.D., executive vice president of theAMA, speaking on "The ame of the Game," and Reunion Dinners on Saturday, May l. e 9 9 �[!!····························· Brown pub6shes history of area medicine rom the natural medicine of the native Americans to the hightech practices of 20th centu!}'_ surgeons, KentL. Brown, M.D.y '42 , has chronicled the extensive history of medicine in the Westfield, ew York area. His recently released book , A Medical History of Westfield, New Yorh, not only recounts the history of nearly 100 doctors who practiced medicine in the area , but captures the striking evolution in the art of caring for the sick over the last two centuries. Brown's history , illustrated with the drawings of jane E. Nelson, is a record of those who tended the ill from the early 1800s when the Westfield area - then called Cross Roads - was first settled. The history begins with Westfield's first physicians and continues to the present. The book features an ex tensive on the Civil War brings to life the {). horror of that conflict. Not only has Brown captured the history of medicine in the Westfield area, but his chapters on what he believes was the first autopsy in Westfield, Prohibition Days, the !lu pandemic, the Lydia Warner atrocity and many other topics offer a unique microcosmic look at the growth of the medical profession in America. Brown practiced medicine for 38 years in Cleveland before retiring to his native Westfield. An assistant clinical professor of surgery at Case Western Reserve University Medical School, he has written and lectured extensively on medical-legal problems. He is the author of Medical Problems and the Law and The Medical Witness , as well as several scientific papers. subject index to help readers pinpoint specific people and topics. A detailed chapter on the remedies and practices of the native Americans includes a fascinating discussion on natural cures. Brown also includes intriguing chapters on root and herb doctors and homeopaths. A chapter z a z w w z < ~ Brown's Medical History of Westfield, New York is illustrated with the drawings of Jane E. Nelson. B 0 0 p y 5 c 0 n w e 9 9 �································· · ······························································[ ! ] Phrnp B. Wels, M.D. '41, named chair of UB CouncH hilip B. Wels, M.D., '41, has been appointed chair of the University at Buffalo Council by Governor Mario M. Cuomo. Wels, a clinical professor of surgery at UB and distinguished alumnus, has served on the council since 1980 and last year was named its vice chairman. He succeeds M. Robert Koren, who was chairman from 1981 until his death last March. "Dr. Wels has been a part of our university community for more than half a century. He knows UB inside and out, and has a great deal of insight into the university's relationship with the Western ew York community," said B President William R. Greiner. Wels holds a bachelor's, master's and medical degree from UB. A founder of UB's fencing team , Wels was a member of the United States Olympic fencing team in 1936 and served as coach of the UB team from 1938 to 1940. He was a member of the UB Athletic Council and an original inductee into the UB Athletic Hall of Fame in 1965. He received the Distinguished Alumnus Award in 1979 and the Samuel P. Capen Award in 1981. A trustee of the University from 1972to 1976, he has been a trustee emeritus since 1979. Wels, a founder of the UB fendng team and its coach from 1938 to 1940, was a member of the U.S. Olympic fencing team in 1936. ciated with Hospice Buffalo - and the hospice concept- since its inception in Buffalo in the mid-1970s. Acting as its first medical director on a voluntary basis, Milch was pan of the group of health care and commLtnity leaders that first introduced the concept to the area and focused the attention of an international American Cancer Society conference held here on it. Milch also worked to educate health care professionals as well as the community at large about the benefits of hospice to both patients and their families. Milch served as medical director of the Palliative Care Unit at Buffalo General Hospital, and has been a staunch advocate for Hospice Buffalo. On the national level , he has acted as co-founder of Milch appointed full-time medical director of Hospice Buffalo oben A. Milch , M.D., '68, has joined the medical staff of Hospice Buffalo as its full-time medical director. Milch , a clinical assistant professor of surgery, has been asso- B u 0 0 p y 0 w Children's Hospice International and is a member of that organization's scientific advisory board. In 1988, he was given the prestigious British Ambassador's Award for his service to dying children and their families. Medical Alumni Association estab&shes Achievement Awards he Medical Alumni Association announces the creation of Alumni Achievement Awards to honorthose physicians who have demonstrated uncommon dedication in research, teaching, technical innovation, private practice, community ervice and school administration. The newly created awards will be presented annually at the Spring Clinical Day luncheon . e �B l · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ·· · · · · · b::J division of laparoscopic surgery, a retired psychiatrist writes, "In three international photo salons sponsored by the Photographic Society of America, my stereo slides won awards. Because most of my photographs are close-ups, I do not use a stereo camera; I use two 35mm single lens reflex cameras whose shutters are synchronized electronically. The electronic flash units that I use are also synchronized at speeds up to 1/50,000 of a second. lam over80 years old, so l find it easier to set up my photo equipment on our backyard patio than to travel to some out-of-the-way place to get unusual pictures. At present, l have a Diamond Star in PSA Competitions. owl am accumulating credits for the next PSA Stereo Division Award, Master Stereographer l." further development of the resi- BERNARD S . STELL '36 , ARTHUR J . SCHAE FER '47 , was a member of the faculty for dency training programs and enhancement of research activities. He is an avid sailor and serves as the Fleet Surgeon of the Knickerbocker Yacht Club in Port Washington, New York. ELLIOTT BRENDER '70 , ~ 11. Elliott Brender '70 American College of Surgeons. sor of surgery at the University of retired from active family prac- California at Irvine and chief of tice. He has been promoted to surgery at Garden Grove Hospi- clinical assistant professor at the ROY M . OSWAKS '71 , lege of Medicine and Dentistry. cal College of Hampton Roads. of KENNETH P . SUN '89 , informs us that he and his wife are Insurance expecting their fifth child. He is pital Center, Company DONALD SCH ERTZMAN '82 , and lntracorp. vania, had his fourth textbook, Clinical Radiology: The Essentials, published byWilliams&:Wilkins, ovember 1992. minutes south of jerusalem, Israel on a West Bank settlement. BURTON L. HERZ '67 , died May 9, 1987. lem. JOHN K . CU S ICK '57 , Schertzman's address is: orthern judean Desert, Israel. com- pleted three years in adult psy- been appointed Director of Sur- chiatry at Massachusetts General. gery at New Rochelle Hospital He is currently finishing a two- Medical Center. Herz is respon- chiatry at Massachusetts General. administration of the department 5 His wife is at 5080 Lemon Bay Drive, Venice, Florida 34293. ER IC ARNOU '91 , died in Ari- automobile accident. ued growth and expansion of the h children. zona on November 5, 1992, in an of surgery, including the contin- p Talbott Recovery Center. He is survived by his wife Pat and six year fellowship in children's psy- sible for the overall direction and a died August 27, 1992. Prior to his death he spent six months at the ROY J . BOORADY '87 , has RAY MONDW. M ITCH ELL'44 , He practices anesthesiology at Bikur Cholim Hospital, jerusaMaalie Amos #109, ptosis and acquired involutional a ew York. practicing family medicine 30 in September. Schaefer lectured B is currently an anesthesiology resident at St. Luke's Roosevelt Hos- Hospital in Lexington, Kentucky Association. is currently a pediat- for Health Care Compare and the Southwestern Division of Cigna a professor of radiologic sciences at the Medical College of Pennsyl- Minnesota, has been elected treasurer of the Minnesota Medical LYN '88 , ton, Texas. come the orthopaedic consultant presented by the Center for Advanced Eye Surgery at Humana ERI C K REE S E R '56 , ofBagley, M ICHELLE V . ANDERSON - rics emergency fellow in Hous- ew Mexico, has be- RICHARD H . DAFFNER '67 , ptosis." jor 'project.'" appointed assistant professor of the Sixth Biannual Multispecialty for the correction of congenital was clinical surgery at the Eastern Virginia Medical School of the Medi- Oculoplastic Surgery Symposium on "Levator aponeurotic surgery writes, "I am continuing as an urgent care physician in Miller now two-years-old and is my ma- ew jersey Col- BERT A. LIES JR . '64 , T I NA MARIE GARDNER '87 , Place, New York. My son jake is tal. Robert Wood johnson School of Santa Fe, Roy J. Boorady '87 He is an assistant clinical profes- BERNARD H . SKLAR '56, Medicine of the re- cently became a fellow of the c a n w n e 9 9 ��BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 1993 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available University at Buffalo. Health Sciences Library. History of Medicine Date A point or period of time associated with an event in the lifecycle of the resource 1993-Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v27n01-1993-Winter Table Of Contents A list of subunits of the resource. Research Hospital News Problem Patients Taking the Stand A Spoonful of Humor Medical School People Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-18 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v27n01 Extent The size or duration of the resource. 32 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1993 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/59a8520632c63aba138f00cb7eaf3b1c.pdf 0a12fc59c7855326d69a10762f093f6d PDF Text Text �BUFFALO PHYS I C I AN Volume 26, Number 4 EDITOR Nanette Tramont Kollig, R. N ART DIRECTOR Alan J. Kegler ASSOCIATE ART DIR E CTOR Scott Robert Fricker STATE UNIVERSITY O F NEW YORK AT BUFFALO SCHOOL OF M E DIC I NE AND B I OMED I CAL SC I ENCES Dr. John aughton, Vice President for Clinical Affairs, Dean ED I TOR I AL BOARD Dr. J ohn A. Rtchert, Chairman Mr Ric hard de Asia Dr Martm Brecher Dr Harold Brody Dr. Rtchard L. Colhns Dr. Donald P. Copley Dr. Alan J Dnnnan Dr. Ttmothy Gabryel Dr. Glen Gresham Dr. Charles Massa ro Dr. Charles Paganelh Dr. Luther Robmson Dr. Thomas Rosenthal Dr. Saleela Su resh Dr Bradley T Truax Dr. Ste phen Spauldmg Dr Jerome Yates TEACHING HOSPITALS AND LIAISONS Batavia VA Medtcal Center Buffalo General Hospttal Michael Shaw Buffalo VA Medical Center Paula Pedene Children's Hospttal of Buffalo Ene County Medical Center Mercy Hospital Millard Fillmore Hospitals Frank Sava Roswell Park Cancer Institute judith Rice Sisters of Charity Hospital Dennis McCarthy © The State Umversity of New York at Buffalo Buffalo Phvsicwn is pubhshed quarterly by the State UmversnyofNew York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. It is sent, free of charge , to alumni , faculty , students, reSidents and friends . The staff reserves the nght to edit all copy and submissions accepted for publication . Address questions, comments and submissiOns to: Edttor, Buffalo Phystcian, State University of New York at Buffalo, University Publications, 136 Crofts Hall , Buffalo, New York 14260 Send address changes to: Buffalo Physician, 146 CFSAddition , 3435 Mam Street , Buffalo, New York 14214 Dear Alumni and Supporters of the UB Medical School: T he medical school and its teaching hospitals together with the faculty have made a major commitment to promote the education and training of an increased number of generalists for Internal Medicine, Family Medicine and Pediatrics. Throughout the past year, significant changes and accomplishments have been made in the governance of the graduate medical education programs and a mandatory two-month long clerkship has been initiated in comprehensive ambulatory care education. Through the recently funded Reimbursement Demonstration Project, six coordinated projects in primary care were funded together with a major project in geriatrics and minority recruitment and retention. These changes have positioned the medical school to address needed reform in undergraduate medical education. While some changes are already planned, UB has applied for a major grant for the training of generalists from the Robert Wood johnson Foundation. The school was visited by an external review committee in july, and we hope to be membered among the 18 awardees when the Foundation announces its choices in mid-November. The next challenge will be to compete successfully to be one of the l2 schools funded for a period of five years commencing in mid-1994. These two initiatives are accompanied by another complementary award. Dr. Thomas Rosenthal of the Department of Family Medicine was a successful winner of a major five-year grant from Health Resources and Services Administration to study the ways in which to develop and promote primary care in rural areas. I hope you are pleased by the commitment to this needed part of medical education and care that UB has made. We will keep you posted on the school's progress in this important area in the years ahead. Sincerely, john aughton, M.D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences Dear Fellow Alumni: T his is the ~ear of Professor William Greiner's inauguration as the thirteenth president of the Umversny , an ausptc~ous event for those of us who support the continued growth and ~ttahty of our medtcal school. Prestdent Greiner has long been a friend of . the_ bwmedtcal soences and has been conststently vigorous in his support of our objectives. For example, Prestdent Gremer and Dean john Naughton recently announced a target of 50 percent pnmary care phystctans by the graduating class of 1995, thus placing us m the vanguard of Amencan medical schools in meeting our country's health care needs. Your Alumni Association has presented the Distinguished Medical Alumnus Award to Dr. Alfred Evans, Yale Emeritus Professor of Epidemiology and UB Class of 194 3. We have also met our Rochester alumni at the Richardson Canal House for an informal renewal of friendships. Support for our current medical residents has continued wtth another "Prep for Practice" seminar. Our Community Physician t. for series on career choices has reached many students p · c1· · 1D d . repara wns Spnng . t_mca ay an Reunion Weekend are well underway toward · n a hvely program abou t phystctan . . . . performance and competence . 0 ur c1ass reumo to organize spring reun d 1 ·ft chatrmen. have been workmg dthgently · 0 n d. 1 . . mners an c ass gt s. We cenamly have reason for pnde m our school and its successful alumni/ae! Yours truly, Don Copley, M.D., '70 �V 0 A 2 L u T u 6 N o 9 N 4 9 2 Research Hospital News The Graying of Medicine e Changing the practice of medicine to meet the challenges of a burgeoning elderly population. Rehabilitation Comes of Age e UB's new Center helps an aging population reclaim its lost abilities. UB' s new SS million demonstrotion project to eose the primary care shortage could become a model for the nation. Page 26. Conquering Ojos del Salado • UB's William Carl, D.D.S., on his mountain-climbing adventure in the Andes. UB medical students wm soon see patients who aren't really sick at all. Page 28. , Medical School People Alumni Classnotes *[limning t~e secono· ~ig~est eleuation int~e Western ~emisp~ere. Harold Brody steps down as chair of anatomical sciences after over two decades. Page 30. ~age 1~. �m ····················· ··········· • • ••••••• 0 •••••• 0. 0. 0 •••• 0 ••••••• • 0 •• • •••• •• 0 ••• • • • • 0 •••• 0 UB-NASA experiments yield unexpected results n experiments with potentially far-reaching ramifications for the U.S. space program, University at Buffalo scientists have found that the human body regulates the cardiovascular system in a totally unexpected manner in the weightless environment of space and takes at least a week to return to normal functioning after even short flights. The cardiovascular research, conducted on NASA's first Spacelab Life Sciences Mission last june, showed that astronauts could not perform some routine tasks at their full capacity for the first days after returning to Earth. And in what the researchers term the most surprising finding of the study, results showed that in space, the human body uses a previously unobserved mechanism to regulate the cardiovascular system. David R. Pendergast, Ed. D., professor of physiology and one of the investigators, presented the findings at a special two-day meeting on cardiovascular response to exercise sponsored by the American Heart Association in Chicago injune. The experiment, funded by a $2.3 million grant from ASA, was developed by Leon E. Farhi, UB distinguished professor of physiology. It was one of three studies on the mission focusing on astronauts' cardiovascular function in zero gravity and under normal gravitational forces once they return to Earth - the first comprehensive human cardiovascular experiments conducted in space. B u a a p "These results will change the way ASA isthinkingabouthumansurvivalinspace," Pendergast said. " ASA had thought man could adapt readily to problems of space flight. This research shows that some functions remain compromised to some extent for at least seven days after a short flight. "This was only a nine-day flight," Pendergast added. "On a much longer flight, the effects could be much more pronounced, or last considerably longer." The project was designed to determine how the heart and lungs perform during weightlessness, and after adjusting to that environment, how they function when resubjected to Earth's gravity or a stronger gravitational force. This knowledge is important, Pendergast . explamed because the success of future ' . depen d on the travelers' space travel Will . . . norma lly during travel ab1hty to funcuon . as well as when they reach their destma· anotherplanet tion-beitaspacestauon, or Earth. , mechanisms and neural "Our bo d ys d reflexes are esi·gned to control blood h y 5 c a A pressure at 1-G ," Pender-gast said. "One of the major concerns regarding the body's adaptation to space flight is that the adjustments the cardiovascular system makes during flight to maintain blood pressure in weightlessness may compromise its ability to readjust to gravity upon return." UB researchers, using equipment engineered by UB technicians Richard A. Morin (U.S. . ret.), Christopher G. Eisenhardt and Claude Miller, took readings of three astronauts' cardiac output, oxygen consumption, mean blood pressure and heart rate five times during the six months before the flight. They calculated stroke volume, total peripheral resistance and the amount of oxygen extracted from the blood. The astronauts conducted the same experiments during the nine-day space flight, and UB researchers took readings again on the first seven days after the astronauts returned, as well as on the 45th post-flight day. Cardiac output was expected to increase initially in space, and then drop to normal in the weightless environment, as it does in experiments conducted on Earth under simulated weightlessness. During space flight, however, cardiac output went up and stayed up. When cardiac output increases, the body u u m n 9 9 2 �··· · ······· · ····· ··· · ·· ·· · ··· ·· ········ · · · ············ ···· · · ·· · ······ · ······ ·· ········· · ·· • 1'3 .~ .. attempts to maintain blood pressure; previous experiments had suggested the body reduces the amount of plasma in the blood to regain cardiovascular balance, freeing up water from the plasma and eliminating it in the urine. But because cardiac output did not come down in space and blood pressure remained stable, the researchers speculated a previously unobserved adjustment mechanism was apparently at work. And, in fact, calculation of the other cardiovascular variables showed that in space, the body had maintained blood pressure through hyperperfusion- engorging organs and tissues with blood. "This type of regulation of blood pressure was completely unexpected ," Pendergast said. "The system's failure to reduce cardiac output and its ability to accept the hyperperfusion are hard to reconcile using current physiological thinking." The researchers now theorize that this phenomenon is at the crux of the cardiovascular difficulties astro- B u reentering gravity. It will be the central focus of their research on future space flights. Post-flight data showed the ability of astronauts to perform work was severely limited immediately after leaving the weightless state and reentering gravity. "On the day they returned, the cardiovascular system was very compromised," Pendergast said. "Stroke volume was low, heart rate was high. The system was trying to compensate for the stress of gravity, but it couldn't. "By post-flight day one, the astronauts were able to perform exercise, but the body was not stable. They could do 30 minutes of exercise but the body was stressed. They couldn't have done more." The astronauts' ability to respond to stress remained compromised for seven days. 5 c o n A u "This is a significant problem that needs to be corrected if we are serious about longer space flights," Pendergast said. "Some more creative thinking has to come into play." All readings were back to normal by the 45th day. Pendergast praised the astronauts for their skill in conducting the experiments under demanding conditions. 'The crew did a phenomenal job getting data," he said. "It's an incredible testament to what humans can do." UB researchers have already begun training more astronauts to perform the same experiments on a Space Shuttle mission tentatively scheduled for next summer. + - u m n B Y L OIS 9 9 B AKER 2 0 �• ································· Area's first ECMO opens at Children's Hospital . . . . . . . . . . . . . . . . . .. . mained on ECMO for six days and finished recovering in the hospital until he was able to go home several weeks later. As many as one in every 4,000 to 5,000 newborns could benefit from the treatment, according to Robin Steinhorn, M.D., director of the ECMO Center. "With the establishment of an ECMO Center here at Children's we're taking on the challenge of caring for these desperately ill babies. We hope to be a resource for the local community as well as the entire state," Steinhorn said. + he Children's Hospital of Buffalo has opened the area's first extra corporeal membrane oxygenation (ECMO) service. Open since late june, the ECMO Center is one of only two in the state (the other is at Columbia Presbyterian Medical Center in ew York City). The state-of-the-art heart-lung machine, used for infants and children with lifethreatening lung or heart failure, completely takes over heart and lung function, enabling the patient's heart and lungs to rest and recuperate on their own. Housed in its pediatric intensive care unit, Children's ECMO service is manS Senator Alfonse M. D'Amato · · aged by an interdisciplinary team consistrecently announcedthattheSening of an ECMO physician, coordinator, ate VAIHUD!lndependent Agen. . tions Subcommlttechnician, pediatric surgeons, attending cies Appropna tee has approved his request for physicians and pediatric intensive care . to renovate The nurses. The unit's first patient, a newborn $2 m1.11 wn . . of Buffalo's Regional 1 with sepsis, was placed on ECMO within Children's Hosplta . his first 18 hours of life. The infant re- Pediatric Intensive Care Umt. . . .. . . . . . . .. . . . . .. . . . . . . . . . . "Children's Hospital is a national leader of health care for our children, providing cutting-edge scientific discoveries and stateof-the-art medical treatments for seriously ill and injured children, regardless of their ability to pay," said D'Amato. "Our children deserve the very best health care available. These funds will ensure that the badly needed renovation of the PICU will go forward without delay to provide for the health care needs of the community's families." Work on the $8.7 million renovation is scheduled to begin next year, pending approval by the State Department ofHealth's Office of Health Systems Management and the completion of additional fundraising efforts. The project includes expanded space for each PICU bed, expanded isolation rooms, enhanced nurses' and physicians' stations, an on-site satellite pharmacy and laboratory and enhanced storage and ad+ ministrative space. $8.7 mORon renovations proceed at Children's B a 0 p y s a n A u m n 9 9 2 �· ·· · ····· ······ · · · · ··· · ··· · · ·· .· ···· ·· · · ··· · ···· ···· ··· ···· ··· ··· · · ·· · ··· · ··· ··· ········ · · · • Legislature authorizes funding for RPCI maior modernization proied tion of a pedestrian walkway system to unite the campus; replacement and modernization of inpatient beds; correction of life safety , health code and infrastructure deficiencies , and restoration of structured parking. he New York State Legislature last March passed legislation that would authorize bonding for a major modernization ofBuffalo's Roswell Park Cancer (RPCI) Institute. Thomas B. Tomasi, Ph.D., M.D., RPCI president, said he felt tremendous "relief, elation and gratitude" as he watched ew York State Governor Mario M. Cuomo sign the bill which would appropriate $241.5 million to rebuild the nation's oldest cancer center. "Relief," he said, "because we had won a long hard fight. Elation because we had taken a giant step toward accomplishing what we had set out to do. And gratitude to the many individuals whose response to "it can't be done" was always "it will be done." Roswell Park's current campus comprises 19 buildings with approximately one million square feet on 25 acres. The major modernization program calls for the construction of a new diagnostic and treatment center for radiation therapy, diagnostic imaging, nuclear medicine and surgery with its related post-anesthesia care unit and central sterile supply. Construction of the center will begin next year, with completion scheduled for early 1996. A new vivarium - which would centralize disparate animal facilities presently spread over five buildings on campus and two off campus - will be completed in 1995. The plan also calls for the construction of a new laboratory building and renovation of other laboratory space to remediate obsolete mechanical and electrical systems and to provide additional space to meet the needs of the institute's basic science programs. Other priorities include the construe- B 0 0 p h The legisla- Artist's rendering of Roswell Park Cancer Institute's major modernization. tive bill passed in March, which is the final legisla- delays in renovations required to repair tive approval required before the project its deteriorating infrastructure, correct can commence, also authorizes the estab- code deficiencies, support competitive lishment of a Roswell Park Practice Plan to programs and facilitate recruitment, were enable the institute to add 30 new physi- chipping away at the institute's oncecians over the next few years without solid reputation as a major national canincreasing state funding. It will also pro- cer center. vide opportunities to develop joint venCuomo made a commitment to reverse tures with other health care facilities , in- these trends and pledged in 1989 and cluded Roswell-owned and operated fa- again in 1991 to do "whatever it would cilities outside the Buffalo area. take" to modernize the Institute. Funding for the project, which took The major modernization formally beyears to obtain, began in 1984, when gan in 1989 when a team of architects, Cuomo appointed a Blue Ribbon Com- planners, engineers and market and fimittee to assess conditions at RoswelL nancial analysts headed by Bohm • BBJ The committee stressed the national im- was selected to conduct the planning portance of the institute's scientific and project. An interagency core committee clinical programs, but underscored the of key management from the Institute, critical need for capital improvements to the Department of Health, Office of Genthe physical plant it found fundamentally eral Services and the Dormitory Authorinefficient and dehumanizing. ity was established to review and approve In the past, Roswell Park- part of the the plan in progress. ew York State Department of Health The combined direct and indirect ecosince 1911 - received approximately 45 nomic impact of Roswell's major modpercent of its funding from the state. ernization program on Western New York Today, the institute receives less than 30 is estimated at $511 million, with over percent from ew York State. That, plus 5,000 new jobs expected to be created. + y a n A u m n 9 2 �0 B u f f a l a P h y sl cIa n A u t u m n 1 9 9 2 �A ~ C T A N E M 0 N D s the baby boomers age, a demographic tidal wave will reshape the structure and culture of medical care for the elderly Already, physicians are learning to care for an older populationsome of whom are astonishingly able while others are remarkably frail- that is relatively new on the planet. Human life expectancy at birth has virtually doubled since the mid-19th century from 40 years to near 80. In fact, since 1900, the number of Americans 65 years and older has grown tenfold, from 3.1 million to 31 million today By the year 2040,68 million people will be older than 65, an estimated 22.2 percent of the U.S. population at that time, as compared with 12.5 percent now. L B L U a 5 T 0 R p A h T 0 s N c ~ 5 a n Y A l AHA 5 m 9 N EY 2 �ere, more than 15 percent of the community is 65 years and older, A preview of the medical community's competitive grant process. The program emphasizes clinical trainresponse to the nation's aging population maybefoundinWestem ewYork. Here, ing, aughton says, because, "The most more than 15 percent of the community is effective part of our education is the in for65 years and older, approximating the ratio that will prevail in the country as a whole in another 15 years. Responding to the needs of this community, the University at Buffalo School of Medicine and Biomedical Sciences is taking a leadership role in training physicians to respond to the needs of older patients. This year the medical school initiated a three-year trial program, the Indirect Medical Education (I ME) Demonstration Project, through which the region's consortium of six teaching hospitals pools Graduate Medical Education (GME) payments from area medical insurers and redirects these funds to train more residents in geriatric care. Funds are also set aside to train residents in primary care and to recruit and retain more minority residents - a strategy recently cited in Hospitals, as a national model for promoting primary care and reshaping graduate medical education. "We're using this as as tim ulus to move us institutionally mal methodologies and patient demonto help in these missions, " says john P. strations. Changes in the curriculum reNaughton, M.D., vice president for clinical affairs and dean of the School of Medi- lated to the medical problems of an aging cine and Biomedical Sciences. During the population will occur as the faculty develnext three years, the IME will provide ops interests and integrates them into the between $4 million and $5 million for curriculum." Already, Susan H. Schwartz, M.D., diresident training in geriatric and primary care, disbursing funds through an internal rector of UB's third-year medicine clerk- 0 B u a 0 p h s c a ship and assistant head of medicine at Buffalo General Hospital, has altered the medicine rotation to include outpatient exposure to the elderly this year for the first time. "Compared to their current exposure, this will change medical students' attitudes tremendously," Schwartz says. "The in-hospital exposure to the elderly is an unfortunate one. For students on inhospitalrotation, the elderly are the people who are in the hospital to die. They [the patients] are at their worst in an acute setting, away from home, where they're disoriented. It can be very frustrating for students to deal with. " Next year, Schwartz says, four of the 11 weeks of the medicine rotation will beat outpatient sites such as nursing homes and day care centers for the elderly. "It's important for medical students to see older patients in outpatient settings where they're walking, talking older people who may have assorted medical problems but are still functioning," she says. "They will see being elderly does not mean being completely infirm, and that there is a reward, clearly, for dealing with the elderly. It's both an emotional reward of just interacting with older people, and it's also the reward that you can make people better, that there are curable or chronic illnesses you can modify if not totally cure. , The geriatric initiatives funded through the IME Demonstration Project also reflect the progress of physicians' understanding of the needs of the elderly - u m n 9 �approximating the ratio that will prevail in the country as a whole in another 15 years. emphasizing preventive and chronic medical care, outpatient care for ambulatory older patients and interdisciplinary geriatric teams. Until recently, many physicians assumed that increased physical frailty was inevitable as aging progresses. A more current approach, often referred to as "successful aging," in reference to the landmark article in Science, "Human Aging, Unusual and Successful" byjohn W. Rowe and Robert L. Kahn, is gaining credence as research indicates that a healthy lifestyle and prevention of conditions such as heart disease and osteoporosis that are often present in an older population lead to increased longevity and a higher quality of life in later years. john Feather, Ph.D., director of the Western ew York Geriatric Education Center, which serves as a regional resource for geriatric education, observes, "If you think of aging as an inevitable degenerative process, then what's the point of trying to help people? You should just try to make them as comfortable as possible. However, if the frailties associated with old age are really disease-specific, then you should aggressively treat disease at any age. The truth probably falls somewhere in the middle; even if you solve every disease, that person isn't going to live forever. " june I. Chang, M.D. , who coordinates the education and training programs in UB's Division of Geriatrics/Gerontology, concurs. "A middle ground might be described as progressive aging, making people as healthy as long as possible, but accepting that some physical changes are going to occur." These philosophic approaches to medi- 8 0 0 p h cal care of the elderly have real consequences, she says. For example, though there is some senescence in aging, Chang says, people shouldn't forget important things like their child's name or someone who is a close friend. She observes, 'Tve had patients with memory loss say there's nothing sume that some surgical procedures or aggressive treatments would not be appropriate; but in many of these instances, treatment might extend life by another 10 to 15 years. Typically, students may not be aware of the importance rehabilitative therapy or assistive devices could have in improving the quality of life for older patients, she says. And they often Number of c ertl·r·led Geriatricians aren't aware of how changes re40,000 lated to aging affect which medications should be prescribed. Even practicing physicians have ....---.~ 30,000 a tendency to misdiagnose the symptoms of older patients, frequently failing to diagnose the treat_ ____, 20, 000 able medical problems that affect the health of older persons, Chang says. Medicine's approach to older patients will clearly receive more and more attention in the decades to come due to the sheer numbers of patients living to their "golden years. " T. Franklin Williams, M.D., the immediate past director of the ational Institute that on Aging and a professor of medicine at can be the University of Rochester, says, "Bedone, that's cause of the rapidly increasing numbers of normal with ag- older people in our society and especially ing. But this symptom really should be the very old, there's no question but that looked into. It could be a problem with the predominant amount of medical pracmedication, depression, a stroke or tice in essentially every field will be with Alzheimer's disease. Likewise, sleeping olderpatients-orthopedics,generalsurproblems that patients typically attribute gery, urology, family practice, internal to age could be symptoms of congestive medicine and cardiology, and so on, heart failure which gets worse at night, through every medical specialty. depression, improper medication or uri"The team approach is the key direcnary problems." tion for geriatrics, and specifically for the Chang works closely with medical stu- most complicated patients," Williams dents to address common misconceptions says. "That's true because the most comabout older patients. She says medical mon situation is a relatively older patient students frequently have a mistaken im- who may have two or three different morpression that people in their 70s or 80s bid medical complications, and may have don't have long life expectancies, and as- depression, dementia, plus social prob- Jo,ooo 5 c 0 A u m n 2 0 �related to care of the elderly with practicfor Graduate Medical Education. lems and functional losses as a result. "These two settings will expose resiing physicians and medical educators in "This is not only recognized in acavirtually every specialty. dents to the practices and principals of demic circles, but many community hosChang concurs. "Our goal for geriatpitals recognize that they need geriatricall y geriatrics with an emphasis on continuity specialized physicians, or geriatricians, on of care for elderly patients. These are real rics in general should not be training experiences in alternative settings away geriatric physicians, but to accept a role staff. They also recognize that in order to be known in a community as the right from acute care facilities, " says David W. as teacher and distributor of information place to come if you're a frail older person Bentley, M.D., head of UB's Division of to our colleagues. " Part of this mission, Geriatrics/Gerontology and the project she adds, is to convince medical stuwith complicated problems, you've got to director for the Geriatric IME Demonstra- dents that care for the elderly is chalbe well-staffed." lenging. An integral element in the develPopulation in Millions, 65 "Attitudes are changing," opment of needed geriatric experand older 10 she says, "but they're changing tise at UB's affiliated teaching hospitals, the Indirect Medical Education very slowly." Demonstration Project this year proIn the absence of a single 60 vides $130,000 in funding from the university-affiliated teaching = seven-hospital consortium for two hospital - which elsewhere t-_ - ____ , new interdisciplinary team initiatives have been criticized as being -~ overrun by medical specialists to train UB residents in geriatric ~~£40 and isolated from their commucare: nities- six of the teaching hos• Beginning in October, 1993, a 30 pitals affiliated with the UB medinew, mobile geriatric assessment team will treat older persons who cal school produced the bluelive in the community at ambu20 print for this first three-year latory care sites at area hospitals. phase of the IME DemonstraThe team, composed of a geri- 19--~:::-:--k::: J0 tion Project. atrician , nurse practitioner and 90 2000 ~ k:: Based on the project's ansocial worker experienced in the care of 201 0 0 ticipated success, UB medical older persons, will provide consultauons 'n::AI{ 2030 ~ school was asked to make a 20 40 presentation to the U.S. Congressional as requested by;residents and their intertion Project. nist-preceptors. Resident training will be ationwide, the demand for geriatric- Commission on Health Care Financing. aughton and senior staff associate provided through these consultations, as trained physicians has already outpaced ancy Gleico represented UB at the hearwell as through team conferences and supply. The Alliance for Aging Research recently asserted that the U.S. , which now ings that explored ways to change the seminars for approximately 40 residents during the first year. has 4,084 physicians certified in geriat- direction of graduate medical education • A new Geriatric Evaluation and Manage- rics, falls far short of the 20,000 needed to for which the federal government spends ment Unit, located at the VA Medical deliver medical care to the nation's 30 $5 billion a year. "We're ahead of where the country Center, will provide rehabilitative assessmillion persons over 65. This Washingment and care for frail elderly patients. ton-basednon-profitorganizationprojects should be going," aughton says, adding Theinterdisciplinarymembersofthis unit that by the year 2030, when there will be that for UB and other medical schools will also provide consultations to the VA more than 65 million Americans over 65, "One of the challenges for physicians wili MedicalCenter'sacutehospitalunits,adult more than 36,000 geriatricians will be be to coordinate medical care with specialday health care program and the geriatric needed. ists from the allied health professions. However, it will not be possible to keep Another challenge will be to integrate care ambulatory clinic. This program is expected to train approximately 20 Departpace with this projected demand. Instead, and prevention. ment of Medicine residents next year in a Bentley, who is also director of UB's "As the reemphasis on developing more proposed, required geriatric module rec- Multidisciplinary Center on Aging, sug- generalists occurs, and we turn around ommended by the Accreditation Council gests that geriatricians should share data our specialty model, it can be done. " + - - so ~~[/ B a 0 p y 5 c a I )..) n A u m 9 9 2 �lRf~li~G l H[ flDfRl~ arion Z. Goldstein, M.D., receives equate severity to require treatment, and nearly two calls a week from nearly 63 percent of this group receive no women who are concerned about treatment. Among persons over 65 living the quality of medical care pro- in institutions, an estimated 65 percent of vided to their elderly mothers. older persons require mental health serOften, the calls come as a com- vices, yet 91 percent of them receive no plaint, says Goldstein, director of the UB treatment. medical school's division of geriatrics. "The Team care is well suited to older paprimary care physician has just relegated whatever symptom is presented as just 'old age' or 'confusion."' A board certified psychiatrist with added qualification in geriatric psychiatry, Goldstein describes the common scenario: "The physician sent the elderly and their families away, saying you're just getting confused, getting old- without making distinctions between what is treatable and what is related to getting old. The stereotyping is horrendous. It's a matter of perceiving treatable, potentially reversible conditions as normal when they could be treated." She notes, for example, that if the symptom is memory loss, physicians need to conduct a differential diagnosis of the nature of the memory loss to identify how severe it is, whether it's something the person needs to adapt to, whether it's progressive or whether the anxiety and depression associated with it are treatable. A complicating factor: older patients are also often reluctant to acknowledge mental health problems, she adds. "They often are unaware of treatable mental health issues or attach a great deal of stigma to it. There's a great deal of fear of the mental health field by this elderly group. They're afraid their independence will be taken away." Depression is by far the most common complaint among an older population. Other typical mental health problems among older persons include dementia, anxiety, paranoia and alcohol abuse. In fact, research indicates that 7.8 percent of adults over 65living in the community have psychological disorders of ad- 1111111• B a 0 p h y s c a ll. u RIG Hl tients, Goldstein observes. "We need to address the specific needs of each individual much more adequately than we have so far. Our whole society needs to do something about the fragmentation of care. Hopefully the next generation will find it much more easy to seek out and find services they need. " + u m 2 �p ~ H J y B E s 0 T 0 c 5 5 a y B a p R h y s N E T A c R E B 0 a n T w A A L M m n N 0 N 0 9 D 9 2 �ul G. Bulger, 68, was reading a report at work one day, rubbing his eyes, when suddenly a giant black blotch covered the right side of the paper. When he looked up, the dark spot remained in his right field of vision. Alarmed, the former president of Buffalo State College had an assistant rush him to his ophthalmologist. There he learned that the condition in his right eye, age-related macular degeneration, would soon affect his left eye as well. Two years later, in 1988, while relaxing with his family at a wilderness summer cottage near Albany, the prognosis came true. �hough laser treatment in his left eye preserved some peripheral vision , Bulger was now legally blind. His ophthalmologist told him nothing more could be done to restore his vision , and sent him on his way. Bulger, frightened by his loss of vision , soon resigned from his position as interim director of the Buffalo & Erie County Historical Society. He became increasingly irritable, dependent on others, and subject to depression. Anticipating the needs of a growing population of elderly disabled persons like Bulger, a group of clinical and research faculty at the University at Buffalo recently founded a rehabilitation , research and infom1ation center for me elderly known as the Rehabilitative Engineering Center on Assistive Technology and Environmental Interventions for Older Persons with Disabilities. The center is the first of 18 national rehabilitative engineering centers to focus exclusively on ilie needs of the aging. It officially opened in September 1991 wiili the initiation of a fiveyear, $2.5 million grant from the Department of Education's ationa! Institute on Disability and Rehabilitation Research. An additional $2.5 million in matching funds were provided by UB and oilier sources for the center. William C. Mann , Ph.D. , director of the center known informally as the REC on Aging, says, "We have a unique service orientation. The ultimate goal of the center is to improve me quality of life by helping people maintain independence in the face of the aging process. While the physician is more typically involved with disease and medical treatment, we are addressing issues of long-term disability, and providing solutions ilirough assistive devices and environmental interventions." Referred by his physician shortly after the REC on Aging received funding in 1991 , Bulger visited the center for a full diagnostic review. The age-related macular degeneration that he suffers from occurs among an estimated 17 percent of Americans who are 60 years and older, and 30 percent of those 75 and older. Specialists identified two devices that would be of use to Bulger: a portable reading device and a computer with voice playback software. Though he remembers his early days ofblindness as, "A low spot that was pretty rough on me, and on other people around me, especially mywife,"Bulgersays. "With these devices, there is a tremendous elevation of the psyche. I have relatively few days of depression anymore." The REC also helped Bulger apply for financial support for me new devices, and provided six weeks of instruction on the devices. Bulger hopes to establish a consulting business, and is already using a desktop device that enlarges print for reading and writing that the Blind Association of Westem New York helped him obtain in 1989. Emmett Turner used the center's services to obtain a wheelchair specially molded to his body. Turner was 58 years old when he fell down a flight of steel stairs on ilie ship he was working on and broke his back. The former construction firm owner and port authority foreman couldn't sit for long periods of time in his first wheelchair and found it painful to ride over bumps.' In ilie new wheelchair, Turner can sit " nstead ofpatients who need treatment, older persons should be viewed as consumers who B u a a p h 5 c a n m 9 9 2 �process, accidents, developmental disabilities or disease. Among the medical conditions typically associated with aging that predispose to disability are arthritis, Alzheimer's, osteoporosis, cancer, heart disease, the inability to regain balance and neurologic diseases such as Parkinson's. Another REC client, john See!, a 71year-old information systems specialist who became legally blind from macular degeneration in 1988 now uses a voice-activated, specialized software package for a new computer that the center helped him obtain and learn to use. See! says if he had known of the center when he was first diagnosed, "It would have made all the difference in the world." Using this equipment, See! works from his home as a computerized maintenance, inventory and purchasing specialist for area corporations. He works for the income, and also because, "I would have just dried up and blown away if I didn't have something to keep me active." One of the RECs goals is to bridge the divide between geriatric specialists and rehabilitative engineers. "The technology people are not focusing on aging, and the aging people are not focusing in on rehabilitative technology and the applications of assistive technology and environmental interventions," says Mann, a licensed occupational therapist. "Perhaps we can bring them together." The center's cross-disciplinary team includes UB faculty in the School of Medicine and Biomedical Sciences, the School of Engineering, the School of Architecture and Planning, the Department of Communicative Disorders and Sciences, the School of Health Related Professions' Department of Occupational Therapy and specialists from UB's teaching hospitals and numerous state and local service agencies. In conjunction with their research efforts, these varied specialists provide wideranging, individualized client services that for nearly l2 hours, and is comfortable riding over uneven surfaces. "I go more places, and stay longer," he says. "It makes me feel a lot better." The medical community is on the front lines as the aging of America takes its financial and emotional toll. Currently, one in five Americans is older than age 55, as compared to one in 10 in 1910. By the year 2050, Census Bureau projections indicate this ratio will be one in three. Physicians are accustomed to providing medical solutions to health problems. However, as the nation's elderly population grows, the medical community is becoming increasingly aware of the need for non-medical approaches to improving the quality of life for older patients, many of whom face disability or loss of function to one degree or another as they age. While advancing age isn't always accompanied by disability, there is a strong relationship between age and disability or the need for assistance with the basic activities of daily life. A U.S. Census survey of non-institutionalized people conducted in the mid1980s found that 9.3 percent of persons 65 to 69 years old needed assistance with one or more activities such as dressing, eating, personal hygiene, housework, keeping track of finances or getting around outside the home. This rate rises steadily with age to 10.9 percent of persons 70 to 75, 18.9 percent of persons 75 to 79, 23.6 percent of persons 80 to 85 and 45.4 percent of those 85 years and over. These rates were significantly higher among persons living in an institutional setting. The research and service activities of the REC on Aging focus on restoring a measure of independence to those older persons whose limitations to mobility, speech, vision, hearing, strength, coordination or mental acuity are caused by normal changes associated with the aging B a a p h y c a n �he ultimate goal of the center is to improve the quality of life by helping people include in-depth assessments of each client's functional abilities, limitations and goals; identification of technologies that meet clients' needs, and assistance coordinating third-party payments for purchasing and training on new devices. The center also features a full-scale interior design testing center where changes in the layout of a home or office are tested before expensive modifications are made. lt also boasts computer and device laboratories where clients choose devices that will be most useful. The research component of the REC focuses primarily on persons 60 years and older. Interviews with about 600 of the center's clients will be used to identify which assistive devices on the market are most u eful for older persons, whether new devices should be created to meet their needs and how to make their living and work space more functional. Based on this input, the REC on Aging B u 0 0 p will design devices that are not currently commercially available to disabled older persons. Items the REC has already invented include a "smart" microwave oven that reads cooking instructions off bar codes and a motorized wheelchair testing platform to which a conventional wheelchair is attached, providing a cost-effective means to evaluate different models of motorized wheelchairs. The survey will also be used to identify and meet the needs of the older disabled person's family members and professional care givers. Survey respondents will be interviewed over regular intervals during the the REC's five-year education department grant, enabling the center to evaluate the long-term effectiveness of its services and the usefulness ofspecific assistive devices and modifications in living and work space. In keeping with a national trend to- h y 5 c o n ward patient empowerment, joseph P. Lane, an associate director of the center, observes that, "Instead of patients who need treatment, older persons should be viewed as consumers who need information to make rational choices. They have a role to play in decision-making. " Glen E. Gresham, M.D., chairman of rehabilitative medicine at UB and medical director at Erie County Medical Center, shares this perspective. just as internists consult with a surgeon if they think a patient needs an operation, he recommends that physicians with older patients with disabilities should consult with rehabilitative and geriatric specialists as well as the REC on Aging. "If physicians have patients who have functional problems that are limiting their lives, they shouldn't just say, 'You have to live with it,"' says Gresham. "The focus should be to help people stay functioning and independent as long as possible." + m n 9 2 �maintain independence in the face of the aging process. to mobility, vision, speech and hearing to read, write, control their environment and communicate in person and over the phone. * Inspection of home and work settings, full-scale testing of recommended modifications such as the enlargement of doorways or installation of hand rails. * Assistance coordinating funding from state agencies, insurance companies and employers. (The REC on Aging's fee-based services are covered by many insurance plans.) And for service providers and care givers for older persons with disabilities, the center provides: *Training and informational seminars for rehabilitative engineers, occupational therapists and institutional care givers for the elderly. * Presentations to residents of nursing homes and self-help groups for the disabled. * Presentations to advocacy groups for the aging, hospitals and church groups aimed at attracting clients who may regain independence with the center's assistance. For more general information, contact information coordinator Thomas Burford, Ph.D., and forreferrals for services contact Peggy Strassheim, social worker, at (716) 831-3141. + he University at Buffalo's new Rehabilitative Engineering Center on Aging offers wide-ranging services. For the medical community, the REC on Aging provides: * A center to which patients may be referred for evaluation and assistance. * Information about the effectiveness of more than 20,000 assistive devices and modifications to home and work settings. *Training for rehabilitation medicine residents, participants in UB's geriatrics/gerontology fellowship program, nurses, counselors, social workers, engineers, occupational and physical therapists and speecManguage pathologists. Because the REC on Aging shares the facilities of the University at Buffalo's Center for Therapeutic Applications of Technology, the following services are available to disabled persons of all ages: * Free information and referrals. * In-depth evaluation of needs and abilities, including identification of helpful devices and environmental modifications and installation and training on new assistive devices. * Custom modification of wheelchairs. * Computer facilities where clients may sample hardware and software designed to help people with significant limitations B 0 0 p 5 c o n A u m 9 2 �• • '' • n the centennial a iversary of the founding of th Sch l of Dental Medicine and the 25 year since graduated from it, Ros ell Park Cancer Institutes William Carl, D.D.S., climbs Ojos del Salado, the second-highest eleva. in the Western Hemisphere. This is his story. xl &Photos By illlam Carl D.D.S. �• �he world looks warm and pleasant through the windows of the Restaurant Miramare in Caldera, Chile. In the harbor, pelicans dive for fish. Small boats sway gently in the water. Beyond the bay, small houses, painted white and green, with flat roofs, cling like aphids to the desert slopes. The sun warms my back and face and drives the last of the lingering cold out of my body. Forty-eight hours ago, I stood on the crater rim of Ojos del Salado and shivered in the summit wind and fog. But now the Atacama Desert and its high plains and mountains are memories of an adventure into a great and unique wilderness. The Atacama Desert in northern Chile is one of the driest deserts in the world. It begins along the Pacific coast as gentle, sandy slopes and terminates inland in snow and ice-covered mountains of more than 20,000 feet high. No rivers flow through this desert; no rain wets the parched earth. The merciless sun during the day, the ever blowing wind and the bitter cold of night, have reduced all life to a minimum. What does grow in that desert of sand plains, saline lagoons and dry salt basins hugs the sterile earth firmly as tufts of coarse yellow grass. B a 0 p y 5 c a n u m n 9 2 ��THE CLIMBERS ENJOYING A BATH IN THE LAGUNA VERDE HOT SPRINGS AT 15.000 FEET . he creatures that inhabit this barren, desolate region reflect its colors in their feathers or furs. The few Oamingos on the shores of the saline lagoons don't have the bright pink shades of their African relatives. The furs of the occasional guanacos blend in with the maize of the salt flat grass, and the small lizards here and there scurry like fleeting shadows over the gray and brown sand. But then there are the rare humans wearing bright blue and red Goretex clothing in this endless wilderness: miners and adventurers searching to fulfill their ambitions and explore where few have tread before. What brought me to this end of the world? Once a year I feel the urge to get away from it all, leave civilization behind and test myself against the adversities of nature. I had climbed Kilimanjaro, Aconcagua, Cotopaxi and Chimborazo. But all of these mountains had the marks of tourism on them. Probably half a million people had climbed Kilimanjaro by the time I did. On Aconcagua - the highest mountain in the Western Hemisphere - the base camps were cramped with climbers from around the world and littered with garbage. Cotopaxi and Chimborazo were covered with snow and ice. That made them a little le s attractive to the average amateur climber. This time I was looking for something different. When I contacted Greg Wilson, B u 0 0 p my guide from Aconcagua, he immediatelysent mea list ofout-of-the-wayplaces. I picked Ojos because at 22,000 feet, it is the second-highest mountain in the Westem Hemisphere. Fewer than 150 people have climbed it. Climbers like those credentials. Besides, in 1992, the School of Dental Medicine in Buffalo celebrates its 100th birthday. I promised Dean Feagans to take the banner of the school to the top. There were four of us, all veterans of many mountains, waiting anxiously in Miami in March for the flight to Santiago, Chile: Peter Spatt, an internist from Colorado; Thomas Sieben, a pharmacist from Connecticut; David Hersey, a psychiatrist from Michigan, and me, a dentist from Buffalo. We had a specialist for any potential physical and emotional problems. In addition, there was Greg Wilson, our guide from Idaho who had recently climbed Mt. Everest and met Fernando and Missal, our Chilean drivers and part-time guides. From Copiap6, we headed north-east into the plains and canyons of the Atacama desert with two, four-wheel drive vehicles, leaving civilization behind. Life on land seemed to die. Clouds of dust and endless sand flats and dunes surrounded us. On the eastern horizon, rugged mountains met the blue sky in sharp silhouettes. The sun was only a few inches above the far horizon as we reached the first saline lagoon. The few flamingos munching in the shallow water took off as soon as we approached the shore. By now we were 12,000 feet high and the cold crept in y 5 c 0 closer as the sun dipped. That first night was a restless one; I never sleep well at high altitudes. The heat already made the air shimmer over the salt flat as I opened the tent flap the next morning. In the east, the three crosses - snow-capped mountains of about 21,000 feet altitude - suddenly loomed on the horizon. The Argentinean border was not far away. We camped for three days at 14,000 feet altitude to acclimatize to the altitude and then moved up to 17,000 feet. The best insurance against altitude sickness and pulmonary edema is gradual adaptation. Because the mountain air is cold and dry, hydration is crucial. Our high camp was at 19,000 feet, immediately at the foot of Ojos del Salado. Everything around oozed barrenness and isolation. On one side was the mighty massif of Ojos; on the other and below stretched the magnificent Atacama Desert with its canyons, driedout riverbeds and endless chains of snow- , W ILLI AM C ARL . D .D .S .. DESCE N D ING F ROM HIGH CAMP A T 19 .000 FEET . u m n 9 9 2 �capped mountains. We had been at high altitude for more than a week and I was anxious to get to the top after a few hours of rest at high camp. But Greg decided to allow for another rest day before our ascent. Finally, March 21st arrived - the first day of autumn in the Southern Hemisphere and the day we made our first attempt for the summit. We had packed ropes, crampons, provisions, water bottles and extra clothes the evening before. The anticipation was palpable. At 4 a.m., there was something different about Ojos. The top had an ominous white cap with a tail pointing toward the east. The cloud lingered at first on the summit ridge and then enlarged. Still, in the silvery moonlight, we continued in countless switchbacks up the scree slope until we reached the lower edge of the glacier at 20,000 feet. With the rising sun came the first gusts of wind carrying crystals of ice and snow. Above, the mountain top melted into B 0 0 p dense, fast-drifting clouds. Reluctantly, we turned back to the refugio hut. Cold and miserable, we sat around and cursed the weather. "You pay for the summit in the currency of toil," Greg philosophized. But in this weather, you couldn't even see the summit, let alone toil for it. All day the wind rattled the hut and snow showers alternated with moments c 0 A u of brilliant sunshine. When night came, no silvery moonlight illuminated the slopes of Ojos; its head remained in the clouds and our dreams of the summit began to evaporate. But weather in the mountains is unpredictable. I fell asleep in the small hours of the night and dreamed I flew a small airplane from mountain range to mountain range. It was 4 a.m. again when Greg called, "The top is clear, the wind has died." We rolled out of our sleeping bags and in the narrow space between the bunks fum bled around for our climbing gear. At this altitude, any exertion, like putting on boots and gaiters, is torture. At 5 a.m. we started to retrace our steps up the mountain. By the time the sun was well up we had reached the level of the glacier where we had to cross it. We strapped on crampons and roped up. The surface broke in large slabs, the snow underneath the ice sheet was soft and deep, up to the knees. Lifting your legs for each step out of a hole just to advance another 10 or l2 inches is agony at this altitude. Soon I measured my progress in half-boot lengths. "Breathe harder," I heard someone yell from above. I tried to answer, but no sound came out of my mouth, only a cloud of vapor that warmed my face momentarily. I concentrated on pressure breathing; breathe in deeply and let the air out with an explosive burst. The slope ahead looked steeper than anything I had ever climbed before. I conjured up the image of the little airplane that took me so effortlessly to the mountain tops in my dream and struggled on. The pain in my legs and the continuous gasping for air eventually gave way to my renewed deter- u m n 9 9 2 �summit of Ojos del Salado. To climb it, some technical know-how with ropes, jumars and descenders was required. I did not have that skill; besides, being scared of heights, I did not want to dangle from a rope at that altitude. Twenty-two thousand feet is respectable. The descent was long and slow, almost as tiring as the ascent. We met the sun again at the upper edge of the snow field and I had a picture taken with the centennial banner of the School of Dental Medicine. We had climbed and descended from 5 a.m. to 5 p.m.- a full day's work. I squeezed a few drops of water out of my frozen bottle and then dropped into my sleeping bag. I left summit jubilation for thenextdayand the long trek back through the desert. Climbing a mountain like Ojos is more than just physical toil - you have to be prepared for conditions that are not on an ordinary day's schedule. One thing is cleanliness. If you are obsessed with it, forget an adventure like this. I didn't wash my hands, let alone the rest of me, for two weeks. There is sand everywhere - in your clothes, in your sleeping bag and between your teeth. The toilet is the far side of a designated big boulder. It offers privacy, plenty of sand and lots of ventilation. You have to bring your own toilet paper and shovel. ights can be difficult on high mountains. You wake up out of a half sleep and your tongue sticks to the roof of your mination. Mini-breaks, while I waited for the slack of the rope ahead of me to pick up, sometimes allowed me to catch two or three breaths before the next step. That was sheer luxury. he steady deep breathing, the exertion and the dry air of the high mountains made my tongue and throat raw and painful. A short break, only a short break to get a drink of water, kept racing through my head. We reached the end of the snow field by early afternoon. Willpower and physical strength shriveled down to two and three breaths for each step of progress for the last few hundred vertical feet to the crater. We struggled up the ridge toward this almost imaginary point, so close to the eye, yet so far for the tired and aching muscles and oxygen-starved lungs. And then suddenly the ground leveled and we were there, on top of our world. I knew from other summits that there would be no magic insight into man and nature, no voice from heaven at that moment. My only thought was: I have to climb no more. The sun was by now behind the clouds and fog rolled in. From the rim, the depression of the crater stretched beyond the rocky elevation that was the actual mouth. You fumble around for your water bottle that's not frozen and squeeze out a few drops. And then you have to visit the far side of the boulder. At first you think about not getting up and going out into the cold for a while, but then nature demands action. You crawl back into your sleeping bag and a little while later it starts all over again. Some nights I had to get up five or six times. That's the price of hydration on high mountains. Physical fitness is essential for climbing. For a couple of months before I left for Chile, I toted heavy loads up and down Omphelius and Pfamer Roads in the Boston Hills, collecting curious looks from people in passing cars. But Ojos del Salado is different from the Boston Hills. As you struggle higher and higher, your back- THE UNIVERSITY OF ATACAMA·s .. REFUGio·· HUT AT 17.000 FEET . B u a a p y 5 c a A u m 9 2 �The memories of the cold, the wind, the sand and the toil faded as the snow-covered peak of Oj os vanished on the horizon. But the memory and the glory of having made it to the top always linger for a long time. And since this was our centennial year at the School ofDental Medicine in Buffalo and a quarter of a century since I graduated from that school, the summit of Ojos was a particularly memorable experience for me. But this was really more than just a mountain climb. It was an adventure into pack feels as if it weighs a ton and the straps cut mercilessly into your shoulders. Every muscle aches; your lungs never seem to get enough oxygen. You want to get to the top, butgravitywants you down. It becomes a balancing act. And then you begin to wonder what you are doing here. If you have any quit in you, the mountain will find it. When you set one foot in front of the other for hours and hours, you need something to occupy your mind. I wrote a few acid letters to people I didn't like. I counted from one to 100 in three languages, then did the multiplication tables and recited poems I had learned in school many years ago. I always knew they would come in handy some time. We left the mountain in high spirits. B a 0 p y a n the unknown. Even Greg had not been to this part of the Andes before. For a directional guide he used an article someone had written a few years ago for a magazine. That's the kind of stuff great adventures + are made of. m n 9 9 2 �• ················································· ··· ················· · ·························· . ' Proied aims to ease shortage of primary care physicians MODEL PROGRAM ESTABLISHED AROUND CONSORTIUM $5 million demonstration project that could become a model for easing the nations current and projected shortage of primary care physicians is being initiated by the School of Medicine and Biomedical Sciences, six of its affiliated teaching hospitals, theNew York State Department of Health, Jour private health insurance payers and Medicaid. The unique project is organized around UBs Graduate Medical Dental Education Consortium ofBuffalo (GMDECB). "The Reimbursement Demonstration Project represents a major cooperative effort on the part of our teaching institutions and graduate medical education directors to respond to known problems that face medical education, the medical profession and health care," said john aughton, M.D., vice president for clinical affairs and dean of the medical school. aughton, who chairs the GMDECB, will direct the three-year project, which also could pave the way for the more efficient use of graduate medical education dollars paid to hospitals. The project will also address ew York State's press- B u 0 0 ing need for more physicians to care for its growing elderly population as well as increase its pool of minority physicians. "We will strive to increase our commitment to the educational preparation of more generalists, and to attract increased numbers of underrepresented graduates from minority and socio-economically disadvantaged populations," augh ton said. "This effort shows the importance of cooperation by a number of diverse constituencies, each of which is involved in graduate medical education in some way," he noted. "Each has a responsibility to provide the innovative leadership this p h y 5 c a n project represents," he added. William R. Greiner, UB president, said, "The project is a clear and exciting example of the way in which we at UB and we in Western ew York can lead in a time when extraordinary new steps and unprecedented collaborations are called for. "It's a network of partnerships within our academic community; it's a way to address critical needs here at home, as well as a model for efforts throughout ew York State and across the nation. It will serve as a template for all of us here at UB, too, as we focus our attention on developing such experiments and leadership throughout our university's endeavors," Greiner noted. Eight new health care initiatives - to begin this fall - form the centerpiece of the project, for which $1.13 million is budgeted for start-up. Funding for the remaining two years is set at $1.7 million and 2.27 million. The funding is provided by the six hospitals through reimbursement from the insurance payers. The hospitals, which currently are reimbursed directly for their indirect medical education costs, will receive increased reimbursement rates and contribute a portion of these reimbursements into a pool to support the eight initiatives. A primary goal of the demonstration project is to increase the number of residents enrolled in the primary care specialties to 50 percent of the GMDECB's total by 1994. Currently, 35 percent of the Consortium's residents are enrolled in family practice, pediatrics or internal medicine. A Primary Care Resource Center, to be located in Beck Hall on the South Campus, will house five health care initiatives aimed at making primary care medicine - historically not as attractive professionally or economically- more appealing to medical students. ationally, less than 20 percent of medical school graduates enter primary care - down from 50 percent in m n 9 2 �without walls"- is fairly atypical of most of the nation's medical schools, which generally run their own medical centers. The Graduate Medical Dental ten have longer ....~~~~~~~~~~~~~~. .r1~~~~"~~~~~~~~ Education Conand less predictsortium of Bufable hours. falo came into The Reimformal existbursement ence in 1983 Demonstration when the mediProject's prical school and its mary care initiateaching hospitives would seek tals entered into to increase the its first consorGMDECB'scadre tium. Consisting of primary care of all affiliated residents by: teaching hospi4 Recruiting tals, the Schools medical students of Medicine and into primary care Biomedical Sciresidencies ence and Den4 Developing tal Medicine, all community sites residency trainwhere medical ing program diresidents can rectors and one practice resident from 4 Developing a each program, medical school the Consortium curriculum track governs all resiaimed at training dency training primary care leadprograms ers through a se4 Designing a ries of comprogram to immittees. prove the teachThe unique ing of primary program has care faculty, and, ~ emphasized 0 4 Developing re~ cooperation search opportuni~ rather than ties and fund recompetition search fellowamong its ships in primary teaching hospicare. tals , many of Other aims of the which were once consentation in its residency programs is 9 demonstration project insidered competing institutions. + clude incorporating geriatrics and the care percent. UB's medical school teaching hospital of patients with chronic conditions into - BY NANETTE TRAMONT KOLLIG model itself- labeled a "medical center residency training as well as reaching and 1963. Primary care physicians currently earn about one-third to one-half the salary their specialist colleagues do. And primary care physicians of- maintaining an 11 percent minority representation in residency programs. UB's current minority repre- �• ..................... . ......... . ................... . ... . .... . ...... . ... . .. . .............. . ... . .. . I Ador'' patients to be used to test competency of medical students 11 B medical students \ soon will be , \ I \ I I seeing pa~, \ I \ f tients ' ' '• '' w h 0 ... won't besickatall. The patients will be faking - to test how compassionate, caring and competent medical students are. UB is joining Albany Medical College, the State University of ew York Health Sciences Center at Syracuse and the nursing program at Regents College in a pilot program to uses tandardized patients - healthy people trained to portray the symptoms and characteristics of real patients - to test medical students' skills. The project is funded by a two-year, $200,000 grant from thejosiah Macy,jr. Foundation. To carry it out, the schools have formed the Upstate ew York Clinical Competency Center, one of six such groups funded by the foundation nationwide, for a total of $1.5 million. Using standardized patients allows examiners to compare and rate performances of students as they diagnose and treat the same patients. Students know when they are being tested with standardized patients, but the encounters take place under true-to-life conditions. "Many of us in medical education have become increasingly concerned about the use of standardized pencil and paper tests I .. .. . as the primary, and at times, only measure of physician competence," said Dennis adler, M.D, associate dean and head of medical education at the UB medical school. "This grant will allow us to start developing tools to assess a much broader spectrum of attributes and skills a physician .. should have. Knowledge, critical thinking, f \ I \ sensitivity, social skills and the ability to communicate are just some of the many components of competence we hope to address in this new interactive manner." The program will begin in January 1993. By the end of the two-year grant period, all fourth-year students in the three medical schools will be required to pass this new performance-based examination by working with eight standardized patients. Albany Medical College will set up the patient training program during the first year of the grant. The program will ex- -- pand to the other campuses during the second year. The ational Board of Medical Examiners is expected to add a clinical skills exam to its licensing process in 1995. + BY LOIS BAKER Knight named chair of Anesthesiology Department au! R. Knight, M.D., professor in Department of Anesthesiology at the University of Michigan Medical Center, .. has been named chair and •• - - - professor of the medical , \ ' ' .. school's Department of Anesthesiology. A University of Michigan faculty member since 1977, Knight also served as assistant and associate professor in the department of anesthesiology and an assistant research scientist in the department of epidemiology there. Before going to the University ofMichigan, he completed a residency in the departments of anesthesiology and surgery at the Milton S. Hershey Medical Center in Pennsylvania. Knight did graduate fellowship training in the department of microbiology at the Pennsylvania State College of Medicine. Knight has authored numerous journal articles and has delivered many presentations. He is a reviewer for thejournal Anesthesiology. + - BY MARK POLLIO �· · ·· ·· ·· · ······ ·· ··· · ······· ·· ·· · ·· · ·· ·· ····· · ··· · ····· ·· ······· · ········· ·· · ·· ··· ·· ··· ·· ·· ·· ··· • · ~ I I UB app6es for maior Robert Wood Johnson Foundation grant he University at Buffalo School ofMedicine and Biomedical Sciences has applied for one of 18 Robert Wood johnson Foundation planning grants aimed at increasing the number of medical school graduates entering generalist physician residency programs and practicing generalist physicians. Under project director john aughton, M.D., vice president for clinical affairs and dean of the medical school, UB's proposal uses its unique Consortium teaching hospital structure to improve the quality and numbers of primary care physicians it produces by effecting long-term changes in recruitment, training and support of the generalist physician. The planning grant is for one and onehalf years. + ers to receive the award in 1992. Robert Adams of the IH's Cancer Training Branch said career development UB researcher studying diet and cancer Bnk wins NIH award o L Freudenheim, Ph.D., assistant professor of social and preventive medicine, has received a $325 ,000 Research Career Development Award from the National Institutes of Health to support her research during the next five years. Freudenheim is one of eight research- B a a p grants are awarded to promising young investigators who have established themselves in their fields. Freudenheim has published articles in professional journals on her research into diet and osteoporosis and diet and cancer. Her work over the duration of the grant will involve further investigations into the effects of diet on breast and endometrial cancers, as well as a study of diet in Italy and its relation to cardiovascular disease and cancer. A University at Buffalo faculty member since 1988, she received a bachelor's degree in human nutrition from the University of Michigan, master's degrees in nutritional sciences and epidemiology from the University of Wisconsin at Madison and a doctorate in nutritional sciences from the University of Wisconsin . + B Jo L Freudenheim, Ph.D s c a }l. u u m Y n LOIS 9 B 9 AKER 2 �Harold Brody steps down as chair of anatomical sciences When the war was over, Brody was assigned to a VA-type hospital on Staten Island, where he worked in the OR until he was discharged. From there, he returned to his hometown of Cleveland and entered Western Reserve University "while it was still pure," Brody jokes about WILL REMAIN ACTIVE IN MEDICAL SCHOOL TEACHING what is now Case Western Reserve University- to study biology. "While I was there," he says, "with my ot only is UB's Harold Brody tor, but Haynes told me that unless I knew probably the only chair of any the anatomy, I wouldn't be a help to him experience with the medical unit and all the studying - I had kind of fallen in love department of anatomical sci- ... and told me to leave the room. ences who was kicked out of an "From then on," Brody said, "I memo- with anatomy. I wanted to do something operating room for not knowing rized Gray's Anatomy at night until1 a.m. with it, so I finally decided to go fora Ph.D. anatomy, but he readily re- I would know what the [surgical] cases in anatomy," which he received from the counts the incident and fondly recalls it. would be the next day so I studied the University of Minnesota in 1953. In 1950, Brody went to the University In fact, he says, it is the catalyst that anatomy the night before." Haynes was began his passion for anatomy and led to pleased. "He had kind of expected it," of North Dakota to head the teaching program in neuroanatomy for 40 firsthis still-ongoing distinguished career as a Brody recalls. "Gradually, I became more and more year medical students. teacher and researcher in the field . While there, his reputation as a reknowledgeable. And I never got kicked Here is what happened. searcher and instructor spread, and with Itwas 1944and Brody was in the Army out of an OR again. " Brody eventually became so knowl- only one neurosurgeon in the state at that medical corps. His outfit was stationed in Southern England at one of a cluster of five edgeableand proficient that Haynes would time (and no neurologists) , he served as a general hospitals set up there in anticipa- assist him. "I did a couple of craniotomies source for general practitioners on infortion of the French invasion. Brody and for shrapnel in the brainandaboutadozen mation on the nervous system. "There was so much to learn," hereseven others had been working as surgical nerve repairs," he remembers. members, adding that he had a couple job technicians and were trained to assist in offersone from Buffalo after a "hallway and perform the closure of wounds, apinterview by Dr. 0 . P. jones" at a conferplying casts, passing instruments, etc. "At ence in Galveston. least from a mechanical point of view," "And so we came here," he says. Brody says, "the enlisted men could close That was in 1954, and Brody and his wounds as well as the surgeons." wife, Anne, had a one-year-old son, David, It was about the time the Allies broke now an attorney in Buffalo. Their second through in ormandy and the surgical son, Evan, who just completed his Ph.D. suites of the general hospital were busy, in exercise physiology, was born in 1957 handling as many as 50 cases a day. while Brody was in his first year as a "We were joined by a neurosurgeon medical student. A year earlier, Stockton from the University of Illinois - Walter Kimball, the dean of the medical school at Haynes. He was put in charge of developthe time, had asked Brody to consider ing a neurosurgical unit. " obtaining a medical degree. Haynes chose Brody as his assistant. Brody managed to complete his degree "The first time I scrubbed with him was five years- all the while teaching gross in for a sciatic nerve repair. He asked me if I anatomy and neuroanatomy and doing could describe the anatomy of the sciatic research. "I would teach when I had to nerve," Brody recalls. teach and attend class when I could." ''I'd never been expected to do anyChairman of UB's department of anathing but tie a knot fast and hold a retrac- "With my experience with the medical unit and all the studying- I kind of fell in love with anatomy. I wanted to do something with it." B u a 0 p h 5 c a n A u u m 9 9 2 �······ ·· ················· · ·············· · · · ······ · ······ · ·· · · · ·· · ······· · ····· · ··· · ······· ··· · · ·• · ~ I tomical sciences since 1971, Brody was marked by his ability to take it in new one of the first people john aughton, directions in response to the burgeoning M.D., vice president for clinical affairs and knowledge and changing aspects the field dean of the medical school, met when he has taken. "Anatomy was almost exclusively teaching, rather than research," visited Buffalo in 1974. "He was very warm, gracious and sen- Naughton recalls. "Brody recruited a fine sitive," Naughton says, adding that Brody's faculty- good researchers as well as fine tenure as chairman of the department was teachers. He has been a stalwart supporter B u 0 0 p h s c 0 A I of the University and the medical school as he continued his own scholarly interests. "He is well regarded as a teacher and committed to the needs of his students. His sense of humor and warmth have served him well. His students feel very good about the education they get in m n 9 9 2 �• · ··· ···· · ··················· ··· ········ ·· · ····· · ·· ·· · ·· ···· ···· ··· · ····· ·· ··· ·· · · ·· ·· · ···· ·· · ··· . ' n anatomy, you have a " very different and unique relationship with your students. You don't see them just in lecture. The faculty struggles through with them. You come to know your students much better over a dissecting table." determine whether there is an optimum number of cells necessary for activity to take place." With widely published journal articles and book chapters, Brody, former editorin-chief of the journal of Gerontology, is an editor of eurobiology of Aging and an editorial board member of five other journals. President of the Gerontological Society of America and a founding member of the ational Advisory Council of the ational Institute on Aging, he continues to be active in professional and community organizations, as well as on several medical school committees. He is also spearheading the development of an anatomy museum "where everything will be on display for the students to use. " Brody, who was aided by Dr. Chester Glomski, professor and vice chairman of anatomy during his tenure, sees more changes ahead- not the least of which is, he hopes, another name change that better anatomy, and," aughton adds, "it is not an easy set of courses to teach." Indeed, Brody's--relationship with his students has, in many ways, been shaped by the very nature of the anatomical sciences courses. "In anatomy," Brody says, "you have a verydifferentand unique relationship with your students. You don't see them just in lecture. The faculty struggles through with them. You come to know your students much better over a dissecting table and at the microscope." Brody's major research interest has been in studies of normal aging in the human central nervous system. He is presently working on the effects of aging and alcohol on the cerebellum, a study in which Dr. Roberta Pentney, interim chairman of anatomy, is the principal investigator. "I have always been interested in cell numbers," he says. "Ultimately, my interest is in trying to B u 0 0 p h y c o n reflects the scope of the activity the department engages in. "One of the first things I encouraged the department to do when I became chair was to change its name. We were responsible for teaching and research in several subjects; I got tired of people saying, 'Oh, you only have one course.' We had not only gross anatomy, but neuroanatomy, histology and embryology. "We've been the anatomical sciences since then." Brody has worked to change the department's name to "anatomy and cell biology" to reflect the additional focus of neurobiology, cell biology, reproductive biology, hematology and functional morphology. The change, suggested by Dr. Barry Eckert, associate professor of anatomy, and approved by the medical school, is stalled at higher levels, but Brody is hopeful it will move forward soon. + -BY NANETTE u m TRAMONT n KOLLIG 9 2 �....... . ... . ........... . ....... . ............. . ... . ....................... . .. . . . . . .... . ....... . . 1973 graduate appointed U of Connecticut Health Center interim chief eslie Cutler, who received his Ph.D. in pathology from the School of Medicine and Biomedical Sciences in 1973, has been named interim vice president and provost for health affairs and executive director of the Farmington facility , including john Dempsey Hospital, for the University of Connecticut Health Center. Cutler joined the University of Connecticut School of Dental Medicine's department of oral biology in 1973 and has been associate vice president and associate provost for health affairs since 1991. He previously served as associate vice president for administration and research. He is currently a professor of pathology in the School of Medicine and a professor of oral diagnosis in the School of Dental Medicine. Cutler is also on the attending + staff of john Dempsey Hospital. Cosgriff elected vice president of New York State medical society state delegate to the American Medical Association. He is a past president of the Medical Society of the County of Erie. An attending surgeon and chief of trauma services at Sisters of Charity Hospital, he has been active in numerous medical organizations locally and at the state and national levels. He is a fellow of the American College of Surgeons, a fellow of the American Association for the Surgery of Trauma, a member of the American College of Emergency Physicians, a founding member of the ew York State Society of Surgeons and a member of the Buffalo Surgical Society of which he is a past president. Cosgriff serves on the state medical society's professional medical liability insurance and defense board. He is also a member of the American Medical Association. A diplomate of the ational Board of Medical Examiners and the American Board of Surgery, Cosgriff was recently honored at a benefit dinner for Mercy Flight. He was recognized for his contributions and dedicated service toward the improvement of trauma care services in Western ew York. Cosgriff has served on the board of directors of Mercy Flight and is a past director of the American College of Surgeon's Advanced Trauma Life Support courses for ew York State. + New officers elected to M111ard Fillmore Hospitals ames H. Cosgriff, Jr., M.D., a UB clinical assistant professor of surgery, has been elected vice president of the Medical Society of the State of ew York. The election took place at the society's 186th annual meeting held in ew York City. Cosgriff had been serving as the state medical society's treasurer. He also served as assistant treasurer and is currently a B u a 0 p h ndrasj. Vari, M.D. , was recently elected as president of the medical staff for Millard Fillmore Hospitals. Vari, a clinical assistant professor of medicine, will serve a two-year term. y s c a A ll l Other newly elected officers include Thomas S. Cumbo, M.D., clinical assistant professor of medicine, president-elect; Thomas A. Lombardo, M.D., clinical instructor oforthopaedics, secretary; Sanford R. Hoffman, M.D., clinical assistant professor of otolaryngology, treasurer, and Robert M. Barone, M.D., clinical assistant professor ofsurgery, immediate past president. Each will serve a two-year term. + Taheri develops FDAapproved device to treat hardening of the arteries he Food and Drug Administration recently approved a new device to assist in the treatment of femoral artery occlusion. Called the Taheri valvulotome, the device was developed by Syde A. Taheri, M.D., clinical assistant professors of surgery at the University at Buffalo and a thoracic and vascular surgeon at Millard Fillmore Hospitals. One of the common treatments for symptomatic femoral artery occlusion is vein bypass surgery. The Taheri valvulotome allows surgeons to remove the valves inside the vein used to bypass the patient's femoral artery. The device also permits simultaneous measurement of the blood pressure through the bypassing vein, Taheri explained. "In addition to removing valves and measuring blood pressure, the Taheri valvulotome also allows for detection of any abnormal communication between the artery and vein, and can effectively locate valves inside the vein," said Taheri, who spent two years developing the instrument. He has performed more than 25 procedures using the new technique, all at Millard Fillmore Hospital. + �•[21 ·································································· · ··············· ············· · . UB researcher to head awision of prosthetic materials at Sisters nne E. Meyer, Ph.D., has be n named head of the division of prosthetic materials of the Head and Neck Center in the department ofotolaryngology/head and neck surgery at Sisters Hospital. Recently appointed research assistant professor in the School of Medicine and Biomedical Sciences, Meyer is renowned for her research in surface science. She received her undergraduate degree from the State University of New York at Potsdam and earned her Ph.D. in surface science, prosthetics, at Lund University, Sweden. She formerly served as section head of the surface science section at Calspan Advanced Technology Center. Meyer is also principal research scientist for UB's Industry/University Cooperative Research Center for Biosurfaces, as well as a graduate faculty member in the School of Dental Medicine's oral sciences program and a research assistant professor in the department of biophysical sci+ ences in the medical school. ology, will serve a two-year term as vice president. Pieroni is a professor of pediatrics at UB and has been with Children's since 1976. Ehsan Afshani, M.D. , director of education for radiology and a clinical associate professor of radiology and pediatrics, will serve a one-year term as secretary/ + treasurer. Sisters Hospital names chainnan of obstetricsI gynecology department Alumni named department heads at St. Joseph ruce]. Cusenz, M.D., has been appointed director of the plastic and reconstructive section of the department of surgery at St. joseph Hospital in Cheektowaga. A 1981 graduate of the School of Medicine and Biomedical Sciences, Cusenz is an adjunct assistant professor of surgery and dermatology at the University. Heisamember of the American Society of Plastic and Reconstructive Surgeons of Upstate ew York and the Buffalo Plastic Surgery Society. Gerald V. Schwartz, M.D. , has been named chairman of the department of radiology at the hospital. Schwartz, a 1961 graduate of the School of Medicine and Biomedical Sciences, has been a staff radiologist at St. joseph since 1968. Board certified by the American College of Radiology, he is a member of the Buffalo Radiologic Society. + ichael Ray, M.D., has been appointed chairman of the department of obstetrics/gynecology at Sisters Hospital. Ray had been acting chairman of the department since 1991 and vice chairman since 1986. He is director of the hospital's antepartum fetal testing laboratory. A clinical associate professor in gynecology and obstetrics, Ray is a graduate of Georgetown University and earned his medical degree from the School of Medicine and Biomedical Sciences at UB in 1965. He completed a fellowship in perinatal medicine at the University of Southern California and has done extensive post-graduate work specializing in obstetrical ultrasound and antepartum fetal testing. ormal]. Sfeir, M.D. , clinical asRay is a diplomat of the American Board of sistant professor of medicine, has ames E. Allen, M.D., a professor of Obstetrics and Gynecology, a member of the been installed as president of the surgery at UB's School of Medicine American College ofObstetricians and Gynemedical staff at Sisters Hospital. and Biomedical Sciences, has been cologists, the Erie County and ew York State Also installed were Paul Burstein, elected president of the medical staff medical societies, the Buffalo Gynecological M.D., clinical assistant professor and Obstetrical Society, the American Instiof The Children's Hospital of Buftute ofUltrasound in Medicine and the Ameriof gynecology and obstetrics, presidentfalo. Allen, acting head of Children's Hospital's Department of Pediatric Sur- can College of Physician Executives. ln addi- elect; Daniel Castellani, M.D., clinical ingery and an attending surgeon there for 27 tion, he is a site visitor for the ew York State structor in neurology, secretary, and EdDepartrnentofHealth/ACOG District II Com- ward Bartels, M.D., clinical instructor in years, will serve a two-year term. Daniel R. Pieroni, M.D., chief of cardi- mittee to Reduce Cesarean Section Rate. + gynecology and obstetrics, treasurer. + Medical staH officers elected at Children's Hospital of Buffalo B 0 Sisters Hosp_ital installs medical staH officers 0 p h 5 c 0 A u u m n 9 2 I �.. ... . . . ......... ............ . .. .... . .. ..... ........ .. ... ..... ........ ..... ................. . . [I] CLASS OF 1 953 "Can't believe it's 40 years! See you in May." M ICH A EL A . S ULLIVAN, M .D., CHAIRPERSON CLASS OF 1943 MARCH "Don't miss our 50th Year Reunion. Lookingforward to seeing you." D UNCAN K . M ACLEOD , M . D ., co-CHAIRPERSON CLASS OF 1 943 D E CEMBER "Please circle the weekend of May 1, 1993. Plan to celebrate our 50th graduation anniversary. Hope to see you there." MORRIS UNHER, M . D ., "Half a century - our 50th Reunion! A special time for all of us. We want to see you. Please try to make a special effort to attend." R ICHARD J. CO-CHAIRPERSON "]oinusforthecelebration!" IVAN L . BUNNELL, M . D ., CO-CHAIRPERSON CLASS OF 1948 "Don't miss our 45th. We need you to make it a success. Please come. We can promise a happy time. " HAROLD L. GRAFF, M .D. , CO-CHAIRPERSON "Two-thirds of us made it to the last reunion. Hopingfor 100 percent attendance at our Spring Reunion!" DANIEL J. FAHEY, M . D ., CO-CHAIRPERSON BUCKLEY, M . D ., co-CHAIRPERSON IN MEMORY Long-time Reunion Co-Chairperson of the March Class of 1943, William H. Georgi, M.D. , died last July after a long illness. CLASS OF 1958 "Our 35th Reunion will take place on May 1,1993. Mark your calendar, reserve the date; great plans are underway! We look forward to seeing you." M ICHAEL T . GENCO. M . D ., CO-CHAIRPERSON I ALFRED M . STEIN , M . D ., CO-CHAIRPERSON s 0 0 p c 0 m n 9 9 2 �• ··························· ·· ··································································· CLASS OF 1973 CLASS OF "It's hard to believe that 20 yeras have elapsed since we graduated. Now that we're all settled and 'huge successes,' let's get reacquainted at Spring Clinical Day this coming May." 1988 "May 1st- Our Five Year Reunion. Don't miss out on the fun for everyone!" FRANK A . LUZI , M .D ., CoCHAIRPERSON LORI GUTTUSO-LUZI , M.D. , CO-CHAIRPERSON MICHAEL A . SANSONE, M . D ., CHAIRPERSON CLASS OF 1963 1 968 CLASS OF "Put the routine aside for a weekend. Come back and enjoy the warm companionship and memories of your classmates and friends at our 30th Reunion. " "It's hard to believe that it's been25 years since we went our separate ways. We really would like to see a tremendous turnout on May 1,1993. Come together and relive some of the special times we all shared. Please try to join us and make this a truly memorable time for all of us." ANTHONY M . FOTI , M.D. , CO-CHAIRPERSON "Each reunion has been rewardingtoall who attended. Let's make our 30th the best yet! Reserve the weekend of May 1, 1963 and renew our friendships. Makeourday!" THOMAS J . CUMBO, M . D ., CO-CHAIRPERSON "We are lookingforward to seeing you for our Silver Anniversary!" JOHN R . FANELLI , M .D ., CO-CHAIRPERSON ROBERT A. MILCH , M .D ., CO-CHAIRPERSON CLASS OF 1983 "Let's get together and renew our friendships at our lOth year reunion." RICHARD L. COLLINS , M .D ., CO-CHAIRPERSON "/ am really lookingforward to getting together with those we have lost touch with. I hope you all make it!" JAMES G . CORASANTI , CLASS OF 1978 M .D ., CO-CHAIRPERSON "Medicine's changed a lot in the past 15 years. Let's get togetherfor Spring Clinical Day and see how much we've all changed. Looking forward to seeing all ofyou in May of'93!" STUART L. DORFMAN , M .D ., CHAIRPERSON a u a a p s a n u m 9 2 �································································································r a a • 172 19 Connecticut ••••...•••••••••.• 123 District of Columbia •••.•••• 19 he 4,924 graduates ofUB's School ofMeclicine Delaware ........................ 9 and Biomedical Sciences are scattered far and Florida ......................... 270 wide across the United States. Georgia •.•••••••••••••••••••.••• SS Here, Buffalo Physician lists its medical Hawaii .......................... IS school graduates state-by-state and in the Dis- Iowa ............................... 6 trict of Columbia and Puerto Rico. The ll Idaho .............................. ] alumni listed in the "Other" category represent physi- Illinois ........................... 63 cians in Canada, England, Africa and other countries. Indiana .......................... 22 Alaska ••••••••••••.••••••••.••••••• 2 Arizona ......................... 84 Kansas ............................ 8 Alabama ........................ I 0 California ••.••••.••••.••••••.. S02 Kentucky ....................... 20 Arkansas ••.••••.••••.•••••••••••• 4 Colorado ........................ 48 Louisiana ...........•••••••••••• 17 Mapping our medical alumni s a a p h y s a n A Massachusetts .•..••••••••• 172 Maryland ..................... 16S Maine ............................ 36 Michigan ........................ 6S Minnesota ••..••••••••.•••••••• 3S Missouri ••.•••••••••••••••••••.• 20 Mississippi ••••...••••••••••••••• 3 Montana .......................... ] North Carolina ••••••••••••••• 66 North Dakota ••••••••••••••••••• S Nebraska ......................... 3 Nevada ••••••••••••••••••••••••. 22 New Hampshire •••.••••••••• 26 New Jersey •••••••••.••••••• 119 New Mexico •••..••••••.•••••• 18 New York •••.••••••••.•••• 2,06S Ohio ............................ l36 Oklahoma •••••••••••••••••••••• II Oregon .......................... l2 Pennsylvania •••••..•••••••• 239 Puerto Rico •••.•••••••••••••••••• S u m 9 ~5 Rhode Island •.••••••••.••••••• 33 South Carolina •••.••••••••••• 29 South Dakota •••••••••••••••••• 1 Tennessee ••••••••••••••••••••• 19 Texas ............................ 91 Utah ••••••••••••••••••.•••••••••• 11 Virginia ••••••••••••••••••••••• II 0 Vermont ••••.•••.••••••••••••••• 13 Washington ••••.•••••••.•••••• SO Wisconsin •••••••••••••••••••••• 27 West Virginia ••••.••••••••••• II Wyoming •••••••••••••••••••••••• 4 Other ............................ 11 9 9 2 �• ............................ . ............. . . . ............................. . . . .. . .... . . .... I niversary with a cruise from IRA L . SALOM '77 , Venice to the Black ea and the june 1992, I received a Master of Mediterranean. " Science in Management from the writes, "In s Wagner Graduate School of Public Service, ew York University. an- I had been enrolled in the Ad- nounces his retirement after 30 vanced Management Program for 1 9 5 JOSEPH 5 . 0 DAVID '53 , years in practice at Children's Clinicians, a W. K. Kellogg Foun- Hospital in Orange, California, dation-sponsored program in where he served as chief of sur- health care policy and manage- gery and chief of staff. He now ment studies." resides in Sun Valley, Idaho. John Ambrusko '37 1 9 6 s 0 1 Harry L. Metcalf '60, 9 8 s 0 MICHAEL D . RUDN ICK '87 , of ew York, was fellows named by the College's completed a fellowship in Adoles- Board of Chancellors during their cent Health in 1991 and was ap- elected president of the American annual meeting held in Septem- pointed director of the Westside cepted an appointment as surgi- Academy of Family Physicians ber in Phoenix, Arizona. cal consultant for the Qualitative Foundation. HARRY L . MET CALF '60, 1 9 3 s 0 JOHN AMBRUSKO '37 , Williamsville, has ac- Assurance Program at Manatee Memorial Hospital in Bradenton, Florida. ROB E RT BARRYS. 5HULTZ '68, J O RDO N '65 , chairman of dermatology at The Ambrusko served as University of Texas Medical medical executive director of the School at Houston, was elected Manatee County Public Health chairman of the National Advi- Department from 1977 to 1990. ofWest Reading, Pennsylvania, has been elected president of the Urological Association of Pennsylvania . Shultz is chief executive officer of Genito-Urinary Associations, Ltd. sory Board for the National Insti- The Doctor john Ambrusko Public Health Complex is named in tute of Arthritis, Musculoskeletal his honor. From 1950 to 1977, Amrusko served as chief of surgery and chief consultant in surgery at Kenmore Mercy Hospital , Kenmore, E. Teen Clinic of Denver's Health ew York. 1 9 7 s 0 and Skin Diseases. Jordon also THO MAS serves on various commiuees and '71 , boards of such professional orga- profes or of pediatrics and ap- G E RALD DISESSA was recently promoted to and Hospital System. His wife, Ann Smith-Rudnick '87, is in private family practice. JOHN CLAUDE KRUSZ '83, is on the executive board of the orth Texas Multiple Sclerosis Society and has served as chairman of the Professional Advisory Commillee for three years. He has a private practice in neurology in Dallas. nizations as the ociety for Inves- pointed division chief of pediatric tigative Dermatology and the cardiology at the University of American Academy of Dermatol- Tennessee College of Medicine, writes, "Marc Levine '83 and I are DEBORAPH L. FELDHEIM '84 , FRANK T . RIFORGIATO '39 , ogy. He is also chief of dermatol- Memphis, Tennessee. DiSessa is celebrating our eighth wedding retired in january. He informs us ogy at Hermann Hospital and a medical director of the cardiac anniversary and have been living that he is the last of the Italian- consultant to The University of catheterization laboratory and the in the Washington, D.C., area. American physicians on Buffalo's West Side, saying, "there are none left." Texa M. D. Anderson Cancer Center and St. Luke's Episcopal non-invasive laboratory at LeBonheur Children's Medical and psychoanalysis in private Hospital. Center. We are both practicing psychiatry practice and are expecting our second child in October." 1 9 4 C HAR L ES J . S MITH '66 , ofBay s 0 Shore, ew York, has been named of West Palm Beach, Florida, writes, WILLIAM J . FOLLE TTE '42 , a fellow of the American College of Radiology. Smith, selected for "My wife, Della (Walters) , and I celebrated our 50th wedding an- 6 u a 0 is now chairman of the section of general Z I NA surgery at Scripps Memorial Hospital, La jolla, California. writes, "After five years in Iowa (where we had a DANA P . LAU N E R '73 , ( DM YTRIJUK) HAJ - DUCZO K '84 , his contributions to the field of son, Alex, born in May, 1989), radiology, was one of 144 new we're back in Buffalo. I am the p 5 a n u m n 9 2 �··· · ···· · ··· ·· ··················· · ··· · ··········· · ·· · ·············· · ·· · ·············· · ····• • ' new director of echocardiography MICHAELJ . 8ARTISS '87 ,com- 1991. Bhayana is currently a third retired in 1986 from X-Ray Associates, a private practice in iagara Falls. He practiced radiology at at Buffalo General Hospital and pleted a fellowship in pediatric year resident at Francis Scott Key was recently inducted as a fellow ophthalmology at Wills Eye Hos- Hospital. of the American College of Cardi- pital, Philadelphia, Pennsylvania, ology in Dallas in last March." I Children's Hospital and Sisters and has joined a private practice in Rochester, New York. ANDREW FR IEDMAN '85 , OBITUARIES Hospital in Buffalo and DeGraff CARL A. STETTENBENZ '35, Memorial Hospital in Kenmore. of Snyder, ew York, died in Feb- He is survived by his wife, the writes, "My wife, Susan, and I JOHN J . O'BR IEN '87 , has have two children: jacob, 3, and started a plastic and reconstruc- William, l. I started a hand fel- tive surgery fellowship in Hous- PAUL V. DOWNEY '36, died lowship at the University of Pitts- ton, Texas,aftercompletingagen- july 20, 1992, in his Kenmore WILLIAM H. GEORGI '43 , died burgh july 1, 1992." eral surgery residency in Buffalo. home after a long illness. in july after a long illness. AMY (MILLER) O 'DONNELL THOMAS P . SMITH , JR . '87 , '85 , writes, ''I'm moving back to announces the birth of Sean Buffalo from the University of Patrick on june 5, 1992. He is Michigan with my husband jack welcomed by his sister Megan, 7, and two children, Sara and jef- and brother, Tommy, 3 1/2. former Mary Agnew Cain, a son ruary, 1992. and six daughters. He Help us find your classmates frey, and will be on the staff in endocrinology at VA Medical Center. I hope to get back in touch with my classmates in Buffalo. " R ICHARD SCARFONE '87 , I rl writes, "Karen and I have recently veryone likes to read about relocated to Philadelphia and are expecting our first child in Octo- LISA BECHTEL '86 , writes, "Un- ber. In May, I was awarded the expectedly, I'm back in Las Vegas, Society for Pediatric Research's coordinating HIV ambulatory care Fellow's Research Award for the at the University Medical Center. study of the use of corticosteroids Most importantly, my spouse and to treat moderate to severe asthma I have two wonderful daughters, in the emergency room setting. " what their fmmer colleagues r JJ Scarfone is an associate professor Mariah and Rose. " Medicine at St. Christopher's Hos- accepted a position as chief of the pital for Children. classmates are doing. division of internal medicine and assistant director of the residency HOWARD CHANG '89 , informs program at Mt. Sinai Hospital in us that he has moved to Los Ange- Cleveland , Ohio. Pamies has a les with his new wife, Dawn, and faculty appointment with Case will be beginning a fellowship in Western Reserve Medical School. pulmonary/critical care medicine at UCLA Medical Center. If you orthopaedics in the department of orthopaedic surgery at the George Washington Medical Center. B u a 0 1 9 9 0 know. just use the attached post card s and we'll print the infonnation as RANJ AN BHAYANA '90, ofPerry Hall, Maryland, announces the soon as we can. birth of a daughter, Monisha Maria Bhayana, born November 27, p h know where they are and what they're doing - please let us JOHN K. STARR '86 , has been appointed assistant professor of Buffalo Physician better by telling us what you and your of Pediatric Emergency Room RUBENS J . PAM IES '86 , has Help us make are doing. 0 n u m n 9 9 2 �A Spoonful of Humor © Stu Silverstein, M.D . Top 10 things overheard in the OR afternational health care reform ') OK, let's close. Wait a minute ( , where's my watch? !J ] Do you have health insurance? I Look, I've got 6.02 X 10 23 more J cases. I'll be out of here in 36 -1 hours. Let's do lunch. I' There aren'tsupposed to be two ~J of these. (\ Insert tab A into slot B. u '( Oh my God, what's that? () Aren't there supposed to be two of these? U Yes doctor. I'll take a table near U • the w indow. l('U r) I've got a plane to catch in 15 minutes, let's get started. Sw Silverstein, M.D., president of Standup Medicine Seminars of San francisco , Californ ia, lecwres nationwide on the role of humor in medicine. B u 0 0 p h s c 0 u m 9 2 ��BUFFALO PHYSICIAN STATE' UNIVERSITY OF Non-Profit Org. U.S. Postage 3435 PAID AIN STREET BU FALO NEW YORK 1421"1 Buffalo NY Permit No. 311 �( l ~ ~ - ~ 0 . , f ij~IUfR~Il~ ~l 8ijff~l0 ~(HOfrl Of · ffifDI(I~f ~~D BIOffifDI(~l ~(lf~(f~ l 9 9 B u f f a t o P h y s I c l a n A u t u m n 1 9 9 2 EJ) �The Class of! 996. h learning, study and gro . train them and make th their four years at UB's . Biomedical Sciences, relationships · ~nd build c ~-------- ,---------~~~~~--~~--~ , ·to the medical school a cquire knowledge that · ~nd . contribute t~ their · lere; Buffalo Phy$ician 96 ·and wishes the.m well ·h e. medical school. tD B u f f a I o P h y s I c I a n A u t u m n 1 9 9 2 �. Jo.Attne Arnold tI Oneil Bains ( A · Sa"raJ. Ballow John Barrett Natthew Bartels 0 Susan Behr Gina Brescia · Kimberly Bonisch · Paul B.;ms Christine Bopp Tiffany Boquard Ronald Bremer John Butsch Russell Canfield· Katherine Catallo f 9. 6 �.( ' ff ~ l A Patricia Cawley Ricl~ard Cl~arles BasJ Cherpelis Melanie Christian Joseph Chruscicki Thomas Cimalo Stephen Cook Tim~thy Cotter Holly Crorriwell David D'Souza .o f r • .l 9 9 Josepl~ DcJames Bradley Davis · Allen Davis ~lanny DeLucca Rob DeHuro 6 B u a 0 p 5 c a n A u u m 9 9 2 �( l A Andrew Drnytrijuk Kathleen Dyson Richard Edwards Simone Elvey ~ -~ o,\lichacl Endl Joshua Fischer Gina Flores Scoll Flugman James Foit Brian Fortman Thomas Gennosa Patti Hamernik Chen Han Hccghan Hart f 6 �{ l . ~ Steven Heintz Jason Ilo Jean Ilsia9 . Tl10mas Hughes Babak Jahan-Parwar Rajiv J~in ,\lark Jajkowski Paul ]ee Erik Jensen Clara Kim Anthony Langome Matthias Lee ]ilmes Ida . 0 f 1 9 9. · Dionne K"rr Timot hy Jorden 6 B u a a p 5 c a A u m 9 9 �' ( ~\ a _ ~ '1k: l i_-_:_ __ J '} J Michael Leonard. Kwok Li Kristen Lukasik Beth MacDonald Dominic Lpomc Cheng' Lo Jiadc Lu ~lichael ~lanka Dori Marshall 1 l .. f l 1 1 9 Christopl1cr Mascia Paul Nab: Peter HcQuiller William ~Icdwid Kimberly Metz 9 6 �(. l· A· Alex ~loinpoint Davicl l\l.ilJcr ~ _Pinaki Hukbcrji Sluini Hukkarnala Dwayne Narayan Nncnna Okcrckc Nayomi Omura Hik~ Oslempowski John Patli • Oscar Piedad Frederick Piwko . ~- 0 f . . Sltarnantha 1 Tcsarajal1 I l 9 9 John Pana""iolopoulos Pa_ras Pandya 6 B a 0 p 5 c a u u m n 9 9 2 �( l John Pulvino Kavitha Ram Eileen Reilly Brian Riegel 0 Mary Rykert Starlecn Schaffer Kristen Schenk David Schmitz f 1 9 Rudolph Schrot Otto Schucckler Douglas Schultz . Karin Selva Lisa Shutt .9 6 �( Jo~athan Sirkin" lnclrani Sinha Sun~ Son Karen Snell Patrick Stein ) 0 f Kristin Stievater ~1ichael Stoner Tova Stram Maxine Szumigala Renate Treadway Millicent Trevett Susan Szimonisz" Julie Szumigala l 9 Meryl Tucker LisaWalk 6 B u a 0 p 5 c a u u m n 9 9 2 �( l .A Jim Wa'xm'onskv 111 c Kee Wee Byron Willis ol Naa'mi Weinstein 1h t HaryWilsch I; uf ~ I ~ 1 ~ .o . Emily Wong' Joseph Wittmann 'l 1 1 \1 ' \'a!, Buf'1Jo l ..t_r ·' · ,I!) I · Mark Zambron Clmck Yates ·.. Jennifer Wrazen 1t em 1 L \\ R;. I C R t .Jt f 1, t} lH[ f.OUOWI~G HUD[~H fROffi lH[ (lAH Of 1996 W[R[ ~OJ PHOJOGRAPHfD.· .Peter Augustino~: Christopher Jayne: ~ ·. Eileen KJlackey: Cozzette Lyons:' I.. Deborah ;\lann: ;l Thomas ;\lead: ::Andrew Stirling: I' " Davi~ Zinkin · Daniel Zorich 'n Bufhl· l 1 'Pil()lOS. ·::-r 10 TO l; 9 9 �qHI Uf R~ ll ~ Al Bq.f f Al 0 ~ ( H00l . o·f ffi f DI ( I Hf AHD BI 0 ffi f DHAl ~ ( I f.H( f ~ l. ~ au ffo t oP h y s I c I an ll.utu m n t 9 9 2 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1992 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1992-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v26n04-1992-Autumn Table Of Contents A list of subunits of the resource. Research Hospital News The Graying of Medicine Rehabilitation Comes of Age Conquering Ojos del Salado Medical School People Alumni Classnotes A Spoonful of Humor Class of 1996 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-10 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v26n04 Extent The size or duration of the resource. 56 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1992 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/50c30866460c3a36ce2f7ab2fcff931f.pdf c5b96c6da6ebd5da36c8d5f2c9aaac4d PDF Text Text �THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST \c umc 2~ "" mhcr l r"'"'"'lld m the bst ts.sue of the P/1\~.n.:n that thl' propili>Cd nC\\ research bu1ldmg was DIRECTOR OF PUBUCATIONS "lancv T L .... EDITOR ""~ rue rr m >nt lolhg r.: "' ART DIRECTOR A An I &.cj:,' r r "kcr STATE; UNIV£RSITY OF NEW YORK AT BUFFALO <;chool of !'.lrd•<mr ~nd B•omrd~ral ~lfDCCS Dr 1.>!: 1 "'au~hton 'V ( hntc \I -'" f.'lr11r. Prt nt lor EDITORIAL BOARD Or J >h D D~ Dr Dr M• Dr D Dr D '\ R r, l h 'd ru BrH hu II rr I r r I) Ra , 1td ~ ol I" ~- ~ JplcR [' \ l \ _ J [l nn-n T1 >th) '' bnrl ~olen <r m !"'ot\\ 'tork C:.t..1tc o; buJgct Th(' offt tal grcundbreakmg a ma;L~r hLstoncal t:Bovent'i I ~6-)C.UCXISI('n<c \\.:sheldon 11.1ay.! IQQ1 Ihcfa~..tht) \\til pro' 1dc nC\\, st.:tc or th(' an rusK rC'K'".trch l.tbor.non('<; dcs1gned to be operated as a . non-d('panmcnt.Jih ilSSt ncd untl It \\Ill al,o serve to umte the Health as envtsioncd .Ls long ago ._, I CJ6l ""=--,....,....,.~,....;..-...., fhe buildmg wtll straddl(' the "p<:~e bel\\een the 'x.hool of Dental Medion(' and th· rnrd•tal o;chool'" Am mal f .1oim AdJmmng the wcc;t side of the lampu.:; \\ t'l beth(' clcgantllc.tlth C,Cicnce<> library and foster Hall, the dental c;lhool"s b.L>~c sctc.nlc fac1hty. On the ea.o.;t s1dc wtll be the med1ca: sdtool complex Hamm.m (Old Nonon) Hall wtll be rcnov.ard for the slhool c; .tdmmtstr.lllvc offu.:es later m th1s dcc.ade .md w:r.nt:ltcd to 1hc new fa~.1ht) When completed Hamman \\ill be bounded on each '>ide by qu.tdr.mgles, and h) 1')<)'), th(' campus w11l 1: \e ho•h pre• ntl' .md the l pacnv to conunuc lOntnhutmg toNe\\ York <.t.!le'" needs,., bH.mied~t~l n.'sl'"ar~h The £acuity and I appreciate L nt\t.T-.;ll\ admtnt ... tr.ttwn 'tl'~'r tl•est.:k slt..:Jcrshlpdnd the\\esteml\oew ,,..,, ........ , m d1d on ou~ bdmlf Thanks 'tmccn:l\', 0 ASSOCIATE ART DIRECTOR ''-C"h 1 l"''ltrt f and Supporters of the UB Medical School: 1 r. ~LJL-.~ a <I a 1.- '1 Jr.o 0• < nl.- P • ~ I Dr L uthc Rc ""' D• Th<' P r'lthal Dr ..,a t• .a ' u~• D <;trp r .,,,a ld n Dr <.'It\ T r X Dr )ncmc ~at John 'Iaughton. M.D. far ( lmu:al Afjatr~ Dca'l, <, h110l c( \ftd1une and BwmtdiCtJI ':lctrna•s \ ltC Prt~tdtnt rr TEACHING HOSPITALS AND LIAISONS ~· n u \ \ "tr , I ( cntr L' flak• t.cncr I It< i'' al M chad ~"-"" flu I' o \ \ \1rJ I ( c " ' ,,.,.u,emi, wheel comes round uga rr...ula l'cdtt ( 1;, Jrrn, lie< pi al <! u'i I< E nr ( o·ml\' \1cJ•c ( rntr• Marv ft.trlflttl \{<!<Y H<>Spll M1l arJ ~, I re llr>pll h t r.,rrk ~a>u f<os" rl J k l 1 rr Ins 11 1 juduh "" ~· tr•• d <t- ••II> II< p.t I Otnnt) \1 ( '' Burr.· \ddrcs~ t; t In "~m ol fl'c '' tr ·. "'w hrk c mmcr.· u d suh r ' em~ tr 1 ~ > rhr C.4J~' H1>~t1• and Btomt'dJ,al 5dmrw C.t.•, l mvcrsll) c£ Ill~ \ rk Bull• <' l , \CI>II) Pt:" Ull<'m I lt'lr,>fhll"' [_•, 1lo."'~ ~ 11, bnngmg wuh 11 u l'C\\ \1edtc.tl \lumm &ard of rm cnthus• ,u._ .tbout !>C'rvmg .h) our new pre< 1dcn• La'>t >car's Board under Hamson set the htghtst .,!a"ldards for us to emulate. In lQ92 1991 we will such pre\ wusl} "-UCl"l''i~£ul .1c uvmco; ,,., the ph~ stCtan c.trcer presentations to sophomon mcdKal sllld('nts, .md the onent.tuon scssrono; for freshman restdem doctor; \\ l pbn .mother )Jnuarv rcccpuon for c.cmor <;tudcnt<,, along Jar out of-tO\\ n rrccptiott- for alumm m oth::r c tlle<.. <.)ur C,pnng Chmcal Day promtses.t forum cl ...ontcmpon.tl)" medtc.tl cone em, mtxc:d \lo ith the pleasures old fnends Our I1tsrm1:m<.hed \1edKal Alumnu<> Award will he presented in '-",,,.,mh..dl:•n Yale Emcntu~ Profc-,.><>r Dr \!£red L,,m. <.urrc'lth \\c .1rc \\orkmg on some nt-v. tde.lS for the commg )car mdudmg.tn IPR<.) rmx k tnal '>t.lntnar and a M.tt< h Da\ <elcbration for scmor., \\ ( '' tll conunuc our ltat"><m \\ 1th the Mcchwl AdmissiOns ( ommlllrc to fL•IIO\\ our lf'J.'fiC.\ stud... nts In addiuon, \lof' f'xpcct to recogmze unsung hlll dl'>Cr"\'ll'J;alumm \lolth a ne\\ catcgorv of Alumm t\thtevement r\\\ards to be presented at a <:.pcctal spnng luncheon. We are seeking opponumucs to suppon and acknowledge our hardworkmg volunteer fawh~ \\care also cono;rdcnng a Medical Alumni Who's Who to help '>pread the \\ ord about our more promment da~mates fhc \car ahe.td prom o;cc; all the cxcuement and mnovauon together our far-flung medtcal school fam1ly. 1k '"""'·" <;end address change• w n.r llu[jalfiPh} siCtull and Bwmrdual ~nrnllsr. 14f\ ( f'> Addu'"" H\5 !l.tJm 'ltrru. Buffalo New Ycrk 14214 Don Copley, M.D., '70 D(JY\ oJ..d. P. ee, rtto, MD . �VOL26,No.3 5UMMER1992 II Research II Hospital News IJI Country Doctors C. K. Huang, diredor of the Healtll Sciences Library, re<eived the first John and Margaret Naughton Spe<ial Recognition Award at the meiKal school' s annual fCKulty meetilg. Page 22 Rural physicians see more patients, work longer hours and earn less money than their urban counterparts. So, why do they do it? Diane Zwirecki finds out. Dr. Muse In an age of scientific specialization, some physicians find inspiration and expression in the humanities. Mark Hammer examines the phenomenon. _..,m --.111 m ASpoonful of Humor Stu Silverstein, M.D., learns about political correctness. m MeaKal School * Buffalo Gueral Hospital sends badly needed meiKal suppttes to Third World nations. Poge 4. Aguide to pahtically corred medspeak. Page 18. The School of MeiKine and Biomedical S<iences graduates Its 146th dass. Page 25. �[1] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. Exercise no substitute for not smoking n a collaboranve effort to determine the connecuon between hfestyle habits and blood levels of htgh-density lipoprotein cholesterol, researchers at UB and the University of Naples have found that smokmg and intensive exercise affect HDL in the body, but with opposite results. Based on an analysis of the habits of797 men who participated m the Olivetu Heart Study in aples, Italy, they found that nonsmokers who paructpated in vtgorous sport acti\ity- at least four hours a week for nine months a year- expenenced an average lO percent increase m levels of HDL, the c;o-called Mgood cholesterol.M Smokers, however, showed no statisticall> relevant mcrease m HDL levels, no matter how hard the> exerciSed. Results of the study were recently published in Preventive Medicme. "From a prevention potnt of view, this clearly says that you cannot run and sttll do everything else you want, because physical activity will not be able to overcome other bad habits," satd Maurizio Tre\isan, M.D , intenm chair of the Umversit) at Buffalo Department ofSocial and Preventive Medicme and one of the pnnctpal authors of the StUd). It has been known for some time that smoking is an tmportant nsk factor for developtng heart diSeaSe and that smokers have lower levels of HDL tn their blood than non-smoker... Meanwhile, studies have shown that high-density lipoproteins help protect against heart disease and that vigorous f) BU~,ALO PHVStCIAN exercise mcreases HDL levels. ~It appears that smokmg and physical activity act on high-denSH) ltpoproteins by the same mechanism, but have opposite effects," Trevisan said. "Mostltkely, they affect a number of enzymes, primarily lipoprotein lipase, a key enzyme in HDL metabolism. Smoking may decrease its activity, while exercise may increase it." The Findings were part of a larger study of the effect of lifestyle habits on HDL levels. The UB-UniversityofNaplesstud) supported previous findmgs that smokmg and being overwetght decrease HDL levels. Moderate alcohol consumpuon and \igorottS, sustained exercise increase H D L while low and moderate levels of phystcal + activity have no effect. BY LOIS BAKER Internationa I rehabilitation assessment standard developed at UB he first international standard for measuring the effectiveness of medical rehabilitation, developed by a University at Buffalo research group, could launch international research in the field and lead to refonns in the way Medicare reimburses the multi-million dollar rehabilitation industry for its services. The Uniform Data System for Medical Rehabilitation was developed through a three-year, $330.000 grant from the , ationallnsutute for Disability and Rehabilitation Research. The keystone of the system, e11:plained Carl V. Granger, M.D., professor in the UB Department of Rehabilitation Medicine and one of its principal developers, is the functional independence measure, or FIM, an easy-to-use instrument that allows trained personnel to assign a numerical value to a patienl's ability to function based on the performance of 18 physical and mental tasks that are part of a typtcal daily routine. By assessing pattents throughout treatmem and after diSCharge, their progress, outcomes and cost of treatment can be measured. The method has been embraced enthusiastically: -.r More than 150,000 patients m 337 facilities in 47 states have been assessed since its introduction in 1987. ._;. FIM has been translated ~ into five languages. ~.;.. Twenty-five facilities in ~ Aust~alia and five in Canada arc ~ sendmg data to UB's Center for i ANI) BtO..-£DICAL, SCt&HTIST I lit lit 2 .. �·························································································· m r3 m Functional Assessment Research, with japan expected to come on-line next. .;. Seventy-five VA rehabilitation centers will jom the system shortly Data collected from participating facilities are fed into a spectally destgned database that generates reports for each facility to compare its performance with similar facilities regionally and nationally. In addition, UB has opened a new database to serve skilled nursing facilities, and another is being developed to process information from m-home therapy services. Researchers have also adapted and are currently tesung the assessment method for pediatnc application, calling it WeeFlM. + BY LOIS BAKER Muscle rehabilitation with non-aerobk exercise can improve aerobic fitness .. VB study that used persons with osteoarthritis of the knee as subjects has shown that strengthening weak knee muscles with nonaerobic exercise also improves cardtovascular fitness. adtne M. FISher, Ed. D.,and colleagues in the departments of rehabtlitative medicine and physiolog} tested the subjects' aerobic fitness before and after three months of ISOmetric and endurance knee f!exton and extenston exercises known as quantitauve progre$tve e.xerctSe rehabilitation. After the program, the participants gained 65 percent more aerobtc power and could walk faster and exercise longer than previously. The study showed that, for this populauon at least, muscle rehabilitation alone can improve aerobic fitness. The findings were reported recently + in Gerontologist. BY LOIS BAKER nme percent having it in at least one meal per week ._;. Those with a higher frequency of eatmg the fish tend to eat larger serving sizes at one meal. ._;. Blacks and Native Americans, along with anglers with fewer years of education and lower LOtal household income, reported the most frequent consumption of ~ fish from Lake Ontario. ~ ~There is still a large percentage of people S using thiS resource, despite the warnings,·· ~ said john E. Vena, Ph.D., principal invesugator and associate professor of social and prevenuve medicine at the Universll) at Buffalo. • • Funded by a grant from the Great Lakes Protection Fund, the study was based on questionnaires returned by 11.717 anglers bile more than 90 percent of who purchased fishing licenses in 16 upanglers in upstate ew York state counties from October 1990 to Febare aware of the state's health ruary 1991. For six counties that border Lake advisory warning that fish Ontario, more than 10 percent of the anin Lake Ontario are chemiglers reported consumption of fish from cally contaminated, most have not changed their fishing habits or Lake Ontario at least once a fish consumption, according to prelimi- week. Venahasbeenfunded nary results from the largest study ever conducted on the health impact of eating by the Great Lakes ftSh from the Great Lakes. The study of more than 11,000 anglers by UB researchers showed that less than half have changed their fiShing habits and only 20 percent have cut their consumption of Protection Fund fish from Lake Ontario, the most chemifor follow-up studies. incally contaminated of the Great Lakes. cluding those of birth outThe study also found that: comes m female anglers and wives of an._;. Sixty percent reported consummg about the same amount of ftSh from Lake glers, and a study that '.viii focus on 350 Ontario in the last year as m prevtous anglers in the responding group that will years, while 30 percent reported eating mvolve taking blood and hair samples to determine who much of the chemicals are less. + .._;. One-third reported consuming the being absorbed by their bodies. Eight out of 10 anglers 1gnore wam1ngs about Great Lakes fish fish in at least one meal per month, with B Y L OIS BAKER �s ······ · ···· · ··· · ······························ · ··············· · ··························· Buffalo General Hospital shi ppi~ bad~ needed medkal supplies overseas uffalo General Hospital has launched a project to ship badly needed medical supplies and equipment to hospitals in Guatemala and the Philippines. Known as the Overseas Medical Assistance PrOJCCt (OMAP), the program was orgamzed b) BGH surgeon F fero Sadeghian , M D , and NanC} E. \ltazuchowski, assiStant admmiStrator for professional affairs. ~While traveling in different pariS of the world, I found that so many countries are in dire need of the type of medtcal and surgical items that we discard," Sadeghian The St. Louise West Side Health Core Center, site of Sisters Hospital's new OB/ GYH cfini<. satd. As an example, the BGH surgeon explamed that once a package ofsutures is goal is to conunue sending these types of counsel. Mazuchowski said support for OMAP opened and parually used, New York State ttems, but also to provtde hosp1tals with larger equipment whtch is no longer in usc has come from several sources, including health department codes do not permit it here," she explained. the hospital's medical and dental staff to be resealed and used In addition to the two organiz- which donated money to cover shipping elsewhere. He noted ers, other BGH staff mvolved charges for medical and surgical that a disclatmer ac+ in OMAP include Lynne supplies. companies each package advising Blanchard, R.N., sterilization of the supplies, if appropriate. Linda Butterfass, R.N., Mal) Ann The OMAP commmee meetsquarterl) to evaluDannenhoffer, ate the proJect, explore Phann. D , Charles , \ ways to expand the Lakso. \thchael program and to \ ' F "oe. ~1 . 0.. prepare pack~ ~'~~.:;;.~....... 'vttchael H. ISters Hospital has opened an obages for shtp- ............_ • stetncs/gynecology clmic featurl ping. To date, mg a wtde range of women's health t threeshtpments · senices and a bilingual nursmg ~ have been sent - staff at 209 Niagara Srreet, Buffalo. to Roosevelt The clinic is located at the St. Louise Hospital, a Also on the West Side Health Care Center, one of the 2,000-bed facthty commtttee are Rtchard hospttal's satellite facilities. Moore and Susan Regan, in Guatemala, and "We serve women of all age categories several to St. Martin de who are providing pro bono with various needs, including teenagers, I Porres Charity Hospital in legal services in connection with menopausal women and geriatric pathe project. They represent Magavern tients," notes joyce D. Heath, M.S., comManila. "As we proceed with this project, our and Magavern, the hospital's general munity services coordinator. Sisters Hospital opens obIgyn servke on Buffalo's west side l . 0 8U,.P'AL0 PHYSICIAN AND BIOMI[O f CAL SC.I:HTIST 5U .... M£R 1882 .. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [1] The clmic 1s also a site for the SISters Hospital Prenatal Care AssiStance Program. The center's staff includes an obstetrician/gynecologist, a registered nurse. a nurse practitioner, a social worker, a nutritionist and a financial advocate. The clinic also serves chemtcally dependent and high-risk pregnant women. + ment of radiation medtcme at Roswell, "It takes less than lO minutes, seems to be more effective, offers greater patient safety and convenience and significantly reduces length of hospitalization. And the potential uses of this treatment seem to be limited only by our imaginations." Shin and his colleagues arc currently administering brachytherapy to patients with recurrent, inoperable lung cancer, particularly those who have failed to respond to conventional radiation therapy. Patients with tumor obstructions in the esophagus may also benefit from this treatment, Shin said, as well as pauents with prostate, breast, head and neck, cervical and endometrial cancers. + Sisters Hospital plans to open ambulatory care center in Amherst Roswell Park Cancer Institute first to offer high-dose brachytherapy igh-dose brachytherapy-a new. more efficient method of delivering radiation d1rectly to tumors - is now being offered to area cancer patients at Roswell Park Cancer Institute Brachytherap). m which a radioacuve pellet is attached to a thin, fieXlble catheter and placed directly on or near the tumor. has man) advantages over convenuonal radtauon therapy The procedure allows the dehvery of a very htgh dose of radiation that rema1ns essenually confined to the LUmor area, sparing the surrounding healthy tissue. In convenuonal radiation therapy. radiation IS delivered indirectly from outside the paucnt's body. According to Kyu Shin, M.D., chair of radiation oncology and head of the depart- he Amherst Planning Board has approved a Sisters Hospital plan to open a fullservice ambulatory care center on Harlem Road at Sheridan Drn•e in Amherst. The Sisters Amherst "" Health Center will occupy approximately 15,000squarefeetof a four-story, 40.000square-foot medical ' office building planned by Ftrst Amherst Development Group. The center will provide mammography, X-ray and CT scanning, laboratory and blood draw station and a full range of outpatient primary•care services. The hospital's Corporate Health Ser- vices division will also be a part of the Amherst complex. as well as a medical reference materials room and conference/ classroom areas for medical meetings and seminars. Ststers Hospital medical staff will also maintain offices for specialties including 08/GYN, cardiology, orthopedics, internal medicine and family practice at the center. "The building of the Sisters hospital ambulatory care center results from the hospttal's need to bring many of its outpauent senices closer to the consumer. Our location will pro,ide easy and quick access from all the northern suburbs,~ said Sr Angela Bontempo. president of Sisters Hospttal. The remainder of the space in the medical office butlding , ...;JJ be leased to physiCians and other health care specialists whose practices are compatible \\.ith the Sisters Hospital facility. The medical office building will be located direclly at the Harlem-Sheridan Drive exit of the Youngmann Memorial Highway. It is scheduled to open this fall. Artist's rendering of Sisters Hospital's planned ambulatory care center. + ���• "Most of these people are my patients, if not friends, then acq11aintances. I just enjoy the rural setting, the people and the attitude. " Rural phvsrcrans sec more patients, work longer hours and cam less money than their counterpart~ m maJOr cities. The\ are more sevcrd) affected b\ shonagesof con~ultants, nu~es, thcraprsts and social support agcnw:., So, why do they do it? And why do other doctors opt for an urban practice? For many, the choiCe b based on their upbnngmg. For others, lb srmply a lifeume dream come true. Ask farmh pracuuoncr Wallace alter wh) he chose a rural practice and he's at a loss to answer- verbally. Instead, he'll rm,te you to hop m hrsjeep and maneuver through the 35 acres oft and he and his ,,;fe Debra O\\ n m the lulls of Boston, 1\Je,-. York. From therr mountainside home which ha~ the look and atmosphere of a ski chalet they overlook a breathtak- 0 8U,P'AL0 PHYSICIAN ing scene of foliage and wildlife. from lheir living room, you can sec the renovated 170-year-old farmhouse a quarter of a mile mva) which houses their JOint practice. Debora and\\ allacc. one of the the first husband-and-\\ife teams to complete residenc> trainmg at the State UmvcNl\ of '\ew York at Buffalo. clear!)' arc dchghtcd "ith thetr choice ofa practtcc locauon. In Wallace's opinion, they ha,·c the best of both worlds, ,,;th ready accc..,., to care m Buffalo. where ~children·s Hospnal 1s a 17-min.ute \-1edE,·ac awa} \\ c're luck) here." In Boston, '\e"' '\ ork, and the ncrghboring hamlet ofPatchin, C\'CT} bod) knO\vs evef}rbody else and adults and children alike are on first-name bases. An hourlong visit for breakfast at a local restaurant AND BIOMEDICAL brings in at least a half-dozen guests who stop and chat ''ith the doctors. Referring to the restaurant's clientele, Wallace Salter notes that "most of these people are In) pauents. if not friends, then acquaintances. I just enjO) the rural seuing. the people and the attitude... If the Boston hills are off the beaten path, then the Salters' ex'J)Crience as resrdents m Point Barro". Alaska, was downright Siberian. Point Barrow is a town of 4,000 located 330 miles north of the Arctic (rrclc Its people are mega-miles from the nearest Cit). m geographic location as well as in mind-set. '-:otes Debra Salter, "The) still have their medicine women ... The) still do things like cupping (placing heat cups on the back) and burning to remove bad sprrits." Both Debra and Wallace spent time in Alaska caring for the resi- SCIENTIST SUMNI:fll I 8 8 2 �dents of Point SarrO\\ and se,·en outlying \'Hlages \\ithin a 300-mtle rad1us Wallace made two mps from Buffalo to Pomt BarrO\\, Debra. one, accompamed on her venture b\ the1ro:.onjcremy, who was two year.; old at the ume. The family lived at the 14-bed hospital where the doctors worked and Jeremy burned off toddler steam by running in the corridor.; (At 70 degrees belO\\ zero. planng outdoor.; was out of the quesuon ) Many of the Salters· pauents were Alaskan p1peline workers and their famJI1es. Complex cases had to be transferred to Anchorage. 700 miles and two-and-a-half hours away by jet. Wallace Salter recalls treating a head injury on a pipeline worker: he was a1rlifted to the scene of the injury and mformed by his pilot that he had 11 minutes to disembark. suture h1s pauent and return to the plane before fuel ran out (at 70 degrees below zero. the temperature IS too cold to restart the plane) I accomplished ll m 13 minutes and ....-e made it back safclv,'' he recalls. Home for mam a Point Barrow family was a tarpaper shack. and basic necessities such as indoor plumbing often simplv were not available "\\ e·d treat a chtld \Vith an ear mfecuon and recommend a humidifier and the qucsuon wasn't, 'Do you have a humidifier?' The question was, 'Do you have runmng water or electricity?"' says Debra Salter. 'They melt icebergs for fresh water," adds Wallace. Tuberculosis, syphilis, hepatitis and other infections ran rampant man area where a sanitation truck visited homes datlv to empty out waste. In sharp con~t to the1r Alaskan e.'.-penence and ultimate choice of a rural practice, the Salters both have experience m urban mechcine, ha-.ing worked in \'arious Buffalo hospital emergenC\ departments. For eight years. they res1ded in the inner cil) and are convmced that their urban medicine counterparts could •keep ~anhattan,just give me that coumn'Slde" "It wasn't neccssanh the pauents as much as ll .... as the hfcstvle," explams Debra. "I JUSt never had the mner-cily attitude. Part of the d1fference for me was my upbringmg. I was ra1sed on a 6,000acre cattle ranch m ew Mex1co. I was just much more used to rural-type living in the first place." �Recent studies show that two trends related to phys1c1ans choices of a practice location arc similarity to their 0\\11 home town and spousal preference. In the Salters' case. both these theories appl). and their decision to open a practice in a country scuing ,.,.as mutual To sa\ thev are happ)''"ith their choice of both profession and lifestyle c, an understatement Ther speak enthus1asucally about every aspect of it, even cham sa\\ season "We have things that walk mto our office that I would nner get 1fl '"as practicing in the city... says \\ allace. "Last fall ''as chain saw season. 'HO\\ do) ou get those annoying blood stains out of vour chain saw?'~ Catherine Weeden. \t D also !)C~ her share of chain saw injuries. <l'> well as farmingaccidentsandsimilar mediCal miShaps. Weeden completed her famll~ practice training at UB in june 1992 and became medical director of the Unt\'Cr'>ity's Rural Health Campus in Cuba, 70 miles south of Buffalo. The campus was funded b\ a 1988legislative grant from 'iew York State. sponsored by the state's Corrurus'>IOn on Rural Resources. Physicians began seemg patients at the campus, located on the grounds of 26-bed Cuba Memorial Hospital. mjuly 1991. In less than a vear. '>taffed by a medical director and t\\."0 re'>idents. the campus has handled 4,000 patient ,;sits Thomas Rosenthal. M.D.. director of the rural campus, comments that "we're where we'd normally be after a couple of years an urban site." ''I'm not sure why I chose a rural practice,'' says Weeden. "I've just always dreamed of being a small-town country doctor." In contrast to Debra Salter. Weeden's upbringing does not mirror her choice of a rural area in which to live and work. She grew up in suburban Orlando. Florida, and attended the University of Tampa College of 'vtedicine. Her link to :-.le" 'r ork's heartland is her husband. M1chael. a minister in Olean- at 15 miles away the nearest Cit\ to Cuba. She describes her patients as ~farmers and small busmessmen. Animal bites, rabies vaccinauons and farm-related accidents are common," she notes, as are injuries to boaters on nearby Cuba Lake. Recently, Weeden treated "horrible lacerations" on a gentleman whose face was caught in a barbedwire fence. "It's not really very glamorous," she says. "He was wrestling with his dog." like her peers from UB, Weeden spent the ftrSt m·oyearsofherres1dency training at the Deaconess Family Medicme Center, an inner-city subsidiary of The Buffalo General Hospital. She sees hkenesses, as well as stark differences, bet\veen her urban and rural pauent experiences. ..Actually, they're very similar populations in some ways," she notes. "Both are largely Medic- I II II 2 �aid patient~. The difference 1s that here, moreofthcmarC\\OrkmgMcdicatdpcople. The) work hard. but don't cam enough to get med1calmsurance. Referring to her adopted rural hfestyle, Weeden says, "It's been a pleasant surprise working here. More and more, I can't go anywhere without ~omeone knO\\ing my name." Access to mcd1cal tcchnoloro , circa 1992. is nota problem. "In th1sage,you're not a.., isolated as you u..,cd to be," she commenLs. One of her colleague:, m Cuba. Kimberle\ \tarkowsk1. \-1 D , echoes \\'ecdcn ~ op1mon Dbtance hasn t Jeopardized an) cases, note'> \-tarkowski. "In an emergenC). v. hen atrtransport becomes necessary, any tunc seems to long. But in all reality. it's reasonable." Born in the tin\ communit) of~ewfane. t\ew York, and raised 111 the nearby to\m oflockport, Markowski d1dn't thmk t\\ice about JOinmg her husband Geoffrev in family pracuce and movtng to a spre;d of land that measured "257 acres, at last count." When they're not treating animal bites or gunshot wounds, the Markowskis raise three daughte~. 14 head of cattle, fi"e rabbits and a dog. Their work represents "famih practice in itsenuret)," <>avs Kimberlev Markowski. "The best place for famth pracucc IS m a rural setting, where there s more of a need than there is in the cit\ In the Cll), there are specialists for e'wythmg. Specialists tend to cluster in the cll~ where thev can be reimbursed for thc1r ~pecialue:, .. Rural or urban. canng for people. building relationships and '>culpting a hfest\·le rooted m personal cxpcnence is what choosmga practice locauon ult1m.11ely comes down to. And for some of toda) \recent medical school graduates, mral medicine is the right choice. 8U,,-ALO .. HYSICIAN AND t's a long, long way from modem medicine to Point Barrow. Traveling to this Alaskan outpost 330 miles above the Arctic Circle, Drs. Debra and Wallace Salter may as well have entered a time warp. Traditional native medicine in Point Barrow borders on the prehistoric; for many an Eskimo, the first line of care is a medicine woman who uses techniques such as burning the skin's surface with coins or metal cups to ward off evil spirits that are believed to bring disease. "The people there equated their medicine woman with a witch doctor. She was very highly regarded ," says Debra Salter. The Salters spent several weeks during their residency training living in and working from a 14-bed Point Barrow hospital. " If the traditional means of treatment provided by the medicine woman didn't work, then they'd seek us out for care." In a procedure commonly known as cupping, Eskimo medicine women heat BIOMEDICAL metal objects and place them on the back. "Evil spirits are associated with illness. If they can get the evil spirit to leave the body, they believe the illness will go with it," Debra Salter explains. The Salters saw four or five cases a month, many of whom were children, brought to the hospital only after such traditional native techniques had failed to cure fevers, ear infections and similar childhood maladies. But not all the natives' medical problems were minor. "Some of the disease processes in children and in the population in general were similar to those you'd find in a third-world country ... advanced tuberculosis, hepatitis B... it was amazing," says Debra Salter. Amazing, perhaps. to the physician educated in a major American university. Buttothe Eskimo bred in Alaska's most remote geographic comer, it was a simple matter of respecting timehonored traditions passed down through the generations. One man's witchcraft is another man's cure. Perhaps it's just a matter of what you believe in. SCtaNTIST + S U M M £ R 1992 CD �I; In an age of specialization, n1any p/,ysicians find inspiration /ronz tlze arts. By Mark Hammer ver the last 50 years or so, American cuilure has come to celebrate s pectahzauon, not only in medtcme, law and academic pursuits, but in virtuallr every arena of human acuvity from mortgage banking to cosmetologr, ,..·here an electroly:.ist can seldom give r ou a good pedicure. In the field of medicine, specializauon is eptdemtc Where once the GP tripped up and d own the statrways of our hves, humming a tunc of his own creation, painting a hulc on thcstde, writing poetry, perhaps doing an autopsy now and then, there now gallops a he rd of otolaryngologists, orthopedists (and orthopedic surgeons), neurologists (and neurosurgeons) , urinary incontinologists, endometrial samplers, comeaologists and investigators into the structural relationships of dihydorpyridine-l)'Pe calciUm channel antagonists. Perhaps because we cast individualism in a sacred light, Americans denve great comfort from the label ~expert." After all, who do you want to sew up your aorta? One way for practitioners to augment the narrow focus of thetr scienufic pursuit is to explore a different creative realm entirely, giving free reign to the intuitive process in a relief from the sctentific. We know the dogmas and strictures that define the realm of the mcdtcal expert can accommodate the errant muse, and have often enough. The world of medicine has yielded great poets, authors and compos- ers. And sometimes, the arts have yielded a physician or two. Anton Chekov (1860-1904), the Russian playwnght who wrote such dramatic masterpieces as The Seagull and The Cherry Orchard, was a (sporadically) practicing physician who lived a life devoted to the arts. He wrote his first short stories as a medical student at Moscow University to help pay off family debts. Although his reputation as an artist far exceeds his work m medicme, Chekov's writing continually encounters and questions the human spirit and the motivations which produce the emotional and physical environments within which the Russian people lived at the tum of the century. His characters continually face a moral struggle in finding their true selves, only to find that the I II II 2 �8 U P' P' A L 0 A N 0 8 IO M COICAt.. I II II 2 G �tragic aspects of life are often comed1c as well. Another example of a man of medicine who devoted his life to the arts ts the American poet W1lham Carlos Williams (1883-1963) 'low v1ewed as a major contributor to American moderniSt artistic ach1evement, \o\lilliarrJS was a general practitioner m Paterson, '\ie,... jerse}. for most ofh1s adult hfe He spumed the large city of New York, both arusucally and medically, in favor of a small commumty where he did everything from setting broken arms and treating chronic headaches CD eu,,.ALO ,-HYatctAN to perfonrung emergency appendectonues and making house calls to deliver babies And yet Williams produced a bo<h of work that includes over 1,000 pages of poetry, se,·eral plays, collections of short stories and books of essar:. and an autobiography. An annual poet!) contest, open to medical students around the country, is sponsored by the Human values m Medtcine program at Northeastern Oh10 University's College ofMedtcmc in honor of Williams. Williams was presented with an honorary Doctor of laws degree by UB during AND BIOt-t£.DICAL its centennial celebration in October 1946 (sees1debaron Williams). His sponsor for that degree, then-Dtrector of Universit) Libranes Charles D. Abbou. sa1d at the ume that Williams had encountered and celebrated ordinal)· American life both wtth his wnung and his medical practice. ~He has been able to see, understand and to express the larger unities of American hfe," Abbou said. '·Like the Universit}. whose hundredth year we celebrate, he too began in medicine, kept faith with all that it demands and sought beyond to that large store of knowledge that fits SCICNTIST SUMME:llt 18St2 �man's mind to grasp the ends of thought." Williams was also a celebrated participant 10 the Niagara Fronuer Convocation in Buffalo m 1951, whtch explored the possibilities of Amenca m the Iauer half of the 20th century A large collection of lus papers is owned by the Universny as well. Williams and Cheko", and numerous others like the Enghsh poet, dramaust and physictan Thomas Campion (1567-1620) and the Austnan doctor and composer understand a great deal of disparate information. -1 believe that doctors think in a way that is amagonistic to poetry," he says. ~because phystctans are often mflextble m their thinking. 'My Simple premLSe IS doctors aren't trained broad!}· m the liberal arts. Their educauon IS generali}' very specialized. Poetic thought goes 360 degrees. And the process of poeuc th10kmg brirlgs the poet mto other mtellectual ar- the physician, or the poet, to encounter new prirlciples that become universal, according to Charles Bernsteirl, a prominent American poet who holds the David Gray chatr ofPoetry· and Lettersat UB. Bernstern has wnuen and edited over 20 books of poell) and essays on language. As a ghost wn ter for 15 years, Bernstein wrote monographs for physicians for medical education publications and abstracts about new experimental drugs and procedures for '~ grounding in science alone won 't make anyone a doctor. There also needs to be an understanding of the intuition that tells us what the whole individual is." Peter Lichtenthal (1867-1924), spent a great deal of their hves pursuing artistic beauty while adhering to their calling in medicine. One reason for tlus lies m the process of commumcauon that underlies much of what an arust does, accordmg to Wilham Coles, M.D., chatrman of the depanment of ophthalmology at lJB's School of Medtcine and Btomedical Sciences. Coles is an accomplished poet published wide!> 10 Buffalo and in magazines around the country - who holds Wilharns as a maJor mfluence on lus 0\\-'11 writing. He 1S also a Jazz mustctan who bills himself as "Doctor jazz," specializing in heritage jazz and blues on the banjo and vocals. "I started writing creatively after Igraduated from medical school. I went imo poetry because 1 was very interested m idea transfer as an educator as well as a public speaker," explained Coles, who has also taught Life Workshops m poetry at UB and won the Callenwold Poetry prize in Atlanta. "Poetry 1S appeal10g because tt is made up of very• concentrated and well thought out tdeas. It's what 1 call the process of poetry, and u centers on communicauon. My medical school trammg left out that kind of process-onented thinking. Let's admu It, most doctors are not very communicauve." The poeuc process brirlgs the poet into various areas of thought, according to Coles, who has also taught poetry·at Emory University in Atlanta, Georgta. And it is through that kind of intellectual diversity that the poet is invested with the ability to BUP'Fo\ LO .. HVSICIAN eas continually. Poetry is the new sensitivity forme, the seventh sense, if you will, that also allows me to reach people across a universal spectrum." An intense attention to detail is what makes creative photography and surgery· complementary, according to NanC} Stubbe. M.D., a clinical physician at UB's University Health Services and a facult} member at the medical school "Wllh photography, you need to spend a great amount of attenuon to set up a good stillhfe scene, for example. If the least thing is wrong, the picture is ruined," she explained. "In that respect, it's very simtlar to medicine, where a physician must be very conscious of detail in her work. And with both, you must devote yourself entirely to the task at hand." Another parallel between med1cine and photography is in the intricate observation essential for both, said Stubbe, who regularly enters her photographs of nature in local photo competitions and has had some of her work published in a local medical newsletter, Medical News. "As a physician, you're taught how to observe a patient very· carefully. whether before, during or after treatment. The same goes for photography. But being a photographer made me learn how to observe without someone speaking about symptoms. In that way, photography has made me a better clinical observer." Changing focus, using the mformation from one field to shed light or bring new intellectual possibility to another, allows AND B IOMEDICAL pharmaceutical companies. He also edIted the Canadian edition of Modern Medicme and wrote and edited over 20 books of poetry and essays on language. •J loved the precision of the medical nomenclature in that it was very specific. But thewritingl was asked to do was often relatively dry·. and most of it was recycled mformauon. And that writing.~ he explamed, "earned a sense of neutral descnpuon, which is the exact oppostte of m} poetry~ Bernstein said he began to notice that his medical writing began toaffectlusown wnting and thinking. He maintair!S that medical writing both altered and expanded his perception of language. ~I found that the medical terminology, the phrasing, staned to creep into my creative work. For example, I wrote a piece about 'dysraphism,' which means the congenital mis-seanung of body parts. And that description seems to have caught on regarding what my creative work does, in general. It's like bad stitching. I'm generalh fascmated by any descnption of abnormality" It IS the large spectrum of feeling that gives doctors-as-writers their field of exploration, accordmg to Richard Seltzer, M.D ,a retired professorofsurgeryatYale Umverstty's School of Medicine and author of six books of shon fiction and essays. His most recent work, Down From Troy, a memoir about lus boyhood in Troy, NewYork,duringtheDepression, is forthcoming this summer from William Morrow Publishers. "I've worked very SCtlNTtaT SUMMIE" t882 G) �hard to transfer the feeling of surgery mto my writtng. And there is a strong similarity between the two for me Both are techniques, crafts." he c;rud won a very simple level, you have a scalpel that draws bloodandapenthatdraw.. mk ln\vnung. you're suturing words together and \\'lth surge[}. you resutunng together the body. I want to report, m the most compelling language that! can use,the suuauon of the human bod)." 11 Tommy Dorsey, Benny Goodman, Glenn Miller, and we do a few modem tunes as well." he said. WThe number one reason why we do thiS is for the fun of it. It gtves us a chance to do somethmg outside of medicine that we all enjoy" \Vhile Schiller finds music to be an escape from the daily rigors and pressures of being a ph)'sictan, a way to enJO}' the com pan) of his colleagues. the technical aspects ofbeing a musician resonate much Washmgton for a year. ~A grounding in sctence alone won't make anyone a doctor There also needs to be an understandmg of the mtUttion that tells us what the whole individual is.·· She also points to the technical expertise associated with both fields as bemg a point of convergence, although she admtts that the basic discipline she gained from studying music for most of her life has made her a better physician. MThere 1S 0n a t'ery simple let•el, you lzat'e a scalpel that draws blood and a pen that draws ink. In writing, you're suturing words together and with surgery, you're suturing togetlter the body." Seltzer, who didn't begm wnting until the age of 40 (he's now 64), satd that once he became entranced with language, his abthty to sense and empathtze with his patients mcreased dramaucally. "In making myself mto a writer, I became a better doctor I saw that! \\.'as much more in tune with my pauents as human bemgs," he explamed. "Because with things like compassion and pll), some people have it naturally and others get it b~ enduring thetr own suffering. I found ll through wntmg In his forthcommg memOir, Seltzer writes of his boyhood and the stress of having parents who had very dtfferent career choices in mind for their son; his father was a doctor and his mother was a singer. "My father wanted me to be a physician and my mother wanted me to be an artist. I guess at 64. I've finally satisfied both of them," he laughed. And satisfacuon, whether personal or otherwise, 1S often mouvauon enough lO want to create provocau"e prose or a prisune photograph, or mterpret a !)'tiCal ballad by Benny Goodman. says Sheldon Schtller, M.D., an ophthalmologtSt from LoutSvtlle. Kentuck), and the onginator of WThe Doctor's Band," a popular 25piece dance band there. He plays the saxophone "I started ll over 25 years ago," he satd. WThtS band allows us to do something wewouldn'totherwisedo. lt'sareleasefor our own stress, kmd of group therapy for us. We're a dance band. We play a lot of music from the big band era, people Like 4D 8U,I'AL0 ~HYSICIAN deeper while offering a sense of commuruty not found in the medical profess1on according to Deborah Shuster, M. D , a graduate of UB's School of Med1cme and Biomedical Sciences m Ma) 1992, and a pathology resident at Stanford liniverstt} She is an accomplished \iOilSt who has played in orchestras m New York and Italy and has a master's degree m mus1c from the Cruvers1ty of Colorado "There is definitely too much speclaltzation in medicme. As a pathologist. rm outside the realm of patient care, but it doesn't have to be that wa)," she explained. "There seems to be no conversauon between the primary care doctors and myself. 1 don't like that at all." Shuster said she wants to be a part of a working community of physicians that is similar to the community she enjors when plaring in a symphony. "Being an artist, marbe I bring a vision of the whole individual to m) work m pathology. Because what finall} makes someone an anist is thatthe) begm to trUSt an innate sense of intulllon when performing or creating." she sa1d ~And medicine is defmuel> more of an art than a sc1ence, because there needs to be a lot of intuition mvolved on the part of the physician. And a pathologiSt can't exist without other physicians, and a musician, at least m my case, can't exist without the rest of the orchestra. Each IS one pan of the whole," said Shuster, who has played in the prestigiousSpolctto Opera in Italy and the Spokane Symphony in ANO BIOMCO!CAL a large amount of minute attention needed to function in both fields. With pathology. I may spend hours looking at one or two cells in hopes of getting a better sense of the whole cause of death," she said. "In mus1c, there is a tremendous amount of practice, sometimes several hours on one series of notes, m order to be able to play a beautiful piece of music." Bemg able to perceive one's singular function wilhin a whole structure, mustcall)' or medtcall), is essential to understanding the entire structure, according to Harold Utt, a French hom player and currently a student in the M.D./Ph.D. program at UB. "To find the value of what you're doing means that you must understand how what you're doing fits in with the whole. "It's the same in art as in medicine," he explained. "When looking at a medical problem, it's very important to identify the underlying causes. And similarly, in order to understand the one part you're playing m a symphony. you must understand the whole p1ece of music." He stressed that there needs to be a dichotomy between the technique and the art of medtcme. "To be a great anist, you must do more than play all of the right notes. You must transcend the ordinary." said Liu, who studied classical music with members of the Philadelphia Philharmonic when he was a teenager. "And it's the same m medicine. A doctor needs to have compassion and an intuition regarding his patients, which leads to a transcendent understanding of the human animal." + SCt&NTIS'T SU,..NEit llil82 ) J �LJ'm '') OS ] ]'IS and the UB connection J J ' he lJnivers1ty at Buffalo"s sored Williams for the honorary doctorsupport and recognition ate he received from VB m 1946 at ItS of William Carlos Williams, Centennial Celebration. M.D.'s work as a creative artist is It was also a dose connection to the made clear by the University's University that enabled Williams to take massive holdings of Williams' papers. part in The Niagara Frontier ConvocaOver 20,000 documentS in the Williams tion in December 1951, when for two collection are housed in the University's days, hundreds of scholars and intellecPoetry/Rare Books Collectuals from across America descended tion, inupon BuiTalo to probe ~The Outlook cluding letFor Mankind in the Next Half ters, manuCentury." scripts, Williams working w a s a draftS of postrong ems, notes critic of and other mas o m e terials. The maAmeriterials span more than 30 years of Williams' career as a writer-from the \Y';//;am 1920s to the Carlos \fT;//;ams' poem 1950s. Williams re- "Lear," u•riften on ltis ceived his medi- prescription pad- part cal degree in 1906 o/ UB's collection. from the University ofPennsylvania. After an internship can artists in New York and graduate study in the ~Expatn­ pediatrics in Leipzig, he returned to his ates," such as Ezra Pound and Ernest hometOY.'Il of Paterson, New jersey, in Hemingway - who left their counl910,determined to care for those m his try to go to Europe during the 1920s own community. Here was a man, as and 1930s. ln his speech at the Convowriter and physictan, who had a strong cation titled ~will the ArtS Thrive or sense of responsibility to community Degenerate During the Next FiftyYearsr and country. He would focus his cre- Williams lamented that American wntaU\'e and medical talentS m Paterson for ers had too often harkened back to Euthe durauon of htS hfe. rope for enlightenment and knowledge, lt was Williams' close relationship instead of focusing on Amencan mtelwith Charles Abbott, the former direc- lectual and artistic achievementS. ~Our first comers, while their bodies tor of Umversity Ubraries for the thenUniversity of Buffalo, which brought went forward into the wilderness, turned much of the material to Buffalo in the back in their minds to Europe,M said 1940s. And it was Abbott who spon- Williams. "After the first burst of BU,.,AL..O flHY81CIAH ANO BIOMIIOICAL affirmation at the time of the Revoluuon, and as wealth increased and the spiritual and Intellectual gradations between individuals became more and more apparent, the trend of mind back to Erope and the past grew in appeal." The second half of the twentieth century could prove to be the period during wh1ch the American artistic genius would shed itS dependency on past European associations and become disunct and smgular, said Williams. The ume, he said, was ~now~ for transformation, for creating a distinctly American literature. "Fifty years is a small space of time. It wdl be hard to say whether we have gone forward or shpped back during that ume, but the way tS dearly indicated. I do not thmk that we shall fail.M Withams' reputation as a wnter has grown steadily since ..... his death in 1963 when he was posthumously awarded the Pulitzer Prize in poetry for his Pictures from Brueghel, and Other Poems. His struggle to propose and define a literature that would reflect at once both the s1mple and complex themes played out m the Amen can experience has been recognized and applauded by a new generation of American writers and scholars. His attitude of looking to the future to defme people's relationships to thetr country and itS history continues to compel and challenge American writers to observe and defme their country's + heritage. - Mark Hammer 5CtCNTl8'f SUMN£11t 1882 G �A Spoonful Po of Humor ically rrect Medical Terms for the Last week I was informed by one of my colleagues that I can no longer use lhe words "woman~ or "female~ because lhey contained lhe words "man~ and "male," which implied a subservient status. From now on she insisted on being referred to as a "Gyno-American." I said, "That would be fine, Dr. Zimmerman ... er, Dr. ZimmerPERSON." Welcome to lhe "Politically Correct (PC)" world of the '90s. PC "newspeak" is no longer just the domain of college campuses and the West Coast. I must learn it, or risk being seen as a "phallocenoist impenahst." For example, someone who is "smelly and dirty" is now considered "hrgterucally challenged." Someone who IS lazy is actually "motivationally dispossessed." If 1t hasn't already happened, we will need to rethink and rephrase medical jargon so as not to offend patients and politically aware colleagues alike. With this in mmd, we are proud to present a primer on "politically correct medspeak." In using these updated terms, you will be looked upon as an enlightened man ("testosterone poisoned human") or woman C[) 8 U , P' A L0 fii'H Y S ICI AN ANO 8 10 tolli: OIC A L. 5 Ct CNT I ST SUM ... C:IIt 1$$2 �I 1 Stu Silverstein, M.D . ..,.. dead :> metabolically challenged ..,.. preemie :> gestationally challenged newborn After trying to resusCitate ~ir. Da\ 1dson for over one hour, we declared h1m "metabolicall) challenged" and called off the code. TillS IS a 27-\"eek ..gescacionall.> challenged newborn," born to a 27-year-old G2 P2 "Gyno-American." ..,.. drug abuser :> recreational pharmacologist ..,.. psychotic C> neurotransmitically challenged Sub-acute bacterial endocarditis is common among "recreational phannacologists." The murderer's lawyer tried to get him offby claiming he was temporarily "neurotransmitically challenged." ..,.. fungus C> Fungo-American (a fungus that resides in the United States) ..,.. sociopath C> ethically diverse Coccidioides is the "Fungo-American" that causes San joaquin Valley fever. Charles Manson's swatisha tattoo on his forehead is a manifestation of his "ethical diversity" ..,.. hernatopoeisis C> he!shematopoeisis Her retic. count was up, indicating that "shematopoeisis" \Vas not impaired "L\tetabolkall_~ Challenged" ..,.. lice infestation C> pedicular enhanced The presence of nits on his halT shafts sug- gested that he '~as ..pedicularly enhanced " (~womyn M) and a role model for future ..,.. male pattern baldness C> reverse Mohawk generauons. On the left are the pohucall} mcorrect terms. On the right, the latest politically correct replacement terms. We have also included a sentence to illustrate proper usage. I don't know wh.> men are so self-consoous A "reYerse Mohawk" malles a man looll so ..,.. amnesia C> memory-tested, Reagano-centrist recollection ..,.. morbid obesity C> verticulohorizontally enhanced His "Reagano-centrist recollective" abilities suggested a worll-up for organic brain syndrome. 1 suggested that he was dangerously sexy. ..,.. menses C> femses Fill in your own sentence, please. "verticulo-horizontally enhanced" and ought to go on a diet. ..,.. autism C> ce.rebro-centricindividual Dustin Hoffman's portrayal of a "cerebrocentricindl~idual~wasmagnificent in "Rain Man ... W. hope this guide is helpful. Bring 1t with you to your next QA meeting or when you give a talk at your next conference. We also welcome additional political corrections. Author's Note: After this guide went to press, I was mformed that the term ~poliu­ cally correct" is no longer politically correct Therefore, when you receive this arucle, please cross out all references to PC and replace them with "multiculturally assessed. I apologize to those offended by my use of the term ~politically correct." ..,.. boring C> REM sleep enhancer That lecture on the '"or k-upfor slwrt stature ("vertically challenged~) children was sure an "R£\4 sleep enhancer " M ..,.. cocaine addict C> cocainist As a "cocainist," he was at risll for becoming REF Tilt Ojjat1al Polatuall~ Corrtct DICUon<U) and Hand!AA>. Htnl") Burd and Chns!oph<r Ccrf motivationally dispossessed Vallard Booi<s ..,.. colicky newborn C> infant of choler Stu Silverstein, M.D., president of Standup Medicine Seminars of San Francisco, California, lectures nationwide on the role of humor in medicine. No matter what we do, this kid will not stop crying. This "rnfant of choler" is driving me up the wall. 8U,,.ALO .. HYIICIAN " Recreational Pharmacologist" AHO BIOfro4110fCAL SC II HTIST SUMMEfl 1882. G> �-- n n ~ ~ '1he sky's the hmit" for UB and Roswell Park's 1 new radiation oncology department -- hen Kyu Shin, M.D., talks about 1nedicinc as his mission, lle stresses that he was "taught to be a good physician, not a just a good clinician." Th£ distinction, he says, is an imp01tant one. "Sometimes, tlte human factor is ~issing." For l.he chatrman of l.he deparLment of radiation oncology at a large medical school and maJOr cancer center, l.he disuncuon could eastly get lost in the technology. Not so for Shm. '" I regard medtcine as my mission not as my JOb," he says. "I like to use my expertise to help l.hcse unfortunate cancer patients. "A good physician looks after patients. It's not just 'nine to live' and then drop it. lt's important. That's why I chose to specialize. I always feel if there's a need I will be there." Shin, who was recruned by UB and Roswell Park Cancer Institute last year to estabhsh a radtauon oncology program, has filled such needs before - creatmg preeminent radiation oncology departments at such presugtous msutullons as the Cleveland Clinic and Lhe Tom Baker Cancer Center m Calgary . Alberta, Canada. He auns to do the same Lhmg for UB. Roswell and the other consortium hospitals - and is well on l.he way, having already introduced several innovauve treatments and applied for residency program accreditation. "This is really an exciting lime," Shin says. "So many positive things are happening here. This is exactly what Dr. (Tho- uons. Buffalo people always go elsewhere to learn Now, they are coming here." Part of Shin's efforts at establishing the radiation oncology program at UB includes building a residency program. "We began l.he recruionent process for a deparLment chair for radiation oncology as far back as 1987," saysjohn Naughton, M.D.. vice president for clinical affairs and dean of the medical school. The department is new to UB, established after the faculty council researched the program. "Radiation oncology is seen nationally as a separate residency program," Naughton explained. "Our policy is if a program has independent status, we consider establishing a deparunent. Obviously, wil.h Roswell Park here, we should take advantage of that." Shm and his deparunent are now drafting curriculums for Lhe three-year residency program, scheduled to begin in 1993. The consortium program will also train two post-graduate fellows. A clinical traineeship was established last fall. The department already provides major traming for Erie Community College's two-year radiation therapy technician program, and works with both medical and tugh school students during the summer. mas) Tomasi (director of RPCI) and the entire institute are trying to do - make Roswell a leader on an international level. ~we can achieve that by having quality programs, and we can actueve quality programs from a quality staff supported by clinical research, patient care and education. And that is exactly what we have here.~ Shin doesn't conceal his enthustasm, and it has spread throughout Roswell's revitalized radiation oncology deparLmenL. Since he arrived a year ago the department has tripled the number of patients it treats each day. last year, l.he radiaoon oncology department logged 16,525 pauent visits. The treatments offered are often the ~last resort" for some, proffered only after ol.her treatments have proven ineffective. One recent success, Shin notes, IS total electron skin radiation. ~Treating the entire skin only IS a techUndergraduate medical teaching (as a nical nighonare,~ Shin explatns. But with third-year student selective) has already Roswell's new low-dose, computer-con- begun. "We intend to go into first and trolled, after-loadmg system - the only fourth year selectives as we expand our one in Western NewYork-Shinand hiS staffing,~ Shin said. colleagues recently treated a patient from Roswell's radiation oncology departSyracuse with mycosis fungoides whose ment has three divisions-clinical, medi"lesions are now completely gone. One of cal physics and radiobiology. "We have the doctors from Syracuse came to team been able to recruit many new staff to the technique," Shin relates, adding "we implement many new programs," Shin have an obligation to teach other institu- says proudly. "The most important role "RGOOD PHYSICmn LOOHS RfTfR PRTifnTS. IT'S nOT JUST \nlflf TO fiVf' RnD THfn DROP IT. IT'S lfnPOfURnT.. �the University has played has been to allow us to recruit a first class staff." One of the most exciting new developments in the depanment is tts computer netv,rork system, scheduled to go on-line this fall. The program, which wHI be a first in New York and probably m the U.S., Shin says, will completely automate all patient record-keeping m the department - from the time patients are referred, through thetr treatment and to follow-up back to the referring physicians. The system will enable physicians to see patients, dictate findings to the computer and send the results to the referring physicians by fax automatically. "just imagine the dynamics of the referring doctors getting their mforrnation the same day," Shin marvels. "Iu s a dream come true." He envisions the system will eventually be hnked wuh the Umverstty's and other area hospttals' systems Another mnovauon Shm has brought to VB and Roswell tS stereotactic radiotherapy-"a prectSton bramsurgel') without a knife and without bleedmg," Shin explains. The procedure, which uses sophisticated digitized computer targeting and planning, "destroys the part of the brain already destroyed by the tumor without any significant side effects," Shin says. The noninvasive procedure, which can be performed on an outpatient basis, is used to treat a variety of benign and malignant lesions, including glioblastoma, arterio-venous malformations, acoustic neuroma, pituitary adenoma, craniopharyngioma, smgle metastatic malignant tumors and solitary. base-of-the-skull metastatic lesions. Most effective for the treatment of target areas up to three centimeters in maximum diameter, the procedure giVes access to deep-seated lesions which were formerly inoperable or reachable only by extensive surgery. Although many centers in New York State are gearing up to do the procedure, Roswell Park is the only one currently performing it. Shin is characteristically already looking ahead. "We're now looking one step further," he says, "using MR1 spectroscopic technology research to find out exactly what happens metabolically when 8U,.P'AL0 ~HY81CIAN "IRfGMO mfOICinf HS mY miSSIOn -noT HS mY JOB. IUHf TO USf mY fXPffiTISf TO ~flP T~fSf UnfORTUnHTf CHnCfR PHTifnTS.N Kyw Shill, M.D. patients are treated by means of megavoltage radiation therap} How does the tumor disappear? Can we predict the radiation response by monitonng the exact metabolic changes? For the first time ever," Shin says, "we may be able to explain why radiation works." Preliminary research, he adds, has already begun. Shin has a great deal of pride in his department, in the University and in Roswell Park Cancer 1nstitute. He is also AND BIONEDIC:At.. grateful for the support he has garnered from each. and mindful the accomplishments realized belong to the multidisciplinary environment that fosters innovation and quality patient care and education. "We are building a very nice department as a group and a family. And that is possible because of Dr. Tomasi and Dr. Naughton. This is an exciting time. The + sky is the limit." SCt&NTIST SU""'WII." 1882 fJ) �University at Buffalo med students win •• I1Cifiotd research awards hree Umversny at BufTalo medical students have won top national research awards. Arlene Lobo, a second-year student, was named a Howard Hughes Med•callnsutute Research Scholar at the National Institutes of Health from the Howard Hughes Medical Institute in Bethesda, Maryland Yvette Vinson and Andrea Williams, also both second-year students, were selected as fellows in Lhe Fellowship Pro- -=-,._..gram in Academic Medicme sponsored b} Bristol-Meyers Squibb Company and The Commonwealth Fund. The fellowships carry$6,000awards. Vinson received hers for her "lnvestigauon of Haemopllilus ducreyi" (memored by Michael A. Apicella, M.D., professor of med1cme and microbiology); Williams received hers for her "Nasopharyngeal colonizauon m otitis prone and non-otHIS prone children" (mentored by Howard Faden, \1.D., professor of pediatncs and co-director of the divisiOnofinfectiousd~SCaseS). + Alums rjve back with generous endowments oscph A. Chazan, M.D., '60,and hiS wife, Helen, have made a pledge to the ~hool of Medicine and Biomedical Sciences' Pathways to Greatness Campa1gn. Their g1ft will be used to endow the Dr. and Mrs. joseph A. Chazan Scholarsh1p Fund es- fl) 8U,,-A 1..0 ~HVS ICI AN tablished in 1985 to provide full tUition scholarships. Chazan is the 1991-92 national chairman ofUB'sAnnual Fund Drive He LS also a member of the medical school's Advisory Board. Paul K. Bin ch, M.D.;43, chmcal associate professor emeritus of gynecology and obstetrics, has made a gift of$1 00,000 to the medical school to endow the Paul Binch, M.D., Endowment Fund. The fund will provide general suppon for research, visiting speakers, equipment and scholarships in the field of reproducuve endocrinolog} . + C. K. Huang honored at annual medical school faculty meeting ix faculty members, e1ght r~1dem physicians and the director ofUB's Health Sciences Library were honored june 3 at the annual faculty meeting of the School of Medicine and Biomedical Sciences. C. K. Huang, director of the UB Health Sciences Library, received the first john and Margaret Naughton Special Recognition Award. Naughton, vice president of clinical affairs and dean of the med1cal school, and his wife established the award to recognize significant comnbuuons to the advancement of the medical sc hool by a staff person or member of the community. Huang, library director smce 1970, IS credited \\ith bringing nauonal recogmtion to the library for its mnovauons and SCT\'!ce. He is a fellow of the Upstate and Ontario Chapter of the Medical Ubral"} Association and a distinguished member of the Academy of Health Informauon Professionals. Robert A. Klocke, M.D., professor of medicine and physiology, rece1ved the AND B IO MCO IC AL ~ Stockton K1mball Award for excellence in academic achievement. The award recognizes contributions to research, teaching and service. Klocke, chief of UB's Pulmonary (. K. Huang Division, is also editor of American Review of Respiratory Diseases. He Vl-'ill deliver the Stockton Kimball lecture at next year's annual meeting. Milford C. Maloney . M 0 Robert A. Kladte, M.D. clinical professor of medicine, received the fourth annual Robert S. Berkson Memorial Award in theArtofMedicinc. The award recognizes excellence in patient care and teaching by volunteer faculty. Robert J. Ge11<o, D.D.S. Robert]. Genco, DDS., Ph D., distinguished professor and chair of oral biology in the School of Dental Medicine, was the first person outside the medical school to receive the Deans A\\ard for outstanding leadership and academic excellence. While noting Genco's numerous contributions to the health sciences at the univerSity, the dean lauded him in particular for assuming the mterim chair of the medical school's Department of Microbiolog} wh1le mainLaining his demal school responsibilities. Louis A. and Ruth Siegel Teaching Awards were presented in four categories: ' Q Q 2 �• pre-clinical, for basic sciences teaching; clinical, for in-hospital instruction; volumeer, for unpaid faculty, and house staff, for resident physicians. Winners were selected from nearly 200 faculry nominated by students. The recipients were: .,;. Alan Lessc, M.D., assistant professor of pharmacology and therapeutics, pre-clinical category. Lesse also won this award in 1990. -.r Fred Luchette, M.D., assistant professor of surgery, clinical category. Luchette also won this award in 1990. -.r Steven lana, M.D., clirucal assistant professor of pedtatncs, volunteer category. -.r Alon Coppens, M D., radiology; Kathylynn Pietak, M.D., med1cme; Ramanathapur Natesha, M.D., surgery; Bruce Solomon, D.O., neurology; Mattheos Falagas, M.D., medicine; Siddhartha Shah, M.D., medicine; Edgardo Salvador, M.D., medicine, and Dawn Hrab, M.D., med1cme, all received house staff awards. + B Y LOIS BA Thomas F. Frawley, M.D., "44, chairman of Graduate Med1cal Education. St John's Mercy Medical Center, Emeritus Professor of \fedicine. St. Louis University School of Medicine, St. Louts, Missouri, and national chairman of the UB medical school's 1991-92 Annual Fund, "''as inadvertently omiued from the list of members of the James Piau White Society in the Winter 1992 cd1tion of Buffalo Physician and Biomedical Scirnlisl. + KER Match Day 1992: most UB med students get their top choice atch Day - that nail-biting time when fourth-year medical students learn where they will spend the next three years as resident physicians- was overwhelmingly successful this year for UB's medical students as 84 percent of them received one of the1r top three choices. Sixry-eight percent of the 141 students who participated received the1r topch01ce. 10 percent received their second choice and 9 percent received their third cho1ce Eight percent were unmatched. In addition, six military matches were made Although a majority of the students (56 percem) will venture out of state for the•r residency training, a full 25 percent of UB's medical students will remain in Buffalo and take their training at the Graduate Medical Dental Education Consortium of Buffalo. + �[1] . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . ..... . .. . . . . . . ~ I Medical school alunri feted at receptions in Florida cnl Indiana he University at Buffalo's medical school recently honored its graduatesatalumnieventsheld in Florida and Indiana. Florida alumni were feted at two separate receptions in February. William Boardman, M.D., '44, and Barry Weiss, M.D., '67, hosted a reception in Tampa at the Westwood Hyatt whtle Thomas Rodenberg M D , '51 , and his wife, joan, hosted East Coast alumni at the Tower Club in Ft Lauderdale. Alumni from various classes attended, mcluding Thomas Bumbalo. MD . '31 , and hiS wife, Ednh Bumbalo's grandson, Thomas Bumbalo,jr., tS a member of the medical school's Class of 1992. Also in February, George Ellis, M.D., '45, hosted a luncheon at the Radisson Plaza Hotel in Indianapolis, Indiana. Thomas Riemenschneider, M.D., M.B.A. , associate vice president for clinical affairs and associate dean of the mcd1cal school , discussed the Western New York Health Sciences Consortium and the lnformaoon Network System that will soon lmk the medical school with its affiliate hospitals and rural health care sites. On hand at the events in Florida was john Naughton, M.D., dean of the medical school , who spoke about the many new developmentsand II programs currently underway at UB. 1 aughton told the groups about the construction of the new biomedical research complex to be completed in 1993 and the Western New York Health Sciences Consortium and its Information Network System. He also talked about the continued recruitment of some of New York State's most talented students and UB's unique uclassroom without walls" clinical training setting. + Medical school begins department chai' secl'ches earchesare underway for the cha1rs of two clinical departments and one basic sc1ence department m the School of Medicine and BIOmedical Sciences. Department heads are expected to be chosen toward the end of the summer for the departments of anesthesiology, radiology and biochemistry, accord- mg to john Naughton, vice president for clinical affairs and dean of the medical school. ~we have outstanding candidates for all posts," a ughton said, adding that UB has been able to attract well-recognized academics of national prominence vying for the positions. In addition, search committees have been formed to chose the city-wide head of cardiOvascular surgery and the director of the Dent Neurologic Institute. aughton said several prominent prospects are in the running for the cardiovascular post, wh1ch is expected to be filled by the fall. The post at the Dent will be filled next summer. + UB med student selected for Ameriam Meclcal Student Association felowslip hristopher Wood, a second-year medical student at UB, has been selected to participate in the American Medical Student Association Foundation's Washington Health Policy Fellowship Program (WHPFP). Wood isoneoflS medi cal students chosen for th1s summer's fellowship fromapoolof74cand!dates. The fellowship is associated with thiS summer's American College of Prevenuve Medicine. In its founh year, the Washington Health Policy Fellowship Program IS designed to introduce promising medical student leaders to the health policy process, current topics in health policy and their role as advocates. The program combines an orientation and weekly seminar <;f'ries with a field placement experience.+ �[I] ( 0 M M E N ( E M E N T I 9 2 he School of Medicme and Biomedical Sciences graduated Its 146th class during ceremonies held in May. Here, fnends and families celebrate with the graduates as they receive their degrees. The Class of 1992 includes 150 students- 146 who earned medical degrees and four who earned combmed M.DJ + Ph.D.s. 8U,.,.ALO .. HVSICIAN AND BIOMEDICAL SCtC:NTIST 5UMM£R 1 g g 2 0 �Alunri meet il Apri for Spri1g Ciicm Day cnl Reurion Weel(end he School of Medicme and Biomedical Sciences held tts Spnng Chmcal Day and Reunion Weekend on Apnl 25. The events, which included a day-long seminar and cocktail receptions, were well-received, as evidenced by thts photo montage. BU e BU,,.A\.0 PHYS ICI AN AND B IO MCOI C Al.. SCICHTIST SUMMER 1992 �A N A N 0 BIOMEDICAL SCIENTIST $ U M M E R 1 Sl Sl 2 El) �CLASS OF 1942 ~ First row, left to right: George L Eckhert, Richard Mnauo, Vincent Cotroneo, Howard Frederickson ~ Second row: Urban L Throm, Richard Ament, Boris Marmolya, Charles A. Baudo, Ivan Bunnell, J. Walter Knapp ~ Third row: Richard Jones, Kent L Brown, Francis Clifford, Vincent Parlante CLASS OF 1947 ~ First row, left to right: Frecleridt Whiting, Wilrtom S. Edgecomb, Robert M. Jaeger, Hans F. Kipping ~ Second row, Robert Ehrenreidt, Wil~am C. Baker, Wilrtam M. Bukowsk~ Arthur J. S<haefer, Ridlard J. Kenr.ne ~ Third row: Ferdinand Paor.n~ Robert J. Dean. Russell J. Sacco, John B. Sheffer, Carl J. Nicosia, HenryS. Gardner, Daniel R. Curtin. James F. Stagg, Peter J. Jurtan, Elbert Hubbard CLASS ~ OF 1952 First row, left to right: Colin C. Madead, Eugene Sigman. Kenneth Altshuler, Barbara G. Coriey, Burtoa Stulberg, Donald F. Doha ~ Second row: John J. Banas, Aaroa Simpson. Robert A. Baumler, Alvin J. Brown ~ Third row: Roy J. Thu111. Kurt J. WegDer, Oliver J. Steiner, Vidor Panaro ~ Fourth row: James N. Schmitt, Bernie P. Davis, Bruce F. Connell. Alfred Lmarus ~ Fifth row: Donald J. Spredter, Eugene W. Loeser, Wilbur S. Schwartz, John Y. Rllllchoff, Travers Robbins, Ralph M. Obler, Neal W. Fuhr �··········································································· · ···················· ~all • CLASS OF 1957 ..,. First row, left to right: Btn Celnilter, Robert B. Sussmcm, Sol Messinger, Arthur L Btdt, Ross Marltello, Frank J. Chafel ..,. Se<ond row: Herbert Metsch, Robert Carpenter, Donald R. Hauler, Sherman Woldmon, Joseph I. Schultz ..,. Third row: Paul Archambeau, Edward Welsenheimer, Bronson Berghorn, Charles F. O' Connor, Richard F. ~iller CLASS OF 1962 ..,. First row, left to right: Charles G. Adams, Ronald Dozoretz, Joseph P. Amenia, Josepla R. Gerbas~ Paul J. LorH ..,. Se<ond row: Robert G. Ney, Morton E. Wei<hsel. David E. Carlson, Phitlp D. Morey, George R. Tzetto, Sebastian FasaneUo ..,. Third row: Seth A. Resni<off, Owen G. Bossman, Alan L Pohl, Morlt Peter Heilbrun, Morton P. Klein, Melvin J. Steinhart, Joseph A. Cimino, Roberto J. Gnbert, Anthony Morkella, Robert Goldstein, Harold Brody ..,. fourth row: Jack C. fisher, Philip Weisinger, Gerald Patterson, Martin F. Abbert, Oscar Oberkircher CLASS OF 1967 ..,. First row, left to r¥rt: Jonathan ~ J. Brian Sheedy ..,. Second row: David C. Stephens, Barry M. fpstein, Barry M. ~ Thomas P. Sheehan, vn&c.n Burie9l, Lon C. Ouem:Jer, John P. Kely, Docdd l Mler ..,. T1Wd row: David FugcrnoHo, Jacob Kritemc~~~, Arthur C~ Ronald Josephson, John B. Keiser, Robert M. Benson, Douglas M. Sirlti1, Trevor Robinson, David R. Dantzker, James Gicrirone, Ridtard Judelsohn, Thomas Augustine, Robert J. Brown, George S. StilT .... Fourth row: F11111kln H. Splm, Arthur C. Sosis, David L Larson, Norman Berltowih, Anthony l.oGallo, Cart W. Ehmann, IInKe Etmger, Alan R. Salmnan, Rocco C. Vetwto, Thomas O'Comor, Douglas Gerstein, Arnold Z. Gold, John J. Teanor, Midtoel !'haps �CLASS OF 1972 ..,.. First row, left to right: Martin T. Hoffman, Steven J. Rosansky, George E. Lundgren. Ywginia F. Howley, lon M. Frankfort, Robert fmhorn ..,. Se<ond row: George Kotlewsk~ Ridlard S. Goldman. Martin Brecher, Edwin A. Salsitz, Richard A. Savage, Stephen J. levine, Murray A. Morphy CLASS OF 1977 ..,.. First row, left to right: AntoineHe Wozniak, Chem1 A. Thorpe, HelenS. fmdlay, Nedra J. Harrison. Undo L Benjamin ..,. Second row: Albert Sddisserman. Carl J. Schmi«, Thomas H. Botsford, Alan S. Kuritzky, Dirk H. Dugan. Richard P. Newman. Joseph Byleby~ Reginald B. Stdes, Eugene A. Paul CLASS OF 1982 .... frst row, left to r9rt: Men CJtuns. waam Schedrter, £Jon Healy, Pilip Steget~~C~~~n. tmo RIDnowitz, Bet+nin Confesso, Y~rginio Keane, Joseph P. leberer, Ancho Abati-Scon, Debbie L K~ fhabetla Bartog, Nancy Peters, Susan fasd!beck. Richard A. WoH, David I. Kuru, Joseph F. Gioia, Gen*l F. Ylfale ..,.. Second row: Jessial Roc:kwel, Robert ~ Stephen Donovan, Robert C. Thomas, Potridl T. Hurley ..,.. T1n row: Michele Leon, An«ew R. Hordes, Robert P. Dudek ..,. Fourth row: Marcia McAvoy, Gerold A. Hinter, Joseph Gelonnini ..,. fifth row: Mary ASce Kely, Kevil J. Bartog, Joseph T. Wayne ..,. Sixth row: Eliot Chartash, David Weldon, Michael A. Cesar, Ivan A. Bcalmwel, fmotlay Geemg �CLASS OF 1987 ..,. ftrst row, left to right: Camille Buonocore, Marina Cotto, Patrick Shaughnessy, Jennifer Cadiz, Bonnie Orzech-Mixon, Kevin Quinlivan ..,. Second row: BrU<e Mac:KeUcr, John O' Brien, Thomas Smith, Michael Rudnidt. JiB Koehler, Timothy Bukowski, Douglas Katz TWs sigaecl origillal of a po&tical Dr. &ush finally arrives YE:.S, I BELIE.\/~ IT IS A Rt.ct.SSION... c.tooa, •Dr. Bnh finaly arrives," donated to tlte medical school by Plllitzer Prizewinning Buffalo News cartooftist Tom Toles, was won by Robert Reisman 'S6 in a siletlt auctiall held d.ring spn.g Oilical Day. �• 1 ·························································································· - I 9 3 0 cology at the Umvef!>ll}' of Pillsburgh C.Chool of Medic me. 5 MAURICE B . FURLONG '35, of jame:.town, New \ork mforms us that hts book, How To Gtt rour Baby To 5/tep, ha!> JUSt been published. A VROM M . GREENBERG '36, of Tucson, Arizona. was named Phystctan of the Year by the Ptma County Medtcal Society. Hts hfe story. "Reflections of an Old Curmudgeon.~ was featured m the Februarv pubhcauon of the Societ\ . 1 9 4 0 5 W . WILLIAM TORNOW '4 6 , IS pre:.tdent of the Hobart Club of Buffalo and mus1c eduor of a weekly newspaper, "The Southtowns CitiZen." Tornow tS an assistant chnical profes.sor of medicine (pcdtatrics) at the Umversity at Buffalo School of 'vi edtcine and B10medtcal Sciences. 1 9 5 0 5 ROBERT E . PLOSS '5 1 , writes, "Iam ahve and well after the Oakland firestorm of October 20. 1991, that burned m~ home to the ground along \\ith 3,000other!>. I w1ll rebutld." ANTHONY P SANTOMAURO '56. was elected a delegate from the State ~ledtcal SoCiety to the house of delegate!> of the Amencan Medical As<,ocmuon A past pres•dent of the ~1edtcal Soctety of the County ofEne. he current!\ serves as a representative from Western ew York on the Council of the Mcdtcal SoCiety of the wntes, "After two \·ear!> of pcdiatnc residency at The Chtldren's llospttal of Buffalo, I transferred to a surgery residenc> at the Eastern Yirgmia Graduate School of "v1edtcme m Norfolk. Vtrgmta Presently I am a second year resident insurgef). I have JUSt matched for a plasuc surgerv restdenc} at the Pennsylvania State Umver!>llY beginmng in 1993. JOHN S . AKER '88, John S. Alter '88 State of '\ew York. He is a member of the board of directors of the .\.1edtcal Uability .\.1utual Insurance Company and IS a member of the State ~1edtcal Soctety'sState Legl!>lanon Commmee. He tS also an officer of the E•ghth OtStnct Branch "v1ed•cal Society which comprises the eight Western New York counues. 1 9 7 0 5 H UGH A . SAMPSON 75, was recently promoted to professor of pedtatrics at Johns Hopk•ns Universll) He is co-editor of the new JOUrnal, Pedimric Allerg> and lmmunolog>. and co-editor of a book. Food A/lug>. published by Black\\ell in 1991. 1 9 8 0 5 ARLENE ROSE CURRY '82, and her husband.john Hntes, are the proud parentS of a baby gtrl, Alyssa Rose, born Januaf) 20, 1992 CHERYL A . KUBISTY '86, tSan J!>ststant professor of medtcine in the Center for Clinical Pharma- A N 0 B tO M NARINDER SHALLA '88.15 now chtef restdent of mternal medicine at '\ew York Umver!>ll}'. He and hts wtfe. \1arva KaltSh. announce the bmh of a daughter. Son) a Shalla, on june 30. 1991. CLIFTON WOODFORD '88 , vmtes, "I've been in San Otego for two years takmg care of dtvers and submarmer<,. We (my wire Kelly and three chtldren) wtll be here ror tWO more years while I complete m\ medtcme restdency at the San Otego 'laval Hospttal " RusseU Van Coeveriag II, ' 77 OBITUARIES ROY E . REED '32, died sudden)} or a heart attack on Februaf}' 2. 1992. MELBOURNE LENT '4 3 , dted Apnl 11. 1992. after suffenng a heart attack. JOSEPH A . VALVO '4 3 , died on March 13. 1992. in Pinehurst, North Carolina. R OY S WARTOUT Ill '4 5 , died of cancer onjanuaf)' 1, 1992, m Temple City. California. RUSSELL VAN COEVERING II , 1 9 9 0 5 MATTHEW J . CYWINSKI '91 , '77. rued unexpectedh on May 2, 1992 rnamed Bonme Zmuda on Februaf} 29, 1992. He tS a general surgef)' hou!>C offtcer at Hen'} Ford Hospual. Dearborn , \11chtgan. Call for nominations Don·t forget to cumplete and matl the attached postcard for OtStmgUtshed Medical Alumnus/a Award. Nominations will be accepted unul March I, 1993. C:OICAL SCtlrHTtiT 1 9 g 2 �I : �Buffalo, NY Permit No. 311 1773 HEALTH SCIEf.tCES SERIALS DEPT ABBOTT HA-L CAMPUS f·A:L 4 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Summer 1992 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1992-Summer Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v26n03-1992-Summer Table Of Contents A list of subunits of the resource. Research Hospital News Country Doctors Dr. Muse A Spoonful of Humor Medical School Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-10 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v26n03 Extent The size or duration of the resource. 36 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1992 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/0af5ee947c7835ea9a73c57959b897fc.pdf 724995e8ef322632a43de73bd2a29914 PDF Text Text �THE BUFFALO PHYS I CIAN AND BIOM E DICAL SCIENTIST Dear Alumni and Supporters of the UB Medical School: Volume 26, Number 2 N DIRECTOR OF PUBLICATIONS NancyTobm EDITOR Nanelte Tramont Kolhg, R.N. ART DIRECTOR Alan J. Kegler ASSOCIATE AR T D I RECTOR Scolt Robert fricker CONTRIBUTING EDITOR Arthur Page STATE UN I VERS I TY OF NEW Y ORK A T BU F FALO SCHOOL O F M E D I CINE AND BI OM E DICA L SC I ENCES Or John Naughton, V1ce President for Clmical Affairs, Dean EDITOR I AL BOARD Or John A Richert, Chairman Or Harold Brody Or. Glen Gresham Or. Nedra Hamson Or. Jame> Kansk1 Mr. Harold Llll Or. Charles Paganelh Or. Luther Robmson Or. Thomas Rosenthal Or. Saleela Suresh Or Burton Singerman Or. Stephen Spauldmg Or Nelson Torre Mr Edward Wenzke Or. Jerome Yates ineteen ninety-two is off to a busy and difficult start. The good news is that the demolition project of the back-end of Harriman Hall is almost completed and construction of the new 110,000-square-foot research building should be underway by April1. Already one can sense the "campus-like" quality that will exist once these projects are completed. Indeed, UB will have a core medical-health-science campus of which we all can be proud. The bad news is that New York State's fiscal crisis will take yet another toll on the level of available state operating revenues. The reductions for 1992-93 will approximate $1.5 million and 25 full-time equivalents. The cumulative reductions since 1990 will total almost $3.5 million by March 31, 1993. lt is very fortunate that we experienced necessary growth and program development throughout the 1980s. O nly through the mechanisms of increased private giving, an expanded research program and the institution of the faculty practice p lan ar~ we able to cope wtth such large reductions in state funding. Even wtth these resources we w1ll be hard pressed to maintain the pace that 1s needed to be a med1cal school of top-rank. We are committed to do our best. Your help and support will be even more important in th_e months and years ahead. The faculty, students and 1 know you w1ll contmue to prov1de tt. We commit ourselves to maintain educational quality and to strive to keep your medical school among the leaders in the country. Sincerely, j ohn Naughton, M. D. Vice President for Clinical Affairs Dean, School of Medicine and Biomedical Sciences T E A C HIN G HOSPI T ALS AND LI AI S ON S Batavia VA Medical Center Buffalo General Hospital Michael Shaw Buffalo VA Medical Center Paula Pcdene ChHdren's llosp11al of Buffalo Karen Dryja-Swiersh1 Eric County Med1cal Center Mary Northen Mercy Hospital MHiard f'Himore llosp1ta!s Frank Sava Roswell Park Cancer Institute judith Rice S1sters of Chanty llospnal Dennis McCarthy © The State University of 1\ew York at Buffalo The Buffalo Physician and Bwmed1cal Scientist IS published quarterly by the State Umversity of New York at Buffalo School of Med1cinc and Biomedical Sciences and the Office of Pubhcauons. ll "sent, free of charge, to alumm, faculty, students, residents and fncnds. The staff reserves the right to ed11 all copy and submisSions accepted for publication. Address questions, commenlS and submissions to: Editor, The Buffalo Physician and Biomedical Scienllsl, Stale University of New York at Buffalo, Umversity Pubhcallons, 136 Crofts Hall, Buffalo, New York 14260 Send address changes 10: The Buffalo Physician and Biomedical Scientist, 146 CFS Addition, 3435 Main Street, Buffalo, New York l4214 Dear Fellow Alumni: W ith an exciting and informative Spring Clinical Day and Reunion Weekend just pa~t, I would hke to thank all of the board members who made ita reality. Dr. Mary Altce Kelly, as Program Cha1r, Dr. Margaret Parowski as Exhibits Chair and all of the others, made this event a big success. ' I would like to thank all the alumni who supported the many activities of the Association. You helped not only the medical school, but many medical students in their educational pursuits. We are a strong and healthy Alumni Association because you have shown that you care. Best wishes for a wonderful and healthy summer! Sincerely, J ~~·~ Nedra ]. Harrison, M.D., '77 �VOL . 26 , No . 2 .......... . . . .. . ........ .. .. . . . . . . . . ............. . . ... . . ....... . . ... . ... .. . . . SPR ING 1992 ..... . . . . ..... . . . ..... II Research IJ Hospital News IJ Perspective on Healing e A pictorial feature on UB's Smokers who quit smoking after bypass surgery were more interested in saving money than their lives, according to UB researchers. Page 3. Robert L. Brown History of Medicine Collection. DJ ASpoonful of Humor m Charting the Secrets of Life e As part of the Human Genome Project, researchers at Roswell Park Cancer Institute are unraveling the mysteries of our genes. ~~ It Hurts to Be Beautiful e Once nearly exclusively the UB researchers see a relationship between lower blood pressure and people with extensive social networks. Page 2. province of women, cosmetic surgery is fast becoming an equal opportunity operation as more and more men flock to surgeons than ever before. m m Medical School People • An early 1900s gas X-ray tube from UB's History of Medicine Collection. Page 6. EZJ Classnotes After a fouryear hiatus to do standup comedy, a physician returns to residency. Page 14. * C 0 V E R Apottery phrenology bust, ca. 1855, from the Robert L. Brown History of Medicine Collection. �· · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · & ' " . North American Symptomatic Carotid Endarterectomy Trial to determine if patients with 30 to 69 percent narrowing of the arteries would also benefit from surgery. + National Eye Institute funds UB retina research VA study shows vascular surgery may help prevent strokes Department of Veterans Affairs cooperative study concludes that carotid endarterectomy surgery should be performed on patients who are at high risk for stroke. Linda Hershey, M.D., chief of neurology at the Buffalo VA Medical Center and UB associate professor of neurology, is one of the authors of the report published in December in the journal of the American Medical Association. "This validates the usefulness of surgery in high-grade stenosis, which can lead to strokes," Hershey saicJ. She added the study results showed that half of the patients who were randomly selected and treated with surgery and aspirin therapy had fewer strokes than those who were receivingaspi rin therapy alone. Thirteen patients from the Buffalo VA Medical Centerwereenrolled in the study that included 189 patients nationwide. The Buffalo study group will join the 8 BUFFALO PHYSICIAN alcolm A. Slaughter, Ph.D., UB associate professor ofbiophysical science and ophthalmology, has received a $143,000 grant from the National Eye Institute to continue research into how the retina functions. Specifically, he will study how neurons in the retina interact with one another. "There have been a lot of advances in eye research in recent years," Slaughter said, "but when it comes down to understanding the retina, we are just getting some real questions answered." Slaughter and his colleagues have been studying retinal function for nearly a decade. One of their discoveries revealed that the eye sees a light going on and a light going off in different parts of theretiM. + Study finds relationship between social contad and lower blood pressure UB study of social interaction and its relationship to blood pressure shows that people with extensive social networks have lower blood pressure than people with little social contact. And while connections with others in general were associated with lower blood pressure, certain aspects in particularthe number of siblings for women and household size and club participation for men - appeared to affect blood AND BIOMEDICAL pressure more than others. The study was conducted by researchers in the University at Buffalo's Department of Social and Preventive Medicine, headed by Maurizio Trevisan, M.D., using data from the 1960 Buffalo Blood Pressure Study. Results of the research were published in the ovember-December issue of Psychosomatic Medicine. To assess the effect of social interaction on blood pressure, researchers selected five categories of social encounters - household size, number of siblings, participation in social clubs and meetings, religious service attendance and maritalstatus-andcompared them with adjusted mean blood pressure levels for the 656 men and 753 women in the study group. Among women, the only category that showed a significant relationship to blood pressure was number of siblings. Those with six or more brothers and sisters had significantly lower blood pressure than those having five or less. Among men, significant correlations with blood pressure showed up only with size of household - the larger the better - and club participation - the more active the better. The researchers were surprised to find no significant relationship between blood pressure and church attendance since other research has shown an asso~iation between attendance at religious services and longer life, less hypertension and better health in at least some segments of the populations studied. + By SCIENTIST LOIS BAKER SPRING 1 9 9 2 �. ... ........ . .... . ........... .. ..... .. .... . ... . . . ......... . .... . ........ . ...... . . Money more important in motivation to stop smoking quit smoking and 13 had not. The smokers listed lack of will power, having nothing to do with their hands and nervousness as the most important rea+ sons for resuming their habits. mokers who quit smoking after bypass surgery considered saving money, not improving their health, the most important reason for kicking the habit, researchers in the University at Buffalo School of Nursing have discovered. And patients who returned to smoking did so within the first three months, they reported in an article in the Journal of Cardiopu l m onary RehabilitaLion. The survey of 46 people taken five years after surgery to determine the perceived benefits and barriers to stopping smoking showed that being more healthy wasn't even the second most important reason for remaining smoke-free. "Feeling better emotionally" (no smoker's guilt) held that position. one of the other potential benefitsfreer breathing, less coughing, feeling better physically- were listed often enough to be statistically significant. Further, the severity of their disease had no effect on p·atients' smoking behavior after the operation. Thestudytracked 197 patients who had coronary bypass surgery at Buffalo General Hospital in 1985. Of that group, 112 were smokers when they entered the hospital. All participated in post-operative programs to help them stop. The smokers' group was resurveyed after five years to find out how many were still smoking and why. Of the 46 who returned the survey, 33 had successfully BUFFAL O PHYSI C IAN By LOIS BAKER Roswell Pen to concUt Plme II breast aner study oswell Park Cancer Institute will conduct a Phase ll clinical trial of liposome-encapsulateddoxorubicin (TLC D-99) to treat women with advanced breast cancer who have not had prior chemotherapy. Doxorubicin is a widely used anticancer drug that has proven effective in treating solid tumors- carcinomas of the breast, lung and bladder-as well as lymphomas , leukemias and soft tissue sarcomas. Although effective, doxorubicin has been limited by the side effects it can cause, particularly damage to the heart, which may be irreversible and can be fatal. "Since the first chemotherapeutic agents were introduced," according to Ellis Levine, M.D. , assistant professor of medicine and the principal investigator of the study, "their inability to differentiate between malignant cells and healthy cells has resulted in potentially life-threatening side effects that have limited the dose that A N 0 BIOMEDICAL S C [I] could be safely given to patients." Encapsulating the chemotherapeutic agent could reduce its toxicity and target the drug to the tumor, according to Patrick j. Creaven, M.D., Ph.D. , associate research professor, who was among the investigators completing Phase l clinical trials of TLC D-99 in 1990. Those trials demonstrated that the toxicity of doxorubicin was reduced to a point where it may be possible to expand its use. When TLC D-99 is administered, its liposomal structures shields the body against many of the toxicities of the enclosed doxorubicin. lt is thought that TLC D-99 accumulates at the sites of tumors and avoids damaging tissue. The liposome breaks down after it reaches the targeted sites and releases the + doxorubicin. I IENTIST SPRING �lfZil · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · ~ BuHmo Genetd flies pm1 i1 study to cid stroke victins issue plasminogen activator, tPA, the clot-dissolving agent that provides hope [or many heart attack victims, is now being studied at The Buffalo General Hospital for its effectiveness in offering similar results for stroke patients. Buffalo General is one of l3 facilities nationwide involved in the study to determine if t-PA can increase recovery chances for stroke patients. The purpose of the study is to investigate whether t-PA can improve recovery by opening blocked arteries from strokes caused by a clot in an artery leading to the brain. "The use of agents like t-PA in acute stroke represents a new exciting chapter in stroke therapy," said Patrick Pullicino, M.D. , UB assistant professor of neurology and chief neurologist for the local 0 BUFFALO PHYSICIAN arm of the study. "Until now , there has been no effective therapy for a stroke. T -PA promises to be the first drug that will reduce the amount of brain damage caused by a stroke. " To be effective, t-PA must be administered within six hours of the onset of stroke symptoms. Pullicino emphasized doctors' attitudes about stroke, as well as those of the general public, would have to change if drugs like t-PA are to be useful. "The lack of treatment for stroke in the past has meant a pessimistic attitude and usually a long delay from the time of stroke onset to the time of arrival at the hospital. " The first BGH patients in the study, sponsored by the California pharmaceutical firm , Genentech, have experienced positive results [rom the drug. + clothing items to first-time pregnant teenagers who receive regular checkups through the Prenatal Care Assistance Program (PCAP) or are in Medicaid assistance in the Sisters Hospital Outpatient Program. PCAP provides free prenatal care to women who have no health insurance. The new program provides a "credit" each time the patient visits the prenatal clinic at Sisters for her scheduled checkup. After eight visits, she qualifies to receive a layette package that includes a variety of baby clothing items, receiving blankets and a specially designed diaper bag. + VA Medical Center one of 14 to receive HUMOR Proiect grant he Buffalo VA Medical Center has been awarded a grant to establish a Humor Resource Center within the medical center The grant, awarded by the HUMOR Project in Saratoga Springs, New York, was one of 14 awarded nationwide from a total of over 100 applicants. According to Michael Ackerman, R.N. , Ph.D. , director of the medical center's grant-writing team , "The Humor Resource Center is part of a larger project at the VA aimed at instilling a sense of humor into the health care setting. These are very difficult times for health care centers, and we feel that by providing an avenue for humor and creativity , there can only be one benefit and that is improved patient care." An integral part of the program is the isters Hospital has begun a pro- use of a hospital-wide humor cart, gram to offer incentives for first- dubbed "The Chuckle Wagon, " which time pregnant teenagers to seek will make a variety of items, including prenatal care. books, videotapes , toys, puzzles, etc., Called "New Beginnings," the available to patients throughout the program provides basic infant medical center. + Sisters Hospital program offers incentives for early prenatal care AND BIOMEDICAL SCIENTIST SPRING 1 9 9 2 �. .. . . . . . . . . . . . . ... . . .... . . . . . . .. . ... ..... . . . . .... . [1] CHOB purchases area's first fully computerized obstetric management system ultrafast CT scanner - an !matron can screen for coronary artery disease by detecting calcifications in the arteries associated with atherosclerotic plaques. Imatron scanners are ultrafast, taking images in one-tenth of a second as opposed to the two seconds required for conventional CT imaging. Because it is so fast, !matron scanning freezes the action of the heart's beat, resulting in clear, precise images that show calcifications. Images taken by traditional CT scanning can be blurry. Studies have shown that when I matron scans show no calcification , the patient is free of coronary artery disease. The presence of calcifications, however, may indicate the presence of CAD. According to Alan S. Brody, M.D., director of the CT Section of the Department of Radiology at Children's and he Children's Hospital of Buffalo has become the first area hospital to offer a fully computerized obstetrical management system in its labor and delivery suites. Purchased with proceeds from its 1990 and 1991 Golf Classic, the hospital's new system provides the staff with vital information on both the maternity patient and her ::~ -~-=-=-= . ./ '_...,.- ~- . .~....ro<t"·-··-:'' baby. From a central station, the system allows ll patients to be monitored at the same time on a single screen display, providing an instant overview of each patient in the system with immediate warning of critical conditions. The hospital, the region's designated high-risk maternity center with 5,000 deliveries annually, also purchased a new technologically advanced ultrasound for labor and delivery. Lawrence Romano, chairman of the '91 Golf Classic, notes "The new computerized monitoring system will enable the hospital to continue offering the highest quality care to maternity patients throughout Western New York. The Golf Committee is very proud of the business community's commitment and support of Children's Hospital. " + assistant professor of radiology at UB , "The Imatron has probably had the very best results in early evaluation of coronary artery disease than anything that's been tried previously. "The !matron scan is a screening test. If the Imatron shows that you have calcifications, it doesn 't always mean that you have coronary artery disease; but if the I matron shows no calcifications, you do not have CAD. In cases where no calcifications are present, an invasive angiogram should not be necessary. " Brody added, "Children's shares its technology and expertise with the community. We have an adult medicine department, and can cure adults as well as children ." In addition to being much faster than traditional CT scanning, !matron scanning uses a much lower dose of radiation. + ChUdren'sHospital becomes first in state to oHer ultrafast a scanning he Children's Hospital of Buffalo has become the only hospital in ew York State to offer ultrafast CT scanning. Research being conducted nationally indicates that use of an BUFFALO PHYSICIAN A N 0 BIOMEDICAL SCIENTIST SPRING �' ' The Robert L. Brown History of Medicine Collection Housed in UB's Health Sciences Library, the Robert l. Brown Robert l. Brown, M.D., medical school archivist and professor History of Medicine Collection offers an unrivaled perspective of medicine emeritus. The collection has grown, and continues into the evolution of the art and practice of modem medicine. to grow, in both scope and breadth with acquisitions and From its pre-Civil War lithotomy instruments to its assortdonations each year. ment of rare books dating back nearly half a millennium, the The instruments collection includes a range of dental tools, collection chronicles the progress of medicine stethoscopes, surgical kits, bloodletting devices, through the tools of its practitioners. One of ..-microscopes, lithotomy tools, obstetrical inonly three formal history of medicine collec- _,.__.,..~------- _:Struments, splints and early X-ray tubes. The tions among medical schools in New York State, oldest instrument - a Roman surgical clampthq:ollection at UB was formally established in dates back to the first century A.D. In 1985, 1972. Annette Cravens established the Edgar R. Before that, it existed as an aggregation of McGuire Historical Medical Instrument Fund donations to the medical school and volumes in honor of her father, a 1900 medical school acquired for the school's library from 1846. alumnus and chair of surgery from 1914 to his One of the first donations was the 1 ,070-voldeath in 1931. The fund supports the purchase ume private library ofUniversity founder james of historical medical instruments. Platt White, M.D. The medical school also Here, The Buffalo Physician and Biomedical acquired Roswell Park, M.D.'s entire 3,000Scientist presents a sampling of items from the volume collection when he died in 1914. Robert L. Brown History of Medicine CollecIn 1986, the collection was named after tion. 0 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST SPRING 1 9 9 2 �'A 19th century Staffordshire leech jar. cupping set and lancets. The practice of bloodletting reached a high point in the early 19th century . BUFFALO PHYSICIAN A N 0 * BIOMEDICAL SCIENTIST SPRING 1 9 9 2 0 �I' ,, I' II I. I~ I~ n II II I~ il !I II This Naval surgical kit . manufactured by w. and H . Hutchinson of Sheffield. contains a trephine. tooth keys and forceps. as well as an This Powell amputation and Lealand saw and "No. 1" stand surgical microscope. knives. Gift manufac- of Theodore tured in England in 1884. represents the height of microscope design and craftsmanship in the 19th century . Gift of William H . Merrilees. M.D. 0 * BUFFAL O PHYSI C IAN A N 0 B IO MEDI CAL SCI ENTIST SPRING 1 9 9 2 �I' r ,.,, II I, I~ II I! II II il II !I This un iden tified art ifact was made by Maw and Ca. of London . a med ical instrument manufactu r er. * •••• BUFFAL O PHY SICIAN A N D BI OMED I CAL SCIENTIST SPRING r 9 9 2 0 �I~ I' ,, I' BUFFALO II I, PHYSICIAN I~ A N 0 II BIOMEDICAL II II I~ SCIENTIST II II 5 F' R I N G !I 9 9 2 �I~ I' ,, I' II I, I~ II I~ II II William A set of Hunter' s lenses for the Anatomia Powell and I~ II II !I Lealand "No. Humani 1" stand Gravidi. microscope. originally * published in 1774. was donated by James Platt .. White. M.D. It is shown here with early 19th century obstetrical instruments. * This set of dental instruments with ivory handles (ca. 1850) is similar to a set made for the Great Exhibition of 1851. Gift of L .L . Mulcahy. Jr.. D .D.S. * B UFFALO PHYSICIAN A N 0 B IOMEDICAL SCIENTIST SPRING 1 9 9 2 (D �I' I' ,, I' II I. II II II I~ II !I II The staff of The Buffalo Phys1nan and Bwmedical Scientist gratefully acknowledges collecuon curator Lilli Sentz for her mvaluable help m producing this feature. 'A trephina- tion set (ca . 1760). 'A trephine was a circular saw used to remove a disc of bone Post mortem from the instruments skull. (ca. 1870). * This set was manufactured by Luer in Paris. * 41) B UFFALO PH YSICIAN A N 0 B IOMEDICAL S CIENTIST S PRING 1 9 9 2 �I, I' \J I~ IJ II II il II !I 'A homeo- pathic drug kit. Founded by Samuel Hahnemann in the early 19th century. homeopathy as a system of medicine was based on the doctrine that diseases can be cured by administering minute doses of a drug which in larger amounts cause the symptoms of the disease. * BUFFALO PHY SICIAN AND BI OMED I C AL SCIENTIST S PRI NG 1 9 9 2 G) �ASp I{}on't know how I got here, but I couldn't get up. I wa\, pinned to the asphalt of Market Street, my legs were moving but I w~sn't going anywhere. ThiswasMarket Street in San Francisco, so why was the Empire State Building looming in the horizon? It was all so strange. Vice President Dan Quayle was dressed in white culottes, playing the accordian. It was more than I could take. But as hard as I tried I couldn't get up. Suddenly I could hear the beeping of a dump truck backing up, heading right for me .. The beeping got louder and more piercing, and wouldn't stop. It was then that I woke up. I was in the Newborn Intensive Care Unit call room, my first night "on," after taking a four-year leave of absence to perform standup comedy. I glanced at my glow-in-the-dark watch (which retails for $295, according to my father. He picked it up for $39.95 and had the slashed sales slip to prove it). It was 7:15 a.m. I managed to sleep until 7:15 on my first night, on call? I thought, "not bad" until G) BUFFALO PHYSI CI AN o on f u I remember that I went to sleep at 6:45 a.m. Better call that number, see what's the problem. "Hello! This is Dr. Silver ... "MEC!!! OR3!!!" CLICK!! No good morning? MEC!!! What a great medical euphemism. Makes me glad I didn't become a plumber, which according to my father wasn't a "dignified job." You spend your life up to your elbows in ... 'mec!"' Fortunately I don't have to get dressed. I never intended to sleep. I just collapsed in my scrubs and shoes. So I just drag myself down the hall to OR 3, wearing what amounts to pajamas and slippers (no bathrobe, though). I'm still waiting for the day when someone will notice this and say, "Hey Stu, get out of those pajamas and put on some clothes. You're a doctor, for God's sake!" Of course before you enter the hallowed ground of the OR, you must cover your shoes with the "shoecovers." I must admit that I was never quite sure whether we do this to maintain sterile conditions or to protect our shoes from falling "mec." (Since surgeons and anesthesiologists wear these covers and their showercaps in the cafeteria, I've always assumed it was for the latter.) I must admit this was my first delivery alone in a long time and I am quite nervous, but just like in comedy one must "never let them see you sweat." At least there aren't any hecklers, but I AND B I OMEDICAL I of Humor still imagine the anesthesiologist yelling from behind the drape. "Hey Silverstein, YOU SUCK! " Where'd you get your medical license from? A raffle? Would you look at him intubate! I'm waiting for Alfred Hitchcock to walk through this scene!" Relieved that this probably won't happen in a medical setting (with the possible exception of quality assurance meetings) , I relax and enter the OR. I begin by casually checking out the equipment on the table as recommended by NAl.Scourseand realize that some things have indeed changed. The NBICU nurse who will serve as my assistant, informs me that we are no longer required to"' suck the meconium into our masks through a Krazy Strawlike apparatus. It is now done with wall suction. Finally we've entered the "safe mec" era in medicine. The delivery goes well. I'm tempted to say, "Thank you! Good night! Drive home safely and don't forget to tip your circulating nurses, they worked hard for you tonight." Luckily, I keep this one to myself. BackintheNursery, l(;~~a:;;Zf£{jjd it was the usual rounds: "This is hospital day 4 forT win A, who is now a five-cell morula, up from two cells yesterday, tolerating masked CPAP with good gases. Twin B SCIENT I ST SPRING 1 9 9 2 �© Stu Silverstein, M.D . .. is still a zygote and is dependent on hyperal. He took in l20cc/kilo/day, urine output 2 cc/kilo/hour and a surprising three runs batted in. " The day was relatively uneventful except when the post call intern desaturated into the '80s. Fortunately he came around with vigorous stimulation and some bagging. And so my final year of pediatric training was finally underway. Starting in the NBICU was my choice; I figured it was one of the tougher rotations, yet it was a "controlled environment," with a finite number of problems and finite number of solutions. On day one, I sounded like a veteran fielding questions from the nurses. "OK, just turn the ratedown,getagasandcall me with the results. Yea, just go up on the PIP and increase the rate and get a gas ... " Oh! "Sorry, didn't realize this was a bili baby. " Ina way,standupdid prepare me for this return appearance on theresidencystage. Here, too , we must p e r - BUFFA LO PHYSICIAN Perform procedures, perform on rounds, and, of course, perform for parents while examining their children to show that we take their concerns very seriously no matter how trivial they appear to us: "Yes, I realize that your son has had abdominal pain since birth, and I AM concerned, however, since your child is 35 years old, I'm going to refer him to a specialist. " I did, indeed, learn some lessons in the comedy world that would come in handy here. I realize that rounds aren't "ExConvict Night" at the local comedy club, and I won't be heckled by a cyanotic mouth breather with no neck. However, medicine does have its version of the heckler and heckling, i.e. , the attending and pimping. I learned in comedy that one must always be prepared for difficult situations in advance. We comedians do this by preparing what the unsuspecting audience perceives as "ad Jibs," i.e., if a couple in their sixties should walk out while I'm performing, I can't rely on luck. I must allow them to get within five feetoftheexit so everyone can see them and pause before saying, "Mom! Dad! You promised that THIS TIME you'd stay for the whole show! " Likewise the performer, I mean resident, must be prepared with "ad Jibs" for rounds. Standard comedian retorts like, "I like the haircut, didn't realize Supercuts AND BIOMEDICAL had a drive-thru window" probably won't work on rounds. Ad Jibs must be more subtle. For example, when discussing the incidence of various diseases, I bear in mind "LaCombe's Rule of Percentages" (Hospital Physician, 1971, 7(2);102), whichstates that the incidence of any disease is either 15 to 25 percent or 80 to 90 percent. Even if I'm wrong, I'll be right if I finish my answer with, "depending on the study. " There are many others, however, since I still have another six months to go and some of my attendings might be reading this, I will keep them to myself for now. And so I am the comedian returning to complete my medical training after starting and establishing my second career as a standup comedian. I couldn't have done it any other way. I feel the same toward comedy that William Carlos Williams felt toward poetry when asked how he reconciled such an unusual combination. They both require an understanding of what people are feeling and fearing in their lives. In both cases it is my job to relieve suffering, and in both medicine and comedy, timing is everything. And my time is up. Thank you! Good night! + Stu Silverstein, M.D., president of Standup Medicine Seminars of San Francisco, California , lectures nationwide on the role of humor in medicine. SCIENTIST / SPRING 1 9 9 2 G) �~ m ~ 0 ~ > " Q • ••• • • • •• • ••• • • •• •• BUFFALO PHYSICIAN A N 0 BIOMEDICAL SCIENTIST SPRING 9 9 2 �Roswell Park research team unravels the human oenome Like a kaleidoscope, the Human Genome Project looks a little different to everyone _ who spends some time observing it. The view depends on the spin thats put on it. B ~ BUFFALO S c PHYSICIAN o AND t t BIOMEDICAL T h SCIENTIST o m SPRING a 1992 s 4D �o physicians and genetic counsel- genes that, when altered through mutation, can cause disease. The lab has identified, among others on Chromosome 11, the genes that cause aniridia, a form of blindness resulting from a complete or partial absence of the iris; Wilms' tumor; diabetes, and albinism. Teams working on other chromosomes have met with similar success; a recent breakthrough was the discovery, on Chromosome 7, of the gene that causes cystic fibrosis. The physical mapping is a tedious process of chemically breaking the DNA into manageable pieces of 300,000 to 400,000 base pairs, then assembling the information into a continuous strand of information - a seemingly endless string of permutations of A, T, G and C. But even success at this gargantuan task, Shows says, will be only the beginning of understanding how genes work; it won't mean that every genetic disease can immediately be eliminated. "It should not be construed that once we know this sequence, this is the prescription of life," he says. "This is just the first step in the long process of understanding the information in the genome. "How they function, how they are.controlled- all these are questions that have to be taken up." Because the Roswell Park lab has the computer capabilities to maintain the physical map, Shows said, biologists - about 200 a year - often write to ask for help in situating a gene they've extracted. The Roswell Park researchers can analyze a sample, match it against the DNA sequence they've stored in the computer database and tell the correspondent that the gene is situated, say, in position l3 on the short arm of Chromosome 11. And so another bit of the human genome code is penciled in. "Here's what I can picture," says Shows, whose enthusiasm for the project is prodigious: "Once we get the physical map and know what genes there are and know what the characteristics of genes are, all of this will be stored on computers. The time will come when biology will be done sitting at a terminal, instead of in the laboratory. "The amountofinformation is astounding. After all, this genome we have sitting here is the product of the universe." Decoding that information doesn'tcome cheaply. It now costs about $5 to pin down each nucleotide base pair; if that figure ors, the project is rich with promise for endinghumanmiseryfromawiderange ofgenetic diseases. To philosophers and medical ethicists, it~fraught with perilous implications for social policy. To pharmaceutical companies, it~ a potential bonanza ofgene therapies, a whole new industry of genes as drugs. The goal of the Human Genome Project, of nucleotide bases. The average chromohowever, is not complex: working in teams some contains 120 million base pairs; the in laboratories throughout the United entire human genome contains 3 billion. States, scientists are seeking to codify the The project, begun in 1990 and expected sequence of nucleotide "bases" that makes to cost U.S. taxpayers $3 billion by the end of up the genes in each of the 23 chromosome its 15-year life, has been compared to taking a pairs in the human body. census ofeveryone on Earth -and getting all The structure of the human genetic their addresses right. code was discovered by James Watson and About 2 percent of the total number of Francis Crick in 1953 when they deter- human genes have been mapped thus far. mined the configuration of the DNA (de"You could argue, why do this? " says oxyribonucleic acid) molecule that is the Thomas B. Shows, Ph.D., an adjunct profundamental molecular unit of life. The fessor at the University at Buffalo School of molecule is a double helix- shaped like a Medicine and Biomedical Sciences and diladder that is twisted. The sides of the rector of the genetics department at Roswell ladder are composed of a sugar-phosphate- Park Cancer Institute. "But to me, it's out sugar-phosphate polymer. The rungs are there to be understood. And what a thrill made up of the four nucleotide bases it will be to understand the human getwo purines, adenine and guanine, and two nome. " pyrimidines, cytosine and thymine. Each Shows' 20-person lab at Roswell Park is rung is formed by one purine and one involved in two aspects of genetic mappyrimidine; adenine always pairs with thy- ping. First is functional mapping - idenmine (A-T) , and guanine always pairs with tifying chromosome sites where diseasecytosine (G-C). Each side of the DNA related genes are located. He said the lab ladder is complementary to the other. has mapped about 400 genes- more than The D A (about six feet of it) is located any other group in the world. in the 46 chromosomes that are found in And then there's physical mapping, the the nucleus of every cell in the body. A primary goal of the Human Genome Project. gene is a chromosome segment that con- Working with a computer database, the tains specific genetic information, such as Roswell Park lab has concentrated its efeye color or the expression of certain dis- forts on the physical map of Chromosome eases. The 23 chromosome pairs are esti- l l, which is estimated to contain 2,500 mated to contain 100,000 genes and each genes. gene contains from 2,000 to 200,000 pairs Chromosome 11, Shows says, is rich in 4I) BUFFAL O PHYSICIAN AND BI O MEDICAL S C I E NT I ST SPRIN G 1 9 9 2 �•• •• doesn't fall to less than 50 cents per base health care and health insurance; the pair, the comprehensive project could be • • effect of genetic testing on parent-child doomed since the amount of money origirelationships . nally allocated is not enough to decode all "We're now moving into the area of of the nucleotides at the present $5 per insurance and insurability," Erbe says. "A base pair cost. The Department of lot of people are very concerned about Energy and the ational Inemployment. But other than the stitutes of Health, the major occasional horrible case there government sponsors of the hasn't been much in the way of project, are counting on developpre-employment screening yet." ments in robotics and other technologiShows, at Roswell Park Cancer cal improvements to make the process Institute, says the concerns about ethical cheaper before the money runs out. • • and social issues, although valid, are Cost considerations aren't the only • overestimated. aspect of the Human Genome Project that • "I get a lot of calls from ethicists and • philosophers who want to know what's has observers worrying. What about the ethical and social implications of this newgoing to happen once the genome is found knowledge? Like the design for a sequenced," he says. "They're all connuclear weapon, the genetic code is somecerned that there's going to be a real probthing that, once discovered, can never be lem quickly. We don't have a real problem unlearned. The world will have to live with quickly. We have a lot of work to do. its effects. "There will eventually be a blood test Writers of science fiction and newspawhere your entire genome is analyzed. It per "think pieces" have found much grist won't be soon , but it will happen. for speculation in the possibilities of the "There's no question that my insurance genome project: company could look at that and, if I had What will it mean for the insurance indussusceptibility to asbestos dust or whatever, try, they ask, when it becomes possible to they could decide I'm uninsurable. You bet identify an apparently healthy person as carrythat's a genetic issue," Shows says. ing the gene for a deadly disease? "But to me, the ethical issues are not as Who will have the right to study an important as the risk/benefit ratio of getindividual's genome? ting that physical map of the genome and Can potential criminals be identified discovering how to treat all those diseases. " through a simple blood test? What does the Human Genome Project Will D A testing create a "genetic mean for the practicing physician? Evenunderclass," shunned in their search for tually, it may make all the difference. In a jobs and health insurance? book by Leon Jaroff, "The ew Genetics: Richard W. Erbe, M.D., a UB medical they would abort a fetus if tests showed the The Human Genome Project and Its Imschool adjunct professor and director of baby would be born with CF. pact on the Practice of Medicine," molecuthe Division of Genetics at The Children's These parents' attitudes, they say in a lar biologist Leroy Hood is quoted as deHospital of Buffalo, knows the range of paper published in the May 1992 American scribing an exacting new world of doctorquestions that are being raised. For two journal of Human Genetics, may be indica- patient relations. After an analysis of a years he has chaired the study group that tive of those of parents faced with similar patient's genome, he says, "the computer reviews all grant applications for proposals choices about bearing children with other will give you a printout of the potential life to study social-policy issues of the Human disorders. history of that individual. ... You'll also get Genome Project. ElSI project proposals range widely in a printout that says, 'You should avoid The project has allocated a generous 3 subject and originate both individually and overexposure to the sun, change your diet percent of its budget to fund the study of jointly from theologians, scientists, actuar- at age 13, etc.' The focus of medicine, the ethical, legal and social implications ies, historians and philosophers- groups basically, will be on keeping people well, (ElSI) of its results. As a result, Erbe finds with little or no experience working with on making predictions about the difficulhis group in an unusual position: it has each other and often little or no knowledge ties people will run into and then avoiding more money to fund research projects than of each others' fields. The concerns they those problems by manipulating their diet, there are research projects to fund. raise are just as diverse: such issues as their environment or their immune sys"In certain respects, the many real is- religious implications of genetic knowl- tems, or applying molecular pharmacolsues are no different for genetics now than edge; professional standards for the use of ogy." Until then, we can only watch as the they've been all along," Erbe says. "But D A typing in police work; the history of now the public awareness is huge, because how people with genetic disorders have pieces of the human genome, one by one, only one in seven of the fertile couples said been stigmatized; the problem of access to fall neatly and inexorably into place. + •• • BUFFALO PHYSICIAN A N 0 BIOM E DI C AL SCI E • NTIST SPRING 1 9 9 2 4D �IN AN 1\I'I'EMPT TO LOOK TIIEIR BEST, MORE AND MORE MEN ARE UNDERGOING COSMETIC SURGERY THAN EVER BEFORE a> B UFFALO PHYSICIAN AND B IOMEDICAL S CIENTIST S PRING 199 2 �lastic surgery, the equal opportunity operation, has come of age. Once the exclusive domain of women, it is becoming more and more popular among men as they flock to surgeons in record numbers for chin implants, facelifts, eyelid tucks and liposuctions. And although women still account for 90 percent of plastic surgeries performed, the increasing numbers of men who seek cosmetic surgery prove that women no longer have an exclusive right to vanity. After 17 years in the business, Hanley M. Horwitz, M.D., has witnessed a change in the type of patients coming into his Williamsville office seeking cosmetic surgery. Ten years ago, he said, 2 percent of his practice was male. Today men represent 33 percent of his patients. What drives a man to seek cosmetic surgery? "A very strong ego to start with," said Horwitz, a 1969 graduate of the State University of ew York at Buffalo School ofMedicine and Biomedical Sciences. "And they can't be easily embarrassed. They also must have an overwhelming desire to have something corrected." Women also are important factors. "Wives are significant," Horwitz said, "very frequently young wives. Men feel it's good for the relationship." With society's intense focus on youth, there is no mistaking that this, too, plays an important role in their decision to seek cosmetic surgery. But that influence, according to Horwitz, is vastly overplayed. "That's one way to look at it," he said, but overshadowing this search for youth is simply the fact that people want to look their best. "Males age better than females," Horwitz said. "They don't get those little crow's feet and spiders all over their faces because their skin is thicker. And they don't get all the wrinkles on their upper lip." A man and woman walk into his office, both seeking a facelift. "Most of the time, they don't need it. Most of the time, they need something done with their eyelids" to achieve the results they want, Horwitz explained, adding that most men are well into their 50s, possibly their early 60s, before they need facelifts. Women, he said, usually need face-lifts 10 or 15 years earlier in life than men , usually in their late 40s. Buffalo surgeon and 1981 UB medical school graduate Bruce J. Cusenz, M.D. , has noticed that in men seeking cosmetic surgery, the aging process, regardless of the age, is more advanced. "Eyelids tend to hang more in men," he said. jack Fisher, M.D., a 1962 UB medical school graduate and professor of plastic surgery at the University of California, San Diego, estimates lO to 15 percent of his patients are male. "Many more men are coming in who feel fine , but look awful with folds and bags of skin." Not everyone who enters a plastic surgeon's office ends up having surgery. Most surgeons have extensive screening systems to weed out potential problem patients who have unrealistic expectations about how plastic surgery will change their lives. Horwitz schedules three office visits for his patients before performing surgery. "The first time I talk," he said. "The second time I listen. I have to flush the type of person he is out. If he can't come in three times before surgery, I won'tdo the surgery, even if l'm doing a doctor- someone I know well." Based on the initial sessions, a good portion of the problem patients are weeded out. "If they had expectations beyond what I could do, I won't even consider performing surgery," Horwitz said. For men , he said, a frequent request is a face-lift that will help them "to get their wife back or they want a job promotion," liON A MALE, YOU WANT TO LEAVE TH:E FEATURES ON TH:E HEAVIER SIDE. FULLNESS GIVES AN IMPRESSION OF AUTH:ORI1Y, AND YOU WANT TO LEAVE SOME WRINKLES." BUFFAL O PHYSICIAN A N 0 BI he added. Overall, the most frequent reason for turning someone away is an unreasonable demand, like obese people wanting liposuction to shed unwanted pounds. "They want to be skinny," Horwitz said, "and you can't do that" with an obese person through liposuction. Enhancing the diagnostic techniques of some cosmetic surgeons is computer imagery, where a patient can actually visualize what he or she will look like after the surgery is completed. But Horwitz calls this method unfair. "If you're showing it to the patients, you're potentially implying a result. You're also giving them unrealistic expec- OMEDICAL SCIENTIST SPRING , 9 9 2 ED �tations. If you're using it to analyze things for yourself and not showing it to the patient, you probably don't need it." Horwitz further explained his aversion to the method. "You can take away the bump on their nose with a computer picture, but it isn't the way a nose is going to look, because you'll have scar tissue and contracture. It's not going to look like that anyway," he said. Women on the whole don't experience as much dissatisfaction as men do after cosmetic surgery. Again , the selectivity of the surgeons comes into play, as those patients with underlying psychological quirks are more apt to be dissatisfied. As a rule, patient satisfaction with plastic surgery is quite high, with more than half of Horwitz's patients returning for more. Both McKissack and Horwitz themselves have had eyelid surgery and are pleased with the results. And both men said they would have it again. But gender is an important factor , as more women than men seek further surgery. "It's much more prevalent in women," Horwitz said. "They have their eyelids done; a year goes by and their face is sagging. It's not unrealistic that they would return for more. "Men get something done, and they're done," he said. The kinds of operations Horwitz performs on his men and Bruce J. Cusenz m BUFFA LO PHYSI CIAN A N 0 women patients are basically the same - rhytidectomies (face-lifts), rhytidectomies with liposuctions, rhinoplasties -but the techniques employed on men and women differ. "On a male, you want to leave the features on the heavier side," he said. "Fullness gives an impression of authority, and you want to leave some wrinkles. On a female you want more of a sculptured look, and you want to remove every wrinkle." Horwitz shares a philosophy held by many plastic surgeons: because of differences in skin thickness and texture, and due to the increased presence of hair follicles, cosmetic surgery on men can bring a worthwhile improvement. On women the results can be spectacular. According to PaulK. McKissack, M.D., a '56 graduate of the University at Buffalo medical school, men are not as good candidates for plastic surgery as women, especially when it comes to facial surgery. "Men's facial skin is a lot thicker than women's because it's hair-bearing," he said. "They also have a stormier course because they bleed more" due to the increased vascularity of the hair-bearing skin, he added, explaining that because of this, control of blood pressure is particularly important in surgery on men. "Women are easier to do," he said. "Their bones aren't [hard] like marble." Men also pose challenges when it comes to hair placement and concealing scars. For example, a face-lift on a male could cause his hairline to migrate behind his ear. To avoid this, hair follicles are destroyed in some cases. Doctors point out that on men it is much more difficult to conceal scars after surgery because they don't wear makeup. Nose surgery differs among men and women, too. "If you overdo it on a man, you can make him look effeminate," McKissack said. Surgeons also cite personality glitches as another source of complication in male cosmetic surgery. "Men are impatient," said james Wells, M.D., chairman of the public education committee for the American Society of Plastic and Reconstructive Surgeons. "And from that BIOMEDICAL S CIENTIST SPRING 1 9 9 2 �Hanley M. Horowitz and female patients. "Men come in just as tentative as the women, and they take a little more time beating around the bush. It takes them longer to open up," Cusenz said, "but once they get going ... " McKissock, who practices in the Los Angeles suburb of Torrance, California, has experienced a marked increase in face-lifts among his male patients. "It used to be considered a feminine operation," he said, "but especially here in Los Angeles, it's quite common." Some procedures, McKissack added, such as pectoral implants for men, are a very small and insignificant pan of plastic surgery. They appeal, he said, to "a certain type of man," such as the body-builder type. "I wouldn't even know who to send a patient to who wanted them . It's a stupid operation," McKissack said. It's a fly-by-night thing, and it will come and go along with a lot of other dumb things because they're a male fad ." "It's frivolous, " he said, "and for a plastic surgeon to call something frivolous .. . but this really is." + standpoint, they are more difficult to deal with than women. "Women are much more attuned to the length of time it takes to recover. Men think they are indispensable," he said. "Before they get out of the recovery area, they have a phone screwed into their ear. " Horwitz described his typical male candidate as a business executive with limited time. "They look at it like this: 'I want to buy a new car. I want to buy a new suit. I want to have my eyes done.' It's just one of many things." And before surgery, Horwitz, said, men are more demanding. "The male comes in and says: 'I have three days off and I want this done.' I say, 'But it isn't what you need.' If he still wants it done, I won't do it. "The female comes in and says: Just do anything you can; I want to look better."' When the surgery is completed, Horwitz added, "males are the most cooperative and the least demanding." By contrast, Cusenz sees few differences between his male BUFFAL O PH Y SICIAN AND B IO M E DI C AL S C IENTIST SPRING , 9 9 2 ED �• ························ · · · ······· · ··········· · ···················· · ······ · · · ·· · · · ········ ~ I UB medical school ranks high in terms of minority graduates years." Many of the programs for minority students - such as the Federal Health Centers Opportunity Program, the Minority High School Student Research Apprentice Program and the summer enrichment programs - have been funded by grants received by Wright. + nderrepresented minority students represent a higher percentage of graduates of the School of Medicine and Biomedical SciB Y M ARY B ETH S PINA ences than at medical schools at Medical students learn how to set up a private or other public universities in ew group practice at UB' s Prep for Practice program. York, according to a survey conducted dents some sort of benchmark from by the American Association of Medical which to make decisions about things Colleges. The medical school ranked like where to geographically set up a 16th in the survey of the 126 accredited practice or buy into one, what some of medical schools in the U.S. Cornell raduating medical residents the facility requirements are for differUniversity's medical school, ranked have rarely received sound ent kinds of practices and how best to ninth, was the only one in New York practical management training handle their own personnel," Richert ranked higher. in how to set up a private or added. The survey showed that students in The program attempted to give resigroup practice once they leave this group made up 12.2 percent of the their residencies. But a new dents further options concerning join704 students graduating from the school from 1986 to 1990. During the period, program at UB, called Prep for Practice, ing an HMO as well , he said. "For the University at Buffalo medical school is helping to change that, according to example, a doctor doesn't have to worry graduated 86 students in the john Richert, associate dean for alumni about getting malpractice insurance if underrepresented category, consisting of relations in the School of Medicine and he works for an HMO. He's already covered. And he receives a guaranteed African Americans, mainland Puerto Biomedical Sciences. salary. I think it's important for a young "We've long been wanting to do someRicans, American Indians and Mexican thing for graduating residents. It's really physician to understand these types of Americans. Maggie S. Wright, Ph.D., assistant long overdue," he explained. "This pro- things." Richert gave an example of how imdean of student affairs, attributed UB's gram touches on things that are never outstanding ranking to a number of fac- taught in medical school about what it portant geographic placement of a pracmeans to begin a practice. This program tice is by pointing out that if a young tors. is practical preparation for someone doctor chose to begin a general practice "For the past decade," she said, "we who's not going into academic medi- near the site of a military base, where have built and maintained a highly succine. " most of the people in the community cessful and comprehensive pipeline for Richert said that the program, which would already be cared for by the base early identification of talented minority students in Western New York and en- took place last November at UB and was doctors, the new practice would unrichment programs for middle and high sponsored by the Medical Alumni Asso- doubtedly fail. "These young doctors school students as well as undergraduate ciation, is designed to help graduating want to be able to make a living. I think and pre-med and accepted medical stu- residents make intelligent decisions this program teaches them and also takes about criteria such as malpractice insur- some of the pressure off by giving them dents." Wright noted that "faculty have par- ance, establishing a market for a prac- options." While practical knowledge was ticipated in summer minority research tice, banking and financing and risk manprograms at the school and have been agement. It was a single-day, eight-hour stressed during the program, Richert extremely enthusiastic and cooperative seminar. "We (Medical Alumni Asso- said that another purpose of the seminar in working with minority student en- ciation) were working in concert with was to present a myriad of possibilities richment programs and projects over the Syntax Laboratories. It gave the resi- to the residents from which they could Prep for Practice program helps residents set up new practices fl) BUF F AL O PHYSI C IAN A N 0 BI O MEDI C AL S C IENTIS T SPRIN G 1 9 9 2 �· ·· ···· · · ·· ····················· · · ·· · · ···· · ··················· · ········ · ········· · ···· · · · • make decisions based upon their own needs and wants. "Do you want to practice alone? Do you have the start-up costs involved in a solo practice7 Or is an HMO the best way to begin? And where do you want to live? These are all important questions, " he said. Ninety residents attended the inaugural seminar last fall and there was nothing but praise for the program, according to Richert. "It really was a smashing success. All of the evaluations were very positive. lthink that anybody who wants to go into some son of private, non-academic practice should be exposed to a program like this before leaving medical school. " + -BY MARK HAMMER UB to estabHsh nation's first comprehensive nuclear imaging training center he State University of New York at Buffalo will establish the first comprehensive training center for nuclear imaging in the United States, funded by a three-year grant from Siemens H.G. The grant is the result of two years of discussions between UB and Siemens. The training center, to be headquartered in the Department of uclear Medicine, will concentrate on positive emission tomography. "We're in the process of organizing a core curriculum to train everyone from the PET technician who assists the chemists, through all of the higher levels of science right up to a director of PET operations," said JosephA. Prezio , M.D. , UB chair of nuclear medicine. " o one is doing that anywhere in the United States. " Siemens needed a center that could train its people in depth in this new BUFFAL O PHYSICIAN field, Prezio said, and UB already had a well-regarded program in nuclear medicine and is establishing a major PET facility. The University , in conjunction with the Buffalo VA Medical Center, will be operating one of the most advanced PET imaging centers in the world by 1993. "The problem throughout the U.S. , and probably the world, is that training for PET has not been organized appropriately, or in enough depth , so that you can send someone to one site and have them come back seasoned and trained, " Prezio said. "Our goal from the beginning," he added , "in addition to establishing the PET imaging center for research and clinical use, was to set up a national educational program that would be unrivaled in the United States. " The center will be organized around four major training groups - technicians, radiochemists, nuclear physicists and physicians. Training of PET technicians will begin this spring. Other programs will accept enrollees as the curriculum is finalized. Training periods will vary from a month for technicians to two years for physicians being trained to interpret PET images. + B Y LOIS B AKER Ri(hard Safeer, right, distusses his poster with Murray Murphy at the Researth Forum. AND BIOMEDICAL Congratulations to the winners of the 11 th annual Student Research Forum irst Honors Winners Richard Safeer: The effect of the "Get Heart Smart" curriculum on middle school students. Diana Sanderson: Urine sorbitol excretion reflects blood glucose level in diabetes mellitus. Second Honors Winners Keung Lee: Characterization of a eDNA clone that encodes a Schistosoma mansoni antigen that may play a role in immunity. Harold Lilt: An integrated physician workstation: Digital patient records and the medical desktop. Atif Zafar: The temporal dynamics of scoliosis: Visualization of spinal geometry. Ann Comi: Copper toxicity and the distribution of copper in normal and Menkes lymphoblasts. Third Honors Winners Shane Ferguson: A controlled comparison of four different surfactant preparations in surfactant-deficient preterm lambs. Andrew Michel and Myron Glick: Cardiovascular risk factor analysis of an old order Mennonite community. Gina Marrero: Effect of combination photochemotherapy and hyperthermia vs. rotenone on human squamous carcinoma. Kristine Tenebruso: ~ Knowledge, attitudes ~I and practices of := women over age 50 regarding breast cancer screening and breast cancer screening practices. + SCIENTIST SF>RING I 9 9 2. ED �. . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .. . .. . . . [1] ' . American Board of Pediatrics and its sub-board of pediatric nephrology. He is a diplomate of the American Board of Medical Examiners and a member of the American Pediatric Society and the executive councils of the American Society of Pediatric Nephrology and the Eastern Society for Pediatric Research. + Children's Hospital appoints Alon Co_ppens to Department of Radiology T he Children's Hospital of Buffalo has appointed Alon Coppens, M.D. , to a fellowship in its Department of Radiology. Coppens received his medical degree from the State University of New York at Buffalo School of Medicine and Biomedical Sciences. He received his postgraduate medical training at Mary Imogene Bassett Hospital in Cooperstown, New York, and completed his residency in diagnostic radiology at the University of Arizona School of Medicine. + -BY . F Bruder Stapleton, M.D. , A. Conger Goodyear professor and chair of the Department of Pediatrics, has been appointed by the executive board of the American Academy of Pediatrics to the academy's Council on Pediatric Research. Stapleton is also pediatrician-in-chief at The Children's Hospital of Buffalo. The Council on Pediatric Research was established to provide a forum on pediatric research; its objectives include promoting pediatric research through the identification of major researchable questions, recognition of important completed pediatric research and the development of statements or other publications on pediatric research. Stapleton, a fellow of the American Academy of Pediatrics, is certified by the BUFFALO PHYSI C PAGE Raghavan appointed division hea~ at Roswell Park Cancer Institute D Stapleton ap~ointed to councU on peCiiatric research 6) ARTHUR IAN erek Raghavan , M.D. , Ph.D. , has been appointed professor of medicine at UB and chief of the divisions of solid tumor oncology and investigational therapeutics in the Department ofMedicine at Roswell Park Cancer Institute. Raghavan earned his medical degree from the University of Sydney, Australia, and his doctoral degree in experimental pathology from the University of London, England. He completed his residency in general medicine at the Royal Prince Alfred Hospital and served a medical oncology fellowship at the Royal Marsden Hospital, Ludwig Institute for Cancer Research, Surrey, England , and a research fellowship in medical and urologic oncology at the University of Minnesota. Prior to taking the position at Roswell, Raghavan served as senior medical oncologist as well as research director of the Urological Cancer Research Unit, Royal Prince Alfred Hospital, Sydney, Australia. Raghavan has published over 150 articles in peer-reviewed journals and presented over 100 papers at national and international meetings. He serves on the editorial board of the journals The Prostate, The Breast and The European journal of Cancer. + AND BI O MEDICAL Head of rehabilitation medicine named at BGH G ary S. Clark, M.D ., a UB associate professor of rehabilitation medicine , has been appointed head of the Department of Rehabilitation Medicine at Buffalo General Hospital. Clark earned his medical degree at jefferson Medical College, Philadelphia, through a five-year premedicaVmedical accelerated program with Pennsylvania State University. He is a diplomate of the American Board of Electrodiagnostic Medicine. Most recently, he served as medical director of Rehabilitation Services at Park Ridge Hospital, Rochester. A fellow of the American Academy of Physical Medicine and Rehabilitation, Clark is also a member of the board of trustees of the Association of Academic Physiatrists.+ Chddren'sHospital names attending physician in otolaryngology department T he Children's Hospital of Buffalo hasnamedMichaelP. Pizzuto, M.D. , to the Department of Otolaryngology as an attending physician. Pizzuto will manage all aspects of pediatric otolaryngology with special interest in pediatric airway and voice. After receiving his medical degree from the State University of New York Upstate Medical Center, Pizzuto completed a residency in otorhinolaryngology at the UB Graduate Medical!Dental Education Consortium. He completed a fellowship in pediatric otolaryngology at Children's Hospital of Michigan. Pizzuto is a member of the American Board of Otolaryngology, Head and Neck Surgery and the American Medical Association. + SCIENTIST SPRING 1992 �·········· · ················· ···· ·························· · ······························ • 1 9 3 0 Hospital (Co rnell University 5 Medical College). WILLARD G . FISCHER'36, fully re- SEBASTIAN CONT I '70 , cine on July 1, 1991, after 54 years. 9 4 0 9 ROBERT 8 J. 0 5 BRACO '80, an- nounces that he is beginning a tired from the practice of medi- 1 1 5 has a private practice in vascular sur- new practice in occupational and environmental medicine in gery in Sacramento, California, Appleton, Wisconsin. Braco re- and is an associate clinical pro- ceived his M.P.H. in 1990. fessor at the University of Cali- JOHN D . WHITE '40, is serving on fornia at Davis. R ICHARD A. SMI T H '81 , has the boards of the Older Americans Council and the AARP in ELLIOTT BRENDER '70 , is as- moved to Boston (Jamaica Plain), Massachusetts, to become an at- Tavernier, Florida. sistant clinical professor in sur- tending pathologist at the gery at the University of Califor- Faulkner Hospital. FRANK A. PFALZER '46 , has David H. Nichols '47 nia at Irvine, and chief of surgery been retired since july 1989. He 1 9 6 0 5 at Garden Grove Hospital, Gar- HOWARD WALDMAN '81 , den Grove, California. his wife,jan, announce the birth of t h eir daughter, Alanna and now lives at 2 Laurel Oak, Amelia Island, Florida, and spends sum- ROBERTA M . GILBERT ' 62 , mers in Western Falls Church, Virginia, informs RETA D . FLOYD'73, announces Denbrook,onSeptember9, 1991. us that her book, "Extraordinary the opening of her new office for Waldman is director of the car- Relationships, A New Way of the practice of psychiatry at 924 Buena Vista, Duarte, California diac catheterization lab at Salem ew York and Muskoka, Canada. DAVID H . NICHOLS '47 , has of accepted an appointment as Vis- Thinking About Human Connectedness," will be published in iting Professor of Obstetrics, Gy- June 1992. Hospital. 91010. D O U G LA S MELVIN R . PRATTER '73 , necology and Reproductive Biol- is AN D PLESKOW '82 , RANDI announce that ogy at Harvard University School JEFFREY of head of the division of pulmo- Rebecca Danielle, born on Sep- of Medicine and Head of the Di- Brewester, New York, writes, "1 vision of Gynecologic Pelvic Surgery at the Massachusetts Gen- have achieved no positions of prominence, written no notewor- nary and critical care at the Robert Wood johnson School of Medicine, Camden, ew Jersey. tember 10,1991, has joined her sisters Sara, 5, and Heather, 2 V2. eral Hospital. thy medical articles and am di- S. CARR ' 64 , vorced. 1 am very happy. " 1 9 5 0 5 JOHN J . BIRD ' 65 , ofWilmette, BERNARD H . SKLAR ' 56 , Fair Lawn, of ew Jersey, retired from active practice October 31, lllinois, is an associate professor of ophthalmology at orthwest- ern University. 1991. ROSS E . MCRONALD ' 66 , BEN CELNIKER ' 56 and his wife, Ilene, announce the birth of was medicine at Rutgers University. 1 9 7 0 his wife Debbie have five chil- Community Hospital of Shore University in Lattingtown, li na, School of Medicine. of directors of the American Lung of D E NNI S L. B O RDAN '70 , was elected vice president of the board of directors of the Ameri- Port Washington , New York, was recently named associate chair- can Diabetes Association , Western ew York Chapter. man of the department of surgery at North Shore University PHYSICIAN A N D orth New York. R ICHARD L . C OLLINS '83 , has recently been elected to the board Association of Western New DAVID M . K E NTON '79 , and their second child, Michael An5 is a vas- cular surgeon at Glen Cove's dren ages 15, 14, 13, 12 and 6. Neuberg is an associate professorof pediatrics in the division of pediatric hematology-oncology at the University of South Caro- his wife announce the birth of CHARLES F . O ' CONNO R ' 57 , BuFFALO and recently named director of sports their son,Jared Brandon, on November 17, 1991. G E RARD VI T A LE '82 , RON W . NEU BE R G '77 , drew, on September 3, 1991. Kenton is a practicing cardiologist in Deerfield Beach, Florida. BIOMEDICAL York. Collins also recently joined Buffalo Medical Group. R E NATA WAJ S MAN '83 , writes, "We have just returned to the USA after spending a year and a half in Israel. Ourfirstson, Oren Sharabi, was born in Israel in SCIENTIST SPRING 1 9 9 2 til �•• ........................................................................................ OBITUARIES July 1991. I am now joining a V I NCEN T J . FASANEL LO '86 , group in Cainsville, Florida, in and his wife Donna proudly an- gastroenterology." nounce the birth of their son, died December 26, 1991 in St. Vincent John , on February 3, Paul , Minnesota. ROBERT LASEK ' 84 , and COLETT E ( PRUEFE R ) LASEK '84 , announce the birth of their BRINA KESSEL RICHTER ' 25 , 1992. Fasanello is a psychiatrist with Westfall Associates in Roch- JOHN J . CONNELLY '42 , ester, January 3, 1992, in Buffalo , New ew York. first child, Christopher Ryan Lasek, on December 10, 1991. died York. SANFORD LEVY '86 , writes, "After travelling the world for GEORGE J . ALKER , JR. , ' 56 , LINDA PETERSON MANDANAS two years, I have settled back in former chair of the Department was recently inducted as a Buffalo and have joined the Cleve- of Radiology, died December 31, fellow of the American Academy land Hill Medical Group, prac- of Family Practice at the annual ticing internal medicine." '84 , AAFP meeting in Washington , ART H UR WE ISSMAN '86 , D.C. GRACIELA has 1991 , in his home in Williams- George J. Alker, Jr., 'S6, ville, New York , following a burgh as assistant professor of lengthy illness. He was 62. radiation oncology. Alker, who worked actively to joined a private practice in gen- promote passage of ( CONSTANTIN O) era]surgeryinBuffa]o, ewYork, State's mandatory seat belt law, writes, "jim with jonathan Reynhout '68. DESEMONE ' 85 , 1 9 9 0 HEIDI DEBLOCK s '90 , and her and I have recentl y moved to the Weissman 's Berkshire, Massachuseus, area, Zachary Arthur, was born on husband announce the birth of but more importantly, our daugh- April 12, 1991. Elizabeth Wende DeBlock on second child, February 2, 1992. ter, Marcela Grace, was born SepJOHN tember 8, 1991. " E. ZVIJAC '86 , com- pleted an orthopaedic surgery of residency at the University of Norfolk, Virginia, has started a Miami's jackson Memorial Hos- plastic and reconstructive sur- pital in june 1991. He is cur- gery fellowship at Eastern Vir- rently doing a one-year fellow- ginia Medical School. ship in sports medicine at the MICHAEL JON DENK '86 , American Sports Medicine InstiANDREW GIACOBBE '86 , of tute in Birmingham, Alabama. was honored by Governor Mario Cuomo two years ago for his service on the Governor's Coalition on Traffic Safety. Alkerwas chair of the Department of Radiology from 1981 until he retired in September 1991. During the same period, he served as director of the Department of Radiology at Erie County Medical Center, where he was a neuroradiologist from 1963 until his retirement. He was honored last year as Richmond, Virginia, writes, "My wife, Laura, and I became the proud parents of our new baby ROBERT F . CAFARELL '87 , writes, "I have combined an aca- daughter, Cristina Maria, on No- demic practice in anesthesiology vember 20, 1991." Giacobbe is at the University of Rochester's currently a plastic surgery fellow Strong Memorial Hospital with at the Medical College ofVirginia. ew York Physician of the Year by Erie County and ECMC. private practice at Rochester General. My wife, Brenda, and I are DEIDRE GREENE '86 , of Allen- town, Pennsylvania , writes, "My expecting our first child in March 1992." husband, Rob Dixon , and I are thrilled to write of the birth of RUS S ELL FUHRER ' 87 , mar- our second child, a daughter, ried Nancy in January and has Aurora, born August 8, 1991." joined the University of Pius- ti) BUFFALO PHYSICIAN A N 0 BtOMEOICAL SCIENTIST SPRING 1 9 9 2 ��BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED Non-Profit Org . U.S. Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Spring 1992 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1992-Spring Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v26n02-1992-Spring Table Of Contents A list of subunits of the resource. Research Perspective on Healing A Spoonful of Humor Charting the Secrets of Life It Hurts to Be Beautiful Medical School People Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-10 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v26n02 Extent The size or duration of the resource. 32 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1992 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/da3a4858834527e0e8e73b2501d593f5.pdf d57d8580b37d59ec8600eac8e8cc0544 PDF Text Text �THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST Volume 26. '\umhcr I DIRECTOR OF PUBLICATIONS Nancy Tobm EDITOR Nanette Trd::1l PI kolhg, R.. ART DIRECTOR Alan J k g1er ASSOCIATE ART DIRECTOR ~con Robert f rit ker STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES Dr john "'Jugl";;on, 'vice t'<r"de·" or ( hmcal \ffa1rs Dean EDITORIAL BOARD Dr Dr Dr Dr Dr ~lr Dr Dr Dr john A R.• hen Chs ma., liar >l<:l Brodv (,Jcn (Jresham '\cdr 1 Ha7nson james Ka~skt Harok L t ( har cs Pag~nelli Antui· cttc Pflc·s L~· her Rohmson Thomas RPsenthal Dr Dr 'iakda Dr Dr Dr :'>lr Dr Surr~r: Smgerman Stephen 'ipaulding '\elson Tc rr I dward \\"c-uke jerome )ates UlLrlO:l TEACHING HOSPITALS AND LIAISONS Ibtana \' ·\ \h:di ... a. Center Buffak• C.cner.>l Ho,pllal \lidwel Shaw Buffatc> \'A ~edicat Ccnte• ( h>ldrcn's lie spital of C:.. '·•lo K.:rrn Dryja-Swit'r\hl tnc Ccuntv ~Icc! .cal (enter .\fwv ,\'orthrrn \lercy HC'pitJI \Iillard fillmore llosp11als Dear Alumni and Supporters of the UBMedical School: P rogrammatJc mitt. a~ivcs often r~quirc an extended._Iead time before thetr values ~an be recognized and their opportumucs brought to frunwn Such IS the situation with the medical school's development of a centralized mformation system and computer assisted education <CAl). In the early 1980s, the school embarked on projects designed to meet ib operatwnalwmputer requirements and to become a leader m CAl. L ndcr the leadership of Dr Alan Reynard and Dr. john Loonsk, the gains hoped for have been rcahzed UB represents one of only a few medical schools that offers a required course m med1cal computmg to ib students and requires medical computer literacy for graduation. [hanks to Alan's and John's leadership we were prepared to computerize all medical student and resident credcntialing information within 18 months of implementation of New York State's new 405 Code requirements; LB IS no\\ considered a model for others to emulate. And we arc considered leaders at the forefront of CAl. I he foregoing developments and successes set the stage for even more exciting opportumues in tht commg years. During 1990 and the early part of 1991, the Graduate I:ducatton Consortium conducted a wnsultant study rcgardmg destrcd future directions for the school and the teaching hospitals. That report, conducted by a consultant staff from Coopers and Lybrand was completed and accepted by the Consortium in 1991. Soon after its acceptance, representatives of the Digital lqUipment Corporation learned of our progress and expressed an mtercst Ill using the Consortium as a model for developmg a truly community-wdc medical-educatton-health care communicatiOn system. Under Dr Thomas Riemenschneider's leadership, a planning program involvmg consortia! member~. D1g1tal, IBM. NY" EX and Siemens is now in place, and there is every reason to be opttm1stiL that UB and its consortia! members will become acttve participants in an adventure that can serve to move our efforts forward and to showcase Buffalo as a leader m these important areas It should enhance the quality of medical education and health care for years to come Both the Physician and I will keep you abreast of future dewlopmenls. '>mcercly, ~ (• 0J ~ 1"john i'.aughton, M.D . Vice Pres1drnr for Clinical Affairs Dean, School of Medicine and Biomedical Sciences I-rani< Sava Roswelll'a; k (anccr lnstitutt: juJ!Ih RICe "'''""of ( harit) llosptc 1l DrnniS \fcC arthv © I he ~tAte L ,.- ver,llv ol "Jew YJr'< "l Buffalo rhc Hu((.. :o Phvs.c <liWild BiomrdtC.II ~(ICII· liSt ts '?Ubltshcd quarterly hv t~c ''"" L mver>II\ cf "'ew Ycrk ll Bt:!' 1lo 'ic' c PI of Mcd ;ctnc and Biomedic~: ~cic,ces and the Office >I Puhhca•tn,s. It is sent 'rce of c'1Jrgl' tt" odumni, fac11 i 1v ... tuclcnts. rcsl· dePts "nl! !nerds fhc st~lf reserves ;.he rag; to edn 4lll c>pv 2.:-:d ~ubmiss..:;'l;:•;; J.c ccpted for ~L.~Iication Address quest .c·ns. {.,.)r;:T"' 1.cnts dnd sub,,-; 'i~lons to: l'ditl r. The Bu([ulo Phv<i.·can cmd Bilnnedical ')dtnt;st ...,t~uc l mver~;~v ol 'Jew Yo:k at Buffalo l nt\'crs··v •·ubh cat Lens, I ~t (rAts Hall BuffJio ...... wYcrk 14loO Send addrc" chan~c' t<>c rl1r lluJ]al·, Phy sloan antl Bwrm:dica! '\ocntisl. l tf. C P~ Ad<!. lion, H 15 Main S~rcct Buffalo. ~ew York 14!1 t Cover Illustration by Jay Lincoln Dear Fellow Alumni: D on't le.t the wmtcr doldrums get you down 1 The Alumm. Assouation is offering some warmmg and cheerful events. On january 18, 1992. we held the Senior Reception for our future alums. As in years past, It was greatly appreciated and enjoyed by the scmors alums and faculty The Chairpersons for the Reunion Classes arc busy making plans for an exctttng n:umon weekend in Buffalo on April 25. You will be heanng more from them during the commg weeks. \Ve have a lot to be proud of in our medtcal school and our strong and active Alumni Association This is due to the strong support from vou, our alums' ' If you have any questwns, please feel free to call me at my office. ':imcerely ~~· ~ Nedra]. Harrison, .\1.D., '77 �WIN T ER 1992 VOL. 26 , No . 1 ..... ........... . .. .. .......... . . . .. . .. . .... .. . . ..... . .. . ..... . . .. ...... . ......... . .. . .. . ...... . ... Research Hospital News Further Notes on 11 The Other Classroom" • The School of Medicine and Biomedical Sciences' dean,John Naughton, M.D. , looks at the advancement of the medical school's teaching hospital relationships. Journey to the Top of the M.D. Ladder • For women, UB researchers have developed a "smart pill" that knows where to go and what to do when it gets there. Page 3. according to some, it's a longer climb. ASpoonful of Humor • A West Coast pediatrician and University at Buffalo graduate prescribes it for his patients and peers alike. Medical School People Alumni Classnotes The neurologic problems of musicians and singers ore the subject of a lecture by neurologist Alan Lockwood, M.D. Page 2. Dean Naughton's further notes on "The Other Classroom." Page 6. * Millard Fillmore Hospitals opens its new podiatry clinic. Page 4. �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 . . . . .. . . . . . . . . . ' ' I ' Success of new biotech drugs depends on prescreening patients Lecture focuses on problems of musicians and singers eurologic problems that tend to strike singers and musicians were the main topics of an evening of medicine and music held in early December at UB's Baird Recital Hall. The combination lecture and recital featured performances of various instruments, followed by a brief presentation on the injuries that typically are found in matching performers. University at Buffalo neurologist Alan Lockwood, M.D., internationally known for his research and clinical treatment of musicians and vocalists who incur neurologic problems as work-related disorders, discussed clinical case studies. Lockwood is a professor of neurology and nuclear medicine. Edward]. Fine, M.D., clinical associate professor of neurology, explained the roles of electromyography and electroneurography in the diagnosis of music-related neurologic problems. An estimated one-third of professional singers and musicians likely will expe- 8 BUFFALO PHYSICIAN rience some neurologic problem related to their work at some point during their careers. While a large percentage of these involve peripheral nerves, others may be traced to the central nervous system. Although surgery is indicated in a small percentage of the cases, a greater number can be treated effectively with physical or occupational therapy. "Although most people are aware of work-related disorders that can occur in various occupational groups, those among musicians and singers are not as well understood in the general population," Lockwood said. UB faculty who performed included Stephen Manes, chair of the department of music, piano; Ronald Richards, a lecturer in the department of music, oboe; Deborah Chung, professor of mechanical and aerospace engineering and Niagara Mohawk Chair of Materials Research, piano and voice, and graduate student Patti Cudd, percussion. The event was co-sponsored by the Buffalo Chapter of Sigma Xi and the UB departments of music and neurology.+ - A BY N D MARY BETH he success of expensive new biotech drugs that are nearing government approval will depend in large part on identifying the patients most likely to benefit from them, according to a UB professor of pharmacy. Speaking at the annual meeting of the American Association of Pharmaceutical Scientists in November, jerome ]. Schentag, who is also director of the Clinical Pharmacokinetics Laboratory at Millard Fillmore Hospital, referred to E5 and Centoxin, both costly new treatments for the often fatal gram negative sepsis infection, as cases in point. "The challenge with these new products is going to be proving that they work and communicating to physicians ~hich patients will clearly benefit from the treatment," he said. "If given indiscriminately, the cost to the health care system for the sepsis drug alone would approach $1 billion. When you're talking about $4,000 to $5,000 for a single dose, you need to pick your patients carefully." Each year, gram negative sepsis infection strikes 500,000 patients, most of whom are already SPINA BIOMEDICAL SCIENTIST WINTER 1 9 9 z �···· · · ·· ··· ····· · · · ····· ·· ······· ···· · · ··· · · · · · · · ···· ·· ·· ·· · ·· · · · ··· · · · · ··· ·· ·· ·· ·· · · · · · · · · ·~ \ . ;... . ill with cancer, heart or liver disease or who have just had major surgery. New treatments for sepsis block the action of endotoxin, the product of bacteria that causes most of the injury. In some cass, the new biotech treatment has completely cured patients. But other patients have seen little or no improvement following treatment. According to Schentag, this discrepancy in how the new drug affects patients is what makes vigorous prescreening of patients so necessary. + - B Y ELLEN geting drugs in the GI tract involve intubation. In contrast, the new targeted capsule is swallowed and its progress monitored by use of a tracking ··' GOLDBAUM Smart pHI" knows where to go after it's swallowed 11 "smart capsule" that allows researchers to precisely direct nearly any medication to a specific place in the gastrointestinal tract has been developed by scientists and engineers at the State University of New York at Buffalo and Millard Fillmore Hospitals. Described at a meeting of the American Association of Pharmaceutical Scientists in Washington, D.C. , the ingestible capsule and its microelectronic technology have important implications for treating patients who require repeated delivery of a drug, such as insulin, to a small area of the intestine where it can be absorbed. David T. D'Andrea, director of the Engineering and Devices Laboratory of Millard Fillmore Hospitals, is co-investigator on the project. Schentag, who also directs Millard's Clinical Pharmacokinetics Laboratory, explained that current methods of tar- BUFFALO PHYSICIAN device worn as part of a vest. The vest houses a computer monitor about the size of a Walkman. As the capsule, which contains a tiny radiotransmitter, passes through the GI tract, it sends out a continuous radio signal as the computer monitor system computes the position of the capsule and triggers release of the drug when it gets to a predetermined spot in the intestinal tract. Schentag noted that the technology would allow for the intact delivery of drugs such as insulin and some of the new biotech drugs, which are large proteins that are usually degraded by the acid in the stomach or the enzymes in the intestine. + -BY AND BI ELLEN O MEDI GOLDBAUM C AL S C .. UB surgeon performs world's first splenectomy by laparoscopy at BGH .. ,. "· \ ,, surgical procedure known as a laparoscopic splenectomy was performed for the first time on October 10 when a University at Buffalo surgeon removed the spleen of a 24-year-old woman at Buffalo General Hospital. Scott A. Tulman, M.D., clinical assistant professor of surgery, says the clinically experimental technique was made possible by the development of new tools for advanced laparoscopic surgery by U.S. Surgical Co. According to Tulman, the woman was suffering from hereditary spherocytosis, a congenital condition that causes severe, hemolytic anemia. The woman's gallbladder was also removed during the surgery, which lasted two and one-half hours. "Although the condition is rarely fatal, it is extremely debilitating and requires numerous blood transfusions or removal of the spleen, depending upon the severity of the condition in the individual patient," Tulman said. During the laparascopic splenectomy, small, half-inch punctures were made in the patient's abdomen and the recently developed laparoscopic instruments were inserted. The surgery was performed with no complications. + IENTIST WINTER �-- - - - - - - - -- - - ----------- - · · · · · · · ·· · · · · · · · · · · · · · · · · · · · · · · · · · · · ·· · · · · ·· · · ·· · · [i] II MDiard Fillmore Hospitals podiatry clinic opens at Gates illard Fillmore Hospitals now offers specialized podiatric care in its newly opened Foot Clinic in its Gates Circle facility. The clinic offers routine podiatric services as well as preventive foot care for patients with diabetes and peripheral vascular disease, according to David M. Davidson, D.P.M., chief of the podiatry section at Millard Fillmore Hospitals. "In addition to meeting the community's growing need for podiatric services, the Foot Clinic helps contribute to the comprehensive, quality health care services at Millard Fillmore Hospitals," Davidson said. The Foot Clinic is staffed by American Board of Podiatric Surgery board certified podiatrists from the hospital's medical staff. + PET imaging center to bolster research and enhance patient care he opening of the new Positron Emission Tomography (PET) imaging facility at the Buffalo VA Medical Center marks completion of the first phase of a cooperative effort between the hospital and the University at Buffalo to bolster medical research and patient care in Western ew York. The center will be completed in 1993 with the opening of a cyclotron facility e BUFFAL O PHYSIC IAN that will manufacture radionuclides for use with the scanner. Work on the cyclotron facility, to be located in renovated space on UB's South Campus, began last summer. Until it is completed, materials used in scanning at the hospital will be provided by outside sources. Once the cyclotron is operating, underground pneumatic tubes connecting the hospital and Parker Hall will be used to transport radionuclides produced by the cyclotron facility for use with the PET scanner. Because of its unique ability to visualize and quantify complex physiological processes occurring in the human body, PET imaging has potential for important advances in the understanding and treatment of major ailments, including heart disease, stroke, cancer, epilepsy and A N 0 B IOMEDICAL S C Alzheimer's disease. The first one in Western New York, the PET scanner at the Buffalo VA Medical Center is one of only four in the state and one of two approved for use with patient care. While there are several dozen PET imaging centers in the U.S., the UB-VA center will have clinical and research capabilities shared by only a few PET imaging centers located at other major research institutions, according to john Naughton, M.D., UB vice president for clinical affairs and dean of the medical school. "This project will put the UB medical school at the very edge of a new frontier of diagnostic medicine," aughton said. While located at the Buffalo VA Medical Center, the PET scanner will be available to veterans and other patients throughout Western New York through a shared services agreement between the University at Buffalo and and VA Medical Center. The center is being funded through a $3.4 million federal grant from the Department of Veterans Affairs, with the balance of the $12 million cost of the center provided by UB, state grant support and private support. Funding includes a $1 million grant from the james H. Cummings Foundation in the form of a contribution to the University at Buffalo Fotmdation's "Pathways to Greatness Campaign." + - B Y IENTIST A R T H U R WINTER P A G 1 9 9 E 2 �First Stereotadic Radiation Therapy performed at Roswell Park Institute most effective for the treatment of target areas up to three cen56-year-old Tonawanda, New timeters in York, man became the first pamaximum ditient in Western New York to ameter. The be treated with Stereotactic Raprocedure diation Therapy of the Brain gives access to (SRTB) for a recurrent malig- deep-seated lesions which were formerly nant brain tumor. inoperable or could be reached only by The procedure, which uses sophisti- extensive surgery, according to West. cated digitized computer targeting, was "The precise, pinpoint accuracy of this performed by Kyu H. Shin, professor and procedure enables us to deliver a high chairman of the department of radiation dose of radiation in single or multiple medicine at UB's School of Medicine and doses to a well-defined, small intracraBiomedical Sciences and head of the de- nial area without delivering significant partment of radiation medicine at Roswell radiation to adjacent normal tissue," Shin and Charles R. West, M.D., research as- said. sociate professor of neurosurgery at UB SRTB requires a high degree of posiand head of the department of tional accuracy. CAT, MRI scans or neurosurgery at Roswell. Roswell Park angiographic studies are performed to Cancer Institute is one of 28 National determine the center and dimensions of Cancer Institute-designated Comprehen- the target and compute the isodose dissive Cancer Centers nationwide. tribution. Treatment is first simulated The patient, who was diagnosed with a to ensure accuracy. The procedure, highly malignant, very advanced which usually takes about one hour, is glioblastoma, had already undergone then performed using the photon beam surgery and conventional radiation which of the high energy linear accelerator. had failed, according to Shin. The suc"We couldn't be more pleased with cess of the new procedure, Shin said, will this first procedure," said West. "The not be known for several months until a dose of radiation was delivered to the repeat CAT scan is performed. "It takes tumor exactly as the computer had caltime to know," Shin explained. "The culated. The future for this therapy is mass is still there and there is no way of exciting and promising for patients. " + knowing whether it's dead or alive until we see no tumor on subsequent CAT scans. With highly malignant tumors , the response is somewhat quicker. " The noninvasive procedure, which can be performed on an outpatient basis, has been used in other centers to treat a variety of benign and malignant lesions, such as arterio-venous malformation , acoustic neuroma , pituitary adenoma, craniopharyngioma, single metastatic lesions and malignant brain tumors. It is BUFFAL O PHYSI C IAN BI O MEDICAL BGH and ECMC announce plans for computer services in a new ioint venture he Buffalo General Hospital and Erie County Medical Center have announced plans to join forces to develop and install a fully integrated computerized information system at the medical center. Under terms of the collaborative agreement , Buffalo General will provide ECMC with a variety of services, including the computer capability required to process ECMC data volumes and operational statistics; installation/systems development; staffing and services; training, and ongoing operational support as well as hardware, software, database and communications support. The ECMC system will be implemented in phases with the first "go live" date tentatively scheduled for early january. The final phase of the project is scheduled to be implemented in january 1994. Under the agreement, ECMC admissions, registration and patient accounting information will be stored in separate data banks at Buffalo General and transmitted to ECMC via a microwave connection. Hospital officials noted that it will be a controlled process to ensure total patient confidentiality between the two institutions. + SCIENTIST WINTER �The following is a continuation of Dean John Naughton's paper, "The Other Classroom," published in the Late Winter 1988-89 issue of Buffalo Physician and Biomedical Scientist • Copies of the earlier paper are available from the medical school. PHOTOS B 0 B BY WALl ON 0 I C A L �BY B U F F A L 0 P H Y 5 I C JOHN I A N A N 0 B I 0 NAUGHTON , M E 0 I C A L 5 C I E N T I S T W I N T M.D. E R 1 9 9 28 �~~ ·- ~---------~~~~-------~~-~------------ uring the Fall of 1988 a major retreat was held at the Buffalo General Hospital focused in its continuing relationships with the medical school. A number of perspectives were presented and positive communications developed considering existing and future relationships. My presentation concerning the development of cooperative arrangements through the formation of consortia, entitled "The Other Classroom," was printed in The Buffalo Physician and Biomedical Scientist. 1 A manuscript detailing the role ofUB's medical school in regional economic development is being published this winter in, Metropolitan Universities .2 This paper will expand on the earlier publication and present some more contemporary views abou t how the University at Biffalo and its affiliated institutions strengthened their relationships through cooperative planning and programmatic sharing. [urrent [onsortial ~trategies GRRDURTE HEDICRL DEHTRL EDUCRTIOH COHSORTIUH OF BUFFRLO The medical school and its teaching hospitals entered into their first consortium in 1983 to respond in an efficient and cohesive manner to the new guidelines promulgated by the Liaison Committee in Graduate Medical EducationJ A major leadership role was provided by Michael oe, M.D., senior vice president for professional affairs and medical director at Buffalo General Hospital; he has been an active leader throughout its development and evolution. This organization , the Graduate Medical Dental Education Consortium of Buffalo (GMDECB), governs all residency training programs in Western ew York. The organization's institutional members include the affiliated teaching hospitals, the schools of medicine and biomedical sciences and dental medicine, all residency training program directors and one resident representative from each program. The work is conducted through a series of committees, i.e., Administrative, Program Directors, Residents and Coordinating. Over the past eight years, the GMDECB has been developed as an alternative model for other medical schools and their affiliated institutions to consider when dealing with the need to change their approaches to managing graduate medical education (GME). The GMDECB is now positioned to deal institutionally with the many issues that 0 BUFFALO PHY SICIAN ono~~ue. m.~., t~e ~rfmf mrector for [ontinuin~ menical fnucation. ~rouinen t~e leaners~i~ for t~is im~ortant innouation. AND BI OMEDIC AL face the medical education and health delivery systems. For example, GMDECB responded rapidly to the new requirements imposed by ew York State imposing the credentialing of medical students and residents. The program directors worked cooperatively to develop the required programs and reporting mechanisms, and with support made available from the Information Service system under the leadership of Alan Reynard, Ph.D. , a computerized reporting system was operational systemwide on July 1, 1990. The total time between the announcement of the new requirements and implementation was about 18 months. Institutionally, GMDECB has moved forward to change the method of orienting new residents. The usual one- to three-day hospital orientation was replaced by a comprehensive week-long curriculum. Its course contents include the usual personnel issues; completion of the required history and physical examination at a single site; training and certification in advanced cardiac life support; learning and evaluation of bedside teaching skills and lectures and small group sessions dealing with medicolegal, record keeping and ethics. Glenda Donoghue, M.D. , theAPFME Director for Continuing Medical Education, provided the leadership for this important innovation. 4 A total of 125 individuals representing specialties in medicine, law, nursing, medical record librarians and hospital administration participate as faculty for this unique and SCIENTIST WIN TER 1992 �important function. The GMDECB responded to the initiatives of the YS Council on GMP·6 ·7 •8 by committing to a ratio of 50 percent distribution of resident positions to primary care (family medicine, internal medicine and pediatrics) by 1994; recruiting and retaining representation from minority and socially underrepresented representatives of at least 11 percent of the total pool , and evaluating and studying the strengths and weaknesses ofconsortia! governance. The Council's subcommittee in Consortia evaluated GMDECB's progress in 1989 and 1991 and reported to the Council that we were meeting its definition and criteria for an operational consortia. The GMDECB's most recent accomplishment was the pooling of resident salaries into a single organization. This has enabled the teaching hospitals to pay all residents across the system one equitable salary and common fringe benefit BUFFALO PHYSICIAN rates. The residents have a consortialwide annual dinner dance, and each receives a UB certificate upon graduation with all member institutions listed on it. These changes together with other attempts at standardization of the education programs are serving to confirm that GMDECB is indeed the "institution of record" for graduate medical education in Buffalo and Western ewYork. vices was formed in 1987. This organization, the Western New York Health Sciences Consortium (W YHSC), has a membership similar to thatof GMDECB. UJESTERH HEUJ YORK HEHLTH SCIENCES COHSORTIUH In addition there are those representatives from the business community and each board chairman of an affiliated hospital and the president ofUB. This organization is incorporated and is not a membership body as is GMDECB. A second consortium designed to emphasize the need to cooperate and to enhance the quality of health care ser- A N D BI OMEDICAL Above, Millard Fillmore i'-11!11111• Suburban Hospital's newborn nursery, now under the diredion of Children's Hospital's Division of Neonatalogy. Left, Buffalo General Hospital's designated Heart Transplant Center. SCIENTIST W I N T E R 1 9 9 20 �----- The formation ofWNYHSC was more difficult than was that of GMDECB because its focus affected more constituents. It originated at the institutional levels and was perceived as a "top-down" organization. The rapidity with which it formed and the breadth of the agenda caused a great deal of consternation for full-time and voluntary faculty alike. The approach taken to accomplish its --------------------------------~- constituents was high, and too little preparatory work was performed to decrease existing tensions and to facilitate the necessary work and leadership. evertheless, a number of significant and positive outcomes can be ascribed to W YHSC during the course of its short history. Among these were: (1) awarding of a Bone Marrow Transplant Center to Roswell Park Cancer Institute (RPCI); (2) completion of a clinical affiliation agreement and faculty contract between UB and the RPCI; (3) designation ofBGH as the Heart-Lung Transplant Center, (4) the formation of a single Division of Neonatology in Pediatrics to coordinate neonatal care at Children's Hospital of Buffalo (CHOB) , BGH, Sisters Hospital (SH) and Millard Fillmore Hospitals (MFH); (5) rationalization of an integrated psychiatry program; (6) securing of a shared agreement between the Buffalo VAMC and UB for a center in Positron Emission Tomography (PET)imaging, goals was to use task forces usually chaired by a UB clinical department chairman or a department's division chief. The composition of each task force included full-time and volunteer faculty, representatives of hospitals, the school and the business community. Most task forces proceeded to achieve their intended outcomes. Three others had more difficulty because tension among the Left, the VA Medical Center's new PET scanner will provide enhanced medical imaging for Western New York through a shared agreement between VAMC and the University ...____ _ --~-......-II!Ci::!!C;,;_:E::::::...::::::__ _ _~--_. at BuHalo. Above, Erie County Medical Center's designated Trauma-Burn Center. «<) BU F FA LO PHY S I CI AN A N 0 B IO MEDI C AL S C I E N T IS T WIN T ER 1992 �and (7) the designation of the regional Trauma-Burn Center at Erie County Medical Center (ECMC). lion dollars, and the scales of economy for BGH will be significant. UB's Health Sciences Library belongs to a regional health library consortium and services the Western New York region. The school has a major computerassisted educational capacity. lt is envisioned that these systems will be added to the other networking activities, thus bringing educational and informational services directly to the bedside and clinical settings in the years ahead. There is no doubt that Buffalo's willingness to enter into more and more cooperative planning has served to move the school and the community into a leadership role in these areas. IHFOJUtJlnOH HET\UORKIHG ll of the above activities serve to network the institutions around the mutual purposes which each shares. One of the beneficial byproducts has been the ability to develop a computer network which links the medical school with each department and each teaching hospital. This network has matured to the point that it is attracting national interest as a model which can be emulated in other regions of the country. Thomas Riemenschneider, M.D., associate vice president and associate dean for clinical affairs, is providing valuable and constructive leadership in this area. In 1990, theW YHSC received a consultant's report from Coopers and Lybrand which will serve as a blueprint to future planning and implementation of this network. Several commercial firms have indicated their interest in pursuing a partnership in moving this system forward since no comparable program with this potential exists in any other community in the United States at the present time. Since UB is also developing unique strategies for interactive computerized education under the leadershipof]ohn Loonsk, M.D., has a networked community-wide system in place and has an outstanding Health Sciences Library which serves medical students, residents, full-time and volunteer faculty and each hospital in Western ew York, the consortium is in a unique position to provide a model of delivery information to a broad range of constituencies in the region. Another example of cooperative planning is that Buffalo General Hospital and Erie County Medical Center (ECMC) are working collaboratively to establish a single computer mainframe for patient billing and medical record keeping. In this model the mainframe will be owned and operated by BGH and services will be purchased by ECMC. The potential savings to ECMC will total several mil- BUF FALO PHYSICIAN [urrent ~tatus ~iemensc~neiner. m.~ .. associ- ate uice presinent ann associate nean for clinical affairs. is prouining ualuaMe ann construehue leaners~ip to neuelop a computer networ~ lin~ing t~e menical sc~ool wit~ its teac~ing ~ospitals. A N 0 B IOMEDICAL While it is apparent that UB and its affiliated hospitals have taken steps to enhance cooperation and sharing, more needs to be accomplished to ensure quality medical education and patient care at a time when the health care system is undergoing rapid, sometimes unpredictable change. Since many constituencies must be represented in the decisionmaking process, yet some decisions must be made expediently, UB's former president, Steven B. Sample, recommended that the WNYHSC model be strengthened through a mechanism of increased centralized control with UB assuming a more authoritative role. This plan, the University ofBuffalo Health System, Inc. (UBHS), received considerable public discussion within UB and the State University of New York system, the New York State Department of Health and at each involved Buffalo institution. While considerable support for a strengthened consortia! model exists, it was clear that progressing toward a cooperative model in which each member enjoys a partnership role is preferred. To that end, UB's president, William Greiner, has offered an alternative plan, now identified as the University at Buffalo Affiliated Hospital, lnc. (UBAH). The affiliated hospital CEOs and the medical school leadership are engaged in developing a plan that SCIENTIST w I N T E R 1 9 9 2G �-- - - - · - - - - - - - - -- ----- ---------- - can be acceptable to SU Y, UB, hospital boards and the full-time and volunteer faculty. The tenets of common agreement and need are being developed; by late 1991 the process of muerging the two consortia into a single organization could begin. It appears that the medical education and health care communities which serve to form UB's other classroom, a "medical school without walls," are committed to increasing cooperative activity in an era of declining resources and changing patterns of rendering medical education and health care. If these institutions and constituencies continue on these vectors, then UB and its affiliates could provide important, necessary leadership for other sectors in New York State and the nation. [ondusions n important lesson learned from the various consortial experiences is that meeting the challenges that face our institutions requires the work of multiple constituencies coordinated by a responsible leadership group. The medical school and UB have an important, but not singular role in that process. Given the history of the medical school and its teaching hospitals, UB must be committed to achieving its major academic goals in an environment committed to taking advantage of diversity and through a philosophy of inclusion rather than exclusion. The GMDECB has served to demonstrate the value of cooperative management, planning and execution. WNYHSC served to demonstrate the need for institutional cooperation and sharing. Although the pressure to render decisions precisely and expeditiously will continue to occur, it appears that the cooperative, multiconstituent model will work more effectively than a strongly centralized, "top-down" organization. 1. Naughton,]. , The Other Classroom, The Buffalo Physician and Biomedical Scientist, Late Winter 1988-89. 2. Naughton, ]., "The Impact on Regional Health Care By A Medical School And Its Affiliated Teaching Institutions: A Potential Model For Other Academic Health Center," for publication in Metropolitan Universities late 1991. 4D BUFFALO PHYSICIAN 3. 1980-81 ACGME Guidelines, The Essentials of Accredited Residencies in Graduate Medical Education , Feb. 24, 1981. 4. Donoghue, G.D., Glieco, . Flint, L.M. , Naughton, ]. "A Core Curriculum for Entering Graduate Medicine Education Trainees" to be published in Teaching and Learning in Medicine later this year. 5. Report of the New York State Commission on Graduate Medical Education, Feb. First Reportofthe Council, Volume I, 1988. 7. ew York State Council on Graduate Medical Education, Second Annual Report, 1989. 8. ew York State Council on Graduate Medical Education, Third Annual Report, 1990. 9. Pristach , C. , Donoghue, G. , Sarkin, R., Wargula, C. , Doerr, R., Opila, D., Stern, M., Single, G. , "A Multidisciplinary Program To Improve The Teaching Skills Of Incoming Housestaff," Academic Medicine, 1991. 1986. 6. Council on Graduate Medical Education A N 0 B I OMEDICAL S C IENT I ST WIN T ER 1992 �The Burn Treatment Center at Erie County Medical Center, one of the significant achievements of the Western New York Health Sciences Consortium. 4. Report of the National Advisory Commission on Health Manpower, Washington, D.C.: Gov Printing Office, 1967. 5. Sickness and in Wealth, ewYork: Basic Books, 1989. 6. Caring for the Uninsured and Underinsured (several articles) , The journal of the American Medical Association, May 15, 1991 , Vol. 265 , No. 19, (pgs. 2491+ 2566). l. The New York State Council on Graduate Medical Education, First Annual Report, 1988. 2. Chapter on Consortia, ew York State Graduate Medical Education Councils' Third Annual Report, 1990 (In Press) . 3. Public Health Policy Forum, American Journal of Public Health, April 1991 , Vol. 81, o. 4 (pgs. 418-420). B UFFALO PHYSICIAN A N 0 BIOMEDICAL ECMC's designated Levell Trauma Center serves the eight county Western New York area. SCIENTIST W I N T E R 1 9 9 2 41) �- ---· - ---- -- ---·. .- - - --·----~~-- By Lois Baker When top administrators at the University of Iowa For women) Medical School met for a presentation on a new security system, the marketing representative turned to the group of distinguished profes- sionals, which included two longer climb women, and asked, "Why don't one of you girls come 0 41 B UFFALO P HYSICIAN up here and try this?" AND B IOMEDICAL S CIENTIST W INTE R 1992 �Mary Ann Bishara, M.D. medical establishment's upper echelons. Aschenbrener instead described her treatment throughout her career as a "day-today kind of minor assault," manifested in this instance by a boorish salesman's offthe cuff comment. The presence of Aschenbrener, Conley and a small number of other female physicians in the top ranks of the formerly all male medical establishment is a sign that women are breaking through societal barriers which in the past forced those inter- ne of the "girls" was neuropathologist Carol Aschenbrener, M.D ., the highest ranking women in academic medicine in the U.S. today. Aschenbrener, executive associate dean at the University of lowa Medical School, perhaps is lucky. She has not experienced the overt discrimination or sexual harassment, such as Stanford neurosurgeon Francis Conley, M.D., reported, during her climb into the BUFFAL O PHYSICIAN A N 0 81 0MEOIC,._L ested in healing the sick to become nurses, not doctors. But unlikejoshua fighting the battle of jerico, their assault on the medical status quo has not brought the walls of inequity tumbling down ; it has created only a small breach, leaving women physicians, after years of proving themselves accomplished, and often brilliant, still struggling for equal opportunity and respect in their profession. "l am troubled ," Aschenbrener said, SCIENTIST W I N T E R 1 9 9 2 4D �"by the persistence of subtle expressions, from men and women both, that indicate still an underlying belief that women are second class, and that yes, they can succeed, but their real place is in the home. I perceive this societal pressure as being more intense now, at least in the media ," she added, "than I did 20 years ago. " Statistics certainly do not paint a glowing picture: • A year ago there were three women deans in the nation's 127 medical schools. Today there is none. • A report published last fall by the American Medical Women's Association and the Feminist Majority Foundation showed that today women make up 36 percent of medical school students but hold only 2 percent of the department chairs. • In 1990, 20 percent of all medical school faculty were women - only a 7 percent increase in l3 years. "At that rate," the report stated, "women will not reach parity on medical school faculties until the year 2077. " Men also outnumber women in the higher faculty ranks. Statistics compiled by the Association of American Medical Colleges show that in 1991 nearly three times as many men than women were full professors. That gap can be attributed in part to women's later entry into the profession. But when the Association followed promotion records of full-time faculty first appointed in 1976, it found that by 1991 , more than twice as many men as women had been appointed full professor. Inequities follow through medical specialities - women are clustered in the lowest paying fields ; through wages- the American Medical Women's Association reports female physicians receive 62.8 cents for every dollar earned by their male counterparts; and through medical organizations- the American Medical Association finally put a women on its board in 1989. By many indications, male and female physicians in this country are not treated equally. The medical profession appears to feature a so-called glass ceiling that prevents women in substantial numbers from reaching the top. How could this situation persist in the enlightened 1990s? For Eileen McGrath, the answer is clear. "I think the only reason for a glass ceiling in any group would be discrimination, and I think discrimination exists because of ignorance." McGrath is executive director of the American Medical Women's Association. "It is clearly documented that a glass ceiling exists," she said, "particularly in academic, but in all aspects of medicine." Nancy E. Gary, M.D. 4D BUFFALO PHYSICIAN A N D BI O MEDI C AL iscrimination against women is partly deliberate, partly unconscious, she said. "Most of the injustices we see are probably the result of unconscious acceptance of values in which one group is privileged at the expense of another group , whether it's race or gender. But the effect is the same, so it is sort of immaterial. I've known very few intelligent men who could defend it logically. " Frances Conley at Stanford has become the standard bearer for women physicians who are frustrated by their treatment at the hands of male colleagues and the medical establishment. Conley's oped piece in the San Francisco Chronicle last june, following her resignation from Stanford Medical School's neurosurgery faculty, detailed years of indignities and sexual harassment, including male colleagues calling her "honey," running their hands up her leg in the operating room and commenting on her breasts. Her public statement shocked the campus and raised a furor in the national media. Conley eventually rescinded her resignation, electing to work within the medical school to bring about change. She continues to press for equal, dignified treatment for women at Stanford and elsewhere. ''I'm here as a conscience," Conley said. "To remind people every time they see my ugly mug that there's some unfinished business." Conley thinks wide spread bias against women exists in many occupations. "Our society has a mind-set," she said. "We've been taught ever since we were small children that women were not quite as good as men. The thing that is most depressing to me is the stereotypical response from institutions to women who make an issue of it. They get rid of them." As a tenured professor with a wellestablished reputation, Conley can't be "gotten rid of. " But she admits her future at Stanford Medical School is not bright. "Things are relatively hostile," she said. "What I did is not exactly an acceptable behavior pattern for women. My department will never forgive me I'm sure." Olgajonasson has not experienced the kind of sexual harassment Conley de- SCIENTIST WINTER 1 9 9 2 1 \ �scribes, but she believes it happened to Conley, and says similar things happen to women in medicine all the time. jonassonchairs the DepartmentofSurgery at Ohio State University College of Medicine, one of two women surgery department heads in the U.S., as of july 1991. She has held the position for four years. "I think it is just constantly part of daily living," jonasson said. "I don't believe women are given the credence that men get. We tend to be ignored, passed off." She has dealt with such treatment in the past by ignoring it, but for young women physicians today she has other advice. "In the past I would have said just swallow it and make do," she said. "I don't know that that is practical, possible or reasonable these days. We have to make it clear we won't put up with these things." "It is not possible as a woman to go through medical school without some discrimination," stated Paula Clayton, chair of the Department of Psychiatry at the University of Minnesota Medical School. Clayton, a specialist in mood disorders, is the only female currently heading a department of psychiatry in the U.S., although the field has been popular with women for some time. She describes her own experience with discrimination as "little things- more in whether you deserve the same office" but tells about the complaints of a friend, a top researcher at Yale. "She has had trouble getting promoted, so there must be some bias against promoting women." Not all women physicians agree that discrimination is a problem in medicine. Nancy Gary, a nephrologist, is former dean of Albany Medical School. She left that position 17 months ago to become senior medical advisor to the administrator of the federal Health Care Financing Administration. Gary said she does not think a maledominated medical establishment prevents women from advancing. She thinks women are underrepresented in the top ranks of medicine because they are latecomers to the profession. "It's a time-related aspect," Gary said. "Women have only been entering graduateschool in any significant numbers since the 1970s. Then you have to add three to BUFFALO PHYSICIAN Pat Duffner, M.D. seven years of training and getting started in the lower academic ranks. Only now do you have a significant number of women reaching the maturity in their profession to realize such opportunities as chair positions." If a glass ceiling exists, it is caused by personal choices, not by institutional discrimination, she feels. "I think there may be limitations on opportunities various people can achieve by virtue of their preparation, their willingness to take risks, their willingness to go on divergent paths to reach certain opportunities," Gary said. "So I think it is A N D BIOMEDICAL a very individualized pursuit of a career that determines whether there is a glass ceiling." Clayton agrees that the choices women make may contribute to their concentration in medicine's lower ranks. "I think we have to take some responsibility for not getting ourselves promoted, " Clayton said. "My experience as chairman, and even before becoming chairman, is you have to be a researcher to get promoted. I don't think women are as intense about their research as they should be. They tend to take care of people. They enjoy that role SCIENTIST WINTER 1 9 9 2 4D �-- - --~~~~~-- and it's instantly gratifying. things are good, you are not going to make to identify the unique barriers women face "The feedback in taking care of people it in academic medicine. in using the system, and find out how to is so much quicker than planning a re"You have to be comfortable with your- get leverage from women colleagues and search project, executing it, writing it up self," Duffner added. "I think if women sympathetic male colleagues." ·and getting it published, that we tend not would just relax to some extent and not Mentoring is indispensable for women to do those things," she said. fight it so hard, and feel comfortable in in medicine, Gary emphasized. "People Clayton speculated that women also their expertise, things would be better. are identified to move on because they've had their career shaped by someone in a may not be advancing as fast as they But that's easier said than done. " Clayton said that if women want to position to guide them and advise them. should because they are not as mobile as men . "There are many women associate advance they have to publish. "And not Then they need the contacts, so when an deans, but why those women aren't being just books," she emphasized. "It's easier opportunity becomes available, someone promoted, that's the disturbing question. to write a non-refereed book than to pub- thinks of them as a potential candidate. " Practical advice notwithstanding, mediSometimes it's tough to get promoted from lish in respected refereed journals. Women within. You have to be able to move. And also have to protect their time, so they can cine remains a demanding profession. For women may not be as flexible. I know of do the research necessary to publish, she many reasons the burden seems to be a woman whose husband greater for women. "I think one ought not told her when they got to have to be an exceedmarried: 'You can move once."' ingly strong person to On the other hand, succeed," Aschenbrener UB's School of Medicine and Biomedical Sciences women may simply be said, "but I think someranks 25th among the nation's 147 medical schools times with women that more particular about the in the number of -women in its student body. A study is the case. There are jobs they take. Jonassen conducted by the Association of American Medical Colleges in 1990 sho-wed that 41.5 percent of UB's still an awful lot of socisaid she has had several medical students -were female . etal factors that are baropportunities to be a canToday the percentage is even higher. This spring riers to women. They didate for a deanship, but 73 -women- 4& percent of the class- -will receive turned them down bestill have to do more medical degrees from UB. The follo-wing table cause the offers didn't work. They still have tracks female graduates for the past 10 years. come from the right place. responsibility for home and children." Clayton too said she has 50% ------------------------------------------;---Aschenbrener has been asked many times, but isn't interested in bethrived in a difficult ca40% ;---;---h ;---;---..... 7 coming dean. reer by following the ad14<-' "Being a dean is more vice of her grandfather - 30% 47 4,~ 4~ ~ ~ nurturing, and I don't - "Do whatever your want to take care of more task is as well as you can, 20% people," Clayton said. " ! and everything else will want to be involved with fall into place." To that 10% philosophy she adds psychiatry and research, some wisdom of her or something bigger than 0 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 dean ." own: develop strong values, stick to them and But statistics tell us that most women in medicine do not have said. "You can't be the token member of reflect on them often. Despite the difficulties women in medithese options. Many are strugglingjust to too many committees. You'll be asked to do that. You have to work the same kind cine face today, the future will be brighter, make it out of the lower ranks. What, then , should women physicians of hours that your peers work. If you have Aschenbrener predicts. "Things are definitely improving," she children, you have to have shared respondo to bring about change? said. "There are more male physicians in "You have to find an area you can excel sibilities." in and focus your interest," said Patricia McGrath, at the American Medical positions of power who are really making Duffner, chief of the medical staff at The Women's Association, said women need a great effort to help women along, who Children's Hospital of Buffalo. Duffner to learn how to use the system to their take delight in seeing women succeed. was one of the early specialists in pediatric advantage. "Doing a good job just isn't I've been very fortunate to have a number brain tumors. going to get you there. Women have to of very fine men assist me in ways I never "If you do good work in a focused area, look at the political mechanisms men use asked for and in ways I wasn't aware of. it's hard to be ignored," Duffner said. "If to get on committee, be appointed to And I've seen peopledoitforotherwomen. you do a lot of little things, even if the committee chairs, get visibility. They have That is very gratifying." + UB RANKED AMONG TOP FOR WOMEN GRAD~ ,,~ ;---- ~r- ~ 4D BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST WINTER 1 9 9 2 �WE~TERN NEW YORK WOMEN ~EE GAIN~ omen may be gaining power ancy ielsen, M.D., paved the way and influence in the medical for Western ew York's women physiprofession, if Western ew cians to be more involved in organized York is an indication. The medicine by becoming the first woman Erie County Medical Soci- president of the Erie County Medical Soety and the Eighth District ciety in 1989. ielsen is a specialist in Medical Society both are internal medicine and a clinical assistant headed by women. professor of microbiology at UB. She also Mary Ann Bishara, M.D., is associated with the Buffalo Medical was elected last May to represent physi- Group. cians in the eight Western New York "Once someone has been the first counties that make up the eighth district. woman to do anything, it's easier for othBefore that, Bishara was president of the ers coming behind," ielsen said. "I don't iagara County Medical Society for two have this load I carry around of blazing years. She is chief of anesthesia at Mount trails" - among her other accomplishSt. Mary's Hospital in Niagara Falls. Bishara said being a female has not hindered her advancement in her field. "I've always been accepted as an equal," she said. "I've never noticed any problems." As head of the eighth district, Bishara monitors problems that develop in the member counties, acts as liaison between the county societies and works with the state medical society. Amy Early, M.D., a specialist in oncology and a clinical associate professor in the Department of Medicine at UB, is -Amy Early, M.D. president of the county group. She practices with the Buffalo Medical Group. "If someone had told me 15 years ago I would be doing this," she said, "I wouldn't have believed them. " The local medical community is very receptive to women, Early said. " l think men for the most part have been very supportive. The two people who were most influential in my career have been men. They have gone out of their way to promote my career. " Early said the medical profession could be perceived by women as a large old boys network, which might make them reluctant to jump in. But that is changing, she said. "In medical organizations, men have gone out and recruited women. The American Medical Association is very interested in female members. " Amy Early, M.D. rrlf someone had told me 15 years ago I would be doing thisr I wouldnt have believed them.rr BUFFALO PHYSICIAN AND B I OMEDICAL ments, Nielsen was the first woman chief resident at Buffalo General Hospital. "But one thing I did do as president of the medical society was make sure young talented women physicians interested in the society had opportunities to sit on key committees. That's what it's all about. " Medical societies are still remarkably male dominated, ielsen said, but not necessarily because of conscious discrimination. "People in positions of power did not know there were women interested in being involved ," she said. "Once that barrier was broken, ina couple of years the executive board of our society was 50 percent female. That's how quickly it can change." Today, opportunities for women in medicine are wide open, in Nielsen's opinion. "Women have always gravitated toward specialities such as pediatrics, obstetrics/gynecology and psychiatry," she said. "But they are now going in to in temal medicine, family practice and the last bastion- surgery. The surgical ranks, even the traditionally male-dominated subspecialities such as colo-rectal and urology, have female residents. There has been enormous improvement compared to a few years ago. " + SCIENTIST WINTER 1 9 9 2 «> �BY ROBERT 5. WIEDER When Dr. Stu Silverstein is examining an undressed patient, he likes to save the balance test for last. ttAs they open their eyes, I tell them, 'You're fine- but somebody just stole your clothes.'" A Spoonful of Whensuturingminorlacerations. Humor he tries out standup comedy routines on his patients. ttThey can't walk out on me, and they don't dare heckle." Moretothepoint, theyusuallylaugh, and sail through the procedure before they know it. (We'll avoid any puns on ttkeeping them in stitches.") • EI!) BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST W INTER 1992 �BUFFALO PHYSICIAN A N 0 BIOMEDICAL SCIENTIST W I N T E R 9 9 2 �--------- --------------~-----~-- • aughter can play an important role in pain-control by distracting patients from pain and discomfort'," Univer_ _ _. . _ sity at Buffalo 1 graduate (1981) Silverstein says. In fact, as he wrote recently in California Physician, he believes that "in the appropriate doses and settings, humor can help in the healing process. It should be part of the plan." The role and application of humor in medicine has been widely discussed since publication of orman Cousins' "Anatomy Of An Illness" but Silverstein has taken it to heart as a practitioner, advocate, teacher - and comedian. A pediatrics resident at San Francisco's Children's Hospital, he is also a professional stand up comic, a regional winner of the 1990 Merit Comedy Competition. Physician-comedian may not be a traditional career combination like poet-musician or author-historian, but it has worked well for him , as a physician, a lecturer- he presents "Stand up Medicine Seminars" for physicians on the virtues and uses of humor in medicine -and an instructor, conducting workshops on comedy writing techniques for health care and other professionals. He also writes jokes tailored for medical personneL Silverstein represents an emerging school of thought whose principle hypothesis is that humor can be a beneficial tool for the healing arts in a variety of ways: ~ Humor can psychologically enhance the doctor-patient relationship and the efficacy of treatment; ~ Humor provides discernible physiological benefits to the patient in several clinical areas; ~ Humor is a mnemonic aid in giving instructions to patients and in imparting 0 BUFFAL O PHYSICIAN information to students and lecture audiences; ~ Humor can improve the outlook and productivity of medical staffs and, as an emotional release valve, help reduce stress overload among health professionals. Patient Morale And Cooperativeness Humor helps to alleviate the feelings of anxiety, apprehension and helplessness that patients experience in clinical and hospital settings. A laugh can ease tension and put a "serious" situation into perspective. Silverstein recalls one colleague who kidded patients as he handed them their dressing gowns by saying, "These quality designer gowns, if purchased from Macy's, would go for twice what we pay for them at the Men's Wearhouse, allowing us to pass the sav- A N 0 B IOMEDICAL ings on to you ... " Lightening the moment with obvious parody made it easier for patients to don this particularly grim and depersonalizinggarment, Silverstein notes. "Sharing a laugh also makes it easier for them to bring up their fears about more serious issues - such as the bill," he adds. Humor also works to "socialize the situation," by establishing the doctorpatient relationship in warmer, less formal terms. Given the current atmosphere of biotech medicine and industrialized health care, the healing process is probably more in need of humanizing than ever, and there is no more distinctively human activity than laughter. Nothing enhances a doctor-patient relationship, Silverstein suggests, like the ability to laugh together and kid one another. The end result, he feels, is SCIENTIST WINTER 1 9 9 2 �increasedpatientcomplianceandcooperation. To paraphrase Mary Poppins, "just a spoonful of silliness helps the me~~ci~~!~ ~~~e:~·, clinical treatment seems to be more effective when dispensed by someone the patient trusts, likes .and feels close to. .And almost mvanably, we are more mclmed to trust, like and feel close to persons who add laughtertoourlives. Humorthushelps establish a bond between previously unrelated individuals in circumstances where such a bond is most needed. As Victor Borge says, "A laugh is the closest distance between two people." A joke made at the expense of the clinical :ituation adds a "we're in this together camaradene to a settmg otherwise characterized by inequality and ~,:0~;:~:!:\',:"~~~n~~~;'.:~~~~~~:~:l BUFFALO PHYSICIAN Humor also works to "socialize the situation," by establishing the doctor-patient relationship in warmer, less formal terms. Given the current atmosphere of biotech medicine and industrialized health care, the healing proc e s s is p r 0 b a b l y m 0 r e d f h u man l.z l n nee 0 1• ng than ever and t h ere l•s n 0 m 0 r e dish 1 tl n c t l v e y u man a c ti vi ty than laughter. • 1 • AND • BIOMEDICAL SCIENTIST WINTER 1992 @) �Top 10 Oscarwinning movies if selected by the "Academy" of Pediatrics By Stu Silverstein, M.D. lQ I Indianna Jones and the Precipitous Delivery 9 8 7 6 Saturday ight Fever ... without Origin Dirty Harry in "Tell me that it's just the flu doctor and I'll blow your head clean off." Sophie's Choice ... Augmentin The Man Who Fell to Earth on Librium s ET makes a Child Protective Services referral 4 3 2 l Sally Field in "Not Without My ... Lawyer" King Kong Rules Out Sepsis Godzilla vs. Fecal Impaction Rosemary's Baby Gets a Psych Consult sphere, lending a note of easy familiarity to impersonal protocol. It leavens uneasiness with laughter. Humor can be a lighthearted acknowledgement of the loss of privacy and control that patients are subjected to by medical procedures. This isn't to suggest that practitioners incorporate handpuppets, novelty bow-ties or five minutes of bedpan gags into their exami- ~ BUFFALO PHYSI CIAN nations or instructions. It is to suggest deal" matters, especially when patient that the inclusion of banter, such as cooperation is essential. And when im"These jokes are free, but we do have a parting instructions for self-medication two-enema minimum," can bring a valu- and self-monitoring, a joke or two may able humanizing quality to an otherwise be an important mnemonic aid. A patient too disconcerted by the gravity of dreary medical context. the situation to remember specific proAfter all, underlying the increasing cedures might very well recall a joke corporate formality, esoteric technology and confusing protocol of modern medi- designed to remind him or her of those cine, the fundamental task of the healer procedures. For example, when prescribing mediremains to make the patient feel better. And few things accomplish this more cation that may impair the patient's motor immediately than the simple act oflaugh- functions, the warning "Don't operate any vehicle, machinery or sexual partter. ner over 300 pounds" - can engrave the PhysiologicalBenefits caveat into the patient's memory more Silverstein doesn't actually extol hu- deeply than a dry recitation of the stanmor as a clinical panacea, but if laughter dard precautions. Humor, in short, can were a pharmaceutical, he'd attract the put things in more engaging, and memoattention of the FDA. "For bedridden rable, terms. When it comes to delivering a progpatients, it can improve the circulation nosis, if the situation is not all that serialmost like an aerobic workout. It stimuhumor is the most immediate and ous, lates the diaphragm and can induce coughing, which is important to pneu- persuasive way to underscore that fact. monia-prone patients in stasis, and more Conversely, if the situation is serious, fun than a respiratory therapist. Muscle- humor can help soften the impact of that tension headaches often disappear after reality, can provide comic respite from laughing at comedy. Laughter can lower intense emotions and can be a vital tool blood pressure, improve digestion by for managing or minimizing the resultstimulating GI blood flow - important ant anxiety or despair. "At best, you'll when you're dealing with hospital food live a long and normal life. At worst, - and as a distraction from pain, can you'll have the satisfaction of making your health insurance salesman wish reduce the need for medications." he'd never met you ." Humor similarly helps to convey Instructional And boilerplate data and terminology to lisMnemonic Aid. teners during lectures, seminars and Humor can do wonders for doctorrounds, according to Silverstein, a vetpatient communication by getting the patient's attention, by helping to express eran of all three. "The professors, things in a more comprehensible way attendings and presenters who work and as a memory facilitator. Given that humor into their material are the ones the diagnosic interaction is often com- we usually remember best. They keep us plicated by the distraction of patient interested and attentive. ln fact, the apprehension, a lighthearted note can more serious the message, the more imalleviate patient misgivings, and thereby portant humor can be." make procedures and instructions less formidable. For instance, the declara- Stress Reduction For tion that, "We'll need samples of your Health Professionals stool, blood, semen and urine," can beMedicine's very intensity, Silverstein come far less stark and ominous an an- feels, makes humor a vital mechanism nouncement if followed by, "Gee, maybe for decreasing the stress inherent in its I should just take your underwear. " practice: "A sense of humor helps keep Humor can convert impersonal de- us from being swallowed up emotionmands made on the patient into "no big ally." The simple ability to joke about AND BI OMEDIC AL SCIENTIST WINTER 1 9 9 2 �- ---- - ---~~~ crisis situations, wo rkload pressures and bureaucratic frustrations can foresta ll burnout and discordant overreaction. Studies of hum or in non-medi cal workplaces show it boosts productivity, aids mental acuity and dimi nishes alienation , conflict and absenteeism. Most importantl y, it can make th e cl in ica l en- vironment less a source of dread and depression. There is, of course, so me antipathy among pro fessio nals toward compromising th e "serious business" of medicin e with "undignified" lightheartedness. But, Silverstein poi nts out, "Humor has always been part of our profes- ~ tu "Schrick Doc" Silverstein, M.D., a University at Buffalo grad (1981) , began doing comedy as a student here , back when medicine was still a gleam in his agenda. "I lived in Ellicot Complex, and I knew I'd need humor when they passed out Elavil along with the dorm keys. ln Ellicot, people would turn the sound down on the TV and have me do the dialogue. I did impressions of professors, Jimmy Carter, Menachem Begin, Mick Jagger. People said l should do comedy, so l went on at the Rathskeller in Squire Hall, which I think is now a dental school; somehow appropriate. I did mock press conferences, I did a lot of material about Buffalo- I was from Brooklyn and used to wonder what people meant by, 'Do you drive a kerr? '" Now a pediatrics resident and working comic, Silverstein has combined his two vocations into a flourishing enterprise, delivering what he calls Standup Medicine Seminars on "The Power of Humor in Medical Practice" to groups of medical professionals, often for Continuing Medical Education credits, and conducting workshops on comedy writing techniques for physicians wishing to integrate humor into their practices and presentations. His "seminar circuit" ranges from California to the east and midwest, and he has been featured in newspapers and magazines, and on ABC's World News Tonight. + e B UFFALO P HYSICIAN sional lives, and it's usually a welcome relief. " The "pro-humor" advocates might argue that it is precisely because medicine is both serious and a business that it stands to benefit fro m those humanizing, comforting and even tranquilizing qualities that "comic relief' so uniquely provides. + AND B IOMEDICAL S CIENTIST W INTER 1 9 9 2 6) �--- • ········································································ · ················· . I Buffalo Academy of Medicine presents Kart Haas OF MEDICINE , MUSIC AND THE HUMANTIES arl Haas, the radio host of the popular "Adventures in Good Music," must know that there always are doctors in the concert hall. And not just because he hears their beepers. Doctors are there because medicine and music have a common theme, which is healing. They are there too because to be effective physicians they must not shut themselves in a diagnostic world. "Medicine is life," Haas told an audience oflargely physicians who had come to his piano recital and lecture last October in UB's Katharine Cornell Theatre. "Medicine is life-healing," he said, expanding his theme. "So is music." Haas's appearance was the opening event in the Buffalo Academy of Medicine's Centennial Lecture Series, a series which this season is prescribing doses of the humanities. Haas' topic was "Medicine, Music and the Humanities." During the course of it he examined several of the great composers, and named a number of scientific and medical discoveries that were footnotes to his text of musical appreciation. "A musician is the poorer for going through life only as a musician," Haas said. "And physicians, too." The "kinship" of music and science, he said, is "creativity." "Medicine," he dared say, "is as much a matter of talent as music." Haas chose to begin his musical examination with Bach, the composer who lived from 1685 to 1750, whose music summed up the achievements of the baroque period in music, and who, as Haas fl) BUFFALO PHYSICIAN "Medicine is life. Medicine is life-healing. So is music. A musician is the poorer for going through life only as a musician. And physicians, too. The kinship of music and science is creativity. Medicine is as much a matter of talent as music." A N 0 BIOMEDICAL reminded, produced in addition to great contrapuntal works, 20 children. The piece he played by Bach was chosen for its "melodious beauty" rather than its intellectual rigor. The scientific achievement that Haas chose for his footnote to Bach was the first recorded attempt to measure the rate of the heartbeat- a very appropriate choice, for one of the notable characteristics of Bach's music is its strong and steady rhythmic pulse. During Bach's lifetime scientists were first envisioning a vaccine for smallpox. During the lifetime of Mozart they were discovering a way to fight dropsy. Mozart died mysteriously, perhaps as the result of an epidemic. He lived to be 35, and died 200 years ago. Since then, it might be argued, there has been more good medicine than good music. For Haas, Mozart represents a psychological advance in music. He played the D minor Fantasia by Mozart, in which he believes the composer bares his soul. "He wasn't a regular guy," Haas said, "and we can only understand him through his music." Haas remarked that each time he plays Mozart he discovers something new about the composer. And he suggested that a physician too should find something new each time he treats a patient. The other composers examined by Haas were Beethoven, Schumann, Gershwin and Debussy. Haas mentioned a few scientific discoveries during their lives. The vaccination against smallpox was discovered, and the stethoscope was invented, during the time of Beethoven, and penicillin was discovered during the lifetime of Gershwin. Beethoven was going deaf, and he was dejected, Haas said, when he wrote his last will in 1802. "Music was the refuge from all the tribulations that befell him," Haas said. He played the slow movement of the Pathetique Sonata, which SCIENTIST WINTER 1 9 9 2 �---- -- ..................... .. ......................................................... • • • • •••• • ~ I I Karl Haas presents uMedicine, Music and the Humanities" as the opening event of the Buffalo Academy of Medicine's Centennial lecture Series. romanticism: "There is no such thing as a creative mind working in a vacuum," Haas said. At the piano Haas did not venture beyond Gershwin, who died in 193 7 of a brain tumor. (He did, however, make passing praise of Leonard Bernstein and Aaron Copland, whom he called great, and he told especially of his admiration for Bernstein, who once impressed him at Tanglewood by being able to sing all the roles of Carmen during a class for conductors.) Haas played a piano blues by Gershwin, and he made it sound urgent. happens to be the theme he has used for his radio program, ever since it first aired in Detroit 32 years ago (one year for each of Beethoven's piano sonatas). Haas gave a heartfelt performance of an Arabesque for piano by Schumann, the great romantic composer who suffered from mental disorders. If you would understand Schumann, Haas suggested, you would best listen to the dual personality expressed in his music. Footnotes to Schumann were not scientific, but included fleeting references to other romantic artists, such as Delacroix, Hugo, Goethe and Schiller. They were all on to 8 U F F A L 0 PHYSICIAN ~ N 0 BIOMEDICAL The "vague chords" and impressionism of Debussy's Prelude from Pour le Piano concluded the musical part of the program, with wonderful washes of notes and harmonies. The harmonies of music do go far in making us whole, Haas suggested. At the close he told of a period of suffering in own life, when his sister was dying, and he found strength in the music of the slow movement of Beethoven's Emperor Concerto. It was for him a powerful example of the healing effect of musicof the composer as physician. + -BY SCIENTIST THOMAS W I N T E R PUTNAM I 9 9 2. $ �• ... . ............................ ... ............. .. .... . .......... . .............. .. ... ... . . . I SSOO,OOO grant received to estabfish supercomputing network for research Med school oHers unique medical computing course he practice of medicine, like nearly every other profession, has been revolutionized by computers. A dazzling array of computer programs is available to the physician at the touch of a keystroke, providing access to everything from full medical texts to electronic mail consultations with colleagues. Students at the School of Medicine and Biomedical Sciences are learning how to use this computer wizardry in a course unique to medical schools across the country. The course is distinctive in two ways: it is mandatory for students and it allows them to apply all the technical tools, interactively, to real-life cases. "What we're doing now is quite different from what most schools are doing," said john Loonsk, M.D. , director of academic computing. "There are some schools with electives in medical computing, and some schools that have mandatory computer literacy courses. But what we've been doing is requiring a course specifically oriented to the use of e BUFFALO PHYSICIAN computers in medicine." Each student is assigned a case to diagnose and treat using the full array of computer-based records and medical information systems that will be available in hospitals in the future. Students have access to the patient's computerized medical records and laboratory and drug reports, as well as computer images of X-rays or CAT scans. Students can use a medical expert system that helps interpret findings and make decisions; a data base of medical literature; full texts of reference books, clinical manuals and journal articles; the full Physicians' Desk Reference of drugs; a program that identifies interactions between food and drugs, and electronic mail for soliciting opinions from other physicians. Loonsk said the students respond well to the new technology. "The time spent on computers is definitely very beneficial," he said. Many come back to us and admit that they had to struggle some, but now that they're in a clinical setting and are seeing some of these tools at work, they're glad they had the experience." + - BY AND LOIS BI O BAKER MEDICAL S C he State University of New York at Buffalo has received a $500,000 grant to set up a supercomputing network that will place it at the vanguard of the emerging field of biomedical supercomputing. The funding comes as a $300,000 grant from the National Science Foundation and a $200,000 contribution from the University at Buffalo. The new system, which is 500 times faster than the current system, will allow faculty to intensify their work in two important research areas: biomedical imaging and the study of ion channels, tunnel-like structures that control the electrical behavior of cells. "Only a handful of medical schools have this kind of facility available for biomedical research," said Anthony L. Auerbach, professor of biophysics and director of the supercomputer project. "And I'm not aware of any other research university in the country having this level of research power available for ion channel studies." Knowledge of how ion channels work can provide new information on brain and muscle function and the causes of certain diseases. "This supercomputer will allow us to do experiments we could only dream of doing before," saidjoseph T. Spence, associate dean for research and graduate studies for the medical school. The supercomputer will support the work ofbiophysical sciences professor Frederick Sachs, physiology professor Donald S. Faber and Auerbach. + - BY IENTIST LOIS BAKER WINTER 1 9 9 2 �. .............. .. ........ . ............. . . . . . . . . . .... . ....... .. .. . ...... .. . . . . ......... ••••~• I UB's rural training track in famUy medicine accredited in rural areas, where the need for primary care physicians is great. The rural campus currently is staffed by two physicians and two resident physicians. It will eventually accommodate four physicians and resident physicians, plus a number of medical students who will rotate through the center. The practice will serve parts of two counties with a population of 21,000. Two private physicians, neither of whom offers prenatal care, currently practice in the area. By 1992, rural campus visits are expected to reach 18,000 per year. The Residency review Committee of the Accreditation Council on Medical Education has accredited similar programs at the University of Washington + and the University of ebraska. he rural training track in family medicine at UB has been accredited by the Residency Review Committee of the Accreditation Council on Medical Education, making it one of three universities in the country approved to train primary care physicians to be country doctors. The rural training program is part of a three-year program. Resident physicians spend the first year in Buffaloarea hospitals and clinics affiliated wit the medical school, and the remaining two years at UB's Rural Health Campus on the grounds of Cuba Memorial Hospital in Cuba, ew York. Cuba is a community of about 1,700 people 70 miles south of Buffalo in sparsely populated Allegany County. The resident physicians live and practice in the area, seeing patients at the rural campus and Cuba Memorial Hospital and Olean General Hospital, cosponsors of the project. "Residents tend to practice near the area where they did their training," said Thomas Rosenthal, M.D., clinical associate professor of family medicine and director of the project. "For the past 40 years, the American medical training system has focused on large urban institutions. " Rosenthal hopes exposing residents to a country practice will help reverse that trend and encourage them to settle BUFFALO PHYSICIAN - B Y LOIS B I This year's forum featured the work of 93 students, the largest field since the competition began. Projects ranged from a study of the effects of cocaine on the brain of a rat, to an analysis of heart disease risk factors in an old order Mennonite community. One student's research took him to Kenya, where he studied health and disease among the Rendille. Most participants conducted their research with the help of summer research fellowships, working at UB and other institutions. Forum particpants presented their research in poster form . UB faculty served as judges; each display was reviewed by three judges. More than 60 UB faculty took part in the judging. + AKER Research forum features wen of 93 medical students B medical students vyed for $500 prizes and the chance to take their research to a national competition during the 11th annual Medical Student Research Forum in early December. A N 0 BIOMEDICAL SC I Medical students present their research during the 11th annual Medical Student Research Farum. ENTIST W I NTER I 9 9 2 ED �rfi,iil".... ............ .... ..... ..... ................ ........................ .. ......... ... .... . ~ Fisher wins award for excellence in writing N adine Fisher, Ed.D. , a research scientist in rehabilitation medicine, recently received the 1990 Sidney Licht Award for Excellence in Scientific Writing from the American Congress of Rehabilitation Medicine. The award was presented in late October. Fisher received her doctorate last May ~ from the Department of Exercise Sci- ~ ence. Her research has been published v; Nadine Fisher, Ed.D. extensively in the Archives of Physical Medicine and Rehabilitation Medicine. Fisher received the award along with fellow authors professor David R. Pendergast, Ed. D., and professor emeriames H. Cosgriff, tus Evan C. Calkins, M.D. , for their Jr. , M.D. , was recarticle "Maximal Isometric Torque of ognized for his Knee Extension as a Function of Muscle contributions to Length in Subjects of Advancing Age ," trauma care at a published in the September 1990 issue dinner in November at + the Hyatt Regency Bufof Archives. falo. Nationally known trauma surgeon, James]. "Red" Duke, Jr. , M.D., delivered the keynote address on the effects of traumatic injuries and the ecoradley P. Fuhrman, M.D., was re- nomic factors of trauma care. Orgacently appointed chief of the divi- nized by the Medical Society of the sion of critical care at The County of Erie and co-sponsored by the Buffalo Medical Group and IndepenChildren's Hospital of Buffalo. Fuhrman, a UB medical school dent Health, the event was a fundraiser professor, is responsible for overseeing for Mercy Flight, Western ew York's clinical research and training programs emergency medical care helicopter serin the pediatric intensive care unit. He vice. Cosgriff, an assistant clinical professor will also participate in of surgery since 1962, has served as the modernization of director of Mercy Flight, chief of trauma the unit and impleservice at Sisters of Charity Hospital and ment new medical chairman of the New York State Commanagement promittee on Trauma. grams as well as build Duke, a Texas native, is a nationally a fellowship program. recognized authority on trauma care. Fuhrman was previously assistant director of the intensive care unit at Pitts- He established Houston's Hermann Hosburgh Children's Hospital. + pital Life Flight and help found the Cosgriff honored at Mercy Flight benefit J Fuhrman appointed chief of critical care at CHOB B BUFFALO PH Y SICIAN AND B I OMEDICAL American Trauma Society . A 1989 candidate for the position of Surgeon General of the United States , he was host of the PBS prog r a m Body watch . He currently serves as professor of surgery at the University of Texas Medical School at Houston. + Bettigole named Red Cross blood services director R ichard Bettigole, M.D., an associate professor of medicine and clinical associate professor of pathology , has been named medical director of the American Red Cross Blood Services Buffalo Region. Bettigole previously served as head of hematology laboratories, blood bank and clinical hematology at Erie County Medical Center. He is a graduate of Yale University and Columbia University Medical School. + John Naughton, M.D., right, dean of the medical school, receives an Award of Excellence at the 19th Annual Black Achievers Dinner held last October. SCIENTIST WINTER 1 9 9 2 �........................ . .. . ........................................ . ........ James Platt White Societr holds annua meeting embers of the james Platt White Society were honored at the society's sixth annual meeting held last October 18 at the Country Club of Buffalo. joseph T. Spence, Ph.D., associate dean for research and graduate studies, delivered a slide presentation on plans for the medical school's new biomedical sciences building. The dinner dance was held to honor society members, who have made annual contributions of $1,000 of more. The members of the james Platt White Society for 1991 are: Dr. Kenneth Alford Dr. William S. Andaloro Dr. Kenneth Z. Altshuler Dr. Amos Ar Drs. Kevin and Elizabeth Barlog Dr. jared Barlow Dr. Charles D. Bauer Dr. Richard A. Berkson Dr. Willard Bernhoft Dr. Russell W. Bessette Dr. Theodore Bistany Dr. Dennis L. Bordan Dr. and Mrs. Harold Brody Dr. Robert L. Brown Dr. August A. Bruno Dr. Elaine M. Bukowski Dr. and Mrs. Irwin Burstein Dr. David W. Butsch Ms. janet F. Butsch Dr. john L. Butsch Dr. Evan Calkins Dr. icholas]. Capuana BUFFALO Dr. Dr. Dr. Dr. Dr. Dr. Dr. .fl l Michael E. Cohen and Mrs. joseph A. Chazan George H. Christ Daniel E. Curtin Roger S. Dayer Carlo E. DeSantis PeterS. D'Arrigo Dr. Edward Diao Dr. Thomas A. Donohue Drs. Thomas C. Doolittle and Leslie Doolittle Dr. Kenneth H. Eckhert Dr. Robert Einhorn Dr. and Mrs. George M. Ellis Dr. Leon Farhi Dr. Daniel Fahey and Dr. Marie Runfola Dr. Donald M. Fisher Dr. Grant T. Fisher Dr. jack C. Fisher Dr. Richard R. Gacek Dr. Matthew A. Gajewski Dr. Kenneth L. Gayles Dr. john W. Gibbs, jr. Dr. Allen Goldfarb Dr. Seymour Grauer Dr. Harvey Greenberg Dr. Mala Gupta Dr. Thomas]. Guttuso Dr. Eugene Hanavan Mr. and Mrs. Edward Hansen Dr. and Mrs. Gerald Hardner Dr. Reid R. Heffner, Jr. Dr. Orvan W. Hess Dr. Takeshi Homma Dr. Bradley Hull Dr. Annabel M. Irons Dr. and Mrs. Kenneth L. jewel Dr. Charles Alexander joy Dr. Herbenjoyce Dr. Stephen T. joyce Dr. james R. Kanski Dr. Ivan W. Kuhl Dr. joseph L. Kunz Dr. Marvin Z. Kurian Dr. Andre Lascari Dr. Eugene V. Leslie Dr. Lawrence M. Lesser Dr. and Mrs. Harold]. Levy Dr. Stanley Lewin Dr. jack Lippes PHYSICIAN A N 0 The James Platt White Society's sixth annual meeting was held in October. Dr. Dr. Dr. Dr. Dr. Don L. Maunz Robert C. McCormick William . Mcintosh Harry L. Metcalf Merrill L. Miller Dr. Eugene R. Mindell Dr. joseph F. Monte Dr. john D. Mountain Dr. Richard L. Munk Dr. Arthur Mruczek Dr. Dennis adler Dr. Richard]. agel Dr. Masao akandakari Dr. Richard B. Narins Dr. and Mrs. john Naughton Dr. David H. ichols Dr. john]. O'Connor Dr. Benjamin E. Obletz Dr. Yasuyo Ohta Dr. Elizabeth P. Olmsted Dr. Arthur Otis Dr. Donald N. Pachuta Dr. and Mrs. Robert]. Patterson Dr. and Mrs. joel Paull Dr. Deming L. Payne Dr. Clayton A. Peimer Dr. Victor L. Pellicano Dr. james F. Phillips Dr. He rbert S. Pirson Dr. Dr. Dr. Dr. Dr. Dr. Ben Rappole Frederic D. Regan Albert C. Rekate Frank T. Riforgiato Alben G. Rowe Richard R. Romanowski BIOMEDICAL SCIENTIST Dr. and Mrs. Charles H. Rosenberg Miss Thelma Sanes Dr. Arthur]. Schaefer Dr. Robert . Schnitzler Dr. Roy E. Seibel Dr. joseph I. Schultz Dr. Elizabeth G. Serrage Dr. Edward Shanbrom Dr. and Mrs. Samuel Shatkin Dr. john B. Sheffer Miss Alice Simpson Dr. Richard A. Smith Dr. John E. Spoor Dr. William Sternfeld Dr. Gerald Sufrin Dr. Eugene M. Sullivan, Jr. Dr. Michael A. Sullivan Dr. Hiroshi Tazawa Dr. MichaelS. Taxier Dr. Charles S. Tirone Dr. W . William Tornow Dr. Anthony C. Trippi Dr. Ronald H. Usiak Dr. john P. Visco Dr. Barbara Von Schmidt Dr. Philip Wels Dr. Paul H. Wierzbieniec Dr. Gary]. Wilcox Dr. james S. Williams Dr. john R. Wright Dr. Hajima Yamabayashi Dr. Tetsuro Yokoyama Dr. Wende W . Young Dr. Franklin Zeplowitz Dr. and Mrs. David C. Ziegler WINTER 1992 ED �• ········ · · · · · ····· · ········ · ····· · ···· · ······ · ··· · ····················· ·· ······ · ········ ·· I 1 9 2 s 0 ROSARI E ROSSELL BENDER medical director of the Urgent Maryland. Theyhavefivedaughters (including five-year-old trip- '20 , of Ft. Lauderdale , Florida, is Care Department of the Western lets). JOHN published in 1991. 9 JOSEPH 3 R. 0 SAAB '34 , ANDERSON '67 , ew York Medical Park, was Board the author of Don't Say Goodbye 1 R . partment of Medicine at johns in 1989. Hopkins. 1 WALTER Z . SCHWEBEL '38 , is 9 7 0 s ROBERT P . GALE '70 , of Los Angeles, California, is a section from general practice and is living in Hamburg, New York editor of a new journal entitled Robert Gole, M.D. and is an instructor in the De- certified in emergency medicine s retired He is in private practice Cell Transplantation. JAMES A . SOLOMON '79 , is assistant clinical professor of dermatology and director of the International Centre for Applied Immunologic Principles at Tufts Medical School/Bay State Medical still active in pediatrics and is the Center. has MELVIN POHL '76 , has returned been appointed to the senior-acLive staff at the Memorial Hospital to Las Vegas as a family practitio- of Salem, New jersey (thisappoint- author of The Caregivers' jour- JANET M . WILLIAMS '88 , ment is only possible after 25 years ney, When you Love Someone With her husband john ]. Barbaccia of service to the hospital). Aids, published by Harpers. '88, announce the birth of their tired in 1982 and enjoys living in STEPHEN C . SCHE I BER '64 , ORESTES G . ROSABAL '77 , Jupiter, Florida for six months the executive vice-president of the who serves the Southern Medi- each year. liams is an attending in emer- American Board ofPsychiatry and cal Association as Councilor for gency medicine at Allegheny director of the Physically Handicapped Children's Program of Rennsselaer County, New York. 1 9 4 0 s A . ARTHUR GRABAU '45 , re- MYRON E . W ILLIAMS , JR . , '46 , tells us that he retired in july from Family Practice and Geriatrics. 1 9 5 0 s JOHN J . LAMAR , JR . , '63 , ner and addictionist. He is the 1 9 8 s 0 and daughter , Katherine Moore Barbaccia onjuly 17, 1991. Wil- Neurology, serves on the Edito- the State of Florida, attended their General Hospital; Barbaccia is rial Board of Academic Psychiatry 85th Annual Scientific Assembly chief resident in anesthesiology and is a member of the Board of in Atlanta , Georgia during at Mercy Hospital. Trustees for the Group for the November. Advancement of Psychiatry. JAN ICE DENISE W IL LI AMS '77 , OBITUARIES HENRY J . WISER '34 died in has a ROBERT M . TABACHNIKOFF private practice in neurology in '66 , was deployed inAugust1990, gynecology at the U.S. Naval Hos- Winter Park, Florida August 22 , Honolulu, Hawaii, and is doing while chief of the Obstetrics and pital in Patuxent River, Maryland. 1991. research in the epidemiology of stroke and Parkinson's Disease. Gynecology Departmental Keller Hospital, West Point, New York, R ICHARD F . BUSCH '78 , and served with the 46th Combat assistant clinical professor of sur- Harry 0. Westphal '58, of Palm Support Hospital in Saudi Arabia City, Florida, retiredjuly, 1991. until mid-Aprill99L gery (otolaryngology) at the University of California at San Di- JORDAN S . POPPER '56 , is an attending in obstetrics and ego, School of Medicine. 1 9 6 0 s MICHAEL I. WE I NTRAUB '66 , is His article "Intermaxillary Fixation THOMAS J . KAISER '43 died in May, 1991. diedjuly 15, 1991, at his home in JOHN WILLIAMS '43 , Cassadaga, New York, after a battle with cancer. com- co-edited a book with Arthur E. pleted the three-month Advanced Fass, M.D. ,onthecombinedmedi- with Intra Oral Cortical Bone Screws" was published in the Management Program at the cal disciplines of neurology and December 1991 issue of The july 11 , 1991 following a six- Harvard Business School in No- cardiology, Heart and Brain: In- Laryngoscope. year battle with lymphoma. vember, 1991. He is medical di- teractions of Cardiac and Neur·o- rector of Kaiser Permanente in logic Disease. Weintraub also co- KENNETH GLICK '78 , Orange County, California authored one of the book's chapters with Allan Rothman, M.D .. wife Sandy live in Baltimore, KENNETH E . BELL '61 , G BUFFALO PHYSICIAN A N 0 BIOMEDICAL HARVEY Z . KLEIN '57 , died on and his SCIENTIST WINTER 1 9 9 2 ��BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO NEW YORK 14214 ADDRESS CORRECTION REQUESTED Non-Profit Org. U.S. Postage PAID Buffalo, NY Permit No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Winter 1992 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1992-Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v26n01-1992-Winter Table Of Contents A list of subunits of the resource. Research Hospital News Further Notes on "The Other Classroom" Journey to the Top of the M.D. Ladder A Spoonful of Humor Medical School People Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-12-10 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v26n01 Extent The size or duration of the resource. 36 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1992 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/ea9203538521e2ddea354a4eecb3ca70.pdf 76d9e665fbe7bcc68b1dd07a99c7ea9a PDF Text Text �... DEARALUMNI ANDFRIENDS, BUFFAlD PtIY~I~!6N STAF F EXECUTIVE EDllOR UNIVERSITY PUBLICATIONS Ro~rt T. Marlett BUFFALO PHYSICIAN EDllOR Connie Oswald Stofko AR:r DIREClOR Alan ). Kegler ADVISORY BOARD Dr. John Naughton, Cluurman Dr. Harold Brody M, . Nancy Gheco Dr. James Kamk1 Dr. Charles Paganelli Mr. Gregory Zittel Or. Antoinette Peter-s Dr. Charle, Pruet Dr. Luther Robinson Dr. Thomas Rosenthal Or. Saleda Suresh Dr. Burton Sing~rman Or. Stephen Spaulding Dr. Nelson Torre Mr. Edward Wemke Dr. Paul W1er:b1en1ec Dr. )trome Yates T he school successfully completed its institutional selfstudy on schedule in mid-June in preparation for the November LCME survey visit. I am graceful to the department chairmen, faculty members, students, full-cime and voluntary faculty members, hospital directors, and board of trustee representatives who served on the Steering Committee and received the reports chat emanated from every aspect of the organization. This sixmonth effort served to establish the state of the medical school today and to develop an agenda of recommendations for casks which should be accomplished between 1988 and the next LCME visit in 1995. Indeed, I chink the process proved that the medical school is strong, the faculty and student body are committed co the achievement of scholarly excellence and meeting the needs of society, and chat each wants the school to improve even more in the years ahead. These are good signals chat the momentum developed over the past several years can be maintained. As has always been the tradition at the UB Medical School over the past 142 years, the multiple constituencies are committed to working harder to attain higher levels of excellence. This should bode well for the upcoming accreditation visit and for our future as we begin to think more earnestly and intently about medicine in the 21st Century. Sincerely, Joh n Naught on, M .D. Vice Presidentfor Clinical Affairs Dean, Schoolof Medicine and BiomedicalSciences WRITERS Li<a Josephson Clare O'Shea Mary Beth Spma David Snyderman Ann Whitcher ILL US TRATOR S M1chad Gelen Glyn,s Sweeny P H OTOG RAPH ERS Doug Levere Dan1d Morelli Ian Rcdmbaugh T EAC HI N G H OS PI TALS Batavia Veterans Admini~rrat1on Medical Center Buffalo General Buffalo VeteransAdmm1'-trat1on Medical Center Children's Enc County Medical Center Mercy Millard Fillmore Roswell Park Memorial lnsraute Sisters of Chamy Produced~ rhe Di<is,onof Um, en1h Relationsm as.<OCUUwn u:,rh,he Schoolof Medirine and BiomedicalSc,ence.s,Suu, Uni,m,r, of Nru Yorkat Buffalo. THE BUFFALO PHYSICIAN ANO BIOMEDICAL SCIENTIST (USPS 551-860) Autumn 1988, Volume 22, Number 3. Published five 11mes annually: Spring, Summer, Autumn, Early \\'inter, and Late Winter - by the School of Med,cine and Biomedical Sciences, Stare Univermy of 1':ew York a, Buffalo, 3435 Mam Street, Buffalo, New York 14214.Third class bulk postage pmd at Buffalo, New York. Send address changes to THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST. 146 C.F.S. Addiuon, 3435 Main Sm,et, Buffalo, New York 14214. Cove r Ph o to: Danit! Mon:11, DEAR FELLOW ALUMNI/ ALUMNAE: T his is the time of year when the Alumni Board develops the program for next year's Spring Clinical Day. Dr. Nedra Harrison is working with her committee on an excellent program for our scientific day, and Dr. Joseph Kunz is working with the reunion class chairmen to gee their plan5 set for their class reunions. Again this year, l will try to keep you abreast of the happenings on and about the Unive rsity through our newsletter, and I remain open to any suggestions you may have. In conjunction w1ch the dean's office, we are crying co establish an award for a distinguished alumnus of our University this year, and plans are being sec forth with the committee to select such an individual. If you have any suggestions as co a distinguished alumnus of our University, please forward the name with a brief biography of the person to myself, Dr. Jack Richert or the dean's office so that person can be brought into consideration. As this year seems to continue co slip by, I can only look forward co my 15th reunion this coming May, and I hope that the members of my class will be active and participate in this reunion celebration. Sincere/), Paul H . Wier zbieni ec, M .D. �Vol. 22, No. 3 Autumn 1988 Features 2 East Meets West. Emerging from years of isolation, China is reaching out to improve the medical care of its one billion inhabitants. Under a new exchange agreement, scholars from Beijing study Western techniques here while Buffalonians learn about Chinese techniques such as acupuncture. Page24 10 Medicineandthe Arts.The creativi ty of health-care professionals was the topic of a summer symposium organized by the UB Health Sciences Library. 14 TykeTrike . The colorful tricycle that six-year-old Sarah Tangelder rides has been modified by UB researchers to give electrical stimula­ tion therapy to her paralyzed legs. Departments Page 10 18 Research.The latest developments in organ transplantation and a new test to diagnose celiac disease were discussed at the 11th Inter­ national Convocation on Immunology sponsored by the Ernest Witebsky Center for Immunology. 21 Classnotes . MedicalSchool.Suk Ki Hong, M.D., discussed his "Thirty Years Underwater" when he gave the Stockton Kimball Lecture at the An­ nual Faculty Meeting. This year's winner of the Stockton Kimball Award was John R. Border, M.0. 24 31 People. Page22 32 Alumni . News of the reunions. 36 Events. �2 hinese B y CONNIE edicine OSWALD STOFKO raditional Chinese medicine has been largely ignored by the west, but seeing it practiced in Beijing has piqued the interest of a group from Buffalo who visited China in March. '~nything that's been going on for thousands of years must have some usefulness;' reasoned James M. Schlehr, a medical student who made the trip. Veronique James, another student, wou ld like to return to China to learn acupuncture after she finishes her residency in pediatrics. "It may be very useful in my practice;' she said. The two students were part of a group that spent a month in Beijing as a precursor to a new formal exchange agreement among UB, Millard Fillmore Hospital, and the Capital Institute of Medicine of Beijing. Other members of the delegation were Daniel Morelli, M.D., vice chairman of the Department of Family AUTUMN 1988 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST ��4 Medicine at UB and director of the residency program at Millard Fillmore Hospital; William M. Healy, M.D., then a resident in internal medicine at Millard Fillmore Hospital, and medical students Ira Rock, Jerry Igoe, Charles Everett, and Wayne Waz. For treating chronic conditions like arthritis or curing the common cold, Chinese traditional medicine does as well as Western medicine, Waz said. He add­ ed chat there's a push in China to find which of the traditional techniques have a good scientific basis and which ones seem to work only because of a placebo effect. AUTUMN 1988 Waz has good feelings about one tradi­ tional technique, acupuncture. Because he once damaged the cartilage in his knee, it aches when he walks on it a lot. While in Beijing, he tried acupuncture and found it got rid of the pain for three or four hours. While it may offer good pain relief, acupuncture is no longer used in China as an anesthetic for surgery because it's not a good muscle relaxant, noted Hea­ ly, the resident. The herbal medicines hold promise, but even the Chinese admit that it's sometimes hard co get as true a dose with their herbal teas as we do with our pills, said Healy, who has long been interested in folk medicine. Sometimes a batch of tea will lower blood pressure well, but the next batch will not. Another traditional technique is cup­ ping. The group saw the treatment per­ formed on a woman with shoulder problems. A lighted alcohol wick is inserted in­ to what looks like a small, glass goldfish bowl. When the air inside the glass is heated, the wick is removed and the glass quickly placed on the patient's skin. A vacuum is formed and sucks the skin in­ to the glass, forming a nasty mark that can best be described as a giant hickey. BUFFALOPHYSICIANAND BIOMEDICALSClENTIST �hina's practice of med• icine is as distinctive as its architecture. Physicians con/ er over medical records penned in traditional Chinese characters, lef~ while a patient re• ceives acupuncture enhanced by elec • trical current, below. The technique is believed to draw harmful substances out of the body. Traditional Chinese massage uses manipulation to relieve pain and restore function. Massage is used for ailments such as arthritis. Because they were in China such a short time, the Buffalo visitors saw techniques being used, but don't know if they provided lasting results. But the patients generally reported feeling better initially, Healy said. B oth traditional and Western styles of medicine are used in the hospitals in Beijing, and patients don't see BUFFAID PHYSICIANAND BIOMEDICALSCIENTIST saving?" Healy questioned. The Chinese doctors read western medical journals and are up on the latest techniques. But they can't use many of those techniques because they just don't have the resources. Needles, syringes, IV tubes, and surgical gloves are washed and reused. Before surgery, doctors soak their hands in an alcohol bath because the water isn't free of parasites . Even photocopy machines are rare commodities. "They do a lot with so little," Morelli said. "They squeeze very hard on every resource." Because they don't have the equipment we have here, Chinese doctors rely almost completely on physical exams rather than lab tests to make diagnoses. The Chinese are very skilled, and the UB students learned a great deal about techniques such as palpating an a conflict in combining them, Morelli enlarged liver or spleen . noted. A patient may receive a Western Waz had hoped to talk with a Chinese pharmaceutical preparation while also faculty member who was an expert in receiving an herbal preparation. medical ethics . What he found was that In rural areas, people often seek out the the Chinese haven't developed ethics intraditional practitioner before they see a to an academic discipline as we have. Inphysician who practices Western stead, Waz noted, they use what you medicine. The traditional methods pro- might call "medical pragmatism." bably ease the symptoms, and the peoSince the Chinese don't have our ple seem satisfied with the treatment. Yet lavish resources, they don't have the the Buffalonians saw people whose thorny ethical issues chat go along with disease had progressed beyond any them. They don't have co decide whether medical care, but who might have been a very sick infant should get intensive helped if they had had surgery earlier. care; they simply don't have any such "I wonder how many people were care to offer. ultimately hurt because they kept going Yet Americans would consider the to the traditional practitioner, delaying Chinese lavish in hospitalization policies. treatment that might have been more life Many people who'd be treated as outpa- AlJfUMN 1988 5 �6 IJ'lat ~cian I!' left, a phy sid em onstrat es tradi- ,. tional Chin ese massage for a pa tient suf- /.../ , f ering low back pain and, at righ t, a wo man rece ives a cup p ing I treatm ent. Note the marks tha t remain on th e w om an 's s kin. A bo ve, bi cy cl es are a c omm o n for m of t ran spor tati o n , th ough the numb er of cars is in creasing. tiencs here are hospitalized in China. A nd once in the hospital, patients stay a long time. For instance, a patient who has a gall bladder removed in the United States might stay five to seven days; in China, he'd be in a few weeks, noted Morelli. T he result is that hospitals run out of beds. Families keep bringing sick relatives back day after day hoping they'll be admitted. The hospitals also run outpatient clin ics that are very heavily subsc ribed, More lli noted . The Buffalo visitors saw some medical cond itions that aren't common in the United States, such as rheumatic heart disease and hepatit is and liver diseases that aren't alcohol related. They got to hea r the heart murmurs AlJTUMN 1988 associated with mitral stenosis . In the United States, residents might see one or two classic cases a year, Hea ly said. In China, they saw six or seven a day. "Now I can say I really hear the classic sounds - just the way it's written in the textbooks. That was a real thrill;' he observed . It was hard to get a hand le on just how common certain diseases are in Ch ina, Healy said. The Chinese would claim that a disease was very rare, then show them 10 cases of it . Healy wasn't sure if they were trying to gloss over the situation or if there was simply confusion over use of the word "rare." Since no one in the Buffalo group could speak more than a few words of Chinese , commun ication was a problem . Medical termino logy, especially drug names, was hard to translate . Sometimes they'd just give up on a point, Healy said. T he Chinese have a six-day work week, but also tried to prov ide relaxation for their guests. "After six days in the hospital, on the seventh day we toured," Morelli said. They visited the Great Wall, the Palace Museum in the Forbidden City, and Mads Tomb. The imperial sites are very colorful, almost gaudy, but it was a welcome contrast to the gray and dingy city. Since most people burn coal in their homes, a brown haze hung over the city on still days, adding to the March gloom. "It's a hard life in China overall," Morell i said . "They do without a considerable amount of day-co-day things we cake for granted ." T his includes simp le things like prepared foods or larger things like the freedom we enjoy. BUFFALO PHYSICIA N AND BIO MEDICAL SCIENTIST �7 #1' eijing physi- ~ cians struggle to care for the city's 10 million in­ At left is the well-baby nursery at a bus, • district hospital. After the rigors habitants. of a six-day work week, the Americans were escorted to popular tions Great and tourist attrac- such as the Wall, above, the Forbidden City, right. "It's like they're black and white and we're color," Morelli said. But the peole seem happy and hopeful. A favorite sight of Waz's was the old men who take their pet birds for a walk to the park. They'd hang the cages in the trees while they chatted with their friends. High rise apartment buildings are sprouti ng up all over Beijing. Communism is loosening up; a lot of consumerism is starting . People in the street are selling things and are allowed to keep the profits. People can voice disagreement with goverment policies, though not very loudly. The thing that stands out most in Schlehr's mind was the time he met a Chinese army officer who had a copy of George Orwell's 1984. The novel, a parable of the evils of communism, was, in all likelihood, banned in China. For BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST the officer to even have a copy means "things are opening up a lot," Schlehr said . The Buffalonians were impressed by the red carpet treatment they received from the Chinese. Few people in Beijing own cars, but the Americans were driven around in a modern Toyota mini-bus, belonging to the Capital Institute. Though it was winter, the Chinese tried to find the best selection of vegetables for their guests. The Chinese took them to operas, concerts, and tourist attractions. They had dinner at the fancy Peking Duck Restaurant with heads of all the city's hospitals. The group was photographed and videotaped at every opportunity . The process always entailed a bit of seatshuffling because each person had to be seated in a place that reflected his pro- per status, Morelli explained. Even parties in Beijing are very structured. There's generally some chatting, followed by some speeches, then entertainment. Th e Buffalonians decided to throw a thank-you cocktail party, but the Chinese guests were very uncomfortable because they didn't know what to do in such an unstructured setting, Waz said. The Americans salvaged the affair by giving some speeches and singing "America the Beautiful," "Under the Boardwalk," and "Take Me Out to the Ball Game:' The Buffalonians say they want to go back to Beijing; some in a few years, some in a few decades. They fully expect that things will be different, though it's hard to say in what way. "So many things cou ld happen," said Waz. "They have to try to get the best of our ideas and avoid our problems'.' AUTUMN 1988 �eets 8 a nu Bu hosp speci equi medi acup 0 right year! yean for E "H big l est Buffalo and Beijing exchange scholars in new program By CONNIE OSWALD smFKO n tiom Ul with Hig~ ~ lectric acupuncture needles combine the old and the new, the East and the West. They're a symbol of China today . China is a country coping with change . le clings co the traditiona l Chinese medicine used since ancient times, using techniques such as acupuncture and herbal medicines. Bue after years of isolation, the most populous country in the world is eager to adopt the medical advances of industrialized nations. To accomplish that goal, leaders from the Capital Institute of Medicine of Beijing on June 7 signed a new exchange agreement with UB's School of Medicine and Biomedical Sciences and Millard Fillmore Hospital. The agreement allows three faculty members from Beijing to visit Buffalo. Two will visit for about two months and the third will visit for a year. In return, six senior medica l students from UB, as well as two residents, will observe medical care in Beijing for one month. The exchange is the result of the opening of China to the outside world, said Du ]inxiang, the acting president of the Capita l Institute of Medicine of Beijing. The Chinese wane to learn the advanced technology of the West in order co develop their own science and technology. "In the past, China was isolated, occluded from the world," explained Gao Tienxiang, professor of cell bio logy and microbiology at the Capital Institute. "It's '8' ALm.JMN 1988 l i ll' ~ Q i From left: Peter Ostrow, associate dean for curricular and academ ic affairs at VB; Jan Jennings , pres ident and chief execut ive officer of Millard Fillmore Hospital; Du Jinxiang; Gao Tienxiang, and John Naughton. a pressing prob lem we feel." Gao is also head of the Institute's laboratory of electron microscopy and the laboratory of cell biology. He acted as the translator for the Chinese dignitaries during their June visit to Buffalo. Du and Gao were accompanied by Li Hui, Gads wife, who is a professor of microbiology and immunology at the Capital Instirue and head of the Department of Microbiology at Shandong Medical University. that the Cap Ki fessc nice prov broa Roa< Tl were an e: Zhe1 grad who ince1 Tl oth~ SL The exchange agreement is important because of the increasing ties between the two countries, said John Naughton, vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences at UB. "As we go down the pike, the U.S. and China are going to have more intense relationships," Naughton said. "This exchange gives us an opportun ity to be part of it:' The Capital Institute was founded in 1960,said Du. Like UB, it's affiliated with jing dim a ne Mill Cap dela BUFFAW PHYSICIAN ANO BIOMEDICAL SCIENTIST BUFF/ 198i �number of hospita ls. But you'll find things in the Beijing ,spirals chat you don't see in Buffalo: ecialties in tropical disease, pharmacies uipped to fill prescript ions for edicinal teas, and departments of upuncture . Chinese students enter medical school :ht after high school and study for five ars, then work as residents for 5 to 10 ars. The Institute provides physicians r Beijing, which has 10 million people. "Health care for 10 million people is a g burden for us; Du noted . The Capital Institute also has affilia)nS in Rochester and Texas. UB already has a systemic agreement ith the Beijing Municipal System of igher Education . UB is the only university in the U.S. to have an agreement with the entire system, which is somewhat analogous to the City University of New York. O ther U.S. universities have exchange agreements with only one co llege in the system. About 100 students and faculty have traveled between China and Buffalo over the past seven years, studying such dive rse fields as music, education, engineering, physiology, and h istory. UB's Health Sciences Library is also setting up a cooperative relationship with China's nat ional medical library, which is part of the C hinese Academy of Medical Sciences and Peking Union Med ical College in Beijing. In anticipation of the new agreement with the Capital Institute, UB and Millard Fillmore Hospital sent a delegation to Beijing in March . In the delegation were Daniel Morelli, M.D., vice chairman of the Department of Family Medicine at U0 and dirt:ctur of the residency program at Millard Fillmore Hospital; William M . Healy, M.D. , who was then a resident in internal medicine at Millard Fillmore Hospital, and medical students Wayne Waz, James M. Schlehr, Ira Rock, Jerry Igoe, Veronique James, and Charles Everett. "This type of exchange buys us more goodwill than does military aid or other types of aid; said Morelli. "It would be a very productive thing for us as a nation to sponsor. It's a way of sharing the wealth we have in a way that goes beyond sharing money." UB mournstwo killed in trafficaccident By JIM McMUL LEN ~ Chinese professor and a UB staff 'II member were killed June l while driving home from a dinner party 1at celebrated the schedu led signing of 1e new exchange agreement with the :apical Institute of Medicine in Beijing. Killed were Sun Keji, an exchange prossor in anatomical sciences, and Berice Poss, execut ive assistant to the UB rovost, the driver . Thei r car was struck roadside by another veh icle on Maple oad in Amherst . Three othe r passengers in Poss's car ere injured. They are Yong-Huan Shen, :1exchange scholar in mathematics ; Yahen Gu, his wife, and Xijou Hou , a -aduate exchange student in education, ho had attended the dinner as an 1terpreter. The dr iver and a passenger in the rher car were also inju red. Sun, 57, had been at UB since August }87 under an agreement with the Bei:1gMunicipal System of Education . The inner party anticipated the sign ing of new three-yea r agreement among UB, 1illard Fillmore Hospital, and the :apital Institute . That formalization, elayed because of the accident, took JFFALO PHYS IC IAN A N D BIO MEDICAL SC IEN TIST Sun Keji place Jun e 7. Born in Sha nghai, Sun received his degree in medic ine in 1954. He served as cha irman of the Department of Histology and Embryology at the Capital Institute of Medicine, where he was recently promoted co full professor. Sun was considered the best teacher at the Institute . Here he was also valued as an excellent teacher, a meticulous researcher and a friend of rhis Universiry, said Harold Brody, chair of Anatomical Sciences . At UB, Sun conducted research on neuroendocrine control of liver regeneration. His work will be compiled and published later this year. He also taught in a medical and dental histology class. "His teaching in the lab was interesting," Brody said. "He had some difficulty in communicati ng because his command of English was not so good. But he was a kind, patient man, excellent at working one-on-one or with small groups of students." He voluntarily tutored several minority students in histo logy. As one stude nt said, "You couldn't help but like him." Sun was scheduled to return to Beijing in mid-August . A memorial service for Sun was held June 7. He is survived by a wife and two children. AUTU MN 1968 9 �MEDICINE AND THE ARTS 10 Many health-careprofessionalslead double lives. Not only do they work in the lab and treat the ill, they also write novels, sing, collect art and build crystal models of nature. Their creativity was the subject of a June 4 symposium on "Medicine and the Arts," sponsoredby the UB Health Sciences Library. ~, .,,-.....,""" -:-- -~""- .... . ~ Carh knew. itation S''. \ ~[ ( ~-~,--- w ~- ~ ~- :.. .. a cour out a most i .. C.. Easing Pain hat makes a musician? It is "neither nature nor nurture; said Karen Miller Allen, associate health sciences librarian and former principal clarinetist for the Mannheim Chamber Orchestra in West Germany. "Boch must be present before musical and other abilities can emerge." A UB doctoral candidate in health psychology, Allen lost the ability to read music after she suffered a head injury . She has long been interested in the psychological and physical aspects of music. "Twenty years ago it was possible only to speculate why music such as Bach's Massin B Minor makes most people feel a certain way. Now it is known that specific chemical changes are taking place, such as the production of endorphins and enkephalins. "Music's role in psychoneuroimmunology is just beginning to be explored, and it is being found that music can influence important changes in this area, too. In Germany, music often is used during anesthesia and during the post-operative period . It has been found that, especially when the patients pre-select their own music and hear it through headphones, that they require less medication, and report reduced pain levels." Alll1JMN 1988 Ci ly the, to writ into a Two U A: -· ·" Ye figure , tionab Notice earth. tanr a A1 gleane, (1896-l and se L "He As me disease TheS~ By CLARE O'SHEA & ANN WHITCHER .... ,.,..."'."r-'"3!!=~-~~,:,£' dent's A1 thur C detecti tives 61 \Yj W. Somerset Maugham mong the world's physician writers, few are as well known as W Somerset Maugham, whose writing reflects the "tremendous bitterness and pain in his life," said John Gaeta, chief of pathology at Roswell Park Memorial Institute and professor of pathology in the medical school. Throughout his life, Maugham was a man of sear ing ambivalence. Born in France of British parents, he was orphaned at IO,taken to England where he was raised by an uncle, and educated at King's School, Canterbury. As a youngster, Maugham stammered and endured the pain of being mocked by other children, said Gaeta. In fact, stammering was to be a lifelong affliction, so severe that the author avoided the telephone entirely, Gaeta said. In Heidelberg, Maugham learned German and acquired a "tremendous philosophical background ."He decided to study medicine and graduated from Sr . Thomas' Hospital medical school in London. His experiences as a young intern in obstetrics are reflected in his first novel, Lizaof Lambeth(1897), the modest success of which prompted him to abandon medicine. The author of novels, short stories and plays, Maugham is perh aps best known for his semi-autobiographical novel Of Human Bondage (1915),the story of a medical stu- BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST by Kat and d Unive A was b, his de; ed the and C them tice, J "1 medic tainec claim< Ir: tions, "P by pe1 and n work, rested ing. 1 interfi dri nk BUFFAU �r's painful maturation. Another famous physician writer, Gaeta said, was Sir Arr Conan Doyle, who created the personality of the ideal !Ctive in Sherlock Holmes. "The literature is full of detecs but none has had the popularity of Sherlock; said Gaeta . Yet Doyle created an interested counterweight to this re of Holmes, who is so smart that his humanity is ques1able, Gaeta noted . "Watson was created for balance. :ice that he's a doctor. He would bring Holmes down to :h. The personality of Sherlock Holmes is not so import as the balance between the two men:' Anoth er writer who infused his writing with observations ned from medicine was the Scottish physician A. J. Cronin >6-1981),who was educated at the University of Glasgow I served as a surgeon in the Royal Navy during World War :-leis an example of tenacity and optimism; said Gaeta. medical inspector of mines, Cronin studied occupational :asesin the coal industry. One of his many popular novels, · ScarsLook Doum, was set in the Welsh coal mining region. Cronin began a London practice in 1926 but quit shorthereafter because of ill healch . He then used his free time vrite his first novel, Hatter'sCastle (1931), which was made > a film, as were five other Cronin novels. Adventures in > Worlds is an account of his years in medicine. As a young man about to begin medical training, William fos Williams showed his poetry to an MIT professor he :w. "Stick to medicine; the professor told him. "Your imions of Keats are very good but you'll need co earn a living~ Williams did stick to medicine, and spent a lifetime in >untry doctor's practice. He also stuck to writing, turning a lifetime of work that would earn him the title of "the st influential American poet of the 20th century." Williams was the subject of the keynote address delivered (athryn Montgomery Hunter . Hunter is associate professor 1 director of the Division of Medical Humanities at the iversity of Rochester School of Medicine and Dentistry. A prolific writer of prose in addition to poetry, Williams : born in 1883 in Rutherford, N.J., and lived there until death in 1963. Later that year, he was posthumously awardthe Pulitzer Prize in poetry for his Picturesfrom Brueghel, ' Ocher Poems(1962). His poetry, which often concerned most ordinary of subjects, benefited from his medical prac·, Hunter said. "Throughout his life, Williams maintained that his :lical practice sustained his poetry and that his poetry sus1ed his daily practice of medicine," she said . "He always med he became a doctor in order to write." In his autobiography, published in 1967 by New Direc1s, Williams wrote: "As l say, often after I have gone into my office harassed :>ersonalperplexities of whatever sort, fatigued physically 1 mentally, after two hours of intense application to the :k, I came out at the finish completely rested (and I mean ed) ready to smile and to laugh as if the day were just start. That is why as a writer I have never felt that medicine :rfered with me but rather that it was my very food and 1k, the very thing which made it possible for me to write." 'ALO PHYSIC IAN AND BIO MEDICAL SCIENTIST Daily, close observation of the mundane and of the rhythms of ordinary American speech often provided the poet with the subject s and themes of his works, as well as the sounds transferred to the dialogue of his characters. And somehow Williams found time to gee it all down on 11 paper. That could mean jotting down poems on prescription pads (some of which are among the 20,000 pieces of Williams' writing stored in UB's Poetry/ Rare books collection). By keeping a sheet of paper rolled into his typewriter at all times, he could even snatch a few minutes of writing in between patient visits. Many important moments of his practice are captured in poems such as "Complaint" and 'The Last Words of My English Grandmother~ Bur it is Williams' first-person doctor stories, including the memorable "Use of Force; that were the most "medical" of his works, according to Hunter. These short stories, written in the '30s and recently collected in paperback, are often told from the point of view of"a crusty, curmudgeony pediatrician." Music Th erapy usic is an extremely personal yet totally universal experience;' said Jill Scott, a nurse who uses her voice and guitar to soothe the pain of the elderly and terminally ill. Interspersing her talk with performances, Scott said "music is a powerful tool char can leave one defenseless. One must respect a person's right to choose the type and amount of music, or even not to hear any music at all. "Some clients respond superficially, some emotionally; said Scott, on-site coordinator of the RN Satellite Program at Fredonia State College . For some it is an intellectual experience, in which the composer's style and technique are topics for discussion. For ochers, it is a physical sensation in which they beat time or move their bodies co the music. The music therapist, she says, "needs to trust music to perform the healing. When music is chosen carefully, words can become totally unnecessary~ In using music therapeutically, Scott first tries to "convey a sense of trust." She then attempts to help the patient express his or her needs and desires. Sometimes, of course, the music is just for fun . Lastly, Scott tries to help her clients find "self-fulfillment and some relief, to help them take care of unfinished business before they die." AUTU MN 1988 �... .., .. . 12 .... ~·,\"t :, cian. Ac Union College, he was a disc jockey, program director and general manager at the campus radio station. At one time, he even considered a broadcasting career . .·.::•-/:\: -: · i, ·, Singing aritone Brian Zunner, D.D.S., the recipient of a B.F.A. degree from UB, performed four songs by Brahms, accompanied by James M. Bigham. Zunner, who has been a soloist with the Buffalo Philharmonic, is in the Dental Residency Program at the Veterans Administration Medical Center of Buffalo. UB assistant professor of clinical pediatrics and otolaryngology Joel Bernstein presented a short recital of diverse works including three lieder by Schubert, arias by Mozart and Offenbach, and a Rodgers and Hammerstein song. He was accompanied by pianist Marjorie Lord. Bernstein is a lecturer and consultant to the Music Department. He has studied vocal performance for the last fifteen years and has performed throughout Western New York. Jan ichard (Dick) Judelsohn finds fulfillment in both jazz and the healing arts. The Buffalo pediatrician, who has hosted a jazz program on WBFO since 1976, seeks to educate the public on jazz from 1945-1965, the focus of his show. Whenever possible, he tries to include commentary about the artists, sidemen, and arrangers, in addition co the date of the recording. In shore, he looks for clues that will give his listeners "optimal enjoyment." Judelsohn, a 1967 graduate of the Medical School and associate UB professor of pediatrics, collects his knowledge through listening to jazz radio programs, talking co musicians, going to clubs and his own playing of the saxophone. Jazz has been his passionate interest since high school when he became interested in the art form as both a fan and a musi- Atm.J MN 1988 Herbert A. Hauptman (p/ q) (q/ p) = (left) (-1)1 /2 (p-l)xl/Z(q-1) he Law of Quadratic Reciprocity, a formula from number theory, is "the supreme example of the art of mathematics," according to Herbert A. Hauptman, UB professor of biophysical sciences. "Youcan see this beautiful formula has a great deal of symmetry just by looking at it. It is well-worth spending the two to three weeks it would cake to prove its validity:' Mathematics is an art, not a science, said Hauptman, who is also president and research director of the Medical Foundation of Buffalo and a recipient of the Nobel Prize in Chemistry. "The great 20th century philosopher and mathematician Bertrand Russell wrote: 'Mathematics possesses not only truth but supreme beauty, a beauty cold and austere, like chat of sculpture, sublimely pure and capable of a stern perfection, such as only the greatest art can show: " Unlike any ocher art, however, mathematics appeals not to the senses but to the intellect, Hauptman pointed out. le is also a more demanding art. "It requires nothing less from the viewer but chat he participate in the creative process itself because the act of understanding requires this participation. The demands on the viewer are great but the satisfactions and the pleasures are correspondingly great." Certain patterns found in the visual, literary, and musical arts, Hauptman said, which "almost always have a regular or repeating motif and show varying degrees of symmetry," are analogous to "the patterns of logical inference, the very essence of mathematics. "It is the recognition and appreciation of these patterns and these symmetries, as well as their significance, which gives pleasure when viewing a work of arc, listening co a musical composition or reading a poetic one, or comprehending usually after a great deal of effort - a mathematical exposition." Hauptman pointed to geometry as a more readily accessible area, combining the intellectual features of mathematics BUFFAlD PHYSIC IAN AND BIO MEDICAL SCIENTIST �and the visual appeal of art. "For many years I've been intrigued by the construction of these extremely beautiful, fascinating geometric solids; he said. "I first made them out of cardboard, then I learned co work with stained glass - using the colors to enhance the symmetry and beauty of the geometric forms. "Was it then only coincidence that my life's work as a scientist was concerned with crystals and their structures which often mimic their geometric counterparts in the world of mathematics?" Transparent models of crystal s created in rose and blue, pale green and white, were projected in slides during Haupt· man's speech. Several were also on display at the Health Sciences Library. 13 Art Collec ting ow does one build an art collection? In the case of Donald A. Lar son, UB's associate vice president for clinical affairs, it came after years of study, observation, and family consultation. Larson said his collection is varied in terms of media, artists, styles and origins. It runs the gamut from comfortably decorative works to tension-producing abstracts . In the view of Larson and his wife, Mimi, art serves to differentiate Ph ysician Wr iter o all those physicians leading double lives as artists, what does the artistic impu lse cost? It doesn't matter, according to Martin E. Plaut, novelist and UB professor of medicine . "le is still better to try than not to try; he said. "Many people who have somehow suppressed the artistic impulse have a feeling of loss, of what might have been. To me, the cost of not trying is greater." Plaut knows of what he speaks. He has published four novels, several under the pseudonym Paul Marttin (a scrambling of the letters of his name), including Cocoa Bll1fles, called "a stunning novel of love, sex, corruption ." He is also the author of The Doctor's Guide to You and Your Colon: A Candid, Helpful Guide to our #1 Hidden Healch Complaint. But he's known failure, too. "I sent off stories in manila envelopes for years; he said. "Editors handled submissions like they were samples of stool. "But there are those little epiphanies, coo; Plaut added. "Like when you walk into a library and find your book listed in the card cata logue." The artistic impulse is not limited co the printed word, Plaut emphasized - or co any of the so-called arts for that matter. "It may be an attempt to grow roses, or to describe a sunset after four days of clouds . Even if it's the way you tell stories or sing in the shower - if you possess it and ignore it, it will cost you more." BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST the spac e within their home. Accordingly, said Larson, "the collection should be controlled in its hanging to provide that differentiation which supports our various needs . Without this selectivity, there would be discordancy both for ourselves and our guests." From the beginning, the Larsons wanted theirs to be a teaching collection for their children . The Larson children would often return to college with a piece of art, bring it back a year later and take another painting or drawing . As a result, Larson joked, "we have a satellite collection in New York City, Austin and Chicago ." Occasionally, the Larsons' taste diverged, but they were able to find common ground nonetheless. "We have learned things about ourselves." Pho tos by Nus baum xhibitors in the Medicine and the Arts symposium were: lvan L. Bunnell, UB clinical professor of medicine and watercolor artist; Karen Flynn-Miller, dentist and mixedmedia artist; Herbert A. Hauptman, UB professor of biophysical sciences and glass sculptor; Anthony Keller, nurse and harpsichord builder; Sanford L. Nusbaum, UB clinical assistant professor of oral surgery and photographer; David ]. Triggle,dean of the UB Pharmacy School and photographer, and Peter L. Weinmann, UB clinical assistant professor of dermatology and photographer . • AUTUMN 1988 �14 TYKE TRIK E Patent,pending device makes paraplegic one of the gang AlITTJMN 1988 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �.. he colorful tricycle chat perky six-year-old Sarah Tangelder rides around her suburban Clarence neighborhood looks similar co ocher "Big Wheels" popular with kids her age. But the dark-haired youngster in the purple sweatsuit quickly explains that her bike is different, special, one-of-a-kind . Equipped with a device based on a patent-pending concept developed at UB, the tricycle provides her with mobility while simultaneously delivering physical therapy for her legs, paralyzed by transverse myelitis. As she pedals around her driveway, she gets one hour of electrical stimulation to her leg muscles each day without having to set aside extra time for her therapy. Until the UB team, led by Frank Mendel, Ph.D., and physical therapist Dale Fish, Ph.D., designed the concept for Sarah, her mobility was limited to a wheelchair. "We felt it would be ideal if she could have therapy as she played; says Mendel, an associate professor of anaromica l sciences in the School of Medicine and Biomedical Sciences . lc's hoped che therapy will strengthen her muscles and cardiovascular system. Aided by health sciences instrument shop director William Tanski, Jr., and retired engineer Robert Kell, the team studied and modified a child's big-wheel tricycle . Handlebars were replaced by hand cranks, which are connected by chains ro the foot cranks, allowing Sarah co use her arms to propel the tricycle. Cams mounted on the common axle linking hand and foot cranks activate microswitches that in turn activate a pair of battery-powered po rtable electrica l stimulators which send electrical signals co selected muscles. Because the speed at which she turns the hand cranks controls the pedals and stimulation co her legs, she can increase or decrease the speed at which she trave ls, but her leg muscles will always be stimulated at the correct arcs of movement. Use of electrical stimulation for therapy is nor new. It's often recommend- BUFFALOPHYSICIAN AND BIOMEDI CAL SCIENTIST ed for individuals who, because of illness or injury, cannot independently exercise weakened or paralyzed muscles. As carefully controlled current flows from a stimulator via electrodes caped co skin, underlying muscle is activated. Although this is an effective form of therapy, it is often inconvenient for a patient to travel several times weekly to a hospital or rehabilitation center where such therapy is typically administered. Even if portable models are used at home, the individual usually reclines or sits during therapy. "The design can also help prevent pressure sores, which develop in chose who sit or lie in a single position for long periods of time," says Mendel. The sores, often referred co as "bedsores; occur IS when lack of body movement cues off blood supply and nourishment co areas of the skin. Sarah's parents, Jim and Melanie Tangelder, report that her neurologist, James Teter, M.D., has detected improvement in muscle strength and increased sensibility since the child began using her special Big Wheel this winter . When it's coo cold to ride outdoors, Sarah switches the tricycle ro a stationary mode, which allows her to ride in place while her muscles receive their alternating JO-revolution stimulation and JO-revolution rest cycles for an hour daily. The stimulation-rest cycles and selection of muscles co be stimu lated can be tailored to the individual's needs . As Sarah gains muscle endurance, the Sarah Tange lder and Frank Mende l, Ph.D. stimulation cycle will be increased . "Being able to connect the portable While Sarah uses her purp le padded stimulator to a mobile vehicle, which the wheelchair to get about much of the paraplegic individual can incorporate in- time, she's able to stand with the aid of to normal activity, encourages consistent specia l, sturdy braces. therapy; says Fish. The UB team estimates that the cost Because the Big Wheel is inappropriate to equip the Big Wheel, excluding labor, for older children and adults, the UB ranges from $1,200 to $1,500. The major team is working on application of their expenditure is for the portab le electrical design to wheelchairs . stimulacors priced from $500 to $800 "The hand cranks could be incor- each. porated near the area of the brake Fish and Mendel be lieve the patenthand les typically found on the pending concept might also benefit wheelchair; Mendel explains. The chair's others whose legs have become paraconventional footrest could be replaced lyzed or severely weakened by certain inwith pedals, which would be connected juries or one of a hose of neuromuscular co the handcranks and electrical disorders . stimulators much as they are on the Big As long as the nerves from the spinal cord co the muscle are intact and the Wheel. Fish notes the team is particularly en- muscles are healthy, electrical stimulation thusiastic about chis work because could be beneficia l. People with multiwheelchairs are the primary mode of ple sclerosis, stroke, or other neurologiclocomotion for many paralyzed people. ally induced paralyses may be candidates Thus, a wide variety of individuals could for this kind of program, they say. receive electrical stimulation while The team hopes there will be a way to engaged in their everyday activities . produce the design for manufacture so For the very young, an all-metal tri- it's easily available in the future for others cycle fitted with the UB design might be like Sarah. sturdier than the all-plastic Big Wheel. The concept was presented in a scienAs Sarah rides with sister Grace, 5, and tific session at the American Physical nine-year-old brother Tom, she's also ex- Therapy Association meeting in Las Vegas on June 14. ercising her cardiovascular system. AUTUMN 1988 �ONE STEP FURTHER 16 Electricalstimulationtechnology movesfrom rehabilitationsetting into the realmof everydaylife By MARY BETH SPINA computer specialist whose lower right leg was partially paralyzed as the result of a spinal inju ry 32 years ago is now able to walk more normally because of the efforts of a research team at UB. The team has adapted existing electrical stimu lation technology, bringing it from the rehab setting to everyday life, to benefit UB staffer Jay Leavitt. (The same team has enabled a para lyzed sixyear-old to ride a tricycle - see accompanying story .) Despite his spina l cord injury, which resulted from a freak tumbling accident in college, Leavitt has maintained an active lifestylebut was somewhat hampered by an inability to lift his right foot from floor surfaces as he walked. "Every 12 days, I had to have the sole of my right shoe replaced - sometimes more often if I walked a· great deal on rough surfaces," he relates. In addition to the cost of shoe repair, Leavitt, who trave ls a great deal in his work, grew impatient with the amount of time it required for him to cross a parking lot or a large carpeted area. UB anatomist Frank Mendel, Ph.D., and physical therapist Dale Fish, Ph.D., worked with Leavitt to reduce his AlJTUMN 1988 decades-old pro blem by electr ically stimulating various muscles in his partial ly para lyzed limb. "We reasoned that if stimulation could be activated by a heelswitch in his shoe that could cause his affected foot to clear the floor, he could walk more normally," said Fish. "And ... save a lot of shoe leather in the bargain," added Mende l. A lthough portable battery-powered electrical stimulators are availab le, they are typically used in clinics as individuals sit or recline during therapy. The team, which includes retired engineer Robert Kell and Leavitt himself, decided to modify a commercial functional electrical stimulation system (FES) called Respond II equipped with a heelswitch to activate stimulation duri ng the "swing phase" of gait wh ich occurs when the heel is not in contact with the floor. The heelswitch is connected to the electrical stimulator which is in tum connected to surface electrodes applied over leg muscles and the top of the foot. Electrical pulses cause the muscles to contract and help lift Leavitt's foot and leg during the "swing phase ." An associated goal is to improve con - BUFFALO PHYSICIAN AND BIO MEDICALSCIENTIST �venience and durability of the system, says Mendel. Ordinary modular telephone cables, equipped with standard snap cpnnectors, connect the stimulator to the electrodes. The cables 17 and connectors allow fast connection and disconnection to facilitate dressing and toileting. The cable system worn under Leavitt's trousers connects to the stimulator and eight AA nickel cadmium rechargeable batteries which are compactly stored in an ordinary camera shoulder case. This arrangement is more convenient than wearing the stimulator on the belt because it does not bind while sitting or block access to pockets. The team concedes there are still some "bugs" to be worked out with the durability of the heelswitch, which must be replaced every two months . Although the basic techno logy for th is system is readily available and used in clinics, few individuals use such systems on an everyday basis. "Companies which developed the FES did not have a person like Jay Leavitt in mind - an active person who will subject existing units to heavy-duty use day after day," says Mendel. The UB team notes that Leavitt is able to walk more normally without lurching and without his mechanical leg brace. Further, the stimulated muscles are becoming stronger and therefore will continue to improve his gait over time. Although his physician, James Teter, M.D., notes improvement in gait and muscle strength in the affected leg as a result of using the stimulator, Leavitt will continue to need the device in the future. Leavitt, who with his wife, Ginger, raises Morgan horses on a farm in Elma, outside of Buffalo, finds the use of electrical stimulation to be a tremendous improvement. "Before I began using the device; says Leavitt, "I was burdened with a heavy brace, and my foot wouldn't clear the ground . Walking was time- and energyconsuming." ~ This research was also presented by the l!I ~ UB team during the scientific sessions of ~ the American Physical Therapy Associa~ tion meeting in June. ! AUTU MN !988 �18 '' yclosporine isn't the end of the (transp lantation) story. The crusade goes on; according to Thomas E. Starzl, M.D., who is known for his work in human organ transplantation . Starzl addressed approximately 250 immunologists and scientists at the 11th International Convocation on Immunology on June 15, sponsored by the Ernest Witebsky Center for Immunology at UB. Delivering the Ernest Witebsky Memorial Lecture at the event, Starzl AUTUMN 1988 said that a new drug, FK 506, cou ld be an improved medication for maintaining the fine line of avoiding donor rejection of the organ without appreciable toxic side effects. Both cyclosporine, which is now given to organ recipients, and FK 506, discovered only a few years ago in Japan, are immunosuppressants . Cyclosporine, however, has severe side effects leading to kidney damage. But, Starzl said, cyclosporine and FK 506, used together, promise to be a significantly improved combination for treating patients who have undergone human organ transplants. FK 506 has not shown toxicity in most animal studies, including non-human primates. Starzl, a professor of surgery at the University of Pittsburgh, noted that one interesting thing about modem drugs is that interrelations with other drugs can be analyzed much faster because of modern techno logy. Thus a major breakthrough in the technique of assessing immunosuppressive potent ial of drugs was the development, by Starzl's collaborators, of a standardized system of employing cell cultures . Using this system, all information now available on FK 506 with cyclosporine A was acquired within six to eight weeks. Within the first year that liver transplant patients were given cyclosporine in combination with steroids, the survival rate doubled and then tripled. There were never any steps backward, said Starzl. "I th ink cyclosporine and FK 506 will be soul-mate drugs because of their synergism (the interaction of the drugs produces an improved effect over those found in each drug separately); he said . "The 64 dollar question is, is FK 506 toxic in humans?" Starzl said . According to Starzl, in rats and baboons it isn't, which leads scientists to believe it won't be toxic in humans . In vitro experiments strongly suggest that FK 506 in combination with cyclosporine A will allow use of both drugs in such low doses that toxicity is extremely unlikely . lmmunosuppression is the part of transplantation that gives this specialty a kind of peculiar identity all its own, ac- ORGAN TRA New drug, FK 5( for avoidin ''I think c and FK 50c because oft synergism,''1 explained. I 64 dollar qi is, is FK SC toxic in hun BUFFALOPHYSICIAN AN[ �cording to Starzl . There are two other areas essential for successful transplantation. One is tissue preservation and the other is tissue matching. Improved tissue preservation techniques have made it possible to preserve organs longer so that a possible matching recipient can be found, and the donor organ can be transported to the recipient. In 1959 scientists described an organ profusion technique (putting fluids through the organ) by which organs could be preserved for several hours . This process has been continually improved. Donor livers could survive for up to 10 hours in 1976, bur using a new profusion solution described in 1987, donor livers now can survive for 24 to 30 hours, allowing transportation between Europe, the U.S., Canada, and South America , as well as between South East Asia and Australia and New Zealand. "The whole conduct of liver transplantation was revolutionized because of this preservation process; said Starzl. "Although this is a truly revolutionary development in liver transplantation; he added, "it's not the end of the line because greed is everywhere . I mean greed in a nice way, beca use no one is ever satisfied. It should not be long before donor livers will surv ive for a week or more.'.' The th ird essential aspect of transp lantation is tissue matching . However, convent ional matching has gone to the back burne r with improved and powerful immunos uppressants, such as cyclosporine A. A cross-matched test in which the seru m of t he prospective recipient is tested with the donor's cells before transplantation is important in preventing a certain number of very early rejections. Starzl pointed out that Felix Milgrom, disti nguished professor of microbio logy at UB, contr ibuted significantly to identifying antibodies in the recipient as the cause for h yperacute rejection; this is rejection of the organ within a matter of minutes after grafting. Cyclosporine and FK 506, no matter how effective in cell-mediated rejection, cannot prevent hyperacute syndromes . There cross-matching seems essential. ~$PLANT ATION 506, shows promise ing rejection ~ 1---1 ---- "'fi -----.! ....;i ~ .., cyclosporine 06 will be drugs their question ,06 imans?'' /\ND BIOMEDICAL SCIENTIST T he final major po int Starzl made was that there is new hope that intestinal transplants will be a 19 reality some day. Prospects for intestinal transplantation include patients with sho rt bowel syndrome, in which uptake of nutrients is severely impaired or impossible because of lack of intestinal mucosa! surface (lining of intestines) . Altho ugh there have been no completely successful intestinal transplantations, Starz l and his team are working diligently to find out what the problems are and how to solve them . Last November Starzl transp lanted small intestines into a two-and -a-halfyear-old girl. The donor intestines, because of the large number of immu nologically reactive cells present in its tissues, were pretreated with monoclonal antibodies to T-cells. The transplant was accepted and was functioning. Then, about three months after the transplant, the child became sick and doctors discovered lesions in her liver. Upon biopsy, they found extended lymphomas, usually associated with the Epstein-Barr virus, a member of the herpes virus family. "We have no idea why the little girl developed the lymphomas in her liver or if it had any connection to the transp lant, but we intend to find our; said Starz l It was of interest that the cells of the lymphoma were of recipient origin . It could be that reactivity of donor lymphocytes to recipient cells facilitate development of lymphomas . T his child was the first one who lived over six months and had a fully functional intest ina l transplant. "Everyone loved this child and was very sad when she died; expressed Starzl. "Bur I feel at least an attempt was made.'.' What is the difference between the bus iness of medicine and the crusade, asked Sta rzl. Th e business of medicine is what successful transp lantation seemingly always becomes, he answered, and the crusade is what hasn't yet been achieved . Intestinal transplantat ion is currently one of the transplant surgeon's majo r crusades . AUTUMN 1988 �20 to have an allergic reaction to gluten and muse restrict it in their diets, they do not form the damaging antibodies which differentiates it from gluten sensitive enteropathy (celiac disease); Kumar explains. There may be many undiagnosed cases among adults who've never shown clinical symptoms of the disorder. "By using our test as a simple screening device, we may find celiac disease is more prevalent than previously believed; .,. __ ""'1 z Kumar adds . The test may also be used ., __ .. ~ to monitor effectiveness of dietary treac'----l j ment for diagnosed celiac patients. § Or. T P. Chorzelski of the Warsaw ~ Academy of Medicine in Poland and his lllliiiiiiiill .. ___ .,~ ~ colleagues initially identified the antibody which is triggered by gluten figures on incidence in the U.S. popula- intolerance. tion . Studies by others suggest it is more A long-time collaborator of Kumar prevalent among certain Israeli popula- and Ernest Beumer, Ph.D., of UB, tions and may be found in one of every Chorzelski found chat the antibody ap300 persons in Ireland . peared in the blood of 70 per cent of To confirm diagnosis, a biopsy is now those diagnosed with dermatitis taken of the mucosa lining the small herpetiformis, a rare skin condition bowel with another biopsy taken six associated with chis specific intolerance . months after the individual is placed on "Ou r research together on skin a gluten-free diet. Additional biopsies disorders with immune system commay be required. ponents led us to investigate the possibiliThe new test, on the other hand, uses ty the antibody would be detected in a small amount of drawn blood . Not on- blood of those with celiac disease as well," ly is it less painful than a biopsy, it is in- Kumar explains. expensive and less time-consuming. Blinded studies conducted in conjunc"With conventional biopsy techniques, tion with Buffalo Chi ldren's Hospita l alternated with dietary challenges of giv- showed the new test revealed the aning the patient gluten products, diagnosis tibodies in the b lood of two previously may take 18 months compared co a day diagnosed celiac patients in a group of or so using our blood test; Kumar 100 persons . Subsequent blood tests on explains . ocher groups with unfailing accuracy Treatment of celiac disease consists of identified diagnosed celiac patients in putting the patient on a gluten-free diet group studies which included patients which eliminates the offending protein . with a variety of other disorders. Those who do not have the autoimmune Also involved in the ongoing studies disorder, which appears co run in as well as refinements in the test are scientists at the School of Medi cine in families, do not make these antibodies. "While some people have been shown Haifa, Israel. TESTDEVELOPED FORCELIAC DISEASE By MARY BETH SPINA A safe, accurate, inexpensive blood test to diagnose celiac disease has been developed by a team of UB researchers in collaboration with colleagues in Poland and Israel. Find ings of studies conducted on the new test were presented by Vijay Kumar, Ph.D ., of UB's Departments of Microbiology and Dermatology, at the 11th International Convocation on Immunology June 16. The convocation was sponsored by the Ernest Witebsky Center for Immuno logy at UB. The test, which has been developed over the past three years, has been shown to be 100 per cent accurate and promises to replace intestinal biopsies (surgical procedures) now used to diagnose the disorder . Kumar says the immunofluorescence test is now being adapted so it can be marketed in convenient test kits in the future . The test is now available at a cost of $40 through UB and a few other medical centers. Test results are generally available within 24 hours, he said. Celiac disease, characterized by weight loss and diarrhea, causes changes in the small intestine due to a reaction to certain proteins called glutens found in wheat and other types of grain. 1n medical terms, the disease is known as a gluten sensitive enteropathy . The test detects antibodies formed in the small incesti!"}ein reaction to the gluten protein. The antibodies appear as cell-tale markers only in blood of celiac patients and those with a rare skin disease called dermatitis herpetiformis. Primarily a disorder found in infants and young children, celiac disease is considered rare, but there are no accurate AlTl1JMN 1988 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST i �21 small general hospitals in rural communities. Or. Nelson is now living at 2734 Miradero Or. in Santa Barbara, Calif. 93105. Steven G. C line (M' 4 7) • of Atlanta, Ga., has retired after serving as chief of radiology at South Fulton Hospital for 25 years. M. Luther Musselman (M'3 7) John C. Inman (M'33) • writes, "I would enjoy news from classmates." Or. Inman retired in 1971due to a coronary. His winter address is 18 Palm Drive, Lake Worth, Fla. 33461. M. Luther Musselman (M'37) i • is president of the Medical Society of the County of Erie for a one-year term . He is also the president of the Buffalo Academy of Medicine. Dr. Musselman is director of medica l education at Millard Fillmore Hospital and an associate professor of Medicine at UB. Carl J. lmp e llitt er (M'46) • writes, "Following a 27-year thoracic surgical practice in Scottsdale, Ariz ., l have been invited to join the Mayo Clinic, Scottsdale, Department of Ca rdiovascular Thoracic Surgery." Linc o ln D . Ne lson (M'46) • has retired after serving 35 years as a medical missionary in the Philippines, where he was directly involved in establishing th ree Raphael S. Goo d (M'48) • was recently elected vice president of the South Florida Psychiatric Society. Or. Good is professor of psychiatry and obstetrics and gynecology at the University of Miami School of Medicine. Yale So lomon (M'50) • a New York ophthalmologist, periodically takes time off from his busy practice and his work at Southside Hospital, where he's chief of ophtha lmology, and his teaching at the State University of New York at Stony Brook Medical School, to go to India, Thailand, and the Caribbean, where, paying his own way and operating gratis, he has restored sight to hundreds of indigent people. Or. Solomon is the founder of a tax-exempt organization, Volunteer Eye Surgeons International (VESl) - with the express purpose of raising funds to cover the costs of travel and living expenses for eye surgeons on onemonth assignments to needy areas of the world. "VESl is unique among the large number of groups involved in providing eye care in developing countries in that it's the only one to cover volunteer expenses." For further information about Volunteer Eye Surgeons International, contact VESI, 375 East Main Street, Bayshore, New York 11706. BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST Stephen C. Scheiber (M'64) And rew Norr is (M'82) Myra R. Zinke (M'SO) • writes, "I am home on disability because professor of medicine in the University of Texas, San Antonio Family Practice Department. of cancer and would love to hear from friends and colleagues." Dr. Zinke resides at 4401 Roland Ave., Baltimore, Md . 21210. Andrew Nor ris (M'82) • of Stephen C. Scheibe r (M'64) • professor of clinical psychiatry at Northwestern Medical School, is president-elect of the Association of Academic Psychiatry . Or. Scheiber is also chairman of the APA Committee on the Impaired Physician, co-chairman of the Fellowship Committee of the 11linois Psychiatric Society, and has been elected a member of the Committee on the Study of Evaluation Procedures of the American Board of Medical Specialties . Fort Co llins, Colo., has published "Cyclotorsional Oiplopia Following Retinal Detachment Su rgery" in the journal Pediatric Ophthalmologyand Sirabismus. Jos eph Ke ith Miller (M'83) • writes, "I have completed a fellowship in EEG and epilepsy at the Un iversity of Illinois at Ch icago. I will be joining the Johnson Neurological Clinic in High Point, N.C. in June." Joseph P. Ri enzi (M'85) • writes that after three years of a genera l diagnostic radiology residency, he began a fellowship in nuclear radiology on July I at Yale-New Haven Hospital, Yale Univers ity School of Medicine. Kenneth Lee Gayles (M'73) • M ichael S. Mill er (M'86) • has been elected to fellowship in the American College of Cardiology. Or. Gayles is an assistant professor of medicine at UB. writes that he is a psychiatry resident at the Medical College of Virg in ia H ospitals . His wife Pamela has just received her master's degree in mental health nursing from the Medical College of Virgin ia. Tone Johnson, Jr.(M'75) • has been appointed clinica l assistant AUTUMN 1988 �22 R ''!:I q.._ pan ahe It's a , CPR, tor of fessio1 The Biornc suppo "It's reside, vance matte prepa1 T h, waso1 schoo' held i goes I: intub: body! heart Wh vance years: cy pro requir "It's quire UB "It ii noise The the ac best ~ "It I Mary "Yo, Pocha I!! ~ g ~ AlJl1JMN 19& BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST BUFFAL �23 IBSIDENTS SUPPORT LIFE > Gettinghands-ontrainingin advanced cardiac life supportwasone of the best r 1rtsof a new orientationprogram,say UB residents i ~ UB placeditself one step 1ead of State regulation s by requiringthe trainingof all of its residents. ~ ·~ r r a common myth that all doctors know 'R, noted Glenda Donoghue, M.D., direcof continuing medical education and pro;ional development at UB. ~he UB School of Medicine and ,medical Sciences gives training in basic life )port skills, but not all medical schools do. It's our perception, and the State's, that idents should know not only basic, but ad1ced cardiac life support," she said . "No teer what your specialty is, you should be pared." ihac's why advanced cardiac life support , one of the topics covered by the medical ,ool's new orientation program for residents d in June . Advanced cardiac life support !S beyond CPR and uses methods such as ubacion, IVs, and medications to keep the :ly functioning for a prolonged period after m failure. XlhileUB's medical school has offered ad1ced cardiac life support for a number of 1rsand it has been required in some specialprograms, chis is che first time it has been 1uired of all residents in all programs. lt's virtually unheard of for a schoo l co reire it of all of its residents," Donoghue said. JB is getting a jump on Scace regulations. It isn't required by the State yet, but there's ise chat it will be," Donoghue explained . ihe new residents were enthusiastic about '. advanced cardiac training, calling it the ;c part of a fine orientation . It totally demystified a code," remarked 1ry Ann Millar, M.D. You definitely need it," added David :hatko, M.D. "I thought we needed it at FAI.O PHYSIC IAN AND BIOMEDICAL SCIENTIST the end of the second year" of medical school. The orientation was offered through the graduate medical education program, which operates under the auspices of the Graduate Medical-Deneal Education Consortium . ln order to attend, residents had co arrive for work a week early and the hospitals agreed to pay them for an extra week. "The hospitals are behind it 100per cent," Donoghue said. The purpose of the program was co prepare the residents for their work in the affiliated hospitals by educating them on the particular issues of practicing medicine in New York Seate, she explained. That includes: Creating a cohesiveness among the residents, who work in several different hospitals. "They're often confused about their relationship to the Un iversity," Donoghue explained. "They know intellectually they're in a University-related program, but they hardly ever see anything of che University." The program also aims co help the residents gee to know each other . Data suggests that if they' re brought into the hospitals as strangers, it takes a week or 10 days for them co function efficiently. If they know each ocher, they work in teams from day one, she explained. "That may be one of the biggest pluses," Donoghue noted. All of the residents from both halves of che orientation were invited to a picnic reception. It was a hot blustery day and the residents joked and mingled and noshed their way co peak efficiency. "It's a good way to get co know each other before you start the rigors of residency," Dennis Dejesus, M.D., a resident in general surgery, said of the orientation . Between sips of an icy drink, Constance G reene, M.D., a family medicine resident, noted that getting co know the other residents was especially helpful to her because she'll be working with so many of them from different departments . Teaching chem to be teachers. In the past, residents went from being students co being teachers overnight without any training. Now they get intensive training. The small-group teaching sessions and presentat ions on how co evaluate students were effective, said Jeff Sceinig, M .D., a resident in surgery. The orientation also videotaped the students to show them using good techniques and co point out flaws. Making su re the residents are aware of the regulatory climate in New York State. The Health Department regulations and credentialing requ irements may be much more stringent than in other states, Donoghue noted. "For a person from outside the country like me, the re was a lot of information," said Bharat Jain, M.D., who is from India. He found the discussion on defensive medicine versus cost control "very progressive." Even American students are unfam iliar with things like DRGs and cost containment . "The nurses would always yell at us about how much money we were running up with these tests,"said Millar. "Nobody ever cold us how much they cost . Now we know." AVTUMN 1988 �THIRTY YEARS UNDERWATER 24 By CONNIE OSWALD SlDFKO olding her breach, the woman plunges below the surface of the frigid ocean water, swimming deeper and deeper in search of abalone, snails, sea urchins, and seaweed. She is one of the Arna - the professional women divers who harvest the fruits of the seas that surround their homelands of Korea and Japan. They may dive as deep as 15 to 30 feet while holding their breach for as long as a minute. Bue what was fascinating co Suk Ki Hong, M.D., Ph.D., a professor of physiology at UB, was the Ama's indifference to cold. In the winter, the water is as cold as 50 degrees Fahrenheit, yet the Ama would wear only cotton bathing suits. About 25 years ago, Hong began co study the Ama . After a decade of research, he demonstrated that they had indeed become acclimatized to the cold, something that physiologi sts had doubted was possible. Hong discussed his findings on the Ama and his other research when he presented the Stockton Kimball Lecture at the Annual Faculty Meeting of the School of Medicine and Biomedical Sciences on May 25. There are 30,000 professional women divers called Arna in Japan and South Korea. The profession has existed for 2,000 years, Hong explained, showing a slide of an ancient Japanese print which depicts an Ama with an abalone knife AUTUMN 1988 clenched in her teeth. Just as their predecessors had done, the Ama studied initially by Hong wore no protective clothing, just cotton bathing suits. Even in the summer, the water never gets warmer than a cool 75 degrees Fahrenheit . "They're exposed to cold all year round," Hong noted. "I went in the water to measure the temperature. I wore a wet suit, but I still felt cold, though the women didn't seem bothered by it." Hong and his colleagues estimated the Ama's daily heat loss to be about 1,000 kilocalories a day. That's an enormous amount - about a third of their daily caloric intake. "This amount of voluntary heat loss is the largest ever measured in human subjects and provided strong rationale for our subsequent studies on human acclimatization to cold;' he explained . The women would voluntarily leave the water when their body temperatures reached about 95 degrees Fahrenheit, Hong said. If asked to stay in the water, they slowly lost consciousness. Hong measured the Ama's critical water temperature, that is, the lowest water temperature the subject can tolerate for three hours without shivering. In general, the fatter the subject, the lower the critical water temperature. Yet the critical water temperature of the Ama was low even if there wasn't a thick layer of fat under the skin, he found . Hong also found that the blood vessels in the divers' hands constricted more quickly in icy water and remained constricted longer than did the blood vessels of those in a control group . Another finding was that these divers had 30 per cent greater basal metabolism rate in winter than did non-divers. All of these factors created a pattern that indicated that it's possible to become acclimatized to the cold. But to be convinced, the researchers had to show that these unique deviations from the norm disappear when cold is removed. In 1977, the divers in Korea began wearing wet suits to insulate themselves BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �25 I Suk K i Hong, M.D., Ph.D. from the cold. This created the perfect laboratory for the second part of the experiment. Through a grant from the National Science Foundation, Hong stud ied the women again and found that by 1982 they had indeed lost their acclimatization. Hong dubbed his talk "Thirty Years Underwater." His career, devoted to studying humans' adaptation to life underwater, has divided itself rather neatly into decade-long segments. In the second decade, he examined the mechanism unde rl ying hyperbaric BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST diuresis, which is the increased urination that occurs when the body is subjected to high atmospheric pressure, as occurs underwate r, for long per iods . T hese experiments were conducted in highpressure chambers in Hawaii and Japan. The diuresis was puzzling because the divers didn't increase their fluid intake to make up for the increased urination, yet the total amount of body fluid remained the same. Hong fo u nd that the primary mechanism for chis diuresis is a suppression of the process called insensible water loss. Normally, peop le lose water vapor through their skin. Hong found chat at higher pressures, the divers lost less water vapor through their skin. His third decade of research centers on explaining, at the cellular level, how the mechanism causing hyperbar ic diuresis works . He and his colleagues at UB have constructed a specia l mini-hyperbaric chamber to study sodium transport in cells under high pressure. The experiments so far indicate that high pressure may indeed interfere with active sodium transport, Hong said. AUTUMN 1988 �26 ext year's Stockton Kimba ll Lecture will be delivered by this year's winner of the Stockton Kimba ll Award, John R. Border, M .D., who is acknow ledged as one of the fathers of modern trauma surgery. Border, a professor of surgery at UB, pioneered ground-breaking treatment methods that dramatically improve the chances of surviva l of patients who suffer severe multiple trauma, such as occurs in traffic accidents . "Few surgeons are recognized as having ch anged a n d imp roved their disciplines; said Lewis M . Flint, Jr., professor and chairman of surgery, as he presented the award. "Dr. Border has improved his discipline nationally and internat iona lly." Several other awards were presented during the annual meeting. Michael E Noe , M.D., clinical associate professor in social and preventive medicine and clinical assistant professor in medic ine and family medicine, received the Dean's Award for his leadership in the Graduate Medical-Deneal Educatio n Consort ium, for his leadership at Buffalo Genera l Hospital , and fo r h is teaching contributions . Distinguished Service Awards went to: Glor ia L. Roblin, Ph.D., clin ical professor of psychiatry; John W. Cudmore, M.D., clinica l associate professor of surgery; John E Moran, Ph.D., associate professor of bioc hemistry; and Peter Nickerson, Ph.D., professor of pathology . The first Robert S. Berkson Memor ial Award in the Art of Medicine was presented to James E Phill ips, clinical professor of medicine . T he award recognizes a volunteer faculty member for excellence in patient care and teach ing. AWARD-WINNING PROFESSORS By CONN IE OSWA LD STOFKO "Few surgeonsare recognized as having changed and improved their disciplines,"said Lewis M . Flint. "Dr. John Border has improved his discipline nationally and internationally." Border,a fat her of modem trauma surgery, received the Stockton Kimball Award at the annual Faculty meeting. AUTUMN 1988 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �27 John R. Bord er, M.D. Phillips said he was very deeply honored to accept the award in the name of all the great teachers who went before him. he Louis A. and Ruth Siegel Teaching Awards were presented in four categories: The preclinical award went to John R. Wright, M.D., chairman and professor of the Department of Pathology. Commendation letters were given to Alexander C. Brownie, Ph.D., professor of biochemistry; Murray Ettinger, Ph.D., professor of biochem istry; Leon E. Farhi, M.D., professor of physiology, and T BUFFALOPHYSICIAN AND BIOMEDIC AL SCIENTIST Charles M . Severin, Ph.D., associate professor of anatomical sciences. The clinical award went to Margaret W. Paroski, M.D., assistant professor in neurology. Commendation letters were given to John A. Brach, M.D., clinical assistant professor of medicine; Ralph J. Doerr, M.D., assistant professor in surgery, and Frederick Munschauer Ill, M.D., research assistant professor m neurology . The volunteer award went to Thomas A. Raab, M.O., clinical assistant professor in medicine . A commendation letter was given to Takuma Nemoto, M.D., research associate professor in surgery. House staff and special awards went to Matthew Antalek, M.O., clinical assistant instructor in medicine; Jon B. Bishop, M.D., clinical assistant instructor in surgery; Robert A. Gianfagna, M.D., clinical assistant instructor in medicine, and Sathyazathi Reddy, M.D., clinical assistant instructor in medicine. Also at the meeting, Mrs . Char les Schen, president of the Auxi liary of the Erie County Medical Society, presented a $10,000 check to the school. The money was raised by the wome n's auxiliary for scho larships and unrestricted funds. AUTIJMN 1988 �28 'DEMYSTIFY SCIENCE: GRADUATES ARETOLD By DAVID M. SNYDERMAN B ecause physicians are the health scientists who most regularly come in contact with the lay population, the UB Medical Class of '88 must do their best to demystify science, according co the noted evolutionary geneticist Rebecca Cann. Cann, an assistant professor at the University of Hawaii, was part of the ream char formulated the "Eve Hypothesis~ the theory that claims that all humans share a common ancesror. She addressed the 142nd commencement of the School of Medicine and Biomedical Sciences on May 22. President Steven Sample also addressed the graduates, reminding them how much they are indebted to their parents for making their college and medical school educations possible. The class speaker was Stephen Hughes, who delivered a farewellco and from the class. Along with 140 doctor of medicine graduates, there were 25 doctor of philosophy degrees conferred. At the University's General Commencement, held earlier in the day, National Heart, Lung, and Blood Institute director Claude Lenfant received an honorary Doctor of Science degree. Lenfant, who received his M.D. in Paris, did postdocroral work at UB during the late 1950s. He did work on pulmonary physiology under Hermann Rahn, distinguished professor of physiology emeritus in the UB medical school. Commencement speaker Cann emphasized the need for physicians co be educators. This need exists, she said, because mosr Americans lack scientific knowledge. This knowledge gap is seen in the inability of many Americans co understand scientific theories, including Cann's own research on evolution. Cann recently was part of the team which "concluded that modern humans can trace the evolution of (mitochondrial) genes to a single female who lived in Africa around AlJfUMN 1988 200,000 years ago; she told the graduates. Known popularly as the "Eve Hypothesis~ the theory indicates that all mankind shares a common ancestor. Cann noted that "mitochondrial genes differ from classically defined genetic systems in that they are exclusively maternal in their mode of inheritance; meaning that all of an infant's mitochondria and their accompanying genetic material come from the mother. BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST �29 A bove, Rebec ca Cann, a memb er of the t ea m t hat f o rmulat e d the "E ve Hypot hesis," spoke at th e 142nd comm en cem en t of th e m edi cal sc hool. evidence of our own evolutionary history better known as biological certainty to the general public; Cann said . She also noted that specialists have developed different "jargons and a vocabu lary that provide an efficient mode of communication benveen peers but that also provide an effective barrier quite impenetrable" to understand ing the developments by non-specialists . Physicians "play an important role in the struggle for scientific literacy in the Ame rican public. Your daily activities will affirm the importance of science and techno logy on B human society today," Cann emphasized . ; She also noted that many college biology ~ students form their attitudes about science i very early in life. "These attitudes largely stem from their exposure to TV and their family physicia ns; she said . Cann instructed the graduates to "use your cited the Office of Technology Assessment's special ab ility and your everyday working report for the National Science Foundation know ledge of the human body to help foster that states that "somewhere between 43 and a bette r understanding of the biolog ical 45 per cent of high school-educated closeness which we humans share." Americans do not believe in human In order to help educate as many peop le as biological evolution and estimates that even possible, Cann urged the physicians to "read, about 25 per cent of college educated travel widely, and talk, not just to your colAmericans hold similar views." leagues but to community organizat ions, It is in light of this that physicians shou ld do everything possible to "make the physical school boards, polit icians, an d lawyers about i Mitochondrial genes "code for a small number of proteins that function in the production of energy for the cell."Cann said the importance of this is symbolized by biological essayist Lewis Thomas's statement that "you cou ldn't lift a finger or think a thought without those genes." However, Cann noted, much of America's population can't fully understand the implications of this type of scientific research. She BUFFALO PHYSIC IA N AND BIOMEDI C AL SCIENTIST AUTIJ MN 1988 �30 your informed (scient ific} opinions." Sample reminded the graduates of the large debt chey owe their parents for encourag ing them co pursue an education as well as seeing them through their schooling, both financially and emotionally. According co Sample, graduation "is an excellent time for you co express appreciation to the many individuals whose leadership, loyalty, and support have played such a significant role in helping you co reach your goals~ Sample feels chac it is imporcant to recognize thac "che individuals who are unquestionably rhe most important members of chis team, and who are deservedly the proudest of all on chis wonderful day are your parents, who throughout your lives and your lifetime educational process have provided direction and support." His sentiments were echoed by the dedication of the annual yearbook, The Iris, to "our parents" by rhe student body. The dedication was presented by yearbook co-editors Lisa Benson and David Brock and accepted on beha lf of all parents by Dr. and Mrs. Dav id Greene, rhe father and mother of a member of the graduating class. Brock said that the graduating class decided co dedicate the yearbook to parents "for instilling the values of caring and self-sacrifice and nurturing our love of learning; for pro• viding emotional and financial support and encouraging us when we needed it most, for giving of your selves so chat we could give to ochers and for just being the re." The class speaker, Stephen Hughes, suggested chat graduates shou ld link their alumni donations co pet causes. "For four years we have complained about our lack of power as medical school srudents; Hughes said. "Each of us has things in the curricu lum or about our education we would like co see improved. I am suggesting thac when you give - and I do encourage you co give - you make your suggestions known, and judge your futu re donations by che response to your suggestions." The graduates were welcomed into the alumn i association by Franklin Zeplowicz, president of the organization . AUTUMN 1988 The Hippocratic Oath was administered to t he new physicians by John Naughton, vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences. The 165 proud new graduates received their diplomas and joined the ranks of more than 4,500 alumni. "This bu ilding is impo rtant if we're going co continue to develop as a majo r biomedical research center; said John Naughcon, vice president for clinical affairs and dean of the medical school. "\Y/eneed facilities and equipment that will provide for ou r immediate needs for development and for a possibility of expansion over a 10-year period or so." SCHOOL PLANS NEWLABBUILDING T By LISA JOSEPHSON J use when you thought the sawdust had seeded, the UB School of Medicine and Biomedical Sciences is planning co build a $50 million research building that will contain approximately 150,000 nee square feet. The building will be 50 per cent larger than the Cary-Farber-She rman addition, which was completed in August 1986. Ir will be almost as large as UB's Recreation and Athletics Complex. The new building will consist primar ily of laboratory and research space. The building probably will be located somewhere co the south of the present medical school complex. It will connect to the Cary-Fa rber-Sherman complex, but there is almost no vacant land nearby, so exactly where to locate che new building poses some problems. Valdemar lnnus, UB associate vice president for resource planning, said the specific site will be decided by the architectural firm. Medical schoo l officials are currently in the process of developing an outline describ ing what activities will be housed there, said Innus . The Ca ry-Farber-Sherman addition, which cost $19 million, was said to be "the cornerstone of the medical schoo l's expansion program ." Alchough medical school officials had hoped che addit ion would satisfy che school's needs well into the 21st century, it does not have the facilities, equipment or space needed for the schoo l co become the major research institution that officialswant it to be. he University had planned a major renovation of the Cary-Farber-She rman complex, but the comp lex doesn't lend itself to the type of renovation requ ired, Innus said. For example, there isn't enough room between the ceiling and the floor for all of the pipes for electricity, gas, water, sewage, heating, cooling, and ventilat ion . Wee labs, which use special fume hoods and sinks, need mo re pipes than office buildings do. Officials want to hurry the building project along because there's a growing need for research space in the medical school. To speed up the process, they've set some guidelines for construction. One is chat the new building shou ld be designed co allow any space to be converted into wet lab space if needed . Another is there should be minimal finishes co provide flexibility. The planning process is expected co be completed sometime this fall, according co lnnus . Ac chat time an archi tectura l firm will be chosen. The schedu le for construction of the building depends on the complexity of the outline given to the architect. Usually co nstruction of a facility of chis type cakes about three co four years. Officials say the building could be completed in as sho re as four co five years or as long as eight years. "le really depends on how long we cake co design the building; said lnnus . "Our approach is co move as quickly as possible through the design process. We will sec ambitious timetables to make the building availab le as soon as possib le." "This is an exciting addition chat makes it possible for us to move forward on plans we've had for a number of years," remarked Naughton . BUFFAIDPHYSICIANAND BIOMEDICALSCIENTIST �31 Frank Schimpfhauser, Ph.D. , assistant dean and director of the Medical School's Education Development and Research Unit, received a 1988 Chancellor's Award for Excellence in Professional Service. A member of the UB staff since 1976, he has helped his faculty apply for federal grams, including several subsequently awarded for research in cancer education and cancer prevention. He served as Faculty Senate secretary for two years and chaired the senate's teaching quality committee for two terms. He also oversaw a review of the Gifted Math Program. Schimpfhauser has co-directed the summer development program for new and recently hired faculty for the past five years. He has published articles on medical education and evaluation and teache s two graduate courses through the Department of Social and Preventive Medicine, where he is associate professor. Schimpfhauser holds his Ph.D. and M.A. degrees from Ohio State University. He received his B.S. from UB in 1965. Russell W. Bessette, M.D., D .D.S., has been appointed head of the Division of Plastic Surgery at the Buffalo General Hospital and UB. A member of the Buffalo General medical staff since 1981, Bessette has broad clinical and research experience and an avid interest in re-establishing graduate education programs in plastic surgery. Bessette will continue his active role in UB's Health-care Instruments and Devices Institute (HID!) as director of the IDEA laboratory at Buffalo General. He also holds faculty appointments in the Department of Surgery and the Departments of Oral Medicine and Oral Pathology at the University. C h ar les F. Dewitz (M'14) • who practiced medicine until the age of 100, died June 29 at the age of 103. As a teenager, he worked for one of the doctors who assisted in treating President William McKin ley when he was shot in 1901, and who treated Mrs. Jefferson Davis, the wife of the president of the Confederacy, in 1903. Dewitz opened his own practice in 1921.He closed his office when he was 92, but continued to see a few patients for eight more years. He is survived by two sons, Charles S. and Robert G.; a daughter, Esthe r D. Eddy; nine grandchildren, and nine great-grandchildren . Frank Schimpfhauser, Ph.D. Peter T. Ost row, M.D. , was moderator for the 22nd annual John J. O'Brien, M.0., Research Symposium held at Mercy Hospital. He is associate dean for curricular and academic affairs and associate professor of pathology at UB. The patient medication information sheets written by sophomores Craig Na rin s and Laura Nic ho lso n were the top entries in the annual c,ompetition held in the spring by the Department of Pharmacology and Therapeutics. Eugene R. Mindell , M.D. , professor of orthopaedic surgery, was named president-elect of the Musculo skeletal Tumor Society at the society's recent annual meeting in Minneapolis . DEATHS Linda Hawkin s, M.D. , Ph.D. , assistant professor of psychiatry, received the 1988 Hyman L. Levin Award at the annual luncheon of the Mental Health Association of Erie County. She is a psychiatrist U and director of the Department of Psychiatry's Education and Training/Medically Ill Chemical Abuser s Program at the Buffalo Psychiatric Center. BUFFALOPHYSICIAN AND DIOMEDICALSCIENTIST Francis R. Daniels (M'24) • died suddenly Oct. 20, 11987,from a heart attack at his home in Sama Ana, Calif. Dr. Daniels practiced general surgery in Rochester, N.Y., until 1954. In 1955, he moved to Sama Ana, where he practiced until 1981. He is survived by his wife, Irma, a son, Dr. Mar cel F.Danie ls, and a daughter, Chantal. Mauri ce B. Gordon (M'34 ) • died on July 31, 1987, in Brunswick, Maine. He was superintendent of Cleveland State Hospital until 1951 when he became director of the Veterans Administration Mental Hygiene Clinic in Newark, N.J. Or. Gordon maintained a private practice and served as assistant director of social rehabilitation at the Postgraduate Center of Mental Health. He is survived by his wife, Ellen, and daughters, Marcia and Judith. Donald M. Secr ist (M'65) • died of cancer on Dec. 6, 1987. After serving as a captain in the U.S. Air Force, he began a private practice in gastroemerology in Aspen, Co lo., in 1973 and continued that practice until his death. Or. Secrist is survived by his wife, Maryellen; a son, Peter, and two daughters, Jennifer and Katie. Georg e W. Fugitt (M'45) • died May 30. The Kenmore urologist was on the staff of Kenmore Mercy and OeGraff Memorial hospitals and had served as president of the medical staffs of both facilities. F-orfive years he was chief of the medical staff at DeGraff and was a member of its board of trustees. Fugitt was chie f of urology at Kenmore Mercy. At UB he was a clinical associate professor of urology. H e is survived by his wife, Betty; two sons, Or. Robert G. Fugitt and David P. Fugitt; a daughter, Diane Fugitt Pugh; a broth er, Warren Fugitt, and two grandchildren. AUTIJMN 1988 �32 TOTAL 1988 AWMNI DONATIONS SPRING $77,980AT ANNUAL REUNION /CLASS DAY CLINICAL he class reunions are a high point of the annualSpringClinicalDay held each year by the School of Medicine 1928 Fromleft, seated: Thelma Brockand RaymondRick/off.Standing:Bmno and Biomedical Sciences. It's a time Schutkeker and Walter King. for chatting about family and mutual acquaintances; catching up on classmates'careers,and talking shop. It's also a time for the traditionalgifts. This year the anniversary classes generously donated $77,980. . $5,750 Class of 1938: ......... $11,460 Class of 1943: ......... $6,900 Class of 1948: .......... $10,930 Class of 1953: ......... $14,400 1938 Class of 1958: ......... seated:Eustace c. Phillies,Leo]. Doll, Walter z. Schwebel, $8,725 Fromleft,Lieberman, Class of 1963: .......... L. ]. Foit, and \\1/alter , ClarenceStraubingerNorman Samuel 5>·doriak.Standing:Charles Donatelli, Vincent L. Rutecki, Russell]. Cla5S Of 1968: · · · • · · · · • · $7, 575 Catalano,SanfordUllman,H. RobertOehler,Carl Hertz,JohnH. Geekier, Harry C. Law, CharlesF. Becker,William H. Tatem, Harold]. Elliott, RichardTerry. and $8,200 .......... Class of 1973: $3,525 Class of 1978: .......... $515 Class of 1983: ........... AUTUMN 1988 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �33 1943 1953 Fromlefc,seated:Erwin R. Chillag,Kevin M. O'Gorman, Morris Unher, amd EdmundM. Tederous.Standing:Marvin L. Bloom,PaulJ. Wolfgruber, Ivan L. Bunnell, Joseph]. Ricotta,CharlesJ. Tanner,PaysonB. Jacobsen, JohnC. Ninfo,JohnR.Williams,AnthonyJ. Marano,and RobertW. Moyce. From lefc, seated: Herbert W. Simpkins, Marvin Wadler,JosephF. Ruh, Thomas E. Comerford,Molly SeidenbergPanner,Jack Gold, RichardJ. Nagel, and Donald L. Ehrenreich.Standing:Thomas G. Geoghegan,John N. Strachan, Curtis C. Johnson,John W. Handel, Milford C. Maloney, Howard C. Smith, Bertram A. Partin, Michael A. Sullivan, Robert A. Peacock,ReinholdA. Ullrich,RobertS. Sobocinski,StanleyL. Cohen,James M. Orr, James R. Coleman, FrancisT. Oliver, Donald 0. Rachow,Harley D. Lindquist, James W. Carlin, and Raymond M. Smith. 1948 From lefc, front row: Lester H. Schiff, Raphael S. Good, Norman Paul, Albert P.Sutton,Darwin D. Moore,EdgarC. Smith, and CliffordW. Gates. Secondrow:JamesG. Borman,Michael Dzubaty, Norman Minde, Judith B. Landau, Oliver P.Jones, Leon Graff, Mary Alice Smith, and David P. Buchanan.Third row: Warren L. Hollis, Cletus J. Regan, Vernon C. Lubs, FrancisPeisel,SeymourZola,Daniel J. Fahey,Robert]. Hall, Myron Gordon,Harry C. Essig,Glenn B. Doan, Ansel R. Marcin, RichardProplesch, B. Edward Heckmann, and Thomas J. Enright. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST 1958 From left, front row: Richard Romanowski, Michael Mazza, Frederick Dischinger,GaspareAlfano, RichardRahner,RichardC. Boyle,and Joseph Bellanti.Secondrow: John W. Float,JohnArmenia,JerryWeisberg,Samuel Shatkin, Marie L. Kunz, Melvin Brothman,Jacques Lipson, and Roger M . Baretz.Third row:JosephZizzi, HaroldZimmerman,ReinhardtWende, Alfred Stein, Gerard Guerinot, Franklin Zeplowitz, Eugene Friedberg, RichardD. Wasson,John J. Giardino,Leo Kane, Dominic Falsetti,James S. Williams, RobertC. Dickson, ElroyE. Anderson,John P.Murphy, Lucien Potenza,and Lloyd H. Leve. Fourthrow: RobertJ. Perez,Franklyn Campagna, Thomas G. Cummiskey, BensonEisenberg,Morton Spivack, and Michael Genco. At.rrUMN 1988 �34 1963 1973 Fromleft, front row: JosephC. Tutton,John Schriver,Mike Sullivan,George Fromleft, seated:RobertLaMantia, PaulKuritzky,SharonKuritzky,Jeremy Lockie, and Joseph Herbstrict.Middle row: Albert Maggioli, Anita ]. Cole, and Stephen Nash. Standing: LeelandJones, RobertFugitt, Patrick Herbert,FrankV DeLaus,AnthonyFoti,CharlesS. Tirone,David Malinov, O'Connor, David H. Breen, and Joseph Mylotte. Robert8. Spielman,and Donald Levine.Back row: John LaMar, Richard B. Narins, William Heyden, LawrenceSobocinski,John R. Fanelli,John Wadsworth,Jason E. Rudisill, Stephen Joyce,and Ernest Fatta. 1968 1978 Fromleft, front row: RaymondMarlin, Thomas]. Cumbo, Sara R.Sirkin, RobertA. Milch, BruceGesson,and GeorgeCohen. Middle row: PaulS. Schulman,Kenneth Jewel, John Gold, Stephen Edelstein,Julian Karelitz, Harold Kulman, and Kenneth Eckhert. Back row: Peter A. Mansk)', Jonathan Reynhcut, Lawrence]. Dobmeier,Brian Joseph, Robert White, and Gerald Daigler. Fromleft, front row: PaulParoski,Mathew O'Brien, RonaldSomogyi,and John R. Valvo. Second row: Richard Elman, Gregory Roberts, Roberta Meltzer, Elizabeth Doherty, Lois Polatnick,Judith Baron-Stone,Franklin Gillig, and Covia L. Stanley. Third row: Gary Eggleston,Steven M. Seidman,]. Thomas Amo, Mario Santilli, FredH. Geisler,RichardSternberg, SimonShaham, PaulWopperer,and Nelson Isada.Back row: HarveyGutman, Stewart Altmayer, Stephen Gawronski, and Alan Koslow. AUTUMN 1988 BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST �35 1983 From left, front row: Galvin Andmon, Borys Loza, JonathonA. Graff, ElaineHuber,Sue MeyersTanbakuchi,and FrankMezzadri. Secondrow: Gwen Nichols, PatriciaFlanagan,Jill Lindner, Andrea Manyon Wild, SharonAlger, YoungheeLimb, CatherineGood/ell.cw, and KarenHorowitz. Thirdrow: Mark Schwager,RichardAmiraian,MelindaS. Cameron,Robert Smolinski,Stephen Kinsman,James E. Wild, RobertStall, Kenneth Zimmerman, Neal Smith, RichardCollins, Michael Michotek, PeterAccetta, Kevin Ferentz,John Feldenzer,Carl Grant, Michael Cane, Marc Levine, and Ronald Marcus.Back row:Allen Rosen,Mark Venditti,and Frederick McAdam. NEWOFFICERS ELEOED TO MEDICAL AWMNI GROUP aul H. Wierzbieniec (M'74) ha s been elected to a one,year term as president of the UB M edical Alumni A ssociation. Other officers are Joseph L. Kunz (M'56), vice president, and Charl es S. Tirone (M'63), treasurer. Wierzbieniec, an orthopaedic surgeon , is clinical instructor of orthopaedics at UB . Kunz, a clinical assistant professor of medi cine at UB, is a specialist in interna l medicine with su bspecialties in gastro enterology and endoscopy. Tirone is a clinical assistant professor of radio logy at UB. BUFFALOPHYSICIANANO BIOMEDICAL SCIENTIST From left, Eugene Be l trami, Robert Patt e rson, and Harold Brod y . JAMESPLATTWHITESOCIETY FORMSEXECUTIVE COMMITTEE he James Platt White Society has formed an execut ive committee made up of society members . T he purpose of the comm ittee is to help guide the society in the nurturing of the medical school, both financially and emotionally. Dr . Robert Patt erson ha s been named chairman . He is joined by Dr . Eugene Beltrami, Dr . Harold Brody, Dr. Marvin Kurlan, Dr . Richard Narins, D r. Clayton Peimer, Dr. Richard Romanowski, and D r. Robert Bernot. Membership in th e society is open to those contrib uting $1,000 to the schoo l an, nually . Currently, ther e are 66 member s. Those interested in mo re information regarding the society can contact any board member . AlJfUMN 1988 �36 OCT.13 OCT.20 ................... T he H arrington Lecture will be held at 4 p.m. T hursday, Oct . 13, in Butler Audito rium . Edwin D. Kilbourne, M.D., Distinguished Service Professor of Microb iology at Mt . Sinai School of Medicine, will speak . Kilbou rn e is a member of the National Academy of Sciences . "Elevated Cho lesterol: A Public Health Crisis?" will be the topic of a conference sponsored by the UB Schoo l of Medicine and Biomedical Sciences. It will be held from 1 to 5 p.m. Thursday, Oct . 20, in Butler Aud itorium. Registration is at 12:30 p.m . For more information, call 831-3714. . AD IMPLIEDNO ENDORSEMENT he Buffalo Physician and Biomedical Scientist, Volume 21 #5, carried an advertisement for Ph ysicians for Social Respon, sibility that caused concern among some readers. While we have previously covered the activities of this group, to which a number of Medical School faculty belong, we had never before run an ad of thi s nature that invited membership . Did this constitute an endorsement of the group on the part of the University, we were asked? The answer to that, of course, is no. The ad was run through a misunderstanding on the part of the Director of University Publications who at that time was func, tioning as interim editor of the Physician. The ad was brought in by a faculty member and the interim editor assumed that since the professor has been referred by the Medical School Office that referral somehow indicated an approval to run it . This was an error because when the magazin e appeared, the dean was sur, prised to see it. In any case, the respon sibility is that of the in, terim editor and the appearance of the ad was not meant to state or imply an endorsement on behalf of the Univer sity or the School of Medicine and Biomedical Sciences. • T ��BUFFALO PtiX§!~~ State University of New York at Buffalo 3435 Main Street Buffa lo. New York 14214 c. K. HUANG BA 57 TREESROOKer. WILLIA SVILLE NY 14??1 -- Address Correction Requested Non-Prof U.S. Po" PAID Buffalo.l Fnm11 N �Profit Org. Postage lo, N.Y. , No. 3JJ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Autumn 1988 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1988-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v22n03-1988-Autumn Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Table Of Contents A list of subunits of the resource. East Meets West Tyke Trike Classnotes Research Medicine and the Arts Medical School People Alumni Events Date Created Date of creation of the resource. 2018-11-12 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v22n03 Extent The size or duration of the resource. 41 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1988 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/8da3556d698c9e5d32463827512169d4.pdf 566020955cb0948d0fab04977a2bda6e PDF Text Text �--:--- I �VOL. 25 , NO. 4 ....................................... . .......................... . ........ . ....................... AUTUMN 1991 IJ Research II HospitalNews II TheResignationof NealRzepkowski.Forced out of Prescriptions for pain havechanged, andso havedoctors'attitudes aboutthis major patient complain t. Page20. Brooks Memorial Hospital in Dunkirk and caught in the storm of controversy that followed the release of the CDC's new guidelines governing HIV-infected health care workers, Neal Rzepkowski is a physician at peace with himself and his life. IEJInWhoseHands?The Patient Self-Determination Act should put patients more firmly in control of their own medical destinies. m Congratulations . YouHaveBeenAccepted! Getting into UB medical school is more com petitv e than ever. E3The Classof 199S. A special photo directory insert of the School of Medicine and Biomedical Sciences' entering class. E!J Ending the Agony• epidemic of pain. EJMedicalSchool EiJAlumni TheHopeClinic lets UB's medical studentsgive backlo their commu nity. Page24. ew techniques to treat the mPeople mClassnotes *TheJamesPlattWhite Neal Rzepkowski, M.D., speaks out onthecontroversythat cast himhis jab. Page 6. Societylavndtes its "'Thotsancl at a Thotsancl" campaign.Page28. �···· ··················· ··· ······ ············· ···•·· ········ ··············· ······· ·· 11 ., ' . Studyshowspetdogs aremorecalming thanclosefriends is that subjects with their pets presen t were apparently less psycho logically threaU!ned than were subjects with their friends present or subjects withou t a comp2mion," the researchers wrote. + he presence of man 's best friend - the four-legged variety - is a more calming influence during the performance of a stressful, evaluative task than , that of a close human friend, UB research ers have found. The researchers believe the resu lts of the study, published in a recent issue of the Journal of Personality MyFriend and Social Psychology,can be amibuted to the fact that dogs are seen as non-judgmental and non-evaluative, while friends are not. The study was conducted by Karen M. Allen, Ph.D., director of training for the Rehabilitation Research and Training Center on Community Integration of Persons with Traumatic Brain Injury; James J. Blascovich, Ph.D., director of the Center for the Study of Behavioral and Social Aspects of Health; graduate student Joe Tomaka, and Robert M. Kelsey, a post-doctoral fellow. The researchers measured autonomic responses of 45 women who reported close relationships with their pet dogs during two sessions in which the subjects performed stressful menta l arithmetic tasks. With pets present, participa nts' autonomic responses remained at baseline while performing the mental arit hmetic tasks. BULwith friends present , participants ' autonomic reactivity increased dramatically. "Our interpretation of these findings e B U FFA. L O PHYSIC I AN B Y SUE W U ETCHER UB1~esearcher receives gra11t fromACS UB researcher has received a $240,000 grant from theAmerican Cancer Society to study the relationship between diet and the development of cancer. ~ Jo Freudenheim , Ph.D., assistant professor of social and preventive mediC"ine, will conduct three studies under the two-year grant. One will examine the role of dietary intake in the development of premeno pausal breast cancer, endometrial cancer an,d pros tatic cancer by focusing on information on dietary intake and health and persona l factors collected in interviews with residents of Erie and Niagara counties with cance r and a group of matched controls. The sLUdywill look at the association betwe,~n the cancers and the intake of fat, calories, carotenoids, vitamins, fiber, zinc and cruciferous vegetables . A second study will focus on 58,000 older, llong-tenn New YorkState residents who completed a questionnaire in 1980 about their health and personal factors. "The group is being followed through the New York State Tumor Registry, " Freudenheim noted. "Sufficient cases have now occurred to allow for a prospective analysis of dietary factors in cancer of the lung, breast, colon, rectum, ovary ,endometrium and prostate. " The third study '<viiilook at data on controls from the first sLUdyto examine the correlation of factors such as energy expen ,diture, occupational time and lei- A.NO B I OMEDtCA L SC i sure time with dietary practices. Smoking, reproductive history and socioeconomic status also will be among the + factors to be studied . - BY A RTHUR PAGE Innovative technique usedto repairaneurysm eurosurgeons at the State University of New York at Buffalo used an innovativeendovascu lar procedure LO treat a cerebra l aneurysm in a mother of eight , eliminating the need for risky surgery and giving the woman a "second chance " at life. The neurosur geons , led by L. Nelson Hopkins, M.0., chair of the neurosurgery de partment at UB and chief of neurosurgery at Millard Fillmore Hospital, threaded a micro-catheter through the patient 's blood st ream and into the aneur ysm . A small coil of platinum wire was placed in the aneurysm and a low-voltage banery current passed through the coil , causing a clot to form and seal off the aneurysm. The coil was released within the aneurysm and left I EN TI ST A U TUMN 1 9 9 1 �····•·· ··········· ····················· · ··········································· · ······ m . WU .. low-up Clin ic and director of the oncology section at The Children 's Hospital of Buffalo. Also on the team were Michael A. Zevon, Ph.D., Geoffrey Lowrie, NinaSeigelstein and Brenda Hall. The study focused on 25 male and 35 female former cancer patients 18 or older who had been diagnosed with cancer five or more years earlier. Among the 39 children born to the male former patients, three had minor congenital anomalies. The frequency of BY ARTHUR PAGE single anomalies was 7.9 percent, compared with 13 percent for the general population, the researchers reponed. Congenital anomalies occurred in five of the 63 children born to the female former patients. The incidence of venuicular septa! defect as a single malfom1ation was 3.85 he use of chemotherapeutic agents per cent in female children of the white to treat children and adolescenLs with cancer does not appear to female formerpatients,ascompared with increase the frequency of con- 0.034 percent in white female infants in genital anomalies in their chil- the general population. The incidence of tetra logy of Fallot was 2. 78 percent dren, according to researchers among the male offspring of the white affiliated with UB and Roswell Park female former patients, compared with Cancer Institute. 0.024 among white male infants in the They report in the lead article in Lhe July 18 issue ofTlie New Englandjoumal general population. Both women who gave birth to a child of Medicine that with Lhe exception of one agent, dactinomycin, a higher inci- with a cardiac defect had received + dence of congenital anomalies was not dactinomycin in chemotherapy. BY ARTHUR PAGE found in a follow-up study of 60 former cance r patienLs. In the case of dactinomycin, structural congenital cardiac defects were found in 10 percent of the infants born to women treated with the drug compared with a 0.60 percent rate for infants in the general popu laLion. Daniel M. Green, M.D., professor of pediaLrics and chief of the oncology secLion in the department of pediatrics at Roswell is principal author of the study. Green also is director of Roswell's Long-Term Fol- behind to permanently seal off circula tion and protect against future hemorrhage. The neurosurgeons from UB and Millard Fillmore are only the founh group in LhenaLion to successfully perform the procedure on patients. "I feel like I'm lucky to be alive," says Jacqueline Talada, 49, who suffered from progressively severe headaches and seizures due to a "giant aneurysm" at the base of her brain. "I feel I got a second chance to be alive, Lhanks to Dr. Hopkins and th e medical field." Talada underwent the procedure July 29 at Millard Fillmore under local anesthesia. Discharged three days after the procedure, she has had no more seizures and her headaches have improved tremendously. The new procedure was developed in 1990 by Dr. Guido Guglielmi, M.D., and a team of neuro-radiologists at the University of California at Los Angeles. + SUE ~· ,. . BY ·~ sample ofBuffalo households. Also working with Trevisan, associate professor of social and preventive medicine and acting chair of the UB Department of Socia l and Preventive Medicine, were Vittorio Krogh, M.D., Linda Klimowski , Susan Bland and Warren + Winkelstein, M.D. Chemotherapy in childhood notshownto increase birthdefects ETCHER Lackof siblingsincreases riskof hypertension eing an only child increases your risk for high blood pressure, accordi ng to UB researchers. Ina study of 1,472 whiteadulLs, researchers found that the mean systolic and diastolic blood pressure and prevalence of hypertension were higher in those without siblings. In the case of systolic blood pressure and prevalence of high blood pressure in both sexes and diastolic blood pressure in men, the differences were statistically significant, Maurizio Trevisan, M. D., and colleagues reported in a letter in The New EnglandJoumal of Medicine. The UB study focused on 6 76 men and 796 women, age 20 to 70, who participated in a survey involving a random BU,.FALO PHYSICIAN ANO BIOMEDICAL S CIENTIST AUTUMN I SI 9 I 0 �1&n1·················· .... . ···· ~ SistersHospital begins modernization proiect ork began in mid-October on Sislers Hospital's $42 million modernizalion projecl. The 28-month project will provide enhanced patient treatment areas and improved seuings for visitors and employees. Major components of the project include new coronary and intensive care unilS, new operating rooms, ambulatory care wing, emergency depanment, head and neck center and a new lobby and elevator bank connecting corridors for easier access to all areas. The project will also address major code and safely issues along with increased cool ing capacity and air conditioning and medical gas systems. "Much of the work will be done within the existing structures so those passing by the hospital will not be aware of most of lhe work," said Timothy J. Finan, Sisters' executive vice president. The projecl will begin with lhe addition of lwo floors atop the hospital's skilled nursing facility to house a ..t;J ....,._I I new 16-bed ICU and eight-bed CCU. A ·' _! connecting corridor will allow for direct .;..W... access between the new intensive care units and operating suite to be constructed. Sisters will also consolidate its laboralories to the hospital's fourth floor. The present operating room space is slated for renovation to house pre-admission, urology , endoscopy and outpatient surgery. The project also includes construe- fl 0 BUf",.A.LO PHYSICIAN · ········································ · ············· tion of a 10, 760-square-foot building behind the hospital to accommodate the hospital's information systems and finance depanmenlS. Also scheduled for renovation and realignment is a significant portion of the hospital's first floor. A new main lobby will be constructed at the present location of the finance and information systems departments. Inpatients and visitors will pass directly through the new lobby to a new bank of elevators linking them directly with patient floors, surgery and critical care units. OutpatienlS will use the new entrance and connecting corridor to a completely remodeled ambulat0ry care wing which will incorporate the emergency department, outpatient department , women's services, corporate health services and satellite radiology and phlebotomy labs. The emergency department will also gain a new entrance to enhance traffic flow for walk-in patients. The project was designed by the Rochester firm of DeWolff Partnership, + Architects. ffi §~ ffl --,i~: Herzigto heodbone morrowtronsplontotion unitot Roswell eoffrey P. Herzig, M.D., has been appointed d irector of the Divisions of Hematologic Oncology and Bone Marrow Transplantation, Department of Medicine, at Roswell Park Cancer lnstitute. Former professor of medicine, division of hematology/oncology and head of the bone marrow transplantation program at Washington University School of Medicine in St. Louis, Herzig is an active member of many professional organizations, including the American Federation for Clinical Research, American Society for Clinical Oncology, American Association for Cancer Research and American Society of Hematology. He has written over 80 scholarly papers, monographs and book chapters. j:~:;!;~ ~-[ ~-___ .... ~-~r. W;~ 8 ►-- ~ ~~ ~ fj§ · ······· ell ~~ b f~~ ~o~ .Aili~~ Artist's rendering of Sisters Hospitol's newlobby. ANO 8tOMC:DICAL SCIENTIST AUTUMN 1 9 9 1 �- -------- ······ -- · ···· · ············ -- -- - -- · ················ A Phi Beta Kappa, Herzig received his medical degree in 1967 from Case Weslern Reserve Universily in Cleveland and his medical residency training at Bronx Municipal Hospirnl in New York. He also served as senior invesLigator, Pediatric Oncology Branch, at the National Cancer Institute. The bone marrow transplant program performs both autologous and allogenic transplantations and conducts research designed to improve long-term survival rates for transplant palients. The division of hematologic oncology treats pati en ts with leukemia , lymphoma, myeloma and other hematologic problems and studies the pharmacological and biological basis of disease progression and response. + BGHparticipates in JCOAH test proiect he Buffalo General Hospital has been selected to participate in the field testing of indicators , or "performance measures, " for theJoint Commission on Accreditation of Healthcare Organizations. The Lesting represents the firsl largescale evaluation of theJCOAH 's trauma care, oncology care, cardiovascular care, medication use and infection control indicators. The indicators are designed to support hospital efforts to assess and improve the quality of patient care. Buffalo General will participate in the testing of infection control indicators. Testing is expected to last about two years. The indicator development project is part of a JCAHO project begun in 1986 to modernize its accreditation process. The new process potentially uses both clinical and organizational performance data to measure an organization 's ability to deliver quality health care. BUF' F AL O PHYSICIAN - - -- ---- · ··· --- · ···· --- · ········ ·· ·· ···· BGH joins other test sites selected from volunteer accredited hospitals throughout the nation. Test site activities include evaluating hospitals ' ability to use computer systems to collect indicator data and to transmit the data electronically to the Joint Commission. A second activit y involves evaluating the reliabilit y and validity of the indicators to assess their potential usefulness to improve the quality of patient care and services. + ~ --- - - - ················· - -- • ·····lrBl - a primary physician. Referrals are based on patient need, geographic location and accessibility to follow-up treatment sites. Some of the benefits of the HIP program include early intervention and immediate response Lo potential problems while patients are still hospitalized, according to program counselor Kathleen McDonald, R.N. Early treatment of alcohol-related problems also reduces the chance of patients developing further physical or psychological complications , McDonald said. According to statewide data gathered since H!Ps were implemented in 1989, approximately 25 percent of patients admitted to hospitals have alcohol or drug-related conditions. + BGH adoptsalcohol intervention program uffalo General Hospital is one of 18 hospitals statewide to , developaHospitallnterven~ V tion Program (HIP) for pa- ,, ./. -~ tients with alcohol-re' lated problems . • f The new program , the first in Erie County , offers counseling , education and linkage and referral services based on inpatient screening on des~~~~ ignated units. Screenings con- , ~ :: ,. ff. ~ i~- ·~ff~ ~\\'- - sist ~f. a series of questions admm1stered by nursmg staff with the permission of a patient 's AND B I OM E DICA L · .~ .,;,..V $C1£NT I ST AUTUMN I 9 II I 0 �I eal Rzepkowski'.sstory is straightforward and only slightly bitter. The 40-year-old UB assistant professor of medicine spends his days in the Spiritua list haven of Lily Dale, New York, an oasis of tranquility amid the storms that have gripped his life. Diagnosed in 1985 as being infected with the human immunodeficiency virus the virus that causes AIDS Rzepkowski was thrust into the nationalspotlightlastsummer I �_I , ~-/ ~ r I I-:___/ _JJ_f I< · ~-- LlVin~ wltll tlleconsequences ofilieCDCsre~ulations new ~overnin~ HIV - osit ive pllysldans. �when he became the first physician lo disclose his HIV-positive status under new guidelines governing health care workers infected with the virus. The Centers for Disease Control issued the guidelines last July after months of delays and deliberations. As a result, Rzepkowski was forced lo resign his fulllime emergency room post al Brooks Memorial Hospital in Dunkirk amid a nurry of national press coverage. Rzepkowski does not, al this point, have AIDS, though he is realist ic about the likely outcome. The possibility of an early death, he says, "hangs over my head like the Sword of Damocles." Save for a half-day of work a week at the Immunodeficiency Clinic at Erie County Medical Center, Rzepkowski's practice is non-existent. "l suppose l could start a private practice. l know I would get a lot of I IIV-negative palienlS coming 10 see me. But a private practice and my past experience of having one means that you're on call with a full-time work week, on call al nighlS and up weekends." So Rzepkowski is careful to gua rd his resl and nutrilion. "I'm not going to have a private practice to prove a point." Monitoring and appropriate medical action, he knows, can delay the onset of AIDS. Rzepkowski iscoping with the stresses of sudden celebrity. He is perhaps a little weary of questions posed by yet another interviewer. His story has been reported by the national press, and further probed on talk shows by Oprah Winfrey and Jane Pauley in her "Real Life" series. Today, Rzepkowski feels fine though he's occasionally fatigued and does have hairy leukoplakia - a white, possibly precancerous, patch-on his tongue, "a sign of HIV-positivity/ he relates matter-of-factly. He is above all, an educator on the AIDS nightmare who doesn't shirk from the known faclS,even when they so impinge on the tranquility of the moment. There is no time for easy dissembling when his mission is the truth. "The average time between getting infected and becoming seropositive, and developing symptoms is 10years- that's the average time. Some people take a lot o eu,,.ALO PHYSICIAN longer. But it is thought that more than 90 percent of these people, eventually, given enough time, will go on to develop AIDS." Rzepkowski's own frank statistical analysis may mean he has only a few years left. So often, he notes, the public con fuses HIV positivity with having AIDS ilSelf. "l don't have AIDS. I have HIVpositive teslS. A lot of people confuse that. Like I say, you can be HIV-positive for 10 years before you have the end stage of that virus, which is AIDS." Rzepkowski has owned his small Lily Dale home for four years, living in the century-o ld community for metaphysical education for the last year and a half. He went to high school in Dunkirk, then moved to Troy where he began studying Spiritualism and earned his B.S. from Rensselaer Polytechnic lnsti tute in 1974. Then came medical school at what was then SUNY Upstate Medical Center in Syracuse (M.D., 1978), followed by a fam ily practice residency in Schenectady's SL Clare's Hospital and seven more years as director of the hospital's Family Health Center. ANO BIOMEDICAL SCllNTIST Board certified in Family Practice, Rzepkowski was drawn to Boston's Fenway Community Health Center in 1988, where he could care for AIDS pa tienlS in the sympathetic setting of a gay-run institution. Openly gay, he "wanted to go learn about the virus and care for these patients." In 1990, weary of high renlS and neighborhood crime, he returned to Lily Dale, where he could tend his garden and consider an uncertain future. By this time, of course, Rzepkowski knew he had the virus. "The odds are," he says, that he contracted it "in 1981 or 1982," before the human immunodeficiency virus was isolated and "safe sex" practices were advocated. Slowly he revealed the news to a circle of friends, and gradually lO professional people he thought should know. "In July 1985, I tested positive; the test first became available to the public that month. Wi thin a short time, I told the director of my program and the nurse epidemiologist at the hospital. They were the only ones who knew - at the time, they were the only appropriate people lO AUTU""N 1 9 9 I �----- - ---------- tell. I also had cared for HIV-positive patients ever since the test first came out. I shared the fact that they were not alone and that I was in their same boat. " This was the beginning of gradual disclosures that led to a front-page story in a New Hampshire paper and later, to blockbuster announcements in the local and national media last summer. "It was open, " Rzepkowski ins ists of the subject. "I also shared it \vith a few of my HIV-negative patients. When I applied for the position at the Fenway Community HealLh Center , I told them l was HIV-positive. " "At the end of 1988, I decided it was worth my while to educate the public in an even more direct fashion than I had. I had been giving lectures across the country on HIV-related topics, and had started to share with public groups that I, too, was an HIV-positive person and that peop le needed to put a face on this condition and see that human beings are walking around with this and are perfectly healthy. " Rzepkowski then took up a series of speaking engagements to public groups and medical assemblies, including the New York State Academy of Family Physicians lastJuly. "Just recentl y, I spoke to the Tennessee Academy of Medicine and the Tennessee Academy of Family Physicians. '' During these presentations, I would say, 'I am also HIV-positive.' In July of 1989, I gave a public forum in Keene, New Hampshire, sponsored by the American Red Cross, on AIDS, dealing \vith the blood supply and how you get the virus and how you don 't. There were news reporters there who asked if they could print this, and I said, 'I'm open about it,' and so I was on the front page of the Keene newspaper. "When appropriate, I put this information on my medical applications . The medical application doesn't ask specifically whether you're HIV-positive or not. So I didn't need to bother with that question. They do ask whether I'm capable of performing medical duties which I am. So that was put down. "LastJune , I went for a physical exam which doctors have to do as employees. I told the doctor in Buffalo that I saw, 'Look I'm HIV-positive and you should BU,-fl'ALO PHY SICIAN ANO -- - ~ - -- - --- know that..' When it was time to fill out my application for work, the question was, 'Are you capable of performing your duties medically ,' and he put yes. Asked for other comments, he said, 'You know doc, I have to put down that you're HIVpositive.' I said, 'That's fine."' Rzepkowski 's former employer, Joseph Gatewood, M.D., director of medical services for Spectrum Emergency Care of St. Louis, which sub-cont racts out to Brooks Memorial in Dunkirk to supply them with emergency room physicians, puts it this way: "This is a problem that goes beyond personal freedoms and rights to know. It's question of physicians and their capability of taking care of patients. The point is that the public is so frightened of this as an unknown fear that their demands to know whet her the doctor has a particular illness - when the statistical chance isso small - strikes me as an irrational reaction. It is much more dangerous to have a physician who's suffering a hangover from having had too much to drink the night before. " In applying for privileges at Brooks, Rzepkowski was asked whether he had been taking any medicine regularly. "Well, I had put 'no' on my original application last year. But this year, I am on AZT regularly. The next question is why, and I put down, 'because I'm immune deficient with HIV.' So that is when the administration knew , in April ~ Healtll Care Workers W'rthAIDS S ince the epidemi c ~egan . nearly a decade ago, the..CD C has reported AIDS in the Jol!owing fl.Umb ers of health care. wQrkei·s. ;J"h e numbers ofH IV~ positive het.ith care workers, which are not reported here, of course, .are greater. Nurses•···-·· ····· .. •··••···· 1,~ ;,- Health aides ......... ...... 1,101 Technicians •.•..•...•. .. ... ...1'41 Physicians ......... ........... . 703 ' Paramedics ......... ... ....... 116 Therapltrts ..... ..... .. ......... ~ 19' Dentists/hygienists ..••.•• 17 1 BIOME:DIC-'L SCI 4 ENTIST -- - - - -- of'91. The direct0r of ER and the appropria te doctors in the hospital knew Jor over ayear about this and had previously called the state health department, and had been reassured that, in fact, I was \vithin my rights to work, that I was not a danger to anyone. " Brooks Hospital Administrator Richa rd Ketcham acknowledges that Rzepkowski told the ER director of his condition shortly after he was granted privileges there in April of 1990. According to Ketcham , the administration knewofhiscondition when Rzepkowski completed his reappointment application in the spring of 1991. The piccure darkened, though, following the release of new CDC recommendat ions July 12. "I think the hospital administration became nervous at this point. According to the new recommendations, not law, but recommendations, HIV-positive health care workers should refrain from 'exposure-prone ' procedures. They ultimately left the definition of exposure-prone up to each individual hospital. At the time this came out, I was called by Dr. Joe Gatewood. He told me that umil we get this straightened out, I shouldn't work. 'We' re put ting you on administrative leave of absence.'" According to Rzepkowski , Gatewood requested input from Rzepkowski on what exactly constitutes "exposureprone " procedures, in view of his expertise on AIDS issues. He met with Ketcham, Gatewood and other officials at Dunkirk 's Sheraton Harborfront Inn . "I thought, this is nice, they're wanting my input on what 's 'expos ure-prone .' Well, I got to the breakfast meeting and they said, 'We've come up with a list of 35 exposure-prone procedures we feel you can't do; therefore you can't work in our emergency room. Therefore, wesuggesteitheryou voluntarily withdraw your privileges for an indefinite period of time, or we can dismiss you. But if we dismiss you, you'll have to put this on all your resumes and explain it all if you ever want to apply for privileges again. "'What is your decision, doctor? ' So, of course, my free will decision was to voluntarily withdraw. This looks nice in the paper- that 1voluntarily withdrew, AUTUMN I 9 9 I 0 �bm what would your choice be? 1f I didn 't voluntarily withdraw, I would have The possibility of an early deal gotten fired. " There is some anger in Rzepkowski's voice as he tells his story, but he claims to understand the "human emotions" that precipitated it. "Given the circumstance of a small hospital and their level of education about AIDS, and not having e)cpen input into the 35 exposure-prone procedures, it's understandable that they didn't want me to work there. " Asked to comment on Rzepkowski's story, Ketcham says, "It's a relatively accurate portrayal. I'd like to reiterate that Dr. Rzepkowski has handled (the matter) very well, superbly, in fact. He was honest and open with the hospital. We tried to be open with him. " The hospital 's list of 35 exposureprone procedures was not arrived at by which I'm afraid it is - then it's critical ln Ketcham 's view, the issue of inofficials at the Harborfront lnn meeting, that the needs of health care workers be formed consent is a compelling one in Ketcham states. Rather, they were deter- addressed. Because clearly the risks of the context of exposure-prone procemined before by members of an ad-hoc transmission of communicable disease dures. "Some ER patients are not in a committee appointed by the hospital 's from patient to health care worker are position to give informed consent. In medical executive committee. Members much greater than the other way around. other situations, if a patient chooses his represented "appropriate medical spe"I find it personally very distressing, or her private physician - and knowcialties" Ketcham said, who then pre- as does the board of trustees and the ingly chooses an HIV-positive physician sented their findings to the medical ex- medical staff involved in this issue, that - that is this person's choice. In ER, it is ecutive committee and later to the board HIV is not treated in a scientific manner. usually not a matter of choice. Thereof trustees for approval. Unlike any other disease , it is treated fore, we believe we owe an even higher In commenting, Spectrum's Gate- through the political process. This has obligation to the community in this rewood cited his own many years as an created a paranoia, hysteria, a level of spect." emergency physician. "It's not just a fear unlike that for any other disease. Of the 4,100 individuals who were business with me. My interpretation as Though much of this is unwarranted, sent letters alerting them to Rzepkowski 's an individual physician of the types of the reality is that hospitals must react to condition, 536 chose to be tested. None procedures that the CDC listed in their public perceptions as much , if not more tested positive, Ketcham reports. July document is that probably there are so, than scientific facts. Some may see In Rzepkowski 's view, the public up to five or six procedures that would this as ducking real issues , not being fair needs to be educated about the disease. be truly 'expos ure-prone ' by their defini- to the physician, but I also have an "It's transmitted in certain defined ways. tions, that an ER physician might do." obligation to the 18,000 ER patients who l think it's fearsome because it's ultiHe noted that he wasn 't criticizing were served by Brooks last year. mately so deadly. That's what people Brooks' list of the 35 procedures, nor the "We have tried to stress the educa- fear. But if you really think about it in process used in arriving at them. "I just tional aspects of this issue and the fact proper perspective , yeah, it's a deadly think that they 've listed some proce- that the risks are very small. The level of virus, but it's hard to transmit that deadly dures that , when beuer support and as- awareness is not what it should be. A virus." sistance is given to hospitals and there is much higher level of awareness is needed As he continues his battle for more better guidance from the speciality soci- ifan HIV-positive physician is to work in understanding of AIDS issues, eties and the CDC, some of the proce- an ER, particularly if he is the only ER Rzepkowski knows that "at any time I dures on the list would be taken off." physician on duty at any one time , as is could get sick. My allergies are acting For Ketcham , the dilemma posed by the case at Brooks." up. I ask myself , is this the allergies or do Rzepkowski'scondition has two aspects: And according to Gatewood, "Most I have pneumocystic pneumonia? ls this "First , there is the scientific approach, probably, of the 5,000 ERs in the coun- the end? Those kinds of things are alwhich would clearly indicate that the try, the vast majority have a single emer- ways lingering. But you have to deal with risks are so small as to not even exist. If gency room physician. An ER physician it and live one day at a time, live life to its the move is toward mandatory testingcan't limit himself to certain procedures." fullest." + «I!) BUFFALO PHYS1CIA.N ANO BIOMC:OICAL SCIENTIST AUTUMN 1991 �------------------ U~lli on·rue ·~.. l·leof · · H·· d• cl .·Too · • • 1 - _ · ,r:w • . - - · • IS • .. · • , ·' .,. 0 is What Do You TI1ink? The Buffalo Physician a11 d Biomedical Scientist wants LO know its readers' "Clearly,someth~•Speculiarwasgoing011in that office.'· Clarissa Cui111inghCl(11 , spohespcrsonfor t11e.AIDSAction Co1111cil,..refer1illgto Acer's,{a~/1 of w1ivetsalpreooutitl1L~ and sterilc·tecff11iq11c. -- · . , 11vFloridadentist.Ac~r. 011how s}iewould • "ILis 111ucl1 _mo1·edangerousta have <1'17hys'i-thaf .UP,'heldth~ Medical Center at cian wn~·ssufferinga l_1angover from having Princeton's policy requiring an HIV1nfected s~rgeoh to seek · informed had 100 m11cl1ta d~nk thci,ightbef~r'e."· JosephGatewood,M.D .. directorcf medical consent from his patients, effecscn•icesfarSpectrum£mergotcy Car~ofSt. .tively .-restricting his practice. Louis, which $1tlJ-comr0;c4· 11utt0 Brooks MemorialHospitalto supplythemwith emer- "The i11h ere11trilh1to know-forpaticn(a 11d e co,ifigency'ro~mphysicia1is,011the risks a pdr,ient doGtoralihe_: always bas ta SUPG{__Sed . facesfrom bei11gueatedbyan HIV-positive deniiality . •Tl1edoctordoc;sn't hal!e 10e11tup a signboard,but therehasto be inJonntd consent ph_y~ician .• ~le gai11gto do invasive proceduFcs. 'First'. "Unfortunatl!ly, this dentist ,did dono ha~· is the absolutebedrocnoJmedicine,. not use very strong aseptic techTIJeKimbei:lyBergalis~sof this~11 orlda,rovoidniques, 'did not use rubber gloves, ablc.·• SaiifordK1,vi1t,M.D.• vicr.cl1ainnan:of for in~ance." Louis _H .. Sulli .van, •the f'lational 'founclation.[or~1ifectious - Qis· Secretary of He.. h and Human ease~ Services, referri1'i to Florida de.ntist David J. Acer, who infected five of his patients with tflY before t dying of AIDS in Sel?tember 1990 .. - ~ .. . . · osure . ."'~ ,.... • • ,. --- tho ugh ts on the new CDC gu idelines on disclosure of HIV-posi tive heahh care workers under certain circum sta nces. Please take a few minutes to wr ite down your comments. We will publish selected responses in an upcomi ng issue. Please mail responses to: and BioEditor, The BiiffaloPhysicia11 medical Scientist, State Un iversity of New York at Buffalo, 136 Crofts Hall, Bu ffalo. New York l-+260. or fax the m 716-636-3765. ,;avefelt if herf1hysicianrejuseaLope1fon11 r;yesurgeryo11heraftershuo!Jliim$.hewas HIV-posi¥ve. Her pl1ysicialfdid ;heppera- "An exposure-prone procedure is one where- it Is likely, concpivable, possible that the doctor's blood will g~t into the patient's circulation. That ~n be through an open wound on the patie,;t, a sore on the patient, but the doctor has to bleed fresh blood ~f his into fhe patient, or get a~ instrument bloodied by himseff ;1ndthen, use it on the patient. Now whether you're wearing gloves or not, doctors don 't easil1 ble.ed when tfley're taking care of patients." N'e~I Rzepkowslti , M.D: " "Dcat.his going to catchme with my boo1~0 11. I'm ,wt going to,sitdown·a11a'dwindl~ away•:, 1 have a messageto pass on. The one 41ing thaL1 am 11otJoing,11owis the tbl11g1 lov~ most i11life and thµtis taking care ofpeople, b_fcaustmedicinehas 110placl.']or thosewho. our tale11.r." an; HIV t,ifcctep,regtirdlrss of,Y_ Aotm, M.D., o,; Baltimort carrliologisl'l\_cit, suffe1ingfi'omJull-blawnAIDS three years afier a rest tube full of HfV-contaminatcd bloodbroke and spilled qvel' his cutji,fgcr. Aoun sued after ad1>1inistr<1tors al the hospi· tal where /Je,was l[di11i1rg refusedco renew his ~ontract. The case was settledfor al!1111disclosed .s11m.· "Ethically and morally ; I think I. . , shouldtnot continue with my work without telling anybody." Dentist lll David J. Acer to a social worker during a hospitalization tor pneumonia a few weeks before selling ''Who do , I blame? l?,o I 'blame his lucrative practice ii:' the SU("~ • mys~lf? I sure don't. I never used • mer ot · 1989, but over .a year before telling his patients he had "Doctors .rre afraid. They want to IV drugs, neve~ slept ~ith anyone AIDS. A few days after telling · know the HIV status of their pa- and never h-?d a blood transfutients-, and doctors who work in slon. I blame Dr. Acer and every them 6y letter, Acer died . single _one of you bastards. Anysurgery ask us about it alfthe time. one that knew Dr. Acer was in"TIie lisFiclosely resembles Lhc-risli of n If we get the patient's permission, -~hicularfatalflJ' during transpoi'lationto . we give the information, oth~rwise : fected and had f~ll =blown "Jlu>S it's up to the surgeon to discover it and stood by not doing a' damn ' ahdfrom 1111 ;, hospital." Albert~Lowe,ifel , thing about it : You are-all just as .M.D.. of New Yorli'Mcdical College,calcu- on his, own. In many institutions, lating the risli of transmissionfrom ·a,1HI'v- blood is illegally and surreptitiously . guilty as he was. You've ruhted infe.:Ledsurgeo·11 t~ a patie11tat las(June's drawn on patients 1o find ou\ Jheir · ·· m]t . life and my .family's." Kiminte,:national~o,iference on AIDS held in status." Paul Rothman, M.D., presi- bedy Bergalis, the first patient to · dent -of Search Alliance, an Los An- contract AIDS from h.e( dentist, Plorcnce,Italy. • David Acer, in a letter to Florida geles . AIDS-res~arch organizatio& 11 :rhe ultimate risk to the \atient is be~lth officials. In a po,st script, tot~ll_va11dgo11e Berga I is also wrote, "If laws .are so abiiolute, so devastating, thfat "I 11ouldhm•e 1111derstot1d it ls unt'enable to argue against down to the AIDS clinic. A~d it_wouldn't ha;rc l\dt formed to provide protection, : inf~fll'led consent;' ; New ' Jersey botheredme at all to_go-dow11. I jusl gave him then .my ~uttering and death was \ Superior Court Judge Philip ·oicoption. Nobodygaveme the .option." Bar~, ..•~vain. Ca;at,man, in a· May 1991 ruling bara Wcbb~_aziotl1er patient infectedwith 1,;IIV "I'mdying guy,-. Goodbye.:t' • • . .. 8Ufl' F' A.LO P + • HYSICIAN A NO BIOMEDIC A L 5Clt::NTIST AUTUMN I 9 9 I G) �Dy Jess:i.e~ 8"te:i:n.. D:i.~moII.d. • ew legislalion may clarify lhe nation's debale over who makes medical decisions on behalf of lhe comalOse and lerminally ill, placing the power lO refuse or accepl lreatment more firmly in the hands of the patient. According to patients rights advocates, doctors, hospital administralOrs and auorneys, the Patient Self-Determinalion Acl, which Lakeseffect December 1, 1991 is likely to lead to more compassionate medical care by improving communicalion between patients and health care providers. Primarily an educational law, the PSDA mandales that federally funded health care providers publicize state laws on patient rights to patients and caregivers alike. But the PSDA also presents logistical, legal and educational hurdles for health care providers: specifically, how to educate and counsel patients so that their advance medical directives accurately reflect their unique circumstances and values. 4D BUFFALO PHYSICIAN A N D 8 1 0 M E O I c' A L S C I E N T I 5 T A U T U M N I 9 9 I ��L'sexcellent law from the perspective thaL more people will be infonned so they're able to make their own decisions, " says Daron Weber, former spokesperson for the national Concern for Dying and the Society for the Right LO Die. "The PSDA may lead to change by making people aware. The key factor is going to be compliance.just how much teeth does the law have." Although health care providers that receive Medicare and Medicaid funding must 11 comply with the PSDA Lo receive these monies, the circumstances under which money would be withdrawn have yet to be spelled out. Written into law as parL of the federal Omnibus ReconciliaLion Act of 1990, the PSDA mandates that health care providers give all patients written information about stale laws on living wills and their rights LO refuse or accept medical treatment. HealLh care providers must ask incoming patients for advance medical directives and place them in patients ' medical charts and also publicize their institution's policy on these state laws. For stales with few or no such laws on the books, the PSDA requires that health care institutions make this known. Simplifying these mandates, a spokesman for the Health Care Finance Administration (HCFA) recommended that health care providers develop clear statements of policies on advance directives, write detailed action plans for staff education and community outreach and decide logistically how LO enter patients' wishes into their medical records LOcomply with the PSDA. HCFA is responsible for writ- ing the terms of the law into regulations , In regulations scheduled to have been issued in October , HCFA was expected to specify how providers should comply,vith the law for patients who are unconscious at the time of admission as well as define exactly when hospitals should give patients information about patient rights laws - before a planned hospital admission, at the registration desk or at the patient's room. Other issues related to compliance with the law may be more difficult to solve. The PSDA spotlights the difficulties of obtaining truly tnfonned consent, says Susan Goldberg, ofMagavem & Magavem, medical treatment so it's harder for them to prove they're competent LO make a decision. There are an awful lot of people out there without the documentation and without families to speak on their behalf." In New York State, the Patient SelfDetermination Act will likely ensure that hospitals now routinely ask patients whether they have living wills LOenter into theu records. Buffalo area hospital administTators say they \viii continue and improve their ei,.,isting educational programs on patients rights for health care staff, incoming patients and the community at large. These educational efforts will focus mostly on two New York State laws: • The Do Not Resuscitate Act of 1988, referred LO the DNR law, which mandates that on admission all patients receive information on how to place their wishes regarding CPR and other "heroic measures " to resuscitate them in their medical records. • The Health Care Proxy Law, effective January 1991, which requires that all patients receive at the time of admission a form and explanation for how to designate a proi,.,-yor surrogate decisionmaker LO gu ide their medical care when they can no longer express their own wishes . These laws have already been gradually, a~d occasionally grudgingly, integrated imo hospital procedures. Peter D'Arrigo, M.D., vice president of medical affairs at Millard Fillmore Hospitals , recalls that when the DNR law took effect, doctors disliked discussing it with patients who needed sunple medical procedures such as having a mole removed. Some patients became alarmed that medical care would be withdrawn unnecessarily or that their health problems were more due than they believed. The proxy THE BURDENOFSUFFERING IN CERTAIN CIRCUMSTANCES APPEARS TO BESOGREAT THAT WITHDRAWAL OFTREATMENTAND WE'RENOTTALKING ABOUT ASSISTED SUICIDE- MAYSEEM TO BETHEONLYACCEPTABLE ALTERNATIVE'.' ~ eu,-FALO PHYSICI A. N legal counsel to Buffalo General Hospital. "There 's risk - particularly with living wills - that a person may sign a form entitled "living Will" and not have really understood what it might mean in a given situation. Sometimes a fonn may give duections that are ambiguous , and people should not sign them without first discussing the contents with their physicians. " Beaufort Williams, an attorney and director of Legal Services for the Elder ly in Buffalo, is frequently appointed to represent patients who cannot adequately express their wishes. He shares a similar concern . "Poor and uneducated people can't always articulate their objections to AND BIOMEDICAL SCIENTIST AUTUMN I 9 9 1 �law was more readily underst0od. But the burden of making medical choices can weigh heavily on prox'Ydecision-makers who now must make decisions on their own that were once made solely by physicians , observes Michael Noe, M.D., clinical assistant professor of medicine and social and preventive medicine and senior vice president of professional affairs and medical director of Buffalo General Hospital. "The burden of suffering in cenain circumstances appears to be so great that withdrawa l of treatment - and we're not talkingaboutassisted suicide- may seem to be the only acceptable alternative," he says. "Before proxy law, certain of these decisions could be handled by a doctor with perhaps a broader, more objective assessment of the medical issues." Hospital ethics committees often help proxy decision-makers who request additional legal, medical and ethical guidance. BGH's nursing, social work and medi- cal staffs are trained to discuss pro>..')' forms with patients. But the hospital strongly advises that patients discuss DNR forms, advance medical directives and living wills with their own physicians. "The types of decisions a patient has to make require an opportunity to have questions answered by a medical person familiar \vith their situation," says Noe. Medical professionals also mentioned a common misconception that educational efforts mandated by the PSDA may help correct: many patients don't realize that the living will is legally recognized in New York State most frequemly when it is accompanied by a proxy or DNR document, and it may not have a binding effect on a particular decision about medical treatment on its own. Stephen Wear, Ph.D., a UB professor who specializes in medical ethics, says, "The real issue people have to explore is the complexity of care for people with chronic degenerative diseases or critical Most medicalethicists believeNew York State's patients' rights laws, especially the health care proxy act, are best applied when physicians discuss them with patients as a matter of course, beforea hospitalization or crisis. Doing so can prevent the problems illustrated by the following recent casefrom a local fwspital. man in his 80s suffers a heart attack while watching a Bills game this fall. 911 is called and he is resuscitated at home and taken to the emergency __ ...___ ,,__ room of a local hospital where he is stabilized, placed on a ventilator and admitted to the intensive care unit. Subsequently it is found that the patient has suffered severe brain damage. Among other things, he cannot breathe for himself. When he is diagnosed in a persistent vegetative state, the patient 's ·wifeand adult children unanimously request that all treatment be stopped, including withdrawal of the ventilator. The physician asks the family whether the patient had made any prior statements while competent about what he wou ld or wouldn 't want in such a circumstance. They 8UFF'ALO PHYSICIAN ANO BIOMEDICAL illness. What does their remaining time look like, how should their care be managed?" Physicians should discuss with their patients exactly how the proxy, living will, DNR and advance medical directive forms are used in conjunction with each other and also how statements on these forms about specific medical procedures would shape the medical response to theirown specific situation, he notes. The PSDA, by tluowing the spotlight on state patient rights laws, is a strong indication , at least, that patients need no longer rely passively on the decisions of medical providers. Clearly, patient rights laws vary greatly from state to state. By providing patients with information about these laws, the PSDA takes a giant step toward helping patients retain control over their medical destinies - even in an era when medical technology has redefined the very nature of death and the process + of dying. respond that although he had never talked about it specifically, they are certain he wouldn't want aggressive medical intervention given his prognosis. The physician advises the family that without the patient's prior competent statements supporting the withdrawal of the ventilator and without an appointed health care proxy to make such decisions on his behalf, this couldn't legally be permitted. The family is aghast. The patient remains in the intensive care unit for several weeks and dies of a second cardiac arrest. Under two recent New York State laws, the Health Care Proxy law and the Do Not Resuscitate law, this patiem 's wishes, if clarified in advance, would have been protected. However, he had not appointed a health care proxy who could decide about treatment ifhe lost the ability to decide for himself. The prox y could have requested the removal of the ventilator. The Do Not Resuscitate law would have protected the family's right to decide whether ventilation could be used to resuscitate the hospitalized pati ent in an emergency but not whether ventilation could be used to keep the patiem alive. A UB professor of medical ethics who attends meetings of num ero us Buffalo hospital ethics committees says such heart-wrenching circumstances are not uncommon and that doctors are learning through these situations the importance of explaining these laws to their patients well in + advance of a medical crisis. SCll!:NTIST AUTUMN 1 9 9 1 4D �[ ~ Il ~ RH I ll1H I I ~ Il ~V~ llHHUf BffIlH[ [ fPI fIl... B R y H C R A D D y E Always prized, an acceptance from UB's School of Medicine and Biomedical Sciences is more sought after than ever by today 's medical school hopefuls. "The combination of the med school's growing national reputation and its affordability are making UB the school of first choice for most candidates we accept, " according to Thomas Guttuso, M.D. , assistant dean and director of medical admissions. "The class of l 995 's rate of 1.9 acceptan ­ ces per seat is the lowest since the early 70s when the medical school applicant pool peaked. That means that today more applicants accepted are saying yes to UB." 4D B U F FALO PHYS I CIAN ANO BI O MED ICAL 5C l £ NT IST A UTU M N 19 9 1 �Maria Bruno, a first-year medical student with a 8.5. in genetics from Purdue, has a long list of reasons for returning to her hometown to sLUdymedicine at UB. "I was impressed with a lot of the things SUNY Buffalo had to offer over higherranked schools," Bruno said. Guttusso points to favorable national rankings as one of the key factors that favorably disposes applicants toward UB. "We're rated the best of the SUNY med schools by The Gounnan Report , which is considered the leading independent 'authority ' evaluating American medical BUF'F ALO PHYSICIAN ANO schools. Nationally, Counnan ranks UB 30 out of 126 medical schools, pulling us in the top 25 percent of American med schoo ls." Guttusso also cites a recent ranking by the Association of American Medical Colleges (AAMC) placingUBas third among all U.S. medical schoo ls based on the AAMC's current institutional goals. Making UB even more attractive to prospective medical students is the school's track record in placing seniors in their preferred residencies. According to Guttusso, 90 percent of UB medi- 810M£0lCAL SC IENTIST cal school grads are currently placed in one of their first three choices, 15 percent to 20 percent above national averages. For first-year student Lew Foulke, a better chance at a prime residency was the deciding factor for coming to UB medical schoo l, despite the location of another school closer to his roots in Central New York. "Of the three schools I was seriously considering, UB's reputation and ranking were the best, which will give me an edge when applying for residencies in whatever my chosen spe- AUTUMN 1 9 g I 41) �cialty turns out to be." Cost, boLh from the standpoint of tuition and area cost of living, also gives a boost to UB's stature among medical school applicants. Tuition for in-slate residents is just over 57,100 which compares to a national average of about $16,000 for public and private medical schools; the most expensive schools charge over $20,000annually. Thecostconsciousness of most medical students has typically been raised by four years of undergraduate education, often at much more expensive private schools. Lara Akinbami, a Harvard University economics graduate is typical of this breed of student, but her career aspirations in medicine also moved her toward puuing even more emphasis on the cost of a medical education. "Having spent two years with the World Bank in Washington , D.C., my interests are in the public polic y of medicine , particularly in the areas of access and affordability," Akinbami said. "Since this isn't the most lucrative venue to take in the medical field, it made good sense to go with a very good school that was also affordable." Not surprisingly, being one of the country's best and most affordable medical schools is making the admission process for UB even more selective. Guuusso, who chairs the Admissions Committee noted, 'The Class of 1995 was the most difficult class to be accepted into in almost twenty years. 263 applicants were accepted this year; that 's the lowest number since 1974." About one in 10 applicants was accepted to the Class of 1995. Given the difficulty of geuing in , how does the Admissions Commiuee make its acceptance decisions? "Obviously, we're seeking people who are talented academically with ability demonstrated by both grades and MCAT scores," said GutLuso. "We also look for the personal qualities that are important for future physicians: awareness of problems in the profession, concern and empathy for their fellow man, the commitment to being a doctor. The final decisions are a balance of all these factors." The overall demographic composition of this year's first-year class hasn 't a, BUFFALO PHYSICIAN radically shifted since the mid-70s when the medical school first started tracking a wider range of student statistics. Women and minorities continue Lobe well-represented, renecting the University"s early commitment in this area. Over the years, the average age of the first year medical student has increased to 23.5 years from a low of 22.1 years in 1976. The class of 1995 has 22 people over 25 years old, indicative of a growing national trend for medical students to pursue other work and academic interests before entering medicine. Darren Caparaso,a 25-year-old Western New York native, who majored in VitalStatistics: Theclassof1995 ' Applicants ................................... 2693 S18 Interviewed.................................. Accepted ....................................... 263 ClassSize...............13SMedical School ................................... 4 MST Program Average Age............................... 23.S Men............................................... 79 Women ...........................................S6 Science Majors .............................. 100 Non-Sci enceMajors .........................3S business at UB as an undergraduate and completed a masters in biology from Buffalo Stale College, credits his work experience in a variety of hospital positions with his decision LO become a doctor. "Wor king in a hospital for several years helped me to focus in on medicine as a career. Being a first-hand observer of what goes on in a hospital environmem also gave me the confidence to know that medicine is the right choice for me. " Although academic performance as measured by GPAs and MCAT scores hasn 't changed significantly, one noteworthy change has been a marked increase in the number of non-science majors, 35 in this year's first-year class. ANO SIOMC:OtCAL SCIENTIST' Gullusso explained, "More than any one particular major, we're looking for demonstrated academic excellence along with leadership, compassion and exposure to the medical field. This gives students the opportunity to get a broader undergraduate education. Of course, to be admitted, non-science majors must fulfill core science requirements and perform well on the MCATs." Foulke, who studied the classics in college and worked in a hospital environment before medical school, explains the seeming discrepancy in his undergraduate and post-graduate fields of study. "I was drawn to medicine by an interest in the growing body of research showing a defin ite mind-body connection which affects personal hea lth. Because I was strong in the sciences during high school, I opted for a non-science major to improve and develop my verbal skills." Regardless of how favorably the Admissions Committee is impressed by the quality of candidates interviewed, the size of the first year class remains constant, having been set at 135 in 1971. Additionally, a maximum of five applicants are admitted to the Medical Scientist Training Program which prepares student for careers in academic medicine as well as medical practice. Guttusso, involved in UB medical school admissions for 16 years, noted that the number of applicants to medical schools has dropped dramatically from the early 70s at UB from a high of over 5,300 in 1974 to approximately 2,700 in 1990. "l think today 's applicants are very aware of the negatives affecting the general atmosphere in medicine: malpractice, government intervention and control over income and the AIDS crisis," Guuuso said. "Co nsequently, applications have fallen off from the early 70s, when.many students viewed medicine as a career for those smart in science to make a lot of money. I see this as a blessing because every applicant we're now evaluating is really com mined to being a doctor for all the right reasons. Ultimately, that 's a positive trend for the medical school and + the profession." AUT UMN I 9 9 1 �.c s s 0 \ l1 THE STATE;_ UNIVERSITY ' . OF NEW YORK SCHOOL AT OF BUFFALO MEDICINE ANO BIOMEDICAL SCIENCES �E ACH YEAR , THE YORK STATE AT BUFFALO BIOMEDICAL SCHOOL SCIENCES 135 ABOUT UNIVERSITY NEW OF NEW OF MEDICINE ACCEPTS STUDENTS AND TO BE AND TRAINS PHYSI- CIANS. T HEY FROM COME FROM SCHOOLS ALL ACROSS WALKS THE OF UFE COUNTRY. AND THEIR ,, DIVERSITY UNIVERSITY BER ADDS TO THEIR RICHNESS AND CONTRIBUTES OF THE TO TH El R CALI- AS PHYSICIANS. , H ERE , WE PRESENT WISH THE THEM WELL FOUR-YEAR THE ON THIS , THE JOURNEY. OF '95 AND BEGINNING OF CLASS �o OmolaroJeonAkinbomi AndrewLouisAllmon Economics Biology RobertAnlhonyBorroli• ScottJonolhonBelote CherylAnneBettigoie MiroslovPatrickBobek English Psychology Microbiology Biology HarvardUniversily SUNYCollege01 Hobartand William Universily at Buffalo YaleUniversily CornellUniversily Geneseo SmilhColleges A Blum Katherine AlbertJohnBonoIll e TrinaAden Biology BolomuroliAmboli Anthony Jomes BortkOWJO, IbrahimA Berhon Biology Biology Biology Biochemistry liberalStudies Vassar New YorkUniversily Universily ol Buffalo Universily al Buffalo IndianaUniversily al Universily of Pittsburgh Bloomington (t lhuomoUdoAlozie I BarryRussell Armondi,Jr Ross JosephBellavia Be1hBernell Biochemislry Biolog9 Biology Biology CUNYCily College Universily al Buffalo Syracuse Universi _ly UnionCollege I EricBlumon Biology MourilsSlevenBoon Biology Cornell UnionCollege ' I C a s s 0 f 9 9 5 �e J~,ief,nn Brounscheidel CherylDeniseBuck TimothyRaymondByrnes LiangRueyChong Biochemistry Biology Biology ChristineChruscicki LoriAnneCohen Biochemistry Biology/Psychology Biology University at Buffalo University at Buffalo University at Buffalo Uoiversity of Rochester SUNYat StonyBrook Carol ElizabethBrietzke TonyTruongBui DarrenMichael • Craig EvonCheifetz Sebastion James Ciancio DeniseKo\herineDoigler Humanities Caporoso Psyc_hofogy Biology Nursing Am~riconUniversity CornellUniversity NiagctroUniversi!{ RichardJosephDeAslo , University at Buffo!o e . Biology JohnsHopkinsUniversity SUNYat StonyBrook . \ Business ' . University al B1.1ffolo (t Mario DoloresBruno . GeorgeJosephBurnett FronkPeterCarnevale KorenAnnChojnod.i Mory LeeCi6toli Genetics Biology Pre-Professional Biology Biology PurdueUniversity Con,siusCollege University of Notre Sr LawrenceUniversity CornellUniversity . . " Dome 2 C a s s 0 f 9 9 Optics University of Rochester �; ' Tracielee Di/v\orco Che!11islry Therese /v\orieDuane Dory!RoyEhlenlield CoroleYerkovichFenlon TyroneDovidFillyaw AlbertBrunoFiorello 'Socio!Science Economics History B.!_ochemislry /v\orislCollege Cornell~niversity CoseWesternReserve University ot Buffalo PsychoLogy JohnsHopkinsUniversity University of Buffalo University ' KorenEileenDull JosepbChris.DiPirro Biology • CynlhioEstherEpstein .Biology AileghenyCollege ConisiusCollege Chemistry ~UNY al B,nghomton . Shone Grego,yFerguson StevenMore Finkelstein JeanneC. Fitzsimmons Biology_ Business' University al Buffalo Universi!Y ot Buffalo SUNYColtegeal Old Biology - \ "Westbury (t AnthonyMale~")DiRubbo ChrislopberJonEast Psychology CornellUniversity . • AndrewStevenFeipberg Sho~nPatrickFerguson DovidFiorello Biology· Chemistry Biology Civil Engineering Syracuse University DukeUniversi'Y._ SUNYCollegeal DornoEvertonFlash NaturalSciences University al Buffalo Ford~omUniversity Buffalo - I J . ' C a s s 0 ,. f 9 9 �e Llewellyn AllynFoulke RondyJasonGoldstein T~omos J Guttuso ToreqShehodehHarb Nigel Ion Henry DouglasJomesHickox Classics 'Chel]ltSlry Psychology Physics Medicol Technology Biology SUNY01 Binghamton SUNYat Binghamton CornellUniversity CornellUniversity CUNYCollegeof University of Rochester i StatenIsland ' MichelleAnn Gome Biology JeffreyScottGron! Lynette Haggerty faith Heavens ArovindHerle EvonHirsch Bidogy Biochemistry Biology English History PurdueUniversity Hobartand William NozorethCollege Oral RobertsUniversity DukeUniversity SUNYCollegeat \ SmithColleges (t KodionMorie Golding Biology B1Jffo10 KateLouiseGuernsey - Biology CUNYQueensCollege CornellUniversity ThomasAndrewHonno AndrewDoveHenry 'v\itchellJosepnHerr Biology Biology Chemistryand Biology Biology SUNYat Albany CUNYMedgor Evers University or Buffalo University of Chicago YuluenHsu College 4 C a s s 0 f .I 9 9 5 �-------- -- - - -- - - ]A l" I , 0 JeoneoReneeHundley SomirKhonjor HuijungKim Biology Biology NaturalSciences ConisiusCollege Corn.ellUniversity ofPennsylvania Universityof Rochester University KathyMtJssey PatricioAnn Krebs Biochemistry . Andrewlouden Philipl. Manzanero Biology Biology Swarthmore College University of Rochester AndrewBennettKlofter BryonRussell Lotzmon MortinC. Mdhoney Oemistry Physics Biology Psychobiology History P1~ FordhamUniversity Universityof Rochester SUNYot Binghamton SUNYat Binghamton CooisiusCollege Oral RobertsUniversity HelenMon Kim EricHeathKossoff Oono lim MicheleMlJrieMonka ModhuiikoMathur Electricol 'Engineering English NeuroS'cience Business Psychology Biology ClarksonUniversity CornellUniversity CornellUniversity CornellUniversity Ohio StoleUniversity TuhsUniversity (\) Christina Maureen Keaney JomesStephenKillius \ (t HeatherMicheleKeene ' ) ) C a s s 0 f 9 5 �19 e GregoryAlan NlcDoniel tv\ariaM.odico , Anthropology , 6iology RerieeNealy DavidMichaelOdell NaturalSciences Chemistry SUNYCollegeat BuffaloStateCollege Hobartand William tv\anhotton College Buffalo ' ' KathrynAnneNlcVicor Psychology University of Chicago NancyPerez Biology· ConisiusCollege Hobartand William SmithColleges SmithColleges· . JomesGory Nalbone GoryJohnNielon Psychology Fro~lin and tv\arshall MechanicalEngineeri~g Biology ':Jhitney.leeOrman Neil NileshPotel MicheleAnn Potempa Scienceand Non- Biology Umversity of·Rochester St LowrenceUniversity Science SUNYat Binghamton University at Buffalo_ Coll~ge (t Brendontv\aneyMiner tv\argoretE. Partridge , Biochemistry , . Susontv\a~reenNaselli Donielle Susan No:ebort . Biology Psy~hology Conis1us College Le!w;:,yneCoUege SusonEljzobethPolls Biology ThomasAndrewOwens TusharR.Patel Biology ' Chemistry Biology St Bonaventure University of Rochester SUNYat Albany CornellUniversity University ' fr C a ( s s 0 f 9 9 5 �I_ G - -- -- - - - -- -------- BethannSchober Chondresh Ajit Shelot ToroAlice Soso Biology PreMedicol ~iology BuffaloStateCollege University at Buffalo KirkMichaelPuttlitz Neal ToddReich life Science ln)egroted Health NaturalSciences. University at Buffalo Sciences JohnsHopkinsUniversity long lslo~dUniversity AmitobhProtimSoho - University at Buffalo ·e lrm RoqibRojo KorenMoy Roll Theresa/11\one Sarafin Morie lo~iseSchmitt NeurosciElnce Biology ColgateUniversity ·St.Bonaventure Biology I St. BonavJ~nlure Biochemistry NazarethCollegeof· • University Rochester ... University , ErikDole.Skoog • Psychology PeterFrancisStengel Bi_ochem1stry Dukeyniversity Canis1us College .' PeterDamionRoy (t Science and GermaineNoncyRowe EvaHolinoSotell Foreignlanguage Biology I Non-Science CornellUniversity Rutger~ University Physics StephenPeterSorrentino LisaLynnStephens Biology ComputerScience TuftsUn°iversity SUNYat Albany JoelAllenShapiro St. Bonaventure t BostonCollege UnlVersity ~ , --.. 7· C a s s. 0 f 9 9 5 �Q ThomesWilliom Stone Eva Tokocs·Dilorenzo Ed9t,1ord JohnTrobulsi Eilene Velez TheresaMorie Wegman TimothyPatrickWhelan History Art Bioche,mistry MolecularBiology Nutrition Dartmouth College HamiltonCollege Univer:sily of Rochester longIslandUniversity CornellUniversily Scienceand Non-Science lof?yelleCollege o ErikJonStumpf Chemistry Wng TsangTong Rolph!Patrick Tufano Chemistry Biology University al Buffsilo HamiltonCollege SUNYat Binghamton TimothyE.Von Duzer , Chemistry BrighamYoong DennisDorrWeimer, Jr. EllenMorie Whyte Biology Biochemistry ConisiusCollege Universilyof Chicago• Universily, / (9RoyceRosanoSyracuse JeffreyMichaelTessier PoulFrederickUpdike Andrew WilliomWorner Bi(?logy Biology Biology Music HofstraUniversily Wendy LynnWeinstein LorraineS. Williams Biology , Psychology CornellUniversily le Mc,,1ne College Universily of Buffalo SUNYat Binghamton 8 C a s s 0 f 9 9 5 Universily of Buffalo �e Bror>Krig Zebrowsk rMJ e , ffrcyleeZo:d man z~bier Ml t~ Alo~Zuccolo Bology SUN 01 on 01AnnArbor 00!')' Gcreseo MJ ,e E @ 81oclie":1stry N?zoref, Co ::,geof R SfynPerry An opology lJnivers~ at & a o 9 C a s s 0 f 9 9 5 �o ATH 0 f Hippoc~ATES I SOLEMNLY SERVICE , I ' WILL PLEDGE MYSELF TO CONSE~.RATE MY LIFE TO THE OF HUMANITY. GIVE TO MY TEACHERS WHICH IS THEIR ( WILL PRACTICE THE RESPECT AND GRATITUDE OUE; MY PROFESSION T HE HEAL TH OF MY PATIE'NT •I WILL RESPECT THE I WILL MAINTAlN BY ALL WITH WILL SECRETS CONSCIENCE BE MY FIRST WHICH AND DIGNI_TY; CONS!DERATION; ARE CONFIDED IN ME; ·, AND THE NOTABLE THE TRADITIONS MEANS IN MY POWER, .OF THE MEDICAL THE HONOR PROFESSION;· ' MYCOLLEAGUES IWILL NOT RACE, PARTY PERMIT BETWEEN I WILL THE . MAKE HONOR. POLITICS, MAINTAIN TIME BE MY BROTHERS CON .SIDERATIONS MY DUTY AND THE THESE PROMISES SISTERS; STANDING NATIONALITY, TO INTERVENE MY PATIENT; UTMOST KNOWLEDGE AND OF RELIGION, OR SOCIAL OF CONCEPTION; MY MEDICAL I WILL RESPECT EVEN UNDER CONTRARY SOLEMNLY, FOR HUMAN THREAT, TO THE FREELY, LAWS AND LIFE, I WILL FROM NOT USE OF HUMANITY. UPON MY �V~llll~f ~IillfIll[Hl~TllilE Ill HillE Rl[HfIlifR~llB o the best of his knowledge, which is considerable, Balamurali Ambati, age 14, is the youngest medical student in the history of American medical education. A memberof the Class of 1995, Ambati was accepted at 13 to the medical sc hool 's Medical Scientist Training Program (MSTP), which on completion simultaneously awards M.D. and Ph.D. degrees. In discussing the historic acceptance, Thomas Guttusso, M.D., who heads admissions for the medical school said, "We believe that Ambati is the youngest ever admitted anywhere, certainly at UB. His application came to us through normal channels and his credentials were excellt:nc. Actually, the academic record for MSTP applicants must be outstanding; admission standards are more rigorous than those for applicants only applying to the graduate or medical school." He added that the one major consideration given to age was that the MSTP program takes seven years which would make Ambati about 20 years old at graduation. But although Ambati's age makes him distinctive, Guuusso said he will receive no special support. "Because the medical school strives to give a high level of support to all students, I'd expect no more than we give other incoming students. His ability to graduate from college with honors in two years is an excellent indicator that no extra support will be needed." Ambati, who modestly acknowledges the recognition and nurturing of his talents he received at an early age, is also quick to point out that a lot of hard work has contr ibut ed to th e considerable BUF"l"ALO PHYSICIAN AND achievements of his short lifteime. A magna cum laude graduate in biology from New York University (NYU), Ambati was on the dean's list throughout his short tenure at NYUand made USAToday'sAllUSA Academic 2nd Team. He plans to pursue both research in neuroscience and a medical speciality in ophthalmology. In addition to his academic successes, Ambati has also coauthored AIDS: The TrueStory, a book primarily aimed at high B IOMEDICAL SCIENTIST school students, wh ich examines the epidemiology, treatment and ethics of the disease. His collaborator on this project was his brother ,Jayakrishna, who started medical school at 17 and is now in the fourth year of an M.D./Ph.D. program at another school. For hls pan, UB's Ambati, on an even faster track, is now on his way to becoming the youngest doctor in the United States. + D RICHARD AUTUMN 1991 Y E fI:) �.._, ~ . ?, r., ~ } L L BUFFALO U S T R A T PHYSICIAN 0 N A N S D B y AL AN SCIENTIST , ,.. ~ -- E. COB AUTUMN ER t 9 9 l �PRESCRIPTION FOR B Y 5 C O T T PAIN : T H O M A S f all the symptoms that physicians are presented with, pain is the one that troubles the most patients and can be the most perplexing to treat. ► Reliable estimates say that one in three Americans suffers from some form of chronic pain - pain that persists long after its useful function as a warning sign has passed. Half of them will become disabled for days, weeks or longer. B UF F ALO P HYS I CIAN ANO 8IOMIEOICAL SC I ENT I ST A UTU M N t 99 t fl> �f pain were a disease, it would be an epidemic. But, of course, it's a symptom with literally dozens of diagnoses. Headache and backache top the list of the most common complaints. Pain also intrudes in the lives of people with arthritis, sciatica, degenerative spine disease , peripheral nerve damage, stroke, shingles and whiplash. And people with cane.er must cope with managing pain which, if left unchecked in the disease 's advanced stages, can be the most excruciating agony known to mankind. Increasingly , physicians in all specializat ions are recognizing pain for what it is: an insidious invader that works in a thousand ways to not only destroy their patients ' quality of life, but affect their physical well-being as well. And throughout the medical field, there's a new awareness that pain, unlike its root causes, nearly always can be controlled. "Up unt il the last decade or so, doctors were more focused on cure rather than care," says Mark. J. Lema, M.D. , who directs the Department of Anesthesiology at Roswell Park Cancer Institute. Lema , an assistant professor at UB's School of Medicine and Biomedical Sciences, is director of anesthesia research for the school's Department of Anesthesiology. "The body 's nervous system is the last medical frontier to discover, " Lema says. "One engram [a nerve bundle in the brain that serves as a switching area for pain I is more complicated than the most complex microchip. " Increasing the difficulty of assessing and treating pain is the problem of measuring an individual's pain. By its very nature , pain is subjective; what one person feels as a minor irritant, another might experience as an agony. Factors as diverse as individual biochemistry and cultural differences all affect what pain feels like and how it is tolerated. "There 's a sociocultural aspect to it - how does one respond to pain? - that 's built up in the early stages of life/ says Romanth Waghmarae, M. D., assistant clinical professor at the medical school and director of pain management programs at Sheehan Memorial Hospital and Kenmore Mercy Hospital. "In certain cultures, children are taught to be stoic, to 'tough it out'; in others, it's considered acceptable to Cl)' and wail and really feel it." Research has shown that Americans of Mediterranean heritage feel pain more deeply than their neighbors whose ancestors were Northern European. And it's widely acknowledged that most women have a higher tolerance for pain than most men, perhaps a blessing that toughens them for childbirth. But individuals' pain tolerances vary widely, even within families. The reasons remain a mystery of biology . Pain specialists, or algologists, sometimes use a simple 10-pointscale, asking patients to rate theirown pain. Though this doesn't make it any easier tO compare the experiences of different patients , it helps in assessing an individual ED BUFFA LO PMVStCIAN ANO B10Mco1cAL patient's progress during treaunent. The biochemistry of pain is simple enough: injured nerve cells transmit a "pain signal" to the dorsal horn of the spinal column. The signal is then relayed through the spinal cord to the thalamus, the pan of the brain that recognizes the impulses as pain. For people suffering chronic pain, though , the ordeal goes far beyond chemistry. They may find themselves in a vicious circle of tension , anxiety and further pain. Waghmarae says pain works subtly to disrupt the fabric of relationships, avocations and habits that make up daily life. It becomes a constant, an uninvited companion that causes people to function on a lower level. It is always present; even sleep doesn't bring relief. "You suddenly become abnormal," Waghmarae explains. "That in itself works against you." People who become disabled may develop a whole range of sympt0ms related t0 the pain that put them out of work. These people may snap at their spouses and children partly from frusuation, partly from edginess related to the pain itself. They might go out less , insulating themselves from any activity that might increase their pain. Their relationships suffer. They become sedentary, causing even more med ical problems , increasing the pain. Depression follows - and so on and on. After a wh ile, pain is only one part of a complex of misery that it has caused. "It changes your life," says Vivian Schiferle, a Town of Tonawanda woman who suffered wiLh chronic pain after a back injury several years ago. "I couldn't think because of the pain. "It's the liule things that change. The way you dress. You have LO learn LO like low nat shoes. Even· to go out to dinner, we would go where the chairs were good. We wouldn't go where maybe the atmosphere was terrific, or to that new place that jusl opened. It was always where the chairs were comfortable." Schiferle's pain has been controlled for over a year now, Lhanks to severa l epidural injections of steroids, a relalively recent innovat ion in pain therapy generally used for cancer and other severe, debilitating pain . In this procedure , an analgesic mixture - most often narcotics or steroids - is injected into the epidural space in the spinal column, deadening Lhe sensation by blocking transmission of the pain impulses. In recognition of pain asa distinctentity , treatable in itself, physicians and hospitals have begun to establish pain management programs. The goal is not only to eliminate patients ' pain as much as possible, but to teach Lhem how Lohave full lives despite pain that won't go away. One such program is the pain managem~nt center at Buffalo General Hospital. 1ts medical director, Gerald L. Peer, M.D., is a clinical assistant professor in the medical school's Department of Anesthesiology. SctCNTIST AUTUMN 1991 �ln addition, there are physical benefits. It has been re"It's very individualized," Peer says of the Buffalo General ported that patients who use PCA after thoracic surgery or program and others like il. "We tailor-make the treatment for repair of broken ribs are more likely to breathe deeply each pat ien L" reducing the risk of pneumonia - because their chest pain Peer says such programs may involve not on ly physicians , is better comrolled. but also psychotherapists, occupational therapists, social "Pain and suffering is second only to incurability when workers and nurses who specialize in pain managemenl. people think of cancer," says Lema, whose practice deals "Many times, " he says, "we can tell a patient that the pain is largely with cancer pain. "It's not even the prospect of dying no longer a sign of ongoing physical damage . The:n we find that scares [patients] so much as the thought of suffering." the best ways we can to help him live with it. " The solutions With some cancers, such as leukemia, the patient's pain is may be as simple as help ing the patient to arrange for relatively mild. But Lema says tissue cancers often encroach ho usehold help, or adjusting his medications , or fining him on nerves and bone , sparking constant and debilitating pain. with a body brace to take the pressure off the afflicted area. In addition, he says, cancer treatments - chemotherapy, The multifaceted approach of pain management programs radiation therapy and surgery is being [eltat the medi - all bear their own costs in cal school as well, says severe pain. Robertj. Schuder, M.D., Epidural mJections, he interim chair and assosays, work "much of the ciate professor in the Detime ." But until repartment of Anesthes iolcently, physicians ogy. shied away from prescribing "We're a pan these opiates, fearing that of the team, " Schuder patients would become ., :says of anesthesiologists. addicted. ~ "We serve as a buffer be::::"'-.. ~,;:;~ For those in end-stage ~ -:.:::::: .:::, tween the an of medicine : ::: cancer, it's a moot point. -:.:.~ ' and the technology of But even for patients with ·• '· : medicine. less advanced cancer, or "And we bring some those with non-malignant humanity to it. You can chronic pain, studies have not on ly do [the job I, you shown that narcotics taken can empathize as well. " only to relieve pain are Schude r says residents highly unlikely to result in in anesthesiology deal with addiction. a variety of acute and "It's very awkward some,· ,: -- ..... •. -,. ..: .• ,, chronic pain situations in ' ...:.·/~/ ~/ times, because we have a ' ,,.,. - ..:--- ~ ; • - ~ 'l ·•,; their work at Western New • , , ... II\\' = ;~ 'l°l/~, i 'l(L war on drugs right now, " '.u.~-...J..:..::.:....:..:.. .~~=-~~~~ ...:J. !.....:!4....:!a. ..:!!:J ~...2~--t York's teaching ----+ Lema says. ''Peoplearesayhospitals. There, to drugs .' Well , there 's a small minority of us ing, '.just say no he says, they are often exposed to what has been ,called the who are saying, 'Let's say yes to drugs when it's appropriate. "' most exciting innovation in pain management in decades: All sons of alternative therapies are availab le as well, from patient-controlled analgesia, or PCA. the widely accepted to the marginal. Besides the holistic Patient-controlled analgesia is most often used for postremedies some sufferers swear by - hypnosis, massage and operative patients , people who otherwise would depend on acupuncture among them - one frequently prescribed treata nurse and a needle for relief of their acute pain. With PCA, ment is transcutaneous electrical nerve stimulation, or TENS. patients regulate their own pain. By pushing a button on a This hand-held device delivers a m ild electric shock directly specialized pump, they self-administer an analgesi,c through to the afflicted area, affording relief by interrupting the an intravenous line. nervou s system's "pain circuit.'' Studies have shown that patients on PCA use less pain "The fact that you have pain limits you," Waghmarae says . medication - and receive bener pain relief - than those "No matter how hard you ti)' to be normal, your behavior who must request a shot. Patient-controlled analgesia changes. " For the patient , he says, the questio n is simple: also gives patiems a greater feeling of autonomy and involve"How do you manag e?" The answer, as physicians know all mem in their recovery- invaluable psycho logical assets as + too well, takes a little mor e consideration. they heal. _,_ -s -;:., 8 uFFAl.O PM vs1c1AN AN O u10M £01c>.L sc1ENTI S T AU TUMN 199 1 6) �················· · ······· ·············· ····· ·················· ············ ······ ····· [i] . ' year, except for the major holidays, " he explained. "We really have an overabundance of student enthusiasm for the projecL." The attitude of the students is "fantastic" according to Juanita Hunter, pro fessor of undergraduate nurse education, project director for the Nursing Center for the Homeless and coordinator of the clinic. "It must be understood that the students generated the idea and did all the work to get it established," she explained. "This situation provides a great opportunity for the students to understand how health care should be provided to such less-fortunate groups Medstudents establsh "Hope Clinic" attheOtyMission STUDENTS JOIN NURSING CENTER group of enthusiastic UB medical students has joined with the University's Nursing Center for the Homeless to provide extended medical care for the less fortunate of Buffalo. The "Hope Clinic," which meets every Saturday EI) BU FFALO PHYSICIAN FOR THE H OMELESS morning at the City Mission, has met with great student enthusiasm, according to, Joseph D. Kay, a second year medical student and co-director of the medical student contingent of the clinic. "We're working on a rotating basis. Four of us work every Saturday during the ANO BIOMEDICAL S CIENTIST AUTUMN I 9 9 1 �· 11 ·························································································· ~ I in our society." The ursing Center for the Homeless, a federally funded non-profit organization, was established by Hunter in 1988 to provide free nursing care for the homeless. The medical students, she explained, began organizing two years ago under the direction of Kayand fourthyear student Geraldine Rubin, third-year students Alissa Shulman, Kristen Paulus and Anne Comi and second-year studentjennifer Wargula. They joined the clinic last June. "The advantage of having a medical clinic to go along with the nursing program is that if you have a person who needs to cons ult with someone who has greater medical expertise, you can refer them to the Hope Clinic." The results have been encouraging so far, but it wasn't easy getting all the pieces in place to make the operation a success, said Kay. ''Our major stumbling block was recruiting community doctors who would volunteer to work for a few hours on a Saturday morning," he exp lained. "We wouldn't be able to do what we do here without a licensed M.D. present." Kay explained that any physician who wants 10 be a part of the program simpl y needs to obtain an adjunct appointment from th e medical school. "And that 's not difficult to obtain. With that, the doctor is covered by UB insurance. " Anthony Bartholomew, a professor at UB's medical school, said that the camaraderie established between the stud ents will be beneficial to them in the future. "I give them a lot of credit. It's great to see first and second year medical students working with senior students to care for patients. They've really made this work." Fourth year medical student Patricia Reddin said that the clients at Hope Clinic present unique problems for the stude n ts and doctors. "You see a very different population here from week 10 .. BUF fl"ALO PHVStCJAN ANO I w e e k . There a re often immigrants who have Iit tie command of the language and that is difficu It," she said while preparing to question a 40 year-old woman from Somalia who had never seen a doctor in her life and was complaining of a non-stop headache. Kay said that the range of ailments exhibited by the patients who frequent the cliniic are numerous but often predictable, given the conditions in which they live. "There are a lot of skin problems, especially the feet and fingers, because a lot of these people are outside a good portion of the time. And of course we see substance abuse cases. We've even had a few cases of tuberculosis, which is really scary." Elizabeth Brown, who works for the Nursing Center for the Homeless, said that the program's success hinges on the cooperation and stamina of all who take part in it. "The students are really hungry 10 get some clinical expe rience to go along with the theory. For the Mission, it's simply something they've never had before. It's really needed. And the potential of the program is just now unfolding.· • Part of the cooperative process that underlies the clinic's success lies in the generosity of various agencies around the city according to Kay. "We have an agreement with the Washington Street Pharmacy where they provide the medication at wholesale, which makes it cheap for us. Millard Fillmore Hospital gives us a lot of supplies that are essential here as well.·· The Hope Clinic examines between seven and 10 patients every Saturday, according to Kay. "But this is as much a learning tool for us as it is a community service. If we can incorporate ourselves into the medical school as a program, they'll provide us with the stability we + need." - S IO M!:D IC A t.. SCtCNTaST SY MA AUTUMN RK HAMMER 1991 e �• ············· · ································· ·· ·· •· ···································•· ' I Dr.James F.Mohn Ends His Distinguished Career atUB A LONG TENURE O F TEACHING is faLher and grandfaLher were both opposed LoJames F. Moh n's choice of medicine as a career. "They Lhought I was a born Leacher buL ever since I was a smal l boy I wanted to be a physician. 1 just never planned that I would combine my medical career with Leaching and thaL iLwould Lum into Lhe longesL teaching span of a full-time faculLy member in the medical school's history - 45 years and nine months to Lhe day." Mohn relishes recalling the smallesL details. AfLer graduating from Fosdick Masten Park High School, he entered Lhe University of Buffalo - helping pay his way th rough school by work ing in The University's maintenance depanmenl. "I remember I was weeding the peony bed in front of Foster Hall when I heard that Germany had invaded Poland." After only two years of pre-med sLUdies, he was accepted into medical school and during his freshman year came under the inlluence of Professor of Bacter iology and Immunology Ernest Witebsky who had lled the Nazis and his German homeland in 1936, arriving in Buffalo three years later. "Witebsky was th e most famous person on the staff of the medica l school, a pioneer in immunology. He took me LO Buffalo General Hospital and had me ster ilize boules - he believed in learning about research from the ground up. 1 stayed with him until he died. " While still in medical school, Mohn contracted pulmonary tuberculosis - e BUFFALO PHYSICIAN "They thoughtI was a born teacherbut ever , RESEAR C H AND SER V ICE he says he still remembers the patient who was the source of his infection. His internship at Buffalo Gene ral was cut short and he entered th e Niagara Sani tarium. JusL before entering th e sanaLarium he took Lime out for his wedding to one of his med -tech sLudents. "We honeymooned on Lake Canandaigua and then 1 went into the sana tarium. It was warLimeand my wife was working at Buffalo General as Wite bsky's chief technolo gist," Mohn recalls. While recovering from TB he rebuilt the institution 's diagnostic laboratory. On Apri l 1, 1945, UB president Samuel Capen appointed Mohn instructor in bacteriology and immunology, officially beginn ing his teaching career. Mohn likes to joke that he "knew all the buildings at UB as people - Capen, O'Brian, Crofts." As his mentor, Witebsky imbued Mohn with the ideals that have stayed with him throughout his professional career wh ich is s till ongoing despite his retirement in January, 1991 from his position as professor of microbiology and directorof the Ernest Wi tebsky Center for Immunology. "WiLebsky believed in the troika teaching, research and service as a necessity for Lhe best teaching of medical sLUdent s," Mohn said. Mohn 's research has taken him to Walter Reed Army Center while on active service during Lhe Korean War and Cambridge Universi Ly where he work ed wiLh Professor Robin Coombs, inventor AND 810ME01C.t.L SCIENTIST sinceI was a smallboy I wantedto be a physician. Ijust never plannedthat I would combinemy medical careerwith teachingand that it would tum into the longestteaching span of afull-time faculty memberin the medicalschoolshistory." of th e Coombs test. His blood group research led him LO make numerous visits to Finland and LO Lhe discovery of a new blood group variant - AFinn· ln 1988 he received the Nevanlinna Medal from the Finnish Red Cross for his co ntr ibuLions LO blood transfusion services. Mohn's expertise has been sought ou t by state, naLional and international leaders. He was one of th e co-founders of the International Society of Hematology, started in Buffalo in 1948. In 1974 he was appointed by the Governor and confirmed by the state Sen ate Lo a council fonned to regulate statewide blood trans- AUTUMN 199 1 �. .. .... . .... .. ......... . ..... . .... . .... . .. . .. . ... .. ... ... . ... .... .. ... .. .... .. . . ...... . .. fusion practices. I le remains chairman of the State Council on Human Blood and Transfusion Services and director of Buffalo General Hospital's transfusion service, named in honor of Witebsky. His blood research led to an mntation to the etherlands to help celebrate the 25th anni\'ersary of the Red Cross BloodTransfus1onScrvicesCentral Laboraton . The court Iv and dapper Buffalo nati\'e took tea with Queen Juliana. who was less well -turned out than he - her slip was showing . But Mohn doesn't mind donning work clothes and working as a carpenter and Bu,-,.Al.0 PMYIICIAN fl] the other way. Ifwe didn't have regional center-,. we wouldn"t be doing transplants and cardiac su rgery." Hi!>long record of Red Cross ser"ice includes a term as Greater Buffalo Chapter chairman He is currenth chairman of the Red Cross Medical-Scientific Advisor) Committee and the chapter fitra\'el nancial development committee. He ,s proud of his -f6 years of \"OlunOf all his honors and awards. though, teer sen 1cc,, Hh the Red Cross In the \tohn sa,d the highest mbute he ever earl} days he ,,as opposed to the Red came when \Vitebskv praised Cross concept of regional blood ser- received him the as a teacher-calling abilit) nces. but soon realized the wi.sdom of his + known. ever had best teacher he the approach. "If you're an objective LLIAMS WI DEBORAH -BY scientist. vou ha, c to face facts . I swung painter to restore his 1851 Elma farmhouse,, here he and his wife raised four children. He collects antiques and art as well as wines and has been working throughout the rear on another pct project of h,s - the Red Cro-.s· \'intage Affair-an auction ofwmes, dmingand ANO &1O,-.iC0ICAL $CIC:HT t lT AUTUMN 1091 e �·······•· ······ ······························· ················· ·•···· ······· [i] . ' Firstannual Southern Tiersurgery meeting heldinOlean hysicians and professors from The Cleveland Clini c Founda tion, George Washington University, Hanneman University Hospital, Buffalo General Hospital, Olean General Hospital and the State University of New York at Buffalo School of Medicine and Biomedical Sciences convened for the First Annual Upda te in General Colon and Rectal Surgery in October. Working with chairman and program director Adil H. Al-Humadi, M.D., adj unct clinical assistant professor at UB and colon and rectal surgeon at Olean General Hospital, were Eddie Hoover, M.D., chairm an of the medical school's Department of Surgery and Bertram Portin, M.D., head of the Department of Co lon and Rectal Surgery, who moderated the symposium. Designed to apprise primary care physicians, internists, surgeons and health care professionals of the most recent developments in the diagnosis e BUFFAL O PHYSIC1AN and management of selected surgical problems including colon and rectal surgery and gall bladder disorders, the Update was the first conference in general colon and rectal surgery held in the Southern Tier area. The program was designed by the Department of Surgery as part of its Continuing Medical Education program. + James PlattWhite Society seeks1,000 donors he Schoo l of Medicine and Biomedical Sciences and the James Plan White Society have launched a "Th ousand at a Thousand" campaign to raise funds for biomedical and clinical research, scholar ships for needy and meritorious students, state -of-the-an laboratory equip11 ment, educational p rogrammin g and unrestr icted support for special needs ichard S. Safeer, a second-year and opportunities. medical student, has received an The campaig n award from the Regional Center was la un ched in for Clinical Nutrition Education September, accordof The New York Academy of ing to Eugene Beltrami , M.D. '54, Medicine for \\tt,'*/JJ, James Platt White a paper on cardio- ~\\! Society Chairman. vascular disease. ~The James Platt Jam es PlattWhite Safeer, who is~,,~ .: • ~ th eoriginatorand ~ § White Society was formed in 1986 on directorofthe"Get ~ ~ the 140th anniversary of the founding of Heart Smart" pro- ~/ ~ the medical school to recognize dedigram, won in the Comcated alumni and friends of the medical munity Work category. + schoo l who contribute $1,000 annually. The James Platt Wh ite Society provides vital financial resources to help the medical school attract the best students, retain top faculty and strengthen biomedical research, educational and clinical programs , Beltrami said. James Platt White was one of the founding members of the University at BuffaloSchool of Medicine and Biomedical Sciences. An obstetrician and gynecologist, Wh ite contributed important improvements in the practice and teaching of obstetrics, conducting the first clinical demonstrations in obstetrics in the United States and advocating anesthesia in childbirth. He was professor of obstetrics for 35 years and dean of the school at the time of his death in 1881.+ Safeerwinsawardfor GetHeartSmart" program fll~ ~ 'fl//m~~ AND BIOMEOICA- SCIENTIST AUTUMN 1991 �·············· · ······· · ·············· · ···· · ····· · ··· · ··········· ··· · · ············· · ····· · ·■ · mm I Medical schoolhonors its facuitymembers even faculty members and six resident physicians were honored at the annual faculty meeting of the School of Medicine and Biomedical Sciences. Michael A. Apicella, M.D., director of the Division of Infectious Diseases in the Department of Medicine, received the Stockton Kimball Award for excellence in academic achievement. Apicella, UB professor of medicine and microbio logy, also serves as co-director of the UB Center for Applied Molecular Biology and Immunology . He will deliver the Stockton Kimball Lecture at next year's ann ual mee ting. Jacob M. Steinhart , M.D., clinical associate professor of pediatrics, was named recipiem of the third annual Robert S. Berkson Memo rial Award in the Art of Medicine. The award recognizes excellence in patient care and teaching by volunteer faculty members. Mary Voorhess, M.D., professor of pediatrics, received the Dean's Award for service to the medical school and the University and outstanding research. Codirector of the Division of Endocrinology at The Children's Hosp ital of Buffalo, she has served on various committees of the medical school and its department of pediatrics. Louis A. and Ruth Siegel Teaching Awards for teaching excellence were presented in the following categories: pre-clinica l, Charles Severin, Ph.D., associate professor of anatom ical sciences; clinical, Bradley Truax, M.D., clinical associate professor of neurology, a nd volunteer , Christopher Valencia , M.D., clinica l instructor of medicine. House staff awards were presented to: Maritza Cotto, M.D., resident physicia n in medicine;John A. Leone, M.D., resi- HislaAngela Bates UBmedical student winsNIMH award isla Angela Bates, a third-year medical student, has been chosen one of six medical students in the U.S. to receive an American Academy of Child and Adolescent Psychiatry James Comer NlMH Minority Fellowship Award. She rece ived a $3,000 stipend to support participation in research in child and adolescent psychiatry last summer. Bates, under the direction of Gary Cohen , M.D., clinical associate professor of pediatr ics and psych iatry, David Kaye, M.D., clinical assistant professor of psychiatry and Richard Clopper, M.D., clinical assistant professor of psychology and psychiatry , was involved in the prospective psychosocial screeni ng of children referred to the Pediatric Endo crine Clinic at Chi ldren's Hospita l for evaluatio n of growth problems or newly diagnosed diabetes mellitus. The Comer Award is funded through a grant from the National Institute of + Mental Health . BUl"F' A LO PH Y SICIAN ANO BIOM£01 C AL SC I ENTIST I dent physician in medicine; Michael Denk , M.D., resident physician in sur gery; Frank Green, M.D., resident physician in medic ine; Nashat Rabadi, M.D., resident physician in medicine , and Joseph Cinderella, M.D., resident phys ician in medicine. A special award was presented post humously toJohn F. Moran, Ph.D., asso ciate professo r of biochemistry and former assistant to the dean for facilities + planning, who died in February. B y A R T H U R P A G E Schwartz headsUB cardiology division effrey S. Schwartz, M.D., has been named chief of the Division of Cardiology in the Department of Medicine. A professor of medicine at the University at Buffalo and faculty member since 1987, Schwartz is the head of the Division of Cardiology at The Buffalo General Hospital. Prior to coming to Buffalo, Schwartz was associate professor of medicine and di rector of the exercise laboratory at tlheUniversity of Minnesota Medical JeffreySchwartz , M.D. School. A graduate of Rutgers Univers ity, he received his medical degree in 1968 from Albert Einstein College of Medicine and did a cardiology fellows hip at the University of Chicago. He also did research on narrowi ng of the coro nary arteries under a National Institutes of Health Young [nvestigat0r Re+ search Award. B Y A R T H U R AVTU-MN I P 9 9 A G 1 E 6) �Kassirer receives -1991 full-time people who were extraordinary teachers and doctors. The environment was very carefu lly designed for the student. l'm sure it's even more so today . After l had begun my career, it was apparent to me that these great teachers and doctors had become role models for me." As an acknowledged specialist in nephrology and internal medicine, Kassirer has received national recogn ition for his work on diagnost ic reason ing and therapeutic decision-making . He is the Sara Murray Jordan Professor of Medicine and vice chair of the department of medicine at Tufts Universi ty School of Medicine, Boston, where he has been on the facu lty since 1961. Kassirer also is associate physicianin-chief at the New England Medical Center, Boston . Kassirer has over 100 publications on a varie ty of aspects of clinical medici ne. A Buffalo native, he auended UB as an undergraduate from 1950 to 1953, entering medical school following his junior year. While attending medical school, he was named to the Gibson Anatomical Society and Alpha Omega Alpha and received the C.V. Mosby Award and the Roswell Park Award in Surgery. He received his medical degree magna cum laude, and did his internship and served as assistant reside nt in medicine at The Buffalo General Hospital. Since 1986, he has served as a regiona l member of the governing board of the UB Medical Alumni Association. He said that his multi-faceted career was a key factor in his securing the editoria l duties at The New England Joumal. "The experiences I had in my early Distinguished Alumnus Award NEW ENGLAND MEDICAL J O URNAL EDIT O R PR A ISES UB SCHOOL erome P. Kassirer, M.D., editor-inchief of The New England Joumal of Medicine, received the 1991 Distinguished Medical Alumnus Award at a Past President's Dinner on September 19 at the Buffalo Club. Kassirer replaced Arnold S. Relman, M.D., last July as editor. He was named following an extensive worldwide search by a distingu ished panel of medical leaders. The New England journal is the oldest continuously pub lished medical journal in the world and is considered the nation's leading medical research journal. Kassirer said that a combination of research and teaching excellence makes UB's School of Medicine and Biomedical Sciences one of the great academ ic centers in the country. "Buffalo is obviously veryimportantto me. It was herethatI developedmy idealsand my knowledgein the field of medicine." "Buffalo is obviously very important to me. It was here that I developed my ideals and my knowledge in the field of medicine," he said. "When I was in medical school here, there was a group of Farleft: Thoma s Riemens chneide r, M.D. , associat e vice president for clinical affairsand associat e dean. left: James Weerick , M.D., Class of 1949 Eit> BUFFALO PHYSICIAN ANO BIOMEDICAL SCIENTIST AUTUMN I 9 9 I �Alumni of theMedical n, , '77, president withNedraHarrisoM.D. , celebrates of Medicine Journal , M.D.,'57, editorof 11,eNewEngland e .Kossirer JeromP . Award us ed the1991DistinguishAlumn , afterreceiving Association her going, it was what she hadn't done LS and said that the one fundamental men yet that kept her going. That reprcsentS career, includinga lot of teaching, helped should be held b>·all docthat al pnnc1p ph) ." set me up for the Job I haYe now. I tors is to perform services ,, h1ch arc very clearly my philoso Associauon prei Alumn al interMedic very The me believe those things made useful and good for people ~rmsull a allydcs1gned aspeci ith en, said. he Kassir sented esung to the search commntec, doctor. \1\ responsibility 1sto do good. tion ofh1s emora in comm in gjob crystal buffalo "I think that it is the most amazin This 1san unparalleled opportunity LOdo ues colleag and friends award. About 75 medicine that there 1s." good 11·sa bit awesome to me," he said + were on hand to honor him. Kassircr, who addres!>cd the 145th "Martha Graham, when she was 80, R E M H A M M A R K B Y commencement of the medical school in II wasn't the awards that kept that said Ma}, made light of his own achic\"e- BurP'A.LO PHY.IC I AN ANO e1oiw:CDtCAL SCICNTl•T AUTUMN �.......... . . .. ....................... . ............ . ............ . ........................ .. Spring Clinical Dayand Reunion Weekend set he MedicalAlumni Associationhas seLSaturday, April25, 1992,for its 55LhAnnual Spring Wilensky, ClinicalDay. KeynOLespeakerGail direcLOrof LheHealLhCare Finance Adminisrration,will address "High Technologyand CosLConLainrnenL in Lhe1990s." Reunion Classes of 1942, 1947, 1952, 1957, 1962, 1967, 1972, 1977, 1982 and 1987 will meeL on Friday, April 24 for CockLail RecepLionsand Saturday, April 25 for Reunion Dinners. Those classes will be vying for the Best Attendance Trophy, won lasLyear by the Class of 1941. CLASS OF 1942 "It's hard LO lx:lievethat 50 years have elapsedsince we graduated./.£r'smaizethis reunion as meaningful ro us as tl1c day we received our diplomas!" RICHARD AMENT, M . 0. , CHAIRPERSON CLASS OF 1957 "The more rhc merrier. It's ce11ai11ly tme for class reunions. Thoseof 11swho have a1te11ded previo11Sreunions /mowhow mud1fm1theyare. l l1opeall my classmatesare pla1111i11gcocomeroour35th , in April '92." SOL M.0 .. MESSINGER. CO -CHAIRPERSON CLASS OF 1947 "A long rime has passedsince we fought rl1ebattle of High Street. Let's relivethosedays and share new stories at rhe 45th classreunion." WILLIAM M . BUKOWSKI. M . D .• CHAIRPERSON CLASS OF 1 952 "Comebacl110see how Buffalo, the School and your classmates have changed in -f0years.We needyou LOmalie r!1isthe bestreunionof all." NEAL FUHR . M . 0 ., CO -CHAIRPERSON "Don'tyou thinli dra1after40 yew:s<ISphysiciansour whole classought LOget cogether011 April25, '92 bac/1in B1if{alo?" ROBERT BAUMLER "Dr. Sol Messingerand I are /oohingfonvard with great expectationsto our 35tl1reose union. We hope that 1/1 auend the 30th who did 1101 will 111al1e every effort to renewoldfriendshipsandshare with otherswhat's happened ro them over t/1eyears." RICHARD MILLER. M . 0 ., CO -CHAIRPERSON . M . 0 .. CO-CHAIRPERSON "Fony years. Ir's beena long rime and a greatprofessional " career.Comea,u/ celebrate! BURTON 5TULBERG . M . D .• CO-CHAIRPERSON e BUFFALO PHY S ICIAN A N 0 8t0MEOICAL SCIENTIST AUTUMN 1 9 9 1 �.. . .... .. .............. CLASS OF 1962 .............. ..... .... ....... .................... .. ............ "It's hard to believeihatfive years have gone by. Lei'sall gel togeiher and renew 1l1e friendships we had. We hope to seeyou ihis Spring." FASANELLO, M . 0. , CO-CHAIRPERSON JACK C . FISHER, CO-CHA OF 1 987 CLASS "Theseare ow·vintageyears. D011'1 miss your 30th." SEBASTIAN . M . 0., IRPERSON THOMAS SMITH . M . O .. CO-CHAIRPERSON ALAN BEITLER. M . O .. CO -CHAIRPERSON OF 1 972 CLASS CLASS OF 1977 CLASS OF 1982 "Be an activist again! Co11taC1 your f rie11ds from rhe classof '72 and meer them i11 Buffalo. the ci1y of chichen wings, beef 011 wec/1 and America's premier football ream!" "Fif1ee11 years liavejlow11by! /-loware our classmatesdoing? Come to the reunion on April 25th and find out for yourself" MAR TIN BRECHER. "Fifteenyears? It can'! be! ELIZABETH BARLOG. Lei'sge1 togeiherbeforea11y M.0 .. CO -CHAIRPERSON more lime passes.Nedraand I loolifonvard10secingyou." "A special grce1i11g10 all of my classmaresll'irh the hope GREGORY YOUNG. M . O ., co-CHAIRPERSON 1ha11992will seeyoubachin Buffalofor our 10-year reunion." M .0 .. CO -CHAIRPERSON PATRICIA OUFFNER . M . D .. co-CHAIRPERSON N EDRA HARRISON. CO-CHAIRPERSON M.0. , ''Tl1esepasi 10 years have go11eby sofast and so muc/1 has happened in our lives. Won't ii be grear 10 get 10gether with old friends and find 0111what's been going 011?See you all al our 10ycar reunion!" KEVIN BARLOG, M.D .. CO -CHAIRPERSON CLASS OF 1 967 "\Ve all have a date with history. I-lopeto see you all at our 25th re1111 io11011April 25th, 1992. Be there if you possibly ca11 !" JOHN P. KELLEY . M.O .. CO-CHAIRPERSON THOMAS P. SHEEHAN. M .0 ., CO-CHAIRPERSON PHYSICl A N A N D BIOMEDICAL SCIENTIST A U T U M N I II 9 I E!) �··············•····················· [I] ' . NoenamedSeniorVP at Buffalo General ichael F. Noe, M.D., M.P.H., has been appointed a senior vice president al The Buffalo Genera l Hospital. A clinical assistant professor of medicine and social and preventive medicine at UB and recipienL of the Dean's Award in recogni lion of ou tstanding service to the medical school, Noe most recently served as BGH's vice president for professional affairs. He will continue to be responsible for that deparlment whi le also serving as the hospital's medical director. "He has received this appointment in recognition of his continued outstanding contributions to this inslitution, particularly with regard to medical affairs, the University-hospital relationship and the improvement of quality assurance," according to John E. Friedlander, BGH's president and chief executive officer. + M JosephChazen M.D. namednational fund drivechairman oseph A. Chazen, M.D., has been named National Chairman of the University at Buffalo 1991-92 Annual Fund Drive. The UB Annual Fund seeks support from alumni and friends across the country for University-wide needs such as scholarships, fellowships , classroom and laboratory equipment, library acquisitions and unrestricted funds. J e, 8UFFALO PHYSICIAN Chazen received his undergraduate degree cum laude in pharmacy from the University at Buffalo and medical degree from the School of Medicine and Biomedical Sciences. Currently he is clinical professor of medicine at Brown University, Providence , Rhode Island, medica l director of the Artificial Kidney Center of Rhode Island and head of Nephrology Associates. He also is co-director of the Division ofRenal Diseases, Rhode Island + Hospital. Milgrom awarded an honorary sciencedegree elix Milgrom, M.D., distinguished professorof microbiology, has been awarded an honorary doctor of science degree from the University of Medicine and Dentistry of New Jersey in recognition of his pioneering work in basic and medical immunology. Among Milgrom 's major contributions is research in the strucLUre and function ofanLibodies related to rheumatoid arthritis and the mechanism of hyperacute rejection in kidney transplants. A native of Poland , Milgrom joined the UB faculty in 1958 and served as chair of the department of microbiology from 1967 to 1985. He was previously chair of the department of microbiology at Silesian University School of Medicine in Zabrze and professor and acting chair a t the University of F 4NO Bt OMEOIC A L SCIENTIST Wroclaw, both in Poland. Milgrom's scientific contributions have earned him the prestigious Paul Ehrlich Prize, the Alfred Jurzykowski Foundation Award and honorary degrees in medicine from the University of Vienna, University of Lund (Sweden), Unive rsity of Heidelberg and University + of Bergen (Norway). Schaefer succeeds father inSt.Jose~hHospital Ophthalmology post aniel P. Schaefer, M.D., will succeed his father, Arthur J. Schaefer M.D., as director of the department of ophthalmology at St. Joseph Hospital, Cheektowaga. The younger Schaefer, a UB medical school graduate, has been a member of the SL.Joseph Hospital medical staff since 1986. His father was director of ophthalmology there since the hospital opened its doors in 1960. Daniel Schaefer served his resident training in oph thalmology al the New York Eye and Ear Infirmary , New York City, and was appoin ted chief residem in his third year. He served a fellowship in ophthalmic plastic , reconstructive , orbital and lacrimal surgery at Wills Eye Hospital, Philadelphia. A fellow of the American College of Surgeons and the American Society of Ophthalmic Plastic and Reconstructive Surgery, Daniel Schaefer is a clinical associate professor of ophthalmology and assistant clinical professor of + otolaryngo logy. D AU TUMN 1991 �-- -------------------- ----- -- - -- ·· · ··· · ··················· · · • ················· · ···························· ··· ············■ • 9 1 2 s 0 '27 , of B . KUITE GEORGE I Conway, New Hampsh ire, is dis ab led due to a fracture of the spine two years ago. L. MAXWELL LOCKIE '29 , is retired and lives in Escondido, California, where he enjoys playing bridge and meeting new friends. 1 9 IRVING 3 B . PERLSTEIN Louisville, s 0 '39 , Kentucky, of retired from practice and teaching in 1989. 9 1 4 HAROLD 0 s K . PALANKER '40 , has been invited to become a founding member of the Albu- left to right:AndyandHelenCappuccino '88, WayneWaz'88, hiswifeMarijonePetruzzi '86, TomBellomo '88, his wife,Cynthia Loya , Loriluizi'88, Margar et Morey'88, FrankLuzi , '88, JamieMusiker '87, herhusband, Michael Nemirov '88. of ogy at the University of Texas for children with cancer in San Amhers t , New York, retired after Medica l School, Houston, edited Diego, which has now been du- N . LUBIN ARNOLD '62 , 25 1/2 years in the US Air Force the textbook /mmwrologic Dis- plicated and spread through- and is now Erie County Health Commissioner. eases of tlte Shin, Appleton and out California with at least six other camps having been formed. Lange, 1991. I look forward to coming back querque Academy ofSurgery. He ROBERTA has been retired since 1987. GI L BERT '62 , read two papers this year: ''Toward a PAUL M. GOLD F ARB '67 , for our next reunion and look forward to hearing about other D . WHITE '40 , has been Natural Systems View of Trans- writes from San Diego, Califor nia, that he will be taking over as appointed to the Monroe County, ference" at the Midwest Sympos ium on Family Theory and Therapy, Chicago Academy of Pres ident of the American Can cer Society for the State of Cali- Sciences, and "Freud, Transfer- American Cancer Society in the ence and Differentiation" at the an United States . Over the last 11 sor and cha irman of the depart- Symposium on Differentiation at Lawrence years, his practice has been lim- ment of obstetrics and gynecology at Albany Medical Center, the Georgetown Fami ly Center, Andover, Massachusetts, is an ited to doing surgical oncology. Washington D.C. He has been a member of a JOHN Florida, Alliance For the Aged Advisory Committee. MYRON GORDON '48 , profes- will be on sabba t ical from JanuEHRLI C H '63 , is now ary 1992 to June 1992 in Lon- FRANK don, England, at Kings College deputy chairman of the depart- Hospital. ment of surgery and director of the division of surgical critical 1 9 F LOYD 6 H. LIPPA 0 '61 , s was care and nutrition at the Graduate Hospital, Philadelphia , Pennsylvania. fornia, the largest division of the aviation medical examiner. He also nies antique aircraft. versity in San Diego. He is active specialist, is di rectorof the respi- COLE '73 , a ratory department and sleep dis- doing surveys of hospital cancer orders center at North ridge Hos- programs. "Of the things that l pital in proud ofis having started a camp PHYSIClAN at Hospital , with the College of Surgeons years, the one that I am most 0 surgeon General pulmonologist and critical care pro- L '72. JEREMY fessorand chairman of dermatol- A N . WARNOCK o rt hopedic s 0 tained affiliation with the Uni- ROBERT I"' RICHARD 7 fort he last 10 years and has main- pital, Dearborn, Michigan. F 9 mu ltispecia lty oncology group three-year term at Oakwood Hos- U 1 orthridge, California. have done over the last several elected chief of surge ry for a 8 members of my class ." E . JORDON A H D '65 , BIOMEDICA\. SC ENTIST C . S GALIA '73 , of Hopedale, Massachusetts, is cur- AR T HUR AUTUMN �■ ·························································································· I OBITUARIES rently vice president for medical affairs and president of the medi- in 1988 and became board certified in 1989. She i's now medical Center. I have just published 'On a Radical Lesbian MATTHEW L. CARDEN ·19 , cal staff at Milford Whitinsville direCIOr of the young adu lt t reat- Feminist While Training in Psychiatry' in Women and Therapy. died August 27, 1991 in Sarasota, Florida. Dr. Carden practiced LAWRENCE 0 . RAMUNNO'87 , 60 years before moving lO Florida. received an M.P.H. from Johns While in Buffalo he served as Regional Hospital. He maintains ment unit for resistant patients at a full practice in internal medi- Four cine/cardiology, and is a clinical ins tructor at the University of Westchester, New York. Massachusetts. JoHN W inds Hospital v . Sosso Remaining in medicine in Buffalo for more than '85 . of Hopkins and is now in private Blauvelt, New York writes, "Re- practice, "near a covered bridge," cently completed a fellowship in allergy/immunology at Scripps in Conway, New Hampshire. in Health Policy and Administra- RONALD DAVID '75 , a lecturer chief of staff as well as president of the staff of Mercy Hospita l. He headed the Eric County Medical Society in 1954. Survivors in- tion at Harvard writes, "'I am re- Clinic in La Jolla, California. SUSAN L. BEHEN '88 . a fourth- signing my post as Acting Secre- Longing for the East Coas t , re- year general surgery resident at tary of Health in Pennsylvania 10 turned to open 'Orangetown Al- Johns Hopkins Hospital writes, clude a son, Dr. Lawrence M. Carden of Sarasota. return 10 academia, write a few lergy and Asthma' in Rockland "I will be doing a six-month fel- JUL IUS T . books and critically reflect on County, ew York. My wife lowship at Oxford University at died May 26, 1991. Dr. Markovitz health and medical care in the Oanel Piscitelli-Bosso, M.D.) and John Radcliffe Hospital, Oxford, had a private practice in Nonh new millennia." I recently had our first child, England fromJanuary'92 toJune Tonawanda, New York until 1955 Lauren Catherine." '92. Any fellow alumni welcome when he moved 10 Lauderda le- to stop by, if you arc in the area by-the-Sea, Florida. DAVIDFORSTER '85 , and Carol Hammer Forster '85 write, "We traveling . Sorry 10have lost touch ticed in Florida until 1980. He is with my classmates survived by his wife, Bernice. friends." cology. arc proud to announce the birth of our first child, Chriswpher JAMES R . MILLER '79 , was re- IRA L. SALOM'77 , ofE!mhursL, New York, has passed the first examina tion given by the American Board of Clinical Pharma- elected president of the New York State Association of County Health Officials. He is Commis- and old MARKOVITZ '28 , He prac- CHARL ES R . LEONE '29 , died May 4, 1991, in San Amonio Brandon, on May 18, 1991. We will be moving back to Northern MAJOR J OHN G . CHR IST IE '88 was deployed LoSaudi Arabia/ while attending a mass for his Virginia in August after two fun Iraq/Kuwait with the 1st Infantry deceased wife. Dr. Leone was an years in California. Division during Desert Storm. auending Carol con- surgeon at Saint sionerofHealth for the Onondaga tinues her practice as pediatri- He is currently in the M.P.H. Vincent Hea lth Center in Erie, County Health Department. cian, and David will be practic- Program at Johns Hopkins and Pennsy lvania, for 40 years. He has been selected for promotion rank of Lieutenant Colonel. His main civic interest for more ing ophthalmology." 1 9 B s O MIC HAEL E LLIOT CAN E '83 , has a pri va Le p rac1 ice cardiothoracic lO surgery in in Bethlehem, Pennsylvania. T INA was president of the staff in 1955. than 40 years was the Boys and MAR IE GAR D N E R '87 , . writes, Girls Club ofErie. He was a mem- Jacob, born July 25, 1990. She is "A large group of UB Medical ber of the board of directors for nowdoingou1pa1ien1 urgent care School graduates met on the sunny shores of Redondo Beach over -+Oyears and in February 10 celebrate the wedding of Tom bership. He was honored in 1983 announces the birth of a son, in Stony Brook, New York. E . O STROV '83 , an assistant professor at the Hershey LAURA BAR BARA MARGAR ET MOR E Y '88 1990 was given a lifetime mem - Bellomo '88 10 Cynthia Loya. 11 with the prestigious Silver Me- Medical Center, Hershey, Penn- chiatrist for Operation Concern was a fantastic evening of cham- dallion by the National Boys Club sylvania, announces the birth of pagne, fresh oysters, stir-fried shrimp, while being serenaded of America. her daughter, Meredith Buckley, in Alameda, California, writes, "I completed my psychiatry resi- inJu ly 1990. dency at UCSF/Langley Porter by a Mariachi band. Enclosed is P OST '87 , a staff psy- Ins1itu1e, and started a position CAROL WEINSTEIN '84 . com- as staff psychiatrist at a Lesbian/ pleted a residency in psychiatry Gay Community Mental Health ~ BUFFALO PHYSICIAN A N D BIOMEDICAL a photo of all the Buffalo folks." ALI CE B E NNE TT EMMA MURRAY'37 ,diedjuly3l, 1989, in Phoenix Arizona. 5C1£NTIST A U T U M N 1 9 9 1 ��YORK AT BUFFALO Permit No.311 :c _ , 5--1 L• Ry ., €PT � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Autumn 1991 Subject The topic of the resource State University of New York at Buffalo.- School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1991-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine. Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v25n04-1991-Autumn Table Of Contents A list of subunits of the resource. Research Hospital News The Resignation of Neal Rzepkowski In Whose Hands? Congratulations. You Have Been Accepted! The Class of 1995 Ending the Agony Medical School Alumni People Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-12 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v25n04 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1991 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/f7637e05266ebe45ca028c9c4e902f83.pdf b0f56d0ca8e43b3eda329c73e56e1884 PDF Text Text Vol 25 Spnng1991 2 ~iomedic �TH h FF\Ll'Pl-'I'.., ,\l"'-l"lfl'-,T l\"<A.[l f1.\'f 1 \, Ol< L R~, ,)R {' Pl "ll( \ ll' J.., ', II le t 'IT "< \r I- • ... \ ,.., ' \It l'F " F\\ E'-. [.., "- tc ,c<11 r \H>ulJ 1,e tr,1'1 •crrt- rri\ m \ r., ch, 1 Kil 1 n11\ H Ju, I, I' \\I t t~, '.[) t tI I nr r1L.Jt-}mc.rl re t.1• short ,'1,hJ.lumni,mdtn,r,l, ,dn1Ptr1bll' • \\h.tt ,, reqi.irt·d, l ~ 1s ,on,tct-r, l I Jcr , !I '1 ' rut- IC. 11 j .ii SL.h,k \ Ill l''l'\ldmg SL.hol,1="11r5SI ( OlC. l nJLr th< ,e l<tr~h1;,of['; Thon I VJtlU5u, A, M,lllt Dem ..1·111'.·ll r. r , • \.IT' 1 ·It n,, rnl ~ r,c hu r·cuuil, tLnds w 11,1,JrJeJ t. iudlnt, l nth, h-1 o 1 IT m, r nltd [ ,h w.ir th. sc h0<l •s,1bletl' Ix ncht < f n• m mix r I tl de nr, \XL hope th t the\ \\ 111h: < 1H1ucll'h •r He '.11 th It i, thvr l irn ' Pll '-.• '' '11.1. 1, 1J ,r, It 11 Ku, ll t,, •I),, ct',,rt \\,~,le n, .. ~1 ITt ',, .....I ' n 1 LL.kh ~,>''r, kr sr1<1tln11• ngn,thmthel9b0, 1 .irrmi- 1u1r But ,,«,r!L. thc,n 1e,,<\,1tposturl\\,1lchmgl hm:un t1J\, l l\,c, r 1111u.1cntt< mu," rhc \ 1• 11- rool, 1h<hol.1rsh1rrunJ"\a~..1 oli,J r I ·.1blihe 1 m ''1l < rl, , 4'< , \\ , 1 u n,,nrr 11, n J .,, I r h,"1-r1 I • (I J, I ,d, d It ml c ,di 1tr n,>\\ th n t ..: u ·t, Inc l1t l, 11, 11 n L ! I\ I I Ul rt " 1c dth, ,11,ltnt fll, Et Tl'K \'-,'-...'t ,Aft \U cl , RI • O rn. JL\dl Ix ch th< tK Tr I fr1, ne • the prton te ,IL,. then l t DearAlumni andSupporters of theUBMedical School, ~ l'-L L • M •~t \ \H Is, x,k (() h~lr tht \\lit II l n •t. tnel'lc.1' t r_.r; 1' f1 lrl p ,nrt r I~ ·t C. 1rcJ n•ht tdt.,ns,lcxrrc• of,, 1\\l,,\\nuJ.1kctl'sh1r~mth \er Ix r,garJs Ill \ IC lll T,, rh "lc.,11 llt.nc. 11r11.:c 111,t•t1t :11 pr rt\t<,k11,k1 I, .... «•I• necJ <L h -•-rr rt " m ,~, h ,r, i,, 'I ·1 'vi 11' I)\\,, <r '"\~ l > H \, 1-11'-.(,H ,.., ITA .., ,~ ·LI \IS{''-" I t \ \ \1e, 1( e • fi It I lll T'<F I . •t \hl f ' ), l 1 \ I 1 .•n ' ',f\ \! , l 1 ' r ! I' ,I l'r,, \ i, ·t I I \j, llc l John N.mghton, M.D. 1 • • r C 111 I \ff.1 r, ,1 l .! I< U.. 11 ~LI l t ' DearFellowAlumni/ Alumnae: \ M ,knr, I thL \I mn1 \, K 111 ,n 1, rn F< th ,n h It \ r 1hLfl m llnm m 1,1h, "d I ,1-r,Lt J ,c \lumn R,un, 11\Xuh11l ml1l,1r, runt.r..,1rm•l l1111,II 1 l\,111tth1, ,c ,r Ill, 1..11.1m 11n rhru,t I 1 ,, 1 t f "l , , 111th ,, 11 ru,n1t th< \lltk<n n It r ,, u. "' " 1 11,k, ,, u di 1 , mr11 " I ,nu l Ir lmun, the \lumn \, ,1111 n h.i k.l I rucpl n Irr, \X, h I I ,Im , ~l'\' ,n, n l' \\ c In I th 1 , < , ti, ,rud,nr, durm tic 1r m tn 111,11, n. l h, e 'l'lll , , t, r 1d1 I cir'-' me tr, ,, 111, rh, ,!11,, md \ ur L 11 ,n, I. \ur di rr, 11111 l l, 111"\\I t ,clt,,l I , 11'< 1, r, m, ,, mx1 1 f, r 1111h, tu ILnt, I I tun< u1 n r ..!11111ll. lll\t nunl r" trh <\I 1111111\ x:1111 1 TI1<\ I I\L K"-l" kn<.« I, ur\\ llm Ill" II -f I 1l1t rl11, ~" 1 II --1H, \• 11 hLIr ntr1h111 rill 11 '" 11111 "rnn th II l Im,< 11I k\ I.I I, r thl t !l 11 I 11 '1rr rt 1h II Ill 1h, "I\ Bertram .\. Portm, M.D., '5, �B UFFAlD P!JY§1~!6iN Srnni.: 1991 II Research II HospitalNews On art and medicme, page 18. II HealingtheSpiritIn sickness, more than just the physical side needs to be addre-.;sed. BJDaggersoftheMind:Shakespeare andNeurology Lance Fogan, M.D., '65, catalogs the Bard's knowledge of the field. m A Curefor Malpractice HeadachesFull-rime SUNY Hmpicalchap/amsare a ma/ pareof the healthcareteam, page6. faculty physicians and dentists form their own insurance company. DJTheChnkalPktureRichard V Lee, M.D., on the affinity between medicine and art. E!J FromShin Splintsto HipPointersUB's new Sports Medicine Institut e helps weekend and professional athlete':> alike. BJCharting theQuality of LifeHarrington Physicumsned a <W)' to quancihquabryof life issues,page 24. lecturer Alvan Feinstein, M.D., laments the inability of basic science to measure the qualit) of life. m m Medical School News Alumni EEJ Research m m m People MatchDay Shakespe,art.' on neurology, />age 13. Classnotes Dand W'.Bt'ntb, M.D . focmes chcmedicalschool on healthcare[or the agm(!, page26. �----:(]}---- ., E I\. ~ 2 ten by a one-year $15,689 grant from the STUDY TOSURVEY HEALTH Great Lakes Protection Fund, which will IMPACT OFEATING GREATfocus on how consumption of fish from the Great Lakes affects risk of malignant LAKES FISH and benign thyroid disease. B researchers chis spring will survey 30,000 New York State anglers anJ their spouses in the largest study ever conducted on the health impact of caring fish from the Great Lakes. The study, funded by the Great Lakes Protection Fund, will focus on the consumption of fish from lakes Ontario and Erie by residents of 16 counries, according to John E. Vena, Ph.D., princi pal investigator and University at Buffalo associate professor of social and preventive medicine. Vena said researchers want to determine the characteristics of the population that consumes fish from the lakes, how their perception of risk relates to their consumption and rhe health effects of that consumption. "There is a long overdue need for a large populationbased survey of anglers to establish a cohort of fish carers," Vena added. The study is funded by a one-year $157,800grant from the Great Lakes Protection Fund, the United States' only multistate environmental endowment. Vena also is the principal investigator on a second study, underwrir- U Vena said the survey of anglers and their spouseswill focuson a random sample of anglers between rhe ages of 18 and 40 who live in the 16 counties and were issued a fishing license in New York since October 1990. The self-aJministered questionnaire will be mailed in May, he added. The 16 counties are: Cayuga, Erie, Genesee, Jefferson, Lewis, Livingston, Monroe, Niagara, Oneida, Onondaga, Ontario, Orleans, Oswego, Sc. Lawrence, Seneca and Wayne. Despite advisories issued by New York State that certain species offish caught in Lake Ontario should not be eaten or consumed not more than once a monrh, Vena said it's estimated that at least 15 percent of anglers eat these fish as often as once a week. He added chat among the Great Lakes, Lake Onrario "has a unique contaminant profile with the highest documented levels in fish of contaminants including pestipol ych lor inated biphenyls (PCBs) and methyl mercury." Vena said that m o s t studies to dace of consumption of contaminated fish from the Great Lakes "have been based on small, convenient samples in ocher states. For New York Seate, there is a lot of data on how much fish is caught, but no data on how much is eaten . We want to know who are the fish eaters and how much they eat and what do they know about the advisories." Once chose who consume the fish are identified, Vena explained, researchers will be able ro look at the associat ion between past and current consumption of contaminated fish, whether consumption has added to their body burden of chemicals and how consumption affects their risk for health problems. Barbara Knuth, Ph.D., assistant professor of natural resources and policy management at Cornell University, will be co-investigator in the study. Also collaborating on the study will be Germaine Buck, Ph.D., Maria Zielezny, Ph.D.,James Marshall, Ph.D., and Jo Freudenheim, Ph.D., all of che the medical school's Department of Social and Preventive Medicine. In the study, Vena's co-investigaro rs will be John M. Lore, M.D., professor and former chair of the UB medical schoo l' s Department of Otolaryngology, and Manuel H. Castillo, M.D., UB assistant professor of otolaryngology. Their study of the consumption of contaminated fish from the Great Lakes as a risk factor for malignant and benign thyroid disease will look at lifetime fish consumption from the Great Lakes in 58 people with cancer of the thyroid and 237 people with endemic goiter not due to iodine deficiency and a matched number of controls. 'This study will be one of the first to systematically evaluate the hypothesis chat consumption offish from the Great Lakes is related to risk for either malignant or benign thyroid disease," Vena said. • - By Arrhur Page �- ---:(]):-- -- .,. E ~ ~ 3 LINK BETWEEN CANCER, ELECTRIC BLANKETS NEEDS MORE STUDY W hile there appears cobe no general increase in breast cancer risk among women who have used electric blankets for several years, there is a higher yet not statistically significant risk among women who use the blankets throughout the night, according to researchers in the UB Department of Social and Preventive Medicine. John E. Vena, Ph.D., and colleagues studied 382 postmenopausal women with breast cancer and 439 controls who were asked about electric blanket use in the previous lO years. The UB researchers say further studies must be done co obtain an accurate picture on the relationship between electric blanket use and breast cancer risk. It has been hypothesized chat chronic exposure to electromagnetic fields increases breast cancer risk by suppressing the normal nocturnal rise in pineal melatonin. • - By Arthur Page More than 500 scientific papers will be presented at the meeting sponsored by the medical school's Department of Social and Preventive Medicine. Graham will be honored at a reception and banquet at 6:30 p.m.,June 11, in the A lbright-Knox Art Gallery, Buffalo. The symposium honoring Graham will explore the directions chat research should cake to define the role of diet in the etiology of cancer. Registration is being handled by the Office of Conferences and Special Events at the University at Buffalo. • - By Arihur Page SYMPOSIUM TO HONOR SAXON GRAHAM A symposium on diet in the epidemiology of cancer will highlight the 24th annual meeting of the Society for Epidemiologic Research co be held June 11 to 14 at the BuffaloConvention Center. The meeting will include a "Symposium on Diec in the Epidemiology of Cancer: Future Directions" in honor of Saxon L. Graham, Ph.D., professor and chair of the Department of Social and Preventive Medicine, who will retire in May. BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST mal imaging equipment and accompanying computer software chat result in che simultaneous production of matching thermal and visual images. "The same electronics that generate the thennal imaging data also provide the visible imaging data," he notes. "The same optics that are used to generate the thermal imaging data are used co generate the visual imaging data." The computers used in today's thermal imagingequipment interpret the body's radiation patterns in terms of temperature, producing readouts of numbers, shades of gray or colors keyed co specific temperatures. Hejazi notes that the image produced is not a visual one, but a "picture" based solely on temperatures that muse be interpreted. Hejazi's electronic and optical equipment modifications result in simultaneous production of thermal and visual images that share a common perspective and size. He said further modifications may provide an ability co superimpose one image over cheoch~ • THERMAL IMAGING DRAWBACK OVERCOME A major drawback that occurs in interpreting the results of thermal imaging has been overcome with technology developed by a researcher at UB's medical school. Shahram Hejazi, Ph.D., has developed patented modifications to standard ther- - B)' Arthur Page SPRING 1991 �---------------------·ffi------------------+E 'll" 4 For most of the last l O years, the hospital's annual births hovered around the 2,400 mark. Births rose steadily over the psychiatric expertise for patients who canlast three years, from 2,472 in 1988, to 2,706 in 1989 and ove r 3,000 last year. nae be properly treated at the Community Sister Angela Bontempo, president of Meneal Health Center because of their Sisters Hospital, attributed the dramatic medical condition," or patients who canincrease to changing patterns in available noc "receive adequate psychiatric care on obstet ric services, a rise in area births, a a regular medical floor." The opening of the new facility increases strong OB residency teaching profile, dedco70 the number of beds operated by BuJfulo ication and hard work from nurses and General for patients with psychiatric illness- physicians and high-profile marketing. She noted that the hospital has been es. The other 60 beds are located in the working very hard over the years to Community Mental Health Center. • strengthen its residency progra m. "We have built up our residency program on obstetrics and gyneco logy," she said, addi ng, "we have improved our facilities and capab ilitie s, invested in people and let the physicians and public know about or the first time in recent history, Sis- what we have. Obviously, we are very proud of our obstetrica l service and are ters of Charity Hospital del ivered • commi tted to its future." 3,000 babies in a calendar year. The milestone delivery came down to the wire as the 3,000th baby arrived on New Year's Eve as I 990 drew to a close. problems," he added . SISTERSMAMMOGRAPHY Noe said the new facility "makes it posUNITACCREDITED BYA(R sible to integrate internal medicine and isters Hospital' s Mammography Unit has been accredited by the American College of Radiology. The unit, part of the hospital's Department of Diagnostic Imaging and located next to its Breast Care Center of Western New York, is one of 1,500 facilities chat have been accredited nationally. Requirements for the three-year accreditation include a peer review eva luation of the facility's staff qua Iifications, equipment, quality control and quality assurance programs, image quality and breast dose. Mammograms are recommended by the American College of Radiology,the American Cancer Society, the American Medical Association and nine other major medical organizations, every one to two years in conjunction with a physical breast exam every year for women between 40 and 49, and every year in conjunct ion with a physical breast exam for women over 50. • S SISTERS HOSPITAL RECORDS 3,000THBIRTH ONNEWYEAR'S EVE F ROSWELL PARK CANCER INSTITUTE RECEIVES NEWNCI DESIGNATION STATUS BGHOPENS 1O-BED MED-PSYCH UNIT B uffalo General Hospital has opened a new l 0-bed acute care medical-psych ia tric unit as part of a 47-bed expansion approved by the New York State Health Department. The new unit, located on the 12th floor of the hospital's 16-scory medical cower, began admitting patients late lase year. Philip C. Noe, administrator of BGH's Community Meneal Health Center (CMCH), said, "ll1e unit is among on ly 20 such facilities in the entire country. Currently, the Erie County Medical Center is the only ocher upstate New York hospital with an acute care unit dedicated to patients who are diagnosed as having both medical and psychiatric R ... . .. _,,.· srtmm 1'191 oswell Park Cancer Institute has been approved by the National Cancer Advisory Board for status as a National Cancer Institute-Des ignated Comp rehensi ve Cancer Center. One of the first three cancer centers co receive the designation under a dual-level eer review system and guidelines estab··hed injanuary 1990, Roswell wasfuvorly recommended for the comprehen·ive designation by NCI's Cancer .;:;:::. fi/ Support Grant peer review com•·. mittee. Fox Chase Cance r : Center in Philadelphia .) and Yale University ...... :-':" Comprehensive . �s Cancer Center in New Haven, Connecticut, are the other two. All three institutions had been NCI comprehensive care centers under designated guidelines issued in the early 1970s. "As one of the original three centers designated as comprehensive following the passage of the National Cancer Act in 1971, it is most gratifying that we are also one of the first centers ro receive redesignation under the new peer-review process," said Roswell direcror Thomas B. Tomasi, M.D., Ph.D. 'The mark of'comprehensive cancer center' is one that the Institute bears proudly." The new guidelines required each center to be judged in new redesignation criteria, including: • A strong core of basic laboratory research, • A viable mechanism for facilitating links between basic/clinical research and outside organizations, • A proven record of innovative clinical research trials, • A significant amount of cancer prevention and control research, • An effective research training and continuing education program, • A wide range of cancer infonuation services for patients, health professionals and the surrounding community and • A substantial commitment ro community service and outreach activities, especially those directed coward underserved populations or those with disproportionate cancer rates. • CHILDREN'S HOSPITAL ANNOUNCES ER APPOINTMENTS hildren's Hospital of Buffalo has announced the appointment of two physicians ro its Pediatric Emergency Room. C BUFFALO Pl IYSICIAN AND BIOMEDICAL SCIENTIST OTOLARYNGOLOGY RESIDENTS RESEARCH DAYSETFORJUNE T Eugene W.Yates,M.D. PaulaMa1ur-Ellis, M.D. Paula Mazur-Ellis,M.D., clinical assistant professor in the Department of Pediatrics, and Eugene W. Yates,M.D., clinical instrucror in the Department of Pediatrics, have been appointed attending physicians. They will be responsible for patient care and supervising the pediatric residents. Mazur-Ellis received her medical degree from the University of Pinsburgh and did her post graduate work at Mercy Hospital of Pittsburgh. She has had extensive training and education in various classifications of life support. Prior to her new position, she was an associate pediatrician in a private practice in Beaver, Pennsylvania and a college health physician at Duquesne University. Mazur-Ellis is a member of the American Academy of Pediatrics and has written articles and abstracts about intellectual development status postHaemophilus Influenza meningitus. Yates was an assistant attorney general for the South Carolina's Attorney General's office prior ro obtaining his medical degree from the University of South Carolina. He completed his pediatric residency at Richland Memorial Hospital in Columbus, North Carolina. A member of the American Academy of Pediatrics, Yates is the co-author of publications on child and adolescent psychiatry. • he Seventh Annual Residents Research Day for Otolaryngology/ head and neck surgery will be held Wednesday, June 5, from 8 a.m. to 3 p.m. in Palmer Hall at Sisters Hospital. The day will include presentation of otolaryngology residents' research papers and will feature visiting professor Guy M. Osoff, D.M.D., M.D., Guy M. Maness professor and chairman of the Department of Otolaryngology at Vanderbilt University Medical Center, who will speak on "The Role of Laser Technology in the Upper Airway 1991." • SISTERS HOSPITAL NAMES CHIEF OF DENTAL MEDICINE ayne C. Jarvis, D.D.S., has been appointed chief of dental medicine at Sisters Hospital. He previously was direcror of the hospital's division of oral and maxillofacial surgery. A graduate of the University of M ichigan and the University of Michigan School of Dentistry, Jarvis completed his residency in oral and maxillofacial surgery at UB's School of Dentistry. He is a faculty member at the Misch Institute for Advanced Implant Dentistry, Dearborn, Michigan, and the Implant Center of the University of Pittsburgh School of Dentistry, as well as UB. He was recently certified and awarded diplomat status by the American Board of Oral Implantology/ Implant Dentistry. • W ~PRING 1<191 �6 YLOIS ASTRAINED PROFESSIONALS , : SIMON TONG CHAPLAINS ARE PART OFTHE HOSPITAL TEAM SPRING 1991 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST ��8 arher Richard Augusryn's first patient when he was a chaplain-in-training threw a bedpan at him. "I told my teacher, 'I only have one suit left,"' Father Richard said after returning home to change."[ can't afford this." Father Richard returned to the hospital and to the room to learn the reason behind the thrown bedpan. The patient, he discovered, had just been cold by a physician that she would need a double mastectomy. After delivering his report, the doctor had abruptly walked out. And the next person co enter the room a few minutes later received the patient's wrath. She apologized; the chaplain-intraining learned he hadn't done anything wrong; she is alive and well today. "That's the creative edge in pastoral care," said Father Richard relating the story years later. "You really don't know what the agenda is going to be." In a setting where most professional staff members have clearly defined duties, the job of hospital chaplain is an anomaly because it deals with the human and rhe spirimal rather than the scientific, and consequently defies easy definition. Local directors of pastoral care describe their work in spiritual overtones: "the soul of the hospital" and "the heartbeat of the hospital." Father Richard has been director of Buffalo General's Pastoral Care Department since it was formed in 1988, and was a volunteer chaplain for several years before char. With the help of a cadre of volunteers, he attempts to meet the spirimal needs of patients in that l,000-bed facility. "Yes, you have doctors; yes, you have nurses," says Father Richard in his tiny Buffalo General office. "You have all kinds of fancy technical things in a hospital. But in sickness there's more than just the technical char needs co be addressed, and chat's the human. "You have ro look at where people are coming from psychologically and spiritually. You cry co put all chose areas in sync, so the healing process becomes alive and real." In an attempt co define what hospital chaplains do, it is easier co state what they do not do. They do nor proselytize, preach, or attempt co convert. "We don't hand out rosaries," says Sister Lucille Socciarelli, director of pastoral care at Mercy Hospital in South Buffalo. "I can spend a whole visit and nor mention God." "I don't have a religious mission," says the Rev. Jackie Lewis, a Presbyterian minister and full-time chaplain at Children's Hospital. "We divorce ourselves from iniriaring the 'Jesus love~ me; Yes I know; For the Bible cells me so' sort of thing, because that's not where everyone is at," agrees Father RicharJ. Humans have cared for the sick since they Jevelnpcd the capacity for compassion, bur the position of professionally trained hospital chaplain is relatively new. As recently a~ the 1940s, ministering to the spiritual needs of Lhe hospitalized was a job often relegated to problem ministers anJ priests. That situation changed in 1951 when a group of Protestant denominations began training ministers for hospital work. The group was incorporated in 1967 as the Association of Clinical Pastoral Education. A similar Catholic organi:arion - the National Association of Catholic Chaplains - was incorporated in I 965. Today most hospital chaplains have at least one year of training and are certified by a board to practice in a hospital setting. Modern hospital chaplains are members of the treatment ream. They serve the needs of the patients, the staff and their families, rather than representing a particular congregation or denomination. They have access to patients' records, and as is the case at Children's, particularly in the Intensive Care Nursery, are encourageJ to record observations on patient charts. Chaplains serve on committees on ethics and institutional review. They receive referrals from physicians likeanyorherspecialisr. The main work of a hospital chaplain, however, is listening. "If nothing else, I'm company," says Eliot Marrus, rabbi at Temple Shaarey Zedek and a volunteer chaplain at Buffalo General. "Most of all, people wane someone co talk co. My role in the crnwersarion is almost negligible." His favorite story about listening involves a visit with an elderly woman in a wheelchair who had no family co visit her. "She looked exceedingly frail," relates Rabbi Marrus. "She J\UFFAL,1 PllYS!CtA:-.:.~Nil ll!OMElllC.~L '<'IE.'-JT!ST �Ina settingwheremast professional staff members havedearly 9 defined duties , thejob of hospital chaplain is ananomaly because ii dealswiththehuman andthespiritual rather thanthescientific, and consequently defies easydefinition. Atleft, Father Richard Augustyn. Atright,Rabbi Eliot Marrus. sort of put out her hand, I took it rather gently, and felt this viselike grip. She pulled me into the chair beside her and then maneuvered her wheelchair so that I couldn't stand up. I was her prisoner for the next 30 minutes while she gave me her autobiography." Rabbi Marrus's experience illustrates a basic tenet of the chaplain training program: lee the patient sec the agenda . 'That might mean being kicked out," says Father Richard. "That might mean listening to how the pastor of their church has raked them over the coals for something. That might mean being with someone who is dying and not saying anything." Father Richard has been a chap lain for 11 years. Ac Buffalo General he manages a staff of 10 trained volunteers. "The national average is one chaplain for every 40 pacients,"he said. "In light of that I shou ld have a staff of 42." His chaplains are assigned to particular floors in order to develop a relationship with staff and long-term patients. They go from door-to-door regardless of denomination. Most people receive him well, Father Richard says, but he has been ejected from rooms on occasion. He figures the negative reaction stems from preconceived notions about a chap lain's purpose. HosPITAL CHAPLAINSWHo PAYS? ospital chaplains are members of the hospital staff and are paid by the hospital. In add ition, many hospitals supplement their pastoral care staffs with trained volunteers. These chaplains are primarily interdenominational and serve the hospital staff and their families as well as patients. Ministers from specific congregations serve their own members as pare of their routine pastoral responsibilities. Father Richard Augustyn, director of pastoral care at Buffalo Genera l Hospital and president of the National Association of Catholic Chaplains, says all Buffalo-area hospitals had at least one full-time paid hospital chaplain as of April 1, 1990. Buffalo General established itsdepartmento nly two years ago. Since then, Erie County Medical Center has elim inated the salary of its director of pastoral care in an effort to cue its budget. He is staying on temporarily as a volunteer . Meanwhile, Millard Fillmore Hospital has just hired its first full-time director of pastoral care. "In Buffalo we're swimming upstream," says Father Richard . "Throughout the country they're cutting departments. All hospitals are feeling the crunch and we just don't know how it's going to pan out . ECMC'ssituation reflects the trend nationwide. "The bottom line is, pastoral care needs to be an integral part of the hospital. We're on the right track. That's what keeps us going." • - BUFFALO PHYSIC IAN AN D BIOMEDICAL SCIENTIST SPRING 1991 �"The concept of many people is that we're here 1roevangeenhance what is going on physically." lize, to slap their hands for not being a good Christian," he says. Chaplains at Mercy try to see all new admissions within 48 "The biggest egg to crack is to get beyond the hurt they bring hours. Currently they are not entitled to record observations with them concerning religion." on patients' charts, but hope to acquire that privilege. While hospital chaplains do not want to be seein as repre10 Sister Lucille said she is received well most of the time. senting a particular religion, Father Richard is of ten called "We always ask 'Is this a good rime?"'she said. "I've only been upon for priestly duties. One of his warmest memorie s as a tossed out of a couple of rooms. chaplain centers around performing last rites for a dying "Usually when people are sick, they are so vulnerable that woman. if anyone can help them, they grasp on to that straw." He had just returned home from the Stratford !Festival in She speaks of being called to visit with a 30-year-old Ontario, where he had seen A Streetcar Named Desire. One woman who had to have a double mastectomy; of comforting of the play's central characters is the unstable woman of a wife whose husband died of a heart attack after going out for questionable character - Blanche DuBois. a Friday night fish fry. Father Richard was in bed when he got a call saying that a Recently she stayed with an only child at the bedside of her Mary DuBois was dying. "I went to her room, krnelt down, dying mother. "The daughter just talked out loud to herself, anointed her and went through the whole thing call ing her and l was there," Sister Lucille said. Blanche," he said. "Her husband came up to me "Lots of times people tell us things they wouldn't afterward and asked if it made a difference that her tell anyone else. After being through something with name was Mary, not Blanche, and I was devastated. a patient, you can be closer than family." Oneof thegreatest "I got back down on my knees, and I'm apologizChildren's Hospital has had a Department of ing and explaining to this woman, who is extremely serviceschaplains can Pastoral Care for at least 20 years, now headed by thin and emaciated, why I cal led her Blanche, and al I Father Frank T uchols. offer is theirtime. of a sudden she got this very wide smile on her face Jackie Lewis, who has been a Presbyterian chaplain - and she died. there for a year, recalls that she was called "Sister" by Otherhospitalstaff "Now I've got all these guilt feelings. I apologized everyone, even when she was pregnant with her first mustrush off lo to her husband, but he put his arm around me and child. said 'Father, you've given me the best gift anyone According to Rev. Lewis, a chaplain's responsianother medical crisis ;a could give me. That's the first time I've seen my wife bilities at Children's can range from providing supchaplain canstay smile in six month s."' port for a woman experiencing a miscarriage, to At Mercy Hosp ital a pastoral care department performing a baptism in the intensive care nursery, to behind. has existed since 1975.Sister Lucille has directed the tending a small child so the parents can be with an Below , SislerLucille. injured sibling. full-time staff of two priests and four sisters for sil< years. The chaplains are part of what Sister Lucille She says that she is received well more often than Atright , Rev. Jack ie calls the "holistic hea lth care team." she would expect. lewis andherson. "[ believe so much in the ministry we are doing,'"' "When I first began as a chaplain, I thought 'Boy, she said "We try to reach people inside of themselve:s if some stranger walked in when I was having a crisis, - spiritually, psychologically, emotionally - to I'm not sure how I'd feel.' But people are very receptive." SPRING 1991 I\UFF.-\LO Pl IYSICI.-\N ANO BIOMEDICAL SCIENTIST �say hello. "A lot of the time I end up playing with the younger kids. While we're playing things come out . Adolescents can be really open and talk a lot, but some of them don't want to talk at all." Rev. Lewis says she loves her work. She could be speaking for all hospital chaplains when she explains why. "There is always a situation popping up that we hadn't dealt with before. That stretches us all the time, and it's exciting. We discover what we really believe about humandignicy, pain and the ultimate value of people's lives." • CHAPLAIN TRAINING ATSISTERS A isters Hospital currently offers the only hospital-based Her first call as a chaplain while doing her clinical training in the pediatric ward at Strong Memorial Hospital left a last- '' chaplain training program in Western New York designed for all religious affiliations. The program at Sisters, accredited by che Association of Clinical Pastoral Education, or ACPE, took in its first students in September 1990. Seven people have gone through the program to dace, and six more \ are enrolled for the summer. \, Sister Margaret Dougherty, directorof pastoral care at Sisters, supervises the program. Would-be students need ing impressionconcerning che nacureof che human response at least a year of theological background to enroll. Her to crisis. "The call was for a baby who had died in the intensive care unit," she says. "When l walked into the room, the doctor was sitting on the floor with the baby in his arms, the parents were sitting beside him, and they were all crying. "I walked in and told them who I was. The doctor handed me the baby and they made space for me in their circle. I could have fainted when he handed me the baby. I didn't expect that kind of hospitality at that moment." One of the greatest services chaplains can offer is their time. Other hospital staff must rush off to another medical crisis; a chaplain can stay behind. Rev. Lewis tells of being with a husband whose wife was killed instantly in an automobile accident. She mer him at the bedside of his 18-month-old child injured in the same accident. "At first he didn't say anything," she says. "Eventually he started to talk about his wife, about how long they had been married, about how the accident happened, about going to the morgue to identify her body - a lot of derails he needed to talk about. "I think he knew that because of my role, I'd be comfortable hearing his pain. All I really did was spend time with him." If there is time remaining after caring for emergencies, Rev. Lewis visits children on the floors. Often they don't know what to make of her. "I'm pretty low key with them," she says. "I tell them I'm not going to do anything to hurt them. That l just came in to students are an ecumenical lot, representing a wide range of experience . "So far we have had a priest, a Lutheran seminary student, an Episcopal deaconess, a Lutheran deaconess and three Catholic laymen," said Sister Margaret. "This summer we have an Assembly of God seminary student, two Baptist seminary students and two Daughters of Charity sisters." Trainees receive 400 hours of instruction per unit, with a minimum of cwo unit s required to become qualified as a hospital chaplain. Students spend 25 percent of their time in group work or individual supervision and the rest of their hours visiting patients. "Students learn about the process of illness, grief, coping, the role of emotions in illness, interpersonal relationships and give each ocher feedback," Sister Margaret said. "What's really exciting to us is chat along with ministering to acute patients, we have some students interning in the methadone clinic. They are really working on the spiritual dimensions of people in treatment. Ir's been a good experience for them." Chaplain training for Catholics is a lso offered through the National Association of Catholic Chaplains, or NACC. A multi-denominational parishbased program certified by ACPE is offered through Lutheran Social Services. • BUFFALOPHYSICIAN AND BIOMElllC -\L SCIENTIST SPRINO 1991 11 �FIG <MIV: SUl'OIK>' l'IIOffTAI. \ UN IMtl!IOII Fl'O'f f Al. GYII\/S ................ 1,AT(II.Al,..,. ~mi&l h~ ,, ./ • I • Ii, �Daggcern of theeMmJg ~ §kJkcespcearce ~ anJ Nce1Li1Jroliog 13 Pox and plague, double vision and dementia: Lance Fogan,M.D. , '65, hasstudiedthemall- throughthe eyes of William Shakespeare.<JIAn award~winning study written by the West Coast neurologistexamines the neurologicaldisordersdescribedin the dramatist's greatestplays. Among "Dr. Shakespeare's" diagnoses: tremors, the neurological complications of syphilis, encephalopathy, dementia, epilepsy, disturbances of srage IV sleep, cerebra l hypoperfusion, sciatica, pharyngeal abnormalities and cranial nerve lesions. "The plays of Shakespeare are the greatest mirror of mankind, reflecting all of our emotional and psychological complexity and diversity," Fogan says. "They give us the fullest possible picture of our nature. "Shakespeare was not only acquainted with the signs, symptoms and courses of diseases of the central and peripheral nervous systems," Fogan says, "but he also understood them well." Indeed, Fogan argues, "Shakespeare could have been a Renaissance neurologist." So careful and complete has been Fogan's research in support of chis contention that he has won widespread recognition from neurologists and Shakespeareans alike.His paper, "The Neurology in Shakespeare," won the American Academy of Neurology's j 32 7 Lawrence C. McHenry Prize in the hisrory of neurology. The study, which examines references ro neurology in32 of Shakespeare's 3 7 plays, not only impressed neurologists, but also attracted the attention of the Los Angeles Daily News, the Washington Post, the Chicago Tribune and KABC-TV in Los Angeles, which invited Fogan to appear on a health series. Fogan's work has also piqued the curiosity of the venerable Folger Shakespeare Library in Washington, D.C., which has expressed interest in having him make a presentation. "Shakespeareans from all over the country wrote co me. Even my mother read about it in Florida," Fogan says. Fogan attributes the widespread interest to the universal appeal Shakespeare holds and the endless curiosity about his life, his sources, his works and his influences. In the Los Angeles area, where Fogan lives, there aregroups of Shakespeare devotees - "geologists, newspaper critics, lay people," Fogan said, who meet to explore different approaches to reading him. While Fogan is pleased with the SPRING 1991 �14 reception to his paper, he is modest about chinking, ideas, motivations, fears. Anhis own contribution to Shakespearean thropology gives one a perception of how studies. There are over 700 references to all of chose facets of a human being demedicine and psychiatry in Shakespeare's velop. The knowledge of the body plays, Fogan says, and other researchers biology and anatomy - is one thing; but have gone over some of the terrain . He in making the person accept your diagnocites studies on Shakespeare's knowledge sis, your ideas about causes, testing and of chest diseases, obstetrics, gerontology, treatment, the physician needs to be able ped iacrics,rheumatology, orolaryngology, co understand the who le person. radiography and dentistry, plus countless "Shakespeare and literature heighten analyses by psychiatrists. But Fogan's study highlights a dimension of Shakespeare not fully recognized before - Shakespeare's breadth of knowledge of medicine, the accuracy of his observations of neurological signs, symptoms and diseases and the appropriate use of this knowledge co depict his characters. "The fullness and accuracy of Shakespeare's observations of behaviorcannot be overemphasized," says Fogan. Or overadmired, as the vo lume of Fogan's mail from Shakespeareans all over the country would seem to testify. Fogan's interest in Shakespeare, he expla ins, grew out of a life-time Lonee Fagan, M.D. , '65 interest in anthropology. "When I was an undergraduate at UB, I wanted to be broadly educated. I my awareness of certain aspects of human knew I cou ld meet the science require- nature and help me to recognize the huments for medica l school without having manity around me, giving me a new to major in a science. What I really wanted awareness of motivations and feelings and to study was mankind, so I decided to helping me to perceive, absorb and share what other people are feeling," Fogan major in anthropology." says. Though a pre-med student, Fogan Fogan became seriously interested in found encouragement for his interests from anthropology professors Henry Lee Shakespeare in the summer of 1977, when Smith Jr. and David Stout. The advisor to he spent a three-month study leave in London and was able co make weekend pre-med students, Roger Gracwick, thought his interest in anthropology co be visits to Stratford. Upon returning, he a fine, if unusual, foundation for medical enrolled in a night course on Shakespeare at the local community college - the studies. Looking back, Fogan values the for- College of the Canyons in Valencia, mative liberal arts education he received California - which offered a six-year course covering the complete plays and ::tsa UB undergraduate. "My backgrou nd in anthropology and poetry. Fogan faithfully attended for all linguistics served as an excellent founda- six years. "I started to notice the double vision, tion for me as a physician. A physician's primary responsibility is working with the dementia, the headaches occurring so people and trying to understand a person's frequently in the plays, and I began co SPRl1'G 1991 takenotes,"Fogansays. ln 1987,asoucgoing president of the Los Angeles Society of Neurology and Psychiatry, he used the occasion of his final address to present his research on Shakespeare. le was so well received that he expanded it into the prize-winning paper. Since that presentation, the paper has been published in The Archives of Neurology(August 1989) and in The New Scientist, the British equiva lent of ScientificAmerican, under the tide "The Neurologist of Avon" (January 1990). le was also presented for a medical benefit at the Old Globe Theater in San Diego (where Fogan appeared in Renaissance costume for the occasion), at the Institute of Neurology of the National Hospital, Queen Square, London and for the UB Medica l School's Department of Neurology in 1989, as part of the annual lecture series. In 1983, Fogan established the Edward Fogan Lectureship/Prize in Neu;!; rology at UB in honorofhis farher. 0 ~ Fogan enjoys balancing his lit< erary interests with his professional 0 responsibilities as chief of the Department of Neurology of Kaiser Permanente Medical Center in Panorama City, Ca lifornia, and assistant clinical professor of neurology at the UCLA School of Medicine . His research interests include cluster headaches and atypica l mycobacceria, a subject he studied for his M.P.H. (Unive rsity of Oklahoma School of Public Health, 1968). His other research in the history of neurology includes a study of John Cheyne, the lace 18th-century Scottish physician and one of the founders of child neurology . Among his many interests outside medicine Fogan includes windsurfing and cooking. But history and literature are his special loves. An<l what is he planning next? "Well, I've been reading Keats with special attention since my last visit to England. And then there's the Bible. I cook a course in literature and the Bible, and found a lot of passages of special interest co physicians there." • ! i BUFFALO PHY~ICIAN AND l\lOMEOICAL SCIENTIST �1\le Ji cali 01seiryaf i ons firom a R en&-issa irn.,c e l.\'lan "Shakespeare might have been a neurologisc. .. he was so good at ir ...His wonderful descriptions and delineations in this great field of our science shows that he had thoroughly mastered the subject in all its branches." The preceding quote is from O.W. Owen's 1893 medical journal "The Medicine in Shakespeare." And while this may have been the first word on "Shakespeare as Neurologist," certainly the current, dominant work on neurological references in Shakespeare belongs to UB alumnus Lance Fogan. His award-winning paper, "The Neurology in Shakespeare," supports Owen's recognition by noting and discussing the various observations, symptoms, signs and disease states of the nervous system that appear in Shakespea re's 37 plays and poetry. Fogan points out that "Shakespeare's works are replete with information and references of particular interest co physicians." The following has been excerpted from Fogan's masterwork: OntheNeurological Complications of Syphilis: The "pox," referring to the venereal disease, is mentioned in many of the works. It became known in Europe in about the year lSOOA.D."Timon of Athens,"which was written sometime between 1604 and 1609, contains many references cosyphilitic symptoms. Timon shows a marked personality change himself; he initially is a cultured and prominent Athenian leader. As the play proceeds his intellect pathologically weakens and at the conclusion he is angry and violent and as his steward Flavius cries out, "a ruinous man .. .full of decay ... " Evolution of a syphilitic into a pare tic clement, I offer in pointed speculation. I\UFF.-\LO PHY,ICl.-'.l--AND lllO MErnL AL S<.'18': Tl~ Of special interest, which again emphasizes Shakespeare's power of observation, are symptoms included in Timon's malignant tirade directed at two prostitutes. He encourages them to give them (men) diseases "and co cause lawyer's voices to 'crack."' Tertiary syphilis can cause aneurysms of the ascending thoracic aorta which can compress the left recurrent laryngeal nerve and paralyze the left vocal chord; this clinical entity is known as "prostitute whisper." Is this what the Bard described, or was it gummas of the larynx which could result in the ninth part of a sparrow." A locus for the foundations of memory appear in "Love's Labor's Lost" IV,2,66: "These are begot in the ventricle of memory, nourished in the womb of pia macer. .." Nearly 400 years later can we be that much more precise in "locating memory?" OnSciatica: One of the several references co this affliction is offered by the "deformed and scurrilous Greek" Thersites in "Troilus and Cressida" V,1,25, as he includes sciaticas as one of the "rotten diseases of the hakespeare was not only acquainted with the signs, symptoms and courses of diseases of the nervous system, but he understood them well. same symptoms? In IV,3,153: Timo n"...Crack the lawyer's voice,/ That he may never more false title plead/ Nor sound his quillets shrilly ..." Tabes dorsal is is the neuropathologic form of the disease responsible for the lightning-like pains in the extremities, and for impotency, which also did not elude the great author. In IV,3,152: Timon"...strike their sharp hins and mar men 'sspurring ...Plague all/That your activity may defeat and quell/The source of all erection ..." OnNeuroanatomy: Shakespeare shares with us his awareness of some neuroanatomy in mentioning pia mater, which in Eli:abechan England referred not only to the membrane covering the brain but also to the brain itself. In "Twelfth Night" 1,5,108 the clown says " ...whose skull Jove cram with brains, ...one of thy kin has a most weak pia mater." In "Troilus and Cressida" Il,l ,66 Thersites exclaims "I have bobbed his brain more than he has beat my bones ...an<lhis pia mater is not worth the south" (i.e., of the southern end of the body). Results of treatment of sciatica must have been frequently disappointing in Shakespeare's day, just as today, for Thersites expounds " ...sciaticas, limekilns i' the palm (or arthritic calcifications), incurable bone-ache ..." Again, in "Timon of Athens" IV,l,25: Timo n"...Thou cold sciatica,/ Cripple our senators, that their limbs may halt as lamely as their manners! ..." On"Extraordinary Measures'': How current his ideas are, even though they were written almost four centuries ago. In 1988, as we minister to our poly-intubated and venrilarory-assistcd patients in incensi,·e ca re units, as we sometimes agoni:e over the appropriateness of our life-prolonging activities, the Bard of Stratford-Upon-Avon admonishes us, as did Kent in "King Lear" V,3,314: "Vex not his ghost. 0, let him pass! He hates him/That would upon the rack of this tough world/ Stretch him out longer." • SPRING !WI �f.l FFALOMn, OAS A'-D Ill MEDICAL"'-""IL'-"Tl'• �• 17 or nearly 20 years, physicians in New York Scace have grappled with the problem of malpractice insurance. Now, chat is changing for full-time faculty physicians and dentists ac four SUNY Health Sciences Centers, thanks co an innovative new insurance company the faculty formed itself. The new company, the Academic Heal ch Professionals Insurance Association (AHPIA), is the only one of its kind now operating in che United Scates, according to its chairman, William P. Dillon, M.D., associate professor of gynecology-obstetrics at UB and chief of the division of maternal/fecal medicine at The Children's Hospital. AHPI/\ began issuing binders in January of chis year. Dillon, who was instrumental in spearheading the development of the company, noted that New York State's malpractice insurance crisis of 1973 began the chain of events that eventually led co the AHPIA's formation. The early 1980s saw malpractice insurance for New York State physicians targeted specifically at full-time University faculty. With their lower exposure and, as state employees, indemnification under Public Officers Law 17, full-time facu Icymade an attractive market, Dillon said. Indemnification under state law, however, has not been interpreted as such by the state's attorney general, leaving SUNY faculty physicians and dentists potentially at risk as the issue is tested and appealed in the courts. In 1986, as part of the United University Professions state contract negotiations, a Labor Management Committee was formed to investigate the availability and feasibility of self-insurance. "The labor-management group concluded it would be to the faculty's benefit co form our own captive insurance comBUFFALO PHYSIC IAN ANO BIOM EDICA L SCIENTI ST licensing of AHPIA. AnewSUNY programformal The company, in the short time it has operating, is doing very well. "More insuresfacuity been and more faculty are joining us. this company as safe or physicians & dentists safer"Wethanmade any other out there," Dillon said. "The New York State Insurance ACADEMIC HEALTH PROFESSIONALS Department is not going to license us if INSURANCE ASSOCIATION FACTS they think we're going to fail," he added AHPIA: • Isa reciprocal insurance company. • Is operated by a board of d ireccors made up of representatives of the medical centers, dental schools and United University Professions who are also subscribers. • Offers both occurrence and claimsmade policies. • Handles all claims occurring from private clinical practice as well as those occurring from a faculty member's employment. pan y," Dilion said, noting the group based its conclusions on two main premises: that the insurance be available only to full-time faculty in the practice plan and that those faculty who joined the company would benefit in the form of lower premiums and, in time and with the approval of the state insurance department, the realization of dividends. Through the efforts of a steering committee of dentists and physicians from the four medical schools and two dental schools and support from the deans, the initial capital was raised. Reinsurance by Lloyds of London, cogether with that raised capital, met all capital obligations under state regulations. "After that," Dillon said, "we submitted our application for a reciprocal insurance company to the Scace Insurance Department," in a process that would culminate over two years later with the In developing this company, he said "we made sure it has belts and suspenders." The Academic Health Professionals Insurance Association writes both occurrence and claims-made policies. Occurrence policies are those that cover incidents occurring during the policy year without regard to when a claim is filed and are available only to physicians and dentists currently holding them with their present company. Claims-made policiescoveronly incidents that arise and are reported during the policy year, but extend back to any incident since the inception of the insured's first claims-made policy (retroactive date). By law, physicians and dentiscs who now hold claims-made policies, as well as those subscribing for the first time in New York Seate, are required to purchase claims-made policies. Dillon stressed that besides the potential for dividends and the benefits offered by self-governance, AHPlA has selected specialist attorneys and would encourage subscribers in the same specialty from other SUNY sites to act as expert witnesses. Its philosophy is co work closely with SUNY Central, the faculty union and the state's attorney general co develop guidelines for the division of responsibility co defend and indemnify losses. "This is a company by and for the faculty," Dillon said, adding, "This is pioneering work. We're taking a problem and responding to it." • SPRING 1991 �Ediwr's Note: Followingare excerptsfrom an articleby RichardV. Lee, M.D. publishedi;ntheMay 1990Journal of Clinical Epidemiology. Lee, a professorof pediatrics and cwUunctprofessorof anthropology,is basedin theDepartmentof Medicineat The Chilclren'sHospira!of Buffalo. n exquisite Van Gogh painting is played at the Albright-Knox Art Gallery in Buffalo. The 0/cl Mill was completed in 1888, two years before the artist's death and over a century before the composition of chis essay. There is nothing medical about it; no earless, demented, bandaged or sick people; no hint of plague fears, no angst . Rather it is a welcoming, friendly landscape, full of warmth and color. It is about two feet square, a cozy painting, incense, arresting . 1am unable to walk along the gallery corridor in which it hangs without stopping. Dissecting my affection for Van Gogh':; painting, or any painting for that matter, probably seems clinically obscure for young modem physicians schooled in "hard science." Van Gogh, I admit, does appear a bit removed from biostatistics, magnetic resonance imaging, coronary angioplasty an<l DNA probes. Aesthetic sensibi1lity,however, ought not co be excluded from clinical medicine. Indeed, how doctors perceive and appreciate art is not merely significant. I maintain that a well-developed aesthetic sensitivity, an awareness of beauty and of ugly, is clinically essential. Physicians are caught not to regard their patients as beautiful creatures, but as creatures to be dissected, poked an<l observed with suspicion . The idea of the human bo<ly as a work of art smacks of religion; that the manifestations of illness might be considered aesthetic seems callous and disrespectful. Art can be triv iali:ed. Medicine is coo serious and too scient ific for such antics. Medicine is too real to be contaminated j $PRING 1991 •►lriiiMIP or distracted by the ethereality of arc. Still, the mythic "art of medicine" continues to circulate and to remind us of a more complete, perhaps humane, medicine. And medicine without aesthetic sensibility and sensitivity is transformed into a kind of neutral tinkering: routine, colorless, boring. Viewing Van Gogh is more than a dissection: individual brush strokes, individual colors combine into a comprehensible whole. The painting reaches out, sei:es my eye and captures my attention. There is immediate comprehension, instantaneous intuition, active awareness. Perhaps it is this intuitiveness that makes physician-scientists so suspicious about introducing notions of art in clinical activities. Yet my comprehension of the nature of a patient's misery is no less intuitive. Examining a patient, looking at a painting, listening co music, share a sense of being possessed, totally engaged, intuitively immersed in the object and the ace of observation. Clinical medicine and looking at a painting unavoidably include my personal interpretation of symbols and symptoms. Boch activities require a storyteller patient or storyteller artist, visual intimacy, time and me. The clinical picture is a unique blend of the patient and the physician: both acting as artist, observer and viewer. The pat ient 's description of che intensity of pain is colored by fear and anxiety, the hope chat this is "just something minor." The doctor's relation of the description and clinical interpr etation is colored by the "fit of the story;" does the pain I\UFFALOPHY~ICIANA"l() BIO~tEL11CAL --C:IENT!ST �19 has more to do with ways of knowing as opposed to ways of doing, with intuition not with technique, with episteme, not f t praxis. match the events and the findings on examination, is the patient asking for relief of something other than pain? Clinical truth, like a Van Gogh painting, is a composite. Master physicians do more than master the craft of medicine. They use it in waysthat inspire, that expand our knowledge and our vision. One connection between art and medicine is epistemologic. Both depend upon intuition, the nonquantitative apprehension and comprehension of beauty and of ugliness. Art proclaims its intuiti\'eness; modem medicine attempts to camouflage it. Van Gogh uses blues, yellows and greens to make a verdant, fecund sensual image. A patient tells me ofarthralgias, allergies, abortions, bruising and photosensitive skin chat has malar telangiectasia and atrophy. Even before the confirmatory laboratory tests have been taken I can tell her I have her clinical picture, a diagnosis. Van Gogh's Old Mill is stunning. My patient's lupus erythematosus is stunning. But different artists, different patients and different physicians can make different pictures of identical scenes and diseases. Our notion of disease and health is the same. The clinical expression oflupus erythematosus varies from patient to patient, the clinical picture is shaped by the powers of description and observation by patient and doctor, but we do not doubt that there is a fundamental biologic disorder that generates the disease, the clinical picture. So the affinity between me and Van Gogh, between my medicine and his art, Academic medicine devotes enormous amounts of energy, time and verbiage to the praxis of medicine: the design and statistical evaluation of experiments and experience, the performance of delicate surgery, obtaining and preserving anatomically precise, computer-enhanced images, the definition and imposition of what is called "quality control." The officiously objective burdens of utilization review and quality assurance ask only about technique and outcome. They do not ask about intuition or interpretation. Compassion and comfort, beauty and joy, are not concerns of "quality control." More importantly, those moments of exhilarating, humbling clinical intuition are not concerns of medical educators and administrators. Because it eludes measurement by standard scientific, statistical studies, clinical intuition is nor taught, or even talked about. We assume it is a gift, an endowment students bring to medicine, not something we teachers impart to them. Despite my lamentations, contemporary medical education works. Perfectly adequate doctors are produced ... never having attended a symphony concert or strolled through an art gallery. Why bother about Van Gogh's Old Mill or Lewis Thomas' LateNight Thoughtson Mahler's Ninth Symphony? Because without them medicine is ugly. And without intuition, and beauty and ugliness, without art, what I do wouldn't be medicine at all. Reprintedwichpemiissionfrom The Journal of Clinical Epidemiology, Volume43, RichardV. Lee,M. D. , TheClinicalPicwre,Co/J)'righr1990, PergamonPress, Inc. SPRING 19'11 ���sawacauliflower earinanybody -= I never --- butawrestler. Sore shoulders and elbows a.> '--' 22 cs a.> E common ailments inpitchers. c:s are ..... a.> -= a.> C:S> ---= -c:s = -= c:s E -= C ~ "There is no place like this in Western New York," says Edmond J.Gicewic:, M.O., of the 13,000square feet of space in Farber Hall that houses UB's new Sports Medicine Institute. The innovative program on the South Campus is designed for the specialized management and treatment of athletic injuries. A joint effort between the UB Medical School anJ the Division of Athletics, it operates under the aegis of the Department of Orthopaedics. Gicewic:, an assistant professor of orthopaedics at UB and the University's team physician for 25 years, says the lnstitute's mandate is three-fold - education, service and research. Its benefits, he adds, will extend to the Western New York community at large. The Institute brings an extra dimension to the practice of sports medicine in the region. Assembled under one roof are all the personnel and facilities necessary to treat athletic injuri es on the spoc: physicians experienced in sports medicine to examine and diagnose, X-ray and casting rooms, physical therapists to supervise recovery and $300,000 worth of rehabi Iitation equipment co help the athlete return co playing form, including a motion laboratory, a $52,000 Biodex machine that assesses range of motion via computer and whirlpools for partial and whole body hydrotherapy. It also offers the University's Athletics Division the quicker anJ more extensive care to its athletes it will require for the planned move m Division ]. As an educational facility, the Spores Medicine Institute is a training ground for students in various specialties who need experience treating athletic inju ries. "We have family practice residents come through so they will know how to handle these things if they are the only physicians in a small community . We hope to rotate our orthopaedic residents through as part of their training. We may have some surgical residents. We will have medical sru<lenrs, nursing students, physical therapy students, athletic trainers," Gicewic: notes, ad<ling, "Athletes sustain many ailments not seen in general me<licine. I never saw a cauliflower car in anybody but a wrestler. Sore shoulders and elbows are common ailments in pitchers, and there's jumper's knee in basketba ll." The lnstitutc's founders, which include Robert Gillespie, M.O., chairman of UB's Deparnncnr of Orthopaedic Su rgery, who pressed vigorous ly for the facility, hope to set up a fellowship in sports medicine to round out the teaching component . Service is the broa<lesr and most public of the lnstitute's mandates. Any person injured in any sporting activity- in competition or personal recreation may come to the Institute for care. Patients are charged a fee for service, as at any other clinic. Although treating people who get hurt participating in sports is not the lnstitute's sole reason for existing, tending coathletic injuries is the its most imme<liate mlc, and UB's athletes were the first to benefit. HeaJ athletic trainer Mike Rielly, who is also program coorJinator for the Institute, works with the athletes <laily. For him the Institute is a tremendous as·er. It provides professional care of the highest quality immc<liarely. During football season, for example, the Institute remained open much of the weekend to rend to high school and college players hurt during Friday anJ Saturday games. Time is critica l nor only for rhe athlete's comfort but for proper assessment of an injury, Rielly says. "If an injury is acute, the quicker it can be evaluated, the better the chance of proper diagnosis. Some signs can be masked if the injury is a llowed to sit for an exten<led perio<l." The Institute also conducts an outreach program for high school athletic trainers, and sponsors symposia for high school coaches in various sports. The research arm of the Institute will study new ways to treat certain ailments for which current treat- Rt.:FF:\LO PllY~ICl:\N :\N[) RIOMEnlC..\L SCIENTl~'T �23 ment is considered inadequate, and take on other projects. One of its most ambitious goals is to establish an injury registry for Western New York's young players. "Every h igh schoo l athlete who gets hurt will fill out a rather detailed form telling how the injury occurred, what the acti\'ity was, whether the field was wet or dry, whether it happened on Astroturf or grass, and when during the game it happened," notes Gicewic:. "We will put all this information into a data bank and study it so we can eventually draw some conclusions." Gicew ic: is pleased with the response the Institute has garnered so far since it opened last August. "We are getting patients from Barker, Medina, Jamestown, Ellicottville. We are seeing a lot of people from all age groups and all walks of life. I think the Institute will be really helpful to the Western New York community." • BUFFALO PHYSICIAN AN[) BIOMEDICAL SCIENTIST Assembled under oneroofareall thepersonnel andfacilities necessary lo treatathletic injuries onthe spot. SPRING l9<ll �24 • ua1 Alvan Feinstein callsfor the creation of a new basic science. By Laurie W Wo I f e hen patients arc diagnosed with a disease, they want to know how it will affect their lives. Will they be able to work, to drive, to parent the1rchildren?Will rhe pain stop? When? And patien~ aren't the only ones looking at chose kinds of questions. In this era of declining economic resources, with its concomitant soaring medical costs, economists and insurance companies are concerned with cost/risk/benefit ratios, noted Alvan R. Feinstein, M.D., when he delivered the 1990 W. D. Harrington Lecture lase October. The distinguished professor of Yale's Department of Medicine and director of its Clinical Epidemiology Unit noted chat if clinicians are co offer evitlence of benefits w the quality of life of their patients they must have a coherent way of describing, measuring and quantifying even simple things like "being able w breathe comfortably" or"beingable to walk without pain." A life may not have been s rRIN l, ! <NI extended by a procedure, but perhaps that life's quality has been measurably improved for the patient. "The current challenge," Feinstein noted, "is in mensuration and quantification. We need a language for drawing fair and relevant comparisons, for example, for the severity of an illness, for relief, for comfort. We must create models that fit the observed phenomena, rather than forcing clinical events into models chat may not be appropriate." Part machematic ian, part philosopher and part provocateur, Feinstein is renowned as thoughtful critic of the established doctrines and practices of clinical medicine. His capacity to "stir things up" was admiringly noted by James Nolan, M.D., professor and chair of the department of medicine, as he introduced Feinstein to an audience of UB faculty, alumni and students. Attending the University of Chicago, Feinstein earned a master's degree, and, in 1952, a medical degree. He trained in internal medicine at Yale and the Rockefeller Institute. After five years as a faculty member at New York University, Feinstein returned to Yale where he has remained except for a two-year visiting professorship at the 0eparcmencofClinical Epidemiology and Biostatistics at McMaster University, Montreal, Canada. Feinstein's lecture was peppered with humor and insight, focusing on the inadequacy of "basic science" to assist practicing physicians in making decisions about managing disease. He urged creative thinking to develop "an additional basic science for observing, quantifying and comparing clinical phenomena" to fill that gap. Feinstein noted that basic science presents two very different challenges: to explain phenomena and to intervene upon chem. The latter is the realm of the practicing physician, who predicts how to manage the phenomena . Feinstein predicted that the clinical observations of practicing physicians will become more important as medical care becomes more expensive and the competition for research dollars increases. While the last century has seen tremendous advances in technology and experimental methods that benefit explication, Feinstein said, "in general, clinicians have not developed a set of basic scientific strategies for making and eva luating managerial decisions" about the prevention and treatment of diseases. As a result, "controversies and doubts regarding the optimal usage, benefits, risks and costs of technology exist at BUFFALO PHY~ICIAN AND BIOMEDICAL SCIENTIST �2S u 5 t every level of clinical decision-making, from the care of a newborn to the care of the octogenarian, from the care of the common cold to the care of a patient with disseminating cancer." In the past, rhe biomedical paradigm has generally been the search for "hard data," obtained wirh a subject or specimen that is preservable (so as ro be reexamined). The results are usually expressed in dimensional terms, and the measurement procedures are objective and made preferably by machine. Absent from the literature on therapy arc what Feinstein referreJ to as "soft data," descriptions of human beings and human life made by natural observation in clinical practice. Soft data, he cautioned eloquently, have a great effect on good clinical decision-making. They are "the crucial harbingers of prognosis. Without soft data we cannot achieve scientific reducibility and identify the people under treatment. BUFFALO PHYSICIA1' AND BIOMEDICAL SCIENTIST a 0 n 5 8 "Does it matter if a congestive heart failure consists of some relatively mild peripheral edema, or whether the patient is gasping with pulmonary edema? Of course, it:does . And yer congestive heart failure, as one part of spectrum of coronary disease, is often described without those distinctions." In arnother example Feinstein remarked rhat cancer studies often fail to distinguish between patients labeled "inoperable .." The category may combine people who will not tolerate surgery and people wlhocould tolerate it, but refuse it. Feinstein challenged his audience to create indices and rating scales to identify clinical phenomena and, in effect, "harden" soft data. In need of indexing are such phenomena as different types of symptom.s within the spectrum of disease, rhe severity of those symptoms, rhe chronometry of the symptoms' manifestations, rhe auxometry (rate of progression of the ailment), rhe co-morbid asso- y T m L e e ciated ailments, rhe reasons for diagnostic or therapeutic decisions and the reasons for a patient's functional limitations. While praising the value of randomized clinical trials in remedial therapy, Feinstein stressed they are not adequate "in an era of burgeoning technology and unstable therapy." High costs, cumbersome logistics, lengthy study durations and the great number of subjects required make randomized trials impractical in prophylactic therapy, especially where the goal is to prevent the adverse progression of a present disease. "It is our job as clinicians - nor rhe mathematicians, statisticians or computer experts - but our job to develop an observational substitute for randomized experimental trials in cause and effect reasoning. If we don't do it, it won't be done, or it will be done badly by people who don't understand the problems." • Sl'Rl1'G 19~1 �---------------------- - ~ ~ ~ I ( ~~ ---------------------- .,. r /f 0 <) 26 The Greying of Medicine David W. Bentley, M.D. 's Mandatefor the 21st Century D avid W. Bentley, M.D., has set an ambitious goal for himself as the new head ofUB's Division of Geriatrics/ Gerontologyto help prepare the University community for the major health issue of the 21st century - health care for the aging. "Geriatrics and long term care is the name of the game in health care today," said Bentley. "TI1e next 25 years are going to be focused on these two domains. The typical health care community and university community have nor been interested in these two domains, ever." Since assuming his position September l, Bentley has sought to make UB an exception to that rule. One month into 1991, he and his colleagues had already submitted four major research granc proposals dealing with issues affecting the elderly. Two have already been funded. In addition to his position as profe ·sor and head of geriatrics, Bentley also serves as director of the University's Multidisciplinary Center on Aging, co-director of the Westem New York Geriatric Education Center and chief of the Geriatrics Service at Buffalo VA Medical Center. He was recruited to increase the research activities of a division already strong in clinical affairs and education. Even before moving into his offices in Beck Hall and the VA Medical Center, Bentley was busy convincing 19 senior faculty in several disciplines to gear their research in progress toward problems of the elderly and to accept postgraduate fellows in gemmology to work along with them. The effort culminated in a $259,200 grant proposal cothe National Institute on Aging which, if approved, would set the University on an ambitirn.1i; course of incorporating age-related research and education throughout the University's disciplines. Bentley came ro gerontology rather late in his career. A graduate of the University of Rochester Schtx)l of Medicine and Dentistry, he took his residency in internal medicine at Vanderbilt University Hospital and did postdoctoral work in infectious diseases at the University of Illinois. After a two-year appointment at the University of Manitoha, Bentley returned to Rochester in 1972 to head the infectious tliseases unit at Monroe Community Hospital, known intemationally for its work in geriatrics. He remained there until coming to UB. He was abo an associate professor of medicine at the University of Rochester's School of Medicine and Dentistry. Bentley became a specialist in geriatrics "by osmosis," he said . He worked closely with its medical director, D. Franklin Williams, now director of the National Institute on Aging. His expe riences at the Rochester hospital convinced him to change his career and hi~ research to focus on the elderly. When the first boards for certifica1ion in geriatrics were offered in I 987, he took them and passed. Bentley said the move into geriatrics was prompted by his own inclinat ions and a look into the future. "For anyone in healrh care, the demographics were very clear," he said. "The most rapidly growing segment of the United States is 85 years of age and older, and the population 65 and over is also growing very rapidly. The epidemic of Alzheimer's disease, for examp le, is much more serious, much larger and more costly than the epidemic of AIDS." Bentley and his sraffhave already scored some successes in steering the University toward the concerns of an aging population. One of his plans for the future is to attempt codevelop a cadre of researchers outside the Center who will apply for and receive funding from major grant-giving organizations such as the National Institute of Aging. "There are only a handful of people at the University now who have those types of awards," Bentley said. He credited the cooperation of his colleagues across the University for the accomplishments of the Division and the Center so far. "The problem chat one has in academics," he said, "is that you have to be good in teaching, good at research, you arc expected to beexemplary in patient care and to be a very good administrator. That is a very difficulr chore for the average person. Without so much support around me, we could nor have achieved all we have in these few months." • - B)' Lois Baker llUFF:\LO PHYSICIAN A:-.111 llll'MEl11CAL !'CIE.Vfl~ �----------------~@~ () ('" If Davidw.Bentley,M.D., (above): ... I ( ~~-- "' ---- -- -------- 0 "The epidemicof Alzheimer'sdisease' for example,is much moreserious,much largerand more costlythan the epidemicof AIDS." BL:FFALO PHYSICl.·\N ~ND BIOME[)IC.~L SCIENTIST SPRING 1'/<ll �--------------------- ~~~I C~ ~--------------------.,. .... (" II o I) 28 The High Expectations of Eddie Hoover New Surgery Chairman Plans for the Future <ldie L. Hoover, M.D., new chairman ofUB's Department of Surgery, credits two people with helping him get where he is today: a college professor who sent him on the right path and a surgeon who inspired him to follow it. "I didn't have any idea about becoming a surgeon," said Hoover, a native of Charlotte, N .C. "I went to college to get away from farming." Hoover chose pharmacy as his major when he enrolled at the University of North Carolina at Chapel Hill, because he knew what pharmacists did . A sophomore history teacher, seeing Hoover's grades, suggested medicine instead, and introduced him to the clean of Duke University Medical School. "My idea of a physician was ro go somewhere where you were needed, open an office and treat patients," sai<l Hoo\'er. "Even when I was looking into medical schools, there were no black specialists." But he eventua lly enrolled at Duke, where rhe emphasis was on turning out people who would stay at medical schools, teach and do research. There, Hoover lancle<lby accident under the tutelage of Paul Ebert, M.D., a dedicated surgeon who woulJ have a lasting influence on his life. "He operated on children's heart s," Htx)Versaid. "I thought that wa~the most exciting thing a per ·on could do in life. I decided I was going to do it if I had to beg, borrow or steal." E "I get fairly immediate gratificationfrom what I do. A person's appendix hurts , I take it out. I like the fix-it approach." As luck would have ir, surgery suited Hoover's personality nicely. "I get fairly immediate gratification from what I do," said Hoover. "A person's appendix hurcs, I take it out; a person has lung cancer, I cure them, rather than readjusting pills because somebody's blood pressure is out of control. 1 like the fixit approach." Hoover did his internship with Ebert at Duke University Medical Center, and when Ebert left Duke for Cornell University Medical Center, Hoover followed. He completed his residency and thoracic surgery training there and at MemorialSloan Kettering Cancer Institute. He went on to hold academic appointments at SUNY-Downstate Medical Center anJ Meharry Medical College in Nash\·ille, as well as Cornell. He has served on the surgical staff of New York Hospital, Kings County Hospital and State University Hospita l, all in New York City; VA Medical Centers in Brooklyn and Murfreesboro, Tennessee; Woodhull Medical and Mental Health Center in Brooklyn and G.W. Hubbard Hospital in Nashville. Hoover assumed his UB position and was named chief of surgery at ECMC on September I. He also is continuing his research, which currently centers around the role of prosraglandins in gall stone formation and hypertens ion and kidney damage in heart transplant patients. The new head of surgery has several goals for his department. "First, we must continue to provide the highest quality patient care, and make sure all the new technology that is safe and makes sense is available to people in Western New York," he said. "Second is resident education. We must provide the kind of training programs that allow us to attract the highest quality residents." His third goal is to make UB preeminent among major public universities, he said. "We need to rum out excel lent physicians and academicians, so we can hold our own in the scientific field." The drive char pressed Hoover onward to success as a surgeon surfaces when he speaks of his plans to move UB toward new surgical frontiers. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �----------------------- ~e~ - I ( ~~ - .;, (' If ~ ------ ----------------- 0 29 EddieL Hoover , M.D. "We need ro start doing lung transplants," Hoover said. "We have approva l from the state but we haven't gotten it starred . We need to move into more laser applications in medicine. Ten years from now, a lot of what we do in surgery will be replaced by laser techniques." Preparing for that inevitability, Hoover lll.:FFALO PHYSICIAN AND BIO~!EDIC.-\L "l"IE.'1Tl!-T has established a study group with the physics and electrical engineering departmen ts to develop appropriate laser research projects. To improve the teaching of surgery, Hoover wants to incorporate the newest audio-\'isual techniques. "The new equipment is so good you can see a lot more watching a TV screen focused on the field than by standing at the operating table," he said. "Now, some students may stand there for six hours and hardly see anything. "We're going to start that by July," Hoover said. "All I need is $30,000. Somehow I'll get it. • - B)' Lois Baker ~l'RllsG 1991 �----------------------~@ - ~I r~~------------------- .,. r /( 0 - -- I:> 30 UB PHYSICIANS USENEW PROCEDURE ToSAVE GEORGIA POLICEMAN rill wearing an eye parch to stave off double vision, a Savannah, Georgia, police officer thanked God and "the doctors in Buffalo" for saving his life after he was shot in the head pursuing a shooting suspect in early March . G. Scan Freeman, 28, was investigating reports of domestic violence in Savannah when the shooting occurred . Fifteen days later, Freeman was airlifted co Buffalo to undergo an expe rimental procedu re in which "micro-bal loons" were placed in his internal carotid artery to keep him from bleeding co <leach. The procedure was performed by L. Ne lson Hopkins, M.D., chair of the Department of Neurosurgery and chief of neurosurgery at Millard Fillmore Hospital. Hopkins use<la micro-catheter co place the silicone micro-balloons co occlude a bu llet-damaged section of Freeman's left carotid artery. "The bullet tore open the left caroci<l artery ... and penetrace<l the upper part of the nasal cavity, where it came co rest" allowing blood co escape out the nose and th roat, Hopkins said. A clot surrounded by soft tissue formed, temporarily closing the com artery, but creating a potentially lifeth reatening situation. Usually, Hopkins said, "the clot will dissolve and the arte ry would again begin hemo rrhaging. If chat happened, I th ink he likely would have bled to death." Freeman's Georgia physic ian recalled that UB neurosurgeons were using to coronary a technique similar angioplasty co prevent an<l treat stroke. T he new technique, however, uses miniaturized catheters and balloons to ac- S srRINU19'11 Top,G.StanFreeman andhiswife,Nancy,lookat X·raysandangiograms of hisskull.Bottomleft,a leftlateralinternal carotid arteryangiogram showsshrapnel scattered adjacent to thetornarteryand thebulletlodgedinthesinus.Bottomright,a lateralskullX·rayal theballoono«lusionwitharrows marking thethreeballoo ns inthe internal carotid. commodate the finer vessels in the bra in. In a four-hour procedure guided by X-ray images, with Freeman totally awake, surgeons th readed a tiny catheter through his femoral artery to the carotid. Hopkins then inflate<l three micro-balloons one primary and two backup- to occlude the tear. They will be left in place and eventually will be walled off by the body. The permanent occlus ion of the blood supply through the carotid will not affect Freeman, Hopkins ad<le<l,exp laining he has sufficient collateral circulation. The bullet will be left in place . The UB team performs about 100 balloon occlusions each year at Mil lard Fillmore Hospital, most designed to prevent stroke and intracerebral hemorrhage from arceriovenous ma lformations an<l aneurysms. The procedure is also used as an adjunct to surgery to de liver chemotherapy to or tie off the blood supply of tumors. The procedure was developed by Grant Hieshcmia, M.D ., professor of ra<liologyat the University of Ca lifornia at San Francisco, and lnrerventional Therapeutics Corp. It was first used five years ago. Nationwide, about 1,000 such surgeries are performed each year. • Bl.JFF,\L,1 rllYSl<:IAN ANDRIOMEnlCAL SCIENTIST �IJ "' 31 KASSIRER TOHEAD JOURNAL NEWENGLAND OFMEDICINE erome P. Kassirer, M.D., a 1957 graduate of the University at BuffaloSchool of Medicine and Biomedical Sciences, has been named the new editor-in-chief of The New EnglandJournalof Medicine. Kassirer will take over the helm of the journal in July, succeeding Arnold S. Reiman, M.D., who has served as edicor-inchief since 1977. He was named on Jan. 29 following an extensive worldwidesearch by a distinguished panel of medical leaders. J The New EnglandJournalof Medicine, published by the Massachusetts Medical Society, is the oldest continuously published medical journal in the world and is considered the nation's leading journal of medical research and opinion. "l am deeply honored and pleased to accept this position," Kassirer said. "Some of the most illustrious names in American medicine have brought great distinction to the pages of The Journalduring their tenure as editor. I hope robe inspired by their examples, and am ready co meet the exciting challenges that lie ahead." A specialist in nephrology and internal medicine, Kassirer is Sara Murray Jordan Professor of Medicine and vice chair of the Department of Medicine at Tufts University School of Medicine, Boston, where he has been on the faculty since 1961. He also is associate physician-in-chief ac the New England Medical Center, Boston. A Buffalo native, he attended UB as an undergraduate from I 950 co 1953, entering its medical school following his junior year. He received his medical degree magnacum laude. Since 1986, he has served as a regional member of the governing board of the UB Medical Alumni Association. Kassirer received several honors while ac UB, including the Freshman Chemistry BLFFALOPHY~ICIANANO lllOMEDIC.ALSCIE?\TIST Jerome P.Kassirer , M.D. , '57 Award in 1953 and the Bausch and Lomb Science Award in 1953. While in medical school, he was named co the Gibson Anatomical Society and Alpha Omega Alpha and in 1957 he was recipient of the C.V. Mosby Award and the Roswell Park Award in Surgery. He did his internship and served as assistant resident in medicine at The Buffalo General Hospital from 1957 to 1959. Kassirer has received national recognition for his work on diagnostic reasoning and therapeutic decision-making. He is considered a national expert in many aspects of clinical medicine, especially kidney disorders. Board certified by the American Board oflncernal Medicine, Kassirer is a member of che board of governors of the American Board oflncemal Medicine and the board of regents of the American College of Physicians, which named him a master in 1990. A member of the editorial board of The New England Journal of Medicine from 1972 co 1975, Kassirer is editor-in-chief of Ciment Therapy in Internal Medicine (3rd edition) and co-editor of Clinical Forum. He ProblemSolvingand Nephrolog)' has authored or co-authored more than 100 editorials, scientific papers, book chapters or case studies on various aspects of clinical medicine. • - ByArthur Page About300 guestsattended theMedical Alumni reception inhonorof the seniormedical doss,held 12inthe January 38thFloor Restaurant of the Marine Midland Center. �__________________ ____ ,,, :z:---------- ----- ----- -- 1., 32 COLLINS LECTURE TOUCHES ON ETHICAL IMPLICATIONS OF GENETIC RESEARCH s researchers unravel the mysteries of human genetic makeup, society must start making decisions about how chat knowle<lge will he shared and app lied. That's the opinion of Francis S. Collins, M.D., Ph.D., associate professor oflncernal Medicine and Human Genetics and chief of the Division of Medical Genetics at the Howard Hughes Medical Institute, University of Michigan at Ann Arbor. Collins spoke to more than 100 physicians, researchers and others interested in genetics on March 26 at Buffalo's Hyatt Regency Hotel. Internationally known for his contributions to recombinant DNA technology. Collins was the inaugural speaker for Children's Hospital's Rose and Al Pastor Lecture Series. "DNA is an elegant scheme for storing information," he said. "Every genetic disordercan be traced tosomethingwrong in the DNA." Collins reiterated his work on isolating Lhe gene for ncurofibromatosb T ypc I a severe disorder of the nerves char affects one in every 3,000 people worldwide. He followed that with an explanation ofhow he isolated the gene for cystic fibrosis using a technique called "chromosome jumping" chat allows investigators co take "large steps across the vast expanbe of a chromosome." It is now possible rn screen for CF carriers, who number one in 25 in this country, he said. Carriers carry the gene A Francis S. Collins , M.D. , Ph.D. for CF but do not manifest the disease themselves. Each baby conceived by two carriers has a 25 percent chance of having the disease, a 50 percent chance of being a carrier and a 25 percent chance of being neither a carrier nor having the disease. "Genetics is not familiar territory to a lot of folks," he said, adding that a pilot counseling program of 2,000 people, such as the one undertaken by Richard W. Erbe, M.D., professor of pediatrics at UB, may give clues as rn how the issue should be approached. Collins suggests chac couples should be screened before a pregnancy is attempted. "The tricky part is that we have to be really careful when we Jo ·omething like this so that people really understand what the information means and there are all sorts of ways chat that information can get confused in people's minds," he said. "We could righc now start a screening program that would detect 85 per- cent of CF carriers," Collins said, but added that a program of this scope has to be carefully planned because it affects so many people and there aren't nearly enough trained counselors to impart the information. "People who are carriers may go away thinking that they are going to become sick themselves. And there are concerns about stigmatizing - that people will feel rhey are personally defective." Collins said he is afraid physicians might be pressured into offering the test if couples who have babies with CF sued rheir physicians, claiming their doctors were aware a test was available. Collins said he knows of an insurance carrier that sent a couple a letter after they tested rn be CF carriers that implied they would be "expected to use the information responsibly." Ir implies that if they had a child, the company wouldn't pay for medical expenses, he said. 'There arc areas where a lot of people get uncomfortable, includingmc,"Collins said. He included sex selection among them. "l do occasionally have people come in co my genetic clinic for just chat reason," Collins said, "and they look very surprised when l say I'm not going to participate. To me, it is an affront tO all the reason · I went into genetics ." He quoted from a Newsweeksurvey on "made coorder" babies chat showed chat I percent of couples would abort if the baby was rhe "wrong" sex; 5 percent would abort if the fetus had a predisposition to Alzheimer's disease (even if the onset was in old age) and 11 percent would abort if the child were predisposed co obesity. "Thar's when we have to ask where to draw the line," Collins said. "When you are looking at selection for traits rather than the elimination of disease. • - By PaulaVoe/I I\UFFr\Ll1 PIIYSltl-\N A1'D lllt)~IEl'IL'.-\l SCIEt-:TIST �---- •,ll ----0 y 33 Midd leton's internationally known research has included studies of the biochemical characteristics of allergic diseases, especially asthma and rhinitis; chemical mediators of allergic reactions; clinical assessment of new anti-allergic drugs, and effects of naturally occurring plant flavonoids on immunologic reactions. • - ByArthur Page MINDELL RECEIVES TwoHONORS ormer Chairman of the Department of Orthopaedics Eugene R. Mindell, M.O., received che Distinguished Service Award from the University of Chicago Medical Alumni Association last June. Mindell, currently professor and Director of Orthopaedic Oncology ar Buffalo General Hospital, was also elected a vice president of the American OrthopaeJic A sociation at its Boston, Massachusetts meeting the same month. • F NOENAMED TOHEAD DEGRAFF REHAB UNIT ohn E Noe, M.D., '84, has been named medical director ofDeGraff Hospical's new 20-bedmedical rehabilitation unit. The unit, which opened last December, is the first of its kind in Niagara County. leoffers an aggressiveapproach cothe rehabilitation of patients who suffer strokes, neuromuscular diseases such as multiple John F . Noe , M.D. , '84 lliott Middleton, Jr., M.D., received sclerosis, some spinal cord injuries or those the Distinguished Service AwarJ of with major joint replacements or amputhe American Academy of Allergy and tations, Noe notes. "Rather than emphaImmunology at the academy's annual si:ing their level of disability what meeting held in March in San Francisco. patients can't do for themselves we Middleton, professor of medicine and adopt strategies so they can do as much for pediatrics and director of the Allergy Divithemselves as they possibly can," he adds sion in the Department of Medicine The new unit, which occupies the ho received the award for lifelong contribupital's entire second floor, provides incense, tions to the academy. high ly focused therapy plus coordinated, A fellow of the American Academy of follow-up home and outpatient care. It Allergy and Immunology since 1961,he has cakes a multidisciplinary team approach, served as the academy's president, treasurer Noc explains, adding "Members of the and editor of its journal, TheJournalof Allerteam include a physiacrist, physical therHe is a member of the editorial ad,·isory gy and Clinical/mmunolog) '. He is also a board of the Journal of lmmunopharmacolapists, occupational therapists, speech clinical professor of pharmacy at UB. Director of the Allergy and Immunology ogyandClinicalAdvancesin the Trear:mem therapists, nurses, a psychologist and sometimes social workers." of AllergicDisorders and international adviDivision at The Buffalo General Hospital, sory board of the Asian Journalof Allergy The former director of the medical rehahe is a consultant in allergy at Children's bilitation unit at Sisters of Charity Hospital Hospital of Buffalo and Buffalo VA Med- and Immunology.He previously served on the editorial board of the Journalof Allergy. and clinical director of inpatienc services ical Center. Author or co-author of more than 190 at BuffaloGeneral Hospital, Noc is cert ified A fellow of the American College of by the American Board of Physical scientific articles and l 7 book chapters, Physicians, Middleton is a diplomate of the and Medicine and Rehabilitation and is a memAmericanBoardof InternalMedicineand the he is senior editorof Allergy:Principles AmericanBoardof Allergyand Immunology, Practice (C.V. Mosby Co. 1988), now in ber of the American AcaJemy of Physical Medicine and Rehabilitation. • its third edition. of which he was an original director . J MIDDLETON RECEIVES DISTINGUISHED SERVICE AWARD E Ratherthanemphasi zing theirdisabili ty...we adopt strategiesso theycan do as muchas theycan. BUFFALO PIIYSICI:\:- .~NP lll0~1EPI< AL SCIE~Tl:-T srRJN(o JQQI �-- --•- ~l--0 -- y 34 DanielM.Green , M.D. GREEN TOHEAD NATIONAL WILMS' TUMOR STUDY COMMITTEE aniel M. Green, M.D., UB medical school professor of pediatrics, has been e lected chair of the National Wilms' Tumor Study Committee. The committee determines what combination of therapies is best for treatment of all types and stages of Wilms' tumor, the most common form of kidney cancer in chi ldren. The committee's protocols are useJ by all hospitals participating in two national childhood cancer study groups, the Pediatric Oncology Group and the Ch ildren's Cancer Study Group. An international authority on the late effects of cancer th erapy in children, Green is chief of the oncology section in the Department of Pediatrics at Roswell Park Cance r Institute and director of the institute's Long-Term Follow-up Clin ic. D Board certified in pediatrics and pediatric lhematology/oncology, he has been a member of the UB medical school faculty since 1978. He also is directar of the Section of Oncology in the Division of He·matology-Oncology at Children's Hospiical. Green is a member of the Scientific Committee of the International Society of Pedliatric Oncology, Society of Pediatric Research, American Society of Hematology and American Society of Clinical Oncology. He has written more than 60 scienrific articles and two books on pediatric oncology. A graduate of Massachusetts Institute ofTechno logy,Green received his medical degree cum laude from St . Louis University School of Medicine in 1973. He did his residency in pediatrics at Boston (Mass.) City Hospital and then completed a fellowsh ip in pediatric oncology at Sidney Farber Cancer Institute, Boston; a fellowship in medicine-hematology/oncology at Child ren's Hospital Medical Center, Boston, and a fellowship in pediatrics at Harvard Medical School, Boston. • - By Arthur Page UB ALUMNI ASS ,OCIATION To UPDATE DIRECTORY h,e UB Alumni Association has contracted the Bernard C. Harris Publishirng Company to produce a comprehensive alumni directary. Scheduled for release at year en<l, the d irectory will inclu de current name, address and telephone number, class year and degree, plus business information (ifapplicable) bound in a library-quality e<lition. All alumni who completed an alumni directory questionnaire mailed earlier this year will be contacted by the Harris Com- T pany to verify the information and take book ordering information. If you prefer not to be listed in the directory, contact the A lumni Association in writing as soon as possible. • ALBINI NAMED FULBRIGHT SCHOLAR, To TEACH, Do RESEARCH INAUSTRIA oris Albini, M.D., professor of microbiology and research professor of medicine at UB, has been named a Fulbright Scholar. Under an awar<l from the Fulbright Scholar Program, Albini, began teaching and research in the Department of Experimental Pathology at the University of Innsbruck in Austr ia in March. He will collaborate with Austrian researchers on studies of immune responses to bacterial components and lymphocyte function in aging. Albini is one of936 academics, professionals and independent scholars from the Unite<l States who have received awards under the Fulbright Scholar Program to lecture, consult or conduct research abroad in I 990 and 1991. A member of the faculty of the UB School of Medicine and Biomedical Sciences since 1975,Albini was a BuswellFellow in the Department of Microbiology in 1975 and a Max Kade Fellow in thedepanmcnt in 1974. Before joining UB, he was a clinical assistant professorat the Institute for Genera l and Experimental Patho logy at the University of Vienna, Austria . A member of the medical school's admissions committees and its M.D./Ph.D. program, he is a member and former chair of the University's Laboratary Animal Care Committee and a member of the UB Faculty Senate. He has served on the orga- B BU~'FALOPHYSICIAN AND BIOME()ICAL !'CIENTIST �---- -~l----0 ' JS nizing committee for several of the biennia l international convocations on immunology sponsored by UB's Ernest Witebsky Center for Immunology, of which he isa member. Albini is president of the Buffalo Collegium oflmmunology. The author or co-author of more than 110 scientific articles, Albini isa member of the editorial board of Immunological Communicationsand /nr.ernationalArchives of Allergyand AppliedImmunologyand a fonner member of the editorial board of Clinical and ExperimenwlImmunology.• - B)' Arthur Page the Hisroryof Orolaryngology,he has been a consultant to the Gillette Corp. and the Ministry of Public Health for the State of Kuwait. In 1975 he served as chief of surgery and assistant hospital director at Yuka Hospital for Tuberculosis and Leprosy in Kalabo, Zambia. Author or co-author of more than 65 scientific articles,Simpson isthe author of texts on common problems,emergenciesand laser surgeryin otolaryngology.He has conducted extensive researchon lasersurgeryand laser interaction with tissue to deal with tumors and ocher disease processes. • - By Arthur Page SIMPSON NAMED (HAIR OFOTOLARYNGOLOGY eorge T.Simpson, II, M.D., has been named professor and chair of the medical school's Department ofOtolaryngology. He will also serve as chief of otolaryngology/head and neck surgery at Sisters Hospital. He previously was acting chair and associate professor in the department of otolaryngology at Boston University School of Medicine and instructor in ocolaryngology at Tufts University School of Medicine, Boston. He also was otolaryngologist-in-chief at Boston University Medical Center and director in the Department of Otolaryngology, Department of Health and Hospitals for the City of Boston and Boston City Hospital. Simpson is certified by the National Board of Medical Examiners, American Board of Otolaryngology and American Board of Laser Surgery. He isa founding fellow of the American Society for Pediatric Ocolaryngology and a fellow of the following organi:ations: American College of Surgeons, American Academy of Otolaryngology - Head and Neck Surgery, American Academy of Pediatrics, American Society for Head and G BUFFALOPHYSICIAN AND IIIOMEDICAL SCIENTI~ GeorgeT.Simpson, II,M.D. Neck Surgery, American Bronchoesophagological Association, American Academy of Facial Plastic and Reconstructive Surgery and American Academy of Cosmetic Surgery. He is a 1969 graduate of Loma Linda University, where he received his medical degree in 1973 and a master's degree in public health in 1975. Simpson completed an internship in general surgery at the University of Alabama Medical Center and residency in head and neck surgery at the University of California at Los Angeles. He was a fellow in pediatric otolaryngology at Boston University and Children's Hospital Medical Center and Harvard Medical School, a U.S. Public Health Service/Association of American Medical Colleges Fellow in Yugoslaviaand American Society of Anesthesiologists Fellow at the University of Alabama Medical Center. Former vice president and secretaryrreasurer of the International Society for TwoALUMNIELECTED TO ST.JOSEPH HOSPITAL MEDICAL STAFF ichael). Gianturco, M.D., '55, has been elected president of the medical staff of St. Joseph Hospital. Gianturco, a board certified genera l surgeon, has been a staff physician there for more than 27 yearsand served as vice president of the medical staff in 1989 and secretary in 1988. Also elected as vice president was Irving Sterman, M.D., '64. • M Michael J.Gionturco, M.D. srRINO 1991 �36 Match Day '9 1 saw the suspense end for fourth-year students as they found out where they will do their residency training. SPRING !'I'll BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �-- ---- 37 Thisstereogram of a humingbird in flightapproaching a feederhaswon severalmedals andhonorable in inter· mentions national competi· lions.Theoriginal colorphotograph S. is byBernard Stell, '36. 1930s Joseph R . Saab '34 ► writes, "still alive and looking forward to my 60th anniversary." Bern ard S. Stell , '36 ► has won several medals in international photo competitions. Stereo closeups are one his specia l interests . Information on his stereogram and its innovative technique will be published by the Internaciona l Stereoscopic Union. "According to my research, what I have accomplished in getting these multiple images in one picture has not been published before in any pare of the world." The reproduction of the stereogram containing three hummingbirds against a black background is really a stereo of a single bird with rapidly beating wings on a single approach to the feeder. Ic has been captured in three separate positions by three closely spaced bursts oflight from the flash units. Walte r Z. Schwebel ' 38 ► is still practicing pediatrics and is direccor of the Physically Handicapped Children's Program for Rensselaer County, New York. 1940s John D. Whit e '4 0 ► of Tavernier, Florida, presented a "Talking Book" project at the Mariners Hosp ital Health Fair in January. Frank A. P falzer ' 49 ► is retired and now living on Amelia Island Florida. He writes chat he is enjoying travel and several hobbies . Ra phael S. Good '48 ► a clinical professor of psychiatry and obstetrics and gynecology at the University of Miami Schoo l of Medicine, is president-elect of the South Florida Psychiatric Society. Dr. Good is a former president of the Miami Obstetrical and Gynecological Society . BUFFALO PHYSICIAN ,~ND BIOMEDICAL SCIENTI ST K e n n e th N i sw and e r ' 4 8 ► received an award for the best anicle in 1989 from rhe magazine Comem/)orary ObscemcsandGynecologyfor his article, "Neurologic Deficits on Trial: What Response." Dr. Niswander is professor of obstetrics and gynecology at the University of Ca lifornia at Davis. Law r en ce M . Ca rd e n ' 49 ► retired on Jan. I, 1990 and is now living in Sarasota, Fla. 1950s Fr ed Lee '56 ► of Ann Arbor, Michigan, was named a fellow of the American College of Radiology. Ge rmante L. Bonca ldo ' 5 7 ► is direccor of the Millard Fillmore Rhcumacology Center, Buffalo, New York, "an out-patient facility for rheumatology patients in a patient satisfying consulcaci ve atmosphere." Th omas P. H amilt on II '5 7 ► has been named Deputy Commander and Direccor of Medical Education ac the Brooke Army Medica l Center, Fort Sam Hous• ton, Texas. W a r r en E. Lev in so n ' 57 ► writes, "I was elected to the Mill Valley City Council in April 1990. and My book MedicalMicrobiology Immunology was published in August 1989." Levinson is professor of microbiology at the University of California, San Francisco. Ga ry Co h en '58 ► has been appointed chief of the Division of Chi ld and Ado lescent Psychiatry at Children's Hospital of Buffalo. A clinical associate professor of psychiatry and pediatrics ac UB, Dr. Cohen previously served I0 years as acting directo r of the divi• sion. John T. Korn ' 58 ► "Entered solo ob/gyn practice in Novato, California in 1964. Mary and I raised and educated four sons. Having accomplished that successful career, I closed my private practice in l 990 and am now enjoying an interim second career of OBG locums tenenswork. In a year or so I willbegin concentrating full time on all my other neglected lifetime goals, such as aviation, sailing, scuba diving, deep sea fishing and traveling. Mary, being relieved of children and household chores, enjoys her days in commercial retailing of ladies accessories." John W. Kosteck i '59 ► an associate clinical professor at UB, received certification in general vascular surgery from che American Board of Surgery. SPRING 1991 �----------------------- ::,,,. _::: --------------- -- - ------ s ll 38 Law rence E. Gra ss ' 63 ► was just elected chief of family practice at Phoenix Baptist Hospital for a two-year term. John J. LaMar '63 ► is senior attending pediatrician at the Memor ial Hospital of Salem, New Jersey, where he has been on staff for 2 5 years. John A. Schriv er '63 ► has been appointed head of the section of emergency medicine at Yale University and director of emergency services at Yale New Haven Hospital. Dorothy C.Rasinski , M.D., 'S9 William E.Abramson , M.D.'60 Do roth y C. Rasinski '5 9 ► will be a participant in the morning program on Spring Clinical Day in Buffalo on May 4. An internist, attorney, educator and author, she recently received a special recognition award from the American Society of Internal Medicine. TI1is award is presented to an internist who has made a significant contribution to the social and economic aspects of interna l medicine. Rasinski's flair for translating dry legal accounts of malpractice suits into interesting vignettes has made her "Legal Briefs"column one of the best-read pages in The lncemisi:HealrhPolicy in Practice.She has been an editor for the Journalof LegalMedicine, son has a private practice in psychiatry and is senior psychiatrist at the Sheppard Pratt Hospita l, Towson, Maryland. z. Ronald J. Kallen '60 ► is direccor ofthe Division of PediatricNephrology and Hypertension at Lutheran General Children's Medical Center in Park Ridge, Ill. Robe rt L. Malat esta ' 60 ► of Warren, New Jersey, has been appointed associate direccor of Drug Safety and Surveillance at the R. W.Johnson Pharmaceutical Research Institute. H arold L. Metca lf '6 0 ► is vice president of the American AcadeLegalAspectsof MedicalPractice, my of Family Physicians FoundaClinicalOiabeies, Journalof Clinical tion with headquarters in Kansas City, Mo. EihicsandHospical EthicsCommit- Willi am E. A br a mso n ' 60 ► "attended my first class reunion and Spring C linical Day in April 1990 and had a ball. Will :me nd in 1995, God willing." Abram- :-PRINUl'l'll Bert A. Lies, Jr. ' 64 ► of Santa Fe, New Mexico, continues to practice orthopaedic surgery with a special interest in disability evaluation aml rehabilitation. He is presently the orthopaedic consultant for the Aspen Ski Company, and is joining the Orthopaedic Associates of Aspen on a pare-time basis as a consultant in rehabilitation and disability evaluation. Saar A . Porrath '6 1 ► of Beverly Hills, Calif., \vaselected president of the National Consortium of Breast Centers . Murra y A. Yos t Jr. '66 ► has been elected vice chairman of the Buffalo Section of The American College of Obstetricians and Gynecologists. Yost is an associate clinical professor of obstet rics and gynecology and assistant clinical professor of psych iatry at the UB School of Medicine. J ohn L. Kiley ' 6 2 ► is medical director of Charter Hospital in Las Vegas, Nev. John E. Spoor '6 6 ► was named a fellow of the American College of Emergency Physicians, appoint- tee Forum. 1960s Mar vin Ku r ia n '6 4 ► has been named to membership on the Board of Governors of the American Biographical Institute Research Association . This prestigious board position carries with it the tide of Deputy Governor. ed assistant clinical professor of medicine at Columbia Un iversity and listed in Who'sWhoin rheEast. T homas P. O'C onn or '67 ► has returned to Western New York to become directo r of radiation therapy at Western New York Medical Park, a new facility in West Seneca . Paul S. Schu lman '68 ► of El Cajon, Cal ifornia, was named a fellow of the Ame rican College of Radiology. S.K. Bosu '69 ► has returned to the United States after serving as a consultant to the Lagos State Government in Nigeria. Da vid M. Sherer '69 ► writes, "Took a trip around Lake Erie last summer with my 13-year-old son, saw baseball in Cleveland, Detroit and Toro nt o and stopped in at Capen Hall. Had a brief reunion with professor Milgrom. Otherwise l'm involved in our Credit Union Board,ski patrol, Golf Club Board and have sung with the Seattle Opera. Am having fun with my wife Barbara and th ree chi ldren. I love Scanle." Sherer isdirecto r of Clinical Laboratories, Group Health Cooperative of Puget Sound. 1970s Elliott Brender '70 ► was elected chief of the depa rtment of surgery at Garden Grove Hospital, Garden Grove, California. Jam es M. Bak er '7 0 ► writes, "Besides a small town family practice, I am do ing phase Ill cli n ical studies for phannaceutical companies in development of new drugs. Miko, my wife, and two children are doing well." BUFFALOPHYSICIANAND BIOMEDICAL SCIENTIST �________________ _______,.... .... 39 I ra L. Salom '77 ► was elected a fellow of the American Co llege of Physicians and certified in geriatric medicine. Russell J. Van Coevering II '77 ► was elected president of the New York State Society of Obstetr icians and Gy neco logists. Salvalore A.DelPrete , M.D.,'78 Leela nd A. J ones '73 ► after completing a residency in psychiatry, Jones left his North Caro lina family practice to return to Buffalo, where he was named director of the medical-psychiatry unit at Buffalo General Hospital. Michael Rad e '75 ► has been elected to the Board of Governors of the American Co llege of Su r• gcons as a Governor-at-Large from Western New York. He is a clinical instructor in surgery at the UB School of Medicine and Biomedical Sc iences. Elaine S. Chirlin '77 ► has a private practice in chi ld, adolescent and adult psychiatry in Cincinnati, Ohio, where she also works in pub lic sector mental health. Ch irlin has three daughters. OrestesG. Rosabal '77 ► waschosen to represent the State of Florida as Co uncilor for the Southern Medical Association, a multi-specialty associat ion providing continuing medical education and practicerelated benefits for physicians. Salvatore A. DelP rete '78 ► of Fairfield, Connecticut, was the 1990 recipient of the Dr.Melville G . Magida Award, presented annually to a Fairfield Cou nt y physician fo r "demonstrated notable capability in patient rre-at• menr and care." 1980s Robe rt Brac o '80 ► is the occupatio nal medicine physician at the SW Center for Occupational Health and Safety of the University of Texas School of Public Health in Houston. William N. Capicotto '80 ► of Buffalo is a fellow of the Ame ri can Academy of Or th opaed ic Surgeo ns. Daniel Paul Schaefer '81 ► has written rwo chapters in che new Adas of Con t emporary Op h tha lmic Surge ry. He is an assistant clinical professor in the department of ophthalmology and assistant clinical professor in the department of ear, nose and throat at the State University of New York at Buffalo. Mark Ch ung '82 ► is in private practice as a pulmonologis t in Lo Alamitos, California. He is a lso a lieutenant commande r with the U.S. Naval Reserve Medical Co rps. BUFFALO PHYSICIAN ANO BIOMEDICAL SCIENTIST Mich elle D. Leon '82 ► is the new assistant program director of the integrated reside ncy in eme r• gency medicine currently being establis hed at the University of Co nn ecticut Medical Cente r. Paul N. Rosenberg '82 ► writes, ''Living happily in Rochester, New Yorkarea with my wifeSuzanne and d1ildren,Aaron, 6,andShelby,3. My practice is limited to oculoplascic, reconstructive and orbital surgery." Adolph Soto Jr. '83 ► of Bronx, New York, was recentl y appo inted unit chiefoflinco ln Hospital, the city's first bilingual, bicultu ra l, inpatient psychiatric program. R obe rt W. Lasek '84 and Colette ► arc living in Danville, Pennsy lva ni a. "Colette has com pieced her cardiology fellowship at Geisinger Medical Center and joined the staff, specializing in echocardiography, rransesophageal echocardiography and imraopcrative echocardiography. I comp leted a fellowship in medical educa t ion at the University ofTexas-Southwesrem Medical Cente r (sponsored by the Emergency Medicine Found ation and the American Co llege of Emergency Physicians). I am active ly involved in teaching eme rgency medicine at Geis inger Med ica l Cente r. We recently celebrated our fifth wedding ann iversary." R. (Pruefer) Lasek '84 Joh n J. Picano '84 ► has completed a two-year clinical fellowship in neuroradiology at Massachusetts General Hospital and is now in private practice in New Hartford, New York. He and his wife, Lynn, have rwo children, John, 3, and Cara, 1, and are expecting their third child in May Marc J. Koblick '84 ► moved to Daytona Beach, Florida after completing an opht halmology fellowship in New Orlea ns, Louisiana. He proudly annou nces th e birch of a daughter, Jacqueline Ann, born July 13, 1990. Andrew C . Friedman '85 ► finished a ge n eral surge ry res idency in Buffalo and has started a plastic surgery residency at Case Western Reserve. Mark Ross Comaratta '85 ► has return ed co Buffalo afte r comp let• ing a retina fellowship. He and his wife Kate have two childre n. Kevin L. Donovan '85 ► was appo inted chief of the anes th esiology serv ice at VA Hospi tal in Nashville, Tennessee. He and his wife, Shar, are expec tin g their fourth child in March 199 I. Nicholas D' Avanzo '86 ► is enjoyi ng private pediatric practice with two partners in the H amptons, N.Y. Jean Ann (Comaratta) Marfurt '86 ► proudly anno un ces the birth of her son, Ryan William, born on August 25, 1990. She is practicing pediatrics with two partners at 1630 Maple Road, Williamsville, New York. Debra Ann Gould '87 ► finished a family practice reside n cy in Rochester,New York, andhasaccepred a two-year position as National ResearchService Awa.rdprimarycare fellowwith the department of family medicine at the UniversityofWashington, Seatt le, Washington. Jill E. Koeh ler '87 ► ann ounces the birth of a daughter, Alaina Joy Moreno-Kochler, on December 17, SPRING 1991 �------------------------ ::,~ ,:.:---------------------- --- s 11 40 D avid R. Bl oo m '89 ► announces the birth of a baby son, Annunzio Joseph, 7 lbs. 6 oz. on November I , 1990. Bloom is an assistant clinical instn1ctor of family medicine and clinical assistant for undergraduate affair; at the University of California at Irvine. Ca rlos Robe rto Jaen '89 ► is senior clinica l instructor and resident in the department of family medicine at CaseWestern Reserve University School of Medicine. Donnico L Moore , M.D.,'78 1990, weight 7 lbs. 11 oz. Koehler 1san attending physician at Hurley Mec.licalCenter in Flint, Michigan. Do nn ica L. Moore '87 ► writes, "Robe rt Man ella '88 was recently hired by Sandoz Pharmaceuticals as an assistant director of medica l operations in rhe cardiovascular area - the fourth UB MD to be hired by Sane.lo: in three years! (Other;: Evan Dcmest ihas '87, now at Bristol-Meyers-Squibb; Michael Sabo linski '88, a=iate director, medica l operations am! myself). Perhap;, this rrcnJ has to do with the required Medical Care Organization courses we cook." Moore now heads a new Jepartmcnt within Sandoz Pharmaceuticab - The Medical Educmion Center. The Center will develop eJucarional programs for physicians and medical student;, on osteoporosis anJ rdatec.l metabolic bone disorders. "My husband (Stan Bernard, MD, MBA) ,me.I! have settled in central New York and love the rural lifestyle while being close to New York City and Phi ladelphia. Sec y'all at our Fifth Reunion!" SPRINt11991 D ebra M. Omi atek ' 89 ► transferred from the program at St. Elizabeth's in Utica to finish two years of family practice residency in Niagara Falls at the Niagara Falls Memorial Medical Center. C harles Eve rett '89 ► and his wife, S,mdra Everett '88, and their son Kristian, delight in announcing the new addition, Nicholas, horn, August I 7, 1990. Obituaries Fr ancis M. C rdge ' 19 ► of Santa Barbara, California, died October 17, 1989 at the age of 95. Au gustus ]. Tranella '39 ► died October 30, 1990 at his home in Greece, New York, after a long illness. An obstetrician, Tranel!a delivered more than 2,000 babies at Highland Hospital before his retirement in 1978. John F. Moran, Ph.D. , associate professor of biochemistry at UB, died Wednesday, Feb. 20, 1991 in hi; home in Snyder. He was 55. Moran served from 1983 co L988 a;, assistant to the dean for facilities planning at rhe medical schlx>I. In that capacity, he wa, the coordinator between the school's faculty and the architect on plans for renovation of existing facilities and the construction of a $30 million addition to the medical school, completed in 1988. A native of Cleveland, Moran joined the UB faculty in 1964 as a research associate in the Department of Biochemical Pharmacology in the School of Pharmacy. He was named an assistant professor in the medical schoo l's Department of Biochemistry in 1967 and associate professor in 1970. From 1975 to 1976, he w,1sa visiting associate professor in the Department of Physiology at the Case Western Reserve University choo! of Medicine. Moran was the recipient of a Chancellors Award for Excellence in Teaching, Distinguished Service Award from the UB medical school and a Siegel Award Commendation for excellence in teaching medical students. Murray J. Ettinger, acting chair of the UB Department of Biochemistry, noted that Moran "put endless hours, energy and empathy into coume lling students. He was the sta lwart of the undergraduate biochemistry program and, more recently, the advanced biochemistry course for medica l and graduate students. Whatever he did, he put his heart, soul and humor into it. His persona l efforts helped countless students over the years." Director of undergraduate studies in the UB Department of Biochemistry from 1968 to 1984, Moran haJ served on the UB Faculty Senate, the medical schoo l's Faculty Council, the steering committee of the UB Department of Biochemistry and the curriculum committee of the UB School of Pharmacy. Moran also was active at Christ JohnF.Moran , Ph.D. the King Church, Snyder, where he was head of the usher's organization, a post he held since the late 1970s, and a former officer of the Christ the King Schoo l Parents' Guild. He also was a former treasurer of the Parents Guild of Villa Maria Academy. A 1958 graduate of John Carroll University, Cleveland, Moran received a master of science degree magna cum laude from the Univers ity of Ottawa in 1961 anJ a doctorate in biochemistry from McGill University in Montreal in 1964. An expert in metabolic biochemistry, he was the co-author of more than 30 scientific articles . He is survived by his wife, the former Karin Yax; two sons, Kevin and Patrick, both of Snyder, a daughter, Megan, of Snyder; and a sister, Martha O'Donnell of Cleveland, Ohio. Contributions in Moran's memory may be made to the University at Buffalo Foundation, designated for the John F. Moran Memorial Fund in the UB Department of Biochemistry, or the South East Community \Xlork Center, I 81 Lincoln Road, Depew, N.Y. lll 'FFALO PHYSIC IAN AND BIOMEDICAL ~IENTIST ��BuffaloPhysicianand BiomedicalScientist StateUniversityof New Yorkat Buffalo 3435 Main Street Buffalo,New York 14214 Address Corre<tioa Reqwested 958 MR. CHUNG - KA! HUANG HEALTH 5CIENCc LI RAqy A880 TT HALL CAMP US ,r1AI L Non-l'ro hc Org. U.S. l'osc~e PAID Buffalo,NY Pcnmt No. 3I I � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Spring 1991 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1991-Spring Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v25n02-1991-Spring Table Of Contents A list of subunits of the resource. Research Hospital News Healing the Spirit Daggers of the Mind: Shakespeare and Neurology A Cure for Malpractice Headaches The Clinical Picture From Shin Splints to Hip Pointers Charting the Quality of Life Medical School News Alumni Research People Match Day Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-12 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v25n02 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1991 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/cc44c68c949906d40cb4e81db435df64.pdf f718e6a1097fa2829afb11d5b66d915f PDF Text Text Vol. 25, No. I �STAFF DIRECTOR OF PUBLICATIONS Nancy Tobm Dear Friends: EDITOR Connie Oswald Stofko s we enter 1991, concerns that previously required only speculation now reqUire appropriate attention and resolution. This transference will be accelerated because of increasing fiscal constraints from all of our usual sources of support and the changing world in which we hve. Chtef among those concerns are a need to foster more independence and self-responsibility among medical students and physiCians for their learning, continued development of a research environment which will ensure continued proJuctivtty of the scientific faculty well into the 21st century and the important need to guiJe clinical training programs to be more responstve to social needs without harming the tremendous contributions made to the age of specialization developed smce World War II. For a medical schcx1l faculty, these area' of concern, as well as a multitude of other problems which must be addressed, seem bxh overwhelming and contradictory. Nevertheless, each of this country's 126 medical sch(Xlls shares these issues and each must present options for solutions. Given the unique circumstances at UB, it seems that these areas of concern will receive our focus and attention throughout the current decade. The faculty are initiating curricular changes, and the school is providing the necessary technology and faciltties whtch will foster educational change; the plans for the construction of a modem research facility to be completed in 1994 are well underway, and a maJor tnstitutional commitment has been made to mcrease the emphasis on educating and training a larger cadre of primary care physicians while recruiting and returning an increased prop.1rtion of residents from minority and socially disadvantaged programs. Thus, while UB and its teaching affiliates will not be protected from the onslaught of constraints that will continue to rx:cur, we have initiated strategies to prepare and deal with the changing environment as we meet its challenges. Best wishes for a happy and successful 1991. ART DIRECTOR Alan j. Kegler WRITERS Peter Askew Lots Baker David Htmmelgreen judson Mead Arthur Page David Snyderman Laune Wolf PHOTOGRAPHERS Mark Dcllas Stmon Tong Robert Walion ILLUSTRATORS Thomas Hutchmson Thomas Rtxmey Dan Zakroc:emskt ADVISORY BOARD Dr. John Naughton, Chairman Dr. Harold Brody Ms. Nancy Glieco Dr. James Kanskt Dr. oseph L. Kunz Dr. Charles Paganelh Mr. Michael Arontca Dr. Antoinette Peters Dr. Charles Pruet Dr. Luther Robmson Dr. Thomas Rosenthal Dr. Saleela Suresh Dr. Burton Singerman Dr. Stephen Spaulding Dr. Nelson Torre Mr. Edward Wemke Dr. jerome Yates TEACHING HOSPITALS AND LIAISONS Batavia VA Medteal Center Buffalo General Hosrital, Mike Shaw Buffalo VA Medtcal Center, John Pulli Chtldren's Hospital, Karen Dn]a-Swterskt Ene County Medical Center Mercy Hospttal, Chuck Telesco Mtllard Ftllmore Hospttal, Joseph R. Ci{fa Roswell Park Cancer Institute, Judi Rtce Sisters Hospttal, Dennis McCarthy Produced by che Dim ton of UnivmiN Relanons m associati<m with the School of Medicme and Biomedical SCiences, Swte L'niverstty of New Yark at Buffalo. Eduorial office is m 136 Crofts Hall THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST (USPS 551--860) Winter 1991, Volume 25, Number I. Puh!tshed by the School of Medtctne and Bwmedtcal Sciences, State Untverstty of New York at Buffalo, 3435 Main Street, Buffalo, ew York 14214. Thtrd class hulk postage patd at Buffalo, New York. Send address changes to THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST, 146 CFS Addttton, 3435 Main Street, Buffalo, New York 14214. A ~L+-s: John Naughton, M.D. Vice President far Clinical Aff01rs Dean, School of Medicine and Biomedical ScierlCes Dear Fellow Alumni/Alumnae: I n September, we were happy to present the Second Annual Distinguished Alumnus/a Award to Dr. David Nichols '47. Professor and chairman of the Department of Obstetrics and Gynecology at Brown University, David is a world-recognized authority on female pelvic relaxation disorders and has been a prolific contributor to the literature in hts specialty. It's time to start thinking ahout next year'~ honoree. Please use the enclosed postcard for your nominations. Our programs for students are going well and we were well represented at the orientation sessions for the incoming University residents and for the freshman and )Untor classes. Mark May 4, 1991 on your calendar for Spring Climcal Day and Reunion Weekend. This year's program, "Bridgmg the Gap Between Medicine and Law," will be highlighted by the Stockton Kimball Lecture, given by Sol Wachtler, chief judge of the New York State Court of Appeals. It promises to be an exceptional program. Smcerely, D~ Bertram A. Portin, M.D. '53 �Vol. 25, o. 1 Winter 1991 In Praise of Housecalls Once a staple in medicine, the housecall is alive and well and making a comeback. New hours could hurt continuity of care, page 10. The resurgence of housecalls, page 4. Residents' Hours State~mandated changes haven't caused the havoc educators thought they would. Epidemiological findings need close examination, page 24. Making a Team for Michael The Craniofacial Center, a multi~disciplinary team of health care professionals, improves the quality of life for a six~ year~old boy and a host of other children. Danger in the Locker Room With illegal anabolic steroid use on the upswing, reliable investigation into its health risks is urgently needed. Thomas B. Tomasi, M.D., Ph.D ., receives Stockton Kimball Award, page 27. Do Bad Habits Breed Disease Saxon Graham, Ph.D., lectures at the 1990 Annual Faculty Meeting. Medical School News Alumni Classnotes Illegal anabolic steroid use is rampant, page 22. Craniofacial Center brings a smile , page 14. �- - - ---®:- - - .r E ~ '1- 2 INTERNATIONALLY KNOWN RESEARCHER TO SPEAK AT (HOB LECTURE STUDY LINKS BALDNESS, BLOOD PRESSURE LEVELS study of Italian factory workers has indicated an association between male-pattern baldness and higher cholesterol levels and diastolic blood pressure readings. Maurizio Trevisan, M.D., co-principal investigator and associate professor of social and preventive medicine at UB, cautions that although the study is the first showing an association between baldness pattern and risk factors for coronary heart disease, it doesn't indicate whether there's a link between baldness patterns and the disease itself nor does it reveal the reason for the elevat~ ed readings. Men with male-pattern baldne s had slightly higher levels of serum cholesterol and diastolic blood pressure (the pressure measured in blood vessels as the heart rests between beats) than those with either no hair loss or frontal baldness only. He said the differences reached statistical significance when the average readings for men with male-pattern baldness were compared with those for the men in the e other two groups combined. - By Arthur Page WINTER 1991 rancis S. Collins, M.D., Ph.D., associate professor of Internal Medicine and Human Genetics and associate investigator and chief of the Division of Medical Genetics at the Howard Hughes Medical Institute at the University of Michigan at Ann Arbor, has been chosen as the inaugural speaker for the Rose and Al Pastor Lecture Series. The lecture, scheduled for March 26 at the Hyatt Regency, is sponsored by The Children's Hospital of Buffalo. Internationally recognized, Collins' work in recombinant DNA technology has led to several important advances in the field, including the location and isolation of the genes for cystic fibrosis and neurofibromatosis type 1. The lecture series is an annual event that focuses on public health issues affecting the Western New York community. Collins is slated to speak from 4 p.m. to 6 p.m. A reception will follow. For more information, call the Public Relations Department at Children's Hospital at 878-7543. e space for about 34 physicians and researchers working on approximately $3 million worth of medical research grants. V AMC's medical research program includes a wide spectrum of both clinical and basic studies. Its proximity to the UB medical school has fostered collaborative investigations within a variety of specialties and departments. In addition to providing new research space, the project included the refurbishing and expansion of 25,000 square feet for clinical activities, outpatient care, and administration, plus an additional 10,000 square feet for animal research. SURVIVORS OF (ANCER IN CHILDHOOD (AN HAVE HEALTHY KIDS dult survivors of two forms of childhood cancer - Hodgkin's disease and Acute Lymphocytic Leukemia (ALL) -are capable of conceiving and giving birth to healthy children, according to the results of two recent studies conducted by Daniel M. Green, M.D., professor of pediatrics at UB and director of the Long-Term Follow-up Clinic at Roswell Park Cancer Institute. VAMC DEDICATES NEW RESEARCH (ENTER he Buffalo VA Medical Center last November formally dedicated its new Research Building as part of a $16.5 million expansion and refurbishing program. The new $13.1 million facility, located north of the medical center, provides BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �- - - ---CID:- - - .r t ~ ~ 3 In the study of former Hodgkin's disease patients, some male respondents reported medically-documented decreased sperm counts and some female respondent reported unusual menstrual cycles. But children born to respondents (who averaged 29 years of age) showed no more congenital defects than children born to parents with no history of the disease and none had been diagnosed with childhood cancer at the time of the study. The ALL study, although conducted among former patients who were younger than those in the Hodgkin's ~ study, showed the same results for ~ ~::; childbirth. "Our study suggest that children treated for Hodgkin's disease and ALL lead essentially normal lives after the disease is cured," Green says. The ultimate goal of these and future studies is to follow these patients and their offspring throughout their lives to determine whether there is a genetic risk involved with these types of cancer and whether these former patients develop other malignancies as they grow older. Counseling is an important part of the clinic's work. "Some women who have had these types of cancer as children are afraid to conceive and give birth because they believe they may have a sickly child or a child who will develop cancer," Green says. "We are able to reassure these patients." The studies were conducted with Michael A. Zevon, Ph.D., director of the Department of Psychology at Roswell Park and associate research profes or at UB, and Brenda Hall, R.N., P.N.P./0., Department of Pediatrics. The Hodgkin's disease study was reported in Pediatric Hematology and Oncology and the ALL study in Cancer. e BUFFALO PHYSICIAN AND 1\IOMEDI AL , GooD NEws, BAD NEws: BOTH LIVER AND BEER IMPLICATED IN CANCER IENTIST § matched controls, the researchers identified a "substantial increase in risk" related to the ingestion of vitamin A in the form of retinol from meat and dairy foods like milk and ice cream. On the other hand, the researchers found no risk associated with vitamin A derived from vegetables in the form of carotene. In fact, the study showed risk of esophageal cancer was lower for persons whose diets regularly included lettuce, other greens and tomatoes. e - By Arthur Page STATISTICS DEPARTMENT JOINS MEDICAL SCHOOL 1£ f you resented your mother's admonitions to "eat your liver," you'll find solace in a recent study out of the UB Department of Social and Preventive Medicine. Organ meats, like liver, head the list of foods that appear to increase the risk of cancer of the esophagus, according to the team headed by Saxon Graham, Ph.D., professor and department chair. On what others might consider the down side, beer (which also scored high in an earlier UB study of dietary factors increasing the risk of rectal cancer) also ranks right up there in terms of riskincreasing food fare. The study, reported in the American Journal of Epidemiology, also uncovered what appears to be the Jekyll-and-Hyde personality of vitamin A, which not long ago was being hailed by some scientists as a factor that would reduce cancer risk. As the result of an in-depth comparison of the diets of individuals with esophageal cancer and carefully he University's Statistics Department has joined the medical school, ending uncertainty about its fate. Now located at 2211 Main t., the Statistics Department is adjacent to the Department of Social and Preventive Medicine. This proximity is expected to enhance research and scholarship, school officials say, since the two departments have complementary interests. John Naughton, M.D., dean of the medical school and UB vice president of clinical affairs, says that the school will soon seek new department chairmen for both Statistics and ocial and Preventive Medicine. He calls this an opportunity to recruit chairs who can bring their departments clo er together. Associate Provost Kenneth Levy is currently acting chairman of Statistics. Saxon Graham, chairman of Social and Preventive Medicine, plans to retire. Levy said that no changes in Statistics Department courses or programs are anticipated in the near future but that a faculty position will be added. e WINTER 1991 ��s The physician housecall is alive and well in Western New York. After years of de . . cline, the popularity of the home visit may be on the upswing again, though it isn't the same as the housecall of the horse and buggy days. Instead of traveling miles to check out a bellyache, physicians now see mainly the chronically ill, newborns, and the frail elderly. "It's really a time..-saver to see homebound elderly folks right in their homes," said David Holden, M.D., professor and chairman of UB's De... partment of Family Medicine. "Frankly, it takes longer for them to get maneuvered out of their beds into wheelchairs, then into ambulances, out of the ambulances, back into the chairs, into the offices, and up onto examining tables - then repeating all these steps - than doing the home visit. "With newborns, I find it's nice to do the first visit in the home, where I can get a good look at the preparations the parents have made, and a better view of the baby's home environment. It's obviously a convenience for the family not to have to bring the baby out of the home when it's two to four weeks old." BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST The physician housecall "still has a very important WINTER 1991 �6 role in health care," agreed David A. Silverstein, M.D., assistant professor and director of undergraduate education in Family Medicine. "It's extraordinarily useful to see a patient's surroundings." For example, if an elderly patient falls frequently, a doctor on a housecall could observe that rooms are cluttered with potential booby traps to trip the forgetful resident. A medicine cabinet may reveal medications the patient doesn't bring to the office, but which may be contraindicated. "You're better able to make an informed decision as to whether a patient - despite what he or she tells you in the office - is comfortable and able to make it at home," concurred Daniel Lasser, M.D., M.P.H., clinical director of family medicine at the Erie County Medical Center and director of the Urban Family Medicine Program. Seeing one patient is useful, and visiting couples yields some extra benefits, noted Holden, who with his wife, Carol, a nurse practitioner, often visits couples in their 80s and 90s. "I gain as much information about how one (spouse) is doing by asking the one not being examined," Holden said. "You can really learn what type of support system surrounds the patient by seeing the home and talking to the people living with your patient, whether it's a spouse, another relative, or a friend. "For example, if you ask an elderly female if she's eating, the answer is almost always 'yes'. If you ask her daughter who's actually watching her eat, you may get a different, and more accurate, answer. Such added insight isn't often available in an office visit where a doctor's questions are directed only at the patient." Holden believes that housecall are becoming more common again now that doctors don't have to worry about whether they can fit all of their equipment into a little black bag - everything a doctor needs is a phone call away. During the last 10 years, the full range of services of practically all labs is availab le for dispatch to a patient's home on a physician's phone order. The services often are performed faster at WINTER 1991 Eugene A. Steinberg, M.D., feels house<aDs help redU<e the fear and isolation of many terminally mpatients. "You can really learn what type of support sy stern surrounds the patient by seeing the home and talking to the people living with . " your patrent. home than in a hospital. The physician also can arrange for physical therapy, occupational therapy, and intravenous therapy in the home. Lab work and therapy visits are covered by major in urance carriers, Medicare, and Medicaid. Home visits help make many people comfortable, and reduce the fear and isolation which many chronic or terminally ill patients face, said Eugene A. Steinberg, M.D., clinical assistant professor of medicine and family medicine and a member of UB's Division of Geriatrics and Gerontology. "We talk to people, listen to people, and deal with the fears that block the learning in the hospital," said Steinberg, who is also medical director of the Buffalo VA Medical Center's Hospital Based Home Care Program. The program at the VA is special because patients are seen in their homes not just by a doctor, but by a team that includes nurses, social workers, a dietitian and a physical therapist, Steinberg noted. Many of the patients the team sees have chronic illness and are stable, such as those who have suffered a stroke or multiple sclerosis. There's also a growing group of patients who are discharged from hospitals sicker and unstable and who are continually readmitted. The team finds that early intervention, such as making small changes in medication, often makes a big difference and can even keep the patient out of the hospital. This not only helps the patient, but saves the hospital money. The team works closely with the oncology unit at the VA Medical Center, providing compassionate posttreatment care for terminal patients, in areas such as pain control, psychological issues, and generally aiming to improve the quality of life. "It's a very different focus from acute care," Steinberg noted. Another group of patients seen by the VA team is those with multiple medical problems. BUFFALO PHYSICIAN A D BIOMEDICAL SCIENTIST �Assistant professor and director of faculty development and continuing education in the Department of Family Medicine, Roseanne C. Berger, M.D., prepares students 0 to determine exactly what they can learn from a housecall." "The housecall by the full team is extremely valuable in untangling confusing symptoms," Steinberg explained, "and in addition provides an excellent opportunity for effective one-to-one education with patients on their turf on how to watch their bodies." If housecalls seem like a well kept secret, it's because physicians haven't promoted or advertised that they make housecalls, said Robert A. Baumler, M.D., an internist, cardiologist, and clinical assistant professor of medicine at UB. That's because many people mistakenly think they can routinely call a physician to their house for whatever's wrong with them. Doctors can't make housecalls for everything because the travel time would consume their day. Another drawback to housecalls is that they may keep patients from getting much-needed activity - there is therapeutic value in getting dressed up for an office visit and getting out for some fresh air, some doctors assert. BU FFALO PHYSICIAN AN D BIOMEDICAL SCIENTIST Critics also argue that medical insurers, including Medicare, don't adequately acknowledge the value of housecalls. Reimbursement rates don't come close to covering costs. Marshall Clinton, M.D., emeritus clinical professor of internal medicine at UB, recalls he "used to make a lot of housecalls, and was trained to do so. You could do a lot for people at home that you couldn't do any other place." Although he still makes calls on selected longtime patients, Clinton says he's one of the physicians who is fed up PRESCRIBING HOUSECALLS House calls are best used when: e It's helpful to assess the home situation, especially for the elderly and newborns. e A patient's condition would be adversely affected by being transported to the office. e A terminal illness affects a longtime patient who may not require hospitalization, but may need a medication change or other support. e Transporting the patient for an office visit would be a hardship or impos- sibility for family members or friends. e It's more convenient for the physician. If a parent calls at 5 p.m. about a fairly well-defined condition in a child that's not likely to require extensive lab work, such as an earache, the doctor may find it easier to pay a house call than wait for the family to get to the office. -Thomas C . Rosenthal, M .D., clin- ical associate professor and director of residency education in family medicine at UB WINTER 1991 �8 Early intervention, often possible only through home visits, tan signifitantly improve outtomes. with government regulations and inadequate reimbursements. "I rather expect I'll be retired within a year," Clinton confided. Despite the drawbacks, the Family Medicine Department remains convinced that there is a place for the housecall. According to a survey by Roseanne C. Berger, M.D., 16 of 26 full-time faculty members in the department visited patients' homes during the past year. Starting this year, all new family medicine interns are receiving an orientation lecture on housecalls by Berger, who is assistant professor and director of faculty development and continuing medical education in the Department of Family Medicine. "We need to prepare (future) physicians to determine exactly what they can learn from a hou ecall," she said. WINTER 1991 "It's important to get students in their formative years to become familiar with what can be done for people in the home . " Some students in family medicine already accompany faculty members on housecalls, and Berger would like to see that opportunity extended to all medical students. "It's important to get students in their formative years to become familiar with what can be done for people in the home," she said. There are many resources available to provide care for people at home, such as visiting nurses or X-ray services, but "I don't think students appreciate it unless they see that in action," she said. Berger notes that doctors are trained in a very high- tech world, and may appreciate being exposed to the low-tech surroundings of a patient's home. Janet V. Johnson, a fourth-year medical student, said she "found it refreshing and mildly surprising to learn that BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �physicians - not just visiting nurses alone- actually make housecalls." She says she not only finds housecalls interesting and helpful, but after making just one call was firmly convinced they'll be an integral part of her own practice. "On my first visit," Johnson recalls, "we were going to see a 51-year-old bedridden man who was cared for by his 78-year-old aunt. When I saw her age in the written report, I was naturally concerned about her ability to function effectively at her age. "But when I saw the aunt at work in the home, my mind was immediately placed at ease because she seemed much younger than 78- and fully capable of handling things. Instead of her age being a concern, the visit put fears to rest." Johnson's evaluation of the home visit summarizes that of many practicing physicians: "I enjoy it, and you can learn a lot from it." e TIME-HONORED PRACTICE DESERVES TO MAKE A COMEBACK orman Chassin, M.D., '45, muchhonored senior statesman of the Western New York medical community, considers housecalls so valuable that when poor health robbed him of the vigor to continue them, he ceased practicing medicine altogether. "I never lost anything from going into a home, and I a lways gained immensely," Chassin said. "There is no questioning the rewards in terms of new information about the patient's lifestyle. This information is the cement that fills in the cracks of one's understanding of a patient." "The whole physician-patient relationship is fundamentally enhanced," he continued. "The physician has answered the patient's call totally, bodily. That is not the same as answering the phone or being in the office. The whole transfer phenomenon, the psychological aspect of the relationship, is benefited." Chassin is respected by patients and physicians alike. When he retired, his patients established the Norman BU FFALO PHYSICIAN A D BIOMEDICAL SCIENTIST "There is no question the housecall is a plus. The primary concern of the physician is problem--solving for the patient, and there is much that can be learned from the patient's setting. We are sometimes surprised with entirely new information that affects management of the patient's problem." Chassin Endowment Fund at the Erie County Medical Center, where Chassin spent more than 20 years as attending physician. The fund provides an annual stipend to the outstanding intern in internal medicine at the center. He holds the Kenmore Mercy Hospital Foundation's highest award for service to his patients and the community. James Nolan, M.D., director of medicine at ECMC and chairman of the Department of Medicine at UB, considers Chassin one of the leading clinicians in internal medicine in the Western New York area. Chassin was instrumental in forming the Committee on Human Values and Medical Ethics at UB, and with organizing the first meeting of clinical chiefs of medicine from area hospitals. Hundreds of medical students have benefited from Chassin's knowledge, which is imbued with extraordinary compass ion and concern for the patient's emotional, as well as physical, well being - an outgrowth of Chassin's long interest in psychiatry. He was headed for a career in the field when he switched at the last moment to internal medicine. Chassin believes that medical treatment should be personal, that ideally physicians should form long-term relationships with their patients, garnering as much information as possible about their lives. Rooted in this belief is his respect for the value of housecalls. "There is no question the housecall is a plus," Chassin said. "The primary concern of the physician is problemsolving for the patient, and there is much that can be learned from the patient's setting. We are sometimes surprised with ent irely new information that affects management of the patient's problem. "Physicians must be aware of the social factors- the patient's immediate family, as well as cultural, ethical, legal and economic constraints. Rarely can one attend a patient in just the physical sense." Making housecalls meshes w ith another Chass in opinion of h ow medicine should be practiced - slowly and patiently. "Nowadays new students and physic ians feel they n eed to do something quickly," he said. "I teach that certain diseases and illnesses take a basic natural course, and that time is an important element. Sometimes it is better not to jump in with aggressive therapy, but to wait for the appropriate moment. "And for many patients, home is a better, even safer, place to heal than the hospital," he said. "Considering all the risks of being in a hospital today - technology gone wild, infection running rampant - home can be better for certain given conditions. "Obvious benefits aside, if housecalls are returning to favor now," Chassin said, "the impetus is probably economic." "The government and other payors have realized that in certain instances, the home call will benefit the payor more than some sort of call in the doctor's office," he said. "If you make the econom ic rewards high enough, the housecall will return." e - By Lois Baker WINTER 1991 9 �10 n 1989, New York became the first state government to step in and tell medical hools and teaching hospitals how to run their residency programs. intervention- intrusion to some- came in the areas of work hours, supervision, and credentialing. (See box for details.) After living with the regulations for a year, the reaction ofUB faculty and residents is still mixed, depending in great part on specialty. But many concede that the regulations aren't as bad as they had feared. SURGEONS ARE STILL UPSET "What you see now is more attending staff working with more junior residents," Hassett said. "In the past, a third-year Surgery was- and is still- the medical service that is least comfortable with the regulations. resident might have helped a first-year resident, but now the When the regulations first-year resident is likely to be getting instruction from a 40were proposed, Lewis Flint, or 50-year-old attending physiM.D., who was chairman of cian who has far more experisurgery at UB, said that they ence. We might get an educawould damage surgical educational windfall out of that." tion so much that it would be But he is troubled by the better to close the program than overall effect of the regulation comply. Flint delivered himself on surgeons' education. from their restrictions by ac"There is a practical fivecepting a position at Tulane year limit on post-graduate University in New Orleans. education in surgery because "My sense is that most of coulf/ ~UtH! &~n U LOP.)P. you can't get anyone to pay for our residents are not happy with more," he said. "And if you cut them," says James Hassett Jr., ~a/~ 'o/,,& /io/bJ an> .;h~~ the amount of time available to M.D., associate professor and residents in those years, you cut chairman of the Task Force on clinical exposure." Graduate Medical Education According to Hassett, the in the Department of Surgery. BY JUDSON MEAD bottom line is how indepen"They don't like anything dently the resident can act when forced down their throats. They he or she is finished with the just want to operate and anyresidency. Hassett worries that some of a resident's education thing that restricts their chance to do that is perceived as a negative." may be shifted from residency to practice. "The essence of surgical education is repetition," Hassett Some residents simply ignore the rules, Hassett said. If said. "The important thing is how many complex procedures they aren't finished with their work, they stay beyond the time allowed, even though the new regulations have built in extra has a resident been exposed to and how many times a resident time for surgical residents. has repeated simple procedures." Surgical residents are allowed to be on call past the normal hours limit if they are "generally resting" with "infrequent" OTHER DEPARTMENTS ARE CONCERNED interruptions for patient care. The exceptions apply only if The view is generally more positive outside of surgery, but residents are on call no more than two time a week and have people's concerns haven't vanished. a 16-hour rest period after they go off duty. In the Department of Medicine, the move to an SO-hour In its attempt to comply with the new regulations, UB's week for residents was coming one way or another - its surgery program has created a patchwork of different rules in national accrediting body implemented the change nationdifferent hospitals, such as instituting a regimen of night wide shortly after the New York regulations were put in place. coverage. The side effect is that there are fewer residents on 'The house staff likes the changes," says Alan Saltzman, duty during the day, spreading them thinner. M.D., clinical associate professor of medicine at UB and Even if the hours requirement has surgeons steaming, clinical director of the Department of Medicine at the Erie some of the supervision requirements are viewed as positive. County Medical Center. "They've clearly been 'decompressed."' :7/ WINTER 1991 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �In addition to giving residents a more humane schedule, the changes have "put more emphasis on the role of the attending physician, which is a benefit." But there are still worries about the effects on education and patient care. Gerald Logue, M.D., chief of staff at the Buffalo VA Medical Center, calls the regulations "a detriment to education." The problem Logue sees is with continuity: continuity of patient care and continuity of resident education. If a patient comes in at night, the night float (a resident who covers two or three different specialty services) does the workup, a different team sees the patient the next day, and yet another team sees the patient the next night. Because residents must take a whole day off every week, they often have to drop out of a patient's care, which decreases its educational value. "It's hard for residents to follow a case," Logue says, "and hopefully patient care doesn't suffer." Even if patient care hasn't suffered, there is no evidence that it has improved now that hours are reduced, notes Saltzman. Yet the state based its regulation of hours on the assumption that long hours were detrimental to patient care. A Minnesota study published in the November/December 1990 edition of the ]ournal of General Intemal Medicine showed that the outcomes for patients who were cared for by the admitting resident were the same as the outcomes for patients who were admitted by a night float and cared for by a different team of residents, Saltzman noted . However, disrupting continuity of care can be expensive, he added. The study found that patients who weren't treated by the admitting resident stayed in the hospital longer and received more lab tests. "It's hard to say whether we've gained as much as we've lost," Logue said. "We don't have people walking around who haven't slept for 36 or 48 hours. But the law encourages a shiftwork approach to medicine that is incompatible with what residents will encounter in practice in the real world." would be. "The mood is settling out," Naughton said. "The initial mood was that this would be disastrous for training, but this has not been borne out. "As far as education is concerned, I think the effects have not been adverse. In fact, what's happened has probably been positive." Whether the regulations are driving the best young doctors from choosing New York State residencies, as some had feared would happen, is difficult to tell, Naughton noted, because other factors also affect residents' choices. Downstate, for instance, the biggest problem in recruiting residents is the large number of AIDS cases. "My feeling is that recruiting for Buffalo has gone fairly well this year," Naughton said. INFLEXIBILITY IS A DRAWBACK In Obstetrics and Gynecology Myroslaw Hreshchyshyn, M.D., professor and chairman of the department, says that, on balance, the regulations have benefited resident training and patient care. However, there are drawbacks. "The negatives are cost, loss of flexibility in handling things as we (the departments) think best, and the creation of expectations that are not always reasonable," he said. Hreshchyshyn thinks the residents in his department are generally pleased with the regulations, but adds that he senses that they are coming to regard the limitation on hours as an entitlement. "The law takes away flexibility in terms of assignment and continuity of care," Hreshchyshyn said. "In this respect it is no different than any other work rule specifying when you can take a coffee break and so on." MOOD IS SETILING OUT Well before last year, Obstetrics and Gynecology was moving toward voluntarily providing supervision by faculty members at the level now mandated. When the regulations were implemented, Hreshchyshyn warned that the cost of requiring, rather than encouraging, the increased supervision would be a problem. His view is the same now. Summing up the situation, John Naughton, dean of the medical school and vice president for clinical affairs at UB, says most people think the regulations aren't as bad as they thought they "This is a costly proposition for the hospitals," he says. "With time it will become routine. The net result is that we have added a very costly component to hospital services." BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST WINTER 1991 11 �12 SUPERVISION, NOT HOURS, IS THE KEY Supervision, not the hours requirement, is the key part of the change, according to George Ennis, senior hospital administration consultant at the New York State Department of Health. "The hours-business got distorted out of proportion at the expense of the supervision issue," he said. Most hospitals in the state are working assiduously to comply with the regulations, Ennis said, and most residency programs have provided the funds needed for supervision. The department has received some complaints about non-compliance and has cited some programs. It is the consensus in Buffalo that local hospitals have had an easier time complying with the regulations than downstate hospitals. "Teaching hospitals in Buffalo have always had rather rigid standards," said Luther Musselman, M.D., director of medical education at Millard Fillmore Hospital and clinical associate professor of medicine. He thinks the changes have worked for the better elsewhere, especially with respect to tightening supervision downstate. HURRAH FOR CREDENTIALING Of the three components of the law, the one concerning credentialing has generated the most enthusiasm locally, even though it has also generated more paperwork. "The credentialing has been positive because it forces us to scrutinize more closely what residents can and can't do and how good they are," said Hreshchyshyn ofOB/GYN, adding that his department is now doing a better job of monitoring both residents and their supervisors. The department absorbs the extra cost this entails. In the Department of Family Medicine, which was already in compliance with the hours regulations, the credentialing requirements have caused the department to formalize what it was doing by keeping better records, noted Thomas Rosenthal, M.D., director of the family medicine residency at UB and clinical associate professor. The internal medicine program at Millard Fillmore Hospital developed an extensive credentialing protocol in 1988 before the new regulations appeared. It specified the criteria for gaining privileges for each procedure a resident encounters during training. WINTER 1991 The internal medicine protocol was then used by UB as a model for the rest of its departments in the Western New York Consortium for Graduate Medical/Dental Education, which coordinates all of UB's residencies at the various hospitals. Credentialing decisions are made by the director of each program. Among all of the training programs in Buffalo, there are 275 procedures which require credentials (for example, inserting an IV line). Keeping track of the credentials of the 615 residents has been streamlined by centralizing the information on computer. All consortium hospitals have access to that computer information. "What this has led to is the possibility of much more information exchange between members of the consortium," says Saltzman of ECMC. "But whether we're teaching better or just creating a better paper trail is a question." Musselman of Millard Fillmore says that the formalization is a good idea because credentialing in the past was more impressionistic. Now computerized data on procedures completed is forwarded to the chairman so he or she has better information on which to base a decision. COST IS A HURDLE While New York is still the only state to directly regulate residency training, others are watching. "The issue has to do with the whole structure of postgraduate medical education," said Ennis of the Department of Health. "The American College of Physicians, the American College of Surgeons, other states, and the federal government are all looking hard at what New York is doing." Indeed, the 80-hour limit on residents' work hours is either under legislative consideration or discussion in several states, including California, Pennsylvania, Illinois, Minnesota, Connecticut, and New Jersey. And in] une 1989, the AM A's House of Delegates passed a resolution by its Resident Physician Section endorsing the SO-hour limit. The biggest hurdle for the states is cost. About two-thirds of the expense the regulations impose on hospitals has been covered by increased reimbursements, either from the state or, in the case of the VA hospitals, the federal government. At the Erie County Medical Center, Assistant Adminis- BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �trator Thomas J. Faith says that at the moment money is not his chief concern. "The money is there to hire ancillary staff, but the problem is finding them," he said. Marcia Brierly, administrative director in the Department of Medical Education at Millard Fillmore, believes that the financial impact will show more clearly in the future. "It's dangerous that the hospital is absorbing so much of the cost of the regulations," she said. RESIDENTS' MORALE IS HIGH But Brierly has also observed a positive change on a human level. "The biggest impact of the regulations on residents is in their morale," she says. "I hear the same thing from people around the state: we didn't see the mid-winter depression we're accustomed to in residents." Lisa Benson, M.D., a thirdyear resident in internal medicine, credits the hours limit with some improvement in the quality of her life. "There's been a real difference - for the better," she said. "There may be a slight deficit in continuity of care, but I don't think it's been significant, and I don't think the change has had an adverse impact on education, either." While surgery residents complain that the regulations make their hours too short, some residents think it's still not short enough. Timothy Gundlach, M.D., who started his residency in surgery, moved to anesthesiology this year, a department that was already in compliance with the regulations before they took effect. There's a camaraderie among surgery residents that tends to minimize complaints about the long hours, he said, but that wasn't enough for him. With only 50 or 60 hours a week spent outside the hospital, there wasn't enough time left for reading or even to conduct a personal life. Gundlach noted that there's a general feeling that if more support staff, such as IV teams, could be hired, it would take the pressure off surgery residents. People are leaving because there's too much work. NashatRabadi, M.D., chief resident in medicine at ECMC, says of going home to bed after being on call: "That was a real pleasure." e BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST 13 HOURS Residents may be scheduled for no more than 80 hours a week, when averaged over four weeks. They may be scheduled forno more than 24 hours in a row. On-duty assignments must be separated by at least eight hours of non-working time. Residents must get 24 consecutive hours off each week. Hospitals must enforce policies that prohibit combined assigned hours and moonlighting hours from exceeding the limits on assigned hours. In certain departments that don't have a high volume of acutely ill patients and where the resident is able to get enough rest, there is more flexibility in scheduling. (Excluded from this clause are anesthesiology, family practice, medical, surgical, obstetrical, orpediatricservices.) Surgery residents can be on call past the hours limit if they are "generally resting" with "infrequent" interruptions for patient care. The exceptions apply only if residents are on call no more than two times a week and have a 16-hour rest period after they go off duty. ON-SITE SUPERVISION A sufficient number of supervising physicians must be present in the hospital 24 hours a day in the acute care specialties of anesthesiology, family practice, medicine, obstetrics, pediatrics, psychiatry, and surgery. Supervising physicians must be board certified or board admissible, or have completed a minimum of four years of postgraduate training. The supervising physician may be a resident in his final year of post-graduate training if the patient's physician can get to the hospital within 20 to 30 minutes of being called. CREDENTIALING The medical staff must provide written documentation of patient-care privileges granted to residents. e WINTER 1991 �14 B y D v A M H D M E L G R E E N ts beginnings were casual meetings in the halls and conversations in the OR lounge at Children's Hospital about five years ago. Sometimes the discussions were prompted by a special patient who had a disfigured face along with problems hearing, speaking, and eating. Other times, the physicians would talk about patients who had more common disorders involving the head and face, such as cleft lip and palate. The doctors were concerned because these patients were being shuttled from specialist to specialist almost unendingly and some of the older children were out of school for surgery more than they were in school. p H WINTER 1991 0 T 0 s B y s M 0 N T 0 N G BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST ��16 The disconnected conversations finally found a direction with the development of the Craniofacial Center of Western New York. The center, begun in 1988, maintains a unique interdisciplinary team approach to diagnosing and treating patients who have disfiguring and disabling conditions of the head and face . It is based at Children's Hospital and has ties throughout the University and community, according to Joseph Bernat, D.D.S., M.S., who heads the center's board of directors and is chairman of pediatric dentistry at the UB School of Dental Medicine. One of the patients who influenced Bernat and colleagues to start the center is six-year-old Michael Manthey, who has presented one of the center's most challenging cases. Many of the doctors now associated with the center have been treating him since his birth, and continued treating him when the center was organized. Michael was born with a rare genetic disorder known as Nager's syndrome. This disorder is characterized by severe underdevelopment of the lower face, hearing loss, and limb abnormalities, according to Robert Perry, M.D., clinical assistant professor of surgery (plastic), otolaryngology, and oral/maxillofacial surgery at the UB medical school and member of the Craniofacial Center's board of directors. Michael had almost no chin; his lower jaw was deformed and retrusive. His tongue is small, he has hearing problems, and he is missing fingers on each hand. His treatments aimed first to help him breathe and take nourishment. The later therapy helped him to communicate and to chew, as well as improve his appearance. When Michael was born he had to receive a tracheostomy to open an airway, as well as a gastrostomy so he could be fed using a tube that entered his stomach through the abdominal wall. He only needed the gastrostomy as an infant to ensure that he got adequate nutrition, but he may always need the tracheostomy. Since his birth, Michael has undergone multiple surgeries on his hands, and has WINTER 1991 been evaluated for laryngeal problems. "Last year we began to organize a treatment plan for reconstructing Michael's lower face," said Perry. Because Nager's syndrome is so rare, the team consulted specialists from craniofacial centers in New York, Toronto, and Dallas, he added. The first course of action was surgery to examine Michael's airway and expand his chin and neck tissue to make room for his new jaw. The next step was to begin expanding the jaw bone, Perry stated. The team used a technique known as the llizarov procedure, which was developed in the 1950s in the Soviet Union to stimulate bone growth. Until recently, this procedure was primarily used to lengthen limb bones. It uses an externally fitted apparatus that is placed over the area where bone growth is required. In 1987, two UB physicians, Monroe Strong, M.D. and Robert Gillespie, M.D., were the first in North America to use the MonticelliSpinelli External Fixation System to promote bone growth in a patient who had a badly infected broken leg. Michael wore a modified version of that device that was fitted over his head and face, said Bernat. It looks like a halo and is securely anchored to his skull. Surgeons cut through both sides of the lower jaw bone, creating fracture sites. The apparatus holds the fracture sites open. As in a broken bone, new bone grows BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �between the fracture sites. As new bone is laid down, the apparatus is adjusted daily to open the space slightly between the fractures, stimulating more bone growth. The result is that now Michael has a more fully developed lower jaw and chin. The next step will be to reconstruct his jaw joints in order to get his jaw to open wider. When the joints are reconstructed, he will be able to chew better. Michael also received help for his other related problems. He wears a hearing aid and communicates through a combination of speech, sign language, and a computerized speech board, noted Sanford Nusbaum, D.D.S., clinical associate professor of oral and maxillofacial surgery at UB's dental school and a board member at the Craniofacial Center. "He pushes a button and it says 'Hello Dr. Nusbaum,"' Nusbaum reported. In spite of his disabilities, Michael is attending regular first grade and doing quite well emotionally. Michael's family is a pillar of support and very much involved with the success of his treatment, the staff noted. Michael's case is one of the few times mandibular (jaw) bone elongation has been done on patients in the U.S., Perry said, noting that the success of Michael's treatment reflects just how important it is for specialists to combine their expertise and resources. This is what sets the Buffalo center apart from the others. "Most centers revolve around a single surgeon who does the majority of the work," Perry explained. Bernat said that this individual becomes "the dominant force, and then the team takes on the personality and flavor and the bent of that individual profession." "We wanted to get away from that model so that everybody's contributions are considered and nobody feels as if they're left out," Perry said. "You can see that in our conferences. Everybody's opinion is respected." "No one part of the team is more important than any other part of the team," Bernat added. "So, the psychologist is just as important as the surgeon." One of the most common congenital disorders treated at the center is cleft lip and palate (CLP). BUFFA LO PHYSIC IAN AN D BIOMEDICA L SCIENTIST Michael'S case is one of the few times mandibular bone elongation has been done on patients in the United States. The success of his treatment reflects just how important it is for specialists to combine their expertise and resources, and it is what sets the Buffalo center apart from the others. CLP, which arises during the embryological development of the fetus, results in the incomplete closure of the palate and an abnormal cleft between the upper lip and the nose. CLP occurs in about one in every 700 live births. The relatively high incidence of this birth defect accounts for about 61 new cases every year in Western New York. Some children with CLP also present other associated problems which could be overlooked and come back to haunt these children later, noted Linda Brodsky, M.D., who is associate professor of otolaryngology and pediatrics at the UB School of Medicine and Biomedical Sciences and is on the board of directors of the Craniofacial Center. For instance, some children born with CLP also suffer varying degrees of hearing loss which may affect their speech development. Many physicians and dentists may not be familiar with the subtleties of these syndromes, Brodsky commented, and they don't know about new treatments and procedures. The center serves as a repository for tried and tested treatments as well as for new technology and the sharing of seminal ideas. And in no better forum can the sharing of ideas and opinions be heard than during the monthly patient conferences, which are held at Children's and open to all individuals interested in craniofacial disorders, said Bernat. At each conference, a lecture on a specific topic is presented to the audi- ence. Then one or more cases are reviewed with the actual patients present. Any of the specialists can examine the patients and review their histories and charts. After the patients leave, the specialists begin their debate about the best plan for treatment. The goal is to get a variety of opinions from all the specialists. "We talk it out - sometimes fight it out," Brodsky said. In the end, everybody must be satisfied with the treatment plan, she explained. It's not enough for an oral surgeon to get up and say "I want to do a bone graft now." Not only does he have to convince other oral surgeons in the group that this is the right thing to do, he must convince the other specialists as well. Most children born with craniofacial disorders are seen by team members immediately- right in the delivery room at Children's Hospital. (Those born at other hospitals may be transferred to Children's if the condition is severe.) In the delivery room, the breathing of newborns with craniofacial disorders is checked. If there's a problem, an otolaryngologi t is called in and may perform a tracheotomy to open an airway in the neck. A few days later, once the physicians are sure the infant is breathing and feeding properly, Luther Robinson, M.D., examines the infant for possible genetic disorders. Robinson, director of Clinical Genetics and Dysmorphology WINTER 1991 17 �18 llizarov's Procedure, developed in the Soviet Union in the 19SOs to stimulate bone growth, was used to lengthen Michael's jaw through the use of an externally fitted device. in the Division of Human Genetics at Children's and assistant professor of pediatrics at UB, is also on the board of directors at the Craniofacial Center. Once this diagnosis is made, the team will have a better idea of how the disorder will behave and progress. From there the doctors are able to make a prognosis. Craniofacial patients generally require years of treatment. For example, patients with CLP may require between four and six surgeries to repair the lip and palate, and may also have to have their dental arches expanded through bone grafts. Treatment will last through their teen years, said Nusbaum, the maxillofacial surgeon. Many of these procedures are timed according to the eruption pattern of the permanent teeth, he added, and this stretches out the treatment period. ln addition, these children "have to be monitored for speech and often they need the help of a speech and language pathologist," commented Nusbaum. Because people are concerned about their looks, a person who has never looked right or sounded right or chewed right may need counseling, as may their families. Success for a patient may be measured in small victories, resulting in a great deal of stress. Older children and even adults are treated at the center, Nusbaum said, adding that the younger patients tend to respond somewhat better to treatment because they're still growing and WINTER 1991 I don't have to relearn speech habits. The coordination of the center's activities requires a monumental effort on the part of support staff. Two of the people who are responsible for keeping the center running smoothly are Deborah Green and Janice Rockwood, R.N. Green, who handles secretarial duties, is helping to set up a fee structure that should save patients money. Patients will be charged a flat fee for evaluations by the team, rather than being billed by individual specialists. The treatments themselves generally are covered by insurance, and patients with congenital deformities often are BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST \ �eligible for state assistance. Rockwood, a nurse at C hildren 's fo r 15 years who h as worked in just about every department, began working at the center last year. "I am a patient advocate," sh e sa id. "Th a t 's m y m a in jo b . I h ave th e responsibility of sch eduling pa tie nts for their appo intments and surge ries, t h e ir preo p e ra tiv e proc edures, a nd patient education ." Rockwood also gives invaluable advice on things such as referrals and payment, and acts on behalf of the patients when they see doctors who are not part of the center. Finally, Rockwood se rves as a sounding board for patients to air their frustrations, fears, and hopes. Because of their enthusiasm fo r the interdisciplinary approach , the team is lobbying lawmakers in Albany to find resources so that other craniofacial cen ters can be started up through out th e state, Perry said. In creating a state-wide network of centers, patient care will be enhanced, the number of surgeries reduced , and costs will come down, Brodsky added . The center has already taken on an international flavor. During June 1989, members of the craniofacial team spent two weeks in the Dominican Republic on an informational exchange miss ion . They spent time diagnosing patients and even operating on nine children . S ix footlockers of supplies and equip- ment , which were don ated by S isters H os pital a nd C hildre n 's H ospita l of Buffalo , we re delivered to C hildren's Hosp ital in the Dominican Republic, Perry said . 19 The team also tra ined some of the loca l phys ic ia ns on n ew techniqu es. Th e t ea m will b e returning t o th e Dominican Republic in N ovember to strengthen ties and share more of their information, he added. Future success of the C ra niofacial Center depends upon continued integration of the various fields of expertise. The team encourages those interested in treatment, education, or research of craniofacial disorders to get in to uch with the center at (716) 878-7149. e Craniofacial Center's Aim: lmproYing uality of Life W hen people usually think about a craniofacial treatment center, they think about corrective surgeries that change the way a person looks, noted Linda Brodsky, M.D., who is associate professor of otolaryngology and pediatrics at the UB School of Medicine and Biomedical Sciences and is on the board of directors of the Craniofacial Center. Here, the concern is not just with correcting deformities, but more importantly, making sure that the patient functions reasonably well, stated Brodsky, who is also a co-head of the Department of Otolaryngology at Children's Hospital. The aim is to improve the overall quality of life. "The center is multidisciplinary in that there are many disciplines involved, but it's also interdisciplinary in that all of the disciplines are intertwined," said Joseph Bernat, D.D.S., M.S., who heads the center's board of directors and is chairman of pediatric dentistry at the UB School of Dental Medicine . "We work very closely with one another, and that's something that we stressed from the very beginning." BUFFA LO PHYSICIAN AN D BIOMEDICAL SCIENTI ST More than 20 health care specialties ore represented in the Craniofacial (enter. In all, more than 20 health care specialties are represented in the Craniofacial Center, including genetics; pediatric dentistry; speech pathology; audiology; psychology, and plastic, oral and maxillofacial surgery. The center currently treats over 200 patients, most with congenital deformities. Treatment generally starts at birth and lasts through the teens, though some adults are also treated. The center also focuses on education for the team members and residents, and it's beginning an aggres- sive research program as well, added Robert Perry, M.D., clinical assistant professor of surgery (plastic), otolaryngology, and oral/maxillofacial surgery at the UB medical school and member of the Craniofacial Center's board of directors. The research program includes a new investigative project on the efficacy of various procedures to lengthen the jaw bone. Initially, researchers will use animal models to test these procedures. Eventually they hope to apply their findings to e humans. �:···················· • • ••••••... . .....•••••••••.•••.......•• • •............•••••...............•.•••••••••••••••.........•.••••••••••••.•........••••••••.•.........•• ! .. 20 .: E R H E I1D A N D N_ T - ;:· .:. --:--:.. : - .- - - .:. - ~- ::. --- ,_ - -~ - -' ( L 0 K ' - w - v. ~<._~- E R ILLUSTRATIONS: THOMAS HUTCHINSON R 0 0 M ........................................................................ ....................................... ..................................................................... I \ �S DE ~ B y LAURIE 0 WOLF 21 <:) """ n 18~year~old body builder takes several types of black market steroids and gains 130 pounds of lean muscle over the next three years. He also experiences fits of depression, violence and I \ delusions of grandeur. Convinced of his omnipotence, he drives his car into a wall at 30 mph, after enlisting a friend to videotape the crash. BUFFALO PHYSICIA AND BIOMEDICAL SCIENTIST WINTER 1991 �22 ................................................................................... These are just two examples of the increasing misuse of anabolic steroids and human growth hormone that have come to the attention of researchers W. J. Kraemer, Ph.D., director of research at Pennsylvania State University'sCenterfor Sports Medicine, and Karl Friedl, Ph.D., a research physiologist with the U.S. Army Institute of Environmental Medicine. Presenting a paper on the topic at last August's Congress of the International Society ofPsychoneuroendocrinology, which was co-sponsored by UB, the pair said that reliable investigation into the health risks of steroid use is urgently needed. Mere scare tactics in the media, Friedl noted, are unlikely to discourage athletes from pursuing a competitive edge with hormones. Instead, the negative publicity surrounding steroids undermines their legitimate applications and impedes scientific study. Kraemer, a member of the U.S. Olympic Committee and the National Strength and Conditioning Association, made a plea for increased drug testing, better role models in athletics, research into alternative training methods, and rehabilitation for athletes habituated to steroid abuse. Anabolic steroids are synthetic de- increased significantly among athletes, mostly male, and has even spread to nonathletes who want only to improve their appearance. Friedl cited a recent study of 12th-grade males in the United States that showed that almost 7 percent use or have used anabolic steroids. Sixteen percent of those were not involved in any competitive sports. In another study of steroid use among male high school seniors, 38 percent reported beginning anabolic steroid use at age 15 or less. Naturally, few steroid users are willing to talk openly. Among those who do admit to using steroids, few will accurately report the amounts, strengths and combinations taken. Anecdotal reports suggest athletes take doses that are from four to more than 100 times greater than those approved in therapeutic treatment. In fact, noted Kraemer, an underground subculture exists to share information on experimental combinations and strengths of different steroids. "Stacking," the taking of multiple steroids at once, is common. Eighty-five percent of these drugs are acquired from pharmacists, doctors and veterinarians. The remainder are mailordered black market drugs, smuggled, stolen or secretly manufactured products. M ere scare tactics in the media are unlikely to discourage athletes from pursuing a competitive edge with hormones. Instead, the negative publicity surrounding steroids undermines their legitimate applica, tions and impedes scientific study. ................................................................................... WINTER 1991 rivatives of the male hormone testosterone and are FDA-approved for treating a small number of diseases. Human growth hormone, somatotropin, comes from the pituitary gland and is sometimes prescribed for children who are not growing properly. But athletes use the substances more than doctors do: to promote muscle growth, to improve athletic performance, and to prevent or speed recovery from injury. Reportedly, the first use of anabolic steroids occurred during World War II, when they were given to German troops to increase strength and aggressiveness. Based on anecdotal reports, steroids were first used in athletics by the Russians in 1954, Friedl noted. Since then, the use of these drugs has BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �"In a controlled research setting, there's no way to study the superhigh doses these athletes are taking," says Kraemer. "It is simply not bioethical to administer the drugs in such massive doses." Hence, most of the information on the health risks of anabolic steroids comes from the treatment of patients who have taken comparatively smaller therapeutic doses, or from the observations of sports physicians. Friedl noted that one important area that needs more research is steroids' effect on the prostate gland. Because the prostate gland is a target for steroids, researchers suspect that repeated use might cause enlargement of the gland or even cancer. He sees many parallels between men's use of steroids and women's use of the contraceptive pill and predicts that it will take a long time for all of the effects of steroids to emerge. Not much is known about the effects of steroids on musculature and skeletal muscle growth. However, it is suspected that prepubescent children and adolescents who take steroids may be in \..l,~. danger of stunting their growth. There are some effects that are more well documented, Friedl said. Heavy users face an imbalance in high- and lowdensity lipoproteins, which may promote arteriosclerosis and heart disease. There have been everal case reports of strokes that seem associated with steroids. Orally administered steroids have been implicated in the development of benign tumors and blood-filled cysts of the liver. Reproductive function and sex characteristics are affected. Males may suffer from atrophy of the testes, low sperm count, and increased libido. These effects may gradually reverse when the drugs are stopped. However, gynecomastia, the enlargement of the breasts, may not. (To rid themselves of this feminizing effect, some body builders resort to surgical mastectomy, Friedl noted.) Females may exhibit increased hair growth on the face, enlargement of the clitoris, deepening of the voice, and loss of menstruation. Acne in users of both sexes is common. The use of human growth hormone is less prevalent than anabolic steroids, partly because it is less available on the black market. In adults, it causes acromegaly, a condition characterized by enlargement of the hands, feet and face. Another area that researchers don't I I \ know much about is the psychological effects of steroids. Kraemer noted that anabolic steroid users report increased energy, greater endurance to stress and a keener desire to compete that can lead to habituation. However, they also report various forms of psychoses: delusions of grandeur, paranoia, auditory hallucinations, depression and mania. Stopping the drugs usually brings an end to paranoia and mania, but may increase depression and apathy. "There is no question that steroids build up bodies," noted Kraemer, "but at what price? The young men and women taking these drugs don't appreciate the serious health risks they're taking, not the least of which is potential psychological damage. There hasn't been a careful ex- perimental study in this area, and one is badly needed. The people at this congress are in a position to take that next step." 23 DNTIERNATDCNAIL CON ff:IERIENCIE RIEFlllECTSS SSIHID ff:T ON SSIP>IECDAILTY "There's been a definite shift in the field of psychoneuroendocrinology ,"explained Uriel Halbreich, M.D., professor of psychiatry, research professor of gynecology/ obstetrics, and director of Biobehavioral Research at UB. Halbreich chaired the 21st Congress of the International Society of Psychone u roe ndoc r in o logy, which wasco-sponsored by UB. The congress brought almost 450 scientists and clinicians from around the world to Buffalo last August to address the theme ofhormonal modulation of the brain and behavior. Research during the past 10 years has spotlighted new mechanisms of brain function, Halbreich said. "We used to measure the peripheral hormones, for example, cortisol, to learn whatwasgoingon in the brain,"Halbreich said. "It was thought that the brain created hormonal changes which then influenced behavior. "But in the early 1980s we discovered receptors for hormones actually in the brain. Now we also study how the hormones, themselves, affect the brain and cause changes in behavior." This exciting shift has advanced the management of mood disorders. In studying this new mechanism of brain function and dysfunction, better drugs are being developed, along with more effective treatments. • WINTER I99I BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �DO BAD HABITS Sometimes, but beware of the correlations 24 pidemiology helps to answer some of society's questions, but its findings need to be closely and carefully examined. That was the message that Saxon Graham, Ph.D., professor and chair of the department of Social and Preventive Medicine, delivered as the Stockton Kimball Lecturer at the 1990 Annual Faculty Meeting last spring. y Graham is an epidemiologist who received the 1990 Distinguished Achievement Award of the American Society of Preventive Oncology for his pioneering research. He has developed most of the epidemiologic methods that are currently used to investigate the relationship between diet and cancer, and he and his group identified many of the foods and food components that increase or decrease the risk of cancer. Graham is the principal investigator of a $6 million, five-year study funded by the National Cancer Institute to investigate the link between diet and cancer. While obviously an advocate of the usefulness of epidemiology, Graham warned his audience to be cautious when dealing with epidemiological findings. WI TER 1991 BUFFALO PHYSICIAN A D BIOMEDICAL SCIENTIST �BREED DISEASE I you make, warns epidemiologist Saxon Graham. 2S "The most fundamental fact of epidemiology is that it is a very inexact science," he said. Physicians should be aware of the trouble spots that could make a study suspect, Graham explained: Too little replication of a result. Replication is especially important in epidemiology because this field is particularly prone to errors in observation, Graham said. These errors often occur in studies that rely upon reporting by patients themselves. Memories of past exposure or behaviors are suspect and "even patients' current observations are not made with the precise tools that clinicians and bench scientists are often able to use," Graham explained. e .,., 'Z ... Too few subjects in the test. "Individuals are so idiosyncratic that it is difficult to generalize a finding to humans as a group from only a small number of observa~ tions," he said. The element Of time. (CONT.PAGE26) W INT ER 199 1 BUFFALO PHYSICIAN AND BIOMEDICAL SCIE TIST �(CONTINUED FROM PAGE 2S) 26 t seems obvious that a study must allow enough time for a pathological effect to show up, but Graham said that this is frequently forgotten. In the case of Love Canal, for example, Graham said, "the convincing evidence probably will not be available for a good many years simply because the diseases these exposures might cause have such a long latency and such low incidence," When researchers do allow enough time, it's possible to make strong conclusions. For example, "one of epidemiology's major accomplishments was to show that cigarettes can kill people after many decades of smoking," Graham said. -{:{Lack of a "dose-response." In other words, risks should increase with higher dosages. -{:{ Inconsistent results. Several years ago, people became concerned over a study that linked saccharine with bladder cancer in one sex. Study after study failed to replicate that finding. Finally, "the most definitive study of the subject showed no relationship," Graham said. He also warned that although animal studies can be useful in corroborating effects found in humans, "what is true for animals is not necessarily so for people." Several studies have shown a relationship between tumors and alcohol in humans, but "so far as I know, the many attempts to cause tumors in animals with potable alcohol have been unsuccessful," he noted. In a case such as this, "where there is a strong association and many replications, I believe the prudent clinician would base his behavior on the epidemiology" instead of on the animal results, Graham said. -{:{ Potential confounders. Other factors can affect the results of a study, and must also be taken into account, Graham noted. For example, lower cancer mortality rates in the Los Alamos population does not necessarily mean that plutonium is good for you. A better explanation for this phenomenon is that Los Alamos residents are much more highly educated and probably have stopped WINTER 199 1 He warned t1uu aitnough animal studies can~ useful in corro"OOrating effects found in humans, "what is true for animals is not necessarily so for ~ople. '' smoking in larger numbers than the comparison populations, Graham said. Finally, Graham warned against throwing out a set of studies just because one or more members of the set has a weak conclu ion. An example is a study that looked at whether exercise can help prevent a second myocardial infarction (heart attack), conducted by John Naughton, M.D., dean of the medical school and vice president for clinical affairs at UB. Although the overall death rate and the death rate due to cardiovascular disease both decreased after exercise, they did so at a rate of "borderline statistical significance." However, Graham said that statistical significance should not be the only criterion applied to this study. "There has been replication of this finding in 22 studies," Graham said, "and the benefit of exercise under medical supervision probably outweighs any potential for harm. "Where there has been much replication of a given finding and all the findings are in the same direction, even though some of them are not quite statistically significant, that finding bears consideration." Thi is especially important when the proposed remedy isn't harmful. UB's epidemiologist isn't the first Graham to win fame for his theories on food. In 1839, the Reverend Sylvester Graham blamed red meats and refined flours as a cause for the rampant sexuality of his day. As a result, "Great-greatuncle Sylvester," as the epidemiologist jokingly called him, concocted his own type of flour, which is known today as graham flour. The idea of fiber as a nutritive additive has come up several times in the past century and a half. Although today you can "taste them again for the first time," as the slogan goes, back in 1888 you really could taste corn flakes for the first time. That was when "Dr. John Kellogg, also to cool the hot blood of Americans, advocated the replacement of white flour by whole grains and invented something close to what we know today as Kellogg's Corn Flakes," Graham said. Fiber has been more recently advocated as a preventive measure for colorectal cancer, but "epidemiologic research on fiber, per se, has been minimal and the results contradictory," Graham said. Fats are being linked to cancer, in· part because countries with high average dietary fat intake also have high colon cancer mortality rates. "But a simple correlation does not neces arily indicate a causal relationship," Graham cautioned. He pointed out that "a significant increase in the stork population in two counties in California paralleled an increase in the birth rate in those counties." The same nations that have a high fat intake also tend to be highly industrialized, Graham explained, and the increased risk could be due to the industrialized nature of the countries, rather than their high-fat diets. And there are possible confounders in the studies linking fat and cancer. "Thus, we need to study not only fats, but also high caloric intake, high body mass, and high energy expenditure through physical exercise in relation to a number of cancers," Graham noted. For the most part, epidemiologists can't make precise recommendations about diet, Graham explained. But epidemiology, through studies which are carefully conducted and interpreted, can "suggest clues for prevention of disease." e BUFFALO PHYSICIAN A D BIOMEDICAL SCIENTIST �-------------------------------------------~®~I~~- -------------------------------------------C .,. ~ (" If 0 27 Giving birth, rejecting a transplant: Torrwsi sees intriguing similarities By LAURIE WOLFE ould birth actually be a mother's immune system finally rejecting the fetus as it would, say, a skin graft? If so, what prevents rejection for nine months, and could that factor be useful in transplant acceptance? These are some of the current questions that intrigue Thomas B. Tomasi, M.D., Ph.D., director of the Roswell Park Cancer Institute. Known internationally for his landmark discovery of the mucosal immune system, Tomasi was given UB's Stockton Kimball Award in recognition of his 25 years of research in immunology and over 30 years of teaching. He will deliver the 1991 Stockton Kimball Lecture at the Annual Faculty Meeting in the spring. In addition to his administrative duties at Roswell Park, Tomasi is a professor of medicine and microbiology at UB and head of the Molecular Medicine and Immunology Division in the UB Department of Medicine. He maintains a busy and productive lab that is looking into several questions on immunology, including the riddle that has always puzzled scientists: How is it that the fetus survives inside the maternal womb in spite of the fact that it carries the foreign chromosomes of the father? Tomasi may have discovered the answer while looking at a different problem. Thomas B. Tomasi, M.D., Ph.D. "Infants of almost all species, including humans, are born without any antibodies on their respiratory and other mucosal tissues," said Tomasi. "Two of our current projects stem from the initial question , 'Why are newborn animals deficient in their mucosal immunity, and could this deficiency be due to a circulating factor?'" Tomasi and his fellow researchers suspected that the factor circulated in the blood . But, working with mice, it was too difficult to get enough fetal blood to proceed. Instead, the researchers used amniotic fluid because it is more plentiful and contains many fetal proteins. Sure enough, they found a substance in the amniotic fluid that suppressed WI TER 1991 BUFFALO PHYSICIAN AN D BIOMEDICAL SCIENTI ST �------------------------------------------- ~@~~~ -------------------------------------------.,. r I r It 0 ..... ~ 28 the immune response. This factor is either identical to or closely related to TGF-13 (transforming growth factorbeta.) Now that they knew what they were looking for, they were able to go back and identify the same factor in fetal serum. The findings were published recently in the Journal of Experimental Medicine. Using molecular techniques, Tomasi's lab has found that TGF-13 stays localized in the uterus. These discoveries led to the next question: Could the factor that makes babies deficient in their mucosal immunity be the same factor that keeps the mother's body from rejecting her fetus? "What we found was amazing-really exciting," Tomasi said. "This substance was present in the pregnant uterus and not in the normal uterus. It appeared at about the ninth day of a 20-day gestation period, reached a peak at 15 days, and then fell off rapidly as birth approached." He speculates that this may be the mechanism by which pregnancy is allowed to persist. "This has important implications," Tomasi said. "It's probably the hormones of pregnancy that are generating this suppressive factor in the uterus. We have found that this substance checks the expression of certain antigens controlled by paternal genes - the antigens that would normally stimulate the graft rejection phenomena. "Now we're wondering if birth actually is a rejection phenomenon. We're also wondering, if you lack enough of this substance, does a miscarriage occur? Up to now we could only speculate. But we're about to begin work with an antibody that will neutralize TGF-13, and this may give us an answer as to whether or not TGF-13 is involved in spontaneous abortion." Within a year, Tomasi hopes to take WINTER 1991 ~~what we found was amazing- really exciting. This substance was present in the pregnant uterus but not in the normal uterus. It appeared at about the ninth day of a 20-day gestation period, reached a peak at 15 days, and then fell off rapidly as birth approached." This may be the mechanism by which pregnancy is allowed to persist. this research further by seeing if TGF-13 is useful in preventing transplant rejection. Studies in his lab have already found that if a skin graft is performed between two incompatible st rains of mice, and the animal is treated with TGF-13, ordinary rejection of the graft is suppressed. "Naturally, this could have tremendous impact on the future of organ transplants," notes Tomasi. "We're just starting experiments with heart and kidney transplants." Interesting ly, in skin graft observations, Tomasi has found that the addition of TGF-13 can be stopped after a certain time without causing subsequent rejection. So once beyond an initial rejection stage, the suppressive agent is no longer necessary. "Of course, further studies have to be made into the toxicity associated with this naturally occurring immunosuppress ive factor," he noted. These experiments are bui lt on Tomas i's earlier ground-breaking work. He fo und that mucous membranes in the body produce antibodies that are distinct from the antibodies found in the bloodstream. T his mucosal immune system provides the body with a vital first line of defense against microorganisms that cause disease. The mucous membranes l ine the areas that come in con tact with the external envi ronment wh e re fo reign organisms can naturally and easi ly invade - the eyes, ears, nose, mouth, and gastro intestinal tract. Today hundreds of scient ists a re building on Tomasi's d iscove ry by research ing various aspects of the mucosal immunity mechanism, the structure of these particular antibod ies, how they are transported, and the mechanisms of vacc ination. Tomasi received his M.D., magna BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �-------------------------------------------:~:-------------------------------------------­ ~ It 0 29 cum laude, in 1954 from the University of Vermont. He then started working on his Ph.D. at Rockefeller University, where he began studies that led to his discovery of the mucosal immune system. As a profe sor of medicine and a research professor of microbiology at UB from 1965 to 1973, he further advanced his work. He left Buffalo to become chairman of immunology at the Mayo medical school, and returned to Buffalo to head Roswell in 1986. Tomasi will soon return to another area of research that he began at Mayo: the immunology of exercise. A casual remark by a friend, a physician associated with the Olympic Nordic Ski Team, was the catalyst that sparked Tomasi's interest. At any one time, the friend said, 20 percent of his cross-country skiers were out of commission with upper respiratory infections, whereas downhill skiers did not suffer the same setbacks. From his own experience as a competitive skier, Tomasi knew that cross-country skiing was far more exhausting than downhill, the equivalent of running a marathon as opposed to the 300 meters. Building on what he already knew about the mucosal immune system, Tomasi found that in athletes pushed to the limit, there is essentially a disappearance of antibodies on the mucous surfaces of the upper respiratory tract. He also saw changes in the circulating immune cells, the natural killer or "Nk cells" that are involved in resistance to cancer. Initially, there was a tremendous drop which then returned to a normal level in about 12 to 24 hours. So, in effect, severe physical stress caused a temporary immune deficiency. Conversely, if a person backed off on extreme exercise and did moderate workouts (this level was naturally different for each person), the person actually enhanced his or her immune response. This phenomenon could have considerable relevance in the treatment of chronic diseases. Of special interest to Tomasi is how physical and emotional stress affect the immune systems of cancer victims. After surgery and radiation, he wonders, why do node-negative breast cancer victims have a survival rate of 80 percent? Is there a mechanism that is damping the immune response of the other 20 percent, and could this be affected by stress? Tomasi is in the process of assembling a team of researchers to tackle these questions, and the many more that are sure to follow. e ANNUAL FACULTY MEETING HoNoRs ToP TEACHERS FoR 1990 he Annual Faculty Meeting held each spring provides an opportunity for the UB medical school to honor those who have made outstanding contributions. Honored in 1990: Roland Anthone, M.D., and Sidney Anthone, M.D., clinical professors of surgery, were named recipients of the third annual Robert S. Berkson Memorial Award in the Art of Medicine. The award recognizes excellence in patient care and teaching by volunteer faculty members. Bernard Eisenberg, M.D., clinical associate professor of pediatrics, received the Dean's Award for service to the medical school and the University and outstanding research. A longtime volunteer faculty member, Eisenberg is a member of the school's admissions committee. Evan Calkins, M.D., professor and head of the medical school's Division of Geriatrics/Gerontology, received a special award as founder of geriatric medicine at UB. A plaque in his honor that will hang in the medical school describes Calkins as "an energetic, imaginative leader with demonstrated qualities of humanitarianism, compassion and a fondness of learning and giving. A true role model for the medical leaders of the 21st century." Louis A. and Ruth Siegel Teaching Awards for teaching excellence were presented in four categories. The recipients were: Pre-clinical award: Alan Lesse, M.D., assistant professor of pharmacology and therapeutics. Clinical Award: Fred Luchette, M.D., assistant professor of surgery. Volunteer award: Thomas Westner, M.D., clinical assistant professor of medicine. House staff awards: Frederick Kohn, M.D., resident physician in obstetrics/gynecology; Robert Erickson, M.D., resident physician in family medicine; Maheswar Rao, M.D., resident physician in medicine; and Karen Drake, M.D., resident physician in obstetrics/gynecology. • CASSEL TO VISIT UB AS HARRINGTON PROFESSOR hristine Cas el, M.D., an expert in medical ethics and gerontology, will visit UB on May 29 and 30 as the second Harrington Visiting Professor. Cassel is one of two women regents of the American College of Physicians and chief of the section of genera l internal medicine at the University of Chicago School of Medicine. As the Harrington Visiting Professor, she will give several talks and seminars.e WINTER 1991 BUFFALO PHYSICIA AND BIOMEDICAL SCIENT IST �-------------------------------------------~@~I~~-------------------------------------------"' r C If 0 ~ 30 Cooperation, not Competition Thomas Riemenschneider strives to unify teaching hospitals around common goal By LOIS BAKER agging along after his father in rural Berea, Ohio, 50 years ago, Thomas Riemenschneider saw firsthand the tie between physician and community. Those early impressions grew into a love for medicine and a commitment to pushing his profession beyond its traditional boundaries, a dedication that Tom Riemenschneider, M.D., M.B.A., brings with him as the new associate vice president for clinical affairs and associate dean at UB Medical School. "Most medical schools will tell you their missions are teaching medical students, research, and patient care," he said. "As far as I'm concerned, there are four missions. That fourth mission is relating to the community -- identifying community health care needs and responding to those needs." His goal here is ambitious: To develop a unique model for delivering health care to the community. As liaison between the medical school and area hosp itals, his job is to convince everyone to work together through a cooperative consortium, for the benefit of all. That effort is already under way. The hospitals' CEOs are meeting to discuss common goals. Next will come meetings between medical directors and department heads. If the effort is successful, Western New York could serve as an example for other communities across the nation. WINTER 1991 "The degree of cooperation here is unique," he said. "Out of 128 medical schools in the country, only a few are close to the model we're looking at here." "The traditional model is one university hospital designated as the primary teaching hospital for students and residents," Riemenschneider said. "My own feeling is, that in recent years, that traditional model has become outmoded, in part because there is an ivory tower around it," he continued. Because the traditional model never existed here, he saw an unusual opportunity to move health care delivery and medical education into the community. In this approach, Riemenschneider has the full approval of John Naughton, M.D., dean of the medical school and vice president for clinical affairs at UB, who has championed a consortium for 15 years. "Riemenschneider comes highly regarded and is well versed in his field," Naughton said. "We think he is going to do a very fine job." Riemenschneider replaces Don Larson, M.D., whom Naughton credits with helping to organize the medical school's Office of Clinical Affairs, and with helping to implement its faculty practice plan. Larson has returned to teaching in the Department of Biology. Riemenschneider earned his bachelor's degree from Baldwin Wallace College and his medical degree from SUNY's Upstate Medical Center, now called the Health Science Center at Syracuse. Now a professor of pediatrics at UB, he developed an interest in pediatrics as a college student, watching his father deliver babies. To test his commitment to medicine, his father got him a job emptying bed pans, where he didn't like the work but loved the excitement of the hospital. At his father's urging, he took a summer job working for a cardiac surgeon. A chance meeting with a physician friend of his father led to a residency and three-year pediatric cardiology fellowship at the UCLA School of Medicine. At UCLA, the appeal of the diversity of practicing medicine in a university setting was obvious. "People had something different to do every day," he said. He was hooked. There he immersed himself in his particular research interest -- adaptation of the newborn heart to extrauterine life. After completing his fellowship and a two-year commitment as chief of pediatric cardiology at Scott Air Force Base in Illinois, he took his first job in academic medicine at the University of Utah Medical Center. He remained three years as assistant professor in the medical center's Pediatric Cardiology BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �------------------------------------------- ~@~ ' ~~-------------------------------------------r .r r If 0 .... <::. 31 Tom Riemens,hneider, M.D., M.B.A., asso,iate vi'e president for dini,al affairs and asso(iate dean at UB Medi,al s,hool. Division, and directed the center's pediatrics honors program. In 197 5 the University of California at Davis offered Riemenschneider the opportunity to become its chief of pediatric cardiology and set up a program in his specialty. He spent the next 15 years translating into action his ideas concerning a broader role for academic medicine. At UC Davis he built the program from scratch; then, to care for the needs of the largely rural population served by the medical center, he set up a network of clinics stretching to the Oregon border. In I982 he returned to his home turf to rebuild the pediatric cardiology program at Case Western Reserve's School of Medicine in Cleveland. During eight years there he made two important career decisions -- to earn an M.B.A., which he received from Baldwin Wallace in 1987, and to become a fulltime medical administrator. He was appointed associate dean of the medical school in 1986. At Case Western Reserve, with the aid of a $425,000 grant from the National Institutes of Health, he started a health education program in the Cleveland Public Schools, using medi- cal students as teachers. That initiative resulted in 17 health care modules being incorporated into the district's curriculum. The chance to build a better health care system that could reach throughout Western New York and beyond was too attractive to refuse. "Most places across the country are still in the old competition model," he said. "In Buffalo the eight CEOs are meeting in our conference rooms and talking collaboratively about what's best for the people of Western New York. Now we've got to bring the medical directors together, and encourage them to begin to talk collaboratively." One of Riemenschneider's major initiatives is to meet with department chairs scattered throughout the teaching hospitals to determine where UB medical school faculty should be placed to best meet community needs and to tackle specific community health problems. This is the kind of challenge that, for Riemenschneider, makes life interesting. He also enjoys spending time with his large extended family, playing tennis and golf, jogging, and country music. He delights in the fact his daughter Laura performs at Nashville's Opryland. He also has a daughter Karen, an art teacher, and a son Jim, a senior at Baldwin Wallace, in business. Riemenschneider admits he sometimes misses working with patients. Knowing he continues to touch patients' lives in a larger context, however, compensates for any sense of loss. "In a way I'm still involved with patients," he said, "but on a larger scale. If I'm able to help organize this consortium and this system of health care, think of all the patients I will have an impact on by providing a better health care environment." • WINTER 1991 BUFFALO PHYSICIAN AN D BIOMEDICAL SCIE TI ST �------------------------------------------- ~@~ I ~~-------------------------------------------C .J' (" .... <:) If 0 32 Dennis A. Nadler, M.D., '71 A mandate to develop a curriculum plan for the next decade By LOIS BAKER ennis A. Nadler, M.D., '71 looking relaxed in his shirt sleeves, glasses dangling from a cord around his neck, is talking with considerable passion about his work as new associate dean for curricular and academic affairs at the UB medical school. "I'm happy," he said. "I'm having fun. It's interesting, and I'm accomplishing things." If it weren't for his salt and pepper hair, parted boyishly down the middle, Nadler could, at 44, be mistaken for one of the medical students he is charged with supervising as head of UB's medical education program. He was appointed associate dean in January 1990, after serving in an interim capacity since the previous July. A pediatrician with a specialty in developmental difficulties, Nadler comes well-suited for the job. He is personable and ea y going, with an empathy for young children that transformed easily into an understanding and appreciation of young adults. The promise of daily contact with students was one reason he took the job. This enthusiasm was not lost on John Naughton, M.D., dean of the medical school and vice president for clinical affairs at UB, when he was searching for a replacement for Peter Ostrow, M.D. Ostrow left the associate deanship to return to teaching in the Department of WINTER 1991 Dennis A. Nadler, M.D., '71, associate dean for curricular and academic affairs. Pathology. ''Throughout his career, Dennis has had a long track record of interest in students and teaching," Naughton said. "I think he has gotten off to a very good start." Nadler said he was programmed since birth to be a physician. The son of a would-be doctor who turned to pharmacy because he couldn't afford mediBUFFALO PHY ICIA AND BIOMEDICA L SCIENT IST �-------------------------------------------~@~~~-------------------------------------------.,. .... I C r If 0 () 33 cal school, Nadler avidly followed the path his father relinquished. Medicine appealed to him and he never gave serious thought to anything else. A Buffalo native, Nadler earned his bachelor's degree in psychology from UB in 1967 and entered the UB medical school. He was headed for a career as an ear, nose and throat specialist until he spent the summer before his senior year in medical school in the pediatric outpatient clinic at Children's Hospital of Buffalo. He decided to become a pediatrician then and there. "There's just something special about children," he said, explaining his switch of specialties. A devoted father, Nadler spends as much time as possible with his sons Noah, 17, Jacob, 10, and Benjamin, 7, and his wife Susan. After completing his internship and residency at Children's, Nadler in 1974 accepted a position as pediatrician-inchief at the Jesse Nash Family Health Center in Buffalo, became an attending physician at Erie County Medical Center (ECMC) and joined the UB medical school's full-time faculty. He served as director of the Department of Pediatrics at ECMC from 1977 to 1988, when he stepped down to devote more time to the University. He had been serving as assistant dean for student affairs at the medical school since 1985. In addition to his current University post, Nadler is medical director for the United Cerebral Palsy Association, and an attending pediatrician at ECMC and Children's Hospital. As the medical school's associate dean for curricular and academic affairs, Nadler is responsible for everything that involves the education of medical students - from basic science and clinical education, to evaluation of teaching methods, to preparation of students for "Teaching students how to learn is at least as important as teaching them what to learn. " residencies, even to financial aid. He finds today's medical students more sophisticated and better educated than their counterparts of 20 years ago. Sophistication aside, he asserts that the basic motivation for becoming a physician remains the same - a wish to aid humanity. "I don't think the majority of students today gravitate to medicine because of the money or because of the prestige. I think they gravitate to medicine because they want to help people. "I came out of the '60s, and we were going to save the world," he said. "I think there is still a lot of that around." Nadler relinquished the rewards of caring daily for young patients for the chance to influence the training of the next generation of physicians. His mandate is to develop a curriculum plan for the medical school for the next 10 years. Toward that end, he has organized a task force to review all medical education - faculty development, student affairs, advising, and several other areas - in addition to curriculum. The task force will also assess the medical school's external resources, such as the area's teaching hospitals and health related professions. He brings to the job a strong conviction that medical schools must change the way they educate students. "The curriculum has always been very hospital-based, "Nadler said. "When I was a medical student that was just fine. I took care of all kinds of fascinating and mundane problems. "But today, people aren't admitted to the hospital unless they are in crisis or in some form of deteriorated condition. So what we're getting in the hospitals is a very skewed population of the extremely ill and extremely old . You can't give students a broad-based medical education anymore if you just put them in hospitals." Nadler favors placing students with volunteer faculty in their offices, and making better use of community-based clinics and hospital ambulatory programs, in addition to using the traditional hospital setting. He also advocates a new classroom approach: stressing creative problem solving over memorization. "Teaching students how to learn is at least as important as teaching them what to learn," he said. "Developing problemsolving skills, clinically based basic science education, reducing lecture time, and placing greater emphasis on independent learning- these are the challenges." Nadler concedes that not everyone views his mission in the same light. "Some think we should continue to be a very traditional medical school. Some think we should become a very innovative medical school. I suspect there is an appropriate balance to be struck," he said. "I hope I will be able to find that balance." • WINTER 1991 BUFFALO PHYSICIAN AN D BIOMEDICAL SCIE TI ST �---------------------------~~: --------------------------" \t- 34 LAW vs MEDICINE SPRING CLINICAL DAY TO Focus ON LEGAL IssuEs ridging the Gap Between Medicine and Law" will be the the theme of 1991's Spring Clinical Day and Reunion Weekend, which will be held the weekend of May 4. The unique Spring Clinical Day program, to be held May 4 in the Buffalo Marrio tt, was planned with the help of the Bar Association of Erie County. Topics will focus on the legal issues in the physician-patient relationship. "Striking a Balance Between the Rights of Patients, Doctors, and Society" will be the title of the Stockton Kimball Lecture, to be delivered by Sol Wachtler, the chief justice of the New York State Court of Appeals. The weekend opens with a reception for all reunion classes on Friday evening, May 3, in the Center for Tomorrow on UB's North (Amherst) Campus. Take the advice of the reunion class chairmen: Mark your calendars for May 4. e "50 years - one-half century. Let's all come to the reunion Saturday, May 4, 199 1." Donald Hall '41 "Old friendships renewed, old memories revived, reflections on life tracing back to our days on high. Come to our 45th reunion." Harold Levy '46 "40 -wow! Looking forward to seeing all of you again. We're not ge tting older, we're getting better." Marvin Pleskow '51 ALUMNI To HosT RECEPTION IN BosToN he UB Medical Alumni Association and the Department of Neurology will host a reception in Boston, Mass. on Monday, April 22 in conjunction with the American Academy of Neurology Meeting. All alumni/ae in the Boston area are invited. e WINTER 1991 I "Long time, no see! Come join your classmates for our 50th reunion." Gene Hanavan '41 "In the past 40 years, the world, the school, medicine have changed. Have we? Let's get together and find out at our reunion." Allen Goldfarb '51 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �---------------------------~~:--------------------------- 35 "35 and still alive! Please return for classmate jive." Edmond Gicewicz '56 "A great time with a great bunch of people." Harold Brody '61 "The 20th was good, let's make the 25th great! Join us May 3-5 to renew old friendships and memo ries." Jared Barlow '66 "We are looking forward to seeing all the I5 -year alumni and renewing friendships." Russell Bessette '76 "Surprise! Five years have already slipped by. It 's time to touch base and catch up on what's happened. Look forward to seeing you in May." Jim Schlesinger '86 Carlo DeSantis '61 "20 years is a long time. Hope we can get together for a good time and to renew old friendships. " "Take a break after I 0 years! Shuffle back to Buffalo to share in the old and the new!" Joel Paull '71 Bruce Cusenz '81 WINTER 1991 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �-------------------~~: ------------------- 36 DAVID H. NICHOLS '47 RECEIVES DISTINGUISHED ALUMNUS AWARD avid H. Nichols, M.D., internationally recognized expert in the field of reconstructive gynecologic surgery, received the second Distinguished Alumnus Award from the UB Medical School and Medical Alumni Association. A 194 7 graduate, Nichols is professor and chair of obstetrics and gynecology at Brown University. A lecturer in obstetrics and gynecology at Tufts University School of Medicine, he also is obstetrician and gynecologistin-chief at Women & Infants Hospital of Rhode Island, Providence, and surgeonin-chief in the Department of Gynecology and Obstetrics at Rhode Island Hospital, Providence. Nichols served on the faculty of the UB medical school from 1954 to 1980 before joining the faculty of Brown University. He was head of the Department of Obstetrics and Gynecology at The Buffalo General Hospital from 197 5 to 1980, chief of the Department of Obstetrics and Gynecology at Sisters Hospital from 1971 to 1974 and associate cancer research gynecologist at Roswell Park Cancer Institute from 1953 to 1960. He also was previously associated with the old E.]. Meyer Memorial Hospital, St. Francis Hospital, and the Veterans Administration Medical Center. Certified by the American Board of Obstetrics and Gynecology, Nichols is a fellow of the American College of Obstetricians and Gynecologists, American College of Surgeons, and International College of Surgeons. He is a past president of the Society of Gynecologic Surgeons, Buffalo Gynecologic and Obstetric Society, and Erie County Unit of the American Cancer Society. WINTER 1991 David H. Nichols, '47 (ALL FOR NOMINATIONS FOR ALUMNI AWARD arch 1 is the deadline for nominations for the third annual Distinguished Medical Alumnus/a Award. The award is presented to a graduate of the UB medical school who is distinguished nationally or internationally in the eyes of his or her peers and has made an outstanding contribution to medicine, the arts, or humanity. The award will be presented at a special dinner in September. Please forward the name of your nominee as soon as possible on the attached postcard. Your cooperation is vital if this is to be a true alumnus/a award. e DoNoRs HEAR TALE oF UB MED ScHooL fOUNDER edical professors of the early 1800s were restless folk who moved from town to town, noted Richard Lee, professor of medicine and pediatrics at UB. When the founding fathers left, the schools often went under. Few schools founded in that era exist today. Buffalo is an exception because one of the founding fathers of UB, James Platt White, was committed to the community and remained active here for almost 50 years. "James Platt White and Buffalo had a remarkable association," Lee said. "If anyone could claim the Buffalo medical school as his child, it was he." Lee spoke at the fifth annual meeting of the James Platt White Society in October honoring members who have made an annual contribution of $1,000 or more. The members of the James Platt White Society from Oct. 20, 1989 to Oct. 18, 1990 are: Dr. Richard H. Adler Dr. Kenneth M. Alford Dr. Kenneth Z. Altshuler Dr. William S. Andaloro Mrs. Rose Bakow Dr. & Mrs. Jared Barlow Dr. Alphonso L. Barragan Dr. Charles D. Bauer Dr. Eugene L. Beltrami Dr. Richard A. Berkson Dr. Willard H. Bernhoft Dr. Theodore Bistany Dr. Willard Boardman Dr. Dennis L. Bordan Mr. & Mrs. Leroy B. Bornhauser Dr. & Mrs. Harold Brody Dr. Robert L. Brown Dr. August A. Bruno Dr. Elaine M. Bukowski Dr. & Mrs. Irwin Burstein Dr. David W. Butsch Ms. Janet F. Butsch Dr. John L. Butsch Dr. & Mrs. Evan Calkins Dr. & Mrs. Joseph G. Cardamone Dr. & Mrs. Joseph A. Chazan Dr. Donald P. Copley Dr. Daniel E. Curtin Dr. James A. Curtin Dr. Peter S. D' Arrigo Dr. Roger Dayer Dr. Thomas A. Donohue Dr. Sterling Doubrava Dr. Kenneth H. Eckhert Dr. Robert Einhorn Dr. & Mrs. George M. Ellis BUFFALO PHYSIC IAN AND BIOMEDICAL SCIENTIST �------------------------------~~:------------------------------ 37 Dr. & Mrs. George M. Ellis Dr. Daniel Fahey & Dr. Maria Runfola Dr. Lucille M. Farrar Dr. Robert E. Fenzl Dr. Donald M. Fisher Dr. Jack C. Fisher Dr. Grant T. Fisher Dr. Edward Forgrave Dr. Thomas F. Frawley Dr. Matt A. Gajewski Dr. Kenneth L. Gayles Dr. John W. Gibbs Jr. Dr. Daniel Goldberg Dr. Seymour Grauer Mr. Wilson Greatbatch Dr. Thomas J. Guttuso Mrs. Marion B. Hague Dr. Martin E. Hale Dr. Eugene J. Hanavan Mr. & Mrs. Edward A. Hansen Dr. & Mrs. Gerald Hardner Dr. Thomas H. Hayden Dr. Reid R. Heffner Jr. Mr. John L. Hettrick Dr. Gary Jeffery Dr. & Mrs. Kenneth L. Jewel Dr. Stephen T. Joyce Dr. James R. Kanski Ms. Catherine Kresge Dr. Marvin Z. Kurian Dr. Vito P. Laglia Dr. Andre Lascari Dr. Eugene V. Leslie Dr. Lawrence M. Lesser Dr. & Mrs. Harold J. Levy Mrs. Ursula Lichtenstein Dr. Jack Lippes Dr. Hing Har Lo Dr. Fred A. Luchette Dr. Robert L. Malatesta Dr. Milford C. Maloney Dr. Don L. Maunz Dr. Harry L. Metcalf Dr. Merrill L. Miller Dr. Eugene R. Mindel! Dr. Joseph Monte Dr. Shedrick Moore Dr. Robert M. Moskowitz. Dr. John D. Mountain Dr. Arthur W. Mruczek Sr. Dr. Richard L. Munk Dr. Richard J. Nagel Dr. Masao Nakandakari Dr. Richard B. Narins Dr. & Mrs. John Naughton Dr. Benjamin Obletz Dr. Elizabeth Olmsted Dr. Dean E. Orman Dr. JohnS. Parker Dr. Jacqueline L. Paroski & Dr. Paul A. Paroski Dr. Margaret W. Paroski Miss Olga E. Paroski Dr. & Mrs. Robert J. Patterson Dr. Clayton A. Peimer Dr. Victor L. Pellicano Dr. James F. Phillips Dr. Frederic D. Regan Dr. Frank T. Riforgiato Dr. Charles Riggio Dr. Eugene Rivera Dr. Richard R. Romanowski Dr. & Mrs. Charles H. Rosenberg Dr. Albert Rowe Miss Thelma Sanes Dr. Arthur J. Schaefer Dr. Robert N. Schnitzler Dr. Joseph I. Schultz Dr. Roy Seibel Dr. Elizabeth Serrage Dr. & Mrs. Samuel Shatkin Dr. John B. Sheffer Miss Alice Simpson Dr. Richard A. Smith Dr. John J. Squad rita Dr. William Sternfeld Dr. Gerald Sufrin Dr. Eugene M. Sullivan Dr. Michael A. Sullivan Dr. Syde A. Taheri Dr. Joseph Tannenhaus Dr. MichaelS. Taxier Dr. JacobY. Terner Dr. Charles S. Tirone Dr. Anthony C. Trippi Dr. Stanley Urban Mrs. Victoria Van Coevering Dr. Barbara von Schmidt Dr. Coolidge S. Wakai Dr. Franklin E. Waters Dr. Paul Wierzbieniec Dr. Gary Wilcox Dr. Richard G. Williams Dr. John R. Wright Dr. Franklin Zeplowitz Dr. & Mrs. David C. Ziegler REUNION (LASSES' GIFTS HELP MEDICAL STUDENTS edical students will benefit in many ways from the generosity of the alumni. As of Sept. 11, the classes that marked their five-year reunions in 1990 donated $123,211 to the University. Class of 1940: Scholarship in the amount of$ 7,3 25 Class of 1945: Gift of $20,810 for the Vincent Capraro Lectureship Class of 1950: Scholarship in the amount of $7,750 Class of 1955: Scholarship in the amount of $6,700 Class of 1960: Unrestricted gift of $43,700 Class of 1965: Unrestricted gift of $8,975 Class of 1970: Unrestricted gift of $9,225 Class of 1975: Unrestricted gift of $4,925 Class of 1980: Gift of $12,251 for the John Paroski Memorial Scholarship Fund Class of 1985: Scholarship in the amount of $1,550 WI TER I991 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �---------------~~:---------------­ }0._ J' S II () 38 Philip Goldstein '31 ~ in memory of Or. Goldstein, an annual memorial lectureship in hepatology and an award to a graduating resident have been established at Millard Fillmore Hospital. The Goldstein Award is given annually to the graduating resident "demonstrating the highest degree of humanitarian qualities in the approach to, and treatment of, patients." The lectureship and award were made possible by Kenneth Goldstein '39, Gerald Goldstein '64, Harvey R. Goldstein '77, Rabbi Brett Goldstein and Mrs. N. Stiller. Murray A. Yost '33 ~ received a certificate and a gold medallion when he was honored with lifetime membership/fellowship in the American Psychiatric As ociation. John M. Constantine '34 ~ of Oneonta, N.Y., retired from active practice in November 1989. Robert J. Krug '35 ~ writes from Tarpon Springs, Fla., "had a mild stroke, affecting left side, but I still get around OK without a cane." Bennie Mecklin '35 ~ writes "Why no news from the class of 1935? I am still lecturing, writing and enjoy traveling." Or. Mecklin resides at 6711 Starkeys Place, Lake Worth, Fla. 33467. Charles A. Bauda '42 ~ sent an article from the Palm Beach Post telling us that at the age of 74 he received a master's degree in WINTER 1991 Milton Alter, 'SS Donald W. Burkhardt '68 William K. Major '69 theology from St. Vincent de Paul Seminary. Dr. Bauda practiced family medicine in Buffalo for 40 years before moving to Boynton Beach, Fla. recurrent trokes. In I 989 he became editor-in-chief of the journal Neuroepidemiology. gy at the University of Southern Alabama. Arthur J. Schaefer '47 ~was a vtstttng professor at the University of Washington Medical School, Seattle, Wash., where he lectured on the pathophysiology and the surgical corrections of malpositions of the upper and lower eyelids. Victor Panaro '52 ~ of Amherst, N.Y., has been elected Councilor for the American College of Radiology. Milton Alter '55 ~ former chief of neurology at the Minneapolis Veteran's Hospital and former chairman of neurology at Temple University Hospital is now director of re idency training in neurology at the Medical College of Pennsylvania. He holds an NIH grant to study the epidemiology of strokes and a supplemental grant to study risk factors for William J. Sullivan '55 ~ is a diplomate of the American Board of Psychiatry and Neurology and is certified in psychiatry and psychoanalysis. He is now specializing in forensic psychiatry. Mary Ann Zavisca Bishara '59~ was appointed president of the medical staff at St. Mary's Hospital, Lewiston, N.Y., for 1990-1991 and continues as chief of anesthesiology at the hospital. Kenneth E. Bell '61 ~ was recently named clinical professor of obstetrics and gynecology at the University of California at Irvine. Or. Bell is medical director of the Kaiser Permanente Medical Center in Anaheim, Calif. F. Robert Weis Jr. '64 ~ was appointed a full professor and director of clinical anesthesiolo- David R. Dantzker '67 ~ is now chairman of internal medicine at Long Island Jewish Medical Center and professor of medicine at Albert Einstein College of Medicine. Donald W. Burkhardt '68 ~ retired from emergency medicine at Kenmore Mercy in Buffalo and moved to Morocco. He is living in a villa in the foothills of the Middle Atlas Mountains. His new address is Villa William & Ruth, 141 B.I.S. Route de Fes, Sefrou , Morocco. John E. Shields Jr. '68 ~ is medical director of the Seafield Center, an 80-bed alcohol and drug rehabilitation center in Hampton Bays, N .Y. Or. Shields was certified in addictionology in 1988. William K. Major '69 ~ a cardiothoracic surgeon, has been elected president of the Medical Society of the County of Erie. BUFFALO PHYSIC IAN AND BIOMEDICAL SCIENTIST �------------------------------~~:------------------------------~'C::l .f S II () 39 Edward J. Coleman '83 );>completed a fellowship in thoracic and cardiovascular surgery at UB in June and joined a practice in Green Bay, Wis. Melvin Pohl '76 );>- is the author of a book The Caregiver's journey: VVhen You Love Someone VVith AIDS, published by Hazelden. Dr. Pohl is chief of Clinical Services at the Pride Institute in Minneapolis, Minn. Russell J. Van Coevering 11'77 Russell J. Van Coevering II '77 );>- is president of the New York State Society of Obstetricians and Gynecologists, Inc. and serves on the board of directors of the Buffalo Civil War Roundtable. Dr. Van Coevering is a member of the President's Associates of the UB Foundation and the James Platt White Society of the medical school. Russell P. Massaro '70 );>- relocated to Albany, N.Y., where he is director of medical services for the New York State Office of Mental Health. Cliphane W. McLeod '77 );>writes, "Looking for a partner for a busy ob/gyn service." Dr. McCleod can be reached at 227 Topi Trail, Hinesville, Ga. 31313. Jay A. Harolds '71 );>- is chief of radiology and the radiology residency program of Baptist Medical Center of Oklahoma City and president of the Oklahoma State Radiological Society 1989-1990. Richard T. Irene '79 );>- of Columbus Ohio, was recently initiated a fellow of the American College of Surgeons. Donald H. Marcus '71 );>- of Sepu lveda, Ca lif., has been elected to a three-year term on the board of directors of the Southern California Permanente Medical Group. Roy M. Oswaks '71 );>- continues as chief of surgery at Bayside Hospital in Virginia Beach, Va. Joseph A. Dunn, Ph.D. '71 );>a senior research scientist at Eastman Kodak, has started a two-year sabbatical in the Biotechnology Center of Cornell University. Robert Braco '80 );>- writes, "Completed my MPH in May and started working for the University of Texas School of Public Health in Houston, looking after the health of employees of major petrochemical companies in the Houston area. It's great, I highly recommend it." Jonathan C. Felsher '80 );>- has a private practice in cardiology and is associated with the Crozer-Chester Medical Center and the Bryn Mawr Hospital. He and his wife, Lisa, have two children: Matthew, 2, and Marisa, 9 months. Renata Wajsman '83 );>- writes, "After working for a year as a gastroenterologist, I am moving on to Israel to take a full-time position in gastroenterology in Tel Aviv-lchilov Hospital." Robert Braco '80 Bruce J. Cusenz '81 );>-is a member of Buffalo Plastic Surgery, a practice specializing in cosmetic surgery as well as traumatic and reconstructive surgery. The practice has two offices: 2800 Main St., Buffalo and 1321 Millersport Highway, Williamsville. Helena Reichman '81 );>-former full-time member of the faculty at the University of Massachusetts Medical Center and private practitioner, is relocating to Brandon, Fla. to join a ob/gyn practice at Humana Hospital. Nora Meaney-Elman '84 );>- of Amherst, N.Y., writes, "Upon completion of residency, I am joining the Highgate Medical Group and practicing full-time in family medicine." Herbert B. Newton '84 );>writes that he finished at Memorial Sloan-Kettering Cancer Center in June , then became the neuro-oncologist for Ohio State's new cancer center in July. "Go Buckeyes!" John Picano '84 );>- completed a neuroradiology fellowship at Massachusetts General Hospital in June and moved to New Hartford, N.Y. to enter private practice. He and his wife, Lynn, have two children, John Daniel and Cara. Lloyd D. Stahl '81 );>- of Leawood, Kan. writes, "Jackie and I were in New Orleans when I was inducted as a fellow into the American College of Cardiology. We have three children: Michael, 8; Mara, 6, and Danny, 2. We are enjoying life in the midwest." Maritza Alvarado '85 );>- writes that she and her husband, Andrew Knoll '84, moved to Syracuse, N.Y. this summer. He began his residency in internal medicine and she started a fellowship in neonatology. Manuel L. Saint Martin '82 );>completed law school and psychiatric residency in Los Angeles simultaneously! He is now conducting a joint medical and legal consulting practice in Los Angeles and Forest Hills, N.Y. Timothy Wacker '85 );>- of Tonawanda, N.Y., has completed a fellowship in gastroenterology/hepatology at the University of Pittsburgh and is looking forward to starting a private practice in the Southtowns. WINTER 1991 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �--------------- ~~~ --------------­ ~'0, s s " () 40 Douglas J. Floccare '86 Douglas J. Floccare '86 ,_.. has been appointed the aeromedical director of the state med-evac helicopter fleet operated by the Maryland State Po li ce. Dr. Floccare currently serves as fire surgeon for the Baltimore County Fire Department's Division of Emergency Medical Services, and co-medical director of the paramedic education program at University of Maryland at Baltimore County's Emergency Health Services Department. Clarence Durshordwe '23 ,_.. an anesthesiologist for more than 40 years in Buffalo, died Sept. 24, 1990. He had served in the U.S. Army during World War I. Joseph F. Kij Sr. '27 :;;;... died July 29, 1990. Dr. Kij treated five generations of patients as he became one of the patriarchs of Western New York's Polish-American community. His many community endeavors included helping to found the former St. Rita's Home for Children and serving on the Lackawanna School Board. He continued his private practice in Lackawanna until I 988. WINTER 1991 Ramsdell Gurney ' 29 ,_.. an organizer of the Buffalo Medical Group, died July 30, 1990. The group is now composed of 70 physicians. Dr. Gurney was an associate professor of medicine at UB. "He was an exceptiona l human being," said classmate Victor L. Cohen. "He was thoughtful, dignified, and devoted to his wife and family and to the art of medicine. His conduct lent dignity to the practice of medicine and to the associate he so skillfully chose." William G. Ford '31 ,_.. an internist for almost 50 years, died Oct. 14, 1990. He worked as a physician for Bethlehem Stee l and was in private practice in Buffalo. During World War II , he served as chief of medicine on the U.S. Army's first hospital ship as well as the USS Ernest Hines, a luxury liner remodeled as a hospital ship. He retired from private practice in 1978. Helen Toskov Wolfson '31 ,_.. a former Buffalo clinical pathologist, died April 10, 1990 in Ambler, Pa. Dr. Wolfson was the only woman in the C lass of 1931. She opened her own laboratory in 1933 and remained in practice in Buffalo until 1974. After retiring in 1974, she moved to West Palm Beach, Fla., where she lived until 1986, when she resettled in the Philadelphia area . Hugh J. McGee '32:;;;... a retired neurologist died, January 27, 1990 in jackson, Mich. Edward Shubert '39 ,_.. died May 18, 1990. William D. Dugan '39 ,_.. a retired orthopaedic surgeon, died April 15, 1990. He practiced medicine at Buffalo General, Children's and Mercy hospitals in Buffa lo and our Lady of Victory Hospital in Lackawanna. He was a member of the Ruffed Grouse Society and the Buffalo T ennis and Squash Club, where he was a champion. Maurice M. Maltinsky '44 ,_.. d ied Jan. 25, 1990. Vernon G . Smith '48 :;;;... a pathologist, died Ocr. 20, 1990. He founded and directed Western ew York Analytical Laboratories 1nc., with offices throughout Western New York. He had also been honored with a team of doctors for early research in cryogenics. Alfred Berl '49 :;;;... a psychiatrist and horsebreeder in Bu llvi lle, N.Y., died suddenly in Puerto Rico on May 9, 1990. Dr. Berl was a former teaching psychiatrist at Yale, former chief psychiatrist of the Manhattan House of Detention and, during the Korean War served as chief psychiatrist of the Far East Command. With a partner, Dr. Berl founded Excelsior Farms in Bullvi ll e in 1965, and bred many top pacing horses, including Fly Fly Solly, who earned over $700,000 and the former world champion pacing gelding Magna Bird. Until the time of his death, Dr. Berl served on the Advisory Counsel of Camp Blueberry Treatment Center for Autistic Children. Haluk Caglar '56 ,_.. assistant professor at UB and a specialist in gynecologic oncology, died june 30, 1990 after a lengthy illness. He was 45. Born in Turkey, he came to the United States in 1971 and attended the UB medical school and Georgetown University Medical School. He received many teaching awards at UB and wrote numerous chapters in medical textbooks. An artist, his paintings were exhibited in galleries in Toronto. David E. Pittman '64 :;;;... a member of the James Platt White Society and supporter of the University at Buffalo Foundation, died on October 26, 1989. He held a number of University appointments, including clinical assistant professor of Medicine at the University of Pittsburgh and the Medical College of Pennsylvania. He was a senior attending cardio logist and the associate director of the cardiovascular laboratory at Allegheny General Hospital and served on the Editorial Board of the Catheterization and Cardiovascular Diagnosis Journal and the Journal of Angiology. He authored 56 scientific papers. Lawrence J. Emrich, Ph.D. ,_.. associate research professor in biometry at UB and a biostatistician at the Roswell Park Cancer Institute, died June 23, 1990. He was 35. Emrich received his doctora l degree from UB in 1983 and was a consultant to the School of Dental Medicine's Ora l Biology Department and to the Department of Psychiatry. At Roswell Park, he headed the statistical consulting and statistical computing laboratories. He was also a statistician for the DineSystems Co. in Buffalo. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST ��~- - ~- - Non-Profit O rg. U.S. Postage Buffalo Physician and Biomedical Scientist State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 PAID Buffalo, NY Permit No. 3ll Address Correction Requested 2194 ~EDICAL HISTORICAL LIB. ABBOTT LI3RARY, SERIALS DEPT. CA. PIJS IIIAIL � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Winter 1991 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1991-Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v25n01-1991-Winter Table Of Contents A list of subunits of the resource. In Praise of Housecalls Residents' Hours Making a Team for Michael Danger in the Locker Room Do Bad Habits Breed Disease Medical School News Alumni Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-12 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v25n01 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1991 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/c54c897a51f284ea0d7cb674f8718b11.pdf 5358dd230af28e29b828ec67532e163d PDF Text Text Vol. 24, No.2 and Biomedical Scientist The medical profession struggles with maternity leave �STAFF DIRECfOR OF PUBLICATIONS NancyTobm EDITOR Connie Oswald Stofko ART DIRECfOR Alan J Kegler WRITERS Joan Damig David Htmmelgreen Jeffery Jackson Arthur Page Mary Beth Spina JeffreyTrebb Sue Wuetcher PHOTOGRAPHERS Debbie Hill Antoinette Mucilh Stmon Tong Robert Walion ADVISORY BOARD Dr. John Naughton, Chairman Dr. Harold Brody Ms. NancyGlteco Dr. James Kanskt Dr. Joseph L. Kunz Dr. Charles Paganelli Mr. Michael Aronica Dr. Antoinette Peters Dr. Charles Pruet Dr. Luther Robinson Dr. Thomas Rosenthal Dr. Salecla Suresh Dr. Burton Smgerman Dr. Stephen Spauldmg Dr. Nelson Torre Mr. Edward Wenske Dr. Jerome Yates Dear Friends: T he.1989-90 academtc year was another busy and producttvf year for the medtcal school, as evtdenced by the flurry of spring activity. It began wtth Sprmg Clinical Day, sponsored by the Medical Alumni Association. The association's efforts culminated successfully with Dr. Arnold Reiman's keynote address at the Stockton Kimball Lectureship luncheon and an excellent fundraising effort on the part of the five-year reunion classes. The weekend was highlighted by the dedication of a wing in the department of Pathology in memory of Dr. Samuel Sanes by the Class of 1945 and the presentation of the first Samuel Sanes Scholarship Award, which was made possible by a generous gift from his SISter and brother, Thelma and Harold Sanes. We were fortunate and honored that hiS wtdow, Mildred, participated m the event. Graduation was highlighted by once agam conducting the Honors Convocation m the Austin Aint Reading Room of the Health Sciences Library. An eloquent commencement address was given by MorrtS Abram, United States Ambassador to the United Nations in Geneva. His remarks were enlightening because of his own experiences wtth acute leukemia in the mid-1970s. The third annual reception honoring and recognizing the many contributions of the volunteer faculty was held at the Albright-Knox Art Gallery. Approximately 200 faculty and their spouses attended. The second annual Graduate Medical Dental Education Consortium dinner· dance completed the Spring's activities on June 22. Each resident graduate received a set of bookends with the UB logo on one and the consortium's title on the other. We look forward to an even more exCiting and productive academic year m 1990-91. As always, the staff and faculty are grateful for the tremendous support provided by our alumni and friends. TEACHING HOSPITALS AND LIAISONS Batavia VA Medtcal Center Buffalo General H<l>'[Htal, Mike Shaw Buffalo VA Medical Center, John Pulli Children's Hospital, Karen Oryja-Swierski Ene County Medical Center Mercy Hospttal, Chuck Telesco Millard Fillmore Hospttal, Joseph R. Ciffa Roswell Park Cancer Institute, ]wl.y Rice Sisters Hospital, Dennis McCarthy Produced by the DitJisum of Unit'f'TSity Relations in association uith the SchOOl of Medicine and Biomedical Saences, ~rate Unit'f'TSity of New York al Buffalo. Editorial office is in 136 Crofts Half THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST (USPS 55I-860) Autumn 1990, Volume 24, Number 2. Published by the School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Third class bulk postage paid at Buffalo, New York. Send address changes to THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST, 146 CFS Addition, 3435 Main Street, Buffalo, New York 14214. John N aughton, M.D. Vice President far Clinical Affairs Dean, School of Medicme and Biamedical ScienCes Dear Fellow Alumni/Alumnae: T he spring of 1990 marked the anniversary of the 53rd year of Spring Clinical Day. In my opinion, this event has been marked by ever-increlli>ing maturity and sophistication for which all alumni can be justifiably proud. The clini· cal and reunion weekend provtdes a major focus for your Alumni Association and this year's program was especially timely, informative, and prognostic. As your new president and on behalf of all medical alumni, I would like to express our appreciation publicly to Dr. Bob Reisman, Class of'S6, for assembling such a superb program. Our outgoing president, Dr. Joe Kunz, served his term with distinction and our gratitude goes to him as well. I would be most remiss if I didn't communicate to all of you how grateful we are to Dr. Jack Richert and to Nancy Druar of the Alumni Office. Without their help and guidance, this asso· ciation would be a far less healthy organization. I look forward to servmg as your prestdent and I hope to continue ro work actively with alumnt, medical students, faculty, and administration as we all work to support and strengthen our medical school. Sincerely, D~ Bertram A. Portin, M.D. Class of'53 �Autumn 1990 Vol. 24, No.2 IJ Research. A $4.5 million grant to study treatment of multiple sclerosis; AIDS fear and drop in blood transfusions; diving for science. II Mommy track? The number of women attending Cover: Photos by Robert Walion. Story starts on page 6. medical school has steadily increased, but is there room in the system for their babies, too? UB women discuss the problems and pressures they've faced balancing family and profession. IIJ Cutting red tape. American doctors have the power to change the medical delivery system in this country, said Arnold S. Relman, M.D., editor,in, chief of the New England Journal of Medicine. He spoke at UB's 53rd Annual Spring Clinical Day and Reunion Weekend. Ill Rubbish. From hypodermic needles to patients' Orientation follows gradWltion. Page 26. facial tissues, the amount of medical waste is growing daily, and it's getting harder to throw the stuff away. ~~ Medical school news. How a 19th,century anatomist got tangled up with couple of body snatchers was the topic of a lecture sponsored by Alpha Omega Alpha. At commencement, diplomat Morris Abram told graduates to "listen with heart." And Match Day was better than ever. m People. Marvin I. Herz, M.D., chair of psychiatry at UB, got a new perspective on the workings of Washington bureaucracy. America's ailing medical system. IIJ Classnotes. Page 13 . Trashing medical wastes. Page 20. �: -------------------------------------------- 2 UB Takes a $4.5 Million Shot at MS UB research pioneer heads team investigating treatment for disease that hits young adults BY ARTHUR PAGE 0 ne of the largest grants ever received by the UB medical school will study a promising treatment for multiple sclerosis, the most common crippling disease of young adults. The four-year, $4.5 million federal grant from the National Institute of Neurological Disorders and Stroke was announced in May. UB is the coordinating center of the multi-center study that will involve 288 patients at Millard Fillmore and Buffalo General hospitals in Buffalo, as well as hospitals in Washington, D.C.; Cleveland; Denver, and Portland, Ore. It will evaluate the effectiveness of intramuscular injections of beta interferon in the treatment of a form of multiple sclerosis characterized by alternating periods of flare-ups and inactivity. Results of the study could lead to the approval of the experimental treatment by the U.S. Food and Drug Administration, according to Lawrence D. Jacobs, M.D., principal investigator and UB professor of neurology. There currently is no effective treatment for multiple sclerosis, which affects an estimated 250,000 Americans. Jacobs has gained international recognition for pioneering work showing the effectiveness of beta interferon injected intrathecally, or into the spinal fluid, in treatment of multiple sclerosis patients with exacerbating-remitting disease. His AUTUMN 1990 co-investigator on the new study will be Frederick E. Munschauer Ill, M.D., UB assistant professor of neurology. The study will involve patients at the William C. Baird Multiple Sclerosis Research Center of Millard Fillmore Hospitals, of which Jacobs is chief, and the Buffalo General Hospital, where he is head of the department of neurology. Other participating centers include the Mellen Multiple Sclerosis Center of the Cleveland Clinic, Cleveland, Ohio; Walter Reed Army Medical Center, Washington, D.C.; University of Oregon Medical Center, Portland, Ore.; and University of Colorado Health Science Center, Denver. Carl V. Granger, M.D., UB professor of rehabilitation medicine, will serve as a consultant on the project. He also is co-director of the Bernard B. Hoffman Multiple Sclerosis Center at the Buffalo General Hospital and chief of rehabilitation medicine at Buffalo General. Data management and statistics will be coordinated by scientists at UB and Roswell Park Cancer Institute, under the direction of Diane Cookfair, Ph.D. Jacobs has been investigating the use of beta interferon to treat individuals with multiple sclerosis since the late 1970s. His work and that of others using beta and other forms of interferon - a substance produced by the human immune system to fight viral infections - is based on, and reinforces, a growing body of scientific evidence that multiple sclerosis is caused by a viral infection that is not effectively countered by an individual's immune system. In two earlier studies, Jacobs and colleagues showed that treatment with beta interferon given by spinal taps reduced or prevented exacerbations in patients with exacerbating-remitting multiple sclerosis. Follow-up analysis of the patients in the first study showed beneficial effects persisting in some patients for up to five years after treatment. The second study, in conjunction with BUFFALO PHYSICIAN A D BIOMEDICAL SCIENTIST �: ----------------------------------------------- 3 researchers at the University of Rochester Medical Center and at Walter Reed Army Medical Center, was considerably larger and double-blinded, with neither participants nor researchers knowing which patients received interferon or placebo treatment. At the end of the controlled study, the disease flare-ups of those who received beta interferon had been significantly reduced, compared to those in the control group receiving placebo treatment. The clinical condition of three-fourths of 69 patients who received interferon was improved or unchanged. In some cases, symptoms disappeared and patients regained lost functions. Jacobs said those studies focused on intrathecal administration of beta interferon because it was believed the substance did not cross the blood-brain barrier and that the only way to get it into the central nervous system was by injection directly into the spinal fluid. He said subsequent studies in animals have shown the same positive changes in the immune reactivity of the central nervous system whether beta interferon was administered BUFFALO PHYSICIA AND BIOM EDICAL SCIENTI ST by spinal tap or intramuscularly. As a result, his focus is now on intramuscular injections. "Even though the intrathecal injections worked and were well tolerated by patients, people don't want to undergo multiple spinal taps if they can avoid it," Jacobs added. Participants will be assigned randomly to two groups -- 144 will receive weekly intramuscular injections of interferon over two years, and 144 will receive intramuscular injections of a placebo once a week for two years. All participants will be followed for two years following their last injection. The study will be double-blinded. Researchers affiliated with a multi-center study at the University of Maryland are conducting a similar study with intramuscular injections of beta interferon. However, there are important differences in the studies. Participants in the Maryland-based study receive injections of larger doses of beta interferon three times per week, while those in the UB study will receive substantially lower doses only once a Lawrence D. Jacobs, M.D., principal investigator, is studying a treatment for MS. week. Jacobs noted that the UB study will utilize substantially lower doses of beta interferon based on a pilot study by his group that indicated the lower dose given once a week will produce the same immunological response as higher doses given thrice weekly. In addition to monitoring participants for exacerbations of their disease, the UB study also will assess progression of disease and disability. Jacobs noted that multiple sclerosis "most often affects individuals at or near the peak of their productivity and consumes substantial societal and health care resources. Fifty percent of patients with multiple sclerosis will be unable to walk or conduct normal work activities within 10 years of disease onset." In addition to previous support from the National Institutes of Health, Jacobs' earlier studies were supported locally by the Baird Foundation; William C. Baird Multiple Sclerosis Research Endowment AUTUMN 1990 �:-------------------------------------------- 4 of the Millard Fillmore Health, Education and Research Foundation; Millard Fillmore Hospitals; Delaware North Corp.; )arne H . Cummings Foundation; the Buffalo General Hospital and the Bernard B. Hoffman Foundation. The late t grant "underscores the commitment to excellence in clinical neuroscience of the UB medical school and its department of neurology," said Michael Cohen, M.D., UB professor and chair of neurology. "In granting this award, the NIH ha firmly recognized Buffalo as a center of excellence in neurologic research. John P. Naughton, M.D., UB vice pre ident for clinical affairs and dean of the medical school, said that while Jacob provided the initiative for the study, "the cooperation of Millard Fillmore and Buffalo General hospitals provided an impetus for getting this off the ground. It's an example of the kind of thing that the medical school can do with affiliated teaching hospitals in the community, with each maintaining its unique focus while coming together for common research projects." Care of people with multiple sclerosis in Western New York is coordinated through the University at Buffalo Multiple Sclerosis System, formed two years ago under the auspices of the UB Medical School and its departments of neurology and rehabilitation medicine. The program unifies the services of the William C. Baird Multiple Sclerosis Research Center of Millard Fillmore Hospitals, the Bernard B. Hoffman Multiple Sclerosis Center of Buffalo General Hospital and the Western New York Chapter of the National Multiple e Sclerosis Society. Arthur Page is associate director in the UB News Bureau and former medical reporter at the Buffalo News. AUTUM 1990 DROP IN TRANSFUSIONS LINKED To AIDS THREAT F ear of AID has decreased not only the amount of blood collected in the United States, but also the amount physicians use, researchers at UB and the Center for Blood Research have determined. The researchers, reporting in the June 7 issue of the New England journal of Medicine, found that blood transfusions have declined significantly since 1984, suggesting that physicians and surgeons are altering their practices. The findings of the research team, led by Edward L. Wallace, professor of management sy terns at UB, and Douglas M. Surgenor, M.D., senior investigator at the Center for Blood Research in Boston and former dean of the UB medical school, were based on national surveys of transfusing and blood-collecting activities in the United States in 1982, 1984, 1986, 1987, and 1988. The findings indicate that some transfusions performed in the past may have been unnecessary, particularly those single-unit transfusions that are given to patients to make them feel better, Wallace noted. Physicians and surgeons now seem to be weighing more carefully the risk of not giving a transfusion versus the risk of transfusing a patient with blood that may be infected with HIV or other transfusion-transmitted infections, he added. "Patients, blood donors and the public at large are apprehensive about the safety of the blood supply, about acquiring AIDS through blood transfusion and even about the safety of donating blood," the researchers said. "Physicians, increasingly aware of the risks of HIV and other transfusiontransmitted infections, are reconsidering the risks and benefits of transfusions, and are turning to alternatives to transfusion of homologous blood, including not transfusing at all." Transfusing fewer units of blood is one way of reducing the risk of contracting AIDS through transfusions, but the risk is already low, Wallace said. In the national surveys of blood transfusing and collecting activities, Wallace and Surgenor found that transfusions of whole blood and red cells peaked at 50.6 units per 1,000 population in 1984 and fell to 4 7.6 units per 1,000 in 1987. Collections of homologous blood (donated for use by other people) was growing rapidly until 1982, when the growth slowed. Collections peaked at 13.4 million units in 1986 and declined to 13.2 million units in 1987, the researchers found. Meanwhile, collections of autologous blood (blood to be used by the donor him elf) -- less than 30,000 units in 1982 -exploded to 397,000 units in 1987. That's equivalent to 3 percent of the homologous collections that year. The researchers concluded that the unprecedented decline in transfusions, coupled with the importation of packed red cells from Western Europe and the effect of autologous collections, forestalled serious shortages of blood due to the lackluster collections of homologous blood. Other re earchers contributing to the study were Steven H. S. Hao, M.B.A., of UB and Richard H. Chapman of the BUFFALO PHYSICIAN A D BIOMEDICAL SCIE TIST �------------------------------------------- - : -------------------------------------------- s Center for Blood Research. The research was funded by a grant from the National Heart, Lung and Blood Institute. The grant, in its fifth year, will be continued for another five e years, Wallace said. - By Sue Wuetcher DIVERS IN UB CHAMBER HOLD THEIR BREATH IN NAME OF RESEARCH W hen the Majorcas hold their breath, it's worth studying. The family team of deep breath-hold divers from Italy took part in tests at UB's Center for Research in Special Environments as part of a research project under the direction of Claes Lundgren, M.D., Ph.D., professor of physiology and director of the center. Data from tests in the chamber will provide scientists with information on changes that occur when the body is subjected to increased pressures in the BUFFA LO PHYSICIA AN D BIOMEDICAL SCIENTIST ocean's depths. That promises to improve water safety techniques for divers as well as benefit patients who have heart arrythmias and other heart-lung problems. Pressure on the body increases as divers go deeper. If a breath-hold diver stays down too deep for too long, he could lose consciousness and die. At greater depths for more than a minute, pressure can compress the lungs, forcing blood into the heart and lung capacity, causing internal bleeding and severe cardiac arrythmias. The Majorcas-- Enzo, 58, and his daughters Patrizia, 30, and Rossana, 32, are athletes who hold their breath for two or three minutes as they dive to depths of 150 feet or more in quest of world records. A sport in Italy since the 1930s, champions of early deep breath-hold diving contests claimed their prize money from an underwater cage placed by weights at a depth that proved a record-setting dive. Enzo Majorca, record-setting diver, floats in UB's hyperbaric chamber. Enzo still holds the record, set in 1976, for the deepest unassisted breath-hold dive of 197 feet. In "assisted dives," the athletes are lowered to the ocean's depths on a small platform. The divers use a lever to control their rate of descent, explained Massimo Ferrigno, M.D., who was instrumental in arranging for the Majorcas to be tested at UB. "They hold their breath only the two or three minutes it takes for them to enter the water, reach the desired pre-determined depth for a record and then ride the platform back to the surface," explained Ferrigno, an anesthesiologist and a former UB Buswell Fellow. The three divers' work at UB took place underwater in the environmental chamber, which has the widest pressure capacity of any in the western world, simulating the pressure of 5, 700 feet underwater to 100,000 feet in altitude. The divers were allowed to go only to the equivalent of 240 feet in the chamber for safety reasons, said Lundgren, and the Majorcas were in full control of their rate of descent. The research team also is studying how water depth relates to triggering of the mammalian diving reflex that has saved people who fell into icy waters. While the coldness of the water constricts peripheral blood vessels, diverting available blood supply to feed vital organs such as the brain or heart, there may be other changes which the pressure of the water may trigger. Italian scientists and physicians in Buffalo as part of the research team were Paolo Cerretelli, M.D., Guido Ferretti, M.D ., and Mario Costa, M.D. The research project with the Majorcas is funded by the National Oceanic and Atmospheric Administration through the New York Sea Grant Institute. e - By Mary Beth Spina AUTUMN 1990 �6 ~MMY~ACK IN MEDICAL SCHOOL? y years ago, few women's faces women in their prime childbearing looked out from med school year, years, medical schools and women books. Then, in the 1970s, barriers have had to face a difficult issue - to traditional male professions began time off for pregnancy and maternity to fall, and today women repre, leave. These stories look at sent more than a third of UB's the problems and pressures medical school classes. and how some UB women With the arrival of so many By AUTUM 1990 D ebo r a h have dealt with them. Willi a m s BUFFALO PHY !ClAN A D BIOMEDICAL SCIENTIST �7 Usa Benson, M.D. '88, spends some quiet time with daughter Eve Guterman. ult's a tough situation, 11 Benson says of maternity leave. ulosing a resident for any length of time can be difficult and we are sensitive to our peers and their work loads.11 Photos by Robert Walion BUFFALO PHYSICIA AND BIOMEDICAL SCIENTIST AUTUMN 1990 �9QUGH ~EING 9 HORT-STAFFED 8 t one time, Lisa Benson, M.D., a 1988 UB medical school graduate and third-year resident in medicine, considered ob-gyn. But because she wanted to combine a medical career with a family, he decided she didn't want those long hours. Benson, 28, had her first child in September and returned to her residency training in April. Her husband, Lee Guterman, M.D., is a resident in neurosurgery. "Initially I intended to only take six months, but there were complications with my pregnancy and my daughter was born early," she explained. "I never thought of only taking ix weeks off. It was an in tinctive thing with me. I just couldn't leave my daughter o soon. "As soon a I knew I was pregnant I let my director know so preparations could be made for my ab ence. When we are short-staffed because people are out on maternity leave there are comments from some residents. It's a tough situation - losing a resident for any length of time can be difficult and we are sensitive to our peers and their work loads. My training will take longer but ~ that's OK." g 'TRUGGLE IS Jf OTHING EW discrimination against women in obtaining residencies then, but with the war and the men, including my husband, being sent overseas, I got the residency." Henrich took 10 years off to have her children, but kept her hand in the field by doing some clinical work. 'W q?HILD ~ARE fZIFFICULTIES Mary Henrich, M.D., displays photos of her sons "I'll just stay right at the hospital and have my child and be back at work three weeks later. I wouldn't recommend . " zt. to my patzents. - Ortman--Nabi J/ he problems women doctor face trying to combine family and career are nothing new. Mary Henrich, M.D., struggled with them half a century ago. A 1941 UB medical school graduate, she was one of only four women in her class. She met her husband, the late Daniel Bot ford, M.D., in medical school, and wanted to have a family. "I very cold -bloodedly chose ophthalmology as my specialty because I decided I could control the hours and it would combinr well with raising a family," explained Henrich, 74. "Then I faced the problem of getting a residency in the field. There was definite AUTUM 1990 Judy Ortman·Nabi, M.D., and her daughter, Jasmine udy Ortman-Nabi, M.D., 34, who has struggled with a system that didn't work for her, supports the call for changes. She is a second-year resident in obstetrics-gynecology and a 1989 graduate of the UB medical school. She was a first-year medical student in Ohio when she had her daughter. Her husband, Hani Nabi, M.D., was living in Seattle. "It actually worked out fairly well because at least I had the summer off, but it was difficult going back to school and caring for my daughter with my hu band so far away," Ortman-Nabi recalls. "Then my daughter had to be hospitalized for respiratory problems." Family members, including one who is a nurse, were able to help care for the child, but that meant the girl had to be taken to their homes, a four-hour drive. "My husband took her the next year, but he had a great deal of difficulty with child care," Ortman- abi said. "It was very complicated and I ended up taking a year off from school. We moved to Buffalo where I fini hed medical school. I've continued to have problems finding reliable child care and my husband travels about one week out of every month." As Ortman-Nabi related her experiences, she was busy arranging for interviews for someone to care for her second child, who was expected shortly. "I'm doing my rotation at Children's right now and I'll just stay right here at the hospital and have my child and hopefully be back at work three weeks later," she said. "It's not something I would recommend to my patients. I'm just taking vacation time. The program that I'm in really isn't flexible. The system definitely needs to change." ~ BUFFALO PHY !CIA AND BIOMEDI AL IENTIST �- 9 UPPORTIVE q?OLLEAGUES [7?ELPED or Heidi DeBlock, 27, who graduated from the UB medical school this spring, life as a medical student and new mother worked out a lot better than she had expected. Despite taking six weeks off during her pregnancy and three months after her daughter was born a year ago, she graduated only a month late. "I had some extremely supportive and kind attendings who helped," she said, "except for one who asked me whether my pregnancy wasn't all a big mistake. I was quite sick during my pregnancy and even had to be hospitalized. "My husband is a pastoral counselor in area hospitals and a minister in Rochester. He commutes there several days a week but he's off on Monday and watches her then, and the other days she's in day care. I nursed her for quite a long period and during days when I was on a surgery rotation from 6 a.m. to 9 or 10 at night my husband would bring her to the hospital or sometimes I would go to her." DeBlock plans to specialize in internal medicine and spent May working at the Johnson Space Center. She took her daughter with her and her husband joined them for a couple of weeks. She wants three or four children and is planning the next one at the end of her third year of residency. "I think it would be too difficult to be pregnant earlier, especially if I am sick again," DeBlock said. "I thought about picking a specialty that would work out well with a family but I decided I had to go with what I liked. Hopefully, there will be part-time positions for me." ~ Heidi DeBlock, M.D., with daughter Alexandria "I have been able to combine medical training and motherhood. I don't have any free time, but it can be done if you want to. " -Brown q lD 9 URGERY AT 'llTH :JCOUR' essica Brown, M.D., 35, an orthopedic surgeon who graduated from the UB medical school in 1984, was doing surgery right up to three weeks before her daughter was born three years ago. It's still relatively rare for women to BUFFALO PHYSICIAN AND BIOMEDICAL SCIE TIST Jessica Brown, M.D., and her daughter (orina enter the field of orthopedic surgery and ra rer yet for a resident in orthopedic surgery to be pregnant. Brown was able to do both because of the support she got from Robert Gillespie, M.D., chairman of orthopedics, she said, adding, "I think I had an easy pregnancy and delivery because I'm a jogger and also lift weights, which l continue to do whenever I can." Brown said she didn't consider the specialty's effects on raising a family; she chose orthopedics because she liked it. "I didn't want to compromise my career," she said. "But once I'm in private practice my hours will be more controlled since many orthopedic surgeries are elective and scheduled. "l took eight weeks off when my daughter was born, and with the support of a good babysitter and my husband, who is a Marine recruiter, I have been able to combine training and motherhood. I certainly don't have any free time, but it can be ~ done if you want to." q/(AITED10 ~VE ~HILDREN rucy Borowitz, M.D., 36, clinical assistant professor at UB, said she waited to have children until after her residency because she felt it was just too hard to combine both. "I've had a zigzagging career which has included study and work in various cities around the country," she said. "But I've always worked part time including when I was in private practice. Right now I am supposedly working 80 percent time, although it is probably more than that." Borowitz is director of the Cystic Fibrosis Center at Children's Hospital, mother of two children, ages four and six, and wife of Philip Glick, M.D. "This is a creative country and certainly programs could be developed to accommodate the needs of physicians and their families," said Borowitz. "It's unlikely that l will climb the academic ladder, but that has been my choice. Medicine is really a wonderful profession and I have been able to combine my family with intellectually stimulating work." ~ AUTUMN I990 9 �10 Susan Graham, M.D., holds her son Peter ._qRAYS A .c71AzARD IN d'JREGNANCY S usan P. Graham, M.D., 36, assistant professor of medicine at UB an~ director of the Coronary Care Umt at Buffalo General Hospital, faced the problem of protecting herself against X-ray exposure during her pregnancy. "I was pregnant and in my third year of a fellowship in cardiology and the official policy was that pregnant women were not to be anywhere near X-rays," she explained. "But I was working with angiograms, so I took extra precautions. I wore extra lead shields and wore a radiation badge to detect any radiation." Graham had her first child last summer soon after coming to Buffalo. Her husband, Jon Kucera, M.D., is an internist on the staff of Health Care Plan. "I worked up to the day I delivered. In fact, it was a Saturday morning and I was AUTUM 1990 making rounds. I was feeling pains and went home and waited for my husband who had also been making rounds. I ended up arriving at the hospital just an hour before I delivered my son. I took off six weeks after he was born." Graham says she feels under pressure to do research and publish to advance her academic career, but right now research has to have the lowest priority in her life. She will continue teaching as a clinical professor if she finds it's just not possible to advance on the traditional academic ladder. "Hopefully, I will find the time to do research, but there are limits to the day and one's energy," Graham said. e qHE f?'YSTEM IS fNHOSPITABLE 1D ~(OMEN ANDdfABIES Ill he system (of medical education) has failed to adequately address the needs of women physicians who also want to raise a family," said Linda Brodsky, M.D., assistant professor at UB and co-director of pediatric otolaryngology at Children's Hospital. "Women face the real issues of their biological clock and a system that really hasn't been able to accommodate their needs." The system's many critics argue that it hinders women who want to combine a medical career with family. Obstacles include a lack of flexibility in training programs, long hours which make breast-feeding difficult, rigid timetables in academic medicine, difficulty in finding part-time positions, and a general shortage of reliable day care. Nationally, women make up more than a third of medical school students and nearly a third of residents, according to Anne E. Bernstein, M.D., director for members-in-training of the American Medical Women's Association and professor of clinical psychiatry at the Columbia University College of Physicians and Surgeons. Two-thirds of practicing women physicians have children. Half of them had their first child during residency training and one-quarter had their second child during that period. Bernstein added that few women reduced their working hours during pregnancy. Women physicians have been struggling for a long time with the issue of maternity leave policies, said Glenda Donoghue, M.D., APFME director of Continuing Medical Education and Professional Development at UB and a director of the National Council on Women in Medicine. "There are certain limitations inherent in the education system," explained Donoghue, who is also co-chair of the Committee on Academia of the American Medical Women's Association and served as chairman of the Committee on Women in Medicine of the Medical Society of the County of Erie. "Residents must work for a set period of time before they can sit for their boards and there is a similar limitation in medical school. Thus eight weeks is probably the outside limit (for maternity leaves) without extending the training period." At UB, the majority of women medi- BUFFALO PHYSICIA AND BIOMEDICAL SCIENTIST �cal students and residents who choose to have a baby during training are able to take time off and get back on track within a year, according to Maggie S. Wright, Ph.D., assistant dean for student affairs at UB medical school. Most request eight weeks off, although some take less time and others more. That agrees with the national statistics, according to Bernstein, who said women take an average of between two and eight weeks. While schools should have written leave policies, Bernstein wrote in the 11 Journal of the American Women's Medical Association, there aren't enough facts to decide how long that leave should be. The data does suggest that a maternity leave of six weeks is recommended for recuperation from noncomplicated pregnancy and delivery, she noted. "We also feel strongly that while maternity or child care leave is not a disability unless there are medical or surgical complications, the housestaff member taking a sanctioned leave is entitled to reimbursement just as if she had sustained a fractured leg," Bernstein said. But residents who seek leaves because of pregnancy create real problems with scheduling and with other residents, noted Margaret McAloon, M.D., clinical associate professor of medicine at UB and medical director of the University Medical Practice Services P.C. "Someone has to pick up the work and it's natural (for other residents) to resent having to work harder," McAloon said. "Right now there aren't any part-time programs that could accommodate pregnancy and child rearing more easily. Pregnancies during residencies definitely play havoc with schedules, especially when three or four women are pregnant at the same time." The system still has its problems, but McAloon notes that some attitudes toward women physicians and their families have improved over the years. "When I was applying for residency programs in the late '60s, I actually was asked about what form of birth control I was using," she recalled. "Of course, I dismissed applying for those programs after I was asked those questions. No one would dare ask anything like that today." BUFFALO PHYSICIA AND BIOMEDICAL SCIE TIST Undo Brodsky, M.D. with her children Jeremy, left; Dana, right, and Rebecca, foreground A number of suggestions have been offered to help physician-mothers. These include part-time and shared residency programs, longer parental leave programs, a flexible approach to the tenure clock, and improved day care options. "I think the idea of the 'mommy or daddy track' is a great one," said Brodsky, a 3 7-year-old mother of three children, ages seven, five and two years. "By this I mean a more flexible system that would be available to all physicians who want to have more time for their families and still pursue academic careers." She decried the "arbitrary timetables" that exist in academic medicine and believes academic medicine imposes the greatest demands on physician-mothers. "I was very lucky with each of my children - uncomplicated pregnancies," Brodsky said. "I took a month off for each and breast-fed for six weeks, but all women pay a great price. They are often constantly tired and worn-out." Brodsky, whose husband, Saul Greenfield, M.D., is head of pediatric urology at Children's Hospital, said she has been able to balance the conflicting demands of her many roles only with reliable full-time live-in household help, plus two part-time assistants at home. Writing in a November 1989 New England Journal of Medicine essay, Carola Eisenberg, M.D., a Harvard Medical School psychiatrist, argued for more choices for both women and men. She supports parental leave and day care programs throughout medical school, residency training and employment. She also calls for stopping or slowing the tenure clock in academic medicine while doctor-parents take off to bear and rear children. "Women will bring into academic medicine a greater emphasis on the importance of the physician's family life," she wrote. "The beneficiaries of this concern will be men as well as women .... Restructuring medical careers to recognize the legitimate needs of physicians' families will be to the advantage of all."'i' AUTUMN 1990 �~· ·~ . · .....,. , ;;..«. : �for America's Ailing Medieal System 8\' CO,~lE OSW.\LD ~OFKO Today's doctoring is no Norman Rockwell scene Their hands may be tied with red tape, but American doctors have the power to break those binds by helping to change the medical delivery system in this country. That was the common thread weaving through talks at the 53rd annual Spring Clinical Day • -.. sponsored by UB's Medical Alumni Association. -- theme of the session held April 28 in the Buffalo - • I "Changing Aspects of Medical Practice" was the Marriott Hotel. �'PAYORS' REVOLT' SPAWNED RED TAPE I I D octors are right in perceiving that there are increasingly intrusive and harassing restrictive conditions being put on the freedom to practice," affirmed Arnold S. Reiman, M.D., editor-in-chief of the New England Journal of Medicine and considered by some to be America's most powerful doctor. Despite the red tape that makes doctors' lives miserable, "medicine doesn't need more micromanagement," said Reiman, who advised his colleagues "to recognize the problem and participate in the solution." Physicians need to work actively toward a system that lowers costs, regains the public's trust, and delivers care to all citizens. "Let's stop fighting managed care and quality assurance," said Reiman, who advised doctors to enforce quality control, rather than fight it. That would get the malpractice monkey off doctors' backs, he said. The seeds for the restrictive climate were sown after World War II, Reiman said, when medical facilities expanded rapidly and specialties became more sophisticated. As health care became more available and more expensive, third-party indemnity-type insurance became popular. By the late 1960s, roughly 85 percent of American had some kind of health insurance, usually through their employers or through Medicare and Medicaid. Businessmen could build hospitals, make it attractive for doctors to practice there, accept only the in ured, and charge what the market would bear. There were no incentives for consumers to keep costs down, and there were enormous incentives for doctors to provide services, the]oumal editor said. "You had the inevitable ingredients for enormous inflation," Reiman said. This led to the revolt of the payors. "When Mr. Iacocca (the head of Chrysler) has to pay $700 per car that he manufactures to pay for his workers' health care coverage, he's not happy; he doesn't like that; he didn't choose to do ~.:~~· .-,.JSJ), . ·~ ·~· ~ "It's a thinly disguised, sanitized version of the kickback. It's an example of what's happening in the conversion of health care from a social service to a commodity. " that," Reiman said. "He was taken kicking and screaming into that arrangement." Uncle Sam is just as unhappy to pay approximately 8 percent more each year for physician services for Part B Medicare, Reiman added. In addition, the public has doubts about the quality and necessity of the tests and procedures doctor are performing. All of this is driving payors to insist on more and more regulations to control costs and increase effectiveness, said Reiman. Doctors are responding by seeing themselves as businessmen: doctors making extra profit by dispensing drugs in their offices; ophthalmologists buying a certain brand of lenses at a discount and charging the insurance company full price; doctors investing in facilities to which they refer their patients- the more patients they refer, the bigger their profit. "It's a thinly disguised, sanitized variation of the kickback," Reiman said. "It's an example of what's happening in the conversion of health care from a social service to a commodity, and doctors accepting that philosophy." Despite the emphasis on commercialism and a free market economy, costs aren't going down because health care is not an industry, Reiman said. "Doctors should support and enforce ethical codes that make it clear that they aren't businessmen," he urged. He suggested several other things doctors can do to remedy the restrictive climate in American medicine. First, every doctor should join organized medicine, become active and vote- in the public interest. "Don't vote the way the longshoremen's union would, or the electrical workers - everybody else be damned, we're going to take care of our own," Reiman said. He added that while doctors should be concerned about the millions of people who are uninsured and should push for more access to health care, they must also help figure out ways to pay for it. Reiman noted that despite today's restrictive climate, doctors still enjoy a monopoly, much independence, the ability to self-regulate, a virtual guarantee of a good living, and enormous power. Their education is subsidized, research for the new techniques doctors use was paid for by somebody else, and hospital-based physicians don't have to pay for the technology that they use, he said. In exchange for all of that, Reiman said, doctors have the obligation to erve the public's interest. They must accept that they have a moral contract with society. Physicians must help find a better system "regardless of whether it's in our particular economic interest or not," he �said. "And if we do, we'll make out very well." Society is happy to pay its experts and heroes - doctors should have no problem getting compensation. Another suggestion is to let young people experiment with group arrangements - they're not going to be lazy because they're salaried, he said. Fee-for-service practice will remain an option, but it won't be the main method of payment because it's impossibly expensive. Specialists shouldn't be paid ten times as much as primary care physicians. He also urged doctors to push for no-fault insurance. "We can afford health care if we make the system efficient and rational," Reiman concluded. "We doctors have to play a role. We'll either help with the solution e or be judged a part of the problem." SCRAP THE SYSTEM T he United States should start over and re-create its medical system, using the best points of the Canadian setup, suggested Robert L. Dickman, director of the Department of Family Medicine at Mt. Sinai Medical Center in Cleveland. In Canada, the government runs the insurance and physicians have great clinical freedom and less paperwork. I ~ ~~ .··~· That's what we're spending our money on now. I think we can do better." Medical care isn't a commodity to be dispersed by doctors the way a baker sells bread, Dickman said. Advertising is fine for hamburgers, but many people find promotions for medical care questionable. He cited the "Baby Grand" program in which a Cleveland hospital gave mothers $1,000 to deliver their babies there. He also noted that in a free market system, McDonald's doesn't wring its hands over the millions of people who can't afford a Big Mac. "If we believe that health care is a commodity, it makes no sense to even talk about the 30 million or 40 million uninsured," Dickman said. "Why worry - unless, of course, there's something special about health care. "If you don't think we're in the business of selling used cars, if you think there's something noble and special about our profession, maybe we ought to think about the possibility of starting over so that we don't find ourselves dealing with patients over and over again about their insurance requirements. "It is my belief that the only way to solve our problems in American medicine is to develop some kind of unitary system that preserves the doctor-patient relationship." Physicians should lead the way, he said, noting that there is already a growing organization called Physicians for a National Health Program. e GRouP PRACTICE Is THE BEST CHOICE I.G . .i Their system can't be transplanted wholesale, Dickman said, but "I believe we can take the best of it and make it work for us. "About 10 percent of our budget in health care is to pay insurance companies so they can build those big buildings in downtown Cleveland and Buffalo. roup practice is, if not the best, one of the best choices for us to deal with complex technology and the incredible pressure on cost of care we face in this next decade," said Edward J. Marine, M.D. Marine is medical director of Health Care Plan of Western New York, a health maintenance organization, and served as associate dean of the UB medical school. Society won't add more resources for health care; it will simply reallocate the resources we have now, he predicted. By the turn of the century, Marine believes, most doctors will find themselves involved in the managed care system. We need managed care; that is, managed costs, Marine said. Managed care refers to any health-care financing plan that attempts to manage costs through controls and influences on services and on payments for services. He pointed out that more than 30 million Americans have no health insurance, and 30 million to 50 million are underinsured. "Everyone agrees that something must be done," Marine said. "Everyone also agrees that someone else should pay for it." The prevailing view in the medical profession is that doctors should ignore the cost of care, Marine said. Instead, he suggested, the push toward lower costs in health care should be led by a group of well-trained physicians dedicated to the best values of the profession who are prepared to apply the best principles of management to medical care. e DISCIPLINING DocToRs T he current system of handling complaints against doctors is not working, said Peter J. Millock, general counsel, New York State Department of Health. It's time-consuming, it addresses too few physicians, it wastes money, and it's so complicated it's unintelligible to patients and doctors. The average case lasts 20 months, Millock noted, and almost all physicians, including those whose licenses �are ultimate ly suspended or revoked, remain in practice during this time. In 1989, there were 67 such cases. The state is now examin ing way to streamline the system. M illock also sees oth er sources of change for the physician discipline system. There may be new ways to identify substandard physicians, including recredentialing. Standards of care may become more precise, he said, and deviations from those standards easier to e tablish. But a member of the audience took exception to the idea of tightening standards of care. "What bothers me is that standards are going to be set and your performance is going to be monitored by how many inches you deviate from the standard. As an individual, that's the most disturbing thing for me. If I wanted to be a robot, I'd be a robot." The comments were greeted by applause. Millock urged the speaker to work his concerns into the changing system. • MALPRACTICE CRISIS T he next malpractice crisis will come in 1995, predicted Donald W. Aaronson, M.D., an allergist who is also an attorney. Though he's not sure what will cause it, Aaronson said it will be child's play compared to the 1975 crisis, when doctors wondered whether insurance would be available, or the 1985 crisis, when prices skyrocketed. Aaronson offered up another depressing tidbit: physicians in general have a 3 7 percent chance of being sued for malpractice during their lifetime; those in ob/gyn have a 57 percent chance. However, there are several things doctors can do to avoid getting sued, said Aaronson, who is also clinical Quality of care soon "I don't believe the old a rt of medicine is lost," Aaronson said. "We care about our patients, but often we don't know how to show it." e may be judged by how Connie Oswald Stofko is editor of the far a doctor deviates from precise standards. One physician's comment: "If I wanted to be a robot, I'd be a robot. " assistant professor of internal medicine at the University of Illinois College of Medicine and editor of Medica l Malpractice Prevention. They include: e Reduce patient injury. This can be done by raising the skills of incompetent doctors. Training programs should retain the physicians' dignity, but bring them up to the level they should be, he said. e Share responsibility. Doctors shouldn't make decisions for the patient. Instead, they should spend time presenting the alternatives. Doctors should also listen to other health professionals, such as nurses and pharmacists. e Keep good records. For instance, carry paper at all times and record phone prescriptions, he suggested. e Improve communication. Patients complain that doctors are concerned only with disease, they don't listen, they don't explain things, and they're inaccessible. Buffalo Phys ician and Biomedical Scientist. PATHOLOGY WING DEDICATED To SANES T he Class of 1945 dedicated the pathology wing in the Cary-Farber-Sherman Addition to the memory of the late Samuel Sanes, M .D., a much-admired professor, during the Spring Clinical Day and Reunion Weekend. The plaque marking the wing paid tribute to Sanes, who died in 1978, as a physician, acting chairman of pathology, and community leader, as well as an outstanding teacher. It contains a quote from Hippocrates: "To hold him who has taught me this art as equal to my parents and to live my life in partnership with him." Those attending the ceremon y included Mildred Spencer Sanes, his widow; Thelma Sanes, his sister; other members of the Sanes family; about 15 members of the Class of 1945, and Barbara Kearney, the first recipient of the Harold S. and Thelma Sanes Scholarship. The cholarship was established by Sanes' brother and sister for students with academic promise and financial need. e �WELCOME BACK G etting together with old friends ts always a highlight of the annual Spring Clinical Day and Reunion Weekend. A reception to welcome return, ing alumni was held Friday, April 2 7 in UB's Center for Tomorrow, followed the next day by the alumni luncheon at the Marriott. The trophy for the reunion class with the highest percentage in attendance went to the Class of 1960, whose chairmen were RogerS. Dayer, M.D., and James R. Kanski, M.D. Special recognition was given to mem, bers of the 50,year reunion class, who wore festive straw hats to mark the occasion. Reunions were also held for graduates of the Classes of 1945, 1950, 1955, 1965, 1970, 1975, 1980 and 1985. Mark your calendars now for next year's celebration. The reunion weekend starts Friday, May 3, 1991. From left, seated: Henry Severson. Morshall Ointon. John Benny, Stanley Urban. Bernard Juveher, James Schaus. Standing: Warren Montgomery, MaHhew O'Brien. Norbert Roberts, Charles Mincks, Robert Hubbard, Wilham Hndebrand, Fritz Guenter, Evan Molyneux, Albert Rekate, Harold Polanker. 1940 From left, on floor: Jacob Steinhart, Ivan Kuh~ Herbert Joyce, Wilham Mcintosh, Robert Schopp. Seated: Raymond Barry, Wilr10111 Loeser, Gearge Thorngate, Wilham Andaloro, Richard Adler, Edward Fargrave, Earl Cantwell. Standing: Donald Groft, Joseph Sheedy, George Elhs, Wayne Templer, Hnton Jacobson. Charles Wiles, Wilham Taylor, Joseph Tannenhaus, Norman Chassin. Theodore JeweH, Albert Rosso, John Hartman. Edward Valentine, John Ouinhvan. John Robinson. Vito Lagr10. 1945 �From left, seated: William Webster, Robert Kling, Helen Sikorski, Richard Leberer, Bob Patterson, Leo Manning, Joseph Mattimore. Standing: Roland Anthone, Henry Pech, John Graf, Robert Bergner, Richard Lyons, James Curtin, James Brandl, Robert Benninger, Vincent Scamurra, Del Dunghe, Roy Robinson, Sidney Anthone. From left, on floor: Franklin Glockner, Francis Klocke, Gerard Diesfeld, Thomas Guttuso. Seated: John Lauria, Robert Malatesta, James Kanski, Roger Dayer, Naomi Leiter, Harold Brody, Marshall Lichtman. Standing: Harry MetcaH, Daniel Rakowski, Donald Donius, Joseph Antkowiak, Algirdas Gamziukas, Andre Lascar~ John Tuyn, Joseph Chazan, Robert Sauer, Eugene Rivera, Harris Faigel, William Abramson, Edwin Lamm, William Stein, Donald Hammel. From left, seated: Robert Martin, John Peterson, John Winter, James Nunn, Richard Carlson, Winifred Mernan, John Baker. Standing: James Garvey, Ray Schiferle Jr., John Foley, Albert Franco, John Kent, Larry Beahan, Robert Pittell, Frank Guzzo, Shedrick Moore, Eugene Whitney. From left, seated: Wilt.am Adler, Patrick Houston, Louis Trachtman, Joseph Cardamone, George Moore, Robert Schultz, Michael Feinberg. Second row: Harry Yerby, Barry Feinblatt, Kenneth Kim, Steven Berman, Calvin Marantz, Ralph D'Amore, Ira Hinden, Jerald Giller, George Strauss. Third row: Gary Jeffery, W. Scott Walls, H. Elt.ott Larson, Wilt.am Bucher. 1950 1955 1960 1965 �From left, seoted: Wilr.om Fiden, Robert Ungerer. Second row: Michael Uppmann, Laurence Lesser, David Rossman, Agnes Szekeres, Roger Forden, Dennis Krauss, Robert E. Lee, Alan Fink. Third row: Jan Novak, Ronald Zmyslinski, Donald Capley, Sebastian (anti, JeHrey Ross, Dennis Dubois, Shafic Twal, Arthur Goshin, Arthur Seigel. Not pictured: Donald Gabel, Neil Garroway. From left, on floor: Mark Borer, James Twist, George Tremiti. Second row: Theresa Stephan-Hains, Barbara Hirsch, Ellen Tedaldi, Michael Grant, Morgoret Paroski, Harvey Arbesman, Constance Lentz. Third row: Nancy Colligan, Maryanne Kiernan, Katherine Jasnosz, Cynthia Parlato, Donald Switzer, Paul Trainer, Donna Oehman, Lynn Steinbrenner, Irene Snow, James Conway, Vivian Fasula, Timothy McCullough. Fourth row: Mark Gilbert, Thomas Masten, Robert Shalwitz, Thaddeus Wojcik, Martin Hale, Eric Tenbrock. From left, seated: Marguerite Dynski, Wilr.am Cohen, Mary Lou Meyers. Second row: Jack Cukierman, James Burdick, Henri Woodman, John Stubenbard. From left, on floor: Sabino Torre, Jack Coyne, Kevin Donovan, John Fudyma, Joseph Zizzi. Second row: Shirley Galuck~ Lynda Stidham, Wendy Delaney, Thomas Cowan, Claudia Fosket, Thomas Medige, Lucie DiMaggio, Adriana Alvarez. Third row: Michael Lahood, Timothy Wacker, Donald Flemming, Ira Handler, Thomas Szalkowsk~ Margaret Reidy, Er.zabeth Maher, Barbara Deuell, Carl Turissini, Amy O'Donnell, Edward Cheslow, Margaret Ubby, Donald Tingley, John Leddy. 1970 1975 1980 1985 ��21 a nurse gives a vac~ cination, a lab technictan uses a Petri dish, or a patient discards a tissue. Medical waste is created. And it's not just hospitals that generate medical waste. Physicians' and dentists' offices make it, and so do laboratories. Finding safe and economical ways to dispose of medical waste is a growing concern for health care providers, research institutions, and universities, as well as for government agencies charged with guarding the public from exposure to potentially toxic substances. Getting rid of such waste isn't as easy as it used to be. Most experts agree that there's more of it, thanks to the proliferation of disposables and single~service items such as disposable syringes, bedding, IV bot~ des, and other supplies. And the percentage of waste requiring special handling has climbed dramatically since 1985. The public's concern about medical waste heightened after medical~ ly related material washed up on beaches during the summers of 1987 and 1988. In addition to aesthetic concerns, fear of AIDS contributed heavily to the public's anxiety regarding medical waste, according to a report from the Agency for Toxic Substances and Disease Registry. However, only a small fraction of persons infected with HIV (the AIDS virus) are hospitalized. At any given time, more than 99 percent of all potentially infectious HIV~infected persons are living in their homes in the community. Thus, body fluid waste eliminated by persons with infec~ tious conditions is primarily being discarded from private homes, accord~ ing to a 1988 Oregon Department of Human Resources study. HANDLE It's getting harder to throw away By Paula Voell CARE �22 Only five year ago, according to 1985 Centers for Disea e Control guidelines, less than 10 percent of total hospital waste needed to be treated as infectious. Today, the percentage varies, depending on whose parameters are used. "Three or four years ago the medical waste given pecial handling was mainly from people in isolation," said William D. Pike, vice president of the Western New York Hospital Association. "They may have had an open wound, hepatitis, pneumonia, AIDS. Now we're handling almost all patient care waste as medical waste." This can account for as much as 50 to 80 percent of total hospital waste if Centers for Disease Control universal precautions guidelines are followed, said Lawrence G. Doucet, a professional engineer with Doucet and Mainka, hospital management consultants in Peekskill, N.Y. Categorizing the wa te ha also become more complex. The terms "infectious," "medical," and "hospital" waste often are interchanged inappropriately. Hospital waste is the broadest category and includes all solid waste. Medical wa te describes materials such as soiled dre sing and intravenous tubes. Infectious waste is that portion of medical waste that could transmit an infectious disease. About 15 percent of ho pita! waste is estimated to be infectious by Environmental Protection Agency (EPA) definition. Experts tress the importance of viewing infectious waste in its proper perspective. All waste, including that from homes, may contain pathogenic organisms. Hospitals in the eight Western New York Counties produce about 60 tons of solid waste daily - that includes the potato peels from the kitchens and the memos circulated throughout the facility. Of that, about 16 tons is treated as infectious waste, according to William Pike. Many of the larger hospitals and the University incinerate their waste, but smaller hospitals use private haulers. David Balbierz, vice president of BFI Waste Systems, says his business has steadily increased. BFI is a private hauler with 80 medical waste disposal sites in the United States. Private physicians and other small hazardous waste generators (less than 50 pounds of waste a month) have also had to change their disposal habits. "You can't put it in the trash any more," said Balbierz. "For a long time this stuff was going out to the curb, into dumpsters or into the sewer." Now physicians, dentist , veterinarians and others must register with the state, fill out tracking forms and submit annual reports. The waste has to be packaged and marked with the generator's name and addres . As the waste travels to its final disposal, the form goes with it. "The tracking system is intended to work as a burglar alarm, alerting EPA and state officials whenever waste has not reached its intended destination and leaving a paper trail that will lead to the violators," according to discussions in the Congressional Record. "THREE OR FOUR YEARS AGO THE MEDICAL WASTE GIVEN SPECIAL HANDLING WAS MAINLY FROM PEOPLE IN ISOLATION. NOW WE'RE HANDLING ALMOST ALL PATIENT CARE WASTE AS MEDICAL WASTE." As regulations become more tringent, skyrocketing costs of disposal take a bigger bite out of hospital and university budgets. A study by the management and technology consulting firm of Arthur D. Little in Cambridge, Mass. notes that nation-wide, disposal costs could rise from $3.7 billion in 1988 to $10.7 billion in 1991. To complicate the problem further, hrinking storage capacity in landfills puts more emphasis on incineration of wastes. "As we approach 1992 and there is less available (storage) capacity in the marketplace, prices will jump considerably for a period of time as new incinerators come on line," said Melissa Forgione, vice president of Medical Waste Services, a Buffalo waste disposal firm. "Then I think prices will decline, and stabilize." In the Buffalo area, almost all hospitals burn waste, said William Pike of the Western New York Hospital Association. Before the waste is incinerated, regulations state that it must be handled with caution. At Buffalo General Hospital, for example, waste is placed in red plastic bags that are transported to a holding room on each floor in a large cart that is eventually rolled to the incinerator. A bracket system on the bottom of the cart allows it to be latched onto the incinerator. "We have a pretty unique system," aid Richard Kerling, director of plant operations at Buffalo General. "Once the waste is in those containers, it's not handled again." The hospital burns six tons of solid waste a day, everything from garbage to paper, at an estimated co t of $240,000 for 1990, according to Kerling. Before the incinerator was operative, it cost the hospital 60-65 cents per pound to have its waste hauled to a landfill in South Carolina. "Since the incinerator went into operation in September 1988, to be conservative, - - - - - - - - - the hospital has saved a quarter of a million dollars in medical waste disposal costs," Kerling said. Despite such savings, Buffalo General and other local hospitals are facing a crunch because the Department of Environmental Conservation has tightened regulations on incinerator emis- �sions. By January of 1992 even hospitals such as Buffalo General, which has one of the newest incinerators, won't meet the new code without costly modifications. "Our incinerator is just a year old, but we'll have to upgrade it to meet the standards," said C. J. Urlaub, Buffalo General's vice president of operations. Installing a scrubber 23 (a device placed on an incinerator to remove air contaminants with water) may cost the hospital as much as $800,000. Other hospitals will pay from $1 million to $3 million for new incinerators, depending on size, Pike said. Adding to the cost is the sophistication of the new machines, which need expensive stack monitoring and engineers to run them. "You can't have the housekeeper light a machine and throw the bags in," Pike said. Hospital administrators are exploring the option of joining with other facilities to cut costs. "If 14 hospitals are spending $70 million, it would be far cheaper to have a few larger sites," Pike said. Some environmental officials favor such a regional approach because it means there are fewer incinerators to operate and monitor, but public outcry has been intense against accepting waste from outside the community. The ot In My Back Yard ( IMBY) cry has become so strident, some wonder if it's turned to NOPENot On Planet Earth. Recently, Medical Waste Services was negotiating to build an incinerator to handle waste from several hospitals, nursing homes and physicians' offices in the southern part of the state. The project was defeated because of citizen outcry. Medical Waste Services picks up 10,000 pounds of waste each week from small generators as well as from Our Lady of Victory and Columbus Hospitals, facilities which do not have their own incinerators. "We provide the packing, permitted hauler and insurance," said Forgione, the company's vice president. Boxes for waste storage and disposal provided to its clients by Medical Waste Services come in three sizes and include a three-millimeter liner. A box 18 by 18 by 24 inches that holds 30 pounds costs $27 for disposal. On average, private physicians produce one box of infectious waste every two weeks, according to Forgione. BFI workers who pick up medical waste are given extensive training in how to handle the waste and what protective clothing to wear, said Balbierz. "Actually, the people who pick up regular (curbside) trash are less protected because they don't know what's in it," he said. Waste haulers point out that ordinary garbage from private homes can include needles (it is estimated that one billion needles are discarded by diabetics annually), as well as waste from infectious di eases such a hepatitis. Misconceptions about treatment of hospital waste abound, despite increasing amounts of attention to the problem, Pike said. "I think people assume that hepatitis will be coming out of stacks and that hundreds of trucks will come to a property and that's just not true," he said. �HOW UB HANDLES MEDIC 24 The University produces about 35,000 pounds of medical waste annually from its 60 laboratories, mainly utensils containing culture media from labs in the schools of medicine, dentistry, and nursing. "The state regulation in relation to the University seem very stringent," said Robert E. Hunt, director of Environmental Health and Safety at UB, which has an incinerator on the South Campus. "For a long time the state regulations said that once infectious waste was autoclaved (sterilized with steam) it could be treated as trash and go to a sanitary landfill. That was no problem for us except for a few labs who had to find a way to autoclave. "But recently a sentence was added to the regulations to require that all regulated medical waste has to be made nonrecognizable, so it has to be incinerated or ground up. We are using incineration but it's causing considerable problems because a big share in poundage is plastic - flask tubes, pipettes and Petri dishes. That's extremely difficult to incinerate efficiently, to bum up at high temperatures efficiently enough so you don't get a lot of byproducts in the air." To cut down on the amount that has to be incinerated at UB, labs are advised to put all clean glass and plas:~m~ tics in special containers 'glass,' Hunt says. These are collected puncture- Balbierz estimates t h at only two to five percen t of waste is pat h o l ogica l waste, but con cedes t h at t h e public has a different perspective. "Th ey h ave t h e misconception that o ur AU11JM 1990 resistant cartons to be disposed of in permitted landfills. Hunt doesn't think the health industry will revert to reusable supplies. "I've thought about it, but there's just so much expense involved with the handling, cleaning and storage of glassware that maybe a lot of researchers would find it impossible to continue." William Pike, vice president of the Western New York Hospital Association, agrees it's unlikely that hospitals will go back to reusables. "The reason we use disposables is sterility. If there was a fault in the autoclave, would you want a needle reused? "And I think that there would be a concern for infection with blood products if we switched from the use of throwaway plastic bags." Pike said that hospitals are more likely to look for ways to cut down on disposable items and encourage recycling in areas other than patient care. "There are other things hospitals could do in such things as packaging for food - eliminating the use of Styrofoam, for example," he said. trucks are filled with body parts, when actually most of our waste is rubber gloves, disposable gowns, the paper used on examinating tables, masks and tongue depressors." Before all the dust settles on how best to dispose of hazardous waste, Melissa Forgione says, people will have to become better informed. Paula Voell is a reporter for the Buffalo News. BUFFALO PHYSICIAN AND BIOM EDICAL SCIENTIST • �... ----------------------------------/f 0 25 The Body Snatchers Elwood lecturer tells how grave robbing and murder charges ensnared a famous anatomist BY JEFFREY TREBB A • 19th century anatomist whose illustrious career was destroyed by charges of grave robbing was the subject of the Charles L. Elwood Memorial Lecture in March. The lecture was delivered by Sherwin B. Nuland, associate professor of surgery at Yale School of Medicine, whose visit to Buffalo was sponsored by the Alpha Omega Alpha national medical honorary society. According to Nuland, it was only stubborn self-assurance that allowed the Scottish anatomist Robert Knox to become implicated in a series of murders committed to furnish specimens for dissection. In his lecture, "Goodness Tainted: Robert Knox and the Anatomy Murders," Nuland told his audience: "Robert Knox (1791-1862) was a paladin destroyed by his own code of honor, for although his drive and talent seemed to promise a glorious academic future, his destiny became his downfall when he was scapegoated for a series of crimes instigated by the medical science of his time. "By confusing egotism with purity of conscience, by believing compromise signifies cowardice and by equating pragmatism with weakness, Knox sacrificed great achievement on the altar of vanity," Nuland said. The actual "scoundrels" were two navy workers on the Union Canal between Edinburgh and Glasgow, William Hare and William Burke. Nuland called both "familiar with all BUFFALO PHYSICIAN A 0 BIOMEDICAL SCIENTIST Detail from "The Anatomy Lesson of Dr. Tulp," Rembrandt, 1632 In 1828, corpses of murder victims were sold for about seven British pounds apiece. the woe, wretchedness, guilt and pollution" life contains and said they embarked on a spree of killings shortly after Hare filled an already-dead neighbor's coffin with tanner's bark and sold the man's corpse to the medical college, becoming quite impressed with the simplicity of the deed. All colleges in Great Britain early in the 19th century were facing an increased need for corpses owing to the growth of surgery with its new emphasis on detail, and also to the higher standards of care legislated by government. AUTUMN 1990 �... If ----------------------------------------- 0 26 And procuring bodies for dissection, Nuland pointed out, usually meant resorting to illegal measures of some variety since the two legal sources, the bodies of executed criminals and those of the unclaimed dead in hospitals, never approached the demand. "The need was insatiable. You just couldn't teach without corpses," he said. Grave robbers, or "resurrectionists," supplied what they could, but eventually graves became clo ely watched over by relatives of the deceased, said Nuland. So Burke and Hare turned to murder. Burke even gave his name to a style of suffocation: To "burke" someone meant strangling him while sitting atop his chest. In all, Burke and Hare killed about 30 persons in 1828, netting about seven British pounds per body. The pair brought suspicion upon themselves after murdering several well-known prostitutes. An elderly woman they brought home from a tea shop, plied with gin, and killed after an evening of dancing and singing, was their last victim. Unfortunately for Knox, the body, purchased by assistants, was found in his dissection cell. Nuland described Knox as a "man of solitary self-regard, endowed with an air of authority, possessed of charm, cultivating distinctiveness." He had studied in Paris with Georges Cuvier, the French zoologist and statesman, who established the sciences of comparative anatomy and paleontology. Shortly after returning to Edinburgh in 1822, Knox established a museum of comparative anatomy at the Royal College of Surgeons in Edinburgh. "Knox's enviable command of language and his showman hip drew students in huge numbers; not only anatomists but artists and divinity students. He was a tourist attraction for AUTUM 1990 cultivated travelers and at the threshold of an illustrious career," aid Nuland. "The greatest anatomy teacher of his day, he was also skilled in paleontology and comparative morphology." But because the body was found in his room, Knox "faced all the frustration built up by a century of grave robbing. He was scolded for every sin ever committed in every aspect of medical science," said Nuland. The press derided him, he was burned in effigy, he was forced to walk through creaming crowds to give his lectures. A folk song closed with "Burke's the butcher, Hare's the thief, Knox is the boy who buys the beef." Few colleagues came to his defense. Even his admiring students left his side. This despite the fact that he was acquitted in court late in 1828, according to Nuland. (Burke was found guilty on Hare's testimony and hanged before 20,000 onlookers. His dead body was sent to the anatomy school for dissection.) Nuland claimed the anatomist was brought low by pride and vanity: "Knox cast ridicule on the opinions and men of the time and flaunted his talents, inviting bombardment. He believed it beneath his dignity to respond to the charges, and the reverberations followed him the rest of his life." Knox lost his job as curator of the anatomy museum and was forced to resign from the University of Edinburgh. He rambled about the country barely surviving by lecturing on anatomy and fishing and writing for magazines in London. He was expelled from the Royal Society of Edinburgh for non-payment of dues. This career as a perennial free-lancer was relieved by only one respectable position as a fellow of the Ethnological Society of London. In 1862, long after his wife and all his children were dead, Knox e died of a stroke. BUFFALO PHYSICIAN AND BIOMEDICAL IE TIST �27 MILGROM OUTLINES WoRK ON ANTIANTIBODIES A t one time, it was believed that the body's immune system could not make antibodies that would be destructive to the host's own tissue. But Felix Milgrom, a distinguished professor of microbiology at UB, helped to prove that theory wrong through his work with antiantibodies. Milgrom delivered the 20th Annual Ernest Witebsky Memorial Lecture in May at the Center for Tomorrow on UB's North (Amherst) Campus. "The theme of antiantibodies is something that I have been pursuing for 44 years," Milgrom said, outlining his research career. "It is something that I have been pursuing from the very beginning of my research." In outlining his research, Milgrom Felix MUgrom, M.D. BUFFALO PHYSICIAN A D BIOMEDICAL SCIENTIST issued a caveat to his capacity audience. "The lecture," he said, "was not designed to be a comprehensive treatment of this topic." Milgrom noted that the audience would require a graduate seminar in advanced microbiology if they wanted to really understand what the topic encompassed. Milgrom worked at UB from the 1950s through the mid-1960s with the late Ernest Witebsky, whom Milgrom called "the world's most brilliant immunologist." Their work made great strides toward disproving the old theory about autoimmunity. Another "first" for Milgrom was demonstrating in the laboratory that some forms of kidney graft rejection are caused by antibodies present in the circulation of presensitized recipients. That was an important piece of information in 1968 when the field of human organ transplantation was new. His research also clarified the structure of rheumatoid factor, an antibody. Milgrom noted that over the years, UB's Department of Microbiology has attracted hundreds of students. About 40 or 50 now head departments or institutes focusing on immunology in the U.S. and abroad. A native of Poland, Milgrom was chair of the Department of Microbiology at Silesian University School of Medicine in Zabrze, Poland, and a professor and acting chair at the University of Wroclaw in Poland, before coming to UB. Milgram has authored about 600 professional articles and has served as editor for several books. He was awarded the Paul Ehrlich Prize in 1986 in recognition of his distinguished service in the fields of immunology and chemotherapy. After Milgram's lecture, the Ernest Witebsky Memorial Awards for proficiency in microbiology were given to Seth Dewey, a medical student; Jennifer Kuracina, a dental student, and Haiping Mei and Ai Shih, both graduate students in microbiology. e AUTUMN 1990 �28 LISTEN WITH HEART, ABRAM TELLS GRADS A very personal message came with this year's commencement speech to the School of Medicine and Biomedical Sciences. The 145 medical students, 25 doctoral tudents and their familie and friends heard diplomat Morris Abram advise graduates to "shorten your stethoscopes to hear what patients are saying and feeling." Abram, the U.S. representative to the European Office of the United ations and Other International Organizations, Geneva, and former Diplomat Morris Abram addresses graduates. president of Brandeis University, keyed his address to the relationship between doctor and patient. But it was more years, had shortened the listening tube than a theoretical overview from a sani- of his stethoscope. tized ivory tower. Abram shared his per"One day a young resident came up anal experiences with the graduates, to thi wise old man and said, 'Doc, talking about hi own bout with why do you use such a short stetholeukemia that lasted five years. scope? Did you buy it that way?' He "The relationship between doctor and said, ' o son, I just had to keep cutting patient is one of extraordinary psycho- it off.' He was a man who paid very litlogical and emotional interplay," Abram tle attention to technology and a great said, reflecting on the sometimes-anx- deal of attention to what he was hearious encounters with hi own team of ing," Abram said. physicians during chemotherapy. In looking at patients this way, Anguish, frustration, and reverence are Abram said, physicians will be able to all felt by the patient toward his physi- determine how much information they cian, he said, pointing out that, in time, can give the patient, whether or not especially with diagnosis of a disease that the patient has the "instinct and will to can be fatal, patients begin to scrutinize fight to survive," and if the patient is the doctor's every word and nuance. realistically facing the severity of his ill"I remember the anxiety of sitting by ness, he added. the phone waiting to hear the results of The historical and technological my bone marrow from my hematologi t. changes that have taken place in I would sit by the phone and think, medicine since 1846, when the UB 'Why hasn't he called? What's wrong?' medical school was established, have Finally he called and he said, 'The bone affected the doctor-patient relationmarrow looks good.' I said, 'What does ship, Abram said. that mean? Does it mean it doe n't look The first hundred years were marked great?'" Abram added with emotion. by a small arsenal of treatments, and The speaker recounted the story of a bedside manner was sometimes the best learned physician, who, through the medicine, Abram said. Technology has AUTUMN 1990 moved ahead in leaps and bounds, but to orne extent it has caused the physician to focus on body parts rather than look at the whole human being. Abram referred to some of the frustrations today's physicians face - the increasing risk of malpractice, bureaucratic red tape, immense amounts of information to be absorbed - all of which result in le time for patient interaction. There is precious little time for "rumination about the symbiosis between the healer and healed" in the cour e of medical training today and among practicing doctors, Abram said. But he urged the new physicians to listen and study their patients, not just from a biomedical standpoint, but also from an emotional one. Abram told the audience that during hi bout with leukemia, he was under the care of James E Holland, M.D., former chief of medicine at Roswell Park Memorial Institute and former director of Roswell Park's Cancer Clinical Research Center. Holland, who wa also research professor of medicine at UB, is now at Mt. Sinai School of Medicine and Hospital in New York City where BUFFALO PHYSICIA AND BIOMEDICAL SCIENTIST �29 he is professor of medicine, chief of the Division of Medical Oncology, and director of the Cancer Center. A lawyer by training, Abram is a man of many accomplishmen ts, said John Naughton, M.D., vice president for clinical affairs and dean of the UB medical school, who introduced the speaker. Abram is a Rhodes scholar, a former president of the United Jewish Appeal, and has served on state, local, and in ternational commissions including a presidential-appo in ted committee examining medical ethics. This year's commencement was highlighted by the graduation of the medical school's first M.D./Ph.D candidate, Edwin Heidelberger. The first graduates of UB's Early Assurance Prog ram, which allows qualified students to apply early, also crossed the threshold from e student to resident. - By David Himmelgreen Richard Condit, Ph.D., associate professor of biochemistry, listens thoughtfully. Dennis Nadler, M.D., associate dean, witnesses the signing of the Book of Physicians by Constantine Petrochko. BUFFALO PHYSICIA AND BIOMEDICAL SCIENTIST AUTUMN 1990 �30 a Martha Pierre, left, shares her exciting news with Shiau-Wen Pien and Jase Rivera. 89°/o GET ToP CHOICE AT 'BEST' MATCH DAY T hey streamed through the doors of Butler Auditorium like the ancient Hebrews making their way through the parted waters of the Red Sea. Some had bottles of champagne, others had babies and spouses. They were all buddies who just completed four years of training in quest of becoming fine physicians. And now they were about to embark on another journey. March 21 was Match Day, the annual event held at medical schools across the country where fourth-year students find out where they'll spend their residencies. The UB students had to wait through the announcements - yearbooks, graduation speaker, and in tructions on how to sign the alumni scroll - before they would get those coveted envelopes telling them where they would be going. AUTUM 1990 Then they waited some more as Dennis Nadler, associate dean for curricular and academic affairs for the medical school and director of the office of medical education, reported on the statistics. The tension was mounting. There were 141 students who participared in this year's match, said Nadler. It was the best year since 1979, when Nadler first began keeping records. This year 67 percent of the students got their first choice, up 2 percent from last year, said Nadler. And another record was broken with a whopping 89 percent of the students getting one of their top three choices. (Five students didn't enter the match: one was a military match, one was a student in the Medical Scientist Training Program who began a residency in January, one chose graduate study in physiology, one accepted a part-time position in Vermont, and one got a position after the match.) The applause thundered through the auditorium as the students realized just how good a class they were. UB students are going to some of the best and most highly competitive residency programs in the country. Nadler exclaimed that UB finally cracked the prestigious residency program at Massachusetts General in Boston. He added that UB is also sending students to other top-notch programs such as Duke and Johns Hopkins. But Nadler had to make the students squirm just a little more. As he clenched the envelopes that would tell them of their fate, he said with a grin, "I made an effort to randomize them." The students booed as if they just saw a Bills player drop a pass. Then, one-by-one, they came up, some with trepidation, but many with beaming smiles splashed across their faces, to get the sacred envelopes. Cheers broke out and champagne corks flew through the air. There were plenty of hugs, smiles, and celebrations. "I got my first choice - Syracuse," said Anthony Navone, a medical student, who added that "after five years and $75,000 it was all worth it." Heidi DeBlock, another student, who brought along her husband Scott and daughter Alexandra, was ecstatic that she was going to Rochester, her first choice. Ralph Augustini, who's a glutton for cold weather, will be spending the next several years at the University of Michigan. He was full of good cheer and drenched with champagne and kisses from well-wishers. "I just want to congratulate all of my classmates," he said. Nadler summed it up: "We have a strong class. We did well, exceptionally w~ll. It was an impressive result especially because the competition is getting tighter every year." e - By David Himmelgreen BUFFALO PHYSICIA A D BIOMEDICAL SCIE TIST �0 " 31 Dr. Herz Goes to Washington UB psychiatry chair tightens up mental health grants BY LOIS BAKER A stint as a senior science advisor at the National Institute of Mental Health (NIMH) has given a UB professor new perspective on the workings of Washington bureaucracy. Marvin I. Herz, M.D., professor and chair of the Department of Psychiatry at UB's School of Medicine and Biomedical Sciences, spent September through December at the NIMH as advisor to the director, Lewis Judd. He found the work in Washington interesting, but prefers to be closer to the front lines. "I got a close look at how the federal bureaucracy works," said Herz, "and I enjoyed meeting people and exchanging ideas. But it's much more rewarding to be in a setting where you can actually work with patients, actively direct their care, and do the research. "These people administer programs that other people do. They don't work with patients, students or faculty. They are far away from where the action is." Herz was invited to NIMH headquarters in Washington, D.C., for work with the Division of Education and Service Systems Liaison because of his expertise. He is one of the few physicians in the United States who has devoted his career to researching new treatments for schizophrenia and other serious mental illnesses. BUFFALO PHYSIC IA AND BIOMEDICAL SCIE TIST "I got a close look at how the federal bureaucracy works , but it's much more rewarding to be in a setting where you can actually work with patients. " Herz's mission was to bring a more scientific orientation to the division's projects.The largest task of this division is to fund clinical trials that try to find more effective ways to treat seriously mentally ill children and adults. The funding is channeled through state Departments of Mental Health. "The problem in the past with these demonstration projects has been that they were never scientific enough to be reported in the literature so they could be replicated," said Herz. One grant that Herz reviewed was an extension of some of his own previous work. It proposed to study schizophrenic patients and the benefits of intervening in their treatment at the first signs of relapse. Herz said that traditionally, professionals treating schizophrenics tum to crisis counseling for the family and an increase in medication for the patient only after the patient has suffered a full relapse which usually sends the patient to the hospital. "When early signs of relapse appear, several days or a week usually pass before the episode progresses to full relapse," Herz said. "By intervening early we expect a decrease in hospitalization as well as less family burden and improved functioning of the patient." Herz said, "My job was to tighten up the demonstration grants - define the population, give a clear description of the grant's intention, make sure they were using randomized control studies, if possible, and valid and reliable instruments to register change. "In the past they couldn't describe what was actually done because the results weren't clear." He also advised the demonstration project staff on ways to treat seriously mentally ill patients, and helped sharpAUTUMN 1990 �0 v 32 PoRTIN Is PRESIDENT OF MEDICAL ALUMNI B ertram A. Portin, M.D. '53, has been elected to a one-year term as president of the UB Medical Alumni Association. edra J. Harrison, M.D. '77, was elected vice president, and Donald P. Copley, M.D. '70, was elected treasurer. Portin, a colon and rectal surgeon, is a UB clinical professor of surgery and chairman of the division of colon and rectal surgery in the Department of Surgery. Certified by the American Board of Surgery and American Board of Colon and Rectal Surgery, Portin is an attending surgeon and chair of the Division of Colon and Rectal Surgery at Buffalo General Hospital. Harrison, a general surgeon, is a clinical instructor of surgery at UB. Copley is a clinical professor of medicine in UB's Department of Cardiology. e Robert M. Barone, M.D., a general surgeon, has been elected president of Millard Fillmore Hospitals' voting medi~ cal staff for 1990-92. Barone is a clinical ~ assistant professor of surgery at UB. e § Q Sister Angela Bontempo, pre ident of Marvin I. Herz, M.D. en the focus of training programs for psychiatrist , social workers and other mental health professionals. He continue to serve a a consultant to the institute. Herz developed an interest in treating serious mental illness during his directorship of the inpatient unit of New York City's Montefiore Hospital from 1961-1963. He later spent 12 years as director of community p ychiatric programs at Columbia College of Physicians and Surgeon and New York ::W.iiiiiiliiiiiiiiiiiiliiiiiiiiiiliiol State Psychiatric Institute. In addition to his UB position, Herz currently i director of psychiatry at the Erie County Medical Center and Buffalo General Hospital, as well as consultant at the VA Medical Center. He was elected recently to the Board of Regents of the American College of Psychiatry. Herz's research has earned accolades in the past. In 1988 he received the American Psychiatric Association's Psychiatric Institute of America Foundation Award for Hospital Research. e ~ Sisters Hospital, has been appointed to the state's Public Health Council. The 14-member council advises the State Commissioner of Health and considers matters relating to the preservation and improvement of public health. e Gregory Branch was one of 10 medical students nation -wide to receive a Metropolitan Life Foundation Award for academic excellence in medicine. The honor includes a 2,500 tipend. He· is now a fourth-year student. e Kandala Chary, M.D., has been elected pre ident of the Sisters Hospital medi- AUTUMN 1990 BUFFALO PHYSICIA AND BIOMEDICAL SCIENTIST �0 ' 33 cal staff. Chary is a clinical instructor in medicine and otolaryngology at UB and has served as president of the Asian American Physicians Association. e 1918fLU EPIDEMICGRAD WAS THERE Thomas J. Dougherty, Ph.D., director of radiation biology at Roswell Park Cancer Institute and associate professor of pathology and radiobiology at UB, received the Gustavus John Esselsen Award for Chemistry in the Public Interest. Dougherty was recognized for his research leading to the development of photodynamic therapy (PDT), a potential new approach to the treatment of certain types of cancer. The award was presented at the annual meeting of the American Chemical Society in April. e Leonard G. Feld, M.D., Ph.D, associate professor of pediatrics and physiology at UB, has been elected to the American Physiological Society. Feld is also chief of the Division of Nephrology at Children's Hospital and director of the Children's Kidney Center of Buffalo, which is located at the hospital. He recently received a $96,600 grant from the Juvenile Diabetes Foundation International to study the long-term effect of the drug aminoguanidine, which will be used to prevent glucose from damaging the membranes within the kidney. e John Naughton, M.D., dean of the medical school and vice president for clinical affairs at UB, has been named Physician of the Year in Academic Medicine by the alumni association of the University of Oklahoma College of Medicine, where he received his medical degree in 1958. aughton was cited for "outstanding contributions and leadership in furthering scholarship, administration and research." e BUFFALO PHYSICIA AND BIOMEDICAL SCIE TIST John D. Pigott, M.D. John D. Pigott, M.D., a specialist in congenital cardiac surgery, has been appointed chief of the Division of Cardiovascular Surgery at Children's Hospital and associate professor of surgery at UB. With this appointment, Buffalo is now offering state-of-the-art heart therapy for children that is not available elsewhere in the state. Pigott had been a cardiac surgeon at the Children's Hospital of Philadelphia. e James J. Reidy, M.D., has been named director and chief-of-service for the cornea service in the Department of Ophthalmology at UB. e John P. Visco, M.D., a cardiologist at Buffalo General Hospital, has been elected president of the hospital's medical staff for 1990. Visco is also a clinical assistant professor of medicine at UB. e Gentlemen: Thank you, sincerely, for publishing the article, "Flu," written by Deborah Brunch Bucki, R.N., M.S. It sure brought back many memories of my early life in Buffalo. 'I was there,' so to speak. In the fall of 1918, I was a member of the senior class, South Park High School. I became ill at school and was excused. I walked home a distance of one-half mile. On arrival home, my mother took my temperature - it was 104. It was diagnosed as influenza and I recovered after one week- no complications. I graduated from the University of Buffalo Medical School in 1925 interned at the Buffalo City Hospitai and remained there 20 years (1925-194 5), except for a two-year period in the mid-1930s when I attended the Johns Hopkins School of Public Health where I was granted the degree of Doctor of Public Health (D.P.H.). I succeeded Dr. Walter S. Goodale on his death in 1941 as superintendent of the City Hospital and professor and head of the Department of Preventive Medicine at the University of Buffalo. All of the doctors mentioned in the article: Goodale, Fronczak, Gram, Cott, Meyer, Sherman and Jacobson, were friends of mine - great men, all of them. I departed from Buffalo in 1945 and for the next 21 years served as superintendent of the New York State Masonic Home and Hospital, in Utica, N.Y. I retired in 1966 and since then have lived in "God's Country," the foothills of the Adirondacks at Woodgate, N.Y. I was 89 years of age in August and enjoy good health. William T. Clark, M.D., D.P.H. AUTUMN 1990 �0 ' 34 most advanced in the world. It features a unique environmental chamber which simulates the equivalent of depths of 5,600 feet beneath the sea or 100,000 feet in altitude. It also includes a centrifuge capable of simulating up to 10 "Gs" or gravities and a submersion basin which provides underwater observation of subjects against specified rates of currents. HERMANN RAHN DIES; PHYSIOLOGY PIONEER LooKED To SKIES, SEAS H ermann Rahn, Ph.D., whose pioneering research in environmental physiology helped provide the foundation for today's aerospace and undersea medicine, died June 23 after a brief illness. He was 77. Leon Farhi, M.D., chairman of UB's Department of Physiology, has noted that while environmental physiology was on the books for a long time, it really blossomed in the early 1940s when Hermann Rahn made his contributions to the field. Rahn, distinguished professor of physiology at UB, served as chairman of the Department of Physiology at the medical school from 1956 to 1973. A native of Michigan, Rahn received an A.B. degree from Cornell in 1933 and a Ph.D. degree from the University of Rochester five years later. Joining the UR faculty after teaching briefly at the University of Wyoming and spending a year as a fellow at Harvard, Rahn, with his colleagues, conducted research which benefited Allied pilots and soldiers in World War II. The Rochester team assisted the U.S. Army in determining the amount of water and other essentials needed for desert survival prior to the landing of U.S. troops in North Africa. Later, the researchers used a converted brewery tank as a primitive altitude chamber to study hypoxia, which caused pilots to lose consciousness at high altitudes. Although he officially retired in 1985, Rahn continued to put in six-day workweeks in his lab until shortly before his death. His research in comparative respiratory physiology involved work with eggs ranging from those of the ostrich to the hummingbird. During 15 years of research in this field, he served as a consultant to the poultry indu try and to those interested in the field he founded, incubation physiology. AUTUM 1990 Hermann Rahn, Ph.D. Although Rahn's scientific interests spanned a range of subjects within biology, his primary interests were comparative physiology and pulmonary physiology, in which man or animals adapt and interact with different environments. Basic knowledge he provided in this area advanced the understanding of lung dysfunction in patients with pulmonary diseases. For this work, he received the American Lung Association's prestigious Trudeau Medal. A device he invented led to development of the self-guided cardiac catheter used today in diagnosis of cardiovascular problems. Rahn's vision, enthusiasm and determination helped build UB's Department of Physiology into an international center for environmental physiology. The Hermann Rahn Laboratory, housed in the UB Center for Research in Special Environments, is one of the Rahn's research earned him many honors, including the U.S. Air Force's Meritorious Civilian Service Award, the highest given a civilian; election to the prestigious National Academy of Sciences and the American Academy of Arts and Sciences; and honorary degrees from the Universities of Rochester, Bern (Switzerland), Paris, and Seoul (Korea). He was the first recipient of the Under-Sea Medical Society's top honor, the Benke Award. During his career, Rahn had been a visiting professor at several institutes abroad and was a president of the American Physiological Society and vice president of the International Union of Physiological Sciences. He was the author of more than 200 scientific articles and four major texts. A dedicated teacher as well as a researcher, Rahn inspired many graduate students and fellows who studied with him at UB to follow successful careers in physiology. A Hermann Rahn Memorial Fund has been established and contributions may be sent to the Department of Physiology, 124 Sherman Hall, University at Buffalo, Buffalo, N.Y. 14214. e BUFFALO PHYSICIAN A 0 BIOMEDICAL SCIENTIST �35 1940., Stanley L. Olinick '40 :l> writes that his busy schedule includes a half-time practice, teaching, writing, friends, tennis and music. Anthony M. Aquilina '44 :l> of Amherst, N .Y., was elected president of the Baccilli Medical Club for 1990. William D. Loeser '45 :l> is now retired from private practice. "! work part time for a nursing home ... love it!" Albert J. Rosso '45 :l> writes, "My wife of 41 years and I have eight wonderful children and 16 fine grandchildren." David J. Shaheen '45 )> retired in 1986 and is now living in Titusville, Fla. Jacob M. Steinhart '45 :l> of Clarence, N.Y., writes, "Still enjoying the private practice of pediatrics, but in a six-man group!" Gilbert B. Tybring '45 :l> who has been retired for five years, edits the Wisconsin Psychiatrist. Vernon G. mith '48 :l> of Orchard Park, N.Y., retired from his private practice in pathology in 1987 due to a severe fracture of the right femur. Max A . Schneider '49 :l> who is known internationally for his work in the field of addiction medicine, was recently appointed an associate clinical professor of psychiatry at the University of California College of Medicine at Irvine. Henry A. Thiede '49 :l> appears in the videotape "The History of Certification in Emergency Medicine" produced by the American Board of Emergency Medicine. This tape was made to celebrate the recognition of emergency medicine as a specialty and to commemorate the individuals involved in the history of certification. Robert Benninger '50 :l> is now retired and enjoying life in Cape Coral, Fla. George P. Bisgeier '50 :l> former medical director of New Jersey Bell, is semi-retired and doing part-time occupational medicine. Karl L. Manders '50 :l> of Indianapolis, Ind., recently published "Indications for Surgery in Back Pain" in Seminars in Neurology. In addition to his practice in neurosurgery, he continues as medical director of the Community Hospital Rehabilitation Center for Pain. Dr. Manders is currently president of the Midwest Pain Society. Ernest H. Meese '54 :l> was elected president of the board of trustees of the American Cancer Society Ohio Division. He has been a volunteer with the Cancer Society for 26 years. Dr. Meese has a private practice of thoracic and cardiovascular surgery in Cincinnati and is an assistant clinical professor of surgery at the University of Cincinnati Medical Center. Milton Alter '55 :l> left his position as chairman of neurology at Temple University and is now professor of neurology and director of the residency training program at the Medical College of Pennsylvania. He holds an NIH grant to study the epidemiology of strokes and was BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST recently awarded a supplemental grant to study risk factors for recurrent strokes. George L. Mye Jr. '55 :l> of Yelm, Wash., retired in July from general surgery and a partnership in a Southern California Permanente Medical Group. David L. Palmerton '55 :l> of Clarence, N.Y., writes, "! retired six years ago, but I am into starting up home health care agencies in Florida and Virginia." Jerome P. Kassirer '57 :l> the Sara Murray Jordan Professor of Medicine at Tufts University School of Medicine in Boston, has been elected to the Board of Regents of the American College of Physicians. He began a threeyear term in April. Daniel C. Kozera '59 :l> a clinical assistant professor at UB, is acting chief of ob/gyn at Mercy Hospital and a consultant for ob/gyn to the Erie County and New York State Health Departments. 1960.\ Franklin Glockner '60 :l> is now working full time in the Division of Orthopaedic Surgery at Albany Medical College and is chief of orthopaedic surgery at the VA Hospital. Edwin R . Lamm '60 )> was elected president of the medical staff at Lakeland Regional Medical Center in Lakeland, Fla. Eugene T. Partridge '60 :l> of Buffalo has 12 grandchildren and is expecting more. Joseph A. Chazan '60 :l> director of the Division of Renal Diseases at Rhode Island Hospital and associate clinical professor of medicine at Brown University, took office in April as governor for the Rhode Island chapter of the American College of Physicians. Jeffrey E. Lindenbaum '66 :l> has been appointed clinical director of a new joint venture adolescent medicine program with Children's Hospital and Medical Center in Seattle, Wash. Stephen E. Langer '67 )> of Berkeley, Calif., is medical editor of the National Examiner. His column reaches 6 million people per week. Dr. Langer is currently president of the American Nutritional Medical Association. John E. Shields '68 :l> is a consultant at the Seafield Alcohol Treatment Center in Westhampton Beach, N.Y. 1970s Jan Novak '70 :l> has been reelected president of the medicaldental staff of the Erie County Medical Center. He is an attending in medicine and heads the gastroenterology unit of the hospital. Kenneth Solomon '71 :l> associate professor in the Division of Geriatric Psychiatry at St. Louis University School of Medicine, presented at the Department of Psychiatry Grand Rounds at the Erie County Medical Center and the VA Medical Center in Buffalo April 20. Patricia K. Duffner '72 :l> has been elected president of Children's Hospital medical staff, the first woman elected to AUTUMN 1990 �36 the post. A professor of neurology and associate professor of pediatrics at UB, she has coauthored a book with Michael Cohen, M.D., on brain tumors in children. past 11/z years she has also been involved in public sector work. Dr. Turner has 2 sons, 5 1/z years and 2 years. Her husband, Alan, is a member of the Dallas Symphony. Arthur W. Mruczek '73 > has been appointed director of the contact lens service at the Erie County Medical Center. The service will include therapeutic as well as co metic contact len es. Mark Chung '82 > writes, "I am a practicing pulmonologist at Los Alamitos, Calif., having graduated from Harbor-UCLA training program, and have been appointed lieutenant commander with the U. . Naval Reserve." Nancy H . Nielsen '76 > has been named to the State University of New York Board of Trustees. A clinical assistant professor of medicine at UB, Niel en practices medicine with the Buffalo Medical Group. She is a medical consultant to the bacteriology laboratory of the Buffalo General Hospital and is a delegate to the New York State Medical Society. Niel en wa the first woman president of the Erie County Medical Society. A member of the board for Professional Medical Conduct, ew York tate Department of Health, Niel en i a longstanding volunteer for the Buffalo and Erie County YMCA. 1n 198 7, she received the Outstanding Achievement Award from UB's Community Advisory Council. Angelo Del Bal o '78 > is the author of an 800-page text for physicians and dentists called Maxillofacial Imaging. It describes imaging techniques used to detect and identify diseases and di orders of the head and neck area. An associate professor in UB's Department of Radiology, Del Balso is also the author of Panoramic Radiography, published Ia t year. AUTUMN 1990 Patricia K. DuHner '72 1980.~ Mark . Borer '80 > is starting a new organization "P.E.A.C.H.," People Educating and Advocating for Children. Robert Braco '80 > will receive an M.P.H. degree in May from the University of Texa School of Public Health in an Antonio. Katherine Jasnosz DeCaria '80 > write "My hu band Anthony and I are the proud parents of Daniel Joseph, born on Sept. 15, 1989." Dr. DeCaria is a forensic pathologist with the Allegheny (Pennsylvania) County Coroner's Office. Walter iemian '80 > is certified by the American Board of Pia tic Surgery, and is now an active member of the American Society of Pia tic and Reconstructive urgeons. Sylvia Turner '80 > of Dallas has a private practice in child and infant p ychiatry. For the Albert Speach '82 > is currently assistant professor in the division of otolaryngology at the University of Kentucky. Jo Ann Pravata Pullen '83 > and her husband, William Pullen, M.D., are the proud parents of William icolas Pullen, born Oct. 14, 1989. William is in private practice in internal medicine and endocrinology in Santa Monica, Calif.; Jo Ann practices medicine at Cigna Health Plans in Los Angeles. Mark C. Steckel '84 > is a clinical instructor in ophthalmology at New York Medical College, and director of pediatric ophthalmology and strabismus at the Metropolitan Hospital of New York, N.Y. In addition to his academic positions, he has a practice in adult and pediatric ophthalmology at 4699 Main Sr. in Bridgeport, Conn. Deidre J. Greene '86 > of Pennsylvania writes, "My husband, Rob Dixon, and I jojned ABC Pediatrics last July in Allentown. We also now have a beautiful son, Patrick, born in October." Janice J. Pegels '86 > write , "Married James Jewell, M.D. on June 10, 1989; enjoying the lake and mountain view from our home in Seattle." James J. Shaughnessy '86 > writes, "I'm living in rural Massachusetts and commuting to Providence for a two-year fellowship in child and adolescent psychiatry. Dale Radka '86 is in the same program." Jill E. Koehler '87 > announces the birth of her son, Alejandro Daniel MarenoKoehler. Dr. Koehler is chief pediatric resident at Hurley Medical Center in Flint, Mich. Obituaries Mitchell!. Rubin, M.D., a kidney specialist instrumental in the development of Children's Hospital as a modem medical center, died April11, 1990 in Charleston, S.C. after a long illness. Rubin, 88, a teacher, clinician, re earcher and pediatrician, was well known for his work in pediatric nephrology. He was a professor and former chairman of the Department of Pediatrics at UB. Pediatrician-in-chief for Children's, he retired in 1972 after 27 years of service. After retirement, he returned to his native Charleston, joining the Medical University of South Carolina, where he established the Division of Pediatric Nephrology. The author of Pediatric Nephrology, Rubin published more than 70 articles in professional journals. He belonged to 14 professional societies. BUFFALO PHYSICIA AND BIOMEDICAL SCIE TIST ��Buffalo Physician and Biomedical Scientist State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 Address Corredion Requested Non-Profir Org. U.S. Posrage PAID Buffalo, NY Permir No. 311 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Autumn 1990 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1990-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v24n02-1990-Autumn Table Of Contents A list of subunits of the resource. Research. Mommy track? Cutting red tape Rubbish Medical school news People Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-12 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v24n02 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1990 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/a14d1a5b2686ae6df94b63e41b3a9872.pdf 34b832c7ebf16b2c680afb2b1ec4d17a PDF Text Text \ol. 24, !'-:u.I PINS & . NEEDLES / ._ NEEDLES & PINS· · .: ___,e----- • • • • . . ' . . ,. . . .. .,_ . �::,,,\I I ()IRH'TOROF rt llUl <\TillN', DearFriends: Nann Tol•n T he current ,.,,,uc of the Ph'ljs1cranmc.luJcs ,m .,mdc det,111 mi: the <,1rccr ,uu:e,~ ot three ,1lumnt ,, ho ,ire me<l1c.,1l <c.hool de n<. M mh 111A. Ltc.hrm n, M D '60 at the Um, er,11\ of Rol.hNtcr, Eui:n1e M '-1i:m m. M () •i;z at tht· Um,ersll\ of Conncd1cu1, ,md F-r.mklyn G. Knox, M.n., Ph.D. '65 di rlw M,1\0 Ml.'d1, ,I -.;._hool L'B l'rNrdcm "11.'H'll R. unplc h.i, rbccJ .i m 11orcmph "' on reuunment , t faLuh, ,, uh rec.ord, , f Mgnthc.mt ,Khre\C mcm Also., p,m of 1h.11t,ISk is the de,elupmt'nt 111mdr\"lduab who rcpn·wm Buftal1),II ,>1hcrqualny m,111u1101iThe thrtt mdr, ,duals pr. filed m<lccJ rc.-presem the be,1 m tC"rm<uf J'C'r.<n 1I md pr< fc ,ron 1I , ,luL,, wrecr pr,>ducu, II\ ,md ,1ch1e,cmC"nt,.mJ (,....,1du,h1pskill-. Oi each \\C"<hould not only take i:re,11pndC",hur IH' should cxpre.,,, to th C"m,iur hc.rrt• tel1 gramudc tor commntmi: their hH"li tu purp<™-"li "c ,1l1hold so dear EPIT\ R C.inn1c (.),,.JIJ 'I ,tl ART DIRECTOR AbnJ Kr,:lcr \\ RITI RS D.i, iJ I limmcli:rttro Anhur r'I:'" Jdtm. Tr,M, "U<'\luctchn r1tun X,RAl'I lERS l'ld·hcHu >- n l..,. Rot...-rt'iJ. 10n AO\'J-.;()RY BO .\RD Dr John N ,u •hhm, l h.:unnan Dr II ,IJ Br~ ~b. """''(,I«' Dr J K.nd, Dr J,...,,h L Kur Dr Ch irk r, mdl, M• I Jul () l'dl<n<•n Dr !\nt It< rcren Dr ( hark, rnrr Dr Luther R >hn ,n Dr Tl1011u,Ru,cnth.il Dr :,,.,Jccb"ur<>h Dr Run n "•~nn.m Dr "r<f'hm "f<'ulJ, John :-.au ght on, ~t.D . Dr l'-cl "' Tom, Mr EJ,. rJ 'iJ.cn,lc \'rec l'rts1d..•mfarClinu-alAffa," Dean, Schoolof i\fofu.11\t' ,md B1omcdic.1/S,,cncts Dr J.-r.....,YJ10 T~\ C lll:-.;G Hl ) '-l'ITA ~ ,\:,;() l.lc\l~O:-;s BarI\ ,a\ A Medic.ii Center Buffilo Umcral lfo,rn l \like \hau Buff k \ !\ ~lahc.il C.cnm I Pu l1i IJrm H..--..rirI K4r Ory '>t. E.rc C ty McJ I ( .enter Manon"-lamnou-,,_, M, rev llo,pnal, C.hu.k r,bw M,llarJ f, !more II r11al,J ""f'h R uffa R ,.,. II r: rl C: nccr In lute /,J,, /uo:c, m Ht,,r11al M.{.anfn Pr .lu«J i....w f\nuan of l 111h-ntt'f Rd.:J k11M>R141rh W XMuf of \ltd, ..mt nd IU,r\S ffl "-"'" l'nil ~ "' Tl II' Bl ff ALO rHhlC.1AN A?-.l) BIO MEDICAL SCIENTIST (USPS m MO) SrrinK 1990, \, 1 umc 24 Numl,cr I PuM ,hcJ '"" tum, nnu;,11, '-rnlll: Summer Atrt n. Luh- \l mr.-r, ,mJ Late \l ,nrcr I') rhc Sc -. I 111M<J1emc anJ B1omcd1ol x,cnc , S1,1c l nl\et>II) f Ne,. ,.,,l II llufl I. • l4}5 M 1nSrr«r Rull lo, Ne,. h-.,l 14214 ThuJ hull r< 1 raiJ II Bufr lo, c• Yorl s.-nJ ,Jdu ,hant< 1 THE BLFFAl(l rmsll lAN AN[) BIOMEOIC'AL S<.1 D.'Tl'-T, 146<~ AJ.lmon. 1415~bin "-trn-t Buff rt l ◄Zl4 cu i-;..,.,' DearColleagues: I I \\ould lakC"to ,h re "uh }OU ex1..crp1, from I IC"ttfr "c r«cl\cd from I m1.'tll~r, t the i:raJuJtmg c.Li, th,mkmi: us tor the -.cnrur rcc1.-p11on "Dc,t r nwmhi:r, ,if tlw ,1!11111111 .i,,oc 1,1t1110 "As stu<l1.·nt,,... 11e le 1mmg th 11 1p1rt from the obi IOU' furu:.11n,, f kecpmi: tr.id, ,,t waJua1~ md org.m,:mg reunion< our ,1lumnt ,ire trul\ mtcrcstcJ m the ,tud1.-nL, mJ the ,;chool 11,clt ~I.mi ,1lumrn ,1ss,x1,111o n, 1h,11111.• h,11·e ,,h,cn c<l m rhC" p,1 I nnohe them,,che, m m.11m.11nmi:the rcput 1110nof 1hc1r alma m llt'1' h\ m ,kmi: ml•ne1,11; Jon 1110n, to the ~hool md c-.1,1hlt,hmi: ,m 'olJ h.,) ncl\\Ork' for gr,1duates. \Vh1le 1he-e ue clfecme mJ o.ll.'-ept.IMCmethoJs, " our lumm h,tH dim.en to h.• more J1redh 1mohl..J. "Through the -.enior rccepttun, the ~pnng Clmrc. ,I n.i, an,1 m,m\ oth,•r ,1lumnt ,1ff 1rs, \OU h,1H· set ,m ex mple for u, ot hlm our ,,lumnr .1ssoc1a11unc.m be "hen 11c..ircs to go furthl·r th1n tht· 1r,1d111on,1,ICU\ I 11,e,. 'wur J<.11\CpnJc ,md concern c.h1llenge, u< to hcconw 11:u,e ,1lun1111 .md contmuc 10 ,!um the s..hool .md the communn, \,h.11 "1mport,mt 10 rh,,1u.in, ,,ho gr Juatc from 1hr, s..hool" ( !,'UCSS thts ~1y, II .ill &-...1",~hes to the ( •1.1.,,, ol '90 .ind to ,111rhc ,1lumnt/,1c .ir,· ,/ <.·ordialh u~LK ::.u Pusidenr, 1',itdirolAlmmuAssoc1a1on �Vol. 24, No. I Srrmg 1990 Research briefs.Sodium and stomach cancer; elderly blacks need more health care; soaking in the tub; healthy wheelchair ; active endothelium. Onpinsandneedles.It's not until everything else Pinpointingpain relief, page6. has failed to relieve their pain that patients tum to acupuncture and UB's June Oh, M.D. Theboywholiveda miracle . No one had ever recovered from such an injury. But Brian Fitzpatrick, a 1986 graduate of the UB medical school who helped treat the boy, was able to see him walk out of the hospital. Microscopes to microchips. From practicing diagnoses The caseof ihe "miracleboy," page 12. to recognizing heart murmurs, computers have emerged as the UB medical schoo l's newest teaching tool. Moreresearch . A major study suggests that olive oil is more "heart smart" than butter and another project investigates temporary shelters for the homeless made of corrugated cardboard. Talentintriplicate. UB boasts three alumni who are currently medical school deans. Take a glimpse at their careers and their recollections of UB. Alumni. A member of the Class of 1971 honors a teacher through a gift to the UB medical school and two members of the Class of 1930 are remembered through gifts. Computers:the UB medical school'snewest teaching tool, page 18. Classnotes . Cover:Illustration by John Ripa UB boasts three alumni who are medicalschooldeans, page26. �--- :® :---.r E t. ~ 2 ·,., •...,1t1;':-ii SODIUM INTHEDIET MAYINCREASE THERISK OFSTOMACH CANCER t's prohably not good fnr your heart, and now 1t looks like higher levels of sodium m the diet mcrease the risk of gastric, or stomach, cancer, according to a ~tudy by researchers al UB. They found a dose-response increase in risk for men and women related to sodium, as well as related to fat and retinol, a form of Vitamin A. Puhlbhed in Nutrition and Cancer, the study of diet in the ep idemiology of gastric cancer was conducted by Saxon Graham, Ph.D., professor and chair of the UB Department of Social and Preventive Medicine, and colleagues. Based on extensive interviews with 293 patients with gastric cancer and carefully-malched controls, It showed "suhstantial reductions in ri,k were associated w1th 111gest1on of carotene ... as well as with increased use of low-temrerature food storage." Vegetables, some nf them rich 1n carotene, identified by the UB researchers as decreasing nsk were celery, cucumhers, carrots, green peprers, tomatoes and oniom. Noting that the incidence of gastric cancer has dropped "drastically" in recent yean., the re-earchers sa1J "the promulgation nf preventive medicine recommendation.-,is less urgent than formerly. "Certamly, however, limiting caloric intake, especially fat, limiting sodium, and increasing intake of vegetables, particularly those containing carotene, are suggested as steps in the direction of inhihiting nsk of stomach cancer. The same may be said for use of refrigeration . "A number of other cancers, such as cancer of the colon and lung, as well as cardmvascular pathok1gies, might also be controlled by these dietary suggestions." The UB researchers found a doseresponse increase in nsk with increases in ingestion of total number of calories, as well as total carbohydrates, fats and protein. "Consistent wnh our finding of increased risk associated with fats and protem, was an incrt::ase in risk associated wirh increai-es in ingestion of meats," they said. The researchers also noted "a numher of high-search foods were associated with increased mk of gastric cancer, including potatoes, potato chips, french fries, pe;u;, nee and pasta." Graham said improvements in the refrigeration of food since the early 1900s may be a maior factor in the drop m gastric cancer. "Both refrigeration and carotene could inhibit oxidation products which could act as carcinogens 111 the stomach," the researchers noted. Other UB researchers participating in the study were Brenda P. Haughey, Ph.D.; James R. Marshall, Ph.D.; John R. Brasure; Maria A. Ziele:ny, Ph.D.; Jo L. Freudenheim, Ph.D., and James P. Nolan, M.D. Also authors of the paper were Dee West of the Bay Area Resource for Cancer Control in Alameda, Calif., and Gregg Wilkinson of the University of Texas School of Medicme at Gah·estnn. - B)· Anhur Page ELDERLY BLACKS HAVE GREATER NEEDS Bur GETLESS HEALTH CARE he elderly black residents of New York State receive far fewer health and social services than elderly whites, even though the blacks' needs are much greater, according to a landmark study by UB's Mult1disc1plinary Center on Aging. Conducted hy Arthur Cryns, Ph.D., professor of soCial work and senior research professor with the center, and Kevin M. Gorey, research assistant professor, the study was the first comprehensive attempt co examine the health and social needs of blacks acr~ the state. The researchers found: Black elderly people arc 4.5 times more "vulnerable" than elderly in the general population, with vulnerahility defined as having three or more unmet health or social service needs. Gorey said needs were simply the "necessit1es of daily living, ranging from transportation, housekeeping and food preparation among the social services, to the health care provided by a physician, hospital or nursmg home." 13.9 percent of elderly blacks are health care "dependent," compared to 8 percent of the elderly in the general population. The proportion of elderly blacks considered self-sufficient is less than one-half that found among the elderly �3 in the general population. Elderly blacks have only half of their social services needs met. Economic reasons were listed as the most potent factors explaining the variation in services among the elderly. "Medicaid does essennally what it was designed to do, but that means nothing for the near-poor, those severely impoverished but unable to meet the criteria for aid," Gorey explained. "Forty-six percent of tho e surveyed lived under the U.S. povert) line. Unfortunately, 26 percent are very close to the po\'erty line and can't meet expenses from their pocket." The study was funded by the New York African-American Institute, a component of the State University of New York established in 1986 to initiate, conduct and coordinate applied and historical research on blacks, especially New York State resi<lents. Japhet M. Zwana, Ph.D., director of research and special proiect for the institute, termed the study ""ery important" and hoped it would be applied co policy decisions addressing the disparity in ser\'ices. The study "demonstrates the magniwJe of the problem and confirms our worst fears," said Arthur Eve, deputy speaker of the New York State Assembly, who added chat he planned to hold public hearings on the issue. "The existing institutions are making a concerted effort. bur the minority community must <levclop our own support network," Eve said. "We must be empowered." He acknowledged the need for more black doctors within the black community, recommending more ,cholarsh1p money to thb end. "Above all, we need more resources and stronger institutiom," E"e said. "It's an unequal system." The study was based on responses to a lengthy questionnaire by 1,542 elderly blacks, 1,057in New York City and 485 in the upstate cities of Buffalo, Rochester, Syracuse, Albany and Binghamton. In most cases, the upstate participants were found to have greater unmet needs than those in New York City, a trend that may reflect the fact that more services are in place in the latter. - By JeffreyTrebb the body to excrete large amounts of water and salt and could he useful in treating people who have fluid retention disorders. For instance, in pregnant women with rnxemia, immersion has been found to lower blood pressure significantly and increase the excretion of salt and water without drugs that coul<l harm the fetus. 'That's the nice thing about immersion- 1r's not a pharmacological treatment," Krasney pointed out. As a person sits in a tub of water, the water preswre squeezes the blood from the legs up into the chest, until the volume of blood in the heart and lungs is coo high. How does the body adjust? It eventually tries to reduce the blood volume by getting rid of fluid through urination. "Water immersion produces a very profound and sustained diuresis," Krasney said. "If we didn't have kidneys, when we sat in water, our blood volume m the body would ri,e enormously." Da\'id Pendergast, Ed.D., professor of physiology, has shown that the response of the kidneys is reduced in athletes, particularly in swimmers, though it's not clear why. The body excretes fluid not only from the blood, bur from cells as well, Krasney belte,·es. A subject immersed for six hours excretes so much fluid, he'd have very little plasma left if all of the tluid came from the blood. Another indication that water is shifted from cells is the fact that people's skin gets wrinkled m water, he said, though the wrinkling coul<l be caused hy the temperature of the water or other reasons that aren't clear. "Our major area of interest i, why chi,; major fluid shift occurs and what implications H has for therapy," Krasney explained. SOAKING INA BATH WARMSPHYSIOLOGIST TOITSBENEFITS ince ancient Rome, people have touted the curative powers of a long, relaxing soak in the tuh. Now scientists are taking a second look at the medicinal properties of the bath in treating high blooJ pressure, inflammation of the kidney, cirrhosis of the liver, and toxemia during pregnancy. Data resulting from this renewed interest in "head-out water immersion," as scientists call 1t, was reviewed in September at the first international symposium on the topic. John Krasney, profe.ssorof physiology at UB, delivered the keynote lecture. Scientists are interested in heaJ-out water immersion, Krasney explained, because soaking in a rub of water causes �--- :(]}---.,. E ._ \. 4 There are probably ma1or shifo in blood flow patterns from one part of the body to another, he added. Krasney's immersion scudtes are pare of a program project from the National Institutes of Health called "Environment and Oxygenation: Delivery, 0iffw,ion, and Toxicity." The principal investigator is Suk Ki Hong, M.D., Ph.D., professor of physiology. The Physiology Department at UB abo uses water immersion in ocher ways: As a t0t)l for studying temperature regulat ion. As a way to study the effects of increased blood volume without actua lly adding fluid to the blood. § To simulate the weightlessness t JosephC.Moll endor f, Ph.D encountered by astronauts. Water immersion is also used in I physical therapy, Krasney noted, and more work should he done to understand how it may affect blood flow to injured muscles. II ealchy" wheelchairs chat do a "The whole area is exploding clinilot more than provide a cally," said Krasney. There are only means of mobility are the goal about 30 researchers in the world study- of UB researchers. ing head-out water immersion now, but Incorporating a patented system they he expects that there will be many developed that enabled a young paramore when a second symposium on the plegic to ride a tricycle, che prototype topic b held in Italy in 1991. wheelchairs being developed by the At the September symposium, researchers would exercise the muscles Krasney received an honorary life mem- of users' legs as well as strengthen their bership in the Doctor Richard Bright heart and lungs. Society, the group formed to perpetuate Wheelchair modifications being research in kidney disease that sponinvestigated by the UB team include :;ored the symposium. the addition of hand cranks and Ironically, the symposium was held in replacement of conventional footrests Bristol, England, co honor Bright, the with pedals. The wheelchair~ would be father of renal medicine. But Bright moved by a combination of the user didn't think very high ly of water operating the hand cranks and his feet immen,ion, noted Krasney. pushing on the pedals as a result of electrical stimulation of muscles in his legs. - By Connie OswaldStofko "This is a new concept to incorrorate exercise inw the normal daily activities of the wheelchair-hound person," ! I explained Frank C. Mendel, Ph.D., associate professor of anatomical sciences and founder of the UB Spinal Cord Injury Research Interest Group. "It would allow the paralyzed or weakened lower limbs to be exercised on a regular and habitual basis," he added. "Every time users move che wheelchairs, they would exercise their lower limbs. This would pump blood pooled in their lower legs upstream so the re would be less swelling of the legs. It also would move their joints so there would be less likelihood of decubitus ulcers forming." Turning the hand cranks and movement of the legs also would provide aerobic exercise strengthening the heart and lungs. Wh ile wheelchair users currently may derive such benefits from costly exercise devices, usually limited co hospitals or clinics, the system proposed by the UB researcher~ would provide them dunng routine activities in the home, at work and elsewhere. The work dates back to a discussion between Mendel and his accountant, father of a then 6-year-old girl who was confined to a wheelchair after her legs were paralyzed at age 3 . With hopes that she someday will walk again, her parents wanted co mamtain the integrity of the girl's leg muscles. The UB researchers' solution also provided a means to strengthen rhe youngster's heart and lungs and, literally, a vehicle for joining her siblings and friends for a spin around the block. They replaced the Big Wheel's handlebars with hand cranks synchronized with the tricycle's pedals using chains and cams. The trike was propelled by a combination of the youngster moving the hand cranks and her feet, held in stirrups, pushing on its pedals as a result HEALTHY' WHEELCHAIRS REALLY GETLEGS MOVING BLFF:\LO PHYSICIAi-.::\1'D lllL1\{Ei'IC\L !-CIE!-.Tlq �--- :CE} ---J'E,.q. s of electrical stimulation of two secs of muscles in the thigh of each leg. Electrical stimulation of the users' leg muscles is a key factor in the benefits derived from the modified trike and the wheelchairs envisioned by the UB researchers. "If we don't stimulate them, che lower limbs would simply go for a ride," Mendel explained. "They would get no exercise." ln addition to Mendel, members of che team are Dale R. Fish, Ph.D., U B associate professor of physical therapy and exercise science; William Tanski Jr., director of the UB Health Sciences Instrument a nd Fabrication Shop; Robert Kell, retired electrical engineer formerly with Calspan Corp.; Joseph C. Mollendorf, Ph.D., UB professor of mechanical and aerospace engi neering and Darold C. Wobschall, Ph.D., UB associate professor of electrical and computer engineering. The work is funded by grants from the New York Stare Science and Technology Foundation, Gaymar indust ries Inc. and Index Electronics Inc. - ByArchur Page Endothelium can respondto variousstimuli, notonlyas the productofinjury,as we havealwaysthought, but:alsoby undergoing 'activatwn . . ,' says RarnziS. Cotran, M .D. endoithelium. BLOOD VESSELS' LINING of Cocran is the Frank Burr DOESN 'TJUSTSITTHERE Professor of Pathology at the he endothelium isn't just a coat for the blood vessels, but is a very active protagonist, according to Ramzi S. Cocran, M.D., who delivered the fall Harrington Lecture at UB. Cocran is a recognized leader in the study of endothelium, which is the lining of the cavities of the heart, the blood vessels, lymph vessels, and other organs. With Guido Majno, M.D., he did pioneering studies on the structu re lll:FFALl ) rHY~lCl:\N ASD 810 \IEDI CAL :;... :tESTl~T Mallory Harvard Medical School and chairman of the Department of Pathology at Brigham and Women's Hospital, Boston. He and hi colleagues found that ''the endothelium must be doing something more than just sitting there as a passive bystander as was previously thought," Cocran said. Endothelium can respond to various stimuli, not only as the product of injury, as we ha\'e always thought, bur also by 1Jndergoing "activation." Endothelial acti\'ation means there are quantitati\'e changes in specific gene products which endow the endothelial cells with new o r altered capacities co perform specific functions. This is significant because the activated endothe lium can express new molecules that weren't expressed before on the surface. These newly expressed molecu les can influence: coagulation adhesion of blood cells co the organs, which can produce inflammation new antigens, especially antigens that can influence rejection in transplanted organs This endothelial activation occurs in the boJy as well as in cell cultures and may lead to vascular inju ry, Cocran said. Endothelial cells can be activated by cytokines, which are stimulating factors (such as for growth) that are released by cells in the immune system (such as lymphocytes) or by endothelial cells. Cocran focused on the cycokines interleukin- I, tumor necrosis factor (TNF), and gamma interferon. A member of the Institute of Medicine of the National Academy of Sciences, Cocran also is a past president of the American As:.ociation of Pathologists and on rhe board of trustees of the American Board of Pathology . He serves on the editorial boards of several medical journals, including the American Journal of Pathology. Dedicated co medical education as well as being a researcher, he is coauthor of a very popular medical pathology book, Pathologic Basis of Disease,which is used at UB and other medical bchools. - By Connie OswaldScofko FormoreResearch • seepage23 �6 and feeingnopain BY ANTHONY Cl I A'-if. ,rn1~(, 1990 c.:upunc111rl•\ ad\'1K·,11e, m,1,1 1hat 11 ,me rt.·ali:6 that nw,t of thc:,e patiench,1, bencfitted b11l1on, ,m1.e It \\a, ~cek Oh\ hdp onl} a, a la t rc-.ort. mtrl,duccd mnre th,1114,000 \e,1r, ago. "The,e pafll'llt ha\·e often heen to \Vhy, tlh·n, Jo "1 m,1ny A llll'ric.in man) doctor,," c:xpla1m Oh. "They'n• ph},ic1,m, remain shpt1c,1l of 11? "~1a}bcthe} feel that other science, h,1\"Cmm1.•de,n-cut prooh l>I hm\ thq work," ,uggc,ted Ju1\l' (Joung R,1) Oh, ~1.D. On the other hand, ,he ob-.:r. e,, "Once ( pl ,1c1 1 ) h,1\ e rcicrred a p.1t1ent, ,1nJ ,een g110J re,ult,, thq h:coml' nh1re c.:onhdult." Oh, as I tant professor of rl.'hab1l1ta• t n • 1.•d11. me at UB and ,mending phy,1cnn m rehah1l11,111onml·d1cine ,1t the Erie Count\' ~kd1c.1l C1.·ntl·r, h.1, CIIJO}cd t,trtlmg re ulb u,mg thl' tedt• nique 1111r1.',II a d1\as1.· r,mcc ,111.hmnu.: p,11n:bur,111, lo\\ l'r b.1d: ,tr,un, t ngem• m,11neur,1lg1,1,m1gr,111w he,1d,1dw, neck and ,h11ulller [Min, Bell\ p,il,), had ph\,1cal thl·r<1p\ and nothing h,1p• o,tco.utlmt 1,, te111H dbm\ ,md e\ l.'n pened; med1c,1wm, and \Ct the problem Mnu, hcacbchc. ,nil per,1,red. The\ come 111 de,1,craIn De1.l'lllher, EC MC opem·d .1 nl'\\' t 1011,\\ 111 mg to g1,·e anyth mg ,\ try." ,11.upun1.tur1.· center, the onh ,ud1 cen• P,111enr,m·I\ come co hl•r 111 de,pcr,1• ter in ,1 \Vcstem Ne\\ York ho,pnal. Oh tlOn, I t the u,uall\· lc,t\ C harr}, able rt. •r1' h.11 5 percent of her patient, to funcuon better, ffillre cncrgeuc, and there l'XPl"rienn· g,111dr1.",t1lt-. The: in ,ome tnsl,lll<.:l'' ahl1.• to return to t 1t1,tH. 1 e,peci,1lh impre~,l\'t.• \\ hc:n wnrk for the tir,1 tune m ,1gc:,. llU!FAI0Pll\'1<1AN A~lll\l \IIDI c\L~lf~TIST �7 / JuneOh, M.D. , left, an assistantprofessorof reh1abilitationmedicine at UB , is oneof the fewM.D.s in the Buffalo areawho usesacupuncture. Aboveis oneherpatients , a 6!;-year-oldwomanwithosteoarth ritis. P n 0 t OS BUFFALO PHY~ICIAS A~O BlmlEDIC.-\L ~IE.'-:Tl~T b 'Y b 0 b \\ a 0 n :SPRISG1990 �8 Torelievekneeandanklepaincausedbyosteoarthritis, needlesareinsertedintothewoman 's legs, above,andhands , right. "My specialty here (at ECMC) is neuromuscular problems," says Oh. "Multiple sclerosis, strokes. Pain resulting from car accidents, whiplash, amputatiom. Anything dealing with muscles or neuroproblems. "I see occupationally related pain X-ray technicians who do a lot of lifting, those who lift a lot of patients they have pain in the shoulder blade, and yet the X-ray shows e, •erything to be O.K. Nobody can find anything, but '<PRISGIWJ acupuncture relieves the pain. I do see a lot of that." "Acupuncture is a respectable, safe approach to chronic pain," said Glen E. Gresham, professor and chairman of rehabilitation medicine at UB and director of rehabilitation medicine at ECMC. Acupuncture is Just one of many different therapies, ranging from drugs to electrical stimulation, that are a\'ailable to doctors to treat pain, and no ~ingle therapy worb for everyone. "Acupuncture is an accepted and respected alternative in this array of approaches," Gresham said. The technique, notes Oh, is almost painless. A number of very fine needles are inserted at designated points that are mapped out on a chart in Oh' s office. (In Chinese, the points have names; in English, they have numbers.) Most people find the acupuncture treatment very relaxing; some of them even fall asleep. �ECMC. She joined the staff of the hospital m 1972 as an assistant attending physician. le wasn't until Oh had lived in Buffalo for several years that she decided to study acupuncture. In a search for alternatives for patients who did not respond to available treatment, she embarked on a specialized 300-hour course in acupuncture at UCLA in California. That course allowed her to become licensed last year to use the procedure in New York Scace. The pink licensing certificate is proudly displayed on her office wall. "Ir took three years to get that paper," she exclaimed. Today, acupuncture constitutes between 30 and 40 percent of Oh's practice. Western physicians do not yet trust acupuncture completely and imurance doesn't co\'er the technique. Perhaps it's not accepted because it's not clear how it works. "No one knows exactly how acupuncture blocks pain," Oh confirms, but ventures a theory. "Pain appears to involve multiple systems including peripheral nerve endings, brain stem, midbrain reticular formation, thalamus, and prefronral cortex. "When I insert needles and manipulate and twist with my fingers, there ts an area that stimulates the pain pathway to I A native of Korea, Oh grew up in a culture that accepted acupuncture. When she was a child, her parents took her to an acupuncturist for successful treatment of stomach pains. She studied medicine in Korea, graduating from the Ewha Women's Medical School in Seoul. Then she completed an internship at the Bronx Lebanon Hospital in New York City before coming to Buffalo to do a residency in rehabilitation medicine at BUFF,-\Ll) r t-n~l(' I -\~ \!',;l) RIOMEPICA I. :;(: l~ Tl'-T Ele<trocles are oftenattached to theacupunctureneedles.In thiscase, Dr.Oh said,thepatient• wasableto get around without herwalker , walkfaster , and evengo shop· pingaftera few treatments. the middle brain and the spinal cord. The concentration of certain naturally occurring hormones (such as endorphin) is increased and the pain is controlled." Successful acupuncture, notes Oh, depends on the integrity of nerve function. About half of all known acupuncture points are in some way directly related to the peripheral nerve, and more than 35 percent are located close to the peripheral nerve. This is not the first time an acupuncture clinic has been housed at ECMC. An earlier clinic was started at the hospital in 1974, back when it was known as the E.J. Meyer Memorial Hospital. The clinic closed after a little more than a year when the initial high demand for acupuncture slacked off, said Ross Markello, M.D., who headed the anesthesiology departments at the ho pital and UB. There were also some doubts about the effectiveness of the treatments, noted Markello, who is now an emeritus professor at UB and an associate medical director at Independent Health, an HMO. A review by psychiatrist~ showed that 33 percent of the patients felt they had some improvement - exactly what you'd expect from a placebo. Oh bristles slightly at the suggestion that acupuncture might be a kind of hypnosis or a placebo. 9 �10 I Inanotherpatientsufferingmusclespasmsandpainafter backsurgery , acupuncture needleswereinserteddirectlyintotheback. Thepatientreportedfeelingwarmandrelaxedafter thetreatmentandthe spasmsstopped. �"It's not a placebo effect at all," she states matter-of-factly. "You can see in China where surgery is performed on alert patients using acupunctu re that's no placebo. "In Western New York it's not as common as it is on the West Coast," adds Oh. "In California, a great deal of acupuncture is practiced, not only by Chinese acupunctu rists, but by physicians as well. Western New York is more conservative, anJ nor as accepting of acupuncture as a medical treatment. "Since I started here at ECMC, and the patients who have come here have had good results, word of mouth has been good. In fact, a neurosurgeon at ECMC has begun to send patients who still have back pain after surgery to me." Doctors' relatives and doctors themselves also go to Oh for treatment. She was able co relieve the "tennis elbow" pain from which one doctor's wife had suffered for more than a year. A physician sought her help for Bell's Palsy, a disorder that leaves one side of the face weakened - the face becomes asymmetrical as one side droops. After six treatments his face is balanced again. Although behavior moJificacion is not really in her lme, Oh has even been able to assist the efforts of hospital employees to quit smoking. "Somehow, acupuncture b very effective to help people quit smoking," says Oh. "People have been able to quit smoking after 30 years!" When acupuncture needles are manipulated in the patient's ear, body chemistry is altered and the desire to smoke is diminished. she said. "Once people start smoking again, they're back in the habit," warned Oh, "but the technique works beautifully. I did it for cwo patients who are employees of the hospital. "I did it reluctantly, because l am not exclusively an acupuncturist. I am a physician who uses acupuncture as a tool in her practice. My practice at ECMC is a medical practice. Thirty or 40 percent of my practice is acupuncture, as indicated when these patients need pain control." Those who are exclusively acupuncturists and do not hold an M.D. or D.D.S. travel a different route ro ger licensed in New York Scace, according to T homas J. Monahan, executive secretary of the State Medical Board. They muse already have an acceptab le acupuncture license from another state or country, along with appropriate training in acupuncture and 10 years of experience outside New York Stace. Because of the way the statute is written, most acupuncturists licensed by New York were trained m Easr Asia , Monahan noted. Licensed acupuncturists outnumber physicians who use the technique in Western New York - Oh has heard of only one besides herself. But perhaps one Jay it won't be so rare. "Acupuncture is not yet completely accepted in the medical profession, bur pretty soon it will be," she predicts. Anthony Chase is the coordinawrof Academic Services for the Educauonal Opponumt)' Programat BuffaloState Collegeand a prolific free-lancewriter HowMANYDIFFERENT WAYS(AN You SPELL RELIEF? cupunctu re 1s 1us t one alternat1\'e for treating pain. While no single method can claun to be JOOpercent effect1\'e, "a ll of these th ings work \'ery well for some people," noted Glen E. Gresham, professor and c h airman of rehabil1tation medicine at UB and director of rehahd1tat1on med1c111e at ECMC. Dru g th e rap y co m b in ed with ph ys ical th era py. This 1s the most common methoJ, according to June (Joung Ra) Oh, M.D., assistant professor of rehabdnation medicine at UB anJ attending physician m rehabilitation med1c111e at the Erie Count) Medical Center. TEN S - tran sc utan eo us el ec tri c al n e rve s timulati o n. An electrode 1s pasted on the skm which deliver, a low-\'oltage current. "A Im of people gee relief from this method," noted Gresham. "l think there's a physiologically similar mechamsm to acupuncture." Tri gge r-po int inj ec ti o ns . "This 1s \'ery fashionable for people who ache all over," noted Gre:;ham. If a physician can find a pomt on the skin that cause:. this allO\'er achines, when pressed, he can inject the point with a local anesthetic or corticoscero1d, or both. The trigger pomts mav coincide with acupuncture point~. Freez ing. Freezing the area \\ ith a \'apocoolant spray bricth frec:cs and numbs the spot. The muscle can be stretched to relca:ie ,1spasm. ., 11 �Timmy Mathias'mother,Kerry,talksto herson as he recuperates. �13 BY EDWARD J.SYLVESTER Noonehadeverrecovered fromsuchan iniury. Theboy'sheadwasattachedto his bodybyonlyhisspinalcord,a fewmuscles, andskin,andhisbrainstemwasdamaged. Butthanksto theworkofa UBalumnus andotherneurosurgeons inPhoenix, the boyeventually walkedoutof thehospital, smiling and talkingto reporters. ... Timmy Mathias 'mangled bicycle �Spnng had arnved in Phoenix, Ari:ona, and the weather on April 26, 1989, was sunny and inviting. But neurosurgery resident Brian Fitzpat rick didn't have 14 time to notice. It was 8 a.m. and he was already in the middle of his bu,y morning rounds at St. Joseph's Hospital when he was ,ummoned to the emergency room: A young boy on a bike has been hit hy a pickup truck and had JUH been airevaced from the accident sm: m suburban Phoenix. In the emergency room, the trauma ream, paramedics, and nursing staff worked on the unconsc10us 10-yearold hoy who was strapped to a hack board and protected by a cervical co llar. X-rays indicated that the boy had suffered ltfe-rhreatening internal injuries and needed to be rushed into general surgery. Fit:patnck, a 1986 graduate of the UB med ical school on a pediatric neurosurgery rotation with Barrow Neurological lnstttute m Phoenix, was called co check for spine and neck injuries, and he began the first medical workup of the case that would dub his patient "the miracle child." At first, doctors had only hmt:, to the extent of the injuries suffered l,y Timothy I. Mathias Jr. From the X-rays 111 the emergency room, taken Fit:patrick and spine specialist Steven Papadopoulos, M.O., saw evidence of a !X)tentially lethal separation of the boy's neck vercehra from his skull. Timmy was sent for CT scam, which offer a much finer resolution than ordinary X-rays. From chose, the doctors suspected somethtng even worse: a fa111tshadow suggested blood on the hmm stem. A, Fit:patr1ck accompanied the unconscious hoy's gurney, rushing from the emergency mom to the CT scan to general surgery, the hoy's condition worsened. He didn't blink when hts eyes were toucheJ anJ his pupils didn't contract m respome to light, a sign of hram stem miury. In genera l surgery, physicians were able to sa\'C moM of the hoy's ruptured spleen, mended his li\'er and kidney, and stopped hi, internal bleeding. was rushingX-rays and CT scans among the specialistsof Barrow's neurosurgery team, but he was deliveringincreasingl y bad news. "It becameapparentthat Timmy's headhadbeen separatedfrom his spine," Fitzpatrickrecalls, "and that the brainstem hadbeen damaged as well." A review of the medicalliterature confirmed what everyone now suspected: No one ever recovered from such an injury. Meanwhile, Fit:patrick was rushing X-rays and CT scans among the specialists of Barrow\ neurosurgery team, but he wa.....deli\'ering increasingly bad news. "It liecame apparent that his heaJ had been separated from his spine," Fitzpatrick recalls, "and that the brain stem had heen damaged as well." A review of the medical ltterature confirmed what everyone now suspected: Of thme accident victims whose skulls had broken loo,e from their spines, a tmy proport ion suffered no bram stem injury; if immobi lized quickly, the, recovered. But of those who suffered any bram trauma what oever, none reco\'ered, no marter how quickly they were immob1li:ed. All either died or remained vegetative. Timmy haJ pulled through general surgery, but Fitzpatrick and his colleagues still faced a challenge. They needed to know precisely where the suspected brain stem inJUI)' was located. There 1s no such thing as exploratory brain surgery, Fit:patnck pointed out later in an interview; the neurosurgeun mu,r know exactly where he is headed tiefore he starts surgery. Only a magnetic resonance image (MRI) would disclme the 1nJury plainly enough for surgery, but the powerful magnet required to take such a scan would disrupt the respi rator, killing the boy. "Our fin,t break was in having a new, experimental MRI scanner," Fit:patrick explained. "This was a low-field scanner, Jes1gned not to interfere with a respirator. The question was, would it work?" It d,d, enabling Fitzpatrick and Papadopoulos to rush a set of cryscalclear scam to the viewing screen. But as each MRI scan was placed m the light in the early afternoon, recalls Harold Rekate, M.O., the pediatric neurosurgeon under whom Fitzpatrick Web working, "the news got worse. We were shocked," he says, a word not frequently heard among neurosurgeons. The separation of Timmy's neck from his skull was more severe than any of them had ever seen, and a walnut-si:ed blood clot pressed against the front of the boy's brain stem. By m1d-afcernoon, a growmg ream huddled around the MRI scam on the lighted wall panels. There was Robert Spet:ler, Barrow's chief, who is known for his aggressive and successful treatment of aneurysms and stroke; Volker Sonntag, the spine surgeon who had in\'ented an implantab le pin that would be used to reconnect the boy's spine to his skull; Rekate, chief of pediatric neurosurgery; Fmparrick, and Papadopoulos. �IS Thethinblackarrowsshowhowthe skullwas separatedfromthe spine.Thefat whitearrowindicatesthe bloodclotpushingonthe spinalcord. RL'FFALOrHYsJCI-\'\ A'\ll f\l0\1ElllC-\l ~-IE'\Tl'-T �16 "Granted, there is little chance we can save him," Spetder told the group. "Bue 1f we do nothing, he will surely die. If we do these things, we're going to lose mo,c of the t11ne.Bur if we don't do chem, we'll lose all the time. "What are we waittng for?" To Fitzpatrick, ,uch a moment marked one of the intangihle values of his residency. "le is reall, that accicude at Barrow that's important," Fir:patnck sar. "And that's Sperzlcr's attitude. He b very aggressive. If there's a chance of saving someone, you take it. "There were three things chat made the surgery possible. First, the aggressive workup as soon as the boy was admmed, mcluding the lo,\,-field MRI scan. There was the assumption that the worst might be true, hut we still might save him. "Second, the aggressive approach Barrow rakes in brain inJttry ,·icttms, especially children." And the third ingredient chat was needed co make the surger,· succcl-sful,of course, was expertise. "Especially Sonnrag's and Spetzler's," Fitzpatrick said. Timmy's head had been immobilized in a cervical collar and a backboard at the accident scene, and 1n the late afternoon Fttzpatrick and Papadopoulos labored to fit him into a halo brace. The halo hrace resembles a medieval torture instrument, with a steel halo chat encircles the head, held by pins screwed into the bone. Four rods ristng from a tight leather vest run through loops 111the halo. Fitzpatrick and Papadopoulos had co make sure they didn't Jar Timmy's head or spine, or they would destro~ the unprotected delicate fihers of the brain stem. Nothmg held Timmy's head on but his spmal cord, a few mw,cles, and skin. And the sp111alcord, to a neural expert, is simply spidery filaments of hra in ttssue. Fit:patrick noted that the location of Timmy's clot was a further complication. Ar the from of the brain stem, tt lay directly hehmd the mouth cavity, and the normal approach for surgery would have heen through the mouth. Bur raking that route would rhk infecttng the brain w1ch mouth hacteria, Above,Brian Fitzpatrick, a 1986graduate of which would certainly be fatal. Spet:ler had developed a technique theUBmedical school, checked Timmy's progress dailyandsawradical improvement. for reaching previously inoperable aneurysms through an approach from Within theconfines of hishalobraceanda the back of the neck. That meant legcast, nmmywasableto laughandplay likeany10-year-oldandeventually walked Fit:patrick and the ochers had co roll the boy onto his stomach hefore outof thehospital. surgery, another reason why the halo brace was critical. It was nearly 5 p.m. as Fitzpatrick and Papadopoulos wheeled Timmy into Operating Room 2 and scrubbed in. Across the hall, Spetzler was completing eight hours of delicate surgery, clamping off a blee<lmg aneurysm deep within a 64-year-old man's brain during a procedure known as a "scambtill" - a complete cardiac arrest in which the bram is drained of blood and chilled to hring metabolic activity below the normal threshold of life. Spetzler scrubbed out, crossed the hall, scrubbed in and hegan again. The doctors cue down to the spme, parred rhe neck muscles, and worked around to the front of the bram stem. Fmally, the clot could be seen. The only hopeful sign they found was that there had heen no new bleedmg. The clot was drained and the doctors began the arduous task of reattaching Timmy's skull and spine with Sonnrag's V-shaped pin. The open ends of the "V" were wired to the vertebrae and the �the surgery, Timmy was essentially Fitzpatrick's patient. "He began to show signs that his paralysiswas improving almost immediately," Fitzpatricksaid. "But the really 1 l big moment came severalweeks later when we asked him to show us two fingers, and suddenly two fingerspopped up. That was the first time we knew he was awake. " "V" point was fastened to the skull with wires looped through tiny holes drilled through the bone. The surgery took about five hours. It was well after midnight, 16 hours after Timmy was brought in, by the time Rekate and Fitzpatrick met with Timmy's parents. They had been told there was only a 1-in-20 chance chat Timmy would survive. Now it appeared he had beaten those odds. Bue how far he would come back was completely unknown. Timmy was now essentially Fitzpatrick's patient, on Rekate's pediatric neurosurgery service. "He began to show signs that his paralysis was improving almost immediately," F1t:patrick says. The morning after the operation, Timmy began moving, though he was too dee p in a coma to follow commands. Timmy's movement was amaz ing enough. "Bue the really big moment came several weeks later when we asked him to show us two fingers, and suddenly two fingers popped up. That was che first time we knew he was awake." Fitzpatrick visited Timmy twice a day on rounds and saw radical improvements day by day. In mid-May, a press conference was scheduled to discuss Timmy's condition. The story of Timmy':, rema rkable surgery had already been told in newspapers and magazines and on television around che world. Speeder had even been inte rviewed by Tass, the Soviet news agency. Tim my was pictu re d , while sti ll comatose and in halo brace, on the cover of Stern, Germany's major news magazine. Tho ugh cheered by Timmy's progress, Fitzpatrick still was as surprised as the rest of the medical staff when Spetzler confidently said at the news conference, "Timmy will walk out of here." Within a month after the accident, Timmy was acting like any I 0-year-old, chatting and laughing. He moved as much as he could while wearing the restrictive halo brace and a leg case, which had been applied a few days after the accident to mend his broken leg. Because several vertebrae are fused with the V-shaped pin, Timmy will always move his head as if he has a stiff neck, but there doesn't appear to be any permanent brain damage. Speczler's prediction was correct, and Timmy finally walked out of the hospital on June 23. Reflecting on that surprising forecast, Fit:patric k finds a lesson for neurosurgeons. "Timmy had a le:,ion we could see, that we removed. That tell you that a more aggressive workup may show a hopeless problem to be treatable, in some cases even curable," Fitzpatrick said. Neurosurgery has appealed to Fitzpatrick since his first year of medical school at UB when he conducted research at Millard Fillmore Hospital with Nick Hopkins, M.D., now chairman of the Depa r tment of Neurosurgery at UB, and James Budny, M.D., vice chairman of the department. "Working with them was very exciting," he said. "It showed me the direction to take." His decision to become a doctor goes back even farther; way back to Amherst Central Junior H igh. His biology class had shown him for the first time "new insights instead of just a continuity, a new way of looking at the world," he said. The son of Robert C. Fitzpatrick, director of research developme nt in the UB School of Dental Medicine, Fit:patrick the n majored in neurobiology at Cornell. After graduation, he did his required year of general residency at Millard Fillmore. Fitzpatrick chose to continue his neurosu rg ica I training at Barrow Neurological Institu t e in Phoenix, A riz., because he wanted a bu y neurosurgica l service. And, he had heard, unlike Barrow, many better-known institutions don't allow residents to perform surgery until their final year. Another drawing card was Robert Spet: ler, Barrow's chief, o n e of t he world's leaders in vascu lar neurosurgery, the area in which Fitzpatrick was most interested. "The staff was young and aggressive, and they were up on the latest technology," Fitzpatrick says. "And technology proved important" in Timmy's case. Soon after Timmy was re leased, Fitzpatrick finished his pediatrics rotation in neurosurgery at St. Joseph's Hospital in Phoen ix and began a sixmonth rotation at trauma-hea\'y Maricopa County Hospital in Arizona. He is now chief neurosurg ical resident at University Hospital in Tucson. Then it will be back to Phoenix and Barrow again, and three more years to complete one of medicine's lengthiest apprenticeships. EdwardJ. Sylt•ester,a memberof the Naaonal Associationof ScienceWriters,is the authorof The Gene Age: Genetic Engineermg and theNext lnduscnal Revolution, «:ith Dr. Lynn C. Kloc;:,and Target: Cancer. 17 �18 STETHOSCOPES TO MICROSCOPES TO MICROCHIPS Computers emerge as medicalschool's newest teaching tool BY DAVID HIMMELGREEN he three-pound preemie is suffering from respiratory distress syndrome. Her breathing is lahored and her skin casts a bluish tint. She's hooked up to a res-ptrator,but the monitor shows that her viral signs are not gO(.xl. This is the medical student's first experience with life-or-Jeach decisions in the intensive care nur ery. Hands sweating and heart racing, the stress 1s almosl unbearable. The student must choose the right course of action. Fortunately, even a bad decision has no fatal comequences. This babv is made not of tlesh and blood, but bits and bytes and pixels - she exists imide a comrucer program. The student types in an instruction to pass a rube down the computer bahy's air passage. The computer responds, mdicaung that oxygen 1s l:,eing delivered to the lungs, and che baby's respiration is returning to normal. The student also breaches easier. Other complication., anse for the preemie, and tomorrow's physician contmues to make decisions, typing in further imrruct1ons. This "dialogue" between student and computer contmut:s for p.:rhaps an hour, simulating four days in the baby's life. Both a confidence builder and valuable experience for the future, this program 1s just one example of the cools now available co UB medical student!\ in the wake of the computer revolution of the lace '70s and early '80s. Today, even computer novices can use powerful software programs to assist them in medical education, research and administration. said John Loonsk, M.D., director of academic computing for the medical school. ILLUSTRATIONS compu· tersimulat ion allowsstudents to honetheir diagnostic skills andevenmake mistakes without endangering a human life. BY Computers can simulate patients and have the potential tl> cut down on the number of animals used in teaching. They can look at X-rays or slide~ 111 new \\ ays and access large amount~ of information, almost instantaneously. And computers are becoming sophisticated enough to help come up with soluc1ons to problem:.. Personal computers (PCs), which are more accessible and user-friendly than mainframe computers, are popping up everywhere in hosritals and cl1111cal practices. AnJ the software programs are relanvely easy to use and more powerful lhan ever. Physicians of the 21st century will be faced with a field of medicme thac 1s more and more complex and speciali:ed. Computers will help them wade through the mass of information and paperwork that they'll encounter, Loonsk predicts. "Future rhysicians are going to need to be computer capable," he said. The UB medical school has been usmg computer, to assist in pre-clinical coursei., ,uch as physiology and biophysics, since the 1970,. During those early days, computers were loaded on rumbling cam anJ wheeled down the hallowed halls to labs and lecture rooms. Today, the medical school has a computer lah, now 111 ib third year of operation, located in the Cary-Farber-Sherman Addition on the South (~fain Street) Campus. Loonsk, who graduated from the UB medical school 111 1986, b director of the lab and the newly appointed chairman of the medical school computer mstruccion committee. The computer lab 1s a multtpurpose facility that uses and de\'elops computer programs. It offers LI SA HANEY I\CHA LO f'HY•ICI ·I' .-1'.'\11BI0 \1f.()ICAL :,c 1E:-.'ll q �computer-aided instruction tn many subjects, teaches "computer literacy," and teaches how to use computers in medicine. "Our students arrive with very wide and varied backgrounds in computers," stressed Loonsk. The objecttve is to bring student:, up to speed on the computers and then introduce them to the power of computers in educat ion, research, and adminbtration. One of the biggest benefits of computers is the way they can manipulate the pictures thal medicine already uses, such ai, rhotos, slides or X-rays. Using a 51bill, Loonsk demonstrated a machine called a digiti:er, which scam. rictures and convens them into informanon that the computer understands. After scanning the bill, the computer presented a super-high quality image of George Washington's face on rhe monitor. The digitizer enhances the image and can :oom in on minute details that may not be seen b, the rhysician at first glance. Currently, Loomk and lrn, colleagues are busy digitizing images that will eventually be used by facully to teach students about things such as the identification oi kidney stones anJ what different tyres of bacterial infections look like. Studenls and faculty ah.o have acces:, to four ,·iden-disk players that interface with computers. Recently, the Medica l Students' Parent:, Council, a group of parents of medical students that conheUnitributes time anJ money to a wide variety of medversityplansto ical school activitie~, donated an lBM eventuaUy tinkthe lnfowindows worbtation with video-disk rlayer, computers computer and touchscreen monitor to the comthroughout the medical schooland puter lab. Medical students use the lnfowindows touchbeammultimedia screen system in their introduction to clinical imagesrightinto meJicine course to study different types of heart classrooms and laboratories. Gone sounds and the cardiovascular system, said Loonsk. A video of real patients being examined 1splayed arethedaysof heftingequipment through the video-disk rlayer. Students can also request images of the heart anatomy simply by oncartsand couching the menu that's disrlayed on the monitor. wheeling it down When the students touch the heart on the thehalls. screen in different spots, the computer plays the different heart sounds that emanate from those areas. Students can abo request graphs of heart sound cycles, Loonsk said. Students also have access to seven CD-ROM players, which are similar to CD-music players found at home. Instead of reading disks that have captured the sounds of Verdi or the Beatles, they read disks that contain computer data. Like the video-disk plaver, CD-ROM players use lasers to read information. But CD-ROM players tend tO be more text-based and rely less on images, though that may change in the future. One use of the CD player is to provide a textbook on a disk, Loonsk said. Scientific American now offers its consult textbook of medicine on compact disc. This CD is regularly updated so that students can get the most recent medical informa- omputerscanenhance an image , whether it's theportrait of George Washingtonona dollarbill oranX-rayof a tibia . Dodorscan thenmanipulate theseclear images , zooming inandetailsthey mightotherw ise havemissed. 19 �tudents canfistentocfdfer· entheartsounds bytouching the various areasof theheartshown onthecomputer screen.Thisis one useof an lnfowindows workstation, whichwas donated bythe Medical Students ' Parents Council. 20 tion with high-rel>Olution images almost instantaneously on the computer. There are also a number of medical Journals publishing on CDs so that access to current rel;earch is becoming easier than ever, Loonsk explained. The computer lab offers a numher of databases, including the Physician's Desk Reference (PDR). Loonsk pointed out that it is important to expose students to the PDR program because It provides them wtth a wealth of information on brand name and generic medications and drug interactions. Medical students are given a worksheet with items about a patient's medical history, such a~ age, sex, symptoms and lab results. After reading the information, the students must consult the PDR to determine drug interactions and decide which medications are best suited to the patient. Students then write down their diagnosis and therapeutic regimen on the worksheet for evaluation by faculty. Loonsk envisions a time when patient medical histories are integrated w1ch many different programs like the PDR.Information from many different oources could then be brought up on the screen at the same time, without having to make cumbersome conversions herween different programs. In the future, the miniaturization of computer hardware may provide the physician with almost .instantaneous access to medical information. "Hypothetically, there are devices chat flip over one eye and allow you to view data as it's projected directly on your retina," Loonsk mentioned. Perhaps one day a physician will be able to use this device to view a patient's medical hi. cory, lab tests, and refer to the PDR in one fell swoop while the patient is on the exammmg table. tudents cangaineasy accessto huge amounts of information using databases suchas thecomputer versionof the Physician 's Desk Reference. There is also a program that reaches UB students how to call up patient lab data from the computer system of the Erie County Medical Center. Soon students may get the opportunity to work on various local hospital computer systems before they begin their clinical rotations, Loonsk added, making the student's transition co real-life medical situations easier. Another clinical database program available co students and faculty 1s MEDLOG, which allows a physician to examine specific charactemcics of his patient pool. For instance, if a physician wants to test a new blood pressure drug on patients with specific characteristics, he can use MEDLOG co find the names of the most suitable patients for chis drug. After the test 1s done, the program can also be used to analyze whether the drug was able to effectively lower blood pressure for the sample of patients, Loonsk said. Another tool used in academic computing and within l>Omemedical schoob is known as "multimedia." Multimedia integrates images, animation, sound, and text on a screen using multiple windows. At UB, multimedia projects will llSecommercially available sofcv:areprograms and reshape them for an individuali:ed solution to a specific problem. One problem is visualizing anatomic relationships. The meandering route of the cranial nerves, for instance, is as confusing as a New York City �ersonol computers con helpdoctors send a letterorcon suggesta possible diagnosis ina porticulor case. road map. Traditional textbook descriptions, illustrations, and the dissection of cadavers all help, but still some students struggle. Now, imagine a multimedia program where a student can view a high-quality three-dimensional rotating image of the cranial nerves, along with a text description, while conducting a dissection with classmates. While chat's in UB's more-distant future, a simpler version of multimedia is expected to be in use at UB by the fall. A eady Loonsk and his colleagues are using the digitizer to create images. For example, images of cirrhotic livers incorporated with text descriptions will be useJto teach students about liver disease. These images and text can easily be manipulated so that students can scan variations in the disease process and compare images to different types of liver disease, all on the screen at the same time. Another plan for the UB medical computer lab is the eventual linkage with computers throughout the medical school complex. Faculty will be able co utilize the lab's resources from classrooms and laboratories in the building. Addmonally, a video distribution network will beam multimedia images and descriptions of things such as disease pathologies and anatomical structures to students while they are in lectures or <lomg laboratory work. Using even simple PCs, the sky's the limit to what students and faculty can do in the medical school computer lab. The lab maintains more than 35 IBM-compatible and Apple computers ypotheticolly , there couldbedevices thatflipoverone eye andallowa personto view dataas it's projected directly ontheretina . and a wide variety of software applications. One program teaches about human heart sounds. Students can choo e to listen to specific preprogrammed heart murmur with the "patient" lying down, sitting up, and breathing in or out. A drawing of a patient's chest appears on the monitor. The computer simulates the sounds a physician would normally hear if he or she were to place a stethoscope on different anatomical points outside the chest. Another helpful tool for students 1sa problemoriented program called Quick Medical Reference (QMR) that'~ run on an IBM-compatible personal computer. Like the systems in banking that decide whether or not a customer is a suitable loan risk, QMR makes decisions about medical diagnoses based on specific clinical findings. "lt (QMR) allows you to look at medical information in a totally different way than if you were to read a textbook or other resource," Loonsk said. "We can put up a disease and then sort the clinical findings in many different ways. "For instance, we can determine the most frequently cited symptom in a large group of patients or the finding that would most strongly indicate that srecific disease." For example, a -rudent can plug in the clinical findings for a pregnant woman who is over 30 years old, obese, and experiencing high blood sugar, excessi\'e urination, and acidosis. Then the student requests the QMR program to make a diagnosis. QMR will interpret these findings and suggest gestational diabetes mellitus (diabetes in pregnancy) 21 �a potential Jiagnos1s, a,, well as lbt other d1sea:,e:, from which the patient might be suffering. The computer lab also offers tools for medical anJ health related research. One project, still in its embryonic stages, is the Scoliosis Tempora l Imaging Project, which bassociateJ with the work of Robert Gillesp ie, M.D., professor anJ chairman of the Department of Orthopaedics. The goal in this pro1ect is co demonsuate, through three-dimensional images, the progression of scoliosb (a curYature of the spine) through time. Even ordinary software used in business offices can be helpful to physicians, though many aren't yet familiar with what's available. "We have word processing, Jesktop publishing, databases, spreaJsheets, and graphics programs," Loonsk said, a,, well as electronic mail. Combined, these programs can help a physician set up long-term appointment schedules, present well-written and concise consults, monitor illness trends within a patient pool, and keep track of billing and payments. In the long term, Looru.k hopes that computers will assist in the nuts and bolts of medicine by quickly retrieving the most pertinent information the physician needs to help a patient. A big complaint in rneJicine today is that physic ians are so specialized and medicine is so technological char there is little time for physicians to per,onally interact with their patients. Loonsk hopes that in the future compurers will free more time for physicians to spend with their patients. a,, 22 WHATS ON THE l\1ENU 7 I f you can't cell the hardware from the software without a scorecard, take a look at this lbt of items being served up at the UB medical school'~ computer lab. Di git izer. This machine scans photos, slides or X-rays and converts them into information that the computer under~ranJs. Then a superhigh quality image appears on the monitor. The d1git1:er can manipulate the image in many ways, :,uch a~ enlarging a portion of rhe image for cloi.er inspection. Tou ch screen monito r. This 1s similar to the monitors found in grocery scores that shoppers can press to finJ in which aisle the anchm y p1::as are located. Vid eo -di s k playe r. V 1Jeo-d1sk players use lasers co read informauon from a disk anJ send moving image, to a television-like monitor and hecomputerlaboffers toolsformedico! researchers and clinicians alike. Byhelping physi· ciansquickly retrieveinformation, computers mayenablethem to spendmore timewiththeir patients . send sound to a speaker. They can also score thousand, of ,nil 35 mm slides. They allow users to see moving images of real people, or a computer-generated image, and move easily between the two. CD -ROM playe r. Compact disk read-only memory players are similar to CD-music players found at home, but imteaJ of reading disks that have captured the sounJ~ of VerJi or the Beatles, they read Jisks that contain computer data. Like the video-disk player, CD-ROM players use laser, to read information. But CD-ROM players today tend to be more text based and rely less on images. Multimedia. Multimedia integrates images, animation, sound, anJ text, and can use multiple windows. Dat·1d Hnnmelgreen, tl'ho i, comple1inghis Ph.D. m anthropoloff'.\' at UB, has done researchon numuon and food habits in Lesothoand Kashmirand plam w remm to Africaw completehisdisseriacion m chefall. �---- :(]}---.; E J. ~ 23 TEMPORARY SHELTER f OR HOMELESS ATUB TESTED portable shelter Jesigned ro prov1Je temporary protection from the elements for homeless persons passed its first fielJ test with flying colors in January, according to physiologists at UB. The device could be used by hnmele:.s person., who refuse to go to a formal shelter or cannot find room m one on cold winter nights. "We certainly con · ider something like this as a la;,t resort," said Tom Harmon, who came up with the idea. Harmon was a street person for three years and is now executive director of the Friends of the Night People shelter for the homeb,. Researchers ,aid that whether it can provide adequate shelter when the tempera tu re drops to near zero Jegrees Fahrenheit and pre\·ent hypothermia - a precipitous drop in core body temperature - remains to be determined in additional testmg. Suk Ki Hong, M.0., Ph.D., professor of physiology at UB, anJ four colleagues monitored Harmon, who \'olunteered for the tesl, for sign, of hypl)thermia. Not only Jid Harmon's core body temperature remain normal. but the temperature wiLhin the two-piece corrugated "pup tent" never dropped below 50 degrees Fahrenheit. The low temperature during the all-night test was 30 degrees Fahrenheit. The idea for the temporary shelter originated with Harmon. He proposeJ a corrugated shelter based on his own experience: One of the hest night's sleep he had while homeless, he recalled, was in a discarded corrugated cardboard box that had been used for shipping a hot-water tank. The corru- gated material is insulating and holds in the warm air. The "Harmon Hotel" being tested by UB physiologists resulted from discussions between Harmon and Peter Pellegrino, sales manager for Great Lakes Container Corp. of Lockport, N.Y., a \'Olunteer at Friends of the Night People, during the bmer cold snap that hit most of the nation in December. The prototype is a two-piece tube that folds flat anJ is easily carried. When a confining band is cut, the tube "almost self-erects," resembling a triangular pup tent. The two telescoping poruons of the tube adjust to the height of the user. Although the user is completely enclosed in the tube, he or she can get out of the tube easily. TomHonmon stayedwormthrough one of Buff ollo' s winternightsinsidethe "Hormo1~ Hotel. " Although the tubes are biodegradable and Harmon envisions using them only once or twice, they can be reused and can be carried after the metal band 1scut. Harmon said he e1wi:iions carrying a suprly of the corrugated pup tents in the trunk of his car and handing them out to homeless people who need chem. He also would like to make chem available to police, fire and ambulance personnel, as well as ocher shelters and soup kitchens. Great Lakes Container designed and developed the prototype at no charge, Pellegrino said. A charge will be assessed if the company eventually manufactures it, he said, adding chat Friends of the Night People will receive part of any profits obtained if the device is sold co any group other than the Buffalo shelter. Assisting Hong in the first field test were Richard A. Morin, director of facilities for the UB Physiology Department; Donald R. Wilson, senior lab equipment designer; Walter S. Marshall, lab equipment designer, and Donald R. Rennie, UB professor of physiology who also 1sa UB vice president and vice provost for research and graduate education. M. Steven Piver, M.D., UB clinical professor of gynecology-obstetrics, sen·ed as medical director for the testing. Chief of gynecologic oncology at Roswell Park Cancer Institute, Piver also serves as vice president of the board of directors of Friends of the Night People. Piver said that during the night Harmon spent in the corrugated shelter in a courtyard on the UB South (Main Street) Campus, "his body stayed as warm ru; if he was in his own bed." For his night tn the corrugated pup tent, Harmon bundled up in a manner he ~aid reflects that of home le ' S persons spending a cold winter night outdoors. He wore two pairs of pant:,, two ,hires, a sweatshirt, two pairs of socks, a coat, gloves, and a pair of heavy boots. - By Sue W111etcher �--- :(]}---J'EJ.q. 24 GOODBYE BUTTER, HELLO OLIVE OIL UB researcherssuggestthe switch could lower the risk of heart disease mericans intent on lowering their risk of cardiovascular disease would be wise co use olive oil instead of butter or margarine, according co a major study by researchers at the UB medical school. The study, repo rt ed in the Feb. 2 issue of the Journal of the American Medical Association, represents a major contribution to the scientific literature. le indicates chat use of o live oil in the diet in lieu of butte r and margarine not only co rrelates with lower blood cholesterol levels, but appears to lower blood pressure and blood glucose levels. The UB study is che first large-population examination of the association between consumption of mono-unsaturated fats like olive oil and risk factors BY ART HUR PAGE for corona ry heart disease, according co Mauri:io Trevisan, M.D., principal author and associate professor of social and preventive medicine. Oche r UB researchers participating in the study were Vittorio Krogh, M.D., Jo Freudenheim, Ph.D., and Alma Blake, Ph.D. The Italian researchers included Paola Muri, M.D., Sal\'atore Panico, M.D., Eduardo Farinaro, M.D., Mario Mancini, M.D., Alessandro Menotti, M.D. and Gio rgio Ricci, M.D. The study has received national attent ion, in part because of the growing interest among the public in hearthealthy eating, but also because the public relations office at JAMA christened it the prestigious journal's storyof-the-week. A film crew from the AMA spent a day in Buffalo, interviewing Trevisan and filming at local restaurants and scores to prepare a video chat was distributed co JOO television stations. On cop of that, the JAMA public relations office distributed a news release about the UB study to about 3,000 people. The landmark study was conducted in conjunction with Italian researchers affiliated with the Italian Nine Communities Study of risk factors for atherosclerosis. The data, collected by the Itali an study, was analyzed by the UB researchers. Resu Its were based on a n a Iyses of BUFFALOPHYSICIAS A)',;[) BIOMEl'IC'.Al ~IE.''TIST �--- :®: ---J' t ~ ~ 2S data derived from dietary interviews and physical examinations conducted with 4,903 Italian adults ages 20 to 59. The subjects included 2,365 men and 2,538 women. Trevisan explained that conducting the same study focusing on the eating habits of a similar number of Americans would have been impossible on two counts. First, very little olive oil is consumed by Americans, although sales have increased in recent years following reports on its lmk with reduced cholesterol levels. Second, Trevisan said, there is very little regional difference between the use of fats m the diet of Americans. In Italy, on the other hand, the researchers were able to compare data for those living in the northern portion of the country where butter use is widespread and little olive oil is consumed - with that for those living in the south - where olive oil is used almost exclusively. "Because of this variation," the authors wrote in JAMA, "we were able to find relatively strong associations despite a relatively crude measurement of dietary intake." They added, however, that "the cross-sectional nature of this study needs co be taken into account in analysis of the e findings. While the results are suggestive of a protective role for unsaturated fats for cardilwascular risk factors, other unmeasured confounders may be the actual etiologic agents." Trevisan said that in their analyses, the re earchers attempted to identify such an influence by taking into consideration confounding effect· of other risk factors for cardiovascular disease, such as age, body-mass index, alcohol intake, moking and consumption of fatty foods. RCFf-\LO PH)SICI.-\S -\Sl1 BIO\IEl'ICAL ~IESTls. Maurizio Trevisan, M.D. The study found that "in both sexes, higher consumption of butter and margarine was associated with increased systolic and diastolic blood pressures and increased serum cholesterol levels." Those associations reached statistical significance only in men. "In both sexes, higher frequency of consumpnon of butter and margarine was associated with significantly higher levels of blood glucose," the researchers said. Increased consumption of olive oil, they wrote, was associated with significantly lower leveb of systolic blood pressure, blood glucose and blood choles terol in both sexes. In men but not in women, diastolic pressure was significantly neganvely associated with olive oil consumption. While the study found that consumption of polyunsaturated fats, such as vegetable oil, correlated with consistent and statistically significant lower cholestero l and blood glucose levels, the association was not consistent for blood pressure. Arthur Page is associate director in che UB News Bureau and farmer medicalreporter at cheBuffaloNeu·s. �--- ·,®~--// ~ 26 Talent in Triplicate UB alumni are at the helm of threemedicalschools BY JUDITH B. HERMAN "I would say there is no highercal/in~1han ministering to the sick. But it is useful, and occasionally importanl, for someone to be a dean." - MarshallA. Lichtman, M.D. orientation and programs for Jevelopmg faculty to <lo research m academic settings {some of whom may well become deans), the cltmate m the '50s and '60s was different, Naughton explained. "At the time these three graduated, Sandberg at Roswell Park. Lichtman wanted to set up an assay for aldosterone, a hormone that had recently been discovered to play some role in hypertension. Referred co Sandberg, a hematologist also trained ith the recent appointment of the school \\ ' ab very small and pnmanly in endocrinology,he then began to get Marshall A. Lichtman, M.O. '60 as <lean of the University of Rochester School of Medicine and Dentistry, the UB medical schlx1l now boasts three deans among its graduates. The other two are Eugene M. Sigman, M.D. '52, Jean of the Univen,ity of Connecticut School of Medicine smce 1985, and Franklyn G. Knox, M.D., Ph.D, '65, who has heen director for education of rhe Mayo Foundation and dean of the ~layo Medical School m Rochester, Minn., since 1983. UB graduate~ achieve dist1nct1on m many areas. Is it so noteworthy to find three of them heading medical schools? John Naughton, dean of the medical school and vice president for clinical affairs at UB, thinks it is. "There arc only 126 medical school <leans at any one time," Naughton said. "Prohably most of them come from the older medical schoob. For Buffalo ro have three of irs graduates at that level of recognition 1snoteworthy mdeeJ." While today UB has a strong research clinically oriented, with comparatively lmle facility and faculty to support a big research endeavor," he said. "Then it was a matter of bright, motivated people somehow finding the right connections and bemg stimulated to do things. "All in all, there have been a lot of things done to enlarge opportunities and create a nourishing atmosphere for UB students to pursue careers 111 research and rbe to positions of leadership in academic medicine," Naughton said. "Sigman, Knox and Lichtman stand as forerunners and models." invol"e<l in some of Sandberg's hemologic clinical work. Sandberg was a major influence and launched Lichtman's career m hematology, hut Lichtman has tributes for a numher of UB faculty members. "l recall with respect and affection nor only Sandberg, but Oliver P. Jones, chair of anatomy, who was very actively involved with students; Douglas Riggs, chair of pharmacology, one of the best teachers I ever encountered; Ernest Wttebsky, Herman Rahn, and Cornell Terplan, all very distinguished teachers who developed outstanding departments which provided rich environments for students in terms of research opportunities," Lichtman said. Lichtman is the author of research papers on various aspects of blood cell biochemistry and physiology and has been engaged in NIH-supported research on blood diseases since 1967. He 1s editor or co-editor of three textbooks of hematology, including the recent fourth edition of Hematology published by McGraw-Hill. MARSHALL LICHTMAN n internationally recognized authority on blood dbeases and the new dean of the Universit) of Rochester Medical School, Marshall A. Lichtman, '60 got his first opportunity to conduct re~earch when he was a student 111 the UB medical school. After his first year, he worked as a summer research fellow under Avery IICFMLO r m~K IAS AS I) 111 0 ~1F.l l1CALSCIENTI:-., �------- :®: -------27 Marshall A.Lichtman , M.D. '60 A scholar of the Leukemia Society of America from 1969 to 1974 and immediate past president of the American Society of Hematology, he is currently chair of the National American Red Cross Biomedical Research Program Scientific Council. Lichtman's training as a physician anJ his activity as a teacher, together with his work in both basic science and clinical departments, have been important preparation for his new 106. "My experience means that I can he comfortable, say, working with molecular biologists on our molecular medicine Rlc ff.-\L O PHY'-ll lAS AS[ ) Rl<JME[)I C AL ~ IESTl~T programs, as well as with physicians in general medicine on the issues that are important to them," he explained. "It's helpful to have had actual experience in all the areas and among all the various constituencies that look to you for leadership. It's helpful to have been in all the trenches." Licht:man joined the faculty of Rochester Medical School in 1965. "I chose to pursue an academic career because I developed an early interest in research as well as in patient-care and teaching," he noted. Dean of the medical school in Rochester since January, Lichtman finds the challenges of his new position are as varied as the satisfactions are great. "As dean, I oversee the school's mission in regard to education, research, and the patient-care activities of our faculty," he said. "A dean has to set priorities among the different departments and programs, establish standards for appointments and promotions and adjudicate various disputes. "But I also have to be a fund-raiser, a cheerleader and then some kmd of role model for the faculty." What makes it so worth while? "I �--------- :®:--------{/ \t- 28 "I went to medical schoolto pursue a careerin research, not necessarilyto become a dean," saidFranklyn G. Knox. Franklyn G. Knox , M.D ., Ph.D'65 enjoy sccmg to other people," Lichtman explaineJ. "I thmk that h an important charactern,t1c of anyone who rakes on any kmd of leadership position." FRANK LYN G.KNOX went to medical school to pursue a career m research, not necessanly to hecome a Jean," said Franklyn G. Knox, since 1983director for education ot the Mayo Foundamm and dean of Mayo Medical School. "My undertaking an M.D.-Ph.D. program, hecommg department chairman and then Jean - none of that was laid out 111 some sort of master plan at the hcgmnmg. There was just a general inclinamm in that direcuon. It JepcnJeJ on hooking up wnh a sympathetic mentor and the em ·1ronmenr making 1t possible for those inclmations w tum mto something." II excretion, rena l phosphate handling and renal hemodynamics - Knox has served on the scientific advisory board of the National Kidney FounJation and the board of directors for the American One of Knox's first mentors as a UB Heart Association and as president of for underii:raJuate was Gerhard Levy, a pro- the Federation of American Sl">Cieties Experimental Biology. fessor of pharmacology. As a UB mediHe has served in numerous capacical stu1dent, Knox workeJ summers in the lab of DonalJ Rennie, now profes- ties with scientific organizations sor of physiology and vice pro\'ost for national and international - and is currently on the Nationa l Research researc:h and graduate education. "I sQ much enjoyed that kind of Council, U.S. National Committee for acti\'1ty," Knox recalls. "I said to myself, the International Union of Physiological Sciences. 'If there's any place you'd like to he, Being dean uf Mayo Medical School where 1, 1t!' The amwer was the lab." Undler Rennie's guidance, Knox pur- 1s not the largest of Knox's current responsibilities. As director for educasued a Ph.D. 111 physiology, as well as an M.D. The Cllmbined Jegree was neces- tion of the Mayo Foundation, he also sary, Knox felt, 111order to be able to do oversees the programs and activities of the Mayo graduate schools in health basic iresearch m disease-related areas sciences and medicine. and ce:ach in a medical school. Despite his administrative responsiKnox joined the Mayo Medical Schcx)l faculty in 1971after doing basic rt"l>earch bilities, Knox is able to continue teachmg as he has every year in the medical at the Natmnal Heart Institute and ,chool for the last 19 years. And, more reaching at the Univer..1ryof Missouri. unusual for someone m his position, he A ditstingubhed anJ highly productive researcher m the field of renal physiology is able to spend half his time on - particularly the regulation of sodium research supported by the National �------- f!J--------29 Institutes of Health. Knox's career is something of a balancing act, perhaps, but he is good at it. "Everything is arrange<l in such a way that I have been able to maintain the research and teaching activit ies as well as carry out my administrative responsibilities, although at any one time any of these could be all-consuming," he said. "So it's a matter of organizing and delegating things so everything comes out even." EUGENE M.SIGMAN // had no aspirations to go into administration or to join a fulltime faculty. I just wanted to be like the rest of the pack, a physician of one kind or another in private practice," said Eugene Sigman, dean of the Uni,·ersity of Connecticut Medical School since 1985. Eugene M. Sigman , M.D . 'S2 Afteir Sigman finished his residency and began m practice urology at Buffalo Genera I Hospital, however, he became involve·d in research and in 1961joined che faculty of the UB medical school m urology. He was awarded Buswell Fcllows,hips tn 1963and 1964 to pursue research in urology and nuclear medici ,ne and was recruited by the University of Connecticut m 1969, a year after the school opened, to head its urology department. "I backed into academia from practice," Sigman said. "But l was deeply interes1ted in medical education, more than anything else, and that's what drew me back." As a new school, Connecticut offered opportunities to develop innovative approaches to educat10n, Sigman said. Courses were multi-discipli narv, based on an organ-syHem approa,ch, with 10 to 12 faculc} members te:achmg a course. The curriculum also included courses in the social and beha\'ioral ~c1ences. Although Sigman has done important work and written numerous papers tn urology and nuclear medicine, his chief interest 1s education. He is a meml;,er of the Association of American Medical Colleges, the AAMC Council of Deans, the AAMCAMA Liaison Committee on Medical Education Site Visit Team and the AAMC-AMA Oversight Committee on Me<lical Education. Sigman traces his own commitment to educatton to the influence of the committed faculty and practicing physicians he studied with at UB, including John H. Talbot, chair of the UB Department of Medicine and chief of medicine at BGH; the late Oliver P. Jones, professor of anatomy, and George Miller, professor of medicine. "My own education at UB led me to appreciate the value of education. The commitment that [ saw - department heads taught the basic science courses - very much impressed me. "In the clinical years, there was only a very small full-time faculty. Instead, practtcing physicians provided free time for educating medical students. That really struck me. In spite of their very busy schedules, they were able to find time to give to students. "I took my residency in the same system. I came to see chat what you got out of the system you had to pay back by contributing to the education of the students who followed you. That's probably what impressed me more than anything else about UB. Plus there are a lot of nice people there." ]11dichB. Hennan is a B1,ffalouriter wah a special interest m medzcme. She has been a 1niter-ediwr w1th the Western Neu York HealrhS~swmsAgency. �--- -/tJ---IJ \t, 30 ALUMNUS' GIFTTOUB HONORS FORMER TEACHER "I will give to my teachersthe respectand gratitwlewhich is theirdue." - Oath of Hippocrates emember chat spec ial teacher who recognized your potential, wh o encouraged your best efforts, and who, through h is or her interest and influence, left a last ing effect upon your life? One way co show your respect and gratit ude is through a gift co the UB Foundation in honor of that special teacher and friend. Jerald A. Bovino '71 recently gave a $500 gift to the UB Foundation in honor of his former teache r, Philip Weis '41. Weis, a clinical professor of surgery, is a general surgeon in private practice, a member of the University Council, and chis year's annual fund chairman. Bovino wrote: DearDr. Weis, I was pleasedto receiveyour recent letter for support for the Unit•ersity at Buffalo Foundation. I would like w tell you why your letter has personal significance. On a cold and snowy autumn day 23 years ago, I flew to Buffalo for my medical school inten,•iew.Like so many of the applicants, I was apprehensii•eabout m)' prospects for acceptance to a school of medicine. My undergraduategrades were good but not outstanding, but my MCAT scores, especially in the sciences, were very high. I was mten·iewed by three members of chef acult:y,but I specificallyremembermy interniew with you. I felt that you u•ere warm and sincere,and you made me «•ant to aLtend the Unit·ersit)' at Buffalo. Analumnus remembers thewarmthandsincerity shownto himbya teacherat UB. �--------- ~®:--------// tt. 31 Although I was subsequentlyacceptedto ocher medical schools, ( many of them more prestigious), I chose to attend UB largely on the basis of our personalcontact. . .. A check is enclosedwhich l would Likeyou to submitfor me in your honor. Warmestpersonalregards from a gratefulstudent, JeraldA. Bovina, M.D. Bovino rece ived nume rous Mosby and Lange awards for outsta nding performance while at UB, and was elected to Alp ha Omega Alpha. C urrently, he is in a vitreoretinal surgical tertiary care hospital-based practice in Toledo, Ohio; has published extensively on the subject of retinal surgery; has se rved as vice president, president and secretary of the Vitreous Society (a professional group), and is an associate clinica l professor of surge ry a t the Medical College of Oh10 at Toledo . ship fund will be used for UB medical studen ts who show academic promise and have financial need. "Both my brothe r, Harold, am l myself ne,·er married or had an y child ren," Miss Sanes explained. "We wanted to do something to he lp others and to show that we had walked across this earth. Since our brother taught at UB, we thought it would be nice to do something for the Uni\'en,ity." The late Winfield Louts Butsch '30 is remembered through an endowed lecture fund established in his memory by h is children, John L. Butsch, M.D., David W. Butsch, M.D. and Janet F. Butsch, and various friends and relatives. Butsch, a prominent Buffalo surgeon and clinical professo r of surgery at UB, died Oct. 24. The gift will be used to sponsor an annual lecture series in clinical surgery. IT'SLAST CALL FOR WORKOF1930GRADS AWARD NOMINATIONS GOES ONTHROUGH GIFTS wo graduates of the Class of 1930 who cherished their work with medica l students are remembered by gifts that will he lp continue that work through a scholarship fund and a lecture series. The late Samuel Sanes '30, a noted physician and professor of pathology at the UB medical school for mo re than 30 years, won numerous awards for his service and contributions to the field of teaching. He is remembered through a scho lan,hip fund in the names of his brother and sister, Harold S. and Thelma, set up through a gift of $100,000 from Miss Sanes. The permanently endowed scholar- here's just a little nme left to make n ominations for the second annual Distinguished Medical Alumnus/a Award. June 1 is the deadline to suggest a name of a graduate of the UB medical school who has made an outsta nding contribution to medicine, the arts, or humani ty during his or her career. The selection will be made during the summer and the award will be presented in the fall at a special dinner. There's a postcard at the front of the magazine for your nominatio n. Hurry! ERRATUM Editor: In the Early Winter 1989 issue, you have a picture and a short note on a classmate of mine, Dr. Har\'ey C. Slocum. You have it labeled class of '36. This is incorrect as he graduated with me m 1932. He is a renred professor of anesthesia m Texas. While in the service at Walter Reed General Hosp ital, he gave the anesthesia to President Eisenhower durmg his surgery for ileitis. - Elmer Friedland , M.D. , F.A.C.P. The Buffalo Physician and Biomedical Scienast welcomes letters from its readers. Address chem to Buffalo Physician and Biomedical Scientist, 136 Crofts Hall. Unit1ersity at Buffalo, Buffalo N.Y. 14260. From leh, Nedra Harrison, M.D.'77, treasurer of the MectKal Alumni Association, chats withShawnCotton andEllen Giampofi oftheOassof 1990at a re<eption inJanuary forthe graduating doss. About 250people attended. �32 1960. Paul J Loree '62 - recent!) 1lwrrad1u' "-:,,,ml •""-x1:ttl,I 111 ,,t ,1phth.1l1rniloi:vw11h Kcnncth Amhonc, M I) m Tort.'lwand,1. fr,1nl E. Ehrl1d, '61 - 1, ,lin·uor ,,t the di\ 1,10n ,,ftr.Ill• m I md prof,,, or of urger) .it Uni\ er 1q in Hahnemann rhit.1,ldpht.1 . D 1\ 1d Ci. l'ublo\\ '65 .- ,, pre 1clcnr-dect ,11 rhc ;,,.e" 1l 1m1hire Onhop-Jt.•,fa::X>Cll'I) Lmu,nle A. Gol,lschl,1gcr'65 .1, board ll"rt1hcd in cma.cenq ml-d1-.mcan<l \\,IS cb:1,-d 11 (cl. lo" , t 1he Amcncan Collct;c of Ellll'f)!l"lll\Ph) ll 1,111'. E.Jordon 't 5 mi:: 11 text book, Dm:,1sc,oJth<' km Ro~'fl t.-dulogic Roger \X'. Sc1hel '66 .- ha been named m1er11n clm1-.al ,l1rnrnr ,-it ,urgcn ,It thl· Eric ( ,1111\1\!1.lcJ1l,1ICcnll'r. Dr. " I •I 1, an ltlcndmg trauma • •1 I and director of state 11 thl• ho,pttal. pra,on 'l'r\lll' ,md ,, c11rrcntl, 1clm1c.1I,l,'<X 1• ,Ill' prof, ,,,,rof both ,urger) and nt UB or1hClp.1C<l1,, J,1u1h D. R,,:hrud, 'i l .- 1, the I\C\\ ,h1cf of orrhop 1cd1c ,uri::cr, Jt Docior, Ho,p1111, lkth l,r.1d !l.1,d1,.il cl'llll'f, fork. ~l'\\ 1 1 Jame M. L,·\\ 1 ' 5 .pri,,ltl' peJ1.1m, pr llflll' ,111h.1 ,pl'll 11mrcr,·,t III dHnllll l lrl'. Dr I t \\ 1., ha, four lh1ldren A 11orld tnl\ cll·r, skillc,I pho• to.gr11lll'r ,mJ ,1 p.11ron of thc an,, Jlcoh,en Jomcd an,lther ,\ \V1lmo1Jacob.--cn,M I) , 1 doctor on an .ucheologac,tl I rot,-.,-orol r,·d 1,llrll s ,II U fl "' w ,1n·mntc rcg11>1\ t,ir m,1n, ,c,1r, ,,h,"c ,.1r1,·,I cxpcd111lln II\ 195". ~1cXICll m1cre,1, m luJed mro1cal,111.!1<"' of the de 11hof Prcs1dem\V1lh1m 1ed ~hron J. D)hich ' McKmlq, d1,.J D« .. Ii, 19"9, 1989, m ::-dll'ncl.1.1<1\ Ou.lo, .1ftcr,1hnd 1llnc". lll·\,,is91 . afrl·r a I, ng I IIn,·~ . Attn recl.'I\mg ht, h.1chdor's md mcd1c,1lJq::reo from John, \ irgmia Pa" lak '36 - \\ ho Hopl..m, Un1\l:r,11), he ,,·i',d pr,tl t 1< ,·d medll 11\l'undcr hcr Ill the u.~ Arn\\ d11rmc\Vnrl,I m.11,I,11 n,1me of R1.:hrcr. d1l•d \Vir I tor I\\O ,car, . Atll'r th,· Jm I , 1990, m Cl ircn ...e. ~ Y, " ir, he 1rnmc<lan mcd1cmc anJ J airer il loni: tllnc,, pcd1atr1l.,a1 John, Hopkm,. , M.D. A. WilmotJacobsen sl11.•111.11nta1mdhl·r rr1, lie In 1926, Jncoh,,·n c.11nl·to c tor 2i \l 1rsunul 19hl, rrat11 Huttilo r., ,..,1,1hh,hin outra11cm she bc.:ame d1re.:1or of "hen dcronmmr ,11Oul,hn'.. llc,,pnal d1n1l 1<1rthe E11l l., mtq In JQ~~. hl' rn,1mcd fael)n '-he also I o a peda uric 1an. Health Dl'partmn Hench, I H •art 1aui::h1 ar sic honorl,I rhc ....I _,.. ,I St.,,[Jnt Children's I ln.i-p11.1l Ste\ l'll T, 11,:h Acndl'lll). thc hr t• n.unmc h, 19:-4 p,11rm ,11Ohio ,urcln of profr"or '-tare UntHr•tt) ,111da11,•nJmg tloor ou1p.111en1 d1111l th, rd Harold MC)cr, ·5-; " ph1,11.:1anm the [)q,;1rtmen1 of Jacob-1.'n•Hcath Ambulatoq ocmx. An:, a P.")l.h1am1, l lime. Ped1a1r1csurgcr) m Columbus 3, 1991.l J1l d J,111. In thl• I 92l',, J,1.:,,h,cn ,,,1, l 'luklrcn\ 11.,,pttal. crcd1tl..J,1uh m1xmi:ii druc from Tamm) J Lm<ncr - a lir•t• German, 10cure a )OUngBuff1lo P 1ulm, A Wall, ' I - 1 )C3r mro11.:al,1udem, wa, \ailed OO)"11h memng1115", h1ch ,, as M,,orkmi: hard" m her prl\ ate m ,1l,lr ,Kc1Jcm I\:·.:. 21 \\ lllll• 1h,,ught 1<1Ix- t.11,11ll"0 l'l'rH·111 (~1l1t..m1a, pr.1lt1u• mt ).1kl.111,l. 'O 1,111nchl·r fam1h m Cicne..... , ol thl· time ni.11 drug 1urncdout ed 1 8.A m rcccl\ Lm,ner to he an earl) f. nn ot ,ulfa drugs, Jt:ftrq j . !Moua ' 2 - ha, m 19-.9 from chem, tr) the hN an11b1011, upcnl'J .1 pr,1cr11.l' an Terre Cnlll'J.:l', I. H.1m\l, ll.111tc,ln,h11M, ,pl'l11lt:mg m In 19H, hl• "'" till· hr,t tn At 1lw UB ml....11,.il"hc,,I, ,t,, g t,tr,ll'ntl'mln1.1 ,mJ cndo:,cop1. rnogn1:c ,md Jc,,nl-,c I num• cl '"mate, El 1mc Cheon 10111('(1 bcrof J1Hr,c ')ndromc a, real• Campbell m pl m Hcathcr and cnttt\ Onl' 7 -- ,a,, I) bdon,:ani: rn Roh·rt GolJl IJn!! ...._ l'\IUl,non pro• outread, an nmg that \,h,n he lim,he, Im rc-1Jcn• \,hi.:h h,· call,·,1 hl·rcd11aq mJ horn,·• mJ1c,n1 the tnr Jcl.! . The q m mtl'm 11ml.J1c1ne m June, o teochondro,h,tropln 1:e l'tnpha "ill that le" g d1sca,e " 1, uh-equcntl) nanwd 1990. hl· \\Ill he con1m11111h,, Ir'-..calk-d . m<' meJ1 prcHm1,c . honor h,, m Ja«>h,en\ d1,,a,c 1r,1mmg\\1th a 1dlo\\,h1p 1n g:i-• which ,rand, tor \ 1!?orou e, en at the age of H E.A I I ~.G., II'()(ntl.'l'Ok,i:,i.llthl· Um, cNt) cl n, and Leamu~ Edlll.-a.111 lll-ahh. 91, Jal.oh,cn mamt 11neJ othle at '-m Dil.1,'<l ( 1hfom1::i Gm,\lh ~I.'" lmoh-mc ll(lur, ,1x d,1)' .1\\cek Till' ,111,lcnti:r,,up I\1ht1 \\Ill J.1«1kcn wa.~ m l.''\l'(n ,m the Pd,M,1h t\. \Vh1tl' 'f-.7 - ol a plaque, "rnc,, ~ ..) commH-n.) OH'I' whether medical pl mt a tree, rnarh-d h\ Tona\\cmd.i, ""holJr A I) mem ner'led 10 1he death ot m Lm J \'( hue and 1ncomptctl."I\Cc "Chri,tophcr .11',1 ha, menH>r\ her 111 ,hip l1eh,ir,1h t\. \\'hire ,11\11<,un.:e l'rl·,1d1.:nt~1d(mlc) ,liter hi.' l\,h 1d: 11.irl\l 11 up ,c1 h.:'l'I\ 1 1'111• thl• •hot m 1 hll at rh,· h1rth ,,t ,1 ,on, \ndre\1 <'.ollct;e Ruffalo E.xposmonm 19 6, \mencan ~i't ,n Fr:m1.:1,, Ohituarics I9SC1- 0 ��I( Buffalo Physician and Biomedical Scientist State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 3581 I d n Requeste Correctio Address II II II I LOCKIE DR L. MAXWELL 92.;i DELEWAREAVE ~UFFALO NY 14209 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Spring 1990 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1990-Spring Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v24n01-1990-Spring Table Of Contents A list of subunits of the resource. Research briefs On pins and needles The boy who lived a miracle Microscopes to microchips More research Talent in triplicate Alumni. Classnotes. Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-12 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v24n01 Extent The size or duration of the resource. 36 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1990 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/29271f84e7bc25fb0e525fabe21b5ced.pdf a287a68baa3b329da1143dd9ccdf4527 PDF Text Text E.rly Wmrer1989 \bl 23, :-<o.i ---• - ····- . ..:::--; .. ; : :: : : \t\fi ~: ; '. ff ·; =-;-!_: ~:~::·~-:- I I I ......... _____ _ ••• ;•. I t • ' ~--u&; :e;;;' ~=f~~:::-; ~-~=~ --------- 1Ile Class of '45 and Its Tn,e Humorists ·.·:·r ' �STAPF OIREC1Ult Of PlJIUCAT1oNS N-yli,bin ..-w l'H'tSICIAN mm:,o "-°"'"""""' ARTDIRECIOll Alan).~ ADVl80RY BOARD Dr J,,hn N...... , 0.- .,.. ........ r,....... Ma. NMKy 01i«o , T he August II, 1989 issue of Tone nuipunc publilhcJ an lmpoftllntanicle de.ling with the cumnr and posa1blefuture 1tMU1 of dx medicalpro(aaion. Not 111rprilinawerethe n111ny a>nc:emcdand nepave pen:ep, bOnL Thfflt ol the moet distftaina: poina arr the public's pcrcq,- tion that physicians no °' """" ''""' Dr,Ku.Ir., 11,o.... kmaclisten r to patients. CONiflcntlv run la, and laU<o ecplam what they arr Dr. J-ph l. K11ru Dr a..ta Pap,,.lli Mr l'auJ.D"-""" Or. O..lo.PN "-Dr. ,,,,'-" Or. U11ha Ran..,.. Dr a.-nduil n-n. .... .... ... 0........ .., .... .... _., "'-"' ..... _ o. 0. -.... °""" warreu -M~~ .......... W...ll'r.,tor.M.Jl :=.":i~ ILLUll'Mmll8 dometo patients. Of all the mucs. these an: the chanca:riat1cs which rhc rnemben ol the prolnaion md1vidually and collectively can corffCt at l1nlcpmonal and cconomtc COit. A:non ally, I find rl\em so intrirwcally fundammtal to the 1ntqrr1ty of a physici an, reprdlca of ipeciaky identification. that I would think thar wouktwant ro dimnwe fflCICconcmu, 81 ei:pedlnowly as posaihlwe c. The b.inh major con«m rdated ro the percepaon of over· cluraing ior ICl"VICa. Fortunately, our 10e1tty supports the con• that-phyadam ahowd be adequately compmsated for rhcir tltttlsand talentLHowever, It II becomina:1nctta111alv col'K:ffllN with the lnc:artsuitv whichelCIIU betwem the kwb of compe:n· NIIDD ftC:doled anclthe pc.abed wtthdrwal of physiciana from czpt dealina'WMhpahmtt Ir -.. of modest co ltmlfN means. obviousrhM:medical,chook, their ttaduna: hoepitab. and the pro(euton at larsc must deal with the1e four llSUCS in a ditect, t'ordlriaht, consuuctive mannn if dw pasunllhC p,ctuttofered In Jmv 1& to be ff'VC!'Sed. • at l.J8"amedical school contin~ to commH ounclves preparlna phystc1ans wellpounded 1n the fundamentals of Klflldftcmedicalpracoce and dedicated to the neelB ol all pat"ac nu. '° ~ (}i-_~~~: ftM:HINGAND John Naup,.,.,, M.D. Va PmidaacforOmamlA//mn 0-,Sdloola(....,.,,,,..., -- ... ~pilll• ..W- .... ~ Nwbk.Sftlll THE BUPl'ALO PHYSICIANAND BIOMEDICAL ......... IICIEHl1ST. c.,, ................ .. eo.liallv, �BUFFAlD \ol. P tJX-?i l~~ n. ~"-4 Earl1 Winter 191N Features fl Top teachers,Page23 II PETScanner . Buffalo is getting state-of-the-art imaging equipment that shows not how the body looks, but how it works. A joint project of the UB medical school and the VA Medical Center, the $12 million center for Positron Emission Tomography should be fully operational by the end of 1991. Meet the chairmen.UB has created a new Department of Emergency Medicine and has placed one of the field's pioneers at its helm. Meet him and five other new chairmen who have visions of new ways to bring UB to the forefront in research and teaching. m Thoughtson a nasty day. William R. Taylor, Class of '45, reflects on three classmates who understood the importance of humor in their profession and their lives. IEJPhoto directory. Here's an introduction students in the basic sciences. to the Departments I] fl Antique treasures,Page30 fl I] Neu· image, Page2 Ill Alumni au:ard, Page26 Cowerlllurnotion:JosephTh,d People. Keep your teaching fresh, even offbeat. That's the advice of award-winning professors Murray Ettinger and Charles Severin. Research.A product called INFASURF significantly reduces respiratory problems in premature infants, according to a national study coordinated by UB researcher Edmund A. Egan lll. Alumni.George W. Thorn, Class of '29, a pioneer in endocrinology, organ transplantation, and kidney dialysis in the United States, received the first Distinguished Alumnus Award from UB. MedicalSchoolNews.Two antique chandeliers have been restored to their original luster thanks to a donation from Robert L. Brown, Class of '44. The pair now graces UB's Health Sciences Library. Classnotes. �2 PlEI s <e<r1lIl1lIl1l<eJr With plans to build $12 millioncenter, Buffalo is poised at a new frontier uffalo is approaching a new frontier in diagnostic medicine with plans to build one of the most ad; vanced Positron Emission Tomography (PET) imaging centers in the world. PET imaging, the latest in com; puter scanning techniques, has the unique ability to visualize and quantify complex physiological pro; cesses occurring in the human body. It has potential for important advances in the understanding and treatment of major ailments, in; eluding heart disease, stroke, cancer, epilepsy, and Alzheimer's disease. EARLYWINTER 1989 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �3 Joseph A. Preiio, M.D., Jayakumari M. Gona, M.D., and Robert E. Ackerhalt, Ph.D. A joint project of the UB School of Medicine and Biomedical Sciences and the Buffalo VA Medical Center, the $12 million center will serve the entire community, including non-veterans. Funding of $3.4 million for the project has been awarded by the federal Department of Veterans Affairs. UB has committed $1.6 million. The balance will be provided by state grants and private support. The James H. Cummings Foundation already has committed $1 million - the largest grant in the charitable, nonprofit BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST PET centers m the nation bave tbe capabilities proposed for tbe Buffalo site. corporation's 26-year history - to the project. The center will be the first PET imaging center in the SUNY system and the only one of four in New York State that's located upstate. There are some two dozen PET imaging centers in the U.S.,but only a handful have clinical and research capabilities on the scale being proposed for Buffalo, noted John Naughton, M.D., dean of the medical school and vice president for clinical affairs at UB. Naughton said the PET imaging center EARLYWINTER 1989 �4 "will be significant not only co this region, but co the entire northeastern United States. This project will put the UB medical school at the very edge of a new frontier of diagnostic medicine." "We will be offering an imaging technology not available in most big teaching centers in the United States; added Joseph A. Prezio, M.O., chair of the UB Department of Nuclear Medicine who will serve as the cenrer's director. "It will also add significantly to the services we offer our patients:• The center will have two major components: a PET scanner facility located at the Buffalo VA Medical Center and a cyclotron facility housed in Parker Hall on the adjacent UB South Campus. The cyclotron facility will produce radionuclides, low-level radioactive materials, to be used by the PET scanner. Underground pneumatic rubes connecting the hospital and Parker Hall will transport the radionuclides. The cyclotron is a specially designed electromagnetic device that will permit researchers to accelerate charged particles or ionized atoms to very high velocities. The particles collide with targets composed of various elements, compounds, or gases, producing the low-level radioactive materials. Most radionuclides produced by the cyclotron will totally decay to a stable element within a few hours to a few days, Prezio noted. The hospital-based PET scanner is expected to be operational by September 1990 and the UB-based cyclotron by the end of 1991, Prezio said. It's anticipated that other local hospitals and private medical practices will decide to buy scanners and use radiopharmaceuticals produced by the UB cyclotron. Millard Fillmore Hospital has indicated that it will open a diagnostic imaging center with a PET scanner, and Buffalo General and other area hospitals have also expressed interest in getting PET scanners. The chief of the PET scanner facility at Veterans will be Jayakumari M. Gona, M.O., chief of nuclear medicine at Veterans and UB clinical assistant professor of nuclear medicine. The director of the EARLY WINTER 198Q cyclotron facility will be Robert E. Ackerhalr, Ph.D., vice chairman of the UB Department of Nuclear Medicine and research associate professor of nuclear medicine. The project has received enthusiastic support from the Western New York Health Sciences Consortium. (That consortium is composed of area hospitals, the UB medical school, and the Greater Buffalo Development Foundation.) In a 15-month child uncontroHeJ ( top anJ normal. old with seizures, center) appear Howevc-r, on the PET image (bottom), the- dark area epileptic event 1s page occurring. is a view of the PET e<Juipment, A PET scan will cost about $1,500, which is comparable to the cost associated with a study using CT scanning or magnetic resonance imaging. lt is less than many invasive studies used to evaluate cardiac, neurologic, and oncological problems, bur without the increased risk of morbidity or mortality associated with them. It's anticipated that soon third-party carriers will provide reimbursement for a PET scan. PET scanning is the newest computer imaging technique to arrive in Western New York. The first CT scanner in all of New York State arrived at the Dent Neurologic Institute at Millard Fillmore Hospital in 1973. It was the fifth in North America. The Dent also got Western New York's first working magnetic resonance imaging scanner in December 1982. For the first two years, it was used only for research. UB President Steven B. Sample noted that Buffalo's PET center "is part of the effort of the University and its affiliated teaching hospitals co establish 'centers of excellence' in healrh care and enhance the regional and national reputation of the high-quality health care delivery system in Western New York. Its establishment also is in keeping with our goal of moving the University into the ranks of the top 10 public research universities in the country." Richard S. Droske, director of the VA Medical Center, said the cooperative effort that led to designation of the new center is another example of how the VA Medical Center and the University work together co benefit the community. "The PET Imaging Center; he predicted, "will lead co quantum leaps in our clinicalcare and research abilities in such fields as cardiology, neurology, and oncology." • BUFFALO PHYSICIAN AND BIOMEDICAL SCLENTIST �To get a better idea of what Positron Emission Tomograpy (PET) imaging is, it's helpful co compare it to the more familiar X-ray computed tomography (CT) scanning. Boch are noninvasive and provide glimpses into the human body. There is a significant difference, however, noted Joseph A. Prezio, M.D., chair of the UB Department of Nuclear Medicine who will serve as the director of Buffalo's new PET imaging center. While CT scanning shows anatomic structures in the body, PET scanning visualizes and quantifies information about physiological and chemical pro­ cesses occurring in body organs. Put another way, CT scanning reveals how organs look, while PET scanning tells how well they function. Because it detects disease-triggered chemical changes in the body that are precursors to anatomic changes and physical symptoms, PET scanning already has shown its value in early detection and treatment of disease. In coronary artery disease, for exam­ ple, PET scanning can help physicians tell the difference between viable and dead heart muscle. PET scanning has potential for major advances in the understanding and treatments of ailments such as stroke, cancer, epilepsy, and Alzheimer's disease, noted Prezio. It also will allow physicians co evaluate the effectiveness of chemotherapy programs in cancer treat­ ment within one day, rather than several months. Pharmaceutical companies will use PET to accurately determine effective drug dosages. Prezio noted that PET scanning has also been used co successfully pinpoint the sire of electrical outbursts in rhe brains of epileptics chat set off seizures, BUFFALOPHYSICIAN AND BIOMEDICAL SCIENTIST and to advance medical understanding of brain tumors. Another difference between PET and CT scanning is the manner in which the images are produced. In CT scanning, low-level X-rays are produced by the scanner unit and pass through the part of the body being studied. A computer generates a three­ dimensional image based on readings that result from the X-rays. With PET scanning, trace amounts of radioactive biological compounds called radiopharmaceuticals are introduced into the patient's body. These radiophar­ maceuticals emit positrons, a positively charged electron. A computer generates three-dimensional images based on the pattern of X-rays emitted by the positrons. Radionuclides, the low-level radioac­ cive materials contained in the radiopharmacuecicals, will be produced in the cyclotron facility at UB. • EARLYWINTER 1989 �6 N ew names,new faces,new directions. Six new chairmen are among the 19 to lead departments in UB's Schoolof Medicineand BiomedicalSciences. Just created is a Department of EmergencyMedicine, which will be headed by G. Richard Braen, M.D. The other new chairmen areStephanieH. Pincus,M.D., dermatology;L. Nelson Hopkins, M .D., neurosurgery; Robert Gillespie, M.D., Ch.B., orthopaedics;F.BruderStapleton, M.D., pediatrics,and Ron­ ald P. Rubin, Ph.D., pharmacology and therapeutics. They have outlinedplans to bring to their departmentsnationaland internationalreputations for excellence. Severalchairmenhave also been reappointed: • JosephA. Prezio,M.D., De- partment of Nuclear Medicine • Myroslaw Hreshchyshyn, M.D., Department of Gynecology and Obstetrics • George Alker Jr., M.D ., Department of Radiology • James P. Nolan, M.D., Department of Medicine • Leon E. Farhi, M.D., Department of Physiology • Saxon L. Graham, Ph.D., Department of Social and Preventive Medicine • Harold Brody, M.D., Ph.D., Anatomy • William H. Coles, M.D., Ophthalmology • Glen E. Gresham, M.D., Rehabilitation Medicine • David Holden,M.D., Family Medicine • John I. Lauria, M.D., Anesthesiology • John R. Wright, M.D., Pathology • John M. Lore Jr., M.D., Otolaryngology PHOTOS : EARLYWINTER 1989 BOBWALION BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �EMERGENCY MEDICINE G. Richard Braen, M.D., has been named chairman of the new Department of Emergency Medicine at UB. He is also head of the Department of Emergency Medicine at Buffalo General Hospital. "Dr. Braen is one of the new breed of emergency medicine specialists," said John Naughton, dean of the medical school and vice president for clinical affairs at UB. "He's been in the discipline since its inception. He's regarded as an academic leader for the discipline and is helping to set the foundation of what the discipline is." Braen is residency-trained and board-certified in emergency medicine. He ran the residency program at the University of Kentucky for several years. He came to UB from his post as assistant professor at Harvard Medical School. The autho r of spiral-bound manuals for medical students and residents, his popular Clinician's Pocket Referenceis in its sixth edition. Braen is working on the third edition of EmergencyMedicine: Conceptsand Clinical Practice. Bl.ifFALD PHYSICIAN A:S:D BIOMEDICAL SCIENTIST G. RichardBraen, M.D., a pioneer in the field of emergency medicine,is chairmanof the medical school'snewest department. Along with a UB medical student, he's working on another spiral-bound emergency medicine manual. 7 He also wrote Managementof the Physicallyand Emotionally Abused: Early Assessment, Interventionand Counseling. Getting a brand-new department off the ground takes quite a bit of work. "Our major goal is education, initially," said Braen. "We'll get into research as time goes by." The department will be very communityoriented, Braen said. It will work with pre-hospital personnel such as ambulance staff and emergency medical technicians. Within the school, the new department will work with medical students at various levels. le will expand the offerings for emergency medicine rotations and offer services to existing cou rses that want to include emergency medicine topics. The three-year residency program will train IO emergency medicine residents a year. Emergency medicine is one of the most competitive residencies, he added. UB's program will be based at two main hospitals, Buffalo General and Erie County Medical Center, with Millard Fillmore and Children's hospitals supplementing the program. Most emergency medicine residency programs use more than one hospital, Braen noted. He hopes to have the residency program in place by July 1991. "The big job in starting a residency program is getting the board-certified emergency medical physicians," Braen said. "In the greater Buffalo area, I can count all of them on two hands, maybe one hand." Nation-wide, there are on ly about 7,0CXJ certified emergency medicine physicians available to fill 30,000 available positions, he noted. Since most of the training programs are in the midwest and west they can't keep up with the need in the east. ' Because UB's training program is located in the east and is at a university, "we1Ibe very competitive and in very high demand, and we'll get very good, qualified residents in the program; Braen predicted. The residents in tum can teach the students. "The key is the people," he said . Ten years down the road, Braen hopes the department will have a fully credentialed residency program that will be supplying residency graduates to area hospitals, that there's an appropriate interest in emergency medicine from medical students, and that there's a well-established research component in areas such as shock and trauma. • (Fordetails on the new department, see page 8.) EARLY WINTER 1989 �8 DERMATOLOGY Stephanie H. Pincus, M.D., has been named professor and chair of the Department of Dermatology ac UB. Pincus also serves as head of the Department of Dermatology at Buffalo General Hospital. Board-certified in both internal medicine and dermatology, she specializes in care of skin problems chat are unique to women. Her research is in a type of cell called an eosinophil, which participates in allergic and parasitic disease. It's found in large numbers in skin disease. Pincus, who is highly regarded nationally as a teacher, comes to UB from a post as associate professor of dermatology and medicine and vice chair of the Dermatology Department at Tufts University School of Medicine, Boston . She was also associate dermatologist-in-chief and director of the phototherapy unit at New England Medical Center, Boston. Re-establishing the national image of the dermatology department is one of Pincus's major goals. Dermatology has a tradition of being strong in Buffalo, she said. In view of the many changes chat have raken place in dermatology in America in the lase few years, it was time for re-evaluation of the residency program. One change was to integrate che department SKILLED PHYSICIANS NEEDED AT 'FRONTLINES'OFMEDICINE ''You never know what's coming in," said G. Richard Braen, M.D. That's the challenge of emergency medicine - it's the front lines in the fight against the trauma of major injury. And because the emergency room is the first stop for many kinds of cases, emergency medicine physicians need skills that cut across many disciplines - surgery, obstetrics, pediatrics, psychiatry, and community relations. Braen, a pioneer tn this relatively new specialty area, has been named chair of UB's newly created Department of Emergency Medicine. "l've been practicing since 1976, and I don't know of a day tha t's gone by when I didn't see something I'd never seen before; said Braen. "l like the variety." Braen remembers the time he was working an evening shift in Lexington, Kentucky. A call came in over the radio to expect five people burned in a car accident. le turned out that all five were deaf and mute. Because their hands were burned, communication was a challenge - they couldn't speak, couldn't write, couldn't use sign language. "We had to do the best we could; Braen said. Ac one time, the emergency room was a kind of Siberia where the hospital's least qualified physicians were sent, or the ER was staffed by interns. "Then it was realized that this was where the most qualified people were needed," Braen noted. Emergency medicine is an important new field, said John Naughton, dean of the medical school and vice president for clinical affairs at UB, because as the technology of caring for patients becomes more sophisticated, people who used to die from major injuries can now be saved. An important part of emergency medicine is the integration with the rest of the pre-hospital system, such as ambulance staff and emergency medical technicians, Braen explained. "We want to make sure the initial care is high so when EARLY WINTER 1989 they come to us they are salvageable;' he said. Many emergency room cases are not true emergencies, Braen noted. Emergency medicine physicians also cake care of minor medical problems at odd hours when the patient's regular doctor might not be in his office. Making sure char patients are properlyreferred so they get needed care, but avoid elaborate services that aren't necessary, is part of the job of the emergency medicine physician, Naughton noted. "There's a lot of emphasis nationally on improving emergency room care - where a lot of mistakes used to be made," he added. It was just a little over 10 years ago that emergency medicine was recognized as a specialty by the American Board of Medical Specialties. UB is one of the few medical schools with a department in this field. "I could probably hold a meeting of all of the chairmen of the academic departments of emergency medicine right in my office; Braen noted, glancing around the room. "There are only about seven or eight, so this is a relatively uncommon position to hold." UB decided to create a freestandtng department rather than a division within surgery because emergency medicine is a more defined specialty than it once was, explained Naughton. It also cuts across many disciplines. A freestanding academic department will be a big attraction to residents, Braen predicted. And, since this is an area where many mistakes can be made, having a freestanding department puts fewer people in the chain of command and makes residents more directly accountable, Naughton noted. The freestanding department was recommended by a special committee appointed by the dean. The hospital directors unanimously supported the plan, and it was in turn approved by the Faculty Council of the medical school, the provost, and the president. • BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �more closely with other hospital departments. Dermatology's administrative and clinical offices were mo\'ed right tnto Buffalo General Hospital. The department also will emphasize more basic resean.:h to educate residents in the pachophys1ology of dermatological diseasl' and its relation to other basic science. "The res1dencs have, in large part, responded very positively, and there's very good esprit de corps; she noted. The next goal is thl· recruitment of more dermatology faculty memhcrs for the Erie County Medical Center and Buffalo General Hospital. ~1orc physician, are needed becau,e new regulations mandate that every patient who is seen by a resident must also be seen by an attending physician. Research is also an important part of the department. "Ulcimatelv, we want to develop a very strong re"Can..h program to further the development of the specialty," Pincus said. She also envisions that dermawlogy will plav an important role in an increasingly busy outpatient practice in the hmpitals. Another aim of the department is to strengthen the faculcv clinical pranicc plan, which provides private care on a fee-for-service basis. "I want to provide good care and use the fiscal rewards for departStephanieff. mental development," she said. Pincus, \Vhen asked about her accomplishment,, Pincus points to photos of her children, ages 17, 13, M.D.,has and I. integratedthe "I'd like to convev to women medical ,cudents Dermatology that it's not easy, but possible, to have a personal and professional life," Pincus said. Department In her quest for an administrative position, Pinmoreclosely cus was happy to find a city where both she and her husband, Allan Oseroff, M.O., Ph.D., who is withother also an academic dermatologl',t, could work. Oseroff is chief of dermatology research at Roswell hospital Park Cancer lnsntute. Roswell'ss1mulrnneous affiliadepartments. tion with, yet independence from, UB allows the couple to work wgecher,with(?ut one spouse working for the ocher. A graduate of Reed College in Portland, Ore., Pincus received her medical degree cum laudc from Harvard Medi cal School in 1968. Pincus served her internship at Boston City Hospital and her residency in medicine at the Umversity of \X'ashingron Affiliated Hospitals, Seattle. She served as senior fellow in dermatology at the University of \X'ashington and resean..h folio\\ BlJFFALO PHYSICIA~ A,'\;0 BIOMEDICAL SCIE?--.'TIST 9 in dermatology at Harvard Medical Sl hool. From 1987-88,she was a visiting scientist at Biogen Research Corp. m Cambridge, Mass. She is a fellow of the American Academy of Dermatology and a member of the Souetv of Investigative Dermatology. · Pincus 1sthe author or co-author of more than 60 articles and abstracts and nine book chapters. • NEUROSURGERY L. ~el,on Hopkms, M.D., has heen named chair• man of the Department of Neurosurgery at UB. He is also Lhairman of the departments of neurosurgery at Buffalo General Hospital, Millard Fillmore Hospital, Children's Hm,pital, and the Eric County Medical Center. A local product, born and raised in Buffalo, Hopkins comes to the chairmanship directly from private practice. His natural interest in arndemic neurosurgery led him co publish a book, several hook c.hapters, and more than 40 ahstracts and papers. He has lectured widely and sponsored national seminars in Buffalo on the management of aneurysms. EARLY 'IX'J!\TER l9bQ �Because of his energetic work as a teacher and IO clinician, several people suggested that he consider lhe chairmanship at UB even though he was a clinical associate professor, not a full-time academician. Re-establishing the reputation of the residency program, which was on probation, was his major goal when he started in January 1989. "A year ago, all but one resident failed the boards, and he was borderline; Hopkins said. "Now, all the residents have passed, and they did well. "In one year, we've turned around the teaching program, and that's largely because of Jim Budny (vice chairman of the department) ." In order to concentrate resources and avoid duplication of services, Hopkins aims co develop subspecialry centers of excellence at different University hospitals. Neurovascular surgery and neurosurgery of the spine would be located at Millard Fillmore Hospital; neuro-oncology, Buffalo General Hospital and Roswell Park Cancer Institute; trauma, Erie County Medical Center, and pediatric neurosurgery, Children's Hospital. Millard Fillmore Hospital is building a lab for spine research, as well as a multidiscip linary back institute for care of patients with back problems in conjunction with the medical school's Department of Rehabilitation Medicine. An exciting area that's being developed at Millard Fillmore is endovascu lar neurosurgery, Hopkins said, which can sometimes eliminate the need for open surgery or make surgery much safer. For example, a tiny catheter could be inserted at the groin and moved through the artery up to the head. Then doctors can inject fluid through the catheter into a tumor or vascular abnormality to take away its blood supply. This procedure could cut the hospital stay from 10 days co just a day or two in some cases. The department also is concentrating on neurologic diseases of the spine and has recruited two outstanding young surgeons who are experts in treatment of patients with spine disorders. "Back pain is the most common cause of disability in the U.S. besides the common cold; Hopkins noted. The department is also trying to develop a program for care of brain tumor~ with Buffalo General Hospital and Roswell Park Cancer Institute. Hopkins received his bache lor's degree from Rutgers University and graduated cum Laudefrom Albany Medical College in 1969. He served his internship in surgery at Case Western Reserve, then served as a resident in EARLYWINTER 1989 L. NelsonHopkins , M.D., aims to develop subspecialty centers of excellence at various University hospitals. neurology and neurosurgery at UB. He is certified bv the American Board of Neurological Surgery. Active with the Congress of Neurological Surgeons, he is general chairman for this year's annual meeting and last year was scientific program chairman. Hopkins is the chairman of a computer subcommittee of a joint committee on education for the two national neurosurgical organizations. He also chaired a subcommittee on drugs and devices for the two organizations. He's a member of the executive committee of the Congress of Neurologica l Su rgeons and has served as a member of the editorial staff of Neurosurgery,rhe group's journal. • ORTHOPAEDICS Robert Gillespie, M.0., Ch.B., who had been acting chairman of the Department of Orthopaedics at UB, has been appointed chairman . A member of the faculty of the UB medica l school since 1985, Gillespie is a professor of orthopaedics . He is also director of orthopaedics ac Children's Hospital of Buffalo. BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST �Establishing a coordinated research program and an organized sports medicine component are two of Gillespie's goals for the department. "I want ro establish a vigorous research base," he explained. Central laborarory facilities for all aspects of orthopaedic research will be located in renovated space in Farber Hall, the old dental school building, probably by June 1990. He also plans to establish a clinical research office with computer linkages throughout affiliated hospitals. Gillespie is working to recruit an established leader in orthopaedic research. Recruiting is also under way for a new scate-ofthe-art sports medicine center . The center, for patient care and research, will be established in conjunction with the Family Medicine Department, che Division of Athletics, and other departments at UB. le will provide overall health care for UB's varsity and intramural sports reams, students who want to gee fie and stay fie, and other residents of Western New York. One of the strengths of the Department of Orthopaedics is its strong teaching program that offers excellent, well-rounded training for residents, especially in spine and hand surgery, trauma, and pediatrics. The residents have a very high success rate on the orthopaedic board exams, Gillespie said. "And we are optimistic that we can move our training program - which is already well respected - to a level where it is regarded as one of the major orthopaedic programs in the country," he said. "Part of that process is to enla rge our research fellowship program co facilitate our research capability and to be able to build a stronger and more complete research experience into the residency training program itself. "We hope to build and strengthen our contacts with other departments th roughout the University, especially Engineering, Physiology, and Health Related Professions." Before coming to Buffalo, Gillespie was an assistant professor in the Department of Surgery, University of Toronto and an orthopaedic surgeon at Toronto's Hospital for Sick Children. He also was a consulting orthopaedic surgeon and clinic chief of the amputee service at Ontario Crippled Children's Center in Toronto and on the staff of the Department of Orthopaedic Surgery, Orthopaedic and Arthritic Hospital, Toronto. Gillespie is an orthopaedic consultant to the Pediatric Institute of Krakow, Poland, which operates under the auspices of Project HOPE . BUFFAl.O PHYSICIAN AND BIOMEDICAL SCIENTIST RobertGillespie, M.D., Ch.B.,plans to establish Since 1970, he has been active in the research into the problem of children with spinal deformities 11 and congenital limb deformities. The author of multip le publications and book chapters on these topics, he has also been an invited guest speaker in many major centers around the world . He received bachelor of medicine and surgery degrees from Sc. Andrew's University, Sc. Andrew's, Scotland, in 1959. He was named a fellow of the Royal College of Surgeons of Edinburgh in 1965and a fellow of the Royal College of Surgeons of Canada in 1969. Gillespie has served for the past four years on che board of directors of the Scoliosis Research Society of North America. • a coordinated research programand an organized sports medicine componentin orthopaedics. PEDIATRICS F. Bruder Stapleton, M.D., has been appointed chair of the Department of Pediatrics and the A. Conger Goodyear Professor of Pediatrics at UB. He also serves as pediatrician-in-chief and chair of the Department of Pediatrics at Children's Hospital of Buffalo. A nationally recognized pediatric nephrologist, EARLY WINTER 1989 �12 i Stapleton previously was professor of pediatrics and chief of pediatric ncphrology at the University of Tennessee Center for the Health Sciences in Memphis. The first step toward developing a nationally recognized academic department is to strengthen its already fine faculty by recruiting talented scientists who can also provide the state-of-the-art clinical skills in pediatrics, Stapleton said. The lack of a research building to show candidates is an impediment to recruiting, he noted. UB's planned research building will help, and there arc plans for Children's Hospital co gee additional research space in the next five years. Another recruitment hurdle is the limited number of people going into academic pediatrics. But UB's Department of Pediatrics has several points in its favor, Stapleton pointed out. It's affiliated with Children's Hospital of Buffalo, a strong pediatric hospital with a unique feature: it's the only children's hospital in the continental United States with a high-risk delivery service and a strong neonatology program. Children's Hospital enjoys a great deal of community support and there's a very close relationship between the hospital and the University. The EARLY WINTER 1989 F. BruderStapleton, M.D., is recruiting talented scientists to strengthen the fine faculty in the Department of Pediatrics. hospital is clearly oriented to support the move to national recognition for academics, Stapleton added. Because UB has a system of affiliated hospitals rather than a single medical center, faculty in pediatrics can draw upon the other hospitals, such as che Roswell Park Cancer Institute. The drawback, though, is that Children's Hospital is geographically separate from the core of scientific activity at UB. Because researchers have to travel between sites, "it takes tremendous commitment to meet patients' needs and conduct research; he noted. Stapleton received his medical degree in 1972 from the University of Kansas Medical Center in Kansas City, where he also served as chief pediatric resident and a fellow in pediatric nephrology. Before joining the University of Tennessee, he was on the faculty in pediatrics at the University of California at San Diego and the University of Kansas Medical Center in Kansas City. He also served as co-associate director of the Clinical Research Center at the University of Tennessee and medical director of its Pediatric Unit and as direccor of research for the department of pediatrics at LcBonheur Children's Medical Center in Memphis. Author or co-author of 88 scientific papers, Stapleton has done extensive research in urinary and kidney problems in children. He participated last year in the development of a consensus doscument prepared under the auspices of the National Institutes of Health chat focused on a long-rage plan to combat kidney and urological disorders. A fellow of the American Academy of Pediatrics, Stapleton is certified in pediatric nephrology. He was recently elected a member of the American Pediatric Society in recognition of his accomplishments in pediatric research. Stapleton also was elected co the executive council of the American Society of Pediatric Nephrology. He is a member of the executive council of the Internacional Pediatric Nephrology Association and the national executive board of the American Board of Pediatric Nephrology. • PHARMACOLOGY Ronald P. Rubin, Ph.D., has been appointed professor and chair of the Department of Pharmacology and Therapeutics. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �___ -_-_ ___ --~- ---- - ---~ Rubin previously was professor of pharmacology at the Medical College of Virginia, where he had been a member of the faculty since 1974. Before chat he was on the faculty of Downstate Medical Center and Hunter College. After receiving his undergraduate degree in biochemistry from Harvard College, Rubin attended dental school at Harvard University, then switched gears and obtained his master's degree in teaching from Harvard. He taught high school science for a year before he decided co go into pharmacology. In 1963, he received his doctorate in pharmacology from the Albert Einstein College of Medicine. Rubin's goal is to build a department of national and international repute. He emphasizes chat he is seeking quality, not quantity. "Quality begets qualicy; he noted. "People build reputations individually. We're not dealing with a numbers game. When I retire, I want to be remembered for having built a good department; nor a large department. He's crying to recruit a "critical mass" of faculty with world-class reputations. In the next four or five years, he wants to see the faculty invited to national and international meetings. "If you have a good department, several faculty members should go on co be chairmen of their own departments; Rubin added. "We've identified a couple who could be in the next few years." One of che strengths of the department is its good young research faculty. Rubin has recruited a colleague from che Medical College of Virginia, Suzanne Laychock, Ph.D., and he's looking for two additional people. John Naughton, dean of the medical school and vice president for clinical affairs at UB, has been very supportive and understands the need to bring in outside people, Rubin said. Having chis critical mass of fine faculty members will in turn attract fine pre- and pose-doctoral trainees, Rubin added. It's important co have an active graduate program with approximately one student per faculty member. You need that blend of pre-doctoral trainees, post-doctoral trainees, and faculty for an optimal intellectual environment, he said. To strengthen che department's teaching program even more, Rubin plans co interact more close1y with the Department of Biochemical Pharmacology in UB's School of Pharmacy. Research is an important part of the department, and Rubin expects the faculty to be productive. However, he stresses that grants are only a BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST - 13 RonaldP. Rubin, Ph.D., emphasizes that he is seeking quality,not quantity,for the Departmentof Pharmacology and Therapeutics. means to an end. He'd be satisfied with a productive faculty member who had one grant. And if a faculty member had two grants and wanted a third Rubin would want to make sure the faculty membc; could handle it. "My goals are productivity. My goals arc quality, not quantity," Rubin stressed. "I think this department as a group feels that. "I'm not against grants; I'm against making grantgetting the goal of your work." Rubin studies secretory mechanisms, also called signal transduction. He focuses on calcium as a mediator of secretion. The author or co-author of more than 80 scientific articles, 19 book chapters, 2 monographs, and numerous abstracts, he also serves as field editor for cellular pharmacology with the Journalof Phar­ macologyand Experimental Therapeutics. He won the faculty member of the year award for excellence in research from the Medical College of Virginia. A member of the American Pharmacology Society and the Endocrine Society, Rubin was on the Public Information Committee of the Federation of the American Society of Experimental Biology. • EARLY WINTER 1989 �14 Bv WILLIAM R. TAYlDR, ~1.D. n the second day of January, the weather in California was so cold and nasty chat it reminded me of Buffalo. I began watching two large gray squirrels playing tn a naked oak tree. They were running at top speed, alternating the lead, up and down branches, then jumping many feet co another tree. All this was 50 feet above the ground, on wet footing and in the rain. Their obvious joy and pure fun broke me out of my slowly developing depression, and changed my thinking to happy thoughts from 45 years earlier. A great day in the history of medicine was Jan. 2, 1944. On that d:w penicillin was released for u,e on the general population and memhers of the Class of 1945 were assigned their first live patients. We were designated a, "junior clinical clerks" and called "Doctor" bv thl· knowing nur,es. That day was also cold and wet in Buffalo. We were herded mto a large room where we met Abe Aaron, full professor of medicine, in charge of converting us "masters of ac.adem1c theory" into "dinicians" - Ill ahout one hour. The most memorable subject covered bv Dr. Aaron chat day wa, the role of humor in the pracm:e of mediune. He proposed char etery disease inflicts a secondary effect on the psyche of the patient and that chis ranges from simple worrv to depre~sion. It is also similar among their kinfolk, if not worse. He assured us that the presence of the physician could etther lift or further depress the mood of the sick room and we Jl/uslralions EARLY WINTER IQ~q must never forget chis potential. He used the word "humor." This must never be of a flippant type, hut a "discreet and appropriate" type; when the doctor leaves the room, ewryone involved with the disease should foci better. This is espt.•dallytrue in those cases where ,pccific therapy \\ ill not cure the primary disease. Abe Aaron then proiected ro our future and promised us that a good sense of humor would be necessary if we were to survive 111 the potennally depressing career environment of disease. Meditating on the above leads me to update three inadequate t)bituarv notices. While our Class of '45 mav not he the most outstanding in every category, we certainly had the greatest collection of True Humori.,ts. It is a sad reality that our three greatest humorists have re,encly died. The ohicuary notices 111 chis UB alumni journal missed their real greatness when they factually reported: Mamn Downe',', Jr. ane,thesiolog1st; Joseph Rutecki-surgeon and anatomist; George Fuggm-urologist. I would like to introduce you to these three outstanding members of my c.lassand offer a few thoughts concerning their true greacnes:s.Furthermore, should they (Xlssess that elusive nbility co read this from their position in the Great Beyond, I would like them to know how much I admired themthen and now. I met Joe Rutecki fir~t because we both went to R1vcrs1deHigh Sthool, where I was a vear ahead of Joe. Accordingly, I did not t'/ JoseplJiie/ BUFFALO PHYSICIAN ASD BIOMEDICAL SCIENTIST �. ----------+~-:j ____________ ::::::-1:➔ ••••-••-~.f•• '' ••••••••••• II 11 I ;.,....... : I t I I , I I I , I I .... - . - :: t - - • - ••••.::: I I I - --- ---------- .. I I I I I I I I I I I I ,-............ - _.,. ~ •' I I I 0 I .. ---_-_-:___ --_- ----•• I ,,' .:L ... I ' ,-----==-- II I I"• I . -------- ----- --- :,I I 1 I ••••• �16 know Joe very well, after all, he was only che laseof a long line of Ruceckis. Joe was known co be unusually smart, bur nor as flamboyant as his older brother. We all knew him as a nice kid. We didn't know che term "humble; but he was that coo. I next met Joe in anatomy lab on the morning of July 5, 1942, the day our class started med school. I was with him every day for the next three years. I had the only car going from Riverside to med school and I drove Joe to and from every day. There was a constant attitude of humor that grew more inescapable as time went on. This was every day in the car, in the classes, and in our frequent bull sessions which were often about a very real WW II, which was not always going well for us. Joe had a specific type of humor we all noticed: he never extracted humor ac the expense of any other person. We identified Joe's humor as "benign humor." I think of the humor of Red Skelton as "benign humor" and that of Don Rickles as "malignant humor." I cannot separate Joe's humor from his sharp and quick mind, which may explain why he made med school after only three years at Canisius College. Joe very rapidly changed from "just another Rutecki." Since he was "Ru" and I was "Ta"in the alphabet, we spent both years of our clinical clerkship not only at the same hospitals, but in the same small groups. It was in the clinical setting chat we saw him use the type of humor char Abe Aaron called "discreet and appropriate." He was often with a patient in the desperate throes of a terminal illness, but I could not help noticing how his innate humor spilled over co make the patient somehow feel better. This was not a phony act just because Aaron had cold us to inject a dose of humor; this was the real Joe who had chis quality from rhe cradle on. Another word we muse use is "sincerity; which he had in full measure. Among his colleagues, Joe was noted for coining nicknames and propagating, if not originating, "rumors." When the med school was between deans, he wanted to start a rumor campaign to get our most eligible classmate appointed. Norm Chassin was not elected, bur he EARLYWINTER IQ8Q ,~..-...._. . .,_,,,_,,~._~......,._,.~, '! rn Jle I courl jesler ' ' anJ a Jarn root! i sluJenl, j 300 pounJs-pfus , I, I i 'e was II . I I' ' J ' of Jumor anJ fun,· i I, I I:, I' ' i: . 'i ii nol an ounce meanness '- ..... • ,n of /, • tm. I' i I I . i' I I' , ~~ ........ ~...... ,- ,~ ·•- •1 - ,,-!: was a dandy. When I lase saw Joe Rutecki it was at our 1985 class reunion. Several of us were in a conversation when Joe joined the group. A classmate said: "Here comes Joe ... now we will all scare laughing." I don't remember che derails of the conversation, but the laugh titre went sky high. As his special "benign" humor went to work on his beloved classmates, he was personally carcinomatosis, bur concealed the grim fact. He was a great guy for me co have known. C hronologically, the next one I met was George Fuggin. This was in September, 1938 when we both scarred pre-med on campus. We met more literally when we both went out for frosh foot• ball. On the first day he played defensive nose tackle and I played offensive center. We bashed each ocher all afternoon. My mother ended my career when she refused to sign the parental consent to play. I don't know if George's mother scuttled him in a like manner, but I was sure he would not make the team. He was 300 pounds-plus of humor and fun; not an ounce of meanness in him. Through countless encounters, four years on cam- pus and then three more in med school, George Fuggitt was always the "court jester" and a dam good student, coo. In med school he was in all my preclinical classes, but he was "Fu" in contrast to my "Ta" so we were on opposite sides of most rooms. George met Gene Morehouse in med school and their chemistry hit it off. They had a running pseudo-feud chat injected humor into every situation. Since George was over six feet call and always on the upper side of 300 pounds, he was dramatically bigger than Gene, who played the straight man. This pair we called our "Laurel and Hardy." Their humor was not necessarily classic benign, but it was also never malignant. At the 1980 reunion party, George was the master of ceremonies. His spontaneous and continuous humor further underlined the rumor (possibly started by Rutecki?) chat George was the only doctor who had his patient laughing during a prostate massage. It is good that George chose urology, where humor is so appropriate. I last saw George at the 1985 reunion. He couldn't be the MC because the ravages of his rumor diminished his ability - but not his beautiful smile. His humor fit well in his huge countenance. The last of our trio was Marty Downey. He sat two stools co my right in histology lab and we met for the first rime on the afternoon of July 5, 1942. At that time l evaluated him as a quiet, incelleccual type. ln those days he started no conversations, but always joined in with comments on all subjects. His comments were always very appropriate and usually raised the level of conversation. He was more a Catholic philosopher than a humorist. As the freshman year progressed, he became more relaxed and the humor began co show. It was especially effective because of his original reputation as an intellectual. Marty Downey and George Fuggitt contrasted in many ways: George was at all times a gross extrovert; George was the biggest man in the class and Marty was probably the smallest; George was not a football payer and Marry was. But both were equal in the quality of their humor. BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST �,.. . .·J • : ~ · .-- .... .~ ... ,,,,,,.... ..- ••:•. • ~•• 0 •• : ... A ., --~...... .. _ ,.,,....,.- .~ • . """' ·-. ··. ~.- : } . : ..~ ~;·.:. ....,...io!!_j~;;\. ··- \-.-~ -·· .. :l ..___:' ..' ' ·.~l ·:·:. . ' ...:--- ----:-::. ~ ·,'··............ ' . ...._.... . ~ ,. ..;,,,,.. .:·....:,:,,: __,,,,,,,,,,, . ,( { .. ·::__ ... . By October, 1942, we had spent three full months with the freshmen dentists. While we spent every afternoon in labs, they were having a series of picnics with endless beer and spectacular couch football games. The lace afternoon lab schedule was aggravating enough, but their arrogance abouc their games was building our resentment to hatred. We finally arranged a showdown game. On the team were several former college star players, but chose Dents were pros. They beat us 35 to 7. Marcy Downey was our entire offensive threat and they identified him immediately. He was so fast and shifty that he was the only one co gain ground all day. The Denes would frequently cackle Marty because they were afraid a mere touch might miss this dancer. Each time Marty would bounce up in testimony to his great physical conditioning, and each time he would make a snide remark about the rough game, but in a manner chat both sides had co laugh. By the end of the game he was both our M.V.P. and top humorist. We arrival. They were not disappointed at the plight of this terribly proper bronchoscopist. We were convulsed ar rhe retelling. ln my medication on the theme, l am somewhat disappointed that Marry Downey chose anesthesiology for his life's work. It is regrettable chat so many of his patients were sleeping rhrough his humor . Bue, to remember the second admonition of Abe Aaron, the physician needs a good sense of humor to survive a career in chis potentially depressing environment of ours. all had to use humo r co accept chat terrible beating, but Marcy was the best. The last time I saw or heard Marty Downey was on the occasion of our 35th reunion. In a small group setting, Marry reviewed a case which he had not been forewarned about. The first inkling that it was co be a sex change operation was when the surgeon in charge made his initial bold incision, actually excision, to change a boy into a girl. This surprised the anesthesiologist, who was attempting to sec up a very proper chart. He gave a resume of the surgery and the comments in the O.R. by all of the various members of the O.R. ream. Marty convulsed chis audience, which led him into a discussion of the gastrocolic reflex of Herman Boser. It seems chat at 9 a.m. his urge to respond to the reflex would have to be answered. Ac 8:45 a.m., Marty set up a phony occupant in each of the two toilet booths in the doctors' lounge at Buffalo General Hospital. He then locked the doors and climbed out over the partition. Then the boys all sat back and awaited the urgent BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST <T here is one more unique circumstance that involved all three: ASTP. ln July, 1943 the military took over all the approved medical schools with a program called "Army Specialized Training Program." Our three heroes were all soldiers, first as privates and later promoted to Pfc.The olive drab uniforms were wool, which can get hot and itchy. Mass formation each 0800 our in High Street was awful as witnessed by us Navy men wacchin~ them from the comfort of inside. Worst of all was the military protocol, which demanded that these privates behave as subordinates to the corporals, sergeants, and most especially the major, who constituted the staff. All the above stimulated the funny bone of our class instead of breaking their spirit. There were many other classmates who were humorists in this regimented lifestyle,but none greater than our Big Three. These were three great men who have left a hole in the remnants of the Class of '45. The level of humor will be lower. If we allow these three men to die and fill an obscure niche in a stack of obituaries, the cause of humor in medicine will be offended. [ hope there is some professor of medicine at UB who repeats the message of Abe Aaron, and impresses the budding doctors chat humor should be a big part of their careers in medicine. I am quire sure each class will have potential Ruteckis, Fuggitts, and Downeys, and they should be officially encouraged in this beautiful line of therapeutics. Can you now see why l love these three men? • J EARLYWINTER 1989 J7 �Graduate Students he scientist values research by the size of its contribu, tion to that huge, logically articulated structure of '' ideas which is already, though not yet half built, the most glorious accomplishment of mankind?' - Sir Peter Brian Medawar (who won a Nobel Prize for his work in immunology). The grandest of goals is shared by the graduate students who are entering the University at Buffalo School of Medicine and Biomedica l Sciences. As it did in the last issue for the medical students, the Buffalo Physicianand Biomedical Scientist now presents a photo directory of the new graduate students. Their biographies inc lude undergraduate major and degree, unde rgraduate institu, tion, and current department. �Graduate )tudents 19 Susan Lynn Dagenais, Peter Augustinos , B,ologyB.A., Hofstra Unitermy, Pacholoin-1 u:,sh co gam more knou:ledgeabouc the human bod,. Kathleen E. Bethin , Bux:hem1s1ryB.S., Unlt'ers11y at Buffalo, Biochemistn. l am a jomt M.D. ·. Ph.D. student. Reva Bhushan , BiologyB.S. and Chemistry B.S.. Si. FrancisCollege, MicrobioloJ::,'. 1 ha,e a ma.1ter'sdegreefrom Rhode Island m B,ologv. 1 am 1nten-s1ed m research,oil pam1mg and baiik. Manja H.E.M. Bouman , Biochemistry Engineer,Hogeschoolf nterstudie,Biochemistry. I'm from rhe Nerherlands.l pla, Korfbal. Margaret Christine Grabb, Bwlogv B.S., Un1<ers11y at Buffalo, M, fa,orue Physiolog:,·. sporesare u>lle-balland basketball. David A. Judd , B,otechnologv,RlT, B,ochemistn. l u·ould ratherbe d~mkmg. Chong-Hyun Kim , Microb,oloi('iB.S., Seoul Nauonal Uni,emiv, Physiology.M, fawrite spori is bou·lmg. Won-Ki Kim , PharJungsook Cho Lee, 1rtac\ B.S. and M.S., Pharma" B.S., Seoul Seo,;!Na11onalUn1te~,- l\'auonal Unn.ersH~. t), Pharmacolog:,. l like Pharmacnlog,.I came plavmg iennis l am a from Korea. neu· Ph.D. studenl in pharmacolog,. Laura Jane Nicho lson, B,olog:, B.A., l.lni,·erm, of · Delauare, Micmbwlogv. l came 10 Buffalo from· ~for.land and for UB's .\1.0. • PhD. program. Xin Sun, B,ochemism B.S., Fudan Uni,·e"uy: ShanghaiProunce, B,ochemistr..;'..h faiher is a professorm • biochemiscr..1 ihmk I'll uork on biomedical Miriam Helene Tiktinsky , Phy1ical Theraf1\B.S., Washmi:conUni,m11y, Pms,olo![).Afier eight w,m as a P.T.,I'm gomg back co school10 do research. Meng-Hang Xia , Tox1cologv B.S., ShanghaiMedical Unn ern1,, Pharmacolog,:I'm from Chma. 1 am a Ph.D. Meiheng Yang, B1ochemmr.B.S., Sichuan Uni, mu,, B,ochemmr.. l came here on July 26. Zhaohui Yang, Biochem,sm·B.Sc., Pe- science. 1ruden1no-.,·.I u·ill enjO\ B,ochenmrnB.S.,Norih• em M,ch1gan Unit·mir,, Parholog:,. I ha,·e an M.A. m biolog,. I ha,e an miere.<tm research. Shih-Ping Yang, M.D., NarionalDefense Medical Cenrer, Physiolog:,. l am a graduaresrudentof rhe departmentof pms,ology Yuan Gao, Medicine B.S.C. PekingUnion Medical College, B,ochemmr.. I chose UB becauseu's a famou~umt'ersuy. king Un1ternr,, Bioch,mmr.. I am onginalh from Chma. 10te l.!B. If. Photoswere unavailablefor: John Delyani , Physiolog:, Haiping Mei , M icro&iolog,. �People 20 Offbeatand Proudof It Ettinger will do anything to spark students' interest "1 try to convey in an emotional way, what's exciting about the subject. I do a lot of 'offbeat' things to stimulate excitement and interest; Murray Ettinger, professor of biochemistry, said from his laboratory. "I have no pride. I'll do anything to create interest and understanding." Ettinger was describing some of his offbeat methods of reaching. "[ meet people ten years lacer and one of rhe first things they mention is collagen superstar~ Ettinge r said a former student gave him this title. "I go overboard crying to get people to understand why collagen (a structural protein) is so exciting," he said. But collagen isn't the only subject to get Ettingcr's unusual treatment. "There is a concept of how enzymes work called induced fit. I used a thinly disguised analogy ro mutually happy sex." Bur Emnger's offbeat approach isn't limited to a single class. "I taught an advanced graduate course and I decided nor to give any exams. Then I found out what rhe great motivator is: a berter motivator than grades ... • Ettinger paused with a twinkle in his eye. "I said, 'Put your hand on the buzzer as soon as you chink you have the answer. Whoever understands it first will get a dozen doughnuts:" Pastries, apparently, motivate students better than finals. These methods apparently are working. SUNY Central recently named him a distinguished teaching professor, one of the highest honors in the system. This is not the first rime that Ettinger's EARLYWINTER 1989 By DAVID M. SNYDERMAN teaching excellence has been recognized. He has received two Louis A. and Ruch Siegel Teaching Awards and many letters of commendation. "Put your hand on the buzzer as soon as you think you have the answer. Whoever understands it first will get a dozen doughnuts," Ettinger told his students. Pastries, apparently, motivate students better than finals. T he medical school class of 1979 dedicated its yearbook to him and he received the S.N.M.A. Award for Service co Minority Students in 1988. "I really felt good about that because I have spent a lot of rime trying co help minority students; Ettinger commented. Ettinger has serious accomplishments co his credit. He has developed several classes, one of which is an elective honors biochemistry course for medical students. "Several students said they were just bored with the first year of medical school. "It's an informal, graduate level course where the students learn from each other. Two co four students identify a disease that they arc interested in. I help chem a licdc bit finding papers about the disease," explained Ettinger . The class has examined such diseases as Down's Syndrome, sickle cell anemia , systematic lupus, Parkinson's, diabetes, muscular dystrophy, and schizophrenia. "lc'swhatever the student wanes. Everybody in the class reads the papers. All that the people who choose the diseases do is lead the discussion. They learn by informal conversation about what they read. And then the following week, we get together with a physician and a patient." This helps the students get a better understanding of the disease, Ettinge r noted. "I've (also) organized a summer program for people who have failed biochemist ry. The objective is not only to learn and pass biochemistry but to learn an approach to understanding any subject," he said. Ettinger teaches methods of learning in this biochemistry course. Students are told they should take the lectures and then, "paraphrase BUFFALOPHYSICIANAND BIOMEDICALSC!ENTIST �People 21 1nternah:c 1t, ~ct II mto vour m, n word . Iii he a good ,tudent, vou have to lome up \\ 1th your O\\ n 'ICU point. \\'hnt a good tcachcr dOC! 1s ,umul tc you to do chat. •t \\ould like p,.:opll' t<> undcr,t.md what I'm t.ilking .,bout ,o that tlll'y rnuld solve a rnrn• plctch nc-., problem• 11, or Emnger, tead11ng add, 'Pile to life. "I like the \'ancty of mv Job. I enJO) my I would go re5c:mh but 1f I did Ju t r=rch, half hall), Teaching gl\cs me rnntan \\1th F people." "1th111 a teach mg exist Et unger' order to "In hO\\L'\er. frame-.,ork of rc,,carch, get a J1 t 111guished te,1<hmg pmtc sor,h1p, fir<t of nil \'<)U han· to hen prof<'S50ran<l vou can't he a profo-or "1thout being a uccessful researcher." Trained ,1, n protl'III < hem1,t, l:tt111~crmm \\Orb "11 h rnecalocn:ymc,, •pc-c1ficallvtopper o:1:idasc. "I'm intl'f('!,tcd m the role of copper m h1ology," lw ,,ud. "Sumulatcd h, quCl>t1on, from m\ O\\ n graduate cudcm,, our work in recent ~car has dnhl·d towards H'llular hmchem1<trv ol ,oppcr; th,ll 1,, how cdl move nroun<l and use copper, and mhcmcd d1,-ca~ of copfl<.'1' b1ochcm1 try (,uch a \X'1l,-0n'sdt l-a,e). "\\'c u,l' the d1,ea,l' ,1s :- rool," he ,ay,. "If not only rnn we cure figure out the d1!-<:asc, the d1~. se, but \\C find out 50me1hmg tm portant about hm, normal cells u e copp~:r." EmngL·r\ n>mmllrnl'lll ro re<l'.lr<h makes lum a be Iler m,cruc1or, he said. "The old a~~c that tcachmg and research complt:mcm <':I<h 01 her 1~ true." Hi, 1ead1111gmetho,.h ure ha L'd on mak• ing an 1mprcss1on, Emngcr ,aid One of his former student, rold Emngcr that one of the pmfc,,or's 5ta1cmcnt ,ihuuc "ho\\ ,Hw1h111g that can r,lllonallv happen probahh \\tll be bsencd in 50mc Lanett <)<tern• had become the ha~• for that phys1c1an's pracucc ol 0 med1eine. "It reall) madc me feelgood." § for Ettmscr,teaching rs a =pons1b1ht~ n t R t,) fic takl·n lightly. "I'm t hL·onl' \\ ho 1< ,urn• lt 111,m:mgI he wholc ,rnw of knowk<lgc about the ,uhJcct. \XO\\! That' rcalh a prl\'llcgc: • ,,c I \furra~ Ettinger, Ph.D. BUI!'AID PHYSICIA~ A~D lll0\1EDICAI SCJE:-:TIST EARLYIX'ISTER198'1 �People 22 Keep It Fresh Severin wins Chancellor's Award for Excellence in Teaching //E ach student has his limitations. You have co adjust your teaching to the student," says Charles Severin, associate professor of Anacomical Sciences. His willingness co adjust, along with his excellent teaching methods, have won him a Chancellor's Award for Excellence in Teaching. One of rhese adjusrmenr, occurred wirh the student of a colleague. Severin, who teaches gross anatomy (primarily to medical and dencal students), was asked for suggestions by Judith Tamburlin, clinical instruccor in anatomy, who teaches the undergraduate gross anatomy class. "A couple of years ago, she had a blind student enroll in a class," Severin began. "Anacomy is a visual subJect; there are areas in anacomy that are cough for a sighted student to understand. "After finding that there weren't any teaching aids at this level for her, we designed this for her." "This" is a braille, raised relief, gross anatomy textbook made especially for Lisa Hoffman, Tamburlin's student. Accompanying the raised drawings are explanations both in braille and on tape. Severin and Tamburlin recently received a two-year, $154,000 gram from the National Science Foundation to develop and assess a similar book for high school students. Writing the accompanying texts was a task that beneficed his regular teaching duties. "Ofren the descriptions we used co teach her, we now use co teach the sighted because they were clear and concise," Severin said. EARLYWINTER 1989 By DAVID M. SNYDERMAN Bue Severin maintains his efforts co help students day in and day out and doesn't limit those efforts to an occasional pupil. Because medical scudenrs have long, unusually inflexible schedules, Severin found it difficult to find office hours agreeable co everyone involved. As a result, he now meets most of his students by appointment. 'I've met with students at seven in the morning, eight at night, and on weekends, if they need help,"he explained. "Some people would call it great lengths, but I Just consider it pare of my job. "I try co make my hours as flexible as possible; I cry co help students as much as I can.• S everin said he has found the students extremely dedicated, once they have come co him for help. "I would make appointments for seven in the morning. I would get here sometimes at ten minutes to seven and I never bear the students here." Severin cakes the special insights he received as a student and passes them along to his pupils. "I try to present co the students little rricks and techniques that I use co remember the subject," he said. One of the "tricks" is co draw the anacomical structures from memory. In fact, Severin asked Lisa Hoffman co cry to draw the pictures that he and Tamburlin had transcribed for her. Hoffman walked up to the blackboard and drew the structure, he said. "There was lots of overlap," Severin said, "but she could do it." Another trick that Severin suggests is "to place chem in the body. You can sit there and memorize rhe conrenrs of the anacomy text, but it's just words." So, he asks students co imagine chat they are inside the body, telling them to look around at the structures that arc there. "Anatomy allows you to do that because it's basically a visual subject." This technique, he said, help, students to remember the anacomy long past the final exam. To Severin, it is important that they "remember it ten years from now~ One of his teaching practices has been to revise a lecture every year - even if he was happy the way it went the previous year. Severin said he was taught not co teach like some professors, who use the same lecture year after year. "After doing that for five or six years, they're bored - you can cell they're bored - and the students are going to sense that as well; he said. Severin said he respected the efforts put in by one of his own professors when he was a student. "He spent a minimum of two hours preparing each lecture after IS years." As for professors who just read a prepared text, Severin says, "that's not teaching. There is no sense in coming co an 8 a.m. lecture if the guy is just going co stand up there and read. "We both know it's readable. The object is to try and get the student to remember it." Often, after the lectures in which he presents his tricks, Severin finds that students present him with approaches they've devised to learn the material. "In effect, they are teaching me ways of teaching." • BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �People :!J sc1plinary He ,~ d1rc1.tor of 1hc ~1ul11d1 and coUB ,II Agmg of I~ Stu the for Cenrer d1rcctor of r '" \\ cm :-:c:."\\'rink Genamc • Educauon Ccmcr :it the Um\.-rsny. M.D ., ho, lx·cn Lebenthal, :-.:anonal ,ttc:. ,. [n,mute of Child Health and Human De ,dopmcnt rhat \\ 111re, tcw grant ,1pplicar1011s involvmg nutm1onal therapy (or inborn errors of mctahoh m. Profc sor of pedrnm at UB, l..ebcmhal LS ..rologv and , h1cfof 1ht•Ol\1,1011nt Gastroc:·111 :-.:um11011,tt ChtlJn·n's Hosp11al ,md J1rc:.'C• tor of !IS lmernauonal ln,mu1c of lnfa111 :-.:um11on and Ga tromrestmal D1sca,c. • Emanuel hc r ry Leitch , a S<.'tond-vearuuJrm. won a n·lkl\\sh1p 1ha1 Tr.IV lcr Gcnamcs Rl.'5Carch • S3,000. of award carries an Trevor Litchmore , a third-year •tude111, \\<>nan American Ht·art A<so,1111on\ Stu• Jent S.:holar,h1p m Ccrcbrova,cular Oisca c • thnt came,. an award of $1,'it"lO. Edwin A. Mirand, Ph.D., J rc-ctor of the Dcparrmcnt of Ec.lut,1t1onanJ dc;in of the of UB, re• Ro,\\cll Park Graduate D1v1s1011 A,,_,-ardm \\ehr H. 1lh \X Dr. CCl\t-d the M tr~h tor h1<conmhuuom to Roswell Park • Memorial Im.mute. Chc1rlt•\ Set•erin, Ph D Ph .D ., meal mmucJudith Tamburlin, tll<< , ,,on I L1llv St anntomKal ror ol n-llo"•h1p for her mno\'amc "hanJ,-on" tt-achmg mcthcxh. In a prQgr.!m mlcJ •Undcrgrnduate Human An.11omv Dcmo11s1ra11on Lahormory and RclmcJ Tt-achmg ~latcrial<~ Tamhurhn ,, ne:umg ,pcc1al materials for lnhorator\' Jcmon<1ramms h) prc,cn mg human 11--uc, ,uch a, hcan and lung , m a hfchke •cate. This 1sdone chrough pla,1mauon, the prote,s o( rt·plauni: dw "acer Ill 11'-U<"'"II h a • ,iliu1111ypc ma1cri,1I. 0 0 John Acquavella, a Ph.D. tudcm m the of Social and Pn:vcnnvc Department McJ1c me, rccc1vcJ the award for the best pa~ pri:5ented on a di<scrcauon m the :-:n- BCHAI.O PHYSICIAS ,\SD lllOMEDICAI uonal Compc:uuon of the Ep1dcmiolog1t Rc~earth. S. ty for • Ra)'mond P. Bissonette , Ph.D .. soc1me tam1lv mcd1c11 ,c l B, was ,..._r of the hoarJ oi dm."ttor, ol idem pre dt-ctcd 1he Un11cd CerchrJI l'al y A ,oc1auon ot • 'ri1rk, Inc. \\b1crn :,.:<"'' ob-,or and heaJ of faan Calkin,, M.D., , anJ Gcromologv n of Jcr ch D, :it UB, h,1, h,cn nanwd ,t ma,1.:r of the American Colkgc of l'h\sitian,. C-.alkms, chief of the Gcromolog~ cc11on nt the \r\ Mcd1cal Cemer, wa, urcd for pron mcJ1<:al '1dmg d1rcc11on and 111<p1ra11oco ,rnJcncs and residents and for hi, le;1Jcr,h1p and '>t!n,cc m rhe field of genamcs. SCIESTISI e prt..,.1dem for John '\aughton, \1 0.. t c mcd1cal school rs and d cln a1 UB, h," hct•n n.11ned pre,1dt·nt of I ht Amcman Heart A~soc1,1tion,:,.:t"\I ); rk S1,1tt ,\ffihatc. ~aughcon ha, puhhsht-d c"renmdv on ex t-rCN' and phy,1cal acuvnv m the prevcn• • 110n "' c,,ronarv ht-:irt disease. Tracy Perapato, 0.0., a th1rJ-vcar family t Buffalo Gencr1I med nt rc,1dcnt Ho•pnal, 'J.On the annual ~c" ); rk Statt Atadcmy of Family Prarnce Rcstdent A-1~arJ • for Rt.,.carth. cudcm, won arac , a fourth-war Timur !-1.'(lmdpn~e for h1~po,.tcr prt'!-1.'lllattona1 the E,1,tcrn Srudenc Rest•;trch Forum 111 Florida m :',.1r h • EARLYWINTER l<l~<l �Research 24 Surfactant Helps Tiniest Preemies UB researcher coordinates national study on IN FASURF By ARTHUR PAGE A single dose of calf lung surfactant extract. inJ_ected into their lungs ~t bmh s1gmficanrly reduces the incidence and sevemy of respiratory distress syndrome in premature and low-birthweight infants, according to a national study coordinated by a UB researcher. Involving 2,506 newborns eighr weeks or more premature treated at 13 medical centers, 1t showed that the infants responded favorably to a form of calf lung surfactant extract called INFASURF. The most dramatic results were in the smallest and most premature newborns, those at greatest risk of developing problems. Edmund A. Egan 11, UB professor of pediatrics and physiology, said chat among premature infants born 12 or more weeks early, INFASURF significantly decreased che respiratory death race, incidence and severtty of acute lung disease and chronic lung problems. For example, the study included 712 infants born 12 co 15weeks early, average birthweight 2 pounds, who received 100 milligrams of INFASURF at birth, and 96 infants who did not. The incidence of severe respiratory disease and respiratory death were halved in the treated group. Among the treated infants, 16 percent developed severe respiratory disease and 8 percent died from respiratory failure, compared to a 33 percent incidence of severe respiratory disease in the untreated infants and a 19 percent death rate from respiratory failure. "Current modification of the continuing EARLYWINTER 1989 The ONY Company was created to make the surfactant available even if it isn't patentable. study incorporates more than one dose oflNFASURF if a premature infant develops respiratory disease even with treatment at birch. This 'rescue' approach promises to further improve the outcome for these premature infants; Egan said. Respiratory distress syndrome, also known as hyaline membrane disease, is a leading cause of death and disability among premature infants. le is estimated to occur in 50,000 of the approximately 250,000 infants born prematurely each year 111 the U.S., k1ling about 5,000 of them. The third child of President John F.Kennedy died of respiratory distress syndrome in 1963. Because of their prematurity, the lungs of affected infants do not produce natural surfactant, a substance that coats the insides of che lungs, preventing them from collapsing when the baby exhales. INFASURF is one of several surfactants granted invescigational new drug (IND) status by the U.S. Food and Drug Administration and is being studied in medical centers across the U.S. The FDA in July approved making one of these surfactants, a synthetic form manufactured by Burroughs Wellcome Co., available for wide use prior co its receiving approval for marketing because of surfactant's potential benefit to infants born with respiratory distress syndrome. INFASURF and ocher surfactant macertals arc still classified as INDs and cheir use is limited to specific study centers. However, their sponsors also arc seeking approval from the FDA for wider use. Egan and UB colleagues in the Division of NL'Onatology at Children's Hospital of Buffalo and Goren Enhorning, M.D. and colleagues at Women's College Hospital in Toronto first used calf lung surfactant extract in the early 1980s. Carefully controlled studies, reported in medical journals, showed that injection of che calf lung surfactant extract protected tiny premature infants from respiratory failure. The 13-center study conducted under the FDA's designation of INFASURF as an IND involves 2,506 infants to date. INFASURF is produced by ONY Inc., a Buffalo-based company of which Egan is president. le wa~ incorporated in 1985 to seek FDA approval for calf lung surfactant extract for treatment of infants at risk for respiratory distress syndrome because, according co Egan, major pharmaceutical companies were not BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST �Research 25 willing to sponsor ir because 1r was not patentable. "The pharmaceutical industry basically has two issues in its product development or selection," Egan said. "One is that a product or drug offer some benefit to people and the other is char it make money for the company. ONY was created to make this surfactant extract available to children, even if it isn't patentable, because we believe it's the most cffecti ve." ONY is a "graduate" of the University at Buffalo roundarion Inc. "incubator." The incubator was created to encourage development of small businesses in high-tech areas. Its offices are located in Baird Research Park, adjacent to the UB North (Amherst) Campus. Both the incubator and rhe research park are managed by the Western New York Technology Development Center. • RESEARCHERS STUDY COMPOUNDTHAT Aas LIKEINSULIN I nsulin can be used co treat diabetes, but how docs it work? UB scientists are trying to unlock that secret by studying a compound called vanadate. To many researchers' surprbe, vanadate, an oxygen-vanadium anion, has been shown to mimic insulin's acnons both in cells and in diabetic rats. Insulin is a hormone rhat causes body cells co take in glucose (a sugar) for energy production and storage. "When you have something that everyone describes as insulin mimetic, it naturally leads you to examine diabetes," explained Gail Willsky, associate professor of biochemistry at UB. She recently received a grant from the American Diabetes Association to investigate vanadium's properties as an insulin ,mitaror, yet Willsky's field of research is nor diabetes. "I'm a vanadium person; she explained. "I'm using rhe diabetes, in a sense, ro understand how the vanadium compounds affect metabolism." The similarity between vanadium's actions stimulating a rt.-ceptoron the outside of a cell. They act in much rhe same way as a key opening a lock. Only a similar key will acnvate chat same receptor. Once the receptor is activated, it will cause certain other things to happen, like increasing glucose transport. lnsulin is a long molecule, while vanadate 0 is much smaller. As a result, vanadacc can't ~ - fit in the same "keyhole" as insulin. Instead it seems as if vanadate acts on a different Ioca'. cion of the receptor. •One hypothesis is thac it is stimulating the ~ protein kinase that's part of the insulin rccepcor inside the cell. Where insulin 1s binding "' ac the extracellular, vanadium effects would be intracellular: Willsky explained. Vanadium would he tripping an internal latch of the lock, while insulin opens the door from the and insulin's came as a surprise LO medical outside. researchers. Willsky said she is looking closely at how "They not1ced in cell culture systems that vanadium alleviates cardiac symptoms of vanadace had an insulin mimetic activity, diabetes in rats. such as stimulating glucose transport; Willsky "The heart, the kidney and the eye are the said. maJOr target tissues of diabetes," Willsky said. Eventually, vanadate was med in animal "I'm working in che heart w1th Robert J. systems. "Ir wasn't until it was realized that Mentzer (professor of surgery and physiology). it had a lot of multiple hormone effects rhar "With James Lohr (assistant professor of it was tried m diabetic rats." medicine) and Margaret Acara (associate proInsulin must be inJeCted, while vanadium fessor of pharmacology and therapeutics), can be ingested orally. Will vanadate ever we're also studying how vanadium treatment supplant insulin? Not likely, Willsky said. alleviates kidney symptoms associated with "I don't envision this in any way replacing diabetes." insulm. Since insulin 1s the body's natural Currently, no drug company 1sinvestigating answer to diabetes, 1t 1s the drug of choice:' vanadium as an insulin substitute "due co the Vanadate might be used to treat diabetics face rhat it is so expensive" to meet Federal who don't respond to insulin treatments, but Drug Administration (FDA) guidelines for that would be many years down the road. drug approval, Willsky said. "My efforts are focused on this very basic science, the result of which could be used in "The problem is the vanadium structure is so ~,mple that they don't see how they can a clinical setting," Willsky said. The vanadium compounds may cause maintain their rights to 1cafter they've gone stomach problems and may make people who for FDA approval. That's what I was told by are hypertensive (prone to high blood research and development people in the drug pressure) even more hypertensive. companies." As a result, Willsky said that the "We're a long way from being able co predict drug companies are afraid that they would how a diabcnc would react to chis drug," not be able ro recoup their research and Willsky said. "I think its higher potential is, development expenditures. However, there if you can really understand how insulin arc companies that are looking at vanadium works, you might be able to eliminate as a tool ro investigate insulin's activity, she said. • diabetes some other way." Hormones, such as insulin, act by -By David M. Smderman BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST § f ! EARLYWINTER 1989 �Alumni 26 Medical Pioneer Alumni Associationhonorsone of its own A m1.'Cl1cal pioneer whose achievements as clinician, scienrist and teacher have spanned 60 years, George W. Thom, M.D., was honored Sept. 21 as the first recipient of the Distinguished Alumnus Award given by the UB School of Medicine and Biomedical Sciences. A 1929 graduate of the UB School of Medicine, Thom 1scredited with establishing the foundations of modem endocrinology and metabolism and with pioneering what 1s believed co be the world's first organ transplant as well as bringing kidney dialysis to the United Scates. Thorn al'-0 initiated one of the first "health plans,• a forerunner of today's group practices and health maintenance organizations. Thom received the award ar a dinner in the Buffalo Club. Joseph L. Kunz, M.D., president of the Alumni Association, made the presentation of a specially designed crystal buffalo. Thom was introduced by John P. Naughton, UB vice president for clinical affairs and dean of the medical school. A professor emeritus at Harvard, Thom is chairman of the Howard Hughes Medical Institute, which he founded with the late Howard Hughes in 1953.The institute has "expanded tremendously," Thom says, and has developed a strong research program "in 40 medical centers throughout the country." Thom is vice president of MIT's Whitaker Health Sciences Fund and chairman of the Whitaker Foundation's Scientific Review board. A member of several visiting commit• EARLYWINTER 1989 By JOAN DANZIG A specially designed crystal buffalo was presented to George W. Thorn, M.D. tees at MIT, he is a life member of the corporation. A Buffalo native, Thom's career as ~ researcher began while he was anending the UB medical school. As early as his second year, he began assisting Dr. Frank A. Hartman in the preparation of adrenal extracts, developing the first workable assay for adrenal cortical extract activity. Thom looks to his work in Buffalo as the start of one of his most significant achievements, "the excitement of developing the use of corcin for treatment of Addison's disease which was an extension of my work with Dr. Hartman at Buffalo.• After graduation, he remained in Buffalo for five years, first as a house officer at Millard Fillmore Hospital and chen as assistant in the departments of physiology and medicine at the medical school. In 1934, Thom was offered a Rockefeller Fellowship, which cook him to Harvard Medical School and Ohio Stace University, where he rejoined Professor Hartman for one year before leaving for Johns Hopkins Medical School. Thom became an associate professor of medicine at Johns Hopkins in 1938.In 1942, after service as a major in the Johns Hopkins Medical Unit of the U.S. Army, Thom accepted an appointment as Hersey Professor of the Theory and Practice of Physic at Har• vard Medical School and became Physicianin-Ch1ef at the Peter Bent Brigham Hospital. His life-long interest in renal disease brought the pioneering dialysis techniques developed by Kolffin the Netherlands to Peter Bent Brigham, where, under his leadership, the now world-wide standa rd procedure of dialysis was put into use. His successful work cleared the way for the development of a program of kidney transplantation. High on his list of lifetime achievements, Thom says, is "the unique experience of developing the artificial kidney for kidney dialysis.• He was appointed Samuel A. Levine Professor of Medicine at Harvard in 1969. At Harvard, Thom initiated the Harvard-MIT Program in Health Sciences and Technology, which culminated in the Whitaker College of Health Sciences. BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Alumni 27 A recipient of many national and international awards, Dr. Thorn received the American Medical Association's Gold Medal in 1932 for his work with Professor Hartman on cortin and again in 1939 for his studies on desoxcorticosterone and pellet implantation. In 1946, UB Chancellor Samuel Capen paid tribute to Thorn as a "leader ... master of the arr and science of medicine" in awarding him UB's Chancellor's Medal for "eminent services in the alleviation of human suffering which have won for you high personal distinction, and through you, have dignified Buffalo in the eyes of the world." A teacher of distinction, Thorn has had a major influence on medical education, particularly during his years at Johns Hopkins and Harvard, \\'here he trained more than 5,000 medical students. Most medical students "know" Thorn, though they may not have mer him, sweating CALLFORNOMINATIONS J Immediately above, Dean John Naughton, left, and Alumni President Joseph Kunz, right, congratulate Dr. Thorn at the dinner. their way through the "Bible of Medicine," Harri.Ion'sPrinciplesof lncemalMedicine, which Thorn edited for 31 years. One of its original editors in 1946, he served as chief editor of the 1977 edition. • BUFFALDPHYSICIANAND BIOMEDICALSCIENTIST unc I is the deadline for nominations for the second annual Distinguished Medical Alumnus/a Award. The award is presented to a graduate of the UB medical school who has distinguished himself or herself nationally or internationally in the eyes of his or her peers and has made an oursranding contribution to medicine, the arts, or humanity during his or her career. The selection will be made during the summer and the award will be presented in the fall at a special dinner. Please forward the name of your nominee as soon as possible on the attached postcard. Your cooperation is viral if this is to be a true alumnus / a award. The 1989 winner is George W. Thorn, M.D., a medical pioneer whose achievements as a clinician, scientist and teacher have spanned 60 years. • EARLYWINTER 1989 �Alumni 28 SPRINGCLINICALDAYAND REUNION WEEKEND T he graduates of the UB medical school have won their share of local, national, and international awards for achievement, but it took an enormous amount of effort, toil, and sweat. Wouldn't it be nice if, just once, someone gave an award for something easy, like going to a party? The Medical Alumni Association is doing that for the first time at its reunion weekend. The reunion class with the highest percentage of attendees will win a trophy engraved with irs class year, which will be displayed in the medical school. Now, don't let the daces throw you. The next Spring Clinical Day and Reunion Weekend will be held in April, not May. It starts off with a cocktai l party Fri• day evening, April 27. Spring Clinica l Day will be held Saturday, Ap ril 28. Arnold Reiman, editor of the Neu: EnglandJournal of Medicine, will deliver the Stockton Kimball Memoria l Lecture. The theme for Spring Clinical Day is "Changing Aspects of Medical Practice~ • Class of 1940 Class of 1945 Class o 1955 "Saturday,April 28, 1990, the evening we hat·e all waited 50 )'earsfor. Let u.s make it our best reuniondetails lacer." William Hildebrand , Jr. "45 )ears! Tempus fugit. Time co renew, time co refreshold friendshipsand memories from the most significantyearsin our lit·es - the Class of '45." Herbert E. Joyce "We are lookingfor a big turnout for our 35th reunion. Plan now to meet with your classmates." James R. Nunn Class o 1950 John A. Winter "Togetherwe canmake our 40th a real winner. Lookingforu:ardto seeing)Ou all in April." Ro bert J. Patter so n EARLY WINTER 1989 BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Alumni 29 Class o 1960 Class o 1965 Class o 1970 Class o 1980 Class o 1985 "It is with a great deal of pleasure and anticipation chatwe lookforu:ardcoour 30th reunion. Near coca! parcicipacionu:ouldbe an added bonus." Roger S. Da yer "Come cosee hou· we, the school, and Bt1ffalohat·e changed in 25 "ears. \\1/e u:ot1ldl0t·e co hat·e :,ou in Buffalo." Joseph G. Cardamone "You can't ignore20 :ears. Step back into the pascand reneu·friendshipsfrom chat hapP) ume. Duse off ,ot1r memoriesand bnng chem along. Come back co reminisceand share some lat1ghs." Donald P. Copley "BAMMO! Ten:-a:11:1 hate gone Ir:,·.Let's gee together and .1eeif che chemiscryis the same." "Lee'sget rogecher and auch up on uhac'shappenedin che lase/ite )el!TS." John E Coyne Margaret Paroski I Jame s R. Kanski Robert M. Moskowitz Class o 1975 Theresa Stephan Hains Joseph A. Zi.zzi "I 0-:,earreunion «:asgreac. 15 will be et·en better. See )'OU acSpringClinicalDa:, m Buffalo." Jack Cukierman BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST EARLYWINTER 1989 �Medical School 30 LIGHTINGUPIN STYLE: LIBRARY CHANDELIERS AREANTIQUETREASURE 0 nee they glittered above nights of music-making in a fabled Buffalo house. Now they shine above studems and researchers poring over books in the Health Sciences Library. Located in rhe HSL:s main reading room, the restored twin antique chandeliers are believed co dare from the 18-¼0s.Robert L. Brown, M.D., associate professor of medicine emencus and a member of the medical school's class of 1944, made the restoration possible through a donation to the UB Foundation. The silver-placed fixtures came to che HSL as pare of the original furnishings of che old Lockwood Library, which was opened in 1935 and was designed by Edward B. Green, also the architect for the John J. Albright house, a huge Tudor mansion on West Ferry Street. These chandeliers once dominated the Albrights' music room, but were moved in the 1930s when che Albright estate was broken up, after the family suffered financial reversals. Originally candle chandeliers, they were electrified when brought ro the old Lockwood. The mansion, built at the cum of the century, was torn down in the 1930s. Albright, a pioneer in the development of electric power and automobile manufacture, gave more than $1 million for the construction of the Albright Art Gallery. While hardly a Morgan, he was, in che words of his grandson, "symbolic of the day~ of the city's greatness." A donation from Robert L. Brown (M'44) made the restoration possible. buildings, was responsible for moving the chandeliers out here; said Brown. He added chat when the old Lockwood Library was rehabili1tated as part of che Health Sciences Library project, "there was no provision for che restoration of the chandeliers. There was even a question whether they would rehang chem, 01rif they did, whether they would electrify chem. By chat time, they were black from age:' Brown, who 1salso che medical school's archivist, wanted to preserve these elegant reminders of the old Lockwood. "After· the library occupied the space, I started making inquiries about having chem restored, but che problem was chat no placer had facilicies co cakc care of :.uch large pieces; he explained. "We also would have had difficulty lnnding someone who would do the rest of the restoration. "Bue as a result of the restoration of the Bueler Mansion downtown, I called the man n 1934, a reporter for rhe Buffalo faening who did their major chandelier. I also located Neu,~described the house's sad end: "l..cav- Marlette Placing, a local firm chat does coming the house, the visitor carries with him a mercial plating." Finding Marlette was a big reverence which is as melancholy as the place advantage since the firm, headed by Edward itself in the face of rhe dissolution it is Marlette, had the large placing baths needed undergoing .... He (Albright) gathered the for the job. beautiful things of rhe world around him and his aestheticism overflowed to give the dry orne idea of the chandeliers' value can be 1rs noted temple of arc." surmised from the pre-restoration ap"We assume that Green, who designed both praisal. I S EARLYWINTER 1989 "Wewanted insurance when che chandeliers were being taken down; said Brown, "while they were off che premises, until they were put back up, that is, for che duration of rhe restoration. They were appraised at $25,000 apiece."The value, of course, "is way up now." Beyond moneta ry considerations, however, was a reverence for the University's past. "We were all concerned about preserving as much as possible of the old Lockwood, which was really an elegant building, the best the University has ever built. The craftsmanship couldn't be equaled today and it would be unaffordable if it could be," Brown said. "Our concern was co preserve as much as we could, and the chandeliers were a significant part of chat main reading room. I wanted to restore them co a scare chat they were ongmally in." In a charming comc1dence, the mother of Edward Marlene's wife, Norma, was the longtime assistant ro Charles D. Abbott, director of University Libraries from 1934 to 1960. Her name was lvah P. Sweeney. The restoration work was done by Jack Kiener, a highly-regarded craftsman who has been restoring antique lamps for 17years and is the owner of Antique Lighting in Clarence. "I'm quite sure these chandeliers are English; said Kiener. He noted, coo, chat the chandeliers have hcen kept together from the beginning, an unusual occurrence in the chandelier world. He explained: "Every piece chat's removable is numbered . Every arm has its spot to fir in. Each piece was made by hand and made for its O\\'n counterpart. "When we disassembled the fixture, there were 20 arms. On che number I arm, for instance, we have a bobeche, a candle cup, and some finials. All are numbered so that they fie back on number I. The numbers are scamped m. Whoever made the fixture numbered them in; this is the mark of a good craftsman. Nothing is interchangeable:' The arms on one chandelier are numbered I through 20; the arms on the ocher are numbered 21 through 40. "Sosince the 1840s, the fixtures have stayed together all chis time; he said. "This is very unusual." It cook Kiener "close ro 90 days" to com- BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �;\fedical School 31 - --- ..---= ------- -=- unrestnued endowment to help meet uncx• peered financial needs and opportunities. Accordmg to Prc,1Jenr Stewn B. Sample. "The S5Z million \qll enable L'B to meet needs char have been identified a, cr1ucal ro the growth of rhe Untvcrsiry, hut for which t.lte funds arc limacd or una\ailable. "State budgetarv Imes cannot meet all rhe needs of the University, nor can they provide the flex1h1hrvchat i, ahsolutcly csscnrial for rhe U111vcr,1rvto rhnvc. Joining pm·atc support w1ch~rate dollars will permit the Umvers1tv at Buffalo ro achieve its go,11of bccommg one of the nation•~mp ten public rl"5Carlh uni\'er--iucs bv the end of the ccnturv." The St hod of Mcd1e1nc and Biomedical Soence, ha, received some of the largest gift, co the campaign rhus far. Ont of the mo,1 rl'CCntwa, a $1 million l;,mmitmlnt from the The chandelien once graced the ,\lbnght Mamion. James H. Cummmg, Foundation, Inc. ro rhe of assist m the funding of a Positron Emis.,ion dav, glorv the n:calling One writer, plerc rhe work on the first chandelier. "This (PEn lrnagmg Cc111cr,a joint Tomographv the remembered mansion, Alhright involved preparmg ir for plating and med1<al slhool and the VA thi: of project her m husr to l1h-d Albright Mr;. •mu"lalc,," reassembling 1r, ,rraighremng all the arm,, Medical Center. This 1,1ranris the largest ever mu,1c room. This was rhe "golden age" of the rewiring it, lacquering it. Also, because 1t wa, awarded m rhe 26-\·ear hi<torv of the Cumhouse, he ,aid. a candle chandelier, we had ro devise ,ome mmgs fuundar1on. ch.mdcl1er,, rhc,e that One like,. ll) chmk way of holdmg the ~ker, m and \\e handOcher significant rnnmbutions mdude a renewed found ha\'e shadow,, the in so long shaved wooden plug, to fit mro the candle of ,ecurmcs valued at nearly 53 million gift • home. UB their in glory socket,." a ml'OI<11school alumnus who wishes from \\"h11chcr Ann B, --ctfor "wa, chandelier \1an,1on The Burler anonvmou<. This i, the larJ:esr gift remain co elecrric1rv." Kiener commented. "At l.iB, \\e md1\1dunl ever rcn·1\·ed in the l1v111g a from had ro put the wire on the outside of rhe fixU111\'er,1tv.both a, a private the of h1,rorv er ,1h wa, that ture. Ir's a solid c:<1,tfixture according to Jo,eph msnruuon, puhhc and w1rcwav,." no \\ere e plart.-d.Ther the Uni\crsirv at of president J. \lansficlJ, fur the expcriencl-d Kiener, the UB proJclt he used to will It Foundation. Buffalo brought its own reward,. "le\ inspiring when to help endowment unrestricted an e,tablish wnR-d vou on rake ~mething frc.,munre,.to he. Unt\'er,1rv ar Buffalo Foundano .n's nc\\ rl-cru1t ,cholar,hips. ,rudenc pro\'1de has \\a< It ampaign black. pach wa, GR'3tnl.._s•C le ro 1t. fim,h "Pathwav< and dinon rcchno)Ojly high purcha,e mcmbcrs, faculty million Ill gift, ratscd more than ..,z1.z nor taken care of hccau,e of how high tt wa,; equipment and support various needs of the and pledges as of Sept. 15, according to no one could keep it up, and it was ht·avily R. Knox. national campaign medical ,-chool for wh1lh other funds arc coated with lacquer and ~arni,h (applied) 111 ~onhrup limited or una\'a1lablc. ,av would 1c.I . prescne cha1rpcr-,on Knox, who 1sLhairman ui rhe hopes char thi, \\OUIJ Another anonvmou, SI million !!!ft ro hoard of !lilarinc Midland Bank, ,aid this that 40 of the hours were ,pent just ,mp' Pathw;w, to Greatness' C-impmgn was the represents more than 40 percent of chc ramping the lacquer off the 20 arms." for rhe Slhtol of ~fodK1ne. dc,11:natt.-d goal. m1lhon pa1gn'<five-year, 552 The refurbished chandeliers alR-adv arc colthe ded1~Jt1on and lcaJcr~h1p of "Through Lampa1gn the ,1fter 19~i. day next 0-.robcr m very "The Launched leccmg rave review,. and members of rhe Cam• Knox Northrup ,eeks ro increa,c permanent endowment the first chandelier was inscalll-<l;said Histtiry we an· well on Commmee, xecutl\'C E pn11,?n funds for the U111\'ers1tvtO pro\'ide pmfc,'-Or• of \fod1cmc Librarian Lilli Sent:, "one of the uhiect1\'es," our achic~mg tL wav our (cllowsh1p,, po,tgraduarc ,1nJ ,h1~. graduate mamtenancc men who hod been 1molvcd re is snll much co be noct.-d."The :-.tansfield grantsarhlcti< holar,h1p,, s, e sra1r,, undergraduat the up running came w1chthe hanging, Jone, bur we arc confident of attninmg our 111-a1J.fine an, programming, aJJ1riom to saying, 'I've got to see that chandelier: Th,tt • and has been the reaction of the ,cudcnt,. roo." library and pocrrv/rare hook collccnons. TOGREATNESS' 'PATHWAYS TOPS$21.2 MILLION T BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Medical School 32 VAN RIDESFASTTRACK FORCANCER EDUCATION W hile black and Hispanic women have a lower incidence of breast cancer than white women, they are more likely to die from the disease, according to Noma Roberson, director of community in• rervention and research at Roswell Park Cancer ln,tirute. One reason for the higher death rate among these women is that "they tend to get into the health care setting only at a very late stage of the disease," she explained. To get minority women into this semng sooner, Roberson has developed a mobile health care program. It operates from a 34-foot recreational vehicle which has been renovated to include examination and counseling rooms, along with a library and classroom. The transformed RV, which has been named the "Health Express," travels around Erie County bringing health education and disease-detection services into poor and minority communities. Roberson, who received a Ph.D. in experimental pathology with an emphasis in epidemiology from UB in 1985, said she has been interested since early graduate school in "women who are underserved (by the health care system), women who are hard to reach." Her doctoral research at UB focused on the specifics needed in breast cancer programs to reach minoriry women. After graduate school, Roberson continued to be preoccupied with the problem of how to reach poor and minority women who might be at risk for breast cancer. "Over the years,"said Roberson, "we've had a number of programs chat have involved major recruitment efforts to get people to come in to use the health care services at Roswell Park. Yet while we've been successful, we have not been as successful as I would like." And then one day, "out of the blue," Roberson came up with the idea of a mobile van. While there are other mobile health care units in the country, the "Health Express• is unique. "Most mobile units are geared to providing EARLY WINTER 1989 Developer Noma Roberson meets the press at the opening of the Health Express. X-rays,"said Roberson; "this one will not (pro• vide them). Instead, it will provide the first step - education and clinical breast examination. "\Y/ewill emphasize the importance of early detection. The women will come in for a 45-minute to an hour program. They will listen coa brief presentation and then actually work with the breast models on a one-to-one basis. They'll learn how to find a lump, see what a lump looks like, what it feels like." Besides learning how to examine their own breasts, the women will also be able to receive clinical breast exams in the examination room of the mobile health care unit. According to Roberson, "a nurse will check the woman's breasts thoroughly to see if there are any problems. If there are, the woman will be referred to Roswell Park or a physician of her chokc.• At Roswell Park, Roberson continued, "a physician will examine the woman even more thoroughly and will make a recommendation if there is a need for X-rays and further examination." All of these services, the classes, the examinations in the van and at Roswell Park, as well as Pap cests, are free, Roberson noted. In addition, she said, the program will provide free mammographies for women who lack insurance. These women who fall through the cracks, a situation which is more and more common, merely must prove that they are needy and that they are at least 50 years old. She added that free mammographies mighc also be provided for younger women, depending on the case. "A 30-year-old woman whose mother died of breast cancer, whose sister died of breast cancer, and who now has suspicious findings on her breast would probably be a candidate; Roberson said. Finally, to help women who have been diagnosed as having either breast or uterine cancer survive "the devastating rehabilitative phase," Roberson said there will be a support group and counseling program. To gee the women to use the van, field workers introduce rhe program to directors of neighborhood centers or schools, then work with the directors to publicize the van's arrival. The "Health Express" has been financed by a grant of $205,190 for two years from the New York State Department of Health. The grant is part of a $1 million fund that was set aside by the stare last year to develop brea,t cancer detection programs. "The intent for chat money; Roberson explained, "was to service the state by developing model programs that would focus on the early <leccction of breast cancer and that could be used in the future across the state." Of the eight programs awarded grants by the Department of Health, Roberson said hers is the only one that uses a mobile unit. In addition to the grant from the Health Department, Roberson has received services from Roswell Park, and from various community agencies, including the Erie County Health Department, Sheehan Memorial Hospital, the American Cancer Society, the Medical Society of Erie County, and rhe Geneva B. Scruggs Health Care Center. "As I add up the contributions of all these agencies, including my own institution, we're talking about a program that is really about a $400,000 program, which we've done for about $200,000. "And that," Roberson concluded, "is just a demonstration of the importance of community coalition for these kinds of health care projects." • - By ElisabethSheffield BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST �Briefs 33 SEMINARS SET ON THEAGING A series of faculty development seminars will be held by the Western New York Geriatric Education Center and the Multidisciplinary Center on Aging from ~bruary to April m Beck Hall on UB's South (Main Street) Campus. Continuing Medical Education credit of category I (CME) will be given for each seminar attended. For more information, contact Patricia M. Krupp, Beck Hall, 831-3176. i MFH OPENSCENTER FOR AMBULATORY SURGERY M illard Fillmore Hospital has opened the first multi-spccialcy, freestanding ambulatory surgery center in Western New York. It's one of the first of its kind in the State. Located m Amherst, the center is designed to accommodate most types of nonemergent, uncomplicated elective surgeries. le has the capacity to perform more than 7,000 procedures a year, including ophthalmologic surgery, breast biopsies, arthroscopic surgery, plastic surgery, hernia repairs, pediatric procedures, and oral and nasal surgery, among other types of minor surgeries. "le is estimated char by the mid-l990s, -15 to 50 per cent of all ,urgical procedures will be performed on an ambulatory basis," said Jared C. Bario", M.D., president and medical director of the center. • ~ A~lllllll~lf should not only be checked by doctors and nurses at the operating room door, hut removed before the surgical scrub, according to Thomas S. Beam, M.O., associate professor of medicine and microbiology at UB. Whtie such mfccnons invariably arc caused by bacteria colomzing the patient, rhc source of infection of a wound may be questionL-d if surgical gloves tear during an operation. Stressing the payoff of an ounce of prevention and noting chat removing a rmg is a mammal inconvenience for most people, Beam wrote in the Journal of the American .'vledicalAssocwtionrhac the most prudent approach i, not to wear jewelry in the operating room. • AN ONLYCHILD OPERATING ROOMIS MAYHAVEHIGHER No PLACEFORJEWELRYBLOODPRESSURE Add co the long list of potential sources of nosocomial infections chat band of gold on a surgeon's ring finger. Because it may harbor bacteria char can trigger a postoperative infection, jewelry BUFFALO PHYSICIAN At-:D BIOMEDICAL SCIENTIST A dulcs who were only-children are more likely to have higher blood p_ressure than those who grew up with siblings, according to a study conducted at UB. The researchers found chat adults who were iii ~ 6 only-children had significantly higher mean systolic and diastolic blood pressures than those with brothers and sisters, regardless of number of siblings. The results were presented at the fourth scientific meeting of the American Socierv of Hvpertension held in New York Cicv. Maurizio Trevisan, M.D., associate professor of social and preventive medicine, said the higher blood pressure found among adults who were only-children could be responsible in part for the finding ma ,eparate srudy of a higher incidence of coronary heart disease deaths among adults without siblings. He postulated thar the higher blood pressure m adults who were only-children may be a consequence of stress resulting from inLreased expectations placed on an onlv ,hild and/or growing up m a limited social network due ro the lack of siblings. The UB researchers investigated the rela• tionship of birch order to blood pressure in 676 white males and 796 white females, aged 20 to 70 years, participating in che Buffalo Blood Pressure Study. • § ECMCOPENSCENTER FORBURNTREATMENT T he Regional Burn Treatment Center of Western New York opened in March ac che Erie County Medical Center. This is the culmination of a two-year planning process berween ECMC and Sheehan Memorial Hospital, which closed its burn service. The medical director of the new burn center is Jorge Rodriguez, M.D., who received his training in the management of critically ill patients at Columbia University and the University of Louisville. The center has eight beds: six for critical care and two for intermediate care. The unit includes cwo hydrotherapy rooms and scareof-the-art monitoring equipment, as well as staff and family conference areas and administrative space. Construction and renovation for the center cost about $1 million. • EARLY WINTER 1989 �Classnotcs 34 held in Hyderabad, India. Harold F. Wherley (M'36) • of Stone Creek, Ohio, writes chat his grandson Rob, (son of Benjamin J. Wherle y, M'65 } 1s starting medicine at the Univer• my of Cincinnati. Albert P. Sutton (M'48 ) • pre;idenc of the New York Section of che American Uro logical Association, organized the Annual ~ieeting held in Lausanne, Switzerland, on Occobcr 22-29. Matt A. Gajewski (M'39) • wa>honored by t he Erit: County L..-i::i,laturewhen tht:v named the Human Scn1c1.:,Center on Buffalo\ East Side the "Dr. ~1att A. St:n ices GaJewsk1 Human Center." Harte) C. Slocum '36 1920's L. Maxw ell Lockie , Ph.G . (M'29 ) • profe"or <.memu, of therapeuttc, at UB, ha, been named to the prestigious rank of "ma<rer•bv the American Colk,gc ofRheumatology. P:iruallvrenred, he now serves as a consultant m rheummology at t he Erie Counry Med1Cal Centl"r, Buffalo General and ~1illard Fillmore hosp1ral,, and Children\ Hospital of Buffalo, where he founded one of chi, country\ first clinic, for children with arthriu,. During hi, medical career he developed method, of diagno,rs and treat• menr for arthrms now used world-wide. 1940's EARLYWINTER !<13Q Andreu• A. Ga~e '44 Edward G. Forgra ve (M '45 ) • informs us I hat he remed from acm·e practice m 1985,but i, still doing somr UR work of the Phi Lambda Kappa Mc<l1rnlFraternity, he was ell-cted to the po,ition of \'ice chairman of the board of the two orizani:anons. Dr. Levy is currently m the Geo rge A. Poda (M'45 ) • private practice of psychiatry m reured aftt:r 381/z years as m1.-dical Buffalo, chairman of che Depart• of Du Pone's ,uperintcndent ment of Psvch1atrv at the ~1illard Savannah River Plant. He i<no\\ Fillmore Hosp1tab, and a clmical teaching at Oak Ridge A,,ouated associate professor of psychiatry Universine, and doing contract at the UB medical school. work for the Department of Energy - "th1, 1s fun!" Andrew A. Gage (M'44) • one C arl J. lmp e lliti e r (M '46 ) • a thoracJC 'C\ surgeon, Joined the scaffof the M.iyo Clime in Scorudale. An:. 'Grear wav co cut back on a surgical pranice. Heare and hand arc still steady!" Annabel Miller Iron s (M'46 ) • of Chevenr e, \\ vo., rctm.J 'rom the Veteran, Adm1ni,trat1on Joseph R. Saab (M'34 ) • of Hospital and 1s now doing Hamburiz, N.Y., celebrated h15 \'olunrecr medical work in the 80th birthday m August. Dr. Veteran, Admm1stracion\ Nur~Saab rccentlv attended hi< ;sch mg Home. Dr. Irons 1, pre,1dent class reunion . of the Woman's Club of Cheyenne, the oldest (201 years) Harvey C. Slocum (M '36 ) • 1s federated cluh in Wvommi:;. profe5sor emeritus of the University of Texas Medical Branch and Harold J. Levy (M '46 ) • Afte r a Colonel (Ret.) in the U.S. ,ervmg as president of the Army. Dr. Slocum live, in San Medical Student Aid Society, Antonio, Texas. which 1sthe ph1lanthro1 < hranch 1930's Paul T. Buerger (M'49) • of Young,cown, ~ .Y.,writes, "I have jomed the Anthropology Depart· ment of SUNY as a graduate stu• dent." of the developer, of the implantable cardiac pacemaker, rClcnrly received two awards. Gage was honored in March at the annual meenng of the American Society of Contemporary Medicine and Surgery in Florida. In April, he was honored during the s<.'<.ond annual Thoracic Surgical Teachmg Days program, co-sponso red by UB and Buffalo Genera l Hospital. Gage is che deputy director of the Roswell Park Cancer Institute and a profc,,or of surgery at UB. Arthur J. Schaefer (M '47) • delivered the fir,t Dr. P. Ramchander Memonal Oration at the Annual Ophthalmolog ical Meet• ing given by che Kanchan Eve Hospital and &-search Cente r 1950's H e r b e rt L. Berman (M'SO ) • has retired from the active practice of plastic and reconstructivc surgery and is now r~iding in Scocc,dale, Ariz. Vict o r A . Panaro (M'52) • was elected to the board of director, of Blue Shield of W1.-scernNew York and Community Blue and serve, as a counci lor for the American Coll~e of Radiology. Roy J. Thurn (M'52 ) • wmes "As a captain in the USP HS Ready Reserve, I recently com pieced a two week ,horc tour of ducy at the Crownpomc, N .M., Indian Health Facility on the NavaJo Indian Reservatton. It was a very rewarding experience." 11 P. Hamilton Thomas (M'S?) • was recalled to active duty by the Unaed Scares A rmy in 1984 as deputy commander, Center, Army Aeromedical followed by an assignment in Saudi Arabia. He is currently chief of the Preventive Medical Service at Brooke Armv Medical Center m San Antonio, Texas. John B. Ander son , Jr. (M'58 ) • medical director for Centerior BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Classnoces 35 pleasure: patients and che opportunity for flight time again. Also appointt-d to che admissions committee, School of Medicine, uni· formed Services University of the Health Sciences." Energy Corporation, ha, been clencd president of the hoard of trustees for the Andrew, School, an independent girls' boarding and day school in Willoughby, Ohio. 1960's Je rro ld D. Canto r (M'69) • \\as ek"<.tedchief of the medical ,raff , t C:ia,ral Communttil-,, Hospital, Santa Ana, Calif. Algirda s Gamziuk as (M'60) • has been appointed ass0<.iaceadministrator for medical affairs at St. Joseph Ho,pital in Check• towaga. 1970'., Seba stian Co nti (M'70) • has Rob e rta M . G ilb e r t (M '6 2) • was named ml-d1cald1rt-ccorof che Georgetown University Family Center. Dr. Gilbert presented a Add1ltion,: Put pap.:r "lat~cn ting the Patient m Charge" at the Midwest Family Theory Sympo,1um in Chicago. Harold J. Le,,y '46 Rob e rt W. Hamilt o n (M' 63) • ha, moved co Tc,k-do,Ohio, where he 1, professor of mt•1.hcineand chief of the ncphrology division of the MedJl'll Coll~l' of OhK England area in chc fall of 1989 after serving a, chief of the ob/gyn department, Supreme Allied Powers Headquarters, Europe (S.H.A.PE.). Belgium. of both the American Lung Associauon ofWC!SternNew York and the ~ev. York Trudeau Sociery. Jeffr ey S. Ro ss (M '70) • \rntes Ro be rt M . Tabac hn ikoff "I have rl"\.Cnth·t-,.-ln apooinwd (M'66) • returned co the :-,.:ew professor and chairman of the Steph en C. Sc heiber (M'64) • R a n da ll A nd e r so n John ha, been ele1.1edto Who'i Whom (M '67) • wa, rt<. nclv bo'lrd certhe \\'orld. He ,en·es a, eXl"CUtl\"C in cmergcn1.y med1unc. He secretary of the Ameman Board of Psychiatry and Neurology and president of the As.soc1auon for Academic P,y<hiacry. Dr. Scheiber 1, also a member of the Award, Committee of the American College of P,ych1atri,ts. Al an Saltzm an (M'66) • has been named clinical director of the Department of Medicine at the Erie County Medical Center. He is chief of the pulmonary disease section and associate chief of mc.-dtcal-.er-viceat the Buffalo \½ Medical Center. Dr. 5almnan serves on che board of che Amencan Lung Association of ~ew York Scatt and is president a pnv,ire practice ,11(:cializin~in \"ascular surgcr\' and IS an associate clmie.tl professor of ,urgerv at the Umvcr,uy of California at Davi,. tified i, a clinical assistant pmfc,,or of familv medicine at UB. D av id Fuga zzo tt o (M '6 7) • is part Jf a group pral CJ<e in ped1atr1t, in Birmingham, Ala. Dr. Fugazmcco w;i, elected to the executive committee at the ;\1ed1calCenter Ea,c Ho,paal. Capt. Elias Rose nblatt (M'68) • write!',"Just completed a tour as director of medical services and executive officer of the Naval Medical Clime in Washm~on, D.C. and have begun a clinical position with the Naval Air Facil• icyat Andrews Air Force Ba<e.A BUFFALO PHYSICIA:-: A~D BIO~EDICAL SCIESTIST Department of Pathology at the Alban\' ;\1t-dicalCenter Ho,p1tal and Albanv Medical Colk-ge, Albanv, N.Y." Roy M. Oswa ks (M'7 l ) • was elected c h1cf of surgery ac Bayside, Hospnll Humana V1rgm1a Beach, Va. W illi am Hru shes ky (M'73) • wnres, "Aftu a do.en years, t the University ofMmnesota m MPIS, I haw returned co ~cw York and profe"<Jr of am currently medicine and m1lrobiologyltm• munobiologv at Albany }..1ed1cal College of Union Lim\er,1tv. While in Mmnc,oca I captured a :--=orwegian Amencan pr~ncc,s, Pamc1a A. \'food, \1.D., Ph.D., and we have recently had our first M.uie Cassandra daughtl·r, :-,.:1Cole.• Melvin R. Pratter (M'7 3) • is head of ch division of pulmonarv John B. Anderson, Jr. '58 and cmical care and profe,,or of Rohen medicine ,11 UMDNJ Sl hool of \"food Johnson ;\1cd1cmeat Camden. Dr. Praucr has two children, Chtusen, age IO, and David, age 6. Michael Row land (M'75) • is president clelt of the North of the Chapter Carolina Amcncan College of Surgeom and was also clccced into of the ~orth membcr,hip Carolina ':,urg1calA"oc1ation, a group limited to a maximum membcr,hip of 100,urgcons. Dr. as chair• Rowland currently scrv<.-s Commmee man of the Cancer and Outr, atienc Commmee at Hospnal. Regional ~loJre Pinehurst, N.C. Na n cy H .• ie lsc n (M '76) • a 'fX"(talisc111 internal ml-dicincand infcccious d1sc3ses, is the new president of the ;\icd1cal Societv of the Countv of Eric She is the first woman 10 lead the organtza1 'on in 1t, 165-vear history. Kev in C. Gree nidg e (M'77 ) • 1s currently an associate professor of clinical ophchalmologv at the ~e\~ York Medical College and lhtef of the Department of Ophthalmologv and director of EARLY Wlt-:TER JQ8Q �Classnotes & Deaths 36 from che NIH in support of my research on hepatic glucose metabolism. Paula and I now have cwo children, Isaiah, 8, and Steven, 3." He served four years in the U.S. Army, entering as lieutenant and bemg discharged as major. He spent 28 years as an instructor for surgical technicians and served with the 96th Field Hospital in India and China. Walter R. Siemien (M'80) • of Winter Park, Fla., is certified hv che American Board of Plastic Surgery. Thoma s J. Sy racuse (M'33) • James F. Twist (M 'SO) • has moved his office for the practice to 2156 of ophthalmology Sheridan Dr., Kenmore, 1'!.Y. Nancy H. Nielsen '76 Jack Hajjar '85 D eni se M. Goo dman (M'83) • glaucoma services ac Metropolitan Hospital Cencer in New York. He recently had a book chapter, "Head Pain Associated with the Eye,"published in Managemencof Facial, Head and Neck Pam, published by W.B. Saunders Company, Philadelphia, 1989. wrnes, "After completing pediatrics at CHMC Cincinnati and a critical care fellowship in Pittsburgh, I am now assistant professor of pediatric critical care at the University of Minnesota, and I practice at the University Hospical." Jo n ath an H. Woo dcoc k (M '77) • has been appointed Eri c P. W ittkug el (M' 83) • has completed his training in pediatrics, anesthesiology, pediatric ancschesiology, and cncical care at che University of Pennsylvania and the Children's Hospital of Philadelphia. He is currently an assistant professor of clinical anesthesiology and pcdiamcs at the University ofCincinnaci and the Cincinnati Children's Hospital. medical director and clinical leader of the Neurobchavioral Inscicuceof che Rockies in Louisville, Colo. Roge r Kaiser (M'7 9) • has been named clinic:JI director of anesthesiology at the Eric Coun• ty Medical Center. 1980's Eric Ten Broc k (M'SO) • has been appointed director of Pulmonary Funccion and Blood Gas at Buffalo General Hospital. He is also director of the Medical Intensive Care Unit at BGH and assistant professor of medicine for the Division of Pulmonary and Critical Care at UB. Robe rt Sha lwitz (M'SO) • of Creve Coeur, Mo. writes, "I was recently awarded a FIRST grant EARLYWINTER1989 Jack Hajjar (M'85) • writes, "On Dec. 13, 1988, I left for the earchquake-devascaced region in Soviec Armenia wich an ICU team from Montefiore Medical Center (where I am doing my fellowship in anesthesia) sponsored by the State Department. The team participated in rescue efforts and worked at the Republic Hospital, the largest in Soviet Armenia. We equipped their ICU with $1 million worth of equipment donated by several industries." He went back to Armenia in April co scare a longterm training and exchange program in order to establish a fully equipped ICU Departmenc at the Republic Hospital. a member of the UB Athletic Hall of Fame, died Feb. 26. He was 79. As an undergraduate at UB, he was a member of the undefeated 1930-31basketball team. He lacer cook up golf, winning the Erie County Medical Society championship. Three years ago, he retired after practicing medicine for more than 50 years. Syracuse was a member of the UB Bison Head Society and Erie County Medical Society. Abrah am S. Lem:ner (M '41) • Deaths Marvin A. Bloc k (M'25) • a retired clinical assistant professor of medicine at UB who was a pioneer in persuading physicians to treat alcoholism as a disease, died Feb.28 in Buffalo at the age of 86. Block wrote widely on alcohol abuse and addressed groups throughout the world. His efforts led co the 1956 vote by the AMA House of Delegates co declare alcoholism an "illness" and to urge doctors to treat its "victims." Ronald Walt er Steub e (M' 3 l ) • died July 9, in Naples, Fla. Jo hn Ca lvin Inman (M '33) • died July I, 1989. He was on the staff of Mercy Hospital, Lake City, Md., for 40 years, serving as chief of surgery and chief of staff. died in June 1989 of heart failure. He served in World War II from 1942 to 1946 as a lieutenant commander, MCUSNR in the Pacific Theater. first as a Seahce, then aboard LSTs. He received eight major campaign scars and a Purple Heare. He was adjunct professor of clinical psychiatry at the Dartmouth Medical School, a member of the psychiatric staff at Mc. Ascucney Hospital and Health Center and served on the Commiccec on Aging of the Vermont Scace Medical Society. In addinon to his pnvate practice in psychiatry, he devoted suhscantial voluntary time locally and nationally to the growth and development of psychiatry. A pioneer in methods of outpatient care and the treatment of psychosomatic illnesses, Lenzner was a Life Fellow of the American Psychiatric Association. BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST ��~oo-Prof1 Ori; L, Po.ta Buffalo Physic ian & Biomedica l Scientist PAID Buffalo,NY 1\-rm t =-- lll State Untvers,ty of New York at Buffalo 3435 Main Street Buffalo, New York 14214 Address CorrKtlon Requested 3 581 DR L. MAXWELLLOCKIE 925 DELEWAREAVE BUFFALO NY 142 0 9 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Early Winter 1989 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1989-Early Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v23n04-1989-EarlyWinter Table Of Contents A list of subunits of the resource. PET Scanner Meet the chairmen Thoughts on a nasty day Photo directory People. Research. Alumni. Medical School News Classnotes. Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-12 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v23n04 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1989 University at Buffalo, State University of New York . Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/aa8f7d2b89af658c8b73ddbb1e980eae.pdf 37ff1706a44303ab813d74a0693eed5a PDF Text Text Vol. ~J. So. l Autumn 1989 �STAFF EXECUTIVE EDITOR LJJ\:l\'ERSITY Pt..:BLIC"ATIONS Robert T Marlen BUFFALOPHYSICIAN EDITOR Conme Os"ald Stofko ART DIRECTDR Al J. 1-:e er ADVISORY BOARD Dr. John :\aught• · . mnan Dr Harold llroJ,, !\Is. :--;ancy Gh..-co Dr. James Kanska Dr )o<cph L. 1-:un: Dr Charles Pagane1!1 !1,1r.Paul D. Pat«scn Dr Antoinette Pecers Dr. Charles Pru<1 Dr. Lu, her Robon;,:,n Dr. Thomas Rosenthal Dr. Saleda Surcsh Or. Burtl>rl Smgc-rman Dr. Stephen Spaulding Dr Ndsc,n Torre \1r Edward \Ven:ke Dr J1n ,rr Y,r, WRITERS M ,rk \1.ir ,~ [; [)· J !1,1.';urllcrman ILLUSTRATOR L H. PHOTOGRAPHERS ~ancr J. Paroso DearAlumniandSupporters of the UBmedicalschool: T he 1933-39 academic year was a stellar one for the school's faculty \'i,'c were honored that the SUNY Board of Trustee, and the chancellor singled ouc three faculty memhcrs for special recognition. Dr. Leon Farh1, professor and chairman of phys1ology, was awarded the title of Oiscmgu1shed Professor. This is pcrhap, the most ~igrnficant award char can be given to a SUNY facultv member since its bestowmenc indicates significant achievement in all phases of academic life and extraordinary evaluatiom by peers world-wide. Dr. Murray Ettinger, profc,sor of h1ochemistry, wa, awarded a Discmgutshed Teaching Professorship. :\1urray, an accomplished academician in all re,pe..:ts, has always excelled as a dedicated teacher of medical, dental, and graduate students. His LOmm1rmcnc to teaching is well known and he is fully deserving of thb spcual rccogmrion. The third farnlty mcmher, Dr. Charle, Severin, assoLiatc profc,,or of anatomical science,, was awarded the ChanLellor\ \fedal for excellence in reaching. Chuck Severin has provided superb leadership smce coming to Buffalo, and together with Dr. Farh1 and Dr. Ettinger, is alway, regarded a, among the ,crongest of the fine cadre of teachers and cducators we have in the medkal school. I am sure chat ca..:hof you Join me m congratulating cl1L-se three fo.:ulcymemhcrs 111their indindual and colk'Cnve accomplishments, and in rendering our thanks for their efforts on the schtx)l's hchalt. Simon Tong Bob\\ 1,n___, Li TEACHING HOSPITALS A'SD LIAISO!'.S Bauv.a \r.:•.:r.i.:~ Adm:. -·r . \ 1ed,cnl Center Buffalo General Hosp1tal, M,l, \hau John Naughton, M.D. Vice Pro~sulenr 1nr Clmical Affain Dean, S.hool of .\lediunr and Riomedical \cienc·cs Buffalo Veterans AJmm1strauon !\1cJ,cal Center, John Po,ll, ( h!Jrt·n's Hospotal, Karrn Dr,Ju \u oenk Enc Count-,: \1cd1Cal( t1.c1.:•". \!anon \forwnousb !\lerq Hos~,11al,Ch,.,k Tele«o \l,llard hllmorc Hc,spn ,!, Debo-rahFenn Roswell Park !\1cmoroal lnsraute, Jud,Ru., S1,1ers Hosp11al,D,-nnrs McC.mll) Pmdw:,db-, rh, Dn mon of l,noi-mm Rela "'"" ,n =ocu,uon u, ch ch.-S..hoolf .\l,,du. nc urul Bo•medocal'i.:1ence,.Stace l nn t'NI) of :\,u )O'fk at B1<jjolo. THE! Bl FFALO PHYSICIA:S: A'\D 810~IEDICAL SCIE:S:T!Sr (U:,PS 5>l•ll601 Summer !OS<), \\,lume '\uml--er 2 P bli-.hc.:dfi\'c umt.~ i.1IJt1ual1v: Spring, ~ummcr, Autumn. Earlv \'C.'tnt(!'r, :id L.::ttl• \Xm«r h 1he School oi !l,l,d,une and B1omc.~1cal X1cnces, State l mvcrstty vf ~""' Y.1rkat Buffalo. IH> !\hon S1ree1, Buffalo, ~c"' fork 14214.Third das 1"ulk rosu~e paid at B"ffalo, :--.;ev. York. Send address changes 10 THE BlA'fAIJ..) PHYSICIA'\ A:--.;D BI0!\1EDICAL SCIE:--.;TJ$T,140 CFS. AJJ,1,on, HJ5 !\bm Sir«c Buffalo. New )c,.k 14214 n. Dear FellowAlumni/Alumnae: T he first D1stingu1,hcd Alum nu., ha, hcen chosen hv che Ad Hoc Commim:c for l9SQ, The m1ard will be presented co Dr. Gt•orge \\'. Thorn, cerrnmly a worthy cho1Ce of one whose ,ntcrnanonal reputation ha, brought muLh h,mor to our medical ,,hool. \X'carc msmuting a program for alumni mtcnicws of pm,pcctlve candidates for medical school admission in distant cities, designed for students who find it difficult to come to Buffalo for their 1nterv1e11.\\'ould you be interested in bcmg of ,ervice in vour cit\, 1fsuch a situation arises? f.:indly contact Dr. John Richert at the Alumnt Offi.:e. \\'c would be most grateful for your help. Please mark Apnl 28, 1990 nn your calendar for next vcar\ Spring Clinical Dav and Alumni Reunion \X'i:ckend. Weare planning a great smnulacmg program. :\-1orc about chis later. Through your support, we ha,·e reached an all-ume mcmbcr• ship high ,,f 1,474 ducs-paying mcmhcrs, mcluding 53 Life \kmbcr ,uhscrihers. It is an honor to serve you as president for the 1939-1990term. Please contact us with any problems or suggestions you may have. ~ ~ 0' - Sia.~,,,, Joseph L. Kunz, M.D. President �BUFFAID \ ol. 21, ~ o. 3 PW-§!~l6N l Autumn 19t!9 Features II ~ ~r/4 The history of trauma care, Page 18 IJ Notjustbecauseit's there.Growing up in the shadow of the Alb orz Mountains in Tehran, Fero Sadeghian, M.0., developed an early interest in mountain climbing that lasted throughout his adult years. He climb s not "just because it's there;' but because of the challenge. "It becomes us against the mountain." His mo st recent challenge: the remote and trea cherous east face of Mt. Everest . Likerubbingsnowon frost bite. A popular treatment for "acute mountain sickness" may actually make matters worse, according to John Krasney, professor of physiology at UB. We'renot hurtinganimals.The scientific community must come together and convey this message to the public: we're not hurting animals, we're saving human lives, medical researchers are told at a campus conference. Mountain medicine, Page 10 Departments MedicalSchool News. From rags to stitches: John Border gives a history of trauma care in the 1989 Stockton Kimball Lecture. School graduates its 143rd class. Pull out all the stops in treating patients, a noted pediatri c surgeon advises. 143rd commencement, Page 20 ■ Specialsection. Meet the Class of 1993 - a directory of this year's incoming class begins after page 24. Thi s year's reunion classes generously pledgFDedAlumni. a total of $102,220. All IOclasses sat for portraits that are featured on pages 26-29. Mountain cl1mbmg, Page 2 �2 Fero Sadeghian to mountain the beauty By MARK is drawn climbing by & challenge MARABELLA up in the shadow of the Alborz Mountains in Tehran, Fero Sadeghian, M.D., 53, developed an early interest in mountain climbing that lasted throughout his adult years. Sadeghian, a clinical assistant professor of surgery at UB, has climbed the Alborz Mountains in Iran, Mont Blanc in France, Kilimanjaroin Africa, Growing AUTUMN IQ89 ~.- the Andes in South America, and even a small peak on the southwest face of the legendary Mount Everest - the highest mountain in the world. Unnamed peak In Himalaya chain. However, Sadeghian's highest and BUFFALO PHYSICIAl-: Al-:D BIOMEDICAL SCIEl-:TIST �most exciting climb u·as in Ma)·, 1988, when he revmted Eierest and climbed its remote and treacherouseast face. There, completelyby chance,he met up with another smaller expedition that BUl+Al.O PHYSICIAN AND lllOMl·DICAI. 5'( ll:1'TIST u·as one of only tu:oexpeditions in his, tor)' to reach Everest'ssummit by way of the eastface. Sadeghian'smedicalex, pcrtise played a key role in the safe return of these historic climbers. Photos: Fero Sade&hlan ,\l l l \11" 1•1~<1 �(From top to bottom) Potala, The once the home of the Dalai lama; climbers three the drove days before transferrin g equipment to yaks ; frostbitten foot of a member of the Americ a n / British expedition a a . a • wile Sadeghian himself did nor set out to attain Everest's summit of 29,028 feet, he trekked ro the h ighest altitude in his climbing career-22,000 feet . Th e callesr peaks Sadeghian had previously visited ranged from 15,000 to 19,500 feet. (The Hima layas are so high chat peaks be low 24,000 feet don't even gee named there .) "To attempt the peak of Everest, a climber must devote a great deal of time co its pur:-uit . It may even be the culmination of a lifetime of preparation;· Sadeghian asserted . "I wish I cou ld make an actcmpt, but I'm a surgeon by profession and find it difficult co make time for ~uch a \'Cnture. Bl FFALO PHY:c-lCIA:S: A'D Bl0~1EDICAL SCIE:S:TIST �5 "Bue still, I've always found mountain climbing co be an exhi larating way co recharge one's batterv from the day-to-day monotony that everyone muse endure;' he observed. "The attraction is not merely because 'It is there'. The mountain attracts a certain breed of people those who seek natural beauty chat is both isolating and challenging. There is a unifying camaraderie among mountain climbers that transcends race, religion, and politics . le becomes us against the mountain ." Certainly, Everest - called Chomolungma hy the locals, meaning "Goddess Mocher of the Earth" BL"FFAL.0PHYSICIA:-.:A:--:O BI0:'-1EDICAL SCIE:-;TJST - represents what Sadeghian seeks in his mountain pilgrimages. Everest separates Nepal from Tihet and has three faces: north, cast, and southwest. The southwest face can be seen from Nepal and is the conventional way of climbing Everest . This face was the first path co the summit con4ucred by the New Zcalander Sir Edmund Hillary, with the Tibetan Sherpa, Tenzing Norgay, in 1953. In 1975, Sadeghian climbed co Everest's southwc!:>t base camp with a small group t h at inc.lude<l two other individuals from UB's medical school - David Greene, M .D., professor emeritus Members of Sadeghi a n's group with members of the American /Brit­ ish expedition. Sadeghlan is third from right. no ace• �of medicine, and Winfield Butsch, M.D., clinical professor emeritus of surgery. Sadeghian always dreamed of one day revisiting Everest. "On my previous climb of Everest my group went through Nepal (where the southwest face base camp is located). But this route has become coo commercialized, busy, and Lrowded," he recalled. The north and case faces are approachable only through Tibet and attempts along chese routes have been scarce. "The cast face base camp in Tibet is more remote and less traveled and I always wanted to sec Tibet," Sadeghian said. "fur many decades the ease face was closed because of poor political conditions in Tibet due to its relations with the Chinese; now with what has recentlv happened in China it is unlikely anyone will be climbing there for some time to come:' The east face provides a significant challenge because it takes days of trekking over high passes to reach its isolated base camp. Sadeghian's month-long trip co Tibet, highlighted by his three-week ascent on Everest's case face, was the culmination of many months of preparation. Sadeghian first contacted the Mountain Travel organi:arion m Albany, Calif., eight months before rhe trip to express his interest in dimbing Everest. The organization then assembled a group of nine climbers who expressed the same interest, secured the necessary mountain climbing permits from the Chinese government, and provided the group with the supplies needed to trek in the Himalayas. All expenses were paid by the climbers. Six months before the climb, Sadcghian started a rigorous workout schedule running six miles, four times a week, with aerobic exercises in between, to im:rease his !'-trengrh and stamina for the challenge of Everest. Sadeghian was appointed the phy~ician for the group and was responsible for carrving antibiotics, sutures, bandages, pain medicine (morphine and Demerol), intravenous and ~urg1calequipment, and a supply of oxygen. He was 101ned by his friend, Nas Efrckhar, M.D., an orthopaedk surgeon at Columbia University. The group of nine was forrunate because it is rare to have two doctors on such a small expedition. 6 Sadeghian and Eftekhar fle\\ into Beijing, China, where they mer the other people with whom they would spend the next four weeb. The appointed leader of the climb was Bruce Klepinger, a full-ume mountaineer. Other members of the group included SI-year-old Jeffrey Davis from Canada; 47-year-old Steven Ncgler, a retired U.S. Air Force officer from Urah; 57-year-old Peter Anson from Minneapolis; 32-year-old Minnie Chin from California, and John and Carol Goodman, AUTUMI\ IY84 married and in their early 20s, from Texas. From Beijing, the climbers spent several days driving over narrow dirt roads along steep valleys and climbing up 17,000-foot passes before they reached Shigacse, the Tibetan town located closest to the east face of Everest. There they transferred their equipment from their truck and three jeeps onto the backs of 17 yaks. Each yak was loaded with approximately 150 to 200 pounds of equipment. The equipment included five double tents, three larger rents, gas-burning stoves and lanterns, and plenty of canned food. Here they were joined by five Sherpas who were in charge of the yaks. Sherpas are Himalayan residents who, due to their climbing experience, are hired to carry supplies and assist rhe climbers on their trek. The group was also joined by several Chinese who were hired co cook, guide, and maintain an established base camp. The mix of the English, Chinese, and Tibetan languages proved cumbersome. The translator for rhe Tibetans was Mr. Chin, a well-respected mountaineer who had been a member of a Chinese expedition to Everest and had lose part of his nose and right hand to frostbite. Another man, named Mr. Jin, translated for the English-speaking climbers. To communicate with the Tibetan yak drivers, the climbers spoke m English co Mr. Jin, who spoke Chinese to Mr. Chin, who spoke Tibetan to the yak drivers. The group traveled by yak for nine days and set up a base camp. Then, carrying 35-pound day packs, they set out to ascend Kangshung Glacier. Climbing along lateral moraines, where an immense glacier had deposited large amounts of rock and debris from its gradual movement down the moumian, Sadeghian and the others could see and hear the thunderous avalanches of the east face. The cast face of Everest is accessible only through the Kama Valley, near Shigatse, which is ,urrounded by mountain passes averaging 18,000 feet. The terrain varies significantly. At lower almudes, it's lush green dotted with wild roses, rail poinsettia bushes, and turquoise lakes. However, the terrain near the passes is cold. barren, and snow covered. When they had climbed to approximately 20,000 feet, the group split up. Five of the climbers, who chose to rest their weary lungs and muscles, visited a base camp char was established for the group that reached the cop. Sadeghian and three others continued climbing until they reached a rocky spur at 22,000 feet. Herc Sadeghian's small group rested for some rime and gazed at the impressive Everest, raking rare photos from che ease face. BCFFALO PHYSICIAK Al\D BIOMEDICAL SCIE:-.:TIST �7 l \ " "These mountain climbing trips always bring tremendous pleasure for me," Sadeghian reflected with a smile. "Not only is the natural scenery and landscape unparalleled, but the variety of people one meets is always so diverse. "During the day we share the dangers, frustrations, and unpredictabilities of the climb," he continued, "and at night around the fire we discuss the day's events and plan the next day's goals. This is the best part of the trip because it brings everyone together like a family." Meanwhile, the other half of Sadeghian's group at the American/British base camp discovered several climbers who were in desperately feeble condition. "What happened was that these climbers got stuck near the top without oxygen, food, or tents," explained Sadeghian. "They were unable to return to their base camp at first because the weather and their weakened reflexes prevented a speedy descent~ Returning from the small peak, Sadeghian's group joined the other climbers at the American/British base camp. It was here that Sadeghian first met the American/British group that managed co put one man on the top without rhe use of oxygen. Only 15 individuals have ever managed to go to the top without oxygen and none before had accomBUFFAI.D PHYSICIAN AND BIOMEDICAL SCIENTIST (From top to bottom) Sadeghian and companions received warm welcomes from natives; Sadeghlan in front of Rongbuk monastery near the north face of Everest; Camp Frost on the way to Everest. a es a s a AUTUMN l'l!\9 �8 (Top) Framed against the Himalayan peaks, the 1,000 •room Potala r ises 1,000 feet above the valley and can be se e n for miles; (bottom ) Sadeghi an watches drivers dinner . yak cook plished ic from che treacherous Getting to the Everest summit face had been accomplished only \\'as done by an American group \'arJ in 1983. east face. by way of the east once before. That led by Andy Har- In chc 1988 attempt, the man who reached the top, Stc\'C Venables of Britain, made headlines across Europe as the first European to reach rhe summit from the cast face. And he accomplished his feat on the 35th anniversary of Hillary's ascent. But the attempt was not without its coses. All of the climbers suffered frostbite to a \'arving degree. One of them, Ed Webster, described his group's traumatic events in a Januarv 1989 Sportsllluscraied arricle. \X'cbster was malnourished, extremely dehydrated, dcmorali:cd, and consramly in tears. He was abo suffering from severe frostbite with black toes and fingers . Another climber, Robert Anderson, was also suffering from frostbite on his fingers and toes, but co a lesser degree. Venables, who reached the top, suffered severe frostbice on his toes and nose. For several hours, Sadcghian and Eftekhar cared the best they could for the climbers' injuries, us- ing medications and bandages chat Sadeghian was rnrrying on his back. "\X'hac they really needed more than anything else;• explained Sadeghian, "were some words of reassuran<.e and some idea as to what to expect as far as prognosis was concerned. At the time, I choughc chac they mighc lose portions of their fingers, toes, and nose, buc I tried co remain as positive as I possibly could." Both Webscer and Venables had to be carried down the rest of the mountain by cheir Sherpas on improvised litters. \X1hen they returned to the BLFFAI.() PHYSICIA;\ A:S:D 810.\tEDICAL SCIE:--:TIST �(Top to bottom) Tibetans friendly are and maintain serene a nature ; 9 two Sherpa children whom the climbers encountered in the T ibetan / Everest region; John Goodman (foreground) Sadeghian the foothills and In of the Himalayas. ed very little, if any, medical treatment. Only a few of the climbers suffered from cerebral edema and required some oxygen, which is no rmal." Sadeghian and his group returned safely down the mountain, hiking over to the north face upon their descent. From the north face the group traveled to Nepal, abandoning their yaks for some wheels before eventually flying back ro the States . One precious souvenir that Sadeghian brought back from h is trek on Everest was a note, written by Miriam Zieman, the medica l advisor from the American/British camp. It was sent to Sadeghian's camp via a Chinese runner and gave thanks for the surgeon's treatment . "May 20t h- 8:00 p.m. - Everest base ca mp " "Endless thanks for your support and encouragement today . It was quite an unbelievable vision to see your companions this morning after three months of isolated company, but to find out that two surgeons were on thei r way down (from a peak just above our base camp) was very reassuring for both the climbers and myself. "It was very gene rous of you to help and advise me. T he past few days were exasperating and it was a great relief for me to have you here . Needless to say, the climbers enjoyed your care and expertise and felt better after your consulta tion." United States, Webster had ro have all the fingertips on his left hand amputated, as well as three on his right hand and pares of three roes on his left foot. Venables lost three and a half toes on his left foot . "Fortunately," noted Sadeghian, "my group need- BUFFALO PHYSICIA1' AND BIOMEDICAL SCIENTIST "One thing I enjoy about being a physician," Sadcghian commenced, "is that, regardless of politics or language barriers, doctors are always well received by people . Closed doors always are opened for physicians." • ALJfUMN 1989 ��LIKE RUBBING SNOW FRO! i I BITE ~ ~ ON By CONNIE OSWALD S1DFKO ike rubbing snow on frostbite, a popular treatment for "acute mountain sickness" may actually make matters worse, according to John Krasney, Ph.D., professor of physiology at UB. Acute mouncain sickness affects lowlanders who travel to high altitudes where the air is thinner. "The symptoms are terrible," said Krasney, who suffered from the condition when he attended a conference in Snowmass, Col., which is 11,000feet above sea level. Acute mountain sickness is marked by a severe headache, along with nausea, irritability, lethargy, severe fatigue, and trouble eating and sleeping. In the past few years, mountaineers have been teaching climbers to treat the condition by breathing into a paper bag . But that makes matters worse and could actually prove lethal, Krasney contends . His findings are important as more and more people ski and hike at high altitudes. Bur, Krasney emphasized, his research also has implications for peop le with heart and lung diseases that inhibit oxygen intake. The idea of breathing into a paper bag has been promoted by neurologist Marcus Raichle of Washington University in St. Louis. Both Raichle and Krasney agree that the trigger for acute mountain sickness is a decrease in the oxygen supply to the b rain. Raichle contends that breathing into a paper bag increases the person's intake of carbon dioxide, which dilates (widens) the blood vessels in the brain. That allows more blood flow, and therefore, more oxygen, to reach the brain. But this dilation of blood vessels is the problem, not a solution, Krasney explained in a paper presented earlier this year during a symposium sponsored by the International Society for Mountain Medicine in Lake Louise, Alberta . ILLU Bl.:FFALO PHYSICIAN AND BIOMEDICAL SCIENTIST S TRATION S: LI SA H A N EY II �THE MESSAGE FOR PERSONS PLANNING This dilation of blood vessels in the brain ele,·ates pressure in the capillaries (the tiny blood 12 vessels that connect larger blood vessels to tissues). That causes a mild form of high altitude cerebral edema - the brain tissues fill with fluid. "Our data says there's already roo much vasodilation" caused by rhe low oxygen level at high altitude, Krasney explained. "If you increase carbon dioxide, you make the situation worse. "Normally, when you go to a high altitude, you hyperventilate. You bring in more oxygen and exhale more carbon dioxide. Thar's a normal response. And we think that has something to do with the eventual resolution of mountain sickness - we think it's the decline of carbon dioxide'.' Krasney says he's upset that Raichlc didn't publish his data in scientific journals before his theory was presented in lay magazines such as Discover. "I think it's a good example of something that could be very dangerous getting into the popular literature." Krasncy said. While acute mountain sickness is a condition that has plagued man for centuries (Marco Polo described traveling over the "Big Headache Mountains" in China), we haven't made much progress in treating it. Theoretically, administering oxygen should help, but it doesn't help immediately, Krasney noted. One option is to simply let the condition run its course. Without treatment, most people recover from acute mountain sickness in a few days or weeks as they become acclimati:cd to the high altitude. However, the condition can develop into a lethal form of high altitude cerebral edema or high altitude pulmonary edema. Then the only thing that can be done is to get the patient to a lower altitude. One treatment that mountaineers arc trying now is the Gamow Bag, named after Igor Gamow of the University of Colorado. The patient's entire body from head co toe is placed in the portable fabric bag, making him resemble a mummy. Then the bag is inflated using a foot pump. Thar increases the pressure in the bag, which increases the oxygen saturation. In many cases, the oxygen saturation is increased enough to begin resolving the edema, Krasney said. It's easier to prevent acute mountain sickness than to treat it. The symptoms are brought on by the failure of people to acclimatize themselves properly to high altitudes, Krasney explained. Once a person reache~ 10,000 feet, he should take a full day to ascend another 3,000 feet. AL'Tl,MN ICl8Q GO TO TO HIGH ALTITUOES IS THAT THEY SHOULOTAKE CARE TO ACCLIMATIZE PROPERLY ANO GO SLOWLY. UP (By comparison, skiing areas in Western New York arc only about 900 feet above sea level.) The minimum altitude to get acute mountain sickness is 8,000 feet - that's the height of Mexico City. The condition can be lethal at 9,000 feet, Krasney noted. Some people with underlying lung problems could probably experience symptoms in Denver, which is only a mile high. He also pointed our that the cabin in a jet aircraft isn't pressuri:ed to sea level, only to the equivalent of 7,000 or 8,000 feet. So passengers arc mildly hypoxic, that is, their tissues aren't getting enough oxygen. "So if you get a headache flying from Buffalo to California, there might be more reasons for 1t than the wine you drank;' Krasney said. "Thar's another aspect - acute mountain sickness or hypoxia can really intensify the effects of alcohol. If skiers make the bar the first stop, they can be quite violencly ill." Exercise can also exacerbate the condition, Krasney and his colleagues believe, because circulation is severely altered at high altitudes. As blood pressure goes up, it may produce an undesirable increa~e in brain blood flow, which causes a marked elevation of pressure in capillaries. Thar can cause a rupture in the blood-brain barrier. "The message for persons contemplating going to high altitudes is char they should rake care to acclimatize properly and go up slowly; Krasney said. "If they can't, they should certainly take ir easy for the first few days at altitude." Certain drugs to prevent acute mountain sickness can be taken before traveling to a high altitude. The standard drug is acctazoleamide, which is distributed under the brand name Oiamox, Krasney explained. Ir works well if taken four to five days before going ro a high altitude, and helps to a variable extent after symproms have developed. "No one has any idea how Oiamox works; he added. Another drug, a steroid called dexamethosone, can also be effective when used prophylaccically. The problem with dexamethosone is chat if you lose your pills or stop raking chem, the symptoms of acute mountain sickness can be amplified in a nasty way. How these drugs work and what ocher therapies could he useful are other areas the UB researchers wane to investigate. "Clearly, anything we develop here is going to have tremendous benefits for people with lung disease who suffer from oxygen lack at sea level; Krasney said. BL,FFALD PHYSICIAJ\. A1'D BIOMEDICAL SCIE:-..TJST .. �TMIS KINOOF RESEARCH FALLS UNCER A BRANCH OF MEDICINE .. CALLEO 'MOUNTAIN MEOICINEt THAT ONLY FIVE YEARS CLO. his kind of research falls under a branch of medicine called "mountain medicine" chat's only about five years old, Krasney said. It looks ac physiological problems caused by high altitude. Krasney performed his research with Douglas Curran-Everett, who was a Ph.D. student at UB and is now at the University of Colorado, and Jun Iwamoto, M.D., Ph.D., a Japanese neonatologisc who is working at UB on a Buswell Fellowship. Iwamoto is from the University of Occupational and Environmental Health in Kitakyushu, which has become one of UB's sister institutions. The reseachers conducted a fairly simple experiment. Sheep were placed in a low-oxygen chamber for four days, which produces the effects of being at high altitude - comparable to about 15,000feet. The real stress of being at high altitudes is the lack of oxygen, not the low pressure, Krasney believes, so using a cumbersome low-pressure chamber with air locks isn't necessary. This experiment lasted much longer than those conducted by ocher researchers which subjected animals or people to low oxygen levels for only an hour or two. The longer time span enabled the UB researchers to better follow che course of the sickness, which generally cakes a few hours co develop, Krasney noted. In the experiment, the researchers used radiolabeled microsphercs - tiny plastic beads only IS microns in diameter. These beads were injected into the left ventricle of the sheep's heart where they mixed with the blood and were d1stributec.l throughout the body in proportion to [i BvFFALO PHYSICIAN AND BIOMEDICAL SCIEl'-'TlST IS ABOUT the blood flow. This is a very high-resolution indicator of the blood flow co a region, in this case, the brain. "In fact, radiolabeled microsphem, have become the 'gold standard' for the measurement of cerebral blood flow,"Krasney explained. "This is the method against which everybody judges the more indirect clinical methods." After four days, the sheep brain was removed and studied. The researchers found signs of cerebral edema. "It appears that edema 1smore prominent in the white matter, but we don't know why; Krasney added. Now that they've studied high altitude cerebral edema, the investigators plan to look at the related problem of high altitude pulmonary edema, where the lung tissue fills with water. The UB researchers also plan to continue collaborations with researcher,. in other parts of the country. They've worked with a group of Army per· sonnel at Triplcr Medical Center in Hawaii who have a lab at 14,000feet on Mauna Kea, an extinct volcano that offers the only snow skiing in Hawaii. The Army is interested in acute mountain sickness because when two armies are fighting at high altitudes, the one that gets acute mountain sickness is the one that loses, Krasney pointed out. Much of the clinical data we have today came from the 1967 Indian-Chinese War. The sickness devastated the Chinese Army during battles in Tiber. Krasney also has startcJ a collaboration with Peter Hackett, M.D., of Anchorage. An emergency critical care physician and a mountain climber, Hackett was one of the two physicians who attained the summit of Mount Everest in 1981with the American Medical Research Expedition. Hackett has established a laboratory at 14,000 feet on the west buttress of Mount McKinley or Denali, which they prefer to call it. "It's probably one of the more hostile environments on che planer;• Krasney noted. Crevasses suddenly open up and people disappear. Hackett and his colleagues have sec up an emergency aid station during the climbing season. Climbing has become so popular, probably 1,000 climbers a year try to get to the summit. A great number will get quite ill and have to be treated or evacuated. They've been able to try some innovative therapies - the climbers are not only ill, but they make very useful research subjects, Krasney pointed out. Control stuJics done at sea level in Buffalo will AUTUMN l'l!N 13 �be coupled with high-altitude studies on Denali, 1-l which has a very well equipped laboratory. This winter, Krasney will cake a course in ice climbing and winter mountaineering in order co go up on the mountain himself. "My interest is co work with the human patients who are suffering from acute mountain sickness and high altitude cerebral edema. I wane to gee some further insights co cake back co the laboratory and attempt to work out the more fundamental issues in experimental animals," Krasney said. "Ir's a nice example of how we can go back and forth from the experimental animal laboratory to the field situation where people arc actually suffering." • Environmental Research Unites The Several Disciplines in Physiology //'An interest in abnormal environments unites the different disciplines in the Department of Physiology," said Leon Farhi, M.D., distinguished professor and chairman of physiology. "Environmental research has always been the core of the department." The researchers wane to know how biological systems reacr co extremes in gravity, temperature, air pressure, and gas density. This research is applied to a wide range of interests, including circulatory and lung disease in newborns, space travel, and deep sea diving. The work goes back co World War II and the respiratory studies of Hermann Rahn, distinguished professor of physiology who is known as one of the fathers of aerospace medicine. He and his colleagues clamped themselves into low-pressure chambers to conduce experiments that had direct application to fighter pilots. "Almost the entire subject of respiratory physiology came out of chose very early studies," noted John Krasney, Ph.D., professor of physiology at UB. "So, in a way, we're still studying things that Dr. Rahn began investigating 40 years ago." In the 1960s, UB was selecred as the site for a federal center of excellence in special environments. The government decided to set up a number of these centers in varied fields such as biology, linguistics, and mathematics. Ir grew out of a desire co enhance the country's research potential in case of an emergency, said Farhi. The government had learned a lesson during AUTUM:--:198Q World War 11,he explained. When the military had co land troops in North Africa, it was discovered that nobody knew how the desert affects humans, nor did anyone know where to find the experts who could study the problem. The centers of excellence were set up with no specific mission - they would simply be available if needed. Teamwork was co be a key element of the centers and UB had already assembled experts in altitude and gravity, temperature regulation, diving, and other fields. With the center "we got a nice pot of money for equipment," Farhi added. "It paid for the big BLiFFALOPHYSICIA:>:A:>:DBIOMEDICALSCIE:>:TIST �ments ar UB came in 1985 when rhe University established an interdisciplinary research center. The Center for Research in Special Environments serves as a resource for researchers in academia and industry who need equipment, technical support, and access ro scientists in environmental physiology and human engineering, explained Claes Lundgren, M.D., Ph.D., professor of physiology and director of the center. "Imagine how difficult it would be if a researcher needed to conduct an experiment with a highgravity load and didn't have rhe equipment," said Lundgren. Nor many agencies are willing ro give a grant for a $5 million centrifuge or a $2.5 million pressure chamber, he noted. And who would have the rime co plan and build rhe equipment, then hire and train personnel? "We're here and available; Lundgren said. The maker of a diagnostic device for eye disease is one company that took advantage of the center's services. It had to test the device to ensure it would function at high altitudes, such as in Denver. The center is working on several projects for the aerospace industry, Lundgren said. It's looking at ways to protect crews against high-gravity loads, such as when a plane makes a sharp turn. Another project looks at the body's reaction to explosive decompression, which could occur when a cargo door blows off. Still another project with local industry involves a mathematical model for a pressure regulator valve that has applications for pilots. Other experiments examine ways to prevent .....decompression sickness, better known as "the bends;" how to swim using a minimum of energy, and how to build a better breathing apparatus for §it use underwater or in hostile gaseous environments. To aid this research, UB's equipment has been improved, Lundgren noted. The deans of the schools of medicine and engineering gave a $250,000 grant for a technical upgrading of the saturation diving system that allows people to live in the pressure chamber for extended periods. Through a grant from the medical school, the pool was clad with stainless steel to reduce upkeep. An upgrading of the human centrifuge from a capability of 7G to 9G or more is expected to be completed this fall. "There have been a lot of improvements to the equipment, reflecting the commitment of the University to this unique facility; Lundgren noted.• I j pressure chamber, the human centrifuge, the swimming tank, and lots of lab equipment." The equipment is housed in the Hermann Rahn Laboratory on UB's South Campus. Once the government provided the equipment, the researchers were on their own to support their research. They've gotten grants from NASA, the Air Force, the Navy, and the National lnstitures of Health. (No classified research may be done at UB.) As well as lab work, field expeditions have been conducted underwater in Korea and Australia, as well as high on mountaintops in the Alps. Another boost to the study of special environ- BL'FFALO PHYSICIAN Als:D BIOMEDICAL SCIENTIST CLAES LUNDGREN DIRECTOR THE FOR IS CF CENTER RESEARCH IN SPECIAL ENVIRON­ MENTS. -B, Connie Oswald Scofko AUTUMN 1989 15 �' l6 ~Y lonni~ ~~wal~ ~rntko he scientific community must band together and convey this message to the public: we're not hurting animals, we're saving human lives. That was one of the points brought out during a day-long $UNY-wide conference on animal rights held at UB in June. The conference was attended by public relations staff, researchers, veterinarians, and administrators from several SUNY campuses and Buffalo hospitals. John Deats, director of public relations at New York University, told the group that when one researcher at NYU was targeted in protest by an animal rights group, the whole university got involved with the matter. At NYU, "we developed a consensus among the faculty: no researcher can stand alone," he said. Deats also emphasized that universities must open their labs - not to animal rights activists, but to representatives of the public, that is, to the media. That suggestion was echoed by Charles (Bud) Middleton, director of the Division of Lab Animal Resources at Stony Brook. It's important to show that the animals are perceiving no pain and that there is a compelling reason for the ~ research, he explained. "But you can't give a partial tour," he warned. "It has to be all or none." The problem with opening all of the labs is that a number of investigators have received death threats, Middleton noted. They fear for their safety and the safety of their families, as well as for the animals and University property. At Cornell, one researcher was the target of months of protests, said Fred Quimby, director of the Center for Research Animals at Cornell. One day she received a phone call ac l a.m. in which an unidentified caller told her char if she didn't drop her research with cats, he would kill her children and kill her. The next morning she dropped her work. Cornell wants to make sure that doesn't happen to one of its researchers again, Quimby said. It has developed a "proactive" faculty committee to stress che point that animal research has greatly benefited both human and animal health. The panel involves representatives from research, teaching, wildlife conservation, and agriculture. "I think this lies at the crux of what we all have to do," he said. "The time of looking at che issues as they relate to our use of animals, with a narrow focus on • AUTUMN 1989 BL'FFALOPHYSICIA:-S A),.;DBIOMEDICALSCIE:-.:TIST �- ~ Q z 0 ::E vi 17 § .i Charles (Bud) Middleton, director of the Division of Lab Animal Resources at Stony Brook, says that it's important to show that the animals are perceiving no pain and that there is a compelling reason for the research. education or research is over. "Standing alone is the way that we're going to be split up and the way that eventually we'll lose this battle. I, for one, feel that we all have the same vested interest and we're all going to approach this in a solidified manner." SUNY is bringing its researchers and administrators together through a new committee on animal research. The purpose of the committee is to share i,deas among campuses on how to protect' the welfare of animals and how to conform to rapidly changing State and federal regulations. One mission of the committee will be to tell the researchers' side of the story - how animal research helps human BUFFALOPHYSICIAN AND BIOMEDIC AL SCIE:S:TI ST welfare. "We're all interested in animal welfare, but that's different than animal rights; explained SUNY Provost Joseph C. Burke. "Animal rights, if carried to an extreme, would make it difficult or impossible to conduct research on animals. Neither our society nor our University can accept that." • AUTCMN JQS9 �Medical Scudencs 18 From Rags to Stitches John Border gives a history of trauma care By DAVID M. SNYDERMAN .000-year-old . mummy was discovered vith an open fracture (where both km and bone are broken). John ~ Border, M.D., pointed out that there were no signs of healing and rhm rhe broken femur was the cause of death. "This is an ancient problem; explained Border, an expert in trauma care. "The results of trauma care were absolutely dreadful. The mortality rate for any significant injury (penetrating wounds of abdomen or chest, or open fracture of the femur) was 50 to 80 per cent. Those who did survhe were permanently disabled. "This began to change for open fractures !are in World War I but did not change for other injuries until the mid '4(}.; and early '50,. "Since rhen the results of care have progressively improved as our knowledge of rhe basic sciences of physiology, biochemistry, and cell biology has improved." Border is a professor of surgery and orthopaedics and a research professor of biophysics at UB. As the recipient of la,t year's Stockton Kimball Award, he delivered the 1989 Stockton Kimball Lecture ac rhe annual faculty meeting this spring. He acquainted his audience with ~ome of the historical developments in trauma care. Border knows of these improvements firsthand because he has played a large role in developing them. The methods that Border has pioneered have decreased mortalitv rate, length of hospital stays, and the amount of permanent disability in patients treated in this manner. Referred ro as •one of the fathers of modern trauma surgery," Border is an advocate of aggressive treatment of trauma patients, which includes performing surgery immediately. AUTl.'M1': 198<1 "Ir is quite clear that our old belief that rhe average of 1,819 days; Border said. In addipatient was too sick to he operated on the tion, "70-100per cent had some degree of pernight of the inJury was wrong; Border noted. manent disability and 20 per cent of these "Such patients get sicker with the passage of were so disabled they never worked again." Today, a simple femur fracture usually rime. They do not get better. They need comcauses three to six months of lose \\'Ork and plete surgical care the night of the injury to help them get rapidly better." no significant permanent disability. Border, who is the director of the trauma "This is a dramatic reduction m time even service at Enc Countv Medical Center from rhe '60s and '70s; according ro Border. (ECMC), reccntlv received the Roswell Park owever, as damaging as \\'Ounds were to Medal from rhe Buffalo Surgical Society and soldiers, there was a \\'Orse enemy stalkwas honored by ECMC for his contributions mg the fighters on the field of battle. co trauma care. "The major problem, in all armies, was nor Border drew the material for hi, lecture death from wounds," Border explained. "The from his new book titled Blum :--111/tiplemaJor problem was dcarh from disease. For Trauma: Comprehensite Paihoph,·s1olog;; and every soldier in rhe American Civil War who Care.Ir is a guide ro the understanding and died of wounds, cwo died of disease. These treatment of blunt multiple trauma cases, for were communicable diseases of childhood, rhe instance, auto accidents. diseases of filth, and problems such as H Border said that for hundreds of years up through part of World War I, open fractures were treated by amputation. In fact, the army field hospitals "were usually marked by huge piles of amputated limbs and dead bodies." As a result, he said, rhc hospitals "were usually quite easy to find." The amputations \\'ere performed in under three mmuces and required up ro six strong men to restrain the patient. The military surgt.'OnDominique-Jean Larrey "at the Barrie of Borodino did 200 amputations m 24 hours," Border noted. \Vhen patients managed co keep borh their li\'es and limbs, "they lost years our of work" and , for the most part, "were permanenrlv and severe!y disabled; he said. "According to Lorenz Bohler (a modern surgeon who "'as an expert m the treatment of fractures), prior to World War I a simple femur fracture kept you out of work an malaria." In fact, it was nor until World War I that disease and wounds had similar mortality rates and not until World War II that wounds passed disease as a cause of death. "These ad\'ances depended on vaccination, ~anitation, and antibiorics," he said. Border remarked that poor sanitary practices of the day horh in and our of the hospital helped co aggra\'ate the disease situation. Sanitation was, m fact, one of the primary problems of medical care until rh1s century, Border said. Wounds were washed \\'ith pieces of non-sterile doth rinsed in a communal "pus bucker." "These rags came from an international rag marker, or were discarded linens; Border explained. "They were later found co be a major carrier of bacterial disease from place to place." BL'FFAI.OPHYSICIA:>.A:S:DBIO~IEDICALSCIE:S:TIST �Medical Students 19 Conditions in the operanng room were little better, Border said, giving the example of a Viennese surgeon from the last century. "This is Theodor Billroth operating in Vienna," Border said, explaining a particular shde. "Notice no hats, no gowns, no gloves. The huge audience is breaching on the wound." Many of the improvements in sanicac1on can be traced co Florence Nightingale's reform of hospitals during the last half of che 19th century. The care during the Crimean War was so bad and so well publicized that the Briti,h government hired a group of young women to go with Nightingale - these were the fir,c paid nurses. The mortality rate at the hospital where Nightingale worked during the war dropped from -l2 per cent before she arrived to 2 per cent while she was there. She later repeated thb performance at a second hospital. As a result, Border said, Nightingale is credited as the founder of nursing as a profession. One of her decisions, although seeminglv simple, was extremely important. "An absolutely valuable change here," Border said, "was doing the laundry with hoc water. It was not until much later that ic was proved that laundry with cold water did not change the bacterial content at all, whereas laundry with hot water did." Another invaluable change that Nightingale made ro patient care was an insistence on accurate patient records and statistical summanes of the patient care. "One has to give her credit for creating modern scientifk medicine," Border concluded. "Pnor to Florence Nightingale there were no hospital records." 0 ne of the next great advances in surgery and patient care, Border said, was the use of anesthesia. Anesthesia entered the scene in 1846. "Bue no doctors could make a living ac it, so there were very few doctors who gave anesthesia, and the tradition was chat the surgeon called on whatever docror walked down the hall; Border said. "No measurements were made of vital signs or blood loss and no intravenous fluids were given during surgery. try of both toxins and bacteria? This is an enormous change in viewpoint. Granted, the basic hiology involvL-dapplies co most ~ritically ill patients and not just to the trauma patient." The care of trauma patients, Border said, has improved "primarily because of a large amount of basic science research, which allows us co understand metabolism, cardiopulmonary physiology, the whole thing that goes wrong with the trauma patient." Florence Nightingale: she improt·ed hospital sanitation. "There was no real professional anesthesia until World War II. At chat time, the armb trained and designated anesthetists. "There was another very important change at chis time and chat is that the anesthetiM should nor only be an echcrizer buc a rcsuscicacionisc; he noted. "This required an enormous development in biochemistry and physiology to know whar to do. "John D. Stewart, a former professor and chairman at the department of surgery, made the major contribution co chis advance." The latest and probably greate<\Cadvance in trauma care i, the realization that we were looking at the problem of infection complccely wrong, Border said. To fight infection, stronger and more numerous antibiotics were used. Bue because che critical illness and infections came from toxins and bacteria in the gut, annbiotics actually encouraged infection by destroying beneficial bacteria which kept detrimental bacteria in check. This allowed the detrimen• cal bacteria to multiply and enter the rest of the body. "The annbiotics we administered to treat infection undoubtedly caused infection; explained Border. "The correct way of looking at chis problem is undoubtedly, how do we support growth of the good bacteria in the gut and how do we support the gut mucosa as a barrier to en• BI.JFl'Al.O PHYSICIAN AJ\:D BIOMEDICAL 5CIENTIST Despite public belief to the contrary, Border said, the total cost of health care has accually gone down because modern medical care has been able to get people on their feet and hack to work sooner. This has more than offset increased hospital and doLtor bills. "You have to understand chat, of rhc total cost of accidental injuries today, only some place between 13 and 15 per cent goe,, for doctor and hospital bills; he said. "Eighty-five per cent of the cost is in temporary and permanent disability and death. "Of this, the dominant portion is temporary or permanent disability. This is where the real cost is." He explained that the net effect of all changes in modern care has been to shift coses from the disability/death category inro the hospital care dassiftcation. "The per diem cost has gone up even more rapidly because of the reduction in the length of hospital stay," Border ~aid. "This trend began in the '40s because it resulted in better care. John D. Stewart also contributed to thb advance. "Unfortunately," he continued, "our political leaders look only at hospital costs and do not look at rhe effect of the changes in care (reflected in hospital coses) on the length of temporary disability, the numbers of cases, and degree of permanent disablity or the mortality rate both in and out of the hospital. "The essence of all changes in modern care that have occurred has been to reduce outof-hospital costs by increasing hospital coses~ A, a result, he concluded, the total cost of health care, when both hospital and ouc-ofhospical costs are caken into account, has "dramatically" decreased "in total coses for many dbease problems, including trauma."• AUTUMN 191!9 �Medical Students 20 \ J THEHEADBONEIS CONNECTED TO. . . F or the 143rd time, the University at Buffalo School of Medicine and Biomedical Sciences has injected new physicians into the practice of medicine. On May 21, during a ceremony held in Alumni Arena on the University's North (Amherst) Campus, 140doctor of medicine degrees were conferred, along with 26 Ph.D.s, and six master's degrees. As proud parents and families looked on, the new doctors strolled down the aisle to receive their hoods and diplomas in a ceremony that featured vocal music hv the 0ermatones, an a cappella group of medical students. John Naughton, vice president for clinical affairs and dean of the medical school, commended the graduate, for the concern they showed for a classmate, John Robin, who contracted cancer during the sophomore year and died in September of 1987. The medical students memorialized Robin in their yearbook, the Iris. Robin's untimely death, Naughton said, "was a tragedy that we all felt," and the medical students' compassion toward their classmate "shows that you are ready to become physicians." The class speaker, Paul Lccat, looked back on the four years the new physitians had spent together. "As I look around the room, I can only think of one four-lccter word that I picked up in New Orleans to describe all of you, and chat is 'fine;" Lccat said. The 1989 yearbook, che Iris, was dedicated co the art of medicine. Loriann Fraas and Diane C1cacel10,co-editors, presented a copy of the yearbook to Lilh Sentz, history of medicine librarian. C ommencement speaker Harry L. Metcalf, M.D., former president of the AmerJCan Academy of Family Physicians and associate clinical professor of family medicine, warned students who were leaving Buffalo that "in about two months you will have acute withdrawal symptoms for chicken wings and Bocce pizza." On a more serious note, he left the class with three things to remember. "First and foremost, you owe a very large deht of gratitude to your parents and family,"Metcalf said. "J\.:evcrforget char many years of struggle, support, and sacrifice went into allowing you to realize your dream." He also urged graduate, to support their medical school and to live up to their responsihilities to help their communities. "\'('hen you arc setrled into your career, give something back to the community in which you serve," he urged. "Participate in your specialty organizanons, the PTA, your church or ,ynagogue, or whatever charitable way you <:hoose. But please, don't he Just a taker~ He concluded with a short anatomy lesson. "There's one more thing you can learn about the body that only a non-doctor would cell vou; Metcalf said. "I hope you'll always remember this: The head bone is connected to the heart bone and don't let them come apart." • BlJFFALD PHYSICIAN AND BIOMEDICAL SCIE:S:TJST �Medical Students \ J BlJFFALO PHYSICIA~ AND BIOMEDICAL SCIENTIST AUTUMN 1989 �Medical Students 22 Pull Out All the Stops Go as Far as Possiblein Treating Patients, Advises Noted Pediatric Neurosurgeon By DAVID M. SNYDERMAN P ediatric surgeons who work with brain damaged and potentially brain damaged children face difficult ethical problems, Benjamin Carson, M.D., told a group of medical students recently. "The whole issue becomes one of how much time do you put into the care of individuals like chat?" he asked, advising the future doctors chat they should, wherever possible, "pull out all the scops" in the treatment of their patients. Ca rson, the director of pediatric neurosurgery at Johns Hopkins Medical School, made the comments at UB May 5 in the first annual Progress in Medicine Lecture sponsored by che Student National Medical Associanon. Carson is known for his separation of a pair of Siamese twins. He illustrated some of the ethical questions confronting physicians by detailing case histories. "I remember a case of a young girl - four years old - who had Ix-en hit by an ice cream truck and suffered a very severe head injury," he said. The girl was brought in over the weekend and Carson did nor sec her until Monday morning. He was told chat "the only function she had at chat point was pupillary reacrivicy." However, when he examined her, her pupils were fixed and dilated, implying severe head trauma . He decided to operate. "T-vo weeks later, she was awake, talking, and responding co commands," Carson said AL,TIJMl\ I98Q Benjamin Carson, M.D., gave the first Progress in Medicine Lecture . with a smile. After two more weeks, "she walked home and was neurologically normal." Many people, he noted, would have argued early on char surgery was a waste of resources, chat the girl's case was hopeless , and chat it would be best to just let her die. "If we had done that, we would have lost someone who was subsequemly normal," he said. In another, similar case, a young boy was seriously injured and the mother wished to pull him off che respirator. Carson talked the woman imo allowing him to treat the boy. "We wem ahead with it, and he subsquently walked; the neurosurgeon said. Although the boy did have some neurological impairments, Carson said, che mother was oveqoyed to have her son alive. Then there was the case of a man injured m a car accident . The patient was in control of his mental faculties despite being depen- dent upon a respirator. "He made a request to us bv sign language chat we disconnect the respirator and allow him to die; Carson said. Boch his family and clergyman accempted to calk him out of it, "but no one could convince him otherwise. After several days we removed che respiracor." Thar brings up the question of what should be done for children in similar circumstances who do not have che experience and know ledge co make similar requests. "How can you make such a dc.-cision(rcmoving a respirator) for someone who hasn't experienced life?"Carson questioned. "That's one of the biggest ethical problems." Carson gave another case history concerning a girl who had been seen by several cop specialists around the country . When he saw her at Johns Hopkins, he felt surgery was in order. However, a well-known neurologist disagreed and attempted co get the hospital to intercede to keep the girl out of surgery. But the neurologist "then made a big mistake; Carson said. "He went to Rome for a conference, and I realized this would be a good time co do it." Carson said the girl has made excellent progress, thanks to the surgery. F inally, Carson told of his experience in the separation of a set of Siamese twins. Traditionally, such twins were either left together or one was sacnficed so the other could live. BUFFALO PHYSICIAN A1'D BIOMEDICAL SCIENTIST �Medical Students 23 However, m the case of the seven-monthold twins brought to him, "the mother didn't want to choose which one would survive and which one would be sacrificed." So Carson embarked on a procedure to separate the twins in such a way that both would be able to live. "We thought the chances were no greater than 50-50," he recalled. After a grueling surgical marathon, in which a total of 70 people were involved, the twins were separated. During their recovery, "they suffered just about every complication known to man but they subsequently began making a significant amount of progress, and eventually went home." The enti re action of separating and caring for the twins cost about $2 million, Carson said, of which the hospital paid half. But no hospital can afford that kind of expenditure on a regular basis. "The way you solve that problem,' he noted, "is you share the wealth. You don't require one institution to perform all of these procedures." • Academi1cLadder; she told her audience that it's important to set goals. Academic promotions - the rungs of the acaderni,c ladder - arc just benchmarks of our succ,ess, not goals m themselves, Behrens emphasized. We must always remember the larger goals - helping asthmatic children or finding a cure for cancer. While setting goals, you can dream big dreams, but the dreams have to be focused through the small end of the telescope of reality, Behnms said. You must also realize that your goals can change. As a teen, Behrens wanted to help with health care in Third World countries, but didn't plan to be a dean. She diid become a dean and her plan to practice in the Third World was deferred, though not abandoned. As a dean, she facilitate:sThird \Xlorldprograms through her school. Still, the pediatrician plans to someday practice medicine in the Third World. Using your personal time carefully is as important as using your professional time carefully, Behrens added. "It took me a number of years to realize that other people can cook and clean, but I'm the only one who can listen to my husband and put psychological Band-Aids on my hurting children," Behrens said. She also discovered that when juggling many roles, it's easy to forget to set aside time for one important person. "] had left out one person - me," Behrens said. "I was giving so much, there was nothing left for me." She learned that she had to attend to her own emotional and spimual wellbeing before she could focus on her goals. There's no room for coasting, Behrens added. "You must develop as a professional and a person for the rest of your life,"she urged. • B:, Connie Osu:ald Stofko CLIMBINGTHE ACADEMICLADDER A t one point m her career, she felt as if she was living in a pressure cooker. She was on 20 cornrnirree:sand trying to juggle her roles as clinician, researcher, teacher, administrator, spouse, and parent. With so many deadlines, it was hard to get through the day, said 8. Lyn Behrens, M.B., B.S. She eventually learned that prioritizing one's goals makes it easier to say "no." Drawing from her own experiences, Behrens, the dean of the School of Medicine at Lorna Linda University and one of only three female deans of medical schools in chis country, took parr in a four-day program on academic achievement. This spring's OW. Harrington Visiting Professor, Behrens is gaining a nauonal reputa• tion for her presentations on faculty development. As part of a session on "Climbing th c B. Lyn Behrens, BUFFALO PHYSICIAN A:-.:D B10:l.1ED!CAL SCIE:-.:TJST one of only three female med school deans in the U.S. AUn..:M:-.: 1'189 �,. Medical Students 24 OUTSTANDING FACULTY HONORED AT ANNUAL MEETING T he 1989 Annual Faculty Meeting witnessed the presentation of many awards for teachmg excellence, research, and service to the school and communitv. This year's Stockton Kimball Award for excellence in academic achievement was given to Saxon Graham, Ph.D., who will deliver next year's Stockton Kimball Lecture. Graham, an epidemiologbt, is a preeminent member and chair of the Department of Social and Preventive ML'Clicine.His work has been primarily m linking diet to various diseases and suggesting dietary modifications ro help prevent the onset of these maladies. His best known qud1es involve colon and breast cancers . Graham has linked dietary fats ro a high risk of cancer of the colon, lung, and stomach. Equally important, he has reported a potential protective effect of carotene in combatting cancers of the mouth, lung, esophagus, and stomach. Graham has also suggested that women who arc m high-risk categories for breast cancer limit their alcoho l mtake. This year's Stockton Kimball Lecture was delivered by John Border, who 1sprofessor of surgery and orthopaedics and a research professor of biophysics at UB, as well as director of the trauma service at Eric County ML-dical Center (see accompall)mg amcle). The Dean's Award was given to No rman Solkoff, Ph.D., a probsor in the Department of Psychiatry, for his service tO both the medical school and the University as a whole, and outstanding research. Special recognition went to Murray Ettinger, professor of biochemistry, and Charles Severin, associate professor of anatomical sciences. Ettinger was recently named a Distinguished Teachmg Professor by the SUNY Board of Trustees and Severin received the Chancellor's Medal for Excellence m Teaching. The second annual Robert S. Berkson AUTUM:-..'19R'I I Saxon Graham Memorial Award in the Art of Medicmc was given to Robert Reisman, clinical professor of medicine and pediatrics. The purpose of this award is to recognize excellence in patient care and teaching by a volunteer faculty member. The Louis A. and Ruth Siegel Teaching awards, which recognize teaching excellence, were presented in four categones: ■ Steven Gutman, M.D., assistant professor of pathology, received the Pre-Clinical Award . Letters of commendation were given to Edward Car r, M.D ., professor of pharmacology and therapeutics; Perry Hogan, Ph.D ., professor of physiology; Alan Lcssc, M.D., assistant professor of pharmacology and therapeutics as well as medicine; Charles Severin, Ph.D., associate professor of anatomical sciences, and John Wright, M.D., chair and professor of pathology. ■ Ralph Doerr, M.D., assistant professor of surgery, received the Clinical Award. Letters of commendation went to Paul Davis, M.D., professor of medicine; Margaret Paroski, M.D., assistant professor of neurology and physiology; Luther Robinson, M.D., assis- tant professor of pediatrics, and lnsook Shin, M.D., clinical assistant professor of neurology. ■ Joel Paull, M.D., clinical assistant professor of surgery, won the Volunteer Award. A letter of commendation was awarded to John Treanor, M.D., clinical assistant pro• fessor of psychiatry. ■ Edward Co leman, M.D., clinical as:;istant insrructor of surgery, was given the House Staff and Special Award . Letters of commendation were given to Donna Desmone, M.D., clinical assistant instructor of medicine, and Deborah White, M.D., clinical assistant instructor of medicine. Also at the meeting, Nancy H. Nielsen, M.0., Ph.D., the new president of the Medical Society of the County of Eric, introduced Charlene Cortese, New York State Medical Society Auxiliary, American Medical Association-Education and Research Foundation (AMA-ERF) chairperson, and Phyllis Caputi, president of the Medical Society of the County of Erie Auxiliary. They presented checks totaling $8,004 to the medical school.• - 8,· Dal•idM. Sm·derman BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST .. ��Medical Students Suraj Arthur Acharva, French LitcralllreB .A , Lniwrnr) of Califonua S.C I am mr,·rc,1edm ,ntL~uumnalmedicine, ch,1mb..>r mu,i,, and arr Kawh Ali:adch, BwloJ<., B.A.. Ctmiell Unn-ernty. Bnrr! Eli:abcth Ann Allen, Trina Bernadette B1ochcmi,1n B S , Allen, BwloJ?Y B.A., Unit a,rr, at Buffalo. I \' assar Colle[!.eI like l(J(Jk foru·ard w sf>,mdmg hiking, mm ies, and caung <'hce.,ecake cnwtht.-r four ,·ears m . .\led sch,-,1fu, m /i.ruwn Buffalo. :--:ancv A. AllenRichard, Bi.. :hemistry B.S , Sl';'\JYat Sum, Brook I h,ll'e 11great st1f>f>or111 c Jamily and Jewel Damita Alleyne, Bwchcmmry, Hof,1ra. I like w ,mg, I lo,e w tratel. I chose lJB becauseof the re.,earch. I'm gladw Ii. m Buffalo. hmm,. Matthe,- Evan Alt.,,, Chcmisrr, B A., \eu YorkL'nn-ernry I cho,e l'B bern111eof rhewe,11 Rmh:·rs. Elvs,a Anne Blissenbach, Bwk,J<., B \ , Fairfidd L nn ,'TS1fy.,\h jat<>me pasume" figure ,karmf!.. Gre~ory A. Andre",, Got<"Tltmenr A. B, Michael Jo,eph Aronica, Bwlos::,B.A., Harmrd L'nm:rsuy. I cho,e L'B med sch(J(JI h.!causc! of Its ow,tand1111! rcpuumon Uml'L'T'ilt)· of Rochl!stc:r. Mike "a t,prcal med srudcnru-hoha1cs l1brarr.:.1 and Ime, w parry Renier Jo,eph Brcntjcn,, / fowry B A., Darnison Jon Michael Bruce, Bwlogy BS. Chemmry B.S , L'nin>rm:,at Buffalo and ,'\Jia[!.ara Una·er,11y.Hello B11ffal11! Colle[!.,'.1 um born ,n Ams1erd,1m,The Nethc'Tland.,. and like \(lllmf!., Behnam A,~harian, B10.:hcm111nB <;_, L'n11m1t)·at Buffalo I look foru·ard w med schml and cnio:,,/i.mf!.a1 L'B Andre" Jacob Bam,r, Bu><:h,·mNry B A., Thoma, Gerard Burke, Mc<·hamcal EnRtneeringB S., Notre Dame Ir's fun to come homefor schoolm rhe,c Crai~ H. Burrow,, B.,,r,,!?Y B.S . Ho11ghton Collt>gc.I enim the an of pantomime curmu_, ume.o;. Carolvn L. Be""1te, Bioloi:yB.A , Camsrm Collef!.e.I <1lsc, Unnc'TSII)of Roche,ier. lune degreesm la1t•, Lookmgfonmrd to music, d..'!lusrry,and medicalsch,.,I. Enj<>y elecm.:alengmeenng. playm,irhe1·1olmand cycling. Heather R. Campbell, Bioloi:yB.S, Cornell L'n11ernr,.I like being uurdoon and bakmgnut necessonl~ · m the ~me ume. �Medical Students Rodnn Cap,ro, P,:«·ho/og,B A , Xcu r,,rk Um1s'T"':· Becominga ph,.\lcklll has />.:ena lifelong ambmun. Ann" Mari" Comi, B,o/og, B.A . f/oly Cm". I reallyrhmk the.,t!qut.1.,rlmt,an.• ab,urd so I'll JIN keep :mu folksgun\lng Li,a Ann Cardamone, 810l01?:B A . Lrmh·nil'\ vfRo,·hesct:r I am tloconh a sc:,:unJ. gencrarum 1>h,"c1<1n /,ur aho a u·c,i:htl,frcr. Andre" C. Cor,dlo, Chcm1Srry13.A.. C,m1dl L'1mernr, I ,d\11hatc J,·,grccs111ltm· and m1Nc. I mincedw round offm~-c.•Jucawm I,:.gomg co mcd1,,1I "h,.,I. T ridJ L. Ei~~n..,tctn, John Alt,xander D:ik, ,\1cchamcalEng111ccr111Jl 81mndK<1lEn.~anccrmg 13.S.. L'n11crnr,lH Buffalo. I cnJm pki,ml! ra,:q1«1ball anJ bmdmg. B.S E Duk,· l 1m a<1r,. I l,ke w f), />kmc,- I'm a ,ucdcnr 1,1101. \!aria T er1!,a Cartai:cna, B,olog, ll S. L'mwrsit) at Buffalo. 11,,w dorhc, Richard Mark Chcmdli, Bwlog, B.A, Comdl Unn•c.>f\!l'.''· h\ nnr JU\( ll pro/1.!s,1,m. 1t', cm Elaine Hee-Young Ch,.,on, lliolo.~",md ~,..-1e1,B -\,. C,,rndl l '1111 <"T\11\ 11,ke ,kuni: and 101111\. William F. Chlo,ta, Biulo.~"B S Ca.,.: \\.'t'.Slt."ntRc:,c..'n 1..: l Hll'~T\ll),' I ~1110: ,k11ni:.,,ulmi:, remm, ,md<1rt.I'm l,x,kmg fi,rn ,ird ro m,·d,ch,x,I \1ichacl La" rencc DuBartcll, Bwlogy 13.A , l 'nn,'T\lt, at /l11ffa/u.A/1,:r _gr,id11a11011 I 1m111Jl,k.: 10 praruct.' /1..uml) m,:Jii.-mc.·. Karen M. Dui:uid, (1t.lt·i:1UUTt.." \'ane"a L. Crother,, Win,ton G. Oou1,:la,, Cherm,rn and llw,:hcnmrn 13~-, l',y,hology ll .A , l 'nn.:rnl\ of Ro,hc,r,'T I U.dtU to ht!-u doctor,o /'II h,:,,bk w (rttm~,: healthfare m necd.:d. Ru/,..-rr,\\'.'csle,an (•oil..:~.:.Fmu ~\'t.'<ir, /rom nou I hope w/,..-<1 ph,"cr,m. Julene Op1al,.,neE,an,, ,\ f ,rr.,/>wl,J!i:'.' /l S. Cumdl L'mwrnr, I ,ho,c L B hl?f,111,c I urn,IJlike w twrk j,,r ih,· \\'.'orlJ I kalrh Gil Michael Farka,h, Hu._hemhtn B-~., L nn cT\11\ dl llujji,lo I ( >r.s,:c1rn,aw,111 m Kl'n)·a n.·r~·~.,cm:Jahuut ,mendingm.:di.al,,hwl <II LB. ,,nnc:dtl\· c.'HJO)' ,1 Jnt."nH, oj ,pc,rb md,«Jml!1cmm, ,kun)(. andu:orklll,1!out I ,m1 Paul Jo,eph Fa,orito, P"chohwlol!", H,mulwn Coll,:g,· I um ,:a~erlo hcgmmed ,, h,.,1 and I hk.:m pl," ,..,,w,h \ kd1,11ITe(hn,,/o~" 13S l '1111,·Nryof \ l1,h1ga11. I ,un <1 <'<Yllfi.:d Sign kmi:11,1~,: m1t:rt>r1.'rc.·r. I Cdn r U.'(UI 10 ,wn ! Ilana L. Fcincrman, B,,..-h,·m"'" 13.S l"nn.:rnr, ,u B11/f<1lo. I thmk 13ujf<1lo " " ~.,..:,u pla..·c<111</Im 11/,ul111/,,_, bt,,kJi,rfour mor,: )'t?(JT\, �Medical Students \1ich,,cl '-cott D,1\IJ K. he,, Bio!oi:y B.S . L'nu ernry ar Buffalo. I'm an early assurance mukm. I'm from N ia1;araFailsand enJO)golf Orn·ego I chose Buffalo ~cau..\l'of ns gtc!at weather. Gloria \1. Gladk,m,ki, Bwlol(Y B A., L'nii·,.,._m::,,ai Buffalo. I trnrkcd in a hmp,caiJoreight :,cars as a medicalsecretllr. and nou am dum)(ini:role,. '-.indr., \I. Gutierre:, Timoth, Danah, H·,ln, Chemmr. BS., Honora \f. Heffner, En1;!i,hB.A , Colgac.t St. Lawrence Lnu·,.,._my.I'm ured.• l,'mtt'l'SII). / «ill he a ihirdgmaarwn Fl·r ~U..,llO, 810ch1;.~mrscry,' B.S.. SL,\ Y ac Biochenmcr:,B.A.. Neu York Un1tcrnry I pia, the drnm sec. I I,ke compwer \Clenc~, and l u,li bea firn gcnt'l'amm phys1cu111 ph::,,s,c1an and I like w piay ciannet. Charle, R. Gr.w, Health SciencesB S .. Beu, B. Grc~oirc, Speechand Drama, K1thl~cn T. Grimm, Canis,us,/Y}'mm!k. I lJnncNI) at Buffalo. I am final/:,a firn,ycar med suukm SL \IY at Gt>neseo./ ha,, a ma.,1ds m library haw a B S. m med wch and aL,oa BS;-.. Jame, \I. hernia, B11smess;<v1an,1J?emcnr B.S, Cornell L'nn-asuy Fr,mhali mJ11nesfurcedme to be the paucm. Nou I i:ct to ,~«! tht>accwnjrom Ute! Wallace E. John,on, Philosophyand Theatre B A. , Yale. I look foruard to leamin.~ ~cicnce,tu.•ochildrt!n. and like w readand sail Robm \i. """• Psycho!oi:yB A , Varonouch. Phowwaphy and owd,.,r s[><ms ahaw B11ffab,. mht.,."ck. Li,a F. Kci,her, BwlogyB.A., Camsn,s College.I, a capuon ri.?all~ · nrce~.\ll~·! Kt·vin J. Kelleher, B,olol(YB A , Camsn1s College. Ba.,kechali, wlle,hall, and rcnm, arc my font' (hueI rau!y use chat,wrd) Jonathan Robert Kemp, Brrx:hem1,cr:, B.A , Neu· Yark Linu ,.,.m, / u·i,h m)' brmht'l'George u·a., here. PEACE. Cath\ Kim, Biology B.S , \1/T Llfe" temporaryso fin~if to the fullesc· u•,,rkhard and piay cwn lu1rdcr: Eli:abeth H. Kim, Bro!ol(Y B A . Camm" Co/le1;eI u-ar11to be /urch~r young! Ricardo Alfon:o Knight, Ph"iail Thera{)yB.S .. Uniwrncy at Buffalo. I ihmk bemg a docc,,rrs the ea,u:.~t u·a-\ to achie,eall charI can be �Medical Students T cd J. Kolia,, Bwloi," BS. , L nn .:mi,· of \fa:hr.i:,m I en}o) pla:m.i:ha,keiroll. .,occcr, anJ the pram,. Paul \t. Ko:1,m,ki, Bwlolt' B .A . C,mrsrus Collei:e I u·an1 w reach hikingrn 1hel'hrlippmes. Brian J. Krah.ik, Elecmcal En.i,ne<.'1111 .~ BS., Comdl L·nriern1, I like playmi: the /nano ari,l .101.n-r, neuh.:rof wh,.-h I' II h,a e wne for Da, id J. Lee, Biolo.i::,/ .'-.·curoKrcnccB.A .. Oh..-r/111 College I'm on Kcuni: Wai Lee, Kc\\•Juni: Lee, Brochemr,1ryB.S , SL',\') <11Hinghamwn l\ycholo.l!)B.A., Comdl Uniwr,11,. I dm«J11111.: u hen I ,ki on /me />kl'lll/? ,o,.-er. lrke ,um1ming lx1-'ke1h,II,1runnmi:. f><11d.:r Julie A. Madcj,ki, Bwchcm1<1r.· B. S . l ·nrt.·Nt) at Buffalo Can' 1 u·au w i:ei S1<1rted on rhrs1,.:11· ewurng (><rrr of m, lrfe Karen \1. Maier, l're;\ieJ B \. . ,\' orre D<1me I Ion! l\·ntrc Durn<? {tH!lNII Jerald Chri,tophcr Timoth, J,1,· L,R,"a, Kuhn, Enl!/i,h B.A , Biolo.l!)B.A .. flamrlwn Collei:e I am l 'mt ..·r,H~' of Rocht',ll'T an attd .\liilor, ,u1dcnJo-:,. · I hale cmds.,<1<.'latl.''srn the heaimful mnny u·eaiherrn Bu//<1/0. appliedscrence111 hro..-he11m1r,, Charle, Hoonjani: Lieu, Chem1>1r.B .A Comd/ Unncrsu, .\fohular Bro/ol:'AB , Tammy J. Linsner, Chcm,,m B.A., Princeton L·1111c·rsr1). I U.'ant w Sl'rtt.' (;od ch a Harru-rckCollq,:e I am lookmi:f"nmrd IO med ph,srcran.' ,chMI Bruce B. \farshall, Bu<me,.1.\fona.11,,,nent, Comd/ Um,crnr,. I Ed"ard F. .\lath, Biololt' B A., Branders \\'.'hLnclo~!.'i orn·ntauon .. i!nd! Jame, Kcillh Mantc.>ne, Gina M. Marrero, Bu><:hernr.\lry BS, ;\11crnhrol".I!) BS, C,mid/ L'nncrnl\ I am /,.,km~ fonmrJ w " ,cry SL;-,:y,11Bmi:hamron I u'll.SIn mg r.a/iprlyrm ,1 beachrn Ca~rfomta,then mmn and ,uul mademe come here. Tr.in !-Idem· Lathrop Chcmr.m, B.A ~l i':Y m Brn1:h<11mon r~uardin,J.? t' xpc:rrence at LB Christina Lc,lie Lin, hate hem a ieach~rf,rr four JCars I like m(),t ,f><,m Un11crn1,· I rhme w be a ph~srcwnh.:came I enJ") pressureand tcn~ion �Medical Students Fiona A. McConnell, Kc,·in Christopher B1ol111;V B A . \\:'11!1,11111Md-,,{ahon, (,oternCollege.I likehangmg ment B.A , f-larrnrd out I hop.:to mdke flm<' L"nlt'c..'n:lly /"d like to hate u praftice in duringmed ,ch,,ol to do sport.'i.makt.·mu~,l, anJ Cha11ta11<1ua Count, 1omcda,. lune fun . frrnfe~_,ion of medirmt.' becau,c I lm·e 1mrk111i: Daniel J.Mollin, BA . P"<"hoh,,,loRY ?\'eu· Yurk L"nrtern!) . I dcoded w i:o ro med on />a.1r ,chwl h<1,ed u uh p.:ople. exf>t!TICUO! Lorncllc B. Mill,, Bwlol!)B S . ,--:cl< fork l 'n,urnr, I cho,e the Claudia F ranee, Michalek,, Nurnni: B.S , D'Yrnml/e I hate a dt.'grt!r 1n nt4rsmg. Michael John Naughtor,, Philosophy B.A.. \',:'il/1am1College I rnn ,p.:ll,\;1ct,.<ehc Andre" Charle, Michel, Bio,:hcm"try B.S . .\f11/m11lk L'mn.>rstt~·1tnJ'" Jly fi.,hmg.and crm,country skiing. I look fonrnrd to s(h<H,I . Tuni: V. Nguyen, Biuengmuring BS , L'C (II B,.,-keh I trill he a third,i:cner<1t1on ph,sic1an. Rogena Leonila Miller, Bwlol!JB.A , Talladega I chme med <ehmlhecau.seI'm mt,.,.e,ted111the medical profernon and helpml( mhcr,. Jennifer Ann Nordby, BiologyB.A . Corne// L"m1,,,.1uy . M>·greatgrandfathergraduated from UB medicalm David A. Milling, .s.' B Unn,.,..m, at Buffalo. I PhdTTMC;i haw a B.S m pharman I c?nJo) racquethalland rcnms. Katherine Anne O'Donnell, Bu..:hem11try B.S . SL'NYat Bmgh.1mwn.I hate <111 ,\1 S m pharmacoloio. 1901! Sanjay R., Ogra, Biolol(;iB. ~ • Cornd1 l'mtcrnt:,. From r,,day. 1am a doctor (,umd><,d) ') . wld me rh,,r ycsterciay Mia Pappagallo, Bwlol()B.A P,ycholol:;i B.A., Lnnernry of Rochc,u:r .\1y p,mport phoro" heucr than mi,!' Jeffrey Richard Parnell, Bwlo);VB S , L'nncr.ll!y Ill Buffalo There" no heltercaret'l' ch.anmed,cme! Vikram N. Patd, Bmchcml\lr\ B S.. SUNY at Swny BrcxJk.I choseLB became I l,ke huffalne.1. �Medical Students Frand, R. Patterson, Bwloif.<BS \1/T I like pla)mg ,porr, and arn,·mcs . ocheroWlUH>r 1':a"er Ra,ack, Neurobwloif.<• Archaeoloifi·.L'nncr,u:, of M1Chiga11 . I decu.ledw p,o w med ,chwl m Bufjal,, b.?rnu,eI Inc Kri,tcn Loui,c Paulus, B,olog, B.S , Come!/ L·mwn1r, I hope clwcu e all b.?wme chet:,·peof ph,,icum char u·e m,ncliL', u"<rnltl. like wgr,w . playmg tennis, dancmg, and oh so much more. Jame, D. Pile, B,o!,,in B.S., L'nrt,·rnc, m ~tichad D. Rabicc, :\1ach13S I /ohm Buf[<lit, . Uymnd\UC:\ , College So m1Khfor children, mtd med ,,h11<>I math and mu,1c - on w are 111,fllratim1al tnl'dtclllt.' '\'ita K. Ram, Chcmicc1IF.ngmccrmg 8 S . t ·1111crnc, 111 Buffalo I like pl,rnnl( t.:nni_,, cookmf!, l'atm~. and l>cmgk:, Arlene I:. R,carJo, :\larcu, Med Te< ·h BS . Sl ,-.;y at Alba1n \\'.'hm I grad,uueI 1nm1 w hate ,m officerm rn:,:,a<·hrm 1heCaril>ne<1n . Romanow!<.ki, Richard llwloi:kal E!a.sr,of Bchmror B .A , Leon Ronco, \lmhcmau.:, B A , 'iLSY at Bmgh<1111wn. I likeco tn.nd lo furt:11,!tl Umtcr.,m ,,f Pcnm,ltanra I'm i:l,~Iw l>cba,:k m Buffalo. mtd mn h,km)( Joruard to ,uu.l,mg m L'B med. countries . I l'nJo)· plaw11(1cnn1, und Eric Joseph Paul Davi ,d Seeman, Schneider, Biology B.A., We.deyan Um,oermy.I enjoy the outdoorsand athleucs. Psychologyand Zoology B S .. Du~• Um,oersity. l l,ke to pla:y golf, cennis, and j(O ,ai/i,ng. Jeffrey A. Senall, B10/og:,• B A , Cams1u.s hi:r!! Richard Scott Safeer, NucnuonalScience B.S . , Camell Unwersicy I relax by Laura J. Pierce, Bioloin B A , l ·111, ernry ac Buffalo. I CllJo' runruin.~and pl,1ymgtenm, . "'"chill College.H,, how are ya, mce to ,ee ya! I enjoy sportsand lookforu:ard to an easy four years. Ju.stlikeei,eryonesays 11 u:,Ube, yeah. righr. Paul Brian Ro,cnthal, Ernnoml(\ BA .. r \l'' ac Bmghamwn lott.' ro rr£ztd.tkmct.' , ,mJ plm ,fx,m . Mark Anthon, Runfola, Prr/•mfr,"'"'"1/Ecrmr,m10B.A., .,otrr Dame . Im h,kmg fonrnrd w lunch. �Medical Students Jdfrn J. <,.,ymour, General S111d1e, B.S.. Cornell L'mwrnry I enJO)tl'eiihr l,frmi, skimg, and music Peter U-Fu Shen, Chemi.,rry B.A.. t.:m,ernry of Chicago. I JOI(for fun Chri,rma Ann Smith, BiologyB.A .. Comdl UmH'TSU). I cho.<e UB becau.,eI low mmhml' Michael K. Soeder, BiologyB.A . lin11ern1yat Buffalo.A pic111re 1sunrrh a thousand,wrck and rho,eBuffalo beachc.,. Andre\\ L. Sherman, BmmessMana;:ement, Cornell l ·111wr1it,. Alu<1yslookmgfor a good game of balland decent road trips. Samiri, So,trc, Laun Amencan L11erawreB10loi::,B.A.. Neu• YorkU1mermy I hope w do some mlunceer unrk m .\iex1co. !1-fan,our \'. Sh1rbachch, Biochemist') BS. CSU-Las Angele.,. I read now ls. Chri,tophcr D. 5prtrn I, Biochemistry B.S, L'm«'TSII) at Buffalo. I am concerned for our enuronmcnt. !min C. Srcinbcriz, Biolo,:;;B.S . SL'NYac Bmghamwn. I cho.<e t.:B becauseof the lackof sun. Ali-sa \iaric Shulman, Farmand F11ncnonB.A., L'mwrsuy a1 Buffalo. I am an ani<1 of che human bod:,and would like w 111e1heseialent< m medicine. '\; 1chola, A. Stathopoulo,, Bio,:hemiscryB.S . t.:nn ,.,.<It:,of Rochester. /' m frnm Rochesterand l,ick checreauwy w fill rh" 1~mow Ed"ard R. Stcphcn,on, Bwlogy B.A .. Fordham lfmwrsicy. l mjoy all rypesof spam and hope w parucipateac l.JB. Gail H. Smallen, BiologyB.A.. Brandeis L'm,ersicy. I plan w go w Honduras. l enjoy playing/Jureand piano. Donna \laric Sia\\ a,:, Bioloir.,B.S. Chemmry s B A. ' )1'0CIISC L'mt·erm,. I don'r always l,ke 1h1s!! 1;,k Patrkia Sticca, Bwlol(Y B.A. Psy·choloit> B A., lJmwrncy· of Rochester. l u·illbe the firn person m my family w auend medical school. �Medical Students \{i(had F. S"<·cnc), Anthmpolo,r.,,Ca,e \l;!e,tem Re.,.:ne L:nnersu\ . .\1d1.:n1e ,hould ~· m1cnll.ltlfJJU1I. Roh•rt \\ . Tahara, P,),hulo,r.,fl.A .. l 'n11,>r"I)m B11Jjalo "' ot onl) am I a c.:rti{it:'d ,cub<,,her, hm I al.", make m) 01m ~,.,. L,,okm!,!fomt1rdto a Kristine L. Tl·nchru,o, ,\.'euTl,,. .1ocii:nl't:', l nit't..'ntt)· of R,x:h.:,t,:r.l lik.: to pl,_,~ tennis but most of all ,:o 01<1 u·uh friend, anJ Ii.a e fim \ idr, C. T ,,11,·n, Life Science, B.S , L 111,ernl\ at Bu!Jalu. I l,k,·ch..-Bill, and hope the1 do JtN a, udl or 1->c?ucr thi, 1..-ar Jo-<·rh S. \',1lcnti, C,,urtcna, Bml,,,r.,/l',~chol"J.::i B.A . Can""" Coll~gc Biolo.i::;B.S L urn Colkge of \\racu,e I hof>c! to combmt! m)· gncH(thwuc rc:~c:arch ba,kgrmmd uuh m) ,p.nt (. ra1i:\\'.111, rhc f><Nrnu ~-l'an u:urkinRm a mol.:rnlar /,wlo/.!)l,_,h mt!d1calt.'ducauun n.-tn1rdin.l? cart..'l."T in rraumd sur.(!t:>n·. JuJ, ,\. \\'c,,,l,m,ki, \ kJicin,,/ C:h.:mMn ll S. L 1111,:rnl\ m 1311/Ja/,,. I'm ,,amng w Thoma, Charle, Wh,·atlc,, BioL,~ /l A. , Cornell L'nnc:nu~ I \.'njo)· Chri,tophcr R. \\'lute, Ch,·mmr) ~li,had B.A . Add1,h, Stmt:, Brmk I um Ann \\',,.xi, 1310/0,r., B.A , C,m""'' Colle/,!<'I cnJo:, trmdmg th.:C<l\) ,t11/l / l,k..B11fft1/o u in.i:,. 1mrk, and u.:t1th.-r b.:gm a r,:1n1rdmg nir,:,:r runmnJ!and am m m1.·Jrcmt' mh.'TC:1ilL'tf m ~diatrrC\ from SL .\'Y ,u Sr""' Brmk. fh,,ma, J. YJnwdla, P"choloi,')B.A , L 111wrnl\ <lt Buffalo I 1,k..ha,k.:1/,,.1/1. l lun,: a Che,.:u..-.I J,J not 11mk th" ,wnm..-rand I h.1te the 1'rd,, nd.:. Atif Zaf.1r, /l1olol:) BA . .\lath BA , L nnenu,· tit ll1<Jfalo. I'm " /11l,;t I .:nio:,/1/e l na, ail,1bl,· tor l'hot<>s: Paul,, A Bcnn,·u, D,n,d ,\1 Fl\ha l,,:ojfr,·) (;. Hoh1k.1)u,cph .\1 1'um1hk1,,mJ liu: Ta\lor. Jona1han I. \\'cin,tcin. Bu,lol!) 13..-\.,Cornell Un11ernt) So much for mightbe a fl,~ht ,urgeon at ,\'AS.-\ t ·111,crnt\ (,ra,/ de.i:rcc E. \\ ilJ, BwloJ.::i B.S SL.\Y ,u Kdh h,kmg J,,ru,1rdw u and tt'~t'c.m..·h I'm cht,llcngmg careerm excncd medKmc. ,chool. .,,-.,,.t med 1t?n ��,, • Medical Swdent.s 25 by che UB Medical Alumni Association. They also received a "welcome to Buffalo package" \\'Ith maps and hints on things co do, provided by the Medical Society of the County of Eric. The orientation also gi\'es the hospitals the ability co sign the residents on co 1hc payroll and perform pre-employment physicals . Approximately half of the residents are graduates of the UB medical school. • SCHOOL HONORS VOLUNTEER FACULTY A reception thanking the volunteer faculty of the medical school for the many hours thev have devoted to the school was held May 12 in the sculpture court of the Albright-Knox Art Gallery. "The volunteer faculty make an extremely important contribution ro the School of Medicine and Biomedical SuencC!-; said John Naughcon, dean of the school and vice president for clinical affairs. "Historically, they've served as role models to students and enriLhed the eJucarional experience in ways chat otherwise would not he possible." • ) I ,. 0. P. JONESDIES; WASDISTINGUISHED PROFESSOR OFANATOMY ORIENTATION EASES RESIDENTS' TRANSITION E sw- asing rhe transition from medica.l dent to resident is a prohlem heing tackleJ by the UB medical school through irs second annual resident orientation. Two separate one-week sessions were hclJ st;ircing June 19. Ahout I50 students parnnparcd. One of the maJor goals of the orientation ts to lcr the rc,idents "gee to know one another," according to Glenda Donoghue, M.D., director of continuing medical education anJ professional development ar UB. The orientatton consisted of lecrure copies caLh day with informarion char the residncts will find u;cful throughout rhc1r rnrecrs, Donoghue said. lndudl-<l were presentauons on organ procurement, rhc new credentialing process, the prevention of malpralti,e, knowing rhe patients' rights, cost conrninment, and advanced cardiac life supporr. Also presented was a program ro teach residents how to reaLh. The first half-day co\'cred the skill, of hedside teaching and the second dealt w1rh the skills of evaluating. A luncheon for the residents was sponsored Jones received his Ph.D. from rhe Univer• ,ity ofMinne,ota m 1935 and his M.D. degree from UB in 1956. He Joined the medical school faculty in 1937 as an assistant professor. In 1943, he was named an associate professor. Lacer that vear, he was promoted co professor and chairman of the Anatomy Department, a position he held until 1971. He was assistant dean of the medical school from 1946 to 1954. Jone, wm,al,o a v1s1t111g professor at several institutions, including Baylor University and National University in Mexico. In 1%4, he was a distinguishL-d IClturer at Tulane University School of Medicine. A member of 15 profc,,,ional societies, Jones was program secretary of the American Association of Anarom1sts from 1954 to 1966. He served on the advisory councils of both che American Society of Hematology (1962-67) and the Continental Associatton of Funeral and Memorial Societies (1954-1971). He ,,·a, accive in the International Society of Hematology, ,.:rving as its vice president from 1958 ro 1962. He was a director of the , ational Society of Medical Research from 1956 to 1961, and president of the Society of Experimental Biology and Medicine, Western New York Section, from 1951-52. Jonl'!<was assoctatc L-ditorof The A11awm1cal R..:cord (1955-1968),and served on the ediconal hoards of Blood (1946-1955), and Folta Haemawlo~1ca of Lcip:1g, Germany (1937-1949). The 1954 edition of Meden1ia11, the joint yearbook of the medirnl and dental schools, was dedicated co him. His other honors include the 1964 Dean's Award from rhe U111versity,and rhe l9il Silver Medal from the medical school. He was a member of Alpha Omega Alpha, the national medical honor society. He was the husband oft he late Dr. Cathryn M. Jones. He is survived by three daughters, Helen Jones of Maynard, Mass., Carolyn Gurney of Asheville, N.C., and Ann Davidson of West Yarmouth, Mass.; a son, Oliver, of Columbus, Ohio; two sisters, Ann An near of Abs(.'(On, N.J., and Evelyn rord of Pleasantville, N.J., and IO grandchildren. Concributions may be made to a fund to he established in his name ar the University. • Dr. Oliver P.Jones (M'56), di,ringuished professor emeritus in the medical school and a leading figure in hematology, dieJ June 18 in his home in Buffalo. He was 83. A native of West Chester, Pa., Jones caught gross :macomy in the medical school from l93i until 19il, when he was named distinguished profC!-sorof anaromy. His scientifil accomplishments were many and worldrcnowned, and his work was said to contain rhe hcst descriptions of hone marrow changes. He was a pioneer in the use of the clcuron microscope in morphological studies of blood. "Not only were his contributions in teaching and research of critirnl importance~ said Harold Brody, chairman of the Deparcml'.nt of Anatomical Sciences, "but the roles rhat he played m helping to Jevclop the organizations and professional journals in hematology were primary from an mtcrnanonal point of view. "Above all, the loyalty and concern for his students were maior facets of his c:haracter and arc rcmemhered by graduates of the Schoob of Med1Cine and Demiscry, as well as hy graduate students during his years of tenure~ During his later year, as chairman and ,tnLC 191I, Jones de\·◊ted himself co examining the early h1scorv of the medical school in addition co the scory of its founders. These ummbution, ,,ere published in national journals as well a, m che Buffalo Phwcian. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST AUTUMJ\! 1989 �Alumni 26 MED SCHOOL REUNIONCLASSES PLEDGE $102,220 TO UNIVERSITY Reminiscingabout theirUB dayswas a greatpastimefor alumni duringthe SpringClinicalDay/ ReunionWeekend, heldtheweekendof May 6. The alumni not only rememberedwhat UB gave 1934 .. . . .. ....... . ... . .. . . . From left, seated:John V. Andmon, Maria N. Samo, Charles E. May, to them, they also took the time to and Max B. Weiner.Standing:JosephR. Saab, EarleG. Ridall, Nicholas Linderman, John M. Constantine, and Harry Bergman. give somethingback to the University. This year'sreunionclassesgenerously pledgeda total of $102,220. Class of Class of Class of Class of Class of Class of Class of Class of Class of Class of AlJTUMN 1989 1939 .......... $18,400 1944 . .... . .... $ 6,725 1949 . ... ...... $ 7,125 1954 .......... $ 8,000 1959 .......... $15,450 1964 .......... $16,255 1969 .......... $ 9,500 1939 ... . .. . .. . ....... . . .. . . left, seated:CarlosC. Alden, William Dugan, Elizabeth Olmsted, 1974 .... . ..... $10,500 From Ruth C. Burton, Marvin Siegel, George C. Brady, and Henry V. Middle row: Kenneth Goldstein, John J. Squadrito,John H. 1979 . . . . . . . . . . $ 8,220 Morelewicz. Remington,John H. Geekier,Lloyd A. Clarke, RoyE. Seibel, and Frank T. Riforgiato.Back row: Alfred H. Dobrak, Frederic Hertzmark, James 1984 .......... $ 2,045 ). Creighton,and A. V. Posto/off. BUFFALD PHYSICIAN AND BIOMEDICAL SCIENTIST • �I Alumni Reunion 27 1944 ...................... . 1954 ...................... . Fromlefc,seated:L.~diafutmcain,Mrs. Strong,IdaSchaer,S)lda Ginsberg, Charloue Fros[ Ph.llis \'(/i/kinson,Jean Boardman,~fo. Sulli,an, Mrs. Momani, Santd M~riaCassara,Jean Bamecc,HelenHudson, Mrs. Gage, and Ka:,,Weygandc.Standing: Mary Lou Bondi, Raymond G. Bondi, Willard H. Boardman,Newland W. Fountain, Anchony M. Aquilina, Clinton H. Strong,Andreu A Gage, Sidney M. Schaer,Fmnk T Frost, Carrol].Shater, RobertG. Wilkinson,JamesR. Su/Iii-an,FrankH. Long, Samuel Cassara,Howard R. Bamecc,Ra)mond A Hudson, Helmw A. Mueller,PaulWeygandt,JamesF.Mohn, /ruin A Ginsberg,Mrs. Mohn, and Casimir F. Piecraszek. From lefc,seaced:John A. KutT)bala,l\'orberc]. Kuberka, EugeneC. Hyz), Sylda G. Lislot·s,Allen L. Less1,1,mg, :S•.1icholas C. Carosella,and CharlesH. Manno. Secondro1t·:Walter A. Olszett·ski,Jacob Lemann, PaulL. Weinmann,Edtmrd F.Wenz/a//,HarryT Olil'er, RobertD. fuley, and Donald]. Murray.Third row:£mesc H. Meese, William R. Kinkel, Eugene L. Belcrami,James £. Youker, Richard F. Mayer, \'(/il/iam]. Hou-ard,Lows C. Cloucier,and RobercH. Miller. Fo1mhroil': ByronA. Genner,£du·ard A. Rayhill, John L. ConbO),Donald M. \X'ilson,and HerbercH. Benson. 1949 . . . . . . . . . . . . . . . . . . . . ... 1959 ... From lefc,seaced:FredShalu-it,, Julia M. Cullen, and Joseph£. Griffin. Standing:Edtmrd W. Rosner,J.B.Ausc,John Sharp,PaulT Buerger,Max A. Schneider,Carmelo S. Armenia, Laurence M. Carden, and James A. Werick. From lefc, seaced:RobercJ. Brennen, Daniel C. Kozera, George R. Baeumler,Sandra\'(lilcse,DorocltyC. Rasinski,Mary Ann Bishara,Joseph F. Monce, £/con M. Rock, and Dadd E. Den,el. Scanding:JosephA. Ferfoi,Julius\I. Rasinski,John]. McMahon,ScerlingM. Doubrata,Logan A. Griffin, Alf M. Tannenberg,Morron H. Heafic,, Jason H. Scetens, James R. Do::-le,Thomas D. Doeblin, and Selbert A. Chemila. BLFFAI.O rHYSICIA:S- A:-.:D BIO~IEDICAL SCIE:--:TIST . . .. . . . . . . . . . . . . . . . . �Alumni Reunion 28 1964 ......... 1974 ...................... . . From lefc, seated: Bela F. Ballo, Gerald B. Goldstein, Lillian V. Ney, ElizabechG. Serrage,William Fleming,Da11idZiegler,and JosephA. DiPoala.Secondrow: Paul Sussman, Stephen P. Katz, Jeffrey S. Carr, Michael Feinstein,Michael A. Judd, RichardWolin,John F. Reilly,Anthony Ferrari,and Charles Ladoulis. Third row: lroing Scerman, ). FrederickPainton,ScephenScheiber,Da11idA. Leff, Marl.'inZ. Kurian, and James C. Tibbem. Fromlefc,firscrow:ElaineMarie Bukowski, Suzanne A11ery,Gordon L. Avery,JudyOufiero,and LawrenceA. Oufiero.Secondrow: Alan G. Bur• scein, Sharon Burscein,and Stephen A. Yerkovich.Third row: Sandy Piecraszek,James C. Piecraszek,Roseanne Berger-Morelli,Daniel J. Morelli,James L. Budny, Pam Budny, Conrad F. Wolfrum, BradleyT. Truax,ElizabethTruax,RichardJ. Buckley,Judy Buckley,Bruce F.Middendorf, Mimi Middendorf, Paul H. Wierzbieniec,Ellen Wierzbieniec, James A. Smith, and Beverly Smith. 1969 ...................... 1984 ...................... . Fromleft, seated:Madeline). White, Moira ). Burke, Evelyn Roisman, Marion Wind, DorocheaA. Downey,and PennyA. Gardner.Secondrow: Hanley M. Horwicz,Gerald D. Scinziano,Louis He111ZY, IsraelKogan, Roberc). Gibson, James L. Ca11alieri,Michael N. Pisick, Han:ey I. Weinberg,TimochyV Siepel,and BernardC. Muscaro.Third row: Thomas S. Scanlon, James J. Whice, William K. Major, David S. Schreiber, Timothy F. Harringcon,Douglas L. Robercs,and Carl ). DePaula. AUTUMN 1989 . Fromleft, seated:HeleneSurowiec,CherylMiller,ElaineSchaafGergelis, Maria Billinson,Maritza Alvarado, Amy SchuecklerRosceing,Jennifer Curletta, Lynn Picano,RoseDeAnwnis, and )ill Pfa/zer.Scanding:Roberc W Lasek, Man: ). Koblick, Herbert B. Newwn, RichardE. Gergelis, Mark Billinson,Andrew M. Knoll, Ke11inP.Rosteing,JosephD. Curletta, John ). Picano,John F. Noe, and Dal •id F. Pfalzer. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Alumni Reunion 29 JUSTWHATIs THEUB FOUNDATION? H 1979.......... .. .......... . From left, seared:Tunde Kashimawo,BarbaraE. Klein, Letitia R. Clark, IvonneS. Cellino, Andrea C. Bracikowski,Norma Creighton,Kathleen Buran,Jody Spooner,Ellen Balon,Donna Irene,LindaA. Cardone,Gale A. Barg,Christine A. Marino, Connie Shields, Marilyn Armenia, and Kay Baron.Secondrow: Robin H. Adair, Ann Canty, Michael Schneider, Susan Lehrer,BarbaraEames,FrederickA. Eames,Katlty Hall, Theodore R. Hall, Walter A. Balon, Peter Condro, Bruce J. Naughton, Thomas L. Mahoney, Thomas McKeever, Mary PacSchreck,Robert L. Baron, Cindy Kaiser, and MargaretNaughton. Third row: Jason Dunn, John M. Canty, Myra N. Rubyci, Michael Cellino, RichardT Irene,James P. Bracikowski,JosephE. Buran, Ted H. Spooner,Donald ]. Armenia, JamesJ. Creighcon, Peter E. Shields,John Naughcon,Jim Cardone,Roger E. Kaiser,and John W. Crofts.Fourthrow: GeorgeBoyar,MichaelCamp, bell, TajudeenA. Kashimawo, Andrew T Costarino,James R. Miller, LIO)·dM. Lehrer,and Frank T Schreck. ave you ever wondered why your gift to the School of Medicine and Biomedical Sciences is acknowledged by the University at Buffalo Foundation? Simply because the University at Buffalo Foundation is the chief administrator of all gifts to the Univer• sity. As a non-profit organization, the UB Foundation seeks, manages, and invests private gift support on behalf of the University. The Foundation was established in 1962 when the private UB join• ed the Scace system to ensure that gifts for the University would re• main at UB and not be dispersed throughout the State. Since its founding, the Foundation has generated more than $140 million in private support. 1988 revenues totaled almost $23 million, of which more than $7 million was earmarked for the School of Medicine and Biomedica l Sciences. Donors can designate thei r gifts to the medical school, a depart· ment, a specific research project, a schola rship or even a new com· purer. No matter what the final designation, the gift is made through the University at Buffalo Foundation. Just as donors make many d ifferent kinds of gifts, the University shows its appreciation in many ways. Individuals who contribute $1,000 or more annually to the medical ~chool receive membership in the James Platt White Society. In add i• tion, for persons who make a commitment of $10,000 or more payable at the rate of $1,000 annually, recognition is given through the Presi• dent's Associates program of the University. For more information about the James Platt White Society or gifts to the School of Medicine and Biomedical Sciences, contact rhe Qf. fice of the Dean (831-2775) or Mary Greene at the UB Foundation (636-3315). • A NUMBER OFPEOPLE MADEMEMORIAL GIFTS: MEDICAL ALUMNI ASSOCIATION ELECTS KUNZPRESIDENT Clas s of ' 39 Gift Fund: • Dr. WillardH. Bernhoft- in memo1)of his brother,Frederick,a member of the Class of '39, who passed away in his lasr year of medical school. • Anna L. Bleich- in memory of her husband, La Moyne. • James Marinello - in memory of his brother, Carlo. • Connie Plummer Miller - in memory of her sisrer, Lois. • Dr. Ann Rudmgerand David Rudinger- in memory of che1rmother, Ellen. • Berry Storms - in memory of her husband, Rober!. • Harriet E. Wesp - in memo') of her husband, Et·erert. Class of '44 Gift Fund: • Dororh) Kennedy- in memory of her husband, Sidney. Class of '49 Gift Fund: • Victoria Van Coevering- in memory of her husband, Russell. Class of '64 Gift Fund: • Dr.and Mrs. David C. Ziegler- in mem07) of Dr. Ziegler'sclassmare and friend, Dr. Sheldon Roth/leisch. oseph L. Kunz (M'56) has bee n named to a one-year term as presi• dent of the UB Medical Alumni Association. A lso elected were Bertram A. Porrin (M '53), vice president, and Nedra J. Harrison (M'77), treasurer. A clinical assistant professor of medicine at UB, Kunz is a specialist in internal medicine with subspecialties in gastroentero logy and endoscopy. Kunz is an attending physician at Buffalo General Hospital and a staff physician at the Oute r East Side Clinic sponsored by the Erie County Health Department. He formerly was a consulting gastroemerologist at St. Francis Hospital. Portin, a colon and rectal surgeon, is a clinical professor of surgery and chairman of the division of colon and recta l surgery in UB's Department of Surgery . Harrison, a general surgeon, is a clinical instruc tor of surgery at the University at Buffalo. • BUFFAI.O PHYSICIAN AND BIOMEDICAL SCIENTIST J AUTUMN 1989 �Alttmni 30 175 ATTEND1STREUNIONRECEPTION he first annual reception to honor the members of the reunion classes at the Spring Clinical Day/ Re'union Weekendwas held May 5 in the Center for Tomorrowon UB's North Campus. More than 175 alums attended the reception sponsored by the UB Medical Alumni Association. The gala event providedan opportunity for all of the returning classes to mingle and it set a warm and friendly atmospherefor the rest of the weekend's activities. We hope that next year's returning classeswill plan to attend our second annual reception on Friday evening, April 27, 1990. (1-r) Mrs. Raymond Bond, Raymond Bond '44, Helmut Mueller '44, Mrs. Paul Weygandt, Paul Weygandt '44. The 50,year reunion class. (1,r) Sandra Wiltse Logan Gr iffin '59. Leininger '59, Daniel Kozera '59, The 25,year reunion class. BL"FFALO PHYSICIA:S: A:-;D BI0~1EDICAL SCIE1'TIST ��Buffalo Physician & Biomedical Scientist State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 N,n l <; PAIi) flu Pu Address Correction Requested 998 MR. CHUNG-KAIHUANG HEALTHSCIENCE LIBRARY ABBOTTHALL CAMPUSMAIL �•Profit Org. i/"""g,, f.10, NY. mit No. lll � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Autumn 1989 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1989-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v23n03-1989-Autumn Table Of Contents A list of subunits of the resource. Not just because it's there Like rubbing snow on frost bite We're not hurting animals Medical School News Special section Alumni. Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-12 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v23n03 Extent The size or duration of the resource. 45 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1989 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/3a41cae185ffc27558085f42c817f643.pdf e41be51c1198e075933af57621de8e9b PDF Text Text �STAFF DearAlumniand Friendsof the school: EXECLTnVE EDITOR Ul's'IVERSITY PUBLICATIONS Rob,,,, 0 T Marlen Bl!FfALO PHYSICIA!\ EDITOR Conni• C.1-v.-ald Stoflo AITTDIRECTOR Alan stlllln from che fine l"Jirorsh1p of Bob McGranahan to the leadership provideJ first hy Bruce Kershner and no\\' Connie Os,vald Stofko, every auempt has been made for its contents to n:fleccmore fully the life of 1he total m<-.:lica!Khoo] in Buffalo as ·xs·mplificdthrough its multiple constituencies, i.c::.,students, fa,;u!• ty, alumni, parents, and affiliated huspitak The compo,ition of the Advisory Boardwas stn:ngthenc,.I and its functions increased. The n:wurces of the University's publications and public relations staff h,ivc added significantly once-missing support and participation. I am plea5e.,Jthat these efforb have borne 1heir fruit. The publication ll'as n."Cognizedfor its excellence when awardt.-da gold m<-dalin thi, year\ rnmpetition sponoored by the Council for Ad· vancemem and Support of Education (CASE), This organization 1• compo5Cd of representatives from the major colleges and universities located throughou t the United States and Canada, and represems profel<sionalsin the areas of publications, alumni rda· tiom, puhlic n:lation~, and fund rai~ing. Of the 82 publications ,·ith whkh the Buffalo Plry~icianand Biomedical Sc1cn1is1was evaluated, there wen: three go!J medals, three silver medals, and chree hmn:e ml-dais awan.k,J. Alan Kegler, the art direnor; Mrs. Stofko, anJ all of those in• vnlved with this publication ~hould he justifhbly prouJ of this r, >gnit1vn. Thl"y have ,,mrked harJ to bring tn our s(.mstituen • cies a timl·ly, informati\'e puh!ication designed to reflect :111aspects of this medical and hiomedirn! edu.:;1tional enterprise. I hope ~·ou arc as pleased as I am about their success. I look forv,ard to their rnmimR.J innovation~ and contributions in the years ;1head. J. Mo(l,r ADV ISORY BOARD f>r.John Naughton. C~ ,.,...,~ D, Harold Brody l.!.. ~&r><:Y C Dr. J..,,,.,,!-:an,. Dr. ]Okf'h L. Kun1 1),-, CharlN l'aRandli M,. P:aul O P:ner,on Dr. An1rn1m~ l't,1,:n Dt Chorln Ptu<1 Dr. L.nhn- Rol,n,..,n Dr. Thon1;10 Jl.,ocnthal Dr. Sal... la Su,...h Dr. Burton S1¥frn•n Dr. S.,ph.n Spaulding Dr. Ndson Tom Mr. EJ,.·arJ \t', :k Dr. Jero Ya,~ WR ITl::RS ),.hrk Marahdla A<thur P~ Da 1d M. S, ,-Jtrma ILLUSTRAroRS Thomas Roonty Jooq,h Thd P HOTOGRA P HERS M•rk Lrw, la , RalinN di - ,..on To" B,,h \J:'abon TE.ACHING H OSP ITALS AN O LIA ISONS !L,.,,·,a \',,,.,_,,,. ,1 I. /'. f'1--~~-' AJmini1tratim McJ1-.,:, ..,,,,., Ruffalo G,,,~r:,I H,,.pu.-.l, .\t,kc Sn.n.., Buffalo V.-,,,,,.ns AJmm1>1rat1on Modk•I C.enu,r, Joh~l'wH Ch,lJ,en·, H,,,;pit.,I. i,.:_. D,,..,.,.,,._,,.,k, Eue Coun,y \\«h, al C4'n1e \l~,;,,,, ""'""""""'' M=v Ho,p,ul, Clu,d Trlr Dm:m,~ m,.. ~ • 1wD11, "' _,..,,a,..,... .... d Elion, N,,. \D"- S< IJ -,;i ___:, R""' r. :1,.,,...:,,11oo1'l(.\t.C.::>< S,.,- l.1n11rntt;,>I PKn, &./fa o. TIIE BUFFALOPHYSIC!A:,./AMl flll). MEDICAL SCJESTIST tLN'S ". -&::• ··-·· ·"" 191:P, \\,h,mc .: l, :-.:umi-... f'yt, .,hed f,.·e t!meo ,rnn«allv, Sprn,K, Summer, ,\.,,u,nn, l:arlv Wn>t,"T, 11,J La,e ll'1n1er . l'T1he S.hool ol McJi<m<"and ~ .....:!,calSc1en<e,, Su!< lln1<·<1'"1,1< of y N..,. Yotk a< Buffalo, Hl> Main Srr,:c1, Buffalo.:,i,.., York 14214.Third cb~• bulk ""''"F~,J •t Buffa!c,,Nrw Yo,. S.-r,~ aJJ,.,.. changes 10 TIIE BUfFAlO i'HYSICIA1' A1'O 1110.\IEDIC.-\L ::;.c:iE:-.:nsr. 146c.F.s.AJJ"""'· HJ" Mmr, Sm,.,. Buffalo, Ncw York H214. Smmdy, --.. Jo hn N aught on , M .D . \· r~si.Jmt j<H C/m,",! Affair, Dean, Schoolof ~lt-dicineand BiomedicalSciences M,llard F,lln1or,: lfo,pna\, R,..,,,,,~ll P:.rk Mm"'t»l ln,t,tule, J, . Si,,c,; H°'p,t.11, D"""" M,-C.nlr, vcr th_ccou_rse~f the past several year~.the Buffalo Ph;11ician and 81om,:d1cal SciffliLJt has ,;hanged <.:ons,Jerab]y.In its mm• Dear FellowAlumni/Alumnae: I \\'ou!d like to wckome th, · rec, m gradu.1te to th, )\.ledical Alumni A"5Ck.1ati,in.'fou an: . .i' ,,__: m· . :-s >IoJr group l'J also like m extcnJ a warm and ~lnlere invita110n to 1he new m,·mhers nf the Uni\'<c'TsityRe~1Jency Program t,, bccom, a= - :.uc· memh.--, Re:.idcm.smay join even if ihc"Yarc n,1t graJuatrs of the L,11ven11v Jt Buffak S,·hoc: of !l.ledi im and Bio1"1ed1c:il 5' icnce We ,ire your <1rganizationand our sole purpose is 10 wrve you ,nd our medical ochool. 'i\'c- art."very im=reJ in anything VOJ wam to hring to our attemion for aJvice, help, or ~urpon. Be 5Url.Jthat any n,mmunication will be prompdv :onsiderl-d and am,nJeJ to within the bt·s1 ,,four ,1hilities. On annther note, l'-e arc gratified hy thc ,·mhusiast1, l\.">,pon~ to the rail for n,,minet'S for 1he Di~tinguishcd Alumnus Award, This emirwm graduat<c'll'il! be announced anJ ho11oredin the fall. I .· 0- ~ ----;, J o se ph L. Kunz , M .D . �BUFFAlD Ptoc§L~~ Vol. 23, No. 2 Summer 1989 Features II Boonorbane?Nobody wants residents to overwork, but will new State regulations that limit residents' hours help or harm medical education? The debate rages on in Buffalo. II SpringClinicalDay.One speaker urged physicians to take a hand in shaping health care policy, while another said that grapefruit pectin may lower cholesterol. The theme of the alumni-sponsored event was "Nutrition in the '90s." Page32: Polio's Aftermath Departments Page 18: Nutrition fl MedicalSchool News. Lectures and conferences covered topics ranging from microbial pathogenesis to the question of whether we have enough doctors in this country . And UB's Match Day was better than ever. I.DJHospitalNews.Treating the fetus as a patient is the focus of the new Buffalo Institute of Fetal Therapy at Children's Hospital. Over at the Erie County Medical Center, they're struggling with post-polio syndrome . Page 2 7: Match Day IJ People.Leon Farhi, chairman of physiology, has been named a distinguished professor by the State University of New York. He was honored for his years of work in human lung gas exchange and the human circulatory system. Page25: Milk & Sleep IJl Research.Routine ultrasound screening of infants could pick up "silent" urinary problems, say UB researchers. ImClassnotes.Find out what your former classmates are doing nowadays. Cover Photo: &b Walion Page 26: Luc Montagnier �2 Boon or Bane? Debate ragesover new regulationsfor residents BY CO~"\IE OS\\ ',\LD STOFKO ependingon whom you talk to, new regulations on residents' hours and supervision are improvingor destroyinggraduate medical educationin the State. They're saving or jeopardizingpatients' lives.There will or won't be enough money and staff to implement the changes. One chairmansaid the potentialfor harm in his residencyis so great, he'd rathershut down his pro­ gram than beforcedto limit hisresidentsto working only 80 hours a week. Another chairmansayshis specialty is already in compliance. PIIOTOS BY BOB \\'J\L I O ' �3 .· ·11 1 1·2' ·10 3. ·9 .8 l l ~ s. 4• 6:01 a.m. Monaa1 Holx-n OriSC'OII.ll:ft. chief surgical residen1. s1ans his 37-hour day ai Buffalo General 1 1osp i1al. ,\ day 111 the lif e of a resident. as chro ni cled in 111 ese p ll otos. would change under nc-w Staw wgulations. BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST SUMMER 1989 �ne student chose an out-ofState residency because he says rhe regulations will damage education, while another stayed in New York because he says the regulations are humanizing medicine. The changes limit residents to working no more than an average of 80 hours a week, with 24 consecutive hours off each week. They also mandate increased supervision of residents. Other changes in the code mandate more formal credentialing of residents' skills and limit residents in emergency rooms to 12-hour shifts. (See box for derails). The 1984 death in a New York City teaching hospital of Libby Zion, 18,the daughter of a well known journalistlawyer, led ro a grand jury investigation. Though rhere were no indictments in the case, the grand jury made several recommendations concerning emergency room staffing, the supervision of residents, and residents' working hours. Then the New YorkState Department of Health appointed an Ad Hoc Advisory Committee on Emergency Services, chaired by Bertrand M. Bell, M.D., a 1955 graduate of UB's medical school. The committee recommended derailed policies on which the new regulations are based. The starring dace for the regulations on residents' hours and supervision was ro have been July 1, but that was uncertain at press time because the Hospital Association of New York Scace filed litigation in State and federal courts to have the regulations deferred. The hospital association proposed that if the regulations are deferred, hospitals and medical schools should develop policies to meet the intent of the regulations. . There's vociferous disagreement on Just about every part of the regulations, but one thing char everybody agrees upon is that the intent is good. The purpose of the changes is ro improve patient care by making su~c t~at residents don't work when they re improperly supervised or sleep-deprived. The changes also try to regain a balance between education and service residents are employed by hospitals, but they're there to learn. 0 4 SUMMER 1%9 A second point of agreement is that the regulations present a number of hurdles. It means a rethinking of the educational system. "We'renot saying it's going to be a piece of cake; conceded a spokesman for the State Department of Health. W cent are we interfering with the educational process and how do we plan co compenate?" In surgery, the regulations are interfering to a great extent and there's no way around it, shore of shuning down the residency program, according to Lewis M. Flint, M.D., professor and chairman of surgery ac UB. If the surgery program is forced to obey the letter of the law, it will damage surgical education so much that it would be better to stop training surgical residents. "I'm quire sincere about ir; he said. Ocher specialties have been able to meet the regulations by reducing the number of patients they see, Flint said. But each surgical resident must perform a minimum of 600 surgeries with in 55 months of training co meet national standards, and UB e..xpectsresidents to perform 800 surgeries. Flint complai ned that the figure of 80 hours a week was chosen almost at random. He doesn't see how residents can work less than 96 hours a week. The program trains residents co act like surgeons, he explained. A surgeon cares for the patient before, during, and after an operation. "Ifa resident operates on a patient, the resident is given as much responsibility for care of the patient as he's capable of shou ldering; Flint said . That includes staying with a patient whds having tro~ble, no matter how many hours the resident has already worked. "If we asked a resident to leave at the end of his shift, he would say 'no; no matter what the health department said; Flint asserted. "They like taking care of their patients and they rake their obligations co patient care very serious ly." hile several other states are examining these conce rns, New York is the first to impose new regulations. Many people question whether these regulations, as written, are the best way to meet these lofty intentions. "Are we improving services co patients? Arc we improving education?" asked Michael F. Noe, clinical associate professor of social and preventive medicine. "There arc a lot of suppositions here that haven't been tested. I'm not sure we have rhc answers co chose questions . "If you decrease the number of hours of experience in the clinical arena by re• quiring residents to work an a~e:3ge_of 80 hours a week, arc you depriving individuals of a certain number of decision-making experiences that are crucial? Will you have to increase the length of training? That question is unanswered; stated Noe, who is also chai rman of the coordinating board and the administrative commince of che Graduate Medical-Dental Education Consortium as well as vice president of he problem could be solved by adding professional affairs at Buffalo General a year co the residency program. Hospital. "There are 100 good reasons for "The fact of the matter is, patient care lengthening the training program, but is a critically important clement in that's nor one of them; Flint said. "A betgraduate education. By decreasing the ter alternative would be to close the pronumber of experiences, you're abgram." breviating the educational process. He criticized the health department for "I'm certain ly not advocating that peomaking wholesale changes in the educaple work in a sleep-deprived state, or that tional system without any evidence chat we should put people through an exrhe changes will work. perience chat is physically or Referring to the death of Libby Zion, psychologically harmful. Bue to what exFlint said, "The incident that precipitated t BLIFFALO PHYSICIA!s AND BIOMEDICAL SCIENTIST �1v ~ c-1I',-- 5 '- this hysteria - and that's what it is, hysteria - happened on an internal medicine teach ing service. "It can't happen on a university surgical teaching service. A jun ior resident is not left alone to make a life-and-death decision ." Junio r residents are supervised by senior residents, who have usually been out of medical school for six years that's longer than some residency programs in other specialties. A major operation is almost never performed without the attending physician in the building, Flint added. There's no data stating chat residents are making poo r judgements because of sleep deprivation, he said . The only data t hat exists says that surgeons get grumpy after being up for 36 hours . Flint expects that the new regulations will be modified . "If they're not, then we're going to have a lot of trouble in surgery; he said . At the othe r end of the spectrum is family medicine, wh ich is already in comp liance with all aspects of the regulations. The maximum workweek for family BUFFALO PHYSIClAN AND BIOMEDICAL SCIENTIST 6:30 a.m . Mo n day Oppos ite page. s urgica l reside rns discuss cases befo re rou nds. 6:44 a.m. Monday Above. Drisco ll sees pa licni s ,n irnc nsive care. 7: 17 a .m. Monday 1.. ef 1. studc rns and rcside rns go 10 a m ee1ing. 10.2 1 a.m. Mo nday Bonom lef1. Drisco ll prepa res fo r surgery. medicine residents is 75 hours, noted Thomas C. Rosentha l, M.D., director of the family medicine residency at UB and clinical associate professor . For years family medicine has used a system of supervision that meets the new requirements. "The faculty is active in patient practice," said Rosenthal, who is also director of the Office of Rural Health. "We utilize, but don't rely, on residents for care." Family medicine is an outpatient specialty, Rosenthal noted . Forty per cent SUMMER 19S9 �6 ·, V 2. ·10 ·9 .8 ~ l ~ 3· 4. 5. ' I.! o:; p 111 \/0111 I, 11 ,\IXM'. l>n."',~I Ix·11onns d ....1gmrncl ( ol<'( IOlll) umlcr 1lw w,111t1ful n 1· or ..,urg,·on lt~ph ( ,HU,Hld J .io p 111 \/011d,1\ OPIX)",llt' p.ag(' I1111",lllllg Ill<' -.,urger) .i 20 pm \/()ll(/d .\ Bdow IJn',!·oll hrt'cll-..., tor lunch w11h S11·,1· S( .ahd. a -.urgw.il r, ·..,1clt·111. 111<'11 ",f wncl..,IIW t'\t'llllls;l Ill lllt'('lings , 111<1I 'Xillllll1111A ;,;.r,l\ 'S . • of residents' time is spent in outpatient care. Ocher specialties fall somewhere between surgery and family medicine. For instance, overall, residents in gynecology and obstetrics work 80 hours a week, but "overall" is the key word, noted Myroslaw M. Hreshchyshyn, M.D., professor and chairman of gynecology and obstetrics at UB. At Children's, which is UB's main and busy - obstetrical site, a resident works in labor and delivery the entire time he is on call. At ECMC, che resi- llLFFAIO PHY~IUAN AND BIOMEDICAL SCIENTIST �dent works in gynecology and may have to attend patients in the emergency room or occasionally perform emerge ncy surgery at night . Otherwise, he can sleep. During a rotation at Children's, a resident may average 90 or 100 hou rs a week, but at ECMC, average only 65 or 70, Hreshchyshyn said. The regulations force the program to distribute work more equally, but Hreshchyshyn doesn't anticipate a problem. He sees more difficulty with the supervision requi rement. The program has BUFFALOPHYSICIAN AND BIOMEDICAL SCIENTIST been working toward providing better supervision for residents already, but che law makes it inflexible and costly, he said. Five years ago, full-rime faculty members started caking turns spending one or two nights a week at Child ren's Hospital co supervise residents - free of charge. "I sold them on the idea because it was good practice, it was good for the patient, and it was good for the resident," Hreshchyshyn said. Little by little he was introducing the idea to each hospital. About a year and a half ago, full-rime and volunteer faculty members at Buffalo General Hospital started spending nights at the hospital. Bur because it was prompted in part by a shortage of residents, the faculty members asked co be paid, Hreshchyshyn noted. Since the supervision at UB's hospitals is being mandated, rather chan performed by faculty of their own volition they too will want to be paid: Hreshchyshyn predicted . Ultimately, his department will find ways to adjust within constraints of the law, he added . Flexibleor inflexible? t he inflexibility of the regulations is the big drawback, agreed Gerald Logue, M.D., chief of staff at the Buffalo Veterans Administ ration Medica l Ce nter. He is professor of medicine and head of the Division of Hemato logy in the Department of Medicine at UB. "The point needed to be made that the re should be a ba lance between education and service , but the point is being made with a nuclear weapon," Logue said. "There are ocher ways co make sure residents are awake and alert chat still allow you educational opportunities . "If these regulations were less driven by hours, it would be better . The hou r thing limits your flexibility." Because che regulations are so rigid, the continuity of care is disrupted, Logue said. Residents can be on call any night of the week, buc outpatient clinics are scheduled only on certain days. If a resident works at night, he has to miss the clinic the next day. Yeea very important need in medical education is co have residents see more ambulatory patients . And residents teach medical students. If the residents aren't around , the education of the students will suffer, Logue said. Because of the invasiveness and intrusiveness of governmental regulations, New York State is the worst place in che country co practice medicine, Logue complai ned . "The regulatory climate is going co drive good people out of New York Stace; he said. Vicki Zeldin, a spokespe rson for the health department, countered chat che regulations are indeed flexible. The rules say chat residents shouldn't work more than an average of 80 hours a week, she pointed out . Some weeks they can work more. "We're not going to be there scopwacch in hand," Zeldin said. "The bottom line is, if someone is coo tired co serve patients adequately, chat patient's life is in jeopardy ." She said chat the position of David Axelrod, M.D., the Scace commissioner of health, is chat "if these regulations didn't go into effect, patients would die. They're very important to the quality of care. "Personally," Zeldin said, "if 1 had the choice between being treated by the same doctor who had been up for hours SUMMER 1989 7 �8 n r 8.20 /l Ill. Monda_, . Driscoll. top lctt. explains 10 a patien t the de tmc1emen1 he'll perform w11I) caruana 8 :32 p m Monday Top ngh1. DriS<"0II helps transport l.>illient 10 surgery 9 pill . .\1011( /cl_\' Lower left. surgery conunues un11I 10:so p.m. .\lidnig/11 At lower right. DriS<"oll discusses a case wilh 01her residents . so I could have continuity of care, or getting a fresh doctor, I'd choose a fresh doctor." Residents rend to resent patients near the end of an exhausting 36-hour-day, she added, and these regulations are necessary to remove some of chat resentment. "Frankly, these are new regulations," SUMMER 1989 Zeldin said. "If we find that physicians all over the State are saying that they can't spend enough rime with patients, we would listen." Nobody is ever comfortable with changing from the familiar way of doing things, she pointed out, and that may account for some of the concerns people are expressing. Residents themselves view the regulations as benign, said James Woytash, D.D.S., M.D., chairman of the House Scaff Committee of the Graduate Medical-Dental Education Consortium. The new regulations "provide the best of both worlds. "They give residents time to spend with patients, and they give them time to keep up with the medical literature and have time for a personal life,"said Woycash, a fourth-year resident in pathology at the Erie County Medical Center. "It looks very promising." Residents in some specialties, especially surgery, are worried about seeing their cases through to completion, he said. They're also concerned that if there's nor enough money to hire all of the needed ancillary staff, patient care will suffer. While residents weren't demanding the changes, no one has left UB because of them. "The doomsday prophets were saying it was going to drive people away from New York State in all areas of medicine," said Woytash. But looking at the latest Match Day results, "the great exodus out of New York Seate hasn't occurred:' For UB medical students, the percentages of people choosing to stay in New York State are about the same as in previous years. From 1985 to 1988, between 56 per cent and 66 per cent of the class stayed in New York. This year, 62 per cent stayed . Anecdotal information from fourthyear medical students at UB, however, indicates mixed feelings about the regulations. John Osborn feels that the regulations will damage the training program in New York, so he accepted a pediatric residency at the University of BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Washington in Seaccle. Classmate Doug Sillarc, on che ocher hand, says che regulations are "making medicine more human ." He chose a residency in internal medicine ac Millard Fillmore Hospital in Buffalo. Ocher students were confident that, no matter what specialty they chose, the regulations will have no effect on them. "l doubt it's going to affect surgeons; said Joseph Ciac ci, who accepted a surgery residency at Mt . Sinai in New York City . "It wasn't designed around surgery residents. The system for surgery is okay as it is. I really think I'll be working just as hard as residents did in the past." Some students who chose out-of-Scace residencies noted char those states are looking at similar regulations, but they aren't expected co be as drastic as New York's. 9 B:50 a. 111. Tlicsdm• Mi er ge 11 111ga • r ha n,e 10 slccp tro m abo u1 1-30 a rn 10 6a m .. 1tw n ro ndu,li ng rou nds and see ing pa 11 e111 s. Drisc:oll rt' \'l t' W S 1cx 1s 111p rcpara 11 on fo r vascu lar surgny Is it practical? e ven if you agree that we shouldimplement these new regulations, many people ask, "can we implement them?" The two biggest concerns are whether there will be enough money and staff. "We believe that the changes to the code carry a very important message; said Thomas J. Faith, assistant administrator ac the Erie County Medica l Center. "They establish a daily menu for che quality of care. I believe that with all my heart . "But being able to do it is another matter." But when push comes to shove, ECMC won't cut back on services, he emphasized. The hospital administrators interviewed agreed that, somehow, they will comp ly with the changes. Bue it won't be easy. "Down the line it might be bette r, but the transition will be wicked; noted Marcia A. Brierly, administrative director in the Department of Medical Education at Millard Fillmore Hospital. The health department says that funding for the changes is available, though the hospitals wonder . Private hospitals, and even the Erie County Medical Center, get most of their funding through third-party payers BUFFA ID PHYSICIA N A ND BIO MEDICAL SCIENTIST ,. Illa..: SUMMER 1989 ��(such as private insurance companies or the Stace's Medicaid program). The State regulates the rates that hospitals can charge third-parry payers. In July, the rates are being increased and the hospitals in the State will receive an extra $270 million to cover the coses of the changes, said Zeldin of the health department. Since an outside consultant had estimated the changes would cost between $200 million and $300 million, chat amount is in the ball park, she noted. Bue since the regulations are so new and haven't been implemented yet, "there's a concern as to whether anyone knows what the financial impact will be," countered Brierly of Millard Fillmore. "It's difficult co know whether chis will cover everything." Finan cially, the Batavia and Buffalo Veterans Administration Medical Centers operate a bit differently from the ocher teaching hospitals. Their funding comes from the federal Veterans Administration, noted Logue. So far, the VA hasn't promised any new money for its hospitals in New York State co meet the code changes, but Logue predicted chat the federal agency may allocate extra funds as other states adopt similar regulations. In the meantime, the Buffalo VA Medical Center will spread its resources more thinly. "It'll be macaroni and cheese instead of steak," said Logue. Cutting back on che number of hours a resident can work is creating a manpower shortage, hospital representatives agree. "The bottom line is there'll be less work done by residents, so there has co be some other way co take care of patients," said Logue. Hospitals are adding more staff, with nurse practitioners and physician's assistants most in demand. Bue since the regulations have created a new demand, they've become hard co recruit, noted Logue. t he health department's position is that it may be difficult, but it's doable. "Our belief is that, except for isolated incidents, hospitals will be able co find BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST II I the staff; said Zeldin. "They should be able co find the ancillary staff and use attendiings without having to hire a lot of extra people. We're not saying it's going to be a piece of cake." The health department isn't going to be counting heads on Day One of these regulations; it just expects a good-faith effort from the hospitals, she said . Hospitals are also looking at adding more registered nurses, phlebotomists, IV teams, and transport people. Logue said that the cost for additional staff at the Buffalo VA Medical Center is approaching half a million dollars. Bue he conceded that it's hard to sort out which changes are being made simply co meet these new regulations. 1p m . -niesda.1 ,\ l>O\' C , Drisco ll :,a w m o re paueni s ,-md 100 k a s h o n brea k l.>e fore \ 'lt' Win g X-rays Wllh Jo hn HIC-Olld. , ·.i:,cu la r s urg eo n opp os i1e pa ge. Orisco ll sc nil , s up lor a \'C'in by pass ~rail SUMMER 1969 �12 "We probably would have had to add an IV team anyway," Logue pointed out. "There was too much service and not eno ugh education going on. If these regulations hadn't come a long, something else would have forced us co do this." To meet the staffing crunch, hospitals would like co hire more residents. Bur the number of residents a hospital may hire is limited by the accrediting bodies, explained M. Luther Musselman, M.O., director of medical education for Millard Fillmore Hospital and clinica l associate professor of medicine. Besides, it would be expensive and difficult to find enough qualified residents to fill some slots. One hospital chat is adding more residents chis summe r is Sisters Hospital. Five new residents from osteopathic schools will start in a program that was begun independently of the health code changes, said A. Charles Massaro, M.O., vice president for medical affairs at Sisters and clinica l assistant professor in medicine and family medicine at UB. Fortunately, the timing is convenient. Sisters also plans to spread hours a bit more evenly between junior and senior residents. Normally, as a resident advances, he spends less and less time on call, Massaro explained. "But (senior residents) are going to have to, much to their chagrin, work more on call; he said. "It was a nice little perk they had, but we can't do it any more. I don't blame them for not liking . " It. While hiring ancillary staff is the hospitals' main strategy, it's only a stopgap measure because "it only helps solve the problem with hours; it doesn't solve the supervision prob lem; said Brierly of Millard Fillmore. In the past, attending physicians or the patient's doctor were on call and could be reached by phone if a resident had questions at night. The supervising physicians had to be able to get to the hospital within 20 or 30 minutes. Now, supervising physicians in seven acute care areas - internal medicine, family practice, surgery, anesthesiology, obstetrics, psychiatry, and pediatrics must be at the hospital 24 hours a day. A resident who has completed four years, or is in his last year, of his residenSUMMER 1989 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �13 cy may supervise ocher residents. To solve chis problem, hospitals have several choices: • Require fellows in subspeciaky training to work at night. • Use senior residents to supervise ocher residents. • Hire attending physicians and pay them per hour to stay in the hospital at night. • Require full-time faculty to periodically spend a night in the hospital. Each of these solutions has its drawbacks. Fellows in subspecialty training won't be attracted to the idea of overnight shifts and it may interfere with their education, said Noe. The problem with hiring senior residents is that there are few of them and, like all residents, they're limited to working no more than 80 hours a week. When it comes to hiring attending physicians, money and availability are the two big drawbacks. BUFFAID PHYSICIAN AND BIOMEDICALSCIENTIST "Physicians are just not out there to hire," said Faith of ECMC. And even if you can find them, you have to be able to pay chem competitive wages. 1:50 p.m mesdm Top ld1 . Hicoua · and Driscoll make rinal prepara11ons 10 1he pa11cnrs leg before ;,urger~ 2 pm nwscfm Bollom 1cr1. suriery Noe estimates chat it would cost at least $350,000 to $400,000 a year to provide 24-hour coverage in one specialty in a single hospital. And what happens to the attending physician who takes care of his practice all day, supervises at the hospital all night, and sees his private patients again the next day? asked Brierly of Millard Fillmore. Another twist to this dilemma is that making night shift work lucrative in order to make it appealing to physicians could work too well. Some doctors may decide to work only nights, she said. Musselman added that with so many of these night positions opening, we may run into a shortage of physicians in the nexc few years . "We'recreating a monster in a different area," Mu sselman predicted. lxgins. 3.10 p.m nwsc/c11· they · prepare 111evein 10 1\!)0ve. l)(> gral1ecf a nocher option is to require UB faculty members to stay overnight in the hospital. "Historically, the residency training experience was chis opportunity to have as intense and as emergent training in patient care as possible," explained John Naughton, UB's vice president for clinical affairs and dean of the medical school. "Residents providing coverage in hospitals around the clock goes back to the cum of the century. The supervising physician can usually go home at night, permitting the resident co fill the gap." Bue that is changing and will be extremely difficult for physicians living in large SUMMER 1<189 �I urban areas such as New York City. Each medical director, with each director of service, is working out what faculty 14 doctors have to be at the hospital overnight, the dean said. The department faculty are involved in the decision. Bue the definition of who may be a supervisor poses a problem, Noe pointed our. Supervisors in certain areas must be board-certified or board-admissible physicians. Bur there are fully qualified physicians who may have chosen co skip the adding char the question may end up being settled in court . If the attending is held responsible for any mistake a resident makes, attendings may view the supervision of residents as a high-risk enterprise they'd rather avoid, predicted Faith of ECMC. Eventually, there might not be enough attendings to supervise residents and the number of people in graduate education could decline. Noe also questioned whether teaching hospitals are being asked to meet a higher standa rd than community hospitals char aren't required to have a full array of specialists on site. "Presumably, the management of patient care at those hospitals can be provided by somebody who can be called from home," he said. ''.A.rewe defining a different, higher level of patient care in teaching hospitals than in other community hospitals?" Otherregulations a certification test and, because a certain time period has elapsed, are no longer eligible to become board certified. "So does a program director have to make a distinction between his faculty?" Noe asked. "It's causing some uncertainty among program directors." Conversely, he pointed out, a physician who is board certified and, by definition, is qualified to supervise residents, may be a subspecialist who finds it difficult to supervise a broad array of problems. Still another problem with on-site supervision of residents is the question of liability of the supervising physician. Can one attending physician be available to perhaps 5 to 10 residents, each of whom is responsible for IOto 20 patients? "Can the attending physician carry that responsibility and meet the intent of the standard? It's uncertain; Noe said, norher portion of the code called for more formal credentialing of residents' skills and for limitations on residents' hours in the emergency room . Generally, those have been easier to meet. For UB, it was a challenge to invent a system that could be shared by its nine different reaching hospitals. A task force of the Graduate MedicalDental Education Consortium, headed by James M. Hassett, Jr., M.D., associate professor of surgery, set up the system. He is also assistant professor of biophysics and anesthesiology . Before the changes, when a supervising physician deemed a resident had shown he was able to perform a procedure satisfactorily, the supervisor gave the resident permission to perform the procedure on his own . The documentation wasn't structured and there wasn't communication between the hospitals. Now the faculty in each specialty have defined uniform criteria char residents must meet before they're allowed co do a procedure on their own. A computer is used to record the number and types of procedures residents do under supervision. Looking at a resident' s record, the chairman decides whether to grant privileges to the resident. When residents move between hospitals, their records move with them. While chis is probably rhe easiest and cheapest of all of the code changes, administrators at Millard Fillmore Hospital noted chat the start-up costs alone at their hospital ran $45,000 . Still another change in the code, in place since October, requires that residents and attending physicians in emergency rooms be scheduled for no more than 12 consecutive hours. The atrendings in rhe emergency room can't be the same ones cover ing the rest of the hospital. Again, cost and manpower are the issues. Faith of ECMC estimates that it will cost about $1 million a year just for physician coverage at his hospital. Rural hospitals probably have the toughest time recruiting physicians, bm city hospitals are scrambling, too. "We're recruiting nationally to staff our emergency rooms and we're just making it," said Musselman of Millard Fillmore, though his hospital was one of several Buffalo hospitals chat had mer the regulations before they went into effect. Noe pointed out that the medical school is planning to establish a residency training program in emergency medicine for 30 residents . "As the program develops it will go a long way to relieve the manpower problems, particularly upstate," he said. Also easing the problem is the fact that people in internal and family medicine are showing more interest in emergency medicine. "I don't think there's any doubt that (the changes to the code) are burdensome," said Naughton. "It's seen as adversaria l rather than as a positive thing. "Bur for us as a medical school, the changes create an awareness that we need to do a better job of supervising our srudents and residents and of credentia ling them. It makes good pedagogical sense. "Sometimes we don't solve a problem without a crisis. In the short haul, it may be tough. But in the long haul, we • should be able to do it." BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �SUMMARY HOURS Effecnw:JwlyI, /989 • Residents may be scheduled for no more than 80 hours a week, when averaged over four weeks. • They may be scheduled for no more than 24 hours in a row. • On-duty assignments must be separated by at least eight hours of non-working time. • Residents must get 24 consecutive hours off each week. • Hospitals must enforce policies that prohibit combined assigned hours and moonlighting hours from exceeding the limits on assigned hours. • In certain departments that don't have a high volume of acutely ill patients and where the resident is able to get enough rest, there JS more flexibility in scheduling. (Ex eluded from this clause are anesthesiology, family practice, medical, surgical, obstetrica l, or pediatric services.) ... •,i t',· /10 :9 ·.8 lil. 2· 3: -, 4.- .7 .? _s•. s p.m . Tuesday Opposite page. finishing surgery 6:50 p.m . Tuesday TOp. Driscoll confers with or . M. carlin and Dave 1tarshman. a surgical resident. 6:57 p.m . Tuesday center. Driscoll examines a patient. 7:05 p .m . Tuesday Driscoll and photograph er BOb Walion end their workday . ON-SmSUPERVISION Eff«aw:1111, 1 989 • A sufficientnumber of supervising physicians must be present tn the hospital 24 hours a day m the acute care specialties of anesthesiology, family practice, mediane, obstetrics, pediatrics, psychiatr¥ and surgery. • Supervising physicians mustbe. board certified or board adm1ss1ble, or have completed a minimum oJ four years of postgraduate tramingi • The supervising physician may be a resident in his final year ofpost graduate training if the padeJj physician can get to the hosp within 20 to 30 minutes of beliDRP called. CREDENTIALING E/f«tiwJan.1 1989 • The medical staff must written documentation o care privileges granted to EMERGENCY ROOM Eff«tiw • Residents and attending ph cians can be scheduled for no mote than 12 consecutive hours. SUMMER 1989 15 �I 16 Samuel 0 . Thi e r �Spring Clinical Day 17 Doctorsurged to shape national policies l 1 l BY CONNlE OSWALD SlDFKO = ~ f physicians don't take a hand in shaping this :::: country's health care ::: policy, they're shirking their responsibilities, according co Samuel _.._-_ ~ 0. Thier, M.D., president of the Institute of Medicine of the Nationa l Academy of Sciences . Physicians should be key players in deciding today's tough health care issues, but "the silence from the medical community is deafening," said Thier, who gave the annua l Stockton Kimball Memorial Lecture at chis year's Spring Clinical Day on May 6. The United States leads rhe world, but we're at a point of instability, said Thier, who is also visiting professor of medicine ac che Johns Hopkins University School of Medicine and clinical professor of medicine ac the George Washington University School of Medicine. It's rime to choose whether we will evolve and remain leaders, or give up chat leadership to some ocher group . Ideas for evolution are desperately needed and they have to bubble up from the medical community. "I don't see a sense chat we're engaging the issue," Thie r said. "What will replace chis? We have the responsibility co chink about what we want next." The policy makers in Washington view the medical community "as apologisesfor the status quo" rather than an active - BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST Physiciansshould be key players in deciding today'stough health careissues,but "the silencefrom the medicalcommunity is deafening,'' said Samuel 0 . Thier, M.D. of the National Academy of Sciences. force for change, Thier noted. One of the issues facing physicians today is access co care. There are 35 to 40 million people in this country with no hea lth insurance at least pare of the year. One to two million are turned away from care, and the rest don't seek care as often. When Thier was a resident at Massachusetts General, physicians who wanted hospital privileges had to contribute time to care for the indigent . Now, some physicians feel that if they're not reimbursed for care, they don't have to provide it. "I believe chat's an abrogation of our social contract," Thier said. Some social problems, such as teenage pregnancy, the indigent, and aging, aren't dealt with adequately because physicians cry co force the issues into a medical model, T hier said. Picture the elderly person who lives in poor housing: he or she becomes depressed, doesn't eat much, and gees pneumonia . The physician successfully treats the pneumonia and sends the person back to the same house. Rather than just treat the pneumonia, we need co keep people functional, Thier pointed out. He noted that in Japan, they tail off the money they spend for medical care for the elderly and spend it instead on housing and fo.od. In this country, we need to create some kind of a plan chat uses preventive strategies and somehow moves from a medical model to a social model, he indicated . We made a mistake 50 or 60 years ago when we separated schools of medicine from schools of public health. "If we simply watch the scene evolve, we won't have met our professional responsibilities," he concluded. • SUMMER 1989 �Spring Clinical Day 18 PECTIN It thickens jelly, but can it thin arteries? �Spring Clinical Day 19 WR:R:T TJE N JBY CON ][JE ((})§W A JLD §TO>FKO utrition in the '90s" was the theme of the 52nd annual Spring Clinical Day, held May 6. The event, which also ) included the class reunions, was sponsored by the UB ) Medical Alumni Association. The topics of the scientific sessions were nutritional of cholesterol; epidemiology of nutrition management and cancer; recent advances in characterizing and managing obesity; new fuels for the gut, and normal nutritional requirements. CHOLESTEROL I II chink we can lower plasma cholesterol and LDL (which is connec ted to an increased risk of heart disease) with _ , .,..v.,a grapefruit pectin and no change in diet," said James J. Cerda, M.D., professor and associate chairman of the Department of 1 , ,I"' 0 • Medicine at the University of Florida at(: ~ Gainesville . According to studies performed by Cerda and his colleagues, grapefruit pectin appears to lower cholesterol. (Pectin , is a water-soluble fiber that binds adjacent cell walls in plants . It's used by homemakers in preparing jellies and jams .) will actually reduce atherosclerosis once In experiments with pigs, Cerda found it forms. That's an important question that even when fed a high-fat diet, the because most of us already have atheropigs' cholesterol decreased when they sclerosis, Cerda reminded his audience. were also fed pectin . The pectin also apThe researchers also conducted a peared to prevent atherosclerosis, the double-blind trial of people with high plaque buildup that results in narrowing cholestero l who couldn't or wouldn't of the arteries. change their lifestyles. He noted that it The next question the researchers wasn't hard to find subjects. would like to look at is whether pectin r. ) ) ][JLJLU§TRAT][O) BUFFALOPHYSIC IAN AND BIO MEDICAL SCIENTIST BY The researchers found that pectin was ,statistically significant in reducing ·cholesterol. One-third of the subjects had at least a 10 per cent decrease in cho lesterol while taking pectin. Cerda emphasized chat he's not suggesting that people rely only on pectin to lower their cholesterol. They should also eat a good diet and get exercise. Since it's important for physicians to advise patients about diet, medical schools shou ld prepare them by teaching nutrition as part of the curriculum, Cerda added, and physicians should also rely on dieticians more than they do. CANCER W hen it comes to reducing the risk of cancer, fiber - but not just any fiber - may be beneficial, according to Saxon Graham, Ph.D., professor and chairman of Social and Preventive Medicine at UB. Vegetable fiber, but not fiber from grains, is helpful in reducing the risk of Jr({))§JEJP>H THIEJL SUMMER 1989 �Spring Clinical Day I zo rectal cancer, according to a study by Jo Freudenheim, assistant professor in Social and Preventive Medicine at UB. Graham pointed out that that's not the fiber the National Cancer Institute cold us to eat. Vitamin A may reduce the incidence of cancer of the mouth, larynx, esophagus, bladder, lung, and cervix, he said. As well as searching for foods char prevent cancer, researchers are also on the lookout for ones chat cause cancer. There's epidemiological evidence eying the amount of far in one's diet co both colorecral and breast cancer, Graham said, but he cautioned that it's a leap in logic to say fats cause chose cancers. He also observed chat closely associated with fats are obesity and the coral calories ingested. These interrelated factors could be connected co cancer of the colon and rectum. And since physical exercise can reduce obesity, exercise may also be associated with decreased risk. Ir is also possible chat exercise by itself may reduce the risk of colon and breast cancer. While the ocher recent, well-publicized recommendations of the National Research Council seem well-founded, there's little epidemiological evidence to support its advice co decrease the protein SUMMER 1989 in our diets or to increase grains or calcium, Graham said. The first strategyin dealing with obesity should be prevention. Physiciansshould recognizethe family at risk - whereone or both parents are obese. OBESITY T he first strategy in dea ling with obesity should be prevention, said Lyn J. Howard, B.M., B.Ch., ER.C.P., head of the Division of Clinical Nutrition at Albany Medical College. Physicians should recognize the family at risk - where one or both parents are obese, said Howard, who is also a professor of medicine and associate professor of pediatrics. Children shouldn't cross over their growth curves, even if the children are at the correct weight for their height. Also at risk of obesity are people with a low resting metabolic rare. Those at risk should hold down their calorie intake, particularly during periods of rapid growth, such as during the fetus' last eight weeks of gestation, early infancy, adolescence, and during pregnancy for women, she recommended. Physicians must advise patients about the fat in their diets. The percentage of fat in the diet, rather than coca! calorie intake, is a big contributor co obesity, Howard explained. Because the sympathetic nervous system regulates the mechanisms that tell the body chat it has had enough co eat or chat it needs to burn up calories, anything that turns on the sympathetic nervous system is beneficial. The best thing is exercise. "Diec is not the first thing, but exercise is," she emphasized . "Exercise has to be a forever commitment." Another thing that cums on the sym- BUFFALOPHYSICIAN ANO BIOMEDICAL SCIENTIST �Sprmg Clinical Da:,· 21 pathetic nervous system is the carbohydrate content in the dier, so people should use carbohydrates as their chief calorie source. For people who have become obese ro a point where it's affecting lifo expectan· cy and health, strong consideration has robe given ro the possibility of performing surgery, Howard noted. 1'\·o pro· cedurcs, gastric bypass and vertical banded gasrroplasty, restrict food intake and ro some extent impair food digestion. They have a 60 ro 70 per cent success rare. However, gastric balloons haven't proved safe or effective, she pointed our. Howard mentioned rhar some new drugs to aid weight loss may be available in the next decade. They will be aimed at increasing rhe mobili:arion of far, mimicking satiety, and delaying gastric emptying. FORTHEGUT FUELS I n certain conditions where the intestines aren't working properly, it may help ro feed the intestines certain fuels that their mucosa use best, said John L. Rombeau, M.O., director of the Nucri• tional Support Service at Philadelphia Bl.:FFAW PHYSICIAN AND BIOMEDICAL SCIENTIST Medical Administration Veterans Center. Patients with intestinal malfunctions are often placed on a regimen of "bowel rest" and fed in a way (such as intravenously) that attempts to bypass the intestines. Bue bowel rest has side effects, noted Rombeau, who is also associate professor of surgery at the University of Pennsylvania School of Medicine. The gut begins to arrophv and the muscous lin• ing of the intestines begins ro function poorly. Studies show that in selected conditions, it may be preferable to feed the intestines certain fuels char the mucosa use best. For example, glucamine, a non-essen• nal amino acid, is seen as the preferred fuel for the enterocytes, the cells that line the small intestine, he explained. Shorr-chain fatty acids are rhe preferred fuels for the colon, with soluble fiber, such as pectin, as a precursor. When part of the intestine is removed, the addition of pectin to a liquid diet improved adaptability of the remaining portion of the intestine, Rombeau explained. Pectin also decreased diarrhea. The shore-chain fatty acids improved the strength of the colon. EMENTS L NORMAREQUIR I t's difficult to establish nutritional requirements, noted Jorge E. Albina, M.O., associate director of the Nutritional Support Service of Rhode Island Hospital. Minimum requirements arc defined as the minimum intake that will maintain adequate function and health, explained Albina, who is also assistant professor of surgery at Brown University. But adequate for what, he asked. ls the goal to reduce dietary diseases such as scurvy? To maintain good health? To reduce the risk of other diseases such as cancer? For hundreds of years, we've been try• ing to figure out what kinds of foods and how much food people require. The first recorded nutritional allowance was written in 1753 when British sailors were told to drink an ounce of lemon juice a day to prevent scurvy. Recommendations have changed over the years, and today different dietary boards disagree on minimum nutritional requirements. "If we try to answer the same question: 'How much food does man require?; I chink we still don't know, but we're learn• ing pretty fast," Albina concluded. SUMMER 1%~ �Medical School 22 Health Manpower Will we have enough doctors? How many is enough? BY CONNIE OSWALD smFKO W ill we have enough do ctors in the future ? That's a hard question to answer since no one has yet decided how many doctors we need, according ro George E Sheldon, M.D., professor and chairman of the Department of Surgery at the University of North Carolina at Chapel Hill. And the kind of doctors we'll need in rhe future changes with every scientific breakthrough. Sheldon discussed "Health Manpower the Future Challenge" March 23 ac the indu ction ceremony of the UB chapter of Alpha Omega Alpha, the national medical honor society. He is a regent of the American College of Surgeons and chairman-elect of the American Board of Surgery. "Nobody has ever decided how many doctors we need,"said Sheldon, a trauma surgeon. "There's no question we've got more than we did 25 years ago, but we didn't have enough then." There was a time when medical schools were turning out large numbers of doctors. Back at the turn of che century, standards were so low chat anybody who could pay the tuition could enter medical school. Then, the Flexncr Report, which urged reform in medical education, was published in 1910.Standards were raised, closing down some schools and causing a shortage of do ctors. Between 1920 and 1950, there were less than 120 physicians for every 100,000 Ameri cans, Sheldon said. SUMMER 1989 "Nobody has ever decided how many doctorswe need," said Sheldon, a trauma surgeon. "There's no question we 've got more than we did 25 yearsago, but we didn't have enough then." Now there arc 200 physicians per 100,000 Americans, but that's only a few more than we had at the turn of the century, he pointed out. If we assume tha t we have enough doctors today, we're pretty good at predicting the numbers we need. But we don't fare as well in predicting what specialties will be in demand. Sheldon described a 1978 study by the Graduate Medical Education National Advisory Committee, which was an extensive and expensive project that projected the kinds of doctors we'll need by 1990. The study was right on target in predicting the number of physicians we'd have - about half a million, he noted . "But it was off by a mile on all the specialties," Sheldon said, because medicine is changing so rapidly. Back in 1978, no one predicted the importance that organ transplantation would have today because cyclosporine, the drug that greatly improved the success of transplanta• tion, wasn't around yet, he said. And no one had heard of AIDS. AIDS is becoming a problem today, but we have to keep it in perspective, he cautioned. More people die on the nation's highways each year than have died from AIDS since it was identified . in the futu re, She ldon noted, the aging populatio n in this country will create new demands for certain types of physicians. And BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST �Medical School 23 there may be a greater demand for sports physicians. He also outlined ocher trends: ■ Before the 1970s, health care was a "corcage industry." Doctors ope raced fee-for-service solo practices. This was coupled with voluntary hospitals. Now, the trend is toward group practices, Sheldon explained, and hospitals have become very fragile economic entities. During Texas' recent oil problems, hospitals closed because they are very dependent on che overall economy of an area. ■ Most doctors work 60 to 70 hours per week, though females tend to work fewer hours, he said. The number of women is increasing, which could mean that the total number of hours worked by physicians will decrease. BUFFALOPHYSICIANAND BIO~IEDICALSCIENTIST "Bur I think that women have kept the quality of heal ch care up; Sheldon said. "As the number of applicants (to medical schools) dipped down, if we didn't have the interest of rhe women, quality would have gone down." ■ The retirement age of physicians, driven by high malpractice insurance rates, has dipped below 60 years old. ■ Medical school enrollment has plateaued . No new schools are being built. An important aspect of the medical manpower question is how much society is willing to spend for health care. The U.S. now spends 12 per cent of its gross national product on health care, while Brirain spends only six per cent, Sheldon noted. But he pointed out that 86 per cent of what Britain spends comes from the government while less than half of what rhe U.S. spends comes from the government. And in Britain, patients wait 28 months ro get a hip replacement or 26 monchs to have a hernia fixed, he added. "These are choices we make in sociery; Sheldon said. "Health care is not going to get less expensive as technology increases. \Y/e have co decide how we'll spend our money." Quoting Rashi Fein, Ph.D., a Harvard economist, Sheldon said, "If we become comfortable with a culture char tells us that health care is analogous to selling shoes, and that the level of health spending and major allocation decisions are to be determined by marker forces, rather than by a political or social consensus, we will be comfortable with rationing." • SUMMER 1989 �Medical School 24 Timothy Murphy, M.D. of diseases caused by microbes (such as BUFFALO IS EMERGING bacteria, viruses, and protozoa), provides vital AS LEADER IN STUDYOF research that contributes to vaccine development and to the control and understanding MICROBIAL PATHOGENESIS of diseases. B uffalo is emerging as a major center in the study of microbial pachogenesis, researchers here report. That prominence is highlighted by a national conference held here in March that was sponsored by the UB Microbial Pathogenesis Graduate Group. "We attracted many heavyweights in the field ro the first Buffalo Conference on Microbial Pathogenesis; said Timothy Murphy, M.D., associate professor of medicine and microbiology and direcror of the graduate group. "This attests to the nationa l respect chat Buffalo has in the field, as well as to the need to collaborate our efforts." Microbial pathogenesis, which is che study SUMMER 1989 Barbara H. lglewski, Ph.D., and Stanley Falkow, Ph.D., national leaders in the field were among rhe six speakers at the March event. lglewski is professor and chairman of the Department of Microbiology and Immunology at the University of Rochester and president of the 15,000-member American Society of Microbiology. She has contributed groundbreaking research in using molecular techniques for studying bacteria. Falkow is professor of microbio logy, immunology, and medicine at Stanford University School of Medicine. He is known for his pioneering work in the field using genetic techniques in order to understand how a microbe adheres to and invades a cell. "Basically, there is a lot of pathogenesis research going on in Buffalo and all over the country," says Mu rphy. UB's new graduare group, as well as the con• ference, offers opportunities for researchers scattered among several departments at UB to organize and communicate with their colleagues. The UB Microbial Pathogenesis Graduate Group includes 25 graduate students and 33 faculty members from the Departments of Medicine and Pediatrics (Divisions of Infectious Diseases), Microbiology, Biochemistry, Oral Biology, and Surgery. "Tom Flanagan (Ph.D., chairman of che Department of Microbiology) was instrumental in recognizing the need for such a group; explained Murphy. "le was formed in order to foster the exchange of ideas and technology among faculty members in different departments who have interest and expertise in the study of molecular biological aspects of infectious diseases." While many of the researchers in the various departments study different types of organisms such as bacteria, viruses, protozoa, and other parasites, they ask similar fundamental questions ('What are the factors in microbes chat enable them co cause diseases?') and use many of the same techn iques regarding pathogenesis. Interaction among departments has facilitated the development of a vaccine for the disease called Haemophilusinfluenzae a bacterial disease, unrelated to the flu, which preys mainly on preschool ch ild ren and causes bacterial meningitis, pneumonia, and ocher serious conditions. "This development is a potentially significant one," explained Bud Nelson, a postdoctoral research associate in microbiology and biochemistry. "Previous vaccines were ineffective in children under two years because their immune systems did nor recognize the vaccine and produce the necessary antibodies. Currently there is a pha rmaceutical firm interested in resting the vaccine." T hrough this interaction among departments, Michael Apicella, M.D., professor BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Medical School 25 of medicine and microbiology, steered Nelson to David Rekosh, Ph.D., associate professor of microbiology and biochemistry. Under Rekosh's direction, Nelson learned a gene sequencing and cloning technique used in Rekosh's lab in order to characterize the specific protein for the new vaccine. "It took about eight months to learn the technique; said Nelson, "but once I had, l rook what I had learned back ro the infectious disease labs at the Erie County Medical Center and continued the studies ." The technique of genetic engineering is a powerful molecular biologica l tool that has revolutionized the study of infectious diseases in the past decade. Since the faculry using these techniques are located throughout different departments, the graduate group allows collaboration for research projects. This collaboration, together with the conference, are examples of the type of interaction needed wirhin the field, both at the University and nationally, Murphy said. • - By Mark Marabella A GLASS OFMILKMAYHELP S leep disorders in che elderly are usually complications of other problems and are too complex ro be whisked away with prescription drugs, said Troy L. Thompson U, M.D., professor and chairman of the Department of Psychiatry at Jefferson Medical College. Thompson made his remarks during the second annual conference on "Current Issues in Geriatric Psychiatry," co-sponsored by the Division of Geriatric Psychiatry, Department of Psychiatry, and rhe Western New York Geriatric Education Center at UB. His was one of five talks presented at the April conference in the Ramada Renaissance Hotel in Cheektowaga . "Conservative estimates indicate chat about 5 million elderly patients in this country have a severe sleep disorder," Thompson said . "For unknown reasons, the death rare among people who 'often' use sleeping pills is 1.5 times higher than that among marched subjects who have never used sleep- BUFFAlD PHYSICIANAND BIOMEDICALSCIENTIST ing pills." Thompson maintains char sleep disorders, such as the common insomnia, are too complex co be whisked away by the hasty prescription of sedative-hypnotics or benzodiazepines. He emphasized rhar, especially in older individuals, insomnia is usually secondary in nature and arises as an aspect or complication of psychiatric, medical, environmental or pharmacological events. "Many sleep disorders, such as insomnia, are merely a secondary symptom of a complexity of factors; explained Thompson . "A patient's complaint of a sleeping problem should trigger a comprehensive review which includes that patient's medical history, family background, and current lifestyle." Many times, remedies for sleeping difficulties need not come from the medicine cabinet or a doctor, Thompson pointed out. An adequate dose of L-Tryptophan, an essential amino acid which is sometimes recommended as a hypnotic, can be obtained by drinking a glass of milk. However, if a sedative-hypnotic medication is chronically needed to maintain adequate sleep, the physician should regularly reevaluate the initial diagnosis, reconsidering such possibilities as depression, anx iety or one of a dozen ocher primary sleep disorders, Thompson cautioned. "Judicious use of sedative-hypnotics in the elderly requires an understanding of drug metabolism in the aged, as well as knowledge of the differential diagnosis of distu rbed sleep; he said, adding that "the clinician should be familiar with the changes in sleep patterns and sleep architecture that are seen in the healthy elderly person." • - By Mark Marabella SUMMER 1989 �Medical School 26 -- Luc Montagnier, M.D. SUMMER 1989 FOCUS ON BASIC AIDSRESEARCH, SAYSMONTAGNIER "we should put our research efforts first in basic research; said Luc Montagnier, M.D., the noted French AIDS researcher, "because we still don't know many things about the virus and how it causes disease. It's very difficult to design new treatments and also to design a vaccine" without this knowledge. Montagnier, a professor at the Pasteur Institute in Paris who identified the HIV virus associated with AIDS, spoke April 12 at the 19th Annual Ernest Wicebsky Memoria l l..e<:cure in Bueler Auditorium. The lecture is sponsored by the Ernest Witebsky Center for Immunology and the Department of Microbiology. According to Montagnier, AIDS is not caused, but only triggered, by HIV (the human immunodeficiency virus). He contends that the virus causes autoimmunity, in which the body becomes immune to itself. The virus hides from the immune system by mimicking che configuration of a human cellular structure so that the immune system can't discriminate between itself and the virus. HIV alone, in sufficient amounts, is enough to induce the disease in susceptible humans, Montagnier says. However, when the virus dose is low, and thi s is probably the case in sexual contact, then some co-factors may play a role. It's important to understand the basic workings of the virus, but "at the same time, of course, we have to deal with the disease in patients and we should try anything that works, even in an empirical way; Montagnier said, referring to treatments that seem to work but haven't yet undergone thorough study. "If something works, we should cry it." In all parts of the world the treatments are the same, he said, and the best we've got is an antiviral drug called AZT (azidothymidine). While it may be beneficial to a patient for months or even years, it's not a cure. Many other compounds are under Phase BUFFALOPHYSICIAN AND BIO MEDICAL SCIENTIST �Medical School 27 I trials, Moncagnier added. The Ernest Wicebsky Memorial Awards for proficiency in microbiology were given co Alison Koehler, a medical student; Kevin G. Cleary, a dental student, and Sam Jayanch Samuel, a graduate student. • BETTER THANEVER l ooking like a contestant on The Priceis Right, Paul Lecat, amid applause and cheers from his friends, ran down the steps of Butler Auditorium to the podium. He received an envelope, tore it open, and jubilancly yelled out che good news - "Akron, yeah!" Lecac had just found out he got the residency he wanted in medicine and pediatrics at Children's Hospital of Akron in Ohio. The occasion was March Day, che annual event where lase-year medical students find out where they'll spend their residencies. About 65 per cent of che medical students got the best news they could have hoped for - chey got their first choice of residency. And a whopping 87 per cent got one of their cop three choices. Students aimed high and were placed in some of che more competitive residency pro• grams, such as Yale, Cornell, Columbia Presbyterian, Strong Memorial, and Johns Hopkins. "le was a very impressive match overall~said Dennis Nadler, M.D., assistant dean of student affairs in the medical school. "It's going • to be very difficulc to cop." Scott Bookner congratulates Joan Murray. Peter Ostrow, associate dean, prepares for a second champagne shower . ./ Doug Sillart and David Bloom BUFFALOPHYSICIAN AND BIOMEDIC AL SCIENTIST Charlene Vita le and Kristina Hart share their happy news. SUMMER 1989 �Medical School 28 NOBEL PRIZE-WINNER EXPLAINS WORK G erald M . Edelman, M.0 ., Ph.D., D.Sc., winner of the 1972 Nobel Prize in Medicine and Physiology,delivered the annua l Edward Fogan Lecture in Neurology on March 16 in the Albright- Knox Arc Gallery . The lecture was sponsored by UB's Department of Neurology. Edelman discussed "Cell Adhesion Molecules in Morphogenesis and Neural Development." In recent years, Edelman has worked in neuroscience. He is the proponent of a theory explaining development and organization of the human brain, which is outlined in his book Neural Darwinism: The Theory of NeuronalGroup Selec1ion. Before that, he worked in immunology. Edelman received his Nobel Prize for his discoveries of the molecu lar configurations of the immunoglobulin molecule. This work led Edelman to consider questions of how ou r immune system develops specificity in recognizing objects chat are foreign to the body. This ana logy has been adapted co che nervous system. Cell adhesion molecules, first described by Edelman in 1977, are markers on the surface of cells chat provide a framework by which the billions of cells in the nervous system are able co relate co one another. These molecules provide the structure by which the nervous system differentiates itself from an immatu re mass at birth, incapable of sensing its environment, to che more mature nervous system able to respond to the intricacies of its environment. Edelman suggests chat cell adhesion molecules provide the matrix by which cells relate co one another, thereby creating specific neurona l differentiation . By chis means, he suggests a mechanis m by which selective parts of the nervous system develop specificity for vision, pain, temperature, memory or fine motor coordination, etc. Related to chis work is Edelman's theory of neu rona l Darwinism. Just as adaptation co the environment is the foundation of Dar- SUMMER 1989 Gerald M. Ede lman, M.D., Ph.D. , D.Sc. win's theory of evolution of species, Edelman's theory proposes that brain development is based upon competition for survival among neural cells and response co stimuli in the environment. Those that are used survive while unused ones do not . Cell adhesion molecules provide che structure that allows cells chat are to be programmed for a specific function to relate to one another. Those areas that do not develop affinities for one another do not survive. This theory of how cells relate to one anothe r and how they differentiate is so important that some people speculate chat Edelman may be in line for a second Nobel Prize. Edelman is the Vincent Astor Professor at the Rockefeller University and director of the Rockefeller University Neurosciences Institute. He is also scientific chairman of the university's neurosciences research program. • - 8)' Michael £. Cohen, M.D. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �Medical School 29 Tai-Hwang M. Fan, a fourth-year student, represented UB at the eighth annual Medical Student Research Atvards Program sponsored b-v the Associated Medi cal Schools of New York. The May event was held in Buffalo for the first time. Judith Tamburlin, cl inical instructor, right, explains her work on an anatom::, atlas for the blind to Stephanie lovino, a graduat e student. The di spla::, was part of the medical sc hool's first Faculty Research Day held April 25. BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST SL:MMER1989 �Hospital News 30 Decked out in a frill:>•hairband and sucking on her pacifier, Carley Mallon is cuddled by her parents, Peter and Diane. Treating the Fetus as a Patient S cace-of-the-arc diagnostic and treatment methods have introduced a new concept in medicine - treating che fetus as a patient. That's the focus of the new Buffalo Institute of Fetal Therapy, formed by che Perinatal Center of Children's Hospital of Buffalo and the UB medical school. The program is the first of its type in New York Scace. "The traditional field of fecal and maternal medicine knows how co treat the mother and normal pregnancies, and how co treat an abnormal pregnancy when it affects the mother; explained Philip L. Glick, M.D., co-director BUFFALOPHYSICIANAND BIOMEDICALSCIE1''11ST of the program, "but it doesn't know how co treat the fetus:' In the recent past, a physician might be able to predict chat a fetus would be born with an ailment, but there was little he could do about it. Now he can cake some action, explained Glick, who is also an assistant professor of surgery at UB and a pediatric surgeon at Children's. Sometimes physicians can treat a fetus surgically or medically while it is still in the womb. A more common action is co plan rhe rime, place, and mode of delivery, and have experts ready when the baby is born. The ocher co-directors of the program are Luther K. Robinson, M.0., director of clinical generics at Children's and UB assistant pro• fessor of pediatrics, and Amel S. Lele, M.D., director of the Women's Clinic at Children's and UB clinical associate professor of gynecology/obstetrics. Glick said a wide range of fecal abnormalities can be identified using ultrasound and rests that sample amniotic fluid, maternal blood, and fetal cells and tissue. Among che problems chat can be detected chis way are urinary tract obstruction, thoracic masses, congenital diaphragmatic SUMMER 1989 �Hospital News 31 hernia, abdominal wall defects, and spina bifida. Some are best corrected after a full-term delivery, others may require a cesarean delivery, and still others may require induced prererm delivery for early correction outside of the uterus. Some may require medical therapy before birth and some may require in-utero surgery. The Buffalo program, Glick explained, rakes a multidisciplinary team approach to the unborn patient. The program has assembled a team of experts consisting of perinacologists, neonatologists, radiologists, cardiologists, anesthesiologists, geneticists, ethicists, clergy, and pediatric surgeons with various subspecialries. Rather than usurp the role of the community physician, the team members act as consultants, Glick said. The results can be very gratifying. I II fit wasn't for you people at Children's Hospital, we wouldn't have our baby today," said Peter Mallon, gazing at his fourmonth-old daughter Carley. Peter and his wife, Diane, 35, were thrilled co find out she was finally pregnant. Their joy turned to shock when doctors discovered through an ukrasound test that the baby girl Diane was carrying had a congenital diaphragmatic hernia. In this condition, the diaphragm (the muscle chat separates rhe chest from the abdomen) hasn't developed properly. Carley's abdominal organs were in the chesc. Her intestines compressed her lungs, resulting in small and abnormal lungs. Although many babies with chis condition also have other abnormalities, a cest called amniocentesis and a thorough feral ulcrasound confirmed that Carley had no ocher birth defects. The doctors discussed the options with the Mallons and they chose surfactant replacement and surgery after birth. When the pregnancy was full term, labor was induced and the baby was delivered vaginally. Surfactant, che soapy coating that prevents the lungs from collapsing in between breaths SUMMER 1989 Philip L. Glick, M.D. and makes the lungs more pliable, was placed in the baby's lungs before she rook her first breath. Surfactant replacement is an accepted therapy for premature babies, Glick explained, but it's a new approach for babies with diaphragmatic hernias. Babies with that condition have lungs that appear similar ro rhe small and sriff lungs of premature infants. It apparently worked. Now the physicians will go back to rhe laboratory and examine whether rhe surfactant really did help Carley and whether they can recommend it for other children. After Carley was treated with the surfactant, she was rushed off ro surgery where all of her abdominal organs were removed from her chest and placed back in her abdominal cavity. Her diaphragm was repaired with a piece of plastic. That indicates how risky her condition was, Glick noted. When plastic is needed co repair the diaphragm, the mortality rate is almost 100 per cent. After six weeks, the baby was discharged from che hospital and sent home without respiracory or feeding difficulcies. "She's coming along real good - she's real alert," Diane said. "She's lifting herself from che crib and crying ro roll over a little bit." "As far as we can tell, she's absolutely normal," Glick confirmed, and Carley's future looks bright. "She will be an absolutely normal five-year-oldon the playground with normal lung capacity." He stressed that it took team work. Work- ing on Carley's case were Diane's obstetrician, ultrasonographers and technicians in radiology, perinatologists and neonatologiscs, geneticists, pediatric surgeons, a developmental pediatrician, house staff, operating room and intensive care nurses, and the hospital chaplain. The Buffalo Institute of Feral Therapy is modeled on a handful of similar programs across che country, including the pioneering effort of Michael R. Harrison, M.D., ac the University of California at San Francisco, where Glick did his general residency in surgery and a fellowship in fetal surgery. The Buffalo program was founded in conjunction wich the deparrments of pediatrics, gynecology/ obstetrics, radiology and surgery at UB and Children's. Its work, Glick noted, is facilitated by che fact that Children's Hospital of Buffalo is che only free-standing children's hospital in the continental U.S. with an in-house maternity division. J.E. "Ted" Sribbards, Ph.D., president of Children's, noced that pediatricians used to wait as long as five years co carry our some corrective procedures that are now carried our in the first few days of life. Glick's work pulls back chat riming even further. John P.Naughton, M.D., UB vice president for clinical affairs and dean of the medical school, said rhe new program "represents an important clinical addition to the Perinatal Center chat has existed at Children's Hospital for the past three years. "It will provide added and needed services for unborn children with feral abnormalities and will stimulate research designed to prevent such abnormalities from occurring and co treat those chat are not preventable." "The future of fetal therapy is inspiring; according co Glick. "As our understanding of the fetal immune system progresses, the possibility of in-utero transplantation of stem cells and whole organs looms as a distinct reality. If che secrets of fecal wound healing can be unraveled, the scarless healing of the fetus may usher in a new era for plastic surgeons. ln-utero fetal nutrition may lessen the mortality and mor• bidity of intrauterine growth retardation. "The list just goes on and on." • BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Hospital Neivs 32 Struggling with Polio's Aftermath BY MARK MARABELLA H en ry Bauld, 78, was struck with polio as an infant in 1912. Although he successfully thwarted this potentially crippling disease, in his 50s he began to experience extreme fatigue and pains in his shoulders. He couldn't walk any distances without becoming exhausted. When he consulted his physician about what was happening to him, his doctor chalked it up to "oldage." It wasn't until last year, when he first consulted the Erie County Medical Center's PostPolio Center of Western New York, chat Bauld learned he wasn't alone in his affliction . Bauld signed up for an appointment with Frederick McAdam, M.O., director of the center and clinical instructor in UB's Department of Rehabilitation Medicine. Following Bauld's initial examination and evaluation, McAdam and the center's specialists prescribed individualized daily exercises and vitamin supplements. Bauld soon discovered that he had renewed energy that he hadn't felt in 25 years. Sudden ly, his formerly diagnosed "old-age" was seemingly in remission. People who had polio as youths are now suffering in their lacer years from chronic muscle and joint pain, fatigue, weakness, and breaching difficulties. They are being diagnosed as having "phantom pain" or symptoms of "old-age," according to McAdam. Because the number of post-polio patients with these symptoms has steadily increased, physicians have begun co realize chat polio may indeed have effects that linger well after a patient's initial onset and rehabilitation. Over the past decade, more physicians and researchers have turned their attention to this syndrome. McAdam began the ECMC clinic in Oc- SUMMER1989 suffering from post-polio syndrome or poliomyelitis. McAdam stresses that the main objective of the clinic is co help a patient mentally and physically cope with this synd rome; there is no miracle cure . The clinic emphasizes the teaching of energy conservation and establishing functional limits for patients. With correct diagnosis and treatment, there is improved quality of life. "Many patients who come to the clinic are wiped out just from getting out of the car and walking into our office,"McAdam noted. "So what we try to do is help them to function more efficiencly in everyday life." P Frederick McAdam, M.D. tober 1987 with two Department of Rehabilitation compatriots, Carl Granger, M.0., professor, and Byron Hamilton, M.O., Ph.D., clinical associate professor. The clinic is now a division of the Neuromuscular Diseases Clinic and Laboratories of UB. At first, the clinic was held one afternoon a month with two to three patients at the most. However, starting in July, it will take place biweekly (then weekly some time thereafter) so that it can better meet the growing need for special post-polio medical care. "The response to the center has been overwhelming," McAdam noted . Since its establishment, the Post-Polio Clinic of Western New York has remained the on ly facility in the area which provides both clinical care and valuable research for people rescribed treatments vary with each patient . While in Bauld's case a vitamin deficiency was recognized, vitamin supplements aren't a common aid. Anaerobic and stretching exercises also vary with a patient's co nditi on and needs. The specialises at the clinic may even recommend orth otic devices - canes, braces, and walkers - to help conserve the energy of the patient . There is already a lengthy waiting list for treatment at the center. It is difficult co handle the high demand because the initial evaluation and treatment is so time consuming and labor intensive . A physiatrisc, neurologist, clinical nurse specialist, physical therapist, occupational therapist, and social worker may all work together on a single case. Once a patient contacts the Pose-Polio Center, a questionnaire is sent asking for the patient's symptoms and medical history. Then McAdam meets with each patient to assess his or her problem using var ious tests, including X-rays, CT scans (computerized tomography), videoflu roscopy (barium swallowing and monitoring), and ocher lab BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �33 Henry Bauld work. Following this, McAdam and his staff establish a specified program for each patient. Most of the time, these programs are designed co endure for the duration of the patient's life. Overall, McAdam is pleased with the clinic's effectiveness and patient satisfaction. "We'remaking a difference in most people's lives, and chat's what's important," McAdam emphasized . McAdam also pointed out chat while one function of the clinic is to help sufferers cope with this debilitating condition, the other function is to gather and evaluate valuable evidence concerning the syndrome . At this time, there is very little known about post- BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST polio an ,d there is no specified cure for the syndrome. The March of Dimes estimates from polio records ,chat there are somewhere in the neighborhood of 500 post-polio sufferers in the West,ern New York area alone. However, McAdam believes there are probably twice chat number because many with this affliction still think it's just aches and pains from old age. This is why educating che pub lic is another important function of the clinic. Donald O'Conner, president of the Polio Survivor Support Group of Western New York, maiintains a symbiotic relationship with McAdams and the Post-Polio Center at ECMC. O'Connor's group helps educate and inform potential patients - as it did with Bauld - of the center's availability. In cum, McAdam recommends that patients join the support group. The condition of most patients affected by post-polio syndrome usually isn't life threatening, says McAdam. However, those patients who had previously been afflicted with Bulbar Polio - polio which affects the diaphragm, incercostal muscles (voluntary muscles between the ribs), or the muscles involved in swallowing - can be affected more seriously by post-polio syndrome. They may experience respiratory disorders and difficulty with breathing which can indeed be life threatening . • SUMMER 1989 �People 34 LEONFARHIJOINS RANKS OFTHEELITE L eon Farhi, chairman of physiology, has been named a distinguished professor by the State University of New York for his years of work in human lung gas exchange and the human circularory system. The prefix of distinguished professor is considered to be the highest academic title in the SUNY system and is held by only about 50 professors. Farhi joins the ranks of poet and literary critic Leslie Fiedler, Gerhard Levy of pharmaceutics, Felix Milgrom of microbiology, Hermann Rahn of physiology, and Eli Ruckenstein of engineering, among others, as UB faculty who are distinguished professors. The honor "recognizes his tremendous contributions to both the scientific world and the University," noted John Naughton, vice president for clinical affairs and dean of UB's medical school. "We feel honored that he was so recognized and it indicates that the efforts he has made and chat the school has made have been recognized." Farhi joined the medical school more than 30 years ago. "I was offered a job here in '58 and have been here ever since; he said with a content smile. "I have always been interested in the heart and the lungs and also in the effect of gravity on the heart and lungs." Sitting in his office, Farhi swiveled in his chair and pointed out the window on his back wall. "See that?" he asked, as he pointed to a cylinder on a circular track, surrounded by a moat of calm water which in turn was circumscribed by a running track. "That's a human centrifuge. We are the only University in the free world ro have one." Farhi explained chat cest subjects sit inside the capsule as it revolves. Centripetal acceleration from the revolution mimics high gravity situations, up to the equivalent of seven times the earth's gravitational field. What Farhi is currently working coward is a June 1990 shuttle launch. He will be studying blood flow in the astronauts before, during, and after their flight. Sound cumber• some? Needles and blood samples sticking out SUMMER 1989 Leon Farhi, M.D. everywhere? Not quite. "We have developed a technique chat allows us to measure the amount of blood the heart pumps out without putting any needles into the subject," he said. Farhi's technique requires the subject co breathe into a bag. "We have developed a sec of mathematical formulas that allow us to use the rate at which CO 2 accumulates in the bag to calculate the amount of blood that brings it there," Farhi said. "If I know how much CO 2 reaches the lungs every minute, I can calculate the amount of blood going through the lungs ." The amount of blood going through the lungs, he said, is the same as the amount that the heart is pumping out. The experiment itself, Farhi ex'])lained,consists of looking at the heart's output under different amounts of stress while the astronauts are in space and comparing that ro their cardiac output on earth both before the flight and after it. "The heart is an organ which is supposed ro regulate itself. In order ro find whether it is acting adequately or not, we look at subjects at different levels of exercise and determine whether cardiac output is appropriate for that level," Farhi said. "We look at the cardiac output as a function of the power output of the subject." The subjects work out on an exercise bicycle hooked up to a power generator. On earth, each subject is tested ro determine maximum power output. In space, they will be tested at 30, 60, and 90 per cent of maximum, he explained. "Out technique looks at an astronaut before flight as a baseline, then follows up on him or her every day in flight, and provides special emphasis after the return to earch; he said. T he problem that Farhi is looking into is known as cardiovascular deconditioning. What it involves is the heart's adjustment to zero gravity and its subsequent readjustment to earth's gravitation. Problems resulting from cardiovascular deconditioning affect the astronauts after they return ro earth. They have to do with the body's ability co return blood ro the heart from its tissues, especially the legs. "Man has developed a mechanism which allows us ro make blood come back against gravity," Farhi said. In space, he explained, there is no gravity and so the body's methods of pulling blood back up from the legs in to the heart are "unlearned." "It's like riding the tiger," Farhi explained. "As long as you keep riding, you're all right." But "if the astronauts stand up without chose mechanisms once they are back on earth, the blood accumulates in the lower part of their bodies. If it's down there, then the heart doesn't pump it back and the brain doesn't get the right amount of blood." BU FFALO PHYSICIAN AND BIO MEDICAL SCIENTIST �People& Research 35 Farhi said chat chis can lead to fainting in asrronaucs after chey return to earch. "That rums out to be a rather important problem for NASA because it amounts to a loss of che inborn ability to cope with the effects of gravity." Five astronauts, three payload specialises, and two mission specialises have been training for this flight since 1984, when they visited UB to gee a chance to use Farhi's equipment. Two of che payload specialists and both mission specialists will fly on the summer 1990 flight while che ocher payload specialise will fly at some time in the future. The experiment was supposed co be conducted on a summer 1986 shuttle flight but was postponed, due to che disaster which befell the Challenger, on which UB alumnus Gregory Jarvis was flying. Along with preparing for the NASA flight, Farhi is conducting other lines of inquiry. "We've been involved recently with the problem of rediscriburion of blood in che lung; he explained. "If you have an area of the lungs char is not breaching properly, che body shunts blood away from rhose pares to the healthier parts of the lung."This happens in emphysema and pneumonia, among ocher diseases, Farhi said. The equipment in Farhi's facility was paid for by che Department of Defense almost 20 years ago. Besides the centrifuge, which is used for studying the effects of gravity and pressure on man, there is a swimming tank chat is used co investigate man's reaction co temperature. Near the centrifuge and swimming tank, there is a diving tank which is being used by Claes Lundgren, also of physiology, co study the consequences of pressure on man. "ln the late '60s; Farhi said, "the Depart· ment of Defense decided it would be a good idea if there were a few centers across the country char could be mobilized in case of a national emergency. Thar was Project Themis. "Our project was environmental physiology. We proposed to study how various environ menta I factors, such as gravity, temperature, pressure, oxygen levels, etc., affect man and his performance." He said che only Defense Department in- BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST volvement was to help scare the program. The agency provided the start-up coses for the facility so chat in case of national emergency, the Defense Department would be able to turn co Farhi's group for specialized research. lnicially, he had a grant with the Air Force. Currently, he is being supported by the National Heart and Lung Institute. Farhi said he has never done classified research. Farhi's well-traveled career has carried him far from his native Cairo, Egypt. He attended college and medical school in Beirut, Lebanon. He was a postdoctoral fellow at the Trudeau Sanacorium, in Trudeau, N.Y.. 1952-53; che University of Rochester department of physiology, 1953-54, and the Johns Hopkins University, 1954-55. Farhi was also an instructor at the Hebrew Universicy-Hadassah Medical Center in Jerusalem immediately before arriving in Buffalo. In 1983, Farhi was named the Western New York Heart Association "Man of the Year" and in 1978 received the medical school's Stockcon Kimball Award for teaching, research, and service. Chairman of physiology since 1982, he was recently appointed co his third term. • - By David M. Snyderman DETEOING 'SILENT' AILMENTS IN INFANTS R outine ultrasound screening of infants could lead co earlier diagnosis and treatment of significant, yet "silent; urinary tract problems in more than 47,000 infants born annually in the U.S., according co researchers at UB. The projection is based on the investigators' identification by ultrasound of significant kidney problems in six of a group of 437 apparently healthy infants participating in a study reported in Pediatrics. The UB researchers said chat if ocher studies show similar results, the medical profession should consider recommending chat che use of ultrasound co check infants for urinary trace problems become a routine pediatric screening procedure. The cost of the rest, which can be done in less than IO minutes, is about $35. The researchers, led by Jacob M. Steinhart, M.D., UB clinical associate professor of pediatrics, turned co ultrasound to dececc a group of problems chat account for the highest incidence of human birch defects. An estimated IOper cent of all humans are born with some form of genitourinary problem. Despite chac prevalence, the researchers said that in private practice they continued co encounter "significant numbers of children in whom renal disease had escaped diagnosis until an acute illness, perhaps unrelated, prompted investigation of the urinary trace." They added, "\Viedecided co undertake chis study to determine whether it would be feasible and cost effective to screen apparently healthy infants with ultrasound in an effort to diagnose renal abnormalities that might be helped by early treatment." The researchers concluded chat "there are a significant number of infants harboring silent urinary trace abnormalities chat can be dececced by ultrasound at a relatively low cost." Referring co the six infants in whom significant problems were identified, chey added: "le seems likely rhac che monetary cost as well as the morbidity would have been greater had these infants' problems not been diagnosed until they had become infected and/or progressed to varying degrees of renal insufficiency." Referring co the incidence of significant problems of l in 73 in their study, they said "one could extrapolate chat, of the approximately 3.5 million babies born in che Uniced Scates each year, more than 47,000 would have significant urinary tract pathologic conditions." Also participating in che study were Jerald P.Kuhn, M.D., UB professor of radiology and associate professor of pediatrics; Bernard Eisenberg, M.D., clinical associate professor of pediatrics; and three clinical assistant professors of pediatrics: Russell L. Vaughan, M.D., Albert J. Maggioli, M.D., and Thomas F. Cozza, M.D. Kuhn also is head of che Radiology Department at Children's Hospital of Buffalo. • - By Arthur Page SUMMER 19S9 �Classnoces 36 for his efforts on behalf of the care of physically deformed children by organizing voluntary surgical reams willing ro rravel into rural Mexican communities . 1930s Richard C . Batt (M'36) • a retired radiologist, writes, "The past three years of my retirement have been successful as a volunteer in helping to rehabilitate selected brain-damaged patients through computer usage." Bernard St e ll (M '36) • a retired psychiatrist, keep s active by teaching photo amateurs at a community college and by creating phoro slides char bring him honors. "I won an honorable mention ribbon in an internationa l stereo exhibition for my stereogram, 'Thar's My Tongue: Ir is a high-speed sequence (three figures) of a hummingbird in flight with its tongue sticking our. In rhe PSA International Traveling Exhibition, I was awarded a second place ribbon for my srereogram, 'Red Lipped Clown' a 3x magnification of a water droplet with an image of a clown . A water droplet acts like a lens; it projects an image of a clown that is about 12 inches behind the water droplet." Dr. Stell also won, for the second year in a row, first place in the December 1988 contest for the Sun Cities home decorating contest. 1940s Richard J. Buckley, Sr. (M'43) • has recently been elected president of rhe New Voice Club of the Niagara Frontier, a support group for laryngectomees . A lfred S. Evans (M'43) • was elected vice president (president• elect) of the American College of Epidemiology . His busy schedu le includes a paper at a Scientific Conference on Epidemiology in SUMMER IQ89 Ernest A. Fatta (M'63) • of Woodland, Calif., is president of the California Affiliate of rhe American Heart Association for 1988-1989. Richard C. Batt '36 Beijing, China, in April; being a visiting professor ar rhe University of Valencia School of Public Health in Valencia, Spain in June and teaching the Graduate Summer Program in Epidemiology at rhe University of Michigan in July. "In August I will fish." Dr. Evans is the John Rodman Paul Professor of Epidemiology, Emeritus at Yale University. The third edition of Viral fn/eccions of Humans:Epidemiology and Control, (A.S. Evans, Ed.) was published in March by Plenum Press, New York, N.Y. Clifford W. Gates (M'48) • former ch ief of radiology services and chief of outpatient services at the Long Beach Naval Hospital, is retired and living in Fountain Valley, Calif. 1960s Jack C. Fisher (M'62) • has been selected by the San Diego County Medical Society as Physician/Cit izen of the Yca·r. The society cited Dr. Fisher's contributions roward establishing a higher regard for the medical school by community physicians, and also Jeffrey Kahler (M'66) • was recently elected to serve a oneyear term as president of the medical sraff ar Sr. Joseph Hospital, Cheekrowaga, N.Y. Dr. Kahler is rhe director of the hospital's orthopaedic surgery section. 1970s Denni s E. Stemp ien (M'73) • was appointed associate company medical direcror of clinical medicine at the General Electric Company in Fairfield, Conn. Melvin Pohl (M'76) • of St . Louis Park, Minn., is medical director of rhe Pride Institute and co-chairman of AMSAODD' s Third National Forum on AIDS and Chemical Dependency. Barlow S. Lynch (M'77) • has a private urology practice in Washington, D.C.,and is an assistant professor in the Deparrmenr of Urology at George Washington University, Georgetown University, and Howard University. Ira L . Sa lom (M'77 ) • writes, "I am enrolled in rhe J.L. Kellogg Foundation Sponsored Advanced Management Program for Clinicians at the NYU Graduate School of Public Administration." Pete r E. Shields (M'79) • is a fellow of the American Academy of Orthopaedic Surgeons. 1980s Thomas J. Lane (M'81) • writes from Bristol, Conn., that his research interest is in chronic fatigue syndrome. Dr. Lane is an assistant professor of medicine at the Universiry of Connecricut Health Center. Richard L. Co llin s (M'83) • has been named medical director at the Northwest Buffalo Community Hea lth Center, a federally funded medical center for the medically underserved . Kenneth Ja y Ru th (M'83) • writes, "I am in solo pracrice in internal medicine in a San Diego beach community. My practice is growing rapid ly and I'd be most interested in having a fellow UB grad as an associate. Please call (619) 226-4524." His address is 5825 Caminito Del Estio, La Jolla, Calif., 92037. Brian Gale (M'87) • writes, "I am a nuclear medicine resident at the Albert Einstein College of Medicine and will begin a radiology residency at New York Medical College in July 1990. I will marry lawyer Marla Kirsh in Augusr '89." Tina Marie Gardne r (M'87) • writes from Fairfield, Maine, "We moved from New York City to Maine; we love the fresh air and free parking. This program is much berrer too?' Dr . Gardner is a resident physician in the MaineDarr mou rh Family Practice Residency Program at the Kennebec Valley Medica l Center. BUFFALOPHYSICIANAND BIOMEDICAL SCIENTIST ��CAMPUSMAIL 998 MR. CHUNG•KAI HUANG HEALTHSCIENCE LIBRARY ABBOTTHALL CA...,PUSMAIL � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Summer 1989 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1989-Summer Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v23n02-1989-Summer Table Of Contents A list of subunits of the resource. Boon or bane? Spring Clinical Day Medical School News. Hospital News. People. Research. Classnotes. Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-08 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v23n02 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1989 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/e75df90ccdda2d8d51acc53ae4a881d8.pdf 4d453869241aa240ad70c4d0932ac018 PDF Text Text Vol. 23, No. I Spnng 1989 and Biomedical Scientist ~ Procedurecan save lives­ but donor organs are needed �STAFF EX[ Cl 'TIVE E[)ffilR UN vl'RSITY PL RLIC'ATK'NS Rehcr1 T M irlcr 6t'rFALO ffi'r<;IC IA1\ l'[)ffi)R C ( l'OIC ()s, 1ld S10110 ART o: {fC'Tl 'R A, in I Kcgl.r Dear Alumniand Friends: 0 n Feb. l, President Stc\en B. Sample announced that the L'nhersity at Buffalo had h,ecn ,m1t<.-dto jom thc_prest1g1?us Assoc.1at1onof AmL'T!<.an Gmversmc-s (AAUl. Tlus orgaruzallon, founded in JQOO , has 5o members, .1 rcprt-s<.:nt,ltlonof tw0 per cent or less of all American umvcr,mes . Sigmfkant in this v~-ar'sadmissions 11asthe fact char rno p:1bhc inst1tut1ons, both from the East, rather than one publ1<.and one private in,titution, each w<:reasked to JOlll. The Uruversity at Buf• falo 1s rhe first public institution from either ~ew York St.tte or New England Jdmirred w th<: organi:arion. The other invitee is Rutgers University. The other member institutions from Ne11 York StJte <1reColumbia, Cornell, ~ew York University, Syracuse, and the Umvers1ty of Rochester. Our acceptance into this important organi:ation signifies the growth and academK maturity that has resulted in the short period of 25 years smcc the merger of UB with the SUNY system. Tod av, Buffalo's l.Jnivcrsity rep resents a comprehensive unit committed to excellence in research and teaching, and to servicing a broad public mission. Special recognition and congratulations are due President Sample, who set this achievement as a major goal from the beginning of his presidency seven years ago. There is little doubt that all of us who current'.y associare oursdves with this academic eN<-rprise and those who J0tn and follow us will benefit enormously in the years ahead. \X'e owe the fTes1dem ,:md Sl.JNY a great debt of gratitude. I hope ) ou are as pleased as we are. ADVISORY BOARD Dr John :--=au~hton,rli.:,rman Dr. H .old Brody ?\ts. N1n1.y GI C\.O Dr. James Knrua, Dr t harl~ P O ,ncll· \.tr. G~•>:"',' Zinc: Dr Antoinette Pctcr-s Dr. l harlc Pru, • Dr. l ,1>i., Rob·.,-;on r>r. rhor RiY.-tnt•11 Dr. S.k•d, Sures [)r b1..rron ')in.ge--man Dr :01erhcn '>1 ulJinc Dr ?\:cl.on rorrc Mr. EJ,.. ird \'<,.,:kc nr f'.:.._ I \\ 1cr; 1 lcr 'l""[)r Jerernc:-Yates WRITERS M \IJ,-,bdi UK l Ar(I _ !'a~t: ILi USTRATORS L1 H~ncy ), re Mir k~ P ul '-•p,ko" k l\.t1kc: ~- ,Iosc1 , c , D ,-, l ,kroc:.·msk, l'HOTOl:RAPHERS ~-L 1-"' \l.•k ' rn:~~LJ Jo hn Na ughton, M.D. \'ice Prc"de'll for Climcal AJfa,rs Dean, School of \ Lhme and Bwmed".al Sciences &,\-, \'( ''"' H.ACHl:S:G HOSPITALS AND LIAIS01'S o· • \ \ ..tcranir. AJn, \'c._:'P.uft 1 .,.r••no: '-crrc Buff..!o Gcn\.r,. 1n1 V \h •• AJrr r · 11 ,nrc 'ohn I ill \kd, ,t , ( b,IJ,,,-, Ho II • l\.an:n Fr. ( um1 \1 l, ,I l n· r, \f'- 0 \1 0 'tl .._,,. nn"'~u ' \1rn Dear FellowAlumni/Alumnae: l➔l h:nn .> \ Ho rt 1 • '- hui.. k, r.u:<(: M,llord F 'lmon- .!, pu ,I, !) l'l J,'rlfl I r ... \1i me. 1al : ' K. " 'i r H< r . I),. nn tit . . .. I-ct \~ -< .artlr- Rt!~ j n .. r'!, ~I JUlo<~~ ~l~ n.; fli' >l Ff \:....l PHY-,ICIAN A \l[) BIL' \lEl11l \~ ,( IEl',,rt,r ,L ,f"i "t> r ,,, '5( \I \dune. ~ ,,1 'luo •er I fu,.,1 1-\ h\c: t mL ~•· · u~ 11\· "'ip..m~ "-lu1 11Y.r, \ ·u1 r--, f. r v \X.mtcr, 1nJ ii..u W t • 1-- th 'i<hoc•I.,. \.kJ1o n, mJ Bmri.l-Ju.. ,1 Sl1cm.1. . ~t.: • l .1 ,er ·\ c•f i\ic.\ Yn·k lt B -,11 l•f\C. \1am '"itrcc·, Buffa!~ 1', , for. I,!•; flu-J , ulk pl . [ p11' f bL.""1 l, ~ "- Yul Send JJrc c mg, '" n:E BL Fl'\.ll PH) -,I( I\ \l AN[' AIL)Mfl:',C \L 'ip ~u_~•:~: IE1';T'>f, 16 ( F 5. AdJ,· " '-t t Buff lo 1', " Y,·l I t .s hard ro heltl'\L rh.H my year as pn ..,tdLnt Jf thl' Alumm Assocaoon 1s .1lrcady ~oming tC',1n end The Sprin~ Cl ,mc.ill Dav k'Stl\ ttK>s,induding the educ anona, sesstC'ns,ind •he gal,1 e\ent for the reunion c.'as,e,, ,!Tl'Sl't for the \\cekend of Mav 6. 1h,s \e,lf the :-.1edtlJI Alumm Assnc.,ation will stirt a nc\\ award for , medic.ii ,tudent or students \\'1th the highest .ic.ademK achkvemcnt in their first and se<.ond \cars. It has heLn noted b\ our board th.it studc:tts rc:c.e1vcs,hul,ir,lups upon <:ntmnce to ,choul, but altu rh.,t the: highest 1-h1e\l'rs .tren't honored before the third year. It is our attempt to recognm: those students. As mentioned in prtvious \Hl'!ngs, the Distinguished Ahmnu,1A:umna A\1,:,.rd, sponsored 1:-ythe A:umm Assouatt('!'l, will he presc:mcd rh1s fall Ad nner honormg th·s person will be held Ill c.Onjun,tton \I 1th our Pa,t Pre,id<.'nts' Dmner. \Xt will h·ep vou po<ted .1, to rhe winner, .Jnd \1·eexrend an opt:n mva.,tion to ill! .,!urns to attend the dmner. In .:losm!l, note thJt 111 the <.<'!"11111!!y~.1r.the Medical Alumn· \I uh the flepartmenrs of Surgerv Assoc1anon will c.o-ho,,trc.-ccpt1011s .,n..l Ant:<tht:si,1 ,,t their 11.it1unalmeetmgs. \Vt: 1m ,te alumm in the .trca, 0( the nauon.il meetings to .JttcnJ. 1 •l t IZl4 cJ?d/V ~~ Paul H . \\'icr:bicn ic c, M.D. �Vol. 23, No. I SPRING 1989 Features 0 Theelusive miracle.Heart transplantation El A hot new field. Thermography, which maps the can be a lifesaving miracle, but the shortage of donor organs keeps this miracle out of the reach of many. various skin temperatures on the body, has great potential in the diagnosis of circulatory and neurological disorders, say UB researchers. ffl Earthquake. UB physicians offer medical assistance to victims of Armenia's December quake. Page 2 lffl BoneGrower.Munro Strong, M.D., associate professor of orthopaedics, pioneered the use in North America of a revolutionary apparatus for people with limb deformities and severe fractures . Page 25 Departments '1'1 Research. Testing "clot busters," cutting costs in trauma cases, and exercises for arthritis of the knees are subjects of UB researchers. ffi1 MedicalSchoolNews. You could call them the unsung heros of the school. They're the voluntary faculty who receive no pay but provide a vital service to the school. Page 21 Page 12 ml HospitalNews. iDJ People.The focus is on Thomas R . Beam, Jr., M.D., who's looking at ways to speed up the FDA's drugapproval process, and Peter Ostrow, M.D., Buffalo's only physician/TV reporter . Spotlight . The watercolor work of cardiologist Ivan L. Bunnell, M.D., Class of 1943, is featured in our premiere of this department. In each issue, we'll take a look at the artistic work of one of our alumni, students, or faculty . Classnotes. Cover lllurtnrtion: Mike Wolruchinow ��3 FORMANY, HEART TRANSPLANTATION REMAINS A DREAM By CONNIE OSWA LD S1DFKO harles Hilton knew he was going to die soon. Though they didn't tell him, his doctorsthought he'd die that night. He couldn't eat, couldn'tbreathe,couldn'twalk. His anginacausedconstantpain. His only hope was to get a heart transplant."I had nothing to lose,"Charles said. "Anything would have been an improvement- even death." Charles was one of the lucky ones. He got a heart in time. That's the life-saving miracle of heart transplants. Bue ochers aren't so lucky. Across the country, 20 co 25 per cent of heart transplant candidates die while waiting for a donor organ, according co Robert M. Mentzer, M.D., director of UB's Heart Transplant Program and a professor of surgery. "It's a very serious prob lem," agreed J. N. Bhayana, M.D., co-director of the program . "We're losing patients ." In Buffalo, heart transplants have been performed since 1984, first at the Veterans Administration Medical Center and now at Buffalo General Hospita l as well. In chat time, 23 transplants were performed. Five people died while waiting for a heart, and, as of February, there were more than iO more patients waiting. Another 15 are being evaluated as possible recipients . SPRING 1989 The UB program has excellent facilities, a top-notch staff, and plenty of willing patients . There's only one shortcoming : the number of available donor hearts. One reason for the shortage is that as heart transplantation lost its experimental status, more and more new centers opened . In 1984, there were only 32 centers in the United States. Now there are 135 and counting . That's causing keener competition for the organs. Another major problem is that people just don't understand about heart transplants . "People don't even realize organs can be transplanted, or they don't know which organs can, or they never thought about donating organs; said Elizabeth A. McNamara, M.S.N., R.N., che transplant coordinator for the Organ Procurement Agency of Western New York. "Then they're faced with the sudden, tragic loss of a loved BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST �4 obert M. Mentzer, M.D., director of UB's Heart Trans, plant Program: "We have to try to think in terms of not wasting organs." one, and when they' re asked if they want to donate his organs, they may say 'nd because they're not ready to deal with it." McNamara pointed out that the best organ donors, especially for hearts, tend to be young, healthy people who suddenly suffer brain death. It's the guy whose motorcycle spun out of control. Or the one who fell during a fist fight and hie his head on the sidewalk. Or the child who walked out between two parked cars. "That's the rub~ she said. "These aren't predictable deaths. The family has just lose a loved one they may have been speaking to a few hours earlier." And the idea of brain death is difficult for families. "It's rough for the family to accept chat their beloved one has died," said Bhayana, associate professor of surgery at UB. "But if they wait too long, the heart may stop or there might be an infection of the lungs. Then the person is no longer a candidate for donation ." "Even within medicine and nursing, you'd be amazed at the number of people who are nor comfortable with the term 'brain deach:" added McNamara . "They chink, 'Well, maybe the person's not reallydead .'" Exacerbating the problem is the fact chat there's no Scace-wide criteria. Instead, the Stace has empowered each hospital co decide how many flat EEGs and ocher evaluations constitute brain death . Because chis is such a trying moment, hospital staff members are often reluctant to approach che family about SPRING 1989 possibly donating organs . "Some of the professional staff take it on themselves not to ask the family, chinking the family won't be able to handle the emotional strain," McNamara said. "Bue chat's nor fair to chem-we need to give chem rhe opportunity to say 'yes' or 'no? "In the IS years I've been in nursing, it's the hardest thing I've ever done. But there's also a redeeming aspect. le helps them go through the grieving process. And it helps chem build a kind of memorial co their loved one to know chat he or she has given three or four people a second chance at life (if several organs are recovered). "I just spoke with a mom whose daughter died in a car accident. She calls every so often to talk . The daughter was an only child and chis was the parents' first Christmas without her . They got through it because they thought of the people who could go on living. They were very happy they gave consent." Boch the Scace and federal governments have now passed laws chat mandate chat families of suitable organ donors muse be given the opportunity co donate, McNamara noted . Every hospital has designated a key person who will be the one co approach the family when brain death is imminent . While a person is still well, he can sign a donor card pledging his organs at his death, or sign che special space on the back of the New York State driver's license. These are considered legally binding . BUFFAID PHYSICIANAND BIOMEDICALSCIENTIST �5 N. Bhayana, M.D. , codirectorof UB's Heart Transplant Program: • "It's a very seriousprob­ lem. We're losing patients." But the most important thing he shou ld do is let his family know his wishes, said McNamara, because the agency won't accept an organ without the family's consent . "Ir's great to carry the donor card around with you, but if your family doesn't know anything about your decision, it's worthless," she said. Because of the high level of emotion that may be involved, the agency won't accept the donor if there is overwhelming family disparity . "We don't want to cause a permanent emotional rift in the family," she explained . In addition, the bad feelings it would generate would work against the agency. "If you turn off one member of one family, and that person tells the story to 50 or 100 people, it turns all of them off; McNamara said. If there is no known next of kin, the agency won't accept the donor . Some people are reluctant to give consent because they hold misconceptions . The agency tries to overcome this problem by assuring the family that donating organs won't cost them any money, that it won't mutilate the person, that they can still have an open casket funeral, and that major religious denominations allow organ donation . Still another reason for the shortage of donor hearts is the small geographic area from which they can be drawn . The average maximum ischemia time is four to five hours; that is, the donor heart can be without blood flow for only four BUFFALO PHYSICIAN AND BIO~EDICAL SCIENTIST to five hours from the time it is removed until it is transplanted . That limits the distance the transplant team can travel to recover a heart . Another factor that may aggravate-or alleviate-the shortage of donor hearts is a new distribution system that started in January . Those involved agree that it's still too early to tell how it will affect Buffalo's program . Under the new system, if a heart is available in Buffalo, the Organ Procurement Agency of Western New York contacts the University transplant program . If there is a suitable recipient at Buffalo General or the VA, the organ stays in the area. (fhe donor heart must be compatible in a number of ways, including size and blood group.) If the Buffalo program can't use the heart, the local procurement agency contacts the United Network for Organ Sharing (UNOS), a national network . That group runs a computer match to find a recipient within a 500-mile radius of Buffalo. Out of all of the suitab le candidates, the person who has been waiting the longest gets the organ . But what happens if a donor heart is available in Rochester or Syracuse or Albany, cities which don't have their own transplant programs? Under the old system, a candidate first would be sought within New York State, so Buffalo would have a good chance of getting the organ . Under the new system, however, the organ goes to the candidate within a 500-mile radius who has been waiting the longest . Ir's feared by some that out-of-State centers will get srrui-o 1989 �Say 6 lizabeth A. McN a~ mara, M.S.N., R.N.: Hospital staffs often ......... are reluctant to ap~ proachfamiliesabout donating organs. many of the hearts that, under the old system, would have been sent to Buffalo. People are also concerned chat these centers won't reciprocate and send hearts ro Buffalo because these ocher centers are larger and able to use every heart that becomes available in their local areas. "Because the system is changing-we hope it's changing for the better-we're not sure how these changes are going to affect our programs;' said Mentzer. "But we all share the same goal, which is to gee as many donor organs to as many patients as possible, no matter where they live. "We're always talking about the patient, but equally important is protecting the donor supply. We have to cry to think in terms of not wasting organs, and placing the donor organ in an environment that has the best chance of being successful, because there is such a demand." Still anothe r factor contributing to the shortage may be the sheer newness of everything surrounding heart transplants. Western New York has had a system for procuring hearts since only 1983, Bhayana pointed our . Before chat, each hospital acted on its own. And since the University program is so new, it doesn't yet have rhe community awareness and support that other, more established programs have, Mentzer added. Predicting the future of organ procurement is difficult . New problems may crop up. For instance, the spread of AIDS may cut into the supply of donor organs in the future, Bhayana and Mentzer speculate. SPRING 1989 For now, a number of solutions to the shortage are being examined. Researchers are looking for ways to increase rhe length of time rhe donor heart can be without blood flow, as has been done with livers. Livers once had to be transplanted within eight hours, but now a perfusion solution has expanded that time frame to 24 hours, allowing chem to be distributed all over the country, McNamara said. Also, the maximum allowable age for heart donors has increased, Mentzer pointed out. It's now 40 years old for males and 45 years old for females. Organs from older people aren't accepted because it raises the chance of implanting a heart with coronary artery disease. The key solution to the shortage, Mentzer, McNamara, and Bhayana agree, is education of both medical staff and lay people. Ir's important to educate the smaller, rural communities around Buffalo, said Bhayana, such as Jamestown, Olean, and Warsaw. "Thar's where we're going to have our donors;' he predicted. "We're trying to get a foothold into the community, especially into the minority community, through the clergy who deal with death and dying every day;' McNamara said. Many minority people have strong religious beliefs, she noted, and if their minister stands up in the pulpit and endorses organ donation, the efforts will trickle down . The organ procurement agency also conduces free BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �7 harles Hilton pends on a suitcasefull of medication, but he and hisfamily see his transplantas "a gift of life and God's miracle." workshops and seminars, and will make presentations to clubs and "anyone who's willing to listen," she said. "We're always in need of additional media attention." "I want to emphasize chat the media has to help us educate peop le," Bhayana added. "If someone is brain dead, his family owes it ro society at large to use his organs ro save somebody else. Thar's what will he lp us." Mentzer pointed out that it's important to get across the idea that organ donations have the potential to save a life. "As long as we can continue to emphasize how important organ donation is, and what the benefit is, we can separate the tragedy of the death from the goodness of the gift," he said. "It's a gift of life and it's God's miracle,"says Martha Hilton, Charles' wife. "There are miracles." Sept. 2, 1986 was Charles' 54th birthday. And it was a birthday in the true sense of the word because that was the day he receiveda new heart at the VA and a new chance for life. Charles' heart camefrom a 17--year-old killed in an all-terrain vehicle accident. "That was the one sad part-that someone had to die to let my husband live," Martha said. The desperatelyill patients waiting for transplantspray for hearts, Charles said; not hoping that someonewill die, but hoping that if someonedoesdie, the heartcomesin time to save their lives. It's difficult for them to wait day after day wonderingif they'll BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST survive long enough to receivea heart. One fellow Charles knew waited three years without getting a heart. A couple of his friends have been waiting six months. Charles had an unusually short wait-only a week. It's been about three years since his transplant at the VA, and Charles,a retiredapartmentsuperintendent,sayshe feelsgreat. He walks a couple of miles a day in the winter and 10 miles a day in the summer. A new endeavoralso keeps him busy. Knowing how difficult it was for his family to commute almost three hours from his daughter'shome in Naples, N.Y., to the VA,Charles hasambitious plans to open a housein Buffalowherefamiliesof out-of-townheart transplantpatientscan stay at no cost. He speaks to veteransgroups lookingfor donations,which can be sent to him at 18 Mark Circle, Naples, N.Y., 14512. Gratefulfor the secondchancehe got, Charlesalsodoespublic speaking on behalf of the Organ ProcurementAgency of Western New York. Through the agency, the Hiltons sent a letter to the family of the teenagedonor, thanking them for chisextraordinary gift. "Everytime my husbandhasa birthday, their son hasa birthday, too," Martha said. • Editor's ::-..'ote: For more infonnac1onon che Organ Procurement Agenof Wbtcm ::-..'ca)ork, Inc., call I-800-227--1771. For more information on ihe UB!Bujfa/o General Heart TransplantCenter, call 1-800-2-12 00-15. C\' SPRING 1989 �8 SPRING 1qgq BUFFALOPHYSICIANAND BI0~1EDICALSCIENTIST �THERMOGRAPHY: A HOf NEW FIELD By CONNIE OSWALD STOFKO he patient's image appearson the computer screenas blotchesof garish reds, blues, and greens,lookinglike a wild paint-by-numbers . The facial features are indistinct, but that doesn't matter. This picture is more like a map than a portrait. The picture was created using a technique called thermography,which maps the various skin temperatures on the surface of the body. This data on distribution of skin temperatures has great potential in the diagnosisof circulatory and neurologicaldisorders,say UB researchers. And they're ready to take the lead in the new and growing field of thermography. "Currently, we are the most active center for thermographyresearchin the country and are expanding rapidly," said Michael Anbar, M.D., chairmanof the Departmentof BiophysicalSciences at UB. "We've got cameras matched by nobody. We've got software matched by nobody-because we developed it. "We want to make Buffalo the national center for thermographyresearch." BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST SPRING 1989 9 �T hermography is a relatively simple technique. "It's ve r y much like taking a 10 photographic image-the re's a camera , it looks at you, it takes your picture. You can even smile if you want to," Anbar quipped. The camera is a rectangular , black metal box about two feet long. A spinning mirror located in a recess of the box picks up the light reflected from the surface of the subject . The light is reflected to another mir ror inside the box, and then to a third. Finally, the lighr is reflected inside the box onto a detector rhar's sensitive to infrared light. (Everyone emits infrared light. Broadly, it can be said that the intensity of the infrared light depends on the temperature of the subject.) The detector changes its resistance depending on the temperature char falls upon it. If a photo detector were used in place of this infrared detector, you'd get a photographic image, Anbar noted . Using the thermographic camera, vivid color images that show the distribution of skin temperatures are produced on a computer screen, displayed in colors ranging from hot red to cold blue. Since skin temperature is a function of the pe rfusion (or blood flow) under the skin, hot and cold spots can indicate problems wirh blood vesselssuch as clogging of the arte ries, thrombosis, or an inadequate blood supp ly to the feet of diabetics. "Whenever you have a perfusion problem, thermography is ideal because it's non-contact, non-invasive to the extreme, it doesn't hurt, you can repeat it as many rimes as you like, and you can quant icace the resulrs; said Anbar . "I feel we haven't scratched the surface of its potential:' Changes in skin tempe rature and blood flow can indicate more than circu latory problems. Since blood vessels can constrict or dilate depending on signals from nerves, we can learn about the behavior of nerves by watching the behavior of blood vessels, Anbar explained. Thermography cou ld be used to flag a pinched nerve or a disorder of the sympathetic nervous system . Thermography can also be used to SPRING 1959 "visualize" pain. That's because when a nerve sends a signal to the brain that registers as pain, it's often associated with a change in blood flow. If the affected area of the body shows a change in temperature, it might indicate that the patient feels pain . However, even if nothing unusual shows up on the thermographic image, the perception of pain can't be ruled out. While this technique can be very helpful in rehabilitation medicine, it also can be abused, Anbar pointed out . Lawyers like to use it when they suspect that a litigant is faking an injury in order to collect money after an accident. "T he r mography has fa llen into disrepute because it has been used so much by the legal profession as a kind of lie detector for pain," Anbar noted. While thermography is now used most- ly in non-surgical procedures, it has great potential for use during surgery, Anbar believes. le could be used in all surgical procedures where perfusion is critical, such as during organ transplants . "Here's a non-contact technique char tells you whether perfusion is uniform, and it could be performed du ring surgery," Anbar said. T he University researchers are investigating ways that thermography can be used to assess irritation to the cornea and to try to prevent the rejection of corneal transplants . Thermography could also be used to check on the healing of skin grafts. The researchers are developing new computer hardware and software for thermography, as well developing better diagnostic tests. 0 EGREES CENTIGRADE 32.4 32.0 31..7 .. 31..4 .. 31..0 30 • I ''ffjl •' 7 .4 ·1 :~ . ~..... 30 ~~, ii. BUFFALO PHYSICIAN �They want to take the subjectivity out of thermography. Instead of simply looking at a thermographic image and making judgments about "hot" and "cold" spots on the body, the researchers want to be able to assign number values to the data . "We're focusing on quantitation of rhermographic information;' Anbar noted . "Ar the moment, we're the only ones in the count ry doing this." The researchers also are crying to develop "normative data; chat is, data from healchy people to provide a baseline for comparison co different pathologies. They hope to use rhermography as a model for diagnostic imaging in general. T he data they're developing may be applicable to any diagnostic imaging problem, from X-rays to ultrasound. "An image is an image, no matter how it's generated," Anbar noted. The UB team is an interdisciplinary group char includes : • Robert A. Spangle r, M.D., Ph.D., associate professor of biophysical sciences at UB • John Loonsk, M.O., instructor in biophysical sciences at UB • James Montoro, biomedical engineer in biophysical sciences at UB who is developing quantitative techniques • Kyu-Ha Lee, M.D., associate professor of rehabilitation medicine and director of the residency program in physical medicine and rehabilitation at UB as well as chief of rehabilitation medicine at the Veterans Administration Medical Center • Linda A. Hershey , M.D., Ph.D., associate professor of neu rology at UB and chief of neurology services at the VA • Steven M . Steinberg, M.D., assistant professor of surgery at UB and chief of the surgical service at the VA • William H . Coles, M.D., M.S., professor and chairman of ophthalmo logy at UB and clinical director of ophtha lmology at the Erie County Medical Cen ter. A relatively new field, computerized rhermography has existed for only about IO years. Buffalo's first rhermography camera arrived at the Veterans Administration Medical Center less than three years ago. Buffalo now has three such cameras-two at the Veterans Administration Medical Center and one in the Department of Biophysical Sciences at UB . By 1992, Anbar hopes to have seven or eight in the area. The Department of Biophysical Sciences decided to put a great deal of effort into thermography because it's a problem researchers here can attack with relatively inexpensive equipment, Anbar said. For example, an MRI (magnetic resonance imaging) machine costs about $2 million to buy and $1 million to run. Thermography equipment costs about $100,000. T hese gra:,•-sca le th e rm og raphi c im ages show th e hand s of a pa ti ent s uff e rin g f ro m a neur olog ica l di so rder. T he han d at left is co ld er . than th e on e a t ·; right. A NO BIOMEDICA L SCIENTIST "We cannot easily become leaders in areas which require larger investmentsand we should be leaders; Anbar said. "With chermograp hy, it's not a 'me-tod situation . Thermography is one of those areas where we have an advantage over anywhere else in the coun tr y." Hardly a bargain-basement techniq ue, thermography can do things that other techniques can't . Thermography looks at the functions of the body, while othe r techniques, such as X-rays and MRI, look at the structure of organs or tissues. The rmography assesses the surface of the body, while the ochers look inside the body . All of the tech niques operate differently and the information each provides comp lement one other. "Thermography is not a substitute and it's not a competitor to these ocher techn iques ; Anbar emphasized. "They're very different. "Thermography can identify physiological phenomena that can't be identified by other means . T here's no simpler, more direct way to measure" some of the functioning of the nervous system. • SPRIN G I9S9 11 ��FromDestruction to Recovery B y M A The Armenian R K MARABELLA rom their devastated homeland in the moun- earthquakein tainous region of Armenia, 10 young earth- December devastated quake victims arrived at snowy Buffalo cities and International killed 50,000 Airport in February for treat- people. But for ment at Children's Hospital of Buffalo and survivorslike MartinMekret- Millard Fillmore Hospital-two major chian, left, life goes on-with help from hosp itals affiliated with UB's Schoo l of Medicine and Biomedical Sciences. some UB physicians. Children's treating youngsters, seven H ospital is Armenian more than any other American hospital. The children range in age from 5 to 14. UB physicians affiliated with the Hand Center of Western New York at Millard Fillmore are treating a 17-year-old and two Armenians in their early 20s. BUFFAW PHYSICIANAND BIOMEDICALSCIENTIST SPRI!'< G 1989 13 �14 Munro Strong, M.D., associate professor in orthopaedics at UB and orthopaedic surgeon at Children's Hospital, was one of a team of 10 American medical personnel who traveled co Armenia for the difficult cask of choosing which patients were co be airlifted to the U.S. for continuing medical treatment. During his nine-day stay in Armenia, he and physicians from Syracuse, Boscon, Philadelphia, and Chicago, in cooperat ion with Armenian officials, selected a coral of 37 patients for treatment in 10 American hospitals . The Armenians were chosen for medical treatment in the U.S. if their injuries were liferhrearening, infected, or healed improperly, according to Strong . Many will receive prostheses and rehabilitation during their stay. "Ideally, you would like co help all of the children and bring them all back co the U.S.," acknowledged St rong . "Unfortunately, we can only directly assist relative ly few of these kids, but these kids we help will gee excellent medical care here." An est imated 3,000 to 4,000 Armenian chi ldren are suffering from serious injuries including broken spinal cords, crushed pelvises and limbs, and infected SPRING 1989 fractures . The earthquake, which hit two and a half weeks before Christmas, claimed the lives of more than 50,000 men, women, and children . Those who have survived or sustained injuries have lose others in the catastrophe . "The children who made th is trip are extremely frightened; Strong emphasized . 'They have been through a great deal. Most of chem in face have lost one or both of their parents. Many of their parents were never even found. Many who came co the U.S. were accompanied by an older sibling, an aunt, o r a grandparent as their guardian ." Buffalo became involved in treating the Armenians through Robert Gillespie, M.D ., acting chair of orthopaedics at UB and chief of orthopaedi cs at Children's . On Christmas Eve he received a phone call from officials of Project HOPE, an independent, nonprofit, international, health education foundation lilit Ermand- based in the U.S. Both G illespie and Strong had worked with Projian, S, left, ject HOPE as orthopaedic consultants to the Pediatric Institute of Krakow, Poland for the past two years. The radiates suninstitute is the largest hospital for children in the world shine. Below: and is affiliated with Project HOPE's continuing education of Polish and Soviet medical personnel. ArevikToroProject HOPE had been contacted by cop White House officials following Soviet Premier Mikhail Gorsian, 13, and bachev's request for aid from the U.S. SonjyPangoian, Strong emphasized char the airlift and treatment of the Armenian child ren is merely an initial gesture 17, are mesfrom Project HOPE, which negotiated a more enduring relief initiative with the Soviets and their Ministry merizedby of Health. The long-term project includes plans co Americansoap develop a rehabilitation facility in Yerevan (the capital of Armenia located 3 7 miles from rhe site of the operas. catastrophe) in cooperation with Armenian authorities . Initially, the facility will provide services co earthquake victims requiring continuing treatment for their injuries. Children fitted with prosthetic devices in the United States will need co have them mod ified as they grow. The project will include training technicians co operate the Yerevan facility and establishing an or- BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �chopaedic and plastic surgery exchange program with American hospitals and universities. "There is no ability co make prosthetics or rehabilitate people with upper-extremity loss in Armenia," noted Strong. "All of the children who had injuries of upper or lower limbs were left unsplinted, so chat the patients we found who had upper extremity nerve injuries had their joints contracted in one (contorted) position or another." There is a great dea l lacking in the medical expertise of the Soviet Bloc as well as the Eastern nations in general, Strong said. He reported that he did not see one spline of any kind the entire time he was in Armenia . "Many concepts considered basic to medical care are not known or regarded there-such as the need for splines or removal of infected bone without the need for amputation," Strong pointed out . Nevertheless, he emphasized chat the Armenians, given the available facilities, did a "remarkable and massive job caking care of the hundreds of thousands of injuries chat literally came into Yerevan within the first several days." It's hard to envision the devastation of the quake . In Leninakan, a town with approximately 200,000 inhabitants, officials blew up unsafe buildings every day at 4 p.m. and dragged the rubble outside of town,. In Spicak, a town of 30,000 chat was very close to the epicenter of the quake, 50 per cent of the buildiings were destroyed and the other ha lf were unsafe . T hose who survived had to be evacuated . "In a small village of about 2,000," Strong sob1~rly recalled, "the entire place was leveled. Not a single structure was left standing. There was simply a pile of rubble for about two miles along the highway . ''Any medical system, no matter where it might be located, would be overwhelmed by such an event. The people there worked night and day in order co save BUFFALO PHYSICIAN AND BIO MEDICAL SCIENTIST few were as 15 lucky as Artem Horontyunian, below, who traveled to Buffalowith his mother.The girls at right check out Polaroidsof themselves. lives." Strong urges people, particularly in ArmenianAmerica n communities, to continue opening their hearts and responding to the needs of the Armenians. Buffalo's Ronald McDonald House, which affordab ly houses our-of-town families of patients who have traveled co Buffalo for medical treacmenc, has graciously opened its doors co the parents and guardians of the Armenian victims. Moreover, all of the hospital services, equipment, and the medical attention given by the Americans have been donated without charge to the victims or their government . "le is a tribute to the quality of medical care available in Buffalo,"noted John P. Naughton, UB vice president for clinical affairs and dean of the medical school, "chat UB physicians working at two of our major affiliated hospitals will treat the largest number of children-IO-airlifted from Armenia . "It is also a tribute co Buffalo's reputation as The City of Good Neighbors' chat it will play host to the families and guardians of these young patients?' UB President Steven B. Sample commented that, "shortly after the Dec. 7 catastrophe, the University at Buffalo was able to lend engineering and technical expertise to the people of Armenia through our National Center for Earthquake Engineering Research. We are pleased to be able to continue this international commitment through our participation in Project HOPE's humanitarian program?' • SPRING 1989 �16 BO GRO R This one device can lengthen or straighten a limb. It can grow strong, healthy bone in the gap left by the removal of infectedbone. And it can do it better and faster than other treatments, says the UB orthopaedist who pioneered its use in North America. By MARK MARABELLA lthough its appearance may resemble a gruesome medieval torture device, nothing could be further from the truth . Called the Monticelli-Spinelli External Fixation System, this apparatus of stainless steel wires, nuts, and rods is a revolutionary system which has given new hope to patients with limb deformities and severe fractures. "The European company that manufactures this device didn't realize the importance of what they had: asserted Munro Strong, M .D., an associate professor of orthopaedics at UB. "I had a difficult time convincing them to increase its production and distribution for use in the States. "This one device can be used to correctangular deformity and limb length, abnormal growth, and rotationa l adjustment." A • SPRING 1989 Ant hony H int o n It has been used for patients who need to lengthen one leg that is shorter than the orher, to straighten a leg that is crooked due to abnormal growth, or to grow healthy bone in the gap left by the removal of an infected bone segment . Ocher devices aren't able ro perform so many diverse functions, Strong noted. Furthermore, they require more extensive surgery and often require rhe use of plates or grafting, which result in weak BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �17 and britcle bones that are more susceptible to fractures. The Monticelli-Spinelli device requires a shorter treatment period than other devices, with only a brief stay in the hospital when the device is initially attached. The device is monitored and cleaned by the patient daily, requiring only intermittent examinations by the attending physician. Furthermore, the device allows the patient to put weight BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST on the limb with only limited restri,ctions. "The most impressive feature of this devic,e is its ability to develop new strong and healthy bone, with few postoperative complications; emphasized Stronig, who is also an orthopaedic surgeon at Children's Hospital of Buffalo. Once Strong convinced the manufacturers of the device's importance, he and Robetrt Gillespie, M.D., acting chair of orthopaedics at UB and ch ief of orthopaedics at Children's, were the first surgeons in North America to implement the device in October 1987. Children's Hospital was chosen as one of four initial North American sites to be study centers for the instrument, manufactured by Jaquet Orthopaedic, S.A., in Geneva, Switzerland, a subsidiary of the Howmedica Company. Just two years later, there are 43 centers SPRING 1989 �18 across the U.S. and Canada, and more than 200 patients have benefited from the system-IS alone have been treated at Children's Hospital. For Anthony Hinton it meant that not only could he avoid the amputation of his bad ly ipfected leg, but he can also look forward to a full recovery. "This device is one of the greatest inventions I know," declared an enthusiastic Hinton . "I didn't think this thing was going to work, but now I'm happy to see that it really has ." Hinton suffered a bad ly broken tibia (the thicker of the two bones in his lower leg) when the tractor trailer he was driving flipped over and pinned him inside the cab. A lthough his leg was set and placed in a cast, he developed an infection within the fracture of his bone several weeks later. This meant that Hinton had to undergo surgery to remove the portion of infected bone . In the recent past, this type of operation meant that the patient might lose the full use of the limb or would have to have it amputated . But that's not the case with the Monticelli-Spinelli device. The stainless steel device is composed of two or three concent ric rings which encircle the limb, stabilized by three vertical rods which look like long bolts. Wires, attached to the rings, hold the severed bone in place and provide che necessary traction tension . Nuts are attached to the rods. As the patient tightens the nuts, the device, and in turn the leg, is stretched . Strong used the device in a technique called proxima l corticotomy in Hinton's case. Once the infected portion in Hinton's lower tibia was removed, a cut was made in the proximal metaphysis (the growth plate in the tibia closest to the knee). Within this incision, a hematoma (a blood-filled swelling) formed, which in time changed to fibrous tissue, and then SPRINC 1989 Hinton had lost about 1112centimeters (.6 inches) due to bone absorption in addition to the 4 centimeters (1.6 inches) of infected bone removed by Strong. So Hinton had his leg lengthened almost 6 centimeters (almost 2.4 inches) co compensate for the bone he lost. Hinton was required to tighten the nuts only a quarter millimeter (about .01 inches) four times a day for six months . This he lped to stretch the healing bone tissue gradually. To prevent infection, which is common in such cases, each day Hinton had to carefully clean the wires which pierce the skin . "I didn't think this thing was goingto work, but now I'm happy to see that it reallyhas,"said Anthony Hinton. "The pain was minor compared to the benefitsI received.Even thoughI couldn'twork, I could still get aroundand put T he device is most often used on younger patients because of their ability to heal and regenerate new bone faster. However, Hinton, at 28, is the oldest patient in North America to have used the device thus far. "The doctor cold me that I was the oldest patient, but that didn't bother me; recalled Hinton . "The pain was minor compared to the benefit s I received from this thing . The only pain involved was when I had to tighten (the nut s) or if I bumped it by mistake. The cold weather during the winter wasn't too pleasant either, but I got used to it. "Even though I couldn't work, I could still get around and put weight on it," Hinton added. "My mother made me a special pair of pants to wear for the winter, and I slept with pillows under my leg." Although Hinton stopped tightening the nuts after six months, he continued co wear the device for two and a half more months to give the new bone, muscles, and tissues in his leg a chance to strengthen. Now that the wires are removed, he will wear a cast for about six to eight months, according to Strong. "There was some inconvenience, buc • now my leg is fixed," said Hinton. weight on it. There . . was some inconvenience, but now my leg is fixed.'' into solid bone. As the incision in the metaphysis gradually began to regenerate new bone, Hinton tightened the nuts . That increased the length of the growing upper tibia and moved it toward the lower portion of the tibia. Eventually, the gap caused by the removal of the infected bone became narrower . Finally, the upper and lower port ions of tibia met, fused together, and became solid . BUFFA LO PHYSICI A N A ND BIOM EDICAL SCIENTIST 1 �Alumni & Et•ents 19 AWMNISETAWARD FORTOPSTUDENTS he Medical Alumni Association Academic Achievement Award has been established ro honor the third-year student or students who have achieved the highest academic standing during their first two years of medical school. The Medical Alumni Association began the award because it was felt that while many awards and scholarships are offered to students when they enter medical school, based on their undergraduate records, nothing is done to recognize the top scholars before their third year of medical school. The achievement award will be presented for the first time during the school's annual awards ceremony for students in August . • T REHAB MEDICINE sm SYMPOSIUM he Department of Rehabilitation Medicine at UB is sponsoring a symposium on "Functional Assessment in Rehabilitation Medicine" to be held July 8-9 at the Marriott Hotel in Amherst . The conference will discuss measurement of the disability of patients in rehabilitation programs and how this scaling is developed and used, said Carl V. Granger, M.D., professor of rehabilitation medicine at UB and head of rehabilitation medicine at Buffalo General Hospital. Ocher topics will include the implications of medical ethics, the implications of financing, and the implications of research. The symposium is geared to physicians, nurses, therapists, social workers, psychologists, and administrators involved with chronic health care services or medical rehabilitation health care services. The cost of the symposium is $195. For more information, write to Granger at the Department of Rehabilitation Medicine, Buffalo General Hospital, 100 High St., Buffalo, N.Y~14203. • T 'l ticipated in the famous Framingham Study. Lasting almost 30 years, it is the longest continvovs swdyof c;:an;liovascular disease. Much of what we know about strokes has come from this study. Speakers from UB are Linda Hershey, M.D., Ph.D., associate professor of neurology, and William Kinkel, M.D., professor of neurology. Organizers of the symposium arc Glen E. Gresham, M.D., professor and chairman of rehabilitation medicine at UB; Carl V. Granger, M.D., professor of rehabilitation medicine at UB, and John V. Basmajian, M.0., professor emeritus of medicine and anatomy at McMaster University in Hamilton, Ontario. The conference is funded through a grant from the National Institute on Disability and Rehabilitation Research, part of the U.S. · Department of Education. Ir's a feather in the cap of the University to be chosen to host this international symposium, said Gresham, who noted that UB's research in chis field is strong. • REMEMBERING YESTERYEAR emember what it was like when you were at UB-the classes, the parties, the friends? The Alumni Association wants to capture a bit of chat feeling through a collection of memorabilia to be housed in a locked display case in the LippschuczConference Room in the medical school. The association is looking for alumni to lend or donate items for display. Items might include pictures, small medical equipment, programs, pennants, buttons, or other souvenirs that remind you of your academic and extracurricular activities. Send items to Dr. John Richert, Alumni Affairs Office, 146Cary-Farber-Sherman Addition, State University of New York at Buffalo, 3435 Main Street, Buffalo, N.Y. 14214.• R CALLFORNOMINATIONS our president and Board of Go vernors has, over the past several years, received many requests for Alumni / ae to establish a Distinguished Medical Alumnus / a Award. Therefore, your president and board are seeking nomination s for thi s award to be presented annually beginning thi s year. The award will be presenced to a graduate who has distinguished himself/ her self nationally or internationally in the eyes of his/ her peers and has made an outstanding contribution to medicine, the arts, or humanity during his/ her career. The selection will be made during the summer and the award will be presented in the fall at a special award dinner. Please forward the name of your nominee as soon as possible on rhe atta ched card. A June 30 deadline has been established for the receipt of all nomination s. Your cooperation is absolutely viral if this is co be a true alumnus / a award. Y WORLD EXPERTS TOMEET ATUB TODISCUSS STROKE any of the world's experts in stroke outcome research will gather in UB's Center for Tomorrow July 10-12for an international symposium on "Methodologic Issues in Stroke Outcome Research~ Attendance at the symposium is by invitation only. The proceedings will be published by the American Heart Association as a supplement to Stroke: A Journal of CerebralCircularion. The speakers will come from the United States, Canada, Australia, Japan, Israel, and Great Britain. They will include two who par- M SPRING 1989 BUFFAID PHYSIC IAN AND BIO MEDICAL SC IENTIST - ---- -------- ��I Research 21 Testing 'Clot Busters' Simple blood test may do the trick ' By ARTHUR PAGE simple blood ccscmay provide an alcernacive co immediate coronary arceriography when it comes co determining whether medications have successfully dissolved blood clots in coronary arteries following a heart attack, according to researchers at UB. The researchers showed chat the test, which measures proteins released into the bloodstream by cells in damaged heart muscle, was 88 per cent accurate. While the test was already available commercially, the researchers were the first co use it for this purpose. It's essential co determine whether rhe blocked arteries have re-opened in order co plan a patient's treacmenc. That determination now relies on coronary arteriography, an expensive and invasive procedure nor available in all hospitals nor at certain times even in chose with cardiac cathecerizacion laboratories. Unlike coronary arteriography, the commercially-available blood test is inexpensive, noninvasive, and relatively risk free. Results of the research, conducted in con• junction with scientists at Emory University, were reported in che December issue of Circulation, the scientific publication of the American Heart Association. Avery K. Ellis, M.D., Ph .D., UB assistant professor of medicine, was principal investigator for the study, funded by the Veterans Administration and American Heart Association. Ellis is chief of cardiology at Buffalo Veterans Administration Medical Center. His UB co-investigato rs were Francis J. Klocke, M.D., who is the Albert and Elizabeth Rekatc Professor of Medicine as well as chief of cardiology at UB and che Erie A . BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST Unlike coronary arteriography, the in a cardiac cachecerization lab. He noted, however, chat "most of the patients chat have infarcts are in hospitals where cathecerizacion labs are not available. Even if they are in a hospital with a cachecerizacion laboratory, you could not logistically make immediate cathecerizacion routine wichouc greatly expanding the facilities and personnel." On the other hand, che blood cescused by the UB and Emory researchers can be used in all hospitals. The researchers are the first co focus on measuring myoglobin, an oxygen-carrying protein essential to the heart's normal functioning, co gauge che success of thrombolycic therapy, according to Ellis. They focused on the myoglobin level in blood samples taken from 42 patients at the time they received a thrombolytic drug and at regular intervals thereafter. The subjects also underwent cardiac cathete rizacion co assess the success of chrombolycic therapy. There was a rapid rise in blood myoglobin levels in patients in whom the drugs resulted in reperfusion. In contrast, che levels rose slowly in those in whom the attempt co open the artery was unsuccessful. The researchers found that a co mparison of myoglobin levels in a blood sample taken ac che time medication was given and one taken two hours lacer corre lated with the resulcs of reperfusion attempts, as confirmed by coronary arreriography, 88 per cent of the time. "The need co develop a non-invasive marker of reperfusion is important in view of the large number of patients in whom intravenous thrombolysis is now likely to be used and in whom subsequent triage becomes an important issue; they said. • commercially~available blood test is inexpensive, noninvasive,and relativelyrisk free. County Medical Center, and A.R. Zaki Masud, M.D., clinical assistant professor of medicine. n the shore time since their approval by che U.S. Food and Drug Administration, thrombolycic drugs have been hailed as a major development in efforts to reduce deaths from heart attack. Experts project that an estimated 150,000 Americans a year who experience a type of heart arrack known as an acute transmural myocardial infarction are candidates for thrombolytic therapy. When successful, it results in reperfusion, oc reopening of che blocked corona ry artery, potentially reducing heart-muscle damage and saving lives. To be effective, the medications must be administered within four to six hours of onset of chest pain. Klocke said corona ry arteriography has been che 'gold standard" for assessing whether a thrombolytic drug has worked on a patient. Coronary arceriography muse be performed I SPRING 1989 ��Research 23 Early Surgery Cuts Cost, Hospital Stay in Trauma Cases By ARTHUR PAGE arly operative stabilization of thigh-_bone fractures in trauma panents drasncally cuts the length and cost of their hospicalizacion, according to a study coor• dinated by a UB researcher. In the most seriously injured patients, the study showed chat even a short delay of only 24 hours increased che average length of hospital stay by nine days and the cost of hospitalization by more than $13,000. Lawrence B. Bone, M.D., assistant professor of orthopaedic and general surgery, said the study is rhe first prospective examination of the benefits of early versus delayed fracture stabilization. The results, scheduled to be reported in the Journal of Bone and Joint Surgery, have been presented before the American Academy of Orthopaedic Surgery and American Orthopaedic Association. Bone was principal investigator for rhe study, which involved patients at Parkland Memorial Hospital in Dallas, where he did his residency in orthopaedics in conjunction with the University of Texas Southwestern Medical Center at Dallas. He is now direc• tor of the musculoskelecal rrauma service in the Department of Orthopaedics at the Erie County Medical Center. The study compared che medical course of parients whose rhigh-bone fractures were stabilized operatively within the first 24 hours after injury with that of patients whose fractured femurs were placed in traction and not stabilized for more than 48 hours. Bone noted that in hospitals without a trauma service the delay in stabilizing fractures in trauma patients may stretch into days. He said the results confirm both che experience of major trauma centers where frac- E BUFFALO PHYSICIAN ANO BIOMEDICAL SCIENTIST cures in multiply-injured patients are stabilized as soon as possible and studies based on review of patient records from trauma centers. B one said che study shows chat immediate stabilization of fractures, whether they be of che femur, pelvis, or other bones, should be a focus of medical efforts to treat trauma patients. "The patients are in the best shape they are going to be in when they first arrive; he added. "There is very little reason nor to stabilize rhe fracture when rhey first come in, regardless of their ocher injuries, and that includes head injuries. "]f a hospital doesn't have the facilities or capabilities co do this, the patient should be transferred to a trauma center chat does chis routinely because it not only saves lives, but is cost effective. By reducing the incidence of complications, we were able to reduce hospitalization costs by nearly half in our study." The study was designed co evaluate the impact of early versus late stabilization of leg fractures on the incidence and severity of pulmonary complications and the occurrence of adult respiratory distress syndrome (ARDS) in patients. A pattern of progressive respiratory failure, the syndrome has a 50 per cent mortality rate, according to Bone. The 177 patients in the study were random• ly assigned co early and delayed stabilization groups, which were subdivided into two groups: the less severely injured and chose with multiple injuries. All emergent and urgent surgical procedures were performed on each patient according co his specific injuries. Only the fracture of the femur was random• ized to early or delayed treatment. Early stabilization had a positive impact among chose with multiple injurie s, with the syndrome developing in only I of 45 patients whose fractures were stabilized early, com• pared co 5 of 37 of chose in chelate stabilization group. ARDS did not develop in any of rhe less-severely injured patients. Bone said significant pulmonary complications developed in 14 of the 37 patients with multiple trauma and delayed fracture stabilization. On the ocher hand, only one of the 45 patients with multiple injuries and early fracture stabilization developed any significant pulmonary complications. Among the most seriously injured patients, chose in the early stabilization group had average hospital stays of 17.5 days at a coca! cost of $19,492, compared to an average of 26.6 days ac $32,915 for those whose fractures were stabilized after 48 hours. In chose who were less severely injured, the average time of hospitalization was 7.3 days for the early stabilization group and 10.2 days for chose whose fracture was stabilized after 48 hours. The cost of hospitalization averaged $5,235 for the early group and $6,929 for the late group. None of the less severely injured patients needed co be placed on a respirator or in an intensive care unit. Among chose with multiple injuries, 18 of 42 stabilized early and 24 of 37 stabilized late required intubation and admission co an intensive care unit. The early group spent an average of 2.4 days on a ventilator and 2. 7 days in the ICU, while in the lace group there was an average 6.9 days on a ventilator and 7.6 days in an [CU. • SPRING 1989 �:!!'''' ' ~ f ~ ~ ~ '! ''' i1, I I: t 11 ~ -' ~ ,i ;~ ~ -. .. .•~ - ~ ~-- . • _,'!. ., :·,, ~ ~ -·--) ~ - -~ ··~ .. .,,~ �Research 25 Exercises Promise Relief From Arthritis in Knees By ARTHUR PAGE new exercise program chat has promise to improve the mobility of millions of Americans with arthritis of the knees is being evaluated by researchers at UB. In earlier studies, the researchers showed chat Progressive Quantitative Exercise (PQE) increased the strength of some patients' leg muscles fivefold, dramatically improved functioning of their knees and their mobility, and decreased pain. Subjects were able to walk better, stand longer, and get out of a chair more easily. One man, an avid fisherman who previously had to pay someone to carry his day's catch up a river bank, now boasts of being able co scale the slope while carrying his fish. The UB researchers, led by co-principal investigators David R. Pendergast, Ed.D., and Glen E. Gresham, M.D., will study the effects of PQE on leg muscles under a $501,597grant from the National Institute on Disability and Rehabilitation Research of the U.S. Depart• ment of Education. Gresham, UB professor and chair of rehabilitation medicine, is also director of rehabilitation medicine at the Erie County Medical Center, where the study will be conducted . Gresham noted that while arthritis of the knees may occur at any age, it affects an estimated one-third of the elderly. When it is severe-with resultant pain, stiffness, decreased range of motion and muscle weakness-it limits the ability to use stairs, get up from a chair, stand comfortably and, eventually, to walk. The UB researchers A BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST The study showed that subjects were able to tvalk better, stand longer,and get out of a chair more easily. The exercisesincreased strength, dramatically improved mobility and functioning of the knees, and decreasedpain. believe chat's due in large part co accompanying weakness of the quadriceps muscle that controls extension of the knee. The goal of PQE is to strengthen the quadriceps muscle by gradually and precisely increasing the amount of work it is required to perform over a three-month period. le involves isometric exercise, focusing on contracting leg muscles without moving the knee, and isotonic exercise, which includes extension of the knee. While their preliminary studies showed PQE cased the symptoms and limitations, che researchers do not believe it affects progression of the arthritis. Subjects' progress will be monitored based on pioneering work in quantitating muscle strength conducted by Pendergast, UB professor of physiology, and Nadine M. Fisher, Ed.M., UB clinical instructor of rehabilitation medicine, who is project director. They showed that not only is there a norm for leg-muscle function at a given age, but that function and strength of the quadriceps muscle decreases dramatically past age 55. Gresham noted chat while the work focuses on arthritis of che knees, che researchers are interested in "improving the rehabilitation of people with a wide variety of musculoskeletal impairments, particularly those affecting the frail elderly." Ocher UB faculty members involved in the study are Judy Cameron-Ruh, RPT, M.S., adjunct instru cto r of physical therapy and exercise science who is physical therapy supervisor at ECMC; Evan Calkins, M.D., professor of medicine and head of the UB Division of Geriatrics/Gerontology; Beverly Bishop, Ph.D., professor of physiology; Carl V. Granger, M.D., professor of rehabilitation medicine, and Theodore Papademecriou, M.D., clinical professor of orthopaedics. • SPRll',:G 1989 �,\ led1calSchool 26 VOWNTARY FACULTY: THESCHOOL'S UNSUNG HEROS ou could call them the unsung heroes of the medical school. Though they receive no pay, voluntary faculry generously give their time and expertise to the medical school. "Voluntary physicians collectively and as individuals receive far too little credit and recognition for their contributions to medical education and to the advances in medical care,"said John Naughron, vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences at UB. Voluntary faculty members serve on school committees, teach courses, represent the school in national and Stace societies, and play an important role at affiliated hospitals . "This information serves ro confirm that there is a role for the voluntary physician, and chat the school has not excluded that role," Naughron said. "There's a need for coexistence and involvement of a strong fulltime and voluntary staff in the years ro come While UB still doesn't do enough co recognize its voluntary faculty members, it is ahead of other medical schools, the dean noted. The long-standing Siegel Teaching Award and the annual reception for voluntary faculty are a couple of examples. A new award, the Robert S. Berkson, M.0. Memorial Award in the Art of Medicine, will be given for che second time in May. The award goes to a voluntary faculty member who exhibits skill in patient care and teaching and who combines the features of scholarship and compassion that elevate medicine in its best sense from a science to an arc. The award is named for Berkson, who was a respected solo practitioner of internal medicine and served on the voluntary faculty from 1949 until his death in 1966. "His devotion ro patients was his greatest attribute," said Philip Weis, M.D., clinical professor of surgery and a member of the UB Council. Weis met Berkson when they were undergraduates ar UB. They continued Y SPRING 198'1 through the UB medical school rogether, graduating in 1941. "He was an excellent student and was interested in people," Wels recalls. "The outstanding thing about Dr. Berkson in his practice was that he was extremely, extremely devoted co his patients. He gave all the time they required. His humanitarianism is unsurpassed to this day. He would spend time with the patient beyond the normal role, and would discuss things again and again with the family in a repetitive way that most physicians would nor tolerate. "He was an ardent reader and always kept up with che newer modalities in medicine . "Dr. Berkson liked to reach, and his students liked and respected him because of his concern and his abilities ." Berkson served as a captain in the Army Medical Corps during World War U. After his discharge, he underwent four years of training in internal medicine, then began private practice. He was on staff at Buffalo General Hospital, Sisters Hospital, Millard Fillmore Hospital, the Veterans Administration Medical Center and the former E. J. Meyer Hospital. He was a fellow of che Ame rican Board of Internal Medicine, a diplomate of the National Board of Medical Examiners, and belonged co local and national medical societies. He loved his community and was active in several Jewish groups. A family man and very devoted father, Berkson encouraged his cwo children, Weis noted. His son, Richard, is now a physician. Berkson was a voluntary physician on the staff of David K. Miller, M.0. "I admired him and he did a good job," Miller said. Years ago, all faculty members were voluntary, he remembers . In 1937, Miller became the first full-time faculty member in the medical school. At that time there were a great number of "service patients" who didn't have a private physician. Times have changed and the number of full-rime faculty continues to grow, buc Miller hopes chat we won't see an end co voluntary faculty. "I think certain people have a great deal to offer in teaching residents and interns, as well Robert S. Berkson, center front, abot ie, enjoys the 1956 reunion with his colleagues from the class of 1941. Also pictured at left, he is the namesake of an atvard for voluntary faculty. as medical students," Miller said. His personal convictions are reflected in his actions. Miller left UB in 1974, but is now a voluntary faculty member with the University of California. BUFFAIO PHYSICIAN AND BIOMEDICAL SCIENTIST �>.!edical School 27 T he first person co receive the Berkson Award was James F.Phillips, M.D., clinical professor of medicine. A specialist in internal medicine with a subspecialty in gastroencerology, Phillips teaches students, interns, and residents at Buffalo General Hospital and in his office. Every year he takes a month-long teaching service. He works with an assistant resident, a couple of interns, and a few students for about one and a half hours a day, five days a week. Sometimes a fourth-year student will spend a month with Phillips, working at his elbow from 7 a.m. to 9 p.m. as he makes hospital rounds and sees patients in the office. Every year Phillips takes on a seven-week preceptorship, meeting with students for one and a half hours, three times a week, to discuss patients. Once or twice a year, he cakes a monthlong service in gastroencerology, supervising the training of a fellow. Phillips meets with the fellow for an hour a few times a week. Every day he meets with the residents and interns who arc assigned to his patients in Buffalo General Hospital. Occasional! y Phillips will lecture. All of this is time consuming work for which Phillips receives no pay. Yee he does it gladly. "I enjoy teaching," he said. !e's a great way co keep up on the latest developments in medicine, he noted. "I learn from my students and they learn from me," Phillips said . As modern medicine races ahead, it's difficult co keep up with every new advance. A student may have access co new information in a field outside of gastroencerology that is helpful to Phillips. Teaching also stimulates a physician co keep on his toes-he doesn't wane to appear uninformed to his students . There's also a certain amount of prestige that comes from teaching, Phillips said. "Physicians respect someone who teaches in the medical school," he said. "Everyone wants to be respected among his peers, no matter what the business. "It's self-gratifying, I enjoy it, so I do it." But he also feels an obligation to teach. As outlined in the Hippocratic Oath and elsewhere, all physicians have the responsibility co take care of the sick, to conduce research, and to teach, he said. The role of the voluntary faculty member will always be here, Phillips predicted. "More and more medicine is being practiced outside the hospical; he explained. "Insurance people wane it chat way, the government wanes it that way, and magical modern medicine allows it. People who work only in hospitals can get a skewed viewpoint. They see only the patients who are critically, terribly ill." But the real world of medicine isn't filled SPRING 1%9 BUFFAW PHYSIC IAN AND BIOMEDICAL SCIENTIST - ---- --- -- �Medical School & Hospital News 28 with intensive care units, he asserts. Instead, it's marked by sore throats and belly aches and diarrhea. The voluntary faculty present rhe world "as it really is,"Phillips said. "The full-rime faculry don't have rhar privilege." A challenge facing medical education roday is how to allow students to spend more time in "the real world" of medicine-offices and clinics, he noted. In his reaching, Phillips tries to inform students about a disease and to convey rhe things he's learned through experience. But he also tries to be a role model and impart the qualities of compassion, kindness, gentleness, and friendliness. Disease doesn't exist on its own; it's affecting a human being and that person's family, he pointed our. "The best way to teach people how to be a good human being is by being a good human being; he noted. When Phillips accepted the Berkson Award, he did so in rhe names of all the great teachers who went before him, especially William Lipp, Elmer Milch, and Clayton Green. "I learned everything from chem," he said. "My name is on it, but rhe award is for all those great people who taught me my trade and taught me rhe love of teaching." • SURFACE SCIENCE IS TOPICOF CENTER acuity from the UB School of Medicine and Biomedical Sciences will participate in a new Biological Surface Science Center established at UB. The research at the center will focus on the interaction of biological materials with another material at the molecular level. For instance, a dental implant should stay securely in rhc jaw. However, a company making chewing gum docs not wane gum that sticks to rhe reech. Surface science can determine why dental implants stick to gums, as well as why chewing gum will nor stick to reech. The co-directors of the center are Robert E. Baier, Ph.D., a research professor of biophysical sciences at UB and director of rhe F SPRING 1989 Health-care Instruments and Devices lnsrirure (HlDl), and Joseph A. Gardella Jr., Ph.D., an associate professor of chemistry. The National Science Foundation (NSF) gave UB a $25,000 planning grant to start rhe center. The center will be funded with annual grants of $75,000 from the NSF and about $200,000 from HIDI, a New York Scare Center for Advanced Technology. Faculty from rhe School of Dental Medicine, the Faculty of Natural Sciences and Mathematics, and the Faculty of Engineering and Applied Sciences, are also involved in the center. • STUDENTS HONOR ENTIRE DEPARTMENT he UB dental class of 1992 has presented an award co rhe gross anatomy faculty and staff in the School of Medicine and Biological Sciences for their outstanding service and dedication. "This is che first time chat an entire class has collectively recognized the efforts of an entire depamnent," said Harold Brody, M.D., Ph.D., chairman of the Department of Anatomy. "I chink chis award exemplifies the sense of cohesiveness that exists between the students (both medical and dental) and the staff within UB's medical school." • T CAPLIFTED FOR NON-RESIDENTS he UB medical school has rescinded its cap on the number of out-of-Stare applicants that can be admitted. However, the medical school will continue to give preference to New York Stare residents. Ir was decided that the cap of 4 per cent of the class, that is, five our-of-State students, was too restrictive. The declining pool of applicants ro medical schools may make it necessary for UB to accept more out-of-State students, bur the cap discouraged them from applying, it was argued. • T SISTERS EXPANDS HEAD,NECKPROGRAM S isters Hospital, in conjunction with the UB School of Medicine and Biomedical Sciences, is developing a "commitment to excellence"in otolaryngology and head and neck surgery. The project is spearheaded by John M. Lore Jr., M.D., chairman of the Department of Otolaryngology and Head and Neck Surgery at Sisters as well as professor and chairman of the Department of Orolaryngology at UB. Sisters has 12 years of experience in treating cancer patients in a special unit. In addition, UB's Department of Otolaryngology has a fellowship in Advanced Head and Neck Oncologic Surgery, which is centered at Sisters and the Veterans Administration Medical Center. Established in 1979, the fellowship is one of the first five to be developed and is one of only 16such programs in the United Scares and Canada. Plans for the center include: • Expanding facilities, equipment, and programs. • Expanding research and establishing a program to develop new biomedical instruments. • Improving medical education for professionals as well as improving educational pro• grams for the public. • Contributing ro and utilizing the National Cancer lnstirure's database on patient treatment and outcomes. • Funding the new position of Chaired Professor of Otolaryngology / Head and Neck Surgery and filling it with a nationally recognized head and neck oncologic surgeon. • Developing an endowment to fund a scientist conducting basic research. • Developing a head and neck tumor registry. • Evaluating treatments, including surgery, radiotherapy, chemotherapy, and irnrnunocherapy. The University's Department of Otolaryngology will continue to work closely with che other UB affiliates, including Roswell Park Memorial Institute, Buffalo'sdesignated corn- BUFFALO PHYSIC IAN AND BIOMEDICA L SC IENll sr �Hospiwl ;-,7c.:H'S 29 BGHNURSING HOME ADDING 80 BEDS uffalo General Hospital is adding 80 skilled nursing beds to one of its nursing facilities and has announced an affiliation with another nursing home. Buffalo General's Deaconess Skilled Nursing Facility is adding a 21-bed pediatric unit, a 21-bed unit dedicated to head trauma patients, and 38 conventional skilled nursing beds. The $7 million project includes renovation and modernization of the current 162-bed facility and is expected to be completed in mid-1990. The Downtown Nursing Home, an 80-bed skilled nursing facility on Buffalo'slower West Side, has affiliated with the General Care Corp., parent company of the Buffalo General Hospital. Both nursing facilities provide services primarily co disadvantaged persons in Western New York. The affiliation is expected to reduce costs for both facilities. • B CATHETERIZATION LAB STARTED ATMERCY Jo hn M. Lore Jr., M .D. prehensive cancer center. Both Sisters and Roswell are members of the Western New York Health Sciences Consortium. • NEWRULES TOCUT RESIDENTS' HOURS c looks like the recommendations of the Bell Commission Report are becoming reality. New Seate regulations that limit the number of hours residents are allowed co work are slated to go into effect July I. Under the new rules: • Residents may work no more than 80 hours a week when averaged over four weeks, and no more than 24 hours in a row. • On-duty assignments must be separated by at least eight hours of non-working time and residents muse get 24 consecutive hours off each week. I BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST • Hospitals must enforce policies that prohibit combined assigned hours and moonlighting hours from exceeding the limits on assigned hours. Buffalo hospitals are still gearing up to meet these requirements. Regulations for emergency rooms went into effect in October. They include: • Limiting assignments for residents and attending physicians to 12 consecutive hours. • Requiring that residents be supervised 24 hours a day. This requirement can be met by a resident in his last year of training if the attending physician is within a reasonable distance of the hospital, explained James P. Nolan, chairman and professor of medicine. The Graduate Medical-Deneal Education Consortium is also developing a formal system to credential residents. This would replace the informal system of documentation of skills chat exists now. • ercy Hospital is now equipped with a Cardiac Cachcterization Laboratory, the first of its type to be constructed distinct from a cardiac surgical center in Western New York. The lab has been fully operational since early October. "Diagnosis and early treatment are critical factors in preventing cardiovascular disease from seriously afflicting chose at risk," stated Anthony Bonner, M.D., chief, Division of Cardiology, Department of Medicine. "A cardiac catheterization procedure is one of the best diagnostic cools available co pinpoint the disease state in those at risk, as well as a tool to develop the proper regimen of treatment." While the laboratory cost approximately $594,000, this expense will be offset by eliminating transportation costs and the time spent waiting to transport patients to another laboratory, noted Mary Ann Gottstine, assis• cant administrator. M SPRING 19$9 �People 30 SPEEDING UP THEFDA T homas R. Beam, Jr., M.D., associate professor of medicine and microbiology at UB, has been named director of a new project that will explore ways to speed up che U.S. Food and Drug Adminisrracion's drugapproval process. The two-year projecr also will develop recommendations for improving the federal agency's monicoring of drugs already on the market for early warnings of serious adverse reactions in patients. The project will be conducted under a $280,550 contract between the FDA and the Infectious Diseases Society of America (IDSA). While the project will focus specifically on antibiotics, ics recommendations are likely to be applied co drug groups across the board, said Beam, an expert in infectious diseases. He is also associate chief of scaff for education and former chief of infectious disease at Buffalo Veterans Administration Medical Center . He praised the IDSA for initiating the project and the FDA for welcoming the cooperative effort between the professional society and federal agency. "To their credit, they recognize that the system is flawed," Beam added . He said problems have been highlighted in recent years by complaints that che FDA drug-approval process unnecessarily delays the approval of new drugs, some of which already are available in othe r countries. Critics of the process calling for reforms have ranged from AIDS activists co officials at the National Cancer Institute. Despite the lengthy process designed to assure the safety and efficacy of new drugs, Beam noted chat some medications approved by the FDA still have been implicated in serious adverse reactions and patient deaths. "The regulatory process chat now takes 10 co 12 years no longer guarantees safety; according co Beam. "At issue is whether the compounding of regulations benefits anyone; he added . "Ir delays the entry of good drugs into the marketplace, creates tremendous costs for the SPRING IQSQ Thoma s R. Beam , Jr., M.D. pharmaceutical industry, is costly to the FDA and means the Ame rican public does nor get access r,o drugs as quickly as people in Europe, Japan and che rest of che world." The classic example cited to defend the FDA's ,conse rvative approach on drug approval iis that of thalidomide, which caused major birth defects in the children of pregnant women who used it in the late 1950sand early 1960s. The drug was not approved for clinical use in the U.S. when che birch defects appeared in children born in West Germany and Great Britain, where it was already available. Whil,e the layers of regulations built into che reviiew process since then have stretched out the drug-approval protocol in the name of safety, Beam noced char "the recent history of drug development has not been one of sue- cessful protection of the American public." He cited the examp le of benaxoporfen (Oraflex), an anti-inflammatory drug for the treatment of arthritis that won the FDA's scamp of approval, yet later was associated with serious complications and the deaths of several patients. Also of recent vintage, he added, were the cases of ticrynafen (Selacryn), a diuretic shown to be associated with irreversible liver damage and patient deaths after it was approved for marketing, and moxalaccam (Moxam), an antibiotic that caused severe interna l bleeding in some patients . While the FDA subsequently ordered benaxoprofen and ticrynafen pulled from the market, moxalactam is still available, although "the physician community has essentially stopped prescribing the drug BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �People 31 because its toxicity outweighs its benefits; according to Beam. He said the examples underscore the need for a "scheme of monitoring that relatively quickly identifies serious side effects and brings them to the attention of the FDA so that physicians can ultimately limit their use of a drug or it is pulled from che marker, if necessary." Beam, who will work ac the federal agency in Rockville, Md., until midsummer, was selected from more than 30 members of the 1,600-member IDSA who applied to head the project. He will collaborate with FDA officials, representatives of che Pharmaceutical Manufacturers Association, national leaders in academic medicine, and approximately 50 members of the IDSA who will serve on pro• • jeer subcommittees. - By Arthur Page HEAIRSALLTHENEWS THATKEEPS YOUFIT s the lights go up on the WIVB news set, Peter Ostrow, M.0., Ph.D., straightens his notes and peers con• fidently into the red-lighted camera which will broadcast his health / medical report to thousands of Western New York viewers. "I used to be nervous at first; admitted Ostrow, associate dean and professor of pathology at UB's School of Medicine and Biomedical Sciences. "But, a year of experience, and doing up to six hours of research for my two-minute segment gives me confide nce chat my report will be accurate and informative." Ostrow was chose n for the three-year position with WIVB over seven other hopefulssome who previously had broadcasting ex• perience. However, with his expertise in the field of medicine, his 14 years of experience in medical education, and his commi tment to UB and the surrounding area, the native Buffalonian had some definite advantages over the others. "I cold the producers at the station chat my idea was to showcase the cutting-edge medical A Peter Ostrow, M.D., left, confers with Jacq11ie \Valker on the news set. research and health care that is going on at the University and area hospitals, which is among the nation's most advanced; explained Ostrow. "And they loved che idea." John Naughton, dean of the School of Medicine and Biomedical Sciences, views Ostrow's position as "an honor to the medical school" which helps to create a positive relationship between the University and the community. W hen Ostrow landed a seat next to anchors Bob Koop and Jacquie Walker, he became, and still is, Buffalo's only physician• reporter. His segments appear live on \'(,'JVB's news broadcast ac II p.m. on Tuesdays and Thursdays and are rebroadcast on Wednesdays and Fridays ac noon. Ostrow's topics have ranged from antibiotics and influenza, co smoking and cancer, to medical history. One of the biggest viewer reponses co an Ostrow report concerned a new drug called ciprofloxacin which helps heal hand and foot infections in diabetics. The clinical research which proved this drug's effectiveness was conducted by Tom Beam, M.D., associate professor of medicine and microbiolog y, and Jerome Schentag, Pharm.D., professor of pharmaceutics, noted Ostrow. This is an im- porcant development because diabetics otherwise have a difficult time fighting peripheral circu latory infections. WIVB and Ostrow received phone calls from Rochester, Pennsylvania, and Canada. However, Ostrow noted char not all viewer response has been enthusiastic. "Once when my topic was syphilis; he recalled, "I had mentioned in my report char Christopher Columbus and his crew brought the disease to the New World. The next day the station received a phone call from an irate viewer who happened to be the man who was almost single-handed ly responsible for having Columbus Day declared a national holiday. He threatened to call the FCC and bring charges against the station, but nothing more came of it. "I feel that if something is true, then it's worth saying; emphasized Ostrow. "The peo• pie at the station aren't only concerned with ratings but with quality and integrity as well." A lth ough Ostrow enjoys working as a television reporter and has learned a great deal from the experience, his primary interests remain in neuropathology and in medical education. Ostrow received nine awards in reaching excellence from his students at the University of Texas at Houston where he was SPRING 19$9 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST -- -- - -~- -- ---------- �Peot>le 32 the director of neuropathology before returning to UB as an administrator in 1984. Ost row began his academic career as an undergraduate at UB in 1962. "Unlike other health / medical reporters, I am responsible for my own material because medicine is my field of authority. My reputation as a doctor and an educator depends upon the accuracy of what I say; Ostrow pointed out. "I have to prepare a lesson plan just as if I were in the classroom. I research the topic and conduct interviews with other medical experts. I don't just report the story-I explain it. "Television is a powerful medium and I see chis job as a great opporrunity co educate and inform the general public about recent advances in medicine." Ostrow's uncompromising pursuit of accurate and informative topics has meant sacrificing many early evenings at home and saying goodnight to his three children . He was also asked to shave his beard and mustache, which he had worn for 18 years, because the producers thought it was a "sinister" and "less than trustworthy" image for a doctor to have. His children, however, thought just the opposite. "My children, the oldest of whom was 15 at the time, had never seen me without a beard: Ostrow remembered vividly. "My youngest child, Rachel, threatened to run away from home if I shaved my beard off. So I let her shave it. I held a basin under my chin and the 10-year-old first trimmed it with scissors and finished it off with an electric razor. "Now that my family ha s gotten used to me without a beard, they like it better." Although Ostrow has appeared on television for over a year, he hasn't gotten used to basking in the limelight. He still gees embar• rassed when he is recognized at the supermarket or at a souveni r booth at Rich Stadium . "I just can't get used to being recognized by strangers; Ostrow admitted . "However, their comments are usually very complimenta ry, which is reassuring. le lets me know that people out there are listening to what l have to say." • - By Mark Marabella SPRING 198'1 of psychiatry at the Erie County Medical ~nre~ • Francis J. Klo c ke, M.D. , the Albert and Elizabeth Rekate Professor of Medicine, has been appointed to the National Heart, Lung, and Blood Advisory Council of the Nationa l Institutes of Health. He is also the chief of cardiology at UB and the Erie County Medical Center. • John M. Lor e Jr ., M.D. , professor and chairman of the Department of Otolaryngology at UB, has completed his third edition of An Atlas of Head and Neck Surgery.Originally published in 1962 and up• dated in 1973,the text is considered to be one of the most complete works relating to techniques in surgery of che head and neck. Lore is also chairman of the Department of Otolaryngology and Head and Neck Surgery at Sisters Hospital • Gerald Sufrin , M.D. , professor and chairman of the Department of U rology, has been appointed to the lntersociety Council for Research of the Kidney and Urinary Tract.• Mark Flanz enbaum , a third-year medical student ac UB, cook first place in che medical school's eighth annual Student Research Forum. He won for his presentation on his basic research on oncogenes. Second place went to Janice Errick , a third-year student. In a three-way tie for third place were Kevin Osterhoudt , a second-year student; Gar y C ro ghan , a third-year student, and John Klemper e r, a third-year student . • Marvin I. Herz, M.D. , professor and chair of the Department of Psychiatry at UB, has been elected president of the Western New York Psychoanalytic Society. He is director Rohit Bak shi , a second-year student at UB's School of Medicine and Biomedical Sciences, received the Saul R. Korey Essay Award in Experimental Neurology, sponsored by the American Academy of Neurology. An abstract of his essay, "N-Mechyl-D-Aspartate antagonist Dexrrorphan limits dinorphin induced paralysis in racs; will be published in the AAN annual abstract issue of the jour• nal Neurology. 1'vo UB medical students have been elected to positions with the American Medical Student Association . Th omas R. Piazza has been named chapter president and Richard S. Musialowski is recruitment coordinator.• Mary Ann e Rokitka , Ph.D. assistant professor of physiology at UB, has been elected vice president of the Undersea and Hyper• baric Medical Society. • SPOTLIGHT SHINES ON ARTWORK earring with chis issue, the Buffalo Physicianand BiomedicalScientistwill regularly feature the artistic work of one of the UB medical school's alumni, students, or faculty. The work could be in painting, photography, sculpture, poetry, fiction, or ocher media. If you'd like co be featured, send us a photo of your artwork, or even a photocopy, so we can see if it will reproduce in black and white. Feel free to send shoes of several pieces. lf we decide co use your work, we'll make arrangements to rake a good, clear photo . If you submit literary work, please send a photocopy. We'd hate co see artwork lose or damaged, so don't send us the original artwork . Please include your address and phone number, and tell us if you're a student, alumnus, alumna, or faculty member. Address submissions to Connie Oswald Stofko, 136Crofts Hall, University at Buffalo, Buffalo,N.Y. 14260. • S BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �"I have been doingwacercolors for more chan25 years. ... Many paincingshavebeeninspiredby nacureobservedduring20 )-etlTS of joggingaround Williamsville. Paincingis a good way w sharpenyour eye, co see more beaucyaround." Ivan L. Bunn e ll, M.D . (M'43), Ca rdiologist, Director of the Buffalo General Hospita l Angiology Laboratory from 1960-1982 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST SPRING 1989 �Clmsnotes 34 1960s Edwin R. Lamm (M'60) • of Lakeland, Fla., is president of the medical staff of the Lakeland Regional Medical Center and also secretary-treasurer of the Independent Physicians Association of Lakeland . G eo rg e B. Kuit e (M'Z 7) • has been disabled since 1970. His address is: lntervalc Rd., Box 1457, North Conway, N.H. 03860. 1930s Or van W. H ess (M '3 I ) • is clinical professor (emeritus) of the Yale University School of Medicine . H arr y Bergman (M'3 4) • received a gold medal in March from Phi Lambda Kappa Medical Fraternity for his contribution to the advancement of medicine and the medical sciences, and particularly for his work in the field of urology. The Bergman's Sign, along with a short biography of Bergman, was included in the 27th edition of Dorland'sMedical Diccionary.The author of several books, Bergman is clinical professor of urology at rhe University of Miami Medical School and New York Medical College. Harry Bergma11 '34 founded and it is in chis spirit char the recipient of the award is honored . 1940s Burton L. O lmsted (M'41) • writes, "Enjoying retirement after 37 years in the practice of plastic and reconsrruccive surgery in Portland and South Portland, Maine?' 1950s John Ambru sko (M '3 7) • is the namesake of the new $3 million public health building in Manatee County, Fla. Ambrusko is retiring after 11 years as medical executive director of the county's health department. In addition, Ambrusko found time for occasional stints as the physician on cruise ships. James E. Youker (M'S4) • will receive the Distinguished Service Award from the Medical College of Wisconsin at the May commencement. Youker is professor and chairman of rhe Department of Radiology and is currently serving as chairman of rhe Residency Review Committee for Radiology. Maxwell Rosenblatt (M'38) • The Maxwell Rosenblatt Commemorative Award has been established by the Public Health Foundation of Los Angeles Coun• ty. It was through Rosenblatt's vision and persistence that the Public Health Foundation was Robert A. Bren ne r (M'59) • gave up private practice to take a full-time position at the Veterans Administration Medical Center in Syracuse. SPRING 1%'1 Tarik E lib ol (M '62 ) • assistant professor of medicine ar rhe UB Schoo l of Medicine, has been elected chief of medicine at DeG raff Memorial Hospital. Virgin ia V. We ldon (M'62 ) • has been named vice president of scientific affairs for the Monsanto Company . She will advise the company on public policy issues in science and medicine . Weldon is also deputy vice chancellor for medical affairs at the Washington University School of Medicine in St. Louis. Marvin Z. Kur ia n {M'64) • has been elected to Who's Who in America and is a lifetime member of Fellows' Leadership Society of the American College of Surgeons. Kurian is a clinical instructo r of surgery at UB. David E. Pittman {M'64) • has been invited to serve on the editorial board of t he Journalof Angiology.Dr. Pittman is associate director of the Cardiovascu lar Laboratory at Allegheny General Hosp ital and a clinical assistant professional of medicine at the University of Pinsburgh School of Medicine . Calv in Ma rantz (M'65) • writes from Santa Ana, Calif., where he is a pathologist / dermatopathologist, that he is now serving as co-director of Laboratory Coastal Communities Hosp ital. Virgin ia V. Weldon '62 Daniel S. Sc hubert (M'65) • of Shake r Heights, Ohio, is currently the edito r of rhe lncernacional Journalof Ps)'chiatryin Medicine. August J. D'Alessandro {M'65) • of Newtown, Conn ., is supervis ing psychiatrist at the Fairfield Hills Hospital and consultant psychiat rist to the Co nnecticut Department of Mental Retardation and Region #4 PGM Review Committee member. Jared C. Ba rlow {M'66) • is president of the New York State Soc iety of Anest hesiologists for the 1989 ter m. Barlow is medical di rector and chairman of anesthesia at Millard Fillmore Surgery Cente r, and associate professor of anesthesiology at UB. John R. Fisk {M'69) • was elected president of t he Association of Child ren's Prosthetic and Onho t ic Clinics - a U.S. and Canadian organization of clinic personnel. D r. Fisk is ch ief of the Child Amputee Clinic at the Chicago Shrinc rs Hosp ital. BU FFALO PHYSIC IA N AND BIO MEDI CAL SCIENTIST �C/assnotc, 35 presented four papers at the 7th Medical Command Radiology Conference, both in Heidelberg, Germany. 1970s Jan M. Novak (M'70) • has been elected president of th e medical-dental staff of the Erie County Medical Center where he is director of the gastroenterology division. Mark Glassman (M'78) • was promoted to associate professor in the Division of Pediat ri c Gastroentero logy at the New York Medical Center. Roy M. Oswaks (M'71) • of Virginia Beach, Va., was recertified in general surgery by the American Board of Surgery. Larr y Zemel (M'73) • married Jesse Stoner in June, 1987. They have a son, Michael, born in April, 1988. Zemel is director of pediatric rheumatology at Newington Children's Hospital, Newington, Conn . Howard R. Goldstein (M'74) • joined the Urological Professional Association in Cherry Hill, N .)., where he lives with his wife, Judy, and three child ren, Lee, Lauren and Daniel. Mic h ael L. Stei n fe ld (M'75) • is clinical assistant professor of cardio logy at the University of Pittsburgh and president of the medical staff at Forbes Health System. Jane K. Dorval (M'76) • was recently appointed medical director of Moss Rehabilitation Ho spital, a 144-bed freestanding, not-for-profit hospital with an affiliation with Temple University's PMR Residency Program. Dr. Dorval is a boa rd -certified physiarrist. Nora 8. W ilcox (M'76) • writes, "I have decided to make a career of the Navy and have been selected for promotion to the rank of comma nd er. Also this summer l was appo int ed head of the Jared C. Barlow '66 Department of Aviation Medicine and senior flight surgeon at the Naval Air Station, \'Vhidbey lsland, \Y/ash." Cliphane W. McCleod (M'77) • reports char he is the only obstetrician in Hin esville, Ga., where he has a solo practice. His wife, Joan, is his office manager and nurse. The McCleods have five children : Cliphane II, 13; Lucien, IO; twins Travis and Nice!, 7, and Natacha, 4. Richard R. Curran (M'78) • an internist with Buffalo Internal Medicine Associates, P.C., has been appointed rhe new medical director for the Alden Medical Center . Angelo M. DelBalso (M'78) • and an alumnus of the Deneal School (72) writes chat in 1988he presented a continuing education cou rse sponsored by the School of Deneal Medicine in lxcapa, Mexico. He also presented continuing education lectures to the 89th Medical Detachment and BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST Mark E. Brenner (M'79) • writes, "Recently completed hand and microsurgery fellowship in Louisville, Ky., and am relocating to Pinehurst, N .C. to establish a practice in hand/orthopaedics/ microsurgery ." Joseph Caprioli (M'79) • of Hamden, Conn., was recently promoted to associate professor of ophthalmology and visual science at Yale University School of Medicine . David M. Kenton (M'79) • writes, "presently practicing cardiology in Deerfield Beach, Fla.,-would like to hear from Mark Brenner and Alan Schimmel." His add ress is: 5580 G Coach House Circle, Boca Raton. William J.Lawrence (M'79) • is vice president of Associated Healthcare in Buffalo. 1980s Jain Avanindra (M'80) • is an assistant professor of medicine and cardiology at the University of North Carolina at Chapel Hill. He and his wife, Diane, have a two-year-old son, Brian. Jan A. Koenig (M'81) • writes, "Completed a fellowship in joint replacement surgery of hip and Jan M. Novak '70 knee. Now in private orthopaedic surgery practice in Long Island, N .Y. Expecting first child (a boy) March 1989." Brett C. Shu lman (M'81) • recently married Amy Libenson, an attorney, of \Y/ilkes-Barre,Pa. Shulman has a solo practice in dermatology and dermatologic surgery in Rochester, N.Y. Arlene Rose Curry (M'82) • of \Y/oodside, N .Y., writes, "\Y/illbe married coJohn Patrick Hynes on May 28, 1989. Unfortunately, my father, Howard Curry, will not be with us - he died March 7, 1988." Richard L Collins (M'83) • writes, "I recently accepted the position of medical director at the Northwest Buffalo Community Health Center . I rook this position in October, 1988. This is a federally funded multi-specialty health center." Mary M. Lee (M'83) • is a research fellow at Massachusetts General Hospital, Boston . Adolph Soto (M'83) • is currencly working as a psychiatric attending at Lincoln Hospital in the Bronx on a special bilingual/ SPRING 1989 �Classnotes 36 bicultural inpatient unit . Soto was married on May 29, 1988. Raymond Graber (M'84) • writes, "l recently married che former Mary Kowalczyk of Amhe rst, Ohio . We hope to start on our 10 kids soon." Graber is director of anesthesia at che Veterans Administration Medical Center, Cleveland, Ohio. M ichele Kaufman Koleszar (M'84) • joined a women's medical group in Bridgeport, Conn., in the practice of obstet rics and gynecology. She marr ied Miklos P. Koleszar in May 1988. David J. Forster (M '85) and Carol A. Hammer (M '85) • were married in Buffalo in July. Dr. Hammer is practicing pediatrics in the Washington, D.C. area and Dr. Forster is associate chief resident in the Department of Ophthalmo logy at Georgetown University Hospital. He will be going co USC / Estelle Doheny Eye Center in Los Angeles in July for a fellowship in uveitis and ocu lar immunology. Lesley Burton-lwinski (M'85) • Finished a residency in June 1988 and is now a clinical instructor in che Department of Family Medicine at the Medical College of Georg ia. Jon M. Wardner (M '85) • who is a resident in P.M.&R. at the University of Michigan writes, "Blackford Middleton (M'85) and his wife Ursula King visited on June 28 en rouce co Palo Alco from Hartford . Enjoyed their company and an evening of gourmet beer casting. To Jim Esse r (M'85 ), we say 'ouzo' ." SPRING 1989 Chr istopher S. Walsh (M'85 ) • presented "Control of Neck Disease in Carcinoma of Waldeyer's Ring" at the October 1988 meering of the American Society ofTherapeuric Radiology and Oncology. Walsh is chief resident in the Department of Radiation Medicine at Massachusercs General Hospital. M. Miles Braun (M'86) • has joined the Internacional Activities Office of AIDS Program in Atlanta, Ga . N icholas D 'Avanzo (M'86 ) • will be completing his pediatric residency in 1989 and plans co open a private pediatric practice in Connecticut. Donnica L. Moore (M'86) • writes "I am well on my way coward recovery from my spinal fusion surgery, enjoying married life, and love my switch from ob/ gyn co family practice." Jos e ph A. Pierro (M '86) • is the first author wich Ors. Berens and Crawford of che Clinical Manual of Radiology,which was released in March. Ros ylyn R. Romanowski (M'86) • has scarced a fellowship in hemacology/ oncology at New England Deaconess Hospital. Evan D emestiha s (M'87 ) • is assistant medical director for Sandoz Pharmaceuticals in Hanover, N.J. He is responsible for products in the neuro-endocrine-metabolic cherapeu tic area including Parlodel (bromocripcine), Sandostatin (occreocide), and Tavist (clemanstine). moor Psychiatric Center, Queens Village. He began his career with the Scace Department of Mcneal Hygiene in 1935 ac Harlem Valley Psychiatric Center, Wingdale. During World War II, Haigh t served in the Army Medical Corps for nearly five years, seeing action in the Pacific. He rose to the rank of lieutenant colonel. He retired from the Army Reserve in 1967 with the rank of colonel. M ichele Kauf man Kole.1:.C1r'84 Brian D. Gal e (M'87 ) • has started his residency in nuclear medicine at Albert Einstein Hospital, Bronx, New York. R h onald 0. Hyndman (M '8 7) • informs us that he is still single. Jill E. K oe hl e r (M '87 ) • announces her marriage co Edilberco A. Mo reno, M.D. of Puerto Rico on April 10, 1988. Dr. Kochler is a pediatric resident at the Hurley Medical Center in Flint, Mich. Thomas P. Smith Jr. (M '87) • announces the birth of a son, Thomas Patrick 111,born on Dec. 25, 1988. Smith has a daughter, Megan Elizabeth, age 3. Deaths J. Roth ery Haight (M'3 4) • retired director of Gowanda Psychiatric Center, died Dec. 9. H e was 81. In New York Seate service for 42 years, Haight was director of the St. Lawrence Psychiatric Center, Ogdensburg; assistant director of the Kings Park and Utica psychiatric centers, and supervising psychiatrist of Creed- John D. Persse (M'42 ) • chief of surgery at Mercy Hospital from 1951 through 1971, died in Sarasota, Ra. He had joined Mercy's staff in 1948 and retired in 1981. Buffalo-born George Hatem, 78, the doctor credited with eradicating veneral disease, opium addiction, prostitution, smallpox, trachoma and filiarisis in China, died October 2 in Beijing. He had hoped co eliminate leprosy in that nation by the year 2000. He was known in China as Ma Hai-ceh, a name chat means "virtue from overseas." Harem received an honorary degree from UB in September 1987 and spoke ar the medical school's Spring Clinical Day in Ju• ly 1986. He is survived by his wife, two children, a sister, and two grandchildren. Former director of Child ren's Hospital Mo ir P. Tanner died August JI, 1988. He was 88. He held the position of director for 30 years - longer than any ocher administrator of his era. When he retired in 1967, a 10-story addition co the hospital was named for Tanner, who was known as "Mr. Chi ldren's Hospital." He also was very active in community and religious organizations . He is survived by a son, Duncan C., five grandchildren, and four great-grandchildren . • BUFFAID PHYSIC IAN AND BIO MEDICAL SC IENTIST ��Buffalo Physician & Biomedical Scientist State University of New York at Buffalo 3435 Ma in Street Buffalo. New York 14214 Address Correction Requested :S:on-Profi,Oll:U.S. Po,tage PAID Buffalo, '-.Y Perma :So. l 11 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Spring 1989 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1989-Spring Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v23n01-1989-Spring Table Of Contents A list of subunits of the resource. The elusive miracle A hot new field Earthquake. Bone Grower Research. Medical School News Hospital News People. Spotlight. Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-08 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v23n01 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1989 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/b9e7d5bc38e6182e6a53b6b4a90ded40.pdf 176af84cc28a3d0cd5088c01ed804b1f PDF Text Text Vol 22, No ~ �Dear Alumniand Friends: STAPF EXfC l '11\ f EC'ffi)R Lil's!\ ER'iITT Pl 3llt ATI->!'>IS R.:bcrt T \hr 6l fh\1.0 PIH~!( Al'<EDr,DR 1d Cor: c l)s" u d /1 =cdia.l ~ tr:mr m· hdd l l.ide,; :i shortl'ned \l'rs :Jn of m\ rem 1•k$to •he rctMlt tees Tro of Board nd n, 1s1r,m• .idm11, ft, t, h, the med1, I •o uixl.i•c i;ned Jc•, rrtre h1< p11,1IT Ho l,rneml Buffalo rh "' 1 1hc !,_.,spit I, 11\ 1hc 1he1r L 111,mLeiu.Jc Lbou1 de\dopml'nts ln~11tutc, "a< ried1c I chool, and JI 1hc Ro wet: P.ir:.. Memon I Thl. hosp11al (l.-sslul s1, .,..i1te \\a OUnt ~•1.1el. well atlendcJ ,md h', C'ndJct .ich , Ii> b c.onpr.itul •l-d fn IJkm .. \ luJblc t me 1,1.. , sul'S m ,111mlorm..illH' •l' nn lOlllcrnm~ rr ,1Jor c,)ntt.wporar\t.-du , >n .md h 'th <,ire. n ,J .-sJrc nd As vou "111 glt'ln from m\- rem.irks. m,1Jor d1..ingt to "• I Nnr llX,11ly, tc\\1dc anJ n.mon.illy "h1 h w1I rH· I med the lxrneen tt.d cx1 ,c h 1hat ps h ch,m :, the rcfauon fhcsc ,hangcs cdu, 110n'-""llll'llll ty anJ ~h, p 111t•ntcJrt· sy•ttm 1hat h.ivc 111tcr.1C11ons \\ill oltcn be tro·1bk-wm • .i1 that 1hc um'iuc 1 dNUPll.-d as 'llOrc .ind r x1stt·d m th, husp t I em ronn, nt "1 1 be mt-d m ,lm riore mt.-d1, I studc111 .md re d nt cdu.a".;>n 1spcdor of tht l.ilrrtnt hul:itor', md ...om'll m ty l'!l\ .ronm,llls, ,mJ mu h tc Urtl-S ot "ork {'C'l'IOrlT',J h\ res1dc111s ~ urned h.., altcrn ht.11th manpowu. ,mpc:nJ ng ,h,mges m thc mmner Ill wh1lh Di,-.;p1te th~ .te'l' w1'I med .ii edu,.1•1on 1sconJul.tcd, thn teach ng hosp1rn: sy '- ·re pJUcnt ,md fl.h, • r<." uon. c<lu.. f ull be. maJur 1n:!fU"TIC'l'o .1 tc,Jlh•ngl.m,1y for the .,, Je'll' lly ,mcntl.-d I, ulty ,rd thr rctrt ll ,>ricnlt'd pFl t1 mg phy,K,JII commun11y Hopctulh. ot us for dc11I ;cr\N 10 reinforce th t cont.er• JnJ tu pr,p,1rc .ill "1th m the mr wuh the rl·,1l11eswh1t.h we ,ire .md "rll he f,1,t·d J. he ye r T h 1< 1c C)frh B11/fle, Pin l<W ~mil,:, ART Dliu.C'TPR AJ,c J K,glcr ADVISORY BOARD [)r )o, I l',; IL n, • tl1<11m: Or H • ,Id Broov ' ( " lf .., :::>r.; .'" Kan \a 1ne1'• Dr C~ 11le. Mr ulTg(lry l • -\ Dr Amm. ttle .trcn 4 Dr l har re I r ,t , R Dr l Dr T om- I >S<:nthal L O< '>Jltt' ', [):,Bu.Dr. 5«phcn 5p:.:.1dmij Dr N -,;'\TorrMr EJ,. rJ \1 ,.., Or H1u1 c,· \\>,er• ,emt'C Or ]<'TI>:'. WRITI:RS \!ark Marc'i.,lla hn "'•ugh· I: •sabcth % fhc J "ue 'll'uctchr ILLUSTRATORS CiiTg B, hop &m F•.:gm'J P l l(mlG R1\ Plll:RS Tong 'i.m Bo "- on Jm· 1 rrat n John n 8 Na u ghto n , M.D. Prc,.Jert/0"'Clrm<.i!IAIJa,r, v•.._.._ u & ...... l. - TE.ACHINGIIOSPITALS ANI> LIAISONS of M, I, me u· 1 Bron: t,c..11'x .,,.e, D.m '><.ho<f l t , A Dear FellowAlumni: "M llarc.lFllh, ore llo-p1·al, Clan•, 1: Day, Bo..ird, A'umm thl' H~CJ. 6, MJy 1,dJ to wh,,h pie , j 10 1 mount. th it the pn:y,rJm h • hu:n cl 11,r1hc pe 1ker, w111 Jay A J, ,11n-; 11 h -<lfJl •1h of l<X1 11' :l nauon 11 "•~ ri,1h• .i'T'r J, i.. •~urmon 1r th '4! •I•• ou• ~ pc 1h,111' ret.r,1011 ,la 1he1r nJ . ,rn p·ogr th1 tt•nd lo ., cvl"-•·rrrd dfort l hh hm l't of Th Alur m· Bo rJ I. t<•t pn t I th nu:·bo ,rd r llHrl·ntl. 01,1m 'J hed Ml-d ,JA ,urr r,u 'A"JrJ. , • p col th1 p 1hlll. I th )r, C. .urJ (-C~ mp n ·n r, , :t< f0r tin ., po t,1rl' "l;. 1d (ard nJ • t nom1nt tkttm,; • 1 <rlter. th n n I' I..)ffi'\lumm the.· ro for -t.l'd 1, \'Ol r n0m1n,ltlon p 1 )· r '-<' ti ,J th1 t th r,nuur. I hi-e I 1. I\',""" Lr.. .r, ti, l11<1or','of ,r 'llt-n':-t yang p thl· l,rg~ I c.·nrol'n,t1,t ••I J~. \'\' on the bo rJ Pixnn. 1,41, l' 1 \ 'I A11•n" I \1cJ ~h lur. 1d wot, J 1cn•lxr r ir • rrori , 10i.:. for" ,rd t '< >flti"'l'H: ! JP"''"' • r~ I,, '1\ ,nc In• ti, It l fl• \1c ·nhcr ' p •n .i• '"l'J"'I; 1 tr t po , t>·••~.pll' <' rc~po,,I f v ~.1bl, •o ,.1 rr, , re 11011 1 the ~.rr, 1<rro\\ Ill's ntJrc r to our Spnll Bl•) \ r C l Pl > " l , C , • A, Ju [' \/T [ j 16 ( f "''.,.. ' . 'l , II h11'1,r, \1 .:... /~//1./~k Paul If. Wicrzbicnicc, M. D. Pre .Jer.1 . I! I l �Vo l. 22, No. 5 Features The best is yet to come. Donald S. Faber, Ph.D ., received the prestigious Javits Neuroscience Investigator Award for his work that has helped change the way we think about the nervous system . I lucky13. For alumnus Larry Schreiber and his wife, Carol, ten adopted children plus three children by birth add up to one big happy family. Cholesterol.Can you trust laboratory measurements of cholesterol levels?An October conference looked at that and other question s pertaining to cholesterol. I Passivevaccine.Edwin D. Kilbourne, M .D., one of the world's leading experts on influenza, is working on an influenza vaccine that actually allows a virus to invade the body . He described his research in the fall Harrington Lecture . Airwaves.Three students find that jobs as radio disc jockeys ease the tension of medical school. ~ Handpicked . The students entering UB's medical school are talented and diverse. Departments HospitalNews.The board of managers at the Erie County Medical Center has more power over the day-to-day operations of the hospital, thanks to a new law that was effective Jan. l. Classnotesand alumninews. A new annual award will honor a Distinguished Medica l Alumnus/a . Cover P hoto: Bob Walion ��3 It's More Than Electrical Wiring Faber gets ]avits Award for researchon nervous system i f ver the last 14 years, Donald S. Faber, Ph.D. has he lped change the way we think about the nervous system . In recogn ition of that fruitful work, and in anticipation of more to come, the UB professor of physiology has been given the prestigious Javits Neuroscience Investigator Award by the National Institute of Ne u rologica l and Communicative Disorders and Stroke . The award, named for the late Sen . Jacob K. Javits of New York, is given to investigators who have a distinguished record of substantia l contrib utions in neurologica l or comm u nicative sciences and who can be expected to be highly productive over the next seven years. The award grants Faber an extra two years of funding for his new NIH grant, bringing it to a total of $1.2 million over seven years. Since the 1970s, Faber and the members of his laboratory have collaborated closely with a group of researchers, led by Henri Korn, M.0., Ph.D., at the Pasteur Institute in France . "The award is the result of our collaborative efforts;' Faber said . This grant, as well as h is previous work, focuses on synaptic interactions in the central nervous system. Faber and his colleagues work with the Mauthner cell in the brain of a goldfish, BUFFALOPHYSIC IAN AND BIOMEDICALSCIENTIST which he finds to be a better experimenta l mode l than mammals or invertebrates. "Ic's a very beautiful system for a number of reasons," Faber said . "The cell is identif ied-you can give it a name . That's not common in other systems. "There are just two of these Mauthner cells, one on each side of the brain . And the cells are large." The job of the Mauthner cell is to trigger the fish's escape mechanism-when you tap the aquarium, the fish swims away. Different kinds of sensory input trigger the cell and trigger it reliably. How does this trigger work? Using microelectrodes, the researchers recorded the Maut hn er cell's responses to inputs from sensory cells and from inhibito ry interneurons (the cells that "talk" to the Mauthner cell). These inhibitory cells are part of the network that controls when an escape occurs. Injecting dyes into the inhibitory intemeu ron, the researchers were able to look at the structu res of the synapses using the light microscope and electron microscope . "By combining physiology and structure, and statistical ana lysis of responses of the Mauthne r cell to inhibitory intemeurons, we have developed a mode l at the microscopic level for synaptic transmission in the central nervous LATE WINTER 1988-89 �4 Does one synapse influence another? "We're excited about the question of cross talk because it opens up a number of possiblr ua)S of thinking about hou the nervous s, stem i0orks." 1 LATE WINTER 1988-89 system; Faber said. "This mode l is common not just to fish, but to most neural connections!' ne aspect of the model is related co the fact that the endings of nerve cells release chemical transmitters in a "probabi listic" way, Faber said . 'There's a degree of uncertainty in the way the connections work ." We often think of the nervous system as a wiring diagram . If you flick a switch, a light bulb goes on. But Faber pictures it this way: You've got 10 light bulbs . When you flick the switch, sometimes all 10 bu lbs light up. Another time just four light up, or none come on at all. Though the stimulus is the same, the message that the cells receive is different each time. This probabilist ic feature also provides the basis, in some systems, for forms of "plasticity" where, with experience, synaptic connections become reinforced . For example, if you stimu late a nerve cell repeatedly, there's a greater chance that subsequen tly all 10 bu lbs will switch on . Faber likes to use the term "plasticity" co describe this phenomenon, preferring that word over "learning" or "memory~ That, in capsule form, is what Faber has been working on for 14 years. About four years ago, Faber and his colleagues began to think about the u nity of a synapse-not on ly how the chemical trigger is released, but how the Mauthne r cell responds . They've developed computer models of how that works, tak ing into account the diffusion of the chemical transmitter in the synaptic cleft (the very small space between the inh ibitory interneuron and the Mauthner cell) and how the Mauthner cell responds to that transmitter . T his mode l prompted the researchers to become interested in new questions, including : Are the adjacent synapses isolated from each othe r or does one synapse influence another? The re are indeed mechanisms for cross talk between adjacent synapses, Faber and Korn wrote in a November 1988 article in the Proceedingsof the National Academy of Science.This work becomes the focus of the Javits Award, Faber explained. "We're excited about the question of cross talk because it opens up a numbe r of possible ways of thinking about how the nervous system works:• he said . The genera l notion about a synapse is chat a chemical neurot ransmitter is released, diffuses over the synapt ic cleft, binds to specific receptors on the other side, and is quickly deactivated when Pac-Man-like proteins gobble it up or carry it away. But Faber has found that instead of being active ly carted away, the chemical transm itter slowly diffuses away. While the chemical lingers, its effect can be compounded . For instance, if two adja- BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �5 Faber thinks a chemical transmitter can change an adjacent receptor site. "If iue're right, we have a tremendous mechanism for modulation of synapses that use even different transmz.tters.'' cent inhibitory incemeurons transmit glycine, the effect is greater than the two individua l effects added up. "The fun thing we want to do in the next few years is expand chat concept;' Faber said. Suppose two adjacent nerve endings, called A and B, release different chemica l transmitters onto one cell. In the old way of thinking, chose nerve endings are isolated from each ocher. Chemical A affects receptor site A and Chemica l B affects receptor site B. Then the chemica ls are quickly deactivated. But Faber thinks it's possible that chemical A may affect not only receptor site A, but diffuse over to receptor site B and change it as well. "If we're right, we have a tremendous mechanism for modulation of synapses that use even different transmitters;' he said . This adds a level of sophisitication to our thinking that's left out of the "wiring diagram" view of the nervous system. He noted that a lot of experimenta l models for plasticity in the nervous system on ly work when groups of cells are active, not when a sing le cell is active . Faber's postulation "is one type of mechanism that explains chat, we hope . We'll try to find our:• aber received his S.B. in electrical engineering from the Massachusetts Institute of Technology and his Ph .D. in physiology from UB in 1968. For cwo BUFFALO PHYSICIAN AND BIO MEDICAL SCIENTIST years he worked ac UB as a postdoctora l research fellow supported by an NIH grant . He left UB to become a visiting research associate at the Max Planck Institute for Brain Research in West Germany, chen moved on to a similar position ac the Universice de Paris. From 1972 to 1974 he was an assistant professor of physio logy at the University of Cincinnati. Faber moved back co Buffalo co cake a position as a research scientist with the Research Institute on Alcoho lism. In 1975 he joined che faculty at UB and in 1978 became director of the Division of Neurobiology, a pose he held until 1986. A prolific writer, Faber has published 82 papers and one book. In addition, he holds numerous positions with faculty committees. Awards are nothing new to Faber. He was an exchange scholar with the Capital Institute of Medicine in Beijing in 1986, a fellow of the Neuroscience Institute in New York City in 1984, a fellow of the Claude Bernard Association in Paris in 1972, and a Grass Foundation fellow at the Marine Bio logical Laboratory in Woods Hole, Mass. in 1969. About the Javics Award, Faber says modestly, "It's a nice feeling to be recognized . le says my colleagues like what we've been doing:' • LATE WINTER 1988-89 �0 Il.§ 6 LATEWINTER1988-<W 0 ceil.Ir BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �7 Larry and Carol Schreiber, the jay of adoption has evolved into a lifetime pursuit. They have adopted 10 children- nine in seven years - in addition to their three children by birth. In the rural town of San Cristobal, New Mexico, population 200, the Schreibers and their 13 children comprise 5.5 per cent of the total population. Their experiences have been so good, they have formed a non-profit organizationcalledChild-RiteIncorporated to help place other children with special needs. The couple's interest in adoption began in Buffalo in 1971 while Larry Schreiber, a UB medical schoolalumnus (M'72), was on his senior pediatric rotation at Buffalo Children's Hospital and Carol was there as a recreationaltherapist. It was there that they met Lawrence, a 17-year-oldhemophiliac. or BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST LATE WINTER 1988-89 �8 awrence "was having various medical, financial, and family problems at the time and cou ldn't return home to his family in New York City. He needed a temporary place to stay while he was being treated in Buffalo;' Schreiber explains. "Carol and 1,having worked extensively with him during his treatment ar the hospital, were concerned for him. So, we offered him our place to stay:' After 10 months he was able co return successfully to his own family. Now 29, Lawrence resides in Buffalo with his wife and three children. Sho rtl y following Schreiber's graduation from medical school, the coup le moved to New Mexico where Schreiber began his summer internship at the University of New Mexico-affiliated hospital in Albuquerque. Working primarily in the pediatric ward, Schreiber met a four-year-old boy named Matthew who had lived in five foster homes after being abandoned by his mother when he was only a year old . Since Matthew had no home or family waiting for him, the Sch reibers yearned to give him a loving and permanent home, something he had never yet experienced in his young life. ln response co Matthew's needs and cheir unwavering emotions, the Schreibers adopted Matthew in December 1972. He was their first child. Only one month later, Sch reiber helped Carol deliver Jordan, the first of three children born to the couple. Lucas, their second son, was born in July of 1974, and their daughter, Gabrielle, was born in November 1978. le was not until 1980 chat the Schreibers considered adoption again. Schreiber was working as a volunteer for the International Red Cross Committee on the Thai-Cambodian border when he met Michael in a refugee camp. Michael was an II-year-old Cambodian orphan who was subjected to horror of watching his family of four die at the hands of the Khmer Rouge. He had been surviving on his own in the war-torn country for several years. Schreiber was moved by Michael's circumstances during his three-month stay in the refugee camp. Having inadequate medical facilities to treat a cleft palace from which Michael was suffering, LATE WINTER 1988-89 Schreiber wrote to his wife suggesting Michael's adoption and treatment in the U.S. Caro l agreed and the Sch reibers applied for Michael's adoption immediately through the United Nations, but there was extensive polit ical and bureaucratic red tape. "The political climate in that region of the world was very unstable ar rhe rime; Schreiber recalls, "so Carol and I were extremely worried that Michae l wasn't going to be released from rhe country ." ;\1tcha l arni eel at L A. International Airport not knoi i g an'\ En lish, Just tearing a tag around hii; neck that identifze his famzh and destination Wzthin u eek,, bab'\/ Yo Ri chaperoned tu o from Korea, arrned zn the U.S. Feeling frustrated and helpless, the couple sought advice and emotional support from Friends of Children of Various Nations, an adoption agency based in Denver. Here they became interested in a nine-month-old girl from Korea named Yo Ri. The Schre ibers were first introduced co Yo Ri through "exchange books" that contain a phorograph and an extensive case history of each child . The Korean infant was also suffering from a cleft palate . However, un like Michael's situation, Korea was politically stable enough co have her released for che Schreibers' adoption. While they were awaiting Yo Ri's arrival, much co the relief of the worrystr icken Schreibers, Michael was finally released from Cambodia . He arr ived in June 1981 at L.A. International Airport, not knowing any English, just wearing a cag around his neck chat identified his family and destination in New Mexico. Within two weeks of Michael's homecoming, baby Yo Ri, chaperoned from Korea, also arrived in the U.S. "June 1981 was a very excit ing month for us with the addition of both Yo Ri and Michael within such a short time;' recalls Schreiber. "After such elation, Carol and I had very few reservations about adoption." In 1983 che Schreibers again adopted two children at one time. Eight-year-old Kevin and his IO-year-old sister, Mary, came to the Schreibers from southern New Mexico . The two black children had only each olher as family after experiencing child-neglect and then several temporary homes through the foster-care system . They were a welcomed addition co the growing Schreiber clan . Next, in 1986 came Gina - all the way from Calcutta, Indi a. Gina, on ly eight years o ld and suffering from polio, was abandoned because her mother cou ldn't care for Gina's special needs while caring for Gina 's six sisters. The Schreibers were informed of Gina's situation through an Albuquerque adoption agency called Rainbow House. Since joining the Schreibers, Gina has had back and leg surgery and is able to walk with the help of braces. When Schreiber flew co Calcutta co escort Gina back to New Mexico, he met Gina's good friend Champa . Champa was co be adopted by a family in another region of New Mexico. In November 1987, Rainbow House called che Schreibers to tell chem chat Champa's adoption didn't work out with her prospective family and chat she was going to return to India. Once again the Schreibers opened their hearts and their home and took Champa in. All of their children are now thriving. Matthew, 20, from New Mexico, is currently a sophomore at Eastern New Mexico University. Michael, from Cambodia, is 19 and attends Pitzer College in California. Jordan, 15, attends Taos County High School. Champa, from In- BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �9 Hen•'s tht whole clan Larn <1nd Mattheu art st<1nclmg m bad,. ln the m1clcllerow, from left ar~ Mary, C hamf>a· Michael; Re) na1clo bemJ:'hl'lcl 1,..,( arol; I 1cas; Jordan and Ket m. Th girls m front ar Yo Rr, Lorena, Gabriell huJ:'grngC 1ela and Gma dia, is now 14. After studying English and the equivalent of eight years of school in merely three years, she attends junior high with Lucas, 14, and Mary, IS, one of the black siblings. Mary's natural brother, Kevin, 13, attends Taos Middle School with Gabrielle, 10, and Gina, 10, from India. And Yo Ri from Korea, 7, attends Taos Elementary. chreiber acknowledges that all has nor been smooth sailing with such a large and diverse family. Problems often arise when another child is added to the family, especially when a newly adopted child is the same age as a child already there. "It is sometimes a difficult adjustment for a child who has already been through BUFFALOPHYSICIAN AND BIOMEDICAL SCIENTIST four or five foster homes; Schreiber added. "It takes a little bit of time for a child to figure out how he fits into the new environment. But that's only natural. All the kids have fit in just beautifully. "We have family meetings all of the time, so that grievances and growing pains are aired before they become too large to handle. We keep the lines of communication open. When we are considering another adoption we discuss it among rhe whole family. If anyone is uncomfortable with an addition at a certain time, then we decide against it. When we do decide to adopt a child, it is a family decision." The latest additions to the Schreiber brood came in the beginning of 1988 with little hesitation from the family. They are Lorena, 4; Ciela, 3, and Reynaldo, 2 - three Hispanic siblings from southern New Mexico. They are now the youngest of the Schreiber children . "Carol and I had never really planned to adopt ten children, but the addition of each individual child, with his or her own diversity of unique personal and cultural backgrounds, has helped all of us grow immeasurably closer and stronger as a family. The tribulations seem minimal by comparison. We have found adoption to be the most splendid thing in our lives; Schreiber emphasized. The Schreibers say they are now at "capacity; but their enthusiasm for adoption hasn't waned . They've steered their efforts coward Child-Rite Incorporated, a non-profit organization they formed in LATE WINTER 1988-89 �---: 10 �h hut II un J hi orgar z ati Ri n th t I he co plt t mp li m~ pro oft often n 1986 to help place "special needs chi ldren" in permanent residences. "Special needs children" is a term given by the government for children in state institutions or foster care who are older (9 years and up), are in sibling groups, have minority backgrounds, or have exceptional physica l, mental, and emotional needs. Most special needs children are placed in state custody or foster care as a result of child abuse, neglect, or abandonment. ... II of the Schreibers' adopted children were considered "special needs children" by the state . The couple emphasizes that their family is living proof of the overwhelming joy chat these often-neg lected children can add to a family. They point out chat the wait to adopt a special needs infant is usually less than a year, which is much shorter than the usual three-year wait for healthy white infants . Also, it is not only possible, but common, for loving single parents to adopt a special needs child. To families who decide to adopt special needs children, the state may pay a stipend depending on the family's income and the specific needs of the child, Schreiber pointed out, but laws vary BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST l from state to state . There are also other subsidies such as food stamps and Medicare, which may include both medical and psychiatric treatment for the adopted children . Child-Rite has placement and referral services that are national in scope. It will refer prospective parents to other agencies and organizations which may better fulfill the parents' needs. Schreiber stressed that Child-Rite does not charge for consultation or referral. Its funding depends so lely upon private taxdeductible donations. Child-Rite works closely with Bob DeBolt and Aid for Adoption of Special Kids (AASK). DeBolt established AASK in 1976 to place special needs children in permanent residences after his family reached adoptive capacity at 20 children. Other Child-Rite board members include Carol Schreiber, who is completing her M.A . in social work at the University of New Mexico, prominent regiona l artist Veley Vigil, and author John Nichols, who wrote The MilagroBeanfield Wars, which Robert Redford recently brought to the screen. For more information concerning adoptions or donations, write to the Schreibers at Child-Rite Inc., P.O.Box 42, San Cristobal, New Mexico 87564, or call (505) 776-8158. • LATEWINTER 1988-89 �12 TRUSTWOR 7• Cholesterol tests yield dubious results hen I was in medical school, I thought if I sent a sample to the lab, I could rely on the values," said Philip L. Green land , MD. "I don't think we feel that's entirely true any more, especially in relation to cholesterol testing." Greenland, an associate professor of medicine and preventive medicine and director of preventive cardiology at the University of Rochester, spoke at UB in Octobe r during a conference on "Elevated Cholesterol: A Public Health Crisis?" sponsored by the UB medical school. The medical literature points out that laboratory measurements for cholesterol around the country aren't very good, Green land said. He noted that 240 mg/di of cholesterol is considered the cut off for high risk. But if a blood sample that has a value of 240 is sent to a lab it might come back with a result ranging anywhere from 226 ro 254. "In other words, you might see a patient today whose true value is 240 and it comes back 254,"he said. "You might see him tomorrow and you measure it again and it comes back 226, and nothing's happened to the patient; it's simply the laboratory variability!' Using the instruments and chemicals they have today, the laboratory people don't think they can get more precise than that, he added. In a 1986study, blood samples were sent to 5,000 labs in the United States. While the true value of the specimens was 262,95 per cent of the lab results ranged from 210to 3IO. That's when peop le started getting excited and the Wall Street Journal ran an article about it on the front page, Green land noted. The problem is with reference materials supplied by the manufacturer that laboratories use to calibrate their resting systems. The best reference material would be blood, but that's coo expensive co use. Manufacturers are trying to come up with better references and have improved their products in LATE WINTER 1988-89 the last several years, Greenland noted . That resulted in some inadequate tests being pulled off the market. Another problem with cholesterol testing is that several methods are used, but the results aren't comparable. One method might give a result of 225 while another yields a value of 240. "Laboratory directors are aware of this problem now and by and large are correcting for it," he said. G reenland indicated that labs shou ld use a system that's comparable with one used by the Centers for Disease Control. While the CDC standardizes systems, it doesn't have enough resources to standardize labs, except for labs conducting NIH-sponsored research. "To my knowledge, between Rochester and C leveland, there is no CDC-standardized laboratory," Greenland said. "Thank goodness we're in New York because the State Health Department is developing a reference lab so that laboratories in the State can send samples to Albany and assure themselves that they are giving answers traceable back to the CDC. "ls that happening now? No. The best thing you can do is ask your lab director if he's using a system traceable back to the CDC." Also ask the lab director for data on the precision and accuracy of his lab, Greenland suggested. While there are a lot of problems with cholesterol testing, testing for components of cholesterol is even worse, Greenland said . There are several components to cholesterol. One, called low density lipoprotein or LDL, is connected with a higher risk of heart disease. But another, high density lipoprocein or HDL, protects people from heart disease. While it might be beneficial to know rhe levels of various components, today's tests don't tell you much, Greenland said. Cho lesterol testing "has problems, but it's getting better," he said. He predicted char we'llsee more specific tests in the future. The cholesterol levels of most of the people in BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST .... �... -.. ' •• , • • •• Bad Food s: • • ••••••• •• •••• cream ► sour cream ► ice cream ► cheeses ► butter ► eggs ► red meat ► sausages ► organ meats ► palm and coconut oil ► �14 "lf somebody enjoys drinking, I might allow him two drinks a night . But I wouldn't recommend it as therapy for a ceecocaler." There's a whole list of drugs chat can lower cholesterol, bur all have drawbacks, Kohn said. Each drug has its own sec of possible side effects. For instance, Nicotinic Acid can cause flushing, gastritis, nausea and malaise. You'll feel lousy for a week, Kohn promised, then these side efects generally disappear . Nicotinic Acid can also cause abnormal results on tests of liver function. The cost can be another drawback. Prescriptions may run $100 a month. And after a while, a single drug may be no longer effective and the doctor may tum to a combination of drugs . "But when you consider what this costs, the patient may be taking $200 or $300 worth of drugs," Kohn noted . "lf the pat ient also happens co have hypertension or something else, he has $200 more of that medication. The patient must be very rich, indeed. "When you're dealing with real patients, you've got to be aware of the costs of all these medications you're ordering or you won't have a very big practice very long." Kohn says he hopes that new cholesterol drugs will spark enough competition among drug companies to bring the price down. "If patients are concerned about the price of drugs, the only alternative we can offer is diet, and they will have to modify their behavior and stick to that diet the rest of their lives," he noted . But this diet is nor well accepted by Americans, he added. His point was illustrated by a 27-yearold woman in the audience. Her mother had had oods to watch out for, Kohn said, include dairy a stroke, she explained, and she was concerned foods, eggs, palm and coconut oil, red meats, about her own cholesterol levels. Ac what point organ meats, and anythingin a sausage casing. Good would Kohn prescribe medication, she asked, adfoods include poultry, fish, cereals, legumes, com ding chat she's not going to give up pizza and oil margarine, sunflower oil, and low-cholesterol chicken wings for the rest of her life. products like Egg Beaters . "That's one of your choices," Kohn said. "You Pasta is good, but be careful of the sauce, he know the risks, and you've got to be willing to acwarned . Fish oils are fine if you use chem instead cept them ." of saturated fats in your diet. If you supplementyour When co prescribe d rugs is a very individualdiet with these oils, he emphasized, it's only going ized thing, Kohn said, and strongly recommended to make you fat. a rigid diet for the woman. He pointed out that Shellfish have some cholesterol, but they also if she planned to get pregnant, she should avoid have a lot of unsaturated fat . So they're fine, but medication since we don't know the effects on rhe watch the drawn butter, he added . developing fetus. Kohn suggested chat two drinks a day can Physicians tend to overlook the contributions elevate rhe levels of HDL, the beneficial cholesterol. co-professionals such as nutritionists can play in Bue more than two d rinks a day can pose ocher getting somebody to alter his or her diet, Kohn problems. remarked in answer to a question . "I don't know if (it helps reduce the risk of heart Yeagle also pointed out that there is a whole disease) because it increases HDL or because it's a family of risk faccors for heart disease, including socially accepted tranquilizer that makes you feel family history, age, sex, smoking, and exercise. better;' Kohn said. Cholesterol levels can't be considered in isolation. • the moderate to high-risk range can be modified by diet, said Philip L. Yeagle, Ph.D ., associate professor of biochemistry at UB who has done research in the basic role of cholesterol in cell membranes . "Five years ago I wouldn't have believed it," he added . At the high range, more than strict diet is needed. A one per cent decrease in serum cholesterol leads to a two per cent decrease in risk, Yeagle added. "Youcan have a very interesting diet and reduce your cholesterol," said Robert M . Kohn, M.D., clinical professor of medicine at UB and medical director oflndependent Health. "However, in order to reduce your cholesterol and keep it down, you have co stick co the diet . If you go off the diet even two days a week, you're not going to have a significant reduction in your cholesterol." Heart-smart refreshments were served during the break at rhe conference . There was plenty of dip and lots of celery sticks, bur not a chicken wing in sight. Instead, participants were treated to fresh fruits and vegetables with low-fat dips, soda pop, and tangy "Red Satin Punch" made from apple and cranberry juice . LATE WINTER 1988-89 BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �I ::: .. r . ~:H4,,.I . /ii!!~ ....,,;:-~· ~.. ~,·:: .• !/~.IJJ;f!. I I' 'I I , Jj1,, j:1:: /. [.:: ,·"' :.: I ....-:, ':°/ l ff::::': ; I • I''/!::: !' I I ., ·1, :·:.:; , .. :: ~ .rlJ(v·. .aL.•• I . • . '.:. : : I • • • -.r- .. •, ' : . j . ~ •i : ·:,, ·; ,' ..... . . .,. ..; •I:• ' ,,, ' . • • • 't .. ' • : : t . . . •1 ' ' ' ' ' , '1 I \ . \ I• .' • I ' C t t . I • I \ • \ 11, , • .f f '\.:,:1,•·, • I I I 'r.','•. . ' ,I I I C ' .' 't I' , j : ' I ; PI . I; I Good . . . . . . . . .Food ... . . . . s: . poultry ► f ish ► cereals ► legumes ► pasta ► corn oil margarine ► sunflower oil ► Egg Beaters �. ..: -', .."..··1.. ...-•-::\•..·..... . ...·. :~~ -· . . .•. .. . -~ _:(FP: ·:i}_:/ ::,-. ~·-. . -' - .- ·.. ..·:,,.. .-:t~ ~ ..\ -: . ...-'.' • . . ...-- .···.·:t'':'; . · .. .- . ·' . ~~ . . • . .:•..:,....!-.: • ., ~ . • ·• . .~ . , . ..,.~·. ~· • r;. • - ;::·•~):: ·: . .. ~ I • ~ ,--; •, I :, _.:: ::·., :T:~•/\.~ ; •• . ..... _ �17 Vaccine Lets Virus Invade-On Purpose By CONNIE OSWALD he soldiers stand ready ar battle stations, prepared to annihilate rhe enemy. Their duty is to make sure none of the attackers get into the fortress alive. That's how conventional vaccines work. Made from a weakened or nonvirulent form of the virus, the vaccine stimulates antibodies-the soldiers that fight off infection. But Edwin D. Kilbourne, M.D., one of the world's leading experts on influenza, is working on an influenza vaccine that would actually allow the attacking virus to invade the body. Kilbourne, a distinguished scientist both in microbiology and preventive medicine, offered a glimpse into his work during the medical school's Harrington Lecture in October. One of the founding chairmen of the Mount Sinai School of Medicine, he's a distinguished professor there and is a member of the National Academy of Sciences. Kilbourne's vaccine uses a single, purfied protein of the virus, a technique that other researchers arc crying as well. But what's really different about Kilbourne's vaccine has co do with the antibodies chat are produced . Instead of standing with guns poised to fend off any invaders, these antibod ies allow the attack ing virus into the body. But once the attacking virus gets inside, the antibodies prevent it from duplicating a great deal. By keeping the quantity of virus low, disease is prevented, yet new antibod ies are induced by the viral attack. The vaccine would allow the enemy within the gates, then suppress the enemy's activities, explained Kilbourne . A study by UB's Pearay L. Ogra, M.D. showed chat such an infection-permissive approach could work, Kilbourne said. Ogra is professor of microbiology and pediatri cs at UB and chief of the Division of Infectious Diseases at Children's Hospital. In Ogra's study, Buffalo schoolchi ldren were given a vaccine similar to the one Kilbourne is working on. "Disease was prevented, though not as well as with a conventiona l vaccine: Kilbourne said. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST S1DFKO "But it showed the approach is feasible. That's the lesson I took away~ The use of a single purified protein, in this case neuraminidase, is a technique rhat wasn't available when Ogra's study was done about IO years ago. It's something char may help overcome some of the drawbacks of rhe earlier vaccine, Kilbourne noted. All of Kilbourne's work with the single purfied protein has been done in mice. The next step is to begin studies in humans. It may be two, or more realistically, three years before a vaccine is on the market, he emphasized . "We've had encouraging preliminary results, but it's not for tomorrow's use in man; he cautioned . Influenza is a highly significant disease, Kilbourne explained, because it paves the way for pneumonia which can prove fatal. Even when it's not fatal, influenza causes fever, aches and pains, and lands people in bed. "Ir cou ld tic up a whole community; he said. "Ir has a high attack rate-it can be devastating econom ically.• The influenza virus produces widespread pandemics of disease in cycles, every 10 to 30 years. Episodes occur when the antigens change so much that they confront the whole global population as new viruses. 'So we all become children again in front of these new viruses,• he said. "We have essentially no past experience with the antigens ~ One advantage to Kilbournc's vaccine is chat since the protein used changes less frequently, we may be able to go for a longer period without having ro change rhe vaccine. Kilbourne is hopeful that his approach will provide a better vaccine for young children. With the present vaccine, child ren under two years old have about a 25 per cent change of developing untoward reactions; that is, developing flu symproms from the shoe. If you give them only a single purified protein, there's less chance of having a reaction. "That's a long way from being proved, but we think that giving one protein is better than giving seven-which is what you have with an intact virus; he said. • LATE WINTER 1988-89 �18 Students on , These three found f their love of mus By MARK M, hey close themselves inside a foampadded room on a regular basis co escape the pressures of their hectic schedu les. No, they're not asylum inmates, bur some may call them neurotic when it comes co thei r passion for music. David Blaustein, Tony Capocelli, and Rohic "Rob" Bakshi are medical students at UB and all have pursued their musical interests as disc jockeys on the FM airwaves. Bakshi, a third-year student, is working at KYUU-FM in San Francisco. He's caking a leave of absence from UB in order co participate in neural research at the LATE WINTER 1988-89 University of California at San Francisco. Capocelli and Blaustein, both fourthyear med students, currently co-host ThursdayNight Jazz on UB's radio station, WBFO, 88.8 FM. Although their styles and musical formats at the stations differ, all of the aspiring M.D.s agree that the air time provides them much-needed relief from the tedium and discipline of their rigorous med school studies. Capocelliand Blaustein Tony Capocelli and David Blaustein, both self-professed "jazz junkies," have been voicing their musical addiction across the airwaves at WBFO for the past thr ee and a half years. "I love jazz and I love neural regeneration research," the 24-year-old Capocelli professed . "If I had to choose an ideal goal right now, it would be to head a groundbreaking team of neural regeneration researchers and have a jazz band on the side. "Even if I never end up running a research lab, I know I'll always be playing jazz." Capocelli and his partner in jazz, Blaustein, met three and a half years ago through their mutual love for jazz. "I had just begun med schoo l and was blowing off a little frustration by jam ming on my alto (saxophone)," explained Blaustein. "I was in the student lounge at about 10 o'clock at night, so the place was pretty empty . Tony, who I didn't know at the time, was corning back from the library and heard me playing . So he brought his acoustic guitar down from his room and started jamming with me. We had a really good session ." Shortly after that, Blaustein and Capoce lli each began their l-to-6-a.m. "graveyard shifts" on WBFO-Blaustein on Satu rdays and Capocelli on Sundays . Although the positions were volunteer, BUFFALOPHYSICIAN AND BIOMEDICALSCIENTIST l J �19 the Airwaves P way to harmonize 1sic and medicine MARABELLA l J the early morning shifts gave the young jazz enthusiasts an opportunity to develop their formats, styles, and selections . The collection of jazz albums in the extensive WBFO library tops 20,000 records, so it took them both some time to distinguish their own repertoire of music for their shows. "They (management) don't give us any specific record lists. As long as we stay within the spectrum of jazz-which is pretty broad-we can pretty much play anyone we want to," said Capocelli. During the year and a half that both endured the graveyard shift, Blaustein and Capoce lli started their own jazz/blues band called Code Bluenamed for their mutual interest in both music and medicine. Code Blue is an "allclear" signal given in one hospital after a Code Red, which is the emergency or cardiac arrest signal. It also represents.the band's own brand of cool blues music which alleviates the "Code Red" pressures of med school. The six members of Code Blue include Capocelli on electric guitar; Blaustein on the alto saxophone; classmates Dave Vogel on electric violin, Esther Ponce on synthesizer, and Tom Grimaldi on bass, and Tom's younger brother Chris on the drums . Whi le the two-year-old band has BUFFALOPHYSIC IAN AND BIOMEDICAL SCIENTIST made no local appearances yet, Capocelli and Blaustein are hoping to play sometime on open jazz night at some of the Buffalo jazz clubs. Capocelli has been playing the guitar and working as a disc jockey since his days as a junior at Windsor Plainsboro High School in Princeton Junction, New Jersey. The high school station had a rock format, so Capocelli didn't develop an interest in jazz until he worked two years at WRUR-a jazz station at the University of Rochester . After completing his undergraduate degree in neurobiology there, Capocelli came to UB to specialize in neurosurgery as well as to pursue his interest in neuralregeneration research. Since WBFO is Blaustein's first experience in radio, it took rhe ZS-year-old native Long Islander a little while before he felt comfortab le behind the microphone . "It (the graveyard shift) was a learning experience," Blaustein admits. "Sometimes I thought that I was the only one listening. On the nights that no one called during my show, it was sometimes cough to stay awake even after drinking a six-pack of caffeine-saturated LATE WINTER 1988-89 �20 Mountain Dew. But after a while both of us established a fairly faithfu l latenight following. We would get the same peop le calling the stat ion at the same time week after week.n Although it was time-consuming, the station helped him tremendously in coping with med schoo l. "The first couple of years of med school were the hardest for me because of the constant studying and lab work . I don't think that I was exactly ready for the work because after I graduated from Emory University (in Atlanta), I traveled around the Un ited States for a year with my buddy . We were proverb ial 'freespirits' -picking up odd jobs here and there as we needed money. So when I started med school, 1 wasn't used to the schedule or the pressure '.' laustein's primary interests in the field of medicine include rehabil itation medic ine and functiona l orthopaedics . Because he majored in psychology and minored in English as an unde rgraduate, he developed a strong interest in the humanities . "I'm more concerned with the human aspect of medicine-like how a patient is going to function in society after a traumatic operation. My job will be to help patients after neurosurgeons, like Tony, get through cutting them up," he quipped . While Blaustein and Capocelli may one day professionally comp lement each other, they are current ly combining their talents on their own jazz show on Thursday nights from 9 p.m. to I a.m. and have done so for the past two years. They have also added a jazz/ fusion hour from midn ight to 1 a.m. Tuning into WBFO on Thursday evenings, one might hear Pac Metheny, Jon Scofield, Chic Corea, or The Yellow Jackets. "Even though some of the old-time LATE WINTER 1988-89 'jazz-purist' listeners take exception to the newer jazz/fusion, overall our listeners have exceptionally increased since ou r days on the graveyard:' Capocelli estimated . Blaustein and Capocelli are currently the on ly student disc jockeys on the air at WBFO. "Sometimes I thought I was the only one listening. But after a while both of us established a fairly faithful late~night following. We would get the same people calling week after week.'' Bakshi While Rohit "Rob" Bakshi began both his medical career and radio career in Western New York, his recent endeavors have taken him across the country to the West Coast . After completing his second year of med school at UB in May, he took a one-year leave of absence in order co pursue neu ral research with Alan Faden, M .D., at the University of California at San Francisco. However, Bakshi has also cont inued performing as a DJ at KYUU-FM, a "top-40" station in San Francisco . Although Bakshi is no stranger to top-40 commercial radio, he was forced to start from the bottom on the "graveyardshift" at the west coast station . Nevertheless, the Bay Area currently has the fourth largest popu lation area for radio in the country, so Bakshi's show is listened to by thousands of people even at the wee hours of the morning . Bakshi developed his interest in radio when he was a senior at Cornell University. There he entered a disc jockey competition for new ta lent for WVBR, the Cornell -owned-and-operated top-40 commercial radio station. Bakshi entered the competition with a field of 75 ocher hopefuls. "1 d idn't really think that I had a chance because I had never worked in radio before. But I worked pretty hard on my demo-tapes whenever I cou ld'.' "Demo-tapes" are demonstration tapes used in the music industry to screen prospective DJs for a job. Bakshi was one of the first of three chosen for the air. Shortly after, he acquired his FCC / FM license and began his nine-month stint at WVBR. After he received his bachelor's degree in biology, Bakshi started medical school at UB and made his local radio debut on the now-defunct top-40 station, WNYSFM 104. He worked the weekend "graveyard shift" for four months until the station was sold {it's now Classic Hits 104.1). Soon after, Bakshi appeared briefly again; this time playing top-40 on the weekend graveyards on the popular WPHD-FM 103.3. Then in the summer of 1987 Bakshi was hired at WKSE (KISS 98.5 FM) for its radio prime-time weekend daytime BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Medical School 21 Rohit "Rob" Bakshi shows. "It was a big break to get the numberone sloe on the number-one local top-40 station;' Bakshi recalled. "l guess they must have really liked my demo-tapes:' During his one-year seine at KISS 98.5, the radio station became Buffalds highest raced top-40 radio station (for 18- to 34-year-old listenership). Moreover, during the 1987 winter rating period, Bakshi's Saturday show from 3 to 8 p.m. was rated number one in Western New York. Bakshi, alias "Rob Miller" on the air, had to follow strict formatting, but still BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST introduced several creative features on his show that made it distinct in Western New York. He created call-in comedy spots for such characters as "Pee Wee Herman" (played by Greg Sambuchi) and "The Jammin' Grandma" (played by Bakshi's girlfriend Lorraine Baeum ler). One phone call in particular brings back pleasant memories for Bakshi . "On Mother's Day I called my mother and put her on the air live. le was pretty funny be,cause she didn't realize that she was on clhe air and said some pretty embar rassin1g things ." As hiis mother, Deebika Bakshi remembers, Rohic wasn't even going to apply for the job because he was sure he wouldn't get it . She encouraged him to app ly and "the number-one DJ had to thank his mother on the air." Rohit's parents have been a prime influence in his life. The 23-year-old was raised in the Buffalo area where his father, Suraj Bakshi, M.D., a specialist in nuclear medicine, works at Roswell Park Memorial Institute . Although Bakshi spends weekends working as a professional top-40 disc jockey, his medical studies have not suffered. This past summer he secured fellowship grants from the prestigious Alpha Omega Alpha Medical Honor Society and from the Ame rican Heart Association in support of his work with neuro logist A lan Faden, founder and directo r of the Center for Neural Injury at the University of California at San Francisco . Bakshi is one of the few pregrad investigators working on Faden's research team . More specifically, Bakshi's research encompasses central nervous system injury and neural-regeneration, focusing primarily upon the endogenous excitotoxins, opioids, and their receptors. Faden's research has been instrumental in the development of naloxone, which has recently been approved by the FDA for testing on acute spinal cord-injured patients. "I really love working as a DJ, but my main objective is to become a doctor. I don't think I will continue working at a radio station when I return to Buffalo in September because my third and fourth years of medical school are critica l years in my medica l education . But after I'm through with my medical training and have established myself in academ ic medicine, I would really like to gee involved with radio again," Bakshi emphasized. • LATEWINTER 1988-89 �\ 22 Handpicked Ne w student s are talent ed and diver se By CONNIE OSWALD STOFKO espire the gloom and doom predictions about the shrinking nation-wide pool of applicants to medical schools, UB had no prob lem finding talented people to fill its 1988-89 first-year class. In fact, it sent out only 301 offers of admission to fill its 135 spaces, noted Thomas J.Guttuso, M.D., assistant dean and director of medical student admissions for UB's School of Medicine and Biomedical Sciences. This is the lowest number of offers UB has sent out since 1974, and UB has the lowest turnover rate of the 12 medical schools in New York State, Guttuso added. While UB accepted only 2.2 students for every one who actually enrolled, some fine medica l schools have had to accept five students to enroll one, he said. "Our school is more popular; Gutruso said . "Our reputation is improving and there's less turnover ." He explained that medical schools across the country send out acceptance letters in different months. Students may accept at one school, then withdraw that acceptance when they hear from their first-choice institution . "Obviously, we're becoming number one for more people if they stay with us," he noted. According to John Naughton, vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences at UB, this popularity can be LATEWINTER1988-89 attributed to the school's improved facilities, stronger faculty, the diversity of the program, and economics-the low tuition and low cost of living in Buffalo. The warm atmosphere of the school is another factor, said Guttuso. He noted that many applicants are offered free overnight lodging with students when they come to town to interview. Students eat lunch with the applicants, and performances by the Dermarones, the student singing group, break the ice. "Faculty are very warm and supportive of students, and students are that way with applicants; Guttuso said. "It's the general atmosphere in the school." "It's an environment rhar stresses achievement and excellence, bur not a frenzied environment of competition," added Naughton. Students play a strong role in the life of che school. There's even a new group chat organizes parents into a support group for the school, he noted. "The number of applications is down, but the quality is nor down-not here," said Guttuso. "In spite of all the negative news about medicine, there are still plenty of people applying" to UB's medica l school. Negative publicity about medicine has eroded the profession's patina of glamor. What was once seen as a lucrative and prestigious profession is now viewed as one filled with long hours and huge malpractice insurance payments . People seriously weigh their decision to become a physician, Guttuso noted, and those who finally do choose medicine are usually very dedicated . "I th ink we'll have excellent physicians from these classes we have now; he said . The numbers bear him out. The class's average underg raduate GPA (grade point average) is 3.43. The mean MCAT is 55.92, above the national average of 54. Three of the new students have Ph.D.s and 15 have master's degrees. "In genera l, we've been getting very good classes;• said Naughton . "T he feeling is that the current classes are really outstanding ." The students come from a wide range of academic and social backgrounds . About 80 per cent majored in the sciences, with about 46 per cent majoring in biology, 10 per cent in chemistry, and 7 per cent in biochemistry. There are a total of 27 majors outside the sciences. About 13 per cent of students majored in the humanities and social sciences and 5 per cent majored in health-related fields. Falling into none of these categories are one student who majored in German literature, psychology, and biological sciences; another who majored in fashion design, and a third who majored in life sciences. The adm issions committee tr ies very hard ro make sure no group is discriminated against, noted Naughton. "This is a very representative class, made up of d iverse people of diverse BUFFALO PHYSIC IAN AND BIOMEDICAL SCIENTIST �23 backgrounds;' he said . "The proof of rhe puddin g is in the class,• Gurruso added . The class contains a record-setting proportion of females-48 per cent. There are 10 black students, four Puerto Ricans, and one Chicano. The oldest member of rhe class is 40 years old, and 25 students are 26 or older. There is one handicapped student . The largest number of students-70comes from the 8th Judicial District (the area surround ing Buffalo). Another 37 come from downstate, 17 from the extended Western New York Area, 6 from upstate, and 5 from out of stare . Because UB is a State school, it must favor applicants from New York State, and some preference is given to students from Western New York. Bur in order to show that rhe school is responsive ro its alumni, children of out-of-state alumni are now cons idered as local residents. BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST They, of course, must have compet itive credentials. "The number of children of alumni from our of state who matriculate is low; Naughton said, "bur we want them to know we welcome their applications ." • Focusedon a goal usic has always been special to D,eborah Shuste r of New York C ity. She received her bache lor's and master's degrees in music, then played viola professionally for five years. Yet she always felt a pull from the field of medidne. "My dad's a doctor," Shuster explained . "I've always loved science and I've always been fascinated by medicine . "As a child, I was encouraged to play music- I got a chance my parents didn't have. So I pursued music. It seemed the thing co, do at the rime." Shuster, now 29, performed with the Spokane Symphony Orchestra in Washington, played with professional orchestras in Italy and South America, and free-lanced in New York City with her own quartet as well as with small orchestras, ballet companies, and opera companies. "But it wasn't intellectually stimulating eno ugh;' she said . "I needed to use the other part of my brain." Shuste r attended a special program at Columb ia University for two years to pick up the science courses she needed, free-lancing on viola in her spare time. When it came time to choose a medical schoo l, she chose UB for several reasons, including the affordable price and its location . Her husband, a guitarist, teaches in Syracuse, so she wanted to stay upstate . Being a cad older than most of the other students is an advantage as she emLATE WINTER 1988-89 �;\, J l I' I 24 barks on her medical career, Shuster says. "I've seen a loc, dealc with people a lot, and that'll make my job easier; she noted . "I'm more focused and I know what I wane." • During his Early Assurance interview , he noted chat some people feel pressure co become a physician because they have a relative who's a physician. But Adams told the interviewer, "My father's not a doctor . My mother's not a doctor . The reason I'm here is because I wane co be here ." His inte rviewer cold Adams that, with his record, he could probab ly go to any medica l school he wanted . But Adams decided o n UB beca use it's inexpensive and he can get a good education here . He noted that since the facilities have just been refurbished, he's among the first to use the new labs. And he likes the staff. "It's a grind, bur I really enjoy medica l schoo l; he said . "It's like one big family. A lot of peop le have different interests, but we're all in the same boat, trying to become doctors." • Creative and dedicated fo.ld Servingothers odd Adams, 22, of Grand Island chose medicine as a career because "I couldn't picture myself doing anything else. I couldn't just sit behind a desk. I wane co work with peop le and help people:' Adams entered medical school through the Early Assurance Program, which allows qualified students to apply early. A biochemistry major at UB, he had a 4.0 average and had taken part in research . He also volunteered in the emergency room at Millard Fillmore Suburban Hospital, belonged to academic organizations, and enjoyed skiing, golfing, and playing basketba ll. LATE WINTER 1988-89 felt a real need to help peop le, as cliched as that sounds," said Hisla Bates, a first-year medical student at UB. A successful fashion designer, she abandoned that lucrative career to pursue her childhood dream of becoming a doctor. Born in the West Indies, Bates lived in Guyana unti l she was six, then moved with her family co the New York City area . In junior high school and high school, her arc teachers cold her she was very talented . "I got so much enco u ragement in arc, I decided to cry ic; she said. "It seemed a very exciting career, I was using my talent, and I felc confident. In science, I didn't get that kind of encouragement, though I was a very good student:' Bates attended the Parson School of Design in Manhattan , majoring in fashion design . After graduation, she worked her way up co become head designer for Herman Geist and did a licensee line for Stanley Blacker. "I traveled extensively thro ughout Europe and th e Orient; ' Bates said . "I started to make lots of money, but it still wasn't satisfying." After three years as a fashion designer, she spent four years as an undergraduate at Hunter College in the City University of New York to pick up her required science courses . She also d id research in the Marine Biological Laboratory in Woods Ho le and at Rockefe lle r University . "I'm glad I did it chis way; said Bates, 29. She's seen much of the world and has developed the confidence chat comes with success. Ac che same time, it was hard to give up a $40,000 a year job where she managed several assistants . But it shows one thing . "I really wane co do this," she said . • f·hsla Bates BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �\[ ",l ( I 25 GROUPSTRENGTHENS FAMILYTIESTO SCHOOL he notion is very simple;' said Peter Ostrow, M.D., Ph.D., associate dean for curricular and academic affairs. "Even though your son or daughter has become an adult and graduated from college, their need for su ppor t from their parents doesn't stop . It may even be greater because medical school is such a stressfu l time." Ostrow, along with a group of inspired parents, spearheaded the establishment of the UB Medical Student Parents Council chis past fall. The organization was form ed in o rder to strengthen ties between the medical school and parents . "(The council) is simi lar to the PTA in grammar school, only it's on a higher level;' explained Ost row. "Most families want to be more involved with what's going on in their son's, daughter's, or spouse's medical education above and beyond Family Day, which takes place on ly once a year." The deve lopment of the council was spurred by the huge success of Family Day, an event initiated in 1981by John Naug ht on, dean of the Schoo l of Medicine and Biomedical Sciences. The day allows families to interact with the medical school's faculty and other students, and stim ulates interest in the school and its activities. Families of freshmen and sophomores v1s1t classrooms and meet facu lty who can answe r quest ions about courses and teachin g methods, while families of juni ors and seniors visit US -affiliated hospitals where those students conduct practical rotations. Naughton introduced the idea of a parents cou ncil as early as 1981,but it wasn't until 1986,when attendance at Family Day surpassed 500, chat the BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST medical school decided the time was ripe to develop such an organization . When Ostrow presented the idea last summer to parents of UB medica l students, he met wirh overwhelming ly positive response. Gail Pitterman, one of the founding parents and a member of the council, spoke about the new organization at the opening presentation for first- and second-year students ar the most recent Family Day. "The primary goal of the Medical Student Parents Council is to give moral and financia l support to students and the ir schoo l;' noted Pitterman. Pitterman said the council is looking for volunteers in various cities co ace as hose families for UB students who need a place co stay when interviewing for residency programs. Local hose families are also needed to accommodate students interviewing for entrance into the UB medical school and to provide hospitality during holidays for chose unable to return home. The council is also inviting parents to work with student organizations and the UB Foundatio n to plan social, educational , or fund-raising events, and to gee involved with publicity for the school. Cu rrently, the council is helping to raise funds co support the medical school's Computer-Assisted Int eractive Video Teaching Aids. Since the counci l's inception, membership has grown from 14 parents to about 50, most from New York State . Some parents who find it d ifficult to attend meetings at UB are consider ing organizing a New York City chapter as well. "We encourage parents and any othe r family members to get involved, make suggestions, or offer their services if they're interested;' Ostrow remarked . "There was a very similar program at the University of Houston where I previously taught that proved to be very successful and popula r with the school and the families of the students . "What's unique about a Medica l Student Parents Council is that it provides people with more info rmed support and activity that isn't always after the pocketbook . "We wane our students' families co know that they haven't lost a ch ild but have gained a med school;' Ostrow said . Th ose who are interested in the council can call (716) 831-2802for more infor• macion. -By Mark Marabella LATE WINTER !988-89 �26 ~ The Other Classroom Buffala hospitals maintain a key role in medical education By JOHN NAUGHTON, !though numbered among the oldest of America's medical schools, UB is one of the few which has maintained the status of a "community-based" medical school for such a long time. Medical historians note that of the northeastern medical schools that survived the 1910 Flexner Report, LATEWINTER 1988-89 M .D. two, namely UB and Albany Medical College, chose to distinguish themselves primarily as centers of clinical training in which our network of teaching hospitals was and is a key element . The merger of the private UB with the public SUNY system did not treat the medical schoo l kindly during the early years of trans ition . It threatened the bonds between the old UB and its already existent faculty and hospital system . The university medical center that was proposed for the Main Street Campus or the future Amherst Campus probably never had any real chance for success. BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST �27 We are still, and will continue to be for the foreseeable future, a communitybased medical school working with a group of affiliated ho spitals . The major differences between now and 1962 are that we have forged through the partnership with the SUNY system a much larger, stronger, and more secu re funding base which has enabled the University and its hospital community co raise their sights and to become compet itive with major medical centers throughout the Stace and the nation . The cha llenge that the hospitals and medica l schoo l share is ro develop the interrelationships necessary to use the investment of the citizens of New York Scace and to make it benefit each of us as individuals, institutions, and communities . I chink we are on char course, and, hopefully, when chis century closes, each of us can look back on the efforts put forth with a sense of satisfaction and accomplishment. The hospitals' principal co ncern in medical education relates co the role of residents in the hospital system and the future of loca l graduate medical education . There are three things we should keep in mind: First, reform of graduate medica l education is upon us. Second, the public policy priorities for graduate medical education at the federal and Scace level are ar variance with much of what occurs in the nation's 127 medical schools . Third, funding mechanisms for support of graduate medica l education will change . Given the above assumptions, we shouldn't dwell so lely on the quality of the graduate medical education programs in Buffalo. We know char the q ualit y is good and it will continue to improve. In stead, we should dwell on any incongruities char exist between institutiona l and recommended pub lic policy, BUFFAW PHYSICIAN AND BIOMEDICAL SCIENTIST "We are still, and will continue to be for the foreseeablefuture, a community~based medical school working with a group of affiliated hospitals." and how these issues might be addressed and resolved. simplified statement of contemporary public policy is char we shou ld prepare more generalists, fewer specialists, and more physicians from minority and underrepresented populations. In reviewing the Buffalo scene, it is apparent chat we are not much different than the other medical schools in the United Stares . It appears that almost half of ou r residents arc in so-called prima ry care programs, i.e., internal medicine, pediatrics, and family medicine . Bue of the 120 residency positions funded for internal medicine and pediatrics, the number used co train genera lises is about the same as che number assigned co fellowships. Since fellows usually come from an existing residency base, we aren't in accord with existing Scace guidelines or developing federal guide lines. To deal with chis situation, it is clear that the faculty and the governance structure of the Graduate MedicalDental Education Consortium will have co develop strategies for change . Th ese strategies might include: • A more formal emphasis on the value of being a generalise and a proper reward system for primary-care faculty . • Transfer of funding for fellows from the reimbursement system co ocher resources. • Increased emphasis on recrumng fellows whose commitment is broader than char of achieving specialized skills for che practice of medicine . • Transfer or reallocation of a large portion of a resident's education from the highly technologically oriented tertiary care center to ambulatory care and community activ ity. You can see why the school has spent a certain amount of its energy over the past few years in reordering its community and hospita l relationships to ensure a new and needed variety of educational opportunities . For in stance, fami ly medicine has been very successf ul in incorporating a suburban and rural network designed to complement its urban base located at the Deaconess Center. Pediatrics complements its tertiary base with o utr each activities ac the Erie County Medical Center and Buffalo Mercy Hospital. Medical students and residents in nonsurgical and non-hospital-based specialties will need educational opportunities in environments othe r than hospitals, and both full-time and voluntary faculty will be needed co facilitate and implement the changes . Two oche r areas of concern are the distribution of future physicians and the extension of ou r affirmati ve action program to resident recruitment and training . The former is being addressed by LATE WINTER JQSS-89 �\I cl t 28 diversification among the primary care departments, especially in areas such as family medicine and geriatrics. The school now has educationa l relationships in these two areas tied directly to the major reaching hospital system . The combination of these organizations has permitted the development of a balanced program designed to ensure opportunities in urban, suburban, small community, and rural environments . As part of the LCME self-study (see Early Winter 1988 edition of Buffalo Physicianand Biomedical Scientist), the clinical chairmen reviewed their performances in recruiting residents from minority and underrepresented backgrounds. Ir was evident chat the medical schoo l's commitment was not adequately incorporated into its graduate medical education mission. The chairs affirmed a commitment to give a priority to chis important public policy issue. They will have to consciously prevent the current matching system from interfering with this priority . le is premature to address the issue of funding graduate medical education, except to state chat New York Stace's new Council on Graduate Medical Education has proposed that all graduate medical education funds provided through the reimbursement funds be placed into a centralized governance under control of consortia. There is a need to deve lop new training programs as well as to modify the manner in which some programs are operated. The Graduate Medical-Dental Education Consortium of Buffalo has recommended the development of programs in emergency medicine, radiation oncology, and plastic surgery over the next three to five years. Soon we will cons ider developing another program in preventive medicine. It is obv ious that even without the LATEWINTER1988-89 future constraints imposed by the Bell Commission, major changes in the conduct of graduate medical education, especially in the primary care specialries, will be forthcoming. More emphasis will be directed toward educational prepararion, less coward service, and more diversity of educational experiences will be required. • ADSMAYSWAY VIEWS OF BIRTHCONTROL elevision and radio commercials advocating birth control may help reduce the high race of pregnancies and abortions in New York State, according co a UB study. The study by the Health Services Research Program of the UB School of Medicine and Biomedical Sciences found that after exposure to a limited media campaign, women were more aware of birth control methods and the risk of pregnancy without birth control, and less likely to believe chat birth contro l spoils the spontaneity of sex and chat it gives men a false impression of the woman's availability. The media campaign, which ran in Buffalo and New York City in the summer and fall of 1987, used paid commercials, not public service announcements, said Harry A. Sultz, head of the Health Services Research Program and professor of social and preventive medicine. Researchers also interviewed women in a contro l city, Syracuse. The "media messages" were developed by a New York City advertising agency as part of a five-year plan by a coalition of family planning agencies and clin ics to reduce the high rates of unintended pregnancy and abortion in New York State, Sultz said. The New York State Family Planning Media Consortium has 23 members from across the state. The Buffalo-area members arc UB, Planned Parenthood of Buffalo and Erie County, Deaconess Center, and Planned Parenthood of Niagara County. The four messages in the campaign's (Ml 5IC THROIJGHOL 11 SONG· Lon.[!er than there't c been fishes m the ocean, l11gher than uny bird 0111;er t'll r flen, thun BUFFAID PHYSICIANAND BIOMEDICALSCIENTIST �29 30-scconcl radio and television spots, underscored with music by singer Dan rogclberg, were: • Birth control: from saving no co takmg rhc Pill, you're coo smart not co use it. • Four out of five young women who don't u,e birth control get pregnant before chev want co. • Boch young men and young women in a caring relationship arc concerned about having children at che right tame. (Young, obviously carmg, couples arc featured in the celcv1s1onspots). • Call 0ocal telephone number) or look under "Binh Control" in the yellow pages. "The intcrt.'Stmg thing is, nowhere, in either Buffalo or New York, wa, there a negative reaction," Sulc: noted. "They didn't get any letters, they didn't get any complamcs. In face, the ads in New York City had the New York Cn~ Health Department's Health Lmc telephone number on them, and there was an immediate Jump in the number of calls to the Health Linc asking for information." The spot wa, aired during prime time on two network-affiliated television ,rations m Buffalo and on rwo Spanish-language television scackms in New York, Sulcz said . Howt.·ver,the maior telC\'l'IOn,rations in Nt.'\\ York said che ,pot was coo controvcrnal and wouldn't nJn the ad. The same mformauon then was placed on 12-foot placards on 500 New York City buses, on carcards on all sub\\ay Imes in the city, and on six radio srat1on,. Once the evaluation of the media campaign wa, completed, the family plannmg consortium placed the television ad m prime t1me m all nine maJor media markets around the Mate, Sult: ,ay,. WWOR-TV, one of New York City's independent television stattons, then approved the ad and aired tt m prime time, he n,oced. The scud, offer, proof that birth control is ,1 way of life for the maJ0rtt\ of young women, Sultz sm<l.Overall, two-rh1rds of sex• ually active women reported they always uSt.--d birth control. A little more than 16 per cent ne\er used birth control, while 16 per cent said they sometimes used contraception. These fig,urcshelp researchers pinpoint rhe population at risk for unintended prcgnan- Bt..FFALO PHYSICIANA:-.;OIIIOMWICALSCIENTIST cy and abortions: those women who never use birch contro l or arc haphazard about its U!'C, about a third of the sample, Sult: says.• - B) S11e\\½,etcher CALIFORNIA DEAN IN APRILWill DISCUSS CAREEDEVEL R OPMENT Lyn Behrens, M.D ., dean of the S(hool of Medicine at Loma Linda e University, will give presentations on professional development as che first Harrmgton Visiting Profe,'\Or at UB. The program will run from April 25-28. Bchrcm is becoming recognized nationally as an expert on profc,,1onal development. One of only three female deans o( medical schools 111 the country, she 1, active in AAMC, especially m programs on advancing the car~-ersof \\Omen. Topics for the introductory program include advancement in ncn<lemia, policies of academic institutions, and professional growth. There will be a short program on UB's servKt.'Sfor rt.-,,earchers. A whole day will focus on research planning, including the characteristics of producttve researchers, the nuh and bolts of research design, and the Loma Lmda faculty model. A management workshop will al,o be held for a small number of people. The program will include the Annual Faculty Research Day, whe re faculty will display posters summarmng their research. Behrens will be available co addrc<< small groups of faculty . The Harrington V1s1tingProfessorship is an expansion of the spnng Harrington Lecture. The new format allow, the v1s1tmg scholar m spend more time at UB developing a topic. The school will continue co sponsor its fall Harrmgcon Lecture. For more information, call Glenda Donoghue, APFME director of Continuing Medical Educat ion and Professional Development, at 831-3714. • LATE WINThR 19!18-89 �30 WE BID FAREWELL TO LOISLEWIS ired in September 1959 when UB was still a private institution, Lois Lewis has worked in the dean's office at the medical school through four University presidents, five med school deans, and explosive student riots. She has also watched the progress of the Amherst Campus from its meager beginnings as a swampy flood plain. "I've seen a lot of changes in UB and the med school during my 28 years working here," Lewis recalled, "and even though I'm happy co be retired, I'm going co miss the University and the med school very much." In late September, John Naughton, dean of UB's School of Medicine and Biomedical Sciences , held a buffet reception in the new lobby of the med school to honor Lewis, who had served as his senior staff administrative director since Naughton joined UB 13½ years ago. More than 100of Lewis' friends and colleagues came to the reception where Naughton presented Lewis with a captain's chair inscribed with the UB seal for her 28 years of contributions and dedication to UB. "She is missed already and will be difficult to replace," Naughton remarked. "She cook pride in everything she did. She paid attention co every detail and always wore a smile. We all wish her the best in her retirement because she deserves ic.• "If Lois Lewis couldn't find something char was requested, then it wasn't findable," Peter Ostrow, associate dean of the med school, said. "She was dedicated and personally involved in the life of the school. She was always a pleasure co deal with and made me feel at home when I first came to UB in 1984.• However, working at UB has nor always meant good rimes and parties. Lewis remembers vividly when student riots erupted on the Main Street Campus in 1969-70 and police occupied the troubled University at che request of Martin Meyerson, president of the University at the rime. "We were evacuated from our offices several times because of smoke bombs and the general threat of violence," Lewis recalled. "The students were protesting (federa l) LATEWINTER19SS-69 government contracts with UB. At the time there was hyperbaric research (the study of rhe physiological effects of high pressure) going on in Capen (now Farber) which was contracted with rhe Navy. They were protesting right in front of our building, so we could see them demonstrating from our windows. It was difficult to enter or leave the building without being harassed by all the people from rhe 'sicins: Ac one point our staff was locked into the office for our own protection. It was a scary time." evercheless, che campus soon became less explosive as talk of a new campus in Amherst spurred the imagination s and expectations of everyone involved with UB. "Originally the med school was planning ro be relocated into Hochstetter Hall on rhe Amherst Campus, but they decided lacer that Main Street was the best location because of its close proximity to the hospitals in Buffalo," Lewis recollected. "It didn't really bother me, though, because I like the Main Street Campus better anyway. It seems more endearing and the city location gives it some character . The Amherst Campus is coo cold and isolating, bur I guess I'm partial," Lewis commenced . "When I first came to UB in 1959, the med school was part of a small private college and graduated a total of only 60 students. Now the med school is a State school with one of the largest budgets for research in the University. The size of the graduating classes have more than doubled while the faculty has tripled." Lewis, a 30-year member of the Professional Secretaries Association, enjoyed the work she did for the University. Working as the BUFFALOPHYSI CIAN AND O!OMEDICALSCIENTIST �31 manager of the dean's office always kept her busy, she says. "There was never a dull moment at the University. There was always something happening-a lot of action," Lewis remembered. "The dean's office was always a busy place, especially since Or. Naughton arrived in 1975. He is one doctor who doesn't play golf on Wednesdays. He doesn't even rake a lunch break." Lewis plans to spend her retirement traveling and visiting her friends. Although she will miss the day-co-day pace of the medical school, when asked what she would miss most about the University, she stated simply, "All of the people." • -By Mark Marabella SCHOOL EXPANDS EARLY ASSURANCE he UB School of Medicine and Biomedical Sciences has expanded its Early Assurance Program to qualified undergraduates at any college, and now offers Early Assurance in the M.0./Ph.O. program. Previously, the program was open only to undergraduates at UB and Canisius College who wished to pursue an M.0. here. Students who are accepted into the Early Assurance Program know in their junio r year of college chat there'll be a spot waiting for them in the medical schoo l, explained Thomas J.Guttuso, assistant dean and director of admissions for the UB medical school. The purpose of the program is co attract highly intelligent students and allow them to pursue a broader range of classes in their last two undergraduate years, Guttuso explained. Students often feel chat they must rake certain science courses that will look good on medical school applications, leaving little time to explore the humanities, he said. In addition, many juniors reduce their courseloads to study for the MCAT, further limiting the variety of courses they take. Since they don't have to rake the MCAT and the pressure of getting admitted to medical school is off, Early Admission BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST students can broaden their backgrounds beyond science, making chem well-rounded individuals. Students need about a 3.5 average in science and non-science subjects and must have completed half of the courses required by the UB Medical School before they can apply, Gurruso said. They must be residents of New York Stace. After they're accepted, students enroll in a clinical preceptorship to see how medicine should be practiced. For local students, preceptorships are arranged at UB. For those living outside of the Buffalo area, arrangements are made with a UB alumnus. Students in the M.0./Ph.O. program are expected to have conducted research before applying to the program. After acceptance, they are encouraged to continue their research at their own college or at UB. Other medical schoo ls in New York State have established early assurance programs and are considering expanding them. • THIERTO SPEAK AT SPRINGCLINICAL DAY r. Samuel 0. Thier, M.0., president of the Institute of Medicine, National Academy of Sciences, will be the Stockton Kimball lecturer at the annual Spring Clinical Day and Reunion Weekend. Thier will speak during the scientific session on Saturday, May 6. The theme for the session is "Nutrition in the '90 s." The weekend will begin with an evening reception for the reunion classes on Friday, May 5. For more information, call the medical alumni office at (716) 831-2778. • MERRILEE$ DONATES ANTIQUEMICROSCOPE n antique microscope valued at $6,500 was donated to the Health Sciences Library's History of Medicine Collection by William H. Merr ilees, M.0., C.M., associate professor of obstetrics and gynecology at UB. A gift from his father, William Merrilees, Ph.D., upon Merrilees's acceptance into medical school in 1936, the Powell and Lcaland No. I microscope was hand-built in England in 1884. It marked the summ it of microscope design and manufacture in England for over 50 years. This microscope was renowned in its time for its innovatively designed stage, which could be rotated 360 degrees, and its steadying stand, which singly required at least 600 man-hours of production. It also introduced the unique ability to be converted to a binocular device by simply unscrewing its monocular eyepiece and replacing it with a binocular eyepiece. Merrilees has also donated 21 titles of medical monographs from the turn of the century. • LATE WINTER 1988-89 �\ VOTERS GIVEMORE POWER TOECMC'S BOARD OFMANAGERS The board now can deal with issues in a timely and businesslike fashion, with less political influence, says the chairman. he board of managers of the Erie County Medica l Center has more power over the day-to-day operations of the hospital, thanks to a new law that was effective Jan . I. The legislation allows the board to deal with issues in a timely and businesslike fashion . "We felt it was very critical because in the eyes of the New York State Health Department, we had the responsibility, but not the authority co ace; said Kevin I. Sullivan, chairman of ECMC's board of managers. The law, passed by referendum in November, "allows us to be more responsive, reduces delays in acting, and reduces political influence over the day-to-day actions of the hospital," he said. Sullivan noted that the county legislature retaii:is certain powers. The board of managers must report to the legislature before programs or services are curtailed. The county still bargains with unions, and the county decides how large a subsidy it will give the medical center. In 1988, the county supplied $5.9 million LATE WINTER 1988-89 K 11 l ~11ll1 m d,c 1rma11 of E( MC\ board of mcma LTS BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �33 of ECMC's $117 million annual budget. For 1989, the county subsidy is $6.9 million . The county subsidy, along with some Scace money, goes toward care of the indigent. Mose of the ocher money in ECMC's budget is received through fees for service, including third-party payments, Sullivan said. The move co governance by a board of managers was prompted by a fiscal crisis in the early 1980s. The county's subsidy co che medical center zoomed up co $24 million in 1984. In 1985, the hospita l superintendent resigned and the firm of Ernst and Whinney was hired to provide interim management. Lacer that year, the board of managers was created co govern the hospital. A cask force sec up by the county identified five long-rerm objectives: Keep ECMC open. Reduce operating costs and financial losses. Continue co serve the community with special attention co the indigent. Operate the facility in a businesslike and cost-effective manner . Continue a leadership role in medical education. Also, in 1985, che county reduced its subsidy co $7.7 million. In 1986, the Vitalnet Group, an independent management firm, was retained to manage the hospital. The goals of its two-year contract were to improve the hospital's operation, ease its drain on county taxpayers, and separate it from political influence. The county further reduced ECMC's subsidy to $6.6 million . In 1987, the medical center repaid co the county $10 million for loans it received during its fiscal crisis. Lase year, the Vicalnet Group decided co let its management contract expire and the referendum was held. Now the board of directors, through a chief executive officer and financial officer, is empowered to operate the hospital on a day-to-day basis. The law also provides two new board members, one appointed by the majority of the legislature and che ocher by the minority. That brings the board to 13 members, all BUFFALOPHYSICIA N AND BIOMEDICALSCIENTIST of whom are voluntary and receive no fee, Sullivan noted. • DEACONESS STARTS GERIATRIC CLINIC he Deaconess Center of Buffalo General Hospital has begun a series of geriatric clinics to help families with assessing and coordinating care of the elderly. During the weekly sessions, the clinic staff primarily provides consultation to caregivers, though some primary care services will also be provided, said June Chang, M.D., director of the clinic. Chang is also an assistant professor of medicine at UB. The clinic directs families co appropriate services and helps with concerns that arise when the patient is under the care of several specialists or takes mu ltiple medications. • NURSING FACILITY NAMESLEVITT acqueline Levitt, M.D., was recently ap• pointed medical director for rhe Sisters of Charity Hospital Skilled Nursing Facility. A geriatrician, she is on the faculty of the Geriatric Division of the Department of Medicine at UB. Levitt is also associate director of the Division of Geriatrics/Gerontology at Buffalo Veterans Administration Medical Center, medical direccor of the Odd Fellow and Rebekah Nursing Home in Lockport, and associate medical director of both the Amherst Presbyterian Nursing Home and the Rosa Coplon Nursing Home. A graduate of the University of Chicago, Levitt received her medical degree from the University of Illinois and completed a residency in internal medicine at UB. She is a diplomace of the American Board of Internal Medicine and the American Academy of Family Practice. In addition co professional memberships in the American College of Physicians, American Geriatrics Society, Maimonides Medica l Society and the Network on Aging, she is on the advisory boards of the Alzheimer's Disease Association and the Carer's Association. • NEWMEDICAL STAFF ELECTED AT MFH orman E. Hornung, M.D., EA.CS ., clinical assistant professor of urology at UB, has been elected president of the medical staff at Millard Fillmore Hospitals. Hornung is a practicing surgeon in rhe Department of Urology at the hospitals and has been a member of the hospitals' medical staff for the past 20 years. He received the American Medical Association's Physician's Recognition Award for the past seven years. Ocher elected medical staff officers include Robert Barone, M.D., clinical assistant professor in surgery, the new president-e lect, a member of MFHs' Department of Genera l Surgery; Andras Vari, M.D., clinical assistant professor in medicine, secretary, medical codirector of the Western New York Sleep Disorder Center, and Thomas Cumbo, M.D., clinical assistant professor in medicine, treasurer, chief of Infectious Diseases with the hospitals' Department of Internal Medicine. • CORRECTION " lease note chat in the Buffalo Physician and BiomedicalScientist, Vol. 22, No. 3, page 7, the edifice you identify as the 'Forbidden City' is in fact 'The Hall of Prayer for Good Harvest' in Tiancan Park, commonly known as the Temple of Heaven Park! This important site is sou ch of the Forbidden City but linked co it ceremonially since the ancient emperors of China paraded in majestic style from the imperial palace co the Temple of Heaven at the time of the winter solstice to invoke the gods!" - Marshall A. Lichtman, M.D. LATE WINTER 1938-89 �34 Vic tor Panaro (M'52) • was elected councilor of the American College of Radiology and member of the Board of Directors of the New York State Radiological Society. Harold K. Palanker (M'40) • of Albuquerque, N .M., was invited by the chief of surgery of the University of New Mexico to be a founding member of the Albuquerque Surgical Society. John D. White (M'40) • was honored for over IO years of meritorious service as a consultant to the Florida Health Professional Services, Inc. Abraham S. Lenzner (M'41) • who has a private practice in psychiatry in Norwich, Vt., was appointed a fellow of che Academy of Psychosomatic Medicine and is now an attending at Mc. Ascurney Hospital and Health Center. Gilbert B. Tybring (M'45) • informs us chat he had coronary bypass surgery in 1988. Dr. Tybring, who is retired, is editor of che newsletter of the Wisconsin Psychiatric Association, Wisconsin Psychiatrist. Reinhold Ullrich (M'53) • is president of the 10,000-member Los Angeles County Medical Association for a one-year term. Dr. Ullrich has a private practice in obstetrics and gynecology in Torrance, Calif. Joseph P. Armenia (M'62) retired from active practice as a specialist in Internal Medicine with the Kaiser-Permanente Medical Care Program in Harbor City, Calif. During my 33 years with Kaiser, 1 served as chief of the Department of Medicine, medical director of the Harbor City Medical Center, and for the last 11years in clinical practice as a general internist." Edward Sha nbrom (M'Sl) • who was among the first to recognize the potential of detergent treatment co inactivate viruses in blood produces, has Geo rge H. Mix (M'47) • in- assigned his patents co the New York Blood Center . Dr. Shanforms us he is retired and living in Summerland Keys, Fla.; "Life brom, senior consultant in che Lindsley E Kimball Research Inin che Keys is great." stitute of the blood center, will Philip C. Dennen (M'49) • of participate in pilot studies co be conducted jointly at Alpha Middlebury, Conn., is che author of the textbook Dennen's Forceps Therapeutics and the blood co improve so lDeliveries,Third Edirion, published center venc/decergcnt technology. in lace 1988by EA. Davis ComResearch has resulted in a new pany. The forward co the book procedure which uses a special was written by Kenneth organic solvent cogecher with Niswander (M'48). detergent to inactivate viruses that can contaminate blood produces. The success of che method was demonstrated in a clinical Jay B. Belsky (M'S 1) • writes study of the blood center's antihemophilic factor concentrate. from San Pedro, Calif., "I have LATE\\~NTER 1988-89 Milton Alter (M'SS) • of Philadelphia, writes, "In September 1987,I stepped down as chairman of neurology at Tem• ple Univers ity Hospital (after 11 years - 1975-1987)." William J. Sullivan (M'SS) • of Los Angeles, Calif., is a diplomate of the American Board of Psychiatry and Neurology. He is certified in psychoanalysis and is now specializing in forensic psychiat ry. Philip A. Brunell (M'57) • is president of the Society for Pediatric Infant Disease and editor-in-chief of PediatricInfant Disease News. Dr. Brunell is associate director for academic affairs and chief of pediatric infant disease at Cedars-Sinai Medical Center, Los Angeles. Edwin R. Lamm (M'60) • is president-elect of th e medical staff of Lakeland Regional Medical Center, Lakeland, Fla. Kenneth Be ll (M'61) • has been appointed associate medical director for Kaiser Permanente in Orange County, Calif. As chief of staff for the medical center located in Anaheim, he is responsible for selecting physicians, setting medical policy, planning new programs, and administering budgets. Dr. Bell is an associate clinical professor of obstetr ics and gynecology at the Unive rsity of California (Irvine) School of Medicine. Joseph P. Armenia (M'62) • received the 1988Citizen of the Year Award from the Western New York Chapter of the American Diabetes Association on May 25. Armenia is a clinical associate professor of medicine at UB and chief of the Division of Endocrinology at Mercy Hospital. During the past 20 years, he has been instrumental in the organization an d development of the local chapter of the diabetes group. He served as its president for many years and is currently chai rm an of the board. Jr. K e nn et h H. Eckhert, (M'68) • has been appointed chairman of Sisters Hospital Department of Surgery. Eckhert is medica l d irector of che hospital's Breast Care Center and is ch ief of surgery at St. Francis Hospital. Maxine Hayes (M'73) • of Bellevue, Wash., has been named director of the Bureau of ParentChild Health Services wich che Department of Social and Health Services. Dr. Hayes is serving an executive session four-year term with the John E Kennedy School of Government's (H arvard University) Center for Health and Human ResourcesPolicy.She has also been selected as che Har- BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �35 D ouglas Pl eskow (M'8 2) • writes chat he and his wife Ran• di Ples kow (M'82 ) completed a vard School of Medicine's Fae Golden Kass Lecturer for 1989. Israel J. Ja co bo wit z (M '73) • of Brooklyn, N.Y., has been appointed director of the Cardiovascular and Thoracic Division of the Maimonides Medical Center. GI fellowship last year. "Randi and I have a two-year-old daughter named Sara. Randi is an assistant professor of pediatrics at Tufts Medical School and I am an instructor of medicine at Harvard Medical School." Larry R. John so n (Ph .D. '73) • is project coordinator of rhe Oregon Health Sciences University Lung Health Study in Portland. He is partly responsible for spirometry quality control at 10 study sites and consults on Chinese and Japanese spiromerry longitudinal studies. Steve n J. Morri s (M'73) • received a J.D. degree from Georgia Stare College of Law in 1988 and is a member of the Georgia Bar. Dr. Morris has a private practice of gastroenterology in Atlanta and is a clinical associate at Emory University. He is president of rhe Georgia Gastroenterologic Society. Dr. Morris is married and has four children. Michael Rowland (M'75) • of Pinehurst, N .C., is general surgeon of the Pinehurst Surgical Clinic and vice president of the Norrh Carolina chapter of the American College of Surgeons and chairman of the Cancer Committee of Moore Regional Hospital. Bess Mill e r (M'77 ) • a medical epidemiologist, division of tuberculosis control at rhe Centers for Disease Control, writes, "The job is great-and if that doesn't keep me busy, my husband and I have two little boys: David, 4 years, and Matthew, 11/2 years-who do keep us busy!" Paul A. Gree nb erg (M'84 ) • Mi chael Row land (M '7 5) writes, "After doing rwo years of surgery and three years of medicine, I'm on my way to do a medical oncology fellowship at MD Anderson Tumor Institute in Houston." Tumor Institute. He helped found the Head and Neck Surgical Society, the James Ewing Society (now Society of Surgical Oncology) and the Radium Society and was president of each. James D . Tyner (M'29) • died on April 29, 1988in Newark, N.Y. He was a past president of che Wayne County Medical Society and a founding member of the American Academy of Family Practice . Ric hard Taylo r (M'30) • a others, Leah and H:adass. Ir's because I became a certified mohel." B o n n ie Ri c hard so n (M '85) • announces that she is scarring a private practice in family medicine in Hudson Valley, N.Y. Dr. Richardson's daughter, Emily Fjaellen Thompson was born in August 198i. M a rk S. B ore r (M'80) • is staff child psychiacrisc and director of the Dover Day Ho:spical for Troubled Youth, Dover, Del. David Stein (M'87) • is a resident in medicine at the Massachusens Medical Center in Worcester, Mass . general practitioner in Blasdell for 51 years, died Oct. 24 following a long illness. He was 82. Born and raised in Hamburg, Taylor served as the town's health officer from 1935co 1975.He also served as the physician for the Blasdell and Frontier Central schoo ls, for the Blasdell Fire Company, and for the Eric County Fair and Exposition. He was active in many UB fund drives. Taylor is survived by his wife, three sons, 12grandchildren, and a great-grandchild. Anth ony S. U ng er (M'8 0) • a Bruce R. Saran (M'88) • mar- Charles F. Banas (M'37) • chief clinical instructor a't George Washington University Medical Center, recently published "Total Ankle Arthopla sty" in Operaci1:e Orchopaedicsedited by M. Chapman, M.D. ried Robin I. Kauffman in Occober 1988.Dr. Saran is a resident at the Medical Center of Delaware, Dover, Del. of scaff at Mercy Hospital from 1966to 1986,died September 13, 1988. He was 75. Born and raised in Buffalo, Banas joined Mercy Hospital in 1938 as a family practitioner. From 1942 to 1946 he served in the Army Air Force-Air Transport Command, Medical Corps . In 1952 he instituted the Allergy Clinic at Mercy Hospital and served as its director for 30 years. He also helped co-organize the General Practice Section and served as its first president. Banas served as the first chief of the Genera l Practice Department from 1956 until his appointment as chief of scaff in 1966. Wes ley S. Bl ank 1(M'80) • writes, "Nan and 1 ha,d another baby girl, Rebecca, to join our rwo Joe l Fiedler (M'81) "' is clinical assistant professor of pediatrics at Sc. Christopher's Children's Hospital in Philadelphia, Pa., and an allergy consultant for rhe North Jersey Medical Group. Mark M. Chun g (M '82) • writes, "I am a practicing pulmonologist in Ora nge County, Calif., and a member of the pr'ofessional staff of UCLA." BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST W illi am S. Mac Co mb (M'2 7) • died at his home in Walnut Creek, Calif., Sept. JI, 1988. He is survived by his wife, Janet, three sons and a daughter. Dr. MacComb lived in Houston from 1952 to 1974. He developed and was chief of rhe Head and Neck Service and was professor of surgery at the University of Texas, M.D. Anderson Hospita l and LATE ll.1r<TIR IQ~ �AlHmm 36 CALLFORNOMINATIONS our president and Board of Governors has, over the past several years, received many requests for Alumni/ae to establish a Distinguished Medical Alumnu s/a Award. Therefore, your president and board arc seeking nominations for this award to be presented annually beginning this year. The award will be presented to a graduate who has distinguished himself/herself nationally or internationally in the eyes of his/ her peers and has made an outstanding contribution to medicine, the arts, or humanity during his/her career. The selecltion will be made during the summer and the award will be presented in the fall at a special award dinner. Please forward the name of your nominee as soon as possible on the attached card. A June 30 deadline has been established for the receipt of all nominations. Your cooperation is absolutely viral if this is to be a true alumnus /a award. our way of showing ou r appreciation to the members for their past suppo rt of the school. Preparation is under way for the 1989 meeting of the society. The James Platt White Society is named for one of the founders of the medical school who was in private practice in Buffalo from 1835-1875. A founder of the American Gynecological Society and one of the founders of several Buffalo hospitals, he made important contributions to the practice and teaching of obstetrics. • GUTTUSO GIFT CREATES TWOAWARDS wo new annua l student awards have been created, thanks to a fund established by Thomas J. Guttuso (M'60), director of admissions for the UB Medical School. One award will go to a senior medical student who has contributed most significantly to research in ophthalmology or who has demonstrated significant concern for patient care while in ophthalmology service. The oth er award will go to a resident who has contributed most significantly to ophtha lmology overall. Guttuso has a private practice in Lockport. He is a member of the James Platt White Society (the school's highest gift recognition group) and the President's Associates (the University's highest gift recognition group).• JAMES PLATT WHITE SOCIETY TOURS NEWFACILITIES DURINGANNUALMEETING he third annual meeting of the James Platt White Society, a group of major annual contributors to the medical school, rook place on Friday, Oct. 21, in the Lippschutz Room of the school. In addition to a tour of the new medical school facilities, the members and their spouses and guests were treated to an excellent afternoon program. The topics ranged from cardiology in Buffalo to bioengineering in anatomy to biotechnology and the human side of AIDS. The topics were excellently presented by facu Icy, not on Iy from the School of Medicine and Biomedical Sciences, but from nursing and physiotherapy. The capstone for the day's meeting was a cocktail reception and dinner in the Center for Tomorrow on the Amherst Campus. All members of the society received an engraved Jeffersonian pewter cup. The cup is LATEWINTER 1988-89 DIRECTORIES SLATED FORMAY DELIVERY he UB Schoo l of Medicine and Biomedical Sciences Directory is coming soon! This comprehensive new volume is a compilation of the most current data on more than 4,655 medical school alumni/ae. Now chat the editing, proofreading, and printing are almost finished, the distribution of this impressive edition will scare. All alumni/ae who reserved a copy shou ld receive it around May 5. If you have a question on your order or wish to place an order, contact the cuscomer service department of Bernard C. Harris Publishing Co., Inc., 3 Barker Ave., White Plains, N.Y. 10601. The phone number is (914) 428-8921. • HERE'S ONEMORE hen we ran one photo of each reunion year in our Autumn 1988edition, we thought we had all of the bases covered. Bue there were two graduating classes in 1943 and we inadvertently left out the spring graduates. Here they are, with our apo logies: Front row: Harold P. Graser, Gertrude S. Swarthout, Kenneth W. Bone, and William H . Georgi. Back row: Duncan K. Macleod, Richard S. Fletcher, Richard J. Buckley, Charles C.B. Richards, Alfred S. Evans, and Joseph H. Melant. BUFFAW PHYSICIAN AND BIOMEDICAL SCIENTIST �,, �MEDICALHISTORICAL ~1~, KIMBALLTOwER, SERIALS DEPT, MAIN ST., CA"1PUS c-/ BUFFALO NY 14214 ff1Jfrl � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Late Winter 1988-1989 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1988-1989-Late Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v22n05-1988-89-LateWinter Table Of Contents A list of subunits of the resource. The best is yet to come Lucky 13. Cholesterol. Passive vaccine Airwaves. Handpicked. Hospital News Classnotes and alumni news Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-08 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v22n05 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1988 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/77748a01ec55afafcc2f48fa6ec5306b.pdf ad6ae51514747afafbd5808acf1aac8b PDF Text Text Volume 21, Number 5 I and Biomedical Scientist Study lryDr. Lau,renceBone demonstratesneed for aggressivesurgeryin trauma cases Lace Winter 1988 �Dear Alumni, Alumnae and Friends: STAFF EXECUTIVEEDITOR UNIVERSITY PUBLICATIONS Robert T. Marlett BUFFALOPHYSICIAN EDITOR Connie Oswald Stofko ART DIRECTOR Alan J. Kegler PHOTOGRAPHY DouglasLevere EdNowak Ian Redinbaugh Simon Tong ADVISORYBOARD Dr. John Naughton, Chairman Dr. Harold Brody Mr. Kevin Craig Ms. Karen Oryja Ms. Nancy Olieco Dr. James Kanski Ms. Marion Marionowski Dr. Daniel Morelli Dr. Charles Paganelli Mr. James Phillips Mr. John Pulli Dr. Robert Scheig Mr. Mike Shaw Mr. Steve Shivinsky Mr. Raul Velasquez Dr. Mary Voorfiess Dr. John Wright Dr. MaggieWright Dr. Franklin Zeplowit:z Dr. Joseph Zizzi,Jr. TEACHINGHOSPITALS BuffaloGeneral Children's Erie County MedicalCenter Mercy Millard Fillmore RoswellPark Memorial Institute Sisters of Charity Veterans Administration Medical Center Producedlry ihe Divisionof University Relatumsin associationwith ihe School of Medicine,State Universityof New Yorkat Buffalo. THE BUFFALO PHYSICIAN (USPS 551-860) Late Winter 1988, Volume 21, Number 5. Publishedfive times annually: Late Winter, Spring, Summer, Fall and Early Winter - by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Third class bulk postage paid at Buffalo, New York. Send address changes to THE BUFFALOPHYSICIAN, 146 C.F.S. Addition, 3435 Main Street, Buffalo, New York 14214. Cover Photo: Dr. Lawren ce Bone,photographedb:,Rob McElroy. T he medical school has embarked on its second Institutional Self-Study in preparation for the accreditation visit by the Liaison Committee on Medical Education (LCME) Survey Team scheduled for November of this year. The first self-study was condurn:d in 1980. We have set an ambitious time-table in that all committee work is scheduled tO be completed during the first six months of 1988 so that a final document can be edited and collated for submission to the LCME by September. Just as was done in 1980, a large steering committee has been assembled with representation of University administration, hospital board members and administrators, department chairmen, faculty and students, alumni, practicing physicians and members of my staff. In contrast tO 1980 , the established commim:es of the Faculty Council are serving as the working committee for the various areas to be reviewed. External representatives have been added to the membership of each committee to ensure that as much communication and cross-fertilization as possible can be and is facilitated. When the task is completed this summer, we will have an appreciation of the progress made since 1980, the current status of the medical education enterprise in Buffalo, and an agenda of tasks to be accomplished bt::tween now and 1995. These outcomes will be summarized in a future issue of the Physician. As I had indicated in an earlier letter, the timing for this study is fortuitous since it comes during the 25th anniversary year of the merger ofUB with SUNY. The process should be helpful to the life and vigor of the institution and in preparing us for a successful accreditation visit next fall. Sincerely, John Na ughton , M.D. Vice Presidentfor Clmrcal Affairs Dean, School of Medrcine Medical Alumni President's Message I t gives me a great deal of pleasure to announce that the recipient of the Stockton Kimball Memorial Award for 1988 will be Dr. Robert Gale of the University of California at Los Angeles - UCLA. Dr. Gale is a 1970 graduate of the University at Buffalo School of Medicine and has distinguished himself in the field of bone marrow transplantation. His prominent role in leading the American effort in aiding the Soviet Union after the world's worst nuclear disaster is, I am sure, well known to all of you. His involvement in this endeavor as well as his consu lt ant role in other nuclear accident incidents continues. His timely and info rm ative lecture at the luncheon will be a highlight of an outstanding program at "Spring Clinical Day and Reunion Weekend" - May 7, 1988. The morning scientific program will be devoted to Controversies and Treatment of AIDS, Breast Cancer, and Coronary Arte r y Disease with national and local experts . Mark your calenda rs now so that we can welcome as many of you as possible from around the count ry and the Western New York area to this program and to your five-yea r reunions. Your A lu mni Association continues co play a prominent role in Medical School affairs, with you r President being a member of the Executive Committee of t he School and a member of the Steering Committee and Executive Committee of the "Liaison Committee for Medical Education" - LCME which is self-evaluating the School prio r to the acc reditation survey in the fall of 1988. If you have not become an Active or Life Member of the Medical Alumni Association, please do so now, so that you can help us continue and expand all the activities I mentioned in the last Newsletter. - Sincerely, Franklin Zeplowit~, M.D. '58 �BUFFAlD Volume 21, Number 5 PtIX§l~~ Late Wint er 1988 2 Lead Poisoning. Screening children for lead poisoning should be a routine part of medical care, Public Health Official urges. 7 Black Monday. One man lost his shirt in the market crash and shot his stockbroker; others shrugged it off. Why the difference? 8 Premenstrual Syndome. Dr. Uriel Halbreich, head of a new Life~ Cycle Center, finds the term premenstrual changes or PMC more accurate. 11 Leeches. What do leeches and microsurgery have in common? Plenty if you ask Dr. Kulwant Bhangoo. 14 Lawrence Bone M.D. Thousands of lives lost following auto accidents and other causes of severe trauma co uld be saved, this orthopaedic surgeon has found, if a new surgical approach is adopted. Departments Page8 Page 14 17 Research. Unique Roswell case report was the key to a breakthrough genetic study published recently by British scientists. 21 Medical School News. The Buffalo General Hospital, a major UB teaching hospital, is establishing the State's second heart transplant center. 30 Classnotes . Two Med School graduates are the co~founders of the Comprehensive Headache Center at The Germantown Hospital and Medical Center in Philadelphia. News of the classes. 35 Hospital News. The Batavia Veterans Administration Center becomes UB's ninth affiliated hospital. 36 Deaths. Medical �POISONING Samephysicianssay it isn't a problemin theirareas becausethey haven'tseena casein 20 years. But many childrenshowno overtsymptoms,healthofficialwarns BY CONNIE OSW ALO STOFKO S creening children for lead poisoning should be a routine part of medical care, recommends Jane S. Lin-Fu, M.D., whose research was instrumental in the federal legislation that banned lead from household paint. Some physicians say that lead poisoning isn't a problem in their area because they haven't seen a case in 20 years. But many children with lead poisoning show no overt symptoms, Lin-Fu cautioned. Even when there are overt symptoms, they're so vague that they're often misdiagnosed, she noted. It's nearly impossible to detect lead poisoning without a blood test. It's also a myth that lead poisoning affects only inner-city children, she added. It's a ''Yuppie" problem, too, especially for those who move into older homes and do the renovat ion themselves. in-Fu is acting chief of the genetics services branch of the Health Resources and Services Administration. That's pa rt of the U.S. Public Health Services. She recently gave a lecture sponsored by the Research Center for Child ren and Youth, one of UB's eight organized research centers. In the United States, Lin-Fu estimates, tens of thousands of children are affected by this condition, which can lead to retardation and even death. While it can affect adults, children are more prone to lead poisoning for many reasons, including the fact that child ren have greate r L Late Winter '8 8 intestinal absorption and retention and their organs are more immature. Routine screening is important because there's convincing evidence that undue lead absorpt ion in early life may be associated with neuropsychological deficiencies and behavioral disorders, leading to learning disabilities. This happens before there are any overt symptoms, Lin-Fu said. And even when it gets to the point of overt symptoms, there's no guarantee that lead poisoning will be detected without a blood test, she noted. The symptoms are vague: irritability, refusal to play, apathy, poor appetite, occas ional vom iting, sleep disturbances, stomach aches, and constipation. Lin-F u , who has three children of her own, noted that these symptoms are common to "no rm al" children. "You have to be very astute to pick it up as lead poisoning," she said. "You can't rely on signs and symptoms to diagnose it." Those are the relatively early symptoms, she said. If nothing is done, the child can experience developmental delays and regressions . A child may stop making sentences or stop jumping. The child may have protracted vomiting, ataxia, or convulsions, or even die. Even when the condition gets to the convulsions stage, lead poisoning can be misdiagnosed. A two-year-old with lead poisoning was operated on twice because it was thought she had a brain tumor, Lin-Fu said. The test for lead poisoning, eryth r ocyte protoporphyrin (E P), is cheap, she said, and has the added advantage of picking up iron deficiencies.Just a small amount of blood from a finger prick is needed. The equipment, a hematofluorometer, costs about $4,000 and is cheap enough to be purchased by a clinic, she pointed out. Because it gives an instantaneous d igital readout, follow-up tests can be performed while the child is still in the office. There's no loss of follow-up. But how much lead is too much lead? The answer has been changing in the last two decades, Lin-Fu noted. Unlike calcium, zinc, or iron, which the body needs in certain amounts, the body doesn't need any lead at all. But researchers forgot that fact when they tried to define "normal" lead levels, she said. "They started studying the 'normal' population, not realizing that the 'no rmal' population was contaminated." In 1970, the accepted level of lead in the blood was a whopping 60 micrograms . Lin -Fu fought a tough battle to get it lowered to 40 micrograms. Today, even 40 is considered much too high, she noted . Various agencies in the past few years have recommended 25, 20, or even 10.S. Lin-Fu said she doesn't know whether the accepted limit should be dropped to zero . She noted that people in the Himalayas were tested and even they had 3 micrograms of lead. There is disagreement ove r when treatment should begin , she noted. The treatment is painful. It Buffalo Physician and Biomedical Scientist �can also be dangerous because it removes vital zinc and forces some of the lead to the brain. Even if the physician decides not to treat the condition, it's important to look for lead in the environment, Lin-Fu said. 3 A major culprit is lead paint on walls. Th e ban on lead in household paint didn't go into effect until 1978, she noted. Lead abatement must be done carefully. If done improperly, scraping the paint off the walls can actually do more harm because it creates fine particles which can be more easily absorbed, she explained. Once the particles get into the rugs and curtains, a regular vacuum cleaner won't pick them up. During lead abatement, it's important to get everyone out of the house, remove all belongings that can be moved, cover everything that remains, and clean up carefully. Disposal of the lead is a problem, too. She noted that when people remove lead from their houses, they just put it in plastic bags and take it to a dump. But it doesn't change into some other substance when burned; the problem is just recycled. ead paint isn't the only source of lead poisoning, Lin-Fu said. "We pay a price" for living in this modern world, she said. "Lead is in the air you breathe, the food you eat, and the water you drink." The elevated lead levels of most children aren't caused by eating paint chips, as was once thought, Lin-Fu pointed out. Small children put their hands in their mouths a lot and ingest the lead from household dust and soil they pick up while playing. Another source of lead is water that sits overnight in pipes soldered with lead. "New houses, including the one I moved into two years ago, have copper pipes with lead solde r ," she noted. People are advised to run their water each morning to get rid of the stagnant water. L Buffalo Physician and Biomedical Scientist Late Winter '88 �4 Othe r sources of lead include industrial emissions, burning at city dumps, storage batteries, ammunition, improperly glazed dinnerware, burning old wood that's covered with lead paint, arts and crafts supplies, colo red ink for newspaper, smoking, some alcohol, and cosmetics such as Grecian Formula. Some folk remedies contain lead as well. "Health care providers must remem- ber this is a land of immigrants," Lin-Fu said, and that people bring these remedies with them. A couple of sources of lead are on the decrease. Leaded gasoline has been banned for newer cars. In the four yea rs since the ban, blood lead levels have decreased 30 per cent. Lin-Fu is convinced the ban should get the credit. "Nothing else could explain such a dramatic drop," she explained. Lead solder for food cans is also on the wane. In 1979, 90 per cent contained lead solder. In 1986, only 28 per cent did. Lead poisoning is still a problem, even though we've known since early in this century that it's preventable, Lin-Fu pointed out. "Here we are 70 years later still talking about lead poisoning," she remarked. • Two UB units working on lead study T wo UB units are working together to compare lead levels in the umbilical cords of newborns to medical and socio-economic data, with an eye to how that information may be related to developmental disabilities. The two units are the interdisciplinary Research Center for Children and Youth and the Division of Developmental and Behavioral Neurosciences of the Department of Neu ro logy in UB's School of Medicine and Biomedical Sciences. During pregnancy, lead is mobilized just as calcium is and may go to the fetus, explained David Shucard, Ph.D., professor of neurology and pediatrics and director o f the Divisio n of Developmental and Behavioral Neurosciences. No one knows what levels oflead are toxic, Shucard noted . The other researchers o n th e project include: • Janet Shuca rd, instructor in neurology at UB • Matthew Lanighan, Ph .D., clinical instructo r in medical technology at UB and assistant director of public health for the Erie County Public Health Laboratory • Robert J . Patterson, M.D., clinica l associate professor ofGYN-OB at UB and clinical chief in the depa rtme nt of GYN-0B at Child ren's Hospital • Robe rt Gu thr ie, Ph.D., M.D., professor emeritus in pediatrics and neurobiology In February, the researchers expected to finish collecting abou t 1,200 blood samples from births at Children's Hospital. The blood is taken routinely Late Winter '88 for other tests, Shucard noted. The researchers also collected medical and socioeconomic data from the mothers' and babies' charts . The informa t ion included the baby's gestational age, b irt h weight, Apgar scores, sex, and order of birth in the family. Information on the mother included hemoglobin level ( there may be a relationship between lead and anemia, Shucard explained), any complications during pregnancy, age, education, and where she lives. Where the women live may show if certa in local areas have higher lead levels than others, he noted. Unlike toddlers, the mothers aren't eating paint chips. The researchers have been looking for fund ing to pay salaries of a gr aduate student and clerical help to analyze the data. State money is available for screening, Shucard noted, but this project doesn't co unt as screening because there are no existing guidelines o n what levels oflead are considered high for u mbilical blood. T here have been very few stud ies in this count r y on the lead levels in umb ilical cord blood, Shucard said . Work is generally done with toddlers, not newborns. A large scale study is planned with federa l support. It will include more of the preventive and socia l aspects of lead poisoning, which are of major interest to Anthony M. Graziano, Ph.D., and Murray Levine, J.D . , Ph .D., the co-directors of the Research Ce nter for Child ren and Youth. • Buffalo Physician and Biomedical Scientist �Yes,I want to help PSRpreventnuclear war. D Pleasesend me more information. D I would like to host a PSRspeakerin my home/c ommunitygroup. D I want to makea tax deductiblecontribution of $____ to further PSR'swork. Name_ ____________ _______ ____ Street Address____________________ City,State, Zip ________ _ _ _ _ __ _ _ _ ~ hone____ PSR.1601ConnecticutAvenue, NW., Suite 800, Washington.D.C. 20009 _ �:I . :!' 1 l ', 5 t 5 ,.. - ,j .. 3 ;:- <,. (. ~. :.: . "! 7 i 9 , 8 8 t, , I_,";> •" • 9 0 7 7 I I • d s s ... ~ ~ S ;;- () l (, 0 9~ G . , 1 1 1i l 1 - . z 1., .... . ... l I - n ' <; ,, :, J - .) ~ ~ ,. ,. ., •... ;:. 1 ~ 2 '/ ,, :,. , . 'i .. i: : 6 0 ' .., .. 1 : "1 • -: 7 ·, I 1 I 7 -• I 7 t• _.. :"-.; s , a 1' ? ti s-s e a a ., -. .. • -l -~ i 9 { I .. £ 9 9 ~ J ~ t. S d , 9 ·-· "' "' :. C. <, r 0 ~ 11.G.(. 0 ·o' :. ( ~ ..... , (. J 7 ~ .... i..; 1t· 1 · • ".I 9 '• -1 1 J O " l 0 1 .,.s4.s4. 'L6 I 5 5 I\ ' '- - , _ , 6,6 J.., "-.' ' _-7· .,. ,.:''H•~,aa •C'9 •• • " ,rq•_t !f9 O ) �1 BIACKMONDAY Someinvestorsshrugged;otherspanicked.Why? BY CONNIE OSW ALO STOFKO 0 ne man lost his shirt on "Black Monday" and shot his stockbroker. Other investors lost just as much -or even more - in October's stock market crash and simply shrugged it off. Why ar e there such different reactions to the same event? It has a lot to do with both the individual's history and the significance of the loss, explained George Molnar, M.D., associate professor and vice chairman in the Department of Psychiatry at UB. Molnar has an interest in stress-related disorders. As a psychiatrist with the U.S. Army Reserve, he looks at the concept of stress and stress reaction to extreme situations. The stock market crash was a stressful situation and could be experienced by some individuals in the same way they would experience other extreme situations, such as a car accident, combat, or the loss of a parent, Molnar explained. These situations have different meanings for different people at different stages in life. T he significance of the loss to the individual is an important factor in how the person will react, Molnar said. Where the loss of $2,000 may break one investor, even a $1 million loss may be dismissed by another as just a "paper loss." The person's reaction also depends on his vulnerability, social supports, the intensity of stress, and how he deals with anger. Alcohol and other drugs can disinhib it behavior, such as violence, that's normally inhibited, Molnar said. One case of violence was the incident in Miami where a man incurred heavy losses and killed his stockbroker. But, according to newspaper accounts, the man apparently had a complicated life history, Molnar pointed ou _t. He was in the government's protected witness program. He may have been an unbalanced individual, prone to impulsive actions, particularly precipitated by events such as his sudden loss in the market. "So in addition to looking at the immediate stress, he was probably predisposed to acting this way," he pointed out. "It didn't come out of the blue." Buffalo Ph ysic ian and Biomdica l Scientist Indiffer enc e and homicidal anger are the two extremes, Molnar said. Many reactions fall in th e middle and can occur long after the crash or other traumatic event. Anxiety disorders, depressive disorders, or adjustment disorders are other means of response and reaction to such events. In some extrem e cases, ther e can be a brief reactive psychosis, Molnar said. Psychosomatic conditions such as hypertension, peptic ulcers, migraine headaches, and irritable bowel may also come into play. Some people just become irritable, angry, or depress ed and begin to self-medicate with alcohol. These feelings can add to ongoing marital conflicts. Stress over the course of the stock market doesn't affect just investors. People who work in the market, such as brokers and secretaries, feel it, too, Molnar pointed out. They find their jobs are more precarious, and their workdays are filled with pressure and angry clients. Often their self-esteem rides with their success in the stock market. "S everal individual s no doubt committ ed suicide, from what I read," Molnar said. Even people who don't have money in the market can feel anxious and alarmed when hearing news reports about the economic situation. S tress-related conditions are eminently treatable, Molnar said. If there are no previous complicating disorders, brief psychotherapy and medication should be sufficient. Treatment will diminish the severity of or remove symptoms and keep the condition from getting chronic. There shouldn't be excessive use of medication, Molnar pointed out; usually a single agent should be used. Molnar noted that most people haven't become ill from the stock market crash. "The great majority of individuals went about the normal business of their lives,'' he said. ''They weren't pleased with the loss of money, even if it was only a paper loss, but they took it in stride. They accepted it as part of doing business." • La tt: \Vintcr '88 �8 PREMENSTRUAL CHANGESARETHE FOCUSOFA NEW LIFE--CYCLE CENTER BY CLARE O'SHEA 0 n two different Friday nights, Jane goes to parties. On Friday night numbe r one,Jane and her boyfriend have three or four drinks and feel equally tipsy. The nex t Friday night, they go to another party and drink the same amount of alcohol. Jane 's boyfriend is no more tipsy than he was last week. But Jane is more impulsive, her concen tration is a little off, her memory's not as sharp as usual. This week, Jane is tipsier. She's also expecting her period. Such an effect of alcohol on women in the premenstrual phase is just one of many possible characteristics of the condition known as premenstrual syndrome, or PMS. Uriel Halbreich, psychiatry professor and director ofbiobehavioral research at UB, rejects the popular PMS label, however, in favor of PMC, or premenstrual changes. PMC is the more accurate term, Halbr eich believes, for a couple of reasons. The term syndrome implies more than one symptom; it is possible, though, to have just one change premenstrually. In addition , research has shown that positive as well as negative changes can be associated with the premenstrual phase . Lare Winter '88 T he study of premenstrual changes as a phenomena is relatively new. "There has been a tendency in the past for the problems associated with PMS to be minimized or simply dismissed by some physicians," Halbreich said. "Often the patient's complaints were not taken seriously or it was implied that he r symptoms were 'all in her head.' 11 PMC research has not been without controversy, either. For example, the theory that women usually are more sensitive to alcohol premenstrually than at other phases of the cycle, and in comparison to their male counterparts, can be a touchy one, ripe for accusations of male chauvinism, Halbriech pointed out. And, indeed, he said, certain preconceptions or biases, perhaps gender-related, may influence such research. A definition of the phenomena of premenstrual changes is still being worked out. According to Halbreich, symptom or symptoms are considered as PMC if: They reoccur cyclically, du ring the premenstrual phase ( that is, the late luteal phase, one to seven days prior to menstrual bleeding); they are significantly changed in severity compared to other times in the cycle; they subside shortly after the onset of menstrual bleeding. Without eve r having heard of PMS, many women recognize changes in the way they feel or behave just befo re the beginning of their periods. Some women are depressed, or go through rapid mood swings; others lack control, are aggressive or compulsive; still others might have an increase in sexual drive, in appetite or in sleep. Halbreich has found that some women consciously alter their behavior during this time - they drink less, for example, or try not to take complicated, high-performance tests. It's difficult to say , he added, just how many women have premenstrual changes. Although the symptoms are quite consistent in one woman, they can vary widely between women. Some women have symptoms for only one day; others for 14 days , the entire luteal phase. "If one defines PMC as including any noticeable changes, some people say up to 80 per cent of women are affected," Halbreich said. "If you count only women who seek treatment and in whom the premenstrual disorder is confirmed , it wou ld be somewhere between two to eight per cent of the normal women's population . 11 The premenstrual changes are conside red a disorder if there is an impaired function , socially or occupat ionally, Halbreich explained. "It also depends on how you do your research - on what group you study, for example," he continued. "We surveyed nursing students and over 90 pe r cent ( reported PMC). Among women executives or highly successful professionals, not even one ( of 23) reported premenstrual changes .'' H albreich has been studying PMC for more than 10 years. Before coming to UB in 1985, he was on the faculty of Albert Einstein College of Medicine in New York City. He was previously a faculty member at the medical schools of Columbia Univers ity and Buffalo Physician and Biomedi cal Scie ntist �lllUSTRATlON : GLYNISS'M:ENV �10 Hebrew University in Israel. Biological aspects of PMC were the focus ofHalbreich's initial studies of the condition. He soon realized, however, that certain methodological issues needed to be addressed first. For example, the groups of women under study were not homogeneous; they did not necessarily reflect the diversity of types of premenstrual changes. A reliable procedure for the clinical and research assessments of premenstrual phenomena did not exist. The Premenstrual Assessment Form, subsequently developed by Halbreich and his assoc iates , uses 95 different items to measure changes in mood, behavior, and physical condition during the premenstrual period. Rather than following the common practice of viewing PMC as a single entity, the form reflects the wide variability of PMC. "While there are more than 200 symptoms associated with PMS, the major ones are depression, anxiety, and diversified discomforts states, 11 Halbrei ch said. responsive to external stimuli. If taken to a party, they can be cheered up. Symptoms of atypical depression are quite similar to those of premenstrual depression. A women with premenstrual depression can also be cheered up at a party, for example. But there are differences, Halbreich pointed out. Premenstrual changes can last just one or two days. A woman would have to be depressed for at least two weeks, however, before she could be diagnosed as having a major depressive disorder. In addition, unlike atypical depression, premenstrual depression by definition is exclusive to one phase of the menstrual cycle, and the depression is usually not as severe. That leaves premenstrual depression out of the category of major depressive disorders. Interestingly, research has suggested that those women who have dysphoric PMC are more likely to develop more depressive disorders in the future than those who do not have dysphoric PMC, Halbreich said. A I s one of the most common of premenstrual changes, depression has undergone especial scrutiny. It has been suggested, by Halbreich and others, that there may be an association between dysphoric PMC ( characterized by abnormal moods, especially depression) and more severe depressive disorders, and that PMC can be studied as a model for such disorders. Among the several types of depressive disorders are atypical depression and endogenous depression, or melancholia, Halbreich said. Melancholia is associated with a variety of biological symptoms including decreased sleep, weight loss, severe depression, guilt feelings, and suicidal ideations. People with melancholia are miserable; if taken to a party, Halbr eich offered as example, they will not be cheered up. Atypical depression, although possible in both men and women, is more prevalent among women, he noted. There's an increase in appetite and sleep and a decrease in energy. People with this form of depressive order are very Late Winter '88 n recent months, his work has taken a multidisciplinary and practical approach in the form of a research and service clinic which evaluates and treats women suffering from negative PMC. The Life-Cycle Center at Millard Fillmore Hospitals, directed by Halbreich, is staffed by two physicians, two gynecologic nurse practitioners, a psychiatric nurse clinician, and a clinical social worker. "We very thoroughly evaluate each patient - though you can't really call them patients because we are dealing with normal women who have symptoms only a short time during their menstrual cycles, 11 Halbreich explained. "We are giving treatment which is aimed mostly at the elimination of the fluctuations of the gonadal hormones." It takes about six weeks to fully evaluate each patient at the Life-Cycle Center. Treatment primarily takes the form of medication - patients are given tablets that influence the production of estrogen and progesterone, usually eliminating ovulation. Hormonal patterns are examined through blood studies. Group therapy and nutritional consultation will be offered in the future. "We schedule patients for two visits, at specific times of the menstrual cycle - once during the phase when they are not expecting the symptoms and once during the luteal phase when they're supposedly having the symptoms," Halbr eich said . "Between the first visit and the second, the patient monitors her symptoms daily so that we can see if these symptoms are exclusive to the premenstrual phase and if there is a change in fluctuations. "We know that for about 70 per cent of the women, the treatment is effective," he added. "We don't yet know why it is not effective for the other 30 per cent, however, or why one drug is effective and another isn't." Studies will be conducted at the center to evaluate the efficacy of new treatments and test medications currently used for other conditions but which may relieve PMC symptoms. Last November, a few weeks after the center opened, patients were coming in at a rate of about one per day, Halbreich said. The center's capacity is two new patients per day. If the PMC studies Halbreich and his associates carried out at Albert Einstein College and Columb ia University are any indication, the Life-Cycle Center should have no trouble finding patients. "Many times family physicians or gynecologists just don't have time ( for PMC patients), but there is quite a lot of demand," Halbreich said. "In New York City, we ( evaluated and treated) close to 800 women over the years. We had more potential participants than we could handle." Women should seek treatment for negative PMC , according to Halbreich, when "the severity is such that there is an impairment of social or individual functioning to a degree that is clearly significant to the women and/or those around her." The Life-Cycle Center is located at Millard Fillmore Hospital, 3 Gates Circle, Buffalo. Appointments can be made by calling 887-4444. • Buffa lo Physician and Biomedical Scientist �LEECHES 11 Theirusewas an important aid in a successful microsurgical reattachmentof a severedear Dr. Bhangoo examines successfullyreattachedear. BY LISA JOSEPHSON W hat do leeches and microsurgery have in common? Plenty, if you ask Dr. Kulwant Bhangoo, Mercy Hospital's ch ief of plastic surgery and clinical assistant professor of plastic surgery at UB. Dr. Bhangoo is the first surgeon in the Buffalo and Western New York area to use leeches as an adjunct in a successful microsurgical reattachme nt of a severed ear. During the early hours of June 2, 1987, a SO-year-old white male patient, Frank lin Dye, was rushed into the emergency room of Mercy Hospita l with Buffalo Physician and Biomedical Scientist severe facial lacerations, including amputation of his right ear. During emergency surgery, Dr. Bhangoo used microsurgical techniques to reattach the ear. Unde r the magnification of the operating microscope, he found a transected artery in the ear and its corresponding stump on the scalp of the patient . The diameter of the small artery was less than 5 millimeters. Using the extremely delicate technique of microsurgery, the two cut ends of the artery were anastomosed using sutures that are barely visible to the naked eye. With the repair of the arte ry , it was possible to get blood flow- ing into the ear. However, Dr. Bhangoo notes, in order to have a successful microvascular reimplantation of an amputated part, it is als0 necessary to anastomose veins in addition to the arteries; this allows the blood brought into the part by the reconstructed arteries to d rain back out into the body's circulatory mainstream. Conventionally it has been extremely difficult to find and anastomose veins in reimplantation of the ear because the veins in that structure are extremely small; in th is particular case, they were cru shed and irreparable. Late Winter '88 �12 l i,, 0 i .____ ___ 0 Dr. Bhangoo(le/!) with patient Franklin Dye. Soon after the surgery, the ear had blood flowing into it, bearing testimony to the successful arterial anastomosis. Howeve r , a few hours later, the ear started to turn blue and became engorged with blood, indicating that there was inadequate outflow of venous blood from the ear. Dr. Bhangoo knew that there was no other surgica l technique that could salvage the ear from succumbing to venous strangulation. He left the hospital k nowing that the only way to save the ear would be to somehow gently rid the reattached part Lace Winter '88 of the stagnant veno u s blood until natural healing of the veins could take place. That takes about five to seven days in a circumstance such as this case. In the past, in simila r situations, surgeons had made small incisions in the reattached parts in hopes of causing sustai ned oozing that would allow for decompression. Howeve r , Dr . Bhangoo said, such small incisions soon clot, even when an ticoagulants are applied topically or given int r avenous ly. Large cuts wou ld mak e the re att ached pa rt suscep tible to in fection . As Dr. Bhangoo walked from th e hospital to his nearby office, it suddenly occur red to him that here was an ideal sit u ation to use medicinal leeches to salvage the failing reattached ear. Medicinal leeches had been u sed very effectively in the past for draini ng blood from patie nts. The leeches attach th emselves wit h microscopic bites infl icted by a row of teeth in their circular jaws which mak es a triradiate incisio n into the sk in. This wound in the sk in remains ope n because of its clever des ign. T he leech, Dr . Bhangoo notes, secretes Buffalo Physician and Biomedical Scientist �in its saliva, three pharmacologically potent substances. A local anesthetic similar to novocaine makes the bite painless, a fact not relevant in amputated parts that are insensitive co pain because of severed nerves. The second su bscance is a potent vasodilator which opens up the blood vessels and enhances the local blood flow. The third and most important substance is a locally acting long lasting anticoagulant which prevents the blood at the bite marks from clotting and allows for small amounts to ooze continually from these sites for between 24-48 hours. This prolonged oozing facilitates removal of stagnant blood in situations such as in Mr. Dye's reattached ear. After making several phone calls, Dr. Bhangoo found that medici nal leeches could be obtained from a company in Westbury, New York, called Leeches, USA, which is a subsidiary of Accurate Su rgical and Scientific Instruments, a co rporation dealing with instruments and supplies for microsurgical procedures. Dr . Bhangoo presented the option of using leeches to Mr. Dye . Faced with the possibility of losing the reattached ear, the patient readily agreed. In fact, Dr . Bhangoo recalled, Mr. Dye was surp risingly nonchalant and very receptive to the idea. "It won't be the first time," he said about the leeches. "I pulled one off my leg as a child after play ing in a pond many years ago." Over the ensuing five days, three leeches were applied to the ear daily. The response was quite dramatic- "nothing short of amazing," D r . Bhangoo no tes. "The dark, plum colored ear would become less swollen and pink in short order with each application." The leech attaches itself co feed and stays on for a period of from 15-45 minutes . Mr. Dye remarked that diffe rent leeches fed at differe nt speeds. "Some engorged themselves with blood and d ropped off within 15 minutes, while othe rs fed more leisurely and took u p to one hour ." Dr . Bhangoo is not sure what causes the animals to stop feeding. It is Buffalo Physician and Biomedical Scientist conceivable, he said, that the increases in the animal's weight may be a facto r, or possibly there may be a built-in mechanism telling it when to quit. With one feeding, the animals are able to susta in themselves for from six co 12 monchs. In order to prevent infection and cross contamination, these leeches, which cost about $6 apiece, are used only once and then discarded. npe.ople think these thingsmust bite you likea king crab,but theyjust go on like a suctioncupand then it is all over. Youdon't even know they are there. The hardestpart is lyingstill so as not to disturbthem.'' Mr . Dye remarked that "people t hink these things must bite you like a king crab, but they just go on like a suction cup and then it is all over. You don't even know they are there. The ha rdest part is lying still so as not to disturb them." Mr. Dye's ear has healed completely and is one of only a very few successful ear reimplants in the world literature, D r. Bhangoo notes. T here are fewer than six documented cases of successful microvascular ear reimplants, he says. T he leeches used are not the ordinary pond variety animals. The supplying fir m obtains them from a leech farm in Wales, United Kingdom. This species ofleeches is called "Hirudo-medicinals;" they are farmed at Biopharm in Swansea, Wales, and then shipped to the U n ited States via air freight . They are maintained in sterile, cool, damp containers for shipment. The organization in Wales, Dr. Bhangoo says, is at the center of the resurgence of medicinal leeches. Currently, apart from their use in salvaging failing reimplants in situations similar to that of Mr. Dye's or as adjuncts in microvascular reattachment of ears, noses, lips, avulsed scalps, digits, and limbs, they are finding wider use in o t her surgical procedures. These include correction of venous engorgement in transposed microvascular free flaps, or pedicle flaps. Leeches over the years have also been used quite effective ly in decreasing swelling following trauma, such as in treating black eyes and hematomas. The idea of us ing leeches medicinally stemmed from the anc ient belief that disease was caused by an excess of corrupt blood. The principle used today is similarly aimed at removing stagnant and unwanted blood from parts of the body . The earliest written reference to the medieval use of leeches was by a Greek in the second century B.C. However, medicinal leeching originated much earlier in India . The French also used leeches. They applied up to SOat a time to "blood patients" and found accidentally that leeches helped pulmonary edema, cardiac failure, and hypertension. Ho wever, pat ients who did not have these ailments were often made wo rse. This was particularly so in conditions such as obesity. Use of the leeches often caused anem ia and blood loss and sometimes lead to death. By the early twentieth century the practice of using them for bleeding had almost died out. Dr. Bhangoo anticipates a widespread readoption of the technique as an adjunct in microvascular reimplantation and also in plastic and reconst ru ctive surgery. But he cautioned that it has to be used judiciously and discrimi nately. When asked whether he will use the technique again, he said, "If the situations are righ t and if the patient is willing, then we will do it again." • Late Wimer '88 13 �14 CE ♦ BY BRUCE S. KERSHNER T housands of lives lost following auto accidents and ocher causes of severe trauma could be saved if a new surgical approach is adopted . This is the finding of a just completed research study by UB orthopaedic surgeon Lawrence Bone, M .D. His study demonstrates that aggressive immediate surgery for multiple long bone fractures significantly reduces irreversible respiratory failure and markedly reduces morbidity rates. In addition, he has found that hospital costs could be halved by the rarely used surgical approach. Nationwide, the primary approach is to surgically stab ilize long bone fractures , such as occur in an auto accident, several days later. Dr. Bone's findings provide convincing evidence that this traditional surgical approach is a major factor in increa sed morbidiry and prolonged hospitalization for the multiply-injured patient with fractures. "Surgeons can no longer ignore the implications of delaying fracture stabil ization," Dr. Bone states. The study provides the "smoking gun" against continued use of the traditional surgical approach, Dr. Bone maintains, "because it is the first published prospective random ized study on the subject, and the results are statistically significant ." While several previous retrospective studies reached the same conclusions, retr ospect ive studies lack a control, unlike prospective studies . "Because the retrospective reviews of patients were uncontrolled studies, their findings made little headway in con- Late Winter '88 Dr. Lawrence Bone (left) with Dr. Steven Lasser. vincing most of the American medical community," he commented. This skepticism has prevented the adopt ion of the new surgical approach to trauma, and probably less than a dozen hospitals around the nation currently use the new approach. "Our findings were that 12 of 28 trauma patients that had traditional delayed surgery developed respiratory failure. However, only one of 30 such patients with prompt surgery developed respiratory failure. That one patient (who was struck by a train) was so injured that we expect he would have died of his multiple, severe injuries anyway," noted the assistant professor of Buffalo Physician and Biomedical Scientist �15 orthopaedic surgery. r. Bone emphasized that it is an economic breakthrough, not just a medical breakthrough . While medical advances often tend co increase hospital coses, chis advance would result in reduced coses if adopted. "le is nearly twice as expensive co delay someone's operation by 48 hours ," he explains . "Thi s is not just because of an additiona l ten days ofhospicalizacion but also because oflonger treatment in the Intensive Care Unit. "Based on our study, it will cost half as much co treat multiple D Buffalo Physician and Biomedical Scientist trauma patients with early fracture stabilization." Bone's interest in the subject was sparked by che work of Dr. John Border, who is acknowledged as one of the fathers of modern trauma surgery. Dr. Bone was trained in trauma medicine under Dr. Border who is a UB professor of surgery based at Erie County Medical Center. Border helped pioneer the new creacmenc methods that enable dramat ic improvement in che survival of patients with severe mult iple trauma. Dr. Border developed the "Total System Approach" co trauma pat ients. It involves six basic techniques, including aggressive Late Winter '88 �16 immediate bone surgery {the one Or. Bone focused on), as well as aggressive cardiopulmonary treatment, massive protein nutritional support, and continuous ventilation of the patient, among others. Where adopted, Border's approach has reduced the mortality rate for severe multiple trauma from 30 per cent to 3 per cent or less. "Dr. Border's studies have focused on a broader range of trauma medicine concerns while mine focused only on orthopaedic surgery," Dr. Bone -----.--remarked. Dr. Border's research, while it demonstrated the importance of aggressive bone surgery, relied on retrospective studies only. This is one of several reasons why this approach is still rarely used. It is also the reason that Dr. Bone decided to undertake this study in 1984. "! saw a need for a study that would definitively establish the role of early fixation in the trauma patient. Because the approach was viewed with skepticism by the medical community, I saw chat this kind of study could change this skepticism," he related. While chief orthopaedic resident at Parkland Hospital, University of Texas-Dallas (1984 to 1986), he became project director for the study. It was funded by a $64,000 grant from the Orthopaedic Research and Education Foundation. Dr. Kenneth Johnson, University of Texas associate professor of orthopaedic surgery, served as co-investigator. Dr. Bone's prospective randomized study compared 125 trauma patients who had femur fractures. They were separated into two groups, one which had early stabilization of bone fractures and one which had de layed stabilization. These two groups were in turn divided by level of injury, whether moderate or severe. In the group with moderate inju r y levels, those with delayed su rgery showed 2.6 times greater levels of abnormal arterial blood gases than those with immediate surgery. Pulmonary emboli occurred in 3.3 per cent of the delayed group, but none in the immediate group had this difficulty. For the group with severe injuries, differences were much more dramatic. Ventilation support and admission to the ICU were required for mo re than twice as many in the delayed surgery group as in the immediate surgery group; amount of time spent in the ICU was almost three times greater in the Late Winter '88 delayed group; major pulmonary failure was 13 times greater ( 42.9 per cent vs. 3.3 per cent) for the delayed vs. the immediate surgery group. The reason pulmonary failure occurs from the multiple bone fractures has to do with the reaction of the body following severe trauma. It appears, Or. Bone states, "that fat from the fracture site, from the liver and from adipose tissue form emboli and other vascular cellular elements that lodge in the lung, ---, mechanically occluding or constricting smaller capillaries." This results in an irreversible reduction in oxygen for the lung. Dr. Bone has presented his findings at the American Academy of Orthopaedic Surgeons meeting in San Francisco, at the American Orthopaedics Association in Washington, D.C., and at the World Surgical Conference in Australia this fall. "I have received a very, very positive reaction from fellow surgeons so far," he says. He expects to pub-lish his results in a primary orthopaedic journal. Or. Bone returned to Buffalo in 1986 after he was invited to join UB's faculty. But his connections to the area are not just career-related. He is a Buffalo native, his family lives in Western New York, and both he and his father are UB medical alumni. Besides receiving his M.O. and completing his surgical residency at UB, Or. Bone has participated in fellowships in Switzerland, Germany, and Texas. He is both director of the Musculoskeletal Trauma Service at Erie County Medical Center and acting chief of the Division of Orthopaedics at Buffalo Veterans Hospital. He has other staff positions at Buffalo General and Children's hospitals . Dr. Bone is unusual because he is one of only several physicians nationw ide who is board certified in both orthopaedic surgery and general surgery. This year, Dr. Bone was honored with the American Orthopaedic Association Traveling Fellowship. He is the author of 15 publications. He hopes his findings will spark interest in the new approach to trauma so that the advances will become standard techniques. Regarding his uniquely fitting last name, the bone surgeon remarks, "I get a little bit of ribbing from my fellow physicians once in a while. On the other hand, none of my patients ever forgets my name." • Buffalo Physician and Biomedical Scientist �17 ROSWELL REPORT WASKEY TOGENETIC BREAKTHROUGH BY COLLEEN M. KARUZA A unique case report of a Roswell Park patient was the key to a breakthrough genetic study published recently by British scientists. Sir Walter Bod mer, of the Imperial Cancer Research Fund, in London, and his colleagues have provided compelling evidence demonstrating that the genetic defect responsible for familial adenomatous polyposis - a premalignant condition leading primarily to colorectal cancer - resides in the long arm of chromosome 5. Their study was published in the August 13 issue of Nature, a well-known British journal. In an article published on the same date in the New York Times, Sir Walter acknowledged that his group's research was triggered by a 1986 published case report from Roswell Park involving a mentally retarded patient with colorectal cancer, extensive adenomatous polyposis and several unusual chromosomal anomalies. This brief report, which appeared in the American Journal of Medical Genetics,was written by Lemuel Herrera, M.D., FACS, director of the Familial Adenomatous Polyposis Registry of Western New York, and several members of Roswell Park's Genetics & Endocrinology Department. Or. Herrera is an assistant professor of surgery at UB. Familial adenomatous polyposis is an autosomal dominant, premalignant condition. If one parent carries the gene for this condition, 50 per cent of the offspring will inherit the gene. "If an offspring develops colon polyps," said Or. Herrera, "there is a 99 per cent chance that he or she will develop cancer by age 35." Moreover, only those affected may transmit the genetic defect to their children. Because familial polyposis is premalignant primarily for colorectal cancer, it is, according to Dr. Herrea, "the classic prototype for studying the genetic back- Buffalo Physician and Biomedical Scientist ground of the number two cancer killer in both the U.S. and Great Britain." Of the 140,000 new cases diagnosed in the United States in l 987, it is estimated that 25 per cent to 40 per cent may be linked to a genetic defect. The human genome has been calculated to have l 00,000 genes distributed in 23 pairs of chromosomes. Chromosomes can be compared to sentences that contain an individual's genetic blueprint, while the genes are the words. The chemical bases that make up these genes are the letters that spell out an individual's inheritance. In the report, Dr. Herrera, who is also a clinician in Roswell Park's Surgical Oncology Department, evaluated a mentally retarded male patient who had undergone a proctocolectomy for a colon carpeted with adenomatous polyps. The resected specimen contained two well-differentiated colorectal cancers. Four years later, the patient developed a large mass which occupied the entire abdominal cavity and was ultimately responsible for his death. An autopsy revealed an enormous desmoid tumor and other congenital anomalies, including a horseshoe kidney, a liver consisting only of the right lobe, absence of the gallbladder, rounded configuration of the heart, and deformed feet. Subsequent cytogenetic studies showed that the patient's mother had normal chromosomes, while the father had an enlarged satellite area on chromosome 22. A similar assessment of the patient revealed that a portion of chromosome 5 was missing; and that the same enlarged satellite area appeared on chromosome 22. Although the family had no known history of colorcctal cancer or adenomatous polyposis, Dr. Herrea and his colleagues believed that the combination of colonic adenomatous polyps, cancer and the desmoid tumor represented a mutant of familial polyposis often labelled as Gardner's syndrome. G ardner's syndrome is characterized by several abnormal growths caused by a single dominant gene, with the colon being the central tumor site. Familial polyposis has been claimed to involve just colon cancer, and not the other anomalies associated with Gardner's syndrome. Recently, there has been evidence to suggest that Gardner's syndrome is the full-blown phenotypic manifestation of the familial polyposis gene. Only five cases of abnormalities on chromosome 5 had been reported previously in the literature, with Roswell Park being the first and only research institute to describe a constitutional chromosome anomaly in a patient with Gardner's syndrome and colorectal cancer. Despite several decades of intensive research, this was the first time that a cytogenetic finding led to the discovery of a recessive genetic effect in one of the most common types of cancer. "At that point, however," said Or. Herrera, "more cases needed to be studied to establish the possible significance of this cyrogeneric abnormality in familial polyposis." Prompted by the Roswell Park report, the British research team studied several families with adenomatous polyposis syndrome from the St. Mark's Hospital Registry in London. For those individuals who later developed colorectal cancer, variants in the generic material were disclosed by ONA recombinant techniques. This indicated a gene deletion on chromosome 5. The British team not only corroborated rhe results of Dr. Herrera's research that indicated that the defect was in bands 2 l and 22 of the long arm of chromosome S, but they also established an Lare Winter '88 �18 assoc1at1on for the gene deletion in both inherited and sporadic forms of colon cance r. With these findings, Sir Walter contends chat teams currently working on this project should be able co sequence the chemical bases of the gene within the next few years. If the promise of the new studies is borne out, periodic blood tests will be available to detect the defective gene in individuals at greatest risk for colorectal cance r; and knowing the gene sequence may lead to more effective treatments. As Dr. Herrera explains, "This research will provide the basis for presymptomatic or prenatal diagnosis of familial polyposis as well as the early detection of a significant percentage of colorectal cancers chat are often associated with the presence of adenomatous polyps in the general population.11 Dr. Herrera's collaborators on the report were Surabhi Kakati, Ph.D.; L. Gibas, Gen Pietrzak, and Avery A, Sandberg, M.D. • Epidemiologist finds link between SIDS & retarded fetal growth N ew evidence linking Sudden Infant Death Syndrome (SIDS) with retarded growth of the fetus during pregnancy has been reported by a UB epidemiologist. According to the study conducted by Germaine Buck, Ph.D., babies who die of SIDS typically, at birth, weigh less than five pounds and five ounces, measure less than 20 inches long, and are delivered earlier than 3 7 weeks gestation. Buck's findings were presented lastJune at the meeting of the Society for Epidemiologic Research in Amherst, Mass. The study, conducted by Buck as a doctorial candidate in UB's Department of Social and Preventive Medicine, also won the Society's prestigious Abraham Lilienfeld Award for best student research. She is currently a clinical assistant professor in the department. SIDS, which swiftly and without warning kills, usually within the first six months after birth, has no known cause. Late Winter '88 SIDS babies are typically normal, healthy infants who are found dead, usually in their cribs. This killer of infants gives no signs, no symptoms, and it strikes rich and poor alike. "Diagnosis of SIDS at autopsy is always a diagnosis of exclusion; it remains as the likeliest cause of death when all other diseases and disorders have been excluded," says Buck. The UB researcher says reduction in birth weight and birth length, called proportional growth retardation, which the SIDS infants share, may be related to insults which occur to the fetus early in the pregnancy. These insults include the mother's consumption of alcohol; consumption of drugs - illegal, prescription, or over-the-counter; inadequate nutrition, and exposure to chemicals or other substances in the environment which can affect fetal growth. These may be particularly criticaI in the earliest weeks and months of pregnancy, Buck believes. "We know, for instance, the fetus achieves about 75 per cent of its birth length by the end of the second trimester of pregnancy," she points out. Therefore, it may be during this time that insults which would slow the growth involving length could occur. I n general, risk of SIDS decreases with increase in infant size. SIDS, which was formally recognized during the early 1960s, occurs in two to three live births pe r thousand in the population of developed nations around the world, a rate which remains unc hanged after two decades. It is extremely difficult, says Buck, to estimate the figures for SIDS in developing nations because infant s there are likely to die within the first year oflife from a variety of diseases and problems connected with nutrition and environment. Buck's study examined birth weight, birth length, head circumference and length of time in uterofor all babies born in New York State in 1974, excluding New Dr. Gennaine Buck York City. She then examined identical factors for infant deaths in New York State for 1974 and 1975. A total of 148autopsyconfirmed cases of SIDS, 114 infant deaths from all other causes including trauma, and 355 living infants who had reached their first birthday were compared in the study. "Even when I examined factors such as education levels and occupations of the parents of the babies in the three groups, none of these data suggested that socioeconomic , educational or health status of the parents affected the SIDS risk," Buck points out. The only factors, she says, which the SIDS babies had in common were birth weight of less than five pounds, five ounces, birth length ofless than 20 inch es and a gestation period of less than 37 weeks. "This is not to say that all babies which fit this pattern will die of SIDS," she emphasizes, "it only suggests that these factors which are the result of delayed development which occurs in pregnancy put them at higher risk than average." Buffalo Physician and Biomedical Scientist \ J �19 Roswell skin cancer study enters second year of tests R oswell Park is entering its second year in a nationwide research study designed to test the vitamin A derivative, isotretinoin, as a prophy lactic against basal cell carcinoma. This five-year study was made possible through a $500,000 research grant from the National Cancer Institute (NCI) . ~ Basal cell carcinoma, a disorderly growth of cells near the skin's surface, is the most common - and most commonly cured - human ~ malignancy. Although cure is virtua lly guaran6 teed with early detection and treatment, persons who have had basal cell carcinomas in the ... past are likely to see new skin lesions developing in the future. The first tumor may appear on the face; the next one on the neck. Cur rently, ased on the results of her study, Buck there is no way to prevent new basal cell carsays it wou ld appear that the earlier cinomas from forming. the mothe r-to-be r eceives prenatal counThe NCI has been investigating drugs that seling and examination, the better for the would arrest or disrupt this regeneration. In a infant. pilot study conducted by the NCI, a synthetic derivative of vitamin A called isotrecinoin "Many women may believe that it's not effectively slowed the development of new skin important to check in with the doctor o r cancers in a small group of patients treated for clinic until they 'show' weight gain. Othbasal cell carcinomas. ers may not believe they are pregnant in Basedon this preliminary evidence, the NCI the first two months, especially if they launched an intensive five-year clinical study of have a history of irregula r menstrual pe r ilow-dose isocrecinoin as a prophylactic against ods," Buc k points out . And some physibasal cell carcinoma . Eight study sires around cians have suggested women not schedule the U.S., including Roswell Park, were sethei r first prenatal visit u ntil after they 've lected to conduct the cooperative clinical trimissed two periods. als. Currently, more than 800 patients nationwide are enrolled in the study. ''The study suggests, howeve r , t h at the At the Roswell Park study site, Dr. Howard earlier the mother-to-be gets adequate nuL. Stoll, director of the Dermatology Section trition, abstains from alcohol and tobacco and clinical associate professor of dermatology, and other chemicals including illegal is the principal investigator; and Ors. B. Dale drugs as well as medications, the less lik ely Wilson and Corne lie Jones, clinical assistant she may be to r un the risk of the baby dying professor of dermatology, are co-investigators; later from SIDS," Buck surmises . Barbara Slusarski, R. N., M.S., is the study Buck's study was conducted with grant coordinator. monies from the National SIDS FoundaThe Roswell Park study began in the spring tion and assistance from the New York of 1986,with 68 skin cancer patients volunteerSt ate Health Depa r tment . • ing as subjects. "The patient s have been ran-Mary Beth Spina domly assigned to one of two groups," said Mrs. i i --------- ~----------- B \ j Buffalo Physician and Biomedical Scientist i Slusarski. "One receives a placebo; the other group, the isotretinoin." The study is "doubleblinded," which means that neither the patient nor the physician knows which agent is being administered. Each patient is required to take two fivemilligram capsules each day and make regular visits co the Roswell Park Dermatology Clin ic. After three years, study researchers will compare che groups to see if the isocretinoin group had fewer basal cell carcinomas . Although they will stop taking the capsules after the third year, patients will still return to the clinic for routine follow-up visits every six months for II patients have been intwo more years. ''.A. formed that should we find proof chat the isotretinoin is effective, the 'blind code' will be broken, and the drug will be prescribed for all study participants," explained Mrs. Slusarski. Conversely, if the drug proves harmful at an y time, the study will be abruptly discontinued. And how safe is isotretinoin? "Physicians have successfully treated more than 1,000 acne pat ients with isotretinoin at doses three to ten times higher than the 10 milligram daily dose in our study," said Mrs. Slusarski. ''.l\swith any medication, side-effects can occur; however, we feel that, because of the low dosage, any side-effects that do occur are very unlikely to be dangerous." Some of the possible side-effects are chapped lips, mild nosebleeds, and tired or irritated eyes. This may occur because isotrecinoin has a drying effect. Unlike vitamin A, isocrecinoin appears to have no deleterious effects on the liver or kidney. "However, if eithe r organ malfunctions, the body may be unable to break down che compound," said Mrs. Slusarski. "We routinely test patients' blood to ensure that these viral organs work normally." Ac che end of the trial, patients will be notified of any significant results, but chat isn't the only benefit they'll derive for their participation . During the five years of the study, patients receive free dermatological care, including check-ups and treatment. • Late Winter '88 �20 Dental researchersJoseph Margarone (left) and Charles Liebow demonstratehow laserwill be used for surgery. LASERUSEDTOTREATSOFT TISSUELESIONS IN MOUTH BY MARY BETH SPINA P ioneering research in the UB School of Dental Medicine shows that soft tissue lesions in the mouth can be successfully biopsied or removed on an outpatient basis with a pulsing carbon dioxide laser beam. Although the laser "light knife" has been used to treat a var iety of medical problems, its use in the oral cavity has been largely limited to experimental surgery under general anesthetic. Charles Liebow, D.M.D., Ph.D., told the Society of Optical and Quantum Electronics in Lake Tahoe, Nevada, in December that a UB team has successfully used the laser to treat some 15 patients. Four had fibrotic outgrowths or "callouses"; four ochers had hemangiomas; two were diagnosed with the potentially precancerous lesion leukoplakia; and five had papillary hyperplasia. The pulsing rather than continuous laser beam has dis t inct advantages in the oral cavity, said Lie bow, an associate professor of oral Late Winter '88 surgery here. The continuous beam can produce inflammation in healthy tissue adjacent to the lesion being removed . "Patients who underwent treatment with the pulsing laser experienced no post operative bleeding and little, if any, discomfort compared to what would be expected using traditional surgical procedures," he emphasized. Since the laser energy source, which literally boils and vaporizes tissue, can deliver a pulsing beam in l / 100,000th of a second in an area as small as one-tenth of a millimeter, small amounts of tissue can be lased. "Microscopic capabilities combined with the laser gives the oral surgeon a great deal of control in a precise manner that may not always be possible with traditional surgery methods," Liebow adds. Deep lesions can be lased in layers; intact biopsy samples can be removed by using the laser to cut around and under tissue in a pie-shaped wedge. "While the carbon dioxide laser has proved itself successful as a surgeon's tool in the oral cavity, I don't anticipate every oral surgeon will use it," he predicted. He believes cases which can benefit most from the laser will be referred to tertiary dental centers where clinicians specially tr ained in its use will perform the procedure. Laser treatment does not appear applicable for oral surgery involving bone no r may it be recommended fo r certain other procedures in the mouth, Liebow said. The UB team has, however, used the carbon dioxide laser to treat one case of periodontal disease with good results. Liebow said that the researchers in the Department of Oral Surgery are involved in other ongoing research which may expand applications of laser technology. Others involved in the study include Robert E. Braun, D.D.S., Joseph Natiella, D.D.S.,Joseph Margarone, D.D.S. and Laurie Hartman, D.D.S ., all faculty in the UB School of Dental Medicine. • Buffalo Physician and Biomedical Scientist �21 e Buffalo General Hospital, a major eaching hospital of the State University of New York at Buffalo, is establishing the State's second heart transplant center. Among institutions which also submitted proposals for the heart transplant center were Mt. Sinai Hospital and Montefiore Medical Center in New York City and Strong Memorial Hospital in Rochester. The State's only established center is at ColumbiaPresbyterian Medical Center in New York. The new heart transplant center at Buffalo General will be directed by Robert M. Mentzer Jr., M .D ., head of the Division of Cardiothoracic Surgery at the UB School of Medicine and Biomedical Sciences and chief of Buffalo General's Department of Surgery. The center will be heavily oriented toward research aspects of cardiovascular surgery, including follow-up studies of transplant patients and the development of bioengineering devices such as artificial hearts and support systems for surgery, Mentzer said. "The Cardiac Transplant Center is an important step forward in the development of Buffalo as a national center of excellence for health care," UB President Steven B. Sample commented. "The establishmen t of the center is the result of cooperation among the University's eight teaching hospitals, including Roswell Park Memorial Institute , the strong support of the community, and our faculty's experience in heart transplantation at the Buffalo Veterans Administration Medical Center, where 12 heart transplants have already been performed." "The Cardiac Transplant Center will enhance the Medical School's academic program in cardiovascular surgery," said John Naughton, M.D., vice president for clinical affairs and dean of UB's School of Medicine and Biomedical Sciences. He also emphasized the cooperative effort among the University's eight teach ing hospitals and the involvement of the Western New York Health Sciences Consortium in developing and supporting Buffalo's program in heart transplantation. Fourteen heart transplants are projected during the first year of operation with an average of 25 each year after that, Mentzer said. The Organ Procurement Agency of Buffalo Physician and Biomedical Scientist STATE'S 2ND HEART TRANSPLANT CENTER ESTABLISHED HERE BY LINDA GRACE-KOBA$ THEBUFFALO ENl:RAL HOSPITAL .," -~n. ... BUFFALO GENERAL HOSPITAL I z i5 ~ i Q :.,__ _ ________________ __J ~ President Sam/1le at podium d111·ingheart trans/1lan1 /Jrcss conference. Western New York will handle organ location and procurement. Mentzer noted that no additional hospital construction or equipment is required before the program's start-up and that two operating rooms, intensive care units, and a newly created stepdown unit on the 13th floor in a new medical tower building will easily accommodate the cardiac transplant procedures. Mentzer, with Joginder Bhayana, M.D., will co-direct a cardiac transplant team con- sisting of University at Buffalo facu lty surgeons from Buffalo Children's Hospira!, Buffalo Veterans Administration Medical Center and Buffalo General. In addition to Mentzer and Bhayana, team members include Jacob Bergsland, M.D., Thomas Lajos, M.D., A. Norman Lewin, M.D., Gary Lofland, M.D., Syed T. Raza, M.D., and Theodore Spooner, M.D. Since 1984, this team has performed a total of 14 cardiac transplants in Buffalo. Late Winter '88 �22 Also involved in the heart transplant program are Francis J. Klocke, M.D., SUNYBuffalo professor of psysiology and medicine, who this year serves as president of the American College of Cardiology, and Lewis M. Flint, M .D., chairman of the U niversity' s Department of Surgery. All persons involved in the Buffalo Cardiac Transplant Center emphasize the cooperative effort that resulted in its approval by the State. Other principals in the program's development include William V. Kinnard Jr., M.D., president and chief executive officer of Buffalo General Hospital; John E. Friedlander, Buffalo General's executive vice president, and Andrew J. Rudnick, president of the Greater Buffalo Development Foundation, Inc. Mentzer said the comprehensive nature of Buffalo's program in cardiovascular surgery could not be achieved by a single institution. Officials at Buffalo's renowned cancer research institute, Roswell Park Memorial Institute, have supported efforts to establish transplantation programs for heart and bone marrow transplants, he said. Pediatric cardiovascular surgery and research studies have been under way at Buffalo Children's Hospital, while researchers at the Buffalo VA medical center have developed a highly regarded program in heart transplants and cardiovascular surgery . He also cited Klocke's reputation as a leader in the study of coronary blood flow in humans who has performed important studies in that discipline. Klocke will initiate new coronary blood flow studies in transplant patients, Mentzer said, particularly in the area of atherosclerosis. Other research studies to be performed within the new center will be a systematic investigation of coronary blood flow in transplant patients. Leon Farhi, M.D., chairman of the University's Department of Physiology, is a leader in respiratory physiology who will participate actively in clinical studies investigating changes in blood circulation after a patient undergoes a heart transplant. "Most heart transplant cente rs are not prepared to study changes in the body after transplants in as comprehensive a manner as we are able to because we have the involvement of so many University departments and teaching hospitals," Mentzer said. "In extensive follow-up studies, we will be looking at Late Winter '88 Governor Cuomo visits heart 1:rnnsplan1 cenwr following announ cement of its cstablishmcnL ways to help patients after their heart transplants through Buffalo General's Cardiovascular Life Sciences Program." Another unique aspect of the Buffalo Cardiac Transplant Center is the University's commitment to biotechnology, Mentzer noted. "We are also going to investigate support systems to maintain patients and the furthe r development of cardiovascular technology," he said. "We are prepared to look at the experimental development of artificial hearts over the next several years. We have associations w~th bioengineering experts at the University and with its Health-care Instruments and Devices Institute. "Most other cardiac transplant programs in the country do not have as well rounded a research base to expand their programs as we do in Buffalo. Our goal is to establish ourselves as a transplantation center as good as any in the country." Mentzer was recruited by the University at Buffalo to head its Cardiac Transplant Program from the University of Virginia, where he established a reputation as one of the leading young researchers in cardiovascular surgery in the country, University officials said. His awards include a National Institutes of Health Research Career Development Award and two Public Health Service Awards. • Buffalo Physician and Biomedical Scientist �23 Consortium wi ll focu s on marrow tran splan ts B one marrow transplants are the initial focus of the new consortium formed by three medical institutions: UB School of Medicine and Biomedical Sciences, Roswell Park Memorial Institute, and the University of Rochester Medical Center and School of Medicine and Dentistry. The purpose of the consortium is to share resources in transplantation medicine in the areas of patient care, research, and medical education. The consortium is also exploring the possibility of sharing resources outside trans- Buffalo Physician and Biomedical Scientist plant medicine. "This cooperative agreement is a good indicator of further inter-institutional cooperation in the two communities of Buffalo and Rochester," said John Naughton, M.D., UB's vice president for clinical affairs and dean of the medical school. "Sharing of our expertise in bone marrow transplantation is a sign of more things to come." "The consortium is unique in that it br ings together in a single program the resources of a nationally designated Comprehensive Cancer Center and two university teaching hospitals recognized for thei r excellence, for the benefits of patients throughout Upstate, Central and Western New York." said Thomas B. Tomasi, M.D., Ph.D., director of Roswell Park Memorial Institute (RPMI). "Each institution will bring unique strengths to the program." "We're looking at an era where cooperative use of resources will be crucial if expensive and complex medical technology is to serve the public efficiently," said Paul F. Griner, M.D., director of the Medical Center at the University of Rochester. The cooperative agreement will establish interactions among researchers on a formal basis, Tomasi said. "The three institutions will work toward sharing common interests," Naughton said, adding that the agreement will include cooperation and exchange in research and education. At first, the interchange will involve faculty visiting neighboring institutions to work on joint research, according to Naughton. Later, the exchange could involve the exchange of senior residents and special fellows from the two medical schools. It is proposed in the consortium agreement that a joint program for bone marrow transplantation be established at Roswell Park Memorial Institute and Strong Memorial Hospital of the University of Rochester Medical Center, enabling physicians to perform allogeneic (donated) bone marrow transplants for patients suffering from leukemia, aplastic anemia and related diseases. The bone marrow transplantation program at RPM! and Strong Memorial will serve patients in Western New York as well as the Finger Lakes and Central New York. Tomasi said RPMI currently offers autologous bone marrow transplants in its clinic. (Autologous transplants involve drawing marrow fluid from the patient, treating the fluid, then returning the marrow to the patient.} This procedure is less complicated than allogeneic transplants, which require special facilities. "Research is needed in the bone marrow transplant area, including gene thereapy," Tomasi said, adding that gene therapy, now an experimental procedure, entails inserting genetic material into the cells to replace missing genes. Tomasi's research team is also studying the reasons why organs are rejected when transplanted to a patient. This research may result in improved methods of transplanting organs, such as the heart or liver. • Late Winter '88 �24 JOHNNAUGHTON : DEAN& VICEPRESIDENT BY CONNIE OSW ALO STOFKO I t's not easy to tell where one of John Naughton's jobs stops and the other starts. Naughton is vice president for clinical affairs. He's also dean of the School of Medicine and Biomedical Sciences. When he's wearing his vice presidential hat, he reports to President Steven Sample. In his role of dean, he reports to Provost William Greiner. "Often I report to both together because you can't separate the roles out," Naughton noted. As dean of the medical school, he takes care of the school's academic needs. As vice president, his job is to work with the local hospital system. Clinical education is different in Buffalo than it is in other places because UB uses a system of affiliated hospitals instead of a single teaching hospital as is the case with most others. "To make the system work in Buffalo, we need the cooperation of the hospitals and the school," Naughton said. "To develop the system was the job of the vice president for clinical affairs. To keep it going is the dean's job." Since about 1983, his duties as vice president have remained stable, he indicated. "My job is to be the University's representative and officer to the teaching hospitals in Buffalo," Naughton said. It's his job to represent not only the medical school, but the other schools and departments that have programs in the local hospitals. However, Naughton isn't placed Late Winter '88 over the other deans. "l have oversight in relation to affiliation needs, but not over programs," he explained. The affiliation agreements with hospitals are now cent ralized in rhe Office of the Vice President for Clinical Affairs. Originally, they were in the office of Edward W. Doty, vice president for finance and management. Any department that sends students to work in a hospital must have an affiliation agreement, Naughton said. Each school pretty much works out the relationships with the hospitals itself. Units with affiliation agreements include the School of Dental Medicine, School of Nursing, School of Health Related Professions, Department of Communica tive Disorders and Diseases, Psychology Department, and School of Social Work. A s vice president, Naughton also oversees lease agreements with the hospitals. UB pays hospitals for space it uses at their facilities. He is also responsible for the clinical practice plans for both the medical school and dental school. Another of his vice presidential duties calls for Naughton to oversee programmatic issues concerned with clinical practice. For instance, he has been working on the attempt to get a heart transplant center in Buffalo. That is, in large part, a patient care issue, but it requires a strong academic presence, he pointed out. But even this example is one of the areas that overlaps with his role as dean, he pointed out. Coordinating the residency programs is another example of the mixture of his roles, he said. Residents are paid by the hospital, so they're agents of the hospital. But they're there for an education, which falls into his role as dean, he explained. The residency program is operated by the Unive rsity faculty who are chairmen of the clinical departments. Invariably, they're also chiefs of the same clinical areas at the hospitals. Naughton's position as vice president differs from the other vice presidencies in one big way - it's a staff position rather than a line position, he explained. That means that although he reports to President Sample as the other vice presidents do, he has no control over resources when wearing his vice presidential hat. • Editor's Note: The Reporter, ihe campus' weekly newspaper, has been running a series of articles on the University's organizational srructure, explaining how each vice presidential area is set up and how it functions. This article on chevice president for clinical affairs attempts to delineate the differences and complementary relationships between John Naughwn's two administrative roles as both vice president for clinical affairs and dean of medicine and biomedical sciences. Buffalo Physician and Biomedical Scientist �25 PHOTODOUG LEVERE �26 It'searthshaking,but rwt anotherPlague,Mohnsays BY MARY BETH SPINA U B immunologist James F. Mohn, M.D., describes the AIDS crisis as "the most earthshaking infection of this century," but cautions against comparing it with The Plague - The Black Death which killed about one-fourth of Europe around the 14th century. Speaking at a seminar organized by the Depa rtm ent of Microbiology on AIDS and other venereal diseases, Mohn noted that unlike The Plague, which in its pneumonic form spread rapidly through casual contact, the AIDS virus is transmitted only in blood and semen and by intimate sexual contact. Transmission appears to be primarily by means of unprotected intercourse with an infected partner, contaminated needles shared by IV drug abusers, transplancental exchange during pregnancy from an infected woman to her fetus, and - much less frequently t0day - transfusion of blood products. Very rare instances have been reported where health workers, in no other high risk group for AIDS, accidentally received the virus from an infected patient through a needle prick, or through infected blood entering an open sore or scratch. Mohn noted that while there's no cure for the virus - HIV 1,2,3 - great strides have been made since the syndrome was first recognized a half-dozen years ago. Not only has the virus been identified, but screening tests sensitive to and specific for HIV antibodies have been developed to minimize its spread through the human blood supply. In addition, there are continuing efforts to educate health workers as well as the general public about methods they should Late Winter '88 employ to prevent the spread of AIDS. "All we have going for us now is prevention through essentially personal hygiene methods," said Mohn, director ofUB's Ernest Witebsky Center for Immunology. He also serves as chairman of the New York State Council on Human Blood and Transfusion Services which Gov. Mario Cuomo charged to be responsible for insuring safety of the blood supply. Mohn said that although there is some promise for AZT, the drug currently approved for treatment of AIDS patients, it has t0xic side effects. The best hope, he believes, is for an effective vaccine to be developed. The lethal effects of the retrovirus HIV can be blamed on the type of cells it recognizes and attacks as well as on the fact that it can remain latent or inactive but alive for an undetermined number of years in the human body, said Thomas Flanagan, Ph.D., a virologist and chairman of the Department of Microbiology. While other viruses have a particular attraction for certain types of human cells, HIV is especially deadly because it recognizes and infects primarily T4 helper cells and, to a lesser extent, certain types of cells in brain tissue. Because the virus attacks, infiltrates, and renders impotent these important T helper cells, the AIDS patient falls victim to a number of organisms found normally in the body and normally held in check by cellular immunity. Among these are the parasite Pneumocystis carinii. S ince the humoral immune system is compromised to a lesser degree than the cellular Buffalo Physicianand BiomedicalScientist ��28 one, it is more unusual for AIDS patients to die from exposure to infectious agents for which they have developed antibodies in the past. Flanagan noted that, compared to other viruses, HIV appears relatively "inefficient" in its transmission. Hepatitis B, for instance, which may also be spread by infected blood, is considerably more efficient in producing active disease than · HIV. This difference, Flanagan hypothesized, may lie in the amount of the virus which may be transmitted per occurrence. Especially of concern are babies born to HlV positive mothers. "Fifty per cent of these infants are born HIV positive with a certain number going on to develop active cases of AIDS," Flanagan said. But among those born HIV negative to positive mothers, it cannot be determined how many will undergo seroconversion or how many years could elapse before this might occur. T imothy Murphy, M.D., a faculty member in the Department of Medicine, told the audience that physicians can estimate the individual AIDS patient's expected survival rate from time of diagnosis to death based upon the syndrome's initial manifestations. "Patients who first present with Kaposi's sarcoma will live about 125 weeks after diagnosis, compared to 35 weeks for those initially presenting with Pneumocysciscarinii pneumonia and 18 weeks for those first affected by other opportunistic infections or disease," Murphy said. In addition to opportunistic infections, some patients develop certain types of brain tumors typically found only in AIDS patients. Murphy's case presentations showed the abstract term "fatal" takes on a more tragic picture: most patients with AIDS will die within three years of diagnosis. Although laboratory screening tests for HIV antibodies can assist the physician in confirming a suspected diagnosis of AIDS, they are more important as a means of screening the human blood supply, according to Roger Cunningham, Ph.D., associate Late Winter '88 professor of microbiology. Screening at blood banks features an initial ELISA (Enzyme Linked Immunosassay). A test sensitive for HIV antibodies, ELISA is repeated twice if the first result is positive. "False positives can result from antibodies in the blood which are not anti-HIV, reacting with material from the cell culture used in growing the virus for use in the test," said Cunningham. If the prospective donor has two positive ELISA results, the blood is tested using the electrophoretic Western Blot, which while as sensitive as ELISA, is more specific. "If the donor is repeatedly ELISA positive or positive on the Western Blot, he or she is barred from blood donations but still may not develop an active infection from HIV," he added. There is no guarantee that those who are HIV negative on these tests are not incubating the virus and might not convert to positive at a later time. But, Cunningham noted, "all that can be done is being done" to protect the human blood supply. "The time required from exposure to the virus co a positive test result is something we still don't know," he explained. Asked later about a recent finding by Johns Hopkins researchers that suggests that some patients who are seropositive for HIV later may convert to a negative test result, Cunningham said this discovery may indicate HIV "acts just like other viruses" in certain aspects of its behavior. "What these researchers have found is what we might suspect could happen," he added. I n addition to scientific questions about HlV and the AIDS syndrome, there are legal and ethical considerations which confront the physician and society, said Cheryl Nohejl, M.D., a UB pediatrician. Among these, she said, are allocation of available resources, maintenance of confidentiality, privacy for the patient, and duty co warn third parties. Some of these issues, notably allocation of resources, figure prominently in controversies involving other types of disease states, Nohejl pointed out. In addition to AIDS, Janek Patel, M.D., and Joseph Mylotte, M.D., discussed other sexually transmitted diseases, notably herpes and gonorrhea. Use of oral contraceptives, the IUD, and changes in sexual behavior since World War n have led to incr~ases in certain venereal diseases such as gonorrhea, genital warts, and genital herpes, they noted. Patel told the audience that the drug, acyclovir (Zovirax), has proved useful as a treatment for patients who suffer from initial outbreaks and recurrences of genital herpes caused by either Type l or Type II herpes simplex virus. The drug, he cautioned, should be given for no more than six months at a time in chronic cases. Daniel Amsterdam, Ph.D., a faculty member in the Department of Medicine and the Department of Microbiology who is based at the Erie County Laboratory, discussed laboracory diagnostic methods for various sexually transmitted diseases. Also included in the seminar, which was offered as part of the coursework for Microbiology 600 and 51 I, were Joseph Kite Jr., Ph.D., and Boris Albini, M.D., Department of Microbiology. • $200 ,000 bequest will provi de scholarship s M re than $200,000 will go toward cholarships for VB medical stuents under the terms of a trust fund established by a Medical School alumnus. The University at Buffalo Foundation Inc. recently received $205,229 from the estate of Vivian Sampson of Chicago, the widow ofW alter Sampson, a nephew of the late UB alumnus Walters. Barnes, M.D. Barnes had established a trust fund for his nephew. The terms of the trust stipulated that the principal would reve rt to the Medical School upon the Sampsons' death if their marriage produced no children. The UB Foundation has used the money co establish an endowed account, the income of which will be used for the scholarships. Buffalo Physician and Biomedical Scientist �29 Barnes, an 1892 graduate of UB, left the University $211,000 upon his death in 1958 at age 89. That money was used to upgrade facilities in Sherman Hall, and a plaque commemorating Barnes was unveiled in Sherman in 1962. A native of England, Barnes came to the United States with his parents in 1877. He had been affiliated with Mercy Hospital in Chicago for mor e than 65 years, and had served as a professor at the Northwestern University Medical School. • ADDEO PROT!,;CTI O!I OF' FAE E. RAO!Ct,L AH •. ERS OJHt •.RECOVER - l"BALI .Y lSCHE :-\IC RAT m : ;,P.T MTSP student wins national scholarship D avid J. Altman, a Medical Scientist Training Program (MSTP) student at UB, was one of thr ee M. O./Ph. D. students nationally awarded a Medical Scientist Scholarship worth $14,000 per year and renewable up to five years. Mr. Altman, an alumnus of Harvard University, received a letter of commendation for academic excellence for the 1984-85 year. In addition to his fine scholarship, he has also been involved in student affairs and in the orientation program for enter ing students. MSTP students are different from other medical students in that they can work coward a M. D./Ph. D. simultaneously, completing both in six co seven years. This program, started in 1982, was designed to narrow the gap of knowledge and understanding that often separates highly specia lized scientists from practicing physicians. • Psychiatry unit changes its name T he School of Medicine and Biomedical Sciences is not the only medical unit at UB that has undergone a name change. The Department of Psychiatry has been renamed the Department of Psychiatry and Behavioral Sciences. The ratio nale for this is that the department Buffalo Physicianand BiomedicalScientist :,: I i----1 ___ ~ ._l ~ I Q ;&Ii i..._ ______ __ ___ _____. Peter Bloom was one of the exhibi tors in UB's seventh annual Medical Student Research Forum held in Decembe r . is the principal unit in the Medical School responsible for teaching and research in the behavioral sciences. Three required courses in behavioral sciences during the preclinical years are offered, and psychiatry is taught in the clinica l years. The faculty consists of both psychiatrists and psychologists with some individuals, especially the psychologists, primarily responsible for teaching courses in the behavioral sciences. Fur thermore, research interest of faculty include such areas as behavioral aspects of health and illness, neuroendocrine effects on behavior, and prevention of mental retardation and mental illness. Dr. Marvin Herz, chairman of the renamed department, points out that 23 other medical school psychiatry departments have already adopted the new names. These include Stanford, George Washington, Johns Hopkins, SUNY Stony Brook, and Univers ity of Texas. • Minority students win Regents awards T wo UB minority medical students have received Regents Health Care Scholarships in Medicine. The two students are Lisa King and John W Smith. The Regents scholarship program is aimed at reducing the critical shortage of physicians in certain areas of New YorkState. It also aims to expand medical educational opportunities for underrepresented minority students and economically disadvantaged students. Scholarship holders receive up to $10,000 a year during their four years of approved study. After completion of their professional studies, they are required to practice in underserved areas of New York State. The UB students represent two of the 40 medical students selected Statewide. • Late Winter '88 ~ �30 HEADACHES ARE THEIRSPECIALTIES The information in chis scorywas compiled by Clare O'Shea from interviews wich Elliott Schulman and Greg Tramuca, brochure information and articles on the Comprehensive Headache Center, and nor.es by Bonnie Schulman and by Bruce Kershner. W hile at UB in the mid-60's, a couple of undergraduates met playing pinochle in the old Norton Hall. Twenty-five years later, they're meeting regularly again. But this time, it's to talk about headaches. Elliott A. Schulman, a neurologist, and G regory J. Tramuta, a psychiatrist, are cofounde rs of the Comprehensive Headache Cente r at The Germantown Hospital and Medical Center in Philadelphia. The center diagnoses and treats patients suffering from one of mankind's most common ailments. The shift from a pinochle team to a headache team was not exactly planned. Schulman and Tramuta were buddies all the way t hrough medical school unt il their graduat ion in 1974. But then Schulman moved to Pittsburgh, Tramu t a moved to Philadelphia, and eight years went by without any contact between them . Then came the day Tramuta was making h is rounds at Philadelph ia's Germantown Hosp ital. It just happened to be the same day and the same hospital in which Schu lman was making rounds, covering for another doctor. "It was totally serendipitous," said Tram uta, now chief of psychiatry at Germantown and a clinical assistant professor at Temp le University Medical School. " Here was someone out of my past - I had not heard from Elliott in years. I was very surprised." ln the years since he had last seen Schulman, T r amuta had completed postgraduate training and a residency at the Albe rt Ein- Lare Winter '88 stein Medical Center. He had held various positions including assistant professor of psychiat ry at the Medical College of Pennsylvania, psychiatric consultant at Germantown and at Wissahic kon Hospital, and psychiatrist at the Fox Chase Cance r Center, where he worked with terminally ill patients and their families. It was at Fox Chase, where he served as chairman of the pain management committee, that Tramuta became interes ted in chronic pain. He began discussing wit h Ge rmantown's chief of neurology, Stephen D. Silberstein, the idea of developing a center where patients with chronic pain could receive multidisciplinary treatment. Schulman arrived in Philadelphia by way of Pittsburgh and Washington, D .C. Afte r an internship at Montefiore Hospital, an affiliate of the University of Pittsburgh, Schulman served as a resident at Georgetown Univeristy School of Medicine and a fellow at the National Institutes of Health. He was subsequently appointed staff neurologist at Temple University Hospital and assistant professor at Temple Univers ity School of Medicine. Currently, Schulman is an attending neurologist at Germantown and is in private practice with Silberstein. T he pain cente r idea surfaced again when Schulman and Tramu t a began p r ivate practices. Because of the overlap between neurology and psychiatry, the two friends were t reating some of the same pat ients, shuffling them back and forth between their offices, then discussing them by mail. Rather than tryi ng to provide service for the whole spectrum of chronic pain problems, however, Tramuta and Schulman decided to establish a multidisciplina ry cente r focusi ng on a manageable segment of pain sufferers. In 1982, the two medical school friends . Buffalo Physicianand BiomedicalScientist �31 along with Silbe rstein and two psychologists, Ronald Kaiser and Joseph Primavera Ill, founded the Comprehensive Headache Center. The center, which meets once a week at Germantown, now includes a social worker and three nurse practitioners. "We knew that we could handle the head and facial pain populations within our disciplines," Tramuta explained. "We think we do a lot better than the primary sole practitioner can for patients with chronic pain problems." "This is a comprehensive approach," Schulman added. "Now that we are working side by side, we can address the problems as they come. We don't have to communicate by mail." The center is able to treat patients more effectively and efficiently because of the accumulated experience and expertise of the staff. In addition, opportunities for specialized research are made easier in such a setting. There are about 15 such centers in the United States. Of these, the Comprehensive Headache Center is one of only three with an inpatient unit, according to Schulman. It remains the only center of its kind in the tri-state area of Pennsylvania, New Jersey, and Delaware. The medical team cannot promise miracle cures, but they can in many cases help reduce the frequency and intensity of their patients' headaches, the two US-educated physicians agree. "ln the past, headache sufferers were never taken seriously," Schulman said. "It was the classic case of'take two aspirins and call me in the morning.' We now know there are treatment plans that really work." W hen the headache sufferer first contacts the center for help, he or she is given an extensive questionnaire to complete and bring to the initial appointment. The patient is given a complete medical exam and is seen by a psychologist or psychiatrist. A psychological profile of the patient is created using the information provided on the headache history along with psychological tests . That profile is given to a staff neurologist. A t reatment p rogr am tailored to the Buffalo Physician and Biomedical Scientist individual headache patient is then designed by the medical team. Treatment will vary, but it may include a change in diet, medication, behavior modification, biofeedback, and psychological and physical therapies. Some of the newer medicines used by the headache center include calcium channel blockers, various antidepressants, beta-blockers and DHE ( dihydroergotamine), an ergot preparation. The center has been involved in testing a nonsteroidal anti-inflammatory agent, and a new selective beta-blocker, Schulman said, and has experimented with low doses of anaprox, a motrin-relative . Those patients in need of inpatient evaluation are taken off all unnecessary medications and, in some cases, given a prophylactic medicine during a five- or six-day hospital stay. Classes are given on headache types, drug therapy, and the social ramifications of headaches. A social worker meets with the patient and family several times during the hospital stay. M any headache patients have suffered every day for years without finding relief from pain. "lt would not be unusual for us to treat a person who has suffered with headaches for over 25 years, often on a daily basis," Schulman noted. "These patients commonly ingest l Oto 12 aspirin or Tylenol daily, along with an assortment of narcotics and ergot preparations." "Because we're really a referral center, we tend to see people with more severe problems," Tramuta added. "These are people with severe headaches, people who daily are taking large amounts of analgesics, tranquilizers, sleeping pills, or specific migraine medications. They're a wide mix of personalities; some are depressed or neurotic, others are not.'' The physical pain frequently affects other aspects of the patient's life. "Severe depression is a common manifestation," Schulman pointed out. "Patients miss school or work, have problems with their families, don't go out.'' ' 'T hey are socially isolated because of their Late Winter '88 �32 headaches," T ramuta added. "Chronic headache pain wears people down. They feel depressed in response to the pain, and frustrated because they can't get rid of it and don't understand why they get it. The pain and the depression can feed on themselves it's a vicious cycle." J ust as there is no one patient that is typical, there is no such thing as a typical headache, Schulman and T ramuta point out. There are many misconceptions about the cause of headache pain. Some people blame their sinus problems. Although sinuses can ache, the headache in the area of the sinuses described by most people is rarely caused by congested or inflamed sinuses. It is more often the pain of a tension or migraine headache. Neither are headaches usually a sign of high blood pressure, allergies, dental problems, or eye problems, according to Schulman. Some sufferers of severe or chronic headaches fear the possibility of a brain tumor. Actually, fewer than 10 per cent of chronic recurring headaches have such a serious underlying cause as brain tumor, blood clot, infection, or hemorrhage, he said. It is now believed that many headaches may result from a biochemical imbalance in the brain, according to Schulman. This involves the compound serotonin which may lead to inflammation of the blood vessels and irritation of the nerves, resulting in a headache. The imbalance can be triggered or aggravated by many agents, including head injury, emotional or physical stress, hormonal changes, drugs, sleep disturbances, noise, bright lights, weather changes, odors ( including certain perfumes), menstruation, lack of adequate exercise, alcohol (especially red wine), large amounts of caffeine, and certain foods such as bananas, nuts, aged cheeses, chocolate, smoked or pickled meats, pickled herring or chicken livers. "Not every headache problem is headacheinduced," Tramuta pointed out. "People should take a close look at their environments.'' The most common Lare-Wimer '88 types of headaches treated at the center are migraine, tension, cluster, and rebound. Migraine and tension are the two major types of benign chronic recurring headaches. Since symptoms of each can overlap, however, it has been suggested that migraine and tension are not two distinct headache types but rather exist at opposite ends of the same spectrum. A bout 20 per cent of the population suffer from chronic, recurring headaches, Schulman said, although almost everyone suffers a headache at some time in his or her life. "More women than men get headaches," he added. "And while more women get migraines, more men get cluster headaches." The tension headache is typically a dull, constant ache which usually affects the whole head. Sufferers often describe the pain as a tight band around the head, often accompanied by a tightness in the neck, dizziness or nausea. Aspirin or acetaminophen often quickly relieves the pain, although it may last for hours or even days. The common migraine pain is usually throbbing, periodic, and one-sided, although it can be bilateral. Often there is a family history of this type of headache, which also can last for hours or days. Nausea or vomiting, sensitivity to light and loud noises, abdominal pain, anxiety, and fever are possible symptoms. The classic migraine may bring the same symptoms, plus it may be signaled by flashing bright lights before the eyes lasting as long as 20 minutes. In rare cases, weakness or numbness in parts of the body or blackout in a part of the visual field accompanies the migraine. Interestingly, a headache need not be part of the symptoms of a migraine. If taken early enough, aspirin or acetaminophen or other prescription drugs can sometimes relieve migraine pain. Drug therapy may be necessary, however, if the migraine is chronic. The cluster headache occurs in bunches from one to five times a day over a period of days or weeks, followed by a remission of six months to a year or longer. Attacks last from 15 to 90 minutes, and recur at approximately the same time every day, often interrupting Buffalo Physician and Biomedical Scientist �33 the person's sleep. The pain always affects one side of the head, is located around the eye, and is described as a severe, boring sensation, like a hot poker is being pushed into the eye. Nasal stuffiness and eye tearing on the same side as the pain are usual symptoms. There are no warning signs associated with the cluster headache, although alcohol frequently brings on che attacks. Cluster headaches are not inherited. The analgesic rebound is a newly described form of headache. The first thing many people do when a headache hits is to reach for the aspirin bottle, or maybe a strong cup of coffee. And they keep reaching, perhaps taking more than 14 tablets a week or more than 100 a month. It has been shown that such abuse of analgesics can perpetuate and worsen the headache pain. And when the medication is withdrawn, the result is a rebound headache which increases in intensity and lasts from four days to one or two weeks. Finally, there is the headache which com- Stress seen as primary cause of children's headaches S tress brought on by social or family pressure is the cause of the vast majority of all headaches experienced by child ren and adolescents. "Headaches are very common throughout all pediatric age groups," said Michael E. Cohen, M.D., speaking at the Annual Meeting of the American Academy of Pediatrics (AAP) in November. Dr. Cohen added, though, that toddlers and children between the ages of 5 and 15 years have the greatest incidence of headaches. Peer pressure, school phobia and family problems such as d ivorce are some of the env ironmental facto rs that can cause stressrel ated headaches in children, Dr. Cohen said. Tension headaches also may develop, he said, as a result of difficulties with sibli ngs or when children have problems achieving their parents' expectations. Buffalo Physician and Biomedical Scientist manly occurs as part of the post-traumatic syndrome chat follows a head injury. Such a headache can have one or several of the symptoms of either migraine or tension headaches. M ore than 300 headache sufferers have been treated at the Comprehensive Headache Center since it opened its doors. The success rate has been about 80 per cent, Schu lm an said, due in large part to drug therapy and the addressing of psychological issues. "We have treated patients as far away as Florida and the Midwest," Schulman said. ''Our youngest patient was 12; the oldest was 80." "We'll get people who sometimes have had headaches for years, who feel wretched, miserable, hopeless," T ramuta said. "They've been told they have to live with this pa in which has disrupted thei r who le lives. It's very gratifying to see people walk out the door feeling a new optimism about life." • Dr. Cohen, professor of neurology and pediatrics at UB, and director of child! neurology, Children's Hospital of Buffalo, explained that stress-related headaches are non-migrainous and can occur frequently or infrequently. He estimated that about 40 per cent of all children have expe rienced such headaches by age seven and about 70 per cent of all children experience th em by adolescence. Medication may help reduce some of the symptoms of a non-migrainous headache; however, Dr. Cohen said that counseling with a pediatrician, child neurologist, or child psychiatrist may be a better alternative. "Counseling of the parents can also be quite helpful," he added. Dr. Cohen estimated that the minority of childhood headaches are caused by physiological problems, such as chronic infections, brain tumors, or blood vessel abnorma liti es. He also noted that sinus problems, visual difficulties and sensitivity to chemicals in certa in foods are often suspected but seldom proven as causes of chronic headaches. • Dr. John \V. Cudmore John W. Cudmore (M'62 ), a physician with Health Care Plan's (HCP) group practice, was recently promoted to Brigadier General, Army National Guard. He is a clinical associate professor of surgery at UB. Cudmore, who received his first commission in the National Guard in 1963, is in charge of 6,500 troops throughout New York Sta te. "What is unusual about my assignment," Cudmore said, " is that a medical officer has been given command of general service troops." During his years of military service, Cudmore has given many more hours than the standard two weeks per year and one weekend per month required for reserve service personnel. He has been called in to assist with floods and blizzards and the prison uprising at Attica Sate Penitentiary and to command Military Medical Support to the 1980 Winter Olympic Games in Lake Placid. "l wouldn't do this ifl didn't really enjoy it," the general said. In his new command, Cudmore will oversee the training of New York State's National Guard and will be responsible for the level of readiness sustained among his troops. The National Guard maintains a force that is prepared to respond to any state or federal emergency that should arise. Cudmore, who has been a full-time member of Health Care Plan's physician staff for five years, is a genera l surgeon and a staff member of Buffalo General Hospital. • Late Winter '88 �34 William S. Edgecomb '47 1940's William S. Edgecomb (M' 47 ) • has been appointed a life fellow of the American Psychiatric Association in honor of his long-time contribution to the medical and general community. Dr. Edgecomb has a private practice in Orchard Park, N. Y., and is currently an assistant clinical professor in the UB Psychiatry Department and president of the medical staff ac Bry-Lin Hospitals. 1950's Patri cia A. Meyer (M'50) • writes, "I would like t0 cell you of my good fortune. I entered the February comest of the Monthly Prescribing Reference and was the winner of a trip to London on che Concorde. Along with the trip, there is a gift of $1,500 for other expenses." 1960's Loui s Trachtman ( M'65 ) • has been elected president of Eta Chapter (Tu lane University) of the Delta Omega Society, a national public health honorary Late Winter '88 soc iety . Dr. T rachtman is comedical director of the State Office of Preventive and Public Health Services and a clinical instructor at Louisiana State University School of Medicine. He is also continuing as assistant adjunct professor ac Tulan e University School of Public Health and Tropical Medicine and has a pare-time pediatric practice. Dr. Trachtman has published numerous articles in che]ournal of the Louisiana Seate Medical Society. Raymond A. Martin (M '68 ) • writing from Houston, Texas, tells us that he is president of the Texas Neurological Society for 1987-1988. He is an instructor in neurology at the University of Texas . 1970's Ar thu r M. Seigel (M'7 0) • assistant clinical professor of neurology and pediatrics at Yale University School of Medicine, writes that in 1987 he published "The Neurological Examination" in PhysicalDiagnosis.Dr. Seigel is a member of the Board of Directors, New Haven Individual Practice Association. Richard J. Goldberg (M'74) • was appointed chief of psychiatry at Rhode Island Hospital and Women's and Infant's Hospital in Providence. Dr. Goldberg is an associate professor in the Department of Psychiatry and Human Behavior at Brown University. Richard S. Elman (M'78) • has been named medical director of the emergency department at Sisters of Charity Hospital. Dr. Elman, who assumed years of practice in general internal medicine at Harvard Community Health Plan, Dr. RockwelI is now a firsc-yearfellow in endocrinology at Beth Israel Hospital, Boston, Mass. Dr. Jederlinic is an assistant professor of medicine: critical care, pulmonary and occupational medicine, at the University of Massachusetts-Worcester. Richard S. Elman '78 his duties on September 1, is the only board certified emergency medicine physician in the Buffalo area. A magna cum laude graduate of Case Western Reserve University, Dr. Elman, after receiving his UB med ical degree, completed an internship in family practice at University of Arizona Affiliated Hospitals. Prior to joining the Sisters staff he was director of emergency services at Lockport Memorial Hospital. Paul Summ ergrad (M'78) • writes, "I have been appointed director of che inpatient psychiatric service at Massachusetts General Hospital. where I completed my psychiatric residency in 1985. I also completed a residency in internal medicine at Boston City Hospital in 1981. I am board certified in internal medicine and psychiatry." 1980's Peter Jederlin ic (M' 79) and his wife Jessica Rockwell (M'82) • inform us that they have two children: Nicole Sarah and Alex Michael. After completing cwo Robert A. Herman (M' 83) • recently completed his residency in psychiatry ac NYU School of Medicine and opened his private office for the practice of psychiatry at 35 West 90th Street, Suite lA, New York, N. Y. 10024. He has been accepted as a candidate at the Columbia University Center for Psychoanalytic Training and Research. Dr. Herman is a clinical instructor at NYU and is assistant clinical psychiatrist ac Bellevue Hospital. Patricia Flanagan (M'83) and Mark Schwager, (M'83) • of Cumberland, R.I., joyously announce their new arrival, Zachary Alexander, born July 8, 1987. Herbert B. Newton (M'84) • informs us chat he has been accepted for a fellowship in neurooncology at Memorial Sloan-Kettering Cancer Center in New YorkCity. He is planning to publish a paper on che effects of cisplatin in che treatment of malignant brain tumors. Blackford Middleton (M' 8 5) • writes, "Mose exciting news is of marriage co Ursula G. King in September. After chat I am happy co report that I marched for my first choice fellowship position which will be at Stanford Unive rsity as a fellow in General Medicine and Medical Informatics!" Buffalo Physician and Biomedical Scientist �35 The Batavia VAMC Batavia VAMC joins UB affiliate group A s if eight affiliated teaching hospitals weren't enough, the UB Medical School has added one more : the Batavia Veterans Administration Medical Center (V AMC). The addition extends UB's educational mission not only to Batavia, 30 miles east ofBuffalo, but into Rochester as well. This is because Batavia V AMC has an outpatient clinic in Rochester. Batavia V AMC is UB's first teaching hospital outside Erie County. "We are pleased at the opportunity to extend our work with the Veterans Administration to facilitate development of education and research in geriatrics and rehabilitation," Vice President and DeanJ ohn Naughton comments. "We see Batavia VAMC as accelerating the school's ability to strengthen its role as a national leader in geriatrics and rehabilitation." Specifically, the new affiliation provides an alternative environment for training students, residents, and fellows in geriat rics and rehabilitation medicine. It will also stimulate resea rch activity in these disciplines as well as in long-term care and home care. For the hospital, it will provide a more focused mission in these areas. It will also help Buffalo Physician and Biomedical Scientist the care of veterans by bringing the University in contact with the hosptial, and enabling the staff to be enriched. All hospital appointments in the future will become UB appointments. Batavia V AMC previously had an educational linkage with the University of Rocheste r. That affiliation was dropped after a review indicated chat the hospital's interests complemented UB's strengths. The reporting relationship of veterans hospitals in Batavia and Buffalo will remain independent. Neither one will have a subordinate role regarding UB and both will sit on the same dean's committees. • State proposal would limit residents' hours A proposal before State Health Commissioner David Axel r od would limit resident physicians throughout the State to working no more than 80 hours a week. The report from the Ad Hoc Adviso ry Commit tee on Emergency Services, chaired by Dr . Bertrand M. Bell, also recommends that non-emergency room residents be scheduled to work for no more than 24 hou rs in a row. They must be off for one 24-hour period a week. An ear lier proposal had recommended that residents work no more than 16 hours in a row. Residents in emergency rooms would be limited to working 12 hours in a row, which is already standard practice, said John Naugh ton, dean of the UB School of Medicine and Biomedica l Sciences and vice president for clinical affiars. An individual who has worked the maximum number of hours as a resident won't be allowed to work additional hours as a physician in another hospital. The proposal also requires that hospitals provide more ancillary care to make up for the decreased workload of house officers . Hospitals must have sufficient IV services, phlebotomy services, and messenger/transporter services to meet the new demands, the committee's report says. All of the recommendations are based on the understanding chat the Department of Health will provide the necessary funds to implement the recommendations; according to the report. • U.S. Army contract at Roswell Park T he United States Army and Roswell Park Memorial Institute have entered into a th ree-year, $488,379 contra ct co develop and test more effective, less toxic interferon inducers to prevent and treat viral diseases. The contract was announced by Dr. David Axelrod, New York State commissione r of health, and Dr. Thomas B. Tomasi, director of Roswell Park. Interferon is a natural protein that cells produce when attacked by a virus in order to "interfere" with the reproduction ~f the virus in the body. Interferon inducers are synthetic mate• rials chat are injected into the patient to scimu• lace che body to produce its own interferon. Dr. Judith A. O'Malley, director of biological resources, and Dr. Jake Bello, principal cancer research scientist in che Roswell Biophysics Department, are the co-principal investigators on the contract. • Late Winter '88 �36 Dr. Ko rn el Lud wig Terplan • 93, former chairman of the pathology department at the University of Buffalo School of Medicine, died Nov. 21 ar his new home in Sonoma, Calif. He taught two generations of medical students and was renowned for his studies of children's brain development. Dr. Terplan, a native of what then was the Austro-Hungarian Empire, had lived in Buffalo from 1930 to last June and had continued his brain research and part-time teaching until last year. A tall man described as formal and private, but noble, by one of his former students, Dr. Terplan was said to have been an inspiring teacher as well as a renowned medical researcher. His description, released in 1932, of body changes during insulin shock is said to have been the first report of its kind. His pediatric brain collection, called one of the world's best, was transferred last year to the UB School of Medicine, where it is used in reaching medical students. He lectured widely on pathology ro medical groups. Born in Aranyosmaror, Hungary, Dr. Terplan was raised in Schessburg, a German Lutheran enclave in the Transylvania part of Hungary. He studied medicine in Budapest and Prague and served during World War l as a medical officer in the Austro-Hungarian Army. He graduated in 1919 from the German University of Prague and did research there until 1930 when he was asked co come to the UB School of Medicine and Buffalo General Hospital. He began here as a research professor in pathology and in 1934 was appointed the department chairman. He is credited with developing UB's modern pathology department. After he retired from UB in 1960 and was appointed professor emeritus, Dr. Terplan continued his research under grants from the National Institutes of Health. He maintained an office in Children's Hospital until shortly before he moved to California. He belonged to the Buffalo Athletic Club, where he regularly swam until about a year ago. Survivors include his wife, lnge; three Late Winter '88 sons, Dr. Martin of Sausalito, Calif., Dr. Peter of Los Angeles and Dr. Fritz of San Francisco, and three grandchildren. (Reprinted from the BUFFALONEWS) Frank Chambers (M'40) of Plant City, Florida, died July 13, 1987. Dr. Chambers had a family practice in Plant City for 36 years. He was a member of the American Family Practitioners and a Federal Aviation Authority medical examiner. He was a veteran of WW II, having served in the Navy as a pilot. He is survived by his wife Elizabeth Bateman Chambers; two daughters, Mrs. Pamela McGinnes and Mrs. Sherrie Mueller, and a son, Dr. Step• hen F. Chambers, all of Plant City. Milton A. Palmer (M'27) of Lancaster, New York, died March 30, 1987. Dr. Palmer was a life member, incorporator, and charter member of the board of directors of the Bufflao EyeBank and Research Society. He was chairman of its executive committee for 10 years, president for 21 years, and was president emeritus . Dr. Palmer was a life member of the Eye-Bank Association of America, and in 1983 he received the Rudy Spitzer Memorial Award for Sight Preservation and Dedicated Participation in the Buffalo Eye-Bank and Research Society. He is survived by his wife, Doris Wheeler Palmer, and a son, William W. • Walter Stafford, Jr. (M'44), a UB physician who once also served as a special assistant to the acting president ofUB, died August 12, 1987, at age 67. He held several faculty titles, includ ing clinical associate professor of neurology, clinical associate in anatomy, and a former title with the Pathology Department. He was a neurologist on staff at BuffaloGeneral Hospital for more than 30 years. Dr. Stafford served with the U.S. Navy in the Philippines during World War II. An accomplished pilot, he once conducted research at Cornell into the effects of high speed flight on the human body. • Dr. John Charles Robin, 38, a second-year student at the UB School of Medicine, died September 2, 1987. A lifelong Buffalo resident, Robin had suffered leukemia for about two months. He held a degree in psychology, a master's degree in natural sciences and a doctorate in pathology, all from UB. Robin was a member of the Erie County Historic Preservation Board, the Allentown Association and the University Club. Survivors include his parents and four brothers. • Norman S. Ellerstei n (M'71), known for his work on the detection and prevention of child abuse, died August 25, 1987 in Amherst after a long illness. He held various positions at Children's Hospital and was an assistant professor of pediatrics at UB's Medical School. Born in Akron, Ohio, Dr. Ellerstein was raised in Buffalo. He earned his undergraduate and medical degrees at UB. Dr. Ellerscein was a full-time staff member and held several administrative positions at Children's Hospital. He was director of the Child Abuse and Neglect Program, run jointly by UB and the hospital, and was director of the hospita l's Child Protection Clinic and of the pediatric house staff program. A fellow of che American Academy of Pediatrics, Dr. Ellerstein wrote many articles and books on pediatric medicine and child abuse and neglect. He was an editorial consultant to many professional and medical journals. Surviving are his wife, a son, and his mother. • A lfre d Mi tchell (M'38) • died on June 20, 1987, in Elmira, New York . Or. Mitchell practiced internal medicine in Elmira, from 1940 co 1987. He was a Diplomat of the Board of Internal Medicine. Elme r G r ob e n (M'4 1) • died Septembe r 5, 1987, after an extended illness. He practiced medicine in Columbus Junction from 194 7 co 1970 when he moved to Iowa City where he practiced until 1983. Or. Groben was an associate professor in family practice at the University of Lowa College of Medicine. He is survived by his wife Martha and two sons and cwo daughters. Robert Wa rd ( M'47) • died on November 25, 1987, in Miami, Florida. Buffalo Physicianand Biomedical Scientist �SPRING CLINICAL DAY AND REUNION WEEKEND May 7, 1988 Buffalo Marri ott 8: 15 , Morning Scientific Session 12:30: CONTROVERS IES AND TREATMENT OF AIDS, BREAST CANCER AND CORONARY ARTERY DISEASE 1 :00: Stockton Kimball Memorial Luncheon and Lecture Honored Leaurer ROBERT P. GALE, M.D. '70 Associate Professor of Medicine, UCLA Medical School Dr. Roberr Gale --~--------------------------------------------------------------NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITEDSTATES BUSINESS REPLYMAIL FIRSTCLASS PERMITNO 2210 BUFFALO. N.Y. POSTAGEWILL BE PAIDBY ADDRESSEE 146 C.F.S. Addit ion State University of New York at Buffalo Buffalo, New York 14214-9980 I,,,II,I111,, I,I,,,II,I,,II,I,,I,I,,I,,I,II11111 I,II �BUFFAlD Non-Profit Org. U.S. Postage PAID Buffalo, N .Y. Permit No. 311 P!iYm§ L~~ State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 Address Correction Requested MEDICALHISTORICALLIB, KtMSALLTOWER,SERIALS DEPT, MAINsr . CA'<IPUS BUFFA~O NY --------------------7--- 142\ ◄ --7---------------------- LETUS HEARFROM YOU Fill out this card (Please print or type all entries) Name __________________________ M.O._ Ph.O.__ Year Received ___ _ Office Address Home Address -- - ------------------ ----- -------------- If not UB, M.D. or Ph.D. receiv ed from In Private Practice: In Academic Medicine: Yes D Yes D No D Specialty No □ Part Time o Full Time □ School _________________ _ Title Other: Professional Society Memberships ------------------------------ News: Have you changed positions, published, been involved in civic activ ities, had honors bestowed, etc? _____ Please send curriculum vitae, clippings, public at ions, or announcemen ts, also include a photo of you rself. --- __ _ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Late Winter 1988 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1988-Late Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_v21n05-1988-LateWinter Table Of Contents A list of subunits of the resource. Lead Poisoning Black Monday Premenstrual Syndome Leeches Lawrence Bone M.D. Research Medical School News Classnotes Hospital News Deaths Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-11-08 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v21n05 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1988 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s). https://digital.lib.buffalo.edu/files/original/36ce526672353412322221af439a7bf8.pdf bec3186fe8e0df16e88c56afb1fdd14d PDF Text Text �STAFF EXECLmVE EDJlDR UNIVERSITYPUBLICATIONS Robert T. M arleu BUFFALOPHYSICIANEDHOR Connie Oswald Stolko ART DIRECTOR Alan /. Kq;)or ADVISORY BOARD Or. John Nauith1on. Chairm,m Dr. Harold Brody M,. Nancy Ghcco Dr. Jame, Kar.<la Dr. Chari<> Paganelli Mr. G"'!;ory Zlllel Dr. Antmnettc Pete.­ Dr. Charle Pruet Dr. Luther Robm<,0n Dr. Thomas Ro,cnthal Dr Sale.ta Sure<h Dr. Burton Singerman Dr. Stephen Spaulding Dr. Ndson Torre Mr. E..lwardWcmlic Dr. Paul W1crzb1en1<-c Dr. Jerome Yatc WRITERS Mynam Damd Carol O..<:os,a Lisa )05ephson Mark Marabella Arthur Page Elisabeth Sheffidd Dear Friendsof the School: T he seventh annual Parents Weekend was another spectacular success. Ir wa held on Oct. 15 and over 500 parents, friend and students participated. As was the situation over the pa t few years, parents from all four classes attended, and core and in­ dividualized programs were conducted. The enthusiasm and sup­ port expressed for the school was at a high level and our goal of involving parents with all aspects of the enterprise was once again achieved. As this event has matured, other innovations have developed. Associate Dean Peter Ostrow is working with a group of parents and representatives from the UB Foundation to establish a Parents Council which will advise us and help guide other activities in which they can and will be involved. This year, a parent, Mrs. Gail Pitterman, spoke at the opening convocational session. Her con­ tribution and commitment were a major stimulus to the success of the event. All in all, this special annual event has confirmed that family involvement and participation in medical school life can add one more dimension of activity to promote those values of humanism and wholesomeness which so many people think are important attributes for a physician co possess. I thank the students, faculty, administrators, alumni, and parents who have helped make this unique event and opportuni­ ty such a success. 1 I Rt,b,,rr A. Ullman lLLUSTRAlORS Barry Fit,gerald l, ( , Sincerely, n__ ~~- ' ---... John aughton , M.D. Vice President /or Clinical Affairs Dean, School of Medicine and BiomedicalSciences Lisa Haney Jane Marinsky Glym.- Sween} Dan ZakrOL-iem,k, PHOTOGRAPHERS Ian Rcdmbauj!h Bob Wal,on Dear fellowAlumni/Alumnae: TEACHl G HOSPITALS AND LlAISONS T B.·uaviaVeteran.,AJmjmstrauon Medical Center Buffalo General Hc»pital. M,~ Sl,,,u Buffalo Veteran< Adminimauon M.d,cal Center, John P11U1 Children·, Hoopital, KJrm Drv/dS«,r,1k, Enc Count\· Mcd,cal Center. Manon Manonou,k:,, , lcn:y Ho,p1tal, Chuck T,l-,co Millard Fillmore Hosp,ral, DeborahFenn Ro well Park Memorial ln•mu,e. J,.d, R,.:e Sisters Ho pttal, Dennu M<Cartm />,oJ.u,:ed "- ,i., Dll'i><<m of Uno,-ro,I) Rola· rioruin assoaarumwith th, Schaol of Medicm£ and S.om..JicalScitna,, Sra!t!Un"~''J of New Yorkar S..1/afo. THE BUFFALOPHYSICIANAND BIO­ MEDICAL SCIENTIST (USPS 551-860) Early Wimer l'l88, Volume 22. Number 4. Pubhshe<l five umc annually : Spnng. Summer, Au,umn. Early Winter, and Late Wm!er - hy thc School of Mttlicm• and Biomedical Sciences, Sta« Uni\'CUotYof New Yori. at Buffalo, H35 Mam Street. Buffalo, N""' Yorl 14ll4. Third class bulk postage paid "' Buffalo, N~· York. Send add"'" change• to THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST, 146 CF.S. AJd,rion, HJ<; Main Strttl, Buffalo, New York 14214. Cover Photo: Bob \1'"1lion he Alumni Association continues to be active through the 1988-89 year, continuing its efforts to provide an excellent program for our alumni in the spring of 1989. This vear's Spring Clinical Day is scheduled for May 6, 1989, covering the topic of nutrition on a dietary and clinical basis. The topic of cholesterol intake and metabolism will also be discussed. The Alumni Association continues to be supportive of the ef­ forts of our students with continuing dialogue with all medical school classes. We have hopes that our students will feel free to contact rhe Alumni Association with any concerns they feel might be in our realm. We have continued all programs of previous years, as well as having considered the po ibiliry of increasing the number of na· tional meetings we attend. If you happen to practice in an area near a national meeting, your Alumni Association will send you an invitation to a reception given by the alumni, which will be co-sponsored by the subspec~altiesgroup for the particular meeting we are attending. The Alumni Association continues to work on your behalf, and we will try to keep you abreast of any new occurrences that are taking place at the School of Medicine and Biomedical Sciences and look forward to seeing you at next year's Spring Clinical Day. Sincerely, (?qJ}(i/~~ Paul H. Wierzbienie c, M.D. .,. �Vol. 22, No. 4 Early Wint er 1988 Features Docs for Jocks.Three physicians look at the ups and downs of working with the Buffalo Bisons, Sabres, and Bills. • A controversialalumnus.Dr. Irving White Potter's method of delivering babies feet first while the mother was under anesthetic relieved mothers of much-feared pain, but excited great controversy among his colleagues. Artificial blood.If researchers can find a way to make synthetic hemoglobin, it should be possible to come up with a substitute for human blood that's free from diseases such as AIDS. Thar's the aim of a $4.5 million federal grant in which UB re­ searchers are participating. Page20 Page8 Self-study . In anticiparion of the l.CME site visit, the UB medical school took a long, inward look. It came up with a thoughtful report and 120 recom­ mendations for improvement. Politicalviolence.Two UB medical students went to turbulent Haiti to conduct research on the at­ titudes of women toward prenatal care. They learned more than they bargained for. Departments MedicalSchoolNews.Reaching ro the heavens, a UB student's project is successfully launched on the space shuttle Discovery and a professor works with students at ASA. Alumni.Reunion chairmen invite classmates to the May 6 celebration. Page24 Peopleand Events. HospitalNews. Classnotes. Page 18 �EARLYltl!NTER 1988 B FFhlD PHYSICIAN hNO BIOMEDICAL SCIENTIST �iJOCK 3 By LISA JOSEPHSO n the middle of thepro­ fessional sports world of tackles, slashes,and line drive hits is the team physician. When there's an injury, he's there to patch and mend. But more than that, team physicianshave to be teach­ ers, counselors,and arbitra­ tors. They're vital members of every sports team. They decidewhether a player can play or whether he sits on the bench. What's it like being a doc for jocks? Three Buffalo physicians talk about what it's like working with the Bisons, Sabres, and Bills. 8l'FF11.ID PH I IAt- AND BIOMEDICALSCIE. TIST EARLY WINTER 1968 �4 BASEBALL u ou need two things to be a 'sport ' physician; said Stephen T. Joyce, M.D. "You have to be intere ted in it and you have to know the right people." Joyce, a clinical assistant professor of orthopaedics at UB, ha been a physician for the Buffalo Bisons, now a Triple A baseball team, since 1970. He is also af­ filiated with Millard Fillmore, Children's and Buffalo General hospitals, and the Erie County Medical Center. "l was chosen to work for the Bisons because of my availability and because I had worked with other sports teams in the past, so my name was known in the sports world; Joyce aid. He was the team physician with the Buffalo Braves basket­ ball team and Buffalo Stallions indoor soccer team. He is also an orthopaedic consultant for Cani ius College's teams and a member of the National fuotball league's Impartial Orthopaedic Arbitra­ tion Board. "I also enjoy sports. l played basketball in college, so working as a physician for a sports team was a way of continuing what I enjoyed," he noted. "It can also be very challenging and in­ teresting at times. It helped me to be a better doctor, I think. It's great on-the­ job training. Taking care of a healthy, prominent per on, you're under a lot of pressure to make sure all bases are covered and you're as conscientious as possible. You always try to be conscien­ tious, but when you're in the spotlight the pressure is greater." Joyce said his role as team physician is mostly a an orthopaedic, musculoskel­ etal consultant. "The trainer plays a more active role in the players' health maintenance and physical therapy and conditioning; he stated. Since the Bisons are a farm club, most EARLY11m,TIR 1968 ~ i ~ ~ ~ "If I advise a player that he will not be able to perfarm at the level he's used to, he usually listens and doesn't play. I tell him you have to be able to run, jump, and skip rope if you're going to play ball.'' players are under contract to the parent major league team. The physician from the majors serves a the primary doctor, and Joyce offer a second opinion. As a result, Joyce doesn't usually feel the pressure that's placed on some sports physicians to patch up an athlete and send him back to play before he' healed. "My bos es have never put pressure on me to put a player back in if I felt he wasn't ready," Joyce stared. "If I advise a player that he will not be able to perform at the level he's used to, he usually listens and doesn't play. I tell him you have to be able to run, jump, and skip rope if you're going to be able to play ball." In baseball, some of the most common medical problems Joyce deals with are shoulder and elbow injuries, which come from a lot of use, and contusions, which result from being hit by the ball or bat. "Often, if you get people to pay atten­ tion to the mechanics, you won't have as many injuries,~ Joyce commented. If a player is swinging a bat the wrong way or twisting his body the wrong way to catch a ball, he can easily hurt himself. Correcting the way he swings or catches can prevent many injuries. According to Joyce, safety is a major issue in any organized sport. He feels that doctors have always been at the forefront of safety issues. "I wouldn't want to depend on the coaches to make the safety decisions if I were a player," he remarked. "Ultimate­ ly though, the owners make the deci­ sions, and they're usually pretty com­ pliant with our (doctors') findings. "If sports medicine has a role, it's preventive medicine. You're taking care of people, not just sports. "Sports medicine is care of the well. It include or should include nutrition and overall maintenance of the body as well as stretching and training." • BUFF/I.IDPHYSICIII.N AND BIOMEDIC/1.L SCIENTIST �5 HOCKEY sports physician is one who maintains good health among players and is physically pre­ sent when injuries occur; according to John L. Butsch, M.D. Butsch, a clinical assistant professor of surgery at UB, has been the team doc­ tor for the Buffalo Sabres hockey team since 1973. He is also affiliated with Children's Hospital, Buffalo General Hospital, and Erie County Medical Center. ul've been interested in sports most of my life; Butsch said. '1 played hockey in high school and college, and I still play once a week for fun in the winter. Being the team physician is a good way to be around the sport and help people at the same time.n Some of the most common medical problems Butsch deals with as a hockey physician are lacerations (cuts), soft tissue injuries (swollen muscles and tissues), and knee and shoulder injuries. "I see broken shoulders a loc; he said. To help keep the players healthy, the Sabres have a neurosurgeon, an or­ thopaedic consultant and an internist on staff, as well as a trainer. The cr;;iner is essential to the players' overall fitness and health, according to Butsch. "The doc­ tor, trainer, and player work together co develop fitness programs and rehabilita­ tion programs" he explained. Although Butsch attends practically every game and spends a lot of time in the locker room with the players, he makes sure his relationship with them stays professional. "If you gee coo buddy-buddy with che players, they tend not to respect you; Bursch stated. "I treat them the same way I would any other patient." Butsch acknowledges that sometimes there is tremendous pressure, either by the player or by management, to let a BUFFALO PHYSICIA)'; AND BIO MEDICAL SCIENTIST John L. But.sch, M.D. "If the player is medically capable of playing, then it's up to him to decide (if he'll play.) Pain is nature's way of telling someone that somethingis wrong. I would neverlet a player in a game until he was thoroughly healed.'' player back in a game before he's ready. "There is always pressure to let the player go back and play, but management is usually good about understanding that a player could get more injured if he goes back too early; Butsch said. "If the player is medically capable of playing, then it's up to him to decide. "Pain is nature's way of telling someone chat something is wrong. I would never let a player in a game u mil he was thoroughly healed." According to Bursch, the Sabres will have a psychologist on staff this season. He feels it's important to have someone available co help players cope with the pressures of being a professional athlete . Although there has been a lot of con­ troversy in sports lately over the illegal use of steroids and the use of illegal drugs, Butsch has not observed a drug problem with the Sabres. "I think in general the Sabres are pret­ ty free from alcohol and drug abuse; he commented. • rug abuse has become a major issue in sports today, espe­ cially in football. A number of players - including Bruce Smith of the Buffalo Bills were recently given 30-day sus­ pensions by che National Football League (NFL) for drug abuse. Oweo Bossman, M.D., was on che three-member panel that two years ago recommended suspensions for players who test positive for drug use. "lf a player is suspected of drug use, the first seep is co evaluate him locally; Bos.smansaid. "If the problem continues, the league becomes involved and suspends the player for 30 days. If he is still found to be taking drugs a third time, he willbe suspended for a year and probably permanently." Bossman, a clinical assistant professor EARLYWINTER 1<168 �6 FOOTBALL of medicine at UB, was an internist for the Bills from 1970 until last season. He is also an attending physician at Buffalo General Hospital. Another aspect of this drug problem involves the illegal use of steroids. Accor­ ding to the American Academy of Pediatrics, the use of steroids is widespread among professional athletes, particularly football players and weight lifters. Bossman acknowledges that the use of anabolic steroids has become a very big issue in the FL. "Last year was the first year they checked for teroids, and this year they are going to do something about ic; he said. "It's very much a problem and an issue. "They are widely used in many sports. If a player is wealthy enough, he can get steroids, called DDR's, that are undetec• table in urine:' Bossman said he would never prescribe any kind of steroids, but he added that they are widely available on the streets, in gyms, and from some trainers. As an internist, Bossman felt it was im­ portant to teach the players preventive medicine. He would talk about drugs and infectious diseases and show videotapes on what happens to people who abuse drugs . He would also meet with all the doctors and players once a year to discuss good nutrition as well as physical conditioning. Some of the most common medical problems he dealt with were hyperten­ sion, ulcers, and infectious diseases such as sore throats, venereal diseases and hepatitis, ~the kinds of things you ex­ pect to see among healthy males: he remarked. The Bills also have special diet, exer· cise, conditioning, and weight lining pro­ grams that last year-round. There are trai ners, dentists, equipment managers, EARLYWINTER 1'188 portant to function as a personal physi­ cian for each player as well as a team physician for management. [ always had the option of treating the player in con• fidence unless the injury would affect the team." Many athletes have to cope with not only the physical pressures of perform· ing well and getting injured, but also the emotional pressures of performing well and of knowing that their careers are relatively short. •When a player's career is on the down­ slide or the team starts to lose a lot, and no one knows who the ax will fall on, many problems begin to creep up; he commented. "The player usually starts having marital problems and often drug and alcohol abu e begins. "As a physician I have tried to stress the importance of having a psychologist on staff for these players, to the Players OU!efl Bossman, M.D. Association; Bossman stated. uManage­ ment doesn't want to assume responsibili• ty for these players, o I feel the Players Association should. Unfortunately, no one has listened yet." When asked abo ut any pressure he might have been under to patch players up and send them back onto the field, Bossman didn't hesitate. ulfa player was having pain and would not endanger himself by playing, I might give him something for the pain; he admitted. "However, if he was in any danger at all, I would not let him play." Bossman left the Bills for personal reasons. a strengrh coach, and other health-care "I used to rhink working with the Bills specialists to meet those needs. was very exciting; he said. "It v.-asalways As a sports physician, Bossman said he a lot of work - just drudgery sometimes had two different roles: uone as a team - but it was new and challenging. physician the other as a personal "After you're around the league for the physician. seventh or eighth season though, it's not uAs an internist I was more like a per­ as exciting. lc's getting to be too much sonal physician~ he said. 1 felt it was im- like a business." • "If a player was having pain and would not endanger himself by playing, 1 might give him somethingfor the pain." BUFFAI.DPHYSICIA. Al--1)BIOMEDICALSCIENTIST �7 for lefr: An 1r• regular lltanium max,llofo.cial im• plant trea ted with bacteria look bump . Left· \ft r 10 second of treatment with tlie B D Uhm, \110le1 Device It loob smooth. Both photos are magnified BUDDEVICEUSES LIGHTTOSTERILIZE IN JUSTSECONDS By MARK MARABELLA B .. ecau e the BUD Ultraviolet Device is so fast, "this machine will make other conventional medical sterilization processes, like the autoclave, obsolete in the near future," according to Robert E. Duthie Jr., president of BUD Industries Inc. He unveiled a prototype of the device, which resembles a stainless steel microwave oven, at Roswell Park Memorial Institute m September. A mechanical engineer focusing upon medical implant and electronic devices, Duthie worked closely for five years with orman G. Schaaf, D.D.S., professor of prosthodontics in the UB School of Dentistry and chief of the Department of Dentistry and Maxillofacial Pros­ thetics at Roswell Park; Michael A . Meenaghan D.D.S., Ph.D., director of UB's Surface Science Center, and other doctors, technicians, and clinicians from UB and Roswell in developing the patented sterilization system for the device. Unlike an autoclave, which takes 15 to 20 minutes to sterilize objects using heat, Duchie's BUD Ultraviolet Device uses ultraviolet light to sterilize objects in mere second . It is able to sterilize crevices that other ultraviolet devices can't reach. The device, using ultraviolet "dynamic sterilization," is able to sterilize surgical instruments and titanium implants that secure maxillofac1al prostheses used for dental and facial reconstruction. Currently, BUD lndu tries is awaiting funding from the National Institutes of B FFAIDPHYSICV,NAND Bl MEDICAL SCIENTlST Health and is applying to the FDA for recommended clinical trials before manufacturing and marketing. Once it has the green light, it plans to build its manufacturing base in the Buffalo area. T raditional ultraviolet sterilizing methods have been considered inade­ quate because the ultraviolet light has to hit all surfaces of the object in order to sterilize it. On irregularly shaped objects, some areas are in shadow. But the BUD device, using "dynamic sterilization," is capable of causing excita­ tion of molecules on all surfaces, Duthie said. The patented secret of the BUD device is a modified germicidal arc lamp which releases large quantities of thermal energy, resulting in microcombustion of organic and inorganic particles on the surface . In a recent paper accepted for publica­ tion in the International)ou:m.alo/ Oral and Maxillofacial Implants, Schaaf, together with Sarupinder Singh, D.D.S., a graduate of the UB School of Dental Medicine, concluded," 'Dynamic steril­ ization' is a rapid and convenient method of destroying potentially harm­ ful bacteria on all surfaces of irregularly shaped objects which supports ultravio­ let light' capabilities for sterilization." The simple procedure for the steriliza­ tion of a body implant or a surgical instrument requires only 10 econds on each side of the object. Sterilization can be done conveniently at the operating table, which will greatly expedite surgical procedures. As Schaaf and Singh noted in their re earch, the sterilization process of a permanent prosthesis implant is vital. The implants, anchored in bone, are made of titanium because it has a natural oxide layer which bonds more reaily to the bone. The BUD Ultraviolet Device energizes the surface of the titanium, in­ creasing the oxide layer, making the im­ plant more compatible with the body. This evidence is supported by Laurie Hartman, D.D.S., of UB's School of Dental Medicine, in a paper also ac­ cepted for publication by the lntem.a­ tional Journal of Oral and Maxillofacial Implants. Add itionally, while conventional sterilization methods use water and detergents, the BUD device employs on­ ly ultra-violet light, which substantially reduces physical surface deterioration of the object being sterilized. This is impor­ tant because anything which comes in contact with the implant surface has the potential to alter it permanently. Furthermore, the BUD device va­ porizes microorganisms, preventing sur­ face contamination of the device itself. For this reason it requires no cleaning and little maintenance. • EARLY Wll-<'TER1986 �Controver.si 8 hen a young Dr. Benjamin Potter, born m 1787, moved from Rhode Island to Batavia, he little thought that he would be the first in a continuing lineage of six generations of physicians who would bear the Potter name. This paper focuses on Dr. Irving White Potter, the fourth generation, who graduated from the UB medical school in 1891. Early in his career it became evident that he had a great talent for obstetrics, and from 1906on he pecialized in that field. His aptitude made him sought after by many physician and midwives when faced with a difficult delivery. In par­ ticular, Potter revised an old technique of version and extraction and developed it into a method that bear. hi name to th1 day. One great ad\•antage of the Potter "in­ ternal podalic version and extraction" is that it shortened the time of deliveries while relieving the mother of the feared painful second stage of labor. To achieve this, once the cervix was fully dilated or dilatable, Dr. Charles Reynolds, a lifelong friend, would administer chloroform anesthesia by the "drop method" until the patient was asleep. Then Dr. Potter would put on long gloves and manually smooth and stretch out the vagina. Reaching into the uterus he would flip the baby around and bring it to the outside world feet first. By 1922 Potter had collected 1,130 cases of version which he reported in his book The Place of Versionin Obstetrics. This excited much unfavorable criticism among obstetnCLans nationally and in­ ternationally. Undaunted, Potter per­ sisted in a method he sincerely believed in and, in his lifetime, delivered 35,000 babies - more than any obstetrician or midwife, living or dead, ever delivered. This figure is remarkable in that it was B R: BFRT A EARLYWINTERI attained chiefly among his private pa­ tients. Dr. Reynolds kept accurate records on these patients, and he informed me that in Potter's busiest year, he delivered 1,800infants - an average of 4.9 babies a day. Over the years, criticism continued. In 1915,Joseph B. Delee of orthwestem University and author of a textbook on ob tetric , remar ed, "F-ew operations are o satisfac ory as version, but none is more dangerous if performed without due consideration of the conditions." W. Whitridge Williams of Johns Hopkins, whose textbook is standard in most medical schools, noted a mortality rate of 6.73 per cent among patient delivered by Potter in 1920.But the mor­ tality rate wa 7 per cent on the first 10,000delivenes on Williams's own ser­ vice, a figure he justified by declaring that many of that number were delivered by students learning their technique on ward patients while "Potter's patients were delivered by probably the most dex­ terous ob tetrical operator in the world." It i important to remember that Pot­ ters mo reality rate stood at 6.73 per cent because he was often summoned to deliver late in labor, in neglected case , or for the most difficult problems con­ fronting other obstetrician . But even considering that, his own alma mater did not support him. The medical school asked Williams to recommend a new pro­ fessor of obstetrics because Mwehave a wild man here; and Williams suggested Dr. Francis Goldsborough, who wa in­ stalled a professor in 1910. Yet Potter displayed fortitude in facing the prevailing criticism, and a guest book he maintained contained signatures of 914 eminent doctors from countries all over the world. A classmate of mine, Orvan W. Hess (M'3I), clinical professor of gynecology LLM RUFFALOPHYS!CJJ\1'AND BIOMEDICALSC1£NTIST �Dr. Irving itePotter, .. A UB alumnus, Dr. Potter delivered 35,000babies in his lifetime -mot of them feet first . using a technique he developed. lrt ing Wlute Potter on his graduauon from the UB medical school BUFFALO PHYSICIA . AND Bl MEDICAL SCIEl'ffiST EARLYWINTER 1988 �lop One fool, then the other, 1s br ught don n If nee an the doctor onunu upuard pres ur on the h1ld'~ head b">push mg on the outside of the mother's abdomen B01tvm. Graspm 1h fee, u uh the first an,l m,d. di f111gen the feet are brought to the our.side u.orld and obstetrics at Yale School of Medicine, noted, "In discussions of obstetrical topics such as version and ex­ traction, or confronted with a controver· sial point of view, it was Potter who usually held the winning card - a voice of authority based on his vast personal experience. H es continued, "Although version and extraction is used infrequently today, Dr. Potter's developments and perfection of the technique (through his talent and courage as a pioneer in its ap­ plication) remains an outstanding achievement of the era during which he practiced obstetrics." In I947, as an internist, I referred a pa• tient of mine to Dr. Potter. She had a central placenta praevia, was in nephritic toxemia, and was convulsing - a life- EARLY \IIJNTER 1988 threatening situation. Potter delivered turning "green" and Potter called for a the placenta first, then a live, normal nurse to bring a textbook on obstetrics. baby girl using version and extraction. "Son," Potter exclaimed, "I am stuck. My mouth fell open in amazement, and Please turn to page 310 and start reading when l could talk, I said, ~or. Potter, I fast so I can learn to deliver the baby." have never heard of this being done nor While the fainting father was frantical­ have I read of it:' ly reading, the baby was suddenly born "Oh, that's nothing; he replied. "I've and the anticipated cry was heard. done four or five of these.ft "Son," Potter said, "you were a big help Mother and married daughter are alive to me. I am grateful; the mother is and well today. grateful; the baby is grateful." Instances of pixieism were not uncom­ mon for Potter. Frequently he would otter was obstetrician-in-chief at two enter a new mother's room carrying a Buffalo hospitals and attending at vase of flowers left outside another room four other institutions. In his prime, he for the night. After joining his patient was an annual lecturer at the New York in a hearty laugh, he would return the Polyclinic Medical School and Hospital vase before his "thefr" was discovered. in New York City. Dr. Herbert Burwig of Buffalo wrote of He was a diplomate of the American a time when Potter allowed a husband Board of Obstetrics and Gynecology, a to witness a delivery. The husband was f-ellow of the American College of P BUFFAID PHYSICIANAND BIOMEDICALSCIENTIST �ll Top The scapula o leT bone 1 pu hed undeT the pubic arch with the index fmgeT m tead of pulling the hoitldeT. PotteT noted that thas uru an 1mprot ement in technique oteT the one he described an an raTlieT paper Bot• tom The head I delat1ered last Surgeons, and a member of the American Medical Association, Erie County and New York State Medical Societies, and the American Association of Obstetricians, Gynecologists, and Ab­ dominal Surgeons. He was also a presi­ dent of the Buffalo Academy of Medicine and a member of the Medical Union, the Aesculapian Club, the Buffalo Country Club, Buffalo Athletic Club, and many others. In 1942 a bronze plaque in honor of Potter was unveiled at the opening of a new obstetrics floor in Millard Fillmore Hospital. This plaque is now treasured in the home of Milton Grosvenor Pot­ ter, Jr., M.D., lrving's grandson. He, along with Paul H. Potter of Buffalo and Ben­ jamin E. Potter of New Hampshire, co­ authored a paper from which I have bor­ rowed heavily in preparing this story. BUFFALOPHYSICIANA D BIOMEDICALSCIENTlST accomplish the maneuver safely, while the attempts of other men to follow my directions are sure to have disastrous out­ come.• Without trying, Potter brought honor and respect to the medical school that rving W. Potter died in 1951at the age graduated him, but failed to name him of B?, having been blind for the last to its faculty. Yet chis was a great man, two years of his life. His method is used whose pleasant personality, humor, infrequently now, and only when the in­ perspicacity, and dogged dedication to dications are precise - rarely "elective­ principles he believed in, raise him to the ranks of Austin Flint, Ro well Park, and ly" as he used ic. Many remarks about Potter centered George Thorn, all internationally on how capable he was in executing his famous physicians who have been technique whereas others les.sable would associated with the University of Buffalo • attempt it and do harm. This led him to School of Medicine. state, Mthemost recent objection to my technique of version is that it is a one­ man method; in other words, that (Ed,IOf'sNeu: RooeTt A. Ullman,AR, M.D., FA.CP., becauseof a natural aptitude and extend­ F.C.C.P., a m,,rnberof rhtc1'wof 1931, is now retired ed experience and practice, I am able to and living in Ari~ona). They repre ent the sixth generation of physicians in the Potter family. A seventh, the son of Benjamin E., has been accepted for pre-medical training. I EARLYWlNTER 1968 �IZ W ith an eye to someday finding a human blood substitute that has a longer shelf life and is free from diseases such as AIDS and hepatitis, researchers from the UB School of Medicine and Biomedical Sciences are participating in a $4.S million federally funded study to develop a synthetic form of hemoglobin. Also participating m the five-year study, funded by the ational Institute of Heart, Lung and Blood, are the University of Iowa, the lead institution; orthwestern University; Johns Hopkins University, and the Research Institute of Scripp Clime. Robert W. Noble, professor of medicine and biochemistry, is the principal in• vestigator for the Buffalo component of EARLY ll.1NTER 1988 the study, which will receive an estimated $1.3 milhon in federal funding over a five-year period. The ',1,"0rk will be conducted at the Buf­ falo Veterans Administration Medical Center where oble is chief of the Laboratory of Protein Chemistry. Working with him on the project are two research chemists at the medical center, Laura Kwiatkowski, Ph.D., research assistant professor of medicine at UB, and Alice Wile, M.S., research assistant instructor in medicine at UB. The aim of the project is to modify human hemoglobin so it can be used as an oxygen carrier outside the human red blood cell, Noble explained. "The problem I that when you take hemoglobin outside of blood cells it has a number of properties that make it a poor oxygen transporter7 he noted. For one thin11;,the hemoglobin mole­ cule breaks up into smaller units that pass through the kidneys and are lost in unne. The researchers will try to design molecules that remain intact. The fact that hemoglobin binds so tightly with oxygen poses another challenge. While hemoglobin has to pick up oxygen 1n the lungs, it also has to release the oxygen to other parts of the body. In the red blood cell, there's a certain molecule that helps the hemoglobin release the oxygen, Noble pointed out. But when you remove the hemoglobin from the red blood cell, that helping molecule is gone and the hemoglobin Bl FFALOPHYSI I~ A:-.DBIOMEDICAL SCIE1'.'11ST �ARTIFIC AL BLOODS GOAL OF $4.5 MILLIONGRANT .. won't release the oxygen. The researcheTh will have to find a way to entice the hemoglobin to let go of the oxygen at the proper time. Another challenge to overcome is the problem of oxidation (the chemical pro­ cess which, in metals, causes rust). Hemoglobin has an iron atom which, if it becomes oxidized, will prevent the hemoglobin from binding with oxygen. Red blood cells have a mechani rn that lows down oxidation and acts as a natural "rustproofing," Noble explained. The researchers will have to find a similar mechanism for their artificial hemoglobin. The Buffalo researchers will work with human proteins manufactured in bacteria, converting them into synthetic BUFFALOPHYSICIJ\NAND BIOMEDICAL SCIE :TIST hemoglobins to be used by researchers at all five centers. They also will study the properties of these synchetic hemoglobins, particularly the kinetic properties of their reaction with oxygen. Using techniques of molecular genetics, researchers at the University of Iowa will insert human genes into a com­ mon bacteria, E. coli,converting them in­ to factories that manufacture the hemoglobin protein. They will then selectively modify the genes to produce single changes in the amino-acid sequence of the protein. The Iowa researchers will grow quantities of the bacteria and ship it to Buffalo. Here Noble and his colleagues will ex­ tract the protein, add the iron-containing heme, purify it, and essentially tum it in- to a hemoglobin molecule. Then they'll distribute it to the investigator at all of the sites who willperform different kinds of measurements on it. oble is confident that the researchers willbe able to modify the hemoglobin . "It's a big leap from there to making a blood substitute," Noble cautioned. "But this is a fin step." The next step would be to learn how to grow the synthetic hemoglobin in large quantities. Noble, whose re earch bas focu ed on hemoglobin for 24 years, said tbe altered hemoglobin may be manufactured in large quantities in E. coli.,which doesn't carry human viruses. Noting that beer breweries grow yeast in large quantities, he speculated that yeast could be a medium as well. • EARLY Wl1"1cR I ��15 MEDCALSCHOOL EXAMINES ITSPAST, PEERINMFUTURE How can we get any better than this? Extensive self-study suggests 120 ways. n a soul-searching document that took l1h years co compile, the UB School of Medicine and Biomedical Sciences lists 120recommendation on how it can im• prove itself in areas ranging from ad­ ministration co academic programs. The institutional self-study was done in preparation for the ovember site visit of the Liaison Committee on Medical Education (LCME). The LCME is the accrediting body for American medical schools. k's composed of representatives of two groups; the Council on Medical Education of the American Medical Association and the Association of American Medical Colleges. Involving the University faculty, staff, students, and hospital representatives, the self- tudy is a massive effort to asse the school's strengths and weaknesses, goals and objectives. UB completed its first self-study in 1980. Accomplishments since then include: The M.D./Ph.D. program was established. The Early Assurance Program, where undergraduates find out as sophomores that they will be accepted into medical school, was established. • The Graduate Medical-Deneal Edu­ cation Consortium was established to coordinate graduate education among BUFFALOPHYSICIAN AND BIOMEDICALSCIEITT!ST the medical school, UB's School of Den­ tal Medicine, and the affiliated ho picals. The Faculty Practice Plan was e tablished is 1984. The Western New York Health Sciences Con ortium was established. The consortium is designed to enhance cooperation among the local health in­ stitutions and strengthen the medical school's networking. Through coor­ dinated centers of excellence, it aims to establish Buffalo as a major health center. Physical facilities have expanded con­ siderably with completion of the Health Sciences Library in 1985, the new animal facilities in 19 6, and the educational wing in 1987. There has been a 102 per cent net increase of funding from all sources. Clinical departments were enriched by 45 new faculty positions, eight ad­ ministrative assistants and 14 secretarial positions. To reflect its broader mission, the name of the school was expanded in 1987 to include the words ~and Biomedical Sciences.ff The priorities for the future, according to John Naughton, vice president for clinical affairs and dean of the medical school, include: EARLYWJNTIJl 1988 �I 16 • Minority education - giving greater emphasis to recruitment. • Strengthening the infrastructure improving things such as audiovisual suppon, the libraries, and assistance with financial aid. • Continued enhancement of the quality of programs. The school will probably develop at least two new departments - emergency medicine and radiation oncology - and probably add four residency programs - radiation on ­ cology, emergency medicine, plastic surgery, and preventive medicine. "I think we've provided the foundation of programs we need in large part; now it's time for improvement and enhance­ ment; Naughton said. T he biggest issue that the UB medical school faces is the lack of a university medical center, Naughton noted. That ingredient works against having a strong institutional bond because it's hard to get all of the faculty together in one place. There's always the worry that it may weaken the quality of education. On the other hand, he added, the school has access to a large, diverse com­ munity of patients and facilities. UB can use these relationships to build quality, but it's a more complicated process than if there were a single medical center. "If you read what our students say when they leave Buffalo, they find the diversity very, very positive; Naughton said. "I think we've figured out ways of coping with this and the self-study helps in that effort.• Other recommendations for the future include: Administration • Ensure that teaching performance receives adequate recognition in relation­ ship co research. • Through educational programs, en- EARLYWINTERl988 Prioritiesfor the future include minority education,strengthening the school's infrastructure,and continued improvement of programs. "I think we've provided the foundation of programs we need in large part; now it's time for improvement and enhancement." sure that faculty have the skills necessary to remain competitive in research. • Offer to graduate students services that are similar to those offered to medical students, such as meeting areas, lockers, publication of research awards and competitions, and research opportunities. Buildings • Improve the infrastructure of Parker Hall by 1992 to accommodate a new PET Scanner, uclear Med icine Department, the Cardiovascular Research Center, and health science shops . • Relocate basic science faculty, who are now at satellite sites, to the Ma in Street Campus by 1994. • Increase the amount of space available to clinical faculty on the Main Street Campus and in teaching hospitals. Health Sciences Library • Encourage the University to recruit more library staff, including an expert in computer searches of sociological, psy­ chiatric, and psychological data bases. • Increase the budget for current serial subscripcions co maintain at least 3,000 titles . Coordinate subscriptions by af­ filiated institutions to broaden the available subscriptions in the region. • Consider the needs of medical, graduate and postdoctoral students and research faculty when scheduling library hours. Help affiliated hospitals find ways to make their libraries more available to students throughout the day. Admissions • Be more aggressive in recruiting and take other steps to maintain the quality of students in the face of a projected decreasing pool of applicants. • Explore establishment of joint degree programs with other units at UB, such as an M.D./J .D. program or an M.D./M.B.A. • Maintain the Early Assurance Pro­ gram and all other recruitment activities in the basic sciences. Continue to place a strong emphasis on the recruitment of minority students. Construct a new 150,000-net-square­ foot research building by 1993-1994. • Complete the LaForge Conference Center and the proposed central dining • Coordinate the development of a facility by fall of 1990. credentialing system for medical students Medical education BUFFALOPHYSI CIAN AND BIO MEDICAL SCIENTIST �17 in accordance with revised New York State Department of Health policies. • Develop a system to determine how many of the school's graduates eventually become licensed. • Make the student advisement system more responsive to students' needs. Iden­ tify a special person in the University Financial Aid Office to work with medical students. • Create special graduate assistantship awards by the basic science departments. Curriculum • Consider whether students should be required to pass Parts I and U of the National Medical Board Examinations before graduating. • Ensure that active, independent learning and problem solving, rather than just lecture , comprise a large por­ tion of every student's education. • Put more emphasis on ambulatory care, geriatrics and chronic disease through the development of a required three-module educational experience. • Increase emphasis on medical ethics, particularly advances in medical technology. • Introduce special topics on nutrition, medical juri prudence, medical applica• tion of computers, and others. The biggest issue that the UB medical school Basic science departments faces is the lack of a • Increase the number of postdoctoral university medical center. On the other hand, the school has access to a large, diverse community of patients and facilities. "I think we've figured out ways of coping with this and the self study helps that effort." Medical students Research and • Limit multiple-choice questions for basic science education third and fourth year-end rotation exams • In cooperation with the Buffalo Veterans Administration Medical Cen­ ter, acquire a PET Scanner. • Work with the Basic Science depart­ ments to increase the annual stipends paid graduate students. • Through the newly established Of­ fice for Research and Graduate Studies, increase the coordination of graduate stu­ dent education and elevate the program's visibility and image within the school. BUFFALOPHYSICIAN AND WOMEDICAL SCIENTIST the unique stresses of medical school life. • Find solutions to the campus park­ ing problem. and increase the use of essay and short­ answer questions. • Encourage the establishment of a series of review lectures for Part I of the national boards . • Coordinate the hours of the Health Sciences Library, Clark Gym, and other facilities to parallel the medical school schedule. • Identify a liaison in the University Counseling Center who is sensitive to fellows and request financial support for these fellowships. • Recruit faculty for the expansion of molecu lar biology and neurosciences. • Encourage expansion of interdisci­ plinary research. • Obtain more funding for secretarial support. • Emphasize recruitment of minority students and establish a program to recruit and retain minority faculty. Clinical departments • Establish residency program in radiation onco logy, preventive medicine, plastic surgery, and colon and rectal surgery. • Establish equitable fringe benefits for faculty members in the clinical sciences throughout the affiliated ho pita] system. • Increase secetarial support staff, clerk typists, and research associates. • Integrate computer networks throughout the medical school and af­ filiated hospitals. • Improve the research facilities at af­ filiated hospitals. • Recruit faculty capable of doing research. • Emphasize recruitment of minority students. Affiliated institutions and clinical affairs • Track the effects and implementation of the Bell Commission report. • Develop plans to provide service to hospitalized patient· independent of the need for residents. • EARLY'1-"INTER 1988 �18 NEWPROGRAM FORGES ~ By ARTHl he Western ew York Chapter of the National Multiple Sclerosis Society and two Buffalo hospitals have launched a new program to coor­ dinate and improve the care of people with multiple sclerosis in Western New York. The program, called the University at Buffalo Multiple Sclerosis System, will unify the services of the chapter , the William C. Baird Multiple Sclerosis Research Center of Millard Fillmore Hospital, and the Bernard B. Hoffman Multiple Sclerosis Center of Buffalo General Hospital. The system was developed under the auspices of the UB School of Medicine and Biomedical Sciences and its depart­ ments of Neurology and Rehabilitation Medicine. The leadership in the two departments "is an important example of how inter­ disciplinary programs can work for the benefit of the people of Western New York; said John Naughton, vice presi- EARLYWINTER1988 dent for clinical affairs and dean of the medical school at UB. The effort is particularly significant since the eight-county region has one of the highest incidences of multiple sclerosis in the United States, according to Arthur V. Cardella, executive direc­ tor of the chapter and chairman of the system's 11-rnemberexecutive committee. With an estimated 1,500 diagnosed cases of multiple sclerosis, Western New York has nearly one case of the ailment per 1,000 population, he added. beneficial services. · increase communi three partners. Plans call for the I by computer. Each system will have medical record tha 1 three agencies. Programs of the Chapter, National Society focus on soc ing, support groups people with mult i families, and the p Millard Fillmore' Multiple Sclerosis f years ago was the f that interferon appe treatment in somt sclerosis, which prE successful trearmen Buffalo General's Multiple Sclerosis ( tention on rehabil maintain the fu, 1 1 he most common crippling disease of young adults, multiple sclerosisaffects an estimated 250,000people in the con­ tinental U.S. Ir is characterized by alter­ nating periods of disease inactivity and flare-ups, known as exacerbations. Activities of the three partner organizations, each offering some specializedservices not available from the others, previously were not coordinated, so some people may have gone without BUFFALO PHYSICIANANI �19 •ARTNERSHIP FORMS CARE HUR PAGE s. The new system will nif tion among the 1er;rtners to be linked :h person entering the ,e one computerized hat i accessible to all 1e Western ew York 1al Multiple clerosis social services, counsel­ JpS, and education for J lciple sclero i , their ! public. ,re's William C. Baird is Research Center two e first center to report )pears to be an effective ,me cases of multiple previously has had no 1ent. 1l's Bernard B. Hoffman s Center focuses its at­ bilitation medicine to functioning and in- \N D BIOMEDICALSCIENTIST dependence of individuals with multiple sclerosis. "We have all the components in place in Buffalo to be a really great multiple sclerosis treatment center," said Lawrence Jacobs, M.D., chief of the Baird Research Center and professor of neurology at UB. "The sy tern is going to blend all of these components under the proper heading of a university program. Wewill be able to deal with a much greater over· view, haring information, ideas, and services." arl V. Granger, M.D., co-director of the Hoffman Center, said that "hav­ ing a chronic disease such a multiple sclerosis does not necessarily mean a pa­ tient's condition is static . --rhe variability of ymptoms and need for flexible treatment plans necessitate an interdisciplinary approach for successful case management of the patient." Granger is also a UB professor of rehabilitation medicine and head of rehabilitation medicine at Buffalo General. The other co-director of the Hoffman Center is Michael T. Genco, M.D., UB clinical associate professor of neurology. that patients will con­ Cardella ·cres.sed tinue to receive care from their private physicians. "We're not •a managed care system," he added. "We're a system for support designed to work with physicians in the community. However, when a case becomes too difficult for a private physi­ cian to manage, we willrefer the patient to appropriate specialists with knowledge and familiarity with the circumstances and needs of those with multiple sclerosis." While the system's medical services in­ itially will be offered at Buffalo General and Millard Fillmore, Cardella said plans call for the establishment of satellite sites at other ho pitals in Western ew York. • EARLYll1NTI:R I �p 0 L I T I C A L 20 = By MYRIAM DA IEL It was to be part research, part vacation, but two students learnedthe realities of life in turbulent Haiti he gunshots were loud and distinct. Seven were heard, one after another. An overwhelming silence followed. The night was still young and we were terrified as we lay in bed in the house of Dr. Michel Vauges, Myr­ iam's uncle. Someone wa knocking on the door; we quickly put on our robes and fol­ lowed Dr. Vauges down tairs. It wa only our s cond night here. Dr . Vauges looked through the window and saw three men. The mid­ dle one appeared hurt. We hesitated before opening the door since, after all, we were staying with members of the up­ per class. The patient was laid on the examination table . He must have been in his early 30s. His body was frail and hi pain seemed unbearable. A bullet had pierced through his forearm, tearing his biceps. He was given a tetanus shot and his arm was bandaged as he was rushed to the hospital. That night we barely slept. It was the summer of 1987, and we had just completed our second year of studies at the UB School of Medicine and Biomedical Sciences. Burning with curiosity and a desire for adventure, we had obtained a fellowship from SmichKline Beckman. Our goal was to explore the attitude of Haitian women coward prenatal care. We chose the beautiful island EARLYII/INTERl9t!tl of Haiti because of its high infant mortality rate and because we wanted to acquire a broader understanding of the background of the growing Haitian population in New York. It was our hypothesis that the economic, educational, and religious status of the Haitian woman would have a great in­ fluence on her attitude toward prenatal care. We had been warned against many things, but felt prepared. . , .... .. ~ ' .... "He must have been in his early . : 30s. His body •., was /Tail and his pain seemed unbearable. A bullet had pierced through his forearm, tearing ' his biceps.'' I • 0, •• ... "'" · Myriam Dani e l: lt was exactly 3 p.m. Thursday, June 25 when my American Airlines plane landed in Haiti. The island appeared so peaceful from the airplane's window. I followed the crowd to the gate. l wondered whether I looked more like a native than a tourist. Although Haitian by birth , l had left:my country when l was four years old. This fellowship was an excellent oppor­ tunity for me to reacquaint myself with my native land. Carol and l had organized our schedules very carefully. We were going to work hard every morning, but the afternoons would be ours. We were going to Cap Haitian, to the beach, BUFFALOPHYSICl/\l-1i\NO BIOMEDICALSCIEJIITTST �V I 0 L E N C E 21 & CAROL DeCOSTA -::::=::::: to the mountains, to the clubs, and even next door to the Dominican Republic. This wa going ro be a summer to remember. The airport wa like every other airport. I was a ked to open my luggage, and a oon as I managed to redo e it, a young man in shorts took the suitca e to a corner and said, "Bernmwemsa ou fxl:Joil bem" - "Give me whatcha gonna give me:' I searched through my pockets and gave him two American dollars. He seemed pleased. He carried my lug­ gage outside where a big crowd was wait­ ing. I heard my name being called and recognized a smiling face in the crowd. It was my uncle, Dr. Vauges. He asked me to wait while he went to get the car. As soon as he left, I found myself sur­ rounded by natives begging for money. As I searched my purse for loose .:. change, the crowd ~ doubled. I was down iii -~- .,.. to my lat quarter f [j .· -- - . ·~ -. :h:/Js~:;le came ~-: -~=:- i While driving to my uncle's house, I i ·:= _-;; raining a medical degree from a U.S. medical school, l never had to worry about my next meal or a place to sleep. Carol De Co ta : I arrived two days later. I'm originally from Guyana, but grew up in New York City. I barely poke French or Creole, but would not let the language handicap me. I had traveled to everal places in the past and was able to adjust quickly. We shared a room at Dr. Vauges's house. We soon realized -- -- . _ __ -~:. :~t·:.:_ · - _- _-_ - ~ -.=-:-- ~--:-:_:_?·"=~~-- f:-:=-;;..~~~ "It was exactly 3 p.m. Thursday, June 25 when my American Ai rlines plane landed in Haiti. The island appeared so peaceful from the airplane's window.'' L._..:_-=:..._,,__::__==.~.....:~.....:~....:::. ~ -..G.?.S t... ~ ~~~a~;;se;:?liill noticed that the poverty and the separa­ tion between the lower and upper class were blatant. The side­ walks were crowded with poor people trying to sell enough goods to survive another day. The sun was frying their dark skins. Their bodies were frail. Some children were unclothed and their feet were bare on the burning pavement. came to notice that although people of various complex­ ions constituted the upper class, only people of darker com­ plexion constituted the lower class. Sitting in the car, 1 could not help the sadness that wa overwhelming me. I had been very fortunate. Not only was I two year away from ob- BUFF.-.LOPHYSICIAN/\ND BIOMEDICALSCIENTIST that America wa indeed the "Land of Freedom." ln Haiti, we felt confined. We couldn't go for a walk whenever we wanted and most of the time had co be accompanied. Haitians love foreigners, e pecially those from America . However, due co the political situation, we had to be cautious. The country was in the middle of a polit1cal debate, in a tran­ sitional state from anarchy to democracy. The people wanted the resignation of the president of the ational Congress, General anfi, whom they felt had violated the con titution. The general strike started the Monday after our arrival. During the strike, all businesses were closed, public transpor- EARLYIVL\ITERl �22 tation was not available, and people were advised to remain in the safety of their homes in orde r to avoid the street riot . The first day of the strike marked the beginning of the never-ending riots which would accomplish nothing but the bloodshed of the less fortunate. That was the night we heard the gunshots and aw our first panent . That evening the whole nation turned on their TVs and radios to listen to General anfi's speech, which many had hoped would be more like a farewell. The initial goal of our study ~'35 to reach women who were not using the prenatal center at Cite Soleil, but the streets became so un ­ safe that the goal had to be abandoned. lt wasn't until July 10, two weeks afrer we arrived, that we were able to work even at the prenatal center itself. Oftentimes, we had to get there by ambulance ince rhe people barricading the streets allowed only medical vehicles to circulate without interference. (Every . four to five days, there were periods called •relief" during which businesses opened and people were allowed to run errand .) We met with Dr. Louis Marie Boulos, the director of the prenatal center, who helped us tran late our questionnaire to Creole. We were then introduced to a team of doctors who were anxious to involve us in their dai ly activities. At last, we found ourselves plunging headfirst into our study. Time was against us. By meeting and talking to ome of the workers in the ho pita! and clinic areas, we were able to learn some of the customs of the people. This enabled us to ask que nons of the women in a comfortable manner and to elicit friendly and . ·}tr=: ·~ ~~i EARLYwn-rTER1'1611 coopernttve response . When we were not m the recoveTy room interviewing the mother , we were in the delivery room delivering the babies. This was the highlight of our summer. We each delivered our first baby in a delivery room con1stingof five bed with a bucket nearby. There were no ma ks, no intravenous fluid and very often no ane thesia. Sometime all five bed were occupied and the babies seemed to be com- --"When we were not in the recovery room interviewing mothers, we were in the delivery room delivering babies. This was the high point of our summer.'' ing at intervals of just a fewseconds. All we had time to do was catch them. There wa n't enough time to hesitate or become frightened. On weekend , when the strike was off, we went to the beach, to the mountains, and even to a few clubs. lt was amaz­ ing how many people still went out dancing. It was almost as if afrer being enclosed in the house all week, dancing was the only way to relieve tension. uring our study, we gained insight into the health-care system and political system. First and foremost, we learned BUFFALO PHYSICIAN A1'0 Bl MEDICAL SCIENTIST �23 to adapt to situations which were not conducive to carrying out research in a smooth and uncomplicated manner. We were faced with the reality that our success in the endeavor depend­ ed on the political climate. Spending several days inside the house and being afraid to go out on the balcony for fear of being shot, gave us insight into the impact of political expression. As for health care, we learned that basic protocols in the U.S. are sometimes seen as a luxury co the people of Haiti. For example, in the deli ery room, the only things that were sterile were the glove . We soon be­ came accustomed to walking in the deliv­ ery room wearing our street clothing. The use of lab coats was seen as a way to prevent health pro­ l fessionals from get­ ting soiled with blood. Being exposed to so much blood, we at times wondered about AIDS. We knew from our class­ es that although Hai­ tians in the U.S. are no longer considered a risk group for AIDS, in Hain things are probably different. Once, after seeing a young doctor splashed with blood from a delivery, we asked him his opinjon on the issue. He reassured us that no health professional had ever contracted the disea e in this center. As long a they did not have a cut, they felt safe. Like every other sexually transmitted disease in Haiti, AIDS was most prevalent among the poor, since they cannot afford any protective devices and they live in crowded areas with poor sanitation. Several studies are currently being carried out on this issue by Americans in Haiti. Meanwhile, we wore our gloves and lab coats and kept the issue in the backs of our minds. BUFFALOPHY ICIN-J AND l\lOMEDICALSCIENTIST We became fascinated with the dedication di played by the professionals in Haiti. The obstetricians worked diligent­ ly to ensure uncomplicated deliveries. This type of practice was conducted despite the fact that the women did not pose threats of liability suits. In our study, we concluded that the Haitian women in Cite Soleil value prenatal care as po itive aspects of the pregnancy. However, it became clear that there was little understanding of the medical and physiological implications ---- -- ... w = ;:;' "In our study, we concluded that the Haitian women in Cite Soleil value prenatal care as positive aspects of the pregnancy.'' of prenatal treatment. Although Haitian women were thought to utilize midwives, most of them used physicians because they considered physicians the people best equipped to provide prenatal care. These women's understandfog of the value of prenatal care could be further enhanced if they became more active rather than limiting their participation to the passive role of accepting treatment. We valued our experience in Haiti. Carol would like to visit the country once again when the still-turbulent political ituation settles. Myriam plans to establish a practice in Haiti in the future. • EARL)' WIN'IBR 1988 ��- -- -- - M d1cal ho I 25 SPENCE FANSTHEFLAMES OF INTERDISCIPLINARY RESEARCH frer a three-year stint as a health scien­ tist administrator at the National In­ stitutes of Health ( IH), Joseph T. Spence, Ph.D., has returned to UB to fil\ the newly created post of associate dean for research and graduate studie in the UB School of Medicine and Biomedical Sciences. At the ational Heart, Lung and Blood In­ stitute of the IH, pence revic:wed applica­ tions for Specialized Centers for Research. From 1980 to 1985, he was an assistant pro­ fessor of biochemistry at UB. Before that, he was a postdoctoral fellow for three years at the University of Wisconsin. Spen ce received his Ph.D. in nutritional biochemistry from Cornell University in 1977. He received his master's degree in nutri­ tion from Cornell and his bachelor's degree in chemi try from St. Francis College. Spence's job is to coordinate the large research mission of the medical school, said John Naughton, vice president for clinical af­ fairs and dean of the School of Medicine and Biomedical Sciences at B. romance-minded matchmaker. But instead of Spence works with the institutional review matchmg up people ba ed on whether they board , u·hich review research involving like pina coladas or walks in the rain, Spence humans, and with the Laboratory Animal makes his introductions based on their Care Committee, which re\•iews research research interests. done with animals. To strengthen graduate "The nature of science is changing," ex­ education, Spence is working with basic plained Spence. "It's becoming more mter­ science chairmen and course direccors on disciplinary.• ways to improve coordination among His own research in the regulation of departments. metabolism, especially the metabolism of car­ Spence is also the medical school contact bohydrates and lipids in the liver, is an ex­ for Dale M. Landi, vice president for spon­ ample of the interdisciplinary approach. Even sored programs at UB. though his background is in nutritional ln his new position, Spence is like a biochemistry, his colleagues at UB encour- The job of the new associatedean is to coordinate the large researchmission of the medical school. He wants to match up researcherswho ha e common interests. BUFFALO PHYSICIAN AND BIOMEDICAL "SCIENTIST aged him to try different techniques and he found himself pending 80 per cent of his time doing molecular biology. "If they didn't tell me I could do it, I wouldn't have tried," he aid. Researcher hav to get used to the idea of working with people who are not only out­ side their department, but even outside the Univer icy at hospitals and other institutions. "There's no shortage of talented people out there: he said. "We're all in this together and we have to help each other out~ He said he hopes the faculty will tap his expertise in reviewing grams and in knowing who the best people are to call if trouble arises. u o matter how big a person is in his field, there11 come a time "-'hen he has trouble get­ ting funding," he noted. Spence advises researchers to have more grants pending. Then, if one isn't funded, there's another proposal written up and waiting ro go. Researchers who do this have a less fatalistic attitude about getting gram support, he noted. His aim for graduate education is to get deparrments to work together more than they do. The graduate school at UB is very decen ­ tralized and each department sets its own ad­ mi ions requirements, its own degree re­ quirements, and does its own recruiting, he explained. More could be accomplished if a more •global" approach is taken. Spence emphasized that he's open to ideas from faculty on research or graduate studies . "What can we do to build on our successes and not move sideways?ffhe asks. • EARLY V-lNTIR 1988 �26 NASACALLED AND CHAMBERLIN A SWERED B ELI BE: inda Chamberlin, clinical assi cant pro­ fessor of urology at UB, was leafing through the back pages of Sciencemag· azine one day last winter when an ad caught her eye: •summer Faculty Position in Space Life Sciences Training Program. At NASA Kennedy Space Center:' Chamberlin "had always been interested in space, since Sputnik went off when I wa a kid." She applied and was one of four people chosen to be a project counselor for an in• ten ivc ix-week training program at the Florida space center for college students in­ terested in life sciences, pre-medicine, and bioengineering or related fields. The purpo e of the program, Chamberlin said, is "to devleop an interest in space-related research so that in the future there will be people co carry on chi research when those now in the field rerire.• Thirty-six student from all over the coun­ try had been selected for the program, one of whom was UB's Ashok Patel. Those chosen had to have at least a 3.0 average - "many had 4.0s" - and a science major. A number of the students were "artistically or musically talented" and several, Chamberlin says, "were so mart it was frightening." The daily program schedule was rigorous. Arriving at Kennedy Space Center by bu from a motel 15 miles away, the students and counselors would attend lectures from 9 to noon each morning. Lectures were given by both re.searchers and astronaut and covered such topics as space pharmacology, how to EARLY '1!,1NTERl'!tll.l HEHI LO launch a shuttle, the depletion of the ozone layer, and "team work." Teamwork was included as a lecture topic, she noted, because the tudcntl needed to be competitive to get into the program, but once in, had to work in alliance with others on one of four ASA project . Each of the proJects dealt with some aspect of living in space. After lunch, the tudents would separate into teams of nine to work in the labs on their re earch project . Chamberlin's team was working on CANDS, which stands for "controlled animal nutrient delivery system; or to put it in a somewhat less elaborate terminology, "feeding rat in space." In the past, rat on flights have been pro­ vided with food pellets pre-glued to the sides of their cages and loose whole potatoes (as a water source.) Besides the fact that this feeding system is messy - "you get food par­ ticlts floating all over the place• - there is no way to determine how much food and water the rats are consuming. "Youwant something you can measure~said Chamberlin. "If the rats aren't doing well, is it because they're not getting enough food and water or is it due to microgravity (weight­ lessness)?" Chambcrlin's students tescecla new diet on the rat : a high moisture, "mashed potato-like paste; called KSC25 that would provide a combined food and water source in premeasured packets. The team studied the rats' development on Linda hamb rim, Ph.D K CZS in animal laboratories that were "ex­ tremely high-tech" and complerely sterile. ot only was all the air filtered before it entered the room , but the slightest variation in temperature or humidity er off an alarm system. Furthermore, to maintain sterile con­ dition within the laboratory, the CA OS team had to shed their short and T-shirts before entering and slip into white rayon "bunny suits" - jumpsuits with maoching face masks, hats, and gloves. RUFFALO PHY, ICIA A 'D BIOMEDICAL SCIE msT �Medi al chool 27 MAcouple of times, when the alarm system wem off, we had to hop outside in our white suits into the 90 degree heat and the 99 per cent humidity; Chamberlin said. "Then we stood there, sweltedng, until they fixed the problem: And of course they had to put on fresh suits before then could enter the lab again. ab lasted through the afternoon. Afrer dinne,- there was usually something sched- BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST uled - a meeting, perhaps, or a lecture. Despite the exhausting schedule, Chamberlin says she'd do it again. "It was really exciting; she said. MAndwe also got to see what was going on with Discovery. The day they mated the shuttle to the tanks, we watched on dosed circuit TV in the headquarters building: The pirit of excitement and enthusiasm at NASA surrounding the space shuttle project was infectious. Picking two buttons up off her desk that read "Launchwork is Teamwork," and "America'sTeam is ... Counting Down; Chamberlin said "they're ah,..ays handing out buttons and people actually wear them. We would pin them to our clothes, our bags, everywhere; The most exciting moment of the summer, however,came at I a.m. on the rourrh of July. "They let in the press and all kinds of im­ portant people were there; she noted. Then, as flash cubes exploded in the balmy Florida night, "they rolled out Discovery." • EARLY\VINTER1'!88 �1 dical chool 28 Richard Cai,oli PROJEaFLIES ON SHUTTLE By ARTHUR PAGE UB medical student's experiment that went up in smoke after the space shut­ tle Challenger exploded on takeoff flew again on the space shuttle Discovery. Richard Cavoli's project v.,asone of two stu• dent expriments conducted in space by the Discovery astronauts during their four-day flight. It involves growing lead-iodide cry tals under zero gravity, a technique that could lead to improved film for use in X-rays and astronomy. Cavoli - whose work and dedication were praised by President Reagan in his 1986State of the Union Address one week after the Challenger disaster - is a second-year stu• dent at the UB School of Medicine and Biomedical Sciences. Cavoli said that it was strange to see his project finally launched on Discovery because he had been working on it for so long. He stopped for :i moment to calculate, and real- EI\RLYWINTIR 19811 ized that he's been at it for eight years now. •rm only 24 years old; he exclaimed. "Thar's a third of my life!" He was thrilled that the space program could "get over the hump- after the Challenger disaster. "I'm glad to see the program didn't suffer too much," Cavoli said. He compared the space shuttle to a Model T. "lt's expensive, you have to get outside and turn a crank, and it's not easy finding gas; Cavo i quipped. But getting into orbit willbe a lot ea icr in the future. His project is one of 57 selected to date by the anonal Aeronautics and Space Ad­ ministration for its Shuttle Student Involve• menc program. It was one of three tudent ex­ periments aboard the ill-fated Challenger. Cavoli was in the old Executive Office Building adjacent co the White House, watch­ ing a broadcast of the Challenger launch when the space shuttle blew up only seconds after blast-off on Jan. 28, 1986, killing seven astronauts and plunging the country into a period of mourning. President Reagan planned to single him out as one of four young American "heroes" in his annual State of the Union Address, originally scheduled for that evening. "It was a real bittersweet moment; Cavoli recalled. Like others watching the launch, his initial reaction was a mixture of shock and denial. While he had witnessed one of has dreams literally go up in smoke, Cavoli's immediate concern was not with his experiment. "The first thing that came to mind was that there were people aboard; he said. "I tried to entertain the possibility they were still alive, even though that wasn't realistic:" He also thought about the impact of the disaster on this country's space program. "I was concerned for NASA and how peo­ ple would view exploring space; Cavoli ex- BUFFALOPHYSICIANI\ND Bl MEDICI\L SCIENTIST �-- - - - - 'vfed1al ho l 29 plained. "l was afraid people would think space exploration wa n't worthwhile. I think it is. A lot of problems we have here on Earth can be solved in space.• Within hours of the Challenger accident, Cavoli and the other three young American heroes scheduled to be aluted by Reagan in his annual address met with the President in the Oval Office of the White House. •He was ju t like the rest of us, in shock," Cavoli noted. •He was very somber in the beginning, but he tried to pick things up a bit; for the sake of the four, three of whom were youngsters. Cavoli returned to Washingron a week later to be recognized by the President when he delivered his re•scheduled speech in the House of Representatives. The UB medical student wa the first of the four exemplary young Americans saluted by Reagan in his addre . "Wesee the dream coming true in the spirit of discovery of Richard Cavoli," the President noted. "Allhis life he has been enthralled by the mysteries of medicine and science. Richard, we know that the experiment you began in high school was launched and lost last week. Yet, your dream lives. And as long as it is real, work of noble note will yet be done." ASA approved Cavoli's project for the Shuttle Student Involvement Program in 1982when he was a senior at Marlboro High School in the Hudson Valley region, working with advisor Annette Saturnelli. Some 2,800student proposals were submit• ted to NASA that year as part of the pro­ i:iram,co-~ponsnrt'CIhy th.. Minn:,( Science Teachers Association. Eighteen of the projects have been flown to date by NASA, which is phasing out the program. Cavoli's work has been underwritten by Union College in Schenectady, from which Cavoli graduated in 1987.He perfected the Project and designed and built the plastic chamber it utilizes working with Charles Scaife, professor of chemistry at Union, and a member of the staff of the college's Engineering Machine Lab. Cavoli's project involves growing lead iodide crystals in zero gravity, with the hope that BUFFALOl'HYSICIANAND BIOMEDICALSCIENTIST If there are dramatic changes in the way larger, purer crystals can be produced in an cry tal grow in space, Cavoli said he might environment freeof the pull of Earth's gravity. be tempted ro go mto crystallography. lf the He said it is theorized that gravity results changes are subtle, he might not pur ue it. in small eddies - like the whirlpool created He knows he definitely wants to do clinical when water drains from a bathtub - in practice. Maybe he'll find an academic posi­ chemical solutions that impact adversely 011 tion where he can combine research and the quality of crystals grown under even the clinical practice. most advantageous conditions on Earth. "But that's off in the future," he said. • That factor can be eliminated if crystal for­ mation occu in zero gravity The plastic cylinder u ed in the expenment has four chambers. One of the outside chambers contain a lead acetate solution, while the ocher co11tains a solution of potassium iodine. The middle two chambers, separated by a thin membrane, contain warer. ozette ynns, A ,;rudenr in rht>Sri,.nce The asrronauts who perform the experiment and Technology Entry Program {STEP) turn valves permitting the two solutions ro conducted at UB, won $5,000 and a diffuse inro the water, creating a bright yellow Digital Equipment Corporation computer solution that leads to growth of lead iodide worth more than 15,000in a national science crystals on the membrane. By analyzing the crystals and videotapes of contest. Lyons also received a gold medal for her their growth process talcen by the astronauts, scientists will learn whether they are fim-place finish in the biology division of the superior to those grown under the force of National Association for the Advancemenc of Colored People Afro Cultural Technolo­ gravity. Ifthey are, it could be a boon for medicine gical Scientific Olympics (NAACP-ACTSO). The comest was held in Julvin Washington, end astronomy, accordine to Cavoli. D.C. Crystals present in image-intensifying Another tudent in the UB program, screens on special films fluoresce in the Kimberly Emerson, won $500 and a bronze presence of X-ray and gamma radiation, pro• medal for her third-place finish in the ducing the images of internal body organs in chemistry division. Emerson also won a the case of X-rays and of heavenly bodies in the universe in the case of gamma-ray film $1,000 award from STEP for outstanding used in astronomy. Cavoli and Scaife work in chemistry during the academic year. Both students are 1988 graduates of City peculate that larger, purer crystals in the film screens would fluoresce more in the presence Honors High School in Buffalo and have begun studies at Cornell University. of radiation, producing more detailed Digital Equipment Corporation donated pictures. If the experiment proves that larger, purer $1,000to the local ACfSO chapter to con­ lead iodide crystals can be grown in space, tinue its program. The UB School of Medicine and Biomed­ Cavoli explained, "it will be trong evidence conducts academic ical Sciences, under STEP. that we can use the method to improve on other similar crystals• that are used in X-ray year and summer programs in medical science research for student in grades IO to 12. and other special films. STEP is designed ro provide research ex­ In the case of medicine, the experiment perience; academic cour es in physiology, could lead to improved X-rays utilizing lower biochemistry, and embryology; tutoring; doses of radiation. In astronomy, it could Scholastic Aptitude Test review ; work with mean an ability to capture on film stars and other heavenly bodies in the far reaches of computers, and counseling for minorities and the universe that to date have not been cap­ the disadvantaged. It's funded through the ew York State Education Department. • tured on film. STUDENTS STEPUP TOSCIENCE PRIZES EARLYWll-,'TER1<188 �Alumni Reunwn Ma, 6, J9d9 30 Class of 1949 Let us hal•e 100 per cent auendance for our 50th cla.ssreunion. l promisea weekend of fun and mniniscence. Dr. Kenneth Gold.stem Hope co see you at the reunion! Dr. James R. Sullfoan Greetings - Let us all TMke an effort 10 get cogecher /or Ol(r '10th Tl'll.nion. Dr. Carmelo S. Armenia I 954 was a vintage year. Come ue if yo11r classmates,like goodwine, improoed01.tertime. Hope to see you at our 35th reunion. Dr. ichcilasC. Carosella. Dr. Edward A. Rayhill Make our 30th reunion a real pearl by being there. Plan now co reseTl>e the weekend of May 6, 1989, so we can renew old friendships. Dr. GeorgeR. Baeumler Dr. Joseph F. Monte EARLYV.'INTER1988 BUFFALOPHYSICIANAND SIOMEDIO\L SCIENTIST �Alumni Reunion Ma o, 1989 31 Class of 1984 We traveled Life's path togetherfor a meaningful period.A quarter of a cen• CUT)' ficcmglyis the time co renew our bonds of col­ legiality and friendship. Please plancoreturnfor our reunion the weekena of May 6, 1989. Dr. Maroin Z. Kurian We promise you an entire fun-filled weekend! Come on backcoyourJOOts for the reunion and show '\lour family where it all s~rted 20 years ago. Dr. Hanley M. Horwit~ Lookingforu1ardto seeing everyoneat our 15th Reu­ nion. We're planning anotherbus tol/.T of the lxm of Buffalo. Please mark your calendar for the weekendof May 6, 1989. Dr. James A. Smith Thomas Wolfewrote,You Can't Go Home Again. Help prol,e him wrongand join u.s for our 10th-year reunion.Come marvel at the changes your former home has experienced. Dr. Frank T Schreck We hat.-ea terrificprogram scheduledro include reac­ quainting you with the many changes at the Uni11=ity and the Ciryof 811,ffalo. We are hapingfor a strong turnout. Dr. Gerald D. Stinziano Dr. PaulH. Wierzbieniec Comeon back to our 10th reumon and see your old BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST friends, reminisce, and parry. Dr. PeterE. Shields I'm lookingfurwardID shar­ inga Jewmemories,laughs and bernwith )'(IU in Ma" 1989. • ., Dr. John F. Noe Cla.ssmates, five yearsha11e passed already. Won't you pleruereservech£weekend of May 5-7, 1989 to reminisce with some old Jn·enas! Hope co see you there! Dr. Dat•id F. Pfalier EAAD"WINTER1988 �Alumni 32 ALUMNIDIREOORY epresentatives of H arris Publishing Co., Inc. are telephoning alumnae and alumni to verify their biographical information for the UB Medical Alumni Association Directory. Information to be verified includes current name, academic data, home address, and phone number (if applicable). The directory willsort the data by name, by class year, and by geographical location. Also included will be special messages from the dean and the Alumni Association, as well as photos and information on the school. Soon, locating fellow alumnae and alum­ ni will be as easy as turning a page in the directory. You may reserve your personal copy when your Harri rep phones, but don't delay. This will be your only opportunity to order this comprehensive new directory. • PLEDGE UPDATE he final numbers are in and the reunion classes of the UB medical school have pledged $159,563 to the University! Here's how it breaks down by class: 1938 .. . . . . . . $5,750 14,060 1943 7,250 1948 11,933 1953 78,590 1958 12,675 1963 9,955 1968 13,250 1973 1978 . . . . . . ' . 5,375 725 1983 • I • • • I • • ,. • I • II- • • ■ • • • I • • • • • • • • ■ I I • • t • • I I ■ I • • • • I • • • EARLY WINTIR l'168 • I • Above: San Frmc1sco, American College of Surgeons, October 198i. Las Vegaswill be che site of a recepuon during the February 1989 meetmg of t he Amem:an Academy of Or( hopaedic Surgeom . 0 Right: Anaheim, American Heart A550Ciation, November 1987 t I • I A recepnon was also held m San Francisco during t he October 1988 meeting of the A merican Society of Anesthesiology. • t f I • I A rccepuo n will also be held m Anahe,m du rmg the March 1989 meet ing of rhe American College of Cardiology. ALUMNIFETED AT RECEPTIONS uffalo is where the school is, but our alumni are scattered to the four winds. To reach its members, the Alumni Association holds receptions across the coun­ try in concert with national medical meetings. It's a time to see old friends and hear about what's new in Buffalo. Most of all, it shows the school's appreciation for alumni support. BUFFALOPHYSICIAN AND BI MEDICAL SCIENTIST �Aumm 33 A reception was held during cheOctober 1988 meeting of the Ameru:an College of Surgeons in Chicago. 0 Left: Atlanta, American Academy of A Orthopaedic urgeon , 't,,,,11February 19 . BUFFAID rHYSICIAN AND SIOMEDlCAL SCIENTIST EARLY WINTER 1988 �P, opl & E enrs EVEN1'S . .................. Robert H. Se lle r, M.D. , has returned from a 1x-momh . abbatical as a visiting professor at Guy Hospital and Medical hoot in Lon­ don, England. A professor of family medicine and medicine at UB, Seller did research com­ paring cost-effective diagnosis of common medical complaints in the U.S. and Great Britain. He also studied po t-graduate educa­ tion in family medicine m Great Britain, Israel, the etherlands, and Denmark under a fellow htp from the 'lbrld Health Organization. • number of continuing medical education cour es are cheduled for 19 9. All are AMA- and AAFP-accredited.The fee for each i $275 for physicians and $155 for other health professionals. Marc h 17-19 • The Clearwater Beach a­ tional Conference on Pediatrics will be held from March 17-19 in the Holiday Inn Sur f Side, Clearwater, Ra. The sponsor is the emour Children's Clinic in Jacksonville, Aa. fur more information, contact Dr. Elliot F.Ellis, P.O.Box 5720,Jacksonville, Ra. 33247, or call (904) 390-3676. Virginia E. Robert on and Ann e G. Riz. zo, third-year medical rudents, and baron L. Ziegl e r, a fourth-year medical rudent, won first place in the Amencan Academy of Family Phy icians' 1988Student Communi­ ty Outreach Award competinon for their pro­ ject, an amt-smoking slide show that was presented to junior high school student . Carlo de Luna, a third-year student, won the runner-up prize m the 1988 Health Research Trammg Program of the e.,. York City Department of Health. Hi report was called "Development of a Computerized Reportable Di ease Surveillance System in New York City~ • D ana G . Wagle , M .D ., clinical a sistant professor in urology, has been named pre·ident•elect of the New York Scace rological Society. The director of the St. Joseph lntercommunity Hospital rodynam­ ics Clmic and Urology Section, Wagle is a past president of the medical staff and the Buffalo Urological Society. • Leon E. Farhi, M.D ., professor and chair­ man of physiology at B, participated in the Consensus Development Conference on Perioperative Red Cell Transfusion held at the ational Institutes of Health in June. The conference discussed problems related to blood transfu ions. • An article written by Venkataraman Batu, M.D ., a clinical associate professor in the UB Medical S hool, has been published in the Te.uu Heart Jwrnal, volume 15, No. 1 The article is titled •t.ong:ferm Survival of Patients with Poor Ejection Fraction; Sutiical versus Med ical Management." • EARLYll'INTER I . Diane Jaeger and Carlos Ruiz, both UB medical students, were among a dozen medical student from aero s the nation who attended the first Betty furd Center Med i al Student Professional -in-Residence Summer School m June . • Allan D . Depew , M.D ., chairman of the Department of Orthopaedic Surgery at Men:y Hospital and clinical assistant professor at UB, has been elected president of the New York State Society of Orthopaedic Surgeons. • Ca rter Pannill, M.D ., attending in medicine at Erie County Medical Center, received the White Coat Award from the resident in medicine of UB in recognition of h1 outstanding teaching. • Harry A. Sultz , D.D .S., M.P.H., professor of social and preventive medicine, addressed the First World Congress on Allied Health in Elsinore, Denmark, in June. He poke on the role of health services research in solving the problems of access to quality care. Sultz directs the Healch Services Research Program of the Schoo l of Medicine and Biomedical Sciences at UB. He is the former dean of the School of Health Related Professions here. • April 14-16 • UB's Department of Pediatrics ts ponsoring the inth ational Conference on Pediatric Lung Diseases to be held April 14-16m the Tradewinds, St. Petersburg Beach, Ra. fur more information, contact Dr. Ian athanson, 219 Bryant St., Buffalo, .Y. 14222, or call (716) 878-7561. June 9-11 • T he Amelia Island ationa l Conference on Family Practice will be held June 9-11 in the Amelia Island Plantation, Amelia I land, Fla. The ponsor is the emour Children's Clinic tn Jacksonville, Ra . fur more information, contact Dr. Elliot F.Elli.~,P.O.Box 5720, Jacksonville, Fla. 33247, or call (904) 390-3676. July 21-23 • UB's Department of Medicine is spo nsoring the 12th National Conferen e on Pediatric/Adu lt Alle!l:Y and Clinical Im• muno logy to be held July 21-23 in the fuur Seasons Hotel, Toronto, Onta rio. fur mo re information, contact Dr. Elliott Midd leto n , Jr., 100 High St., Buffalo, .Y.14203, or call (716) 845-2985. Augu t 4-6 • The Cape Cod Co nference on Pediatrics will be held Aug. '1-6 in the Tara Hyannis Hotel, Cape Cod, Mass. lt is spon ­ sored by the emours Children' Clinic in Jacksonville, Ra. fur more information, con• tact Dr. Elhot F.Ellis, ID. Bax5720, Jackson­ ville, Ra . 33247, or call (904) 390-3676. • BUFFALOPHY' ICIAN 1\,-D BIOMEDI I\L IENTIST �, :o~p,cal et 35 CHILDREN'S GETS $1.2 MILLION GRANT espiratory Syncyrial Viru (RSV), one of the most common respiratory tract infecrions in infant , willbe the subject of a $1.2 million grant at the Infectious Diseases Divi ion of Children's Hospital. RSV is a viral infection affecting millions of children world-wide, many of them under the age of two. Each year, 100to 150children are admitted to Children's Hospital with RSV "The National Institute of Allergy and In­ fectious Diseases grant will provide research funding through 19Q3;said Pearay L. Ogra, M.D., chief of the Divi ion of Infectious Diseases at Children's. Ogra is professor of mkrobiology and pediatTics at UB. •For the next five years, we will be looking to unde~tand what k.ind of lung disease RSV Produces, what are the best ways to immunize and treat RSV-induced disease and whether RSV infection increases allergic sensitivity to agencs - such as ragweed or pollen - par• ticularl y in allergy-prone patients." Symptoms of the infection include fever, wheezing, inflammation of mucous mem­ branes and watery eyes. The acute infection can last 7 to JOdays. RS can produce bron­ ~hiolitis, a severe lung infection, or croup, an inflammation of the larynx and upper airway. "Preemies have a high race of severe RSV infection: Ogra noted. "Westill don't know why RSV is more severe in children than adults.Working with Ogra are Howard S. Faden, M.D., professor of pediatrics at UB; Robert C. Welliver, M.D., professor of pediatrics at UB; Cindy Shuff, R.N., and several postdoc­ toral fellows. . Blood and throat samples &om RSV pa­ tients will play an important role in the research to develop an oral vaccine possibly composed of proteins &om the virus. "An oral vaccine may be more effective ag.ainst RSV than an injectable one; Ogra said. "Lymphoid tissue in the intestine has a tremendous capacity to produce immunity in th e lung and genital tract." While key answers to preventing RSV in- BlJFFhl.O PHYSICIA AND B!OMEOJCl\l SCIENTIST STEWART HEADS FLOW CYTOMETRY fection remain, Ogra 1scautiou ly optimistic. "We'reclose to under randing the nature of rh1sdisease,"he said. "Whether we willbe the ones to find the vaccine or whether our work will be a stepping stone in that direction is a matter of probabilities." • arleton C. Stewart, Ph.D., a noted immunologist and flow cytometry expert, has been named director of Roswell Park Memorial lnstitute's newly established Flow Cytometry Facility. Flow cycometry is a "high-tech" method of diagnosing and monitoring the progress of cancer. Roswell Park's facility will provide researchers ~'ith advanced capabilities for rapidly identifying normal and cancer cells I? and sorting them for diagnostic and func­ j;l tional purposes. The devices used have a level of sensinvity not available before and can 6nd ~ rare cells that may be cancerous and indicate ~ rhe pread of disease. Stewart comes to Roswell Park after seven A new three, torv research building 15 years at the LosAlamos arional Laboratory under cons1ruc1ion at the Vet<'rctnsAd mini.nration M d1cal Cenrer. rt•~part 01 in New Mexico, the last three years as chief 16.5 million e:cpansion project. of the experimenral pathology group, which has the mo t advanced flow cytometry laboratory in the world. He also had been an adjunct profcswr of pathology at the Univer­ sity of New Mexico School of Medicine since i VACONSTRUalNG RESEARCH BUILDING onstruction is under way on a $16.5 million expansion project at the Buf­ falo Veterans Admim tration Medical Center that includes a new three-story research building. The new building should be done in about a year. A covered corridor will connect the new building to the far end of the first-floor C Wing of the main building. The researchers on the 10th and 11thfloor of the main building will move to the new building, ~tarting a series of"domino" moves that will eventually see a number of new clinics becoming available in the Outpatient Department where space is needed badly. The money, &om the National Institutes of Health and the VA, will also pay for refur­ bishing the research facilities in the main building. The moral of this story might be that good things come to those who wait - the medical center has sought this funding since 1974. • 1982. • NEWREHAB CENTER OPENS IN AMHERST uffalo General Hospital has built an outpatient rehabilitation medicine and cardiac rehabilitation center on Bailey Avenue near Maple Rd. in the Town of Amherst. Called the Amher. c-General Rehab and Cardiac Center, it is an extension of the ser­ vices now offered at the hospital in its Rehabilitation Medicine Department and Cardiovascular Life Sciences Program. Outpatient servicesoffered at the center in­ clude physical therapy, occupational therapy, speech-language therapy, a return-to-work program, and medical rehabilitation. The center will accept only patients referred by a physician. • EARLYW!NTI:R1988 �Clas n te 36 Will iam J. Cunningham (M'69 ) • was named as istam vice president of Hoffmann-La Roche, lnc. and director of Clinical Research for the com• pany's new Dermatology Divi­ sion. ln his new position, Dr. Cunningham is responsible for strategic planning and clinical research and development, as well as registration and professional services activities related to der­ matologic products. Clara Unra t h-Zick (M ' 25 ) • would like to hear from members of her class. Dr. Zick's address is RD 8, Box 8062 Plotts Road Newton, N.J. 07860. ' Arthur W. Strom (M'32) • was elected laureate by the Michigan Chapter of the American College of Physician . Dr. Strom's winter adress is 2900 Gulf Shore Boulevard N., Naples, Aa. 33940. Samuel R. Patt i (M'34) • of Duokirk, N.Y.inform us that he retired in 1986. Maurice B. Furlong (M 'J5) • is medical director of Rehabilita­ tioo and Child Assessment Ser• vice at WCA Hospital in James­ town, .Y. T James A . Curtin (M'5 0) • is serving as chairman of the Board of Governors of the American College of Physicians for 1988.Dr. Curtin is chairman of the Depart• ment of Medicine at Washington Hospital Center, Washington, D.C. John . Parker (M ' 57) • is president of diagnostic asoociates Theodore W. Koss (M ' 41) • of in Latrobe, Pa. Dr. Parker was ap­ pointed an alternate delegate co Smithville, Tenn. i "eojoying the June meeting of the AMA. retirement and evading malprac­ tice insurance." James R. Do yle (M'59) • is an Frank L. Tabrah (M'43) • of anesthesiolog1st with Healthcare Honolulu, Hawaii, is professor of Medical Center in Tustin, Calif. Commuoity Health at the niversity of Hawaii, School of Mcdicne; 3S50Ciatemedical direc­ tor of the Straub Clinic and Hospital, and research 3S50Ciateat the Cancer Research Center of Hawaii. Dr. Tabrah is editor of Medical Manual for the Pacific Islands, econd edition, 1988. William F. Kneer (M'46 ) • of Grand Mand, N.Y., has retired after 38 years of active private practice in ob/gyn at DeGraff Memorial and Kenmore Mercy Hospitals. EARLYWINTER19118 Jeremy Col e (M'73) • of orrh­ ridge, Calif., passed his sub pecial­ ty boards in critical care medicine and is now triple board certified - pulmonary-internal medicine and critical care. Or. Cole is an assistant clinical professor of pulmonary di ease at UCLA. Ral ph R. Hallac (M '7 3) • is now associate chief of nephrology and chief of medical intensive care at Englewood Hospital in Englewood, N.J. Dr. Hallac and his wife Betsyhave three children: David, IS;Jamie, 12, and Steven, 7. Jo hn Claude Kru sz: (M'8 3) • has a private practice in neurology at Presbyterian Hospital of Dallas. Rob ert . Sch ni tzler (M'65 ) • is clinical professor of mL'<licineat the University of Texas Health Science Center, San Antonio, Texas, and is continuing as presi­ dent of the Cardiovascular In­ stitute for Continuing Medical Education and Research. Dr. Schnitzler serves on several na­ rional com mitrees and is currently chairman of the Subcommittee on Pacemakers. John G. Oyster (M'84) • is a partner in Dy ter and Oyster Family Phy icians and ass1Stant director of Family Medicine Residency at Memorial Medical Center, Niagara Falls, N.Y. Jeffrey G. Straus (M'84 ) • writes, •J authored an article en• ritled, 'A New &trobulbar Nee­ dle and Injection Technique; pub­ lished in the February 1988issue of OphlhalmicSuliery- The instru­ ment and method have been patented and will be marketed soon. l was an instructor at the 1988Annual Symposium of the American Society of Cataract and Refractive Surgery. The meeting was held in Los Angeles and the course was entitled 'Safer Eye Blocks Peribulbar, Retrobulbar, and Improvement: I have been accepted for a fellowship in Anterior egment Ophthalmic Surgery at the Manhattan Eye, Ear and Throat Hospital:' Lisa Strano-Paul (M'87) • re­ ceived the Carroll L Birch Award, the first prize in the AMWA national essay contest, for her honors thesis called "The Pathophysiology of Beta Thalassemia in Mice with Emphasis on Iron Deposition." Frank A. Luzi(M'88 ) • married Lori Guttuso (M'88 ) in April. BUFFALOPHYSICIANA D BIOMEDICALSCIENTIST �LET US HEAR FROM YOU LET US HEAR FROM YOU I want cokeep in touch with my classmates. Here is my news for the Classnotessection. I want co keep in touch with my classmates. Here is my news for the Classnotessection. Name Name Addn:ss Addn: Ci11, Stan,, Zip I I I Telephone l)qrtt/Ycar Pr.iuon or m le Other PfOllram/Ycar Comp~1cd Other PfOllram/ YearCompleted D,grcc/Yc~r PosiI ion ln1<it u1ion Telephone City, S1~••• Zip oT ti t lt- lmmution New,: Ncwa: I I I I • .., . , ' ' ' . '' , . • I 'I , , I I If '. ' ' I I I �Buffalo Physician&. State Unlversily of Ne 3435 Main Street a o, New York ~42 MEDICALHI TORJCALLIB. Kl~SALL TOWER, Sf. IALS DEPT M,AJN ST. CA r:>us RLIFFALO NY 14?14 � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Early Winter 1988 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1988-Early Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1988-v22n04-EarlyWinter Table Of Contents A list of subunits of the resource. Docs for Jocks A controversial alumnus Artificial blood Self-study Political violence Medical School News Alumni People and Events Hospital News Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-31 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v22n04 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1988 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/eb8c86dd30c4eb8efff8ab4e790bb275.pdf 58a0aba09f5017d0236e7205b69b4273 PDF Text Text Vol. 22, No. 2 SUMMER 1988 COLD,.BLOODm MURDER Or was it? Psychiatristsdisagree. �Dear Alumni, Alumnae , and Friends: BUFFALD PtJX§J~~ STAFF EXEClJllVE EDllDR UNIVERSITY PUBLICATIONS Robert T. Marle1t BUFFALO PHYSICIAN EDllDR Conni, O,,wald S,ofko AITT DIRECTOR Alan J. Kegler ADVISORYBOARD Dr. John Naughton, Chairman Dr. Harold Brody Ms. Nancy Glicco Dr. James Kansk1 Dr. Charles Paganelli Mr. Raymond Paohm Dr. Antoinette Pe,ers Dr. Charles Prue, Dr. Lu,her Robinson Dr. Thomas Rosenthal Dr. Saleela Suresh Dr. Burton Singerman Dr. Stephen Spaulding Dr. Ndson Torre Mr. Edward Wenzke Dr. Paul Wierzbi,n1ec Dr. Jerome Yates A unique program was held for all first-year residents in Buffalo by the Graduate Deneal and Medical Education Consortium of Buffalo. The program direc· tors have developed a one-week educational orientation pro· gram designed to prepare each resident with training in Ad· vanced Cardiac Life Support (ACLS), preparation for using proper teaching skills, understanding the issues of stress and coping, and several ocher areas that are of concern co brand new physicians as they accept the responsibilities associated with residency training. This week-long event is unique because it adds a week co the usual 52-week experience and it represents a coordinated effort sponsored by all of the residency training programs in the Consortium. In other words, it represents a core curricular experience as opposed to the usually provided vertical training experience by discipline. We plan to repeat chis effort on an annual basis and it could serve as a model for other universities around the country. We are heartened by che idea and the enthusiasm of the faculty who will be instrumental in the program. I am convinced chat chis activity represents another piece of evidence chat the medical school in Buffalo is both maturing and accepting its proper leader• ship role among the medical schools in New York Scace and the United States. Sincerely, John Naughton, M.D. Vice Pre5idencfor Clinical Affairs Dean, School of Medicine and BiomedicalScienm W RIT ERS Lisa Josephson Edwin M1rand Mary Beth Spina ILLUSTRATORS Barry Fmgerald Glynis Sweeny Dan Zakroczemsk1 PHOTOGRAPHERS Doug Levere Ed Nowak Ian Rcdinbaugh Simon Tong TEA C HING HOSPITALS Batavta Veterans Administration Medical Center Buffalo General Buffalo Veterans Administration Medical Center Children's Eric County Medical Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Chamy Produ,::,d lry tht D1u.11onof Um,=,ry Rtlation., in a.s.socuuionU-1th ,ht School of Mtd,cmc, S111re Umoro11)' of N= York at Buffalo. THE BUFFALO PHYSICIAN AND BIOMEDJCAL SC IENTIST CUSPS 551-860) Summer l9S8, Volume 22, Number 2. Published fi,.., rimes annually: LatoWinter, Spring, Summer, Aurumn, and Early Winter - by the School of Medicine, Stace Umvcrmy of New York ar Buffalo, 3435 Main Street, Buffalo, New York 14214. Third class bulk posragc paid ac Buffalo, New York. Send address changes 10 THE BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST, 146 C.F.S. Addition, 3435Mam Scrccr, Buffalo, New York 14214. Cove r Illustration: Dan ZakroqtTJUki Dear Fellow Alumni: T his year's Spring Clinical Day, again as years before, was a rousing success. The reunion classes met at che scientific program, and heard Dr. Robert Gale deliver the Stockton Kimball lecture detailing a firsthand accounting of the dangers of nuclear energy. This year we will make every effort co continue all the pro· grams that the Alumni Association has previously sponsored. A new program is the hosting program, where senior medical students are the guests of an alumnus at his house during che time that they are caking an interview. This program is new and we'd appreciate anyone who can put a student up for a night while he is taking an interview in another city co participate. Please do not hesitate co contact myself or Dr. Jack Richert at the School of Medicine and Biomedical Sciences. This year we will sponsor a University Consortium Residency Social Event as the new residents come to Buffalo. We also sponsored a welcoming party for the new medical students at the Medical School. If anyone has any further ideas as co what the Medical Alumni can do for the school or their members, do not hesitate co contact me. Sincerely, Paul H. Wien ;bieniec , M.D. �Summer 1988 Vol. 22, No. 2 2 Murder. Psychiatric experts who testified for opposing sides debate the "insanity defense." 8 Sprin g Clinical Da y. "Today's challenges in medicine" - breast cancer, AIDS, and myocardial infarction - were discussed at the annual event sponsored by the Medical Alumni Association. Robert Gale, M.D., who led an American medical team to treat victims of the Chernobyl nuclear disaster, was the main speaker. 12 Alumni Speak. Distinguished graduates revisited UB to deliver lecPage 18 tures: Franklyn G. Knox, dean of the Mayo Medical School, talked about funding for the National Institutes of Health; Alfred Spring Evans, director of the World Health Organization's Serum Reference Banik, discussed the Epstein-Barr virus, and Bertrand M. Bell, author of the so-called Bell Commission Report, defended the proposal to limit residents' hours. Departments 18 People . In his latest book, Louis Bakay offers a fascinating compilation of information on some of history's most interesting and influential surgeons. Page 14 25 Research. Divers take a simulated plunge to find ways to make diving safer. 26 Hos pital Ne w s. Here's a look at the man for whom Roswell Park Memorial Institute was named. The first cancer research center in the world, it celebrates its 90th anniversary this year. 36 Medical School N ews. Most UB students got the residencies they wanted on Match Day. Page8 JUL2 8 1988 �MURDER cOIJMILOODED , Or was it? Psychiatristsdisagree. ■ y co••·· OSWALD STOfKO of a $2,000 ames F. Bradley, 63, had paid off most Sitting in IRS debt, but still owed about $450. lDillon, an IRS Bradley'sCheektowagakitchen, Michae umentsallowing agent, was pressingBradley to signdoc rsto cover the the government to seize one of his two ca rest of the debt. came back Bradleywent upstairs,got his M,1 rifle, ke a good Act to the kitchen, and told the agent to ma n three times in of Contrition. Bradley then shot Dillo ain in the head. the torso,felt for a pulse,and shot him ag g, both the That's what happened in the 1983 killin t they disagreed ha d.W ee gr sea fen de the d an on uti ec os pr found not guilty by on was whether Bradley should be reason of insanity. o testified Brian Joseph, M.D., the psychiatrist wh severeparanoid for the defense,states that Bradleyhada mea concretiza, personalitydisorder.The IRSagent beca adley could do tion of Bradley'slifetime of fears, and Br nothing else but shoot the man . ution,stated Syed A. Farooq,testifyingfor the prosec who knew right that Bradleywas a mentally healthy man into his own from wrong, but decided to take the law hands. by reason Should Bradleyhave been found not guilty ing a continuing of insanity?The case was discusseddur entof Psychiatry educationpresentationof UB's Departm this spring. J �3 Bradley felt that his home was his fortress; he would kill to protect his wife and home, psychiatrists say. BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �4 Brian Joseph, a clinical assistant pro• fessor in the Department of Psychiatry and a clinical associate professor in the School of Health Related Professions ac UB, says yes, Bradley is not guilty. Bradley had a difficulc youth, Joseph said. His mother died the day before his sixth birthday. He and his brothers were cared for by an aunt, then moved to an orphanage, then to foster care. One brother eventually committed suicide and another died under unclear circumstances. Though he was an intellectual and a member of Mensa, on many occasions he displayed deranged behavior, the psychiatrist said. Bradley would seem normal and pleasant on an initial meeting, but he couldn't sustain an interpersonal relationship, Joseph said. He overresponded to real or imagined slights. He was relentless in his pursuit of the redress of any injustice, almost on a daily basis. "These weren't j~st normal tendencies" Joseph said. "This was excessive, exa~gerated suspiciousness of all activities all of the time." Like the character in the novel Catch 22, Bradley constantly volunteered for dangerous assignments during his military service in World War ll, alchough he never received chem. He lacer exaggerated his war stories and even people close to him thought he had seen action. The M-1 rifle he used in the shooting was not from his military ser• vice, but purchased by Bradley in the 1960s, Joseph said. When Bradley was discha rged in 1944, the Army psychiatrist said there was a marked possibility he might become SUMMER 1988 psychotic. Bradley claimed he was never separated from the military! He probably tried to commit suicide in 1971 when he drove his car in front of a train, but was uninjured, Joseph said. He invited his wife to enter a suicide pact with him in the mid-1970s, but she demurred. Planning to volunteer for the Nixon presidential campaign, he walked into campaign headqua rters wearing army fatigues and was turned down. He jumped from job to job. Between 1946 and 1981,he held 41 jobs, including those of teacher, mental health aide, and postal worker. Bradley worked for the IRS in Virginia. One day he picked up and left for Buffalo without telling his employers, Joseph said. He was fired and Bradley claimed that a "punitive audit" was started. Bradley kept a journal which revealed that he thought he was omniscient. He rarely mentioned friends in his writings, and he intellectualized co conceal his feelings, Joseph said. "He has an explanation for everything," Joseph said. "Everything can be rationalized." The reason he left the army, Bradley rationalized, was that someone was doing something to him. Bradley volunteered for Meals on Wheels, but dropped out because he felt they short• changed him on his travel allowance, the psychiatrist said. He wrote numerous, vague letters to public officials, including U.S. presidents. Bradley began rambling that he didn't understand why Dillon wouldn't leave him alone, Joseph said. He felc there was a plot against him by the IRS and decided that Dillon was a domestic enemy of the United States. Referring to the Goetz case where a Bradley would seem normal and pleasant on an initial meeting, but he couldn't sustain an interpersonal relationship. He overrespondedto real or imagined slights. "These . weren't 1ust normal tendencies'' Joseph said. ) TIS continued on page6. BUFFAID PHYSI CIAN AND BIOMEDIC AL SCIENTIST �5 No Syed A. Farooq, a clin ical assistant professor in the Department of Psychiatry and in the Department of Family Medicine ac UB, says Bradley should not have been found not guilty by reason of insanity. The question is not whether Bradley had a mental illness, Farooq said. The real question is whether he meets the criteria set up by law: whether he has a substantial degree of mental disease or mental defect that takes away his ability to know and appreciate the consequences of his actions. Farooq disagrees with Joseph on the severity of Bradley's condition. "ln the Bradley case, my interpretation was that he didn't have a substantial degree of mental disease:' Farooq emphasized. A videotape d interview with Bradley, conducted by Farooq, speaks for itself, the psychiatrist said. Portions of the interview were shown during the trial. (Several universities and federal departments, including the FBI and IRS, are now using the videotape to teach forensic psychiatry, Farooq noted.) "If you look at the tape in its entirety, there's no question of his guile or innocence," Farooq said. Bradley had some paranoid thoughts, but so do a lot of people, Farooq said. If a woman is afraid to go out alone after sunset, we may call her paranoid, but she may be realistic. "Paranoia is very common in society; Farooq said. "If you look at the Victorian era, ic was very common for ladies to pass out . Hysteria was the order of the day. That has been replaced in the '70s and '80s by paranoia. People are paranoid BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST about the government - maybe for justifiable reasons." After the shooting, IRS agents protested that their local supervisor went overboard by setting quotas on how much money each had to bring in by the end of the week. Bradley had agreed to pay, but disputed the schedule of payments, Farooq pointed out. One test for substantial mental disease is to see if the person functioned normally in society, and Farooq concluded that Bradley did. Bradley came from a very humble background. He grew up in an orphanage, educated himself, and received a master's degree at a time when having even a few years of college education was rare. He served his country in World War II. You've goc co give the man credit for volunteering for dangerous missions, even if he wasn't chosen, Farooq said. Bradley probably was passed over for dangerous assignments because he and his younger brother were the only living members of the family, and the military excused soldiers in such circumstances. Bradley probably could have been excused from the draft if he had wanted but pa id his dues to his country. ' Bradley later bragged to friends and relatives about these war exploits that never occu rred. But this exaggeration isn't out of the ordinary, the psychiatrist noted. "Talk to any veteran and you11see that everyone paints himself as a hero,"Farooq said. "People minimize their failures and glorify their successes. That's not abnormal. We all do that." Bradley raised two successful children. His son is a Harvard Law School graduate and his daughter is a Ph.D. The man was law-abiding to a fault, Syed A. Farooq "In the Bradley case, my interpretation was that he didn't have a substantial degree of mental disease," Farooq emphasized. A videotaped interview with Bradley, conducted by Farooq,speaks for itself, the psychiatrist said. NO conunuedon page 6. SUMMER !<188 �6 TIS ....... . . . . . ... .. .... . subway rider shot several teens he said were going to mug him, Bradley remarked, "For every one person mugged on the subway, hundreds are mugged by the IRS for as little as $30." "This man got fan mail in jail~ Joseph noted. In a videotaped interview conducted by Farooq, Bradley said he would kill to protect his wife and home. "To my way of thinking, I did nothing wrong but protect against a domestic enemy;' he stated calmly on the videotape. "Bradley had a paranoid personality disorder," Joseph explained. "This man was afraid all of his life. He was projecting his fears on something external." When Dillon came into his home and threatened to confiscate his possessions, "For the first time, the fear came inside. "Try to imagine that snakes terrorize you,"Joseph explained. "Youlive in dread of them every day of your life. One day, you find one in the kitchen. You don't panic; you've trained for this moment for 60 years. You get the rifle you've had for 25 years and destroy all of your fears. "Bradley couldn't do anything else because he was faced with the concrerization of his fears." NO . . . ..... ... .... .. ..... With his college education and status as a veteran, Bradley could have had any job he wanted, but underachieved, in Farooq's view. Bradley viewed his house as his fortress. When Dillon came to see him, he felt he was under attack. He knew he was breaking the law by shooting Dillon, and he knew Dillon would die. But Bradley felt justified in his actions, Farooq explained. "Probably his adjustment was not the most ideal, but that's the most I'd be willing to say," he said. "I would not even be willing to pin down a diagnosis. "There was a neurotic factor. But chat neuroticism chat made him change jobs, that made him underachieve, does not make him psychotic; does not make him mentally sick to the point chat he did not understand what he was doing." Farooq contends that the real issue in this case was the "heavy-handed tactics of the IRS." That case was never presented, Farooq said, although Terrence M. Connors, the defense attorney, disagrees. "The IRS has become the internal Gestapo in this country," Farooq said. "I felt very sympathetic to Mr. Bradley and Mr. Dillon. I feel both of them were victims. "Mr. Bradley himself was very unhappy • he was branded as mentally ill." THE Decision Bradley was initially charged with murder in the second degree (murder in the first degree involves killing a police officer,but the charge is essentially the same). The penalty is 15 years to life in prison. Bradley was found guilty of a lesser charge of • manslaughterand got a prison sentence of 6 to 20 years. He could be paroled in the fall of 1989, . Joseph noted. • Farooq said. If he were co categorize Bradley, Farooq would call him obsessive-compulsive. "Sure, there were some oddities in his behavior, but nobody's perfect," Farooq stated. "If he changed jobs frequently, does that give him a free ticket to kill anybody?" A lot of intelligent people, such as business executives, change jobs frequently, Farooq added. SUMMER19<!8 BUFFALOPHYSICIA.'-AND BIOMEDICALSCIENTIST �7 Joseph has testified in 13 jury trials and has done hundreds of evaluations of one sort or another. Farooq has testified extensively and worked as a consultant in the legal those as justification for why the person system. When testifying, Farooq prides shouldn't be held accountable for his ac- himself on using ordinary language. "1see my role as helping juries undertions. Others, like Farooq, interpret the law. They ask whether this person knew stand the issues involved," he said. 1 try the nature and consequences of his ac- to talk in language people can undertions or whether he had a big break with stand. Judges have remarked to me, 'You're the first one whose reasoning and reality. rationale I could follow? e's a philosophical difference, Farooq "And you've got co realize that the peoexplained. Some try to fit psychiatric ple who decide if rhe accused is guilty or dogma on the circumstances while not guilty are the jury. By definition others, like himself, try to interpret the they're lay people." statutes. Since the statutes talk about Psychiatrists are paid for their time as significant mental illness, Farooq expert witnesses, but that doesn't mean understands that to rule out minor they'll say anything the client wants. degrees of mental illness. When approached by an attorney, There are very few people who are real- Farooq says he makes it clear that the atly entitled to plead not guilty by reason torney may not like his findings. of insanity as the statutes are written. It's Sometimes the defense attorney will drop attempted too often, Farooq said. out when he finds out that he'll have to Even if a person was abused as a child, pay for Farooq's evaluation, even though it doesn't give him a free ticket to kill, there's the possibility it may be used by Farooq contends. Society still expects the prosecution. him to be a responsible citizen. Joseph said he receives about $150 an Polls show that the public believes the hour and makes no bones about his fees. "insanity defense" is overused. But Joseph Since he's an expert and his work is as said that if a lawyer uses the insanity significant as legal work, it should be defense a lot, he must have the "Rhett highly compensated, he said. Butler Syndrome" - a penchant for lost When you're an expert witness, "the causes. It doesn't work often, and lawyers defendant isn't the only one on trial, you use it in only a small percentage of cases. A study in New Jersey in 1982showed are," Joseph said. "I would ask anybody that out of 32,500 felonies, there were who says we do it only for the money only 50 insanity pleas. Of those, only 15 co try it. I don't see people flocking to do it." were successful, he said. The Psychiatrist as Expert Witness A Tom Toles editorial cartoon shows a five-headed psychiatrist on the witness stand. The heads start arguing with each ocher about whether the defendant is mentally ill. Finally the heads end up calling each other crazy. Yes,psychiatric experts disagree, but it's no different than any ocher field, say the psychiatrists who testified in the trial of James F. Bradley, the convicted killer of IRS agent Michael Dillon. Expert economises can't agree on whether the stock market is going co go up or down, noted Syed A. Farooq, a clinical assistant professor in the Department of Psychiatry and in the Department of Family Medicine at UB. He testified for the prosecution in the Bradley case. Engineers couldn't agree on whether a faulty design caused the Pinto automobile to explode after minor collisions, said Brian Joseph, a clinical assistant professor in the Department of Psychiatry and a clinical associate professor in Health Related Professions at UB. He testified for the defense in the Bradley case. In the Israeli trial of John Demjanjuk, charged with being the infamous Nazi "Ivan the Terrible; it was handwriting experts who didn't agree, Joseph added. "It doesn't make psychiatrists any better or worse," Joseph said. "So why pick on psychiatrists if they disagree?" One reason that psychiatrists don't always agree as expert witnesses is because they view the law on the "insanity defense" differently, said Farooq. If the defendant has some "soft" signs of mental illness, one psychiatrist uses BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST I Technically, it didn't work in the Bradley case even though Bradley was found guilty of a lesser charge, Joseph noted. Joseph and Farooq each have a great deal of experience upon which to base their opinions. Yet Joseph says he finds it interesting and challenging and he enjoys the give and take. A sense of helping patients is also a motivation, despite the fact it does nor take place in an office or a hospital. "And I've been watching 'LA Law' too much~ he quipped. - C.O.S. • SUMMER1'188 �8 By CONNIE OSWALD SIDFKO & USA JOSEPHSON memorial to the victims of the atomic bomb at Hiroshima reads, "Let these souls rest in peace for we will not repeat this error." "I hope that's ttue; I'm not entirely certain it's ttue," said Robert Peter Gale, M.D., Ph.D., a specialist in bone marrow transplantation. He gained world-wide attention when he led an American medical team that created victims of the 1986 explosion of the Chernobyl nuclear reactor. That disaster has profound implications for today's world. Gale, a 1970medical graduate of the UB Medical School, gave warnings about nuclear war and nuclear accidents when he presented the Stockton Kimball Memorial Lecture during UB's Spring Clinical Day on May 7. He received the Stockton Kimball Award for his timely and positive impact on the field of medicine. Gale, an associate professor of medicine in the Division of Hematology and Oncology at the University of California at Los Angeles, noted that we can't prevent nuclear accidents. "In 1988, we are dealing with some very complex technology nuclear energy, nuclear weapons, and space exploration; Gale said. I • "We are at the very limits of our technical expertise, and accidents cannot be prevented. We had Challenger, we had Three Mile Island, we had Chernobyl, and we will have more. "The consequences of these accidents are global. An accident anywhere is an accident everywhere." Radiation released in che Chernobyl accident covered Europe and parts of Asia and Africa, rhen headed toward Los Angeles, he pointed out. There might be an increase of 30,000 deaths from cancer over the next 50 years due co the accident - about half will occur inside the Soviet Union and half will be outside. Gale gave his speech just before flying to Kiev to meet with radiation specialises from all over the world. This meeting is part of his continuing commitment co provide optimal health care co the 135,000 people who were evacuated after the Chernobyl accident. "We're committed to a lifetime of follow-up of the survivors," he said. "That's longer than my lifetime since some of the survivors are children." Gale also wants to use this accident to learn as much as possible SUMMER 1988 about che relationship of radiation and cancer because chis is the best model of carcinogenesis we have. It's assumed that cancer is caused by changes in ONA. lf it can be discovered how radiation does that, it might be possible to learn how other things, such as nitrites, do it. Gale recently treated the victims of a different kind of nuclear accident in Goiania, Brazil. An unemployed laborer found a radiotherapy machine in a deserted building, left behind by a clinic that moved co new quarters. He took it to a junk dealer and they found a ball of cesium 137inside. Fascinated by the way it glowed, they broke it apart and gave it to family and friends. Some painted che substance on their bodies. Some even ace it. About 300 people were affected. "Don't think it couldn't happen in the United States," Gale warned. Several people died, including a six-year-old girl who ate the cesium. Her body, which will be highly radioactive for the next 300 years, is entombed in a concrete sarcophagus. "This is her brother, a 12-yearold boy who we were able to save; said Gale, showing a slide. "But he's highly radioactive. And except for a brief visiting period, we don't allow him to be in the company of other humans. You may think of him as the 20th century equivalent of a leper. He will excrete the cesium in about a year and will be able co return co society." Nuclear accidents also leave us the equivalent of the 20th century ghost town, he noted, showing what used to be a city with a population of 45,000 near the Chernobyl reactor. It's now evacuated and is crumbling under its own weight. Other forms of energy have a nuclear risk, coo, he noted. We have the 6th Fleet in the Persian Gulf guarding our supply of oil. A nuclear "accident" is more likely to occur there than at a nuclear power station. Medical intervention was possible in the case of the Brazilian and Soviet nuclear accidents. Patients could be saved if you could keep them from dying of bleeding or infection, Gale said. Medical personnel used antibiotics, protected environments, antiviral agents, and the replacement of missing blood products. To prevent or reduce the number of deaths from infection, in Brazil Gale tried an experimental drug called GM-CSF to stimulate the growth of bone marrow. The treattnent caused no side effects and seemed effective in several cases. The medical staff caring for radiation patients had to take elaborate BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �■ precautions because the patients themselves were radioactive, Gale noted. All of the patients' blood products had to be treated as radioactive wastes. Nurses were protected by high concrete walls and the staff was garbed in complex protective apparel. No female physicians of child-bearing age could work with the patients. The radiation levels of physicians had to be checked several times a day co make sure they didn't contaminate non-medical personnel. When it comes to nuclear war, however, "We shouldn't waste too much time making plans for a medical response; he said. If a nuclear device were exploded over Detroit, you'd probably need 42,000 burn beds. In the entire United States, there are only 1,500. And many of the physicians in the Detroit area would be among the half million people who would be killed immediately in the explosion. The average modern weapon is 30 times larger than the bomb that was dropped at Hiroshima, where 193,000 died. Whether you're talking about a limited or full nuclear exchange, you're talking about thousands and millions of times the result that occurred at Nagasaki, he noted. We can compete with the Soviets in football or the arts or literature, but we better not go head to head with them in nuclear strategy, Gale warned, or "it will lead to the end of civilization as we know it." If there's a bright side to the Chernobyl accident, it's that we found out that the Russians and Ame ricans can work together, Gale said. It also demonstrated a very clear mandate to change the status quo. • rollowing the theme of "Arming the Clinician for Today's Challenges in Medicine; the program of the May 7 Spring Clinical Day emphasized the practical aspects of three topics: breast cancer, AIDS, and acute myocardial infarction. Spring Clinical Day '88 and Reunion Weekend were sponsored by the Medical Alumni Association at UB. 1~1,~r ~,~~f~ J. Carl D'Orsi, M.D., emphasized the importance of mammography as an early detection device for breast cancer in women. D'Orsi, professor and vice chairman of the Department of Radiology at the University of Massachusetts Medical Center and professor of surgery there, addressed the concerns women have about get- BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTIST • • • • • ting cancer as a result of radiation from a mammography test. He said the dose of radiation in a mammogram is very low. He cited a study conducted to test the effects of radiation, which found that the death rate from breast cancer in the study group with a mammogram was below that of the control group without one. "Studies show that women who have mammograms have a lower incidence of breast cancer," said D'Orsi. "This is because we're able to find smaller breast cancers earlier and therefore are able to cure more. "The benefits of a mammogram are far greater than the risks of radiation from the test. We shouldn't hold back on doing them." D'Orsi also pointed out what doctors look for in mammograms. They look for stellate masses; fine, irregular clump calcifications, and architectural distortion and asymmetry. "The aim of a mammogram is co identify the malignancy before it becomes palpable," said D'Orsi, that is, before it can be felt or couched. Although mammography has been shown to decrease the in! cidence of breast cancer, many I physicians still don't use the test. 2~ According to D'Orsi, 41 per cent <.!) of physicians agreed with the use ~ of mammography, but only 11per _, I;\ cent used the test. ~ "The reason for this; said D'Orsi, "is the expense. The price is beginning to be addressed so that patients who don't have insurance can still have a mammogram." After a mammogram has been taken, D'Orsi advocated the patient's right to a precise report with specific recommendations. These included a routine follow-up, ultrasound, a six-month follow-up, and localization biopsy, depending on what's found on the mammogram. "A negative mammogram doesn't mean breast cancer isn't present; said D'Orsi. "In up to 10 per cent of the cases, a mammogram can't identify clinically palpable masses. This means that women over the age of 40 should visit a docror once a year." Breast conservation is equally as effective as mastectomy in many cases, but when dealing with a kind of breast cancer called duct carcinoma in situ (DCIS), the situation is more complicated, said Frank Gump, M.D. He is a professor of surgery and chief of breast services at Columbia University. "DCIS was a rare lesion until the wide-spread advent of screening mammography; said Gump. "The diagnosis is made on a mammogram when small flecks of calcium called microcalcifications draw the physi- _____ SUMMER IQ88 9 �I JO ■ ■ ■ ■ ■ cian's attention to the problem." In normal situations, no palpable mass is present in the breast, and the physician doing the biopsy is unable to recognize anything other than normal breast tissue. These lesions require preliminary localization with a needle technique so that the surgeon biopsies che right area. Confirmation that the microcalcification has been removed necessitates X-raying the specimen of breast tissue to be sure the calcifications are actually contained in the biopsy. "Mastectomy has been the traditional treatment for all kinds of cancer including invasive and in situ,• said Gump. "Patients are puzzled when they discover that breast preservation is a standard option for invasive cancer, and yet are told that mastectomy must be considered for in situ cancer, when it is a far earlier form of the disease." While mastectomy and radiotherapy are equivalent treatments for invasive cancer, it is not certain that the same can be said for in situ cancers. "It is generally agreed chat mastectomy will cure essentially all patients whose in situ cancer is detected when it is a purely microscopic lesion," said Gump. Although radiation therapy has been proven to work well on invasive cancers, there have not A ' been any randomized trials done for in situ cancers proving the same thing. "For that reason, the treatment for in situ cancer remains controversial, and patients muse participate in the final decision; said Gump. • j I~ ~ Education is the only cool we have now co control AIDS, but it's not enough, indicated Raphael Dolin, M.D., head of Infectious Diseases at the University of Rochester School of Medicine and Dentistry. Education isn't working well with some high-risk groups such as intravenous-drug users. It is working well with a highly motivated and highly educated cohort of gay men in San Francisco, but even that group sees a rate of new infections of l per cent a year. This is not co say we don't need education; we actually need more, Dolin said. But we also need co look to treatment drugs and vaccines - that's our only realistic hope. It's important to remember that the infection works in two ways, he said: SUMMER 1988 • It kills the white blood cell or renders it incapable of fighting infection. • Or, it enters the cell and remains in a latent state until it's somehow "perturbed~ Then the latent infection becomes an active infection, although Dolin said it's not certain how chat happens. Drugs such as Recrovir, also known as AZT, seem beneficial in killing the active infection, but there aren't any drugs that can cure the latent state, he explained. That's the key problem in finding drugs to fight AIDS. "lt's really our inability to cure these latent infections that is at the heart of che problem of developing antiviral therapy; he pointed out. The different "lifecycle" stages of the virus have been increasingly well defined and that may lead us to a specific biochemical inhibitor for each stage. When it comes co vaccines, there are two main problems, Dolin said. First, there may be an immunopathologic component. That means that if the body tries to mount an immune response, it'll make the disease worse or make the individual more susceptible, he explained. Second, there are different strains of the virus called HIV, and the strains might operate differently. A variety of vaccines have been proposed. The ones that have been looked at in great detail s are the "subunit" preparations made from purified glycoprotein from the virus. The trouble is chat the purer you make them, the less effective they become, Dolin noted. The University of Rochester was among a group of centers that tested a subunit vaccine called gpl60. It hasn't proved very immunogenic, he said. "Both the antiviral and vaccine approaches (co controlling AIDS) are receiving an enormous amount of attention and unprecedented resources," Dolin said. That's reason for optimism. "On the ocher hand, the problems themselves are extraordinarily complex,• he added. Whether we11be able to meet our goals in fighting AIDS is open to question. "However there is no question about the urgency for control measures and the terrible human tragedy this disease represents." Ross G. Hewitt, M.D., a clinical instructor in the Department of Medicine at UB and director of the lmmuno-Deficiency Clinic at the Erie County Medical Center, noted that in Buffalo the incidence of AIDS is low. ln addition, many of the cases didn't originate locally; people contracted the disease elsewhere and moved back home to get BUFFALOPHYSICIANANO BIOMEDICALSCIENTIST �11 the support of their families during their illness. ECMC is coordinating the care of AIDS patients in Buffalo. It treats many of the AIDS patients, possibly because their poor health has drained their bank accounts and the county hospital takes indigent cases. But ECMC won't be able to handle the increasing number of cases. "AIDS will have co become as well known to primary care physicians as diabetes and hypertension are,• Hewitt said. "We won't be able to handle all of the primary care ourselves." • To cut down on complications, it has been found, it's better to delay angioplasty (a procedure chat involves opening the blood vessel wider by inserting a catheter with a balloon on the end, then inflating the balloon). It's better to perform the angioplasty between 18 and 48 hours later, Ryan said. There are limitations to rhrombolytic therapy. The therapy can't be used for people over the age of 75, primarily because of the risk of bleeding, he noted. Another drawback is that in about 20 per cent of the cases, the blood vessel closes up soon after it's opened. The reinfarction rate In the last 10 years, we'veseen the advent of new therapy that is revolutionizing our approach to patients with acute myocardial infarctions, said Thomas J. Ryan, M.D., professor of medicine at Boston University School of Medicine and head of the Section on Cardiology at University Hospital, Boston University Medical Center. Called thrombolytic therapy, it was performed for the first time in 1978. The idea behind it is to remove the fresh clot that's blocking the coronary artery and is causing che heart attack. The guide wire of a cardiac catheter, nothing more than a piano wire, is pushed through the artery, Ryan said, and a thrombolytic agent called streptokinase is infused into the artery to open it. This procedure has been repeated many times in the last decade. It's been established that in the United States, if there are no contraindications, rhrombolytic agents should be used, he said. "When you do something to the clotting mechanism during an acute heart attack, you seem to save lives,"Ryan noted. Summarizing all of the srudies that have been done since the early 1980s, he said that thrombolytic therapy seems to accomplish that objective. It dissolves the blood clot and increases blood flow to the damaged myocardium, restoring some of its function. When that is done, a person's chances of survival increase. The earlier the therapy is given, the more effective it is, and it's best if given within cwo hours of the attack, he said. "That means there has to be a change in our culrural approach co getting to the hospital with symptoms of acute infarction," Ryan pointed out. "Not that many patients get there that soon. We have developed a remarkable denial mechanism in the United States and the latest comers to the hospital tend to be physicians.• BUFFALOPHYSICIANAND BIOMEDICALSCIENTISf is higher for patients who receive thrombolytic therapy than it is for the control group, he said. "We're saving lives with this therapy, but there are a lot of dayto-day questions," Jeffrey S. Schwartz, M.O., said about thrombolytic therapy. "Hopefully the answers will be coming out shortly:' Schwartz is a professor of medicine at UB and is head of rhe Division of Cardiology at Buffalo General Hospital. A hot topic, even in the popular press, is what drug is best co use. "If you read the New York Times, you probably know as much as the rest of us." he quipped. Most of the attention has focused on srreptokinase and tissue plasminogen activator (tPA}.Screptokinase may be as effective as tPA if given soon after the attack occurs. It costs about $200. On the ocher hand, tPA may be more effective than streptokinase if given later after the attack, bur it costs 10 times as much. Another day-to-day question is what physicians should do if a candidate for thrombolytic therapy arrives at a hospital that doesn't have a catheterization lab. Schwartz suggests that the patient receive the thrombolytic agent, such as srrepcokinase, then be transferred as soon as possible to a hospital that does have a catheterization lab. Other physicians suggest waiting to see if the patient remains stable during his entire hospital stay since a percentage of these patients won't need catheterization. "I tend to think I'd rather transfer the patient as soon as possible after the thrombolytic therapy rather than wait until something happens and you have an unstable patient." Schwartz said. It may not be necessary to catheterize all of these patients; Schwartz is doing that to be conservative, though he noted that he might change his view. • SL'MMER 1988 �RESEARCH FUNDING 12 It's important, but political issues could tie it up, says Knox B y T C O N N he National Institutes of Health (NIH) need more money in order "co cake advantage of che new opportunities chat medical science is making possible," but issues such as fecal research may become stumbling blocks for getting chat funding, said Franklyn G. Knox. Knox, dean of che Mayo Medical School and a graduate of both the pharmacy and medical schools ac UB, made the comments in April during his Bristol Myers lecture series at UB. As president of the Federation of American Societies for Experimental Biology, Knox was scheduled co testify the next week during Congressional hearings on the NIH budget. Using fecal tissue for research and therapy is a difficult political issue that may hamper the funding quest, Knox explained. "People who have strong views in those areas may tie up the larger picture," he noted. "The use of fecal tissue has some very important research and therapeutic implications at this point in time. The political difficulty has co do with tissue chat might be the produce of an abortion. People who are not in favor of abortion are not in favor of SUMMER 1988 E 0 S W A L D fetal research. "Certain controls are important, but a complete ban on fecal research is not in che public's interest." Fecal tissue has traditionally been used in the general area of toxicology, he explained: studying how che things that mothers might ingest or come in contact with will affect the fetus. "It's vital co continue the coxicologic studies for the health of future generations," he said. Fetal tissue can also be used therapeutically, he noted. For example, fetal tissue implanted into people suffering from Parkinson's disease seems to be more effective than mature tissue in treating that illness. Another political issue involves the very few but highly publicized incidents of fraud in biomedical research, Knox said. "The alleged misconduct in research casts a cloud over the research community as a whole," he said. "Unfortunately, it needs co be addressed. It is a fact on the current scene, even though we wish it weren't." K nox said that Congress should specify the number of research grants it S T O F K 0 wanes to fund rather than giving scientists a lump sum. Specifying the number of grams would provide stability co research, he said. That, in turn, would encourage young people co choose research careers. le would also give Congress a sense of what is being funded. Congress would have a target co shoot for and therefore a commitment co a certain level of activity. Researchers would also probab ly end up getting more money, he noted. Bue the drawback co specifying numbers of grams is that Congress tends co dictate co the NIH how money should be used, he added. T he proposed NIH budget is $7.1 billion, but $7.6 billion is needed just to maintain the current level of research. Knox believes the budget for the 1989 fiscal year should be $8.2 billion. "I don't lightly bring this recommendation, considering the budget dilemma," he said. "The re will be restraints in spending on every federal front, including biomedicine." Funding for research is important because "in the past, it has resulted in extraordinary advances in human health, which suggests that the money hasn't been spent, but invested," Knox said. For every dollar spent on health research, $13 is returned to the economy, he noted. And basic as well as applied research muse be funded, he contended. The classic example is the BUFFAIOPHYSICIAN AND BIO MEDICALSCIENTIST �of pharmacy in pare because his father was a pharmacist. "My father was my first role model," he noted. Another role model was Gerhard Levy, a distinguished professor of pharmaceutics at 13 UB, with whom Knox did research. Knox received his B.S. cum laude in 1959. Knox went on for his M.D. at UB, then branched out to the M.0./Ph.D. program of the medical school under the encouragement and guidance of Donald Rennie, professor of physiology and vice provost for research and graduate education. Knox graduated from that program in 1965. A prolific researcher, Knox has done much work in renal physiology, especially in the areas of regulation of sodium excretion, renal phosphate handling, and renal hemodynamics. Before joining the Mayo Clinic and Foundation in 1971, he was with the University of Missori in Columbia and with the National Heart Institute. He has been dean of the Mayo Medical School and director for education of the Mayo Foundation since 1983. He has served on the scientific advisory board of the National Kidney Foundation and the Board of Directors for the American Heart Association. Knox has served in I!! numerous capacities with ~ scientific organizations - na~ tional and international 8 and is currently on the National Research Council and the U.S. National Committee for the International Union of Physiological Sciences. "My career developed far beyond my original expectations," Knox said. "What 1 originally expected was to combine a career in education and research. I didn't anticipate this level of activity. "In other words, it worked out pretty well." • i broad-based polio research chat allowed people co avoid the iron lung, he said. Rather than studying only the development of better iron lungs, the answer lay in virology and developing a vaccine to prevent individuals from contracting the illness. "The money saved on that disease alone illustrates the point," Knox said. The very substantial progress in AIDS research that has been made in a short time wouldn't have been possible either without a broad research base that had been built years before, he pointed out. BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST Research training is a long process, Knox added. If we waited until a specific problem like AIDS ,arose before we trained researchers, there would be an intolerably long wait for a solution. K nox received his training at UB. He chose the field SUMMER1988 �• use as Sir Thomas Moore was a "man for all seasonsn because of his contributions to mankind as author, atesman, lawyer, and saint, the EpsteinBarr virus can be called a "virus for all seasons" because of its list of "contributionsn to human illness. That was rhe message of Alfred Spring Evans, A.B., M.A., M.D., M.P.H., EA.CE., who presented the D. W. Harrington Lecture in April. Evans, a 1943 graduate of the UB ./2 14 ample, 80 per cent of children are infected by the time they're 18 months old. In more hygienic and developed countries, people usually contract the virus much later in life. "It's transmitted by intimate oral contact - kissing - which is more fun; Evans noted. The virus may also be transmitted by other means, such as sharing soda pop bottles, but that's not well supported, he said. A Vz'rusorallSeason The Epstein-Barr virus has a long list of 'contributions' to human illness School of Medicine, is the John Rodman Paul Professor of Epidemiology at Yale University and the director of the World Health Organization's Serum Reference Bank He has written 200 publications. The Epstein-Barr virus can be credited with a diverse list of contributions to human illness, Evans said. There are acute manifestations, such as mononucleosis; chronic infections, also called the chronic mono syndrome, and several malignancies, particularly Burkitt's lymphoma and nasopharyngeal cancer. The virus may play a different role in each of these settings. Evans said he first came into contact with the virus when he was a young military recruit in Pennsylvania in 1944. He came down with infectious mononucleosis, accompanied by jaundice. It wasn't until 10 years later that it was shown that the virus is transmitted through salivary exchange, as in kissing. ln 1946 Evans was invited to work on the cause and clinical features of infectious mononucleosis at Yale University with John Rodman Paul who, in 1932, had discovered rhe heterophile antibody that is diagnostic of infectious mononucleosis. A cute mononucleosis is transmitted through saliva, Evans reiterated. In less developed cultures, mothers pass the virus to their babies when they pre-chew food for the children. In Ghana, for ex- SUM\tER 19ll8 Epstein-Barr virus infections aren't reported in most states. But in Connecticut, where they are reported, they've proved to be more common than rubella, hepatitis, mumps, and measles. Not everybody who is infected with the virus comes down with symptoms, and Evans suggested that stress may be a factor in determining who gets sick. At West Point, it was found that highly motivated cadets who were doing poorly in their studies came down with symptoms more often than those who were doing well. "There's probably a relationship between stress and the immune system," Evans said. "I don't know how it works, but it's probably for real." There's a chronic condition called Epstein-Ba rr Virus Syndrome, chronic mononucleosis, or chronic mono syndrome. (Evans objects to the label "Yuppie Flu" because that term only muddies the waters.) The symptoms are vague, but the hallmark is relentless fatigue, he explained. Some patients can only work one or two days a week. They may be unable to sleep and have pains in their joints, fever, sore throat, and recurrent headaches. It's not certain what causes the condition. Evans told an anecdote of a physician who varnished his living room with tung oil, then came down with severe mononucleosis syndrome. In the BUFFALOPHYSIC IAN AND BIOMEDICALSC[ENTIST �15 Kissing is one of the more enjoya ble ways of contracting the Epstein-Barr virus. The v irus is no fun at all. laboratory, it's been found chat an ingre• dient in tung oil activates the EpsteinBarr virus. "I would be skeptical of varnishing with tung oil until we found out more about it; he noted. There is a diagnostic test for the chronic condition, but the test is available only in research laboratories, Evans noted. The test checks to see if there are any antibodies to a product of the Epstein-Barr virus called EBNA I or Bam-K. Patients with the condition are unable to produce these antibodies. It's a pretty reliable marker if the antibodies BUFFALO PHYSICIAN AND BIOMEDICAL SCIENTISf are absent. T he Epstein-Barr virus is also in• volved in malignancies, such as African Burkitt's lymphoma, nasopharyngeal cancer, and Hodgkin's disease, he said. The evidence for a causal relationship is strongest for African Burkitt's lymphoma. In Hodgkin's disease, Evans found that antibody levels in healthy people who ultimately developed Hodgkin's disease were twice as high as in healthy people who didn't develop the disease. However, Evans isn't sure what to con- elude from that information. It could be that the Epstein-Barr virus is directly involved in the development of Hodgkin's disease. Or it could mean that the Epstein-Barr virus altered the immune system, allowing Hodgkin's disease to develop. Or it could simply be a marker; that is, it doesn't cause the disease, but can signal that a disturbance in the immune system is present that permits the emergence of Hodgkin's disease. Evans' father, the late John Evans, was a professor of anesthesiology at UB. Evans dedicated his lecture to his father and to his late wife, Brigitte. • SUMMER 1988 �16 Be ll To keep costs down, patients move through the hospital faster. "lc's the 'sicker-quicker' syndrome; he said. Medicine is also more highly technical today. While his teachers hadn't bee n able co cure much, they hadn't been able to do much to a patient, either, Bell noted. "The number of decisions that residents must make that could adversely affect the patient outcome are infinitely greater than they were 25, 15, 5 or even l year ago; Bell pointed out. Ir's very hard to convince the public that sleep-deprived residents can make consistently good decisions, he said. According to data compiled at greater New York City met ropolitan area hospitals, to be on call in 1988 in a volunta ry teaching hospital means a resident gets an average of 2.6 hours of sleep per day. That's the average for 122 different residency programs, including those that aren't acutecare specialties, he noted. There's only anecdotal information from the New York City municipal hospitals. One comment was chat there's no such thing as sufficient sleep for residents on call, Bell added. Normally, the resident who is on call during the night presents cases in the morning. Bell said he gave up on that practice because the residents were too sleepy. Residents are worried that they won't get a good education unless they work these long hours. Bue you can't be getting an education if you're th ree-quarters asleep, Bell countered. REDUCING RESIDENlS' HOURS B) CONNIE OS\X~LD SlDFKO I n 1960, people would have thought you were crazy if you suggested limiting the hours that residents work, said Bertrand M. Bell, M.O., author of the so-called Bell Commission Report chat recommended precisely that. Bur things are different today, Bell told his UB audience at the March induction ceremony of the Alpha Omega Alpha medical honor society. The recommendations that had been made by his group about eight months earlier had seemed radical, bur are becoming accepted in a short period of time, he noted. Bell, a 1955 graduate of the UB Medical School, is special assistant to the commissioner of rhe New York State Department of Health and a professor of medicine at Albert Einstein College of Medicine. In October, the Ad Ho c Advisory Committee on Emergency Services, chai red by Bell, made 19 recommendations involving emergency room services, the use of physical restraints, a drug compatibi lity information system, and the supervision and working conditions of residents. Included was a proposal chat residents be limited ro working 80 hou rs a week. These recommendations represent major reforms co the health-care system and would require a restructuring of the residency programs in the State. SUMMER 1'188 ell said that he thinks the recommendations of the committee will become the norm because they're becoming accepted in a short period of time. The time is right for these changes, he explained, and a quiet revolution is occurring. The first thing chat helped set the stage for change is the imbalance between care and cure that has evolved in the 30 years since he received his medical education. When Bell was a resident, he slept in the hospital - he really was a residentof the hospital. His teachers, who had been educated in the pre-NIH, pre-antibiotic era, knew what it was like to care for pneumonia patients before there was penicillin. "They were caring, and they communicated that to me as a student, and to their patients; Bell said. Today, cure is a rather dramatic focus of health care. In the last 30 years, we've forgotten the balance between cure and care and have placed the patient's needs in the background, he concends. Another reason for the quiet revolution is the realization by the public that the work of residents could be adversely affected by sleep deprivation or by lack of supervision . Residencies are different than they were 30 years ago, Bell said. Patiencs are sicker, and there is more intensive care. B 0 thers worry that the continuity of care will suffer and that residents will develop a time-clock attitude toward their work if they work fewer hours. But if we really believe in continuity of care and the residents' commitment to the patient, we're going about it wrong, Bell indicated. You can't make a commitment to the patient when you're sleep deprived. Two weeks before he gave his talk at UB, Bell received a report from the Ha rvard medical faculty saying chat their residents suffer from increased stress and fatigue for several reasons: the increasing patient load, more critically ill patients, and the decrease in ancillary hospital support, such as IV teams. They found BUFFALOPHYSICIAN AND BIOMEDICAL SCIENTIST �17 Res id ents aren't learni ng if they're half asleep, says Bertran d M. Be ll. it's hard for house officers to express problems about their work or personal lives. "lt's a problem not just in New York State," Bell pointed out. Residents are under such stress that they11 refer to arriving patients as "hits" or "crocks"or "gomers.•Residents develop cynical attitudes toward patients and begin to think of them as the enermy, he said. We have to show residents that we want them to care for patients as people, and we have to treat residents as people, too. Residents have suffered a significant number of injuries and deaths driving home from on-call duty. Bell told his audience that just the week before someone he knew was seriously injured in such a car accident. There's evidence that residents suffer from suicide, substance abuse, and family problems. "Residents need time to sleep, go to the bank, maybe even see a friend," Bell said. He also told of the final meeting of the ad hoc committee, which was attended by physicians and bureau crats. One doctor was arguing that a resident who had been on duty for 24 hours could deliver BUFFALO PHYSIC IAN AND BIO MEDICA L SCIENTIST a normal baby. One of the laymen commented to another, "Maybe for his wife, but not for mine.• "That's really telling," Bell said. T here's also not enough supervision in hospitals, Bell argued. Supervision is very important because a physician can do so much to a patient. The margin for error is very small. Yet the highest ranking physician on duty at night and on weekends could be a person who has been out of medical school for only one year. "We need to change the basic ambiance. Too often we encourage medical students and residents to show what they know," Bell pointed out. "They should feel very comfortable showing what they don't know. That's supervision. Asking the right question of the right person is the best way to learn." This in turn will help them deal with patients better. They can let the patient know that they may have to look something up or ask someone in order to answer a question. "Patients appreciate knowing their doc- tor will find the best experts when that's what's needed," Bell said. "And remember, we're talking post-graduate medical education, not service. We have to strike a balance between education and service. "The recommendations of the committee make sense," he asserted. "What we really want is quality assurance. If we have excellent patient care, we will have quality education." State Health Commissioner David Axelrod has agreed that some new money is necessary to implement these changes, and it's possible to get it, Bell said. Quoting Axelrod, Bell said that a society that's willing to pay for liver transplants and other expensive techniques will find the money for this. More ancillary staff is needed, but the issue is where we'll find the people, Bell said. There's a shortage of health professionals, such as physician's assistants, midwives, physical therapists, and nurses. If you want nurses, just pay them more, he remarked. Now that the demand has been identified, Bell said he is curious to see how it plays out in the educational system. • SU MMER 1988 �18 A s Dr. Louis Bakay walked through the rare books section of the Health Sciences Library at UB, he was like a young child, filled with wonder and awe, seeing something for the first time. He exuded enthusiasm for the history of medicine as he talked about the variety of rare books in this collection. "Isn't this beautiful; Bakay remarked in his thick Hungarian accent as he gently turned the yellowing pages of a medical book from rhe early 1700s. Watching Bakay casually stroll through the beautiful wooden bookcases filled with antiquated recollections of some of history's most important doctors, one can't help but get caught up in his excitement. "As a young man, before I went to medical school, I was seriously considering becoming a historian. That interest has never left me; said Bakay. Bakay, who retired in 1983 as chairman of the Department of Neurosurgery at UB's medical school, has used his retirement as an opportunity ro work full-rime on his ocher love - history. "Some doctors have no interests ocher than medicine," Bakay stated. "Then, when they retire, rhey have nothing to fill that void. I have been collecting data on medical history ever since I was a young doctor, and as time went on, I did more and more." Bakay has already published seven books and is currently working on another one. Neurosurgeons of the Pase,Bakay's latest attempt ac educating the public on the history of medicine, is a fascinating compilation of information about some of history's most interesting and influential surgeons. Bakay's command of this subject, his multilingual vocabulary (he can read eight different languages) which enables him to interpret ideas char others can't, and his enthusiasm make this book SUMMER 1988 interesting reading. Bakay describes rhe history of neurosurgery from the early Middle Ages to the late 19th century. He details some colorful and unusual men and their contributions to the surgery of the skull and brain. "Their work was closely related to the gradual improvement of surgical tools and co the transition of the concept of brain function from a mere metaphysical concept to a rational discipline of anatomy and physiology," said Bakay. Many of the simpler instruments still used today were actually invented anywhere from 400 to 1,000 years ago. The prototype for the drill was described in the early 1500s,and some other tools even go back ancient Roman rimes. Various knives and pliers used to remove pieces of bone were already in use in the 15th century. "Although back then; Bakay laughed, "these cools were used to remove not only broken bones, but also teeth." Also, instruments used to separate the dura mater {hard membrane covering the brain) from the skull are still used today. "Do you know what the literal translation of dura mater is!" Bakay grinned. "Ir's 'hard mother:" 1r is this sense of humor, and Bakay's appreciation of rhe unknown, rhar makes a rather cumbersome and difficult subject interesting. "I write mostly for my amusement; said Bakay. "Ir's challenging searching through such ancient materials and crying to translate the old languages. However, Medieval French is murder. "It can be very frustrating trying ro read B \' L s A J BUFFAIO PHYSICIAN A1'D �19 "I l J J 0 s E .i-;DBIOMEDICAL SCIENTIST p H s 0 N some words," he explained. "fur was surprised co discover that some major surgery on the head and example, in the 16th century an educated surgeon brain was done much earlier than we mentioned using plaster on the head (professionals) thought," said Bakay. and feet for patients with epilepsy "Brain tumors were actually removed in and other nervous disorders. In the pic- the late 1700s. The general opinion by tures there was a Pisces sign shown over modern day doctors was that this wasn't the guy's head. I wasn't sure if the word done until the 1880s."As Bakay writes: "While the history of craniotomy harks was supposed to be translated as plaster or fish, because it could mean either one. back to prehistoric times, and operations I decided to go with plaster. It was very on the skull were practiced all through funny though and had me confused for recorded history, surgery of the brain years. itself is of relatively recent vintage. Injury "The only other frustration l en- to the brain, either accidental or surgical, countered was trying to put my mind in was considered lethal well into the eighthe mind of someone who lived 600 years teenth century. There was one notable ago,"said Bakay. urhar was very difficult exception, Francois Quesnay, a French at times." surgeon of the mid-l 700s, who advocated In the Middle Ages, medicine was in- exploration of the brain in appropriate deed primitive compared to today's cases." Quesnay made a statement well medical technology. As a result, infection known to modern neurosurgeons that was rampant, especially in hospitals. "The conditions were filthy," Bakay traumatic swelling of the scalp can be commented. "Well-to-do families had mistaken for a depressed fracture, "a form operations performed at home where the of contusion which is very apt to deceive infection rate was lower." young practitioners." Quesnay was also the first surgeon who This was evidenced in his book when one surgeon from the mid-l 700s com- suggested surgical removal of intracerebral tumors - in 1743, stated mented that he wouldn't perform trepan (a surgical technique using a circular saw Bakay. "He based his opinion on his exto make a hole in the brain) in the perience dealing with abscesses and foreign bodies lodged in the brain tissue. hospital, "on account of the unwholeHe queried whether, once a tumor causes some scare in the air." Medicine has improved greatly since intolerable pain in the head, 'and if we the late 1800s. Two things that made should succeed in discovering its posimodern surgery what it is today are an- tion, would it not be reasonable to extiseptic and anesthesia, which were first tirpate the tumor, rather than leave the used on a practical scale in the 1870s. patient to perish miserably.'" Although Bakay rakes the history of "Before this, doctors used all kinds of potions to help dull the pain and kill medicine seriously, his sense of humor comes through constantly. fur example, bacteria," said Bakay. "Opium and in the chapter on Quesnay, Bakay writes: alcohol were used quite freely, inside and "Quesnay also became the physician out." and prorege of Madame de Pompadour, Neurosurgery, as a science, did not the king's official mistress. Quesnay, by emerge until the first half of this century, and was not considered a specialty by now 'Premiermedecin ordinaire'of Louis XV, rescued the king from a very embaritself until the 1920s. SUMMER 1988 �People 20 rassing situation when the latter became ill in the Pompadours' house, and according to some information, even improved the couple's love life by sound advice. This definitely needed improving because Madame de Pompadour was frigid." Another Frenchman, Antoine Louis, "one of the foremost surgeons of his age," helped invent the guillotine. Louis "was interested in the head in more ways than one. He helped the good Doctor Guillotine, a philanthropist who wanted to improve the method of execution with his new machine and who experimented with Louis on sheep at the Bicetre (hospital). The first experiments did not work out well, the blade, no matter how sharp, was likely to crush the neck rather than slice it. It was Louis who suggested that the blade be made slanted rather than straight across. Et voila, the guillotine as we know it was born." O ne of Bakay's favorite surgeons, Bereogario da Carpi, was "one of che great surgeons of all times," according to the author. Da Carpi wrote the first comprehensive monograph devoted entirely to head injuries in 1518, and developed his own instruments including the prototype of our brace with interchangeable drill points. Da Carpi was also the first surgeon who stated: "I do not believe that injuries to the meninges (various membranes covering the brain) and the brain are always mortal and that such patients cannot recover." He was aggressive in his treatment of patients and described the cases in derail ac a time when medical texts rarely contained case histories. "He was recognized as an authority on head injuries for centuries to come," stated Bakay. However, da Carpi was only interested SUMMER 1988 This 15th• ce ntury trepan , as illustrated in Neurosurgeons of the Past, was used to drill hol es in the skull. in treating patients who had a lot of money. Bakay noted, "he only undertook a cure after stipulating for his fees, which he reckoned not by tens, but by hundreds of crowns." Skilled surgeons such as Quesnay and Berengario da Carpi were the exception, not the rule, in the 16th and 17th centuries. Surgery in Europe, for the most part, was in the hands of barbers ("barbitonsores") and bathkeepers ("balneatoresj who were familiar with sores and skin disorders. There were also quacks of all kinds on the scene, and "itinerant scone cutters who occasional ly also removed a stone from the head with a sleight of hand!' "Some of the barbers were experienced, but most of them were abysmally ignorant, the bane of the profession," commented Bakay. In 1512, Henry Vlll prohibited craftsmen, women, sorcerers, weavers, and smiths from performing surgery. However, executioners, who were also torturers, were allowed to practice. "After all," writes Bakay, "they had some familiarity with human anatomy, at least in osteology (dealing with bones)." By the late 19th century, many changes in medicine had begun to take effect. Ernst von Bergmann, considered one of the great surgeons of Europe by 1882, introduced steam sterilization as well as the scrubbing of hands before surgery. He sterilized instruments, gowns, and linen used in the operating room, and insisted on long and meticulous scrubbing of the surgeon's hands. Bakay added, "When an old friend and fellow surgeon from the provinces visited him and asked, 'What's new in surgery?' he replied, 'Today we wash our hands before surgery!" Another major contribution Bergmann made co medicine was his meticulous experiments on the cardiovascular and respiratory effect of increased intracranial pressure. Bakay has been collecting material for this book over the lase five years. The bulk of material came from the Robert L. Brown History of Medicine Collection of the Health Sciences Library at UB. However, some material came from Bakay's own private collection that he's built up over the years. "I chink it's a crime that no kind of medical hisrory course is required for medical students ; said Bakay. "1t'simportant for surgeons today to know the history of medicine. Nobody knows anything past the beginning of this century." • BUFFALO PHYSICIAN ANO BIOMEDICAL SCIENTIST �People 21 Cedric Smith , M.D., professor of phar• macology and therapeutics at UB has been certified by the American Medical Society on Alcoholism and Other Drug Dependencies.• James P. Nolan , M.D., chairman of the Department of Medicine at UB, has been named Governor of the Yearby the American College of Physicians. Nolan was honored for his success in developing local programs for the society and representing the society at the State level on issues concerning health and public policy. He is currently governor for the society's New York Upstate Region and pres• ident of the society's New York Scace Chapter. • Research published by Herb ert Schuel, Ph .D ., an associate professor in the Depart• ment of Anatomical Sciences in UB's Medical School, has been listed as one of the most frequently cited articles in the field of developmental biology in the past 30 years. Schuel's article, "Secretory Functions of Egg Cortical Granules in Fertilization and Development: A Critical Review~ was published in Gamete Researchin 1978. le is listed as one of the top 17 articles in developmental biology cited from 1955-1985 by other researchers who have contributed to the professional literature in the field. The listing was included in a recent issue of Current Contents which devoted an article to citation analysis of developmental biology journals over a period of three decades. • Maire T. Hakala , Ph.D. , MSC, who pioneered the development of using the drug 5-fluorouracil (FUra) in combination with citrovorum factor (CF) to treat patients with advanced colo-rectal and breast carcinomas, was recently honored at an international sym• posium on "The Expanding Role ofrolats and Auoropyrimidines in Cancer Chemotherapl She is a research associate professor in pharmacology in the Roswell Park Graduate Division. The symposium, held at Roswell Park Memorial Institute, included leaders in the field of clinical cancer chemotherapy from the Federal Republic of Germany, Italy, France, Canada, and the United States. • BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST Rae Rodne y Jacobs Rae Rodne y Jaco bs (M'62 ) • inter• nationally known for his work in developing a spinal rod used in treating spinal fractures and deformities as well as developing other forms of spinal fixation devices presently in clinical trial, died suddenly on March 14. Jacobs was a professor of orthopaedic surgery at the University of Kansas and chief of orthopaedic surgery at the Veteran's Administration Medical Center in Kansas. As a member of the Association for the Study of Internal Fixation (ASIF), a research group working on new implants for straightening the spine of fracture patients, Jacobs traveled around the country teaching his technique for internal fixation. The locking hook spinal rod system, which he patented in 1981 and introduced co che or• chopaedic marker in 1985, is used in fractures of the thoraco-lumbar spine chat result in either posterior ligamentous disruption, or vertebral body fracture, or both, and in spinal deformities such as scoliosis, kyphosis, lor• dosis, and spondylolirhesis. Jacobs was director of one of the most prestigious spine fellowships in the world. This fellowship program will continue, and an international spine fellowship has been created in his honor. In addition, the Rae Jacobs Spine Society has been established in his honor to support and carry on his work. Described as "a big guy" with a chick salt- and-pepper beard and moustache, Rae Jacobs was known for his love of life. "He was an ex• tremely colorful man with many interests; said Jean Oberhaus, his secreta ry for rhe last eight years. He was not afraid to start a controversy. "lf there was a rule against something he wanted to do, the rule was wrong, not him; remarked Dr. Pasquale Montesano. "He didn't play by a lot of the rules in the medical profession. Rae did what he felt was right, regardless of what others thought." As a fellow of Jacobs at Kansas University, Montesano became one of his closest friends. "He was the kind of guy who went out of his way to make people feel at ease; seated Montesano. "When I went co Kansas for my fellowship interview, Rae set me up in a hotel, took me out co dinner, and cook the time to get to know me as an individual. "Although he had firm religious and fami• ly commitmencs, he always gave a lot of his time outside of work to his residents and fellows, and was well-liked and respected by all~ In 1972, Jacobs was chosen to be a traveling fellow of the American Orthopaedic Association, and recently received the 1988 Volvo Award in Clinical Sciences, an annual award given for spine research. He was also an active member of che International Society for the Study of the Lumbar Spine and of the American Academy of Orthopaedic Surgeons, was on the board of directors for the Scoliosis Research Society, and was chairman of the North American Spine Study Group of ASIF since 1985. As a professor at Kansas University, research and reaching were his greatest loves. Jacobs was very supportive and gave his time generously, but he was also very demanding of chose who worked with him. "He had a different way of getting perfection from people; said Montesano. "People strived to get his approval because they wanted co satisfy him because he was such a great guy:' He is survived by his two sons, Chris and Greg Jacobs; his father, Darwin Jacobs, a graduate of rhe UB Dental School, and his • mother, Mabel Jacobs. - L.J. SUMMER 1988 �It takes dedication and grueling training to be a physician - or a 22 cross-countrychampion, Dr. David O'Keeffe has discovered RESIDENT ONTHE RUN By LISA JOSEPHSON How does one person juggle a medical residency, a wife and three kids, and a competitive running career? The answer's simple. Get up between 4 and 5 a.m. every day, have an extremely supportive family, and love what you do. This is the life of David O'Keeffe, a third-year family medicine resident at UB, who recently competed in the annual World Cross-Country Championships in New Zealand. O'Keeffe's manner is very relaxed, but he becomes animated when talking about running. His blue eyes light up with excitement and his voice conveys his passion for his sport. "I feel like a real runner now; exclaimed O'Keeffe. "I went down to New Zealand with all the runners you read about in the papers who are trying out for the Olympics. I feel like I deserved to be there, though, because I qua lified, and it was the best race I have ever run. Everything involved in it went in my direction." O' Keeffe is able to balance the th ree aspects of his life by getting up very early in the morning. A typical day begins at 4 a.m. on the running track with his dog Ash ley. "She helps me train; O'Keeffe jokes. "She goes crazy if I run without he r." H is training varies depending on his schedule at the hospital SUMMER 1988 Dav id O' Keeffe and his level of endurance at the time. In an average week, O'Keeffe runs between 70 and 75 miles. However, one day each week he runs only 4 or 5 miles or not at all. "Most serious runners average between 90 and 100 miles a week; said O'Keeffe. "I make compromises and do what I can do. I don't do as many miles as most runners, but my intensity is higher." He runs 440-yard track intervals, faster than race pace, with only a 110-yardrecovery. He repeats this 24 times. This continues BUFFALO PHYSICIAN AND BIO MEDI CAL SCIENTIST �23 for a few months until he feels he's ready co move up to 880 yards 12-to 16-hour day, depending on whether he's on call or workat race pace. He also runs hill repeats, up and down a large hill, ing in the outpatient clinic. When asked how he finds time for a social life, O'Keeffe co get ready for cross-country races. "Cross-country is a tougher race because you run across grass, quipped, "l don't. My wife and l don't go out. That's okay, though, right dirt, hills, ruts, and watert said O'Keeffe. "It's also the most fun." because we don't have the money anyway, and we're happy now.~ O'Keeffe, who's been married for five years and has three fter a grueling, hour-long workout on the track, O'Keeffe stops home, briefly, to shower, eat, and say good morning children aged 4 years, 3 years, and 8 months, said, "My family the to his kids. Then it's off to the hospital for an approximately sometimes suffers because of my hectic schedule, but when A BUFFALOrHYSICIANAl'.D BIOMEDICALSCIENTIST SUMMER l<l!<S �People 24 chips are down, they will always come first." Of tremendous help to O'Keeffe is his wife Mary's support. "I wasn't going to run in the National Cross-Country Championships; said O'Keeffe, "but my wife pushed me. She said, 'How can you not run?'• On the subject of running, O'Keeffe can't say enough. His interest really began in high school when one of his teachers encouraged him to run. But it wasn't until he went to Manhattan College as an undergraduate that he became a serious competitor. "A friend of mine was the captain of the track team, and convinced me to go out," he stated. "At that point, l wasn't a runner and was in terrible pain for the first few months. Something kept me going, though, until 1 got past that point. "I guess I was always athletically inclined toward running. I had the right build, and I enjoyed it because I got a sense of accomplishment. There was a very individual satisfaction I got from running. I could see the results." O'Keeffe became fairly good in college, but he lacked the confidence needed to really excel. "Running is a very mental sport," he said. "It's all mind over matter. You're going to have pain, but you can push yourself beyond that if you wane to." hen he began medical school, he gave up running because he didn't think he'd have the time. That didn't lase very long, though, as his love for running overcame his need for time. "I got back into running because it was important to me mentally and physically; he recalled. "l figured I was going to be tired anyway. 1 might as well feel good and be rired." O'Keeffe quit running two more times; once when he started his third-year of clinical work and again when he started residency. Both times he went back after only a short time. "It reduced stress, helped me sleep better - residents don't get too much sleep - and minimized the fact that residency was an attack against my well-being. Running was something 1could do for myself that could help me maintain control." O'Keeffe started running competitively in the Buffalo Runner of the Year races and did quite well, which motivated him to run even more. Then last year, he entered the Turkey Trot, held annually in Buffalo. "[ ran a very good race," he admitted. W A s a result, he entered the National Cross-Country Championships two days later and came in 40th out of about 200. "That meant enough to me to say, yes, I can run these races and do well," he said. SUMMER1988 O'Keeffe's biggest achievement to date was qualifying for the World Cross-Country Championships in New l.ealand. He's very proud of his performance. "I was lucky for the trials; he said. "Some runners who could have easily beaten me were not there. But there were also runners there, who expected to qualify, whom I beat. "It was really an over-achievement, though, because I really had no right to be there. I was surprised I got to the national level so soon." O'Keeffe's outcome at the World Championships reflected his quick jump onto the fast track. He came in 140th out of a field of over 200. Although he was disappointed with his performance, O'Keeffe is more determined than ever to continue his running career. "Once I get to that race day, everything is on the line. You can't pay for that thrill," he exclaimed. "I learned a lot from the New l.ealand race," he admitted. "l know not to ignore my physical limitations, and I also gained more confidence and motivation. I'm running more now, between 90 and 100 miles a week in preparation for next year." O'Keeffe plans to be in at least the top ten in the Nationals next year. "lfI can accomplish that, then I'll aim higher," he said. "I figure l have about lO more good running years left to do what I can do." Asked if there were any similarities between running and medical school, O'Keeffe replied, "You have to sacrifice to achieve what you expect in both. You can't be cavalier and still accomplish your goals." O'Keeffe also plans to study and practice sports medicine, which he feels concretely connects the two disciplines. "I think being an athlete will help me in treating other athletes; he said. ln the fall, O'Keeffe will be doing a six-month fellowship in sports medicine at Union Memorial Hospital, affiliated with Johns Hopkins, in Baltimore. He then intends to return to UB and work in family medicine and help develop a sports medicine program. O'Keeffe plans to modify his medical career within the next 10 years, depending on how well he does with running. However, he stated that he could never give up medicine for running or running for medicine. "I could never work hours and hours on just one thing and do nothing else. I would be bored," he said. "Medicine is very important to me. I'm excited about sports medicine and wellness, but I'm not willing to become obsessed with them. "I can run and have a career as a doctor, which I feel is better than those who just run, because I'm able to concentrate on what's really important to me." • BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Research 25 20-fooc-long, seven-foot-diameter chamber from 1:30 p.m. April 19 until they emerged April 27 at 8:07 p.m., spent their final 31 hours being decompressed. Their tissues had become saturated with nitrogen after the first 24 hours in confinement, Lundgren says. Meals were delivered twice daily via airlocks to the three, who had most of the comforts of home in their four-bunk chamber, which was also equipped with bath and coilet facilities. One of the three, technician Jerald George, celebrated his 23rd birthday on April 23 with a specially decorated cake and the gift of several goldfish in a bowl. When the divers emerged, the goldfish swimming in their glass container - shared l!I the spotlight. ~ The three men were quick to give credit to ~ the dozen crew members who worked outside the chamber around-the-dock. Most of chem right , and Dan A nd erson, M.D., seated . worked 12- to 14-hour shifts co monitor the divers and the intricate equipment used to determine the oxygen pressure required for gas washout from blood and tissues at a variety of pressures. A physician was always on duty outside the chamber to help ensure the divers' well being. The scientists involved in the study say they hope that when data is compiled and evaluated it may provide new information leading to more precise guidelines for faster characterized by joint pain and discomfort in and safer decompression of divers. body organs. "Being able to determine methods by which This life-threatening medical problem ocdecompression can be accomplished more curs when divers, who have accumulated quickly - yet safely - is of interest co divers amounts of nitrogen in blood and tissues and to the diving industry, which has many because of underwater pressure, surface too man-hours tied up in the decompression proquickly. This nitrogen build-up must be cess," the UB scientists said. gradually reversed before they can safely Lundgren estimates that it will be several return topside. months before the results of the study are Decompression may require several hours complete. co several days, depending upon the length The divers, who shared champagne with and depth of the dive, explained Claes Lundgren, M.D., Ph.D., the UB professor of friends and co-workers after •re-surfacing,"said they did not suffer from claustrophobia or physiology who directed the study. anxiety during confinement. The chamber used in the study has the Admittedly glad to be out of the chamber, widest pressure capacity of any in the Western they praised the technical crews who were world. le is capable of simulating depths awake and alert even as the divers slept. 5,700 feet below sea level and altitudes up to "It was defintely a team effort," they em100,000 feet as well. phasized. • The three UB divers, who lived in the ia Jerald Geo rge, left ; Domini c DelRosso, UB divers emerge high and dry; have hopes to make diving safer By MARY BETH SPINA T hree divers at UB who lived for more than a week in a chamber pressur• ized co simulate conditions found SO feet below sea level, emerged April 27 amid cheers from co-workers and media. They are Dan Anderson, M.D., Ph.D., a fellow in the Department of Physiology, who directed the study inside the chamber; technician Jerald George, and engineering student Dominic DelRosso. The three, who were continuously confined to the chamber, participated in a study supported by the New York Sea Grant Institute which may provide guidelines for faster yet safe decompression of divers who work ot play deep below the water's surface. Divers who resurface too quickly after being exposed to increased atmospheric pressures found underwater can suffer from decompression sickness or "the bends," BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST SUMMER 1988 �By EDWIN A. MIRAND t the turn of the century, both society and the medical profession held prim1nve and harsh attitudes toward cancer panenc,. Deeply concerned by this, Dr Roswell Park was determined to change those attitudes m a systematic fashion. Park felt the only way to conquer cancer \\as through organized research with the full resources that an institution can provide. This was a bold and original approa(;h m the 19th century, particular• SUMMER IQRS ly the idea of getting f(Overnment funds to support the effort. What Park gave to the cancer com• munity at large was a legacv - the con• cept of a cancer re-earch center. Le ders in medicine and science from the U.S. and abroad came to visit Park to study his institutional concept. As a rc,ult, other cancer centers \\ere started. Still one of the large~t cancer centers m the world, Roswell Park Memorial ln~titute, the nsmute \\h1ch Park found- ed and now bean, his name, celebrates its 90th anniversary this year. Founded in 1898 at the University of Buffalo Medical School, the insmutc connnue~ its University tu.:~ through its status as a graduate division of UB. known Park, an internationally ~urgt.-on,was among the fir~t to call the attcnnon of the country and the world to the fact, long contested, that cancer is steadily on the increase. Born in Pomfret, Conn., on May 4, SCIENTIST IIUFFAI.OPHYSICIAN AND BIOMEOIC'.AL ��Hospital News 28 1852, Park later moved to Chicago. A gifted surgeon, he traveled to Buffalo in 1883 to become professor of surgery at the University of Buffalo School of Medicine, leaving behind an established practice. D uring the next 30 years, he became a prominent figure in the Buffalo community and one of the leading names in the field of surgery and cancer. "Dr. Park has done more work and better work than any person in America in this direction and his work has not only met with great encouragement and recognition abroad, but is recognized as being as good as any done there," stated Dr. W. W Keen, a famous surgeon in the early part of this century . The famous Dr. William Osler in 1903 wrote to Or. Park: "considering the enormous and increasing importance of the subject, it is surprising how little systematic work on cancer has been undertaken in this country . So far as I know, the only Institute devoted to it is that organized by you and supported by the New York State Government. I was most delightfully impressed on my recent visit with the character of the researches going on in the Laboratory." A nothe r colleague who encouraged Or. Park to continue with his organized research approach to tackle the cancer problem was Or. William H. Welch of Johns Hopkins, who is credited with transforming United Scates medical schools from the worst in the world to the best in one generation. When Park's institute added a hospita l to its facilities, Dr. James Ewing, an internationally renowned professor of pathology, became convinced that progress in cancer research depended on this idea of developing a cancer research hospital where research findings could be applied directly to the treatment of cance r. SUMMER 1988 In 1901 th e can ce r ce nt e r m o..,ed int o a building inscrib ed "Gratw ick Lab o ratory - Univer sity of Buffalo ." Park f elt ce rtain that a cure f or can ce r wo uld be fo und qui ckl y and th e building th en w ould be turn ed O'-'er to UB . Th e building was re placed by th e prese nt Scien ce Building in 1954 . Park compiled an ourstanding record as a professor and a researcher and was referred to as a "Renaissance Man." Or. Charles G. Stockton described him as "vigorous, handsome, highly trained; possessed with the traditions of learning, a pervading sense of humor, and an air . .. of distinction; a skilled musician, a witty and brilliant conversationalist .. . he quickly formed an extensive acquaintance among the foremost wherever he went." His students recognized him as a superb reacher. Park's knowledge was prodigious and he was widely read in history, classical mythology, and the humanities. He wrote extensively on esoteric subjects such as medico-Christian symbolism, thanacology (coping with death), the relationship of che Grecian mysteries co the foundation of Christianity, student life in the early Middle Ages, and the works of Giordano Bruno, the 16th century philosopher, astronomer, and mathematician. During his career, Park received honorary degrees from Harvard (M.D.) and Yale (LLD.); served on many national and international boards and committees; wrote 167 textbooks, articles, and monographs, and lectured before numerous scientific societies throughout the world. I n 1904, while speaking before a group of physicians and scientists in Berlin, Park predicted chat at the then-present rate, cancer deaths would ultimately rival deaths from tuberculosis. Time has not only proved him right; it has made his ultimate goal - che cure for cancer more imperative . Park was a man of boundless determination and energy. He was plagued by ill health during che last year of his life, but remained active. He planned the Internacional Confere nce on School Hygiene, convened in Buffalo in 1913. BUFFAI.O PHYSICIAN AND BIOMEDICAL SCIEl'fllST �--- - -- - - Hospital News 29 Following a heart attack, he returned to hospital and college service, and continued to perform many operations with his customary skill. To the protestations of chose nearest to him and of his devoted associate Dr. Edgar R. McGuire, urging more rest, he used to quote a favorite aphorism, "the future reserves for us repose enough." On Feb. 13, 1914, he wrote co Dr. A. L. Benedict: "Within two or three days l hope to be able to get away for a much needed rest of somewhat indefinite length." Early in the morning of Feb. IS, he died. The life of Dr. Roswell Park was so full and rich, his accomplishments so large and many, that it remains an example of usefulness. Those of us associated in the conquest of cancer appreciate the importance of his designs to approach cancer problems through systematic research in an environment of an institution charged with the mission co unravel the mystery of cancer. Since Park, other permanent institute directors have been Dr. H. R. Gaylord (1904-1923), Dr. B. T. Simpson (19241943), Dr. L. Kress (1945-1952),Dr. G. E. Moore (1952-1967),Dr. J. T. Grace (19671970), Dr. G. P.Murphy (1970-1985),and currently Dr. Thomas Tomasi. • Editor'sNoce:Dr. EdwinA M,mnd i.sa=ce direc- tor of the RoswellParkMemoriallnsmure and dean of the RPM/ Gmduate Oi.,i.sionof UB. Catholic hospitals form PPO called HealthSource T he nine Catholic hospitals in Western New York have formed a preferred provider organization (PPO) called the Western New York Preferred Provider Organization and marketed under the name HealthSource. BUFFAIOPHYSICIANAND BIOMEDICALSCIENTIST The plan aims to provide high quali- without compromising the quality of ty, low cost health care, primarily to care,• he said. Though self-insured employers are the employees of self-insured businesses and to the employees of the nine hospitals, plan's main target, HealthSource will also according to Thomas J. Doney, executive contract with ocher health insurance companies, offering a fully insured health director of HealchSource. The plan has been described as a mid- product. To participate in HealrhSource, physidle ground between a health maintenance organization (HMO) and cians must purchase one share of stock in the enterprise and pay a one-time fee indemnity insurance coverage. The PPO is different from HMOs of $250. The governance structure heavily inbecause patients aren't limited to seeing participating physicians, though there volves physicians, Doney noted. The are financial incentives to using these board of directors consists of an administrator and a physician from each preferred physicians, Doney said. It's also different from ordinary health hospital. insurance. ln the PPO, a self-insured The participating hospitals are: employer will pay the health-care claims • Mount Sr. Mary's Hospital, of his employees directly to the doctor Lewiston or hospital without using an insurance • Our Lady of Victory Hospital, company, Blue Cross/Blue Shield, or Lackawanna other indemnity insurer. • St. Francis Hospital, Buffalo The doctors and hospitals benefit • St. Francis Hospital, Olean because competition for patients is so • St. Joseph Intercommunicy keen, he said, and the plan will channel Hospital, Cheektowaga patients to participating doctors and • Sisters of Charity Hospital, Buffalo hospitals. • Kenmore Mercy Hospital, Kenmore Employees will benefit from the plan • Mercy Hospital, Buffalo because it will offer them many benefits, • Sc. Jerome Hospital, Batavia such as office visits, while reducing costs, "This represents the largest health-care Doney said. network in Western New York, and it's Self-insured employers benefit because probably the least costly; said Doney. the plan will help them control costs, HealrhSource is run by the Western Doney said. The nine Catholic hospitals New York Care Network, a for-profit corare probably the least costly in the area poration. Its focus now is HealthSource, and the participating physicians have bur other projects are planned. agreed to accept a fee that often is less "We want co provide health care conthan they're charging now. sistent with deeply held religious beliefs," said Richard 8. Russell, vice president of ealrhSource is setting up a strin- the board of directors of HealrhSource. Bishop Edward Head noted that the gent utilization review and quality assurance program to make sure chat first hospital in Buffalo was a Catholic physicians are doing the proper thing, at hospital - Sisters Hospital. "Now there are nine and they've the proper time, at the proper cost, he explained. For example, a second opin- joined together to give good health care and make it as accessible as possible ro ion for surgery is mandatory. "le will help che employer reduce costs people who need it," the bishop said. • H SUMMER 1988 �Hospital r-,ietvs JO N ano-technology will eventually allow the reconstruction of body organs one atom at a time, and by the year 2500 death ,, ill become a voluntary event. We'll have to rethink our whole concept of death. That wa~one of the forecasts made by Leland Kaiser, Ph.D., president of Kaiser Associates, a management consulting firm in the health-care industry. He discussed "Health-care Public Policy: 2000 and Beyond~ during the 1988 Vital Issues Symposium cosponsored by the Millard Fillmore Hospitals and the Millard Fillmore Health, Education, and Research Foun• dation, Inc. The event was held in UB's Center for Tomorrow. The next few years will be the white• water period of health care, Kaiser said. In the short run there'll be pain, but in the long run there'll be gain. Everybody's going ro pay more for health care, he predicted. Shortly after the year 2000, health care will constitute 22 per cent of the gross national product. "That's awful,~he said. "We should be spending 50 per cent. There's no better way to spend money than to promote the well-being of people. "If we could take every dollar our of Shortly after the year 2000, health care will constitute 22 per cent of the grossnational product. "That's awful. We should be spending 50 per cent. There's no better way to spend money than to promote the ~ell-being of people." RLFFALOPHYSICIA~ Al\D BIOMEDICALSCIEi'.71ST �31 LI.I.ISTRAllON 8AARI'FITZGERALD BUFFAID PHYSICIAN AND BIOMEDICAL SCIENTisr SUMMER 1988 �Hospital News 32 defense and put it into health care, I'd rejoice. It costs less to heal a person than to kill one. So don't get caught up on the bandwagon of 'Let's decrease health-care costs!" Some patients won't have the money to cover the expensive and mindboggling technological innovations that are on the horizon. In the next seven years, the gap between the "haves" and "have nots" will become greater, he predicted . We need this inequity in the beginning to create equity in the end, he explained. People will learn that, sta rting with their first jobs, they must save for health care and their old age. If you live to be 100, you can't trust the government to do that for you, he added . People will be willing to pay for health ca re, Kaiser predicted . "We have one product people can't live without - life,"he said. Therefore, people will mortgage their houses or sell their cars to pay for health care. "You can live without shoes, but you can't live without life," he pointed out . "So people will save money and change their lifestyles~ T he most expensive equipment coming is an NM R imaging holograph, which might cost $50 million, Kaiser said. The machine would be able to project a large three-dimensional image of internal organs. To see what's wrong with the patient, the doctor will simply have to take a stroll th rough the image. The Japanese are already building something like it for the television industry. Hospitals of the future will play a different role than they do today - they will become body shops. Every single part in the body will be replaceable. ln the future, -as Kaiser cells it, a man will be able to walk into a urologist's office and say, "Doc, I just shot off my water SUMMER1988 Supercomputerswill revolutionize health care. Every patient will be monitored on,line by computer through sensors attached to their bodies. Kaiser thinks that someday there will be cybernetic care units where a computer does everything from evaluating a patient's condition to dispensing medication to collecting money for the bill. pump!" "Not to worry; the doctor will reply as he bolts on a new one. Each hospital will eventually offer its own unique high-tech product, Kaiser said . This will create a na t iona l marketplace in health care. Patients will peruse consumers' guides describing what each hospital offers, then hop on a plane to get the service they need. Supercomputers will revolutionize health care, he said. Every patient will be monitored on-line by computer through sensors attached to their bodies. Kaiser thinks that someday there will be cybernetic care units where a computer does everything from evaluati ng a patient's condition to dispensing medication to collecting money for the bill. Almost everything now done by doctors at the bedside will be taken over by nurses. Doctors do much of their bedside work because of the perception that they can do it better than nurses can . But if you're using supercomputers, the difference between the skills of doctors and nurses disappea rs, he pointed out. Hospitals will need fewer people probably one doctor per hospital and one nurse per floor. Those people will be better trained and better compensated. Paradoxically, the computerized hospital makes possible more nurturance, Kaiser said. Since people won't have to do those things that machines can do better, they'll have more time for human contact. Kaiser emphasized to his audience that they have control over the future. The way to change the futu re of health care is to change the way doctors, nurses, and hospital trustees th ink and to draw up a blueprint for change. "The future's too important to guess at; he said. "If you make a forecast, and then go and do it, your accuracy (in predicting the future) will be very high~ - c.o.s. • BUFFALOPHYSICIANAND BIOMEDICALSCIEl'n1ST �Hospital News 33 John P. Visco, M.O., clinical assistant professor in medicine, vice president; Richard Peer, M.0., clinical assistant professor in surgery, secretary, and Matthew J. O'Brien, M.O., clinical assistant professor in medicine, treasurer. • Modernization program set at cancer center R Oswell Park Memorial Institute plans a multi-million dollar modernization program that will create a stare-of-the-art facility, including construction of a new hospital, at Roswell Park by 1995. The first phase, to be completed in September, will be an inventory and evaluation of existing facilities at Roswell Park. New construction and renovation and/or selective demolition of facilities are being considered, said Gail E. Johnstone, director of planning. Many projects are planned or proposed in connection with the modernization. They include bone marrow transplantation, a magnetic resonance imaging center, a division of cell and molecular diagnostics, and a center for NMR/peptide structure and function. "When the major modernization program is completed, Roswell Park will be able to offer cancer patients from Western New York and around the coun• try the most up-to-dare cancer treatments available; said Thomas B. Tomasi, M.D., director of Roswell Park. "It will also provide research facilities that will enable Roswell Park to compete even more successfully for grants to develop and advance promising leads in cancer research~ • Sisters joins team to treat disaster victims S isters of Charity Hospital has joined the National Medical Disaster Team, a comprehensive medical system to provide acute care for mass casualties. The federal system supplements local and state disaster plans in providing medical care to victims of major natural disaster or industrial accidents in the United States. It is BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST Children's chooses medical staff officers J ohn P. Menchini, M.O., a clinical assistant professor of pediatrics at UB, is president of the medical staff at Children's Hospital of Buffalo for 1988. A graduate of Canisius College, Menchini received his medical degree from UB. He has been an attending physician at Children's for 15years and has a private practice in Buffalo. Particia K. Duffner, M.0., an associate professor of neurology and pediatrics at UB, is the new vice president, and Richard Judelsohn, M.O., a clinical associate professor of pediatrics, is secretary/treasurer. • John P. Menchini Schaefer elected head of Sisters medical staff A rthur J. Schaefer, M.D., clinical associate professor in ophthalmola cooperative effort of the Veterans Adogy at UB, has been elected presiministration, Department of Health and Human Services, the Department of Defense, dent of the Sisters Hospital medical staff for the Federal Emergency Management Agen• 1988-89. Schaefer is chief of ophthalmology at cy, state and local governments, and the Sisters and Sc. Joseph's hospitals, and direc• • private sector. tor of ophthalmic plastic and reconscructive surgery at both the Erie County Medical Center and Buffalo General Hospital. Other officers are David Albert, M.O., research associate professor in urology, homas D. Doeblin, M.0., clinical president-elect; Kandala Chary, M.B.B.S., associate professor of medicine at clinical insttuctor in medicine, secretary, and UB, has been elected president of che Algirdas Gamziukas, M.D., treasurer. At-large members are Carl Schueler, M.0., medical staff at the Buffalo General Hospital clinical instructor in family medicine; Ralph for 1988.He succeedsSidney Anchone, M.D. Doeblin is an artending physician in the Sperrazza,M.O., clinical assistant professor in gynecology-obstetrics; Kenneth Eckhert Jr., Department of Medicine at the hospital. Other medical staff officersfor 1988include M.O., clinical assistant professor of surgery, Michael M. Madden, M.0., clinical assistant and Norman Sfeir, M.0., clinical instructor professor in anesthesiology, president-elect; in medicine. Buffalo General elects medical staff T • SUMMER 1988 �I Research& Medical School 34 Patients believe sinus surgery helps P atients who undergo nasal or sinus surgery overwhelmingly believe it has helped relieve breathing difficulties, nasal congestion and other symptoms associated with moderate to severe recurrent sinus problems, say UB researchers. The study, said UB otolaryngologist Sanford R. Hoffman, M.D., is the first to clearly demonstrate the health benefits patients perceive they derive from this type of surgery. Hoffman, who directed the study, is clinical associate professor of otolaryngology and is affiliated with the Buffalo Otological Group (BOG). "Studies like this one," says Hoffman, "are becoming increasingly important in medicine as a means of assessing potential health benefits in light of efforts to contain costs to patients and third-party payers~ Study results also provide physicians with information which helps them assessthe potential benefits to patients prior to surgery. The UB study, conducted by faculty in the Departments of Otolaryngology and Social and Preventive Medicine, was based on retrospective reports from 114patients treated surgically for sinus problems in 1984-85by members of the BOG. Hoffman said 88 per cent of the patients reported they had benefited from the surgery. When asked to be more specific, 90 per cent claimed it alleviated breathing problems they had prio r to surgery; 88 per cent noted their nasal congestion had improved. There was also noticeable improvement in sinus-related head or face pain reported by 85 per cent. The study showed sinus infections decreasedfollowing surgery in 83 per cent while 80 per cent said the surgery lessened pesky post-nasal drip. Only 12 per cent claimed to have received no benefit from the surgery. Hoffman notes that the 114patients m the study were treated without use of sinus endoscopy, which was not in common use in the U.S. at the time the surgeries were performed. Endoscopy, which utilizes a metal tube containing fiber-optic rods which provide improved lighting and magnification of the surgical area, allows even more precise surgery to be performed with less damage to surrounding tissue. "We could therefore expect when the surgery is performed with use of endoscopy, the patients' perception of health benefits may be ever greater today," Hoffman said. Even though there have been technological advances in diagnosis and treatment through CT scanning and endoscopy, the physician should continue to emphasize the historical signs and clinical findings as primary considerations for the surgery, he believes. Others on the research team were Raffi Dersarkissian, a UB medical student; Steven H. Buck, M.D., and Gerald Stinziano, M.D., clinical assistant professors of otolaryngology; and Germaine Buck, Ph.D., an epidemiologist in the Department of Social and Preventive Medicine.- M.B.S. The questionnairesare coming! Tog111e et·eryalumnus and alumna an opportumiy io be accuraiel)'listed in che upcoming neu Alumni Oirecwryof ihe UB School of Medicine and Biomedical Sciences,we'll soon mail questionnairesto all for whom we ha11ea curreni address. Pleasebe surew completeand ren,m wur direcWr) questionnaire as soon as possible. SUMMER1%8 The information will be edited and processedb) our publisher,Harris Publishing Co., Inc. More than 4,500 of our great alumni will be includedin ihis impressive ne«· directory. Don'i wke a chanceof beinginadvertently omicted - return )Our questionnaire prompcly! • Lebenthal honored for work in nutrition E manuel Lebenthal, professor of pediatrics at UB, was recently honored for his work in infant nutrition and gastrointestinal disease during a program commemorating the Holocaust. The program, called "The Jewish Physician's Commitment to Future Generations: Lessons from the Holocaust," was sponsored by Chabad House of Buffalo. Lebenthal IS director of rhe International Institute for Infant Nutrition and Gastrointestinal Disease and chief of the Division of Gastroentcrology and Nutrition at Children's Hospital. His commitment to the problem of hunger and the world's children has made itself felt all over the globe. His research contributions have enabled Third World nations to seem the specter of infant malnutrition, chronic diarrhea, and infant mortality. Lebenthal is editor-in-chief of The lniernational Journalof PediatricGasiroenrerology and Nuirition and a member of UNICEPs Scientific Board for Health. In 1984,he received the International Prize of Modern Nutrition for his outstanding contributions on the impact of gastrointestinal development on infant nutrition. • Thoracic surgeons honor Richard Adler R ichard H. Adler, M.D., professor of thoracic surgery at UB, was honored at a thoracic surgical teaching days program held in April at Buffalo General Hospital. Adler is the founder and past director of the cardiothoracic residency program at the UB School of Medicine and Biomedical Sciences. He is also past head of the Division of Thoracic Surgery at Buffalo General. Adler has been associated with UB and Buffalo General since 1955when he established the thoracic divisions at the institutions. Considered a regional resource for treat- BUFFALOPHYSICIANAND BIOMEDICALSCIENTIST �Medical School & People 35 uses high-frequency sound waves to diagnose and creat diseases of the eye. One recent application of chis technology, developed under Coleman's direction, is the acoustic biopsy, a painless, non-invasive procedure chat often eliminates the need for diagnostic surgery.• ment of cancer of the lung and diseases of the esophagus, Adler also is an influential and highly respected professor. In 1982-83, he received the Louis and Ruch A. Siegel Distinguished Teaching Award with Honors for excellence in teaching ar UB. The Buffalo General Hospital Department of Surgery gave him the C.P.Chandra Outstanding Teaching Award in 1984-85. He was the only American physician chosen in 1968 to spend a year in Taiwan as a visiting surgery professor at the National Defense Medical Center in Taipei. • Finland's Red Cross honors James Mohn J UB students receive prestigious fellowships S Jame s M o hn ames F. Mohn, M.D., director of UB's American Blood Commission. He is a conErnest Witebsky Center for Immunology, sultant in hematology for the Erie County Medical Center and the Vetecans Administra· was one of 20 international scientists rion Medical Center and is director of the honored by the Finnish Red Cross-Blood Transfusion Service (FRC-BTS)for their work Ernest Witebsky Blood Transfusion Service of the Buffalo General Hospital. • in blood and blood transfusion services. Each of the 20 received a specially struck bronze medal featuring the profile of Harri R. Nevanlinna, M.D., first director of the FRC-BTS, and the organization's logo, two intertwined hearts depicting blood transfusion. Nevanlinna, who is retiring and was also Jackson Coleman, M.D., a 1960 honored at the dinner, was a Buswell Fellow graduate of the UB Medical in UB's Department of Microbiology Blood School, has received the presGroup Research Unit from 1969-70. tigious Lucien Howe Award. Mohn, a 1944 graduate of the UB School Coleman, an internationally renowned of Medicine, is professor of microbiology and ophthalmologist and chairman of the Departdirector of the Blood Group Research Unit. ment of Ophthalmology at the New York Hospital-Cornell Medical Center, received He is chairman of the New York Council on Human Blood and Transfusion Services the award from the UB School of Medicine as well as irs Regulations and Standards Com- and Biomedical Sciences and the Buffalo Ophthalmologic Sociery. mittee. He is a member of the Erie County The award is named for Lucien Howe, AIDS Advisory Council and an ex-officio M.O., a membe r of the UB faculty from member of the AIDS Institute Advisory 1882-1923. Council for New York Scace. Coleman has been the John Milton In addition, he's a member of the board of McLean professor, chairman of Ophthaldirectors of the Greater Buffalo Chapter, American Red Cross as well as its executive mology, and ophthalmologist-in-chief at the board. Mohn is chairman-elect of the chapter New York Hospital-Cornell Medical Center and is vice chairman for blood services. since 1979. Among Coleman's significant concribucions He is one of the founders of the International Society of Hematology and has to medical science is the development of served on numerous committees of the ophthalmic ultrasound, a technology chat Coleman receives Lucien Howe Award D. BUFFAIDPHYSICIANAND BIOMEDICALSCIEl\'TIST everal UB medical students have won nationally compericive fellowships. They include: • Anthony Blanford and Barbara Creighton won Smichkline Beckman Medical Perspectives Fellowships co study changes in medical care among the Athabascna Indians. Only 30 of these fellowships are awarded. • Rohit Bakshi won an Alpha Omega Alpha Fellowship and an American Heart Association Fellowship in Cerebrovascular Disease.Seven AOA fellowshipsand 10 heart association fellowships are awarded. • Geoffrey Hamill won an American Heart Association Fellowship in Cerebrovascular Disease. • Jennifer Henkind won a University of California at Davis Ophthalmology Fellowship. • Chi Kim won a Travelers Geriatric Fellowship. Ten of these fellowships are awarded. • Howard Stoll and Ramesh Parthasarachy won Children's Hospital of Los Angeles Summer Research in Oncology Fellowships. Ten of these fellowships are awarded. • Jennifer Broman received an Infectious Diseases Society of America Research Fellowship. Ten are awarded. • ERRATUM The second meeting of the James Platt White Society was held in October. A headline in the Spring 1988issue of the Buffalo Ph)sicianand BiomedicalScientist mistakenly billed it as the first meeting. SUMMER 19<!S �Medical School News 36 fil Students Find Good Match With Residency Programs arch 23 was one of the first warm days of spring, but not warm enough to make people sweat that much. The tension in Butler Auditorium was palpable. Even casual observers were biting their nails. This was the day when the senior medical students found out where they would spend their hospital residencies. Students had listed their choices and were matched through computer with programs across the country. The students waited nervously for their names to be called. To make the anticipation more cruel, the envelopes weren't in alphabetical order. A group of students toward the front of the auditorium opened a bottle of champagne even before their names were M called, perhaps out of confidence that they were there to celebrate. As students were summoned, they walked hurriedly to the stage, a couple balancing babies on their hips. Then came sounds of ripping paper, followed by squeals and shouts, hugging and clapping, handshakes and back-slapping. In a few cases, there was disappointed silence. "We'rewithin a percentage point oflast year, which was a particularly good match year; noted Dennis Nadler, M.D., assistant dean of student affairs in the School of Medicine and Biomedical Sciences. Of the 131 participants, about 60 per cent were matched with their first choice. About 14 per cent received their second choice and about 8 per cent, their third. Only about 7 per cent were matched below their fourth choice, according to Nadler. Cameras flashed and champagne corks popped like firecrackers on the fourth of July. The group near the front of the auditorium opened its second bottle. There was an announcement about a party to be held that evening at Paddy O's. Then the shouts subsided and the noise fell to an excited babble as students compared notes with friends on the pros and cons of their destinations. For the most part, this was a subdued class, remarked one veteran observer. Subdued, but happy. • �LET US HEAR FROM YOU LET US HEAR FROM YOU I want to keep in touch with my classmates. Here is my news for the Classnotes section. I want to keep in touch with my classmates. Here is my news for the Classnotes section. Na me Name Add ress Address C ity, State, Z,p Telephone Degree/Year Position or title Other Program/Year Comp leted Institution City, State, 7,p Telephone Othe r Program/Year Completed Degree/Year Position or ulle News: News: □ Chtck if "'"- add~ss □ Check of nm add~ss lnscnution �BUFFAlD PtiY§J~!6.N State Univers,ty of New York at Buffalo 3435 Main Street Buffalo, New York 14214 Address Correction Requested � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Summer 1988 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1988-Summer Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1988-v22n02-Summer Table Of Contents A list of subunits of the resource. Murder Spring Clinical Day Alumni Speak People Research Hospital News Medical School News Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo physician Buffalo medical review Date Created Date of creation of the resource. 2018-08-31 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v22n02 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1988 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/7310f19c9046f66cd4f6920e55f34d34.pdf c24a55871beeb69a2788087f7f4b5a5c PDF Text Text �Dear Alumni, Alumnae, and Friends: W STAFF EXECUTIVE EDITOR IVERSITY PUBLICATIO S Robert T. Marleu BUFFAI.D PHY !CIA EDITOR Connie Oswald Stofl:o ART DIRECTOR Alan J. Kegler ADVISO RY BOARD Dr. John aughton, Cha,nnan Dr. Harold Brody Ms. Nancy Gheco Dr. James Kanski Or. Charles Paganelli Mr. Raymond Paolini Dr. Antoinette p.,,.r Dr. Charles Pruec Dr. Lu,her Robinson Dr. Thoma Rosenthal Or. aleela uresh Dr. Burton Singerman Dr. S cphen Spaulding Dr. elson Torre Mr. Edward Wcruke Dr. Jerome Yates Dr. Franklin Zcplow1tt e welcome a new edito r for the Buffalo Physicuman:1 Biomedical Sciencisc with this edition. Connie Oswald Stofko, formerly associated with the Univer­ sity's weekly publication, the Reporcer,wa cho en co replace Bruce Kershner. We know that she will maintain the high tan­ dard and innovations that Bruce brought to the publication and chat she will be a strong editor. The Advi ory Board ha been reconstituted and will meet with her and a sociated member of the publication staff five times annually. 1 hope you will continue to find the publication informative, attractive, and illuminating. Please conta t Connie with any sugge tions that will he lp improve the publication. ince the last publication, the school has been involved in two new programs. Working in coopera tion with the School of Social Work and with faculty and administrative represen­ tative from the School of ursing, Health Related Profession , and Dental Medicine, we ecured approval to be de ignated one of six Alzheimer's Centers by ew York Scare, and we were awarded a major grant program from the ational Institute of Developmental Disabilitie and Rehabilitation Re earch to e tablish a Traumatic Brain Injury Center. The latter will serve as a school-wide, State-wide and national resource and will have linkage co McMascer University in Hamilton, Ontario. Dr. John Edwards will direct the former pro­ gram and Dr. John oble of the School of Social Work and Dr. Barry Willer, a faculty member in P ychiatry, will co-direct the latter effort. We look forward to exciting programs emanandg from these two effor which will benefit students, faculty and patients in the year ahea · incerely, John aughton , M.D. Vice Presidencfor Clinical Affairs Dean, School ofMedicine W RITE R Pat Donovan Marmie Houchens Lisa J=phson Clare O hea Mary Beth pina ILLU TRATORS Greg Bishop Joel Johnson Jane Mann. kv Glynis weeny Dan Zakroetcm k, Medical Alumni Pre ident' T PHOTOGRAPHERS Doug Lcvcrc Ed Nowak Ian Redmbaugh TEACH! G HO PlTALS Batavia Veteran, Adminmracion Medical Center Buffalo General Buffalo Veterans Adm,nmrauon Medical Center Ch,ldron', Erie County Medical Ccnrcr Men:y Millard F1llmore RoswellPark Memorial Institute Si tcrs of Chamy ProducedIr, ,ht D"'mon of Un1H•r11t) Rela­ uon.s '" ,mocianon w11h tht hoot of Median,, talt Unn,rs,ry of eu, Yorkat 811//olo. THE BUFFAI.D PHYSICIA A D BIO­ MEDICAL SCIENTI T (U PS 551-860) Spring 19 • Volume 22, Number I. Pu Ii hed five times annually: Late Wimer, pr1ngt umm~rt Autumn, and Early Winter - b',' the School o( Medicine, State Univernty of cw York at Buffalo, 3455 Main Sutt<, Buffalo, cw York 14214. Third class bulk postage paid at Buffalo, ew York. Send addros changes 10 THE BUFFALO PHY ICIA 'D BIOME[).. !CAL CLENTIST, 146 CF.S. Addiuon, 3'135Main treet, Buffalo. 'ew York M2H. Cover P hoto: Tyrie<Redden, plwwgrr,phtdI,:, Ian Redmbaugh .· Message he Governing Board of your Alumni iacion . ' after h much deliberation, has decid_ed to authon~~ publication of the first Univers1cya~ Buffalo Sc .11:e Medicine Alumni Directory. This comprehensive volume w\ produced by the Bernard C. Harris Publi hing Company, nc., a respected firm with much experience in chi field. 4 500 The re earching and compiling of all rhe data of over • alumni has begun. The directory willcontain names, addresses, · I·nformad phone numbers and academic and current pracnce tion. It will be collared into alphabetical, cla s year, an geographical eccion . You will be contacted in the near future by the Harri Company to upply chem wirh all the information required. I hope char you will promptly upply chem with the data re• quested so that in May 1989 the completed directory can be relea ed. We will then join an increasing number of school char have a valuable quick reference of fellow alumni. ln response to uggestions by ome of our alumni, your Alumni A ciation, in clo e cooperation with the Director of Medical School Admi ions and the Assi rant Dean of Alum­ ni Affairs, has formu lated a plan whereby the Alumni Office will be notified when children of alumni make application for admission to the School. The Alumni Office will acknowledge the fact by letter that a child of one of our alumni has applied to the School. The Office can erve as another area for you to contact to possibly assi c you if you have any questions, relative to rhe admissions process. Please continue to let us know if you chink there are other programs that the Alumni Governing Board hou ld become involved with to continue to improve and expand your alumni as ociation' activities. Sincerely, Franklin Zeplowitt, M.D. 'S f �Vol. 22, o. I pring 19 NO POSTAGE II I NECESSARY IF MAILED IN THE UNITED STATES BUSINESSREPLYMAIL FIRSTCLASS PERMITNO. 2210 BUFFALO.NY : Robert Warner Rehabilitation Center n up to produce succe torie . patients get "fighting power" through · Kenneth Foon, M.D. may have to prove that they've kept ) keep their licen e . nedical center i often thought of a Sulewski, M.D., want women to feel POSTAGE WILLBEPAIDBY ADDRESSEE Buffalo Phy ician and Biomedical cienti t 146 C.F. . Addition 3get 3 million grant to develop pro­ of home and community care. tate U n iver ity of ew Yo rk at Buffalo Buffalo, ew Yor k 14214-99 0 1t e tabli he a center at UB to cen­ and educational ervice . l,,,ll,l..l,,l,l,,,ll,l,,ll,l,,l,l.,l,,l,ll111,, l,II uepartments 24 Hospital News . Rural ho pita! co-op get grant to help with col­ laborative projects. Page12 30 Medical School ew . Luther K. Robinson, Jr. want to fight birth defect through prevention. 35 Classnotes. 36 Events . Phy ician symposium. Page8 will display their artistic ide at a June ���4 yrice Redden wa one and a half, bur he wa n'c talking yet. Hi mother, Aretha, wa worried. "I would bang pots and pan together, and Tynce wouldn't react; she said. "I have a nine-year-old son who wa talking when he wa one, so when Tyrice hadn't aid a word by the rime he wa one and a half, I knew something wa wrong." A hearing peciali t referred Tyrice to the peech, Hearing and Language Depart· ment of the Children' Ho pital. Through chat department, he came in contact with the Robert Warner Rehabilitation Center. The Rehab Center offer one of ew York tare' mo t complete program for handicapped children. It encompa e 11 clinics and i che only facility in the region chat can provide both multidisciplinary and multimedical pecialty evaluation . A handicapped child gees all che service he needs, from social work to medical care, under one roof. The services char Tyrice took advan­ tage of were cho e of the Speech Depart­ ment and the Early Childhood Center. Ac the Speech Department, Tyrice wa diagnosed a having a everc senorineu ral hearing lo . This meant tha t the inner ear, which contain thou and of little hair as well a the nerve of hear­ ing, was not developed properly at birth or wa damaged. Inner ear problem of this kind cannot be corrected. However, Tyrice al o had a conductive hearing lo which affected the middle ear. Fluid or ticky matter built up in hi ear o chat the tiny bones chat produce ound wouldn't move. Afte r peciali c drained chi fluid and provided him with special hearing aids, Tyrice was able to hear ounds . "Tyrice doe very well with his hearing PRING 19 aids," aid a hearing peciali c in the peech Department. "He can hear people talking, but he i till learning language." Tyrice had inten ive speech and language therapy five time per week from the time he was two and a half un­ til hi graduation from the center la t year. A a toddler, Tyrice al o went to che Early Childhood Program, which help developmentally delayed children. The room there are built down cale o children can reach everything by themselve . Each room i equipped with a "kid- izcd" kitchen enabling che children co function on their own. They Ty rice we ar his "ph oni c ear" in hi kind ergarten clas . "I'm very proud of Tyrice. I didn't think he'd get as far as he has in such a short time. He's the youngest in his group at school and he's saying words instead of just pointing and mumbling." help prepare nack , clean up after them elves, learn art and craft , and play games that focu on overcoming their individual handicap a well a sharing with other children. ow five, Tyrice has entered a kindergarten cla for hearing-impaired children in che Buffalo public chool y tern. "I'm very proud of Tyrice. I didn't think he'd get a far a he ha in uch a hort time; hi mother said. "He' doing very well now. He' the younge t in hi group at school and he's aying words in tead of just pointing and mumbling, which i what he wa doing before he received therapy." Although Tyrice has not reached the le el of an average five-year-old yet, hi teacher expect him co be forming entence by next year. Hi mother at· tribute Tyrice' ucce s to the Rehab Center and to the continuing support of hi current chool. Thi is only one of the many ucce corie chat have oc­ curred at the Robert Warner Rehabilita­ tion Center. The Center and Children' Ho pita! of Buffalo are partners in providing rehabilitation ervices for children with phy ical and mental handicap . The Center' primary goal is the re toration of the child to hi or her true potential - phy ically, intellectually, emotionally, and ocially, according to David . Getman, pre ident of che Children' Guild. (For more on the rela­ tion hip between the Children' Guild and the Rehab Center, ee related cory.) The Center's multidisciplinary team of profe ional help in the treatment of multihandicapped children. The team evaluate and treats children with mi ing or deformed limb ; pre chooler with developmental delay ; and children and young adult with various cype of neuromu cular di order , cerebral pal Y, impaired peech and hearing, learning handicap , and eizure problem . "The comprehen ive nature of che Center i what make ic o rare," said German. The Center's profe sionals are from pediatrics, occupational therapy, phy ical B .FFAlO PHY-1 IA • AND Bl MEDICAL , IE1'. 'TI ;r �therapy, ocial work, peech / language audiology, p ychology, rehabilitation nursing, education, nutrition, and other medical pecialtie . They all work together a a ream with rhe child, the family, the referring agency, and the referring phy ician, noted Lucille Phillip , director of the center' Early Childhood Program. The eleven clinics are located in one building, which enables the profe ional staff to confer with one another on a regular basi . "l\voor three raff member then it down with the family and e aluate every a peer of the child' ca e. The clinic are: Cerebral Pal y, Developmental Di abilitie , lnten ive Care ursery Follow-up, Limb Disorder , euromu cular Orthopedic Rehabilita­ tion, Head Trauma, PK , eating, pina Bifida, Developmental Genetic , and Mental Retardation. nece ary. For in ranee, a child who i in the Ear­ ly Childhood Program may al o be e aluated regularly by an orthopedist, pro theri t, occupational rherapi r, social worker and or educational-vocational coun elor, depending upon rhe child' handicap. •Every child goe through an exten ive evaluation," aid one pedal education teacher. "Fifteen group of peciali t diagno e each child and an education plan i \vtitten regarding the treatment proce ." Another unique a peer of the Rehab Center i it lekocek. Lekotek mean "play-library" in wedi h. Familie are allowed to choose four toy a month co take home and u e. Each toy i cha en to meet the developmental level of the pecific child. "The lekocek's philo ophy i the in­ tegration of the child into the family," aid ue mith, director of that unit. "It i a upport ervice to famili through play. We help parent focu on T he Center regard parent a a handicapped child' greare t re­ ource. raff member try to help parent look at what their children can do, inread of what they can't do. The Center erves approximately 3,000 children a year and work do ely with the parent of the patient . ue Laforrest, the Center' head nur e, commented, "The Center i longitudin­ al." To en ure that all rhe need of rhe children are met, the Center ray in contact with other agencie that the pa­ tient u e - chool , other health-care provider , pediatrician , and family doc­ tors. omeone from rhe Center al o meet with rhe child and family at lea t once a year until the child turn 21. ital to the Center' exi tence are the ocial worker , who prepare the family for the difficult ta k ahead of them. A ocial worker visit each child' home, often to make ure the parent are car­ rying out what they learned. ocial worker also refer parent having difficul­ ty dealing with their child' handicap to an appropriate upporc group. The variety of ervice offered makes the Children's Guild unique. Each clinic i run independently of the other , yet they all work cooperatively when Children's Hospital buys former high school T he Children' Ho pita! ofBuf­ falo recencly purcha ed the former Bi hop McMahon High chool on Delaware Avenue in Buffalo. The chool will hou e the Early Childhood Program currencly located at the Children' Guild of Buf­ falo, and the Therapeutic Pre- chool program, currencly at the ho pital. A day-care center for hospital employee i al o expected to be hou ed in the chool. The tentative date for it opening i Augu c. According co Karen Dryja, director of public relation at Children' Hospital, one major benefit in acquir- ing the chool I that it will allO\\ rhe ho pita! to complete it current renovation fa ter by temporarily relocating certain clinics at rhe school. "lt i a perfect locacion, right down che treet," aid Dryja, "and 1cha big beautiful meeting room . The extra pace will allow u to consolidate many program that are currently all over the place." Dryja said che building is in good condition, o very little renovation ha to take place. The hospital i ex­ pected co decide ometime in early June exactly what ocher program will be housed at the chool. -L.J. • .P RL-.: G IQ 5 �6 the po itive a pects of the child by getting them directly involved in the child's rehabilitation. A a result, the quality of interaction is improved." The first lekotek opened in Stockholm, weden, in 1963.Concerned paren and teachers of children with handicap felt a child's true potential could be ignificantly improved through early intervention. The Rehab Center' lekotek, one of many established aero s the United States, opened in 1984with funding from Quaker Oat , which owns Fi her-Price Toys. Fisher-Price al o gives the lekotek many new and experimental toys not yet on the market to test how children will re pond to them. The current library ha just under 1,000 toy and serve approx­ imately 70 families. The lekotek receives funding from public and private corpora­ tions, foundation , individual con­ tributor , and fund-rai ing events. Pro­ gram familie pay reasonable annual fee , but no one i denied ervices. A lso important to the Center is_its affiliation with the UB medical chool. "What goes on at the Center i an in­ tegral part of the School of Medicine and Biomedical cien e " at UB, e pecially the Department of Pediatrics, noted Robert E. Cooke, M.D. He is medical director of the Robert Warner Rehabilita­ tion Center, head of Pediatric at Children's Ho pita!, and chairman of Pediatric at the School of Medicine. "All the physician here (at the Center) teach cudent a well a treat patients," Cooke aid. "Graduate cudents and re ident al o play a particularly large role. "The cudent learn about develop­ mental i ue , are directly expo ed co every type of problem possible, and learn how to diagno e patients with multiple handicaps." Cooke also remarked that the Univeriry provide an important re earch func­ tion. Faculty from the UB Pediatrics Department will be heading a genetic lab to be housed at the Guild. "Many of the medical problems we face PRING 19 Donna now, an occupational therapi t, help a toddler improt1e fine motor have their origins in genetic and family hi tory," he aid. Genetic i involved in chemical di orders, molecular di ea es, Down yndrome, and PKU, an inborn error of metaboli m where the body can't process certain proteins such as amino acids. The Center till ha the ame mission today as it did in 1959 when it began. kill · It concentrate on the rehabilitation of the whole child, o he or he may lead the fullest life po ible. According to Get· man, the additional concern the Center ha today i reinforcing the child' own sense of self-worth and encouraging fami­ ly support, o that eventually the child can function independently de pite the di ability. • BUFFALOPHY !CIA ANO BIOMEDICALSCIENTIST �pre ent building wa erected. le con­ tained 65 beds, which were usually filled, and there wa often a waiting Ii c. After the polio epidemic ended, Robert Warner, a phy ician at Children's Ho pica!, saw che opportunity co u e the Guild building as a rehabilitation center. Children's Hospital established the Children's Rehabilitation Center in che Guild building in 1959. The Guild furn­ i he it building, ucilicie , maintenance, and housekeeping service without cost to the Center, Getman noted. The hospital provide all the Center' health care programs and professional raff. All the physicians on caff at the Center are faculty member of the UB School of Medicine and Biomedical ciences. Children's Guild is key player in Center's mission T he Robert Warner Rehabilitation Center would not exist without che long e cabli hed Children's Guild, according to David . Getman, president of the Guild. The root of the Children' Guild go back co 190 , when a group of dedicated BUFFALOPHY ICIAN AND Bl MEDICAL IENTIST women organized an inpatient clinic at a ummer home in Fore Erie. The clinic wa primarily for victim of polio, cerebral pal y, and limb amputation or abnormalicie . le wa called the Crippled Children' Guild. During che polio epidemic in 193 , che The Children' Rehabilitation Center wa renamed the Robert Warner Rehab­ ilitation Center in 19 2, honoring it founder and long-time medical director. le offer one of ew York tare's mo t complete program for handicapped children. In 19 4, the name, "the Crippled Children's Guild; was legally changed co "the Children' Guild" because many pa­ tients and parent felt "crippled" was a derogatory term, aid Getman. In addition co providing the facility and money for equipment, the Guild provides recreational events for patient such as camping trips on Beaver I land, ski program at Kissing Bridge for severe­ ly handicapped children, and AMP camp, a pedal camp for amputee and children with limb disorders. The Guild ponsor research programs into the prevention of certain handicap and epidemiologic research in the field of birch defect . It al o provide tuition aid for cudenc pursuing career in rehabilitation. The principal financial re ource of the Children's Guild are income from legacie , member hip due , private dona­ tion , and gift from foundation and bu ine e . The Rehabilitation Center also receives federal and Seate grants, reimbursement from governmental health agencies, and fee for ervices rendered. - L. J. • PRl GI 7 �NEW AGE PHYSICIAN Ken Foon combines netv biological agents and humor to give patients 'fighting power' By ''I have no fighting power; Jerome Pallazzolo, 35, thinks to him elf after receiving yet another blood tran fusion to increa e hi deva caringly low blood cell counts. uffering from one of the rarest form of cancer, hairy cell leukemia, he i b coming a regular at the ho pica!: a blood tran fu ion every other week and ho pitalizati n every few months to fight an on !aught of infec­ tions. But inspired by hi wifo and daugh­ ter, Pallazzolo, like many terminal cancer patients, harbors a warehouse of hope. Gathering hi last ounce of strength, Pallazzolo vi it a young oncologist who i testing an experimental cancer drug, alpha interferon, a natural di ease­ fighting protein chat can be copied in the laboratory using recombinant D A technology. Pallazzolo i a likely can­ didate for the therapy. With a loo e, gangly cride, a dark­ haired phy ician greet Pallazzolo with a hand hake and cap the thin man' hould r, inviting him to it down. Groucho Marx collectible decorate che doctor's office, and family photos mile disarmingly from each corner of the room. "Pick your favorite;• the ancer pecialist ay , handing Pallazzolo an economy-size pickle jar of colorful, ugly "mad balls" - a bizarre, crowded a ort• ment of dramatic, distorted rubber face . The patient laugh . All tension dissolves. Immediately, Pallazzolo enses chi doc­ tor i different from the multitude f specialist he ha met over the year of PRING 19 ARMIE HO CHE hi illn . The youthful-looking doctor u e humor a therapy, explain omplex treatment modalities in a way patient can ea ily comprehend, and hi compa sion is earne t. Mo t of all, he i confi­ dent and optimistic about chi ex­ perimental cancer treatment. oft- poken and articulate, Kenneth A. Foon, M.D., shares his findings on in­ terferon. Interferon i one of the new biological therapie that use the body' natural defense y rem, or ynthecically engineered clones of it, as an alternative or complement to candard mode of anti-cancer treatment urgery, chemother_apy, and radiation. As Foon talk , hi eye twinkle, igniting a boyi h ze t he doe n't cry to conceal. "People are coming in here deathly ill with virtually no chance to live. Within months, we are turning their live around; Foon tells Pallazzolo. Les than three years lacer, Pallazzolo i among the robu t rank of leukemia patients treated with interferon. At the miraculous rate of 92 to 94 per cent response, their tumor shrank or went in­ to complete remi ion. Even better, FDA approval for alpha interferon (termed leukocyte A interferon) as a treatment for hairy cell leukemia came le s than one year after Foon and his colleague at the Univer icy of Michigan medical center published re ult of the cudy. "It spurs you on," Foon ay year later. "If a rare cancer could be turned around, I believe there are other cure out there." Today, Foon i applying hi rare brand of optimism and impressive experti e at Ro well Park Memorial In citute as head of the Clinical Immunology Division. Clinical immunology is an exploding area in oncology re earch which deals with te ting new cancer treatment and drugs in patient rudies, or clinical trial . Thi summer, Foon will be directing a pa­ tient tudy u ing interleukin 2/LAK (lymphokine activated killer) cell therapy for lung cancer and lymphomas (cancer of the lymph y tern). A profe or of medicine at the UB chool of Medicine, he i chiefly in­ terested in exploring treatment for leukemia and lymphoma and develop­ ing immunotherapies or biological , including promising agent uch a monoclonal antibodie . "Ken Foon bring pecial experti e in biological modifier . He is an excellent lecturer, and hi vitality and enthusiasm make him the kind of role model we want," aid Thomas B. Toma i, M.D., Ph.D., director of Ro well Park. "He i an exceptional find." How many doctor have een a 90 per cent cure from a ingle cancer therapy? How many have had the opportunity to train with the greate t phy icians and re earchers in their field at the mo t pre rigiou institute in the country? And how many re earcher at age 40 ha e publi hed 175 cientific paper in the mo c highly re peered medical journal - with ch pin-off of addre ing a many as 54 international medical con­ ference in one year? BUFFALOPHY I IAS A),;O Bl MEDICAL IE:-.'1151" �Productive, en­ ergetic, and downright nice, Ken Foon i re­ garded as a "new age phy ician" who ha the win­ ning blend of chari ma, busi­ ness savvy, medi­ cal experti e, and a per onality that is equally outrag­ eous, off-beat, and comic a it i thoughtful, com­ pa ionate, and intense. A world expert on u e of mono­ clonal antibodie as anti-cancer agents, he i a pio­ neer in the u e of interferon in the treatment of ma­ lignant diseases. He i a master at peer relations without lo ing hi patient-centered philo ophy. "He' the mo t patient doctor I have met," said pa­ tient Pallazzolo. "He never ru he me out of the room." Yet, hi dedication to medicine ha not impeded other area of his life. He i a modern dad, involved with the activitie and nurturing of hi young family, and has a true partnership with hi wife, Rebecca Garrett, M.D., a rheumatologist who is erving a rehabilitation medicine residency at UB. An outdoor man, Foon is camp doctor and canoe guide for a children's ummer camp in Canada. "He is a lover of life, a lover of people, a lover of thing ,• aid a lifetime friend. A strong intere t in psychology and a love of science led this Detroit native of Ru sian-Jewish heritage to pecialize in oncology medicine. Mo t cancer patient die, said Foon, o helping chem addre i ues of death and dying is a critical ele­ ment of their care. Foon's day i pent vi iting laboratorie and patient floor , mining the ideas and di coveries of scientists and phy ician to advance them into the patient realm. In­ ternational contact with major phar­ maceutical and medical equipment firm BUFFALOPHYSICIA AND BIOMEDICALSCIENTIST often receive call from patient and phy ician eeking his advice on new therapie and drugs. The urgency of patients on che ocher end of the phone motivate him. He believe ba ic scienci t need to work hand-in-hand with phy icians and patient to accelerate uch advancements, and he ha posi­ tioned him elf a the go-between. To qualify, he in­ ve red year hon­ ing hi understanding of the pure cience in ~ order to peak to cientists in their term . An incerni t help win vital indu try support for the e with sub pecialties in hematology and costly, time consuming, highly taffed oncology, Foon completed hi medical venture . education with high di tinction at "Ken is an orche era leader, a ma ter Wayne State Univer ity, which later at gathering expertise and material to named him a distingui hed alumnus. He generate clinical trial ," said ark Roch, then erved hi medical residency at the M.D., a istant profe or of medicine at Univer icy of California chool of the Univer ity of Michigan who worked Medicine, an Diego. olidifying hi science background, he with Foon on the interferon/hairy cell leukemia tudy. "He under tand the full erved three years as a public health of­ spectrum of the cientific approach to a ficer with a research po t in immunology problem." at the ational In titute of Health, "I didn't go into medicine co cure mice," Bethesda, Md. Foon then completed a two-year residency at Wa hington VA Foon quipped. The dying cancer patient and Georgetown Univer ity hospital i ever on hi mind. Foon recall a fellow resident who and conducted hi fellow hip in hema­ sought hi aid after being diagnosed with tology/immunology at UCLA, where he cancer. "He dropped out of medicine to was appointed a sistant profes or of keep him elf alive," aid Foon. "lt wa re­ medicine. markable to ee someone deal with hi ecognized for hi early leukemia di ease o rationally. He took the rein and turned every stone." Hi friend ur­ re earch, Foon wa recruited to the ational Cancer In titute, Frederick, vived and o did the positive memory. Foon saw himself in that patient, ome­ Md., in 19 I co head the monoclonal antibody-hybridoma section and lacer one who can't - won't - contain the rush to explore new avenue to ave a was named director of the Cl clinical inve tigation division, both in the life. burgeoning Biological Re pon e Modi­ A walking clearinghouse with the nickname, "Doctor Telephone," Foon fier Program. He then spent two year ! ~ R • PRI.·a 19 s 9 �as associate chief and director of clinical hematology at the Univer ity of Michigan, where he held an as ociate profe orship in medicine. Groomed by the mo t influential and controversial medical "super tars" in 10 cancer research - Robert Gale, Bob Oldham, and Ron Huberman Foon quickly became one of the world's rank­ ing expert on the treatment of leukemia and lymphoma . One of his fir t papers, co-authored with Gale, became a major reference on the surface marker for leukemia. In lacer studies, publi hed in the ew England Journalof Me.dicine,Foon's group used in­ terferon to treat lymphoma , showing a 50 per cent re ponse rate in patient . His re earch with interferon and hairy cell leukemia was the good news the medical community had been waiting for: interferon, the over-hyped anti• cancer drug many believed would be the •magic bullet" again t cancer, had hown little activity fighting solid tumor ; the re earch of Foon and hi colleague , however, showed interferon' success in treating elective cancers of the blood and lymph sy terns. Foon was a pioneer in the u e of monoclonal antibodies (cloned white cells chat target and fight infection) as therapeutic and imaging reagents. His collaboration with Oldham' group at CI, al o publi hed in the ew England Journalof Me.dicine,howed the excellent diagno ric capabilitie of monoclonal an­ tibodies for certain lymphoma . "The beauty of u ing monoclonal an­ tibodies for diagnosis is all the machinery in nuclear medicine is che ame; only the reagent i different; Foon said. His tudie how mou e monoclonal anti­ bodie have extremely accurate tumor pecificity, are highly purified and are well tolerated by patient . Foon i exploring way to link radio­ active i otope , agents u ed in nuclear medicine, to antibodie so chat when the antibody fa ten ro tumor cells, the i ocope will light up to hm the exact cancer ire. The greate t advantage of antibody reagent i they are rumor- pecific, not body part• pecific, so potentially one diagnostic test using antibodies, or isotope linked to antibodies, could iden­ tify all cancerous growth . Current technology requires a erie of expensive PRING I cans or test co detect cancer in various pares of the body. Within the next few year , Foon predicts, labeled monoclonal antibodies, or antibodies linked to radioisotope will not only expand their diagno tic role in tumor detection but may treat patients a well, aving an enormou amount of time and money, reducing risks, and resulting in more exact diagno e . Foon is expected co be on the cutting edge of that technology, according to Tomasi. Foon holds the pre tigiou a ociace editor hip for ~ntibodies, lmmunocon­ jugate and Radiopharmaceutical" and "Cancer Research. He has written several book and has been asked to write a chapter in a re peered medical text book which reflects hi belief chat medical intruction needs to teach both clinical and scientific a peer of patient care. Here in Buffalo, Tomasi believe that ap­ proach will enhance the Univer icy teaching program and attract younger doctors to the area. F oon's dream i co "re-create the fa t track at Roswell Park." Facilirie like the Grace Cancer Research building, the FDA t ting center, and a laboratory chat generates isotope used in im­ munocherapy and diagno tics pave the way for Ro well to be a pioneer in te ting and manufacturing unique cancer drug , noted Foon. "It's a rare situation to be able to take an antibody to a scientist's lab, get FDA approval, and give it back to the patient without leaving the ho pita! ground ; he pointed out. He turned down an offer to head a cancer in tituce in outhem California co accept the position at Roswell Park, where he believes opportunities to con­ duct "unique research" compete with any in the country due co the "tremendous trength of the basic ciences" at the in­ stitute and the University. Foon use another rare weapon against cancer: humor. A elf-revealing photograph hang in hi office. Wearing red boxing hon boxing glove , and a grin, Foon hold a less than convincing boxing pose. Entitled, "The fight again t cancer,• the picture show that he bring 100 per cenr of him elf to hi work, humor and all. By turning curiosity into cures Ken Foon find "fighting power• for cancer pa• tients world-wide. • CANCER RESEARCH MOVES 1DTHE BEDSIDE L aboratory re earch i being con­ ducted near the bed ide of cancer patient in an innovative clinic at Ro well Park Memorial Institute. The concept i clo ing the gap between the promi e of new treatment and their availability. To cancer patients who race against time, chat may be a life-saving difference. Ro well Park i the only hospital in the country to open uch a combined ward; the clinic feature a 12-bed patient unit connected to four modern research laboratorie . "\V/edidn't want to eparace the basic scientists from patient care; aid Kenneth A. Foon, .0., professor of medicine at UB and chief of the new Clinical Im­ munology Divi ion hou ed in the unit. He i al o director of the interleukin 2/ LAK (lymphokine activated killer) cell program to be conducted in the ward. The experimental cancer therapy rev up che body' immune system to de troy rumor. Designing the ward, roon and Thoma B. Tomasi, M.D., Ph.D., Roswell Park' director, "did the unheard of" when they hou d rheir entire research team mack in the middle of the mo c important pare of their mi ion: the patients. Compared co candard collaboration method , the new way i fa ter, more convenient, and flexible. Before, physi• cians met with clinical and ba ic scien• ti ts at weekly multi-agenda meeting , aving their que tions and observation until then. Often, everyone, e pecially the researcher , felt isolated. To olve that, the Roswell doctor imply in• croduced a do e of convenience. "The idea of conjoining the lab and pa· tient areas in a phy ical facility is unique" aid Robert Oldham, M.D., director of 8UFFAIO PHYSICIA, AND BIOMEDI L , IENTIST �the Biological Therapy Institute, an af­ filiate of Biotherapeucics, Inc., Franklin, Tenn. Oldham, who worked with Foon at the ational Cancer ln titute, is a well known advocate of tronger bond be­ tween phy ician and researcher . He believes the clinic - by sheer practicali­ ty of design - will create an unparalleled eras -fertilization of ideas which should accelerate re earch, benefiting patients. Foon advanced M.O./Ph.D. collabora­ tion "from the mental ense into phy ical reality; aid Oldham. Laboratory to bed ide research is a boon to patients in investigative studies. Patients have a right to under rand what's happening in the laboratory, said Oldham. N ot only doe this new clinic ring in a new marriage ben11een cientists and physicians, but Roswell Park is the only facility in a nation-wide program chat is studying interleukin 2 (ll2) and lymphokine activated killer (LAK) cell therapy on lung cancer and lymphoma (cancer of the lymph system). The three common cancer to be studied in Buf­ falo are technically termed non-small cell lung cancer, Hodgkin's di ea e, and non­ Hodgkin's lymphoma . Roswell Park will also look at the effect of ll2 without LAK on melanoma (skin cancer) and kidney cancer. Five ocher study ice will be looking at different can er . "LAK cell eem to chomp on tumor cell and ignore healthy cell ," aid Foon. Compared to standard cancer treatments, uch as chemotherapy, radia­ tion or surgery which damage healthy ti ue, chi i a major tep forward. lL2/LAK therapy treats cancerou growths throughout the entire body by turning a patient's own white blood cells into "killer cells" chat attack tumor . This "adoptive immunocherapy" removes a pa­ tient's white blood cells from the body, activate them with IL2, and reinfuses powerful, anti-cancer fighting LAK cells back into the patient. Interleukin 2 a natural hormone of the immune ystem, can be produced through recombinant D A technology in large quantities with greater than 95 per cent purity. The potent substance belongs to a family of chemical com­ pounds, called lymphokine , that erve as messengers to monitor the activities BUFFALOPHYSICIA AND BIOMEDICALSCIENTIST of the immune system. Crucial to IL2's u e as a cancer drug is its T-lymphocyce growth factor, which in laboratory culture activates the pro­ duction of LAK cells, anti-tumor killing cells. To activate the number of LAK cells in the circulation, IL2 is injected into a patient. This lymphocyte priming is per­ formed by extracting white blood cells through a four-hour blood- eparacing process, called leukapheresis, and creating the patient with 1L2.Patient are leukaphere ed on four consecutive days. Leukapheresis uses an elaborate machine to remove white blood cell from the patient while returning red blood cells and p!a ma. Another device automatically eparate white blood cells Foon explain how white blood cells are removed during leukapheresi . for u e in the laboratory. After five day in culture, the activated cells - now called LAK cells - are harvested, tested for their toxicity and injected back into the patient. Ro well Park will al o administer a 24-hour con­ tinuous infusion of relatively low do e IL2. Preliminary findings of lL2's effect on IO different cancers led to its b ing heralded in 1985 as a major cancer break­ through, ba ed on the fir c inve tigacion by Steven A. Rosenberg, M.O., chief of urgery at the acional Cancer 1n titute. Since then, reports on its effectivene s have been more cautionary, particularly in treating skin cancer. IL2/LAK cell therapy is, however, effective for kidney cancer. A mall number of patients with lung cancer and lymphoma have been treated with IL2/LAK, and they have reported encouraging respon e , parcicularly for lymphoma, said Foon. Side effects oflL2/LAK cell treatment include swelling of the pleen and flu-like symptom : fever, chills, malaise, nausea, and inflammation. Dangerou ly excessive water retention, up co ten per cent body II weight gain, was experienced in early Cl patient scudie . Lower do e of IL2 have reduced that ri k. Foon anticipates le than five per cent body weight gain for patients in rhe Ro well tudy. Co- ponsors of the study, DuPont and the wi -based Hoffmann La-Roche, cha e five sites nation-wide co study IL2/LAK cell therapy on various cancers. Later the sponsors named Roswell Park a sixth center. The Com­ panie didn't intend to add a sixth site, but after vi iting the Buffalo facility, they were so impre sed with the experci e of the raff and re ource , they decided co include Roswell a well. Company repre entatives wanted to pursue what they believed would be a long-term relationship with the "prom­ ising group" at Roswell. DuPont is providing a • teriCell" machine that automatically separates white blood cells, and Hoffmann La­ Roche is upplying their patented in­ terleukin 2. By early ummer, 40 patient will be admitted to the Ro well rudy, which will report findings in about two year . Pa­ tient receiving IL2/LAK will have a two-week hospital ray, and at night they will be tran ferred from the daytime clinic to patient wards. Some participant will be treated on an outpatient basis. For the Roswell study, eligible patient must have inoperable non-small cell lung cancer, non-Hodgkin's lymphoma , and Hodgkin' di ea e. Patient mu t be I years or older show good performance status, and have good blood count with reasonably normal blood chemistry. Foon is accepting physician referral and may be contacted at 716/ 45-4464. Foon is known internationally for hi expertise in biological modifier . He i a world expert on cancer treatment using monoclonal ancibodie (genetically cloned antibodie produced from a ingle white blood cell that target and destroy tumors), and he is a pioneer in determin­ ing the effects of interferon (a natural virus-fighting protein or a ynthetic copy of it) as a cancer drug. -M.H. • SPRING IQ �IUIJSTIWlON(Wj ZAKROCZE �PROVE IT Recredentialing would test doctors' knowledge 13 P hysician in ew York tate should go through a re~rede~tia_ling process every nine year in order to re­ tam their hcen e , according to a recent report of the ew York tate Advisory Committee on Phy ician Recredentialing. With today's rapidly changing technology, the public needs to be as ured that doctors are keeping abreast of change . The intent of recredentialing i to guarantee that citizens of this State will get the highe t quality care possible and that the possibility of injury to the patient will be reduced, aid John aughton, vice president for clinical affairs and dean of the School of Medicine and Biomedical Sciences. aughton is also a member of the committee. Under the current system, physicians register with the tate every three years, but it's merely a formality. Recredentialing could go into effect in mid-19 9 or mid-1990, aughton estimated. Ocher tates are examining imilar issues, but none is making such an extensive recom­ mendation, he added. Under the report's proposals, ph icians would have a choice of how they would be recredemialed: ■ Certification or recertification by an approved special­ ty board. This option would be open to all physicians. The vase ma­ jority of physician would be recertified this way, and it will probably become the national standard, aughton noted . Fifteen of the 23 national medical specialty board already require recertification, and the re t are expected to follow suit, the report noted. ■ Hospital raff peer review. This option would be open to tho e with hospital privileges. The burden would be on the ho pica[ to keep a file on each of it physician because it wouldn't know which doc­ tor would choo e this option at the end of nine year , aughton pointed out . Physician might find this proces uncomfortable becau e it might foster a feeling that someone is always looking over their shoulders, he added. ■ Medical records review. Thi review of a physician's office records would be analogous to peer review in the ho pita!. Exactly how chis would be carried out hasn't been decided yet, the report noted. This option would be open co those who don't take care of patient in a ho pita!. More and more physician are caring for patient out ide of hospital as the medical community trie to contain cost and offer more ambulatory care, aughton aid. k's e timated that 15 co 20 per cent of practicing physi­ cian in ew York tate fall into thi category, according to the report. They range from highly pecialized doctors and BUFFAID PHY ICIAN AND BIO MEDICAL SCIENTIST family physicians to general practitioner with varying amounts of training. ■ Tests. This option would be open to all physicians. The tests are till being developed, aughton aid. He pointed out that they won't cover basics, but will cover the physician' pecialry area. ■ Inactive Ii t. Physicians not in active practice could elect to be placed on the inactive list and have their medical licen e held in escrow. (They could be recredentialed in one of the way listed above.) A ny physician judged co be below standard would u ually be granted a time-limited licen e and be told co do remedial work the report said. The remediation might consist of self­ instruction or a continuing education program. lf the deficien­ cies haven't been corrected at the end of the specified period, the medical license could be suspended until they are corrected. The ew York State Advisory Committee on Physician Recredencialing was appointed by the Department of Health and the Board of Regent (the Regents over ee profe sional licenses). The co-chairmen of the committee were Alfred Gellhorn, M.D., director of medical affairs for the Health Department, and Marrin Cherka ky, M.D., a representative of the Board of Regent. The report was accepted unanimously by the members of the committee, aughton noted. Many constituencie were represented - physicians in practice, organized medicine, medical educator , hospital administrator , national medical organizations concerned with certification, and tare government. The committee i an advi ory panel, and its report eek people' reaction . "Im sure it's going co be controver ial; aughton said. "Phy icians already feel under the gun, under pres ure, in almo t every aspect of health care."Hospital are trying co con­ tain co ts, controversy surrounds malpractice claim , and phy i­ cians are embroiled in debate over how they should be paid - through new ystems uch a health maintenance organiza­ tion or through the traditional fee-for-service route. " ow you're throwing one more thing called recredential­ ing on the plate," aughton said. "It puts one more demand on how a physician proves his worth. There will be a lot of outcry and concern." The recredentialing process isn't designed to mea ure medical competence, the report emphasized. Competence im­ plies chat a phy ician ha not only skill , but the wisdom and judgement to use them. There are no validated tests for com­ petence. - C.0 . . • SPRING 19 �14 W hen Joan ulew ki, M.D., cold colleague she wa caking a job at the Veteran Admini cracion Medical Center, he got two dif­ ferent reactions: some would con­ gratulate her; other would cringe. "They'd say 'Why i a gynecologist go­ ing to the VA?' It's like I was going to iberia or omething," said Sulew ki, a sociate profe or of obstetric and gynecology at UB. That's typical of the misconception ulew ki faces a he develops a program of health care e pecially for women at the VA medical center. The military conjure up image of irility and ma culinity in many people's minds, but there have been women in the ervice for year . In World War 11, there were Wacs, Wave , and even female pilot called Wa ps. Tho e special designations were eventually dropped and women became a routine part of the military. It's now estimated that 11 per cent of people in the military are women and about four per cent of people who choose long military careers are women, ulewski aid. There are about 16,000 women veterans in We tern ew York. And these numbers are increasing. B y C 0 E 0 To erve the e women better, the VA y tern for two years ha been trying to promote women's health care, aid Sulew ki, who i al o gynecology ection chief of surgery at the VA medical center. The Buffalo program i taking the lead and may erve as a model for programs aero the country . In the 'N.soutpatient clinic, women get a battery of IO or 12 general and gynecological te ts. If appropriate, they'll be referred to ocher clinic within the hospital. The VA ha the late t equipment for women's health care, she aid. There is laser surgery; mammography, a test for cancer of the brea t; the mo t ensitive ultra onography, which can pick up ab­ normalities in the uterus and other organ , and a den itometer, which can a e bones for osteoporo is. The hospital will al o offer infertility ervices, ulew ki noted. Legislation that was pas ed in December finally allows not ju t the veteran, but the veteran's pouse, to be tested for infertility at the 'A. IThe fertility evaluation isn't com­ plete without both partie being checked, she explained.) '1 don't know of any other VA medical center that has the expanded service we W A L D T O F K 0 �I.WSll!AllON JANE MAR1NSKY �16 have; ulewski pointed our. ulew ki wants women to know that the 'A welcome chem. Even caking into account char there are more male veterans than female veteran , it eems chat women u e the hospita l much le s than men do, he explained. About 40 of every 1,000 male veteran ek care at the VA, but only I out of every 1,000 women do. "When I read the stati tic , l ju t can't believe the number ," he aid. le' a problem aero che country. The 'A Ho picals in the mid-Atlantic region of the niced cate have a notoriou ly low rate of u e by women, ulew ki noted. he' not ure why women don't u e the 'A. It has pecial ervice for women which are inexpen ive and good. le may be that women imply don't know chac the ervice are available to chem. They think of the 'A medical center a a ho pica( for men, but it' open co any veteran, ulewski <..mphasized. till, he realizes chat the ho pital i u ed predominantly by men and being with the "boys" can make ome of the male veteran relaxed - more relaxed than they'd be at home with their familie . "They're relaxed in dre , attitude, and verbiage, and female may feel a little bit uncomfortable; Sulew ki aid. To remedy chat, the ho pita! et a ide ome bed exclusively for female in­ patient to give them a little mor privacy. Women can al o get a televi ion in their rooms if they feel uncomfortable watching TV with the men in the pa­ tients' lounge. The ho pita! provides nicecie uch a women' pajama . And the raff is working to make ure women' anitary upplies don't run out, which has been a complaint in the pa t, ulew ki noted. SPRI,"G 1 B "Sulewski wants women to know that the VA welcomes them. About 40 of every 1,000 male veterans se.ek care at the VA, but only 18 out of every 1,000 w omen do. It's a problem across the country." ut women won't cake advantage of the e ervices unle they know about them . ulew ki i trying to publicize the 'N.s offering through health fairs and contac ting female veteran by mail. Another reason female veteran may not use the ho pita) is because it ha an image problem. In off-hand comments, people have remarked co ulew ki that women aren't "poor enough" co go co the 'A - they can afford to go elsewhere. Tho e comments don't make sense to ulew ki for two rea on . Fir t, everything she reads cells her chat women are the poorest of the poor, e pecially elderly women. econd, the comment imply that the 'N.s ervice are inferior. They're cheap, but it' like gercing Cadillac ervice at Yugo price . Except for neuro urgery and ob retr ies, the VA Medical Center ha every service you can imagine - it's comparable to other ho pitals, he said . It was the fir t ho pita! in the area to do cardiac transplants. It has rhe lace r equipment and ometimes get instruments earlier than ocher ho pica! becau e of the government procurement system. le al o ha killed per onnel. And the co t are low. Veteran would probably be better off using the VA medical center than buying Medica re which requires a quarterly payment, he noted . For instance, the most a vet will pay for outpatient ervice is 25 a day, no mat­ ter how many re c he or he receive . At certain income le el , service are free or prorated. Service is also freeif you have a service­ relaced disability, and you don't have to have hrapnel in you co qualify, ulewski pointed out. For in ranee, someone who wa diagno ed as having multiple clero is while he o r she wa in the er­ vice would qualify. BUFFALOPHY ICIA:--A, ·o BIOMEDICALSCIENTIST �17 I Inpatient ervice are al o inexpen ive. The full price for up co 90 day a year i 540. Again, ome veteran qualify for lower rate or free ervice. I "How many women veteran out there are ju c trying to make end meet and would benefit from the e er­ vice ." ulew ki asked. he cold of one patient who uffered broken bone and went co a private clinic. "!c drained her financially," he aid . " he was o graceful to hear about the 'A." Women can al o be helped through re earch. ulew ki noted that the 'A y tern enjoy collaborative tudie , and he look forward co uch re earch with other medical center . One question he'd like to con ider i whether gynecologi t hould be u ing ultrasound exam in cead of the manual pelvic exam. The advantag co the ulcra­ ou nd are chat it may provide more information than a manual exam, e pecial­ ly for older women and obese women, ulew ki said. ew ultra ound vaginal probe may make the exam more comfortable. Unlike conventional ulcrasound in­ strument , the probe doe n't depend on the patient having a full bladder in order co tran mic clear image of other organ . Pelvic exam are performed now becau e doctor are accustomed co do­ ing chem, and ultra ound may be more coscly, she said. But ac the 'A Ho pita!, the co c may not be a much of a factor. The an wer to que tion about ultraou nd and re ulc of ocher re earch pro­ ject will benefit more than ju c veterans, ulew ki predicted. "One of the greace c thing the U.S. did wa allow service people co go co chool; he said. We've all beneficted from a bet­ ter educated population. BL"FF A LO PHYSICIA ts At- 0 81O~1EDICA L IE!\:11iT "The most a vet will pa for outpatient services is 25 a day, no matter how man y tests he or she receive~. 'How many women eterans out there are just trying to make ends meet and would benefit from these services?' " "And now maybe by allowing women' health care at VA medical center , we'll improve healch - not only of the veteran , but of all women becau e of cudie that are performed." Before taking her po t at the 'A Ho pita!, ulew ki was director of ob cetric and gynecology at Buffalo General Ho pica!. She' proud of the fine birching room that were recently ec up while he wa there. ulew ki i also board certified in gynecology and reproductive endocrinology. Combining that experience with her activiry in many women's group , he' an appropriate choice for rhe new post at the VA. 'A admini tracor have been very sup­ portive and in trumenral in getting the program off the grounc!, he noted: Gerald Logue, chief of caff; Richard Oro ke, medical center director, and John Pulli, admini cracivea iscam to the chief of raff. "They recognized the dire need for uch a program; he aid. he al o credit John aughcon, vice pre idem for clinical affair and dean of the chool of edicine and Biomedical cience at UB. The interaction between che Buffalo 'A medical center and the UB medical chool i unique, he aid. or many 'A ho pica! are connected to a medical chool where the dean talk to che medical director regularly. "We have enlightened leader hip; he aid. The re pon e to the women' outreach program so far has been heartening. Before her fir c health fair publicizing the program, ulewski em invitation to ome female veteran . About 20 per cent of che replie came back with warm, handwritten notes de cribing how graceful the women were co hear about the program. "Maybe the image i lowly changing," ulewski mu ed. • ' PRI.'GI �Surviving Traumatic Brain Injury By MARY BETH G rowing number of person who have uffered traumati brain injury (TBl) are urviving their injuries becau e of medical and ciencific advancement . But when they arri e home, they often find the community doesn't have the rehabilitation ervice they need. To addre chat problem, a national center has been e cabli hed ac B under a 3 million, five-year cooperative fund­ ing agreement with the U. . Department of Education. The ational Rehabilitation Research and Training Center (RRTC) for Com­ munity Integration of Person With Trau­ matic Brain Injury will conduce re earch and develop training program on i sues related to re-entry into the community of per on with TBI. Thi i one of five TBI center funded nationally. 'J hile the other are med­ ically oriented, the B center will gear it efforts toward provider of home and community care. The funding wa awarded co B' chool of ocial Work and che of edicinc and Biomedical cience by che acional In cicuceof Di abilicic and Rehabilitation Re earch ( IDRR). While mo c of che RRTC' major pro­ jects will be located in Buffalo, one will be conducted in Hamilton and r. Catharine , Ontario; another will be located in Philadelphia, Pa. ln addition to funding from IDRR, UB ha allocated 45,000 co develop a state-of-the-art computer y tern co escabli h and maintain a national data base. Additional funding for each of che fir c two year will be provided by UB ro attract an internationally known vi icing professor in the field of neurop ychology. Co-director of the RRTC are John oble, Ph.D., M. .W., and Barry Willer, Ph.D. oble i profe sor of ocial work and rehabilitation medicine at UB. Willer i associate profe or of p ychiatry. William Mann, Ph.D., a ociare pro­ fes or of o cupational therapy in UB' . PIUNOl Pl A chool of Health Related Profe ion , will be training director of the RRTC. "Thi project on community integra­ tion of per on with TBI is critical for everal rea on ; aid Fredrick eidl, Ph.D., dean of UB' chool of ocial Work. He empha ized chat the cope of our national problem concerning TB! con­ tinue co increa e at a breathtaking pace. About half rho e person aff cred are between the age of 15 and 24. Becau e chi is a relatively new prob­ lem, there are great gap in ervice for the e people and their families, he aid. The project, which involve many peo­ ple, agencies, and rvic in the .. and Canada, repre ems a major effort co bring cience, reason, and scholar hip to bear on the problem of TBI. J ohn aughron vice pre idem for clinical affair and dean of the chool of Medicine and Biomedical cience ac B, pointed out that the medical chool i very plea ed with che ucce fut out• come of o~le' and Willer' effort . Over the past 12 year , aughton noted, the University ha recruited an out randing faculty in rehabilitation medicine who e contribution to developing an environment which could upporc and nurture such a program a the RRTC have obviou ly paid off. "This new program is the first multidisciplinary program developed be­ tween the chool of Medicine and Biomedical cience and the chool of Social Work and complement the efforts of the We tern ew York Health cience Con ortium. The Con ortium include an acure head injury unit at Erie Coun­ ty Medical Center and ha upported Our Lady of ictory Ho pita!' certificate of need for a 26-bed chronic head injury treatment unit; he said. aughton added that the program's emphasis on community care and up­ port ervices represent an innovative and timely approach co dealing with thi �imporrant public health problem. A large number of per on with TBI have been injured in automobile ac­ cident , noted Richard wiczer, depuc • commi ioner of the 1 ew York tate Education Department' Office of Voca­ tional Rehabilitation. The e people are 19 pnmaril young and can be rehabilitated to re-enter their community a produc• tive member of ociety. He aid that the project i indeed a co r effective one, for "whate\'er we pend toward rehabilitating any person who is di abled, there i a great return." Pamela Burn , founder and executive director of the ew York rate Head In­ jury A ociacion, aid that communic integration and community erv1ces for per ons with head injurie and their families are the mo t needed component of rhe rehab11icative y tern. Burns, who i al o vice pre idem of state a ociacion affair for the ational Head lnjurv Foundation, noted chat 5 per cent of tho e admitted to hospital with diagno e of head injury are di charged co home and communit . There are no pecific head injury re ource to erve chem. C o-director oble said it i e rimated by che acional Head Injury Foun­ dation chat from 177co 295 per on per I 0,000 population annually uffer TB!. Of chi number, approximately 4.3 per cent are left with re idual deficit which make community re-entry after hos­ pitalization difficult. "Funding of the RRTC; he noted, "i a re pon e to the 19 6 amendment to the Federal Rehabilitation Act of 1973 which recognized chat many di abled per on could not be gainfully employed without benefit of inten ive, ongoing upporc ervice ." Co-director '\ iller al o ired che face chat government interest in TBI in• dividual ha been purred b intensive effort of advocacy group . o t notable of the e i the acional Head Injury Foundation and their affiliate , primari­ ly compo ed of family, friend , and care provider for tho e with TBI. "An important concept in dealing with Q di abled per on i to remember that ~ they are peoplefir t," '\ iller empha ized. 5 Thi concept, he added, i ingrained in J the underlying philo ophy of the RRTC ~ and all it a ociated projects. • i BLFFALO FHY.ICL-\ . .. ... D 81 \ 1EDI L - IE1''TIST �ALZHEIMER'S "I didn t realize that an one could become so impaired. If ou can imagine being sentenced fore er to a foreigncountr , among strangers w hose language ou don't understand who don't understand you; if you can imagine forgetting our own face and who ou are and were and the terror of losing everything that e er had meaning, then ou ha e some idea of what the go through." - daughter of an Alzheimer's patient PRl~G N ' gram to Y-Buffalofor the e cabli h­ ment of an Alzheimer' Di ea e A i cance Center co erve the eight coumie of'>; e tern ew York. le i one of ix gram awarded aero che rate for the purpo e of cenrralizing diagno tic, a e mem, and educational ervices for patient , their familie , and profe ional caregivers. The Alzheimer' A i cance Center i headed b John Edwards, .D., B pro­ fe or of medicine and family medicine, and i expected co be operational chi month. Diagno tic ervice will be pro• vided at the Erie Counry Medical Cencer while the Cencer' admini trative office will be located ac the Deacones Center of che Buffalo General Ho pical. "Ultimately; say Edward , "we expect to pro ide the fine c diagnostic and a e mem ervice for all form of dementia, including Alzheimer' Disea e. earlv "Our econd goal i co a ure com­ a century ha pa ed ince German neuropachologi t Aloi Alzheimer iden­ prehen ive delivery of medical ervic to the e patient and co their familie with t1fied the ravaging disea e that bear hi name, but it cau e remain a my tery, che a i ranee of communicy-ba ed social and health ervice agencie , and co diagno i i difficult, and drug cherapie educate familie , health care provider , have pro en ineffective again t it and the community about demencia." di a crou effect on cognition and behavior. Diagnostic ervice will be delivered by Alzheimer' Di ea e afflict more than a multidi ciplinary ream of health care 2.5 million American 11,000 in profe ional that include phy ician We tern ew York alone. The be t p ychologi t , social worker , nur e , and e timace are unreliable, however, ph ical and occupational therapi t . A becau e they do nor account for two-member ervice coordination team thou and till in che early, undiagno ed will function a a permanent link be­ cage of illne . or do tati tic reflect tween che Center and the ervice the "hidden" iccim - family member organization in the community chat will who not only endure the agonizing lo provide po c-diagno tic ervice . of a loved one over the cour e of a The Center's educational component decade, but mu t pro 1de nearly con cam will be conducted through the carecaking during the four co five year Mulcidi ciplinary Center for the tudy chat mark the middle cagesof the illne . of Aging, che '>;e rem ew York The ew York tate Department of Geriatric Education Center, and the Health recently moved co addre the chool of ur ing, all ac UB, and che burden impo ed by Alzheimer' and We tern ew York Chapter of the related di order by awarding a 50,000 Alzheimer' Di ea e and Related BL:FFALO PHY !CIA~ A~D 810 \tEDI L . CIE. :n. T ��22 Disorders A o­ ciation (ADR­ DA). In cooperation with these organ­ ization , the Alz­ heimer's Disea e A i tance Center expects to present a major conference in 19 9 that will ad­ dre s a essment and post-diagnostic issue confronted by health care profe sionals. "Another vehide for the education of physicians; say Edwards, "is the con­ sultation proce it elf. When a patient i referred to the Center, his doctor will r c ive an evaluation report outlining what wa done and what wa found . In this way, physicians become familiar with the best methods of diagnosi and begin to order them on their own." arly ymptoms of Alzheimer's Di ease may appear several year before diagnosis is established. Those such a dep ression, short-term memory lo , con­ centration difficulties, anxiety, and catastrophic reaction to mino r incident are similar to tho e of other irreversible dementias, but may also ignify far le s serious and more treatab le condition . For this reason, early recognition of Alzheimer's-like ymptom is extremely important. "Certain medication or do age ," Ed­ wards points out, "may produce symp­ toms associated with mu lti-infarct dementia or Alzheimer's Disea e chat may disappear when the drug i di con­ tinued or the do age altered." En­ docrinological disorder , depre ion, and stress respon es following emotional or physical trauma can also mimic ymp­ com of irrever ible dementia. "From the medical perspective," he add , "one of the important thing we in­ tend to focus upon is very careful a ses ment to be ure that we don't let rever i­ ble dementia lip by unrecognized. At all co t , we mustn't mis potentially remediable cau es of the e conditions." The Center' diagnostic procedures will involve the review of the patient' medical hi tary, upp lemented by infor­ mation gathered from a variety of E PRJ 'G 1 neurop ychological te ts and physical and psychiatric profiles, as well as blood tudie and computed tomography scans. Although phy icians at some Alzheim­ er' centers claim a cliagno tic success rate of nearly 90 per cent, Edwards cautions char a definitive diagno is can only be possible at autopsy or through brain biopsy. "Essentially, we diagnose Alzheimer's and related disorders by ex­ clusion - the elimination of all oche r possible reasons for the clinical picture "We have to realize that just because an individual has Alzheimer's or a similar illness, it doesn't mean that there aren't any number of physical problems present. The alleviation of an aggravating physical condition may reduce confusion . . . and make the patient more comfortable." presented by the patient," he explained. Edwards makes the point that testing can have beneficial re ulcs for the patient even if the ultimate diagno is is that of an irreversible dementia. "We have co realize; he says, "that ju t because an individual ha Alzheimer' or a imilar illne s, it doesn't mean that there arent any number of physical pro­ blems present. The alleviation of an ag­ gravating physical condition may reduce confu ion, depre ion and so on, and make the parient much more comfor­ table." Arthur Cryns, Ph.D., director of the Multidisciplinary Center for the Study of Aging and a UB professor of Social Work, applauds the multidisciplinary ap­ proach to be used at the new Alzheimer's Cente r. He point out that the older popula­ tion is increasing rapidly, and many phy ician aren't used co dealing with the elder ly in large number . "As a result; Cryns says "many doctors find it difficult to a e s dementias, which are e sential­ ly, though not exclusively, diseases of the aging. "By including heaJth care profe ionals from many fields in the asse ment pro­ cess, the Alzheimer' A si ranee Cente r can develop a comprehensive mechanism for diagnosis at the optimum level~ Once diagnosed, patients with A lzheimer's Disease and related disorders are usually cared for at home by relatives for many years before nursing home placement becomes fea ible or po sible. While often in good physical health, they are "labor-intensive" patients who require a great deal of attention and, ultimately, in-home cu codial care. T he middle rage of Alzheimer's Di ease is referred co by caregivers as "the wor t." le invo!ve year of bizarre and even dangerous behavior precipitated by an inability to perform purposeful movement, a lo s of ab tract speaking ability, delusions, hallucina­ tion , and paranoia. This i followed by evere long-term memory lo , profound hypoaccivity, reversion to early life behaviors, and death, frequently from re piracory infection. "During the midd le stages," say Joan Mrozin ki of ADRDA, "in-home patient care becomes increasingly difficult. Pa­ tients are confused and frightened, ometime hostile, and finally have to have all their needs met by a caregiver ... an adult child perhap , and frequent­ ly an elderly spouse. lc's very demanding phy ically and emotionally for the fami­ ly." "The inclusion of ocia! workers, BUFFALO PHYSICIAN AND BIOMEDICAL SClENllST �psychologist , and peer- upport groups as isolating the gene chat causes the familial the diagnostic and treatment problem adviso r to the Center recognize that form of Alzheimer's, and physicians are that physicians, patient , and their the caregiver needs considerable support becoming more proficient at managing families have confronted for o many in order to provide competent care once their affective symptoms, there is no year. the patient leaves che medical setting; prevention and no cure now. "Through this effort ... chis collective Cryn says. "The e profe ional offer laying on of hands ... we bring to bear Some estimate indicate chat the physicians and familie a great deal of number of Alzheimer's victims alone will che resources at our command so that a istance in managing difficult patients neither the patient nor his family needs nearly triple during the next five decades and in coping with their own sere reac­ an increase that promi es to strain the to feel abandoned:" tions ." The Alzheimer's Di ea e Assi ranee re ources of families and the health care Mrozinski, whose mother uffered delivery y tern. Perhap in recognition Center is co be governed by a policy from Alzheimer's Disea e for 12 years of chac face, annual federal research fund- board composed of John aughton, before her death, say , "There is no M.D., vice president for clinical affairs preparation for the kinds of behavior and dean of the School of Medicine and families have to contend with . .. the Biomedical Science ac UB; Fredrick W. wandering, the paranoia, total di orien­ Seidl, Ph.D., dean of the School of Social tation, physical and mental disintegra­ Work- Bonnie Bullough, Ph.D., dean of tion. It's deva eating. It's exhausting . I che School of ur ing; Gloria Olm tead, never felt a if I'd done enough.n acting commi ioner of enior Service for Erie County; Mary Ann Boll , direc­ Gary Brice, associate director of the Multidisciplinary Center for che Study tor of the Coordinated Care Manage­ of Aging, concurs. ment Corporation, and haron Len­ "Alzheimer's isn't going co go away, and hardt, pre idenc of the local chapter of it's becoming more complex for the ADRDA. erving on the Center's advisory board caregiver to handle, Brice aid. "Since are Jane Peltier, project director of ADR­ 19 2, we've offered them training to help them cope with che more difficult aspects DA's Western ew York Chapter; Mary of the illne , but the face is that there Jo Anderson, Catholic Charities; Diane Huff, director of the Community Alter ­ aren't enough nursing home beds and native Services As ociacion; Ronald many family member have to work oucMaier, chairman of the We tern ew ide the home, so they find it difficult to York Human ervice Consortium; Mar­ provide the kind of constant attention vin Herz, M.D., chair of UB's Depart­ required. They need all the help they can gee." ment of Psychiatry; Michael Cohen, .D., chair of UB's Department of Through its association with the Mul­ eurology; Glen Gresham, M.D., chair tidi ciplinary Center for the Study of of UB' Department of Rehabilitation Aging and the ADRDA, the Alzheimer Medicine, and Kathleen Barrett, chief A si tance Center i expected to link administrarive officer of the Odd Fellow caregivers with training like chat referred and Rebekah ursing Facility in to by Brice, as well as with re pite pro­ Lockport. grams, legal and financial a sisrance, in­ amed as ociate directors are Arthur home health aides, day care and Cryns, Ph.D., professor of ocial Work; ing for the study of the e disorders ha housekeeping ervice , nur ing homes, peer-support groups, and ocial service increa ed more than 500 per cent since Evan Calkins, M.D., professor of medicine and family medicine; Linda agencies. the lace 1970s. The first re earch breakthroughs are expected to be in Janelli, R. ., Ed.D., clinical instructor of diagnosis, rather than in an under rand­ nur ing; Bradley Truax, M.D.,a istant lzheimer's Disea e and ocher pro­ ing of the multiple cause or treatment professor of neurology; Marion Goldgre sive, irrever ible dementias are tein, M.D., clinical a ociate profe or of among the most serious disorder to af­ of che e di order . psychiatry; John Feather, Ph.D., a istant onechele s, Edwards maintain that flict our older population. They are the by pooling the knowledge and expertise profe or of medicine, and Carol owak, fourth leading cause of death among of several health care profe ions, the Ph.D., clinical associate professor and adults, and at least 337,000new cases are Alzheimer's Assistance Center "offers an associate director of the Multidisciplin­ diagnosed annually . excellent opportunity to re olve ome of ary Center for the cudy of Aging. • Although researchers are closer to "Some estimates indicate that the number of Alzheimer's victims will nearly triple during the next five decades, an increase that promises to strain the resourcesof families and the health care delivery system." A BUFFALOPHYSICIA A.'JD 81 MEDICAL SCIENTIST SPR1'J G I 23 �Hospital ews RURAL HOSPITALS Co-op pools resources T he Rural Healthcare Cooperative, Inc., a group of 12 rural ho pital in We tern ew York, ha re­ ceived a 700,000 grant for a shared com­ puter ystem and ocher collaborative project . The four-year grant i from the Robert Wood Johnson Foundation. The member of the cooperative are Brooks Memorial Ho pita! in Dunkirk, Cuba Memorial Ho pital in Cuba, Jame town General Ho pital in Jamestown, Jone Memorial Ho pical in Wellsville, ewfane lntercommuniry Hospital in ewfane, Olean General Hospital in Olean, t. Francis Ho pital in Olean, t. Jerome's Hospital in Batavia, alamanca District Ho pital in Salamanca, Tri-County Memorial Hospital in Gowanda, WCA Ho pical in Jamestown, and Gene ee Memorial Ho pical in Batavia. on-hospital member are the Depart­ ment of Family Medicine at UB, Mercy Health Sy tern of We tern ew York Inc., and Vital net, the holding company of Millard Fillmore Ho pital. A major function of the grant i quali­ ty a urance, aid Thoma C. Rosenthal, clinical a sociate profe or of family medicine at UB. In quality assurance, a ho pical ex­ amines it elf to make ure it services are up to par. For example, it should review the appendectomies chat have been per­ formed and find that 10 per cent were done on what turned out to be normal appendixes. If the number i lower, doc­ tors are waiting coo long co do surgery, Rosenthal explained. To perform these quality a urance SPRING I co another hospital in the co-op, the se­ cond ho pital doesn't have to go through all the work of compiling another pro­ file. The work has to be done only once. And it also prevent a physician from getting in trouble at one hospital and simply going down the road to another rural hospital - something that ha been known to happen, he noted. A nother a peer of the gram will look at providing services chat haven't traditionally been offered at a small hospital. With the national trend toward fewer inpatients, hospitals must look for . ~,,,~ ..11/1/1,,i ' way to remain financially viable, he aid. ~t.• , , ,r,, , '-:,. , _.·· . ·•\ ,.. They also want to find ways to meet local ··· . . . ,.._..,. ·, ' 'ti• .•tl"• · · , '~:~· need . \)\1•.t.. ... '.'.:''"':;,,-\;.:.'.'•. 1~-'"~";,~ .._.. For in ranee, walk-in acute care center ~ might be established. These are modifica~ tion of the emergency room. They're designed for people who have ailments ~ uch a sore throat that don't require the drama and expertise of a full emergency review , a large volume of information room, but need to be een by a health­ needs to be computerized, he noted. This care provider. grant will help develop a computer net­ Another idea is co et up wellness work co erve all member ho pitals. centers. People would receive an evalua­ Special nurses are al o needed to go tion and perhap an exerci e prescription through patients' chart and dig out che for getting into hape and staying in appropriate information. A small hape. Tying in with chat are cardiac ho pica( may nor have enough work to rehabilitation centers for people with keep one nurse bu y at this all the time, heart ailment . o hospitals can hare personnel. The ho pitals will also look at haring The computer will also be imporcant service . The two Olean hospitals for medical credentialing. When a physi­ Olean General and t. Francis - are go­ cian applie to one ho pital in the group, ing to share obstetrics and pediatric his or her applicarion is reviewed by the rather than duplicate chose services in a co-op. mall city, Rosenthal said. The advantages co chis, Ro enthal ex­ Some hospital beds will be converted plained, are chat if the physician applies to long-term, skilled nur ing bed . Tri4 ~ ' - - i · ·· i I BUFFALOPHY ICIA AND BIOMEDICALSCIENTIST �Hospital 1 ews 25 County Memorial, Cuba Memorial, and WCA hospital are planning such conversions. The Univer ity will play a key role in continuing education for phy icians, nurses, and ancillary staff, Ro emhal said. Re earch comes under this um­ brella. The aim is to develop a rural health network to study rural health trends and rural health care issues. "By doing research, we're also stimulating people and helping them to maintain their credentials," he noted. Two projects have been started. One is to look at the office procedures of fami­ ly physicians, particularly regarding en­ dometrial biopsie . The other is to look at the survival rate of women who have had acute myocar­ dial infarctions. That' never been done in rural hospitals before, and the tatistics may be different from the city or suburbs because of the difference in support of the community and family, Rosenthal explained. The Univer ity also plans to eventually use the ho pita!s in the co-op as teaching sites, he added. Another part of the grant will be everal model programs. These include women's health care services, programs for people who have been hospitalized for alcoholism, and programs for the pa­ tient leaving the hospital who needs er­ vice such as intravenous medication for a time at home. Ro enthal is the program director for the UB family medicine residency pro­ gram and served as clinical advisor for obtaining the grant. David M. Holden, professor and chairman of the Depart· ment of Family Medicine, was instru­ mental in initiating the idea of the co­ op and grant. While the University assists the group, the cooperative is run by the member ho pita) , Rosenthal emphasized. • BUFFALOPHY !CIA AND BIOMEDICALSCIENTIST Balloon used to open aortic valve at BGH A n alrernative to open heart surgery for high-risk patients has been performed uccessfully at Buffalo General Ho pital. The procedure, known as balloon valvuloplasty of the aortic valve, was per­ formed in December. It was the first such procedure at the hospital, according to Djavad T. Arani, M.0., acting director of the Department of Angiology at BGH and clinical associate profe or of medicine at UB. The procedure was performed on an 6-year-old female patient who wa discharged after three days, Arani said. The patient had a severe narrowing of the aortic valve resulting in conge tive heart failure. The procedure reopened the aortic valve and the blood flow returned to normal. Balloon valvuloplasty is somewhat similar to balloon angiopla ty of the cor­ onary arteries, Arani explained. A local anesthesia is administered and a catheter with a balloon attached at the rip i in­ serted into the femoral artery in the groin area. The catheter is advanced aero the aortic valve into the left ventricle, the heart's primary pumping chamber. "Once the balloon i in the aortic valve, it is expanded with angiographic contra t olution," Arani aid. "Expan­ sion of the balloon usually results in dila­ tation of the ob tructed valve and re-establi hment of normal blood flow through the aortic valve:" He observed that patients with aortic valve disease usually undergo open heart surgery in which an artificial valve is inserted. "Balloon valvulop!asty i a new alter­ native to open heart surgery for high-risk patients," he said. Patient in the high­ risk group include the elderly with ad- vanced heart failure, or individuals with severe lung disease, cancer, or renal failure. While open heart surgery normally cakes everal hours, the length of a balloon valvu!oplasty is approximately 1 to 1½ hours and the patient is con cious, Arani noted. He aid that persons who have aortic stenosis, or a narrowing of the aortic valve, ri k evere heart failure or sudden death if the condition is not treated. "Once the aortic valve narrowing reache a critical point, the pressure in the left ventricle continues to increa e and the situation become life­ threatening," Arani explained. "We will continue to use balloon valvuloplasry for patients who are not candidates for open heart urgery. In ad­ dition, we also will use this modality to treat patients who have a narrowing of the mitral valve." (The mirral valve con­ nects the upper and lower chambers on the left side of the heart.) Along with Arani, members of the angiology team involved in the fir t balloon valvuloplasty at BGH Included John P Visco, M.O., clinical a siscant professor in medicine, and James G. Conley, M.D., as istant professor in medicine. • ECMC names Pruet new medical director C harles Pruet, M.D., has been ap­ pointed medical director of the Erie County Medical Center. Pruet was director of otolaryngology at ECMC for one year and has served on the medical staff of Veterans Administra­ tion Medical Center as associate chief of staff for education and chief of otolaryn­ gology. Before that, he was in private practice in Florence, Ala. PRING I �Hospital ews 26 Joseph Zizzi, M.D., who wa medical director for eight years, has been named deputy medical director. Last summer he asked that a replacement be found o that he could return to teaching and pa­ tienc care. In hi new po ition, Zizzi will be respon ible for developing a Physician Ca e Management Program in coopera­ tion with the County Department of ocial ervices to provide recipients of public assi tance with health care ser­ vice which would be coordinated with one primary care phy ician. Zizzi will al o seek to increa e private phy ician activity at the ho pita!. Pruec is a graduate of the Univer ity of Alabama at Birmingham Medical chool and ha completed a fellowship in head and neck oncology surgery at UB. He i a fellow of the American Academy of Otolaryngology / Head and eek urgery, the American College of Surgeons, the American Academy of Facial, Plastic, and Reconscruccive urgery, and the American ociety for Head and eek Surgery. Pruet is also a senior member of the As ociation for Academic urgery and a liaison fellow of the Commi sion on Cancer, Ameri­ can College of Surgery. He has published in the area of oco­ laryngology / cancer of the head and neck. Zizzi,a cardiology attending phy ician, began his ECMC a ociation in 1958 after graduating from the UB Medical School. He was acting hospital director from 1984 to 1986. He ha been president of or held of­ fice in the Western ew York Heart A ociation, the We tern ew York Society of Internal Medicine, the ew York Heart Assembly, the Medical Socie­ ty of ew York State, and the medical­ dental staff of ECMC. PRING 10 sional societies, including both the Erie County and ew York Scace Medical Societies, Armenia is al o a member of che American Medical A ociation; the American, ew York State, and Western ew York Societies of Internal Medicine, and the American and Buffalo Diabete Association . Ocher medical raff officers elected for 19 were: Andrew Green, M.D., clinical in truccor in medicine vice president; Anthony Bu caglia, M.D., clinical assis­ tant professor in medicine, secretary; and Bernard Mu cato, M.D., clinical in true­ tor in gynecology-obstetrics, treasurer. • ECMC expects to get regional AIDS center Josep h P. Arme nia A Diplomate of the American Board of Internal Medicine, he ha published in the area of cardiac disease . • Armenia elected president of Mercy's medical staff J oseph P. Armenia, M.D., chief of the Division of Endocrinology, Depart ­ ment of Medicine at Mercy Ho pita!, has been elected president of the hospital' medical staff for 19 8. Armenia, a clinical associate profe sor of medicine at UB, i also a 1962graduate of the UB chool of Medicine. Follow­ ing his intern hip, re idency, and en­ docrinology fellowship at Buffalo General Ho pica!, Armenia was in the U.S. Army Medical Corps from 1966-196 and received the Army Com­ mendation Medal. An active member of many profes- T he Erie County Medical Center expect to soon receive final State approval for its designation as a regional AIDS center. ECMC will act as a re ource for ocher hospital . It will provide consultation, re ource information, and a sisrance to a variety of health care providers in managing their AID patients, aid George McCoy, chief executive officer at ECMC. According to McCoy, ECMC has been providing some unique ervice co the AIDS population. "We are the only ho pita! in the area to provide a clinic for patients with a confirmed diagnosi of AID ; he said. Becau e of the ho pital's work with UB, ECMC patients benefit from the University's participation in a ational In tituces of Health grant to evaluate new cherapie for the treatment of AIDS, McCoy noted. "This de ignation will assist the Medical Center in attracting more grant fund , which will contribute to expanding the knowledge ba e about AIDS; he said. Case management will be a cor- BUFFALO PHY ICIAN AND BIOMEDICAL JENTIST �Hospital eivs 27 ner tone of the Medical Center's AlD program. "Client will receive a comprehen ive treatment plan for all phases of their disease; said Ro Hewitt, M.D., who will be medical director of the new program. He is a po tdoccoral re earch a ociate in medicine at UB. "The treatment plan," Hewitt noted, "will include arrangements for inpatient, outpatient, and home care ervice . The plan will cake into account both medical and nonmedical needs of the patient and his or her family or social network. An assessment of social, financial, psychological, and piritual needs of the client will be integrated into the overall treatment plan. "Ca e management service will im­ prove the continuity of care and it should reduce the co t of care," Hewitt aid. ince ECMC i already functioning as a resource center, the designation pro­ bably won't produce dramatic change , McCoy said. "Over time, the hospital hope to tim­ ulate the development of ervices not currently available for AIDS patients," he aid. Included in such ervices will be ho pita! and re idential ervice . • Med-dent officers elected at ECMC M urray Ander en, profes or of surgery at UB, has been re­ elected pre idem of the medi­ cal-dental staff of the Erie County Medical Center. The chief of cardiova cular urgery ha been a sociated with the ho pita! for more than 21 year . During that time he has held numerou offices on the medical-dental taff. Elected pre idem-elect is Jan ovak, clinical associate professor in medicine at BUFFALOPHY !CIA AND BIOMEDICAL SCIENTIST UB, ECMC sign new affiliation A Murray Ander en UB and head of the ga troenterology unit at ECMC. The new ecretary is Frederick Mun chauer Ill, re earch a i cane professor of neurology at UB and attending in neurology and medicine. Re-elected crea urer is eil Dashkoff, clinical a istanc professor in medicine at UB and chief of the cardiac catheteriza­ cion laboratory at ECMC. Re-elected representative of the volun­ tary staff are Michael San one, clinical assistant profe or in ophthalmology and assistant attending in ophthalmology, and Edward tehlik, clinical a i cane profe or in medicine and a i tam at­ tending in the medicine- pinal cord in­ jury unit. Re-elected representative of rhe full-time raff is Rocco Venuto, professor of medicine and head of dialy i ervice . Ju tine Krawczyk, a i tam profe or of medicine and director of the coronary care unit, i the newly elected repre en­ tative of the full-time staff. • pact new affiliation agreement be­ tween UB's chool of Medicine and Biomedical Sciences and the Erie County Medical Center, a ma­ jor teaching hospital of the Univer ity, was signed in February at a Capen Hall ceremony. The agreement reaffirms the institu­ tion ' hared education and research misions and outline a spacereimbursement plan chat i expected to increase the ho pital's income by approx­ imately $750,000 in 19 . Among tho e present at the ceremony were UB Pre idem Steven Sample; George McCoy, chief executive officer of ECMC; Erie County Executive Denni Gorski; John aughton, M.D., vice presi­ dent for clinical affairs and dean of the chool of Medicine and Biomedical Sciences; Kevin ullivan, president of Medaille College and chairman of the board of tru tee of ECMC; M. Robert Koren, chairman of the UB Council; Provost William R. Greiner, and Robert ]. Wagner, vice president for Univer icy services. The agreement, which updates an af­ filiation agreement igned by the two in­ stitutions in 1962,further defines the role of the Univer icy in relation to the ho pita!. Specifically, it brings the rela­ tionship between ECMC, the Univer i­ ty, and the School of Medicine into line with those between the Univer icy and it other major teaching hospital . ample aid the agreement "define and reinforce our institutional relationhip with the Erie County Medical Center and generally defines the ground rules by which we pur ue our hared goals. "ECMC is a major participant in our Medical School's research and educa- PRING I �Hospital ews & People 2 tional activitie . The new agreement will h Ip the school fulfill it goal , particular­ ly in the field of medicine, p ychiarry, trauma, and rehabilitation medicine." ullivan , chairman of the ECMC board of manager , indicated chat he is plea ed with the agreement , which he aid, "replace one that i badly out of date ." The new affiliation agreement, he aid, "more accurately reflect our current rela­ tion hip and de ignates the medical center a a major academic center for reimbur ement purpo e ." Erie County Executive Dennis Gor ki noted that under the term of the up­ dated agreement, the ho pita! will iden­ tify pace used by the Univer ity ex­ clu ively for re earch and teaching ac­ tivitie and UB will reimbur e the ho pital for each u e. "We expect," he aid, "that in 19 alone, Erie County edical Center will realize additional income of 750,000a a re ult of the term of the new affiliation agreement." • Deaconess changes name to reflect new mission K nown for more than 90 year a the Deaconess Ho pita! of Buf­ falo, the health care facility lo­ cated at 1001 Humboldt Parkway ha been officially renamed the Deacone s Center. Buffalo General Ho pita! has o crated Deacone s ince 1979 when the two facilities merged. Acute care ervice were di continued at Deacone sin 19 5. The facility wa licen ed a a hospital until la t year when it wa given the sole de ignation of" killed nur ing facility." In addition to the skilled nur ing facili­ ty, al o located at the Deacone Center ' PRING I are the Family Medicine Center, the lm­ med iate Treatment Center, and alcoholi m and dental clinic . On Riley Street aero from the Deacone s Center is the Family Planning Clinic. Thou and of per on visit che Family Medicine Center annually where UB re ident phy ician provide a comprehenive range of health care service . Vi its to the Immediate Treatment Center in 19 7 nearly doubled tho e for the previou year. The ITC is a walk-in unit open 65 day a year to care for patient requiring quick treatment for minor in­ juries and ailment . ince it founding in I 95, Deacone s ha undergone several name changes. E tabli hed as the German Deacone Ho pita!, it later was renamed the Deacone s Hospital and Home, and eventually, the Deacone Hospital of Buffalo. • Wil on Greatbatch , an adjunct profe or in electrical and computer engineering at UB, has been elected a member of the pre tig1ous ational Academy of Engineering for inven­ ting the fir t implantable human heart pacemaker. More than 1.5 million live have been av­ eelby the device ince it was invented in 1960. Greatbacch i president of Greatbatch Gen­ Aid Ltd. His mo t recent research project fo u on the field of immunology. • Robert Guthrie , M .D ., a UB scienri t in­ ternationally known for hi research in in­ born error of metaboli m, ha been named mterim president of the We tern ew York Chapter of Physician for ocial Responsibility. Guthrie, who is known for hi work in developing the PKU test for newborns which is used throughout the world, replaces Tim Byer , M.D., a UB faculty member who has moved to ew exico. The group is compo ed of physicians and ochers who aim to educate the public about the importance of reducing the threat of nuclear war. • Marvin I. Her z, M .D., professor and chair­ man of UB' Department of P ychiatry, i the recipient of the American P ychiatric Association' third annual Psychiatric In­ stitute of America Foundation Ho pica! Re earch Award. The honor wa bestowed for Herz' our­ randing contributions in hospital p ychiatry research. The award wa o be pre ented during the American Psychiatric sociation' annual meeting May 7-13 in Montreal. • Franci Klock e, professor of medicine and phy iology, and president of the American College of Cardiology, was recognized a the "Heart Per on of the Year" by the We tern ew York Chapter of the ew York tare Af­ filiate of the American Heart Association at February' Annual Heart Ball. • John aughton , vice pre idem for clinical affairs and dean of the chool of Medicine and Biomedical Sciences, was recognized a the Person of the Yearin Medicine by the a­ rional Confe rence of Christians and Jew , Buffalo and Erie County Chapter. • amuel Shatkin , D.D . ., M.D. , clinical associate professor of urgery, wa recently elected to fellow hip in the American Academy of pediatrics. hatkin ha been elected a Pia tic urgery Fellow of the academy. • Erratum T he name of the Department of P ychiatry will remain the ame. After di cu sion, it was decided not to change the name to the Department of P ychiatry and Behavioral Science . The matter wa incorrectly reported in the late winter 19 edition of the Buffalo Physicianand Biomedical ienci.sc. We regret the error. • B FFAI.OPHY. I lAN A D BIOMEDI L IE1'"1b 1 �29 Mar e k Zaleski ZALESKI HONORED FOR TRANSLATION OF POLISHBOOK U B microbiologi t Marek Zaleski, M.D., Ph.D., ha been honored for arxism & his translation of Christianity:the Quarrel and the Dialoguein Polandby Jozef Tischner, the piritual leader of Solidarity. Zale ki was honored along with co­ tran lator Benjamin Fiore, .J.,of Cani ius College. The UB profe or, who left his native Poland in 1969, is u ed to his role a a tran lator. In December, he a isted UB radio station WBFO with telephone interview to Lech Walesa which were sub equemly BUFFALOPHYSIC !A, AND BIOMEDICALSCIE1''TIST rebroadca t to Poland via Radio Free Europe. La t year, he helped tran late into Engli h Lech Wale a' autobiography, Lech Walesa: A Wayof Hope,publi hed by Henry Holt Co. lnc. In 19 4, he and Fiore translated for Harper Row Jozef Ti chner' collected er• mon , piric of olidarity. Ti chner's late t work, translated by the Buffalo educator , devote 164 pages co the original manu cript of the priest-philosopher. The Poli h version was published in 19 I by the French publi hing house, Editions potkama. An additional 62 pages by Zaleski and Fiore provide detailed foomoces to explain portions of Ti chner' text, including event , in idem and people familiar to the Poli h reader but perhaps le o to the American. Ti chner, in hi late t book, writes that dialogue i po ible between the Communi ts and Catholic of Poland. Further, he detail the hiscory of their relation hip ince the end of World War ll and the indicators which ug­ ge t dialogue may be kept con tructive and reali tic. The Engli h version of the book wa publi hed in February by Georgetown Univer iry Press. • PRll·c JQ , �BIRTHDEfE(TSThe bestcureis prevention,says geneticist JO ((Last By CLARE O'SHEA !'IU,'G I week I aw a woman who_ wa poor and didn't have a doctor; he wa drinking half a fifth of gin a day, and he was pregnant. That lady i a walking time bomb. he might have d.t.'s if he comes into the ho pital. And she has a 50 per cent ri k of having a baby with a birth defect or mental retardation." Luther K. Robin on, Jr., a i tant pro­ fe r of pediatric at B, treat uch pa­ tient all the time. But one of hi goal as director of Clinical Genetic and Dy morphology at Children' Ho pita! i to help top uch cragedie from happen­ ing. Through information. "I would like to ee a better informed populace," Robin on said. "There are creative ways of providing information that may relate co better health habit for people who may not go co doctor . We need co think of tho e ways. That's one of my challenge ." The clergy, Robinson added, might be "unrecognized allie " in the di emina­ cion of important health information. A a dy morphologi c, Robin on tudie birch defect . He came co Buffalo lase ummer from the Univer icy of Texas Medical chool at Hou ton, where he was assi rant professor of pediatrics and director of the March of Dime Birth Di abilitie Center. Here at UB and Children' Ho pita!, he has three roles: physician, teacher, and re earcher . The physician role take Robin on from the bed ide of children with birth defect such a neurofibromaco i , ickle cell anemia, or cy tic fibrosi , co their familie , whom he evaluate for po ible genetic contribution to tho e birth defect . A little boy goes home after an opera­ tion, for example, and oon after ha blood in hi urine. He i diagno ed a having malignant hyperthermia, com­ monly referred co as MH. Robinson ce cs the boy's mother and find chat he, coo, i predi po ed to MH. With chat infor­ mation, the mother now know chat he and her son will need co cake dantrolene before undergoing any type of urgery in B ' FFAlO PHY ·1 IAl . A1'D BIOMEDICAL IE, :ilST �31 BUFFALOPHYSICIA, AND Bl MEDICALSCIENTIST �Medical chool 1 32 order to avo id ide effect uch as mu · de cramps, fever (hyperthermia), or acido is. "In addi t ion to the clinica l service I do, I am a teacher; Robinson aid. "le i im• portant o me that I can teach tudenc , phy ician -in-training, and practicing phy ician thing that I kn w may im­ portant to their daily pra tice of medicine." R ews but mothers read chi sensational infor­ mation in rhe lay literature and have seriou que tion ." T he divi ion of genetic , located in a red brick h u e next to Children' Ho pica!, receive many con erned call every w k, fr quently from mothers anxiou about che effect of rheir behavior or health habit on their babie . The e call are taken by the generic raff, which include three coun elor . obin on' re earch work, like hi job, i multifaceted. Fir r, there i the clinical delineation of birch defect , which involve "evaluaring babie who have irth defect , trying co r cognize uh-population of individual with pecial kind of irch defect , and trying to identify way that tho e specialized birth defe ts arise," he explained. Recognizing new genetic di order and conveying such finding to the genetic community is another omponent of Robin on' researc h work. But the mo t difficult pare of hi re earch, according to Robinson, i the identification of teracogen , or harmful agents that an increase the ri k of birth defect in the developing human fetu . "For example, in 196 and then again in 1973, chroni prenatal exposure to alcohol wa hown co increa e the risk for birth defect and mental retardation in the human fetu ; Robin on aid. " ince then, there' been a con ern about whethe r binge drinking is also deleteriou co the developing baby. You would think that ince alcohol or it by-products cro the pla enca and gain acce ro the baby, three or fou r day of binge drinking could be deleteriou . ome pre cription "They take information (on} the nature medication cro the placenta and have and gestational timing of chc expo ure, harmful effect on the deve loping baby, and any kind of familial ri k that may and we're concerned about chose a well." interplay with the expo ure and incr a e Reports on putative teratogen need th liability for birth defect ," Robin on aid. "We review all the information a al o to be tested, Robin on added. well a any p rtinent current literature, "'Weu ed co think that oral contracep­ tive , for example, dramatically increa ed then call the woman back and end a let­ che ri ks for cardiac defects. But ub e­ ter to her and her doctor." The gen tic division ha immediate quenc view have sugge ted that that relation hip wa made in error, that oral acce to ceracogen databases, uch a contraceptive may not increase the risk . that maintained by the Reproductive Toxicology Center in Wa hington, D.C., Lot of babie ar conceived while their mother a e taking oral contraceptive , thank to the recent addition of com- "Families are oftentimes not so concerned that ou have a name for the baby's condition but about real family issues: 'Ism child going to be retarded?Is m child going to die?' " ~PRING I purer equipment funded in part by the tare Health Department. If appropriate the pregnant woman and her family are brought in for con­ sultation. Later, che baby is brought in for a follow-up examination. "Fortunately, most of the expo ure are not harmful," Robin on said. "A lot of women worry about conceiving \ hile taking oral contraceptive , they worry about taking a pirin or antibiotic dur­ ing pregnancy, they worry about fever and pregnancy. We know rhat high maternal fever {104degree or more) can incr a e the ri k for birch defect , but itting in a jacuzzi may not be a problem. We get lots of life tyle kind of call ." T here are a out 3,000 known genetic di order , according co Robin on. Among the mo t common of di order he treat at Children' , he aid, are Down' yndrome, fetal alcohol yn­ drome, and defects related to the central nervous y tern. Once a baby i diagno ed with a pecific birth defect, the parents will need special coun cling. Family members may have to be evaluated for po sible predi o ition to the di order; they al o may need he lp in under randing and ac­ cepting the whole situation. "They're oftentime not o concerned chat you have a name for the baby' con­ dition but about real family i ue : 'ls my child going to be retarded? I my child going to die?' "When a family has a child with a birth di ability, there' a denial proce : 'What the doctor i telling me isn't really true, it' the wrong diagno i or the wrong baby;" Robinson continued . "Then there's the anger: 'The e guy are crazy and I hate them all: And the guilt: 'who e ide of che family did it come from?' n Regardle of whether the baby ha spina bifida or i born prematurely, the family will be asking similar que cions, Robin on aid. "lf the baby de liver at 2 week ge ta• tion, and instead of being delivered out of urburban memorial ho pita) he' now at the Chi! ren' Hospital hook d up to BL'FFAID PHYSICIAN A , 'D BIOMEDICA L SCIE~"TIST �Medical chool ~ ews "The rapid explo ion in technology contra t with a mailer gain in 33 under tanding in term of per onal, ocietal, and cultural concern ," he aid. "We have che ability to detect di ea e now before the per on ever even ha it; we can ay, 'At age 40 co 50, you're going co come down with a di ease: Jc' exciting chat we have the technology to do that, but there' al o a re pon ibility to pro­ vide chat information in a way chat i upportive (of the per on who receive ic). " ow, people wane co di cu thing , they want to be informed. And doctor have co be able to communicate with their patient in a true relationship rather than (continue) the unequal kind of ic­ uacion chat has gone on in the past." • International meeting on immunology set by Witebsky Center ''I Luther K. Robin on, Jr. all the e monitor , it' the ame proce : 'What did we do wrong? Thi can't be happening co u : • B e ide providing progno i and recur­ rence ri k counseling to familie , the genetic taff ha taken an exrra step in­ to the community with the Genetic Con rtium. The con rtium meet with member of variou advocacy group that bring together people afflicted with or in­ cere ted in pecific genetic di order or di abilitie . Down' yndrome, neurofi­ bromato i , cy tic fibro i , and cleft lip are among the di order repre ented by local group . "Many cime parent gee che impre ion from talking co ocher members of che healch care team that their child' con­ dition i rare," Robin on aid. "And 'rare' gee cran laced into 'freak of nature: 'unusual; 'nobody in Western ew York or the world ha ic: We cry co get people with rare di order talking co ocher peo­ ple who might be imilarly affected or have common need ." The very exi cence of uch upporc group indicate greater communication among phy ician , patient and their familie , and che general community. Ac the same cime, technological ad­ vancement have made identification of birth di order and potential ceratogen ea ier co pin down, under cand, and publicize. Bue there are till genetic i ues chat need to be addre ed, Robinon empha ized. mmunology and lmmunopathology of the Alimentary Canal" will be the theme of the 11th International Con­ vocation on Immunology ponsored by UB' Erne t Witeb ky Center for Immunology from June 12 tO 16. The convocation, which will be held at the Buffalo Hyatt Regency Hotel, will feature some 35 scienti t from around the world and include topic uch as: ■ Ba ic immunologic consideration , in­ cluding immunologically re pon ive ti ue cell of gingiva, tonsil , Peyer' patche , and liver. ■ lmmunopathologic condition , with empha is on periodontal di ea e, heparin , and liver ho t respon e to metasta es. ■ utritional effect on the immune re ponse including milk and protein-losing vaccine. Thoma E. tarzl, widely known for hi work in human organ rran plantation, of Pittsburgh, Pa., will present the Ernest Witeb­ ky Memorial Lecture on June 15 during the convocation. peaker at prcviou convocation have in­ cluded internationally known demist who e experti e lie in vanou areas related to immunology. Each convocatton focu upon a particular theme which would be of interest to demi t as well a clinicians. • PRJ),,;GJq BUFFALOPHYSICIA A ·o 81 MEDICALSCIENTl!,T �34 25 ATTEND1STMEETINGOF JAMESWHITE SOCIETY T wenty-five members of the James Platt White Society, a group of ma­ jor annual contributor to the School of Medicine and Biomedical Science , attended the second annual meeting of the Society on October 23, 19 7. Held in the Roswell Park Room of the new­ ly renovated Health cience Library on the Mam Street Campus, the meeting was opened by Dean John aughton who ex­ plained the School' selectivesprogram. Then, members ac in on a team-caught selective seminar on ethical dimen ions in medicine taught by teven Wear, Ph.D., clinical a i · cant professor of medicine and assistant pro­ fessor of philosophy, and Jame Bono, Ph.D., in tructor in medicine and adjunct assistant professor of comparative literature. The two instructor were a isted by con ultant Jack Freer, M.D., clinical assi rant profe sor of medicine, and Ellen Weis man, J.D., who dealt with medical/legal i ues. Member of the ociery participated along with rudent and faculty in the eminar discu sions. Also during the meeting, Dr. Marvin Kurian, secretary of the Buffalo urgical Society, presented historical memorabilia from the Society for display in the Academy of Medicine Room in the Health Science Library. PR!lsG I Society member toured both the Medical School and the Health iences Library, then rode the Buffalo rapid transit line to the Marine Midland Center, downtown, for a reception and dinner in the 3 th floor din­ ing room. The dean, faculty members, and representative of the UB Foundation also attended. Each member of the Society was presented with a Jefferson pewter cup a a memento of the meeting. The James Platt White Society is named for one of the founders of the School of edicine who was in private practice in Buffalo for over 40 year (1 35-1 75). A founder of the American Gynecological ociety and one of the founders of several Buffalo hospitals he made important contribution to the prac­ tice and teaching of ob tetric . • University at Buffalo School of Medicine Alumni Directory F (Above) Dr. Kurian (left) and Dean aughton. (Below) Guest , tudents, and faculty mingle at coffee break. inding a former classmate can be ju t like looking for che proverbial "needle in a hay tack.• But not anymore. Soon an impr ive directory of our great alumni/ae wilt be available to help you locate your old friends. The University at Buffalo chool of Medicine Alumni Directory, scheduled for release in May/June 9, will be the most up-co-date and complete reference on over 4,500 chool of Medicine alum­ ni ever compiled! Thi comprehen ive volume will include current name, ad­ d~ and phone number, academic data, plu bu iness information, bound into a cla ic, library-quality edition. Your Alumni A ociation has con­ tracted the Bernard C. Harri Pubh hing Company, Inc. to produce our Directory. Harri will soon begin re earchmg and compiling the information co be printed m the Directory by mailing a question­ naire to each alumnu /a. The Univer ity at Buffalo chool of Medicine Alumni Directory will soon make finding a School of Medicine alumnu /a a easy a opening a book. Look for more detail on the project in future t sues of the Buffalo Physician. BUFFA PHYSICIAN AlsD Bl MEDICAL SCIENTI T �Classnotes 35 Jerome Ka.ssirer (M'57 ) 1940s Arthur J. chaefer (M '47) • has been elected president of the American Society of Ophthalmic Pia tic and Reconstructive Surgery for 19 . Dr. Schaefer is chief of ophthalmic plastic and recon tructive urgery at the Erie County Medical Center and chief of ophthalmology at ister of Charity Ho pita! and t. Jo eph's lntercommunicy Ho pital. 1950s · Robert inclair (M'55) • wa an honor graduate of the 3rd Marine Divi ion Atomic, Biological, and Chemical Warfare Defense chool. Hi cla wa made up of officer serving with all Marine Corps unit in the Far Eat. Arthur Klass (M'56) • authored chapters on laser in &astroenterology in SurgicalLasers: A Clinical Guide, publi hed by Macmillian in 1987. Dr. Klas , whow as recently elected co fellow hip in the American Col­ lege of Physicians, is chief of the GJ Endoscopy Unit at Sinai Hospital, Detroit. Jerome Ka irer (M '57 ) • of Weston, Mas ., has been named ara Murray Jordan Professor of Medicine at Tuft Univer icy. Dr. Kassirer, a n internationally known internist and kidney speciali t, i an a ociace chair­ man of medicine at Tufts and associate physician-in-chief at the ew England Medical Center. He i recognized as one of the leading investigator in two young field - clinical decision analy is and cognitive cience as applied to medicine. Dr. Ka irer erves as a ational Member of the Gover­ ning Board of the Medical Alum ­ ni Association. 1960s Thomas J. Guttuso (M'60 ) • has been named assistant dean at the UB chool of Medicine and Biomedical Sciences. He will also continue his role as director of medical school admis ion . John E. hield (M'68) • a speciali t in internal medicine and gastroemerology, was recently named medical director of the Seafield Alcohol Treatment Center in We thampcon Beach, .Y. IIUFFALOPHY ICIAN A D BIOMEDICALSC!Els'TIST Thomas ]. Guttuso (M'60) 1970s Thomas V. Krulisky (M ' 70 ) • of Lo Angeles was inducted a a Fellow of the American Psychia­ tric A ociarion. John E. Billi (M'77) • i medical director ofM-CARE and assistant dean for clinical affairs at the Univer icy of Michigan edical Center, Ann Arbor. Ronald A. Vidal (M '77 ) • a pecialist in otolaryngology, was elected ro fellowship in the American College of urgeons. Dr. Vidal is in private practice in Clinton, Iowa. Jame Reynold (M'78) • ha been named head of the Depart ­ ment of Ophthalmology at Children's Ho pita! ofBuffalo. He is the author of numerou publicarions, and serves as the ophthalmology editor of Healch­ net Computer Information Serv• ice, a ubsidiary of The Source, CompuServe, and Delphi. Michael L. Wolff (M'78) • an assistant professor of medicine at Albany Medical College, received the 19 7 Albert H. Dougla Memorial Award for Excellence in clinical reaching from the Medical Society of the tare of ew York. Dr. Wolff wa recently elected a fellow of the American College of Physicians. Dr. Wolff, his wife, Linda, and their children: Leah, 7; Aa ron, 4; and Eve, 11/z, reside in Ca tleron, .Y. Peter J. Jederlinic (M'79) • write that he i now an assistant professor of pulmonary and occu­ pational medicine at the Univerity of Ma achu etc . Hi wife, 1980s Je sica Rockwell (M '82) , is an endocrine fellow at Beth I rael Hospital in Bo con. " icole, age J l/z, and Alex, age 11/z, are our finest accompli hmems!" Richard A . mith (M' 1) • i chief of taff and director of laboratories at St. Francis Hospital in Buffalo. Dr. Smith is an assistant clinical professor of pathology and anatomy at UB. Manual aint Martin (M'82) • writes, "finishing up Juris Doc­ ror Degree at Southwestern Uni­ versity Law School in Los Angeles, California. Will start practice in Medico-legal con­ sultation for lawyer and doctors this ummer.• SPRING I �Events 36 MEDICINE AND THE ARTS W hen a physician ha mething co ay, he may ay it in a ien­ tific journal. Or, he may ay it with a era hing ere cendo on the piano. r in a poem. r with the vibrant hue of a photo. The multifaceted quality of health care profe. i nal will be the focu of a day­ long ympo ium on Medicine and the Arts in Buffalo et for aturday, June 4 in the Health cience Library. Ir i cheduled to la t from 10 a.m. to 4 p.m. Pre ented by the Health ciencc Library at B and the Friend of the H L, it will h w a e ·ome local health care profe ional who have dabbled in such media a writing, mu ic, phor graphy, painting,. rained gla , and even art lie ting. It'll also how the ignificanc role health and medicine play in our ulrure, a· reflected in arr. William Carlo \Xlilliam , the famed poet who wa a pra ricing physician, will be the topic of the keynote peech. Keynote peaker will be Kathryn Montgomery Hunter, Ph.D., of the hoof of Medicine at the niver i­ cy of Ro he ter. The moderator for the event will be Alan J. Drinnan, M.O., D.D. ., chairman of oral medicine at B. For re ervarions and information, call ancy Fabrizio in the Health cience Library at 31-240 . • Bl'FFALO rHY~I IAN A1'D Bl MEDI Al SCIE1'1L T �LET US HEAR FROM YOU I want to keep in touch with my classmates. Here is my news for the Classnotes section. ame Addrc Cicy, tatc, Z,p Telephone Ocgrtt , Year Other Program/Yea r Completed Position or title lnsmucion cw: D Clt«k 1fntw addrru �� Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician and biomedical scientist, Spring 1988 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1988-Spring Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1988-v22n01-Spring Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo physician Buffalo medical review Date Created Date of creation of the resource. 2018-08-28 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v22n01 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1988 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/46066fc3272c8d2f90d5df97dd93f3ce.pdf 8ee18efe4a1a4b909a293a88518959fe PDF Text Text p VCXUME 21, H y s c UMBER 3 A N AUTUM ''87 UB Medical Students in the spotlight �BUFFAID PHYSICIAN Dean' s Message STAFF EXECUTIVE EDITOR U IVER ITI PL BU ATIC R bert T M rl tt EDITl~ Bruce ART DIRECTOR Alan J K ler ASSISTA T ESI Rebecc Her ld ER PHOTOGRAPHY Phyl!t Clm r p er Doug! Le, re Frank Luterek Ed wak ADVISORY BOARD Dr. J hn au h n Cluumu.m Dr Har ld Brod Mr. Kevm Cra1g M . Karen Dr))a M n Glteco Dr. Jame Kan kt M . Man n Manonow k1 Dr Dame[ Morell1 Dr. Charles Paganellt Mr. James Ph1lltps Mr. John Pul!t Dr. R bert Sche1g Mr. M1ke Shaw Mr. Steve hivm k) Mr. Raul Velasquez Dr. Mary Voorhess Dr. John Wnghr Dr. Magg1e Wnght Dr. Franklm Zeplowm Dr. Joseph Zm1, Jr. TEACHING HOSPITALS Buffalo General Ch1ldren's Ene County Med1cal Center Mercy M11lard F11lmore Ro well Park Memonallnsutute S1sters of Chanry Veterans Adrmm tration Med1cal Center Produced by !he DiVISron of L nwers11y Relatrons m assoaarron u.uh !he School of Medicine, State Unwerstty of New York at Buffalo. THE BUFFALO PHYSICIA ' (USPS 551-860) Autumn 1987, Volume 21 , umber 3. Pubhshed ftve nmes annually: Late Wmter, pnng, Summer, Fall and Early Wmter - by the School of Medicine, State UmverSltV of New York at Buffalo, 3435 Mam Street, Buffalo, New York 14214. Tiurd class bulk postage paid at Buffalo, ew York. Send address changes to THE BUFFALO PHYSI· ClAN, 139 Cary Hall, 3435 Mam Street, Buffalo, New York 14214. D ear Friends of the School of Medicine: Last June I presented a talk on "The Reprofessionalization of Medicine." While preparing my remarks, I was struck by the fact that as we struggle to cope with the many changes that are occurting in medical education and medical practice, we are faced with the challenge of returning to the fundamentals. For example, I have viewed the dramatic impact that changes in the financing of health care and new malpractice legislation have fostered. It is clear that constructive adaptations to these changes will require our recommitment to those values and concepts that our forefathers identified as intrinsic to the practice of medicine. amely, we must: (1) be willing and able to maintain our professional values and attitudes in the care of all patients regardless of their socioeconomic backgrounds; (2) strengthen our values of compassion for and our dedication to the needs of patients and society; and (3) remember that physicians are primarily servants of the needy and the ill, and that we must help them attain the highest quality of life possible. Clearly, physicians will participate actively and meaningfully in the evaluative process through Quality Assurance Committees, but will no longer be the sole reviewers and judges of performance. Thus, we will feel more and more uncomfortable if we are not committed totally to the goals and objectives which have been intrinsic to the profession for centuries. Sincerely, John Naughton, M.D. Vice President far Clinical Affairs Dean, School of Medicine A Message From The Medical Alumni President A t the request of an alumnus at a past annual meeting of the Alumni Association at Spring Clinical Day, your governing board investigated the suggestion that there should be a new "Life Membership" dues category, as well as annual dues. Much thought and effort was expended on this and last spring such a recommendation was approved at the annual alumni meeting. Life Membership now exists in many of the Medical School Alumni Associations across the counrry. This category will consist of a one time dues payment of$500.00, which entitles the alumnus to continuous membership throughout his or her lifetime. No yearly dues statements will be welcome to many. An appropriate Life Membership certificate will be sent to you, which we hope you will display with pride. We encourage you to avail yourself of this new category, if possible, but remind you that annual dues remain the backbone of your alumni association. You will hear more about this in the Newsletter, which will accompany your alumni dues bill in a few weeks. To all of you who will attend the American College of Surgeons meeting in San Francisco, please mark your calendar so that you can attend the UB Alumni Reception in conjunction with the Department of Surgery, on Wednesday, October 14, at the Westin St. Francis Hotel, 6:30 to 8:00 PM, in the Elizabethan Room D. We invite all UB alumni and former housestaff who are now in the San Francisco area to join us at the reception. Once again remember the 1st weekend in May, 1988, "Spring Clinical Day & Reunion Weekend," so that all of you having 5-year reunions beginning with the C lass of 1983 will plan to attend. Sincerely, Franklin Zeplowit:z;, M .D.'58 �----- -------- ~ BUFE p H CONTENTS Exceptional Achievers. As if medical students didn't have enough to do with just their classes to concentrate on, many here at UB have been stretching themselves even further, becoming involved in research presentations, being elected to positions of national leadership, initiating their own educational programs, and receiving major awards. Articles on pages 2-9 tell the story. 1 The Buffalo Medical Journal. When that publication ceased to exist in 1919, few medical journals extant on the American continent surpassed it in age. For 74 years, it recorded the principal medical events in Western New York as well as general currents in American medical thought and society. 1 The Enigma of Eating Disorders. Back in the 1950s, society told adolescent girls that if they remained virgins, they would marry well and live the good life. But 30 years and a sexual revolution later, young women now see thinness as the key to success and happiness. MEDICAL SCHOOL NEWS • 13 A second me- HOSPITAL NEWS • 24 CLASSNOTES • 34 morial service is held for body donors. "We Made It, " the Class of 1987 sighs at commencement. Dr. Guthrie wins the Chancellor's Medal. Recent donations make possible scholarships and awards. Annual Faculty Meeting brings honors and prizes. ALUMNI • 26 Spring Clinical Day focuses on "Things that go wrong in the summer." Class reunion photos. Dr. Zeplowitz elected Alumni Association president. DEATHS • 36 �2 They 're involved in research, being elected to national leadership positions, starting their own educational programs, and winning awards Exceptional Achievers BY KATHLEEN RIGA A s if medical students didn't have enough to do with just their classes to concentrate on, many here at UB have been stretching themselves even further, becoming involved in research presentations, being elected to positions of national leadership, initiating their own educational programs, and receiving major awards (see accompanying article). UB medical students have distinguished themselves by being prominent at research forums throughout the country. Laura Post (then a senior, now an M.D.), seniors Helen and Andrew Cappuccino, and juniors Geoffrey Seidel and Stuart Varon presented their research at the Eastern Student Research Forum, hosted by the University of Miami School of Medicine in March. Post's research, for example, examined biochemical evidence that sea urchin hatching enzyme is a chymotrypsin-like proteinase. She worked under Dr. Herbert Schue!, associate professor of anatomy. Seidel's research under Dr. James Williams, clinical professor of surgery, compared malignant and nonmalignant disease and the outcome of color resections. Helen and Andrew Cappuccino, with Dr. Zale Bernstein, clinical instructor of medicine, looked at the AUTUM '87 effect on platelet aggregation of serum from patients with HIV-associated ITP. Varon's research on garlic is profiled in an accompanying article. Post and the Cappuccinos, along with junior Carlos Jaen, made presentations at the National Student Research Forum in Galveston, Texas, in April. No other med- r=;;;:::=!i;;;_;;;·;~::4~~=Jr I <\uard for r tentWll BUFFAID I PHYSICI AN I ical school was represented by more students at either this or the Eastern Student Research Forum. Jaen also participated in the Society of Behavioral Medicine Convention in March in Washington, D.C., while sophomore Louis LoBalsamo was the sole UB representative when he presented his research to the International Society for Heart Transplantation in March, in New Orleans. Jeffrey Young, now graduated, presented findings at the Associated Medical Schools of New York meeting last May. LoBalsamo and Dr. Jacob Bergsland, assistant professor in surgery, explored ways to prevent damage to transplanted hearts from oxygen radicals, which result from reperfusion of the heart. The effectiveness of alternative self-help smoking cessation manuals was compared by Jaen under the direction of Dr. K. Michael Cummings, research assistant professor in social and preventive medicine. Lastly, Young examined vascular responses to exercise in long term diabetics, under Dr. David Pende rgast, associate professor of physiology. Senior Lisa Benson has chosen to get involved in organizational activity. She is highly visible as the national student coordinator for the American Medical Women's Association (AMWA). Dr. Post �- -----~ - - -- 3 was not only involved with research, but she also was elected to the position of liaison from the American Medical Student Association (AMSA) to the American Psychiatric Association (APA). As liaison, she was given the opportunity to provide the APA with the medical student perspective. Other very active students are Norinder Bhalla, Polity president, and Katherine O'Leary who is editor of the Northeast Region Newsletter for AAMC's Organization of Student Representatives. In a similar position is sophomore Joan Murray, who was elected as a liaison between AMSA and the Student National Medical Association (SNMA). Her primary task is to increase the involvement of members of SNMA with AMSA. W hat motivates medical students to undertake research or leadership positions when coursework already consumes their lives? It seems to be summed up in two words, commitment and priorities. "Ifl don't make the changes, no one else will," states Joan Murray. "In my liaison position, I can represent minority goals and also represent the goals of the medical profession. After all, they're both the same, to attain the best possible health care system." For Louis LoBalsamo, his goal of conducting research while going for his M.D. is easily explained. "I went through college and got straight 1\s. When I entered medical school, I wanted a challenge beyond just getting good grades. I wanted something new and refreshing." For him, research was that challenge. Lisa Benson, national student coordinator for AMWA, agrees with Murray and LoBalsamo. She is committed to making a difference in her field while she is still a BUFFAID I P H YSICI AN I student, not just after she is established in her career. As for priorities, she feels that, "Just to exist, sleep, and study are not enough; good grades are not enough." So now she plays a nationally prominent role. Wanting to do it, and actually doing it, are two different things, however. Ms. Benson says, "If you're efficient, you can make time for community service." Ms. Murray attends out-of-town meetings by doing her studies ahead of time and trying to get time off in advance by arranging exam schedules. The Cappuccinos and Mr. LoBalsamo do their research on weekends and part-time after school. Also, a summer research fellowship enabled LoBalsamo to do research fulltime for ten weeks before resuming to classes this fall. Ms. Benson admits there have been conflicts. "I overcame those conflicts with the support of the administration. Without AUTUM '87 �4 the support of people like Dr. Glenda Donoghue and Associate Dean Peter Ostrow, I could not have made the necessary arrangements for alternate exam times and schedules that made it possible for me to attend national meetings," she comments. "They said, 'What she is doing is important for the school, not just for herself.' " EXCEPTIONAL ACHIEVEMENTS B esides research and national leaderhip positions, other students have initiated educational programs. Lisa Benson and junior Sharon Ziegler are the driving force behind the studentinitiated Anti-Smoking Task Force. The program was modelled after an anti-smoking education program organized by Doctor Oughta Care (DOC) at the University of Virginia Medical School. It is intended to educate youths in order to discourage them from smoking. Approximately 70 first- and second-year medical tudents compri e the "student brigades," which go to Buffalo-area junior high school with elaborate presentations. Their focus is on tobacco advertising, and for this they make use of a slide show put together by DOC. According to Ziegler, the response after approximately 30 presentation "ha been wonderful. It's effective because the kids haven't heard about the ads yet." The UB task force is the first such student-initiated program in ew York State. Directing their teaching toward their peer are everal other medical students, who have taken the initiative to organize classes in such diverse areas as sign language, medical Spanish, and CPR training. The UB School of Medicine does not offer a CPR course until the end of the sophomore year. Juniors (then sophomores) Jim Meisel and Steven Samuels, believing it is important for freshman and sophomore medical students to also have basic skills in CPR, decided to organize an extracurricular CPR program for first-year students. Meisel and Samuels began the program last year and continued it through the year, working in conjunction with the Buffalo Red Cross and the UB student-run AUTUM '87 IBY BRUCE s. KERSHNER I "Exceptional achievement" is the only way to describe the academic performance of UB's medical students during the 1986-1987 year. Numerous medical students have won nationally competitive fellowships and prizes, double the number attained last year. For example, UB students were awarded three of the 30 SmithKline Beckman Medical Perspectives Awards granted nationally; usually, only one is given for each medical school. One Howard Hughes Fellowship went to UB out of two dozen nationally, while an HSS-sponsored Secretary's Award for Innovations in Health Promotion and Disease Prevention, out of only a handful nationwide, was awarded to a UB student. Furthermore, UB medical students won four different awards that are given to only five to seven recipients nationwide; these are fellowships from the American Urological Association, Alpha Omega Alpha, and the Society of Nuclear Medicine, as well as the ]ames Ewing and the Surgical Oncology Fellowships. Major Recognitions and Fellowships Received By UB Medical Students Award Student Comment Lisa Benson ational leadership position AMSNSNMA Liaison Joan Murray Liaison between two national medical student a sociations AMSNAmer. Psychiatric Assoc. Liaison Laura Post ational Student Coordinator of American Medical Women's Association �5 Award Student Comment SmithKline Beckman Medical Perspectives Fellowship Sean Cao Myriam Daniel Carol Decosta Only 30 awarded nationally American Urological Association Fellowship Paula Sardler Only 5 awards nationally Society of uclear Medicine Fellowship Melissa Katz Six awards nationally Alpha Omega Alpha Fellowship Jean-Christopher Biebuyck Seven awards nationally James Ewing Surgical Oncology Fellowship Gary Croghan Seven awards nationally American Academy of Allergy & Immunology Craig 15-20 nationally Howard Hughes Fellowship Ahron Friedberg arins Carlos Jaen The Secretary's Award for Innovations in Health Promotion & Disease Prevention Second Prize, N.Y. State Easter Seals Jean-Christopher Biebuyck NCIINIH Summer Research Fellowship Saba Saleh 25 nationally for NIH research H.S.S. sponsored For essay Commencement Honors Baccelli Award Richard Scarfone Most outstanding academic performance in the clinical years Robin M. Bannerman Memorial Research Award Laura Post Most meritorious research in biomedical science initiated in the Summer Fellowship Program Gilbert M. Beck Memorial Prize in Psychiatry Curt Pinchuck Sabrina Popp Academic excellence in Psychiatry Buffalo Surgical Society Prize in Surgery John Griswold Academic excellence - junior, senior years Dr. Cyrenius Chapin Award Michael Apostolakos Dolores Leonard Deborah Shalders Achievement in clinical sciences Children's Hospital Prize Richard Scarfone Excellence in understanding disease in childhood Dean's Award Alan Beitler Participation in extracurricular activities in Medical School while maintaining a high standard of academic excellence Gordon S. Ehrlich Award Bonnie Orzech Demonstration of significant understanding of childhood disease Dr. Austin Flint Awards Steven Kassman Gretchen Pankow David Rosenblum Achievement in basic sciences BUFFAID IPHVSICI AN I Baird Point Ambulance Corps. According to Meisel, "We tapped into Baird Point's continuously-running CPR course offered on Sundays." The program was overseen by Or. Michael Adragna, clinical professor of anesthesiology. Upon completion of three sessions of training, students received certification in CPR. All members of the University community are welcome to participate in the training, for which they must pay a nominal fee. ext year, Meisel and Samuels would like to establish workshops in basic first aid for freshmen and sophomores. Certification in CPR would be a prerequisite for the program. However, Meisel says, "We are only in the planning stages right now." B ecause of the predicted skyrocketing of the Hispanic population of the United States in the near future, junior Carlos Jaen perceives a need for physicians to have some knowledge of Spanish. Jaen believes, "It is important for physicians to know basic Spanish to communicate basic things with their patients." This prompted Jaen, along with fellow juniors Mary Kennedy, Stuart Varon, and Victor Vega, to "An anti-smoking awareness program, an extracurricular CPR course for freshmen and sophomores, and a course in medical Spanish are among the educational programs initiated by students." organize a course in medical Spanish. Seventy-four freshmen and sophomores participated in the program, which consisted of weekly classes taught by the four founding students during the students' lunch break on Thursdays. For 20 minutes each week, the class was broken down into AUTUM '87 �6 several small groups, led by 16 tutors. Unfortunately, after the seventh lesson was completed, the course had to be cancelled. According to Jaen, "Things got crazy with exams and other commitments." Among those other commitments was a 1:00 psychiatry class which was moved from the South Campus to the Erie County Medical Center, making it impossible for students to attend both that class and the language lessons. Jaen says he and the other course organizers are looking to the future, however, and are currently in the planning process. "The interest is there," says Jaen, "Hopefully we can take the momentum we generated and incorporate it into a more structured class." One of the students taking the Spanish course was sophomore Virginia Robertson, who also somehow found the time to initiate her own course in sign language. The course developed out of Robertson's personal interest in learning sign language and her awareness that many of her classmates shared her interest. Thirty medical students participated in AUTUMN '87 Award Student Janet M. Glasgow Citations Gretchen Pankow Academic excellence Bonnie Orzech for women Jennifer Cadiz Deborah Shalders Leslie Mechanic-Rosenstein Bernhardt & Sophie B. Gottlieb Award Alan Beitler Expertise in areas outside of Medicine Norman Haber Memorial Award John Centonze For proficiency in otolaryngology Dr. Heinrich Leonhardt Prize in Surgery Brian McGrath Academic excellence in surgery Liberman Award Robert Cafarell Jeffrey Wasserman Interest, aptitude in the tudy of anesthesiology Hans J. Lowenstein Award in Obstetrics John Griswold Marci Krop Academic excellence Maimonides Medical Society Award Steven Domiano Most oustanding academic performance in the basic science years Medical Alumni Association Award Stephen Merry BUFFAID (P H YSICI AN I Comment Community" commitment �7 Award Student Comment G. Norris Miner Memorial Award Timothy Pitler Demonstration of outstanding clinical competence in family medicine David K. Miller Prize in Medicine Michael Kufka Demonstration of Or. Miller's approach in caring for the sickcompetence, humility, humanity Bernard H. Smith Memorial Award David Bernstein in Clinical eurology Gretchen Pankow Academic excellence in clinical neurology John R. Paine Award in Surgery Steven Kassman Research of merit in the general field of surgery Mark A. Petrino Award Deborah Shalders Demonstrated interest and aptitude for the general practice of medicine Clyde L. Randall Society Award in Gynecology-Obstetrics Douglas Katz Academic excellence Emilie Davis Rodenberg Memorial Award Andrew Plager Academic excellence in study of diabetes and its complications Philip P. Sang Memorial Award Gretchen Pankow Michael Rudnick Mary Smyth Abiliry to relate well to patients, faculty, and staff Morris & Sadie Stein euroanatomy Award Steven Oomiano Excellence in neuroanatomy Upjohn Award Thomas Smith Research ability John Watson Award in Medicine Jeffrey Young Enthusiasm for and commitment to scholarship in medicine E.J. Weisenheimer Award Michael Bartiss Excellence in scholarship and patient care in ophthalmology Frederick B. Wilkes Pediatric Award Alan Beitler To the graduating student entering a career in pediatrics who has best exemplified Dr. Wilkes' skills and dedication to patients the introductory course, learning fingerspelling and basic symbols for beginning communication in health-care settings with deaf patients. According to Robertson, the goal of the course was to enable the future doctors to "at least greet and ask basic questions, make them feel more at ease, and establish a rapport with them." The classes, funded by the Polity stu- "One of the students taking the Spanish course also somehow found time to start her awn course in sign language. The course developed out of her interest and her awareness that many other students shared that interest." dent organization, were conducted in cooperation with St. Mary's School for the Deaf. "It was a wonderful experience for us all," said Robertson. "It opened our eyes to the inherent problems in communication which can arise from working with deaf patients." She added, "The more we learned about the needs of the deaf, the more they sounded like everyday people, with more than just one thing to think about." Because of the success of the program and the incredibly positive feedback it has received from St. Mary's teachers and principal, Sister Virginia, Robertson hopes to organize further classes next year, including some at a higher level for those who already have some basic knowledge. Summing up how UB's medical students manage to find the time to take on ambitious projects, Joan Murray explains, "We find the time simply because it is important." • BUFFAID I PH Y SIC I AN I AUTUM '87 �8 Med student may be on the scent - literally of a new disease cure A UB medical student may be on the scent, literally, of a new disease cure - and the scent is garlic. Stuart Varon, third-year medical student, discovered that the ingredient that produces the distinctive odor of garlic is a potent killer of the intestinal parasite that causes amoebic dysentery. The disease infects about 400 million persons a year worldwide . His findings were published in the July issue of the Journal of Infectious Diseases. Varon and parasitologist David Mirelman of Israel's Weizmann Institute of Science showed for the first time that allicin is effective against dysentery amoeba (Entamoeba histolytica) in laboratory culture - and works as rapidly as the leading drug now used to control the parasite, metronidazole. Because of the widespread and long-standing use of garlic in food, it is assumably relatively nontoxic. Demonstration of this new pharmaceutic action of allicin could lead to the development of a new family of powerful antiamoebic drugs. Varon made the discovery during two months of research at the Weizmann Institute in Rehovot, Israel, where he was participating in a research program. He returned to Israel this summer, this time to continue the research at the Kuvin Center for the Study of Infectious and Tropical Diseases, Hadassah Hospital, Jerusalem. Varon, interestingly, was led to the discovery by an old - a very old - source. An orthodox Jew, he found a medical reference to garlic in the Talmud, a medieval Jewish Biblical commentary, while he was deepening his Jewish background during studies in Jerusalem in 1983. "Five things were said of garlic: it satiates; it keeps the body warm; it brightens the face; it increases semen; and it kills parasites in the bowels. " While in Israel, Varon examined the scientific literature to discover what was AUTUMN '87 BY BRUCE S. KERSHNER already known about the medicinal characteristics of garlic, and in particular allicin. His findings were very interesting. The active principle of the bulb had already been demonstrated by modern science to have antibacterial, antifungal, and antitumor effects, as well as powers to prevent arteriosclerosis and to reduce sugar and lipids in the blood. Historical records of the therapeutic value of garlic also abound. However, there were no scientific demonstrations of the possible efficacy of allicin in combatting E. histolytica. Varon, a Long Island, . Y., native added that a drug company 40 years ago once even patented allicin but never started its mass production because it could not figure out how to get rid of the smell. According to Varon, his first contact with the use of garlic to relieve digestive troubles was the result of an accidental meeting in 1982 with a former Peace Corps volunteer. While in Africa, his acquaintance came down with an intestinal parasite and was treated there by a steady regimen of fresh garlic. T he aroma of garlic, wafted along by Varon's intellectual curiosity, soon arrived in the Israeli laboratory. Presented with all the exciting data, Prof. Mirelman put all the facilities of his laboratory to work on the problem with Varon. Using known laboratory procedures, garlic oil was extracted from quantities of crushed garlic, whose distinc- BUFFALO I PHYSIC IAN I tive odor became overfamiliar to researchers at the Institute's Department of Biophysics. From this crude mixture, allicin was isolated by standard preparative chromatography. Pure allicin, later shown to contain the entire antiamoebic activity of the garlic oil, irreversibly killed rapidly growing E. histolytica cultures at extremely low concentrations (30 ug/ml). Moreover, two other non-pathogenic members of the Entamoeba family were similarly inhibited. Because of allicin's instability, both its odor and its curative properties are strongest just after a clove of garlic is cut. Varon found that storage on a laboratory shelf for several days significantly reduced its antiamoebic action. That explained why dry garlic powder and garlic oil capsules (sold in health food stores) showed no antiamoebic action, even though those forms have been shown to be better than raw garlic in fighting other diseases. Varon, who cooks with garlic, notes that cooking also destroys the allicin. Fortunately, refrigeration or freezing does preserve its potency. "Because allicin has oxidizing properties," notes Prof. Mirelman, "we think that the substance is taken up by the amoeba and destroys sensitive sulfhydryl enzymes participating in energy transport in the organism. It has already been suggested that this mechanism may account for the known antibacterial and antifungal properties of this material." Varon feels there is a lot of promise in allicin because drugs presently used for Entamoeba infection sometimes have unpleasant and even serious side effects. The possibility of developing a new family of drugs based on allicin with low toxicity should attract wide attention. The other advantage of garlic is that it is widely used in some areas of the world where dysentery occurs. Its familiarity to the public may make it easier to adopt as a drug. • �9 BUFFAID !PHYSICIAN! AUTUM '87 �10 "For 74 years, from 1845 to 1919, it recorded the principal medical events of Western New York as well as general currents in American medical thought and society. " THE 'BUFFAID MEDICAL JOURN~ BY LILLI SENTZ History of Medicine Librarian Health Sciences Library SUNY at Buffalo (The Buffalo Medical Journal can be considered in some respects to be the spiritual ancestor of the Buffalo Physician. This fascinating history of the Journal is reprinted with permission from the Bulletin of the Medical Librarians Association, Vol. 73 (3) , july 1985.) W HEN THE Buffalo Medical journal ceased publication in 1919, few medical journals extant on the American continent surpassed it in age (1]. Founded in 1845 by Austin Flint, Sr., the journal recorded for 74 years the principal medical events in western New York as well as general currents in American medical thought and society. Historically, medical journalism has never been an easy venture. Of 120 such journals in the United States between 1820 and 1870, one-half were discontinued within six months to three years, and of those published in 1870 only 13 had existed more than ten years (2]. Like most of these journals, the Buffalo Medical Journal had chiefly a local circulation, but unlike most it succeeded in building a national reputation and in weathering crises that brought down similar publications. AUTUMN '87 The Journal actually went under five names during its 74-year history: Buffalo Medical] ournal and Monthly Review of Medical and Surgical Science (1845-60) , Buffalo Medical and Surgical Journal and Reporter (1861-62), Buffalo Medical and Surgical Journal (1862-95), and Buffalo Medical Journal (1895-1919). Volume 15, No. 1-13 has the running title: New York Monthly Review of Medical and Surgical Sciences and Buffalo Medical Journal, and it is listed as being absorbed by American Medical Monthly and New York Review in 1860. The journal resumed publication in Buffalo in 1861 as a new series. Fielding H. Garrison saw 19th-century medical journalism as flowing in three channels: periodicals recording the transactions of scientific and medical societies, periodicals devoted to original scientific work, and medico-social periodicals devoted in part to editorial opinion and current medical information [3]. At its peak the Buffalo Medical journal encompassed all three categories, leading Garrison in 1914 to mention it in the same breath as leading journals of Berlin, St. Petersburg, Boston, Bristol, Edinburgh, Dublin, and New Orleans [4]. BUFFAID 1PHVS1CIANI FOU DING A D PURPOSE The first issue of the Buffalo Medical Journal appeared in June 1845, and it was one of 94 such journals started in that decade alone [5]. In his introduction, Austin Flint, Sr., noted that the location of Buffalo made it ideally suited to the collection and diffusion of information, and to the exchange of views and opinions among members of the profession. Connected to the East through a network of canals and railroads and to the West through the Great Lakes, Buffalo was then a city of 30,000 inhabitants , with a medical community of 70 physicians. The following year saw the founding of the University of Buffalo and its medical department, an event in which Austin Flint, Sr., was also instrumental. The objectives of the Journal were to emphasize original communications, to keep subscribers informed about discoveries and improvements in the field of medicine, and to offer a medium for exchange of opinions [6] . During its 74 years of existence the Journal featured many important articles. The famous account by UB co-founder Austin �11 Lt. Col. William Warren Potter, assistant surgeon, 49th Regiment, N.Y. Volunteers , Journal editor from 1888 to 1911. Photo taken short after Civil War. Flint, Sr., from orth Boston in the county of Erie, on the true nature of typhoid fever was abstracted in the fourth issue of the Journal [7]. Many of Frank H. Hamilton's (another co-founder) articles on fractures were first published in the Journal (these later formed the basis for his Practical Treatise on Fractures and Dislocations, which went through eight editions). John C. Dalton's lectures on physiology were published here, as was the report of the first application of the principle of enucleation to ovarian and abdominal tumors [8]. At the turn of the century, Roswell Park was a frequent contributor not only in science, but also on the subject of medical history. The Journal was fortunate in having few changes of editors, a factor that contributed to its long existence. In his historical reminiscence on medical journalism in Buffalo published in 1895, William W. Potter divided the first 50 years of the Journal into four epochs [9], the first three presided over by Austin Flint, Sr. (1845-1855); by Sanford B. Hunt, who was briefly succeeded by Austin Flint, Jr. (1855-1860); and by Julius F. Miner (1861-1879). The fourth epoch, which lasted until William W Potter assumed the editorship in 1888, marks perhaps the lowest point in the history of the Journal. But from 1888 until Potter's death in 1911, and under his successor, A. L. Benedict, the Journal again followed an objective and impartial policy. The editorial department addressed the issues forcefully, and obituaries, society transactions, public health reports, and other local data provided a wealth of information. Indeed, Fielding H. Garrison saw the preservation of the transactions of medical societies as one of the chief functions of the local periodical [10]. MEDICAL DEBATES The Buffalo Medical Journal is also a remarkable document in social history, because it recorded the changing attitudes of American society. The debate over the propriety of demonstrative midwifery, in· troduced in this country in 1850 by James Platt White, professor of obstetrics at the University of Buffalo, began in the pages BUFFAID ! PHY SICI AN I AUTUM '87 �12 ar left) Pres1 nt McKmley at Pan \mencan Expo rtwn 1901; bt.lou,) \lF.])f(' \ L .JOl H.\\ L. Htm Fhnt, , fi t edrtor th Journal. \1 >TI \ 1' 11\T. \ , t. l '' ~c: ~ D • 1 n ;.;. r IU II \I tl indignant editor who in 1915 issued a plea for women physicians, defending their role and contributions [16]. A LOCAL PERSPECTIVE ON HISTORY of the Journal and in the local popular press (11]. Charges and countercharges concerning the actual event and the moral issues involved culminated in the Loomis trial, in which Dr. White brought a libel suit against Horatio . Loomis, a local physician thought to be the author of two slanderous letters. Dr. Loomis wa acquitted, primarily because the jury ignored the judge's charge, but as Dr. 0. P. Jones has written, "the profession has long since thoroughly vindicated Dr. White by using clinical illustration of labor as a teaching method" [12]. Two recent historical studies cite the Loomis trial and its implications for medical education, the issue of specialization, and the status of the medical profession [13]. Several attitudes toward women physicians are vividly registered in the Journal. Without mentioning her by name, Austin Flint, Sr., commented on the admission of AUTUM '87 Elizabeth Blackwell to Geneva College in a January 1848 editorial. He viewed her admission as a historic event that would open the door to women candidates at other institutions. Although he did not expect women to become general practitioners, but rather to devote themselves to special branches, he thought the influence of women on the profession would be good [14]. However, that view was not shared by the editorial department in 1857, when the following statement appeared: "The real lady is as much out of place in the practice of medicine as in a regiment of dragoons; and once begun in the rivalries of practice, with the opportunity for scandal which a feminine taste would develop, would soon be lost in the intriguing gossip. Monthly nurses are bad enough" [15]. Apparently no one was sufficiently offended to respond. Austin Flint, Sr., would have been in much closer agreement with the BUFFAID PHYSICI AN ] The cataclysmic events of the Civil War and World War I are recorded by medical officers from the area who submitted reports of their experiences to the Journal. One prominent example is the personal military history Three Years with the Army of the Potomac by William W Potter, which he prepared toward the end of his life for posthumous publicction [17]. When President McKinley was assassinated in Buffalo in 1901 during the PanAmerican Exposition, national attention was focused on the city. He was attended by local physicians, notably by Drs. Mann, Mynter, and Parmenter, and - at the close of the operation - by Roswell Park, the area's most prominent surgeon. Dr. Park had been in the midst of an operation in iagara Falls when notified of the shooting. For seven days the president lingered. When he died, the quality of his medical care immediately came into question, although the autopsy report declared the "death was unavoidable by any surgical or medical treatment and was the direct result of the bullet wound" [18]. The Journal's September issue that year contains special contributions by those assisting in the operation on McKinley as well as the official bulletins. It also includes a signed statement denying reports that there had been serious disagreement among the surgeons and physicians in attendance. �13 CONTROVERSY AND CO SOLIDATION One cns1s that almost caused the demise of the Journal did lead to a brief suspension of publication and a slight name change in 1859-60. Austin Flint, Jr., who had become chief editor, moved to New York City. A local publisher and co-owner of the journal, A. I. Mathews, used the opportunity to include an advertisement offensive to the readership in the October 1859 and in the January 1860 issues. Unfortunately, that ad has been lost, because of the practice of excluding advertisements before binding journal issues [19], but Dr. Flint's reference to keeping the Journal "pure and unsullied" makes possible a fairly informed guess as to the nature of the ad. He explained that "the editors were wrong in supposing that one who advertises quack remedies female regulating pills, etc. - in the daily press, would be able to make a distinction, unless under compulsion, in favor even of the Old Buffalo Medical Journal" [20]. Dr. Flint, Jr., severed his connection with Mr. Mathews and made arrangements to merge the journal with the New Yark Monthly Review. However, the loss of the local character of the Journal was keenly felt by the medical community, and in August 1861 it was reintroduced under the name of Buffalo Medical and Surgical Journal and Reporter, because Mr. Mathews claimed to own the old name. The new editor, Julius F. Miner, suggested that Mr. Mathews use the more appropriate name Buffalo Patent Medical Journal for his publication [21]. Another crisis occurred in the 1880s. The drive to reform American medical education resulted locally in the founding ofNiagara University in 1883. The editors of the journal strongly endorsed the new institution, dismissing the charge of rivalry with the University of Buffalo. A second element of discord in the community was the appointment of Roswell Park, newly elected lecturer at the university, to the surgical staff of Buffalo General Hospital. Dr. Park had come to the city from Chicago. The appointment was seen by some as a snub to the professional talent of the city, and it was a wound to local medi- cal pride. These two events divided the community, and in 1886 a rival journal, the Medical Press of Western New Yark, was founded with Dr. Park as editor. For four years the two journals coexisted in the city with one segment of the medical community contributing to one, the rival segment supporting the other. In his discussion of medical journals, S. D. Gross wrote that "we rarely meet with an instance in which their pages are tainted by literary jaundice, or polluted ribaldry and personality" [22]. But the journal was not entirely free of those charges during this period, when neither selection of material nor editorial content could substantiate the repeated claims of impartiality. Realizing that a contest for a field so narrow could only harm local journalism, the editors in 1889 reached an accord to merge and conduct a purely scientific and nonpartisan journal, thus avoiding one of the pitfalls that had destroyed so many journals in other communities [23]. On March 14, 1911, William Warren Potter died, and it was with some reluctance that his successor, A . L. Benedict, took on the editorial duties. The idea of assuming sole responsibility for the Journal was somewhat alarming to him, and he was also concerned that these new duties would interfere with his work as a practicing physician. However, veneration for an institution more than half a century old and a sense of local pride became the deciding factors. Sir William Osler wrote to the new editor in 1911: "Dear Benedict: I am very glad indeed to hear that you are in charge of the Buffalo Medical Journal, for which I have always had an affection, a good deal, I must say, from the appreciation I had of the splendid men who were its founders and it is a journal, too, that has, all along, done good work" [24]. During Benedict's editorship there are repeated references to increased subscriptions and to adequate advertisement revenue, although exact figures are never given. But efforts to enlist others in the affairs of the journal failed. When the journal was absorbed by the Medical Review of Reviews, New York City, nine of the thirteen members on its editorial staff, including the managing editor, were in the military service. The Medical Review of Reviews, a BUFFAID I PHYSICI AN I publication of national scope and circulation, promised to preserve the identity of the local journal after the merger. Dr. Benedict took some comfort in observing that the surrender of local control was a result of war conditions, and not economic factors, but he also expressed disappointment that Buffalo was not more highly regarded as a medical center [25]. • REFERE CES 1. The Union Catalog of Medical Periodicals records at least six name changes for the publication from 1845-1919. 2. Miller G. The nineteenth-century medical press. In: Blake JB. Centenary of Index Medicus 18 79-1979. Bethesda, Md.: U.S. Dept. of Health and Human Services, 1980:19-30. 3. Garrison FH. The medical periodical and the scientific society. New Orleans Med and Surg J 1914;67:503-9. 4. Ibid. 5. Ebert M. The rise and development of the American medical periodical. Bull Med Libr Assoc 1952;40:243-76. 6. Editorial. Buffalo Med J 1845; 1( 1): 1-3. 7. Flint A, Sr. Account of an epidemic fever which occurred at orth Boston, Erie County, . Y., during the months of October and November, 1843. Buffalo Med J 1845;1(4):91-5. 8. Miner JF. Remarks upon the different modes of treating the pedicle in ovariotomy. Buffalo Med J 1869;23 or 8( 11 ):418-23. 9. Potter WW. 1845 - then and now - 1895. Buffalo Med J 1895;51 or 35( 1):65-113. 10. Garrison FH. The medical periodical and the scientific society, pp. 503-9. 11. Editorial. Buffalo Med J 1850;5(9):564-5. 12. Jones OP. Our first professor of obstetrics, James Platt White (1811 -1881). Buffalo Phys 1974;8(1):42-7. 13. [a] Atwater C. Making fewer mistakes: a history of students and patients. Bull Hist Med 1983;57(2): 165-87. [b] Drachman YG. The Loomis trial: social mores and obstetrics in mid-nineteenth century. In: Reverby S, Rosner D. Health care in America. Philadelphia: Temple University Press, 1979:67-83. 14. Editorial. Buffalo Med J 1848;3(8):494-6. 15. Editorial. Buffalo Med J 1857;13(3):191. 16. Editorial. Buffalo Med J 1915;70(6):357-9. 17. Potter WW. Three years with the army of the Potomac - a personal military history. Buffalo Med J 1911;66(12):647-76. 18. Autopsy Report. Buffalo Med J 1901; 57(2) :224-5. 19. An extensive search was undertaken to locate this particular ad, but without result. 20. Editorial. Buffalo Med J 1860;15(10):652-4. 21. Editorial. Buffalo Med J 1861;16 or 1(1):32. 22. Gross SO. History of the American medical literature from 1776 to the present time. ew York: Burt Franklin, 1876. 23. Editorial. Med Press W Y 1889;4:282-4. 24. Editorial. Buffalo Med J 1911 ;67(4):228-9. 25. Editorial. Buffalo Med J 1918;74(5):159-61. AUTUM '87 �14 BY CHRIS VIDAL THE ENIGMA OF EATING DISORDERS For young umnen, they can be a protest against a society that denies their nature ack in the 1950s, society told adolescent girls that if they remained virgins, they would marry well and live the good life. But 30 years and a sexual revolution later, cultural morality and standards have changed, and young women now see thinness as the key to success and happiness. The result is a devastating number of young women who starve themselves, abuse laxatives, force themselves to vomit, and employ other measures to keep their bodies from consuming even a minimal number of calories, according to Katherine Steiner-Adair, Ed. D., research associate at Harvard Medical School's Center for the Study of Gender, Education, and Development, and an associate psychologist at Children's Hospital, Boston. Steiner-Adair's March 2 7 lecture on "Normal Female Development and the AUTUMN '87 BUFFAID (PHYSICIAN I ��16 Development of Eating Disorders" was among those presented at "The Enigma of Eating Disorders," a two-day conference sponsored by the UB School of Medicine's Department of Psychiatry and the Anorexia Bulimia Buffalo Association. Cultural values and roles are the root of the willful self-starvation of anorexia nervosa and the vomiting and purging of bulimia, Steiner-Adair said. "If we look at the problems of adolescents in our society, we will see what is wrong with our society," she said. "It may be that socio-cultural values make anorexia and bulimia an acceptable part of growing up female now." One of the keys to understanding the issue is to examine the development of the female adolescent, and what it means to grow up female. But this examination is complicated by the fact that most studies have been conducted from a male orientation, leading to conclusions that may not be applicable for half the population. "If you look at the psychology of women, you hear a different language," SteinerAdair said. This difference is important to understanding the development of female adolescents, as opposed to males in the same age group. That difference in language is what researchers call a "care" focus for deciding issues of moral dilemma, an orientation that relies on feelings and emotional needs, as opposed to a "justice" focus . "There is a natural tendency for men and women to use a (particular) pattern of thinking more," she noted. A ccording to research, one-third of women make decisions ba ed on the "care" focus; one-third, on a "justice" focus; and one-third, on a combination of the two. Half the men studied, on the other hand, made decisions based on a "justice" focus; the other half relied on a care-justice combination . None made moral dilemma decisions strictly on a "care" basis. Our culture teaches women that the "care and responsive focus to self and other's needs is the most important way of AUTUM '87 thinking about moral problems in life," according to Steiner-Adair. But this lesson may serve to cloud others that are being taught at the same time, especially sociocultural lessons about independence. "When we talk about development, we talk about a movement from dependency to autonomy," Steiner-Adair said. But this rite of passage is perceived differently by males and females. Boys view the opposite of dependence as independence. Girls, on the other hand, may perceive the opposite of dependence as loneliness and isolation. This translates into "if I grow up I have to be totally self-sufficient," which is a terrifying prospect to these young girls, Steiner-Adair said. Individuation, therefore, is seen as a loss. Females develop as they experience themselves through relationships with others. The identification process for girls becomes one of self-differentiation, of having a distinct sense of self while still being connected with others, Steiner-Adair said. The difference in views of dependenceindependence begins with the games children play. Boys, she noted, play games like king of the hill, which teaches them to compete, give orders, become autocratic, and never mind if they step on someone on the way up. Girls play games that, like jump rope, require sharing and communication skills, and will discontinue a game or change the rules rather than see someone's feelings hurt. In puberty, success of social skills is important to girls because of their need for external support. Girls, therefore, are vulnerable to external acceptance and feedback for development of their identities. N ormal rebellion against family and society may backlash for adolescent females, as it does not for adolescent males, Steiner-Adair said. For a boy to be in interpersonal conflict is a confirmation of his identity, but for girls, the same interpersonal conflict is a disconfirmation of identity. BUFFAID ! P HY SICI AN I "It is made clear (to girls) from home, school, the media, and society at large that interpersonal compliance is expected," she said. In the last 20 years, girls have been put in a double bind. Because development is such a comparative process for female adolescents, the way girls perceive their bodies is central to the way they think of themselves. Because the ideal of thinness is culturally supported, girls are socialized to be unable to accept their bodies. In fact, about 80 percent of adolescent girls are anxious and uncomfortable about their bodies. "How can a female value parts of herself that society has taught her to devalue? Society teaches girls to deny the validity of who they are as people," Steiner-Adair said. Dieting and food are very much a part of growing up female; the dividing line between healthy and unhealthy orientations is emphasis. "It is normal for female adolescents to be concerned with weight," Steiner-Adair said. "It is when eating becomes confused with autonomy and independence that eating disorders are likely." Eating disorders such as anorexia nervosa or bulimia emerge at adolescence because at this point females are at a crossroad requiring them to shift from dependence to autonomy, a transition that is devastating when autonomy is viewed as loneliness, Steiner-Adair said. The rounded female form, historically associated with pregnancy and maternity, also represents interdependence and interrelationships. The thin form represents the independence that the adolescent thinks society wants her to achieve. "Anorexia nervosa and bulimia are forms of protest against a society that denies the part of the psyche that is rounded .... "These adolescents are truth-tellers," she said. "They tell their story with their bodies. They tell the story of the difficulties of growing up female in a society that denies their voice." • �17 Medical School Neus Second memorial service held for body donors 0 Chapel honoring those individuals interred earlier that day and all the individuals who had donated themselves to the University over the preceding two years. Over 100 relatives of these donors attended the ceremony as well as medical students and faculty of the department associated with the gross anatomy class. Dr. Charles Severin, associate professor of anatomy and coordinator of the gross anatomy course, arranged for the memorial service. At the ceremony, Father Fisher noted that these individuals had a common desire to help others even after their deaths. After the ceremony, family members were invited to visit the gravesite and view the memorial, which was placed there in 1984. An identical monument may be found in an area of Mt. Olivet Cemetery where Roman Catholic remains are interred. A photograph of the plaque is in the gross anatomy facility to remind students and staff of those individuals whose bodies have been contributed to benefit others through education • and research. n May 21, 1987, the Department of Anatomical Sciences conducted its second memorial service associated with the interment of the remains of 153 individuals whose bodies had been donated to the School of Medicine for use in teaching and research at the University. The service was held in the Newman Center Chapel on the North Campus, with burial in the Skinnersville Cemetery adjacent to the chapel. UB's School of Medicine is able to fulfill its teaching and research needs through a Body Donation Program administered by the Department of Anatomical Sciences. Over 6,000 individuals are currently enrolled in the department's program with approximately 600 new registrations a year. The remains of approximately 160 individuals are brought to the University each year. All costs associated with transport of the bodies are assumed by the University. The Reverend Edward Fisher officiated at the memorial service at the Newman Center BUFFAID PHYS ICI AN I AUTUMN '87 �18 '' 142 M.D.s, 5 Ph.D.s receive degrees ( 0 ne hundred and forty-two new doctors received their M.D.'s together with five others who received their Ph. D.'s in microbiology and biochemistry - as the Medical School celebrated its 141st commencement in Alumni Arena last May. Vice President John aughton, dean of the Medical School, called the convocation to order, praising the students for their dedication and hard work while reminding them that a doctor's work is never complete. "The path you have taken to reach this point has not been an easy one. You have endured long hours and Herculean workloads. But you have persevered, and as you enter the medical world, never lose sight of the goals that have brought you here today." Dr. Alan B. Beitler, chosen by his peers to be the cia s speaker, expressed his gratitude to his classmates for their ardent support. "I must express the gratitude I feel for all of you," Dr. Beitler said in his address. " o one can do it on his own. You have been a wonderful class and I am proud to consider myself one of you." Dr. Beitler then used a Dickensian approach, speaking of the past, present, and future, in his assessment of the journey he and his fellow students have made and the challenges that await them. ·~s I look at the past it is with a sense of gratitude to those who stood by us. We could not have made it on our own. There are so many who have made this day possible for all of us." Dr. Beitler expressed his deepest thanks to the graduates' husbands, wives, and "significant others" for their patience and understanding, as well as to the parents for their unending support. Of the moment, he spoke about the pride each candidate felt and the sense of accomplishment that accompanied the day. He remembered the arduous AUTUMN '87 BUFFAID P H YSICI AN I years of work that each endured and the special feeling of knowing that, as he triumphantly said, "we made it., For the future, Dr. Beitler reminded his peers that the medical profession is filled with problems and that it is their task to help correct these maladies. ·~s students, we could look at the world through rose-colored glasses," he said. " ow we have earned the opportunity to bring our ideals to the profession and make it the best we possibly can. "We must make sure our ideals are tempered �19 '' at 141st Med School commencement by a sense of perspective. Remember that it is our duty to serve humanity, and never lose sight of that objective." B efore keynote speaker Dr. Mary Jane EngIN LESKO land, associate dean of the John F. Kennedy School of Government at Harvard, addressed the students and their guests, an unscheduled appearance was made by the Dermatones - a singing group several of the students formed to divert themselves from the rigors of school. They performed "Buffalo," ice Bennett, and were given a warm ovation for their lighthearted rendition. In her speech, Dr. England stressed the growing number of women and minorities entering medicine and the revolution in health care. "You represent a diverse cross-section of humanity," she began. "Increasingly, the medical work force is seeing more women and people of color entering than ever before. It is your job to be the vanguard for this new generation of medicine." Dr. England, also president of the American Medical Women's Association, voiced her concern for the movement of health care away from the physician to a system of group care run by non-professionals. "Within the next 10 years we will see a complete automation of the health care field. Insurance companies will buy out the present organizations, offering life, auto, fire, home, and group health plans. Eighty per cent of health care will come from multi-institutional organizations. "The medical profession is in a crisis," she warned. "Physicians cannot afford to sit in their offices and wait for patients to beat a path to their doors. No longer is the physician seen as a person to be emulated. Health care has passed us by." Dr. England related stories of doctors who had become disillusioned and depres ed over the reality of the situation. "Medicine as an art has vanished. The once sacred relationship between doctor and patient has deteriorated into simply a business transaction. "You have the opportunity to be leaders in the area of social justice, to improve the quality of family life, to set examples for the less fortunate. You must be leaders in shaping health care. You must step outside your day-to-day tasks to make health care accessible to all. Do not let yourselves be isolated in your offices. There is a need for your talent to improve the situations for our most vulnerable populations." In concluding her remarks, Dr. England recalled the words of john F. Kennedy, espousing courage, judgment, integrity, and dedication. "These are the historic qualities of the leader and the physician." • BUFFAID I PHVS I C I AN I AUTUM '87 �20 Biophysics offers grad student awards T he Department of Biophysical Sciences announces the establishment of the Biophysical Sciences EcclesHauptman Graduate Student Award for an outstanding new entrant to their graduate program. The award is named in honor of the two Nobel Prize Laureates of the Department. It carries a stipend of $8000 in addition to a tuition waiver. It will be awarded to the applicant judged most likely to make distinguished contributions to the biophysical sciences. The department offers a broad spectrum of research programs and the award is equally applicable to any of these. Send inquiries and applications to: The Director of Graduate Studies, Dept. of Biophysical Sciences, 120 Cary Hall, SUNY Buffalo, Buffalo, NY 14214. • ! @ § it DR. GUTHRIE AWARDED CHANCELlD!tS MEDAL U B at its 14lst general commencement in May awarded the Chancellor Charles P. orton Medal to Robert Guthrie, M.D., the UB professor emeritus of pediatrics and microbiology whose test for the genetic disorder PKU has prevented mental retardation in thousands of children worldwide. About 150 million children have been tested for PKU worldwide. In America, 3.5 million children are tested each year. The SUNY Board of Trustees also approved the awarding of an honorary doctorate to George Hatem, M.D., a Buffalo-born physi- AUTUM '87 cian who is chief medical advisor to the government of the People's Republic of China. President Steven B. Sample hopes to present the Doctor of Science degree to Hatem personally on a trip to China later this year. Hatem is credited with virtually eliminating venereal disease, leprosy, and drug addiction in mainland China. He is the first non-Chinese to gain citizenship in that country. In another spring event, Dr. Herbert Hauptman, UB's 1985 Nobel Laureate, received the UB Alumni Association's Walter P. Cooke Award. • BUFFAID I P HY SICI AN ) Two departments hold research days T wo successful research days were held by the Departments of Biochemistry and Orthopaedic Surgery last spring. The Department of Biochemistry's event was the Eighth Annual Research Symposium on Aprill4, while the Orthopaedic Department's was the 16th Annual Orthopaedic Residents Scientific Day on May 14. At the Biochemistry research symposium, 54 posters were displayed, representing the work of approximately 100 faculty, doctoral, and postdoctoral researchers from the Medical School, Roswell Park, and the Medical Foundation of Buffalo. The Orthopaedic Residents Scientific Day featured ten scientific paper presentations by residents and fellows, as well as presentation of diplomas and certificates to four graduating residents and five fellows. Visiting professor was J. Leonard Goldner, M.D., James B. Duke Professor and chief emeritus, Division of Orthopaedic Surgery, Duke University Medical Center. He spoke on "Complications of Adult Foot Surgery" and "Musculoskeletal Aspects of Emotional Problems." • �21 Medtcal School Neus ck ANNUAL FACULTY CONTINUING EDUCATION DAY ''Linking New Technology With Medical Practice" SATURDAY, NOVEMBER 21st, 1987 BUTLER AUDITORIUM Morning Session Applications of Modern Molecular Biology to Clinical Medicine Afternoon Sessions The Tools of the Physicist in the Hands of the Physician: Two Applications of Electromagnetic Radiation and Horizons in Therapy of Coronary Artery Disease Watch your mail for more information Gifts establish awards for faculty and students I U BY SUE WUETCHER B medical students will benefit from several awards and scholarship funds that have been established by, and in memory of, Medical School alumni. The University at Buffalo Foundation Inc. also has received money that will be used to establish an award for volunteer medical school faculty. The scholarship funds and awards are: • The Lloyd H. Leve Fund, established by Lloyd H. Leve, M.D., of Rochester, a 1958 UB Medical School Alumnus. Leve has committed $100,000 to support scholarships or cardiovascular research, whichever is deemed the neediest from year to year by the Medical School dean. • The G. Norris Miner, M.D. Memorial Award, established in memory of 1932 UB Medical School alumnus G. orris Miner, M.D., by his widow, Margarita L. Miner. The fund, established with a $5,000 donation from Mrs. Miner, will award $250 annually to a graduating medical student who has shown interest and competence in the practice of family medicine. Miner was a family practice physician in orth Tonawanda for 40 years. Medical student Timothy Pitler received the fund's first award. • The Robert S. Berkson, M.D. Memorial Award in the Art of Medicine Fund, established in memory of longtime UB clinical faculty member Robert S. Berkson, M.D., by his son and daughter-in-law, Dr. and Mrs. Richard A. Berkson of California. The $10,000 gift will be used to grant a yearly award to a volunteer physician faculty member with at least five years of continuous service in recognition of the physician's ability in patient care BUFFAID I PHYSICIAN I I and teaching. The award will consist of plaques for the recipient and the Medical School, and $500 to be used for the purchase of books for the Health Sciences Library or medical library of the award winner's choice. The award winner will choose the books to be purchased, in consultation with the director of the specific library. Berkson, a clinical associate professor in the Department of Medicine, taught from 1949 until1966. He and his son are both alumni of the UB School of Medicine. • A $10,000 gift from Dr. and Mrs. Robert Bemot of ew York City and a $25,000 gift from Morris Lamer, also of ew York City. The gifts will be placed in a single endowment account to support Medical School scholarships. Bernot graduated from the UB Medical School in 1960. Lamer's gift was made in honor of the Bemots, who are his daughter and sonin-law. • A permanently endowed scholarship fund to aid first- and second-year medical students at the University has been established in memory of Dr. Ange S. Naples, a 1931 graduate of the UB Medical School. The fund has been established with contributions from members of Dr. aples' family. Dr. Naples was a practicing ophthalmologist in Buffalo and Tonawanda throughout his professional career. He retired in 1983 and died • in 1984 after a short illness. AUTUM '87 �22 1 ((T DR. BROWNIE KEYNOTES 1987 FACULTY MEETING his is the only lectureship in which we honor a previous dean," began Vice President and Dean John Naughton, in opening the 1987 Annual Faculty Meeting, "and also the only lectureship where we allow the honored speaker a full year to decide what he will speak on." The Stockton Kimball Lecturer for the May 27, 1987 Annual Faculty Meeting was Alexander Brownie, D. Sc., Ph. D., professor and chairman of the Department of Biochemistry. As is traditional, last year's winner of the Medical School's highest honor delivers this year's Kimball Lecture. Dr. Brownie reviewed the history and current status of re earch on the adrenal cortex, his primary research interest. The research aims to shed light on how adrenal deficiencies lead to pathogenesis of certain diseases, especially hypertension. He emphasized a very straightforward fact: "If you don't have an adrenal cortex, you die ... yet we don't know everything we should about it." In reviewing the early history, he related that Kendall and others determined that the adrenal cortex's function was to produce steroid hormones from cholesterol, including cortisol, aldosterone and androgens. Subsequent research, however, showed that "at the level of the adrenal, what controls cholesterol is rather complex." Brownie described the relationship between hyperadrenalcorticism and hypertension AUTUM '87 H e also noted that research done on anabolic steroids, not surprisingly, shows that hypertension is now appearing in athletes who use them because of their effect on the adrenals. Dr. aughton began his Dean's Report by announcing that this is the 25th anniversary of the Medical School's statehood. (In 1962, the private University of Buffalo became part of the SU Y System.) He then reviewed the school's highlights over that period. His first example was that the faculty meeting was taking place in the new state-of-the-art Buder Auditorium. Two of its many unusual features are its multiple large screens and a dressing room in back for presentation of patients. He cited other construction highlights such as the new CFS Wing and new Health Sciences Library and Dental ~ School buildings. "We are attracting stronger and stronger 0 ~ medical and graduate students each year. We f2 have high student morale, and their extracur~ ricular participation is greater than ever. We have at least one department among the top seven in its field and we're now a model for other schools to follow." In summary, "The as leading to three conditions: Cushing's SynMedical School is now whole and its future and drome, hyperaldosteronism and congenital stability are now assured," he commented. adrenal hyperplasia. Research has found that As for future progress, he pointed to the new elevated levels of deoxycorticosterone are diWestern ew York Health Sciences Consorrectly related to the degree of hypertension. He tium which will enhance health care and the then described in detail all of the biochemical economic status of the region; the development processes involving the adrenal cortex. of a Ph.D./M. D. program; the enhancement BUFFAID I P H YSICI AN I �~1eJical plans for Roswell Park Memorial Institute; creation of both a new University bioengineering program and a new associate dean for research affairs. Lastly, the School's name will be changed to the School of Medicine and Biomedical Sciences to reflect the doctoral programs and biomedical research carried out by physicians, Ph.D.s and other scientists. In her Faculty Council President's Report, Monica Spaulding, Ph. D., associate professor of medicine and otolaryngology, noted that the Council began in 1969. This year, they established new curricular changes, including the ability to take fourth year neurology in the last half of the third year. The Council also determined the criteria for graduation with honors; clarified requirements for the Early Assurance Program and inclusion of Canis ius College students; and attempted to clarify criteria for promoting clinical faculty. She announced that next year's Council president will be Thomas Flanagan, Ph. D., new chair and professor of microbiology. J ohn Wright, M.D., was presented with the first of the evening's major honors, the Dean's Award. "This person is selected for his unselfish work, representation of the dean and other major contributions," remarked Dr. Naughton. "This year's honors go to a department leader, one who binds wounds, even sacrifices his career for a while," the dean continued, referring to Dr. Wright's service as interim director of Roswell Park Memorial Institute. Dr. Wright, professor and chairman of pathology, is recognized for his abilities as a researcher, teacher, administrator and clinician. His research has focused on amyloidosis, cardiovascular pathology, especially of the aged, oncology, and other areas. He is the author of 50 publications. The native of Winnipeg, Manitoba, came to UB in 1974 to chair its Pathology Department. Interestingly, he first came to UB in 1963 for his residency and later was a Buswell Research Fellow. He has clinical associations with the ECMC, Roswell Park, Buffalo General, and VA hospitals. He is associate director of Erie County Laboratories and was acting head of Children's Hospital's Pathology Department. The medical alumnus of the University of Man- itoba served on the faculty of Johns Hopkins University Medical School from 1967 to 1974. His relationship with medical students is exemplified by 12 teaching or medical class honors, including seven Siegel Teaching Awards or commendations and the 1986 Student National Medical Association Award. The Stockton Kimball Award was presented to Suk Ki Hong, M.D., Ph. D., for his academic and research achievement, his contributions to UB and the community, and to "fulfillment of excellence in all of its meaning." The professor of physiology is respected for his research in underwater physiology, gas exchange and renal physiology. He is the author of more than 140 distinguished journal articles and is highly visible in national and international physiology circles. He received his M.D. degree in 1949 from Yonsei University, Korea, and his Ph. D. in 1956 from The University of Rochester. He is the recipient of many academic awards and has played major roles in the American Physiologic Society, NIH, National Academy of Sciences, and others. A special presentation was given to Evan Calkins, M.D., internationally known pioneer in geriatrics and gerontology. A striking portrait of Dr. Calkins was unveiled, to be hung in the Medical School. The professor of medicine and head of that department's Geriatric Division has been with UB since 1961. He is the codirector and co-founder of the Western New York Geriatric Education Center and founded the Network for Aging in Western New York. The Harvard graduate was the 1984 Dean's Award winner. Four Siegel Teaching Awards were presented (see separate article). In addition to the awards, Dr. Nancy Nielsen, representing the Erie County Medical Society, and Mrs. Clarence Sanford, president of the Medical Society's Women's Auxiliary, presented a check for $11,996 to the AMA Education Research Fund of UB's School of Medicine. It provides medical student loans from a general fund. Other announcements included appointment of the new chairman of ophthalmology, Dr. William H. Coles; 17 new basic science faculty, and 113 clinical appointments; 14 retirements and memorial remembrance for five faculty who died during the year. • BUFFAID I P HY SICI 23 School AN I Five named best teachers of year T he "Best Medical Teachers Of The Year" have been chosen by UB's medical students. Five Medical School teachers received Dr. Louis A. and Ruth Siegel Awards at the Annual Faculty meeting. The awards are chosen through nominations by the school's 500 medical students. Perry Hogan, Ph. D., was honored with the Pre-Clinical Award, given to the best teacher of the basic medical sciences. Comments about Dr. Hogan cite his "genuine interest and enthusiasm in the subject which elicited a high level of performance from our class." The professor of physiology has been awarded two previous Siegel Teaching Awards. W inner of the Clinical Teaching Award is Martin Brecher, M.D. Like Dr. Hogan, Brecher previously won a teaching medal for pediatric teaching at Children's Hospital. Dr. Brecher was cited for "presenting an incredible amount of information in an orderly, concise fashion to students as well as patients and families." Dr. Brecher is associate professor of pediatrics and acting chief of Roswell Park's Department of Pediatrics and Children's Hospital's Division of Hematology-Oncology. F azlollah Loghmanee, M. D. , won the Volunteer Teaching Award for excellent teaching by a volunteer faculty member. The clinical assistant professor in pathology and dermatology is based at ECMC's Medical Examiner's Office. T he House Staff Award went to Felix Lim, M.D. , for his teaching abilities as a hospital resident. Dr. Lim last trained in internal medicine at Mercy Hospital and is now a hematology fellow at the SUNY Medical Center at Brooklyn. A Special Teaching Award was given to Lee Guterman, Ph. D. He is unusual because he is currently a third-year medical student recognized for his teaching of other medical students. Because of previous Ph. D. training he taught a • neuroanatomy course to fellow students. AUTUM '87 �24 I Iospital News RPMI Announces New Administrative Appointments ECMC has available a coordinated system of alcoholism services which includes acute, rehabilitation, and outpatient treatment. • D New Plan Will Strengthen UB/Roswell Park Ties r. Andrew Gage, M.D., a sociate director for clinical affairs at Roswell Park Memorial Institute, has been promoted to the position of deputy institute director. Dr. Jerome W. Yates, M.D./M.P.H., currently associate director for centers and community ffl oncology, Division of Cancer Prevention and Control at the ational Cancer Institute, has z been appointed the new associate director for ~ clinical affairs, as of October 1, 1987. ~ A ~ Dr. Yates, a nationally recognized expert in ~ public health policy and its impact on cancer L,;..::o-.....- treatment and the quality of life of the patient, has directed the NCI's national community cancer center program since 1982. A graduate of the University of Illinois College of Medicine, Dr. Yates also holds a master of public health degree from Harvard University, he Erie County Medical Center indid his residency training at Marquette Univertroduced a new alcoholism rehabilitation sity, and was a clinical fellow in oncology at service to Western ew York la t June. Roswell Park. Prior to joining the NCI, he Opening of the new service follows several served as chief of medical oncology and associyears of planning with the County Department ate director for the Vermont Regional Cancer of Mental Health, the State Division of Center. Alcoholism and Alcohol Abuse, and the State Dr. Yates will have primary responsibility for Health Department, according to Dr. Robert conducting the Institute's clinical programs Whitney, director of ECMC alcoholism erand will play a key role in the implementation vices and clinical assistant professor of of the clinical elements of Roswell's Strategic medicine. Plan. Dr. Thomas B. Tomasi, RPM! director, "Our new intensive inpatient treatment sernoted, "We are very fortunate to have attracted vice is a major step in the process of patient such a person to Buffalo. He is a superior clinirecovery and will offer its graduates the opporcian and an outstanding administrator who has tunity to develop a fresh start in a new way of risen rapidly to a top post at the NCI. He will life," he said. bring considerable expertise in public health During an anticipated 28-day stay in the new issues, especially in the areas of cancer preven20-bed unit, patients will receive group and tion and education." individual therapy, occupational and physical therapy, educational programs, and supportive Dr. Gage, UB professor of surgery and a medical care. surgical consultant to VA. Medical Center, It is anticipated that 260 patients who suffer Buffalo General, Sisters of Charity, and Kenfrom the di ease of alcoholism will be treated more Mercy hospitals, will join the executive annually under the new service, according to office in the capacity of the institute' deputy Dr. Stephen Stayer, director of the new chief operating officer, responsible for cooralcoholism rehabilitation service and clinical dinating Roswell's diverse activities, as well as assistant professor of psychiatry. for the development and implementation of a With the opening of the new program, long-range plan and new program initiatives. • ECMC Forms New Alcohol Rehab Service T AUTUM '87 BUFFAID I PHYSICI A N I new plan for Roswell Park Memorial Institute proposes sweeping new changes in its structure, salaries and plans for construction - and also a significantly strengthened relationship with UB. The Long Range Strategic Plan for Roswell Park was announced last April by State Health Commissioner David Axelrod, M.D., and Thomas Tomasi, M.D. , the institute director. "This plan provides a practical framework that will enable Roswell Park Memorial Institute to enhance its stature as one of the leading comprehensive cancer centers in the world," Commissioner Axelrod said. Dr. Tomasi commented, "The plan addresses many critical decisions facing the institute and outlines the institute's strengths and areas that need to be improved for the future." The long-awaited plan recommends removing the institute from the jurisdiction of the State Health Department and establishing it as a public benefit corporation. Whereas the Health Department now oversees its operation, the new plan would set up a new board of trustees and give the institute director greater executive powers. The report also recommends that Roswell Park strengthen its relationship with the UB School of Medicine by signing an agreement that would expand and reinforce its affiliation as a teaching hospital. Dr. Tomasi wants UB to be more involved in Roswell Park's doctoral, post-doctoral, and residency programs. The closer relationship will also be reflected in changes in the institute's infrastructure: for example, heads of Roswell Park units will also serve as heads of the same UB units, e.g. , radiation, oncology. Salary enhancement to increase competitiveness, retention, and quality of staff �25 Hospital Neus medical scientists and physicians is another part of the plan that involves UB. Dr. Tomasi said that physicians' salaries at Roswell Park have not been competitive with other academic institutions, including UB. A stronger affiliation agreement with UB would help remedy the recruiting problems, and also benefit joint UB!Roswell programs. The plan would develop a faculty practice plan (UB established one in 1984) to correct wage scale deficiencies. Currently, Roswell Park and UB representatives serve on search committees to fill key positions at the institute. Those named to fill the positions will have joint UB appointments. That joint appointment, Tomasi added, will help supplement salaries. Other major features of the plan are to: • Construct a new clinical facility by 1993. • Establish a magnetic resonance imaging center to meet regional needs and strengthen the radiation medicine program. • Establish a scientific advisory board to help maintain quality of research and provide directions for new research. • Increase marketing efforts to retain and attract more cancer patients. • New V.A. Medical Center Director Appointed M r. Richard S. Droske is the new director of the VA. Medical Center, Buffalo. Mr. Droske holds an M.B.A. in hospital administration from Wagner College and a B.S. in mechanical engineering from University of Pittsburgh . "I'm looking forward to working in the Western ew York area and plan to continue the close positive working relationship with all individuals who help in providing quality health care," he commented at the official announcement of his appointment. Mr. Droske began his career in the Veterans Administration as an assistant chief, Engineering Service, Butler, Pa., in 1963. He then served as chief, Engineering Service, Batavia V.A. Medical Center from !968 to 1972. From 1972 to 1973, he attended Wagner College in a graduate education program in hospital administration. Following the graduate program, he was appointed as an associate director trainee at V.A. Medical Center, East Orange, N.J. From 1974 to 1980, he held the position of associate medical center director at Vancouver, Wash. ; Syracuse, N.Y., and Allen Park, Mich. In 1980, he was appointed director, VA. Medical Center, Cleveland, Ohio, and in 1982 he was appointed director, V.A. Medical Center, Castle Point, N.Y. He served in the U.S. Air Force from 1953 to 1954. Mr. Droske is a member of the American College of Healthcare Executives, D. A. V., the American Legion, and the Association of Military Surgeons of the United States. - John]. Pulh BUFFAID ! P H YS I C I AN I Treatment Center Staffed by Family Medicine Personnel B uffalo General's Deaconess Immediate Treatment Center (lTC) has altered its physicians staffing and the center is now staffed by doctors in the Deaconess Family Medicine Center. Before April!, the lTC- which provides treatment for minor medical problems was staffed by outside contracted physicians. The lTC is now staffed with board certified attending physicians in UB's Department of Family Medicine. The attending physicians will also oversee Medical School family medicine residents. The staffing was changed to ensure a higher standard of patient care in the lTC. • AUTUMN '87 �26 Alumni Warm weather woes: guests. The all-clay event was sponsored and organized by the UB Medical Alumni Association, the Medical School, and Continuing Medical Education. Key organizers included John Przylucki (M '73), clinical instructor in surgery, and Joseph Kunz (M '56), program chairman and UB clinical assistant professor of medicine. r. Reisman, clinical professor of medicine and pediatrics, noted that 20 per cent of the population suffers from hay fever or pollen allergy. Because of advances in treatment, Reisman exclaimed that "in today's world, no one should be suffering from allergic rhinitis anymore." Previously, immunotherapy ("allergy shots") D '' T SUNBURN and antihistamines were the primary treatment options. Because of the side effects of antihistamines such as sleepiness, and the inconvenient long-term nature of shots, other options were sought. First, Reisman explained, a new, non-sedating antihistamine, Seldane (terfenadine) is now available for those who don't like other antihistamines. Even more significant are the safe and effective steroid nasal aerosols that have been developed (e.g. beclomethasone, flunisolide, cromolyn). Unlike nasal decongestants, they are not addictive and don't injure the nasal lining. These new steroids are safe for periods up to several months and usually provide major symptomfree relief. Dr. Reisman recommends immunotherapy only for chronic allergy, not just for seasonal allergy of four to six week duration. he trees are blooming, the sun's out, and two of my fellow guest speakers complained over breakfast about the antihistamines they're taking. Yes, for an allergist, this is the season when 'paradise' begin . " So jested Robert Reisman, M.D., as the first guest speaker of UB's 50th Annual Spring Clinical Day. Held in downtown Buffalo at the Hilton Hotel, the May 9, 1987, event featured five speakers who addre sed "Warm Weather Woes: Things That Go Wrong In the Summer." The major topics included the late t advances in treatment of insect and pollen allergies, poi on ivy, photodermatitis, drowning, hyperthermia, and recreational accidents. Internationally known cancer pioneer James Holland, M.D., delivered the Stockton Kimball Memorial Lecture before almost 300 AUTUMN '87 BUFFAID r=e=[ v SIC IAN I �27 Alumni Problems of summer photosensitize individuals, induding perfumes, tetracycline, sulfa, dyes, food additives, and even, ironically, sunscreens. He remarked that "drinking can be dangerous to your health," and then related that limes in gin and tonic have caused skin reactions that persisted for months. No breakthroughs in sunburn treatment have been developed since the sunscreen PABA. Prednisone may relieve severe reactions, but prevention and avoidance are still the best approaches, he commented. However, even sunscreen is ineffective for polymorphous light reactions which can develop from exposure to longer UY waves. He did mention one "breakthrough" of sorts: "Sunscreens are now available that blend invisibly and can be used with cosmetics." An unusual fact is that Buffalo has a respiratory allergy not found anywhere else. For a few weeks every year, huge swarms of sand, or caddis, flies emerge along only one section of the waterfront. When they are breathed in, their emanations and debris cause many residents to suffer allergic reactions. Allergies to stinging and biting insects are another summer malady. People vary greatly in their reactions to such insects, and can be uniquely allergic to specific species. The most severe reactions can be anaphylaxis (0.4%), encephalitis, neuropathies, and Guillain-Barre Syndrome. Onethird of such sensitive people also have histories of other allergies. In contrast, some people, such as beekeepers, get no reaction whatsover, Reisman remarked. Tests show that they can have high HEATSTROKE levels of lgG antibodies. The noted allergist described two treatments for known sting-allergic people. With the use of a kit, epinephrine can be self-administered with an automatic injector immediately after a sting. "Sting immunotherapy is also very effective," adds Reisman, who has extensively researched this approach. S NEAR DROWNING ummer cutaneous diseases were discussed by Carl Ehmann (M '67), who is a clinical associate professor of dermatology. He distinguished between phototoxic and photoallergic reactions. The latter reaction cannot occur upon first exposure to sun, but requires repeated exposures and only involves a small percentage of the population. He noted that dozens of chemicals can BUFFAID I PHYSICIAN I AUTUM '87 �28 Alumni Progress in the treatment of poison ivy has also been slow. The newest developments are "prophylactic gels and sprays for sensitive people likely to come in contact with poison ivy," such as in vegetation clearing. Otherwise, avoidance, washing, topical steroids, and antihistamines are all that are available. T reatment of near-drowning was the topic ofjohn Lauria (M '60), clinical professor and chairman of anesthesiology. He elucidated many new understandings about drowning, including the fact that "resuscitation should begin in the water, if at all possible," to prevent rapid brain damage from cutoff of the oxygen supply. "Once out of the water, a gasping effort within five to ten minutes is the best prognostic sign available.... If no gasping occurs within 40 minutes, neural recovery is very slim." He cited the statistic that 50 per cent of drowning victims who arrive in the hospital comatose will die, and the other 50% will have significant neural problems. Dr. Lauria recommends immediate transport to the hospital if any loss of consciousness has occurred, no matter what. This will allow treatment of delayed complications stemming from overlooked head or spinal injury or epidural hematoma. One unusual but not infrequent complication is "secondary drowning." While a patient may initially recover, damage to alveoli due to aspiration or other causes can result in loss of consciousness as much as 12 hours later. He described two involuntary reactions that can lead to different results, the diving reflex and laryngospasms. Few are aware that 10 to 15 per cent of drowning victims die without having any water in the lungs. This is due to very tight laryngospasms, which can asphyxiate as effectively as water in the lungs. In contrast, the diving reflex, which is particularly well developed in children, can prevent brain damage from asphyxiation. Dr. Lauria emphasized that prevention is still the most desirable approach. This includes legislation such as child-proof barriers to pools; education that drinking alcohol can lead to drowning; funding to provide life guards for rapid rescue; education about safety in water; and training of the lay public so they can pro- AUTUMN '87 Dr. James F. Holland leaunng at Spnng Urmcal Day luncheon. vide rapid on-the-scene resuscitation, including CPR. And finally, he explained, there is no risk to would-be rescuers from legal liability or contracting AIDS. N oted sports physiologist, David Pendergast, Ed. D., updated the audience on heat stroke and exhaustion. He began by noting that a dozen high school football players die each year from hyperthermia. The UB associate professor of physiology corrected a common misunderstanding about heat BUFFAID !PHYSICIAN] loss. "Sweating does not release heat, only evaporation of sweat does it." That is why humid air greatly reduces the ability to rid the body of heat. Dehydration can also do it, since it reduces the availability of water for sweat. "However, one can satisfy thirst with 500 ml. water but not correct dehydration, which may require nine times that much." Pendergast added that older people are at higher risk of hyperthermia than the young because they lose their sweating effectiveness and vasodilation ability. �29 Alumni Dr. Pendergast had a special caution for physicians. "Measurement of rectal temperature in hyperthermia is not the best way because it is too slow to change. Esophageal temperature gives the most accurate reading of core temperatures. R ecreational injuries were addressed by the team physician for UB sports, Edmond Gicewicz (M '56). The clinical assistant professor of surgery was a captain and assistant coach (while in Medical School) ofUB's football team and also medical class president for two years. He described how different parts of the body are vulnerable to injury from different sports. "In basketball and football, it's knee injuries; for pitching, it's elbows; tennis, it's shoulders and elbows; wrestling, it's ears. Overall, the most commonly injured parts are the knee, thigh, ankle, and shoulder. "The greatest danger is for all of you out there. It's a mistake to try to compete with your younger counterparts or your children," he stressed. "Our joints are less flexible, muscles weaker, and neuroconnections less quick." Besides accounting for age, he emphasized other preventive measures, such as use of proper equipment, use of warming and stretching exercises, regular exercise, and avoidance of alcohol. P eter Ostrow, M.D., associate dean for curricular and academic affairs, welcomed the luncheon gathering. "This is the 50th anniversary of Spring Clinical Day. It is also the 25th anniversary of the State's promise of a first-class lecture hall. Now we finally have one, the modem Butler Auditorium in Farber Hall." Dr. Ostrow summarized the notable achievements of medical students, who were awarded one of only six Society of Nuclear Medicine Fellowships nationwide, one of only seven AOA fellowships and one of only a small number of Hughes and Beckman awards, among other honors. The honored speaker for the Stockton Kimball Memorial Lecture was James F. Holland, M.D. , chairman and endowed professor of Neoplastic Diseases, Mt. Sinai School of Medicine, and director of the hospital cancer center there. The acclaimed cancer chemotheraphy pioneer won the 1972 Albert Lasker Award, often called the 'i\merican Nobel Prize." He also received the American Cancer Society's National Annual Award and many others. The author of almost 500 publications, he plays editorial roles with ]AMA, the Journal of Clinical Oncology, and other journals. Dr. Holland was on UB's medical faculty from 1955 to 1972 and was Roswell Park's chief of medicine and director of its Cancer Clinical Research Center. In his lecture, "40 years after Amethopterin," he reviewed progress in cancer treatment. The first chemotherapy, he noted, was in 1863, when sodium arsenate was used to ameliorate a woman's leukemic condition. Aminopterin, a close analog of amethopterin or methotrexate, was developed in the 1940s. Since then, drug combinations, including methotrexate, have raised the child leukemia survival rate to 50 to 75 per cent, while drug and surgery combinations have considerably improved rates for almost all other kinds of cancer. Dr. Holland then cited two examples of how politics has threatened the progress of cancer research. During the Nixon presidency, one senator put forth a national cancer bill, he related, but ixon opposed it. When the president saw he might lose since both houses supported the bill, his representative and the senator struck a deal. The bill went forth as " ixon's bill" and was passed. A recent example just occurred under Reagan, Holland continued. "The GAO did a study of the CI's research funding in relation to cancer progress. The findings were deliberately misinterpreted by a Reagan costcutting official to pressure legislators to be less generous to cancer research." As far as the future is concerned, "the genetic revolution is opening a new chapter in cancer therapy. Using genetically manipulated bacteria to produce human proteins, interleukin II and interferon are showing promise." Holland concluded that interleukin II is very effective for metastatic melanoma, sarcoma, breast and rectal cancer, and other forms ~a~r. • Dr. Hoeplinger wins 1st prize for exhibit F irst prize for best medical exhibit went to Mark A . Hoeplinger, M.D., at the 50th Annual Spring Clinical Day Exhibits Program held in May by the School of Medicine, in conjunction with the Medical Alumni Association. Dr. Hoeplinger's award-winning exhibit tried to show what modem laser surgery can do for patients with vocal chord problems. An advantage of modem laser surgery is its ability to safely evaporate growths, polyps, and nodules with great precision. A clinical instructor in otolaryngology at UB's School of Medicine, Hoeplinger recently opened his own practice in West Seneca. Second prize was awarded to Allen Richmond, Ph.D., clinical instructor in otolaryngology, for his educational exhibit on the efforts necessary for the complete rehabilitation of the laryngectomy patient. In order for the patient to regain the ability to speak, a silicon prosthesis is inserted during an operative puncture procedure. The speech pathologist then works together with the surgeon to rehabilitate the patient post-operatively. Dr. Richmond was assisted by Richard Buckley, M.D., John Kloepfer, and the New Voice Club, which is a group of patients who have undergone the total laryngectomy procedure and now offer support to similarly involved patients in their recovery. Third prize went to George J. Alker, Jr., M.D., and Angelo M. DelBalso, D.D.S., M.D., for their presentation on a new method of imaging the maxillofacial region. This new type of x-ray unit, which is a modification of the panoramic technique applied to other facial structures, gives better images at a lower radiation dose. Dr. Alker is chairman and professor in the UB Radiology Department. Dr. DelBalso, a clinical associate professor of radiology at UB, is director of maxillofacial imaging at the dental school here. • BUFFAID !PHYSICIAN I AUTUM '87 �30 Alumni CLASS REUNIONS 1937 First Row seated on floor - left to right: David H. Weintraub, M. Luther Musselman, Irving Weiner Second Row seated - left to right: Theodore C. Flemming, Robert W. Upsett, Charles F. Banas, Edwin 0. Kriedemann, Angelo Lapi Third Row standing - left to right: William F. White, John Ambrusko, Charles F. Stewart, Kenneth M. Alford, Charles Woeppel, Francis E. Ehret, Soli Goodman, James D. MacCallum, George F. Koepf The Spring Clinical Day program featured reunions of several Medical School Classes pictured on this and the following pages. The traditional class gifts to the School of Medicine from the groups pictured totaled $107,597, including these group contributions: Class of 1937: $7,637; Class of 1942: $51, 200; Class of 194 7: $7, 225; Class of 1952: $8,075; Class of 1957: $6,110; Class of 1962: $12, 725; Class of 1967: $5,325; Class of 1972: $4,150; Class of 1977: $5,150. AUTUMN '87 1942 Left to right - seated: Richard Ament, Kent L. Brown, Joseph E. Anderson, Michael A. ]urea Seond Row standing - left to right: Howard N. Frederickson, Vincent ] . Parlante, L. Walter Fix, William]. Staubitz, Boris L. Marmolya, Richard T. Milazzo 1947 First Row seated on floor - left to right: Robert ]. Dean, Frederick D. Whiting, Hans Kipping, Jack Lippes, Jerome l. Tokars Second Row seated - left to right: William C. Baker, Arthur J. Schaefer, Hallie B. Mont, William M. Bukowski, Salvatore Aquilina Third Row standing - left to right: John B. Sheffer, James F. Phillips, Peter ]. Julian, William S. Edgecomb, James F. Stagg, Jean Czysz Yockey, Richard]. Kenline, Carl ]. Nicosia, Elbert Hubbard lll, David H. Nichols BUFFAID !PHYSICI AN I �31 Alumni 1952 First Row seated on floor - kft to right: Ralph M. Obkr, Roy J. Thurn Second Row seated - kft to right: Charlotte Weiss, Wilbur Schwartz, Burton Stulberg, Barbara G. Corky, Phoebe Saturen Third Row seated - kft to right: Robert A. Baumler, Byron Sheesky, David Hertz, S. Aaron Simpson, Oliver J. Steiner Fourth Row - kft to right: Donald F. Dohn, Neal W. Fuhr, John Y. Ranchoff, Victor Panaro, Albert A. Gartner, Jefferson Underwood, Travers Robbins, Donald H. Sprecker, Francis A. Fote, Milton Lapp, James Zelkr, Melvin Dyster 1957 First Row seated on floor - kft to right: Daljit S. Sarkaria, Ben Celniker, Arthur L. Beck, Bernard D. Wakefield Second Row seated - kft to right: James E. lAsry, Gemumte L. Boncaldo, Harold C. Castilone, Robert B. Sussman, Sherman Waldman, Richard R. Riley, James T. Collins Third Row standing - kft to right: Capt. D. R. Hauler, John S. Parker, Frank J. Chafe!, Jerome P. Kassirer, Sol Messinger, Richard F. Milkr, Charks O'Connor, John K. Cusick, Ross Markello 1962 First Row seated on floor - kft to right: Joseph R. Gerbasi, Philip D. Morey, Gerald E. Patterson, Joseph P. Armenia, Charks G. Adams, Gary C. Hauser Second Row seated - kft to right: David E. Carlson, Robert G. Ney, Rae R. Jacobs, Roberta M. Gilbert, Marvin Z. Kurlan, Sebastian S. Fasanello, Paul J. Loree Third Row standing - kft to right: Michael M. Madden, George R. Tzetzo, Gordon R. Lang, William P. Scherer, Bernard Polatsch, Morton P. Klein, Ronald I. Dozoretz, Morton E. Weichsel, An- thony P. Markello Fourth Row standing - kft to right: Dean A. LeSher, Thomas 0. Fitzpatrick, Jack C. Fisher, Martin F. Abbert, Alan L. Pohl, Melvin J. Steinhart BUFFAID P HY S ICI AN ) AUTUMN '87 �32 Alumni 1967 First Row seated on floor - left to right: J. Brian Sheedy, John R. Anderson, John J. Treanor, Donald E. Miller, Thomas P. O'Connor Second Row seated - left to right: James Giambrone, Jonathan S. Ehrlich, Barry M. Epstein, John W. Gibbs, Carl Ehmann, Laird C. Quenzler, Barry R. Weiss Th.ird Row standing - left to right: John P. Menchini, Jacob S. Kriteman, Thomas P. Sheehan, John P. Kelly, Burton L. Chertock, Anthony J. Lo Galbo, Ronald Josephson, Michael M. Phillips, Rocco Venuto, Paul Goldfarb, Trewr Robinson, George Starr 1972 First Row seated - left to right: Linda A. Kam, William T. Murray, Lawrence Schreiber Second Row standing - left to right: Richard Goldman, Stuart Rubin, Ian Frankfort, Philip C. Moudy 1977 First Row seated - left to right: Russell J. VanCoe.,ering, Helen M. Findlay, Thelma Caison-Sorey, Linda Smith, Nedra J. Harrison, Marciana Washington, Janice D. Williams, Haroey R. Goldstein Second standing - left to right: Robert M. Stabo, Duret Smith, Jeffrey A. Mogerman, Kenneth D. Anthone, Ke.,in C. Greenidge, Alan S. Kurittky, Carl J. Schmitt, Larry M. Altschul, Ste.,en S. Stone, John D. Zimmerly, Gregory Young, Ronald W. Neuberg, Elsburgh 0. Clarke, Albert Schlisserman, Jeffrey K. Seitelman, Howard A. Lippes, Ronald A. Vidal AUTUM '87 BUFFAID I PHYSICIAN I �33 Alumni Dr. Zeplowitz named president of Alumni group F ranklin Zeplowitz, M.D., has been elected president of the UB Medical Alumni Association. Zeplowitz will serve a one-year term as president of the Governing Board, which represents more than 4,500 alumni of the School of Medicine. A 1958 graduate of the University of Buffalo School of Medicine, he was elected into the honor society Phi Beta Kappa. A specialist in general and pediatric surgery, he is a member of the staffs of Buffalo General and Children's hospitals and is an attending surgeon at Mercy Hospital and Our Lady of Victory Hospital. Dr. Zeplowitz is a diplomate of the National Board of Medical Examiners as well as the American Board of Surgery and is a fellow of the American College of Surgeons. He is a past president of the Maimonides Medical Society and of Our Lady of Victory Hospital Medical Staff. Other elected officers of the Alumni Association are Paul H. Weirzbieniec, M.D., vice president, and Joseph L. Kunz, M.D., treasurer. Wierzbieniec is a member of the American Board of Orthopaedic Surgeons, past president of the Western ew York Orthopaedic Society, and vice president of the New York State Society of Orthopaedic Surgeons. He is an assistant attending at Millard Fillmore Hospital and an associate attending at Buffalo General Hospital and is on the courtesy staffs of Children's Hospital and Erie County Medical Center. The UB clinical instructor in orthopaedics earned his B.S. from Rennselaer Polytechnic Institute and his M.D. from UB in 1974. Dr. Kunz earned his B. A. from Canis ius College and his M.D. from the UB School of Medicine in 1956. The UB clinical assistant professor of medicine is staff physician for the Outer East Side Clinic, Erie County Department of Health, and is associated with Hamlin Terrace Health Care Center, and Buffalo General and St. Francis hospitals. • BUFFAID PHYSICIAN I AUTUM '87 �34 Classnotes Hebert Berwald (M'27) • travelled from Napa, California, to attend Spring Clinical Day and his 60th Reunion. He reports: "The dinner was attended by Dr. Meyer Riwchun and myself only, but we enjoyed each other's company. I guess after 50 years, or at the latest 55 years, little attendance can be expected." George B. Kuite (M'27) • retired in 1969 afte r becoming totally disabled. His address is Intervale Road, North Conway, ew Hampshire 03860. 1930's William L. Seil (M'30) • informs us that he is retired and living in Homosassa, Florida. Arthur W. Strom (M'32) • was elected a Laureate of the Michigan Chapter of the American College of Physicians. Dr. Strom retired from private practice in internal medicine in 1977. His hobby has been fly fishing in the rivers of Michigan. Dr. Strom's activities are now divided between Naples, Florida, and Hillsdale, Michigan. AUTUMN '87 Thomas S. Bumbalo (M'36) • Before he departed from the Buffalo area, the Buffalo Pediatric Society presented Dr. Bumbalo with a plaque commemorating his achievements over the past 55 years. Dr. Bumbalo served on the Children's Hospital staff since 1936 and was on the facu lty of the Medical School for 55 years. He is a past president of the Erie County Medical Society and the Western ew York Hospice, and a former administrator of the Edward J. Meyer Memorial Hospital. Dr. Bumbalo is also past vice president of the ew York State Medical Society, and a former member of the Erie County Board of Health. Dr. Bumbalo now lives in Haines City, Florida, and is obtaining a limited license to practice as a volunteer in the Migrant Workers Pediatric C linic in Polk County, Florida. Julian Ascher (M'40) • of Buffalo is assistant professor of internal medicine, emeritus. Dr. Ascher has been retired since 1984. Stanley B. Clark (M'41) • of Forestville, New York, is a past member and vice president of the Forestville Board of Education . Dr. C lark is a specialist in radiology and geriatric medicine. Thomas F. Frawley (M'44) • has received the Laureate Award of the American College of Physicians. This award was given in recognition of Dr. Frawley's commitment to excellence in education and professional performance in medicine. Dr. Frawley is professor and chairman of Graduate Medical Education at St. John's Mercy Medical Center, St. Louis, Missouri. Dr. Frawley is currently serving as a National Board Member of UB's Medical Alumni Association. 1950's Karl Manders (M'SO) • has biographies in Who's Who in America 1986-1987 and Who's Who in The Biobehavioral Sciences 1987. Dr. Manders has a private practice in neurosurgery in Indianapolis, Indiana. Burton Stulberg (M'52) • of Buffalo was honored at the Adolescent Psychiatric Clinic's 50th Anniversary celebration by the Erie County Legislature, the BUFFAID I PHYSICIAN Mental Health Association, and the Board of Directors of the C linic. Dr. Stulberg was cited for more than 30 years of service as director of medical services of the Clinic. John LeValley (M'SS) • informs us that he is retired and his new address is: 414 Madeira Avenue, Coral Gables, Florida 33134. Richard H. Musgnug (M'59) • of Cherry Hill, ew Jersey, wrote a chapter for the reference book Demis on skin atrophies entitled, "Clinical Dermatology," published by Harper and Row. Dr. Musgnug is an assistant clinical professor of dermato logy at Thomas Jefferson Medical School. 1960's Kenneth E. Bell (M'61) • recently completed the Kaiser Permanente Executive Program at Stanford University Graduate School of Business. Dr. Bell has a private practice in obstetrics and gynecology in Anaheim, California. Ray Hippchen (M'61) • writes that he joined the Mid-Dakota �35 Classnotes Clinic in Bismarck, orth Dakota, in January 1987. He is a clinical associate professor of pediatrics at the University of North Dakota School of Medicine and has been a practicing pediatrician in the Bismarck community for the past ten years. Jack C. Fisher (M'62) • recently was elected a director of the American Board of Plastic Surgery. He is a professor of surgery, and head of the Division of Plastic Surgery at the University of California, San Diego. Roberta M. Gilber t (M'62) • gave a paper at Georgetown University Family Center's Annual Symposium in 1986, "What is Communication?," especially in regard to relationships. Dr. Gilbert has a private practice in psychiatry in Prairie Village, Kansas. Virginia V. Weldon (M'62) • deputy vice chancellor for medical affairs, Washington University School of Medicine in St. Louis, has been elected to the ationa! Board of Medical Examiners. Dr. Weldon is vice president of the Washington University Medical Center. She is also immediate past chairman of the Association of American Medical Colleges, and the first woman chosen to lead the organization. Dr. Weldon is recognized nationally as a spokesperson on issues in medical education, biomedical research, and legislation affecting health care costs. Leonard Jacobson (M'64) • of Cincinnati, Ohio, writes that in 1986 he was president of the Cincinnati Society of Ophthalmology. John A. Manzari (M'64) • is the director of pulmonary services and vice president of professional affairs for United Health Services, which includes hospitals in Binghamton, Endicott, and Johnson City, New York. Dr. Manzari is a clinical professor of medicine at Upstate Medical Center, Syracuse. Robert N. Schnitzler (M'65) • is clinical professor of medicine at The University of Texas Health Science Center, San Antonio, and is president of the Cardiovascular Institute for Continuing Medical Education and Research. Dr. Schnitzler serves as program chairman of the Island Symposium on Cardiac Pacing, Maui, Hawaii . Richard J. Goldberg (M'74) • has been appointed psychiatristin-chief at the Rhode Island Hospital and Women & Infants Hospital in Providence. Dr. Goldberg is an associate professor in the Department of Psychiatry and Human Behavior at Brown University. The author of numerous books and papers, he is currently a reviewer for the Journal of Hospital and Community Psychiatry, Psychosomatics, ]our- nal of Nervous & Mental Disease, and Social Science & Medicine. John C. Rowlingson (M'74) • of Charlottesville, Virginia, writes that he has been promoted to professor of anesthesiology at the University of Virginia Medical Center, and is continuing as director of the Pain Management Center. Mark J. Polis (M'77) • was conferred as a fellow of the American College of Surgeons in October, 1986. Dr. Polis has a private practice in urology and urologic surgery in Williamsport, Pennsylvania. Michael Thomas Ross (M'81) • will join the staff of the Department of Emergency Medicine at Hurley Medical Center in Flint, Michigan, as assistant director of the Emergency Medicine Department and director of training in emergency medicine. His responsibilities will include development and implementation of an emergency medicine residency. Gerard F. Vitale (M'82) • has completed five years of general surgical training at North Shore University Hospital, and is now a BUFFAID I PHYS ICI AN I fellow in vascular surgery at St. Vincent's Hospital, Portland, Oregon. Catherine A. Goodfellow (M'83) • of Rochester, New York, writes, "Entered private practice in pediatrics starting July 1987 on half-time basis while keeping up with our children: Jordan, 6; David 4; Andrea 2; and Aaron 9 months." Michael S. Wenzel (M'83) • has transferred from Quantico, Virginia, to Gaeta, Italy, where he will serve as medical director of a branch of the Naval Medical Clinic for two years. He is also working on publishing a presentation he made. Michael P. McMullen (M'84) • completed his family medicine residency program in Rochester, ew York, in July 1987 and will be joining the Highgate Medical Group in the fall. Craig J. Schmidt (M'86) • writes, "I have recently completed my internship at St. Elizabeth's Hospital in Boston. July '8 7 began my three-year ophthalmology residency at Boston University Affiliated Hospitals." AUTUM '87 �36 Deaths Dr. Thaddeus J. Bugelski (M'41), 77, died February, 1987. The gynecologist-obstetrician served as an Army Medical Corps major and commanded battalions in Europe for four years. The unit under his command was the first medical banal ion to enter the Dachau concentration camp. He set up a hospital there to care for survivors and was awarded the Legion of Merit for his service. Bugelski was associated with Buffalo General, Mercy, Deacones , and St. Joseph Intercommunity hospitals, and was chief of staff for the latter two. He was a member of the county, state, and national medical societies • and the American College of Surgeons. UB pediatrician Dr. Wilbur J. Fisher died February 24, 1987. The UB clinical assistant professor of pediatrics practiced medicine in Buffalo for 45 years. Trained as a classical pianist in high school, he gave up plans for a musical career to enter medicine. He earned his bachelor's and medical degrees from Yale and Johns Hopkin . He was a member of the county, state, and national medical societies and the Maimonides Medical ociety. He is survived by a son, Dr. Julian, a faculty member at Harvard Medical School. • Dr. Ward White (M'42) died October 12, 1986, in Port St. Lucie, Fla., where he had lived ince 1964. He practiced medicine for many years in Gowanda, where he was a general surgeon at Tri-County Memorial Hospital. • D r. Carl). Graf, 69, died April25, 1987, in his home in Sea Island, Ga. The 1941 UB Medical alumnus gained a national reputation in neurosurgery. After neurosurgery training at Buffalo General Hospital, he was appointed a diplomate of the American Board of Neurological Surgery as well as to the Board of Psychiatric eurology. He served as one of the founders and president of the eurological Society of America. He served as part of Project Hope in Peru in 1963. Until his retirement, he was a professor of neurology at the University of Iowa's College of Medicine, whose library was named after him. His urvivors are two sons, a sister, and his mother. • AUTUMN '87 John G. Ball (M'36) died suddenly March 19, 1987, from injuries sustained in an automobile accident. Dr. Ball established a general practice in 1938 in Bethesda, Maryland, until his induction into the U.S. Army in 1942. He served in the Philippines and was discharged in 1946, at which time he resumed his practice in Bethesda, retiring in 1982 after 40 years of practice. Dr. Ball held numerous medical association positions including president, Medical Arts Society of Greater Washington; and member, state president and Fellow of Letter to the Editor: Editor: It was interesting to read the article on medical inventions in the Buffalo Physician, Late Winter 1987 issue. In 1942, I devised the first serial section biopsy instrument which became the official instrument of the American Cystoscope Company and was featured in their catalogs for eight years. The instrument was well received and, incidentally, I was awarded the American Cancer Society Award for this new invention. Mr. Fred Wallace, president of American Cystoscope Co., told me they had tried unsuccessfully for 25 years to make such an instrument. Originally, I had devised this instrument as a prostatic biopsy device, but it became very popular for bone, muscle, skin, etc., as it gave a serial section of the tissue. This provided the pathologist with the earliest identification of carcinomatous v. benign tissue. Harry Bergman, M.D. Class of 1934 Clinical Professar of Urology University of Miami BUFFAID ! PH YSICI AN ! Academy of Family Practice. Dr. Ball is survived by his wife, a son and a daughter. • Dr. Donald Duncan, chairman of Anatomy at UB from 1943 to 1944, died February 17, 1987, at 84. He was a distinguished and widely known anatomist who also served as chairman of the University of Texas' Department of Anatomy. He served as editor of the American Journal of Anatomy and president of the American Association of Anatomy, from which he received the Henry Gray Award in 1971. Nine �Deaths department chairmen of anatomy came from his faculty at Galveston. Interestingly, several museum dissections which he prepared while at UB are still used in the teaching of gross anatomy and neuroanatomy. • Dr. Max Landsberger, clinical associate professor of pediatrics (emeritus), died recently. He had served 41 years on the Medical School's faculty. • On January 28, 1987, Joseph E. Rutecki, M.D., died. He was a UB clinical assistant professor of anatomy and clinical associate in surgery for 35 years. • Dr. Eugenia Fronczak-Bukowska, 83, died April 15, 1987. She was the first woman master's degree graduate from Canisius College (1924) and earned her M.D. from UB in 1928. She specialized in gyn-ob and geriatrics and wa; medical director of the Downtown ursing Home. She was associated with other nursing homes, the Red Cross' pheresis unit and was on the board of directors of the Erie County Health Department, for which her late husband served as commissioner. For 40 years, she was on the medical staff of the Felician Sisters Institutions (founded by her father, also a doctor). They honored her with an award, as did the Catholic Diocese of Buffalo, the Women's Society of ew York and D'Youville College, where she was on the board of trustees. She was also active in a variety of Polish organizations. She is survived by two sons, a daughter, and seven grandchildren. • Erratum: • In the Spring Issue, p. 7, Jon Pullano's profile of Dr. Richard Lee said that Dr. Lee landed the 74 7 Flying Tiger. It should have read that "he was given the privilege of flying it for part of the time." In the same issue, p. 34, Dr. Worthington G. Schenk, Jr.'s name was misspelled, and he has put in 36, not 26 years of service at UB. -----------------------------------------------------------------NO POSTAGE STAMP NECESSAI?Y IF MAILED IN THE UNITED STATES BUSINESS REPLY MAIL FIRST CLASS PERMIT NO. 2210 BUFFALO. NY POSTAGE WILL BE PAID BY ADDRESSEE BUFFAID P H Y S c A N 139 Cary Hall State University of New York at Buffalo Buffalo. New York 14214-9980 1... II .1 •• 1•• 1.1 ... II .1 •• II .1 .. 1.1 •• 1.. 1.11 ..... 1. II �BUFFAID I p H y s c A Nl State University of New York at Buffalo 3435 Main Street Buffalo. New York 14214 Non -Profit Org. U .S. Postage PAID Buffalo, N.Y. Permit No. 311 Address Correction Requested Fill out this card (Please print or type all entries) Name - - - -- - - -- - - - - -- -- - -- - - - - - - - - - M.D. __ Ph.D.__ Year Received _ _ __ Office Address Home Address - - - - -- - -- - - - - - - -- -- -- - -- - - - -- - - - - - - - - - - - - - If not UB, M.D. or Ph.D. received from In Private Practice: Yes o No In Academic Medicine: Yes D o Specialty No D Part Time D Full Time o School _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Title Other: Professional Society Memberships News: Have you changed positions. published, been involved in civic activities. had honors bestowed. etc? _ _ _ _ _ _ _ __ Please send curriculum vitae. clippings. publications. or announcements. also include a photo of yourself. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Autumn 1987 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1987-Autumn Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1987-v21n03-Autumn Table Of Contents A list of subunits of the resource. Exceptional Achievers The Buffalo Medical Journal The Enigma of Eating Disorders Medical School News Hospital News Alumni Classnotes Deaths Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-28 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v21n03 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1987 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/d0d2e8057d2c900cb8f50519e9c927b9.pdf 3136785eac64c47730e28c22f159a19d PDF Text Text p H y s A N SUMMER'87 VOLUME 21, NUMBER2 - Doesthephysicianhavea rol.eto play? �BUFFAID I PHYSICIAN I Dea n's Message STAFF EXECUTIVE EDITOR, UNIVERSITY PUBLICATIONS Rolxn T . Marlett BU FFALO PHYSICIAN EDITOR Bruce S. Kershner ART DIRE<..."TOR Alan J. K11:lcr PHOTOGRAPHY Phyllis Chmcophn Douglas Levere Frank Luterek Ed Nownk ADV ISORY BOA RD Dr John Nau1thton. C:lu111man Dr HarolJ Brody Mr . Kevin C raig Ms . Karen OryJa Ms Nancy Ghcco Dr Jame s Knnsk, Ms . Manon Manon o"sk1 l)r . Dan1d Mordh Dr . Charle, Pagandh Mr . James Ph1ll1ps Mr . John Pull, Dr . Rol,.,rt Schell! Mr . Mike Sha" Mr . Steve Sh1vansky Mr Raul Vclasque: Dr . Mary Voorhc ss Dr . John Wn1tht Dr. Maggie Wright Dr Franklin upl01mz Dr J=ph Zam, Jr. D ear Friends of the School of Medicine. In the last issue of the Bufflo Physician,l announced that a new Consortium involving the eight teaching hospitals and the School of Medicine would be formed. A more complete story is enclosed in the contents of the current issue. Since the March 10, 1987 announcement, the hospital directors, consultants and my office have been busily engaged in the formation and implementation of the consultants' recommendations and suggestions. Although far too early to assessthe ultimate potential and/or outcome of this organization, there is obviously a spirit throughout the professional and non-professional community which is supportive of the con• cepts embodied in the goals and objectives of the Consortium. In these rather turbulent times for medical schools, hospitals in general, teaching hospitals in particular, and physicians (whether they be tenured academic faculty or engaged principally in private practice), it is apparent that a spirit of cooperarion designed to promote the best in academic medical centers and to maintain Buffalo's momentum as an academic health center exists among the organization's membership. In the months ahead our commitment co the attainment of mutually agreed upo n goals will be tested many times. There is every reason for optimism because of the long tradition of ongoing working relationships between the Medical School and its teaching hospitals and the full-time and voluntary faculty who conduct the academic and patient care activities in these facilities. As we work cooperatively to prepare for the realities of the I990's, I think our past history bodes each of us well and chat the Medical School and its missions will be strengthened con· siderably in the years ahead. Sincerely, John Naughton, M.D. Vice Pmiden1for ClinicalAffairs Dean, SchoolofMedicine TEAC HING HOSP ITALS Buffalo General C hildren', Enc Count\ MeJ1calCemcr l.11:n:y Mallard Fillmore Ro,,.dl Park Memorial lnst11u1c Sister s of Ch:imy Veterans Adm1mstrat1on Medical C enter Produced lry the D1rn1on of Unmirsuy Rdau on, in ruso,:1a11onu uh rhe S.:hool of Medicine , Stare Un1«'TJIIJ of Neu YOTkat Buffalo THEBlJFFALOPHYSICIAN(USPS 551 -86 0 ) Srnng 19!:!7. Volume 21 , Number I Published (ave t i me< annually : Late Want e r, Spr1n1t. Summer, Fall and Early Winter - by the School ot Med1c1nc, State Uno• ver s11yof New York at Buffalo , 3435 Main Street, Buffalo, New York 14214 . Third class bulk po sta1t• paid at Buffalo . New York . Send address changes to THE BUFFALO PHYS! • CIAN. 139 Cary Hall , 3435 Main Srreet . Ruffalo. N~w York 14214 A Message From Th e Medical A lumni Associa tio n I am proud to be the President of your Alumni Association for che next yea~. Col)ectively, as an active association, we work in close cooperauon with the Medical School and the Dean the student body and its governing group, and with you, our alumni.• Spring Clinical Day in May, was again a great success, both scientifical· ly and socially. We hope tha t all the alumni will look forward to the 1st weekend of May each year and plan to attend what will now be named "SpringClinicalDay and Reunion Weekend." I woul~ like ~~ ~ear from you concerning any suggestions, advice, or construcnve crmc1sm you may have for the Alumni Governing Board. Add ress your comments to me, at 3435 Main Street, 139 Cary Hall, Buffalo, New York 14214. In the future I will kee~ you abreast of all the alumni upcoming events and the recepnons at nanonal meetings throughout the councry both in t his column and in my newsletter to you. ' Havea wonderfulsummer! Franklin Zepl owitt , M.D. '58 �B p H y Cm,•r arr b, B,...,.da ~lvn, CONTENT S 2 Ph ysicians and Smoking Ce ssation . "Doctors are simply not fulfilling their jobs as advisors and protectors of their patients' health if they do not assertively instruct their patients to quit smoking," according co Michael Cummings, Ph.D., of Roswell Park and UB. Also: A Doctor's Primer on Motivating Patients to Quit, information about Nicorette, a nicotine-based chewing gum designed to help people quit smoking, and news of a student brigade from the School of Medicine that has launched an attack on teenage smoking. 8 Kno ckin g the Supernatural. Three of the founders of the School of Medicine conducted one of history's earliest scientific investigations of paranormal phenomena when they looked into the mysterious "Rochester Rappings" of the mid 1800s. 11 High T ech Babie s. Western New York Technology Development Center has spawned three of them. A NOBE L YEAR • 16 They say that winning a Nobel Prize cakes a year out of your life. But what a year it is! IN P URSU IT OF BUTTERFLIES • 18 lchiro Nakamura, an associate professor of pathology, travels the world in pursuit of his life-long hobby. terflres hat,e been the life-long lwbln 1cnaro Nakamura of Dr. PEOPLE • 20 MEDICA L SCHOO L NEWS • 22 Dr. Leon Farhi is developing a prospectus for a new Institute for Biomedical Engineering. School plays pivocal role in new medical consortium. RESEARCH • 29 The Poor and Cancer. Poor management practices plague the nation's blood supply. Marijuana use may decrease male fertility. HOSPlT AL NEWS • 34 CLASSNO T ES • 36 �2 "D ouors arc ,imply not fulfilling their Joh-. , ad Visors and protl'\.tors o( their patients' health i( chev do not as<;(;rtivelv instruct their panents to quit smoking." So ,race, MKhacl Cummings, Ph.D., o( the Department o( Cancer Control and Ep1dem1ology at Ro,well Park ~1cmorial ln,citutc and a UB I nical a<-<-istantpro(e-.sor of "()<. :ii and pren:ntive ml.J1Cine. Cummings 1s also the director of Roswell Park's ,mok ng control program and a man committed co helping pt'Ople to quit smoking. DOCTORSSHOULD PLAYCRITICALROLE IN AIDINGPATIENTS 1D QUITSMOKING BY SHA \\N CAREY SUMMER'Bi "Smoking c1.-ssat1onrepresents one of our mo,c nht-eff1.'Cm·eforms of discasc prevention," Or. Cumm ·r pointed out, "and physicians, as well as other health professional,, can and should be cff1.'l..tivcanti• smoking counselor,;. The pay-off outweighs the effort." "Phy<-iciansshould first of all 1dent1fya patient as a smoker or a non-smoker and then treat the smoking just as they would high blood pressure, for example," Cummings says. "Helping a patient co scop <-mokingis a gooJ m1.-d1cine,and, in my opinion, it is of ab,;olute n1.'C1....,sity that physician<.look at it in ch1.<-amclight." He bas<.><; his strong statement on two point that <-mokin is the ,ingl most important cnuse of preventable di-.easc in America; and that smokers' physicians can play the most int<.-gralrole in motivating their patient, co quit. This latter point i, h-i~ on a <.rudvconduct1.-dby Cumming at Roswell Park last year. In this study, 283 cigarette-smoking patient, of 28 familv pracnce r1....,1denr, were BUFFAI.D ' • y followed over a period of three months to asS<.~<; change in smoking behavior "\\'c found wide vananon among the doctors in tht percentage of their patients who succ1."1.,k-din quming," Cummings noted. "It rang1.-dfrom anywhere ht.•cwcen :ero and 20 r r cenr. "Obv1ou,h we wen: intcr<.-:-.tcd in finding out why. We made some rather nmable discoveries. "Interestingly, of the four doctors who were ,mokers themsclv~. not on1.· had a patient who successfully quit smoking. These doctors were bs likely to tnlk to their patient, about qu1mng." Further· �3 ; ~ i0 ~ ---------------------------------"-----------------------...J more, the patients of smoking doctors can often tell that their doctor smokes, whether or not they actually observe it or are told about it. A ccording to Cummings, a definite trend developed in the study. The more adamant the stance against smoking by the physician, the more seriously the patient would consider quitting. Consequently, the percentage of patients who actually quit smoking over the three month period was highest for those physicians who took the hardest and most determined stance against smoking. Because they can have such a pos itive effect on smoking cessation, Cummings says it is imperative that physicians and the health community as a whole take it upon themselves to see that the people they treat quit smoking. "Smoking is the largest contributor to health problems in this country," Cummings said. "It is time for physicians to realize that smoking should be treated as a disease and not an unrelated aspect of a patient 's lifestyle." Previous research by Cummi ngs indicates that if a doctor can get a patient to quit smoking for three months, the odds are BUFFAID s CT-H V I C I A N I j good rhat that person will nor start smoking again. According to Cummings, an earlier study indicated that if a smoker can make it th rough the first few weeks of quitting without a cigarette, the nicotine withdrawal symptoms which often accompany quitting (i.e., irritability, fatigue, insomnia) will lessen significantly, and rhe person will have a good chance of remaining an exsmoker for good . "Smokers and their physicians should know that withdrawal symptoms associated with quitting smoking will decrease rapidly after cessation," Cummings said. SUMMER'87 �4 significantly decrease the prevalence of cigarette smoking and eventually reduce the incidence of smoking related diseases. "The Community Intervention trial will determine if a broad, persistent, and sustained application of our knowledge of smoking prevention and cessation, when delivered in an environment which is supportive of nonsmoking, can substantially reduce the use of cigarettes in a clearly defined population," Cummings said. "We are hopeful that this trial will identify methods which we can apply co our nation-wide goal of smoking cessation." Cummings reports that the project is one of the largest of its kind ever undertaken and represents an important commitment by the National Cancer Institute to reducing cigarette use. The award will also establish Roswell Park's preeminence as a center for research in what Cummings terms "the most important behavioral health issue of our time." In addition to the significance of this long term study, Cummings is doing what he can to decrease smoking right now. Early in 1987, the Buffalo News ran a week-long series titled 'Time to Quit." The stopsmoking series, put together jointly by Roswell Park and the News, was aimed at encouraging Western New York smokers to make quitting their primary New Year's resolution. Cummings estimates that about 10,000 Erie County smokers quit smoking as a result of the News series. On the heels of the News series came the report by the New Yerk State Health Department that every year smoking claims the lives of more than 26,000 people in New York State alone. This sobering statistic should weigh on the consciences of many who are contemplating quitting, as well as physicians who do not urge their patients to quit. ''Withdrawal symptoms associatedwith quittingsmoking will decrease rapidly. Becauseof this,a doctorcan, in a very shortspan, do a greatdealto enhancea patient's longtermhealth." "Because of chis, a doctor can in a very short span do a great deal to enhance a patient's long-term health." ummings' urging of doctors co become a prime force in the reduction of smoking is just part of a larger, nationwide vision. "Approximately a half-million Americans die every year from the effects of smoking. And even though smoking rates are on the decline, this statistic indicates that the decrease has not been rapid enough. Ir is our goal to work coward a smoke-free America by the rum of the century," he says. To help him do this, the National Cancer Institute awarded a $2,196,864 research contract co Cummings last November. With the contract Roswell Park will become one of 11centers in the United Scates and Canada to participate in a cooperative program to evaluate a community-wide anti-smoking effort involving physicians, the media, worksites, and other groups interested in helping people quit. This eight-year, experimental project will determine if a communitybased anti-smoking campaign can C SUMMER '87 T hrough extensive research Cummings has been able to determ ine which factors most strongly influence a smoker co quit. He has incorporated these findings BUFFAID f PHv $ 1 C1£1LJ �5 A DOCTORS PRIMERON MOTIVATINGPATIEN1STO QUIT SMOKING 1. Identify which of )'OUT patients are smokers.This should become as routine as measuring vital signs. Charts of smoking patients should be flagged. Schedule visits for smoking treatment only. 2. Take a firm, no-nonsenseand assertive approach in instructing your smokingpatientsto quit. Mose patients need to be cold, nor advised, to quit smoking. 3. Avoid ambiguities,uncertaintiesor a lack of commitment in )'Our approach. The slightest ambiguity may be all chat some smokers need to justify continuing their habit. 4. Assist the patient in settinga target date for quitting. It will add structure to the patient's effort and strengthen his or her commitment. 5. Schedulea follow-up visit within ten days after the quit date. This commits the patient to follow through and to discuss any problems. It also allows the physician a second opportunity co motivate the patient if he or she has relapsed. and come up with a guideline for counseling smokers co quit. "First, and perhaps most important, is office management," Cummings said. 6. Provideyour patientswith the tools quit smoking. Prescribe, when appropriate, Nicorecte gum (see accompanying article). Instruct them on what clinics or support programs to enroll in and how to minimize weight gain and withdrawal symptoms. to 7. Useyourofficeenvironmentto send a stronganti-smokingmessage.Prohibit smoking, display anti-smoking posters, and provide literature in waiting rooms on smoking cessation and hazards of smoking. 8. Serveas a non-smokingrole model for yourpatients.Smoking doctors are much less effective in getting their patients to quit than non-smoking doctors. Patients will be reluctant to accept "do what I say, not as I do" advice from another smoker. And most patients can tell if their doctor smokes, even if the doctor tries co conceal it. • "Smoking should be banned in healthcare facilities and smoking reduction materials should be made available in waiting rooms. The office management BUFFAID t c, L !!. v 1 , A N:=J ''The decisionto stop smokingrequires threemotivational factors.Smokers must:perceivethe risks;understand the benefitsof quitting;and believein their abilityto succeed.'' system should also allow for routine assessment of the patient's smoking status, time to talk with patients about smoking, and scheduling of visits for smoking treatment only, as is done with ocher medical conditions (e.g. hypertension). "Second, the doctor should help cultivate the patient's motivation to quit. The decision to stop smoking requires three motivational factors. Smokers must: 1) perceive the risk of smoking in personal health terms; 2) understand the benefits of quitting, and; 3) believe in their ability to succeed. "Finally, for patients interested in quieting, a quit plan should be devised by the physician. This plan should include a date for quitting, a scheduled follow-up visit, and may include a prescription for Nicorette chewing gum, manufactured by Merrill Dow, Inc. (see sidebar), referral to a stop smoking clinic, and / or use of a selfhelp guide." According to Cummings, providing the motivation to quit is the key to actual smoking cessation. Since a smoker's physician plays the most integral role in motivating a patient to quit and in actually succeeding, it dramatically underscores the responsibility of the physician in resolving the nation's most preventable killer. • SUMMER '87 �6 NICORETTE BY SHAWN C A REY icorette, a nicotine-based chewing gum that was designed to help people quit smoking, has received a thumbs-up from a leading authority on smoking cessation. The quit-smoking aid was invented 20 years ago by Claes Lundgren, M.O., Ph.D., UB professor of physiology, and has been marketed in che U.S. by Merrill Dow, Inc. since 1984. "When used properly, Nicorette does aid in smoking cessation," notes K. Michael Cummings, research assistant professor of social and preventive medicine and director of Roswell Park's anti-smoking program. He has reviewed many clinical studies done on rhe effectiveness ofNicorette in smoking cessation. According to Cummings, these studies consistently demonstrate Nicorette's value as an aid in cessation. "In fact, heavy smokers probably benefit from it the most. I would recommend it to almost anyone trying to quit smoking and I think chat physicians should definitely include a prescription for the gum in their treatment of smoking cessation," Cummings emphasizes. N SUMMER '87 Nicorette, available over che counter in Sweden but only by doctor's prescription in the United States, is effective in weaning heavy smokers from cigarettes because it eases rhe nicotine withdrawa l symptoms which accompany smoking cessation. To avoid experien cing a "nicotine fit," smokers are instructed to chew a piece of Nicorette instead of lighting up. Cummings stresses char rhe only time Nicorette hasn't proved effective is when it has been used incorrectly by a patient. When prescribing Nicorette, a physician should make sure the patient knows how to use the gum properly . "When a physician prescribes insulin, he doesn't simply send the patient off and expect him to know how to administe r it to himself," Cummings said. "The physician should sit down with his patient and go over exactly how to use Nicorette. Even have him chew a piece of rhe gum and make sure he's chewing it properly. "The most common side effects people BUFFAID L!....E.vS1C1E.JL] using rhe gum have experienced are almost all due ro improper chewing of ic. They chew the gum coo quickly, cake in coo much nicotine, and ger nauseous. They chew coo hard and chey experience headaches. The failure race of Nicorecce is most commonly related to che patient noc using it for the prescribed amount of time. Some scop using it after a week or a month and wonder why it doesn't work. "Again, in most cases where Nicorecte is unsuccessful in bringing about cessation ir is because of incorre ct use. Often the patient uses the gum while continuing co smoke. Obviously in these cases the gum is not being used properly." Cummings urges physicians to take the time co first learn the proper procedures for using Nicorette gum and then to teach these procedure s to their patients. "However, motivation is still the key," Cummings said. "Nicorette will ease the craving for nicotine, but it's still up to the smoker co reach for Nicorette instead of a cigarette when these cravings come on ." • �7 STUDENTBRIGADES IAUNCH STATE'S1ST ANTI--SMOKING DRNE N ew York State's first anti-smoking campaign to be initiated by medical students has been launched in Buffalo. The campaign is being carried out by "Student Brigades" from rhe UB School of Medicine, who have begun their "atta ck" on area junior high schools. As part of a student -initiated AntiSmoking Task Force, their aim is to educate seventh and eighth-graders in hopes of discouraging chem from starting to smoke. The educationa l program is conside red by the American Medical Women's Association to be the model reaching program nationally. According to Sharon Ziegler, secondyear medical student and task force coordinator, the primary focus of the program is on "tobacco advertising and the subtle influences which encourage young people to begin smoking." Secondarily, they arc teaching youths about the health effects of smoking. The task force consists of approximately 70 first- and second-year UB medical students, who go to area junior high schools with an elaborate presentation. The core of the presentation is a slide show, intended to "raise students' consciousness about advertising, which is a powerful force to get youths to smoke," says Ziegler. The students are shown slick ads that use sexy models, cloches, and sports to sell cigarettes. The goal of the task force is to show students how to avoid being "conned" into smoking by these persuasive ads. Ziegler says, "Student reaction so far has been wonderful; it's effective because the students haven't been influenced by the ads yet." The task force has chosen to aim the BY KATHLEE N RIG A stuilt' in Ru:cr ancl V 1 1<1Lnman Ctl cws~ m Clon•n~< Jr l1rgh program at junior high school students because, "it has been epidemiologically found," says Ziegler, "that high school is too late for such programs to work;" many people have already started smoking by then. She admits that "junior high may also be too late, but no research has been carried out yet on grade school students." he UB program, which was cited in a November 1986 article in The New York Times, was the brainchild of Lisa Benson, a third-year medical student. Benson got the idea for the program after hearing a lecture given by Dr. Allen Blum, founder of the Atlanta-based organization, Doctors Oughta Care (DOC). While speaking at UB in the Spring of 1986, Dr. Blum described the anti-smoking education program organized by DOC at the University of Virginia Medical School. Benson presented che idea to the American Medical Women's Assocation (AMW A), T BUFFAID jPMVS1CI AN ) for which she is national student coor• dinator. AMW A responded enthusiasti cally and decided to implement the program here. It rook the UB chapter of AMW A an entire year to go through the process of research, gecting videotapes, slides, data, permission, and funding. Finally in March of 1987, the "Student Brigades" made their first presentation. According to Ziegler, 30 schools in the Tonawanda, Kenmore, Cheektowaga, Williamsville, and Amherst areas have been contacted by the cask force and the response has been overwhelmingly positive. Because it cakes longer to obtain permission from public schools, more of the presentations ro dare have been made in private schools. Ziegler would like the task force ro become involved in ocher smoking prevention activities, in addition to the classroom presentations. Following the lead of a poster campaign run by DOC in Georgia, she hopes to organize a community-wide anti-smoking poster contest at UB. The DOC campaign produced such slogans as "Kool ... Cool as a Corpse" and "Emphysema Slims" - satirizing cigarette brand names. As a model reaching program for the nation, the Anti-Smoking Task Force program at UB is likely to pave the way for similar efforts throughout the country. The SUNY Health Science Center-Brooklyn has followed suit, adopting the idea and preparing to implement the program soon. The Task Force is funded and cosponsored by AMW A, the American Medical Student Association, and Polity, the UB medical student organization. • SUMMER '87 �8 c had been a beautiful mid-February week in Buffalo - moist, snow-free lawns, gentle sunny days, and 42 degrees. Street lamps, misty islands oflight, burned above the roadways in that curious evening almost a century and a half ago. At the Phelps House, a hotel across from a downtown Buffalo park, three well-dressed men were seated in a semicircle on elegant ne,, chairs, across from cwo single women seared on a sofa. All three men coldly scared at the women's legs, then in turn each laid his hands on the women's knees. The women showed no signs of alarm. The year was 1851. A nineteenth century brothel? Hardly. It was the scene of one of history's earli~t scientific investigations of paranormal phenomena, condurn:d by three of the founders of Scace University of New York at Buffalo and its Medical School. The cwo women on the sofa were Mrs. Leah Fish and her younger sister, Margaret Fox. Kate, the youngest of the Fox sisters, was absent that night. If you have never heard of the Fox sisters, they are the founders of "modern spiritualism." Spiritu alism, the concept that there is a world "beyond," includes the belief that certain individuals, or "med iums," can communicate with this afterworld. Around since ancient rimes, the belief waned over the cenrunes until the Fox sisters breathed new life into an old idea and reint roduced the concept into "modern spiritualism." Through them, thousands of 19th cenrury Americans were once again able to "hea r" spirits, and occasionally even "see" their work in action. For those of you not so comfortable with these notions, take heart, for there were people back then who felt as you do. Among them were three of Buffalo's most high ly respected physicians I th:~~es ti;e~~v~s:;y,A!~~ Charles A. Lee. The three UB docto rs were the ones examining the years earlier. According ro the knockings, he had been buried in the cellar. Within days, earnest digging ensued, but without knee. on February 19, 1851,and to say the success becaU!,cthe hole continuously filled least, they believed chat the sisters were with water. The previous owner of the clever but fraudulent "Fox~." house, living in a nearby rown, meanwhile got word of what was going on and promptly collected signatures attesting to T he story really began not in Buffalo, his good character. No charges were ever but in the village of Hydesville, 30 placed, but news of the strange rapping at miles east of Rochester. the Fox hou!>espread across the country• On the evening of March 31, 1848, the side. house of John and Margaret Fox, in the A fewday, passed before people realized quaint village of Hydesv1lle, became filled the knockings occurred only in the with no1s<..-s. The Foxes had just r<..-cenrly pre!>enceof the sisters, Margaret and Kate. moved into their rather modest home. Rather than accuse them of trickery, people John Fox was a reformed alcoholic, and by a,sumed that che sisters were gifted all accounts, both he and his wife were l"hannels for the supernatural. le was not faithful Methodists with no interest whatlong before Margaret and Kate were off to soevt:r in the occult. But that night the Rochester co hve with their eldest sister, walls, the doors, the floor were all knocking Leah Fish, a divorced music teacher. The re, loudlv, and che family huddled together. the rapping continued in full force. Their two daughters - Margaret, 15, and Rochester awoke to their call. Kate, 11 - were apparently just as fright• Numerous invesnganons were conducted ened as their parents. by members of the community - docrors, ln the following days, more than a dozen lawyers, politicians. The sister, repeatedly neighbors dropped by to see what the stir undressed before female commmees, to was really all about . On and off, rhe affirm that no concealed devices were rappings continued. With neighbors prespr<..-sent. Nothing was ever found. As word ent, an incredible thing happened. Somespread, Leah realized there was profit to be one developed a system through which made. P<..'Oplefrom hundred~ of m1k'S communication was established with the around would come to hear the "Rochester source of the knockings. A set number of Rappings." Among them were such noted raps was understood to mean either yes or figures as James Fenimore Cooper and no, and through a more tedious process, Horace Gn.'Cley.Unnoticed by most people the alphabet was recited continually, while was the fan that only the two younger the knockings thus spelled out messages. <-1ster" could produce the raps. Leah became Everyone was dumbfounded. The knockthe bustnl'SSleader of her two "psychic" ings not only correctly guessed the ages of sisters. She lx-gancharging price~of $1.00 a several people, but answered more personal head for public seances and 5.00 for questions as well. Then the mysterious rappnvate ont-s, which were hefty fees back pings indentified their source as the spirit of then. Leah later explamed that the feeshad a peddler, Charles B. Roena, who had been Ix-en"pr<..-xribedfor us," presumably by the murde red in the house some four or five ,pint world. ___ _ _________ __, KNOCKING women's .. . .. . • .. . . • • • • • • • • • •• •• ••• THE SUP SUMMER'87 BY PA UL O LC HV ARY t_ _ •• • ••• • • • • • • • • • • • • , . ••••.•. u ap~:~t<..!;°6~ se:. e::~ oc~1:: siom, hundred~ of people claimed to have s<..-en mov · ing tables and chairs, and �Cf) C ~ ~ m ;,, o5 _, lllUSTAA TIONDANIEL ZAKROCZEMSKI \0 �at least at one seance, a playing guitar was said to have floated about the room. W.H. McDonald, a prominent journalist from 1c,, York City, reportc-d that the rap, varied "from a hght clear metallic c;ound to a muffled one" and occurred "now on the table before us and agam on the floor and in \ a nous di~tant parts of the room." Many cynics left these seances as believers. Soon, the Fox sisters were on the road. Their "act" was a ravmg success and rc-gularlyattracted overflow crowds. After the sisters traveled to Albany, New York C1t\, and cvcrvwhere in between, the\ finally came to Buffalo m 1851.Ors. Austm Flmt, Charlc-s Lee, and Charles Coventry were waiting for them. few days prior to February 19, 1851, the three doctors had attended one of the sisters' public seances "from motives of curiosity," as they reported in the Buffalo MedicalJournal,of which Austin Flint was the editor. The three were impressed. "We were surprised and puzzled by the loudness of the sounds, the apparent evidences of non-instrumentality on the part of the females, and the different dirc"Ctionsfrom which they seemed to emanate." But lest we forget, they were men of science, men of A Sl MMER '87 reason.Their years of education had taught them, almost to the point of instinct, to have an inherent mistrust of any such claim with which they were not familiar. Austin Flint's ancestry had "M.D." stamped all over it. His grandfather, Austin Flint, had been a respected surgeon in the American Army of the Revolution. The younger Austin Flint earned his degree in 1833at Harvard Medical School and came to Buffalo in 1836. Or. Flmt was well known for his medical writings. From his investigation of an 1843typhoid epidemic which claimed ten lives in North Boston, N.Y., Flint published a classicalstudy of the disease, that was the first to link it with having water-borne origins. In 1866, he published a medical textbook, A Treatiseof chePrinciplesand Practiceof Medicine,which eventually sold over 40,000 copies in the U.S. and abroad. Later in his life, Flint was elected president of the American Medical Association. By all accounts, he had been a popular and effective teacher as well. In August 1846,he became co-founder of and first professor of medicine at the University of Buffalo, holding the wordy but deserving title, "Professor of Principles and Practice of Medicine and Clinical Medicine." Flint was part of a highly capable team. Or. Charles Lee, who had once studied for the mmistry, was perhaps best known for being a prolific writer on medical and scientific subJects. His many publications on alcoholism ("intemperance," in those days) and on the management of institutions for the insane reflected not only his scientific but his humanitarian concerns as well. In 1846at Geneva College, Leehad had a key role m the admittance of Elizabeth Blackwell as a medical srudent which led to her becoming the first woman M.D. in the nation. As another co-founder of the University of Buffalo, Charles Lee became its fir:;t professor of pathology. Lee was quite a teacher, as confirmed in a medical student's diary from 1848-49:He was "the greatest of all the professors. . and worthy of our hearts' best and warmest emotions." And there was Charles Coventry, UB's first professor of physiology and medical jurisprudence. Like Austin Flint, Coventry was not the only physician in his family. His father, Alexander Coventry, was a doc- BUFFALO rJ M 'f \ ~ A N tor m Utica, where Charle5 gre,, up on a farm. Chark~ himself was too frail to work the farm, indeed he was sick throughout much of his life,but he somehm\ managed to graduate with his M.D. in 1825 from the College of Phv~icians and Surg1:on~ of �ll Western New York in Herkimer County. Coventry had always been deeply concerned over the poor treatment of the insane in county almshouses, and in 1836 he had a direct hand in establishing the "New York State Lunatic Asylum" in Utica, which, despite its archaic name, was a model institution. Coventry was a committed, industrious person. In February 1849, while teaching at Buffalo, he had an onset of hemoptysis - bleeding from the lungs - but returned to his duties five days later. February 19, 1851, Coventry and his two colleagues stepped from their conventional roles into a highly unconventional area, opening the door to a new object of research: spiritualism. T he three doctors must have felt their whole belief system threatened by the claims of the Fox sisters. Through a process of exclusion, they first put any supernatural explanations on the back burner. Then, with the understanding that the sisrers had been repeatedly examined by committees of women, and that rooms had been searched as well, they eliminated the possibility of artificial "knocking" devices. During the public seance, it became apparent co the doctors that only Margaret was capable of producing the sounds, and that it required quite an effort of will on her part. "lt was The Fox sisters, Margaret and Kate, with the third sister, Leah. plain," they said, "that it could not be continued very long without fatigue."They came to the conclusion that the source of the knockings was nor spiritual at all, bur wholly anatomical! The hard evidence they were looking for was, indeed, hard enough to knock on: knees. Margaret Fox, it turned out, had simulated "messages from the other side" simply by snapping her joints. Many of us can "crack" our knuckles, fewer can snap toes or knees. But some rare individuals can loudly dislocate certain joints with uncanny skill. During the initial stages of their investigation, the UB doctors came across a "respectable lady of this city," whom they identified in the Buffalo Mediail Journal only as "Mrs. P." She was able to produce sounds remarkably similar to the "Rochester Rappings," claimed the doctors, just by dislocating her knee joints. And she could do this without any obvious movement of her legs. That, reasoned Flint, Coventry, and Lee, was exactly the answer co the Rochester Rappings: the Fox sisters were merely accomplished "joint snappers." On February 17, the doctors published their allegations in the pages of the Buffalo Commercial Advertiser. By the following day, Leah and Margaret had placed a short bur clear retort in the same newspaper, part BUFFALO r:::,r:[ v S1C 1A'L] of which read: As we do not feel willing to rest under the imputation of being imposters,we are t'ery tl'illing IO undergoa properand decent examination, provided tl'e ain select three male and three female friends u'ho shall be present on the occasion. Little time was wasted. The next day, a meeting was held at the Phelps House. A detailed report of the investigation appeared in the March 1851 issue of the Buffalo Mediail Journal. After a short delay, the two Rochester females being seared on a sofa, the knockingscommenced,and were continued for some rime in loud tones and rapid succession.The "spirits" were then asked ''tvhether chey would manifest themseli'esduring the sitting and respondto interrogatories." A series of raps followed,which were interpreted into a reply in rheaffirmative. The tuo females ivere then seated upon ttl'O chairs placed near together,their heels re.stingon cushions,theirlowerlimbs extended, with ihe toes elevated and che Jeer separatedfrom each ocher. .. We were prerty well satisfied chat the displacementof the bones requisitefor the soundscouldnot be effectedunlessa fulcrum were obtained by resting one foot upon the other, or on some resisting body. There was no knocking. The spirits refused to cooperate. When the sisters resumed their former positions, the knockings resumed. At this point, the sisters consented to a request by the doctors to have their knees held. Were the knee joints truly the source of the knockings, at least some bone movement would be perceptible to the holder. The experiment was only a minimal success. There was plenty of knocking whenever the knees were not being held, but only once otherwise, when Or. Lee relaxed his grip for a moment, were two or three faint raps heard. Leepromptly affirmed that "the motion of the bone was plainly perceptible to him." A fter the doctors published their findings, they were contacted by several people who could produce knocking SUMMER '87 �12 sounds not only wirh their knees, but with roes, fingers, hips, and in one case, a shoulder. In their amazement, the doctors pronounced that a door had been opened to "a new and curious field of physiological inquiry" and suggested to any eager scientists that "Articular as well as articulaced sounds seem to claim an investigation which they have not heretofore received." With regard to the Fox sisters, however, the doctors were convinced rhat Margaret's knees were the primary source of the knockings. The displacement occasioning the knockings is sufficient to remooe the ridge of bone which divides ihe ltl'O articularsurfacesof ihe upperexcremir.y of the tibia, from its situation in the sulcusbec1.veen the condylesof the femur, and ro carry it, more OT less, 1<pon che surfaceof the outer cond)le. This mooemeni givesrisecothe firstsound,and the recumof the bone coicsplacecausesthe secondsound, which in the Rochester knockings, generally follows quickly upon the firsi. The evening session of February 19came to a standstill when the two parties could not come co an agreement over a proposal by the docto rs co bandage the sisters' knees, so as to minimize the amount of bone movement. Tension had been high throughout the meeting, and at one point, Margaret is said to have broken into tears. It had been a grueling investigation, wirh periods of utter silence as long as 40 minutes. Nevertheless, the doctors were confident rhey had substantiated their allegations, that this would likely be the end of the Rochester Rappings. Nor so. Many people, particularly the "non-medical" public, found it difficult to believe that the knockings were jointproduced. As the doctors themselves frankly admitted, for many "it required almost as much stretch of the imagination to believe that such sounds could be produced in the joints, as that they involved a supernatural agency." Several questions remained. At seances, while participants would remain in place, knockings would come now from the wall, now from the doo r, then from the floor. How could the sisters have carried off this illusion? Simple, the doctors said. SUMMER '87 Variations in the supposed distance of the sounds simply reflected variations in the intensity of the sounds. As a ventriloquist "throws" his voice, the Fox sisters could "throw their knocks." But probably the hardest idea for people co accept, especially chose who had been co the seances, was that an)one could produce sounds of such intensity - reportedly loud enough to have caused vibrations on doors and tables without making themselves obvious. To this, the doctors simply responded that of all the joints in the body, the knee joint was the one "most favorable for the production of loud sounds." ''The FoxSisters becamelegendsin the spiritualistworld. In thefallowing years, theycontinuedto draw hugeaudiences, communicatin g to the faithfulvarious messages from the worldbeyond.Later, theystirredexcitement in England.In the 1870s,however, Kate Foxdeclared spiritualisma fraud: 'Many a time I have wept, because, when I was young, I was ledintosucha life.' " These three UB doctors were the first to present a solid theory on the Rochester knockings, and they were followed in the years co come by a number of other investigators, many of whom presented varia- BUFFAID l..L ti_ 't ~ I ..Ll_ A__!Lj tions on the joint theory. For rhe most part, however, their explanation fell on deaf ears. The faithful, of whom there were many, ignored the expose. After the doctors had published their reports, the knockings became a secondary attraction. Instead, the "spirits" focused their energies on kicking tables and chairs, ringing bells and gongs, and playing the banjo. Margaret Fox and Leah Fish abruptly left Buffalo on February 25, 1851. The Fox sisters became legends in the spiritualist world. ln the following years, they continued to draw huge audiences, communicating to the faithful various messages from the world beyond. Later, they stirred spiritualist sentiments all over England. But in the 1870s,Kate Fox - who had been absent during the Buffalo investigation - declared spiritualism a fraud. Every so calledmanifescacionproduced throughme in LondonOT anvwhereelse was a fraud. Many a time I·have wept, because,when I «<as young and innocenr, I was led into such a life. In 1888, Margaret followed suit, admitting that the primary source of the knockings had been their toes. Thus, it seems the Buffalo physicians had been correct in principle, though slightly off target. The story does not end here. In an ironic twist, Dr. Charles Lee later became a convert to the doctrine of the spiritual rappings, and felt indignant coward his uncompromising friends! (No explanation of this could be found.) Another bizarre event occurred when a skeleton was found in the basement of the original Fox house in Hydesville near the turn of the century. Spiritualists claimed it was that of the murdered peddler, Char les Roena, but this was never substantiated. Back to the present. Dr. Paul Kurtz of the Philosophy Department at UB heads the Committee for the Scientific Investigation of Claims of the Paranormal (CSICOP), continuing a tradition started here 136 years ago by the th ree Buffalo doctors. Like his predecessors, Dr. Kurtz and his ream go around "knocking" psychics and "rapping" beliefs in the paranormal. • (Poul H~ron Olchvory 1so UB groduote 1n English.o profeSSIOl10Iwr,ter and o student of the intangible sodeof hfe) �13 TECHNOLOGY CENTER SPAWNS THREE In 1982,the WesternNew York Technology Development Center (TDC) was createdto spur the growthof "high technology"enterprisesthat will boost the economicdevelopmentof the region. The TDC, closelyaffiliatedwith the University, utilizes UB's tremendous pool of expertiseto establishstare-up companiesusually headed by UB researchers.Profiledhereare threeof the morethan a dozenincubatorcompanies spatuned. it hassuccessfully D esearchers in UB's Medical School continue to play a major role in the merging of biomedical research and technology that promises to spur new business in Western New York's depressed economy. For example, Or. Robert Baier, research professor of biophysics, directs the Health-Related Instruments and Devices Institute (HID!) and a large number of the researchers in HIDI and the Western New York Technology Development Center (IDC) are medical faculty. While many of the new devices or enterprises created by medical faculty have medical applications, others end up yielding non-medical applications. One such example is the "incubator" business established by Or. Hebe B. Greizerstein, research assistant professor of pharmacology and therapeutics. Her business, EB Associates Laboratories, Inc., is managed by the TDC, which was formed in 1983 to help the transfer of University research to industry and create new businesses. Greizerstein's enterprise is one of its biggest successes. Greizerstein developed her lab in R HIGH TECH BABIES BY DAVID C. WEBB response to the need for chemical analysis of industrial substances. While chemists can analyze plastics, paints, and adhesives in a matter of minutes with computerized Fourier-transform spectrometers, for example, the investment in equipment and in the salary of an on-site chemist may be too high for small companies to absorb. Even large companies sometimes find it difficult to justify the investment. To meet the need for chemical analysis outside the company lab, Dr. Greizerstein established her laboratory in the UBassociated, TDC-managed incubator. Although many materials can be ana- BUFFAID , _,4::EJ IT""B • sD lyzcd by her lab's equipment, Greizerstein decided to specialize in analysis of paints and adhesives. "We did a marketing survey and discovered that, although many labs work in this area, chis particular technology was available in only five companies nationwide," Greizerscein said. While the number of companies probably has increased since 1984, when che survey was taken, Greizerstein has managed co make a business out of filling che technology gap in the paint and adhesives industry. She says her business entails a lot of interesting detective work to crack down the right chemica ls co match the ingredients of a sample. One chemical company was wondering why its product was not performing properly. Greizerscein tracked down an impurity that was picked up in a shipping company's trucks . The shipping company apparently had not cleaned the trucks completely after a previous delivery. SUMMER'87 �14 T o avoid preiudicing the m;ults, Gre1zerstein seldom wants to know what sample she is analyzing, preferring to work with hlind samples. The analysis of the sample 1s then compared with the analyses of known samples to make a match. In connection with her company, Gre1:erstein has develop<.-d her own "library" of computerized analyses of paints, adhesives, and other materials, which are added to standard hhraries for even more complete analysis of the-.c materials. She rL>tentlyadded a library of 6,CXX) raw materials as well. "I generally phone in results co a client," Gre1:erstein said. "Then I di-,cuss any problem and make observations." Occasionally she gets jobs outside her specialty. Gre1zeNein once analyzed the methanol content of Italian wines for a wine distributor. She also has analyzed the organic content of cement used in the construcnon industry. Because of her success in the business, Greizerstein now plans to add a machine that will analyze gelatinous materials by gel permeation chromatography. Recently, she also acquired a gas chromatography machine to analyze solvents used by the paint manufacturing industry. SUMMER '87 hildren's Hospital of Buffalo and the Western New York Technology Development Center (TDC) have announled that the "orphan" drug, lnfasurf, has rL>teivedFDA approval for clinical trials. ONY, Inc., a new "incubator" company comprised of academic physicians and sciennsts who developed lnfasurf, will conduct the clinical testing in cooperation with the TDC. Or. Edmund Egan, profossor of p<.xi1atricsand chief of neonatology at Children's, is pm,1dent of 01':Y. Infasurf, an extratt from the lungs of calves, has been shown in limited testing with prematu re babies co reduce the incidence of respiratory distre.s syndrome (RDS) by 90 per cent. This and associated complications remain a major faccor in death (10,CXX)per year) or long term disability (25,CXX)per year) for very premature infants. The announcement of the orphan drug approval was coupb:I with the announcement that ONY is now the 14th incubacor company co be formed out of the work of the TDC. C BUFFAID [. PH • I ' ~ I A N I Oi Y was formed to bring the results of this research to market after pharmaceutical companies expressed no interest in lnfasurf because of the limited market potential. Drugs can be designat<..-das "orphans" by the FDA when a limited market for the drug inhibits usual commercial development. This status offers programmatic and financial incenm:cs to develop effective drugs with limited markets. To date, only 90 drugs have rCleived FDA "orphan drug" status. During clinical trials, lnfasurf will be tested in hospitals and clinics throughout the United States on over I ,<XX)premature babies. The ~cw York State Science and T cchnology Foundation is supporting the clinical trials with a $40,CXX) grant through its Rec.carch and Development Grants Program. "We are exmed to enter clinical trials," Dr. Egan states. 'The next few months will hopefully confirm what has already been learned in creating a limited number of premature infants at the Children's Hospital of Buffalo, the University of Rochester, and the Hospital for Sick Children in Toronto. We expect lnfasurf will be available as an important product to protect premature infants from respiratory distress syndrome." • �15 ,~ 'I ' ~ / / / , Dr ( lart1 1\.1Ambn" BY DAVID MONTGOMERY new company has emerged from the ferment of medical expertise at the UB Medical School, and this one shows promise of developing a product that could improve conventional methods for removing impurities from blood. Hemex Inc. recently moved into the high technology incubator operated by the Western New York Technology Development Center at 221 l Main St. The head of the company is Dr. Clara M. Ambrus, a research professor of gyn-ob and pediatrics at the Medical School. After years of research with associates in New Haven and in Buffalo, Dr. Ambrus and colleagues found a way co purify blood of metals which can be harmful in large amounts, such as aluminum and lead. The technique has wider potential, however, because it seems to improve on A old ways of cleaning blood that involved injecting chemicals into the patient. Hemex's "extracorporeal treatment" protects the patient from possible side effects of those chemicals, because the antidotes never enter the patient's body. "You are treating the patient with the same materials without getting the material in the blood, and therefore you are bypassing the toxicity," said Dr. Ambrus, who was born in Italy and educated in Hungary, Switzerland, and the U.S. Hemex's staff is small. There is one fulltime technical assistant while Dr. Sidney Anthone, co-director of the dialysis unit at Buffalo General Hospital and UB clinical professor of surgery, collaborates on clinical work. A prototype of Hemex's blood purifier has worked safely in patients, Dr. Ambrus said. She is now applying to the federal government for permission to use a newer model on patients. It is kidney dialysis patients whom Hemex may be able to help first. About a third of the patients on dialysis in the U.S. - or 24,000- suffer from aluminum intoxication, Dr. Ambrus said. The aluminum may enter the bones and cripple a person, or affect the brain. The current treatment is to inject the antidote into people who have aluminum BUFFAID ( PHV $1¢1 AN) poisoning. But the antidote itself may cause harmful side effects, and the treatment lasts more than a year, she said. Hemex instead uses a cartridge about the size of a rolled up newspaper. The cartridge is attached to a patient's arm, and the patient's blood is pumped through the cartridge. The cartridge contains the antidote, and the antidote captures the aluminum as the blood flows through. Both the antidote and the excess aluminum remain in the cartridge while clean blood returns to the body. The trick was to fix it so the large metal molecules would remain in the cartridge while the blood cells would not be tempted to stay there too. Also, the drug molecules would have to stick in the cartridge. Hemex's treatment should take less time than injecting the antidote, Dr. Ambrus said. She said the same system could be used safely to capture lead from a person's bloodstream, and eventually it might be an effective way to clean a range of toxic subtances from blood. "With all the environmental problems that we have, I'm afraid we will be kept busy for a long time," she said. • (Mr. Montgomery is o writer for tt-e Buffolo News, wnch gave permission to use this Morch 13. 1987 ortide.) SUMMER '87 �16 SEI.ILING IN ?\FTERA NOBELYEAR BY BRUCE S. KERSHNER (LaseDecember,Dr. HerbertHauptman, T hey say that winning a Nobel Prize rakes a year out of your life. Bur what a year it is! For Dr. Herbert Hauptman, UB's 1985 Nobel Prize winner in Chemistry, it did mean a year's interruption in his research and administrative activities at the Medical Foundation of Buffalo. But it also meant being privileged by participating in one of the world's most regal and dazzling annual pageants; being seared beside the Queen of Sweden during the banquet; invitations to deliver keynote addresses before dozens of scholarly societies around the world; and being bestowed more than 20 additional honors and medals. In a different - but just as important vein, his "Nobel Year" meant the opportunity to speak out in support of funding for basic research before journalists, public officials, and lawmakers; the chance to raise the awareness of fellow scientists about the role of his discipline in advancing scientific and medical knowledge; and the distinction of being able to inspire the minds of future young scientists who have met and heard him at special functions. Dr. Hauptman is president and research director of the Medical Foundation of Buffalo, Inc. and has a joint faculty appointment with UB's School of Medicine in its Department of Biophysical Sciences. He was awarded the Nobel Prize with Dr. Jerome Karle for his discovery of the Direct Methods, a way of determining three-dimensional crystal structures of complex molecules. The now-standard technique made it possible for the first time SUMMER'87 UB research professorof biophysics, ended a year-longseries of lectures, tours,and ceremoniesthat followed his winningof the Nobel Prizein Chemistry. This article relates what it was like duringthat year,and what it is like- or even if it is possible- to return to a normalscheduleafterward.) to identify and devise new drugs for medicine and industry, resulting in the saving of millions of lives. Immediately following the October 16, 1985, announcement that he had won the Nobel Prize, Dr. Hauptman was swamped by dozens of newspapers, TV and radio interviewers, and hundreds of congratulatory calls and letters. His picture appeared in news broadcasts and stories around the world. The buzz of excitement reached its second crescendo on December 9 when Hauptman attended che Nobel Award ceremonies in Stockholm. "My wife and I were numb, dazzled, and impressed by the pageantry of it all. The Swedes went out of their way to make ic che most momentous occasion of your life. le was the ultimate in pomp and pageantry and the whole royal family was there. 1was awed by it all. "We were given an attendant whose job was to make everything easy for us. We were literally spoiled and were given the royal treatment in every sense of the word during our 12 days there." Those 12 days included banquets, lectures, luncheons, concerts, dances, and parties. The first major event was the premiere performance of "Music and Peace - in Homage to Alfred Nobel" by the World Philharmonic Orchestra. Performances by leading musicians from orchestras of 117 countries symbolized the ideal of Alfred Nobel, who felt that contributions to humanity must not be confined by national boundaries. The official awards ceremony was aweinspiring, as described in the Medical Foundation's newsletter "Impact": "As Dr. Hauptman walked forward on the stage of the concert hall to receive the golden medallion from King Carl Gustaf XVI, trumpets blared a fanfare that sent chills up the spine. Later that evening Dr. Hauptman sat beside Queen Silvia at a banquet for 1,400 people in the City Hall. Even the photographers were dressed in white tie and tails. A battalion of 700 waiters served the banquet with precision and gusto . "The following evening Dr. and Mrs. Hauptman dined with the King and Queen at a more intimate dinner at the palace attended only by laureates and spouses. Dr. Hauptman rook this opportunity co present a gift of one of his stained-glass sculptures to the royal couple." Dr. Hauptman and his wife Edith had only a brief time to come down from their "high" before commencing the year-long schedule of trips, lectures, and appearances. By the end of last December 1986, when his official "Nobel Year" ended, he had traveled to Germany, Canada, Poland, Japan, �17 and China and numerous U.S. states. A reception with President Reagan and lectures at Johns Hopkins, the National Library of Medicine, the National Research Labs, the American Chemical Society, Rutgers, and Chicago's Museum of Science & Industry were among the American stops on his lecture tour. "Before my award, I lectured out of town perhaps three or four times a year and traveled once or twice out of the country," Hauptman relates. "After the award, my invitations averaged once a week." His most hectic month was April 1986, when he had 18 scheduled invitations. A s expected, there were many touching moments besides the official Nobel events. "My most emotional was the ceremony arranged by the grade school where my wife teaches. All the classes gathered to read me poems and tributes that they wrote themselves. When the first grade class gathered around me, I couldn't find the words to express my feelings." Hauptman especially enjoys the oppor· tunity to share himself with youth. In Lindau, Germany, he met 400 to 500 gifted high school students from across Europe at the annual meeting of Nobel Laureates. Similarly, in Washington, D.C., he met one-on-one with gifted students at the American Academy of Achievements symposium dedicated to che inspiration of youth. Two of the more fascinating countries he visited were China, where he spent cwo weeks lecturing and touring, and Poland. "I was invited to che former German part of Poland - Wroclaw. People there went out of their way to make everything comfortable for us. I was particularly impressed by the strong vocal opposition to the current Polish regime." Among the two dozen honors he received were the National Library of Medicine Medal, the Albert Einstein medal from the Academy of Arts and Sciences, honorary doctorates from City College and the University of Maryland, and the Chinese Chemical Society's major award. Locally, he received the Chancellor Norton Medal from UB, honors from Erie County and Roswell Park, and the Buffalo News' Outstanding Citizen of the Year award. Lastly, "Herbert Hauptman Day" was declared by the Scace of Oklahoma, the City of Buffalo, and two ocher cities. hat was his reaction to the serious, though positive, interruption in his work? "I anticipated I would be resenting all the demands on my life. But I recognize the need to accept all the invitations, which I have done. I found it is an enjoyable, not unpleasant, experience. I'm not sure if I would choose this co the exclusion of anything else. Bue getting chis kind of recognition clearly carries with it an obligation." While che experience interrupted his work, it did not stop it. "I had an assistant carry on pare of my research. Now I am gee- W BUFFAID C I [.!_tl____ yJ_ I_ I A N ting more and more into it again. However, I have a less direct role in some of it and I am more involved in guiding ochers." The goal of his research continues to be co refine and expand his techniques so they become a useful cool in determining even more complex molecular structures. His publishing was only slowed somewhat, though it changed in nature."! wrote 12 to 15 articles during the past year or so, but they were broader articles for nonspecialist audiences such as overviews (i.e., one in the July 11, 1986 Science), a history, and a review article for an encyclopedia. They're very time-consuming and eat up a lot of my time." Some invitations are scheduled into 1989. His bookings include Holland, South Africa, Hawaii, Sweden, and Australia. Hauptman finds he is still treated differently now. He refers to one recent example in which a limousine was waiting for him and his wife at a Washington, D.C., meeting. "That never happened before the prize!" The past year and a half have also been a real learning experience. 'This (fame) is something one has to adjust to. I've also found I had co bone up on many invited lecture topics in which I did not consider myself as much of an authority as I am in my specialty." He has also found he now has the oppor• cunity to speak to much larger audiences. "Previously, I lectured only to crystallographers. Now, I have a much wider audience that is willing, in face, eager to hear me." He cites one example of a group of radioastronomers who have a problem of a similar nature to what he is working on. "They use radio wavelengths which arrive at different frequencies ac different telescopes at different rimes. They are interested to know if my methods can be used to analyze their problem." Whether Dr. Hauptman's obligations, schedule, and treatment by others are different, he feels he is basically the same person he was before the prize. "I know I'm very fortunate. Bue there are a lot of people out there who also have great accomplishments, but may never get a major award. Unfortunately, there are only so many awards." • SUMMER'87 �18 I chiro Nakamura began his journey co the desert in the evening, and by dawn had reached the end of the road. From there his quest followed the streambed. Sometimes, he tramped through dense jungle. On other occasions, he had to pass through army roadblocks and mine fields. An,'' , did it all in the pursuit of butterflies. Nakamura, an associate professor of pathology at UB, began his hobby in his native Japan where it's a very common pastime. He started when he was only in the third or fourth grade. "I've been doing tl-,is longer than I've been doing anything else," he remarked. At UB, he uses his training in biology and biochemistry to conduct research in immunology. "I got into biology because of my interest in butterflies," Nakamura said. "I decided nobody would pay you to work with butterflies." A high point in his hobby came in 1975 when he discovered two new species of butterflies. He was doing postdoctoral work in Israel when he made the finds in the Sinai Peninsula. On weekends, Nakamura would drive 13 or 14 hours to get to the site. He'd leave home at 8 p.m. so chat when he came to che end of the road at 5 or 6 a.m., there would be enough light co see the screambed he had to follow. The area is partly desert, but there are high mountains where the winter snows provide water in spring. It's just what butterflies like. Nakamura had been used co the dense forests and monsoons of southwest Japan. But he found chat the desert isn't lifeless. "I like the desert much more than the forest because of the vastness of space," Nakamura said. "It comes alive after the rain - it's so beautiful." The area was under Israeli occupation then, but is now part of Egypt. Nakamura noted that if Israel hadn't occupied the area after che Six Day War, the butterflies might still be unknown today. Geographically, it's easier co approach the area from Israel. Few people had collected butterflies in the area before, so Nakamura felt he had a good chance to find something new. And he did. B oth of his di~overies ar~ very small species, he explained, selecting a wooden box from the dozens that line the shelves of the study in his Amherst home. The box contains neat rows of light brown SUMMER '87 B' CON osw, STOf "I like the desert muchmore than the forest because of the vastness of space," N akamurasaid. "It comesaliveafter therain - it's so beautiful. . . ." PHO · SIM ra and pale blue butterflies suspended on pins. Called "Pseudophilotes sinaicus," these butterflies measure about three-quarters of an inch. His other discovery, "Strymonidia jebelia," is mostly brown, with light blue lines and dots . "They're not rare, but nobody had been there at the right moment before," Nakamura explained. "They fly perhaps only two or three weeks all year. If you miss the time, you won't find chem. "They're not particularly beautiful," he added almost apologetically to his visitor. They do pale in comparison with the huge and almost garish "bird wings" chat he and his wife, Mitsuko, collected in Malaysia. These butterflies are the size of a small sparrow and display shades of green and yellow that are as bright as neon lights. BUFFAID Q H Y S_ I ~ .!. ~ • •••••••••••••• ♦ , l In Pur ••••••••••••••••••••• BUTTE �19 thing ahout the fasnnallng "That\ hutterflies," he --aid. "Ea, h 'Pl'Cle!-ha, 11,own hah1ts. You have to know that to car,h them." Trudging through the Jungle, you'd have a hard time ,atchmg the l.1rgt:"bird wmg,." Bur it\ a lot ea,,l·r if vou kmm chat they flv high along the stream,. His fovor11ehutterfl1c, arc those in a group rnlled "orange ups." Thl•y'rc white or vellm\ with orangl' wmg rip,. Some :ire gravi,h grl~n. They're not much co k•ok at. But the 'Pl'tic, arc cln-.cl~ related and 1t\ difficult to di!mnguish th,•m, he said. "I( a group 1s complirnted and d,ffault to classifv, n\ more challengmg, and I get mtcresteJ," he explainL-<l BY )NNJE S WALD OFKO ''When I was studying butterfliesin the northernpart of Israel,nearLebanon, an armyfortification surroundedby mine fieldsposedproblems in gettingto the site.'' "It's not the beauty chat attracts me as much a, the lhallcnge, I think." Nakamura said. "Colk'tt1n~ ,pccimen, in itself is not p:irurnlar· ly imcre,ung. "But while vou get to know them, vou collect them." 1 } of it rsu ······································· A n ,mportam pan of getting to know huttlrfhcs 1s to get to know their environment You must st.~ where they fly, how they fly, and what plant, they cat, Nakamura insists. "That\ more important than seeing the actual SJ1l'Clmcn,"he explains. It's not like ~tamp rnlk-cting where, ,f you have the money, you just buy the stamp you ~RFLIES wanr. ome people would lahel the hohhy nuel becau-.c the bunerfl1e, arc ktlk,J. But the hutterfltt.., would live onlv a ,hort time m the wild and mo,1 are kilk-d hv spider, llr hird,, Nakamura ,aid. And they rnn he prest•rvcd for even hundreds of years - for a long timt· -.crn- a uo;efulpurpose. ,pt-c1men, The study. But for t hl· ,ame rea"-m', he opf.'(>st•,ptXlple who colk'tt huttcrfl,es Just to ,ell them. It rnuld some typ<:s from Cuba rnn he he lucranvc of dollar,. But the pt-ople thou,ands "-lid for who buv rhem m1~,set.'ingthem m 1he1rnatural habitat and learning about them. Nakamura ,aid he ha,n't been many rlaccs IO study huuerflit"S, hut h,, itinerary would make a tra\'el agent drool. In addition 10 this rnunrry and h,, nanw Japan, he's ,cudll'd them m India, Southeast A,1:1,the Middle Ea,t, and Europe. "But there arc so manv plact-s I'd like to go to," he laments. Topping the list arc Africa and South America. The tropic, arc the rich ;m~a, for butterflies. \Xlhere\'cr there are lntl·rl..,ting butterfl,e,, that\ where Nakamura goc,. When he was studymg hutterflil.,, Ill the northern p;1n of Israel, near Lchanon, he always had a problem gcmng to the site That's Ix-cause there was an army fomfication ,urroundL,J hv mine field,, he cxplamcd undramatically. Whether he got there on a par• 11rnlar day depended on whether the offiter in l harge would give him permission to pass through the roadblock. "It was a most interc~ting area, but J)l'<lple didn't go there," he said. Whenever Nakamura travels at the right umc of the year, he triL-,..to find umc for his hohby. "I( I have a rnnference in California m April l>rMay, certainly I bring my net," he s.11d • SUMMER'87 �20 People UB'sBlACK HERITAGE It beganwiththeMedicalSchool BY CLARE O'SHEA 1o,cpli Robert l.ote T ypically male, typically white -that's what you'd probably find if you looked at just about any American university class in the early years of this century. But to celebrate Black History Month, the UB archives staff did some digging and came up with a few interesting exceptions to that stereotype. "UB's Black Heritage," an exhibit in the Undergraduate Library, highlighted four former UB students with several things in common: all attended the Medical School, all graduated before the first quarter of this century, and all were black. There's no way of knowing for sure if other black students attended UB before the turn of the century, Chris Densmore of Univeristy Archives explained. In the 50 years of UB history char elapsed before the first yearbook was published in 1898, few figures were compiled and few student photos collected. But the occa- SUMMER'87 sional tintype photo or yellowed document traced back through the years did yield some interesting results. An account from an old Buffalo newspaper, for example, helped locate Joseph Robert Love (1839-1914), described in an article on the commencement of 1880 as "the first colored gentleman graduated from the Buffalo College." Love was an Episcopal clergyman who studied medicine as an "auxiliary to his ministerial calling;" his intention was "to undertake under Bishop Holly of the island of Hayti, West Indies, the introductions of the church in San Domingo," according co the commencement article. le has been said rhac Love's writings exerted an important influence on Jamaican history. Another black student prior to 1900 was Frank L. Watkins, who came co UB from Montgomery, Alabama, graduated from the UB Medical School in 1891, and died in Buf- BUFFAID IPHYS1¢1AN) falo in 1921. Bur little biographical information about him is available. Equally sketchy is the information available on Henry Harrison Lewis, from the Class of 1918, who was a member of the first class of the University's College of Arts and Sciences before he transferred to UB's School of Medicine. The fourth early black graduate is far and away the best known locally. W. Yerby Jones (I 904-1979), a graduate of rhe Medical School class of 1924, lived in Buffalo for more than 50 years. A prominent ophthalmologist, Jones served as chief of staff at the former Meyer Memorial Hospital. An early photo of Jones in a band uniform was included in the exhibit. Also included in the exhibit was a statement of UB's nondiscriminatory policy. Included with documents from the UB Endowment Fund Campaign cond ucted in 1920 was one which declares that UB is "For all Buffalo Boys and Girls regardless of race, creed, or class." • �21 Pcop e Prof has role in new hearing center A UB professor ac che Buffalo Otologic Group (BOG) and Sc. Mary's School for the Deaf were together in<tru• mental m esrnbli,hing the Northeast Cochlear Implant Center co screen and rehabilitate ind1v1duals\\ith profound hear111gloss who could benefit from ccxhlear implant de\'iCl-<. The dev1Ces, implanted surgically, aim to convert acoustical sound energy to electrical energy which then ,nmulare:, the auditory ner\'e of the ear. C'linical <tud1t.-,,have shown the de\'u;es to be succes.sfulin snmularing a ~nse of hearing in profoundly hear111gimpa1n'<.lor deaf persons. Irwin Ginsberg, M.D., clinical profo,-.or of orolaryngology, who will perform the surgical s the center, has performed rhe prcx-(.'<.lurefor operation locally at Millard Fillmore Hospital -Gares Circle. The BOG at which G111sberg is chief orologist was one of ten phvsican groups nanonally co cl1111callvevaluate new J?eneration, of a cochlear implant device de,ignt.-d by 3M Co. Lase month, a Buffalo-area patient became the first nationally 10 receive the latest version of one of the:c;ede\'ICl..,known as che Vienna implant. Although che U.S. Food and Drug Adminl\trauon ha, granted approval for general use of some tVpl'S of the cochlear implant devices, it has approved the Vienna device only for clinical investigational use. It is expected, however, chat It will be approved f()r more general use 111the near future. The Center's program will include criteria for selen1on of cochlear implant recipients as well as ongo111ge\·aluanon and rehab1lirnnon of each candidate in areas of speech, language • development and aud1torv discrimination. Am-Pol Eagle cites Przylucki, Gorzynski wo Medical Schoo l-assoc1ared people have been selected as 1986Cimem of the Year b~ the Buffalo Polish com• municy newspaper, Am·Pol Eagle John E. Przylucki, 1986-87president of the UB Medical Alumni A,socianon (M'73) and clinical m• ,truccor of surgery,\\ as the Citi.:en of the Ycar in Medic:111eawardee. He is an arnve rnemhcr 111the Poli,h Union of America and serves as its national medical dirl-.:tor. He is also an attendmg surgeon at Millard Fillmore and St. Joseph\ lntercommunity hospitals. He was president of the WNY chapter of the Amem,in Colk-gc of Surgeons, <.hrectedMillard Fillmore's lncen,iw Care Unit for 9 years, and " a memhcr of numerous medical societies. Eugene A Gorzynski, Ph.D., rl-c:ei,:ed the Cm.:en of the Year in Science award. The prof<...,sorof microb1ok,gy earned his Ph.D . from UB in 1968 and completed postdoctoral train• ing at Roswell Park in 1969. He 1s pr(.=ntlv chief of the Veteran\ Admm1stration Ml-dical Center's Microbiology S<.-ction.A Fellow of the American Academy of Microh1ology, he is author of more than 50 research papers He served H disnnguisht.J years in the U.S. Army and rcceivcJ a presidential appointment from President Johnson ro sen·e as commander of a IO()(}.bcdRt-,,en·e Armv Ho,p1tal, a first for a non-phyS1ci,m at chat ume. He" al-.oa mcmhcr of the Polish Room Collection Advisory Com• • mmeeacUB. T BUFFALO l-~t,. :C.t AN Dr . Sambamurthy Subrama nian, former UB profes'SOr of surgery and cardiologist at Children's Ho-.pital for 19 vears, has left for M1am1ChilJren's Hosp1rnl. He plans to '-Ct up an 111ternational center for treating heart di-.c~..ein children. The native of India served as chief of Children's Division of Cardiovascular Surgery. A veteran of more than 5000 heart oper:mons on children, he was called "Dr. Super \,fan" by his pediamc patients. Appearing frequently in the media, he was one of Buffalo's most easily n-.:ognized donors by thl· ruhlic. He pioneerl-d several improved tl'<:hniques. One was a h,·potherm1a chamber that 1mprovc-sthe abilirv of physician, to lower the hody temperature of infants in preparation for heart surgery. He also devised a tl-chnique that minimize, u..eof blood m <mall children by diluting the patient's blood instead of using • transfusions. Dr. Lewis Flint, proft.,,sor and chairman of surgery, was appointed by UB President Steven Sample a~ arnng chair of the Dep:irtment of Neuro,urgery until a r>1.'rmanent chair is appointed. Former chairman Dr. John Kapp stepped down earlier this year when he left for • anothtcr p<>"itmn. Dr. A r th ur J. Sc h aefe r , clinical professor of opth:ilmology, lx-came president-elect of the American Sooctv of Ophthalmologic:, Plastic anJ Rcconstrun1vc Surgery at a n:monal meeting 111New Orleans last Novcmhcr. He w1lla"ume the presidency of the society, which ha, over 200 member,;, 1111988. He serves as chief of ophthalmology at Sister's Hospital and professor of is also clinica l assistant • otolaryngology. SUMMER'87 �22 Medical School News BIOMEDICAL ENGINEERING UB is developingnew institute underthe Graduateand ResearchInitiative BY CONNIE 0S\'1/ALO STOFKO "W hat we don't need at this University is one more paper organization," declared Leon E. Farhi, the developer of the prospectus for the Institute for Biomedical Engineering. The institute i~to be a freestanding institute, supported through the Graduate and Research Initiative, explained Donald W. Rennie, vice provost for research and graduate education (and also professor of physiology). It is poised for earlier development than the ocher centers planned through the initiative. Farhi, special faculty associate to the provost and chairman of the Physiology Department, was charged by the provost to see what it would cake co set up chis biomedical engineering enterprise. It's in a very preliminary stage, Rennie noted. "It is not always easyto get the engineerand biologist to talk to eachother. Thebiologistis trainedto discover thingsand the engineeris trained to inventthingsthat don'texist.Thereis an intellectualgap.'' T he business of the institute will be to foster biomedical engineering research and teaching throughout the University, Farhi explained. It will draw upon faculty from engineering, medicine, pharmacy, dentistry, and natural sciences, Rennie said. SUMMER '87 The institute will support existing programs, wherever they happen to be. The University has enormous strength in departments on both BUFFAID L!:E.i s .!. C I A N I campuses and at its teaching hospitals, Farhi noted. The institute will provide a physical nucleus, possibly to be based on the Main Srreet Campus. That campus, the home of the Medical School, is equidistant between the engineering programs located on the Amherst Campus, and projects located in teaching hospitals. The institute will support advanced projects and provide several services including: ■ Editorial work on manuscripts and gram applications . Sometimes researchers don't get funding because their knowledge doesn't show through in applications, Farhi noted. ■ Technical support. Researchers often need a special piece of hardware to be crafted for a specific project. The hospitals and the Main Street Campus don't have shop facilities. ■ Enhance intellectual exchange. ■ Conferences. The institute would sponsor symposiums that would bring together the leading people in their fields to put together a book or manual on given topics. "It's expensive, but it's worth every penny," he said, because it would bring Buffalo into the limelight. I �23 Medical School News E ventually, the institute will have teaching at all levels, Farhi predicted. In the beginning, it will nor go through the time-consuming process of setting up teaching programs per sc, but will be concerned with courses at the undergraduate and postdoctoral levels. These courses will be facilitated by the institute, but offered through departments. For instance, there might be a biology course for electrical engineering majors and vice versa. Poscdoccoral students might take a course in systems engineering for biologists. "\Y/e will produce a generation of students who won't bear the label (of biomedical engineers), but will have the knowledge," Farhi said. Ac che graduate level, it is more important to provide research training than to offer courses, he noted. commiccees co look at what's already being done at the University and how the institute will fie in. Farhi said he hopes the subcommittees will report back in rwo months. In three to four months, the steering committee could have a real plan for the provost. T he work of the Institute for Biomedical Engineering will be interdisciplinary. "The rule of the University is to overlap - to gee together people who have things in common and either don't know it, or have no mechanism to get together," he said. The institute may overlap with existing research centers. For instance, it will have things in common with rhe Surface Science Center. (That Dental and Medical Schoolassociated center studies interfaces between substances, such as between a dental implant and the jaw, or between ,ki wax and the snow.) While the areas overlap, there arc differences. The Surface Science Center also studies things rhar have no biological relevance, Farhi explained. With all of this cross-disciplinary work going on, it is possible that problems with turf may come up, he noted. A steering committee has been appointed for the institute, Farhi said. It is representative of the faculty and is in charge of courses, research, and the general direction of the institute. The steering committee will name sub- "But I'd rather ,cc chose problems arise than have people working in little cubicles" of their own disciplines, he explained. "Unless we can facilitate interaction, we haven't done our job." Ir is nor always easy to get the engineer and biologist to talk to each other, Farhi pointed out. The biologist is trained to discover things, and the engineer is trained to invent things that don't exist yet. ur 1-eon rarni . (NOTE At deadlme, u uas learned that, because of the unexpected illness of Dr Farh1, Ur John Wn.1:hr,pro/esmr and chainnan of Patholog,, mil coordmal th effort.) "There's a big intellectual gap," he ,;aid. He's aiming to train people who will be just as at home in biology as they are 111 engineering. "If we can do chat in Buffalo in the next 2 5 years, we will have done great things," Farhi commented. • BUFFAID · ~~ ~ SUMMER'87 �24 Medical School Ne«s D unt"I llaTd Tds, I, and DT John Naughton M Fall Cha l n T Angt la Bon SCHOOLIS PIVillAL IN NEW WNYCONSORTIUM BY BRUCE S. KERSHNER T he UB School of Medicine will play a central role in the newly created Western New York Health Sciences Consortium. Formed by Buffalo business and medical leaders, the new organization represents an unprecedented partnership among local health care providers, educators, and researchers. The purpose of the consortium is to establish health care as a major force in regional economic development efforts. It is also designed to address projected hospital revenue losses of $39 million and job losses of approximately 1,300 by 1990. The new endeavor is unusual because it encourages cooperation among the area's SUMMER '87 hospitals in an effort to benefit the entire regional health care enterprise. The consortium is the result of the "Strengthening Health Care in Buffalo" project, which is co-sponsored by the Greater Buffalo Development Foundation (GBDF), the UB School of Medicine, and Buffalo General, Children's, and Millard Fillmore hospitals. "The agreement to form the consortium reflects an understanding on the part of the University and its teaching hospitals," commented UB Vice President for Clinical Affairs John Naughton, M.D., dean of the School of Medicine. "This understanding is that maintenance BUFFAID U,.-vs ,~ of quality education enterprise and patient care services will become increasingly difficult, given constraints on government funding and insurance coverage. The goal to have as strong a health care system as possible and to make Buffalo as competitive as possible with other major academic medical centers is achievable." Naughton is one of those instrumental in creating the consortium. The consortium's members include the Medical School, the GBDF and all of the University-associated teaching hospitals: Erie County Medical Center, Roswell Park Memorial Institute, Buffalo General, Children's, Millard Fillmore, Veterans Ad- �25 Medical School Neus ministration, Sisters, and Mercy hospitals. The consortium concept was the recommendation of a seven-month, $350,CXX) study by APM Consultants, Inc. of New Yo rk City, a study funded by the New York State Department of Health and Buffalo General, Children's and Millard Fillmore hospitals. T he project has four goals. The first is to put the area's hospitals on a sounder financial footing. The hospital system, the consultant report emphasizes, currently operates on "a thin margin of profitability ." The goal intends to "recapture Erie County's outmigration," that is, the attraction and retention of more patients who currently travel to ocher cities for specialized medical services. The second goal is to broaden the scope and service of health care in the area, and to fill some critical gaps in medical care. One of the ways co attain this goal will be co develop medical "Centers of Excellence" which, because of their reputation, will be capable of drawing more patients, as well as quality doctors, personnel and funding. A Cancer Center of Excellence, building on the strong foundation at Roswell Park, is a logical first step. The UB School of Medicine directly benefits from the consortium's third goal, which is to build up and strengthen the Medical School and its research and medical education programs. "The school is right now outperforming its own financial resources," states James Kagan, the consultant who conducted the study that recommended rhe consortium. "According to a comprehensive national survey (the Gourman Report) that rates the nation's medical schools, UB's Medical School is rared 30th our of I 25. By financial standards and State funding levels, UB should be 60th." B y upgrading the Medical School, the health care enterprise of Western New York would also benefit. This is because the Medical School plays an important role in attracting quality doctors, residents (doctors-in-training) and medical students, as well as funding for clinical and research programs. Increased funding will lead to an even greater ability to atcract quality medical personnel. A large propo rtion of the county's doctors are on the school's faculty, which numbers 2,400. Furthermore, the Medical School is closely linked to eight major hospitals which comprise its teaching hospital system. The fourth goal of the consortium is to maintain Buffalo's low health care costs through efficient delivery of services and maintain the delivery of high quality, accessible care to the indigent. The first and second goals try to add ress the problem of 10,CXX)Eric County residents leaving the area annually for treatment in cities like Pittsburgh, Cleveland, Rochester, and New York City. Defunct faculty group donates $1,000 for library acquisitions The consultant report stares that by attracting 3,CXX)to 5,CXX)patient admissions from outside Erie County, 128 million to 130 million could be generated annually. Furthermore, by retaining the 3,CXX)to 5,CXX)patients who currently leave Erie County for treatment, $11.3 million ro $18.8 million could be generated annually. 84 per cent of grads get one of their top choices on Match Day Other actions that the consortium will try to encourage arc joint ventures among participants. The development of stronger medical technology centers is needed ro compete with those of top-rated medical centers. Therefore, consortium members will consider entering into joint ventures and financing to ensure that goals are met. An example might be the development of a regional magnetic resonance imaging (MRI) Center. (MRI is an expensive hightech device that provides a new way to diagnose disease.) In addition, shifts in hospital services arc urged to save critical financial resources. • BUFFALO (PMVS1¢1ANj A check to purchase additional books for UB's Health Sciences Library has been donated by remaining members of the now-defunct Health SciencesFaculty Organization. Jack Klingman, Ph.D., professor of biochemistry and former officer of the group, said that the gift represented funds which had been on deposit in the organization's treasury. The organization, which originated in the early 1960sat UB, focused on activities which would coordinate medical - :ind later - health sciences education at UB, and the Downstate and Upstate Medical Schools. Klingman contacted all known past members of the organization who agreed to present the halance of the treasury to the Health Sciences Library. • $1000 A nother Match Day has come and gone, and the results have decided where members of the graduating classwill spend their lives during the next three to five years. Dr. Dennis Nadler, assistant dean for student affmrs announced that 84 per cent of the 132 applicants matched their first, second, or third choices, with 60.6 per cent to their first choice. Fifty will remain in Buffalo, 34 will go to other parts of New York State, and 48 will move out of state. "We did especially well in the most competitive specialties. For instance, we marched six our of the 384 positions available nationally in orthopaedic programs. This was much higher than other schools. We also had four or five marched into emergency medicine programs nationally," commenced Dr. Nadler. Ocher strong showings were made in ophthalmology and otolaryngology. • SUMMER '87 �26 Medical School News .. virtually identical to those who were not a part of the learning program . A second example of skepticism involves the u-.c of h\·puten<ion S(rl-cning pr~rams. Dr. Sacken's extensive research has demonstrated that these sucening programs appear successful upon first glance, but that, when examined in depth, they arc not beneficial. \'Chile che find• mg, are clear, they have nor hcen welcomed by advocates of wmmunity,wide screening pro• gram<. "Tell those goddamn Canadians to <tay awav from our meeting,," ,,as che rc,ponse his studies re,:eived at the U.S. Narnmal Blood Pre,sure Annual Conference. S. ~kett ge>1.--. so far a, to recommend some unusual applicanons of ,kcpncism. He ad\'(Xates applying skepnc1sm to the claims of socalled "experts" who, once e,tabli<hed a, experts, can Jo more harm than good to their d1s.:1plint-,,One . way they do this is by ignoring research or findings that conflict with their past re,ults. Dr. Sackett concludt-d his <pel'Ch with the ultimate paradox of the evening hy asking, "Shouldn't we be skeptilal about the professed effo,:nvene-.,of teachin~ medical ~cudcncsco be skepncal?" Dr. Sacken earned his medical dl-grce from tht: University of llhno1s-Chicago, the site of the inmal chapter of Alpha Omega Alpha (AOA). He was student president of the honor society. He came to Buffalo in 1963 to work with the Public Health ScrvlCe. Sackett's reputation quickly spread and as a result, he wa, offerl'CI the posmon of chief teaching fellow at the UB Medical School by Dr. Calkins. Unfortunatelv for UB, Dr. Calkins remarked, Sackett was given an irresistible offer from McMaster to head their Clinical Epidemiologv department. He went on to become chief of medicine at two of their major teaching hospitals. The AOA inducuon ceremony was moderatt'CIby Edwin Jems, M.D., clinical pro· bsor of pathology and president of the Epsilon chapter of AOA. Vice President Naughton welcomed ~tudents, parents, and friends to the new Butler Auditorium m Farber Hall. A brief hl'tory of AOA was detailed by senior medical student and student represen· tat1ve to the AOA advisory committee, David S. Rosenblum. Rosenblum gave the English 25 INDUCTEDINTO MEDICALHONORSOCIETY "Y BY KATH LEEN RIGA ou are the cream of the cake. You're the ones we expect to carry u, through in the future." This 1sho,, 25 medical honor society inductees were greeted hy Vice Pn.-,,identJohn Naughton at this year\ Alpha Oml>ga Alpha induction. Introduced hy Evan C-ilkins, M.D., as "om: of the most exciting men in medicine m North America" was keynote speaker David Sackett, M.D. A former UB Ml-<lical School faculty member, Dr. Sackett i< currently professor of med1Cme and of clmical epidemiology and biostatistics at McMaster University in Hamilton, Ontario. SUMMER '137 Dr. Sackett addressed "The Need for Skepticism m Medicine." He recommends a kind of skeptic1,m he refers to a, "constructive skeptK1<m."This is a positive way of applying skepnusm so as to assist us in sorting scientific truth from fallacy. To demomtrate the nel-d, Or. Sackett pre:..?nted the re,ults of a ,rudy he and his associates conductl-d. It focused on the que:;tion of whether teaching hypertension patients about their d1<,eascwould improve their com• pliance w1ch therapy. Their findings showed that while patients' knowledge of the disease did me rease, their rnmpliance w1th therapv ,, as BUFFAID l:HY ~ ... N �27 Medical School Ne«s translation of the AOA motto, which is "worthy to serve the suffering," and explained that the Buffalo chapter is one of I05 nationwide. Harold Brody, M.D., chairman and pro• fesssor of anatomical sciences, accompanied Dr. Jenis in inducting the new members of AOA for 1987. They are Adam Ashton, Melissa Chaffee, Glenn Eiger, Robert Goldklang, John Griswold, Douglas Katz, Theresa Kinnard, William Kinnard Ill, Dolores Leonard, Brian McGrath, Curt Pinchuck, Andrew Plager, Richard Scarfone, Thomas Kowalski, Ann Marie LeYine, James Schlehr, Janet Flier Sundquist, Mitchell T ublin, Mark Verra, Marc Weitzman, Oleh Zazulak, and Gregg Zimmer. • Med School is UB's top research unit Sherman Annex gets two-story addition hile the Medical School's major new expansion has been the focus of much attention, another building expansion has W quietly taken place with little notice. That expansion is the two-floor addition to the Sherman Annex, at the SE corner of the Medical School complex facing Bailey Avenue. Comprising 9500 net square feet and 16 rooms, it enlarges the Physiology Department and its Hermann Rahn Environmental Physiology Lab. The former hallway between Sherman Hall and Sherman Annex was relocated co allow new office and lab space co be added. New, large equipment and storage rooms associated with the Hyperbaric Labs were constructed, including a large compre:;sor building with more equipment to operate the pressure chambers chat simulate deep sea and high altitude conditions. Large rooms for gas mixing and purifying facilities, a machine shop and an enclosed outdoor tank form arc ocher features. The move into the $800,000addition was completed last fall, with a six-week interruption in operations. • T he UB School of Medicine generated 42.4 per cent of the University's sponsored research expenditures in 1985-86. This was far more than any ocher major unit of the University. In specific dollars, the Medical School was responsible for $16.9 million out of UB's coral of $39.8 million. In addition, UB's affiliated teaching and research institution, Roswell Park Memorial Institute, generated $21.4 million (not included in preceding figures). This most recent year's coca! is an increase of almost 18 per cent, or more than $3 million, over 1984-85. Research spending was almost equally divided between the basic science and clinical departments. Three Medical School departments topped the list for the entire University: Medicine ($3,493,817); Physiology ($2,772,737); and Pediatrics ($2,537,022). The other highest departments were Biochemistry ($1,859,640); Microbiology ($1,255,458); Biophysical Sciences ($762,943); Social & Preventive Medicine ($715,544); Pharmacology ($592,480); Family Medicine ($518,576); Pathology ($512,831); Psychiatry ($375,359); Nuclear Medicine ($329,644); Anatomy ($3 I 5,494); Surgery ($207,374), and Rehab Medicine ($204,433). • "" ~ § I ~ / or of radwlo vat Mt \11u11 'It hoof of Me the sptakt n al th lir I .Nauonal <.onferen c m ~,I nc« m Max11lofac1al 1tnag111 h d Ne l ember 'I Bat Ene ( ounr, M, da al ( enr r I h < on fer<nc,, oordmated f,, G orge Alk r M LJ aml Angelo V lBals<>,M D, V V \ attra ted r laoloi:nt, fr ms t t n tat , and(. anada Highl,ghttd uer< tal -<>/•th-art t ~h11111u III ma,,llofa 11111magmgund their dmacal cnrr la raons Alker as haarman and f>rofessor of radanlog,, DdB lso 1 ,lartclor of maullof11~1al radaolog, al the \ hool of Dental M d1<1n<and lamcal tL< onatt" professor m 1hc Meda al ')c /Joof', D I I BUFFAID CT l!.!1.......!.. ..Ct ~N ] SUMMER '87 �., , ...... ~ ,, \ 6 r �29 Research P oor Americans are more likely to get cancer - and co die from ic sooner than more affluent Americans, concludes a UB Medical School study done in conjunction with che American Cancer Society (ACS). The ACS study, prepared by Donna Funch, Ph.D., shows that a person's chances of survival after diagnosis of cancer have more to do with economic status than with racial or ethnic background. Dr . Funch conducted the study as a faculty member in UB's Department of Social & Preventive Medicine; she has since joined a Boston research firm. Co-researcher with Dr. Funch is Dr. Saxon Graham, professor and chairman of the department. The study, "Cancer in che Economically Disadvantaged: A Specia l Report," was presented publicly in late 1986. It is the first report of this magnitude that studied cancer as a specific health problem in relation to economic status. The report asserts that previous studies did not look at socioeconomic status and racial differences separately. By comparing these factors, the UB study was able to demonsrrace thac economic factors were more critical chan racial or ethnic considerations. Poor whites and poor blacb both fared more poorly than middle class Americans of all origins. Among the nearly 34 million Americans below the poverty line (23 million whites, 9.5 million blacks, and 1.2 million of other races), che report found a relative cancer survival rate IO to I 5 per cent below the American overall rate of approximately 50 per cent. Also included in the report are statistics compiled from previous studies that estimate that poor Americans have a 60 per cent greater chance of developing lung cance r and a JOOper cent and 100 per cent greater chance of getting esophageal and stomach cancers. "The harsh realities of poverty create barriers to the health care system," said Dr. Harold Freeman, chairman of the ACS Subcommittee on Cancer in the Economically Disadvantaged. "The poor focus on day-co-day survival. They tend to have a lack of education, co be fatalistic and powerless in their thinking. And they usually use the hospital emergency room as their entry to the system," which reduces the chances of catching cancer at its early srnges. POOR GET MORECANCER AND DIE SOONER FROM IT, UBstudy finds BY BRUCE S.KERSHNER The report found other factors besides quality of health care that put the economically disadvantaged at a health disadvantage. For insrance, smoking, alcohol abuse, nutrition, and occupational hazards may have more influence among the poor. The report offered several recommendations. They include adoption of a goal to provide cancer screening to all Americans at risk by improving the cost effectiveness of these programs; inclusion of socioeconomic status as a cancer risk factor for all ACS research; and increased education of health professionals regarding the role of economic status and cancer. To improve health care for the poor, the report recommends development of expanded out reach programs by communitybased emergency rooms and clinics, as well as educationa l efforts to bette r inform the poor of the need for early health detection. Because the findings cross racial lines, an ACS spokesperson maintains, it raises important ethical questions as to whether the national policy toward health care for the poo r should be made a higher priority. • BUFFAID (PH"<S1¢1AN) SUMME R '87 �30 Research GEMENTOFTHE f BYS~ ''Becauseof poor management,few people aresettingasidetheir own bloodfor use duringelectivesurgery to protectthemselves againstAIDS, and otherviraldiseases.' ' SUMMER '87 P oor management of the na11on\ blood ,upply is to blame for the umlcrusc of cxNing aurologous blood ,upph • program,. &-cause of ch,,, few people arc setting aside 4u:mm1t."Sof their own blood for use during dl·ct1ve surgery to protect themselves against AIDS, hepatitis B, and other viral disease,. This management concern is one ;bpt.'\:t of a five-year, multimillion dollar resc.mh proJect being conducted bv a former dean of the UB School of Mc<l1cmeand a UB management profo,,or. Co-researchers for the management aspect of this study, aimed at improving the safety of the nat ion's blood supply, are Douglas Surgenor, Ph.D., and Edward L. Wallace, Ph.D. Dr. BUFFAID PMV --c:, ~N Surgeno r was dean of the UB Medical School from 1962to 1968,as well as UB's vice president for health sciences. He is now a Harvard professor of biochemistry and president of the Harvard Center for Blood Research, which is a sponsor of the study. Funded by a SCORE gram from the National Heart, Lung, and Blood Institute, the project, which 1sm its second year, coordinates the separate studies of six scientists who are studying viral transmissions through the blood or epidemiology of these diseases. These comvestigator.. include leading AIDS researchers Max Essex, Ph.D., Jerry Groopman, M.O., and two other Harvard professors. "The lack of use (of autologous blood supplies), to a large extent, 1s the result of having �31 Research NATION'SBLOODSUPPIY ~ i ~ 1& g ~~---~ <t IX ........ inadequate sy,ccms m inform ehg1hk• p:iticncs, urge thl·tr participation, 1nd mala- it l'a•ier for them to prl-<lcpo<itblood," Walla<e maintains. rem mechani•m<, "Unle;s \\c ha\e the ,l, the program itself i, nm good enough," The n~ar<h 1sd1~1dl,Jinto thrl"<'m,un are:i,, Wallace ,ay,. The fir,c <un·cv< bl1xxl lOlll-ctions n.nrionally o,er chc past four or tt\'C vears, including an examm:mon of blood ,horcagc, and what i, l3U<ing rhcm. "ls chis a n•al cuthn,k lx'l.:ausc:of tlw fear of I\IDS' Or 1s II ju<t c \Chcnl?"he a<ks. T ,cud, s an <'Xammatton of tramfus1on patterns of hrn,p1tnls Ir •t I data ho,, char acrQ<;<tht <O\lntfV transfu,ion,, "hich had lx·en m, rea,mg at an h, ._,o d part,,, t~ annual rat<' of 5 per ccnc from 1980to 1982and were ex!'l(.'\tl-<lm ..-onunue their gro,Hh due co the aiting populauon, ,harplv levek-J off lx-gmning m 19 3, \\'allacc ~\'· Thev are ,cud)•mg ,u,pcdcd <,IU'l'-'of chi, tk-clme. The third part of tlw ~tudy i, d ·vot<-J co numlogou, donation programs, which Wallace say, are tht• onh· ,, av c,• H t II· rem, c th ri,k of contracung a viral disease through a blood tran,fu~ion. "We're mtercsted in findmg out th<·extl·nt of a labtl t nJ utih:auon, nd th•• pr~ram' whether phv,1uan, and ,urgrons arc acmcly of the hah1hcv promoting 1t," he -a,·,. "&--cause prohlcm, ,f this program " available, ,md 1f phv ician~ ,md surgeons kmmmglv, \\ith det:mform patients of thi, 11\C ,urgery, don't BUFFAID y s program, then• 1sa qUl"tion of whether thcy'n• g1,en thl· knm, n n,ks. h<·mg fully rl"!>po11,1h!c, Aucologou-, tran,fu,1on, ;1rcthe ,afe,t tVpl' of blood tra11,fu,1on,, nnd nre \,,Jdv a\'mlahle. )\·t, wh,lt• 30 per ll'm to 35 per cent of the surgcn performed 1, d<"-U\e, anJ the!'<.·p:mcncs Ml· cli1tihlc Ill donate their own bkl<xl 111 advance for u..,;cduring ,urgery, on!v about one m 10 or one m 12 parciup,ttc,. m chc.-scpro• gr:im,, \\'allau• md1cntl". "The quc,rnm "• why i, 11 that patient, and ph\s1c1an, arc not D<Ci\cly uulmng cx1•tmg (,tutolog,lu,) program',°' h<· quern-,,. Such pr02tarns mU5Che dC\clopcd and promoted, operating ,y,tem, l",tahh,hcd, pa11c111, monitor<-J, hlood ~1,1r<~3tl,J,"Tiu, i, w hl're I • dunk the manag<·ment 1tapl'XM,." SUMMER·11; �32 Research Marijuanause may decreasemalefertility T hrce potent compounds in marijuana are capable of decreasing fertility in sea urchin sperm and may similarly affect human sperm as well, report researchers at the UB Medical School and two Canadian universities. Results of the collaborative study, published in and Cell Biology,a CanaMarch in Biochemistry dian scientific journal, constitute the first evidence that the compounds directly affect the fertilizarion process necessary for reproduction. The three compounds - THC (delta 9 tetrahydrocannabinol); CBN (cannabinol), and CBD (cannabidiol) - are among 100 compounds called cannabinoids found in marijuana. THC is the major compound responsible for the "high" experienced by marijuana smokers. SUMMER'87 BY MARY BETH SPINA Herbert Schue!, Ph.D., associate professor of anatomical sciences at UB who headed the study, says the infertility which was induced by treating the sperm with the compounds was reversible. Infertility of the sperm increased, he says, by raising the dosages of the cannabinoids and lengthening the amount of time the sperm were exposed to the compounds. Schue! says the study shows that sea urchin sperm but not eggs exhibited reduced fertility BUFFAID j PHY $1¢1 A!L] when treated with the com• pounds. "We were surprised to find that when the eggs were treated, they were able to be ferrilized with sperm which had not been treated," Schue! notes. The treated sperm, however, were shown to have diminished ability to fertilize normal eggs. "Since the egg undergoes many of the same basic cellular events during fertilization as does the sperm, one would have expected both ro be affected," he adds. R esearch elsewhere has demonstrated that cannabinoids affect the reproductive processes in several animal species. When given to mice, there is evidence both of suppression of the male hormone testosterone and of in- �33 Research creased numbers of abnormal sperm heads. In female rats and monkeys, the compounds sup• pre,s ovulation. And in humans, they have been shown to reduce sperm motility and decrease count and concentration of sperm as well as disrupt ovulation. "While all of these reported change, created by the presence of cannabinoids in various species affect the reproducuon processes, the change which we found more directly is involved with the fertilizanon ab1ltty of the individually-treatt.-d sperm," Schue( explains. The exact mechanism by which this occurs, however, is not yet known. Schue(, who has conducted com1derable research on fertility using the sea urchin model, say, the creature is ideal for studies which may lead to more information about causes of human infertility. Collaborating on the study were Regina Schue(, research associate at UB; Dr. Arthur M. Zimmerman, University of Toronto, and Dr. Selma Zimmerman of Glendon College at York University in Toronto. Fund~ for the study were provided by the NSF, NIH, and the Natural Scienc~ and • Engineering Council of Canada. Roswell is testing second biological anti-cancer agent B 1olog1calagents designed to stimulate the body\. defen\C, a~ainst cancer are the lat~t weapon, in the fight against cancer. Physicians at Roswell Park Memorial Institute have scarred testing a new mcmhcr of this family; so new in fact, that it ha, not received an official name a, yet. Thb is the second biological agent ro go mto clinic·al mal at Roswell Park m the la,t 15 month~. Clinical studies on the first drug are still in progress, and will continue in parallel with the studies on the new agent. Both ,tud1es arc being conducted under the d1rern(ln of Dr. Pamck J. Creaven, clmf of clin1Cal pharrnarnlogy and therapeutks at Roswell Park and a,sociate re;carch profc•,sor in UB's Roswell Park Graduate D1~1sion. "B1ologa:al agents are one of the most 1mporrant new approaches to cancer treatment that we've seen m some ume," according to Dr. Creaven. The body has cells that arc designed to recognize and deal with attack by organisms from out,1de, but these cells have had difficulty recognmng and attacking cancer cells because they originate in the patient's own tissue. "Biological agents have been very successful in snmulanng animal defen;c against animal cancer, but human cancers are cougher to deal with," explained Dr. Creaven. "We hope that this ne\\ drug will stimulate the body's defense cells to de,troy cancer cells." An innovative feature of the new treatment is chat che drug is "entrapped" in fat d roplets to direct the drug specifically to the cells it is designed co stimulate. "We hope that this delivery system will increase the drug's effectiveness and reduce its toxicity to the patients' own tissues," according to Dr. Creaven. The new drug is being given twice a week for four weeks, the schedule most effoct1veagainst animal rumors, and at the present time, is being t<.~tedagainst all type- of cancer. "As w1ch any ne\, drug," Dr. Creaven explained, "we start by using the agent in all rypes of cancer, and, b:ised on the results, frxu, on the tumor, in which the drug ,;eems to be • showing activity in later studies." lnterf eron found to reduce episodes of one form of MS e,ults of a study by UB neurologist Dr. Lawrence Jacobs indicare chat :ic nve ep1sod~ of disease(exaccrbanons) which occur in a form of multiple sclerosiscan be significantly r<.>ducedwith spinal injections of interferon, a substance normally produced by human cell,. He and his fellow researcher, reported the double blind study in the December 20, J986, ,._,ueof the British medical journal The R Lancet. The UB climcal profos<,0rof neurology and m,earcher at the Dent Neurologic Irwitute located at ~1illard Fillmore Ho-p1tal led rhc- BUFFAID ~..!!,...-tl•~·~ - N study of three U.S. medical centers. He said the results at this stage of testing are encouraging enough that he hopes the treatment may, in ume, replace the more standard treatment approaches for patients with exacerbatingremitting multiple sclerosis. Jacobs empha,1zcs that while interferon is not a cure for the crippling neurologic disorder, wh1eh has no known cau:,e, it significantly prevents exacerbations which would otherwise be expected m the cour..e of the disease. It has not been proven to be effecuve, however, for the progressive form of multiple sclerosis in which progr~ve debilitation occurs without exacerbation,. "Dr. Jacobs' study is an example of significant clinical research being done in Buffalo to discover the causes and treatment of one of our mo-t ~ous nc-urological diseases," relates Dr. Michael Cohen, professor and chairman of neurology ar UB. "Although the findings are not conclusive, rhey certainly merit connnued study and replication. Dr. Jacobs 1sto be commended for his research and we look forward to further reports of his srud1es in the future." Approximately half the patients with this form of the disease at the Dent Institute, Walter Reed Army Medical Center, and the University of Rochester Medical Center received inJeCtlonsof interferon, while the ocher half received sham spinal taps with sterile water injected mto subcutaneous tissue (placebo treatments). Patients in the recipient and control groups were matched for their pre-<;tudyexacerbation rates based on their past medical histories of active periods of disease. Natural human beta interferon in dosages of I million units each were given via lumbar (spinal) punctures once a week for the first four weeks of the study and once a month thereafter for five months to thO<,Cin the expenmental groups. followed over the Patients in both groups w<.>re two-year period during which their clinical status was rated using two accepted neurologK scoring systems. At the end of the study, the exacerbation rates of the interferon recipients had decrea<ed by 57 per cent, which the inv~ugator~ attribute mainly to the mterferon treatment. The controls' rate had deueased by only 26 per cent which was felt • to be a placebo effect. - Brnce S. Kmhner SUMMER'87 �34 HosJJital Neus Children's dedicates the Peter and Tommy Colucci Liver Center T he Children's Hospital of Buffalo dt.'Clicated che Peter and Tommy Colucci Liver Researth Center Memorial last November. The Center is named after the <;ons of Mr. and Mrs. Anthony J. ColU\:ci, Jr., who lose their lives co liver disease. The Center is housed in the lmemacional Institute for Infant Nutrition and Gastrointestinal Disease at Children's, and is supported by the Peter and Tommv Fund, Inc., which fosters research in pediatric liver disease, and aid, families of afflicted children. Emanuel Lcbenrhal, M.D .. chief of UB's Division of Gastrocnterology and Nutrition, and direcror of the institute, will supervise research at the Center. (From Children's Hmpital's "Bambino," November 1986.) • Medical Foundation celebrates 30th year T he Medical Foundation of Buffalo, Inc., has celebrated its 30rh year. Located across from Buffalo General Hospital, the foundation gained recognition when its president and research director, Dr. Herbert Hauptman, won the 1985 Nobel Prize in Chemistry. With a staff of 25 Ph.D. scientists, its 15-member molecular biophysics group is possibly the largest in the country. The independent, non-profit institute conducts research on hormone-related disorders, including cancer, heart disease, diabetes, arthritis, birth defects, and related problems. It was founded in 1956 by endocrinologist George F. Koepf, M.D., who is its prt.-sident and chairman of the hoard. Dr. Koepf is a 1937 UB medical alumnus. • MFH adds residency in family medicine 1llard Fillmore Hospital has commenct.-d its new family medicine residency program, based :n the new Louis Lazar Family M SUMMER'87 Medicine Center ac che hospical's suburban facility. The three-year program plans to accommodate four residents per year. Daniel Morelli, M.D., vice chairman and director of graduate education at UB's Department of Family Medicine, will direct the program . The Lazar Center was funded in part by an endowment from the Lazar family. Dr. Lazar is a UB undergraduate alumnus and a clinical associate profes..-;or of family mc<licme. He formerly chaired the hospital's Familv Practice Department. • ECMC's acute care and skilled nursing units are accredited F ollowing a recent full survey of the acute care hospital and its Skilled Nursing Facility, the Erie County MediLal Center ha, received a three-year accreditation of hoth facilities by the Joint Commission on AcLrcdication of Hospitals (JCAH). The JCAH is a nationally-recognized bodv which assesses the quality of care rendered in health-care facilities. Accrt."Clitationinsures continued participation in the Medicare reimburscmenr program and is also recognized by rhe N.Y.S. Health Oepartmenr as an indicator of the quality of care rendered by rhe insritution. • Mercy acquires new bone disease diagnostic device J oseph A. Prezio, M.D., chairman of UB's and Mercy Hospital's Department of Nuclear Medicine, has announced the acquisition of the newest, most reliable equipment for che diagnosis of osteopenia/osteoporosis, a painful, crippling bone disease that strikes one out of every four women over the age of 65. "This new Dual Photon Bone Densitometer," notes Dr. Prezio, "utilizes well-tested techniques for precise, efficienr measurements of bone mineral content, allowing physicians to accurately assess osteoporotic patients without subjecting them to high levels of radiation." The system, which features an advanced computer and specialized program, provides Mercy's staff with greater flexibility in working with patients, as well as in obtaining and viewing results. le provides physicians with unparalleled quality and production of clearer images for more thorough evaluation of critical areas. • Tri ..County opens Conewango satellite T ri-County Memorial Hospital of Gowanda, N.Y. recently opened an unusual satellite facility, the Conewango Valley Medical Cenrer. It is designt:d to provide ambulatory services for the largely Amish population of chis rural Chautauqua County area. Funded by a $203,000 NY Department of Health grant, it is a cooperative venture between the UB School of Medicine, the Health Department, the hospital, and the community. The center is unique because about 20 per cenr of the construction and interior work was performed by community members. lrs rural and Amish population, as well as native Americans and clients of area mental health facilities, create a specially di\'ersc population which will be attractive to physicians at UB. • BGH graduates its last nursing class T he Buffalo General Hospital School of Nursing, the oldest hospital-based school of nursing in the United States , graduated its final class of 23 women and two men January 4, 1987. Founded in 1877, the Training School for nurses, as it was then known, was the first nurses' training school west of New York City. In 1942, the Traming School and the then University of Buffalo struck a contract to allow nursing candidates to receive instrucnon in anatomy, chemistry, miuohiology, and sociology. In the mid-1940s, the name was changed to the &hool of Nursing, a reflection of the effort to make nursing more education oriented rather than :;crvice oriented. The final 25graduates join more than 3,700 BGH School of Nursing graduates. • �35 llospual Neus Buffalo General team offers assistance for cardiac care in India A Buffalo General Hosrmal heart team returned last March to Western New York after a two•wt-ek ,;sir to India to teach ne,, tt-.:hmques in cardiac surgery and co help establish an angiology department. The <ax-member team, which instructed per· sonncl at NC\, Delhi's Batra Ho,pual and Medirnl Research Centre, induded Buffalo General team leader, Joginder Bhayana, M.D., UB a<socaareprofe,!Or of surgery, and DJavad Arani, M.D., d1reuor of the BGH Ang1ologv Department and chnzcal associate professor of rned1cme. A heart unit has bt.-en m operation at the New Delhi facility smc.:e1968,but Barra did not perform angioplasty, Dr. Bhayana said. Dr. Arani wa, responsible for ass1snng m rhe start· up of an angioplasty program there while Dr. Bhayana pro\'lded instruction m heart valve repair and such bypa,s procedures as internal mammary grafting. "A lot of heart valve work is done in India bt.-cause of the high incidence of rheumanc fe"er," --aid Dr. Bhayana. "The fever, which is u)mmon co developing counmcs, adversely aff1.-.:tsthe heart valve." Dr. Bhavana was comacced last vcar bv N.S. Dixit, M.D., one of Batra's cardiologists, to wmc to India and to update their hospital with the latest pnx:1.-durc,and tf.."Chnolog1es. "It'< ah,avs samfvmg to go mto another u)untry and help," Dr. Bhayana added. "We wanted co give them the latest wchnology and • help them w grow." Roswell's OSCC renewed until 1989 T he Organ Systems Coordinating Center (OSCC) at Roswell Park Memorial lnsmute has been extended through July 1989by the National Cancer Institute (NCI). The OSCC will receive Just over 51 million per year for the next thrt'C years to continue efforts on developing research projects targeted at cancers of the hladder, breast, central nervous system, large bowel, pancreas, pro,tate, and upper aerod1gestive system. The NCI escablished the OSCC at Roswell Park m 1984 through a cooperative agrt'Cment gram. Dr. James Karr, d1r1.-.:mrof the OSCC, said, "This decNon was bascJ on the succe,ses registered by the OSCC during its recemly completed second year of • operauon." SUMMER '87 �36 Classnotes Medica l Staff of Mercy Hospital of Buffalo. Dr. Fanelli, who has served as chief of the Department of Family Practice at the hospital since 1974,also has a private practice in Orchard Park. Charles D . Ross (M'47) • has retired from pediatric practice after 32 years and is now a medical consultant with the California Stare Department of Health Services. Alan l. Mand elberg (M'72) • writes: "I am a board certified Do nald Pinkel (M' 5 1) • was one of three doctors to be awarded gold medals and $130,000each recently at the eighth annual General Motors Cancer Foundation Research Awards in New York City for making hallmark contributions to cancer research. The former UB faculty member, presently at the University of Texas' M.D. Anderson Hospira! and Tumor Institute in Houston, was chosen by a committee of 31 international scientists for his work in helping to develop cancer chemotheraphy that cures some children of leukemia. While in Buffalo, Pinke! trained at Mercy and Children's Hospitals and was chief of pediatrics at Roswell Park. Pinke! is also a previous winner of the coveted Lasker Award . Ra y J. Thurn (M '5 2) • received the Clinical Teaching Award from St. John's Hospital, Sc. Paul, Mn. Saar A. Porrath (M'61) • of Beverly Hills, Ca., is the author of a book, A MuliimodalityApproach co Breast Imaging, published by Aspen Press, Rockville, Md. J o hn R. Fan e lli (M'63) • has been elected president of the Dr John R ophthalmologist in North Hollywood, Ca . I took a fellowship in cornea and external eye disease in Rochester, N.Y. I am currently assistant clinical professor of ophthalmology at USC , Los Angeles County, School of Medicine, Chai rman of Continuing Education and Commissioner for the Joint Commission of Allied Hea lth Personnel in Ophthalmology, and chief of ophthalmology at Saint Joseph's Medical Center in Burbank, Ca. I have recently developed a computer software program for ophthalmology, and have had a chapter accepted for publication in a new book published by the Conrecr Lens Association of Ophthalmo logists." Letter To The Editor Editor: It was a pleasure to receive rhe December 1986 issue of the Buffalo Physicianwhich I have read from cover to cover ... One particularly interesting article was the chronicle of the recent renovation, expansion, and development of the facilities at the Medical School and of the history of rhe Medical School on High Street. This was interesting since The University of Texas Medical Branch at Galveston, which has a long and interesting history, has an architectural parallel. A particular view in that article which struck me as a fascinating parallel ro the recent history at Galveston is the picture of Alumni Hall, which disappeared in 1954with the razing of the High Street building. This hall is almost a duplicate of the recently renovated lecture hall of the original medical school building at Galveston built in 1891. The general layout, the sliding blackboard, the tiers of folding chairs and even the balcony entrances are almost identical. I have enclosed a photograph which might be of interest to you and illustrates the remarkable similarity .... As just a note, I would pass on to you there are at the medical schools in Galveston and Houston alone, five medical alumni chat I hall <1t the olcl UB A I know of and three of us are from the Class of '64! Sincerely1ours, Charles T . Ladouli s, M.D . Associate Professor Deparnneniof Paiholog) · �Deaths Ra ym o nd Ru ss Sto ltz (M'25) • died July 12, 1986 in Upper Momcla1r, N.J. He had a general pracnct•, oh<.tetric, and gyne<:ology in Passaic, N.J. for 50 years. Dr Scoln wa< in· strumemal in the establishment of an expanded Emergency Room at Passaic General Hospital and servc:don the hospital's medical staff for 50 years. He wa< the re<:ipientof the Golden Menr Award given by the Medical Society of New J~rs.:y m recognition of his 50 years as a physician. He was a member of the 50-Year Club of American Med1dne of the American M1.-dical A<S<x1at1on. He is survived by hi, wife, Mildred, and hi• daughter, Millicent Rae. J. Whit e (M'4 2) • a retired surgeon, died in Port St. Lucie, Fl. on October 12, 1986. While at the University at Buffalo he wa< captam of the wrestling team. Dr. White served with the 52nd General Hospital in England as a surgeon. After the war he was associatoo with the Tri-County Memorial Hospital for twenty years before his retirement. He was a founding director of the Port St. Lucie Bank (Barnett Bank) and served as director emeritus of the bank until his death. Ward Erratum: ■ In the February 1987 issue of BuffaloPhvsician,it was erroneously repom-d that Dr. Jack L1ppcs had taken a position ac another university. It should have read chat he took a leave of absence for one year to serve as vtte president for re,earch at Family Health lnternac1onal at Re.earch Triangle Park, N.C. He has since returned • to his UB position. ----- - --;:~ ~--------------------------------------------r--i---IF MAILED IN THE UNITEDSTATES REPLYMAIL BUSINESS FIRSTCLASS NO. 2210 PERMIT NY. BUFFALO. POSTAGEWILL8E PAIDBY ADDRESSEE BUFFAID P H Y S C I A N 139 Cary Hall State University of New York at Buffalo Buffalo, New York 14214-9980 I,,I,,1,I,,,II,I,,II,I,,I,I,,I,,I,II,,,,,I,II I,..11, �BUFFAID I p H y s c A - No n-Profit Org . U.S. Postage PAID Buffalo. N. Y. Perm it No. 311 N State University of New York at Buffa lo 3435 Ma in Street Buffalo. New York 14214 Address Correction Requested ~EDI CAL HISTORICAL LI B. ~IrBALL TOWE R, SERIALS DEPT. MAIN ST. CAMPUS lJFFALO t--i Y 14:2 14 FIii out this card (Please print or type all entries) Name -------------------------- M.O._ Ph.O.__ Year Received ___ _ Office Address Home Address - --- ------------- ------- ------------ - --- If not UB, M.D. or Ph.D. received from In Private Practice : Yes J In Academic Medicine: Yes No □ Specialty No □ Part Time D Fu ll Time D School __ _ ______________ _ Title Other: Professional Society Memberships -- - -- -- ---- - --------------------- News : Have you changed posit ions. published, been involved in civic activities , had honors bestowed . etc? _____ Please send curr iculum vitae. clippin g s. publications. or announcements , also include a photo of yourself. _ _ _ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1987 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1987-Summer Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1987-v21n02-Summer Table Of Contents A list of subunits of the resource. Physicians and Smoking Cessation Knocking the Supernatural High Tech Babies A Nobel Year In Pursuit of Butterflies People Medical School News Research Hospital News Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-28 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v21n02 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Rights Holder A person or organization owning or managing rights over the resource. Copyright 1987 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/b29e3d080e7bbf597d7cb8e73559085b.pdf 9c871732a7f0ed5838d2ade9108dd933 PDF Text Text p VOLUME y H 21, Nl'MBER s C A N Spring '87 I • Adventures in Health Care �BUFFAID PHYSICIAN Dean's Messag e STAFF EXEC l TIVE EDITOR. UNIVERSITY Pl BLKATIO:-.:s Robert T Marlett BUFFALO PHYSll lAN EDITOR Bruce S Kershner ART DlREC.TOR Alan J Kegler PHOTl..'>GRAPHY Phyllis ( hnstopher Doui,:las Lt.•vere Frank Lutcri:k Ed No"ak ADVISORY BOARD Dr John Naughton. C hairrr.u'l Dr Harold Brody Mr Ke,m Craig Ms Karen DryJa Ms Nan,~ G!ite,o Dr lames Kansk1 Ms Manon Manono"sk1 Dr Daniel Mordh Dr l harles Pagandh Mr James Ph1ll1ps Dr lohn Przvluck1 Mr John Pulh Dr Robert "iche1i: Mr M,h :::iha" Mr :::ireveShwmsky Mr Raul Vdasqur. Dr Mary Voorhe s Dr John Wright Dr Maggie Wright Dr Joseph 21::1,Jr D ear Friends of the School of Medicine: The formation of the Western New York Health Sciences Consortium was announced on March 23, 1987. This new organization will be composed of the eight teaching hospitals m Buffalo, the School of Medicine and representatives of the business community nominated by the Greater Buffalo Development Foundanon. The decision to form this new organization culminated two years of discussion and study focused on how the Buffalo health care and medical education community could best ensure the maintenance of a strong, competitive position at a nme of tremendous changes m the medical and health care systems throughout the United States. Thanks to the fine leadership provided by APM consultants of New York City, 1t became clear that in our environment, a co-operative, rather than an instuuuonally compctmve, response to change was preferrable. The consortium's ambitious goals arc to strengthen the teaching hospital system, to enhance the overall com mun1ty Image as a health care provider, and to facilitate the school's continued growth and stature. The consortium will begin to take shape in coming months and over the course of the next two to three years, its effectiveness will be determined. If successful, it can serve as a model for other commun111cscomparable to Buffalo and It will demonstrate the feasibility of applying the academic health center concept to a regional rather than a geographical s1te-spec1fic framework. Future publication of the Buffalo Ph~s1cwnwill keep you abreast of our progress. Sin.:erdy. John Naughton, M.D. Vicc Prcmlenr for Clrn1c:al Affam Dean, School of Mcd,crne TEACHING HOSPITALS Buffalo General Children's Eru.-(,.:,11ntv Mcd1LalCenter Merq Millard F1llmon· Roswdl Pork M<monai lnsmute Sisters of ( hartt~ \ eterans Admtmsrrauon McdKal ( enter Medical Alumni Association President's Message Pre.Ju, d b-, th, 1>11<um<•/ L n,,_.,., :, H atwnJ m WS°"- a'wn "uh th,: '\,.J,ool of Med,,,.,, \tct•, l n,, ,.,.111, of "'"' \ mk ul R d/ulr, rHE BLFFALOPHY:::ill lANCUSPS 551-860) Spring 1987, Volume 21. '-lumber 1 Published five 11mes annually Late \\linter, SrrmJ,?, Summer, Fall and brly Winter - by the School ot Mi:d1one, :State l.m · vasn~ of Ne" York at Buffalo. 34 ~5 Mam Street, Ruftalo. Ne" York 14214 . Thud class bulk postage paid at Ruttalo, Ne"' YorL: Send address changes to THI:. Rl FFALO PHYS! CIA!'l, 139 Carv Hall. 34 3'i Main Str.-et, Buttalo, Ne"' York 14214 D ear Colleague: To mark the 50th Anniversary of Spring Clinical Day, this year's symposium will be held on Satu rday, May 9, 1987 at the Buffalo Hilton. "WARM WEATHER WOES THINGS THAT GO WRONG IN THE SUMMER" will offer an overview of common summertime injuries and illnesses and how to treat them. Our Stockton Kimball Lecturer.James F. Holland M.D. is professo r and chairman of Neoplastic Diseases at Mt. Sinai Medical School 1n New York. He 1s also director of the Cancer Center at Mt. Sinai Hospttal. Between 1950 and 1970. he served on the faculty of the University at Buffalo's School of Medicine. He received the Lasker Award 1n cancer chemotherapy 1n 1972, the American Cancer Society National Award in 1981 and the Columbia University Gold Medal for d1st1ngu1shed achievements m medicine in 1983. We invne all physicians to Spring Clinical Day. The program should prove to be an exciting and informative one. -John E. Pn :.ylucki, M.D. '73 I �H y I CONTENTS 2 Window Into The Br ain • "A window in to the brain" is how a UB psyc hi atrist refers to the biochemi, cal tests for depression that he is developing. U riel Halbreich, M.D., says the safe and reliable blood test represents significant progress toward diagnosing this widesp read psychiatric ailment . 4 Tropical Medicine • In three related articles, a trio of UB associated physicians relate their experiences with medical ca re in tropical environments. Dr. Joseph Molea tells of time spent with a medical mission in Ecuador ( Page 4 ). One need only visit the tropics to be quickly snapped back to the earthy reality of how poorly many modern medical solut ions apply to most of the rest of the world, he notes. Dr. Richard V. Lee recalls the adventures in med icine that have taken him from Vie tn amese refugee camps in Thailand to the Himal aya mountains, to a Sioux Indi an reservation (Page 7). Fin ally, Dr. Samuel Lieberman recalls his expe, riences with the first M.A.S.H. type units in the Pacific Theatre combat zone during World War II (Page 10). 1 Touching • The soph istication of medical technology has tended to diminish appreciation for the potency of human contact in medical care. The act of laying on hands can still contribute immensely both to spir itual and co rporeal health, writes Dr. Richa rd V. Lee. HOSPITAL NEWS •1 7, 26, 29 Gent•ral Krueger, ch11 ff for Gen. Douglas MacArthur, au,ards Lcgwn 01 Merri to Dr. Samuel Lieberman, Luton, Philippine,, I 945. For an account of Dr L,cbcnnan's scnicc with M.A.S.H. units in the Pacific Theatre during \Vorld War II, sec page JO. RESEAR C H • 22 With all the billions of dollars the United States has spent fighting cancer, why is there still no cure? ON GETT ING S HOT AT • I 9 Guns arc just ALUMNI too damn final and unfor• giving to be ignored as an issue by physicians, writes Dr . Lawrence Beahan. MED I CAL SC HOOL NEWS • 26 PEOPLE• • 25 30 CLASSNO TE S • 35 �2 ((A WINDOW INTO THE BRAIN window into the brain" is how a UB psychiatrist refers to the biochemical tests for depression that he is developing. Uriel Halbreich, M.D., says the safe and reliable blood test represents significant progress coward diagnosing this widespread psychiatric ailment. Not only is the test relatively accurate, but it promises to be one of the first tests that is essentially non-invasive, safe, and inexpensive for different kinds of depressions. It is also convenient for the patient since blood drawings take place only during the afternoon, require no hospitalization, and permit the patient to move freely during the procedure. "It is clearly an efficient and elegant technique," Halbreich comments. The professor of psychiatry performs the test by measuring certain chemicals in blood samples of patients. One of the primary chemicals he analyzes is MHPG, a metabolite of the brain neurotransmitter noradrenalin. MHPG levels reflect changes in noradrenalin activity of the brain, which is closely associated with depression. If M HPG levels are abnormally high or low for the age of the patient, this reflects various abnormalities of the brain. Levels of another hormone, cortisol (regulated by noradrenelin), have also been found to be elevated in some depressive patients. Along with clinical interviews, measurement of M HPG and cortisol in the blood are now valuable tools in diagnosing depression, Halbreich states. Halbreich believes that the biological tests that are developed from his findings are likely to become an essential part of diagnostic procedures in psychiatry. His approach will lead to a psychiatric diagnosis chat will be based on a combination of clinical symptomology, pathophysiology, genetics, and treatment response. Halbreich discovered that just a single plasma drawing from one to four o'clock in the afternoon could accurately repres- Spring '87 BY BRL'CE S. KERSHNER ent levels of cortisol and MHPG over an entire 24-hour period. His research turns the afternoon continuous test for cortisol and MHPG from an experimental procedure to a clinically reliable and replicable one. "This is now a blood test that is simple, inexpensive, and practical. Previous methods, for example, required 24-hour blood samplings, cumbersome samplings, and less accurate urine or riskier spinal fluid taps." Halbreich began his work to devise tests for depression in 1982. In the late 1970s, the dexamethasone suppression test was claimed as the first specific test for depression. It became widely used until experience led to disillusionment. Physicians discovered that rhe test was not helpful and too general since it often showed positive not only for depression but also for weight loss, alcoholism, schizoeffective disorders or even unspecified stress. Use of the test is being disbanded with no substitute. Halbreich 's test is part of a battery of reliable and practical tests that are currently being developed. albreich and others have identified three variables that are manifested in the afternoon continuous test and must be accounted for in any test for depression. First, M HPG levels increase with age. Halbreich adjusts plasma MHPG levels for this variable. Second, depressives don't just differ from normals by having abnormal levels of MHPG; they have euher abnormally high ( 60%) or abnormally low levels (25 % ) for their age. While Halbreich has not found any convincing clinical differ ences between these two subgroups, they are different in their pathophysiology, and hence in their treatment response. The choice of treatment for those with low MHPG levels should be different H BUFFALO ~ i.' Ll...£ Nj from those with high levels. "High M HPG levels, however, might be more difficult to treat," the Israeli-born scientist remarks." We are looking for an appropriate treatment for that group." The third variable is diurnal rhythm. Halbreich found that depressives often have MHPG peaks offset from normals, either coming on earlier or later. Normal peaks occur in the early afternoon. He suspects that abnormal diurnal rhythm of noradrenalin might be as important as abnormal quantities of that neurotransmitter. This is another factor that will be tested in future research. Halbreich just completed testing of 340 patients to identify other correlations. He is seeking to find out if different depressive states across diagnoses share similar physiological conditions that relate to cortisol and MHPG. He is also correlating abnormalities of cortisol and MHPG with severity of certain psychological symptoms. For example, does low guilt feeling correlate with low levels of cortisol and high guilt feeling with high levels of cortisol? ls the diurnal variation of mood associated with elevated levels of cortisol? These and other psychologi cal factors are being quantified from indepth structured clinical interviews. Before coming to UB in I 985, Halbreich was a faculty member at Albert Einstein College of Medicine for 5 years, and previous to that, on faculty at the medical schools of Columbia University in New York City and Hebrew University in Israel. A native of Jerusalem, he earned his M.D. from Hebrew Univer sity Hadassah Medical School in 1969. He served in the military until 1972, attaining a rank of vice chief medical officer in the Israeli Navy. After his residency in Israel, he was also chief psychiatrist for the Israeli Navy. Halbreich has been honored with the Ben Gurion Award and another research award in Israel and the National Research Service Award in the U.S. • �3 BUFFALO JP1-1vs1¢1ANI Spring '87 �4 Or. Molcu u ,tit clt,ld, Tl'll m front of medical ,ara,an 1n Ecuador NEW WORLD ILLNESS /THIRD WORLD CURE BY JOSEPH MOLEA (M"86) W e practitioners of Western medicine speak proudly of new medical advances, devices, and other achievements made possible by modern technology and research. However marvelous these achievements may be, one need only to visit the tropics to be quickly snapped back to the earthy reality of how poorly many of these modern medical solutions apply to most of the rest of the world. The experience which, for me, best illustrated the problems associated with applying methods of modern medicine in Third World nations took place four years ago as l was beginning my medical education, some I 00 kilometers into the Amazon rain forests of Ecuador. A technological marvel known as the "Ecuadorian Pipeline" snakes through these jungles connecting the oil fields of the "Oriente" region with Ecuador's Pacific coast across the snow capped peaks of the Andes. The pipeline took Texaco ten years to build and paved the way for the country's membership in OPEC. It also opened this area co access by land. The pipeline brought with it settlers to mix Spring '87 with the indigenous populations of the region formerly isolated from the outside world. It also served as an anachronistic backdrop for an eye-opening lesson in health care. I had been designated as a "working visitor" to an American mission hospital in Quito. A medical caravan had been organized to one of the small towns which had sprouted up along the pipeline, each one naming itself for its distance down the pipeline from its origin at the oil fields. Our destination would be "Kilo metro 14." The team, under the direction of Ron Guderian, himself a Ph.D. in clinical pathology, consisted of one M.D .. two nurses, one student nurse, and myself. I was to be the "lab tech," a position for which l was aptly suited since we had virtually no lab, just an antiquated, monocular microscope and some glass slides. We were to provide basic medical care to the people who lived in and around "Kilometro 14" who had virtually no other access to care throughout the year. It was an exciting prospect for a budding, young medic like myself. Why not1 We had the cure, right? BUFFAID L..!.:E.Y _.i I £_ I ~ N Despite my sense of anticipation, before leaving Quito I confessed some feelings of inadequacy to Dr. Guderian regarding my role . He assured me that I would be equal to the task. He merely suggested that I "hang around" the hospital lab for a few days before leaving for the trip. When I asked for specifics, he quelled me with a quick gesture of his hand and promised to explain everything to me after our arrival. This seemed a tremen- �s dous vote of confidence for one as inexperienced as myself, but I deferred exploring other more obvious possibilities (like the need for "warm bodies") and wandered off to find the lab. e arrived at "Kilometro 14" a few days later, having left the mountains of Quito earlier that morning and rambled down the dirt road which parallels the pipeline the better part of a W day. Our "clinic" was to be the local church - a windowless edifice, smaller than you might expect, with four wooden walls, a concrete floor, and a corrugated tin roof. Most of the homes in the area still used more traditional building mate rials such as bamboo and thatch. We set about stringing rope at one end of the building and hung blankets behind which the doctor could examine patients in relative privacy. We then took the mirror BUFFALO ce:. -.:. V _ll~I AN ] off of the microscope and rigged it with a flashlight bulb and battery to make it functional inside the church. The "dental office" was set up inside our converted step van. Or. Guderian, a veteran of many such caravans, had learned to give mandibular nerve blocks, fill cavities, and pull teeth, a service for which the "campesinos" (local people) were willing to wait in the hot sun for days. By 8 a.m. the following morning the Spring '87 �6 sun was already blazing, and we were all ready to go. Approximately 50 people were already seated in and around the church watching us make our preparations. Dr. Guderian began to show me how to analyze the samples of stool: a glass slide; a toothpick; a particle of stool, moist from inside of the bolus. Smear the slide. A drop of saline and a coverslip. Use both low and high power. His explanation took all of ten seconds. He was already halfway out the doo r by the time I collected myself enough to protest. "No stain?," I asked. "Don't need it. When you find something that doesn't look like stool," he said, "come and get me." I sat there fo r a moment staring at my make-shift table while the "campesinos," their numbers seeming to have doubled, sat staring at me as 1 prepared to examine their most intimate byproducts. Then I dutifully made my first slide and placed it on the stage. I looked through the oculus and tried co focus on something tangible in the amorphous mass. It was just as nondescript as 1 had expected ... for about two complete turns of the centering screw! In that instant a speck of amber interrupted the gray ooze. I switched to the "high dry" lens and tried to get a better look. A yellowish, footballshaped object snapped into focus. An oblong delineation marked the center and two perfect circles decorated each end. I retrieved Dr. Guderian with a melodramatic flair and some cryptic statement about "have found something.•• ((T richuris trichiura," he announced. "Whipworm eggs; unfertilized." I noted the name and removed the slide from the stage. The next five specimens all had T. trichiura. So did th e sixth. But, instead of just re moving the slide as I had previously done, I happened to turn the centering screw one last time when, wonde r of wonders, a rounder version of the first ellipse appea red. I was up and back with Or. G. "Ascaris," he said after a glance, "Fertilized." The nexc five specimens all had T. trichiura and Ascaris . My next revelation gave me a bit of a start for as I Spring '87 adjusted the focus a slight movement caught my eye. "Strongyloides," went his explanation of the writhing cylinder, "larval stage." Thus, the morning proceeded. Lunch rime found me 50 specimens the wiser with Ancylostoma duodenales having been added to my list. After we had finished our cooked, unripened bananas and rice, Dr. Guderian asked me if I had found any Amoeba yet. I assured him that there had been none, asserting the "More medicine was not the solution. Public health was the issue. As I watched them leave, I thought my time that day might have better been spent behind a shovel than in a laboratory.'' full weight of the morning's vast experience. He, in turn, assured me that there had been and invited me along to see. Back at my table he picked up the next slide and prepared it, placed it on the stage, and began to examine the specimen. The delay was just long enough for me to begin co taste victory. Then he motioned for me to examine the field. At first I saw nothing; no remarkable colo r or movement. Finally, I noticed a seemingly perfect circle floating lazily through the microscopic debris, its geometry the only notable contrast with its environment. "It's the cyst form," quipped the doctor. "They're a little hard to find." The afternoon added even mo re players to the cast of my endeavor to identify the resident pathogens of "Kilo metro 14." Gia rdia lamblia was easily identified with its distinctive resemblance to a ten- nis racket with a pair of crossed eyes on the paddle. The tear drop-shaped, flagellated Chilomastix mesnili playfully turned somersaults, somehow hinting at its nonpathological role. Balantidium coli, its cilia beating vigorously, churned through its fetid environs. Taenia solium and saginaturm eggs made their appearance with their angry scolexes armed with poised hooks. One hundred and ten samples by the end of the day. One hund red positives. More organisms than I would ever again identify in my medical school career. We treated everyone who was symptomatic; protozoa! infections \\'ith merronidazole , intestinal hel minthes with piperacillin. Most patients received both. A rather productive day I thought. ((T hey'll all be reinfected within two weeks," said Or. Guderian as -he at dinner. I sat dumbfounded explained that in these parts, while the fecal-oral route was certainly well traveled, the path co the latrine was virtually uncharted. "They don't even dig them," he said. "They use their fields. You can't change habits with medicine." That evening we showed a Walt Disney cartoon film to the people of "Kilometro 14." It depicted two neighboring peasant families amidst their homes and garde ns. One family was dirty and sick. The other family was clean and healthy ... and had a latrine. The "campesinos" watched and laughed with obvious delight at the lighthearted parody of themselves. When the film had ended I watched them as they p repared to return down the pipeline to their homes and wondered if the crowds would be any bigger at the latrine the next day. I also reminisced about the events of the day; how much I had seen through the lens of my microscope, and how little effect the medications we gave would eventually have. More medicine was not the solution. Public health was the issue. All else was folly. And I thought, as I watched them leave, chat my ti me that day might have been better spent behind a shovel. • Dr MOleo 1sc uuently o hrst -yea , reStdent at Episcopal Hospt101 pt) , ode1 p~o Po �7 MEDICINE AS AN ADVENTURE Traveling the world, Dr. Richard Lee likes to do, not just see BY JONATHAN edicine is an adventure, even on Park Avenue," says Richard V. Lee, M.D. But Lee's adventures take him far away from the "Park Avenue"-type setting to which he refers. Treating Vietnamese refugees in Thailand, in fact, is about as far away from Park Avenue as one can get. In the fall of 1979, Dr. Lee received a call from a Jesuit priest at Georgetown University asking him to go to Thailand and set up a program to train medical students and housestaffs in refugee camps on the Thai border. The situation in 1979 was that the C. PULLANO Thai government was granting temporary asylum to those people who were fleeing from the Vietnamese. From October I 979 until early l 980, al most 200,000 people crossed over the border into Thailand. (CCSDPT Handbook: Refugee Servi ces in Thailand, 1986.) In April l 980, Dr. Lee went to Thailand to set up one of these camps near Nong Khai. "When I left, l didn't know exactly where l was going. We flew into Bangkok in the middle of the night. l had to land the plane (a 747 Flying Tiger) myself." Once in Bangkok, he was sent by the Catholic Relief Services (CRS) to Nong BUFFAID jPHv51¢1 AN 1 Khai to investigate the area. "We had to travel at night because it was too dangerous to travel during the day. We went across the river to Nong Khai. I stayed in a house on the river where I could hear shooting at night. Whenever we went back to the camp in the morning, we would find wounded and dead. There was malaria, measles, tuberculosis, and death all around. The survivors were shipped to other camps which were equipped with hospitals." After six weeks, Dr. Lee returned tO Bangkok and wrote a report to submit to Georgetown University and the CRS to formally institute a program to train doc- Spring '87 �8 tors for refugee diasters. This program, now known as the University Volunteer Internship Program, sends fourth-year medical students to Thailand to volunteer their services for six to eight weeks. The program trains doctors to work under the adverse and even primitive conditions of these refugee camps. Lee serves as UB coordinator of the program which is administered at Georgetown. His involvement guarantees placement for qualified UB medical students. "The program is an eye opener for medical students," Lee says. "They get to see medicine like it was 100 years ago. Clinical decisions are made purely on the basis of your ability as a physician." Lee said that the students learn that "being a physician doesn't mean surviving by the use of your equipment. Medicine at these camps is quite different than at ECMC. The students have to rely on their ability to do a physical examination." s an observer, Lee is quite taken with the refugees that he has met. "These very tough people are survivors, and I admire them." The most recent of his travels led him to India, where he hiked through the Himalayan Mountains. He also was invited as a visiting professor and guest lecturer to the Sher-I-Kashmir in Kashmir, India. "When I was hiking in the Himalayas, 1 found isolated valleys of people with their own isolated health problems. We went into these valleys and vaccinated them against tetanus." He notes that in the U.S., we don't consider tetanus to be a serious health problem, but in the Himalayas, it is. "I would like to figure out a way to A Tib<'tan Spring'87 Buddhist monk, \1•·asln taccinc research, X, i ,, !rans, Bra~il. organize a medical trek of students, faculty and housestaff to spend a few months in the Himalayas to treat these people and also vaccinate them against tetanus." ee's experiences with non- Western cultures started shortly after graduating from Yale Medical School in L Ladal 1964, when he took two years off from his residency to work on an Indian reservation in Poplar, Montana. "I was a surgeon at the Fort Peck Indian Reservation. I worked with Sioux Indians and another tribe whose name, when translated from their language, means 'Big Bellies.' It was this experience Ladakh, patnarch BUFFAID J:: ~ y T ~ I .!J._ N_] �9 that sparked my interest in other cultures and the isolated diseases related to these groups." Lee then spent the next year in private general practice in Chester, Montana. "[ was one of three doctors in an area the size of Connecticut. People came from miles to see me. I did a lot of appendectomies and deliveries. It was an experience that most interns don't get." Because of Dr. Lee's work with Indians in Montana and his background in infectious disease research, he was selected to participate in a 1972 study of diseases among certain lndian tribes in Brazil. "These tribes were so isolated that they rarely contracted any infectious diseases, such as measles. When such a virus arrived, everyone would contract it, and there would be a high death rate. "We tested a new measles vaccine to see how long it would last. These isolated tribes were perfect for testing because we could go back 12 to 18 months later and check their progress. My last trip there was in 1984 and the vaccine was still working." Lee's interest in these tribes could not be described as purely medical. "As a third-year medical student, I became fascinated by othe r cultures. Our own culture is only one small segment of humanity. I think physicians should know as much about other humans as poss ible. Lee came to UB in 1976 as vice chairman of the Department of Medicine and served for three years. Besides being a professor of medicine and pediatrics at the Medical School, he serves as the head of the Department of Medicine at Children's Hospital of Buffalo and as chief of the Division of Maternal and Adolescent Medicine for UB's Department of Medi- cine. He is also an aviation medical examiner and a consultant in internal medicine for the New York Zoological Society at the Bronx Zoo. His many professional honors include the Student Teaching Award at Yale School of Medicine, UB's Housestaff Teaching Award, known as "The White Coat," and fellowships in the American College of Physicians, the Infectious Diseases Society of America, and the Amer ican Academy of Family Practice. Lee is a reviewer for theJournal of lnfeccious Diseases, JAMA, and seven other journals. His journalistic duties include being consultant editor for both the Amencan Journal of Medicine and Human Sexuality. He has authored over 100 technical papers, chapters, and other professional articles, as well as 60 essays and editorials, most as a monthly columnist fo r the American Journal of Medicine. Read one of Dr. Lee's essays on page #15. riting is my passion - I like to write," Lee says. "I feel that it is valuable for doctors to improve their writing skills, and to write more often. They should not restrict their writing to scientific papers, but should also write for the people they treat and not just other doctors." Lee considers himself a believer intraditional medicine and this idea is reflected in his writings. But some of his colleagues think these traditional ideas are "too conservative" and consider him a "dreamer" searching for utopia. With all of his duties and research, it is hard for him to find time to write, but somehow he manages to keep a diary. "I do considerable writing at four o'clock in the morning. [ also writt: on weekends and whenever I am on a plane. Intercontinental flights are long and tedious, and writing helps me kill the time." Although Lee presently engages in human research, including studies of the medical complications of pregnancy, the effects of parasites, and the effects of diabetes on pregnancy, his research is not limited to humans. He is currently involved with a study of gorilla colonies at the Bronx Zoo and the Buffalo Zoo concerning the presence of a virus known as HIV (Human Immunity Virus) which is much like AIDS. His research goal is to develop an antidote for HIV. Lee says there are two cases in the Buffalo Zoo with a related virus. "I got interested in gorillas when l was at Yale during a discussion with one of my professors. I compared working in an emergency room to being in a zoo and he asked me if I would like to make rounds in an actual zoo." Returning to the tropical medicine projects that take him traveling around the world, Dr. Lee sees himself as more than a tourist. "I don't like just to see things, I like to do things. That's what is great about being a doctor, you can do something. You might not be able to cure a person, but you can always find ways to benefit him." When asked where his next travels may take him, he responded "Australia or Antarctica. Those are the two continents that l haven't traveled to yet. There are some very interesting cultures and settings there that I would like to study." Throughout Dr. Lee's explorations, he is not just a spectator, but a participant in cultures where 20th century Western medicine remains a foreign concept. • Rcfug,c morha and child, Thniland. Ref ugec camp staff. Thailand. BUFFAID (PHYS•¢~ Spring ·s7 �10 THE FIRST M.A.S.H. UNITS Anesthesiologistrecalls WWII combat surgeryin the tropics ( Abot·c) Paticnrs who.~e tvo1mds need, or,e:ratwn tl'eTC brought into this surgical dugoul on Bougainv,lle, 194 3. (Larger photo) Members of a surgical lt•am al the clearing station on Bougamt ille, puparing u oundcd soldiCT (or opCTatwn, 194 3. BY BRUCE S. KERSHNER oday's anesthesiologists practice their profession in air conditioned 0. R. 's, with sophisticated monitoring systems and state-of-the-art narcotic agents. However, at least one UB anesthesiologist remembers what it was like during the dark days of World War II to work under tropical heat and humidity without the use of gas machines, oxygen, or whole blood, and limited to the anesthetic choices of drop ether, spinal, or intra venous . Or. Samuel Lieberman, clinical associate professor of anesthesiology, served in the Pacific Theatre from 1943 to 1945 as the only anesthesiologist member of an advanced surgical unit, that is, a mobile operating room located in the combat zone itself. What was unusual was that it T Spring '87 was the first ti me such a concept was practiced in a war. "It was the first radical surgical attention in a military situation in which skilled personnel and equipment were all brought up to the fo rward areas (front lines), close to where the injuries occurred," notes the former U.S. Army Medical Corps captain, who was a member of one of only a few such teams in the South Pacific. "We were actually the first 'M.A.S.H.' units ( Mobile Army Surgical Hospitals)," he said, referring to the popular TV show by the same name. "Before that, physicians and technicians of infantry battalions performed only first aid at the front line. Casualties had to be evacuated to remote rear areas, away from combat, where adequate skilled personnel and facilities ��12 existed," Dr. Lieberman notes. Mobile operating teams in the combat zone did not appear until World War II for two simple reasons. It was not realized until then that a now-basic principle should be applied to military situations, the principle that the quicker the surgical care, the less shock, pain, infection, and mortality. Second, the actual mechanics of assembling such a mobile operating room had never been done before. Dr. Lieberman played a pioneering role by devising the first guidelines for the o rganization of an anesthesia section of a medical ba ttal ion servicing an infantry division. In a May 8, 1944, document, he introduced his outline of the mechanics of such a battalion by noting that "heretofore, medical battalions in this theatre have not had an organ ized section in Spring '87 anesthesia." r. Lieberman recalls what it was like before the first "advanced surgical units" were created. "Evacuation of the wounded was a difficult problem in the South Pacific Theatre. Theatre. There were no roads, no helicopter evacuation.Transportation was by stretcher bearers through jungle ter rain to off-shore ships. Besides the fact char these ships were nor hospital ships equipped for major surgery, the ships were also targets for enemy planes." These difficulties made it soon obvious that early medical care should be emphasized. "Our surgical team consisted of a neurosurgeon, a general surgeon, an orthopaedic surgeon, and an anesthesiologist, represented by myself," he continued. D BUFFAI.D [L H V S I °y CF] "Our neurosurgeon was recruited from the johns Hopkins hospital unit stationed in Fiji, while our general surgeon was recruited from the Yale University hospital unit in Auckland, New Zealand. I was from the 43rd Infantry Division on New Georgia Island, Solomon Islands. A 30man team of male operating room technicians was also drawn from these hospital operating rooms. Our first assignment was to join the 39th Infantry Division at Guadalcanal for the invasion of Bougainville. "Usually, our operating table was the same stretcher which brought the wounded soldier to us. During surgery, this stretcher was supported by up-ended medical equipment wooden boxes. I was often responsible for administering anesthesia simultaneously to several patients. Anesthesia �13 (Clocku m· from iop l.f1) Surgical unil a11achcd lo l 03rd lnfcmlrv Regimen! on l\:cwGuinca, 1944. Vieu 1hrough doorwcn of a surgical icam al uork ,n a duguu1 shell<'T 1111 Bougaintille.japanesc f,a11c111in Solomon Island, being udmmislL'TeJ ,1ernal infusion of pe111111hal. Closeup of a spcciallv cquipt1t•d an1"s1hesi<1box, Lu~on, 194 S. consisted of Pentothal, local, regional, spinal, and, later on, continuous spinal anesthesia. I secured the malleable Lemmon needle from Pilling Co. in Philadelphia and improvised a continuous spinal mattress. Continuous spinal was consistently an excellent anesthetic." The UB alumnus (B.A., 1934; M.D., 1938) retired from practice in 1983, after serving as chief of DeGraff Memorial Hospita l's Department of Anesthesia for 35 years. He is a Fellow of the American College of Anesthesiologists, a diplomate of the American Board of Anesthesiology, and a member of numerous medical organizations. Besides being a pioneer in military surgical care, Dr. Lieberman was one of the ea rliest to promote ·md demonstrate the effectiveness of intravenous anesthesia using pentothal sodium for combat zone surgery of war casualties. Until 194 3, it was still contended that it was too dangerous. ln his 1944 Anesthesiology article, Dr. Lieberman showed that it was a preferred alternative to open drop ether. Of cou rse, these "primitive" alternatives have been replaced by much more effective agents of the 1980s. r. Lieberman's memories of those challenging times were revived recently when he read a Ne« • York State journal of Medicine Uan. 1986) article that portrayed one doctor's photographic history of a WWil portable surgical hospital in the South Pacific. " I was surprised when it claimed to be the only thoroughly photo-documented account of those surgical units, even though few of the arti- D cle's photos showed actual surgery at the front line. I quickly went to my files and pulled out my photograph collection." A sampling of that historical record is shared here, and, with one exception, none has previously been published. Because of his unusual service, Dr. Lieberman was awarded the highest commendation or medal that the U.S. Army can award a medical officer, the Legion of Merit. Today, the principle of earliest possible surgical care for a wound is axiomatic. While helicopter evacuation and technological advances have radically changed military surgery, the mobile surgical teams that Dr. Lieberman played such an early role in developing will probably always be an important component of combat zone medical care. • Spring '87 �Spring '87 BUFFAID IPMvs1¢1AN] �15 Touching Modern technology has tended to diminish the potency of human contact in medical care BY RICHARD he sophistication of medical technology has tended to diminish appreciation for the potency of human contact in medical care. In primitive and ancient medicine, the touch of the priest, shaman, or healer had magical effect. Not so very long ago scrofula - "the king's evil" - was treated by being touched by the king. The act of laying on hands still can contribute immensely both to spiritual and corporeal health. Dr. Lewis Thomas in his book The Youngest Science: Notes of a Medicine Waccher observes that touching is medicine's oldest professional technique. He stresses that sick people need to be touched, and part of the misery of being sick is being cut off from others. Sickness can make people feel like outcasts unattractive, possibly contagious. The common tendency is to shun the sick. One can see how the touch of the trusted physician might have almost redemptive value. Unfortunately, Dr. Thomas points out, the art of human touch is being dropped by the modern physician, who is evolving into a brilliant but remote interpreter of charts. The detached, scientific approach is rather in keeping with the distrustful independent spirit of our times. Walk down a city street and watch how people move among fellow beings avoiding all contact. Touching is unpleasant. Purses are held protectively and the wallet pocket is quickly checked after a brush with another. Unrequested touch, even by a Samaritan or a physician, may be pursued by zealous lawyers as assault. And, in the T V. LEE. M .D. odd way that science at different times tends to support social attitudes, threats of nosocomial infections, herpes, and acquired immune deficiency syndrome serve to exaggerate the dangers of being touched. Isolation has come to have therapeutic and protective connotations rather than indicate cruel segregation of the sick. In contrast to urban societies, many primitive tribes relish touching. In an Indian village in the Amazon Basin each woman has children sitting with and on her, or at the breast; young men hold hands or sit so they are touching; children grasp the hand, arm, or leg of any nearby adult; dancing is often done with everyone holding neighbors' arms and waists (while American youth dance u•i1hou1touching!). Touching is communication, symbol, and solace; a fundamental property of being alive. sic primate studies of Dr. Harry Harlow, in which adequately fed monkeys who were dep rived of tactile sti mulatton of mothers or playmates became socially withdrawn, sexually inept adults, underline the importance of touching in development. Monkeys given wire dollmothers suffered ill effects, while those with soft cloth doll-mothers to which they could cling were normal -which reminds us of "security blankets" our human children cling to. These "transitional objects," as psychiatrists term them, fortify the child on the difficult trip from Mama's cuddles to lonely independence. Lack of touching among humans may produce psychologic and social pathology in dimensions as yet unknown to us. It seems especially important fo r medicine, the trustee of touch, to maintain a lively interest in touching. 1ving things have a profusion of specialized organs and organelles to feel and to touch. Among syncytial creatures, the capacity to feel and identify collegeal cells is essential for existence. For a ciliated protozoan, dis ruption of the cilia - the organelle of touch and locomotion - is rapidly fatal. Among young humans and primates, absence of touching is devastating - even when all nutritional and life-sustaining needs are met. The psychiatrist Rene Spitz found that infants raised in an orphanage under good hygienic conditions, but impersonally and without tactile stimulation, gradual! y wasted and died, or became irrevocably mentally defective. The clas- T L BUFFALO s L..L[_f t C I A N _] he evolution of medical touching begins with the essen~ial caring that propels one to be a physician, to which must be added the awareness of the sy mbolic power of touch to communicate and to share. Touching recreates a syncytium: a merging, a reassuring sense of intimacy and community. Touch ing was recognized early on to have restorative and comforting powers. The science of medicine began to shift the emphasis of medical touch from magic to information gathering. Physicians touched patients not only to convey solace and communion, but to find out how tht: body was altered. Hippocrates shook patients to hear the splash Spring '87 �16 of fluid in cavities, and felt for the spleen and body temperature. The development of objective clinical techniques initially emphasized direct contact between the physician and patient. Leopold Auenbrugger struck the chest of consumptives with his fingers in order to assess the contents of the lungs just as he had struck the wine barrels owned by his father's business. During the course of the usual examination, the physician had to touch the patient, and in that touching the physician conveyed the comfort of shared concern and of wisdom. For the patient there was magic still in the laying on of hands. The decline of "the magic" in the doctor's touch began when Laennec fashioned a stethoscope to avoid touching his ear to the chest of a fastidious young woman. For the past 200 hundred years, technology has fashioned increasingly precise and useful devices which physicians can use to examine the human body without having to touch it. As medical practice has become more technically oriented, physicians have become increasingly separated from their patients. In contrast, a surprisingly popular profusion of hands-on healers ( touchers) have emerged. Chiropractors, physical therapists, massage therapists, and faith healers have moved inco the void that ailing humans feel modern medicine has created. The success of these practitioners of touch attests to the need our fellow humans have for this primitive and uni versal ingredient. This need was poignantly described by a physician-cancer patient, Dr. Fitzhugh Mullan, in his book Vual Signs. At his lowest ebb a psychiatrist listened to his toubles and, without preamble, asked if he would like to be held." My native embarrassment at being held by a man was totally overcome by my desperation. His sense of succor was so spontaneous, generous, and accurate ... " Dr. Domeena Renshaw, in an article "How Physicians Cope with Dying Patients" (Chicago Medicine, Jan. 21, 1979), writes, "Prescribing physiotherapy - regular backrubs - may be of far Spring '87 more importance than preventing bedsores, since they may provide for a few minutes, twice a day, sustained human touch which can give much emotional reassurance. Quiet hand-holding, a pat on the shoulder ... can be of comfort even to a drowsy patient, as many have later reported when lucid." In this vein, a number of programs have been reported in which puppies are brought to children confined in hospitals, to the isolated elderly in nursing homes, and to the hospitalized mentally ill. These visits facilitate rehabilitation and combat depression. "Observations of people stroking their pets could mean that animals provide an outlet for an innate need to touch and fondle" (Article in The Sm11h.1onian,July 1981 ). Dr. M. H. Hollender, professor of psychiatry at Vanderbilt University School of Medicine, along with a number of coauthors, has conducted several studies of people's wishes to be touched and held. He has found that people in a variety of situations - men, women, mental patients, pregnant women - have strong longings to be held or touched by another. Dr. Hollender writes, "The wish to be held .... is likely to be intensified and to become a relevant issue in the treatment of anxious or depressed patients." Subjects repeatedly said that being held provided security, protection, comfort. Some so desperately needed the touch of another that they would trade sex, which was not desired, just for the opportunity to be held. Patients made remarks such as: "Sometimes I just need a pat on the knee ... a rub down the back or a tussle of the hair." " ... being held makes me feel more secure, as though I am not alone. And just the fact that somebody cares about me enough ... to be considerate and gentle with me when I feel this way is enough to give me some hope to go on and get through the moment." "It makes me feel safe, like nothing is going to happen to me." Others had the insight to link the wish to be held co childhood: "Why does a child want to be held when it cries? It is BUFFAID ED CU :!. .1._!_J;_ - ~ held and it doesn't cry anymore ... maybe something like that just stays with you." "Pre verbal children will crawl and stumble for a while and they will come to their mother to be held and then wander off, like their battery has been recharged . Adults do this too." "It is very important for me to be held ... Especially when I am upset and feel all alone. I have to be held and told that everything will be all right - just like a baby. I have to be held." icrocomputers have not changed the fundamental isolation ofillness and they have not the power of touch. Only another living thing can touch us. The communion of two living creatures through touch carries on the inexpressible hope for the human community and for life itself. Medicine and religion have been relatively protected from the proscriptions to physical contact which aesthetic, legal, and moral trends have produced. That protection appears to be eroding. Nevertheless, contrary to popular notions, the modern practice of medicine need not be lacking in touch. Touching remains a fundamental tool both for feeling the patient and for the patient feeling helped. In diagnosis, pitting edema is otherwise indescribable and hard lymph nodes still mean tumor until proven otherwise. Cold, clammy skin and a thready pulse regularly make me anxious for the well-bemg of my patient. Touching patients, beyond the perfunctory handshake, transmits the physician's concern and willingness to risk contagion and litigation for the wellbeing of the patient. When all else fails in caring for the sick, I find I instinctively return to fundamentals - co touching. Perhaps contemporary physicians should explore the possibility that the fundamentals will enhance the potential of sophisticated technology. Perhaps by touching more, and more effectively, there will be fewer failures. • M (Rep nnted wu h pe rm ,ss,on from Phys1c1 o n & Pot1en1. July 198 3) I l i �17 Hospital News I New anticancer drug holds promise I i T he term ara-CDP-DL-PTBA may look like an indecipherable cryptocode, or a string of random letters afloat in an alphabet soup, but to a handful of Roswell Park Memorial Institute scientists, these letters represent one of the most promising anticancer drugs to be developed in years. A compound derived from the drug cytosine arabinoside, ara-CDP-DL-PTBA was developed by Dr. Chung I. Hong and his associates in the lnstitute's Neurosurgery Department. Dr. Hong is an assistant research professor in UB's Roswell Park Graduate Division. Although presently confined to the laboratory, this new compound appears to be substantially more effective at a lower dosage than its parent compound, ara-C, or any ocher ara-C derivative against leukemia in animals. Not only has the compound proven effective, but it has eliminated many of the drawbacks associated with ara-C administration. "Cytosine arabinoside is highly effecttve against leukemia, but it must be given continuously," explained Dr. Hong. "Its half-life (how long the drug stays in the body) is less than five minutes and then the drug decomposes. Even before the drug reaches the cancer cells, it either disappears or converts to an ineffective compound. Continuous administration is the only way that ara-C can be effective." Several researchers have tried to modify the ara-C in order to maintain its activity; but by doing so, they have run into an even greater problem. "These modified compounds are unsuitable for administration," said Dr. Hong. "They will not dissolve in water and that is the only way they can be injected into a patient." Dr. Hong and his colleagues Alex Nechaev, David Buchheit, and Alan Kinsits began experimenting with various compounds to determine which would best protect ara-C from decomposition during transport to the target site. Lipids seemed to be the vehicle. Lipids, which compose the body's membranes, are important molecules for any type 9 --9 -86 BY COLLEEN M. KARUZA of biochemical reaction. According to Dr. Hong: "I had the idea that ifl combined lipids with a nucleoside drug (in this case, ara-C), I would have the most expedient method of drug administration." D r. Hong and his laboratory staff con cocted several different batches of lipophilic compounds until they made the fortuitous discovery that one batch had its own unique, biological activity. That compound was ara-CDP-DL-PTBA. "Not only did this compound have the potential to protect and transport the parent compound, bur BUFFAID L.LB _L[ CD..10 _"!_ it looked like it possessed its own anmumor and immunopotentiating activity," said the scientist. These acttvit1es translate into several biological wonders, such as cancer cell necrosis and metastatic arrest. The Roswell Park researchers tested their compound against leukemia in mice. Only a single injectton was required; in contrast, araC had to be given continuously for three days. "The poor mice couldn't budge," said Dr. Hong. The ara-C mice survived 14 days, twice as long as the control group animals who were not inoculated. All of the ara-CDP-DL-PTBA mice survived 27 days, and three-quarters survived more than 30 days. "Of course, we are talking laboratory research," said Dr. Hong, "and yes, we arc presenting data from animal models. But we can't overlook the importance of this preliminary research and its future implications." If the drug survives the battery of rigorous toxicology and pharmacokineric tests headed its way, it will be subjected to clinical trials. It is here - in the clinic - that the drug's applications will be clarified. However the drug's initial promise, said Dr. Hong, is still cause for optimism. Within the Roswell Park laboratory, the lipophilic compound has demonstrated a significant antitumor activity with long-term survivors. The formulated solution, in water, has remained chemically stable during refrigeration and has retained its antitumor activity over a period of four months. It has a significantly longer half-life than that of ara-C, and it interacts with blood lipoproteins which may play a possible role in target-specific delivery of the drug. Lastly, the compound does not have to be given continuously, and only one injection is required. Dr. Hong said that several pharmaceutical companies have expressed an interest in his compound, and its formula was recently issued a patent. "We have a long way to go," noted Dr. Hong, "bur we are more than a little encouraged with our preliminary data. This compound has generated much excitement and, at this point, we are confident." • Spring '87 �18 have always ltkeJ guns, pamcularly rifles I love the ru.:h wooden srncks, the -.mell of gun Oil, the ~nap and clack of a \\ell oiled acuon, and the -.hiny spi ral bore of the barrel. My associations with them were to my <lad's stones of his youth on the western edge of the Ad1rondach. He told of his dad and his uncles anJ brothers farming, logging, and hunting 1n what seemeJ to me an ideal adventurous way of life I gre" up on Henry Fonda tn "Drums Along the Mohawk," Gary Cooper in the "The Plainsman," and Tyrone Power as Jesse James Gun'> meant history, family, power, and manline s. My attitude toward guns was galvanized into '>omething more complicated and unsettling, however, when, on a fam- I PHOIOS OOUGIASlfVl Spnng'87 BY I.A WREN( E BEAHAN, M.D. (Cla ss o f 1955) BUFFAID f~y ,( 1A.N ) �19 ((ON GETTING SHOT AT'' my family's past and perhaps country's frontier. ily ski trip, my two young sons and I were shot at and held at gun point. My first childhood recollection of a gun was a percussion cap-fired, muzzle loader made in Belgium for use in the American Civil War. My great grandfather kept it over the door at his farm on Tug Hill near the Adirondacks. He called it his "rabbit gun" though it was about .50 caliber. When he died, great grandma gave it to my dad. When I left home, dad let me take it along. It hasn't been fired in at least 65 years. It is a long, heavy piece, but one of the nicest treats I could have as a kid was for dad to get it down and let me dry fire it. 1 used to need help to hold it up. My grandfather and his brothers did some logging west of C ranberry Lake. They moved into the woods with their families and a gang of men. Dad was born there. The women cooked for the lumberjacks, Uncle Barty supplied venison for the camp, and Uncle John made some money on the side by guiding "Sports" from the city. I have a copy of a grateful letter from President Taft's cousin praising the good food and hunting he found with them. I don't know much of rhe rifles they used there. he next one I remember was a Model 1892 38.40lever-action, 13-shot Winchester, "the gun that won the West." T In 1920 at l 6, dad was working as a hired hand on a farm on Pine Plains, now part of Camp Drum. On a Sunday he and a friend were hunting rabbits. They stopped in at an old timer's place to visit. Dad admired the Winchester over the door and jumped at the chance to buy it for $7. He kept that one carefully put away. He used it for a rare deer hunting expedition. I think he actually went hunting only three times after he was married, but the tradition remained strong in our house. When I was about IO he took my cousin and me out in the country "to hunt woodchucks." We each got to fire the Winchester once at a woodchuck hole rather than at an actual woodchuck. It made a terrific bang and much smoke . We felt like pioneers. Firing it was like pass ing an initiation. We were first shown how to load and unload, carry, clean, and store the rifle. We were told not to lean it where it might fall and damage the sights. Most explicitly, we were taught never to point a rifle, even an "unloaded" one, at anyone. The po int was made to us over and ove r that an awful lot of people were shot with "unloaded" guns. The Winchester is promised to my oldest son, passing me by. After a while I inherited an old "Franklin air gun." It took a lot of pumping before it could shoot a BB the length of our cellar. During World War II, we acquired a German Mouser single-shot, bolt-action .22. It is more heavily constructed than most. Its simple sturdy lines are pleasing and it is very accurate. This became my rifle. I used it for target shooting in my teens and once in a ve ry great while since then. My ownership of it is more of a concrete tie to the myth of BUFFAID s C N~J I p H y I I A. tO our At Maxwell Air Force Base they tried to convert me and I 00 other recent graduates of residency programs into military officers. Nor much of the program caught my interest except the opportunity to shoot the fabled Colt 45 automatic pistol designed for the Philippine jungle and use an M-2 carbine switched on automatic. I saw no war in my four-year peacetime tour in Japan. T his is about where I stood with guns until we went on that ski trip to Aspen, Colorado. My wife, Lyn, and our three boys (Teck, Jess, and Nick, then I 2, 10, and 8) flew tO Denver. We lugged along five suitcases and ski boots and poles for everyone. We rented a car and drove through the snowy mountain scenery to Aspen. I think it was on this trip that we visited Buffalo Bill Cody's grave. He was a hero of my dad and me. Dad used to read aloud t0 rhe family back in the days before TV. Stories of Buffalo Bill, Wild Bill Hickok, the building of the Union Pacific Railroad, and the Alaska gold rush were our favorites. Those images were dancing through my head as I found myself and my family actually "Out West." We stayed at a place in Aspen that had eve rything you could want. It was called the "Skiers Chalet and Steak House." They had delicious, big western steaks cooked just right. It was at the base of the old Number 1 single chair lift. The lift was memorable because it was equipped with cozy robes to wrap around you and keep out the wind. Behind the chalet was a swimming pool they kept at a steaming 105 degrees. It was a delight to heat up in the pool after skiing, then roll in the snow, impervious to the cold, and jump back in just in time. I have a picture of all three kids in mid-air or rather midsteam, about to splash back into the Spring '87 �20 nI was chilled and angry. My Wild Bill Hickok fantasy was to go back at night and blow his brains out. My conscious reaction was rM y God, I'm glad we got out of there alive.' '' water. Their nakedness reminds me of our vulnerability when threatened with actual gunfire. So we skied several days and then took a day off. We had seen posters advertising snowmobiles for rent in a nearby valley. It seemed an interesting change of pace so we went out there and signed up. Lyn and Nick decided to pass. Jess got on behind me and Teck rode another machine. The guy who ran the rental business assigned two girls to go with us making a party of four machines and five ride rs. He gave us straightforward instructions on where to go and we followed them. We went a cons iderable distance up a snow-covered, fence-lined road and then at the head of the valley uphill along a trail. The noisy, effortless motion over snow on a b right mountain day was fun. After a bit the snow got too deep for us so we headed back. Teck was in the lead, I was second, and the girls were behi nd. We heard a shot. We dismounted. l saw a man in a field at some distance from us. He had just fired his rifle in the air. One of the girls had made a loop into his field and he didn't like it. We were too far from him to be hea rd so I attempted to motion our intention to leave his Spring '87 started walking toward him. Jess wisely hid behind our machine. Teck followed at a distance to back me up. He told me he had thought of eithe r hiding or tak ing off on his machine, hanging over the far side, Indian style. I do n 't know what the girls did. territory. We got back on our machines and started to move. He shot again. I heard the shot and saw it make a chest high hole in the snowbank just ahead of me. We all stopped again. This time he held the rifle on me. I BUFFAID (PHvS1¢1 AN j he fellow was tall, skinny, dressed in dungaree jacket and pants. He had scraggly long red hai r, a bea rd, and wild eyes . He was angry and lectured us about the way snowmobiles had been tearing up his valley and had injured one T �21 glad we got out of there alive." In reflection, I am certainly glad none of us were ar med. If we had shown any resistance someone wou ld have been shot. We went direct! y to the sheriff and reported the wild man. The sheriff was not greatly impressed. He seemed to know of this fellow, and he promised to have a talk with him. That night we had dinner at Jake's. The theme depicted on the menu was of a claim jumping. There was a mine, a smoking rifle, and the upturned boots of a dead man. It was not amusing and did nothing to enhance my appetite. We all had had enough of the frontie r mentality and were ready to head back to civilization. of his dogs. I was apologetic, quiet, and polite. He pointed the gun down and away. I said we had intended to stay on the road and the trail; we were renting these snowmobiles and we would tell the owne r about the problem. Teck said I acted "nervous and just exactly r ight." Finally the man with the rifle said we could go. He gave us this admonition, "If you are ever in this situation again don't start riding away. The only choice that leaves me is to shoot you." We left. I was chilled and angry. My Wild Bill Hickok fantasy was to go back at night and blow his brains out. My conscious reaction was, "My God, I'm Though I still have a fond fascination for rifles, this brush with reality has greatly tempered it. I do not like it when my grandson playfully points a toy gun at me, though I can understand the impulse. I now have considerable sympa thy with the idea of rifle registration and limitations of access to handguns. These mythic coys can quickly and finally destroy fragile human bodies. The mo re of them that are around, the more hurt that can be done. et me cite some statistics. Jagger m the June 1986 issue of JAMA says that 45 % of U.S. households have firearms.1 Kellerman in t he Neu• EnRlanJ Journal of Medicme of the same month tells us the most common reason people give for having a gun in the house is self-defense. Yet on ly 2% of gun deaths have to do with defense against intruders . In cont rast, a gun kept in the home is 1.3 L BUFFAID L .!...IE:J IT.:E ~ J; 11 Firearm violence should be a primary public health issue. We physicians should take up arms against it just as we have against polio, tuberculosis, and cigarettes. Guns are just too final. ... " times as likely to kill someone accidentally and 37.0 times as likely to be used in a suicide as it is to kill an intruder. 2 Furthermo re, there are 200,000 casualties from gun shot incidents in the U.S. each year. This is second only to motor vehicle deaths. J Hand guns are used in 68% of su icides, 68% of homicides, and 92 % of accidental gun deaths. 1 It seems clear to me that firearm violence should be a primary public health issue. We physicians should take up arms against it just as we have against polio, tuberculosis, and cigarettes. Last year, I had two more crushing blows to the fantasy that I once had with guns - first with the shotgun suicide of a patient, and shortly after, the gun suicide of the son of a good frie nd. Guns are just too damn final and unforgiving to be ignored as an issue by physicians. • Bib li ography 1 McGorell Edmund, T Flanagan (Ed) Sourcebook of Criminal Justoce Stat,sltcs 198'1 US Dept of Just,ce 2 Kellermann. Arthur. 0. Reay "Protectoon or Pero!?An Analysis of F11eorm-Re1oted Oeolhs ,n the Home " New England Journal of Med,c,ne June 12. 1986 VOi 31'1 No 2'1. 1557-1560 3 Jogge r. J. P Dietz ·oeoth and lnJury by Firearms \Vho Cores?' JAMA June 13. 1986 Vol 255. No 22. 31'13. 31'1'1 Spring '87 �22 Research Billions Spent on ResearchWhy no Cancer Cure? W irh all the billions of dollars the United States has spenr fighting cancer, why is rhere still no cure? The Narional Cancer Institute, one of the National Institutes of Health, will get $1.4 billion in 1987 alone. Thar's an increase of $Z26 million over the previous year. Ir's more rhan NIH even dared ask for. Bur it's nor all that much, said Elliott H. Stonehill, Ph.D., assistant director of the National Cancer Institute. He was at UB recently at the second in a series of workshops offered by che Office of the Vice President for Sponsored Programs. "The amount of money we spend in one year won't build one damn baccleship," Stonehill said. Nor is it enough to launch one spaceship. He objects to the term "war on cancer" because that implies full mobilization of resources. But only a fraction is being spent on cancer, Stonchill said. In the last two decades, it's never been possible to fund 100 per cent of the grants chat are approved, he said. Fifteen years ago, the institutes funded about 50 per cent of the approved grants, and that was conside red excellent, Stonehill noted. In recent years, about ZS per cent were funded, and now it's back to about 30 per cent. A smaller percentage of proposals is being funded because the scientific community has increased and the budgets of proposals have increased, he explained. "The total amount and the quality are condensed at the top," Stonehill said. "The scienrific community is nor going to suffer." Conrroversy often surrounds how rhat money is to be used. Should it be used fo r basic research or research on treatments! Should anticancer agents de rived from the immune system be given priority over traditional chemotherapy drugs? "There is always some disagreement with the Cancer Institute on priorities," Stonehill Spring '87 BY CONNIE OSWALD STOFKO UB's Office of the Vice Pres ident for Sponsored Programs has more information. C noted. But each researcher's proposal is judged by his peers, he pointed out. If a su rgeon complains that not enough surgery is funded, it's because "surgeons are saying they shouldn't be funded," he said. Basic research is number one at the National Cance r lnstiture, he said, but research on treatment is also important. The institute doesn't put all of its eggs in one basket. "But it's impossible to get a community of more than two people to agree which basket gets priority," Stonehill said. "I think we make the best decisions we can under the available circumstances." The five areas of greatest research interest now are: ■ Recombinant DNA and hybridoma techniques. ■ Monoclonal antibodies for detection, diagnosis, and treatment. ■ Molecular genetics studies. ■ Biological agents in therapy (such as interleukin-2). ■ AIDS-related research. His advice to researchers here is to develop good research plans and submit them quickly. BUFFAID ) PMVS tCt AN ) ritics of the National Cancer Institute cite statistics that cancer deaths have increased 8 per cent since 1950. "The data do show that the rate of cancer occurrence has increased, and it's believed by many to be due to environmental influences," Stoneh1II said. These include things like smoking, asbestos, and radon. Ir also has to do with population densities, he added. As people move from farms to cities, they are exposed to environmental pollutants. And viruses may affect more people in a densely populated area. Bur a major reason for the increase in the occurrence of cancer is the increase in smoking. Young people are smoking more and women aren't quitting. 1986 marked the first time that more women died of lung cancer than breast cancer, he said. These are the women who started smoking 20 years ago . Somehow today's young people must be convinced of the dangers. "The problem is, how do we project inro young people rhe concept of death due to something they think is pleasant and innocuous?'' he asked. Another reason for the increase, in cancer 1s the dramatic drop in heart disease, Stonehill said. Since people aren't dying of heart disease, they're living longer and have a better chance of developing cancer. This increasing longevity in the nation keeps making it harder to ma ke headway against cancer, he noted. "Thar 8 per cent isn't as bad as it could be," Stonehill said. "It might be double that if we weren't as successful as we are." T he National Cancer Institute has a plan to cut the cancer rate in half by the year 2000, Sronehill said. Ir wants to reduce the number of deaths due to cancer and reduce the incidence of cancer. �23 Research To do that, the institute 1s trying to cut smoking 1n half by I 990, Sconehill said. The effect would be a 15 per cent reduction m deaths from lung cancer . Doctors don't always use the trea t ments that are available, Stonchill maintains, and correcting that would account for another 15 per cent of the goal. One reason they don't use the treatnwnts is th at they think they're being kind, he said. To save the patient the disturbing side effects, physicians may give less than the curative dose of a drug. "They think they're being kind because they save the patient two weeks of blet'ding and hair loss and cosr them their lives," he asserted. Another reason the physicians don't use the treatments 1s that they may not know they're available. For phys1c1ans who don't have enough t1me to keep up with their reading, there is a "Physicians' Dara Query" for computers that tells what protocol is appropriate and who the expert 1s in their neighborhood, he said. But many phys1c1ans don't have access to a computer. "And doctors don't like to refer their patients away," he said. "They treat what they don't know how to." Stonehill 1s aware that statemt'nts like that are bound to anger people. "But I stand behind those strong remarks," he said. The other ways the National Cancer Institute will try co cut the cancer rate in half are th rough nutrition, which Stonehill estimates will account for 5 pe r cent, and through new and experimental therapies, which he expects would account for another I 5 per cent. "I think this 1s feasible, realistic, and accomplishable, but it needs the efforts of a lot of people," he said. Progress is already beinl! made . "We're treating, even cu ring cancers for people under age 55," Stonehill stated, "so tht' death rares are going down. We're winning the battle for young people bur nor for people in their 60s and 70s." In children's leu kemia, cance r of the testes, and Hodgkin's disease, the survival rate for five years has gone from 10 per cent to 85 or 90 per cent, Stoneh1II said. He conceded tha t these aren't as prevalent as lung cancer o r cancer of the colon. "Bu t the 12 types that kill the most people have been reduced significantly in the past 15 yea rs," Stonch1II said. • BUFFAID J PH Y $ 1 C 1 )N j Sp rin g '87 �24 Hospital News LJ (!) z Q z 0 :; ;;; 0 5 l gc H. McCoy NEWECMC ADMINISTRATOR rie County Medical Center has a new administrator, George H. McCoy. He was selected as its chief executive officer in September, I 986, by the ECMC Board of Managers and NFHS, Inc., the firm contracted to manage the medical center. He will be employed by Vitalliance Management Services, the management division of NFHS, Inc. McCoy had served as first deputy commissioner of hospitals for Westchester County Medical Center since 1978. He gained recognition as its chief operating officer by nearly tripling its number of patient days, turning around its severe financial status, adding new facilities, and enhancing its reputation. The native of rural Virginia spent eight E Spring '87 years in the U.S. Army before earning his B.A. in biology from City College of N. Y. and his M.B.A. in health care from Baruch College. In 1963 he was hired as a neurology research assistant for Yeshiva University's Albert Einstein College of Medicine. He shifted to administration of the college hospital in 1969, including a time as its senior assistant administrator. He was deputy executive director of Kings County Hospital Center from 1977 to 1978 before heading Westchester County Medical Center. He was also on the part-time faculty of New York Community College and Marymount College for a number of years starting in the 1970s. Mr. McCoy's preliminary goals for ECMC are to "formulate a strategic plan addressing BUFFAID !P 1-1v $1C 1A N I the myriad issues facing ECMC, give full consideration to the terms of the NFHS contract approved by the County Legislature, maintain a close relationship with the Board of Managers, and establish community alliances." The ECMC Board of Managers, which helped conduct the 10-month long national search, is chaired by Kevin Sullivan, the vice chairman of Key Bank of WNY. Formed in 1985, the I I-member group includes its vice chair, Mary Anne Romanowski, and secretary, Paul Figueroa, City Court Judge. UB Vice President and Medical School Dean John Naughton, M.D., and John Armenia, M.D., UB clinical professor of ophthalmology, are among its other members. • l I �25 Alumni 11:00 7:15 Reg,srranon and Connnencal Bn,akfosr 8:00 WELCOME John E. Przy lucki , M.D. '73 President, Medical Alumni Assoc,anon Peter T. Ostrow, M.D., Ph.D. Associate Dean, School o( Medicine SUNY Buffalo Joseph L. Kunz , M.D. '56 Program Chairman ANNUAL SPRING 1 CLINICAL DAY I Medical Alumni Association State University of New York at Buffalo Continuing Medical Education 8:15 SUMMER - AN ALLERGIC ENVIRONMENT Robert E. Reisman, M.D. '56 Clin1cal Professor o( Medicine and PcJ,atncs, Departments of Medicine and Pediatrics, SUNY Buffalo School o( Mcd1c1ne To review the current physiology management o( common summer emergencies, in1unes and illnesses which any phys1c1an. regardless of c,alty, may become involved. and nme with SP<'- 12:10 D1scuss1on 12:20 Business Meeting 1:00 STOCKTON KIMBALL MEMORIAL LECTURE AND LUNCHEON Honored Lecturer: James F. Holland, M.D. Profcsso r and Chairman of Ncoplasnc Diseases. Mount Sina, School of Medicine; Director. Cancer Center, Mt. S1na1 Hospital. New York 40 YEARS AFTER AMETHOPTERIN 9:40 D1scuss1on 9:50 CONCEPT 11:40 SPRAINS, STRAINS AND OTHER PICN IC AILMENT S Edmond J. Gicew icz, M.D. '56 Assistant Clinical Professor o( Surgery, SUNY Buffalo School of Med1c1ne Team Physician, UB Sports D1scuss1on 9:10 WARM WEATHER WOES: THINGS THAT GO WRONG lN THE SUMMER 11:30 D1scuss1on 9:00 CUTANEOUS DISEASES FREQUENTLY SEEN IN THE SUMMERTIME Carl W. Ehmann, M.D. '67 Clinical Associate Professor o( Derma tology, SUNY Buffalo School of Medicine Buffalo Hilton Saturday, May 9, 1987 PHYSIOLOGI CA L AND MEDICAL ASPECTS OF EXPOSURE TO WARM WEATHER AND EXERCISE David R. Pendergast, Ed. D. Associate Professor of Physiology, SUNY Buffalo School o( Medicine Coffee 10:20 DROWNING: PREVENTION, AND TREATMENT OF THE NEAR DROWNIN G VICTIM John I. Lauria, M.D. '60 Cl1n1cal Professor and Cha1rman, Department of Ancsthes,ology, SUNY Buffalo School of Medicine 10:50 D,scussmn BUFFALO IPHVSl~IA N ] Dr. James Holland, this year's Stockton Kimball Mcmonal Lecturer. 1sno stranger to the UB School of Medicine. He served on our faculty for 15 years fr<>m 1955 to 1970 and has returned for v1s1ts and lectures. Besides h,s prominent position at Mt. Sina, School of Medicine and Hospital, the Columbia medical graduate ,s a winner of the covered 197 2 Lasker Award for his cance r chemotherapy research, as well as The American Cancer Society National Award 1n 1981. On JAMA's cd,ronal board and WHO's Expert Advisory Panel on Cance r, he has published over 400 amdes and books. Spring '87 �26 Medical School News New Med School office is not for woillen only T he Office of Professional Development is not for women only. This recently created office in the UB Medical School has been developed in response tot he needs and concerns of women and minorities in the field of medicine. But it is clearly concerned with the career development needs of young men m the field as well. "The title 'professional development' was chosen instead of the Office for Women in Medicine in order to clearly convey our concern for cill young faculty," points out Dr. Glenda Donoghue, director of the new office. "Our main objective is to create career development programs in support of women with an emphasis on the issues and needs of women physicians," comments Vice President John Naughton, dean of the UB Medical School. Since 1970, the enrollment of women in medical school has increased by 40 % and is still on the rise. But the increase m number has not been accompanied by propomonate increases of women into high level academic and administrative roles. The new program has been created to try to address this national issue on a local level. "At UB the sizable number of women faculty provides an increased opportunity for career development and growth within our school," Dr. Naughton pointed out. "The Office of Professional Development is the vehicle by which women will be made more aware of the vast career opportunities which await them." "A large number of women doctors go into private practice and do not choose an academic career in medicine. They may not possess the skills necessary to succeed in net• Spring '87 I BY BERNA DETT E M. CO MMI SA working," claims Dr. Donoghue. "For many reasons, women do not have the opportunity to make the professional connections that men make," she added. D r. Donoghue attributes part of this problem for women physicians to the insufficient number of visible female role models in the profession. She hopes her program will help to alleviate this imbalance. "The problems are not confined just to women, they are compounded for minorities. And m rhe competition for academic slots, young male faculty can encounter similar problems," Dr. Donoghue relates. The first responsibility of rhe program affects the area of faculty development for both new physicians and established faculty members. Implementation of some kind of mentor system allows more established faculty to share their expertise with newer physicians, benefiting both. Faculty members can volunteer or be nominated by their depart• ment chairmen to this role. Dr. Donoghue sees her office as "filling in the gaps" in the educational process. The office is encouraging and making progress towards developing programs in skill development. "During their medical training, for instance, physicians are unlikely to be exposed to extensive grant writing in the way that Ph.D. candidates are," Dr. Donoghue emphasized. To enhance the skills that are necessary for grant writing and to improve a physician's abilities as a researcher, UB's Office of Sponsored Programs, in conjunction with the BUFFAID f P HY 1¢1 .1.€:7 School of Medicine, is developing programs to educate individuals in the specifics of grant writing. Young faculty often lack networking abilities. In an attempt to remedy this, the Office of Professional Development held an informal reception for all new faculty in the I 986 academic year, to meet with department chairs and administrators. Donoghue's office also set up a panel discussion by Dean Naughton and five tenured faculty on the topic of rime management in academia, which discussed how to organi,e and balance time demands between work and family. On a more formal level, any individual can speak with Dr. Donoghue for recommendations as to who would be a good advisor or mentor for his or her career. D r. Donoghue is also the director of rhe Office of Continuing Medical Education. She believes that both this office and the program of professional development have closely related goals. "Continuing education is intended to help you to improve your performance in your role in medicine," Dr. Donoghue said. She wants to see faculty doing the teaching 1n the continuing medical education programs. "It will give them an opportunity to enhance their own skills as teachers and presenters, while providing education to their colleagues," she said. Another facet of the program is Dr. Donoghue's concern for including residents and interns in professional development pro grams from the onset. Recently, medical residents were surveyed and voiced their interest in having the Medi- �27 Medical School News cal School develop a program to provide them with beccer skills as teachers. Dr. Donoghue believes chac chis and ocher professional development needs should be met by che faculty." We are concerned with enhancing our resident staff's skills, and with the faculty involvement, we arc one step closer to including all students in early career devel opment. If residents perform better, they in turn become more visible and better role models for students," she said. Dr. Donoghue is a clinical associate professor of nuclear medicine and a former UB instructor of psychiatry. A native of Sydney, Australia, she began her career there as a family practitioner, a specialty she truly loved. She and her husband Niall, a professional singer, left Australia "to chase after Niall's career, because we knew we could both find work in any city," sht> chuckled. Niall is now locally famous as Buffalo's foremost Irish tenor. Dr. Donoghue relocated to Buffalo after reading an ad in the lrnh .vled,cal Journal announcing openings for residents and interns at Mercy Hospital in Buffalo. Originally intending to stay for only one year, Dr. Donoghue instead decided to stay here and specialize in the field of nuclear medicine. While working at Mercy Hospital, Donoghue and two of her colleagues, Dr. Saleela Suresh of the Department of Rehabilitation Medicine and Dr. Susan Grenz, a resident at the time, formed what is known today as the Women Physicians' Association. The organization resulted from a conversation among the trio about the lack of female role models in the hospital. Interest grew from other women physicians in the area and five years later, their organization became Branch No. 79 of the American Medical Women's Association (AM WA). Besides co-founding the local association. she served as president for ,rs first five years. The local group also works closely with a UB student branch of AM WA. By benefiting the School's faculty and residents, the two professional development programs under Dr. Donoghue's leadership will, ,n turn, enhance the quality of the Medical School's programs and the future doctors and researchers they will produce. • Gould family gift honors 1898 grad T Dr. Richard). he Medical School's General Scholarship Fund has received a donation from Thomas J. Gould, Sr., through his son Thomas J. Gould, Jr., of Hendcrsonv1llc, Tennessee. The cider Gould, who passed away recenrly, made the $500 conmbution in memory of his father, Dr. Richard J. Gould, a UB medical alumnus, Class of 1898). Dr. Richard Gould, who died in 1925, was a founder of Omega Upsilon Phi and a member of the surgical staff of Deaconess Hospital. The fund will be, used to support needy, meritorious medical studm~. • Gou ld 0 L... ____ ...J The ~crio1u atmosphet-e of a Med ical Schoo l patho logy class was sudden ly !Tan va Scottish bagpiper u ho marched down the aisle of Farber H all 's Butler Auduo n um. , hu January 12 incident was the beginning of a co lorflll ccremon) maTk ing the official mot:e in to the school's 1ust completed $19 million n eu• u mg ( Buffalo Ph)sician, Dcccmhe-r I 986). Medical School officials int ued the 140 rnrprised sophomoTe medical st udents 10 pick up the11 microscopes and join the march, and the entire class folloued m a prncession beh ind the bagpiper mro the newt< ing. BUFFAID CT1:!....i.S1 ¢t ANI Spring '87 0 a' �<, f Ill 5 ii �29 Hospital News $1. 7 Million Lithotripter T hrough Buffalo General Hospital UB's Medical School has become the first institution in New York Seate co include a lithomptcr among its associated facilities. The $ 1. 7 million device 1s the stareof-the-art method for non-surgical treatment of kidney scones. I Manufactured by a West German aerospace corporation, 1t was purchased through a Joint venture between Buffalo General Hospira I and a group of urologists who formed the Wesrern New York Ston<: Treatm,rnt Center (WNYSTC). Among those who played a major role were WNYSTC president Dr. David Albert, M.D.: vice president Joseph Greco, M.D.: secretary, Rarry Malin, M.O.; treasurer, H. Rolf Weber, M. D.; and Gerald Sufrin, M.D .• chairman and professor of UB's Departm<:nt of Urology and director of Buffalo General's Urology Department. Dr. William Kinnard, president of Buffalo General. spearheaded his institution's efforts. The UB School of Medicine also played a crucial role in its acqu1sit1on. This is because the State Department of Health requi res l1thompters to be placed only with a medical school teaching hospnal with an active, university-based urology r<:s1dency program. The device 1s located at Buffalo General. a UB teaching hospital. Known formally as an extra-corporeal shock wave lithotripter, the machine pulverizes kidney scones using multiple shock waves ( 1500ZOOO) generated by an underwater spark plug. Patients under general or regional anesthesia arc submerged ma large tank of water for the 45 to 60 minute procedure. The stone 1s precisely located using a two-beam Fluoroscopy X-ray unit, and th<: stone d1s1ntegration 1s observed on telev1s1on monitors. After the procedu re. fragments pass within two or three days as dust or finely ground stones through the patient's urinary tract. Up to 1000 patients may be treated at BG H n 1988. with an over 90 pe r cent success rate ~xpected. I 50,000 have been treated worldwide since I 980. The clinical advantage of the procedure is that 1t is non-invasive, spares the patient excruciating pain, and minimizes recupera- non time (two to four days. instead of seven 14 days). In contrast to ns high cost of acquis1ton, 1t is a cost save r for patients. to ((B esides its clear clinical benefits it will also benefit the Medical School's educat1onal and research programs in urology," states Dr. Sufnn. His department anJ the Med ical School will be responsible for 1ts use in medical education, residency training. and research programs. ''The lithotnpter 1s important 1n our educauonal programs because 1t allows us to provide the most contemporary training 1n this area," Sufnn notes. "By having access to the machine, our residents will remain at the cutting edge of urology. Residents will be trained not only in use of the procedure, but in the pre-treatment and post -treatment aspects, as well as in its limitations and complications. Family phys1c1ans, 1ntcrn1sts, surgeons, anJ other non-u rologists will also benefit by being familiar with its applications. since stone disease 1s common (occu r rini: m one of every I 000 people)." Dr. Sufnn points ourchar UB medical st udents are already learning the biophysics of stone treatment. The device's availabili t y contributes to the Medical School's status. Besides being the first hthompte r in the SUNY system, it is one of only two in upstate New York. There arc five in the State and I ZS na tionwide. Less than half of all medical schools have them in their programs. Sufrin already sees several research applications. "I expect it will be used to aid the study of the process of stone fo rmation, especially 1n the research of Dr. Geo rge Nancollas (a renowned chemist and M<:dical School faculty member). This may lead to ways of pre1 •en1tnl(, not just treating. stone disease. Predicting the likelihood of re-growth of the scones is another aim." Sufrin anticipates another research direction." We may study whethe r focused shoc k waves can arrest malignant cell growth, as animal research suggests. "By its association with the SUNY sys tem, use of the machine for clinical research or educationa l use will be open to any trained urologist," Sufrin adds. • BUFFAID ~ _i_I. ' _{ J... A iL..) Sp ring '87 �30 People It's in the Record Book ust announced is the newest entry BY BRUCE S. KERSHNER into the 1987 edition of the Guinness Book of World Recr-------------------ords: the world's smallest I thermometer, invented by Frederick Sachs, Ph.D., a UB biophysicist. The minuscule device, called the ultra-microthermometer, is one-fiftieth the diameter of a human hair . A liquid-filled double barrelled glass tube, or pipette, it tapers into a tip that is invisible to the unaided eye. "The sensing tip is one micron in diameter," the associate professor of biophysics explains, "while a single strand of hair is 50 microns in diameter." (There are approximately 25,000 microns to an inch.) The tiny invention netted a world record, as well as a little fame, for Fred Sachs, but he just considers it a means to an end. "I invented it simply as a research tool. I use it tO measure temperature changes in single cells, as part of a research project to understand membrane responses. No existing instrument was small enough to measure the temperature, so one had to be invented." He had no idea it would lead to a world record, to be read in the internationally popular British publication. The invention was patented in 1986. Besides being necessary for his own research, the device can measure temperature changes in single cells or different GUINN~ BOOK OFRECORDS Spring '87 SmallestTbennometer Dr Frederich Sachs, a biophysicist at the State University or New York at Buffalo, has devel• oped an ultra-microtbcnnomcte r for measuring the temperature orsmgle living cells. The tip as one macron an diameter. about one fi(taeth the diameter or a human hair. parts of cells, including capillaries, nerves, muscle cells, and microorganisms such as amoebas, making it useful for other medical researchers. With it, they can measure chemical reactions or metabolism in very tiny volumes. It can be used, for example, to match predictions of biochemical models for muscle contracting, which could lead to understanding mechanisms of various muscle disorders. The diminutive device is useful not only in research, but also for specific applications. It can be used to measure temperatures of integrated circuits in order to improve their design by avoiding flaws. It may also be used tO improve design of auromobile engines by developing temperature profiles of flame spread in combustion chambers. BUFFAID L..!.HVS ¢1 AN ) s achs' "little" accomplishment may have made the record books, but he is also responsible for a major accomplishment that will make the history books. At the age of 43, Sachs became the "father" of an entirely new field of science. In 1984, while studying cell membranes, he and his post doctoral associate Falguni Guharay, Ph.D., discovered the fundamental mechanism for the sense of touch and body awareness. The mechanism for this sense had eluded scientists until Sachs discovered the first mechanically-sensitive ion channel molecule. Since then, they have been found in the membranes of a wide variety of vertebrates, invertebrates, yeast, bacteria, and even green plants. When any physical force contacts cell membranes, the fiber network is stretched, triggering these special ion channels. This releases a flow of ions through a hole in the molecule and into the cell, creating an electrochemical chain reaction which transmits the message to the rest of the organism. What results is the perception of rouch, erotic sensations, pressure, stretch, general body awareness, balance, and orientation to gravity. The mechanism, essentially, explains how all living things physically perceive themselves and their world, a phenomenon underlying the very existence of life. "No higher organism can survive �31 People without being capable of such a fundamental action," Sachs notes. His research has now led him to suspect that the same mechanism may also be responsible for other essential processes: cell growth and division, as well as the sense of hearing. His studies of frog eggs suggest that the ion channels provide the biofeedback for the cell to "know" when to divide. Hearing may also be explained by the stimulation of ion channels in the ears' sensory cells. As the founder of the field that studies the mechanical senses at the molecular level (there is no formal name for the field yet), Sachs is excited. "There are only two or three other groups in the world now researching this field. We're working in the unknown, without bearings or sign posts, using only trial and error and serendipity." One of his goals now is to develop a chemical or antibody that can block the ion channel reaction. No sensitivityblocking drugs have been found, though black widow venom is now being tested. As for his most famous device, the record-breaking thermometer, Sachs is enjoying all the fuss, but is a bit embarrassed. "It is an honor to be in a book side-by-side with Neil Armstrong, the Wright Brothers, and Babe Ruth. But is the ultra-microther mo meter on the same scale? And then there are all those other records - the book covers such a range from the monumental to the silly." However, this is not the first time Sachs has received wide public attention for his work. The 1986 yearbooks of both the Encyclopedia Brnan111caand the World Book Encyclopedia described his ion channel discovery and his thermometer. This year's attention in the Guinness Book is unlikely to be his last • lied area of touch research. He has begun design work for a prosthesis for people who arc both deaf and blind. He proposes a way to translate sound into skin vibrations that might some day enable deaf / blind people to understand speech through their skin. An array of a dozen or so vibrators over various parts of the body would transmit different frequencies specially selected for skin absorption. Different patterns of frequencies could be designed to produce a unique sensory language. "Ultimately," Sachs envisions, "such a person could put on the device and wear it tO the symphony." Dr. Sachs has certainly had success with his other inventions. He has developed ten so far, with eight of them patented or patent-pending. r. Sachs received his Ph.D. from the SUNY Health Science Center in Syracuse in I 971. After holding research positions at the University of Hawaii and the NIH, he joined the faculty of UB's School of Medicine in 1975. He is on the editorial board of the Bwphysical Journal and is a reviewer for Science and six other journals. He is author of more than 40 publications, the latest of which were published this winter. D Agencies were at first reluctant to fund his pioneering research because it is so unconventional. The NIH and the Army, however, now have ongoing grants to devise new techniques to study cell membranes and to develop prototypes for robotic sensors by using ion channels as transducers for mechanical devices. Sachs is also looking into another app- d)rrm• I I, I 9S6 at E I \C pro{<Ssor l ,._an u.a.\ honored ut uu: x:u,a cu~nl /or n,~ sen re-, and <1ccomplul11nen1s lfr u re,pon<abl, for brmgmg I~ D,partment of \frd1C m, lo nurwnal prum1n1 U('t and hw h,cn an 11Ht"Tnui1onul leodcr an g,..,.1alnc ,nc.:d1c1ne. arthntu and Thrumutu,n. \n annual lcc-wr<sh,p u as e,1abl1Sh,J in hi,; hono,, throrrl{h th, g, nermal'Y of the<. las, of 1970. ( fhoSt uuhmg lo dnnatt· Jur1her may wntad Ur. Don Coplc'Y OT Dr. Jan Notak 111 Eric Countv ratwn of E,an ( a,~ .... • , 'Years m Bu{ I mcuu.1ne and l B's /oruu•-r cha1rrnan of ~fed1c1nc 1or Medical .1 C<nt<'T,) BUFFALO C!..J!_ v s•~• A N::::J Spring '87 �32 People Scholarship fund honors Dr . Jewett Ogra is widely recognized for his research in immunology and infectious diseases. Born m Kashmir, Asia, he is a graduate of Christian Medical College in Ludhiana, India. He is the chief of the Division of Infectious Disease and Microbiology Laboratories at Children's Hospital of Buffalo. He has served on several international committees such as the Workshop in Respiratory Viral Infections, 6th International Cong ress of Virology, Sendai, Japan, as well as on numerous national and local committees. He is the author of over 300 publications and books, and editor of a -J. Pullano • number of journals. A scholarship fund has been established at Dr. Children's Hospital ro honor Theodore C. Jewett, Jr., professor of surgery, for his contributions in the field of pediatric surge ry. Revenues from the Scholarship Fund will be made available for lectureships, fellowships and / or schola rships. The purpose of the fund is co support successive generations of surgeons who will continue the ideal of Dr. Jewett through engaging in service, education, and research in pediatric surgery. • (From Ch1ldren·s Hospita l's news letter ·aomb1no ..) Harry Metcalf heads organization of family doctors T he new president-elect of rhe largest organization of family doctors 1s UB"s Harry L. Metcalf, M.D. The clinical associate professor of family medicine was recently elected tO head the 57,000-member American Academy of Family Physicians (AAFP). Metcalf previously served as chairman of the AAFP's Board of Directors and its executive committee and in other leadership positions in the Kansas City, Mo., based organization. Besides representing family doctors on a national basis, the AAFP was instrumental in establishing family medicine as a distinct medical specialty, and was a pioneer in developing con tinuing medical education to enhance rhe quality of family medicine. The UB alumnus (M.D. in 1960, B.A. in 1956) has been on the Medical School faculty for 11 years. He has served as th e school's admissions director and received its Outstanding Teacher Award in 1984 and its Distinguished Service Award in 1981. Metcalf is president of the Highgate Medical Group where he practices and is affiliated with Millard Fillmore Hospital. He is a Fellow of the AAFP and is board-cer tified by the American Board of Family Practice. He is also on the board of directors of the N. Y. State Spring '87 Academy of Family Physicians and is accive in other medical societies. In community affairs, he has been honored with an award from the National Institutes of Health for his work in high blood pressure education; the Outstanding Service Award from the N:ircotics Guid:ince Council of Erie County; and the Outstanding Service Award from Erie County. • Pearay Ogra, James Nolan elected to AAP T wo UB professors have been elected to the prestigious Association of American Physicians. They are Pearay Ogra, M.D., professor of pediat rics and microbiology; and James Nolan, M.D., professo r and chairman of the Department of Medicine. The AAP was founded in 1886 and its membership includes 950 medical school faculty and clinical investigators. Membership is regarded as a prestigious honor among members of the medical profession. Nolan, a graduate of Yale University School of Medicine, is also the directo r of the Department of Medicine at Erie County Medical Center. He presently serves as governor for the Upstate region of the American College of Physicians. BUFFAID f P HY $ 1 CI AN f D r. Francis Klocke, professor of medicine, has been voted president-elect of the American College of Cardiology. The chief of Erie County Medical Center's and UB's Division of Cardiology earned his medical degree in 1960 from UB. He has been on the Medical School faculty since \ 965 and was appointed to an endowed chair in 1983 as the Albert and Elizabeth Rekate Professor of Medicine and Cardiovascular Disease. He is also a professor of physiology. With 14,000 members , the American College of Card iology is the primary professional organization for its specialty, comprising nearly all cardiologists in the U.S. Founded in 1960, it focuses on activities that improve cardiovascular patient care and continuing physician education. It also provides advice to governmental bodies when appropriate. The Buffalo native is a diplomate of the American Board oflnternal Medicine and has held other offices in the American College of Cardiology. He is currently second vice presi • dent of the American Heart Association, WNY Chapter, and chairman of the National AHA's Council on Circulation. He has been chairman of several National Heart, Lung and Blood Institute committees and currently chairs one of its boards. He was involved with two U .S.-U.S.S.R. cooperative Health Agreements and symposia relating to lschemic Heart Disease. Dr. Klocke has bee n honored previously with UB's Stockton Kimball Awar d, Manhattan College's Alumni Achievement Award, and St.Joseph's Collegiate lnstitute's Sign um Fidei Award for 1986 -J. Pullano• �33 People Hematology, chose 20 stocks which experienced a gain of 33.5 per cent. "I'm satisfied with my performance," Or. Lehman said. "It was fun and quite a few people have commented on the article in Barrons." Dr. Lehman was also featured in an article in the Buffalo News for his stock-choosing endeavor. • (From BuffaloGtent'ralHospital's ··rulsebcat" May Dr. Ge rald Su frin , professor and chairman of urology, has been reappointed to chair the Education Council of the American Urological Association. The council suggests new strategies to enhance educational goals of the association through its various committees. He also received two honors. Sufrin was elected to the Society of Pelvic Surgeons, a highly selective professional group with only 125 members nationwide. He was also appointed to the Board of Directors of the National Kidney Foundation of Western New York. • Dr. George S. Parlato, clinical assistant professor of psychiatry, has a practice in psychia try in Orchard Park. The Medical College of Wisconsin medical graduate ( 1959) is a member of Erie County Medical Society and the American Psychiatric Association. • Dr. M. Steven Piver, clinical professor of gyn-ob, has just been appointed chief of the Gynecologic Oncology Department of Roswell Park Memorial lnsmute. He is chief of the UB Medical School's Division of Gynecologic Oncology in its Department of Gyn-Ob, as well as the president of the local chapter of the American Cancer Society . • 1986. ) This post is important because the committee providt:s direction and leadership for the activities of the association at large. Dr. Ruben Cartagena , clinical associate professor of urology, was appointed to the Audio-Visual Committt:e, which oversees and ensures the quality of presentations and programs of the association. • Buffalo Phys ician art d irector, Alan Kegler, has been awarded a Brome Medal for graphics by the Council for Advancement and Support of Education (CASE). The nationally known educational organization selected Kegler for his layout and graphics for two articles in the Dec1:mber 1985 Buffalo Physician,a profile on Dr. Felix Milgrom and a Holocaust research profile of Dr. Norman Solkoff, "Children of Survivors." • Dr. Marvin Herz, professor and chairman of psychiatry, received two awards last October: the Peter L. Heggs Memorial Award from the Erie Alliance for the Mentally Ill and an award from the Mental Heal ch Association of Erie County in recognition of contributions of his department in the area of mental health services delivery. He was also appointed to task forces or to chair committees for the Association of Clin ical Psychosocial Research, the American Psychiatric Association, the American Association of Chairmen of Departments of Psychiatry, and the American College of Meneal Health Administration. • Dr. Edward Simmo ns, professor of orthopaedics, was a visiting professor at the Medical College of Wisconsin and a guest speaker for the Milwaukt:e Orthopaedic Society last October in Milwaukee. In November, he was a guest faculty member at the Kenton Leatherman Spine Symposium in Louisville, Ky., speaking on scoliosis and spinal surgery. • Two urologists have been appointed to posts in the American Urological Association. Or. Kevin Pranikoff, asssoc1ace professor of urology, was recently elected to the Executive Committee of tht: Association. Dr. Harold A. Lehman placed 48th in the nation in an investment contest sponsored by Barrons, a weekly business publication. Dr. Lehman, a UB resident in clinical pathology and a researcher in the BGH Department of BUFFAID ! P ttv S 1 ¢1 AN ) Dr. Venkataraman Balu, clinical associate professor of medicine, published an article on stress-testing panents with poor left ventricle function before and after coronary artery bypass surgery, in Texas Heartjournal, March 1986. He also presented papers on exercise and long-te r m survival of patients with ischemic cardiomyopathy at the I 0th World Congress of Cardiology, Washington, D.C., September 1986. Balu is chief of the Echocardiographic section at Buffalo VA Medical Center. • Dr. Ad ri an 0. Vladutiu , professor of pathology and microbiology, recently released a new book, Pleural Effusion, published by Futura Publishing Company, Mt. Kisco, N. Y. Vladutiu is director of the lmmunopathology and Chemisrry Labs and director of Clinical Labs at Buffalo General Hospital. He was also awarded an NIH grant to study effects of anti-Ia antibodies on auto1 mmune Thyro1d1tis. • Dr. Eugene Mi nd ell, professor and chairman of orthopaedics, has been appointed by the American Academy of Orthopaedic Su rgeons to their Residency Review Committee in Orthopaedic Surgery for a three-year term. • Or. Lise lotte Fischer, emeritus associate professor of psychology in the Departments of Psychiatry and Pediatrics, has been active since her 1983 retirement as a Children's Hospital clinical child psychologist. Last fall, one of her paintings was exhibited in a special show at the AAO Gallery (her second oneperson show there). It will also be reproduced m a special color catalog of the representative art of Western New York, to be distributed to all major art museums in the U.S. and possi- Spring '87 �34 People surgery. He was on UB's faculty from 1959 to bly Europe. Her other paintings were shown at Children's Hospital. Dr. Fischer lives in Amherst. • l~Q Agost ini Mo lenti (Ph.D. '70 and M.D .. University of Milano, Italy) was appointed visiting professor of pathology at Harvard Medical School. He is professor of pathology at Northwestern University and directs the Endoctrine Pathology Laboratories at that university's hospital. Or. Molteni published three articles recently on pulmonary endothelial dysfunction and fibrosis in the lnternacronaljournal of Radiation Oncology, Biology, Physicsand Proceedingsof the Societyfor Experimencal Biologyand Medicine. • Dr. Nasir H. Gardezi is a fellow in cardiology in Buffalo General Hospital. The University of Punjab, Pakistan, medical alumnus is a member of the British Medical Association. • Dr. Edward Hender so n, professor of medicine, has been re-elected co the national board of trustees of the Leukemia Society of America. Dr. Henderson is chief of medical oncology at Roswell Park Memorial Institute. The board is comprised of business and professional leaders who volunteer their time co promote and expand the society's programs of research, patient aid, public and pro• fessional education, and community service. As a member of the national board, Dr. Henderson serves on the Medical and Scientific Committee, as well as participating in the Grants Review Subcommittee. Or. Henderson is on the Board of Trustees of the Western New York Chapter of the Society. • Dr. G. Worthington Sche nck, Jr., professor of surgery emeritus, was honored at the Surgical Alumni Association meeting at Erie County Medical Center. The former director of Surgery at ECMC retired last October after 26 years of service. • Dr. Margaret Acara, associate professor of pharmacology and therapeutics, has been appointed to the Editorial Advisory Board of the Journal of Pharmacologyand Experimental Therapeutics for a two-year term. • Stat e University of New York confe rr ed an honorary Doctor of Science degree during UB's May 1986 commencement on Dr. Brian McMahon , considered to be a major figure in the development of modern chronic disease epidemiology. His reseach has been responsible for methodological advances in the study of many diseases, icnluding Hodgkin's Disease and breast cancer, and has set the course of expansion for the entire field. He is Henry Pickering Walcott Professor of Epidemiology at Harvard. • Spring'87 • Dr. Tarik Elibol, clinical assistant professor of medicine, has been re-elected chief of the medical and dental staff at Degraff Memorial Hospital, North Tonawanda, N.Y. The Cleveland Clinic-trained gastroenterologist practices in Kenmore, N.Y. and received his M.D. from the University of Istanbul. • Dr. Milford C. Maloney, clinical professor of medicine and chairman of Mercy Hospital's Department of Medicine, was recently honored by the Trocaire College Board of Trustees at their Fifteenth Annual Benefactors' Reception for his many years as a valued benefactor of the college. Dr. Maloney, recently selected for a threeyear te r m on the nine-member Board of Trustees of the American Society of Internal Medicine, is a member of the AMA, the American College of Physicians, and the American College of Cardiology. He is also on the Board of Directors of Blue Cross of Western New York and the Health Systems Agency of Western New York. • Dr. Donald R. Becker, former UB clinical professor of surgery and Surgery Department chairman at Deaconess, was the recipient of the Outstanding Clinical Teacher Award from the Class of 1984 at University of Connecticut Medical School. He was also appointed associate chairman of the school's Department of Surgery last November. At nearby St. Francis Hospital, he serves as director of BUFFAID [l Mv $ 1 ¢1A N j Dr. Marek Zaleski, professor of microbiology, recently received a grant from the National Endowment for the Humanities to translate to English a book by the Polish philosopher Rev. Jozef Tischner, The Polish Shape of Dialogue, which describes the Polish experience with the clash between Christianity and Marxism. Zaleski is a member of rhe Transplanracion Society and the International Society for Experimental Hematology. • Dr. Michael Ap icella, professor of medicine and microbiology, has been appointed chairman of the National Institute of Allergy and Infectious Disease. He is also head of the Division of Infectious Diseases at ECMC. • Dr. Glen Gresham, chairman and professor of rehab medicine and medicine, has been appointed to the public education and community program committee of the American Heart Association. He also is chairman of the Heart Association's subcommittee on stroke and is director of rehabilitation medicine, Erie County Medical Center. • Dr. Joseph Zizzi, clinical associate professor of medicine, and Dr. Leonard Kat z, professor of medicine, were elected to the Board of Directors of the Coordinated Care Management Corporation, a United Way agency which oversees long-term care of the elderly in Erie County. Dr. Zizzi is medical director at ECMC. Dr. Katz is a gasrroenrerology attending at ECMC. • �35 Classnotes Dr. Virg i nia V . Weldon Alfred Evans (M'43) • has been awarded the Abraham Lilienfdd Medal by the American College of Epidemiology for his outstanding research in infectious disease and for his teaching in epidemiology. The distinguished epidemiologist is currently the holder of an endowed chair at Yale University, as John Paul Professor. He has been Yale professor of epidemiology and director of the World Health Organization's Serum Reference Bank. He has also been president of the American Epidemiological Society. The Buffalo native retains a strong area connection - his daughter is married to the son of Dr. Charles Paganelli, UB professor and associate chairman of physiology. Virginia V. We ldon (M'62) • deputy vice chancellor of Washington University School of Medicine in St. Louis, was honored with a day-long symposium last June. The symposium, "Future of Graduate Medical Education in the U.S.," honored Weldon as chairman of the Association of American Medical Colleges (AAMC). Elected to the AAMC office last year, she is the first woman chosen to lead the association in its l 09year history. She is also vice president of the Washington University Medical Center. Weldon, professor of pediatrics, is a specialist in pediatric endocrinology and is well known for her many published studies of mechanisms of abnormal growth in childhood. She is a physician at Barnes and Children's hospitals and is recognized nationally as a spokesperson on issues in medical education, biomedical research, and legislation affecting health care costs. She 1sa fellow of the A men can Association for the Ad vancement of Science, and 1~on the boards of directors of numerous c1v1corgamrnt1ons. A nth ony V. Grisa nti (M '65) • has been elected 1987 vice chief of the staff at Saint Joseph Medical Center, Burbank, California. Dr. Grisanti practices otolaryngology, head and neck surgery, and facial plastic surgery in Burbank. He 1sa Fellow of the American College of Surgeons and Diplomat to borh thc American Board ofOtolaryngology and Head and Neck Surgery and the American Academy of Facial Plastic and Reconstructive Surgery. Richard H. Daffner (M'67} • of Pittsburgh, Pa., has been named a Fellow of the American College of Radiology. He is also on the Editorial Consulting Board of Skeletal Radiology. OavidJ. Fugazzotto (M'67) • is practicing pediatrics in Bir- cal Center, Mt. Kisco, N.Y. He also serves as chairman of a Committee on Health Planning. Dr. Welch, his wife Florie, and their child ren, Laura, 12; Peter, 9; and Ian, 5, reside in Mr. Kisco. mingham, Al. He was re-elected to the executive committee of Medical Center East, 1n Birmingham. Brian S.Joseph (M'68) • was recently certified by the American Board of Forensic Psychiatry as a diplomate in forensic psychiatry. In addition to his private practice, Dr. Joseph is chief of psychiatric services, Erie County Department of Mental Health. Morris J. Stam bier (M'68) • writes: "iust joined the staff at Hall Mercer Children's Center at McLean, a division of Massachusetts General Hospnal, as a consulting psychiatrist. I have 3 children - Elisabeth, 9; Ben, 6; and Sam, 3." Bruce M. Prenner (M'70) • was promoted to associate clinical professor of pediatrics, Division of Pediatric Allergy and Immunology at the UCSD School of Medicine, La Jolla, Ca. PeterC. Welch(M'74} • was appointed chief of medicine and vice president for medical affairs at Northern Westchester Hospi- BUFFAID L.!..J:L'!' 1. ' C I A N j Eric J. Russell (M'74) • was appointed director of the section of neuroradiology, Department of Radiology, Northwestern Memorial Hospital (Northwestern University); he was also appointed associate professor of radiology and ocolaryngology at Northwestern University School of Medicine. In December he presented a paper at the meeting of the Radiology Society of North America, "Improved Detectability of Mult1pk Cerebral Metastases with Gadolinium - DTPA enhanced MRI: A Comparison of Um:nhanced and enhanced Images." ThomasC. Rosenthal (M'75) • left private practice m Perry, N. Y., and is now medical director of the Family Practice Residency Program at Deaconess Division of Buffalo General Hospital. Patrick Hayes (M'76) • writes: "recently received boards in emergency medicine; elected chairman of Department of Emergency Medicine at Riverside Methodist Hospital, Columbus, Oh. My wife, Karen Glasgow (M'76), and I have a three-year old, Gavin. Karen 1s an internist with a local H. M.O." Michae l Lippman (M'77) • informs us that his cor rect address is: North Seattle Public Health Center, 10501 Meridian Avenue North, Seattle, Wa. 98133. Spring '87 �36 Classnotes Debra L. Hovanec-Burns (Ph.D. '82) • is a research associate at Reed Neurological Research Center, UCLA. Tere nce L. Chorba (M'79) • was awarded the annual Alexander D. Langmuir prize by the Alumni Association of the Epidemic Intelligence Service, Centers for Disease Control, for a manuscript regarding parvovirus B I 9. A later version of the manuscript was published in the September issue of the Journal For lnfe cr,ous Disease., . Dr. Chorba resides at 403 Longleaf Drive, Chapel Hill, N.C. 27514. Jan i ce Denis e Wi ll iam s (M'77) • announces that she has opened a private practice in N. Y. after Binghamton, spending six years at the Mt. Vernon Neighborhood Health Center where she was assigned by the USPHS in 1981. Dr. Williams is listed in "Who's Who of American Women." Ri chard S. Elman (M'77) • became a Diplomate of the American Board of Emergency Medicine. Dr. Elman is the director of Emergency Services at Lockport Memorial Hospital and Western New York Regional Medical Director of National Emergency Services. Matthew J.O'Brien,Jr. (M'78) • has been appointed chief of the Department of Medicine of St. Francis Hospital, Buffalo, N.Y. Dr. O'Brien is a member of the American College of Physicians, and is certified by the American Board of Internal Medicine. Bruce M. Benerofe (M'79) • writes: "I am affiliated with the New York Eye and Ear Infirmary in New York City and have just opened my second office for the practice of ophthalmology in Randolph, N.J." Spring '87 Micha e l R. Privitera, Jr. (M'79) • is co-clinical director of the Affective Disorders Inpatient Unit and consultant in geropsychiatry at the University of Rochester Medical C enter. In addition, he is an assistant professor of psychiatry at their medical school. The Pittsford, N.Y., resident recently published" Assessment of Suicide Risk in Patients with Personality Disorder& Major Affective Diagnosis" in the May 1985 Journal of Quality Assurance (QRB), as well as "The Influence of Weight Loss on the Dexamethasone Suppression Test" in Psychrarry Research Vol. 12 ( l 984 ). Deborah M. Weisbrot (M'79) • after completing a fellowship in child psychiatry at Cornell University Medical Center, is now an assistant professor of psychiatry at the Albert Einstein School of Medicine and a unit chief of a psychiatric unit at Bronx Municipal Hospital Center. Barbara R. Hirsch ( M'80) • has a private practice in endocrinology in Great Neck, N. Y. Richard L. Collins (M'83) • of Buffalo, N.Y. writes: "I recently returned from Boston, Ma. where I did my internal medicine residency at St. Elizabeth's Hospital of the Tufts University System." Dr. Collins is now at Millard Fillmore Hospital on a full-time basis. We s ley Blank ( M'SO) • writes: "My wife, Nan, two daughters, Leah and Hadass, and I have moved to Andover, Ma. I am the new obstetrician / gynecologist for Chelmsford Medical Associates, Chelmsford, Ma. Andrew S. Ross (M'80) • writes that in July he will be joining Barrow Colon and Rectal Associates, Boca Raton, Florida. Dr. Ross has three children, Dara (age8), Ilana (age 4) and Jordana ( l ). Patricia Boutis (M'81) • has completed a child psychiatry fellowship. Joel Fiedler (M'81) • is an assistant professor of pediatrics at New York Medical College. Dr. Fiedler resides at 12 S. Darling Avenue, New Rochelle, N.Y. Richard A. Smith ( M'8 1) • attending pathologist at Mt. St. Mary's Hospital, Lewiston, N. Y., and St. Francis Hospital, Buffalo, has been elected a Fellow of the College of American Pathologists. BUFFAID jP Hv S1C1.£1LJ JohnA.Feldenzer(M' 83) • a fourth-year resident in neurosurgery at the University of Michigan Medical Center, has received the Mayfield Award from the Joint Section on Spinal Disorders of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons at their annual meeting. Dr. Feldemer received the award for his investigauon of how spinal infections cause paralysis of the lower part of the body. AnthonyE. Turiano(M'83) • writes: "Recently completed residency at University of Maryland F.P. Program; appointed medical director of Lowell Community Health Center in Lowell, Ma.; married a Med School classmate, Deborah L. Foster (M'83) - she finished a residency in pediatrics at Rainbow Babies' and Children's Hospital in Cleveland and is now in fellowship - child development - at Boscon 's Children's Hospital with T. Berry Brazelton, M.D." Or. Turiano's new address is 20 Brookfield Road, Andover, Ma. 01810. �Classnotes M. Miles Braun (M'86) • wntes: "l am workmg for one year as a Public Health Intern in the Division of Epidemiology of the New York State Health Department focusing primarily on injuries and AIDS. I expect to begm a psychiatry residency in July 1987 at the Maine Medical Center." Donni caLM oore(M'86) • of Philadelphia, Pa., announces her engagement to Dr. Stanley Bernard (Baylor School of Medicine '86). A September 1987 wedding is planned. Letter To Th e Editor Dear Eduor: In reference to your article "M.D. Stands for Mother-Daughter" (December 1986, Buffalo Phym:ian), I would lake to make a correction. Dr. Helen Sikorski and Camille Hemlock did not set local and UB medical history for the first mocher-daughter team to have graduated from the School. That d1sttnctton belongs to my wife, Dr . Elizabeth Barlog (Class of 1982) and her mother, Dr. Jacqueline Paroski (Class of 1949). My wife and mother-m-law did not publicly announce this fact. Dr. Parosk1 recently retired after serving the North Tonawanda area as a pediatrician for 30 years. My wife completed one year of general surgery residency at UB before completing a residency m anesthesiology at UB tn 1985. She •~ currently an anesthes1olog1st at the Veterans Admm1srratton Medical Center. I would appreciate the appropriate correctton m a future Buffalo PhyiKtan. Stna>rd) ~ours, Ket1inJ. Barlog, M.D. Cl,m of 19/fa ----------------------------------------------------------------NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES BUSINE SS REPLYMAIL FIRSTCLASS PERMITNO 2210 BUFFALONY POSTAGEWILL BEPAID BY ADDRESSEE BUFFAID P H Y S C I A N 139 Cary Hall State University of New York at Buffalo Buffalo, New Yo rk 14214-9980 I11111,1 .. 1II 1,111, III I,,11,1111,11111111ll111111,11 �BUFFAID I p H V s c A Non -Profit Org . U .S. Postage PAID Buffal o. N. Y. Permit No_ 311 NI State University of New York at Buffalo 3435 Main Street Buffalo. New York 14214 Address Correction Requested 92QQ29QQ48OO MO J9 EVE~ETT H. WESP 89 ""AYNJRODRIVE EGGERTSVILLE NY 14226 DR• FIii out this card (Please print or type all entries) Name ___________________ ________ M.O._ Ph.O._ _ Vear Received ___ _ Office Address Home Address ------------------------ --------- ------- If not UB, M.D. or Ph.D. received from In Private Practice: Yes In Academic Medicine: Yes No Specialty No Part Time FullTime 1 School __________________ _ Title Other: Professional Society Memberships - -- ------ ------------------------ News : Have you changed positions, published. been involved in civic activities, had honors bestowed, etc? _______ Please send curriculum vitae, clippings, publications, or announcements, also include a photo of yourself. _ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1987 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1987-Spring Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1987-v21n01-Spring Table Of Contents A list of subunits of the resource. Window Into The Brain Tropical Medicine Touching Hospital News Research On Getting shot At Alumni Medical School News People Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-28 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v21n01 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1987 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/da517174be8e5eb27b5c591b2323386a.pdf ef3585afc948b715087383f7cedc0599 PDF Text Text p H y s A N LATE WINTER 1987 VOLUME 20, NUMBER 5 UB Inventors · And the Advance of Medicine �BUFFAID PHYSICIAN I Dean's Message D lA DIT R ear Friends of the School of Medicine: The Fall and Winter season have been busy and productive ones for the faculty. Not only are we accommodating to a new educational center and relocation of the administrative offices and services, but we are embarking on some very interesting academic adventures. Three of these are related to future educational and research opportunities. The SU Y system has proposed a major commitment to the enhancement of graduate education and research. This initiative has been received with enthusiasm by the School's faculty and apparently by the governor and state legislature. During the course of the next several months, a task force will work to advise my office on how we might participate in this endeavor. These thoughts will be further processed through university-wide committees appointed by Provost William Greiner. A second University initiative in which School of Medicine faculty will have an important role is that of developing a biomedical engineering program. Dr. Leon Farhi, chairman of the Department of Physiology, will serve as a special assistant to the provost to coordinate and implement this effort. Obviously, this program will serve to strengthen interrelationships between the School of Medicine and Engineering, and between basic science faculty and clinical programs. The timing for this initiative could not be better. The two schools already conduct many mutually important activities, and the formalization of a program will serve to accelerate these activities and to establish Buffalo as a leader in this area. Lastly, we will embark on establishing an Office of Biomedical Affairs which will coordinate the graduate student education program and support the research mission of the Medical School in the years ahead. A national search has been initiated to identify the best qualified person to serve as an associate dean to lead this effort. Such a position will help facilitate our ongoing research and graduate education effort and to enhance the growth and development activities that lie ahead. Sincerely, John Naughton, M.D. Vice Prestdent for Clmtcal Affairs Dean, School of Medicine Medical Alumni Association President's Message P lease help us celebrate the Golden Anniversary of Spring Clinical Day on Saturday, May 9, 1987. Our 50th Anniversary Program will focus on common medical problems occurring during warm weather months. The Stockton Kimball Lecture will be given by Dr. James F. Holland, professor and chairman of the Department of Neoplastic Diseases at Mount Sinai School of Medicine in New York. He is also director of Mount Sinai Hospital's cancer Center and is a past Albert Lasker Award winner. -john E. Przylucki M.D. '73 �BUFE p H y s ( O\er !Stratlo'l t>y [) mellakroc emsk CONTENTS - --- ~ 2 Inventor • The word conjures up a variety of images, from the basement tinkerer in the grand tradition of Rube Goldberg, to the creative genius of Thomas Edison and Leonardo da Vinci. UB has shown strong support of research aimed at the invention of new devices and techniques. This story is about some of our homegrown inventors and their ideas. Associated stories on pages 6, 7, and 9. 11 AIDS Research • "We're sort of catching up to the AIDS virus in our ability to understand it," say UB researchers David Rekosh and Marie-Louise Hammarskjold who are studying the envelope protein of the AIDS virus and the way it binds to white blood cells. If that process is understood, it may be possible to develop a vaccine that prevents that binding. 1 Computers in Medicine • One of the first books, and apparently the first textbook, to be developed on the subject has just been released, written by Michael Anbar, Ph. D . Associated stories: Roswell Park's "Computer Playground," page 17. An "Overview of Computer Applications in Clinical Medicine," page 18. MAPPING THE GENOME e 22 Ontogeny reciprocates phylogeny. Pretty words, but o nly an embryologist or mo lecular bio logist can really appreciate their true significance. al mwntor DJat'<ld \rani, M D, and angwlog' kam at Ruf· falo General mserung double loop cathct<'f durmg <ardi I gy angwplasr' operauon. Se page Z HOSPITALNEWS e 25 Sisters nam es a new p resident. BOOKS e 26 How to survive a bashing: New volume b y Lo uis Bakay traces the early history of cranio to my. PEOPLE e 29 UB researcher Robert G uthrie, whose d evelopment of the PK U t est has p reve nt e d m e nta l reta r datio n in tho usands of children, has been named a wi nne r of th e p r estigio us Kenned y Foundatio n Internatio nal A ward. ALUMNI e 34 C hairs of class reunio ns, which are slated for the 50th Annual Spring C linical Day, May 9, issue invitatio ns to their gettogethers. �2 MEDICAL INVENTIONS UB f~culty have contributed a large and rapidly growing number of new devices and techniques ((I nventor." The word conjures up a variety of images, from the basement tinkerer in the grand tradition of Rube Goldberg, to the creative genius of Thomas Edison and Leonardo da Vinci. SUNY Buffalo has shown strong support of research aimed at the invention of new devices and techniques. Some of these have broad applications, others are for specialized use. Acquiring a patent on an invention is ideal, but not always of paramount importance. The pursuit of knowledge and the satisfaction of knowing that one can benefit society is its own reward. UB has contributed a large and rapidly growing number of inventions over the Dr.]ack Lippes; his Lippes Loop is pictured at top of page. 02187 BY PAUL MROZEK last century. The School of Medicine has been the major contributor of inventions in the past, accounting for 45 per cent of all UB invention disclosures submitted since 1980 (or a total of 42 inventions). One of the most well known, and some would say one of the most historically important devices created in Buffalo, is the IUD contraceptive. It was patented in 1962 by Dr. Jack Lippes, whose name was given to the device that is known as the Lippes Loop IUD. The UB professor of gyn-ob, a 194 7 medical alumnus, served on the faculty here for 32 years before taking a position at another university in 1986. Groundbreaking research was also done in Buffalo by UB doctors William Chardack and Andrew Gage, together with engineer Wilson Greatbatch, which led to the perfection of the world's first successful implantable heart pacemaker in 1960. Researchers at UB are encouraged to use the Office of the Vice President for Sponsored Programs (VPSP). This office assists faculty with the invention disclosure process. The VPSP submits completed invention disclosures to the State University Research Foundation's Office of Technology Transfer, which in turn determines patentability of new inventions. The Technology Transfer Office the VPSP, and the Western New York Technology Development Center collaborate in marketing inventions. BUFFAID I PHYSICIAN! D r. Djavad Arani, ~li_nical associate professor of med1cme and acting head of the Angiology Department at Buffalo General Hospital, has invented a device that is widely used during balloon angioplasty of coronary arteries. Now being marketed by user, the device is called the Arani double-loop guiding catheter for angioplasty of the right coronary artery. Coronary artery disease is a narrowing of the arteries due to a fatty build-up on the interior walls of the blood vessel. Until 1977 when angioplasty was developed, advanced cases of coronary artery disease were usually treated with coronary . bypass surgery. Bypass surgery reqUires general anesthesia, opening the fhe team who det'eloped the first implantable cardiac pacemaker at the VA Hospital in Buffalo, examming a patient in 1960 (1-r: William Chardack , MD. . ., A n d reu> G age, M.D.; and Wilson Greatbatch, engineer). �3 chest and bypassing the blood artery using a vein from the lower extremities. Angioplasty is performed on a conscious patient. Entrance to the body is usually gained through the groin or arm under local anesthesia. This method greatly reduces the major risk which could occur during bypass surgery. The guiding catheter is sent through the vascular system to the aorta until the tip of the catheter goes into the coronary artery. A balloon, attached to a second catheter, is sent through the guiding catheter to the point of the blockage, where the balloon is then inflated. The pressure of the balloon is regulated until the narrowed artery expands to its normal diameter. One technical problem with the original technique was that the guiding catheter tended to pull back to the aorta, leaving no support for the balloon. This problem was especially prevalent during angioplasty of the right coronary artery, which has a tortuous course. The Arani double-loop catheter was designed to alleviate this problem. The double-loop has two curves: one is positioned against the anterior wall of the aorta, and the second is positioned against the posterior wall of the aorta. The tip of the catheter goes into the coronary artery. The combination of the two curves gives considerable support to the guiding catheter, and prevents the tip from recoiling back into the aorta. USCI began manufacturing Arani's device in November, 1985. A film highlighting the device and demonstrating how to use it was shown at a meeting of the American College of Cardiology in March 1986. Latest marketing figures show that the Arani double-loop catheters are selling at a rate of 1,000 per month, with large increases expected. Recent improvements in angioplasty technology, as well as an increased experience of angioplasters, have resulted in a marked increase in the number of angioplasty procedures. Currently about 25 per cent of patients with coronary artery disease can be treated with angioplasty. In the U.S. about 80,000 angioplasties were done in 1985 and almost 120,000 with coronary artery disease were treated with angioplasty in 1986. film and degrades film contrast. The device has already been built and is currently being tested. Clinical tests are being sponsored by a grant from the National Institutes of Health. Results so far show that the device does remove most of the scatter and vastly improves the contrast of X-ray film. According to Rudin, "the unresolved question of the tests is how much more useful information is to be gained from better X-ray pictures." Rudin, along with associate professor of Radiology Daniel Bednarek and several assistants, has also patented a new improved version of this, called the conical rotating aperture wheel device. According to Rudin, the first device involved the synchronization of three motors and three shafts, which calls for constant upkeep to keep them all aligned. Rudin states, "the conical rotating device has only one shaft and one motor, which will make it very easy to use. It is much more elegant geometrically, and it presented some challenging design problems. Once it is made, it will be very easy to operate.'' In the August, 1986, edition of Medical Physics, Rudin disclosed a new design for the wheel patterns which are used in his inventions. The wheels will have an optimized design, with a slit pattern and different angular widths, along with a spiral-shaped aperture pattern. This design will again make Rudin's devices more efficient and will eliminate more scatter from X-ray film. t the right wrm arteT) shou ing a set ere narrotvmg. Tip of the guiding catheter is shown b) the upper arrou and the louer arrou points to the arterial narrowmg. (Immediatelv abote) same angiogram after angioplast), shouing complete disappearance of the narrOtVIng. S tephen Rudin, associate professor of radiology, has patented an invention which has potential widespread application in X-ray technology. It is called the rotating aperture wheel device, and its function is to eliminate scatter in X-ray film. Scattered radiation fogs up 0 3! 5<>1l Dr. Stephen Rudin with rotary apertur del'ice. BUFFALO !PHYSICIAN! J ohn Kapp, chairman of the Oepartment of Neurosurgery, has had two devices patented: an arterial pressure control system, and an artificial metal and plastic vertebrae. Both of these are implantable medical devices. The arterial pressure control system is an electronically controlled computer device that is implanted on arteries leading to aneurysms. The computer will regulate pressure on arteries to prevent ruptures. Kapp stressed that, ' 'This device is not for permanent treatment. It is for early management, and is used temporarily before surgery." There is nothing comparable to it on 02/ 87 �4 the market today, and only the prototypes of Kapp's device have been built. The potential for saving lives is enormous because aneurysms are unpredictable and can rupture without warning. Kapp's device should decrease the risk of there-rupture of an aneurysm during the first several days after the initial hemorrhage, when direct surgery on the aneurysm is especially dangerous. Kapp's artificial vertebrae is used to replace vertebrae that have been destroyed by cancer. According to Kapp, "It is a last ditch device that is used on a patient with cancer of the spine when all other treatments fail." It has been approved for use on humans, and at present has been implanted in four patients. Chemical and radiation therapy was attempted on these four patients, but proved ineffective. According to Kapp, the device has potential, but it needs to be studied in more patients in order to collect data. Only then would it become commercially available. At present, only one vertebra has been replaced at one time, but Kapp and his associates are working on the problem of stringing together longer segments of the metal and plastic device. n Kapp's artificial vertebrae. sure level to pesticides is zero. If part of the grid turns red, this indicates exposure. The amount of grid that is red determines the amount of exposure, and dictates cleanup, and treatment if necessary." The badge is designed to detect exposure to organophosphates, which are widely used as pesticides in agriculture. Probably the best-known of this group is malathion, which was widely used in California to combat the medfly outbreak in the San Joaquin Valley. Baier feels positive about the usefulness of his product, commenting "The applications of this indicator are potentially lifesaving. It could be worn by migrant workers, and it can be understood even by illiterates. Everyone understands a traffic light. Farmers could use it to monitor the amounts of spray on fields and to avoid contaminating adjacent crops." D r. Robert Baier, head of the Health Care Instruments and Devices Institute (HIDI) since 1984, has invented a pesticide dosimeter. The patent is held by the Calspan Corporation, for which Baier worked when developing his device. Also named on the patent is former Calspan employee Dr. Vito DePalma. DePalma and Baier worked together to develop the dosimeter for the U.S. Army. The badge that Baier would like to see marketed for public use is a modified one, less suitable for military purposes. Baier states, "It is a simple, cheap device. It could probably be sold for less than 50 cents. The badge is color-coded with a gridiron face. If one can read a traffic signal, one can understand this device. If the grid remains green, expo- 02187 But Baier has run into a problem, and it is one that is all too familiar these days -product liability insurance. Baier states that "it is absolutely ludicrous that no one is willing to insure a product that can do so much good. The suggested premiums would cost more than any potential earnings from sales." He still feels ethically bound to bring this product to market. "It is a shame on society that a useful device such as this cannot be manufactured. I'm not trying to get rich. But I feel that even if I break even on this it will be worth it." The business consulting firm of Michael and Michael in Williamsville has been dealing with the insurance companies on a daily basis, trying to resolve the fate of the pesticide dosimeter. To avoid any possible conflict of interest between his roles as the head of HIDI and the marketer of a medical device, Baier has left everything in the hands of Michael and Michael. Baier feels there is much good that can be accomplished working with HIDI, and he feels confident that Michael and Michael will do their utmost to get the dosimeter insured and on the market. In addition to the problem of getting liability insurance, there is the added worry of the so-called "deep pockets" theory during liability lawsuits. Basically, that means that a person suing for damages tries to include as many parties as possible in the action, hoping that at least one of them will have money to pay if damages are awarded, or may want to settle out of court. Baier's previous employer (who holds rights to the dosimeter) is concerned about this possibility. The patent for the product will not be released to Michael and Michael without the required liability insurance. Baier comments, "It's a silly kind of thing. But that's today's world." M ary T aub, associate professor of biochemistry, has been involved in the study of kidney cells for ten years. She has recently developed a method of Dr. Kapp BUFFAID I PHYSICIAN I �5 culturing renal proximal tubule cells. The development of this type of cell culture system means that these kidney cells act very similar in vitro as they do in vivo. The possibilities for use are numerous. The kidney contains many marketable products, such as erythropoietin, which helps the maturation of red blood cells and plasminogen activator, used in som~ heart patients to prevent clotting. If produced in culture, these products can be obtained more easily and less expensively. Drug companies, in this case Bristol Labs, and Merck, Sharp, and Dohme, are involved in several studies using the kidney cells in culture. The two companies are testing the use of this system as an alternative to, or a supplement for, animal drug studies. Research can be done with cancerous renal cells to ascertain the effectiveness of a drug. Other studies are being performed with normal, nonmalignant renal cells to check the toxicity of drugs. The kidney cells are also used for more in-depth research of immunecomplex diseases of the renal cells. Taub cites some other applications for the renal cells. "More studies could be done with these cells to study heart attacks. What a lot of people don't realize is that the kidney receives 25 per cent of the cardiac output, and that a lot of deaths during heart attacks are due to renal failure. These cells should be studied in culture in order to better understand what happens to the kidney cells during renal failure. Another example is diabetes. Many juvenile diabetes patients have kidney failures. This disease needs more research, research which could also be done in culture." Unfortunately, Dr. Taub cannot patent her technique because of premature disclosure in a paper. But Taub adds, "I really don't care at the moment. There is so much excitement surrounding this, and I'm so busy doing more studies, and collaborating with other studies in the Physiology Department, and also in Microbiology and Pathology. I'm just Loop Guiding Catheter. trying to accomplish as much as I can." Taub also noted that several drug companies have hired her for consulting work to help monitor their research with the cultured renal cells. M ichael Apicella, professor of medicine and microbiology, has recently applied for two patents with the help of the Office of Technology Transfer. Both of the patent-applied-for techniques use the same basic technology for a rapid identification system; both systems are used to identify bacteria. The first test, using an antibody assay, can identify H influenza bacteria in only 30 minutes. Previously, the identification of influenza required biochemical tests which took 18 very expensive hours to run. Apicella's test is both quick and relatively inexpensive. Using the same technology, Apicella developed a test to identify lipopolysaccharides, and more specifically, the Neisseria gonorrhoea bacteria. This test can be run in less time and with less cost than existing tests. It can also be run without the expensive lab equipment that was previously needed. Marketing feasibility studies are underway for both of these identification systems. Space does not allow descriptions of all of US's medical inventions, but a sampling of others includes a customized way of synthesizing radioactive ligands for radioimmunoassay (Roy Slaunwhite); a novel flow electrophoresis (Carel Van Oss and Boris Albini); a method for detecting and quantifying carbon isotopes with mass spectrometer (Michael An bar); a lactulose-xylose absorption test (C. Roche-Lidder); and a method of reducing toxicity of acetomenophen (Edward Nelson). The inventions highlighted in this article are as diverse as the inventors who created them. Some, such as Dr. Arani's double-loop catheter, will be used during tens of thousands of operations each year throughout the world. Others may receive only esoteric plaudits in the form of peer respect and journal articles. Then there are those such as Robert Baier's pesticide dosimeter, which, despite their obvious public benefits, may never be manufactured. There is one thing that all of the researchers have in common: A desire to perfect a technique or a device, not for the praise that accompanies it but because of the desire to create something for the good of society, to make that which is difficult a little easier. . . the search for the ultimate widget. UB, with its renewed commitment to scientific research, has the potential for more scientific breakthroughs in the future. The pursuit of knowledge and the satisfaction of knowing that much good is accomplished are their own rewards. • (Mr. Mrozek is a professional writer a nd a UB undergraduat e alumnus.) dos1meter. BUFFAID IPHYSI¢1AN ] 02/ 87 �6 An accident or inspired dream can shape the invention process M ost times, new devices or techniques are the result of years of intense research and laboratory tests. But, occasionally, things are discovered, or at least conceived, by accident or by inspired daydream. Charles Goodyear discovered how to vulcanize ru bber when he spilled a mixture on a hot stove. The ancient Greek mathematician Archimedes discovered how to measure the density of gold when sitting in a public bath. He was pondering the problem of how to check the purity of a crown of gold. Watching the level of the bath water rise and fall as people sloshed in and out, he suddenly realized that different metals would displace water in varying amounts. Archimedes jumped up and ran naked through the streets, yelling "Eureka, Eureka (I have found it, I have found it)." T homas Lajos, associate professor of surgery at UB and Buffalo General, has invented three devices, one of which is patented and two of which are patent-pending. One of his inventions fulfills the o ld maxim that necessity is the mother of invention. While recuperating from a thumb injury sustained while skiing, Lajos designed a new ski pole grip that helps prevent the very injury he incurred. According to Lajos, "For the past decade, there have been 250,000 thumb injuries suffered by skiers each year. And the numbers have not gone down. This necessitated a new approach to the problem of the ski pole grip." In his younger days, Lajos competed in the sport of fencing. He recalled that the hand guard on the sabre gave adequate protection against accidental injury from an opponent's sword thrust. The basic concept for this new ski pole grip came from inverting a sabre handle, thereby encasing the fingers and thumb in a soft 02187 available to consumers in the near future. Rossingol Co. is tooling up for mass production. Lajos, who performs cardiac surgery when he is not skiing, has invented two devices, atrioventricular pacing electrodes, which are used in heart pacemakers. The electrodes, basically specialized wires, provide an electrical stimulus to the heart so it will contract and pump normally. In a diseased heart, the naturally occurring electrical pathways can be ~ blocked. A pacemaker provides an elec....,.~,,;~.-~ ~ trical energy source for a diseased heart. ~ The pacemaker, via the electrode, deliv~ ers the stimulus to the atrium and the Q . l O it ventnc e, circumventing the blockage . .~...,....._..;__ _ _ _;;..;.._~-----' and allowing the heart to contract in Dr. Thomas Lajos with neu s/..1 pole grip. sequence. Lajos' first patented electrode was BY PAUL MROZEK produced in the mid-1970s, and modified forms of it are still being used today. The second, a bipolar electr ode, is plastic cover, and preventing any hand patent-pending. The bipolar electrode injuries during a fall. involves the use of two wires in a harnessHe compares his hand grip to the type device which delivers two different modern ski bindings developed in the stimuli from the pacemaker; one to the 1970s. Lajos noted that, "The new ski atrium and one to the ventricle. This bindings were invented by orthopaedic device is widely used in the U.S. and surgeons over the last 15 years. They realized that the numbers of broken legs abroad. from ski accidents were reaching unbelievable figures, totally unacceptable to ne invention in world-wide use is the orthopaedists. They knew that some the smoking cessation aid, nicoof the injuries were preventable, just as I tine gum, invented by Dr. Claes Lundgren, know that thumb injuries are preventaprofessor of physiology. Lundgren is also the inventor of 13 other inventions, ble if a better grip is made. I hope the rate of thumb injuries drops the way the eight of them patented, including undernumber of broken legs has." water breathing devices and a special Lajos and his family, all avid skiers, exercycle (see Buffalo Physician, May have tried rough prototypes of his new 1984.) grip and discovered it works just fine. "Like everyone in the early 60s, I saw "We went out west to Jackson Hole, smoking as a medical problem. I was a where the real skiers go. I showed it to the smoker at the time ...and became conSki Patrol and they were quite impressed," vinced that smoking was an addiction, commented Lajos. The grip should be not just a bad habit picked up from social 0 BUFFAID I PHYSICIAN! �7 and behavioral patterns. This notion was strengthened by the fact that the nicotine free cigarette had failed as a commercial venture and that scientists gradually learned it was not the nicotine but the other things in the smoke that were the serious health problem." The idea of the invention struck Or. Lundgren when he thought, "What is more reasonable than a non-cigarette source of nicotine for smoking withdrawal?" He explained further, "My idea was to supply nicotine in a clean form, without the carcinogens and carbon monoxide, as a means of getting away from the real dangers of smoking - and without experiencing the withdrawal symptoms.'' Or. Lundgren brought his idea to the pharmaceutical company within days. They made the first prototype gum that same year. "The first preparations were a bit of a disappointment," he remembers. This is because the acidity of the saliva interfered with the rate of nicotine absorption. The company resolved that problem with a special preparation, an ion-exchange nicotine resin complex. Another unusual hurdle was something encountered by many inventorsskepticism. Lundgren found "total disbelief and substantial resistance to the idea, even among physicians. Imagine, offering nicotine in a chewing gum of all things! " Now sold in many countries, it first became available in the U.S. in 1984 and is now a common smoking cessation aid. F or many people, going to the dentist stimulates anxiety or discomfort. For Michael Anbar, Ph.D., it stimulates inventions. His dental chair experience inspired the chairman and professor of Biophysics to devise three dental inventions that would, if put to use, relieve himself and others of some of the miseries of dental problems. "One day several years ago, after leaving the periodontist's office, I started to think, 'How can you treat periodontal disease non-surgically and nonsystemically?' Instead of treating with systemic antiobiotics, a surface anti- Continued o n Page 3 7 Invention Disclarure SUNY process facilitates patenting of discoveries BY CONNIE OSWALD STOFKO I fa researcher really wants to see his technology get used in the marketplace, he'll take the time to go through the invention disclosure* process, said Hank Kung, Ph.D., who discovered a drug that has been patented through the University. Kung, an associate professor in the Department of Nuclear Medicine, developed a drug that will allow safer, less cost! y, and often more accurate diagnosis and management of stroke and other brain diseases. One of the major considerations for Kung in his decision to pursue the invention disclosure procedure is the tremendous cost involved in getting a drug approved by the Food and Drug Administration (FDA) . The studies required before a drug is approved can cost between $5 million and $10 million, he said. A drug company would not want to spend that kind of money developing a drug if it didn't have patent protection. Otherwise, another company could come along and take advantage of the work, he explained. "So in order to see something applied in the marketplace, it's the process you have to go through,"Kung said. Before the State University Research Foundation Office of Technology Transfer was set up, there were federal agencies that could help, but the process was very cumbersome, he said. "Now the State finally realizes there are benefits for both the State and the companies." A larger slice of royalty payments is just one of the incentives that now exist to encourage researchers to file "invention disclosures," said Edward M. Zablocki, coordinator for industrial and BUFFAID I PHYSICIAN) external relations in UB's Office of the Vice President for Sponsored Programs. UB researchers are required to go through the invention disclosure process when they discover something that may be patentable or licensable, he explained. The researcher submits a form to UB which is then sent on to the State University Research Foundation's Office of Technology Transfer. That SUNY office handles the determination of patentability, then tries to market the idea to industry. If the discovery is successfully patented and licensed, the researcher, directly and indirectly, receives most of the royalties generated, Zablocki said. The researcher personally receives 40 per cent of the gross royalties- "a fairly liberal figure," Zablocki commented. A big recent change is that another 48 per cent is split almost equally among the researcher's laboratory, his department, and an account used for research development funds, Zablocki said. Some faculty members did not submit invention disclosures in the past because they were unaware of it, Zablocki explains, or thought it was time-consuming. "However, an invention disclosure can be completed in about 30 minutes," Zablocki notes. Inventions by University faculty are receiving increasing attention as one component of UB's role as a catalyst for economic development in Western New York. The goal is that inventions will be licensed by WNY companies, including some companies begun by the inventor. The WNY Technology Development Center is actively marketing these UB inventions to area companies. • ·Invention disclosure forms and assistance can be obtained by calling che V P for Sponsored Programs ac 63().332!. 02/ 87 ����11 AIDS research Couple's cell study could lead to vaccine ((w BY CONNIE OSWALD STOFKO e're sort of catching up to the AIDS virus in our ability to understand it," said David Rekosh, Ph.D., associate professor in biochemistry at UB. While on sabbatical at the Karolinska Institute in Stockholm, Sweden, Rekosh studied how the proteins on the outer shell or "envelope" of the AIDS virus operate. He worked on the project with his wife, Marie-Louise Hammarskjold, M.D ., Ph.D., who is now assistant professor of microbiology here. The couple is applying for a grant to continue the work at UB. The two studied the envelope protein of the AIDS virus and the way it binds to white blood cells (lymphocytes). If that process is understood, it may be possible to develop a vaccine that prevents that binding, they said. "If the vir us can't attach to the cell, it can't get into the cell, and you won't get the infection," Hammarskjold explained. The envelope protein on the outside of the virus will recognize and bind with only certain proteins. Recently it has been found that the virus can invade brain cells and cause symptoms, but generally, it's the T-4 lymphocytes that are attacked, Rekosh said. The T-4 lymphocytes are the cells of the immune system that help other cells, called B-cells, make antibodies . When the T-4 lymphocytes are invaded, the body can't make enough antibodies, weakening the body 's defenses against other infections . The AIDS patient develops "opportunistic" infections that prove fatal. In their work, Rekosh and Hammarskjold have taken a gene out of the AIDS virus and put it into an "expression vector." An expression vector allows foreign proteins to be made where they normally would not be made. The researchers introduce their expression vector into animal cells rather than into bacteria. "You use the cell as a factory to produce the protein you want," Hammarskjold explained. I nstead of manufacturing a whole virus, the cell merely manufactures a protein from the virus. There are many advantages to this. First, researchers can work more easily because there's no infectious virus around. Hammarskjold said that people working with the virus must take precautions even though it probably would take an injection, not just an open cut, to BUFFAID !PHYSICIAN I 02187 �12 become infected with it. The manufacture of envelope protein has been accomplished by most other groups in bacteria rather than in animal cells. But envelope protein made in bacteria doesn't behave normally, Rekosh noted, and it is not useful for many types of studies. "We've been able to produce a lot of protein, and we've been able to show that it's extremely similar, if not identical, to the protein made by the actual viral infection," Rekosh remarked. "It looks the same, and in a couple of different tests, it acts the same." In Sweden, researchers are testing to see if the protein binds to the T-4 cell. Rekosh is confident it will. Rekosh and Hammarskjold have been able to produce quantity as well as quality. "We do better in the production of protein than the virus does," Rekosh said. He noted that these expression vectors are a source of protein for other researchers who request it, as well as for their own work. an AIDS vaccine. "For a good vaccine, you have to understand how the envelope protein helps the virus get into the cell - that's the basis of the science we want to look at," he explained. "You can make a better vaccine if you know how the virus interacts with its host cell," Hammarskjold agreed. "Even if a vaccine was developed tomorrow, the scientific question of how the protein works would still be there," Rekosh added. "Not only is it a medical problem, but it's a scientific problem, and it's as interesting as any other." R ekosh, who is co-director of UB's Center for Applied Molecular Biology and Immunology (CAMBI), hopes to be able to link his basic research to clinical research starting at CAMBI. nlf the virus can't attach to the cell, it can't get into it, and you won't get the infection." A nother advantage of the UB researchers' method is that the manufactured protein is free from other components of the AIDS virus, Hammarskjold said. If the protein reacts in a certain manner during a test, Rekosh and Hammarskjold can be sure the results are caused by that particular protein. "We have a pure sy tern," Rekosh said. Other researchers have manufactured the envelope protein by transplanting one of the AIDS genes into the vaccinia virus which is harmless to most people. But that method as a vaccine has the added complication of having body cells infected with the vaccinia virus. Using the whole envelope protein, either in a vaccinia virus or by itself, is a naive approach to vaccine development, Rekosh said. Parts of a protein, rather than a whole protein, will probably be needed, he argues, and scientists must understand which parts to use. It's going to take science, not just technology, to develop 02187 M ichael Apicella, M .D., professor of medicine and microbiology at UB, is the other co-director of CAMBI. He recently was named head of the Buffalo-based portion of a National Institutes of Health study to evaluate treatments for AIDS. ew drugs will be tested at a clinic at Erie County Medical Center. Buffalo, Syracuse, and Rochester have ben designated as a single center. Ray Dolan, M.D., of the University of Rochester, has been named head of the center. The Buffalo funding for the first year of the five-year study will be an estimated $200,000. Apicella will be assisted locally by Ross Hewitt, M.D., a fellow in the Division of Infectious Diseases. Rekosh hopes to have access to clinical BUFFAID !PHYSICIAN I Drs Rekosh and Hammarskjold in their lab. specimens such as serum from the clinicians. It may even be possible to develop a better test to diagnose AIDS than is available on the market now, he speculated. "We may be able to provide clinicians with some expertise on how the virus works, and they can provide us with ... ," Rekosh paused thoughtfully, " ... reality. It's important to remember there's a patient at the end of all this." Rekosh and Hammarskjold will also keep ties with researchers in Sweden. Eva Lindstrom, a student who was supported by Hans Wigzell, professor and head of the Immunology Department at the Karolinska Institute, was here for three months. She assisted while learning the method and took the technology back to Sweden, Rekosh explained. "The research we're doing, the questions we're asking, and the technology we're using are as good as is being done anywhere," Rekosh said. "We're at the forefront. "I've never had any trouble getting �13 S grants for research I thought was important, so I'm optimistic we'll get funded ." A IDS is important because of its tmpact on our society, he said. It encompasses moral, social, political, and educational issues. Sexuality in our society was changed a great deal by herpes, and that condition isn't even lethal, he noted. "AIDS is the best thing that could have happened as far as the fundamentalists are concerned," he said. "If the disease had come into pregnant women instead of homosexuals, society would have seen it as a great threat and done something about it. The gay community is very embittered about that." With the hysteria surrounding AIDS, there are fears that there may be attempts to quarantine people with AIDS, or to quarantine even people who are "antibody positive." A person with antibodies may or may not ever get the disease, and, in a couple of cases, people seem to have cured themselves, Rekosh said. And even if a person has the disease, there's clear evidence that he's not infectious through normal, casual contact, even with close family members. "I'm against using the AIDS antibody test to discriminate against people," he stated. Because it touches on topics such as drug addiction and sex, the AIDS issue "hits western society at its weak spots," Rekosh said. "It makes us deal with things we don't want to face. Since it has spread to prostitutes, we're going to have nice, ordinary middle-class men bringing it home to their wives. But nobody wants to admit this goes on." He emphasized that one of the keys to battling AIDS is education. He criticized the short, non-substantive reports carried on television. "They're always pressed for time," Hammarskjold added, tapping her watch. "They say, 'This is interesting, but we don't have time.' " BUFFAID ! P HYSICI A N I wedish television devotes hours and hours to groups of specialists who discuss the issue and give good, clear advice . But a survey in Washington, D .C ., showed that many health care workers in that city don't know how the disease is transmitted, she said. While the Swedes are "a hundred light-years ahead" of Americans when it comes to dealing with AIDS in a straightforward manner, even they have political problems, Rekosh said. An example has to do with the way AIDS is spread among drug addicts. The problem is much worse in Stockholm than it is 500 miles away in the city of Malmo. People in Stockholm can't purchase syringes legally, but those in Malmo can cross the channel and buy them legally in nearby Denmark. Government officials don't want to make it legal to purchase syringes for fear it will promote drug addiction, Hammarskjold pointed out, and right now drug addiction is a bigger problem than AIDS. Other diseases around the world affect more people than AIDS does, Rekosh admits. Schistosomiasis, which he is also doing work on, affects 500 million people, mostly in Africa and South America. The famine in Ethiopia is killing more people than AIDS is. "But people in the western world are not used to people dying next door, left and right," he said. Rekosh cited statistics presented at an AIDS conference in Paris by ]. W. Curran, an epidemiologist at the Centers for Disease Control. If there is no change in social habits or treatments that are available, by 1991 there will be 174,000 people in the U .S. with AIDS requiring care. In addition, 179,000 will have already died. Rekosh related a prediction from Wigzell of Sweden: "If our research efforts cause a vaccine to be found one day sooner, it will save at least 500 lives." • 02/87 �14 COMPUTERS IN MEDICINE Dr. Michael Anbar's text on the subject is one of the first of its kind to be published BY BRUCE S. KERSHNER 0 ne of the first books, and almost certainly the first textbook, ever to be written on the subject of computers and medicine has just been released. The coauthor and editor of the precedent-setting book, Computers in Medicine ( 1987, Computer Science Press, Rockville, Md. 299 pp. ), is Michael Anbar, Ph.D., chairman and professor of the Medical School's Department of Biophysical Sciences. Not only is Anbar's textbook the first to be written on the timely subject, it is the only textbook that addresses the philosophical issues, challenges and opportunities that computers have created for the field of medicine. 02/87 In addition to teaching computer literacy to health professionals, the volume portrays the dramatic impact that computers are having on medicine, ranging from prosthetic devices that are taking us closer to the possibilit y of the "bionic human," to artificial intelligence and computerized diagnosis that have raised unfounded fears about the computer "replacing" the doctor. The book is unusual in that it is aimed at such diverse audiences. One intended audience includes physicians (particularly those who got their educations in the B.C. [Before Computers] era) as well as medical students and hospital residents. The second audience is the computer BUFFAID I PHYSICIAN] science and engineering community, especially those who would like to apply their technology to the advancement of medicine. Lastly, the book is designed for all readers "who wonder about the role of computers in medicine and may worry about the impact of the growing role of automation in healthcare." While computers are contributing to swift changes in medicine, Anbar is clear that they are not a serious threat to the physician's domain. "There are two myths that doctors believe regarding computers in medicine,'' Anbar explains. "The pessimistic myth is that computers will take over and replace the doctor." The reality of computer- �15 Dr. Mlchacl Anbar assisted diagnosis, he explains, is that it can never accomplish what the mind of the doctor can. "This is an absurdity," Anbar states. "It cannot weigh all the variables, all the exceptions, all of the subtleties of direct interaction with the patient," he emphasizes. "Furthermore, medicine requires a larger amount of humanism than any other technology-intensive profession," he continues. "Physicians must manifest more 'human' attributes than any other professional; they must combine lucid reasoning, intuitive heuristic creative thinking, and decisiveness with compassion and interpersonal interactive skills. Consequently, the physician will proba- bly be the last professional to be replaced by a mechanoelectric device." W hile Anbar assures that the diagnostic and decision-making role of the physician is not threatened by the computer, as the pessimistic myth implies, that doesn't mean the doctor's role in society won't be affected. Computers will strengthen the role of skillful surgeons and other physicians who will use even more sophisticated computer-assisted equipment and tools. At the same time, home based computerized health instruction will greatly increase the health education of patients. This will contribute to the decline of the father role of the BUFFAID !PHYSICIAN I physician, Anbar asserts. The internist and family physician, for example, may become more of a learned consultant than an authority figure to a growing number of health-educated patients. The optimistic myth regarding the role of computers in medicine goes like this: if we could put all data of all patients into computers, we could solve any medical diagnosis. "That can't happen because there is no way to standardize patient data and diagnosis that could lead to accurate computer diagnoses applicable to the entire field of medicine." Different doctorS will describe the same condition in different ways. :~nd semantic differences are very 02187 �16 subtle. Another optimtstlc variation of this myth, Anbar says, is that "computer storage of medical data is infinite." The medical record for one patient totals 50,000 bits of data. For the entire field of medicine, there are hundreds of billions of bits of information, Anbar comments. "No 20th century computer can store all that information in its active memory. Even if it could, it would be impractical and too time consuming to enter all the data and too time consuming to wait for it to be printed out. Even if that became possible, information overload or overdiagnosis could result." Overdiagnosis is the finding of marginal abnormalities in certain parameters not originally required to establish a diagnosis. This, however, can be avoided by designing the program to ignore inputs not warranted on the basis of prior information, Anbar relates. T he book is "user-friendly" in that it minimizes technical jargon, especially in its philosophical discussions. It also gives reassurances that computers are "friendly" (that is, not so threatening), as indicated by chapter titles such as "You Are the Master- The Machine at Your Service," "Your Humble Consultant" or "The Clerk That Never Forgets." The benefits that make computers "friendly" are in place and rapidly accelerating. They are increasing the ability to substitute missing bodily functions through prosthetics: limbs, cardiac functions and hearing. They are enabling us to produce better surgical tools or tools that can perform tasks not previously possible. They have revolutionized diagnostic imaging so that "One picture can be worth a million words." Computers have also increased the output of clinical lab analyses a hundred-fold with no increase in staff or space. Office management for the practicing physician is also being made less of a chore through computerization. The monitoring abilities of the computer are affecting the nurses' role by making patient surveillance more effective and eas ier. "Controlled medication and 02187 intensive care units are also drastically different today because of computers," An bar relates. Home-based patient monitoring is affecting hospital programs and medical costs. For the lay public, computers now make possible home-based, self-prediagnosis as well as the self-instruction that will produce a much more healthwise population. For the medical community, computerassisted instruction ("The computer as Socratic teacher") is also affecting the way medical students are being taught. Anbar's book, in fact, originated because there is no textbook on the subject that he can use for the computer literacy section of the Clinical Biophysics course that he teaches. The course, incidentally, is one of the very few required courses in American medical schools that teaches computer literacy to medical students. Not only did An bar find there were no "computers in medicine" textbooks on the market, but he had another motivation to write the book. "Physicians as a group are computer-shy. I wanted to overcome the built-in resistance of clinicians to using computers. Right now, they're using computers primarily by default, that is through laboratories, equipment, and office management." Anbar predicts many more exciting new medical uses of computers in the future. "Their use in prosthetics is likely to lead to a form of artificial vision within 20 to 30 years in which external signals will be linked directly to the optical nervous system. "In diagnostic imaging, computers will ultimately be able to analyze the images themselves to assist the physician who will still make the decisions. They will also enhance the images so that doctors can recognize features not previous! y possible." 0 ther future developments will improve medicine while creating difficult changes for other health-related professions, Anbar states. "The other health professions will also have to adjust to computerization. Pro- BUFFAID I PHYSICIAN I tocol-driven treatment using computers in ICUs, emergency rooms, nursing homes and home care will greatly improve patient care. They will be able to monitor and administer medicine and pain-killers constantly, around the clock, and will not ' forget' tasks because of fatigue or stress. But the cost efficiency of 'electronic nursing' and 'electronic paramedics' will also change the nature of those fields." Computers will also revolutionize the written word. Electronic textbooks, such as all of "Harrison's Principles" or the Merck Index, will be able to be called up instantaneously . Computer-assisted instruction and computerized textbooks will become standard. "In current society, the written (printed) word has more weight and prestige than the computerized word. The unexpected change will be that the prestige of being published in respectable journals or of writing a textbook may be lost if screen displays or printouts become the primary medium for the word. It may affect the basic motivation, as well as the process, for publishing." Dr. Anbar's coauthors include Fred Snell, M.D., Ph.D., professor of biophysical sciences; Robert A. Spangler, M .D., Ph.D., associate professor of biophysical sciences; Peter D. Scott, Ph.D ., associate professor of health behavioral sciences. Dr. Anbar has been a leader in biotechnology for many years. He serves as editor-in-chief of Health Care Instrumentation. The Hebrew University Ph.D. graduate former! y served as a professor in the Weizmann Institute of Science, head of the Israel Atomic Energy Commission Department of Radiation Research, a delegate to the 2nd UN conference on Peaceful Use of Atomic Energy, and as one of the directors of the Stanford Research Institute. Anbar came to UB in 1977 to serve as chairman of the Department of Biophysics and also holds professorial positions in UB's Dental School and the Roswell Park Graduate Division. He founded UB's new Health-Care Instrument and Devices Institute (HIDI) and was its first e director. .. �17 ROSWELL PARK'S COMPUTER PLAYGROUND ((A computer playground for the serious scientist" that's how Roswell Park Memorial Institute refers to its Theoretical Biology Unit. It is the first computational laboratory in Buffalo to combine theoretical calculations and molecular modelling, and is the latest regional technological resource center for area scientists. The unit, under the direction of Dr. Robert Rein, is primarily a biological and chemical construction site, where the blueprints for future cancer drug development are drawn, intricate molecular processes are mapped, and protein and nucleic acid prototypes are designed. Here, scientists study the molecular biology of the total cancer process, using advanced computer technology to build visual models. "Each piece of laboratory equipment," said Dr. Rein, " is invaluable for studying complex molecular processes, and for providing researchers with a better structural understanding of chemistry and biology." Included on the laboratory's roster of state-of-the-art equipment are the recently purchased Evans and Sutherland PS 300 computer graphics system -the only one of its kind in Buffalo-the Tektronix 4081 system, a VAX 111750, and a HP 1000 computer. This equipment was acquired with external support from NASA and the National Foundation for Cancer Research. The computer graphics system, the pride of the Theoretical Biology Unit, is used for molecular modelling, drug design, and for solving the most complex chemical and biological problems. With this system, intangible thoughts become tangible images. Experimental "pencil and paper" research appears as magnified, threedimensional architecture on the computer's screen. Each "building block" of the molecular model revolves in brilliant colors, which mimic laser light in their intensity. To capture the three-dimensional details of the structures, special eyeglasses are worn by the system's operator. According to Dr. Rein, the system is BUFFAID I PHYSICIAN] unlimited in its use and application. "We can expedite the design of hundreds of thousands of promising cancer drugs," he said. "We can observe peptidyl transfer in atomic detail or conduct structural studies of cytolytic toxins or study the binding of bioactive macro-molecules to cell receptors. With this one piece of technology, we have successfully erased many scientific boundaries." Dr. Rein hopes the PS 300 and other high-tech computer systems will entice Western New York scientists to use the Theoretical Biology Unit as a regional resource. "I plan to encourage and initiate collaborative research with area scientists who require state-of-the-art modelling technology to pursue new projects or extend existing ones," the researcher explained. "With our modelling expertise and equipment, we can handle almost any problems from biology to chemical engineering. I'd like to see more integrated, multidisciplinary scientific programs being conducted within our laboratory." e 02 / 87 �18 COMPUTER APPLICATIONS IN CLINICAL MEDICINE: AN OVERVIEW BY BLACKFOR D MIDDLETON, M.D. (Class of 1985) I t is estimated there are one million generally accepted facts in the field of internal medicine and conservatively another million facts in all the subspecialties of medicine. 1 Although some have questioned the need for computers in medicine, 2 it is clear the information explosion in medicine is making it increasingly difficult for a physician to master the essentials of even the narrowest medical specialty. Medical practice is becoming ever more dependent on computers and it appears imminent that one of the physician's most personal domains, medical diagnosis and decision-making, will be the next field to take advantage of the computer revolution. Beyond the acquisition of a massive data base, physicians also face the task of integrating their knowledge, their moral or ethical codes, and their perceptions of a patient or problem in order to devise a rational and acceptable plan of action. The science and art of diagnosis are under more and more intense scrutiny as computerbased techniques are being developed that strive to mimic the process of diagnosis. Before computers do indeed enter the physician's personal realm, numerous problems, both technical and societal, need to be resolved. This discussion aims to illuminate some of these problems, as well as aid the reader in understanding the ways computers will actually assist in diagnosing disease. Medical D ecision Making The cognitive span of expert medical diag- 02187 nosis has been equated to all previous experience for any one doctor. 3 That is, he or she may draw on any of his or her past experiences in terms of knowledge, practice, emotions, or moral stance in evaluating a patient. To narrow down this search for relevant data in the physician's total experience, various techniques are employed. One diagnostic process, the "heuristic" approach may be divided into six well-defined steps:4 1) aggregation of groups of findings into recognizable patterns, 2) selection of a "pivot" or key finding to narrow the field of probable diagnoses, 3) generation of a "cause list" of diseases explaining the key finding, 4) pruning the "cause list" in light of the findings in the case, 5) selection of a diagnosis, and 6) validation of the diagnosis. Simplistically heuristic reasoning may be thought to proceed by trial and error with if-then rules of thumb. 5 For example, if a manifestation of disease is present, then disease may be present. In this manner the cognitive span is reduced and focused. Older doctors appear to use more heuristic techniques6 and thus may approach problems with a broader perspective, while younger doctors tend to have a limited perspective of the problem at hand and use more "algorithmic" (like a flow-chart) reasoning. It is in just those initial stages of diagnosis requiring the broadest cognitive span that doctors are needed most. 3 In his 1973 landmark paper on medical decision making, G .A. Gorey 7 came to BUFFAID I PHYSICIAN I �19 four major conclusions regarding medical decision making: • Clinical judgement is based less on detailed knowledge of pathophysiology than it is on gross chunks of knowledge and detailed experience from which rules of thumb are derived. • Clinicians know facts but knowledge is largely judgmental. Rules are learned to focus attention and generate hypotheses quickly. Thus, clinicians avoid a detailed search through the entire problem space. • Doctors recognize levels of uncertainty associated with the rules they use but do not routinely quantify or utilize these certainty concepts in any formal statistical manner. • It is easier for experts to state their rules in response to misconceptions they perceive in others than it is for them to generate such decision criteria out of context. Four Paradigms of Computer Assisted Decision Making If computers are to adequately emulate human reasoning processes, they will need to use several "reasoning" techniques similar to those humans use. However, the techniques humans rely on 5 include such subconscious "sources of power" as knowledge-based or experiential rules of thumb, the ability to divide a problem into managable sub-problems, the ability to reason by analogy, goal-directed reasoning, and the ability to recognize serendipitous solutions. It is extremely difficult for computers or their programming software to simulate any one of these techniques, let alone integrate them in an operational fashion. Computers traditionally have been most effective using "power-based" applications such as algorithmic, statistical, or mathematical modelling to assist decision making. Recently, however, the field of artificial intelligence has arisen and research has shifted to "knowledge-based" strategies using heuristics to enable computers to emulate human reasoning. 8 Certain generic problems surrounding the use of computers arise with any of the above techniques. Computers, of course, must be programmed. This implies an inevitable delay between realization and application of new knowledge whereas for humans 02/ 87 �20 hopefully there is little or no delay. This delay with computers may only be temporary, however, since computers may soon be able to learn 3 and some progress has been made in that direction. 9 The need for dynamic programming that is flexible and easily updated is well recognized. IO Another problem, especially in the field of medicine, is associated with the machine representation of clinical data. This information may be very subjective and prone to considerable variability and inaccuracy. 11 Disagreement among observers is common, and reproducible, quantifiable scales have not been established for all clinical indices. Also computer applications are typically very specific for one problem or setting. Computer programming is often not transferable even among similar situations. This severely impedes general acceptance of new techniques, increases the work required to integrate computers into health care settings, and prevents the realization of economies of scale that would make computerbased techniques financially desirable. 10 Computers are being used for many of the business aspects of health care delivery, but before they may be used in clinical medicine more standardization and uniformity is required. Finally, it is clear computer systems cannot be implemented to take over all business or clinical activities at once. Diagnosis assisted by computers 12• 13 must be gradually phased in to the system, adding those work centers or tasks as they become amenable to computer support. Computers have successfully used algorithmic approaches to problem solving but this has limited general utility in medicine. Clinical algorithms are appealing because they drastically reduce a problem to one of two choices, thus reducing information overload for doctors. They may increase the quality of care and compliance by patients with well-defined problems. 1 Decision theory applies real values to choices at decision points in algorithms and may help doctors and patients make difficult choices rationally. 14 However, the algorithmic approach suffers because it does not allow for a comprehensive approach to problems and becomes very cumbersome in complex situations. It allows only two options at a time with no awareness of the sequence of events or indirectly related fac- 02187 tors. 1 While algorithms do help to quantify decision making, they also require assigning subjective values to health and suffering, 1 and may be too time consuming to be useful clinically. !4 One extension of the flow chart approach uses statistics (Bayesian) to assign probabilities to outcomes given certain preliminary factors or events. The appeal of this approach lies in its ability to consider many factors at the same time and still accurately determine the probabilities of various outcomes. It is limited, however, because it assumes independent diseases and symptoms and requires an extensive data base to determine their statistical relationship. Also unknown factors not accounted for and failure to include them may lead to spurious or invalid results. The last problem with the statistical approach is that it bears little resemblance to human reasoning and can provide no explanations for its predictions. 1 The ultimate numerical technique employed by computers is exact mathematical modeling of an event. The advantage of mathematical modeling is that it produces a non-probablistic result that is precise. It depends on well characterized, isolated, quantifiable relationships that may be represented by an equation. Few such situations exist in medicine. 1 The most promising development regarding the application of computers to medicine is Artificial Intelligence (AI). This approach developed as a response to the limitation of more traditional computer based models of reasoning. The goals of artificial intelligence are: 1) The development of computational models of intelligent behavior (cognitive and perceptual), and 2) solving problems usually thought to require humans. 8 Artificial intelligence uses techniques based on both the mental processes and qualitative judgements culled from experts by symbolically representing them in computer programming. One of the better known systems is MYCIN, developed at Stanford University, to aid in the diagnosis and treatment of bacterial infection. Briefly, this program stores 500 generally accepted rules of infectious disease with specific patient information in a dynamic database. The program interacts with its user when it needs more information to satisfy all premises of a BUFFAID I PHYSICIAN I Situation before applying a rule. Application of a rule enters a new fact about the case into the dynamic database. The same process occurs for diagnosis and then selection of therapy.'· 8 A particularly appealing feature of the MYCIN program is its ability to demonstrate its "reasoning" to the user, e.g., when the stain of a specimen is Gram negative, a bacterial infection is possible. Rules used and inferences drawn may be displayed, covering diagnosis and selection of therapy all the way back to the initial premises.8 The system may also be easily updated and debugged without destroying the entire rule and inference making system - an essential if it is to be truly useful in the real world. 8, IS Another well known AI application in medicine is Internist- I. Developed by R.A. Miller and Jack Myers at the University of Pittsburgh, this system strives to cover the entire field of internal medicine.I 6 With roughly 75 per cent of the knowledge base of internal medicine in its programming, lnternist-1 does remarkably well. Briefly, lnternist-1 is guided by two heuristic principles: defining problem areas through a "partitioner" algorithm, and the conclusion of diagnoses within problem areas. Each manifestation of disease is assigned a value in three variables: "evoking strength, frequency, and import." The evoking strength represents how strongly a diagnosis could explain a finding. Frequency assesses how often patients with the disease have the finding. Import is a diseaseindependent measure of the importance of the finding or to what extent it must be explained in a patient. A list of possible diagnoses is formed and diseases are rankordered using the above variables in much the same way a physician would - the number of findings explained by a disease, versus the number of manifestations of the disease not found in the patient. When two contending diagnoses each explain no more of the manifestations than the other, three strategies are employed by the computer to reach a conclusion: "pursuing" a diagnosis for confirmation, " ruling-out" a diagnosis, or "discriminating" between diagnoses. The machine " asks" the user for additional data to reach its conclusion but may defer or only reach a "tentative diagnosis" if it cannot make a "definitive" diagnosis. �21 Although the lnternist-1 program performs well, it has several limitations that prevent it so far from being used clinically. 16To begin with, the knowledge base is not complete. Undoubtedly programmers will forever be adding to and updating the knowledge base as the field of internal medicine expands. The program can make several diagnoses in different problem areas but cannot "explain" complicated multisystem problems. It has difficulty reasoning anatomically, or temporally. Issues Surrounding Use of Computers In Clinical Medicine First, there are "acceptability" and "performance" issues, 1 as well as issues surrounding the accessibility of computers. 10, l7, l8 Computers have had a hard time gaining acceptance in clinical medicine. Possibly a "critical mass of people" must become involved before computers will be widely used in medicine l8 or perhaps doctors will not accept computers until it is clear computers can do something they cannot. 6 Furthermore, at this time it has not been demonstrated yet that computer assisted diagnosis or decision making will improve health care. IOIssues of security of patient information, l8 cost, 8, 10 and the possibility of additional personnel 10 arise in an already labor-intensive industry. Computers must be speedy, reliable, helpful, and versatile before they will gain widespread use. 8 Intertwined with acceptability is the issue of accessibility. If health professionals cannot use a computer, it will never be accepted. The man-machine interface is an area of intense research --computers must be user-friendly. 18They must be logistically placed in the work environment to permit easy integration into daily work.10. l7 If computers reduce the workload and save time for health professionals, their use will be naturally reinforcing. 19 The use of computers in clinical decision making raises questions also in the area of accountability. If it is assumed the programming is up to date and the machine is well integrated into the health care delivery system, problems in other more mechanical areas may yet arise which are beyond the doctor's control. The machine may fail, power may fail, or there may be informa- tion errors resulting from data entry errors, or inaccurately assigning one patient's data to another. Gardner has identified the need for systematic redundancy in hardware to prevent electronic or mechanical problems from endangering patients. 17The computer software, in addition, must have built in checks for anomalous data - data that a doctor would recognize as not being right. Evaluation of computer assisted diagnosis must go beyond the ability of a machine to compute the correct or probable diagnosis. As with any new technology or procedure, it should be rigorously evaluated against clearly stated objectives prior to general implementation. 18 One six-stage evaluation scheme that would effectively evaluate the diagnostic ability of a computer has been proposed 15 but more general work remains to be done on the general impact of computer assisted decision making in medicine. How will it change the physician-patient interaction? Will it demean or redefine the physician's role? Will physicians' clinical acumen decrease with increasing reliance on machines, or will the number of expert consultants decrease as they may be replaced by machines? 19 Will faceless computer diagnosticians change health seeking behavior in patients, or make them more prone to litigation against a nonfeeling, non-entity? Con clu sion As the knowledge base expands further in medicine, computers will increasingly be called upon for information management. To make this information generally usable, sophisticated computer programs and techniques must be developed to facilitate the man-machine interaction. There is clearly a great need for research to devise sophisticated ways to represent-medical knowledge for computers. 8 Medical knowledge itself must be continually explored and amplified to find "intermediate pathophysiologic states" l6 that would make diseases and their manifestations more interpretable by computers and humans alike. More work needs to be done in modelling human thought processes - inference mechanisms, how to handle uncertainty, and how to learn from mistakes. Finally, work needs to be done on how to smoothly integrate computers into current systems, and in BUFFAID (ISHYSI¢1ANI assessing the impact of the technology on health care operations, economics, and the physician-patient interaction. Despite all the problems relating to the new field of artificial intelligence in medicine, physicians should realize that the same technology that got us to this point will make it possible to overcome these problems. The way technology has developed, it is not a matter of "if," but "when," and in exactly what form, computers will enter the physician's domain. • (Dr Middleton. a 1985 UB alumnus. IS 1n the residency program of the Un111ers1ty of Conneclicut Health Center 1n Fam1ngton. 0 He 1s. InCidentally. the son of UB dlerg1st Dr. ElliOtt Middleton.) REFERENCES KumJC, eta!. "Computer-Assisted Decis1on Makmg in Medicine." 1- Med. & PhUosophy, 9:135160, 1984. 2. Pauker SG, eta!. "Towards the Simulation of Clinical Cognition: Taking a Present lllness by Computer," Amer 1- Med, 60-981-996, 1976. 3. Blois MS. "Clinical Judgement and Computers." (Special Article) Neu Eng. 1- Med., 303: 192-197, 1980. 4. Eddy DM, Clanton CH, "The ArtofD~agnos1s: Solving the Clinicopathological Exercise." Neu Eng. }. Med., 306:1263-1268, 1982. 5. Lenat DB. "Computer Software for Intelligent Systems." Sc1enn/ic American, 251 :204-213, 1984. 6. Ziporyn T. "Computer-Assisted Medical DecisionMakmg: lnterestGrowmg."1-AM.A., 248:913-918, 1982. 7. Gorry GA. "Computer-Assisted Clmical DeciSIOnMaking." Methoci< of lnfonnanon m Med1cme, 12:4551, 1973. 8. Duda RO, Shorthffe EH. "Expert Systems Research." Science, 220:261, 1983 9. Blum RL. "Discovery, Confirmation, and Incorporation of Casual Relationships from a Large TimeOriented Clinical Data Base: The RX Project." Computers & Bwmedtcal Research, 15:164-187, 1982 10. Friedman RB, Gustafson DH. "Computers m Chmcal Medicme, A Critical Review" (Guest Editorial) Computers & Btomedtcal Research, 10:199-204, 1977. I I. Komaroff AL. "The Variabtlity and Inaccuracy of Medical Data." Proc. IEEE, 67:1196-1207, 1979. 12. Simborg DW." etworkingand Medical Information Systems." 1- Medtatl Systems, 8:43-47, 1984. 13. van BemmelJH. "A omprehensive Model forMedical Information Processmg." Methods of Information m Med., 22:124-130, 1983. 14. Schwartz WB, eta!. "Decision Analys1s and Clinical Judgement." The Amer. 1- Med., 55:459-472, 1973. 15. S:olovits P, Pauker SG. "Computers and Chnical Decis1on Makmg: Whether. How, and For Whom1" Proc. IEEE, 67:1224-1226, 1979. 16. Miller RA, Pople HE, Myers JD. "lntermst-1, An Experimental Computer-Based Diagnostic Consultant for General Internal Med1cme." Neu Eng. }. Med., 307:468-476, 1982. 17. Gardner RM, et a!. "Computer-Based ICU Data I. Acquismon as an Aid to Cit meal Decision-Makmg," Cnucal Core Med., I0:82 3-830, 1982 _ 18. Dowhng AF. "Medically Onented Computer-Based Information Systems." Medtcal Core, 20:253-254, 1982. 19. Gottinger HW. "Computers m Med1cal Care: A Revie"." Methods of ln/ormauon m Med., 23: 63-74, 1984. 02 / 87 �22 MAPPING 'IHE: GENOME BY RUSSELL). VAN COEVERING, II Class of '77 and Clinical Instructor of Gyn-Ob ntogeny reciprocates phylogeny. Pretty words, but only an embryologist or molecular biologist can really appreciate their true significance or import. Our friends, the molecular biologists, have developed a new technology that puts humanity on the threshold of assuming the greatest power and responsibility it has ever known. To put it simply, man has proposed to map the entire human genome and splice DNA into human blood cells to treat a rare genetic enzyme deficiency disease. The disease is ADA (adenosine deaminase) deficiency, and there have been only 100 cases reported in the world. In this disease, bone marrow cells lack the ADA activity and the enzyme metabolite deoxyadenosine increases to levels which inhibit T and B cell function in the immune system, resulting in a severe immunodeficiency disorder similar to the condition of the famous "bubble boy." About 30 per cent of these children can be treated by bone marrow transplantation; the rest all die by the age of two. Using restriction endonucleases to cut DNA and inserting the ADA gene into a harmless human virus, scientists at NIH have been able to insert the gene first into mice and finally into chimps with expression of the gene by the host cells. Great care has been taken to produce a viral carrier that will self-destruct to ensure safety. The carrier protein is harvested from a group of cells infected with a virus that has had the viral RNA (which codes for packaging of the RNA) and protein together deleted. The only thing that 02187 BUFFAID !PHYSICIAN I buds off the infected cell membrane is the empty carrier protein. The ADA gene is then spliced into the RNA of Maloney Murine Virus and the RNA sequence that codes for the viral coat protein is deleted to create a virus that is incapable of infecting other cells because it lacks the protein carrier. The viral vector is then formed by packaging the virus which lacks the ability to infect cells into the empty protein coat previously produced. The protein coat is discarded after initial infection of the host cell. There is negligible chance the virus will mutate or acquire the entire protein coding sequence and hence become infectious. . The expression of the ADA gene varies between five per cent and 5000 per cent in different individuals, and there is no need for tremendous efficiency in infecting human cells to achieve therapeutic effect. The disease is lethal without treatment, and the only cells exposed to the treatment will be bone marrow cells which will then be reintroduced into the host through an IV. Application for permission to treat takes more than five months and 12 days and likely requires a year before approval or disapproval. In light of the lethal nature of the disease and minimal biologic risk, I would expect this first attempt at gene splicing in humans to be approved. Because the disease is rare, few individuals will ever be candidates for treatment. We must now decide if we have the wisdom to assume the responsibility for alteration of the human genome and set-up the ground rules for such intervention in the future. �23 S lightly more mundane, but of probably greater immediate import, is the proposal of the Japanese and Americans to map the entire human genome. Armed with computers to store the base sequences, restriction endonucleases to cut DNA, and molecular DNA probes and Southern blots to identify specific base sequences, investigators propose to finish the work of decoding the entire human blueprint. Only about one per cent of that blueprint is active in the adult organism. The rest of the DNA is composed of interons - regions that are translated and then cut out before transcription - and "unused" sequences. These unused regions provide regions for variable expression of DNA in different cells and circumstances. They comprise the genetic heritage that links us with all of the other life forms on the planet. Many of these genes are probably used in the formation of the embryo and then switched off permanently unless they are somehow turned on again as occurs in some cancers. By doing computer homology of the base pairs found in the DNA of different species, scientists have been able to trace the evolution of different enzyme systems and our relationship to other living creatures. There are at least 300 plant compounds with estrogenic effect, and they certainly weren't developed so that we could use them to produce birth control pills or other human hormones. T he most significant change brought on by this new technology will be in the field of prenatal diagnosis over the next decade. CVS (chorionic villus sampling) will allow perinatologists to obtain gestational cells at an early date in pregnancy. Genetic probes specific for single gene defects will allow physicians to screen for those defects. Until now genetic BUFFAID PHYSI¢ 1 ANI diagnosis relied on the ability to measure gene products to identify genetic defects. The problem in early pregnancy was whether those genes were expressed at the same levels throughout pregnancy and whether the screening level was valid or not. The direct analysis of DNA for the involved genes and the evaluation for homozygosity or heterozygosity will obviate this dilemma. The intent of genetic screening is not to cause abortion. It is mainly intended to allow couples to choose if they can accept the responsibility of a child with a major birth defect and help prepare for the birth. The most distressing choice will be abortion, but the information will be helpful to both the obstetrician and mother in avoiding a crash Cesarian section for fetal distress in labor to save a child that is already severely damaged by nature. Screening for birth defects with CVS 02/ 87 �24 ing when appropriate. The simple fact is that we are developing the means to diagnose many major diseases before birth and may some day be able to offer treatment rather than abortion for them. F rrsome think it unnatural to tinker with the human genome; others see genetic engineering as a panacea.'' and gene probes will not become automatic as soon as you enter the obstetrician's office- only two to three per cent of term infants have a major defect and 10 per cent have some identifiable abnormality. Nature does the major job of screening for us with 75 out of every 1,000 fertilized eggs failing to divide or implant properly and another five aborting spontaneously by 14 weeks of pregnancy. About 90 per cent of the 20 per cent that abort after implantation have major chromosomal or structural defects, and 90 per cent of the conceptions with major defects are aborted by the natural process before humans have any hand in the matter. The onus will be on the obstetrician to do a fastidious history for any family history of defects and offer screen- 02181 arthest off and most hopeful is the prospect of treatment for some of these horrible diseases. The first step will be taken with somatic cells and not germ cells using a self-destructing carrier so there will be negligible risk the treatment will be transmitted to the progeny. The next step will be to learn about gene regulation in mammalian embryos. We may then consider treatment of germ cells by gene splicing. If a defect affects the entire organism, there will be no other way to treat efficiently unless you treat early in embryogenesis. Defects causing damage in many tissues and organs will require carriers with tremendous efficiency and innoculum size to achieve therapeutic effect unless treatment is performed in the early embryo. The Ethics Committee of the American Fertility Society has recently published their report on ethical issues in reproductive technology. They have done quite a thorough review of the matter. Most notable is their definition of the preembryo as the organism from conception to 14 days of life. The definition is not supposed to be theological - it merely represents the biologic fact that after this stage of embryogenesis the organism becomes committed enough to individuality that twinning does not occur. It is during this stage of development that most gene splicing and treatment would be possible. T he mapping of the genome has progressed relatively slowly up until now, but mechanization will speed the process tremendously and decrease the risk of introducing human error into it. The switch causing testicular differentiation has recently been identified in the region on the short arm of theY chromosome- without this region the organism becomes female, and with it, male, regardless of whether it is XX or XY. Associated with this is the hypothesis of a critical region on the X chromosome BUFFAID IPHV$1¢1AN) necessary on both X chromosomes for normal ovarian development. These two locations do not contain all the codes that make us male or female, but we think we have found the first switch to start the process. Two other areas on theY chromosome are of unique importance. One is a region on the short arm of the Y chromosome named the pseudoautosomal region. It was previously thought that the X andY chromosome do not undergo crossover, but this region has been shown to exchange genetic material. The clinical importance is that traits in this region on the Y chromosome can be passed to either a son or a daughter from the father where this was thought only to be possible for autosomes before. The other area on the Y chromosome discovered by mapping is a region extending from the short arm of the Y to the long arm present in humans but absent in chimps. It seems to have been translocated from the X chromosome with the sequences reversed and part of the original Y spliced between the two end regions. This region does not seem to undergo crossover and may be the first evidence of a major chromosomal change in the evolution of man. What does the future hold for this new gene technology? Some think it unnatural to tinker with the human genome; others see genetic engineering as a panacea for all ills. In humans it will help us understand ourselves and our diseases and may offer us some hopes for cures. A cancer is very similar to a fetus- if we understand how one turns off the switches, we may be able to manipulate the other. If we can learn to control the switches in bacteria, we may be able to domesticate them and harvest vast crops of sugars, cellulose, oil, and coal. Forget the energy crisis if we farm the "lower" species as well as we do plants and animals. The purpose of life is to reproduce and pass the life force to eternity. After that the code times us to self-destruct and let our progeny follow. We must now decide whether we have the intelligence and responsibility to tinker with the blueprint of humankind. It is not a responsie bility to be taken lightly. �25 HOSPITAL NEWS Sisters Hospital Names New President Hand Care Center Opens S M ister Angela Bontempo, D.C., is the new president and chief executive officer of Sisters of Charity Hospital, Upstate New York's largest Catholic hospital. She takes over from Sr. Eileen Kinnarney, Sisters Hospital president since 1983. Sr. Angela formerly headed St. Mary's Hospital in Troy, N.Y. She is treasurer of the Board of the Daughters of Charity Health Systems East and has been an adjunct professor in the School of Management at Rennselaer Polytechnic Institute. She received her nursing degree from Maria College, Albany, a masters's in hospital administration from St. Louis University, and an M.B .A. from Yale. • ~ ~ Sl § if Sr. Angela Bontempo of Blood, Annals of Internal Medicine, and Hematologic Pathology. He is a member of numerous societies and is a fellow of the American College of Physicians. He chairs the Medical Advisory Board for the WNY Hemophilia Center and the Professional Education Committee of the WNY Chapter of the Leukemia Society of America. An author of 55 journal articles and 17 book chapters, his hematological research is currently funded partly by the NIH . RPMI Cancer Program Approved VAMC Names Logue Chief of Staff V eterans Administration Medical Center in Buffalo has appointed Gerald L. Logue, M.D., as its new chief of staff. That position was earlier held by Andrew Gage, M.D., who is now associate director at Roswell Park Memorial Institute. The professor of medicine and head of hematology at UB since 1982 has been closely associated with Buffalo General Hospital. From 1973 to 1982, he worked at Duke University Medical School and Durham VA Medical Center in North Carolina, where he was associate chief of staff for research. The University of Pittsburgh medical alumnus is a member of the editorial boards T he Commission on Cancer of the American College of Surgeons has designated Roswell Park Memorial Institute as an approved Comprehensive Cancer Program. Roswell Park is the only nonfederal hospital in Western New York having such approval. Established in 1956, the national Hospital Cancer Program encourages participating hospitals to equip and staff themselves so they are able to provide the best in diagnosis and treatment of cancer. The program promotes consultation among family physicians, surgeons, pathologists, and other cancer specialists. An integral part of a hospital's cancer program is the tumor registry. Information collected through the registry allows Roswell Park to participate in national studies that are designed to improve patient care. e BUFFAiD (PHYSICIAN I illard Fillmore Hospital and Clayton Peimer, M .D., opened the new Hand Center of Western New York last September. Peimer, the center's director and a UB associate professor of orthopaedics, remarked, "The center offers a coordinated approach to hand surgery, therapy, and rehabilitation." The only center of its kind between Cleveland and New York City, it specializes in upper extremity and micro-surgical reconstruction and rehabilitation, especially from acute trauma or chronic sports-related injuries. The center is a division of the UB School of Medicine, which helped develop the facility. • Children's Forms Home Care Company C hildren's Hospital has formed a new home health care company . The hospital-affiliated Children's Hospital Home Care Company (CHHC) will provide health care products and services to patients receiving certain therapies at home-based and other non-hospital sites. The therapies include high tech infusion therapy, respiratory therapy, and apnea monitoring. Hollis Mahaney , R.N., the new president, will coordinate and market the patient services to provide all home health needs for patients. e (From Children's Hospital's newsletter "Bambino." October 1986.) Sisters Hospital Joins 43 .. Hospital System S isters of Charity Hospital has become part of the largest Catholic not-forprofit health system in the United States in a newly announced coast-to-coast network of 43 hospitals under the direction of the Daughters of Charity National Health System . The action unites the new system's health care facilities ( 15,000 beds) and a large number of other health corporations located in 17 states and the District of Columbia. • 02 / 87 �26 BOOKS ttHOWTO SURVIVE A BASHING'' AN EARLY HISTORY OF CRANIOTOMY - FROM ANTIQUITY TO THE NAPOLEONIC ERA by Louis Bakay, M.D. Springville, ILL., Charles C. Thomas, 168 pp. BY ROSS MARKELLO, M.D. (CLASS OF 1957) "If I see more clearly, it is because I stand on the shoulders of giants." -Isaac Newton N ow from the prolific pen of Louis Bakay comes another history of medicine book. Until now there has been little scholarly compilation of the people who developed neurosurgery over the course of two millenia. Louis wrote this book using the Rare Books Section of the Health Sciences Library as the source of most of the material. His own multilingual vocabulary was used for the translations. And the distinctive Bakay wit flavors the prose, making interesting reading of what otherwise might be a "boring" subject. The book falls roughly into three parts- the instruments, the players, the operations. The function of the brain was not generally appreciated until the 1600s though it was known for a long time that a crushing blow to an opponent's head quickly and reliably terminated hand-to-hand combat. Then as now, those who knew and practiced better carefully avoided criticizing in print the Galenic tradition taught for centuries. As Louis writes. "No lesser a person than Aristotle regarded the brain simply as an agent for cooling the heart and preventing it from being overheated. The heart was considered the source of emotions and feeling, an idea which survives in the vernacular to the present." Simple tools, e.g. the dural separator, had been used in Roman times. Drills, bits, and skull fracture elevators were quite good by the end of the Middle Ages and have not been appreciably changed until the introduction of power-driven tools. 02187 ApplicatiOJ repan by Gar n 17 38. The surgeon presses down on the handle with his chin. BUFFAID fPHYSt¢1ANI "!remember a madman (who) was preoccupied with his head and wanted it trephined ... He finally found a surgeon who obliged -but egad, in doing it, he laid open the longitudinal sinus, and the man lost a great quantity of blood ... the man became exceedingly quiet and rational afterwards." "The dura exposed by either trauma or surgery should be covered with strips of Chinese silk dipped in rose oil. Upon the appearance of laudable pus (as compared with the less laudable variety that is darker and smellier), honey should be added to the rose oil 'to cleanse the membranes'." We have heard of Pare and Vesalius, the famous military surgeons. But Louis introduces us to bon vivants such as Berengaria de Carpi ( 1460-1513 ). De Carpi wrote a treatise on the treatment of head injuries which became the neurosurgical gospel for more than a century. (One can't help but notice a fondness for Berengaria by the author, and indeed there were both familial and character similarities.) Others include Fabricus al Aquapendente, Scultetus and Giovanni Andrea Della Croce - all later Renaissance surgeons. Also catalogued with amusing annotations are surgeons from Central Europe, France, and the Mediterranean - Bryzantine and Arab. "Berengaria was not a sterling character. He was a true son of that brilliant but not particularly moral era. While he is painted as a great surgeon, an erudite man of good taste, he is also shown as a scoundrel." Necessity being the mother of invention, as weaponry became more sophisticated, the �27 BOOKS surgeons had to develop new ways of managing injury - from straightforward skull depression to entry of the cranium by increasingly sharper and higher-powered missiles. While the vast majority of craniotomies undertook to manage trauma, by the eighteenth century, hydrocephalus, craniosternosis, and an occasional tumor had been tackled. "The patient was Don Carlos, the young son of Philip !1 who, while in hot pursuit of a kitchen maid, fell on his head. Vesalius trephined him ... probably removing an epidural collection of blood. By the next day Don Carlos was awake ... The seemingly miraculous recovery was attributed to the mummified cadaver of the Francisan friar Diego whose dessicated body was placed next to the dying prince after the operation." Louis has chronicled for us a microcosm of human as well as medical history - the relentless march of civilization, the ultimate triumph of reason, intelligent observation and experimentation. If you like history or medicine, you will find this an enjoyable evening's reading. It should be required reading for the wielders of the trephine. For us laity, it's highly informative entertainment. In the past 40 years several physicians from old Budapest have contributed greatly to our School of Medicine with their Old World charm and scholarship. Louis Bakay has probably done the most pop-med writing. He writes like he does neurosurgery - with class! • Dr. Louis Bakay nzf you like history or medicine, you will find Dr. Bakay's latest work an enjoyable evening's reading. It should be required reading for those who wield the trephine; for the laity, it's highly informative . " entertarnment. Diagram of I 7th cent procedure. BUFFAID !PHYSI¢1ANi niotomy (Dr. Markello. 1s also professor of anesthesiology. Dr Bakay. professor of neurosurgery. served as the Neurosurgery Department cha1rman for 22 years.) 02187 �~ 0 z �29 PEOPLE KENNEDY FOUNDATION HONORS GUTHRIE Developer of PKU test wins international award BY MARY BETH SPINA U B researcher Robert Guthrie, M.D., Ph.D., whose development of the PKU test has prevented mental retardation in thousands of children, has been named a winner of the prestigious Kennedy Foundation International Award. Furthermore, he received two other major honors. This January 29, he was presented with the prestigious Blake Marsh Lecture at a meeting of the Royal College of Psychiatry in London, England. On July 18, he will also receive an honorary doctorate of medicine degree from the University of Edinburgh, Scotland, for his pioneering work. The Kennedy Foundation, established in I946 by Joseph and Rose Kennedy in honor of their late son,Joseph Kennedy, Jr., killed in World War II, is the only private foundation in the world which focuses on the p roblem of mental retardation. Its international awards have been presented on five previous occasions since 1962 when then-President John F. Kennedy initiated them. Previous winners include Mother Teresa and psychologist B.F. Skinner. Guth r ie was one of nine to receive the award from Eunice Kennedy Shriver Nov. 17 at the National Academy of Sciences in Washington. Shriver, executive vice president of the foundation, desc ribes Guthrie as a "brilliant innovator who initiated the process of postnatal screening for inborn errors of metabolism which led to mental retardation." She pointed out that the Guthrie PKU test, required for newborns in ever y state and all industrialized nations, has saved the lives of thousands of PKU babies worldwide. The PKU test, which utilizes a spot of dried blood taken from the newborn's heel, can determine the presence of phenylketonuria, an inborn error of metabolism which can lead to retardation. Infants identified soon after birch as being unable to properly metabolize the protein food product phenylalanine can then be placed on a special diet to minimize or prevent retardation. T he rest is administered annually to some 3.5 million newborns in the U.S. An estimated 150 million babies worldwide have been rested since the mid-1960s. Since rhe development of the PKU test, BUFFALO ( P HYSI¢1A N I Guthrie and his colleagues have developed other screening tests which utilize a sample of dried blood applied to a special type of paper. Dr. Michael Garrick at UB developed a test for screening for sickle cell anemia. Guthrie also has developed screening tests for galactosemia as well as for maple syrup urine disease, histidinemia, and homocystinuria. In recent years, the modest, tireless professor has been promoting screening tests for lead poisoning. The problem is particularly severe in certain foreign countries where galena, a sulphide of lead, is widely used in a black eyeliner called kohl. Pregnant women who use this popular cosmetic can introduce lead poisoning into the fetus. On the UB faculty since 1958, Guthrie received the M.D. and Ph.D. from the University of Minnesota. Although he has never been a practicing physician, his work has benefitted many patients seen in the clinical setting. He has played a major role in planning the Sixth International Symposium on Neonatal Screening which was held in Austin, Texas, Nov. 16-20. e 02 / 87 �30 MEDICAL SCIIOOL NEWS FLOOR PLAN OF E 0 B F c -, A 0 G 0 0 G ROUND 0 With many activities, classes and offices shifting into the spanking new four-floor Cary-Farber-Sherman (CFS) Wing of the Medical School, here is a floor plan to orient you until you've learned to get around. Hopefully, you've already learned the layout of the rest of the Medical School complex. A B C D E F G Outdoor Courtyard CARY HALL Animal Facility Lobby Receiving Student Lockers & Offices Office of Medical Education; Asst. Dean of Curricular Affairs H Offices H 0 0 .... ,,_----'o 0 \ F <j \ c ---- 0 B -, A E 0 I 0 I / .JJ- -- 1ST / A Outdoor Courtyard B CARY HALL C Animal Facility D Lobby E Conference Rooms F Lounges & Study Areas G Interim Offices ofV.P. for Clinical Affairs, Med. School Dean G 0 02/87 BUFFAID I PHYSICIAN! <j �31 MEIJICAL SCHOOL NEWS THE NEW CFS WING B Do c A E F A Outdoor Courtyard B CARY HALL C Animal Facility D Lobby E Interdisciplinary Teaching Labs F Pathology & Microbiology Teaching Labs G Pathology Museum I I D 0 ~ 0 ,______.., 1-------:::1 0 c B --~o D - - - - - - - - - - -1 A A Outdoor Courtyard B CAR Y HALL C Animal Facility D Gross Anatomy Teaching Labs E Embryology & Histology Teaching Labs BUFFAID !P H Y S I ¢ 1 AN ) E 02/ 87 �32 MEDICAL SCHOOL NEWS Naughton reelected to AMA deans council V ice President John Naughton, dean of the Medical School, has been reelected to a second three-year term on the Administrative Board of the Council of Deans of the Association of American Medical Colleges. The ten-member board serves as a screening body for issues that face the AAMC and is part of the executive committee that represents all of the AAMC's constituencies. Dr. Naughton is the first board member from UB and is currently the only member from New York State. • Discharge program was first of its kind T he country's first comprehensive educational program on discharge planning was held July 21 to August l by UB's Western ew York Geriatric Education Center. "The greatest learning experience I've had in 25 years"- that was how one health professional summarized her experience at the first National institute for Discharge Planning and Continuity of Care. This two-week course, the first intensive, comprehensive, interdisciplinary learning experience ever designed specifically for professionals in continuity of care, drew professionals from around the country who work in a variety of settings, including hospitals, HMOs, nursing homes and colleges. The course included classroom instruction, a field practicum in which participants observed continuity of care in a setting unlike their own, and an independent study project relating course materials to the student's own experience. Co-sponsoring the precedent-setting program was the private organization, the National Institute for Discharge Planning and Continuity of Care. John Feather, Ph.D., UB research assistant professor of medicine, serves as its co-director as well as the WNY Geriatric Education Center's associate director. The Geriatric Education Center is an HHS- 02187 funded regional center designed to increase professional and faculty education in issues related to aging. It was co-founded by Dr. Evan Calkins, professor of medicine. Faculty represented the wide spectrum in the continuity of care field such as health care administration, social work, nursing, and law. e Red Cross lauds student project T he American Red Cross, Arlington County (Va.) Chapter, wrote a letter to Vice President John Naughton, M.D., commending the UB chapter of the American Medical Student Association (AMSA) for its organization of a very successful bloodmobile at the AMSA's 36th Annual Convention in Arlington. Eddie Phillips, UB's AMSA president, spearheaded the event, with other UB students assisting. Their objective was to dispel the public's fear of contracting AIDS through the act of donating blood. In addition to the 90 units of blood donated by AMSA members at the convention, Phillips was able to get a commitment from numerous other chapters to carry out similar events in their schools. e BUFFAID I PHYSICIAN I Students, pare c. I faculty enjoying Family Day actit•ities, October 19, m the lounge of the Medical School's new addition. John I. L _ of Post 78 of the American Legion presenting two $2,000 scholarships to VICe Prcs1dcntjohn Naughton, freshman medical student Bonnie Sunday, and senior medical student Stct>en Domiano .Not'Cmbcr 7, I 986. �33 MEDICAL SCHOOL NEWS SLencs from the firs meeting ]ames Platt White Soctety on Not•ember 7, 1986. Members of the new sodet~, all ntaJOr benefactors of the Medical 'ichool, met tuth the dean and his staff in the rcnot a ted Butler auditorium (immediately abotoe) and later had lunLh at the Center for fomorrou on the Amherst Cawtt ftnfJ tJhoto). Support for SEFA up by 8 per cent B esides contributing to the community through education, research, and clinical advances, the UB medical community contributes in another major way: direct giving. The 1986 SEFA Campaign demonstrated the continuing generosity of the Medical School community by ending with $83,000 in donations, 8 per cent ($6,500) over the goal of$76,500. Last year's donations wP.re $69,000. The number of donors also increased, for the first time breaking the 50 per cent mark with a 54.5 per cent Participation rate. The School contributed 22 per cent of the University's total of$374,000. Just as positive is that over the past four years, the Medical School has doubled its total giving, and average gift size has increased to $211. e ilyn GISt Farqt presenting the I ORtl ..... h.D., professor of cell biology and pathology at Yale Vnivers ~• Lecture at the Medtcal School. BUFFAID IPHYStCIAN) OZ/87 �34 ALUMNI Reunions set for May 9 Richard Ament William M. Bukowski Ross Markello Let's all get together May 9, 1987. -William M . Bukowski M.D. 1 47 Theodore C. Flemming William]. Staubitz Harold Castilone We want to see you. Let us make May 9, 1987, the 50 Year Reunion of the Class of' 37, a happy and rewarding event as was june 9, 1937, the day we all received that meaningful Diploma. -Charles F. Banas, M.D. '37 Theodore C. Flemming, M.D. '37 Our 45th Reunion is fast approaching. We look forward to seeing those of you who can be here [or this event. - Richard A m ent, M.D. '4 2 It would be fun to see how we, the School, and Buffalo have changed in 30 years. Love to have you at the 02187 N eal W. Fuhr -Ross Markello, M.D. '57 Harold Casrilone, M.D. '57 William]. Staubirz, M.D. '42 Let's try to make our 35th the best Reunion to date. Please make every effort to attend. Your support is appreciated. -Neal W. Fuhr, M.D. '52 BUFFAID I reumon. PHYSICIA N I �35 ALUMNI Sebastian Fasanello Ian M. Frankfort ]ames P. Giambrone Gregory Young It's hard to believe that 15 years have elapsed since we graduated. Let's gee reacquainted at Spring Clinical Day this coming May. Don't miss our Twenty-Fifth. We need YOU to make it a success. -Sebastian Fasanello, M.D. '62 -Ian M. Frankfort, M.D. '72 Carl W. Ehmann Nedra Harrison We are anticipating a strong turnout for chis year's zoch Anniversary It's inconceivable to me that 10 years have already passed since we graduated. Nedra and I are looking forward to seeing each of you at our reunion this May. of our class. Several class activities are planned and efforts are being made to encourage our out-of-town members to come to Buffalo this spring. -)ames P. Giambrone, M.D. '67 Carl Ehmann, M.D. '67 BUFFAID !PHY51¢1ANI -Gregory Young, M.D. '77 Who seeks and finds that which is beautiful in all people and all things especially renewing old friendships at the roth Year Reunion. -Nedra Harrison, M.D. '77 02187 �36 ALUMNI M ISSING ALUMNI: Please contact the Alumni Office (716-8312778) if you have information on these Alumni. Dr. Frank G. Lockwood Dr. Joseph Presant Dr. Joseph 0. Hayes Dr. Philip L. Reitz Dr. Albert G. Connette Dr. Geraldine Somich Dr. Martin H. Jansen Dr. Gustav Seliger Dr. Dr. Dr. Dr. Dr. Bruce Ettinger Dennis Goldfinger Adele Gottschalk Harold W. Grotsky Melvin Pisetzner ANNUAL SPRING CLINICAL DAY Medical Alumni Association Saturday, May 9, 1986 Stockton Kimball Lecture: James Holland, M.D. inter, nationally knoum oncologist, Albert Lasker Awardee and former UB Medical School Professor. Scientific Sessions Exhibits Stockton Kimball Luncheon Spouses Program Class Reunions Watch your mail for more information. Dr. Christopher oell Dr. Glenn L. Post Dr. Keith L. Barnard Dr. Elsburgh Clarke Dr. Carin Craig Dr. Mark P. DeMarie Dr. Mindy Friedman Dr. Richard E. Hafner Dr. Phyllis lanuzzi Dr. Genevieve Losonsky Dr. Hera Y. Nahar Dr. James Norcross Dr. Rodney A. Parker Dr. James Peng Dr. Elizabeth Read Dr. Sharon L. Sageman Dr. Janet Shalwitz Dr. Cheryll Smith Dr. Harold H. Warren Dr. Marciana Washington Dr. Gary Wasserman Dr. Floyd W. White 02187 1 he Medr.:al Alumnr Uoternmg Board )tanc to rr~;ht: Dr. joseph E Gnjfm, Dr. john A RKhert ( Asmtant Dwn), Dr. john K Qurnlwan, Dr. ~orman ( hassm, Dr. ( :armelo S Armenra, Dr Frank] Bolgan, Vr C harlts]. Trrone, Pr fost.ph L Kunz. :;eatt.d, left to right· Or. Charles I I annt-r. Dr. John Naughton (Dean, School of Medrune), Dr. john £ Prnluckr, nr Frnnklrn J.pnfnOI t~ Dr. Paul H. Wrerzbrenrt.c BUFFAID I PHYSIC IAN I �37 EUREKA Continued from page 7 bacterial agent might do the job." So he devised a novel therapeutic device that can be implanted in the gum to kill the periodontal disease-causing bacteria. So far, Anbar has written a patent disclosure for it and has discussed the new concept with several companies. An bar has two other dental inventions inspired by his "oral" experiences. The second is a patented dental adhesive that seals fillings to teeth like a "super glue." Called polyphosphonate, the polymer has proved effective in the lab. The third invention is a hydrophobic fluoridereleasing polymer for use as a cavityfighting dentifrice. Colgate-Palmolive now has the patent rights. Anbar's experience during the energy crisis of the mid-1970s led to a major invention. "My family and I were camping with our recreational vehicle one day and I got tired of the incessant loud noise of the electrical generator needed to run the appliances. It got me thinking about quieter alternatives." His quiet alternative is a new electricity-generating process that burns coal using lead oxide but with no oxygen. The result is a lowpollution method that directly creates electricity with a cheap fuel. "It was competitive with nuclear energy or nonpolluting conventional power sources during the mid-1970s, but interest in the invention subsided with the economics of the 1980s." The first director of UB's Health-Care Instruments and Devices Institute (HIDI), Anbar has 20 or so inventions, most of them patented. D aniel Bednarek, associate professor of radiology, had an inspiring idea. The result was the creation of an optical density comparator, which is used to measure the density of X-ray film after it has been developed. Bednarek's comparator allows radiologists to easily check processing equipment for quality control. Does the film have the same darkening or lightening? If not, the equipment can be adjusted or repaired. But, states Bednarek, "The idea was perhaps too good. The device is so simple and inexpensive, no one is interested in marketing it." It still has some possibilities, though. Bednarek comments, "There might be a need for it in a dentist's office or a small radiographic facility, where there isn't a need for a thousand dollar piece of equipment (a densitometer) with minutely accurate readings." • --~---------------------------------------------------------------NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES BUSINESS REPLY MAIL FIRST CLASS PERMIT NO 2210 BUFFALO. N.Y POSTAGE WILL BE PAID BY ADDRESSEE BUFFAID PHYSICIAN 139 Cary Hall State University of New York at Buffalo Buffalo, New York 14214-9980 1••• 11.1 •• 1•• 1.1 ••• 11.1 •• 11.1 •• 1.1 •• 1•• 1.11 ••••• 1.11 �BUFFAID I P H Y s c A N I State University of New York at Buffalo 3435 Main Street Buffalo. New York 14214 Non-Profit Org. U.S. Postage PAID Buffalo, N .Y. Permit No. 311 Address Correction Requested C. K. FUANG BA 57 TREEBROOK CT. ~ILLIA~SVILLF NY 14221 Fill out this card (Please print or type all entries) Name - - - - - - - - - - - - - - - - - - - - - - - - - - - - M.D. __ Ph.D.__ Year Received _ _ __ Office Address HomeAddress _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ____ If not UB, M.D. or Ph.D. received from In Private Practice: Yes D No D Specialty In Academic Medicine: Yes 0 No D Part Time o Full Time D School _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ___ Title Other: Professional Society Memberships News: Have you changed positions. published, been involved in civic activities. had honors bestowed. etc? _ _ _ _ _ _ __ Please send curriculum vitae, clippings, publications. or announcements. also include a photo of yourself. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Late Winter 1987 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1987-Late Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1987-v20n05-LateWinter Table Of Contents A list of subunits of the resource. Inventor AIDS Research Computers in Medicine Mapping the Genome Hospital News Books People Alumni Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-27 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v20n05 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1987 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/68d44fc8cdf340f947369ea2e298ea50.pdf fd1cbfdacc5ab1dbd8654b8421e615ea PDF Text Text p H y s C A N DECEMBER19 VOLLME ZO,NUMBER4 ----- $19millionaddition triplesschool's facilities �BUFFAID ( P ► Y S I C ~ Ii] Dean's Message D iTAff EXE( L'TIVE WITOR, LI IVER ITT PUBLI A Tl ) Robert T drlett BUFFALO PHYstCIA Brue Kershner EDIT R ART I IRl:CT R Im J. 'egler PH )T )GRAPHY Ph\ II t hr t ph r Dougla Levere Ed,' wak Fran~1 peck r Mr Ke1,m( rui: Ir h C ha" Dr J hn Prz~luck, Dr ) hn h hr Ms Karen Dr J 1r J Dr [)r Ja Dr H Dr Dr l>r Or 1r i Ir Or TEACUI G HO 'PIT ALS The Ruffalo Gen rnl ear Friends of The School of Medicine: This issue of the BuffaloPhysicianfeatures the new addition to the Medical School complex on the Main Street Campus. The opening of this modern new wing fulfills a promise and a dream which has possessed the faculty and administration of the School of Medicine since the University of Buffalo joined the State University of New York in 1962. It seems fitting that the new struccure should open as we celebrate our 25th anniversary as a major publicly supponed medical school and university. The new addition will provide a modern centralized animal facility which will expand the capacity for animal research by over 20,000 square feec. The remainder of the facility will, in large pan, be devoted co the enhancement and conduct of medical student and graduate student education. It will provide modern space in which to conduct laboratory education and for faculty to introduce new methodologies to the educa­ tional mission. Just as important, badly needed suppon space will be provided for faculty and students which should be conducive to improved student-faculty interactions and to modem suppon services including teaching carrels, multidisciplinary teaching, and computer· assisted instruction. Some of the educational space in this complex will also complement che services provided by the Health Sciences Library. Obviously, chis is an exciting period for the School of Medicine, hue the work has just begun. Once this complex is opened, Farber Hall will be closed and the next phase of renovation and modernization will begin. By lace 1989or early 1990, new teaching and research space will become available for some of the basic science departments. On behalf of the faculty, students and administration, I wish to thank our many benefactors who have made the new addition a reality. These include the local university administration, SUNY-Ccnttal adminiscra· tion, the SUNY Board of Trustees, the Western ew York Legislative delegation and the government and citizens of ew York State. In addition, the dedication and commitment of the faculty, former and present medical students and their families, and the ongoing suppon and contributions of a faithful alumni have all contributed to this effon. With your continued support and the School's perpetuation of a 140 year old tradition and commitment, the future looks bright indeed! Sincere!:,, John Naughton, M.D. Vice PresidentfO'I'ClinicalAffairs Dean,Schoolof Medicine l h1ldrcn° Ene iunty Mcd1e,1lCenter , ierq Mill m.1hllmore R, "ell I', rk Mcm ,nal In urut<· 11rsotChm 1eran Admm1 1ra11on Med, al .emer Pmdu cd /t1 rhe Dn, 10n uf Puhl, Aff.irrs, H,irf)' R }a k m, dire wr, ,n r >erar, n ..,ch che hi ~•I nt Med, rm•, rare l nnersrr1 of e" rork r Buftal> l lO, A Message From The Medical Alumni Association I am pleased to report that our 1986 Stockton Kimball lecturer, Or. George Hatem, was one of the recipients of this year's Alben Lasker Research Awards. The citation for his Award said he made "legend­ ary contributions to the conquest of venereal disease and the eradicanon of leprosy in China" and his accomplishments "made medical history and improved the health and well-being of 800 million people." LnJanuary we are ho ting a reception in San Francisco. We are looking forward to meeting alumni from the area and alumni who will be attend· ing the American Academy of Orthopaedic Surgeons meeting. I would like to take this opponunity to encourage you to contribute to the success of the Medical Alumni Association by becoming a dues­ paying member. John E. Prulucki, M.D. '73 President �CONTENTS 2 1 THE CFS ADDITION • The newest milestone in the 140-year history of the medical school's buildings has just been reached with the opening of the new Cary-Farber­ Sherman addition. Associated stories: 140 Years of Medical Buildings - Page 7; Legacy of School Imprinted on Other University Buildings - Page 11. AIDS • They may be at opposite poles when it comes to their theories, but AIDS researchers are in agreement on at least one point: don't raise false hopes. HAYFEVER• Sometimes it's the little things in life - like ragweed - that bother you. Robert Reisman, M.D., has been researching new treatments for the estimated 18 million hayfever sufferers in the U.S. Related stories: The Medical Editor as Guinea Pig - Page 21; Dr. Reisman's Work on Immunization Against Insect Stings - Page 23. STUDENTS • 16 Class of 1990 is the most female & the oldest in Medical School history. MEDICAL SCHOOL EWS • 17 Facilitiesfor Dental School, Health Sciences Library are dedicated. ALUMNI • 28 M.D. stands for mother• daughter in the case of Ors. Helen Sikorski and Camille Hemlock. PEOPLE • 35 Dr. Elliot F. Ellis named president of the American Academy of Allergy and Immunology. Other news of people you know. HOSPITALNEWS• 31 CLASSNOTES • 32 DEATIIS • 34 EXERCISE • 25 Cancer / Exercise link established. Exercise seen as aid for CF patients. 12 6 �....... II C--F--S ADDillON MARKS NEW ERA BY BRUCE S. KERSHNER T he newest milestone in the 140-year history of the Medical School's buildings has just been reached with the opening of the new Cary­ Farber-Sherman Addition. Attached to the west side of Cary Hall, and bridged to Farber Hall, the modern building enlarges the School's headquarters net space by 39 per cent. The new 19 million building is the cornerstone of the Medical School's expan­ sion program and is just the first of a three­ phase construction plan. The CFS Addition, as it is presently ab­ breviated, includes a wide range of facilities, some hifted from other locations, others totally new. It houses the new animal facilities, a host of teaching labs, student �3 PHOTOFAANOSsPEO<ER12 0 �4 services and act1vtt1es,seminar and con­ ference rooms, lounges, a pathology museum, and administrative office space. Directing and monitoring the three­ phase con truction program is Associate Vice President for Clinical Affairs Donald Larson, Ph.D., and John Moran, Ph.D., a istant to the dean for facilitiesplanning. Dr. Moran i also associate professor of biochemistry. They act as liaison between the School and the S Y Consrruction Fund in Albany, the architect, and campus architectural services. "The new building represents a tremen­ dous contribution on the part of the citizens and the State of ew York and heralds a new day in our educational pro­ gram for current and future studies," states Vice President John aughton, M.D., dean of the Medical School. "It hould create an environment in which learning the fundamental requirements of medicine will be more stimulating, plea ant, and effective. "The new facility will also enable ac­ tivities of both the clinical and basic science faculty to be better integrated, which will also benefit tudents' educational ex­ periences," comments Dr. aughton. "It will enhance our ability co apply the lessons of the GPEP Report" (the national study that recommended sweeping changes to enhance medical education into the 21st Century.) T he Central Animal Facility is the ingle largest occupant of the new building, claiming just under half of the CFS Addition. Located in its orth Wing, "it is now one of the largest animal facilities in the nation," remark its director, Shaheen akeeb, Ph.D., D.V.M. "It occupies 41,000 net square feet and has 113 animal room ." The new facility will benefit both the animals and the researchers who use them. "It modem housing and equipment pro­ vide the best environmental controls for the healch and comfort of the animal, e.g., ventilation, heating, lighting, and hygiene," explains Dr. akeeb. "For the first time, there are also indoor exercise runs for dogs." The outdoor runs on the Farber Hall roof will be a thing of the past, 12 along with their weather-related disadvan­ tages. For the faculty, the animal unit's greatest benefits lie in it modem equipment and in it convenient proximity. "Of great impor­ tance are its cace-of-che-artsurgery and X-ray rooms, which contain modem equip­ ment and services chat are ideal for all researchers, whether campus- or hospital­ based. ever available before are specially designed animal room for infectious disease and for particular projects with special needs. The absence of these wa a big handicap in the past," akeeb comments. The unit' central location will serve the faculty better. "Everything will be conve­ nient and in one place. There11 also be less duplication of support services." The facility provides housing for all the animals, which until now have been kept in separate labs throughout the Cary­ Farber-Sherman Complex. Although the aim is co centralize a many of the Universi­ ty's animal labs as po ible, ho pical-based animal units with small animal will remain at several teaching ho picals. A nocher of the immediate benefits of the new building is the improvement of student instruction, states Dr. Larson: "The new facilities will offer more oppor­ tunities for innovation in the curriculum." Comprising its educational facilities are 20 basic science teaching laboratories, as well a four seminar room . Ten of the labs are for microbiology and pathology, seven are for histology and embryology, and others are interdisciplinary, for use by physiology, pharmacology, biochemistry and biophysics. The new Gro Anatomy Lab also has state-of-the-art storage and support facilities associated with it. Demon tration rooms for anatomy, em­ bryology, and histology accompany the labs. The new wing, which will now become the focus of student life, represents a big boost to medical student activities. "It will definitely enhance the quality of student life," emphasizes Dr. Larson. The most prominent feature is a large comfortable student lobby and lounge. Student locker rooms, offices for student organizations, BUFFAID jPHV$ 1 ¢1AN I and a new Office of Medical Education are additional features, along with 60 study carrels (desk stalls). Among the conference rooms is the new Lippschutz Room, replacing the old one at Cary 131-133.Lounges for faculty and staff are ocher new features never previously available. "These facilities will greatly �5 The four-floor CFS Addition totals 99,540 square feet of net u able space such as classrooms, offices, lounges, and labs. It expands by 38.6 per cent the net total area of the Medical School's headquarters, in­ creasing it from 258,07l square feet (for the existing Cary-Farber-Sherman complex) to 357,611 net square feet. When hallway , stairs, and such are included, the gro area of the addition is 178,703 quare feet, representing a 43.2 per cent increase in gros square footage. The co t of the new addition totals $19 million, while the just completed recladding of Cary, Farber, and Sherman Halls co t 7.1 million. The ongoing renovation of Farber Hall (only} i estimated to co t another $14 million. enhance the ability of campus-based and hospital-based faculty to socialize and interact as part of the University community," said Dr. Moran. T he interim headquarters for the School's administrators will occupy part of the new building until Phase 3 of the construction is completed. Until that time, the CFS addition willbe the home for Vice President and Dean aughton and his staff: Associate Vice President Larson; Associate Dean for Alumni Affairs and Registrar John Richert, Ph.D.; Assistant Dean for Financial Affairs Anthony Campanelli; and all of their administrative and secretarial staff. The Medical Alumni Association will be housed there as well. One unique feature is a new Pathology Museum that includes a historically valuable collection of pathology slides dating back to the 1930s.Part of the collec­ tion comprises the valuable historical legacy of Dr. Komel Terplan, who pio­ neered preservation techniques for brain specimens that make his slides among the finest in the world. They were created in the Children's Hospital's Brain Pathology Lab that the 91-year-old Dr. Terplan has operated for 56 years. ''Anotherof the immediatebenefitsof thenew buildingis the improvementof studentinstruction. The new fadlitieswill offe:ropportunities far innovationin __ ___:.1 " t he CUTTLCULUm, MedicalSchool officialspointout. T he history of the construction can be traced to 1974. At that rime, under then Vice President for Health Sciences and acting Medical School Dean F. Carter Pannill (currently professor of medicine), a master plan recommended that changing demands of the School required additional space and facilities for students, faculty, ad.mini tration, and conferences. The new Medical School facility was just one part of a larger expansion program undertaken by the SUNY Construction Fund that en­ compasses the just completed Health Sciences Library (see separate article) and BUFFAID !PHvS 1 ¢ 1 AN I the relocation of the Dental School out of Farber Hall and into its new headquarter , Squire Hall. The Dental School had shared Farber with the Medical School since 1953. Medical School con truction began in 19 3 with groundbreaking for the new ad­ dition. The first milestone was completion of the newly renovated Butler Auditorium in Farber Hall, which received it first cla during thi fall 1986 semester. The 2138-seatauditorium is now the school's primary lecture hall. It features a number of modern accoutrements uch as a sophisticated audiovisual system, con­ tinuous benching and "down lighting" which illuminates desks when the room is darkened. "The new Butler Auditorium is now a first class lecture facility," comments Dr. Moran. Besides the Buder Auditorium, the ju t­ completed first stage of the construction in­ cluded the new CFS Addition, recladding and new windows for Farber, Cary and Sherman Halls, and an addition to Sher­ man Hall with a tank farm and compressor house to upport the hyperbaric research facility operated by the Phy iology Depart­ ment. In addition, a tate-of-the-art chemical torage building services all the health science departments. The second part of the construction is ongoing and includes renovation of most of Farber Hall, including the space that the Dental School recently vacated when they moved into Squire Hall (see eparate article). Completing renovation on the remain­ ing parts of Farber, Sherman, and Cary will comprise the third part of the construction project. Thi phase will include the new Harry G. Laforge Center, named after the UB alumnus and emeritus faculty professor who attracted millions of dollars to the School. The new center, to be located on the fir t floor of Cary Hall's north wing, will function as a continuing medical education center, with exhibition pace, several seminar rooms, and a major conference theater. The new theater will be con­ structed from the existing Lippschutz Room together with Room 135. Comple­ tion is expected in 1989. The late Dr. Eugene Lippschutz will continue to be commemorated in the naming of a new conference room in the CFS Addition. �6 "Phase 3' other longer-term benefits will be to allow us to modernize facilities for research and graduate and undergraduate education," Dr. Moran comments, adding, "Farber Hall will also have modernized heating and air conditioning, a change that will be enjoyed by all." D r. Moran points out that many people deserve thanks for their efforts throughout the 12-year-long process since the project wa conceived. "Among those, we are grateful to the professional efforts of individuals in Architectural Services, Design and Con truction, the S Y Con­ struction Fund, and the Capital Equip­ ment Division." The new building will be referred to for the time being a the Cary-Farber-Sherman (CFS) Addition, a cumbersome named used for construction purposes. lf or when that name will be changed is the respon- sibility of the UB Council. "It should also be noted that neither we nor anyone in the Medical School are responsible for the new building's interior color scheme," Dr . Larson jests, adding, "The colors were chosen by the architect." Color preferences aside, it seem ironic that the future benefits of the construction should be so eloquently summarized by a medical student who will have graduated by the time it i all completed. One medical tudent, a member of the UB Medical Student Association, Polity, wrote in it spring 1985 newsletter "Pulses": "The sound of construction drills and hammers will reverberate through the halls of the Medical School for a number of years to come. The Class of 1989will encounter a new world with facilities vastly different from the ones currently enjoyed at UB. Both inside and out, the Medical School is transforming into a modem research and teaching facility for the 1990s." • A Quick Sketch of the Medical School 's New Building, The CFS Addition South Wing : Floo r 3: Demonstration room and seven embryology / histology lab - - /I Floor 2: IO reaching labs for microbiology and pathology, seminar room Floor 1: Offices for VP/Dean and hi taff Ground Floor: Offices orth Wing: Floor G through 3: Animal facilities Floo r 3: Gro anatomy lab and support services Floor 2: Interdisciplinary labs and a lounge Floo r 1: Student carrels Faculty & staff lounges Conference rooms, including Lippschutz Room Floo r l and Ground Floo r: Student lounge & lobby Ground Floo r: Student lockers Student organization offices Office of Medical Education Offices for Associate Dean for Curricular and Academic Affair and his staff 12 6 BUFFAID jPHY$1¢ 1 AH J �7 T 140Yearsof MedicalBuildings he new Medical hool addition i only the lac t in a series of Medical hool buildings that go a far back a l year . In the fall of 1845, a group of young lawyers and doctor met in a mall officeon Main rreet co discusscreation of Buf­ falo' fir t medical school, the Univer icy of Buffalo. One of tho e present, Austin Flint, r., M.D., convinced chem co incorporate as a true univer ity, not solely a a medical college, as would otherwise have occurred. His foresight paved the way for the new in titution to later expand ic ope into a large univer icy offering a diver icy of degree . The Univer ity of Buffalo wa formally reared in Augu t, l 6, with the edical Department a it only unit. le wa an auspi­ ciou period, for two months later in another city, what may be the mo t important event in American medicine occurred - the fir t demon tra­ tion of the alleviation of pain during urgery. The new chool' dean, Frank H. Hamilton, it regisrrar Au tin Flint r., the treasurer James Platt White, and five other phy icians served a its first faculty. All but one of chem are now enshrined on UB' campus in the names of its roads (see accompanying article). They chose a their fir t building a rented, remodeled old "edifice," the First Baptist Church located at the northeast corner of Seneca and Washington Streets. That site i now occupied by an immense hole, that i , the construction site for the proposed Pilot Field baseball stadium. UB's and the Medical School's first course wa taught in that temporary classroom on February 24, 1847, to (:I) BY BRUCE S. KER H ER medical tudent . 1 The school' fir t graduation occurred on June 16, 1847,with 17 men receiving medical degrees. Incredible as it was to be able to earn an M.D. in less than four month , admi ion requirements and fee were also astonish­ ingly minimal. Admission was on the ba i of a certificate chat was essentially a high school equivalency. Fees totaled 112 for the entire semester, including matriculation ( 3), ruition and dissections ( 70), and room, board, and fuel ($39). That temporary Medical School head­ quarter not only made UB hi tory a its fir t building, it was also the fir t in the City of Buffalo's history to be used for higher education. 2 The building was used for three years while the faculty sought out a new building. They selected a site at the southwest comer of Main and Virginia Street . Completed in 1849, it co t 15,tXlO, all of it "donated by BUFFAID !PH'l'$ 1 ¢1ANI public-spirited citizen who were, in the main, elf-made men." 3 randing on that ite today i a nearly vacant retail tore building, once previously a public library. An historic metal plaque identifies the ice as the old Medical hool building. hortly after the 1 9 building was con eructed, a milestone in medical hi tory took place within it. In its basement janitor's quarter on January l , I 50, wa performed the first clinical demonstration of obstetrics in history.·' Or. Jame White' lecture to hi medical student on midwifery and the actual live demonstration of childbirth under their observation not only made UB the first to demon crate the now-fundamental ubject, but also caused a national concro er y. The incident erupted into the public eye, resulting in searing editorials, public ca tigations, and a lengthy libel suit! Or. White, of course, ultimately triumphed. Many other historic event occurred while the School was based in its second headquarters over the en uing 43 years. Dr. Flint introduced the binaural tethoscope to America and discovered that typhoid is a water-borne disease. John C. Dalton, Jr., M.O., was the first physiologi tin America to illustrate lectures with animal vivisec­ tions as a teaching method. Dr. Hamilton performed the world's first successful free skin graft. These are only a few of the achievement of the early history of the UB medical school and it outstanding, widely­ regarded founding faculty members. T he 1880sand '90s brought a flurry of changes and challenges to UB. For the first 40 years of its exi tence, UB and 12 6 �8 the Medical School were one and the same; no other school exi ted. The changes began in 1886 when the College of Pharmacy was created, followed in 1887 by the Law School as well as the Department of Veterinary Medicine {which folded soon after due to financial difficulties). The Dental Schoo l was formed in l 92. The challenge were represented by the founding of not ju t one but five new competing medical school in Western cw York . UB was the sole medical school until 1879, when three other medical colleges formed. Two more opened in 1880 and 1883. All had gone out of business by 1884 except that run by iagara University. Instead, it merged its faculty and programs into UB and closed its doors in 189 . Another kind of change developed in 1891, when the UB Council determined that yet another new building should be erected . "Through the energy and untiring industry of . . . Dr. Charles Cary, a suffi­ cient sum of money was obtained to (begin) erection of the new building." Two years and $150,000 later, the third headquaners of ,the School was constructed. Located at 24 l-1.ighStreet its campu i now occupied by the Towne House Hotel and Restaurant next to Buffalo General. The old Medical Schoo l building was sold to the Buffalo Catholic Institute for $67,750, which helped co defray the costs of the new con- 12 6 truction. The new, largely fireproof brick building occupied a urface of 12,000square feet {215 feet in front, 78 feet on the east side, and 9 feet on the west side). It contained a main amphitheatre (Alumni Hall), with seating for 400; two slightly smaller lecture room ; recitation room , and other lecture rooms. It also served as the home of the Pharmacy and Dental schools. The new building must have been quite a "monument," if one is to believe the Medical School's announcement: 4 1tgivesthefacultyof the institunonthe greatestpleasureto make chisannounce­ ment, becausethey feel chat they have the most casceful., a:,mfonableand best arrangedmedicalcollegeedifice in the United rates; perhaps even in the world. . . 1t is built in accordancewith BUFFALO jPHv$1¢ 1 AN j ''The MedicalSchool was located at 24 HighStreet.But...its 'campus'was l.ocated directly opfx>site in the tavernof the German-American Brewerywith its 1Oct beerand free lunch.'' �9 ~ g 5 j ~ ~ ___ _:-,..-_ ... _,c;:--t ~ ~ ~ ite. One of the homes of Joseph Ellicott (the "founder" of Buffalo) rood for 70 years on the exact iceof the High treet Medical hool location. While the new campu was being planned, Ellicott' home wa moved to Amher t treet where it wa enlarged. The Univer ity acquired chi newly vacant parcel for 22,275, con idered a fair price.6 Five year after the hool' High treet headquarter were completed, the hool literally "gave birth" to what wa to become the fir c cancer research center in the world. UB Professor of urgery Ro well Park a ked for the tace to fund a cancer research lab and in 1 9 , the .Y. tate Pathological Laboratory, the early Ro well Park Memorial Institute, wa housed in the Medical School itself. In 1901, it wa moved to a separate building, UB' Gratwick Research Lab. Roswell Park In titute i till a UB teaching ho pital. -=== -=----.-~ ~ ~ ___________________________________ the most modem ideas of heating, plumbing,andventilation. le is finished entirely with terra ama, pressedbrick, ironand hard wood,than which nothing can be more attractive,and has been so tastefullydesignedandso well built that it is now pointed coas one of the most attractive buildingsof any kind outside of ew York City. While the description of the building wa lofty, one description of the campu was earthy: The MedicalSchoolwas locatedac 24 High treec.Bueperhapsa morerealistic appraisal was that its "campus" was locateddirectlyopposite- in the tavern of the German-American Brewery. With the purchaseof a schoonerof beer for 10 cents, the Brewerysuppliedto its students andfarulry. .. pickled herring, __. peasoup, small franks, fair-sizedham­ burgers,picklesgalore,a mountainof rye breadon aiery table,not to mention the celery, olives, red radishes,and sliced onions.Includedin this nominalJeeof I 0 cents were che use of spoons,knives, forks, and papernapkins,but alwaysac­ companiedwith the plea "do nocremove the silverware from the premises." cudentsmadegooduseof their ''captive audience" situation with faculty. o matter howfaculty longedcoescapefrom the smell of onions and garlic reeking fromstudents always eager! pursuing them co ask endless questions, the nominal price and huge quantities of goodfood proved coostrongan incentive to forego.5 Few are aware chat the hoot's third new headquarter stood on a very hi toric BUFFAID jPHvS1C1A I ~ 0 nly 16 year after the High treet headquarters were built, plan were already being laid for what wa to become UB' Main Street (now South) Campu . Between 1909 and 1919, UB purchased mo t of the land for the future campu , to be located in the northea t comer of Buffalo. Part of the land that was sold to UB wa the infamous Erie County Poorhouse and IZ 6 �1 Hospital (once branded a "The Snakepit of Buffalo"), and referred to al o a the in ane asylum and aim hou e. The ho pital (not related to today's Erie Counry Medical Center) provided medical care on ly for the home's resident . In 191 , part of the ho pital burned, an event which led to the transfer of it patients to the newly con­ structed Buffalo City Ho pita! at Grider Street, later renamed Erie County Medical Center. A new building was constructed for the institution in Alden, where it i now known a the Erie Counry Home and Infir­ mary. ln 1922, the new campu ' fir t building, rhe School of Pharmacy's Fa ter Hall, wa constructed adjacent to the former Erie Counry Poorhouse. The Medical School did not relocate to the new campus until 31 years later. In 1950,a new "Medical-Dental Building" was proposed for the Main treet Campu . With groundbreaking in April 1951, it wa conceived to maintain the high tandards of the schools and to be flexible in keeping pace with the rapid strides in medicine. ks promoters included the Medical Alumni Association President William Orr (M.D. 12 6 '20), Stockton Kimball, and Chancellor amuel Capen, among other . The new Medical chool headquarter were dedicated on December 12, 1953, with obel Laureate Charles Best, the discoverer of in ulin, presiding over it ym­ posium. At a cot of 4.1 million, it cot more than all previou campu building combined. It wa also one of the 12 largest medical school building in America at the time. Its first classes were held in Fall 1953. First called the Medical-Dental Building, it was soon renamed Capen Hall, in honor of the di tinguished chancellor and holar who brought UB into the modem era. About two decades later, the new orth Campus wa opened and it largest building and UB' headquarter took the name Capen Hall. 1n December 1974, the edical School building wa renamed Farber Hall, after B alumnu idney Farber, M.O., a cancer pioneer. T he rapid growth of the Medical School soon exceeded the capaciry of the new building. In 1959, the fir t major BUFFAID jPHvS•¢1A j expansion wa completed, a four-story wing known as herman Hall. At a co t of 1.6 million, it expanded the hool' building pace by 46 per cent . It wa named after DeWitt Sherman, a UB medical alum­ nus and pediatrician with many hi torical achievements (see accompanying article on building names). One year later, another major addition wa completed, expanding the Medical School complex by 53 per cent to 415,000 gross square feet. Fir t known as the Health iences Building, it wa renamed Cary Hall after Charles Cary, UB medical alum­ nu and faculty member who cofounded the hool' High rreet headquarters in I 93. Except for a mall addition to Farber Hall in 1963, the new complex atisfied the need of the School for more than cwo decad . In 1974, however, the same year that Farber Hall was renamed, the new CFS Addition was conceived and pro­ posed. Thirteen year later, it became a reality. Looking over the hoot' hi tory, one hopes chat the new addition will atisfy the chool's needs well into the 21 t Century. • Bibliography I. 2. J. 4. Umv. of Buffalo lru Alumni Yearbook, I Q • Niagara Fronuer, p. 55. Ne" York ate Medical journal, , 'o, . 5. 1955. F,ftv-Third Annual Announcement of the Uru,er-,1ryof BuffaloMedical [kparrmem (Buffalo, Gu.,, Co .. I ). 5. Goccheb, Dr. Bernhardt. "The Medical hool of 1930." Buffalo Medical &ueu , pnng I , p. ~6. 'Y Buffalo hool of Med,nne. Th1>is an early edn:ion of what was lacer renamed BuffaloPh)<ICUln .) 6. Park, Julian, IQJ7. A Hutory of the L'n1<,,.,1hof Buffalo . Buffalo Historical 1ery, Vol. XXJI.,pp. Q-11. �11 MEDSCHOOLLEGACY LNES IN BUILDINGNAMES ON BarH CAMPUSES BY BRUCE S. KER HNER N ot often realized is that the legacy of the School of Medicine ha been literally imprinted on many ocher University building not normally a sociated with che Medical School. This legacy exist in the names of the building themselves. In fact, one our of four of UB's building (that were named after a person*) have names associated with Medical School personalities. Similarly, almost half of the names of University roads (on both campuses) are of people associated in one way or another with the Medical School. This is due in pan to the fact that UB was the medical school during the first 40 years of it exi tence and that its founder included many physicians. But the names selected for Univer ity building also include those of people who have lived up to the la t 25 years. 1t seems appropriate that UB' South Campus, which includes all but one of the health profession schools, has seven, or 32 per cent of its buildings named after Medical School people.* oc surprisingly, the Medical School's buildings are among those so named, e.g., Drs. Cary, Farber, and Sherman are alumni, faculty, benefac­ tor , or research pioneers of the School. Examples of ocher South Campus buildings with medical-associated names are Beck, Kimball and Wende Halls (see accompany­ ing Table for details}. Six buildings on the onh Campus are named after people tied co the Medical School (e.g., Baker, Bell, Hochstetter), representing 22 per cent. However, 63 per cent of onh Campu roadsare named after medical personalities. They include mo c of che founders of the Univer ity (Drs. Hint, Coventry, White, Hamilton, Hadley, and Lee) as well as its first woman alumnu (Dr. Moody). Of course, other school and di iplin left their imprint on campu buildings, too. The next largest number of building were named after businessmen who were bene­ factor to other schools ofUB (9); attorney or Law hoot alumni (9); and politician or administrators (5). Figures associated with the fields of art, humanities, civi affairs, pharmacy, dentistry, inventions, philanthropy, engineering and early Buffalo history also contributed one to several names of building . Complicating the count i the fact that some people fall into several categories. For example, Edmund Hayes (of Hayes Hall) wa a military general, a UB administrator, and benefactor. • *&cfuckdfrom 1/wartim ar~ ch,, Ii or so bu,/dmgsof IJBno< namtd after spt,afic mdwidual.s,.rudi as Sen:ia Caut:r Bwldmg,AlumniArenaor Cmter ForTomorrou. South Campus Sherman Hall (and Sherman Road) Cary Hall BUFFAID jPHv51¢1ANI DeWitt herman, UB medi al alumnu (I 90s),also professor of pediatric in 1909. In trumental in getting pediatrics recog­ nized as an independent teaching discipline, expanded Children' Ho pita! from a 16-bed co a 200-bed facility and was among the first to win admittance for medical students to ho pita! wards for reaching purpo es. Hi and hi wife' will provided for che con trucrion of a new Medical hool building by chi name. Their endowment fund in 1977 enriches the School's medical reaching programs. (Home of part of Medical hool) Charles Cary, M.D., UB medical alumnu , professor of anatomy and medicine (1 78-1911),a brilliant reacher and benefa tor. Helped establish the hool' third new building (1893). (Home of part of the Medical School) 12 d, �12 Kimball Tower Farber Hall Beck Hall How e Re earch Lab Heyd Drive Wende Hall tockton Kimball, UB Medical School dean (1946-195 ), and nationally known medical educator and community lead r. (Home of Schools of ur ing and Health Related Profes ions) idney Farber, B medical alumnu (1923), whose discoverie in chemotherapy of cancer and hi definition of total care of children with cancer are regarded a great milestones in cancer research and care. (Central building of the Medical School) Edgar Beck, UB medical alumnus (1919), associate professor of clinical medicine and Buffalo General phy ician until his death in 1969. (Home of the Department of Medicine' Geriatri / Gerontology Divi­ sion, the Y Geriatric Education Center, and the etwork in Aging of Y, Inc.) Lucien Howe, M.O., profe sor of ophthalmology for 30 year and president of Buffalo Academy of Medicine. Co­ founder of Buffalo Eye & Ear Infirmary (1 76) and founder of Harvard' now­ internationally known eye and ear infir­ mary. Establi hed neonatal ilver nitrate use in eye . (Hou the uclear ience Materials Center and pare of the Chemi try Department) Charle G. Heyd, B medical graduate (1909), received Legion of Honor in 1932 for service co France during World War 11. (Road curve around Squire Hall) Grover W. Wende, UB medical alumnu (I 9) and one of country' foremost dermacologi t . erved on urgeon General's Advisory Committee for detec• tion and treatment of venereal and kin disea es during World War I. (Hou Center for Media tudies and Educational Communications Center) Hochstetter Hall Bell Hall Baker Chilled Water Plant Park Hall Flint Entrance &Loop Coventry Entrance Road Lee Entrance Road orth Campus Fronczak Hall 12 6 Franci E. Fronczak, UB medical (1 97) and law (1900) graduate, internationally known American public health authority, associate profe sor of hygiene and preven­ tive medicine and UB Council member. Gained fame for his medical work in Poland during World War 11which brought him high honor from France, Poland, and U.S. (Hou es Department of Geography and Phy ic & Astrono my) BUFFAID JPHY$1¢1ANj White Road Hamilton Road �13 Ralph Hoch tetter, oil pr ucer, banker, philanthropi c. Donated hi estate of 15 million for re earch fellow hip in medicine. Died in 1955. (Houses part of hool of Pharmacy) Lawrence D. Bell, founder of Bell Aircraft (now Aerospace) Corp. Awarded Chancellor' Medal in 1947. His founda­ tion established an endowed chair in the School' Phy iology Department and a general purpose fund in engineering. (Houses Computer ience Department) Melvin H. Baker, founder of ational Gyp um Co., benefactor, Chancellor's Medal winner (1957).Chaired Y tate' American Cancer Society and Crippled Chi ldren's Guild of Buffalo. Julian Park (1 1965),Ph.D., son of Dr. Ro well Park and founder of UB' liberal arts program, UB alumnu , faculty member, dean of College of Arts and Science for 36 years, author of early hi tary of the School . (Houses Department of Psychology, Hi tory, iology, and Political ience) Moody Terrace Loop Road Hadle y Road Millard Fillmore Academic Center and Coll ege Mary Blair Moody, M.D., first woman medical graduate (1 76) of UB. ationally recogni:ed a one of the most brilliant women in medicine and frequent recipient of honor and award . Fir t woman admitted co Erie County Medical iety. (One of three major entrances to Ellicott Complex) George Hadley, M.D. one of Medical chool' fir t faculty, profe sor of chemi try. Di overed tran ition of car h into glucose. {A cro road on orth Campu) Millard Fillmore, 13th U. . president (I 50-1 53), fir t chancellor of UB and the Medical hool, retaining that po ition even during hi pre idency and until his death in 1 74. Benefactor of UB and Buffalo culture. (Millard Fillmore Academic Center house Archaeology Program and Millard Fillmore College B's ight hool) TeachingHospitals Millard Fillmore Ho pital Austin Aim, Sr., M.D., co-founder of UB and the Medical hool, one of it first faculty member , medical pioneer. Discovered the "Aim Arterial Murmur;" that typhoid fever is a water-borne di ea e; and chat TB i of microbial origin. Also popularized use of binaural scetho cope. (Primary entrance road co orth Campu ) Charles B. Coventry, M.D., co-founder of UB, one of first faculty, professor of phy iology and medical jurisprudence . (Major highway entrance to orth Campu) Charles A. Lee, M.D., co-founder of UB, one of first faculty, professor of pathology. {One of orth Campus entrance roads) James Platt White, M.D., co-founder of UB, one of fir t faculty, professor of pathology. (One of arch Campu entrance roads) Frank H. Hamilton, M.D., co-founder of UB, one of fir t faculty, professor of urgery, one of the ranking surgeon in the country. Performed fir t succ ful kin graft in hi tory. {One of orth Campus entrance road ) Roswell Park Memorial Institute Erie County Medical Center BUFFALO (PHY$t¢1ANI amed after President Fillmore (see above). (Houses one of the bases of UB's Depart­ ment of Family Medicine, several research lab and residencies) Ro well Park, M.D., B profes r of urgery and founder of the first {and now one of the best) institution in the world devoted to cancer research; it tarted as a unit of the Medical hool. A renowned researcher and phy ician, he wa also the first to obtain government fund for cancer research. 0oim programs/research.) David K. Miller Building: amed after the former director/ chairman of the Depart­ ment of Medicine and Erie County Laboratory for over 30 year . The building wa named after the Harvard graduate in 1984 and houses UB's Departments of Medicine and other department in what was previously F-Building. E.J. Me)'er MemorialHospital : amed after the UB medical graduate {l 91) who turned then Buffalo City Ho pica! into a UB teaching ho pita! in 1920. Served a hospital pre ident and UB urgery professor. After 32 years, Meyer Ho pica! was renamed Erie County Medical Center • in 197 . 12 6 �Don't get your hopes up, AIDS researcherswarn BY CO T hey may be at opposite poles when it comes to their theories, but AIDS researchers are in agree­ ment on at least one point: don't raise false hopes. It appears likely that a treatment will 12 6 IE OSWALO STOFKO be developed before a vaccine can be found, and the prospects of finding an effective treatment soon are bleak. "I bet treatments come before vaccines," said Luc Montagnier, the French research- BUFFAID IP~vs 1C1 AN I er who identified the LAV virus associated with AIDS and is now trying to develop a vaccine. He spoke at last ummer's 10th Interna­ tional Convocation on Immunology, span- �1 the vaccine trials probably would be the sex partners of AIDS patients, such as the wife of a hemophiliac. B efore wid pread use of a vaccine, researcher want to know if it ha any long-term effects or dangers. For example, Montagnier said, if the vaccine is too much like a protein in the body, the antibodies formed may attack body cells as well as attacking the AID virus. Montagnier is trying to develop a vaccine through transduction. Some genes of the AIDS virus are inserted into a virus that is harmless to humans, such as the vaccinia virus. The vaccinia virus is then introduced to the body in the hope that it will prompt formation of antibodies to AIDS. The problem is chat the AIDS genes often become free, causing the vaccine to become less immunogenic. Montagnier said a way ha to be found to securely attach the AIDS gene to the harmless viru. Another problem is that even if a vaccine is developed, it may be effectiveonly for the train of the virus from which it was produced, the researcher added . The virus often changes from one person to another and even changes a little within an individual. M sored by the Medical School's Ernest Witebsky Center for Immunology. If all goes well with his search for an AIDS vaccine, it will still be a year before it can be tested on chimp , he said. Then comes testing on humans. It may be dif­ ficult to find volunteers, he noted. Those who would be most eager to try a vaccine may already have been exposed to AIDS . If they have AIDS antibodies, it's too late for a vaccine, he explained. Others who take precautions against being exposed to the virus probably wouldn't be interested in trying a vaccine. Montagnier said those who volunteer for ichael Apicella, M.D., professor of medicine and microbiology, agreed with Montagnier's assessment of the situa• tion. "l would hope a treatment comes before a vaccine," he stated. "A vaccine is easily IO years away - maybe never. The hope for a short-term solution is bleak. It's dreadful." Apicella, co-director of UB's Center for Applied Molecular Biology and Im­ munology (CAMBI), heads the Buffalo­ based portion of an NIH tudy of AIDS treannents. (See accompanying article.) "There are no drugs available now," Apicella said. "The whole purpose of this grant is to get people interested and get them looking for possibilities." When promising drugs are identified, they can be tested in a controlled study. For instance, some drugs have been used in the gay community of ew Yark City, he said. These drugs can be studied systematically for their effectiveness and for ide effects. BUFFAID /PHY$ 1 ¢tAN f "So much of what we know is anecdotal," Apicella said. Apicella heads the Buffalo-based portion of the five-year lli study. The clinic will be set up at Erie County Medical Center. Buffalo funding for the first year will be about 200,000. lli has funded I4 centers nationally. Buffalo, Rochester, and Syracuse have been designated as a ingle center. The expertise at UB is toxicology and drug kinetics {how the body distributes and excretes drugs). In addition to new drugs, some standard treannents will be evaluated, Apicella said. Apicella noted that the virus affects different groups of AIDS patients, such as gay males, hemophiliacs, and drug abusers, in different ways. Buffalo has a good mix of these different patient populations. One fortunate thing about the disease is its limited manner of transmission, he aid. It can be spread only through sexual rela­ tions or through needles. If it could be caught as easily as chicken pox, "we'd be in big trouble," Apicella aid. • UB participating in AIDS drug evaluations U B has been selected to participate in a ational Institutes of Health study to evaluate new and existing drug for treatment of AIDS. Michael Apicella, M.D., professor of medicine and microbiology at UB, named to head the Buffalo-based portion of the cudy, says some 30 local AIDS patients per year are expected to participate. Buffalo funding for the first year of the five-year study will be an estimated 200,000. The clinic will beset up at Erie County Medical Center. The study, which has designated the cities of Rochester, Buffalo, and Syracuse as a ingle center, is headed by Ray Dolan, M.D. of the University of Rochester. NIH has funded 14 centers nationally. Apicella, who will be a isted locally by Ross Hewitt, M.D., a fellow in UB's Division of Infectious Diseases, says it has not been determined which drug will be evaluated. "Some of the drugs may have been undergoing testing elsewhere in the world while others will be new drug compounds," he says. • 12 6 �16 Class of '90 is the most female, oldest ''N your usual class" would be an understatement for the 140th entering class of the UB Medical School. The Class of 1990 is the most female, the oldest, and includes the second highest number of minorities of any class in the School' hi tory . Furthermore, more Western ew Yorkers and people with master' degrees comprise the class than at anv time since records have been kept . The fre hman class comprises 7 men and 57 women (42.2 per cent). It 24 minoritie include 17 black , 4 Puerto Ricans, one Mexican­ Arnerican, and cwo ative Americans. The highest number of minorities wa 25 in the Class of 1972. The number of Western ew Yorker i 86, four higher than the previou high of 2 in 19 2. Only two are from out of tate. The average age i 24.2 year , the olde t ince r ord have been kept. That tati tic i kewed partly because the class contain the School' oldest entrant, a 55-year-olduoman . However, it till in lude a rL-cordhigh number of tudents in older age categories. The 135 rudents were selected from a pool of 2,590. The number of applicants has been dropping teadily, reflecting a national trend in which fewer people are choo ing medicine as a career. UB's highest number of Med hool applicant was 5,000 in 1972. "The declining trend is predominantly among white males," explains Dr. Thoma Gurruso, the School' admi ion director and also clinical assistant professor of ophthalmology. "If the trend continue , American medical school will be 50 per cent female in ten year ." rudent with master' degrees total 23, a record for the hool a well as a reflection of the older tudent trend. While 5 per cent of the entrants expectedly had science, especially biology, chemistry and health-related degrees, unconventional degrees occur also. These include electrical engineering, geology, economics, busin , mu ic, religion, philosophy, and foreign language. One Med hool freshman ha a dental degree and three have Ph.D .. 12 6 ot The March 24 ceremony was carried out by Commander Bill Drinan, commanding officer for the avy Recruiting District, and Chri Herold, ho pica! corpsman and chief of medical program for the di trice. "We're excited about this opportunity to come to UB to commission our first woman medical tudent," Commander Drinan said. During the ummer, Ms. Hart served a clerkship or participated in officer indoettination programs as a tudent. In addition to the scholarship, she receives avy pay and benefits following medical school. After receiving her M.D., he will be obligated to apply for an in­ ternship at one of the four military-associated ii teaching ho pitals and to practice on a military O base for three year , or she must complete her ... ~ re idency in a military hospital three year after __________ her intern hip. Harr was selected for the program, which started in 1975, based on excellence in Graduates from UB, the University of academic performance, references, and a Rochester, Cornell, Canisiu , and U Y personal interview. Binghamton contributed almost 40 per cent of he received a B. . in biology and a B.A. in the class. Others came from uch schools as German from yracuse Univer ity in 19 5. Her Duke,Johns Hopkins, otre Dame, Columbia, Ii t of honors includes three year on the Dean' Fordham, Georgetown, as well a Harvard, Li t, membership in the pre-medical honor Brown, Dartmouth, MIT, Yale and a ho t of society, Alpha Ep ilon Delta, and membership other colleges. in the foreign language honor society, Phi Mean MCAT scores averaged 9.07 and the igrna Iota. • average undergraduate ience G.P.A. was 3.32, both a drop from la t year . The three tudent entering the M.D.-Ph.D . program, all female, had MCAT or averaging 10.4. The Early urance Program is gaining in popularity. Ten of it 15 applicants were accepted. • I Student travels to Ivory Coast on MAP fellowship Female med student commissioned in Navy U B first-year medical student Kristina Hart became the first female medical rudent to be commi ioned by the avy in Western ew York. It was also the fir t time uch a ceremony cook place at UB; historically it has been held at the Federal Building or on a ship. Ms . Hart also received a scholarship from the avy for tuition, living expense , and a monthly tipend, which totals 12,000 a year. BUFFAID jPHv$1¢1ANI T hird-year medical student tephen Merry has been selected as one of 37 senior medical students from orth America to receive a fellowship from the Medical Assistance Program (MAP)/Reader's Digest Fellowship. The announcement came from Dr. C. Everett Koop, surgeon general of the U. . Public Health Service, and chairman of the selection committee. The fellowship, made po ible by a gram from the late DeWitt Wallace, founder of Reader's Digest, provided travel grams for Merry toward an externship at Bapri t Mission Hospital in the Ivory Coast, where he spent four months assisting in urgery and obstetrics. • �17 ., M Dental building, new library dedicated ore than 1500 individual braved early morning fog Sept. 20 to attend outdoor ceremonie dedicating the new hoot of Dental Medicine building as Daniel H. Squire Hall. T he new buildings of two si ter in tiru­ tions of che Medical School - che School of Dental Medicine and the Health iences Library - were dedicated with great fanfare chi ummer. Donald A.B. Lindberg, M.0., director of the ational Library of Medicine in Wa hingcon, 0.C., the largest medical research library in che world, was keynote peaker at the dedication of the ew Health iences Library held Augu c 19. The library is now housed in the freshly refurbished original Lockwood Library at Main treet. Lindberg poke on the new field of medical informatics and the computerization of medical cataloging using laser discs and artificial in­ telligence. "Increasing specialization puts greater need on medical informatics. ln the old day , a doctor could know most of the field of medicine. But specialization is here co cay and the health science libraries have to respond to chat fact," he noted. UB's Health Sciences Library, one of 125 resource medical libraries aero the U.S., is part of a formal national network that provides health care professionals with widespread access to published medical information. Health professionals throughout Western ew York and area health care institutions are regular users of the UB Health Sciences Library, which contains 236,000 volumes. The Dental School previou ly hared Farber Hall with the Medical hoot for 23 years. Congratulating Dean William M. Feagans, 0.0 .. , on the newly renovated building, UB President teven B. ample noted that Squire, who served as dean of the hoot from 1912-1935,was instrumental in advancing the quality of dental education locally as well a nationally. The spacious, airy building, which prior to renovation served as the rudent union, features many innovation and new services. On the fir t floor, vi itors are greeted by a striking three-story, brushed aluminum original sculpture patterned after the O A molecule. C ark onference Room an the H L, the H L' H to ol .-d ol 10 BUFFAID IPHYS 1 ¢ 1 ANI The School i the first dental school in the nation to install a special tomographic unit called Zonarc, an imaging device which use less radiation than conventional tomographic equipment. The School also ha a new Center for Laser Utilization and a new Pain Control Center. Innovative laboratories on the second floor allow for production of glass cast crowns, one of the newest aesthetic advances in restorative dentistry, and provide special equip• mem for production of partial dental frameworks. • IZ 6 �IIAYF S ''Hayfevervictimsusually sufferfrom themiddle of Augustuntil thefirst frost.The symptomsare shownduringeve:ryTV commericalfor antihistamines. '' 12/, b ometimes it i the little things in hfe that bother you. Ir' also the little things that can push a person over the edge, cause major problem , and generally make life unbearable. An example of one of those big little things comes from a wild plant known a the ragweed. When it releases it pollen m mid-Augu t, it affect milli of people with a r ction called ragweed al rhinitis, commonly known as hayfever. Hayfever victims usually suffer from the middle of Augu t until the fir t fro c. The ymptom are familiar: runny nose, congestion, watery they're shown during every TV commercial for antihistamines. Robert Reisman, M.D., UB clinical professor of medicine and pediatrics, and co-director of the Allergy Research Labora­ rory of Buffalo General Ho pital, has been researching alternative treatments for the estimated l million hayfcver victim in the U .. Besides hoping for a fro t by Labor Da , one obvious treatment i avoidance therapy, uch as using air conditioned room or keeping windows closed. Another oprion is to take medication. For mild ro moderate hayfever reaction , antihista­ mines can be very effective in relieving symproms. Reisman scares, "During the last few years, new ancihi tamines ha\'e come on the market which minimize drow iness. These are highly recommended." Another po ibility i use of steroids either as a nasal inhaler, in tablet form, or by injection. While these method usually work well over the hart term, they only relieve symptoms; they do not arrack the cause of BUFFAID jPHY$1¢ 1 ANj Immunization, 4111-.aA through the injection of pollen extract, i con idered the combatting hayfever. It tackles the causes, and works like a vaccine. The ba ic concept of immunocherapy for allergic rhinitis has nor changed in any sub tantial way since it was first introduced in 1911. But Reisman is crying to bring immunocherapy into the econd half of the 20th century. �19 uqMROZEK seven years, Reisman's re­ search has con­ centrated on the tory immune y tern was orig­ inally rudied in detail by Dr. Thomas Tomasi when he was a UB researcher. (He is now the director of RoswellPark.) This sy tern is usually associated with the production in the nasal passages of antibodies that fight viral infections such as polio and the influenzas. Reis­ rudies revolve around the use of a nasal inhalant to vaccmace the body against the effects of the ragweed pollen. Reisman and his co-mvesrigators are the only ones in the country currentlyusing a nasal inhalant to deliver immunizing do. of ragweedextract.The are also the fir t co use polymerized e:·tracr in chi manner. At thts year' March meeting of the American Academ y of Allergy and Immunology, Rei:man outlined the latest results of hi resear h. For several years, he has extensively tested local intranasal immunocherapy for use again t ragweed allergic rhiniti . "The nasal spray L analogou s to giving shoe , except we're squirting it into the nose," Rei man said. Research was done u ing che double blind control method. The control group was given a placebo, while the test group was given a ragweed extract. In different tests, Rei ·man alrt.-redthe do ing schedules and the e. ·tract solutions. From the result , Rei man concluded that "the t response came from large doses of pollen solution. And the best solu­ tion was a polymerized extract, in contra t to an aqueous extract. We found chat the aqueous extract caused significant side effect in some patient ." The advantage of the polymerized extract is char it slowly releases rhe ragweed solution into the system, as opposed to a water olution which relea es the extract much coo quick­ ly. This quick release can cause the type of allergic reaction which the patient is trying co avoid. The results have been encouraging, Rei man cares. "We are definitely stimulating the secretory immune yscem. This type of therapy is effective in immuniz­ ing against the ymproms of hayfever. le relieves, or prevent , the symptoms." A nother large definitive study wa undertaken just thi summer, with a group of 50 to 60 ubjecc recruited from the community. Thi study checked the BUFFAID jPHVS1¢1ANI validity of th u of high do ing chedule \\ith a polymerized extract a the be t type of therapy. Rei man had no trouble finding volunteer . Ragweed sufferer from all over the continent write him letter inquiring about the availability of his na al pray. De pite po itive results from the research, Rei man know there i much more work co be done to perfect the pray. "We do know that people who get chi treatment make local antibodi in their na al secretions, but at pre nt, we cannot correlate the amount of timulation with the response of the people who get the treatment. In other words, some people have a low antibody re ponse and they till get better, and there are other with a high antibody response that cl n't gee better." The po ibility of a greater public availability of the intrana . al spray a immunocherapy again t hayfever i exciting. The pray i inexpen ive, . 1mple, and it cau es no significant ide effects. According ro Rei man, "it definitely should be considered for more wide pread u e because of tho e advantage ."Reisman al o commented that he "ha no idea when the na al pray will be available for the general publi . le depend when a company would do the marketing studies." ln thi in ranee, the company would be Key Pharmaceuti­ cal, which has helped support Rei man' na al pray rudies and hold the patent on che polymerized extract. The implication of the na al pray are taggering. Chronic hayfever sufferer who opt for parenteral 1mmunocherapy typ­ ically receive injections once a week for three, four, or five month . Injections then continue once a month for an in­ definite period. If Reisman' nasal mi t is manufa cured f, r lOn umer u , it will great!~•simplify hay­ f, v r treatment. • �N V. 0, tp ~ 36 ILLUSTRATION DAN ZAKflOCZEMSKI �21 THE MEDICAL EDITOR AS GUINEA PIG BY BRUCE S. KER HNER A s the University's medical editor, I spend most of my time as the out ider looking in at others' research experimencs. Bue in one case, the ituation wa reversed: l wa the insider looking out during one recent experiment in which l served a a volunteer subject. The experiment for which l volunteered was the double blind testing of a ragweed nasal extract pray conducted by UB allergist Rohen Reisman, clinical professor of medicine and pediatrics, based at Buffalo General Ho pital. (See accompanying articles detailing hi research.) 1 promptly responded to hi public request for volunteers, curious to find out if he was really onto something that could relieve the Lifetimeof sneezing and muco al mi ery I had endured. 1twas also satisfying co know l could contribute in a small way to medical cience. My other strong motivation wa the curio iry of seeing an experiment from a subject's view, albeit, one which would ultimately be relegated to an anonymous stari tic in a technical journal article. By the end of the fir t day, my arms looked like they had been worked over by an inexperienced tattoo artist or an over­ zealou 1960s body painter. Both my arm were injected up and down in neat little rows with variou allergy extract , close to three dozen in all. Each injection created its own "body art," a series of pink wheal with unique shapes and sizes, but all sharing the same intense itch. "Looks like you're going to be a perfect subject," the assi ting researcher remarked. With a black marker pen, he highlighted the "an work" by out­ lining each bulging wheal with an inner and an outer circle. Then he labeled each one with a number and a letter. By the time he was fini hed, my arms displayed a curious sequence of black-edged, pink­ centered concentric circle in rows extending from my wrist to my elbow. The climax of the experiment's first day was the nasal mucu ample procedure. "Just pray chis in your no e so we can be sure to gee enough mucus for the lab testing," l wa told. Eager to donate my best mucu ample l compressed che spray bottle inro my nostrils a vigorou ly a l could. What followed was an eruption of mucus so great that it instantaneously filled up my inus and na al pa sages and could hardly be contained in the dozen ti ues 1 grabbed, one after another. "You only needed to pray a little bit," che assistant told me. "That wa quite a quirt of histamine you gave yourself." "Oh, i that what was in the bottle," I dead-panned. "Well, it certainly looks like you got enough of my ample." While my head reeled, I reminded my elf that thi brief "initiation rite" into the realm of the research experiment paled in comparison to the hundreds of neezes, wheezes, tissue boxes, raw nostril and antihistamine-induced stupor l had uffered since childhood. I wa given a mall squeeze borde and told to spray it in my nose twice a day, tarting at two sprays per nostril and increa ing gradually to five spray each. Detailed records of effects had to be written on multiple forms. Every two weeks, 1 was given a brief physical and a new bottle con­ taining a progressively stronger solution. Keeping in line with experimental protocol, neither I nor the research fellow knew if I had the control substance or the real polymerized ragweed pollen extract. The twice daily sprays throughout the BUFFAID IPHY$1¢ I AN I spring and early summer month resulted in a number of sneezes and blows that alway ended ten or IS minutes later. The reaction from the earlier sprays was mild bur the on encraced solutions taken only weeks before the ragweed allergy eason began felt no different than snorting a pollen-laden ragweed flower. After 20 sneezes in rapid succession, I was repeating to myself, "Remember, you're doing it for science, you're doing it for all those fellow allergy sufferers out there." Fortunately, even these intense reactions ended within the fir t ten minutes. The experimental spraying ended ten days before the ragweed allergy eason wa to commence. I waited in su pense for the fir t day to arrive. On Augu t 12, I experienced my fir t very mild reaction, a slight watery discharge, and recorded it on the detailed urvey form I had to maintain. Ten day elap ed and I till had only mild, very tolerable reaction , an occa ional sneeze, a blow here and there. "Must be a really mild year," I thought, "or maybethe experiment i working?" By the time September arrived, I wa certain I had been given the experimental extract and that it had indeed immunized me ro mo t of the ragweed reaction. September passed, followed by the fir t frost of the season, effectively ending my 23rd active ragweed season. Two weeks later, my conclusion was confirmed when the medical secretary informed me I had indeed been given the active ingredient. The nearly ymptom-free season made my effort worthwhile. Hopefully, Dr. Rei man' ragweed allergy treatment will be marketable in a few years. ow I only have to worry about my gra allergy, my mold allergy, and my tree pollen allergy. • 12 t, �22 I ~ i~~~~~~~~~....-~.......~~~~~~ I 12 6 BUFFAID j P HV$1¢ 1 AN ) �23 Dr. RobertReismanis attemptingto refine immunizationtherapiesusingvenominjections BY PAUL MROZEK A 1lergicreactions to insects stings are a major medical problem in the U.S., causing at least 50 deaths per year, and probably many more which go unrecognized. Robert E. Reisman, M.D., has been researching this problem for the past 15 years. Reisman is a clinical professor of medicine and pediatrics at UB. But hi favorite hat to wear is that of co-director of the Allergy Research Laboratory at Buffalo General Hospital. He is also a former president of the American Academy of Allergy and Immunology. At the latest of his ongoing presenrations at academic symposia, Reisman presented an update on his research on stinging insect a1lergies. The research i concentrated in two areas: understanding the mechanisms for allergies, and the refining of immunization therapies. Reisman breaks this down into more immediate criteria. "One, we are striving for a continued understanding of the natural history of the disease process. Two, we are trying to decide who should be treated. And three, what are che proper criteria for topping treatment? When does someone have enough?" The venom immunotherapy which Dr. Reisman i involved with has proved to be highly successful in che prevention of subsequent sting reactions. The venom immunotherapy follows the basic guide­ lines for traditional allergy injection treatment. There are two major stinging insect families in the U.S. - the vespids (yellow jackets, hornets, and wasps), and the apids (the bumblebee and the honeybee}. The yellow jacket is responsible for the largest number of stings, mostly because of two factors: they nest on the ground and they are attracted co food. So it's possible that not all of the yellow jackets' fierce reputa­ tion is deserving. It's just that sometimes their nests get stepped on, and they manage BUFFAID jPt-tY$1¢ 1 A I to make pests of themselves during family picnics. The typical victim of an insect sting is under the age of 20, and chance are two to one the person i male. Thi probably reflects the fact that young males engage in more outdoor activities where stinging insects are encountered, as compared to other groups. Reisman's re earch confirmed that allergic reactions can be venom-specific. Certain people are allergiconly to the sting of individual insects such as yellow jackets and ochers are allergic only to apid sting . Some are allergic to both. What this means is that there are other factors besides the lgE ancibodie that can modulate anaphylaxis. And these factors need to be more clearly defined and studied. R eisman states, "We've learned how co diagnose insect sting allergies through the availability of purified venoms. They can be obtained commercially. Years 12 6 �24 ago, we used to employ individuals co collect venoms f-rom different stinging insects; we did this for three or four summers. Before that, therapy was tried u ing whole insects ground up into a solution, but that wa found to be ineffec­ tive." The purified venoms are used to detect allergies through standard skin and blood tests. Bur the venoms themselves are analyzed even further. "We fractionate the commercial venoms, then cescdifferent components to see which pans of the venom are really responsible for the allergic reactions," Reisman explains. Different people have reactions to different components in the venom. According to results of Reisman's tests, there are at least three or four different components in each venom which have allergenic properties. At this point in the research, the practical applications of the separation of venom component are limited, but more studies are going on. Studying the types and amounts of antibodies in the blood is central to this research. IgE antibodies reacting with venom are respon ible for the allergic reactions following insect stings. These antibodies can be measured by the immediate direct skin test, the classical test to diagnose allergy, or in the blood by a specialized radioimmunoassay. Immunity to insect stings is thought to be mediated by specific IgG antibodies reacting with venoms. Early studies were done with beekeepers who are highly immune to insect stings. Beekeepers were found to have high levels of lgG antibodies in their blood. If these apiarists were stung, they incurred only minor local reactions, leading many beekeepers to the opinion chat they would rather be stung by a bee than bitten by a mosquito. Subsequent studies by insect-allergic individuals indicated that their immunity to further stings was mediated by the developments of these lgG antibodies. IZ 6 T here are three approaches to therapy for people who have a history of allergic reactions co stings. The first, and least reliable is avoidance. Since avoidance is not practical, Reisman recommends that a prone individual makes sure chat emergency medication is always available. ''Allergi,c reactionsto insectstingsarea major medical problemin the U.S., causingat least 50 deathseachyear andprobablymore. The typicalvictim of an insectsting isa maleunder the ageof 20.'' Acute allergic reactions to stings are treated in the same manner as anaphylaxis f-rom any cause. The symptoms of anaphylaxis may vary, but can include hives, flushing, upper airway edema, angioedema, broncho spasm, circulatory collapse with shock and hypocension, bowel spasms with diarrhea, and uterine contraction . The drug of choice for treatment is epinephrine hydrochloride. Amihista· mines can supplement the epinephrine if necessary. Symptoms co be especially watchful of are edema of the upper airway, which has been identified a a common cause of death, and hypotension and BUFFALO jPl-fv$ 1 ¢ 1 AN j shock. Kies containing emergency medica­ tion are available. lmmunotherapy can provide virtually 100 per cent protection to patients who elect to undergo the treatments. Initially, small doses of venom are given over short periods of rime. Gradually, the injections are spaced out to one per week, with increasing amounts of venom, until the dose reaches a maximum measure which is equal to the venom f-romone sting. At this point, injections are given once a month, and treatment i continued indefinitely. The purpose of the venom injections is to stimulate ever increasing amount of lgG antibodies. Once the production of the lgG antibodies reaches the optimum level, allergy protection i achieved. Despite its success, there are unresolved problems with immunotherapy. "How do you select patients who hould undergo treatment?" Reisman comments. Research has shown that rhe sensitivity of individuals to insect stings varies over a period of rime. In untreated individual , one ring may result in a systemic reaction while a sub equent sting mav cause only minor local discomfort. " ot everyone who rests positive should undergo immunotherapy. Hopefully, we will develop criteria co that effect. I believe we are getting closer to solving this problem," Reisman said. A corollary to the question of who should be created is the question of when treatments should be halted. This may relate co the decline in the potential allergic response indirectly measured by skin and blood tests. Using these criteria, venom injections have been successfully dis­ continued in a large number of patients. Reisman is continuing his research into these and other unanswered problems that deal with allergies and immunology. Great strides have been made in a short span of time concerning the stinging insect allergy. • �25 Cancer/ExerciseLinkEstablished BY BRUCE KERSHNER A dd a new dimension to lowering your risk of cancer: exercise. And add a new occupational di ase for office worker , secretaries, and d k­ bound manager and pro~ ionals: higher ri k of colon and po ibly brea t cancer. These are the implication of two new scudie by UB epidemiologi t]ohn ena, Ph.D., who report chat lifetime regular exercise lower the incidence of colon cancer and po ibly brea t cancer. The a i cant professor in the B Medical School' Department of Social and Preventive Medicine recently reported hi finding chat indicate that risk of colon cancer i doubled for individuals who work a majority of their adult lives in sedentary occupation . Another por­ tion of thi research uggesced chat sedentary women have a tati tically ignificant higher risk for brea t cancer. He reported these srudies chi June at the annual meeting of the Society for Epidemiologic Research in Pitt burgh. "Our research and ongoing research by ocher how chat flack of] exerci e is one of the strong t and mo c con­ istent risk factor for colon cancer ever found, even more than dietary factor ," Vena emphasizes. Concerning the brea t cancer a cion, Vena describes hi finding a "intriguing." "We should continue to tudy the role of phy ical activity (and) brea t cancer to determine the exact relationship," he ugg cs. Vena' fir c rudy to how exercise' protective effect for colon cancer u ed data from Buffalo's Roswell Park Memorial Institute, one of UB's teaching ho pita! . U ing 1957-1965patient data, he compared the occupational phy ical activity of 210 white male patients with colon cancer to the exercise tatu of 1431 patient without can er or dig tive disea . In addition, 276 white male rectal cancer patient were compared. Patient ages ranged from 30 to 79 year . Vena's newest study, to be publi hed in the AmericanJournalof Clinical utrition, important, hi Wa hingcon tate analy i also corroborated hi fir t Buffalo area tudy on colon cancer. T hree measures were u ed for the Buffalo cudy: the number of work year in sedentary job , the proportion of work years in u h job , and the proportion of life pent in these low exercise jobs. All three mea ures howed the ame trend, that colon cancer ri k i doubled for sedentary and light work occupations. Dr. Vena used the Department of Labor' physical activity cla sification y tern. It defines sedentary work a re­ quiring the lifting of a maximum of 10 lb . or 1 , uch a lifting or carrying ledgers, mall tool , and d k material , and involving con iderable itting with occa ional walking and randing. Light work involv frequent lifting or carrying of object up co 10lb . and no Q heavier than 20 lbs., with more fre­ Q quent walking, standing, or pu hing or .., pulling of control while seated. ~ Medium work requires frequent lift­ ing and carrying of 25 to 50 lb. object , while heavy to very heavy work in• volve lifting and carrying of 50 co 100 lb. object . Frequent or trenuou movement, walking or climbing 1 also con­ sidered in the rating y tern. § j turned up the protective effect of exercise again t colon and brea t cancer based upon analy i of occupation and cause of death of 430,000 white males and 25,000 white females, both group from Washington Seate. The Wa hington rate study howed a tatistically ignificant 35 per cent higher ri k of colon cancer for sedentary men, and a 40 per cent higher ri k for sedentary women. For brea t cancer, hi analy i resulted in a imilar figure, 35 per cent, for sedentary women. These results corrobo­ rate several rudies by ocher researchers which demonstrated even tronger exercise protective effect for breast cancer. Ju t a BUFFAID !PHv$1¢1ANI D r. Vena presents several theories to explain the connection between exerci and lower colon cancer ri k. "Phy ical activity could shorten the tran it time of cool pa age, which would reduce the duration of contact with a fecal carcinogen." uch carcinogen could originate with either dietary fat-engendered steroids or carcinogens ingested in food. "Exercise may also increase tool motility by inducing production of certain hor­ mones such a pro caglandin , which may also protect against cancer," he explain . 12 6 �26 The last theory is that inadequate exercise contributes to obesity, which i a cancer risk factor in icself."Obesity has been directly correlated to an increased incidence of cancer of the colon, breast and endomerrium ," states Dr. Saxon Graham, co-investigator for the ational Cancer In titute studies and chairman of UB's Department of Social and Preventive Medicine. Can one compensate for a sedentary job by regularly exercising on one's personal time? "Yes," Vena answers, "a home exer­ cise program would accomplish that. But the reality is that national catistics how chat the only group chat regularly exercises is younger people. Middle to older age groups still do coo little exercise at home. These studies show that most of the physical activity of individuals is till job­ relaced." He also notes chat the 1957-1965Buffalo data he first analyzed "were collected prior to the era of growing popularity of recreational exercise and interest in improved fitness through jogging and other activities." Thus, off-the-job exercise was an insignificant factor in that study, lending more confidence to his results for on-the­ job exercise. On the other hand, not accounting for exercise, on- or off-the-job, may explain the incon istent findings of many previous diet/ cancer studies, Vena maintains. For instance, fiber and cruciferous vegetables were shown to protect against cancer in many studies, but in others showed a negligible effect. Interestingly, Dr. Vena' tudies consistendy show no correlation between exercise and rectal cancer, despite the proximity of that organ to the colon. "We suspect that, unlike the colon, exercise may not affect contact time with carcinogens in the rectum." Vena intends to clarify the exercise/ cancer relationship through continued studies. "Much more needs to be done before we can (definitively}say these find­ ings have preventive implications," he states. "We know little about potential mechanisms, latency, and threshold effects. Our work is cut out for us." • I2 EXERCISES They'reneededto improve qualityof lifefor CF patients BY WENDY ARNDT HUNT F or chose with cystic fibrosis, it's not a matter of doing exercisesto better the chances of a long and healthy life. It's a matter of doing them to improve the quality of the years they have left to live. The average age of survival for someone with cystic fibrosis is 20. A decade ago, it wa 12. For several years now, Frank Cerny, Ph.D ., research assistant professor of pediatrics and an exercise physiologist, has been working with those suffering from this incurable genetic disease. Believing that exercise is a vital component of life, he has researched whether and what exercise can help cystic fibrosis patients. Cerny, who is director of graduate education in the UB School of Health Related Professions' Department of Physical Therapy and Exercise Science, wa formerly associate director of che Children's Lung Center at Children's Hospital of Buffalo. He initiated his research by identifying normal adaptations co exercise. During exercise, three primary systems in the body muse adapt: the lungs must deliver oxygen and remove carbon dioxide; the heart and blood vessels must deliver oxygen to the muscles, and the muscles must utilize oxygen to produce movement. In cystic fibrosis patients, the first system breaks down. Cerny discovered that patients experience di tress, however, only when the disease i most severe. During laboratory studies with in­ pati.ents, Cerny found chat exercise helped chem cough up mucus and sputum. Exer- BUFFAID (P1-tv$ 1 ¢ 1 AN I cise did not prevent lung deterioration, but it did seem to maintain lung function. Cerny wanted to see if there were good and bad ways to exercise. Should con­ tinuou exercise or stop-and-go exercise be prescribed for therapy? ''Exercisehelpsthese patientscoughup mucusand sputum. It doesnot prevent lungdeterioration, but it doesseem to maintain lungfunction." By observation, Cerny says, most children prefer intermittent exercise like playing tag versus continuous exercise like jogging. Physiology suggest children are not designed for endurance. He found that stop-and-go exercise was better for those with an advanced case of cystic fibrosis, because it gave them the same benefits with less risks. The chances of their oxygen levels decreasing and their carbon dioxide levels increasing were smaller, which lessened the chances of their experiencing difficult breathing. One exercise that seems advantageous to cystic fibrosis patients is rowing, an upper body exercise. Cerny believes that improv- �27 I n certain group of patients, Cerny aw that po rural drainage could be elimi­ nated if exercise was substituted. Cerny, with Irene Sills, M.D., a istant professor of pediatrics, also researched the effects of exercise on chose with diabetes. During tudies where ubjects participated in stop-and-go activity, Cerny found that lactic acid levels of diabetics were significantly higher than chose of the control group. Lactic acid changes the pH of the cells and blood, which promotes fatigue. Physically, diabetic children would probably be better off participating in con­ tinuou activity. But since children seem to like intermittent exercise more, Cerny experimented co see if there was a way to help diabetic children play as they prefer. He found that if they ingested either glucose or fructose before play, their lactic acid levels were lower than if they didn't. Since he was 15, Cerny has helped children learn to enjoy exercise. He believes they should be taught how to enjoy physical activity so that later in life they will benefit from it. Calling many adults "cardiovascular derelicts," he blamed their early physical education. The father of three sons says too many physical education classes rifle the child's natural tendencies because they are too narrow in their approach. They should be more imaginative. They should introduce students to more activities. They should emphasize not the acquisition of skills, but the appreciation for participation. Cerny thinks many adults sit in front of the television set on Sunday afternoons because they never learned chat exercise can be fun. ing the strength of the respiratory muscles can benefit these patient . Rowing can improve their respiratory muscle function and their overall fitness and promote their sputum expectoration. Cy tic fibro i patient must cough up the mucu and putum chat accumulates in their lung . They die because they drown in their own secretions. An accepted therapy is postural drainage, which demands chat someone beat on the chest or back of the cystic fibrosis patient for up ro 30 minutes each day to help them remove these secretions from their lungs. BUFFAID IP~vs 1 C 1 AN I For healthy children, Cerny says there are no disadvantages to exercise, if it is appropriate. "If inappropriate," Cerny says, "there are a multirude of disadvantages." He pointed out that gymnastics, for example, can cause muscular imbalance and spinal problems. European studies show that some youngsters pushed into competitive gymnastics have one leg up to one inch shorter than the ocher. • 12 6 �2 M.D.Stands ForMother--Daughter BY PAULA VOELL D r. Helen Sikorski values the "M.D." she has had since 1950, and he' delighted that her daughter Camille recently joined her in the medical rank . The two set local and UB medical history when Camille graduated from the UB hool of Medicine in May, making them the fir t mother-daughter ream to have graduated since che school was establi hed in 1846. "It's kind of a joke around our house chat 'M.D.' rands for 'mother-daughter,"' aid Camille. Dr. Camille Hemlock, her daughter, is now doing her psychiatry residency at Bech Israel Ho pita! in ew York. When Helen graduated, there were nine women (an unusually large number for that era) in a cla of 72; in Camille' class, 4 of the 136 were women. Ir's clear that more than male­ female ratios have changed in the intervening 36 years, however. By the time he was 6 or 7, Helen knew he wanted to be a doctor. Fortunately, he didn't know chat a girl from a poor Buffalo family couldn't a pire to uch an ambition. "I was too young co know any better," said Helen. "I ju t knew that I had a cremendou interest in wildlife. I wa alway collecting frogs and nakes and rabbits and dissecting chem. I found the dolls the ocher girl were playing with the greatest bore." When she cold her parents she wanted to be a docror, they didn't take her seriously. "My mother assumed I was saying the same kind of thing as the little boy next door who wanted to be a fireman." In high school, her intere t deepened. "There was no question of the direction in which I was headed." 12 6 A fter working her way through UB's Medical School and completing her residency in Buffalo,Sikorski opened her private practice above a Buffalo bakery, furnishing it in " alvacion Army, Goodwill and Early Attic decor." "When HelenSikorski wasin laborwith herfirstpregnancy,it coincidedwith a patient'slabor.She went to the hospital to beprepped,then deliveredherpatient, and went backand hadherOtvn baby two hourslater." She found chat patients didn't resist being created by a woman. "I found people had a lot less trouble accepting a woman doctor than I ex­ pected,"said Helen, who was named Woman of the Year in 1968 by the acional Medical and Deneal Association, an organization of doctors of Poli h ancestry. BUFFAID jPHv$1¢JANj When her daughters were babies, she parked cribs out ide her office door, and patients amused chem or waited while she changed them. When the girls were older, they were allowed to knock on the door that separates the house from the officefor only three reasons: being sick, a fire, or a flood, Helen said. She and Camille laughed as they remembered the time Camille tapped, tentatively at first, harder when her knock wasn't answered, to an• nounce that the kitchen was on fire. The only other time she knocked was when a neighbor' t. Bernard jumped in their swimming pool and couldn't get out. Eventually, members of a high school football ream came over to lifethe dog out. H elen aid it was difficult for her to be caught between wanting to be a good mother and a good physician. "It cakes a special kind of woman co endure in medicine,' she said. "It's a strange profession when you have to get out of bed and leave your own sick child to take care of another one. "And I've never known a man who has taken care of his patients, done the paperwork, and then come home to wash a load of laundry or wash dishes. You can say a woman can hire someone, but you can only do that to a point." When she was in labor with her first pregnan• cy, it coincided with a patient's labor. "l went into the hospital to be prepped, had an enema, then I scrubbed in and delivered my patient," said Helen. "Then I wem back and had my own baby two hours later." Camille ha observed the tension in being a woman doctor. She recalled one incident when �29 he accompanied her mother to a convention. "I remember being in the lobby of the hotel," said Camille. "At lunchtime, all the male physi­ cians went to the bar and all the women went to an F.A.0. Schwartz store to buy coy to take home to their children." When she started medical school, Camille planned co be a family practitioner, a her mother i , but changed her pecialty when he realized chat many ailments have psychological components and found she was good at p ychiatry. Helen said her daughter will practice medicine in an atmo phere much changed from when she started. "It was strictly private care and caring for our patients," he said. "We had professional independence. That's no longer in exi tence. BUFFAID (PHY$1¢1At.l This relation hip we had is replaced with a labor-management relation hip. ow we have a health care industry, and the ability to retain confidentiality is lost. With all the paperwork we have, every Tom, Mary, and Harry reviewing your chart." • (Ms Voell is o features wroter tor the Buffalo News. trom wh ich th is June 4. 1986. art icle wos condensed with perm ission trom the Buffalo News.) 12 6 �30 Robert Gale returns to give address here R obert Gale returned to the city of his alma mater last August to address the 15th Annual Meeting of the lnter­ national Society for Experimental Hematology. He i the 1970 UB medical alumnus who has been a major news figure ever since he became the fir t Western phy ician since World War U co be invited to the Soviet Union to cope with di aster. Gale addressed the Hyatt Regency meeting on "Lesson From Chernobyl." Gale's visit to Buffalo was facilitated by the fact that he was the second society member to register for the conference, before the Chernobyl disaster occurred. He wa one of 500 researcher from 22 countrie at the meeting, which wa hosted by Ro well Park Memonal Institute. Gale aid he would return to the U.S.S.R. a couple of weeks later. "I'm going to be involved in Chernobyl for the very, very long term," he cold the Buffalo, eu.s. Gale' fir t top in Buffalo after checking into h1 hotel room was the famous Anchor Bar, where he and a colleague drank beer and ate a 12 6 double order of the famous dish, chicken wing , that was invented there. Gale was both pessimistic and optimistic about the Chernobyl accident. He said it showed how limited the medical community would be in a larger scale nuclear radiation inci• dent, such as a worse meltdown ... or a war. It was also clear that the casualties of the incident will continue to mount for years, he said. On the po itive ide, he believes the disa ter ha benefited peace negotiation between the U .. and U.S.S.R. 'The fact they would let us come there at all i a major indication that Gorbachev is willing to compromise," Gale observed. "In the end, 1 believe there will be more good from this than the tragedy of 30 lost live ," he told his audience. The California re idem related another lesson, that "there are no limit co what we will do to help each ocher. As phy icians, we understand chis. Bue i wa good to see that nations would act that way." Gale is one of the world' leading peciali t in bone marrow cran plantation and i the chairman of che advisory comminee of the International Bone Marrow Tran plant Regiscry. • BUFFAID jPHVS1¢1ANI Dr. & Mrs. Chazan endow scholarship A generous donation by Joseph A. Chazan, member of the Class of 1960, and hi wife, Helene, has made po ible establi hment of a new scholar· ship for medical tudent . The 10,000 Joseph and Helene Chazan holar hip i for medical tudents from the Buffalo area who demon trate academic ex• cellence. The Chazans' donation has already contributed toward part of a scholarship for fir t•year medical student Jose Rivera. "I remember what it wa like when l was a medical student," Dr. Chazan relates. "l had to take our loans while my wife upported me through school as a teacher. I wish there had been uch a scholar hip available at chat time." An imerni t and nephrologi t, Dr. Chazan i the medical director of the Artificial Kidney Center of Rhode Island. He i a clinical associate professor at Brown Univer icy Medical School and also director of the Division of Renal Diseases of Rhode Island Hospital. His donation makes him one of the fir t to be admitted to the James Platt White Society, the Medical School's new society for benefactors who donate over 1000 annually. • �31 WNY's lstin-vitro baby born in July BGH installs the State's first multi-beam machine D octor ac Children's Ho p ita! announced lase July 7 the birth of the first in-vitro baby in Western 1ew York. The baby girl was born by caesarean section. The ho pica) recorded its fir c u ful in-vitro pregnancy in che Fall of 19 5 a part ofic infer­ tility clinic program. The program i offered through the Ob-Gyn Oeparrment, under the direction of Abraham Munabi , .0., research assi cane professor at UB. • B uffalo General Hospital is the first ho pita! in ew York State and one of the first health-care facilities in the nation to use a new multi-beam linear accelerator. The advanced radiation therapy machine features two photon and five electron beams in various power settings. le enables doctors to treat the entire body with radiation while pro­ viding greater variety and maneuverability in specific areas, according to Vitune Vongrama, M.D ., head of the Radiation Oncology Depart­ ment. With the new linear accelerator - housed in expanded, modem facilities - Dr. Yongrama expects to treat JO per cent more patients thi year. In 1985, the taff treated 30,617 patients, a record in keeping with OOH's role as a leading provider of radiation therapy in Western ew York. The new equipment, because it is so efficient, will enable the staff to help more patients in years to come. Dr. Yongrama predicts that 30 to 40 per cent of the Hospital's radiation therapy patients will be treated with it. He points out that these patients will experience an improvement in the cancer cure rate with radiation therapy using the powerful linear accelerator, recognized for its high degree of reliability. • (From Buffalo General's quarterly , ..Ufe Works", Spring 1986} Sisters introduces Expresscare Service S i ters Hospital has introduced a new con­ cept in Western ew York medical care with it new Expresscare service, intended to reduce waiting rime for patient with minor injuries and ether medical problem . The ser­ vice is the fir t of its kind in an area ho pita!, according to the hospital. In the emergency department, patient are evaluated as co the extent of the ir problem. Those with more serious emergencies are im­ mediately taken into the main emergency area, while chose with less critical problems are directed to a separate Expresscare area and • administered co by taff. BGH dedicates Center for Radiation Oncology T he Buffalo General Hospital' Wende Radiation Oncology Center wa dedi­ cated last July 11, with a pecial tribute co world-acclaimed radiation therapy speciali c Walter T. Murphy, M .O. He founded the BGH Radiation Therapy Oeparrmem and headed it from 1963 co 1973. He i also author of RadiationTherapy, one of the fir t Arnencan textbooks in che field. He i a UB emeritus pro­ fessor of radiology. In expanded facilities in Buffalo General' new medical cower building, the Radiation Oncology Oeparrment treat approximately 1,500 new patient a year u ing X-rays and ocher forms of radiant energy. tare-of-the-arr equipment in che new deparrmenc includes a multi-beam linear accelerator, an advanced hyperrhermia unit, and a highly efficient treat­ ment planning computer y tern. • BUFFAID /PHvS 1 ¢1A I RPMI adopts new method of urinary diversion R o well Park Memorial Institute ha adopted a new method of urinary diver ion which promises co more effectively imulate che primary function of the bladder while enabling patients co voluntarily control urine functions. Termed the Kock Pouch, it i formed using 75 cm. of the ileum to reace an internal continent ilea! reservoir requiring draining only three times a day. Dr. Martin Dineen recently learned che promi ing two­ • hour procedure and is now performing it. Lazar honored in naming of center at suburban unit M illard Fillmore Suburban Ho pita! named it new Family Medicine Center in honor of Loui Lazar, M.O. Lazar, a UB undergraduate alumnus, is a clinical associate professor of family medicine. He has pra riced family medicine in the area for 40 year . The new Family Medicine Center is a 6,000-square-fooc facility with eight examina­ tion rooms, conference areas, and audiovi ual capabilities, located in the Medical Office Building behind the ho pica!. • 12 6 �32 Karl Manders (M'SO) • who is founder and medical director of rhe Head ln1ury and Coma Arousal Center ar University Heights Hospital, Indianapolis, In., described his center and its advantage for brain-injured patients in Indiana Medicine, December I986. J. Anthony Brown (M'61) • ofThousand Oaks, Ca., i chiefof surgery at Westlake Community Ho pital and past chief of raff at the Lo Robles Regional Medical Center. David B. Olim (M'61) • is practicing dermatology in Fort Washington, Pa. Dr. Olim is a clinical instructor at Temple University. MarshaH E. Bar hay (M'63) • who is an a i tam clinical pro­ fessor at UCLA, has recently publi hed three paper . Hospital, and chief of The Divi­ sions of Angiography, CT Scan­ uclear Medicine at ning and Pottstown Memorial Medical Center.' Robert . Schnitzler (M'65) • was chairman of an interna­ tional meeting for those involved in Cardiac Pacing. Preparations for the 6th Sympo ium are in pro­ cess for the Island of Hawaii in February of 1987. Or. Schnitzler is clinical professor of medicine at the University of Texa Health Science Center at San Antonio. John E. poor (M'66) • was appointed director of Emergency ervices at Mary Imogene Ba tt Ho pita!, Cooper town, .Y. Leonard A. Argentine (M'68) • WTitesfrom Oneida, .Y. chat he was recently appointed medical director of AHMMPRO, a subcontractor for the ew York State PRO. He has had a private practice in internal medicine from 1974-1986. Kenneth K. Kim (M'65) • Albert Biglan (M'68) • was informs u that he has been chief of staff of Children's Hospital and Rehabilitation Centre, Utica, .Y. since July 1985. appointed one of the editors of the Journalof Pediacric euro­ science and also received the Phy ician ' Recognition Award from ht medical in titution. He is a clinical associate professor of ophthalmology at the Univer icy of Pitt burgh. Biglan i on the ex­ ecutive committee of Children' Ho pita! of Pitt burgh and prac· tice at Oakland Pediatric Ophthalmology, Inc. He erved formerly as executive director of the American Diopter and Decibel iecy and i a Diplomate of the American Board of Ophthalmolo­ gy and Fellow of both the American College of Surgeons R. Scott Scheer (M'65) • WTites:"I have just been named director of a new radiotherapy and magnetic resonance imaging facility in Pottstown, Pa. in addi­ tion to prior duties. The new facility i called Pott town Scan­ ning and Treatment Center. I remain president and director of Medical Imaging Services, medical director of Mobil Ultra­ sound of America, chief of radiology at orri town tare 12 6 and American Academy of Ophhalmology. In rwo previou year , he received the di tinguish­ ed Teaching Award from Eye and Ear Ho pica) ophthalmology resident in Pirc burgh. He is author of 45 publication and ha five more m press. William (M'69) • recently published two chapter on retinoids in the 1985 book Psoriasis by Marcel Dekker, Inc. Retinoid therapy was the topic of cwo other chapters and two journal acciclesthat he wrote from 19 3 to 19 5. He is director of dermatology re earch at Hoffman-LaRoche, ucley, .J., and i on the adjunct faculty in dermatology at Columbia Pres­ byterian. He is also a Fellow of the American Academy of Dermatology. Bruce M. Prenner (M'70) • was recently promoted to as ociate clinical profe or, pediatric immunology divi ion at the University of California at San Diego. Elliott A. Schulman (M'70) • along with Gregory Traumuta (M'74) have developed the Com­ prehensive Headache Center at Germantown Hospital in Phila­ delphia, Pa. Elliott re ides in Wynnewood, with his wifo, Bonnie, and son, David. John E. Knipp (M'72) • a specialist in internal medicine and gastroemerology, is chief of medicine and director of medical education at the Cornwall Ho pital, Cornwall, .Y. BUFFAID jPHv$1¢1ANj J. Cunningham Maxine D. Hayes (M'73) • i assistant professor of pediatrics at the University of Washington School of Medicine and medical director of the Odessa Brown Children's Clinic at the Children's Orthopedic Hospital, Seattle. William J.M. Hrushe ky (M'73) • was promoted to associate professor and granted tenure at the University of Min­ nesota. Dr. Hrushesky, who was recently inducted into Who's Who, has several patents granted and has had 180 publications. The lH lA and NHLBI} and CI are renewing support to rudy Timing of Drug Delivery, Aging of Cardiovascular System and Genetic vs. Environmental Causes of Hypertension. Daniel R. Beckman (M'74) • write "after eight year in general practice, I resigned and began a residency in pathology here in Wisconsin. l will be looking for a job as a surgical pathologist in 19 7." Howard R. Goldstein (M'74) • recently was awarded Fellowship in the American College of Surgeon and the American Academy of Pediatric . He co-authored two chapters in "Robert Smith's Operative Surgery: Urology." Michael S. Dahn (M'75) • is currencly completing his Ph.D. in biochemi try at Wayne State Univer icy, where he is an a is­ rant professor of surgery. Last February, he was awarded the Stanley Dudvich Award for research in metabolism and nurri­ tion by the American Society of Parenteral and Enteral utririon. In 1985, the Fellow of the �33 Benjamin J. C onte sa (M' 2) • having completed hi ane the iology re idency at assau County Medical Center, i now at the Jordon Ho pita! in Plymouth, Ma. American College of urgeons publi hed "Management of Aortofemoral Graft Failure" in urgery (Gyn-Ob) and described the ignificance of hypo­ albuminemia following injury and infection in American urgeon. Andrew M. Karen Zier (Ph.D .'75 ) • has been awarded a grant from the Diabetes Research & Education Foundat1on to use cell fusion to rudy a type of T cell, a white blood cell, that re earcher · believe cause Type l diabete mellitu . Results of this project may aid in development of a treatment for Type I diabetes. Her project i one of a number of pro­ ject funded by a total of 400,000 in grants from the non-profit Diabetes Research & Education Foundation, based in Bridge­ water, .J. The foundauon awards grant with fund pro­ vided by it ponsor, Hoech t­ Rou I Pharmaceuticals, lnc. Henry M. Bartkowski (M'76) • moved to Columbu , March 19 6, to practice full-came pediatric neuro urgery and engage in brain edema research ac Children' Ho pica! Medical Center of Columbu in affiliation with Ohio tare Univer ity. Paul B. Cotter (M' 76) • ha a private practice in ophthalmology and i clinical instructor of ophthalmology at Tufts. Jane King Dorval (M'76) • writes chat he was recently mar­ ried to Dr. Jeffrey H. Dorval. he is assi tant medical director of Mo Rehabalitacion Ho pica! in Philadelphia. Linda hriro Schenck (M'77) • writes "my specialty is being the full-time mother of Carly ; orris (M'82 ) • after graduating from the niver• it of Roch ter Department of Ophthalmology, opened a "solo practice" in Colorado." Cindy Wei icholas 5; and Teddy 2, while being in another rare t\',IO day a week and teaching 1/z day a week. l'm m my second year in the P ychoanalycic P ychotherapy doctoral program of the Chicago lnstitute for Psychoanaly i . l commute twice a week from Min­ neapoli (where there i no psychoanalytic institute or train­ ing available.) l am active in women' medical organization . Have rved on the board of Min­ n ta Women Phy ician for two years now. Was recently ap­ pointed to the board of the Alpha Epsilon Iota Foundation, a non­ profit organization which assists women medical rudents by granting funds, cholar hip , making awards to women in medicine. I am married to Carlo Schenck (M'76) whose interest is in the rudy of sleep disorders. He i on rhe p ychiatty raff of the Hennepin County Medical Center and the Minne ota Regional leep Di rder Centre. He is a faculty member of the Univer ity of Minnesota Depart­ ment of P ychiarry." Terence Alice G . Karpik (M' 79) • fini hed a fellowship in uveiri at Indiana University in December. Dr. Karpik is a clinical a i tant professor at the University of Indiana and Purdue Univer icy. tanle y J. Berke (M' 1) • has completed a fellow hip in glaucoma and anterior segment urgery at Massachusett Eye and Ear Infirmary and will be entering into private practice in Lyn­ brook, Long lsland. Hi paper on "Choroidal Detachment" wa ac­ cepted for presentation at the An­ nual Academy of Ophthalmology meeting in ew Orleans in ovember I986. BUFFAID !PHVS1¢tANj Chorba (M'79 ) • received the 19 Alexander D. Langmuir Prize awarded by the E.L . Alumni Association for the our randing manuscript d rib­ ing an epidemiologic investiga­ tion by an officer of the Epidemic Intelligence Service (E.I. .) at the Center For Disease Control. Hughes (M' 3) • writes char she finished an anesthesia residency and will cay on at Yale as a fellow in pediatric ane the ia. Her hu band tephen Hughe (M' 3) wa appointed chief re ident in radiology at Yale. Dougla J. Floccare (M'84) • has completed an intern hip in general urgery at Case Western Reserve, and i currently a resi­ dent in Emergency Medicine at the John Hopkins Ho pita! in Baltimore, Md. Andrew M. Knoll (M' 4) • recently completed a 6-momh course of in truction in Aeropace Medicine, including primary flight training in the TH57B SeaRanger Helicopter, and wa designated a naval flight urgeon. Lt. Knoll i rationed with M.A.G. 26, Marine Corps Air tation, ew River, Jackson­ ville, .C. John J. Picano (M'84 ) • received rhe Dr. orman Chassin certificate of achievement as the outstanding intern in internal medicine at ECMC, Buffalo (June 1984). Dr. Picano is currently a first-year resident in diagno tic radiology at Lahey Clinic Medical Center in Burlington, Ma. 12 6 �34 D Dr. Elmer T. McG roder (M'21) died . Dr. August 13, 19 5, at the age of McGroder was a Fellow of the American Col­ lege of urgeons and a member of the Academy of Medicine, the Medical Society of the County of Erie and the Medical Society of the Stace of ew York. • John A. Leone, 83, (M'27) • died July 12, 1986, in t. Catharines, Ontario after a hort illness. The iagara Falls native retired la t year after 5 years as a general practitioner in that city. He had been on staff at iagara Falls Memorial Medical Center and Mc. Sc. Mary's Hospital, Lewiston. He was a member of the American, state and iagara County medical associations. Survivors include his wife Rora; and two sisters, Oanilene and Helen. • Th addeus T. P rzybycien, 79, (M'33) • died August 14, 1986, in the Amherst ursing Home. The 1933 UB medical alumnus retired in 1983 after 50 years of general medical prac­ tice. The Buffalo native was a staff phy ician at Sisters, Deaconess, St. Joseph lntercommunity, and Veterans ho pitals. A life member of the .Y. Scace Medical Society, the Erie County Medical Society honored him in 1984 for 50 years of medical practice. Or. Przybycien performed on early radio shows and with the Buffalo Symphony Orches­ tra as an accomplished violinist. He was a pro­ lific writer and active in literary and arts societies. His survivors are a daughter, Genevieve; a sister, Adeline; a brother, William, and three grandchildren. • T District phy ician. He was also chairman of the Y Blue Shield Board of Director in 1974-1976 and was on the Genesee County Board of Health. He was recognized as a pioneer in developing medical theories linking heart disease with ex­ cess weight. ln 1951, he authored the book Your Weightand Your Life, a respected modem approach to weight reduction. The theatre devotee was assistant director of the "Broadway to Batavia" shows. He received orstar Bank's 1986 "Good eighbor of the Year" award and was pre idem of the Rotary Club and Batavia Club. He was also a member of the county, rate and American medical societies. He is urvived by his wife Almeta; a son, Dr. Alfred L; a daughter, Brenda; a brother; four sister ; and two grandchildren. • Th omas C. Hobbie (M'34) • died on March 11, 1986, in Sodus, .Y. Or. Hobbie was a member of the medical staff at the Myers' Community Hospical; Sodus Central School physician; charter member of the Sodus Rotary Club; served as president of che Wayne County Medical Society and State Health Officers. He was active in the local AFS Program and Boy Scout Council. He was an active member of the Fir t United Presbyterian Church of Sodus. He is survived by his wife Elizabeth and six daughters: Mary, Elizabeth, Susan, Katherine, Margaret, and Ellen. • Paul A. Alfano (M'41) • a retired surgeon, died May 27, 1986, in Sisters Hospital. A native of Buffalo, after service in World War II, he moved to Chicago. • A lfred L. George, 75, (M'34) • died June 5, Dr. Jane Carroll Brady Wiles (M'45 ) • 1986, in Batavia, Y. He was Genesee Memorial Hospital's current chief of staff, its chief of cardiology, and director of its inten ive care unit. Born in Lebanon, he served his internship at Deaconess Hospital and completed post• graduate studies in internal medicine at Harvard, Mayo, Duke University, and NYU. He was a State Medical Society delegate for more than 20 years and was the Batavia School medical director of the Erie County Home Health Department from 1969 to 1984, died unexpectedly near Baltimore, where she was vacationing. The 66-year-old Buffalo native held a bachelor's degree from Cornell University and was one of a handful of women graduates of the University of Buffalo Medical School in 1945. She was a board member of che UB Alumni Association, a member of the ew York State 12 6 BUFFAID jPHY$1C1ANj Medical Society Special Committee Governing Public Health and chairwoman of UB's Spring Clinical Days Committee at the time of her death. She also was a member of the Erie County Medical Society, American Medical Association and ew York State Public Health Society. Or. Wiles-who had celebrated the 40th an­ niversary of her wedding to local surgeon Dr. Charles E. Wiles (M'45)-was the daughter of another well-known Buffalo surgeon, the late Or. John C. and Leila Brady. She served her in­ ternship at E.J. Meyer Memorial Hospital and, in 1947, as an associate of Dr. C.A. Helwig, participated in the development of the Pap smear test for cervical cancer. She had pub­ lished one of the first papers on Pap smears. From 1948 to 1952,Dr. Wiles worked for the American Red Cro Blood Bank here. She aJso served as assistant to her father from 1948 to 1960, then was in general practice from 1960 to 1969. She is survived by her husband, two daughters, four sons, two sisters, a brother, and seven grandchildren. • (Adopted 'w1thpermission from the Buffalo News from an August 30. 1986ort1cle.) Dr . Paul We inberg (M'48) who was 60 and lived in Austin, Texas, Died February 27, 1986, in Baltimore of lung cancer. He practiced obstetrics and gynecology in Baltimore from 1955 until 1968, then became a professor at the University of Texas Medical hool. While in Baltimore, he was active on the taff of Sinai Ho pital. Born in Baltimore, he was educated at the John Hopkins University and the UB Medical School. He served in the U.S. Army during World War nand as a medical officer in the Air Force during the Korean War. While in Baltimore, he was a member of the Oheb halom Congregation and of several medical group. A lectureship in hi memory has been e tabli hed at the Univer icy of Texas Health &ience Center• an Antonio. He is survived by hi wife, Lenore Caplan; a son, Bruce, of Arlington, Mass., and two daughters, Beth of Denison, Texas, and Barbara of Dallas. • �35 major pediatric and allergy/ immunology jour­ nals. Dr. Elli i the author or co-author of over 100 publications. He has been a member of the Academy since 1962, becoming a Fellow in 1968. He served formerly as secretary and as its representative to the U.S. Pharmacopeia Allergy/ Immunology panel. Dr. Ellis received an A.B. from Kenyon Col­ lege in 1950 and his M.D. from Case Western Reserve University School of Medicine in 1954. He is a Diplomat of the American Board of Pediatrics and the American Board of Allergy and Immunology. He has also served as a member of the American Board of Allergy and Immunology and as president of the Board. • -] . Pullano Dr. James F. Phillips, clinical professor of medicine, was honored as one of the recipients of the 1986 Award for Brotherhood in Medicine. He was selected by the ational Conference of Christians and Jews, Western .Y. Chapter. The association is a non-profit nationwide organization that promotes intergroup education to eliminate prejudice and discrimination and to build bridges of understanding between all groups. • Elliot Ellis named Academy president U B professor of pediatrics Elliot F. Ellis, M.D., ha been elected presi­ dent of the American Academy of Allergy and Immunology. Chairman of UB' Department of Pediatrics from 1975-1984, the UB pediatrician and allergi t serves as chief of che Allergy/Im­ munology Division at Children' Ho pita!. The American Academy of Allergy and Im- munology is the largest professional medical specialty organization representing allergi t and clinical immunologists. It has 3,850 member in the U.S. and Canada and over 300 member in 41 foreign countries. Dr. Elli is internationally respected as co­ editor of the two-volume text Allergy:Prindpl.es and Practiceand the two mo t recent i ues of PediatricClinics of orth America, devoted to the subject of allergy. He has authored section in several major pediatric textbooks on allergic disorders, serves on the editorial board of five journals, and i a reviewer for a number of BUFFAID jPMv$1¢1ANI Dr. Irene M. Hulicka, Distinguished Professor and research professor of medicine, a pioneer in the field of gerontology, has been installed as president of a major section of the Gerontological Society of America. She is former dean of the Faculty of acural and Social Sciences at the State University College at Buffalo where she is currently professor of psychology. Hulicka received her Ph.D. from the Univer­ sity of ebraska, the B.Ed. from the University of Alberta, and the M.A. and B.A. from the University of Saskatchewan. Considered one of the pioneers in geron­ tology research, Hulicka says she got into the field "by accident" in 1959 when she was associated with the Buffalo Veterans Administration Medical Center. Much of her subsequent research has dealt with memory, learning, self-concept, and freedom of choice among the aging population. • 12 6 �36 Dr . George Hatem receives Lasker prize T he keynote peaker for last May's UB Medical Alumni Association Spring Clinical Day, Dr. George Hatem, has been honored with the most presngiou privately funded American civilian prize, the 19 Albert La ker Award for Public Service. Dr. Hatem, called Ma Haide in Chinese, is the Buffalo-born doctor who senled in China in the 1930s and became in charge of the country's healch affairs. Besides being honored at the 19 6 UB alum• ni event, he was also given pedal recognition at last June' Medical School commencement. His associations wich UB include personal friendships with a number of UB doctor , especially past Medical Alumni Pre ident Charles Tanner, who helped arrange his vi it co the U.S. last spring. Buffalo Physicianwas also recognized by the Lasker Foundation indirectly. The July 1986 issue's cover photo by UB student Ken Welgoss of Dr. Hatem was selected as the foundation's official photo of Hatem, appearing in their award publications and announcements. Incidentally, the Lasker Award for Medical Research wa given co another doctor who 12 6 poke at UB last semester, Luc Momagnier, M.D. The co-discoverer of the AIDS viru spoke at last summer's UB Convocation on Immunology. • Dr. Kung awarded $352,000 NIH grant D r. Hank F. Kung has received a major gram from 1H to continue his three-year study of drug agents usedto diagnose brain diseases. The 352,000 grant to srudy " ew Brain Perfusion Imaging Agents" will enable che associate professor of nuclear medicine to study the isotope TC-99m, otherwise known as T echnitium 99m. This agent is the most com­ monly used isotope in nuclear medicine research today and is used to detect possible disease which can affect che brain. Dr. Kung and his colleagues plan co make further progress using the diagnostic method in animals. Their ultimate goal is to perfect it in animals so thac it can be ready for experimental use in humans. Currently animals being tested with this new chemical are rats and monkeys, monkeys being the closest subscirute for humans. "The basic problem that we have," noted Dr. Kung in reference to his research with the chemical, is "increasing the imaging time so medical instruments used to detect the agent in the brain do have time to dececc TC-99m." This compound could indeed show more promise than the agent HIPDM, another agent developed by Ors. Kung, Monce Blau, and Robert Ackerhalt of the Department of BUFFAID jPHY$t¢1ANI uclear Medicine, as a valuable brain diagnos­ ing tool for neurological diseases. HIPDM is a tracer compound which has been proven effec­ tive in mapping blood flow in the brains of patients with such diseases as stroke, brain rumors, epilepsy and senile dementia. Dr. Kung continues co work on this research with research assistant professor Dr. Simon Efange and also Dr. Ackerhalt. Dr. Blau who is now retired has contributed greatly to the continua­ tion of this research. Dr. Kung is a native of China and received his Ph.D. in medicinal chemistry from UB. He is a member of the Society of uclear Medicine and the American Chemical Society. He has published more than 23 journal articles pertain­ ing to brain perfusion imaging agents, HIPDM and TC-99m. Dr. Kung is also a founding member of the ational Chinese uclear Medicine Club. • -B. Commisa D r. Stephen Wear , assistant professor of medicine and philosophy, was just appointed a member of the Advisory Board of the Journalof Medicineand Philosophyuntil 1988. Its editorial board chairman is Edmund Pelligrino, M.D ., of the Kennedy Institute of Ethics, Georgetown University, and last year's UB Medical Commencement speaker. • �Dr . John Lore , Jr., profi rand chairman of the Department of olar ngology, ha become president f the American iety for Head and 'eek urgery. The Society devises programs for the devel pment of head and neck urgery and pro­ mot high profi ional and ethical tandard relating to the practice of major head and n k . urgery. In a separate a tion, Dr. Lore was hon red by being appointed to the Board of Director of the Yul Brynner Research Foundation, In . The Chicago-based philanthropic foundation is named in honor of actor Yul Brynner, who died from can ·er in 19 5. Dr. Lore, who has publi hed over 300 anicle , d research in the area of head, neck and thyroid cancer. He has pubh hed the book, An Atlasof Head and , 'eek urgery,now in its third edition. ince coming to UB, Dr. Lore ha held the position of chief of the head and neck urgi al unit at both i ter · of Charity and Children' hospital , Univer icy chief at ECMC, and at­ tending consultant at the VA Medical Center. The 'ew York City native received hi bachelor's degree from Holy Cro College and his medical degree from YU College of Medicine. He came to UB in 1966a a profi r of urgery and head of the Division of Otolaryngology and became it department chairman in 1972. In addition to hi medical career, he ha an interesting other career as the owner and operacor of Tamarack Ridge Colden, .Y. k1 Reson in • B. Ccmm,sa ERRATUM The July 1986 i ue's 'The Origin of the Buffalo Surgical Society" referred to one of it founding member , Dr. Julius Ricter. The correct pelling is Richter. Also, in the December 1985issue, p. 4, Dr . John Border i erroneously indentified ai, director of trauma service at Buffalo G ncral Hospital. It hould read "on staff at Buffalo General." Dr. Frank Ehrlich is Buffalo General' direc­ tor of trauma services. ------------------------------------------------------------------POSTAGE STAMP ECESSAl?V If MAllED THE U ITEDSTATES BUSINESS REPLYMAIL FIRSTCLASS PERMITNO 2210 BUFF ALO.NY POST AGE WILLBEPAID BYADDRESSEE BUFFAID P H Y S C I A N 139 Cary Hall State University of New York at Buffalo Buffalo, New York 14214-9980 1,.,11,1 ..1,,I,I,..11,1,, II,I,,I,I,,l,.l, 11 ..,,,I,II �I BUFFAID IP H YSICI A on -Profit Org . U.S. Po tagc PAID Buffalo , . Y. Permit o . 311 NI State University of New York at Buffalo 3435 Main Street Buffalo. New York 14214 Address Correction Requested ---------------------7---~n-usHWFROM-YOU--7---FIII out this card (Please print or type all entries) Name ___________________________ M.D.__ Ph.D._ _ Vear Received ___ _ Office Address Home Address ----------------------------------------If not UB, M.D. or Ph.D. received from In Private Practice : In Academic Medicine: Yes Yes Specia lty No No Port Time Full Time School __________________ _ Title Other: Professional Society Memberships ---------------------------------- News: Hove you changed positions, published , been involved in civic activit ies. hod honors bestowed. etc? _______ 1, 11 Ii Please send curriculum vitae , clippings, publications, or announcements, also include o photo of yourself. _ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, December 1986 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals edical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1986-December Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1986-v20n04-Dec Table Of Contents A list of subunits of the resource. The CFS Addition AIDS Hayfever Students Medical School News Exercise Alumni Hospital News Classnotes Deaths People Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-27 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v20n04 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1986 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/99b7c7367a434966b63d34efc3037695.pdf 4d63f88949f6f3a3fb7e75c55cb0cd77 PDF Text Text p VOLUME 20, H y s C A N EPTEMBER 1986 UMBER 3 Saxon Graham to look at effects of diet �BUFFAID I !PHYSICIAN Dean 's Me age D STAFF EXECUTIVE EDIT R, , IVERSITY PUBLI A Tl R(,N'rt T. Marlerc , A !ATE EDITOR Bruce '. Ker hner ART DIRECT R Alan J. Kes.:ler PHOTOGRAPHY PhyllisChristopher Douglas Levere Ed owak Franct pecker ADVISORY BOARD Dr John NaUJth<on,Do:in Sd,oal of MedlCI""' M . ancy Gheco Mr. KevanCraig Mr. Make "haw Dr . harlcs Tonner Dr John fohtt M . Karen Dr yJa Mr John Pull, Dr Chari~ Paganelli Dr Jam Kan 1 Dr. Harold Brody Dr John Wright Dr. Robert hc1g Dr M c Wngh, Dr Mary Voorh Mr. tev,, Sh,vanky M . Manon Man no,. ear Friend of the hoot of Medicine: The 19 6 academic year mark the lx"J.lmningof a new era for the hool of Med1cme and the Health ience mpus at Buffalo. The chool of Dental Med1cme moved to the completely renovated Squire Hall over the course of the ummer. That school is now hou ed in modern facilitie which, beside quire Hall, include an addition for the clinical activities and the renovated Fo ter Hall m which mo t of th basic science activity of the school i perl rmed. Thi unit now truly represents one of the fine t dental educational resources in the United tares. Thi event coupled with the opening of the expanded Health Science Library has served to move the Health iences enterprise forward. During the course of the 1986 academic year, the new wing of the School of Medicine, the centralized animal facilities and the renovated Buder Auditorium will also becom operational. Medical tudents and other health science tudents wt!I now be educated m modern leccure halls and laboratory facilities that will lend themselves to a much improved environment and to the pro pects of greater innovations in educational methodologie . For example, the faculty can now plan for more mall group teaching, more individual attention to tudent : an~ the application of computer and other technologie to the educanona mi ions. k During the cour e of the year the University togeth r with ew Yor f State's Construction Fund will develop and initiate implementario~ 0 the next pha e of development of the Mam Street Campus facih 0 ~· Mo t of Farber Hall will be cl sed and the old Dental chool faciht11~ will be upgraded to accommodate the n ds of the Medical Schoo be ba ic 1encedepartments. Our tudents, faculty, and alumni should impressed with the support provided by the citizens of ew York Stat to en ure that U Y Buffalo i numbered among its ister unit as a trong, competitive, modern educational enterprise. incereb, John aughton, M .D. Vice President fur Clin ical Affair Dean, School of Medicine Mr . L Kolwo Dr. James W,IJ TEACH I G HO PIT ALS The BuffaloGeneral Children\ Erie Cooney Mc<l,calCenter Mercy Millard F,llmore Ro w II Park Memorial In t1Cute ters of Chamy Veteran Admint trallon 1 Medical Center PmducN by rhe D,v, 10n of Public Affairs, Harry R. jaclr. in, d,rtt:wr. rn 3SS<JC,arron wirh rhe hoo/ nf MN1cme, rare Un1ver<1ryo ew Yc,rlcar &ffa/o. THE BUFFALO PHYS! IA (U PS 551-860JSep1embcr 191:16-Volume 20, Number 3. Published (,ve tlm annually : ptembcr, o.c. February, May, July, ember - by the Schoolof Mcd,cme, State Un1ver ttV of "" York at Buff lo, 3435 Mam trcct, Buffalo,, ewYork 14214 . Third c1... bulk postage pa,J at Buffalo. 'wYork.POiTMASTER , ndaJdr cha"8"5toTHEBUFFALOPHY !CIA, . 139 Cary Hall, 34 35 Ma,n trttt, Buffalo, cW York 14214. A Message From The Medical Alumni Association D uring the past few year , the Medical Alumni A ociation has ho ted many out-of-town reception at major medical meeting throughout the country for the benefit of you, the alumni. These recepti n are d i ned to keep you informed of the various undertakings of the Alumni Association and to keep you abreast of what' happening at the Medical School. The fir t reception this year will be held in ew rlean at the American College of urgeons lmical ongre m conjunction with the Department of urgery and Dr. Lewi Flint. I encourage all alumni who plan on att nding to top by and say hello to old tea hers and friends. At the pring Clinical Day Annual Busin Meeting, a new classof member hip was created: Associate Member. This was done to open up the Alumni Association to graduate of the University residency training programs who are not graduates of the Medical School itself. I encourage all those who are eligible to jom now. Your member hip i truly welcome. Lastly, I would like to thank all those who contributed their time and effort to making this year's pring Clinical Day a resounding success, members who gave so generously to the and tho reunion cl Medical School. John E. Prt ylucki , M .D . •73, President �P H Y S C A N , CONTENTS SOCIAL & PREVENTIVE MEDICINE • It com­ prises one of the most diversely trained faculties of any department in the Medical School, including physicians, epidemiologists, sociologists, biomedical scientists, and statisticians. $4 MILLION CANCER STUDY • Dr. Saxon Graham of Social and Preventive Medicine has received funding from the National Cancer Institute to begin a new study of the links between diet and cancer. A SEARCH FOR QUESTIONS • "The discipline practiced in Social and Preventive Medicine is unusual - it leads to more questions than answers," sociologist and epidemiologist James Marshall says. TRANSPLA TATION SPECIALIST • 12 Alumnus Robert P. Gale was called on to aid the victims of the Chernobyl disaster. JOB LEWI MITH • 14 UB student of the 1850s became a pioneer of American pediatrics. TEACH! G EFFEC­ TIVE ESS • 18, 24 Two profes ors look at good teaching. BUFFAID [PHY$1¢1ANj MEDICAL CHOOL EWS • 20 The Annual Faculty Meeting and the 140th commencement. PEOPLE • 37 A. Wilmot Jacobsen still youthful at 88. Other news of people you know. BOOKS • 43 HOSPITAL NEWS • 25 Dr. Thomas Toma i is the new director of Roswell Park. Buffalo General dedicates tower. UB, Millard Fillmore Hospital sign affiliation. CLASS OTE • Inside back cover. ALUM I • 31 Reunion classes pledge $130,000. 09 / 86 �2 SOCIAT;&P Wide--rangin g departmentis home to one of the m0 s BY BRUCE S. KERSH ER I t comprises one of the most diversely trained faculties of any department in the Medical School, including physicians, epidemiologists, sociologists, biomedical cientists, and tat1st1cians. The fields represented by UB's Department of Social and Preventive Medicine are many, including such closely allied and overlapping disciplines as preventive medicine, medical care organizations, epidemiology, public health, health behavior, medical sociology, and community health. Yet, for all its diversity, this relatively young department, run by Saxon Graham, Ph.D., is a cohesive team whose multi­ disciplinary research has made the department one of the most productive and respected in its field. The departme,1t has nine full-time and 14 active part-tim faculty members. Dr. Graham and his department attained international prominence as a result of their epidemiological re earch which has made Buffalo one of the primary centers for the study of cancer and its correlations with diet, behavior, and lifestyle. ver 130 journal articles have come out of th ir cancer epidemiology studies to date. Other factors being r searched in relation to cancer ar occupation, family history, stress, and personal habits, including exercise and smoking. Among the resea rch areas also being explo red by individual faculty members are oc­ cupational hazards in non-malignant disease, factors contributing to both suicide and hypertension, issues related to toxic waste exposure and response, and methodological studies that lead to more refined and effective urvey de ign and analyses. The department's research projects totalled almost $ 00,000 in ex­ penditures last year. Forming the central underpinning of 09/ 86 the department's research program are the series of ational ancer lnstitute grants that are administered by Dr. Graham. Over the past I years, Dr. BlJFFAID [PHv$1¢1ANI Graham has received four major grant from CI that have been aimed at the role of diet and other factors in cancer risk. The most recent project is a 4 million �3 Ost diverselytrainedfacultiesin grant ( ee ace m anying article) that initiated a new tudy of 3,500 We tern ew Y rkers and will continue analy i and administration of two ong ingsurveys, ~DI CTNE the Medical Sdwol a cohort study of 58,000 ew York State re ident and a survey of Western ew Yorkers begun in 1981. A total of 12 or so c -inv stigators are currently at work on various aspects of these nationally­ significant studies. The 1981 Social Epidemiology f Cancer tudy, al o funded by a 4 million Cl grant, i till being analyzed, with continued reporting of it re ults both in journals and at sympo ia. This study urveyed 5,500 Western ew Yorkers for a ociations between diet and cancer ri k, especially of the mouth, larynx, lung, e ophagus, stomach, colon, bladd r, and rectum. As with the new 1986 grant, occupational, family history, and other factor were analyzed. The gr at volume of data that the investigations yield d has demanded not only the efforts of the primary inv tigator, Dr. Graham, but also those of several other co-inv ti­ gators, among these James Marshall, Ph.D., associat professor; Tim By r , M.D., M.P.H., a ociate professor; Maria Zi lezny, Ph.D., associate professor; John Vena, Ph.D., assistant profe sor; and Br nda Haughey, Ph.D., as ciate profe or. The sh er ize and multi­ di ciplinary natur of the study has required the coop ration or con ultation of many others uch as Jame olan, M.D. ( hairman, De artment of Medi­ cine), Gerald ufrin, M .D. (Chairman, Urology), Myron Hreschchyshyn, M.D. (Chair, Ob-Gyn), and Takuma emoto, M.D., and Donald Shedd, M.D. (Ro well Park). T h inve tigation by Graham and his team of eight researcher has been respon ible for a ignificant part of the cientific knowledge about, a well as the national awareness and public attention on, th rol of diet and life style in cancer. This includes the apparent links between carotene, other retin id (a ociated with Vitamin A), and fiber and a protective f~ ct again t certain cancer . The recent tudies by Graham and hi coresearcher hav al o correlated exce ive alcohol, BUFFAID (PHv$1¢1AN] 09 / 86 �4 tobacco, alt, meat and fat con umption, a well a be ity, with higher risks ~ r pecific types of cancer. Furthermore, they found that cooking reduces the protective effect of vegetable , while certain way of cooking meat can increa e ri k of cancer. They al o found that brea t feeding is as ociated with lower ri k f premenopausal breast cancer, and al o that allergy-prone people tend to have lower frequencies of certain cancer . Many of these findings have been corroborated by other population urveys and animal tudie , but the inve tigation str s the need for much more inve tigation to explicate the relationship and to replicate the inquiries. Another ongoing tudy, begun in 1980, involves the largest cross-section of American of both ex over a wide spectrum of backgrounds, occupation , thnic, and other parameters of any cancer/ diet epidemiological study to date. Thi cohort survey of 5 ,000 ew Y rk tate citizen will result in new findings 09/ 86 and publication years. over then xt 10 to 15 Much of th succes of the department's wide-ranging, multidi ciplinary re earch program, according to its faculty members, i attributed to Saxon Graham. "The me hing of per onalities and di cipline , " Jim Marshall explain , "i a reflection f his personality. He ju t doesn't fit into parochial kinds ofboundarie ."Then, he added, "Dr. Graham wa one of the fir t people train d in sociology to become an important cancer epidemiologist." Dr. Graham attributes the achievements of the department to the exceptional quality, innovativene s and industry of th individual faculty member . "They include diverse personalities and intel­ lectual interests which happily fit together in a highly productive way. There i a spirit of mutual helpfulness and collab ration rather than of competition in our group," the chairman explain . "Every one of them is unusually inventive; they BUFFAID [PHvJ1¢1AN) are long on new, strategically important idea and, equally u eful, they have the energy and dedication to put the idea to work in their inve tigation . For example, at the recent meeting f ur national ociety, our relatively mall group of 5 epidemiologists addre ed three plenary se ion , gave two scientific paper and one po ter ession." T he little time Graham ha left aft r conducting research and administering hi everal large I grants i pent in admini trating the department which he ha headed for five year . Plannin for new program and personnel occupi much of hi attention a well. 11 We have a variety of needs to enhance the teaching and re earch program in the department," Graham comments. To do this he i recruiting a health behavior specialist ( with public health training) to implement a new program that tudie and teache meth d to modify behavi r that improve health. The research would �be directed at uch major health factors as making, weight control, and dietary change . Another expanded empha i will be on medical care organization . One newly arrived recruit is Denni Bertram, M.D., Ph . D. (degrees from Wa hington University and John Hopkin ,, re pec­ cively), who will enlarge th department's research and t aching into the di tribution of medi al care, the role of diffe r nt health care organizations such as HMO's, and social issues such as malpractice and care of th elderly . The department al o ha goals to create programs in psychiatric epidemiology of str diseases, and in nutritional epidemi­ ology. F llow sociologist Jam s Mar hall, Ph.D., plays a major role in th depart­ ment's diet / cancer studi , and also conduct res arch inco tress disease among policemen and suicide epidemi­ ology. He is profiled separately in the accompanying article . S erving as the "attending physician" for the I diet / cancer studies is Tim Byers. Dr. Byers, with a medical degree from Indiana niversity, also ha a Ma tee's in Public Health from the Univer ity of Michigan. He was responible for part of th analy is of the 19 l diet / cane r tudy, emphasizing the role of cartotene in pr tecting a ain t certain cancer . Corr lation between lung cancer and diet, and implication in public health are other areas f focus. One ju t completed study was published this spring in utrition and Cancer with co-investigator Dr. Blackford Middleton, then a UB medical student and now a re id nt with the Univer ity of Connecti­ cut Health Center. The inve tigators evaluated 10,000 Ro well Park patients using 1960 data . The tudy 1 nds upport to the evidence that Vitamin A from fruit and vegetable sources may protect against squamous cell tumors in variou organs. Byer note with inter t his findings from two recently published studies. Examining lung cancer cases from a ational Tumor Registry tudy of 50,000 subjects, he found a predominance of cancer in the upper lobes, particularly in young people. "Thi may suggest an infectiou cofactor in lung cancer," Byers theori zes. A secondjustcompleted rudy provided strong evidence that brea t feeding provides ome protection effect against pre-menopau al breast cancer . ince many of the department's tudies rely on subjects' memory of th ir past diets, one might wonder a out the accuracy and validity of the re ulting conclu i ns. Dr. Byers concluded from a two-y ar funded inquiry that eopl did, indeed, have relatively good recall about their and their pauses' diets from fiv to eight years earlier. ffA study just completedby the department offered strongevidencethat breastfeeding providesa measure of protectionagainst pre--menopausal breastcancer.'' Some of Byer ' future goals are to continue work on th diet-cancer relation­ ship, to study the possibility of a relation­ ship betwe n cancer and magnetic fields, such as may occur with certain configur­ ations of home wiring, and to begin a teaching / r earch project in the preven­ tion of diarrheal di ea es in developing countries. W hile diet ha been a major focus of the department's CI grant , life style, occupation, and non-dietary factor are important empha a well. John Vena, Ph.D., has been the full-time faculty member largely responsible for analyzing these factors. Two fascinating finding by Vena from the department-wide CI tudies were recently publi hed. In the AmericanJournal BUFFAID (PHv$ 1 ¢1AN ! of EpidemiologyQuly, 1985), he and his co-researchers reported that people with a history of hives, hay fever, and other allergies tend to have a decreased ri k of a number of cancer . Vena speculates it may have omething t do with allergy sufferer ' immune ystems. He also reported in the ame journal (September 1985) that the ri k of colon cancer is raised in sedentary workers, suggesting that physical inactivity increases colon cancer risk. He theorizes that exerci engenders prostaglandin which timulate peristalsis and h rtens the transmit time of tool , reducing contact with any t cal carcinogens. Among his other proj cts are a larg cohort study of BuffaJ municipal worke r over a 30-year period; a March of Dimes study of ethyl ne oxide exposure and disease risk in ho pita! workers; a project that correlates kidney function in battery workers with lead exposure ( with Rocco Venuto, M.D.); and an investigation into community exposure to radioactive and toxic waste dump . He expects there will be a demand for more research in toxic waste epidemiology, and is exploring the feasibility of developing a respon e team. He is al o working with a union co-op to set up a community-based occupational health clinic, the first diagnostic health clinic in Western ew York dedicated to occupa­ tional di ease. 0 ne of the newest arrivals in the department is Maurizio Tr visan, M.D ., assistant professor, formerly with the University of aples Medical School, Italy. Specializing in cardiovascular disease epidemiology, Dr. T revi an is conducting a ten-year long longitudinal study of arte riosclerosis in factory workers near aples. Purely by chance, a erious earth­ quake occurred after part of the sample was already screened, leaving a post­ earthquake screening group. He found that the tress associated with the earth­ quake disaster raised serum cholesterol, triglycerides, and pulse rate. He is now following up to see if the effects of acute stress on coronary disease were sustained, if they correlate with magnitude and type 09/ 86 �6 of damages due to the earthquake, and if th effect of stress on coronary risk factors i media ted by personality type, c ping mechanisms, and social tatus. Another continuing project i his study of 5,000 re idents of an ancient Italian city. T revi an is studying the relation betwe n hypertensi n and intracellular odium, potassium, and metabolism. He i crying co ee if he can predict who will become hyperten ive based on the pr ence of abnormal intracellular ion tran port pathways. He has several proposed projects, among them a new tudy to predict salt sensitivity in hypertensives. T he unique re earch focus of R ob rt O'Shea, Ph.D., ass ciate professor, is ocial and preventive dental medicine. In addition to directing the department's Graduate Studi Program, the sociologist is trying to identify ef~ ctiv way for dentists to promote cigarette c ation. Advice, que tioning by the denti ts, prescribing nicotine gum, office design to discourage smoking, and ways to develop non-smoking staff to serve a role mod ls ace all being evaluated. "l'm al o working with an ral pathologist, Dr. Joseph Sowin ki, trying to quantitatively determine, through oral inspection, the consequences of smoking on gum, lip, mucosa and teeth. ot only can this be used to demonstrate th con equ nc of smoking on a patient," O'Shea explain , "but there i al o a need for an objective, non-invasive way to tell if someone is smoking." Dr. 0' hea is al o working on dentist­ patient relation hip with Dental ch ol p ychologisc/ researcher orman Corah, D.D.S. "We now have 25 behavioral actions that will decrease the psycho logical disc mfo rt that is one of the major reasons why pati nt avoid dentists." They have found, for instance, that anxiety is reduced when the denti t explain a procedure and expect d I vel of discom­ fort in advance and during th operation. One future project of his i to develop effective ways to train hygi nists, not just dentists, on how co promot cigarette ce sation. "There ar over 200 hygieni t schools, and half the population ees a 09/ 86 total of 140,000 dentists each year. The dentist-hygienist-patient relationship goes on for a long time . The dental office is an ideal place to promote prevention. T he department's resea rch output would grind to a halt without proper tatistical design and analy i . Performing this essential role is Maria Zielezny, Ph.D., the department' , in fact, the Medical chool's, only full-time bio tati tician. The UCLA doctoral graduate help to et up proper methodology for a wide range of proj cts. he also advises on proper procedures and directs researchers how to design their own studies. On sele red proj cts, she executes the analysis. ''The Buffalo Bisons baseballteam is the subjectof Dr. Michael Cummings' smokelesstobacco study in which he is measuring non~cancerproblems of the mouth.'' While much of her att ntion is devoted to Dr. Graham's 1 studies and other in-hou e grant , her ervices extend to work being done by ocher departments and schools, such as Rehabilitation Medicine's functional a essment study with Dr. Carl Granger; Dr. Michele Alexander's asthma elf-managem nt research; ursing's cudie of sere s incontinence in the aged; and project of the chool of D ntal Medicine and Health Related Profe ions. The department's close as ociations with Roswell Park Memorial Institute are not widely known outside the departm nt. They includ epidemiological cour es jointly caught by specialists from both in titutions. ln addition, the cour are attended not only by UB medical students, BUFFAJD [PHYS1¢1ANj but by graduate students from programs in the department, as well as in UB's Roswell Park Graduate Division. Departmental co-investigators at RPM! in recent years have included Arnold Mittelman, M.D., Donald hedd, M.D., Ronald Vincent, M.D., and Curtis Mettlin, Ph .D. Dr. Roger Priore's stati tical consultation co the department has been especially valuable . Examples of this close association are exemplified by two department faculty members, Diane Cookfair, Ph.D., and Michael Cummings, Ph.D. D r. Cookfair, assistant professor since 1984, was until recently also assistant co the dean oflJB's Roswell Park Graduate Division and a director of Graduate Studies in the Roswell Division. ow stationed at the Social and Preventive Medicine Department headquarter at 2211 Main St., she continues her cancer epidemiology research. Dr. Cookfair has received funding co conduct several epidemiologic studies concerning the role of radiation in ca rcinogenesis. Using Roswell Par k data, she is currently assessing the long term effects of thera, peutic irradiation for benign gynecologic disorders in 6500 women treated over a 30-year period. Dr. Cookfai r is also taking part in a mulciple center international coho rt tudy ponsored by Cl and lA RC. The purpose of this study is co determine the incidence of second cancers among worn n irradiated as treatment for cervical cance r, and to assess whether specific types of cancer are more common among irradiated patients than non, irradiated patients. Also a joint project with NCI is her study concerning hormonal profiles among women treated for cervical cancer, in which she is trying to determine whether estrogen levels differ among women treated with pelvic irradiation and non­ irradia ted women . She is also conducting an epidemiologic study of chromosomal abe r ration following therapeutic irradiation in collaboration with D r. Avery Sandberg. In the area of occupational epidemiology, Cookfair is working with John Vena on various studies concerning �the occupational etiology of cancer. B ased at Roswell Park is Michael Cummings, Ph.D., clinical a istant professor, who is active in several joint projects with the department, all in smoking cessation. The growing concern over passive cigarette smoke exposure is one of Cumming's areas of re earch. Because it is currently hard to quantify such exposure, Ors. Cummings and Marshall are con­ ducting biological measurements of passive exposure, and will compare that with subjects' own estimates. They will also identify architectural and other parameters that affect smoke concentration. The Buffalo Bisons baseball team is the subject of Cumming ' smokeless tobacco study, in which he is measuring non­ cancer oral problems. " ineteen out of 25 players chew tobacco," Cumming comments, "and we have found a three­ fold gum recession among users . Five also had non-malignant oral lesions. We now have ongoing tests to see if their cell crapings have any D A aberrations." Cummings, who runs Roswell Park's Stop Smoking Clinic is also studying the effectiveness of a variety of making cessation techniques: quit smoking employee cont sts, self-help cessation booklets, and training programs for M.D. 's on how to counsel their patients on smoking. One future project Cummings hopes to participate in is a major CI study of smoking intervention with the heaviest smokers. F rank Schimpfhauser, Ph.D., associate professor in the department ( and al o Medical School assistant dean for educational research and evaluation) is conducting educational research. With a 250,000 CI grant, he and Paul Kostyniak, Ph.D., ofUB's Pharmacology Department have developed courses in cancer prevention for first-and third-year medical students . Schimpfhauser is also assisting Robert 0' hea in the research design and evaluation plan for their smoking cessation research. The department currently has 34 master's students and 20 Ph.D. students seeking d grees in epidemi logy. "These rogram have been quite successful and run in conjunction with Roswell Park," Dr . Graham remarks. Graduates of the program take courses taught by both the UB Ro well Park Graduation Division and Graham' department . Dr. Robert ' hea is coordinator of the doctoral program. The department's other succes ful educational program is its Ph.D. and post-doctoral program, which curr mly ha four fell ws, all funded by CI. The department's curriculum offers numerous cour es in epidemiology, with cour es dealing specifically with the area of chronic disea e (Tim Byers and Maurizio Trevisan); c mmunicable disea e (Mary Lou Fleissner); nutrition (Byer ); occupational & envir nm ntal factors Uohn Vena); biostatistics (Maria Zielezny ); cancer ( urtis Mettlin f Roswell Park); psychiatric epidemiology BUFFAID (PHvS 1 ¢1AHf Uoseph Vana); and re earch methods, stress epidemiology, and medical demography (Jim Marshall), among others. Richard Jones, Ph.D., is one of the department's most popular profe or , teaching health services planning and organizational administration. Other instructors in the department's courses are UB faculty members Frank Schimpfhauser, Gloria Hienemann, Marcia Ru s I, Pat Milkow ki, Mike Cummings, and Diane Cookfair. In the medical student curriculum two required courses are taught: the fre hman Health are Organization cour e (Denni Bertram, Arthur Go hin, RobertO' hea); and third year Epid miology and tatistics courses (Michael and Maria Zielezny as directors). One lective for eniors is in preventive medicine, taught by Ors. Tim Byers, Richard Rothenburg, and Le nard Katz. • 09/ 86 �Saxon Graham receivesgrantfrom NCI for study of diet--cancer links 8 $4MILLION CANCER S axon Graham, Ph.D., profe or and chairman of UB's Department of ocial and Preventive Medicine, ha received $4 million in funding from the National ancer In titute ( Cl) to begin a major new study of the links between diet and cancer. It is believed to be the largest study of its kind to date, in terms of funding. In addition to the $4 million grant, funds for indirect co t totalling roughly $2 million were also awarded by I. The five-year investigation will rely on the cooperation of 3300 Western ew Yorkers who will be comprehensively 09186 BUFFAID IPHv$ 1 ¢ 1 AN J surveyed to provide the thousand of items of data which will be evaluated by Graham and his associates. "This is definitely a community effort. The infor­ mation from Western ew Yorkers who participate may lead to significant findings that would shed more Lighton the r lation­ ship between cancer and what we eat and how we live," Graham commented. "The study will accomplish several things," Dr. Graham explained. "It will either confirm or refute previous findings for certain cancers. It will also provide new data on everal cancers rarely studied before. Lastly, our study will examine the implications and refine our knowledge of previously di covered cancer ri k factors. "For example, fats have been associated with increased risks of some cancers," Graham continued. "This study will clarify if fats are related in and of them­ elves, or because they con­ tribute to total calories ingested or because they contributetoobesity. The po sible benefits of phy ical activity will also be examined, especially as it relates to reducing obesity." Experienced nurse inter­ viewers will question the Erie, iagara and Monroe County citizens about virtu­ ally all aspect of their diets, life tyles, smoking and drinking habits, and health record . ursing and child-bearing hi tory will also be gathered from women subject . The sur­ veys, which will take approximately two and on e-half hour each, began thi spring . �9 G raham' new grant i hi fourth major grant from I during the last 1 year that ha tudied the cial epidemiology of cancer. The previou tudies have been re ponsible for much of the knowledge that certain dietary factors, such as carot ne and fiber-rich foods, can lend protection again t certain cancers, while exce ive amounts of others (fat , alt, meat, alcohol, tobacco) increa e cancer risk. Dr. Graham p int ut in all of these cases, however, chat in contrast to the impression given in ome popular ac­ counts, the correlation is not always trong and can sometime be contradic­ t ry. When correlation are shown, chey u ually apply to p cific cancers and not necessarily to all cancer . Epidemiologists with Dr. Graham in thi newest study will be Jame Mar hall, Ph.D., who will focus on the study's methodology, sociological analysis, and cancers of the mouth, bladder and rectum; Tim Byers, M.D., M.P.H., cancer epi­ d miologist, to focu on lung cancer as well as nutritional correlation ; John Vena, Ph.D., to investigate occupational and environmental components, as well as the role of exercise; Maria Zielezny, Ph.D., and Roger Priore, Ph.D., statistics; and John Bra ure and Mya wanson, computer analyst . Among a contingent of ix clinical co­ investigators are James olan, M.D., chairman ofUB's Deparonenc of Medicine (investigating pancreas and other 01 cancer ); Gerald ufrin, M.D., chairman ofUB's Department of Urology (cancers of the prostate, bladder and testes); Myron Hreschchyshyn, M.D., chairman of the Department of Gynecology­ Obstetrics (gynecologic cancers); T akuma emoto, M.D. (breast cancer); Colin Campbell, Ph.D., of Cornell Univer­ sity ( erological studies of nutrition); and William Rawl , M.D., ofMcMaster University ( viral origins of cancer). Th re are cw imp rcant aspects of the new project that have not been done during the previou 18 year of Graham and hi team' epidemiological project . First, erol gical studies will pr vide inf rmation on nutrient level and on exposure to viru e . econd, several body organ will be tudied that have not yet been c mprehensively examined for cancer c rrelation : the cervix, lining of the uteru , breast, ovary, prostate, and pancrea . His preceding studies correlat cl cancer incidence with all the organs of the alimentary tract a well a the lung , bladder, and larynx. These organ will be tudied in m re detail in the new pr ject. T he multi-million dollar grant will not only fund a new urvey, but will also continue the analysi and administra­ tion of two ongoing tudie . The first ne, begun in 19 0, involve the largest cross- ection of pe pie over a wide pectrum of background , occupations, ethnic, and other parameter of any cancer / diet epidemiological tudy to date. Thi cohort urvey of 58,000 ew York tate citizens is still re ulting in new BUFFAID !PHvS1¢1ANj �findin and publications. ( e accompany­ ing article). The second ongoing analy i is ba d ona 1981 urv yof5,500Westem ew Yorker that correlated lung, bladder, and Gl tract cancer with diet and lifestyl , the predece r to Graham's 1986 study. This grant i al ode cribed in the accom­ panying article. A Yal Univer ity Ph.D., Dr. Graham, has been on faculty at UB ince 1956. Graham ha chaired the UB Department of Social and Preventive Medicine since 1981 and is also professor of ociology. He served previously as acting chief of Roswell Park Memorial Institute' Depart­ ment of Statistics and Epidemiological 09/ 86 r fTheinformationfrom participantsmay leadto significant findings on the relationshipbetween cancerand what we eat and how we live.'' Research. He and many other faculty memb rs in his UB department continue to have do e or direct a ociations with the nationally respect d cane r institute, which is also one of the UB Medical School's associated teaching hospital . Outside of the univer ity, he i president of the Society fo r Epidemiological Re­ search and ha editorial roles with the journal of utrition and Cancer and th American Journalof Epidemiology.He is a member of th Board of cientific Counselors, Divi ion of Cancer Prevention and Control ( 1), and also of the American ancer Society's linical In­ vestigation Advisory C mmittee. • - BUFFAID \PHv$1¢1ANI Bruce . Kershner �A_Search for ,..,.,,,, estions ((The discipline we practice in thi department, social and preventive medicine, is un­ u ual because it I ad to more questions than answers," ociologist and epi­ demiologist James Mar hall, Ph.D., com­ ments. "We need intelligent questions, however, to know where to direct our efforts to come up with intelligent answers. " aid another way, ometimes the b t answer to a qu tion i another question," h adds. Jim Marshall is one of three sociologists in the Department of ocial and Preventive Medicine. With a Ph.D. in sociology from U LA, he is active in four major research proj ct and in teaching. member academy class of 1984 suggests that "immediate, day-to-day support, not just that from family and friend , make all the difference," Mar hall relate . "The upport you receiv on a day-to­ day basis is crucial." The second police / stress project, with Dr . V na a primary investigator and Dr. Violanti as co-re earcher, analyze th phy ical health of policemen on the beat. They have found a striking excess of suicide, c rtain cancer , and m king­ related di ea es among 2,000 member of th entire Buffalo Police Department over 30 y ar . n (Marshall's pet project is uicide risk, hi original thesis topic. " uicide is ne f the mo t fa cinatin , tragic, and telling ph n m na of human existence," he tate . "We devote so much of our G P t ward extending longevity and prolonging life - and yet 30,000 pe pie each year say, 'l want no more of it.' " "The highest rates," he says, "are among retired white men, th group with the mo t power in our society. Yet, the I we t rate are among black w men, who have the toughest road in many way ." Hi re earch hows, ironically, that while older white male suicides hav ropped 50 p r cent ince 1950, t enage male suici e ha increa ed 50 per cent in the am period. Mar hall plans to expand his suicide studies to include the role of economic status. • One of the major coresearchers in Graham's I grants, Marshall serves a a methodologist. Research d sign and devising valid and eff ctiv ways to ask survey questions, and tatistical analy is are among his ta k . "When you have such a large body of data, there are no rules to analyze that data," Marshall states. "I help to make sense of those data. I assi tin determining if the statistical findings make sense in light of the bio­ logical knowledge." He i active in analy i of data relating to oral, bladder, rectum, and other cancers. Mar hall is involved in two studies of police stress, one with a former Ph.D. student of hi ,John Violanti, Ph.D. (now director of the P lie Academy in Albany), and the other with John Vena, an a sistant profes or at UB. The first study involves measuring p ychological tress and comparing it to the presence of support setting , both in and out of th close-knit academy erring. So far, hi study of the entire 140- BUFFAlO [PHY$ 1 ¢1ANI 09186 �12 1RANSPLANTATI~ON SPECIAfd.l-Alumnus RobertGale journeyedto the USSR to aid the victimsof Chernobyl BY MARY BETH SPl A T h name of Dr. Robert P. Gale truck a familiar chord with several Buffalonians this spring when they heard through the media that the UCLA transplantation speciali t was going to aid victims of the hemobyl nuclear power plant disaster. Gale, a 1970 graduate of UB' School of Medicine, left Buffalo 16 year ago to pursue internship and r sidency at U LA. Later, he earned the Ph.D. in microbi logy and immunobiology there, and in 1977, wa named director of U LA's Program in Transplantation Biology. Former classmates and teachers who aw him describe on tel vision hi missi n to assi t radiation victim of Chernobyl noted he hadn't changed very much. He was still the serious, intense, and obvious! y dedicated person they remembered. Harold Brody, M.D., Ph.D., chairman of UB' Department of Anatomical Science , noted he had written r com­ mendation for Gale' U LA int mship and re idency. "I still have copies of the letter ," aid Brody. Hen ted Gale had be n a serious student, a hard worker who had earned some elective credits at UB by serving in small hospitals in Ethiopia and Thailand. ' l wasn't urprised that he was so prominent," Brody con­ tinued, "a gr at many of our students have done very, very well and he is one of them." William Dillon, M.D., one of Gale's classmates and now head of UB's Division of Maternal/Fetal Medicine, was pleased 09/ 86 to see the UCLA physician / researcher in the spotlight. "He was sort of a quiet guy who demonstrated his individuality even in medical school - very intense, very intelligent," said Dillon. One of Gale' former roommates, Jan ovak, M.D.,directoroftheGI Unit at Erie County Medical Center and a UB faculty member, said he believed Gale is probably "one of the mo t prominent medical graduates at UB in the last 20 years." ovak noted, "H ' had an im­ pressive career and he's omebody UB can be proud of." Former classmate teven V. Grabiec, M.D., a clinical a sociate professor in UB's Division of Allergy and lmmunology, pointed out that several members of the lass of '70 chose medical specialties in which immunology played a major role. Whether or note Gale selected oncology and transplantation partly because of the outstanding immunol gists who taught the Class, Grabiec could not be sure. "They certainly influenced some of the rest of u in these directions," he explained. press reports uggest that Gale, long prominent in the profe sional litera­ ture for his research in leukemias and marrow transplantation, had thought about the medical consequences for vic­ tims of nuclear accidents long before Chernobyl occurred. It is certainly a I gical assumption, sine leukemia patients must undergo near-lethal dose of radiation to kill their own bone marrow before th y can receive marrow transplants that are as compatible as possible from BUFFAID (P H v$1¢1AN) near relatives or other . TheenormityoftheChemobyldi ast r, however, sugge ts that hundreds would be potential candidate for either the marrow transplants if near "matches" could be found from donor , or for transplantation of fetal liver tis ue which could hopefully be an acceptable sub­ stitute. Ga le' kill in the field of transplanta­ tion medicine, coupled with his well­ known tenacity to e k every possible chance medical cienc can offer for his patients, was ju t what the oviet patient needed. Thi combination, ironically, was what had led him to be reprimanded by the ati nal In titutes of Health, a prime funder of hi re earch. He had been cha ti ed by IH for performing "unauthorized" exp rimental bone marrow tran plants which had not been approved by an internal review committee at UCLA. Later, the panel gave its approval. It wa n ver ugg st d, IH personnel said later, that Gale didn't have the welfare of his patients at heart. The incident wa one in which a dedicated physician wa infinitely more concerned with the immediate lifeand death situation of despe rate pati nts than with the often sl w, tedious bureaucratic system involved with approving experimental treatment. As the hernobyl situation reached the Western press, Gale recognized an obligation to offer his help. When Pre i­ dent Reagan's offer of humanitarian aid was rejected, Gale, as chairman of the advisory committee of the International Bone Marrow Transplant Registry, had �13 two other ideas. The ne he found m t pr mising wa to p r anally c ntact Dr. ArmandHammerwhomheknew . Hamm r, head of Occidental Petroleum, ha long had busine and humanitarian cl alings with the viet Union . G ale's offer to help mobilize aid for the hernobyl victims was cabled direct­ ly to Mikhail G rbachev by Hammer who received a return me age from the Soviet leader that said, "Pl ase send him (Gale) immediately." In a mission und rwritten by Hammer, al mobilized p cialists including hi colleague Dr. Richard hamplin; U LA ti u -typing p cialist Dr. Paul Tera aki who has been a peaker at UB 's Inter­ national Immunology Conv ation; and I raeli scienti t Yair Reisner who was known for hi experti e in u ing !ant lectins to remove T-lymph cytes from marrow to reduce rejection ri k in marrow transplant . Dr. John Han en at the niversity of Washington arranged for Gal to coor­ dinate com put r data on potential marrow donors in orth America; Dr. John oldman of Hammersmith Ho ital in England coordinated imilar data on poten­ tial European donors. Ti ue-typing mater­ ials for ab ut 200 person as well a laboratory apparatu and the new im­ munomodulator dru cycl porin A were flown from around the world to oviet m dical faciliti as soon as Gale and hi colleagues ord red them. In all, about 15 nations participated in aiding hernobyl victims either through per nn I, expertise, or equipment and medicines. ...J I .__ ___________________ .:...,_____ ix of the 35 Ch mobyl victims eventual1y received fetal liver ti sue tran plants; the oth r rec ived donor marrow. It was a ma ive effort n the part of Gale, the physician known for his per i tent supp rt of hi own patients at U LA. He has well rved the hem by! patients through hi kill, his determina­ tion but perhaps mo t of all, through his BUFFAID [PHY$ 1 ¢1ANI ........:, ____ ___J compassion. Although it will be some time before the final figure can be tallied on the long-term health ff; cts of the hernobyl accident on the opulation affected, Gale and his colleagu were able to spar ome live and, a importantly, to hare their medical knowledge with their viet counterparts. • 09 6 i �14 National serviceaward honors r 9th century UB pediatricspioneer BY JAMES R. MARKELLO, M.O. (Class of 1961) l> I s E \ s I: s INF.\~('\' \XI> f 'IIILIJII00ll . Pllll.l I[ }, '\ El.l"Mll H \" t I, I , Ill&. T he Job Lewis mith Award is pres nted annually by the om­ munity Pediatric ection of the American Academy of Pediatric to a pediatrician for "outstanding community ervicc to children through teaching, public ervice, and inn vation in panern of patient care ." Thi award honor Job Lewi Smith, a Buffalo Medical ollege (now U Y Buffalo ch ol of Medicine) tudent of the early 1850 , who became one of the two pi neer of American pediatrics. 09/ 86 While a boy on the family farm on the ea tern hore of Lake kaneatele , near th village of Spafford (Syracuse area) in Onondaga ounty, Job Lewis attended the ortland Academy to prepare for college. Up n graduation from Yale in 1850, he had not selected a profession; everal months pa ed before he decided to pur ue medicine. Following in the footsteps of hi brother, tephen, Job Lewi moved to Buffalo in 1850. He attended lecture in the Buffalo Medical College and erved the equivalent of one BUFFAID jPHY$ 1 ¢ 1 AN I year of internship at the isters of harity Ho pital. 1 Smith had the good fortune of studying under Austin Flint, from whom he acquired skill in phy ical examination and proficiency in performing autop ie , of which he later performed surprisingly large number . Flint influenced Smith to develop the habit of making careful note of hi clinical and pathologic ob ervations. The e, together with diligent study of dome tic and foreign medical literature, formed the ba is for hi later writings. ��16 mith' lifelong dev tion to Flint i evident in th e obituary memoir !, Reminiscences of ProfessorAustin Flint, M.D ., L.L.D., wherein he ret r to Flint a "the ydenham of th e ninet enth century." Again following in the t t teps of hi brother, tephen, Job Lewis moved from Buffa[ to ew York ity wh re he enrolled in the College of Physician and Surge n , graduated in 1853, and ent red practice on West 49th treet. tephen became founder of the American Public Health Association; Job Lewis pioneered the pecialry of pediatrics. He would have been known as the father of American pediatrics had it not been for Abraham Jacobi, who arrived from Europe in l 53 and ente red medical practice in ew York City, later urpa ing mith in his influence on American pediatrics . The parallel careers of Smith and Jacobi in ew York ity , sharing common diatric inter t and activiti s, brought the two "giants" tog thcr on many cca i ns, uniting their effort in the gene i of American pediatrics. mith found time for several contri­ bution to th medical literatu re. Hi first a er, ublished in 1854, was a review f mallpox, an epidemic of which wa declining in ew York. Subs quent pub­ lications discussed hydrophobia, remittent f ver , cholera, meningiti , diphtheria, tuberculosis, rickets, summer diarrhea, and t tanu of the new born . The r lation hip of di ease to "poverty, defectiv nutrition, and in anitary c n­ ditions" of vividly de cribed hanty tow n life was propo ed. Advantage of brea t feeding were pre en ted at the fir t meeting of the American Pediatric ociety. mith stated: "Infants dep rived of thei r mother's milk or its substitute, the milk of a wet nurse, during the period wh n nourishm nt at the hr ast is the mode of alimentation ... nearly all perish d oon after birth, and from causes which wer plainly referable 09/ 86 to the mode of feedin g. He also ob erved how "The teamboat every morning brought foundling to the (Blackwell's) Island, and every afternoon removed an equal number for burial in Potter Field ." l His treatise on ricket pointed out that "children treated with cod-liver oil did best." mith embraced the popular belief that "deformity or ocher abnormal devel p­ ment of the fetu is som times due to the emotions of the mother," citing ca e to upport hi belief.4 Smith's 'Treatise on the Diseases of Infancyand Childhood'was adopted as a pediatricstext by medicalschools throughoutthe US until the 1890s; it was al.sothe practitioner'smainstay.'' ff H i Treac'.seon the Diseasesof Infancy and Childhood, publi hed in 1 69, underwent eight editions in 27 years, ref\ cting a rapidly xpanding pecialty even at that time. It wa adopted a a pediatric text by medical schools thr ugh­ out the United tares until the late l 90' . Acclaimed to be n t on ly the favorite f medical student , it became a main cay of the general practition r. The American Pediatric ciety owes its origin to Job Lewis mith . He BUFFAID JPHY$ t ¢1AN I influenced the official ranking of pediatri cs as a specialty in l 0, when the ection on the Diseases of hildren was formed at a meeting of the American Medical S i ty in Richmond, Virginia . even years later , following a m eting of the ninth Inter­ national Medical ongr , mith, who served a chairman of the Pediatric Section, called together a few c II ague and propo d formation fa new, independ nt society" rganized n the highe t p ssible lit rary and ci ntific ba i , and that it mu t not enter into entangling alliances." Th propo al b ing approved, mith was elected temporary chairman . The name American Pediatric ociery wa elected, and an invitati n wa ent to potential member in the United tates and Canada. ne year later, l 8 , formal organizati n wa accompli hed; Abraham Jacobi was elected the fir t pre ident, at mith's ugge tion . mith became the econd pre ident in l 9. Sir William O ler was the fourth pre ident in 1891 . Recogniz d f r hi leadership in pediat ric , mith was appointed phy ician to the orthwestem Di pen ary, to the ew York F undling A ylum, to the urse ry and hild' Ho pita!, to the Infant' H pita! on Randall' I land, and to the Charity Ho ital. In 1861 he was appointed clinical profe or of the diseases of children in the new Bellevue Ho pita! Medical College and in 1867, clinical professor of morbid anatomy. Job Lewis mith died June 9, 1897, apparently of congestive h art failure, a few days after itting up with a sick child, who e pennile father mith helped by giving him money. • 1 2 J 4 Fabe< H K. Job Lewis Smith. torgotton pioneer J Ped1otr 63794 1963 Smith J L Reminiscences of Professor Austin Flint. MD . LLD M Rec 29:467. 1886 Smith. JL TrAm Ped1otr Soc 1.86. 1889 Cone T.·H1sto,,yot American Ped1ot11cs Boston. Little. Br<>vm,and Company , 1979 Dr. Marke/lo is professorof pediatrics, East Carolina University , Greenville,N. . �17 Med students cite 4 outstanding teachers U B' medical rudent recently pn:­ ented four faculty members with the 10th annual Dr. Loui A. and Ruth iegel Award , which recognize faculty a "Teachers of the Year" in four categoric The award were given during the chool' Annual Faculty Meeting last May. Murray J. Ettinger, Ph.D., received the Pre­ Clinical Teaching Award. He is a graduate of Hahnemann Medical ollege in Philadelphia, Pa. A profe or ofbiochemi try, he joined the UB medical faculty in 1969. He also received this award in L984. Ettinger developed ummer tutorial pro­ grams for students who fail biochemi try in which he stresses study and learning skill that can be applied to all subjects. The linical Teaching Award was pre ented to Frederick E. Mun chauer Ill, M.D. A graduate of McGill Univer ity of Montreal, Canada, he is currently a re earch assi tant pr fes or of neurology and internal medicine. He i a member of the American Academy of eur I gy, the American liege of Physician , and the American iety of Medical Engineer . Thi year' Volunteer Teaching Award went to Lawrence M. herman, M.D., clinical instructor of urgery. A graduate of the University of Michigan, he i a member of the American ollege of urgeon and the Mai­ monide Medical ociety. He presently erves as medical director of Hospice Buffalo, Inc. The Buffa! House taff Teaching Award was pre ented to arlos A. anto , M.D., clinical a i tant in trucror in gynecology and ob tetric . The native of an Juan, Puerto Rico, received hi M.D. from Univer adad entral del aribe h I of Medicine in ayey, Puerto Rico. He is a Juni r Fellow of the American ollege of Obstetric and Gynec logy. The awards are chosen thr ugh tudent nominations which are in turn reviewed by an awards committee comprised of representative of all four medical chool cla e . tudent nominate individual and arc asked to describe the meri and attribute of nominee . The award committee review and make its deci ion based on the number of nominati n and the quality of written tatements. • - Jonathan Pullano 2 7 faculty participate in orthopaedics event T wenty- even member of the Department of rthopaedic urgery were participant in the February I 9 6 53rd Annual Meeting of the American Academy of Orthopaedic urgeons held in ew Orleans. The meeting wa attended by a total of over 1 ,000 individuals, report Dr. Eugene Mindell, chairman and profe or of BUFFAID [PHY$1¢1ANj rthopaedic surgery. A am piing of ome of the papers pre ented by department faculty include "Aneury ma! Bone Cysts of the pine" by Dr. William apicotto, clinical assistant instructor, and Dr. Mindell. A retr pective tudy of forearm fracture in children wa di cu ed by Dr. Michael Grant, clinical assistant in tructor, and Dr. Richard Weis , clinical a ociate profe r, while Dr. Ed immon , profe or, and Dr. R. Geoffrey Wilber poke on managing lower back pain a oc1atcd with colio is. UB orthopaedic surgeon Jame Wopperer,James Whitc,Jr ., Robert ill ·spic, and Benjamin bletz pre ented a long term followup of infantile eptic arthriti of the hip, while Dr . White, imm n , and David Berens compa red T, myelography, and di cography m the diagno and management of lumbar dis disease. Pre ented at the American ciety of urgery of the Hand meeting wa UB orthopaedist Dr. Michael Feinberg' open digit te hnique in Dupuytren' contra ture. The Re ident ' and Fellows' Hand urgery nference paper by Dr . wen May, Jayton Peimer, Mark Koniuch, and raig Howard compared fibron seal adhesive and nonab orbable microsuture in peripheral nerve repair. • 09/86 �18 09/ 86 �19 CLINICALTEACHINGKEEPS THE PROFESSIONALIVE BY JAME M. HASSETT, JR., M.O. Associate ProfessOTof u~gery and Biophy5\C5 T ,. eaching i one of the basic roles of any clinician. le is integral ro the therapeutic relationship between the physician and the patient. Without the true knowledge of the di ease and the therapeutic trategy, any patient's compliance will be lessened. lt is integral to the professional relationship between the physician and the other health care professionals. Without the knowlec}ge of the disease proce s and the therapeutic plan, the dedicated c operation of the entire health care team is reduced. It is integral to the continued development of the physician. Without the continued and lifelong acquisition of the scientific knowledge base, the physician will soon become a modern day shaman . le is mandatory for the continuation of the profe ion . Without the communica­ tion of this knowledge ba e to the succes ive eoeratioo of physicians, the profession itself will ooo die. Those clinical specialties requiring the ma tery of highly technical skills depend on the ability of the eoior "craftsmen" to impart their skill and judgement to the ucceed­ ing generations. The simple de cription of an art form is insufficient to impart the entire meaning of the art and its practice. These clinical specialtie still depend on an "apprentice" form of educational develop­ ment. Those clinical specialties which are more abstract depend le son the apprentice-master relationship for the educational development . The knowledge base can be almost completely acquired by the diligent and scholarly review of the appropriate science and its clinical applications. The apprentice function till exists bur at a much less significant level. The role of the physician-teacher depends on the specialty and the tudent's level. At the initial clinical contact point, all medical students are anempting to learn the "rule of medicine" and the application of the e rules to the clinical situation. Regardless of the clinical specialty, the teacher in this situation has a primary re pon ibility to guide both the intellectual and professional development of the tudent. The level of contact will change within the different specialties but the empha i hould always be re ponsive to the personality differences of the tudents in­ volved. The educational effort must include but hould not be limited to consideration of the cognitive material. The student's pro­ fessional relation hip with the patient and the development of the clinical personality hould alway be considered. It is in ufficient if the teacher relates to the student only through the subject maner itself. This type of relation hip is much coo super­ ficial. It is insufficient if the teacher relates to the student only a a disciplinarian, demanding high degrees of performance and penalizing a performance if it fails to meet ome arbitrary level. lr is also insufficient if the teacher ignore the student and shows no interest in his professional devel pmem or thought process. ( ee P. 24 article on teaching styles.) Educational succe at the clinical entry level depends on a variety of traits and conditions. First, the teacher must possess a great wealth of knowledge. Second, the teacher must have the time co devote to the develop­ ment of the educational environment and the development of this environment in the clinical sening. Third, the teacher must have a sincere interest in the student' development and be willing to communicate the principles of medicine to the student at the student's level. Finally, the teacher must have the patience and clinical maturity to balance all of the e without jeopardizing the clinical outcome of the patient involved. one of these conditions will be successful if the teacher can not motivate the student to work and become personally involved in the educational effort. The motivation to learn is unfortunately not inherent in every student. In some students, motivation i based on the fear of failure and is focu ed on performance in a written examination. The concept that each patient care problem is ate c is often not perceived by the student. If the student is motivated only by test performance, the desire to acquire knowledge and clinical ability may be weakened in the clinical environment. If the desire to help the patient is an insufficient educational motivation, the de ire for knowledge i completely lost. BUFFAID !PMvS•C•ANI U nfortunately, making the . transition from regurg1tau n f material during a written examination to the use of this ame material in a clinical situation is often difficult and the process is not uniform in all students. The teaching technique which I have found t be the mo t uccessful utilize all of these c ncepcs and employ them with the educational dynamics of the "small group" model. I find this ideal in the clinical erring. In each clinical situation, I attempt co develop four pecific educati nal goal . The fir t g al i to motivate each student to learn the cientific basis of the patient's problem and co use the patient as the focus of the course curriculum. The second goal is to make the student profes ionally re pon ible for hi own education and create an atmosphere in which elf-direction is possible. The third goal is to control the student 's educational development without destroying the student's elf-e teem . The final goal i to constantly encourage and channel the tudent' natural f inquiry and diligence. If these processe goals are achieved and the proper educational environment is created, the outcome is dramatic and the proc i fun. Medical teaching will not improve until the criteria for advancement in academic medicine adequately reflect the importance of the art of teaching in the education of the medical student . Pre ently, the criteria for promoti n to unqualified rank in mo t medical school includes the demonstration of clinical xpertise, scientific excellence, and educational effort. The first two are difficult co d but rea on­ ably easy to document. The la ti the mo t difficult to do well and the harde t to certify. Mo t students can recognize quality in teaching. The ability to document and quantify this, however, is difficult. The presently accepted as umption that a g od sciemi tor clinician ha al o acquired the communication skills to be a good teacher hould be challenged. Medical education will improve when rhe teaching effort and the skills of communication become as important as scientific or clinical expertise in academic devel pmcnt. • (Dr.Ha etti a1984 iegelTeachingAward Winner.) 09186 �20 AWARDSHIGHLIGHT ANNUALFACULTY MEETING ( (G etting the tockton Kimball Award last year was something Likegetting an excellent report card in grade school," mu ed Dr. Pearay gra, the 1985 tockton Kimball Awardee . "In grade s h ol, you went home and got hug and kis e from your family for your hard work. In receiving the Kimball Award, I got those 'hug 'from my profe ional family." Thus Dr. Ogra began his pre entation a this year' tockton Kimball lecturer at the Medical cho I' Annual Faculty Meeting n May 2 . The Kimball Lecture is traditionally given by the previou year' Kimball Awardee. Dr. Ogra add re d the Katherine Cornell Theatre crowd on immunological activity on mucosa! membrane surface . He identified eight sites where such activity occurs : the GI and respiratory tracts, salivary, genital, urinary, mammary, and eustachian / middle ear site . Regarding the brea t site, Ogra referred to his re earch that has emphaized the important role of breast feeding for immun logy. Briefly reviewing the hi tory, the profe sor of microbiology and pediatri de cribed how IgA wa first found in erum, and then in milk; in 196 I, Dr. Thoma Tomasi discovered it in external secretion . Toma i, incidentally, was on UB's faculty for eight year and will return sh rtly as the ju t selected new director of Roswell Park Memonal Institute (see separ­ ate article). Dr. John Bienenstock (who presented this year' Harrington Lecture the following day) di covered lgA in the re pira­ tory tract, Ogra added. "Researchers have discovered a number of common characteristics of the mucosa! immune system," the native of Kashmir commented. "All have contact with the external environment; all have muco-ciliary epithelium and a secretory component of lgA. In addition, they have organized follicle of precur or 09/ 86 lymphoid ti ue and they also have lymphocyte traffic." gra went on to de cribe potential inter­ actions between pathogen and ho t ites in mucosa! ti ue . He explained the po ible mechani ms f lgA regulation, including the way they regulate activity, proliferate, circu­ late, and expre s them elves, and what deter­ mine indu tion of vaccine immune re ponses . ln an wer to a que tion, Ogra gave hi opinion that he did not think an intranasal flu vaccine would be developed within the next five year but chat it would definitely be developed after that time. V ice President John aughton, dean of the Medical chool, reviewed the pa t year's mile tone in his Dean's Report at the Annual Meeting . "One mile tone was that (a peak of) 24 or 25 department chair were occupied at one point during the 19 5-19 6 year ... but that changed when two more chair­ men announced their retirement ." The dean al o announced that 19 new clinical faculty po itions were established in the State budget. Many honor were be towed upon our BUFFAID IPHv$i¢1ANI faculty, the dean commented. Foremo tamong them wa the obel Prize in hemistry awarded to Herbert Hauptman, Ph. ., medical director of the Medical Foundation of Buffalo, Inc., and re earch profe r of biophysics . Dr . Robert Gale (M'70) attained international attention a the first . . physician to be invited to Russia to treat the Chernobyl radiation patients . The Early Assurance Program "came of age," aughton aid, with its first applicants about to enter the Medical chool. Ten more were "inducted" to enter the hool in 19 and consideration i now underway to add Canisius ollege t the program. Among ho pita! and clinical developments during the preceding year, the dean rated that the clinical practice plan now ha 9 .6 per cent compliance and 276 participants . "We also have a new Board of Managers for Erie County Medical Center, a new affiliation agreement with Millard Fillmore Hospital, and a major new facility at Buffalo General. In addition," the dean said, "the Buffalo and Batavia VA Medical Center will oon enhance their geriatric program . " The tockton Kimball Award, the Medical hool's highest honor, was presented to Alexander . Brownie, D.Sc., Ph.D., professor and chairman of the Department of Bio­ chemistry, in recognition of hi outstanding contribution to the life f the chool, dedica­ tion to teaching, and hi re earch c ntribu­ tion on the control of adrenal cortex and hyperten ion. A graduate of Edinburgh Univer ity in Scotland, Brownie came to UB in I 963. He i currently al o research profe or of pathology and re earch profe or of medicine. A member of the Endocrine ociety and the American Society of Biological hemisrs , he is treasurer of the A ciation of Chairmen of Medical chool Departments of Bio­ chemi try. Hi Ii t of awards include teaching �21 award from the Medical 1973 and 19 3. ((The chool's Cla s of Dean' Award goes to rwo faculry members (Ors. Eugene Mindell and Richard Ament) whose contributions to the chool of Medicine are legendary," Dr. aughton tated. "Dr. Eugene Mindell has led the Orthopaedic Surgery Department for 22 year . During that rime, he has established a nationally competitive re idency training program and ha recruited an outstanding faculry. In addition, he has become an a ociate editor of The Journalof Bone and Joint urgery and was appointed to the Re idency Review ommittee." Besides being a past president of the American Board of rrhopaedi urgery, he is a fellow of the American Academy of Orth paedic Surgeon and a founding member of the Orchopaedi Research ociety. Dr. Mindell recently announced he will step down as department chair. Dr. Richard Ament, the second Dean's Awardee, "has contributed ignificantly to the growth of the Department of Anesthesi­ ology, and has been responsible for the development of a strong program in the re idency training of anesthesiologists," the dean said. Ament is a clinical professor and director of education programs in UB' Department of Anesthesiology and an anethesiologist at Buffalo General Hospital. The Buffalo native i an alumnus of UB's chool of Medicine. He i a past president of both the American and ew York State Societies of Ane the­ siologi cs and currently erve as treasurer of the World Federation of ociecie of Ane the­ siologists. He wa recently al o honored with the American ociery of Anesthesiologists' highest award. Dr. Marvin L. Bloom, clinical profe sor of medicine, joined with Dr. aughton in formally announcing establishment of the Dr. Harry G. Laforge Convocation Center, in honor of 84-year-old three-time UB alumnus and emeritus professor Harry LaForge. heduled for completion in l989, the onvocation enter will contain a classroom, everal BUFFAID IPHVStCIANj seminar room , and a demonstration room and will be used by the Medical School a a center for continuing medical education. The Buffalo native ha been re pon ible for bring­ ing milli n of dollar of contribution to the niversity, including those of The Hochstetter Foundation. Laforge i one of UB's till practicing senior phy ician de ribed in the ongoing erie (Buffalo Physician December 1985). ' While on UB's faculty as an obstetrician­ gynecologist, he establi hed the Gynecological Re earch Fund in 1948 and co-founded the Annual Participating Fund for Medical Educa­ tion with Dr. Bloom and four other physician . He was honored in 1961 with the amuel P. apen Award, the niver iry' highest alumni award, and i now an emeritus professor. In addition to the awards,James H. Congriff, Jr., M.D., presented a check from the local Women's Auxiliary of the ew York tate Medical ociety for$ l 1,250 to the American Medical A iation-Education Re earch Fund of UB's chool of Medicine. Thi fund is et up entirely to enhance the experience of medical students by providing student loan from a general fund. . Other announcements at the annual meeting included appointments of two new chairmen Dr. Joseph Prezio ( uclear Medicine) and Thomas Flanagan (accin chair, Microbiology) , and the report of the Faculty ouncil by Dr. Reid Heffner, vice chair of Pathology . ew faculty appointments included 89 clinical and 23 basic cience faculty. Four faculty retired at the end of the year and a memorial remembrance was held for the 11 faculty who died during the year. • 091 6 �22 151 receive degrees at 140th Commencement ((w ithin the next few hour , before the un ets, each one of your will be in­ ve ted with power to play God." That wa the invocation offered by Rabbi Samuel Porrath at the School of Medicine's 140th Commencement held in the Univer­ sity's Alumni Arena la t May . Hundreds of proud families and friend ignored the high heat and humidity and voiced their congratula­ tions to the 136 medical tudents who received their M.D. 'sand 15 others who received their Ph.D.'s. After a call to order by Vice President John a ugh ton, dean of the Medical School, Uni ver­ ity Pre ident Steven ample congratulated the new doctors . "These degrees are public testimony of academic achievement and the effort put f rth to attain that achievement," ample said. Class speaker Dr . Walter traus spoke of hi experience in Peru, comparing medicine in an underdeveloped country to the tech­ nologies available in the United States. "In Peru you g to the ho pita! to die," Strau aid, "In the U . . you got the ho pita! to live." Yet with all of this technology available, there are still people in this country without health care becau e of cuts in ocial Security and Medicare, he empha ized. "Within American ociety," he added, "certain population are left out of health care. This is no different than in Peru. I can under tand this in an underdeveloped country like Peru, but for the U.S., this is shameful. We can replace organs and split genes, but we can't provide health care to those in need ." Dr . trauss' concerns were al o shared by keynote speaker Dr. Alfred Gellhorn, director of public affair for the ew York Seate Department of Health. Dr. Gellhorn is a medical profes or and educator who has worked for the health care needs of ociety. He ha been pivotal in shaping health care policies in New York State. ''There has been a devolucionof the patient­ doctor relationship," Dr. Gell horn said. "Thi is a major problem in health care today. Try 09/ 86 to receive your patients a people who are struggling with life. You hould reassure them that the quality of medical practice is high. "We can avoid bad clinical analysi with proper supervision," Dr. Gellhorn advised. "Be sen itive to your limited knowledge and consult with senior phy icians and chiefs of surgery." Talking of the shortage in ew York tate of primary care physicians in general medicine, general pediatrics, and general gynecology, Dr. Gellhorn said, " cw York has more residents than any other state . We lead in every area of medicine except family medicine. Only SO per cent of these residents meet public need ." D r. Gellho _rn emphasized that there are four m1l11onpeople in ew York who live in areas with a shortage of primary care physician . These people, many of whom are BUFFAID jPHV$1¢1AN) over 65, live in poverty-stricken areas with incomes under $8,000 a year. Two-thirds of these people live in ew York ity, where there are only 258 primary care phy icians for every million people. "We need a redistribution of health staff and the development of knowledge in primary and secondary medical profession , "Gell horn said. Turning to the ethical obligations of being a doctor, Dr. Gellhorn reminded the graduates of their debt . "Your education at UB was ubsidized by New York State," he said, "and your residency training is aided by federal, State, and private funding. 1 think we are all indebted." "You have a civic responsibility beyond your medical respon ibility," Dr. Gellhorn cold his new colleagues. " erve in your community and be knowledgeable of national and international i ue . Your role as doctors 1 J �I J is more than one of reacting to ituation that have happened. You mu t al be concerned for the value and problem of ociety." After the keynote addr es , Dean a ugh ton made a special pre entation to Dr. George Harem for hi 50 years of ervice to mankind. A Buffalo-area native, Dr . Hatem received his M.D. in Switzerland and has spend mo t of hi career in China, where he has been re pon ible for the ereadication of venereal di ease, le ro y and other pandemics in that country. "Teaching i the transference of knowledge from one generation to another," Dr . Hatem said . "Thi i the 140th transference of that knowledge at this institution." "The future is your ," he aid to the graduates . "Remember humanity." F ollowing Dr. Harem were Ors . Laurie Loiacono and Dr. Howard tark as co- editor of The Iris, announcing it dedication to Dr. teven Gutman . A pa t recipient of the Dean's Award, the John E. Foley Award, and the iegel Award for clinical teaching, Dr. Gutman was recognized for his pragmatic teaching and witty presentation during his four year in Buffalo. "Today i a day to reflect on accompli h­ ments," re ponded Dr. Gutman, "Completing medical school is a hell of a feat. 1t is a privilege to be a teacher of future phy icians." After Dr . Gutman's re ponse, Dr. Peter Ostrow, as ociate dean , gave the Charge of Maimonide , honoring the 50th anniver ary of his birth. Dean aughron then delivered the Oath of Hippocrate . Dr. Sample confer­ red rhe degrees while Ors. Maggie Wright, Ian athanson, and Jame olan hooded the new M.D.'s. As each of the new doctors signed the Book of Phy icians , mall groups of cheers came from proud families and friends. In rhe benediction, Rabbi Porrath offered one last message. "Leave with pride . Walk with pride. You are now partners with God ." - Jonathan C. Pullano • James Platt White Society honors donors T he choolofMedicineha announced rhe formation of a new society for major contributors to the cho l. E tablished this Fall 1986, the group will be known a the Dean's James Platt White * BUFFAID !PiiYS1¢ 1 AN I Society and will include all donors to the School of $1,000 or more annually. These contributor provide the upporr which helps to make a very g od in titution an excellent one. The commitment each donor makes at thi level helps to put the School on the cutting edge - enabling the very best tu ems to come to the University at Buffalo's Medical cho l; attracting and keeping ome of the top faculty in the nation; and strength­ ening programs which are vital to the advance­ ment of an internationally-renowned chool of Medicine. The Schoo l is very plea ed to recognize and honor each one of its pace etting contributors and look forward to the exciting future they are helping to create. ( *James Platt White ( 1 11-1881) was a grad­ uate of Jefferson Medical College. He began practicing ob / gyn in Buffalo in 1835 and continued in private practice for 40 years. Dr. White was one of the founder of the Medical School; vice president and pre idem of the ew York State Medical ociety; and vice pre idem of the American Medical A ocia­ tion . He wa a founder of the American Gynecological iery and one of the found r of several Buffalo hospitals. He contributed important improvements in the practice and teaching of ob terries by conducting the fir t clinical demonstrations in obstetrics in the United States ( 1850). He also modified ob­ stetrical forceps, reduced an inversion of the uterus ( 1856 ), and advocated anesthesia in childbirth. Dr. White was a professor of obstetrics for 35 year and dean of the School at the time of hi death .) • 09186 �24 TEACHINGSTYLES: WHICH ONE IS YOURS? W hether you are one of the Medical chool' 2400 part and full-time professors and in­ structors, one of the thousands of alumni who are in faculty po itions at ocher in titu­ rion , or in other health profe ion roles, most of you are involved in the art of teaching at one time r another. You reach innumerable medical students, do t ral student , residents, nurses, dental tudents, and therapists . You even teach each other at conference and emina r . o what i your style of teaching? Doe it make you effectiv · or boring? onfrontational or ea y going? Teaching and learning ryles were the topic f one faculty development workshop held at UB. Dr . Norman olkoff, profe or of p ychology in the Medical School's Depart­ ment of Psychiatry, described six particular teaching styles and their pitfalls: • Pat ern ali stic - This type of teacher chink "l'm a replac ment for your parents. I will make all of your imp rtant deci ions for you." Some student may grow to be depen­ dent, while other may grow re enrful. • A u thoritarian - "The information I impart to you may not be challenged; I am the expert," is the attitude of this type. The problem is chat independent judgment i discouraged and tudents don't learn to differ­ entiate between the expert and the information. • a rci.ssistic - This kind of teacher need constant admiration. When he doesn't 09/ 86 receive it, he becomes dcpre sed o r tries to be even more sensational. tudents d n't cru t the teacher and are less apt to take the ubject eriously. • Judge mentaL- The in tructor compare or ridicules tudent . tuden av id the in­ structor because it's easier to remain unaware of one's deficience than t risk humiliation. • E lit i t - Other ' opinion are treated with disrespect and student are patronized. The student maintain di ranee and feel shortchanged. • Compu lsive - The teacher bombard tudent with everything he know about a topic. The re ult is that student get over­ whelmed and turn off. Or, they arc con tantly a king which portion of the material are important to learn. A wa pointed out in the discu ion after olkoff's talk, the methods noted aren't ne essarily bad or mutually exclusive. A teacher might embrace a combination of the style or may use different style as the emesrer progresse . When not taken to the extreme, they can be effective. Just a there are different teaching tyles, there are different learning tyle , olk ff said. He advi ed participant to be aware of individual learning differences and to avoid the a umption that because they learned in a particular way, everyone el e hould. BUFFAID (P H Y$1¢1 A N) The learning cyles olkoff described are: • Av oid a nt - Becau e of poor pre­ university preparation, the tudent expects failure. He may be overwh lmed and retreat. The teacher hould try to recognize thi early and recommend remedial ervic s. If the avoidan e i ignored, it reinforces the expected failure. • In teractive - The e tudent need rein­ forcement from ochers, including the teacher . • Competitive - Especially in professional schools or graduate school, the e tudent are very concerned about grades. The greater the emphasis on grades, the fiercer the competition in class will be. • D epend ent - They see the teacher as the expert and need guidelines and con tant encouragement. Gradual weaning i possible. Adding to the challenge of the difference in learning tyles i the wide range of back­ grounds among students, olkoff said. They represent different ethnic and racial group , age , life tyles, and education goals. He urged the faculty devel pment workshop participant to look ar und the room and notice that che teacher , to , represent many different cultures. "Your own culture will influence you, especially if English is not your first langauge," he said . Solkoff told them to try to understand them clve , how they perceive their tudent , and how their students perceive them. "We all have needs, prejudices and value , " he noted. • �25 Dr. Thomas Tomasi is new RPMI director al needs expansion. "As far as my own re earch is concerned, l plan to remain active and to maintain a lab of my own, " he added. 0 ne of B's affiliated ho pita! ha added a new director. Ro well Park Memorial Ho pita! will now be headed by Thomas 8 . Tomasi, M.D., Ph.D. , tate Health Commi ioner David Axelrod, M.O., ha announced . Or. Toma ii an internationally recognized immunologi t who had been most recently director of the Univer ity of ew Mexico ancer enter in Albuquerque . Toma i emerged a the leading candidate for the director hip of Ro well Park following a earch for a new director that began la t October. More than 50 candidates were evaluated by the search committee. The search began after Or. Gerald Murphy, director for 15 years, resigned. Or. John Wright, chairman of B' Oepartmenrof Pathology, was selected co serve a interim director while the earch was under way. From 1965 through 1973, Or. Tomasi was profe or of medicine at B and director of it Division of Immunology and Rheumatic i ea e. "It i a real plea ure to be back in Buffalo after 12 year , " commented Dr. Toma i, who al o has family in Buffalo . "We look to Or . Toma i to bring a fre h and innovative approach to the leader hip of Roswell Park Memorial Institute and to the design of a strategic plan to guide the cancer center into the 21st century," Gov. Mario uomo aid in a tatemenr. "During my fir t 12 months, I will meet with the clinical and re earch faculty to initiate my continuing education proce con­ cerning the in titute and it need ," Tomasi noted. "I'd like to trengthen Roswell's clinical and graduate education problem ," he said, adding, "One of my goal al o will be to ati fy the need for additional high quality per onnel. The commitment of the State and the prestige of the institute will certainly help draw high quality staff here . lt will also be nece sary to addre s need for more patient space, including pos ible constructi n of a new hospital." Axelrod mentioned that Or. Toma i and his institution will work to enhance the T "W ell knoum immunologist, most recently the director of the Uni versity of New Mexico Cancer Center, was sel£cted from 50 candidates. " undergraduate and graduate programs of 8 . "I am intere ted in furthering relations with UB . The interaction with UB will be of benefit to both in tituti n ," Tomasi agreed. Ti have existed between Ro well Park and UB for many year . Roswell oeprate a major graduate program, the Ro well Park Graduate Division, which is a separate unit under UB. In addition, the institute is one of rhe six affiliated teaching hospitals of UB's Medical chool, and is used to tram medical tudents and re idents. La tly, about 85 per cent of Ro well' senior scienti ts have joint faculty appointments with UB, mo tly in the Medical chool. "Research areas at Roswell that need to be strengthened," Toma i related, "include re­ earch inro use of certain natural substance from blood cells, biological modifiers uch a interferon. The bone tran plantation program BUFFAID (PHVS1¢tANI omasi's discovery of the existence of the human muco al immune y tern laid th foundati n for development of oral vaccine and an under randing of the major function the muco al system erve in health and di ease . He is the author or co-author of more than 300 scienafic article , and ha servt!d on the editorial board of everal scientific journal . F llowing graduation in 1950 from Dart­ mouth Collegt! with highest distinction, and the Univer ity of Vermont School of Medicine magna um laude in 1954, Dr. Tomasi erved his intern hip and re idency training in internal medicine atthe olumbia Pr byterian Medical enter in ew York. He received his Ph.D . in biochemistry and immunology from Rocke­ feller niver ity in 1965 . After complenng his research training, he was recruited by the Univer icy of Verm nt a chairman of the Oivi ion of Experimental Medicine and chief of medicine at the DeGoe briand Ho pita[, the major teaching hospital of the univer icy. While he wa at UB for eight year , he was ba ed fir t at Buffalo General where he did clinical work in immunology. He then moved to Erie ounty Medical enter where he al o taught medical tudent and treated patient . He left UB co become chairman of the Department of Immunology at the Mayo linic and Medical School. In 1981, he moved to the Univer ity of ew Mexico, where he became director of its cancer center, Oistingui hed Profe r of ell Biology and chairman of its Department of ell Biology, among other po itions. Dr. Axelrod pointed out "the extra rdinary job done by Or . John Wright, the interim director, to whom we are vt!ry much indebted, along with the cooperation of SU Y. Wright will now return to UB to resume his chair­ manship of the Deparment of Pathology . While Tomasi has received numerous h n r and recognition , it is al n table that among that 66 po tdoctoral fellow he has trained, 12 are n w department r divi ion chief: . • 09/ 86 �26 Designed for the 21st century, new buildin g optimizes pa tient care and convenience for p hysicians ( e pledge our elve to re pect the dignity of every human being and co care for them with cenderne , patience, and integrity. From che mo tcommon ca k to che mo t highly-skilled mind and hand, we promi e co do ur be c. o one can promi e m re ...no one hould promise les ." *** ( w *** With che e words, the Re. Rev. Harold B. Robin on, Bi hop of the Epi c pal Di ce of We tern ew Y rk, helped dedicate the new Buffalo General Ho pica!medical tower build­ ing on Friday, June 20, 19 6. The tower ha been designed co meet We tern ew York' health care needs well into the 21st century. le did not happen overnight, but is the re ult of a decade of planning, designing, and building, under the guidance of William Kinnard, M.D ., BGH president ince 1975. Moreover, it is the culmination of a 130-year commitment co excellence in hospital-ha ed healch care delivery . 09/ 6 The 1 50s were an era of great change in Buffalo. The city had een its population increase by over 700 per cent in le s than 20 year and the University of Buffalo had functioned for nearly ten year without an affiliated teaching ho pita!. By I 55, the City of Buffalo had seen its population increase to 74,214. In chat year, a group of civic-minded citizen raised funds to purcha ea parcel ofland on rural High treet, at the edge of the burgeoning city. There, three year later , they opened the Buffalo General Ho pita!, a 100-bed facility heated by 25 wood-burning st ves. Then U .. Pre ident Millard Fillmore dedicated the ho pita! on June 28, 185 . It was just the beginning. venteen building projects during the next 11 I years and a merger in 1979 with the Deaconess Ho pica! of Buffalo re ulted in a ho pita! complex with ten time as many beds a its 1 5 ancestor. The BGH opened a urgical amphitheater in 1 99, a children' hospital in 1909, its fir t BUFFAID (PHY$ 1 ¢1AN I outpatient clinics in 1932, and a bigger, better urgical suite in 1937. The hospital ' fir t eparate emergency department opened in 1952; the area's first inten ive care unit followed 13 years later. 1969 marked the dedicati n f Buffalo General 's A Building, with improved emergency care facilitie and more patient beds. ln 1973, the ommunity Mental Health nter opened .. Over the year , there were many medical "fir t " - We tern ew York' fir tu e f hypodermic needle , thermometers, in ulin to treat diabete , " patch-graft" technique in cardiac urgery, and ucce ful kidney tran plant and c hlear implant procedure . The 19 6 dedication marked the beginning of another new era. *** The concept for the BGH cower pr je c emerged from the hospital' ongoing long­ range planning process. In the mid-70 , tudie indicated the mutual benefits of the BGH and Deacone planning together to meet their community' future health care need . �27 "A joint decision wa made by the ho pital's governing boards to merge and chen to fully develop acute-care facilitie at High erect and to utilize the Deacone ( I 00 I Humboldt Parkway) as a I ng term care facility," explained Thomas A. Carmichael, BGH vice president and director of planning . With quality patient care as our top priority, we decided to rebuild our inpatient facilitie and renovate our older building for upport departments and office area . From an economic standpoint, it wa the mo tefficient way co address our patient ' need." The 19 6 dedication marked the comple­ tion of the new construction pha e of the project, re ulting in a virtually new 18-level A Building . The second phase, renovati n of B, , and D Building , will be fini hed by next summer. Building Ai connected co Building Bat ten level , providing direct access between patient care and support department . The hospital's new 16-room urgical suite, for in ranee, i a corridor away from the renovated Department of urgery offices. "The program is being completed in pha es to en urea continuity of q ualicy care through­ out chi five-year process," Carmichael added . * grow," Kinnard told the Dedication Day crowd. "Our 'new' Buffalo General Ho pital i large enough for us to continue our role a We tern ew York' health care leader. At the ame time, we will continue to recognize each patient's individual, pecial need . " And in the words of Bi hop Robin on, the hospital will serve "the healers and the helpers, those who teach and those who learn, rho e who weep and those who laugh, the rich and the poor, the loved and the unlovable, the cared for and tho e who have no helper." It will be there whenever its community need it. • - Diane M. Zu:1recki I ** The new building optimizes patient care and phy ician convenience. Patient rooms have private showers, individual wardrobe compartments, and direct-dial telephones. Panels of windows aero s the upper-floors provide panoramic views of the City of Buffalo and its landmarks. The surgical suite features pecially-equipped rooms for cardiac , orthopaedic, and neurourgical procedure . There is a 30-bed mater­ nity department, a 20-station renal dialysis unit, and a new I bby, admissions area, and 250- eat auditorium. A total of 66 inten ive care bed include 1 for coronary patients, 16 in medical l.C. U ., and 32 in urgical I. . U • In all, the tower hou e 790 acute-care beds. There are 60 more beds in the Mental Health enter and the goal for the Deacone Divi ion is approximately 240 long-term care beds, according to armichael. The new BGH tower was dedicated to the hospital' patient , employees, physicians, and volunteer . "Together, we've watched chi ho pital BUFFAID [PHVSICI A Nl 09186 �28 UB, Millard Fillmore sign affiliation pact ( ( T he merger of intellectual a ets," Jan R. Jenning , the president of Millard Fillmore Hospital, call It. "The formalizing and strengthening of a profe sional partner hip," adds UB Vice President John aughton, M.D., dean of the Medical School. Thi is how they describe the significant new agree­ ment which formalize the affiliation between the Medical chool and Millard Fillmore Ho pital, the nivcr ity's sixth affiliated hospital. The other five affiliated hospitals are Erie ounty Medical enter, Buffalo General, hildren's, V.A. Medical enter, and Ro well Park . Beside Millard Fillmore's main hospital facility at Gates Circle, the agreement include its Suburban Hospital in Amher t. "Thi ho pical will provide additional bases for obstetrics and family medicine residency training, and i unique in that it will for the fir t time provide a suburban environment for training and programs," aughton re­ marked. The affiliation agreement is clearly of mutual benefit to both in titurion , aughton and Jennings agree. "Millard Fillmore Hospital 09/ 86 will complement, not compete with, our efforts," Naughton emphasized. "Our goal is to come do er in joining educational and institutional intere ts ." Jan Jennings, in his president's message in la t pring' is ue of the hospital' quarterly, The Reporter,stated that Millard Fillmore's "multihospital sy tern now is a part of the resources (of U Y Buffalo), tapping into th se benefits while lending its own expertise." The benefit to the Medical School and Millard Fillmore Ho pital will be noticed in their clinical, re earch, and educational program . In the educational arena, both medical tudent and re idency education will be enhanced. Millard Fillmore' ambulatory program will provide more opportunities for expanding training urgery rotations. The fact that the ho pital has the large t clinical pharmacokineric laboratory (do ely tied to UB's School of Medicine) in the country is a real strength, the dean points out. imilarly, it strong bioengineering group is unique among Western ew York's hospitals, and will nicely tie into UB's Health Related In trument and Device Institute (HIDl) and Center for Advanced Technology (CAT). The affiliation will, in particular, help Millard and UB adapt to the changing trends BUFFAID (PHvS1¢1"N) in graduate education programs." ew York State will soon be etting targets for a reduc­ tion of residency program ," Jennings ex­ plain . "The first to go will be the non­ Univer ity affiliated, and rho e not offering the triad of in truction, research and patient care," char the Accrediting Council of Graduate Medical Education now demand . Millard Fillmore Ho pital (MFH) now participates in three University-affiliated re idency programs : ob-gyn ( with rotations recently added to MFH' uburban Hospital); radiology; and family medicine ( with a second trainin site just establi hed at the Suburban Hospital, in addition to the base at Buffalo General's Deacones facility). Millard Fillmore ha ix free standing residency programs: anesthe iology, internal medicine, neurology, pathology, and surgery. These are the programs that could be affected by rhe tate' new rules, according to Jenning . A the new affiliation agreement is imple­ mented, the e free- tanding program will gradually associate with the University' pro­ grams and become part of the Graduate Medical-Dental on ortium . The joining of six MFH programs with UB' residency programs will broaden the range of training experience available . The most notable new opportunity may well be for neurology residents , since the respected Dent eurologic institute offer experience available nowhere else in We tern New York. The gradual merging of residency programs and implementation of the affiliation agree­ ment will probably result in ome full-time joint faculty appointment . Both UB and the hospital have goals to enhance and expand their re earch efforts. The coupling of their effort through the affiliation will therefore a i teach institution in striving toward thargoal. A with education, UB will benefit by being able to tap the hospital' research re ource , notably neurology, bioengineering, and pharmaco­ kinetics. UB's research resources will, in turn, help Millard Fillmore to attract quality clinical re earcher and funding. La tly, in the clinical arena, enhancement of programs will gradually take place. "We will ensure, however, that implementation will be evolutionary so that disruption of �29 programs will be prevented," a ugh ton assured . In add1ti n, the B-a iated hand urger program run by Dr. layt n Peimer, who hold B appointment in orthopaedic , anatomy and rehab medicine, relocated to M FH in January 19 6. Furthermore, the Millard Fillm re and hildren's hospital now have an affiliation agreement for a neonatal care and high risk pregnancy program ( ec separate article). Dr. aughcon pointed our how the B affiliation conforms to national trend and pre ures on the health care y tern. Be ide the national trend toward re idency programs becoming univer icy-associated, "inter-institu­ tional cooperation i now required in thi day and age." In addition, the training of d crors to better meet the need of the expanding uburban population will n w be enhanced by the addition of a uburban ho pita!. More than ju t a linking of two separate in tituti ns, the agreement i really the con ­ necting fa circle of relation hip . Millard Statistical Profile on Millard Fillmore Hospital ( 1985) Year Founded No. of Pattents 1st Year o. of Patient Admitted 1985 Ga tes Circle Suburban 1872 1974 347 16,27 563* o. of Beds Total 92 4 39 8,3 2 24,6 60 151 714 77 .3% Average Per cent Occupancy 17,289 Total Inpatients 10,356 2 0 ,0 10 o. of Outpatient Visits 20,010 o. of Emergency Visit 22,414 28,439 Total Patient Days - Oro s 159,094 51,891 664 1, 82 Live Births 50 ,85 3 210,985 2, 546 34 3 No. Doctors on Active Staff No. of House 2 7,645 95 taff o. of Operations 13,847 5,759 9 3, 561 ,000 Gross Patient Income $78 ,650,000 Total Operating Expenses Total Donations from $ 600,125 Community •1ndude.s skilled naming fa.:1l111es BUFFALO fPHv$1¢1ANI Fillmore's parent company, Vita!liance orp . ha a subsidiary which is now c ntracting to manage another important affiliated ho pita!, Erie ounty Medical enter. • Children's & Millard plan joint care effort C hildren's and Millard Fillmore hospital announced la t May that they will be finalizing a formal agreement to mutually develop a plan for enhancing Millard Fillmore' ob-gyn servi e . The agreement repr nts a unique arrangement between the two major tea hing ho pita! for the enhancement of ob tetrical and neonatal are in W ·stern ew York . The relationship involve a ooperative interaction whereby Millard Fillmore ubur­ ban Ho piral' · labor, delivery, and newborn program will be enhanced with the additions of ervice from The hildren' Ho pital. The linkage will parri ularly benefit mother and babie with unexpc red and dangerou om ­ plicarions of childbirth. According to J.E . t1bbard , pre idem of hildren' Ho I ital, "Thi rr je t, a neo ­ natal / pregnant patient tran fer agreement, will expand th· current medical ervi e available to Millard' urroundingcommunity, a uring m re omprehen ive are for the children and women four region ." The initial pha e of the program will ur over the next ix co 12 month . etailed guideline have been establi hed t maintain effective operation procedure and maximize efficiency of care. The Children• Hospital perinatal program will hare person­ nel, policie , and training with Millard. The maternity and normal newborn pr gram will have ommon polici 'S and tructure at both h pita! a well. hildren' and Millard Fillmore Suburban will engage in a joint proce to a recruit a full-time chief of neonarology and a full-time chicfofo tetri andgyne ologyat uburban. In additi n, two nurse clinicians, one pecial ­ ized in labor and delivery, the ther in neonatology, will be pre enc at Suburban to facilitate the development of a center of excellence in ne natal care. 09 86 �30 In conjunction with the enhanced ob / gyn service at uburban, Millard Fillmore Gate Circle will close its delivery unit bccau e of the teadily declining number of deliverie ( 662 last year). The Gates Circle facility will continue, however, to operate its ob / gyn clinic which serve more than 3,000 women a year. This clinic "and the enhancement of ob tetrical care at Suburban will enable us to c ntinue ur trong commitment to providing the highe t quality of care," aid Jan R. Jennings, pre idem f Millard Fillmore Ho pitals. Edmund A. Egan, M.D., chief f newborn inten ive care at hildren's Hospital, aid, "Our regional perinatal center will continue to be a referral facility for high-ri k pregnan ie and newborn inten ive care for Millard Fill- more uburban Ho pita! and all of Western ew York. In addition, we will be directly involved daily in the operation of Millard Fillmore uburban's maternity and newborn program." In 1985, hildren' Hospital delivered 4,500 babies; Millard Fillmore uburban ircle Hospital delivered I, 2 and the Gate Hospital, 662 babie . • shock-free, gentle movements that reduce dizzine and tre s, while producing highly effective radiography and state-of-the-art imagery . It is especially u eful for ga tro­ intestinal studies and its com act, micro­ computenzed X-ray control enables con­ vement remote control operation. • in the blood ve els. A contrast medium 1s miected into the patient's arm or leg through a catheter. A computer linked to an x-ray machine creates an image of the dye circulat ­ ing through the part of the body bemg tudied. The computer 1s able to subtract from the x-ray picture all the part not being tudied - images of bone, fat, and mu de -leaving only a picture of the arteries." And because tt's computer controlled, it is com­ pletely upgradeable," ay Dr. David Rowland, chief of radiology and a UB clinical a si tant profe sor of radiology. "If there are changes or if new program are developed, we just simply change the software." • Ho pital briefs New device will treat kidney stones B uffalo General Ho p1tal has joined forces with the Western ew York Stone Treat­ ment Center to undertake acquiring an Extra­ corporeal Shock Wave Lithotripter, according to William Kinnard, Jr ., M.D., president of the h pital. De igned for non-surgical treat­ ment of kidney stones, it will be hou ed at the f he W Y h spiral under the operation urologist group. • BGH creates new care corporation B uffalo General Hospital' corporate restructuring ha created General Care Corporation, a parent holding company that oversee health care and human service enterprises. Ir has also entered into a joint venture with Home Health Care of America, Inc., and the Buffalo Me 1cal Group to form AdvancedHome areofW Y,aprogre ive home health care company. • RPMI adds gyroscopic table for X-rays R oswell Park Memorial Institute has ac­ quired the area's first Toshiba Universal Gyroscopic X-Ray TV Table. It offers patien 09/ 86 Mercy is first with 'Li£eline' voice unit M ercy Hospital is the fir t hospital in .Y. State to use a new "Lifeline" Voice Unit. imply by pre ing a personal help button, worn by the patient at all times, the voice communicator can be activated by the Lifehne subscriber wtthin 200 feet of the home unit. Depending on the patient' res­ ponse, the Ambulatory Care enter evaluate what help may be needed, including an emerg ncy quad response . • Sisters improves angiography system S I cer Hospital ha greatly improved angiography procedure and reduced pattent anxiety by introducing Western ew York' only fully computerized digital sub­ tractton angiography y tern. The sy tern produces image of the artene which can reveal narrowing, blockage, or ther roblems BUFFAID jPwvS1¢1AN) First layperson heads Mercy board T he first layperson to be named pre ident of the Mercy Ho p1tal Board of Director has been announced by lts admini trator i ter ~heila Mane, R . . M. The new pre i­ dent is attorney Co urtl and La Vallee, a B law graduate and partner m the law firm of Moot, prague, Marcy, Landy, Fernbach and mythe. The ho pica! al o announced the opening of it new Ga ·trointc tinal Lab, a even ­ room uite with modern equipment . • (From Mercy Hosp1to rs "Merceven ts· neNSletter) �Reunion class es pledge $1 30,000 T hcclasse of 1931, 1936, 1941, 1951, 1956, 1961, 1966, 1971, and 1976 joined together this year to make the large t pledge in the hi tory of the B ch ol of Medicine. ver $130,000 wa pledged t the chool through the' B Foundation by the member of ten alumni cla se who met la t May for their reunion . One alumnu , Richard C. Batt, M.D., lass of 1936, a retired radiologi t who re ides in Glen Fall , . Y., donat d a valuable ollection of 12 x-ra y tube and 266 radiological j urnal published in the early 1900 . The tube include six tatic ele tricity tube u ed in elcctrothcrapeutics; a Pifford ga tube, pro­ duced about 1907; and two hot-cathode vacuum x-ray tubes of the type invented in 1913 by Dr. W.D. oolidgeand manufactured by General Electri o. "I have treasured the above items not only a gift from pioneer radiologi t or their wid w - buras ource of pirit, knowledge, creativity, and a type of thinking in our prcdece sors who e ientific carche for truth have helped me. ow I would like to hare these with other ," Batt aid. His contributions to B arc now hou ed in the new Health iencc Library. Batt pecialized in rhe field of radiology be au e of the influence of Dr. J.W. Baylis, the physician wh br ught him into thi world. Bayliss became a pioneer in radio! gy. Coincidentally, part of the tube collection Batt donated once belonged ro Bayli s. Batt, a Buffalo native, practiced radiology from I 940 ro 19 3, when he retired. Since 1946, he ha lived in Glens Fall . For ~ ur year before entering private practice, he wa chief of radiology at Glen Fall H spiral. He designed hi wn building, located at 2 Park Street, to accommodate hi practice in radiology. Batt began his collection - x-ray were fir t di covered in 1896 - because he was fa cinated with the people who preceded him. "I t ' edifying to ee what went on before us," Batt said. - W. Hunt • 19 31 First Row Seated (left to right): Virgil H. F. Boeck, Walter . Walls, Walter D. Westinghouse, Jame E. Long. Second Row Standing (le(, 10 right): Joseph C. Tedesco, Gustave A. Daluiso, Donald Donovan, Thomas S. Bumbalo, Robert A. Ullman . J9 J 6 First Row Seated (left to right): Donald Brundage, Hubbard K. Meyers, Martin A. Angelo, Eli A. Let1en, Thomas F. Houston, William F. Lipp, Marvin Amdur, Edward G. Eschner. Second Row ,anding (Left to right): Fred E. Gorman,John G. Ball,John T. angelosi, Harold F. Wherley, Vicwr L. PdLicano, Alexander}. Bellanca, Willard G. Fischer, Walter P. Ko/:,rucki, Alfred Chcrr:;, Bernard tell, Richard C. Bau, Jerom '). Glauber, Thomas C. McDonough. 1986 donations 10,allcd $31,337. BUFFAID [PHV$1¢1ANI 09/86 �32 We express our deep appreciation to this year's 1,251 dues-paying Medical Alumni. A special thank you to the nine reunion classes 1936, 1941, 1946, 1951, 1956, 1961, 1966, 1971, 1976 - who contributed a record $13Z,8ZO. l 3 to the Medical School. Your generosity has made a lasting benefit to your School! T hose who earn medical degrees from UB's Medical hool are not it only alumni. Every year approximately 200 physicians complete their re• sidencies from UB Medical chool affiliated program , thus represent• ing the "other" group of UB Medical School alumni. To reinforce thi fact, the UB Medical Alumni A sociation is recognizing graduates of UB's residency programs by formally e tablishing a new cla s of mem• ber hip: Associate Member. Further contributing to this rein­ forced emphasis i the fact that all free- tanding re idency programs in Buffalo will gradually be merged with the University y tern, as dictated by State policy. UB residency program graduates are encouraged to retain their ties with the Medical School and its eight a ociated teaching ho pital . Residency program alumni in­ tere ted in joining their alumni as ociation may contact it at (716) 631-2778. • 09 86 1941 First Row Seated (left to right); Pasquale A. Greco, Mary Henrich Botsford, Thaddeus Bugelski, George L. Eckherl, Elmer S. Graben, Roman). hubert. econd Row (Left to right): Donald W. Hall,Jack W. Herrmann, Allen A. Pierce , Phili1> B. W eis . Third Row (left to right): Russell . Kidder, Eug ene). Hanavan, Harold L. Kl einman. Fourth Row (left to right); Bradley Hull, Arnold Gross. ,Q86 dona tions totalled $7, 425. 1?16 First Row eated (left 10 right): Han-y E. Petting,John L. Smith, William P. Wal.sh, W. William Tornow, Annabel M. Irons, Edward F. Gudgel, orman omoff, Harold). Levy. Second Row landing (left to right): Edward A. Fial, Paul M. Walctak, Richard). Valone, harl es D. Bauer, ~yron E. Williams, Ross Imburgia, Eugene M. Marks, Amo). Piccoli. Third Row Standing (left lo right): Lawr ence H. Gold en, Carl). Im/)ellitier , Richard W. Munschauer, Herbert S. Pirson, Roland T. Pixley , Arthur G. Vogt, Stanley J. Cyran , harl es A. Joy. 19'36dona tions totalled $18, 443. BUFFAID s [ P " V I C I A N I �1951 First Row eated (left to right): Robert L. ecrist, Anthony C. Barone, Eugene V. Leslie, Dean John aughton, Allen L. Goldfarb, Th eodore L. Bash, August A. Bruno. econd Row landing (l eft to right): O.P.]ones, Donald L. Barone, Marvin]. Plcsko~v, Robert H. Burke,Jay B. Belsky, Adolph Smith, Gerard E. Schult:::, Carl R. Conrad, Milton Robinson, Wilson W. haw, Edward A. Penn, James V. LoVerde, Leonard . Dan:::ig, Ludwig R. Koukal. 1986 donations totalled 12,500. 1956 First Row eated (Left to right); Jack D. Grabow, Hugh F. 0' eil, John M. Hodson. econd Row eated (left to right): H erman R. Schoene,]ean G. Haar, Peter F. Gol'Tgen, Edmond] . Gicewiq, Richard R. Gacek, Joseph L. Kun.;. Third Row randing (left to right): Bernard H. Sklar , Paul . Ronca, Peter D'Arrigo , John D. Bartels, Robert E. Reisman, George]. Alker, Warren M. Swager,Joseph]. Darlak. Fourth Row (left to right): George H. Chri 1, Robert B. Corretore, Dennis P. H eimback, Datiid Ben-Asher, Anthony P. Santomauro, Carl . chueler. 1\)86donauons totalled $9,415. 1961 First Row Seated (left 10 right): Seymour Liberman, Edwin]. Manning, Frederick . Cieslak, Ronald H. Usiak, Carlo E. De antis, ylvia Rou si Kennedy, Michael Madianos, Datie B. Olim, Harold Brody. econd Row tanding (left to right): Geoffrey O. Carr,]ames R. Marke/Lo, Kevin E. Bove, orman E. Hornung,]. Anthony Brown, Henry F. Goller, Richard C. Hatch, Gerald V. chwart::;, David R. Fleisher, Eugene A. Cimino. ,Q86 dona11ons101alled , 2,925. 1966 First Rou , eated (Left to right): Robert M. Barone, Michael 1. Weintraub, Jared C. Barlow, John Rubenstein, Thomas W. Bradley, Louis}. Antonucci, anford H. chwarti. econd Row landing (Left 10 right):]ohn E. poor,James]. Cuffe, Melvyn B. Lewis, Edwin H.Jenis, Jeffrey L. Kahler, William G. Gross, Kenn eth Klemenlowski, Ross L. Guarino, Virginia Rubenstein, William L. Sperling, Ross E. McRonald, Wayne P. Fricke, Charles]. Smith 19 6 dona11orutotalled $8,, oo. 1971 First Row Seated (Left 10 right): Scott D. Kirsch, David M. Rowland, Michael Baron,John M. Antkowiak, igmund S. Gould. e_ond Row tanding (left to right): tanley B. Lewin, James]. McCoy, ll1~ J. Weinrieb, Douglas S. Richardson, Martin . Mango. 1o86 donauons lotalled $9,875. 1976 Fir t Row eated (left to right): Robert Rutkowski, Russell Besseue, hristinc Pritiitera, Carmen Metildi, Deborah Beiter, Robin L. Millcr. econd Row landing (left to right): Alan Burke, Leonard Metildi,]immy Macool, Adolfo Firpo, ALB. Benson 1()86donauoru 101al!ed $4,815. BUFFAID JPHV$1¢1ANI 09 / 86 �34 an Francisco, California A 0 C American Academy of Family Physician October I l, 19 5 Y our Medical Alumni A ciation, in it attempt to bring the As ocia­ tion to all its members, ha held receptions in conjunction with national medical meetings, in various cities throughout the country. The r ceptions have pro­ vided Alumni with the opportunity of meeting with old and new friends, seeing and hearing about the many changes that are taking pla e at the Medical chool; how the ity ha begun to develop its 09 6 waterfront and revitalize the downt wn area with new and rehabilitated building and a light rail transit that will run from downtown to the University. Tho who have attended the recep­ tions have enjoyed themselves. Won't you join us when a future reception is held at a nati nal meeting that you would be attending or one held in your city? BUFFAID [PttvJ 1 ¢ 1 ANI "" �35 AAMc Octoht!r 29, 19 4 hicago, Illinois r * American ollcgc of ' urgeon October 16, 1985 Chicago, Illinois 10 o ogica l ollegc of arch 10, Atlanta, Georgia * American College of urgeon October 22, 19 6 ew Orleans, Loui iana Co-hosiedlry Dcp' t ' urgcry BUFFAID s•c c> H v 1 ,.. N 1 09 1 ��37 ot acobsen This seniorpediatrician exhibitsyouthfulnesswell into his geriatricyears This i the last in a erie f profiles of nine UB enior phy te1an . They r present only a ampling of individual who, after leaving a legacy in their fir t seven decade , decided to remain active contributor to ociety long after other would have withdrawn. Together, they helped to create new institutions or bring them to national prominence; change the face of medicine through their pioneering di coveries; and attract renowned figure and tens of millions of dollar to their in titutions. They live their Ion and fruitful live as models for their y unger peer to emulate. Unquestionably one of the finest examples to emulate, the spirited and portful A. Wilmot Jacob en i ne of th e rare people who publi hed hi phil ophy for healthy living into the advanced years - and then actually followed ic. I t eem only fitting that a phy ician who has treated three generation of patient in their pediatric years should exhibit o much youthfulne long into hi own "geriat­ ric" year . In fact, A . Wilmot Jacob en, M.D ., , rivals many of the children he see With hi agility, rapid gait, enthu ia m, and the parkle in his eye. He exemplifie the quote by Harry Erner on Fosdick, "It i magnificent to grow old if one keep young ." When he i not eeing patients ("now cut way down to 50 a week"), Dr. Jacob en' Physical and intellectual activity covers the gamut from competitive ports to writing, re earch, art , gardening, and traveling. With time taking it toll on other , he remark about hi active schedule, "my older colleagues are dropping out, and are being replaced by Younger people." On UB' medical faculty since 1927, the erneritu professor of pediatrics ha lived and Practiced at 187 Bryant St. for half a century. Jacob en' wife, Evelyn Heath Jae b en, is two year hi elder and a UB alumna and BY BRUCE S. KER H ER fell w pediatrician. Their private home rand adjacent to Children's Ho pita I, the in titution who e pediatric department they helped to shape. After completing his residency at Johns Hopkins Ho pita!, A . Wilmot Jacobsen came to Buffalo' hildren's Hospital in I 926. There he contributed to the h pital' rise to nati nal prominence by organizing what turned out to be the area' first major out-patient pediatrics department. In a econd way, he helped u her in the new era of academic clinician that led to the h pita!' ri e under Dr. Mitchell Rubin, beginning in 1945. A told by Dr. Rubin, "You don't do these things alone. Dr. Dougla Arnold, who was then head of the Department of Pediatric at the BUFFALO (PHYS1¢1ANj Children' Hospital, and Dr. William Orr who was professor of pediatric in the De~ partment at the Medical School, b th gave up their po ition when I came and the two position were combined into one position for me. Dr. A. Wilmot Jacob en resigned his po ition as head of the Out-Patient Depart­ ment. I would ay the trio of them were tremend u ly upportive f what we were trying to do . We could not have developed the Department f Pediatrics without their upport and their willingne to give up their po itions" (from an interview by Dr . Ronald Batt in Buffalo Physician, December 19 3 ). Ever ince he arrived at Children' , Dr. Jacob en has been there throughout every new development, contributing to it growth and nurturing. Besides Jacob en' integral role in the rise of hildren's Hospital, he is re p n ible for veral clinical achievements . In 1935, he wa the fir t to recognize and de ribe a number of diver e yndrome a really belonging to one entity which he called hereditary o te hon­ drody trophy. The disease wa ub equently named Jacob en' disea e in hi h nor by the late Dr. Robin Bannerman. Jacob en had the di tinction of having a second di ea e named after him, at lea t for a while, when he reported the fir t ca es of cat scratch fever in the area . He ha had a lifelong intere t in writing, especially in the areas of general and medi al hi tory. Hi fir t publication, a 114-page hi tory of hi World War I army artillery unit, pre-date the be inning of his medical career by five year . He ha uncovered a number f fa cinating medical subjects since then. In a 1961 journal of europsychiatry, he reported the fir t his­ torical case of the benefit of convul ive h k therapy . He dis overed the case in the 09 �38 diary of a missionary wife on Hawaii in 1850 where he de cribed how she inadvertently took strychnine instead of quinine. he sur­ vived the severe convulsions only to realize afterward that she had suddenly topped suffering from what would be considered today a p ychiatric disorder . The pediatrician is best known in recent years for his medical analysis of the assassina­ tion and treatment of President McKinley in 1902 during his visit to Buffalo (see Buffalo Physician,September 19 4 ). Hi controversial conclusions have been discussed before medical societies, and have appeared in the LosAngeles Times, Chicago Tribune, and elsewhere. Another one of his major hobbies is tennis, which he still plays competitively three times a week. A tenni enthu iast for 77 years, he was described in a local magazine article" Age is a State of Mind For The Tennis Vct" when he wa about 0: "Jacobsen moves agilely from side to side while awaiting the chance to lap home a forehand winner. Good-naturedly likened by the group to the 'Roadrunner' canoon character in view of his slight physique and quickness of foot, this remarkable man still possesses a flat forehand unrivaled by most. " Among his other active hobbies are photo­ graphy (he won hi latest award last year), painting ("l have dozens"), and gardening (highlighted by his fern collection of 25 species). Hi worldwide travels have slowed a bit in recent years, but not before he compiled several lifetimes of tales and adventures . One of his most memorable wa a 1958 voyage that turned out to be the first expedition by tourists to Mexico's "Lost Canyon of the Conquistadors," formally known in English as Copper Canyon. Still not found in tourist literature, the unexplored abyss is deeper than the Grand Canyon by 2,000 feet. Despite the tropical erring of cactus, waterfalls, and orchids, "at the summit," his account goes, "we slept in a pup tent that was buried in five feet of snow overnight." During the expedition, Jacobsen received his mo t unusual payment for medical services. One day he wa approached by a primitively­ dressed Tarahumara Indian man who had abdominal pain. He examined the man and, 09/ 86 fearing appendicitis, advised him to get to the nearest hospital (250 miles away). The grateful man paid his thanks in what he considered the mot meaningful way. He presented Or.Jacob­ sen with a memento of his ancestors - a pre-Columbian, tone-age pounding axe. The sense of both wilderness and history of the forgotten Copper Canyon is summed up in one experience. "Riding mules down pre­ carious cliff-edge trails, we arrived upon an ancient pani h church at the bottom of the canyon. It was an odd sensation," Jacobsen relates, "to realize that it was con tructed in 1530, and we were the first white people to visit it in perhaps two centuries." His medical expertise came in handy during another expedition, this time a 1983 vi it to the Canadian Rockies . En route by horseback to snow-capped Mt. Assiniboine, he and his party arrived at their cabins to find a group bearing tretchers with the limp bodies of two young women. Unconscious, in severe shock and po ibly with spinal injury, the women had been in a bush plane accident. After administering first aid, Jacobsen and his wife reported the incident over a ham radio, only to be told that their remoteness would make plane rescue very difficult. While theJacobsens were waiting for further word, four young women suddenly arrived in mountain-climbing tog , announcing that they had heard of the accident over their radio. "We're trained nurses ...and wonder if we can help." After a night of hard work caring for the patients, the medical care providers saw to it that the two injured women were carefully loaded into the rescue plane that had managed to land on the tiny alpine lake. The last remaining problem was that the pilot was afraid he could not make it over the surround­ ing mountain walls in the thin air. "l feared we'd have to deal with a second era h . lt was a very tense moment," Jacobsen related. "Half­ way across the lake, the plane ro e into the air, then sank down to the water again .... Only seconds before the rocky horeline, it rose in a steep climb. Our spirits rose with it as it ...deared the hilltop .Just." He later published the account in a Canadian magazine. Jacobsen has clearly found the secret of enjoying life at 88. So what does he advi e his youngers? "Exercise, activity, the outdoor life BUFFAID jPHV$1¢,APtl - and keep a good ense of humor," he smiles . He clearly practice what he preaches, as his chedule of physical activity demon­ strates . A one might expect, he' already put down his philosophy on aging in a 1964 article "De enectute : A Pediatrician Take A Long Look" (excerpted in the accompanying article). He quickly recited what may be the supreme example of fitness. When he was exploring Mexico's Copper Canyon, he met an Indian runner (messenger) who could travel, virtually non-stop, for five days at a time, covering 500 miles! The runner was later discovered by a Mexican government agent interested in get­ ting him into a national racing competition . Upon being shown the beginning of a 26mile-long marathon crack, the lndian innocent­ ly asked the agent, "How many lap do you want me to run?" Born in Baltimore in 1 9 , Jacob en i descended from Danish ancestors who arrived here around 1800. He earned his bachelor's degree in three years, and then his M.D . in 1923 from Johns Hopkins. Be ides being an examiner for the American Board of Pediatrics, he served as president of the Erie County Board of Health and the Buffalo Academy of Medicine, among other positions. His wife Evelyn is the grandniece of Dr. Silas Hubbard (b. 1821 ), who played a role in the establishment of UB's Medical School, and she i the niece of Elbert Hubbard, the founder of Raycroft Village in East Aurora . After graduating from the UB Medical School in 1924, she saw all the pediatric patients who came to the Children's Aid Society through the outpatient department at Children's Hospital. She retired from practice in the 1970s. Evelyn Jacobsen, incidentally, has the interesting distinction of being one of the only persons still living to have known Frank Lloyd Wright, the famed architect. He was a dose friend of her family, with whom he tayed when in Buffalo, and was the builder of the home she grew up in. In addition to past honors and recognitions which both Jacobsen have received from UB and various societies, Children's Ho pita! in 1985 named their Out-Patient Department, the "Jacobsen-Heath Ambulatory Clinic" in �39 Przylucki heads Medical Alumni J the couple's honor. A. Wilmot Jacobsen's continuing ze t and enthusiasm are best summed up by hi own remarks. "My own reaction to the aging rocess is an optimistic one ... . Whatever old age holds in store for me, my guess is that it will not be boredom. There are too many books I haven't read, too many places I haven't seen, too many memories I haven't kept long enough." • To Live To Be 100 And Like It T hefoUowingareexcerp from A. Wilmot Jacobsen's essay on aging, "De Senectute: A Pediatrician Takes A Long Look" written at the "tende r" age of66 for Millard Fillmore H spiral Bulletin, Vol. II, 1964. "To Live To Be I 00 and Like It" is one of the subtitle in hi essay. "It has been said that old age is a state of mind." "I am forced to a simple conclusion:(about artammg longevity) (1) Eat less. (2) Take more exercise.( 3) Laugh." " I like the advice of the old fellow in Kansas ,vho «•asasked by reportershow he lived to be I oo. He said 'Just keep breathing,keep breathing.' " "Our aim shouldbe not so much to add yearsto life as to add life coyears." ''The dean of the FordhamSchoolof Medicine "]usticeOli<JeT Wendell Holmes,in his nineties scared as a f ac1 that 'People who laugh actually (once passed) a preuy girl and (turned) to his lwe longerthan thosewho don't laugh.' We might companion with the remark, 'Oh, to be se1-oenry (add), 'He who laughs, lasts.' " again!'" " I turn... to William Lyon Phelps, who wrote "We don't use our bodies enough - we let with manifest conviction 'To say that youth is them rust and that seems w be the f asr.estway to happier than maturityis like sayingthe view from age." the bottom of che rower is betterfrom rhe top. As "The human body can absorb a tremendous we ascend, the horizonis pushed away. Finallyas amount of abuse...yet a week in bed will enfeeble we reachchesummit, it is as if we hadthe world ac CVeri the strongestman." our feet.' • JI BUFFAID IPHV$1C1ANI o hn E. Pn:ylu cki, M.D. , was elected president of the UB Medical Alumni As ociation, which represents more than 4,000 UB alumni who practice medicine in 4 7 states, Puerto Rico, and other counrrie . Dr. Przylucki replaces Dr. hades Tanner (M'43), who erved as president for the 198519 6 year. Dr. Pn:ylucki, a clinical instructor in surgery at UB, is a past vice-president and treasurer of the Alumni Association. Before he earned his M.D. from the UB Medical chool in 1973, he received hi B. . from Georgetown Univer ity. He trained in surgery at Millard Fillmore Hospital, where he present! y serves as director of the Intensive Care Unit. He is a member of the Erie County Medical ociety, the ew York State Medical Society, and the American Board of Surgery, and is a Fellow of the American College of Surgeons. The other new alumni officer are the vice­ president, Franklin Zeplowitz, M.D.; and the treasurer, Paul H. Wierzbieniec, M. . After earning his undergraduate degree from UB, Dr. Zeplowitz graduated from UB' Medical School in 1958, when he was elected into the honor society Phi Beta Kappa. He is a member of the staffs of both Buffalo General and Children's hospitals. He is also an anending surgeon at Mercy Hosptial and Our Lady of Victory Hospital, where he served previously as Medical-Dental raff president. He is a Diplomate for the ational B ard of Medical Examiners as well as the Ame rican Board of Surgery, and is a Fellow of the American College of Surgeons. Zeplowitz is also past president of the Maimonides Medical Society. Dr. Wierzbieniec i a member of the American Board of Orthopaedic Surgeons and president of the Western New York Orthopaedic ociety. He is an assistant ancnding at Millard Fillmore Hospital, an associate anending at Buffalo General Ho pita! and is on the courtesy staffs of hildren' Ho pital and Erie County Medical enter. The UB clinical instructor in orthopaedic earned his B.S. from Rennselaer Polytechnic Institute and his M.D. from UB in 1974. • 09 / 86 �40 BGH symposium honors Dr. Schimert G eorge Schimert, M.D., who estab­ lished che Divi ion of Cardiac Surgery at the Buffalo General Hospital in 1960 and headed it for 23 years, was honored at a BGH-spon ored international medical sympo ium la t April. The event also com­ memorated the twenty-fifth anniversary of the Hospital's cardiac surgery program. Participating in scientific programs in the Hospital's newly opened Harlan J. Swift Auditorium were Buffalo General staff and visiting physicians, including world-acclaimed transplant surgeons C. Walton Lillehei, M.D., and orman E. Shumway, M.D. Schimert and humway, along with heart transplant pioneer Christiaan Barnard, M.O., trained in cardiac surgery under Dr. Lillehei at the University of Minnesota. the Asian mainland. ince his arrival as the first full-time director of the BGH open heart program, Schimert has led the ho pita! to the forefront in cardiac care. At the time of his arrival, Buffalo General, supported by the Hartford Foundation, was e tablishing its first-rate Cardiovascular Angiology Laboratory, which has provided strong support for Schimert's work over the years. The Hospital's cardiology team in 1960 consisted of Ivan Bunnel, M.O., and David Greene, M.D., both of whom have worked with Schimert throughout his career. Schimert is acclaimed for his pioneering use of the patch-graft technique and the use of the free internal mammary artery in bypass surgery. He is also credited with performing one of the earliest double valve ( 1963) and triple valve replacements ( 1964) with long­ term survival; determination of myocardial sodium-potas ium ratios ( 1966); being the first surgeon in Western ew York to correct a ventricular septa[ defect correction after an acute heart attack (I 966); ventriculoplasty ( 1967); the first replacement of the mitral valve backwards through the left ventricle ( 1972); the area's first coronary artery bypass surgery ( 1972); intra cavitary ventricular cooling ( 1975 ); and the first use of papaverin in cardioplegic solution ( 1982). Schimert was born in Hungary to a family line of physicians dating back 150 years. He obtained medical degrees from the Friedrich Wilhelm University, Germany, and the Paz. many Peter University, Hungary. Cardiac surgeon throughout the world, including many in Western New York, have trained under Schimert. He has been affiliated with the UB Medical School since 1960. As part of the BGH cardiac symposium, chirnert received the University's Profe or Emeritus Award in Cardiac urgery. The award was presented by Lewis Flint, M.D., chairman of the UB Department of Surgery. After interning at Tampa Municipal Hospital and serving his residency at Grady Memorial Hospital and the Emory University School of Medicine, Atlanta, Schimert went on to Min­ nesota. Working there with Shumway and Barnard, he developed hypothermia techniques and one of the earliest heart pumps. Also while working under Lillehei, Schimert was sent to Korea, where he established the eoul ational University Medical College and performed the fir t open heart operation on Also paying tribute to chirnert during ceremonies April 25, were humway; Buffalo General Ho pita! President William V. Kin­ nard, Jr., M.D.; and Bunnell. Thomas Z. Lajos, M.D., acting chief of cardiovascular surgery at BGH, and Schimert's wife Florence unveiled a portrait of chimert which will hang near the Cardiac Surgery offices upon completion of the hospital's building and renovation project. - Diane M. Zwirecki 09/ 86 • BUFFAID jPMvS1¢1ANj Norman Shumway speaks at BGH event I nternationally acclaimed heart surgeon orman E. Shumway, M.D., participated recent!yin a ymposium on cardiac surgery at the Buffalo General Hospital. Speaking at a scientific session as part of the 25th anniversary of the hospital' heart surgery program, Shumway di cussed "Heart and Heart Lung Transplantation." Shumway founded the heart transplant program at Stanford University, one of the world's most e teemed and experienced cen­ ters . Combined heart-lung tran plant tech­ niques pioneered by his Stanford urgical team have been equally successful. He is chairman of tanford's Department of Cardiovascular urgery. utlining the history of heart transplanta­ tion, Shumway noted worldwide intere t in this procedure which began with the first successful transplant performed by Christiaan Barnard, M.D., in December, 1967. humway provided follow-up statistics and data on patients who had heart transplants during the first 18 year of the tanford program. He reported that rehabilitation has been almost complete in the more than 200 patient who urvived for one year following surgery. With the introduction of the cardiac biopsy procedure, he noted, first-year survival rate following cardiac transplant increased ignificantly. Then, the introduction of cyclo porine heralded a new era; the present one-year survival rate is approximately 80 per cent, with two-thirds of all patients surviving for five year after surgery. �41 A of January, 19 6, 30 heart-lung tran • plant had been performed at tan ford, includ­ ing 29 tran plantations and one re-transplanta­ tion . humway cited difficulty in obtaining donor lungs as the reason fewer heart -lung than heart transplant are performed. Fourteen of tanford' 29 patients were alive and well several month following urgery, he aid . He noted that it i difficult to obtain total hemo tasi following thi urgery; there­ fore, mortality i hi h. He pre ented photograph of heart-lung tran plant patients two year after surgery, highlighting uch ucce torie as a Texa high chool ~ otball c ach and mathematic teacher . Reporting on current developments in heart­ lung transplantion, Shumway noted a new derivative of cyclo porine, cyclo porine G. nil being tudied, cyclo porine G may be le renal-toxic than its predece r . Re earcher are al o looking at new way to pre erve donor lung for tran plantation, he said. humway graduated from the Vanderbilt niver ity chool of Medicine and went on to re idency training at the niver ity of Minne ota. While at Minne ota, he began his prestigi us research career. His tudi in luded the u e of total body hypothermia for direct v1 ion intracardiac urgery, pro thetic graft for blo d ve el replacement, inve tigati n of coronary circulation and ventricular fibrilla ­ tion, and the de ign and development of an effective pump and oxygenator for open heart surgery . Shumway went on to Stanford in 1959 and began his studie on cardiac tran plantation. Beginning with experiment to perfect tech­ nical details, he proceeded to inve tigate and document the clinical, phy iological, and pathological event following orthotopic cardiac transplant with both h mografts and autograft . This information wa critical to ucce e achieved later with immuno up­ pre ed ho ts, a key tep before this treatment for end- tage heart disea e could be applied to • humans . -Diane M. Z,urecki Biophysicist featured in two encyclopedias T he re earch of B biophy ici t Frede­ rick achs, Ph.D., will have the unusual distinction of being featured in the science yearbook of two major encyclopedias. The Encyclopedia Brittanica 's 19 6 1ence m the Fuwre will de cribe Dr. achs' di c very f what could be the fundamental mechani m of the sense of touch and pre ure perception. The associate professor fbiophy ical ciences found that a number of unrelated cell in animal and even plant have certain molecules that are sensitive to pressure, stretching, r touch. When timulated, an electrochemical re pon e is triggered which travel into the cell. BUFFAID JPHvS1C1ANI The World Book Encycl pcdia' 19 6 Science year Book will feature a different subject. It will de cribe Dr. ach ' unu ual invention, the world's smalle t thermometer. ailed the ultra-microthermometer, it is 50 time mailer than a human hair and its tip is almost invisible to the unaided eye. achs did not et out to break record , but developed the device a a means to an end . He de igned it to mea ure the temperature of individual cell or even part of cells. Compo cd of a h llow gla pipette filled with a metal alloy, it is tipped with a layer of gold. It is capable of mea uring temperature change as hort a 100 micro econd . The device i also under review for inclu ion in the Guinness Book of World Records. 09/ 86 ��43 DIFFERENTIAL DIAGNOSIS OF COMMON COMPLAINTS BY G YA. TAYLOR ((T hirty symptoms account for m re than 70 per cent f the chief complaints with which phy ician are confr nted; therefore, the phy ician who has ma tered the differential diagn i of the e ympt ms will be able t accurately diagno e nearly all the pr blem en in a typical medical practice." With chat a umption, B family phy ician and internist Robert H. lier, M.D., ha brought together year of experien c, with an excen ive literature review, to produce hi new bo k. Differential Diagnosis of Common m­ plaints( 19 6, W .B. aunders mpany, Phila­ delphia, PA, 35 pp.) i designed to aid phy reran in accurately diagno ing the m t common c mplaint . eller is a profe r in the B Medical hool' Department of Family Medicine and Medicine. Hi new book i unique in that 1r is the fir r that deal primarily with the differential diagno i of common complaint . He define differential diagno i a the determination of which of two or more di ea es with imiliar ymptom i the one from which the patient i suffering. "The purpose of chi book (which i the fir t of thi kind) i to help phy icians ac­ curately diagno e the mo t common complaint ," explain eller. The volume al ha the n tew rthy quality of being written in a conci e manner which make the ubject matter readily accessible to a broad pe trum of health profe ional . Hence, in addition to practt ing physician , re idents, and medical tudents, it i anticipated that nur c practi· troner as well as phy ician a i rants will al o find the book u eful. In fact, although not expre ly written for the general public, the text i free of superfluous detail that some laymen might find it both intere ting and informative. He tre es, however, that "thi book i n t to be utilized by the general public a a means f self diagn is or in the place of seeing a phy ician." ellcr's appr ach deviate harply from the traditional organization of literature dev red to di a cs. "Most medical school curricula, text , and continuing education courses deal with BUFFAID (PHV$1¢1ANI 09 �E 44 diseases. Patient , however, usually come to their phy ician complaining of headache, backache, or fatigue - not migraine, spinal stenosis, or depression.To address this reality, this book i organized around common presenting complaints, the patient ' ymptom rather than their diseases," a rts lier. Each of the book's 31 chapter c n iders a different symptom. The chapters, according to eller, are organized c approximate the problem-solving proce chat mo t physicians use to make a diagno is. "Initially, the presenting ymptom uggests several diagnostic po ibilities. Then this diagnostic list is further defined and reduced by additional, more pedfic, historical findings; by the patient' phy ical findings; and then by the results of diagno tic tudie ," explains Seller. In the introduction to each chapter, Seller provide relevant definition a well as a list of the most common causes of the con idered symptom. In the introduction to the chapter "Backache," for example, he gives the eight mo t comm n causes of back pain and notes that of them, acute Jumbo acral strain is the most common, accounting for 80 per cent of the cases. Or. Seller provides interesting account of the medical history of some of the symptom described . In the chapter, "Belching, Bloating, and Flatulence," he writes, "The problem of bloating and flatulence has been recognized ince the time of Hippocrates, who taught that pa ing ga is necessary to well being." Seller continues, "In the days of early Rome, it was noted that all Roman citizen shall be allowed to pass gas whenever necessary." For each symptom Seller also considers the nature of the patient; that is, he identifies those conditions which are mo t prevalent within particular patient subgrou . uch ubgroups can include adults, children, the elderly, the premenopausal, the diabetic and the hyper­ tensive. In the chapter, "Fatigue," S Iler explains that the symptom of fatigue can often be attributed to depre ion and, in turn, the symptoms of depre i n vary with, among other thing , socioeconomic status. "Depressed middle class patients will state that they feel sad or blue, guilty, helpless, 09/ 86 lonely or anxiou . They may complain of crying spells, initial insomnia, early waking, lo of appetite, headache and decreased libido. Patient of upper ocioeconomic clas more often complain of fatigue, insomnia, anxiety and cen ion, dis atisfaction and decrea ed interest in work or social life," writes Seller. In the chapter that discu s bloating and flatulence, eller explains," A patient, particu­ larly of African or Mediterranean descent, complaining of exce bloating or flatulence may have malabsorption and subsequent fermentation due to an inherited lacto e intolerance." ''Dr. Sellerprovides interestingaccounts of medical history: In the early days of Rome, it was noted that all Roman citizens shall be allowed to pass gas whenevernecessary.'' Each chapter has a section, " ature of the Symptom," which further identifie the additional characteristics of the symptom (how, when, where, acute/ chronic, duration) . ln the chapter, "Headache," he describes how the type, severity, and location of pain are important in the differentiation of the cause of headache . "Tension or muscle contraction headaches usually are dull, not throbbing, steady, and of low, but persistent, intensity. In contrast, the pain of a migraine headache is severe, initially throbbing, and later penetrating. Acute sinus headache pain is usually described a severe, throbbing and pressure-like." BUFFAlD jfl'HV$1¢1ANj Furthermore, each chapter i divided into additional sections discussing such topi as as ociated symptoms, precipitating and aggravating factor , ameliorating factor , physical finding , diagnostic tudies, and less common diagnostic considerations. At the end of each chapter Seller includes a convenient summary table. These tables um­ marize the prominent differential diagno tic features of the most common diseases that cau e a particular symptom . Moreover , che book' thorou h index facilitates i use as a reference text by a health profe ional, who i pre enced with a patient afflicted by a pecific ymptom, when diagn i i not immediately apparent. Dr. eller expects that Differential Diagnosis of Common Complainrswill be useful in aiding health profe ional in arriving at a diagno i as rapidly as pos ible. eller advises all phy ician , residents, and medical tuden to remember the adage, "If you don't think about it you will never diagnose it." Dr. Seller, a University of Pennsylvania medical graduate, has served on B' faculty ince 1974. During his first eight year at UB, he served as chairman of the Department of Family Medicine. His office i based in Buffalo General's Family Medicine Center at Deacon Divi ion. The Philadelphia native was a research fellow of the American Heart Association (S.E. Pennsylvania Chapter) at Philadelphia General H pita! and completed his r idency at Albert Einstein Medical enter. He was on the faculty at Hahnemann Medical Hege and Hospital, Philadelphia, for 14 year before coming to Buffalo. Seller's research has focused on hypertension and conge tive heart failure. He i the author of eight book chapters and 73 journal article and is author or editor of two other books. He i certified by the American Board of Internal Medicine and the American Board of Family Practice, and is a Fellow of the American College of Physicians, American liege of Cardiology, and American Academy of Family Phy icians. •· (Mr. Taylor, a UB pre-med tudent, is enrolled in the Medical chool's Early Assurance Program.) �cardiologist al o recently de cribed angiotension­ convertmg enzyme inhibition, a new therapy for hypertension and conge rive heart failure, in PostgraduateMedicine, October 1985. In May 1985, he pub!i hed a comprehensive clinical review of standard oral antiarrythmic agent m CardiovascularRevieu·s and Rcporu. He practices at Wa hingron (D .. ) Adventi t Ho pita!. Lance Fogan (M'65) • became president of the Los Angeles Society of Neurology and Psy­ chiatry. His late t publication is on treatment of du ter headache, April 1985, in Arch111es of Neurology. Th omas P. O'Connor (M'67} • who pecializes in radiation therapy in lndianapoli , recently published a chapter on lung cancer radiation therapy in Lung Cancer, published by Springer-Ver lag. Ro bert Di Bianco (M'72) • announces the birth of his second on, John Michael, last Sep­ tember. Bianco is a clinical a oc1ate professor of medicine at Georgetown University. The John E. Billi (M'77) • writes that he has been appointed medical dirL'Ct r of the University of Michigan Medical Center' Alternate Delivery System and HM . "My wife beryl Hirsch (M'77) i enjoying private prac­ tice pediatrics. We have a two­ year-old on and a five-month­ old daughter." Brian Kaufman (M'77) • pre ented a paper "Effect of Albumin V . Cryscallo1d On Hemodynamics and xygen Tran port in Intensive Care Patients" at an International Workshop of Albumin And The ystem1c Circulation held at Grinde!wald, witzerland. ------------------------------------------------------------------NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITEDSTATES BUSINESS REPLYMAIL FIRSTCLASS PERMITNO 2210 BUFF ALO.NY POSTAGEWILL BEPAID BYADDRESSEE BUFFAID P H V S C I A N 139 Cary Hall State University of New York at Buffalo Buffalo, New York 14214-9980 1..,11.1 ..1I,1,111,11,1 ..11II111,1 .. 1,II,ll11111 I,II �P H Y S on -Profit Org . .S. Postage PAID Buffalo , .Y. Permit o . 311 A N C State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 Address Correction Requested ---------------------7---Lif-USHWFROM-vou--7-----Flll out this card (Please print or type all entries) Name ___________________________ M.o.__ Ph.D.__ Year Received ___ _ Office Address Home Address ----------------------------------------If not UB, M.D. or Ph.D. received from In Private Practice: Yes In Academic Medicine: Yes Specia lty No No Part Time Full Time School __________________ _ Title Other: Professional Society Memberships ---------------------------------- News: Have you changed positions, published , been involved in civic activities, had honors bestowed , etc? _______ Please send curriculum vitae , clippings, publications, or announcements, also include a p hoto of yourself. _ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, September 1986 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1986-September Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1986-v20n03-Sept Table Of Contents A list of subunits of the resource. Social & Preventive Medicine $4 Million Cancer Study A Search for Questions Transplantation Specialist Job Lewis Smith Teaching Effectiveness Medical School News Hospital News Alumni People Books Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-27 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v20n03 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1986 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/b10a35c87c76c8086920bfcf413b427c.pdf fd86c801579df55cb64e26810e02f265 PDF Text Text I p H y s C A VOLUME20, NUMBER2 N I JULY 1986 A legendin Chinesemedicine I �BUFFAID !PHYSICIAN! Dean's Me sage TAFF EXE TIVE EDITOR, U !VER ITY PURLICA TIO 'S Rohen T . M.ir\1:tt A . S .IATE EDITOR Rru " . Ker hm:r ART [)JREl.1( R Alan) Kq:ler PHOHX,RAPllY Phyllis ChrM, ,phcr Ken Weig,, EJ , 't,w,,k hanc1 pt:,~er ADVJ 'ORY BOARD I r. J,,hn , .1ugh111n , 11~,m St h,",/"' Mt-../,cm, M .• ~nq (,I,., n Mr. Kevin Cr,11 g M,. ~farm1e:Houch.:m Or. Charle Tinn r Dr. J,1hn F, her M, '.ircn l ryJa Mr. John Pull, [ r. h.,rlc Paganelli Dr. Jame ·.m,k1 Dr. H.nolJ Rnxh· Dr. John Wngh1 Dr. Roi-en - he,g Dr M,11:1!1<: Wni:hr Dr. M.u, V,,.,rh,..,, Mr. 'tcvc h1v1mk\ M, . M,m,in Mari11now,k1 Mr. \,,·inJcr Rh.111,1 Dr. Jame W,IJ TEA HI G HO PITAL liener 1\ The Buff.1111 Ch,IJr-,n\ Erie Count\ McJic,11Center Merq Mill.uJ F1llmon: Roswell Park Memorial ln,tuute Mer- ol Ch.m11· Verernn, AJminisrrat1on McdKal Center PmJuced b• rhe Dms1Pn of f'ubl" R. ],, hon, Jir<>cror, m a. ><>c1,wonw,rh che Schnol of ,\1ed1cme, rilte Univers1rr of New Affair • Ham York at Buffalo . THE BUFFALO PHYSICIA (USPS 55 l.a60)July 1966-Volume 20. umbC'r 2. Published five nmes annually: Ft.bruary, by the May.July, Sep,ember, D«=berSchool of Mcd,cmt., State Univm;1ty of New York at Buffa.lo, 34 35 Mam Srrttt, Buffalo,New York 14214. Tlurdclassbullc ~ paid•t Buffalo, ew York. POST­ MASTER: Send addresschanges10 THE BUFFALO PHYSICIAN, 139 Cary Hall, 3435 Main Street, Buffalo, cw York 14214 D ear Friends of the School of Medicine: The contributions of four faculty members were recognized at the Annual Faculty Meeting on May 28, 1 986. Dr . Marvin L. Bloom, clinical profe or of medicine, joined with me in formally announcing the establishment of the Dr. Harry G. Laforge Convocation Center. Thi multifaceted educational unit will be constructed as a part of the next pha e of construction and renovation on the Main treet Campus, and it will be u ed in large part for continuing medical education. Dr. Bloom, together with Harry Laforge and four other Buffalo phy icians, were major leaders in organizing the Annual Participating Fund for Medical Education (APFME) which raised funds to support the School of Medicine. Dr. La Forge was instrumental in attracting the Hochstetter Endowment to the School of Medicine, and is still an active member of the faculty . The planned convocation center should be completed in early 1989. The Dean's Award went to two faculty members whose contribu ­ tions to the School of Medicine are legendary. Dr . Eugene Mindell has led the Orthopedic Department for twenty-two years. During that time , he has established a nationally compeative residency training program and has recruited an outstanding faculty . In addition, he has become an Associate Editor of The Journalof Boneand]oinc urgeryand was appointed to the Residency Review Committee. Dr. Richard Ament has contributed significantly to the growth of the Department of Anesthesiology, and has been responsible for the development of a strong program in the residency training of Anesthesiologists . These two individuals have helped move the chool forward through their contributions and we are pleased to acknowledge their efforts with this evidence of gratitude from the faculty and school. The prestigious Stockton Kimball Award for academic excellence and achievement was given to Dr . Alastair Brownie, professor and chairman of biochemistry . He was recognized for his research contributions in the areas of hypertension and steroid metabolism, for his dedication to teaching and for his contribution to the life of the school. The School of Medicine is indeed fortunate to have many dedicated and contributing faculty embodied in the spirit of these four gentlemen. We thank them for their contributions on the School's behalf and look forward to next year's awards ceremony. Since,-ely, John aughron, M.D. Vice Presuknt fOT Clinical Affairs Dean, School of Medicine �BUFE P H Y S C A N CONTENTS A MAD FORM OF ART• Psychiatrist Stuart L. Keill and Music Professor Muriel Hebert Wolf have joined forces to explore the role psychopathology plays in the cherished Western art form known as opera. MEDICAL MINIATURES• Dr. Philip Wels of the Department of Surgery has a unique collection of 280 figurines of physicians. «<Everybody has a couple of them," he says, "but not this many." HE MADE HISTORY• Dr. George Hatem, one of the most famous physicians in modern history, was keynote speaker at the 49th Spring Clinical Day. In China, he reports, they pay the doctor when they're well, and stop paying him when they're sick. SENIOR PHY ICIA S PEOPLE• • 5 Dr. Maxwell Lockie is both 83 and a leading arthritis authority. Dr. Vivian Cody has climbed Mt. Fuji in sneakers, toasted moun­ tain dieties with Andean natives, and contributed worldwide to crystal­ lography. Dr. Norma Panahon 's parents are leaders in the new Philip­ pine administration. Other news of people you know. BUFF AW SURGICAL SOCIETY• I I Dr . Marvin Z. Kurian traces its origins. CHRO IC PAI , 0 TEOPOROSIS &. AID • 16 Spring Clinical lectures focus on a trio of diseases. 18 HOSPITALS • 26 ECMC's Head lnjury Unit serves all of WNY. Children's will manage School 84. STUDE TS• 29 RESEARCH • 31 Two VB pediatricians re­ port breakthrough in treat­ ing respiratory failure in premature infants. CLASS OTES • 34 DEATHS•34 �2 Opera is a repository for numerous aberrations BY ANN WHITCHER t tT here will be six murders, five suicides, and one execution - and that's before we even have intermission," Dr. Stuart L. Keill, UB clinical professor of psychiatry, announced early in a lecture to an audience of opera buffs. He and UB Professor of Music Muriel Hebert Wolf have joined forces to explore the role psychopathology plays in the cherished W estem art form known as opera. The pair regularly give lecture recitals and have participated in a "Night of Opera and Madness" in New York as part of an American Psychiatric Association meeting. Dr. Keill says opera can give important clues to the nature of clinical psychiatry. Verdi's Lady Macbeth in Mac.beth, for instance, is "a veritable textbook of psychopathology: delusions, hand-washing compulsion, sleep walking and suicidal behavior." 07/ 86 Wolf, an experienced opera producer and scholar, says she met Keill, an opera buff of 37 years standing, socially. The "Verdi's 'Lady Macbeth' is a textbook of psychopathology of hand--washing compulsions,delusions, sleepwalking, and suicidalbehavior." idea of arranging "psychopera" programs soon emerged. Wolf explains that opera, to start with, is "a mad form of art," an BUFFAID j PMvS1¢1 AN j "enlargement of life," and "irrational entertainment." Moreover, since opera's beginnings, there have been a plethora of mad scenes. Those of the 17th and 18th centuries, however, "were more dramatic than psychological." Because of this, modern stage directors "often must employ visual means to render this earlier madness more believable," says Wolf. "During the glorious age of bel canto (beautiful singing) in the 18th and early 19th centuries," Wolf and Keill note in a paper presented before the American Psychiatric Association, "madness influenced musical form and language particularly the singer's - more than the drama, which often lacked convincing motivational forces." Among the best known examples of this musical age were the works of Donizetti. His Lucia di Lammermoor contains probably the most famous "mad �BUFFALO IPH Y$ t¢1 AN j 07/ 86 �4 scene" in all opera. "At least a third of Donizetti's 70 stage works," notes New York Times music critic Donal Henahan, "provide scenes of hysteria, delirium, melancholia, suicides, and murderu works which drew curious audiences to the 'theatre of the mad' in much the same way as modern audiences go to be thrilled at horror movies." Psychological approaches to opera have changed with the times, however. Writes the UB team: "Later in the 19th century under the influence of Freud, there was an intensification of emotional/ dramatic weight in proportion to the larger canvas of grand opera created by orchestrally­ conscious composers and conductors." And by the 20th century, psychological and social themes actually proliferated, thus requiring new, more psychologically subtle, approaches to the "inner nature of opera." Wolf adds that psychological probing can enhance operatic inter­ pretations, too often ultra-stylized or plagued with unconvincing gestures. "lf one can analyze a character's illness in great detail, it can be a tremendous aid for the performer," she says. Opera is a repository for numerous mental aberrations brought on by jealousy and a wide range of other mental states commonly displayed in the opera house as shown at one lecture/recital presented by Keill and Wolf. At that performance, they enjoyed and then commented on a duet from Bellini's I Capulettie I Monrecchi, based on Shakespeare's RomeoandJuliet. The tale of the doomed teenage lovers could have come from the pages of metropolitan American newspapers, with their all-too-frequent reports of adoles­ cent suicide, Keill explained. In Bellini's Il Pirata,excerpts from which were also performed here, Imogene goes mad with grief when her beloved is condemned to death. I n Hamlet, an 1869opera by the French composer Ambroise Thomas and based on Shakespeare's play, Ophelia "goes through four mood stages," says Keil!. She grows progressive! y more demented, yet thrills audiences with the brilliance of her coloratura part. 07/ 86 In Verdi's great Ote!lo, based on Shakespeare's Othello, "the logical and persistent growth of Othello's psychotic jealousy as reinforced by Verdi's violent and passionate music, makes Othello more human as a character and more credible as a victim mentally incapacitated by Iago's manipulations," Keill and Wolf point out, quoting the Verdi biographer Francis Toye. Some characters, Keill states, show evidence of various "organic syndromes." For example, Violetta in Verdi's La Traviata, a beautiful courtesan who finds love too large, "has a terminal tuber­ culosis, and, likely, organic brain damage leading to her delirium shortly before her death." Floristan in Fidelio, Beethoven's only opera, "also has what appears to be an organic delirium due to sensory deprivation and starvation. Fortunately some human contact, candlelight, and a loaf of bread promptly cured him." In the case of the revengeful woman, Azucena, in Verdi's ll Trovatore, her hallucinations and madness may have been caused by "a stroke or a chronic nervous system infection." She may even have taken "a mescaline-like medication." So there's more to this character, usually played "as a crazy lady with a fright wig," than her voice, said Keill, during a recent lecture/recital. "She may not have been mad, but (only) toX"ic.'' The psychopathology depicted is more accurate, though not necessarily more complex, with the opera of this century, Keill and Wolf state. 1n Shostakovich's Lady Macbeth of Muensk, the composer conceived of Katerina "not as a lost human being, but as one tormented by conscience; she thinks about the people she killed." Paul Hindemith's 1926 German opera, Cardillac, is an arresting work about a respected though isolated, gifted but psychotic goldsmith whose creations drive him to murder his customers in order to repossess their purchases . Cardillac can be read as a powerful statement on the artist's frequend y precarious situation in modern life. But it doesn't rule out a psycho­ analytic interpretation. Said Keill during one lecture/recital: "In the early days of BUFFAID jPHvS1C1,1, N j the psychoanalytic movement, (Cardillac's character) would have been termed the sad outcome of an unpleasant resolution of the toilet training period; he never learned to unleash his constipation." Here was a real misanthrope, Keill ex­ plained, who could only aim his affection, "in an almost sensual way," at things he owned, namely his jewels. Cardillac is a loner, in the most staggering sense. Adds Keill: "These kinds of people rarely do well in psychotherapy." Wolf and Keill believe that opera may create a forum for debating issues connected with the insanity defense. This is because of its increasingly sophisticated, psychologically deft stage techniques, and the more psychologically probing contemporary libretti, as well as a better psychological understanding of establish­ ed older works. It's their contention that opera, with its unique blend of stage and orchestra, music and drama, voice and bodily comportment, may help the layman understand the development or unraveling - of madness, or psycho­ logical disorder. "Many an audience has been won over in an operatic insanity plea by psychotic vocal pyrotechnics and histrionic gestures, thus creating pathos for the protagonist or demonstrating humanitarian qualities of an unsympathetic or perhaps guilty character," they write. "Insanity has provided an artistic and aesthetic rationale for the murders of children and other innocent victims. It has lent credibility to the irrational behavior of those 'madly in love.' Through the hallucinations ( of the operatic characters), the audience has not only obtained invaluable information about past and future lives, witnessed the precarious passions of potions, and shared misuses of power - supernatural and demonic - but has vicariously observed or experienced the sufferings of organic disorientation." • (Dr, Kelli. ofter six yeas at US,wlll be shcring his unusual Interest with new OJdiences ln Baltimore. where he hos Just taken a position with the University of Mor;land) �5 At 83, he's still an active arthritis authority The following profile is the third in a series that portrays a number of unique individuals who fall into that category some refer to as "senior physicians." They were selected for their habit of achieve­ ments and contributions to society that began when they were young and still con­ tinue unabated into what others call the ((retirement years." This issue acknowledges one more such individual, the diverse, dis­ tinguished, and dedicated Maxwell Lockie. BUFFALO I P HY SICI AN ) 07/ 86 �6 BY BRUCE S. KERSHNER ((This year I hit harder and straighter than I've ever done in my 68 years of playing golf." Because golf is a sport that can sorely test one's joints, this is a fitting statement for Maxwell Lockie, M.D., who is both 83 and also one of America's foremost arthritis authorities. Dr. Lockie, UB emeritus professor of medicine, has been on the American scene since the early 1930s carrying out pioneering research in over 80 kinds of arthritis conditions and gout. One of the first five designated arthritis specialists in the U.S., he shaped his field with early discoveries and advances in the treat­ ment of arthritis with Indocin and phenyl­ butasone, in the role of diet in gout, in treatment of gold salt toxicity, and in diagnosis of arthritis using special bone joints as indicators. He left other marks on his field by founding two professional societies (The Medical Society of the U.S. and Mexico and the Inter-Urban Arthritis Society) and training 28 rheumatologists. And he is probably one of few such specialists around who can claim to have examined 28,450 arthritis patients ( and to have kept an accurate count of all of them). Dr. Lockie officially retired from his active practice of 52 years in 1985, at his wife's insistence. But like the other senior physicians profiled in this series (Buffalo Physician, December 1985 and May 1986), his retirement is more accurately a shifting of attentions. "I'm stilJ doing research, with my most recent journal article published in 1985. My 140th publication is now in preparation," exclaims Dr. Lockie. He devotes three hours a day to his research with Merck, Sharp and Dohme on the tolerance of steroidal anti­ inflammatory drugs. Lockie has been one of Merck's principal investigators since 1938. He was the first to study Lndocin in the U.S. and among the earliest to use it in suppository form . He reads 40 medical journals a month, gives four professional lectures a year, and regularly gives opinions to and works with attorneys on malpractice suits. 07/ 86 F or recreation, he plays golf three times a week. "I'm par 5 holes and right down the middle in three in front of the green," Dr. Lockie says, proudly adding, "that's pretty good for a man of my age." He has served as president of the Country Club of Buffalo where he plays golf. While he still retains his outstanding stamp collection, he recently ended his hobby of many decades, the collecting of rare old books, when he donated the entire collection to UB's History of Medicine Collection ( see Buffalo Physician, May 1985). Until that generous donation, he had acquired what is believed to be one of the largest private collections of historical books on arthritis and gout. Totaling 174 volumes, the collection includes as its oldest book the 1701 Mysteries of Opium. Other old works include Cheyne's An Essayon Gout( 1721 ), Cadogon's Treatment of the Gout ( 1773), and Dover's Ancient Physician'sLegacy To His Country (1742). Among more recent works are Sir William Osier's first edition of Principles and Practice of Medicine, Austin Flint's 1873 volume by the same name, Oliver Wendell Holmes' 1883 Medical Essays,and Roswell Park's 1912 The Evil Eye Thanatology. Between golf games, research, and hobbies, Lockie enjoys dining out with his wife and friends, including classmate Dr. Harry Laforge (profiled in the De­ cember 1985 Buff a lo Physician). Serving on the Buffalo Club's art committee with Seymour Knox (a major UB supporter and arts benefactor) also demands some of his attention. D r. Lockie's career in medicine started when he was a soda jerk in his uncle's business, "Lockie's Drug Store," where he worked for eight years. During the Great Flu Epidemic of 1918, the drug store ran out of help and young Maxwell Lockie had to work 12 hours a day for six weeks. During that hectic time, several doctors who came in suggested he take up pharmacy as a career. Several years later in 1923, he earned his pharmacy degree from UB's School of Pharmacy ( where he met classmate Harry Laforge). While dispensing medicine as a new pharmacist , he againreceived advice from BUFFAlD I P H v $1¢ 1 AN j visiting doctors; this time they urged him to earn a medical degree. And that he did, receiving his M.D. from UB in 1929, ranking second highest in his class. "If it wasn't for pharmacy, I wouldn't be who I am today," he says. Like his friend Laforge, Dr. Lockie is a three-time UB alumnus, since he also earned his bachelor's in medicine in 1925. While in medical school, he also served as an assistant engineer for two summers, responsible for the painting and inventory of the Peace Bridge while it was under construction . As a resident at Buffalo General Hos­ pital, he decided to specialize in arthritis when he realized that little was being done for patients with that disease. Through his career, Dr. Lockie has met quite a few interesting people. In his early days, he met and later treated �7 the use of BAL to counteract the toxic effects of gold salt therapy for rheumatoid arthritis. He was one of the first to use special bone joints in the wrist and hands as indicators of rheumatoid arthritis. His discovery of the therapeutic limitations of phenybutasone (Buta zolidin) is now in standard use. He learned that the drug should be discontinued if it is not effective within a week. Partly as a result of his efforts, Buffalo became one of the world centers for use of gold to treat rheumatoid arthritis. To round out his list, he was the first to use IBM punch cards as a means of storing and retrieving data of patients with arthritis. Among his honors, he is the recipient of a number of special awards and honorary memberships, including many from foreign countries such as Mexico, Brazil and Switzerland. Dr. Lockie's sage advice to his fellow physicians includes many principles recommended by the other physicians profiled in this series. "All doctors should have other interests besides medicine, and you should not let :;:; your medical career compete with your family," he emphasizes. For optimizing ~ one's longevity, he feels strongly that one i!: should work hard, sleep well, and not 0 drink too often. "Adequate vacations are also an essential part of life," he relates, adding, "It also helps to have reliable associates to take over while you are gone." Furthermore, "l believe you should were Jack Winter, Germante Boncaldo, not go co bed with (unresolved) and Ray Partridge. His professional problems." friends include other UB notables, John In relating to others, he advises that Talbott (with whom he co-authored the "people should adopt the attitude that book Progressin Anhriris) and classmate everybody is human just like I am. One George Thorn ( with whom he did one of must be forgiving and not hold grudges." the first papers on cortisone in 1932 in He puts most of the credit for the JAMA). Dr. Janet Travell, President quality and longevity of his life, however, Kennedy's personal physician and the on his wife. "Most of all, make sure to first woman to attend a president, was marry a wonderful wife who is under­ another close Lockie friend. standing and encouraging but makes sure Dr. Lockie has been with UB's faculty you don't overdo." since 1932. Several years later, he became As for the progress made in his field, professor and chairman of the Department Lockie is satisfied. "When I first began, I of Therapeutics. In 1965, he was appoint­ felt I could help one out of ten patients; ed professor of medicine. now I can help nine out of ten." Even with all that progress, though, r. Lockie originated the diet treat­ ment for gout in 1935 by pre­ Lockie is optimistic about the future of cipitating an acute attack of gouty arthritis his field. "Rheumatology is still a wide using a high fat diet. He first described open field." • ! g i Buffalo businessman Harold Ruslander (also a close relative of Buffalo-born comedian Mark Russell). "He had a beautiful case of gout!" Lockie smiles. Dr. Lockie completed his residency at Johns Hopkins. There he met and worked with Maxwell Wintrobe, who popularized the blood sedimentation rate in the U.S. (Lockie introduced it to Buffalo in 1932 ). He also met Dr. Russell Cecil, who wrote the standard textbook on medicine, the predecessor to Harrison's Principles. They later became close friends. He had an encounter of a different sort with one of the greatest medical lumin­ aries. "As a resident at Johns Hopkins Hospital, I lived in Osier's room. People would regularly come up and open my door to see where he lived," Dr. Lockie recalls. Among his notable medical students D BUFFAID IPHY$t¢1A N I 07/ 86 �MEDICAL Dr. W els has collected 280 figurines of physicians BY CONNIE OSW ALO STOFKO ((Look at the expression on his face," said Or . Philip B. Wels , clinical professor of surgery, as he gazed at a small Italian statuette depicting an autopsy . The dead man, surrounded by his bowels, heart, Rosary, and prayer book, looks rather surprised and horrified as the figure of the doctor performs the procedure. A favorite of Dr. W els because of the detail involved, the handmade piece is one of 280 figurines of physicians in his extensive collection. And like most of the other pieces, the work is somewhat whimsical. "Most of them have some sort of humor attached to them," Weis said. "They're sort of a satire on physicians." The items range from two feet tall to less than an inch high and come in wood, metal, ceramic, stone, and cloth. Wels, with the help of family and friends, has been collecting the figures since 1958 from all over the world, including England, Germany, Austria, Czecho­ slovakia, Italy, Greece, Spain, Portugal, Peru, Japan, Taiwan, and China. Now he has donated the entire col­ lection through the University at Buffalo Foundation, Inc . It will be displayed for the first time in the Medical School this summer. 07/ 86 Why would Weis part with such an interesting collection? "That's a good question," he replied in his unassuming manner. "l feel - and I'm really sincere about this - the University has done so much for me. My whole life - professional, athletic and social - has been centered around the University. I wanted to do something different for the University. His affiliation with UB started as a student. Wels received his B.A. in 1937, his M.A. in 1939 and his M.D. in 1941. He's on the UB Foundation Executive Committee and a member of the Univer­ sity Council. Weis has been on the Medical School faculty since 1950. Some may know the physician's name from hearing about the Dr. Philip W els Symposium Fund that brings in top professionals in general surgery to speak every year. The endowed fund was made possible by donations from Wels' family and friends in honor of his birthday several years ago. The athletic part of his life at UB has been equally stellar. One of the first five inducted into the UB Hall of Fame, he was also a fencer on the Olympic squad. His Olympic aspirations were crushed, however, when the games were cancelled in 1940 because of the war. BUFFALO IPHV$ 1 C 1 AN I H e now golfs and you'll find a statue in his collection depicting the stereo­ typical golfing doctor. But not all of the figurines reflect Weis personally. "We didn't discriminate," he said. "We have some female doctors, too." Somewhere in the vast queue of miniature doctors, there's also a nurse. "We stuck one nurse in to keep her quiet," he said jokingly of office nurse �9 "' ! 0 I C< 0 ,:-------------------Peggy Haselbauer. Haselbauer started the whole collection off when she brought a woodcarving for Wels from Germany in 1958. She later sent for more figurines from the same set. There are now about 40 in that set alone. The set also includes a man wearing nothing but a polka dot tie which Wels gleefully explains is a doctor after taxes . He thinks that particular carving looks i like Ronald Reagan. An optometrist in the same set looks something like Richard Nixon, he maintains . Another carving in the collection is a skeleton with a sickle representing death. "It's part of the profession," Wels said . "It came with the set," Haselbauer chimed in. W els pointed out a beige Bencini figure with spaghetti-like hair depicting an "old-fashioned" doctor not using a stethoscope. The doctor has his ear in the vicinity of a voluptuous woman's heart. Many of the pieces depict doctors with hypodermics or giving shots. Not a single one of the fabricated patients, however, was getting the shot in the arm. There are, however, more dignified depictions of the physician. There's a Greek-style figure of Esculapio, one of the fathers of medicine, and two small metal likenesses of Hippocrates. There's at least one "distinguished gentleman" in the collection, Haselbauer said, indicating a Royal Daulton figure of a seated, white haired man. A "classic" scene shows a sick child lying on two chairs with her physician seated beside her, Wels noted. The curios in the collection represent the different branches of medicine. There are many representing internal medicine, surgery and obstetrics because they are the bulwark of medicine, Wels explained. The obstetricians are most often shown grabbing a newborn by the ankles. Surgeons are depicted in a number of ways. It's apparent that a wooden figure in surgical garb is a cardiac specialist because he's holding a heart, W els pointed out. A ceramic figure displays an appendix snared in his surgical instrument. A plastic surgeon holds a large diagram of a nose detailing how he will make it smaller. Another has jars of spare parts labeled "chins" and "noses." One physician attends to a patient's ski injury. Another has a most uncomfortable look on his face while attending to his own cut finger. There's a modern-looking metal piece showing a psychiatrist and his patient. A wooden physician mixes his own medicine, a duty few doctors have to do today, Wels noted. There are also anesthe- BUFFAID jP Hv $1¢ 1A Nj siologists, ophthamologists ologists. and radi­ T he collection displays caricatures of physicians' specialities, said Vice President John Naughton, dean of the Medical School. "Some are humorous, some are serious, some are works of art," Naughton said. Through a constellation of appearances, the physicians' behaviors and per­ sonalities also come through, he noted. "Ecstatic" is how the dean feels about getting the figurines for the Medical School. "We're really thankful that Phil wants to donate them," he said. "They will no doubt add a dimension to the new Medical School building." The monetary value of the exhibit is being set by appraisers, a time-consuming process since the collection is so large. There are so many items in the collection that W els took photos with him when traveling to ensure that new souvenirs didn't duplicate any piece. Many were gifts of his wife, family, and friends. Perhaps the most common element in the collection is the stethoscope. A large, chubby owl, covered in feathers and wearing an expensive-looking suit, wears on around his neck. A clown has one draped around his neck. A sleek Lladro in subdued tones contrasts with a roly­ poly Mendins piece of pottery done in bold colors. Some of the pieces, like a glazed set of Czechoslovakian figures with milk white coats, are no longer available. A few of the pieces, including a Hummel, show little boys dressing up as doctors. A Rockwell cene depicts a grown-up doctor examining a little girl's sick doll. Wels' collection reflects fads and trends. You can spot Snoopy in surgical greens. There are "pet rock" doctors as well as Smurfs. The modest W els had a hard time understanding why such a big fuss was being made over his donation. After all, lots of physicians have these kinds of statuettes. "Everybody has a couple of them," Wels said. But as he glanced at his collection, he admitted,"not this many. "e 07186 ��II ''THEORIGINOF THE BUFFALOSURGICALSOCIETY'' BY MARVIN Z. KURLAN, M.O., Clinical Instructorof Surgery T he Buffalo Surgical Society , pres­ ently with 109 Fellows and 13 senior Fellows, had its origins in the exuberant, fast-paced, and expanding days of the early 1920s. Buffalo had a population of a little more than a half­ million. There were several major hospitals in the area, including the Buffalo General, the Deaconess, Emergency, the Columbus, Our Lady of Victory, Sisters, and the Millard Fillmore . Nineteen-twenty-three saw the ascen­ sion of Calvin Coolidge to the Presidency . This was an era characterized by practically autonomous surgical dynasties at the respective hospitals . Apparently , out of a desire for more direct communi­ cation and camaraderie, the idea of a local surgical society came into being. Julius Ricter was chairman of a group of individuals known as the " committee on organization." This committee met during the last quarter of 1923 and formulated ideas that would govern the establishment of the new society. The committee was composed of Dr. E.M. McGuire, professor of surgery at the University and the Buffalo General Hospital and the heir to Roswell Park 's surgical mantle; Dr. Marshall Clinton, a UB associate professor of surgery (and great grandson of DeWitt Clinton and father of Dr. Marshall Clinton, currently clinical professor of medicine) ; Ors . Thew Wright, King, Trick, Lathrup, Lewis, Andt, and Och . These men authorized and directed Dr. Ricter to inquire of the then present societies , what their constitutions and by-laws were, so as to provide a model for the proposed group . We have letters of inquiry to Dr. Charles G. Heyd of the ew York Surgical Society for a copy of their by-laws and constitution on December 16, 1923. The same day a letter was sent to Franklin H. Martin inquiring as to the name of the secretary of the Chicago Medical Society. The by-laws and constitution were sent from the ew York Medical Society, an organization of 70 members, to Or. Ricter in January 1924 . One week later, a letter arrived from Dr. Charles H. Sawyer containing the by-laws and constitution of the Chicago Medical Society which had been founded in 1900 and had revised its constitution in 1919. On January 3, 1924, the following letter went forward to some 20 prominent Buffalo Surgeons: BUFFAID jP1ivS1¢1 .A Nj "M1 Dear Doctor, The expression has been voiced by a number of surgeonsin our ciry,particularl1 tlwse wlw are members of the American College of Surgeons, that it would be advantageous w have a local organi.::ation amongthem whic-hwouldrepresentall groups in the ciryand tend towardunif'Jingthe men engaged in surgeryas a specialty. With the in view, a formation of such an organi.::ation numberof men have beencanvassed, and it is encouragingw sa1,that all, withoutexception, have voicedkttn enthusiasmfor the project. This letteris thereforewrittenw enlist'JOUr support asking 'JOUw attend a subscription dinneratthel3uffaloClub,Thursday.January 1 o, ( 1924) at 7: 30 p.m., and thus make 'JOUrself one of the founders of the Surgeons Club of l3uffalo. Sincerely - Julius Ricter Another subscription dinner was held February 21, 1924, at the Buffalo Club, requesting the founders to be present to complete the organization of the Buffalo Surgical Society. There were evidently more items for discussion, for there was a third provisional meeting held Friday, April 4, 1924, and we are privileged to have the original minutes of this meeting. Dr. Marshall Clinton, the chairman pro tempore, called the meeting to order and called upon several of those present to voice their opinion as to the desirability of organizing a surgical society similar to those existing in other large cities of the country. The consensus of opinion was in favor of such an organization. Chairman 07/ 86 �12 Clinton then called upon Secretary pro tempore Dr. Thew Wright to read the proposed constirution which had been amended at the previous meetings. The constirution and by-laws were read section by section, but no additional amendments were offered and they were adopted in toto. Nominations and Elections were called for and the following slate of officers was elected: Dr. Marshall Clinton, President; Dr. Thew Wright, Vice President; Dr. Julius Ricter, Secretary; and Dr. Frank W . McGuire, Treasurer. Dr. Critchlow moved that additional members invited to join the society be included among the Founders of the Society. It was moved that the constitution and by-laws be printed in a "convenient booklet with a list of the founders of the society and a copy mailed to each of the members." (17/ 86 "The officialseal of the Societyis partiallytaken from the BarbersGuild of London;the motto, 'IncidendoSano,' is taken from the coat of arms of a Scottish nobleman,and translated means, 'we cut to cure .... ' " BUFFAID IPMvS1¢1AN] President Clinton appointed Dr. Julius Ricter, a committee of one, to have designed an appropriate seal for the society. Meeting adjourned . The seal of the Buffalo Surgical Society is an amalgamation of the coat of arms of the Barbers Guild of London, the charter of which was granted by Henry VI in 1451, and the Surgeons Guild of London founded in 1569 by King Henry VIL The fleams or figure seven-like medieval lancets are from the first group. The green and silver background is taken from the second group. Dr. Clinton suggested the Buffalo head on the seal. The motto, lncidendo Sano, is taken from the coat of arms of a Scottish nobleman and translated means, "we cut to cure." During the first year many procedural and organizational questions were raised and debated. There was a clinical meeting held at the �13 Buffalo General Hospital, Friday, October 3, 1924, hosted by Dr. Clinton and three cases presented included a case of cleft palate, a case of cicatricial conttacture of the neck with rotational graft coverage, and a case of toe amputation following failure of sympathectomy for Buerger's disease. The final meeting of the first year of the Buffalo Surgical Society was held at the summer home of Dr. Clinton in Rose Hill, Ontario, Canada, July 16, 1925. The idea was raised and carried forward that a $25 prize be sponsored by the Society and given to the medical student at the then University of Buffalo who had attained the highest average during the junior and senior years in surgery. On November 7, 1925, Dr . King discussedthe program for the forthcoming year and voiced the idea of visiting other cities and clinics; thus came into being the very popular pilgrimage. The idea of local chnics and a yearly pilgrimage remained popular with the membership and visits were taken to Montreal, Boston, Cleveland, Chicago, Sayre, Pa., and Phila­ delphia . The idea for the RoswellPark Lectureship came in 1948 from Dr. Henry Kenwell, then president. The growth of the society in national prestige is a reflection of its steadfast maintenance of the RoswellPark Lectureship, and the recipient medalists constitute an elite coterie of the great figures in Ameri­ can surgery. Today the Society numbers 118 mem­ bers. Its current president is William Heyden. • (Dr. Kurian expresses his apprec iat ion of the assist­ a nce of Dr. Bertra m Partin a nd MIidred Ho llora n for the ir research Into the history. Dr. Kurian is a lso assista nt attend ing p hysic ian at Mill01d Fillmore Hospital and is o member of the Presid enr s Assoc i­ ates of the l/ 8 Foun dat ion . a g ro up of major benefactors.) BUFFAID IPHVSICI AN I 07/ 86 �14 Few can equal the medical successes of George Hatem O ne of the most famous physi­ cians in modern history was the keynote speaker at the 49th Spring Clinical Day last May 10 (see accompanying article). George Hatem, M.D., born and raised in Buffalo, made his mark in history by developing the massive programs which eliminated numerous endemic diseases from the most populous country in the world and moved China into the modern age of medicine . Few if any doctors can claim to have been so intimately associated with such success in eradicating venereal disease, opium addiction, prostitution, smallpox, trachoma and filiarisis. Leprosy has been reduced by 80 per cent. Dr. Hatem, or Ma Hai-De in Chinese, was invited to the UB Medical Alumni Association's major event by his personal friend Charles Tanner (M'43), then association president. Dr. Tanner got to know Dr. Hatem through Harem's cousin, Theresa Ode in Buffalo. When Chinese­ American relations thawed in the 1970s, Dr. Hatem invited his cousin from whom he had been long separated to visit him in 07/ 86 BY BRUCE S. KERSHNER China. Unable to get the necessary permission, Ms. Ode asked for Tanner's help with the authorities. His efforts succeeded and Dr. Hatem soon met Ms. Ode in China. Dr. Hatem 's first visit to America since he left in the 1930s was in connection with a sad development. Hatem had been diagnosed as dying of pancreatic cancer and wanted to see his relatives for the last time. After arriving in Buffalo he met with Dr. Tanner, who urged him to undergo further testing because he was suspicious of the existing diagnosis. It turned out that a common duct stone had been mistaken for the pancreatic cancer. Since then Tanner and Hatem have spent time with each other on four occasions and have become close friends. It was only fitting that Dr. Tanner should have him as his - and the Medical School's -guest again. Dr. Hatem mused that he is not the first Chinese doctor to come to Buffalo. "In 1874 in Buffalo, Dr. Lu-Si Han, a BUFFAID PHv$1¢1ANj specialist in 'electricity, eclectic and homeopathic pathology,' was asked for his medical certificate. Not having one, he went back to China and penned his own certificate with his own seal.'' When he returned, he presented it in Buffalo where it was accepted with no questions asked. Hatem detailed the great decadence and disease of the old China. "In Shanghai in 1933, there were 950 brothels, 30,000 prostitutes (90 per cent with syphilis), 10,000 opium dens, 30,000 employed in the drug trade, and 7,000 gambling houses. On one lane alone there were 21 brothels, and the names of all 100 prostitutes were in neon lights." While Hatem was treating syphilitic policemen, a well dressed man once offered him 2 kilos of heroin, saying, "If you prescribe it, we'll send you all the patients." He politely turned down the offer. A fter describing how he and his team virrually eradicated venereal disease by 1959, he related what happened �in the 1970s. He had arranged to have instructions on the newer venereal diseases sent to China from the Centers For Disease Control in Atlanta. "When we read the instructions for treating the 19 known sexually transmitted diseases, I remembered thinking 'we're damn lucky we got through with our eradication programs when there were only four' and that was before AIDS!," he added. Hatem's program to eliminate the epidemics has already been described in the May 1986 Buffalo Physician. To Hatem, the successes with VD, narcotics, smallpox, and other epidemics are very nice, but now history. His efforts are with the future. He has thrown himself totally into his bold program to eradicate leprosy from China, and indeed from the earth. So sure is Hatem, that he ( or his successor) plans to announce the erad­ ication of that disease from China at the meeting of the World Congress of Leprosy, to be held in Shanghai in 1998. "We will eradicate the oldest disease in the world in the oldest country in the world," he declared. The 76-year-old doctor also shared BUFFALO jPHv$1¢1A I his country's approach to preventive medicine. In China, he said, the meager financial resources are directed as much toward preventing as toward curing disease. The U.S., however, throws mas­ sive resources toward curing, and neg­ lects prevention, violating the wisdom of the adage, "An Ounce of Prevention is Worth a Pound of Cure." Hatem summed up the Chinese approach by remarking, "The tradition in China is to only pay the doctor when you're well, and stop paying him when you're sick." • 07186 �16 CHRONICP ((c hronic pain is a disease state of its own - and the most frequent cause of disability," announced Jennifer S. Kriegler, M.D., to participants at the UB Medical School's 49th Annual Spring Clinical Day last May 10. Dr. Kriegler was one of six invited speakers who enlightened the 340 attendees on chronic pain, osteoporosis, AIDS, and medical progress in China. Charles Tanner (M'43), 1985-86 president of the Medical Alumni Associa­ tion, opened the day's events, together 07/ 86 with Vice President and Dean John Naughton and Paul Wierzbieniec (M'7 4 ), who chaired the five hours of talks and ceremonies. Dr. Kriegler (M'76) emphasized that chronic pain directly costs Americans $50 billion, with back, arthritis, and headache pain each costing $10 to $13 billion annually in health care. She noted that 250 million work days are lost annually due to back pain alone. Dr. Kriegler is assistant professor of neurology at Case Western Reserve University, and director of the University Hospital's Pain Center in Cleveland . The social costs, however, are just as great, Dr. Kriegler continued. Seventy per cent of chronic pain patients get divorced, relations with friends are damaged, and chronic depression is standard for such persons. Twenty per cent attempt suicide. John Rowlingson (M'74) also spoke on pain. "There is no scientific or mathe­ matical way to quantitate it. Its only outward sign is behavior. Furthermore, the fact there is no physiologically positive test DOES NOT MEAN there is no pain or that it is all psychological." Rowlingson is associate professor of anesthesiology and director of the Pain Management Center of the University of Virginia Medical Center, Charlottesville. The characteristic depression, deteri­ orating mood, and problems with selfimage and interpersonal relationships led Dr. Kriegler to comment, "Physicians should remind their patients' families that these people are not 'crazy,' just depressed.'' She further described the "Chronic Pain Cycle" that should be broken in any effective program. The stress due to the physical pain and its social effects causes increased muscle tension. This increases the pain, which in turn increases all the BUFFAID jPHY$1¢1ANI ' stresses, and the "vicious" cycle goes around again. K riegler and Rowlingson detailed the modern approach to pain - the pain management center. It uses a multi­ disciplinary approach (medical and nurs­ ing specialists, behavioral, physical and occupational therapists, and social work­ ers) as well as a total system approach ( using all treatment options, devoting all of its time and personnel to reducing pain, and working with the patient for prolonged periods). �17 ~OPOROSIS, "Our center also requires the family to be involved in the program, and marriage counseling is required," Kriegler remarked. Pain centers employ state-of-the-art techniques such as epidural and intra­ thecal endorphin and newer narcotics, as well as new antidepressants , anti­ psychotics , and Trans Nerve Stimulation (TNS). "We realize that total relief of chronic pain is uncommon, so we also teach our patients how to cope with the pain that is left when they complete our program," Rowlingson explained. Up to 40 per cent of patients experience no relief . "These fall into several categories: those with complicated low back or pelvic pain, those with complex psychological problems, and those who are not working but capable of working (low motivation)," he continued . "And women succeed better than men." Just as chronic pain has a "vicious" cycle, so does osteoporosis, explained Robert P. Heaney, the John A. Creighton Professor at Creighton University, Omaha, Nebraska. "The bone loss due to osteoporosis leads to fractures which lead to pain and disability. This decreases the patients' activity, which unfortunately leads to more bone loss. "Our research in osteoporosis is at the same stage in 1986 as anemia research was in the 1920s," Dr . Heaney stated. He demonstrated recent findings which reveal that microfractures not visible in x-rays make bones prone to fracture due to trauma; low bone mass and poor bone architecture are both major factors . Another recent development is that NIH now recommends that women consume 1000 mg. of calcium daily ( 1500 mg. for post-menopausal women) compared to the median of 500 mg. that women now get. This change also reflects the findings that many women absorb calcium poorly, and its mucosa! absorp- DAIDS tailed treatment for osteoporosis. High calcium intake and estrogen treatment, together with physical therapy, exercise, and extension are recommended. Vitamin D and sodium fluoride are promising but experimental. Androgen and calcitonin nasal spray are also experimental. Getting back to lifestyle, both speakers made it clear that both excessive alcohol and tobacco increase osteoporosis risk. Cigarettes increase the risk 50 per cent, while alcoholics often have a bone mass of a person 40 years older. "We suspect that alcohol 'pickling' and nicotine are just as toxic to bone cells as they've been shown for other cells." U tion declines with age (35 per cent absorption at 35 years, 20 per cent at 65 years). While there are several treatment options for the disease, Dr. Heaney stressed that low bone mass cannot be reversed, only arrested or prevented. "A pill will never correct a bad lifestyle," he asserted, referring to poor diet and exercise. John H . Healey, M.D., assistant professor of orthopaedic surgery at Cornell and orthopaedic surgeon at New York's Hospital for Spinal Surgery, de- BUFFAID IPHVS1¢1AN) The 18,000 cases of AIDS are just the tip of the iceberg," announced Bernard]. Poiesz, M.D., who introduced the third topic. He is associate professor of medicine and microbiology and chief of oncology at the SUNY Health Center­ Syracuse . "Not only are there thousands with immune complex diseases and associ­ ated infections, but there are millions of asymptomatic carriers of AIDS virus." Dr. Poiesz detailed new discoveries relating to the HTL V Ill virus itself. He described several features that make the AIDS virus unique. "AIDS is unique because its DNA can degrade back into RNA and it has three extra genes. When they're copied in a cell, portions float free and can kill the cell." AIDS viruses also have cylindrical cores, not the spher­ ical ones of all other viruses , he said . The AIDS virus envelope is also thick for a virus of its type. Although the retroviruses HTLV I (a cause of leukemia) and 11 have similar names, HTL V 111(the AIDS virus) is not related to them - it shares only 1 per cent of its genetic makeup with the other HTLV viruses. Lastly , few realize that cats, cows , and monkeys get AIDS from retroviruses particular to those species. • 07/ 86 �BY SHIFRAH SANDLER T hough Dr. Vivian Cody, Ph.D., has climbed Mt. Fuji in sneakers, toasted mountain deities with Andean natives, and contributed worldwide to the field of crystallography, when asked about herself, she responds, "Oh, I'm not really very interesting." But this attitude clearly belies both her success and her personality. Obstacles were common throughout Dr. Cody's schooling. She found it difficult to learn to read in grade school. In college, her ��20 interest in chemistry placed her in a less than welcoming, male-dominated realm. This was evidenced by the fact that her being the only female in her classes created opposition. However, during a post-doctoral fellowship year in 1970 at the Medical Foundation of Buffalo, the director recognized that Vivian Cody had the right stuff for the research team. That was the beginning of her crystallography career. She is now a senior research scientist there. On UB's faculty since 1978, Dr. Cody is a research associate professor of medicine. Cody's expertise has blossomed for the past 15 years . Her research on the thyroid gland and chemotherapy have warranted invita­ tions to speak at international conferences around the world. This meshes well with another facet of Vivian Cody - as she puts it, "Give me an inch and I'll take half a globe ." Her first presentation at an international crystallography conference in Japan offered an opportunity to explore Mt. Fuji. Having arrived 36 hours before presentation time , Dr . Cody and a colleague set out at noon in street clothing, without food, water, or rain gear and "marched on" through 29 hours of rain, snow, sleet, and fair weather. They rested on floor space in an open shelter and worked on lecture notes with wet and running ink. Reaching the top, their hopes of seeing sunrise were shrouded in fog. Undaunted, she had her walking stick branded by monks at the top before she descended from the summit. A total of 12,500 feet later, she addressed several thousand of her new peers. Since then Cody's love of adventure has taken her on a trip up the Amazon River, to the Easter Islands, and into the Australian outback. She speaks about her travels at the 00/86 8u i 5 Q 0 it Buffalo Museum of Science and throughout the area. Some of these trips are coupled with professional conferences ; others are simply undertaken out of curiosity. T here seems to be a connection between Cody's successful crystallography research, her expeditions, and her archeo­ logical avocation. She is president of the area chapter of the New York State Archeological Association. When I looked through micro­ scopes in her research lab and studied the computer graphic projections of X-ray infor­ mation which she uses to find chemical pathways for medical treatment, I realized that Dr. Cody's research involves viewing complex arrangements from various angles, organizing information and envisioning path­ ways. Finding patterns within complex con­ glomerations of substances is also the basis of archeology. An archeologist recognizes tiny, significant fragments in a sample of earth that can indicate when prehistorical civilization flourished in that area. Cody's observations of the exotic places she visits are highly informed and factual, yet still touched by a sincere sense of awe. The connecting theme in BUFFAID I PHYS l¢1 AN I �C all areas of her expertise is the combination of a trained eye and open mind; knowledge coupled with curiosity. For example, "lt seemed like a reasonable request when asked ifl'd like to hike the Inca trail," says Cody. "What started as a simple visit to Inca ruins, turned out to be a month­ long backpacking trek through the V ilabamba Mountains, following original Inca roadways, covering nearly 120 miles through the land where the Inca held the Spanish at bay for more than 40 years before the final collapse of their empire. For weeks we traveled through the heart of this empire, our path taking us over several passes dose to 17,000 feet before winding down toward Machupicchu nestled among the mountain peaks at a mere 8,000 feet." The trip resulted in a breathtaking slide collection and a beautifully written account of the journey, in which there is no mention of the fact that Dr. Cody literally hovered near death for most of the trip. Her body is unable to acclimate to extremely high altitudes and she suffered from pulmonary edema. When asked if it was worth it, however, her response was quick and unconditional, "Sure, I got to hike the Inca Trail!" ody's NIH-funded thyroid research involves trying to determine the three dimensional structure of thyroid hormones and their analogs." We try to learn how they interact with both transport proteins and their receptors," she relates. Her goal is to develop new hormone-like drugs useful for treatment of disease. Another major thrust of her research is with the fascinating flavones, an array of compounds produced by plants that can have hormone-like properties. "We're looking at these flavones that are not structurally related to thyroid compounds but behave somewhat like them and can influence them. Using the findings from our flavone research, we hope tO design unique drugs that would have thyroid-like functions," she comments. She recently co-chaired a five day symposium in Buffalo with Dr. Elliott Middleton, professor of medicine, on plant flavonoids that was attended by scientists from around the world. Her newest project uses crystallographic and computer graphic techniques and applies them to developing new cancer drugs. To conduct this study, she was selected to receive a prestigious five-year Faculty Research Award from the American Cancer Society. By working closely with the clinician and clinical biochemist, she is looking to determine the molecular structures and biological activity of drugs that inhibit tumor growth and to design new clinically effective compounds. "What is unusual about this project is that it coordinates input from clinical scientists at an early stage, BUFFAID j PHvS 1 ¢ 1 AN I at the bench level, not after the clinical data have been developed and collected," she comments. Before joining the Medical Foundation she was a post-doctoral fellow in chemistry at the University of Missouri, St. Louis. She earned two degrees in chemistry, her bachelor's from the University of Michigan in 1965 and her Ph.D. in 1969 from the University of Cincinnati. Cody also has an appointment in UB's Roswell Park Graduate Division. Besides her research at the Medical Foundation, she is editor of their quarterly publication, lmpacr.. Active in the community, she is treasurer of American Women in Science and is an active panelist and lecturer for professional and civic groups, locally, nationally and inter­ nationally. Cody's research receives funding from highly competitive sources such as the National Institutes of Health, The National Science Foundation, and the American Cancer Society. Writing all her own grant proposals, she has kept herself well-supported for 15 years without any University or corporate salary. She seems tersely pleased with this fact, yet just a little impatient with all this talk about what she has already done. Clearly, Vivian Cody is far more interested in moving toward her next discovery or her next adventure than in dwelling on past accomplishments. • (Ms. Sandler Is a \Al alumna aid writer.) a professional 07/86 �22 Dr. Norma Panahon'sparents, closefriends of the Aquinas, have major roles in new government W hile a UB psychiatrist was visit­ ing her native Philippines in 1981, her Amherst home was occupied by Corazon Aquino. Then relatively unknown and in the shadow of her husband, Mrs. Aquino is now president of the Philippines. Corazon Aquino stayed at the home of UB clinical assistant professor of psychiatry Dr. Norma C. Panahon, while Panahon's mother entertained them. "She (Aquino) called the Phili~ pines to return the gesture by making sure we, in turn, were guests at their Philippines home," says Dr. Panahon, whose parents, Jose and Betry Calderon, have been close friends with the Aquinos for years. Dr. Panahon's father, along with the late Benigno Aquino, had been a prominent opposition leader during the 20-year presidency of Fer­ dinand Marcos. With the remarkable change in government, the UB psychia­ trist's parents are now major leaders in the new administration. Dr. Panahon's own history in the Philippines reflects the bitter change in that country that occurred with the first few years of Marcos' power. lnJuly, 1967,asayoungpsychiatry graduate at the University of the Philippines, Panahon started a residency she was soon to leave - for a door-to-door job. Door-to• door, that is, campaigning for her mother's election to a second term as governor of the remote ueva Vizcaya province. "l had to go door-to-door, shaking every­ body's hand and introducing myself," recalls Panahon, pointing out that the media is still not accessible to Philippine politicians. "We 07186 BY PAUL OLCHVARY were obligated to feed the community," she explains, adding that it was not uncommon to have 300 people over for lunch. For all the hard work, however, her mother was not reelected. According to Panahon, her defeat had little to do with mere popularity: "She was outmaneuvered because she refused to buy votes or resort to terrorism." Panahon remembers seeing people bribed and threatened so they would submit duplicate copies of their ballots. It was December of that same year that Panahon left for the U.S., "disgusted and disenchanted" with what she had seen in her home land. BUFFAID IPHYS1¢1 AN ) D r. Panahon has come a long way after more than 18 years in the United States. Now a VB faculty member, she devotes most of her time to her private practice in Amherst. Recently, she was elected president of the Phili~ pine Psychiatrists in America, and is currently treasurer of the Western New York Psychiatric Society. Panahon left the Philippines with her husband, Dr. Alvin Panahon, who was her classmate at the University of the Philippines. Today, he is clinical assist­ ant professor of radiology at UB, director of radiation therapy at Niagara Falls Memorial Hospital, and co-owner of the Radiation Oncology Group. Having worked for 18 years at Roswell Park, his last position there was associate chief of radiation therapy. After he finished an internship in Milwaukee, the Panahons moved to Buffalo in July, 1968. Why Buffalo? Dr. Panahon tells of a psychiatry profes­ sor of hers in the Philippines who had trained at VB. "Quite a few of my fellow residents at the University of the Philippines landed in Buffalo because of that affiliation with our professor," she notes. The Panahons had originally planned to return home after completing their residencies, but as the Philippine situa­ tion worsened, the U.S. became more and more of a home. Dr. Panahon spent eight years working at the Buffalo Psychiatric Center and one year at Veterans Administration Hos­ pital. She also developed her private practice. Meanwhile, trouble was brewing in the Philippines. Panahon's father, Jose D. Cald­ eron, was one of 300 men elected to a �23 constitutional convention before the second term of then President Marcos. Having been a cabinet member under former President Pico­ dado Macapagal, Calderon was now placed in the situation of having to defend the demo­ cratic form of government he believed in. Marcos, on the other hand, promoted a parliamentary form of government so he could be prime minister for Life.According to Panahon, Marcos was "buying off people to make sure it would be the way he wanted it." When Marcos saw this wasn't working, he created unrest around the country (staging ambushes, for example) to justify a declaration of martial law. In 1972, when Marcos finally imposed military rule, he immediately ordered the arrest of all active members of the constitu­ tional convention . Jose Calderon was among the first 12 to be arrested. Benigno Aquino, the youngest senator in the country, "sure to be the next president ... a very charismatic man," according to Dr. Panahon, was first on the list. Hardship breeds friendship, and so it was. After the declaration, Marcos had final word on everything, and his first order of business was to close off all communications across the country. According to Panahon, most Filipinos were confused at first: "They were wondering why there was no television and no newspaper." Many newsmen were out of jobs. One of them, in hiding, showed up at the Calderons' house shonly before Christmas, and Dr. Panahon's father gave him some money for his family. Says Panahon, "They used that as an excuse to get my dad, though they never filed charges against him." For six months, Jose Calderon was im­ prisoned, and if not for good fortune, it may BUFFALO [P1-1v$1¢1ANI have been much longer. For years, he has been an active member of the International Christian Leadership, a largegroup based in Washing­ ton, D.C. The ICL had organized an annual "Presidential Prayer Breakfast" for Congress and the Senate, during which Calderon's name came up. Dr. Cliff Robinson, head of the group, decided to visit him. With the appearanc ,e of Dr. Robinson, Calderon's re­ lease was immediate and, ironically, noncha­ lant. Panahon recalls, "Dr. Robinson just grabbed my dad and took him home." Calderon remained under indefinite house arrest. A lawyer by trade, he was president of several mining and petroleum firms. Wherever he went, whether down the street or to board meetings, a troop of soldiers was never far behind. Dr. Panahon could still call her father from the U.S., but "you knew the phones were tapped, so you just talked superficially ... 07/86 �24 nothing political, all in code," she says with a wry chuckle. Many of Panahon's friends were doctors still living in the Philippines. For the most part, their attitude toward the government reflected the country's in general. People were afraid to speak, cast into an artificial apathy. "All my doctor friends decided to restrict their work to non-political, purely medical (affairs), and dance with the music." In 1974, Dr. Panahon's mother came to the U.S. for a medical checkup, and it was found that she needed a coronary bypass. Panahon 's father personally pleaded to MarC05for permis­ sion to leave the country, with a guarantee that he'd rerurn. He stayed in the U.S. for only a month or so, until his wife was well on the road to recovery, then rerurned to oversee the family businesses. He remained under house arrest. By 1978, Dr. Panahon and a sister in the U.S. were finally successful in petitioning for their father to be an immigrant. After he arrived here, he became active in organizations such as the "Free the Philippines Movement," and established contacts with other Philippine exiles in the U.S. A fter eight years of imprisonment, Benigno Aquino was sent to the U.S. in 1980 for open heart surgery, with the inter­ vention of President Carter. For the next three years, Calderon and Aquino maintained a close friendship, like other Philippine exile leaders in the U.S. Two weeks before Aquino was assassinated upon his return to the Philippines, he drove from Massachusetts to be with Calderon at his birthday party in New Jersey. Ironically, Aquino's assassination remarkably changed the tide of things. Explains Panahon, "After Aquino died, you had millions, including the church, saying 'Enough is enough.' They saw that there's power in numbers." Calderon and a group of political exiles in the U.S. organized the "Ninoy Aquino Movement," and Calderon remained a close advisor and father figure to its members. Also, many of Panahon's physician friends became politically active 07/86 righteous person." Panahon agrees that Aquino needs a lot of help, but points out that she has surrounded herself with an impressive lineup of advisors. Asked whether she believes Aquino can work through the disorder that Marcos left her, Panahon concedes that "it will be a lot of tough work ...to dismantle these 20 years of chaos." However, she believes the most important factor for the success of the new gove.rnment will be not only the support of the people, but also a reestablishment of trust for politicians. "CorazonAquino needsa lot of help; it will take a lot of toughwork to dismantlethese 20 yearsof chaos left behindby FerdinandMarcos." after Aquino's death, joining groups like NAMFREL (National Movement for Free Elections), an organ~tion that monitored ballot counting. Their letters to the U.S. expressed pride in becoming more active participants in history. Just after Marcos abandoned Malacanang Palace, Jose Calderon was awakened by a phone call from a dose advisor to Corazon Aquino, placed from inside the palace. When he was finally convinced of the news, Calderon immediately called his daughter. Says Panahon, "My dad called me up right away, and he said, 'The boxing is over!' ... he was screaming on the phone. "I just cried," Dr. Panahon says, "because my biggest fear was for my dad - he's now 67 - not to be able to see this during his lifetime." Dr. Panahon has faith in Corazon Aquino, whom she describes as "a very moralistic and BUFFAID jPHvS1¢1 A N) D r. Panahon 's parents have both returned to the Philippines. Since January, her mother had been a campaign manager and " 'watchdog' for Cory," says Panahon . Today, she is governor of her home province, located, fittingly, near Marcos' home province. As for Panahon's father, he was just appointed as one of 45 commissioners to write the new constitution for the country . "My dad is now in a position like Thomas Jefferson and the founding fathers of America," Panahon smiles. In addition, Panahon'ssister Lilia, an econo­ mist who manages one of the world's major financial funds, will serve as an advisor to the new government. Dr. Panahon is thankful her parents always emphasized education, and set a good example themselves. Her father went to law school at the University of the Philippines with Ferdinand Marcos, and her mother received her M.A. in education after her fifth pregnancy. As for Dr. Panahon, psychiatry intrigued her from the beginning at medical school in the Philippines, and she says, "l guess l love to tallc:." The Panahons have made no plans just yet to move back to the Philippines. After having been away for so long, Dr. Panahon points out the importance of being realistic and practical. Also, they have three children to raise. However, with Marcos gone, more options will be open to them. Panahon's husband, being a radiation therapist, is in a specialty not readily available in the Philip­ pines. As for herself, she says, "The Philip­ pines has about 120 psychiatrists for 60 million people." • �25 Smith heads Governor's long term care panel J ust appointed to Governor Mario Cuomo's New York State Project 2000's Advisory Panel for Long Term Care is Lester mith, Ph.D., clini cal associate pro ­ fessor of medicine at UB. Smith i nationally kn o wn as an expert on the subje ct of aging and was d irector of the U B Multidisciplinary Center for the tudy of Aging for five years until last year. The panel is part of Project 2000, an undertaking introduced by Governor Cuomo in his 1985 State of the State address . Its purpose is to identify and examine key oppor­ tunities, challenges, and options facing the State throughout the balance of the 20th century and beyond. The advisory panel to which Dr. Smith was appointed will study such concerns as the impact of the aging population on health care needs. The panel and Project 2000 are ad ­ ministered by SUNY / Albany's elson A. Rockefeller Institute of Government . "The remainder of the century will witness pronounced growth in the proportion of the population who are elderly, especially in the number of those over age 75," declared Sharon Dawes, executive fellow at the Rockefeller Institute and study director of Long Term Care 2000. "During the first decades of the next century, this trend will accelerate even more dramatically. Demands for long-term support services are likely to be particularly heavy. " Smith, an Arkansas native, earned his bachelor 's degree from the University of California, Berkeley ; his master's degree from Howard Medical College, and his doctoral degree in biochemistry from University of California Medical School, San Ftancisco . Before joining UB's faculty, he served as an administrator in the NIH for nine years and was founding administrator of the National lnstirute on Aging. Before leaving that position to come to Buffalo, he had initiated several national programs in biomedical aging which are now located in over 200 institutions and budgeted for more than $42 million. He was also chief advi sor to the White House and Congress on new programs for initiatives related to the elderly . He became the first full-time director of UB's nationally respected Center for the Study of Aging in 1980 . The Center has been designated by the State as the headquarters for aging studies for 64 state-wide colleges and universities. Smith currently serves as editor of the Gerontolo gist journal. He is also director , Home Equity Living Plans, Inc.; a member of Congress ' Black Caucus Brain Trust on Aging, and a member of the Special Populations Committee, American Cancer Society, N.Y . State Division. As author or editor of 25 books and articles , his research focuses on biological processes of aging, especially relating to lipoproteins, immunology, and protein synthesis and also on aging patterns among the minority elderly . • Anesthesiologists honor Dr. Richard Ament Dr. Richard Ament (M'42) has received the highest award of the American Society of Anesthesiologists . The UB clinical professor and director of educational programs in the Department of Anesthesiology was selected for the Distinguished Service Award at the Society's annual meeting in San Francisco. The award is given to exemplary individuals who have made outstanding contributions to anesthesiology in education, research, and organizational activities. The 66-year-old graduate of the UB school BUFFAID jPHVS1¢1 A.N I of Medicine has been with UB as a faculty member since 1949, and has long associations with Buffalo General and Children's hospitals. His leadership positions cover the entire gamut of his specialty, medicine in general , and community activities. He has served as president of both the American and the New York State Societies of Anesthesiologists; on the executive committees of the World Federation of Societies of Anesthesiologists and the American College of Anesthesiologists ; as president of the Jewish Center of Greater Buffalo and of Temple Beth Zion; as vice president of the Jewish Federation of Greater Buffalo; on the national executive board of the Boy Scouts of America; as an executive committee member of Buffalo General Hos~ pita! and as a committee leader in county, state, and national medical societies. He has also been a senior examiner for 25 years for the American Board of Anesthesiologists. • 'Buffalo Physician' . . . 1s a pnze wmner B uffalo Physician is co-winner of a nationalaward. As part of UB's Office of Publications, it shared in a Silver MedalAward from CASE (Council for the Advancement and Support of Educa­ tion) and Time Maga­ zine for the University's total publications program. The national competition evaluated entries from 60 institutions. Buffalo Physicianwas one of four periodicals entered (the others were Reporter, S01nce,the University's science digest, and UB Today, the alumni newspaper). Five recruitment pieces and other University-wide publications made up the rest of the total entry. Judging was based on content, editing, writing, graphics, photography, and printing. Robert T. Marlen is director of University Publications, which includes Buffalo Physician. The Ph::,sician'seditor is Bruce S. Kershner, • while Alan J. Kegler is its art director . 07/ 86 �26 ECMC'SHEAD IN YUNIT BY BRUCE S. KERSHNER ( ( T hesenseofhumorisoneofthe functions that is most easily lost after a head injury - and also among the most difficult to restore," states Dr. Thomas Dickinson, supervising clinical psychologist for the Head Injury Unit at Erie County Medical Center. Treating loss of psychological functions after brain trauma is just one of a spectrum of responsibilities of the Head Injury Unit. The unit is the only comprehensive center for such injuries in Upstate N.Y. (the nearest similar U.S. facility is in ew York City). The four-year-old program is headed by physiatrist James Czyrny, M.D., clinical assistant pro­ fessor of rehabilitation medicine. lts coordinated therapies include physical, occupational, and speech therapy; rehabilita­ tion counseling; a speciali?ed nursing staff; and psychological rehabilitation, headed by Dr. Dickinson, also a clinical assistant pro­ fessor of rehab medicine. "We are the highly speciali?ed head injury unit for the eight counties of Western New York," relates Dr. Dickinson. "We work primarily with inpatients after their acute care to improve their physical and cognitive functioning and to smooth adjustment troubles. Our patients also return for outpatient treatment." Dr. Dickinson adds that area physicians and hospitals are encouraged to refer their head-injured patients to the unit. The unit plays a vital role for the community since serious head injury is the leading cause of death for persons under 35. The National Head Injury Foundation estimates that of the 400,000 people who suffer head trauma every year, 100,000 die. Another 30,000 to 50,000 are left permanently disabled - 75 per cent of those because of mental, not physical injuries. "They are functionally retarded. And the health system must deal with them for the rest of their Lives," explains Dickinson. "That adds up to $2.4 to $4 billion a year for care." ITT/86 Once out of the ICU, the trauma patients are stabilized neurologically and surgically, and when they are out of coma, they are moved into the rehabilitation unit. Immediately, the medical rehabilitation team works together to improve the patient's physical, cognitive, and social skills. Physiatrist Dr. Czyrny monitors the patients for medical complications. He conducts evoked potential studies and stimulates sensory and other nerves to the brain cortex to measure latency, amplitude, and presence or absence of normal wave forms. "That is the best predictor of outcome for the patients," Dr. Czyrny remarks. Czymy treats post-traumatic sei?ures and evaluates mental status for changes, especially post-traumatic hydrocephalus. He also evaluates and diagnoses peripheral nerve injuries and development of the abnormal calcification of soft tissues around joints known as heterotopic ossification. As head of the team, Dr. Czyrny also convenes the group once a week to discuss progress. He interacts with other physicians who are providing acute services, especially the surgeon, orthopaedists, neurologists, and psychiatrists. Discharge planning and family education are his responsibilities as well. R ehabilitating the psychological functions of each patient is a challenge, Dr. Dickinson observes. "The average loss in IQ due to brain trauma is 20 to 30 per cent." For a person with average intelligence (100 IQ), this means an IQ reduced to 70 to 80. "It can be just as disabling for an intelligent person, however, to have a 20 per cent lQreduction because of the traumatic effects it can have on career and creativity." Sense of humor and creativity are among the higher functions of each individual, and those are the ones that are lost most easily and regained last. When it is not lost, the sense of humor can be altered, resulting in socially inappropriate joking and laughing. BUFFAID IP MvS1¢ 1 AN I Immediate or short-term memory is also lost easily, causing serious problems. "It may even be so serious that a patient can forget to include potatoes in the potato salad," Dickinson noted. Long-term memory fortunately is more easily recovered. The brain-injured often experience life­ long problems with concentration and distraction, he remarks. "They also have difficulty in their visual and perceptual skills and cognitive abilities." Dickinson evaluates these losses through a battery of tests. "The most severe social problems result from frontal lobe injury. This causes losses in the ability to plan for the future, and problems with impulsiveness and social inap­ propriateness." Where emotional distur­ bances are great enough, consulting psychiatrists provide medication. While the injuries cause the brain traumas, the family trauma can be just as disrupting. "The whole family is affected. Higher divorce rates, alcohol problems, and discipline problems are common," Dickinson remarked. "But our family counseling provides some help by preparing them for the social possibilities." The other team members also start therapy early to prevent problems. Range of motion exercises by therapists are begun even while the patient is in a coma. Splints and casts prevent contracture, which can set in after only a week of immobility. Preventive measures to avoid skin necrosis include regular changes of position by nurses, water or air mattresses, and nutrition supplementation. The speech therapist tries to establish contact and provide stimulation while the patient is comatose since auditory stimulation is now recogni?ed as beneficial. After the person is conscious or mobile, speech therapy accelerates to include memory and reorientation exercises (sometimes using special computer programs). Physical therapy maintains range of motion and mobility through sitting, standing, walking,and progres- �27 -; ., ~ ~ J L,;.. _______________________________________ sively more exertive exercises. Simultaneously, the occupational therapist refamiliarizes the patient to daily routines of washing, feeding, dressing, and so on. Closely coordinating and vitally reinforcing all the therapies, Dickinson emphasizes, are the nurses. "The team's effectiveness depends on them." ( (T he average age of our patients is 24, with two out of three being men. Sixty per cent were in motor vehicle accidents, while the rest were injured by falls, gunshot, bicycle, and diving accidents," Dickinson continues . It is typically the young, at their physical _ prime, who are brain-injured. "It is the 20-to 30-year-olds who drive faster and live more recklessly," Dr. Dickinson comments. Interestingly, this sudden increase in head trauma began with the oil embargo of 1973 . " Despite decreased travel and lower speeds," Dickinson went on," people also used smaller cars ( which provide less protection in acci­ dents) and increased their motorcycle use. This led to an increase in both rates and sever­ ity of head injury. In fact, our peak periods are the three holiday weekends of the summer ." The next change in the trend, Dickinson hopes, is that seat belt laws are expected to reduce head injuries . The ECMC unit handles six to nine patients BUFFAID !PHV I Cl t,N I ____ __ _____ ..;.....;,_-", __ I ___. ;1 at any one time, with an expected total of 55 this year. "That's an increase over last year, but it is due to an increase in referrals , not to more being injured," he clarifies. Medical advances have had a contradictory effect on the head-injured, Dickinson says. " Acute neurosurgical management, CAT scans, ICU monitoring for intracranial pressures, for example, allow better and earlier diagnosis and prevention, on one hand. On the other hand, trauma care advances have increased the survival rate of the more severely injured ones. This increases the challenge for the medical rehab team since these patients are the ones with the most serious impairments." • Cl1/86 �2 Children's Hospital will manage School 84 C hild ren's Hospital has announced plans to take over management of School 84 from Erie County and move the Robert Warner Rehabilitation Cen­ ter to the school, located on the Erie County Medical Center Campus . Hospital President Ted Stibbards said that ''the additional space and facilities will allow the Hospital to treat a greater number of disabled children in a more effective manner, while making the best use of the resources available to handicapped children. We are convinced that expanding the use of School 84 will provide the most outstanding rehabilitation center in Western New York, paralleling any facility in the ortheast," Mr. Stibbards states . The takeover will also save taxpayers a minimum of $600,000 annually. Under terms of the proposed contract, the county will lease School 84 to the Hospital for an initial period of 10 years, and will continue to subsidize the health-related services of the school's educational program to a maximum of $1 million per year. It currently costs the county $1.6 million to operate School 84. Children 's plans to reduce operational expenses by maximizing use of the facility with the addition of after school and weekend programs, as well as increasing the range of services offered. Robert E. Cooke, M.D., pediatrician-in­ chief at Children's and medical director of the Rehab Center, also spoke about the benefits of the takeover . UB's A. Conger Goodyear Professor said, "the building, instead of being used five hours per day, could be used 16 hours per day and would provide University­ affiliated training for specialists in physical and occupational therapy, recreation programs for the disabled coordinated with the Scruggs Center, and expanded speech and hearing programs for the severely handicapped , as well as strengthened educational programs for these children." The 18-classroom School 84, constructed by the county in 1968, was designed to 07/ 86 educate and rehabilitate area children with multiple handicaps. • ( Flom Children's Hospital's "Bombino ." ) ECMC opens clinic for movement disorders T he area's first clinic for movement disorders has opened at Erie County Medical Center . Patients to be treated in the clinic have Huntington's or Parkinson's Disease, Tourene Syndrome or a range of tremors, tics, or gait disturbances, according to Dr. Reza Samie. Among patient symptoms to be treated are extreme slowness of movement (brady­ kinesia); tremors; uncoordinated movement (ataxia), or slow twisting / writhing from involuntary movement (dystonia) . While most patients treated in the clinic have Parkinson's Disease, he looks for more patients who have Tourette Syndrome, tremors, and Huntingcon's Disease. Helping Dr. Samie treat the whole patient are a neuropsychologist, a social worker, and a pharmacist, when needed. Each patient receives a complete neurological examination. During each visit, areas of patient dysfunction are carefully rated and treated, if possible. Emphasis is on drug therapy and treating the psychosocial aspects of patient disorders . "There is no cure for these neurological disorders at this time . But with correct diagnosis and treatment, there is improved • quality of life," relates Dr. Samie. (Condensed from ECMCs l'\6\NS letter "Update .") RPMI team reports on ultra-sonography T wo Roswell Park Memorial Institute researchers report in theJmma! of Surgical Onc.ologythat ultra-sonography is more precise in diagnosing palpable breast cysts than mammography. Although mammography (and palpation) will always be the best detectors of early-stage breast cancer, Dr. Dutzu Rosner, .associate chief of the Breast BUFFAlO jPHvs1C1 AN ! Surgery Department, and Roswell Park nurse practitioner Donna Blaird explain , it is not always able to differentiate between a fluid­ filled cyst and a solid tumor . Sixty-six patients with benign cystic masses and 120 with histologically-confirmed invasive breast cancer were clinically examined and evaluated by the two methods. The researchers conclude that "what ( ultrasound) can do will significantly reduce the high incidence of surgical biopsies performed on women with benign breast disease." • Buffalo General using new intravenous pump B uffalo General Hospital has instituted use of a small, portable new intravenous pump that will yield big savings and patient benefits. The Harvard Mini Infuser System will save $90,000 annually due to lower waste of drugs and a higher degree of quality assurance. Replacing the conventional Volumetric IV pump, it will provide inter­ mittent intravenous administration of drugs. Its convenience for patients lies in its ease and flexibility in attachment to the patient, and it is quicker to set up. • An HMO for the disabled under study T he State Office for Mental Retardation and Developmental Disabilities has awarded Robert E. Cooke, M.D., a $50,000 planning grant for the assessment and im­ plementation of a University-based centralized HMO-like service for more organized care of the developmentally disabled in Western New York. Dr. Cooke, pediatrician-in-chief for Children's Hospital, was awarded the grant in his capacity as chairman of the UB Department of Pediatrics. States Kim Griswold, R.N., M.P .H., coordinator of the new system, "We are the first in the nation co look at an HMO­ like system in terms of the developmentally disabled." • �29 Ettinger gives his 'last lecture'-early I BY BERNADETrE M. COMMISA W hat would you tell your students if you had only one more lecture to give before you left this earth? That was the intimidating question taclcled by Murray Ettinger, Ph.D., professor of bio­ chemistry at the UB School of Medicine, when the Undergraduate Biochemistry Asscx;iation invited him to share his thoughts and philosophies in his "last hour." "Ettinger's Axiom," he declared to the primarily pre-medical student audience, is summed up with the following words: "School really stinks!" He emphasized that this commonly expressed feeling has its basis in the fact that students do not see relevance in many of the subjects they are taught. He stressed that one truly learns to understand a subject only when it provides meaningfulness to one's life. "Meaningfulness and importance are the keys to learning," he continued. "And learning is accomplished through curiosity, interest, and necessity. Makesure that you learn the relevance of what you are taught in school. lf it is important to you and if you are interested, then you will learn." C entral to Ettinger's message for his "last lecture" was what he termed "The List ofFives." This list includes fiveacademic subjects from which he believes one can create relevance and perspective in a world where it seems so lacking. Lurking within literature, math, science, history, and philosophy are the antidotes to Ettinger's Axiom that "school stinks." By reading literature, students can learn about life and relationships with others that are so fundamental to all individuals. Ettinger reminded the audience that this understanding can be accomplished without necessarily studying the systems of psychology. "Remember that there were ways to under­ stand the psychology of people long before Sigmund Freud." Realizing that his audience's interests are mainly in science, he reiterated that the feeling that "school stinks" is caused partly by the fact that most math does not appear to be relevant to everyday life. The concepts in math that contribute relevance to the life of scientists are Euclid's axiom, derivatives, integrals, and Gaussian distribution. These are the most basic mathematical c.oncepts that need to be learned, he said. "lf students would learn these most relevant concepts, they could be spared much of the misery when learning more math ," he said. "Remember, if math is relevant to you, then you will appreciate it more ." The third discipline that Ettinger believes can provide insights for the life of a future scientist is history . But this cannot be accom­ plished just by learning by rote, he pointed out. The five periods in history he feels are most applicable to scientists are Ancient Greece, Ancient Rome, the Renaissance, Feudalism, and the Age of Enlightenment. These are where the seeds of rational thought, the scientific process, and intellectual freedom and tolerance can be learned. Ettinger paused momentarily when he spied the tape recorder of this reporter . He jokingly remarlced, "I hope you are not a representative of Accuracy in Academia, since I did not include the Industrial Revolution on my list." He then explained that he does not consider this period to be as important or relevant in a basic scientist's life. Philosophy is fundamental to the develop­ ment of future scientists, too, he continued. BUFFAID IPHVS1¢1ANI "It is a discipline which teaches a scientist how to think and how to approach science ." But there is one great misunderstanding about science, he said: "Science is not truth," he exclaimed. He related he was shoclced when he realized this in graduate school. He explained that "Experimental science is not truth but is simply a measurement which gives you a little average and a lot of error." Ettinger finds that the concept of evolution, the fifth on his "List of Fives," yields a particularly interesting view on life. "lt shows common origins of living organisms. The fact that a protein in me is the same as a protein in a pea seedling means that (the basic stuff of) a human is no different than that of a leaf," he said . "In my last hour , I would like to be remembered as a curly-haired guy who smiled a lot because he enjoyed what he was doing," said Ettinger, and referring to the fact that he had successfully related his philosophy within the allotted time, "and that I delivered my 'last lecture' in exactly one hour!" • 6 minority students are Regents awardees S ix UB minority medical students received Regents Health Care Scholar­ ships in Medicine, State Commissioner of Education Gordon Ambach announced recently. The Regents Scholarship program is aimed at reducing the critical shortage of physicians in certain areas of New Yorlc State and expanding educational opportunities for underrepresented minority students to pursue careers in medicine. The six UB medical students are Ruben Guzman, Carlos M. Lopez, Lourdes Maldonado, Raul Vazquez, Yvonne P. Waldemar, and Janet S. Winston. Scholarship holders will receive up to $10,000 a year for up to four years of approved study, depending on financial need. After completion of their professional studies, scholarship holders are required to practice in underserved areas of New York State. • Cfl/ 86 ��3/ PIRA _T _ORY OUGH Hyaline membrane diseasein premature infants can be reduced by lung surfactant infusion treatment BY BRUCE S. KERSHNER T he major cause of respiratory failure in premature infants can now be greatly reduced because of a break­ through developed by two UB pediatricians and their University of Rochester col­ laborators. Research by neonatologists Dr. Melinda Kwong and Dr. Edmur,d Egan demonstrated that the risk of hyaline membrane disease can be lowered by 90 per cent, according to their article in a recent issue of Pediatrics. The respiratory distress syndrome affects as many as 10,000 premature infants a year. They accomplished the 90 per cent reduc­ tion in incidence by extracting lung surfactant from calves and infusing it into the lungs of premature infants at birth. Besides dramatically increasing survival, the preventive treatment "will shorten the hospital course of many infants in the future," Drs. Kwong and Egan agreed. They pointed out that infants receiving the calf lung surfact­ ant were shown to require less oxygen and respiratory support in their first few days of life. Dr. Kwong is assistant professor of pediatrics based at Children's Hospital, and Dr. Egan is professor of pediatrics and chief of neonatology at UB and Children's Hospital. Children's Hospital. The two physicians explain that full-term babies are born with adequate surfactant in their lungs, but extremely premature infants have an insufficient supply of the substance. The surfactant is necessary to keep the alveoli of the lung open. Surfactant deficiency produces progressive lung collapse and inadequate ventilation. If the insufficient surfactant doesn't result in death, the premature infant begins pro­ ducing its own surfactant by three days of life. An average of 70 per cent of untreated, extremely premature, 24-28 week gestation infants develop hyaline membrane disease. Drs. Kwong and Egan conducted their clinical trials in 1983 and 1984 using 14 treated and 13 control premature infants in a prospective, double-blind trial. Dr. Robert otter, a University of Rochester M.D. and chemical engineer, extracted the calf lung surfactants and prepared them in his laboratory. Extraction removes 90 per cent of natural surfactant. The surfactant extract was instilled in the lung at birth before the first breath; it was only later that diagnosis of respiratory disease took place. The control group received only a saline solution. BUFFAID j PHv S1¢1 AN j Both controls and treated infants needed breathing assistance because of their immaturity even if they did not have hyaline disease. To diagnose the disease, prospective criteria were established, including oxygen re­ quirement and amount of mechanical ventilation needed, lung compliance, and x­ ray findings. In the treated group, two of the 14 developed respiratory disease within 48 hours of birth. This compared with seven out of 13 of the control group. I t was first discovered in 1959 that "preemies" often die because of deficient lung surfactant. Research in the 1960s ex­ perimented with the idea of administering artificial replacements and were unsuccessful. A 1980 study using an artificial mixture of phospholipids blown into neonatal lungs prompted Dr. Egan in 1981 to start ex­ perimenting using premature lambs. Kwong's and Egan's study is one of the first to use a preventive strategy for respiratory distress syndrome of premature infants. Pre­ vious studies have given surfactants to infants already diagnosed with the disease (called the (fl/86 �32 rescue strategy) with some success. The UB study was conducted in collabor­ ation with studies from the universities of Rochester and Tor onto, which had slightly different designs. "The fact that three separate studies from three separate inst itutions found surfactant extract effective suggestS strongly that it has a real future in the treatment of premature infants," remarked Dr . Egan. The Rochester research of Dr . otter and Dr. Donald Shapiro was reported in the same October 1985 issue of Pediatricsas the UB study; the Toronto study of Dr. Goren Enhorning was published shortly before it. Dr . Enhorning has just joined the UB faculty as a professor of gynecology and obstetrics and director of the Perinatal Center at Children's Hospital. Dr Egan explained that calves' lungs are used for several reasons. Freshly killed calves are readily available and their lungs would normally be discarded during food processing, he remarked . Also, there is no risk from infection from human disease such as hepatitis, as would be the case with extracts from human lungs. Furthermore, it is not yet possible to obtain natural surfactant in large amounts from humans. "The source at this time must be from animals ," he emphasized. A calf lung yields enough surfactant (0 .5 - I.Ogram) for fiveto 10 babies. One premature infant typically requires I 00 mg. of surfactant , although the amount varies with size. To extract the material, calves' lungs are washed out with saline. A centrifuge process recovers the natural surfactant, and solvents are used to extract 90 per cent of the protein, leaving CLSE or "calf lung surfactant extract." This extract is resuspended in saline. Approxi­ mately 3 ml. of the fluid is instilled by syringe into the trachea, followed by 7 cc. of air which becomes the first breath. Breathing is assisted with a ventilator for as long as needed. D rs. Egan and Kwong are currently setting up procedures to establish UB as the center for 10 or so other universities to conduct trials. The process to extract surfactant in Buffalo is now being set up to enable 15 g. of surfactant to be extracted within one or two weeks. A company has been formed to produce CLSE and is located 07/ ~ in the W estem New York Technology Develop­ ment Center incubator facility at UB. Egan predicts that FDA approvals for wider clinical trials will occur this year and that surfactant, if proved safe, will be in common use within five years. While animals must be used at this time to extract the substance, "artificial synthesis of the surfactant is our goal. It is theoretically possible but not predictable," Dr. Egan relates. The two pediatricians are involved with other neonatal clinical research . Dr. Egan is using animals to study problems of lung function and how the lung manages solutes and water in health and disease. He has been a senior funded scientist with NIH since 1974 , with current funding totaling $750 ,000. Dr . Kwong is researching neonatal asphyxia using pigs to learn ways of preventing and treating organ damage caused by insufficient oxygen in neonates. Dr. Egan, a medical graduate of Emory University, Atlanta, has been on the UB Medical School's faculty since 1977 . Dr . Kwong graduated from Indiana University Medical School and has been on UB's medical faculty since I 981. • Are dental fillings harmfulto health? BY SEBASTIAN CIANCIO, 0.0.S. A re dental fillings harmful to your health? This question has been raised because silver fillings - properly BUFFAID IPHvS1C1AN! termed silver amalgam fillings - contain mercury, which is known to be toxic in sufficient concentrations. The answer is no ( unless you are one of very few people who are allergic to mercury) . Half of the American population has at least one silver filling. Silver amalgam is the most widely used filling material throughout the world. Silver fillings are therefore a product that has received a great deal of testing - and there is no scientific evidence to show they do harm. Certainly, there is no justification for replac­ ing fillings already present in the teeth merely because these fillings are made of silver amalgam. As the American Dental Association has pointed out, such replacement operations involve risks of their own, up to and including the unnecessary loss of teeth. Nevertheless, a few individuals, including some dentists, claim that the mercury used in dental amalgam fillings is a health hazard related to a long list of ailments, ranging from headache to multiple sclerosis. They point to studies that have shown increased mercury vapor in air exhaled following the insertion or removal of amalgam fillings, or during gum chewing by people who have amalgam fillings. They also claim that when silver fillings corrode , mercury is released into the body and becomes part of various body tissues, particularly nerves. Let's examine these charges . • Mercury is used in preparing the filling material and to facilitate hardening once �33 the filling is placed in the tooth. The fiUing hardens within minutes and once it does, the amount of mercury vapor it releases drops to the point of being negligible. • Some studies have shown that the level of mercury in a patient 's urine increases following the placement of amalgam fillings, and that this increase remains detectable for as long as a week. The levels of mercury discovered, however, were more than l 50 times lower than the amount known to be harmful. • It is true that some amalgamfillingscorrode. But most of the mercury released during corrosion recombines with the amalgam and remains "locked" in the filling. Even if some mercury did escape and was absorbed by the body, the amount would be too small and would be released too slowly to cause problems. • It is also true that if you have amalgam fillings and chew gum, your breath may contain an increased amount of mercury vapor. This increase is shortlived, however, and, at most, amounts to one­ fifth of the mercury level considered safe by the National institute for Occupational Safety and Health for constant on-the­ job exposure. A few people (less than 1 per cent) are allergic to mercury and should not have amalgam fillings. It has been suggested, there­ fore, that e\!eryone be tested for mercury allergy before receiving silver fillings. There are, however, several problems with the mercury patch test that is used to check for allergies - including the possibility that the test may acctually induce allergy in some individuals. Furthermore, the accuracy of the test has not been well documented. Still, allergy testing may be necessary for some people who have reactions to recently installed fillings. (Symptoms include itching and redness of the skin, usually in the immediate area of the filling.) These tests should be. administered by an allergist or dermatologist who specializes in such procedures. For those who wish to minimize their exposure to mercury, two other materials are available for use in dental restorations: gold inlays and fillings made of composite resins. Gold inlays are much more expensive than silver fillings, however, and the composite resins now on the market tend to wear down when used on the back teeth . • Dr. C iancio is C linica l Prof8SSO!ol Phormocologv In the Medica l School and Cha irman ol the Denta l School's Deportment of Periodont ics.Artic le rep1inted t,y perm ission from Rx: Being Well. RPMI tests use of Vitamin A derivative BY COLLEEN KARUZA R oswell ParkMemorial Institute has received a $500,000 grant from the National Cancer Institute to test the vitamin A derivative, isotretinoin, as a prophylactic against basal cell carcinoma. Basal cell carcinoma, a disorderly growth of cells near the skin's surface, is the most common - and most commonly cured human malignacy. Although cure is virtually guaranteed with early detection and treatment, persons who have had basal cell carcinoma in the past are likely to see new skin lesions developing in the future. The first tumor may appear on the face; the next one on the neck. Currently, there is no way to prevent new basal cell carcinomas from forming. The National Cancer Institute (NCI) has BUFFALO jPHV$1C1AN) been investigating drugs that would arrest or disrupt this regeneration. In a pilot study conducted by the NCI, a synthetic derivative of vitamin A called isottetinoin effectively slowed the development of new skin cancers in a small group of patients treated for basal cell carcinomas. Based on this preliminary evidence, the NCI has launched an intensive five-year clinical study of low-dose isottetinoin as a prophy­ lactic against basal cell carcinoma. Eight study sites, including Roswell Park, were selected to conduct the cooperative clinical trials. At the Roswell Park study site, Dr. Howard L. Stoll, director of the Dermatology Section and clinical associate professor of derma­ tology, is the principal investigator; and Ors. 8. Dale Wilson and Cornelie Jones are co­ invesrigators. Barbara Slusarski, R.N., M.S., is the study coordinator . Two hundred skin cancer patients at Roswell Park will participate in the NCI "double-blinded" study. "The patients will be randomly assigned to one of two groups," Mrs. Slusarski said. "One group will receive a placebo; the other, the isotretinoin." Patients will take two 5 mg. capsules each day for three years and make regular visits to the Roswell Park Dermatology Clinic. After the three years, study researchers will compare the groups to see if the isotretinoin group had fewer basal cell carcinomas. Although they will stop taking the capsules after the third year, patients will return to the clinic for routine follow-up visits every six months for two more years. "All patients have been informed that should we find proof that the isottetinoin is effective, the 'blind code' will be broken, and the drug will be prescribed for all study participants," explained Mrs. Slusarski. Conversely, if the drug proves harmful at any time, the study will be abruptly discontinued. And how safe is isotretinoin? "Physicians have successfully treated more than 1,000 acne patients with isotretinoin at doses three to 10 times higher than the 10 milligram daily dose in our study," said Mrs. Slusarski. "As with any medication, side effects can occur; however, we feel that, because of the low dosage, any side effects that do occur are very unlikely to be dangerous." • 07186 �34 world-wide competitions, as a top ranking stereographer by the Photographic Society of America. In 1983 I was 18th, in 1984 I was in the 28th position and in 1985 (the last tabulation as recorded in the PSA Journal) I was in 13th place." John Stobo heads unit at Hopkins T he appointment of yet another UB Medical School alumnus to a nationally prominent leader hip position took place last year when Dr. John Stobo was named ChiefoftheDepartmentofMedi­ cineofJohns Hopkins University School of Medicine. tobo, who received his under­ graduate degree from Dartmouth College, graduated from the UB Medical School as a member of the Cla s of 1968 . He formerly held positions in the Department of Immunology at Mayo Clinic and Research Foundation and associate professor in the depart­ ments ofRheumatology and Im­ munology at the Howard Hughes Medical Institute of the Univer­ sity of California. Stobo is also currently chair­ man of the Arthritis Foundation's research committee and councilor of the Western Society of Clinical lnve tigation . He serves on the editorial boards of the Journalof Molecularand CellularImmunology and RheumatologyInternational. He is a member of the American RheurmtismNrocia!ioo,treAmn:an Association of Immunologists, and the honor society Alpha Omega Alpha . Stobo has received everal awards including the Merck Award for Excellencein Medicine and the Maimonides Medical Society Award . His research focuses on rheu­ m a tology and immunology, especially T-cell reactions . • -- G. Taylor <Jl/ 86 George W. Thorn (M'26) • received a major honor when a 16-story biosciences research building on the Harvard campus was named the George W. Thorn Building for Medical Research. The building is owned and occupied jointly by Harvard Medical School, Brigham Hospital, and Howard Hughes Medical Institute. Thom is a co­ founder of the Hughes Institute and has served as its director of medical research, chairman of its Medical Advisory Board, and currently chairman of its Board of Trustees. Thorn is Hersey Professor of the Theory and Practice of Physic at Harvard. He is also one of the founding editors of Harrison'sPrinciplesof InternalMedicine. At the naming ceremony, Harvard Medical School Dean Daniel T osterson said of Thorn, "He is that rare physician who has made signi­ ficant contributions in each of the career paths of medicine teaching, research and patient care:, Bernard S. Stell (M'36) • a retired psychiatrist, writes "l continue to be recognized in John D. White (M'40) • has been chosen as the Miami Lighthouse for the Blind repre­ sentative to the Florida Keys. Dr. White has been renamed as consultant to the South Florida Home Health and Professional Services. Donald W. Hall (M'41) • retired from practice in 1983 and is now medical director of New York Plasma, lnc. and a physician in the pheresis area with the American Red Cross. Morris Unher (M'43) • informs us that in October 1985 he was a visiting professor of obstetrics and gynecology at IWATE University Medical College, Morioka, Japan. Eugene). Morhow (M'45) • writes that he retired in December 1985. His new address is 57 Sherwood Drive, White Sulphur Springs, West Virginia 24986. Leonard Berman (M'46) • was elected president of the Past Presidents' Association of the Erie County Medical Society. His poster and VHS tape pre­ sentation, "Surgical Management of Chrohn's Granulomatous Enteritis -a 32 Year Follow Up of 367 Cases (1952-1984)" was presented at the Xlth Biennial Congress of the International Society of University Colon and Rectal Surgeons in Dallas, Tx., and at Spring Clinical Day in Buffalo, N.Y. Myron Gordon (M'48) • was elected assistant secretary to the American College of Obste­ tricians and Gynecologists at the College's Annual Clinical Meeting in New Orleans. Dr. Gordon is professor and chair­ man of the department of OB/GYN at Albany Medical College. Dr. Gordon's career includes research in family plan­ ning and contraception; cerebral palsy, mental retardation and other neurological diseases in children; and most recently, the prevention of low birth weight, and prenatal care and nutrition. He has been a consultant and advisory panel member to various federal government agencies on perinatal research and over the counter contraceptives. Dr. Gordon has authored nearly 50 scientific journal articles and book chapters. Robert D. Sanford (M'49) • afrer retiring from the Phelps Dodge Corporation, is now with the Family Health Center in Casa Grande, Az. Irma M. Waldo (M'49) e of Hillsdale, N.Y., closed her solo pediatric office afrer 35 years. She is retaining school jobs and will continue as medical director of an alcohol center and nursing home. �5 Patricia A. Meyer (M'S0) • of Haines City, Fl. writes: "After attending my 35th Class Reunion in 1985, I believe that I can claim the honor of being the first female OB/GYN resident in Buffalo and the first OB/GYN resident to have a baby while a resident. I trained under Dr. Ed Winkler at E.J. Meyer Memorial Hospital (now Erie County Medical Center)." Dr. Meyer is Field Professor of Family Medicine at Meharry Medical College. Morton A. Stenchever (M'56) • is associate editor of Obstetrics and G:,necology, the official journal of the American College of Obstetricians and Gynecolo­ gists. Dr. Stenchever is professor and chairman of the Deparonent of OB/GYN at the University of Washington, Seattle. Joseph A. Oipoala (M'64) • is an assistant clinical professor of medicine at the University of Rochester School of Medicine. Marvin Z. Kurian (M'64) • was promoted to Lt. Col. in the U.S. Army Reserve Medical Corps in January. He was elected to the Research Editorial Board of Sports Meaicine Journal. Dr. Kurian is a member of the Presidential Associates of the UB Foundation and the John Wille.esClub of Wille.esCollege. Stephen E. Langer (M'67) • writes a weelc.lyhealth column for the NationalExaminerentitled "Medicine Man." His book, Solving the Riddle of lllness, was published by Keats in 1984. Dr. Langer has a private practice in George David Goldberg (M'70) • has been elected to fellowship in the American Academy of Neurology. Or. Goldberg is chief of staff at the John C. Lincoln Hospital, Phoenix, Az., for 1986-1987. Orthomolecular Berkeley, Ca. Medicine John W. Kraus (M'72) • is chief of staff at Lourdes Hospital, Paducah, Ky. He is in private practice specializing in gastroen­ terology. in Julian R. Kareliu (M'68) • a specialist in nuclear medicine, was elected to the Executive Com­ mittee, Saint John's Hospital and Health Center, Santa Monica. Dr. Karelit:z has been in the screen writer's program at UCLA for the past four years and received a certificate in screenwriting in the spring of 1986. Dr. Karelit:z headsa medicaland literarycorpor­ ation for film and television writing. S.K. Bosu (M'69) • was recent­ ly appointed chief consultant in pediatrics/neonatology by Lagos State, Nigeria. Dr. Bosu is an associate clinical professor of pediatrics at the University of California at lrvine. Peter Mansky (M'68) • reports he practices general psychiatry and psychopharmacology in Albany, N.Y. Heison the clinical faculty in two departments at Albany Medical College of Union University and on the editorial board of Ps:,chiatric Quarter!:,. Manslc.yhas published widely in the areas of depression treatment and drug and alcohol dependence. Richard N. Warnock (M'72) • informs us that he is a medical examiner for the FAA and a pilot with commercial and in­ strument ratings. A specialist in orthopaedic surgery, Dt. Wamoclc. is director of the Sports Medicine Department at the University of Lowell, Ma. In 1980 he was guest editor of the Antholog:, of SportsMeaicine. Tone Johnson (M'75) • is a diplomate of the American Board of Family Physicians, and a fellow in the American Academy of Family Physicians. Dr. Johnson has been selected by the Military Academy (West Point) to serve as its liaison in South Texas. Steven Lari (M'75) • moved to Atlanta where he has a private practice in psychiatry. He is affiliated with the Charter Peachford Hospital and the Ridgeview Institute in Atlanta. Stanley Kramer (M'76) • writes "I am medical director of the Community Health Care Plan, an HMO in Stamford, Ct., and also continue happily practicing primary-care pediatrics." BUFFAID IPMVS 1 ¢ 1 AN I Nora B. Wilcox (M'76) • recently received the Mary Lyon Award from Mount Holyoke College, Mass, her undergraduate alma mater. Dr. Wilcox is a Lt. Commander in the U.S. Navy Medical Corps and flight surgeon at the Whidbey Island Naval Air Station in Washington State. The award honors young alumnae who have demonstrated achieve­ ments during the past year. Wilcox previously received the Sikorsky Helicopter Rescue Award for her participation as attending physician in a helicopter rescue. She is in charge of four squadrons of naval flight personnel and their families and is part of the Naval Search & Rescue team. She was commis-­ sioned in the U.S. Navy in 1980 after completing a residency in nuclear medicine in UB's Medi­ cal School affiliated hospitals. JamesJ. Creighton,Jr. (M'79) • just published "Primary Malignant Tumors of the Upper Extremity: Retrospective Analysis of 126 Cases" in the November 1985Journa!ofHand Surge,:,.He is an Arizona Medical Society member and lives in Phoenix, Az. 07186 �36 Dr. Alice Unger • who was a clinical associate professor of child psychiatry, recently died at the age of 78. After graduating from the Universiry of Bonn in Germany with the Doctor of Medicine degree in 1931, she attended the Universiry of Berlin and specialized in pediatrics. She practiced this specialry there and in this country until she started her residency training in psychiatry in 1954 at Buffalo State and Meyer Memorial hospitals. Continuing her interest in children, she also trained in child psychiatry in Buffalo and joined the faculty of the Department of Psychiatry where she remained until her retirement in 1977. Dr. Unger was beloved by her students and patients. She not only taught medical students, psychiatric residents, and nursing students, but was also active in supervising pastoral counselors and nurse clinicians. As a former pediatrician, she headed the liaison service to the pediatric wards, also teaching pediatric residents basic facts about child psychiatry. Her research and clinical interests focused on suicidal attempts in younger children, many of whom were also involved in drug abuse. She also specialized in treating patients with Anorexia Nervosa and was acknowledged to be very successful with difficult patients where others had been unable to help . Personally, Dr. Unger was warm, friendly, conscientious and always helpfully cooperative with her friends and professional associates . She made an important contribution in the development of child psychiatry in the Department of Psychiatry and communiry . She will be missed by all of us. • --S. Mouchly Small, M.D. Dr. Edward R. Cannon (M'40) • died recently. A resident of Cazenovia, N.Y., he was, among other things, respected by his class colleagues for his leadership in the recent Class Reunion Gift program and for his generosiry. • Dr. Rocco A.V. Spano• died at the age of 93 on December 20, 1985, after a short illness. The pediatrici an had treated patients for more than 60 years. Born in Calabria, Italy, he received his 07186 M.D. from the Universiry of Naples in 1919. He served as a professor there for two years after five years in the Royal Italian Army Medical Corps. In 1923, he came to the U.S. to visit a brother in Rochester and was convinced by a doctor in Buffalo to remain here for his medical expertise. Spano practiced pediatrics in Perrysburg in 1925 and then in his Buffalo home starting in 1934. He was also an Italian consul for 12 years until the early 1930s. He was one of the first doctors on staff at Columbus Hospital and was on staff at Children's Hospital. A member of several medical societies, he was one of the founders of the Italiancultural organization, the Dante Alighieri Club. He is remembered for his generosity to his patients, many of whom never received bills. He saw patients until the year he died. He is survived by his late brother Oomenics's children and two sisters, Catherine and Marie, both ofltaly. • Dr. Harry Baltaxe • died on August 24, 1985, of a myocardial infarction. He did his internship and residency at E.J. Meyer and Millard Fillmore hospitals . A medical graduate ( 1960) of the University of Lausanne, Swiaerland, he had a successful academic career at SUNY Upstate Medical Center in the 1960s, at Cornell, and at the Universiry of Nebraska, where he was professor and chairman until 1980. From 1981 until his death, he was a professor at the Universiry of California at Davis. Contributions may be sent to his memorial fund in care of John Rosenquist, M.D., Department of Radiology, Rm. 109, UCO Professional Building, 4301 X Street, Sacramento, CA 95817. • Dr. Thomas Kent Terrell (M'47) died in Buffalo on July 24, 1985, at the age of 62. Or. Terrell was a Fellow of the American College of Anesthesiologists and a Diplomate of the American Board of Anesthesiology. His memberships included the New York State Sociery of Anesthesiologists, the American Sociery of Anesthesiologists, Inc., the Medical Sociery of the Counry of Erie, and the Medical Sociery of the State of New York.• BUFFAID CTE'i" s' I C I AN : Dr. Fraser D. Mooney, M.0. 88, the first physician to hold the title of director of Buffalo General Hospital, and who retired as director after 34 years in 1962, died August 22 in Pompano Beach, Florida. After his discharge from the Canadian Army, he enrolled as a medical student at McGill Universiry in Montreal where he obtained his M.D. and a master of surgery degree. In 1924, he became an intern at Buffalo General Hospital. The Hospital's first resident surgeon, Dr. Mooney was put in charge of medical and surgical administration, and in 1947 was given the title of director. The Nova Scotia native was widely credited with organizing the Hospital into departments and had a reputation for meeting each hospital patient personally to inquire about care . Upon bis retirement, the Buffalo Chapter of the American Red Cross presented him with a certificate for distinguished service. He was a UB adjunct medical faculry member for almost 30 years . Or . Mooney was the founder and first president of the Western New York Hospital Council and a past president of the Hospital Association of New York State. He also was a past president of the American College of Hospitals, an national organization based in Chicago. Or. Mooney is survived by his wife, Norma; four sons, Fraser, Robert, Daniel, and Thomas; a daughter, Charlann; 17 grandchildren and four great great grandchildren . • Dr. John Paroski (M'BO) died suddenly on September 19, 1985. Dr. Paroski had served as a pediatric resident at Children's between 1980 and 1983 . Following a one-year appointment as chief pediatric resident, he left the hospital in 1984 to enter private practice with Tom Foels, M.D. The Buffalo native was admired for his caring nature and the warmth he displayed towards his patients. He offered an abundance of gentle concern for each child he treated. He is survived by his wife, Dr. Margaret Werick Paroski, and children, Andrew and Jacqueline. • �■ ROSWELL PARK ONCOLOGY SEMINARS: • Update of Controversies of GynecologicMalignacics, chaired by Dr. Steven M. Pivcr, Saturday, Sept. 20, 1986. • Trends in Management of Advanced Prostate Cancer, chaired by Dr. Robert Huben, Friday, October 3, 1986. Both will be held at Roswell Parle Memonal Institute, 666 Elm Street, Buffalo, NY 14263. Contact Gayle Bcrsani, R.N., Coordinator of Continuing Education, (716) 845-2339. Fee: $45 - Physicians; $15, Allied Health Professionals; No fee, students. ■ UB PEDlATRIC CONTINUING MEDICAL EDUCATION PROGRAMS FOR 1986: • The 9th National Conference on Pediatric / Adult Allergy and Clinical Immunology.July 10-12, 1986. Four Seasons Hotel, Toronto, Ontario. Credit Hours: 20. Fees: $325 Physiciansin Practice,$185 Allied Health Professionals. • The Cape Cod Conference on Pediatrics. August 1-3, 1986. Dunfey Hyannis Hotel, Hyannis, Cape Cod, MA. Credit Hours: 15. Fees:$300 Physicians in Practice, $175 Allied Health. • Advance in Ga tro­ enterology and utrition, 19 6. August 15-17, 1986. Dunfey Hyannis Hotel, Hyannis, Cape Cod, MA. Credit Hours: 25. Fees: $275 Phy icians. Contact: Rayna Saville, Pediatrics, Children's Hospital, 219 Bryant Street, Buffalo 14222. Tel. (collect): 716878-7630. ■ CHILDREN'S HOSPITAL ALUMNI DAY. September 26, 1986, Kinch Auditorium, 9-5 p.m. "Genetics of Hyperlipo­ proteinemia in Children" by Jean Courtner, M.D., former chief of pediatrics at Children's, now U. Penn. professor of pediatrics; also with Children's Hospital of Philadelphia. ------------------------------------------------------NO POSTAGE STAMP ECESSARY IF MAILED IN THE UNITEDSTATES BUSINESS REPLYMAIL FIRSTCLASS PERMITNO 2210 BUFFALO. NY POSTAGEWILL BE PAID BY ADDRESSEE BUFFAID PHYSICIAN 139 Cary Hall State University of New York at Buffalo Buffalo, New York 14214-9980 I,,,11, I,,I,,I,I,,,11, I,,II,I,,I,I,,I,,I,11,,,,, I,II �on -Profit Org . P H Y S U.S . Postage PAID Buffalo , . Y. Permit No . 311 A N C State University of New York at Buffalo 3435 Main Street Buffalo. New York 14214 Address Corredlon Requested J• AV 23 OURSHC D u 142 9 - -------------------7--~~-_;;~;,;-;;o;.-vou--7------------Fmout this card (Please print or type all entries) Name _ ________ ___________ _______ M.O.__ Ph.D.__ Year Received ___ _ Office Address Home Address - ----- --- ----- ------ --------------------- If nol UB, M.D. or Ph.D. received from In Private Practice : In Academ ic Medicine: Yes Yes ..J No Specialty Part Time - Full Time School _ __________ _______ _ Title ___________________ _ Other: Professional Society Membersh ips --------------- - -- - - ------------ News : Have you changed positions. published. been involved in civic activities. had honors bestowed. etc? ___ Please send curriculum vitae, clippings. publications , or announcements. also include a photo of yourself. -- ____ _ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, July 1986 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1986-July Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1986-v20n02-July Table Of Contents A list of subunits of the resource. A Mad Form of Art Medical Miniatures He Made History Senior Physicians Buffalo Surgical Society Chronic Pain, Osteoporosis & AIDS People Hospitals Students Research Classnotes Deaths Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-27 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v20n02 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1986 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/485735cf822210f55d099734146efd9e.pdf 7ca079607af208977e480e5cb9e214b3 PDF Text Text P H Y S \'C I l. IE 2 \ • 'L'\181:R Th Hi tory of M dicine Coll ction C A N �BUFFAID HYSICI A 1] D an' Mes ag~ Tr\ff El D I:.E Tl I u lcer R RT DIRH f R Im J K •lcr e.tr Friends of The chool of Medicine: metcen e1ghcy-s1xllx1b like a h;:mner year for the hool of "1cdicme Alter ,1long, long \\a1t th ne" wmg of the Main treet Complex will be completed and opened. Th, fr ilit} will hou e a totally new and modem animal facility and the major tea hmg and support ,;ervice. for the medi al tudent . The av::11labil1tyof mul­ t1purro,c teaching facilities and of many mall teaching-conf..•rence nx1m hould facilitate the pro\'I mm. of educational inmwat1on, and mnre personali:ed tea hing-leammg experiences. ln add1t1on, the ne\\ facility will prov1d the admm1strat1ve home for the h1X1Ifor ,lt lea,r the next two }ears. In the fall, Farber Hall will be cln ed ,md a two year renovation pmJect will he m1t1att..J. When completed, the ,1d­ mm1 tranv office,, with the exception of those dedicated to the academic support of medical student , will he relocated to the Farher Hall facility. The Medical Alumni ,1re making 19 6 a hanner year a well. The· have planned another c ·cellent program for ,prmg lmi ,11Day. Their ,p •cial gu twill he a former Western ew Yorker, Dr. George Harem, who ha, been a maior leader in medicine m Mainland hma for man) year . He " re,pons1hle for the eradi am n of luetic di,ea e in hm,1 and 1, cummrly leading the way ro prevent and eradicate leprosy. Dr. Harem will make many appearance. during his "return home" and will be providing valuable insight~ on the current qatu of life in Chm, • Dr. John Richert and r. Jo eph M,msfield have worked clo.dy with the leader of each of the Reunion la~ . It i apparent chat ch,, program will once again be a huge succe ... My thank to che leaders and to ea h of rhe cla se, for th 1r contmucd upporc of our endeavor.;. The e pro)?ram ,erve to facilitate the chool' progres in many area .. incerel)', John aughton, M.D. Vice Pre ident for linical Affairs Dean, hool of Medicine 0 PIT LS er,11 ,I ( m er I In 111utc Medical Alumni A ociation Pre ident ' M s ag A I thmk .1hout completing m) term as your pr· iJ nt, I w1.h w c~ank my dMinguishcJ hoard of phy 1c1ans_for1t, uppport ,mJ w1 counsel. Our ,um for the )car wa to build a hndge herween the wisdom ,md knowledge of the older phys1c1an, and the energy anJ th· technical prowe s ot ch• younger dt tor . ur 1r,t . tep m rhi, pH e wa, the development of a newsletter. We look for.vard to more effort, in communic.1tion m che year to come. I had thought of enticlmg these remark , "From ulfa co Laser," wh1 h would be a review of my year, in medicine. I have always believed that I was privileged to work m medicine during the "golden )ear,." The wonder drug, cue mortality rate. dramatical! and permitted m,my surgical technique to ·volve. I can still remember ailing ulfa "the holy powder." The development of mammography and th C. T. an, for example, as well as all of the daca collection from elccmm1c momconng of all kmd have given u. so many more diagno. tic cools. We are encermg a whole new age of la. er surgery which may make urger)· ,1 we know 1c h >lete. A. I kx>k hack over 4 •. 1m year,, I want you to know I feel it wa.· a very exciting time co he a doctor, During this time, a doctor wa a highly respc ted member of his com· mumty. "Tim , arc a changing" - we ,1IIknow the new problem t>nthe hori:on. As Hemingway > wi ely wrote, "Life break. people m many places, but ome gee . cronger m the broken place .. " Charle. ]. Tanner, M.D. '43 �B P H Y S A N CONTENTS THE AR O I T • Arsoni Tare perhap · the most p y hiatri :tud · mi 'judged riminal - of our ·o iety. by Or. eorge olnar ha found thm most arsonists hav no particular fa cination with fir and do not get any exual ·rimulation from them. 5 A E THE IOLOGY 8 TRA ELI G TIGHT 1 A ·ocicty hanges and a · the field of medical knowledge expand ·, the development · that result are ultimately reflected in the work pla e of medic in - the operating room in term of n w appli ations or advance · in anesthciology. HOOL • 17 HO PIT L EW • 24 TUDE EW CHAPTER • A new haptcr in th hi ·rory of the Hi -rory of Medi inc ollection b gan with it, renaming a the Rob rt L. Brown Hi tory of Medi inc ollcction and the opening of it elegant ne\ quarter: in the refurbi hcd Health nee , Library. RE E R H • 21 Dr. M ·ra in nc,, op,:rating room at Buffalo General. ce Anc,thc,iology Update. • omething wore than diarrhea u ually trike · mo t traveler . They and their doctor · don't talk mu h about it. MEDICAL EW UPDATE • A - T • 27 L M I• 2 Dr. George Hatcm, Buffalo-born medical advi. or to the hincse, will keynote the annual pring linical Day, ay 10. PEOPLE • 31 LA OTE CALE DAR • 36 , �2 THE He' likel to be a young, white male who gets no exual gratificationfrom fire, tud finds A r on1 t, ,1rc rcrh,1r the mo,t mi,Ju lgcJ crimin,11, of our ,oc1et). "Before I ,t,mcJ thi, ,rudy my impre itm ot the ,ir 0111c w,1 ch,n of ,1 pyrnm,miac who got tHne e. u,11gr,1tific,1tion from,ettingfire ,"rel.He Dr. C.,eorgc Moln,1r, a llU,ltc profe or ,md \'ice chairm,111 of the Department of P,ychi­ arry. But upllll completion of rh1.· mu,r c11mprel1en,l\·c modern rwchiarnc rrntile of ,1Nmi,t w d,1t,:, he re,1li:e,I rl1.1r h1 inin,11 11nrrc-,sion \l ',I' nll more than .1lal,e rereon·r ·. Fl1r exampk-. rhc cPnclu 1011, of h1 ,tu Ir re\·eal thM tllll r ,1r mi,r, han: no r,1rt1cular fa,cinarion w1th fire, :mJ Jo llllt gee ,m1· ,:. u,d nmularion frpm rl11.·m. Dr. Molnar, who i, ,11,oclimcal J1rec.:tor l5 o of p,y hiatry at Ene ~ouncy Medical 'enrer, i well kmmn for hi rnm 1r1 ·ire,1 of re,earc.h mro p,ych11pharmacology an I mooJ d1 order . Ju t a, the condu ion, of thi tud\ rmmpreJ rhc re\·1,lllll of h1 own i lea of the ar onisr, he hope the re ult will en·e ro guide and educ. 1tc the poli c and the court, to the face char .ir 0111,r ·ire not 1hny, h.ir 1-cmc 1.nm111.1l,, 1 the) uc oircn Jep1ucJ anJ treated. Thi i parrl) related to the fa t that ,1Nll1 1 perhap, the e.1,1e,r crime to commit. "Other \'io­ lenr crime require ncrn: and pcrh.ip the u,e of ,1gun or ,1knife," e. phm Dr. ~fol­ nar, "hut all the ar PnM need, 1 ,1 march ,md ,1 piece of pap ·r. "Thi, tudy look- ,lt ,ir Pni r .i ,1 BUFFAID (PHv$1¢1AN 1 group," ,rare, Dr. Molnar. Though other im·e,tiganon ha\'c ,rudicJ ar m ,md the ar-,0111,t( the mo t not,1hlc h) Lewi ,md Yarnell puhli,hed in 1951), r. Molnar note that, "th1 i, th · hr t contemporary ,rudy which kxlk at all a peer of.ill types tif ,1N1111,t. " Unlike the 35-yc,ir-til I ,ru ly, which limircJ it ,,1mplc to ar­ ,0111t, with a h1,rory of mental health prnhlem,, 1olnar' ,cuJy c.1n·cr, the com­ plete population of arrc,tc I ar on1 t 111 ,1 mctropolit,m count , mduJmg tho,c w1th mi prior mental or rimmal h1 tory. Al o, r yd11 Hric d1agno i, ha hccnmc mud1 more refine I in the three JccaJc ,incc the la,t clas iL,ll ,rudy of chi n pc \\ ·,1 ,lttempted. [ r. Molnar heL,lme mterc tcd m under- �3 raking a study of arsont ts while attending patients tn the lockup unit of Erie ounty Medical enter. Tlus unit rreab tho c in need o( med1 al attention who have been arre ted nr convicted of arson and other cnme .. He encountered one patient \ ho had ct tire to h1 apartment, hut hdonged to a dbtinguishe J fomil) an I had no pre­ v1nu · histor 7 of mental problem or cnm­ mal record. Dr. lolnar d1agno ·eJ the pa­ tient as ~uffenng from manic Jepre sive disorder, which he treated with lithium. A a result, the patient responded well an I recovered. Yct the arson charge re­ mained pend mg over the paru::nr although thts individual wa , from a psy hiatric ,tandpomt, not re pom1hle for his actions at the t11ne. Because it took Dr. Molnar an cxtremcl) long and difficult time to get the patient cleared in the courts, he rcali::ed that others with imilar condi­ tion \\ ho arc convicte of arson might suffer rhe unfortunate plight of a prison term ever though they may not necess ,H­ ily he dc,erving of one. T he research for tht study, begun in early I9 I, tonk four years to a· imi­ latc. Dunng this period Dr. Molnar'. re­ ,earch collaborators were Lydia Keitner, executive d1recmr of Foren ic Mental Health ervtcc~, Robert Ford, commis­ ,ioner of Ene Count't Central Police er­ vice , and Thoma~ Harwood, Ph.D. They surveyed the records and files of 225 people \\ ho had been charged \\ i th com­ mimng the crime of arson O\Cr the previ­ nu four-year pennd. Where records didn' pmviJe suffi tent information, in !1v1Ju­ al were interviewed per onally. The data obtained from the rccl1rd and interview, were analy:cd for 7 variahle, per person. Dr. tolnar chose the variahlc to account for as many relevant factor, as pos,1hle, "The majorit of per on committing thi crime are not hardcorecriminals but rather individual who, driven by anger, exercise ver poor judgment . .. . Often the ar onist want to get even with a wife or lover who ha caused him pain .. IJ Arson i, ea } ro .:ommir. All the ar­ ,oni,t m·eJ, i, paper and a m.uch, ,a}, Dr. George 10/n,1r. BUFFALO ~ K1i ranging from w ·h ohv1ou, parnmetcr ,1 mental health history, 1.nminal hi tory, ·ex, race, and age, w lither \ariables ,u1.h a family and educattonal hackgrnund, the mental ,rate ar the time ,){' the offcn c, and whether the per ·on ,1cted alone or with partner. From the data it became apparent th,lt the most commlln mnti\e h1r ar,on 1, rl'­ venge. Ver, often the arsont ·t wished to get even with a wife or Inver because of an incident or ,enc. ol mctdenr, which cau,ed him ,e\'ere emotinn,1! pam. Or. 1oln,1rcited one example of a man who,e wife C\ i red him and hmught a lo\·er in to live with her. The man, who haJ re­ cently lo,r hi, ioh of man, year,, wanted to pre\'ent her an l her lon;r from acquir­ ing the hnu e that he had worked tor all his life, ,o he attempted to ,ct fire ro it with gasolme. In the cnur,e of thi, at­ tempt, the hushand and his wife were humed and the house caught fire. " ascs of thi, ryp • indicate that the maiont~ of per on. ommitting th" crnne are not hardcore <.rnnmal type hur rather 111d1v1dual,who, driven h, .inger, exerised ver, puor judgment," empha,i: •s Dr. Molnar. Howe\ er, the stud) also revealed two ,mailer classes of offender~: a younger group, adolcscenr, and teen,, who com­ mie nr-,on for excitement, and an old r group \\ho commit ar. on ~olel) for profit, u uall) 1murance fraud. Members of ch'. e two grnur~ ~howed a tron!! tendency ro act with partner wherea the revenge ar­ ·0111 r mo, rly act alone. "The pre,ence or absence of an accomplice appears to he �-f ,1 p,nn:rtul 111J1c.m1r,1, tll thl' m11ri,·I.' 111 rh1' i:nml.'," ,1,,en Dr. :-.loln,1r. Th1N.' oft •n 11.'r,\\'h11 form ,1 i:nmin,11 p.Htnl.'r h1r .mJ c11mm1t ,\Nll1 f11r rrntir 1M1,1lh1.,H"-I.'thl.' gn:arc r ,11nount of J.1m­ ,1gl.', in t1.·rm, of Joll.ir ,·.1lul.', hur qum.' ir11n1cillv rhl'\ 11,11,ecm r11rl.'1.l.'I\I.'lcssl.'r d1argl.' . Th1, 1, hecathl.' rhc ,Kt nf l.',po,­ mg p •oplc ro p11, 1hle 111iury or death Jr.,,,, m11re,ennti-, harge of ,ir on 111thl.' hr r nr ,1.'n>nd legree en'n 11n11C,hualtie, actualh ll ·,ur. In cuntr ,i-t, rrorertr J,1111.ige ,1l11nc hring le" , ·nou, d1.irge, of third ur tm1rth J •gre · ,\N .ll1. Prntn-muri­ ' atl.'J ar 11111,tfoll into rhe latter 1.,1teg11r) l.'vcn though their ace 1, ,,h, a\, r1l.'-meJ1t,tteJ ,mJ often 111n1ln: high rrnpl.'rt\ lamage. The) tr\ ro ,wo1J human ca,u.1l­ t1e, h) ,h.tmg ,lt night 11rar prl.'-pl,mnl.' I rime, ,,hen It 1, known rhac ,1 hutlding 1' unocu1p1c I. r oni t, mot I\ aced h) ,mgl.'r 11r re­ \'l.'nge, ,1ht1ur 5 per ci:nr ot the ror,11. c.1u, • pmp rty Jamagc, gl.'ner,111. hdu,, 5 0. They 11"ren lac• hrsr or ecnnd Jl.'­ gree ch,irge,, hn\\'I.'\ l.'r. hec\ll,e other, ,1ri: 111the area at rhe nme chi: 1ltfon,e i om­ mmeJ. Thu , scare [ r. Molnar, "in the Je(1111t11mnf the often e rhcn.' 1, ,m un­ u,ual empha,1, on che rx1,,ihil1cy 11f risk w porennal v1Ct1ms rather than on the monvc for nr thi: 1 rual m1tc.1in1eof the u1 me 111rcrm, of per,on,1I 111Jur\ 11r pnipcrty lo . Thi ddininon appear, tn 111 lucl.' ,omc d,,rorrion 111 the iud1 1al pro­ cess mg of chi: ,1r,nn1 t," he m)[e . I n the profil..: 1f th• typical ,1Nm1,t, ,e\'er ,11 1.h,1r,1ren,n ·, emerge ,,h1ch ,me wnulJ nor commonly a, iciate w1rl1 thh da ofoffenJer-,. The r pica! ,ir nni r "i, ,\ 27-ye,u-llld, \\h1tl', mgle, un­ employed male with a grade chool eJ11c,1t11111.Unlike most vinlcnt nmc , ar,lln 1 mmt oft '11 comm1ttcd h ,, hire, rather rhan hy minont1e,," e plain, Dr. Moln,u. The typical profile abo reveal, "con 1J­ er,1ble fomd di rupt1on 111d11J1ngthe ah­ ,cnce of the lather." The aNm1,t u lnll\ burns "h1, own or another familiar placl.' during rhe ,ummer mtmth 111 the e.irlicr hour of the mormng while under the 111tluence of !rug, anJior alcoh 1I. I fl' ha, a prior arrc t hiswry bur Ji I not go to J,HI for chos • h,irgc,. H i likely ro have a rri ir mental hi:,.lth reC11rdhut al,o ha, d \·cry low pn1hahi11t\ of hemg luunJ inG)m­ perent en ,tand mal m to he determined n1lt criminally re ron 1bll.'. He u,c, ,1 im­ plc, lxirJering up11n crude, modu operan Ji, ,mJ ,1, fire, g11, pniJu I.' lti\\· monet.11)· I.image. 1'.!t1r1:rhan lik..:h, he ,1 t out 11f,l mnti\'c of rc, ·enge, ,mgi:r, 11r lither tnrm of em11t1tH1 ,d e,rrcss1l,n, bur without ,111 overt ,e,u.tl content ." Fmalh, Dr. Molnar ,Jd,, "9L per ent nt ,111ar 0111st,arc rw,..:r caught, ,\Ccor !mg w ,tr'llll mve,cigaror,." Thi, i... hecau,e ut thl' u,ual l.1ck of ev1Jcn c ,H rhe , ·en..:. :-.hi...t ,ir,0111,r ha"c hi wrie, ut only and few .ic­ mmor cnmc, 11rn,mc at ru.ilh ,peci.1lize 111the 11tfen e of ,1r,on. A ,1gn1f1·,mt pmporm1n, h11we,·er, are re­ \'(1lnnt? drnir 1>tfenJer, 111n1h-ed in rhe mi.>nr.11 hi.>,1lrh y,t..:m, ,mJ, ,lt other nmc . the cnm111,1IJll'-ti e \'stem. .,II. ' tati,ti cal Profile of the rsoni,r • 7 i • t LT•lg( ,i"t' 1 :. 7. - j,,r 111~11 and ~; fin- u nnen • 96 1\1 Du nor hat I! a ""lle(!t'educ·1C11111 1 11 • • Art not 11u1rrlt'd 7' ,, M,,t~ mc n/>lo .d • ,1 fm ,r mc111t1/h<• ilth fmh­ • lem /11tor::, • 6 ,, o \'i'hue e til''u / l,11C llll rc,ord CIT(I mmor fnwr Ll'lllllll B ,r uffalo ha h.iJ It, fair ,hare of rrohlcm ,,nh rhc cnml' 11'ar,11n. In the I.ire ,e,·cnri ·,,,hen rheri: wi:re a laq.(l' numher tif t.·mpt\ 111Jum,1I properc1e, ,md ahanJon..:d huil 1mg, 111Ruffalo, p,1rt1cu­ l.irl} 111th..: d1mntln,n ,ecmin, the gm\\'111g int.1den e 111ar 1111 t11gether "1th the Jcprc,,ed econ11111\po,e,I a ,e\·erc thre,1t to 111.1mfurmerlv rhri, ·111gnc1ghhorhoo k The rate of ,,r,on re,tched ,uch ep1dem11. proportion, in Buffalti, , 'e,, Y11rk, PhilaJclphi,1, ,mJ other citie th ,H 111197 111gre" cn,Ktl'd leg1,l.1t1on which re­ qu1r •J n,monal rt.>pnrring of ar,lm h) the F. 8.1. AN>n \\a at 1c, peak 111I 97 when ,o ine onom1c ond1t1on, 111 many c1t1cs fo rcrcd inc1Jenr- of insur.1nce frau I and BUFFALO (PHV$ 1 C t AN I ,·,md.ili m which commonh u,ed ar,11n ,1 .i tool. ~ 111e 19 I the frcqu ·nq h,1 Jc­ d 111eI. Bcn,een I 9 ' 2 and I 9 4, fnr 111t.inc •, 111 1dent, of ar on in Enl' 'iiunt\ decrea,cJ Imm ' 74 co 662, a 14 per cent reduc.non. However, t1xla) it ,rill rem,1111 ,lt ,l le\'cl re,r<111,1hlefor rhl' en,..:lc, Im, , 11pl'rh ,1p, hundred, nr thl1u,and nf ll\ ·e, ,111I hun lreJ, 11fm1ll1on of dollar, l'Wr\ ve,u ,Kro, the n ,,rion. Mtilnar, a nari\ ·c o Lit, 1.1,earned hi, undcrgraJu,nc degree frl1m 'amhriJgc l 'n1, ·r...ity ,mJ hi, me lical degree ( 1957) from the n1vcr,ir, · uf Florence, Irah ·. He cnmplctcd h1, re . iJcn y at , 1cMa,ter n1,·er It), Ontarin, and cr\'Cd on the faculty there for eight vcar heforc om111g co ' Bin 19 He 1, 1 fellow of the merican P, ·ch1.irnc A, oc1at1on, a. well a, r,1't treasurer e,tern . ew York ,mJ ,ecrer,1n of it, Di met Bran h. He ha, ,erved a, an exam mer for the Am ncan B..1ardtif P y­ chiarrv and eurology anJ i a on ulranr for rhe Fmcn,ic Mental H 'alth crvicc of Enc Cnunr,. Or. 1t1ln.1r i, abo a ting commander uf the 365th Evacuation Hov ptt ,11, l'. ' , Air for , , ' iag.ira Fall . H.... pnmar, re ear h fo u, nn r ychoph.1rma olng · and ml1t1dJ ....nrd ·r 1, upporceJ by a meJ1cal ,1.:hrn)l-adrn1111, ­ ri:rcd grnnt from the . . Puhli Health 'ernce and NIH. H1:" ·urrcncly ,eeking to opnmi:e l1th1um maintcnan c tll prc­ venr m1K>l di order,. A .1 rc,ult nf hi . re c·u h, hi: 1 a re ogn1:ed expert on the rel.mun h ewe n lim al ..:ffc t and hlooJ II.',cl, tif mt1d1:pre,,anr mcdi arion,. Thi: rmtile ·rn..:rg111gfmm chi, ,tud) d1tfer, grearl, from chi: plipular imag • of the P) r11ma111a anJ 111,teaJ pre enc the l.ugc,r group tif ar,oni t ,h ,I group of ,oually 111adcqu.ite 111J1,1dual, wht1 e ,\C• rinn, ,uc often given 1mpetu~ hy their menral pmhlcm . " ll t 11fthl.' ,H oni es \\ hum I l.'ncnuntered were nut orherw1,e threatening hut more often unhappy anJ lerrl.'-...ed ind1, 1Jual...." ,,1y, Dr. , loln ,tr. It 1, h I horc th ,H the con du 10n, 11fthe ,tudv \\'Ill he u,1:hil to tho e pcr,nn who 1m·I.' tlg,ue .,r,t>n and \\'ill l--etrcr cn ,1hle rhcm to un lcr,tand rhe u1m111.il and, rhu , the crime. • (Mr Taylor Is o sophomore pre -med. chem istry mo 1or cl UB Lost w inter. he was honored by be ing the first recipe nt of he Mort in Luther King Award and Scholar S 1p) �5 ANESTHESIOLOGY UPDA Four hospital report new application & advan e IW RRL ('ES . KER 11 ' ER A .., ·o ,et\ h,mge, and a the iidd of med1Lal knll\\ l­ edge expan i,, the de­ n:lopment, that re ult are ultimately reflected in the work place of medicine - the op 'rat­ ing room. Whether 1t has to do\\ 1th the grow­ ing geriatric popula­ tion, the increa e 111 heart tran,plant,, or che dc,·clnpmcnt of ne,\ drugs, it ,..,often -...ioner or later reflected a a new application or advance tn ane,che,1olog,. The B l epartmcnr tif Ane,the. 1olog re­ pllrr, numerou. new de­ velopment, rhar arc occurring throughout it four rca h,ng hll,pi­ rnk Dr. John Lauria i, chairman of the Medial hool\ Anc thcs1ologv [ ·partment, ba,eJ at Ene ount\ Med, al enter anJ '---------------------------------....1 compmmg 35 full- and in~ room ,ll Buffa/() ,l'n ·r I. D Afan· \'igucra in ncn or part-time fa ulr\ prac­ u,111g newer ultra-,hort-a ttng narcon tl ing throughm,t the mulci-ho,pital agent ,uch a, Fent,ln\ I and ufentanyl ,y,tem. that ha\'C remarkable cardiova cular ra­ Dr. Launa potnt . to an intere,ring ,me hility." The,c two haracteristics enable the iology focus in ,en~ral areas at Erie these agent, w be applie i to trauma pa· iunty Medical enter. "We are now BUFFAlD I y rienr. , who need rhe :cabil,t , .mJ to out-pa­ r,cnt . . who nee I the fonrure ch.tr ,11low. rapi I ,l\\akenmg. Ir- u,e for outpatient ,..,1b newe t applu.:arion. Launa al o norc, thar medical ,tu.Jent, are I emg t,1ught tech­ nique ot resw, ·1tat1on an I circulat1on while urgery ,rnd anesrhc,101og) re,,dent are I emg rratned 111 •a h other' peL1,1lt1e,. 'ew equipment ar E M( enable, ,mcv rh ' 1lllog1,t, m lll more ,n, a,I\ e monitliring of pan ·nt, tor .irdi,11.out­ put, 1-,lolld ga,e . , and other tuncoon, . Tiu 1 c,rc ·ially impnrtanr t~ir rhn e with trauma or mul­ t1pk ,v . cem di. ea,e nr ~ for unu,ual patient pllp~ ul,ttion ,uch a, men~ rally rctar le,I pelipl '. § l r. 1ichael Adragn,1, ~ a . istant professor of ane the ,nlogy ba,ed ar E M , " tn\'oh-cd in as matmg work with a 111\,tenou. and dramatic di. ea,· ailed "the ane,the 10!0gi t. ' nightmare." 1alignanr h ·r·rthenrna (MH) ,., b •lieved to 1-,ethe leading cause of anc,the,1a-related death . A g ·nen- �6 call -trnmmineJ Jismder, it. n11',lcaling name has nothing to do \ ith an er hut m!;'an. "high temperature going from baJ to wor e." Adragna feel. ;1 more accurate name would be fulmmant hyper­ mctaholism . Discovered in 196 , thi di e·1 e an affect one in 2 50 patient but one of it~ m steries is that only a sm II percent of these pc ti nt, a tually ha e a re;icrion. Dr. Adragn a has also confirmed that M H- ·u~ cptible pMients can un­ dergo multiple urgeries without any sign nfan MH recction, and then inexplicahl\ develop an MH reaction during a ·uhcquent urgery . The rea on 11 is ·o alarming i · that, if it is not detected in advan c, agents givl.'n to induce ancsthe,1a can trigger a pecrrum of phy iologi al malfunctiom leading m a sudden rbe in body tempera­ ture to 11 °F. or more, with a 40 to per cent mortality rate. Hospitals well pre­ pared for the di orJ r, however, re orJ as low a. a 7 per cent mortality rate. D iagnt)',i · u. ing a mu cle hiup test re cntly becam availah l for adult at Erie ount Medi al enter, and for p diatri patient. at hildrcn' Hospital (according to Dr. Leo Kane, profe · or of nesthcsi llog ). "The true tragedy about MH," Dr. Ad­ ragna remark , "i that MH I now pre­ ventable. We can diagno ·c it with labora­ tory te t . Once diagno ed, , c can pre­ vent the trim~ering of H under ane the ia by using certain agen t~ together with dantrolcne (the antidote which re­ ver. s the MH yndrome). "Ever ·ince we've been able to diagno e MH through lab t t , ample~ have had to be ent to Mas achu ·ett General Hos­ pital. ow, we ha c obtaine<l funding J we an purcha ·' the equipment t do our own te ting, making UB th eighth mer in the nation" o equipped. Whereas Ma -. sachu ·ett _ Gen ral perform the le reli­ able alcium uptake te t, the new UB fa ility, t J be located at Eri unty Labrator , will condu t the tate-of-the-art caffeinc-haeloth n contracture test. The biop . y enter will begin operation by um­ mer I 9 6. Working with Dr. Adragna to . tabli h the r. Leila Edwards, linical hemi try and Toxicology Divi ·ion. h i al o a 05/ 6 'Patient-controlled analge ia is a ignificantnew program at Buffalo General Hospital, one of the few of its kind in an up tate hospital." B clinical a i cant pro~ )f of pathol­ ogy, biochemistry, medicine, , nJ m di al technology. The contra ture te t requires ·urg1cal removal of a 2-inch piece of thigh mu I extra ted for re ·t purpo c during urgery for another procedure. Ane ·rheri , om­ patible v ith MH would have to be u ed for uch operations. sing a pecially deigned in trument, the mu le i bathed in a ph iology olution ro which is added caffeine and or haloth , ne, which auses certain characceri tic reactitm, if MH­ positive. Dr. Adragna al o t ted · not her method laimed by a lora<lc study to be a non-inva ivc Jiaglll si. for MH. In rheLeptemb1.r 19 5 is ueofAnesthe iology he confirmc :l that rhi blood t sc did nfll we rk, agr eing with a previnu Florida tuJy. He is also inve . tigating the social and emotional impli ation of MH. He has found that physician respond differ ntly co patient _ with MH by occasional! mi. informing them ("You can never have ·urgery"), denying that th y have the on­ dition r even avoiding them a patient . A. a result, the e patient, fr quenrly feel i olated from the health care deliver y t m. He ducare · hi MH patients about how to rectify uch ituations in advance. The new full approval of UB' re. iden y program in ane the iology i another new worthy item. Dr. Richard Ament, educational coordinator of th program and clinical profe or of ane the iology based at Buffa( eneral, reports that in ovember 19 5 the Re iden y Review mmittee in Ane th iol gy granted appr val to the UB r ·idency progrnm. BUFFALO s ( p " V I C I " ' nly our year old, it began in 19 1 under provi~ional taru \ hen the three inde­ pendent h) pital program · were amalga­ mated inm on Univer•ity-wide pr gram -including ch addition of A Ho ·piral in the program. Appro imately linical re·ident~ parti ipatc in the program, che majority at Buffalo eneral and Erie ouncy M d1cal Center. Dr. Lami a is Ji­ rector of the residenc program. Beginning in July 19 6, all ane th . iol­ ogy re id nt · will be required to have a third clini al year of training. In the UB re idency, m n option are available inluding ub p cialty training in carJiova cu lar ane the ia, p in management critical care at the Bu falo en rat Ho pi­ ral, and pediatric an the i and ob·tetrial ane the ia at hildren' Ho pita!. Ad­ vanced ane the iology training is being uffered a a third-y ar option at rhe VA Ho pita!. P aci nt· nrrolled analg ia i a ignifi anr new program at Buffalo Gen r I, making it one of the ew h > pi­ rat in up rate ew York to h, ve chi val­ uable . er ice, a cording to Dr. Mar Viguera, the ho pita!' Ane the iology Departm •nt h ad and a UB clinical a ~nciar profe or. "Ju t by pre ing a but ­ ton, ertam ratients can lf-admini t r analgesia as they need it." The computert ncrolled Harvard infu ion pump ad, mini ter . pr per dosage of analge ic through the IV .olution and is now avail­ able to Jme po c- urgi al, orrhc paedic, and ho pice patient . "Ir i. valuabl b · cau ·c pain relief need are n t pr dicrable for each patient. Thi liminatcs delay~ and wide swing in pain r Ii f that J cur , ith th le efficient randard method," Dr. iguera comment . Buffalo n ral' oth r new program in olving ane the iolog i it Pain Man ­ agement mer which be am fully oper­ ational la -r . ummer. Initiate I by r. Vig­ u ra an<l Dr. arl Granger, profe or of r habilitation medi ine it is directed by . Vigu ra. The multi di ciplinary center tr ats patient with a ute and chroni pain, both benign and malignant. le con­ form · co nation-v ide trend in which ane th iologi t are pla ing a major r le in treating chronic pain n e tablishing and directing pain lini �7 Th c nt r tr at 15 patient a week with a wide r nge of technique . Ane the iology-relared cherapie in lude edarive and narcotic programmed withdrawal for benign p in; t mporary and permanent nerve blo k ; ·pecialized teroid and/or narcotic inj ction , an I epidural narcotic . rher t chnique in­ clude phy i al therapy, hypnotherapy, biofeedback, and sleep pattern optimi:a­ tion. Three other anesthe iologi t ·raff the center: Dr . Merle T andoc, Erne to Yu, and Thaddeu~ Ruckow ki, all UB Anes­ the iology faculty. Dr. Lydia Wingate overs e · r habilirarion pro dur , while r. . orina Rydel k, and Jame chiffner serve a psychologist . Ane the iology at Buffalo General i expanding physically a~ well a program­ matically. !t has ju t moved into new quarters in th Twin Tower , with new . R.' that are mu h larg r, better lit, and more conveniently, efficiently, and ·afely laid out. The mod m de ·ign in­ clude a central terile core eparate I from urrounding ancillary facilities including a pre-ane the ·ia area and recovery mom. At Veteran . Admini Cration Medical nter, knowledge in ane ·rhe iology i being given new application among the increa ing number of geriatric pattcnt in the veteran population, and among heart tran ·plant patient , according co Dr. Daniel Whelan, a si cant prnfe ·or nf ane the iology. "Anesthe iologiM mu ta count for the very we k heart of heart tran plant paienc , " Dr. Whelan explains. " o we use different agent , u has kecamine in read of ·odium pentothal. We mu c al· J ac­ count for their extreme anxi cy at che mo­ ment of anesth ia. ince we can not give chem the normal pre-op medication, w mu c deal with anxiety thro 1gh per onal interaction, through bed ide manner, to calm them down." imilarly, the geriatric patient who are increa ingly common at VA Ho pita! and other · in the y tern pr enc pecial rob­ lem to the an th iologist becau e of their en itivit to all drug , and th ir more di ea ed condition , e pecially in term of the lung . The effective approach for uch patients i more intensive monitoring and tight r drug do ing. • Dcmon,rration T ar Anl'~thl' ia T,·aching D,n . ANESTHESIA TEACHING DAY he 19 6 RicharJ . Terry Ane the ia Teaching Day held Fehruary at the Buffalo en ra! Ho pita! chool of 1ursing over·d a range of rate-of-the-an dev loprn nr. in the field. Dr. Marc Vigu ra, clinical pm­ es or and heaJ of Buffalo eneral' Ane . the iolog Department, introdu ed rhe sc ·ion and poke about rhe fir r year of the ho pita!' pain management center. Buffalo eneral's patient-controlled analge ia rrogram wa profiled, and an update on the role of methad me in the treatm nr of post-op pain wa pre ented by Dr . Michael Madden and tephen Dungar. Presenting th larence Dur hordwe L crur were Erne t Yu and Katharine Doy! . The ane ·rhe iologist' role in creating herpe zo t r wa al o dL­ cu ed. The next important vent in ,mes­ che iology cake place on Ma 2 and 3, 19 6, with a meeting of We tern w York and anadian ane the iologi t . ponsored by UB' and Mc a ter Univer- BUFFALO P1-1v$ 1¢ 1 A I ity's ane the . iolog departm1.:nt,, the an-Am nnfcrence will provide urJaces on new mus le relaxants and nar oti . ; tate-of-the-art monitoring; infant resu ·­ citation, and anesthc . iology' relation to the immune tern. lntcresce rhrsic1an hould all Dr. D.H. Morri on at (416) 521-21 • 05/ 6 �.....__LING TIGHT BY RICH RD \. LEE, ~LO. /', 1(,w11 ,[ \ kd1,111c T hl' num mu, jokes, thl' rrofus1o n lll rm:J1cal and meJ1,1 prcc.aumm,, and rhc enormou ,1les ot , nt1pasmuJ1c , .111n1'im1c, Pepto 81,m11l. .mJ \\ .uer ruriltcr, 1n i1c.,He the gra\ It) wrth whi ·h Amcncan traveler, regar i Jrarrhea. That there 1, truth in this .mx 1et) 1,0 c.,i..1nn,,lly lramancall · 1llu,rr.ircJ h\ nl on1c. c.·xpln,1\ ·ene m the Loune, on a crowdl' I hus tour lll the tl'mrll', of Rangkok, at the umm1t of thl' Tl'mrll' of the un at Teotthuacan, or Jurin • an dl'­ gant geisha dinner in Tnkyo . But on the wholl', thl' d1arrhl' ·~ dikmma sel'ms over­ lnne . It I true char diarrheal Jisea • i , along with mea le,, mabna , anJ malnutrinnn. ,l maJor ·ause of infant and chil lhl ,J morl:11J1ty, nd mnrtaltty throughout mo,r of th, c;1rth' land ma,,. It i. true that o asional trav I r acquire • almone lla , h1gelta, ampy lol:-acrer, and ,iardia: in ­ fc nnns chat pr x..lu e tllne,, more ,e,·erL' than ch • tr,ms1cnt cramp, and quirts cmrseJ I:,· enterotoxm -pnx..lucmg gur flora - the tra\'eler' omplamt we hear ,il->our rhe mnst. It rs true rhar chulern remains a ,eriou enJ mi and errJcm1c threat m rare, of ch ear, 11Idle, an i Far Ea t. Bur diarrheal dis •as' Jc •rve discrimm ·mng deportment, not hy~tcrrcal hyperl·iole. It was in amr at ouch Horr, a remark­ ahlc green valle · m the mid r of the desert 1orthern Frontier L ism c, a of Ken •a' pla e that oul l have m p1rcJ Tolkien' Rrvenddl, th t the notion of "trave ling tight" came to life. Here m a tran4u1l. fem le valle\ into which we de,cended from the dry, nJ dusty scrub de,crt, one of the amdy began a traveler's trot. I cxpre-..s d urpme rhat th re t of the rarcy viewed 05 6 rh..: raricnt with gre.1t envy, bur omeom' ol--ern ~J rhar when traveling, e. rectally campmg 111 chc bush, a linle loosen ' " \\a a desirable thing. To which th • "lucky one" ,,J kd rh ,1t life \\'a, lighter for tho, ' who travel loose an 1 he,I\ 1cr for tho . e who rra\'d tight. The icsr ,ruck in m\ mind like the melody you cannot cop wh1 tlmg. I mu,t ,1Jmn that there have hel'n mn..:, during my work m the back country ol outh America, Africa, and sia char I would have welcrnned, while squamng and ,tra111ing bch111d ,1 bush, uvcr a p1r, or on a slipper Asian-sry le 'i(juat miler, a rush of loosene,s! Th fa t of the matrer 1, rhar traveling ttght onsttratton - is probahl · more ommon, much more annoymg, aml va-..rl· more p ' N'-tent than traveler\ diarrhea. Ameri an traveler, and their Jo ror, just don't talk about it very much. ! remain ama:ed by the controst rm ­ du ed by th' mertcan con ·crn w1rh bowel r gularrry at homt:, demonstrated h the innumerable a lverti, mcnr~ for laxatives an I ,oft tni let p,,rer, ,md rhe meri an concern to pr vent i1arrhea .1wa • from home. L nfortunaccly, phy.,.. cians hare part of the blame for a laml'nt· able but unrecogrn:eJ epidem ic o nnsti ­ parion among Am 'rt an travelers, 1 · abetting the :uppres,ion of rhe I a, t hint of colonic peristal 1. with Lomotil m Im­ od1um. d<lfrequent hange . of plumbing and e, retor attirud , w the h mical par . I •sis of normal colore cal motility and 'l)U h, ve an emononall unprepared travel r caught in the grip, o deva . tattng and at time dialx)li al gur immobility. Im, gin , the disma of the well-indo tn· nate<l hygienic Ameri an, avoid ing all BUFFALO H Y A - frc h fruits and vegecahle ., di da111ing water, anJ miffing l ur normal gasrmcolic rctk , e. hy will r )\\'Cr, husyn' , and inig . , \\ rth no lxn\'el movement after e1ghr or I Ja ·s awa; from the afecy nf ,1 rrivarc, shin , pm ·lain toiler. 1uch of th1,;, Ii may come from ,l Jc ltcatcl camouflaged ob,e,s1on with tmlct .. merican onccrn about toilets - not bathrooms I ut toill'rs - is .t pcn •l'r,inn not foun I tn mo-..c of the world, where excretion i. a nccc . siry and carried out, on demand, in pla ..:, ocher th irn rhe barh ing and lean . ing area! Many culture have glorified the bath Roman, Englt h, Japanese. Few, ex ept in mrh merica, ha\'e onverred the hathroom from a pla e of pul:-,li and pri­ vate clean ing to a place, primarily, of e rering. In fo t, in many parts of rhe world, the cxcrctorium i, separate from the harhing room. o d 1ubt a lot of colonic compul,1ve­ ne . dem •e. from the English phy 1 1an nf the lace 19th ' ntury, ir lifford A lhutt, who popu lari2cJ the thcor of auwintox1cati(m, the notion that tllnc~s ould h· produce I l y retention of feces an I the absnrpttnn of to . ins. f cour ·e, chis\\ as be­ fore 1:-iologir appre iatc l he enormou, resilien and coughn . of th mu o ·a nf the ga:tromtestinal tra t. De ·pite the fol­ la ) of aucoincoxi ation, orth Amer­ , ans continue to op rat with the notion that daily bow I movements at home are hygieni , wherea bowel movement ahroad, e pe iall loo c one , are un­ healthy an I unnatural. T he curiou · thing ,, th, t paraly:ed inte tines are a greater risk of conContinued on Page 35 ��THEHISTORY OF MEDICINE N ew chapter opens as rare collection move to new quarter, takes new name JW RR CE ~·- KERSH 11:R A new hapter in the h1,tor · of the H1,tor) of Medicine olle tion h 'gan with its ren ammg as the Roh rt L. Brown H1,tor of Med1c111e ol­ le non and the open mg of 1rselegant new quarrers in the refurh1shed Health 1cnce~ Libr,H) 111 0 tober, 19 5. on - tributing to the new hapt r ar a number of generous new donation~ which have expanded the s ope and value of the ol­ lecnon. The Hi tory of edi ine ollc tion i a little known but highly fa cinating unit of the University's Health ien e Li­ bra1y. ne of only three formal History of Medicine collection among medical ,chools m cw York rate, 1t contain, in 1t. rare hoob coll' non more than 12, olumes extending ba k 425 years . There are al o di tin t ollection of medical in­ trument . and memorabilia. The entire collection i maintained by Lilli entz, its librarian. The ollection I housed in exquisite urrounding that re reate a historical feeling to match the onrcnrs of the mom . The ·pacious r, re book mom are lined with richly hued wooden ,helves from the original Ll kwood Library of 5 year ago. ulprures, curious mcdi al intruments, plaque , old photograph and even the death mask of Ro well Park line th wall , while large, leather bound volumes of an ol:w1ouslyearlier age fill the ·helve . The ollecrion I ol:wiou ly l f great monetar as well as hi:torica l, value. B c, use of thL, two . pecial mea .·ure. have been taken. During its move last fall from Kimball Tow­ er to the forme r Lockwood Librar , the colle tion was �II in ured for I mill1on. nee then w col­ lection wa · helved, a tate-of-the art fire extingui hing · tern wa in ·tailed to minimize damage from the greate r threat co hi ·rori al work.. The Halon Fire Ex­ tingui hing y tern, when triggered by moke or flame, relea e a ga into the room that remove ox gen from the cir, excingui hing the fire without damag­ ing the hook . The ga i . cored in a large to re harg . tank chat co . t 35 T h bulk of the collection i compo ed of the rare hook , mo rly 19th cen­ tury monographs with particular trength in ob-gyn, urgery, denti tr , p ychiatry, and pharma olog . Appro imarcly 50 book publi he<l prior to the 19th c ntury by Galen, Ve .aliu , inclu1e Wl rk Thoma ydenham, John Hunter an<l Thoma Willi . A librarian Litli entz de crib it, "other ignificant work in rhe Hi rory of Medicine oil tion bear mentioning. William Harve ' · nawmi al Exer ,wcicm-, oncerning che Generation of Liv­ ing reatures ( 165 3) i the mo t impor­ tant book on that uhject in the 17th entury. The illu rrarion in William Cowper' ada , Myowmia Refomww : or an Arn.uomica1 Treaii e on che Mu cle~ of the Human Body ( 1724), are base.! on drawing . hy Rubem and Raphael, and thi · aclas is one of the mot beautiful publi -hed in rhe I th century. William Beaumont' · Experiments and Ob erva­ tions on rhe Gusmc ]wee, and the Ph) t­ ology of Digestion ( I 33) record - th , proce of dige tion in vivo, and Thomas Addi on' On the Constitutional c.mdL>eal Effectsof Diseaseof the uprarenalCa/>sule ( I 55) i _ a r, re work on the disea e · of the adrenal glands." The olde t volum i the Froben ediuon of Galen's Omnia, Qune, Exumr, in Lmmum ennonem onver a ( 1561 ). ne of r. Roswell Park' donations i the 156 edition of Ve ·aliu . ' De Humani Cor­ pori Fabrica Libn eprem. Dr. Park wa. B's renowned profe :or of surg r) for 31 year and fir t director of the in ·ritute for the stud , of malignant di ea e which ur­ rently hear · hi · name . R fleeting the br adrh of Ro well Park' intere rs are the Engli h translation of the Charaka-Sanhiw, the ancient sy. rem of Hindu medi ine, Yarrow' - Introduction w the tud of Mortw.1ry Citswms Among onh merican Indian , and num mu ti­ tle on super ·rnion and thanarology (the study of the phenomena and psycholog · of death). Do umenting the hbtory of West­ ew York meJ1 me and all rabilia olle non. It contain . )earhoob, bulle ­ tin . , alumni catalog,, and facult pub!t a­ tions. f particular ·1g111ficane 1sits hold ­ ·alJm1rru.11 foun :led ings of rhe Buffaloi\lec.11 in I 45 b) Austm Flint, ~r. The Memorabilia Colle tton, mm 111 the Untverstt')rch,ve . , al,o on ta ins Dr. Roswell Park\ donation of "nineteen raploob of new paper ltrpmg an :I print d ,rem su h a~ announ emcnts, program . dinner menu . , and ocher memor !:,,!ta, m luding one book dealing with the a ·. a ·ination of Pr 1d'nt McKinley," librarian ent: ~rate . "The ·crapbook - are invaluahle document. of social and cultural hbtnr) ... but also cast g!tmr,e , often humorous, into the li\'e · of many in th ommunity . For ex mplc, one clipping reveal, that h rle: ar , a promm 'nt meml:, r of the med, al pmfe -sion (and the perslm for whom the 1ed1cal hool' ary Hall i: named) wa am:sted for dnvmg at rhe reckle srceJ of I Z mile . per hour m rhe early part of the centul")-." However voluminou, Ro. well Park\ craphoob collectiom are, me glanng omi ion ha - left u with a major my ·­ tery. "While he Jo uments many facets of his lifo," exp! in Lilli enc:, "it is curi ­ ous wh · no corre pondence h · s ever sur­ ,.1\·ed. Th,, is <le-p1ce the fact that qm)ta­ non .: from hb letter . do aprear in man) place ·. " harle . rockron, in hi · 1914 memmr of Ro ·well Park, states in fa t that "the hara tenscics of Dr. Park a a letter writer are well t!lu,trat d." To th, day, histori al expert ,till have no lues vanas to why all of hi. corre,ponden 1 h d. A v I")-' incere ting u m o the arh ive 1s the Provenance File, whi h re­ cord · all of the olle non 's donat,om, previous owner' lxiok plates, own r's sig­ natures, and insti­ tutional and per­ s nal 1,- Pl-OTO fRANOS SPECKER �12 Librarian L,/11 t:nr= ro lt'\I book from tht· H1,tor1 of 1<.'d, r im· Co/It< t11m. "' ~ u &: l!2 ____ ~ ;;.,...__.,~ hrary r,1mr . Pr,l\'enance is rhe re 111 . :n:e o( a tillllk' rrenuu ll\\11l.'rh1r. lrhough originalh intended to rec11rl!11,c.11 lbn,1tllll),, thl.' iile ha, 11\l\\ riecome ,, \'.1lu.1rile 'l'Un.:e of ll, .11mell1c,1I h1 ton, lihnn:111 ,'t·nt: noted 111,m unrurili,hed 19 5 m,m• u,cnrt ahnut the file. A hl"t 111curn1u,-lunk111f.,!in,trun11:nt, \In ·e u,ed lnr a \ arier)· l,f l.'qualh unnu (,md ....,merune lancl.'rou ) rm e­ ~ 1eddurc, 1 inclullcd in rhe ta,c111.1t1111,! 1c,1I In rrument Collect1nn (,ee ,tCcum­ ranying .,mclc ). The collect1on\ earl1e,r ,1Cyui,1t1un, were nhrn1n ,J hefore the collecrnm 1N:I( came lJHO being a a torm,11 unit lll the l1hrary. An unknown numht'rllt then-new volume. ac4uired for the 1ed1c,1I chllol' lihnH) 111the I \ ha\'' rroh,,hly urv1ve i to riecome now-h1,toncal \'lllume 111cmrmated into the collccnon. , in l' the original record, have not survt\·ed, the number w1ll ne\·cr he known. In an) ., c, the n1veNt) at Buffalo Medi al Libraf) hegan in I 4 7 \\ 1th 519 Vl>lume,ohra111cd at a cmr of 29. 96. The lihrcll'\, In aced ,lt Wa,hington and •ne a trcct, (next to where the M,,rine 11dl.md enter now ,can&,), wa are i hr for '\ 111 B. Fox, 151.6 rhe fir. r to en·e a, lihrarian. nc of It, ft r,r donations ( I I ) \\ a, rhe rnvare lil,raf) · ot I ,L 7 n1lume, ,,tJame Platt '\ hire, one oi the (,,under of the L.:n1ver,1t\ and the 111",t Profe..,.,nr of Ob,remc .ind D1,ea,e, llf \'\'omen an :I Children. He wa al o the t1r,r to intro­ duce cl1111caldemon,rrarion of midw1fer) 111th 1, countrv ( I 50). Two years before the MeJ1cal chool an :I 1t. l1hran mo\'ed to 1r- High ~ treet location m I 93, G ·orge 1 • Burwell, an emin 'nt Buffalo rhy,1 ian heyuearhed h1 more than I, volumes to the medical lihrarv. By 191 , th· Fle,ncr Rerort on Medi ,1IEducation referred to "a go(1J lihran· of l vnl­ umcs, curr 'nt German and Engli,h penoJ1cal, with a Ii hr.man in ·h,1rge." Fnur year l.irer, uplln the l ',1th 11119I4 of Dr. Roswell Park, h1, entire olle non nf 3,C volume, \\a, lonared to rhc li­ hrar , ,uh tant1all\ cnl irgm~ \\ hat ,, ,h tll he ome the H1 tllr) of ~ledi me Collec­ tion. Rare ,mJ hi-toncal work graJuall\ ,,c­ cumulard Junng the followirn.: dec,1Je,, hut remained e. scntially an unar­ rrec1ated, d1-..1rg,mi:eJ clement 111d1t111gubhahle from the gencr,il he.11th ,c1 'n ·c volumes of the lihrary. In fo t, during one renod hefore the BUFFAID _A_.._ L!.....!!....!' ' ......... ___, 2 ~ wile cion wa, e. tabli~heJ, the older and rarer hook were housed 1n an old w1re­ cageJ room with a locked door. "The d1,­ llrga111:ed, un acalogeJ collect1on wa ha ,cally una\ ailahle - almo,t no one knew 1r \\',.ls there and 1t Just languished," Lr. Bnmn rd.ires. "Furthermore, the ke) \\a given out to pcorle who re..:iueMeJ1r. There\\ ,i-. l1ctle ontml an I no idea 1fany hoob l1 arrcarcd .JS a r •suit." The llll\\'• emrt\ caged rnom ,ull stands 111Farher Hall. In 1972, . K. Huang, rresent director of the lihrar , m,1dc rhc dec1s1on rn recog­ ni:e the long under-re ogn1:cd h1sroncal colic t1on h) e,cabli hing 1t as a serarate entlr), the H1srol) of kdi ine Collec­ tam. Two year later, the collecnon an I the entire Health c1ence. Library relocated tll the outh amru.' K1mhall Tower; th,1t build mg, 111 tum, \\.l', \ ,lCated \\ 1th the Iiriran' Octoher 19 5 move w the elegant form r Lo kwood L1hrar1 . The uillc t1on wa ub,equenrl) renamed the Rohen L. 8nm n H1 tor, ofMed1c111eCo l­ lecr1on 111 honor of the hool\ former actmg and .lS',\lC1ate dean, an a . o 1ate profes ,r of med, inc •mentus who pla ·ed a maJor role 111 1b dcvelorment (. ee ,1 comranymg amcl ). • 1 �13 GRUESOME Bizarr arly in trum nt re th tuff of ni htmar BY RRL A 1 J grotc.quc, o\'er,1:cJ enema . )Tinge, 1mrrumcnt. to dnll kull hole . and dental dnll, that an: the ruff of nightmare, arc a tew of rlK· more um1,11;1(medical 111,trumcnt, now on di pl.1y in the newly ,how ,1,ed Huon ot Medicine Collcctmn 111 the Health Su­ en c Lihrar). Ii anyon1.: ha, e,·er douhteJ thL· prol,!n: , meJ1une ha, nude ,tnLC the la t centur\, nne need onl, ,·1,1t the collection r11h,n·e th11 c doul b re111l1,·ed.The kJ1c,1I ln­ tnmk'nt, Collection u\11 isr, of ,I ,, ide r<1n!.!cllf medical anJ dental 111trument bt1ng h.1ek en the I th ccntur,·. It m­ cluJc ,1 pre- '1nl \X:'·1rsurg11:,1Ikit, ,m ,mnquc m1Lr11uipc, hncer,, ,1rcha1c ,rerh11,1.:opc , ,md Jcntal tool . The olde r in rrnment i ,11,11rcrh.1ps rhe mo t gruc,nme - .m I th centun Frend, dv,rer. It 1, a n111e-111ch-long, pewter cncm;1 ,,­ rll1gl' with ,1 cur\'t.'d en L u e I tn tor ·1hlv e,·,1cu,Hc tool c1H1renr . Purgmi.: ".1, 11JKC a p11puL1r (.ind forrunatdv pa ing) f.1J, C f'l'• CJ,111 among the wdl-to- lo, lcadmg Moliere to s.HLa,nally pro lam, the enema 7ringc to he "the ccptcr llf kmg ." n I SL trephine u,cd co Jnll kull hole for brain urgery loob ,rnk111gly like a modem tool u,eJ for the . ame purp1he. Another drill, th1 time for dental ;.urgery, ha, an l 73 patent , nd ,., u111quc 111that it 1, unf:1mil1,u to expert-, tmm the :m1th­ s1m1an In tttut1on. An I 5'"1,,h1tc porccbin hust mappl' I with intricate blul' lme and W\lrJ, \\',1s u l'd tn tl'acl, plrn ..·nolog). Thi ",1 thl' Lil'nLl' and 1nterprctawm ot I ump, 11t1 tl,l' kull which uppo L·Jl) indic,Hl'J ch,1ractcr tntts. A comparison of the numl'f\ll1' hum~" 1111thl' head 111the ,1u­ thm ot thi, ,irticlc prove I llcf1111t1c:hthl' f,il,1t) 1if thl' phrcrnilogy thcllr\'. D ental rlwl ia Lan he 111tanth111JucL·Jh, Jl"t one look ,lt thl' cnl­ ll'Ltllln \ I th cl'ntun Jental tooth kcr. The cumber ome mol with 1c, frighcen111g hlunr honk ,md 11mg handle wa used to extract teeth. L\ed heti.ire knowledge ot f, m The 'atural Hi,toq of thl• Hum.in Tt·l·th, lry Jchn Hunter ( 177 ) Pt1 BUFFAID P HY AN ,mc,thl',1a, th1, not- o-prcc1,l' 111,trumcnr ,11o ),mkcJ 1)ut teeth adJ,icent ro chi: m111hll'J one and cvl'n hrnkl' J 1w 111the pnKL' Such happening, wl'rl' .1 n1uc111c da)' ,nirk hir dentl t ol that era. One I '59 machine l.11mci to rclie,·l' tll,1th p,1111,,1 well 1 Lllre hc.1J,1 ·he,, 1r­ rhriris, wnmcn\ compl,1111r,, ,m I Jtht ,ihour ,111\thmg cl,l' ir ,icc11mp,my111i.: hrochurl' Cllul l include. It w,1, the ·k<:­ rroma!_!nl'to 111,11.: h 111l', .i ,m.111 cle1.:tnc,il gl'nl'rator th,H coukl he ,1rrachl'd to ,m\ pare llt thl' body. The hi:arrc n,lturc ul these 11btrumcnt 1 mar he I h~ rhc 1'c,1ur, of ,,iml' 11ther . ,,\ rarcicularl\' clcganr and ,·en d · ·11rmn· antique hra" nH r,i,cope l.1tL' b.ick tll I , .1, io cver.11anr.1Ct1\'l' bn , murt.1r­ .111J-rc,t1k ( rhcr in,trumcnt mdu h: t11r111cr, k l1L11 lh,iul Dl',m ,w k.t11nK1mb,1II\ earl) 19th cenrun ,tctho, ~ore (nu ll' ior 1mc car <1111\') w1rh l.ucr 1mc 111alk•tor li,­ r •ning with tw,l c;1r . nc 111rrumcnc rl'• 111.1111' ,1 my,ren. ,h.1pl'J like ,1 l,1rge h1)l­ lo\\ kc, wirh lnll threa ling ,H 1ml' l'nd, thl' tool pmb.1hh date l ,1ck. w thl' I rh Cl'n­ run. One expert ha Ufl111Sl'llthat It m,l\' havl' hcL·n u l' I t11 Jram tlt11d from ho Iv cav1t1es. The recentlv e,cahli,hl'd Edg,u Mc lllre Medical Instrument Fund mm makes it p1 s. ihlc to expand the collcct1nn through pur ha es a, well as donations. • �14 totlie Collection D onati on enrich and diver if it range HY RRL'l 'E . KER-.;fl, ' ER T he 11,,111 tor\ Med1c111e ~olle · t1on Wlluld he !cs, 1mrre · 1\'e rllday 1f n weren't (ilr the lonation, 111• of gcncrou ltv1Jual,, cm­ pha 1.:c, the cul­ lcumn \ lihranan. L1ll1 em:, anJ the Medical chlllll\ ,lrlhl\ 1,c, l r. Roh Rmwn . llt llnh J,d rhe llJnarnm, of Dr,. Jame, Platt White, Jeorge Burwell, Rll,­ wcll Park, anJ many orhers create anJ ,1ugment the collc tllm I ·!me 1c\\ as for­ mall · e,rahli,heJ in 1972, hut c..onmhu­ tllln 111e then Cllntmue rn cnn h ,md Jl\·er,1fy 1r. The following 1s a sampling of ,ignifi­ cant Jonac1ons to the colic non in the past two year : 174 h1mmcal volumes JonateJ hy Dr. L. Maxwel l Lo k1e, a 1929 medical alum­ nu, and emeritus profes ir of meJ1unc. Hts oll • ram, which empha,1:es the his­ tory of th · tudy of gout .ind rheumaci,m, 1 one of the largest private col le tions of h1smncal worb on the ,uhie t. H1 olde c book on gout, the 1721 he ·ne' n Esstl) On ,0111, t. a comp,m1eJ hy O\'er a Jo:l'n other I th centurv worb on the suhie t. Other nor, hie ontrthur1om arc u~nn Flint\ I 73 Pnnc1ple., and Practin 11/Medrcme, 1r William . ler\ fiN •di­ tion of the hook by the same title, Oliver Wende ll Ho lmes' I 3 Medical E sens, 5/ 6 and Dr. Ro-,wcll Park\ 19 I 2 The Etil E-::,e T/uuwroloJ.,"i. The o lJe,t work 111 the ennrc collc rnm 1sDr . Lo k1c\ mp of the 17 I M::,stc..>rrcs 11/O/mmi. 23 hooks from the cnllcct1on of Dr. fa eubcrger, ailed "thl· dean of med, ,11 h,,ronan," and th· "greatest philosoph1al ht torran of mcdtctne." He helped t',­ cabli,h the scud of me !real hi tor, n, an \n.1romk,1l Ju.iii, (,tl,on• ,mJ on p.1;:t· / 5) fn>m konc. Anatomicac '1}'Andrea~ \'e,aliu., ( 191-1 t·dition ). Wood nu, J,ll<' from 15-13. BUFFAID HY ~ N__) a ,1lc1111cJi, ipline and \\ as the founder of an rmpmtant h1~tor, of med, me museum in icnna. Donated b hr , m, Dr. FrcJcrr k eubcrge r, lrmcal a,­ so rate rrofos ·or emcritw, of owlaryngol­ ogy, the boob date from I 97 to 194 . They wer • ,,·nrten and igncd b · Max cuherger, who died rn 1955, an<l 111 luJc derail •d me kal historic including that of ALNna. Hi, opu. nwJ.,11111111,rhe n, •o ,·ol­ ume Hi.,tol) uf Medrcmc, 1 nll one of the greate. r texthook. on the ,uhicct. The 'euhergcr gift wa, publtcl exhihrted hy the l,hrar, last foll. Th,-, gift i the cecon<l examp le ofFreJ­ errck euhcrger's generosi ty to the Med­ I al chool. In the 1950\, on the oc ,Non nf the l1hrary' mo\'e from High erect co old Capen Hall, Dr. cubcrger donated eight lay ha relief portrait . which mm lmc the hall\ of the History of Mcdr me ollc t1on. cu lpted hv artist Dom ppcl, the portray mk1ng ltkenes,e ot ,u h meJ1 al greats ,is Maimoni ic , Freud, Galen, William Harve , and Ve altu,. The Edgar R. McGurre H1 tori al Med­ ical In trumcnt Fund was esrnhlr hed 111 January, 19 5, b • Mr~. Annette Crnvem in honor of her father. Dr. M Guire gr.i<luaced from the B Medical choo l, ( la,, of 19 . He wa. ns-.istanr ro l r. Rosw •II Park from 19 2 to 1914, and su ceeJed Or. Park as professor of surgery . Dr. M JUire held the hair of surgery until his death in 1931. The Mc urrc lnstrumrnt Fund ur- �15 (\1scle to rhe I lealth ·cien e Lil rary. Puhl1shed 111 19 , rht defin1m ·e !.ic­ s11nde edition of anarom1cal ira\\ '111g,, which is limited w 99 sees, ha . heen descrihcd a. the puhli,hmg event of all runes, and won the lnrernatinnal Pri:e for e,cellence m hook design ,ind rroJu t1nn in Lei :1g, Germany, in 19 2. Lennar lo\ drawing . han~ hecn repro luced in full color nn 176 folio rage~ in the original chronolog, and are rlacc I loose 111 a portfolio box for e,1'y a ce, . . The May 19 ' 5 BHffa/11 Pir).11ci,mgives further derails and an 1llu:trat1on of this donation hy an ne\'erin~, who i, a 1977 alumnu, and clini al instructor of oh-gyn. ne pasr maim donation w the nld Medical-Deneal Lil rary hy the Buffalo Academy of 1ed1c111e,mcidenwlly, le l to the construction of a rn,im named 111 that group's honor, nnw tran,terred to rhe collecnon '. n '\\' qu ,1rr •r,. Thar room 1, the mecttng place fm the Aca lemy' month])- meetm(!s, Collect1vel\', the Hi,rory of Medicine Collectinn accurately reflecb the mmd, and career . of Its donor., as ~ir Will1,1m O,ler eln 4 uentl\' t,1tcd: "A library re1 re­ ,ent: the mmd of ih collecrur, hi, fanc1e, and li.1ihles, his strength and weakne, , h,, pre1ud1ccs and pre erences. . .. The friendships of h,~ life, the pha e · if his growth, the vagarie . ot his mmd, all are represented.'" • "' G ~ ~ • t-rt\ 11\ the "P n l \ t:'11,Ulu' File ,1f rlu.' l h-.1or, 1l f ~h.·J,...me R1111 .,I,, ... L,11,"" "' . i<l, 5 \ 11nr11~ il,hl·d C.,ll cdh> O, -;L \;) m.1n,1-., n p1) . ,__ ______ ......._ __________________ ___J m,•nt Fund. ports the acquisition of hi torical meJ1cal instrument by the Health ciences Li­ hrary. The first rurchase from the fund con ists of an antique hra,, mi ro. core ( omround hino ular) manufo tured by R. J. Beck, London, a., I 0, repre­ enting Briti. h microscope making at it, very best. It is on di pla), in the o llec­ tion' gallery. A collection of ·ix prints, in luding two Daumier lithograph , three figurine , and 6 monographs were donated la t ummer to the collection by Mrs. Haro ld T. chweitzer. The items were co llected by her late husl and, a B medica l alumnus, las of 19 I, who practice I internal medicine in Buffaln for many years. The colic tion i. particularly ,crnng in hoob ahout rhys1cian, and ,-cienti,ts, an 1 re­ fle ·ts Dr. chwemer's interest in medical history, hingraphy, and arr. The donation was re ently exhibited in ch' main lohhy of the Health cien c. Lihrary. Dr. Max L. Land·berger, emcritu~ clin­ ical associate in pediatri s, donated 6 7 titles to the collection last spring om­ posed of 19th and early 2 th century pediatric monograph,. On January , 19 5, Or. Russell J. Van Cocveri ng 11pre cnced a copy of Leonardo da Vinci' Anawmical Swdies in the ollec­ cum of Her Majesty che Queen ut \Xlincbor BUFFALO L.L:H V 5, I C I A N ] �16 Dr.RobertL.Brown He played a major role in the collection's development D r. R,1h·rt L. Rnrnn, Medical ,'chool arch I\ 1,t ,inJ a ,uc1,1te pnife",1r of mcd 1clllc cmcriru,, ha, been honored h) ha\ mg the L' n 1\·er, 1t) \ H 1,tor) ot Medicine \1llccmm n,imeJ ,1frcr him. Dr. Bnl\\ n plawJ .i ma1or role 111 rhe de­ velopment of the cnlle [l(Jn mer the pa t 26 ·car,. The Rllhert L. Rnrnn 111,wrv lli Medicine Collecuon 1, a unit lif the ni­ wrsit)' Health c1 ·nc · Lihrary. Dr. Brown hegan h1, a"llCI.H1on with rhe lihr,iry ,1 a,,1sranr Jean of the 'chool of M • heme 111I 959. He \\ a re,po1v,1hle for the then McJ1c1l-Denral L1brar\ huJgcr .mJ acquisition, fundmg. 1n 1961, while he wa Medical , chllol ,icrmg Jean, the libr,H) became part ,ii the ni­ \·cr-,1ty Lihranc ,y,tem and wa ren,uncJ the Health c1cncc, Librar). But under Dr. Brown\ J1recrn111, the Mc IK,11 chool CllntmueJ to timJ ,pcoal pr,11cu, including the pre,ervacion of the hi-.tor1cal cullecuon. In 1974, he wa, appomteJ Med1rnl chuol arch1vi,t, and ,1, cpn,ulrnnr tP rhc.: Hi,wry of 1cJ1cmc Cullect10n, he relo­ cated to the library\ dfice . lk ,uh­ equcnrly undertook the d1fhcult prou!, of compiling all the record. of the meet­ ing, of the faculr) and e. ·ecuti\ c cumnm­ ree of the Medical chool ,incc 1, 46 ,,nJ other pm1ect, related to the School\ hi tory. The 'B medical alumnu ( 1944) .1nd A lpha Omega Alph,1 member received the ~eJ1cal Alumrn Aw,1rJ m 1974 and rhe D·an\ Aw.irJ m 1967anJ 1971. Bllrn 111 Buffalo Ill 192 l, he ha. pre\lou l) ,erwd a, director of the Vi itmg ur,c, A,,ou­ atton and was a memher of rhe MeJ1<..,1I 1-ounJanon of Buffalo among urhcr or­ ganization,. He bec.ame an emenru, fac­ ulty memher 111 19 5. • 051 6 �17 MEDICAL SCHOOL NEW SCHOOL APPOINTS _ECHAIRMEN The Medical chool has a/)pointed threenew deparrmencchairmen, lea ~ ing only two hairs currently vacant, Microbiology and Ophthalmology. The new appointment·area follows: J ohn P. K,1pp, M. D., is the new ch,1im1an of the Deparrmen of Neuro urgery, re­ pla ing Dr. Fran: Gla!>aucr, who was a ring chairman. Kapp i · widely re og­ m:ed in the field, and 1-; li,red m Marqui,' 1979 BesrDocwr: m cheU. . (ba ed on urvey llf the narmn', medical pec1alisr ). n,Ht\'e ,if V1rgmi.1, Kapp attended [)uke l'niwr It\ where he rt>ce1\'·J h,, hachellir\ Jcgrce, Im mcJicnl Jcgr•.:: (1961). anJ hi, Ph.D. in ,mam nn . He ,11npkr.::d hi, re,iJenc, ar rhe Duke l,'m\'cr,it\ _ hool ,if MeJicm.:: 111 1969 anJ \\a, a ,urg1c.1I intern at rhe 1'-!eJical College of 1rgini,1. K,1pp "·'' a maJllr m rhe ledi al Corp,, U .. Arnw, where he ,er\'ed ,h chief, Neunilog1cal 'ern e, Z4rh Eva ·thl• non Ho,p1ral. Prior to coming co R, he wa, pmfc ,or oi neum,urge~ ,lt rhe Un1ver,1t) of M1"1"1pp1 ' lmol of Medicine in Jacbon. The pmle"nr of ncum,urgCr) has puhli heJ 75 journal article. and chapter·, a well a a I9 4 book, Cerebral Venous y rem and Dis1irders. His re, ·ar ·h focu,e, on J1,ca,e of the hram ,uch a ,rmke, br,un rumor , anJ Ji,­ nrJer. of che cerebral venou y ·rem. One of h1, primary goal, 1, roe rabli,h a maim neum­ oncnlog\ enter m Buffalo, fnr treatment of br.1111rumor,. In a IJmon ro hi, re,ear h, patient, and meJi al , hool re ponSJhditie,, Kapp is ,d,o an 11w·nror of meJical dev1 e,. H1, fir,r 1, an Arterial Pre ~ure ntrol y~tem, an elecrri­ cally-controlled computer device implanted on arcerie, leaJmg co aneury,m, which is Je,igned m regulate pressure on them ro rrevent rhe1r rupturing. Thi, ocher 1n1·ention i artificinl mernl and pla,cic vertebrae which can be u,ed ro replace verrehme Je,rroyed by cancer. Hi. numerou, profe,,1onal member hip in­ clude the medical honor ociety Alpha mega lpha. American He ,ur A,soc1at1on, troke ouncil, American ollege of Surgeon , American A,sticmt1on of eurolog1cal ur­ geom, ongre~, on eurological urgeons, and the American 1cdical A, ociauon. BUFFALO fPHv$1¢1ANI D Alker, 1.ll., the ne,, chairman of the Radtology Depart• ment, has scn·ed a, a ttng chairman ,in e 19' I. The clm1cal pmfc, ir of r.1lining} 1 al ·n director nf mdiology ar M . consult­ ing raJ1olngu ;ic hoch the A M ·Ji al Center anJ We,r eneca Development Cenrer, and ,1 rending raJ1olog1,r ar E M ~. Alker i, ,1!,o clinical assoc1.1te pmie,sor of nucle,H med1 me. Ongmall} mm Budape,r, Dr. Alker at­ tended Alleghen} College and re e1ved hi r. George 51·t, �1.D. from UB m 1956. He nmplcreJ h1, re,1Jenq .it E..J. Meyer emonal Ho,piral (mm E.nc C\iuncy MeJ1cal 'ente r). A retired major m the . '. Army Re,crvc, A Iker, •rv •J a c.1pt,11n,ind t,1ff mJ1olog1st at the \V1lliam Beaumont General Ho,p1tal m El Pa,o, Texa,. A Iker ha, pul--ll'heJ 42 amcle, ,mJ chapters anJ a 19 0 book /foul 1111111). He deal, cxtcn• 1\·cly with hcaJ ,md neck mJLme, m fatal traf­ fic ac 1denc,, well a, with hydroceph,1111,. ,1, Compmeri:eJ mmography (CT) , annmg m ,pme, head, and hnm m111ry I another research focus of his. Alker w,1s a v1 1tmg proicssot m the People\ Republic of hma at the univer me of Kunmg , ChengJu, and Lha,a la,t year. The American Mc i1c.1IAssociation of u• mmot1v • MeJ1 me, Erie .ounry McJ1 al , >· c1cry, cw York 'care Medical icicty, ,m<l the )(.iery of hairmcn of Ac.1dem1c R,1<l1ol­ ogy llcp,1rrment ,ire only ,1 c11 nf the many profcs\lonal nrga111:ar1om m wh1 h Dr. Alker 1 mvolvcd. He " p,M president of the Buf­ falo Ra<l1ologic,1l 1 1cry and 1, trca,urcr of the Ccr\lcal , pm· Re ear h >cn:ry. Dr. Alkcr 1, ,11'0 mvolved with the Buffalo ,u h­ oli Phy 1c1an C,udd and 1, ha1rman of the Western ew York Coalition for afety Belt U e. He 1, .l'i',\lCtatc editor of the ioumal Com• 05/ 6 p111cnzcdRudrology (,mce 19 3). A senior member of rhe American ciety of euroradiology, he I a d1plomate of boch the American Board of Radmlogy and the Amer1 an Board of u lear Med1cme. O ne of the newest ,lppoinrme~b i Jo,eph A. Prc:10, M. D., a, ha1rman of the Departmcnc o uclear Medicine. The clm1Lal profc ,nr of nuclear mcd1cme ha, erved a acnng dcp,1rtment cha1rman mce fay 19 3. He h,1 ,er\"ed a, (ha1rman o ercy I lmp1tal\ 1uclcar Med1c111eDepart• menr s111ccI 964, the ,amc year he Jomcd rhe UB Medical hool faculty. The 2 3-member UB Department of u lear Med1cmc 1s mvolvcd with re c,uch, tea hmg, ,md rr-.1m111g111a ~rec1alty th,1t 1, con crneJ ,, 1tl1the u e of rnd101sotope, ,1' imaging ,1gents pnJCes cs for that can depict organ. and L°xid~ J1agno. tic purpo e . Born m Troy, . Y., Pre:m earned hi l--achelor\ Llegree from M,mhattan ollege N. Y., and hi, medical degree in I 959 from Georgetown ni,·er:ity. In that year, he wa, decreJ to the Alpha mega Alpha Medical BUFFAID (PttvS1¢1AN) Honor oc1ety. He al o scrveJ m the U. . Army Re,crvc as Hmp1tal CtimmanJcr, 365th encral Eva uation Hospital from 196 7 co 1973. Prez10 ha, previou. ly erved as Mer y Hos• p1rnl\ m d1 al staff pre,1dcnc and a member of m Board of D1rcctt1rs. He 1.· now the dire tor of the hmpit,11\ Office of Medical Education. I le I a past president of the Enc ounty Med­ ical o 1ery and current ,ccretary of the th Disrnct Medi al o 1ety of the tare of . Y. He was recently ,1 member of the Erie County Board of Health and currently s •rvcs on the Board for Profc sional Medical 'onduct, . Y. rate Deparrmcnc of He .11th. Pr ·:10 1, board-certified m mternal med1 me, nuclear meJ1cme, and endocr111ol­ og and metabolism. A ti~•c m the community a, \\·ell a his pro­ fc,sion, he 1, pa t president of rhe Board of EJu at1on of ts. Peter Paul hool. Ham• burg, a former tru,rcc ofT mca1re College, Ruf­ falo, and former national chairman of eorgerown U111\·er,ity's Medi al Alumni Fund. H1 n:scar h f<JCuse on di.1gnost1c 1magmg of chc p,m reas, , rotum, and other organ , as well ,1, enJo nne Jysfuncriom. He is currently rcsearchmg new brain 1mag111gagent,. • �19 \ J EDUCATIONRESEARCHUNIT PURSUESEXCELLENCE ''The purswt of e, t:llence" 1, a phra,e heard fr 4ucncl) m recent year a, Amenc ,1\ out­ look on education change, anJ the countr) hcg1m to i w, more inren ively on edu a­ tional 1, ue, . Dr. Frank ch1mpfh,1w,er, a. ,i rant dean and director o B\ Medical EJu a­ tion Re earch and Evaluation Unir, i, conerneJ with excellence in the medical profc,. ion. " ur unit supports the me Jical program\ goal of proJucmg not only competent tech111- BY m UtutL-dat the niversity," th' a,S\ 1ate pm­ fe,,or of S\ 1,1I ,md prevcnr1,·c mec.li ine ex­ plain . . \) hde many o the tu lie. ,pccificalh evaluate the hool', program,, the Re eareh Unit al,o oll ,1boratc, on ,tud1e that look at broader i,,ue, and proHem,. Example, m lud srud1e of anirndc, of med1 al ,cuJcnr, coward, gcnamc patient . , pcrfom1ancc pattern of ,tu• Jene, with m•n-, 1en e ba kgroun I , ancl tu• Jent are 'r J 1 1on-makmg. "We ,plore 1 • ,ue . ,1nJ tllp1c, of nac1on,1l mcere,t," , ,1y. ~ch11npfhau,er, "m ,cc hm\ UR i drnng rcb­ t1vc to orhcr pr11gr,m1,aero" the nation" ,ind tll "provide fecdbad, tll committee on cmeJ w1th urn ulum, aJm1"1on , an I udenr ,1f­ fair.... Annrher obJecciYe of the unit i, ro a I t facult) 111 developing, implemenrmg, an I evaluacmg e lucatmnal grants and oncra h wh1 h aJdre, area, of educammal re,car h and ne11 cur­ riculum de\'elopmenc,. ch11npn1au, ·r ,peaks \\'Ith pnJe about the ,u cc , that the unit ha had m th" ar' ,l. "With rhe help of our focuk) che School ha, b•en able co re e1ve nl'er 2 million m exrem:il fundmg for Progr.1m De, ·elopment act1vit1e, . Progr.1111,m c,mcer cduc.1tiun and cancer rrevenuon, a, well ,1, in physmloiri, cost contammenr , and clinical asse,,ment ha, •e been ,up­ ported. Wnhm each program we have hmught faculty together for worbhnp, on cour . e de, ·elopment, tudenr a ~e, ment, an I program e\'alu.nmn." One of the mo,t 1mponant an I mo r ch .1llcn1:mg a,pe t. of rhe unit' w,,rk, howe\'er, ,.., ongomg con,ulc.itilm with f.1·ulcy mem ­ ber ,mJ dep ,1rrmenr, to 1mpnn-e teaching program,. "Mo . t ,lf llUr eftort are m ,uppmung faculty work m ' \'alu gi ,md cnmm1ttce ~ ,nmg ,md 1mpnl\ mg c Ming expl.un, ~ progr,1m. , " ~ ch,mrf~ hauscr . "In rh ,1c meJ1 111 1. a .:'11111111111,-~IIIIII ,·en dynam1 field, we 11,mt ,111 e, inng m,unrnm cian,, but abo highl} 4ualifieJ profo,sional , trained ro perform their evenru,11 role . m s(>Ci ·ry. In medical eJucamm o,· •r rhe pasr everal year, rhere h,1 been a clear mm·emenr ro gee he)·onJ the mer• b,1 1 . ; there •'-m mcre;i,­ ing concern or broader Jefmmon, o excellence in teach mg .1,"ell a, m learn mg." Although rhe Re c,uch ,m I v,1luJt1on Unir I mall, with h1mpn1au er ,mJ Dr. Ran lolph amacki, rhe as I rant J1recror. nmpri mg the ore:. it Jc:al, with a wide range (>f oncern an I activities. Formed 111 1976 ,l part of a newly-c tabli hcd ( f. 1 e o Mc lical Edu auon, chc un1c emplo) educational rcch­ n14uc, an I methodolog1e to a, ,,r fa ulry 111 1mprnvmg curriculum anti in. rru rion w1rhin che Mc Ii al hool. "Our obie tm~ ha been to work with the fa ulty to help chem Jo their job. better," -.1ys h1mpfhau,er simply. " ur effort involve, aspect . of re. earch, program J vclopmenr, ;md on ulration. The unit con­ du ts studies, fore ample, to eval­ uate the u cc,, of n 'W progr.1m, BUFFAID IPHY$ 1 C1A I �20 MEDI AL CHOL E\Xl ,m,1 challcngmg y,tcm ol progr,1111, •" the ticld change \Vhnc po"ible, we cnc11ur,1gerr,,g­ r,1m, to con,1,I ·r metho,I, ol lcammg wh1 h excenJ hcy,,nJ the · cqu1,1t1on nt ,1mple knowledge and lw,1c fa t,. We want ,wJcnt t<l IX"'c" kill, in Jc 1,1on-makmg, patient 111ter.1ct1on, ,md problem-,olnng. ~ewer cnur,e, anJ hnnor program , e rnhli heJ by faculty, Inn: arpma hcd thc,c area, ol con­ cern. The work ,,t lacult) m medical cJuca­ non, therefore, proviJe, opportun1t1 ·, for d1f­ lercnt approachc, anJ method, from tho,c tnJit1onall) u cJ 111Un1\'cr,1t, 111,truct11m. "One Jtlemm,1 we lace i, that while mo t meJ1 ,11 educ.Hor h,l\'c ., strong h.KkgrounJ m mcJ1 111 • there i, no •"'urancc that rhc, .ire ,1 knll\deJgeahlc 111 cJu ,1t1onaI ,kill,," rhc unit he,1 I n,1re,. While \\'C h,l\'C hecn ,1hle r., Wllrk r.Jther well I\ 1th man of our f,Kuln, rhere 1, tN1,,II) v,1liJ com:crn or e1·cn Jch.m· o\'cr rhe ,1pplll.it11mof cdue,mnn.,I pr111c1plc. F,Kulry with dm1 11b.1 kground, m,I) feel char "educatmnalisrs" can't re,111)unJeN,md the n,uure .mJ dem,mJ ol rhc matcn,11 hcmg neither b.1si ,c1cnt1 t, nnr clm1uan,. Educ.nor , in rum, worr, th.It mcJ1c,1Ipn,tc ,1on,1I, dnn'r lull) unli:e or apprc ·1,1tcthe 1m­ p,irtancc· nf cduc1t1onal ,kill .md technique·,. To that cnJ educ.mon,il1,i- 111 mo,r mcJ1c,1I ,chool, h,t\'C t) pcJ their mcd1c,1Il,Kulr) col­ lc,1guc•into three group,: "hclie\'er , ""nlln-1 c­ lie\'er," ,m I "undc 1,led,." "Ci1\en ,uch ., ,chemc I think our gre,uc,r .111, l,1Ct1,,nre r, 111 work mg "uh rhc unJec1,lcd. , ·cmg thll,c \I Im h,l\'cn'r workcJ llll cdu ,1mm.1I m.1ttcr, l~c.,mc mrcrc,teJ ,mJ 11woln~J in rhe Je­ wlop1m:nt of ne\1· pr,1gr,1m or m the 1mpnwe­ mcnt of ongoing program, 1, \'Cr)' grattfrmg," h1mpfh,1u er ·ommenr,. Havmg ome m Buffalo mm the Ohlll wre .ollcge .,f MeJ1cme, ~ h1mpth,nl'er ,, prlluJ llf his umt ,mJ cnJoy 1r, man, ch,11lcnge,. "The m,un J1fterence berween our \H>rk and the \nirk of ln11·er-it) fa ·ult\ 111 eJuc.1tmn. I Jepanmcnr, i, rh,1t we ,He ·nn,r,mtl) thmkmg 'applicannn, 11nplemenranon ,md outcome'. Thc<lr) 1 applied - nor ,imply J1,­ cu,, d. 1ven our ong ltng a tl\'ltle of grant \\ nrmg ,1nJ upport, comm1rcee work, program evaluation, tudcnt intern tion, tea hmg, ,md a host of pmfc"1onal mvolvcmcnc,, lite ha, rarely been Juli." • 05 6 M d School et pace in campu ,wide drive T he 19 5 EFA am~.ugn official!· cl,,-eJ with rhe l--1eJiul , chool nnce .1g,1111 cnnrnl,utmg ,1 ma1or ,hare of rhe 111\'er,1rv, rotal. EFA. m the Emplll\' e Federared ,1r) \ ,mnu.11 'nireJ \I a c.1mp,1ign. Medical :chnol contributors exceeded their £,Ml t,\ 13 per cent ior a total of *69, 111.62. This i, rhc h11?hct pcrccnt.i(!e for ;my , ·hnol or l.irgc unit of the Un1ver-it) (rho,e havm(! I or more employ 'es). The chool\ pledge, rcpr ·,cntcd over 21 per cent of rhc 111\'ersiry\ weal onrnl>urion, of 325, The,e a compl1'hmcnr, are m p1re ol the f,1Ctrhar nnh 46 ~r cent of employee, ram i­ patcd in the c.1mpaign. The awr,1ge rleJge "a,.;194. ompared ro la,t y •,u, rhe pledge, arc 22 per ent higher, though the I 9 5 figure, did not ex eeJ the goal t, · .1, high ,1 percentage "' I 9 4' dnnatinn,. • Lu·• Harrini;:wn tlln'r Lclio Orci, .\I.D., 'fX'aking on "The /n,u/in Fav ron: Tour of rht• P/.mr • urrt>undinJ.! and ., Vi,ir ro th£' A.,.,cmbh Linc•," pre t'ntt-d l ncmber 12, 19 ; in f.1rber Hall. Th£' director of tht• Dep.1r(mt•nt of forphn/01," , of hool of "ont• of di tm• cdl of b· our Dr. (,iu t•ppe ndrc,, B prof•·--or of miaobiofoi::l· • Or i i, nott•d for hi, n•• ,t>arch and thl.' beaut, of hi, mor­ pholoi;:i al ,/idc, (and ht• i., ,1 profc,­ ,iona/ n-di). BUFFAID jPHvS1¢1A j painrt·r .i­ �21 RE EARCH U FOURNEW RESEARCHUNITS B Pre,1dl'nt - ten:n B. -',1mple rl'ct'nrl) ,mnouncl' I torrn,Hl(ln ul ,,.\.<'n ne\, rl', •,1rch cenrer, ,It B. Je,igned tll pnw1Je ,upport t~,r l.tcult\-111· 1ti,1teJ, muln-d1 .:1plin,1ry proi:r1m,. F1ur of the center ,1re a, ic1,1red with the -cht 1111! Ml'dicine. E.1ch will recci,·e Imm · 60,L l rn • 1L , 1iver tl1ree year to ,tllll\\ 1t to hecome ,elf-,uffiuenr; then e,1 h 1. expected to hring m evl'ral time ,1, much ectern.11 funding. The m.mn ·r 111which c,lLh u111tc,1rrie nut the,e 11h1en1ve " u111qu· 111 I l,m't he e,1,1h deciphered lnim rhe Lenru\ nrle . The,e h11rt de, npt1on 1>f the four le,IK,11 ~ hPol-,1,­ ,oc1ateJ center pro,·iJe 111 1dc,1ol \\ h.1t the, d11. T x1c logy R arch Center P UL J. KO TY lAK The Tox1colog:,.· enter "The mo,r 1mr<1rt,mt rL·, urLe o the To. · 1Culog) Re l',ir h C..:nter 1, 1r memh..:r hip, \I h1ch 1, trul; 111 interd1 dplmar; gn,up," noted r.1ul j K11St)l1l.lk,director"' the centl·r ,mJ ,m ,l ,1x1.ltl pn,te '"r11f ph,irm,KPl1,L!\,mJ th..:rapcunc . methods of asse smg neuroloRtcal ha~ard.sof entironmental polluwnt·, among other efforts. Mol cular Bi I g and Immun I gy The center L'nJ"Y' p,1rnop,mon Imm the , hu,,I, "' Med1un •, Dent.ii ~1cd1cme, Ph.1r­ m,1q, . '.1tur,1ISci •n e, an,1 M,1themanc,. ,mJ Health Rel.1ted Pn,fc 10n .1r B, ,1 well ,h from the (,re,lt Like L.1hor.1tllr\ ,lt Bull.ti" t,1te College. :-surface :c1ence Center ,mJ the Elecm,n :-.t1cro, ope F.1ciliry. The phil,i-,,phv ol rhe n·ntcr I nllt to pull e. · i,ting rn11cct, under a ", ntr,11 umhrella," hut to p,l\\n cPllnh<ir,lCi\·e re l',1rch proJc t w1rh a high r<itentinl tore tcrn,11lunJmg, Km­ ryni,1k cxpl.uncJ. The c •nter ha ,uhrnmeJ • 1.466 m1ll1on m new grant ,mJ con r,1ct ar• plicatilln which ,uc current!; under re\"le\\. TorK of re e,1rch include dewlopmg nc\, method, w ,1 ,e, neurolugic,11 ha:.ud, of en­ nronment,1I r<1llur.int , devcl11pmg ,1group of new rnd1ophnrma ·eur1cal u ed in ex:immmg the hram, ,1n I in vitro merh,xl of re ring kid­ ney prn ,,n . Thi center, ·,,- lirccted h ~11Lh,1d Ar1Lell.i, prote,-..,r iii me licine, nd m1crnh111I• ,,g}. ,111 f D,1nd Reh, h, I S(>Cl,lCe rn•k ,r I I h1ochem1 rr; .mJ mi roh1olugv, , -rvc, .1 1 tocu, for r ·opl • Imm httercnt J1 cirlme,, \\ ho ,h.1rc ,1 cornmun mtne r. :,.,1cmhcr inclu le hi,,chem1,t , 1rnnumlllllg1 t . ch111 1,111,,pr tem ch •m1 t , virolog1 t , m I e111.:meer,. Onl' llf rhe kc, mtere t Ill the gr,,ur 1, hn,11111?ne\1 \\ ,l\" to develop \ ,1·cme . There ,ire n1,\\ 1 tll nmc proJect which mernher ,m..• w,,rkml! on in t\n> .mJ three,, Ap1c ·ll.1 e. rl.,ined. The e mclu le \\ or!.. ,111 fl,i.:moph,lic, m /l11cn~11. a h.Krcna rh.u c,1t1e, men111g1t1,111 ,mall childn.:n .md mleLtiou hwnLh1t1, 111 pec1ali:ed expem,c ,md l.1h..1r,1tPr\ fKiline,, not norm,1lly ,1\",1il.1hlcto a toxicol­ ogy center, ,tr ,na1l.1hle, Ko rv111.1k .11d. The,e mc.:luJe the niwNt\ 'uLleu: 1ence ,md Technlll11g, Fa ilir , rhe :-.ta, • re • trometr\ F,Kilir, 111the , h1l<ilof :-.1ed1cme. ,md the '1coler 2 D , ,1 ,r,1te-llt-rhe-,1rt in­ ,trument u,eJ w Jere r rhe pre,ence "f chem1c,1l. The enter\\ ill ,11o coll.1h..irare with the stHd_·ing BUFFAID [PHY$1¢ A r Cent r t r Appli d �22 RE EARCH aJult . The aim i, to Jdmc aspect, of rhc ll'll w.ill ,rruccurc. Another pmJcLt deal, with chl't1N1m1a,i-. Molccul.1r hwlogy ,mJ 1mmunolog~ re ·hniquc, arc u,cd ro ,tuJy the para 1tc th,1t cau,c, thi d1,ca, · in Alm;a. The center 1, also work mg 111) .m ann1Jiotypc vac inc, a whole nC\\ ,irca of vaccine Je\'cl.,pmcm, ApiLcll,1 note,!. Thi, mcthn,I permit, .1 vacunc rn IL· dcn·l,1ped \,·1rhour u,mg the Ji,ea c 1,rg,1111,mor tumur ,1, the 1mmunog ·n. Having ·,1 C\>mmon ·t of e4u1pmcnt 1 ,me ((1't-efccc1ve ,1d\;mt,1gc of the center. E.Kh pmJect need, cert,1111rechnolugic, m pl.ice, Apicella pointed our, hue to ,ct chem up tor c.1ch mdi, •1du,1Iwould he an mc.:rcdihle dfort. The center\ t,1,ilitie, mduJc the :-..hmo­ donal L,h "h1d) it nm for rlw Urm er It\. Tlw Monoclon,11 Lah make annbodic fora pe1.if11 : ,ice nn t\11 ,111c1~cn with mice. MI HAEL APl ELLA chi tosomiasi , an influenza vims that causes meningiti in children,and a new clli s of vaccine are in his center' realm of interest. C nt r £ r R 1n Special Environm nt taculry, rhy,1nll1g1,c,. ,md clinician, ,1rc all m­ arch PmviJmg the equipment anJ ,peciali:cd pcr,onncl nccJcJ for rc,carch m unu,u,11 phy,1c,,1l env1mnmcnr, i the purpo cot thi, ccnter, cxpl,11ncJ II J1re tor, 'be undgrcn, ,11,o,1 pmfc,,m of phy,1ology. 'pccializcJ cquipmcnt, hou,cd m the I lcr m.mn R,,hn Laborarorv m Sherman Annex, mcludc, thc human ccnmfugc and ,1 doughnut-,hapcd 1mmcr 10n ['<Xll. The en­ trifugc 1.an generate ,1 high gra, it, load while 11nmcr,ion in rhe pn<>Ic.m simularc lll\~cr th.in norm.ii gr,w1ry, LunJgrcn exrlamcd. Ocher 'l"l't.:1,11 cn\'mmmcnt cxamincd ar the ccnter mduJc extreme m tcmpcr,1ture, ,llr rrc ,11rc, .md g,1, Jcn,1t . Thi. rc carch i, .ipplicd n, a 11 iJe range of mtcrc,r, mcluJmg urrnlarory and lung di,ca,c m newlx1rns, ,pa e rr,1,·cl. ,lccp ,c,1 J1vmg, anJ rhc tuncminmg of ,1 J1cscl enginc. Thc inrcr,u.:non of pcoplc from d1 lcrent J1s­ ciplme, at thc Cl'ntcr ha cncour,1gcd ncw wnrk, hctter idea,, and more cflcu1ve in­ ,rrumencanon, Lundgren ,,11d. l::ngmecrmg \'nlvcJ. Al,o important to thc center ,Ir<.!pcc1ali;cd and highl, tr,1incJ per onnel uch ,1, ,1diving tcam and othcr people \\ ho h,mJle d,mgemu . high pressure equipment. "E,·cn if I had the llltmc,, I couldn't go out ,mJ bu, the tr,1mcd pcr,nnncl." Lundgrcn ,aid. \V1thour the cente r, it might take t\·e ,ir rcn year, rn ,1rr,mgc rhc ncce",lf\ ,rcc1ali:cd cympmcnt and pcr,,>nncl to conJuct ,I mglc I.., i ~Ll..1111-s~ __ _l_ __ LAE LU OGRE The work of hi center ha applications in circulatoryand lung di ease, space travel, deep ea di ing, and die el en~ gine. two-month cxpernncnt, LunJgrcn pointed out. The center provide continuity that ol\'e, rhac pmblcm. Surface Science Cent r tmlying the interface hcrween ub ranees 1· the Joh of the surface scienfr,r, ..ay, the 05iK6 BUFFAID jP1-1vS1¢1A N) __.:: �23 RE EAR .,H enter\ direcwr Michael Meenaghan, who i. ,in hoth the Denrnl and Med, al School\ facult1. Rc,car her, here might tud\ the interface netween a dcnral implant and the Jil\\', nr he­ tween ,k, wax ,md smm. Thev might ,eek ne11 material, for ,urg1cal 1mplanh to which tis,uc won't adhere, nr look for ,ubscan that will m,1ke good glue,, he explained. The center pool the knowledge of individu­ als from h1ophy,ical science. , physics, hem, try, me licme, d ·nt1 tr), chemical engmeer- "\X/1thout rh' people, you an lock the d 1or ,md throw ,1way the ke\ - the <'qu1pmenr' no go<.xl," he aid. Current programs ot the enrer m lude 1m­ planrnhlc biomedi al del'icc engmeering. ur­ foce chara ten:arion, chcmL tr and m,1terial ,c1encc, fundamental urfacc , icncc ,md char.1ctcri:anon, ;md b1olog1cal cry,calli:,1tinn. • Ml H EL MEE GH (in lab c at) urface cience looks at the int ,rfa ·e between ub tances: between dentlll implantsand thejllw, betweenski wax and now. Research total nears $14 million T ing, electnc.11 and compmer cngmecrmg, mathematics and natural ,ncnccs, and geol­ ogy. It. ~rccrmg crnnmmec has n:pre enrat1vc from med, me, dentistry, engmeermg, natural sciences, chemistr), the Healrh-c.ire Instru­ ments and Device, Institute (HID!), and the Cabpan/UB Re. earch enter ( UBR '). A rcprc cntauvc I ill he n,1med l.uer from Rt .• well Park Memorial In mute. The urnt also plam. to work w1Ch . urfacc scientist at the Urn\'er It) of Toronto, Meenaghan ,aid. Poolmg available equipment, a well a pooling re,ourcc to huy new equipment, "an advantage n( the enter, he noted. The kill of the faculty an<l lah te hni ians mvolved is equall important, M 'c;naghan sai I. he 'ch,x,1 of 1edl(me ,pcnr ,ilmo,t 14 m1ll111nm ,pon ireJ research I.ht ycar, a 5.9 pcr cent 1ncre,1'e over rhe prcccdmi:: 1 •,tr. The .\:h,,ol\ re,earch c • rend1rur ·, were lu,:hrh more th,m 42 per c ·nt of rhe n11·crS1t1 \ meal r ·,carch exrend,rure,. Th,, W,1' reported h Dr. O..mald Rennie, rhcn \ 1cc pre,1denr for re,e,uch, .md current!\ \'il:~· prnn"t for re,c,tr h ,md gr,1d11atce lucatmn. Hr ,, ,11"1,1 pnife,",r llf ph ·,11,log1. The figure, 111 luJc re e.1rch con lucced h\ ,me med, ,11fo ulr1 l:-.1,eI ,u \'erenn, Ad­ mm1,rr,Hmn Med1c.1lCenter (1\here rhcre wa, ; I m1ll1on 111 re earch ,upporr for A ,raff who are UB fo ulry). TI1e figure · for such af­ f,btcd foculr\ ar Children\ wa, ·9 , 7 I and for rho,e ar Ruffalo C,cneral, 196. 310. The war\ wwl, du noi m lude, howcn~r. three c.ucgonc-: I) R fa ·ulr, affd1,1tcd \\ 1th Roswell P,irk Menum ,11 ln,tltute, where • 2 million w,1' ,pent, much of it h Medical hool-,1fftl1accJ re,ear her,. 2) The I lcalrh- ',ire ln,rrumenr, anJ Device, In. tirnte (Hll I) which expended 432,214, 111 research. More ch,1n 4 per nr BUFFAID (PHV$t¢1ANI of Hll)I' re,c.ircher MC MeJic,11 ch,,.,,I t,1v uln·. 3) In munonal m,rn:hmi:: tun I . F11·c 1>urllf the nmc L'111l'er,1rydcr ,1rrmenc, \\h1ch expended mllre th,m ;1 m1ll1on were lcJ1 ,11. hn,11dep.1rrment , ,, ,rh the depart­ ment, of 1•,11c111e(;3 .2 5 mrll,on) ,md Phy,1011,g\ (;2.43 million) topping 1h • It t for rhc U1111·er-it\. Ocher, ,p~·ndmg m·er $1 mil­ lion were Pcd1amc, ( I. 7 m1ll1on), 81ochemi,try ( I. 53 m1ll10n) and M1crob1ol­ ogy ( ' 1.66 m1ll1on). ( rher ,x,I dcrarrmcnr, ,pend mg O\'Cr rese,trch were: A111phyv 96);:, ,al · Pre1·ent11·e 1 al ·c,c Mcd1cm ; Pacholng\ ( 444,2-H); Ph,lrmaco o crapeunc, ($35 ' , 59,); Family edi me 3 , 9 5); P,ych1arry ); Anacom I ,en es ( 265,667); ed, me ( 4 49), ,md uri;:ery 96). Federal agenc1e, wcr ,rill the pnmaf) IH, , F and che source o( ~upport, with Health Rc,our e, dmm,,nm,111 pnw,dml( the h1ghc,t amounr o( fund . . • 051 6 �24 HO PITAL EWS Children's starts international project T\ cnt\' lllllnth ,llt<·r ch,: proJl'ct ho:, ,111'<' 1>ff1c1.1l. rho: lncanat11ir1.d ln,n­ tuCl' lnr lnl,mt 1 'utnt11>n ,md l,., tro1nt~,nn,1I [),,,,1 ,: .,t (. hi!Jr,:n' I lo rtC,il of Rutt,1111 h,i- h<'<'llm,llll!Ur,Hl'I. • '.1t1on.1I, 1111..:rn.111,m.il. ,m I h ,11 dig• llll.trll'' 1111nl' I \\1th Dr. Em.mud l.d ·nth,11, t,n111Jcrand ,hro: rnr 111th<· m,t1tllt<.:,r,1 cl.'lo:• hr.HI.' 11s,,p,·nmg on l Llnh,·r ~9. 19 5 &·· .rn,:, I rho: R pll\•1C1,m' o:tlort , Butt·.11,,1 nn\1 th,· w,,r!J-111,lo:co:nto:rt.,r rho: tu,11 .mJ 1rc.11mo:ntnt chronic d1,1rrho:,1,one: ul rho: worl,I', m,1j,,r killer, ,,t childrct undl.'r It\,: ,•.1r , ,kl. I l·bo:nth.111 d11d of tho: UR I)" 1,1<mi>f l ,,1,rrc,cnto:rolog1.m,I • utntwn ,It (. "hilJn:n' l I,, r11,1l,md ,1 rrok ,,r I rc<l1.llfll , Tiw ln,t1t1110:\1,1, m1,k !'(' ,,hie: 1hroud1 ,I 1 m1ll111ni:r,1nt fr11m 1hc Un11<d 't,H<.:• Accnq for lnto:m.m,mal l11.'vdurmo:nr (Al[)). I In 11.:1,mI c1.1lir- from 15 mmtn~, worlJ11,J._.h.11·.-,1lr<•,1,I\hccun rr,11nmgm tho: rnJ, of mt.mt 1111tri1i1>n ,mJ l!,1'tromco:rnul J, • c.1,: , pl'c•h~ 1111chronic ml,1nt d1,1rrho:.1. 1011,n Th, in,nrnto: 11 tll ntkr ,1 nc11 ,l11110:11 m~,lic,tl rl.' o:,u·h ,mJ th<·11ppc.1rt1m1t tnr hil• drcn' Ho,r11,1I 10 r,1rtiup,1to: m rh, dul ,,I lo:l'd P,•Ji;un­ rr ,hl1:in I n ,m mt<·m,IIH>n,11 c1.m, tr,,m "under-,! ·vdll('l'1.I" .m,1 "l1:l'cl11p• m1( c,,unrric will l!,un kn,m l1:II!<'m I nh the dm, ,11,md h,1,1..:m,· ...,nc.111,ir, ,,I nmnci11n,1l .111,Ipatlwphy 1oloc1c.da r 'LC of mtr.Kr,1hlc dw l,1s:.1Iho • d1,irrhc,1111mf.lllC\', In ,1Jd1t1<>n, r1t,1Iwill ,Ill ,1 rho:hl.'.idquarrcr, for o:,·._.11 ,1,11c1.1rcd r1:,l.'.1rd1cl.'ntl'r In .ired m: L1m,1.md Aro:1.ju1r,1, Peru, ,·urah,11,1and P1lcmh,1ng, ln­ d,ml',i 1; R.mckok, Th;11l,md; .md Du.11.t, c.,mo:roon. It \I ,1, c 11m.1t<·dh, the \Vorkl I lcalth Or­ cani:.mon rh.n m 19 4, lt1·c m11l1onc.htlJrcn undo:r rhc age of f11·cd1cJ lrom rhe r,1,·agc, of inalnutrimm .mJ dchydr.nmn. Tht.! c uhli,h­ mo:nr 11i.rn mtcrnat1,m;1( no:rwork of ccnrl'r will pnw1de th<· 1ntl'rchang,: of id •,1, .mJ Ill• do:pth ,malp,, of tho: mtcractmn uf m0Jul,1ttn1! f.tCtor, of mf,mt nucnrmn. Dr. Lcbo:nrh.11, hildrcn' Ho pn,11,md rhc 0 IJr. Emanuel I..•bcnt/1al UR ()1\ 1,1011,,t (.,,1 troo:ntl.'rol,,g, .md , '111r1t11>n( m rhc l ·1.,rcmcnt , t Po:d1Jtr1<) h,ll'l' hccn unll'l:r ,1lh rec.ml<.:l m rho: cn·1 "<•,mJ l'C'l',\r\:hol chi pr,1hlo:mIm thl· r,1 t ,,x )'<,Ir • Tho: All) cr,mr 1, rho: re:ult of ,:, tl'n 11·<· o:tlorc l:,y <.,mcr,· ,m:in ),tLk !<1:mp mJ 11.1, o:n11>\ cJ rho: '"l'I ,,re 111rlw l.'nt1ro: 0:11 Y,,rk <.oncrc 11n,11 Ide •.m, n, r,1rt1 ·11l.irh 'o:n •· tor , I 1\ nth,m ,mJ n -\111,11, , 111J Con­ crc ,1110:11 L1F,,kl' ,11\J ,,11,I.:. Dr. l.,•hcmh,tl cn·c, 1, ._.,l1111r-in-ch1d ,11 tlw Jmmuil of Ped, rr11.t,.i rr11rntL'T11lo(!}and , 'umcwn. The I.' t.1hli,l11ncnr I t rho: c,liton,11 I 11rJ ,,t rho:Jo11nu1/,nuJl· up , I ouc,r,m,lmt: ._.r ·rt, m th<· ho:ld trom ,ill ,1ur rhc wnrld, \1,1 Jttl' co h1, dlort, ,md m111,111un. In ,1dJ1r11,n,rho: Jd1mm·c rs th..K1k m tlw 111.'kl. Tnchook 11/limm>..'1Hcrnl,IJ:', and, ·111nun11 m /nJ,mn. 11,1, u>mptlo:J m chi J1,·1,1<m,Ill,! <' lire I h I 1. l o:h.c nth.ii. Tlw h.,ok, .,uch,ir ~ h, nwr<' th,m IJ.) 1 ur-t.mdm!! .111thurlfl<.: , 1 • Eleven named to ECMC board E lo:wn .1pp,1mtml'nt , mdudmc th.u R 1·1Co:rr •sidcnr .md l\lo:.J1C ,1l ol 'd,,,,,I d.:,m John, mghr11nto tho: hrst h.i.1rd 1>fman.lC<'r, for Enc C.11unt\ Med, ·,1! Ccnrcr h.1, h.:o:n ,mnou nccJ h1 Eric C,,unc1 ~. o:cum·,: EJw,ird Rmkow,ki. The appmnrcc,, onfirml.'d hy the Lo:g1,larurc,mcluJc rcprc,cn• BUFFALO H v A N t.it1\·c, 111 tho: h,,mc" comm1m1tv, l.1h.,r 11111,,n,,,m,I c,1mm1mir ,>r!,!ani:.mrni-. Th<' ho.ml pf m,uuccr, ro:,ult.:d from rho: rcf)l>rthv ,1 12-mcml-,sr t,1,k t1,rc1:that 11,1, ••r · p.unrcd m I ) ·4 h\ rhc Counn· l.o:c"l.ttur<.:t1> rL'1.nmmc11d ,1 turnr<.:d1rcdl\lll tnr rho: Mo:d1t,1I ( ·._.nro:r.Tlw 1,1k tnn:L'met wo:d..ly1wer ,1yo:,H• l11nt:p,:noJ. It, mcmho:r II o:ro:rccommcn,11:d t,i tho: Lcc1 l.11url.'t.,11,,wmc ,1crl'o:nwnch- th1: .md L •casl,uur<.:lc,1Jcr,h1p. Count E ,'<lltl\'l' 11 .1, dl.',1!.!ncdro hL' h1p,1rr1,.m The comm1110:o: ,m,I w rcptl'' ·nr rhc , ,mmurnt\. Mr. Rol-,o:rr ( 'k•mo:ntl.' it Ern,c \\'hmno:\ C,1J1,ult,mr, ,._.n·cJ ,1, t,ll il11,1rnr,,t rill' t,1,k hir ·;:. Cro:at1Pn of chc hoard of m.mago:r,.11,1, ,1p­ pn ,\'c,I h1 n 1cr, an o\·<·mhcr. 19~5. H\,:, ,t till' ll<'Whoar,l mcmh ·r ,lrl' mo:mh,•r, .,f the <·.·1,1mcml.'dic.11'l'ntl'r t.1 k force:. Tho:\ ire: no:11h.,,1r ILha1m1.1n,1'l \ m Sull1\·,m. 1·1<;,• ha1rm.1n of rho: h,l,trd 111 "-e1 B mk; new 1·1u· d1,11rm.m,M,11'\Anno: R11111.mm1 ,k1, ch:i1rm.m hu p11,1!\ ,t,11'1,,ir\ h,,,ir,l; ( try Ju,lc<• ul ti,._. I' aul Fn,:110:m,1, nc11 ,,:no:t,lr\, (,o:n<.: d,1m,, h,·.1J ,,t th,• R1ildmc Tr.id..: Coun ·ii; .md 'R VJLc Pro:,, knc ,1ughwn. Al ,. [)r j,,hn Armcna.1, .m ,,phth,1lnml­ lll.!\ ,mo:n,lirn.: t EC, IC Jncl dmJC,11prok, >r of ophrh.1lm, ,I,•!.!\,J.11nc,(.., o:nnn,i, a Rutl,1111 hu,mc--m,111,'J 11 iii<•tl'otn , ti,rnll'rd1rl.'<.:tor,,1 '; J,11110:, \V,1J \lnrth, .1 >u,11'l'l'I Ill:' .H EL!'--1<. l111ver; E. l\·t..:r Ru<ldv.<.: o:u1t1\·,:\'ic· rrc,1• ,IL'nt ,md ,1hum.111re,,1urcc, ,ml ·11mpurcr<.: • pat ,It Ciukh,ml.' R.rnk ,md Daniel A ki:r, rrc,1dl.'ntol tho: Buffa!,,(. hapt<'r, NAACP. • (From ECMC Update newsletter. Dec 1985) BGH announc new program B._. 1 le, rhc Paricnc-C.onrrnllcd An.1!­ go:,1,1Program, de, nheJ m the ,1rt1dc ,1h..1111 111:1\,me,thc,il1log\' dew lnp· mcnr, (,,:,: rag,:, 5-7 of thi, '"uc), cwo nrho:r 110:11 rn1J.:r,1m,ha, .._.ho:o:n,mnuunco:d h\ Rutt,11,1 <.,en •r,11Hn,r1ral. ■ A Rd11.1hilu<11ion !G.:ronr11l111. T\ rue, a 2 -ho:d u1111m thl' new Twin Tuwcr. It, goal i, to .1s,i,r cldcrh ,md di ahlcd pa11cnc, ,mJ tht.!1r �25 R habilitation C nt r rec i e major grant t.imilie, m .1 l.irt1m: r,, .111 ,1lrere,I lit..,f\le .m I to return 1<1the c,1111munir, ,1, mdq enJl·nrh ., l'<h ,hie. Th<' mul11-d1,c1rlm,iry team em• rh,1,1:e, rhe c,,nc,•rt ot ,dt c;1re w11h r,1t1enrs t.1km!.( .m ,1.:t1,·e role· 111 1 l,mn1ng .mJ 11nrle­ mentmg rlwir ''" n c,1r,·. Th.: T\\ 111T,,wer ,, rh.: reLenth Llllll('let ·J ,1 lditll>n r,, th• H11.:h , rreet f cl,rir,1I. ■ Ph,,1.;1{111 FmJ.:r,,1 n.:,, c11mmu111n·,en·1ce. rr,,\'1Jc, n.unc .. 1,I Ir· ,c, ,mJ tdcrlwn.: num­ her, ,,r R<,H.,i-,,, 1,1Ccdd,,uor, w l'n,1hll' c.11ler w tm I ,reu,1lt\' nw,lic1I ClTl', • Grant extend Ro well' cane r rv1ce information R n wdl Park ~km,in.11 In-mm.:' C.mcer lnf,,rm.mun .::l'r\'icl' ha, been .11,,mleJ.1 ·7 l.470wnrr,1·rfwmrh.: ,m,m.il ( ancer In,rml{e ( 'Cl) ro onnnu orcr,mon, rhn>u!.(h . \"·l'mber 15, l 9 9. Th.: ·ontr,Kr urrxirr anJ m.unt.1111, rhl' wll-frcl' tl' ll'rhune ,l'r,· tel' ,1 h I h, r,, J,ne, h,1, hrout.:hr nmeh, ,1 cur,m: c.m er mtomurum rn 11\t:r I , l , l'II Torker,. The Ro,well Park ,er, 1cl' 1, r,ut of ,1network of ' 'l-funJeJ re!.(11m,1I,,tfice, thrllugour the Uni red ,·rare,. E t,11-li,hcd m I976, rhe ernce h,i- taken ,111 111cre,1sm!.(numher of c,1lb ea h ye;1r, rc,Khmg a reak ot 17,9 I 11119 4, ,1nd lot.:i,:mg1r, l rhcallon pnl 17, 19 'i. E,1·h d,1\', rr.uned coun •for, .1n,w ·r qrn,,­ rnm, ,m ·,mca rre\'en11on, dl·tect11m, and treatment. " ur oumelors are not ph 1,1c1an,, med,md therefore :lomit give owr-the-phone 1c,1l ,1J\'1ce or c.111cer d1agn11,e,," ,a,J Ru"ell 'uanJra, J1rect,1r llf the R,"well Park ,er\'tLe. ":ome of the que tllln, we r~pte,111) h,111Jle deal ,1•1rhh,m w qulC ,mokmi:, how en h,mge ,ml'\ J1er, wh,1t cancer urron gwur, ,ue ,l\'• ,11h1t:,lc(ll patient, ,mJ their tam,lie , whert· tt> go for a c,111cer , r ·enml( exam111,1mm, how to 1d nt1f · can l'T w,1rn111g,11.(nak .mJ \I hat cancer rre.1tmenc, .ue hemg u eJ ft1r ,re 1ft1, an er.. The ( ancer lnf,1rm,1rnm 'ern e oper.1te, during ofhcc hour, and I co-,pomorcJ by R,, • 1,ell P.irk and the Am •nc.111 ',mcer .::o 1ec,, e,1 York tare anJ e,tche,ter D1vismn,. • ti A t\Hl•\l',1r, 4'il ~ i:r,tnr h.1, l:,een 111,tr le,I r,, rhe Chikln:n\ I h"p1t,1l Rd1.1btl1t,1t111n ·nr r c,, ·,c,,l li,h ,1 rellow,h1r T r,11nm-! rmi.:r,llll 111ne\'el,,pmen• ul Di,,11-ilml',. Th.: Pr ,i.:r,1m, 111,11rurc,IJuh I, ,,J,reLt ·d h l"lr. Rohen E. C,><.,kl'.pnik ,< r ,mJ cha1rm.111of ped1.11nc .,, wdl .1, re '1.1tn­ L1,111•111-d11cf ,111I me Ii ,,I Jirt:Ltnr pf thl' Reh.,b ( ·nter ,,t <.h,I lrcn\ H,isr1r,1I. Dr. lkm,1rd H. mith ECMC honor Dr. Bernard Smith T ht En Count\ ~1e 11·,,I Center ,! •die.ate I the [)r. Bcrn,u I H. '1111th u i1ton11m "1 tnber 24 Junm: cert·· mllnie, helJ llt1t,1Je rhe l 1 -,c.11 uinkrl'IK<' the.Her. The ,Ill lttonum , n,1me I t,ir [ r. :mlfh. ,1 UB pr,1k",1r of lll'lm1lng\' ,111Jlm.'ctllr ,,f the P •p,1rrment llf eurt1lllg\ ,1t rhe llll' liL,ll center ft ,r ,1 quarter ·entur\, from 195) tu !9i9. lled1eJnn ).1nu,1r, 27,195. Km 111n f,,r e,tcllence 111re,Khmg and p.111ent tfl', he \\,1, n,1mc,I ,,ut t,mJmg te I her h\ rhe !9ti5 ,cn111r cl.i" of the UR hoof t1f 1'1l' liunl'. He ,11"' ,1ttr,1Lte,I ,1 h1rge number of re,1Jent, rn tr.11n 111neun ,l,,g\'. Thrnugh re,e,uch, he a,kleJ 111,1ghtinto rhe treatment nt uch li,e,1,e, •" cen·1 .,I ,r,111J,·l,is1 , eptlep v, and other lll'Un1l,1g1·.11JN>r• fer . He w,1, .1urlwr ut nu1m:rou, publicatmn, m th<' h •IJ ,,f neurol,,gy. Three of h1, cc. tl-innb ,ire u,e I .1r nw,ltc,il ,chool, thniugh• our rhe u 1u1HT\. , tr, .. 'm1rh un, etleJ ,, plmrogr,1ph nf her l,1te hu,b,md ,1lunt.:with ,1pl,1que \\ hu:h re,1 I : "Ph"lsK1<1n, Teacher and "chokzr UB Prof.: ,f '.:11mlr1~ar EC\1C 1953-1979 ,;r Hr, Jcdi.:<11.:dl'Tl'lc'l' 1,1 chi!<IT!, \ ·1c1Kl' ,mJ /mtdlCl' oj nc11rnf11,1,,:.• m,f,1red,1 gcncnuwn oj ph.. 1cum, w ,rm c fur <'\tdkncc " • BUFFAID C ,.I&.J I p H y s I '" York The i:rant, m.1 le p, '"1hl · h rhe r ire )ttt 'l' ,( , t.:nr.11 Rer 1rd.1uun .111I l ,·­ \'Cl, ,pm,·nr,111 1,.1bilml' (O~!R[)[)), ,, p,trl nf ,1 ,r,11e-\\ 1,le pru1ect 1,ht<:h will h • h,N' I ,It 'l'\·er,11 meJ,ul unl\·er 1tll''· rthur \Vl·l-b, Ill'\\ h .1pp,11111e I L lll\[111 ,1oner ,if l )~1Rnn. u111,lu,·1nl ,t l'ne, .. t rl.111n111gl'' 1011,"hKh le f tll rhc ,1rrn l\ .,, l •f [,l[C ,upr,.irt tPr the Tr,11n111gPn,gr,1111. "Thl· rur1 ". pf thi, rrui.:r,11n ,, {ll 11Hl'Tl',t I pn:p.1r • phy,,u,111 t.,r t ueer, 1111,,,rkmi: 11uh the ment.1111 rerarde,I ,m I ln·elopmen­ r,tlh ,l1 .,hie I. 1,·,rh th,· 1nren11, n th.11 thc qu.,J. 11, ,,t l,lrc ,1 ill h · 1g111t1c,mtlv 1mpt1l\ e I," ,rare [)r. Ct111ke. ,111 The i:r,mt en,1hle, rhree re,e,1rcher , ,111,,f ,1httm h.1d e,pre, · I 1ntt:rl',t in rh, .Ul',t. to b,•gm 1r.1in111i.:lul1 I. E.,·h rh,,,u,m "ill fl',. ·l01 .m 1mr,.,runr ,1rea of 11we t1i:,mnn an,I will e,rend th,, kmm k,li.:e r,, , ,mnu ..:enter mn,h-eJ in th1, prui:r 1m, mcludmg LIR, SLho,ll 4, the Reh,1h l 'enter, \Ve r .:'enec,1 De\'elopmenr l enter, J. . Ad,1111[ l',·el,1r­ ment.1l C..enrer. ,mJ G •nc, ,1 lTUgg , ,mmrer­ med1ate 1,,1refo iltt\ for the menr,111) ret.trdl'd. l'liegll n.w,,ln,. 1\.1, n., clina:.1I m,m1ct,1r Ill pe,liatn . "111 onccnrr,1te h, ctt,1rr- ,m the ,1re.1,of c,1rdlll\,1, ·11l.1rI roblem, ,mJ the .,i:mg menralh r ·wr le,I popul,mnn: M,11H1 Ll•e, M. l)., will t,,cu ,,n reh,1h1ln,1t111n ,md the mcJ1L.tl man,1g ·mcnr ot ynuni.: h1I lren, .111I [ el-il-1e Korwm, 1',. 1.[)., cli111c,1l•'""r,1111 m­ ,rrucwr m rcdi.im · , 11tll 11we,ng,1te l',H, 1w, ', ,md thro,11 rrnhlem in Lle\'Cl11pment,1II\' d1 .ihlcJ p.menr,. ~fah,1el ~1 ,11!, ~1.[ ., "h" 1 Imm John, lfopkm,, 1 co,1rJ111,1tnr 11f rl1L' progr,1111. A muln-d1 nplm,1~ ,1rrwach "ill be t,1ken �26 I-IO PITAL EW m the program, which will cover a wide r.mge ot unu,u,11 pmhlem, m the Je\'clnpmenrally di,,1hlcd. lnvohed d1 1pltne will mcludc dcn­ t,11; ncun logt ,11; pharmacologt al; mtemal, family and physirnl medic me; g,1,trncntemlog1 ,11; p. ych1,,ml; genamc ,md generic. Th,, ,pc ifll focu, ,in ,uch d1 or 11.'r,i, expccced t1> dr,l\, attennnn en the ,·am1u, unique need of thc,e p,nti ·ul.1r p,menc,. "By imprn\'mg chemet1cal ,mJ clinical tr,11n111g,we hope tn 1mpro,·e the qualtt)· uf care. TI11, i, the fir,t org.m1:ed effort ro provide tr,11nin1.:tor phy,1c1.111,,and it 1 our intcntmn tn re ruit mire phv,1 i.m, hy creaimg a ,ming mterc,1 through residency progr.11n,," e ·pl,11n Dr. Cooke. The Pr1igr.1m' ulr1marc eo,11i, to ,1chieve ,1 h1eher level of 1..1rcthmuehou1 the ommun1n for Jc\'el11pmcnt.1llv J1,.1hled cin:cn . • Law on head RPMI' ho pital T he C\\' York care Department of Health ha appointed Mr. Rohcrt E. Law on a. hospital dire wr at Roswell Park Memorial lnsriru1e. Mr. L::W'<lll will direct and coordinate all a,pc t, of hospital management at Rt swell Park; develop y. tern, to 1mpro"e the quality of care n.:ce1ved by panent,, anJ develop a tanagemcnt A uon Phm which , 1II1Jenr1I\ goab for the 1mutute's ho,pnal. During h1, 25-year career, he has played maior admm1,cr.m,·e role, at the Pre,bytcnan­ Univer icy Ho . p1tal (Uni\ er..icyof P1mburgh); Dehrnare Ho p1tal (W1lmingcon Medi al enter); Temple Univer 1t} Hmpirnl, Ph1laJelph1a; Health Care Facilmes at the Unl\·er-ity of Medicine and Denuscry of ew Jer cy, and most re nrly, at Pre,byrcmm He,1lth Re'>l1urcc, In . , in cw York '1ty. • (Repnnted from the Chddren·s Hosp,tol Newsle er. "8ombno1 Outpatient clinic car for alcoholic T 1i help combat the growing prohlem of alcoholt,m, Buffalo cner,1I I lo,p1t<1Ire cntly e,rahl1,heJ an Al oholt m utp,ment ClmtC. nder rhe au.p1cc, 1il the Famil) Med1Cme Center ,md located m the ba,emcr.t of the ~acone,, D1\'I mn, che Aloholt,m linic\ m1 10n 1, to ,er\'e the Buf­ falo Geneml Ho,p1rnl Corporatmn and the ur­ munJmg commun1t). The dini i the hram­ ch1ld of Ellen rant B1 hop, Ph.D., vice pre,1dcnr llf ambul,1tor care and din1cal m trucwr lm1 al of p,ych1atry, and Freden ·k oolq, a ~l'tant pmfe, or of family medi inc. ~tn ti) outpancnc, the program opcr.ite. with two full­ ttmc counselor,. ~ erv1 e, indudc a· e,,mcnr anJ diagno,1,, linkage ,mJ rcierral to mpancnc treatment fa ,line .1 needed, individual and groupcoun­ ,clmg, educar1,mal ,md d1dact1c prescncanon,, and group thcrap) anJ comultatlnn. Th" fir..r pha c of rrearment, which la,t .ibouc five weeb, ,11 o include, brcarhalyzer ,inJ mx1cology ,creening to ensure clients re­ main ,ii ohol and Jnig free. 05/ 6 The seC(lnd phase focu,e on the "here and now" prohlcm, that rhre,1ten )bnetv. Br th1. umc, c.11·nt, lo. e their resi,rance and resent­ ment, admit their al oholt,m, anJ e.·pre" a desire Jnd con urrcnr ,1hil1t\ co remain 1hcr. ,mg a group appn,,ILh for adJe I upport, clients work through problem w1rh lamtl ·, pr11hlem, ,nth ,elf, .md the mild Jeprc"ion chat often a companies this pha,e of 1rear­ men1. The horte t trc,umcnt pha,c, .1frer-carc, ,rrc,sc, mamtcn,mcc. "By rh" umc the pers m ha worh,J through a \ ,mety of pcr;onal I sucs ,mJ ha, maJc a rremendou, aJJu rmcnt," Mr. Gary Bait:, program coordinator, noted. The clinic e,·alu,1te, whether the pcr'>lm can Jo with ut the ,upix rt of the other clients m chc group, ,1lrhough 1t nll prlw1des support and moniror pmgrc ,. A hallm.irk oi the Outpatient Clinic' treat­ ment pl,m "work mg with the Iienc\ family, ince interper..onal relation and famtl) dyn.im1cs are often involved m ,m alcoholic'. liic. It 1s nor um1,ual to ha\'e more than one ,1lcohol1c in a fam1h anJ about 70 per cent of ,1lcoholt patient . have one parent who is al ...1 an al oholic. • (Adopted from Buffalo General Hosp,tors "'Pulsebeot") BUFFAID ~.! --A- . Children' announc in--vitro fertilization C h1ldren' Ho,p1cal. in onjun tion wirh B, ha, announced 1t, fmr m­ nmi fcrtilmtt111n pregnanc . hil­ Jren' Hn,p1ral w,1 plea,eJ that rhe ,u e, c.1me carh in rhc ncw progr.im with rhc ninth patient to und •rJ,?othe procedure. The hn,p1cal' In-Vitro Program i, under the d1recuun of Dr. Abraham K. Munabi, re e, r h , si cane profes )r. Dr. . Jame~ hen, cl1n1 al ,1 i rant pmfe,.,or of gyn-oh ,lt B, 1,a member 111the In-Vitro urgical ce,1m at hilJren' HI p1tal. The In- mo Program ,lt hildren\ i, a popular and integrnl omponcnt of the llm­ prchen i\'e mfcmltty ,er\'icc, that the Dep,1rr­ menc ot G\necology and h remc provide, t1>the community. The fociltt) 1 unique m rh,1t 1t is eqlllpped rn cc. t ,rnd rre,1t both male ,mJ female mfcrtil1rr. ln-,·itro fcrtili:ation 1, ,1pm e.,.,of remov­ ing a w,,man\ egg, in the !ah, anJ fcrtil1:mg rhem w1th her hti-h,m I' ,pcrm. u e ,full tercili:ed ll\'.1,1rcrcimplanrcJ m the uteru,. • �27 TUDE Med School Talent Show BY BER ADETTE aralyn oram (' ) nckled rhe 1\'0ric . with Bill\ Joel\ "Rootbccr Rag" to enJ the e\'enmg. • Ml A N ation -wide med, al chool admi. ion, ,tu lie, have called ior the re ognmon o( a broader range o( tal­ ent in c,indidarc, applying to medical school. ,enc· maior, arc no longer the only favored candidate, now that ;1 broa J range o( mtere t, and talent. in the art and ,en e. 1. rhe new ideal. Here " one demon tranon of the UB Medical chool\ leadership 111th,, rren I: the 19 6 annual Talent how on Februar, I. F,r,t-year ,cudent Jonathan Bean and David Blau,re111 opened the ,how with their m inologue, "How to Be an Emcee," followed by ,l omed · . kit in which the\ portrayed rwo conrra ting medical tudent, 111rhe pro e,, of ne wrmng letter co rhe1r re,pect1\'e p,uent,. ,tudent t p1fied the "nerd" who eniov, h,, neurophy,iokig • cl,1, o much chat h • u,e ht Minolta amer,1 co photograph pickled bra111 ,tern,. The other ,rudcnt \HOtc home about how e ·cite I he is about the "nt e" girl. he mer on Chippewa rrect. A appella mger,, the Dermarone,, con­ tinued ,m old tradition h} performmg their l.woritc tune, "Blue Moon," and inm.ited a new one by inviting "any former Dermatone. m the audience to Join m ing111g ." The older members al,o donned ,unglasse while perform mg. M1rch Tublm {' , ) lln flute, Tony a['(Kellt (' '9) on guitar, ,md David BhnNe111(' 9) on a. were the mo whli performed " hord,," an ongmal piece by Mitch Tuhl111. apnvaring the audience with their piano \·irtlllNty were Arthur \Xle1'man (' 6) with hi, 111terprerntionot Brahm.' pu 79 and Marth,1 Pavlak, . (' ) with her performan e of "Toc ­ cata" h Khach ,uun,m. Ever,·one\ favorite ac 11mpanht Jo,ette T eus her (' 7) proved chat the piano wa not her onlv t,1lent. 'he jomeJ "H" Boy Elro ·." a rock-n-roll group better known a, Adam A hmn (' 7), Hliward ' r,1rk (' 6), ,md Jonathan Hughe . , ,1, a \'Oc,1li,t belting the rnnc,, "He.ir11,we," ,mJ "Tw"r · hour." The ,1ud1en e JlHned rhc band 61 dancmg on the ,rage floor. Kevin Kio ner win MAP fellowship D r. C. fa ·rett Koop, urgcon General of the L' .. PublK Health er\ ·tel', ha ,mnounced the ,cle non of B med1C.al,tudenr Kenn Kio ,ner n, nne ot the rec 1p1ent, of the I 9 '6 MAP 'ReaJer' D,ge,t lnternarion,11 Fellmv,h,p . Kl1i-ner wa, one of 42 ,enior medical ,rudcnt . m orth Amcnca ro rece1\·c the unporrnnr ,m .1rd. The Fellowsh1p provided .i tra\·cl grant to Kio ner co ,er\'e ,u a rural 1111 ,ion ho pica\ m a Third World count~ . \1 h,le q,Junteering hi, rnne ,ind medical m1m111gto fre4uencly understaffed facilitie , he al,o learned med,cme a, pra need under the difficult con ­ dmom oi the Third World . ~ tmlent~ wer ' ele red on rhe ba ,, of an excellent ,,cadem, ,t ,mdmg, per,onal de­ \'elopment, cultuwl adaptabiltt\', mnuvation, world c1mcern, Je ,re flir voluntar, · ,ernce, and a ,mcere mtere t in Third World mcd1 al m1' ,on,. The fcllowsh1p wa m,1de poss1hle by ,1 grant from rhc late DeWitt Wall.ice, founder of Reader' D,ge,r, and awarded under the au­ ,p, e. nf MAP International, a hn tian global he,1lth organ1zat1onin Brun w 1 k. G ·ur­ g,a. That agency ha awarded tr,wel gr,mt, ~mce 1971, to 1,000 student who have served m 6 3 develop mg countrie . • BUFFAID T"F. V s ~ N LS, b �2 ALLJMNI GEORGEHATEM Buffalo-born medical adviser to the Chine e will keynote annual pring Clinical Day T" rhi: Chm.: c, lw ,, the ''\'mm: lrom ,w.:r,c.1 " (thl.' rrnn l,mon ,,t h1, Chm.: l' n,1m.:, M.i Hai T ch); hi.' " rhl' vcncr,1tl.'J, no ... 11.'l(t:nd,ir) men ,m docror wh,, cnnquerl.'J \'enl.'rl.',1!J1,ea,I.', Jrug aJJ1unin .. mJ pri,-rmmon in the mo,r rorul­ uu councr,· in he worlJ. Tu chi.' Amenc.m,, h · 1, G ·on.:I.' H,1tc111, M. [)., rh1:Buffaln-1:x,rn Amenc.in ,on of pour Ld>.ml.' · 11111n1l(rantwho h1111,elt1111cr.irl.'Jcu Ch111.i 50 y.:,u, ,igo tu hl.'Cl>meche pl.'rsi•n wht1 "know more al:x,ut R,..J Ch111,1,mJ 1c, k•.1Jer, chan an\ lore1l(ner alivl.'" (accorJmg ru r.:­ noll'nl•d 1ourn,1li t Edg,1r ·now). I lar.:m, ch.: chief m.:d1 al adv,,or to che mamhmJ hm.:,e l(,wernmenr, will rerurn rn h" hometown to I.: thl' keynotl.' ,peak.:r ,ll the UB MeJ1L,il ,~chool' 49th Annu,11 Alum111 :pnng ~lm1c.1l Da\ on M,1\ I , 19 6. He " dearly one "' the mu,c f,1m1111s phy >Lt.in to \'hll B. Ruffolo May,,r J1mm1 Gnf in ha, de­ clarl'll that J,11 "Ul.'orge H,1tl.'m Day" and will prl.',ent him thl.' kl.'\' t,1 thl.' cay. " o orhl.'r namin on earth can makl.' rhl.' I.um ... that a riw venere,1I dise,ise ,md pw,rnutmn h,t\'I.' hecn completcl} l.'ra li­ L,Hl.'J ... anJ ,uh,c,mtliltl.' 1c." \Hite 1,1urn­ ali,c Lloyd hearer, 111a 1973 ParaJI.' Maga:me u1vcr ,tor,· al'l1u1 rl1l· fa mating dncror. I l,1tem UT\'l\'CJ ,ill the 11ar-wrackl.'J years of hrnral Japane, ... mvJ 100 and civil war ro hecumc rhe chief of wtf tif the hme,e ln,n­ lllte ot 01.'rmamlogy and Venere,1log}. nJcr hi, leaJl.'r~h,p, the ReJ Army wa, rrean:J dur­ ing th• 3(l,, and 4 ,. 'r.irting 111 l 949, rhou,,md, uf"bare fom ductllr. "or rarameJ,c Wl.'re rra ml.'d .ind ,enc ,icm , rhe ounrry 1dl.' ro ,camp out VD ,mJ ir, mob. Hi, hue,r pmJect ro crnJ,c.ue lepro,~ h<1, rl.'ducl.'d hat dhea, • hr O per cenr. The fir-t non-Chm.:,e m gam cin:emh1p m rhc Pe11ple\ Rcpuhli uf Chma, Harem "Je­ scnbeJ hy Jtmrn, lt,r hearer a, '\hon, stocky, harmmg, mforrn.11, profound, phdo oph,cal, and well rl.'ad." In mrerv1ew , he prefers to d, rn" h1 work r,1rher rhan him elf. (11.'orge H,Hl.'m 111.'\'a plannl.'d to go tu Chm,1 . HI.' h,1d no polmc,1I com llrtun, when he left medic.ii ,chnol. lnterl.',tmgly, he ult1milt<-'h ended up 111Chm,1 rarrl1 bec,ui,I.' of ,mr,-: ·mm,m m '11nh C,m1lma where hi.' went n, ,chnol. He w,1 dhcnmmared agam,c m high ,choul ,mJ colkgl.' 1,1.'c,llhl.'he w,1, thought to l,e Je\11,h. And he en ounrereJ LJlll>t,1,aga1n,t Jew, ( which .1pplied w h1111,1, .i Ll.'hane,e) 111ml.'d1cal , lwol, to which he ~pplied. ~o he de 1ded w gu ro he n1veNn of Gene, ,1 l\1ed1c.il :ch110I, w1t:erland, where hl' l',Hnl'd h1, M. [). in 1934. nee 01-...r­ ,e,1,, h~ Jec1dL·d to ''-''-' more l.'xonc cuuntnl.',. Tol(ethcr 1nth cwu y,1ung Je111,h doctors, he ,elec ed Chm,1 to le,nn ahnur w,irm weathL•r lli''-'·"''°' hec;iu .: hL· pl,mned cu rl.'rum ro prnc­ c1cl.'meJ1cme 111the ,outhern U . .:. U pt>n arm mg in 'hangha1 111 1936, he ,rem rime trl.',1tmg the pnli e and rhe1r pm,cirutl.' girl fnenJ,, mfecred with an 1mpre,­ \ll'I.' ,1rray nl 1·enerl',1l di. ea,e . h~1rch afrer, fa,, Ze[) ,ng w,1, ell.'ctl.'d he,1J of rhc Com­ mum,r Parry ,md l.'nr word ro ,'hangh,11 rhar hi.' \1•,1nred a "\; e tem-tra1111.'d dncwr ,md an hone~r Jou ma Ii r." Hatem 1,,1. .ipproached and convmccd of tht: Jc,perate nel.'d for h1 . er­ v1cc,. Alrru 1snc and advenrure oml.', he de­ odd to 1:11•1.' 1r a tr,. 'i</irh journali,t Edgar ' ml\\, hi.' rr.1n:lll·J 11l'erland, nl.'akmg through .imm,1h,t army \me, until c.ipturl.'d l:,ygueril1.i who brought them w ~hou En-L11 and l\,foo. H ... wa, nnl.' of only rwo rraml.'d rh, 1cians for the enrne Rl.'d Armv. Aftl'r survivmg the hi,ronc Long March ro Yen;m ,mJ many l:iattlt.>, Hatl.'m returneJ to hangha1 \\ hen thl.' ReJ Army rook over hma m 19-¼9. It wa then he cmh,1rked on hi, pro­ gram which changl.'d thl.' fact.>of Chma. hma wJ, ,n poor before the Ren1lunnn char parent~ ofcl'n ,nlJ rhe1r daughter ro hmthcl keepers m ordl'r to surv1,·e. H,uem t,,und VD v1rruall\ panJem1 , - I pl.'r cl.'nt ,if, hanghai t\ a ,yphilitic. ·'Fir,t," he rt.'latt.>d m ,m 111ten·1ew f,,r rlll.' oimcr-E.\/>rc" 111 1973 hy Uoy J ,'hl.',irl.'r, .. "they cln,e I du1, n ,111thl.' hri,rlK•I m the c1t11.' Thq· ,ep,ir;1ted clll.' mm.ul.', from rlll.' ownt·r­ ,mJ the pimp,, and 11rgani=l.'drhl.'m into , ·Mt· nu, group, fr,rl.'x.1111111,Hmn ,md cduc.1non. Thi.' girl, wh11 \\'l.'rl.' fnunJ tn l:,e mlc red - mnre than 9L pl.'r Cl.'nl - wne 1111ccred w11h pen1 ·ill1i1 ,md rhen pa,, ·d on for ,,1c1,il rc­ hahd1ranon. "Thi· w.i, d,me bl' g1,·111gJoh, tl1 thme who ha,1 h · ·n prthltturc, lt1r only ,1 horc pcmxl of tlllll.'. The lung-termer, were a ked to l.'ntl.'r Rel1ahihrati11n Center, where they were colJ: 'Y11u ,lrl.' not tl1 hlamc for ,,h ,1t h,1ppened to yt>u. Y11uwerl.' t 1ctmi- o1 rhe old ,ncicty. )nu ;m ,1II m;1ke new !il'e, h1r y,1ur,l.'1'-I.',.Yuu L,111 ,111I ·am to ,cr,·c other,.' " The girl, were then encourag ...J to recnunt ch...,r p.1,c 111''-'"'"n, where rhe\ could hcd th.,,r guilt. ,h,1111· ,md h,"11l iry, .,, ,1 -,uh.ir-1,. They wne raughc to r~;1J and wrne anJ then taught 1rnJ...,. "(,raduall1 rhl.'1r pmle ,md Jig• 111~\ ,1' hum,rn h •mg, were rc,mred," Hatl.'111 cnntmueJ 111 rhe C()Uflt'r mren 1ew. "On(e rhev were uired ,md rehahilit,Hl'd, rhe\ llere ,enc uuc ,1, nur. e , teachers, cll.'rk~. with rhe ,1ssurance char nc\'er ag,1111would rhe government rcrmit pnvert\ l' dn1·e chem llr rht.>irchi!Jren into pro,titll[ion." T hen H,uem set out w eliminat the l'icof venere,11 d"ease. He relared, "To lmd millions of V. 0. ca e ,careered through­ out the world's mo ·r populou, country alleJ for new m ·tho,ls. You ju.r couldn't bkx.xl-te . t 750 million people or whatt.'Vt.'r the populauon w , back then. "After mu h di u · 10n, we decided that we would have ro train a cadre corps for venereal J, ea c eradication, a group of people who would recogni:l' rhe symptom. of venereal dis1mis �29 ALUMNI ea e ,mJ ch,m!!e rhe ,1mtu le, ot the renple r,m.irJ it. ·•B,N ,11lvwe u,ed two metho I, rn find ,mJ tre,H V. D. One ""' the re ·hnic,11 methnd , r.1km!! ,ltde re,cs ,mJ ,o forth. And the other \\,1 the pol1t1 al merhoJ of drawin!! up .1que,­ tionn,ure ot I que,non,, .1 y.:, ,in w.:r to ,in, one oi ,, hi h wou Id ,ugge,r \' . D. "Thi, q11e,tlllnna1r.: \\ ,1, ubm1tt.:d to rhnu,.md, anJ thou,an I, of pe,1ple, ,1,kmg rh.:m 1t the) ,utkrt·d inim ,km r,1,he,, t,1ll111g hair, 1?en1tal ,ore,, ,md orher ,11?n, of V.[). ne 1112 who h.1d an,wereJ ye. to at least ,me of rhe IL 1ue,t1on, w,1, tound to han· ,yph1lt . The Tibetans ,mJ he Mongolian were the worst off. In m.m, of rhe1r mnn,1 . tene, that I per-im,111, mve,rig,Hed 1 t,,unJ anywhere trom (' rn 9 per cent ot the lama, mfo red with ,whil1,. "ToJ,1), \OU coulJ r.ib~ .i group ,,f Jer­ matnlogi,r, anJ , enerealog1,r. from ,my coun­ tf\ ,md let them go thn,ugh our m,1JnrChme,e citie, ,mJ wke our fir,t IOm1llmn people, and 1 J,m't rhmk the,'d (mJ one or rwo ca e, oi )phili ." Eltmmanng opium ,1 ld1 non w.1, less ·om­ plicarcd. H,1tem helped en mit1,1te ,md ,1J­ mm1,ter the n,1rc,1n program wh1 ·h w,1rked like rhis: An ,mnouncement ,,a, m,1de when Mao be ·,1me Premier th.it all nar one, dealer, would be executed 1f rher J1 I n,1t cea,c. Mn,t didn't bd1t·ve 1'1ao me.int ir, ,md ewcunnn, took place until opium ,ellmg \\a, \'lrtually erad1 aced. oing ba k to h1, pa,r, Harem fir~t thought of hecnmmg ,1 Jnct<1r a, an eight-year-old dur­ mg the great flu ep1de1111c of 191 . While he w,1, 111 bed with a he,t mfectmn, th mtt:rn, ,eemed brut,11, ,,hde p..1king h,1le, in him co leave drains. "'o I thought 'maybe if 1 become a dl tor I can do the same thing to them'," he wrote in a 19 ' 4 am le 111 lww Re ·<>n­ .,rrucc. His other ,cimulu, ,, ,1, co emul.1te an old Buffalo family pr;i t1t1oner whn never aske I for mone) and .a w his family chmugh all dine:• es. "He has been my life-long hero," he s,1id. At 13, Harem wa ,ent co , 1rrh C,1rolm,1 work for a Lebane e merchant bec,m,e his fam1I, nul ln'r afford to take care nf four hil­ dren . He became h1, high chnol\ valed1 to· rian and got h1, pre-med eJuc.itmn at the Uni­ versity of orch arolma, hapel Hill. After to Dr. corgc Hatcm: he helped stamp out VD in China. BUFFAID n,LL:-l ~ �3 ALUMNI le,wm g for meJ1cal ,ch oo l m Europe, he J1 ln 't return ro America for decaJe, . H i, 1<1't re l'nt . pmJCCt 1, to d1m111,1te lcpr<"\ 111 hm ,1. He re alls m the Covm>r mtcn ' 1e11what he founJ m 1950 when the RcJ Arm\ re,1ehl·J the la,t corner of South China. "Lepm,\ 11,1, l'nJem1 . The ,utfcrer wen : ,hunneJ. They were ,o mol'ed, 'll graceful. when we ta lked to them that the experience w,is memur,1hlc for the loctor , ,1, wdl. I latcm founded ,m ,1, oc1amm of Jnuor,, the Chma Lepm,\ FounJ ,ltllln, which npcneJ ,1 lcpr o, llntrol center. I le o rg,m1~eJ effort . 49th ANNUAL w lncace the leper, anJ with the modern lep ­ ro,y ure chat JevclopeJ, h 1, team reduced the le er popul ,uion from 500, 0 m 1949 rn l rnJ ,1i, mmcly 111i,olaceJ hill com­ mu111t1e,.Hi goal 1, w climin ;ne it hy 20 1 . Hare , , know, hat America cannot ,1pply Chma' method, w Je ,11 with tt, pmhlem,. But hts advice ro Americnn medicine is to put a much greater emphasi, on prevention. Ameri ca Joe not pnw1de the raft to carri out, m actually 11nplemenc, prevention pro­ gram,, he m,11nrn111,."Thi, 111a Clluntry that ,pend, ,o hugely lln medicine. If Chma haJ ,1 t in) fraction of those funds," he wrote ,n ,morher article 111 Chma Recon.:;tmcts (Feb. H,1rcm kept a very low profile durmg the 1950s anJ 60s because he feared hosnl1ry coulJ be directed at hi American rehmve,. ince ixon\ ino-American detente of rhc 70 , however, he ha, vi,iteJ the . . , the la,r rime 111Buffalo in 19 Today, with China marchmg ahead on wh.,u he de , ribc , as the final battle again t leprosy, he believes he can . till live to rea li:e hi, dream to eliminate lepro y by the end of the century. Thar will end his per,onal Long M,uch agam t di ea~e · that have plagued hina for millcnma. • Buffalo Marri tt Inn, aturday, May 10, 1986, Ballroom. 7:15 a.m . Rcgi,rr.uiun anJ Cuntment.il Bre.1kl.N :00 WELCOME , Ch,1rle, J. T.mncr, M.0. '43 rr esiJ.-m, Amcm:,m Alumni A,-..,ci,ullm John Naughton, M.D. [),:,m, Schnol ol McJi,mc .mJ \'Kl' Prc, ,Jcm 11,r Chmrnl Aft,m,, l! rnver tt\ at Buffalo Paul W . Wierzbienie c, 1.0. '74 Pro1:mm Ch.11rm.in SPRING CLINICAL DAY: ADVANCES IN PAIN :45 CONTROL, OSTEOPOR_, OSIS AND AIDS PAI :15 0 TEOPORO I 10: 15 PRE E TIO OF O TEOPORO l PROMISE A D PRO PECT Robert P. Hean ey, M.D., John A. Creighton Um ­ ,·cr-i ty Pr,,fe,-.., , Cre ighton Untn~r- 111·, Omaha, 1':chr.,,ka 11: 15 AID O TROL MA, A EME1 T Of CHRO IC PAIN - A 1 EUROLOGI T' POI T OF VIEW Jennifer . Kri~l er, M.O. '76 A,,N.1nt Prof ""r ol 'curolog\ C.,"' \Vc,tcm; Direcrnr, Pam C1:nrcr, Un1v-,r.i11 Ho,p ir~l,, Clcvclan J , Ohu, EVALUATIO D MA AGEMENT CO EPT FOR CHRO IC P I - PAI E TER APPROACH John C. Rowling on, M.D. '74 A,"-.:1ate Profow,r ol A nc ,t hcsiolog1· anJ D1recmr, Pam Man.t)?<'memCenter. Un1vcr;ir 1 of Vtrgtnlit MeJocal Center, Ch.irln rrew11lc, Virginia 9 : 15 Di cu~ston 11 :30 BlOL GY A D EPIDEMIOLOGY OF H M T -LYMPHOTROPIC VIR Bernard J. Poies:, M.D. A-.....,c1,11e Pr,,te"o r, Mcdtemc, anJ M1croh10l11gy, UH, ogy, yracuse., U Y ' "' York ; Ch ,cf. 'cc t 1onnfOncol­ r ,r,ue lcJ1c;1ICenter 12:00 12:15 Ru, me-., MeecmK 1:00 TO KTON KIMBALL MEMORIAL LE CHEO T RE A D L Honored Lecturer: George Ha1cm (Ma Hai Teh), M.D. 'mm Medical AJv1'l,r, MmMry Public Hca lch, Penr le\ Republic of China or 9 :30 Coltec 05/ 6 19 5), "she could run her medical crvice ·, preventive ,1nJ thcrnpcutIC, m grnnd . ryle." BUFFAID jPHY$r¢ i AN j �PEOPLE OUR SENIOR PHYSICIANS Dr . T erplan, Th orn and Rubin remain active (T hi the e nd in a profilin th car r , ac ompli h, ment and ad ice of veral not d U B ph icia n who till co nt ribu t to medic in and i t in to th ir late 70' , O' and ev n b ond 10 . W ha e profil d th e ind i, vidua l n 1t onl y to r o nize th m and their acco mpli hm ent , but m d I to mulat a w all ap, proac h the a e th at too man y ca ll th "r t iremen t year . ") CHOOL' REPUT ATIO ANDPATHOLOGYMU EUM AMO G TERPLA ' LEGACIE Q ualicy beget qualir . It wa the quality of judgement of young r. arl ori (lacer to becom a obel Laureat ) chat leJ him to recruit Komel Terplan, M.D., to B m 193 . It was the qualit), ofTerplan's original re­ earch that ontributed to the Medi al hool\ reputation m pathology. And 1t wa,, in turn, the quality of Terrian\ rec, ognition of talent that had him recruit cveral of the B medical luminarie who led the niver,1ty w prominence in 1.-,atcriok)gy ,md m1cmbinlogy. He attracted, for example, Erne . t Witebsky and Erwin eter to Buffalo, and that put B "on the map" in rho e fields. Thi di . tingu1shed tradinon that Terplan helped e tabli . h ha . continueJ rhmugh the attracting h re of ocher high! re­ spe ced med1 al ientbts, too many co enum rate. Dr. T erplan, 91 year -old, continue . to contribute his talent . to the me lical com ­ munity. He remain . th director of the Brain Pathology Lab at hildren' Hospi­ tal and ts con ultant pathologi t to everal hospicaL. In the Brain Lab whi h he ha operat d for 55 ea r , he i converting a valuable histo ri , l lega y into a Pathology u um for hildren' · Hospital and B. BUFFALO 'P Hv s1¢1 AN ) He i now halfwa · through cataloging the I 2 , 0 ltdcs tn th olle rion . Born in I 94 in Au . ma-Hungary, the emeriru professor of pathology earned hb bachelor' (summa cum laude) in 1912 from the Humani ti Lutheran G m­ nasium m Transylvania. He re iv d his M. . from the German ni\'er tt), of Prague in I 9 I 9, one y ar before rl on graduated from th hool. He tay •d there w be ome asso tare professor of pathology. "My first 11 •car. m the world­ famous patholng} department w re in re­ lative 1solatton doing re carch," he re­ late . One o( ht lei ure acttvities then wa mountain climbing and skung in th Ausman 0olomire . In I 9 3 , he received two 111v1tat1on ., one from Buffolo and anorher from "a very good univcr tt in Germany ." "I wa in­ terc ted in the rman po. irion and they liked me, coo." But the erman chair­ man, intere~ungl , re ommended that the young Terplan go to the .. "Bad times arc oming oon," he told Or. Terplan. That wa enough to change his 5/ (l �2 PEOPLE · 1/,,n mmJ, ,mJ ,u Terpl,m aLce ce I UR\ i1wi­ canon. "I wllulJn't haw hl',red lung 111 German) t>eL,llhe of Hitler. I would have left anywa). Be,, le,, I felr much more m hllmc reaching tn Buffalll than 111 Prague." Terpl,m hr, t>ecame krill\\ n for h1, re­ ,e,nch on TB, 1111riared111 Pragu '. Among hi ,everal do:en TB article,, the mo,t important work followed hi hllut and re­ covery mm che d1 ea,e 111 193 , after which he gatneLI internanonal attention r,y b ·ing rhe ftr,r to determmc and analy:e the parhogenc,i, nf recurrent TB in chil­ dren. T erplan rionecrcJ nm onh 111 TB, l ut also in Hodgkm\ d1,ea,' .ind rhyroi liti . . Ht, do:en nr ,o arttcle, on Hodgkin' Jis­ ea. e are widely quoted. H L proud of being wre earcher w1rh Witet>,ky on hrnnic rhyroiJiti an 1 aucrnmmuniz.1tion. He also did much of the hi rological work for W1reb,ky a, well a, for ,moth r luminary, John Talbert. Among ht, other achi vemenr,, h was: ■ di overer )f the detrimental effe c on the mtestinal tract ot anril:11ori -re,1v rant raphylococct, cau~ed hy overu ' of antihiori ,. 05.' t, ■ fir~t m les rihe exactly h 1w brain lamage in children with congenital hearr d1sea e can re,u Ir fnim carhetcri: , tion ,m ,urgery. ■ widely quoted for mtginal work on genetic abnormalitie, tri om1es 13, 17, and I . ■ one of the first to de cribe fatal hypoglycemia 111 children 1ue to in,ulin ,hock. ■ one of the in co Jc rihe chc cffe t. of laetrile intoxicati m on the hram, and ■ founJer of the Buffalo ociety of Pathologi~b. in addtrton to ht re . card,. Or. T erplan' leader,hip haJ a great ef e t on pathology 111 Buffalo. He w ,b chairman of B's Pathology [) partm 'llt for 26 year, (1934- 196) and hie parhologi,t for Children' and Bu alo General hospital ior 30 year.,. Dunng tho,e deca le,, he "promoted, with all of my treng h, rhe full-time ~y,­ tem, ,o that profe, or . coulJ dc\'ote their tim' ro teaching and re earch." H now pends on ·iderabl time pre­ paring hi pc tholog • colk ci,ln or thc museum. "Th ollection are large col ­ loidal ection . of frontal plane through BUFFAID A '< the hr. in. It i, very unuwal en find ,uch a high quality technique, which wok a tremendou, amount of labor by nw former techniciam and myself. I am pr,iud of thi, work," he exclaim,. He rem ,11n, a ti, e in other \\'cl)' , ',\\'im­ ming one-half mile twi e a week, "down fmm my 4 -year habit of a mile a lay until 19 3. "] al,o am \'ery interested in ,tudying h1,tory," he ay,, pomting our hi 19 3 article in Can ·a on th, L'niver tty of Prague's hi,tmy. To keep healthy, Terrian recommend , "It i, \'ery good not to neglect your hody or your mind. U,e your intcllc t all the rime a y >u get older. Get "alue out of tc ,iching and leammg from re,idenr,." Hi creed is " 'Men ana in corpore ·ans,' Larin for ' healthy mind in a healchy body.'" He al o empha i:e, that one ·hould "re­ tain your mdependent Judgement for whatever you feel i right - Jo nut ,ac­ rifice your principle, or join politi al alignment ju~c ro get ahead." mong hi, recognitions T erplan i an honorary profe, or or m rnb r of numer ­ ous univer 1t1e and st; 1etie. , b siJe lo al honor . But one of hi ml t mtn·ing mu­ ment came when, after year a a faculty member here, he was in\'ited to return to Prague to teach. B a ulty members quickly orga111zedand succeeded in k cp­ ing him here. In hi, u ·ual quiet , nJ ver) mode t man ­ ner, T rplan aiJ ,ofr l ·, "] wa, \'cry, very flattereJ." BUILDER OF NEW PHY ICIAN A D I TITUTIO D rs. orge W. Thom, 7 , and Mitchell Rubin, 3, repre enc in­ dividual who left legacie in the 111 tmmons the · founJcd or brought ro �33 PEOPLE Thorn\ devnc1on to future generation 1, medical ,ru­ mJicared I,} rhe over 5, denr, he rrain.:-d. More ind1recrh, he reared a medical institution which i· now one nf the mosr imp irtant in the country . He initiated one of the fir,t "health plans," or rnral health ,,pprna he, n} an a aJemi c hlhpi­ tal (Brigham Hospirnl 111 Boston). The ,uccess of rh.., plan made ir rhe hart,mger of wday' ·multi-specialty group pra rices and healrh maintenance plans. prominence; they al,o haJ an impact on medi al knowledge anJ the training o new phy i iam which will la t for into rhc future. They are men who have nor ,lnwed down in ol1tinuing their work in building in mutions. Following are brief profiles of the e two remarkable men (detailed pro­ files are m the Decembn I 9 3 and • ep­ tember 19 4 issues of Buffulu Ph)'siciun). It ould l,e ,aid chat mo,r American physi ian, under che age of 55 hav, sweated and muttered under their breach while . rudymg George Thorn' booJ... in medica I school. For he i, one nf the llrig­ inal editor, of che "B11:,leof Medictne," .~ of /nthe 2212-page Harrison ' 1 Pnnci/>le 1emt1IMeJicine. (He ,erved a. editor or 3 I year anJ wa, chief editor forrhe 1977, rh edition.) The 'B medical graduate ( 1929), now pm e,,or emeriru, at Harvard, nor onl} wnite the "R,nle," nut founded the How• .ird Hughe, Medical Institute, IT' Whitaker ollege of Health cien e, and the Harvard-MIT Medi al hnol Pro­ gram. Th' Hughe, edical In rirute, with 5 billion in asset- and an O milli on re, arch budget, i, now the large r harir ­ al le re earch mganization in the U . . While at John--. Hopkin and Har\'ard, Thorn also estahli,heJ rhe founda­ tion - of modern endncnnoplog an I metabolism, being re,ponsible for the ba ·ic knowledge about nrrisone, . teroid,, the adrenal gl, nd ,ind its Jisea . e~ that 1s now taken or granted. He pioneered , roo , what 1· believed to be the world\ fir.-.r organ mmsplant and brought kidney dialy,is to chi- country. Recngni:ed w1rh nine honorary de­ gree,, Thorn place . particular value on rhe honor be ·rnwed hy his alma macer, rhe UB Chan ellor\ Award, in 1946. "It is highly dc. irable, in planning for the future, w develop extracurri ular ac­ r1vitie. before retirement," h ' advi . c · his younger colleague. "It is abo e ·s•nt1al r,, pace one . elf after retirement an :I nor be disturbed by your lowering work capa 1ry." Thorn cncm1rage , "clini al in\'est1ga ­ ti,m by mor M. D. '. - I regret thar 1t 1s in decline. lmporrnnt Jiscm :eries arc u,e• le s unle . s arried into the clinic." Now, a. chairman of th' hoarJ (and former president) of Howard Hughes Medi al In tttutc and in other leader ·h1p pwit1ons in the Whitaker Foundatil>n and it Health cicnce Fund, he onrinue to aid new phy i ians and institutions by funding faculty and graduate tudencs at univer.,itt : , round the nation. He germinated one more mstirution, of ort - hi peconal arboretum. Planted in the 195 ' , the Thorn Arboretum BUFFAID c~nc TFl boasts orchards of fruit and nur trees .u Man hester-hy-rhe- ea, M,w,achu ctr,. There, h.:- is able ro vtsit anJ rend h.., planttngs at the p.i e he chooses. Wheth 'r 1r i:, his arboretum or hi· ocher insritutt on . , eorge Th nrn\ work 11 di unrinue tn bear fruit for many gencr ,1rions. D r. itchell Runin seem a~ a lerr , r_ launching new imrirucions atrer hi "retirement" as he wa at launch mg Children\ Hosrin I and LIB\ Dep ,Htmenr of Pediatrics to national prominence. He came to the niver~1ty from John· Hopkin . in 1945 a, L' B\ fiL t hill-t1me rm es or and chairman of pe liatrics. (He 1s rill an emeriru~ profc~sor.) The re­ hab1lirarion linic he esrabli~he :Iwas Ruf­ foIn'.- first and the ~econ I in rhe nation . He wa, "in . rrumcnral m changing LB to U Y by changing tt rnm a small lo al mstttutton co a cnsmopoltran and respecr­ able lm1,·er 1ty and me :l1cal school," ac­ cording to Dr. John Warner, former pre • idcnr of rhe Buff, Io Pediarn • o iety . His a a lcmic re earch cmrhasi . was �34 PEOPLE one ot the clement. that uplifted Chil­ dren' .md L'B' rcpuc,1cinn . During h,, nearly clucc decade, here, he man.1gcd t11 B. ,1rtrncr ;1 hmt of tine physi 1a11-.to covering l'\'Cl)' p ·J,arnc rcc1al1t\. And man · of hi former rudt'nt ntl\\' head pediatrics department tn three other cnunrric, ,1nJ at O'-' ·r ,1 dti:en import.mt mcrican u111vcr,1rte ,md mcdic.1I in­ stitutions. H, · cmph,N, on pcr,nnal research ,peciali:ing 111r •nal di ca c .md h,, ,Ill· choring tit d1t' l ,NC rdcrcn ·e, Pdu1111c ~1,hm/11~,-:,, led Dr. Philip Calcagno, d,,. rtngui,hl'd , ·orgcrown 111\"L'r it· phy i­ ci,m and flmner B prnfc or, tll mil Ruhm "The F,1thcr 111, 1o :lcrn cphr 1l­ BGH . og\ ." Tn rcmatn producnvc 111 one's l.ircr year,, Or Ruhm aJ\'1,L' , "l\.1amrain .111 ,1'°'llL1at1t1n\\ nh younger ph · tct m in ,m ·1 adcm,c environment . ever c11111• pl ·tel) rctir · from your profc 11111 - 'r •­ tn:.1d' yourself. Attend 11nkrcnce, \\ h,ch excite ynur ,1\\',lfL'nc,,, .ml cont1m1c rc,1J­ ing conrempnral)· i l ·a 111your f,clJ." L ,cl), "Pur uc .1 hobh\'." R11h111\hohhy i rhc , 1()l111.wh, h he learned to play 77 year ,1go, ,md which ,., still "played lnr 11l\ own 1111,1:cmcnr." leer Z7 vears at B, Ruh111 returned tll his ,1l111a· 111,ttn, the '111vcr 1t\' of Ch.u­ le wn, \1uth arolma. R,tther th.in 1,1k up the ,un, Dr. Ruhin ju,c re ume :I hi, tnstirution-huddmg 111,1 new locanon. luring h,~ "retir·mcnr," he e,nhli,hc,I the nl'\\ Children\ R1:h;1htl1t<1nun ·nrer of ~'ouch arolma. rc,1tcd th· l '" 1 1011 of Pc 1rnmc cphnilogy ,lt the ~1 • lie.ti Coll •ue ot ~nuth C..an1Iin,1, ,md foundcd chat .·care\ fir t Children\ Hn p1tal. no\\ un :ler c1 nstrucwin. the • men ·m1 Jo11m,1I of Children\ Di.\Cct5c:de cnl->eJ him, "he ha, nut re­ tired. He pmhahh J11c, nnt knuw how." • emerg ncy erv1ce Frank E. Ehrli h, M.D., ha, hccn ,1ppu1nrc l ,1 ,.. 1.1tcprok ,r pf urgtcn ,m I n,1mc I lire • r,,r < I emergen(\' mcJicme mJ tr.mm I en 11.e ,It Butt.1l0 ( ,encr.1I Ho p1t,1I. l r. E:.hrlich will hc,1J ch,• hu pn.11' ne\\ Iv t.•rmc,I l 'p,irtmcnc t•I Em.:n.:cn ) . 1•Ji ·111 • anJ ch.: , le iK,11 huol\ J1\'i,1un h rhc ,amc nam,:, unJer rhe L Fl I 'P 1rcm.:nt ,, urgcry. lfr \\ ill Jin~d l'r• \ ICc ,11 the re cnrh LrC,HN Immel, 1ccTr.:,lt• mcnt cnrcr ,lt rhe Pcac,mc , 01\"i ion. A, Flutt.110(,cncr.1I, Ehrl1(h will c. p.mJ rhc rr.ium.1 en Ke ,mJ emcn:cnc\ Jcp,lrtment. "I ..:on,i.:lcr ch, quite ,m oppt1rtun1rv," he rd,1te . "I ,,I I l1)(1 t.,m,1rJ to wnrkmg \\ 1th Dr. Le\\ 1 Flmc wh,1 1 1m,· oi rh.: pr.:m1.:r ,tirg 'on 111 rhe counrn." Dr Flmc ,, 1.:h.11nn.1nol B' l"kp,irrmcnr ,,f un.:.:n, hc.1Jyu,mere,I ,ir Enc Counrv . 1cJ1L.1I Center. Dr. Ehrlich \\ti( do-cl\ ·1)(1rJ11i.1r.:h1 dfort w1rh ECM ', which I rhc pnm.u, center tor rr.mm.1 rn,gr.1m J,:vcl, 1rmcnt,. 1 0!\'CNt) Ehrlich' •,1 xt,lt •J r · pt>n• ,ihdme \\ ill h · to c uhh,h .1 rc,1dcnq rm• cram Ill emcrcen y ml.Ji me. He rcc,1!,!n1;· . howe\'er, char "1c\ , ch.illenge t,1 ,t,irr up .1 ne\, re 1Jcm. progr,im m th1 time ol he.11th hudget ·unm!,!," He, rrre wtc, the ,rwng up­ port ,11Dr. Flmr. For B', meJ1 ,1I ,tudcnt , he ,um, to pl.I\ BUFFAID • crF::Y:m~~ .m .1Jv1 my wlc for tho ·c c,m,,Jcrmg cmcn:cnq m,>J1cme a, .1 c,ireer. Th.It J, ·•r­ ime I nm, rhe mo,r ,oughr-.1frer progr,1m 111 the ',1t1on.1IM,uch. "~fan· 8 alumni I ccome mrcrc,ted in emergencr meJ1cme hut unforrun.1tclv h;n-c tll le,\\ c rhc ,1re.1co pur uc their hclJ. Bur w1rh ,1 rc,1Jency program, we won't l,1 e chem ,1, olccn ,mce m,m\ will t,I\ or return," Dr. Ehrl1Ch e pl.1111. In rhe ,1re.1of eJucat1lln, he'J like rnJl·,·dop ,111de,n,·e m eml·rccncv mcJu.:me rh.ir ,, nor rc,mcre I to urgen. Currenth, he ,1 , there 1 onh ,I lourrh \'Car l'lect1\'c m cmcrgenq ur!,!ery ,If 1:nc ·ount\ , fcJ, ·.ii Ccnrer. n,1m e ,!I Buttalo, Pr. Ehrlu:h came hcre lrom the Lonem.mgh V.11leyMemorial H,"r•· r.11 111 John trn, n, Penn,\ Iv.mu, where he cn·cJ ,t 1.:h.11m1.1nof rhe Dcr,irrmenr nt Emergenc1 \1eJ1unc. He graJu.1tcJ Imm the UFI~ 1ed1L1I , 1..hool 111 196 3 ,mJ t:r\'l·,l m th1..· , ,I\'\ tor 11 ye,1r . H1..• \\ 1, J1,char!!ed 111 1975 ,1 ,I comman ler Ill th' '1\ \ , 1cJ1c,1l _:_,rp,. Ehrlich' prcv1ou ho,p1c.1Iappomtml'nt Ill• dude ch.ur111.1n for rhc [ •p,1rrmenr l>I Emeri,:cnc1 , le l1cmc ,It hoth rhe Church} I.is, p1t.1I C,,rpor,Hlt>n ,mJ r Agne Ho,p11,1I m B.1lt1m,,re. He h.1 hcen on the mcJic,11 (,icul• tll""' horh Penn ...'t.He,mJ T,·mplc nl\·cNt\. A mcmhcr of rhe menc.in Collei:e ,,t E:.m.:rgenn Phv,1c 1ans,' menc m College ot ur1.?eon, ,In I the Amcnc m T r.1uma ' ic1et\', Ehrlu:h .,l,,1 ~n·e, on the 1 '1t1on,1l Amcric,1n Colle1.?e nt Emcrnenq Ph\' 1c1.1m Tr,1um.1 '1mmmcc ,mJ rhc &1,1rd 1,t D1rc·wrs ,,t rhc Emcrgcnc · ~1eJ1c1l ~crncc ln,mucc. Hc h.1 puhl1 hcJ exren,11·el1·. p.1mcul.1rlv 111rhc .irc.1 ,11rraum.1 ,mJ emergency m,•J1cme. f\c,1Je, rerum,ng to Buffolo he ·,Hise , ,f rht· pmf.: ,1unal ch.1llenge ,if de\ eloping ,1 re,1• Jen I program .md e.·p,mJmg rhc rrium.i center, Ehrlich h,1J l>thcr re.Nm,. "Retummg w,1 m,1Je e\'cn more ,Hrr.1cci,e hc1..m 1..· I coulJ he part ,11chc ,1caJcm1c nu lieu that l'\'e .ilway~ re,peLtl>J, le will he cxc1tml,! to he\\ 1th peer \\h,1 were ,It one umc m\ mentors." (&side ,1rrenJ111c B\ :--.1cd11...1f ~ chl>ol. he ,p.:nc the hr-r ,e,uof h1, re 1denq; ,H Buffalo liener.1I.) He notcJ ,,ne more mor1vantm: "I al I like the <'f'pt>rtunity to 'cive h.,ck' ,,,methmJ.: to the ~1eJ1cal ' hool." • �35 PEOPLE TRAVELINGFrom page Dr. M. te\'CO Piver rccein:d the 19 5 Our­ tanJmg Teacher of the Year A\\ arJ trnm the ch,d rc,,Jcnt o the B Dcp,mmcnr of Ob,tcmc,-Gynccolog . Dr. Pi,·cr, ch1t:1 of clinical in·ocn1log1c oncology ,H Rl, well Park Mcmonal In mute .md clinical profe,,or of gyn-ob at the un1vcr,1t), 1,a honored fnr 11urtanJmg contnl->utuin rn rc,1Jenr education. He 1,,b ,11,o recently dccccJ , 1n·-rre. 1lcnr/ pre. iJent-dccr of rhc Enc C11unr1 nar, Amcnc,m C,mccr , o ,cry. • Dr. Martin Mango h,1. 1->cenn:-decrcd prc,,­ denr of rhe Wc,rem 1 'e" York , iety of ln­ tcm,1I Med, me for I9 5- 6. Al,o rc-dccted ,1, officer, wen.' Ors. R bert cheig, vice prc,1denr, Rajinder . achar, ,ccrcrary, and Khalid J. Qazi, rrea,urcr They ,ire all f,1culty m the Medi , I ~chnol\ DcparrmenrofMcd,cme. • 8 tracting hactenal diarrh ·a and are more likcl) ro ha\'e ymproms of diarrhea longer than if the ahdomin,ll ruhing ha heen left alone. Mot1l1ty an l emptying are fun­ Jamcntal host Jefemes of hiologic tubing su h a. the ga,trointe,nnal tra r. A ngi i tube with poor peristalsis and slow transit of inrralummal content: allows for the prolifcra~10n of even a small inoculum of toxin-producing or in\, s1ve ba tena. Re­ duced ga trrnntesnnal motilit') may pro­ long the illne h') allowing 111\as1ve ha teria ro pmlifernte, attach, anJ imade the mu o. a nther than hurr) ,ilong and out. Diarrhea arrears to he a healtli) cleaming response. To mhihit with meJicanon the increa ed mord1t') rcsulnng from rhes' in­ fections Ola) wm en, nd prolong the prob­ lem. Furthermore, the cnterutoxin­ camed traveler's diarrhea i. a rc,ult more increa ed intestinal motility from mucosa! irritation h\ pathogenic organism,. It i. usual!) a hort-lived, not infrequenrh wcl omed, nui . ance tor those who are traveling nght. Bec;rnse o many dmrrh a-cau:1ng ha teria have hecome ant1hl(lt1cally sophisn­ c.ued, he ause Cehem1calcorks may ha\·e di. turhing ill effc ts, .1nd hccau e tr,ll'el­ ing tight can lie iusr plain un omtorcable, it would seem prudent for ph •:icians to re ogni:e rhe d -letenow, a,pects of Amer­ ican howel anxiety. Avoiding had water ,md 1mpmperi) prepare I food 1, goo I cnm ­ mon sense . Attempting to avoid rhe vast horde of nom1al gasm,incestinal bacteria i · not even quixotic, JU. t foolhardy. I think 1r 1s far l:-,etter to educate the 1111mune ,vst ' 111 of the gut mucosa and to maintain a health , nmm , I flora, than to utter the agonie of tr,n·eling tight. • Dr. John aughton,, KC pn:,1dcnt torclm,~ .tl ,1tt,11r,,md dc.m ot the B 1cd1 .11Schcd, ha 1->cen.1pp,11nrcdtll ,1 c.ir h committee ro ,elect ,1new d1recwr for Ro well P.1rk Mcm11r1.1lIn rmuc. Buffalo, b1 ,r.irc hc,1lrh cornm1,­ sioner D..w,dAxelrod, M. D. Dr. John Wnghr, di mnun .md professor of parh1,log\, currcnrh • ,ervc, ,1 ,l ring d1recr,1r ot rhc ln,rnure. Dr. Robert Gille . pie h,1 heen n.1med ,1 UB protc"or ot 11rrhop,1edic urger\ ,mJ al,,1 he,1J ot the Dep,mmenr of rth1,p,1ed1L ,H Chil­ dren\ Ho,p1r.1I, Buft,1l0. Dr. Gille pie come, to Butta lo from the H,1 p1tal for _ , k Children m Toront11. • . ffalo, n-cene C rl , \ I (,u l BUFFAID J PHvS 1 C1AN j a o f. L5 ( �36 Ron.Id . Young (M'65) • \\ii' ,1r1.imrcd 111 J,mu,ir\ \' Prnfc ,r mJ ·h 1el of dw [)11'11011 of eun,-urt:<'r\ (l cp.1rtml·nt ,,t urgcn) 11 rh<· Ill\ ·r,11\ ot ('.1l1t,,mi.1, lr\'111· ,m ldirntor11f ch..-r..-,1JenL\ tr.11111ni.: pmgr,1111,H the . . Irvine McJic,11 ,enter. 1-1..-\\ 1, f<1rmerh pnifc""r of neuro,un: 'f\ ,lt rhe UCL .'Lhnol uf M..-d,cme ,md ch,ct of nL·11r1"uri.:ery ,It H 1rl ,r 'LI( LA MeJ1cal 'enter m Torrance. Pmte,rnmally known for hi. work 111 the treatment of chron1 pam, neuro,urgeon he 1. one of the 111 rhc world en u,e elecmcal mmul.mon of the l-,r,1111 ior rreac­ mcnt of d1ff1Culr pam proble,m. In April I 9 5, he performed the worlJ\ fir r neuw urg1c.il l:,ram tumor oper.itmn ,,,ch rhe com• putemed rd><it. D avid L. Buchin (M'66) • m­ nounce, that he rci.:cmlv 11p·ncd m rgenl C ire l cnrcr (will-. Ill· :--tc !i1C,1l ('Im,·) m R.1lc1i.:h, '(. ALE tc,, D onald P. Pinkcl ( '51) • re­ n:nch I et.:1me K.m.1 Re • 1n:h ( h.urm,m ,m I rnif ·, ,r of pL·J1,11nt, ,lt rhe Llnl\L'r-11r of Tc ,,, y,rcm C mtcr Center .mJ 1\1.1). n ler on H,,-p11,1I .mJ Tumor In,ricurc m I lou,ton, T. Burton tulb ·rg (M'52) • of Butt,1l0 h.1, hccn de, ,Hl',I 1,,che ,r ttu, of l lfc Fcl low 1-,\the A mer• ll,111P,ydll,\Cru: "ociarum .1nJ \\·,1, h,more I ,H rhc 19 5 mnual nll'l'(ll1L!, hanci~ 8. Haber (M'56) • 1 pre,,Jcnt ,,t the mcJ1c1I ,c.1tf of Amor-OgJen Ho,p1L1I 111Elm1r,1, ' Y. Da id E. Pittman (M'64) • ,, 1 ,1 t.lnt d1111c11 prnfc ,r ot mcJu.:mc ,It chc L1rnwr 11y of Pm,huri.:h ~ cho,,I of le l1t.:me mJ ,1 ,11t11tc J,rc<.tor ot rhe \.,Ir• J1n,·.i cular l;1hor,11ory of 1lcgheny Gcneril Ho,p,c 1L In . ovcmher he prc,enccJ "Cl 111ic,1I Applteam,n of CarJ1.11: 'achc­ ren:amm ~ cuJie," ro rhc Fa ·crre ounty 1eJ1 al 'oc,ety ,mJ the Beaver eJi al enter, r:m J MeJ, al RounJ,. LSI 6 Richard . Wamo c k (M'72) • mform, u, ch,1r he ,, a medical tor thL FA 111,II ptl,11 c .. 1111111er w1rh commcrc1,1I ,md 111,trnment r.umg,. A ,rcuali,r m 11r­ th,1peJ1c 11rger1, Dr. W,irnock ,, d1rci:cor ,,t the ::,pllrt, :--1.-lidne L •r,1rtnwnt IC chc 'niwr it\ 11! Lowell. MA. Eri J. Ru ell ( '74) • h.i, hccn pn,motcd lo 1ssoc1,1tcpn•• le"or of r,1 linlngy ,ll Ru h Med­ IL11 C.\1llecc, 'h1L,1go, IL In m1'er, he ga,·e the Al [ 16rak I CLrurc .it 1hc Bu f,1ln R,1diolog1i: 1I \ic1et) meermg, "M,1gnetiL Rcsimance lmagmg." He I cur­ n.:nth· 11wc,nga1ing Ga iol1111um [ TP conrr.1,t mcJ,um tnr m.1gnc11 re on,mce 1m.1gmg. He ha, ,1daughter, ,ahr1cl lc Rohm, ai.:c rhre •. lbert chli,~erman (M'77) • 1111111unc ·, thl· rcl11 ,1C11lll ol h1, otfu:c t"r che pr.1u1 c 111"phrh,11m,,1,,i.:\ r,1 P,1rl-.l.mJ Protc"'"n.il P,1rk, °till<' #I 2, 3 75 .',,lllh­ wc,tl'fll PK111lc,,lrLI, re hard P.irl-., 'Y. l r. chl1"crm,111 ,, ., the Americ.m Ac,ldl'IH) fell,m of Ophthalnwlog\ Jeffre K. citclman (M'77) • 1--cL,lllll',1 l1plom,1rc 111 hilJ ps)• ch1,11r1111rhc Amenc,m R.,,1r I ,,f P,yLhi,ltf\ ,m,l I\Je11rnl11g1 in -;ep­ tcmhcr. " ow enJ<1\111gpn,·,1tL' pr,1ct1Le,111 I p,1rt•t1me 11..,1,lcmi<: 111L,,ng lk.1d1," Pr. -.,e,tclm,m ,, ch,urm.111 11f p,yd1i.1rry ,H 1 1m111q11e: :,..,1,he.ti Center. ,,r a pcre era i (M' ) • ha, 1mweJ ro Mechanic \'illc, PA. Dr. Ger,ic1 ,, a 11111al 111,tnKt,ir m the 1-1.irn,hurg F.1mtly Prac 1cc Pwgram. Jon M. Wardner (M' 5) • \Hite , '\t,Hting Juh I 9 6, I will l-,eg111 .1 P Y-11('<blt1on, Dep,irt• ment of Ph y,ical Med, me and Rchahtl1C,H11m, n1ver 1t) ot M1ch1g,m le 11 ,11Center, nn Arlx1r, l1ch1g,m." r. \; ardncr ,, ,1 n 1r111g 11111al f.•llow at rhe oluml-,i,1 111\'ersny College of Phy,1c1,m, and • urgcon,. BUFFAID 1-t'!.....1..Lt~ DAR ■ A. E::TH~'I )LOGY CA.'. AM MEETI . M,1y 2-3, 19'6. 1agarn-on-The-L.1k •, 0111.irio. pomnred l:,y Dcpr. of Ane,R ,mJ che,1olog\ ,ll horh , 1 , fa,ter l111,·crin, nt,1rio. 1c\\ Top,·, m lude /'..-hhclc Rcl,1xanr, and ,1rconc ; : rate of the Arr l\1n111toring; Inf.mt Re­ ,u cicanon, An •,the 1,1,md Im­ mune \,tem. Earl) rcg1,tr,mnn ,md re cptmn, 5:3 -7 p.m., Fri• J.1y; Program, :15 a.m.-3:30 p.m., at. Com.,c Dr. [.II. lomson, (416) 5!1-21 ■ l cPARTMI:: P Y HI TRY ' MEDICAL ED PR RAM ': 'T 1, 1G • May 23, 19 6 , 1(\30 ,1.111. l::nc ount\ Med1L 11 'enter. hJ floor Amph1thc,ltl'r. "L,l,nr uory T c,t of Dcrre, um: What ,, Their C.'l1111Cal Future!" John GreJcn, .1.D., ch.mm,m, De ­ p.1rrmcnr of P,ychi.irn, l '111\'er­ ,11\ of fo:h1g,m, lcJ1c.1I ( enter. • June 6, 19 6 , I l:30,1.111. enc ( .ounr) l\1eJ1cal .ente r, 3rd flnor ,1mphnhemer. "P,)choherary Re~ear h and Pr.icrice: An rt-to-Arr Talk." Mom, B. Parloff, Ph.D., clm1cal psy hnln­ gist, Department of P, chology, Amen an 111ver1ry, Wa,hmg ­ ton, D. '. • Jun 5, 19 6, I :3 -II :3L ,1.m. Veccr.m, Ho,p1tal , Rnom 11 3. "Recent Pn ,gre,, 111P, ·ch,­ from atry: 1e,\ De\'dopmenh rhc AP Annual Mccung." Panel D, u mn. • June 25, 19 6, 9-10:k ,1.m. ,ow anJ ,1 P ·ch,am · ,enter, Grnwne BIJg. "CJtlw,mda Grand RounJ, 111P, ·ch1atry." Marvin I. �CALE DAR Her.:, M. D., Professor anJ h,ur­ m,1n, Dept. of P ·ch1c1t1y, UB. J. • The Cape od onferen e n Pediatric. Aug1,-c 1-3, 19 6. Dunfc\ Hyanni, Hotel, H ·anni , Care Cod, MA. Credit Hour.: 15. Fee : * 3 Ph\ 1c1,m m Pr,ic­ ticc, 175 Alli d Health Profo ,1on.1L. Comact Dr. M. forph\ or Dr. erap1glia (716) 34-92 . ■ 10TH I TER ATIO, AL V ATIO 0 IMMU LOGY Vaccine cw oncept, and Development . Jul~ 14-1 7, 19 6. Keynme ,pc,1ker for W,rd, k\ Memon,11 Lecture: [ r J,m,1than Uhr, Dall.,,, Tcx,is. 'r<ms<>red hy UB Erne t W,reh y Center for lmmunolo1n- Cont1·t Dr. J,ime, 1ohn, Rm. 210 herman Hall, U YBuffalo, Tel: (716)- 31-2 4 . Yl4214. ■ UB PEDIATRIC UI 'G \.1EDICAL 10 PR RAM. • The 9th ational C nferenc c o n Pedia tric Adult Allergy and Clinical Immunology. July I I 2, 19 6. Four ca on, Hotel, Toront,l, Ontario. r Jic Hour.: 20. Fee,:* 32 5 Phy.ic,ans m Prac­ tice, !, 5 Allied He.11th Profe • . ional. • Advan e in Ga. troenterol­ ogy and utriti n, 19 6. Augu,c 15-17, 19 6. Dunle) H\,lnni Hmcl. Hyanni , ,1pc Cxl, MA. Credit H,iur.: 25. F e . ·275 Ph 1c1;m, m Pr,icucc, 175 Al­ lied He.11th Prolc ioml . Cont.i t: R, vn.1 ',wille, Pcd1.1tric, hildrcn ', H,, p1tal. 2 19 Br~anr :rrect, Ruttalo 14222. Tel. (wllect): 716- 7 • 7630. 'PRI G EMI. AR ESEARCH E.0 I'M • May 9, 19 6. 1:3 p.m. "Alohol U c and V1nlenr Bc­ h,wior," Jame Cnllm,, M.D., entor resc,irch ""'ologist, Re­ e,irch Triangle In nnm:, Re• , ar h Tri,mglc Pirk, C • Ma · 16, 19 6, I 3 p.m. "Drmkmg and Dnnkmg Pmh• h.mm lcms for Women," Wilma , Ph.D.. ,md RKh,uJ Wil nack, Ph.D., ~hl ll ot Medicine .md Department ,,t 'xiolot::\', Univ. of orth Dakota, Gr,md Fork , D. ,, charge f,ir ,emin,1r . -~----------------------------------------------------------------NO POSTAGE STAMP ECESSARV IF MAILED I THE U ITEDSTATES BUSINESS REPLYMAIL FIRSTCLASS PERMITNO 2210 BUFFALO, NY POSTAGEWILL BE PAID BY ADDRESSEE BUFFAID P H Y S C I A N 139 Cary Hall State University of New York at Buffalo Buffalo, New York 14214-9980 I,,,11, I,,I I,I,,,11, I,,II,I,,I,I,,I,,I,11, 1111I,II I I �-; 11'" BUFFAID I p H y s I I C A Non -Profit Org . . . Pos1age PAIO Buffalo . N. Y. Permi1 'o. 311 I N State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 ,,., ~ ~ AddressCorrection llequested i ~ . I l II II I ,,, J l 7--- LETusHEARFROM YOU-- ,--------------------- Fill out this card (Please print or type all entries) i, Year MD Received Name I 7--------------------- Office Address Home Address If not UB, MD received from In Private Practice: Yes D In Academic Medicine: No Q Yes □ Specialty No 0 Pert Time D Full Time c.., School I i' I Title J other: Medical Society Memberships News: Hove you changed positions. published. been involved in civic activities , had honors bestowed, etc? 1, ,t Please send copies of any publications. research or other original work. also include a photo of yourself. .I � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, May 1986 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1986-May Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1986-v20n01-May Table Of Contents A list of subunits of the resource. The Arsonist Anesthesiology Update Traveling Tight A New Chapter Medical School News Research Hospital News Students Alumni People Classnotes & Calendar Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-16 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v20n01 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1986 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/c2dcfd6c4bc2e05daae70702a506418c.pdf e08e7a07b7931f78bd2250a647f0bef2 PDF Text Text p H VOLUME 19, NUMBER 5 y s FEBRUARY 19 6 �BUFFAID PHYSICIAN Dean's Message STAFF EXECUTIVE EDI1DR, UNIVERSITY PUBLICATIONS Robert T. Marlett ASSOCIATE EDI1DR Bruce S. Kershner ARTDIREC1DR Alan J. Kegler PHOIDGRAPHY Phyllis Christopher Madonna Dunbar Ed Nowak Francis Specker ADVISORY BOARD Dr. John Naughton, Dean School of Medicme Ms. Nancy Glieco Mr. Kevin Cratg Ms. Marmie Houchens Dr. Charles Tanner Dr. John Fisher Ms. Karen Dryja Mr. John Pulli Dr. Charles Paganelh Dr. James Kanskt Dr Harold Brody Dr. John Wright Dr. Robert Scheig Dr. Maggie Wright Dr. Mary Voorhess Mr. Steve Shivinsky Ms. Marion Marionowski Mr. Novinder Bhalla Dr. James Wild TEACHING HOSPITALS The Buffalo General Children's Ene County Medical Center Mercy Millard Fillmore Roswell Park Memorial In ntute Sisters of Chanty Veterans Administration Medical Center Produced by rhe Drtision of Publrc Affam, Harry R. Jackson, director, in a.<· socrarion turh rhe School of Medrcme, Scare Unin~rsiry of Nev.- York ar Buffalo. THE BlJFFAl.D PHYSICIAJ\: tlJ PS 551-860) February, I986 - Volume 19, :\'umber 5. Published five times annually February, May, julv, September, December bv the &hool of Medicme, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 142I4. Second cia s postage pa•d at Buffalo, New York. POSTMASTER: Send address changes to THE BUFFA!.D PHYSICIAN, 139 Cary Hall, 34 35 Mam Street, Buffalo, , ew York 14214. Dear Friends: Two very significant events occurred during the fall in which faculty members who emulate the highest values of academic performance were honored for contributions to the advancement of medicine and science. The Buffalo Medical Foundation, the community, the School of Medicine and the University were honored when Dr. Herbert Hauptman was awarded a Nobel Prize in Chemistry. The faculty member in the Department of Biophysical Sciences since 1970 is an active contributor to graduate student education and departmental functions. We congratulate him for this exceptional accomplishment and thank him for his many contributions to the school and the scientific community. The Physiology Department hosted the Fall meeting of the Ameri· can Physiological Society, in iagara Falls in October, 1985. A number of satellite symposia in which Buffalo faculty played a key role were held. As part of these activities, a special symposium was conducted to honor a Distinguished Professor, Dr. Hermann Rahn, who received an additional accolade by the dedication of the new environmental laboratory in his honor. Dr. Rahn came to Buffalo as the Lawrence Bell Professor of Physiology, a professorship funded in part by the local chapter of the American Heart Association. During his long and distinguished tenure, he fashioned a strong, productive department which has ex· celled in teaching and research. He is one of three Distinguished Professors in the school's faculty, and shares a great deal of the credit for fostering its commitment to scientific investigation in Buffalo. John Naughton, M.D. A Message from the Medical Alumni Association The literature abounds with articles about physicians under stress. We are more and more seeking to reduce some stressful situations with younger physicians joining a group practice or HMO instead of private practice and some older physicians retiring or moving out of state. Stress always has a positive and negative side. Some stress causes high motivation, but too much stress takes a high toll. Doctors are humans too. Taught to think of others first, a doctor's stress-related problems ultimately affect the welfare of the patient. Impairment of the physician can lead to drug abuse, alcoholism and even suicide. The stress of constantly giving and not receiving can unduly strain a doctor's family relationships. Having stress in the market place as well as at home leads eventually to profound problems. The physician's colleagues may begin to notice that the doctor shows up late, gives wrong orders, seems to have more accidents, or is involved in a separation or divorce. Because the safety of the patient is so important, colleagues and families should not ignore signs of impairment. Support systems are available for coping mechanisms and should be set in motion promptly. Programs for stress management are available in all 50 states. Many medical societies have a hot-line for such services. Although only 10% of physi· cians find themselves in trouble, a figure similar to that of other professions, the publicity that could result is damaging to all physicians. In another vein, I am happy to tell you that Dr. George Hatem of the People's Republic of China has accepted our invitation to give the Stockton Kimball Lecture at Spring Clinical Day on May 10, 1986. In a unique way Dr. Hatem was responsible for the elimination of drug abuse, prostitution, and venereal disease in the People's Republic of China. Affectionately known as "Dr. Horse," this American, who has lived and worked in China since the 1930s, was able to be very close to those who engaged in the absolute struggle for power. -Charles 1. Tanner, M.D. President, M'43 �A N Dr. Herbert Hauptman, winner of 1985 Nobel Prize in Chemistry, with model of molecular struc· ture. Cover Photo: Fran· cis Specker. CONTENTS 2 NOBEL LAUREATE • "There's nothing like a Nobel 8 HERMANN RAHN • Last October was a memorable month for Hermann Rahn, Ph.D The distinguished professor of physiology, known as "one of the fathers of aerospace medicine" among his fellow scientists, received two major honors at a physiology conference. Or. Rahn also contributed to this issue ''A Brief History of Physiology at UB:' 16 Prize," everyone agrees on learning that Herbert Hauptman, Ph.D, a Medical School research professor and executive director of the Medical Foundation of Buffalo, is the 1985 Nobel Laureate in Chemistry. The first mathematician ever to win the Nobel, Or. Hauptman acknowledges in an interview that "it's great." FORUM • Clinical Ecologist Doris Rapp, M.D., and Allergist Elliot E Ellis, M.D., provide contrasting viewpoints on the field of clinical ecology or environmental medicine. The approaches and concepts associated with this new approach to treatment of allergies have stimulated considerable discussion and a wide range of opinion as their two pieces suggest. MEDICAL SCHOOL NEWS • 29 Dean visits Beijing and Kunming to expand UB's cooperative relationships. Regular physical activity benefits cardiac patients, Dr. Hennann Rahn: honored at Physiology conference. national study finds. Inter· national flavonoid confer· ence is first of its kind in the U.S. Med students demonstrate you don't get AIDS from giving blood. PEOPLE • 32 Dr. Richard Judelsohn doubles as a disc jockey on WBFO-FM. Other news of people you know. CLASSNOTES • 35 CALENDAR • Inside back cover. ��3 -------ERT He and ] erome Karle share a · N abel Prize for developing a method to determine crystal structures of molecules BY BRUCE S. KERSHNER ' 'T here's nothing like a Nobel Prize!" exclaimed a broadly smiling UB President Sample before the University Council, following the news that UB research professor Herbert Hauptman, Ph.D., had won the 1985 obel Prize in Chemistry. "This is GREAT!," bubbled Dr. Hauptman, the first mathematician ever to win the Nobel, summing up in a similar brief phrase the jubliance one feels upon receiving the highest award of a lifetime. The excitement still hasn't subsided for Herb Hauptman and the Medical Foundation of Buffalo, Inc., where he serves as executive and research director. Hauptman is now in demand everywhere for recognitions, keynote addresses, and appearances. The most important of those appearances was his acceptance of the prize in Stockholm, Sweden, on December 10. He also spoke on "Direct Methods and Anomalous Dispersion; the subject of his research. The research professor of biophysical sciences learned of his award October 16, 1985. He shares it with college classmate and former co-researcher Jerome Karle of the Naval Research Laboratory in Maryland. They received the recognition for the mathematical method, called the Direct Methods, they devised in the 1950s that determines the three-dimensional crystal structures of complex molecules. Such a technique sounds like it should be of interest only to mathematicians and chemists. But the significance of Haupt- BUFFAID I p H v s I c •t A N I man's technique, and the reason for its recognition, is that it is now the standard-and virtually the onlytechnique to identify, synthesize, and manipulate new biologically important molecules such as hormones, vitamins, antibiotics, and other drugs. Nearly every new "revolutionary" drug yet devised to treat disease depended upon Hauptman's method to be developed. Most of the new industrial chemicals being created rely upon the formula. It can safely be claimed that thousands, if not millions, of lives have been saved or have had. suffering reduced because of Hauptman and Karle's technique. "I guess that 40,000-50,000 structures have been found using the techniques-90 per cent of all new structures, 5,000 each 02/ 86 �4 year; the 68-year-old Nobel Laureate comments. "Every pharmaceutical and chemical company must apply the Direct Methods to solve the structures they later develop~ Because medical researchers must use the technique to identify chemicals in biological processes, Hauptman has indirectly contributed to fundamental knowledge about how the body works. A few of the drugs developed out of the technique are artificial steroids useful in treating breast cancer, and enkephalin, a chemical thought to be a natural paincontrol substance produced by the human brain that may lead to new pain-killing drugs. The heart disease drug, digoxin, a much safer variant of digitalis, was derived using the technique, as were a number of vitamins, antibiotics, hypertension drugs, hormones, and uncounted others. The other aspect of the revolutionary contribution of the Direct Methods is the speed with which structures can be determined. Twenty years ago, it took two years to calculate the structure of a simple antibiotic molecule that had only 15 atoms. Today, it takes only two days to determine structures of 50-atom molecules. With computers, it may soon become possible to do it in minutes. "The delay, however, now remains with the process of making the crystal (a prerequisite to identifying its structure). That can take a week or a month," Hauptman remarks. I ronically, Hauptman and Karle's breakthrough remained unaccepted and controversial for 15 years. "The reaction from the scientific establishment was disbelief. Papers were published showing the solution was no more than a minor improvement over current methods. Harsh criticism and even open hostility greeted Herb's presentations at scientific meetings; according to the quarterly publication of the Medical Foundation of Buffalo. Dr. Hauptman added, "Part of the reason for the resistance from the crystallography establishment was that the earlier crystallographers did not have a mathematical background." And while he claimed that he had solved a major problem in the discipline, Hauptman actually had no academic training in crystallography. What Dr. Hauptman had solved in 1958 was the "unsolvable" struc- 02186 Drs. Hauptman and Karle on the evening news with CBS' Dan Rather. ture of colemanite, a natural 12-atom hydrous calcium borate-something never done before. It wasn't until others had repeatedly solved complex structures that this breakthrough finally was accepted by the scientific community. It then literally became one of the fundamental methods underlying crystallography, pharmaceutics, applied chemistry, and medicine. Because of this, the American Crystallographic Association in 1984 recognized Hauptman and Karle's accomplishment with their highest award, the A.L. Patterson Award. That same year, the American Institute of Physics pronounced it one of four major advances in the field of crystallography. X-ray diffraction provides the data required for analysis by Hauptman's methods. "When a single wave-length Xray beam is projected on a crystal, it is scattered (diffracted) in thousands of directions. This X-ray diffraction pattern is automatically recorded on photographic film," Hauptman explains. The X-rays reflected from these crystals form pictures appearing as arrays of thousands of spots of differing brightness. By analyzing the intensity of the dots, the phase, or angular measurement that varies from zero to 360 degrees, is calculated. The Direct Methods allow this data to be used directly to derive the molecule's structure. Before the formula, the pattern could be used only to guess at possible structures (the indirect method). Hauptman, first as a graduate student at the University of Maryland, then as a scientist with the aval Research Lab in the early to mid-1950s, believed he could solve the "phase problem" as it was called. With his strong grounding in higher mathematics, he and Drs. Jerome and Isabella Karle not only formulated the phase problem into mathematical terms within five years, but also solved it. The native of Bronx, N.Y., earned his BUFFAID I PHYSICI A N I bachelor's and master's degrees in mathematics in the late 1930s from City College and Columbia University, respectively. After various technical positions in the military during and shortly after World War II, he joined the Naval Research Laboratory as a physicistmathematician in 1947. After he received his Ph.D. m mathematics from the University of Maryland in 1955, he joined its faculty on a part-time basis. His primary research continued at the Naval Research Lab where, beginning in 1965, he directed various divisions and branches. In 1970, he joined the Medical Foundation of Buffalo, Inc., the same year he joined UB's faculty. Two years later, he became the Foundation's executive and research director. The Medical Foundation's primary work is basic biomedical research. With a staff of 25 Ph.D. scientists, its IS-member molecular biophysics group is possibly the largest in the country. The independent, non-profit institute conducts research on hormone-related disorders, including cancer, heart disease, diabetes, arthritis, birth defects, and related problems. As a UB Biophysics Department faculty member, Hauptman's University involvement includes research and teaching as well as active membership on various committees. Author of two books and almost 150 scientific articles and chapters, Hauptman had been honored with many other awards and distinctions before the Nobel was awarded. Since receiving the Nobel Prize, the recognitions and honors have increased further. At a press conference held before a crush of cameras and reporters, President Sample, publicly congratulated him and thanked him for bringing great honor and credit to the University, as well as to the entire research community of Western ew York. The University research community then had its opportunity to express its gratitude, at Dr. Sample's State of the University Address two weeks later. As Or. Hauptman watched, the audience, most of them fellow researchers, expressed itself in the simplest way for a large group-a rousing standing ovation. • �NOBEL LAUREATE: An Interview With Buffalo's Newest VJ.P. BY BRUCE S. KERSHNER L ast month, UB professor Herbert Hauptman, Ph.D., received the greatest professional honor when he was awarded the Nobel Prize in Chemistry. The following is an interview with Dr. Hauptman following the news on October 16, 1985, of his prize, shared with his former coresearcher Jerome Karle of the Naval Research Lab in Washington, D.C. Q It was a thrill to hear that you had been selected for an honor as important as the Nobel Prize. How have things changed for you since then? BUFFAID I PHYSIC I AN I A. As for changing my career or my job, it's hard to imagine picking up and moving on at my age (of 68). The prize has certainly changed things, though I hope only temporarily. I'm much busier now and it's hard to get any work done. I have so many invitations to speak, I am nearly booked all the way through June 1986. I was warned this would happen. This 02/ 86 �6 is the common complaint of all Nobel Laureates-that it takes a year out of your life, in a good way. One change that I hope it will produce is to promote the importance of pure scientific research, which is not sufficiently appreciated by the general public or by community leaders. Basic research is so important because of the valuable-and often unpredictable-benefits to mankind. We need the support of the enlightened public if we are to be allowed to continue such important work using public and private funding. If my research had not been publicly funded, it may never have been completed and the revolutionary advance to all humans may not have been realized. ing how proud they were. One niece sent me a 15-foot-long computer printout "card" that said "CONGRATULATIONS UNCLE HERB." Another woPlderful letter came from a relative I've never seen who told me the deep effect it had on her twin 11-year-old daughters. Q Your fellow scientists weren't so quick to recognize the contribution? A. Yes, I and Jerome got quite a hostile reaction in the 1950s when we tried to show we had solved the "phase problem" [which had been the barrier to directly solving chemical structures]. Many didn't believe it could be done or thought it was only a minor improvement. One well known crystallographer told me that if he could solve a certain complex structure with our formulas, then he would be convinced. And it did happen. But it took 15 years after repeated solving of structures before the final skepticism about the method was removed. Q Q. Did you get any unexpected calls from people out of your past? A. Yes, I heard from relatives, classmates, and colleagues I haven't heard from in years or even decades. One of the most touching was a phone call from my old high school math teacher, now retired in Florida. He waited weeks to call me until he was sure I was the same Herb Hauptman he had taught at Townsend Harris High School in Manhattan. He told how proud he was that now he has "a third notable person among his former students." He told me that he had taught Jonas Salk (discoverer of the polio vaccine) and also a Nobel winner in economics. I know one invitation you didn't tum down was the one in Stockholm December 10. A. Yes, that's when I accepted the Nobel Prize in Chemistry. Q I understand you first heard the news about your prize under unusual circumstances. A. Yes, underwater-that is, I was swimming in the YMCA pool when I was called out to answer an important phone call. Dripping wet, I picked up the phone. My initial reaction was numbness, shock, disbelief. Then I got dressed and rushed down to the press conference. Q And what was your wife's reaction? A. She heard it when I called her during classes at the elementary school where she teaches. I said "Honey, I won the obel Prize." She responded "I can't believe it!" and then accidentally hung up. Then she dashed into the hall and shouted the news to anyone who would listen. When I called her back again, she realized she had hung up by accident. Q What about your family's reaction? A. My daughter, a research psychologist in Washington, D.C., was very happy. The family never expected it. Some of my relatives sent me beautiful letters describ- 02/86 Dr. Hauptman : his fe llow crystallographers were especially proud. Q Any interesting reactions from your colleagues outside of Buffalo? A. An absolutely terrific response-400plus ecstatic letters and phone calls. My fellow crystallographers were especially proud because this was the first time in six decades that a Nobel Prize had directly recognized the field of crystallography. Interestingly, several others previously got obels for their research which utilized my technique. My fellow Nobel Laureate, Jerome Karle, heard the news over the intercom while in a jet 30,000 feet up. The entire plane of passengers and crew broke open champagne and toasted him. He told me later, "It took a long time for this to be recognized." BUFFAID I PHYSICIA N I Q How do you feel about getting all these calls and suddenly being in demand now for all kinds of appearances? A. I accept it as part of what just happens. I would be more selective, though, if it were to become a permanent thing. I do really enjoy the nice things that happen, such as the Oliver Wendell Holmes Elementary School student who told me how he loves crystals, sent me a picture of a crystal that he drew, and asked me for my photo in return. I sent a photo to him and then I learned of the great morale boost I had given the boy, who had serious problems at home. Q When did you get interested in math? �7 A. I remember I was about five or six while living in the Bronx. I became interested in numbers at the same time I was learning to read. Q What kind of effect do you think this will have on the Medical Foundation of Buffalo? A. ~ I think it will certainly help us in our research funding and our prestige and visibility, both locally and nationally. Q Do you have anything else you'd like to add? A. Yes. All this that has been happening can be summed up simply by saying, "This is just GREAT!" • Other UB Nobel Laureates H erbert Hauptman is not the first UB faculty member to be associated with a Nobel Prize. He is, however, the first to have been awarded a Nobel while actively affiliated with the University. Dr. Carl Cori won the Nobel in Medicine in 1947 for research at George Washington University on the isolation and synthesis of phosphorylase. The work was started at UB and Roswell Park when he was a young assistant professor of physiology from 1927 to 1931. He died at 87 in 1984. Sir John Eccles, 82, received the Nobel in Medicine in 1963 for his work on the brain, before joining the UB Medical School in 1968 as a distinguished professor of physiology and biophysics. He headed a laboratory here until 1975. Interestingly, all three UB Nobel Laureates have been Medical School faculty. Because of the joint appointment of Sir John Eccles, the Department of Physiology (the School's oldest department) and the Department of Biophysical Sciences (the School's youngest basic science department) each can claim two Nobel Laureates. • Dr. Tim Byers A SECOND 1985 NOBEL WINNER T he UB Medical School has a second 1985 Nobel Prize winner. This year's coveted Nobel Peace Prize went to the International Physicians For the Prevention of uclear War, cofounded by American physician Bernard Lown, M.D., and Russian physician Evgueni Chazov. In a very real sense, the prize, rarely given to an organization, is shared with its 135,000 members. This includes 120 area physicians, dentists and medical scientists who comprise the local chapter, roughly half of whom are associated with UB and the Medical School. Formed in 1981, the Western ew York Chapter of Physicians for Social Responsibility is part of the American group, one of the affiliates representing 41 countries. The American group has over 25,000 members and 110 chapters. An excited Dr. Tim Byers, president of the UB chapter and assistant professor of BUFFAID I P HYSI CI AN I social and preventive medicine, commented, "The award will strengthen our organization's prestige and financial support, as well as our credibility with the public and media." Six of the eight members of the local chapter board of advisors are with the Medical School: Drs. James olan, Carter Pannill, Leonard Katz, Thomas Bumhalo, Ivan Bunnell, and David Greene. The obel Committee selected the group because it had "performed a considerable service to mankind by spreading authoritative information and by creating an awareness of the catastrophic consequences of atomic warfare." The organization, which is not associated with any other nuclear issue group, engages primarily in education, through a speaker's bureau, horline and media presentations. • 02/ 6 �8 HE NRAHN 'Father of Aerospace Medicine' receives major honors BY BRUCE S. KERSH ER L ast October was a memorable month for Hermann Rahn, Ph.D. The distinguished professor of physiology, known as "one of the fathers of aerospace medicine" among his fellow scientists, received two major honors at a physiology conference. The U.S. Air Force bestowed the Meritorious Civilian Service Award on Dr. Rahn during the University's Satellite Symposium on Environmental Physiology held in mid-October. The University, in turn, honored him by dedicating one of its largest laboratories to him. The former Environmental Physiology Laboratory was renamed the Hermann Rahn Laboratory for Environmental Physiology. The laboratory, part of Sherman Hall and Sherman Annex, houses the human centrifuge, the doughnut-shaped Immersion Basin, and the Hyperbaric Chamber. Dr. Rahn received the honors for his research and vision which helped lay the foundation for the new field of aerospace medicine and which established UB's Department of Physiology as one of the international centers for this area of research. His pioneering work on the interaction of man and his environment includes fundamental studies of life at high altitude, underwater, and in space. Asked for his reaction to receiving two major honors in two days, Rahn quietly responded, "One cannot express such feelings-they go so deep." Vice President John Naughton, dean of 02/ 86 the Medical School, stated, "He has exemplified only the highest qualities of academic science and of humanitarian behavior. His unselfish devotion to the University and the scientific community have not only reflected on him, but on all who have been privileged to know or work with him." Dr. Leon Farhi, professor and chairman of the Department of Physiology, said of Rahn's essential role, '~!though environmental physiology has been on the books for a long time, it really blossomed only in the early 1940s when Dr. Rahn made his contributions. "Over the last 40 years, Dr. Rahn has cast the foundation of our understanding in many areas of respiratory disease: What kind of medicine would we be practicing today, if we did not understand lung mechanics, alveolar gas exchange, or ventilation-perfusion relationships?" (pioneering studies by Dr. Rahn). Also considered one of the fathers of modern respiratory physiology, Dr. Rahn through his research has provided the basis for many of the principles underlying diagnosis and treatment of pulmonary disease, especially in intensive care. Dr. Rahn first encountered respiratory physiology during World War II. The country was then engaged in a major effort to give its pilots air superiority over the enemy by achieving higher altitude, while protecting them from hypoxia (lack of oxygen). One of the proposed solutions lay in in- BUFFAID I PHYSIC I AN I creasing alveolar oxygen tension by raising the total gas pressure within the lungs. In the open cockpits that were then in use, this meant pressure breathing. And so Dr. Rahn went to work, establishing the physiological effects of positive pressure breathing. A pioneer in gas analysis, he has taught such concepts as the distribution of alveolar ventilation perfusion ratio and the alveolar-arterial oxygen difference. Dr. Rahn also clarified some of the laws pertaining to gas diffusion when several gases are present in a mixture. He was one of the first to apply the Clark Oxygen Electrode to his research work and to show clinicians the value of this tool. Relying on principles of physical chemistry, he also dissected the mechanisms by which protein binds hydrogen ion, and described how this combination is affected by temperature. He also devised the first selfguiding catheter, a balloon-tipped device that was to re-emerge as the Swan-Ganz Catheter, a now essential tool in diagnosing cardiovascular disease. Although Dr. Rahn has enriched several areas of knowledge, his main contribution, in the eyes of many of his fellow scientists, may well be his emphasis on the unity of science, demonstrated by his unique ability to recognize parallels and adapt to one problem-or one whole field of studyideas and techniques developed in other disciplines. �9 Dr. Hermann Rahn (center) at Physiology conference with Mrs. Rahn, and French ph ysiologist Dr. Pierre Dejours. D . r. Rahn's legacy, Dr. Farhi emphasized, goes beyond his research~Her­ mann Rahn has imparted his wisdom and enthusiasm to a whole generation of younger people." He has trained and left an imprint on numerous graduate and medical students as well as post-doctoral trainees, many of whom occupy leadership positions in this country and abroad. One of those, Dr. Frank Knox, is dean of the Mayo Medical School and was just elected president of the American Physiological Society. He also attracted to Buffalo some important UB scientists. Two examples are Dr. Donald Rennie, UB vice provost for research and graduate education, and Dr. Farhi, whose physiology experiment will orbit the earth in a 1987 space shuttle. The two honors are just the most recent Dr. Rahn has received. Last May, he was selected for the American Lung Association's most prestigious award, the 1985 Edward Livingston Trudeau Medal, for his research in respiratory physiology. He has also received honorary degrees from the Universities of Paris, Seoul (Yonsei), Rochester, Peru, and Bern, Switzerland, and was elected to the National Academy of Sciences and to the Harvey Society, in addition to 16 other honors. He is a past president of the American Physiological Society and past vice president of the International Union of Physiological Sciences. The naming of UB's modern lab after him is fitting since he played an essential role in establishing it in 1968. The laboratory, including the three-story high, 6400-square-foot room that houses the Immersion Basin, is unique in several ways. It is the most comprehensive such lab in the world. It is also the only centrifuge in the world where one can go into its chamber and watch it. All other centrifuges are housed in confined rooms with observation windows in the surrounding walls. The reason UB's lab allows this is because of its equally unusual architecture. During planning of the facility in 1968, architects insisted the centrifuge must be surrounded by a wall for safety purposes. BUFFAID I PHYSICIAN I Dr. Rahn and others also wanted the room to house the Immersion Basin, a doughnut-shaped pool for studying underwater physiology of divers. So the late Dr. Edward Lanphier designed the centrifuge to be surrounded by a wall, as required, but in this case it was a wall of water, the Immersion Basin. An author of over 210 scientific articles and four major books, Dr. Rahn has had several books and' a special issue of Respiration Physiology dedicated to him. After graduating from Cornell University, he went on to receive his Ph.D. from the University of Rochester in 1938. He served as chairman of UB's 140-year-old Department of Physiology from 1956 to 1972, and was appointed a Distinguished Professor in 1973. In referring to the ways that Dr. Rahn has contributed to respiratory medicine, in both basic and applied knowledge, Dr. Farhi concluded, "If one needed a living example of the dictum that 'the physiology of today is the therapeutics of tomorrow', we have it in our midst." • 02 86 �Dr. Charles Coventry: first professor of physiology. �11 A BRIEF HISIDRY OF PHYSIOIDGY AT IHE UNNERSITY OF BUFFAID BY HERMANN RAHN Distinguished Professor of Physiology W hen the Medical School opened in the winter of 1846, exactly 140 years ago, there were seven professors. One of them was Charles Brodhead Coventry, the first "professor of physiology and jurispn.idence." (Today the University's Coventry Entrance on the North Campus is named in his honor.) As in other medical schools in our country at that time, physiology was taught from English textbooks, relying heavily on vitalism and empiricism. Coventry followed along these lines, as a well established practitioner known for his studies and reports on the epidemic of Asian Cholera that existed in Albany and ew York City. He also taught obstetrics and shared his teaching in physiology with Austin Flint, Sr., our first professor of medicine and known today for the "Flint arterial murmur." In 1851 the physiology scene at Buffalo changed dramatically with the appointment of John Call Dalton who at the age of 26 was appointed professor of physiology and morbid anatomy. He had received his medical degree in Harvard four years previously and had gone abroad to study with Claude Bernard in Paris, at that time considered the greatest physiologist in the world. From his time on, physiology was no longer dominated by vitalism and empiricism because Dalton introduced for the first time in America live and anesthetized animals for demonstration of various physiological principles. Dalton was also one of the first profes- sors in America to devote his whole time to the study of physiology and did not depend upon a medical practice for his income. Dalton left Buffalo in 1855 to later become president of the College of Physicians and Surgeons in New York City, a founding member of The American Physiological Society, and was elected to the ational Academy of Sciences in 1864. His published "Human Physiology" went through seven editions. In 1859 Austin Flint, Jr., the son of the former professor of medicine, was appointed professor of physiology at the age of 24. He also had studied with Claude Bernard and Charles Robin in Paris. Unfortunately, he left for Bellevue Hospital Medical College a year later. He published many basic physiological papers as well as a fivevolume text, "Physiology of Man." Between 1861 and 1912 the Chair was occupied by William H. Mason, Julius Pohlman, and Frederick C. Busch. In 1912 Frederick Pratt arrived from Harvard, having studied with Walter B. Cannon, one of America's greatest physiologists. He commissioned Frank Lloyd Wright to build a home for him, which still stands on Tillinghast. During his tenure at Buffalo he accomplished one of the epochmaking demonstrations of the ali-or-none principle of skeletal muscle, settling a problem that had perplexed physiologists for about half a century. Pratt was succeeded in 1918 by Frank A. Hartman, who was the first professor of physiology in our school with a Ph.D. BUFFAID I P H Y S I C I AN I degree. His annual salary was $3,500. He soon became preoccupied to the exclusion of all else with isolating the vital hormone from the adrenal cortex. He eventually purfied cortin, received the Chancellor Norton Medal from our University (the highest award bestowed by the University of Buffalo for service to the University and the community), the Gold Medal of the AMA, and universal applause. In 1934 Hartman accepted a call to Ohio State University and was followed in the chairmanship of the department by Dr. Fred Griffith, Jr., who had joined Hartman earlier as an assistant professor. Dr. Griffith's great impact was as a teacher, and during his long reign many medical students and graduates spent a year or two with him, later to become professors in various medical schools including our own. I n 1956 Hermann Rahn took the chair in physiology as Lawrence D. Bell Professor in cardiovascular physiology. He was given the unusual opportunity of building a completely new staff as well as designing Sherman Hall. This coincided with the new era of public fun.ding of equipment and research support. He decided to set aside one part of Sherman Hall for the possible creation of a new Department of Biophysics and was in part responsible for persuading the dean and the president to create this department, which was initially financed through the Annual Medical Participating Fund under 02/86 �12 the leadership of Dr. Edgar Beck. Soon a young staff for Physiology was assembled, and by 1961 there were Drs. John Boylan, Beverly Bishop, Suk Ki Hong, Donald Rennie, Charles Paganelli, Barbara Howell, Leon Farhi, Edward Lanphier, and Werner oell. Of this original group all but three are still with us today. In spite of the youth of the staff the department began to attract postdoctoral fellows and visiting professors in the areas of pulmonary, renal, and neurophysiology as well as the area of heat exchange and high pressure physiology. By 1968 we had attracted 60 visiting scholars, many of whom today occupy leading positions in various parts of the world. (For a sampling of some of the more prominent ones, see the accompanying article on the Physiologists Gallery, which pictures all of the department's former visiting professors and postdoctoral fellows.) In 1968 the Laboratory for Environmental Physiology was built, under the direction of Dr. Leon Farhi. This includes a human centrifuge, a submergence basin, and high pressure facilities, and is one of the unique laboratories in a university setting. A current ASA program under Or. Farhi's direction, using these facilities, is ~ 0 z @ Q 0 i!' Navy frogmen utilizing Physiology's immersion pool for breathing study. 02/86 BUFFAID I PHYSICIAN I training scientist-astronauts for investigation of cardiovascular responses during zero G exposure for a 1987 shuttle flight. A separate section of neurophysiology was established with Werner oell as director. In 1968 John C. Eccles, obel Laureate, joined this group for seven years; it became the Section of Neurobiology, presently headed by Donald Faber. In 1972 Donald W. Rennie became chairman of the department, followed in 1980 by Charles Paganelli as acting chairman, and in 1982 by Leon Farhi, the present chairman. Since 1956 the full-time faculty has grown from seven to 28, and we have had approximately 170 visiting professors and postdoctoral fellows, 60 per cent from abroad. The research activities over these years are revealed in some 900 publications. It is interesting to note that 21 of these were with other departments of our University and some 50 with other American and foreign institutions. Fifteen books were edited or authored. One of the more unusual activities has been field expeditions. Since 1959 some 35 of these have been launched to various parts of the world, working on problems not easily studied in the laboratory at home. These quests range from studies of the metabolism and work performance of the Eskimo and seal kidneys in Alaska to lung physiology and thermoregulation of the diving women in Korea and Japan and the sponge divers in the Mediterranean; from studies on the acid-base balance of animals in the Amazon to the physiology of the migrating salmon in British Columbia; from development of chick embryos at high altitude in the Rocky Mountains to providing medical support for underwater archeology in Turkey. The program for graduate study leading to the M.A. and Ph.D. degrees was initiated 60 years ago by Professor Hartman and is probably the earliest graduate program in our medical school. During the Hartman-Griffith regimes from 1921 to 1956 there were 10 Ph.D. and 15 M.A. students. In the subsequent years, 43 Ph.D. and 25 master's degrees have been granted. Since 1966 our graduate program has been rated by the American Council on Education between No. 7 and 20 of the top 100 schools in this country. • �13 1000 PHYSIOIDGISTS MEET IN BUFFAID AREA A full-size, walk-through mock-up of Phillips continues to work on an artificial walking system that combines braces, NASA's Space Lab 4 and research findings from more than 800 Functional Electrical Stimulation (FES) to muscles, and a computer that enables FES scientists highlighted the 36th Annual Fall to propel the patient. He predicts that the Meeting of the American Physiological Society Oct. 13-18 at the Niagara Falls Contime will come when many riow crippled by spinal cord injury will benefit from the vention Center. More than 1,000 scientists, including work being done at Wright State and space researchers from the U.S., the Soviet Union, and China attended the meeting which covered topics ranging from exercise physiology to virology. UB physiologists were in charge of local arrangements. Attendees had considerable interest in the mock-up of the NASA Spacelab which in 1987 will carry an experiment designed by Leon Farhi, M.D., chairman of UB's Department of Physiology. Drs. Millie Fulford and Robert Phillips, two of the astronauts who will assist in conducting Farhi's experiment in space, also attended the (LR) Dr. Leon Farhi, Dr. Walter Gary, and Dr. Roger meeting. The two astronauts have received training at UB in order to elsewhere. conduct Farhi's research aboard the LifeAlso speaking was neurocardiovascular nurse specialist Kathy Kater of St. Louis' sciences shuttle. Barnes Hospital who reported on her work Two scientists presenting material at the event also spoke to UB's Spinal Cord Ininvolving the provision of structured senjury Research Group at a special meeting sory stimulation to head-injured patients on-campus. during and after coma. This treatment can Chandler Phillips, M.D., a key scientist improve the functional levels of these paat Wright State University involved in intients later on, Kater reported. novative research which enables paraplegThe study which she conducted suggests ics to walk aided by computers and it is important that such stimulation be electrical stimulation of muscle, told a incorporated into therapy as soon after ingroup of 25 attending that "the research jury as possible. has progressed considerably" since he last Sensory stimulation therapy was convisited Buffalo two years ago. tinued three months following coma. FaBut he cautioned that much work has mily members learned the techniques, too. yet to be done to develop a commercially When patients achieved cognitive Level 7, viable electronic walking system that will indicating independent mental function, functionally restore self-mobility to patherapy was concluded. tients paralyzed by spinal cord injuries. After three months of the study, the BUFFAID I PHYSICIAN I most dramatic response appeared in patients in a moderate coma group who received sensory stimulation. "While those in light coma experimental and control groups did well, they generally had less to overcome than those who had a greater degree of coma to begin with;' Kater explains. Those in a deep coma group who received the special therapy made better progress than deep coma patients who did not receive the structured sensory stimulation. O ver three dozen UB scientists contributed a wide variety of lectures, symposia, slide sessions, and poster presentations at the meeting. A refresher course on exercise physiology and its clinical applications included talks by its organizers Vice President John Naughton and Dr. David Pendergast, associate professor of Comeau. physiology as well as by Dr. Gerd Cropp, professor of pediatrics. Dr. Sadis Matalon, associate professor of physiology, talked on oxygen radical damage to lung tissue, while Dr. Beverly Bishop, professor of physiology, cochaired a symposium on the role of receptors in health and disease. Participating in a discussion of physiologic functions in conscious-behaving animals were Drs. Don Faber, John Krasney, and Joan Baizer, all faculty from the Physiology Department. Cellular and membrane function at high pressure was discussed by Drs. Suk Ki Hong and Perry Hogan, both professors of physiology, and four others. Slide sessions were presented on the effects of gravity on cardiovascular and fluid dynamics by professor and chairman of physiology, Leon Farhi, while Dr. Bob Klocke, professor of medicine and physiology, chaired a 02/86 �14 slide show on lung physiology. Dr. Fred Sachs, associate professor of biophysics, spoke on ion channels in chick membranes. A sampling of other lectures given by non-UB scientists included findings that marijuana smoking by sheep during late pregnancy may damage or kill offspring; research which could lead to a vaccine for Non-A/ Non-B hepatitis; and Mt. Everest as a testing site for physiological changes at high altitudes. UB's involvement was augmented by a three-day Satellite Symposium on Environmental Physiology that immediately preceded the national meeting. Organized by the Department of Physiology, it included six speakers from UB and 22 others. Breathing under water was discussed by Dr. Claes Lundgren, professor of physiology, while Dr. Henry Van Liew discussed resistance and inertance when breathing a dense gas. Drs. Suk Ki Hong and Charles Paganelli talked about water exchange in hyperbaria and Dr. Hermann Rahn illuminated the audience with a talk on Rubner's "Law" which correlates the body size of an animal with its life span and metabolism. The banquet speaker, Dr. Ewald Weibel of the Universitat Bern, Switzerland, selected the enigmatic topic, "Fried Eggs on a Flying Saucer," in which he explored the oxygen pathway and its environment. • Delegates at international physiology m eeting. 02/ 86 PHYSIOIDGY'S ROGUE DEPICTS VISIIDRS OF B ' 'T he Rogue's Gallery'!.._that's how Dr. Hermann Rahn affectionately refers to his department's Physiologists Portrait Gallery, a display of over 1,000 portraits of all the physiologists who have come to UB as visitors over the last 25 years. The gallery was initiated by th~ Distinguished Professor of Physiology in 1960 when he was chairman of the department. Dr. Rahn cannot say if it is the largest such collection of physiologists' portraits, but it is certainly the largest such photo gallery he has ever encountered. The gallery is a unique record of the department's-and the School's-recent history, because it pictures virtually every one of the visiting professors, scholars, and post-doctoral fellows that have come to the department. Its photos include many of the leading physiologists on the national and world scene. These scientists who were early postdoctoral researchers at UB are today in the following positions: Enrico Fernandez, president, University Peruana Cayetano Heredia, and permanent secretary, National Academy of Medicine of Peru; John Knowles, director of the Massachusetts General Hospital, later president of the Rockefeller Foundation; Claude Lenfant, director of the Heart, Lung, Blood Institute; Pierre Haab, dean of the Medical School and chairman of the Department of Physiology, University of Lausanne, Switzerland; Johannes Piiper, director, Max-Planck-Institut fur Experimentelle Medizin, Gottingen, Germany; Emilio Agostoni, chairman, Department of Physiology, University of Milano, Italy; Tulio Velasquez, past president, Peruvian Medical Association; John B. West, professor of medicine, University of California, San Diego (Dr. West, interestingly, also led the first medical expedition that climbed Mt. Everest); Benjamin Covino, professor of BUFFAID I PHYSICIAN I Physiology chairman Charles Paganelli viewing portrait gallery. anesthesiology, Harvard University; Soedarso Djojonegoro, vice president, Airlangga University, Indonesia; Alan Groom, professor and chairman of biophysics, University of Western Ontario; Tetsuro Yokoyama, professor and chairman of medicine, Keio University, Japan; Claus Albers, dean of the medical school, University of Regensburg; Peter Deetjen, professor and chairman of physiology, University oflnnsbruck; Paolo Cerretelli, professor and chairman of physiology, University of Geneva; Peter Winter, professor and chairman of anesthesiology, University of Pittsburgh School of Medicine. Using a Polaroid Land camera purchased in 1959 by Dr. Donald Rennie for his first Alaska expedition, Dr. Rahn began the custom of taking portraits of the �15 GALLERY T 25 YEARS FIRST M.D./Ph.D GRAD GAINS DUAL NATIONAL PROMINENCE T he first graduate of the Medical School's M.D./Ph.D. program has attained national prominence in both aspects of his joint degree. Franklyn G. Knox, M.D., Ph.D., was elected president of the American Physiological Society this summer. He has also served as dean of the Mayo Medical School since 1983, and as director for education of the Mayo Foundation. His training at UB was in renal physiology. Before earning his M.D. and Ph.D. here in 1965, he received his B.S. from UB in 1959. After leaving the University, he spent three years with the National Heart Institute and then another three as a physiologist with the University of Missouri. In 1971, the Rochester, N.Y., native moved to Rochester, MN., to join the Mayo Medical School. He is now professor of physiology and medicine. He currently serves in a wide range of leadership positions in organizations. He is on the board of directors and executive committee of both the American Heart Association and the Federation of American Societies for Experimental Biology. A member of the Council of Deans of the Association of American Medical Colleges and chairman of an NIH study section, he is also the National Academy of Sciences representative to the International Union of Physiological Societies. He was the editor of the Journal of Laboratory and Clinical Medicine and on the editorial board of nine other journals. The Alpha Omega Alpha member has received numerous awards, most recently the 1985 AAMC Award for Distinguished Research in the Biomedical Sciences. His 162 publications cover a wide range of renal studies. • department's distinguished visitors, including lecturers invited to departmental seminars. The camera has been in use ever since. The Portrait Gallery is located in the hallway outside the department office in Sherman Hall. The more than 1,000 photos are mounted on 20 boards, each with 52 portraits. A registry allows one to quickly locate the picture of each visitor, and each photo is identified by name, institution, and date of visit. "These are my colleagues from all over the world; Rahn proudly states. The physiologist humorously points out that since many of the scientists have made repeated visits, the gallery offers us a good "opportunity to study changes m physiognomy with time." • Dr. Frankl yn Knox (center). BUFFAlO I PHYSICIAN I 02/ 86 �16 In the rapidly changing field of medicine, there are always certain emerging new approaches and concepts which stimulate considerable discussion and a wide range of opinion regarding their validity and value in the clinical arena. One such new field is called clinical ecology or environmental medicine by its adherents. Its theories and therapies diverge sharply from those of the allergists and clinical immunologists and their scientific basis is challenged by them. We are fortunate in Buffalo to have national leaders in both traditional allergy and clinical ecology who have arranged to discuss and Environmental Medicine: 1\n Expanded 1\pproach to 1\llergy BY DORIS RAPP, M.D. Clinical Assistant Professor of Pediatrics S orne advances in medicine have required 20 to 30 years from conception to delivery by the mainstream of medicine '. Although rigid scientific documeNation is required before new concepts can be accepted, we must be careful not to prematurely abort a different approach merely because it is new. Observations which are confirmed repeatedly cannot be ignored merely because adequate explanation is not currently available. The human body still retains many mysteries to challenge and perplex the minds of both clinical and academic physicians. An expanded approach to allergy is currently recognized by over 3,000 American 02. 6 and British clinicians and academicians who practice ecologically-oriented medicine or allergy. The American Academy of Environmental Medicine is one subset of this group. Over 50 per cent of these members, called clinical ecologists, are board-certified in one or more of 19 different medical specialties. The connecting thread among this diverse group is the recognition of the unsuspected role of environmental factors in each specialty. How Is Allergy Defin ed? T he term, "allergy," means "altered reactivity; in essence, that a nontoxic sub- BUFFAID I PHYSICIAN I stance could affect one person, but not another 2• In 1926, the definition became more restricted 3 in that an immunologic mechanism must be known to explain all "altered" allergic reactions. Hence, a more limited view of allergy was initiated. Ironically, this view was intensified by the outstanding Ishizaka study which proved that immunoglobulin E (IgE) contained human reaginic antibody. Many allergists are reluctant to diagnose an allergy if this antibody level is not abnormally elevated. Patients, however, do not always fit into this limited diagnostic category. They Continued on Page 18 �17 support each contrasting viewpoint in the following articles. We appreciate the effort that Dr. Elliot Ellis and Dr. Doris Rapp have expended in preparing their articles and we are glad to accommodate them as an appropriate forum for such a discussion. This reflects the long tradition of this institution-and all American universities-in providing a setting for the rational and free interchange of ideas. It should be noted, however, that the viewpoints expressed by the two authors are their own and may or may not be shared by the School of Medicine or the editors. Clinical Ecology: Myth and Reality BY ELLIOT F. ELLIS, M.D. Professor of Pediatrics A llergy, as a modern clinical discipline, has evolved over the past 25 years from a medical practice largely derived from empiric observations to a clinical science whose foundation is based upon understanding of the biologic phenomena involved in hypersensitivity disorders. For treatment of allergic disorders, affected individuals have looked to allergists who are specialists with formal residency training in clinical allergy and in relevant basic and applied immunology, physiology, and pharmacology. Recently, a group of physicians who have designated themselves as "Clinical Ecologists" have appeared on the Ameri- can medical scene and have promoted themselves widely. The founders of the "Clinical Ecology" movement had their roots in allergy, and the diagnostic and treatment methods presently used by their followers have some superficial resemblance to those of the conventional allergists. Thus the "ecologists" tend to be confused with allergists in the minds of the public and even physicians. However, the "ecologists' " practice, unlike that of the allergists: is based primarily on anecdotal evidence and largely invalid studies published in obscure or noncritically reviewed medical journals. Inordinately represented among "Clinical Ecologists" are physicians with charismatic personalities who BUFFAID I P HYSICIAN I use the mass media, particularly popular magazines and television "talk" shows, more than accepted channels for communication of medical findings. This article responds to the claims of the "Clinical Ecologists:' The identification of immunoglobin E (IgE) in 1966 by the Ishizakas as the principal carrier of "immediate type" or. reaginic allergy ushered in a new era in the scientific investigation of a group of diseases that affects as many as 20 per cent of the population. In 1986 we recognize the central role of the tissue mast cell in immediContinued on Page 24 02. 6 �18 RAPP From Page 16 often present with some combination of classical allergic symptoms only to be told that they do not have an allergy. All clinicians have seen patients who look and act allergic, but the negative skin tests relegate them to an ill-defined medical limbo requiring prolonged therapy with the drugs commonly used to treat allergy. The specific etiology of some of these patients' complaints can be detected after evaluation by physicians who apply the newer, broader concepts of allergy. Herein lies the crux of the present day difference of opinion. Traditionally allergists maintain a restricted and limited view. Clinical ecologists, or specialists in environmental medicine, find the original broader definition of allergy more applicable in clinical practice 2• Is a medical approach to relieve symptomatology by using an endless array of drugs for indefinite periods of time superior to elimination of etiologic factors? Are the neuroses which develop from a child's steroid facies and body less severe than those created because a child can eat his favorite food only once every four days. If the newer allergy concepts relieve hay fever and asthma, as well as symptoms in other body areas, why accept the former and deny the latter? We must critically scrutinize the repeated successes claimed by ecologists, especially when some of the preliminary scientific evidence suggests that meaningful cause and effect relationships exist. This article will elucidate the major differences between traditional allergy and the newer, more precise adaptations utilized in the environmental approach to allergy. How Do Ecologists Differ From Allergists? Scope of Illness. They differ in the scope of illness recognized as allergy. Traditional allergists confine their limited approach to well-defined, IgE-mediated conditions such as allergic rhinitis, conjunctivitis, asthma, and anaphylactic food reactions. Ecologists recognize these same IgE-mediated complaints, plus a wide range of acute and chronic non-IgEmediated medical illnesses. The same 02186 chemical mediators travel to all body areas, not to arbitrarily limited body compartments, i.e. lungs, nose, eyes. Scientific studies indicate that IgE- and non-IgE related symptoms respond similarly to testing and treatment4•5. If we learn to recognize the patients with early evidence of mild to moderate environmental illness in our routine allergy practice, we may be able to prevent the development of an end-stage form of the disease which is manifested by severe incapacitating symptoms and innumerable sensitivities, i.e. "20th Century Syndrome." The challenge is to be able to differentiate the somatic from the functional or mixed aspects of any patient's complaints. For obvious reasons, an undetermined number of severely environmentally ill patients are erroneously labeled as malingerers or functionally ill. Allergists recognize illness caused by inhalants, pollens, molds, and IgE-mediated food reactions. Ecologists, also, investigate the role of non-IgEmediated reactions to foods, chemicals, hormones and pathogenic organisms6 . Allergy Testing. After a detailed history and physical examination, both ecologists and allergists test patients with the same rock allergy extracts. Neither group has a standard testing method. Table I compares the two methods. Provocative testing is, in essence, a quantitative bioassayi. Individual skin tests with progressively weaker blinded dilutions of extract can reproduce many patient's exact symptoms. Subjective and objective monitoring can show changes in pulse, nasal patency, lung function, handwriting, picture drawing, blood pressure, measures of cognitive function, EEG's, and immunologic parameters before, during, and after single allergy tests. The dilution which eliminates symptoms caused by a stronger concentration of the same test allergen is called the Neutralization Dosage. It is used, as needed, to prevent or relieve symptoms caused by intentional or unavoidable exposures to known offending antigens. This testing is a refined and improved, but most time-consuming variation of routine allergy testing. It appears to be effective for detecting and treating both IgE and non-IgE-related antigen sensitivities. It must be clearly understood that only Provocation/ Neutralization testing detects BUFFAID I P HY SICI AN I the commonly missed non-IgE-mediated sensitivities to foods, and that Neutralization treatment often relieves symptoms more rapidly and effectively than drugs. Some ecologists use Rinke! titration8 or treat IgE-related illness directly from "in vitro" tests9 . Neither cytotoxic tests nor urine therapy are recommended by clinical ecologists 10 • Allergy Treatment. Both ecologists and traditional allergists utilize varying degrees of dietary manipulation, environmental control, allergy extract, and drug therapy 11 • The emphasis, however, varies greatly (Table Il) 12•13 • Both groups recommend diagnostic elimination diets. Ecologists believe that one-week diets, excluding highly allergenic foods, can quickly relieve some acute and chronic symptoms 14 • Subsequent daily single food challenges can provide fast, inexpensive, accurate answers. Rotary diets enable patients to tolerate many problem foods at four-day intervals. Patients' records are meticulously and critically evaluated concerning what was eaten, smelled, or touched prior to each significant worsening of illness. Allergy-environmental-control by the traditional allergist varies from no instruction, to a printed sheet, to in-depth discussion. Ecologists emphasize an understanding of toxic and chemical reactions, in addition to dust, feather, mold spore, and pet avoidance. Health educators teach patients to recognize the diverse environmental factors which can cause illness, and how, when, and why such exposures must be evaluated, and eliminated, or avoided, if possible. Both groups utilize allergy extract therapy. Routine allergy treatment is administered subcutaneously, one to three times weekly, for up to 30 weeks and then monthly for two or more years. The ecologist's neutralization therapy can be safely self-administered either sublingually or subcutaneously. The frequency of either therapy is gradually tapered according to need. If the treatment dosage is correct, the need for drug therapy is often minimal or unnecessary. Some patients respond so well to dietary and home changes that the need for allergy extract or drug therapy is either sharply curtailed or unnecessary. In recent years, a wide range of remark- �19 \ 1 ably specific drugs have proven to be increasingly effective in relieving or masking allergic symptoms. They are used at times, to the exclusion of other measures, for treatment by some allergists. The side and long-term effects of continuous drug intervention, and possible long-term effects of smoldering persistent illness must concern caring physicians. Ecologists suggest symptomatic drug therapy initially, but the continued need for drugs indicates an inability to recognize, eliminate, or avoid offending factors. When this happens, all aspects of the patient's history and diagnosis must be reevaluated. Compliant-responsive patients appear to require fewer medications and seldom require steroids'· 11 . "Ecologists suggest symptomatic drug therapy initially, but continued need for drugs indicates an inability to recognize, eliminate or avoid offending factors. When this happens, all aspects of the patient's history & diagnosis must be reevaluated.'' \ J In summary, the typical allergist stresses symptomatic drug and allergy injection therapy first, and lesser degrees of dietary and environmental control. The clinical ecologist stresses dietary management and environmental control first, and to a lesser degree, immunotherapy. Drug therapy is markedly de-emphasized. This broader ecologic approach, however, requires continued patient instruction, supervision, compliance, and encouragement. Allergy and the Literature Scope of Food Allergy. From the '30s to the '50s, Rowe and Vaughan claimed a diverse group of idiopathic symptoms due to foods responded to dietary management 16·31 . These include depression, irritability, hyperactivity, fatigue, head and muscle aches and gastrointestinal complaints. In the '40s and '50s, Randolph expanded the role of environmentally-related illness to include chemicals 18·19 . In 1954, Speer 20 discussed the allergic-tension-fatigue syndrome and attributed unsuspected somatic, behavioral, and activity changes to foods and common inhalants. These concepts have never been fully evaluated, accepted, or included in many medical curricula, in spite of repeated claims of success. Diagnosing Food Alle rgy. Many articles state that the only reliable proof of a food allergy is to reproduce symptoms repeatedly by blinded oral challenges with encapsulated powdered foods 21 . This method will prove IgE-mediated food allergies, but will not detect the common non-IgE-mediated food-related illness which requires more antigen and may cause delayed as well as immediate symptoms. The recurrent major errors or omissions in studies related to food allergy are: l. The investigators often do not select patients who are presently sensitive to the food being tested. The existence of a food sensitivity must be confirmed at the time the study is begun. 2. If sufficient antigen is not fed to a patient with a non-IgE-mediated food problem, the patient may not react. Each patient's challenge dose must be individualized. A few capsules of dried food may not represent the quantity, nor the quality a child eats in daily life. Widely quoted food industry subsidized studies claim that food coloring is unrelated to most hyperactivity in children 22.23. Cookies with 26 mg. of food coloring, however, may not cause an observable response in a child who routinely ingests and reacts to 100 to 400 mg. per day 24•26 • 3. Food challenges must simulate real life ingestion. Dehydration alters food antigenicity. Swallowed capsules miss oral mastication, the initial phase of digestion. BUFFAID I PHYSICIAN I 4. The placebo must be a placebo. Cookies made of milk, wheat, egg, sugar, and chocolate, for example, cannot be the vehicle for evaluating a food coloring challenge unless the patient is proven not to be sensitive to any of these common allergenic ingredients22. 23 ·21 • A recent double-blinded study indicates these common foods can cause hyperactivity in some children 21 • Placebo and challenge capsules should not be coated in chocolate unless this has been proven to be nonantigenic14. 5. The initial and confirmatory food challenge item must be identical, and should be presented in the form usually ingested. 6. Patients must be observed for both immediate or delayed reactions. . 7. Many parameters must be monitored during food challenge studies. One cannot assume some symptom is unrelated to a blinded challenge because that complaint was not anticipated. One challenge may interfere with a child's activity. Another child might develop nausea or misbehave. If a study monitors only the ability to learn, a sensitivity could be missed 24 •21 . 8. During food challenges, timing is critical in order to avoid overlooking masked food sensitivities to frequently ingested foods. To unmask a sensitivity, a food shall be fed on an empty stomach at a 5 to 12-day intervaF8 • Ecologists have recognized this cause of confusion and missed food diagnoses since 1951. The literature abounds with challenges at intervals of four or more weeks. Could study patients have been in a refractory state? One should evaluate all references to or studies subsidized by the food or drug industry very critically. Boards of nutrition foundations, for example, often represent large food conglomerates. Could they have vested interests? It is perplexing that some investigators state they have never witnessed nervous or behavioral disturbances during doubleblind food challenges when they appear to be reproduced so easily and frequently2q. The author has movies, videotapes, handwriting and drawing samples that clearly document behavioral changes due to ingestion of foods or skin testing with stock allergy extract in a double-blinded manner (available upon request). 02186 �20 Are Ecologic Testing Methods Valid? Successful oral food desensitization was reported in 1935 30 . Black and Vaughan reported equivocal success with similar oral pollen or food desensitization 31 • Although the efficacy of sublingual therapy m medicine has long been accepted 32 , the use of sublingual allergy extract therapy from 1944 to 1978 has been referred to as anecdotaP 3 . Traditional allergists accept that the nasal mucosa can be used to treat ragweed pollen allergies. Ironically they deny that the sublingual mucosa could be equally effective. From 1975 to 1984, four major review articles 34· 37 repeatedly quoted four major "controlled" studies, 38 -4 1 as evidence that sublingual provocation testing and treatment, or subcutaneous treatment could not differentiate between placebo controls and food extracts. Unfortunately the recent articles 35· 37 consistently fail to mention the majority of the published positive controlled studies which show the reliability of provocation testing49·60 • Based on these biased review articles, the newer concepts applied by ecologists have been unfairly judged to be neither valid nor reliable. Opponents' Literature (Widel y Quoted) Sublingual Testing and Treatment. The "controlled" studies include two short Food Allergy Committee Reports 39•40 , one double-blind study 41 , and a Letter to the Editor 38 • In these studies the methodology was vague, the challenges not randomized, and the food antigens not masked for color and taste. There were few internal controls, no outside evaluators, and no details about the intensity of the subjective or objective responses to either the challenge antigens or placebos . The 1973 Food Allergy Committee Report included data from two experienced and seven "purposely selected" inexperienced investigators 39 • The subjeers had "suspected" unproven food allergies, not necessarily to the foods being tested. The 1973 study discarded 50 per cent of the data "because the design of the study was faulty and gave an inordinate number of positive (i.e. favorable) responses" 42 . The statisticians for the study referred to the "faulty protocol" and 02/86 stated that "because of the design of the study, one must be careful about drawing any conclusions."43 In spite of that admonition, sublingual testing was labeled as neither reliable nor sensitive. The 1974 Food Allergy Committee Report failed to correct the limitations outlined in the 1973 study 39 . Part of the conclusions of the 1974 study were based on the admittedly flawed 1973 study. Both had flagrant inconsistencies, confounding variables, and obvious errors in design and execution. Lehman 41 studied patients who were purported to have food allergy with test foods and placebos to which they may or may not have been sensitive. He showed that changes in the appearance of the nasal mucosa were unreliable in determining a food allergy. Ecologists, however, do not use his unique and irrelevant end point for diagnosis. ''A 1981 summary report was critical of sublingual or provocation/ neutraliza~ tion tests and treatments. They missed all the positive studies from 1974 to 1979. Why ... .?" The Letter to the Editor 38 discussed the efficacy of neutralization by experienced ecologists. The antigen and placebo responses were both 70 per cent. Was the placebo really a placebo? This study was never published. Provocation/Neutralization. A 1981 summary report was critical of sublingual or provocation/ neutralization testing and treatment modalities (Rinke! Technique)44 . Without references it states that none of the controlled, double blinded sublingual studies shows provocation/ neutralization to be effective. They missed all the positive studies from 1974 to 1981. Why? BUFFAID I PHYSICIAN I Hirsch et al. 1981 Study45 : The investigators had less than four hours of didactic training in the Rinke! technique prior to the study. The only statistically significant finding was the Symptom Medication Index used to assess subjective improvement. Suppressor T-ee!! activity changes, shown to be affected by neutralization therapy, were not measured. Bronsky et al. 1971 Study46 : This abstract discusses no placebo and does not describe the procedure used. It does not specify if the children were sensitive to the test food. The investigators' expertise regarding Provocation/ Neutralization must be questioned seriously because they "infrequently" provoked and were unable to "neutralize" symptoms. Crawford et al. 1976 Study47 : This abstract represented a study of subcutaneous provocation. It is difficult to evaluate because of the lack of details. Draper 1972 Study48 : This article discusses Rinke! Titration. It concludes that a single intradermal positive food allergy skin test should be confirmed by a subsequent oral food challenge. There were no placebos or controls. Proponents' Literature (Rarely Quoted) Sublingual Testing or Treatmen t. In 1981, King published a double-blind, rigidly controlled study 49 that shows the efficacy of sublingual testing with stock allergy extracts as a means of demonstrating cognitive emotional symptoms in 30 patients. The study is valid, reliable, and included repetitive pre- and post-base rate trials without testing, pre- and postscreening trials with placebos, multiple randomized challenges with 18 allergens and placebos, proper masking for odor and taste of both antigens and placebos, and agreement checks for reliability of inter-rater interpretations. Sound statistical analysis provided a basis for the favorable conclusions. Miller studied eight chronically ill foodsensitive patients 50 • After Provocation / Neutralization testing, he prepared treatment allergy extracts. The patients received four 20-day courses of injections with randomly assigned coded placebo or allergy extract. The food extract was superior to the placebo at 99.8 per cent lev- �el of confidence. One single-blind study 51 and eight additional double-blind studies demonstrating the efficacy of sublingual testing and/ or treatment were published between 1974 and 1983 52•57 • Critiques of each article are available upon request. In all nine studies, the antigens and placebos were masked for color and taste, the challenges were randomized, and the strength and amount of antigen and the method of testing used were current and standard for environmental medicine. There were no inconsistencies between the data presented in the text and the tables. There are no abnormally high placebo rates, and no unexplained loss of patients. Provocation/Neutralization. Three recent double-blind controlled studies support and substantiate the validity of this testing approach 58-60 • Boris et all 58 demonstrated that inhaled animal dander caused a 20 per cent drop in FEY 1 in 19 asthmatic dander-sensitive patients. This drop increased to 31.8 per cent if they were pre-treated with a place- · bo, but decreased to 10.7 per cent if the patients were pre-treated with their neutralization dose of dander. The decision to publish this article was reversed 17 months after acceptance for publication in an allergy journal. Why? Two recent subsequent studies have reconfirmed these findings. Rea et al 59 studied 20 patients with known food sensitivity. In a double-blind manner they were given either the neutralizing dose for their allergy extract, or a placebo, prior to a known offending food challenge. The neutralizing dose was found to be highly significant (p less than 0.001-0.05) in 4 / 5 sign/ symptom parameters monitored in comparison to the placebo. In 12 subjects, 4/ 6 variables were neutralized 60 per cent of the time. In 8 subjects, 2/6 were neutralized 85 per cent of the time, and the placebo neutralized 4/ 6 variables 15 per cent of the time. McGovern et al60 studied six patients in a double-blind, randomly controlled oral or chemical provocation study. The challenge foods caused symptoms during provocation intradermal testing. He monitored 19 immunological parameters prior to, and repeatedly after provocation. Markedly fluctuating parameters of inflammation were demonstrated, and correlat- ed directly with the onset and disappearance of symptoms. Double-blind studies by McGovern, 61 Crayton, Brostoff, Rapp and Egger await publication60•61 • Time will tell if quality research in this area will be allowed to be published. Immunology What Clinical Immunological Findings Do Ecologists See In Their Practices? Ecologists see patients who appear to have bizarre multi-organ responses to specific food, inhalant, pollen, mold, or chemical challenges. A theoretical single model to explain both the symptoms, and the lack of end organ specificity would be an immune complex immunopathology. Single food challenges have demonstrated both IgG and IgE complexes which "These methods afford a way to relieve some acute and chronic symptoms quickly in some patients. This frequently obviates the need for a plethora of medicine for symptoms." correlate with the onset of symptoms62 • Appropriate diets or pre-treatment with oral sodium chromoglycate can decrease both complexes and mediator relea;e. 62 ·74 A number of studies have indicated that environmentally-ill patients have immune system abnormalities 5.63-67 . These are reflected in abnormal levels ofT or B cells. The helper/ suppressor ratios are often abnormally low, or infrequently too high. Excessive complement utilization is not uncommon 5 . Some investigators have noted low IgG and low IgA, as well as elevated levels of IgG- or IgE-immune complexes. Ecologically-ill adults often have leukocyte counts which normally range BUFFAID I PHYSICIA N I from 2700 to 5000/ cu mm., and very low normal serum IgE levels. These abnormal parameters often appear to improve after proper environmental control, dietary management, chemical avoidance, and immunotherapy. A diminution of immune dysfunction in association with clinical improvement has been documented. Neutralization therapy appears to initiate a biochemical process which, at times, favorably alters the ratio of suppressor to helper Tee!! function. Opponents have labeled Provocation/Neutralization therapy as "experimental" and "unreliable:' The correct term should be "effective but not fully explained:' Innumerable clinical applications indicate it is both safe and reliable, especially for some patients wno have not responded favorably to traditional allergy care. When the Federal Register announced Medicare might withdraw funding for ecologic testing methods, they received 11,635 positive patient letters versus 32 negative letters (mainly from doctors). These methods afford a way to relieve some acute and chronic symptoms quickly in some patients. This therapy frequently obviates the need for a plethora of symptomatic medications. Critics Emphasize That Ecologic Medicine Is Expensive. In-depth initial and follow-up discussions of a patient's total environment and education concerning home, school, or work place are immensely time-consuming. Critical evaluation of dietary records, various exposures, and symptomatology takes many hours. Skin-testing with single dilutions of single antigens at 10-minute intervals, while monitoring a number of objective parameters, requires an unprecedented amount of professional time and patience. Extracts often must be prepared in normal saline because of phenol sensitivities. They are expensive to stock and a challenge to maintain. More paramedical professionals are needed, i.e. health educators, dieticians, nutritionists, and psychologists. The overhead in ecologic offices is at least 25 per cent higher than in most typical allergists' offices. One must consider that the patients' medical expenses prior to ecologic care must be contrasted with the diminished need for medications, medical consultations, office visits, and hospitali- 02/86 21 �22 zations after the patient improves4·14·ZO,ZI.Jl,JJ. How do you calculate expense when an incapacitated adult becomes a productive self-supporting member of society or a child is finally able to learn?4,15,17.68. Immunological Principles That Support Th e New Allergy Approach 69 •74. Both groups accept that food antigens combine with IgE or IgG antibodies to form immune complexes, trigger complement activation and anaphylatoxin production, and that chemical mediators are released from mast cells or basophils causing increased capillary permeability, edema, and allergic symptoms. Ecologic methods, however, cannot be explained by a limited interpretation relating antigenic reactions to IgE antibodies because many patients do not have an elevated serum IgE level. The concept that increasing doses of injected antigen will cause such a large antibody production that the immunologically reactive cells will become exhausted and unresponsive, simply does not explain the many non-IgE mediated allergic problems which respond to the newer variations of testing and treatmenri0 • Provocation/ Neutralization represents a clinical example of the accepted phasic immune response. One dose of antigen provokes an immune response 71 ·7l , weaker dilutions of antigen inactivate or neutralize that response, and still weaker dilutions of antigen will again provoke a response. The immune system is attempting to maintain homeostasis. NossaF 2 showed that dilutions weaker than 10-7 or stronger than 10-3 moles produced tolerance, whereas dilutions between 10-3 and 10-7 produced immunity. If the rat can respond differently to 0.001 than to 0.0001 moles of antigen, why can't humans? Does precise testing during Provocation/ Neutralization similarly alter the body's phase of immune response in humans? This obviously needs more study. This phasic response is due to the modulatory effects of the suppressor T cells which respond to various concentrations of antigen. "Tolerance" develops when the specific suppressor T-cell factors are dominant over the specific helper/ inducer T cell factors. This provokes a reciprocal synthesis of anti-idiotypes 02/ 86 ''Critics emphasize the expense of ecologic medicine. But how do you calculate expense when an incapacitated adult becomes a productive, self supporting member of society?'' which enhance suppressor cell acttv1ty. The latter, in turn, suppress the idiotypeproducing cells and a cycle of ever decreasing intensity is established until the baseline is again reached. How Is This Related To Provoca· tion/Neutralization? 58 •59 •62 ' 72 •74 • In essence, this method of testing is theorized to alter the ratio of antibody to antigen by the addition of a small amount of antigen. The immune complexes normally formed each day when antigens and antibodies combine must be removed quickly from the circulation by macrophages. If they are not, complement and polymorphonuclear cells are called into action. The latter can destroy nearby tissues in the process of removing the complexes. If the modulation is not balanced, clinical immune complex illness results 61-6 3. In addition, macrophages respond to antigen from skin testing by secreting antigen-specific helper and suppressor factors which affect antibody formation and circulating antigen-antibody ratios. When the T suppressor lymphocyte function becomes inadequate to control IgE-forming B cells, allergy results 73 ·74. It is thought that precisely chosen doses of injected antigens can stimulate and possibly "train" skin macrophages, enhancing their suppressor function. Antigen-antibody interaction in immune complex formation is highly dynamic. In seconds or minutes, complexes dissolve or recombine, complement is activated or inactivated and anaphylatoxininduced mediator release may or may not BUFFAID ! P H Y S I C I AN ! occur. A minute amount of antigen or antibody can shift the reaction rapidly and markedly. The right amount of antigen could shift the curve from a pathogenic to a non-pathogenic mode, relieving symptoms during neutralization. The correct amount of antigen appears to maintain equilibrium so that some patients remain asymptomatic. Mast cells and basophils release histamine by local and systemic IgE and non-IgE mechanisms. Injected antigens interact with mast cell-bound IgE in the skin to release histamine which can either "turn on" allergic symptoms by stimulating effector cells or at other concentrations, "turn off' further histamine release. Symptoms can be relieved by injecting the precise amount of antigen which "turns off," not "on; more histamine release. It, therefore, appears that two major mechanisms explain non-IgE mediated allergic responses. The first is related to altering the antigen/ antibody ratios with minute amounts of injected antigen so that surplus antigen induced immune complexes can be cleared more efficiently. The second is related to the precise amount of antigen needed to "turn off' histamine release. Both mechanisms initiate a series of complex humoral and cellular changes which can stimulate and suppress certain T and B cell functions to help restore homeostasis and a patient's sense of well-being. Conclusion The broad scope of environmentallyrelated illness has just begun to be appreciated. Physicians must help patients increase their awareness concerning potentially deleterious health factors. The ideal treatment is avoidance, but if this is not practical or possible, a trial of neutralization therapy should be considered. In the next few years less time-consuming methods will surely become available, but at present, these methods appear to help and should be utilized. Rather than refusing to observe, or discounting what is seen, the academic medical community should join forces with practicing clinical ecologists to evaluate and elucidate the significance of their clinical findings. They should endeavor to build upon the preliminary evidence which has been presented so that rigid �scientific studies can be designed to document and explain the enigmatic complexities and clinical successes noted by ecologists. Many ecologically-ill patients have a positive personal and family history of allergy. Many have typical and atypical allergic symptoms after ingestion of common foods or exposures to inhaled allergens or chemicals which can be relieved by avoidance. Their symptoms can be reproduced and relieved by single-blind allergy skin-testing using the newer variations of the traditional methods. These arguments suggest that allergy is at least one facet of the medical problem. Whether we label these observations allergy, sensitivity, or intolerance is really not the issue. Toxicology, nutrition, the psyche, and innumerable non-immune or unknown factors are probably inexplicably interwoven in ecologic illness, just as they are in many illnesses. Because of the politics of academic medicine, the astute clinician is once again relegated to a role secondary to that of the academician. We all know of potentially . helpful medical methods which have been stifled by heads of departments who favored other avenues of investigation. We all know of journals sharply edited by academicians who censor what we are allowed to read. Only the naive would not have realized that prestige, power, the pharmaceutical industry, and the pocket book have major influences upon the practice of present day medicine. Having practiced traditional pediatric allergy for 18 years, I appreciate and understand any skepticism some readers may have concerning this entire topic. The expanded role of foods and the environment in allergy seemed illogical when I first heard about it ten years ago. With immense incredulity, I tried Provocation/Neutralization. Unequivocally, this method provides relief for some patients not helped with routine allergy care. Why does the Canadian Ministry of Health 75 conclude in 1985 that environmental hypersensitivity illness does indeed exist and requires further investigation? Those who refuse personally to critique the literature, to observe or listen to the patients who claim to be helped, or to try the techniques and evaluate them for themselves must be asked one difficult question: Why are they reluctant? Shouldn't the patient be our top priority? If something helps, even if we don't understand why, shouldn't we use it? Greater understanding will benefit both our patients and our profession. "Only the naive would not have realized that prestige, power, the pharmaceutical industry, and the pocket book have major directive influences on medical practice." (Dr. Rapp board-certified 1n pediatrics and pediatnc allergy. ~ a fellow 1n pediatrics. pediatric alleiQY. preventive medic100. and enwonmental medicine. She received UB's 1985 DIStinguished Alum,.; Award and is the author of 34 techr;cal articles and five book~ Besides lectunng extensively, her clir;cal studies hove been shown as documentanes in Canada. England. and Germany. Her latest book. "The Impossible Child" with a companion video tape. will be released shortly.) Source of Test Antigen Tradit ion al Allergy Stock Supply Companies Same Method of Testing Scratch, Prick, Intradermal Intradermal, Sublingual, Rarelv Scratch Cone. Used I:IO Dilutions (Weak to Strong) 1:5 Dilunons (Strang to Weak) Items Tested Dust, Mites, Pollens, Molds, Foods Same as Left Plus Chemicals, Hormones, Bacteria Way to Test 10-40 Ag at Same Time 1 Ag Dilution, Single Blindly, Every 10 Minutes Monitored Size of Wheal and Erythema After 10 Minutes Size of Wheal, and signs and symptoms plus when indicated, q. 10. min. pulse, PFM, BP, drawings, wnnng, and immunological parameters Treatment Dust, Mites, Pollens, Molds, :--Jot to Foods All on left, plus Foods Method of Rx. S.C. Allergy Extract. Administered by Physician or Nurse. Sublingual or S.C. Allergy Extract taken by Patient . Environmental Medicine ~ Trad itional Allergy Text {Ref. No. 17 · Middleton) pages 1182 Total Text Environmental Control 7 (0.5%) Food Allergy Allergy Extract Therapy Drug Therapy PHYSICIAN I 807 154 (19%) 16 (1.3%) 86 31 (2.6"ol 2 (3%) 210 (18%) BUFFAID I Clinical Ecology Text {Ref. No. 18 • Dickey) pages (11~o) 6 (0.7"''0) 02 86 23 �24 (Due to space limitations, bibliographic references have been condensed using Lancet's former style. To obtain complete bibliography, contact editor of this magazine.) De~qgned to 12. I 3. 14. 15. 16. I 7. 18. 19. ldenofy and Treat Env~ronmemal 70. 72. 73. furman, R. Medocal Hypoth""". 1981, 7, 1009-1017. 2. Von Ptrquet, C. Allergie. Munch. MecL Wochen~hr. 1906, 51, 1457. 3. Doerr, R. Arch. Dermatol. Syph., 19Z6, 151.7. -1. Rea, \"('.)., eta!. Ann. Allergy, 1981, -17, JJB-34-1. 5. Sandberg, D.H., et a!. Lancet, !'<b. 19, 1977, 388-JQI. 6. McGovern,).)., et a!. Ann. Allergy, !981, nt23. i. Mtller, J.B.: Food AllMg). Prot.ocarn:e Tesrmg and lnJecUon thera~. Charles C. Thomas, Sprongfield, IL, !972. 8. Rooke!, H.). Arch. Otolaryn., 1963, 77, 302-326. 9. Nalebuff, D.)., Conun. Educ. on OR.L. & Allergy, 1978, 40, 47·59. 10. Acad. of Envtr. Med. Position Paper. A New Medtcal Specialty II. Regard mg Cert am Testing and Treatment Modalaies for Aller· 71. REFERENCES I. 67. Rea, W.j. Ann. A llergy, 1977, 38, 245-251. 68. M• ll ma n, et a!. Ann. A llergy, 1976. 36, 149-160. 69. Levm, A. & Miller, J.B. A Presentauon to Insurance Companies and Ecologic 74. 75. gic Conditions. Amer. Acad. Envir. Mecl. , Amer. Acad. OrolaryngJC A llergy, and Pan-A mer. A llergy Soc., Jan. 1984. Jerne, N. D. Lecture, Mar. 20, 1975, Basel lnst. for Immunology, Ba~el. wit:erland. Mnch 1son, N .A. , Immu nology, 1968, 15-509. Nossal, G.V., Shell am, G.R. Immunology, 1968, 14,2]3. Rocklm, R. E. eta!. ew Engl. J. Med., 1980. 302, 1213. Brostoff, j.: Immunologica l Mechanisms of Product ion of Food Allergy Sy mptom!!;. Presented at the Brit. Soc. for Clio. Ecology wnh Soc. for Chn. Ecology (USA ), May 30, 198-1, Torquay, England. Canada M•mstry of Hea lth, 1985, 2 vol. , 512 pp. lOt h A. Hepburn Block, Toronto, ON. M7AZC-!. Ill~ ne". 198-1-1985. Gerrard, JG., Food Allt<T. :O,'eu Prnpecmes. Charles C. Thomas, Sprongfield, IL., !980. Middleton, E., Jr., et al: Alli?J'g)- Pnnoples and Praaice. St. l..oui!;, C.V. Mosby Co., 1983. Doc key, L.D., Clmli:al Ecolo~ . Sprongfield, Charles C. Thomas Pub!., 1976. Rapp, D.j., All"!:'" and "''" romih. N.Y., SterHng Pubhshong Co., 1980. Shambaugh, G.E., Amer. J. Otology, 5(1),63-65, 1983. Rowe, A.H., Food Allt<T Sprongfield, IL Charles C. Thomas, 1972. Shambaugh, G. E. So. Med. & Surgery, Jan. 1933, 15-19. Randolph, T.H. Ann. Allergy, 19-15, 3, -118. Randolph, TD. J. Pediamcs, 1947, 31, 560. Speer, F. Ann. Allergy, 195-1, 12, 168. Bock, S.j., May, C. Allergy, 1978, 33, 167-188. 20. 21. 22. Conners, C.K. Pedtatrics, 1976, 58, 154~166 . 23. Harley, J.P., et a!. Pediatncs, 1978, 61, 818-827. H Swanson, j.M. Smnce, 1980, 207, 1-!85-1487. 25. \X'eic;!>, B. Amer. Health, May/june, 1982, 68-iJ. 26. R•ppere, V. Bm. J. Cion. Psychology, 1983, 22, 19-32. 27. Egger,)., et a!. Lancet, Mar. 1985, 541-5-!5. 28. Rmkel, H.)., et aJ, fuod Ali<T Sprongfield IL Charles C. Thomas, !951, 10-16. 29. May, C.D. 'ESA Proceedmg>, 1981, 2(4), 100-201. 30. Kesron, B., eta!.). Allergy, 1935, 6, 431. 31. Vaughan, WT. & Black, J.H., Pracnce of All~. St. Lou"' C.V. Marsh Co. 3rd ed., 321-323, 1954. lZ. C.buld1, M., Kamg, J.). Oral Therapeuncs & Pharrnacology, 1965, I, -1-10. 33. Hanc;el, EK., Tram:. Amer. Soc. Ophtha lmologic & Otolaryng. Allerg1·, 1970, II; 93. 3-1. Colbert, T.M. J. Allergy & Chn. Immunology, 1975, 56, 170-190. 35. Groeco, M.H., )AMA, 1982, 247, 3106-llll. 36. Van Metre, T.E. Pe-diatric Clinics -of 1orth Amenca , 1983, 30, 7-817 37. 38. 39. -!0. -II. -12. -!3. -1-1. 45. 46. -17. -18. 49. 50. 51. 52. 53 . 5-!. 55. 56. 57. 58. Re1c;man, R: Amer. Academy of Allergy: Pmmon Statements· controverc;ial techniques. Allergy & Clin. Immunology, 67, Jll-JJ8, 1981 Ka.Jm. E., Co!Her, R. JAMA, 1971, 217, 78. Breneman, )C., et a!. Ann. Allergy, 1973, 31, 382. Breneman, )C., et a!. Ann. Allergy, 1974, 33, 16-1. Lehman, C.\"1" Ann. Allergy, 19 , -15, 144. Breneman, )C., et a!. Ann. Allergy, !97l, 383. Breneman, ).C., et a!. Ann. Allergy, 1973. 385. )AMA, Jq81. 241'(14), 1499. H"«:h, S.R .. eta!., J. Allergy & Chn. Immunology, 1981, 68. IJ3. Bron<ky, EA, et a!. J. Allergy, 1971, 4/; 10-1, (Abstract). Crawford, LV., eta!. J. Allergy & Clm. Immunology, 1976, 57, 236. Draper, WL, Arch, Otolaryngology, !972, 95, 169. King, D.S., Bmlog~eal Psych•atry, 1981. 16, 3-19. M•ller, ).B. Ann. Allergy, !977, 38, 185-191. Green, M. Ann. Allergy, 197-1. 33, 27-1. Rapp, D.). Med. ). Austral.a, 1978, I, 571. Rapp, O.j. Tran'. A mer. Soc Ophthalmology & Otolaryngology, 1q7s, ts, t4q. Rapp, D.). J. Learnmg D«abd•nes, 1979, 12, 42-50. Mandell, M, Conte, A. lnrernauonal Acad. Prev. Med .. july 5-6, 1981. 0 hea, )A, Porter, S.E). Learning D«ab.I•nes, 1981, 14, 189. Monro, J Proc. Nutr. Society, 1983, 42, 241. Bow., M., et a!. Allergy & Immunology, 1983, 71, I, Part 2, 9!. (Ab-.trau) 59. Rea, W.j., et a!. Arch. Otolaryngology, 198-1. 110, 2-!8-252. 60. McGovern, j.J.. et a!., Otolaryngology, 109, 192-297, 1983. 61. 62. 63. 64. 65. 66. Mt.:Govern, J.J., et al. Poster abstract at Amer. Coli . og Allergy Meeting, On. 1984. Bro<toff, J., et a!. Lancet, 1979, june 16, !268-1270. MeGa-ern, J.J. Orthomolecular Psychmtry, 1983, 12(1), 60-71. McGovern, JJ, et al. lnternauonal j. for B1osocia l Research, 1983, -!(!), 40-42. Rea, W.j., et a!. Ann. Allergy, 1978, 41(2), 101-110. Rea, W.j. Ann. Allergy, 1978, 40(4), 24 3-251. 02/86 BUFFAID !PHYSICIA N I ELLIS From Page 17 ate type hypersensitivity disorders and have an understanding on a molecular basis of the nature of the events leading to the triggering of mast-cell bound IgE and the release of the biologically active molecules (known as chemical mediators) responsible for tissue injury and the patient's signs and symptoms. Insights into the fundamental nature of IgE-mediated allergy have led to the development of both immunologic and pharmacologic methods for modulating the release of mast-cell-derived chemical mediators to the great advantage of allergy sufferers. It has also become evident in recent years that there are many nonimmunologic factors that can trigger mediator release from mast cells and basophils. Since mediator release is the final common pathway leading to tissue injury, what appears to be a typical allergic reaction, hives for example, may have no immunologic basis at all. Great care must be taken by the allergist not to confuse immunologically and non-immunologically based reactions with each other and in particular not to use immunologically based methods to treat non-immunologic conditions. While the interaction of antigens with antibodies of immunoglobulin classes other than IgE (IgG, IgM for example), or with sensitized lymphocytes, may cause tissue injury in a variety of immunologic disorders, e.g. lupus erythematosus, the allergist concerns himself principally with conditions in which IgE-mediated allergy may be involved. Evaluation of patients with common nasal, lung, skin, and gastrointestinal symptoms frequently proves the involvement oflgE-mediated sensitivity. For example the prototypic IgEmediated disorder is ragweed hay fever, a condition affecting the respiratory tract, due to sensitization to ragweed pollen. However, we recognize that many environmental substances, e.g. various kinds of inhaled particulate matter, foods, drugs, that satisfy the chemical requirements for immunogenicity, are capable of causing disease in various parts of the body. Thus individuals with IgE-mediated allergy can suffer not only from hay fever and asthma but also from skin, gastrointestinal, and other organ-system disorders. �The allergist, by a combination of a thoughtful history obtained from the patient, a reasonable number of skin tests based upon the history, and other tests as indicated, is able to arrive at a correct diagnosis in the large majority of instances. Subsequent to the identification of the allergen responsible for the patient's illness, a therapeutic program is initiated that involves: (1) Avoidance of the allergen to the extent possible. If a child is allergic to cat or dog dander, there is no substitute for elimination of the dog or cat from the child's environment and this is the treatment of choice. Similarly, if a food can be shown to be an important allergen by history or skin testing, then avoidance of the food is the most effective, safest, and least expensive treatment. (2) Immunotherapy (also known as allergy hyposensitization) by a graded series of subcutaneous injections of extracts of those allergens that cannot be avoided, e.g. pollens, is often helpful. However, there is an important caveat regarding immunotherapy, namely that immunother- · apy should only be used for those allergens and in those diseases where it has been proven to be effective on the basis of properly designed and controlled studies. The value of immunotherapy has been established using extracts of pollens and house dust in patients with hay fever and asthma and in subjects allergic to the venom of stinging insects. Immunotherapy using food extracts by any route of administration has not been proven to be efficacious. Administration of food extracts may be dangerous in certain circumstances and should not be used. (3) Pharmacotherapy to modulate the release or generation of the chemical mediators of the allergic reaction, or to block or reverse mediator effect on the affected body tissues, is a most effective way of treating IgE-mediated disorders. T his thoughtful approach to diagnosis and therapy is successful in the large majority of instances in providing the patient with relief of complaints when the latter are indeed due to allergy. While allergists spend much of their time evaluating the role that lgE-mediated allergy plays in the pathogenesis of many common respiratory, gastrointestinal, and skin conditions, they are equally concerned with disorders in which IgE is not involved or plays only a minor role. For example, allergists/ clinical immunologists have made major contributions to understanding: (1) an important group of occupational and environmental diseases, the hypersensitivity pneumonidities, and to the role of toluene diisocyanate (TDI), trimellitic anhydride (TMA), formaldehyde, ozone, sulfur dioxide, and oxides of nitrogen as symptom-producing chemicals in susceptible individuals; (2) the role of drugs, e.g. aspirin and other simple chemicals e.g. sulfites, as provocateurs of sym- "The only characteristic unifying the Clinical Ecologists is that the overwhelming majority have had no scientific training in laboratory or clinical research." ptoms in patients with asthma and rhinitis; (3) the pathogenesis of signs and symptoms of angioedema in patients with complement-system mediated disorders such as hereditary angioedema, and (4) the interaction of various immunoglobulin classes in the pathogenesis of immune complex disease, and most recently the role of arachidonic acid metabolites (prostaglandins and leukotrienes) in various disorders. The claim that the "traditional" allergist/ clinical immunologist is concerned only with lgE-mediated diseases is false and ignores years of research and publications in reputable scientific journals. In contrast to the allergist/ clinical immunologist's approach to the diagnosis and therapy of allergic diseases derived from hypotheses which have been validated by sound laboratory and clinical investigation, the so-called "Clinical Ecologists," existing on the fringes of medical science BUFFAID )PHYSICIAN] have made expansive and vague claims about a "new approach to allergy." "Clinical Ecology" is not a recognized medical discipline, has no residencies, nor formal training programs; it is, rather, what has been called a "medical subculture" with an ideology that stresses environmental causes of mental and physical illnesses with particular focus on illnesses that have been diagnosed as psychiatric.' The founders of the movement particularly dedicate their work to "all patients who have ever been called neurotic, hypochondriac, hysterical, or starved for attention while suffering from environmentally induced illnesses~ 1 Theories and practices espoused by "Clinical Ecologists" are not new. They were formulated by Herbert Rinke! and Theron Randolph over 40 years ago. They were, however, rejected by the best clinical scientists of their day because of lack of validity. 1 "Clinical Ecologists" offer an alternative to traditional medicine and in particular, dissociate themselves from "traditional" allergists whom they say "are principally interested in bodily mechanisms and in drug treatment." At a time in the history of the United States when there is great concern among the public about the contamination of the water, the air, and the environment in general, it is easy to understand the appeal of clinical ecology, which fits very nicely with the back-to-nature, organic food, megavitamin, antifluoridation, antidrug (meaning medication of any kind), have-your-child-birth-at-home movements, and anticonventional medicine philosophy of some of our citizens. As a group, "Clinical Ecologists" who have formed organizations with legitimate sounding names (Society of Clinical Ecology, American Academy of Environmental Medicine) come from many backgrounds in medicine- family practitioners, psychiatrists, otolaryngologists, urologists, and pediatricians. While some are certified in one speciality or another (E T, family medicine, pediatrics), their training in the theory and technical aspects of "Clinical Ecology" consists of a few days to a week, here or there, taking courses put on by other "Clinical Ecologists," themselves self-trained. Their only unifying characteristic is that the overwhelming majority have had no scientific training in laboratory or clinical research. 02/86 25 �26 Aside from one or two academic dropouts, none are, or ever have been, members of medical school faculties in departments of microbiology or allergy/immunology. On an individual basis, physicians who espouse the "Clinical Ecology" theories are generally quite charming, ofren charismatic, reasonable sounding physicians with a definite evangelical bent. They are precisely the kind of physicians who are likely to be the most effective purveyors of the placebo effect regardless of the nature of the treatment proffered. 4 Some compare themselves to Semmelweiss in the sense that he, too, was not believed for his theories regarding the cause of puerperal fever. As a group they feel there is a conspiracy among the "traditional allergists" to suppress their findings. Yet the history of science has shown that fundamental truths cannot long be suppressed. The table accompanying this article, which was abstracted from a publication on Laetrile, shows a striking similarity among the attitudes of various cure movements throughout the history of medicine in the United States and those of the "Clinical Ecologists~ 5 The diagnostic and treatment techniques used by "Clinical Ecologists" are a curious mix of in vivo and in vitro methods for measuring lgE-mediated allergy, immune complex disease, and cell-mediated immunity with other methods known as "the unconventional and unproven procedures." These include leukocytotoxic testing, intracutaneous and subcutaneous provocation and neutralization, sublingual provocation and neutralization, and a few others. For example, the "Clinical Ecologists~ claim that they can not only provoke various symptoms including convulsions (seizures) by the subcutaneous injection of an extract of a food or chemical to which the patient is "sensitive" but can also neutralize a seizure by a weaker dilution of the same extract that produced the sign or symptom. If the sign or symptom, be it a seizure or other, cannot be neutralized by injection of a weaker dilution, then they "go the other way" and increase the concentration of the neutralizing solution. They perform allergy skin tests with sugar solutions, motor-vehicle exhaust fumes, Coca-Cola, and other similar materials which have never been shown to induce an immune response. The 021 6 American Academy of Allergy and Immunology and the National Center for Health Technology have concluded that these methods have no scientific basis. 6•7 While the "Clinical Ecologists" decry the use of pharmacologic agents, many U6e not only conventional drugs but others. For example, sodium bicarbonate given intravenously or orally in the form of"AlkaSeltzer Gold" is a favorite among "Clinical Ecologists" "to neutralize" the patients' symptoms. The entire scheme is designed to always provide an answer, always to find a cause, and there never being any questions, is very satisfying to both doctor and patient. Not only have the "Clinical Ecologists" failed to prove that their clinical observations are valid, but they have not provided the scientific underpinning for their theories. Their "research" is published in obscure journals, e.g. Journal ofMetabology, Orthomolecular Psychiatry, and in E T journals (where apparently they have found a sympathetic but uncritical ear), often as a "preliminary report" (the definitive report never follows), and the treatments are an unbelievable 99.8 per cent effective.8 sentially invalids. Newspapers regularly run features on these unfortunate people who believe that they can survive only in the middle of a desert or on top of a mountain and thus make a sensational feature story. 9•10•11 While individuals so affected are said to be "allergic to everything," chemicals and odors of all kinds and foods have received major emphasis as causal factors in their illness. Two recent studies of patients with "the 20th Century Syndrome" (one of seven pa- "The entire scheme zs designed to always find an answer, always to find a cause. Since there are no questions, it is satisfying to both doctor & patient." W ho are the patients of the "Clinical Ecologists"? In our American society there are a number of individuals, generally adults, who suffer from a variety of multi-system complaints. These complaints may be referable to any organ system in the body but the more common symptoms include fatigue, nausea, headache, dizziness, poor memory, confusion, abdominal pain, nasal irritation, throat irritation, and musculoskeletal pain. Less commonly the subject is troubled by anxiety, crying, anger, "fuzzy" thinking, "spaciness," hyperventilation, faintness, numbness, etc., etc., etc. Extensive biochemical and immunologic testing has failed to show any evidence of relevant organic disease and yet the subject is severely disabled. They have been led to believe by the "Clinical Ecologists" that they are "allergic to everything" and a new syndrome has been invented to accommodate their complaints. They are said to suffer from "the 20th Century Syndrome," "Total Immune Disorder Syndrome," or "Total Allergy Syndrome" and must live severely restricted lives in stringently controlled environments and are es- BUFFAID !PHYSICIAN I tients by a psychiatrist 1 and a 50-patient study by an allergist/clinical immunologist 12) have concluded t hat these subjects are ill but not with organic disease. Their complaints and clinical patterns are typical of a variety of psychiatric disorders, e.g. somatization disorder, hypochondriasis, conversion hysteria, anxiety state, and depression. 13•14 One must be very careful, however, not to apply a psychiatric diagnosis before all other organic causes of illness have been excluded. Very recently it has been shown that some individuals with chronic marked fatigue, chronic mild sore t hroat, myalgia, and other various non-specific complaints (very reminiscent of those of the "20th Century Syndrome" sufferers) had evidence of persisting Epstein-Barr infection (the virus of infectious mononucleosis). 15 Of interest is the fact that many of these subjects had turned to non-traditional forms of therapy including megavitamins and "Clinical Ecology" after unsuccessful consultation with traditional medical practitioners toward whom much anger and �distrust was directed. "Clinical Ecologists" have also become involved in the controversy concerning a link between anti-social and criminal behavior and diet. While no single mechanism has been advanced to explain the putative relationship between dietary compost non and aberrant behavior, hypoglycemia, excess sugar intake, food additives, and food allergies have been proposed. Despite lack of scientific evidence to support the diet-antisocial behavior link, stimulated by the "Clinical Ecology" theory, the diets of inmates in correctional facilities have been modified as has the sugar intake of juvenile delinquents. A critical review of the studies purporting to support the relationship between diet and antisocial behavior has shown them to have serious flaws in study design and statistical analyses. 16 A legal precedent for criminals who seek to explain their antisocial behavior by blaming "a reaction" to a dietary constituent has already been established in California. In 1979, on the recommendation of the jury, a judge sentenced a police officer who murdered the mayor of San Francisco and a councilman to a term of only five years. The officer's lawyers successfully argued that the policeman's irrational behavior was due to a chemical in a "Twinkie" that he had ingested. This result, the product of the "Clinical Ecology" mind-set, has come to be known as the "Twinkies defense." Another group of subjects whose behavioral patterns are not easily explained are children with attention-deficit disorder (also known as hyperactivity syndrome of childhood). These children have been extensively investigated because of the claim that artificial food colors and flavorings are responsible for their aberrant behavior. The major criteria for diagnosis of this syndrome includes inattention, hyperactivity, and impulsiveness. The condition is most often diagnosed when a child enters school and affects boys more than girls by a ratio of 5:1 to 9:1. While it is highly probable that there are many etiologies for this syndrome including genetic predisposition and prenatal and perinatal insults to the central nervous system, the food dye and flavoring hypothesis has received the most recent attention. Many well-designed, double-blind controlled challenge studies (conducted under the auspices of eminent medical and behavioral scientists representing major medical and other scientific organizations and hardly tools of the food industry as charged by the "Clinical Ecologists") have failed to support the food and dye coloring hypothesis as a cause of the syndrome in the overwhelming majority of affected children. 1i Food allergies have also been implicated in the etiology of hyperactivity but in this instance too there is little evidence to support the hypothesis. onetheless in the hands of the "Clinical Ecologists," children are subject to rigidly controlled diets and treated with drops of food and other extracts administered under their tongues for indeterminate periods of time until the parents become discouraged or they run out of money. Families are torn apart because one parent believes the "Clinical Ecologist" and the other parent sees no relationship between the child's behavior and dietary composition or favorable results from "the drops-under-the-tongue treatment." Despite the lack of scientific validity of their practices, 18•19 "Clinical Ecologists" have a vocal patient constituency as did the supporters of Krebiozen, the cancer cure of the 1950s, and Laetrile of the 1970s. The clinical ecologists provide simple answers to complex questions. It is much easier for the distressed parents of a hyperactive child to believe that he is nutritionally damaged than to be told that the fundamental nature of the problem is poorly understood or perhaps the child has a behavioral problem. Similarly, for the obese person to feel that food allergy makes him crave food or the alcoholic to believe that he drinks because he is allergic to grain products, and therefore craves them, is more emotionally acceptable than facing the facts. Other patients who are dissatisfied with the opinions rendered by physicians who espouse a scientific approach to diagnosis and treatment will seek healers who provide explanations more to the patients' liking and which fulfill their psychologic needs. Since patients seem to be satisfied by the treatment that they receive from "Clinical Ecologists," and indeed they (or their insurance carriers) are willing to pay large sums of money for the care, how are they BUFFAID (PHYSICIAN! harmed? If one is not concerned that the theories underlying "Clinical Ecologists'" treatment have no factual basis and that the treatment is ineffective, there are yet other concerns. First, the restrictions placed upon the patient's life and those around him are considerable. Some of these unfortunate individuals are virtually hermits, and visitors to their dwellings must take extraordinary precautions (wearing only cotton clothing doubly washed in Ivory soap and "Food allergies have been implicated in the etiology of hyperactivit) but in this instance also there is little evidence to support the hypothesis. . .." 1 soaked in baking soda; hair shampooed with herbal shampoo prior to the visit; no plastics, deodorants, perfumes, or shaving lotions allowed; and shoes left outside the door). Second, children who are misdiagnosed as being "allergic" or otherwise adversely affected by foods or food additives have severe dietary restrictions imposed upon them and are prone to develop neurotic attitudes about foods as they get older. Third, patients' lives are diverted in a totally non-productive way that does not permit them to enter or continue in the mainstream of social and occupational life. For example the great majority of individuals who claim to suffer from "20th Century Syndrome" are unable to work and are seeking Workmen's Compensation for "industrial illness." Fourth, individuals who carry out antisocial activities are able to avoid responsibility for their actions by claiming "it was not their fault" and a food reaction was to blame. Fifth, there are serious ethical considerations involved in introducing treatments before they have been proven 02186 27 �28 to be safe and effective. Some would regard this as human experimentation, without proper safeguards. Sixth, the public is forced to pay for unnecessary increases in utility construction costs, e.g. erecting wind barricades to "protect" the home of a person with a "20th Century Syndrome" from dust stirred up during a small sewer project and neighbors denied sewer service (an actual case in Buffalo). Finally, at a time of increasing concern about health care costs, large sums of money are being wasted on the "Clinical Ecologists' " exorbitantly expensive diagnostic and treatment regimens. (Dr Ellis IS chief. Allergy/Immunology Dtvrs10n. Children's Hospital and is the new presrdent of the Amencan Aca demy of Allergy and Immunology. He is the past charrman of the US Department of Pediatrics and rs coeditor of the textbook Allergy· Prrncrples and Practice.) (Due to space limitations, bibliographic references have been condensed using Lancet's former style. To obtain complete bibliography, contact the editor of this magazine). REFERENCES Brodsky, C.M. Psychosomatics, 1983, 24, 731-742. 2. Randolph, T.G. and Moss, R.W. An Alternative Approach to Allergies: The New Field of Clmical Ecology Unravels the EnvlronI. memal Causes of Mental and Physical Ills. N.Y., NY, lippincott & Cromwell, 19 3. Loveless, M.H. ). Allergy, 1950, 21; 500-509. 4. N. Cousins. Saturday Review, 1977, 10, I. 5. Laetrile: The Commissioner's Decision. H.E.W. Publication No. 77-3056, 1978, p. xii. 6. American Academy of Allergy: Positton StatememsComroversial Techniques. J. Allergy Chn. lmmunol., 1981, 67: 333-338. 7. Report from National Center for Health Care Technology. ).A.M.A., 1981, 246, 1499. 8. Moller, ).B. Ann. Allergy, 1977, 38, 185-191. 9. Voell, P.: Allergic to Everything. Buffalo News, Section D, pp. 1-2, Sept. 24, 1984. 10. Allergy Sufferer is Seekmg co Cheat Death. Buffalo News, july 3, 1984. II. Brody, J.: Clm1cal Ecology: Uncertain Quam1ty. Ne\v York Times, Secuon C, pp. I & 8, Jan. 2, 1985. 12. Terr, A.l.: •Env1ronmemal Illness•: A Clinical Rev1ew of Fifty Cases. Ann. lmern. Med. Accepted for Publicauon. 13. Monson, R.A., Smorh, Jr., GR. N. Engl. ). Med., 1983, 308, 1464-1465. 14. Diagnostic and Statistical Manual ofMemal D1sorders. 13th Edition. Washington, D.C., Amer. Psychiatric Assoc., 1980, pp. 241-252. 15. Strauss, S.E., Tosato, G. Ann. lmern. Med., 1985, 102, i-16. 16. Gray, G.E.: Diet, Crime, and Delinquency: A Critique. Nutr. Rev. (Suppl). In press, 1985. 17. The National Adv1sory Commmee on Hyperkinesis and Food Addiuve. Final Report co the utmion fi:>undation. 18. Gneco, M.H. ).A.M.A., 1982, 247, 3106-3111. 19. Van Metre, Jr., T.E. Pediatr. Chn. N.A., 1983, 30, 807-817. TABLE I COMMON CHARACTERISTICS OF VARIOUS CURE MOVEMENTS The proponents don the mantle of science while at the same time traducing the reputable scientists of their day; They claim that prejudice of organized medicine hinders their efforts; They cite examples of physicians and scientists of the past who were forced to fight the rigid dogma of their day; They rely heavily on testimonials and anecdotes as evidence that their remedy is safe and effective; They do not use regular channels of communications, such as journals, for reporting scientific information, but rely instead on the mass media and word of mouth; Their chief supporters are not people trained or experienced in treating the disease or in scientific methodology; They offer a simplistic theory for causation of disease; Their remedy is easy and pleasant, compared with the frightening therapies wielded by orthodox physicians; They claim the mode of administration of a drug and the method of treatment can be learned only from them. Laetrile. The Commissioner's Decision. H.E.W. Publication No. 77-3056, 1978, p. xii. 02186 BUFFAID I PHYSICIAN I �29 MEDICAL SCilOC)L EW DEAN VISITS CHINA 1D REINFORCE THE UB CONNECTION . BY BRUCE S. KERSHNER T The Fifth Family Weekend last October was the most well attended to date, with over 600 participating, including 369 famil) members and guests. (Clockwise from top) Second )ear medical student Ann Levine (far right) cont•ersing with her mother (far left), u:hile children and wife of second )"ear student Richard ]unke play around table. 2nd )ear medical student Gail Pleban (far right) enjO)mg activities with her fiance, mother, and aunt (sitting). Wendy Zimmer and other students on Farber Hall steps. he "Chinese Connection" to the UB Medical School has been further reinforced by a personal visit to China by the school's highest officer. During the last two weeks of September 1985, Vice President John Naughton, dean of the Medical School, was a guest of Beijing Second Medical College and Kunming Medical College in southwest China. The goal of the visit, aughton's first to China, was to ·expand the University's formal agreement with China's major educational system to include the UB Medical School. The original agreement, signed in 1981 (after two years of negotiations) by former President Robert Ketter and renewed in 1984 by President Steven Sample, provides for four programs: exchange of scholars; fellowships for visiting graduate students; joint research; and exchange of publications. The agreement also stipulates that the Beijing System is not to enter into an extensive collaborative effort with any other U.S. university. Although over a dozen UB departments or schools so far have participated with China under the University-wide agreement, the Medical School's involvement has included only visits by Chinese faculty in pathology, physiology, and immunology. The purpose of Dr. aughton's visit was to discuss expanding the program to include more frequent medical scholar exchanges, including having medical professors visit China, training programs here for Chinese researchers, and collaboration in research, especially oncology. The results of the meetings with the Chinese officials will be discussed with President Sample to prepare and finalize an agreement later this year. BUFFAID fPHYSICIANi One Medical School department, Nuclear Medicine, already has an independent ongoing exchange agreement with Beijing Normal University, signed in 1983 (see Buffalo Physician, May '84, and July '85). UB's School of Management also has an agreement independent from the University-wide agreement. Accompanied by his wife, Margaret, Dr. Naughton toured Beijing Second Medical College and other Beijing sites such as Red Square, the Summer and Winter Palaces, and the Ming Tombs. They also visited the Great Wall, the Terra Cotta Men near Xien and in southwest China near Burma, Kunming Medical College, and the Forest of Rocks. "Their education system is so different. They have five-year medical colleges combining both undergraduate and medical students. Students have severe competition. Only one-fourth of all Chinese applicants are admitted and there are only 59 medical schools, each with 500 students per class; Dr. Naughton comments. UB's medical classes average 135. Another difference "is that China puts out mostly generalists, few medical specialists. Also, its research programs are just beginning, but I'm glad to say, also rapidly improving; he adds. Regarding the rest of that vast country, Dean aughton was impressed with the friendly, proWestern attitude. Also, while the Chinese still struggle economically, food production is quite adequate and a certain amount of capitalism is appearing, especially a free market in farming. "However, people still live in austerity, and transportation and housing are still problems. The country is clearly in transition from old to new." That transition, it appears, will be boosted by the Medical School's efforts, as we benefit • from their cooperation. 02/86 �30 MEDICAL SCHOOL '"TEWS Exercise benefits cardiac patients BY BRUCE S. KERSH ER R egularly performed physical activity benefits cardiac patients by improving their physical working capacity and sense of well being and by decreasing the demands on the myocardium at rest and low levels of exertion. These findings, initially reported in non-controlled studies of myocardial infarction patients, were confirmed by a randomized trial directed nationally by John Naughton, M.D., vice president for clinical affairs, dean of the School of Medicine. The National Exercise and Heart Disease Project (NEHDP) was initially funded in 1972 by the Rehabilitation Services Administration while Dr. Naughton served at George Washington University's School of Medicine as director of the RSA-sponsored Regional Rehabilitation Research and Training Center. When he became dean of UB's School of Medicine in 1975, Buffalo became the administrative center of the study. Other collaborating centers included Case Western Reserve School of Medicine (Dr. Herman D. Hellerstein), University of Alabama (Dr. Albert Oberman), Emory University (Dr. Charles Gilbert), and Lankenau Hospital, Philadelphia (Dr. Alan Barry). The study recruited 651 male patients each of whom was followed for at least three years. Actual intervention was terminated on December, 1980, and reports have been forthcoming from the investigators since the summer of 1981. Dean aughton and his collaborators have been proud of this scientific effort, because it "represents the most comprehensive study of a group of myocardial infarction patients who were treated with exercise intervention." Almost half of the 651 patients, 323, were randomly assigned to an exercise regimen and the other 228 were assigned to a control group. All patients were followed in the same manner for three years. Almost twenty per cent of the patients had recovered from two or more heart attacks. The national project served to confirm that 02/86 graded exercise testing as well as regularly supervised and prescribed exercise could be performed safely. "There were no serious complications with either the testing procedure employed to evaluate a patient's progress or in the actual physical activity programs," Dean aughton reported. The study demonstrated that regularly performed physical activity enhanced physical working capacity, and resulted in statistically significant decreased plasma triglycerides, resting diastolic blood pressure, and body fat content. There were some areas of disappointment for the investigators. For example, on the question of longevity, there was good news and bad news. The good news was that the mortality rate was 37 per cent lower in the training cardiac patients than in the sedentary patients. Unfortunately, although a very promising finding, the difference did not achieve statistical significance. Thus, the results must be interpreted conservatively since the "case for exercise is either proved nor disproved" on this matter. "Had we been able to study more patients in the same manner, perhaps 1400 to 1500 patients instead of 651, this question probably could have been resolved once and for all," Dean Naughton stated. "The agency simply wasn't able to provide sufficient funding to perform the definitive study; we may have lost a unique opportunity forever." The $5 to $6 million funding for the study, begun in 1972, would not be much compared to a new and more comprehensive study. Another area that probably disappointed many exercise enthusiasts is that related to the effects of exercise on high density lipoprotein cholesterol, HDLC. Dr. John LaRosa of George Washington University conducted this part of the study. The results indicated that neither plasma cholesterol nor HDLC levels were affected by the physical activity regimen. It would appear that their indices must be treated primarily with diet or some other form of intervention. Dr. aughton and his fellow investigators learned that patients with and without exerciseinduced abnormalities such as abnormal ST segment changes on the electrocardiogram and low thresholds of work capacity also benefited BUFFAID !PHYSICIAN I from exercise intervention. One subgroup that did not benefit was the group of patients with a low peak systolic blood pressure response. "These patients' heart muscles may simply have been too diseased and compromised before the study began," Dean aughton commented. Dr. Naughton is on the executive committee of the Council of Deans of the Association of American Medical Colleges (AAMC). He is also president of the Association of Medical Schools of New York. An internationally known cardiologist, Dr. Naughton is an author of 110 scientific publications and has served on the President's Council on Physical Fitness' medical advisory committee and was president of the Western ew York Heart Association. He is a member of the American Medical Association, American College of Physicians, the Medical Society of ew York and the American College of Sports Medicine, among others. Dean aughton, in reflecting back on this research experience, was pleased with the scientific soundness of the study and with the compliance and commitment of the investigators and patients. Hopefully, an opportunity to further explore the_effects of exercise in longevity will arise in the future. • Flavonoids are conference topic Y ou may have never heard of the flavonoids or know that your daily diet contains about one gram of these plant chemicals. You may also have been unaware that these chemicals may be very important to human health because of their anti-inflammatory, antiallergic, antiviral, anticarcinogenic, and antitoxic effects. These fascinating substances were the focus of the first interdisciplinary and international meeting of its kind ever to be held in the U.S. Two UB medical scientists, Dr. Vivian Cody of the Medical Foundation of Buffalo, a research associate professor of medicine, and Dr. Elliott Middleton, UB professor of medicine anp pediatrics and director of the Allergy �31 1EDIC AI CHC )()[ ~\\1 Students promote blood donations BY BRUCE S. KERSHNER ' Med students offer good example at blood drive. Division; and a British plant chemist, Dr. Jeffrey Harbourne, organized an international meeting on Flavonoids in Biology and Medicine held at Buffalo's Hilton Hotel July 22-26, 1985. The conference highlighted the many aspects of how flavonoids may work in affecting health of humans and animals. The flavonoids are present in fruits, vegetables, grains, nuts, stems, leaves, flowers, and wine. There are about 2,000 of them in the vegetable kingdom, and they are important chemicals for normal plant growth, development, and defense against infection and injury. Flavonoids also determine taste in many fruits and vegetables and even control plant resistance to insects, a subject discussed by Dr. !sao Kubo from Berkeley. Thirty-five other researchers (including Drs. Cody and Middleton) from the U.S., England, Germany, France, Israel, Hungary, Switzerland and Japan presented reviews of their research on the origins and nature of flavonoids and their effect on body chemistry and cell function. Reactions to allergens, viruses, and cancer that may be affected by the flavonoids and their importance as health-related dietary substances were discussed. Some 125 researchers from many countries were in attendance and many presented results of their work in poster sessions. The relationship of diet to health has long fascinated mankind and continues to be a major focus of research. While quite a lot is understood about dietary fats, carbohydrates, proteins, vitamins, and fiber, relatively little is known about the health effects of many low molecular weight substances such as the flavonoids found in plant foods. Over several decades of investigation, flavonoids have also been shown to cause a remarkable array of biochemical and physiological effects in mammalian cell systems, strongly suggesting that there may be an important plant flavonoid-animal cell interaction which has evolved throughout the long relationship of plants and animals. It seems possible the ubiquitous dietary flavonoids may be important in the regulation of mammalian cell function through dietary intake (and uptake into cell membranes), and that they may possibly act as natural biologic response modifiers. Some flavonoids are known to be absorbed from the gastrointestinal tract of animals and to distribute into various tissues, but much remains to be learned about the pharmacokinetics of flavonoids in man. • BUFFAID (PHYSICIAN! ' w e figured that we, as medical smdents, would demonstrate to the community that there is no reason to be afraid to donate blood; Eddie Phillips, second year medical student and president of UB's chapter of the American Medical Student Association, states. "There's been a serious drop in blood supplies because people think they might get AIDS by donating. That's just false." So he and UB's chapter of the American Medical Student Association organized to contribute to the Red Cross' campus blood drive from October 7-9. Participation rates were at an unusual 40 per cent. After students with colds, high blood pressure, and other problems were screened out, 211 units of blood were contributed campus-wide, with 70 of those units from medical students. Because of the explosion of publicity and fear about AIDS, the public has unfortunately reduced its contribution of the blood that area hospitals so desperately depend on. This situation especially worsened with the disclosure that AIDS-contaminated donated blood had transmitted the disease to unsuspecting people. Phillips hopes the students' action will contribute in correcting the public's misconception that donors of blood can get AIDS. With the success of this year's first organized effort by the medical students, Mr. Phillips has proposed that a national campaign be adopted by the American Medical Student Association. He made the proposal at its fall national meeting. The organization has 32,000 members, with several hundred at UB. • 02/86 �32 v; g ~ L_~~~------_A~~A-~~----------------------------~~~------~~~--~~ ' 'M Doctor &DJ onday is usually a busy day for pediatricians; says Dr. Richard Judelsohn. "Mothers have been dealing with their kids' problems all weekend, and it seems they all come into the office on Monday." He pauses and adds, "For me, it's good the show is on Monday nights." Dr. Judelsohn is not talking about football. The show he refers to is the jazz radio program he has hosted for the past 10 years. "Modern Jazz; The First Twenty Years" airs Mondays from 8-9 p.m. on WBFO-FM 88, UB's public radio service. Patient and softspoken, with a quiet manner and business suit, Richard Judelsohn is the quintessential image of a pediatrician. Being a physician with two offices would keep most doctors occupied most of the time. Being a radio host with the responsibility of preparing and running a show would keep most disc jockeys busy 02/ 86 BY VALERIE BINIO BIEBUYCK most of the time. And being Communicable Disease Control Officer for Erie County Health Department sounds like a full-time job in itself. Yet Richard Judelsohn does all three. "I spend two-thirds of my professional time in my offices delivering primary care, and one-third as medical director for pediatrics at the Erie County Health Department," he explains. Depending on the show's topic, Judelsohn volunteers between two and 20 hours a week to preparing for his radio program. His dual roles as doctor and D.J. can be traced to the influence of his parents: his mother was a music teacher and his father a pediatrician. At the age of 13, Judelsohn BUFFAID I PHYSICIAN I began studying saxophone, and took up jazz in a program at Buffalds Bennett High School. "Through those years, I was interested in jazz as a player and a fan; remembers Judelsohn. "At Union College, I got into broadcasting. As a freshman, I had a jazz program and I maintained it for all four years." For a time, the future physician considered broadcasting as a career, but ultimately decided that "the personal rewards of dealing with human health were greater:' Adds Judelsohn, "I think my father, who is not a musician, would have been upset if I'd chosen music over medicine. His life really was medicine. He was singleminded in his devotion to it." Upon entering medical school here in 1963, Judelsohn began a dozen years' hiatus from jazz broadcasting, but not solely because of the demands of his education. �33 Explains Judelsohn, "Jazz was at its nadir in the '60s. There was little work in the field then. Concurrent with my beginning medical school, there was a change in nonclassical music. Rock music had been just fun, party music which no one really took seriously. Then during the 1960s, rock music began to convey a message, and jazz went downhill." During the Vietnam War, Judelsohn satisfied his military requirement with the U.S. Public Health Service at the Center for Disease Control (CDC) in Atlanta. His work in the immunization division there led him to travel throughout the United States to implement vaccination programs. "I remember 20 of us going to Idaho and vaccinating all the children in the state against rubella in one week;' he says. His two-year experience at the CDC left a lasting impression on him. He says, "I learned a lot about communicable diseases there. When I came back to Buffalo, I didn't want to work just in private practice. I wanted to work in public health, as well. Luckily, there was an opening at the Erie County Health Department." W hen he returned to Buffalo, Judelsohn joined his father's pediatric practice and shortly thereafter, a third partner joined. According to Judelsohn, "With three people handling the practice, I wanted to get back into jazz. Then one day in 1976, I was invited to be interviewed by WBFO on immunization. After the interview, I asked the show's host to take me around the station. Seeing how interested I was, she asked, 'Would you like to go on the air again?' and I said, 'Sure!' ". A revamping of WBFO's jazz programming had created the opportunity for which Judelsohn was waiting. Although he was nervous about going on the air after his 12-year absence, Judelsohn says that feeling was quickly dispelled. He adds, "I find it very relaxing to Dr. Judelsohn in WBFO control room. sit in the dark control room by myself and just listen to the music." But Judelsohn does much more than just sit and listen. He selects the records, operates all the controls, and most importantly, he teaches. He explains, "O~e of my primary responsibilities is to teach about the music-the history of jazz, the artists, and their contributions." Although he has a loyal following of listeners, Judelsohn does not count his wife and two teen-aged children among them. "They can hear me talk at home," he says, laughing. Judelsohn has no plans to retire from broadcasting in the near future, and the recent interest in reissues of old recordings has provided him with a plethora of new material. He explains, "When I first started, the station had about 3,000 jazz records. Since the show is limited to jazz music of the years 1945-65, I could only play one-third of those. Today we have literally thousands of records which are prior to 1965. The reissue is a windfall:' About forty per cent of the records he plays on the air are from his private collection. The two roles of Dr. Judelsohn often mix and complement each other. He frequents Buffalds Tralfamadore Cafe, which features jazz music, and is often called on by the management to treat visiting artists. In addition, his experience on radio and his position at the Health Department make him an obvious contact when the local news media report on health issues. During the past ten years, he has been interviewed on radio and television more than 100 times. But jazz and pediatrics complement each other in Dr. Judelsohn's approach to his BUFFAID I•PHVSICIANI professional work, as well. According to him, "Jazz itself is largely improvisation, and broadcasting involves a lot of that, too. The type of medicine I practice allows for some element of that. I wouldn't recommend it to a surgeon, but for pediatrics and preventive medicine, improvising the message I'm trying to get ;:~cross sometimes helps." Dr. Judelsohn also feels that the creativity of his work in jazz enhances his practice. "Jazz involves a lot of creativity," he says. "I like to think that my programming is creative, and I like to think that my practice is creative-individually tailored to the needs of each patient." Although Dr. Judelsohn's life is decidedly busy, it is also remarkably balanced. He works hard, but his decision not to push himself beyond his limit is evident in his relaxed demeanor and the sense of personal calm he conveys. "If I wanted to be in a two-person practice I'd make more money but I'd have to work a lot harder. I'd have less time to spend with my family." In addition, Judelsohn wants time to teach UB medical students in his capacity as clinical associate professor of pediatrics. He returned to Buffalo after an internship and residency at Cornell Medical Center in ew York City in part because, "I wanted the opportunity to be involved in medical education at a fine school. I enjoy the faculty responsibility." Judelsohn believes his approach to work and leisure will avert the potential problem of physician "burn-out," common in the high-pressure practice of pediatrics. Says Judelsohn, "There is a fair amount of career change in this field. I think I've set up a very good mechanism to avoid that, with a group practice in two offices, my public health work, and my once-a-week avocation." (Ms. Biebuyck IS a free lance wnter lnteresln-,gly, her husband Jean Chnstophe and her twin brother David ore UB medical students. and her ~ster is on anesthesiologiSt at Cornell.) 02/86 �34 PEC)PLE Margaret Heckler, former secretary of Health and Human Services, appointed Dr. Evan Calkins as one of five new members of the ational Advisory Council on Aging. The appointment of the chief of UB's Division of Geriatrics/ Gerontology was announced by T. Franklin Williams, director of the ational Institute of Aging which supports research and research training on the aging process, diseases, and other special problems which affect the aged. Calkins, who has been with UB since 1961, is the co-founder of one of four Geriatric Education Centers funded nationally. He received the M.D. from Harvard Medical School m 1945. Former chairman of the Department of Medicine at UB, Calkins has research interests in arthritis as well as in treatment and research of conditions which particularly affect the elderly. • Dr. Raymond M. Baker, associate research professor of pharmacology, received a $95,008 grant from the ational Cancer Institute to investigate the molecular basis for drug resistance in tumors. • Dr. Venkataraman Balu, clinical associate professor of medicine and staff cardiologist at V.A. Medical Center, presented a paper entitled, "Is Ischemia a Major Factor Affecting Exercise Performance in Patients with Compromised Lefr Ventricular Function?" at the 12th !nteramerican Conference of Cardiology in Vancouver, Canada, on June 18. Approved for publication is his other paper, "Stress Test Evaluation of Patients Following Coronary Artery Bypass Surgery," an abstract for the International Symposium on Cardiovascular Surgery 1985 and the 15th annual Symposium of the Texas Heart Institute, Houston, Texas. • Dr. Marek B. Zaleski, professor of microbiology, has been awarded an $8,000 grant to undertake a scholarly translation of Rev. Jozef Tischner's Polish Form Of Dialogue. Zaleski was co-translator with Rev. Benjamin Fiore, S.J., of Canisius College, of Tischner's The Spirit of Solidarity, which was published in 1983 by Harper & Row. • 02/ 86 Dr. Alexander Bloch, research professor of pharmacology, received a $142,909 grant from the National Cancer Institute to study chemodifferentiation as an approach to cancer therapy. • Stuart Keill Dr. Tin Han, research professor of medicine and associate chief cancer research clinician at Roswell Park Memorial Institute, is one of the new members of the Board of Planned Parenthood of Buffalo and Erie County, Inc. • Dr. Stuart L. Keill, clinical professor of psychiatry, was elected president of the American Association of General Hospital Psychiatrists at their annual meeting in Dallas. The chief of psychiatry service at VA Medical Center will serve for two years. • professor of family medicine and medical director of Health Care Plan of Western ew York, has been elected chairman of the Medical Director's Division, Group Health Association of America, Inc. • Dr. S. Subramanian, professor of surgery, is D r. Enrico Mihich, research professor of the recipient of the 1985 Myrtle Wreath Award in Medicine "in recognition of great medical skills affecting the lives of children from all over the world, and for his excellent teaching and humanitarian efforts." The award was presented on Sept. 21 at the meeting of the international Jewish Women's organization Hadassah at the Amherst Jewish Center. Dr. Subramanian is also chief of the division of cardiovascular surgery at Children's Hospital, chief of cardiac surgery at ECMC, and associate attending surgeon at Buffalo General and VA hospitals. • pharmacology and director of experimental therapeutics at the Grace Cancer Drug Center at Roswell Park, co-chaired two symposia at the Third International Conference on lmmunopharmacology in Rorence, Italy, in May. • Dr. Gerald Sufrin, professor and chairman of urology, has been appointed to the Program Committee of the American Urological Association. The Program Committee is responsible for reviewing manuscripts submitted for consideration for presentation at the annual meeting of the American Urological Association. • Dr. Emanuel Lebenthal, professor of pediatrics and also head of the Department of Gastroenterology at Children's Hospital, chaired an international symposium concerning infant nutrition and gastrointestinal diseases in Brussels, Belgium, in late August. He is also director of the International Institute of Infant utrition and Gastrointestinal Diseases at Children's Hospital, which just officially opened. • BUFFAID I PHYSICIAN I Dr. Edward J. Marine, clinical associate Dr. John R. Subjeck, research associate professor of radiology at Roswell Park, was awarded a $89,809 grant from the ational Cancer Institute to study stress proteins, drug tolerance, and cellular deprivation. • Dr. Richard E. Bettigole, professor of pathology, has been named chairman of the Upstate Region of the Inspection and Accreditation Program of the American Association of Blood Banks. Dr. Bettigole is director of the Blood Bank and Hematology Division of the Erie County Laboratory. • Dr. Eugene R. Mindell, professor and chairman of orthopaedic surgery, was selected to represent his profession in JAMA's annual special issue, Contempo '85, that reviews the preceding year's new developments in every medical specialty. Dr. Mindel! authored the update (October 25, 1985) on orthopaedic surgery, focusing on, among other items, the use of the arthroscope to preserve intra-articular knee structures, and a new technique utilizing roughsurfaced prostheses with sintered wire mesh and beads which promises to provide long-lasting, secure £ixation without using bone cement. • �35 CLASSNOTES Milford Maloney 1940's Eric Russell 1960's Arthur J. Schaefer (M'47) • Francis J. Klocke (M'60) • was clinical associate professor of otolaryngology and ophthalmology, lectured at the symposium on current techniques in eyelid and lacrimal surgery at the University of Medicine and Dentistry of New Jersey Medical School. Dr. Schaefer also presented a lecture on practical eyelid surgery at a seminar sponsored by the New York Eye and Ear Infirmary Post Graduate Institute. recently selected to serve as president-elect of the American College of Cardiology, a highly prestigious and visible national position. He is also serving as chairman of the Safety and Data Monitoring Committee for the Multi-Center "TIM!" study. "TIM!" stands for Thrombolysis in (acute) Myocardial Infections which uses tPA as the lytic agent. Dr. Klocke is presently professor of medicine and physiology at UB and chief of cardiology at Erie County Medical Center. 1950's Dr. Milford Maloney (M'53) • clinical professor of medicine, once again established a gold medal record in swimming at the New York State Empire Games, held last summer at UB. Dr. Maloney bettered his own meet record of 31.68 seconds set in the men's 50 meter freestyle (55-59 age group) in 1982 with a 31.57 mark. He is chairman of medicine at Mercy Hospital, Buffalo. David Pittman (M'64) • published an article on Dressler's Syndrome in the March 1985 Resident and Staff Physician. He also served as program director for a symposium entitled "Technical Aspects of Optimum Cineangiographic Imaging': April19 and 20, in Pittsburgh. He is an assistant clinical professor of medicine at the University of Pittsburgh and an associate director of Allegheny General Hospital's Cardiovascular Laboratory. Dr. Pittman is a Fellow in The American College of Cardiology, the Society of Cardiac Angiography, the American College of Angiology, and the American College of Physicians. Michael Rowland August J.D . D 'Alessandro (M'65) • is medical director of Catholic Family Services of Danbury and Meriden, Connecticut. He is also a consultant psychiatrist to the Youth Services (Counse\ing League) of White Plains, ew York. His article "The Romanticists and Their Contributions to Psychiatry; appeared in the Psychiatric Quarterly, Spring 1984. Calvin L. Treger (M'67) • ts clinical associate professor of medicine-dermatology at the University of Washington and a member of the Multi-Specialty Polyclinic in Seattle. Dr. Treger is past president of the Seattle Dermatology Society and the SEA Academy of Internal Medicine. RobertS. Baltimore (M'68) • is co-editor of a book entitled Topics in Pediatric Critical Care, published by Yale Journal of Biology and Medicine in 1984. He is author of recently published articles on Pseudomonas infections and indocarditis in children. Dr. Baltimore is an associate professor of pediatrics and epidemiology at Yale University School of Medicine. BUFFAID !PHYSICIAN I Gary Merrill 1970's Eric Russell (M'74) • is an assistant professor of diagnostic radiology at Rush Medical School, Chicago. He is author of 23 articles and four book chapters, and his most recent appeared in the November 1984 issues of Radiology and Neurologic Clinics. He is a member of AOA (UB, 1973), the American Society of Neuroradiology, the American Society of Head and Neck Radiology, and the Chicago and national medical societies. His wife is Sandra Fernback, M.D., an assistant professor of radiology at Northwestern University. Their daughter, Gabrielle, turned three this month. Stephen D . A rnold (M'75) • a specialist in internal medicine, is director of the Hypertension Unit at Straub Hospital, Honolulu, Hawaii. Dr. Arnold is co-investigator of SHEP (Systolic Hypertension in the Elderly Project)-a 17 center study funded by the ational Institutes of Heart, Lung & Blood to assess systolic BP over a five-year course in a double blind study. 02/ 86 �36 CJ.,ASSJ. C)TE Ly nne Hochberg Pace (M' 75) • is chief of the ophthalmology section at Buffalo Veterans Administration Center and clinical assistant professor of ophthalmology at UB. Dr. Pace's third son was born in March 1985. Michael C . Row land (M' 75) • was elected to a three-year term as secretary-treasurer of the North Carolina Chapter of the American College of Surgeons. Dr. Rowland, who is a general surgeon in Pinehurst, North Carolina, is the 1985 representative from the orth Carolina Chapter to the Young Surgeons Meeting in Chicago. Michael R. B ye (M ' 76) • writes, "As of July I, 1985, I have assumed the position of director of pediatric pulmonary medicine, and assistant professor of pediatrics, for the Albert Einstein College of Medicine of Yeshiva University." Gar y Alexander Merrill (M ' 78) • who was named "Man of the Year" in Arkansas in 1984, announces that he has moved on to make his mark in another state. He is now with the Orange County, CA Health Care Agency, juvenile Health Services. His new address is 331 City Drive South, Orange, CA 92668. (See photo on prev ious page.) Bruce D . Rodgers (M ' 79) • is joining the division of maternal and fetal medicine at Buffalo Children's Hospital. Dr. Rodgers, who is an assistant professor of obstetrics and gynecology at UB, was elected chairman of District II, Junior Fellows, American College of Obstetricians and Gynecologists. 02/ 86 Robe r t J. Rose (M'7 9 ) • writes that he has moved to Mariposa, California, to open a private practice in family medicine with his wife Carolyn J. Rose, M.D. He is director of Emergency Service and chief of Medical Staff at a hospital in Mariposa. Ste phen B e nham (M'80 ) • informs us, "Have designed my own examination tables. Photos will be sent if requested. Makes the office look more like a comfy, home-like atmosphere." Dr. Benham, who is practicing family medicine, has an office at 3 Pearl Street, West Sidney, New York 13838. Chri s topher M . Rig s b y (M'80) • has been appointed assistant professor of medicine in the Department of Diagnostic Radiology at Yale University. He recently completed a fellowship in computer tomography, ultrasound and MR. Anthony S. Unge r (M'8 0) • of Roslyn Heights, .Y., has a fellowship in arthritis surgery at the Hospital For Special Surgery. Dr. Unger is a clinical instructor at Cornell Medical College. Douglas Pleskow (M ' 8 2) • writes "My wife (Randi Gordon Pleskow M'82) and I have just recently completed our residency training at Case Western Reserve University in pediatrics and medicine, respectively. We have moved to the Boston area to start our fellowships. Randi is in a combined fellowship in gastroenterology and nutrition at Boston Children's Hospital and Massachusetts General Hospital. I am doing a fellowship in gastroen- terology at Massachusetts G eneral H ospital. K evin Scott Ferentz (M'83) • writes "I have been selected ch ief resident for this year. I am finishing up my term as vice president o f the M aryland C o nference of Family Practice Residents. I am o ne of 30 residents natio nwide to h ave been selected to attend a three-day workshop o n undergraduate medical educatio n sponsored by AAMC, to be held in Washington, D.C. in September (and I miss Buffalo!)." 49TH ANNUAL ALUMNI SPRI G CLINICAL DAY Recent Advances in Osteo po rosis Pain Control and AIDS Saturday, May 10, 1986 Buffalo Marriott Inn 8:00 a.m. - 1:00 p.m. Advances in AIDS, Bernard Poiesz, M.D., associate professor of medicine, Chief, Section of O ncology, Upstate Medical Center. Advances in Osteoporosis, Robert P. Heaney, M.D., John E. Creighton, Professor, Creighton School of Medicme, Omaha, NE. Advances in Pain Control, Dr. Jennifer Kre1gler, M.D. (M'76), Director, Pain Center, Dept. of Neurology, University Hospital, Cleveland, OH. Spnng Clinical Day Exhibits Program 1:00 p.m. Stockton Kimball Memorial Luncheon and Lecture: Med1cme m China, George Hatem (Ma Ha1 Teh), M.D., renowned Buffalo-born physician and advisor to Chou En-Lai and People's Republic of Chma smce 1936. Saturday Evening: Reu mons fo r classes of 1936, '41, '46, '51, '56, '61, '66, '71, 76. Contact Medical Alumm Office (716) 831-277 for mformation. O ne of the most fascinating physicians living today will be the keynote speaker fo r t his year's major medical alumm event, Spring Clinical Day Program, May 10, 1986. Dr. George Hatem, or Ma Hai Teh in Chinese, has served as the physician and close advisor ro Chou En-La1 , the People's Republic of China and the Red Army since !936. The native of Buffalo is noted for his hisrorical role in eradicating venereal disease m that populous country, as well as helping to establish programs to eliminate the prostitution that spread it. He also helped initiate and administer the program that vi rtua ll y rooted out opium addiction. With anginal training as a dermatologist, he became a generalist who helped to vastly upgrade the pnmary medical care system of C hina now comparable to many developed countries. Eradicating leprosy has been a more recent project of his. Born in Buffalo In !910, he earned his M.D. from University of Geneva In !934. Two yea rs later, the Maronite Lebanese·American settled in Shanghai to assist the police force in treatmg venereal disease and prostitutes. He ts one of the few western· ers who have observed the decades of war, marches, revolution and great progress of China. His rich experience over three and a half decades will be shared with the UB medical community in his add ress at the Buffalo Marnott Inn as the Stockton Ktmba ll Lecturer. See announcemen t above for other details of the event. BUFFAID !PHYSIC Margaret Kadree (M'83) • presently doi ng her residency in intern al medi cine at Howard U niversity, has been voted outstanding resident and will be chief resident in intern al med icine. This is considered a rare ho nor in such a short period of time for this specialty. While at UB, she received the Dea n's Award. I AN! �JAR • World-acclaimed cardiac surgeon George Schimert, M.D. will be honored April 25, 1986 at Buffalo General Hospital with a tribute and ribbon-cutting ceremony for the Angiology Department and Cardiac Surgery Division, which open their fresh quarters in the new 16-story medical tower. Dr. Schimert advanced cardiology by devising the multivalvular replacement and prosthetic heart valves and two coronary bypass techniques, the free intermammary artery graft and induced hypothermia of the heart. The 65-year-old former chief of cardiac surgery at BGH will also be named UB emeritus professor of surgery. Famed heart transplant surgeon Norman Shumway, M.D. of Stanford University will be the keynote speaker for the event, which will include a Scientific Symposium from 9 a.m. to 3 p.m., the tribute at 3" p.m. and banquet at 6:30 p.m. UB speakers are to include Drs. John aughton, Lewis Flint and Thomas Lajos. For more information, contact Marmie Houchens, 845-2041. • The Sarasota N ational Confe rence on Pediatric Lung D isease. March 14-16, 1986. Sarasota Hyatt House, Sarasota, Fl. Credit Hours: 20. Fees: $325 Physicians in Practice, $175 Allied Health Professionals. Contact: Rayna Saville, Coordinator, Pediatric C.M.E., Children's Hospital, 219 Bryant Street, Buffalo, New York 14222. Telephone (collect): 716-878-7630. • Pediatric Continuing Med· ical Education Programs • The Sheraton Bal Harbour Conference on Pediatrics, Feb. 28-March 2, 1986. Sheraton Bal Harbour, Bal Harbour, Fl. Credit Hours: 18. Fees: $275 Physicians in Practice, $175 Allied Health Professionals. • Biochemistry Conference • "Workshop on Membrane Transport." March 7, 1986, UB Center for Tomorrow. Contact Dr. Philip Yeagle, Dept. of Biochemistry 23 Farber Hall, SUNY Buffalo, (716) 831-2700. ------------------------------------------------------------------111111 BUSINESS REPLY MAIL FIRST CLASS PERMIT NO. 2210 BUFFALO. NY. POSTAGE WILL BE PAID BY ADDRESSEE BUFFAID c P H Y S A N 139 Cary Hall State University of New York at Buffalo Buffalo, New York 14214-9980 NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES �BUFFAID P H Y S c A N State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 ALf A ~~~ ER Fk P~ J I CHE rc;TPY 102 C Y ALL c ---------------------l--Liius-HEARFio~vC>u_] ____________________ _ Fill out this card (Please print or type all entries) Name ________________________________________________________ Year MD Received _____________ Office Address _______________________________________________________________________________ Home Address _______________________________________________________________________________ If not UB, MD received from --------------------------------------------------------------------In Private Practice: Yes 0 In Academic Medicine: No 0 Yes 0 Specialty _____________________________________________________ No 0 Part Time 0 Full Time 0 School _____________________________________ Title --------------------------------------- Other: ______________________________________________________________________________________ Medical Socie~ Memberships ________________________________________________________________~ News: Have you changed positions, published been involved in civic activities, had honors bestowed, etc? _____________ Please send copies of any publications, research or other original work, also include a photo of yourself. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, February 1986 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1986-February Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1986-v19n05-Feb Table Of Contents A list of subunits of the resource. Nobel Laureate Hermann Rahn Forum Medical School News People Classnotes Calendar Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-16 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v19n05 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1986 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/52df62dca4ee62132f73763352eb4e70.pdf e06da1d166fe298b6e1ae71829ea6f07 PDF Text Text �Dean's Messag e D ea r Alu m ni a n d A lu m n ae: he follof 19 S can be charactcmcd as one of transmon for the School of~1edicme. Dr. Felix M1lgrom st'-l'IX'd Jm, n from hi 5 position ns chairman of the Oepanmcnt of Micmb10IQS)',a chair which he hclJ for 17yc:ir . Dr. M1lgmm pn>vtdcd smmg, 1,•(foc• uve, IIClcntfie leadership in the tmdiuon established by hts mentor ond pn.-dccc<-sor, Dr. Ernest \\ 11d,,ky. rortunaccly for the S1:hool, Univer­ sity and Buffalo, he will continue to serve m the role of D1sungu1shcJ Professor and connnuc to c.onmbutc to th..-od\-oncemcnt of knO\, ledge anJ setencc in the years ohcad. My office and the faculty arc 1trntcful to Felix for his dcd1cauon, perseverance and comnbuuons to this msn• tuuon. A ph)ucal transmon occurred this fall\\ hen the new Health Science Library wa$opened. This fine faahty 1slocated m the tcxally rcfurb~ hcd and cnlari;t.-<l old Lx:hood L1br:1rv.Already one of the lcndmg health sciences hbrancs in the U.S., tlus facility should s1gmficantly add 10 the cducauonal and research m1hcu. ln addmon, nC\\ fac1hucs wdl en• rich the library's capacity co meet the needs of the ho pnal •y<tcm and prncnang phys1c1ansin \\esrern ~C\\ 'tork. All 111all, 11 has been o good and productive •eason for faculty •1nd the msmuuon. We look forward to more such enJ0)'3ble cransmons m the years ahead. T - Jo hn Na ugh con, M .D. Medical Alumni Association President's Message n reading t~, \ ~ , · " uc of a nC\\ medical journal called "Humanl' MeJ1cme". A Journal of the Art and Sc,enceof Medr<me, I was impressed by an amcle 1H1ttcn by Dr; Stanley Grebcn, inti· tied "V1cwpomt~ Dr. Grl'hen, \I.ho 1~professor of psylhiatry and psy• chotherapy at the Universtty of Toronto, s:iys: "Even though \\.e choo~ from the most giftedum1.crs1cystudents m Ontario, we con~tontly have evidence of d15appomting personal quolmcs m some of the medical stu· dents, interns, residents, and young phys1cums "ho ha1.e been tram1,..J s:iy they seem to be mu~h in this faculty. Some of the rcpons \\.C recc11.-e more interested in tcchmcal matters, in disease, in procedure;, and in self adva1:c:ementthan they were in p:ments as people, chat they \\ere inconsiderate and Inhumane .• ." I posedthese questions to myself. Is thts happening m our McJ1cal &:hool at our Uni1.1,.TSity? Are we selc.:ung the wrong students for m1,..J• ical school? I suspect our selection procedures ore not at fault, but the envnonrr.cnt and the atutudcs to which we subJect our students and intern< may be. We u;cd to speak about a young doctor's de1.elopmg hts "bed-side manner." We seldom hear that term any more, but Dr. Grehcn points out m hts antclc that there arc two factors m psychotherapy that can help us m the aforemcnuoneJ dilemma: I. W'hothe therap1stldoctor ts and how he or <he bcha1.es. 2. W'hat the chcrnpist/Joctor does. "Panents felt helped \\.hun the thcrapm (or Joctor) had the follow• ing qua\1t1C$:empathetic concern, respectfulness, rehabihcy, self aware· ncss, and strength ..•. The5e arc qunlines we 1ttk m our fnends and hcnre we seek them in those who wall look after us when we arc ill or fear we arc 111.The manner of the physicrnn at the bedside or m the exnmining room i~ of cxcepuonal importance." In spite of the young doctor's fascmauon \\1th the "hard soence " and "hurgcomng tnhmcnl capab1lit1cs; Dr. Grcben rcmmJs us thnc "medicine is and should be seen as o noble profession which has its root< m SCtencebut which 1s at heart 011 art. A lways this mixture of science anJ art will be imperfect and yet will conunue co be a sou rce of comfon, succor and help to troubled and oiling people." I - Charles J Tanner , M ,0 . Clrus of 1943 �B p H y s A C N Or. Felix Milgrom sieps down as chairman of Microbiology a/1er 18 years. Page 15. CONTENTS BREAKTHROUGH IN TRAUMA TREATMENT • Dr. John Border has developed an advance in treatment of severe multiple trauma which could save up to 10,000lives a year-if hospitals would substitute his methods for traditional treatment. KOHL • A lead-contaminated eyeliner poses monumen­ tal health problems for entire popu lations and cultures in the Mid-East and South Asia, Dr. Robert Guthrie has found. OUR SENIOR PHYSICIANS• Retirement age has done little to slow the contributions of a group of UB-associated physicians ranging in age from 77 to 101.First part of a series. • 12 'Promises and Realities ror Mentally Retarded Citizens' investigates the problems and benefits of deinstitu­ tionalization. 'How to Raise A Brat' is a humorous par­ ents' guide for coping with problem behavior. UB authors produce large crop of other books. • 15 Dr. relix Milgrom steps down as chairman of Microbiology, marking the end of an era for that 44-year-olddepartment; Dr. C. John Abeyounis is act­ ing chair. The late [ Mic.robiolu ,,., rtment State doctors stage slow­ down to protest excessive malpractice premiums. Health Sciences Library moves. Robert E. Baier heads HIDI. • 25 Dr. John Wright settles in as interim director of Roswell Park. Move to High Street culminates Deaconess/Buf­ falo General merger. Sisters opens new physical and oc­ cupatonal therapy wing. • 22 Sometimes a student's choice of a specialty has more to do with dislikes than with any special arrrac­ tion to a field of practice. 139th freshman class has 83 men, 52 women, 20 minorities. • 28 Dr. Lewis Flint heads Sur­ gery. Oth<'r news of people you know. • 31 Class reunion chairs issue invitations for Spring 1986. ::s DEA H..., • 34 • 36 �2 BREAK 10,000 lives could be saved each year if all h ospital s used Dr. Border' s method s BY BRUCE 5. KERSHNER t's a frustration common to all medi­ cal researchers who have develoP<:da medical advance: the lengthy nme period chat almost always elapses before the new technique or development actu­ ally comes into general use. Even after government approvals have been secured and scientific requi rements for testing and validation arc satisfied, the researcher remains painfully aware that the state-of-the-art m medicine docs not enter the mainstream of medicine for many years. Until then, the new advance re­ mains largely unavailable to patients whose well-being and lives could otherwi~ be directly benefited. One such researcher in this frustrating position is John R. Border, M.0 ., UB professor of surgery. Acknowledged as one of the fathers of modern trauma surgery, Dr. Border has pioneered and developed ground-breaking new treatment methods that dramatically improve the survival of patients with severe multiple trauma such as from traffic accidents. Although his successful new techniques have been available to the medical com­ munity for at least three to four years, phy- I 12/85 sicians in only a few American cities other than Buffalo have adopted them. Since the techniques cons1Stently reduce the mortality rate of severe multiple trauma patients from 30 per cent to 3 per cent or less, an estimated 5 to 10,000 lives per year could he saved tf all hospitals employed Border's procedures. In addition, many hundreds of thousands more could lead more productive, normal lives if Border's treatment were used. In researching reasons for the mortality of trauma patients, Dr. Border discovered unexpectedly that "mortality rates are more affected by the type of treatment than by the magnitude of the injury." Ex­ cept for brain-injury, he learned that the main factor determining mortality rates was the way the trauma patient 1smanaged on the night of entry. Compared to Dr. Border's approach, cu rrent treatment of fracture trauma in moderately injured patients results in peri­ ods of hospital stays and time on the ven­ tilator which are two to four times longer, a 74-fold increase of bacteria in the blood (infection), four times more pulmonary emboli and two to three times more pain BUFFAID :r::x:JO CE]! V I ' C medication u~. Dr. Border has yet to lose a fracture trauma patient to the multiple system organ failure that results from tradi­ tional fracture managemen t. Dr. Border's approach includes six bas• ic techniques: I) Aggn.'SStvetreatment to prevent failure of heart and lungs. 2) Aggressive, immediate surgery for bone fractures (rather than the trad1t1on­ al "conservative" repair of bone fractures several days later). 3) Massive protein nutritional support to prevent protein malnutrition, including oral feeding as soon as possible. High glu­ cose administration is to be avoided. 4) Ventilation of the patient continues after surgery until proven it is no longer needed. 5) The patient is simng up on the day after surgery and no traction or casts are used. 6) Removal of all necrotic tissue around wounds and fractures during surgery on the first day. Dr. Border confidently states that if his approach is used, "I expect that in the ab­ sence of severe brain injuries and pre- �3 Dr. John Border checks x-ray of mrury. existing organ failures, the patient will reliably survive, that he will be on the ven­ tilator two to four days, out of bed and sitting up by one to three days, eating by three to seven days, out of the intensive care unit by seven days, out of the hospi­ tal by 21 days, and back to work by four to six months, and that he will have no significant permanent disability!' r. Border developed his new ap• proach because of the unfortunate pattern typical for many accident victims with major multiple injuries. Although they may survive the original trauma, many die days or weeks later of multiple system organ failure. The Harvard Medi­ cal School graduate learned that this or­ gan failure results from a combination of protein malnutrition, sepsis, and cardi­ opulmonary problems. Significantly, the traditional method of treating trauma pa­ tients is what usually leads to these often lethal conditions. The "secret" of the success of aggressive fracture surgery is that, "after you've been severely injured, you don't get better with time, you get worse; he emphasizes. The patient's system is strongest immediately D after the accident, not days later when traditional surgery on fractures first takes place. "I can't overemphasize the importance of aggressive fracture surgery. Conservative treatment also prolongs the late septic state; Or. Border declares, pointing out that it results in an infection rate 74 times higher and a fracture complication rate two to four times higher than that of ag­ gressive surgery. "On night of admission, there is no sup­ pression of the immune system, the least chance for introduction of virulent hospi­ tal bacteria, and there is much less bleed­ ing in the operative wound. The combined changes reduce the risk of wound in­ fection." Rather than stemming from external sources of infection, the sepsis of trauma patients that leads to death, Border dis­ covered, results from internal sources. "Re­ tained necrotic tissue (crushed muscle, blood, and bone tissue) leads to decreased antibacterial activity. The same changes lead to entry of bacteria from the intesti­ nal contents. By the time conservative sur­ gery removes the dead tissue, sepsis has already begun," Border explains. "When BUFFAID !P H v S1¢1AN ; immediate surgery is performed, a thorough cleaning of all necrotic tissue is absolutely necessary" to maintain the sys­ tem's antibacterial activity and to prevent entry of bacteria from the gut. The second source of infection associat­ ed with the traditional approach is relat­ ed to inadequate nutrition. Without sufficient protein support, rhe body will draw upon its own resources of stored nutrients, especially muscle protein. This muscle breakdown leads to malnutri­ tion in the gastrointestinal mucosa which in turn leads to entry of toxins and bac­ teria. With the gut unable to confirm the intestinal bacteria, they spread to the rest of the body and cause sepsis. Or. Border explains that the problem is worsened by the fact that "when an acci­ dent occurs, the intestine stops working, leaving the bowel full of bacteria and tox­ ins which accumulate~ Furthermore, since the intestinal cells are not being "fed" by oral ingestion of food, the efficiency of the barrier of the gut-liver complex is grossly reduced. This is one reason why Border stresses the importance of immediate to very early ingestion of food. Independent from the prevention of sep12/85 �4 sis, massive prote in suppo rt is an essent ial pa rt of his protocol because th e injured body needs it to repa ir its tissue. He pro­ vides four to six tim es more protein a nd 25 to 50 per cen t mo re calo ries (with glu­ cose) than h ealthy people requ ire. However, Dr. Borde r wants other ph ys1ciam to kn ow t hat glucose must no t be given at levels of 100 per cent or more in cxces'- of no rmal requi rements. Excessive glucose will lead to development of fat in th e liver, causi ng ch is viral organ co break dow n. Besides sepsis and ma lnutritio n , che third reaso n for the demise of trau ma pa­ tients has bee n cardiopu lmona ry failure. Placing tra um a patients o n vent ilato rs for as long as needed prevent s cardiopu lmo­ nary failu re (due to far emboh). Immedi­ ate n:senion of all necrotic tissue is very important in reducing the duration ofl ung failure. He found chat conse rvative surgery, which 1:allsfor traction requiring a supi ne posmon, prevents the lun gs from breath­ ing deep ly. Th is causes rete n tion o f secrt:• tio ns and leads co pu lmonary edema and pneumonia. A~ress1ve surgery, o n the other hand, permits che panent to sic up­ right, breat he deeply and cough up secre­ tions, fur t her minimiz in g cardiopu l­ monarv d1fficult1t:s. A bo aiding th e panents' rl'Covery is the reduct io n of pro lo nged pain a nd an.x1ety norma lly associa ted with de layed repair of fracture~, fears of successive ope r­ aciom, and inabi lity to talk because of m­ rubanon. Prolonged pain and anxiety , Dr. Bord er emp h asizes, complicate recove ry because of thei r harmfu l effects on the cen­ tral nervous svstem and upon ingestion of food and pro tein metabolism. Dr . Borde r hopes his app roach will be­ come standar d not on ly for che sake of pa­ tients bu t also for 1csbeneficial effect on society. "We could cut hospital stays and use of hosp ital resou rces in h alf,"he states . Patients are also muc h more likely to recover sooner and to return to produc­ tive lives. Why is his app roach not mo re widesprea d ? Dr. Border speculates tha t ne\\ understa ndings of o ld prob lems arc alwavs slow co be adopted. He also believes chat there is inadeq uate communica t ion between o rt hopaedic and genera l su rgery departments in che U.S., so t hat fractur es are treated by both disciplines as though there were no other injuries (rathe r than by using the "total patie nt " app roach ). Dr. Border ch inks his approac h will be adop t• ed onlv where hospitals include neu rosu r12/85 geons, orc h opaediscs, su rgeons, anesthesiolog1s cs, rad iologists, and re­ habi litation specialists as part of chefront line team, workin g closely rogeth er. Dr. Borde r is att empt ing co publicize his app roach co tra u ma management wah a very active lecture program and t hrough publications. For example, he described his ad van ces in th e care of tra uma patients in an October 1985Annals of Surgeryartic le and in a bookto be pub lished called To­ cal Care of Severe/" Injured Man (Marce l Dekker, N.Y.). He also sees his tr aining of surgical resi­ dents and medical students as a hopeful sign. Two of h is trai nees h ave estab lished th e approach in Dallas and Houston , for examp le. But despite all h is efforts, adop­ tion of the technique m other hospita ls has been slow. Dr. Borde r first came co UB m 1959 as an NIH research fellow and th en as a resi­ dent before joi ning the full-rime faculty in 1965. He is directo r of trauma service ac Eric County Medical Center and Buffalo Genera l Hospita l. His co- resea rchers include Or s. Roger Seibel and John LaD uca, both climcal as­ sociate professors of surgery; Dr. James Hassett, Jr., assistant professor of surgery; Dr. Geo rge Babikian; Barbara Mill s, and Donna Border. Even with the dramatic improvement in the success rate, Dr. Border is continuing research to answer remai nin g quest io ns th at will imp rove trau ma trea tment fur­ ther. Precisely what level of protein leads to the septtc condition? Wha t is the exact rou te of bacte ria from the G.I. tract? What is the int erna l mechan ism in rctninc d necrotic tissue that triggers phagocyte ac­ tivity? le is iromc t hat as Joh n Border advances the state of the art of med icine, the main­ stream of medici ne will probably never quite keep pace. • A rare opportunity in medical science I t I a wn.: uµportun1ty that medical science no" enables u~ co redu ce the mortality rare of trauma patients from 30 per ,ent co 3 per lent or less. These arc the most common!) seen <.e\erdy tnJured patients m ho~p1tak Ir h e4u:illy unfortunate that the ne\\ methods of treatmenc that mah· thb pos­ sible :ire uuli:ed in onlv a few ciue, m the U.S.In hospital, m e\ery other c.uy, rrnd1t1onal treatment co ntinue~ to he provid­ ed, n.:sultmg m unnelessary higher mor­ tality rates and lowered productivity among tho,e chat do survive. After ,car, of rcsearc.h, \\e and ocher, ha\'e de,eloped a system of treatmg trau­ ma patients that largely prevents the general sepsis and multiple organ failure that 1s mostly re,ponstble for late deaths among trauma patients thac are not hrain­ injured. \Ve have learned that it b primar­ ily the LOnservative management of frac­ tures chat causes the current late high mortality rates via septic deaths . \\c nO\\ knm, that the con\'CllllOnal management of fraltures encourages macrophage-driven metabolism "1th its had consequences for entry of gut bacter­ ia leadmg co genernl scp,is and rnulnplc syskm organ failure. \Ve no\\ know chat by surg1r:illy LOrrecung bone frauures on mght of nrn\'al am! by cxc1~ingall necrot­ ic. u,suc, \\e can reduce macrophage­ dri\·en metabolism and a\'oid mnny of the lace problems that lead to Jcach, BUFF AID L!L.L 1 _Q - prolonged d1 Jb11in, increa,ed pain, nnd dr.bt1C increasesIn cost. \Xe also know that the guc is a major sourLe uf bactena and mxins in miured man, anJ chat support of intestinal mucosa 1, most important m preventing the,e se1.:ondary baccenal m· suits. In foLt, we may chnractcri:e the,c sernndary banerial problems as due to gut mucosa-liver protein malnutrition. There­ fore, the prov1,1on of high protein enteral nutntional support 1salso most imporrnnt 111 preventing the late septil deaths of mul­ nple trauma. It appear, probable that these proce• durcs, combined with v1gorow; support of ~,xygen transport, will salvage thou,ands of lives a year chat arc 11()\\ lost. It also ap· pears probable that the Lost of such care and the pain suffered by ,uch p:mcnt~ could he reduced by one half. I urge my fellow physilians to learn more about chis raJkally different apprual h for treating these trauma patients. le,~ a con­ siderable departure from the con\'Cnuon­ al methods now being taught, but pmv1Je, clear gains. h requires that orchopaedists who are superb fracrure surgeon, become from line members of the trauma team. Mo,c trauma cemcr s ,hould con~1dl·r ,idopting this approach as soon as 1x1ss1ble. - Jo hn B o rd er, M.D. P ro feHo r of Sur.iiery Direc tor of 'fraum a S ur .iier), Erie Count y M edi cal Cen te r an d Buffal o Gen eral Ho,p ical �5 KOHL Eye liner poses health threat 1n A sia BY BRUCE S. KERSHNER W eread now and then of cosmetics taken off the American market because of un­ healthy effects. But few would have ever imagined that one cosmetic, an eye liner, could be having monumental health effects on entire populations and countries in Asia-and may have been doing so for generations, if not centuries. Dr. Robert Guthrie, UB profes­ sor of microbiology and pedi­ atrics, has chanced upon the alarming discovery that women in many Middle Eastern and South Asian countries have been extensively using a lead-based eye liner and also applying it to in­ fants and young children. Dr. Guthrie's investigations have shown that this preparation has caused lead poisoning, which results in mental retardation, be­ havioral problems, lower produc­ tivity, and even death. If the problem is as widespread as early data suggest, then it is not too far-fetched to wonder if chronic, widespread lead poison­ ing may be having profound ef­ fects on the health, economic productivity, quality of life, and even sta­ bility of the populations affected. The black eye liner, called kohl (ko-hol) in Arab countries and surma (shur-ma) in Pakistan and India is apparently popular in those regions because of its cosmetically­ attractive glittery platelets of galena, a sul- phide of lead. "Galena is the cheapest and oldest source of any metal," Dr. Guthrie comments. This Middle Eastern kohl should not be confused, however, with the American­ marketed "kohl stick; a black mascara that is safe to use. While carbon black and possibly other sources for eye liner are also used, prelimi­ nary information from Kuwait and India suggests that galena is a common additive and even the primary ingredient in many of the cases observed. Dr. Guthrie is internationally noted as the discoverer of the test for detection and prevention of PKU, a genetic disease that causes severe mental retardation if not treated. He has also helped in developing BUFFAID PHV$1¢1A N I other tests to detect and prevent a variety of other causes of mental retardation, and lobbies extensively for laws to require test­ ing and control of lead contamination in America. "I 'm certain there is a monumental problem out there," Dr. Guthrie states concerning the eye liner ingredient. "Now we have to get the word out about the problem to the governments and citizens of those countries so they can begin to deal with it." The problem, however, is not just "out there," reminds Dr. Guthrie. In the U.S. reside rough­ ly 800,000 Pakistanis, East Indi­ ans, Arabs, and other Middle Eastern Moslems. In England, there are one million Pakistanis and Indians alone. "The use of black eye liner is a traditional custom among both the unedu­ cated and educated classes," he clarifies, "including the wealthy." Dr. Guthrie started to suspect a problem in 1982. He was in Toronto in August of that year, lecturing on lead exposure test­ ings at the Toronto meeting of the International Association for Scientific Study of Mental Defi­ ciency. After his ta lk, he was ap­ proached by Dr. Azza Shaltout, a Kuwait University pediatrician. She suspected a problem with the eye liner, but didn't know how to test for it, so Dr. Guthrie provided her with diag­ nostic filter papers to return to him for testing. Over the next year, several hundred filter papers with blood samples were test­ ed by Dr. Guthrie's lab. "Some of the sam- �• • l • r • pies had the highest FEP levels I had ever seen; Dr. Guthrie related, referring to the laboratory indicators of blood lead levels. FEP is free erythrocyte protoporphyrin. High FEP levels can result from interfer­ ence of lead with heme (organic blood iron) in the blood. Ors. Guthrie and Shalcouc found seri­ ously elevated lead levels in 66 per cent of the randomly selected blood samples obtained from a Kuwaiti hospital emergen­ cy department. Five infants' blood lead levels were so high, they needed urgent treatment, and one eight-month-old infant died of acute lead encephalopathy. An additional screening by Dr. Guthrie's lab of 198healthy children ac a "well baby" clinic in Kuwait disclosed that 36 per cent had elevated FEP levels. The children originate from various Middle Eastern countries. In March 1984, Dr. Guthrie visited Kuwait where he reported the early find­ ings. Upon his return visit in March, 1985, he was shown x-rays of che bones of new­ born Arab infants showing "lead lines." These are the well known results of ex­ posure co lead of children during skeletal growth. However, they had been virtual­ ly unheard of heretofore in newborn in­ fants and are evidence of pre-natal exposure. "It was so alarming because it meant that the infants had been contami­ nated as fetuses because of the lead in the pregnant mother's system; he remarked. When Or. Guthrie lectured in Kuwait, he discussed the problem with Dr. Al 12/85 0 MM 10 Awadi, who also happens co be the wife of Kuwait's minister of health. Dr. Guthrie exJPects that the health minister, having be,en alerted to the possible crisis, will cake positive actions chat will make Kuwait the first Asian country to assess and deal with this serious problem. Kuwait now has a lead testing program and also a newly es­ tablished lead clinic. "Lead toxicity may contrib­ ute to low socialstatus of 3rd world women." Information about the actual extent of chtelead contamination is very limited. To Dr. Guthrie's knowledge, nobody has sur­ vt:yed the Asian countries co quantify how e>:tensive the use of lead-based eye liner really is. Only scanty information is avail­ able, but it suggests a very widespread haz­ ard. For instance, one Indian pediatrician found that seven out of eight eye liner sa1mplesthat he obtained contained 20 per cent to 80 per cent lead. Twenty-five of 29 Siurma samples in a 1978British Medical Journalstudy were primarily lead sulfide, aind 10out of 13in a 1981Annals of Tropi­ study were lead contaminat­ cal Paediatrics ed. Furthermore, a 1981 report from a Kuwait hospital showed that the children le-ad-poisoned by kohl came from Kuwait, Saudi Arabia, Syria, and Iraq, and from BUFFAID L..LE...i s C I I I A N Bedouin populations. Ors. Shalcout and Guthrie's recently drafted article 1 about the situation con­ cludes that "the frighteningly high inci­ dence in the small samples" and especially among "healthy children at (the) 'well baby' clinic" indicates that lead poisoning must be a serious health problem in Kuwait. In investigating the problem, Dr. Guthrie found only three medical journal articles between 1978and 1981that dis­ cussed lead contamination from cosmet­ ics among Moslems. "However, the relatively obscure articles did not alert Middle Eastern authorities co the problem. In India, only a few doctors know about it, and probably no awareness of the problem exists in Pakistan, in che Arab countries, or anywhere else in Asia," Dr. Guthrie remarks. "Kuwait is the only ex­ ception." The eye liner, surma is applied to che eyes' conjunctiva! surfaces rather than co the outside of the eyelids. It is applied co the eyes, and sometimes to the navels, of all newborn infants. Females literally wear it from cradle to grave, including during pregnancy (causing fecal absorption). On some occasions, it is applied up to three times a day. Furthermore, it often contains menthol, which results in profuse lachry­ mation and stimulates children co rub the eyes. This facilitates absorption through the tear ducts and by the hand-co-mouth route. Lead is so toxic, Dr. Guthrie explains, �that he now believes there is no safe threshold . At very high levels (above IOOug/dl. blood), symptoms of lead en­ cephalopathy can appear, such as vomit­ ing, convulsions, stupor, paralysis, and death. Ar lower levels with no apparent symptoms, long-term effects on develop­ ment may appear during childhood. These include hyperactivity, learning disabilities, mental retardation, lower achievement in school, and behavioral problems. Brain, stem audiometry of young children has shown reduced nerve conductivity cor­ relating with blood lead levels recorded two years earlier. They demonstrate that the reduction is related directly co the lead elevations which remain below so called "safe" levels. T reatment of lead poisoni_ngis accom­ plished through chelanon therapy. EDTA and penicillamine, administered in­ tramuscularly, bind the lead so it can be excreted. Dr. Guthrie believes that the solution to what may be a global problem appears co be simple: investigate the extent to which the eye liner is used in all the Mos­ lem countries, legally ban sale or impor­ tation of lead-containing kohl or surma, establish lead programs to screen children and adults on a mass scale, and treat tht lead-poisoned patients identified. The realities are a different matter, however. Use of dark eye liner is a tradi­ tional, possibly ancient practice, deeply rooted in diverse cultures. The lead-based eye liner is cheap and easy to obtain, es­ pecially among poorer and tribal peoples. Cont rolling its distribution may be difficult because it is often obtained from local "healers" and market places, rather than from commercial sources such as modern retail stores . Government action in Third World countries, especially in such heavily popu lated countries as India and Pakistan, is a slow process. If the oroblem is as widespread as early data suggests, its implications are fright­ ening, indeed . The average IQ of the coun­ tries affected may be seriously reduced, with effects on the ability of those socie­ ties to improve their social conditions and their scientific, educational, and cultural contributions and achievements . Reduced IQ and level of healch could have pro­ found effects on the quality of life and on economic productivity. The behavioral problems caused by lead poisoning, if ex­ tensive enough, could potentially affect the political stability of an already unsta­ ble region. • 'Submitted lo< publcotion In "Soence and SeMce In Mental Retordotior\ Joseph Be<g.M.Q. Ed Methuen PIJbLLondon ~ lieohon expected 1986 7 LEAD THREATENS SUBURBS, TOO ■ BY BRUCE S. KERSHNER cad poisoning in children is now a problem among affluent and suburban populations, not just for children of inner city and lower income populations, as previously thought. This finding has been confirmed by UB microbiologist Robert Guthrie, M.O., Ph.D., in a recent study which found that one out of 160 mostly white children from suburban, rural, and more affluent fami­ lies had serious lead levels in their systems. The commonly held belief is that lead poisoning, especially from lead-based paint, is restricted to lower income, inner city, and often black 1:hildren. While ex­ cessive lead level~are much higher in these populations, the 0.6 per cent level in suburban, higher income, largely white children means that 6,000 of every one million Lhildren in this group arc at moderate to serious risk from lead poison­ ing. Common effects include lower intel­ ligence and, possibly, behavioral and medical problems as well as mental retardanon. Dr. Guthrie and his co-researchers rest­ ed 24,624 pre-school suburban and rural children, mostly from Western New York. Ninety-six children were confirmed ro have lead levels ahove 30 ug/ dl in their blood. This survey i, continuing and has reached 35,000 children. "Wesuspect their major sources of lead exposure arc from leaded gasoline fumes and lead-based paint; the UB professor of microbiology and pediatrics explains. Gasoline fumes are inhaled by children liv­ ing or frequenting zones near highway cor­ ridors. The lead-based paint is unexpectedly present in many old homes in more affluent areas, a condition rarely suspected by most of the owners. There are 30 million lead-contaminated dwellings in the country, according to Dr. Vernon Houck of the Center for Disease Control. The children were tested initially using filter paper blood specimens taken at baby clinics, health maintenance organizations, pediatricians' office~. and day care programs. Followup confirmatory tests take place L BUFFALO JPAVS1c,.-.N1 at the Stace Health Department facilities in Albany and were analy:ed at the UB Department of Pediatrics' lead clinic at Erie County Medical Center, directed by Dennis Nadler, M.D., clinical assistant professor of pediatrics. Other co­ resea;chers included Charles Francemone, M.D., assistant professor of pediatrics, Adam Orfanos, M.S., and Kari Widger, B.A. Even the phrase "excessive lead levels" is misleading, since, as Dr. Guthrie empha­ sizes, "The level of lead considered to be ha:ardous has continually dropped as more information has been obtained." He remarks, "There is apparently no thrt."Shold for the hazardous effect of lead. Low lead exposure causes non-specific symptoms, es­ pecially lowering of the intelligence." It is possible that an)' lead in one's system low­ ers IQ and the more lead, the greater the retardation of intelligence, whether in chil­ dren or adults. Even "at 15 uq, when no clinical problems arc ~en, lead can ~till in­ hibit enzymes used in the synthesis of heme (red iron-containing pigment in blood that absorbs oxygen). In a forthcom­ ing article, Dr. Guthrie cites research us­ ing bminstem audiometry of children that found "there is a direct relation between low level lead exposure and decreased nerve conductivity two years after ex­ posure, with no apparent threshold in the blood lead concentration." Dr. Guthrie points out that the federal government was at first slow to admit there was a problem. Former EPA adminis­ trator Anne Gorsuch even tried to relax lead srandards. Now, the Maternal & Child Health Service, the Center for Dis­ ease Control, the Assistant Surgeon General of the U.S. and the EPA support nation-wide testing programs and com­ plete removal of lead from gasoline. Guthrie suppom, and is lobbymg for, mandatory blood-screening of preschool­ ers, estimated to cost about 50 cents per test if done in volume. Progress has been slow, however. But, as he remarked in a guest editorial m Medical World Nrn·s, "Children with their vulnerable central nervous systems can't afford ro wait." • 12/85 ��9 OUR SENIOR PHYSICIANS Their contributions continue well past retirement age BY BRUCE S. KERSHNER ou hear so much about it- aging Americans and their demands on the medical profession and society. But here you can read about another story - older physicians and their contribu­ tions to the medical profession and society. Not only is UB's Medical School a leader in the growing field of geriatrics / gerontol­ ogy, but it also has a remarkable group of individuals in its medical community who contributed impressively to society throughout long careers, and still remain activeeven vibrant-into their 80s, 90s or longer. · In this first of a series, several of these individuals will be profiled. This has been a challenging task. How can one effectively capsulize such a long legacy of contribu­ tions and such a rich variety of experiences in a group whose ages range from 77 to 101 years, and who span a cumulative total of almost 1,000 years? These alumni and emeritus faculty will also offer a little practical advice and wisdom reflecting their obvi­ ously healthy approach to living and aging. Our only regret is that a wider sampling of senior physicians and medical research­ ers could not be profiled because of space and time limitations. Y STILL SEEING PATIENTS AT 100 hen Dr. Charles E Dewitz received a Selective Service notice last year identifying him as "someone who should be register­ ing for the draft," he attributed the mis­ take to a computer error. After all, he had served his country dur­ ing two world wars, and both his sons saw overseas duty in World War II. So in typical no-nonsense fashion, and with more than a tinge of tongue-in-cheek W humor that characterizes this long-time doctor, who will turn 101-yt!ars-oldthis January 28, he filled out the accompany­ ing questionnaire and returned it with co­ pies of two documents he feels certain will clear him of any non-compliance penal­ ties: his draft card, dated Sept. 12, 1918, and a 1947 letter from Selective Service removing his name as an examining phy­ sician for his local draft board. As yet there has been no response, but he says with a chuckle: "Sometimes I can't sleep because I think they're going to catch me." BUFFAID fPMv$ 1 ¢ 1 AN I 12/85 �Dr. Dewitz is a native and was a lifelong resident of Buffalo until he moved to Eg­ gertsville six years ago to live with his daughter. His daughter, Escher D. Eddy, who followed her dad into the medical field, is a pharmacist and director of the Department of Pharmacy Services at Chil­ dren's Hospital. Dr. Dewitz is in remarkable shape. His only ailments are a touch of arthritis that flares up now and then and a cataract, dis­ covered last year. The eyeglassesprescribed then are "in a drawer someplace. I don't need them because the sight in my other eye is good," he explained. His hearing is acute, and except for an appendectomy in 1932, he has enjoyed good health all his life. A general practitioner, he gave up his office at 3210 Main Sc. nine years ago when he was 92. Some patients, however, refused to give him up and continue to call on him at home. "I see five or six patients a month," he said. He keeps up with the latest technology by reading several medical journals a day. "I'm not caking on any new patients, though," he warned with a twinkle in his eye. In 1978 he and his lace wife, the former Shirley Sanderson, celebrated their 60th wedding anniversary. They met while she was a nurse and he an intern at Buffalo General Hospital. While longevity appears co be a family trait - his mother lived to be 83 and his father 85 - Or. Dewitz attributes his long life to exercise and moderation, which he contends are keys to healthy living. "You can eat almost anything if you do so in moderation," he said. "Vitamin pills; he added, "are not necessary if you eat well-balanced meals that include vegeta­ bles and fruit~ Dr. Dewitz smokes a pipe after meals and enjoys an occasional cigar. Is one drink a day acceptable for healthy living? "Some doctors recommend two; quipped the doc­ tor, who sometimes has a beer with meals or a mixed drink during the "cocktail hour." He sleeps eight hours a night and may nap in che afternoon - but not during "General Hospital," his favorite soap opera. r. Dewitz showed an early liking for che medical field. His parents, who came to Buffalo from Germany in 1881, resolved to assist him in acquiring his professional training. At age 15, he learned lab work in the D 12/85 Franklin Street office of Dr. Charles Stock­ ton, a leading physician of the day. "He specialized in diseases of the stomach and no matter what your ailment was, you had a tube stuck down your throat to get a sample of stomach con­ tents. From that we could diagnose ulcer, cancer or gastritis," Or. Dewitz said. "X-rays were just beginning then, and the first area doctor to have a machine was Dr. William Ward Plummer, an orthopaed­ ic surgeon. Franklin Street, between Vir­ ginia and Allen, was known as Doctors' Row," he added, reeling off the names of more than a dozen physicians with offices there. After five years as a lab assistant, Or. Dewitz almost quit medicine. "A friend suggested l'd make more working for the railroad. But Or. Stockton, who was on the University of Buffalo medical faculty, took me aside and said the most I'd ever earn on the railroad would be $85 a month. Medicine, he said, pays more in the long run," he recalled. A 1914 graduate of the UB Medical School, Or. Dewitz is described in a 1923 "History of Buffalo" as being "naturally scientific."He already had acquired a wide reputation, and his judgment was highly respected by both his associates in the medical profession and by his patients. He began independent practice in 1921, when he took over the Allen Street prac­ tice of Or. Matthew D. Mann, who oper­ ated on President William McKinley after he was shot at the Pan-American Exposi­ tion in 1901. Dr. Dewitz applauds recent develop­ ments in his field. "l think it's wonderful chat we have men who are able to do or­ gan transplants," he emphasized. "I can remember when some doctors were afraid to stick a needle in a vein." president of the Confederacy, was travel­ ing to New York from Chicago in 1903. She became ill and was taken off the train at Buffalo. Dr. Stockton treated her in the Castle Inn, the former home of Millard Fillmore, located where the Statler Build­ ing now stands. I had to run to a store for a gallon of olive oil required for her treat­ ment," he said. In the early years of his practice, office calls were 50 cents co $1 and a house call was $3, he noted. "I never did get rich, but I've had a very satisfying life serving others. I've had three cars - a 1926 Hudson, then a Nash and finally a Dodge. Yearsago, if you cook care of a car it lasted a long time; he said. "I have a favorite saying: 'Suns will rise and suns' will set again, but when this lit­ tle light goes out, there will be one long night for sleeping'. I've always been con­ cent to work. Hard work never killed any­ one." (Sect1011on Or. Dewitz wnllen t>y Uso MuehtX>uefand ,epmt ­ ed with pe,m.ss,on from the Buffalo News. Joi\ 24. 1965.Whe<e M~ Muehlbouer aso writer.) N onetheless, he is disturbed by what he feels is the lack of closeness be­ tween patient and doctor today. "I listened to my patients. Leechem talk - it's a good way to rid chem of unwarranted fear and worry," he said. Among his souvenirs is a calling card of the late actress Marie Dressler, whom he met in the office of his mentor, Dr. Stock­ ton. "She was appearing in Buffalo at the time. Vaudeville was big in those days, and often we got passes from entertainers who came in with ailments," he said. Dr. Dewitz also recalls another encoun­ ter with a famous person: "Mrs. Jefferson Davis, widow of the BUFFAID ]PH v $1 ¢ 1ANI Dr Hobart Reimann AT THE FRONTLINES IN MEDICAL RESEARCH D uring the 64-year career of Hobart A. Reimann, M.D., it seems that when he wasn't creat­ ing patients he was travelling; when he wasn't travelling he was writing; and when he wasn't writing, he was painting. He somehow held appointments at ten �' academic institutions, in Prague, Persia and Peking; Indonesia, Minnesota, and Philadelphia; add Buffalo and Beirut, to bo ot. He published over 350 scientifi c ar­ ticles and a number of books, and con­ tributed seven "firsts" to medical science. Then he retired to become a professional painter. Hobart Reimann, 88, began his medical career when he graduated from UB (M'21). After interning at Buffalo General, he held research positions in N.Y.City and Prague. China was where he began his teaching career, as associate professor of medicine in Peking Union Medical College in 1927. While professor and chairman of medicine at the University of Minnesota School of Medicine during the 1930s, he was the first to report sporadic staphylococcalpneumo­ nia (simultaneously with Henry Chicher­ ing), as well as amylodosis. In 1936, as Magee Professor (and chair­ man) of medicine at Thomas Jefferson University School of Medicine, Philadel­ phia, he expanded his original contribu­ tions to medical science. He considers the most significant to be his findings on atyp­ ical pneumonia, where he pointed out the mistaken cause of many cases of pneumo­ nia (commensalavirulent pneumococci) that until then had often been treated un­ necessarily with antibiotics. His 1938 con­ tribution was recognized by JAMA when his article was reprinted as one of 51 Land­ marks in Medicine, Centennial Series, in September 1985. His ocher "firsts" at Jefferson included being the first co recognize viral dysentery (1945) and the relation of polyartericis and trichinosis (1947). While chairman, he suc­ ceeded in greatly expanding his Depart­ ment of Medicine and initiated its first residency program in medicine, unusual for the Great Depression era. His prolific publishing led the JAMA editor to describe him as "among the most frequent of published contributors . . . perhaps even the most frequent." After seven years in overseas universi­ ties, Reimann and his wife settled in the Philadelphia area, where he remains today. As professor of medicine at Hahneman Medical College, he published his pioneer­ ing research in periodic diseases, maladies such as peritonitis and psychoses that recur every seven or multiples of seven days. Since retiring, he has put down his pen for a paint brush and germinates flowers instead of medical firsts. Besides tending his one-acre garden, Dr. Reimann is an accom­ plished painter. He had no formal train­ ing, but his work has been distinguished by appearing on the cover of a 1972 issue of JAMA and winning a prize at an American Physicians Arts Association show. He has painted six commissioned portraits, and has had two one-man shows. Most of his hundreds of paintings have become gifts for friends and prizes for charities, or have been sold for the benefit of Jefferson and Hahnemann. Among his favorite memories are some of the famous people he has talked with, including Nehru, Indira Gandhi, the Shah of Iran, Indonesian President Sukarno and, especially, Sr. Alexander Fleming shortly after the introduction of penicillin. His experiences in China were particu­ larly memorable. During World War ll, he flew to China as part of a government team to control an alarming cholera epi­ demic. While flying over the Himalayas, \ '\.f A cou?r pai nt ing by D r. Rei man 1972. BUFFAID IPJ-1 V$ - CI AN I r1 the team had co jettison all their medical cargo because of engine trouble. With no equipment left, they worked in a primitive earthen floor hospital, using coke and beer bottles for suspensions and I.V. needles ~ground to the hilt." He advocated massive rehydration, thereby reducing the death rate from 50 co 5 per cent, ironically the same general mortality rate in the more sterile and better equipped U.S. To celebrate VJ Day and co honor the team's efforts, the Chinese held a banquet for their American associates. He remem­ bers. the Chinese head nurse, who spoke halting English, rising for a roast, exclaim­ ing "Kam pei, kam pei; Bottoms up, every­ body show your bottoms!" With all his accomplishments in medi­ cine and art, it is fitting that Dr. Reimann considers one of his most lasting contri­ butions to be in training new physicians~! am pleased to have been an efficient pedagogue." BACKGROUND MEN OF PHILANTHROPY ''I figure I've personally delivered some 11,000 babies," comments Dr. Harry G. LaForge. Few would dispute the claim of this 83-year-old gynecologist-obstetrician, who sees up to 50 patients a week, "down from my very active days when J used to see that many in a day." Harry LaForge did much more than bring babies into the world. He also brought into UB's world a series of major philanthropic contributions that he esti­ mates may total $20 million from various funds. Together with men like Dr. Virgil Boeck, he was a "behind-the-scenes" person, work­ ing tirelessly and persistently so that area philanthropists would direct their dona­ tions to the University. Independent of those efforts, his own personal philanthro­ py has generously helped others. Fitting for his profession, he notes on the first line of his curriculum vitae, "Born 8/ 28/ 02, Buffalo, West side, home deliv­ ery." He's thrice a UB alumnus, first in pharmacy (1923), then in medicine (1934), and finally an M.S. in Medicine (1937). "1 decided to become a physician while work­ ing as a salesman for Eli Lilly. After call­ ing on all those doctors, it finally occurred co me, 'Why not become one?' " His philanthropic efforts began in 1944 with the student loan fund that bears his 12/8S �In his office next to Millard Fillmore Hospital, Dr. Boeck carries a patient schedule that is almost undiminished compared to previous years. The medical graduate of UB (1931) specializes in inter­ nal medicine, particularly cardiology and diabetes. The assistant clinical professor emeritus in medicine played a primary role in initiating one of the first formal teach­ ing programs in medicine at Millard Fillmore Hospital. He was also involved in one of the earliest tests for Orinase for di­ abetics. name and now totals approximately $50,000. In 1948, he established the Gy­ necologic Research Fund (which he esti­ mates at $50,000) at Buffalo General Hospital, and in 1952 donated money co equip the Endocrine Lab at Children's Hospital. His philanthropic work expand­ ed as co-founder of the Annual Participat­ ing Fund for Medical Education. It now totals $400,000 in assets, and, interesting­ ly, later provided the seed money to stare up the Buffalo Physician in the late 60s. More recently, he chaired Buffalo Gener­ al's 1970 Fund Drive chat raised $700,000. All these accomplishments are public record. It is his background efforts, however, chat are not widely known. "l asked to meet with Ralph Hochstet­ ter who was going co donate a large sum co the University of Rochester. After in­ terviewing him, l arranged for Chancellor Furnas co meet with him and he 'walked out' with $100,000 in municipal bonds as a donation co UB." With the assistance of Virgil Boeck and ochers, he kept up his discussions with Mr. Hochstetter and was intrumental in getting him to will half of his estate co UB. The Hochstetter Foun­ dation now totals $10 million and is res­ tricted co medical students only. The Hochstetter Building on UB's North Cam­ pus was named after Ralph Hochstetter and is now the home of the departments of Pharmacy and Biology. "I also met several times with Frederick Slee, at the time my next door neigh­ bor, co discuss his donating co UB. Nothing seemed co come out of the meet­ ing, though. Then suddenly I learned about his donation; Laforge relates. The donation totalled $900,000 to the Univer­ sity's arts programs. "I'll never really know the exact effect l had on him." The emeritus clinical associate professor of ob-gyn succinctly explains his unswerv­ ing philanthropic motivations as follows: 12/85 "If there wasn't a UB, there wouldn't be me, M.D." For all his philanthropic work, Dr. Laforge received the University's highest alumni award in 1961, the Samuel P. Capen Award. Dr. LaForge's advice co younger physi­ cians about aging is simple: "I encourage all of you co keep seeing patients. le keeps your brain going and alert." Regarding his own "retirement": "I'm never going co re­ tire. I love medicine and I look forward ev­ ery day to seeing patients. Who the hell wanes co look out a window?" In his later year:,, :.ecing patients is clear­ ly his ~hobby.•i quit playing golf years ago because my game kept getting interrupt­ ed by women in labor." D r. Virgil Boeck, 77, also played an im­ portant role in bringing philanthro­ py to UB. His contact with Ralph Hoch­ stetter was direct-we was the benefactor's primary physician. His familiarity with Mr. Hochstetter, together with LaForge's efforts, ultimately led co the gift that numerous medical and other students will be beneficing from for decades. UT IT Dr. Boeck has always been a leader in a variety of organizations. He organized St. Joseph's lnrercommunity Hospital's Department of Medicine and was chief of medicine there for 15 years. He was co­ founder and first president of the Western New York Society of Internal Medicine (1951-52)and the second president of New York State Society of Internal Medicine. Unlike his friend Harry Laforge, Virgil Boeck's interest in becoming a physician started very early, as an eight-year-old. He opened his first practice in the 30s in the Finger Lakes area, where he became presi­ dent of the Yates County Medical Socie­ ty. He remembers fondly those years in the small town of Dundee when "people respected and appreciated their doctor." Other than Ralph Hochstetter, his most memorable patients were from his World War II days as an assistant corps surgeon in the Far East. He treated the president of South Korea, Syngman Rhee, for pneu­ monia; Secretary of War Patterson for a bad cold, and the Russian Ambassador co Korea for stomach pains (which turned out to be a malignancy). His advice for younger physicians: "Re­ main active and dedicated and keep up your medical education." His advice for older physicians: "Associate with younger physicians." • �13 ( OKS DEINSTITUTIONALIZATIO & REALITIES PROMISES ''F or mentally retarded persons, the promises of deinstitutionalization have not mer the reality of dei n­ stiturionalization; maintains Barry Willer, Ph.D., associate professor of psychiatry, in his new book Promisesand Realities For Mentall)• ReiardedCitizens: Life In the Community (1984, University Park Press, Baltimore, Md. 269 pp.). The book reviews the hisrory and investigates the problems and benefits of deinstitutionali­ zation of the mentally retarded. It is intended for !:>oth policy makers and students in policy analysis as well as for physicians, parents and practitioners in community service work who deal with mentally retarded persons. Dr. Willer began the book after completing his final report on the •Deinstitutionalization of Mentally Retarded Persons in New York State," prepared in 1980 for the then Depart• ment of Healch, Education and Welfare, Office of Human Development. That study has been widely recognized as one of the most compre­ hensive investigations of deinstitutionalization completed co date. Willer co-authored the book with James lntagliata, Ph.D. (UB 1976), research director of the University Affiliated Facility at the University of Missouri-Kansas City. Dr. ln­ tagliaca was a clinical assistant professor of psy­ chiatry at UB for seven years until 1984. Dr. Willer is a supporter of deinstitutionali­ zation for mentally retarded persons. However, he learned from his investigations that New York's deinstitutionalization program was mov­ ing too fast to allow for careful planning and prevention of unforeseen problems. Further­ more, Willer asserts that the program has placed too much emphasis on group home placement without caking advantage of other beneficial deinstitutionalization alternatives. "The pendulum swung suddenly from empha­ sis on institutionalization to emphasis on large scale and rapid dcinstitutionalization, especially in group homes. I believe that it swung too far and in the process overlooked some of the other alternatives that in many cases can be both more beneficial and less costly," he comments. BUFFAID IPMV$1C1ANj Willer's book is no armchair study. The prac­ tical thrust of the volume is his discussion of recommendations based upon derailed visits and investigations of numerous group homes and facilities in New York, other states, On­ tario, and Puerto Rico. An important benefit of deinstitutionaliza­ tion, Willer agrees, is that living in a normal­ ized atmosphere encourages norma l behavior. Such normalized environments include the natura l family, group homes, foster and adop­ tive homes and homes for the elderly. In most of these community-based settings, mentally retarded persons have adapted co the main­ streamed lifestyle much better than expected­ and certainly better than those still in insti­ tutions. T here arc many reasons for the choice of Promisesand Realitiesas the book's title. One of the major promises was that deinstitu• tionalization would benefit all those released from institutions. The reality is that some have 12/85 �BOOKS not benefited because of the way the program has been implemented. A group home, for ex• ample, may be of greatest benefit to one men­ tally retarded person, while placement with the natural family may be the only beneficial form of deinsticucionalizacion for another. But the state has, up until recently, chosen group homes almost co the exclusion of any other al­ ternative, with negative effects on some in­ dividuals, Willer explains. Or. Willer discovered chat the emphasis on group homes was so great that other alterna­ tives were not only overlooked but even active1y avoided. "I realized chat the deinsricurionalization policy even took on an 'anti-family' aspect. For example, placement with rhe natural family, sometimes the most effective method, was actively discouraged. While funding was provided for group home placement, little was provided for natural fa. mily placement. Community support services were also largely unavailable. In face, families were nor even informed about the services char were available co them." Another promise was chat rhe mentally retarded could live independently. While this certainly proved true for a large number, Willer believes that "most handicapped persons will never live independently, those who do are not necessarily happier or better off because of it, and some clearly do not want co." le was the speed with which the policv was implemented chat also caused problems, Dr. Willer learned during his research. Dr. Willer feels chat "cases were nor always handled effec­ tively in the rush and pressure to deinstirution­ alize as quickly as possible." For example, he adds, "deinstitutionalization was often accom• plished by closing the door to new mentally retarded persons genuinely in need of inscitu­ cionalizacion." The lack of planning is also reflected by che fact that, "at the current rate of growth, there would be ten times greater ca­ pacity in group homes as there are mentally retarded people," he remarks. A third major promise was that dcinstitunon­ alization would cost less. However, group home placement costs approximately as much as in­ stitutionalization, and total costs may actual­ ly be much greater. This is because placement in group homes is not reflected in a propo rtion­ al reduction in the costs of running the insti• cutions that formerly housed the patients. Unless an institution is actually shut down, basic coses of running and maintaining it continue. What Dr. Willer points out is that the poli• 12/ 85 cy emphasis on group homes is the most cost· Iv deinstitutionalization option. The least expensive options such as placement with natural, foster, or adoptive families, have been largely ignored. As a result the budget for state mentally retarded services has increased at rates three co four times faster than inflation, while che budgets for other state services have in­ creased at or below che rate of inflation. Among the ocher "realities" Dr. Willer refers co arc chc unintended consequences of dein­ stitutionalization on the family. Many parents, after difficult deliberation, decided years ago to institutionalize a child. After getting used co dependence on an institution co provide life­ long care for that son or daughter, they are now being cold that the professionals who had ad­ vised chem to do it were "wrong;" now che professionals recommend a radically different approach. Family members wonder if the professionals could also be wrong this time. W hen Willer's findings were released in New York Scace, they received a chilly reception from some authorities and advoca• cy groups who were enthusiastic supporters of deinscitutionalization. "They supported dein­ scicucionalizacion, especially group homes, so strongly that they resbced any criticism, even when it was presented for constructive pur­ poses.• According co Dr. Willer, chcy viewed his HEW report as an attack on deinstitutionali­ zacion in general, when it actually questioned only the speed of the program's implementa• cion and its overemphasis on a single option. Dr. Willer's in-depth investigations did turn up some group homes in the scare that were poorly run, as evidenced by the deterioration of individuals placed in chem. However, most group homes, he found, were operated with few problems. • Dr . Will er'~ f indmg s go t a c hill )· rece pti o n . BUFFAID CTJ[ V _!. 1 ¢1Alf"] Dr . C onclr e ll tvi t h cl ie nt s in h is unc o m_,.,ntional of{ice. HOWTORA C hild psychologist Dr. Kenneth Con­ drell has sec down 20 years of ex­ perience working with children and parents in his new book just released nation­ wide. Hoo: To Raise A Brai, written for a lay­ man / parent audience, describes in a humorous and chatty scyle how co recognize rhe common mistakes chat parents make-and then how co avoid them. Dr. Condrell is a clinical assistant professor in the Department of Psychiatry. Nine chapters identify many of the most common problems that parents encounter. He first describes, step-by-seep,the way parents can foster problem behavior. The reader then knows which of their responses or approaches co avoid. Condrell follows chis by describing, again in a step-by-seep manner, the way ro in­ teract with your child co avoid or rectify problem behavior. Condrell feels that, like his instructional ap­ proach (a layman-oriented adaptation of what psychologists call paradoxical techniques), some of his chapters are rarely seen among popular how-co-parent books. "How to Alienate Your Teenager" is one such example, as well as "Divorce and How to Use Your Kids• and "How to Make Your Children Jealous." Condrell makes it clear that the conse• qucnces of not hearing the messages that your children are sending you can be severest when they become teenagers. In rhe chapter "How to Alienate Your Teenager; he gives 16 proven ways co do it. Samples of several of these ways are: Method number two "Criticize Frequently" instructs parents to "Always look for opportu­ nities co criticize ... Criticize his music, his messy room, his cloches, his sleeping lace ... just keep nagging and picking ac all chis nor• mal teen behavior and in a short time he will be avoiding you like the plague." �15 BOOKS lISEABRAT "Run Grounding Into the Ground" (Method No. 8) instruets parents "when you ground your teen, make sure it's for two or three months. Better yet, make it an indefinite grounding until you feel he has proven himself. Keep him in the dark. This way he will think he is ground­ ed forever." The tench method, "Be an Adule," remind;, parents to "try real hard to never recall the feel­ ings of your own teen years. In chis way you won't be able to have empathy and put your­ self in your ccen'sshoes ... Forget the child and teenager in you." Condrell emphasizes chat he certainly didn't invent all the techniques. "] never made up all these techniques on how to do it wrong­ parents created chem. In over 20 years of treat­ ing troubled families, I just collected all the parenting mistakes from parents who didn't even know they were making chem." After receiving his Ph.D. in clinical psychol­ ogy from UB in 1964,he was senior supervis­ ing clinical child psychologist at E.j. Meyer Hospital and on the faculty of UB's Depart­ ment of Learning and Behavioral Disorders. He entered full-time private practice as a clinical child psychologist in 1968and was appointed co the faculty of the Medical School's Depart­ ment of Psychiatry in 1974, where he super­ vised and lectured co psychiatric residents and caught medical students for a number of years. In 1977,according to Condrell, he developed the first private practice group of child psychol­ ogists in Western New York specializing in serv­ ices to families and children. For the past several years, he has collaborated with the judicial sys­ tem and Bar Association to improve ways of handling the issue of child custody. A regular guest on the popular "AM Buffalo" television program for the past eight years, he helped or­ ganize an hour-long TV program on child abuse in May, 1980.Over the years, Condrell has been a consultant to the Buffalo Associa• tion for the Blind, the Children's Hospital of Buffalo, the New York State Department of Mental Hygiene, and ocher groups. He is a member of the American Psychological Associ­ ation, the Psychological Association of Western New York, the Society for Pediatric Psycholo­ gy, and the Menea l Health Association of Western New York. He recently appeared on ABC's national show "Nighcline" to discuss child rearing and was honored by the Erie County Legislature in July for his service co \VNY's families. • Med School authors have fruitful year I was a ·fruitful year for new books by UB's medical community. A large crop of books have come across the editor's desk this year from faculty and alumni. The following is a small samp ling and by no means should be viewed as complete as we are not notified of all new publications. Dr. Pearay Ogra was the editor of Neona­ t tal Infections:Nutritionaland ImmunologicInter­ actions (1984, Grune and Stratton, Inc., 352 pp.). This important monograph features 19 chapters written by 30 distinguished contribu­ tors, including five from UB's Medica l School. Or. Ogra is professor of microbiology and pedi­ atrics. 1'vo major works were edited by Or. Michael Anbar , professor and chai rman of b10physics. Clinical Biophysics(1985,Warren H. Green, Inc., Sc. Louis, 747 pp.) was coedited by associate professor of biophysics, Dr. Robert Sp engler, and Peter Scott , Ph.D. This relatively new field of medicine covers a range of technologies , such as computers, ultra­ sonics , NMR imaging, nuclear medicine, bioe­ lectric techniques, biomedical engineering, and biophysics medical applications. Or. Anbar's ocher book, The Machine at the Bedside:Strategiesfor UsingTechnologyin Patient Care (1984, Cambridge University Press, 363 pp.) is about the technology of health care­ its creation, dissemination, and use. It discuss­ es how che technological revolution is shaping modern health care. Sixty-one scientists, bi­ oechicists, planners, policy makers, analyses, nurses, physicians and others contributed. Dr. Carel van Oss, professor of microbiol­ ogy, published Molecular Immunology:A Text­ book(1984,Marcel Dekker Publisher, New York, BUFFALO IPHVS1¢1AN) 725 pp.). His coed itors are M. Zouhair Atas­ si and Darr yl Absolorn , research assistant professor of microbiology. A second edition of A Concise Handbookof Respirato1') Di5easeshas been published by Dr. Satter Farzan, clinical professor of medicine at ECMC and colleagues. The textbook was published by Reston Publishing Co., Reston, Va., in 1985. Headand Neck Canceris the new book of Dr. Donald Shedd, research professor of surgery at Roswell Park Memorial Institute (1985,C.V. Moshy Co., St. Louis, 848 pp.). Dr. Shedd and four other physicians edited the book which represents the proceedings of the First Inter­ national Conference of the Society of Head and Neck Surgeons and the American Socie­ ty for Head and Neck Surgery. One of the Buffalo area's major physicians associated with the hospice movement, Dr. Robert Milch , has co-autho red a government monograph wich D r. Ai-nold Fre eman, on controlling and managing pain in the termi­ na lly ill pediatric patient-Palliauve Pain and SymptomsManagementfor Childrenand Adoles­ cents (1985,Children's Hospice International and U.S. Department of Health and Human services, Division of Maternal and Chi ld Health). The· publication instructs health care providers how co use the hospice concept to maintain the quality of life for children in their lase stages of life. It reviews different ways co deal with pain and fear of death at different age levels and gives details on appropriate use of analgesics and other discomfort-controlling drugs for the hospice patient. Or. Milch is vice president of Hospice Buffa­ lo and clinical assistant professor of surgery. Or. Freeman is professor of pediatrics anc.lRoswell Park's chief of Pediatric Oncology and Hema­ tology. Roswell's pediat ric nurse administrator, Ellen Clark, also was a co-author. An unconventiona l book on a non-medica l topic is the result of efforts by a medica l alum­ nus: BullsBearsand Dogs:A ScockMarket Strate­ gy (1984,Albright Press, Oakland, Ca., 160pp.). The author, Or. Jason Farber (M'33), after years in medicine, has been active in the finan­ cial arena as an executive of a pharmaceutical company and financial consultant to founda­ tions. He caught at the Medical School for five years during World War II and 1s a Fellow of the Ame rican College of Physicians. Notice of new books by faculty and alum111 should be sent to Buffalo Physician, 136 Crofts Hall, SUNY Buffalo, Buffalo, N.Y. 14260. • 12/85 �16 FELIXMIIDROM After 18 years of distinguished leadership Microbiologychairman becomes 'private citizen' BY C. JOHN ABEYOUNIS, Ph.D. Acting Chainnan and Profes_~or of Microbiology A fter 18 years of distinguished leader­ ship, Dr. Felix Milgrom has stepped down as chairman of the Department of Microbiology in the School of Medicine. In commenting about this move, he is fond of cit­ ing Benjamin Franklin who said that it is a pro­ motion when a public servant becomes a private citizen. As a "private citizen" in the department, Dr. Milgrom will now devote all of his time to teaching and research. Felix Milgrom received academic distinction here by his appointment as Distinguished Professor in 1981,following a long and fruitful career in teaching, research, and administration that began 40 years ago in Poland. In 1946, he completed his medical education, which had been interrupted by the Nazi terror of World War 11,by graduating from the University of Wroclaw. That same year, he joined the labora­ cory of Dr. Ludvik Hirszfeld, a world-famous bacteriologist and immunologist, who was at that time chairman of the Department of Microbiology at Wroclaw and was noted for his work on the heredity of human blood groups. In the European tradition, Felix Milgrom was engaged in research for an additional two years to earn his M.D. degree, and in 1951 he was awarded the Docent degree, which is equi­ valent to an American Ph.D. By 1954 he was an internationally recognized immunolo­ gist; he had attained the rank of professor and was chairman of the Department of Microbi­ ology at the Silesian School of Medicine at Zabrze-Rokimica, Poland, an unusual accom- 12/85 plishment at the age of 34. Dr. Milgrom left Poland and came to Buffa. lo in 1958 with his family, after accepting an offer from the late Dr. Ernest Witebsky, the former chairman of the Department here (at that time known as the Department of Bacceri­ ology and Immunology). Once again he ad­ vanced quickly in academic rank. He joined the department as a research associate and in six years had achieved the rank of professor. In 1967, he succeeded Ernest Witebsky as chair­ man. In the following year, together with Dr. Witebsky and other senior members of the department, Dr. Milgrom was instrumental in establishing the Center for Immunology, a move that has given international recognition to the department, as well as co the School of Medicine and the University. Formation of the center provided a focal point for the strong but diversified community of immunologists that had developed in Buffalo. Among the activi­ ties of the center is the sponsorship of inter• national meetings which are held in Buffalo every other year. Outstanding investigators in microbiology and immunology attend these meetings to give lectures and discuss their research. The first of these convocations was held in 1968, and the tenth will be held this summer. Being aware that a strong graduate program was crucial for the vitality of an academic department, Felix Milgrom initiated expansion of the Department's program soon after assum­ ing the chairmanship. This program was initiat• BUFFAID jPAYS1C1ANj ed in 1951 and had trained 21 Ph.D. students by 1967. At that time, the Department offered seven graduate courses, and there were 10 graduate faculty members. One of the new chairman's first acts was to increase the gradu­ ate faculty co include virtually all of the aca­ demic microbiologists and immunologists at various local hospitals, as well as those at Roswell Park Memorial Institute. Today the graduate program is one of the largest of its kind in the country, with a roster of 36 graduate faculty and a listing of 20 formal courses. Of the 114Ph.D. degrees awarded by the program to date, 93 were conferred during Or. Milgrom's tenure as chairman. Expansion of the gradu­ ate program served two significant purposes. It broadened the expertise within the department, and it forged the microbiology community in Buffalo into an effective academic team. F elix Milgrom's academic heritage, which can be traced back to the "father of Im­ munology," Paul Ehrlich, has had a strong in­ fluence on his approach to research. Today, he is one of a few scientists with profound knowledge of the entire field of immunology. His basic research has been intertwined with the development of immunological techniques which have practical application in clinical medicine. Or. Milgrom's very first contribution in research occurred very soon after World War LI,a time when syphilis had reached epidemic proportions in Eastern Europe. He developed a simple test for this disease that could be per• ��MEDICAL SCHOOL NEWS vide evidence for the idea that Paul-Bunnell an­ formed on a drop of dried blood. He used chis tibodies arc produced in response to a novel rest for mass examination of over 2 million sub­ antigen that is formed in the course of infec­ jects, a fear chat contributed greatly to bring­ tious mononucleosis. ing syphilis under control. Much of Dr. Milgrom's early research in­ volved studies on so-called natural antibodies. n addition to the above described studies, In chis work he was the first to show that the Or. Milgrom has made significant contri• combining site of an antibody molecule may butions in other areas of immunology, inhave more than one specificity. Also, several years before it was shown that lgM antibodies had ten combining sites, he was the first to demonstrate chat an anti­ body molecule may have more than two combining sites. In 1956, Dr. Milgrom described a factor in human serum which was termed anti-antibody. This antibody reacts only with lgG molecules that arc bound to an­ tigen. The observation led him co propose that new antigenic sires on an antibody molecule may be exposed as a result of binding of that molecule to antigen. He also postulated that serological denaturation of an individual's own lgG may lead to the forma­ tion of the various antibodies to IgG that arc detected in sera of pa• tients with rheumatoid arthritis. He obtained experimental evi­ dence substantiating this view by showing that rabbits will form an­ tibodies to lgG when they are im­ munized for a prolonged period with a foreign antigen or even when they are immunized with their own denatured lgG. Dr. Milgrom also has done ex­ tensive work in the area of organ transplantation. He was the first to demonstrate that certain forms of kidney graft rejection are caused by antibodies in the recipient's circulation that are Dr. Milgrom flanked by portraits of h1~mentors . directed against che grafted tissue. Or. Milgrom also has devoted considerable attention to the study of hecer­ eluding human blood groups and serum ophile antigens and antibodies. Of particular groups, autoimmunity, renal immunopatholo­ significance has been his work on Paul-Bunnell gy, and tumor immunology. antigens and antibodies, which are important Felix Milgrom's achievements are well recog­ in the diagnosis of infectious mononucleosis. nized in the national as well as the internation­ F-ormany years the appearance of Paul-Bunnell al scientific community. He enjoys the antibodies in this disease has mystified inves­ reputation as one of the world's leading immu­ tigato rs. He was che first co propose and prono logists, with over 400 scientific publications I 12/85 BUFFAID !PHV$1¢1ANI co his credit. He has been the mentor of over 80 Ph .D. students and postdoctoral fellows, many of whom have made their mark in research and occupy key positions in the aca­ demic community of their respective countries. Or. Milgrom's accomplishments have been recognized by the awarding of several honorary doctor of JJ1edicinedegrees: by the University of Vienna, Austria, in 1976; by the University of Lund, Sweden, and the University of Heidelberg, Ge rmany, in 1979; and by the University of Bergen, Norway, in 1980.The occasion in Vienna was particularly joyful for Or. Mil­ grom since the medical tradition in his family began with the graduation of his great uncle from that institution. Also, the honorary degree from the Univer­ sity of Heidelberg formalized Or. Milgrom's academic heritage. Both his mentor, Ludvik Hirsz­ feld, and Emil von Oungern, who was the mentor of Hirszfcld, trained with Paul Ehrlich there. The Milgrom family has had a long tradition in medicine. Felix Milgrom's father and great uncle were physicians. His brother is a physician. His wife, Halina, whose father was a physician, is a UB clinical assistant professor and dermatologist with recogni­ tion in her own right in the clin­ ical and research aspects of that medical speciality. Their two sons, Henry and Martin, also are phy­ sicians. Henry is a pediatric aller­ gist and Marcin is a surgeon. Throughout his career, Felix Milgrom has remained true co his academic heritage. Speaking at a dinner given recently in his honor, he concluded his remarks by citing a poem which was given to him by his spiritual grandfather, Emil von Dungern . You wanted to look into the face of nature And for this you fought all your life Still you did not pierce Nature's shield And the everlastingnature defeated you. And unfulfilled remain your longings. The poem concludes "/chweisseswohl, und doch wir kampfen weiter." I know chis well but still we keep fighting. • �AN ERA HAS ENDED ) 44-year-olddepartment has roots in G~rmany BY THOMAS FLANAGAN, Ph.D. Professorof Microbiology A \ l The late Dr. Ernest Witebsky, founder of the UB DeJ1artment of Bacteriology & Immunology, a~ it wa., known then. n era has ended for the Department of Microbiology; a new one has commenced. The new era will be opened by Dr. C. John Abeyounis, who was appointed acting chairman on September I, I985, and is the chird person to lead the depart­ ment since its incepnon in 1941. He follows Dr. Felix Milgrom, who just retired as chair­ man after almost two decades of illustrious service to devote himself full-time to research and teaching. He in turn followed the found­ er and first chairman, Dr. Ernest Witebsky. While the official founding of the department occurred in 1941when Dr. Wicebsky was desig­ nated chairman of the Department of Bacteri­ ology and Immunology, the scientific and mcellectual roots of the department originat­ ed m Heidelberg, Germany, in the early part of the century. Emil von Dungern, a student of Paul Ehrlich, the "father of immunology," and Ludvik Hirszfeld conducted pioneering scudies on human immunogenetics in the In­ stitute for Cancer Research at the University of Heidelberg. Several years later, in the same institute, another student of Ehrlich's and friend of von Dungern, Hans Sachs, collabo­ rated with che young Ernest Witebsky in pi­ oneering research on the immunologic specificity of organs and tissues. Hirszfcld returned to Poland where he later became chairman of che Department of Microbiology at che University of Warsaw. He was to become the mentor of Felix Milgrom. Thus, the heritage of the Department of Microbiology derives from Ehrlich and in­ cludes the beginnings of immunogenetics and scudies on organ and tissue specificity. Ac the beginning, the department consisted of Dr. Witebsky, a diener (assistant), August Fischer, and a technician, Anne Heide (Miss Heide retired from the University in 1982 af­ ter 52 years of service), and was housed in three rooms in the old Medical School on High Street in Buffalo. The teaching responsibilities included presentation of bacteriology and im­ munology to second year medical students. James F. Mohn, presently professor of microbi­ ology and director of The Ernest Witebsky BUFFALO IPHvS1¢1ANj Center for Immunology, joined che department in 1942as a student assistant during his medi­ cal undergraduate days and became a faculty member upon his graduation in 1944.Three years later, in 1947,Dr. Mohn took responsi­ bility for the medical course which he led suc­ cessfully for 28 years until 1975when Thomas D. Flanagan and Murray W. Stinson became course coordinators. In the lace '40s and early '50s, Dr. W1tebsky continued his studies on blood group sub­ stances and tissue specificity. He had attract­ ed to the department, talented young investigators such as Noel R. Rose and Sidney Shulman who collaborated on the tissue speci­ ficity studies focusing on the antigenicity of thyroglobulin. Their collaborative efforts resulted in the first experimental demonstra­ tion of autoimmunity. They showed that rab­ bits immunized with their own thyroglobulin developed anti-thyroglobulin antibodies and, most significantly, the rabbits mounted an im­ munological attack on their own thyroid glands. The work was later extended to human diseases of the thyroid by the demomtratton of anti-thyroglobulin antibodie, in the sera of patients with Hashimoto's thyroiditis and other thyroid diseases. The research established the concept of autoimmunity as an immuno­ logical phenomenon, a fact with highly signifi­ cant clinical implications. Felix Milgrom joined che department m 1958.He came to Buffalo physically by way of Paris, where he had worked with Pierre Gra• bar, and spiritually by way of Heidelberg and the lineage of Ehrlich. He brought his own in­ terests in immunology which very much com­ plemented the existing research. He collaborated closely with Dr. Witebsky on projects dealing with tissue and organ speci­ ficity. His work later extended to issues of transplantation and tumor immunology. Also very significant were the research ac­ complishmcnrs of rhe late Dr. Erwin Nerer. He pioneered development of che passive hemag­ glutination test which aids diagnosis of a vari­ ety of coterie bacterial infections. He also coined the term "enteropathogenic" for certain 12/85 �MEDICAL SCHC)OL ~'JEWS normally friendly E. coli in the gut which can cause disease in infants. A graduate program was the natural out• growth of the research activities of the expand­ ing faculty (Almen L. Barron, Ernst H. Beumer, and Joseph H. Kite, Jr. had joined the department during the period 1954-58). Dr. Mohn first l.'Stablishedthe formal graduate pro­ gram and lacer Sidney Shulman and Almen Barron acced as directors of graduate studies. The post was filled by John Abeyounis from 1974 until 1985 when Bernice Noble assumed the co-directorship. The early years of the pro­ gram produced a small number of graduates, but with the winning of a National Institutes of Health Training Grant in 1961,the program grew rapidly. There were three Ph.D. degrees awarded before 1960;from 1960-1967,14Ph.D. degrees were awarded; from 1968 co 1974, 31; and from 1975co the present, 66. The depart· ment has awarded at total of 114 Ph.D. and 132 M.A. degrees. In addition, more than 135 postdoccoral fellows have received research training. C oncomitant with the expansion of gradu­ ate training, the focus of research broa­ dened. Prior co 1967 when Dr. Witebsky re­ tired and Dr. Milgrom assumed the chairmanship, most research interest centered on several aspects of immunology, particular­ ly tissue and organ specificity, transplantation, and autoimmunity. At this point new faculty were recruited, Dr. Joseph M. Merrick and Dr. Murray W. Stinson, with research interests in microbial physiology, Dr. Arlene Collins, and Dr. Harshad Thacore with interests in virolo­ gy, Dr. Carel van Oss in molecular immunol­ ogy, and Dr. Marek Zaleski in immunogenct ­ ics. In the lace '60s and early '70s, several direc­ tors of clinical microbiology laboracories in University-affiliated hospitals joined the faculty and conmbuted significantly to the ml.-dical and graduate teaching programs. In particular, Dr. Erwin Netcr became very active and influential. Thus a number of graduate stu­ dents received their training in the hospital laboratories of the community. In a similar manner, faculty members in clin­ ical departments or at the Roswell Park Memorial Institute with interests in immunol­ ogy and medical microbiology were appoint­ ed co the graduate faculty of the department and undertook the supervision of many gradu­ ate students in their laboratories. More recent recruiting of faculty continued 12/85 to emphasize maintaining strength in immu• nology as well as broadening the scope of research activity. In recent years, the depart­ ment has developed in areas such as molecu­ lar biology and parasitology. The current spectrum of research is very broad. For example, Dr. Philip LoVerde, with a background and training in traditional parasitology had developed a project applying the methods of molecular biology to the problems of immunity co schiscosomiasis. Dr. LoVerdc and his students and collaborators arc seeking the genes that code for the protec­ tive antigens of the schistosomc. Once identi- fied and cloned, the gene will be incorporated into an expression vector to produce the anti• gen. The process will be used to produce a vac­ cine against schistosomiasis. Cellular immunology 1sthe focus of a num­ ber of department research efforts. Dr. Diane Jacobs is concerned with the events of 8-cell activation: Her work deals with the interaction of bacterial lipopolysaccharides with the 8-cell surface in triggering proliferation. The sig­ nificance of cell-mediated immunity in virus diseases is under research by Dr. Thomas Flanagan and his colleagues. Dr. Joseph Kite continues his research into the role of cellular mechanisms in autoimmunity. Research on the basic biology of viruses is being conducted in the Virus Laboratory. Dr. Arlene Collins is studying the persistence of coronaviruses in cells using in situ nucleic acid hybridization. Dr. Harshad Thacore is inves­ tigating the molecular biology of viral interfer­ ence and interferon. Dr. Murray Stinson and Dr. Boris Albini are investigating the significance of streptococcal cell products in the phenomenon of bacterial adhesion and their role in immunopathology of the kidney. Dr. Abeyounis is acting chairman D r. C. John Abeyouni, has been ap• pointed acting chairman of the Department of Microbiology. He replau:s the internationally-recognized outgo­ ing chairman, Felix Milgrom, M.D., who head­ ed the widely respected department for 18years. The search for a nc\\ permanent chairman will begin shortly. Dr. Abeyounis, a professor of microbiology, has ser\'ed as director of graduate studies for hts department !Since 1972 and as associate chairman since 1983. He has been on UB's faculty since earning his Ph.D. here in 1965. A member of numerous professional socie­ ties, he is contributing Lxlitorto the International Archi\·es of Allergy and Applied lmmunoloir.,. Among his numerous publications in tumor and transplantation immunology, he is co­ editor of three boob including the 1985 Anri bodies:Pmrectite, Destnu:mc and RegulatonRole. BUFFAID I CJC:FvS l ¢1AN The North Carolina nativc's reseanh also to­ ~use,,on diagnosing cancer usmg antibodies m blood scrum as well as using immunologk ap­ proaches in cancer therapy. • �lmmunop;irhology continues to be an impor• tam focus of res..-arch. Dr. \'t'nebsk\ ha, been calk-d "rhe Farhcr oflmmunopathology" in this wuntry. It 1, fitting therefore chm tlm area of irn csci1tat1on 1s a maior part of thl· re.scareh our put of the dcpanment. Dr. Fehx M1lgrom, Dr. Giuseppe Andrl"s, Dr. Bon Albini, Dr. Ern,c Beumer and Dr. Ikrmn· Noble all :1Tl' 11wol\'ed m 1mmunopathologi{ Tl"'l"ar~h. In addmon, the area of rumor 1mmunolQ£y conunucs to gTO\\ through rhe effons of Dr. C. John Abcyounk He and his students arc in\'l'st1ga11ng rumor-associatl-d unrigcn, m animal models rclaung to human l"llnccrs. So n can be ,Cl'fl the re-.carch acuvnics of rhl" department cxpam.k-d and d1H·rs1fied\\ 11h the b'T'O" th of rhe faculty ond the graduate pro­ gram. The number of scu.•nnficpubltcauon, m• CTl'.lSCdyearly throughout the '60s, 'iO,, and mto the 1io.;, R.,r thl· IIH' yl-ar pcrnxl 1980-IQ&t, an m eragc of ahout 80 Journal aruclcs or hook chaptl't'S and three boob per year \\ere authon:d or l-dited hy member, of dw depart• ml·nt. Rc,l·an:h fund111ghas cont111ued to hl• su,rnmcd e\cn m che face of mcrca mg com• pctmon for 3\'allablc rcwurces. munology, now Thl' Ernest W11chsky Center for Immunology. Dr. Witcbsk\ "as the <enter\ fir,t director. The purpose of the center "as to provide a formal structure ro act as a caraly,t for immunologrcal n"SCar{hand teach mg m the Buffalo medical an<l ,lientilll communitie~. This s1 ter m<titu11011of the Dcpartmenr of :\11crohology 5ponsors a biennial mrcma11onal LOnvocauon on immunology, a h1cn111nlsum­ mer program m 1mmunol\>g1cal methods m re,ear< h nnd diagnosis, a journal calbJ Int C5 1igat1t'C lmnumology, and monthly round-table discussions on 1mmunological toptC'5 hy local and v1~111ngmH'5t1gators. Buffalo ha no" senc<l a the ho t for nmc 1nrcrnational con­ voca11011.~ m immunology, makmg 11one of the world's llll'Cttn~ cemcrs for immunologist,. OH,r the years, the ml-<ltcal teachmg pro­ gram has undergone s1g111ficanrexpansion. \X'nh the mcrea,e m s1:e of the mcd1,al school cla~'<'Sand accompanying, han~e~ 111 1hl· over­ all nll'<l1u1l curriculum, the depart mem, as other•, \\a, challenged to occomph~h more with less ume and sometimes \\1th l~th:m­ adcquatl' n-sour<l'5, In the early 'iOs the total time nllotted for till' ,cccmd•yl·nr cour,e, Med­ ical M1crohiolQ£y and Immunology, \,a, reduced by 33 pl'I" <.cm. In order to provide m• ,trucuon for interested studenrs, two clccu\'e courws, 111 medical micrnhmlogy and 111clini­ cal immunology, were mst1tuted. A~ a rc,ult of the connnumi: process of cumculum reform, the department nO\\ offer~ an honor cour-.e for sc<ond-year students m addiuon 10 the re• quired core cour5l', An ck"<.tl\'eis offernl 111the ,prmg semL'Stereach year 111 Advanced ~fod1cal M1crob1ology and Clm1cal Immunology, 1.:omhmmgthe two l'llrlu:r offering.<,In thl" thrrd year, there arc t\\O popular ~dL'CllH'S,one m Clm1cal Microh10IQ£Y,the other rn T rnp1cal :\1cdicme. The department also prm1dcs in• ,rruct1011 m the School of Dentnl Mcd1cme, prcsen11ng the <L-cond-ycarcour•c, Ad\·anccd Dental M1crob10IQITT. Courses arc also taught R l ccogniuon of the traditional strength of the department m immunology led co the hltshment, 111 1968, 01 the Center for Im• BUFFAID on the undL·rgraduate k·\'cl for students of nurs­ lllg, pharmacy, and ml'(ltcal technology, At the graduate level, ZOcour cs m vanous spcaal1zcd areas arc offerl-d, The Sdmol of Ml·d1une 1s eng,tgcd in a search for a new chamnan of Minohiology. The man or \\Oman who fil-,umcs the po,111011 ",II in hem a m h legacy of academic accom• ph,hmcm .md tradition. The fonrlty of the c.lL·parcml'lltwill pro\'1de the new IL·nderw1rh a firm base of experience and knowledge for the l?;rO\\ththat \\ill t.ikc pla<e in the next era m the life of the dl"Partmcnr. • State undergoes doctors' slowdown N l'\\ York S,.,tc ,md,:r ..111 a maJor do< tors' sl\mJm, n m June and July to protest CXleSSIVCmalpr;ictlle premium< 1h:it rose alm~t 100 per cent m one year. Although It created d1fficul11csm some UB read, • hospital<, 1he sl°"dm, n fortunat<'­ (y had m·Rlig1bleeffells on the tcad,ang func­ tions of thl Medical School, bccau c clas,cs \\ere not m session, reports Vice President for Clinical Affairs John ~aughton. Some dcx tors had hca, 1erworkloads 111trau• ma care an<l in some surgical spcnal11es ,uch as orthopaedics, neurosurgen· and oh,t<'tTI<-'• gynecology, cspt.-ciallyat Erie Count) :\1cd1cal Cc·nrer, Children\ and Millard Fillmore ho<p1• tak Rc,1Jl·nt, at rho,c hospital- al,o ex• pcnence<l he;ivier workload,. Workloads m other hosp11als remamed the <amc or were 50mcwh:it rL'<luced. Hundrl'tls o WNY phys1<ians JOll1edother5 turcwi<lc t,-, l0hby tn ma55e m Alhany. They SU((eed<·d In getting the k-gislaturc to pass a bill chat slmH-<lthe rate of mcrea,<' m prcm1• urns. The ncuon wa< <On<idcred to be n tern· porarY mca urc only, acconlmg to Dr.Anthony Samamaun, (:\1'56),an area leader Ill rhc issue. •[n realuy, we were only huymg ume over the summer," Santamau«, stlltl-<l. A 19,membcr tnsk force of the :\1eJ1cal Society of the Seate of :-,.:C\\ York ha, been mecllnl'.\\\1th Gov. Cuo­ mo\ rcpr,·scntanve simc July. They have pre<ente<l proposals which contain a renewed request for a aip of S250,000on awards for pam and <uffermg m successful malpracuce la" u1rs. Prm1sions for \'oluntnr\ hmdmg arh1trat1on and a taxpayer•suppom•d reserve fund ro p,1y for ~ttlcments exceeding phy<1nan'i. coverage arc abo 111 the proposal, as of this wmmg. • 12/85 �Health Library moves to Abbott T he UB HL>althSciences Library, where stu­ dents, faculty, and researchers have spent literally millions of hours since its inception 138 years ago, has moved to its fifth home. It took three weeks to move its 240,000 volumes and audio-visual materiab to Abbott Hall, located 750 feet to the south of its form­ er home in Kimball Tower. The move was com­ pleted October 7, 1985. Abbott Hall is the original Lockwood Library on the Main Street Campus of the University. The move of the library, anticipated for sever­ al years, increases library space from 38,000to 60,000 square feet. lt is the second move for the HSL in recent years. Prior co moving to Kimball Tower in 1974,it was located in Farb­ er Hall. Noting that UB's HSL is one of the cop med­ ical/health related libraries in the U.S., its direc­ tor, C.K. Huang, says that the newly increased space puts 1cin the top 20 of similar libraries located at 132 medical schools nationally. "There are others which have more space, but certainly few which equal ours in quality and function; Huang says proudly. The Healrh Sciences Library has come a long way from its beginning in 1847 when it start­ ed with 519 volumes purchased at a cost of $829.96,a year after opening of the UB Depart· ment of Medicine at Washington and Seneca Streets. Instrumental in early development of the fa. cility was James Platt White, M.O., who was a member of the founding faculty of the School of Medicine, a professor of obstetrics and dis­ eases of women and children, and a library committee of one. In 1881,a bequest from White added 1,070 volumes to the library, which by then had moved to Main and Virginia Streets. In 1891, a bequest from George N. Burwell, M.O., a prominent Buffalo physician allowed the ad­ dition of another 1,000 volumes. The lace Roswell Park, M.0., provided 3,000 others. Early interest and support of the library prompted che famous Flexner Report on Med­ ical Education in the U.S. and Canada issued in 1910to note that at UB there "is a small museum and a good library of 8,000 volumes, current German and English periodica ls with a librarian in charge." In 1953,when the Schools of Medicine and Dentistry moved to the former Capen Hall 12/85 (now Farber) on the Main Srreet Campus, the library became the Medica l-Dental Library. In 1961, it was renamed the Health Sciences Library and incorporated into the University Libraries. The new facility in Abbott Hall will feature the History of Medicine Collection and a Me­ dia Resources Center in its basement; services and reference on the first floor; bound period­ icals and the main reading room on the second, and books on the third. Moving the books and other materials was planned so char entire sections of shelves could be transferred intact to designated areas at Abbott. "Obviously, we couldn't just pack up the books in boxes and move them. Can you im­ agine how long it would take us to gee them back in the proper order?" Huang laughs. • Baier appointed director of HIDI R obert E. Baier, Ph.D., P.E., an internationally-known biomedical en­ gineer-scientist, has been appointed Robert F RmP.- BUFFAID c ~::::::ic:r LJ:.£-,. ..- director of the Health-ca re Instruments and Devices Institute (HIDI) at UB. HlDI, an advanced technology center, was funded initially in 1984to develop and evalu­ ate health instruments and devices in cooper­ ation wich industry. While more than $500,000 in industry-related research has resulted since HIDl's ince"ption, efforts will be intensified to meet the full opportunities available through­ out Western New York and elsewhere, Univer­ sity spokespersons say. O riginal funding and subsequent marching funds for HIDI were provided through the New York Department of Commerce's Science and Technology Foun­ dation. "Dr. Baier's credentials and past experience in the fields of engineering as well as surface chemistry will provide renewed impetus in fostering a relationship between local and University scientists and industry which can result in improvements in the Western New York economy," says President Steven Sample. Baier, a registered professional chemical en­ gineer and a nationally certified environmen­ tal engineer, holds eighc patents and is founder of Baier, Inc., a start-up company located at the Western New York Technological Development Center at 2211 Main St., Other investors, ac­ cording to Baier, are assuming control of that company as he takes directorship of HlDI. A faculty member in Biophysical Sciences (Medical School) and Oral Pathology (Dental School) since I970, Baier was a staff scientist at Arvin/Calspan Advanced Technology Center prior co joining UB full-time. His achievements, which in 1983earned him che prestigious Clemson Award from the So­ ciety of Biomaterials, include work on the in­ terior surface of the artificial human heart and development of umbilical cord vein grafts. His research on determining properties of the sur­ face skin of dolphins, conducted at the Aquar­ ium of Niagara Falls, were featured last fall on NBC's "Today" program. With more than 200 research publications to his credit, including journal articles, books, text chapters and audio cassettes, Baier has also served on the editorial board of the Journalof BiPmedicalMaterialsResearchfor more than a decade. He has been a consultant for American Cyanamid, Meadox Medicals, Cordis Corp ., Baxter Travcnol, Science Applications, W.L. Gore, Davis & Geck, and Astronics Inc., com­ panies which represent a wide range of interests from artificial human organs to polymers. • �STUDENTS STUDY IDOKS AT WHY STUDENTS CHANGE FIELDS I t has frequently been observed chat the career a medical scudent chooses to enter after graduation is often different from the field of specialization he or she had intended to pursue when beginning medical school. With the issue of possible physician oversup• ply gaining increased attention, interest has been growing in understanding why certain students choose particular fields of specializa­ tion. Dr. Frank Schimpfhauscr, Ph.D., Dr. Ran• dolph Sarnacki, Ph.D., and Dr. Leonard Katz, M.0., of the UB School of Medicine have con­ ducted a study to better understand this choice process (Journal of Medical Educacion,April 1984,p. 285-290). Previous scudies elsewhere have dealt with the students' career selections, focusing on a variety of characteristics such as personality, age, value systems, and demographics. Schimpf­ hauser and his co-researchers approached the question from a different angle. "Our study dealt primarily with 'negative factors' involved in the choice process; explains Schimpfhaus• er. "We looked into reasons students move away from certain fields. A student may start medi­ cal school intending co go into family medicine, for example, only to decide he doesn't like this area. There appeared to be negative faccors that cause students to reject their initial choices. This is mainly what we were interested in." The study was based on retrospective career choice questionnaires filled out by 98 students from the 1982graduating medical :school class at UB, in which students were asked co pin­ point exactly when in their medical curricu­ lum changes in choices occurred. The questionnaire revealed that 50per cent of th(.-se students changed career preference prior co graduation. Says Schimpfhauser, "We wanted to determine to what extent a student rejects an initial preference because of negative factors encountered in that field as well as because of the usual attractive features of a new choice." The questionnaire completed by the students included three items: the area of medicine ul­ timately selected for practice; che point in the four-year undergraduate medical curriculum at which the career choice was made; and, if a change in career selection occurred, when and why it occurred. Schimpfhauser, Sarnacki, and Katz then undertook to classify data gathered from student responses. They first established nine basic career categories: internal medicine; pediatrics; ob­ stetrics/gynecology; psychiatry; family practice; BY CATHERINE KUNZ surgery; surgical specialties (emergenc..y medi­ cine, neurosurgery, ophthalmology ::md or• thopaedic surgery, for example), medical specialties (dermatology, neurology, preventive medicine, etc.); and hospital-based specialties (anesthesiology, pathology, and radiology). Open-ended responses ro the question regarding reasons for change m specialization were classified according co the general content factor being expressed and to whether it wa, an attracting or repelling factor. Schimpfhaus­ er and his co-researchers sorced the respon,es by what determined the choice-personal fac­ tors, curriculum influences, future career con­ cerns, the influence of other,, extra-curricular influences, and philosophical or psychological reasons. Each of these categories had both a negative and positive c:omplemcnr. A student, for example, who cited "opportunity for fami­ ly life" as a factor which led to the choice of anesthC5iology as a career would be cact.-gorize<l as expressing a "personal" fauor leading to a positive attracnon for anesthesiology. The sys­ tem of categorization alro included general "like" and "dislike" categories for factors not covered in any of the other categories. A nalysis of the responses revealed rhat of chose students who changed career prefer­ ences, 84 per cent did so because of negative reasons relating to the initial choice, while only 16per cent did so because of a positive aspect of another field. Schimpfhauser and his associ­ ates compared the method by which students decide on a discipline to that by which a scien­ tific hypothesis is generated and tested. "lnitally a choice is made, similar to any hypothesis. The choice is then presumed to be tested by ex­ perience, the acquisition of new information, and the evaluation of any nC\\ data regarding the choice. If chc choice is found to be want­ ing, it is rejected and a new hypochcsb is then generated." Factors chat contribute to thts process can be seen in some of the responses given by the students in Schimpfhauser's study. They com­ mented on a wide variety of influences rang­ ing from contact with people within their chosen field to practical considerations relat­ ing to the various careers. Perhaps the most basic factor considered by students is the character of the field it5elf. Some BUFFAID J R PH '!. I t_ ~ students, for example, were attracted by the var­ iety in family medicine. The discipline offers wide opportunities for placement, ~ome said. It offers an opportunity to treat the "whole" per­ son and involves the practice and knowledge of many kinds of medical fields and an inter­ auion with many levels and kinds of ailments. For others, however, this variety was cited as a negative faccor which caused them to aban­ don the field. Quite a few students did not feel themselves competent enough in different areas to be good family practinoners. Students who enJoy working with their hands and with different kinds of machinery were attracted to surgery and the surgical specialties. The "active" nature of these dis­ ciplines drew them from more intcllcctually­ pcrce1ved fields involving chiefly diagnosis. They appreciated the opportunity co work directly co improve a patient's condition. Said one srudcnr, "There's a feeling chat you arc making people better in surgery." Radiology, on the ocher hand, attracted those students who appreciate primarily intellectual activity. "Radiology seems like fun," said one student. "It's like visual puzzles. To me, this specialty is more cerebral than physical. I find the ward work and clinics of other fields rather boring. There is less management and more thinking m radiology." I n changing career choices students also rook into account the nature of the patients en­ countered in the practice of a field. "I changed my mind from intern;il medicine to surgery at the end of my third year, just after finishing 12weeks of medicine; rcmemhers one student. "I found medicine frumating because of the many chronic problems you have to deal with. It also seemed as if most of the patients were well advanced in years. The rounds every day seemed endless at times." "I could see a lot of fru,rrarion in future ye;irs dealing with chronic illnesses and poor patient compliance," agreed another student who switched into surgery from internal medicine. On the ocher hand, patient condition was a positive factor for some students who ultimate• ly chose family medicine, pediatrics, and ob­ stetrics/gynecology. Some mentioned that one positive aspect of these fields is chat their con­ tact is usually with generally healthy people. klealism and philosophical motives entered into the choice process of some students. Sever­ al entered certain specialties in order to serve 12/85 �STUDENTS specific segments of the population. Love of children and a wish to help them led to some careers in pediatrics, while rhc desire to upgrade the health of women led ochers ro rhe fields of gynecology and obstetrics. The wish to help a particular group led ro the choice of other careers as well. One black student, for exam­ ple, responded, "As a black member of society, I wanted to choose a division of medicine in which I could be of particular service. I found there were very few black dermatologists; black patients prefer a black dermatologist. The der­ matological problems in different populations often require different or modified treatment from another population, requiring special knowledge or skill." More practical concerns played a part in rhe choice of career as well. "How docs one lead a family life when involved in family medicine?" asked one student realistically. Indeed, the desire for more stable work hours often led stu­ dents away from such disciplines as family medicine and obstetrics and into hospital-based and surgical specialties. "The hours are hard to bear; commented one anesthesiology student. Said a radiology student, "Radiology affords one a more 'normal' lifestyle. I have other in­ terests which I wish to pursue and I should be able to do so as a radiologist." One of the stronger factors influencing stu­ dent career changes, however, was the nature of the contact that the students had with professionals within their chosen field. The in­ formation that students gave in this area is im­ portant because rhese are rhe factors that professionals within a discipline can have the greatest effect on. Schimpfhauser found that faculty members provided positive influences if they presented interesting courses, acted in a way that students perceived as professional and displayed concern for patients. Students also reacted both positively and negatively to professionals and institutions in various fields that they came into contact with. M any students who chose pediatrics, tor example, cited the positive influence that their experiences with Buffalds Children's Hospital had on their career choices. Said one student, "I found pediatrics to stand alone in meeting my concept of medicine. The excellent pediatric care that Buffalo offers no doubt in­ fluenced me greatly. It was finally possible for me co be a humanitarian, a scientist, and a pa­ tient advocate all at one rime. If I had trained 12/85 elsewhere, I might nor have made the same choice." "I'm sure glad I came to SUNY/Buffalo for medical school; said another. "The availabili­ ty of a Children's Hospital has given me excel­ lent training in pediatrics." Sometimes, however, the image put forth by professionals within a field had a negative ef. feet on a student originally interested in that field. "I eliminated family medicine early on be­ cause of our family medicine course," said one student. "It portrayed family medicine doctors as bumbling, ignorant, and our of touch with medicine. Other medical fields also put down the family practitioner so much that it appeared that no one thought he or she was worth anything." One student in internal medicine noted that rhe professionals encountered in the third year of medical school seem to have an especially strong effect on a student's decision. "From dis­ cussion of this topic with friends, as well as from my own experiences; rhe student explained, "the decision is strongly influenced by the degree of alienation one feels during third year rotations; i.e., I was alienated by many mem• bers of rhe surgical faculty and some r~idents. Personality problems shouldn't play a role ideal­ ly, but in fact, they do." While Schimpfhauser found certain dis• ciplines, notably psychiatry, to be quite stable, retaining most of the students who chose it originally, he found that other fields both lost and gained students. Certain disciplines, however, were consistently on the losing end. In 38 per cent of the changes, for example, the discipline rejected was family medicine. While rhis field was a common early choice for stu­ dents entering medical school, 76 per cent of these students rejected chat initial choice and selected another specialty. The field attracted only one student who hadn't selected it as an initial choice. By contrast, most of the students who ulti­ mately chose internal medicine, surgery, surgi­ cal specialties, and medical specialties had initially selected a different field. Internal medi­ cine, for example, received 48 per cent of its students by conversion from another specialty. Schimpfhauser and his associates maintain that for medical educators and those concerned with student career selection, understanding the process of change in career choice may pro­ vide a basis for strategies co influence or sup­ port career decisions. If there is a desire to increase the proportion of students entering fa. BUFFALO jPHvS1¢1AN) I cho e ml rna med1 me mo ti be ause an 111tegrat1Le approa<.h m manag, It fosters KATRINA GUEST Iv r 1ect d a µ ialt m n,rgery be au of th year~ of trammg and the In I th e I, r l an and han• ec1fic t P ts STUARf LfRNl:.R Mcd1cmc f1uts uc:/1 111phas1s cutel 111 mt! t e ,. ts lotv d e • mily medicine, for example, recruitment efforts would likely be most profitable if directed ro the group of students initially expressing a preference for char field with carefully designed followup and retention efforts. Schimpfhauser and Sarnacki both propose ways that disciplines like family medicine which consistently lose students may attempt to re­ tain them. Says Sarnacki, "It is possible that �2., STUDEN TS D BORAH RI( HTER l hat d c1ded p , h11.1tr, th go mto l health elopmg nd be• an gne '- n to the ,t:ho most JAMES S( HAUGHN ESSY l 't clecHlecl a am t fam1h prav b <.<lttse its 11/Lt, le leave vou t o lutl fam1h and p r nal time, u h1le allous Pnchiatn pnor1t, on fam1h l1f l al o like Ps:>• ch1atn because It 1s P<lt1tnt or1~•11ted, 011 g t to sp nd a lot f tune u 1th ,our ti .. those fields in a position to lose students might be able to provide newer and more exciting ex­ periences which would cause students to main• tain interest." Schimpfhauser agrees. "It may be chat con• tinuing and early contact might gee students more involved and interested in their chosen specialty. The faculty should keep in contact with students and discuss with chem their feel- ings about the field. They should cry to pro­ vide positive exposure to the field and try to keep up a positive relationship with their students. "This was a study that we felt was really im­ portant to do; Schimpfhauser concludes. "We've always asked students to tell us when they changed fields-we've never formally asked them why-very few medical schools do. I think the study pointed out to faculty that the im• age they present influences student choices. The study of student responses helped us con• firm what was felt already but also explained some of the reasons behind the choice process. I think it has brought us to a better understand­ ing of this important process." • Class of 1989: 83 men, 5 2 women, 20 minorities BY BRUCE S. KERSHNER T he statistical profile of the I39th fresh­ man class of medical students is now in. As in the lase several years, the proportion of women and minorities remains consistently high. According to the Medical Admissions Office, the Class of 1989 is comprised of 83 men and 52 women (one less than last year). The 20 minorities include II Blacks, seven Puerto Ri­ cans, one Native American, and one Mexican American. In addition to the 135 medical Stu• dents, four more are in the M.0./Ph.D. program. Down from last year, 68 originate from Western New York. Seven hail from other parts of upstate, 51 from downstate, and nine are from other states (the last two represent an in­ crease over last year). As with lase year, biology, chemistry, and bi­ ochemistry undergraduate majors dominated. However, 25 per cent have non-science and non-health-related degrees. This conforms to the recent GPEP report's recommendations to recruit students with broader, more liberal edu­ cations. Some of the more unusual undergradu­ ate majors include sonography, ceramic engineering, music, African studies, business, economics, math, political science and foreign language. Four of the new students have a Ph.D., one has a D.D.S., and 14 have master's degrees (same as last year). BUFFAID ! P HVS 1¢I AN I Med freshmen at orientation. Mean MCAT scores average 9.35 for all categories (9.48 last year); undergraduate science GPA averaged 3.35 (3.37 last year). • Tobak wins prize for PMI project T hird-year ml!dical student Mark Tobak was recognized last spring for his Pa­ tient Medication Information sheet (PM!), which was selected as the choice of the AMA Division of Drugs for the Department of Pharmacology and Therapeutics' PM! Award. PMl's help physicians do a better job improv• ing patient compliance with a prescribed regi­ men. In a second year course, students learn how to write PMI's in order to improve their ability to communicate effectivelywith patients. They are challenged to write a PM! as an elec­ tive exercise and for judging in competition. • 12/85 �26 HOSPITAL NEWS Wright settles-in at Roswell Park BY BRUCE S. KERSHNER 0 ne of the country's major cancer research centers, Roswell Park Memorial Institute, received new leadership last summer when UB's John R. Wright was unexpectedly appointed as new in­ terim director. As chairman of UB's Depart­ ment of Pathology with 50 faculty and staff, he will now also oversee operations of an in­ stitution employing 2,500 physicians, research­ ers, and other support staff. Dr. Wright was chosen to succeed Dr. Ger­ ald Murphy, who abrupcly resigned after serv­ ing as director of the institute for 15years. Dr. Murphy will now devote his efforts to full-time research in the newly created position of direc­ tor of oncological research programs in urolo­ gy at UB. Dr. Wright will remain chairman of the UB Medical School's Department of Pathology. He will continue his teaching duties, will oversee faculty development and promotions, and direct the organization overseeing residency programs and other activities. To assist him and to conduct the day-to-day operarions of the department, Reid Heffner, M.D., professor of pathology, will serve as associate chairman. While he serves an interim Institute director until August 1986, Dr. Wright has taken a leave of absence from his other role as head of Buffalo General Hospital's Department of Pathology. Dr. Wright is currently conducting a thorough evaluation and review of all of Roswell Park's resources and programs. His goal is to assure that its considerable resources fit into an overall long-range plan for continued quality research, patient care, and education. Presbyterian Health Resources, Inc., based in New York City, has been contracted by the State to provide management expertise and to develop a short• and long-range plan for the Institute. Wright is working closely with them in chis planning process. Another one of his primary goals is co stabi­ lize the institution and its day-co-dayoperations during this transition period. He wants to strengthen and improve the clinical services and co evaluate the feasibility of developing new clinical facilities and improving the salary schedule for clinical staff. The search process for a permanent director is expected co be completed in summer 1986. 12/85 Wright will play an active role in this process. Of particular importance to the University, he "will explore ways that the institute and UB can interface on a more active level." He be­ lieves that both will benefit from a closer rela­ tionship. Roswell Park is already part of the UB Medical School's teaching hospitals system. "l would like to increase the interchange be­ tween the two institutions among the gradu­ ate programs," he comments. Roswell Park has a large post-graduate and doctoral program operated by the Roswell Park Graduate Divi­ sion of UB. All institute scientists in this divi­ sion are UB research faculty members as well. T wo ocher areas where Dr. Wright plans co strengthen Roswell Park/UB ties arc in faculty recruitment and residency programs for physicians. He would like University department chair­ men and departments to have greater input in recruitment for new institute academic staff, particularly in the clinical areas. A large propor­ tion of the institute's clinicians also have faculty appointments with UB's School of Medicine. "ln particular, I would like to develop residen• cy programs (for physicians-in-training) at Roswell that would be part of UB's system of residency programs; he explains, adding that "this would also apply to post-graduate train­ ing programs." Dr. Wright earned his M.D. from the Univer­ sity of Manitoba in 1959. He completed his residency in pathology with UB's program at Buffalo General Hospital in 1964. Following a Buswell fi!llowship at UB, he was on the faculty of Johns Hopkins University Medical School until 1974, when he returned here co chair the Pathology Department. Among his recognitions, he has been select­ ed by medical school classes for nine reaching awards or citations. Dr. Wright's involvement in the field of on­ cology began before he was assistant professor of oncology at Johns Hopkins. He has pub­ lished a dozen or so articles on oncology. He is currently principal investigator for a $254,000 cancer education grant. He has served as consultant to Roswell Park's clinical staff since 1975 and has been on their Board of Visitors since 1981. Shortly after Dr. Wright was appointed, the N.Y. Seate Department of Health appointed Andrew A. Gage, M.D., as associate institute director for clinical affairs and Verne Chap­ man, Ph.D. as new associate director for scien­ tific affairs. Dr. Gage, a UB professor of surgery, has been the chief of staff of Veterans Adminis­ tration Medical Center since 1971. The UB Medical School graduate was one of the de­ velopers of the world's first successful implant­ able cardiac pacemaker in 1960, and played a central role with Buffalds first heart transplant in 1984.The award winning surgeon is current­ ly state governor for the American College of Surgeons. Dr. Chapman has been a cancer research scientist at Roswell Park since 1972 and chair­ man of their Molecular Biology Department since 1982. Also an associate research professor of biol­ ogy at UB, he is a former chairman o( the Roswell Park Association of Scientists. High Street move culminates merger F or two of Western Nt:w York's oldest health care institutions, the final trans­ fer of acute care services to the new Deaconess Tower, 100 High Street, represents a rich heritage of caring and the culmination of one of the state's largest hospital mergers, begun nearly a decade ago. Merger talks between the Buffalo General Hospira! and the Deaconess Hospital of Buffalo were initiated in 1976 and resulted in the for­ mal merger of the two hospitals three years later 0anuary 1979). Today, all acute care services are concentrated at the High Street site with the Family Medicine Center, Family Planning Center, Skilled Nursing Facility and the Im­ mediate Treatment Center housed at Dea­ coness. A s Deaconess embarks on a new era of serv­ ice to the community, it is also celebrat­ ing 90 years of service as a health care provider in Western New York. The Deaconess spirit of "friendly care" was founded nearly a century ago when the Reverend Carl L. Shild, pastor of the old St. Stephen'~ Evangelical and Reformed Church, returned from Europe with a program for improved care of the sick which he had observed while at Kaiserwerth-on-the­ Rhine, Germany. There, special nursing edu- r �2 HOSPITAL NEWS > cation was offered to German Deaconesses, an old world order of women dedicated to the sick and poor of the church . A group of pastors representing several German churches in Buffa­ lo, spearheaded by Rev. Shild, formed the Dea­ coness Society of Buffalo in 1895 with the ultimate goal of establishing a hospital. A build­ ing was rented at 27 Goodrich Street, and on November 14, 1895, the first patient was ad­ mitted co the German Deaconess Hospital of Buffalo. The hospital's mission was founded on Chris­ tian charity, "to help the suffering and mankind." Within a year, the Deaconess out• grew its facilities and moved to a site on Kings­ ley Street. The new hospital complex, dedicated on November 21, 1896, consisted of three di­ visions including a home for the Deaconesses, the east wing for the sick and the west wing as a home for the aged. Each division could accommodate about 40 persons. Fifteen years later, the hospital underwent another expan­ sion with a new building on Riley Street. The home for the aged was discontinued and the original building was converted to a residence for nursing students. During World War II, the upsurge in patients led Deaconess officials to borrow government funds in order co increase the hospital's bed complement from 197 co 337. The most recent major bui lding project was completed in 1961 with the dedication of a new $4.5 million hospi• tal facility on Humboldt Parkway. r "Rooming- In" at D ea con ess, 1910. First ambulan ce, 1900 . In addition to the spirit of its people and mis­ sion, the hisrory of the Deaconess Hospital has been characterized by its growth. From a small rented house on Goodrich Street with strong religious ties, to a major non-sectarian teach­ ing hospital and now, as an integral part of a multifaceted health care system, the Deaconess vision has been realized by a shared commit­ ment to excellence in health care. A n important part of the Deaconess heritage is rooted in specialty care and educational programs. The two most ac­ knowledged examples are the Wettlaufer Eye Clinic and the Fnmily Medicine Program. The former Buffalo Eye and Ear l:nfirmary chartered in 1876 and later renamed the Wett­ laufer Eye Clinic, merged with Deaconess Hospital in 1959. Renowned for quality serv• ice, the clinic also served as a prestigious train­ ing center for ophthalmology residents. In 1969, the Hospital's role in developing con­ temporary family practice physicians took shape with the first university affiliated residency pro­ gram for family practitioners in Western New York. Currently located in the Deaconess Di­ vision, the program provides comprehensive fa. mily oriented care to over 11,000patients each year and serves as rhe primary training center for an average of 30 family medicine residents annually. Education and training programs were also offered in general surgery, obstetrics a:nd gyne­ cology, pathology, radiology, urology, orolaryn­ gology, and colon and rectal surgery. The Deaconess Hospital School of Nursing, estab­ lished at the turn of the century, trained hundreds of registered nurses before it closed in 1973. Its educational focus intact, the Deaconess prided itself on being a community hospital, serving the peop le of Buffalo and drawing the greatest percentage of patients from its sur­ rounding neighborhoods. Among its primary services, obstetrics and gynecology was tradi­ tionally one of the hospital's busiest and most progressive. The Deaconess maternity service, which has recently moved to its new home on the eighth floor of the Deaconess Tower, is recognized throughout Western New York for BUFFAID [PHVSl¢1ANI its family-cente red approach to child birth. Deaconess was one of the first hospitals to al­ low fathers to actively participate in the birth­ ing process, and later, to employ a nurse midwife and allow siblings to be present for the birth. Now, the maternal/child program offers care for high risk pregnancies and teenage preg­ nancies through its outpatient and inparient services. A s it enters a new era the role of the Dea­ coness as a community-oriented health care institution continues with a 200-bed skilled nursing facility committed to the comprehen­ sive care of its elderly residents. And in the area of education, the Deaconess skilled nursing fa. ciliry provides a unique learning experience in geriatric care for students through its ties with UB. The people of Deaconess, many of whom arc now located on the new Buffalo General cam­ pus , share a legacy once described by the lace Bruce J.Bausr, administrator of Deaconess from 1970 to 1977:"... a feeling of friendliness and concern for all permeates its walls and reaches our to engulf the sick, the poor, rhe troubled and the friendless." The spim of Deaconess lives on - in a new setting, with a new mission. (from BGHs .Jufy 1985 'Pulsebeot") Sisters opens new PT/OT wing I n March, 1985, Sisters Hospital's new Phys• ical and Occupational Therapy wing opened. It is believed to be the largest of its kind in Western New York, according to hospital spokesmen. In addition, plans have been finalized for construction of the new Emergency Depart• ment at Sisters to open in spring of 1986. Sr. Eileen, president of the hospital, said the State Health Department has approved renovation of the current facility and expansion by approx• imatcly 1,600 square feec. Construction of the new department is ex­ pected to cost $750,000. "We arc very excited about this project," Sr. Eileen said. "The Emer­ gency Department is a critical part of the hospi­ tal's health care services and we have been considering updating for several years." The project will involve expanding the Emer­ gency Department into part of the driveway area cur rently used by ambulances. • 12/85 �!8 PEOPLE Dr. Lewis Flint heads Surgery BY BRUCE S. KERSHNER "The surgeon is a bridge-tender in medical research. We assess the accom­ plishments of the basic science community and chen bring those chat are appropri'<!teto surgi­ cal practice across into the clinical arena." These words by Lewis Flint, M.D., new department chairman, suggest the approach he will cake as he leads the UB Department of Sur­ gery into a new era. The former professor of surgery at the University of Louisville School of Medicine and chief of surgery at Humana Hospital/University is respected nationally as an authority on trauma and general surgery. He will apply his expertise to the Medical School that his distant ancestor, Dr. Austin Flint, Sr. served so famously. The earlier Dr. Flint, UB's first professor of clinical medicine, registrar and treasurer of the Medical School, was known as "the American Laennec" because he popularized the use of stethoscopes in this country. "I was impressed by che overall strength of the University and by the tradition of the depart­ ment; Dr. Flint remarked about what motivat­ ed him to come to Buffalo. Then he added, "I was very attracted co the city and the University." Besides che Flint family connections, "there are other interesting similarities between Louis­ ville, Buffalo, and their two universities; he re­ lates. "Boch cities are dominated by heavy industry and both were hurt by the recent recessions. Both universities have very long his­ tories with medicine as the earliest components of their institutions; both started as private schools, then became state institutions." In contrast to UB, the Duke University med­ ical alumnus points our, Louisville has a strong tradition of for-profit institutions (even the university hospital is for-profit). "Humana has enormous access to capital and is willing to fund a project if they like it. At UB, we don't have such a relationship to large sources of cap­ ital; in addition, the restrictions placed upon the University by the state bureaucracy limit flexibility." Furthermore, "while UB is much stronger in its basic research (compared to Louisville/Hu­ mana), it is interesting that the University of Louisville's Department of Surgery is its most 12/85 research-oriented department, more so than UB's surgery department; Dr. Flint explains. These differences form the basis of two of Dr. Flint's primary goals for his department. He would like to further strengthen the basic and clinical research in surgery "to form a solid group of surgical scholars .... Surgeons as a group are traditionally one of the most under­ funded groups chat apply to NIH." Then he adds, "And, as with any university, I'd like to develop a well-endowed research program." His ultimate goal is ro produce a surgery depart­ ment of national stature. Lewi! Flmt Dr. Flint emphasizes that "to be a good clin­ ical surgeon you have to be well versed in research, and to be a good surgical researcher, you must be involved in the clinical arena." He plans, too, to expand his department's clinical role in the community. "I'd like to ex­ pand our faculty to provide more well-defined services. We are currently too small to meet all areas such as Veterans Hospital's needs or the need for a stronger plastic surgery program. I would like our department to be recognized in the community as a clinical resource; he com­ ments. He would also like to expand the rela­ tionship with Roswell Park Memorial Institute BUFFAID 1PHvSt¢1Affj so that each insrirurion can contribute its strengths to rhc ocher. Flint sees his department in a position to con­ tribute to cohesiveness among all the teaching hospitals' surgery departments. "What we should recognize is that our goals overlap and many times are the same, based on the mutu­ al recognition that each has a stake in quality. In working coward strengthening each of our departments, we should realize we don't have goals in conflict, we have goals in common. In addition we each benefit from the University's network of informal education that would be more expensive for each hospital to do on its own." In the educational arena, Dr. Flint secs his department as embarking on a new era. "We arc in the midst of combining our graduate edu­ cation programs into one program in surgery. Currently, there arc two, one at Buffalo General and one at Eric County Medical Center. I would like to eliminate this duplication of ef­ fort, with two recruitment programs and inter­ view procedures, and change it so that they complement each other." Dr. Flint considers the training of future sur­ g<.'Onsto be essential to improving the quality of education in surgery. "To be a good surgeon­ educaror, you must be well-versed in all three arenas of education, clinical practice, and research." He stresses that surgery professors should serve as role models, especially as physicians who arc not afraid to get close to their patients. He also feels that the surgeon should serve as educator to his or her patients (in teaching them ro care for themselves) and also to the ocher health professionals. "One definite goal is co develop programs to facilitate the entry of minority surgeons into academic surgery. Minority students have few role models in surgery." Put simply, Dr. Flint's educational goal is co create an educational atmosphere so chat our medical students "leave proud of UB" and so that "they recognize that Buffalo is one of the best places co go to learn to be a surgeon." In the area of his personal research, Dr. Flint has published almost 60 publications and IO book chapters, much of the work focusing on control mechanisms in microcirculacion, in­ cluding the response co hypovolemic shock. He currently has applied for funding to investigate pharmacological effects of Naloxone and ocher drugs on shock, as well as microcirculacion con­ trol in diabetic animals. He plans also to establish prospective trials �PEOPLE directed toward cost issues such as devising methodologies that can shorten hospital stays. Studying post-traumatic metabolism in patients (wit h Dr. John Border) is another future project. Before coming to the University of Louisville in 1975,the Georgia native completed residen­ cies at both Duke Hospital and the Medica l University of South Carolina and was a Fel­ low in trauma surgery at University of Texas Southwestern Medica l School. The AOA member is the immediate past president of che Society of University Surgeons, currently that society's representative to the American Board of Surgery, and chairman of the publications subcommittee of the Ameri­ can College of Surgeons' trauma panel. Besides membership in numerous societies, he is associate editor of Current Conceptsin Trau­ ma Care and on the editorial board of Surgery and Hean and Lung. • Dr. Norma Calde ron Panahon, clinical as­ sistant professor of psychiatry, was elected the new president of the Philippine Psychiatrists in America during the organization's annua l meet­ ing in Dallas, Texas. A graduate of the University of the Philip­ pines, Or. Panahon is a board certified psy­ chiatrist in full-time practice in Buffalo. She was appointed by the president of the American Psychiatric Association to a four-year term as a member of the National Committee for Asian A merican Psychiatrists and has also chaired the Women's Committee of the District Branch of the W.N.Y. Psychiatric Society for five years. She is current program chairperson for the Western New York Psychiatric Society. Or. Panahon is married co Dr. Alvin Pana­ hon, also a clinical assistant professor of psv­ chiacry at UB. He is director of radiation therapy at Niagara Falls Memorial Hospital and associate chief at the Radiation Department of the Roswell Park Memoria l Institute. Of note, Dr. Panahon is the daughter of Jose 0. Calderon, former cabinet member under Philippines President Picodado Macapagal. Jose Calderon is now a prominent opposition leader-in-exilewith temporary residence in New Jersey. • Dr. Heinz Kohl er, research professor of microbiology and director of che Department of Molecular Immuno logy at Roswell Park Memorial Institute, has been recognized for his research by being selected to be on the cover of the August 1985 issue of ScienceDigescmaga­ zine. Th<>fr·:nure story described Kohler's and five others' work in trying to combat cancer by developing new approaches. As described in the February 1985 issue of Buffalo Physician, Kohler recently perfected a technique by which vaccines against cancer in mice could be deve­ loped using monoclonal antibodies. Science Digest described Kohler's work alongside that of researchers from Yale, the National Cancer Institute, Harvard, and the University of Chicago. • Dr. Pearay L. Ogra was recently presented with che Kalhana Award for outstanding con­ tribution in science by the Kashmir (India) Education, Culture and Science Society. Or. Ogra is professor of pediatrics and microbiolo­ gy at UB and also the director of the Division of Infectious Diseases at both UB and Chil­ dren's Hospital. A native of India, he was presented with the award by Fail Singh, presi­ dent of India. Examples of Or. Ogra's scientific contribu­ tions include his research on the highly benefi­ cial role of breast feeding in effectively protecting infants against infections of the in­ testine and respiratory tract. Or. Ogra also dis­ covered that certain viruses may produce allergy and asthma similar to chat caused by pollen and food. With a colleague, he has shown how malnutrition can result in severe diarrhea by affecting the way virus infections develop in the intestine. In addition to his research, Dr . Ogra is a trustee of the International Pediatric Research BUFFAID IPHVS1¢1ANI Foundation, senior edicor of PediatricResearch, and editor-in-chief of the InternacionalJournal of Microbiology(U.S. region). • Dr. T heodor e Putnam was selected by the Buffalo Pediatric Society as che 1984Pediatri­ cian Of The Year for his excellence in commu­ nity service and contributions to Children's Hospital. Or. Putnam, clinical assistant professor of pediatrics at Children's, joined UB's faculty in 1967as a resident, and became an active mem­ • ber of Children's medical staff in 1970. Dr. Datta Wagla, clinical assistant professor of urology and director of urology and hemodi­ alysis at St. Joseph !ntercommunity Hospital in Cheektowaga, has been elected president of the hospital's medical staff. • (l D r. Sebast ian C ianci o, clinical professor of pharmacology and therapeutics and professor and chairman of the School of Dental Medi­ cine's Department of Periodontics, has been elected to a five-year term on the U.S. Phar­ macopeia Committee of Revision, which is responsible for ensuring the accuracy and ade­ quacy of the U.S. Pharmacopeia and National Formulary. He has also been named editor of the new monthly denta l newsletter which will focus on medications involved in the health and well­ being of dental patients. "Biological Therapies in Dentistry" will keep dental professionals abreast of implications of using medications. • 12/85 �PEOPLE Dr. Margaret MacGilli vray and Dr. Mary Voorh ess, professors of pediatrics at UB and co-directors of pediatric endocrinology at Chil­ dren's Hospital, are co-researchers of a three• year, $107,500 grant from the National lnsti• rute of Health and Human Development. With Richard Clopper, a psychologist at Children's, the grant will be used to study the behavioral and physiological effects of two types of hor• mone treatment for teenage males with hor• monal deficiencies. This study provides the first prospective comparisons of the effectiveness of the two treatments as well as basic data on the interrelationships between hormones and be­ havior during puberty. • Dr. Laurence M. Sherman, clinical instruc­ n Dr. Patrick J. Crcaven, associate research professor of pharmacology, received a $776,650 grant from the National Cancer Institute to conduct studies in clinical biological pharma• cology. • Dr. Glen E. Gresham , professor and chair­ man of the Department of Rehabilitation Medi­ cine, has recently been appointed to the Public Education and Community Program Commit­ tee of the American Heart Association. Dr. Gresham is also chairman of the Heart Associ­ ation's subcommittee on stroke. • y Voorhess tor of surgery, has been appointed medical director of Hospice Buffalo, Inc. He has served as the Hospice home care physician for the past five years and maintains a surgical practice with offices in Snyder and Kenmore. • Dr. Joseph Anain, clinical assistant profes­ sor of oto laryngology, has been elected medi­ cal staff president of Sisters Hospital. Elected co other offices were Dr. Bertram Portin, clinical professor of surgery, new presidenc-elcct; Dr. Nelson Torre, clinical associate professor of medicine, new secretary; and Dr. Art hur Schaefe r ('4 7), clinical associate professor of ophtha lmology, new treasurer. • Dr. Michael Apicella, professor of medicine and head of the Division of Infectious Diseases at Erie County Medical Center, was appoint• ed chai rman of the Infectious Diseases Stu d y Section at the National Institute of Allergy and Infectious Diseases. • Dr. Leonard Katz, professor of medicine, and Dr. Joseph Zizzi (M'58), clinical associate professor of medicine, were elected to the board of directors of the Coordinated Care Manage­ ment Corporation, a United Way Agency which oversees long-term care for the elderly of Erie County. • Dr. Murray J. Ettinger, associate professor of biochemistry, was recently honored in Philadelphia as the Hahnemann University Graduate School's 1985 Alumnus of the Year.• Dr. Arthur 8. Lee, Jr., associate ptofessor of surgery at UB from 1973 to 1984, is now chair• 12/85 BUFFAID [P t1 YSl¢IANI man and professor of the Department of Sur­ gery at the Morehouse School of Medicine .• Dr. Jaya Ghoora h, assistant professor of radi­ ology, was appointed chief of the Diagnostic Rad iology Department at Roswell Par k Memorial Institute . • Dr. Robert Huben, clinical assistant profes­ sor of urology, has been appointed ch ief of the Uro logic Oncology Department at Roswell Park Memorial Institute . The Cornell Medical Col­ lege alumnus has been at Roswell since 1982.• �31 ALl l'v1NI Dr. William F. Lipp '36 "Our 50th: The greatestreunionfor a greatclass. Pleasecome." Dr. Frank C. Hoak '36 Dr. Jerom e J. Glauber '36 "Forrnno1j.\ reasonsour 35th will not be in uilifor­ nia but again in Buffalo. Al Goldfarb has some outstandingplans for this reunion. We're looking fonrnrd to seeing all of )Oa." Dr. Eugene V. Leslie '51 Dr. Allen L. Goldfarb '51 CLASS OF 1941. "/i's that time again for us to get-together." Dr. Donald W. Hall '41 "Hard to belict:eit's gomg to be 40 yean. It's ume u:e renett' old acquaintances." Dr. Harold J. Levy '46 BUFFAID Lf_!:tvS1¢1AN) 12/85 �·32 I Dr . Lou is J. Ant onu cci '66 "Smee our fifteenth reunion dicl not matemil1~e, here's hoping for a largeattenclancethis commg .\fm. LouAntonucci and I aregomg to do our be<t to ~ up an k"Tl'stmg11< • ,ul." CLASS OF 1956 "I enc-oumgc all 30 )Car grads from near and far to make pLms to attt'lld this )ear's SpringOmical affair. U:~urge )OU to I mt the neu campr,s,the new Buffalo,but mo.it of all to 1·im u ith ~our col­ leaguesof Ir one davs." Dr. Edm ond J. Gaceu·icz '56 Dr. Kenn eth V. Kl em ent owsk1 '66 'The 15th - It happem only once. This mil be our Silt er Ann11·ersan • a good ume to come together to celebratea11drcneu fr1end\h1ps." Dr. Carlo E. DeSanti s '61 Dr. Harold Brody '61 "Scott and I are!both lookmgfonwrd at the I 5th Year." to sec:mgyou Dr. Martin N . Man go '71 Dr. Sco tt D. Kir sc h '71 (No t Pictur ed) "It has been 10 years smce our graduation /mm McclicalSchool cmd perhaps one-half that num­ ber ofwars smce completingresidencies.The op­ f>OTtunitiesu e used to hai·e discussingtnth one another our fmurc plans hate recently been /cu and far betUC<'ll.PerhapstH' can rekindle tho«.' friencL1hips and diKtmions at our upcoming 10th ,l'ar reunion." Dr. Ru sse ll Bessett e '76 BUFFAID PHYS ~~ �AL MISSING: Your Help Is Needed \Ve need your help in lcx:atmg missing reun­ ion class members. Please contact the Alumni Office (716-831-2778) if you have information on the alumni li,tL-<lbelow: Dr. Virginia Richter Dr. Dr. Dr. Dr. Dr. Dr. Dr. Dr. Or. ~1 Deborah Bieter Tawni A. Frank Norbert Goldfield Melvin Gossman Hal S. Hemme Jane T Kmg Joseph Lightsey Robert Morse John Ncander Dr. Or Or. Dr. Dr. Dr. Or. Dr. Or. Marie Ncxck Raymond C Noel !'.1arie Th1:re,t Obama Agnes Samuel Vickie Sidou Oli\'la Smith Timothy 5purling Warren L. Thau Donald Tracy Dr. Robert S. Berkson Dr. John S. Doherty Dr. Warren E Greene Dr. Gene W. Hair Dr. Raymond S. Kibler Mr. Muri E. Kina( Dr. \1ildred Templeton Dr. Henry M. U,1ak Dr. Richard A. Wills Dr. ''faylor 0. Bailey Dr. Robert H. Burke Dr. Daniel E. Cordova Dr. \\'ill1am Cunningham Dr. Bertram Helfaer Dr. Joseph C. Sieracki Dr. &nJamin S. Park Dr. Leonard A. Pisnoy Dr. Albert J. Soha Dr. Stanley C. L'retskv Dr. John G. \\'alsh Dr. James Chrismdoulou Dr. Joan E. Clemmons Dr. Eugene M. Sp1ritus Dr. Michael H. Armani Dr. Barbara A. Bennett Dr. Kenneth A. Burling Dr. Richard J. D1Gennaro Dr. Thomas G. OiSessa Dr. Colleen L. Gratto Dr. John C. Guedalia Dr. Barry \X'. Haight Dr. Louis C. Iann o ne Dr. Charles G. Jalkson Dr. Lawrence 0. Ostrow Dr. Thomas S. Sven,son BUFFAID (PH9$T¢JAN) 12/85 �34 CLASSNOTES Pasquale A Greco Pasquale A. Greco (M'41) • clinical associate professor of urol­ ogy, and Dr. Philip Wel s (M'41), clinical professor of sur­ gery, have been reelected to the Board of Trustees of the UB roun­ dation, Inc., until June 30, 1988. Burton R. Stein (M'43) • re­ tired on April I, 1985, from his internal medicine and cardiology practice. He lives in Lewiston, Idaho. William Tornow (M'46) • clin• ical assistant professor of pedi­ atrics, was named "Pediatrician of the Year"by pediat ric residents at Mercy Hospita l. This award is presented annually to the out• standing pediatrician on the Mer­ cy Hospital staff. Dr. Tornow teaches medical residents at both Buffalo Children's Hospital and Mercy Hospital. Arthur J. Schaefe r (M'47) • clinical associate professor of otolaryngology and ophthalmol­ ogy, lectured at the sympo­ sium on current tech­ niques in eyelid and lacrima l surgery at the University of Medicine and Denrisuy of New Jer• sey Medical Schoo l. Dr. Schaefer also presented a lecture 12/85 on practica l eyelid surgery at a seminar sponsored by the New York Eye and Ear Infirmary Post Gradua te Institute. Jo hn L. Musser (M'Sl ) • has retired after 15 years as chief of several mental health clinics for the State of Hawaii Health Department, and is now living in Florida. His new address is 2032 Canopy Circle, Zcllwood, Florida 32798. Richard Gacek (M'56 ) • has received the prestigious Pietre Caliceti Award from the Univer­ sity of Bologna in Italy for his research in head and neck sur• gery. He is currently with Upstate Medical Center in Syracuse. Arthur Klass (M'56) • is a chief of GI Endoscopy at Sinai Hospi• ta!, Southfield, Michigan . He is also the past chairman of the GI Section of the Michigan State Medical Society and past presi­ dent of the Detroit G I Society. He chaired the G I Section of the In­ ternationa l Medical Laser Sympo­ sium in 1979 and 1983. Dr. Klass George Starr '67 at Empire State Game s. is author of a chapter of the re­ cently published book, "Laser Pal­ liation of Esophagus Cancer" in Surgical Endoscopy, Year Book Medical Publishe rs, 1985. Sherman Woldman (M'57) • clinical assistant professor of pedi­ atrics, has recently been appoint• ed chairman of the Depa rtment of Pediatrics for the M illard Fillmore Hospitals, Gates Circle and Suburban . In addit ion to his private practice in Cheektowaga, he is active in the Leukemia So­ ciety of Ame rica, Inc., where he served as president of the board of directors. D r. Woldman has been recognized in M arquis' "Who's Who in the East" and in the American Biographica l lnsti­ tute's International Book of Honor . Francis J. Klocke (M'60) • is serving as chairman of the Safe­ ty and Data MonitoringCommit­ tee for the Multi-Center "TIMI" udy. "TIMI" stands for Throm­ bolysis in (acute) Myocar­ dial Infections which uses tPA as the lytic agent. Dr. Klocke is presently professor of medicine and physiology at UB and chief of card io logy at Erie County Medical Center. �CLASS NOTES Joe l Bernstein (M'6 1) • dini­ M1lford-\\'hmnsvdlt· Regional Hospital medical swff, director of the Echocard1ography Lnhoraco­ rv at the ~filford Hosp1rnl, and a m1.;mhu of the facuhy at the University of Massat hu,cm MeJ­ ilal School. cal assistant profe,sor of otolaryn­ gology and pediatric:,, lectun:d on "Rhinitis and Omis Media with Effusion," at the conferenn: on "Allergy and Immunology for the Rhinologist," on July 19 in Bir­ mingham, Alahama. Seymo ur J. Lieberman Marilyn Barker (M'75) • re lently moveJ to Eau C'l.iire, Wis­ consin, anJ has opecneJ m office for the praltice of ix-dmmc,. (M'61) • is prt.-,;idenc .md a member of the Board ofTru,tcc, of the :\1ed1cal Society at Mt. Sinai Medical Center of Clevdand. He 1s also a memhcr of the Board ofTrustt.'\.-s of Council Gardens, a low m­ comt.• housing development, and serves as medical executive com­ mittee ,ecrerarv at a nur,ing home. Dr. Lieberman is an a<,i<­ tant clinical proft.-.,sorof mt.-d1cine at Case-Western Rt.-serveS,hool of Medicine Richard Eugene Dubois (M'63) • reports he is in private Practice in internal medicine in Atlanta, Georgia. He is pre,idcnt of the Gt.-org1aSociety of Internal Medicine, presidcnr-clect of the Med1eal Assouarion of Atlanta, and co-chairman of the Southern Medical As.sodarion. He pub­ lished "Chronic Mononudeosis Syndrome" in the November 1984 Souiht.'T11 \fed1cal Journal. Lan ce Fogan (M'65) • 1s proud to announce ht· will provide an annual bequc-sr in his father\ name to UB\ Department of Neurology. His father passed away 30 years ago. This money 1s to he used either ro endm~ an annual lecrure,h1p in neurolog} or co support some other educational acriv1tv recommended by the Dep-artment. Dr. Fogan is dm.-c• tor of neurology at the Panorama City, California, Kaiser­ Permanence Medical Group. He interned at the Seton Hall Col­ lege of Medicine and then ob­ tained his M.P.H. while at the Un1wd Stares Public Health Serv­ ice. After complcung his re,1dcn- Melvin Pohl (M'76) • has a pncy m neurology ac Case \\esrern Reserve University, he moved m his current California ro,irion. Richard A. Berkson (M'72) • C. Wayne Fisgus (M'66) • a,­ ,1,tant profr,"or of OB-GYN at the Medilal Umvcr,1rv of South Carolina, 1, past president of the C:,parcanburg 08-GYN Society and past chairman of the OB GY~ Department ofS1 1rranbull! General Hospital. George Starr (M'6 7) • sho\\ n on page 34 ,it the skeet shooting l·ompctmon at last summer's Em­ pire State Games, the "Olympics o( --:t..,., York Scace~ whkh were hdd m Buffalo and at UB, wa~ part of the Central New York Squad for Olympic Skt'et Shoot­ ing. The S} racuse p..-dmmc1an competed l<x:allyro qualify for rhe regional ream and panicipated in lb hours of compernion at the ,care-wide event. He karned the sport as a medical offker in the Navy. The clinical assistant profcswr of pediatrics m Upstate ~fcdical Center had not visitl'CI UB for 18 years and w.is im• pre,sed by nil the new construc­ tion. Currently president of the Onondaga County Pediatric So­ ciety, he reports chat thee Gold Medal in Skeet was won by a pre­ medical student from Fordham University. wa, reelected thamnan and clin­ ical chief of med1une at Sr. Mary Mt"<:IK-al Center m Long Beach for 1985. He write,, "Have enioyed annual meering. of PHI CHI \\t.-,,t. with Ors. James Weber '72 and Jame, Pietraszek '74."Dr. Bcrbon who 1s an assistant clinical profo,-. sor at the UCLA School onvk-d1cine has a solo pracrke 1n endocrinology in Long &ach. Jeremy Co le (M'73) • \Hite~, ·1 have Just been ch tcd to fellow­ ship in the Amem :an Colk-ge of Chest Phys1c1ans • Dr. Cole 1s an assi,rant clinical profeswr at the UCLA Medical Center. Arthur C. Sgalia (M'73) • in­ ternist 'card1olog1sr in Milford, Massachusetts, recently pamc1pared in the National Ambuhto­ rv ~1cdical Care Survey conducted by tht National Center for Health Stari,ncs. The survey colhtcd informa­ tion ahour ambulnrorv patient,, their prohlems, and the rt.'SOurct.-s used for their care. The resulting published statistics will help pl,tn for more effective health services, determine health manpower re­ quirements, and improve mcJu:al education. Dr Sgal1a is a member of the BUFFAID I p H y j ..:.c::I£.R ,lte practllt in family mt'Clicmt· m Las Veg,h, :-..:evada. Or. Pohl 1, medical program director of Growth A,scxiatl.'$, an outpatient treatment group for akuholism and chcmirnl dependency, and dinical d1renor of the Chemical Dcpcndcnly Unit of Montevista Center in L·1, Vega,, 'le\'ada. C liph anc W. McLeo d (M'77) • i, chief of ob 'gvn at the USAF Hospital, \\'illiams AFB. He coaches lictle league ba•,eball and is team physic:i,m for the San Tan Youth S0t·c:er Association. In 19:SZand 1984 he wa, nominac• t.-d for Out,r,mdmg Young Men 111 America. Dr. Mc Lcod lives \\ ith his wifr· and five children, four sons and one daughter, m Chandler, Arn:ona. Ga ry A lexander Merrill (M'78) • wa, n;imed "Man of the Year" in Arkansas for 1984. He wmes "fur any of thmc who mrght be wondering what I've hccn up to, I am the former assis­ tant director of maternal and d11ld health and director o(infant and child health m Arkansas.• Paul M. Bergstrand (M'SO)• 1srnmplenng a res1denly tn fami­ ly medicine ,11 the Umversity of ~finnt.-,.ota , 12/85 �CLASSN OTES & DEATHS Edward A. Loizides (M'8 3) • completed two years of general surgery at SUNY Stony Brook. He is beginning training in uro­ logic surgery in the Section of Urology at Yale University School of Medicine and Yale-New Haven Medical Center. Eric P. Wittkug el (M'83) • writes "Upon graduating from Medical School in 1983,I partic­ ipated in a short-term medical project in the Dominican Repub­ lic with the Christian Medical So­ ciety. It was an exciting experience in third world medicine! During the 1983-1984academic year, I served as a combined medicine­ pediatrics resident at the SUNY Buffalo program in July 1984. In July 1984,I moved to Philadelphia to further my training in pedi­ atrics at the Children's Hospital in Philadelphia. When 1complete my pediatrics residency in July 1986,I will begin an anesthesiol­ ogy residency at the Hospital of the University of Pennsylvania. My ultimate goal is an academic career in pediatric anesthesiology and critical care. April 1985, I married Kimberly Kellner who is an elementary teacher. Our new address is: 48-22 Revere Road, Drexel Hill, Pennsylvania 19026. Kennet h Scott Zimmerman (M'83) • now completing his in­ ternal medicine residency in Buffalo, plans to join a group practice in the Buffalo area. Joseph Carrese (M'84) • has been given the Howard K. Rath­ burn Award for outstanding per• formance as a medical intern. This award is given annually to a medical house officer who com­ bines the ideals of compassion, humility, and integrity with out• standing clinical practice. He is an inte111at che Francis Scott Key Medical Center in Baltimore, Maryland. lZ/85 DR. EDWARD L. FINK, 72, former chief of urology at St. Joseph lncercommunity Hospi· ta!, died June 27, 1985.A native of Brooklyn, Dr. Fink attended New York University and the Long Island School of Medicine. He began his practice in Buffalo in 1950. Dr. Fink was a mem­ ber of the Erie County Medical Society and a past president of the Medical Arts Society. During World War U, he served in the U.S. Medical Army Corps in Europe as a major. Sur­ viving are his wife, Angela; a son, John, also a doctor; two daughters, Carol and Lucille; a brother, Chester, and two grandchildren. DR. ROBERT E. SHEA (M'52) • an eye surgeon at Sisters Hospital for 34 years, died at 72 on June 9 after a short illness. The UB medical alumnus was also an M.I.T. alumnus. After becoming a commander in the U.S. Navy in World War II, he began his practice . He served as an eye doctor for the Buffalo Bills and worked with the Wetlaufer Eye Clinic. A county and national medical society member, he was also a member of the Catho lic Physi• cians Guild. He is survived by his wife Mary; two daugh­ ters, Mary and Colleen; two sons, Joseph and Robert, Jr.; and a brother, John. DR. JOHN P. CROSBY (M'36} • formerly with Lockport Memorial Hospital, passed away recently. DR. ROBERT J. POWALSKI (M'54) • died after a short illness on May 15, 1985.He was 56. A Buffalo area obstetrician-gynecologist for 25 years, he was an associate clinical profes­ sor of ob-gyn. The Buffalo native was a past medical staff president of Sisters Hospital, where he served his residency. The county, state and national medical society member also belonged to the Buffalo Gynecologic & Obstet ric Society, rhe American College of Obstetr ics and Gynecol­ ogy, the Pan American Medical Association, and the Catholic Physicians Guild of Western New York. H e is survived by his wife, Joan; two daugh­ ters, Karen and Lynn; two sons, Dr. Robert, Jr., and Mark; parents Mr. & Mrs. Thaddeus Powalski; and two sisters, Renee and Janice. DR. AN DRE W J. CHARTE RS (M'32) • 79, died June 9 in Millard Fillmore Suburban Hospita l after being stricken ill in his home . BUFFAID jPHYS1¢1A N I Dr. Charters was a general pract itioner and sur­ geon for more than 50 years. He was both an undergraduate and medical graduate of UB. Until his retirement in 1982, he was associated with Millard Fillmo re and Children's hospita ls and used the same office that his father practiced in 100 years ago. He was a membe r of the Erie County and American Medical Associations and of the Ma­ sonic Order. He is survived by his wife Helen; a son, James, a daughter, and six grandchildren. DR. JAMES W. JORDON (M'30) • died Ap ril 5, 1985 in Naples, Florida. The former professor of dermatology at the University of Buffalo retired from private practice in 1969. He is survived by his wife, Helen; a daughter, M rs. Robert Brown of Watertown, New York and a son, Dr. Robert E. Jordon of Houston Texas. DR. NORBERT G. RAUSCH (M'33) • died March I, 1985 after a long illness. Dr. Rausch received the Roswell Park prize in sur­ gery upon his graduation in 1933.Dr. Rausch was an associate in dermatology at the UB Medical School and a member of the medical board at Buffalo General Hospita l and Meyer Memorial Hospital. After his retirement from a private practice, he worked as dermatology consultant to Veterans Hospital. Dr. Rausch authored many scientific papers and addressed the National Congress of Dermato logy in Lon­ don and Munich, West Germany . He is sur­ vived by his wife, Marga ret; rwo daughters, Judy and Jill of St. Petersburg, Florida ; a son, Robert; and five grandchildren. DR . EUGENE H. RADZIMSKI (M'41) • died March 6, 1983. Dr. Radzimski, a clinical associate professor of ophthalmology at the UB Medical School, practiced ophtha lmology in Buffalo for 40 years. He was a Diplomate of the American Board of Ophthalmologists and past president of the Buffalo Ophthalmologic So­ ciety. He was a commander in the Naval Med­ ical Corps, in World War 11 , PacificTheater, and received the Asiatic Pacific Campaign Medal, American Campaign Medal and t he World War 11Viccory Medal. He is survived by his wife, Helen; two sons, Eugene and Michael, and a daughter, Camille . �CALENDAR ■ BUFFALO GENERAL HOSPITAL PROGRAM • Hov. co Read a 12-Lead Elec­ trocardiogram.Feb. 24-26, 1986. West Palm Beach, FL. Sponsored by Buffalo General Hospital. Contact Dr. Jules Constant, Cardiac Study Fund, Box 114, Hiler Branch, Buffalo, NY 14223. (716) 836-5172 or 845-2165. ■ DEPARTMENT OF PSY­ CHIATRYCME PROGRAM • Useof Lithium m Children.Jan. 29, 1986. 9-10:15a.m. WNY Chil­ dren's Psychiatric Center. Gary Cohen, M.D., Acting Medical Director, Department of Child Psychiatry, Children's Hospital; Clinical Associate Professor of Pediatrics, UB Dept. of Psy­ chiatry. Contact Murray Morphy, M.D., or James M. Serapiglia, Ph.D., SUNY Buffalo, Dept. of Psychiatry, 462 Grider St., Buffa­ lo, NY 14215. ■ UB DEPARTMENT OF PEDIATRICS CME PRO­ GRAMS FOR 1986: THE SHERATO N BAL HAR­ BOUR CONFERENCE ON PEDIATRICS • Feb. 28-March bour, Bal Harbour, FL. Credit Hours: 18. Fees: $275.00 Physi­ cians in Practice, $175.00 Allied Health Professionals. ■ THE SARASOTA NATIO NAL CONFERENCE ON PEDI­ ATRIC LUNG DISEASE • March 14-16, 1986. The Sarasota Hyatt House, Sarasota, FL. Credit Hours: 20. Fees: $325.00 Physi­ cians in Practice, $175.00 Allied Health Profossionals.CONTACT: Rayna Saville, Pediatric CME, Children's Hospital, 219 Bryant St., Buffalo, NY 14222. (Collect): (716) 878-7630. ERRATA In the July 1985 issue, Dr. Steven Piver's tide was incorrectly listed as "deputy director." His correct title should read "directorof gyneco­ logic oncology at Roswell Park." 2, 1986. The Sheraton Bal Har- ------------------- -------- ---- ------------- --- ---- ------ ---------111111 NO POSTAGE STAMP NECESSA171' IFMAILED IN THE UNITED STATES BUSINESS REPLYMA IL FIRSTCLASS PERMITNO. 2210 BUFFALO. NY. POSTAGEWILL BE PAIDBY ADDRESSEE BUFFALO PHYSICIAN 139 Cary Hall 3435 Main Street Buffalo, New York 14214 �PHYSICIAN State University of New York at Buffalo 3435 Main Street Buffalo, New York 14214 920029004800 MD 39 DR . EVERETT H . WESP 8 9 MAY N AR D AV E NU E EGGERTSVILLE NY 14 226 -------------------7-us LET HEAR FROM YOU -T·--------------- Fill out this card (Please print or type all entries) Name ___ _ ________ Office Address - --Home Address -- _ _________ --- - -- ----- --------Yes D In Academic Medicine: -- ---- If not UB, MD received from ------- In Private Practice: ____ --- No D YesD ----- Part Time □ Year MD Received _ _____ --------------- ------ -------------- --- _______ _____ __ -_ ___ ___________ Title _______________ ___ __ ___ _____ Medical Society Memberships ------- _______ _ Full Time D School _ _____ Other: __ _ ------ -------------- Specialty _______ No D _ ____ ___ _ ___ ________ _ _ _ _ _ - ------------------------ News: Have you changed positions. published. been involved in c ivic activities , had honors bestowed . et c? ______ Please send copies of any publications, research or other original work. _ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, December 1985 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1985-December Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1985-v19n04-Dec Table Of Contents A list of subunits of the resource. Breakthrough in Trauma Treatment Kohl Our Senior Physicians Books Med School News Students Hospital News People Alumni Classnotes Deaths Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-16 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v19n04 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1985 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/7c3dd6f97f92ab850a8b63e19517a5e5.pdf 92b09b286e10e7cc11474b70b9da16ef PDF Text Text �STAFF EXECl'TIVE EDITOR, U:'lii\'ERSITY Pl'BI.ICATIO:\S Robert T. \1arlett ASSOCIArE EDITOR U;"I;I\"ERSITY Pt 1BI.ICATIO'\S Connie Os\\ald StofKo Message From The Dean tl. '1\'ERSITY .\IEDICAl. EDITOR Bruce S Kershner Dear Friends of Buffalo's School of Medicine: ART DIRE< IUR Rebetu Bernstein DESIG:'Ii Abn J Kegkr Demse Kubler PllUfO<,RAPIIY Ph) l'1s Clmstuphcr Hugo l nger ADVISORY BOARD Dr john :-.:augh•on, !Jean ''chool of l!etltcme \Is. :-.lanC\ c,I eco Dr Ed\\ in A Mir.1nd I >r john Cudmore Dr Dr. Ms \lr Dr. Dr Dr. D D Dr 0~ Mr Carmelo Armenu john Fishtr K:tren Drvja John Pulh Char,Ps P.JgaPell james Kansk H.uold B,od\ John Wright James ;.;ulan Maggie \\ ng~.t Man Voorht.~s ';teve '>h \ msk \ TEACHING HOSPITALS rhc Buffalo General (ll'ldren\ Deac.oness hrie Count) \led c..I Centtr \lerq ~l!li.Jrd 1-i !more Rnswell Park Memorul lnstitut<.. Sisters of C!Jar.ty \'eter"ns Adnm strJuon ,\ledical Center Produced bv the nuzszon o; Publzc Ajjt1irs llanJ' R jatl.:son dir!!ctor in association u ith tiJ!! \chao/ of .ll!!dzcine, ~tale l nit'£ rsilv of \'eu }brk at Buffa/r,. filE Bl ffAID I'HY~I( <;<;t 860) Seplc -nbc 198S IAN (I WS \ lurrc 19, 1\iul"''>er ~ Puh! heJ 'rvc wrcs Jnnt•· JIIV fchrLJr}. May Ju.} <;epr "'lbcr, Decerr'Jer hv rhe S< hoot f \!cdr· <lr. , St;.• l nl\eNt} of Nev. York at BL'falo, ~I')') Mo..:l ~m~er, Baffalo. '<c\\ \ork ll.?li Se(():ld class posLJgc p4.d dl Bllff.llo, cw \ork 1'0:-,T~IAST~R ~end address changes ro Hlh :1\'hA· LO PIIYSI< lA., IW f•rv flo~ll, ~~~<; Main street, Buffa'o, Ne\\ \ork 11211 A summ:tr) of the 19H'I Accreditation Report of the I.ia1sun Committee on \lcd•cal Education (I.C\IE) -, the top:<: of nne of this issues pnncipal articles. The LC\11· is .1 non-prullt or­ gani7~1llon empowered b) the Department of l:duc:nion to survey and ac.credit Amerilan \kdical Schools, It Jlso pro­ vides this servic.e for Canadian \lcd.cal Schools The LCMI­ memhershtp is docloped jomtly from the Americ.m :\1cdica Assoc.nron (AMA) and the Association of American Medical Colleges (AAMC); there ar~ public members on the govern ing body as wei . I Jm pleased to report th.1t the School of Mcd cine at Buffalo rccel\·ed a full atcrediLitlon status for a pc•1od of four years The Survey Team \!embers \\ere very posit ve ..bout thei• vtsit and 111 the detailed report highlighted 24 points of accomplishment "nee the 1980 visit As 1s the cast. wuh al such \!sits .1 nun•ber of weaknesses were Jlso idenufred. Fortunat<..h mo t of these have been resoln.d sinct tht October, J<)?lq VIsit, for exampk, 11\e ch~lr'> have been appointed and the admtnJstrative reorganii'~ltion of the universitY and tht mediCal school has been complctt.d. A major <..oncern for the nsitors rcl.ued to the future stabilit) of the hospital system Th1s concern, while once unique to us in Buffalo, is now a nauonal one since the ways in '"hich gr.1duate medical educatiOn and pat1ef't care services are financed IS changmg rather precipitously. Buffa J(J\ situation of having an excess bed capacit) for acute care serv1cc 111 the face of a re:Jil\"ely weak econom1c base and the absence of a umver~uy-owned or wanaged clini­ cal facility suve to lughl.ght th~ prol>lcm. fhe v1s.tors' pnurit) fo ePsuring stabihza t .cJn of the mtdic;~l school's progr.uns reqUired tl lt the\ highlight an area which will requirt a great deal of attention in the )Cars •mmediatd} ahead Obvious!) the depart ment chairmen, sehoul administratton at all le\ cis and the hospital directors and. their respeu n· boards w.ll pa) .1 gre4t deal of .menuon to this important ..spect of our aca­ demic endeavors. The next scheduled LCME 'is it \\ 11l be m 198H That VISit will follow the conduu of the school's second institution-\\ 1de self-study, and should (JC.Cur at a time wh<.!1 a large proportion of the construt.Uon proJeCt> on the M.1in StreLt Campus are completed \\e look forward to an even more suc.cessful VISit at that umc fohn l'+iaugbton, M.D. �HEALTH SCIENC'-S NOV l1 1985 RECEIVED Emergency physician urges colleagues, patients, and families to prepare better for terminal illness and dying. What are the patient's rights in deciding between these extremes? Medicare payments based on "diagnosis related groups" encourage "quicker and sicker" patient release and pose new concerns for physicians. Director of the Kennedy Institute of Ethics tells Spring Clinical audience that the clinician must be an ethicist, too! Some old time practitioners used more than the basic 12 drugs to treat their patients. An injection may replace surgery in the treatment of strabismus. The highest potential cure rates for advanced ovarian cancer to date are reported by two Roswell Park physicians. More men are surviving prostate cancer. Research aims to help diabetics with poor eyesight to maintain their independence. Antihistamines and other medications can contribute to tooth decay. Immunizatio n could wipe out primary cancer of the liver. ( The school has been reac- credited. Thirdyear class bestows 9th annual Louis A. and Ruth Siegel Teaching Awards. Report on lead poisoning presenteel at the Annual Faculty meeting. United Way and American Heart Association join forces. SEFA campaign to start. orial Hospital in ewfane with Millard Fillmore. Television show gets material from Millard Fillmore. Buffalo General opens orthopaedics floor. Three hospitals introduce home health care. Sisters and Roswell Park get state-of-the-art mammography equipment. Proposed merger would join InterCommunity Mem- At the Spring Clinical Day, organ transplants were discussed, alumni officers were elected, and prizes were awarded for scientific exhibits. One hundred and fifty receive their M.D. degrees at the !39th Medical School Commencement. Fourth-year student Walter Lee Straus wins fellowship usually given to faculty. �• 2/BUFFALO PHYSICIAN �C:OI)IE • l~l.lJIE By Michael T. Ross "Code Blue, 506 South," drones the mechanical voice. Sud­ denly a whistle of beepers halts the cacophony of the crowded cafeteria. A procession of whitecoats vanishes. "Code Blue, 506 South" chirps from their pocket trans­ mitters. This scene dazzles hospital visitors daily and stirs the adrenaline and dread of hospital personnel. The euphe­ mism "code blue" warns of imminent death and summons a medical team to intervene. A patient's cozy room becomes a shadowy closet of stuffed whitecoats. Rapidly they assemble a congested ar­ ray of machines, wires, and polyethylene tubing. A gaunt, elderly man lies naked and inert in the crowded medical theatre. The face is drawn and lifeless, barren eyes stare with lids half closed. Two whitecoats alternate chest com­ pressions. Soon, limpid bags of fluid hover over the ashen body. With bore needles in hand, doctors puncture the skin below the collarbones seeking venous access to the still heart. Suddenly, crimson liquid gushes outward as clear plastic tubing is advanced into the upper chamber of the life-giving pump. A barking, staccato voice triggers a rapid round of chemical injections through the polyethy­ lene veins. A haggard whitecoat unsuccessfully pushes a curved tube into the mouth as other hands suction copi­ ous, green and hemic fluids from the opening. Sweat pours from the doctor's brow as she finally guides the external airway into the static passage. Quiescent lungs soon bel­ low as squeezing hands pump oxygen through a rubber bag. "Stop CPR," yells a harsh voice. ervous eyes freeze on the heart monitor with the coarse, wavy lines. "Ven­ tricular fibrillation ... epinephrine ... bicarbonate ... lidocaine." There is no response. "Get those paddles go­ ing!" The jab of a red button summons a shrill hum and a bleeping light. A whitecoat presses the metal surfaces to the chest wall: "Everybody off!" The body convulses for an instant as the heart is jolted with 400 watt-seconds of -current. A scent of burnt flesh enters the air. Strained eyes converge on the green window of the cardiac monitor. "FLATLINE! ... epinephrine ... bicarb ... isopril drip," commands the unwavering tongue. A peculiar pattern dances across the screen. "V-Fib!" cries the tense voice: "Paddles ... bretylium ... bicarb ... defibrillate, damn it!!" Still another bolt of current hitches the body instant­ ly. The drama persists through several repetitive cycles. The resuscitation is successful, the crew is spent. A square machine covered with dials, switches, and corrugat­ ed, plastic hoses wheels into the room to assure respira­ tion. There are no smiles, no twinkling eyes, nothing to distinguish success from miscarriage of effort. Only the sighs are remarkable. Mr. Smith once again is alive. The swishing of the ventilator and the beeping of the cardiac monitor prove it. As whitecoats disappear and talk of lunch lades the air and buries the tension of the still corridor, a languid intern drags himself to the patient's chart to prepare the disposition. Hurriedly, he writes the transfer orders. Then his hand scrawls the record of the code and a transfer note unintelligibly. He is numb as he enters the diagnosis: "Col­ on cancer with liver, lung and brain extension: prognosis poor." The patient is rushed to the intensive care unit. Med­ ical technology tingles the spine and shivers the soul. Daily, seventy million television sets mimic the dramas and ritu­ als of the monolithic churches of modern health care. A thousand periodicals limn stunning accounts of lives re­ stored. In the boisterous excitement of technologic exal­ tation the real drama is overlooked. "Mrs. Smith, you understand your husband is not responding very well to chemotherapy. Should his heart or lungs give out, do you want us to intervene?" asks the doctor. After a pained and querulous pause, the stricken wife replies, "Yes, doctor. Do everything you can." The scenario is common. Patients and families agonize. Legal, clerical, and health professionals disagree. What is to happen when the body lapses into the final phase of dying? Who will receive technology which prolongs physical life? When do efforts to extend life cease? Who decides? These questions are basic. Often, the patient is too ill to register a rational choice or even a response. Uncer­ tainty and guilt inundate families as they ponder allowing a loved one to die. Frequently, strained or mysterious fa­ mily relations preclude decision-making. The doctor, too, has uncertainties and fears. Death is anathema to physi­ cians; it is a badge of failure. Viewed in this light, deferment of communication is understandable. Discussion obligates realization of the chasm between unrealistic expectations and the reality of our inevitable mortality. Ultimately, everyone eschews the matter. No one decides. As physicians, we are taught to combat trauma and disease. From the biomedical perspective, it is natural to replace failing human parts with more capable machines. Not to do so raises the spectre of malpractice. When the patient or family cannot decide the limits of medical in­ tervention, we are obligated to sustain physical life at all costs. Our commitment to this approach intensifies as medical technology increasingly mandates more discrete biochemical and physiologic criteria for what we term life. Philosophical musing about the quality of life and the digSEPTEMBER 1985/3 �nity of death is considered dangerous in the clinical arena. As Americans were are conditioned to expect quick mends and cures for all maladies plaguing humankind. The serious limitations of modern medicine are known to few. Technologic borders are unbounded we are told. A cure is as close as next month's press release from the New Eng­ land journal of Medicine. Still, only the dying know how much suffering our technology demands. The medical renaissance relinquishes the human reality of the passage from birth to death. We isolate dying as a baneful, undig­ nified, and alien process; in a sense, we have denied our birthright. o longer do we die at home with the support and love of those important to us. In the modern era, we die in quarantine beside the insular swish of ventilators and beeps of heart monitors. Where does this lead us? For the patient and dear ones, dying means prolonged suffering, anguish, and alien­ ation. The family inherits tormented memories and a stack of bills. Health personnel and their specialized tools are diverted from other needy patients. Finally, the cost to so­ ciety mounts feverishly. Last year, health care absorbed over two hundred and fifty billion dollars. By 1990 the figure will exceed seven hundred billion. Ultimately, diminishing fuel for this unwieldy system will deny us access to health care, education, and other grapes of civilization. The impact of fiscal retrenchment is already upon us. It is doubtful that rational guidelines will evolve for eleventh-hour decisions whether to continue ineffectual therapies or revive hopelessly moribund people. Certain­ ly, the search for answers will be prolonged and mired in conflict. Right now, there is a right to die with dignity. The in­ dividual can decide: Does one choose to die at home with the comfort of loved ones or in isolation with noisy machines? For those threatened by a potentially terminal illness, the decision is best made before advancing disease precludes the chance to decide. Personal wishes may be communicated to family members, friends, and doctors or more formally in a living will established with an attor­ ney. If circumstances prevent care at home, there are other alternatives such as nursing homes, foster care, or hospices. When one enters the hospital, s/he can dictate the level of technical, medical intervention through discussion with the physician and a written statement in the medical record. Of course, the ability to make a thoroughly in­ formed decision depends largely on the physician's will­ ingness to communicate all the pertinent medical facts and uncertainties. While legislators and administrators battle and grap­ ple to evolve viable health-care policies, physicians have a professional, if not moral, commitment to enact solu­ tions in their daily practice. Hiding behind the fear of mal­ practice litigation serves only to delegate the critical and tender responsibility for human life to impersonal paper managers with priorities far removed from the individual patient. The special privilege of practicing medicine ob­ ligates the physician to preserve the life and humanity of the individual s/he attends. How can the caring physician fulfill this responsibility and allow his patient to die? For those of us who are physicians, the ethical dilemma in withholding active treatment from a dying patient seem­ ingly is at conflict with our purpose as healers. Our rigorous training requires the use of science, quantifiable experience, facts, and criteria to guide our judgement in selecting treatment for the individual patient. However, when the issue concerns whether to intervene in the fact of imminent death, the medical model languishes in the 4/BUFFALO PHYSICIAN effort to quantify a surfeit of immeasurable human varia­ bles. Too often, physicians elect to consider just the med­ ical questions. Only by sharing responsibility for the decision to relinquish life-sustaining measures with the patient, when able, and his family, can everyone feel the best treatment was rendered. Teaching and communicating with patients and their family members are critical for the physician to provide humane care. When a terminal or critical illness is identified, do we satisfy ourselves with a 100-word ex­ planation? Do the patient and family understand the full significance of the condition? Are all the options explained thoroughly? Do the patient and family know all the limi­ tations of medical treatment? How about the suffering in­ volved with further care- the necessary medications and procedures, their frequency and side effects, the degree and duration of pain and discomfort necessary to obtain a given result? Is death or potential disability completely reviewed with the patient and family? What will it be like to serve out one's life on a respirator? With a mechanical or baboon heart? With partial or complete paralysis, con­ stant pain, infections or disfigurement? Are they prepared for numerous, repeated hospitalizations? What should the family do when illness approaches its final stage? When their loved one with end-stage heart failure or emphyse­ ma gasps feebly in the night? When a mother or wife with metastatic cancer lapses into coma? Should an ambulance or doctor be called? Can the family manage the last mo­ ments of their loved one's death at home? Are there ad­ vantages or disadvantages to that? Does the patient or family feel guilty? Should there be resuscitative efforts? What would that involve in suffering and hope for meaningful life? What should other health professionals know about the patient's condition and wishes regarding health care? How is this best communicated? Questions such as these will need to be answered for patients and their families to avert the cruel and costly ex­ ercise of medical technology in prolonging suffering when only a heart beat is to be gained. Obviously, knowledge of a critical or terminal illness provokes a plethora of feel­ ings from shock, grief, and denial to confusion and guilt. The extent to which the physician explores these emotions and clearly elucidates all the facts and variables will power­ fully influence the choices selected by patients and their families. Unless we create an opportunity for such com­ munication, our technical efforts fall short of our commit­ ment as healers. In my own practice as an emergency physician, I con­ front death and critical illness daily. Quite often a patient or family member chooses to deny further treatments, procedures or resuscitative efforts when presented with a clear understanding of all that is involved. The emergen­ cy department operates at a hectic pace in a volatile set­ ting where such communication is easily avoided if not overlooked. Communication demands time, but it remains a valuable tool in my armamentarium of medications, procedures, and skills. How often I wish more of my col­ leagues in other areas of medicine would better prepare their patients and their families to deal with terminal ill­ ness and dying. Though we fight to sustain the gift of life, it remains ours only for a while. We all have a passage to complete. If we avoid this reality, the likely consequences will be crueler and more painful than death has ever been. • Dr. Michael T Ross (M '81) is an attending emergency phy­ sician at Proz•idence Hospital in Southfield, Michigan, near Detroit �-~~- -- --- - -------------------- •• 0 • ...._.es? B y Steven M. Shiv insky, Director of Corporate Public Relations, Millard Fillmore Hospital L ife and Death. What are the patient's rights in deciding between these ultimate extremes? A difficult question. No easy answers. There are no more questions raised than answered at the medical-ethical symposium sponsored by Millard Fillmore Hospitals on April 2, but two points were made very clear. Ethics committees are fast becoming an es­ sential tool for dealing with the almost day-to-day life and death ethical dilemmas faced by physicians and hospital administrators. And physicians must act as agents for society, taking the lead in determining the necessary guidelines in life and death issues. If they do not, then the state and the courts will do it for all of us. Like it or not. The day-long symposium was chaired by Ronald E. Cranford, M.D., director of eurological ICU at Hennepin County Medical Center, Minneapolis, and a na­ tionally respected expert in the field of medical ethics. The symposium consisted SEPTEMBER 1985/5 �of a roundtable discussion of medical ethics, a lecture by Dr. Cranford entitled, "Murder and the Humane Care of the Dying: The Courage of Our Convictions," and a pri­ vate afternoon session on ethics committees for adminis­ trators and physicians from Western ew York hospitals. From the discussions came the conclusion that medical advances are far outrunning society's ability to develop clear guidelines. Further, these guidelines must be addressed at four levels: ethical, legal, political, and economic. Also without definition of guidelines, or at least the establishment of an ethics committee for leadership, there is nowhere for the health-care professional to turn in time of crisis. To give a wide-ranging perspective on the issues, the roundtable was multi-disciplinary, and included Jan R. Jen­ nings, president, Millard Fillmore Hospitals; Peter S. D'Ar­ rigo, M.D. , Millard Fillmore's medical staff president and clinical assistant professor of medicine; Edward]. Mann­ ing, M.D., Dent Neurological Institute and UB clinical associate professor of neurology and anatomy; Richard C. Marcus, attorney, Falk & Siemer; Richard Hull, Ph .D., UB associate professor of philosophy and assistant professor of medicine; Michael St. Peter, news director, WEBR news radio; Msgr. Edward Ulaszeski, representing the Roman Catholic faith; Rev. Terrence Clarke, the Episcopal faith; and Rabbi Martin L. Goldberg, Ph.D., the Jewish faith. Issues included when to resuscitate a hopelessly ill pa­ tient, when to withhold lifesaving procedures for such pa­ tients, how to treat severely low-birth-weight babies with poor prognoses, when to artificially feed a severely in­ competent older person, and how much credibility to place in a family 's wishes for a hopeless patient. To address the life or death issue from an ethical perspective, Dr. Cranford cited relatively recent medical advances which created the debate in the first place. "Cardio-pulmonary resuscitation saves 35,000 to 50,000 lives per year. Before CPR, we had very few brain dead and vegetative patients," he said. Now there are between 5,000 and 10,000 vegetative state patients in the United States, exerting a tremendous drain on the medical delivery system . For instance, keeping a vegetative patient alive for 18 years can cost upwards of $16 million. "The threshold question is who has the right to in­ terfere with the natural process of death," said attorney Marcus. "There is an overriding state interest in the answer" but the laws, if we want them, must come from the public. Referring to certain religions which refuse medical procedures such as transfusions, Dr. Hull insisted on a " mixture of [consideration of] individual rights and the compelling rights of the state." The issue is "not a right to die but a right to have religious beliefs respected and accept the consequences of those beliefs." The physician's point of view was rather one of deter­ mining where a medical doctor fits into the ultimate ques­ tion of the anticipated death of a patient. "We are blessed and cursed as physicians with a messianic complex- to have all the answers. I can only do what I am comfortable with. This is tempered by my opinions, beliefs, and biases," noted Dr. Manning. "It is difficult and dangerous to give a physician the right to kill ," said Dr. D'Arrigo. "The primary player is the patient. It is extremely important to listen to the patient. The patient comes to me for advice, and has the right to refuse my advice, if he understands the consequences." The religious leaders came prepared with their respec­ tive faith's doctrines. However, their pronouncements con6/BUFFALO PHYSICIAN fused the discussion with debate over "the soul." As Rab­ bi Goldberg commented, "Death is the departure of the soul" and the soul is defined as "individuality, awareness control ... when this is gone, life is gone." Rev. Clarke agreed, noting "There is something about us that is more than the stuff we are made of ... I am more than the body I live in." " Death is when the body has lost the basic structure for human unity . .. The soul is no longer able to com­ municate with the body," according to Msgr. Ulaszewski. and dying is a moral issue to many, and a legal D eath concern as well. This does nothing to clarify the is­ sue. The first step must be at the medical professional lev­ el, according to Dr. Cranford. By developing norms and standards in ethics committees consisting of one-third phy­ sicians, one-third nurses, and one-third others, including clergy, social workers, and technicians, the first step toward legal/moral guidelines can be attained. This is where the concept becomes controversial. Ac­ cording to Dr. Cranford, once the norms and standards are decided, they will surely be tested in the courts. Only after legal challenges will they be adopted by legislators as law. This, he says, is the method to assure that correct ethical standards are adopted. Further, it means physicians must slip ever deeper into the maelstrom of medical liability proceedings. However, Dr. Cranford has reason to believe this method will succeed. As co-chairman of the biomedical ethics committee for Hennepin County Medical Center he was involved in a life and death decision last November. In July of 1983 a 57-year-old patient choked on an improperly placed res­ training strap at the Medical Center. He slipped into a coma for 16 months. In a precedent-setting case, the Minnesota Supreme Court, for the first time, relied on two independent bio­ medical ethics committees for advice on whether the pa­ tient should live or die. Noted Dr. Cranford, "This was the first time in the United States where ethics committees submitted an opin­ ion in writing to the court. This is the role some of us en­ vision for the committees in the future-to actively cooperate with the courts in difficult decisions." The court ruled it was not in the best interest of the patient to be kept alive by a respirator since he was given virtually no chance of recovery. He was disconnected, lived for 13 hours, his brain showing no signs of activity, and died last November 28. Deciding to end treatment to a 57-year-old man is one thing. The legally binding court rulings are black and white for all to see-but the issues are not so clearly defined. The case of Baby Doe, for example, became a political is­ sue as well as a legal one. "The issue was addressed politically, and the Baby Doe laws are fundamentally bad," said Dr. Cranford. He sees the laws as a political compromise, one which questions what is in the best interest of the infant and leaves the gray areas between black and white laws to the families. And, again , he sees the role of legislation as the last step, not the first . "I would much prefer to see a social policy evolving through the courts- as developed by med­ ical professionals." The most serious issue, according to Dr. Cranford, is economic. Cost containment is a national health-care pri­ ority. Physicians will be called on to ration treatment, as .. �will administrators. The best interest of the patient must now be weighed against the best financial means.* Diagnostic Related Groups (DRGs), for instance, will "change the climate of health-care" said Dr. Cranford, "but on the up-side, the issue of regulation will be placed on the hospital." The eventual medical-economic decisions will be very difficult and require more than just one doctor's opinion. Hemodialysis preserves the lives of otherwise healthy peo­ ple, at $15,000 per patient annually, but is also used to brie­ fly prolong the existence of the terminally ill. Intravenous feedings, costing $150 per day, can give complete nutri­ tion to patients temporarily unable to take food by mouth-but can also extend the lives of patients who have little or no prospect of leaving the hospital alive. Economics will pose increasingly important issues for the hospital bioethics committee. They should make the decision on termination of treatment, said Dr. Cranford. The committee acts as a sounding board, facilitates a con­ census that includes family input, and establishes guidelines. The committee can educate, establish policy, consult and advise in a non-binding fashion, and perform a retrospective review of decisions made. "Further, the scene will change so dramatically in the next five to ten years," according to Dr. Cranford, "that self-education is essen­ tial to the process." "Whether physicians, already embroiled in a malpractice liability crisis, will guide us in finding ethical answers to questions of life and death is yet to be " determined. T he physician is the leader in the process. As such he should tend to the "Three C's", as defined by Dr. Cran­ ford. Communication, caring and common sense must all interact within the patient-family-physician triad. If one ele­ ment of the "c's" breaks down, then ethical dilemmas are possible and probable. It will be the family who inevita­ bly face the fact that we live in a world of scarce resources. The physician or nurse should be able to turn to the bi­ oethics committee for guidance. Will the physicians do it? Will they take the lead in establishing the necessary ethical guidelines? National and state-wide professional groups "are seeing the handwrit­ ing on the wall," according to Dr. Cranford. "It will take a forcing of their (the physicians') hand, and only when they 're significantly threatened. But we are in the process of doing it. The American Academy of Pediatrics and the American Academy of eurology are developing guidelines now.'' Ethics committees are proliferating in the United States. It seems they are the only answer to a legal and po­ litical system years behind advancements in medical tech­ nology. Continued involvement of physicians and other medical professionals with ethics committees has proven effective in setting legal precedents for health-care. The field of bioethics is in its infancy, but its rapid growth requires anyone in the health-care industry to get involved now. Whether physicians (already embroiled in a malprac­ tice liability crisis in New York State) will eventually guide us in finding the ethical answers to so many difficult ques­ tions of life and death is yet to be determined. Despite all the unanswered questions, one thing's for sure, leadership is needed and the time to begin is now. • · " Hospital cost control: a bitter pill to swallow" lends an interesting perspective on the cost containment issue. Writing 1n the March-April 1985 Harvard Business Review, Henry J. Aa· ron and William B. Schwartz take a look at Great Britain, where medical services are ra­ tioned. They warn that even if the United States institutes most of the measures currently being proposed (ie: HMOs, PPOs, etc.), Americans, like the British, may still have to do without some of the health care benefits they now take for granted. (See also Ross Market­ to's article on British health care rationing system, Buffalo Physician, Vol. 19, No. 1, May 1985.) SEPTEMBER 1985/7 �Pressures for early discharge pose health care challenges 8 /BUFFALO PHYSICIAN �DRGs Are Increasing Pressure on Physicians for Quick Discharge ... Prospective payment for Medicare using "diagnostic related groups" (DRGs) has revolutionized the delivery of health care in most of the United States over the past two years. Beginning on January 1, 1986, this system will be in place in ew York State. One of the major changes caused by this new system is a greatly increased emphasis on discharge planning, to facilitate efficient discharge of patients from the hospital, and to ensure that patients receive continuous care at an appropriate level. Because prospective payment gives hospitals a financial incentive to release patients as rapidly as medically possible, it has led to a sharp decrease in average patient length of stay. As patients are released "quicker and sicker," the physician is under great pressure both to discharge the patient as quickly as possible and to find adequate continuing care for patients who often have complex medical needs. The physician's role in discharge planning is both more com­ plex and more important under prospective payment. Focus On Acute Problems Leads to a Lack of Long Range Planning Hospital discharge planning has often been an "or­ phan" responsibility in the past, receiving little emphasis or attention. Generally these tasks have been performed either by the social work or nursing department, but most hospitals did not have a well integrated written plan for how discharge planning should operate. During hospitalization, the patient's acute illness is the focus of action for the whole health care team. This fo­ cus, however, often leads to a lack of attention to the ad­ vanced planning needed for continuing care. In addition to the medical problems that must be addressed after dis­ charge, complex social problems can prevent a smooth transition from one level of care to another. With the im­ plementation of DRGs, it becomes increasingly important that the skills and knowledge of all health care profession­ als be coordinated effectively to ensure both effective dis­ charge planning and quality continuing care. Prospective Payment Changes The Rules for Discharge Planning Prospective payment using DRGs has changed many of the constraints and incentives hospitals work under and has changed the rules under which discharge planning is conducted. The hospital loses money for every addition­ al day the patient remains in the hospital over the num­ ber of days set for a particular DRG. One of the ways in which patients have been held up in the past has been in­ effective discharge planning, and hospital administrators are anxious to make discharge planning a well organized and effective unit of the hospital. The increased impor­ tance of discharge planning is reflected in the popularity of such procedures as "pre-admission discharge screen­ ing" in which patients in certain high risk categories who are likely to need complex discharge plans are assessed as they enter the hospital. Discharge planning begins even as acute care treatment begins. Some physicians feel that this increased emphasis on "moving the patient out" leaves them in the intenable po­ sition of having to restrict acute care while at the same time providing adequate continuous care. Issues of mal- practice and ethics are important considerations here. Many physicians report that hospital administrators now place great pressure on them to discharge patients as quick­ ly as possible, even if the doctors feel that the patient can­ not be safely released. Such pressures are real, and in some cases have led to punitive actions such as the suspension of hospital privileges. Despite these pressures, physicians alone have the le­ gal responsibility for and the training necessary to make clinical decisions on the course of patient treatment. The physician will be under increased pressure to justify ex­ tended hospitalization, but if such treatment is medically necessary, under prospective payment the hospital must retain the patient, despite the financial loss. To work effectively in the new system, the strengths of all members of the health care team must be used. Given the shorter average length of stay, the physician cannot ef­ fectively assess all the health care and social needs of the patient needed for effective discharge planning. In addi­ tion physicians generally are not familiar with the com­ plex financial reimbursement system for continuing care and work closely with those who are to prevent delays in discharge. Effective discharge planning requires, above all, the coordination of services. The physician's unique role is in coordinating the clinical treatment plan after dis­ charge, and in working with other health care profession­ als to solve social and financial problems. Continuity of Care An Important New Opportunity for M.D.'s The continuity of patient care is also important be­ cause more and more physicians will find themselves em­ ployed by non-hospital health care organizations. The Department of Health and Human Services estimates that between 1,000 and 2,000 U.S. hospitals will go out of bus­ iness in the next ten years as a result of reduced patient stay. A greater percentage of doctors will be employed by other types of organizations, ranging from emergency centers to nursing homes. The ability to make use of the growing variety of health care organizations and to effec­ tively coordinate services for patients will become a larg­ er part of the physician responsibility. The key, once again, is coordination. The physician should not assume respon­ sibility for providing all the assessments and all the infor­ mation that is needed, but should work with others on the health care team to adequately manage this informa­ tion, and find all the services needed for the patient. The pressures brought by prospective payment for quicker discharge make many physicians uncomfortable. They worry not only about the quality of care provided for their patients but are also disturbed by an intrusion into patient care of limitations based on financial rather than medical needs. However, physicians do not give up their legitimate area of expertise in making patient care decisions and in coordinating services. Prospective pay­ ment provides the opportunity, if used effectively, to coor­ dinate information provided by a wide variety of health care personnel and to provide patients with the best pos­ sible continuing care. This will be the challenge of prospective payment for all health care professionals. • By john Feather, Ph.D., associa te director, Western New York Geriatric Education Center a nd research assistant p rofessor of medicine. SEPTEMBER 1985/9 I I ' �g I O.. L - - - - Medical Ethics and Transplants 10/BUFFALO PHYSICIAN ' 'T By Bruce S. Ke rsh ner here's nothing more ch~llengi?g than lecturing to a group m their post­ digestive state," Edmund Pellegrino, M.D., quipped to several hundred phy­ sicians who had just finished lunch at UB's 48th Annual Spring Clinical Day. Dr. Pellegrino was the keynote speaker for the event held May 4 at the Buffa­ lo Marriott Inn (see accompanying articles on other facets of the event). The honored lecturer spoke on "Medical Ethics and Organ Transplantation." He is director of the Kennedy In­ stitute of Ethics at Georgetown University, the John Car­ roll Professor of Medicine and Medical Humanities at Georgetown, and the author of Humanism and The Phy­ sician and A Philosophical Basis of Medical Practice. The former dean of SUNY/Stony Brook's School of Medicine explained how ethics relates to medicine. "Ethics will not give us the right or wrong answer. Ethics begins �issue and artificial hearts. Just· as difficult is the question surrounding the tak­ ing of organs from donors. "We should have the right to self-determination, the right to decide about our own or­ gans. However, the voluntary approach to donations has proved insufficient as a method of supply," he remarked. The required request method often puts the family in a difficult situation where they have no choice but to de­ cide, yes or no, about donating their loved one's organs at the height of their grief. Dr. Pellegrino also described the "pres umed consent rule" which says that , unless you specifically state other­ wise, your organs may be taken. However, the former chan­ cellor of the University of Tennessee commented, "where presumed consent exists, as in France, the organ supply is not much better off because doctors are unwilling to remove organs without someone's consent." A third method of obtaining organs in some countries is mandatory organ donation, at the other end of the spec­ trum from voluntary donation. Another variation of the voluntary method is the "Market Place Method" where licensed organ brokers get paid to seek out viable organ donors. Voluntary donation can also be encouraged through widespread education programs which push the altruistic motive, especially for multi-organ donations. An important caution, Dr. Pellegrino emphasized, is that "ethics does not address the question of 'Who pays?' because it is not an ethical decision. It is, however, an im­ portant public policy decision." Whereas Dr. Pellegrino encouraged physicians to play an important role in bioethical decisions, allocation of medical costs, he said, is less in their domain. He did pose interesting questions nevertheless such as, "When $2Vz billion is spent by Americans each year on bass fishing or horse racing, are we really spending enough on health? " or " How much should be spent on the old versus the young?" Regarding this last kind of question, Dr. Pellegri­ no maintained that "the measure of the moral standing of a society is how it treats those on the margins of society." are the responsibilities of the physician in ethics? W Dr.hat Pellegrino suggests that physicians should tighten when someone challenges your view of what is right or wrong. It tries to get at the fundamental axioms and sup­ positions that you base your decisions on," he explained. Then he added, "The Hippocratic Oath is totally insuffi­ cient to address the ethical questions we face today." He went on to differentiate science and ethics. "Science tells us what we can do; ethics tells us what we should do. In addition, ethics often looks at two goods in conflict, not just good vs. bad." The former is the most common ethical dilemma in medical ethics. "The difference between the ethicist and the physi­ cian," Dr. Pellegrino elaborated further, "is that the physi­ cian must sooner or later make a decision , particularly a decision that must be based on sound science." Dr. Pellegrino, also former president of Catholic University, suggested some of the major ethical questions surrounding organ transplantation. "There's the question of organ availability, especially who gets the limited sup­ ply, and the dilemma of rationing, i.e., 'first come, first serve'. Then there are the questions raised by the Baby Fae up the medical criteria first, in order to strengthen our abil­ ity to deal with the ethical issues. Doctors must also be prepared to resist those who are afraid of the new knowledge that comes from technolog­ ical advances, especially those advances that have changed the definition of death. On the other hand , "doctors must not be tempted to 'fudge' on the aspect of death when someone is waiting for an organ," he warns. Dr. Pellegrino also cautioned about the dangerous "bandwagon effect" in which transplant programs are in­ itiated at institutions that are not fully prepared for such a venture. A NYU. medical graduate, Dr. Pellegrino has had a dis­ tinguished career. In addition to the previously mentioned positions, he also served as president and chairman of the board of directors of Yale-New Haven Medical Center and is the recipient of 31 honorary doctoral degrees. He is the founder of journal of Medicine and Philosophy and the author of 350 publications. " It is just as important for the physician to consider ethics alongside microbiology, pathology or any other medical discipline," Pellegrino said in his concluding re­ marks. "Because of our unique position in society, the cli­ • nician above all must be an ethicist, too." SEPTEMBER 1985/ 11 �Cou Syrup Dr. Silas Hubbard had quite a formula THE LARKIN COMPANY Sept. 13, 1915 COUGH SYRUP Dr. Silas Hubbard's Formula Ingredients 33/.o pounds Drug Mixture Wahoo No. 1: While Pine Bark 15 pounds Spikenard Dandelion Drug Mixture No. 2: Drug Mixture No. 3: 3 2 Wild Cherry Bark Horehound Squ1lls Boneset Catn1p Pennyroyal 15 15 pounds ounces 33/4 pounds 33/4 pounds 1V4 pounds 15 ounces Drug Mixture No. 4: Extract Licorice 2V2 Drug Mixture Granulated Sugar 215 No. 5: Glycerine 30 Tmcture Lobelia 7V2 Fluid Extract Senega Chloride of Ammon1a Oil Wintergreen Alcohol O.K.2 Water pounds pounds pounds ounces 7 112 ounces Tincture Ipecac Drug Mixture Fluid Extract No. 6: Bloodroot pounds pounds 40 ounces (fluid) 40 ounces (fluid) 75 (flu1d) 3 ounces ounce gallons 75 gallons 1 Directions 1. 2. 3. 4. 5. 6. 7. 8. Heat the water to boiling Add No. 1 and let simmer 2 hours Add No. 2 and let stand V2 hour Add No. 3 and at end of 15 minutes draw off and place in drug press. Th1s should yield about 60 gallons. Add No. 4 (Extract of Uconce) and reduce 1n vacuum still to 20 gallons We1gh and add No. 5 (Sugar, Uconce, Tr. Lobelia, Tr. Ipecac) F1nish to 450 pounds with Distilled Water (Water measures 24 1n kettle) Add No. 6 (Bloodroot, Senega, Ammonia, Wintergreen, Alcohol) Add OK2 2This was the recipe followed by the Larkin Company The let­ ters 0. K. stand for the secret ingredient, unknown to the workers who blended the misture. At the end an official from the laboratory brought the 0. K. and added 1t. 12/BUFFALO PHYSICIAN Dr. A. Wilmot Jacobsen, M.D., Clinical Professor of Pediatrics Emeritus D uring the past half century, as a result of the tremendous increase in medical knowledge, therapeutics has become ever more complex. Today, a physician consulting his reference book listing prescription drugs will find un­ der the heading Asthma 60 preparations, under Arthritis 60, under Anti-bacterial 300 to choose from-and there are 2,000 pages more in the book! He may think back long­ ingly of the good old days when, as he has been told, the practicing doctor's armamentarium consisted of 12 drugs. But sometimes the practitioner a century ago did resort to complex mixtures. A case in point is that of Dr. Silas Hubbard, born in 1821. He went to school at the Academy of East Aurora, then to Allegheny College at Meadville, Pa., and in 1842 graduated from the Medical Col­ lege of Castleton, Vermont. Out of funds, he walked home to Buffalo, where he opened an office in a one-story brick structure on Exchange Street not far from Main Street. He was greatly interested in raising funds to found a University in Buffalo, which started with a medical school in 1846. A regular contributor to the Buffalo Medica/jour­ nal, he once wrote an article to correct a statement he had made in the Journal nearly 70 years before, and which the editor published with great glee. In middle age he be­ came obsessed with the theory that many diseases were caused by germs, and there was a suspicion in many minds that he was going mad. In 1855 his pioneer instincts impelled him to go west, and he moved his family into Indian country to the vil­ lage of Hudson, Illinois, which needed a doctor. He was soon very busy with a frontier practice, covering half a dozen townships in his two wheeled gig in summer, and on horseback in winter. His old house in Hudson is listed in the National Registry of Historic Places, and on the shores of Lake Bloomington is Hubbard Park. The entrance is dedicated to Silas Hubbard and his portrait is in bronze on the gate. On the lawn in front of the little house is a tablet stating that "here Silas Hubbard lived, labored and loved for 43 years." While Silas Hubbard practiced medicine in Illinois, his son Elbert Hubbard had become famous in the south Buffalo Town of East Aurora by founding the historic Roy­ croft Village and artisan's colony.' In 1900, at the age of 79, Silas Hubbard returned to East Aurora where he could be near his son. Here the old man lived happily in retirement for the last 17 years of his life, dying at the age of 96. At the time of his death, he was the oldest physician in ew York State. Of necessity a frontier doctor had to concoct his own medicines, and Dr. Hubbard 's expertise in botany stood him in good stead. In his tramps about the countryside he would gather roots, leaves, berries and barks to be brewed into various febriluges, carminatives, restoratives, and electuaries. One of the most successful of these was a cough syrup, which was considered a sovereign reme­ dy. "By popular demand" the Larkin Company was in­ duced to market it, and by good fortune, from their old records, I was able to retrieve the formidable and astonish­ ing formula. a: w I 0.. ~ a: I 1 The founder of Roycrott Village, Elbert Hubbard I, d1ed as famously as he had lived by pensh· 1ng 1n 1915 w1lh the smk1ng of Lus1tama H1s son , Elbert Hubbard II ran the Roycrott V1llage until the mid-1930's when 11 folded It took almost 50 years to rev1ve the h1stonc art1sts' v1llage, wh1ch IS now open to the public aga1n Two of Dr S1las Hubbard's liv1ng descendants also have a connec11on to UB Elbert Hubbard Ill , UB med1cal class of 1947, practices fam1ly med1c1ne 1n East Aurora He also served on the Med1cal School's faculty for s1x years 1n the 1970's S1las Hubbard's granddaughter, Evelyn. IS the w1fe of noted UB!Ch1ldren's Hosp1tal ped1atnc1an A Wilmot Jacobsen , aulhor of th1s art1cle (.) (/) ::::; ...J >­ I 0.. g 0 I 0.. ��result of spreading toxin to the muscle. The procedure has been used by Dr. Armenia to treat !6 patients. ':About 40 per cent are adequately treated with a single injection. Others, depending on condi­ tion, may need a second or larger dose for correction," he said. The toxin is also being used to treat an involuntary lid closure known as Blethorospasm. • (From ECMC's "Update") Chemotherapy nets successful results T Dr. Armenia injects drug into eye of patient. Injection used for crossed eyes S urgery may no longer be needed to treat strabismus or crossed eyes, according to Dr. John Armenia who heads the eye muscle clinic at Erie County Medical Center. The clinical professor of ophthalmolo­ gy and a small number of other ophthalmologists in this country are in­ jecting small amounts of a drug into the overworked muscle responsible for pull­ ing the eye out of alignment. How he and the others are doing it is through recording of electrical stimulation from the eye muscle to guide a small nee­ dle to the site of injection. The drug Oculinum or botulinum A toxin works by blocking nerve signals to 14/BUFFALO PHYSICIAN the eye muscle. Neither muscular scarring nor irritation result during the five- to ten­ minute procedure. Following the treatment, the injected muscle, slightly weakened, begins to stretch. And the muscle on the opposite side of the eye begins to tighten as it starts to pull up the slack. One injection may turn off the muscle for up to several weeks. Should the process of weakening/tightening be repeated sufficient times, the eye muscle will balance during the process of over­ correction, Dr. Armenia said. "The injected muscle will have time to lengthen while the opposite one will tighten to reach a better-balanced po­ sition." There are no serious complications, he said. The only "nuisance" effect is tem­ porary dropping of the upper lid, the By Colleen Karuz a he highest potential cure rates for advanced ovarian cancer, to date, have been reported by two Roswell Park Memorial Institute physicians, who have successfully treat­ ed the disease with aggressive, high-dose chemotherapy. In the December 198'-1 issue of Cancer Treatment Reports, Drs. joseph). Barlow and Shashikant Lele of Roswell Park reported that eight (47%) of 17 advanced ovarian cancer patients treated for one year with a chemotherapy program devel­ oped at Roswell Park were disease-free, based on the negative findings of "second­ look" surgery. Dr. Barlow is a research professor and Dr. Lele is a clinical associ­ ate professor, both in ob/gyn at UB. ':Advanced ovarian cancer is one of the most chemotherapy-responsive of all solid tumors," said Dr. Barlow, chief of Roswell's Department of Gynecologic On­ cology. "However, the initially high response rate is accompanied by a high relapse rate, with patient five-year survival statistics usually falling substantially below 10 per cent." The physicians described the drug pro­ gram as "an alternating regimen of four weekly injections of cisplatinum and five monthly courses of high-dose methotrexate-leucovorin, plus cytoxan (MECY)." If patients demonstrated a response to th is treatment after six months, the cycle was repeated. After one year, if all examinations, including surgi­ cal "second-look" abdominal exploration, with m icroscopic examination of biopsy tissue and abdominal washings, were �negative, the chemotherapy was stopped and the patients were followed in the out­ patient clinic. "Eight of the 17 patients are alive today," Dr. Barlow pointed out. "In fact, after 26 to '±3 months of observation, six patients have had no evidence of dis­ ease and are apparently cured." Drs. Barlow and Lele tested the effec­ tiveness of another multidrug regimen­ cytoxan, hexamethylmelanine, adriamycin and cisplatinum (CHAD)-in tandem with the MECY regimen in a second group of 16 advanced ovarian cancer patients. "We found the CHAD regimen to be signifi­ cantly inferior to the MECY regimen," ex­ plained Dr. Lele. "All but one patient had developed recurrent tumor before or at the time of 'second-look' surgical procedures." "Second-look" surgery, also known as "second-look" laparotomy, is the most ef­ fective prognostic indicator of advanced ovarian cancer and is correlated directly with long-term survival. "Only patients with negative second-look laparotomies can be considered potential cures," said Dr. Barlow. The physicians, encouraged by these results, will continue to closely monitor the patients to determine the extent and possibility of cure. "A 'f7 per cent nega­ tive 'second-look' laparotomy rate," not­ ed Dr. Barlow, "is remarkably high for advanced ovarian cancer, and the results are the best reported to date. We feel that this chemotherapy regimen will signifi­ cantly improve long-term survival rates for patients with this disease." • More men survive prostate cancer F ive-year survival rates for all clini­ cal stages of cancer of the prostate-including both black and white men-have improved from 58 per cent in 197'-l to 64 per cent in 1978. This 6 per cent improvement translates annually to over 13,000 more men surviving cancer of the prostate five years now compared to the mid 1970s. This is the major finding of the prelimi­ nary report on long- and short-term sur­ veys of patterns of care for cancer of the prostate in cancer programs approved by the American College of Surgeons (ACOS). The surveys were conducted between July 1983 and May 1984 by the ACOS Commission on Cancer Patient Care and Research Committee. The data were ana­ lyzed and the preliminary report was pre­ pared by the Cancer Control & Epidemiology Department at Roswell Park Memorial Institute, under the direction of Dr. Curtis Mettlin, in conjunction with the National Prostatic Cancer Cooperative Treatment Group. The long-term survey evaluated patterns of care for patients diagnosed with cancer of the prostate before 1978, and the short­ term survey was concerned with patients diagnosed in 1983. Both surveys solicited information from hospital tumor registries on characteristics of patients, disease, diagnosis and treat­ ment, and, in the long-term survey, sur­ vival. Additional selected data items, e.g., survival, were included from previous studies in 1974 and 1979 for comparison. "In these surveys, 908 institutions from every state volunteered information on 20,515 patients diagnosed in 1983, and 686 hospitals, again from every state, con­ tributed data on 18,575 patients diagnosed before 1978," according to Dr. Mettlin. The preliminary report also observed the following trends in detection, staging, and treatment: • The trend toward earlier detection of prostate cancer is continuing. The propor­ tion of patients classified as clinical stage A in 1978 and before was 22.9 per cent compared to 27.2 per cent in 1983. • Black patients continue to be more likely to be diagnosed wth advanced dis­ ease. In 1983, 37 per cent of black patients were diagnosed with stage D disease com­ pared to 23 per cent of white patients. • The use of radionuclide bone scans as a diagnostic and staging tool for cancer of the prostate continues to increase. In 1978, 58.2 per cent of patients were reported to have received a bone scan. In 1983, this increased to 69.2 per cent. • There are major shifts in patterns of treatment between the most recent sur­ veys and previous data. For example, hor­ mone therapy has decreased for almost all but the advanced stages, while the use of radiation therapy for clinical stages B and C disease has increased markedly between 1984 and 1983. Have these trends been primarily responsible for the improved survival rates? According to Dr. Mettlin, "We're not sure if the improvement can be attribut­ ed to one or all of them. We think that the improved survival rates may be the result of these treatment trends plus earlier di­ agnosis, more accurate staging, and there­ fore, more focused treatments. "We think this is very important infor­ mation and in our future analyses we will examine the variations in staging and pat­ terns of care provided that may account for this substantial and widespread pattern of improving survival," they said. • (Reprinted from RPM/'s "Clinical Newsletter," Spring 1983). Diabetes grant to focus on eyesight T he New York State Department of Health Diabetes Control Program has awarded almost $27,000 to Paul Davis, M.D., a UB endocri­ nologist and professor of medicine; Anne Skelly, R.N., clinical assistant professor in UB's School of Nursing; and Allene R. Van Son, R.N., coordinator of the diabetes teaching service at the Erie County Med­ ical Center. Dr. Davis is also head of UB's Di\ is ion of Endocrinology and chief of medicine at the Veterans Administration Medical Center. The purpose of the research is to help diabetics who suffer vi­ sion deterioration maintain their in­ dependence. Patients with type II diabetes who have low vision will be identified and taught not only the relationship of the disease and vision, but ways of dealing with the every day dilemmas they encounter. The three-member team hopes to edu­ cate and screen 400 diabetics who are pa­ tients in the primary health care clinics and the diabetes clinic at ECMC. From among the 400, they want to select 250 for individualized instruction and a home visit six to eight weeks after tutoring by a public health nurse. Over 10 million U.S. citizens have dia­ betes, which is the leading cause of new blindness in this country today. Diabetics are at risk to vascular changes in the reti­ na of the eye, to glaucoma and to early for­ mation of cataracts. With other monies from the diabetes control program, Davis and Van Son, SEPTEMBER 1985/15 �founder of the American Association of Diabetes Educators and author of Diabetes and Patient Education: A Daily Nursing Cballenge, are investigating the cost of in­ tervention. With support from the E.). Lilly Com­ pany, Davts and his colleagues at ECMC are part of a national study that is com­ paring the use of humulin insulin against animal-species insulin in patients with in­ sulin resistance, insulin allergy, and/or lipodystrophy. • Medication can promote cavities I f you have hay fever this season, you'd better brush your teeth. This is because antihistamines can contribute to tooth decay, Dr. Sebastian chairman of the School of Dental Medi­ cine's Department of Periodontics, added, "Extra attention should be given to these patients; they'll need prophylactic visits to the dentist, a stricter program of brush­ ing and flossing. and possibly a mouth rinse wth plaque-reducing properties.'' • Immunization may erase liver cancer P rimary cancer of the liver could be virtually eradicated by early and widespread immunization against the Hepatitis B Virus (HBV) which research has linked to de­ velopment of the malignancy, says Nobel Prize winner Baruch S. Blumberg, M.D., Ph.D., associate director for clinical research at Philadelphia's Fox Chase Cancer Center. z z m ::;) u. "::E (.) I Q. <{ [[ ...... ~ ------~------------~~.M~--~~.w~~~----~_. Ciancio, clinical professor in the Medical School's Department of Pharmacology, says. He points out that dental patients should be warned that antihistamines and certain other medications may cause xerostomia (dry mouth) which creates conditions that foster dental caries and periodontal disease. "The dry mouth can lead to more plaque accumulation," Dr. Ciancio said in the January 1985 issue of Dental .t!anagement. Dr. Ciancio, who is also professor and 16 'Bl'FFALO PHYSICIAN ~~ Blumberg, who delivered the 15th an­ nual Ernest Witebsky Memorial Lecture April 18 at l 'B's Center for Tomorrow, first identified HBV as the agent of Hepatitis Band, with colleagues, subsequently de­ \·eloped an effective vaccine against the infectious agent. The agents which cause Hepatitis A and Hepatitis Non A/Non B have not yet been identified. Since a persistent, chronic HBV infec­ tion appears necessary for development of primary cancer of the liver, those who experience an acute bout of Hepatitis B and recover do not have increased risk for the cancer. While primary cancer of the liver is rela­ tively rare in the l'-S., it is more widespread in other parts of the world, notably Taiwan, mainland China, and parts of Africa. In Taiwan, for instance, it is the second most common cause of death in men. "There is a high prevalence of carriers of HBV in areas where primary liver cancer is common," says Dr. Blumberg. Further evidence shows the surface anti­ gen is found in the cancer as well as its surrounding cells. While not every person who is identified as an HBV carrier will develop primary cancer of the liver, the odds are "-!0 per cent or higher in carriers among certain populations studied. While males are more likely than fe­ males to be HBV carriers and develop the disease, "it is important that children born to mothers identified as carriers be pro­ tected from the virus immediately after birth with the HBV vaccine which is now being manufacturered around the world," Blumberg told the audience. As more countries begin producing the vaccine, its costs will decrease, he adds. Vaccine production is underway in mainland Chi­ na, for instance, where primary liver cancer is more prevalent, and all new­ borns now receive the vaccine. In the t:.s., those who appear most at risk for developing Hepatitis B infections are those in the health field , such as nurses, physicians, and dentists who con­ tact it through handling blood and other body fluids. Other high risk patients are drug abusers who share common needles. l 'nfortunately, many in these high-risk categories have not availed themselves of the vaccine, says Blumberg. Preceding Blumberg's lecture, UB chair­ man and distinguished professor of the Department of Microbiology Felix Mil­ grom, M .D., presented the annual Ernest Witebsky Memorial Awards for Proficien­ cy in Microbiology to medical student DavidS. Rosenblum; dental student Caro­ lyn Melita; and graduate student Jan Ed­ ward Valeski. The Witebsky Memorial Lecture was presented by the Ernest Witebsky Center for Immunology and l 1B's Department of Microbiology. • �MEDI(:AL SC~li()()L NEWS Medical school gets full accreditation T By Bruce S. Kershner he UB School of Medicine has received continuing full accredi­ tation for a period of four years from the Liaison Committee on Medical Education (LCME). This commit­ tee is the nationally recognized agency for accreditation of medical schools. Reaccreditation is a vital process that has fundamental effects on a school's standing and reputation and on its ability to maintain the quality of its programs and faculty. "The reaccreditation report represents a significant improvement over the last visit in 1980," Vice President john Naugh­ ton, dean of the Medical School, com­ mented. In 1980, reaccreditation was conferred for two years. "At their 1980 visit, the team raised a number of questions. At this 1985 visit, they were satisfied that those questions had been addressed," the dean remarked. The LCME team identified 24 strengths and nine concerns that it wants addressed by the next evaluation in 1988-89. T he most important concern was re­ lated to the " fragile financial status of the major teaching hospitals" which the team viewed as posing a threat to residen­ cy programs and to the " potential future resources for the School." Dr. aughton sees the financial instabil­ ity of some of the hospitals as a problem that the School has little control over. Nearly all of the other concerns, however, are under the control of the School, Dr. Naughton says, and he is confident that all of those concerns will be addressed soon. For instance, the LCME team cited an undesirably high number of vacancies in department chairmanships. Since the team's visit last October, however, all but one of those vacancies have been filled. Two other concerns were related to the possible confusion that could result from several new key dean's staff positions as well as from the appointment of a Univer­ sity Provost and Dr. Naughton's joint ap­ pointment as both medical school dean and vice president for clinical affairs. Dr. aughton remarked that since the survey, Construction continues on Carey-Farber-Sherman addition. the transition had ended and the new team has quickly defined its roles and de­ veloped a close rapport. Two concerns about the residency pro­ grams are being addressed now as the rela­ tively new Graduate Medical Consortium deals with the programs' weaknesses. Three residency programs remain on pro­ bation out of a total of 32. The report's desire to reduce the number of foreign medical students is also being addressed by the Consortium. Library hours and lack of 24-hour study halls, and over­ scheduling of the first- and second-year curriculum are other concerns now being worked on. A mong the first strengths identified by the team were the effectiveness of the leadership of Dr. aughton as dean and President Sample and Provost Greiner. In addition, the accrediting team reported favorably about the excellent morale of the faculty. Counted among the School's strengths were strong, cooperative relationships be­ tween teaching hospital administrators and the School, and the enthusiasm and commitment of department chairmen and other prominent faculty. The close affili­ ation with Roswell Park was also cited as major asset. The quality of a number of depart­ ment's research and teaching programs was commended. Those mentioned in­ clude physiology, biochemistry, biophysi­ cal sciences, gross anatomy and the basic sciences program in general, as well as the new Geriatric Education Center and the Departments of Medicine, Pediatrics and Family Medicine's ambulatory care pro­ gram. The new M.D./Ph.D. program and the Buswell and other fellowship pro­ grams were also cited. Two major new additions, the State­ mandated clinical practice plan and the Graduate Medical Consortium (that coor­ dinates residency programs), were both judged as successful and as major unify­ ing forces. The minority recruitment and admissions program was also deemed "very successful" by the accrediting team . The LCME committee is an indepen­ dent body enfranchised by the Depart­ ment of Education and composed of representatives from the AMA and the As­ sociation of American Medical Colleges. Its next visit will be during the 1988-89 academic year. • Third-year class honors six faculty T the clean had his opportunity to honor faculty members for ex­ cellence; now, it was the stu­ dents' chance to bestow their honors on particular medical faculty members. The third-year medical class an­ nounced their six selections to receive the 9th Annual Louis A . and Ruth Siegel Teaching Awards at last May's Annual SEPTEMBER 1985/ 17 �MI~l)IC,AL S<~EI()()L I~ S Dr. Steven Gut­ man was named best teacher of the year. Faculty Meeting at B's Katharine Cornell Theatre. Judged the best teacher of the year in 1985 in the pre-clinical teaching category was Dr. Steven Gutman, assistant profes­ sor o f pathology at Y.A. Medical Center, who was hailed for "demonstrated comp­ etence and knowledge of his field , together with a complete and precise lec­ ture style notable for the fact that no one falls asleep in his class." Later, Dr. Gutman remarked , " Teaching keeps me young, keeps me current, and ensures that I periodically review and reassess tenets basic to my medical prac­ tice. That 's the bottom line. With or without the Siegel Award , I generally seem to get more out of teaching than 1 put in." Selected as the best clinical teacher of 1985 was Dr. Steven Noyes, clinical assis­ tant professor of medicine. According to the Siegel Award Selection Committee, Dr. Noyes is " known for the fervent energy he invests in medical student teaching and for his Socratic method." Three House Staff Teaching Awards were presented to: • Dr. Scott Crandall, clinical assistant in­ structor in gyn-ob; • Dr. James Corasanti, clinical assistant instructor in medicine, and • Dr. John Brach, clinical assistant in­ structor in medicine. Dr. Harry Metcalf, clinical associate professor of family medicine, was ho­ nored with the Volunteer Teaching Award. Judging for the Siegel Teaching Awards 18/BUFFALO PHYSICIAN is based on student nominations request­ ed from all medical student classes. Stu­ dents complete nomination forms which ask for a nominee's qualities and merits. The ability to act as a role model , effec­ tiveness and enthusiasm as a teacher, abil­ ity to stimulate thinking and problem solving, and an attitude demonstrating sensitivity toward the human condition arc some of the attributes that the awards committee reviews in making its de­ cisions. The annual teaching awards originated with Dr. Louis A. Siegel who endowed the awards in 1977. A 1923 UB medical alum­ nus, he served as assistant professor in gyn-ob for 21 years before leaving UB for heatlh reasons in 1946. He was said to be an inspiring mentor who possessed en­ thusiasm and dedication as a clinical teacher. He died in 1981. • Lead poisoning is faculty topic A n alarming report on possible widespread lead poisoning in Asia from the use of lead-based cosmetics highlighted 1985 's An ­ nual Faculty meeting of the Medical School, May 29, at UB's Katharine Cornell Theatre. Dr. Robert Guthrie, who opened the event as the Stockton Kimball lecturer, also disclosed his equally alarming research findings that 0.6 per cent of white suburban children have excessive lead levels. Dr. Guthrie emphasized that the medi­ cal community should not complacently be deceived into thinking that lead poisoning is just a problem for inner city children. He pointed out that dust from lead-based paint even in affluent older homes can be absorbed by children, in addition to widespread gasoline lead sources. Lead toxicity is a society-wide problem of enormous significance because of its effects on population average IQ. " If all sources of lead contamination were re­ moved from the nited States, average IQ would increase up to four points. This translates into two and a half times fewer people with IQ 's under 70, and two and a half times more over 130 IQ." The State of the Medical School is very good , Vice President John aughton, dean of the school, said in his annual ad­ dress. In agreement was University Provost William Greiner in his brief com­ ments to the audience of 200. The Dean's Report summarized the results of the report of the Liaison Committee on Med­ ical Education (LCME) which reaccredit­ ed the Medical School for four years (see separate article). The dean also announced that Dr. Francis Klocke, professor of medi­ cine and physiology, would be the first oc­ cupant of the Albert Rekate Chair. Dr. Paul Davis, president of the Medi­ cal Faculty Council and professor of medi­ cine, capsulized the entire year's activities of the Council in a matter of minutes: 14 by-law changes were approved, :38 charges to eight standing committees were made (and 90 per cent of them were resolved), and the Student Affairs Com­ mittee rewrote the student grievance procedure. His report did not convey, however, the truly significant contribution the Council and its committees made to the governance and operation of the School and to the resolution of conflicts and difficulties. Before awards were presented , a memorial remembrance of faculty who died during the year was offered by Dr. Bob Brown. Almost 70 new faculty ap­ pointments were announced by the School's 25 departments. In addition, 14 faculty were appointed to emeritus status, including Dr. Bob Brown , former acting dean , Dr. Robert Guthrie, this year 's Stock- l �., Dr. Ogra joins a group of many UB med­ ical luminaries in becoming a Stock­ ton Kimball Awardee. Past recipients have included Drs. Ernest Witebsky, S. Mouchly Small, Mitchell Rubin, Hermann Rahn, 0. P. jones, Erwin eter, Leon Far hi, Felix Milgrom, Donald Rennie, Francis Klocke, Giuseppe Andres, Bud Schenk, and Bob Guthrie. ton Kimball lecturer, and Dr. Bud Schenk, last year's Stockton Kimball lecturer. Mrs. Robert Schuder, president of the local chapter of the American Medical Associ­ ation's Women's Auxiliary, presented their AMA-ERF check to Dr. Naughton. M ajor Medical School recognitions for the year included bestowal of the Stockton Kimball Award on Dr. Pearay Ogra, professor of pediatrics and microbi­ ology, for teaching, research and service contributions to the University and his profession that few individuals match. The 46-year-old native of Kashmir India is recognized world-wide for his r~search in pediatric infectious diseases, immunol­ ogy, and otorhinolaryngology. The director of UB's Division of Infec­ tious Diseases at Children's Hospital earned his degree from Christian Medical College, Ludhiana, in 1961. He came to the U.S. as a resident in Binghamton (N.Y.) General Hospital in 1963. After pediatric residencies at the niversity of Chicago and N.Y.U./Bellevue, he came to UB as a Buswell Fellow in virology in 1966. He is editor-in-chief of the Internation­ al journal of Microbiology (U.S. Region , Viral Immunology), serves on the editorial board of six other journals includingjour­ nal of Pediatrics, Injection and Immuni- T Dr. Andrew Gage received the Dean's Awa rd. ty and Pediatric Infectious Diseases, and is a consultant for 12 other journals. He is or has been a member of national profes ional and NIH committees too numerous to mention. Dr. Ogra is the (co)author or editor of 316 publications and chapters, and five books. He has received four previous honors including the 1978 Mead johnson Award for Pediatric Research from the American Academy of Pediatrics, and the 1984 Kal­ hana Award for Outstanding Contribution in Science from his home State of Kashmir. The Stockton Kimball Award w as pres ented to D r. Pear ay Og r a, a: w I Q. ~ ir I u (/) ::::; --' >­ I Q. he Dean's Award went to Dr. Andrew Gage for his important contributions to the School. The professor of surgery and chief of staff of Buffalo Veterans Ad­ minbtration Medical Center served as act­ ing chairman of surgery until that position was filled recently. A B undergraduate and medical graduate (1944), Dr. Gage has been on UB's faculty since 1944, first as a resident and ultimately as a tenured faculty member. He has served the School in diverse ca­ pacities on its Executive Committee, Faculty Council , Graduate Medical Con­ sortium, and others. His numerous profes­ sional positions include past president of the American College of Surgeons (W Y chapter), Heart Association of WY, Associ­ ation of Veterans Administration Surgeons, Buffalo Surgical Society, ational Associ­ ation of Veterans Administration Chiefs of Staff, and the American College of Cryosurgery. He has also served on the editorial boards of four journals. Dr. Gage has played major historical roles in medicine, most notably with Wil­ liam Chardack and Wilson Greatbatch in developing the world 's first implantable cardiac pacemaker in 1960. More recent­ ly, in May 1984, he played a major role in planning and organizing Western New York 's and UB's first heart transplant. His research findings in cryosurgery, cardiol ­ ogy, and vascular disease have appeared in 144 articles and chapters. He also was one of the founding investigators for the national Veterans Administration Cooper­ ative Study of Surgery of Coronary Heart Disease. He received the Ellender Medical Foun­ dation Award for Outstanding Contribu­ tions to Cryosurgery in 1979, and the 1980 Distinguished Service Award of the As­ sociation of Veterans Administration Sur­ geons. Dr. Gage is the latest in the lineage of Dean's Medalists that includes Drs. Evan Calkins, Albert Rekate, joseph Aquilina, james Phillips, William Chardack, Philip SEPTEMBER 1985/19 �MEDI<~AL SCJI()()L NEWS to strengthen as part of its responsib ili ty to the community. This year's goal for the Medical School is 561,000 . Last year's con­ tribution was 56,000 . Chairman of this year's SEFA campaign is Robert Wagner, vice president for university services. Last year's SEFA chair­ man and assistant chairman, Vice Presi­ dent John Naughton and Assistant to the Vice President Dr. Richard jones, are on the 1985 SEFA Steering Committee. The School 's commitment to the campaign is also i ndicated by the full-time administra­ tive support that will be provided by Bar­ bara Mierzwa, assistant to the chairman of Biochemistry. Dr. Gerald Sufrin, right, and Dr. Wi lliam Staubitz v iewed the unveiling of the portrait of Staubitz that accompanied the presentation of h is Special Re cognition Award. Wels, Douglas Surgenor, james Nolan, Robert Brown , and O.P. jones. A Special Recognition Award to Dr. Wil­ liam Staubitz was accompanied by the un­ veiling of his portrait. Dr. Staubitz, eminent urologist and chairman of the Department of Urology from 1960 to 1978, was also director of urology at Roswell Park for ten years. He is a UB medical graduate (1942) and is noted for his contributions in testicular cancer, es­ pecially in developing and implementing plans of therapy for the disease. Recent­ ly, he was elected president of the presti­ gious Society of Pelvic Surgeons. The Ruth and Louis Siegel Awards were announced by Assistant Dean Frank Schimpfhauser and third-year medical stu­ dent Michael Denk (see separate article). Heart Association joins United Way T he United Way of Bufalo and Erie County and the American Heart Association became partners in community service on August I. Under the new agreement the Heart As­ sociation will receive an annual allocation for its operating budget from the Un ited 20/BUFFALO PHYSICIAN Way. "As a United Way beneficiary, the As­ sociation will be able to expand its range of prevention and education services throughout the community," said Dean John Naughton , past president of the Heart Association . With supplementary funds from national sources, six local researchers on cardiovascular disease will also be funded in 1985-86 by the Heart Association. Give YOUR Way­ Support SEFA T ' he University's annual charitable campaign, the State Employees Federated Appeal (SEFA), will run from September 18 to October 18. Faculty and staff may choose among a dozen national health agencies, 15 inter­ national organizations, and the United Way and i ts 75 affiliated agencies. Infor­ mation on ways to designate recipient groups and various giving options, includ­ ing payroll deductions, will be provided on donor cards to be distributed during the campa ign. The Medical School has a record of solid support for SEFA and a position of leadership in the campaign that it seeks Robert Welliver, Buswell Research Day speaker, discussed viral in­ fections in human respiratory tracts and their IgE-mediated im­ munological responses. Dr. Wel­ liver is an associate professor of pediatrics at Children's Hospital. Presentations were given by five Buswell fellows: Drs. Abraham Munabi, Claudio Burdignon, Katherine Gaines, Phadip Rusta­ gi and Giovanni Camussi, as well as medical student researcher Cliffm·d Carroll. �~------- HOSPITAL NEWS 'I A bit of Buffalo is in 'St. Elsewhere' I in late 1981, Thomas Fontana came to Millard Fillmore Hospital for two reasons: first to visit his mother, Marie Fontana, coordinator of the Women's Clinic, and second, to prepare for his new job as writer/producer for "St. Elsewhere," the now successful BC ser­ ies about the fictitious St. Eligius Hospital. "I came basically to observe firsthand what happens behind the scenes at a major hospital," the Emmy-award winner said of his visit to Millard Fillmore where he spent a few days before joining the cast and crew of "St. Elsewhere" at the MTM Studios in California. Luther Musselman, M.D., emeritus clin­ ical associate professor of medicine at UB and director of medical education for Mil­ lard Fillmore Hospitals, guided Mr. Fon­ tana on a tour of the hospital where he met the medical staff president and the chiefs of surgery and neurology. "I got a general feeling of what goes on and also picked up some specific lines here and there," Mr. Fontana said about the extensive tour which included the lec­ ture halls, library, and surgical suites. "! also spent about half-a-day in the emer­ gency room, which was very helpful." The Gates Circle employee cafeteria, of all places, provided Mr. Fontana with more insight than any other place in the hospital. "I just casually sat in Millard Fillmore's employee cafeteria and tried to eavesdrop and overhear conversation," he said. " By sitting in the cafeteria, I picked up a sense of the hustle and bustle in a big-city hospital." Fortunately, the critically acclaimed ser­ ies has been a hit and Marie Fontana con­ tinues to forward articles and letters about Millard Fillmore and other hospitals in Western ew York to her son. "I try to send him brief stories about unique occurrences that he might incor­ porate into an episode," she said. "For ex­ ample, I wrote Tom about a doctor here at Millard who receives an anonymous rose every Monday morning." That tidbit has yet to appear in the program. Even though Mr. Fontana toured Millard Fillmore and continues to stay in touch with the hospital through his mother, the characters and the stories that take place on " St. Elsewhere" are fictitious, and he emphasizes that point. Despite its critical acclaim and Mr. Fon­ tana's Emmy Award last year, "St. Else­ where" almost didn't make it past the third season because of low ratings. Now it has found an audience that appreciates its qualities, ranking ninth in improved rat­ ings among all returning series. Watch closely, you may see a little bit of Millard Fillmore Hospital in the next episode. • (Reprinted with permission Millard Fillmore Hospital's "Reporter." Winter 1985) will enhance the efficiency of patient care. Following a greeting by William V. Kin­ nard, Jr., M.D., hospital president, a por­ trait of Benjamin Obletz, M.D., former head of orthopaedics at the hospital and former chairman of UB's Department of Orthopaedic Surgery, was presented by James Cole, M.D. , one of Dr. Obletz's former residents. Eugene R. Mindell, M.D., current chair­ man of UB's Department of Orthopaedic Surgery, introduced Dr. Obletz who spoke on the history of orthopaedic surgery at Buffalo General. Amy Forrest, R. ., talked on the significance of the dedicated or­ thopaedic floor. • (From Buffalo General's "Pulsebeat," May 1985) Hospitals introduce home health care A TV show's plots may seem very familiar to Millard Fillmore Hospi­ tal employees. Orthopaedics located on BGH's 16th floor A group of distinguished or­ thopaedic surgeons from around the world attended a ribbon­ cutting ceremony May 30 on the 16th floor of Buffalo General Hospital 's just opened twin towers building. All or­ thopaedic patients will be located there. According to Edward H. Simmons, M.D., professor of orthopaedic surgery, as­ signment of orthopaedic patients to one geographical area will allow more ready assessment by nurses and physicians and national trend in health care has left the hospital and come home to Buffalo. Home health care has arrived at three Buffalo hospitals. Sisters of Charity Hospital introduced the first hospital-based home health care program in Western New York on April 1. Close behind are Buffalo General Hospi­ tal's Advanced Home Care of Western ew York which commenced June 14 and Mil­ lard Fillmore Hospital 's program, which began on August 15. Sisters' program provides home health care services for up to 100 patients at 75 per C<';nt of comparable costs in an insti­ tution. Sisters studied home health care services for nearly three years before com­ pleting its plan, which has been approved by the Health Systems Agency and State Department of Health. Buffalo General formed a joint venture with Home Health Care of America, one of the largest such services in the coun­ try. It also reorganized its corporate struc­ ture to form a for-profit subsidiary, General Home Care. The new program's board is chaired by Dr. Gerald Logue, as­ sistant professor of medicine, and seven other Medical School faculty members, among others. Millard Fillmore's YitalCare Home Health is administered by Niagara Frontier Health services, a subsidiary of the Hospital's parent company. One of the board members is Dr. Thomas Cumbo SEPTEMBER 1985/21 �- -·------- Il()SPITAL TEWS L Norman Durawa, chiefradiologic technologist, demonstrates the ease and flexibi lity of the new mammography unit to Leti tia Parke r, senior x -ray technician, at Roswell Park Memorial Institute. of the medical faculty. According to Business First of Buffalo, "One of the greatest incentives driving ew York State hospitals into the home health care business is the advent of the diagnostic related groups," said james Kel­ ly, executive assistant of the Medical So­ ciety of Erie County. "Patients will have to be discharged earlier under ORGs," Kelly said. "Home health would be another alternative to the acute care patient, and the hospitals won't lose money." The weekly business newspaper report­ ed that nationally, 20 per cent of all hospi­ tal patients and 25 per cent of all nursing home patients could be treated in the home. Erie County currently has 35 in­ house health care organizations that pro­ vide a variety of services. • Hospitals get units for mammography S isters Hospital and Roswell Park Memorial Institute have acquired new state-of-the-art mammography units. Sisters Radiology Department has ac­ quired the I26 Xeroradiography system by Xerox Medical Systems. It provides the radiologists with a superior quality mam­ mographic image compared with conven22 /BUFFALO PHYSICIAN tiona! x-rays. Clinical assistant professor of radiology Or. Eugene Chl<;>sta said the new equipment greatly enhances their di­ agnostic capability because of the system's ability to spot cancer in difficult areas. ''About 10 per cent of all breast cancers are close to the chest wall and are difficult to see using the standard x-ray. Xeroradi­ ography enables us to see small deep le­ sions and nodes that might otherwise be hard to locate." The new 70,000 Phillips mammogra­ phy unit for Roswell Park's Diagnostic Radiology Department generates the lowest radiation dosages reported to date. The unit provides magnified images of the breast, thus enabling the radiologist to de­ tect even the most minute calcifications. The unit guarantees better positioning ease and patient comfort, as well as sig­ nificant improvement of the quality and readability of the x-ray films. • Merger to expand Millard Fillmore M illard Fillmore Hospitals' Presi­ dent jan R. jennings, has an­ nounced further expansion of the Millard Fillmore multi­ hospital system through a proposed merg- er with Inter-Community Memorial Hospital in Newfane. Approval of this merger will increase the Millard Fillmore system to six sites, spanning from Cuba, ew York, near the Pennsylvania border, to Lake Ontario. Millard Fillmore Hospi­ tals was the first multi-hospital system in the State with construction of its subur­ ban Buffalo satellite in 1974. In only the past year, the two-hospital multi has ex­ panded to six sites. ''A special sub-committee of the Inter­ Community Memorial Hospital board of directors was formed in early 1984 to ex­ amine all possible avenues for the future of the hospital. Following months of study, a decision was made to merge with a regional hospital. Millard Fillmore was chosen because of our long standing, ex­ cellent relationship with the hospital through the iagara Frontier Health Serv­ ices Consortium," explained Inter­ Community Memorial Hospital adminis­ trator Ray Clark. As part of the merger agreement, Inter­ Community Memorial will maintain a board of directors and will have represen­ tation on the Millard Fillmore corporate board of directors. "We are very pleased by the decision of Inter-Community Memorial Hospital to merge into the Millard Fillmore multi­ hospital system. We anticipate Millard Fillmore Hospitals and Inter-Community Memorial Hospital will benefit in the areas of financial management, teaching, and overall health services. Most importantly, ewfane and its surrounding communi ­ ties are assured of improved and secure health care for years to come," Mr. jen­ nings said. The merger will allow management functions to be combined in such areas as data processing, personnel administra­ tion and finance, thus eliminating dupli­ cation of services. Further, Inter-Community Memorial will gain a reinforcement and addition of medical and professional services. The merger also will facilitate a wider distribution of costs and reimbursements, and allows the hospitals' residency pro­ gram graduates to set up practice in the Newfane area, while retaining affiliation with Millard Fillmore Hospitals. The merger is expected to be completed in late 1985. • (From Millard Fillmore Hospital's "Reporter," Winter 1985) ' J �Graduates advised to remember goals T By Bruce S. Kershner he 139th Medical School Commencement-and the first such commencement to be held in the University's Alumni Arena-was attended by 1,200 enthusiastic family members and friends. One hundred and fifty medical students received their M.D. degrees, together with 16 who received Ph.D.'s in microbiology, biochemistry, pathology, pharmacology, and biophysics. Honors awards were granted to 28 men and women. Vice President john Naughton, dean of the Medical School, called the convoca­ tion to order. Speaking to the students' fa­ milies and guests, he said, "Many of you attended the first Family Day we held four years ago. Thus we have a longer and closer relationship with you than with many of the families in the past." Dr. Jack Coyne, who became a Cathol­ ic priest before he entered medical school, spoke on the opportunities for personal growth during as well as after medical school in his class speech. He reminded his (now) fellow physi­ cians that the camaraderie and mutual support that helped the 1985 class survive and succeed in medical school should not end with the M.D. Urging his classmates to continue their personal commitment to others throughout their lives, he remind­ ed them that " no one lives to be happy by obtaining that joy from himself." Dr. Coyne also emphasized that no phy­ sician should ever lose the vision of his purpose in life. "The only true happiness comes from living our lives with a pur­ pose." The purpose of, and need for, a physician was brought home by Dr. Coyne in quoting the statement by Dr. Tom Dooley that, "Over half of the earth lives their entire lives without ever seeing a physician." Tying together his points about the need for giving mutual support and a human-oriented purpose and goal in life, Dr. Coyne remarked that "it is so difficult to remain goal-oriented without each others' support. ... Promise yourself to be so strong that nothing can disturb your purpose of mind." Before he concluded, he related his ex­ perience as a clergyman in a Cambodian refugee camp before entering medical school. " 1 was approached by an over­ worked doctor who asked me for as­ sistance. He gave me a stethoscope and told me to just listen to the children's chests and tell him when I heard anything unusual sounding. With great hesitancy, \ J Medical degrees were awarded to 150 UB students. I did what he said. I listened for five minutes, hearing nothing unusual before I realized that the stethoscope's conduct­ ing end had been facing the fresh air-! had been listening to nothing at all! " ' ' Generation At Risk ," the keynote address by Dr. Robert . Butler, was aimed at alerting the audience to the impending crisis in medical care for the growing number of older citizens. Butler is Brookdale Professor and chairman, Department of Geriatrics, at Mt. Sinai School of Medicine. The first director of the ational Institute on Aging is interna­ tionally known for his research and public role in care of the elderly. He won the 1975 Pulitzer Prize for his book, Why Surviue? Being Old in Ameri­ ca. Among his other books is Love and Sex After Sixty. On the National Steer­ ing Committee for the Gray Panthers, he is also on the boards of the National Council on the Aging, Physicians for Social Responsibility, the Alzheimer 's Disease and Related Disorders Associa­ tion , Inc. , the National Ballet Society, six professional journals, and numerous other professional organizations. Besides the Pulitzer Prize, he has been honored as the Meritorious Professor of Gerontology and Geriatrics at Hunter Col­ lege, as one of the Washingtonians of the Year (1976), and by over 20 other awards. Dr. Butler chided the medical commu­ nity for not dealing with the imminent problem of the aging. With all the effort of the last 25 years on socialized medicine, rising health costs, malpractice and other legal , social and political issues, Dr. Bu­ tler declared that " we haven't prepared ourselves for the greatest challenge of all : the Longevity Revolution ." He explained that life expectancy has increased 25 years since 1900, a true revo­ lution considering a 5000-year trend of minimal improvement in longevity. " Eighty per cent of all deaths now oc­ cur after 60 years of age. The 80 + year­ old group is the most rapidly rising age group," he commented. The " Longevity Revolution" has been caused by two major factors, Dr. Butler remarked. The first is the reduction in in­ fant mortality due to advances in technol­ ogy and medical knowledge. The second is related to the preventive effect caused by Medicare (and public education), SEPTEMBER 1985/23 �resulting in drops in cancer and heart dis­ ease since 1960. "The Longevity Revolution is one of the greatest social, political, cultural, and eco­ nomic challenges of our time," he stated. "I ask this graduating class to be part of the leadership in dealing with this revo­ lution." Dr. Butler pointed out that the next group to become part of this revolution is the large population of now middle aged citizens who will reach retirement age by 2000, including the parents of the 150 new doctors in the commencement hall. Since the next group after that will be this decade's graduating classes, "you will be the greatest beneficiaries of that revolution," Butler told the graduates. He identified six areas that the medical community and society must concentrate on if the "Longevity Revolution" is not to become a crisis. "In the educational sphere, we must have systematic training programs in geri­ atrics," he advised, adding, "but I am against creating a geriatrician. Instead, we A graduate signs the Book ofPhysi­ cians at the 139tb Medical School Commencement_ must incorporate geriatric principles into all the disciplines." Then he noted that "not a cent of Medicare support for resi­ dent programs has ever gone to geriatric training. "We must also work as an interdiscipli24/BUFFALO PHYSICIAN Cheers offamily and friends greet a graduate as be receives his hood. nary team for the geriatric patient. Medi­ cine for old age is infinitely more complex than that for the middle aged. "At the same time, we must continue to support programs that emphasize disease prevention and health promotion. In the area of policy, we must develop a long term plan and foster rehabilitation pro­ grams to enhance the quality of life. "It is essential to work for solutions through health research, and to increase aging research. Our goal should be to gain control over the mechanisms of senes­ cence and immunity. "Lastly, we must try to deal with the group who will receive the greatest im­ pacts of infirmity- the family." He stressed that families, and society as a whole, will have ro bear the burden of the aged's health care needs, a ponderous responsi­ bility for which they must prepare now. Dr. Butler reminded the audience of our avoidance tendency by quoting Marcel Proust, "Old age is one of those realities that we retain the longest as an ab­ straction." After the keynote address, Dr. Maritza Alvarado, as editor of the Iris, announced its dedication to Dr. Charles Severin, as­ sistant professor of anatOmical sciences. The coordinator of the Medical School's Gross Anatomy course was a 1984 Siegel Teaching Awardee and also won five teaching awards while at the University of Texas. Dr. Severin opened his response by commenting, "One of my first goals has been to never forget what it is like to be a student. I've tried never ro forget that. "Now you former medical students will have the role of teacher of both patients and students. "Remember to demand only the very best but also to treat each student, each person, with respect for his or her abili­ ties," he urged. He also called on the students to apply this attitude to members of the Other med­ ical professions that physicians must work with. ''As Dr. Michael Debakey once said, 'On many occasions, a quick thinking nurse saved my neck.' " Following Dr. Severin's response, Dr. Peter Ostrow, associate dean, gave the Charge of Maimonldes, and Dr. john Naughton delivered the Oath of Hippo­ crates. Provost William Greiner conferred the degrees while Drs. Robert Mcisaac, Ed­ ward Carr, and james Hassett hooded the new M.D.'s. Each new doctor appeared on the plat­ form to the accompaniment of his or her own cheering section, as applause reverberated from one corner of the vast chamber to another. After all medical graduates had signed the Book of Physicians and doctoral degrees had been conferred by Dr. Alex­ ander Brownie, Dr. Thomas Flanagan an­ nounced the honor awards (see listing). • �TS sistant professor of social and preventive medicine here commented, " I t is unusual for a student to receive this grant, which is usually awarded to faculty." Straus will use fellowship in Peru U B fourth-year medical student Walter Lee Straus was awarded a SmithKline Beckman Medical Perspectives Fellowship for 114,062. He was one of onl y 33 to receive the fellowship which is funded by the Na­ tional Fund for Medical Education. Dr. Tim Byers, Straus' advisor and as- Mr. Straus, a nati ve of New York City, will travel to the Institute for utritional Investigation in Lima, Peru, to develop an education program on infant and child nutrition in th t country. The Medical Perspectives Fellowship Program, now in its eighth year, is ad- ministered by the ational Fund for Med­ ical Education and supported by a grant from SmithKline Beckman Corporation, a health care and technological company. NFME was chartered by Congress in 1954 to mobilize vol untary support for medi­ cal education . It has awarded over 1158 million to educational institutions and or­ ganizations dedicated to improving med­ ical education. This year's fellowships • totalled over $101,000. The following awards were announced at the Medical School Commencement: MEDICAL ALUMNI ASSOCIATION AWARD community commitment John Coyne DAVID K. MILLER PRIZE IN MEDICINE demonstration of Dr. Miller's approach to caring for the sick - competence, humility, humanity David Forster Shirley Anain BERNARD H. SMITH MEMORIAL AWARD IN CLINICAL NEUROLOGY academic excellence in clinical Neurology Christopher Lander Margaret Reidy DR. CYRENIUS CHAPIN AWARD achievement in clinical sciences Paul Berkowitz David O'Neil Carl Turissini JOHN R. PAINE AWARD IN SURGERY research of merit in the general field of Surgery Phelps Kip CHILDREN'S HOSPITAL PRIZE excellence in understanding disease in childhood Lynda Stidham MARK A. PETRINO AWARD demonstrated interest and aptitude for the general practice of Medicine Margaret Libby Debra Salter CLYDE L. RANDALL SOCIETY AWARD IN GYNECOLOGY-OBSTETRICS academic excellence Randall Rosenthal EMILIE DAVIS RODENBERG MEMORIAL AWARD - academic excellence in study of diabetes, its complications Timothy Wacker PHILIP P. SANG MEMORIAL AWARD ability to relate well to patients, faculty and staff John Bowen John Fudyma THESIS HONORS Alan Finkel BACCELLI AWARD most outstanding academic performance in the clinical years Christopher Lander Timothy Wacker GILBERT M. BECK MEMORIAL PRIZE IN PSYCHIATRY - academic excellence Roseann Russo BUFFALO SURGICAL SOCIETY PRIZE IN SURGERY academic excellence - junior, senior years DEAN'S AWARD participation in extra-curricular activities the Medical School while maintaining a high standard of academic excellence I I 1n DR. AUSTIN FLINT AWARDS achievement in basic sciences Christopher Lander Elizabeth Maher Timothy Wacker JANET M. GLASGOW AWARD academic superiority for women Elizabeth Maher JANET M. GLASGOW CITATIONS academic excellence for women Darlene Eldredge Roseann Russo Elaine Schaaf Lynda Stidham MORRIS & SADIE STEIN NEUROANATOMY Christopher Lander AWARD - excellence in Neuroanatomy UPJOHN AWARD research ability Blackford Middleton BERNHARDT & SOPHIE B. GOTTLEIB AWARD - expertise in areas outside of Medicine Joel Shugar JOHN WATSON AWARD IN MEDICINE enthusiasm for and commitment to scholarship in Medicine Lawrence Fisher NORMAN HABER MEMORIAL AWARD for proficiency in Otolaryngology Margaret Reidy Oonald H. Tingley DR. HEINRICH LEONHARDT PRIZE IN SURGERY - academic excellence Frank Lacqua E.J. WEISENHEIMER AWARD excellence in scholarship and patient care in Ophthalmology Kevin Donovan Christopher Lander FREDERICK B. WILKES PEDIATRIC AWARD - to the graduating student entering a career in Pediatrics who has best exemplified Dr. Wilkes' skills and dedication to patients Thomas Szalkowski LIBERMAN AWARD interest, aptitude in the study of Anesthesiology HANS J. LOWENSTEIN AWARD IN OBSTETRICS - academic excellence Shirley Vandermey Galucki Paul Alan Berkowitz MAIMONIDES MEDICAL SOCIETY AWARD most outstanding academic performance in the basic science years John Leddy DR. LOUIS SKLAROW AWARD for oustanding peformance and achievement (presented June 26) SEPTEMBER 1985/25 �Medical Alumni Association President's Message Our theme for this message is communication, and as A.T.&T. so aptly says, we are planning, "to reach out to touch someone" - you. Your Board of Directors has decid­ ed to encourage the formulation of alumni chapters. To initiate this, our association is planning to have a cocktail party and a video-taped presentation of the progressive programs at the Medical School at various specialty meetings such as: American Academy of Family Phy­ sicians in Anaheim, California - Oc­ tober 10-13; American College of Surgeons in Chicago, Illinois - Oc­ tober 13-18 and American College of Cardiology in Atlanta, Georgia March 9-13. Your enthusiasm could help to promote interest in the formation of satellite chapters in various geo­ graphic areas. This could lead to an input of your ideas into the na­ tional medical alumni association. The Spring Clinical Day on May 10, 1986 would be an ideal time for our "ex-officio board mem­ bers" to get together with us in Buffalo. Your President and the Board Members would like to have you respond to any idea you read in this editorial or ideas about Spring Clinical Day. Let's communicate! Charles Tanne r, Jr. , M.D. Class of 1943 26/BUFFALO PHYSICIAN a: w <!l z :::> 0 <!l :::> I § ~ L---~L---~-----L----~------~----~--~~--~----~~----~ Participating in the Spri ng Clinical Day were, from left, John A. Riche rt, Charles J. Tanne r, D ean John Naughton and Carmelo S. A rmen ia. Transplant surgeons discuss advances ' 'T By Bruce S. Kershner here was this woman who was discovered to be mis­ sing a sixth chromosome and was a universal organ donor. Then an ailing mafiosa king, in need of several organ transplants, disco­ vered her and chased her all over the country. It all ended happily, however, with the woman running off with a trans­ plant surgeon into the sunset." So described Byers Shaw. M.D., one of the speakers at the 1985 Spring Clinical Day, humorously referring to an interest­ ing novel he came across a while ago. While the novel clearly presented too romantic and rosy a picture, all the promi­ nent transplant surgeons who spoke at the UB Medical Alumni Association's major annual event agreed that recent advances indicate an optimistic prognosis for organ transplantation. Dr. Shaw was one of six major guest speakers at the <18th Annual Spring Clini­ cal Day, held May 4 at the Buffalo Marri­ ott Inn. Occurring on the same day were the alumni reunions of ten UB Medical School classes and the Scientific Exhibits Program featuring 21 exhibits by area phy­ sicians and medical researchers (see separate articles). Moderated by Frank Bolgan (M'51), clin­ ical associate professor of surgery, the scientific program focused on the status and future of organ transplantation. Up­ dates and comparisons of kidney, liver. heart, and lung transplantation were presented with the keynote address focus­ ing on the ethical issues surrounding or­ gan transplantation (see separate article). T he program provided the several hundred attendees with an unusual opportunity to compare differences and difficulties between various types of or­ gan transplants, as described by the lead­ ing specialists. The first successful kidney transplant, explained William E. Braun, M.D., oc­ curred in 195'!, nine years before the first successful transplant of any other type of organ. Only identical twins were used for renal transplants during the first five years, a period during which it was learned that the original disease of a patient could recur after a transplant. 1960 was a his tor- �ical vear when a hemodialysis unit for renal tranplant patients became the world's first artificial support system. Dr. Braun reviewed the process of re­ jection and the donor-matching proce­ dure that became refined after non-identical twin renal transplants began in 1959. Dr. Braun is director of the Histocompatibility and Immunogenetics Laboratory and chief of the Medical Renal Transplantation Service of the Cleveland Clinic Foundation. In one year, 196.3, both the first success­ ful lung and liver transplants took place. The first heart transplants waited until 1967, but the first heart/lung transplant wasn't accomplished until 1981. Patterns of frequency of organ trans­ plants were similar for liver, lung, and heart transplants. An initial flurry of trans­ plants in the first several years was fol­ lowed by a marked decline in frequency as low survival rates led to discourage­ ment about the desirability of types of transplants. Dr. Shaw is assistant professor of surgery at the University of Pittsburgh. The frequency pattern for renal trans­ plants, however, did not show the same temporary decline because of greater suc­ cess rates. For example, survival rates for kidney transplants in 1975 had risen to 90-95 per cent (for transplants of organs from living donors), while the liver trans­ plant survival rate in 1978 was only 50 per cent for one year and 26 per cent over six years. Rates for heart and lung transplants were even lower. This all changed, however, when the immunosuppressant cyclosporine was in­ troduced in 1980. The revolutionary drug led to a sudden increase in all transplants. By 1985, survival rates for liver and heart transplants hovered around 75 per cent and 65-70 per cent for heart/lung trans­ plants. Dr. Shaw declared that "cyclospo­ rine should no longer be considered experimental but instead the standard regimen for most transplant patients." Cyclosporine, Dr. Braun explained, not only lowers rejection but also shortens hospital stays from 21 down to 12 days. It is not without its disadvantages, though. It is nephrotoxic, possibly even with sub­ threshold doses, a particular concern for renal transplant patients. Furthermore, its absorption rate differs for each patient and it is contra-indicated by a dozen or so major drugs such as cimetidine and acy- Colleagues view an exhibit at the Spring Clinical Day. clovir, and with hypertension patients. A rebound effect is another hazard, since "withdrawal of cyclosporine results in serious rejections," Dr. Braun points out. Cyclosporine's other disadvantage is economic. Its 55000 annual cost to a sin­ gle patient is not paid for by the govern­ ment, commented discussant Dr. Duane Freier, l'B professor of surgery and head of surgery at Buffalo General Hospital. Dr. Joginder Bhayana, l'B associate professor of surgery and director of the transplant program for l1B's affiliated hospitals, provided perspective on the economic costs of transplants: "The thing that all the organ transplant critics over­ look is that the cost of all heart transplants performed around the world every year is equal to only one-tenth the cost of a sin­ gle nuclear submarine." Another statistic coming out of the meeting is that in 198.3, 2000 people do­ nated kidneys, hearts, livers, and lungs, out of 22,000 potential donors. Over half of the donors were heart donors. While criteria for kidney donors and recipients are relatively flexible, criteria for other organ donors and recipients are much more severe, with lung donors be­ ing the most difficult to locate, Dr. Jack Cooper commented. He is head of the Di­ vision of Thoracic Surgery at Toronto General Hospital and the l'niversity of Toronto. Heart transplant candidates, Cooper said, must be less than 50-years-old with less than one year expected survival, but otherwise healthy in non-cardiological respects. Dr. Bruce Reitz pointed out, however, there are more candidates be­ tween 54- and 6'!-years-old than there are between 10 and 54. Dr. Reitz is professor of surgery and chief cardiac surgeon at Johns Hopkins. Two criteria common to several of the organ transplants are not based on physi­ cal conditions. Drs. Bhayana and Shaw stressed that transplant candidates must have sufficient family and social support to enhance their care and chances of recovery. The other criterion is that the patient's mental state be relatively healthy. "The patient must have the ability to ac­ cept the procedure, understand its impli­ cations, and assume its cost," Dr. Bhayana noted. The history of Buffalo's role in organ tranplantation was brought up by the speakers. For instance, Dr. Reitz explained, a Buffalo woman was the first successful recipient of a heart/lung transplant in 1981. The pioneering efforts of Dr. Gerd Cropp, UB professor of pediatrics, led to the first heart/lung transplant in a cystic fibrosis patient (also a Buffalo resident) performed in 1983 in Pittsburgh. SEPTEMBER 1985/27 �U B's Dr. Bhayana reviewed Buffalo's program. UB's first heart transplant occurred on May 14, 1984 at Veterans Ad­ ministration Medical Center. The most re­ cent of the six performed to date took place last April 20. Four of the six, includ­ ing the first heart transplant patient, are still alive. Three other patients were wait­ ing for transplants at the time of the con­ ference. Heart transplant operations have also been performed at Buffalo General Hospital and an agreement is being negotiated to enable a non-veteran to be operated on at Veterans' Administration Medical Center. Other discussants at the ali-day event Dr. Theodore J ew e tt (M '45) address­ ing Spri ng Clin ica l Day a udience. were Dr. Roland Anthone (M'50), clinical professor of surgery and co-chairman of Buffalo General's transplant program; Dr. John Vance, clinical associate professor of medicine and director, Pulmonary Labora­ tory, Millard Fillmore Hospital; and A. Theodore Jewett (M'45), professor of sur­ gery and pediatrics and associate chair­ man of Children's Hospital's Department of Pediatric Surgery. Outgoing Medical Alumni Association President Carmelo Armenia (M'49) and University Vice Presi­ dent John Naughton welcomed the at­ tendees. With all the statistics, clinical compari­ sons and facts, Dr. Shaw reminded the au­ dience of the fundamental point. Showing a slide of a reunion of child liver trans­ plant patients with their doctors, Dr. Shaw pronounced, "We should all remember we are not just talking about numbers, but about lives." • 28/BUFFALO PHYSICIAN Tanner elected alumni president C harles]. Tanner, M.D., was elected president of UB's Medical Alumni As­ sociation at Spring Clinical Day, May 5. Dr. Tanner received his medical degree here in 1943 and is also a graduate of St. Bonaventure University. He trained in sur­ gery at Erie County's Meyer Hospital and then went into the U.S. Army where he served as commanding officer of an over­ seas station hospital. Upon return to Buffa­ lo he completed his surgical residencies at Roswell Park and the Veterans Adminis­ tration and was a fellow in cardiovascu­ lar surgery at UB. Dr. Tanner opened his office at 2705 South Park Ave. in Lackawanna in 1950 and has been on the surgical staffs of Mer­ cy Hospital, Our Lady of Victory, Sisters Hospital, Millard Fillmore Hospital, and Emergency Hospital. Dr. Tanner is a Fel­ low of the American college of Surgeons and a member of the Roswell Park Surgi­ cal Society, International College of Sur­ geons, American College of Abdominal Surgeons, American Geriatric Society, American College of Angiology, and the Associations of American Railroad Sur­ geons and Military Surgeons. Other 1985-86 alumni offiers are the new vice president, john E. Przylucki, M.D., a UB clinical instructor of surgery and Williamsville resident; and the new treasurer, Franklin Zeplowitz, M.D., a South Buffalo general and pediatric surgeon. The UB Medical Alumni Association founded in 1875, represents almost 4,000 alumni who practice medicine in 47 states, Puerto Rico, and other countries. • Koreishi's exhibit wins first place F irst prize for best medical scienti­ fic exhibit went to Faruk Koreishi, M.D., at the Annual Spring Clini­ cal Day Exhibits Program. The May 4 event at the Marriott Hotel is the major program sponsored by the Medical Alum­ ni Association. Dr. Koreishi's award-winning exhibit portrayed and described the modern treatment of macular degeneration, a weakening of the eye's retinal cells and the leading cause of blindness in adults over the age of 60 in the U.S. His treatment uses the krypton laser, now believed to be the most effective treatment of a major form of macular degeneration. Dr. Koreishi was the first to introduce the krypton laser in Buffalo in August 1983 for the purpose of treating eye disease. Sandra Boglione was the exhibit's photographer. Dr. Koreishi, clinical assistant professor of ophthalmology. has had fellowships at the Massachusetts Eye and Ear Infirmary and Albany Medical Center. A Fellow of the American College of Surgeons, he is also a member of the N.Y. State Ophthal­ mological Society and the American Academy of Ophthalmology. He maintains a private practice in Amherst. A scientific exhibit created by John Zoll, M.D., and his Roswell Park Memorial In­ stitute colleagues won Second Prize in the competition, which included 21 exhibits. Their entry described a state of the art method of taking a brain cancer biopsy. Drs. Jaya Ghoorah, Koshiaki Tsukada, Charles West, and Prama Luther, all UB medical faculty, helped prepare the exhibit. Third Prize was presented to Charles Wiles, M.D. (Class of '45), and James Cogriff, Jr., M.D., UB clinical assistant professor of surgery, for an exhibit on di­ agnosing choledochal cysts. A sample of some of the other exhibits included: • "Computerized Instruction at the Bedside" by Dr. Donald Copley, clinical assistant professor of medicine. • "The SUNY Buffalo Medical School Heart Transplant Program" by Dr. joginder Bhayana, associate professor of surgery, and seven colleagues. • "The Use of Moh's Surgery in the Treatment of Skin Cancers" by Dr. john Phelan, clinical assistant professor of sur­ gery and family medicine; Dr. Halina Mil­ grom, clinical assistant professor of dermatology; B. Dale Wilson, assistant professor of dermatology; and Dr. joseph Buecker, all of Roswell Park. • "Posterior Neck Dissection" by Dr. Keun Lee, assistant professor of otolaryn­ gology, and Dr. Don Duplan, clinical as­ sistant instructor of otolaryngology. • "Heart-Lung Transplantation in Cys­ tic Fibrosis" by Dr. Gerd Cropp, profes­ sor of pediatrics, and five associates. • �THE NUMBER OF DUES-PAYING MEDICAL ALUMNI INCREASED FOR FISCAL YEAR JULY 1984 JULY 1985: Thank you to the 1,324 dues-paying Medical Alumni listed here. A special thanks to the nine reunion classes-1935, 1940, 1945, 1950, 1955, 1960, 1965, 1970, 1975-who contributed $125,000 to the Medical School. \X'endell R. Ames john F. Argue \X'illiard H. Bernhoft Russell F. Brace Raymond H. Bunshaw Benjamin Coleman Kenneth H. Eckhert Gasper J. Fatta :\Iaurice B. Furlong Leo N. Kuczmarski Victor B Lampka james .\lark Bennie 1\l ecklin Charles E. Moran Daniel D. Peschio Francis \\'. Ryan Clayton G. \\'eig George S. Young .. Marvin L. Amdur .\l:trtin A. Ange lo john G. Ball Richard C. Batt A. J. Bellanca A l fred Chern· Edward G. Eschner Willard G . Fischer jerome J. Glauber Irving Hclfert Frank C. Hoak T h omas F. Houston Eli A. Leven Wi lliam F. Lipp T homa s C. McDonough V ictor L. Pe lli ca no Haro ld F. Wherley Kenneth M. Alford john Ambrusko William L. Ball Charles F. Banas Francis E. Ehret Theodore C. Flemm ing Stanley]. jackson George F. Koepf Angelo Lapi Rose M. Lenahan Robert \X'. Lipsett Alice Challen Lograsso james D. MacCallum Paul J. Maloney M. Luther Musselman Norton Shapiro Irving Weiner Da\'id H. Weintra ub William F. White Charles J. \'V'oeppel Charles F. Becker Russell J. Catalano James R. Cole George :'.1 Cooper Charles Donatell i Norman J Foit C. M . Furtherer Alexander L. K inbaum Harry C. Law Samuel L. Lieberman Alfred A . Mitchell H . Robert Oeh ler Eustace G. Phillies Maxwell Rosenb latt \\ 'a lter L. Sydoriak R1chard N. Terry 3 19 5 from left: front row, Floyd W. Hoffman, Wendell R. Ames, Willard H. Bernhoft, Kenneth H. Eckhert, Daniel D. Peschio, Bernard Drexler and Leo N. Kuczmarski; se­ cond row, John F. Argue, Benjamin Coleman, Richard M. McNerney, Maurice B. Furlong, Robert J. Krug, Carl A . Stettenbenz and Bennie Meeklin, and third row, Clayton G. Weig, Russell F. Brace, Francis W. Ryan and George S. Young. Carlos C. Alden, Jr. Grosvenor \'V': Bissell LaMoyne C. B leich George C. Brad~ Ruth C. Burton Alfred H. Dobrak William Dugan Matt A. Ga jewski Kenneth Goldstein Man· in Mogil john F. .\lontro} Elizabeth P O l msted A. \'. Postoloff Frank T. Ri forgiato Roy E. Seibel .\! arvin Siegel John]. Squadrito Franklin E. Waters Everett H. Wesp :\! ar vin N. Winer julian J. Ascher john M. Ben n) Mi l ford N. Childs Marshall Clinton , Jr. H erbert H . Ecc leston Wi ll iam H i ldeb rand, Jr. Bernard \X'. juvclier Evan \X'. Molyneaux Warren R. Montgomery, Jr. Harold Palanker Russell E. Reitz Norbert J. Roberts Robert H. Roehl james P. Schaus, Jr. C. Henry Severson Allan W. Siegner Wi ll iam 0. l ' miker Stanley T. Crban John D. White joseph T. Aquilina Berten C. Bean Robert n. Byrne Anthony J. Cooper Robert W. Edmonds George A. Gentner Pasquale A . Greco Arno ld G ross Donald W. Hall Eugene J. Hanavan, Jr. Harold L. Kl einman Daniel J. McCue Frederick E. Mott john J. 0 'Brien SEPTEMBE R 1985/29 �Allen A. Pierce john T. Pitkin Roman Shubert Anthony ). Virgo Philip B. Wels Leonard Wolin Floyd M. Zaepfel .. 1945 from left: front row, Paul B. Cotter, Jacob M. Steinhart, Herbert E. Joyce, Ivan W. Kuhl, William N. Mcintosh, Earl K. Cantwell, Alton A. Germain and Ge­ orge A. Poda; second row, Vito P. Laglia, George W. Fugitt, Edward G. Forgrave, DeanJohn Naughton (guest), Charles E. Wiles, Kornell Terplen (guest), O.P. Jones (guest), Williams S. Andaloro, William D. Loeser and Richard M. Greenwald; third row, Raymond S. Barry, Frederic D. Regan, Richard H. Adler, Joseph Tannenhaus, Peter Terzian, Gilbert B. 1)!bring, Robert C. Schopp, John P. Long, William J. Rogers, Jane Brady Wiles, Victor C. Lazarus, John G. Robinson and Edward L. Valentine, and back row, George M. Ellis,Norman Chassin,John K. Quin­ livan, Leslie A. Osborn, Hilton R. Jacobson, John E Hart­ man, K. Joseph Sheedy, Wayne C. Templer, Donald N. Groff, Joseph E. Rutecki and William R. Taylor. 1940 from left: front row, John Benny, Stanley Urban, Bernard Juvelier, William Hildebrand, C. Henry Sever­ son and Harold Palanker, and back row, Robert Roehl, Julian Ascher, Albert Rekate, Edward Eppers, James Schaus, John Zoll, Milford Childs and Warren Mont­ gomery. 30/BUFFALO PHYSICIAN Albert J. Addessa Horace L. Battaglia Charles A. Bauda Kent L. Brown Vincent S. Cotroneo George L. Eckhert \X'illiam ). Follette Aloysius A. Kalinowski Harrison M. Karp Diana D. Kibler Boris L. Marmolya Richard Milazzo Vincent J. Parlante john D. Persse, Jr. Edward L. Schwabe William ). Staubitz .. Ralph T. Behling Paul K. Birtch ~1arvin L. Bloom Richard ). Buckley Ivan L. Bunnell Louis F. Ciola Paul A. Cline Alfred S. Evans L. Water Fix B. joseph Galdys Stewart L. Griggs john P. Guinther joseph V. Hammel Edgar A. Haunz Richard). jones Ruth F. Krauss Melbourne H. Lent Anthony ). ~1arano Ronald E. Martin George Marvin Robert C. McCormick Franklin Meyer Amos). Minkel, Jr. Robert W. Moyce john C. Ninfo Kevin M. O'Gorman Walter R. Petersen Adrian J. Pleskow Col. Bradley W. Prior Charles C. B. Richards joseph ). Rtcotta athan P. Segel Gene D. Sherrill Ralph E. Smith, Jr. Winslow P. Stratemeyer Gertrude S. Swarthout james W. Taft Charles). Tanner, Jr. Hazel J. Trefts Louis A. Trovato Morris Unher joseph A. Valvo LaVerne G. Wagner john R. Williams Paul). Wolfgruber Anthony M. Aquilina Willard H. Boardman Raymond G. Bondi Clifford F. Bramer, Jr. Robert L. Brown Eileen L. Edelberg Herman Edelberg Richard W. Egan Newland W. Fountain Thomas F. Frawley Frank T. Frost Andrew A. Gage Irwin A. Ginsberg Harold P. Graser Raymond A. Hudson Sidney R. Kennedy, Jr. Frank H. Long, Jr. Federico ). Maestre Francis C. Marchetta William A. Potts joseph Ross Sidney M. Schaer Carrol J. Shaver Walter F. Stafford, Jr. Clinton H. Strong james R. Sullivan Paul L. Weygandt R. G. Wilkinson, Jr. Richard H. Adler William S. Andaloro Bruce F. Baisch Raymond S. Barry Norman Chassin Paul B. Cotter George M. Ellis, Jr. Edward G. Forgrave �George W. Fugitt, Jr. A. Arthur Grabau Richard M. Greenwald Donald N Groff John F. Hartman Hilton R. Jacobson James H. Johnson Herbert E. Joyce Vito P Laglia Victor C. Lazarus William D. Loeser William N. Mcintosh Leslie A. Osborn George A. Poda John K. Quinlivan Frederic D. Regan John G. Robinson William J. Rogers III Albert J. Rosso Lillian E. Rowan Joseph E. Rutecki Robert C. 'ichopp David ]. ~haheen K. joseph ~heedy Jacob '\.1. ~teinhart RO) Swartout, III \X'illiam R. Taylor Wayne C. Templer George Thorngate IV Gilbert B. Tybring Edward L. Valentine Charles E. \X iles jane B. Wiles John G. Allen Charles D. Bauer Donato ]. Carbone Alexander R. Cowper john T. Crissey Lawrence II. Golden Edward F. Gudgel Ross Imburgia Carl]. lmpellitier Charles A. Joy Harold ]. Levy Eugene M. Marks Maynard H. Mires, Jr. R. joseph "laples Harry Petzing Amo ]. Piccoli Herbert ~- Pirson Albert G. Rowe Henry M. Tardif W. William Tornow Myron E. Williams, Jr. Bruce D. Babcock \\'illiams C. Baker Edward S. Breakell \Xilliam M. Bukowski Ste\·en G. Cline ]. Desmond Coughlin Daniel E. Curtin Williams S. Edgecomb Robert ]. Ehrenreich Elbert Hubbard III Robert M. Jaeger Peter]. Julian Hans F Kipping Richard J. Marchand Anthony S. Merlino Hallie B. Mont Donald C. Nuwer James F. Phillips Philip L Reitz Arthur J. Schaefer Robert L. Segal john B. ~hcffer james F. STagg joseph C. Todoro Jerome I. Tokars Victor C. Welch, Jr Frederick D. Whiting Donald B. Thomas Edward C. Voss, Jr. Gertrude L. Waite Anne A. \X'asson William S. Webster Sidney B. Weinberg Myra R. Zinke Eugene J. Zygaj Rebecca G. Solomon Edward R. Stone Paul Weinberg ::,. Paul Zola Frances R. Abel Carmclo S. Armenia ]. Bradley Aust, Jr. Alfred Berl Harold Bernhard Manuel H. Brontman Lawrence !\1. Carden Julia M. Cullen Joseph E. Griffin Arthur ~1ogerman jacqueline L Paroski Frank A. Pfalzer, Jr. Robert D. Sanford !\lax A. Schneider Fred '>halwitz Rober G. '>mith james D. Stuart Pierce Weinstein james A. Werick Charles]. Wolfe ' James G. Borman !\1ichael Dzubaty Daniel J. Fahey \X illiam F. Gallivan, Jr. joseph P. Gambacorta Raphael ~- (,ood !\lyron Gordon Harold L. Graff Robert J. Hall \X'arren L. Hollis Ralph A. Kilby judith B. Landau Vernon C. Lubs john J. Marinaccio Ansel R. Martin Norman Minde Raymond E. Moffitt Darwin D. Moore Kenneth Niswander l\orman L. Paul Francis J. Peisel Cletus J. Regan Thomas C. Regan Lester H. Schiff Edgar C. Smith Irwin Solomon Seymour Aberle Roland Anthone Sidney Anthone Lawrence D. Renken Robert A Benninger Robert E. Bergner George P. Bisgeier James ]. Brandl Charles Brody Grace B. Busch Carl A Cecilia Frank Chambers, Jr. Flossie Cohen James A. Curtin Adclmo P Dunghe. Jr. James C. Dunn Carmen D. Gelormini Sergio R. Irizarry Robert N. Kling Richard J. Leberer Karl L. Manders Patricia A. Meyer Robert ]. Patterson Henry L. Pech, Jr. Roy W Robinson Clarence E. Sanford Helen F. Sikorski Hyman Tetewsky I jay B. Belsky Frank J. Bolgan August A. Bruno Carl R. Conrad I lan-ey D. Davis Eli Engel William S Glassman Allen L. Goldfarb Myron C. Greengold Mark E. Heerdt Ludwig R. Koukal Harold P Krueger Eugene \'. Leslie james \'. Loverde Thomas J. Murphy john L. Musser Daniel A. Phillips Donald P Pinkel Marvin ]. PleskO\\ Robert E. Ploss Melvin C. Reinhard, Jr. Milton Robinson Gerald E. Schultz Robert L. Secrist Adolph Smith Bernard Smolens Eugene M. Teich james W. Weigel Lester E. Wolcott Donald J. Adams john ]. Banas Robert A. Baumler Alvin]. Brown Lawrence]. Comfort Bruce F. Connell Barbara G. Corley Donald F. Dohn Melvm B. Oyster Neal W. Fuhr Albert A. Gartner, Jr. joseph E. Genewich Donald J. Kelley Melvin R. Krohn Milton C. Lapp SEPTEMBER 1985/31 �Eugene W. Loeser, Jr. Colin C. MacLeod Victor A. Panaro John Y. Ranchoff Harry B. Richards Travers Robbins James N. Schmitt Byron E. Sheesley S. Aaron Simpson Donald H. Sprecker Oliver J. Steiner Burton Stulberg James Irme Szabo Roy]. Thurn S. Jefferson Underwood Kurt J. Wegner William ]. Howard Eugene C. Hyzy Benjamin C. Jenkins John A. Kutrybala jacob Lemann, Jr. Allen L. Lesswing Lucille M. Lewandowski Sylvia G. Lizlovs Charles H. Marino Ernest H. Meese Donald ]. Murray N. Allen Norman Harry T. Oliver Walter A. Olszewski Edward A. Rayhill Edwin B. Tomaka Marlyn W. Voss Paul L. Weinmann Donald M. Wilson Stanley L. Cohen Thomas Comerford, Jr. Felix A. Delerme Donald L. Ehrenreich Sander H. Fogel Thomas G. Geoghegan Jack Gold john W. Handel Jerome E. Hurley Curtis C. Johnson Herbert E. Lee Edmund A. Mackey Milford C. Maloney Richard ]. agel James M. Orr Bertram A. Porrin Donald 0. Rachow joseph F. Ruh Molly R. Seidenberg Howard C. Smith, Jr. Harold Smulyan John N. Strachan Michael A. Sullivan Reinhold A. Ullrich .. David H. Abel Irwin]. Averbach Eugene L. Beltrami joseph L. Campo icholas C. Carosella Louis C. Cloutier John L. Conboy Robert D. Foley Byron A. Genner III Florence M. Hanson Edward W. Hohensee Arthur Y. Hoshino 32/BUFFALO PHYSICIAN 1950 from left: front row, Adelmo P. Dunghe, Patricia A. Meyer, HelenE Sikorski, James C. Dunn, Myra R. Zinke andJoseph M. Mattimore; second row, RobertJ. Patter­ son, Roy W. Robinson, Robert A. Benninger, Clarence E. Sanford, Richard J. Leberer and Leo E. Manning, and back row, Donald B. Thomas, Roland Anthone, Henry L. Pech and James J. Brandl. Laurence T. Beahan Richard A. Carlson Vincent S. Celestino James R. Collins Louis R. Conti Lloyd Damsey C. Daniel Fagerstrom Albert A. Franco Frank ]. Gazzo Michael ]. Gianturco joseph Gordon Cleora K. Handel Alan C. Harrer Sami A. Hashim Kathryn M. Keicher John H. Kent S. joseph Lamancusa Gary J. Mastman Winifred G. Mernan George L. Mye, Jr. john H. Peterson Leonard R. Schaer Anthony B. Schiavi Ray G. Schiferle, Jr. Robert A. Smith James G. Stengel Marrin C. Terplan Barbara Von Schmidt David F. Weppner Eugene B. Whitney John A. Winter Donald A. Wormer 1955 from left: front row, Eugene B. Whitney, John C. Read, Louis R. Conti, Alan C. Harter andJames M. Gar­ vey; second row, Vincent S. Celestino, Anthony B. Schia­ vi, Winifred G. Mernan, Richard A. Carlson, Cleora K. Handel, John H. Kent, Albert Alfred Franco, and back row, FrankJ. Gazzo, MichaelJ. Gianturco,John E Foley, James R. Nunn, Ray G. Schiferle,John A. Winter, Martin Terplan,James R. Collins, John H. Peterson and Donald A. Wormer. •• George]. Alker, Jr. John D. Barrels M. David Ben-Asher Helen E. Buerger Robert B. Corretore Peter S. D 'Arrigo Mark A. Dentiger �1960 from left: front row, Thomas J. Guttuso, Daniel A. Goldberg, Eugene P. Rivera, GerardJ. Diesfeld, Eugene T. Partridge and Donald J. Coleman; second row, CharlesJ. Riggio, Daniel T. Gianturco,James R. Kanski, RogerS. Dayer, Franklin Glockner, Joseph A. Chazan and Edward J. Graber, and standing, George B. Pfoertner, Theodore Bistany, Donald A. Hammel, Joseph G. Antko­ wiak, Francis J. Klocke, Daniel A. Rakowski, Robert L. Malatesta, DavidN. Mesches,JohnA. Tuyn, Andre D. Las­ cari, Robert T. Guelcher, Algirdas Gamziukas, Robert H. Sauer, DonaldJ. Donius,JohnM. Budzinski, Thomas H. Wits chi, William J. Stein, Harry L. Metcalf and Harold Brody (guest). Richard R. Gacek Edmond ]. Gicewicz Peter F. Goergen, Jr. Frederick P. Goldstein Dennis P. Heimback John M. Hodson Oliver P. Jones, Sr. Joseph L. Kunz Thomas Luparello, Jr. Sue A. McCutcheon Robert G. Mcintosh Frederick C. Nuessle Robert Ollodart Hugh F. O'Neill Jordon S. Popper Erick Reeber Robert E. Reisman Paul C. Ronca Bernard H. Sklar Herbert Tanney Axel W. Anderson Paul L. Archambeau Julian Barker Bronson M. Berghorn Benny Celniker Marvin N. Eisenberg Gerald Friedman Myron Garsenstein Barbara ]. Hetzer Harris H. Kane! joseph F. Kij, Jr. Harvey Z. Klein Charles E. Lowe Ross Markello Herbert Metsch Richard F. Miller Charles F. O'Connor Richard N. Rovner Donald E. Schaffer ] . David Schnatz joseph I. Schultz Herbert Silver Robert B. Sussman H. Gregory Thorsell Bernard D. Wakefield Edward ] . Weisenheimer Sherman Waldman . Gaspare A. Alfano John V. Armenia Ronald E. Batt David A. Berkson : Melvin M. Brothman Ronald W. Byledbal Franklyn N. Campagna Bernice T. Comfort Robert C. Dickson Frederick W. Dischinger Domonic F. Falsetti John W. Float Eugene A. Friedberg Michael T. Genco john ] . Giardino William L. Glazier John F. Holcomb Hilliard Jason Leo A. Kane Louis Katz Marie L. Kunz Lloyd H. Leve Michael A. Mazza Robert ]. Perez Lucien A. Potenza Richard A. Rahner jason A. Reder Elliott Rivo Richard R. Romanowski Walter H. Rothman Albert H. Shaheen Samuel Shatkin Morton Spivack Alfred M. Stein Ann A. Tracy Richard D. Wasson Morton B. Weinberg Reinhardt W. Wende James S. Williams Franklin Zeplowitz Harold B. Zimmerman joseph A. Zizzi George R. Baeumler Mary Ann Z. Bishara William P. Blaisdell Robert J. Brennen Donald L. Cohen Constantine Cretekos David E. Denzel James R. Doyle Richard A. Falls joseph A. Ferlisi Seymour D. Grauer Logan A. Griffin Daniel C. Kozera jacob Krieger William ]. Mangan john ]. McMahon joseph F. Monte Elton M. Rock Mortimer A. Schnee Russell C. Spoto jason H. Stevens Raymond C. Thweatt ''I William E. Abramson joseph G. Antkowiak Julian T. Archie Robert Bernat Theodore S. Bistany john M. Budzinski joseph A. Chazan D. jackson Coleman Roger S. Dayer Gerard J. Diesfeld Algirdas Gamziukas Daniel T. Gianturco Franklin Glockner Daniel A. Goldberg Edward]. Graber Robert Guelcher Thomas]. Guttuso Donald A. Hammel john H. Harrington james R. Kanski Francis ]. Klocke Edwin R. Lamm Andre D. Lascari Robert L. Malatesta David N. Mesches Harry L. Metcalf Hyman Nadel Harry H. Nakata Eugene T. Partridge George B. Pfoertner Daniel A. Rakowski Eugene P. Rivera Gerald L. Saks Robert H. Sauer Marvin Shapiro William ]. Stein john A. Tuyn Thomas H. Witschi .. Harold Brody ]. Anthony Brown Eugene A. Cimino Carlo E. Desantis Allan S. Disraeli David R. Fleisher Richard C. Hatch William J. Hewett SEPTEMBER 1985/33 �Frank E. Ehrlich Anthony M. Fori Anita ]. Herbert Stephen T. Joyce Paul A. Lessler George . Lockie Albert ]. Maggioli David N. Malinov Don L. Maunz James B. Miller Richard B. Narins Ronald G. athan Thomas J. Reagan John A. Repicci Jason E. Rudisill Lawrence ]. Sobocinski Robert B. Spielman George L. Steiner John . Stumpf Eugene M. Sullivan, Jr. Charles S. Tirone joseph C. Tutton John M. Wadsworth Howard M. Hochberg Norman E. Hornung Richard 0. Loeb \1ichael Madianos Edwin]. Manning James R. Markello Philip W. McMillin Brenton H. Penwarden Saar A. Porrath A. Thomas Pulvino Stephen D. Rader Paul T. Schnatz Arthur T. Skarin Paul Stanger Jacob Y. Terner Ronald H. l 'siak Robert Winters Charles G. Adams Joseph P. Armenia James T. Bumbalo joseph A. Cimino Martin Cowan John W. Cudmore Harold C. Domres, Jr. Jack C. Fisher Anthony J. Floccare Joseph R. Gerbasi Roberta M. Gilbert Joseph W. Hanss, Jr. M. Peter Heilbrun Rae R. Jacobs John L. Kiley Arthur C. Klein Morton P Klein Gordon R. Lang Paul J. Loree Michael M. Madden Anthony P Markello Philip D. Morey Robert G. Ney Gerald E. Patterson Alan L. Pohl Seth A. Resnicoff Howard M. Silby Melvin]. Steinhart .. •• Lee N. Baumel David S. Berger Max M. Bermann James R. Blake David T. Carboy Frank V. Delaus 34/BUFFALO PHYSICIAN Seamus E. Carmody Walter A. Ceranski Paul Cherkasky Michael Feinstein Anthony V. Ferrari George R. Glowacki Michael Goldhamer Gerald B. Goldstein Leonard Jacobson Marvin Z.Kurlan David A. Leff Bert A. Lies, Jr. \1arilyn A. Lockwood Leo M. Michalek, Jr. Ronald S. Mukamal Lillian V. Ney David E. Pittman John F. Reilly, Jr. Sheldon Rothfleisch William Salton Stephen C. Scheiber Elizabeth G. Serrage Irving Sterman James C. Tibbetts, Jr. David]. Weinstein Richard W. Williams Richard W. Wolin David C. Ziegler Thomas W. Bradley James D. Felsen C. Wayne Fisgus Melvin Fox William G. Gross Ross L. Guarino Jeffrey L. Kahler Melvyn B. Lewis jeffrey E. Lindenbaum joseph F. Martinak Charles Michalko James ]. Moran Donald M. Pachuta Bert W. Rappole H. John Rubinstein Helmut G. Schrott Roger W. Seibel Anthony B. Serfustini William L. Sperling John E. Spoor Murray A. Yost, Jr William H. Adler III John]. Bird William C. Bucher, Jr. Joseph G. Cardamone \1ichael S Feinberg Lance Fogan Jerald Geller Anthony V. Grisanti Gary H. Jeffery Kenneth K. Kim Donald P Lewin David 0. Lincoln Calvin Marantz George B. Moore Robert M. Moskowitz R. Scott Scheer Robert N. Schnitzler Daniel S. Schubert Robert W. Schultz Joel Steckelman Louis Trachtman Edward H. Wagner Benjamin J. Wherley ' •• Sean R. Althaus Louis J. Antonucci jared C. Barlow Robert Barone John R. Anderson Barry M. Benisch Robert M. Benson Norman Berkowitz Richard H. Daffner David R. Dantzker Barry M. Epstein Douglas D. Gerstein 1965 from left: front row, Lance Fogan, Jerald Giller, R. Scott Scheer,JohnJ. Bird and Gary H. Jeffery, and back row, George B. Moore, Robert W. Schultz, Robert J. Schuder, Joseph G. Cardamone, Leon V. Lewis, Kenneth K. Kim and Benjamin J. Wherley. �John E. Shields, Jr. Stuart C. Spigel Morris]. Stambler Richard M. Stamile Jean D. Williams Charles P. Yablonsky John W. Gibbs, Jr. Frank J. Harford Burton L. Herz Leon Hoffman Ronald P. josephson Richard G. Judelsohn Murray C. Kaplan John P. Kelly Michael M. Kline Jacob S. Kriteman Roger]. Lagratta Martin S. Liberman Anthony ]. Logalbo John P. Menchini Donald E. Miller Dorothy M. Murray Thomas P. O'Connor Steven E. Rinner Harvey A. Schwartz ]. Brian Sheedy Thomas P Sheehan Arthur C. Sosis Franklin H. Spirn George S. Starr James M. Strosberg jack S. Waxler ''' ' Leonard A. Argentine William E. Clack Marc N. Coel Gary H. Cramer Thomas J. Cumbo Geraldine F DePaula Lawrence J. Dobmeier Kenneth H. Eckhert, Jr. Stephen A. Edelstein Ronald J. Friedman Bruce H. Gesson Raymond Hansen Kenneth L. Jewel Brian S. Joseph Richard F. Kaine Milton P. Kaplan Z. Micah Kaplan Gary D. Karch Julian R. Karelitz David Kramer Harold L. Kulman Peter A. Mansky Raymond A. Martin Kenneth W. Matasar Robert A. Milch Jonathan C. Reynhout Robert D. Rodner Barbara Blase Sayres '.. David Amler David H. Atkin Alan H. Blanc Sogba K. Bosu joel B. Bowers James L. Cavalieri ll Laurence A. Citro Lang M. Dayton Arthur L. Deangelis Carl J. Depaula Roger J. Ferguson Robert]. Gibson Peter S. Herwm Hanley M. Horwitz Russell G. Knapp, Jr. Israel Kogan Daniel B. Levin William K. Major, Jr. Richard T. Milazzo, Jr. James A. Patterson Michael M. Pugliese Douglas L. Roberts Warren Rothman Steven J. Sandler Thomas S. Scanlon David S. Schreiber Robert S. Shaps Lester S. Sielski Timothy V. Siepel Michael F. Smallwood Wilbur L. Smith, Jr. Gerald D. Stinziano Harvey I. Weinberg Madeline ]. White 1970 front row, William L. Fiden, Shafic 1Wal, Evan Caklins (honoree), Jan M. Novak and Dennis P. DuBois, and back row, Sebastian Conti, Arthur R. Goshin, Den­ nis L. Bordan, Arthur M. Seigel, Donald P. Copley and Laurence M. Lesser. joseph D. Gentile George D. Goldberg Arthur R. Goshin Dennis ] . Krauss Alan I. Leibowitz Michael L. Lippmann Russell P. Massaro Frank A. Miller Alan M. Podosek John A. Rider Jeffrey S. Ross Arthur M. Siegel james K. Smole\ ~hafic Y. Twa) Robert .\.1. Ungerer Harold M. Vandersea Henry L. Whited Allan S. Winzer ' Ronald H. Blum Dennis L. Bordan Sebastian Conti Donald P. Copley Vincent G. Cotroneo Allen Davidoff William P Dillon Nancy L. Eckhert Carl Ellison Charles A. Fischbein Ellen R. Fischbein I Richard M. Anscher Michael B. Baron Gerald M. Beresny Jerald A. Bovino Alan H. Bullock Manny E. Christakos Kenneth J. Clark, Jr. Terence M. Clark Eric M. Dail Sigmund S. Gould Harvey Greenberg ~cott D. Kirsch B. Lewin La\vrence D. Lubow Martin N. Mango Donald H. Marcus Denis G. Mazeika Paul M. Ness Roy ~1. Oswaks Robert \X'. Palmer joel H. Paull David W. Potts David !\.1. Rowland Sam Seideman Kenneth Solomon Richard I. Staiman William C. Sternfeld llja]. Weinrieb ~tanley Richard A. Berkson Martin Brecher Da\'id S. Buscher John ]. Dalessandro Patricia K. Duffner Robert Einhorn Russell S. Elwell Robert Z. Fialkow Jan M. Frankfort Stuart Greene Virginia F. Hawley Linda A. Kam SEPTEMBER 1985/35 �Areta 0. Kowal john W. Kraus Robert B. Kroopnick Paul S. Kruger Stephen). Levine Kenneth R. Lindyberg Alan I. Mandelberg Ira L. Mintzer Charles A. Moss Philip C. Moudy George C. Newman, Jr. Karen A. Price Kenneth C. Rickler Richard ). Rivers Stephen). Rosansky Edwin A. Salsitz Stuart R. Toledano joseph E. Tripi Harold ). Weinstein john W. Zamarra jeremy Cole Nancy L. Dunn Robert G. Fugitt Kenneth L. Gayles joseph M. Greco Michael A. Haberman Ralph R. Hallac Jeffrey P. Herman Fredric M. Hirsh Paul Kuritzky Sharon Kuritzky Dana P. Launer Jeffrey Light james S. Marks Charles). McAllister Arthur W. Mruczek joseph M. Mylotte Robert L. Penn Melvin R. Pratter John E. Przylucki Michael A. Riozzi, Jr. jacob D. Rozbruch )on P. Rubach Michael A. Sansone Mark . Scheinberg Roger M. Simon Gary ) . Wilcox jonathan Wise Linda Young Lawrence Zemel 36/BUFFALO PHYSICIAN Gordon L. Avery Daniel R. Beckman Marvin T. Boyd James L. Budney Elaine M. Bukowski Alan G. Burstein Thomas D. Chmielewski John H. clark Stephen Commins Thomas A. Donohue Donald R. Greene Benjamin A. Hart Edward A. Legarreta joseph P. Lemmer Hing-Har Lo john P. Manzella Diane L. Matuszak Daniel ). Morelli Kathleen W. Mylotte Sanford R. Pleskow Dominick R. Prato john C. Rowlingson Eric ). Russell Elliott A. Schulman Roy E. Seibel, Jr. Norbert ). Szymula Carl A. Todoro Bradley T. Truax Robin L. Trumball Edward L. Valentine Thomas L. Walsh Paul H. Wierzbieniec Stuart A. Wolman Janerio D. Aldridge Kenneth Anolik Penny Asbell john Asheld, Jr. David Bendich James Burdick Alan Calhoun Coley Cassiano William I. Cohen Marc F. Colman Jack Cukierman Ronald David joseph DiSanto Marguerite Dynski Ben Echols Robert E. Fenzl Hal A. Franklin Lilian Li Fu Patricia Hart Edward W. Holifield Tone Johnson Leonard M. Klein Robert Lapidus Richard Levine Mary Lou Meyers Charles Natalizio Peter Neumann William G. Novak Thomas Rosenthal Michael Rowland Eli Roza Stephen W. Sadow john Stubenbord Stanley). Szefler Michael Taxier John Theobalds Christine Tolins Henry P. Tomiak, Jr. Dennis C. Whitehead Thomas Hadley James). Macool Ronald Marconi Gerard McPhee Walwin Metzger joseph Misiti Erwin Montgomery, Jr. Melvin Pohl Geraldine Krypel Kelley Michael Tamul Bernard M. Wagman john Wiles Brummitte Wilson .. Michael Bye David A. Dellaporta Marcellene Doctor Adolfo Firpo-Betancourt Timothy Gabryel Andrew Gage John E. Billi Thelma Caison-Sorey Avery Ellis itza F. Ellis Helen Marie S. Findlay Maria C. Finley Harvey R. Goldstein Gerald E. Grossman edra ) . Harrison Michael S. Kressner Alan S. Kuritzky Michael Lippmann Barlow S. Lynch 19 5 seated, Christine L. Tolins, Henry P. Tomiak, Patricia Hart, Peter R. Neumann, Stephen W. Sadow, Em­ meth A . Daniel andJoseph DiSanto, and standing, Jack Cukie rman, Hal A. Franklin, John B. Theobalds, Tone Johnson, Henri T. Woodman, Ronald David, Dennis C. Whitehead, Paul D. Trautman, Michael E. Rinow, Wil­ liam I. Cohen, Lawrence G. Millhofer, William H. Hall, Marguerite Dynski, Marcus L. Guice and William G. Novak. 7 �Bess I. Miller jeffrey A. Mogerman john D. Norlund Mark J. Polis Theodore C. Prentice Thomas A. Raab Carl]. Schmitt Jeffrey K. Seitelman jeffrey P Seltzer janet C. Shalwitz Richard P Singer Reginald B. Stiles R. ]. Vancoevering II Ronald A. Vidal janice D. \X'illiams Robert Anolik Roger P Bowers Daniel P. Cannucciari Gary E. Eggleston Scott D. Goldstein Alan R. Koslow Paul Miles-Matthias Charles W. Morgan Paul A. Paroski Lois A. Polatnick joel ]. Reich Greg Roberts Barry I. Rosenberg Mario D. Santilli Ronald M. Somogyi Covia L. Stanley Donald J. Armenia Bernice]. Blumenreich Terence L. Chorba Peter J. Condro Nancy G. Dvorak Frederick A. Eames james G. Egnatchik juanita A. Evereteze Paul A. Koenig john M. Lamancuso Edward L. McCleary Bruce D. Rodgers Robert ]. Rose Arthur P. Rosiello Daniel Saltzman David M. Simpson Ian K. Slepian David D. Stahl Richard S. Urban : I Edward Bartels john Cardone Barry Clark Richard Emanuelson Kathryn Francis joel Gedan Mark Gilbert john Mageli Richard Roy john P Shayne Lloyd D. Simon james Twist Anita Vigorito james Bronk Dan Castellani Bruce Cusenz James J. Czyrny Paul Fadale Barry Feldman joel Fiedler jonathan Gewirtz Marshall Goldstein joseph Greco Todd jacobson Robert A. Jakubowski Peter Kroemer Augustus Ohemeng Michael T. Ross john Peter Santamaria Daniel Schaefer Brett Shulman Ross Silverstein Howard Sklarek Steven Teich Da\·id Weldon Pauline Wills Stephen Pollack Paul N. Rosenberg Arthur Schantz William Schechter Sharon R. Silbiger Robert Stern Gerard F. Vitale joseph T. Wayne Mary A. Whitbread Sharon A. Alger Lilly M. Barba Lars V. Boman Edward]. Coleman james G. Corasanti Kevin S. Ferentz Therese M. Giglia Arthur M. Goldstein johnathan A. Graff Carl L. Grant Stephen L. Kinsman Mary M. Lee Younghee Limb Bruce J. Lippmann Borys Lc)Za joseph K. Miller Kenneth R. Murray Charles R. Niles Cynthia A. Prisrach Allen D. Rosen David J. Rosenfeld Mark Schwager Neal T. Smith Robert ] . Smolinski Michael S. Wenzel Andrea N. Wiesel Eric P Wittkugel . : Kevin Barlog Jill Brody Richard Corbelli Amelia A. Erickson Daniel E. Ford joseph F. Gioia Elaine Healy Wendy Kloesz David I. Kurss joseph P Leberer David C. Levine Douglas Pleskow Randi Gordon Pleskow Andrew Francis Michelle Kaufmann Madeline R. Lalia Thomas Mahl William Reichman SEPTEMBER 1985/37 �i l/(tUj p p:;., "lit[) FOliNDAfi0\.1'-i.,./f{U? 1~1!-~d ~ [~~d.-- ,ys l\:'LLAI(:; ~~ :so w (!) z :::> g :x: cii '\'U Cfas:toJ '?'5 P~" "lli6 FOU lWIO~.INC.t.//,OOO a: ttU'5- thettson:/- ¥" '35 JJ;ilj r lli5 FOL lli5 FOliNlWIL) . .s '{.5c ~~A-~ ~ 1' '55 p ~-~~------{\'U~ {k._ ¥ to 1l{Oj 'i "'fs ll5 fOliN[1.\Til)N.I'i.t-/5{):) JJ..!Vf .f. 1~1 f-' 1-wlf. .J:A,z.u....<. r"'" ~ ·m~::- \.\io fOLINOMION. INC.$/QOCO ~.dJ.J. 'J' / l 5 ~ . .Ei::::=::D-'ZI.-==::::::!.J Making presentations to the Medical School are representatives ofreunion class­ es. Left to right, from the top, are Willard H. Bernhoft and Kenneth H. Eckhert, Class of '35, $14,000; Harold Palanker and William Hildebrand, Class of '40, S6,000; Herbert E. Joyce, Class of '45, $20,000; Patricia A. Meyer and RobertJ. Patterson, Class of '50, Sll, OOO; Anthony B. Schiavi and John H. Kent, Class of '55, S9,500; RogerS. Dayer andJames Kanski, Class of'60, S34,000;Jerald Giller andJoseph G. Cardamone, Class of '65, S7,500; Donald P. Copley, Class of '70, S7,000; and Jack Cukierman, Class of '75, SJO, OOO. 38/BUFFALO PHYSICIAN �awarded annually for major scientific con­ tributions to the control, prevention, or treatment of lung disease. • Dr. Leon Farbi, left, presents the Edward Livingston Trudeau Medal to Dr. Hermann Rabn. DR. HERMANN RAHN , DISTINGUISHED PRO­ sor of physiology, received the 1985 Ed­ ward Livingston Trudeau Medal from the American Lung Association (ALA) at the ALA's national annual meeting held this year in Anaheim, California. It is the ALA's most prestigious award. The ALA presented Dr. Rahn the award for his outstanding contributions to the understanding of the lung. One of the fathers of modern respiratory physiology, Dr. Rahn in his research has provided the basis for many of the principles underly­ ing diagnosis and treatment of pulmonary disease, especially in intensive care. Dr. Leon Farhi, professor and chair­ man of physiology, said of Dr. Rahn in his introduction at the awards ceremony, "Over the last 40 years, Dr. Rahn has cast the foundation of our understanding in many areas of respiratory disease: What kind of medicine would we be practicing today, if we did not understand lung mechanics, alveolar gas exchange or ventilation-perfusion relationships?" A further contribution has been his analysis and description of the fundamen­ tal principles of acid-base balance in the blood and the way in which this balance is affected by temperature. Dr. Rahn has been a pioneer in gas anal­ ysis for over 40 years. He has taught such concepts as the distribution of alveolar ventilation perfusion ratio and the al­ veolararterial oxygen difference. Dr. Rahn has also clarified some of the laws pertain­ ing to gas d iffusion when several gases are present in a mixture. He was one of the first to apply the Clark Oxygen Electrode to his research work and to show clini­ cians the value of this tool. After graduating from Cornell niver­ sity, Dr. Rahn went on to receive his Ph.D. from the University of Rochester in 1938. He taught physiology at the University of Wyoming; the University of Rochester School of Medicine and Dentistry; and UB. He has been a consultant to ASA's Man in Space Program and to the U.S. Air Force School of Aviatio n Medicine. An author of over 210 scientific articles and four major books, he has had several books and a special issue of Respiration Physiology dedicated to him . " Hermann Rahn has imparted his wis­ dom and enthusiasm to a whole genera­ tion of younger people, many of whom are in the audience today. Indeed, his reputation as a researcher is surpassed onl y by his fame as a teacher and intellec­ tual leader," concluded Dr. Farhi. The Edward Livingston Trudeau Medal was established in 1926 to honor a found­ er of the ALA and its first president. It is ROBERT E. COOKE, M.D., MEDICAL DIRECTOR of the the Robert Warner Rehabilitation Center, has been named chairman of the Department of Pediatrics. He had been acting chairman since Dr. Elliot Ellis stepped down December 31, 1984. He was also appointed Children's Hospital's pediatrician-in-chief. Dr. Cooke, a pediatrician for over 40 years, has been medical director of the Robert Warner Rehabilitation Center since May of 1982. He is currently the A. Conger Goodyear Professor of Pediatrics at the School of Medicine, an endowed chair in pediatrics concerned with ambulatory care. Dr. Cooke, 65, is respected as the crea­ tor of Project Head Start in 1965, now a multibillion dollar child development pro­ gram. before he was appointed by Presi­ dentjohnson to create Head Start, he was named to President Kennedy 's Panel on Mental Retardation. The task forces that Dr. Cooke served o n ultimately led to the creation of Medicare, Medicaid and the National Institute of Child Health. Previously, h e was pediatrician-in-chief at johns Hopkins Hospital, president of the Medical College of Pennsylvania and vice chancellor for health affairs at the niversity of Wisconsin. The Yale graduate is chairman of the Robert E. Cooke SEPTEMBER 1985/39 �international scientific collaboration." He is research director of the French Nation­ al Center of Scientific Research in Stras­ bourg and director of its Respiratory Phys­ iology Laboratory. Chief editor of the jour­ nal Respiration Physiology, he has served as secretary general of the Association of Physiologists and president of the Com­ mission of Respiration, International n­ ion of Physiological Sciences. • ical specialty of family practice in 1969. Membership of the national group totals more than 57,000 with more than 29,000 certified diplomates in the specialty of family practice. • DR. S. MOUCHLY SMALL, PROFESSOR OF PSY­ chiatry, has been appointed to the State Board for Professional Medical Conduct by Health Commissioner Dr. David Axelrod. Mary Anne Rokitka Scientific Advisory Board of the Joseph P Kennedy Jr. Foundation. Among his numerous other leadership roles, he is a board member for the International Spe­ cial Olympics, the Association of Retard­ ed Children in Erie County and the Encyclopedia of Bioethics, and was past president of the Society for Pediatric Research. Active in many professional societies, Dr. Cooke is a past president of the Soci­ ety for Pediatric Research and is a mem­ ber of the American Pediatric Society, the American Medical Association, the Ameri­ can Academy of Pediatrics, and the Ameri­ can Academy of Cerebral Palsy. • DR. MARY ANNE ROKITKA, RESEARCH ASSIS­ tant professor of physiology, was elected secrtary of the Undersea Medical Society at its June meeting in Long Beach, California. Dr. Rokitka has held several appoint­ ments within the society which is devot­ ed to diving and hyperbaric medicine. She currently serves as liaison officer between the society's home office and the local Great Lakes chapter. THE UNIVERSITY PRESENTED ITS HONORARY Doctor of Science degree to internation­ ally respected physiologist Pierre Dejours at the 139th General Com­ mencement shortly before the Medical School commencement in the same hall. The French re earcher was cited as "a meticulous investigator and champion of 40/BUFFALO PHYSICIAN DR. HERBERT E. JOYCE, CLINICAL PROFESSOR of family medicine, was recently appoint­ ed to the Commission on Education of the American Academy of Family Physicians, the national organization for fam ily doctors. One of the major functions of the Com­ mission is to encourage and assist medi­ cal schools and hospitals and other organizations in developing and maintain­ ing adequate courses and facilities for the education and training of family physi­ cians at the graduate and undergraduate levels. Headquartered in Kansas Ci ty, the AAFP was instrumental in establishing the med- Buffalo Physician editor, Bruce Kershner, received one of the highest national awards in writine among academic institutzons. The Uniuersity s medical editor is co-winner of the Gold Medal for Excellence in Periodical Writingfrom the Council for the Adt•ance­ ment and Support of Edu­ cation {CASE). CASE is the national professional organization for higher education and the honor is their highest award. The award-winning arti­ cle, "Neck Breaking Sur­ gery: Dr. Edward Simmons Pioneers Techniques," was written for the February 1984 issue ofBuffalo Phy­ sician. Kershner shares the award with Linda Grace­ Kobas, director of UB s News Bureau and editor of SOURCE, the University s research digest, where his article later appeared. The appointment runs from Jan. 1, 1985 to Dec. 31, 1987. The State Board of Professional Medi­ cal Conduct, composed of four physicians and one layperson, is the first step of the review process for complaints against physicians for unprofessional conduct. The Board is similarly charged to review complaints of professional misconduct against physician assistants. Dr. Small is considered a pioneer in the field of community psychiatry and is also a noted psychiatric educator. A member of 30 professional organizations, he is list­ ed in Whos Who in America and Ameri­ can Men of Science. In addition, he has �served on advisory committees, locally, statewide and nationally, of organizations which deal with either education or men­ tal health/psychiatry. • DR. ELLIOT F. ELLIS, PROFESSOR OF PEDI­ atrics, was named president-elect of the American Academy of Allergy and Immu­ nology at the 41st annual meeting of the Academy, March 15-20. Dr. Ellis is scientific director of The Women and Children's Research Founda­ tion and ch ief of the Division of Allergy and Immunology at Children's Hospital. A member of the Society for Pediatric Research, American Pediatric Society and American Association of I mmunologists, he is also a fellow in the American Acade­ my of pediatrics, American Academy of Allergy and Immunology, and American College of Allergists. Complementing his reputation as a dis­ tinguished physician, Dr. Ellis has been awarded various honors and has authored several books and articles. He has been a member of the editorial boards for major medical publications, including thejour­ adjunct professor of chemical engineer­ ing, by Consul G.]. Schouten of ew York City at the International Institute in May. The ceremony was held in conjunction with the 40th anniversary of the Allies' liberation of The Netherlands from the azis. Some 50 Western New Yorkers with ties to The etherlands attended. VanOss received the knighthood for his 16 years of service to his native country as Consul to Western New York. The list of those selected for knighthood is an­ nounced each April 30 on the birthday of former Queen Juliana of The Netherlands. • nal of Medicine, journal of Respiratory Diseases, Annals of Allergy, journal of Asthma and journal of Allergy and Clin­ ical Imm unology. • DR. CLARA M. AMBRUS, RESEARCH PROFES­ sor of pediatrics and ob/gyn, and Dr. Julian L Ambrus, research professor of medicine, were part of an American dele­ gation which discussed medical co­ operati on with the government of Hun­ gary last winter. • DR. ARTHUR ORLICK , CLINICAL ASSISTANT professor of medicine, is the new presi­ dent of the Western New York Chapter of the Card iovascular Society. The card io lo­ gist, an attending physician at Erie County Medical Center, is also a fellow of the Council on Clinical Cardiology of the American Heart Association and the American Council of Cardiology. • QUEEN BEATRIX OF THE NETHERLANDS HAS bestowed the Knighthood and Order of Orange- assau to Carel]. van Oss, Ph .D., who serves as Netherlands Consul to Western New York. The Knighthood was bestowed on van Oss, a B professor of microbiology and Carel J. van Oss DR. LAWRENCE SHERMAN, CLINICAL INSTRUC­ tor of surgery and medical director of Hospice Buffalo, Inc. , was among a select group of d istinguished professionals invit­ ed to address the first American Confer­ ence on Hospice Care held in Boston , June 9-1 I. "Fo rging the Future of Hospice" was the theme of the conference, where Dr. Sherman talked on "The Physician ­ Directed Hospice: A Choice of Role Models." The conference brought together Hospice professionals from across the na­ tion in a wide range of fie lds. lt was spon­ sored by the American journal of Hospice Care. Hospice Buffalo has also announced that Dr. Robert Milch (M'68), clinical as- sistant professor of surgery, was re-elected as vice president of the organization. Dr. Thomas Bumbalo (M'31), emeritus clin­ ical professor of pediatrics, retired from the board after si x years of service. • DR. GERALD SUFRIN , PROFESSOR AND CHAIR­ man of Urology, has been appointed chair­ man of the Education Counci l of the American rological Assoc iation. The as­ sociation is the primary national organi­ zation for educational, research, and scientific activities in urology. It originates, coordinates, and directs various educa­ tional and research endeavors of the As­ sociation. Dr. Sufrin has also participated in sever­ al recent national events. He chaired a ple­ nary sessions at the annual Scientific Meeting of the American Urological As­ sociation dealing with renal carcinoma. He was part of a symposium on ben ign prostatic hyperplasia sponsored by IH. He will also be on a committee which will develop a computer assisted learning pro­ gram in urology. Sponsored by the Ameri­ can Urological Association, it recognizes newer approaches to educational en­ deavors in urology. Lastly, he participat­ ed in an American Urological Association retreat of leaders in urology aimed at forming a basis for future directions in urologic research. • DR. BRUCE DOW, ASSOCIATE PROFESSOR OF physiology, was awarded a SI 17,392 grant from the Nationa l Institutes of Health to study the color vision of macaque mon­ keys to understand how the human brain interprets what it sees. Specificall y, he hopes to understand how the visual cor­ tex, which is part of the brain, crea tes color vision. • DR. JERROLD WINTER, PROFESSOR OF PHAR­ macology and therapeutics, has been awarded an $83,266 grant by the Nation­ al Institutes of Health to study how drugs of abuse affect the human body and be­ havior. • DR. ALAN DRINNA , CLINICAL ASSISTANT professor of medicine and professor and chairman of Oral Medicine in the School of Dental Medicine, was elected secretary of the Pathology Section of the American Association of Dental Schools at its annual meeting in March. • SEPTEMBE R 1985/41 �PE()PLE FOUR OF NINE OF ERIE COUNTY MEDICAL Center's Photograph Contest winners were UB medical faculty. The June 7 contest included the following UB win­ ners: Dr. Robe rt Whitney, first place in color prints; Dr. Franz Glasauer, second place in color; Dr. Robert Cannon, third place in color; and Dr. Ge orge Alke r (M'56), second place in slides. • DR. G. WORTHINGTON SCHENK, JR. , WAS honored at the 36th annual Surgical Alum­ ni Association meeting held May 24 and 25 at the Erie County Medical Center. The emeritus professor of surgery and form­ er director of surgery at the medical center retired in October following 26 years of service. Honoring Dr. Schenk were 475 atten­ dees who came from as far away as Colorado. • DR. EDWARD SIMMONS, PROFESSOR OF OR­ thopaedic surgery, was invited as visiting professor for the Carl Badgely Lecture­ ship, where he spoke at the niversity of Michigan Medical Center on September 21, 1984, on surgical treatment of low back pain. He was also selected to present the Sixth Annual Risser Memorial Lecture March 13-14, 1985, at Orthopaedic Hospi­ tal, associated with the University of Southern California. • DR. JOSEPH BENFORADO, FORMER ASSOCIATE dean of the Medical School and associate professor of pharmacology from 1958 to 1967, is now professor of medicine at the University of Wisconsin, Madison Medi­ cal School. He was just elected vice presi­ dent of the U.S. Pharmacopeia! Convention for a five-year term. He also reports that "the last of my six children will be graduating from the niversity of Wisconsin this month." • DR. DORIS RAPP, CLINICAL ASSISTANT PRO­ fessor of pediatrics, was honored by the UB Alumni Association with its Distin­ guished Alumni Award on June 7. Dr. Rapp was an undergraduate at UB. DR. LESTER SMITH HAS RETIRED FROM HIS post as director of UB's Center for the Study of Aging, where he served for five years, and has returned to a more active role as clinical associate professor of medicine. • DR. HAROLD J. LEVY (M'46), CLI ICAL AS­ sistant professor of psychiatry, was chos­ en president-elect of the Medical Student Aid Society at the organization's recent an­ nual scientific sessions held in Miami Beach. Dr. Levy is chairman of the Department of Psychiatry at the Millard Fillmore Hospitals and clinical director of psy­ chiatry at Bry-Lin Hospital. MSAS is a philanthropic national group offering interest-free loans to medical stu­ dents in need of financial assistance. • 4 2 /BUFFALO PHYSICIAN DR. SAXON GRAHAM, PROFESSOR AND chairman of Social and Preventive Medi­ cine, was elected this June 29 as president of the Society for Epidemiological Research. The 1,400-member society is the largest epidemiological society. The professional group serves as a fo­ rum for research and sponsors the Ameri­ can journal of Epidemiology, the premier journal of the field. Founded in 1963, it also fosters graduate education concerned with efforts to improve prevention of all diseases. • DR. JAMES MOUN (M'44), PROFESSOR OF microbiology, assisted the N.Y. State Coun­ cil on Human Blood and Transfusion Serv­ ices and the State Health Department in drafting a policy statement for the Com­ missioner of Health on possible federal regulations on reporting cases of transfusion-associated AIDS. He also helped the American Blood Commission arrange a Policy Conference on AIDS, Ethics, and Blood Supply. • DR. LEO E. MANNING (M'50), CLINICAL AS­ sistant professor of medicine, has been elected president of the Medical Society of the County of Erie. Dr. Manning was installed at the Society's annual meeting held at the Buffalo Hilton, May 23. He is a specialist in internal medicine in Am­ herst, and will serve a one-year term. He succeeds Victorino Anllo, M.D. Dr. Manning has previously served as the Society's president-elect, vice­ president, and as delegate from Erie County to the state medical society. He is also a member of the American Medical Association, the American Society of In­ ternal Medicine, and the Western New York Society of Internal Medicine. Dr. Manning is past president of the Kenmore Mercy Hospital medical staff. He is a diplo­ mat of the American Board of Internal Medicine and a Fellow of the American College of Chest Physicians. The other officers elected for one-year terms are: Dr. Allen L. I.esswing (M'54), clinical instructor in orthopaedics, president-elect; Dr. Thomas W. Bradley (M'66), clinical assistant professor of fa­ mily medicine, vice president; and Dr. Nan cy H. Nielsen (M'76 ), clinical assis­ tant professor of medicine and microbi­ ology, secretary-treasurer. • TWO UB PHYSICIA S WERE HONORED JU E I at the Hyatt Regency Hotel during the 65th annual graduation ceremony for medical/dental residents of the Erie County Medical Center. Dr. Alan Aquilina was honored with the Teacher of the Year award. He is an assistant professor of medicine and is medical director of the asthma clinic at ECMC. Dr. John Picano was given the or­ man Chassin Award for outstanding house officer. He is a first-year house officer in internal medicine and a clinical assistant instructor at ECMC. The outstanding teacher of the year award is selected by internal medicine house officers at ECMC. • DR. HA K KUNG, PROFESSOR OF NUCLEAR medicine, received a grant for $89,040 from the National Institutes of Health to develop new radioactive drugs for non­ invasive diagnosis of heart disease. • �1920's LAWRENCE CARLINO (M'27) • v. ho practiced medicine in "liagara Falls from 1929 to 1968, retired and continued to school himself in physics. His new book Tbe Proto-Spin Tbe­ my of the L'ni1•erse (198-i, Van­ tage Press, New York, 12-i pp.) describes a new approach to understanding the physical universe and its philosophical implications. and a total membership of600 which includes foreign and senior members. He is a Diplo­ mate of the American Board of Surgery, a Fellow of the Ameri­ can College of Surgeons, and a member of the American As­ sociation for Cancer Research, the Society of Surgical Oncol­ og), the Buffalo Surgical 'ioci­ cty, and the Medical 'iocictics of the State of :--lew York and of Eric County. 1930's JOSEPH GODFREY (M'31) • received an honorary doctorate in science from D'You\"illc Col­ lege, Buffalo, at their com­ mencement ceremonies last May. Dr. Godfrey left UB's School of Medicine in 1978 as a clinical professor of or­ thopaedics after 36 years here. He is now assistant chief of or­ thopaedic surgery at the Bethesda, Md., "laval ~1cdical Center. ALBERT ROWE (M'3l) • was ho­ nored b) Sisters Hospital, Buffalo, on March 27 for his generosity and financial sup­ port to the hospital. The clini­ cal assistant professor of anesthesiology received a plaque for his philanthropy in helping to provide fetal monitoring, coronary stress testing, and stereotactic surgery equipment to the hospital. Society of Internal Medicine for 1985-1986. He is director of the Medical Liability Mutual In­ surance Company, a member of the Buffalo Medical Group, P.C., and a clinical associate in medicine at UB. 1960's WILLIAM E. ABRAMSON (M'60) • helped to form and was elect­ ed first president of the Drug Abuse Doctors Association of ~taryland. The Association is composed of physicians active in drug abuse treatment pro­ grams utilizing methadone maintenance treatment. Dr. Abramson is director of the Comprehensive Drug Abuse Program at the Sheppard & Pratt Hospital, Towson, Maryland. DONALD A. HAMMEL (M'60) • as­ Frank C. Marchetta 1950's JEROME P. KASSIRER (M'57) • has assumed office as a Governor of the American College of Physicians for Massachusetts. Dr. Kassirer, a specialist in nephrology and medical deci­ sion making, is professor and associate chairman of the Department of Medicine at Tufts L'niversity School of Medicine. He is also associate physician-in-chief at the New England Medical Center. sistant professor of radiology at Northeast Ohio University Col­ lege of Medicine, is the first president of the Northeast Ohio Radiological Society. He is chairman for the annual meeting of the Ohio State Radi­ ological Society in 1986; chair­ man of the "Blue Ribbon" Citizens Committee reviewing finances and operations of Por­ tage County, Ohio; delegate to the Medical Staff Section of the AMA and the Ohio State Medi­ cal Association; and member of the board of directors of the lo­ cal Health Systems Agency (HSA) PHILIP D. MOREY (M'62) • has 1940's MARY ANN ZIVISCA BISHARA (M'59) • was elected to the FRANK C. MARCHETTA (M'44) • Board of Directors and ap­ pointed to the Executive Com­ mittee of Blue Shield of Western New York. Dr. Bishara is chief of anesthesiology at St. Marys Hospital, Lewiston, New York. VIRGINIA V. WELDON (M'62) • WILLIAM J. MANGAN (M'59) • is president of the New York State deputy vice chancellor of Washington l'niversity School of ,'\lcdicine, received a Doctor clinical associate professor of otolaryngology, was elected president of the American So­ ciety for Head and Neck Sur­ gery at the organization's recent annual meeting in Puer­ to Rico. The Society of Head and Neck Surgery has an active membership of 350 physicians been elected to Fellowship in the American College of Cardi­ ology. He is currently associate professor of medicine at UB and attending physician at Buffalo General Hospital. of Humane Letters degree from Rush University. and while at Rush, delivered a speech on quality in medical education. Dr. Weldon is professor of pediatrics at Washington University School of Medicine and vice president of the Washington L'nivcrsity Medical Center. Current!) she is chairman-elect of the Associa­ tion of American ~tcdical Col­ leges, and is the first woman chosen to lead the association in its 108-year history. LEE BAUMEL {M'63) • is the med­ ical director for the Eating Dis­ orders Treatment Unit and director of the Biofeedback Department at the Beverly Hills Medical Center. CARY PRESANT (M'66) • was ap­ pointed director of the oncol­ ogy program at Queen of Valley Hospital, West Covina, California. Dr. Presant present­ ed a paper "Human Tumor De­ tection by Indium-III Labelled Liposomes -A, A New Method For Tumor Imaging" to the In­ ternational Congress for Cancer Detection and Preven­ tion in Vienna, Austria, in 1974. Dr. Presant lives in San Marino with his wife Sheila and their four children. DAVID FUGAZZOTTO {M'67) • is serving on the planning com­ mittee for the state chapter of the American Academy of Pedi­ atricians scientific meeting. "I recently moved to new quart­ ers with the same four-man group in a growing practice. Will add fifth member this July." The pediatrician lives with his wife, Pauline Bumba­ lo Fugazzotto in Birmingham, Alabama. 1970's RICHARD A. MANCH {M'71) • was recently elected chairman of SEPTEMBER 1985/43 �the Department of Medici~ at the Good Samaritan Medical Center, Phoenix, the State of Arizona's largest hospital. DR. CARL F. CORI, 87 • who won the Nobel Prize in medicine in 19'!7, died at his home in Cambridge, Massachusetts, on October 30. 1984. Dr. Cori was assistant professor of physiology at UB from 1927 to 1931 and a biochemist at Roswell Park from 1922 to 1931. Dr. Cori and his wife. who passed away in 195', shared the Nobel Prize with an Argentinian for their research on the isola­ tion and synthesis of phosphorylase. This work was started at CB and Roswell Park and completed at Washington University in St. Louis. A medical graduate of the German Univer~ity Medical School, Prague, Czechoslavakia, in 1920, Dr. Cori. came to Buffalo after two years as assistant professor of pharmacology at Univer­ sity of Graz, Austria. In addition tO the obel, Dr. Cori received the Albert and Mary Lasker Award from the American Public Health Association, and was elected to the American Academy of Arts and Sciences. ROY M. OSWAKS (M'71) • gave a talk in June to the Virginia State Podiatric Society on "Manage­ ment of Fluid and Electrolytes in the Surgical Patient." Dr. Os­ waks resides at '!609 Bathurst Road, Virginia Beach, Virginia 23<!64. HENRY M. BARTKOWSKI (M'76) • (Ph.D.) informs us that he is now with the Pediatric Neu­ rosurgery Service of the Department of eurosurgery at UCSF. JANET. KING (M'76) • has been appointed assistant medical director of the Moss Rehabili­ tation Hospital, Philadelphia, Pa. Dr. King is an assistant clin­ ical professor at Temple University School of Medicine. JEFFREY SELTZER (M'77) • writes "After completing a pacemak­ er and electrophysiology fel­ lowship sponsored by NASPE (North American Society of Pacing and Electrophysiology) at Boston University, I moved to the wilds of Connecticut to practice. FACC in 1984." RUSSELL J. VAN COEVERING, II (M'77) • is now a Diplomate of the American Board of Ob­ stetrics and Gynecology, hav­ ing been Board certified in Obstetrics and Gynecology December 3, 1984. "I recently finished work on my third clin­ ical study on Syntex's new Birth Control Pill, Trinorinyl." JOHN CORBELL! (M'79) • ad­ dressed the XII Interamerican Congress of Cardiology on the subject of ''Percutaneous Transluminal Coronary An­ gioplasty After Previous Coro­ nary Bypass Surgery" in Vancouver, British Columbia. 44/BUFFALO PHYSICIAN Dr. Corbelli completed fellow­ ship training at the Cleveland Clinic in invasive cardiology and coronary angioplasty. He is now in practice with Eli Ger­ manovich, M.D., at the Millard Fillmore Hospital, Buffalo. ew York. PETER CONDRO (M'79) • married Alice Magner, M.D., in Philadel­ phia in October '84. In June he finished a fellowship in nephrology at Temple Univer­ sity Hospital. His new address is 10255 Glendye Road, Rich­ mond, Virginia 23225. 1980's STANLEY JAY BERKE (M'81) • in­ forms us that he is completing a residency in ophthalmology at Nassau County Medical Center and beginning a fellow­ ship in glaucoma surgery on July I, 1985, at Massachusetts Eye and Ear Infirmary in Boston. KEVIN SCOTT FERENTZ (M'83) • a resident in family medicine at the University of Maryland, has been selected chief resident for 1985-1986. Dr. Ferentz resides at 2717 Jenner Avenue, Apt. B, Baltimore, Maryland 21209. DR. SAMUEL A. VOGEL, the first Buffalo physician to use insulin in the treatment of diabetes, died March 18, 1985. He had prac­ ticed medicine for 50 years before retiring. His widely hailed breakthrough for diabetic patients resulted from his previous as­ sociation with Jocelyn Clinic of Boston, which introduced in­ sulin to the C.S. He trained there in the late 1920s. Famous Buffalo writer Taylor Caldwell's novel, Dear and Glorious Physician, was dedicated to Dr. Vogel. After earning his M.D. from the University of Illinois Medi­ cal School, he served in Great Britain during World War II with the U.S. Army Medical Corps. He was associated with Buffalo General and Millard Fillmore hospitals. The associate professor of medicine was on UB's faculty from 1925 to 1970. He was a member of the county and national medical soci­ eties, the American Board of Internal Medicine, the Maimonides Medical Society, and was a fellow in the American College of Phy­ sicians. He is survived by his wife Charlotte; a daughter; a brother Dr. Henry E. Vogel; four sisters and three grandchildren. MARTIN J. DOWNEY (M'45) • clinical associate professor of anesthesiology and chief of anesthesiology at Children's Hospi­ tal, died on Feb. 22, at Buffalo General after a long illness. Dr. Downey was not only dedicated to his work as a prominent anesthesiologist, but stood as a dedicated member of his native community as well. Born in Buffalo, he received his undergraduate degree from Canisius College. Dr. Downey was also an attending anesthesiologist at Buffa­ lo General Hospital and Erie County Medical Center. He was con­ sulting pediatric anesthesiologist at Millard Fillmore Hospital, Roswell Park Memorial Institute, and Brooks Memorial Hospital in Dunkirk. A distinguished member of the health profession, Dr. Downey served as a diplomate of the American Board of anesthesiologists; a fellow of the American College of Pediatrics, Anesthesia Section; and a member of the American Society of Anesthesiologists. Dr. Downey was a past president of the adjunct board of Buffalo General Hospital and of the Western New York Section �of the State SoCiety of Anesthesiology. He is sun·ivcd by his w1fe, four daughters, a son, two brothers, and a sister. DR. DONALD KERR-GRANT died in a traffic accident on Fehruarv GLEN~ C. HATCH (M'28) • who practiced general surgery 10 Penn Yan for 4'-1 years died August 9, 19H'-I, at the age of HO He retired from practice in 19~6, and had been !i\·ing in Clearwater, Flori da. until the time of his death, which occurred after a brief illness. Dr. Hatch had been a member of the American College of Surgeons since 19·t0 lie enlisted in the Armv in 19'-12 '' ith the rank of captain and served in North Africa :md Italy with the 9·Hh Evacuation llospital for 2 1/2 years. One of the highlights of his Army career was as a participant in the now famous landing in Anzio in 19+i Dr Hatch received four battle stars during his 5-11.!. years on ac tivL duty. Dr. !latch\ picture appeared on the front cover of Tbe Hujfa lo .l!edical Rer reu; \'ol. I, number •t, \X'inter 196~ issue. He is surviwd by his wife of '5 t years, Beatrice; three chi! dren: Richard C, a 1961 l'B .\!cdical School graduate, Peter .J., and Bette, as well as six grandchildren. 10, 19H'5, in Malaga. Spain. Dr. Kerr-Grant served as associate med­ ical director of the Robert Warner Rehabilitation Center here from 1961 until his retirement in 1982. He was an associate professor emeritus of pediatrics, serving on l'H s faculty for 20 years. Dr Kerr-Grant, who specialized in neuro-developmental medicine at the Rehab Center, was a native of Australia lie ac­ quired his undergraduate degree from St. Peters College in Adelaide, South Australia, and completed h1s medical degree at the Uni\·ersit) of Adelaide in 19'-12 He interned at the Royal Victoria Infirmary and the Royal Adelaide Hospital in Australia. FoliO\\ ing his residenc) at the ChiI· drcn's Hospital in Cincinnati, Ohio, in 19'5'5, he \\as certified h) the American Board of Pediatrics. Dr Kerr-Grant served many teaching appointments in Aus­ tralia throughout his distinguished career, he was also an assis rant professor in pediatncs at Oh1o l'nl\·ersitv lie left for London, England, .tfter his retirement in 19H.!., and was \acallonmg in Spain at the time of the accident. He is survived by his wife, El.1yne, two daughters. Carolyn and Fiona, of England; and two brothers, Colin and Allan, both of Australia ------------------------------------------------------------------- III II I NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES BUSINESS REPLY MAIL FIRST CLASS PERMIT NO. 2210 BUFFALO, N.Y POSTAGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, New York 14214 �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO, NEW YORK 14214 LET US HEAR FROM YOU Fill out this card (Please print or type all entries) Year MD Received _ _ _ __ Name Office Address ________________________________________________________________________ Home Address ________________________________________________________________________ If not UB, MD received from --------------------- -- - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - ­ In Private Practice: Yes No 0 In Academic Medicine: Yes 0 Specialty ----------------------------------------------- 0 No 0 Part Time 0 Full Time 0 School Title___________________________________ Other: Medical Society Memberships___________________________________________________________ News: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.? Please send copies of any publications, research or other original work. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, September 1985 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1985-September Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1985-v19n03-Sept Table Of Contents A list of subunits of the resource. Code Blue Life and Death DRGs Ethics & Transplants Cough Syrup Research Medical School News Hospital News Students Alumni People Classnotes Deaths Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-16 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v19n03 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1985 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/0efd4f0ba243f5ce9b97957c635f934c.pdf 57c47ed11b3c461608143d05cd7ec52f PDF Text Text Volume 19, umber 2, july 1985 the ] �STAFF EXECUTIVE EDITOR UNIVERSITY PUBLICATIO:-IS Robert T. Marlett UNIVERSITY .'\IEDICAL EDITOR Bruce S. Kershner ART DIRECTOR Rebecca Bernstein DESIGN Alan j Kegler PHOTOGRAPHY Ed :-.lowak Marc I..t:eds Phyllis Christopher ADVISORY BOARD Dr john Naughton, Dean School of J!edicine Ms. :"'anq Glieco Dr .Edwin a. Mirand Dr. john Cudmore Dr Carmelo Armenia Dr. john Fisher Ms. Karen Dryja ~lr. john Pulli Dr. Charles J>-aganelli Dr. james Kanski Dr. Harold Brody Dr john Wright Dr. james Nolan Dr. Maggie Wright Dr ~1ary Voorhess Mr. Steve Shivinsk} TEACHING HOSPITALS The Buffalo General Children's Deaconess Erie County Medic-al Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Chanty Veterans Administration ~ledical Center Produced by tbe Dil'ision of Public Affairs, Harry R. jackson. director, in association u·itb tbe Scbool of Medicine, State Unir·ersity of Neu· }brk at Buffalo. THE Bl'FFALO PHY~ICIA:-.1 (lSI'S SSI H60) july 19HS Volume 19, :-.lumber 2. Puhhshc·d ftve times annu ally February, May, July, September, De<·emher - hy the School of \kdicinc, State l nivcrsity of New York at Buffalo, 3435 \lain Street, Huthlo, ::-o;ew York 1~21'< Second class postage paid at Buffalo, r"ew York. POSTMASTER send address changes to THF Hl'FFA· LO PHYSICIAN, IW Cary Hall, .~4~S \lain Street. Buffalo, New ll>rk l~ll~ Message From The Dean Dear Alumni and Alumnae: In this issue of the Buffalo Pb)'sician, .\1r Bruce Kershner 10cludes an interview with me concerning my tenure as Dean. As I reflect on that inten·icw and on mv ume in Buffalo, I look hack with a great deal of satisf;ction on the accomplishments of the past decade 1 remember vividly mv first encounter with the search committee in the summer of 197·1 when one member correctly asked many penetrating questi<>ns, many of which reflected the long-term frustrations which antedated the state's assum10g control of the l niversitv and .\1edical .School. Yet, each member of that committee w':ls ohviouslv dedicated to the mission of the School and the l niversiiy and the potential for Buffalo's ;\ledtcal school w':ls apparent Since arri\ ing 10 1975, 1 have witnessed the completion or near completion of many important building projects at our affiliated institutions~a totally new Erie County :\1edical Center completion of the Children s Hospital Tower. completion of the :\1illard Fillmore project. significant additions to the Veterans Administration Hospital, and the soon-to-be-completed Deaconess 'Ibwer of the Buffalo General Hospital. In addition, the University s new Health Sciences Library will he completed this summer, and the new teaching wing of the ~1edical School and its adjacent antmal factlity should be ready for occupancy 10 1986. These projects, together with substantial strengthening of the faculty, the leadership prO\ ided hy a stellar group of department chairmen, an active, contributing faculty council, the formation of the city-wide consortium for Llniversity-supervised graduate medical education programs. a strong and committed alumni organization, and the current tmplementation of a faculty practice plan represent only a few of the factors that have helped account for the momentum developed during the past decade. I remain convinced that when the next decade ends we will be able to reflect on another set of accomplishmenrs which serve to substantiate the .\ledical School's commitment to excellence in scholarly achievement and in health care. All of the elements are now in place. If we fail in the future, the fault will rest primarily with those of us whose task it is to lead the at-ademic enterprise of the School. I am confident that our goals wtll be achteved. I thank all those constnuencies who have joined in the effort to make the School a better place in which to be educated, to conduct research, and to improve health care in Western :"'ew York. I look forward to your continued support in the years ahead. · -John Naughton, M.D. Medical Alumni Association President's Message For members of our Alumni Association to the '':\lid 80's • see three maJOr concerns. In the fir't place, ethical questions must be dealt with in the area of artificial heart and other organ trJnsplants; besides the ethtcal concerns, we must also address the tremendous costs. Secondly, we must be concerned Wtth reasonable and equttahle settlements in malpractice litigation so that we l~an afford to practice our professions in New York and other states that have medical insurance problems. Thtrdly, for our local Alumni, one of our most significant concerns ts to act as role models for the students interns. and restdents we meet_ daily and to provide, to the best of our vaned abthttes, stgnificant workshops and seminars for medteal students who are studving in lJ · _ . ty ~eeping in touch with young creative scientific mtnds is one of the best \~~rs nl\er_s.: ones own mind. }· to stn:tch \\"on't each individual member of our group consider what he or h on any of these concerns s e mtght do to \VOrk -Charles Tanner, Jr., M.D. Class of 1943 �THE University holds memorial service for 400 individuals who donated their bodies for use in teaching and research in medicine through one of the most successful programs of its kind in the east. CURIOUS HIST Yesteryear's methods of obtaining bodies for study ranged from the use of executed criminals and black slaves to the oncethriving business of grave-robbing-and even murder. T DS • The world's smallest thermometer and the world's smallest heater have been devised by Dr. Frederick Sachs for use in a biomedical research project here. 0 C UB biophysicist Sachs has discovered what could be the fundamental mechanism for the perception of touch, body awareness, pressure, and stretch. Dean Naughton celebrates a decade of service. UB, Beijing ormal University exchange visits of nuclear medicine scientists. Four major appointments announced. Howe Prize, Harrington Lecture Walking study by Eadweard Muybridge exemplifies mote ment studies possible at tbe Gait Analysis Lab at tbe Children's Guild. See page 23. Area hospitals pool collection efforts. Buffalo General joins Life Flights Program, opens pain center, and begins move to new tow- ers. Children's CLASS NOTES • dedicates Hemo34 philia Center. Fa- DEATHS • 3S mily Medicine moves. Gait AnalInside back cover ysis Lab is only one of its kind in COVER ART: the area Detail from 'The Creation of Man,' Arthur Weissman fresco by Michelis a "class act." angelo, Sistine Other news of Chapel, Rome. students 29 Writer disagrees with criticisms of McKinley's medical care. ��''WE DISCOVER ONLY WHE WE GIVE." Thus IN TRIBUTE TO THE states the painting hanging in the chapel of the historic Skinnersville church on UB's Amherst Campus. It is a fitting quotation for the 400 deceased persons who were memorialized there last year for generously donating their bodies to UB's School of Medicine for the purposes of teaching and research. The memorial service, held ovember 29, 1984, was the first public memorial service to honor the donors at this medical school. Their remains, some donated as far back as 1971, were placed under a marker that gratefully acknowledges their unique contribution to the advancement of education in medicine. Dr. Charles Severin, the associate professor of anatomical sciences who headed a committee to honor the donors, says that the generosity of these individuals should be recognized by the community. Most become donors, he adds, out of a sense of wishing to help their fellow humans through medical and dental research and training. Dr. Harold Brody, chairman of the Department of Anatomical Sciences, notes that currently there are some 6,000 persons registered with the department. The program was initiated by Distinguished Professor Emeritus O.P. Jones in the early 1950's when he was chairman of the department. Dr. Brody relates that "most schools have similar programs now, but UB's is one of the earlier ones and certainly has been unusually successful. In fact, it appears to be one of the more successful programs in the East." Of the 6,000 names now on file, approximately 150 die each year. These satisfy the needs for the teaching and research commitments of the Medical School and area hospitals. Dr. Brody cannot fully explain why the donation program is so successful, except that donors are obviously motivated by the altruistic desire to benefit society after they have died. That the School does not need or want publicity for the program, Dr. Brody comments, is evident from the fact that 500 to 750 new registrations occur every year, even though knowledge of the program's existence is spread primarily through word of mouth. Before Dr. Jones started the program, the Medical School obtained its cadavers for medical instruction from .i ndividual donations and unclaimed bodies. "It's a state law-and a law in most other states- that unclaimed bodies can be used by medical schools for education," Dr. Brody notes. Today, however, UB's School of Medicine rarely accepts unclaimed bodies because of the success of its donation program. Besides being prompted by word of mouth, inquiries about the program come occasionally from attorneys or as a result of questions addressed in newspaper columns. Such respectable or orderly procedures were not always in existence, however. In the 1700s and 1800s scandals occasionally surfaced when some doctors were discovered to be receiving bodies from grave robbers or even thugs (see accompanying article). The cadavers at UB are used for instruction not only for medical students, but also for dental, nursing, and occupational and physical therapy students- a total of 600 students per year. Approximately 50 hospital residents, graduate physicians and dentists also attend special programs of dissection. UNSUNG HEROES OF MEDICINE heir best known use, of course, is for the teachin~ of T anatomy to medical and dental students. Dependmg By Bruce S. Ke rshne r JULY 1985/3 �on the specific course of instruction, four to eight students perform dissection on a cadaver. Instruction is also given to many groups of nursing students who observe dissection but do not actually handle the body. While nursing students do not perform an actual dissection, they are able to observe the normal position of structures in the human body during demonstrations by members of the faculty. Less widely known uses of cadavers occur as well. Cadaver study is part of the residency program and is especially crucial for ophthalmology, otolaryngology, and other surgical subspecialties. Cadavers are also used by Ph.D. students, hospital residents, and faculty for basic research. These studies involve changes in joints with age, the effects upon joints of automobile accidents and studies of anomalies (the presence of unusual variations and structures). For these studies, the cadavers may be used in a fresh , rather than an embalmed condition. The Department of Anatomical Sciences handles inquiries and registrations for the program. The department provides interested persons with information and forms. Beside completing and signing the forms, applicants must inform their families and attorneys and keep a card on their person. The body donation registration process is simple, unlike a will. Furthermore, to be in a condition useful for the donation program, bodies must be obtained with minimal delay, something not possible with a will which requires lengthy time for settlement and probate of the estate. With one exception, organ donations are not recommended. "We recommend to all registrants that they donate their eyes for use by living persons. This can be done through the program," Dr. Brady explains. "Other organ donations, however, are handled by m~dical organizations unrelated to our program. These bodies cannot be used for later study by medical students". When a person in the donation program dies, the family or hospital informs UB or its contracted funeral direc4/BUFFALO PHYSICIA tor. The University pays for transportation of the body t the School within a 100-mile radius (for greater distan the family pays for all but 100 miles of transportat~es costs). Private memorial services held shortly afte ~~n donor's death are arranged by their families. After the ~ de has.been used for me.dical ~ducation and research, the 3nfvesny also pays for Its ultimate burial or crematio less the family requests a private interment. n , unPredictably, both the families and the commun·t _ large often have a morbid curiosity about the cadav 1 Y adt. ''After Its . ' aII expI ained to them er an w h at h appens to It. · f'1ed . Wieve • never h a d any obJ'ections , most peop Ie are sat1s b · d one wit · h t h e b o d 1es, ' " o r. Brody remarks "F a out. w h at IS ly members recognize it is a service to the commu~it am~ are frequently enthusiastic about the idea." Respe yt ~n both the donors and their families is of utmost impor~ or to the School. Condolences are always sent to next of ~.ce Before any students, researchers or faculty use a bo~n. " they are all reminded that these people donated the y~ selves for medical science and that respect and good co~­ duct must be followed. All users take this very seriously" Dr. Brody stresses. ' At t.he No_vember ceremony attended by about 100 people, mcludmg members of the first-year medical class Rev. ~ohn ~ma_ras of UB 's Campus Ministries led the brief pub.l!c service ~n the 125-year-old ewman Chapel. Followmg the serviCe, a marker honoring the donors · t h e .ad'Jacent Sk'mnersville Cemetery. was unvei·1e d 1~ • s . Anh Identical G d marker will be placed at Mt . 01·Ivets t T1mot y ar ens to commemorate Catholic donors. · Re':'. Kamaras expressed the feelings of all concerned " In their death, these people have 1·oined au · . · · · bodies so we wh n1que· SOCiety. Th ey h ave g1ven t h e1r may . ld o f med1cme. . . The impact tho remam h a d vance t h e f1e will last past this generation. ey ave made "We thank these unsung heroes f . . become teachers of our nation's h 0 1 me~1cme who have ea ers. • ° �The Curious History of Body Dissection J. ..r 1 ~""" ,(,. , ., -.It ·~"f' >Y<rli .,j..,..,J -~Al " •1 A, . . magine yourself as a medical student in 1825 . Your distinguished professor gives you your next assignment: "We are going to begin anatomy class this week. Please go out to the cemetery behind the village church tonight and bring back a fresh body. And don't let anyone see you!" Not exactly your usual class assignment. But body snatching, as it was called, was indeed engaged in from time to time by both medical students and physicians in those days. The early days of medicine in Buffalo are no exception. Contrasting starkly with today's orderly and respectful methods C?f obtaining human specimens for anatomy classes, the htstory of human dissection is probably the most colorful-and morbid-aspect of the history of medical education. While today's medical schools rely on body donation (the willing of one's body after death) and the use of unclaimed bodies from public morgues, yesteryear's methods ranged from the use of bodies of executed criminals and Black slaves, to the once-thriving business of grave-robbing and even murder. Until the last 100 or so years, these JULY 1985/5 ��methods dominated the long history of medicine because superstition and archaic laws either made it illegal to practice human dissection or severely restricted the supply of legal cadavers. It would be impossible to imagine medicine being taught today without medical students learning human anatomy through dissection of cadavers. Dissection is a basic discipline of medicine, and the earliest to which a medical student is exposed. evertheless, until 1846, the medical schools at Yale, Jefferson, Columbia, and the University of Pennsylvania conferred degrees without anatomy courses. In the misty ages before recorded history, primitives believed that supernatural retribution would occur if the human corpse was tampered with. Even in ancient Egypt, sophisticated methods of embalming did not increase anatomical knowledge because "mutilation" of the dead was forbidden. In ancient Greece, dissection was banned for a long time, punishable by death. The Greeks believed ghosts would avenge any mutilation of a body. Even Hippocrates never opened a human or animal body. History's first liberalism toward dissection began with Aristotle (384-322 B.C.), who conducted and promoted dissection-but only on animals. The boldness of Herophilus of Alexandria (350-280 B.C.) led him to become the first person to dissect human cadavers for anatomical study, but also led prominent citizens to accuse him of dissecting living humans. Finding the seat of the soul was the goal of his contemporary, Erasistratus (310-250 B.C), who dissected unburied bodies even more actively. Two of his complete skeletons that survived at his Alexandria school remained the only ones in the world for centuries, causing intellectuals to journey there from all over the Mediterranean world to see them. Human dissection was banned again by the Romans when they conquered Alexandria in the first century A.D. The Romans believed that physical dismemberment of the dead prevented resurrection, but they nevertheless had no qualms about sponsoring and enjoying great displays of bloodshed, mutilation, and perpetration of inhumanities upon the living The Romans did tolerate dissection of animals, however, permitting Galen, one of history's gteatest medical men, to write the world's first anatomy text. The only authoritative work of its kind, it remained revered and unchallenged for the next 1400 years. Its only problem was that it was based solely on animals and thus left a legacy of anatomic confusion that was heretical to question even into the 18th century. Galen was the last to practice dissection in any form as superstition and hostility to science gripped Europe until the end of the Medieval Period. Over llOO years passed before the Italian Mondino de Luzzi dared to become the first European to teach from a cadaver. With the blessings of the Pope, he held the first public dissection in 1315, using the body of an executed criminal. As the Rennaissance unfolded, first France and then other countries one by one permitted human dissection. But the rules were strict: it could be done only on executed criminals in public and no more than once a year. In som~ places, only barbers could dissect while physicians and students gazed on. students flocked to the anatomical lectures. Imagine, if you will, the typical anatomy class of the early 17th century: Magnificent anatomical amphitheaters were constructed to seat up to several hundred paying spectators. And spectators they were! Besides students and physicians, curious outsiders, young hecklers, beggars, monks, politicians, prostitutes, and other strange visitors attended. During carnival season, masked mummers and flute players added to what was often a tumultuous and clamorous social function. One document reveals that much more was spent on alcohol and refreshments for a demonstration than on the cadaver, supplies, and equipment. In fact, demonstrations were often fittingly referred to as "circuses," though the word was used to describe the circular shape of the theater with its concentric rising tiers of stands. As if the scene weren't ludicrous enough, dogs were allowed to lurk around the dissection table, waiting to snap up any discarded organs or appendages. The table was lighted by torches or candelabras and was connected to a system of winches, ropes, and levers. The dissection took place according to a stylized rigid structure with five distinct steps, beginning with the bones Body Dissection Becomes a Fad These restrictions gave way as dissection became popular and entered its "Golden Period" (1400-1600). Cadavers became available from hospitals, prisons, poorhouses, and suicides, providing an adequate supply. . Dissection became so popular, in fact, that mediCal JULY 1985/7 �die in order to depict Christ on the cross." Public reaction led to a temporary cut-off of cadavers, and grave robbing entered history for the first time. . . Collections of human cadavers remamed styhsh for quite a while, however. The barbaric genius, Peter the Great, was so enamored of a German anatomist's collection that he paid a fortune for it in 1717. Russian porters were hired to transport it to St. Petersburg, but part of the collection was ruined when the porters got thirsty on the way and drank the pickling alcohol! Interestingly, whiskey was used in later decades to preserve bodies. Body Snatching Becomes a Profession I R I and muscles, followed by the abdominal organs, the heart and lungs, the brain, and finally the vascular and nervous system. Despite th~ circus atmosphere, the course was not really for the unmotivated. Vesalius' strenuous course, for example, had 12-hour day sessions, every day for three weeks. The necessity for this schedule is obvious when one realizes that dissection had to proceed just ahead of decay, and dissections occurred only once a year. Oddly enough, during the Golden Era, the role of the artist in human dissection actually overshadowed the role of the physician. DaVinci, Michelangelo, and Titian were avid dissectionists. In fact, artists ironically conducted more dissections, obtained cadavers more readily, and were less biased and more accurate in their descriptions than were physicians. DaVinci completed 100 dissections and 779 anatomical drawings. So stylish did dissection become that the body of Pope Alexander V was publicly dissected after his death. Michelangelo even went to the extreme ?f demanding repayment in cadavers for any contracts wah the church to produce sculptur~s ..T~is lead to. the rumor that t~e renowned artist was wtlhng to cructfy a man and let htm 8/BUFFALO PHYSICIAN As continental Europe entered the modern period, human dissection generally remained acceptable and cadavers were easily available from many sources. Great Britain and America remained the glaring exceptions, however. Although Britain boasted fine medical schools, the only legal (and very inadequate) source for cadavers was executed criminals. Compounding the dilemma were the anti-witchcraft law that punished anyone disinterring a corp~e and the contr~dictory education. law that required candtdates for a medteal degree to furntsh evidence they had dissected several cadavers. The students added further pressure by publicly accusing their professors of inactivity or parsimony when supplies were low. So physicians met their demand for specimens by grave-robbing. At first, the physicians and their apprentices themselves robbed the graveyards, but it became more practical to hire society's "rascals" to do it-low class grave diggers, criminals, and mercenaries that became known as body snatchers, resurrectionists, sack-' em-up men, and bogey men. Clever gangs could resurrect up to 400 corpses a year bringing in 1500 guineas ?r $26,000 (in 1985 dollars) a yea; at a rate of $69 a body. Smce more was paid for unburied b?dies, grave robbers always care~ully watched sick, pen~~~ess, and ~omeless people unttl they died. They also JOmed up wtt.h un~crupulous undertakers, who substituted heavy obJects m the caskets, and split the fee. Many graveyards, especially paupers fields became so plundered (up to 2000 bodies a year removed from one Dublin cemetery) that relatives of the deceased would pay for wrought iron coffins, hire armed graveyard watchmen erect special iron grills around their loved ones' coffins' and even set traps and spring guns. ' Demand became so great that resurrectionist gangs organized into unlicensed guilds that roamed the count~yside on dark nights. When the full moon shone, they either stayed home ~r drank themselves into a stupor in the tave~ns. Sof!le gUJids even had monopolies on certain cem~tenes. Thts.led to qu~rrels and even gang wars, includmg desecr~ttOn of coffms, _van?alizing of physicians' laboratones, vtolence, and pohce mvestigations. Huma.n freaks a~d especially giants were coveted by the more avt.d anatomt~t~ of that era. The aptly named Dr. John Hunter, m competttton with other surgeons, schemed in I ~83 .to pro~u~e the body of the dying Irish giant, Charles C? Bnen. 0 Br.ten, upon learning that the doctor had destgns upon hts ca.rcass, ordered that when he died he should be placed m a lead coffin and buried at sea. But the men whom the _und~rtaker hired to watch the eightfoot corpse, a~ the htstoncal account goes, "watched also th.e opport~,mty to refr~sh their lesser but Jiving bodies ~!th ltquor. Dr. Hunters servant met the "body" guards m the ale house and finally convinced them to switch stone for the body for the exorbitant (in 1783) price of $ 2 , 500 . �Thus the mortal remains of Charles O'Brien were conveyed to the doctor's home in the middle of the night for dissection. In an example of loyalty that few physicians have ever known, one surgeon's apprentices disguised themselves as mourners at the wake for a 7-foot-9-inch giant. Somehow, they convinced the mourners to drink whiskey laced with laudenum (opium). With the relatives in an inebriated stupor, the loyal medical students lifted the giant's coffin onto a detached door and triumphantly marched out before the enraged relatives discovered the act. When a mob later arrived at the medical school, the dean quelled a riot by paying them all off. Body Snatching Brings About a B~cklas.h As in Great Britain, legal supplies of cadavers m Amenca (executed criminals and men who died in gun duels) were scarce from 1790 to 1830. Expectedly, grave-robbing flourished . But unlike in Britain, the illegal sources were primarily the bodies of Black slaves, as well as white paupers, since this was the most socially powerless group in 19th century society. In some areas, body snatching was so prevalent that many paupers and slaves were acutely aware that burial in potter's fields (paupers' graveyards) was a mockery whenever anatomy classes were in session at nearby medical schools. Asking to buried elsewhere was often their dying request. During a debate about the issue, one politician lamented, "Rattle his bones over the stones, He is only a pauper whom nobody owns." Lest the reader think that body snatching did not cause public uproar, a number of major riots did periodically erupt. Indignation in Great Britain even led to the murder of two surgeons in 1830 (certainly a much greater threat than malpractice suits). America has the distinction of having had more antigrave robbing uprisings and riots than any other nation. The worst was the "Doctor's Riot of 1788" in New York City, triggered by publicity about body snatching. The Columbia Medical School was ransacked, four doctors were almost lynched, and the state militia had to be called out"to quell a mob of 5000. When it ended, eight rioters had been shot dead. Perhaps the most publicized event in the bizarre history of dissection was related to two Scottish men who went a little overboard in their greed to profit from the dead. William Burke and William Hare were a couple of low-life entrepreneurs who eagerly engaged in grave robbing for one of the greatest anatomists of the time, Dr. Robert Knox of Edinburgh, Scotland. Dr. Knox, a heavy user of cadavers, never questioned where the cadavers carne from so Burke and Hare decided to increase the supply by suffocating unsuspecting old women and men. By the time they were captured in 1828, they had murdered 16 people. Hare turned state's evidence, and Burke was convicted. Dr. Knox's punishment was public disgrace, but Burke's was public dissection- after his execution, of course. Burke's hanging was witnessed by 25,000 paid spectatOrs, and his public dissection by an?th~r 2?,000, probably the greatest audience for a dissection m history. His skeleton now stands in the Anatomy Museum m Edinburgh. The morbid murders led to the passing of the Warburton Anatomy Act of 1832, Britain's first law that made unclaimed bodies available for medical dissection as well as body donation through wills. America's first law was passed by Massachusetts the preceding year, also makmg it legal to use unclaimed bodies. Though the statute ended grave-robbing in that state, it took up to 50 years for many other states to pass their anatomy acts (Pennsylvania in 1867, Illinois in 1885). Buffalo's Body Snatchers Buffalo was no different from other cities with medical schools. Dr. Oliver P. Jones, UB's distinguished professor emeritus of anatomy, in his 1981 Buffalo Physician article, "Confessions of Three Grave Robbers," described five known grave robbing incidents involving UB and Buffalo. The earliest occurred nine months before the University of Buffalo received its charter in 1847. William Waterman, M.D., grave-robbed six bodies and tried to ship them to an Ohio medical college via Canada. He was convicted and sentenced to a three-year prison term , but was pardoned after serving eight months. Dr. Corydon LaFord was one of UB's first demonstrators of anatomy and our school's first documented body snatcher. 1848 records indicate that $10 per cadaver was paid. LaFord later moved on and up to professor of anatomy at the University of Michigan, bringing his body snatching trade with him. In 1858, documents reveal, one of our physiology professors requested $25 from the Medical School dean to purchase. two stolen bodies. Even one of our alumni was a body snatcher. Dr. S.W. Wetmore (Class of 1862) became demonstrator of anatomy and with the help of his students, personally dug up bodies. So where does such a man of distinction go next? He became a dean, of course, of a rival medical college in Buffalo (now defunct). Even then, he still practiced his body snatching on the side. Body Snatching Scandal Is Laid To Rest Many other bizarre events ensued during those decades, especially in neighboring Ohio. The (now) University of Cincinnati College of Medicine was the location of two of the most unusual incidents. In the 1860s, the responsibility for supplying the cadavers for that medical college rested on the broad shoulders of a Mr. William Cunningham. But "Old Man Dead," as he was known, went too far when he delivered a smallpox corpse to the school, infecting several students. Cunningham's skeleton now rests in the University's museum. The second incident is almost too incredible to be true. In 1878, U.S. Senator John Scott Harrison passed away and was buried. The next day, one of his sons went to the (now) University of Cincinnati to locate the stolen body of a friend . One of the bodies shown to him, to his absolute horror, was that of his just buried, just "resurrected" father, John Scott Harrison, who also happened to be the son of the 9th U.S. President William Henry Harrison and the father of the (yet to be) 21st President Benjamin Harrison. The other son, politician Benjamin Harrison, arrived on the scene the next day, arousing public emotions even more. Three years later, Ohio's anatomy act was passed. Virtually all 50 states now have anatomy laws that make unclaimed bodies available for medical education. However, a large proportion of medical schools obtain their cadavers by bequest and, in UB 's case, the body donation program is so successful that it is the only source for specimens. Today, the entire controversy about grave robbing has been laid to rest, pardon me, I mean that the issue is dead and buried. In any case, little has been mentioned about the origin of those familiar demonstration skeletons hanging in the glass cases ... . Well, that's another story. • JULY 1985/9 �he world's smallest thermometer and the world's smallest heater may soon be entered in the Guinness World Book of Records. The minuscule devices were invented during the last several months in the laboratory of UB biophysicist Frederick Sachs, Ph.D., to measure temperature changes in single cells as part of a biomedical research project. The ultra-microthermometer and ultra-microheater, as Dr. Sachs refers to the instruments, are part of hand-held devices that taper into a tip that is invisible to the unaided eye. "The sensing tip and the heating element are both approximately one micron in diameter," the associate professor of biophysical sciences relates. For comparison, a single strand of hair is over 50 microns thick (there are approximately 25,000 microns to an inch). Dr. Sachs has recently submitted a patent application for the devices. In addition, his article describing them will be published this fall in the journal, Methods in Enzymology. "The thermometer is a double barrelled glass micropipette with a hole between the two barrels near the tip. It is filled with an ionic solution. The pipette is attached to an amplifier that measures the electrical resistance of the solution," Dr. Sachs explains. When the pipette is inserted in or touched to a single cell (or any other microscopic object) the attached instrument can measure the temperature because the resistance of the pipette solution varies with temperature. The ultra-micro- 10/BUFFALO PHYSICIAN thermometer is capable of detecting temperature differences of one ten-millionth of a degree C, making it one of the most sensitive thermometers ever invented. Dr. Sachs believes it may also be the fastest thermometer in that it can measure changes in temperature in as little as 100 microseconds. The diminutive heating element is also a tiny glass pipette. It is filled with a bismuth-tin alloy and coated on the outside with gold. Where the outside and inside metal layers join at the tip is the heating element. Heat is generated because the ultra-microheater is attached to an electrical current source. The gold layers that produce the heating element are only 100 angstroms, or 50 molecules thick. Heat can be produced and varied to within onetenth of a degree (centigrade). Up until now, the smallest thermometers were a thermistor, a type of semiconductor used to measure the heat of chemical reactions, and a thermocouple, composed of two dissimilar metals that generate a temperature dependent voltage. The two devices are, respectively, 100 times and 20 times larger than Dr. Sachs' ultra-microthermometer. Although smaller heaters can be produced by using integrated circuit technology, they are not, for all practical purposes, useful as general purpose heating elements because they cannot be easily manipulated or moved from one object of study to another. Dr. Sachs did not invent the minuscule devices to seek a world record. "I just needed a way to measure the temperature of the cells we were experimenting with " he points out. "No existing instrument was small enough to measure the temperature, so one had to be invented." It �wasn't until the devices were perfected that it occurred to him they were the smallest such instruments in existence. Similarly, it never occurred to Dr. Sachs to submit the record to the Guinness Book of World Records until a short while ago. "Yes, it's a good idea to document the record for them. And, besides, my son will really get a kick out of it," he adds. he devices were developed for Dr. Sachs' investigation into ion channels, which are special molecules on cell membranes. They are the smallest units of biological excitability because they transmit electrical impulses, when stimulated by touch or chemicals, that are perceived as sensation by the brain. Dr. Sachs recently discovered the first mechanically-sensitive ion channel (see accompanying article) that may explain the fundamental mechanism for the senses of hearing, touch, and body awareness. Dr. Sachs personally invented the ultramicrothermometer, and had assistance for the ultramicroheater from Research Assistant Professor Tony Auerbach and research technicians Rich McGarrigle and Jim eil. His research is currently funded by a ational Institutes of Health grant. Sachs. is working with the HealthRelated Instruments and Device Institute (HIDI) and the Western ew York Technology Development Center, two UB-spawned high-tech businesses. They are looking to develop manufacturers in Western New York that will produce Sachs' and others' devices for specific applications. In medicine, the microscropic heater may be useful in surgery as an ultra-microcautery that could make very fine incisions. Its advantages over laser surgery would be its inexpensiveness and its ability to regulate temperature during cauterization. Industrial applications being considered are in measuring temperature of integrated circuits to improve their design by avoiding flaws. The devices may also be used to improve the design of automobile engines by developing temperature profiles of flame spread in combustion chambers. The tiny thermometer can also be used in research in which it is necessary to measure temperatures of single capillaries, body cells such as nerves, single celled organisms such as amoeba, and chemical reactions taking place in very tiny volumes. It can also measure metabolism in different parts of a cell. For instance, during a contraction cycle of a muscle cell, the ultra-microthermometer will tell which parts of the contractile mechanism of the cell are absorbing or emitting heat. This can be used to match predictions of biochemical models for muscle contraction. "We are constantly thinking of new things to do with the device. It will have many potential applications," Sach states. The tiny instruments are not Dr. Sachs' only inventions. He has two patents related to microelectrodes and a patent pending for an automated device to produce electrodes. The last mentioned device is now being manufactured by Sutter Instruments of California. Four other inventions have patent applications under review. He is on the editorial boards of the Biophysical journal and the journal of Cellular Neurobiology and is a reviewer for Science and six other journals. • JULY 1985/11 ��Trackin the Sense o Touch By Bruce S. Kershner "Stimulate mv ion channels!':_could this become the catchword o( the future to express erotic interest? Maybe not, but it could be the way to explain how erotic stimulation-as well as all tactile and kinetic sensation-actually occurs in the body. A UB biophysicist has discovered what could be the fundamental mechanism for the perception of touch, body awareness, pressure, and stretch.1 Dr. Frederick Sachs has found enzyme molecules on cell membranes that, when touched. send an electrical impulse through a channel in their structure to ultimately transmit physical sensation. The +-!-year-old associate professor of biophysical sciences refers to those molecules as ion channels because of the exchange of ions through their pore-like structure. Dr. Sachs calls this mechanically sensitive type of ion channel the " 'quantum unit of mechanical excitability.' If you subdivide it, there's no excitability left, while larger structures just involve more ion channels and the couplings between them," he explains. "These ion channels appear to be an essential mechanism by which the body communicates with itself and individual cells communicate with themselves," Dr. Sachs points out. This cell-to-cell internal communication means, in effect, that the body can be viewed as one large sensory organ. These sensations include not only the generalized touch sense (both sexual and non-sexual) but also such diffuse and internal responses as blood pressure, cerebrospinal pressure, heart and lung inflation, bladder filling, distension of the gut, and organ stretch, even extending to such universal functions as cell volume regulation and body homeostasis. These physical senses are referred to as mechanoreception. In addition, the mechanically-sensitive ion channels help to explain the senses of hearing and balance, which depend on the pressure-sensitive hairs in the cochlea and vestibular. At first glance, one would expect that much is already known about the mechanoreceptor mechanisms. For instance, the structures of certain microscopic, specialized sensory organs in skin, inner ear, muscles, tendons, and joints are well known. These organs, which include muscle spindle organs, cochlear hairs, Golgi tendon organs, Pacinian and Meissner's corpuscles, and Krause end bulbs. respond to mechanical deformation from pressure, stretch, and tension. Some of these organs, when physically stimulated, produce an electric current which results in impulses that travel through the neural pathways to the spinal cord and brain where they are perceived as touch, pain, pressure, or sound. Other less complicated sensory organs such as free nerve endings and Ruffini endings are found throughout the body but until now, have been too small to measure for their response. Dr. Frederick Sachs at work on the mystery of touch in his campus research lab. JULY 1985/13 �Extracellular Intracellular Cytoskeletal Strands The knowledge about these organs' structure and ability to send impulses has told us little about how the physical stimulation is actually translated into the electrical nerve impulse. The situation is analogous to a person who has learned that flicking a light switch turns a light on and off because it somehow sends an electric current to the light. The person will not, however, understand the fundamental mechanism if he does not actually know how the switch box electronically performs the operation. The answer to how physical stimulation is translated into electrical impulses, Or. Sachs found, is at the molecular level in the cell membrane. The existence of ion channels is not new but other known ion channels such as those in nerve synapses, Schwann cells, muscle, blood, pancreas, and heart cells seem to be insensitive to mechanical stimulation. Thev are instead triggered by electrical current or by chemicals such as calcium ions or neurotransmitters. The ion channels that Dr. Sachs discovered are the first known to be sensitive to mechanical stimulation, that is, they can convert (transduce) mechanical energy into electrical energy. Or. Sachs' research indicates that the process that ultimately leads to perception of pressure and touch probably works as follows: "The cell membrane is basically composed of phospholipids overlying a cytoskeleton network of fibers," he elucidates. "Interspersed across this fibrous network are large protein molecules." The large proteins are the ion channels, and could be referred to as the sensory "quark," or the smallest indivisible unit capable of responding to mechanical stimulation 14/BUFFALO PHYSICIAN Cross-section (above) of ion channels on cell membrane. Patch clamp probe (below) measuring muscle fiber ion channels. en 0 w w ...J u a: <( ::. § L-----------------------~~~==~------__j~ �by producing an electrical impulse. "The molecule is suspected to contain at least one lysine group and have 250,000 atomic weight, but nothing else is known about its structure," he adds. hen a physical object comes into contact with the W cell membrane, the fiber network is stretched. The ion channels attached to this network are triggered. Because their structure is "pore-like," the triggering releases a flow of ions (the generator current) through a hole in the molecule and into the cell, depolarizing it. This in turn evokes an action potential which travels up the nerve axon or releases a chemical transmitter. In either case, the message travels the neural pathways until it reaches the brain and is perceived as pressure, touch, or erotic sensation, depending, of course, on where it originated on the body. Interestingly, the ion channels Dr. Sachs has studied so far are not selective for any type of cation. They do not distinguish well between potassium, sodium, lithium, cesium, or even certain organic chemicals. Because they are situated on the cytoskeletal fibers, the ion channels gather energy from an area of membrane (1/IOOth of a square micron) 100 times larger than the area occupied by the molecule itself (100 angstroms). The protein that serves as an ion channel is also an enzyme because it is capable of catalyzing (lowering the free energy for) the passage of ions from one side of the cell membrane to another. Though they don't act like classical enzymes, "they are, in fact, very efficient enzymes, capable of sending an ion across an energy barrier that is 80 times its thermal energy. This is at least 10,000 times higher than the most efficient soluble enzymes," Dr. Sachs reports. Dr. Sachs made the discovery with Dr. Falguni Guharay, research associate in biophysical sciences. "With a tissue-cultured skeletal muscle tissure of a chick embryo, we used a patch clamp to measure ion channel activity," Dr. Sachs relates. A patch clamp is a small glass pipette with a micron-wide tip filled with saline solution. After it is pushed against the cell membrane, a micrometerdriven syringe creates suction to draw in a small bubbleshape'd portion of membrane called a "bleb" (a little "blob"). "Some, as yet mysterious, forces hold the bleb of membrane in place and seal it tightly to the glass," Dr. Sachs continues, "so that any current that flows through the membrane is forced to flow into the amplifier instead of leak back out into solution. "What we noticed when we applied the suction was that considerable bursts of ion channel activity occurred. When we increased the suction, the current increased in the bleb. We also learned that the current varied as we varied the suction and that it could be repeated indefinitely." Because he knows the geometry of the pipette bubble, he could actually estimate the force needed to stimulate the ion channels. The channel is only I/IOOth the diameter of the pipette, but is activated by stretching attached micro-filaments that are I/IOth of the diameter of the pipette. He estimates that between two and five strands are attached to each ion channel. T o make sure the ion channels were not a type that was already known, Drs. Sachs and Guharay treated them with a-bungarotoxin and acetylcholine. The channels remained active, confirming that they were not altered nicotinic acid channels, which were the original object of their research. Dr. Sachs discovered the mechanically-sensitive ion channels unintentionally while he was trying to understand the mechanisms of chemically activated ion channels. "Because we discovered the mechanically-sensitive channels by serendipity, it emphasizes the value of basic research. You just can't predict where new and significant answers will show up," he emphasizes. "I wasn't even touching a tactile receptor cell, but a muscle cell." Similar activity has apprently been measured in other types of cells, but, Dr. Sachs says, those researchers dismissed the responses as artifacts or overlooked their significance. Dr. Sachs is still at the earliest stages of this new field of research, but he postulates that the discovery could lead to a great expansion in our medical knowledge. "It may become possible to manipulate the mechanoreceptors to correct flawed blood pressure regulation in humans and the syndromes caused by it," he speculates. It could also have potential in prevention of pain, in rehabilitation of sensory and motor-impaired patients, and in sexual problems of a physical nature. Studying these new ion channels is now Dr. Sachs' first priority. He plans next to define the chemical nature of the channels and their fiber attachments. He will attempt to develop antibodies that will "stick" to the channels to block them, one method of further verifying their role. He expects to describe his newest results at the annual American Physiological Society Conference in a symposium, "The Cytoskeleton and Membrane Signalling." The conference will be held in Niagara Falls, .Y., in October. He hopes that his findings will gain attention elsewhere so other researchers will investigate further. After coming upon the ion channels, Dr. Sachs "suddenly realized there is almost nothing about it in the literature. Here's a mechanism that is so universal-it is absolutely everywhere, but there is virtually no information about it. "Not only is there no forum or journal that deals with this, but there are probably only four groups in the world working on this mechanism," he notes. Three of the groups are located at M.I.T., Massachusetts General Hospital, and the University of San Francisco. Although the exact role of these ion channels is still unclear, Dr. Sachs theorizes that in some cells, they might be related to cell volume regulation and that they could be prototypes of the transducers in free nerve endings or specialized sensory organs. "This mechanoreceptor function is probably so fundamental that if you have a congenital error, the embryo is dead. You just don't see general syndromes relating to flawed mechanoreceptor systems-it's so deep and essential to life," he comments. Since it may be the same mechanism found in both animals and plants, it could be an integral part of the physical senses of all organisms. Dr. Sachs received his Ph.D. from State University of New York's Upstate Medical Center in Syracuse, N.Y., in 1969. After holding research positions at the University of Hawaii and the ational Institutes of Health, he joined the faculty of UB's School of Medicine in 1975. He is on the editorial boards of the Biophysical journal and the journal of Cellular Neurobiology and is a reviewer for Science and six other journals. An author of 42 publications, he is currently funded by an NIH grant. The New York City native holds two patents for microelectrode apparatus and has several others pending. • 1 Journal of Physiology (June 1984 and June 1985 (in press) issues) JULY 1985/15 �. )ICAL S(,EIOOL EWS Dean for a Decade: Dr. Naughton reaches a milestone D B y Bruce S. Ke rshner ean for a decade- that's the milestone that john Naughton, M.D. reached on March 1, 1985 . The Oklahoma University graduate left George Washington University in 1975 to become dean of UB's School of Medicine, replacing acting dean F. Carter Pannill, Jr., M.D. Since then, much has changed at UB and the Medical School. And some of those changes bear the indelible imprint of Dr. Naughton as he has strived to strengthen the School's standing among the 127 medical schools in the nation . A brief celebration to honor Dr. and Mrs. aughton was held in Farber Hall, where they were presented with Waterford crystal. When asked to reflect on the past ten years, especially the School's reputation, the dean and vice president for clinical affairs replied, "When I first came, Buffalo had always been recognized as a school with a lot of potential. 16/BUFFALO PHYSICIA It was especially acknowledged for strengths in areas such as immunology, physiology, pediatrics, and cancer research (in association with Roswell Park). But in the mid-1970s these strengths had not achieved a mass effect for the School. "Since then, we've been able to deal with many of those problems that were preventing us from obtaining that overall reputation of excellence. I think our image has grown nicely. It's been reflected by our commitment to neurobiology and neuroscience (directed by Don Faber), our strong programs in gerontology (led by Evan Calkins), as well as our respected programs in pediatric lung disease, spinal surgery, hand surgery, biochemistry, biotechnology, pediatric surgery, and GI research, to name a few." With these and other programs he mentioned, such as anatomy, biophysics and pharmacology, Dr. Naughton hopes that the Medical School will grow during the next ten years into "an unquestioned enterprise." He feels fortunate that some of his initial goals in the triad of education, research, and clinical programs have �been largely met while others are making good progress. "One of my goals was to strengthen our educational enterprise and to make sure we had a curriculum that was solid and yet provided opportunity for diversity and individualization," he related. ''I'm very satisfied with our results." Strengthening the research programs he feels has made great progress because the School has successfully recruited faculty with demonstrated research skills, who in turn have recruited more extramural support. to the status of clinical enterprise, "Our creaR eferring tion of the Graduate Medical Consortium has helped to realize the goal of improving the coordination of the clinical education of the house staff," he explains. "And we have also strengthened the role of the department chairmen (25 of them) as academic leaders of their programs-that was another one of the original goals." One of his objectives, however, the building program, has been frustratingly slow to be realized. The new Medical School facility, under planning and construction since 1982, is scheduled to be completed in 1986. "Ten years ago, one of our problems was that a lot of the basic science faculty were dispersed around the city because the orth Campus wasn't ready yet," he commented. "Now that the nursing and pharmacy schools have moved to separate quarters, it has allowed us to reorganize and centralize at least the basic science faculty to the South Campus. The only major basic science unit off campus is Social & Preventive Medicine, and that unit will be relocated here when the building program is completed." The completion of the new building, Dr. aughton feels, is required before the pre-clinical programs can be totally operationally sound. But an ongoing challenge will remain even after the school moves into its new quarters. "The threat of instability in our clinical enterprise will always remain because we're still a medical school with a number of fragmented programs dispersed over a wide territory," he states. These operate at a time when the hospital enterprise is also threatened both locally and nationally by major changes in health care. '1\lthough we're a much more secure medical school than in 1975, we're still somewhat vulnerable-we don't control everything about our environment," he explains, referring to government funding and regulations as well as radical developments in the health care industry. "We'll always have to work to strengthen our clinical enterprise while making sure that our educational mission is maintained. All of the ongoing difficulties are not one day suddenly going to be resolved. Protecting what we've already accomplished has to be one of our future goals." Besides completing the new building (and the improvement or programs that it will make possible), and ensuring that current accomplishments remain safe, Dr. aughton has a well thought-out blueprint for the next ten years. An even greater emphasis on research and develop- mentis an important objective. The M.D./Ph.D., Buswell, Summer Fellowship, and other programs will be tapped to solidify this goal. In addition, Dr. aughton wants to strengthen and stabilize the 15 clinical departments, and also encourage more clinical research. Keeping ahead in recruitment of quality students is a very important element in his plans. "We're always looking for ways to attract the highest caliber students," he notes. The vice president wants the admissions program to continue its commitment to strengthening and enhancing its recruitment of minority and underserved groups. He also wants UB to be the school of choice for Western ew Yorkers who want to train as physicians and medical researchers. uring his ten years, Dr. Naughton has seen many D changes and difficulties. "When I arrived here, we had gone through a period of chronic difficulty. The School had to make the transition from a private to a public institution. Every time an accreditation team visited, there were always more problems that hadn't been dealt with than those that had been," he related. There was also a quick succession of deans, three in six years. Dr. aughton has seen the School's reputation grow since those days of instability. He points to the greater national role of the School's professors in professional organizations. The School has increased from the 40th percentile to the 66th in student academic standing, and from 35th place (out of 127) to 26th place in extramural funding. How has the dean changed over the same period of time? Of course, he assumed the position of vice president for clinical affairs in 1984, while remaining dean of the Medical School. But on a personal level, he recognizes that he had to Jearn "that you don't achieve all of your goals in a short time. It's a long time-frame and I've had to become more accepting of the need for patience." He also recognized that you can't do everything yourself and that it is crucial that you select- and rely ondedicated, capable people to carry out your goals. "We couldn't have accomplished what we have, or what we plan, without the assistant and associate deans, staff, faculty, students, alumni, and others who have been willing to carry their share. I am grateful for their help." When pressed to select areas that he is particularly proud of, Dr. Naughton replied that he "feels good that the School has operated in an open fashion and that we encourage participation from all our constituencies." He also points to the fact that the annual faculty meeting has become a major event with wide participation. Another accomplishment is that the School has full accreditation without the need for annual progress reports. "That makes you feel the effort was really worth it." Lastly, the 51-year-old cardiologist is pleased that the health care community and community-at-large "see the School as a place of action and important medical developments. And it is clear that they often look to the School for leadership. I feel very good about that." • JULY 1985/ 17 �\ Beijing-DB exchange visitors 1 T he People's Republic of China hosted the UB Department of Nuclear Medicine's representative, Dr. Hank Kung, Ia t fall, as part of the precedent-setting agreement between the department and China. In turn, UB hosted three Chinese scholars and researchers this April. The three-year agreement between UB and Beijing ormal University (BNU) in China appears to be the first agreement between U.S. and Chinese scientists to conduct joint research in nuclear medicine. Dr. Kung's visit was the first visit from Buffalo resulting from the faculty exchange program between the two universities. Radiopharmaceutical research and collaboration with BNU's Department of Chemistry, which has been ongoing since the agreement commenced, will result in joint publication of scientific articles in Chinese and American journals. The latest development in the cooperative program was the week-long visit to Buffalo in early April by vice chairman of B U's Chemistry Department, Professor Liu; director of B U's radiochemistry lab, Professor Jing; and radiochemical researcher Mr. Sun. While here, they lectured and toured facilities. D r. Kung spent a month in China, with nearly half that time being spent in Beijing, the nation's capital. There, he lectured on his research to the BNU Chemistry Department's Division of Radiochemical Research. Dr. Kung and his associates have perfected a brain imaging agent that permits safer, less costly, and often more accurate diagnosis and management of stroke and other brain diseases. Refered to as J123HJPDM, the drug is used in the diagnostic brain-imaging technique called single-photon emission tomography (SPECT). "Now, because of the visit," Dr. Kung relates, "we will initiate two new research projects. We'll introduce for the first time the basic techniques and research methods to develop new radiopharmaceuticals which will yield benefits in the care of patients." Dr. Kung refers to joint research using Technetium 99 (TC-99m) which , besides I 12 3HJPDM , is the other ongoing research project between the two countries. "TC-99m is now the most important diagnostic radiopharmaceutical being used," Kung points out. While in China , he spoke before one group of 500, and many other groups, presenting information on the state-of-theart of radiopharmaceuticals in the U.S. Besides BNU, he also visited Beijing's major heart institute and their tumor research center. anjing, a city of 1-1/2 million near Shanghai, where Dr. Kung spent two days, is the national training center for all teachers and professors. Kung lectured there before the national meeting of the Society of Nuclear Medicine. He visited and lectured, too, at the Wuxi uclear Medicine Institute, also outside Shanghai , where China's most sophisticated nuclear medicine facility is located. Several days were spent in Hongxuo (formerly Hangchow), south of hanghai, at Jiejang Medical College. Shanghai , the world 's largest city with 12 million, was where he spent his last five days, lecturing at the second Medical College of Shanghai and the uclear Medicine Department, among other activities. A lthough Kung accomplished much scientifically during his month-long visit , all was not business. He did get to visit some cultural sites, including the l J �awesome Great Wall of China, the Summer Palace and the Great Palace in Beijing. He had a chance, too, to visit with his long-separated family. Dr. Kung was born in Fujien, near Hong Kong, but left the country when he was four. This was his first visit back to his land of birth . He was glad to have been reunited with his brother and uncle and spent time with them in Shanghai. Kung's wife Mei-Ping accompanied him to China. They also visited her uncle and family there. When asked about his personal impressions, he commented , "I had mixed feelings. I'm still very much attached to the history and culture of China. It's a beautiful country. But it saddens me to see the poverty and know the citizens do not have too much control over their own fates. "Though China is quite poor compared to American standards, I was still impressed by the researchers in China who, despite the poor conditions, make great strides in both research and patient care. "The physicians in China are not a wellpaid bunch-the chauffeurs who drove us around probably make more than the MD's. Salary is controlled by the government; there is no private practice. Financial rewards for intellectuals suffered during the Cultural Revolution and that effect is still present. ''As a result, doctors choose their field only because of their love for it ," he concluded. Initial contact with Chinese nuclear scientists occurred in July 1980 at a scientific conference in St. Louis, followed by a 16-month research stay at UB by a BNU professor. Dr. Monte Blau, former Nuclear Medicine chairman, then visited China for one month, followed by a two-month visit to Buffalo by BNU 's Chemistry Department president. The agreement was reached shortly thereafter. Further visits by Chinese scholars to conduct research are expected. An associate professor of chemistry, Dr. Xu, is expected to arrive at UB this June to spend a year conducting research planning. She will be funded by a Chinese government support fellowship. Summing up his feelings about his visit to China , Dr. Kung says, "I came away with a better understanding of what they • are doing and what they need ." Dean announces four appointments F our major appointments in the Medical School 's administration were announced recently by Dean John Naughton. Dr. Dennis Nadler, clinical assistant professor of pediatrics since 1974, has been appointed assistant dean for student affairs, effective January 1, 1985. For the past five years, Dr. Nadler has been involved in preparing and advising students in pediatrics, and for the past two years has run the resident matching program in association with the School's Office of Medical Education. His appointment formalizes and expands these duties. In coordinating the student advisement program , he will continue to prepare dean's letters and run the match program. His expanded role will include responsibility for restructuring the program to make it more relevant and helpful for students to select their career goals and to get into their preferred residency programs. Other areas for an expanded role will be developed as the program's needs indicate. Dr. adler is a UB Medical School alumnus (1971) and completed his pediatric residency at Children's Hospital in 1974. He has been acting director of pediatrics at Erie County Medical Center since 1977 and is pediatric consultant for the United Cerebral Palsy Association, WNY Chapter. D r. Gerald Sufrin has been reappointed as chairman of the Department of Urology, effective for three years. He has been that department's chairman since 1981. The professor of urology is also director of urology at Buffalo General Hospital. He was recently selected to the American Association o f Genito-Urinary Surgeons and the American Urological Association. The Alpha Omega Alpha member was previously appointed to the Surgery, Anesthesiology and Trauma Study Section of the ational Institutes of Health (NIH) , is active on other committees of NIH , and the National Kidney Foundation, and is on the board of trustees of the Foundation of Buffalo General Hospital. T he new chairman of the Department of Neurology is Dr. Michael Cohen, who served as acting chairman since June 1983. The professor of neurology and pediatrics received his medical degree from UB in 1961 and his bachelor's from Dartmouth in 1957. He is the director of Children's Hospital's Pediatric eurology Program and was medical director for the United Cerebral Palsy Association, WNY Chapter, for five years. A Buffalo native, the Alpha Omega Alpha member is on the editorial board of the journal of Pediatric Neurology and the author of several dozen research articles and book chapters. He is a fellow of the American Academy of Neurology, and is active in numerous professional University, and hospital organizations. D r. Marvin Herz, similarly, has been reappointed as chairman of UB's Department o f Psychiatry, where he has served since 1978 . The professor of psychiatry is director of psychiatry at Erie Co unty Medical Center and head of Buffalo General's Department o f Psychiatry. He earned his master's degree in psychology from Yale and his medical degree from Chicago Medica! School (1955), where he was honored in 1982 with a DisJULY 1985/19 �tinguished Alumnus Award. Before coming to B, he was a professor of psychology at Emory University, Atlanta . The author of 70 publications has been active on numerous committees of the ationa! In titute for Mental Health and the American Psychiatric Association. • J. Donald Gass receives Howe Medal T he prestigious Lucien Howe Prize Med:Il in recognition of outstanding contributions to ophthalmology has been awarded to J. Donald Gass, M .D., of the niversity of Miami 's School of Medicine and Bascom Palmer Eye Institute, Miami, Florida. The awardee was selected by a special committee appointed by University President Steven Sample. The Medal and a 250 honorarium were presented to Dr. Gass by Vice President john Naughton, dean of the Medical School, at the annual dinner meeting of the Buffalo Ophthalmology ociety on April 18. The Howe Prize had been awarded most recently to Dr. Byron Smith of ew York City in 1979. The medal has been awarded every several years since 1928. • Rehabilitation is Harrington Topic D r. Philip H. . Wood, 1985 Harrington Lecturer, (pictured at right) spoke on the criteria for rehabilitation of elderly and handicapped patients during a presentation at UB's W Y Geriatric Education Center on April 10, 1985. The professor of community medicine at the University of Manchester also presented an epidemiology of rheumatic diseases. He is director of the Epidemiology Research nit, Arthritis and Rheumatism Council for Research in the UK. 20/BUFFALO PHYSIC1A �Hospitals pool collection efforts S mart shopping for low credit will save six area hospitals more than $90,000 this year, according to Buffalo General Health Care network Coordinator joanne Spoth. Member institutions of the BGH network - formed two years ago to provide quality, cost effective health care to the WNY community - recently signed a one-year agreement to pool their combined S3. 7 million in unpaid patient hospital bills to realize a collection savings between 10 to 25 per cent. Buffalo General Health Care Network is comprised of Bertrand Chaffee Hospital, Springville; Buffalo General Hospital , Buffalo; Genesee Memorial Hospital, Batavia; Lake Shore Hospital, Irving; Lockport Memorial Hospital, Lockport; and TriCounty Memorial Hospital, Gowanda. After six months, hospitals turn over unpaid patient bills to a collection agency which recovers the debt for the institution at a commission fee of 35 to 50 per cent on the recovered bills. Financial officers of the BGH Network hospitals decided to contract their combined debt to receive low rates in the hospital 's pay back to the collection agency. The agreement, effective April I, is anticipated to save the six hospitals approximately $90,000 this year. The plan, which protects the confidentiality of individual hospitals, states that a flat rate will be charged for accounts placed with the designated Buffalo-based collection agency within six months after patient services are rendered. Also, extra savings with the agreement will be realized: a retroactive clause applies the new, lower rate to any accounts the individual hospitals may have with the agency. "The agreement's financial benefit to etwork hospitals represents one of many fiscal matters the coalition is currently considering. It also shows that small and large hospitals are working together for the benefit of everyone," said Ms. Spoth. More than 1500 acute care beds and about 4400 hospital employees are represented by the Network, which is committed to joint planning to provide people throughout W Y with the best in • health care resources. BGH participating in OIL Flights T he Buffalo General Hospital has become a participating member of a charitable nationwide emergency program that provides transportation to secure donor hearts for heart transplants. The Oil Industry Lifesaving Flights Program (OIL Flights), based in Houston , Texas, is available to all major transplant centers in the United States. OIL Flights also provides transportation for liver, heart-lung, and pancreas transplants. Under the OIL Flights program, which began January 1, 1984, participating oil company members assist in the transport of organs, donors, recipients, or surgical teams by making corporate aircraft available or by contributing funds to charter aircraft for emergency flights. Buffalo General joins the program which includes eight other transplant centers. Among them are Stanford University Medical Center; the University of Pittsburgh Medical School; and the Mayo Clinic. There are 47 participating oil industry companies with 55 available aircraft located in 21 cities in 11 states. There is a strong need for the OIL Flights program. Few medical insurance policies cover organ transportation requirements. Also, many organs for transplantation require rapid transport, and the type of aircraft necessary is not always available locally. In a heart transplant, for instance, surgery must be accomplished within four hours after the donor heart is removed. OIL Flights provided the transportation for BGH's second heart transplant which involved a flight from Philadelphia to Buffalo to orth Carolina and then back to Buffalo. The Organ Procurement Agency of Western ew York, which conducts the search for donor organs, coordinated the transportation through OIL Flights. BGH has recently signed an official participation agreement with OIL Flights to supplement existing local transportation services and insure the necessary transport for future heart transplants. Locally, 12 companies are involved in efforts with the Buffalo General Hospital to arrange transportatio n for the heart transplant program. They are American Precision Industries Inc., Conax Corp., Delaware North, First Mark Securities, Gaymar Industries, Gibraltar Steel Corp., Marine Midland, Moog Inc., Sierra Research , Sorrento Cheese, Envirogas, Inc., and Faller, Klenk & Quinlan Inc. Envirogas Inc. supplied the transportation for BGH's first heart transplant. • JULY 1985/21 �I Pain center opens at the General I by Tracey Wild n an effort to help patients in discomfort , the Departments of Anesthe iology and Rehabilitation Medicine have introduced a Pain Management Center located in the Ambulatory Care Center of Buffalo General Hospital. After visiting pain centers at the niversity of Cincinnati and at Baylor College of Medicine, Houston , Dr. Marcos G. Viguera, clinical associate professor of anesthesiology, and Dr. Carl V. Granger, professor of rehabilitation medicine, decided that a more ambitious center for BGH was needed . The new program attempts to deal with patients that suffer acute, intermediate, or chronic pain through the involvement of several disciplines to treat the problem in a comprehensive manner. Drs. Merle N. Tandoc, Ernesto L. Yu, and Thaddeus C. Rutkow ki , all clinical instructors m 22/B FFALO PHY !ClAN anesthesiology, are among those who are involved in the Center. A number of physical therapists and physicians from the specialties of neurosurgery and orthopaedics will also give consultations and assist in the program. According to Dr. Viguera, one medical or psychological specialty often cannot handle the management of complex pain by itself. "When a patient complains of pain," said Dr. Viguera , "he or she is often shuffled from one specialist to another. Our new Pain Management Center provides a central location where the specialists come to the patient." To most effectively devise a course of therapy, the patient is asked to complete a comprehensive form that is used to identify typical pain syndromes. After a preliminary investigation and examination , conferences are held by the team to develop a therapeutic plan best suited for the patient. "We can significantly relieve the patient's pain," said Dr. Viguera, "even though it sometimes may not be perma- nently eliminated. By changing attitudes and modifying behavior, we can teach patients to live with a discomfort that may not go away." Some of the techniques used to help patients include electrical stimulation, nerve blocks, physiotherapy and exercise, biofeedback , steroids, or epidural narcotics. Typical of one recently successful approach, the use of hypnosis made it po sible for a police officer recovering from a bullet wound tO regain strength in his arm and shoulder, which because of agonizing pain, had made it nearly impossible for him to carry on his daily activity. Currently, patients are being treated by the team of physicians and psychologists on both an inpatient and outpatient basis. Treatments are covered by most health insurance policies. • (from BGH's April 1985 "Pu/sebeat") High rise towers usher in new era M arking a vital era in health care, ribbon cutting ceremonies February 12, 1985 announced the official opening of Buffalo General's new high-rise medical centerthe most modern and technically advanced hospital in Western ew York. "This new facility will serve the community far into the next century," said Robert). Donough, immediate past chairman of the Hospital's Board of Trustees and vice chairman of orstar Bancorp. " The twin towers represent an immediate benefit to the area's economy with over 40 million spent in local building materials and 30 million in wages." The new city landmark, which is the second highest building in Buffalo, will contain S22 million worth of state-of-theart medical , surgical and diagnostic equipment. Said William V. Kinnard, Jr., M.D., Hospital president: "The hotel services of the new facility are dramatically improved from the old , obsolete physical plant. Buffalo General has always applied its scientific and medical acumen; now the new environment matches this long tradition of skill and desire to serve people". He anticipates complete transfer of services to the new building by Spring 1986 and completion of renovation projects in existing facilities by Spring of 1987. • �I I keep Iittles ones occupied. The Center now benefits from direct ancillary services provided by the Deaconess, including cashier, housekeeping, maintenance, security, and mail services. Shared medical services at the new location include physical therapy, laboratories, and x-ray. Patients and employees of the Center also have access to the Deaconess Cafeteria and vending area. • Anesthesiology has first 'teaching day' T Hemophilia unit opeps at Children's T he dedication of the Pediatric Unit of the Hemophilia Center of Western New York, Inc., took place at Children's Hospital on February 8, making Children's the only center for treament of this disease in pediatric patients. The Unit, in the making for two years, will now allow the Hemophilia Center to reach a higher level of comprehensive care in the treatment of hereditary blood disorders. The Center was originally established in 1969 in E.). Meyer Memorial Hospital. In 1978, what is now known as the Adult Unit of the Hemophilia Center was moved to the Erie County Medical Center. Now with two locations, it will be the only specialized facility in the eight counties of WNY to treat individuals with geneticbased blood disorders from infancy through adulthood. James R. Humbert, M.D., director of the Hematology-Oncology Division at Children's and professor of pediatrics and microbiology at UB, will serve as comedical director for the Pediatric Unit. The Hemophilia Center can now provide diagnostic and comprehensive treat- ment with a staff that includes adult and pediatric hematologists, physical therapists, strong laboratory back up, and orthopaedic and genetic consultants, as well as a social worker. Services provided will include school visits and physical education instructors to aid in the hemophiliac child's adjustment to a normal lifestyle. Instruction for families will also provide the opportunity for home therapy programs. • (Reprinted from Children's Hospital's "Bambino," Februar; 1985) Family Medicine moves to Deaconess N ew headquarters for the Family Medicine Center at the Deaconess Division of Buffalo General Hospital provide the roomy, modern accommodations that the fast growing department has needed for some time. The move into Deaconess was completed December 17, 1984. Remodeling of these areas has given the Center comfortable accommodations for its health care professionals and the 11,000 people they treat. The 18 examining rooms are bright and efficiently organized. A corner of the waiting area is equipped with toys and books to help he first Richard N. Terry Anesthesia Teaching Day was held January 26, 1985, at Buffalo General Hospital. Sponsored by the Departments of Anesthesiology, the program featured lectures by a dozen area anesthesiologists. Dr. Richard Ament, clinical professor of anesthesiology and Dr. Michael Madden, clinical assistant professor of anesthesiology, moderated. Drs. Stephen Gladysz and Dr. Marcos Viguera, clinical associate professor and head of BGH 's Department of Anesthesiology, spoke on anesthesia for kidney transplantation, while Dr. Robert Thomas, Jr. , clinical assistant professor of surgery, and Dr. Richard Terry, clinical professor of anesthesiology, presented a paper on anesthesia for heart transplantation. Epidural morphine for postoperative analgesia and nerve block for surgery of the lower extremities were two other topics discussed. • Gait Lab serves three functions B y Wendy Arndt Hunt T he Gait Analysis Laboratory, situated in the Robert Warner Rehabilitation Center at the Children's Guild near Children's Hospital of Buffalo, has been established to determine the need for and the efficfl.cy of surgical procedures and rehabilitation treatment protoco.ls. Up to now, judgements for these have been made on the basis of subjective observation, not JULY 1985/23 �HOSPITAL NEWS objective measurements. This facility, equipped with one of 15 Vicon systems in use in North America, will allow scientific assessment of both normal and pathological movement to be done. The director is Sandra Woolley, an assistant professor in the Department of Physical Therapy and Exercise Science in UB's School of Health Related Professions. The medical consultant is Craig Blum, M.D., an orthopaedic surgeon highly respected for his work in pediatrics. He is clinical ~ssistant professor of orthopaedics. Initially, those who come through the laboratory will be pediatric patients who suffer from cerebral palsy and limb disorders, but eventually, clients will range from the very young to the very old and from those who are "normal" to those who have sports injuries. The laboratory was funded with more than SIOO,OOO from the Children's Guild, as well as funds from Variety Club (Tent No. 7) and Variety Club Women. The lab has three important functions. First it's intended to be a clinical facility where assessment of pre-operative patient performance and evaluation of postoperative surgical procedures and/or rehabilitation procedures can be completed. It is also a research facility where new types of equipment, for example, prosthetic-orthotic, can be designed and developed, where treatment protocols can be improved, and the basic kinesiology of human movement studied. Finally, it's a teaching facility where health professionals, specifically students from UB's schools of Medicine and Health Related Professions, can learn to understand the basis of human movement. The Vicon system is a complete system for biomechanical analysis and display. To measure movement in three dimensions, it combines three techniques: cinematography, electromyography, and force plate analysis. 2 4/BUFFALO PHYSIClA The patient, who wears a bathing suit or similar apparel, walks along a 40-foot walkway as video cameras record the walk. A force plate is imbedded in the walkway. Light-weight cylindrical markers are taped to the patient's skin at strategic points. Surface electrodes or wire electrodes are also affixed to the patient, connected to a mall amplifier pack located at the patient's waist. A telemetry system transmits the signals to a stationary receiving station. Also, micro-footswitches are taped to the heel, ball, and big toe of a patient's foot. A wire connects the footswitches to the EMG amplifier pack. All data is channeled into a computer. A natural gait is required for an accurate assessment, so the Vicon system minimizes the use of equipment or cables that would encumber the patient. And because it's important to reduce the effect of pain and/or fatigue, the system maximizes the collection of information during a minimum number of trials. Since human movement results from a complex interaction of the musculoskeletal and neural integration systems, it's necessary to examine and assimilate all these contributory variables. The Vicon system does that. The system, which employs state-of-theart equipment, was developed in England by a biomechanist. The Gait Analysis Laboratory is the only one of its kind in Western ew York, said Woolley, who with many others saw the need for such a facility. • �DENTS 2 students present research findings T wo UB medical students, summer fellows in the Medical School's 1984 Research Program, were selected to present their research projects nationally. Jeffrey Young, second-year medical student, described results of his project at the 1985 ational Student Forum in Galveston, Texas, and also at a session sponsored by the Juvenile Diabetes Foundation International held at the University of Pennsylvania, April I4-16, 1985. The purpose of his research was to evaluate the impact of long-term diabetes on muscle blood flow and oxygen transport during exercise. His advisors were Drs. David Pendergast, associate professor of physiology, andJehuda Steinbach, clinical associate professor of nuclear medicine and research associate professor of medicine. Michael Herrmann, third-year medical student, presented his research at the Seventh International Symposium on Germfree Research at orre Dame University in June, 1984. He tested various drugs that exhibit inhibitory activity on enzymes of the purine metabolic pathway. This is part of a search for a safe, economical, and reproducible technique to pretreat bone marrow prior to transplantation. His advisors were Drs. Patricia Bealmear and Joyce Jividen of Roswell ~~- . Seniors 'survive' Matching Day T he second most important event in a medical student's career became part of history again last April when 136 UB students survived Match Day. Or. Dennis Nadler, new assistant dean for student affairs and coordinator of the residency matching program, announced this year's results before the silent, suspense-filled auditorium. All but eight students were matched during the announcements; those eight have subsequently been matched. This year's results were similar to previous years, with 87 per cent matched to one of their first three choices, and 64 per cent matched to their first choice. Twelve others made arrangements outside the Match Program. The most popular specialties were internal medicine and surgery, followed by pediatrics, and family medicine. Thirtyseven percent of the seniors will remain in Buffalo-area programs. The matching is accomplished through the ational Resident Matching Program of Evanston, Illinois, whose computer generates the results. Students select residencies based upon their order of preference for programs and cities while the programs select students based on their review of the dean's letters of applications. The Class of '85 will now spend the next three to six years around the nation completing their residencies in order to obtain the proper credentials for medical practice. Other faculty who assisted Dr. Nadler in the process were Drs. Donald Barone, Murray Morphy, Steven Noyes, Richard Curran, Timothy Murphy, Peter Ostrow, and Daniel Morelli. • Ms. Post attends Columbia program T he College of Physicians and Surgeons of Columbia University awarded medical student Laura L. Post a grant of 500 to attend that university's three-day postgraduate medicine program on "Alcoholism and Drug Abuse-Problems in Clinical DecisionMaking" at the Smithers Alcoholism Treatment and Training Center of the St. Luke'sRoosevelt Hospital. Ms. Post was also elected to the Board of Trustees of the American Medical Student Association at their national convention in Chicago last spring. She will represent Region II. Her election wa~ reported in the April issue of New Pbysz• cian. JULY 1985/2 5 �Arthur Weissman at the piano in his University District living room. �STUDENTS T by Paul Mrozek he 1985 UB Medical School Talent Show received an extra dose of class from Arthur Weissman. That's class, as in classical piano. Weissman took the stage in jeans and sneakers. then took the audience by storm with a Beethoven piano sonata. Beethoven and casual attire usually don't lend themselves to each other, but Weissman's B.F.A. in musical performance doesn't seem to be congruent with a career in medicine, either. Weissman, Class of '86 UB School of Medicine, received a few double-takes when he entered med school. ow, almost everyone accepts him as an equal, and he has quite a few fans among his peers. He is presently doing part of his clinical clerkshop in pediatrics at Children's Hospital. When asked about his career decisions in music and medicine, Weissman replied, ''I've had the best of both worlds so far. When I graduated from Williamsville South High School in 1976, my heart was really set on the piano. I received a scholarship offer from UB's Music Department, so I jumped at the chance to continue my music. In college I became interested in medicine after my father (a psychiatrist) began to show me what he did in his practice. So I wrote to a handful of med schools to find out the courses they required for admission. Then I took all the required courses as electives in my junior and senior years." People outside of the Music Department may perceive a music degree as a somewhat easier accomplishment than other majors. Weissman begs to differ. ''It's not an easy degree. Some of the music courses are as difficult as med courses but in a different way. With a performance degree, a stude~t must give public concerts, department recitals, as well as performances before faculty review panels." There are a handful of UB med students and residents who have an artistic bent, which Weissman thinks is good for the school. "It is basically a self-contained program, so it can lend itself to this type of diversity. And it seems as if more and more schools are taking this into account in their admisions policies. I believe it can only help the school, the students, and the overall atmosphere" There are also some very practical advantages to music training as applied to medicine. Wi~h his acutely tr~ined ear Weissman had no trouble learnmg how to momtor a pat'ient's heart. In some instances, his hearing was too fine, and he had to learn to filter out extraneous noises when listening to a heart beat. Throughout his years of musical training one of Weissman's favorite composers has been Beetho~en. He relates not only to Beethoven's music, but also to the man. "I like to play a lot of Beethoven's works, but I've also studied Beethoven the person. From his life you learn about humanity, about suffering, how to accept difficulties, how to triumph over them. My appreciation of these qualities has made me into a better person, and I think they are qualities that every doctor should possess." Everyone knows the rigors of the academic grind that medical students endure. Long hours, 2'±-hour call, prodigious amounts of information that must be absorbed over short periods of time. Each student deals with the pressure in his or her own way. Weissman finds his music a great reliever of stress. When stationed in a hospital for a continuation of his clerkshop, one of the first things he does is find out if the facility has a piano. He plays when he is on call or on break. Working 72 hours a week, he still manages to find time to play at least several times per week. This outlet will become more valuable to him when he begins his residency, which has even longer hours and greater responsibilities. Most hospitals do have pianos, although not all the instruments are of the same quality. eissman explains: "Pianos are unique; they have perW sonalities with their own characteristics. One hospital I was stationed at had a piano with a short keyboard, so I couldn't play certain pieces on it which needed more than three octaves." Weissman wondered if he would be able to remember musical pieces while he was being bombarded with mountains of information in his med courses. "It's funnv I thought I might have difficulties trying to recall the musi~ for some works, but regardless of how much material I have to absorb for school, it doesn't affect my musical memory. I guess I must use different parts of the brain for each." At his home in the University District, Weissman plays on his Steinway. In winter, he doesn't play as much as he would like because the front room where the Steinway is kept gets too cold. "I have to soak my hands in warm water, which is something concert pianists do before performing. My wife thinks the best time for this is right after supper. At home in winter, even if I soak, my hands get cold after half an hour in the front room, so I really can't play too long on the Steinway." Summertimes are different. The neighbors seem to like it when the windows are open and he fills the block with the strains of Bach and Mozart. "No one's complained yet. And I do get some compliments. People two streets over know who I am, although I make it a point of courtesy not to play late at night." In addition to his love for classical piano, Weissman has a keen interest in pop music. As an undergraduate, he and several members of the Music Department formed a progressive jazz group called "Sienna," which played in several Buffalo bars. The group's JULY 1985/27 �musical preference ran toward jazz fusion in the vein of noted keyboardist Chick Corea, and the band "Return to Forever." Much of "Sienna's" repertoire consisted of original compositions. Although they never made it big, the band did have a small but loyal following . Weissman said, "We had a lot of fun, but we didn't play enough commercial music to become really popular. The best that can be said about 'Sienna' was that we never lost any money. Of course, that doesn't mean we made any either." All musicians develop a stage presence. It may not have much to do with the mechanics of playing an instrument, but it adds that extra vitality so important for audience/performer rapport . This disciplined flair can be a valuable asset to med students and residents. Weissman explains : "Presenting a patient, giving a concise H and P, can be a nerve-wracking experience, especially if it's in front of several hundred people. But I've done enough performances on the piano so that it hardly fazes me to get up in front of a crowd. That 's not to say that the presentation is easy, you have to prepare for it, and be ready to answer any questions that may arise." In UB 's Department of Music, Professor Stephen Manes was Weissman's undergraduate piano instructor. Manes states that Weissman is "a fine talent, an intelligent musician, very sensitive. He's just terrific on the piano. For his bachelor's degree recital, which is a public concert, Arthur gave one of the finest departmental recitals I've ever heard. And he did some very difficult pieces; I remember quite vividly his performance of Mussorgsky 's 'Pictures from an Exhibition' " Weissman credits his family for giving him the impetus to pursue dual careers. His father, Seymour Weissman , is a practicing psychiatrist, and he also plays the violin as a serious hobby. 28/B FFALO PHYSICIAN Arthur's mother, Gladys, has always had a deep appreciation for classical music, and has been a volunteer fund-raiser for the Buffalo Philharmonic. Arthur started taking piano lessons in third grade and hasn't stopped playing since. But his parents didn't push him . "They never ordered me to play the piano or go to med school. Growing up in a musical and medical environment just gave me the exposure to want to excel at both. My parents just said, pick a career and be the best you can." Giving him some extra support is Weissman's wife, Pat. She has a background in art with a B.S. from Buffalo State and is employed as art director for Tapecon Inc. Although they 've been married for five years, her husband can still surprise her. Pat remarks, "One day he's in the front room playing the piano. I walk by and glance at the stand for the music, and he has one of his med books propped up so he can study while he's playing." Weissman claims he's only done this once or twice when he's "trying to get through some really boring material. It's not very effective anyway." Weissman's two older brothers both pursue careers related to medicine. His brother Paul is employed as a computer programming consultant to hospitals. His brother joseph is an M.D, employed in a research capacity by Technicare, a company which makes MR's, now known as MRI's. Arthur Weissman's long-term goals are ambitious. Musically, he wants to progress until he feels he is able to perform as a serious classical pianist. In medicine, he still has some time to make decisions, but he's leaning toward specializing in surgery. With his finger dexterity, it doesn't look like he will have any difficulties tying the surgeon's knot. • �DR. CHARLES C. CANVER, CLINICAL ASSIS- tant instructor of surgery, informs us that he has published an article in the March 1985 New York State journal of Medicine, "Chlorpromazine in experimental gastric ulcers induced by restraint and cold stress." He is a surgical resident at Buffalo General Hospital. • DR. DAVID DUBE, ASSISTANT PROFESSOR OF medicine, spoke on Alzheimer's Disease on Health Call, a program aired over CableScope in Buffalo. He also reviewed ''Aging is for Everyone" on ''AM Buffalo," aired over Channel 7. Dr. Dube is an attending physician in medicine at the skilled nursing facility of Erie County Medical Center. • GOVERNOR MARIO M. CUOMO PRESENTED Dr. James F. Phillips, immediate past president of the Medical Society of the County of Erie, with the First Annual. Eleanor Roosevelt Community Service Award at recent ceremonies in Albany. The clinicil assistant professor of rehabilitation medicine accepted the award on behalf of the Medical Society and the United Way of Buffalo and Erie County as two of the principal organizers of a health care project for the unemployed and uninsured who are ineligible for Medicaid. The program marked its first anniversary on january 5, 1985 . More than 500 organizations throughout the state were nominated by the New York Voluntary Enterprise Commission, sponsor of the awards. Seventeen finalists were selected based on their outstanding ability to identify and meet a broad range of community and humanitarian needs, according to Governor Cuomo. "By acting on their concern for others, the recipients of these awards have had a direct positive impact on society," he added. • DR. ALAN J. DRINNAN, CLINICAL ASSISTANT professor of medicine and professor and chairman of the School of Dental Medicine's Department of Oral Medicine, was honored recently by Washington University which presented him with the William E. Koch Memorial Award for his outstanding contributions to continuing education in the fields of dental diagnostic sciences. Drinnan has also recently completed a videotape program on " Diagnosis of Tongue Diseases" for the etwork for Continuing Medical Education, a division of VIS, a national TV service available to hospitals and medical centers. • DR. JAMES P. NOLAN, PROFESSOR AND CHAIR- man of the Department of Medicine, has assumed office as a governor of the American College of Physicians, the 60,000-member national medical specialty society. Elected locally, Dr. Nolan will hold his post as the ACP governor of Upstate New York for four years. In his position, Dr. Nolan will keep the organization's members in his region up to date on the College's policies and activities, advise its ruling body of matters concerning his region, and recruit and endorse new members and Fellows. Also, included in Dr. olan's responsibilities are the planning and execution of an annual scientific and business regional meeting, and representing the College to the public. A 1955 graduate of the Yale University School of Medicine, Dr. Nolan is a specialist in internal medicine and liver disease. The American College of Physicians, founded in 1915, is the largest medical specialty society and represents doctors of internal medicine (internists), related subspecialists, and physicians in • training nationwide. DR. FRANCIS KWCKE, PROFESSOR OF MEDI- cine and physiology, has been named vice chairman of the American Heart Association's national council on circulation. The chief of cardiology at Erie County Medical Center was also program chairman of the 34th scientific session of the American College of Cardiology held March 11-15 in Anaheim, California. He and a 20-member committee planned a core curriculum of mini courses that presented a clinically-oriented review of cardiac disorders. Also on the program was an update on what is new in treatment of cardiac disorders. • JULY 1985/29 �PEOPLE development, evaluation, and issues in educational research. Dr. chimpfhauser received his Ph.D. in education and evaluation from The Ohio State niversity in 1972 and is associate professor in the Department of Social and Preventive Medicine where he teaches graduate courses in program planning and evaluation. Dr. Schimpfhauser recently co-directed the first University-wide Program on Faculty Development for new and recently hired faculty in which several Health Sciences faculty participated. He was also recently elected secretary to the University Faculty Senate. • A UB MEDICAL SCHOOL PROFFSSOR RECEIVED the Buffalo News' Citizen of the Year DR. HOWARD L. STOLL, JR., CLINICAL ASSOCIare professor of dermatology, has bet.n appointed chief of the Dermato logy Section at Roswell Park Memorial Institute. Certified by the American Board of Dermatology and Syphilology, Dr. StOll has been affiliated with Roswell Park's DermatOlogy Department ince 1958. Roswell Park's Dermatology Service deals with the detection, treatment, and control of skin tumors as well as developing improved methods of cancer treatment and prevention. Dr. Stoll, an alumnus of Harvard University and the University of Pennsylvania Medical chool, is a member of several prestigious national and regional professional organizations, including the American Academy of Dermatology, the ociety for Investigative Dermatology, and the Buffalo-Rochester Dermatological Society. Dr. toll has authored and/or coauthored over 40 journal articles and book chapters. • DR. FRANK SCHIMPFHAUSER, ASSISTA T dean for medical education and director of the Medical 's School 's Educational Evaluation and Research Unit, was recently appointed coordinator of the Educational Workshop program conducted annually at The Association of American Medical Colleges Meeting. Mini workshops for medical faculty, re idents, and admini trators focus on tOpics related to teaching improvement, curriculum 30 /BUFFALO PHYSICIA Award, as announced in the Sunday Buffalo News Jan. 27, 1985. One of eight selected for the award, Dr. John Border, professor of surgery, is internationally respected for his advances in the field of trauma surgery. He has directed the Erie County Medical Center's Trauma Center, one of only six in the nation, since 1968. He is also research professor of biophysics. The Buffalo News recognized him for his contribution to reducing death rates and increasing productivity of accident victims. He has pioneered treatment techniques, including the use of amino acidrich intravenous fluids, that help trauma victims recover from severe multiple injuries. He has served as an officer of several local and national surgical societies and was guest editOr of the Wcrld Journal of Surgery's volume on multiple trauma published last January. • The second grant of 63,493, will aid in the study of the effects of mal nutrition on Rotavirus infection and immunity. Dr. Marie Riepenhoff-Talty, assistant professor of pediatrics and microbiology, will be principal investigatOr of this study which will examine the effects of nutrition on the outcome of this virus which is often one of the most common causes of diarrhea in young children. Dr. Ogra will be working as co-principal investigatOr in this study which will look at behavior patterns in mice in order to determine the reason for the susceptibility to malnutrition a a result of the Rotavirus infection. • DR. BERTRAM PORTIN, CLINICAL PROFFSSOR of surgery, has been elected president of the American Board of Colon-Rectal Sur~y • DR. GERALD P. MURPHY, RFSEARCH PROFFSsor of urology and Roswell Park Memorial Institute director, was recentl y reelected secretary-general of the International Union Against Cancer. • DR. IMRE MAGOSS, PROFFSSOR OF UROWGY, is president-elect of the W Y Chapter of the American College of Surgeons. He also received the Chester A. Kmack lectureship award from Hoffman-LaRoche Co. Dr. Magoss is chief of urology at Erie County Medical Center. • DR. DIANE COOKFAIR, ASSISTANT PROFESSOR of social and preventive medicine, spent part of last December and January in Paris on an International Union Against Cancer Travel Fellowship to work at the Inserm Institute. • THE ATIONAL INSTITUTE OF ALLERGY AND DR. M. STEVEN PIVER, CLINICAL PROFFSSOR Infectious Diseases has awarded two grants totalling 174',321 to Children's Hospital for the Division of Infectious Diseases. Dr. Pe aray Ogra , professor of pediatrics and microbiology, will be principal investigator of a 110,828 grant to further the study of Immune Response to Respiratory Syncytial Virus. The purpose of this study is to look at the mechanisms by which children develop such respiratOry problems as asthma as a result of this common virus which usually occurs in the first two years of life. of gyn/ob and deputy director of gynecologic oncology at Roswell Park , was reelected president of the jewish Famil y Service of Buffalo and Erie County, an organization which offers aid to the unemployed and underemployed, coordinates mental heal th programs, and coun els troubled individual . • DR. WILLIAM}. BREEN, CLINICAL ASSISTANT professor of medicine, was appointed to serve on the Medical Society of the State of ew York 's Committee on Cardiovascular Disease. • �()P CHILDREN'S HOSPITAL HAS ANNOUNCED THE installation of the Hospital's 1985 Medical Board Officers. They are: John E. Fish-. er, M.D., president; Leo A. Kane, M.D., vice p resident ; John Menchini, M.D. , secretary-treasurer. The officers act as liaisons between the Board of Trustees and the medical and dental staffs. In addition , they make medical recommendations and coordinate and supervise medical staff activities. Dr. Fisher, president, is director of the Department of Pathology at Children's. A UB clinical associate professor of pathology, he is also a certified anatomic and clinical patholigist. A fellow of the College of American Pathologists and a member of the Society for Pediatric Pathology, he also serves as president of the Western New Yo rk Society of Pathologists. Dr. Fisher graduated from the University of Dublin, Ireland , and has been on the Hospital staff for 14 years. Dr. Kane, vice president, is assistant director of anesthesiology at Children's, as well as a UB assistant clinical professor of anesthesiology. He is a member of the American Society of Anesthesiology and the ew York State Medical Society. Dr. Kane received his medical degree from UB and has been at Children's for over 20 years. Secretary-treasurer, Dr. Menchini, is an attending pediatrician at Children's. He is also a UB clinical assistant professor of pediatrics and is in private practice in Buffalo. A graduate of Canisius, he holds a medical degree from UB. Dr. Menchini has been on the Children's staff for 12 years. • ogy ; treasurer, Dr. James Evans, associate professor of surgery; and secretary, Dr. Jan Novak, assistant professor of medi• cine . DR. ADRIAN VLAD UTIU, PROFESSOR OF microbiology and pathology, received the AMA's Physician's Recognition Award and the Pathology Continuing Medical Education Award from the American Society of Clinical Pathology. He is also research associate professor of medicine at UB. • DR. FRANK BAKER , PROFESSOR OF SOCIAL and preventive medicine and psychology, has left UB to become professor and chairman of the Department of Behavioral Sciences and Health Education at the johns Hopkins University School of Hygiene and Public Health . He was director of the Division of Community Psychiatry here. • DR. HAROLD BRODY, PROFESSOR AND CHAIRman of the Department of Anatomical Sciences, was honored by the Community Action Corps for his contribution to older citizens related to his research on the aging brain. The Community Action Corps, one of UB 's largest student organizations, presented the award at a May 3 reception in observance of Older Americans Month. Dr. Brody was one of four honored. Co-sponsoring the event were the Western New York Geriatric Education Center, the Network in Aging, and Center for the Study of Aging, as well as several other UB departments and student groups. • DR. JOHN LaDUCA, CLINICAL ASSOCIATE professor of surgery, is the new president of the medical-dental staff of Erie County Medical Center, where he is attending in surge ry. The new president-elect is Dr. Ross Markello, professor of anesthesia!- DR. WALTER S. WALLS, CLINICAL ASSISTANT professor of gyn /ob, was appointed to serve on the Medical Society of the State of New York's Committee on Maternal and Child Health . • DR. GUSTAVE P. MILKEY, CLINICAL ASSOCIATE professor of surgery, has been elected president of the Kenmore Mercy Hospital Medical Staff for 1985. Dr. Mil key joined the hospital's surgical staff in 1951 , after earning his degree from the Syracuse University College of Medicine. He interned at Buffalo General Hospital before completing his residency training at Buffalo General , Millard Fillmore, and Meyer Memorial hospitals. Dr. Milkey is a fellow of the American College of Surgeons and is certified by the • American Board of Surgery. JULY 1985/31 �LETTERS Writer defends McKinley's care Editor: I certainly enjoyed your account of Dr. Jacobsen's long-standing intere t in the McKinley assassination. Even for a medical student graduating in 1962, that event in Buffalo's history held considerable appeal. I first read about the care rendered to McKinley soon after I located publications written by and about Roswell Park in secondhand bookstores along Allen Street. This led to my own research of the events following McKinley's injury. Park may well have been disappointed that his return from iagara Falls was not awaited before the decision was made to explore the President's abdomen. However my sources indicate that Park did arrive at the scene of surgery before the procedure was completed. He was quoted as saying he approved of all that had been done. Perhaps he was being discreet rather than candid at a moment when divisiveness among the surgical consultants would have been counterproductive. As I progressed through my surgical residency, I re-examined McKinley's post-operative care in the context of modern trauma management standards. Eventually, I wrote my own version of the story for Resident and Staff Physician in March, 1968. My opinion then and now is that the bullet McKinley took in hi upper abdomen led to traumatic pancreatiti and that omissions in fluid management were more contributory to his death than was the conduct of his laparotomy. How critical can we be today looking back on an event that ought to be judged by the medical standards of that day? I can understand why the President's surgeons wanted to operate quickly. Rapid death due to exsanguination following abdominal gunshot injuries was well known in those days. M.A.S.T. suits were not yet invented; blood banks were not available. Conditions for surgery were cer32/BUFFALO PHY !CIA tainly not ideal on the Exposition grounds but neither were they in iagara Falls or in other small Western ew York communities where Roswell Park, and perhaps also Howard Mann, traveled frequently to operate. And there was no shortage of consultants. The growing team of surgeons ready to offer assistance included Drs. Rixey, Mynter, and Parmenter in addition to Mann and Park. Ch:~rles McBurney of ew York had also been called to Buffalo as a special consultant. He arrived, saw that McKinley was doing well, predicted recovery, and left promptly, only to learn of the President's death after he returned to ew York. Roswell Park himself, who had taken a personal look at the bullet's damage before the incision was closed, predicted full recovery; his words were quoted widely in the press. The President did well for five days. However, on the morning of the sixth post-operative day, his pulse was rapid, his color pale. Weakness of the heart was feared and digitalis prescribed. He had eaten breakfast but now his abdomen reflected signs of ileus. Dr. Charles Stockton, professor of medicine at UB, saw him that day and concluded that a "mild intestinal toxemia" had set in . Traumatic pancreatitiS was unknown in that day; chemical determination of circulating amylase was not yet possible nor was its significance understood. Fluid accumulation in a nonfunctional third space was not a concept McKinley's surgeons could perceive or act upon. �LE1.~fERS Total recorded fluids administered the sixth and seventh days were less than 2000 cc, not even enough for replacement of basic requirements! Drugs given on the seventh day were all stimulants : camphor, nitroglycerine, strychnine, adrenalin, even brandy! Several enemas were given (no doubt worsening the President's electrolyte status I suspect). Everyone, Dr. Stockton included, feared that the heart was failing, and in a way it was, although not from lack of pumping capacity. McKinley's pulse was sky high! What was missing was a circulatory volume to pump. The patient was in shock! Urine output had fallen severely the final day and specific gravity measurements reflected severe urinary concentration. The pathologists' autopsy appears to have been done as hastily as Dr. Mann's surgery. Nevertheless we know that the gastric suture lines remained intact. The principal finding was "retroperiteal gangrene" according to the pathologist but what he was looking at was a hemorrhagic edematous pancreas. Dr. Jacobsen is well aware of the retrospective quarterbacking that goes on after any Presidential illness or accident. I am personally acquainted with a member of President Kennedy's resuscitation team; that was a herculean effort doomed to failure because of the extent of the injury. evertheless, Kennedy's doctors experienced considerable abuse for their unsuccessful efforts. McKinley's team was similarly maligned in the press as Dr. Jacobsen points out. However, I wonder whether Professor Stockton was justified if he indeed criticized Mann's surgery publicly. Stockton after all was an integral player on the team attending the President. Nether he nor any of the surgeons were aware of the pathophysiology or fluid dynamics of McKinley's cause of death. Would Park have succeeded where Mann failed? Roswell Park was in fact a skillful, imaginative, visionary surgeon. He would have known enough to place a drain. Mann was more familiar with the pelvic organs than he was familiar with the pancreas and its fragility. However, I doubt that a drain would have been the deciding factor. either am I convinced of the validity of comparing Dr. Mann's failure with Dr. Park's subsequent success saving the life of a woman with a selfinduced upper abdominal gunshot wound. Do we know for certain whether her pancreas was at the terminus of the bullet's trajectory? The McKinley assassination makes for an interesting analysis of skilled physicians and surgeons under sudden pressure to perform without error and without failure while under constant press scrutiny. The challenge is too great! In the case of Presidential illness or injury, there are always more cooks stirring the pot than are required for the desired results. My conclusion is that Buffalo surgeons distinguished themselves as well as any of the medical teams attending the final hours of the four U.S. Presidents we have lost to assassins' • bullets. jack C. Fisher, M.D. (M'62) Professor and Head, Division of Plastic Surgery University of California School Of Medicine and Medical Center, San Diego The Buffalo Physician invites your reactions and comments on articles appearing in the magazine. Please address letters to: Editor, Buffalo Physician, 136 Crofts Hall, Buffalo, N.Y. 14260 JULY 1985/33 �( Five UB Medical School alumni are the new officers of Buffalo General's medical staff. Dr. RogerS. Dayer, clinical professor of surgery, has been named president of the staff for 1985. Serving a one-year term, he heads a medical staff of nearly 900 physicians. He assumed office on January 28, 1985. Dr. Dayer (M'60) is a surgeon at Buffalo General. He has been on the BGH staff since 1961 and has served in the military as chief surgeon at Fort McPherson. A member of the American College of Surgeons, the American Society of Gastrointestinal Endoscopy and the Erie County Medical Society, Dr. Dayer has been appointed to numerous committees. The new president-elect is ored with the Distinguished Allergist Award by the American College of Allergists and received a commendation from the Veterans Administration Medical Center. A founding member and past president of the Buffalo and Erie County Allergy Society, he is a life member of the Association of Military Surgeons. He has been published widely in allergy journals including thejournal of Allergy and Annals of Allerg)\ a well as in several pediatric and general medical journals. He is a Fellow in the American Association of Certified Allergists, the American Academy of Allergy, the American College of Allergy, and the Royal Society of Medicine. A county medical society member, he is also a past president of the Medical Historical Society of Buffalo and Erie County. Donald R . Ehre nre i c h (M'5 3), clinical professor of neurology; new vice president, Sidney Anthone (M'50), clinical professor of surgery; new secretary, Robe rt A. Milch (M '68) , clinical a sistant professor of surgery; and new treasurer, Thomas D. Doe blin (M'59), clinical associate professor of medicine. 1920's VICI'OR L. COHEN (M '2 9) • associate professor emeritus of pediatrics, was recently hon- 34/BUFFALO PHY !CIA 1940's Academy of Ophthalmology. MAX A. SCHNEIDER (M'49) • was honored as "Man of the Year" by the Southern California Alcohol & Traffic Association in Los Angeles on February 12, 1985. Dr. Schneider informs us that his acceptance speech emphasized that the use of alcohol and other mind altering drugs is a "people problem," not just a police enforcement problem. He recommended that all levels of education from grade school through junior and senior high school include once-a-month group therapy "to help kids deal with their feelings and needs if we are to reall? prevent the prime causes of death and disease in America's youth-accidents, homicide, and suicide." Dr. Schneider is currently the associate director of recovery services at St. Joseph Hospital (Orange County, CA), president of The California Society for the Treatment of Alcoholism and Other Drug Dependencies, president-elect of the American Medical Society on Alcoholism, a board member of the ational Council on Alcoholism both locally and nationally, and holds appointments in both the Departments of Medicine and Psychiatry of the niversity of California at Irvine College of Medicine. clinical associate professor of ophthalmology, was elected vice president of the American Society of Ophthalmic Plastic and Reconstructive Surgery for 1985 at the society's annual meeting in Atlanta. Dr. Schaefer also gave two post-graduate courses on plastic and reconstructive surgery at the annual meeting of the American JOEL M. BERNSTEIN (M '61 , Ph.D. ' 72) • clinical assistant professor of otolaryngology and pediatrics, gave an update on the pathogene i and management of otitis media with effusion to the 41st Annual Congress of the American College of Allergists at Bal Harbour, Fla., in February 1985. Dr. Bernstein also lectured at two ear research conferences in January, 1985, with Dr. Hiroy uki Tsutsumi, research instructor of pediatrics, Dr. Pearay Ogra, professor of microbiology and pediatrics, and Drs. Byung Park and James Humbert, both professors of pediatrics. EUGENE CIMINO (M '6I) • is co- chairman, Department of Ophthalmology, at St. Mary's Hospital in Rochester. 1970's ERIC RUSSELL (M'74) • informs us that his two most recent articles have been published in Radiology and Neurologic Clinics. He is an assistant professor of diagnostic radiology at Rush Medical School, Chicago. The AOA (1973) member is married to Sandra Fernbach, M.D., and their daughter Gabrielle just turned two. 1950's ANGEW M. DEL BASO (M'78) • EUGENE SIGMAN (M' 52) • form- ARTHUR J. SCHAEFER (M'47) • 1960's er associate professor of surgery at B, has been named dean of the University of Connecticut School of Medicine. He has been an associate dean and surgery professor there since leaving Buffalo. The Buffalo native interned at Buffalo General and VA Medical Center. Urology and cancer research are among his specialties. was recently appointed a professor lecturer in oral pathology at Georgetown University. He also is an assistant professor in the Department of Radiology and uclear Medicine at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, and recently was granted membership in the American Society of Head and Neck Radiologists. He earned �C . 1 ~C)TES & l)EATIIS his D.D.S. and an M.A. in pharmacology from UB. A radiologist at Providence Hospital in Washington, D.C., he recently appeared on the Washington Talk Show "Focus on Washington" to discuss the new ways to treat problems of temporomandibular joint dysfunction and radiographic diagnosis. He was previously in charge of head and neck radiology at the U.S. aval Hospital in Bethesda. REGINALD B. STILES {M'77) • is in family practice in Fort Wayne, Indiana, and is a clinical instructor with Indiana niversity. The AMA member is also a member of the Allen County Medical Society and an AAFP diplomate. 1980's ISAIAH PINCKNEY II (M'82) • was the recipient in September of the President's Award of the ational Council of Educational Opp9rtunity Associations. Dr. Pinckney is currently chief resident in the Family Practice Program at Brookdale Hospital, Brooklyn, ew York. missed and warmly remembered by all those who knew him. He was director of the joint Divisions of Medical/Human Genetics at UB, Buffalo General, and Children's Hospital. Born in England, Dr. Bannerman was a graduate of Oxford University and St. Thomas' Hospital Medical School in London. In 1957 he came to the U.S. to accept a fellowship at the Johns Hopkins niversity Hospital. In 1963 he became head of the Medical Genetics Unit at Buffalo General and in 1975 director of the Division of Human Genetics at Children's Hospital of Buffalo, thereby consolidating genetics in the Western ew York area. Robin Bannerman was a distinguished scholar who made valuable contributions to medical knowledge in fields of hematology and medical genetics, including major research with new hereditary anemias. He maintained a clinical practice, and was actively involved in teaching as well as in research leading to numerous significant publications in his field. He was a visiting professor at medical schools and institutions in Paraguay, the West Indies, and the universities of Cambridge and London. During the 1983 Medical Genetics Exchange Symposium, he was a group leader. The former president of the Medical Historical Society of W Y was also on the board of the American Society of Human Genetics. He was a member of numerous medical genetics and hematology societies. His survivors are his wife, Franca; and three daughters: Dr. Catherine, Francesca, and Isabella. Donations to his memorial fund may be sent to Division of Medical Genetics, Department of Medicine, Buffalo General Hospital, 100 High t., Buffalo, .Y. 14203 or to Hospice Buffalo, 1212 Main St., Buffalo, N.Y. DR. FRANCIS KENNY (M'3 1) • a retired Buffalo physician who specialized in heart diseases, died January 22, 1985, at 77 after a long illness. A clinical assistant professor of medicine at UB for 22 years, he had long affiliations with St. Francis Hospital in Buffalo and Buffalo General Hospital (where he completed his residency). At St. Francis, he served as chief of staff and chief of medicine. The Buffalo native maintained his private practice for 46 years and retired in 1977. He was a member of the Bishop's Board of Governors of the Catholic Diocese of Buffalo and an honorary life member in the Knights of Columbus. He was also a member of Alpha Omega Alpha medical honor society. Surviving are his wife, Helen; two sons, Francis and John; a daughter, Eileen; two sisters and three grandchildren. DR. ROBIN BANNERMAN, internationally renowned geneticist, died of pancreatic cancer on March 8, 1985. The professor of medicine and pediatrics who was on the faculty since 1963 will be DR. JOHN} . PATTI, 75, (M'38) • former town of Sherman, .Y. health officer and school physician, died April 13, 1985. He was graduated from Canisius College and interned at Our Lady of Victory Hospital, opening his practice in 1940. The Dunkirk native interrupted his practice by serving in the U.S. Army Medical Corps in World War II. He ran a community immunology clinic and served the town and the School Board. A member of the county, state and national medical associatins, he was affiliated with several Chautauqua County hospitals. Surviving are his wife, Estelle; three daughters Verity Mae, Suzanne, and Cynthia; a stepson, Mark; a stepdaughter, Paula ; a brother Joseph; and seven grandchildren. JULY 1985/3 5 �DR. BERNARD H. SMITH , the dean of Buffalo neurologists who established UB's first, full-time academic Department of Neurology and its first neurology residence program died January 24 at his Eggertsville home. His appointment to UB in the mid-1950s launched an era in Buffalo medicine which saw neurology emerge as a specialty in its own right after years of historically being intertwined with psychiatry. Dr. Smith's classic, elegant teaching style, which inspired and mesmerized his students in the classroom, was equal to his talent as a bedside teacher in the hospital. A brilliant scholar, he sought to expand his students' minds and imaginations by frequently punctuating his lectures with quotes from Burns, Keats, and others. A skilled teacher at virtually all levels, Dr. Smith was known for his ability to communicate with patients and their families as well as with medical students, residents, and professional colleagues. In establishing B's first neurology residency program , Dr. Smith, who retired in 1979, saw many of those he trained go on to head their own departments of neurology or establish private practices around the country. Some of his residents have ventured far from Buffalo and are practicing and teaching in France, Spain, India, Japan, and Korea. Prior to coming to Buffalo in 1953 , Dr. Smith was a fellow at Montreal Neurological Institute as well as a lecturer in neurology at McGill University and an assistant in Outdoor Clinics at Montreal's Royal Victoria Hospital. A native of Scotland, he graduated M.B., Ch.B. with first class honors from the niversity of Aberdeen Medical School. In 1950, he received the diploma in psychological medicine from London University and six years later, the M.D. degree with honors for his thesis on epilepsy from the University of Aberdeen. Dr. Smith's lengthy medical career began as a house physician and surgeon at Aberdeen Royal Infirmary. He entered the Royal Army Medical Corps in 1941 where he earned the rank of 36/BUFFALO PHYSICIA Lt. Colonel and after World War II , served as a consultant in nutrition with U RRA. He came to the U.S. in 1950 as a fellow at Cincinnati General Hospital. In addition to his commitment to teaching, Dr. Smith authored three textbooks on neurological subjects, including Principles of Clinical Neurology. He was a prolific contributor to professional journals on a variety of neurologic subjects and had served as an advisor to Consultant and Physician and as a member of the editorial advisory board of Psychosomatics. Dr. Smith was a fellow of the Royal College of Physicians of London, certified by the American Board of Psychiatry and eurology in eurology with special competence in child neurology, a fellow of the Royal College of Physicians and Surgeons of Canada, and a Foundation Fellow of the Royal College of Psychiatrists. He served as head of the Department of Neurology at E.). Meyer Memorial Hospital for 19 years and was a consultant to the Veterans Administration Medical Center, Millard Fillmore Hospital, Roswell Park Memorial Institute, iagara Falls Memorial Medical Center, Brooks Memorial Hospital (Dunkirk), Gowanda Psychiatric Center, ). . Adam State School, and Craig Developmental Center. Dr. Smith had been a visiting professor at several institutions, including the niversity of Colorado at Denver, the niversity of Toronto, and the University of Maryland at Baltimore. After his retirement from B, he continued his interest in nature conservation and preservation of wildlife. A keen amateur photographer, he never missed an opportunity to expand his education, taking two semesters of Greek at UB and later the study of Gaelic. He continued to travel abroad, an activity which had interested him from the days of his Royal Army Medical Corps service in India and Burma which had been highlighted by a walking trip he made into Tibet in 1944. Dr. Smith is survived by his wife, the former Ruth Hanna. DR. MARIO MONTES, 62, chief of laboratory services at Veterans Hospital and professor of pathology at UB, died January 30, 1985, after a month-long illness. On the medical school's faculty since 1962, he held a special place for those who knew him, and the Annual Medical School Talent Show was dedicated to him. A native of Lima , Peru , he earned his medical degree from San Marcos University tn 1952. He came to Buffalo in 1953 on a fellowship from Buffalo General Hospital and spent his career at many area hospitals, including Buffalo General, Mercy, Erie County Medical Center, and Lockport Memorial. He became a professor at the Medical School in 1984. Dr. Montes was a member of various professional groups and an avid writer, tennis player, student of philosophy, and supporter of antinuclear activities in his spare time. Besides his 84 scientific publications, his poetry was widely published and well-known in Spanish-speaking countries. One of his major poetry works is The House of The Twilight Voices (English name). Survivors include his wife, Ann ; a son, Michael of New York; and a brother, Alberto, of Lima, Peru. �l)AR 8TH NATIONAL CONFERENCE ON PEDIATRIC/ADULT ALLERGY ANDCLINICAL IMMUNOWGY • July 11-13, 1985. Toronto, Ontario, Canada. Contact: Rayna Saville, Coordinator, Continuing Medical Education, Children's Hospital of Buffalo, 219 Bryant Street, Buffalo, ew York 14222, (716) 878-7630/7640 . • PLANT FLAVONOIDS IN BIOWGY AND MEDICINE: BIOCHEMICAL, PHARMACOWGICAL AND STRUCTURE-ACTIVITY RELATIONSHIPS • July 22-26, 1985. Buffalo, New York. Contact: Elliott Middleton, Jr., M.D., Director, Allergy Division, Buffalo General Hospital, 100 High Street, Buffalo, New York 14203, (716) 845-2985. • CAPE COD CONFER- ENCE ON PEDIATRICS • August 2-4, 1985. Hyannis, Massachusetts. Contact: Rayna Saville, Coordinator, Continuing Medical Education, Children's Hospital, 219 Bryant Street, Buffalo, ew York 14222, (716) 878-7630/7640 . • 3RD INTERNATIONAL SYMPOSIUM ON INFANT NUTRITION AND GASTROINTESTINAL DISEASE • August 25-30, 1985. Brussels, Belgium. Contact: Rayna Saville, Coordinator, Continuing Medical Education, Children's Hospital, 219 Bryant Street, Buffalo, ew York 14222, (716) 878-7630/7640 . • AMERICAN PHYSIOWGICAL SOCIETY • Fall Meeting, October 13-18, 1985. Niagara Falls, ew York. Contact: Leon Farhi, Chairman, Department of Physiology, 104 Sherman Annex, S NY at Buffalo, Buffalo, New York 14214, (716) 831-2739. • EIGHTH INTERNATIONAL CONFERENCE ON LABELED ANTIBODIES • November 5-7, 1985. Tokyo, Japan. Contact: Dr. E. Beutner, Department of Microbiology, 219 Sherman Hall, S NY at Buffalo, Buffalo, ew York 1<+214, (716) • 831-2905. ERRATUM' -~~--------------------------------------------------------------- I BUSINESS REPLY MAIL POSTAGE WILL BE PAID BY ADDRE:SSE:E: Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, New York 14214 J �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO, NEW YORK 14214 -----------------------------------------------------------------~ LET US HEAR FRO YOU Fill out th1 c rd print or type II entrie ) (PI Year MD Received Nm Office Addr ss Home Addr s If not UB, MD received from In Priv te Pr ctlce: Yes Sp 0 y F I,. In Academic Medlcln : '1: e S hool Other: M dlcal oci ty News: H yo ember hlp h ng d po s p b h d � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, July 1985 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1985-July Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1985-v19n02-July Table Of Contents A list of subunits of the resource. The Unsung Heroes of Medicine The Curious History of Body Dissection One for the Records Tracking the Sense of Touch Medical School News Hospitals Students People Letters Class Notes Deaths Calendar Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-15 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v19n02 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1985 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/947128a7da08519da866691db0817e32.pdf 23098d7601c26d400e01f3f9c20b368f PDF Text Text \olum~ PHYSICIANS FOR THE 21st CENJ:URY 19, umber l, la, 198<; �Message from the Dean 11( iffi Ph l El IIOR l t t he repon hut .11 :11 d I H h • ur r 1 D t'lh 111 .md h m p I) [) u t J g ~ m um und r r [) [) ht rogrnm cd Ph I d I are gen( r.111\ tx. en , onh\\ h1le "e re on er , kfl un aid Taken e the moue k G 110 PIT I o Gene IJ n 1 n ( n '- n h r:uu n )f nd ore I lcd1 al mer ~ la r orl I In lllUtC trail n l'rodm cd ""' ct, r /I tb( cl oof tat, l 1111 ti/ IJuffalu H e II fair 11 r n or R /m W/1 II II 1th ICIIIC' if <11 ) ork rdle r 10 red m math • head th pcr,pect1\ nd \alue ahc: ur mtd health, II n - Job11 Vice Pre /dent for t,J 1rr} }OU ~~ .1 011 a1'gbton, t.D . li11ical Aff11irs A Message from the Medical Alumni Association II e uc (pag 2"'7)1 th f111.ah1.cd 8th p rm I I b deH>ted t the tlmd} uh1c(t of r ed b our progr.im chairm cir rcspeltl\c fi Id of end ht."gr,cn b\ Edmund The The cmr K, cl km d Progmm m:111011 all re to kton \\n d 1 h<."rof due pa, m alumni h s mad II po 1hk to ha , c mg re cpuon f. r th m nc n llcgt of Ph} 1C1an m Z9 19 'i ccmg , ou .it prmg Chm .ii Da, J I th Buflal Mam ue: nal '\ m I I am loo Inn aturd \ t I\ - Carmelo Pre J 11 \ . rme11ia ldt>111 , M' 9 �------ -- ---------------- ~ - - - ------ BUFFALO PHYSICIAN 3 PHYSICIANS FOR THE 21 t CENTURY • blue ribbon panel of medical educator ha relea ed a long­ a aired report that r commend immediate major r tructuring of the y t m rhich educate and train future phy ician B Medical chool official apprai our · el tive Program (') and admi ions program (8), in light of the e r comm ndati n . 10 EAR IMPLANTS • Two B otolaryngol gi t are pioneering dev lopm nt with ne and promi ing ochlear implant for the deaf. ELEGA CE I MEDICINE • n e ay by a Buffalo phy ician a k , ' uld you tru t a doctor ith an alligaror on hi long white 12 14 • oat'?. THE SURVIVORS' CHILDRE .B p ychologi t ha embarked on a major tudy of the children of Holocau t urvivor chat may hed light on how the horror of orld ar II affect lacer g neracion . Med student in anatom y lab : 1s /be training too scientific? RE EARCH • HO PITALS • Two ' B geron ­ tologisc. initiate study of care for the elderl} . ur ­ gery can aid tho c with pain­ less narrowing of oronary arcerie . 1 e" stud) designed to fight diabcte . Coro ­ nary angioplasty prove effective :tool quaiac test beginning to gain acceptance . Ami ­ tumor drugs studied. Photo d~ namic chcor) closer co FDA ap­ proval I Ro well Park recei\ ·e. ➔ 33. 36 grant from N I. Kid­ ner Center open · Pediatric Dialysis Cnic. B H com puterizes it operating room schedule . LB Dental ' chool changes its name 22 Tl'DE , T BOOK • 'The Painful Pres rip ­ cion ': Rationing Ho pital arc 28 PEOPLE • Phy ­ sician donate rare book of Leonardo 's ana­ tomical drawings . Other ne" · of people you kno" 30 CLA • ward winner . and the Annual 24 Talent ho" DEATH OTE • 3'1 • 36 ��PHYSICIANS 21stCENTURY FOR THE I t 'as half a century ago •hen the la t major ov rhaul of the American med ­ ical education y tern a attempted. ow, 52 :ear later, a blue ribbon panel of medical educator has relea ·ed a long-a 'aired report that recommend immediate, major restructuring of the y tern which edu ate and train futur physicians. Th e chang are d cribed in "Phy ician For the 21 t Century," the report of a pan I e tabli hed by the A ociation of American Medical Coll g , 1 hich represent all 121 medical chool in the .. , including UB' chool of Medi­ cine. The committee· full nam i th Panel on the General Profe sional Educa­ tion of the Phy ician and College Preparation for edicine. iting what they perceive a an accelerated erosion of the medical educa ­ tion y tern, panel member fi el that determin d action mu t be taken now to arre ·t the tr nd befor ''critical and irrever ible damage is don ." The GPEP Report, a it i now known (for it acronym taken from "General Profe ionaJ Education of th Phy ician"), arrives at five conclusions embody­ ing a numb r of g neral principles. It trongly ·rates that the medical education y tern hould reduce the role of rote memorization and lecture tim and hift emphasis toward learning the proper attitud s value , and kill befitting a caring and humane practitioner. A ociated with thi ignificant hift would be greater encouragement of tu­ dent to broaden their I arning experi nee with a liberal education rather than the narro er, mor pecialized scientific mphasis that currently predominate both the pre-medical and medical years. ~ w UJ ...I 0 BY BRUCE S. KERSHNER a: ~ §:c a.. 3 �tive . Thi · poli y i reflected in the urriculum committe ' deci ion made prior to the GPEP Report . The e deci ion re uced lecture time at the chool co the 20 to 30 hour per week range , quarely in the middle for all medi al f ho I and con iderablv le than the 30 to ➔ O hour . ome chool . · Ho e-,er, Dr . 0 trow and aughco n feel that furth er reduction in lecture time would be difficult to achie e and reduction of mem rization ·could even be detrimental. They empha i7..edthat factual knowledge of medicine i e.·panding t o rapidly co reduce o r eliminate memori 7..ation. " Medical edu acion is inherentl y diffi cult ," Dr . O trow tare . " Th e task of memorization i mu ch greater today (and mu h more anxiet y-producing ) than a generation ago. tudentJ today mu t unav o idably face chi · dilemma : while rhe amount of data is continually ri ing. the amount of time co learn it has remained tati c." The que tion i not if we can furth er reduce the amount o f memorizati o n but ..which fact are mo t relevant to be taught ?" • hat is done with time formerly allotted to lecture ? That r duced lecture time at the 1edical chool ha been partly replaced by more onferenc time , ·mall group tutorial. and laboratory experience . " Th concept that medical chool hould encamp edu cational diver ity i a very constructive recommendation ," Or. aughton agrees. hile exi •ting alternative learning t rmat are ade­ quate for now , che dean notes that " we have the opportu ­ me hange in the furur , however . That nity to make opportunity will o me hen the new m dical chool faility open in 19 . It ill give u more small eminar r om . If ·e'v had a prob! m in the pa t with the l cure part of ur program , it ' becau e our facilitie have not lent them ·elve to alternate wav of teaching . The new facility ill provide that opportunity. " The de-empha i f memorizati o n of fact in medi ­ cal , ch ol hould b balanced. the report maintain , by en uring that tudent learn the technique of learning . Thi i so independent learning and problem . olving can be undertaken by the cudem apart from the convenci n­ • I " e tea h/you learn " approach of lecture ·. ince it i impo ible to teach (or to learn) all the fact . of medi ine within four year , the panel' 29 member . indicate that thL approach will hone the pr blem- olving kill. doc ­ tor ill need to diagno e and treat patient on a daily bai . It hou ld al o enable them tO keep up with the rapid growth of medical knowledge, through continuing edu ­ cati n , long after they have left medi al h I. recommitmenc t0 education a the foremost goal of medical chool i promoted by the report . It claim . that the prioritie , re ognition, and rewards accorded to re earch, patient care, and training of resident . and radu­ at tudent " has militated again t the education of medi ­ cal tudenc ," and urges that this profe c. ional education be reemphasized and reinvigorated. The report ees two change of faculty involvem ent a es ntial to thi recommitment to education a · a pri ­ ority . Fil'. t it urge a more inten e invol\'ement of faculty in the role of mentor and clerkship up rvi or ·. econd, it ould like co ee profe or working more with mailer group of student in tutoriaJs, eminar , and other cuing as alternativ to lecture cime. B ide inc rea •ing the relative priority of education among medical chool endeavor , e eral propo al are aimed at increa ing both the continuity and coh ivene s of the medical curriculum. The report ugge t way to inc grate the ba ic and clinical ien e , a well a t mooch the transition from th clini al year, of medical chool into the re idency . Cohe ivene of the curriculum ould al o be enhanced by creation of "an interdi cipli ­ nary and interdepartmental organi7..ation of fa ulty mem ­ ber to formulate a coherent and comprehen ive educational program ." Thi council ould en ure that compatibility b tween di cipline and concerns between department wou ld be addre sect. ow that adrnini trator and faculty at B' Medical hool have had ome rime t dige t the report· _ ~ weighty recommendations, their re pon i mixed . The consen u of the dean and many of th a o iate and a • i tant d an i that while ome of the ugge ti n arc wor ­ thy and hould be adopted by medi al . cho L , c rtain other recommendation are not reali tic and would be difficul t or ven detrimental to implement . As far a B i concerned , "Our medical ch I had adopted many of the recommendation year before the rep rt or while it wa being developed, " comment: Or. Peter O trow, a ciate dean for curricular and academic affair . Thi progre ·. ive approa h taken by the school has re ulted in admi ion , urriculum , and admini ·trative change that fully or partly addre all bu t three or four of the 27 recommendation . " For tho e recommendation the chool hadn 't already addr ed before the report , omc are worthy for u to pur ue-and me definitely aren't. For chose principle we agree with, the report cer ­ tainly provide u with an impetu to put chem into ef ­ fect ,'' Dr . 0 trow replied. Promoting Independent Learning and Problem Solving Skills The Medi al chool' interc t in adopting alternative learn ­ ing fi rmat has al o enabled the chool to addre s another major prin iple of the GPEP Report : the teaching of in ­ dependent learning and problem - ol ing . kill • o expanion f metli al knowledge need not be re tricted t0 the medical chool ear . " I agree thar· •cientific information hould be learned in a context that truly motivates the _cudent co I arn ," re­ mar Dr . trow . " That i hy clinical -oriented problem olving or ca e tutly format · are now available here ." ( ee accompanying article on the ek tive Program.) an ex­ ample, 0 trow referred co the patient-oriented problem ­ . olving (P P ) project in the curriculum . One mul­ tidiciplinary POP i the CP , or linical-Pathological orrelation . . In the CP , tudent are given raw data (patient hi tone . , X-ray. , lide . lab data) from a real clinical ca e. The • tudent try to analy7.,ethe medical problem and how it should be remedied . ft r their attempt ·, peciali t are called in to pre ent their analy e . P are offered in each ear of medical chool. " We pe~t the first.year tudent co get very far, but great­ er u ce I expected of the tudent in each ucce i e year,'' Dr . 0 tr explain . Problem- . olving format will become a "tVeeklv event next year. have ocher trategie . · in place for independent lcarrnng, Dr . aughton add . " We have a number of honor . cour ·es for tudent moti ated t0 do more than Les Empha is on Memorization and Lecture Time •:~e.. Dr . Ost row and ice Pre idem John aughcon, dean f the Medical chool, both generally agree that too much sere on memorization and le ture time i counterproduc - 4 �their regularly required ,York . We al o encourage tudent to parcicipate in the i honor , e have a trong ummer re earch program (in which the ·cudent · conduce re earch with a enior faculty member ), and there L an integrated I. D./Ph. D. program ." hile the e alternative ~ rmat. for learning are valu ­ able, they are not for everyone. nd that , Dr .• aughton feels, i another area where the GPEP Report ha< exagger ­ ated it prioritie . "Their re ommcndation · all on chooL to e:;tabli h independent learning program · ~ r 100 per cent of th tudent . The fact are that alternativ \\ay of education work for ·e]e ted • cudem , not all • tudent . While the goal i orthy , the me hani m houldn 't be ap­ proached in a nai\'e way," aughton contend . Shift Toward Teaching Value comment o tudent \\ ill re eive more detailed feedba k . On the urface , the PEP Report ' recommendation to encourage reaching of m re attitude , alue , and kill (a ppo ed co fact ) appear . ound. But, a. with ome ocher recommendation ·, a clo er look re eal. pr blem · in uch a implistic olution that are related to the mher­ ent difficulty of teaching medicine . Dr. aughcon tr ngly upporc- the concept fin till ­ ing value and attitude in future phy ician . But he be­ d deficiency lieve · th rep rt again ver tare thi upp in the medi al education y rem and may even go far a to dimini h the imp rcance of cientific, factual under canding and value y cem . Ob\'i0u ly, attitude and valu are important. "'The que tion i , what are the attitude and value that we're trying to develop? One ha to be careful not to overem­ ph · ize one et of value to the detriment of anorher " the dean articulate . ''Ever one feel that humani ti value are important to ere but it' al o important that tudent learn ch attitude and value of good ientifi prepara ­ tion , the valu of p · e ·ing clinical knowledge a op­ po ed to clinical opinion . that they learn to make olid judgement ba ed on a mu h evidence and ·pe ifi in­ formation · they can . " I take 1he po icion that every day a medical student i being caught, ome attitud and value i being rein­ forced . The GP P Report give · the me · age that not enough i being gi en on humani tic value , but it shouldn't be interpreted chat chat et of value i. more im ­ portant than other et of alue ." Dr . O ·trow um up the dilemma u inctly. " In a patient-d ctor relati n hip, the bottom line i : if, ou had a hoi e bet ·een your do tor giving the right an wer (about your medi al problem) or having a go d attitude, whi h would you choo e? hile patient obviou ly wane both, the be t outcome i • nor po ible without the ound medi al kno •led e." Learning medicine ·hould be a lifetime cour e, 0 tro" believe , and he draw upport from the far- ighted quoce of the noced phy ician, ir '\ illiam ler, in 1905: ··we expect co much of the tu dent and v,e cry 10 teach him mo much . Give him good methods and a proper point of \'iew and all other things will be added a hi e peri nee grow ." & Attitude Perhap more than any other concept the GPEP Report repeatedly empha ize that value , attitude , and kills hould be taught co a greater degree than i currently done in the American m dical education y rem . Dr . trow b Ii ve · thi i an area where L'B ha been p cially re pon ive. "F r many year ·, we've ent student · out to preceptor hip • where they wicn the caring rela­ tion hip of phy i ian to patient ," he relate . " \Xe al ha,·e a trong elective program for fir ·t and third year. . Fir tear tudem mu t elect from among cour e with hu ­ manistic as well a factual a ·pect such a medical ethic, di ability, minority and under erved population , occupa ­ tional and environmental health , and alcohol and ub tance abu e. The GPEP Rep re empha ize not only the teaching of attitud and value but al o expli it criteria co mea ure tuden ' performan e in the e nearly-impo , ible-ro ­ quantify attribute . Dr . Frank chimpfhau er, i cant dean for education and e aluacion , r ponds to the . e recommendati n by yllabu for the referring w a re ntly developed cour Third -Year Clerk •hip in Medicine, a ho •pital -ba ed rotat­ ing program thar gi es tudent clinical experience among up to 66 familie of di e e . ''Third-y ar clerk hip oordinator have held retreat and made oncerted effort to encourag excellence in tea hing and learning, " Dr . _chimpfhau er explain . "W◄ realized we had both c clearly idemif_ and a e ,vhat the tudent · hould kn w and be able t do , and to iden­ tify, ob erve, and a c important a peer · of profe . i nal gr wth and behavi r." The syllabu ~ r ea h of the ix third -year program pell out in rea enable detail what the minimum level of competency in kno ledge and fact hould be. Becau e of thi , teaching effort and program time can be u ed more effectiv ly to develop profe ional kill uch a profe. ional and patient intera tion, clinical deci •ion­ making and elf -as es ment ," chimpfhau er point out. Th e tion on student e\'-aluation and grading in the Medi­ cine Program read , "Practic of th tandards of profes ional conduct, in­ cluding hone ty, integrity, recognition of one ' own limi­ tation , c mpa ion, en itivity to patient ' need , and , re pc t i r their di nity and privacy, tru tworthine punctuality, and fulfillment of obligation and re. pan i­ bilitie , i expected from and i taken into account in evalu­ ating the cud nt ." tudent evaluati n form in the clinical year likewi e Ii t many of the e attribute a grading item . Th e were added a recently a tw year ago. The form al o leave pace co encourage fa ulty to provide m re ub cami e Integrating Ba ic and Clinical Science The report' _1 t re ommendation urge way to integrate the basi cience , ( u h a anatom ·, phy iology and path l­ ogy) with clinical cience in the third y ar. B ha for a number of year integrated the ba ic cience into the third year through an interdepartmental program of ·ele tive offerings. ln addition to the third-year clerk hip , each tudent mu t choo e a one-week elective . Example in­ clude uch t pi a · geriatric , deci ion analy i in clini­ cal medicine, biophy ical monitoring, oncology, and diagno tic microbiology . In addition, clinical correlation of di , a e proce e are integrated into ome fir t· and ·econd -year cour e , u h pathophy iology. Promoting Liberal Education The Medical chool ha undertaken everal way to en ure that tudents with non- cience and liberal edu ation ba k­ ground can qualify for medi al chool without being penalized for their relati ely mailer undergraduate e perience in the cience ( ee accompan ing article) . But the report ' r ommendation to encourage a broad aca- 5 ��demic background and a liberal education doe not ap­ ply olely to admini trati\'e tandard . The report urge · chool to encourage the liberal edu ation empha L throughout m dical cho I. It al o criticize · the y tern­ wide pre ure to pe ialize a early a po ible and to take electi\'e "dir ect d mainl} toward gaining a re idency p ition ." Again . the ·ch I fore at-. this problem everal year a o and addre ed it. according to Dr. 0 trow . by requir ­ ing 6 urth -year medical student to ha"e th ir elective curri ulum appr ,·ed by their clinical advi r . The ad, •ior monitor their pro ram partially for the purpo e of preventing the premature ·pecialization that the GPEP Report warn - again t. Establishing Interdepartmental ing ervice - are arranged . The acce ibiLicy of the latter t ·o program i indicated b) the fact that they are utiliz d b} roughly half of the medical rudents during their four years here . Summary Council To further reinforce the priorit of education. the report would like to ee all medical chool e tabli h an interdi ciplinary and interdepartmental organization of faculty which would devi e educational program and work out incon i ten ie between di ciplin . uch an organization, the rep rt ay , hould have the upporc of the general faculty . Dr. , aughton ' initial re:pon e to thi recommenda­ tion i that " we 're ahead of mo c medical chool in that regard b au e we ha\'e an influential faculty council, whi h i an interdepartmental body with el erect represen­ tati,· s ~ r ea h department. The council appoints the cur ­ riculum and a ademi standing committee (that in most medical cho I the dean ·would app int). They bring rec mmendation for change and quality control to the hile the tOtal c uncil that are pas ed on to th dean.'' dean make the final deci ion. he ere· e that their recom­ mendation · are generally implemented becau e the coun1Iha a . olid reputation for making fea ibl . ound, and worthwhile propo al ·. Establishing CJ) 0 "' ~ u a: ~ § :i:: a. In ummary , Dr . aughcon maintain that the rep rt over tate · the pr blem in Ameri an medical education " There' no crL i , ju t inherent difficultie · in medical education - it' alway been diffi ult to edu ate future doc ­ tors. In it · attempt to remedy what it ·ee • a nst. , ll ver­ look the genuine ucce of the American medi al education y~tem ," e pecially when compared to other countrie . He contend that while many of their re om ­ mendacion are upportable, ocher are :imply unreali . ti becau e the • were formulated to correct wide ·pread flaw when in actuality the problem exi c a isolated phenome ­ na among each of the 12.., ·chool . oc all of the chool' re pon e to th recommen ­ dation could be de rib d in chi rep rt becau e of . pace limitation but the admini cration ' point i · lear. They maintain that the ~ledical chool at B ha tri\'ed not to be an example of the y tern-wide educational deficien ­ cie that the PEP Report beli ves co exi t. In ·cead, rhe • hool ha ught to monitor and improve it. educarion ­ al pr gram gradually , over the year . rather than to wair for a panel of exp rt to tartle them into rea ting . If the 1edical chool is proud of it re rd o far, it would be erroneou . however, co onclude that it. admini rrator · are complacent or re i tant to thi report' - r ny report ' re ommendation . Their re pon e i ·imp!) that this report i only ne part of the hool' continuing pro e of crutinizing propo al · that may improve the qualiry of medical education here. Tho ·e t-.·ho wi h to judge the . ucce · f toda} · · effort. may have to wait until the 21 t century . • SelectiveProgram aheadof its time Student Support Programs One of the last recommendation i that each medical chool h uld develop a y. tern for effective upport and coun eling of medical . tudent to help th m deal with the emocional tre and pre · ure thar become o much a part of their edu ation . Dr. Maggie \! right, a · i tam dean for tudent affair . agre with thi ugge ti n wholeheartedly, and in fact t-. appointed by the 1edi al hool in 19 1 co expand the ho I' tu ent upp rt y tern n a full-time ba i . ''Noc only d I upport thi recommendation. bur che Medical ho I' admini tration al o crongly promoces academic excellen e and good mental health for all it tudent ,'' . he omment. he oordinates tudent upport ervice for the cho I, whi h in lude coun elling. tutorial ·, the faculty ad, ·i ory program , and the ·tudent /fa ulty/admini tration program . tudent are in~ rmed of the e upport ervice during orientation. In addition , a. ummer Enrichment and ademic upport Program, e ·cabli hed in 1969, i availa­ tudent during the ble to di advantaged and minority ummer and thr ugh ut the year. The ere ourc available to medical tudent contrib ­ ute t0 ·ati fying thi GPEP recommendation . The chool' faculty advi ory program provide each tudent with an advi or to a , i t him or her in dealing with career option • per onal matter , and academic concern . For academic a ·i tance, a tudent tutorial program i available for ev­ ery ba i ience cour e. For per onal problem . coun el- F By Frank chimpfhau er, Ph.D. Assi tan/ Dean for Det'elopment and £z,a/uation and Associate Profe · or of Medicine our year prior to the AAi1C' rec nt report on " Phy­ ician for the 21 t emury," UB' faculty introduced a program for fir t-year medical tudent which ad­ ed manv of the i ue and recommendation dr outlined in tliat report. One , ignifi ant re ommendation wa that medi al facultie hould offer education­ al experience that require tudent to be active , indep ndent learner and prob) m- olver rather than pa ive recipi nt of information . Buffa] · ele ti, ·e Program now include nine cour e from among ·hich each tu ­ dent mu t elect one during hi or her fir t year. The in ­ tent f the elective Program i to deal with current so io -medical problem , be multidi ciplinary in natur . pre em content currently unrepre ented in the curricu ­ lum, and pro ide lecture -alrernativ in tructional methods and experience . elective cour e have provid d oppor­ tunitie to vi it clinical fa ilitie , interact •ith patien , and di cu alternative point of view ith expert in the field. One uch course. " Perspe tiv on Envir nmental and 7 �of attitude t0\Y:trd canc er along with elf -reported appli­ cation of pren:mi n principles in clinical etting ., and a retro pective evaluati o n of th e relevance of the original cour e components . Additi o nally , videotap e of a ample of the selecti, ·e program tudem and co ntrol tudem en­ gaged in patient interviews (in family medicine) " ·ere ob erved and oded for the use of pre, ·emion technique . While in ming tudent ~id not differ in the amount of knowledge o f cancer and prevention principle , tu­ dent in the program cored ignificantly higher than con ­ trol - hath at the end of the co ur e and during the longitudinal tudy . ver the years o f th e follow -up tudy, the pr gram· student . sh wed a minor lo · in retention of informati n. but control tud em . cored . on the aver­ age. almo t the ame o n all four te ting occa ion . ccupation I Health - F cu ing on ancer Prevention,' wa <.level pec.l through a three -year c ntract awarded to the ' chant by the National Cancer Institute . Under the leader hip of Dr . Paul Ko tyniak, a ociate profe · or of pharmacology and project coordinator. Dr. Jame 01 on. a si tam profe sor of pharmacology and cour_ e coordi ­ nators, and my elf , as principal inve tigator for the on­ tracL. several faculty member - cooperated in developing a c ur e v..hich ha now been di eminated nationallv through the National ancer In citute . · Like the other fir t-year elective , the Environmen ­ tal and Occupational He.alth cour e focu e. on ciobio1 gical i ue . ' pe ifically , it purpo e i. to ·en . itize the medical wdent co cau, e of preventable disease and co the phy ician · role in influencing patient ·· altitude · and hehavior which have an impact on their health. Addition ­ ally, rudent di cuss the rol phy ician , as respected com ­ munity member , may play in hanging lo al, state. anc.l federal policie · whi h impact on di . ea e pre, ·ention. The our e focu e · on cancer induced bv em •ir nmencal and occupational factor . The e cancer example · are particu ­ larly appropria te ·ince they pre em ome of the most difficult problem · in the interpretati n and extrapolation of cientific data, the promulgation and enfor emcm of regulation , and the applicari n of behaviorial modifica ­ tion principle . Group di cus ion are directed toward i • ue · of control in the initiation of the di ea e where intervention may have a ignificant impact on di ease prevemion . W hile not . ignificantl) differ ent, -deceive <;tudent · at­ titude toward cancer tended to be more po -itive than those of control tudents . tudent. v. ith greater kn wledge tended to ha\ ·e mor e posiri, •e attitude . Anatr es of tu ­ dents ' clinical beha, ·ior sho ·ed that elective program tUdent. mentioned ri k factor more frequently than did controls, but the difference " 'as not ignificant . They asked more que , tion · about o upation. alcohol u e. hobbie , c.xpo ure to toxic sub can e , obe ity , and genetic , and the) were signifi ancly more con erned about family hi • ton · than were ontrol tudent . . measured b\' the elf ­ report a es mem . . ele tive tudem ,' appli ·ation of prevention principle , '\\-'asno greater than that of controls . The p st-course evaluation ratings of the four cour e unit · ·hawed the following: (a) the unit , ·'the natural his ­ tory of can er," " ri k factors ; · and "beha, ·ior m difica ­ tion /patient educati n," were all per ci, ·ed a. b ing very relevant while ··political /medical -legal aspect of di ea e prevention " were per eived as being only moderate!} rele­ vant; and (b) tudents ' perception of the valu of the cour ·e and ic · component . were po itively and -ignificant­ ly correlated with their level. of retention of our e materi­ al and their concurrent attitude toward cancer i. ue.. The ignificantly po itive correlations between ·tudent · kno ledge and the perception of the value of the unit on risk factor are e. pccially nmeworthy . \X.'hile ·tudent may chool I am about carcinogene ·L in other medical course , the unique value of chi · -elective lie in en -iciz­ ing student · to environmental ause f ancer . The po i­ tiv correlation between knowledge and attitUde, found for both ekctive and control tudent , sugge t that the c ntinued devel pmem of the cour e will haw beneficial re. ult in the future . • 0 ,, r the years, approximately 13 faculty members and community health profe ional - have voluncarily par ­ ti ipated in thi cour e, thereby contributing to it mul ­ tidi iplinary nature. Dr . Jame, OI on ha di cu ed environmental hazard and mechani ms of carcinogene i ; Or. Jame Has ett f the D partmem f urgery has di cu ed clini aJon ology; Dr . Harry ultz. Dr.John \'<::na. and Dr. Robert O ' he of the Department of . ocial and Preventive Medicine have di cu . sed a pects of health pro­ motion and epidemiology; Dr. Peter es ner of the Depan­ m m o Pharmacology and Therapeuri s, poke on adver e effect of tobac o : Diane R u ch of Ro well Park hru: di cu ed community re ource : Ors . Gola ze ·ki, iovino, and Hall have c vered topic. . on health beha\'ior modification, health education, and making c ation; uzanne ~l unday of the chool of Denci try ha dealt with patient relation hip ; Dr. pence, of hemi try , nutrition and cancer; and An Dallman of Environmental Health and aferv and Tom henk of Gen ral Motor have addre ed indu ·crial hygiene . ' tud nL di cu , ed occupational health on a visit to the Durez Divi ion of Hooker hemical · and Pia tic in orth Tona·wanda led by Barbara rah m and Dr . Paul Ko tyniak , and Jean Doerr covered the topi of compen ation and reco\'ery, in a M t Court hearing at the La" · chool. Of particular ignificance, an applicati n from UB 's Medical choo l wa one of tw a cepted from am ng 30 other propo al to conduce a follow -up study of short - and long-term cour e utcome ,. I, a principal inve tigator , with Dr . Lu 'Pai and M . Toni Peter rving a re earch a sociat , coordinated Lhi pha e of the program' evalua­ tion . EYaluation utilizing candardized and newly vaJidated measure have demonstrat d the value of the program . 1 ot only did the tudy mea ure the amount of knowledge gained, but attitudinal and beha\'ioral change were al o a ed: all three mea ·ures ere tak n both at the Lime of the cour ·e and at two interval ub equem co it. The e measure included Tin n te r of kno ledge and urvey UBsupportsa more 'libercal' pre-med N By Bruce S. Kershner o di . cu:smn about the wa} future doctors are edu­ atcd in medical school coukl be complete •ithout dis u ing the way the e future doctor are admitted to medical s hoot. Among the 2- ·weeping recommendation de cribed in the " Phy ician for the 11 t entury" Report 8 �ar five propo al to alter medical . chool admi ion tan­ dard and preparation . Th " GPEP" report i ued by a panel of the Ameri­ can A ciation of Medical College . recommend that medi al chool hould place more emphasi on a broad­ er, le · . cience-dominated liberal education background for entering tudents . To do thi , the blue ribbon pand ould like admi . ·ions criteria for medical chool changed to reflect a decreased requirement for cien e cour e . In contra t , the report urge that requirement for effective •ricing kill be ere s d to an even greater degree than generally occur . The tightening of requirement for ef­ fective writing kill turn out to b the mo t hotly debat ­ ed i ue relating to the admi ion recommendation . The UB Medical choor catal g doe make it clear that applicants are e. peered tO have attained the writing kill nece ary for cholarly profes ional communication . H wever , the GPEP report doe not feel this kind of re­ quirement i , by it elf, ufficient . The report trongly encourage , the addition of an e ay te t to the Medi aJ College dmi •ion Test (M AT), the rigorous and oft n intimidating exam required for all m dical chool applicant . n experimental e. ·ay te ·t will be included in ne t pril' M T, but it will not be grad­ ed or u d in calculating MC T core for three year ·, at whi h time a deci ion will be made whether ro formally incorporate it into the te t. eriou que rion have been rai ed a to how ell a te t could be objectively graded . In particular, it eff er on minoricy applicant . i a ·eriou con em. The l\linori ­ ry ffair ection of the A ociation of merican Medical College ( AM ) ha expre · ed mi gi,·ing a. to che method of coring th e ay, how it w uld be u ed. by medi al admi ion committee . and how the es. ay que tion w uld be • elected. " n e ay te t could ha\'e the ef ­ fect of putting minority applicant at an additional di advantage ," Dr . laggi Wright. a i tant dean for tu­ dent affair , point out. "The Northea , t Region MC linority Affair Committee will certainly oppo e an e ay te t if all th potential problems are not worked out in advance." It i ironic that if an e · ay te t doe have a negati\'e effect on minority admis ion , it would directly conflict with the GPEP Repon· endor emenc of proYid ­ ing "equity of acce to a medical career " for minoritie . " Te ting for writing skill i important, " Dr. Wright ay , " but the problem of an ay on a national exam would be avoided by imply ha,·ing each hool de,·elop it own ay to test writing aptitude. The AA 1C hould urge ea h chool ro do it it own way." T he mewhat le contro, ·er ial recommendations to encourage a more liberal, le • pecialized education are upponed by Dr. Thoma Gutcu o, director of admis . ion for B' 1edical chool. " It' · only logical that the majori­ ty of people intere ted in medicine will be cience major . But pre -med tudent · hould till try to take a many noncience cour , e a they would like," Guttu o recommend ,. " It i not nece ary for tuden ro take ju r cience cour. e to get into medical ·ch ol. In fact, they 'd be better prac­ ticing phy i ian if they didn 't narrow them elve coo much." Then he adds, 'Td like ro ay t pre-med tudenr : take some humanitie and broaden your elf! " Thi attitude i reflected in the admi i n re rd . ince the clinical a·. i rant profe or of ophthalmo logy be­ came admi ion director in 1981, the number of non ­ cience majors in the entering la ha averaged 28 per cent higher than in the preceding four-year period. He ha al o helped e tabli h the chool' Early ur- 9 ance Program, whi h began la t year. Thi , pro ram allow premedical tu dent · to apply, for the fir t time , to the chool of Medicine in their ophomore year, one co two year earlier than ther tudent . If admitted. a rudent can concentrate more n learn­ ing and per onal development and le n the uncercaint _ and . train that many premedical tudent go through in their junior and enior year . "Ir will free up the . elected tudenc c rake non ­ cience cour:e which they might not ha\'e taken ," com­ ment Dr. Gunu o. The fir t tudent in the program will enter the ch al in 1986. However, Dr . Guttu o w uld like to have the admi sion catalog updated to retlect the current hoot policy (an action that ould comply with the report · recommen ­ dation a well) . The cbool of Jfedicine 19 3- 6 Regi ter. written roughly two year ag . till require a relatively heavy -cience cour ·e load (one year each in biology. gener ­ al chemi cry, organic chemi try, and phy ic with a trong recommendation for calculu . quantitative and physical chemi try). De pite the heavy . ci n e empha i , the urrent ad­ mi ion catalog de, cription till encourage a liberal edu ­ cation. For example, two ye r. of o ial ciencc and one year of humanitie are recommended, a · well a the re­ quired one year of Engli h. The catalog advi ·e " cudenc · [to] prepar ch m l\'e broadly in the variou field of knmvl dge" and that "the o ial ciences are con idered a important for pro . pe tive medi al cudem a are fur ­ ther cour e in rhe physical and biologi al cience ." The cacaJogal warn again t the er- pe iaJization in ience while in colleg that rhe PEP Reporr i con­ erned about: ·· n increa ·ed preparation of work in the cience . how ,·er, i n ub , titute for work of high quality. tudent ar generally advi ed not to rake cour e · that anticipate the content of the curriculum of the chool of Medicine ." It i ob\'ious that the pecialization in cience among do tor often begin . b fi re they enter medical chool. The GPEP Report addr s e thi by urging hang in und r­ graduate education , a w II a· m di al ch ol urri ula . The ·'premedical yndr m " au e tudenc to "t ke cour e after couce in the cience " in their struggle to n­ han e their hance of medi al admi ion . " By the time their college tudie are completed, the e cudent often have forfeited the imelleccual challenge and reward th t tudy in the humanitie could have afforded," ' the report read . It recommend that undergraduate ch ol. require liheral studies no matter whi h pr fi ion a cudent plan to enter . helly Frederick. B'· undergraduate preprofe ion ­ al health career ad\'i or , agree• . " I tell pre-med student , 'take what you 're incere red in, becau e you may not be able tO take uch non- cience cour e again .' " he ee the rea ·on for rhe " premedical yndrome ·· a o iety-wide . "Pe pie have an impre i n chat you mu ·t take only ien e to get into medical s hoof. The tuden s ominue that mi concepti n the mo c, along \.Vith their parent ." Although ome change are occurring, mo tun ­ dergraduate and medical hool till perpetuate the im ­ pre ion . All interviewed hav agreed that changing the mi con­ ception will be a gradual proce ·• . The perception - of tu ­ denc and their parent will change only when eu h medical hoot change it admi ion tandard . with regard to ience emphasi together with the upport of the AAM and adoption fa imilar approach by the na­ tion· und rgraduate cho I . • �a: "' a. ~ :,: ii: :,: (.) ::::; "' _, >­ :,: a. §:,: a. 1\vo UB otolaryngologists ~· are pioneering development of promising new aids for the deaf Dr. Dauiel Fahey (abor •e) 10 oiillil' �T wo B otolarnygologists ,york111g ·epar::ttely at two Buffalo ho ·pitals are pioneering dl'wlop­ ments with the new anJ promising cochlear im­ planL for the deaf. At Buffalo General Ho pital, Or. Daniel J. Fahey surgically implanted the first artificial intra-cochlear im­ plant in \\e tern ·ew York on December 26. I98-t. On another front. Dr. Irwin A. Ginsberg will under­ wke Phase I clmical testing to e,~aluatc an e\"t:n newer ex­ perimental de, ice called the extra-cochlear implam The Buffalo Otological Group, which he din:cts. was selected h) 3 \I Company as one of only 11 medical group. nation­ ally to e,aluatl' the new device. urgerr will be conduct­ ed at :\.lillard Fillmore Hospital The :nt Company de igned both the intra- and extra-co hlear devices. Dr. Fahey and Dr Ginsberg an: both clinical profes­ or of otolaryngology at L'B. Dr. Ginsberg is also clinical associate professor of anatomy. The intra-cochlear device was recently approYcd by the Federal Food and Drug Admmi tration-a step that doctor· and management at the Buffalo General Ho. pi cal had been awaiting before giving the green light to estab­ lL h BG H JS one of the few major Cochlear Implant Center.., in rhe nation. The Buffa.lo General Ho pital officially appron!d a Cochlear Implant program on r--.ovemhcr 29, 198.:+,the same day a· the FDA ruling. Hospital admini trators al o dnlicated 10.000 to purcha. e -pecial equipment for the o;urgical procedure and rehabilitation. They are seeking hospitalization insurance CO\'Cragc for implant patient:. The BGH team hope'> to perform one implant each monrh. local craftsman, L:.1,·crne. tcnis-who lose h1 · hear­ ing at age .30-waited lO years for the electronic ear im­ plant. After undergoing the historical surgery at the Buffalo General Hospital he look:-. forward after years of silence to hearing hi. ·on's ,·oice. the rhythm of mu •ic the tele­ phone, and doorbell The two-hour operation was performed by Dr. Fahey, <.hicf of the Di,·i. ion of Otology of the Depamncnt· of Omlaryngology at BGH and pre.·ident of the board of the Buffalo Hearing and ~ peech enrer Dr. Fahey cramed with specialist Jt the Hou. e Ear ln titute of Lo Angele. who pioneered the urgical and rehabilitative techniques used in cochlear implants. level and adju. t their ,•oice. accordingly. Al o hearing the \'Olume of one· - own ,·01ce helps hearing impaired peo­ ple speak at comfortable ll'n:ls," Dr. Fahey comments. Patients who can benefit from hearing aids in com­ municating \\llh the hcarmg \\orld hould nut be consI de red candidate fur implant . urgcry at thh time Dr ,insberg emphasizes. Ideal patients for the procedure arc probably those who became deaf after they learned to peak and whose deafness wa · caused by meningitis. ad­ ,·anced otosclero">i. or omtoxicitY. "Of the e.·timatcd 200,000 deaf persons in the l. .. on!) about 25 per cent or 50.000 may be candidates for rhc . urgcry,'' Dr. Gin. berg add .. For many of these. the ochlcar implant is probabl} the best alternati\'C available toda,·. The newer extra-co hlear de, ice ha not n:t been im­ planted in human. and Or Gin. berg i. hopeful he will be oon. performing one of the fir ·1 operation. The surgical technique used ro implant either of the de, ices i nor particularly djfficult, says the l B surgeon. But patients require more than the operation to fully benefit from the de,·icc . "'The patient must be highly moti\'ated and h. ,·c realis­ tic expectation about the procedure," he add . The Co hlcar Implant program :1.t the Buffalo Gener­ al im·oh·e. a comprehen i\"e incervie · ~ Jth rhe patient and his or her famil) to inform them of its expectations Test. , including x-rays, are made and wdied to determine the condition of the inner ear so the. urgeon can plan the ur­ gical methods. The procedure for the intra-cochlear implant. a mastoidectomy performed under general am:. rhe ·ia. con­ sists of implanting a nickel-size electronic rccci\'er beneath the scalp heh ind the car. The rccch·cr sends clectri al sig­ nal. m·cr a wire cle trodc which i. surgically implanted some 6 mm. into the round window or entrance to tht· inner car. nother \\'ire ,vhich 1s al. o connected to the recei\'cr h implanted under the calp. Approximately six weeks later. an externally worn transmitter and signal pro e-;sor are fitted and ad1usrcd The sound is picked up hy a tiny microphlme worn clipped to a hirr pocket, collar. hair clip. e\'egla..,sframe, or car mold T T he cochlear implant electronically 'itinrnl.ues the pa­ tient'.- audiron nerw which then transmits sound sen­ ·arion to the braiI1. Electrodes an: surgicall,· implanted in the inner car and a recci\'er is ccured under the ..,kin be­ hind the ear. n external transmitter signal proces. or and miniature microphone produce the electrical impulse ,·i­ tal for rhe brain'· perception of sound. Dr. G111sbcrg, who toured last year n:uionall) and abroad to ob:er\'c , arious techniques and ear implant de,ice .. says the public -;hould not be misled as to the de,·ices· cffccti\'cnc. s. " ochlear implant do not miraculously enable totally deaf patients to hear a. if they had ncn;r experienced co­ ral hearing lo s," Dr Ginsberg says. \X hile the devices may aid proundly deaf persons to distingui. h bet\.Yeen sound , the rc<;ult i not real hearing. lio,Ye\'er, the cochlear implanc 1,; ·ill enhance deaf per­ ·on. · ahilir} to communicate in many way . The de\'icc 'I\. ill help them di tinguish certain me hanical ound .. es­ pecially lifcsa\'ing ·ignals such as car horns, siren , train whistle , and fire alarm . Also, dailv ound- like a tea ket­ tle •hist le, child'· err. foot tep .. 'and the cadence and direction of voice· '\\.·ill become discernible. In addition to increa. ing awarene · of their ·urroundings. nc\\ responiveness ro ound will help the e patient: obtain better control of their own \'Oice. and improve their cffecti\·e­ nes · in lipreading. "With the implant, patient can determine room noise he experimental extra-cochlear de,·ice operate:-. on a •imilar principle co rhe intra-cochlear de\'ice but the wire electrode implanted doe.· not 1m-ade the round "in­ dow. The le .. in\'asi\'C dc,·icc Or Gin berg belic,·c..,, may pron: preferable at this time for ome patients he ause of rapidly changing technology "The implants roday are in their infancy and might he compared with the cry tal radio ,;et of ye. tcrday in con­ t r,1st to the transistor set of coday." he point-- om Thus. 11 ma) be found in the future that patients "ho.-e ,·ital round window membranes ha,·c been entered surgically for the intra-cochlear implant cannot rece1\'e the more sophi ticated devices which will be developed in the next fe\\ year . ,'The dream of cochlear implants i to integrate deaf people into our society. This will sa,·e them year-, of peial education and greath reduce their social 1.·olation. · -;aid Dr. Fahey. "The impi'ant give .. them dues of. ounds Instead of total ·Hence. the\' will be able to hear the tern po and rhythm of <;peech and mu. ic and even di. cern a male ,uicc from a female one, With training, they will be able to recognize the \'Oi e. of indi\·idual family member.., · Dr. Fahey believe the implant ignificanrly increa e · understanding and awarenes . "A good. peechreadcr may understand :;o per cent of what i ·aid by ob. erving ex­ pres ion and reading lips. The implant gi\'e· the sound clues that will considerably increa. e the o,·erall compre­ hension." • 11 �I MEDICI By Richard V. Lee, M.D. Projessor of Jledicine 12 E �M atient.. the media, bureaucrats, and legi lator too P often confuse expensi\·e clothes and cars, fashiona­ y colleague on the igmoidoscopy tahle. head down, bottom up, had complained of rectal bleeding and pain. Indeed. the rectal exami­ nation had been painful and had located the fissure and cxternal hemorrhoid that the hi tory predicted. Even a busy internist in his lace 30s couldn t talk his way out nf the indignity of the ·igmoido:cope. Result. of the sigmoido copic examination were normal e.·cept for the fissure, the hemorrhoid. - what I was taught to call cryptitis and papillitis - and a shared :en. e of subdued \·ulgarity. He agreed to a barium enema if the problem per isred. \Xe shared a cup of coffee before he returned to hi office patients, relieved of the anxiety of rec al carcinoma. After a humorouslv indelicate com·ersa­ tion about bowel habit .. fiber, extra "-"ater for drink and for cleanhne. s. and anorectal suppo. itories. I trudged off to give a lecture, pondering how to a cend from the :tnus m the abstraction of carbohydrate m<.:tabolism in the dia­ betic pregnancy. I en1oyed giving the lecture immensely, but I ·uspect the students found me informal, undignified. and inelegant. \\'e hec1.ra lot abollt elegance in :,;cience and medicine the ·e da) s. One of the fine l accolade for a nice piece of research 1s to de cribe it as "elegant.·· Clinical technol>gy. especially the image produced by manipulation of complex machine . attract· the elegant adjecti,·e from the popular a. well as the medical pre. s. \X'ith all the intere:t in and fu:-, about elegant science, phy ician. and medical scientist. have begun stri\'ing for elt:gance. I confess to deep-routed di ·crust of any phy. ician who "·ork · at elegance or is at best described by the adjecti\"e elegant How can we be so caught up with elegance when the practice of medicine is \'ibrantly \'ulgar and deliciou ly ear­ thy? Patients bring all the mammalian protuberance anJ orifice· with their respective invader . ·ecretion . and ex­ cretions to physicians to examine and to treat. E.· ept for the clothe~ and the glo\'es I wear and the location. there is really little difference between nw examination of one of my hock's ewe in difficult labor· and my examination of the genitals and pelvic organ. of a young woman with an acute pelvic infection The patients and I arc barricad­ ed from intru ·ion of curious and bumptiou. by tander:. l talk to both ,;vith much the ame pc1.tterand intent. to rea:. ure, to soothe, to explain and exclaim, to how my respe t and concern for another living creature .. lost of our patients and my colleague would be di gu ·tcd or dis­ tantly amused by the exposure of the imilaritie · between being a good ·hepherd and being a good phy ician. The fact is, our ideas of illness and care an: influenced more b) appurtenances and appearances than by biology. Cloches, protective gloves, and notions of modesty, d1gn1t), and elegance are exclusively human foibles that reflect the constant ·etf-cnn. ciousne ·s that distingui. hes us from the re t of nature ·elfi h elf-consciousnei;. and emphas1 of appearance and appurtenanc<. allow for the emergence of fashionablenes in medicine. A lot of modern medicine ha focu. ed upon the superficial: elec­ tronic representatio~ of the paticnt, not the body and spirit of the patient. W'e teach \Vith slide·. \ideotape . mo­ vie . and model more than with flesh and blood. \Xe spend va ·c amounts of energy attempting to appear dig­ nified. detached, and elegant. \X."eare faintly offended by phy:ician ·ho get "too in\"ol\·ed" with their patient·; who cry and laugh and rejoice. ~ ·ithout profe sional reticence, with the folk ~vho have tru red their life and farnih· to their phpician. \Xeare pm off. a little embarra. sed, by dying. defecating, and disillusionment. Perhaps it i · my jaundiced eye, but isn't there a resemblance herween the dandified urinoscopist of 500 years ago and the white-coated oscil­ lo. copi t of 1984? a hle address, and expen ive equipment containing televi­ sion screen. and digital di. play with quality in medicine and, therefore, good hiology. Euphemi tic biology - the notion that di. e~e is omehow di. connected from the vul­ garity of body fluids and function , that phy ician arc . up­ posed to cure, not comprehend, biology - ha not on!) di\'erted medicine a~ ·ay from the patient, it h d iverted medical science away from fundamental research into fashionable "ars on cancer and other popular ailment . Costly que ·ts for cure , a! opposed co ba ·ic science, are the occupations of fashionable physicians too bu y and elegant to muck around in the biologic barn. Academician· are increa ingly taken up with the ques t for elegance: that i. how they are rewarded through grant and promotion .. Ho vital. and practitioner are caught up in the quest for elegant appearance, since that is how the public has been wrongly taught to decide on quality. tu­ dent learn Lhat clean white coats and the late ·t journal article" are more imporram than getting clo e to the pa­ tients and their bodie . Each day at the hospital whe re 1 work and teach, 1 watch student· of medic ine and nurs­ ing. ne\\· and old alike. assign the task of collecting peci­ mens of secretion. and excretion co le. s well-trained and lcs. in\'Ol\'Cd helpers. Ward attendings di dain examining the patient for more ethereal discussions of pa thophysiol­ ogr oronaq care unit and imen ivc care unit round con­ sist of looking ac complex flo" i;heet '. o cillo cope , and digital di plays. l am laughed at for opening and . melling the contents of sputum jar , for examining the contents of bedpans. and for empha. izing the fundamental vulgar­ itv of medicine. · 1 am reminded of the pat ient ho pitalized on multi­ ple occasions with hemopty i . He had undergone bron­ choscopy and x-ray everal times but continued to perplex the housestaff. their attendings. and the speciali t con­ sultants. Finally, one night. he brought in a little piece of blood) tissue in a dirty pickle jar to con\'ince e\·eryone of his plight. E\'eryone had looked at it rather di. gu tedly and distant!). and em it off to the pathology department ~ hile he was admitted and underwent ye t another bron­ choscopic examination that demon crated negati,·e re ·ults. Of cour. e. I wa agitated the next day at morning repor t when I heard the tory Had the staff performed gram train? Had they looked at a wee prep? Had they te ted 1t with benzidine? \\'e trooped of co the lab, , alvaged the sample before it was fixed for proce ing, and made a wet prep, which. bowed the elliptic red blood cells of a fmvl. A lot of money and procedure might ha\·e been aved had we not been o squeami hly elegant. ood medicine require biologic intimacy with all those inelegam mammalian orifice and protube rances. Good medicine require a robust and riba ld . ense of hu­ mor to appreciate and be ensitive to the remarkable dilem­ ma. and di tre . e that beha\·ior and biology can p rod uce. :'\1ora1and . tyli tic priggi hne. and el gant euphemism ha,·e no place in the examining room of a barn or a ho pi­ cal. It i all coo ea y co lose ight of the biology =- the na­ ture of the disea:e and the concern of the sufferer " hile stri\'ing for elegance. As one of my boy cautioned me: "Watch out for a doctor with an alligator on h i. long "hite coat." • (Reprinted with permission from the American Journal Of Medicine , Technical Publishing , a Division of Dun-Donnelley Publishing Cor­ poration , a company of the Dun and Bradstreet Corporation - all rights reserved .) 13 ���. urvi\·or. . he found no difference . I lcnce • he argue that we cann t onc lude that every son or daughter of a • ur­ vi\ ·or is neces arily damaged. their family, their · hecr where people protected them, took care of them. nd so I think that ' why it happened . It happened in ocher countrie as well. In I orwar there ~va only a mall Jewi h population, buc when they came back there \Ya a parade . They were honored . There · no parade for them in the nited tate , they ju c came trickling in . It was hard to get thi country to even allov­ chem to come in ." In fact, olkoff note , th nited tate and England knew about the extermination of Jew and did nothing about it. Has that nightmari h lap e of human con cience taught u anything? History eems co unfold like concen­ tric circle in a pool. ometime we meet the pa ·r in rhe pre em c, ·en a we ·truggle tO keep it out of the future . T o get a better gra. p of any p ihle an wer , olkoff ha de igned a omprehen ive behavioral analy i of children of Holocau t urvivor . He hope to find ho sur­ viv r · attitudes and per onalitie affect their crength to deal not nlv with the trauma of the Holocau c but with life in general. The . tudy. which will be funded by the a­ ti nal In titute of Health, involves 180 people . Compared will be: hildren of urvivor of concentration and exter ­ minati n amp , children of people who urvived in hid­ ing, with parti an r with hri tian familie , and hildren f Ea tern European parent ho came to the . ' , before che Holocau c. The JOO-item un ·ey includes que cion on : political leaning , age placement among iblin ·, income of fami ­ ly, attitude toward health , danger, anger, academic and nona ademic expectation , feeling · ab ut heroism, wel­ fare of other ., u e of alcohol , cigarette and drug ·, inter­ marriage, religio ity, importance of the ' tare of I rael, feelings about parents' experiences , a, ilability of infor ­ mation on the Holo au tin parent 'and children· home ·, and auitude co ard erman . The que cion on the , urvey and che carefully truc­ tured tati ti al appr ach of the tudy speak of ientific hone ty . • ay olkoff, .. nainly there are parent . whose per . ecutory experience left permanent ar . Tho e par­ ent \viii pas on their p ·y hopachologies , damaging their hildr n . But there are m ny more urvivor . who have come to term appr priately with their horrifying ex­ perien e ·. "It eem ::isth ugh in case where there are di curbed children of urviv9r , in almo tall tho e in tance , the par­ ent either did not talk \'ery much about it, or ompletely denied chat anything happened . Although you ould ee the number on the arm , when the e children , ould a k, the parent "-'Ould ay, 'You don 't wanr to know,' or 'l don't ,vane to talk about it, it up ·et me too much.' or 'I don 't ,,,.ant to burden vou with it:._which of our e would bur­ den the children them dve · becau . e the guilt would be enormous . "People ,_,ho ttle in urvivor ommunitie eem to ha\'e problem . They ·eem to be con tantly reminded of their experience and , in a wa), ominue co li,c the Holocau t. People who came t term with their ex­ periences, perhaps aying, 'chi happened , 1cannor undo it, we now have to be concerned about it not happening again,' eem co do well . ·· hildn:n of urvi\ •or in rho ·e familie • where par­ ent . were able to explore their current attitude about the non-Jcwi h world a hone tly as po . ible r le apt to hav eriou p. ychological problem . Jncere tingly, a Jarg per emage of hildren of ur ivor go into health care field . hildren f un-ivor who developed creati e kill , ome of their outrage and writing, arr, mu ic, t expr horror creati\'ely , do well,'" ac ording t olkoff . o it et'.m that communication is the key to tran mitting ::1 lega y f trcngch . Expre ing and haring the powerful feeling th t trauma engender , however c m ­ plex and difficult it may be, eem c lighten, or enlighten the burden . av lk ff, "Tho e urvivors who enc ro I rael • ecm t · have far fewer important p. ycho logical problem ·. The community there as et up to commemorate . Once a year there· an outpouring of emotion. The e pe pie were n t een a · heep. they were een almost as martyrs . And going back co I. rael alma t re em bled returning to S olkoff ha found parallel in another one f hi tu die on "delayed tre syndrome ·· experien ed by Vietnam era \Cteran . He believe the similar itie bet ·een sym­ ptoms are largely attributable co the phenomenon of capeg acing. ay olkoff , " People become capegoat "-'hen chey cannot defend them ·elve and when they ha\'e been · apegoac before . Vietnam veteran . ·ere · apegoat · of American policy . o one wanted them during the war. They were often defen ele · , and they recurned co le, than a hero · welcome . The mi ion xpr ed co them upon entry into armed ervi e wa in direct conflict with their experience later on . Th ' is mu h like the experience which awaited Jews entering concentration camp under a ign reading 'Arbeit Macht Frei ' ('J ork Will Make You Free); and who were then either murdered immediate! ·, or tortured and ·worked " co death a laves. Jewi h sur ­ vi ,·ors entered di ·placed per ·on camp . t await emigra ­ tion left to the whim of ·tranger . Their communitie · were destroyed , they were mo tly unwelcome in German} and Pol:ind , their previou · home . imilarly, returning veteran found a radically changed ·ociety in which they were pit on and called baby killer ." The re ults of Dr. olkoff . re ·ear h promi.e to be u e­ ful for treating all sun i, ·or of trauma and per ecuti n . Though phy ·ical effect . of brutality may be intractable, psychological trauma. even from the Halo au ·t , may hold seeds of :crcngth. In . truggling to omprehend the incom ­ prchen . ible, we may find dynamic formulae co hore up our inner trcngth and balance . Thi may be the only real way to finally balance the • cale. of justice . ' olkoff not on!\ studie the effect of the Hol cau c but he al o ceache about it to rai e people ' a"'·arene of how . uch an event could occur. lore importantly , he be ­ lieve . chat to avoid repetition of our grim rror , we mu t learn to teach chem . The relati n hip between the vent and the emotion of the Holocau t i • the ubject fan imerdi ciplinary un­ dergraduate cour e taught by olkoff and Dr. William heridan lien, an hi torian, at UB. "Hi tori al and P v­ chological Analy e of Genocide " i a ix-credit cour ·e with a con i ten tty full enrollment and good attendan e. The y tematic e. terminati n of . ix million people by a highly "cultured , civilized '' nation i a problem which re­ quire con ideration from many pecpeccive , the profe -. or feel.. While lkoff Holocau r re earch may ultimately provide a few an wer ' , the cour e i · intended co entertain the very que ·cion that, th ugh they may remain unan ­ wered. will in pire erious examination of reality . The cnur e taught by olkoff and lien elicit que tion , tear , , nd mo . t ften the comment, " I am no longer apathetic .''• Ms. Sandler is a UB alumnus and a professional writer. 16 �RESEARCII Project looks at care for the aged T By Gu y Tay lor wo prominem LB geriatrics specialists have initiated a project whi h is apparent!) the fir I sy temalic cudy in • ew York cace­ and po ibly in the nation-that addre · ·­ e the quality and future direction of care for the elder!). Thi precedent- euing study will be conducted by Dr. E\"an Calkiru; and Dr. Ar­ thur Cryns, ·ho recei\"ed a 39,5~0 grant from the A, DRU Foundation to inve tigate the quality of geriatric health care in a health maintenance organization (HMO). Dr. Calkiru. i a profe or and direccor of the Di\"i ion of Geriatrics and Gerontology, and Dr Cryns i a profe or in the chool of o ial Work. The tud}', "hich began on January I, 19 5, i a collaborative re earch effort be­ tween Heal!h are Plan, Inc. (HCP) and the Western ew York Geriatric Education Center, a unit of B' chool of ~ledicinc H P co­ inve tigacor will be Ors. Edward larine and Leonard Katz, medical and a o­ ciace medical direc­ tor , re pecti\'cly, of that organization. Dr. Katz will func­ tion as the O\'erall project coordinator. Primary objec­ ti\'es of the re earch will be co conduct a quality of care tudy of the health erv­ ice provided by HCP co it ub ·crib­ er 6- year of age or older. This will in\"olve a tratified ample study of ap­ proximate!)' 250 el­ derly HCP mem­ bers. mong varia­ bles LO be in\'e ti­ gated will be diag­ no tic a e ment and treatment outcome·. A , omewhac more ubjectiw factor co be. rudied i. that of patient- -acisfaccion ich the health ser­ vices received The resulting data will be used for development of a candardized geriarric patient ·ati faction ·cale. Dr. Robert Nichols. a profe · or of educauonal psychology a1 Band a caling expert of na11onal reputation will have major re~ponsibility for thi part of the study. The re earch project, de cribed here, i of special ignificance becau e y 1ematic empirical information about geriarric health care in HMO-setting i relati\'ely rare. Dr Calkins. a graduate of the Harvard Medical chool, is the director of the Wetern New York Geriatric Education Center The narionally prominent phy i­ cian i author of many ·cientific publica­ tions in the field a well a editor of a for­ thcoming tex1 on geriatric medicine. Dr. Cryn i a clinical and re earch p ychologi c and co-director of the Western Nev.· York Geriatric Education Center. He, coo, has publi hed e. ten ive­ ly in the field of gero-p ychology ith a particular empha is on geriatric health 17 care and ocial ervice need as e· ment. Dr. Marine, m addition to hi medical director hip a1 HCP, holds a faculty ap­ pointment in both family medicine and internal medicine at the 'B chool of Medicine. Currently HCP's a sociate medical direccor. Dr. Katz I a profe or of internal medicine ac B. It i anticipated that re ult of chi re earch will be used to advance the ef­ fec1ivene of geriatric health care ar HCP as well a co cimulace further re earch of chi · kind in imilar etting . • New application for bypass surgery S urgery can add year to the live of people who have narrowed coro­ nary arterie but how no ymp­ com of heart di ea e. according to a report dell\·ered at the annual "cientific e · ion of the American Heare ociation by a ream of L'B phy ician from Buffalo General Ho p1tal. The report ugge t that oronary artery bypa urgery may prolong the live of patient who ha\'e ignificant harden­ ing of the coronary anerie but are without painful ympcom . Thi patient group ha traditionally been created med­ ically with drug and directed change in life tyle. Coronary bypa · . urgery i frequently u ed to control che c pain. It u c co prolong life has been controve ial among doctor . Howe\'er, a team of B/Buffalo General Ho pical phy ician. •aid their tudie how that urgery extends life. Pa­ tient with clinically ignificant coronary artery di ease without chest pain who un­ dergo bypa urgery ha\·e a urvival rate beuer than chat of the public at large, the report cates. The team tudied 1 ➔ 9 patien who had no che t pain when the deci ion for ur­ gery wa made. Results show a urvival rate of9 7 .5 per cent after ix years, accord­ ing 10 Dr. David G. Greene, BGH angiol­ ogi c and profe or of medicine at CB. "\~'e belie\·e our rudy ho · chat even the patient who has recovered unevent­ fully from a heart arrack hould be tudied co ee whether urgery will prolong hi life," Dr. Greene told the AHA group at a recent gathering in 1iami, Florida. �RE EARCH \ fight diabetes The grant was provided by Dr. Greene pointed out that the pa­ the cw 'tbrk ·1ate Ht.-althRc.<,earchCoun• tients' survi, al rate in the Buffalo study cil to stud} the cau e. and impro,·e treat• exceeded that of a larger study reported ment of diabetes. a year ago to the AH that found six-year The gram -tvasawarded to Dr. Basab K. survival rates of 90 per cent for 390 pa• Mookerjee, profe or of medicine, b} Dr t1ents treated medically and 92 per cent John Jack, the representative of the • 'i .S. for 390 patient treated surgically. In that Health Re!>earch Council. Coronar} Arter} Surgcn tudy (CA S), patient were as igned at random to one of the two groups ugge ting no significant difference in survival rates between medical urgical treatment, the CA rep rt implie · that surger} could be postponed until a pa• tient's heart dist.-ase symptoms could not be controlled with medi ine, Dr. Greene .~aid He added that some medical centers "' found the demand for bypa · ·urgery declining after the CAS findings were z publi hed _______ ....... Dr. ,reene suggested two reasons for if 1,;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; the dbcrepancy bet ween the CA and (L-R) Dr. Mookerjee , UB Research the Buffalo team's conclu ions. The Vice Pr esident Donald Rennie, and proiecc was carried out in 15 surgical Dr.JobnJack , .Y.S. Health Research centers, omc of which had surgical mor• Council. talicy rate of up co 6.'¾per cent, he not· ed. whereas surgical mortality race at Dr. Mookerjee' gram i one of 17 given Buffalo General Hospital have been below co scientists around the state following the 2 per cent since 19-.5 198 ➔ ·85 appropriation of 250,000 in In addition, some patient~ a! signed ran­ funding for diabete re earch. An addi· domly to the medical treatment group in Clonal 150,000 has been earmarked for the CAS proiect underwenc surgery as diabetes education and control programs. their ·>·mptoms worsened. The shift from The American Diabetes Association and the medical co che surgical group led to the Juvenile Diabetes Foundation have a falsely elevated impre ion of the results worked together toward such state fund­ of medical management, Dr Greene aid ing for the pa t decade. JDF and ADA Dr Greene spoke as a representative of \'Olunceer · ha\'e made se,·eral trip to Al­ a large group which conducted the Buffa. bany to encourage leg1 Jator to uppon lo study. Other members of the team were the bill· Ors. Ivan L. Bunnell, Djavad T Arani, Ge­ Dr. Mookeqec i · co-chief of \e terans orge chimert, Thomas Z Lajos, Arthur Admini trauon Medical Center' D1vi ion B. Lcc,Jr .• orman A. Lewin, Syed T Raz:.1, of ephrology. Hi gram will help him Walter T Zimdahl, John M. Bozer, Robert tudy how certain diuretic drug interfere M. Kohn. David C. Dean, John P. \isco, wHh the-bod}·· ability to properly utilize James G. Conley, and Gretchen L. mith, ugar and energy. By under tanding what R. . • cau es thi unde irable ide effect, Dr. From BGH's 'Pulseoeat:· Nu, 1984 Mookerjee hope to develop way of avoiding it in diabetic and others under­ going kidney therapy. One million ew Yorker have diabetes-12 million people nationwide, wHh 5 million of tho e remaining undi­ By Bruce S. Ker hner agno ed. Diabete i. till incurable and is the country' third h1ghe t cau e of death UB d1abete researcher has been by disease awarded an 18,6o0 gram. pan of a larger effort that repre ·ems the poke men for the Juvenile Diabete fir t time that 'cw York 'rate has Foundation and the American Diabetes A ociation hope the S400,000 for provided direct funding for re earch to re ·t.-archand education will contribute to diabete prevention, better ueaunenc, and a cure. E rabli hed within the cw York tate Department of Health, the tate Health Research Council v..-as created by the Governor and Legi lacure in 1975 to coor­ dinate and integrate re earch in health­ relaced areas and promoces independe nt medical re earch in particular. ince its in­ ception in 19 5, the Health Research Councli has funded 50 proiect totalling 9.9 million in grams ratewide. UB has fared very well, and in fact, has received ➔ 5 av-:ards, more than an} other ingle in­ • •citution in che enure rate. ! g State underwrites diabetes research A 18 Non-surgical method effective I t wa pring 1981 when Dr , eil Dashkoff introduced coronar, an­ gioplasty to Western ew York. ince then, the cardiology attending the Erie County Medical Cencer has used the non- ·urgical procedure to treat evere narrowing of corona!) arteries in over 200 patient . Mo t have had single arterr di ease; the remainder double or triple artery disease. 1\vo-thirds of the le ion have been in the left or anterior de cending coronary ar­ tery of the heart. The others have bee n in the right or circumflex coronary arter­ ies of the heart. The dara mimic national . rati. tic . he aid. During the procedure, two catheters are u ed. One is inside the other. After the outer or guide catheter enter the coro­ nary artery to be treated, the inner or bal­ loon catheter moves forward unde r fluoro copic/pre ure monitoring until it pas e the lesion Once there, the catheter i intlat­ ed/detlated during a 20 to 25- econd pe ri­ od by a controlled pressure pump. And the cycle of inflation/detlation i repea t­ ed until the le ·ion of anerio clero cic plaque is compre ed again t the ve el wall and/or is opened co allow blood to tlow freely through the widened artery. Candidate for the procedure are care­ fully selected. Important are ice of le­ ion(s) and angina ymptom · uch a increasing pain. Always a\'ailable is car di­ ac randby should the rare complicat io n l ' �RESEARCH \ I of heart attack occur. The procedure of angioplasty wa in­ troduced in thi · country in 196'¾. Drs. Judkins and C. Dotter used the procedure to dilate narrowed anerie · in leg of pa­ tients who e severe peripheral vascular di ea e made them poor candidates for urgery. During the omewhat crude procedure, catheters of increasing ize were u ·cd to open clogged blood ve els. Due to inju­ ry to artery and hemorrhage, the proce­ dure was abandoned. Ten year later, a wis team under Dr. A Gruntzig used a double lumen balloon catheter to open narrowed portions of blood ,·e els Following great ucce s in treatment of peripheral and renal anerie , percutaneous coronary angioplasty (or PTCA a it i · called) wa ucce · fully in­ troduced in 19.,~ In 19 I, the medical community ·was on the frontier of angioplasty. Today, with im­ proved in trumentation and experience, the ucce rate for coronary angiopla ty i 90 per cent, Dr. Dashkoff aid. During the co t-effecti\'e procedure, the patient i in the ho. pita! for two to three day and i back to ·ork in a matter of week. Credited with helping to e tablish the procedure at the medical center i Elizabeth loan, nursing team leader. Dr. Da hkoff said, ''Angioplasty is le s complicated to repeat than i. hyp:t! s ur­ gery. It i a promi ing, non-surgical alter­ native for elective patient ." • (From ECMC's NeNSletrer, Update, Dec. 1984.) Stool slide test use increasing T he tool guaiac lide te t, the newe ·t and mo t widely pro­ moted creening Le t for colorec­ tal cancer, i imple, effective, available, in­ expen i\'e and noninva ive. But re ·ult of recent population urvey and mas colorectal cancer creening program have revealed that many people are not a·ware of thi re t and that only a mall percen­ tage - three to twenty per cent - ha\'e actually taken it. Do these le -than­ promi ing tati tic reflect a trend among community physicians co forego using the ce r in favor of more time-re ted crcen- 1 I z < :l: 0 w if IL ~ a: 0 z < 19 ing method ? Is there a negative bia coward it in medical circle ? " o," ays Dr. K. ~lichael Cumming , clinical a ociate profe or of social and preventive medicine and a Roswell Park Memorial Institute cancer researcher, •ho recently polled a group of, 'ew York tate family phy ician for their opinion , belief , and attitude about the tool Guaiac tide Te t ( G T). "There i often a long time lag between the d1 covery of a medical innovation and it acceptance and adoption by community phy ician . The G T i a very good example of chi phenomenon," he said. Introduced in the late 1960 , the G T enable indi\·iduaJ co test their tool (fece ) for occult (hidden) blood at home. Blood in the tool may be an early sym­ ptom of colorectal cancer. "De pile what much of the literature i reporting, the G T i beginning co gam acceptance and re peccabilicy among fa­ mily physician ," Dr. Cumming noted The re ult of the urvey bear chi ouc. Of 131 family phy ician polled. 10....(82 per cent) indicated that they provided guaiac lide for patients co collect scool peci­ men at home. The re ponden . however, reported that they were more likely co recommend the G T to patients m·er age ➔ O than to their younger counterpart . "This re ponse was expected," aid Dr Cumming , " ince more than 90 per cent �RE 'EARCH of colon:c1.al cancer patients arc m·cr age ➔ O." Ph\''>1cians' allitudes wward 1.he <,(,Sr wen: ·gt'nerJlly fan)(-:.tblc.Q\·er 90 pu cent of the rcspondems. regardlc ·s of whether 1hc) w,ed the <,(j T, indiL'atcd that the) helit:\"cd the test tn he a useful first-line screening tool fur colorcct:.il cancc.:r, :.to,; ,-..-ellas for noncancerous pathologies Df the colon and reetllm. such as polyps and hemorrhoids. Phy-,ici:ms who use the <,(,ST 1n their praetice. howc\·cr, were more hkdy than · nonw,cr.," IO rate the 1.cstas being more effccti\·e in detecting carlr·st1ge colorectal c1mcer than other methods, such as the digital n:ctal e:umi­ nat1on or proctosigmoidrn,copy. In terms of patient compliance anti SGS"! , compk:-.:ity, 'iO per cem of the nonuscrs .md 11 per cent ot rhe users bdic,ed that patients would be unwilling m perform the te,r at home. ReJsons sug• gestcd li1r this unwilhngnes ,·aricd, hut patient compliance with tht: "iG'-;T\ dkt:Jr\' restrictions ,, ••1 the reason most cited l;y 65 per cem of tlK· nonusers and 'H pt:r cent of the users. (li> mcrea-.c tht: accur,1Cyof thL',tool analysis. it is hclil'\"Cd that a spt:cial meatlc-.s. high tiher diet should he startcd 2 ➔ hours before the stool spccimcn is collccted, anti con tmued for three dav.,. Vitamm C is also prohibited). Thirty per cem of the non• u,cr.,, as cnmparctl 10 only te.:npt:r ccm of the users, pen:eh·ed the ·csT\ im,truc­ tirn1' a. being 100 complex for patients 10 undt:r-,1:intl and follow on their own. Rc.:gardkss of compat1bili1~· with cur­ fl'nt scrL·t:ning pracuces, physicians \\ ho indicated that they u,ed the SGST wt:re morc like!} than nonusers to report using screening tests for other I) pes of cancer in medical examinations of asymptom:11ic patients. According to Cummings. "chis finding may rdkct differences in phy. i­ dans · opinions about the bcncfits of ear­ ly cancer tlt:tcction and 1he \"alue of cancer screening." Cummings belic\·es that his stud, will hdp 10 uggcst ways to promote 'iG T use among more primary c;1re physicians. "ruture prommional efforts, as suggest­ ed b) our sun·ey, should emphasize the 'iG'iT\ rdall\c merits, especiall) its effec1i1·cne s in detecting early-stage colorec­ tal cancer, 11ssimplicity, and its acceptance by patients.'' notc.:d the rcscarcher,. ·'For example, one might tre ·s the fact that the "iC,'iT Lan detcl'l cancers in parts of the colon nm reached hy the d1g1t or proc­ tos1gm01tloscopc. or highlight the fact that the SGST is inexpem,n: and nonim~a.-;i\"t' - two points of particular imeresc to pa­ uents Cummings h:istencd 10 p01nt out he docs not espou-.c ··sheh mg" alternath·e screening methods. especially in ,·it:~· of the insufficiem c\'ldencL that screening fi>rcolorectal cancer by fecal tx-cult blood can ,1gn1ficantly reduce mortality from the disease. 'What should he made clear is the 'iGST\ usefulness to physicians .\lure spccifi<..ally, that the <,C,STcan help physicians detecr colorec:tal cancer in its earl) cage,. often before symptom., ap­ pear Nearly two out of rhree of all colorcnal cancer patients could bcndit from early detection and prompt trt:at· n1en1." • Dr. Vit •ia,r Cody Cody investigates anti-tumor drugs D r. Vinan Codv, a researLh as. oci­ ate professor of med1cme and a ~lt:dical Foundation of Buffalo sc1enw,c, has bccn awarded a three-year research grant by the , auonal Cancer Institute to study the rclation~hip between molecular ·tructure and biolog­ ical activity of drugs that inhibit Lumor 20 growth. The compounds that Dr. Cody 1. studying arc inh1b1tor:, of the enzyme di­ hydrofolate reductasL which i: pre.~ent m all cclls and L required for cell growth. primar) funcuon of this enzyme i 10 produce the component · of the genetic material, D:'l:A.The goal of this program is to find a drug th:11will inhibit thi en­ Z) me only m cancer cells and thereb) shrink tumors. Also working on this proiecr are Dr. P-aul Sunon, a rcscarch scientist who re­ cently joined the Foundation ·wff. and Dr. \X'Jlli:imJ \\clsh. Department of Chemis­ try, Uni\"ersicy of Cincinnati, Cincinnati, Ohio. Dr \Xelsh's collaboration involves calculating certain physical properties of the. e drugs in ordcr to understand how their biological function h affected by changes in 1he e propertie ·. le ha., het·n shown that within the ser­ ie of anlllumor drugs under invesuga­ tion, a change in one atom can cau. e a ')00-fold mcrc.:ase Ill ac1ivi1y. By studying the cry. Lal.tructures of these compound~, Dr. Cody will bt able to determine how small change· produce such large differ­ ences m cht:1r biological activny \'fith this mformation. new modifica­ tions can be ""designed" to produce more spt:cific a111icancer drugs with fewer side effects. ''.\lokcular leH'I engineering · is how Dr. Cody characterizes che de ign of uch drug . Dr. ody joined the Medical Founda­ uon staff in 19-0 as an endocrinology tramee working on the structures of steroids. Prior to this she ,,a. a poM­ doctoral fellow m chem1stq at the Univer­ sit) of \fissouri, St Loui.. She recei,·ed her B. · in chemistry from 1he Lniver ity of .\lichigan in 1965 and her Ph.D. in chemi•1rv from rhc nn·crsit\ of Cincinnati in 1969 Her mher ma1or' re earch work at the Foundation is on the structure-activity relationships of thyroid hormone . Archeolog) is one of her major oucside imere t:.. he has participated in field cx­ carntions at archeological sitcs and has tra,-cled to major sites in Mexico, Guatemala, Peru. and Easter Island Dr Cod, i active in the Frederic Hougton Chapter of the New York State Archeolog1cal ssociation and has t1ught courses at the Buffalo ~luseum of cienc:e on the ar­ chcolog) and culture of the Incas and the people of Ea ter I land. he has gi\"en lec­ ture locally describing her climbing ex- �RESEARCH feels and .safety of photodynamic therapy." Tht: new computcr sptem. claim i1s proponc.:ms. Iean:-s nothing to guesswork. "In other words," ,aid Dr. Dougherty, "wl' arc dc.:aling with a medical cxpert systt·m that stores and records all relevant p,ltient and tn:atml'nt d:na. monitors and controls light dosage le\·els. and guidc.:sa physician through any of a number of procedures. The laser 1rcaurn.:nr begins two to three days af1cr a patiem is injected wi1h hematoporphyrin dcri,·ativc, when the rumor is highly ligh1-scnsiriw. The oper­ ator tells the compu1a the desired amoum of light necessary for uealml'nt. T seyo (right), clinical coordi,iator of RPMI's Pbotody,iamic Tber­ demonstrates Fuji Pbotofrin computer-controlled laser 011 penences 1111he \'1kababa moumams of Peru on 1hl' Inca Trail and hcr visit 10 Easter Island. Dr Cody. also with an appointmcnt in l"B's Hoswdl Park Gradtl.lll' Division. has rl'u.:nrly bccn gh·cn an Amcrican Cancer ociety Faculty Resc-Jrch Award for fin: years Her further plans induc.k cosponsor­ ship of an interna11onal sympm,ium of pl:mt tlan>nokb this July. in collabor:111on with Dr. Elhot1 \liddkton, head of L B's lkrgy Di\ ision and prothsor of med1• cine. \t rhe \kd1cal Foundation of Huffa­ lo. she sen·cs as associate re-,earch scientist 111 their :-.tolccular Biophysic:, Department and is editor of their quart­ erly publication, "Impact"' (from "hich part of this article "·as borrowed). • Laser therapy closer to approval A computcr-comrolh.:d laser system dcsigned by Fuji Photo. of Japan and Photofrin. Inc. of Cheek• towaga. may bring photodynam• ic therapy se\·eral stcps clo;.er ro oh1ain­ ing FDA appro\'al, reports Dr. Thomas Doughcrty. the LB professor at Roswell Park ~lemorial Institute who pioneered the C:llKcr treumcnt o\·cr a dccade ago. .\n im·estigational trc.ument that com• bincs a light sensitive drug and \ isihk red laser light 10 destroy c:incerous cells, phocodynamic therapy has been used 10 m:at m·er 2.000 patients at rnon: 1han -'>O facilitics both in the l 'ni1ed Stales and abroad. But .llLhough it has bct.:n shown to eradica1e or shrink 1hc mo;.1 stubborn tumors. phoLodYnamic therap) has nm. to date. relinquished its inn:st1gational sta· tus and its use in tht.: l nitcd tatcs has been rcscricted 10 specialer centers, such as Roswc.:11Park. To obcain its appro\'al, the Food and Drug Administration rcquires that sLUdics im•ol\'ing an im·es1igational drug - such as the hematoporphyrin dcri\'ativc that Dr Dougherty u. es - be carcfull) con­ trolled, in complianct: with FDA :tan­ dards. "Control \\ 'Js difficult Lo achie\·c, because the Lrea1ment proe<:ss, especial­ ly in the amount of red light used. vaned from phpician to physician. and from in­ stitution 10 institution," c.·plained Dr. Dougherty. HowcYcr, with the incroduc­ tion of the compmcr-comrollt:d laser, we fed that t-.·ecan standardize the trcatmt:nt within 1hc parameters of an FDA protocol, thus demonstrating unequivocally the ef. 21 he computer ?1akcs ih calculati?ns based on the md1\'ldual patients dat.1. tktermines the treatmt:nt time, and dis­ plays it: thcn. it measures the fiber out­ put to dett:rmine 1f the laser 1sgenerating enough power, and again displa~.s 1hc an­ swer \X'hen the fibt·r 1s in place tht• opcr• a1or simplr pushes a swnch and the 1rca1ment begins and ends automaticall,·. In addi1ion 10 being an cxcclknt rccor~l­ kccpcr, tht nc,, laser system 1s 'paticnr­ fnendly." As Kenneth \\ "eish;1upt, prc.,i· dent of Photofrin. Inc .. explained: "!~1scrs arc high energy dc\·ices that can do damage to normal tis ..,uc. Our insLrumen­ tation allow-, us to trcaL patients wnh rcduccd risk The computer knows - .ind thaL lets the physician kntw, if and \Yhen 1he patient is rcCl'i\·ing too much ligh1." Once the rclc\'ant research data is c.ol­ lccted, a 'e,, Drug Application ( DA}"·Ill be filed \\ 1th the FDA \\ 'c fccl that we \\ ill be.:able to file.:an !'\DA 111l\VO ,ears." said ~Ir \\'cishaupr. "\\t: arc pr~babl)' looking a1 at least three years before final appro\'al 1s given and commercialization bccomes possible." Dr. DougherL) bclie\'es that, \\ithin the next decade, phmodynamic therapy will join surgery. chemotherapy, and radio therap) as a ,·iable, successful cancer treat­ ment. "\Xe'vc come a long wa) since 19~2 wht:n this treatmt:nt "as 1us1 little more than a dream:· he said. "Just the other day. I \'\,t~ looking at the firs1 lighL source we built. It's falling apart and gathering dust. Looking at the new system. I'm amazed al how far we·vc come u:chnologically." • From RPMrs •Reg,onal Cancer Report," Nov 1984. �HO PITAL EW Roswell receives core center grant T he 1\auo~al Can.ccr lns111utc(, Cl) has prm 1tlctl 13.i.868 to support the second year of Roswdl P-Jrk Memori:11 I n uture\ three-year Core Center Grant. The funding period is from December I, 198~. through Novem­ ber 50. 1985 Dr. Gerald P \lurphy, direc­ tor of Rmwcll ~trk, i. the principal inn: tig:uor on the RP:'\!I Core enter Gr-Jnt. Or. ~lurphy is a LB resear h profes­ sor of urology ore enter rant!> arc a\·ail::ibk from 1 Cl onlY lO in tillllions with I) a base o pecr-rcvic\,cd research funding in excess of -,o,oooannually; and 2) e\ idcnce of intcrdis iplinaq coordination, interaction and coopcrauon w 1thin the ccmer The obJCClivt: of the RPM! Core cmer Gram is to de\elop hared resources wi1!1111the ln.titutc that arc ccmral to O\'er­ ::ill program objectives and that contribute to priori I) activities in various discipline . Roswell Park maintains a ·ore Grant Commiuee of senior . caff members 10 re\iew objectin:s of the Core Grant Pro­ gram, 10 monitor actiYHics and accom­ pli hmems of core projects to d,Hc, and to idcntif) future projects. Two shared re. ourccs currcmly up­ ported arc. I) the Compmer ciencc Methodology l nit, which develops com­ puting, st.Hi. ti al. and systems manage­ ment methodologies for the desig n , 1mplcment:Hion, dar.acolic tion, data en­ try and editing. retrie\·al. analy i . and c\·alu:nion of ha. i and clini al can er rc. earch; and 2) che Med i al Record Regis­ try, which provide casefmding and refer­ ence dat.1for detailed clinical re. earch and cpidemiologicai swdic . The Core enter Gram also pro\·idc · developmental fund., ro new and recent­ ly trained in\'cstigators working in promis­ ing field t\'hi h arc under development within the lnStitUle. ,·ix mvestigator rec:e1,·edsupport during the previou year of the ore enter Grant in diverse area u has immunology. bioph} ic . psrchol­ ogy, and ancer comrol. The ore rant ommim:e was in­ strumental in the pa t year in defining the rationa le for a linical rcsearch center at Ro well Park to facilitate research that de- § --=~=--~ J: "-L!:::..._________________________ Patient Feld. undergoing treatment at Pediatric pends on acce. s co clinical material . In addition to rhe concinuation of the Core enter ram activnie de cribed abm·c, the second-year gram include fund to support a nucleus of taff for projects in the Cancer Control · Epidemi­ ology Department, such as the Cancer Pre\'t:ntion-Dete tion Center. • Pediatric dialysis unit opened T he Kidner enter of Butlalo at Children'. ·H spital announced the opening of 1t Pediacric Dialysi 'nit, rhc fir t specialized facility in \'\'c tern cw York to care for infants and children w·ith renal failure. Jan. 9, 1985. The L'nit will enhance other crviccs provided by ihe hildren' Ho pita! Kid­ ney Center. Peritoneal dialy i i a relarive­ ly new pro edure rhat enable patient with kidney failure ro live a fairly normal life; they no longer have 10 \·isit the Ho pi­ ta! cveral times a week for hemodialy i treatment . Instead. their disea c can be managed at home w•1th the new technol­ og~ now available. Hemodialy i will aJ o be provided in the L nit for patient. re­ quiring thi erYice. • 22 Dialysis Center witb Dr. Leonard High tech aids scheduling at BGH A urgical computer, de igned and developed here make Buffalo eneral Ho pital ne of rhe few ho pita! in the cou m y co com­ puterize it opera ting room chedu ling. The high tech y tern i the mo t ad­ vanced of it kind, and according ro B H y. tem Analy t Arnn nand, it unique capabilitie for multi-departmental com­ munication and a built-in ca e cart scheduling plan are bringing new bu in 10 BGH. After months of operation, the com­ puterized cheduli ng i accompli hing it obje rive: to increase efficiency in the u e of operating room . Reports how opera­ tion are running into le overtime, le urgcry i being performed on weekends, and the O.R. chcdule it elfi righter with mo I room n w being used during pri me urgical time. According 10 Or. 1arco G. iguera, clinical a ociate profe or and head of BGH' Ane the iology Department, the efficiency of the new ·y tern i bringing more busine to Buffalo Gen eral. He pointed our that the entire O.R. chedul­ ing had been done by one pe r on with �HO PITAL EWS one telephone , pencil, era. er, and paper Potential surgerie were scheduled cl e­ \Vhere primarily becau e the telephone line wru; alway~ bu y, he said . T\-vo phone line are now manned b} everal highly tr-.1inedoperator . In a plit second . an eniire day· schedule appear · on the display crcen complete with the critical information for ea h case. " The computer is an ab olute hie sing . \'\e are cheduling two patient , in the time we u ·ed to do one." aid Dr. Viguera. Thi ucce . is the re uh of better plan ­ ning and clearer communication . data bank h Ip · to more accurately determine the length of . urgery. Before, it had been ba ed on liberal time e timatcs for the general procedure . No~. computer operators gather information to bcner judge how long the indindual ' ca e will take. Ensuring that the needed equipment, tests and ca ·e carts arc chcduled and coordinated for each pn cec.lure helps reduce on:nime by ,ivoiding unnecessaq delay . Initially when a urgical ca e i.., hooked, computer operators ask a serie!> of question concerning it. • hould an} special te t · be ..,chedulcd or dedi ated equipment arranged?'\ ' ill the patient be tran ·ferred to a bed 111I L' or a nur ing floor? Thi information i · fed into the main program , and then the program ex­ ecute. the data co be automatically fed to the appropriate departmental report . Designed as a small information system, the computerized surgical program has a word proce . sing function wi h prints daily or emi-daily report for the variow, department : admi ion . . utilization rt'view, X-ray, patholog} , and pur hasing . Replacing numcrou • cumbersome "bits of paper," these individualized print -ouh contain information pertinent 10 pecific department with a rerouce check-off lis1. A master report include information from all department and is the work ·heet in the operating room. The computer has on -line data st0rage capacity of 67 million byres and off-line toragc of ➔ O million byte . The hedul ­ ing program is de igned to adapt \vhen surgical procedure are mo, ·ed to the ne,, building which will increase it currcm 16-room cheduling format to 21. "The operating room atmo:-.pherc b in ­ ten e. If a te c is not per ormed or ome ­ ching unplanned happen , the whole schedule is thrown off , and patients wan for hour!> in the hall ,aim and ciency can be maimained b) pl:inning ·oordinating each surger} ; · said Anand ma} effi ­ and Mr • Rep, ,nrBd lrom Bliftalo Generals "Pulse/Jest, N,:,v 19114 Millard Fillmore, Cuba hospitals sign management agreement C uba ~1cmorial Hospira! and Millard Fillmore Ho pita!. announced the signing of a comract management agreement in eptember 198-t. The agree­ ment called for che immcdiace appoint­ ment of a new chief executi,·e officer and chief fi -cal officer for rhe Allegany aun­ ty institution, lo med 60 miles . outht'a . c of Buffalo. The chief executi\'t: offt er and chief fiscal officer will be con idered member of the Millard Fillmore Hospitals' manage­ ment staff , re ponsiblt: to the board of truscee, of uha Memorial Hospital and the presidenr of the ~lillard Fillmore HospnaL . George E Taylor, M D .. chairman of the Board of uba Memorial , aid : " \Xt'. recognize thac a small hospital need. co have an associacion with, and the expt:rtl e in management that can be af­ forded by, a larger ho~pital ~\". tern. After a great deal of inn:stigation we betie,·e thac Millard Fillmore Hospira! is the be c ·uiced co -en e our need. " Jan R Jennings . pre idcnt of Millard Fillmore. ,rared that " che management team and medical staff of Millard Fillmore are pleased to han .' the opponunit} co work with Cuba ,\lemorial Hospital. " Thi · agreement maintains 1he autonomy of both ho pita! . Each will conrinue under 1he direccion and control of it pre em governing board. The management contract make , ay;iiJable to uba Memorial the killed ho pital management , tecbnt al ervice and other dcparum:ntaJ re ource offered by i\lillard Fillmore . Further. both ho pital will gain in the area of hared upporc serYi es, improved patient are and financt' . This i the fifth ho pita! to come undt'r the managemt'nt of ~1illard Fillmore The 23 other four are: Millard Fillmore Suburban . heehan Emergency Hosp1cal, L3fayecce General , and Gates Circle . A hospital · are added to the group. Millard Fillmore plans to reduce operating co, t · and /or improve sen ·ice . Mr. Jennin > informed those at­ tending the pre . conference char their fir t commitment i co the patienr and the offering of service at a lower co t tu the mstltution . Admini trativc co . t · can be reduced by che sharing of expt'n es. ome of the reasons Cuba ' hospital board ~elected Millard Fillmore according co Dr . Taylor . Is their record of uccessful dealing with the New York State Health Department. and the fact that they are a regional institution inrere ted in local \tall!>-. ~ ithout the expen e of a big cor ­ porace organization. (From Cuba Patriot & Free Press, Sepr 12. 1984) • Dental school changes name T he name of the LBS hool of Den­ ci err ha. been officially c.hanged co the :chool of Dental Medicine, 8 Pro\'osc \X'illiam re111erhas announced . Pre,,idenr Steven B. , ample note when the LB :chool "a~ estabibhed in 1891, dentistry\ primary mi sion wa treatment of l)ral dbease . At thc time, he ays, empha5is was on . urgical treacmcnt of hard and ·oft ti . ue", prosthetic , and variou · manipulative technique~ for rcscoring cee1h Dcnt1 ·cry has cha1,ged dramatically m-er che year , howe,·er . expanding co in ­ clude maintenance of oral health, pre, ·cn1ion of oral di ea e and medical and urgical treatment of the oral cavity . While dental educaci n remains tl1e primar} aim of the chool , the name change refle t the School 's growing , ex­ ten ·ive, internacionally-known rc~earch omponent and the expanding nature of demi •try . UB Dcnta.I Dean Dr. \X'illiam Feagans says mosr dental chools in the orthcast are called choob of Dental Medicine. He 8' n< tc , howc, ·er, that graduates of ·chool, which currently hare the . ame building as the medical chool , will con­ tinue to recein: the D.D.S. (Doctor of Dcn ­ t.11 urgery) de ree. • �WWI bonus funds two scholarships A t the clo:e of \Xorld \\ar I. the L . go\'ernment gan: bonuses to all World \Var I soldiers to show its gmtitude to them for fighting in The \Var to End All Wars. The Lorenzo Burrows. Jr .• :-.1.0., American Legion Post -a of Buffalo , however . said, · Thanks . but no thanks. " Jc was the only \ett:ran · post in merica that voted against the bonus be ause the\ thought the countr) couldn 't afford ii", :ay its present-day commander Edward R. Ahrens. The po ·tat the time wa com ­ posed most!} of physicians who were members of the 23rd General Hospital in Europe, a. well as auornevs . But Congress. acung without the hies. ings of Post -a. appro\'ed the solclter bonuse an} way. Though they wi. hed to decline it. members of the po t had no chmce but to accept it. pon receIv111g the money , tht: group's members set up a fund to care for the post ·s mdigent member . ·of ourse there arc no mdigent doc ­ tors. · -\hrt::ns told the Bujfalo .\ell's. so the n:teran. deposited the 8,000 in a bank accoum which remamcd untouched and forgotten until three year., ago. "It (the ac­ count) was Ius1 one of thrn,e thmgs that weren 't on the minds of people," :-.tr. hrens remarked This year near!\ · 66 years after the (,reat \Xar 'end~d. two l B medical . tudents received scholarships, courte . } of those frugal \\'orld \'\'ar I \·etc rans. e ond -year student tc1·e Domiano recd\·ed 2,000 and Lance Besner, a third­ 1,000 (;\Ir. Be ner year tudcnt, reccin:d also recci\ed the Booke Aw·ard, describ cd 10 an accompanying arucle .) The funds were taken from the ebon Rus. ell ;\lcmorial Tru. t, named for one of the post's co-founcier" , a physician, former B professor of medicine, and alumnu ( lass of I 95) Earning I per cenc mterest over the years, the go\'ernment bonw, had gro,, n cons1derabh · The scholar. hips were presented in 1 O\·embcr 111 Buffalo during one of the po t' two annual meeungs, held ac tts " headquarters, " 1hc . a1urn lub . Je-.ting to a Buffalo Neu·s incernewcr. ~Ir. hrcns added, ·· nd we don't ha"e b111go1· Toda;, the po t mcludc about 225 pro- fcs ionals ,vho li\'e 10 1hc Buffalo area and are \·eteran: of \Xbrld \\ 'ar I and 11as well as of 1he Korean and Vietnam confltet.. • Hooke brothers present award A ctor orrell Bookc and his brother Frederick recent!) pre emed a B medical studcn1 with a . cholar­ ship a..,,ard named m mcmon · of their parcncs , Dr \olomon G. Book~ and Rose Yasgur Booke . \olomon Bookc \'.as an alumnus of the <;chool orrcll Bookc Is ,m accomplished actor lUrrcntl) beM known to 1he public for hb role as " Boss Hogg " in the popular tclc\'1sion ,enc " The Dukes of Hazzard ." Frcdcm .k Booke ban attorne\ in Encino California · · Third -year LB medical '>tudem, Lance Be ncr of Bethpage, i\ Y , Is the firs1 reci­ pient of the award . It ..,,a. e tab Ii hed a year ago w ilh a donation 10 the LB Foun ­ dation . Int . for the purpose of setting up an endowment fund. The fund support 1he B Medical chool\ Student Enrich ­ menc Progmm. which prO\ idc special grancs to medical cudenc: . The Booke Award w1U be ubstantially increased next year, tt ,vas announced . The award was pre enced November I 111 the Medical chool. B President 'itevcn ample and Vice Pre 1dent and Dean of the Medical chool John aughton introduced che Booke brothers. The awardce i a 1982 gmduatc of John Hopkins Lniversity . While there, he wa. on the Dean '· Li. t four time ,md was a member of the Alpha Epsilon Delta Medical Honor ocIety. �Rudnick wins research award UB STUDENT SCHOLARSHIPS AND RECIPI E TS 1984 - 85 ■ James Cumming cholarship ward- Beck } \X'a1ford Bclaycnh Befekadu ■ Almon Cooke cholar h ip Janel \X'inston Timoth\ McDaniel ■ Josephine ■ O ton Award Augustine Agocha Selwyn Adams Lionel \X'illiam Kim Doh.on Guillermo Wal1ers Cheri Durden ■ Lance Besner ■ Loui Beyer Award and the UB Foundation Award ■ ■ Wardell cholarship econd year - Robert Elliot Award t1:ven Kassman ■ cholarship Rohen \tagro Janet Flier ■ Goodale cholarship second , third , fourth year Lloyd Brown Abraham Horowitz Award and UB Foundation :ward M.S. Waugh tockton Kimball Award fir t year \X illiam Kuehnling Oleh Zazulak Sanford Levy ■ - te\'(:n Domiano Lmce Besner ~Hchele Lauria ■ Veterans cholarshp econd year UB Foundation Award Peter Buerger :'llitchcll Tublin Paul Phillips Helen Hess :-.1arit1.aCotto ince his m:nriculation at LB. Besner has re eived the cholar I ncenti\'C. A\\,"ard, a ommendation for cadcmic Ex­ cellence in 1983 and 198--1, and 1hc Douglas S. Riggs Award for Academic Ex­ cellence from the Depar1ment of Pharmacology. olomon Booke. a na1ive of cotland. was graduated from the niver ity of Buf­ falo Medical chool in 192-1.Hee cablish­ ed a family practice in Buffalo, with hi office and home a1 Butler and Lon. dale tree1 on the city· ea t ·ide. The Bookc brother· were born in Buf­ falo and lived here until the family mov­ ed to California when orrell -asa young man. Frederick Booke i · as ociated with the law firm of Flame, ·anger and Gray on, • in Lo Angele and P,,aJm pring . .Medi cal student EdwardJ . Stullk recem ­ ly recefred the 198 4 Dr. John B. Sheffer Award, based on overall performa,t ce in the laboratory . Dr. be/fer (left} , former bead of pathology at Dea cones , and Dr. Job,i M. Hodson (right} , chairman of the Deaconess Medical Ad visory Committee, presented the award to .Mr. Stulik. 25 M ichacl Rudnick, a second year LB medical student, has been awarded a March of Dime· tu­ dent Research gram of 1,000 for a chree-momh project at the Children's Ho pita! of Buffalo. He will work with Dr. Gerd J.A. Cropp. profe sor of pediatrics, on the "Oxygen Cost of Breathing in ys­ tic Fibrosis." • Erickson wins German fellowship T he Federal Republic of Germanv has just m\'ardcd its Alexander \'Ori Humhold1 Foundation Award 10 doctoral student Roger Gordon Erick on. The 1.3,000 research fellowship is gi\ en to scienti. ts who ha"e demon trac­ ed excellence in research. It also pro\'ide. a scHing for foreigner co \\·ork with \X!esr erman . cientbc · and learn about Ger­ man culcurc. l\fr. Erick on will . pend up to one and one-half years there as a l'., _ enior Scienti ·t conducting re earch in neurobiology. He is currently completing hL do coral degree under Dr. Bruce Dow, a sociatc profe. sor of physiology at UB. The Humboldt foundation wa · origi­ nally e tahli. hed by the \X'est German government to repay America for the benefits chat they deri\'ed from the po. t­ \Xbrld \X'ar II ll1arshall Plan. According to lllr. Erick on, Wt ·t erman} 1. one of on ly four foreign countrie with both a ophisricated le\·el of biomedical research and a ·illingness to fund visiting foreign re earcher . Erickson will be studying "i ion and control of eye movement u -ing cat· and rabbit . He i · currently recording neural acrivity in the visual cortex of monkey., the re earch . ubjec t clo esc co human .. The Buffalo residem is the tenth B re. ear her 10 be elected for the Hum­ boldt ward ince it began. Pa t a\vardee included nationally prominenc Dr. Her­ mann Rahn. a founder of che field of pa e medicine: Dr. Avery andberg, prominent cancer researcher and B re ear h profC! or. both of the chool of .\.1edicine; and lase year' recipient, Jim twood, Ph.D., �TUDE associate dean of the faculty of Natural Sciences .ind \fathcmatic .s and assouatc pro cs!>or of chc:mistr} • 'Marx Brothers' emcee show T he .\larx Brothers masquer-Jdcd as medical master-. of ceremonic!> Jt the School of \lcdicmc's Annual TI1lcm how on Fchruar) I. The show\ proceeds will go toward the fund ­ ing of local hypertension clinics . Thirteen acts offered something for e\·eryonc with nine musical forms rang ­ ing from Bcc -l3op and 8roadway to Clas ­ sical and Irish Folk Mark Tobak. \\'alter Gaudino. and <..liff Carol (all Class of '8~) played the \t.1rx Brmhers , wnh · Groucho " taking the role of the " new " .\kdi ·al School Dean In tht • opening skit , Chico and Harpo \ isir Dean roucho 's office to apply to medical school \\ hcn the} ask Groucho ·rs this thc Doctors S hool? ," he answers. " Yes. it's thc finest on<: in \\btcrn . cw York in a t ii ·. the 011/y one in \X'cstern e\\ York Larq Ramunno, the sho\\ 's director. collahoraccd wirh Felio\\ students in the irst act hy singing acapclla with Thc Dc:r­ matoncs group " Bluc .\loon. " Bcatlc,. Bil ­ ly Joel and barbcrshop singing were rhc:ir choices \X'1th his . dcction of Opus 15on pianQ. Archur \\c1..,sman (Cl.tss of '86) proved that you c.111kct·p an audience spellhound hy playing Bee1hon:n in hlue jeans and ten ­ nis shoes touching and dramatic r<.:ndition ot Neil Diamond\ " You Don't Bring Mc Flowers " wa.., sung b} Deborah Shalders and Larry Ramunno (both Class of '87) . "Dueling Guitars " offered a mix of comedy w1th Country and Irish Folk played hy Geoff :\larkowski, Pat Ryan and Pac haughncssy (Class of '8~). ,,hile Sara lyn otaro\ ('88) piano piece " Bumble Boogie " ontrasted ·ich :\tichclc Lauria\ ('88) , 1rav111sk}selections on clarinet. As with last year's talent shO\\, adrenal . ecre ­ tions were stimulated and tympanic mem ­ branes vibrated by the final rock ·n roll sele tion. of Adam Ashton ('8~). Amr Kopp ('8..,). Howard tark ('86), and Ed Kenman, a graduate student. • 26 �48rn ANNUAL ALUMNI SPRING CLINICAL DAY: ORGAN TRANSPLANTATION Dr. Edmund ATURDAY, MAY 4, 1985 BUFFALO MARRIOTT I :15 Regi tration Breakfa t and Continental 8:00 WELCOME Carmelo . Armenia, 1.D. '49 President, Medical Alumni .\ssociaIion John augbton, 1.D. Dean, ·chool of Medicine and Vice President for Clinical ffair. l 'ni vers1ty at Buffalo Frank J. Bolgan, M.D. '51 \1odera1or ; linical Associate Profes,or of, urgery, CB; Chair, Department of Thoracic and Card1ova · ular urgery, Millard Fillmore Ho . piral 8:15 KID EY TRA PL TATIO William Eugene Braun, M.D. Dire tor. Hi tocompatibihty and lm­ munogenetics Laboracoq., Chief, :-01cdi cal Renal Tran plantation Sen ice, <;taff , Department of Hypertension and i\ephrology, Cle\·eland linic Foun­ dation 8:45 Chairman, Transplant Program, Buffalo General I lospital 9:00 OVERVIEW D PDATE 0 PLA TATIO OF CLI ICA.L TRA THE LIVER Byers W. haw, Jr., 1.D. As. istant Professor of "iurgery , l nin;rsi I} of P1mburgh Pi11sburgh. Pa. 9:30 DIC Theodore C. Jewett , Jr., 1.D . '4 5 Profe.-sor of urger} and Pediamc~ 8; A. sociate Chairman, Department of Pediatrtc urgerr, Children·. Hospital of Buffalo 9:45 offee BALLROOM 11:15 DI CU A T Joginder Bhayana , M.D. Assodate Professor of urgt:r} and Direuor of lbnsplants, l 8 11:30 L G TRA PLA TATIO Joel D. Cooper, 1.D. Head. Di\·is1on of Thoracic urgery. 1bronto (,ent:ral Hospnal and l ni,·ers1l} of loronto 12:00 DIC T John W. ance, 1.D. Clinkal Associate Professor of .\lcdi­ one. l B D1rccror. Pulmonar) Labora­ ton-, \lillard Fillmore Ho. pit.ii 12:15 10:15 RDIAC TRA PI.A TATIO C RRE T TAT Jack C. Copeland, Ill, M.D. Profcs. or and Chief. ecuon of Cardi­ ovas ular and Thoracic • urgery, Arizo­ na Health cience enter. Tue on. Az. 10:45 Duane T. Freier, M.D. Profe or of urgery, 8; Head. Department of urgery, Buffalo General Ho pital Roland Anthone, M.D. '50 Cltnical Profe or of urger}. CB: o- D. Pellegrt,,o HEART/L G TRA PL TATIO Bruce A. Reitz, M.D. Profe ·sor of, urger}. Johns Hopkins 'n iver icy chool of Medicine and Cardiac , urgeon -m-Charge the Johns Hopkins Hospital , Baltimore, ~Id 2 PA EL DI 10 Gue t peakers 12:45 1:00 TOCKTO L CHEO Edmund D. Pellegrino, M.D. Director. Kenned) ln:.t1tutc of Ethics. ,corgctown Lni\'ersity: John Carroll Professor of \1cdicine and ~lcdical Hu­ maniue:., Georgetown Cnh·ersity Medi­ cal Center, \Xashington . D.C. �BOOK The British are more parsimonious health with care; we may have to be B y Ro Markello, M.D. Profes ·or of Anestbesw The Painful Prescription Rationing Hospital Care by Henry J . Aaron and William B. Schwartz, Washington, D.C., Brookings Institution, 1984, 160 pp. T/Jef amou · exc/Jange be­ tween Erne t Hemingway and F coll Fitzgerald in u•bich Fitzgerald remarked, "T/Je rich are dzfferen t from you and nze" and Herning­ way replied. "Yes, they ha,,e more money" applie a l o to tbe difference between the American and Briti h health care sy tern. HOW DO THE BRITISH DO IT? There seems tu he no end to the harnn ­ gues about burgeoning health care expen ­ ditures in the Lnited rates threatening the economic stability of the coumry and ul ­ timately pla ing u. all in the poor house Fin: n:ars ago when monetary infla t ion was the predommam on ern of the na­ tion, health care was held up a.-.a ma1or \'tllain . Today, federal budget deficits han: replaced inflation as the bogey -man. and again health care is held responsible as one of the culprit: \X'hatcver the predominant c anomic concern of the nation, ·ealthy phy~i ians with their profligate encumbrances of health care dollar.'> arc the fall guys . One cannot escape the fact , however. that Grear Britain ....:.an advanced litt:rate so• cicty , with a responsible pre s - i.pends per capita in the neighb rhood of 60 per enc of what we in meri a tlo for health care. Are the British as a . ociety undcr­ ·cn ·ed~ Do they li\'C shoncr , more pain ­ ful live ' Do British hildrcn pcnsh in the streets for lack of care? I lcnr}' Aaron i a staff econombt with the Brookings In ucution \\ 'i ll iam Sch'l.vanz is a physician at Tufts who along with tephen Pauker and our own Jerry Ka irrer ha,·e contributed a great deal to our undcr..canding of the decision-making pro ·e ·s and its appli at ion to cli111cal medicine In this well -written narrauvc. Aaron and Schwanz report their finding. after a lengthy tutly of the l ' nued King ­ dom health care ystem Their reaso111ng went something hke thi - ulumaceh if the L , is to cap or decrease health lare expenditure:-. . rauoning of heal ch care will have to ccur . The British alread) ration health care . How do the\' do ll; \\hat Is the impact on the health anti well being of the population; And finally, what arc the perceptions of the British physicians • nd the populace at large? Three factor a count for most of the differences between Brtll h and C" ex­ C "' UJ penditures : I) lower wages in Britain (for UJ _, all lasses of health care profc ·sionals) ; 2) u a: lower races of surgcr) , hospitali1~1ion , or other cxpen . i\'e procedures per popula ­ ~ tion ; and , 3) le . intensity of care. The authors examined the last two factor . in some detail since the casual observer in this ·ountrr would interpret them to 4. Great Britain ha. only one -sixth the mean • lower standard of care. CT scanning capacit) . Keeping in mind that their information i. from the late 19~0s. their results can be 5. The British ho pical y ·rem ha onl) . ummarized as follows · 10-20 per cent as many intensi, ·c care bed.'> • Three therapeutic procedures arc per population . J\losr ho p1cal· ha\'e fe'>' provided at cs. cnually thc: same Jc,·cl in ICL bed· or none ar all . Britain a in the l ' S. 6. The rate of coronary aner} . urgery 1. All pacients wuh hemophilia obtain in Britain is approximately 10 per cem that high qualicy treatment of the •. 2. ~Jcgavolcageradiotherap) is available 10 virtually all patients with can er "ho 7. Hip replacement occurs approximate ­ can benefit bencr from it ly ~5 per Ct:lll a.'>frequently in Br itain a 3. Bone marrow transplama11on occur · in the t.:: . w 1th the same per capita frequency m • hcmorhcrap) for pmentially ura­ both countries . ble tumor i. admini tered at approxi ­ • ther ·en ices are clearly rationed . macel) the same rate ac;in the U. . but ~ r 1. X-ray examinacion per capita o cur tumors noc respon ive to chemotherapy, half as frequently in England a in the l '. trcatmem is rnrely undertaken . and onl) half as much film per examina ­ tion i c nsumed. \\"orld Wttr If profound()' cbanged political and ·ocial attitudes tou •ard 2. Race of trcatmem for hronic renal bealtb care 111 Britain .\Ja11ysoldier failure i less than half in Britain than that and cil'ilia11s treated for bombing i11of the U . . }'Ct kidney tramplantacion rates 111ries receil'ed bigb quality medica l art: comparable , the differences account­ care for the first time in t/Jeir lil •es ed for by a chr ni dialy~is rate in England and tbey got it ·Jree ... le.. than onc-chirtl that of the L' . "Tbe pn1 •a te patient pays to az·oid 3. Total parenteral nutrit ion i under­ u •ait111g, tile national bealtb sen ·1ce taken perhaps 25 per cent as often in Brirai n . pa tient ll'ait · to m•oid paying " 28 �BOOK t) to their lives. lndidduals with hip dis ­ ea. e al o are apt to Iive c\·eral years. \X:'ithout urgery , re. ource would have to be expended 10 care for them irn mu h as they can be invalided . Thus, urgery for hip di ease has an economic payoff and may be one of the reasons why the rate are not too different in Britain a com­ pared with the U.. The author go on to Ii t se\·eral factor · that eem to influence n: our e allo ation . ome reflect the in ­ fluence of administrative arrangements on the allocation proces . ther are an ex­ pres ion of ocie ty' value judgment . or attempt to make the m t efficient u e of re ources . L sing the m1cllccrual di. :sccting micro ­ scope , the author aLtt: mpt 10 explain the e seeming di crepancies . For life and death 1tua1ions-sen:n: automobile.: m1u­ ry, d1abeuc coma _ myocardial infarc ­ tion - the Bnu . h y tem accommodate:-. al the . ame qualit) as that rendered in the l : . Our two s,·stems differ markedly when it comes to tho e illne::,. cs affecting qualit} of life The Briti h do not expend large amount::- of re. ource::- on mdi,idu ­ al who ·e expected life pan is brief anti in which the quality thereof Is Judged to be poor . Patients ,vith end -stage renal di ease who are elderly or who have under ­ lying d1abe1e or other muhiple -sy. tern diseases are not given access 10 chronic dialysis . For younger patient~ \'\·ho ha\·e acute renal failure , dialy~is with the expec­ tation of 1ran. plantation doc occur at about the ~amc frequency in both countries . There i logic in the difference be­ tween surger} for coronary artery di ease and hip replacement. Coronary bypa · in England i mu h le · than that in the l ' .•. ina much as individual · with coronary ar­ tery di . ea e ·an be 1rea1edmedically and can function \"\-ith a fair amount of quali - 1. Age. The British do not scrimp on health care for children . Their expendi ­ ture per child arc 119per cent of that for an adult , whcrea in the l ' . . we pend three rimes more per adult a compared with children . The difference is lower ex­ penditure on adults in England . 2. Dread Disease. Can er tench to eli it more fear than ome other illne · e : hence . mcgavoltagc radiotherapy in En­ gland occun- a.~frequently a.~it doc m the L'... as does cancer chemotherapy in tho . e individuals with a reasonable expectation of prolongation of life. 3. Visibility of Illness. Hemophilia and archriri produce vi ·1ble mi cry. Perhaps that I why those illne . ses recei\·e on a per capita ba 1s almost a. much re ource in England a in the L 4. Advocacy. Pre sure groups u. ing the politi al proces are able to encumber an inordinate amount of resources for a giwn rare illne · . 5. Aggregate Cost. If the cot.a.Ico ·ts for a given illne s are percei\ ·ed to be fairly small, for example, hemophilia, there i lit ­ tle pressure for rationing . 6. Need for Capital Funds. For ·cn ·­ icc requiring large outlay~ of capital or equipment, buildings , and per ·onnel . pre . ure · will cur to ration or do without alcogcther 7. Costs of Alternative Modes to Care. If o ts of not treating are percei\·ed to ex1:ed co t of acrivc intervention (hip replacement), there will he little pre sure for rationing . 8. Quality vs. Quantity. Rather than reducing quality to trc tch their health care dollar · fun her, the Briti h tend to give high quality co fewer people . lkili b pbysicians often /Jai·e to re- 29 fuse certain patients treatment . Tbe local intt•rnist u·bo conl'inces bimself !bat tbe patient is unsuitable because be is ·a bit crumbly · can ay "no " ll'ith less di comfort . Becau ·e of t/Je respect tbat most patient. bm·e for pbysicians . doctors ' recommendations are usually follou :ed u•ilb little com ­ plaint DEALING WITH RESOURCE LIMITS. ·in e phy ician under the ational Health en ·i e ha\·e e\·ere con ·craint: n the mL-an· a\'ailable to chem for treatment , the) tend to make choices u ing their be ·t judgment. For tho e, paru ularly the ter­ minally ill. requiring chronic dialy is, a great deal of r:itionalization o curs . , oci ­ cry doe not appear to object and there 1 nor the concern for malpra 1ice action that might o cur in the .. Phy ician · do admit that if a patient in I t or if a gener ­ al pracuuoner in ist . then cr\lce that otherwise would not be pro\'ided will he a\,lilable There ha. occurred in the Brit ­ ish press . en :re criti i. m to rationing , par­ ticularly in the ca5e of coronar) artery urgeq, and the inace ·sibility of care for minority group .. ccondly , there 1. an in ­ creasing pri\'atc care y rem m Great Bn­ tam for those with means to pa) outside the , at1onal Health en·ice ;,ystem. ln ­ crea: ingly, employers are including priv,uc health in urance a a fringe benefit. The thru l of thi. bo k differ ,·er) In­ tie from what puhhc health people ha\·e been tr) mg to cell u · for the better part of the century. namely, curative health care doe . not influence the O\'erall mor ­ tality of a population \·cry much , but it can encumber a great deal of . ocict, ·.­ resources imprO\ ing the lot of a very few. The amount of re ourcc a society choo cs Lo allo arc for health care i the re:ultant of a number of force both o cial and economi The Briti. h pend le s (or en umber !es ) becau. e thC} are more philo -ophical (or pa si\'e?) about certain kind . of illne . s in relarion to tht· rest of their needs. Ameri ans because the) seem co be much more a tion -oriented and ·u piciou of O\'ernmem control , would probably nor be nearly accepting of the British sy rem of rationing . Ne\·enhele , ina mu h as our own ocial evoluuon fol­ lowed that of Britain and \Xe. tern Europe, we may well be ailed up n to ration care in thi countr). If 0 , the Briti h model may be a reasonable one to follow • �PEOPLE Physician donates rare art books A By We nd y Arndt Hunt rare, three-volume ec of book featuring 201 of Leonardo da inci' ana­ tomical drawing ha · been donated co the Univer icy through the B Foundaci n by a 1977 hoot of Medi ine graduate . In memory of hi father and in honor of hi mother, r. Ru ·ell J. an oever­ ing II , linical a i cant profe or of B- Y , ha given B the Corpu of Ll the Anatomical tudie in tbe Collec­ tion of 1-/er Maje ty tbe Queen at Vind or astle . It will be hou ed in the Health cience Library on B' ouch ampu . The ,000 edition i one of 99 print d in Engli h by the Curwen Pre . of London in 1980 under the pon r hip of the John n R print orporation , a ub idiary of Har oun Brace Jovanovi h, publi her . Until chi, one, no ingle edition included the entire ind or collection of Le nardo ' anaromi al rudi , hi h date from 1--t 3 co 1513. Thi edition pre ent the bulk of th se tudie many of which he completed after he di. ecced 30 corp e - in chronolog ­ i al ·equence a companied by a tran ription and an Engli h tran lation of the ani t ' note . A olander box hold the fac i­ mile . Two te t volume accompany chem. About the c xc, written by co ­ editor Carlo Pedretti and K nnech Keele, a ar h 19 3 i ue of The Art Bulletin tates, " The cholarly contri ­ bution of Keele, in placing Leonardo ' note and imag in th cont xc of ch hi tory of anatomy, and of Pedretti, in e tabli hing the chron logy of the drawings and r con eructing the page equence of tho e heet which had originally con tituted notebook go far beyond the achievement of earli ­ er editors of Le nard 's ork ... They not only give us new insight into Leonardo ' a hievemem a an in e tigator of the human body, but al o offer an unparalleled per peccive ,, , J on hi intellectual and methodologi ­ cal development during the alma t 30 y ar pann d by th ind or tudi ." Pedretti, who ha written 16 book and 30 article during hi three de­ cade of re earch ab ut Leonardo, h r f arc hi tory at the been a pr ~ niver ity of California at Lo Angele in e 1960. Ke 1 , who ha tudied 30 the Leonardo dra ing at the Royal Library at ind or Ca tie for o er 35 y ar , erv d a pr id nt of the Hi tory of edicine ection of the Roy­ al ociety of Medi ine . In 19 , he at wa named the fir t Fulton fello Yale. Van Coevering, who practice a an ob t trician in outh Buffalo, d dicat­ d th publication in m mory of hi �PEOPLE the Public Educacion and Community Program Committee of the merican Hean s ociation, Dalla . He will ato continue to er\'e a chairman of che ub­ commirtee on Stroke. Dr . Gre ham i a member of the Editorial Board of the AHA journal , troke : A Jou ma/ of Cerebral Cir­ culation and of the AHA troke cientif ­ ic Council. • DR. K Kl HO G, PROFISOR OFPHY IOlr ogy, received the tover-Link Award of the nder ea Medical ociety in June 198'1. He ju c returned from a ·abbatical lea\'e in Japan where he directed a C.. -Japan ooperacive Dive . • DR. H RVEYPREI LER, RfSEARCH OCl­ ate p rofe · or of medicine, will wdy the re pon e determinant in acuce myelo yt ­ ic leukemia with a 3.3 ,0'12 gram from the National Cancer lnstitme . • (L-R) Dean aught011 , Dr. Vati Coevering , and Health Sciences Librarian Huang with art book. father, Rus ell J. Van oe\'ering r., M.D ., a 19'½9 B gradua te, and in honor of hi mother, Victoria an Co vering. Educated a a nur , the eld r Mr . Van Coever ing manage her son ' ob tetrical practice, wh ich wa one hi father' . ot only becau e he b lieves it' a good re ource for cudent , but al o becau e he wanted Buffalo co have one of the rare edition , an Coever­ ing dona ted a th re -volume et to UB. an Coe ering , hi ._ ife, Kathleen, a nur e prac ti tioner who work be­ id her hu band, and two daughters r ide in Buffalo. • THE E CHIEFOF DR. WCI lhe anccr enter Branch in the Di\ •i ion of Cancer Prevention and omro l at the National Cancer Institute . He erved on CB' facu lr from 1966 co 19-,'I as a re earch profe o r of medicine. He was al o former chief of pediatric at Ro well Park Memorial Institute. • C.K. DR. FRANKORSI I, R~EARCHA ISTA T profe ·sor of microbiology. will tudy the comparat ive immunity of childhood and adult leukemias with an 8,000 gram rom The A sociation for Re earch of hild­ hood Cancer , Inc . (AR ). • DR. RICHARD J.R. JOH O , CLI ICAL ·ociate profe or of radiology, received a '16,50.3 grant from the ational Cancer In •1itute 10 ·upport and maintain the n::search program . of Roswell Park Memorial In titute· Radiation Therapy Oncology Group . • DR . ~ ULG. F , 'CHA D DONALD. FABER recent ly publi hed an article in cience (Augu 1 198'1)chat de cribed new finding on the myelin heath re i tance of axon and their implications for pathophy . iol­ ogy . Dr. Funch i. a re earch as i tant profe or of phy iologr and Dr . Faber i a profe or of phy iology . • DR. CORNELIUS o·co ELL,CLI ICAL I cant profc or of fami ly medicine and a phy ician at i ter Hosp ital. ha recei\'ed DR. E RICOMIHICH , R~EARCHASSOCIATE the p cate ew York Phy ician Recogni ­ tion Award from The American ollege of profe or of pharmacology, i conducting Phy ician for hi out tanding contribu ­ research on drug den:lopmcm and cancer tion to patient care and teaching. • therapeutic with a recent 105,092 grant from The ational Cancer In titute . He DR. GLll IL GRISHAM , PROFfSOR AND al o received a 9'1,.3'1'1gram to cudy chairman of 1he Department of Rehabili ­ cancer chemotherapy and it immunolog­ tation Medic ine, ha been reappointed to ic effect . • 3 DR. BEVERLY Bl HOP.PROF~OR OFPHY iology, recently went on a lectu re tour that included Japan, Au tralia , and cw Zealand . • DR. LEONFARHJ , PROF~OR D CHAI~ of phy •iology, ga"e the Alvin Rie k Lec­ ture at the Medical College of \X'i con • in in 10\·ember 198 ➔. DR. ASHfSHK. MAULIK , CLI ICALI TR C­ tor of medicine, has relocated hi practice of internal medic ine and cardiologv to 2628 West tatt: erect in O lean. .Y. He b chief of medicine at Olean eneral Ho , pita! and is the director of the cardi ­ ac treatment center at t. Franc i Ho . pi ­ cal in Olean. Dr. Maulik i cenified in internal medicine and i a fel!mY of The American College of Phy icians, The merican ollcge of Cardiolog}', The Ameri an Heart A sociation (Coun ii on Clinical Cardiology) , The ew York ardi­ ologica l ociecy. and the Royal College of Phy~icians of anada. He i. aLo a mem ­ ber of the American Medical As ociation and the ew York 1edical ociety. • DR. GERALD FRI , CHAIRMA A D profe sor of urology . wa recently ap­ rological pointed to the American ociation ommillec which elect A A cholar . Thi · committee i national in cope and includes three other member . The A A cho lar program invite · ap- �PEOPLE Rogovio , form r a ·i cant auorney gener­ al of the L'nited tate and chief oun ·el of the I R , and W. Clement tone, re­ tired h1cago bu inc ··man and political figure . Dr. Pe ch's wife, Donna tone Pesch, i · also a board member and i daughter of \V lement t0ne . he ha been very active m the pre-.·ention of child abu e and has served pr ident of che W. Clement & Jc ie tone Foundation, a philanthrop ­ i organiwtion. Or. Pe·ch previou ly crved a dean of Mi hael Ree c ' cho I of Health ience , of tanford niver ity inc. and director of the plicauon . from mdJVidual ompleLing Lhcir urologic rcs1dcn ·y Lraining who wbh to pursu<.:a career m academic urol ­ ogy Tho e mdividuab ·ho receive such an award spend two years primarily in basic research in order Lo de, ·elop their research capabilities :election of the ap­ proprime individuals therefore impans directly on the future of academic urolo­ gy and i a particularly critical cask. the meric-Jn Urological sociation notes .• DR. CARLPORTER , R RCH OCIATE pr fes or of patholog}. wa awarded an 81. 7 21 grant lat fall to ·cudy p lyaminc deri, ·auve a anti-can er agents . • DR. ARNOLD FREEMAN , PROFF.SSOR OFPEDl­ :nric • received two recent grants , a ~0.935 grant from The American Cancer Society 10 conduct a work ·hop on pedi ­ amc brain tumors . He al o was awarded a 10,12 grant from The . o 1auon For Re carch of hildho d ancer. In . to condu t pharmacokinetic stud1e · with high -dose hemotherapy. • DR. J. ED O PO TES, A OCIATIPROF sor fur logy , will stud} gamma intcrfe ­ r nm cellular , , ·iral and immune y terns with a recent grant for ➔ 5 ,:\36 from the acional ancer lru,u1ute. • DR. J ES LEE, PROF OR OF MEDICIE and director of h penension at the Erie unty kdi al Center, ,va hon red re• cently at the ait.ama Medical ·chool in Japan wiLh a testimonial itin his pioneer­ ing tudie on the role of kidney pro taglandin in bl d pre sure regula ­ Lion and ability of the kidne)- to eliminaLe alt The recog_nit1on took pla c during t he International onferencc on Pro ·1.aglandin in Kyoto , Jap.m Also the medical director of E killed nur ing facility. Dr. Lee di overed and identified the bl od pressure lower ­ ing and ·aft-lo ing pr ta landin in the kidney 25 year ago. Hi current ·ork in the field is upport ­ ed by a grant from the \X'e tern e," York hapter of the Kidner Founda ri n, the . . t te ffiliate f the American Heart ociation, and the 'ew York tale Health Re earch ouncil. • • DR. LEROY P~CH , DEANOFTHE B CHOOL of 1edicine from 1968 lo 19""1 , ha· been selected a the new hairman of Ht.-allh Re ource orpora11on o America . Dr . Pe ch has pre, iou , ly , erved a · deputy J si. Lant ~ecretar} for Health and cit:mific ffair ac the L. Department of 1-lt.-alth, Education and \Xelfarc . Iii other past po­ sitions in Jude pr fc sor and hairman of the Department of .\lcdi ine at Rutger :-.1edica1 chool. and pre 1dent of Mi hael ReeseMedical enter, a large tertiary care center in hicago . I-le 1sa well -known cli­ nician and academician and al. o i pre i­ dem of hi own holding corporation, Pe• h and ompan} The company for which he crn: a · chairman , Health R~ ur e Corp ration of America, i now one of the large t such corpomtion · in it field . The company' net re,·cnue gre" from ➔ . 2 million in 1982 to 200 million in I 83. Headquar­ tered in Houston. it i inv lved in numer ­ ou health program ranging from pre, ·cnti\·e medicine and wcllne to ex­ ercise and h spital treatment It own a number of hospitals, including onhwcst Medical enter in H U!,tOn, •hich will bt: one of the large t privately owned ho pi ­ tals in the L'. when it i · completed . It abo own ne of the large I L'. . health are con ulting firm , John hon and · oc n the board of d irector:. with Dr . Pc ch are pr minent cardio\'a cular ur­ geon Dr. Michael DeBakey· Mitchell 32 SE ERAL B PROFESOR A D PH~ ICIAN at the Erie ounry Medical enter recent ­ ly vi ired the People.· Republic of hina and Tibet. The . tudy cour was organized by Dr. Franz Gia auer , profe · or and acting chairman of curo urgcry, under the au pi es of the Congress of curolog­ ical ' urgery and the ontinuing Medical Edu ation Deparcment of the UB Medical ch ol ther faculty participating were Dr. George Alker , acting chairman of radiology ; Dr. Eugene Le Uc, clinical prufe sor of radiology and nuclear medi­ cine ; Dr. Imr Mago , profi or of urol· gy. and Dr. Reinhold chla eohauff, a c1ate professor of neu rologr, In addition to the ight eeing which at time wa breathtaking , e pecially in Tibet , visits t medical chool and ho pi ­ tal in the following citie ·ere arranged : Hong Kong , Kunming, Lha ·a, hengdu. Beijing. Le ture pre enred by the par­ ticipant were well-received and the di • cu , ion and exchange of medical knowledge were mutually fruitful. The ho ts were very grateful and appreciative of their vi ·it and frequently reciprocated with gra iou banquet , they r p rt. Thi wa the -e nu ·uch study tour to hina for Dr ·. la auer and Alker • DR. RICHARD BETTIGOLE , profc r of medicine and linical a · oci ­ ate profc or of pathology, wa named chairman of che p rate Region of In pec­ tion and Accreditation program f the America n o iation of Blood Banks. He L director f the blood bank and hematologr divi ion of Erie unt , Laboratory. • �PEOPLE DR. MARYHENRICH ONEOF l WESTERl ew York women honored ccober 31, 19 4 for out tanding er\'ice co their com­ munitie and profe. ion. by UB' Com­ munity Advi ory Council. In private practice ince 19 ➔ 3, the UB clinical a istant profe or of ophthalmol­ og}' is a pa I board member of the Zonta Club and i acti\'c in the hurch Council of Holy Trinit} Lutheran Chur h where he chair the ocial Mini. crie Commit­ tee. The latter deal with social problems and church re ponsibiliti to the commu­ nit}'- he i a pa t pr ident of the local club of her alma mater, ,\It. Holyoke Col­ lege, and a member of the American led­ ical A ociation, the Erie ounty Medical o iety, the Buffalo Ophthalmology o­ ciety, and the American cademy of Ophthalmology. • the voluntary staff 1· Dr. Jo epb Gerba ­ i , an attending in surgery and clinical as­ ociate profe. sor of . urgery • American \1edical ociation, the Ameri­ can ademy of Pediatric . and the Ameri­ can Academy of Cerebral Pal y. Dr. Elliot F. Elli will continue at hil­ dren's Hospital a~ head of the Divi ion of Allergy and a scientific director of the ne,...ly formed Re ear h Foundation. • From Children's Hospital's newsletter "Bam bi­ no," December 1985. DR. :YERY iDBERG , RFSEARCH PROFF.SSOR of medicine. recently received two grant. from The National ancer Instirure. A 61, ➔ 9 ➔ grant will be u ed 10 inve tigate hromo ome of human bladder tumors. Anu-cancer drug ) tern will be t ccd u ing the e ond grant for l,➔ 69. Dr .• and­ berg is al o a re carch a ociatc professor ofphy iology in LB' Ro-well Park Gradu­ ate Divi ion . • Robert E. Cooke John LaDuca DR. JOH LaDUCA , B CLI IC L A OCIATE pro~ or of urgery. i the new president of the Erie Count} Medical enter medical-dental taff. He i an auendmg in urgery Other officer are: pre idem-elect, Dr. Ro Markello who is profe .. or of ane the io logy and an aHending m ane the iology; trea urer, Dr. Jame Evans who is an attending in surgery and a ociate profe or of urgery; and secre­ tary, Dr.Jao ovak who i clini al direc­ tor of the GI unit and a· i tant profe · ·or of medicine. Reelected repre entative of DR. ROBERT E. COOKE , . CO, GER Goodyear professor of pediatri and medical director of the Robert \X'arner Re­ habilitation enter, has heen named act­ ing pediatrician-in-chief of Children s Ho pital and acting chairman of L'B' · Department of Pediatrics. Dr. Cooke·s appointment became effecti\·e on Jan I, 19 5. upon the re. ignation of Elliot F. El­ li , M.D. , "'ho erved as chairman for over JO year•. Dr. Cooke. a pediatrician for over ➔ O year • ha· been medical direccor of the Robert Warner Rehab1hta11onCenter ince May of 1982. He is also chairman of the cicntific Advisory Board of the Joseph P. Kennedy, Jr Foundation and a board member of the . o iation of Retarded hildren of Erie Count). Hi· distingui hed faculty title is an endowed chair con­ cerned with pediatric ambulatory care. Dr Cooke was pediatrician-in-chief of John. Hopkins Hospital from 1956-19..,3. and from 1965-69 ,...-as chairman of the na­ tional steermg committee for "Project Head tart' which 1.· no,... a mulu-billion dollar child development program. Active in many professional ocieties, Dr. ooke is a past pre. idem of the oci­ ety for Pediatri Re earch and a member of the American Pediatn ociety, the 33 DR. GERALD P. MURPHY , B RFSEARCH PRO­ fe. or of urology, director of Roswell Park .\1emorial Institute. and immediate past­ president of the American Cancer ·ocie­ ty, has been appointed chairman of the .·oc1ety's important Public I sues Com­ miuee. The Public Issue ommince deal ith regional, ·care, and federal legislative is­ su s. evaluating their content and pre. em­ ing the ociety' viewpoint Re cntly, the Public I. sues ommittee was instrumental in passing of the Com­ prehensive moking Education Act. • �OTES CLA C harle Ladouli ( 1'6 ), upon learning that everal area cla mate were unable to attend the May 1984 -0th reunion of the la of '6<i, want to note "chat the Cla s f '6q i well repre ented in the Hou ton area not ju c in number . but by a elf-appointed b dy --The Phenomenon Club' " Thi alumni gr up welcom all B medical alumni h live in or vi it the Hou ton area for any rea on and e, tends "an open invitation to all ho care t j in u in body and spirit." It al o onduct - periodi meeting of profc ional and ocial in ­ tere t. Th fir t meeting of " The Phenomenon Club" was held at the D lub of th Texa Medical Center of Hou . con, on December 13, 198'f. Dr. Ladouli rite , "Dr. Leroy Leed , founder of Ob-Gyn A ociace of Hou ton and p t pr id m of the Hou ton o­ ciet furni hed bona fide 'working' replica of the Havana cigar fav red by our famou no • emeritu profe or of anatomy, O.P.Jones! . . . ur newe t emi re, RobertJordon, chairman of Oermatolo at the niver ity of Texa Hou ton, not only elected the wine but al o contributed heavilv to the Havana overc r." Dr. Steve cheiber, profe· or of p ychiatry at the nive ity of Ariz na, was their gue t for the second meeting f the "Ph nomenon lub" in Hou ton, F bruary 10. Lo king far ahead, Or. Ladouli ugg t that B con ider having atellit tran mi i n of pring linical Day in the future , including tran mi ion t a Hou ton ite. The a ociate profe or of pathology can be ontact d at niver ity of Te , Medi al Branch Ho pita) , Galve ton, Texa ., 550. • d1capped on the Florida Key . He i,elcome . any information hi. peer can a sist him with in this project. Dr. \X'hice· · addr~ s Is. 2.3 ➔ ~1ohawk 1reet, Ta\'er­ nier, Florida .330~0. GEORGE THORNG TE I ( 1'45) • writes. ·• fter 12 yt:ars I \\-ill re­ tire from the practice of Ob­ Gyn on the Monterey Peninsu­ la. ontrarr to what many may think. I will not dernte my elf t the tud} of g If " 1930's ILLIAM M. HA ZEL (M'3 l ) • who i prof es or of epidemiol­ ogy in the l!niversicy of Illinois a1 hicago ' S hool of Public Health. \Va honored re entl) by that university 's spon . r­ ship of a ·ymposium to mark the 25th :mniver arr of h1 landmark paper produced in conjunction with • athan Man ­ tel on the tratified anal) " i f categorical data . HAR EY C. profe . or LO M (M'32) • emericu . of CHARL E. IL (M' 5) • h been elected governor of the American allege of · ur e n · for a three -year term . Dr. Wile pre enced an exhibit on chokdochal cy ts at the annu­ al meeting in an Francisco. am:sthe. iology at The l'ni, ·cr ­ sil) of 1i·xas Medi al Branch. recently w~ elected to facult} membership in the TexasAlpha hapter of lpha mega Al­ pha. the nmional hom rary medical ·ociety. The award is made to medical faculty mem ­ bers who demon . irate out­ standing leadership ,tnd achie,·emem M' 6) • h s been ce Pre idem of the r nsorcium of c ncil and to hild the International peaker Plat­ form . In eptember he ·a ap­ poimed 10 the 12th District Medical uality Review om ­ mittec, Department of Medi al Quality ·uran e. ARTB R J. CHAEFER(M' ) • lini al a ociate pr fe ·or of ophthalmology at l ' B. was in ­ ducted into t J eph ' C I- 1940's JOH D. HITE( f 0) • i estab­ lishing a con ·uhing crvice for the blind and phy ically han- 3 legiate In titute' " ignum Fidei " ociety recently. The award i iven to t. Joe' alum­ ni ho have made outstanding contribution co their profesion . Dr. chaefer i currently chief of ophthalmology at i ter · Ho pita! and t. Jo eph' lntercommunity Hospital in Cheektowaga . He wa al o elected vice pre idem of the American ociety of phthalmic , Pia tic, and Recon trucrive urgery for 19 5 at their annual meeting in Atlanta. 1950's MILFORDC. MALO, EV (M'53) • an internist -cardiologi t and clinical profc.-sor of medicine at l'B, wa ekcced to a three­ year term a tru ·tee of the merican ociety of Internal ~ledi ine. He i • al o dire tor of L B's affiliated medical re •idenY training program at lercy Hospital. JEROMELE I E (M' 58) • after more than 20 years of federal service with the National In ti• !Ute of Mental Health heading the p. y hopharmacology re­ search program ha left the Public Health ervice to be­ come re earch profe . or of psychiatry at the P ychiatric Re earch emer at the ' niver ity of Maryland. 1.960's ROBERTJ. 1 LAruT (M'60) • i pre idem of 1he ew Jersey b tetrical and ynecological oci ty. Dr. Malate ta, a clinical profe or of ob tetric and gy ­ necolo y at Rutger chool of Medicine, 1 a member of a number of profe ional organi­ zation : American ociety of Planned Paremho d Phy i­ cian , laternal Mortality subommittee of the 'ew Jer er Medical o ietr. and the Paren- �OTES CLA cal and hild Health ervice Advisory ommittee of the ew Jer ey tate Department of Health . WE DE WESTrGRO E WGA ' ( '61) • a Roche ter rad1ologi t recognized nationally and in ­ ternationally as an authority on diagno ing breast cancer, poke at the econd annual ulver 1emorial Lecture in Radiology on December 10. 19 '!. Jc wa co - pon ored b) the ulver Memorial Lecture hip Fund of the Buffalo General Ho pital and the Buffa. Io Radiol gy ociety. Dr. Logan lectured on " Breast Cancer Di­ agno i : the Radiologi r' Ex­ panded Role." A Buffalo native, Dr. Logan has been a catal) 1 in the early diagno i and treat­ ment of brea t cancer. he i one of rhe few private practice radiologi ·t in the field and promote u e of the most ad­ vanced fi rm of diagno tic im ­ aging : mammography, thermography, and onogra ­ phy . he i al o a trong advo­ cate for patient education in thi field . he i author of everal publication on brea. t cancer dete tion and i a mem ­ ber of many profe ional or ­ ganizations, including the American allege of Radiology and the American ancer o ­ ciety . he is a con ulrant to the Ro well Park Memorial lntitute . JACKFISHER(M'62) • of La Jol ­ la, California, a profe or of urgery at the niver ity of California , an Diego , received the hancellor ' Award for Community ervice . He was cited for e cabli hing a mobile urgical unit for treatment of birth defect in developing na­ tion and for e tabli hing a Youthful Offender Recon tru tive urgery Program. RICHARD E. DuBOI (M'63) • i pre ident of the eorgia oci - ety of Internal Medicine and pre ·ident-elect of the Medical ·sociation of Atlanta . Dr. DuBoi is an a. ociate clinical profe or of medicine at the Medical College of eorgia . THO M. FOTI (M"63) • clin ical a o iate profes or of p ) · chiatry , and hi famil) have been named "Family of the Year" by rhe Eastern Tenni A ·. ociation . Dr. Foci, his 'i\'ife. and three children were cited in January in William ville . Dr. Foti de cribe him elf as a " o­ cial " tenni player while hi wife ha won cournament prize and i an organizer of junior tournament . RICHARD NARI ( 1'63) • has contributed money t the ' B Foundation to tabli h the Dr. . Robert arins Memori l Fund at L'B. The endowed fund-a memorial t0 hi father-will benefit tudem 111 the chool of Medicine' Department of Dermatology . A dermatologist in ,.; illiam ville , .Y., for the pa t l""' year , a­ rin aid , " I would not be where l am today without my father and B Without que ·. tion , my father wa my clo e t friend . He '>Va my greate t in piration ." Hi father , an earl} 1930 graduate of Loui iana ' tate U ni\'er ity, made hi home here after marrying Buffalo native Pauline ~ alien . arin . He practi ed dermatol ­ ogy in thi city fr m 19-19un­ til hi death in 19-1. He was affiliated with Millard Fillmore Ho pita!. Hi widow live in William ville . THO Y . GRJ A Tl (M'65) • wa named chief of urgery for 19 5 at aim Jo eph Medical Center, Burbank , California. He i a Diplomat of the merican Board of Otolaryngolo&) , a Fel­ low of the merican College of urgeon and , al o a fellow of the American Academy of Fa- 35 cial Pia tic and Recon tructive ' urger) . Tl I (M'66) • i prac­ ticing orthopaedic in La \'e­ g- , e\'ada. He i a con ulting team phy ician for the Urn verity of c, ·ada, La Vega· and team ph} •ician for the La \e­ ga merican Profe ional o er Team. Dr . ' erfustini is currently vi e hief of taff at the ·outhern 'e,-ada Memori ­ al Ho pita!. A.H. ERf JOH E. HIELD (M'68) • ha been appointed Medical Dire tor of the eafield Alcohol Re­ habilitation Ccnrer. \Xethamp ­ ton Beach, 1 cw York . 1970's EB I. FEI TEI ( ' 0) • re­ cently became vice chairman of the cicntific Advisory ouncil of the National Kidney foundation of ' outhcrn alifornia . He al o recently be­ came as istanr editor of the American journal of Nepbrol ­ ogi 1. He i an a:. ociate profes - or of clinical medicine at l nh ·er ity of outhern alifor ­ nia in Lo Angele .. I le i a fel ­ low of the American College of Phy ician and a member of the Ameri an , ociety of ephrology and the American Federation for Clini cal Re earch . Hi~ re em journal ar­ ti le describe hi. re ·earch on nutriti o nal therapy for acute renal failure and chrroid func ­ tion ,vith nephrotic syndrome and chr o nic renal failure . The re carch appeared in .Uedicine, American J ournal of Nephr ol­ og)\ and Joumal of Clinical Endocrin ology and ,\Jetabol­ ism JERALDBO I O (M' J) • recent ­ ly published four re earch ar­ ticle in the American j ournal of Opbtbalmol ogy and two other journal in that field . The~· dealt with subje ct in ­ cluding retinal detachment ·urery, radial retinoromy in the macula , and intrarctinal hemorrhage in cystoid macu• lar edema . In pri\'ate practice in vitreoretinal urgery in Tole­ do. Ohio. Dr. 80\'ino i direc ­ tor o f education in ophthal ­ mology at the Medi al College of Ohio . THOMA . tlLLER(Ph.D.' I)• i the o-author of " Cognitive ­ Behavioral Pharmaceutical pproache To en ory Pain 1anagement" in a recent is uc of Topic in Clinical Nursing On B' faculty a clinical a . i rant profe or of p ychiatry Jerald BoviHo �CL & DEATH from 19 9 co 1981 at Veterans llo pita!, he i now associate profcs or of p. ychiatry at che L niversicr of Kentucky . Ix·­ ington DR. HAROLD T. CHWEITZER, ""6,died in Millard Fillmore Hospital on O\'ember 21, 19 <1. The Buffalo nauve \\-~ a practicing ph) i­ cian in Buffalo for more than 50 year'>. An alumnus of l B .\led1caJ chool (M'3I), he was named clin­ ical~ isram professor emeritus in 19-9 in recognition of his many years of cr\'i c. He \\.IS on the faculty for ➔ l years. In 1981. the. e\\ York race Medical ocicty honored him for 50 years of medical . en·ice to the public. He <;erved as ass1.1antsuperintendent of the old E.J feyer Memorial Hospital in the I930s. In 19➔ 6. he entered full-time pri­ vare practice and began his as ·ociation with ;\11llard Fillmore Hospicil. lie wa known for his long hours spent reaching young physicians, ,•i ·lting ratient .. and working at che hospital. His ·un·ivor. arc hi wife. Roslye; a son, Howard. and daughter, onme, both of Buffalo; and rwo grandchildren, and Ne k urgery at Ea rem Virginia Medi al hool. tICHAELP. RADE(M" 5) • was recently inducted as a Fellow of the American allege of. ur­ geon . A member of the \1er­ cy I lo pica! caff in Buffalo since 1980, he i · al ·o a mem­ ber of the Buffalo Trauma o­ ciecr. rhe Buffalo , urgical ociccy, the Buffalo Vascular ociety, and the . cace and county medic1I s cietie: . K.ENETH OLOION {M I) • is current!} staff p ychiamst on the Geropsychiacry Unit at the heppard and Eno ·h Pratt Hm,pital and adjunct as Iscant profe or. Department of P r· chiatry, l'niversity of \1aryl :md chool of \ledicine in B:ilci­ morc. lie has pubhshed 50 paper. and book chapter in JOH BRAD ILFS(M' 6) • bep ych eriacrics and sexuality ame a full partner in the prac­ Hi book (co-edited with or­ harles E man B. Levy, M D.), .1Je11i11 tice of urgery with osgriff, Transition Tbeory and Tb r­ \X'iles. M.D .. J me Heyapy, wa · published by Plenum Jr., M.D. and William den, M.D. Publi hing ompany in 1983 He ha been elected a Fellow of the Gerontological :o iet}' EDR J. HARRIO (M' ) • i of America and the American no\\ a Oiplomate of the men­ eriatrics ociet) and is past can Board of urgery and i President of the Baltimore­ Board cnil1ed in General Washington ciet) for P y­ :urger)'. chogcriacric .. I le is a frequent lecturer around the country ANGELO . DELBAI.SO(M' ) • and recently returned to Buffa­ who is al· a 19-2 Dental lo to give the keynote addre s hool graduate wa. recently at a ·ympo ium emitled "Men­ appointed a profe · orial lec­ tal Health and the Elderly: \X'ho turer in oral pathology at Owns the Problem?' ponGeorgetown University. Dr. Del ored b} the \Xt: tern New 'rbrk Bal ·o i a member of the ecwork on Aging. Ken live at American o iety of Head and 5319-1 Br ok \X'ay in Colum­ 'eek Radiologists bia, Maryland, with hi c,vo children. DR. ORMA HEILBRU (i't1"29)• a Buffalo radiologist who prac­ ticed medicine in the icy for :;6 years. died January 21, 1985, in h1· home after a long illne . He was - . The cw York Cit)' native mo\'ed to Buffalo when he wa cwo-years old. He earned his bachelor'. degree fr m UB in I9r; in Medi­ cal • chool. he specialized in pathology and internal medicine. Dr. Heilbrun received a fellow~hip in hematology at the Har• \':.ird ~kdical ch ol and started an internal mcdi ine pra Lice m Buffalo. He later trained as a radiologi t .tt the Cniver. it\' of Rochester and scabli hed a radiology pra uce in Buffalo in· the 1930. During \X'orld War II , Dr Heilbrun \\-Js chief of radiology for the . •. rm} in Atlantic ity, l\.j. fter the \\.tr, he returned to his radiology pracnce in Buffalo and joined the clinical faculty at the U B Medical chool. Dr. Heilbrun al ·o ·en ed a· a con ul­ tant co \~teran. Ho pita! for many years I le retired from his office prncuce in 19-2 but remained ac­ th·e as a radiologist and linical teacher at l"l3 and Buffalo cncral Ho pital. In 19:32 he married the former Evelvn Le\\', who died in 1961. In 1963 he married the former Hele~ imo~s of I ew York City. GREGORY YO 'G ( 1' 9) • clini­ JOH C. ROWLI G O (M' ) • cal 111. tru tor m medi ine, ha. write. that he has collaborated been appointed a sistant chair­ on and co-authored a bo k man of Emergency Medicine at th t wa released October 8-1: Millard Fillmore ·uburban arron, H , Korbon , G . Ho pH.al in Amher t , N.Y. Hi Rowlingson , J .. , Regional primary responsibility will be A11estbesia Teclmiques and to expand his department's Clinical Applicc1tto11. Green service . After completing his tratton Publisher . residency ar Millard Fillmore o pita!. he wa on the medi­ JEFFREYP. POWELL(M' 5) • w cal . ta f of Bertrand haffee appointed consultant in .\lemorial Ho pital in pring­ otol ryngolog} at the a,-:.1I ville, .Y He is also a physician Medical emer in Pon mouth, advisor ro the '- yarning-Erie Virginia. Dr. Powell is an ,u ·is­ Regional Emergency Medi al tam profc or in the Depart­ 'e rvice . a regi nal planning ment of rolaryngology/Head org, nization. He was a mcmb r of the lpha mega Alpha honorary med­ ical society and the Eric County Medical • o icty, an elected fel­ low of the American )liege of Radiology. and a member of Temple Beth Zion. ·urvi\ ing arc his. econd ,vife; two daughters, Robie and Bar­ bara, both of Cambridge. l\1~ •. ; a son. Dr M . Peter of :ale Lake icy, l rah; I\YO i. cer·, and ~even grandchildren. (From Buffalo News. Jan 23, 1985) .W. CHAIKJ ( 1'2 ) • died May 1-. 19 ➔ in New York icy. Dr. Chaikin wa a Life Member, American Colkge of Phy. ician ; Diplomate, American Board of Internal Medi ine; Dlplomate, American Board of astroenterology. He wa. an a. sociate clini­ cal profes ·or of medicine. Ne,...-York \1edical ollege. Dr. Chai­ km was active in the prl\-:tte pra ti e of medicine for over 50 year 36 �CALE DAR REHABILIT TIO ' tEDl­ CINE CO Tl UI G IEDI­ CAL ED CATIO PRO­ GRAM • :-.1av 29-51. 1985. "semmar in l;>wcr E. trcmitr Prosthetics." \cter.ms Adminis­ trauon :-.kdic:.il Center 305. Contact Henr) J. l,.Jtron,ki. Re­ hab :-Okd1dne Coordin:nor, 83 -9200 ext. r2 I. PEDIATRIC CO, TI ING MEDICAL ED C TION PROGRAM : • UROLOGY A, D EPH­ ROLOGY, PDATE 1985 • Saturd:t}, June 15, 1985 The Ccmer for 'fomorrow/l B, Am­ herst Campus. Crcd11 hours: 6 Fcc: 15 • THE 8TH A­ TIO AL CONFERE 'CE 0 PEDIATRIC/AD LT ALLER­ GY A D CLINICAL IMMU'OLOG . Julr 11-1.3, 1985. 111c Four Sl.'asons Hotel Toron­ to Ontario. Credit hours. 20. Fi.:e ;',00 phys1e1ans 111 pr:ic­ t1cc, 1~5 Allied I kalth proks­ sinn:tb • THE CAPE COD CO FERE C ON PEDIA­ TRICS • ugust 2- 1, 1985 . Dunfc) \ ll}"Jnnis Hotel, llyan­ ni., Cape Cod, MA. Crcdit hours: 15. fr<:: 500 ph) sicians 111pr:u.:uce, 1-5 llied Health profc:-sionab. • THE 3RD I. TER Y~IPOSI­ TRITIO E Tl' L DI EA E • August 25 .rn, 1985 111e Brussels C.onvcntion I !all, Brusseb, Belgium Credit hours: ~ . Fn: • 525 phys1C1.ns in practke, 185 Allied Health professionals. For furtl1er infi r­ m.1tion picas\.' contact. Rayna . a\ ilk, Pediatric Conunuing kdic:al Education, Children\ Ho~p,t;tl of Buffalo, 219 Bq~lllt St., Buffalo, , ·y l'-¼222 lclc­ phonc -16-8-8--650 • PLA T FLAVO, OID I BI­ OLOGY A 'D MEDICI E: BIOCHEMICAL, PHARMA­ COLOGICAL, A ·o TR CT RE-ACTIVITY REL TIO HIP • July 22-26, 1985; Hilton llotel, Bufl:110, , · Y. sponson:d b) l B .ind the ~lcdical Foundation of Buffalo, Inc C~1E Credits. 20. Fcl.': IOU Contact: Mcd1e:1l Foum.la11un of Buflalo, Inc., -5 rl•~h St , Buflalo, , ·y l-i205 . ---------------------------------------- -------------------------111111 NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES BUSINESS REPLY MAIL FIRST CLASS PERMIT NO. 2210 BUFFALO, N.Y POSTAGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, New York 14214 �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO, NEW YORK 14214 LET US HEAR FROM YOU Fill out this card (Please print or type all entries) Year MD Received Name _____ _ Office Addre s -----------------------------------Home Address -----------------------------------If not UB, MD received In Private Practice: In Academic from _______________________________ Yes ,., Medicine: Yes D No [] No _ Specialty _______________________ Part Time :::1 Full Time _ n School Title _________________ _ Other: Medlcal Society M'embershlps _____________________________ News: Have you changed positions, published, been involved in civic activit ies, had honors bestowed, etc.? Please send copies of any publications , research or other original work. _ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, May 1985 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available University at Buffalo. Health Sciences Library. History of Medicine Date A point or period of time associated with an event in the lifecycle of the resource 1985-May Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1985-v19n01-May Table Of Contents A list of subunits of the resource. Physicians for the 21st Century Ear Implants Elegance in Medicine The Survivors' Children Research Hospitals Students Books People Classnotes Deaths Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-15 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v19n01 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1985 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/cde2968a5baabef1d30b7504bdf1c741.pdf b21815a0f86c6e5f220721294299a46e PDF Text Text _, ,fr'\1 1 ic l<2 3 fi !! 6 ·a 1·1 .... I 4 ;l )· ,.., 0 0 10 / 13 1~ ,...;(. ~~ )); 11 ..• .• A 15 16 fl\ II ~ ., 5 17 12 ... 0 18 / �STAFF EXH l Tl\ E EDITOR, ·1\'1.RSITY Pl BLICAl'IO. S Robert T Marlett l. 'l\'ERsrrY \IEDICAI. EDITOR Bru e s Ker,hner RT DIRECTOR R he .1 B rn,1cm DE! JG . Ian J Kegler Denbc Kuhler PHOTOGRAPHY Ed 0\\ak tare Leed, DVI ORY BOARD Dr John . augh1on. De,m \chool oj ,lfedicfne ~h . • 'anq• Ghe o Dr r.d\\ m A \l1rand Dr John Cudmore Dr Carmelo Armenia Dr John Fisher 1, Karen Dr} 1a Pulh Dr Charle Paganelh Dr. Jame Kanskl Dr Harold Brody Mr John Dr. John \'i right Dr. Jame . 'olan Dr. \lagg1e Wright IJr. \lary \'oorhc,. \Ir. StC\C ~hivinsky TEACHI G HO PIT ALS The Buflalo Gener.ii Children's Dea ·ones Ene County Medi<.,11Center \lcrcy \hllard F1llmore Ro,..,,-cll Park .\kmonal lns1i1u1l' Si,1crs of Ch rily Veteran Admmi tr.Ilion \ted1cal Center by the Dil'l.<10n of R _/,u-k.-011, d1rec1or 111 a ..~ociat1on 11·1/h tbe \cbool of J\letlic111e, \late• I 1111•cr.H/J'of .Veu• ) ork at B11Jfalo Produced Pub/Jc ,ljfarrs, llarr:y THE BUFFALO PHYSICIAN, (USPS 551-860) February 1985 Volume 18, Number 5. Published five times annually: February, May, July, September. December - by the School of Medicine, State University of New York at Buffalo, 3435 Main s1reet, Buffalo, New York 14214_Second class postage paid at Buffalo, New York. POSTMASTER Send address changes to THE BUFFALO PHYSI• CIAN, 139 Cary Hall, 3435 Mam Street, Buffalo, New York 14214 Message from President of the Medical Alumni Association Dear Medical Alumnus: 'l11t• pring Clinical Day c icntific Program, under 1he•direction of Dr. Frank Bulgan, progressing vcrr sati factoril) The excning and timely topic will he organ transplan1.mon. To dale the follO\\ ing ,peakcr:, ha\'e agreed to participate: • J;tck Copeland, :-1.0., Arizona Health Sciences Center, Tucson. Arizona: Heart Transplantauon. 1s • Bruce Reitz, M.D., Johns Hopk11h lTnivcr ity, Baltimore, ,\laryland: I lean/Lung Transplantation • Bvcrs Sha\,, :-.t.D, ni,ersil\' of Pllbhurgh, l'llts­ b~rgh, Pennsylvania: l.h·er i·ransplantati~in. • '- 1lham E. Br:1un, .\1 D., Clc\·cland .linic Founda­ tion, Cleveland, Ohio: Kie.Inc} Transplamati< n The final program will he mailed to you in .\larch 1985 Reserve the day - Satur­ da\, ,\1av '!, 1985. · The ·:1lumni receptions the :-ledilal Alumni Association hosted at the Amencan Col· lcge of Surgeons meeting in san 1-rancisco and the AmcrJcan A'iso iation of :-kdical College:-. mL-cting in Chicago in October of this year were very sue essful and well at 1cnded. Old acquaintances were renewed and new relat1onsh1ps initiated. In \'ie,, of the favorahle response to these t,vo receptions, the ,\kd1cal Board of Gmernors is planning to increa!>e the numhcr of reception.~ to include other spccial1ics on an annual ha~is. The number and frequency of these receptions v.-111 be dctcrmined hy thc amount of funds available, which in turn depends upon the number </f alumni ,, ho 1>:•) their annual dues. Your continued support is appreciated. - Carmelo Armenit1, ,U.D. �BUFFALO PHYSICIAN 3 MEDICAL REVOLUTION • n w method that p rmic effec tive vaccine co be ma produced with ut kn wing th pecific antigen invo lved ho ld pr mi e for such disea e a cancer, a B re ea rcher ha found . 9 LEUKEMIA UPDATE • Hundred f people ev ry year are be ing diagno ed a having leukemia when they ac tually have a b nign pre-leuk mic cond itio n , Pr D or Tin Han ha di covered. 0 th r wor k by the ame re earch r rev al that certain g nec ic defect cau e ome leukemia vic tim t have a sho rter survival pan. RE EARCH • HO PITALS • PEOPLE • Exposure to high oxygen con entrations may cause pulmonary damage. Tuman, of chc eyelid can be cffccti\'cly treated by c ryo urgery ~-i1ho ut damag ­ ing th<: eye\ duct system . 13 Millard Fillmore adds ad\'anccd patient monitor ­ ing system . Roswell selected a one of chrec cop cancer ho pitals . Thom lark b the nt:\V executive vice president of Children's. John E. Friedlander named chief operating officer by Bu falo ,cncral. 19 hildren 's name · clinic for the Doctor Jacobsen . Dr. Lewis .\I. Flint, Jr. appointed chair of , urgcry . Dr. Carl Granger rccci\'cs grant for nationwide data system for rehab centers , co ­ authors landmark CCXI in rehabilita ­ tion medicine with Dr. Glen Gresham . Other news of people you knO\, . 28 MEDICAL CHOOL EW • Clinical teaching brings students face LO face with real pt:oplc and real dbcascs . ,\lcdical School helps l •ni\'crsity CX · ct:ed its SEFA Ap­ pt:al Goal. Two prominent researchers pre ­ sent pecial lectures here . 14 Clinical clas es offer pra ctical exp e ri ence: page 14. BOOK • The Impaired Physi­ cian . Teachers and Teaching in C.. .\lcdi al chools . Two books edited b) alumni. 22. AL M I • ln ­ vications to class reunions issued by class chairmen . 32. DEATH DOCTOR I THE ART • Joel Bernstein combines opera and otolaryngol ­ ogy. 25. CLA 36 • 35 OTES• ��By Bruce S. Kershner revolutionary new vaccine method that permits n ctiv vaccin co be ma pro­ duced without u ing the di ease organi m itself - or ev n knowing the pecific an­ tigen - ha been perfected, and it crearor predicts it ill dra tically increas the ability to d velop vaccine for di ea e uch a cancer which p(eviou ly have re i ted uch att mpt . Heinz Kohler, M.D., UB re earcher at Ro well Park Memorial Institute, produced an effective treprococ ­ cu vaccine for animal by u ing monoclonal antibodie a tate-of-the-art method of cloning c lls that "manufac­ ture" di ea e-fighting agent in the laboratory. Essen­ tial to thi ucces wa hi application of the "immune network theory" devi ed by thi year's co-recipient of the obel Prize in edicine and Physiology, Dr. iel Jern , with whom Kohl r work d in th 1970 . Kohler' accompli hment i the fir t practical m thod using the ob 1Prize winner's th ory. "We pro­ ved experimentally that this approach can yield prac­ tical benefits," Kohler announced. Hi finding were reported in the Decemb r 14 is ue of cience. Kohler i a B re arch profe or of microbiology and director of Ro well Park Memorial In titute's Depart­ ment of ol cular Immunology. A u, 0 w w .., u a: ~ now, the traditional method of making accines U ntil had certain requirements that limited their application. Fir t, the traditional vaccine method requires u ing the di ea e organi m it If and al o require the i ola­ cion, purification, and extraction of the di ase organi m or it antigen. �" lt i often diffi ult t make effective vaccin through the normal proce hich alway start from the material chat come from the actual antigen , e.g., flu iru ," Kohler explain . " The difficulty i due to a qu . tion of ~e.hnology . iru e , for example, require very pc 1fic cond1t1on , uch a live cell . lt i al o a que tion of price . Purifying a viru become very expensi e and impractical for ma s pr duccion. " . . The new vaccine procc hke the convenc1onal pro ce enable one to produce the accine rclati el inex ­ pen ively and in large quantiti for ma s producti n . Kohler point out , " The new vaccine method will nor replace vaccine already I?rod~ced ec~n i:nicaJ_lyand afe­ ly. Where it doe apply 1· wtth _certain nu~uon where vaccine are not currently po 1ble or fea·1ble. " The vaccine produced by thi new m~thod will _be much afer than inactivated or attenuated v1ru e which carry ri k factor ." Kohler add . . The mo t promi ing application for the new vaccine meth d i for variou type of can er. Another valuable applicati n will be fi r i!1fant di_ea e . . " Mo t vaccine don t work in y ung infant becau e their immune y tern i too immature to work effecti ely," Kohler remark . . . The ucce . of the nev-, vaccine method wa po · 1ble becau. e of Kohler ' combining of Jerne' the ry with the " high technology " of the monoclonal antibodie proce iel. Jerne deve Iope d h.I ·•·immune networ k t h eory " in 19 q . " It repre em the mo t elaborate and logical ex­ planation chu far for the inte~cti e proce e _by which the body 's immune y tern n e to the occa 1~n ~hen needed to combat di ea e, and then fall back mto inac ­ tivity when it i not needed ," rated a ew York Time article that announced the obcl Prize election in ctober The obel Prize winner ' theory i that the foreign ubstance are the body ' target fi r mounting an effecti e immune defen e. According to the theory , images of thc ·e antigen exi t ithin the immune y tern. The e image , hich Jerne call idi type , repre ent internal antigen . The new idi type vaccine method u ·e. chi ·et of inter ­ nal antigen in read of the actual di ea e-a o iated anti­ gen . " Thi .will ~nable us to av _id the ri k. fact~r or re­ quired punficauon of convenll nal vaccine , Kohler remark . " The concept of idiotype offer opportunitie for e ploitation ;· Kohler rate . " lf the tru cure · of the antigen are pre -exi ting within the body' immune network , the logical next rep would be co find out if it is po · ible to utilize the e pre-exi ting tructure to create new vaccine . to u e here conventi nal vaccine are not available or effective . That i. what I et out to do ." H The monoclonal antibodies pr cedure i what enable laboratorie co ma · produce idiotype accine . Thi cace­ of -the-art method u e laboratory culture to literally clone cell that have been pecially elected to produce the specific de. ired antib die . With the help of laboratory mi e, the antibodie are produced in ma quantitie for vaccine . One of only five central monoclonal center in the nation ha been e tabli hed at B for the purpo e of ma s producing antib die . ith Kohler ' experiment, the antigen u ed wa a ,·irulent train of trepcococcu pneumonia. The re ult was a va cine that proved effective again t the bacteria in mice. hy did Kohler choo e thl organi m when an effec ­ tive vaccine for it already exi t ~ r human ? " Thi wa our first attempt co produce a va cine applying the con ­ cept of Dr. Jerne' network theory . o we cho e a di ease organi m which i a well known model and ho e im ­ mune defen e i well kn wn, " Kohler explain . Referring to hi ucce ful application of the theor y, Ko~ler elaborated, " If you can do it once , you can do it again . The ame technology for known bacteria antigen will work for any antigen . Only ome detail have to be worked out. " ne maj r area where Kohler feel thi - or any vaccine method will not be practical i for common cold viru e . " en if a vaccine i developed today , it may no longer be effective tomorr w. old viru e t o ea ily mutate and become re i tant to accine ," Kohler comments. . Kohl_er received his medical training from the niver ­ ny of Vienna and the niver icy of Munich, where he earned hi M.D. in 1965. From 1965 co 1970, he held re earch po ition at the Max Planck In titute in Munich and Indiana L'niver ity. He conducted re earch with Dr . iel Jerne at the Ba el ln titute for Immunology in 1974 and 19 5. He wa profe or of pathology and biochemi try at the niver ity of Chicago , wher e he pent 12 year . In 19 l , he joined Ro well Park Memorial ln titute and B in his pre em p sition . iagara ni er ity appointed him re earch profe . or in their Ro well Park Graduate Divi ion in 1982 . H nored in 1978 by the .. Public Health ervice with their Re earch Career De elopment ward , he wa elected pre idem of the Chicago A ociation of Im ­ munologi cs for 19 - 9 . He ha erved in editorial p i­ ti_on for_two immunology journal and i currently prin ­ c1p~I editor of International Ret>iew of Immunology . Be 1de h !ding po •icion on panel and committee for and the American ancer ciet y, he i a member of vanou profe ional organizati n . 11: i excited about the dire tion for hi future re­ K. ohler earch. T~e new appr ach applie e pecially well to anttgen as oc1ated with ancer, her e immune therapy has, up to now , failed . The approach applie to all cancer , not ju t tho e which are a , ociated with viru e . The im ­ mune y tern can be trained to respond to the abnormal antigeni c truccure of the malignant cell . " ur next ·tep i co develop an experimental cancer vaccine for mice and then .. . for human ," Kohler con ­ clude . Ob erver will have co wait a vear or o to I am if he can indeed pr oduce a mou e vaccine for a pecific type o f cancer. i ting Kohler in hi work are two Ro well Park Memorial In titute cienti t , Dr . Ronald Ward , cancer re earch cienti t, and Dr. Mary Mc amara , re earch affiliate . • i it po ible to develop a va~cine for a di ea e in which the structure of the anugen r even the di ea e' cau e - are unknown? " We cienti t may not kno the e an wer ," Kohler re ponded ith a gentle mil , " but the body ' immune !" y cem kno " It i like a police department with trained blood hound . They I c,ne what the policemen can't ," he elaborated . " Our immune y tern has the capa ity to · niff out ' the antigens, recognize them and , like a dog barking , how u , the cienti t , how to make the 1diotype vaccine . All we ha e to do then i to i olate thi idiotype antibody pecific for the undefined or unknown antigen ." O 4 ��-- _,,.,,,.... - �B ob is a tall and attractive man. A slim waist and broad houlders upport hi boyi hly hand­ ome face, and hi phy ical appearance allow no hint that middle age i pas ing. Strangers in­ variably underguess hi age - a few wi p of gray in hi neatly trimmed sideburns providing the only tangible clue co hi ixty-plus years. ome time ago, a a fellow in vitreoretinal urgery, I had the privilege to work ide by side with Bob. Our relation hip was punctuated by frequent conver ations and reflections. of which I hope I have gleaned enough about Bob' life and philosophy to recount chi story Bob wa a professor at the Univer ity of Iowa at the time. A native of Wi con in, Bob was raised in the farm country near Madi on. He spoke sparingly of hi boyhood experiences but the fond memories of his youth trickled through to the present. He cold me of hi early love for the outdoors, kindled by hours of dapping gras hoppers for wily trout in the meadow creams that course rib­ bonlike through the Wi con in country ide. Hi orman Rockwell youth led to medical chool and marriage, and Bob moved to Los Angeles to start hi practice. The geography was wrong and the cayon the coast was hart. I don't know why but perhap Bob ensed a conflict bet­ ween his traditional midwestern values and the changing California life tyle. The next move would be more permanent, and Bob and his wife, Lonnie, returned co the heartland of the coun­ try. Appointed to a po t at a major midwestern univer ity, Bob was content in hi role as teacher of young phy icians. Lonnie, a killed regi rered nur e, relinquished her profes­ sional duties to rai e a family. Through innovation and hard work, Bob wa a pioneer in hi field. He became univer all} re peered for hi unique contribution· to hi pecialty. Bob i a gentle man. A thoughtful man. A generous man. He advanced through the rank of academic medicine in a graceful way. Younger, more flamboyant doctors came and went through the years but Bob' reputation spread and hi work receiv­ ed worldwide recognition. Lesser men, more aggressive ~y their nature than Bob, petitioned the elite academic ocietie fruitlessly for member hip. The c same societies olicited Bob. Bob yearned for adventure. He poke enthu ia tical­ ly of hi rrea ured book collection, the source of many a vicariou expedition. Titles with African rivers, afaris and bearers, ibi and springbok, wings and feathers, and hot and hell danced eternally in hi thought . Bob poke of his love for fishing and hunting. With no ready acces co the African veldt, he devoted hi leisure time to water- fowling in the Missi· -ippi flyway. I v.ras fortunate to witness his sensitive approach co the port, and feel hi duck hun­ ting was, in a greater sense, an accurate mea ure of the man. Duck ea on rang through the hospital. Lunch hours ·ere filled with animated talks. "Teal and widgeon ." "Black duck , mart and ary." Everyone was planning a trip to the mar h. I could ense that Bob was caught in the ex­ citement of the sea on. The time was right for the water ­ fowl to fly. We were all invited and the trip was planned as we waited five long day for the weekend to arrive. Late in the afternoon on Friday, Bob told u that he would not be going. Lonnie had planned activitie · with the children . He felt that was more important. He could "alway- hunt another day." After all this wait, l thought "How could she!" I knew he was as anxious for the trip as the rest of u , bur he e med undisturbed. His hunting. along with hi role as a physician, had found a place in perspective with the rest ofhi life. I admired him I wished I could adopt a imilar value cale for my own life. I chink we all do. One afternoon the following week, Bob took off for a few hour to go to the marsh . The re t of the group had to rend co their ho pital duties, and though Bob would ha"e loved our company, he had no choice bur to take the long drive alone . I asked him about the trip the next day. He poke oftly of wind and cattails . He described fog and rain. He told me of diving muskrats and mud -caked dens. "Were there any ducks - any ·hootin'? " ", ure," Bob smil ­ ed, and returned to hi - patients . He had learned earlier than most that the waterfowling experience i. more than merely chasing duck . A student of medicine can learn valuable le ·sons from his teacher that are unrelated to the curriculum Most medical chool profe ors can capably lecture about pros­ taglandin and mitochondria. The secrets of ribosomes and R A are revealed in the standard texts. Thoughtfulne s, humility, and sen ·icivity, howen!r, at­ tributes that are truly valuable in a phy ician, cannot be taught or learned in a clas room or library. A physician ­ teacher can only impart them to his tudem by example . I knew that there was a great deal more to be learned from thi man, but our time together grew short and my move from the college town came all too fast. I regret that we never had the chance to hunt together. I hope some day we will. I know that when autumn arrives, when green change to burnt ienna and falls to the ground, when temperature drop and icy gale· pierce the skin, I'd like to be tucked into a protected blind and talking about lift: with Madi on Bob. • By Jerald Bo vino, M.D. ('71) 7 ��.. Some 'leukemia' patients don't have it after all By Bruce S. Ker hner H undred of people every y ar are unfortunately receiving diagno e of an early tage of leukemia wh n they actually have a benign, non­ lethal pre-leukemic condition, Dr. Tin Han, a B re earch profe or maintain . Tin Han, who erve a a ociate chief cancer r earch clinician at Ro well Park Memorial In titute, rec ntly di covered the new condition. He call it benign monoclonal B-cell lymphocyto i , or BMBL for hort . Hi de cription of the con­ dition appeared in the July is ue of Blood ( ol. 64, o.l). Of all fir t diagno e of chronic lymphocytic leukemia, 25 per cent, or ap­ proximately 1,700 per year, are identified a ha ing the early tag ( rage 0) of the u ually lethal di ea e. Dr. Tin Han found that roughly half of uch patient that he te ted actually had BMBL. Thi mean that thou and of patient now think they have leukemia hen many of th m may only have the benign condition. The patient actually having BMBL ha e therefore been pre ented with an unnece arily frightening impre ion that could have profound effect on the cour e of their live and on their familie . "We hould not diagno e these patients a having leukemia," Tin Han as err . BMBL is a non-malignant, mild condition that appear to b a precur or to chronic lymphocytic leukemia (CLL) though it do not nece arily advance to tru l ukemia. Tin Han and hi colleague identified 3 7 patients diagno d a having Stage O CLL. They found that 20 or 54 per cent remained at tag O for 6 ½ to 24 year without treatment. In contrast, the 17 true CLL patient advancd to higher tag u ually within ev ral year and the median 1 ngth of time for cage O to advance through cage 5 and d ath a 12 ½ year . Patient with the newly di covered lymphocyto i condition xhibit high hit blood cell count imilar to that found in true leukemia, but do not po e any oth r ign of J ukemia uch a enlarg d pleen and lymph node r abnor ­ mal red blood cell or platel t count . Phy ician do not normally treat pati nt at thi tage. While BMBL re emble th early tag of true CLL, Tin Han ha identified certain tendencie as ociated ith BMBL patient , be ides th optimi tic prognosi . 9 �one of the te red BMBL patients had gentic abnor­ malitie , while one third of tage O CLL patients who e di ea e advanced to later stage did. The total number of lymphocytes, including the blood and bone marrow counts, were slightly higher in tho c with di ease progre • sion than tho e without advancement to later cage . erum immunoglobulin levels in BMBL patient were normal or slightly depre ed in all but one patient (who had slightly elevated level ). Jn contra t, CLL patient tended co have much lower levels of this ubstance. "To avoid giving a mi leading diagnosi , do tor should order a cytogenecic study with all cageO patients," Tin Han care . "lf the chromo ome are normal, chance are favorable the condition ill have a benign cour e; if abnormalitie are found, a poor progno i and diagnosi of early cage CLL can be given." Another difference wa that female dominated the BMBL group, while there wa no exual tendency in the early tage CLL group. It is well known that twice as many men contract CLL a •omen. Tin Han carefully followed the fate of the BMBL pa­ tients to ee if they ultimately acquired CLL. f those who did die, none did so becau e of LL. Dr. Tin Han, a native of Burma, received his M.D. from Rangoon niver icy chool of edicine in 1958. He has lived in the . . ince 1960 when he came to complete hi residency. He joined the taff of Ro well Park Memorial In titute in 1964 and became a faculty member at 'B in 1968. In 1978, he won the Redway ward for Medical Writing, pre ented by the Medical Society of the tace of ew York and ew York late Journal of Medicine . He wa elected for hi article on immunity and diagno is of untreated Hodgkin' Di ea e. He i a member of the American Federation for Clinical Re earch, the American A ociation for Cancer Re earch, The International ociecy of Lymphology, American Association of lmmunologi t , and numerou other organization . Hi research colleague , all Roswell Park dentists, in­ clude Dr. Howard Ozer, B associate profe sor of medicine and microbiology; Dr. Edward Hender on, profes or of • medicine; Dr. J. Minowada; Dr. . ademori. Dr. Ti n Han 's s tud ies on le uk em ia ar e b ei ng conduct ed at Genetic defect can shorten survival rate P Dr. Tin Han, LIB re earch profe or of medicine and as ·ociate chief cancer re earch clinician at Ro ·well Park Memorial Institute, has found that the prognosis is poor for chronic lymphocytic leukemia patient who have chromo omal abnormalities in addition to an extra number 12 chromo:ome. His findings were de cribed in the Feb. 2, 1984, Neu• Engla11djournal of Medicine (Vol. 310) and the Oct. I 98 ➔ Journal of Clinical Oncology (Vol. 2, o. JO). C ing new techniques developed by him and hi col­ ur­ leagues, he found that only 2 7 per cent of patient vived eight year after being diagno,ed with chronic lym­ phocytic leukemia (CLL) if they were identified with these multiple genetic abnormalities, called complex trisomy 12. In contra t, 87 per cent of all patients with normal chromo ome survived eight year , and nearly the ame proportion, 84 per cent, urvived eight years if their only genetic defect wa an extra number 12 chromo ome (pure tri omy 12). The poor progno i appear· to require the By Bruce S. Kershner atients with a major type of leukemia are likely to have a shorter urvival if they po e certain genetic defect , a UB re earcher ha di covered. Hi di covery, imultaneou ly with a wedi h group, demonstrates, for the fir t time, that genetic defects are associated with chronic lymphocytic leukemia. 10 �,, !z @ ~ x Q. combination of both the extra number 12 chromosome and one or more other abnormal chromosomes. " hromo omal defect are well known with chronic myelocytic leukemia, the other major form of leukemia, but have never been reported for LL," Tin Han points out. • ince 1981, Tin Han and hi· colleagues have studied 80 per cent of the CLL case that have been referred to Ro well Park from other hospitals. They found that •¼5per cent, or 29, of the 65 case. pos e scd genetic abnor­ malicie . Of the e 29 patient with genetic defects, 10 had the abnormal extra number 12 chroma ome (indicating normal progno i ) and had the complex tri omy 12 that lead· to ·horter urvival. f the remainder, three had the l'fq + chromo omal defect and eight po es ed other genetic defect . The group with the latter two categories of genetic defect did not exhibit a clear urvival pattern, though their urvival rate - appeared intermediate in length compared to the normal chroma ome and complex tri omy 12 group . 11 The average predicted longevity after LL i - diagno ed 1sfive years for patients in all tagc of the di case. Roswell Park, bccau e of its long experience and succe sin cancer treatment, however, had a median urvival of eight to nine years, con iderably longer than for the average hospital. The national median survival for patients in advanced cagesof the di ea. e i I½ to two year , while it i approx­ imately four years at Ro well Park. Be ides the finding's major ignificance in predicting survival and di ea e progre · ion for leukemia patients, it also has other implication . It allow re earchers to nar­ ro\v in further on the po ible genetic cau c and relation­ ships of leukemia. Researcher may al o learn the function that certain chromosome have, knowledge which would have wide-ranging implications. Determining the rea on for the genetic defect - i. one of the next major steps for re earchers. Tin Han at first suspected two po. ible cau e ·: I) natural change in genetic makeup a the di ea e advance , a proces. called clonal evolution and 2) the effect of chemotherapy and radiation treatment . "I do not believe that treatment cau e the genetic ab­ normalitie , though it cannot be ruled out without further testing," he explains. If he i correct, it i good new for those who treat leukemia patient since their treatment is not contributing to horten their urvival. Tin Han's early research into thi question sugge t he is corre t that multiple genetic defects are a ociated with more severe form of the di ea e. At lea t one patient has been ob erved to develop complex tri omy 12 during the di ea. c· evolution. In ad­ dition, "of nine CLL cases that progre ed to ad anced ·cages,'' he comments, "three exhibited genetic abnor­ malitie at early stage (Stage O)." Tin Han I he itant, however. co make conclusions based on such a small sample The 8q - and l ➔ q + defect. are already recognized as a marker, or diagno tic indicaror, for Burkitt's lymphoma, though their as ociation with leukemia is a fir t. Chr<?mo ome 8 i the lo ation for an apparently cancer­ causing gene a sociatcd with Burkitt' (B-cell) lymphoma. The Ph - l geneti abnormality also ha a well-e tabli hed association with chronic myelocytic leukemia ( ML). The apparent genetic a - o iation to LL wa not discovered earlier because, unlike with their experience with CML, scienti ·ts could not induce CLL cell to divide an event that i required before hromo omes can b~ studied. The rea ·on was that re earcher - had been using the wrong type of agent to promote cell division. "You cannot induce B lymphocytes to divide u ·ing T-cell mirogens," Tin Han cmpha ized. o re earchcr associated with Roswell Park and B set about to develop B-cell mitogen . They ucceeded in 1981 when they learned that Epstein-Barr viru. and agent excracte~ ~rom the ince cinal micro-organism E. coli and the medicinal herb pokeweed caused B-cell co divide. Al o noticed by the doctor wa the fa t that virtually every CLL p~tient who had abnormally high erum im­ munoglobuhn blood level al o pos essed the tri omy 12 defect even at early • cage . It not only how that the chr~mosor_nal _defect manife t it elf in phy iological way but JC al o indicates that the genetic defect i a marker for chat group of LL patients. All thi research point to the ultimate direction for future re earc~er , "the attempt to di cover an 'oncogene' o~ cancer-cau mg gene for chronic lymphocytic leukemia," Tm Han comment . • �RESEARCH High oxygen levels may damage lungs E B y Cath e rine Kun z xposure to high concentrations of oxygen during routine treatment may cau e pulmona ry damage which cannot be detected by routine clinical test , say adis Matalon , Ph.D. , an a ociate professor in the Department of Physiology at 8. Matalon ha conducted several experiments which indicate that animals expo ·ed co high oxygen levels uf­ fer ilent damage to the lung . " IL i dif ­ ficult to recommend a pccific cour e of action to docror bccau e clinical judge­ ment enters into so many of the cases. Each case must be judged eparatcly." He feel , however , chat phy i ians hould be aware that undetected damage may be tak· ing place. The toxic effect of cxces ive oxygen have long been recognized. The ga pro ­ ·duce radical - entities which de troy protein , lipids , and other uh tances vital co the operation of cell and organs. Through the production of the anti­ oxygen enzymes catala e and superoxide dismuta c, the body i able to handle oxy ­ gen in relatively small amounts (air on ­ tains 21 per cent oxygen). Although higher concentrations are absolutely vital in treat­ ment of variou respiratory and car­ diovascular di ease and emergencies, doctors are aware of the danger of high oxygen JeveL and therefore are on the alert for ign of damaging side effects . " Quite often, " ay Matalon, "allhough one know chat a level of oxygen causes side effect , there i no choice but 10 give it. What we have been investigating is whether oxygen cau e damage to the respiratory sy rem before oven ympcoms uch as fluid from the lungs or hypoxemia (deficient oxygenation of the blood) au ed by lung de truccion are noted ." Matalon ' preliminary ob ervati n , con ­ ducted with the help of Dr. Edmund Egan of the Department of Pediatrics at 8, in­ dicate that this might be the case. In the first pha e of the tudy , Matalon expo ed rabbits and heep to 100 per cent oxygen for 4 hour . Although the anima l appeared healthy at the end of this period - eating, drinking and ex­ hibiting apparently normal pulmonary function , Matalon found indicacion of severe lung damage. Radioactive material wa injected into the alveolar pace in the animals ' lungs . Whil e the tight alveolar membranes of a healthy lung keep thi material in ide che alveolar space, mem­ branes in a damaged lung become leaky, allowing the radioactive material to escape into the blood . U. e of this proce s in ­ dicated that lung damage had , in fact , taken place and that prolonged exposure to pure oxygen caused this damage to grow progre sively more evere. Dr. Sadts Matalon cotiducting aidmal s tud y o,i ox y ge,i exposure. T he major thru t of Matalon 's rudy , however, c ncerns the clinical use of somewhat lower percentages of oxygen . While very high concentrations of the gas may be u ed in the treatment of newborns with respiratory illne es or of people who are very ill, the dangers of extreme ­ ly high level are recognized . Oxygen level of 60 per cent or les are usually used. therefore. " le i generally believed that breathing 60 per cent oxygen will cau e no idc effect , no matter how long it ts breathed . From basic studies, we questioned the premise that 60 per cent oxygen is inn cuou ," recalls Matalon. In collaboration with Dr. Robert ot ­ ter and Dr. Bruce Holm from the niver ­ snr of Rochester chool of Medicine , a third experiment was conducted in which rabbits were exprn,ed to 60 per cent ox­ ygen for three weeks. Periodically the rab­ bits were removed from the oxygen and the partial pre ure of oxygen in the blood was mea ured . " We found that, indeed, 12 after a second week in 60 per cent ox ­ ygen , the value wa lower than what it hould be, indicating damage to the lung ," n:counts Matalon . While this pha e of hi . cudy had been conducted using healthy animal , Matalon recognized that high concentration of oxygen are rarely u ed unles ome kind of pulmonary disease ha been detected . High concentration of oxygen are often needed, for example, in rhe treatment of people with lung fibro is, the body ' reac­ tion to pneumonia -like disea e, in which the fibers of the lung are replaced with a le ela tic substance called fibrin . Would animals with pulmonary fibro i be more vulnerab le to the tox ic effects of oxygen? CollaboraLing with Dr . Jame Goldinger of the 8 Department of Physiology, Department of Pathology pro ­ fe sor Dr. Peter icker on and Dr. Janice Olszowka from the Department of Anesthe iology , Matalon conducted a study in which an agent wa injected in­ to the animals which produced pulmonary disease followed by lung fibrosis . Pure oxygen was then ad­ ministered to the animal . "The outcome of thi experiment was quite interesting ,·• nored Maralon. ''Animab with lung fibro is actually had a 30 per cent hi[-lber rate of urvival in 100 per cent oxygen than healthy animab. " Acting very much like the immuni7..ation proce , fibrotic di. ease causes the body 's anti -oxygen enzyme to be activated, allowing the animal to be better able to deal with oxygen levels. " The re ults are encouraging ," ay Matalon . "While thi . experiment obvious ­ ly cannot be done on human , there i good indication chat human exposed to oxygen show rhe ame general responses a animals. If we can enhance the number of anti-oxygen enzyme , we could in ­ crease the body' ability to tolerate high level of oxygen ." Another po sible way to decrease damage done by high levels of oxygen was suggested by another group of ex­ periment conducted by Matalon . It wa not known whether the damage done by the oxygen i permanent or whether it is reversible once animals resume breathing normal air. To find out , Matalon expo ed animals to pure oxygen for 64 hour before returning chem 10 room air. Although all of the animal became very "ick , only half of them died . Why did half �RESEARCH die and half urvive? Expo ure to high oxygen concentra­ tions damages lung " urfactant" - a material produced in the lungs which make it easier co breathe and keeps the lungs from collap ing. The ability of an animal to survive depends on the amount of damage done to the surfactant system. Perhaps, hope Matalon, injection of ar• tificial urfactanc may be useful in treating thi problem and therefore in increasing an animal' ability to urvive in oxygen. lf way could be found to minimize or eliminate the damaging side effects of oxygen treatment, patients could be given the oxygen that they need without the danger of pulmonary damage. Matalon and hi technician , Mr. Renee Bu h and Mr . Scott Curtis, plan to continue to in­ vestigate the effect of artificial surfactant and anti -oxygen enzyme . Matalon al o Cryosurgery 'safe' for eyelid tumors T Tbe goal is to minimize side effects. ,.. plan experiments using 45 percent oxy ­ gen, hoping to establi h afer standards of oxygen concentration for different type of medical treatment . By offering a new appreciation of the po sible limitation of oxygen treatment, Matalon hope both to rai e awarene of the ga ' possible damaging effect: , and to c tablish possibly afe limits for it use. Matalon ' re earch has been upported over the la t six year by three IH grant totaling 800,000 . In addition, the mo t recent support ha come from the Cum ­ ming Foundation. umors of the eyelid can be effec­ tively removed by cryosurgery without causing re idual , perma ­ nent damage to the eye's fragile duct sy tern, LIB re. earchers report. Cryosurgery , a technique in which tissue is " killed " by subjecting it to uper ­ cold tt:mperarures followed by liquifica 1ion of the tissue and ubsequenc sloughing, was fir t u ·ed in 19 2 to remove eyelid lesions . But the B study, funded partly by a grant from the ational In titure for Den­ tal Re earch, i one of the first to in­ vestigate the extent of injury and course of repair 10 eyelid and lacrimal duct system following the procedure . In the study at 8, conducted by Jo eph atiella, D.D .. ; Arthur Schaefer, M .D., clini al associate profes or of ophthalmology; Andrew Gage, M .D., pro­ fessor of surgery, and Don Liu (now of Henry Ford Hospital , Detroit), freezing was produced on the eyelids and lacrimal drainage sy tern in ten Rhe u monkeys. Under ane rhe ia imilar to that ad­ ministered Lo human patient with eyelid lumors, the animal were divided into four groups. The research, says atiella , i important becau e many malignant tumors which develop on the eyelid - melanoma, basal 13 and quamous cell car inomas - arc in clo e pr ximity co the lacrimal du t system which keep the eye and its ur­ rounding tissue moist. The fir t group received ti ue freezing at a temperamre of - 6o0 c at midportion of the right lower eyelids , the right upper punctum and cannuli ulus . The econd group underwent the ame technique but rather than a ingle freeze received two freeze-thaw cy les. The third group had left lower eyelid in the midportion and left upper punctum and cannuliculus frozen in a ingle cycle of - 30° ; the founh was lreated identically but under ­ went two freeze-thaw cycles at -30°. As with clinical patienc who undergo the pro edure for removal of eyelid malignancie , tyrofoam wa placed over the cornea of the animal ' eye to prevent injury . Each freeze-thaw cycle wa fr m one to one -and -one -half minute . Biop ie iaken of the frozen ti ue one week, one month and three month following the procedure showed the least ti ue damage and more complete repair ccurrcd in the ti ue frozen once to -30° . The healing was rapid, however. in all animal and usually complete within a month following the cryosurgery. atiella point out that while temperature in the range of - 30° pro ­ duce exten ive cell de truction, - 40°C to - 60°C appear neces ary co kill various type of malignant cell which are more resisiant than normal one to freezing .• �MEDICAL SCHOOL NEWS Clinical classes reflect real life By Connie O wald Stofko C linical teaching has a major benefit: you 're operating in the real world with real people and real disea e . And it ha a major draw­ back: you 're operating in the real world with real people and real di ea e. That seem to be the consen. us of everal clinical faculty at UB. "The real problem is you're dealing with human being ," aid u7.annc Aquilina, clinical assi tant profes or in graduate education for nur ing . "You're dealing with clients and it' unpredictable. The cla room by con­ trast is very organized." Aquilina, who teache in an outpa­ tient clinic at Children' Ho pita!, find that reality creep into the clinic in a way that's unlike the cla room. Mother try to hold onto creaming, . quirming babies while students struggle to examine the tot . The children seen that day might not have the particular type of ra h a clinical instructor wanted to talk about. Or a patient may not how up for an appointment. " ometimc you have little control over the type of learning experience," she aid. "But the students learn that this is the real world." Thi real world ha· real patients. The patient become a third member of the teaching team. The instructor must impart technical information to the student, and at the same time cultivate attitude coward the patient. "You have to reinforce the idea of the patient as a per on and how disea e can influence that person," said Dr. John aughton, dean of the Medical chool and vice pre idem for clinical affair .. "It's a more active and complicated enterpri e. It's taking reality and ap­ plying it to what hould be done in an individual situation." The paradox in the sy tern is that in the struggle to eradicate disea e, the empha i has been placed on technology. The ystem can become deper onalized. medical school, U B's "people-oriented," however, is aughton said. It attempt to give tudents a strong foundation in the cientific aspects of medicine without lo ing ight of patient a people. "We don't want to make tudents hardened and unfeeling," he said. "We want to make them compas­ ionatc and caring. "We take students away from, in essence, lay attitudes. But we hope they keep ome oftho e attitudes they 're real, pure and meaningful a to under tand what people arc about. "But to make the y tern go, we have to add all the c other kills." During training, everybody the tu­ dent work with i ick. That becomes the norm, aughton aid. "The awarene s of icknes become muted over time - you get u ed to it," he said. o the linical in­ tructor mu t strive co keep the stu­ dent sensitive. Clinical in tructor have to remind // In clinical tnstrllction, drawbacks 14 and advantages are the same: real problem . �MEDICAL SCHOOL NEWS "Clinical education is most suc­ cessful when done informally - in the hallway, cafeteria or office et­ ting," augluon said. " hen you go to a ho pita!, what you often ee are small group of phy ician clu tered around talking. That' pr bably mo t valuable. "The problem is that it' random. Everybody might not get everything he need ." That' why la room intruction can't be eliminated. impromptu nature of clinical T heteaching i the primary difference r ie nce of w orking wttb be r ep ce d by le ctures. student not only that they're work­ ing with people, but al o chat they're working with ick people. "It' important to remember that these people are ick; they're in­ capacitated at thi time," aughcon aid. "They become more dependent - uddenly they're dependent on the doctor, the nur es and the orderlies. "It doe n't matter if it' a relatively minor ailment. The lo of in­ dependence i real for everyone. That in itself can be traumatic for a patient who' been vital and active." In their eagerne to be friendly, tudents may actually offend patient , e pecially elderly patient . "For example, it' very common for a tudent, even a hou e offic r, to call a patient by hi or her first name," aid Dr. Jame olan, professor and chair­ man of the Department of Medicine. "They're trying to be friendly. "But the patient didn't ask to be called by hi first name. And the doc­ tor didn't a k the patient to call him by hi fir t name." Calling a patient, e pecially an elderly patient, by hi or her fir t name can make that person feel like a child again, olan explained. And that just reinforce the demeaning a pect of being in a ho pital. "Yet the student mean it in the be t way," he aid. he experience T people can't of working with be replaced by classroom lectures or by practice with simulator. The imulator , mannequin-like device u ·ed to practice techniqu uch a drawing blood, don't come close to the experience of doing it on a person, said Dr. Paul J. Davi , pro­ fessor of medicine at B and chief of medical services at the Veterans Ad­ ministration Medical Center. " imulator don't talk to you, they don't di era t you, they don't make you weat," he said. "There' no penalty" if a cudent make a mi take. "But you undermine your relation­ ship with a real patient when you fail; when you don't draw blood the fir t or econd time." The medical tudent have only minimal expo ure to the e kind of techniques, Davis aid. While they are carefully upervi ed o they do not harm the patient, their inexperience might cau e pain. linical in tructors al o have to C help their tudents face their fc l­ ing about the real-life event called death. The be t time to explore a tudem' attitude to ard death and dying, ac­ cording to aughton, i when it happen . 15 between clinical and cla room teaching, Davi noted. An instructor want to be prepared on a number of topic without formal preparation, but there are pitfalls. "The cholar hip might not be en­ tirely valid if one call upon one' ex­ p rience rather than the literature' experience," Davi aid. The instructor may not remember hi experience accurately or may remember more exp rience than he actually ha . "You have co be on guard again t exaggeration; gilding the lily," h aid. If there' an unu ual problem, a go d teacher will come back the next day with a reading list for hi cud m , olan said. But the in true- �MEDICAL SCHOOL NEWS tor can't have the list prepared before ever eeing the patient. "You never know what' going to come in," olan aid. "You're uppos­ ed to be conver ant, but you can't alway be. So you come back the next day and be more conver ant." Clinical in tructors are expected to teach, do research and practice. "If you don't have the clinical ex­ perience, tho e kill ru t away," olan aid. too, he noted. It doe n't get to be a grind becau e there are many dif­ ferent things that a clinical in tructor must attend to, including administra­ tion. "Time is an elastic concept," Davi •aid. "You ju t try to gee to a certain level on your priority list." olan added that L'B relies heavily on voluntary clinical faculty. They aren't paid and are not expected to do re earch, he aid. , , I n"wethe talked old days," aughton aid, problem of clinical teach­ A nother about the 'three­ ing is evaluations. legged tool' - teaching, research and care. "The ten ion i , if you give good care to patients, you get more patient and that can di tract vou from research or teaching. Or, a good researcher might be tempted to give up the other two. "The challenge for the clinical faculty member is greater than that tor other faculty member or a prac­ ticing phy ician . There are a lot of decision he or she must con tantly make." one of the clinical in tructors had any magic formula for balancing teaching, research and practice. Davi aid it's ju ta matter of juggling your prioritie for the day. ''And then you hope not too many people are offended by your choice of priorities on any given day," he aid. Lengthening the work day helps, "A major problem i in evaluating clinica l performance of tudems," Davis aid. "It' enormou ly difficult. 1 o one has devi ed any canon on that. "The extroverted tudent doe bet­ ter becau e he tends to peak out. The more sen itive student may be less impre sive becau e he failed to ay something." Evaluation of a clinical instructor is also difficult, olan aid. In a clinical setting, a tudent examine. a patient, then the in trucror examines the pa­ tient to see how well the tudent did. While the chairman of a department can sit in on a lecture cla to ee if the in tructor i covering the material, that approach i impractical in a clinical eccing. Feedback from the house officers or students is more ef­ fective, olan aid. Still another problem is that ome in tructors may not observe at the 16 bed ide enough, Davi and olan agreed. Davi um med up three point that are important in clinical teaching. Fir t, hone t data collection is critical. econd, the tudent must be en itive to the patient, to the way the data i collected and to the way it' di cus ed in front of the patient. And last, the tudent mu t be made aware of the enormou and everpre­ senc re ponsibility he ha for the patient. "You can't walk away from that," Davis said. " ot if you want to feel good about what you're doing.'' • Med School leads SEFA campaign T he Medical School played an im­ port.ant role this year in helping the niversity's 1984 State Employee Federated Appeal (SEFA)cam­ paign meet its goal. The Medical chool urpa sed its goal of 46,003 hy over 10,000 or 122 .3 per cent of goal, for a total contribution of SS6,26l. The 10tal contribution of lJB's employee was over 2,s,000, well abO\'C the goal of 260,000. That represents 2 per cent of Erie County' tor.al. The University is now the largest divisional employer in Western cw York. EFA encompasses the ,5 organi;,.acion.~ under the Lnitcd Way as well as everal hundred other . The Medical chool contributed more than money, however. Vice President John aughcon, dean of the Medical chool, served a chairman of the Uni\'er ny SEFA campaign. Dr. Richard Jones, a· isrant to the vice president, acted a as ist.antchair­ man for the campaign. Dr. Naughton ex­ pre ·ed his gratitude to the C niver icy community for their great cooperation in exceeding this year's goal, which was 40,000 greater than last year' actual pledges. The Medical chool gave the highest amount of any unit within the Univcrsit) and its percentile rank wa highc t among the niver ity's large units. "Thi indicates the Medical chool' im­ men e generosity in helping to support health and human services in our com­ munity," Jones commented. "It is clear �MEDICAL SCHOOL NEWS that our medical faculty and taff recognize the health and human service necd5 because of their role in the com ­ munity and proximity to the e problems ." Participating agencies offer health ser­ vice ., child and family care , neighborhood programs (through com­ munity center ), care for the elderly , emergency aid (emergency fo d vouchers or Red Cro . s shelter program for fire and disa ter victims, for example) , and infor ­ mation and referral . ervices. Over 300,000 persons from all economi , religiou . , and ethnic backgrounds were erved la t year b} the e local agencic ., including 504 l lB employees and 202 member of their familie . Gifts arc hared among all 100-plus par­ ticipating agencies, according to a predetermined arrangement and accord ­ ing to local need - or an be earmark ­ ed for the agency of one '. choice . " We can be ju tifiably proud of our commitment to the Western New York community as expressed through these conmbution . .. l view rhi: as a signifi­ cant accomplishment for our University ,' President tcven ample remarked . Robert Wagner, vice pre ·ident for university services , served a associate chairper on and will chair the 1985 cam­ paign . A steering committee comprised of 32 'niver ity employees helped coor ­ dinate the 198-1campaign . • Top researchers are guest speakers T wo prominent medical research­ er were guest speakers for annual memorial lectures held thi · October . The nnual Erwin , etcr 1emorial Lee· ture, held ct0ber 5, in Children 's Hospital, is the first sin e the famous im ­ munologi t died 1ovembcr 2, 1983. This year' Harrington Lecture, on the other hand, marks its 81st year. John B. Robbin , 1.D., the Netcr Memorial lecturer , i chief of the Developmental and Molecular Immunity Branch of the ational In titute of Child Health and Human Development ( IH) . The Harrington Lecturer, K. Frank Austen, M.D., i the Theodore Be\ ier Bayle Profe sor of Medicine at Har\'ard Medical chool Type B (HIB). HIB i a common cause of bacterial meningiti , pneumonia, and other respirat0ry tract and invasive . ., di ea e.. Re earchcr . pent ~oyear performing un ucce sful experiments attempting to devi c an effective vaccine for these bacteria. Becau e HIB infect only humans , there are no good animal models for tuclying the di. ea e. ucce was final­ ly reached when method to bind or con­ jugate thymus -dependent antigens were devised . The uccc · with immuni;,.ation for this organi m was po ·sible becau e immuniza ­ tion can be acquired through cro s reac­ tion with other organi m that share similar antigenic chara tcristic , such as Pneumococcus . Thi was also predicted by Dr. eter. In fact, Dr. Robbin, ·tre sect that natural immunity to HIB i gradually a quired by children through interaction with non -pathogenic bacteria such a~ H. coli . Dr. Fra11k Auste11: Harri11gto11 lecti,rer. The 'eter le turc cries honors the internationally -known bactcriologi . t and immunologi. t who was with l ' B and Children 's Hospital for -17 years after emigrating from ermany . I le developed the test u ed in diagnosis of a \'ariety of cnteric or gut bacterial infe tion and coined the term " enteropathogenic " for certain normally friendly Escherichia coli bacteria in the intestine that can cause disease in infant ·. A major figure in hi · field, he howed that neomycin was effec­ tivt: in treatment of infantile diarrhea . In 1982, the Centers for Di case Control honored his contributions by naming a newly 1dent1ficd bacteria, Cedecea neteri, after him . In discussing prevention of inva ive disease due 10 Haemophilus influe11zae Type Band similar organL ms, Dr. Robbins several time pointed out the historic role that Dr. eter played in research with the c organi m. . One of Dr. eter's con­ tnbutions wa: his observation that certain group of E. coli are 1<..'ading cau cs of diar­ rhL'a in infants . He was met with incredul ­ ity but was soon proven correct. Dr. Robbin reviewed the history of research on the cncap ulated bacteria and focused on che mechanism by which im­ munology develop with H. influenzae 17 Using technique and principles developed partly as a result of "lcter's work, Dr. Robbin aid, recent re earch has found that the mo t effective im ­ munizing antigens arc those combining 1118with those of E. coli . tetanu toxoid r a combination of pneumo o cu. and tetanus. The next step for re earcher , Dr. Rob­ bins stated, is co devi e way in which in ­ fants' own cells can produce antibodie .~ for HIB to fight meningius . Dr. Robhin · received hi · MD . from ew York 'niversity and has held faculty po itions at the niversity of Florida and Albert Ein tein College of Medicine . I le ha erved in various administrative po i­ uons in che National Inscicutcs of Health and the Food and Drug Admini tration. A recipient of ·cveral profe sional awards, he has worked as a con ·ultant for WHO . D r. Austen , the Harrington lecwrcr, poke about the biosynthesi and metabolism of leukotrienes. L.eukotrienes. like prostaglandins, arc biologically active end product . of the pathway re. ulting from the metaboli m of arachidonic acid . They have p tent histamine -like actions and two type are slow -reacting ub tances of anaphalaxi . "Leukotricne are one of the most ex­ ciring development in relation to our understanding of membrane events in cell �MEDICAL SCHOOL NEWS biology," Or. Au ten announced. "It is unlikely that anybody engaged in cell biology is not dealing with experiments in which the metabolism of arachidonic acid is not involved in one way or another." He expla ined that, up until recently, these ubstance were thought of as simply one of the products of anaphalac­ tic reactions, with a limited biological role. Now it i believed that every pathological­ ly perturbed cell rclea es from it mem­ brane arachidonic acid, which u then pro­ cessed to either pro . taglandin or leukotriene. Dr. Au ten, who received hi M.D . from Harvard in 1954, has been on Harvard's faculty •ince 1961. Beside having a nam ­ ed chair as professor of medicine, he is also physician-in -chief at the Robert Brigham Division of Brigham Ho pita! in Bo ton, and chief of rheumatology at Beth I rael and Brigham & Women's Ho pnals. An author of almost 600 scientific articles, he currently crves on the editorial boards bf 11 journals. He i a recipient of numerous a"',ards and current ly serve on nine professional committees . The Harrington Lectureship was c tablished by Dr. Devillo W. Harrington, a B graduate and profes or of genito­ urinary and venereal disease at B from 1886 to 1905. The first lecture was given in 1903. In 1896, to commemorate the 25th an­ niver ary of his graduation from the chool of 1edicine (18""'1) , he made the in­ itial gift to establish the endowed lecture fund. The fund was supplemented by a bequest on his death in 1905. • 400 scientists attend convocation ty, immune complex mediated pathology, tumor defen e, transplantation, allergy, pregnancy, and aging. to the attempts to administer monoclonal antibodies com­ plex , to drugs as toxins , the whole gamut of the bustling field of antibody research was reviewed . Held alternate years, the Convocation focu cs upon specific topics in im ­ munology, attracting nationally and internationallv -known scientists . Most years· the vast majority of Con ­ vocation speakers ha,·c been from outside the Buffalo area, but nearly one-third of the 50 individuals on this year's program were local scientists . These were internationally-known allergists Dr . Elliou Midd leton, Elliot F. Elli , and Robert Reisman; Dr. J. Craig Venter, '\\'ho with hi wife Dr. Claire Fraser, wa. the first to iden­ tify existence of autoantibodies to Beta­ adrcnergic receptors; Dr. Guiscppe An ­ dres, a pioneer in the role of antibody and kidney disease; Dr. Philip T. I..oVerde , who is working to develop a vaccine against certain para itic infections ; and Dr . Pearay L. Ogra, widely known for his work in pediatric virology , notably the Respiratory yncytial Viru (R "\'). Others included Dr . James F. Mohn , well -known immunohcmatologi t and director of the Ernest Witebsk) Center for Immunology; Dr. Felix Milgrom, ch:1irman o UB's Department of Microbiology and a long -time re carchcr in the field of tissue immunology and tran plantation; Dr. Carel J. van Oss; Dr. Marek Zaleski , Dr. C. John Abeyounis; Dr . John H. Kite Jr. ; Dr. Ernst 11. Beu tner ; Dr. Heinz Kohh.:r; Dr E\an ·alkins ; Dr. Richard Bankert , and Dr. Boris Albtni. This line -up illustrates the trong commitment of the Buffalo cicn ­ tific community to the stud) of humoral immunity , for which the foundation . were M ore than ➔ 00 scientists and clinician attended the inth International Com ·ocation on Immunology sponwred by L B's Ernest Witebsky Center for Immunology , June 25-28 at Buffalo 's Mamon Inn. Topics of the Convocation were an­ tibodies and their triple roles as protec ­ tor and destroyers of the human body and regulators of the body' immune response. From the genetic and mo lecular mcchani ms involved in antibody syn ­ thesis through their ro le in autoimmuni- Dr. Felix Mtlgrom was among well­ known speakers at the tntb In­ ternational Con­ vocatto,r on Immunology. 18 laid by the late Dr. Ernest Witcbsky . Dr. Hans Wigzcll, professor of im­ munology and pioneer in cellular im­ munology from Karolin ka Institute, tockholm ( weden), highlighted the Convo ation as pre entor of The Erne t Witebsky .\lcmorial Lecture. Dr. Wigzell is known for describing over a decade ago the existence of white blood cell called null cell involved in the body 's defense system , either Tor B cells . null cells arc either natural killer cells or killer cells which work in a sociation with amibody. Proceedings of the Con\'ocation will be published by A.G . Karger/Basel and will be available next ,·ummcr . Those in ­ terested in obtaining a copy should con­ tact Tht.: Ernest Witebsky Center for Im­ munology at C l6) 831-2901 �HOSPITAL NEWS Advanced system for patient monitoring A new, cientifically advanced pa­ tient monitoring y tern has come on line in the critical care unit at Millard Fillmore Hospital. The com ­ puterized Hewlett Packard y tern. ailed "HP Care-Net ," i an integrated patient monicoring ystem that provide . the late t in total care and information management for critical care patient . " There i no other y tern a advanced in We tern e · York ," aid Dr . James Williams, B clinical profes or of urgery and chief of surgery at Millard Fillmore . HP are- et monitor a patient ' vital ign continuou ly, and tores all thi in ­ formation for later reference. The data management module act like a personal computer, working with doctor and nurse to give the mo t preci e care to each patient , explained Dr. William . In the past, vital ign would be record - ed regularly by the nurses. But if a patient uffered an emergency and a doctor wanted the mo t recent vital ign , he might get readings from 15 or 20 minute before . 1 o • the computer can how the doctor the patient ' vital ign from the pa t everal hour , and right up to the minute the emergency occurred . Vital ign the computer can monitor continuou ly include : heart rate, elec­ trocardiogram wave form , re piration, temperature, and up to three " inva ive" pre ure u ing a catheter . The e include arterial, pulmonary artery and venou pre · urcs . According to Dr. Williams, " The direc ­ tion medicine ha taken is toward inten ive physiologic monitoring . With the refinements in monitoring we can now in­ tervene in the patient ' course a it i evolving. " Dr. William aid the new v tern allow Millard Fillmore to monito~ more vital ign than wa previou ly po ible . Fur­ ther, doctor can do calculations at the pa- ystem pro v ides the latest in total care and information 19 tient' bedside , he aid. An example would be a doctor wondering if a pa­ tient 's circulation could he helped by dilating hi or her capillarie to improve oxygenation of the tis ues. The doctor can now program the computer u in the monitored values, and the computer will work up the exact tatu of the capillary bed. If the e values indicate the patient ill be helpccl , the doctor will follow through with the treatment. aid Dr. William of the e advance , " We have been able to intervene in a very meaningful way on behalf of our patient . For example , we have cut the mortality rate for patient with major infection from 50 per cent to le than 10 per cent. The rca on for uch an improvement in patient care revolve ar und the availabil ­ ity of " total patient data mangemenr. " ritically ill patient are no monitored constantly . And if a doctor i in one critical care unit checking a patient , and he wonder how hi patient in another unit i doing, he can call up that patient ' vital manag e m e m for critical car e pati e nts . �HOSPITAL NEWS ign u ing the computer . Further, if one of hi patient ' vital igns goe out ide the limit he ha pre cribed , the computer will notify the doctor that there i a pro ­ blem . Again , the doctor ou ld be in another unit u ing the monitoring y tern and the omputer would tla h the other patient ' information on the ·creen. The !IP Care- et y tern al o has great re ear h p tential. The availability of up ­ to-the-minute information on critical care patient mean their progression can be carefully traced and better under tood . onver ely, a relap e can al o be careful ­ ly analyzed to ee what happened ju t before the emergency o curred . (From Millard FJ/lmoreHo5p1tafsReponer) • Roswell is one of the three best R oswell Park Memorial In titute wa elected as one of the three · top . . cancer ho pital in a survey conducted by Good Housekeeping Magazine . The urvey i publi hed in the periodical' ovember 19 i ue. Over 250 medical director , chid of caff, department chairmen , and hospital pre 1dent and vice pre idems at major medical center were interviewed by the Good Housekeeping taff . Each was a k­ ed : " Which h pita! - other than your own - do you consider mo t ou ·randing in term of patient care?" Ro well Park ,vas cited , along with Memorial loan -Kettering Cancer Center, in ew York City , and M .D. Ander on Ho pital and Tumor Institute, of Hou ton , a an example of excellence . NCI funds center for organ systems R o ·well Park Memorial In mute ha been elected by the ational Cancer In titute ( Cl) , following nationwide competition , to e. tabli h and implement the Organ y ·tern Coor ­ dinating enter (0 C ) for Cl ' Organ y tern Program . Cl announced Ro well Park' election in lateJune, 19 4 , and awarded the In titute a three -year cooperative agreement grant of approx ­ imately 3 million to fund the O CC. Roswell Park Memorial The O CC opened Augu t I , 1984. Dr. Gerald P. Murphy , director of Ro well Park, i the director, and Dr. James P. Karr, cientific administrator of the ational Prostatic ancer Project at RP I , i the a ociate director . Dr. Karr is al o a UB faculty member with the Ro ell Gradu ­ ate Divi ion . According to Dr. lurphy , " Ro well Park was able to compete ucce fully for thi prestigiou grant ba ed on the ucce of the ational Pro tatic Cancer Project , which h been headquartered here ince 19"'2; and the In titute 's demonstrated ability over the years to clo ely coordinate clinical inve Ligation, cancer patient care, and re earch Through the O CC, the ln titute is e entially being asked b}' Cl to promote thi concept throughout the nited tate ." CJ' Organ y tern Program i the re ult of the recommendation made by the 1 ational ancer Advi ory Board in 1982 to reorganize and expand the I a­ tional Organ ite Program. The Board al o recommended that admini trative coor ­ dination of the Organ terns Program be conducted by a central headquarter the Organ y tern Coordinating Center - located outside the Cl. The ational rgan ite Program wa · e tabli hed in 19 2 to timulate re earch 20 Institute: one of tbe best. on important cancer problem - urinary , bladder , large bowel , pancreas, and protate - that had not attracted the level of effort commen urate with re earch lead available and the mortality and morbid ­ ity they cau e. The planning , direction , coordination , and implementation of each project were provided at four eparate Headquarter Office out ide Cl through a unique scientific and managerial partner hip of the biomedical communit y and CI. nder the rgan y tern Program , the ational Brea t Cancer Program has been added as the fifth ite. The e tablishment of the O further olidifie thi partnership by consolidating the external administration of the Organ · y ·terns Program into a central O C to improve the overall efficiency of planning , oordinating , and implementing the program . The O will treamlinc ad mini trativc and programmati c upport by eliminating unnece ary duplication and multidis iplinary interaction both within and among the five program ; ignificant ­ ly improve the cost effectivene of the program ; and provide the appropriate mean of funhering both ba ic and clinical re earch effort . (From Roswell Par/e 's C/,nica/ Newsletter.August 1984.) • �HOSPITAL NEWS ECMC introduces laser bronchoscope A new attachment is adjoining laser to broncho cope at the Erie unty Medical enter, according to Dr. Doug! Klotch, a i i;am profe or of ocolaryngology and direccor of otolary ngology at the hospital. The new attachment i a et of endo cope ouplers donated by the volunteer board of the medical center. It i believed to be the only one in u e in Erie County. "Wit h the Ia er bronchoscope, the urgeon can vi ualize the invi ible laser beam in ide the broncho cope and manipulate it via a joy tick," Klotch aid. As a re ult, le ion who e a ce were limited by conventional urgery, now can be removed with pinpoint accuracy. "W ith the laser broncho cope," aid Klotch , "we can reach areas below the larynx. We can place the ventilating bron­ cho cope through the larynx and remove benign tumo uch as juvenile papiUomas there a well as stricture in the trachea. " ot onlv do we have more control over the s·urgical removal of benign tumor from the larynx but there i le welling and earring following urgery for the patienc." To date, Klotch ha u ed the la er bron­ cho cope co treat tracheal tenosi and papillomato i in the trachea. • Children's names executive VP T he Board of Trustee of The Children' Ho pital of Buffalo ha announced the appointment of Mr. Thom O. Clark a e ecutivc vice pre i­ dem, effective 1 ovember I, 198 ➔ . Clark come to Children' Ho pita.I with an exten ive background in ho pita! ad­ mini tration and pediatric health care. He wa mo t recently a ociate admini trator at the 698-bed Ho pita! for ick Children in Toronto, Ontario. Prior ro that, he erv• ed as assi tant admini trator and director of nur ing ervice ~ r the Children' Hospital of Alabama. In addition to hi eight year of ex­ perience with children' ho pital , Clark has al o erved a director of nur ing er- vice for the Ea t End Memorial Ho pita! in Birmingham, Alabama, and for lonroe County Ho pita.I in Monroeville, Alabama. He hold a ma cer' degree in ho pita! and heaJch admini cracion from the nfrersicy of Alabama in Birmingham. He injection to the arteries to visualize the blood flow y tern. The traditional angiogram involve· urgi al team, one 10 two hours on che x-ray table and ad­ mis ion co the hospital for overnight ob ervation following the pro edure. The new sy rem will allow the dye co be inje ted int the vein in tead of the anerie . tiJi;,.ationof the vein i le risky co the patient :Ind allow for a quicker and afer examination. With the D 211, ex­ amination· can be performed on an out­ pacienc basis, eliminating the need for hospitalization and reducing cost. • BGH appoints chief operating officer l Tho m 0. Clark is a member of the acional A ociation of hildren' Ho pitaJ and Related In titu­ tions ( ACHRI) and a member of A HRI' Continuing Education Commit­ tee. He i. also a member of the American Ho pita! A ociation, the ational League of ursing, and the American ociety of • Hospital 1 ur ing ervice Director . OH E. FRIEDLA DER ha been named chief operating officer by Buf­ falo General Ho pitaJ. Mr. Friedlander, ho will oversee the day-co-day opera­ tion of the ho pita!· High treet and Oeacone · divi ion and it community mental health center, will report to Or. William V. Kinnard Jr., ho pita! pre ident . He previously was northeast director of health care consulting for the manage­ ment con ulting firm of Coopers & Lybrand in Bo ton. He a al o a i tam dir ctor of the cw Jersey Oivi ion of ental Health & Ho pital . He · earned hi B.A . from American International allege and his M .. in health care admini tration from orthea tern ni ersity . • Sisters adds new diagnostic weapon A revolutionary ne~v "state-of- the ­ an" piece of equipment ha become part of isteri- Ho. pital's Radiology Department'· ar. enal of diagno tic weapons. The unit, called the Picker International DA 211, i a com­ puterized digital subtraction unit which i currently being interfa ed with exi •ting x­ ray diagno tic equipment. The new y tern i being u cd a an ef­ fecc i ve alternative to a tandard angiogram, which u e a ntrasting dye 21 Jo bn E. Fried lan d er �BOOKS High stress and physician fall-out B y Ro Markello , M.D. Pro/es or of Anesthesiology The Impaired Ph ys ician. Edited by tephen C. cheiber and Brian B. Doyle, Plenum Medical Book Co., ew York and London , 1983, pp . 200. ,'The di tre ed phy ician will often tart irregular office hours , be prone to poor eating, and leeping habit , and will be inefficient and di ordered in hi work. " " The lack of recognition of a phy ician-patient ' di tre i related to the colleague 's con ciou or un ­ . con cious denial that a phy ician can be emotionally di turbed. " Phy ician , like navy pilot , live with the lurking fear that they might not have " the right tuff .'' tephen cheiber ( B Cla of '64) teache p ychiatry at the niver ity of Arizona . AJong with colleague , he has a embled an informative little treati e concerning a ubject u ually di cu ed in hu hed tone behind clo ed door . The " impaired phy i­ cian " i a term that ha been coined to de cribe the individual who i lo ing the kill to cop with and manage tre and who demon trat one or more of the elf -destructive ymptom which can ultimately lead to alcoholism , drug addiction , or suicide . It i estimated that even to eight per cent of phy icians are no or will become aJcoholic ; 100 per year com ­ mit uicide in the U.. ; 4 per cent have bad marriages ; I. 5 per cent are known drug addict . While the figures lend themselves to controver­ sy, no matter how you slice it , phy i­ cians are far more prone to emotional decompensation than the general public . How are the women doing? Fair. They have a higher suicide rate. The tres e of culturaJ expectation (fami­ ly, etc.) coupled ith profe ional re pon ibilitie make for greater con ­ flict. It ' too soon to ay but perhap the women will fare b tter ince they don 't have to live up to the " macho " image. Other data pre ented how that uicide rate for male phy ician are no greater than for the general population, that women have rates 3-4 time that of male , and that p ychiatri t have higher rate than tho e in other pecialtie . What are medical school doing? Of 20 urveyed , only one u e a com­ bination of pre-admi ion interview and the MMPI. Mo t u e a pectrum of faculty or upper cla advi ement, a well a elf -help di cu ion group to aid tudent through the mo t tre ful period in chool. While mo t claimed to have counseling er­ vice available for tudent in need , early intervention occurred rarely. One chool wa oppo ed to any type of pre -admi i n creening for fear it might keep out of medical chool porentially fine phy ician . Talk about THE IMPAIRED PHYSICIAN ~.L11·,i t•, Stephl:'n C. Scheiber Brian B. Doyle 22 denial! " The con ensu is that physician with per onaJity difficultie antedating medical chool are vulnerable to the occupational ha7..ard of a medical career." OK , what can be done? cheiber ugge t ome action for the admi ion committee. any medical tudents who ought p ychiatric help had per onality problem before entering medical chool and the ma­ jor cau e of maladaptation wa "'the per onality they brought with them." A careful social hi tory will identify tho e candidate who have a higher probability of becoming impaired. Depre ion and alcoholi m rates are much higher where there i a family hi tory of uch . I'm ure ome of u would object to hi que tioning of eneure i , parent-child relationship , home atmo phere, and maritaJ rela­ tion hip . How far doe a committee invade privacy in the name of weeding out people who will not be able to handle average phy ician tre ? ·cheiber make a plea for bet­ ter informed , more ophi ticated ad­ mi ion committee which include p ychiatri t ·. I hope ome school cake up hi challenge for a 20 -30 year longitudinal tudy of high v . low risk tudents and ub equent emotional disturbance bur I doubt if any will. di cipline, Medicine i a high tr taxing man co the limit of their adaptive ability . The image of the all­ knowing , caring , n ver -failing , calwarc i an unreali tic expectation. Medical organizations are beginn ­ ing to deal reali tically with impaired phy ician by way of continuing education program . The be t they can do i improve awarenes and help ympathetic colleague direct a deteriorating phy ician toward help . cheiber ' bia remain - above all , better creening for medical school. Thi book can be read in everai hour . It has u eful information and r pre ent a " tate of the art " type publication. • �BOOKS Medical education: who's doing it & how Te acher and Teaching in Medical School . Hilliard Jason andJane Westberg, Appleton Century Croft , orwalk , Conn ., 1982, pp . 3 20 . , ,I had arrived at medical chool filled with emhus ia m and hope . Most of what I had found i be t de crib ed a dull drudgery and a pr eoccupation with trivia ." I recall " Hill y Ja on " ( Ia of '58) a a eriou , articulate etas mate. While the more cynical of u had mode t expectation of the impact of medical chool on ur future career., Ja on t0ok the initiati e to tr y for im ­ provement. On a on e-year leave from medical tudie , he participated in th e famou experiment in medical duca­ tion in the mid-50 at Buffalo. ub . e­ quemly, he ha enjoyed a produ ctive quarter century as a national leader in medical education . He currently live in Coral Gable , Florida . In the mid O' , when medical chool were in the mid t f coping with expl ive growth, a mall group et out to urvey ducation - ad­ dre sing not what wa being taught , but rather who was teaching and hoU'. The book i a compendium of the rudy design and finding . ome of th finding : • Worn n and minoritie had not achieved an appreciable p r entage of total faculty ; many full -tim e teacher pent little or n time teaching medical tudent but in read graduates ; two -third of faculty in primary care di cipline do not perceive them elve a primary care phy ician ; most faculty tay at one school . • Mo t faculty do not read medical education literature at all , and about 40 per cent read "general " journal , i.e. JAMA and The New England Jow· ­ naf . Jason neverlhele find en - courag ment that one -fifth have taken ome formal instruction in education , and mo t eek out and are en itive to feedback from tudent and colleague . "Out and out didactic treatment is hopele ly antiquated ; it belongs to an age of accepted dogma or up­ posedl y complete information. " - Flexner - 1910 The formal lecture co large groups of ·cudenrs remains the predominant form of basic cience education . Mo t clinical teaching now occur in mall group and in a patient erring which i what Flexner ugge ted 75 year ago. In 20 year , there ha been measurable progre -s toward in­ tegrating basic cience in clinical medicine and in che u e of " applied " eminar . " Learning complex idea , altitude , or kill u ually involves adopting new or different characteri tics, which , in turn , in olve taking risk ." (It also involv e. a gr eat deal of energy expenditure l might add .) Finally, Ja on make a plea for facul ­ ty development - a y tematic pro ­ gram to enable teacher to become more effective . Many chool have program for augmenting in e tigacive and clinical kill of the faculty few have them for education. It ha been almo t 30 year in e George Miller pearheaded th ven­ tur in medical education in Buffalo . When medicine was in the growth of the 60 and 70 , re ource were made available and a good bit of thought wa expended thereto . The " true believers " did not accomplish the revolution for which they had hoped . They did achieve awarene and mode t improvement . I chink there are everal reason why ucce wa mode tat be t: • In the past 10 year , the tudy of cognition has discovered that the way in which we I am and apply is likely inborn - with the educational pro­ ce s having very small influence . 23 TEACHERS AND TEACHI G IN U.S.MEDICALSCHOOLS Hilliardk1!,011 kmcW tbcrµ While e would like to think of the phy ician a a logical , cientific problem - olver , the va t majority of what we in fact do i pattern recogni­ tion with tereotypcd re pon e. Fear of di approval and emulation of perceived authorities influ nee behavior a much if not more than logic . Built -in y temacic perceptual errors give u 'probability di tortion . • The concern to improve medical education wa merely pare of the fer­ ment in education in the we tern world in the 20th century . u e wa not much better in the world -at-large. • Inspired informal teach ing i a dif ­ ficult ta k that ~ w do well. With the perceived ver upply of phy ician in the 80 , l fear there will be little enthu ia m ~ r academic in­ terest in medical educati n . It will r quire a ocial catacly m u h a another homing war, economic . depre ion , or large un erved p pulace - before ther will be ide pread intere t in the educational proce in medicine. " Ya did good Hilly! " Future g nera­ tion will appreciate the work of your elf and olleague . • ��DOCTORS I THE ARTS Bernstein cotnbines opera & otolaryngolog y A s otolaryngologist, Joel Bernstein knows ,; ·ell the configuration of the laryn . , hem its vocal cords function as a reed instrument , producing a rudimentary music with eV<:ry u_tte~ance As professional sin~er. _Bernstein. also kn?\'~ the physi~al demands of _concert smgmg, how tremendous stamina 1sneeded 1f the \"OICe1s to float wllh grace. pn:cis1on. and richness of tone . Physiologicall :. what distinguishe, singing from .speaking, is the manner in which breath h e. ·pell ­ ed to vibrate the vocal cords . As B rnstein is well aware, singing require more breath - and e\'er more breath - the louder, higher. and longer one sings . . \Xell known in \-X 'estcrn , ·ew York as a concert performer for roughly the last de ade , Bernstein , a baritone , has performed everything from the luminous lieder of Schubert and Schumann , to more vocally demanding roles in opera and oratorio . He credits his late father , Harold Bernstein, for affording him an early familiarity with music, ·pecifically in its rich instrumental textures . The elder Bernstein grew up with Harold Arlen, the late Buffalo-born composer, pianist , and arranger who wrote the entire score for Tbe \'('izard of Oz, including, of course. the famous Judy Garland signature piece , "O\ er the Rainbow ." "They played a lot of music together as kids. My father was a fine musician \Yho played the sax and the clarinet. He played in \arious bands around town and even cut a kw records. · A nati\·e Buffalonian, Bernstein began singing as a young boy in the synagogue. There , as his voice gradually deepened with the onset of puberty, the young Bernstein progressed from soprano parts to alto roles. and finally to singing the bass line. At the same lime. he was exploring other dimensions of music. especially in learning more about the instrumental line and the texture of \X'estern music itself . "I tarted playing the violin about age seven. and took ks ·ons for another eight or nine years," he remarks. "I also played the French horn for about five years," adds the clinical assistant professor of otolaryngology and pediatrics, who holds ~I.A. and Ph.D. degrees in microbiology from B, in additi o n to the 7\.1D. from the Medical School ('61) . He continued his choral work through his high school Bernstein as Monterone In Ver­ di~ Rigoletto (page opposite) and in bis office, ready to see patieHts (at right). By Ann Whitcher 25 �DOCTORS l 1 THE ARTS days and al o during his year a an undergraduate at Harvard. Following graduation from medical chool in 1961 and a one-year re idency at what i · no"° Veteran · Administration Medical Center. Bernstein managed to sandwich in time singing in a Boston temple. while serving a three-year residencv at the Ma sachusett Eve and Ear 'infirmary. , After returning· to Buffalo, he oon became active in presenting musicals at the Buffalo Jewish Center with ocher members of the center· Drama Committee. There, he appeared in everal Gilbert and Sullivan operettas, and al o had lead role in Guys and Dolls, The Apple Tree, ,Hilk and Hone;: Oklahoma. Will the Mai/train Run Tonight, and The Education of Hyman Kaplan. B y the early 1970s, Bern­ stein had decided that, his musical culture notwith­ tanding, the time had come co cudy voice eriously - and with gusto. "At the time, l aid to myself, you know, I real­ ly have sung all my life, but I've never studied voice." There was a certain irony in the fact, he added, that "here I wa · an ears, no e and throat man who was eeing people with voice disorder and problems. I certainly did not begin to study voice serious­ ly becau e I wanted to help my pa­ tients. 'Tm not saying that. I imply decided that singing was a very im­ portant part of my life that gave me great joy and atisfaction." Although Bern cein had embark­ ed on erious voice tudy partly to prepare for additional musical comedy roles, he quickly found himself immer ed in ·•a whole new world" of opera. oratorio (the religious, non-liturgical counterpart of opera; unlike opera, however, there is no visible dramatic action), and lieder, which usuallv refers to the German art ong, especially of the 19th cen­ rury. Here he was confronted with an e pecially demanding art form, one which calls on the singer not only co exerci e great phy ical control, but also to carry the musical phrase with a mix of subtlety and pa sion. The . singer mu t also exhibit the dramatic skill of a good a tor. A tall order, and one which make opera, with it. heavy dramatic underpinning , a daunting challenge for the concert singer. Bern tein chose a his first voice teacher Heinz Rehfuss, the Swis -born bass-baritone and CB professor of music, who enjoyed a distinguished inging career on the European stage. The European-trained inger coach­ ed the American otolaryngologi t for four year . Their spirited conversa­ tions often mixed the musical and purely anatomical. Remarks Berns­ tein: "We u ed to have conversation about the function of the larynx, although I didn't always agree with him on ome of his concepts (regar­ ding larynx function). Yet he caught me a great deal. He gave me many idea ." In addition to bolstering his vocal powers, Bernstein had to harpen hi language kills - essen­ tial in concert inging - and now has proficiency in German, Italian and French. Since 19T, Bernstein has studied "off and on" with B associate pro­ fessor and University Opera Workhop director Gary Burges , a lyric tenor who has sung with the :i.n Franci co, Greek National, Metropol­ itan and Philadelphia Lyric Opera companies. Burges has twice invited Bernstein co perform with him as part of the Mu ic Department's annual faculty recital serie . In the late 1970s, Bernstein per­ formed frequently with the niver­ sity Opera Studio (precursor to to­ day's Opera Workshop), directed by B associate profe sor of mu ic Muriel Hebert Wolf He wa tephen Jumel in the Opera tudio world premiere production of ,\,fadC1me Jumel, an opera by Buffalo composer and retired Buffalo tate College music profe sor Anton Wolf. From 1976-78, he performed in several Opera Studio productions, including Gilbert and Sullivan' The Gondoliers - where he played the Duke of Plaza Toro - and The orcerer, where he sang the rote of J .W. Wells. Bern tein has performed in the Art­ park production of Ros ini · The 26 Barbet· of eL•ille.He ha also sung in a Western New York Opera produc­ tion of Samuel Barber's 1959 The Hand of Bridge, a one-act opera about four people '"ho, eated around a small green table, are more preoccupied with per onal problems than with the card game. He was the magician Dapertutto in the 1982 B Opera Workshop production of Jac­ ques Offenbach's Tales of Hoffmann. And he wa Abimelich, the satrap of Gaza who cornfully di. mi se the Israelites' devotion co God, in the Opera acra production of Camille ampson ainc-Saens' 187"'.' opera, and Delilah. Additionally, he was the bass soloist in the Buffalo Choral Art Society presentation of the Cherubini Re­ quiem: with the Univer icy at Buffalo Chorus, directed by Harriet imon , in both Buffalo and Rochester pre en­ tations of Mendelssohn' oratorio Eli­ jalJ; and in the Handel oratorio Judas ,Haccabeus in a 1983 Temple Beth Zion pre entation, part of the Buffalo Philharmonic's" tained Glass" serie . I ndeed, Bernstein's musical re ume resounds with mu. ic divergent not only in terms of content and musical tyle, but also in what is vocally demanded from the singer. The list includes Rodgers and Hammer tein tunes with the Buffalo Pops Or­ chestra, directed by Bern tein's good friend, the late Robert chulz; bass soloist in Dvorak' 1890 Requiem .\1ass, a part of the Kenmore Methodist Church concert eries, and bas soloi c in Handel' .Wessiah both with the Buffalo Choral Art ociety and the St. Paul's Epi copal Cathedral Choir of Men and Boys. In May, 1984, he cook on the fun, if formidable, role of Daddy Warbucks in Artpark's pro­ duction of Annie. In addition, he has sung in performances of 1ozart's Re­ quiem, Oebu sy' 1884 cantata L'en­ fant Prodigue, the latter pre ented by Opera acra, and in the B Chorus's pre entation of Fantasia on a Christmas Carol by the 20th century English composer Ralph Vaughan William . He wa Juda in Opera Sacra's presentation of Massenet' �DOCTORS l11 THE ARTS Mary A!agdeline, and sang the role of .\larcello in a \Xetern 'cw York con­ cert version of Puccini's famous opera La Boheme. He was the cantor at Tem­ ple Beth Zion for four year until the new full-time cantor, Gail Hirshenang, wa engaged not long ago. The cantor is the olo or principal inger in Jewi h worship Remarks Berns­ tein ''This, of course, took a great deal of commitment. The new antor usuallv calls me to fill in when she goe. on vacation." Singing the role of Monterone, the deeply outraged father who level an all-important curse, in Artpark's .-cag­ ing of Rigoletto, is a particular favorite. "I would ·ay chis was the highlight of my singing career After having been chosen from the chorus to take over rhe role - two weeks before the concert - well, it was quite an event. !though it'. a ·mall role, you're in center cage for five minutes in the first act." Some of the other operatic and oratorio role. have had their fair share of dramati coloring, although Bern­ stein win cs at some of the more florid moments. He recalls singing the role of Herod in the 185"¼Berlioz du Chri ·t (The In­ oratorio, L 'E11Ja11ce fancy of Chri. t). in which Herod, singing a mu ically stirring aria. nonetheless proceed to call for the killing of all the ne ·born children in Jeru alem, azareth and Bethlehem "River of blood will flow." sings Herod 'It's ju:t terrible," says Berns­ tein till, he. ay , such roles offer him "a real opportunity to dramatically portray a role." Since many of Bernstein's roles have been in oratorio or 10 " hat amount co concert ver:,,ionsof \uJrious operas, Bernstein has not had to call on great acting power. ln an~ case, the musi al characteri tics of a piece in­ tere t him the most. For LhaLn;ason, he doesn't del\'e into intensive ps) · chological study of the character, or invoh'c himself with musicological re earch. "I usually rely on the direc­ tor to give me hi ideas about the role. I'm not the type of person who is willing to take that kind of time to study the character. My particular concern i u ually with the singing, with the execution of the musical pan of the role. I uppose that\ ,vhy I'\·e been called a mediocre actor and a good inger rather than the other wa) around. ''.Although I think that I've acted better than they thought J did," he adds. !though his invol\'ement in the musical aspects of opera is e tabli h· ed, Bernstein 1 · no opera buff. He prefers to keep a safe distan e from opera' rhetorical excess, . oap opera­ ish plot twist , and libretti loaded with psychological maladjustment of even• ilk. Comments Bern rein: "J realli· enjoy listening to great singers. I ju t marvel at the control and the outstanding talent of ome of the peo­ ple who are • inging throughout the world. And there are o many good inger . it' just incredible. Knowing <;omething about . inging. knowing omething about the anatomy and physiology of the larynx, and having participated, I just marvel at some of the great singerc; "But an opera huff I'm not. because so much of opera is so hokey, even absurd. For example, some people enjoy watching (~ozart's) Co i fem Tulle (a tale of lovers, disguise and infidelity) or The Marriage of Figaro (also by ,\tozartJ sea on after eason. I don't But what I think is great i to listen to the tremendou talent of the great . ingers of toe.lay.again, to marvel at the vocal sound that ome people can pro• duce." After all. the voice is an in. tru• menc, he note. , and the in. trumencs of great singer. like the American baritone herill Milnes and the . pani h tenor Placido Dommgo. can be compared to the playing po"'·er of the late ,·iolini ·t David Oi ·trakh. or mu icians of similar stature. Ho,, does this engaging physi­ cian/singer find time for his striking mix of re earch, clinical practice, and serious foray· into the art ' Bernstein says his evening usually are free "for my re. earch, my reading and my mu ic, ·ince I have chosen a field in which I can make a lot of people happy most of the time." His otolaryngological practice, he ex­ plains, is confined "to general ears, no e and throat problem of a u ual- 27 ly non-serious nature rather than head and neck urgery. As a result, I don't see a lot of seriou. ly ill people with cancer of the head and neck who require a great deal of post­ operative care." His area of creative fulfillment al o embrace an active re earch in otology. "Ju t a my music has given me the opportunity to express myself dramatically and musically, m) re ·earch, too, ha given me the op­ portunity to express myself and, of course, helps me a lot in term. of the di ·ease I treat." Over the year , Bernstein has made numerou presentations of his research at many universities and be­ fore such group as the American ca­ c.lem} of Otolaryngology, the Pan American Medical Association, the American . ·eurotology ocicty, 1he . ew Jersey ~tedical . ociety, and before numerous \X'estern , e York medical meetings. In 1982. he ,vas a \ isiting professor at Children"s Hospnal of Pittsburgh, Otitis Media Research Center. In 198➔, he recei, ed The International Award of Merit from the Belgian-Dutch ociecy on Allergy in Otorhinolaryngology. Bern­ stein received the honor for his pioneer work and sustatned research on the role of allergy and other im• munological proces. es in otitis media with effw,ion, an inflammation and infection of the middle ear marked b) drainage of fluid. The aw~trd wa presented on April II, 198 ➔• in The Hague. Bernstein ubsequently spoke at the First International Symposium on Immunology and Otolaryngology in L trecht. Bern:'itCin' home life continues to have a firm musical underpinning. The LB phy ician and his wife Sheila arc the proud parents of three ·ons, David, Jonathan and Jimmy, all of whom, to one degree or another, have ventured into music. Jimmy, the youngest, "may become a profes· sional mu ician," hi· father reports. Jimmy, a tudenc at William ville outh High School, is tudying per­ cu sion with Lynn Harbold, percus­ sionist in the Buffalo Philharmonic Orche tra and lecturer in the B Music Department. • �PEOPLE Children's clinic named for Jacobsens W By Dave Condren hen Dr. A. Wilmot Jacob en came from Baltimore to Buf­ falo to e tabli h an outpatient department at Children ' Ho pita!, he had anticipated that hi work here would be of brief duration. "l expected to stay a year," the highly regarded pediatrician and retired B pro ­ fe or of 42 year aid October I , 1984 That was hi plan in 1926. " I decided to cay on becau e they had people who knew what a ho pita! ought to be," he added, explaining why he i till around 58 year later. To a ure that the contribution of Dr. Jacob en and hi wife, Dr. Evelyn Heath Jacob en , will never be forgotten , the Children' taff and tru tee honored the couple in October by naming the hospital 's fir t-floor outpatient clinic the "Jacob en-Heath Ambulatory Clinic ." The facility had been known merely as the " D-1 clinic area." The urpri e honor wa announced during the medical taffs quarterly meeting in the Marine Midland Tower. Quipping that he has been " laboring under the assumption that to have something dedicated co you , you had to be dead," the 86-year-old Dr. Jacob en ac­ cepted the honor on behalf of himself and hi wife , who could not acrend. '' I 'm really very much touched that you all were willing to remember Evelyn and me in thi way," aid Dr. Jacob en, who till erve n the staff of Children ' and care for patient a well. An author, teacher and lecturer as well as a pediatrician , Dr. Jacob en not only founded the outpatient department at Children ' but erved as it director for 19 years. Hi wife founded the Children ' Aid ociecy in 1925 and remained active in it until 1975, when he retired . The ociety erved a an adoption agency and cared for abandoned and battered children. " Thi i a red-letter day on the Jacobsen calendar," remarked Dr. Jacobsen as Dr. Bernard Ei enberg, chairman of the medical taffs Recognition Committee , pre ented him a copy of the in cription that ill go on a plaque to be hung in the ho pital. Dr. Ei enberg i a B clinical as ociate profe or of pediatrics and social and preventive medicine. "As I look back over half a century , mo t of our joy and triumphs have been con ­ nected with Children 's Hospital, " he cold hi colleague . umbered among tho e joys , Dr. Jacob en aid, wa his o n experience a a patient at Children 's when he contracted "a ca e of chicken pox ." Because the ho pital complex has literally grown around the Bryant m:et home that the Jacob ens have occupied for 50 year , Dr. Jacob en noted that he and hi wife "are the only two (physician ) on duty 24 hour a day and 365 day a year in ide of Children's ." (ReprintedfrMI rhe BuffaloNewswhere M, CondrenIS a wrlrar) • Lewis Flint chairs Surgery Department D r. Lewi M. Flint , Jr., ha recent­ ly been appointed the new chair­ man of the Department of urgery in the chool of Medicine , as well a director of urgery at Erie County Medical Center. The appointment of Dr. Flint, a native of Dekalb County in Georgia, mark the ucce ful end of effort to ecure the er­ vices of a mo t highly qualified surgical phy ician co head the department. A profe or of urgery at the niver ity of Loui ville chool of Medicine incc 1975, he ha al o erved a chief of surgery at Humana Ho pital. Dr. Lewi received hi bachelor 's and his medical degree (1965) from Duke niver icy. He comp leted re idencie at both Duke Ho pita! and the Medical Univer icy of ouch Carolina. He was a Fellow in trauma surgery at the niver ity of Texa outhwestern Medical chool for two year and served for a imilar time in the U.. Army. He ha member hips in numerou pro ­ fe ional ocieties, including the American urgical A ociation, American College of urgeons, Alpha Omega Alpha , th o­ ciation for Academic urgery, and the ociety of niver ity urgeons , of which he wa pre idem. 28 Lewis M. Fltnt , Jr. Most recently , he i the repre entative of the o iety of niver ity urgeon to the Ameri an Board of urgery, chairman of the American College of urgeon · publication committee , and a member of it executive committee on trauma . He erves as a o iate editor of Current Con ­ cept in Trauma Care and i on the urgery editorial board of the journal and Heart and Lung The author of almo t 60 publication as well a 10 book hapter , hi exp rti e al o led to the making of the motion pic ­ ture, " Management of the Multip le Injury Patient," which won the 1981 ETHICO Film Award pon ored by the outheastern urgical Congres . Hi primary re earch empha i i on the field of trauma , e pecially the development of urgical technique for the treacmem of the patient with multiple injurie . • Granger receives data center grant D r. art . Granger, profe or of rehabilnation medicine and medical director of The Buffalo General Hospital Rehabilitation Medicine Department, ha received a three -year �PEOPLE grant totaling one -third of a million dollars to develop a nationwide uniform data y tem for rehabilitation center . The a­ tional In titute of Handicapped Re earch of the U.. Department of Education i funding the project for 116,898 in the firs.t year. ccording to Dr. ranger, che uniform data 1 tern i the key to documenting the effectivene of rehabilitative care and co improving cost efficiency . The need for a common information haring program wa tated by the merican A! ademy of Phy ical Medicine and Rehabilitation (AAPM 'R) and the American Congre s of Rehabilitation Medicine (ACRM), which jointly e tabli hed a IQ-member national ta k group to addre s the project. Dr. Granger , one of the elect in ­ dividual on the task force , said the pro ­ je t i a respon e 10 the pos ibility of a change in the reimbur ement >' tern 10 a pro pective payment method for rehabil ­ itation ervice . These ervice include phy ical therapy , o cupational therapy , language training, p ychological and ocial adaptation , medical evaluation treatment , and management. Working with Dr. Granger to establi h the niform ational Dam et is Dr. Byron B. Hamilton , director of research at the Rehabilitation In titute of Chicago , who i · currently a one -year re earch fellow ...- ...... with the B Department of Rehabilitation Medicine . Coordinating their effort · through the re ources of che Buffalo General Ho pital and the niver ity, the doctor will begin thi ongoing work by establishing common definition of medical term related to rehab medi inc , devi ing a common method to mea ure effectivene s of care, and creating a uniform means of a e ing co t . thcr pha e of the projt: t include gathering and analyzing information on patient groups and identifying the patient who most benefit from inpatient rehabilitative ervice . In addition co the project ' goal of pro ­ viding better ervice to the nation ' di abled , other objective of the niform Data et arc to provide more comparable and acces ible information to upport the accreditation of program and to ju tify reimbur ement for service . Dr. Granger points out that the uniform information y tern is being devt:loped to be compatible with computer equipment expected to be in u e at mo t facilitie . A pilot ce t of the data v tern will be conducted at five rehabilitation ho pital within the next two month . The revi ed program will then be field re ·ted in 15 rehabilitation facilitie . Dr. Granger an­ ti ipate that che ational Datasec will be operational in rehab center aero che country by mid-1986 . • Carl V. Grattger 29 Granger, Gresham edit landmark book H By Bruce . Kershner ailed as "a landmark " and a "gold tandard " at a recent American ongre of Phy ical 1edicine and Rehabilitation meeting , Functional Assessment in Rehabilitation Medicine i a book that aim co bridge the gap bet­ ween rehabilitation theory and practice . After five year of effon , che 08-pagc volume wa relea ed thi pa t November . It wa authored and edited by Dr. arl Granger , profe or of rehabilitation medi ine, and Dr. Glen Gre ham, pro ­ fc or and chairman of B' Department of Rehabilitation Medicine. They each head tho e department at Buffalo General Ho pital and Erie County Medical Center , re peccively. honly after che book wa relca ed, the author pre ented a copy to Vice Pre ident John aughron a a gift to che Medical chool. " We feel the book is indeed a 'fir t' and clearly e tabli he our department here a a leading center for chi cype of experti e and re earch ," Dr. Gre ham commented. The hook i de cribed a unique in that it combine concrete guideline for disability as e ment with technical infor ­ mation o phy i ian can more effective ­ ly de ign theraple appropriate 10 the real need of che patient . One particular approach Dr . Grnnger and Gre ham take i to make the phy i­ cian aware of the many in eparable a pe t of effective rehabilitation - not only one-to -one therapy but al o modification of the environment and of public policy . The author ere char the ultimate ucce of therapeutic effort i often affected greatly by attitude - the attitude of go ernment, ociety and rehabilitation profe ionals c ward the phy i ally impaired , a well a che anicude of the di abled patient coward hi or her own physical problem . Thirty -five noted contributor redefine term and models o that di ability can be accurately a e ed within a broad con ­ text of patient trength and weakne e . Example of chart include life cycle maintenance co t and rehabilitation cost compared t minimum level of a ceptable life maintenance and level of di ability . Other areascovered by che b ok are the �PEOPLE theoretical basis for functional asse ment and the contribution of epidemiology co health care planning for pat ients with chronic and di abling disease. The author al o focus on the current statu of func ­ tional as e ment and where research is still needed . After earning hi M.D. from ew York niversity-Bellevue Medical Center in 1952, Dr. Granger completed his re i­ dency at Walter Reed General Ho pital. Formerly a faculty member of the medical chool at Yale and Tufts univer itie , Dr. Granger met Dr . Gre ham at Tufts. Their productive relation hip ha continued to this day. After four years in a named chair at Brown University , Dr. Gresham joined UB' faculty in 1983. An author of more than 50 publications , he won the Licht Award for cientific Excellence in 19 9 . Dr. Gresham ha chaired B' Depart­ ment of Rehabilitation since he joined the faculty in 1978. He al o directs Erie Coun­ ty Medical Center 's pinaJ Cord Injury nit. A medical graduate of Columbia University College of Physicians and urgeon , he completed hi clinical train ­ ing at the University of Cleveland and Ca e We tern Re erve chool of Medicine . Formerly a profe or at Yale and Ohio tate, he received the Di tingui hed er­ vice Award from the Ma achu etts Coun­ cil of Organization of the Handicapped. • Drs . Granger (I) & Gresbam (r) present ve tigator for a B chool of ur ing four ­ year grant of S435 ,451 from the ational Institute of Aging and the Div i ion of uring in the U.. Department of Health and Human ervice . B wa elected a one of four national ites to re earch different behavioral intervention for incontinence . Patricia Burn , R. ., of the B chool of ur ing will be principal inve tigator. • DR. CAREL) . VAl OS.S , PROFFSSOR OFMICRO ­ biology , visited the Central Laboratory of the Blood Tran fu ion ervlce of the etherlands Red Cros in the etherlands in April. While in that country, he al o presented a lecture entitled " urface Tenion and the tability of Particle and Cell ." • DR. E. DOUGLASHOLYOKE , RESEARCH PRO­ fessor of urgery and Ro well Park reearcher, received a 217,372 grant from the ational Cancer In titute to cudy the pathop hy iology of cancer meta tasis. • DR. CARL . PORT ER, RESEARCH ASSOCIATE professor of pathology and researcher at Roswell Park Memorial In titute ' Ex­ perimental Therapeutics Department , received a S200 ,000 gram to tudy the in­ hibicor of polyamine bio ynthesis and fuoc~n . • DR. KEVI PRANIKOFF , ASSIST T PROFES ­ or of urology, is the co-principal in- A. Cbarles Massaro DR. A. CHARLES MASSARO , CLI ICALASSO­ ciate profe sor of family med icine, has been appointed vice pre idem for medical 30 copy of book to Dean affair at i ter of Charity Ho piral. The announcement of the po ition wa made by r. Eileen Kinnarney , pre idem of Sisters Ho piral. De. Massaro will act a a liaison between the medical taff , ad­ mini Cration , and board of tru tee with primary responsibility for coordinating clinical activitie and re ource of the ho pital . In order to as ume hi new dutie , Dr. Ma saro left hi family medicine practice with the Cleveland Hill Medical Group in Cheektowaga in January and also relin ­ quished his practice a chief of family medicine at ister . He will continue as the hospital ' direccor of medical education. Dr. Ma aro wa president of the i ter Ho pita ! medical raff from 1976 to 1977 and founded the ho pital ' family medi ­ cine residency program in 1982. He holds a fellow hip in the American Academy of Family Physician and i an attending phy1cian at t. Jo eph 's lntercommunity Ho pita! in Cheektowaga. • DR. ORMA MOHL , CLI ICALASSOCIATE profe or of anatomical cience at the chool of Medicine, received the Maimon ­ ide Award from the local chapter of The Alpha Omega Dental Fraternity and the national Israel Bond organization October 21 in Buffalo . Dr. Mohl i a sociate dean for academic affairs at the B Dental chool , a well as profe sor of both oral medic ine and orthodontic . Dr. Alan Gros , vice pre idem of the fraternity , conferred the award which i given " to out tanding member of the �PEOPLE dental fraternity who are recognized for their ontribution to profe ional ex­ cellence in meeting human need in up­ porting Alpha Omega project ." Mohl i al o program director of the M .. graduate degree program in the oral cience , director of 1he po t-graduate clinic in the hool of Denti stry , and a vi iting profe or at Tel Aviv niver ity in I racl . A member of the national , tate and county dental societie , he ha received numerou awards and i well known for hi re earch. • in clinical in the C.. ; automation Iaboratorie ; and immunochemical method for quantification of drug . • DR. CLARAM. AMBRS, R~EARCHPROF~or of pediatric and ob -gyn, poke at the 8th Internacional Conference on Throm ­ bo i and the Mediterranean Blood Club in Turkey la t June. , he lectured on platelet inhibitory agent in meta tatic di ea c, ickle cell di ea e. and chronic arcerio clerati di ease, as well a other ubjects . • DR. ROBERTG TE OOD, JR., CLIIICALI tructor of medicine and phy ician at Mer­ cy Hospital , ha been ele ted to the Peer Review Committee of the Medical ocie ­ ty of the County of Erie. • DR. KARE R. CHOEE, CLI ICALI TR C­ tor of ophthalmology and a phy ician at Mercy Ho pital , was elected to a three-year term on the ominating ommittee of the Medical ociet} of the ounty of Eric .• THE ILLIAM. HAISTEAD S RGICAL TEACH­ ing Award was recently presented to Allen Le swing , M .D., clinical instructor of or ­ thopaedic , and Philip Wei , M .D., former chief of urgery at Millard Fillmore Ho pita) and linical pr o fe sor of urgery . The award i pre ented annually by the re ident · of Millard Fillmore to tho c in cructor they felt exemplified the be t teaching technique in general surgery and the pecialtie . • DR. PHILIP K. LI, R~EARCH A I TA T profe or of pediatric , visi ted The Peo­ ple' Republic of hina in June, vi iting Beijing Children 's Hospital , the econd Medical College of Beijing , and Inner Mongolia Ho pital. He poke on technical training of lini al laboratory per onnel DR. JOH J. O'BRIE , CLI ICALA 1ST 1' profe or of medicine , retired a director of medical edu ation at 1ercy I Iospital of Buffalo on eptember 30 , a po ition he held for 15 year ·. His career panned 3 ➔ year at Merq Ho pita!. A graduate of t.:B' chool of Medicine , he ompleted hi re idency at Buffalo ' Veteran Hospital in 1950. He recei\'ed numerou awards over the year , in ­ cluding the Fir t merican College of Phy i ian Llpstatc Ph) i ian. Re ognition Award in 19 3. In 198 , a lectern wa donated and named in hi honor by the medical/dental staff of Mercy Ho pital. • DR. BER ICE OBLE , OClATE PROF~ OR of microbiology , was appointed a member of che Immunological Device Panel of the Food and Drug dmini rration , June 1, 198 . • DR. LEO ARDJ. laSCOLEAJR., AS I TA T profe or of microbiology and pediatric , pre ented a eminar entitled " Rapid Diagnosi of Haemophilu lntluenzae In ­ fecIion " at the European ympo ium on Infection of Haemophilu Intluenzae held a1the L'nivcrsity Ho pital of Terra a in pain thi Ma} , • 31 Pearay L. Ogra DR. PEARAY L. OGRA , PROF~ OROF PEDl­ atrics and microbiology, lectured on the " Mucosa! Defen e y tern'' aI the Interna ­ tional Academic Conference in Immuno ­ logy and lmmuno -Pathology on April 11 in the etherland . In 1ay he presented a lecture in Mexico City at the Interna­ tional Meeting of Maternal hild Health Care. • DR. D~IDERA. PRAGAY , CLINICAL OCITE profe · or of biochemisIry, wa- a, arded the omogyu- endroy award during the pstate cw York ection meeting of the American As ociation of linical hemi try on October 19. This award has been given for ten consecutive year to clinical chemist and scienti ts who per­ formed out tanding er vice in their field .• DR. HAROLD0- DOUGLASS , JR. RESEARCH profes or of urgery and Ro well Park re earcher in their urgi al Oncology Department, received a 68 ,100 grant to upport and maintain the re earch ba e of the Ga trointe tinal Tumor tudy Group here. • DR. GI EPPEA. A DR~ , PROF~ OR OF microbiology , wa an invited participan1 at an International ympo ium entitled " Evolu1ion of Renal Disease: Current Knowledge and Per pective " held in Bergamo , Italy , April 16-18. • �ALUMNI Class of 1940 Class of 1930 ''Looki11gforu•m·d to our 55th Reu­ nion Dr. Mary Catalano '30 ·'Our 10tb u·as great. Let's use our •+5th as a good practice n111 to make the 50th perfect." Dr. William Hildebrand '40 Class of 19SO ''ff 's time to reneu• old frie11dsbips. '· D1: Robert J. Patterson '50 Class of 19;; "30 dou•n and 30 to go - Let's get ll'ilh it.I" Dr. John H. Kent '5 5 Dr. Anthony B. Schia v i '55 Class of 193; ''Be sure and put May 4t/J, 1985 on }'Our calendar and come for our ·50th. ee u•ho made it. Bill Bernhoft and I will greet you with a Friday nigbt, May 3rd reception. Let u know 1Jyou have any uggestions." Dr. Kenneth H. Eckhert '35 Class of 194S ''For the 40th An11iuersary of our Graduating Class u·e u•ill hold our 8tb Reunion during Spring Clinical Day. Jtake_vourplan now to return for Ibis auspicious occasion.·· Dr. Herbert E. Jo y ce '45 �ALUMNI MISSING: Your Help Is Needed We need your hdp in locating miss­ ing reunion class members. Please contact the Alumni Office (7168~ 1-2~..,8)if you have information on the alumni listed below . "Let:~ all return for our l 5tb. ' Dr. Rog e r . Da ye r '60 Dr. James Kanski '60 rau • ... rash .. rare . . reacb rise old rememher . . . reneu· refresh .. rejoice you11g again ... D,: Donald P. Copley '70 ''1965 . . 20 years ago ll'e·re changed. BuHalo :\ cba11ged . . . it:'° time to meet again coml! for a u•eekend of nostalgia! Dr. Joseph G. Cardamon e '65 Dr Clarence Atwood Dr Stanfon..l J. Brumley Dr \X tllard Clcn:land Dr . Louis Cowen Dr. Frederick Georgi Dr . John (,losser Dr. ln ·ing Hyman Dr. Kerin P. Lyons Dr . John 11 :'\lcCahc.: Dr Do1m.:111cS. ~kssina Dr Ralph O Conner Dr Lawlor E Quinlan Dr \\ tlliam Rohcnson Dr Rua \I slater 1935 Dr Dr Dr. Dr Dr. Dr 194:0 \X'1lltam R . Case\' Otto B. Geist . Thomas E C,riffin RohL'rt 11 Stein Rolwrt Stm kton I lenr~ S. \X'ol,inczyk Dr \lllton ,\lackay Dr \orman S. ~fanica 194:5 Dr \\ 11liam Pcterson Dr Sigmund Stem 1955 Dr. Edgar Rothcnherg 1960 Dr ~1ark Reagan Dr Barnett alzman Dr Ronald f, Young 1965 Or. Elliott Brender Dr. lien I Fink\ Fole{· Dr. John Dr . Thl'odore J. °ilajl"k Dr. Baris I Lit\ak Dr Joseph \'. ,\lcCarth\' Dr Susan ,\loshman · Dr Daniel Palczvmk1 Dr Joel P Purs11er Dr . AgrH..·s'-,zekeres Dr Howard \X ienl'r 1970 b. ··11opinp, to hal'l! a large turnout of holh in a11d 0111of t01l'n classmates." Dr. Jack Cttkierman '75 33 �ALUMNI Dr Dr. Dr. Dr. Dr. Dr. Mark F. Colman Raymond Dur o Richard Ferreras Sandra Gray Donna Hanlon Eileen Harrison Dr. Patricia Han Dr. Jo eph V. Hender on Dr. Michael A. Lambert Dr. James M. Lewi Dr. John Lovecchio Dr. Margert Piirman Dr. Dianne K. Rapp :1.975 Alumni Ac ­ tivities: (Al left) Alumni President Carmelo S. Armenia {left) and Mrs. Armenia (far right) with friends at Alumni recep­ tion in San Francisco. (Below) Group portratt of Alumni Association board . Standing , left to right: Dr. Franklin Zeplowilz '58 , Dr. Joseph L. Kunz '56 , Dr. Joh11 E. Przyluckl '73, Thomas Smith (Polity Preslde11t) , Dr. Charles J. Tirone '63, Dr. Joh11 A . Richert (Assistant Dean). Seated , left to right: Dr. Robert A. Baumler '52, Dr. Charles]. Ta11ner '43, Dr. Carmelo S. Armenia '49 , Dr.Jane Brady Wile '45, Dr. Frank]. Bolgan '74. '51. Board members not in picture: Dr. Eugene M. S11/livan '63, Dr. orman Chassin '45, Dr. Paul H. Wlerzbieniec �DEATHS DR. GERALD . KAI ER (M' 5) • died after a year-long battle with cancer on July 26 111 Mercy Ho p1tal. He was 35. The Buffalo native recei\·ed numerous chola tic and extracurricular honor in high school. at tht: L·niver ity of Roche ter and at 8. After a two-year fellowship in cardiology, he joined Buffalo ardiology A ociate . He wa known a· a gentle and caring phy ician ~·ho main­ tained courage and dignit) throughout his illne The determina­ tion he exhibited during his illne was the same that helped him build hi career while helping his wife, Dale, through la~ chool. He cherished his time with his two young on , Alan and Jonathan, and loved gardening, oftball, and the Bo ton Red ox. Hi medical partner, Brian DJ\rcy, remember him as "an ex­ ample of ilent, towering trength." Dr Kaiser is al o ·un•ived by his parent., amuel and Jean Kaiser. • DR. JAMES H. GRAY (M'H) • died eptember 23 in Buffalo at the age of ..,3 He earned his bachelor· and medical degree· from the nin:r 1ty of Buffalo, complermg h1 medical degree in 1935. Hee. tabli hed a family practice in pringville from 1935 10 1948 During \Xbrld War 11, from 19"-12to 1945, he was an ir Force flight urgeon. auaming the rank of major. During his er­ vice, Gray received a commendation from President Franklin D Roo. evelt for re. cuing \vounded men from a burning plane m France. As a phy ician in pnngnlle, he helped establi h an oh tetric ervice at Chaffee Hospital, and he also erved a the ·chool doctor Hi daughter, Mrs. Marjorie Burrow of ewfane, aid her father "always made hou e call He was alway a\ailable to peo­ ple and \'-as a caring person who wa · lm·ed by his patients and re pected by hi peer ... She explained that he helped to e tabli h the obstetrical unit at Chaffee becau e, ac that time, he delivered babie at people' house or had the expectant mother tran porced to a hospital JOBuffalo in ca e of complication he aid he felt an obstetrical unit wa needed in outhern Eric County for difficult del1,·enes. In 19➔ 8, he became an industrial phy ician for General Elec­ tric, at the Hanford tomic Work in Ri hland, Wa h From 19 9 to 1955, he wa in family pracuce 111 Friendship, Y., also. erv­ ing a school phy ician and ecretary of the Allegan} ounty Medical oc1ety From 1955 to 1960, Dr. Gray was an indu trial phy ician at Harrison Radiator JOLockport, and from 1962to 19..,, was an examining phy ician for the Workmen' Compensation Board of the tare of New York. He also had a part-time family practice in Ransomville. After retirement, he ~as a part-time taff member at 1he Lockport Memorial Hospital· Emergency Room He wa a member of the AMA; the American A oc1a11onof Industrial Phy ician ; the New York State, Erie, i\iagara and Allegany County medical oc1et1es;and the Lockport Physician As ociat1on. He wa an a\.1d golfer and fi hcrman and pent the winter month in Englewood, Fl. He wa · married to the late Frances Ingraham Grav and the late Helen Orm hy Gray. He was the father 35 of the late Marilyn De.Marchi . ·urviving are daughter , Bets) of i consin, and Maqorie of e\1,, fane; a on Jame· of Maryland, a stepson; brothers, cott of Florida, and Robert of pringville, a ister, Margaret, six grand­ children; a great grand on; and one step grandson • (From Niagara Gaiette, September 25, 1984) DR. 'GE . NAPLES(M'3 1} • died at age 80 on Jul} 21 in his si ter' Amher t,, '.Y. home. A Buffalo native, he served the old E.J Meyer Ho. pital from 1931 to 1935 before joining rhe Army. He served at Veterans AdmJOistration ho pita! around the country before being discharged in 1946 a a Colonel. He opened his practice in 19"-I-,and retired in 1983 becau e of illness. He wa a phy ician a sociated with ECMC, Buffalo eneral, Deaconc , Columbus, Millard Fillmore, heehan Emergency, and \'eterans Administration ho pita) Dr Naples was pre idem of the medical taff at "heehan in 19-r2 and at Columbu in 197➔• He was a member of the national, state and county medical ocietie , the Buffalo Eye Club, and the Resene Officer Associauon H is urvived by two brothers, Chn ty, of Amherst, and Dr R Joseph of orning; and three sisters, Phillipine of Amherst, tella of Kenmore, and Maria, a physician, of Syra use. • ESTHER L. McCA OLES, Ph.D. • renowned for her . cienufi re_earch in animal nutrition, lipid metabolism, and the chemistry of algal polysaccharide , died at the age of 60 re ently at her home in Hamilton, Ontario. Esther McCandle s wa born in Brooklvn ew York and received her Ph D. in animal phy iology, · biochemistry,' and neurology from Cornell L'niversny in 19<i8.From her first post­ do toratc position a assi tam in phy iological chemi try in the Department of Physiology, e~ York ·tate Veterinary College, Cornell L'niversity, he became rese-.irchphysiologi tat the Public Health Re earch lnstllute for Chroni Di. ease, at 'B. Her most rece~t po ition wok her in 1964 to Mc 1a ter niver ity in Hamilton, Oma no, ~ here he was appointed full professor in • the Department of 81olog} in 1969 DR. GOPI ATHKARTHA• 5..,,diedJunt: 18 in Erie Count\' Medical Center. The late re earch profe. sor of biophy ic ~-orked at Roswell Park Memorial ln titute for 25 year as a senior x-rav crystallographer. He wa noted for his analy is of protein stru~­ ture and x-ray dispersion. The native of Kerala tate, India, had been visiting professor at tht: Protein Research In titute m Osaka.Japan fie was al o on the faculty at 1agara lJnivcr it\ ~ftcr receiving his doctorate' from the L'niver ·icy of Madras, India, he pur ued advanced training at the Cavcndi h Laborator\' JOCambridge, England. Following that, he worked at the National Re:earch ouncil, ttawa. Canada, and the Polycechmc Jrn,titute of Brooklyn. He i urvived h} his wife, Indira, four ·ons, Krishnan, Govindan, 1van, and Vijayan; six . i ters and a brother • WILLIAMK. MAJOR(M'43) • died in Waterloo, 6, 198·-I e~ York, on August • �CLASSNOTES 1930's School of Dcntistr). color, 2) human interest. 3) a sequence of three prints. My sequence wa a one-to-one magnification of a reddish golf ball plashing into a bowl of light blue water. I used two electrornc flash units, ct on manual with a tla. h duration of 1/25,000 of a econd; each suc­ cessive dropped ball hn the surface of the water s<:veral micro econds later than the one before it." ~ledicine and 1960's A DRE LA CARI (M'60 ) • re­ ports that his third book, Hematologic ,\,fanifestations of Cbildhood Diseases, has been published by Thicrne-Suanon, Inc. Dr. L.-iscariis professor and chairman of the department of pediatrics at the Medica l ol­ lege of Pennsylvania in Philadelphia. 1940's DR. DAVID M. ROWLAND' (M l) • clinical a. i tam profcs. or of radiology, has been named chief of radiology at istcrs Hospital assuming his n<:w post on October I. JOSEPHP. LEMMER (M' 4) • a specialist in rheumatology, has been elected to Fellowship m the American College of Physi­ cians. Dr. Lemmer is a resident of Roanoke. Virginia, and is on the staff of the Lewi -Gale Clinic and Hospital of Salem, Virginia. Francis Ehret DR. FRA Cl EHRET(M'37) • cli nical associate profes or at OB and Sister Hospital allcr­ gi t, retired on July I aftt:r n<.>ar­ ly 44 year on that hospital's medical taff. He intend to continue his work at the allergy clinic but hopes to pend more time playing ten­ nis and go lf and look forward to returning to hi favorite ac­ t Iv ny, horseback riding through the countryside and Joseph Ricotta woods surrounding hi cabin in the BoMon Hill . JO EPHJ.RICO'ITA (M'43) • has been elected chairman of the Buffalo ection of The American College of Obstetri­ cians and Gynecologists. He has just completed three years as vice chairman of this cc­ tion. Dr. Ricotta is a private practitioner in Buffalo. 1970's WILLIAM P.DILW (M'70) • of Lakeview, New York, has been elected vice chairman of the Buffalo <;ection of The Ameri­ can College of Obs tetricians and Gynecologists. Dr Dillon is an associate professor of ob/gyn and the dire.:tor of the di\'ision of maternal-fetal medicine at B. Henry M. Bartkowski JOELH. PA LL(M' I) • clinical HENRY M. BARTKOWSKI (M' 6) • instructor in surgery, was recently elected president of the Buffalo Plastic urgcry oci ·ty. Dr. Jeffrey \k1lman. assistant profe ·sor of surgery, i the new vice president; and Dr. amuel Shatkin (M'58), clinical associate profcs or of surgery, is the new secretary treasurer. David 1950's DR. GERARD T. GUERIOT(M'58) Bernard S. Stell BERNARD. STELL(M'36) • of un City, Arizona, won a Polaro id SLR 680 camera in Polaro id' "Pict ur e Yourself in a Porsche" comest. His picture ~ elected as a fou rt h place w inner from 1,000 fmallsts: "Polaroid had 3 categories. I) • has bt:en elected vice chair­ man of the Rochester ection of the American ollege of Obstetricians and Gynecolo­ gists. Dr. Guerinot'· article on toxic shock syndrome will be published shortly in Spectrum. an international medical jour­ nal. Dr. Guerinot i a clinical asociarc professor of ob/gyn at the 'niver icy of Rochester M. Rowland presented his re ·earch on "Prc­ and Pose-Treatment of Acute Middle Cerebral Artery Occlu­ sion with the 'low Calcium Channel Antagonist imodi­ pine in the Rat" and "The Ef­ fects of Brain Tissue Storage and Handling Techniques on NMR Relaxation Parameters" at the Sixth Internacional ym­ posium on Brain Edema held in Tokyo, Japan, in ovembcr. Dr Bartkowski is an assi tant profes or of neurosurgery at the University of California at an Francisco. DR. LEWISGRODE (M' ) • was recently appointed as. is­ tam profe or of ophthalmol­ ogy and di rector of the Cornea­ Externa l Disease Service at the Univer. icy of South Florida College of Medicine in Thmpa, Florida 36 �CLASSNOTES COMING SOON 48TH A1 Michael _ AL MEDICAL ALUMNI PRI G CLI ICAL DAY aturday, May 4, 1985 cientific Sessions Exhibits Cla S. Kressner MICHAEi.. KRESI 'ER(M' ) • a sp ciali t in troenterolog, m ' Rochelle 'e\\ York, has been elected 10 Felio\\ hip in 1he Amcnc:m College of Ph> 1 1an Dr Krc.-,ncr "ill be honored during the omoca tion ccn:mony at the College Annual c ion in March 19 5 tockton Kimball Luncheon pouses Program Reunions Watch your mail for more detailed information. ~-~--------------------------------- -------------------------111111 NO POSTAGE STAMP NECESSARY If MAILED IN THE UNITED STATES BUSINESS REPLY MAIL FIRST CLASS PERMIT NO. 2210 BUFFALO , N Y. POSTAGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, New York 14214 �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO, NEW YORK 14214 9200032234 0 D 44 BRO ~. ROBERT l• 156 BRA TWOOD ROAD UFFALO Y 14226 ,,....,_ ...... M ._,_...,_. -------------------------------------------------------------LET US HEAR FROM YOU Fill out this card (Please print or type all entries) Year MD Received Name ____ _ Office Address -----------------------------------Home Address -----------------------------------­ If not UB, MD received In Private Practice: In Academic from ------------- Yes D Medicine: Yes D -- No D No ---------------- Specialty _______________________ D Part Time D Full Time _ D School Title._________________ _ Other: Medlcal Society Memberships _____________________________ News: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.? _______ Please send copies of any publications, research or other original work. _ _ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, February 1985 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1985-February Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1985-v18n05-Feb Table Of Contents A list of subunits of the resource. Medical Revolution Madison Bob Leukemia Update Research Medical School News Hospitals Books Doctors in the Arts People Alumni Deaths Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-15 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v18n05 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1985 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/4b81d6d34054e0dfd561887e59e0de35.pdf db499bd216e60e8f7aa5e2cdc6ad71fc PDF Text Text e minoritie ~·. . . . .k....""'r Medici �STAFF EXECUTIVE EDITOR, UNIVERSITY PUBLICATIONS Robert T. Marlett ART DIRECTOR Rebecca Bernstein UNIVERSITY MEDICAL EDITOR Bruce S Kershner PHOTOGRAPHY jim Sulley David S. Ottavio Ed Nowak ADVISORY BOARD Dr john Naughton, Deem School of Medicine Ms. Nancy Glieco Dr. Edwin A. :V1irand Dr john Cudmore Dr. Carmela Armenia Dr. john Fisher Ms. Karen Dryja Mr. john Pulli Dr. Charles Paganelli Dr. james Kanski Dr. Harold Brody Dr. john Wright Dr james Nolan Dr. Maggie Wright Dr Mary Voorhess Mr Ste\e Shivinsky TEACHING HOSPITALS The Buffalo General Children's Deaconess Ene County Medical Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Charity Veterans Administration Medical Center Produced by tbe Dil'ision of Public Affairs, Hany R . jackson, director, in associati011 u ·itb tbe Scbool of .Hedicine. State U1li1·ersity of :Veu• York at Buffalo THE BUFFALO PHYSICIAN, (USPS 551-860) December 1984Volume 18, Number 4. Published five times annually: February, May, July, September, December - by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. POSTMASTER: Send address changes to THE BUFFALO PHYSICIAN, 139 Cary Hall, 3435 Main Street, Buffalo, New York 14214. MESSAGE FROM THE D EAN Dear Alumni and Alumnae, The past few weeks and months were active ones for the School of Medicine. President Steven B. Sample, the university's president for the past two and one-half years, completed his university reorganization on August 1, 198-1. William Greiner, professor of law, was appointed Provost, and I was appointed Vice President for Clinical Affairs. I will continue to serve in a dual role maintaining my academic position as Dean of the School of Medicine. Other university administrative officers are Mr. Edward Doty, Vice President for Fiscal Affairs, Dr. Donald Rennie, Vice President for Research and Vice Provost for Graduate and Professional Education and Mr. Robert Wagner, Vice President for Lniversity ' Services. In my vice presidential role I will report to the President. Its functions include coordination of the clinical affiliation requirements of the university and supervision of the faculty practice plans in the schools of Medicine and Dentistry. I will report to Provost Greiner together with the other university deans in all academic matters. The reorganization has moved smoothly, and it appears that the school's relationships to the university administration have been strengthened significantly. Administrative change occurred in the school as well. Dr. Peter Ostrow moved to Buffalo from the University of Texas at Houston to assume the duties of Associate Dean for Curricular and Administrative Affairs. Peter is a pathologist with a special interest in neuropathology. He is well regarded as a teacher and will bring a required expertise to the needs of our students in the years ahead. Mr. Anthony Campanelli joined the school's staff as Assistant Dean for Fiscal Affairs. He replaces Ms. Bernice Fiedler who served the school faithfully for over 17 years. Mr. Campanelli has had a long experience with the university and will provide strong administrative leadership and support for the departmental chairmen. Dr. Donald Larson has assumed the role of Director of the Office of Clinical Affairs in addition to his duties as Associate Vice President for Clinical Affairs. He will be assisted by Ms. Nancy Glieco, and this office will be responsible for the administrative support of the newly formed Consortium for Graduate Medical and Dental Education, the Faculty Practice Plan and Continuing Medical Education. The above changes and appointments at the uni\·ersity and school levels should provide the necessary support to conduct our academic responsibilities in an effective and meaningful manner, and should serve to clarify the responsibilities for achieving the institution's goals in the areas of medical education, biomedical research, patient care and community service. -john Naughton, M.D. MESSAGE FROM THE POLITY PRESIDENT Dear Fellow Student: One activity we wish to initiate some time in early january is the opening of hypertension clinics in the underserved areas of Erie County. These clinics will be primarily staffed by first and second year medical students with a clinical facult} member present as supervisor. The purpose of this project is two-fold . First, to expose pre-clinical students to the needs and concerns of the underserved and, second, to demonstrate to the local community the desire of medical students and the medical profession to be of sen·ice to them:·tour hope is to see this project continued on an annual basis. Anyone interested in information regarding this or other student activities should call "Murmurs," the telephone information line of the student body at 831-3923 . -Tom Smith President, Polity �BUFFALO HEALT'·i PHYSICIAN 2 . ~J YELLOW FEVER • Thomas Bumbalo recalls how William Crawford Gorgas made medical history ridding a "damp, tropical jungle" of yellow fever, typhus and dysentery during construction of the Panama Canal. 7 CHINA TAKES GIANT LEAP AGAINST PKU • Robert Guthrie, UB professor of pediatrics, is working as rapidly as possible to obtain and send supplies to China of the special infant formula that is essential to prevent brain damage caused by the disease, PKU. 9 has been recognized by the American Crystallographic Association for one of four maJOr advances in that field- development of the mathematical model that determines the threedimensional structures of biologically important molecules. Dr. Hauptman also blends his mathematics with art work, having created 3 5 crystal forms in multi-colored stained glass. U.S. Postal Service Ownership Management and Circulation Statement. Required by 39 U.S.C. 3685. Title of Publication: Buffalo Physician. Publication No. 551860. Date of Filing: 11184. Frequency of Issue: 5 times per year. No. of Issues Published Annually: Five. Annual Subscription Price: Free. Complete Mailing Address of Known OHice of Publication: SUNY/Buffalo, 3435 Main St., Buffalo, NY 14214. Complete Mailing Address of the Headquarters of General Business OHices of the Publisher: University Publications, 136 Crofts Hall, SUNY/Buffalo, Buffalo, NY 14260. Editor: Robert Marlett, 136 Crofts Hall, SUNY/Buffalo, Buffalo, NY 14260. Managing Editor: Bruce Kershner, 136 Crofts Hall, SUNY/Buffalo, Buffalo, NY 14260. Owner: State University of New York at Buffalo School of Medicine, 101 Farber Hall, Buffalo, NY 14214. Known bondholders, mortgagees, and other security holders owning or holding 1 per cent or more of total amount of bonds, mortgages or other securities: None. For completion by nonprofit organizations authorized to mail at special rates (Section 423.12 DMM only). The purpose, function, and nonprofit status of this organization and the exempt status for Federal income tax purposes: Has not changed during preceding 12 months. Extent and Nature of Circulation A. Total No. Copies (net press run) B. Paid circulation C. Total Paid Circulation D. Free Distribution by mail carrier or other means E. Total Distribution F. Copies Not Distributed G. Total Average No. Copies Each Issue During Preceding 12 Months Actual No. Copies of Single Issue Published Nearest ·to Filing Date 6100 7500 6000 6435 6000 100 6100 - 6435 565 7500 SI S Bruce Kershner HERBERT HAUPTMAN • RESEARCH • 'Phone-in' program helps reduce heart attack victim mortality rates. Does the quality of social life affect cancer? Dolphins aid in research projects. Loss of smell can suggest brain tumor. 14 MEDICAL SCHOOL NEWS • Graduate Medical and Dental Education Consortium formed . Eight minority high school students work in UB labs. Peter Ostrow is new associate dean. 20 HOSPITALS • Children's Lung Center designated Regional Apnea Center. Children's Hospita! installs Sendex computer system. J.E . Stibbards is new administrator at Children's. ECMC dedicates building to David K. Miller. 24 PEOPLE • Maggie Wright: a season of honors. Emanuel Lebenthal wins International Nutrition Prize. Other news of people you know. 30 CLASSNOTES • ews of the Classes. 37 DEATHS • 39 STUDENTS • 138th freshman class includes 82 men, 53 women. UB ranks 19th in percentage of minorities in medical freshman class. 27 COVER ART: David S. Ottavio ��( ~ 7;'/ fi I ' I I YELWW FEVER T JAMAJCA RIBBEAN SEA .ANTIC 0C£AN =_.,~(_ )~ / o more fully appreciate Dr. William Crawford Gorgas' role in the construction of the Panama Canal, we must first visualize the 40-mile Isthmus of Panama, with the city of Colon on the Atlantic side and the city of Panama on the Pacific side. In 1885 James Anthony Froude described the isthumus as "a damp, tropical jungle, intensely hot, swarming with mosquitoes, snakes, alligators, scorpions and centipedes; the home, even as nature made it, of yellow fever, typhus and dysentery." When Ferdinand de Lesseps, the renowned French builder of the Suez Canal, first visited the Isthmus in 1881, M. Le Blanc, a French resident of Panama, warned him of the endless problems he would encounter: "If you try to build this canal, there will not be trees enough on the Isthmus to make crosses for the graves of your labourers.'' During two yellow fever epidemics of the DeLesseps' Universal Interoceanic Canal Company construction period in the 1880's, the burials of canal workers averaged 30-40 a day.1 BY THOMAS S. BUMBAW, M.D., M.Sc. (Med.) / �French attempt ended in a dismal failure, mainly T hebecause of the devastation wrought by yellow fever, malaria, and dysentery plus the De Lesseps' Company fraud and corruption that eventually brought disgrace to De Lesseps and his associaties. In 1904, President Theodore Roosevelt, after much soul searching, committed the United States to the completion of the abandoned French Panama Canal Project. The ultimate American success was in great part due to President Roosevelt's appointment of Colonel William Crawford Gorgas, at the insistence of Dr. William Henry Welch of Johns Hopkins, to take charge of the hospitals and sanitary work at Panama. 2 Even at that early date, because of his success in eradicating yellow fever n Havana, Cuba, Dr. Gorgas, a former student of Dr. Welch, was recognized by the medical community as the outstanding authority on tropical medicine. William Crawford Gorgas was born in Alabama on October 3, 1854, the son of a Confederate general and an Alabama governor's daughter.3 On July 15, 1869 he enrolled as a preparatory student at the University of the South. William's early scholastic record at Sewanee left much to be desired. However, motivated by his parents' concern over his study habits, William buckled down to serious study, winning the Alabama Scholarship Gold Medal and a A.B. degree from the University of the South on August 5, 1875. 4 Young Gorgas' greatest ambition was to follow in his father's footsteps and make the military his career. However his attempts to enroll in West Point were unsuccessful even though his father, an alumnus of West Point, appealed to President Grant in William's behalf. When William reached his twenty-first birthday and he no longer was eligible for admission to West Point, he decided to enter the army via the Army Medical Corps. In 1876, at the age of 22, he enrolled in the Bellevue Medical College of ew York City from which he was granted a medical degree in 1879. 5 On one of his early assignments as a young military surgeon at Fort Brown, Texas, on the Rio Grande River, Gorgas contracted yellow fever. His recovery made him immune to the disease and made it possible for him to carry on his long and arduous struggle against yellow fever. Marie Doughty also contracted yellow fever during a visit at Camp Brown. Gorgas' professional attention to Miss Doughty blossomed into a romance and he married her. At that time the etiology of yellow fever was unknown. One of the theories prevalent was that yellow fever was borne by the breezes and was the result of environmental filth. In 1881, the Cuban physician Carlos Finlay belit;ved that the carrier of yellow fever was a small, comparatively noiseless mosquito, the Aedes Aegypti, which at the time was known as the Stegomyia Jasciata. Early in his career Gorgas, together with many other medical professionals, was skeptical of the mosquito's role in transmission of the disease. He, too, believed that yellow fever was a disease of filth and that control of the disease consisted of isolation of the patient, enforced environmental sanitation, and the quarantine of infected localities. Because Gorgas was immune to yellow fever, the army routinely assigned him wherever an outbreak appeared. His clinical expertise in treating patients established him as the top yellow fever expert. In 1898 during the Spanish-American War he was put in charge of the yellow fever camp at Siboney, Cuba. During the Spanish-American War, American soldiers died at the rate of 200 a day, not from enemy action but from yellow fever, malaria, typhoid fever, and dysentery. 7 This high mortality rate from infections prompted the Surgeon General to appoint an American commission of sc_ier:ttists to determine the cause of yellow fever. The commtsston, headed by Walter Reed, included 4 �ed team paid for its success with the life of Lazaer who contracted yellow fever while working with infected mosquitoes. s Dr. Carlos Finlay had earlier allowed his infected laboratory mosquitoes to bite non-immune volunteers. To his chagrin none of the volunteers contracted yellow fever. While Finlay was convinced of the mosquito's role in the transmission of the disease he was unable to scientifically prove it. It was the Reed Commission that finally determined that a period of "extrinsic incubation" existed in the transmission of yellow fever. The Commission proved that the Stegomyia mosquito must bite and suck the blood of a yellow fever patient in the first three days of illness. Then an incubation period of 12 to 20 days must elapse before the infected mosquito can transmit the disease to another victim.5 Late in 1898, Gorgas, now a Major, was ordered to Havana, Cuba, as Chief Sanitary Officer with specific instructions to free Havana of yellow fever. As a result of the Reed Commission's success in proving the mosquito's role in the transmission of the disease, Gorgas, now totally convinced that the Stegomyia mosquito was the culprit, set about with tireless industry to rid Havana of yellow fever. After a meticulous study of the life cycle and bionomics of the Stegomyia, Gorgas detailed his sanitation team to destroy adult mosquitoes by covering all pools and collections of water near all dwellings with a film of oil. All yellow fever patients were isolated behind screens, and mosquito larvae in standing water indoors and outdoors were destroyed by a spray of kerosene. In three months Gorgas freed Havana of yellow fever. n 1902 , it became quite apparent that the U.S. was preparing to take over where the French had failed in the construction of the Panama Canal. Because of Gorgas' success in Havana, he was raised to the rank of Colonel and on March 1, 1904 , was appointed Chief Sanitary Officer of the Panama Canal Project. With his Havana success behind him, Gorgas assumed he would have a free hand in his fight against the diseases that vanquished the French. It was not so. Gorgas soon enough found that he had to contend with unreasonable bureaucratic obstacles and arrogance. As the Chief Sanitary Officer, he was subordinate to the Panama Canal Commission headed by Admiral John G. Walker of the U.S. Navy and other eminent engineers and politicians. Admiral Walker stubbornly refused to believe that mosquitoes played any role in the transmission of yellow fever and malaria. General George W. Davis, the Canal zone governor in offering fatherly advice to Gorgas, told him, ''I'm your friend , and I'm trying to set you right. On the mosquito you are simply wild. All who agree with you are wild. Get the idea out of your head. Yellow fever, as we all know, is caused by filth." 1 A less determined and dedicated man would have surrendered to the bureaucratic pressures. Gorgas, however, became more determined and in 1904 spent valuable time in Washington, D.C. lobbying for support. His persistence led to constant bickering with the Canal's officialdom who recommended to President Roosevelt that Gorgas be replaced as Chief Sanitary Officer. Before taking action, President Roosevelt consulted with Dr. William H. Welch, dean of Johns Hopkins Medical School, who succeeded in convincing the President to retain Gorgas. Roosevelt summoned Theodore Shonts, the Chairman of the Canal Commission, who had recommended Gorgas' dismissal and ordered him, without equivocation, to fully support Gorgas. 1 As a result of this episode, the President promoted Gorgas from Chief Sanitary Officer to a member (At left) Yellow fever patient inside a portable isolated cage. (Above) William C. Gorgas in I 1882. " ~----------------------------~ James Carroll, Jesse W. Lazaer and Aristides Agramonte, a Cuban physician. The Commission's research in confirming the mosquito transmission of yellow fever, using volunteers who were subjected to the bite of infected mosquitoes, resulted in one of the most significant contributions in the history of preventive medicine. This renown- 5 �of the Panama Commission. At Roosevelt's request all health and sanitation functions were placed in the newly created Sanitary Department headed by Gorgas, and the President's intervention won for Gorgas the full support of the Canal officialdom. Now, mosquitoes' breeding places were brought under control, patients were properly isolated, and piped water and faucets were introduced, depriving the mosquitoes of free standing water containers for breeding. Within a relatively short time, yellow fever, for the first time in Panama, was under control. The incidence of malaria was likewide drastically cut by draining swampy land and by covering mosquito breeding sites with oil. With his rather short-sighted reasoning, Goethals transferred essential functions from Gorgas' department resulting in serious delays in sanitation projects. Nonetheless, by this time Gorgas had the support of the scientific communities of the entire world. General Leonard Wood, who was Governor-General of Cuba at that time, said in support of Gorgas, "As the world grows older, a generous measure of the credit for the construction of the Panama Canal will be justly given to William Crawford Gorgas." Never tiring of tackling one major task after another, Gorgas now directed his energies to the task of repairing and refurbishing the two hospitals of the Isthmus. These soon were on a par with the best hospitals in the continental United States. His success is also reflected in the fact that the general mortality rate of the United States in 1914 was twice that of the Canal Zone. 1 y 1908, however, the Canal administration became Bplagued with serious problems and widespread resignations. President Roosevelt and William H. Taft, Secretary of War, decided to create a new commission made up entirely of military personnel who could not leave their posts at will. Colonel George Goethals, a confirmed penny pincher, became the executive head of the 40 000 canal workers when he was appointed Chairman of the Canal Commission and Chief Engineer. Once again Gorgas had to contend with an obstinate adv~rsary whose main goal was to keep costs down, the obvtous forerunner of today's "cost-effective" policies. Goethals particularly aimed his economy barbs at Gorgas and on one occasion scolded the physician with this remark, "Do you know, Gorgas, that every mosquito you kill costs}he l}-S. Government ten dollars?" Gorgas' response was, but JUSt think one of these ten dollar mosquitoes might bite you, and ~hat a loss that would be to the country." 1 With the control of yellow fever, Gorgas now directed all his energy to containing malaria by drawin~ on his Havana experience where he reduced the malana death rate from 564 to 44 yearly within a period of 10 ye~rs. Control of malaria in Panama turned out to be a trymg and formidable task, much more difficult than the control of yellow fever. An attack of yellow fever made the victim immune, if he survived. However, an attack of malaria did not make the patient who survived immune. This phenomenon contributed to a more or les~ constant incidence of malaria. While the female Stegomyta lays her eggs on clean water in and around inhabited dwellit?-gs, the Anopheles mosquito lays her eggs on swampy, dtrty or muddy water anywhere. The heavy equipment, wagons, and horses used in digging the Canal, constantly created ruts, tracks, cracks, and holes that promptly became pools of water - suitable breeding places for the Anopheles mosquito. Fighting the Anopheles became an enormous task. Swamps had to be drained; ruts and holes had to be filled, and concrete drainage ditches had to be constructed. Gorgas' study of the Anopheles mosquito determined that the average flight of the mosquito was about 200 yards. The scrupulous clearing of an area 200 yards around all dwellings of puddles, ditches, tall grass, and flower beds deprived the Anopheles of its breeding beds and so diverted the mosquito's activity to the jungles of Panama. Kerosene poured on all water surfaces instantly destroyed the mosquito larvae. The reward of Gorgas' fight against the Anopheles mosquito was a remarkable reduction of hospital admissions for malaria from 40 per cent in 1906 to 10 per cent in 1913. His other efforts also succeeded in dramatically reducing the incidence of pneumonia. Notwithstanding his success, Gorgas' relationship with Colonel Goethals did not improve. The Colonel insisted that Gorgas' functions were mainly engineering functions. istory records that in 1914, Gorgas, together with H two of his co-workers, made the first unofficial and risky voyage from the Pacific to the Atlantic, not in a seaworthy vessel but in a canoe. The official grand opening of the canal was celebrated on August 15, 1915 with the transit of the steamer Ancon. The cost of digging the canal was staggering in lives and dollars. The combined French and United States cost in dollars was $639,000,000. The cost to the United States alone was $352,000,000. The cost in human life from 1904 when the United States took over the project was 5,609 lives lost to diseases and accidents. The combined death rate of the French and United States projects was 25,000 or 500 deaths for every mile of the canaP 3 Thus the greatest of the seven wonders of American engineering was completed in 1915.9 Recognition and honors were now bestowed on Gorgas. In 1908 the A.M.A. elected him president and honorary degrees were granted by Oxford, the University of Pennsylvania, Harvard, Brown, John Hopkins, and the University of the South, his alma mater. In 1914, while Gorgas was visiting Rhodesia as a consultant, President Wilson appointed him Surgeon General of the United States. While visiting London in 1920 Gorgas suffered a stroke and was hospitalized in the Queen Alexandra Military Hospital on the Thames where he was visited by King George V and presented with the insignia of the most distinguished Order of St. Michael and St. George. Gorgas remained in the hospital for four weeks and expired on July 3, 1920. He was honored in death with a royal funeral in London's St. Paul's Cathedral and was buried in Arlington Cemetery amongst other military heroes of America. • Thomas S. Bumbalo is Clinical Professor of PediatricsEmeritus and Medical Director, Erie County Medical CenterRetired. Bibliography I. Gorgas, MD; Hendrick, BJ. William Crawford Gorgas His Life and 1\\Jrk. Garden City: Doubleday and Page, 1924: 140-143. 2 . McCullough, D. The Path Between the Seas, The Creation of the Panama Canal1870-1914. New York: Simon and Schuster, 19TT: 407. 3. Fishbein, M. A History of the American Medical Association 1847-194Z Philadelphia: WB Sanders, 1947: 707-708. 4. Gibson, JM. Physician to the 1\\Jrld, The Life of General William C. Gorgas. Durham: Duke University Press, 1950: 35-37. 5. Christie, A. Medical Conquest of the "Big Ditch': South Medical Journal, 1978: 71:717-723. 6. Kamish, WJ. William Crawford Gorgas 1854-1920. American Journal of Surgery, 1964: 108: 921-922. 7. Bateman, OL. A Pictorial History of Medicine. Springville: Chas. C. Thomas, 1962: 285. 8. Lyons, AS, Petrucelli, RS. Medicine, An 1//ustrated History. New York: Harry N. Abrams, Inc. 1978: 559. 9 . Windows of the 1\\Jrld. Kansas: Touring Rimes, 1983: 2:1. 6 �Guthrie helps China take giant leap against retardation By Bruce S. Kershner C hina has just taken a giant leap forward in eliminating an important source of mental retardation, through the personal efforts of UB pediatrician Robert Guthrie, M.D., Ph.D. The professor of pediatrics is working as rapidly as possible to obtain and send supplies to China of the special infant formula that is essential to prevent brain damage caused by the disease, PKU. Rarely has there been such a clear and simple solution to a serious medical problem as the Guthrie test for PKU and its special diet treatment. Guthrie is the internationally respected professor who devised the PKU test that has literally saved thousands of children from the anguish of mental retardation. PKU, or phenylketonuria, is the inherited metabolic liver disease that causes severe brain damage if not promptly identified and treated. Upon the invitation of Shanghai pediatrician Dr. Guo Di, Guthrie visited China in March to provide his expertise and contacts to help establish a comprehensive treatment and newborn screening program for PKU infants. The People's Republic of China had no screening of any kind until two years ago, and the current testing program is minuscule compared to the kind of nationwide program that is really needed there. Guthrie points out, however, that even if a successful program of screening tests to detect PKU is established throughout China, it will be tragically ineffective without the diet needed to treat the metabolic disorder. That is why Guthrie is now working both to procure and transport boxes of the special diet formula to the PKU children in China. He is asking assistance from a nationwide network of 35 PKU parents groups, Project Hope, Bristol-Myers (the manufacturer of the special formula), several airline companies, and the U.S., Chinese, and Japanese governments. Furthermore, donations from the public to purchase the special diet would be of great assistance in the effort. Anyone interested in making a donation should contact Sally Bloom at 831-2351 to find out where donations may be sent. One case costs $155 and ten cases per year are needed for each child. China is one of the major countries in the world without an effective PKU program. "I estimate that up to 2,000 babies are born with PKU every year in China," Guthrie relates, "and only 15 have been identified to date. There is enough special diet formula to treat only six of those at this time." infantile PKU program has screened 250,000 China's newborns in 25 hospitals around Shanghai, Peking, and Szechuan province. At that rate, only about one per cent of the newborn in China will be screened each year. Dr. Robert Guthrie: his test for detecting PKU in infants bas meant that at least 12, 000 individuals are growing up normal who otherwise would have been retarded. PHOTO: NOWAK I ! I �The first 1 'h cases of the needed formula were donated by the local PKU parents group while the next ten cases were donated by Bristol-Myers Company. These supplies were sent by diplomatic pouch over the first six months of 1984, but this approach is inherently difficult and slow. The second set of supplies, two cases, was sent to Project Hope headquarters by Dr. Ronald Stein, executive assistant to UB President Steven Sample, with the cooperation of Congressman Jack Kemp. Guthrie currently has a commitment by Project Hope to send most of the remaining cases that are needed. With only 15 known PKU children in China, 150 cases or so would be needed over the next 12 months. Ironically, establishing a successful screening program also means a much greater demand for the special diet. The 15 identified PKU children are literally only the "tip of the iceberg," and increased testing will greatly increase the number of Chinese infants known to have the disease, Guthrie points out. The urgency of getting special formula to China, Guthrie emphasizes, "is because the retardation process begins at birth. Without treatment roughly one-half of a child's intelligence is lost within the first year; another 25 per cent is lost within the second year." Every month Dr. Guo Di, director of the Shanghai Institute for Pediatric Research , learned about Guthrie and his test from Japanese contacts. He invited Guthrie to China in 1981, but despite several attempts, Guthrie was not able to arrange a visit until last spring. Dr. Rui Chen, in the meantime, had spent two years in training at the Los Angeles Children's Hospital where there is an intensive program of research and treatment of inborn errors of metabolism, such as PKU. Dr. Chen met Dr. Guthrie there. Following his training, Chen and Dr. Guo Di initiated the first PKU screening in China. "I didn't know how tough it was for the Chinese doctors to invite me," Guthrie comments. "Not only is it difficult and slow to obtain approval from the Chinese government, but it is also very expensive for the Chinese hosts. I learned that, for every day I was there, it cost the equivalent of one month's salary for one doctor." J apan, the first Asian co~ntry to te_st for PKU, now has the most comprehenstve screenmg program in the world. Taiwan and French Polynesia are other countries in that region that have initiated PKU programs. Only two states in the U.S. do not have a legally mandated screening program. New York State's program for PKU is "very good," according to Dr. Guthrie. About 100 PKU patients are associated with the Robert Warner Children's Rehabilitation Center in Buffalo while a smaller number exists in Rochester. The Guthrie test, developed by the UB professor in 1961, uses a drop or two of blood taken from a baby's heel and analyzes it in a laboratory. Now a standard test in hospital nurseries, it is mandated by law in 48 states and is used in over 30 countries. The Guthrie test can identify the estimated one of every 10,000 infants who has the hereditary disease. More than 100 million babies have received Guthrie tests since they were devised two decades ago. This means that at least 12,000 people throughout the world are growing up normal who would have otherwise been retarded. Since Guthrie initially developed the test for PKU, he and his associates have devised 30 additional tests for a number of other newborn diseases. The analyses associated with the Guthrie tests can detect, for example, sickle cell disease, as well as galactosemia, a fatal defect in sugar metabolism, and congenital hypothyroidism, an absence of thyroid hormone that produces cretinism. One in 500 babies of African descent is born with sickle cell disease, while one in 4000 to 5000 babies is born with congenital hypothyroidism and one in 50,000 has galactosemia. Guthrie's interest in mental retardation is not incidental; one of his six children and a niece who has untreated PKU are retarded. Guthrie, 68 , has lobbied for years for the mentally retarded. For the past 14 years, he's been a part of a national effort to get people to realize that lead poisoning affects one out of every 25 children in the U.S. The problem is not restricted to black children, since one of his studies showed that 0.7 per cent of suburban and rural children had lead poisoning, some at alarmingly high rates. Last November, Guthrie was the recipient of one of the highest awards of the National Association of Retarded Citizens. A recipient of numerous other awards, he shares his expertise as a consultant to agencies in the U.S. and as far away as New Zealand. A resident of Williamsville, he is also director of UB's Biochemical Genetics Laboratory and a professor of microbiology. • "Every days delay in getting the special formula means a loss of potential for nine children with PKUn of delay means a loss of potential for the nine children known to have PKU in China who are not currently receiving the special diet. This does not account for all the future children who will be diagnosed with the disease as the PKU testing program becomes established. "Sending PKU diet to China is only a stop-gap approach," Guthrie explains. "What we are really hoping for is that China will become self-sufficient in producing the special formula." He estimates it will take a Shanghai pharmaceutical company 1 'h to two years to produce sufficient quantities to meet the growing demand. The special infant diet is a mixture of pure amino acids derived by digesting milk casein with enzymes to separate it into individual components. Charcoal is used to remove the phenylalanine, which causes the metabolic disease, and the other missing amino acids are added back. A minimal amount of phenylalanine from milk is also added because even PKU patients require a small amount . Phenylalanine blood concentration must be measured regularly, however, to account for individual variation. Little is known about dietary requirements of adults with PKU. Many adults with PKU probably must remain on a phenylalanine-low diet, while some may remain healthy on a normal diet. More research is needed to clarify the matter. An adult diet permits the consumption of any food that does not contain protein, since all protein contains approximately 5 per cent phenylalanine. Protein is suppled by consumption of the special diet together with controlled, measured quantities of proteincontaining foods. 8 �ERT MAN: �T he multi-faceted stained glass crystal art objects that break up the sunlight in the display case bear a striking and ironic resemblance to the life and career of their multi-faceted creator, Dr. Herbert Hauptman. Nationally recognized pioneer in crystallography, mathematician, UB Medical School professor and artist, Dr. Hauptman also serves as executive and research director of the Medical Foundation of Buffalo, Inc. (See accompanying article on Hauptman's art). The UB research professor of biophysical sciences was honored May 21 with one of the highest awards in his field. He received the A.L. Patterson Award, the second to be given by the American Crystallographic Association. The award, presented at the group's annual meeting in Lexington, Kentucky, recognizes outstanding research and significant contributions to understanding the structure of matter by diffraction methods. months earlier, in the January 1984 issue of Physics F our Today, Hauptman was singled out for praise for being from only one or two protein crystals, thereby reducing both preparation and data collection time. "Although we've tested the formulas and feel confident they will work," he said, "we're cautious about proclaiming success until the final tests are done - until we've used them to find the structure of an unknown protein." Dr. Hauptman and his colleagues are also experimenting with fusing other methods to improve the techniques further. "However, this research is still at an early stage," Hauptman explains. "We have not yet applied it to unknown structures - this is still five to ten years off." X-ray diffraction provides the data required for analysis by Hauptman's methods. "When a single wave-length Xray beam is projected on a crystal, it is scattered (diffracted) in thousands of directions. This X-ray diffraction pattern is automatically recorded by a computerized diffractometer or on photographic film . The direction and intensity of the beams, using the formulas, enable us to determine the structure of the crystal," he clarified. The phasing technique solves the structures by comparing two or more diffraction patterns obtained by varying the number and position of atoms not properly belonging to the structure, but intentionally added to produce small changes in the diffraction intensities. During and before the 1950's, solving the molecular structure of chemicals with as few as 10 atoms was a difficult challenge. Most organic molecules, because of their complexity, were not solvable. Though highly sophisticated, these methods were largely based on trial and error, as much an art as a science. As described in the Medical Foundation of Buffalo's quarterly, Impact, "The scientist would make an educated guess about the structure, then test his hypothetical model to see if it fit the data he collected. A direct approach, that is, calculating the structure directly from the data, was viewed as impossible. Due to certain missing elements, the data were considered inadequate for such an approach. This was called the 'phase problem' in crystallography." But Dr. Hauptman believed that the phase problem could be solved. He was then a graduate student at the University of Maryland and also a scientist with the Naval Research Lab in the early to mid-1950's. With his strong grounding in higher mathematics, he not only formulated the phase problem into mathematical terms within five years, but he also solved it. "The reaction from the scientific establishment was disbelief. Papers were published showing the solution was no more than a minor improvement over current methods. Harsh criticism and even open hostility greeted Herb's presentations at scientific meetings," according to responsible for one of the four major advances in the field of crystallography. Physics Today is the magazine of The American Institute of Physics. The scientific advance for which Dr. Hauptman was honored is the mathematical method that he developed in the 1950's that determines the three-dimensional structures of biologically important molecules such as hormones, vitamins, antibiotics, and other drugs. Using X-ray diffraction, his Direct Methods approach assists scientists to understand the biological and chemical processes at work in nature. It also sheds light on why drugs work the way they do and yields knowledge that leads to more effective disease-controlling drugs and drugs with fewer side effects. "These methods are allowing us to design drugs in a systematic way, unlike the trial and error methods that have traditionally been necessary," the professor elucidated. Hauptman and his colleagues at the Medical Foundation of Buffalo have become the leading authority on identifying ways to modify and refine steroids, including cortisones. Research leading to improvements in digitalis and thyroid hormones is now in progress. Other future work to determine the mechanism of antibiotics and ionophores is planned. The latest improvements in the techniques may facilitate the solution of DNA structures in the future. Though Hauptman's Direct Methods approach greatly improved scientists' abilities to identify the structures of smaller molecules of 60 to 100 atoms, the method has not been effective for solving large structures such as proteins and other macromolecules with hundreds, thousands or more atoms. Proteins in particular are highly sensitive and don't crystallize easily. The requirements for multiple crystals have frustrated researchers for years. Even if good crystals can be obtained, solving the structure usually means one to two years of work. Hauptman set to work on solving the problem S ofo Dr.determining macro-molecule structures. By 1981, he developed a new technique that fuses the Direct Methods approach with two existing methods to speed the study of protein structures and advance a wide range of disease research projects. Physics Today Oanuary 1984) reports that Hauptman's newest advance "could be a major improvement in the strength and convenience of the phasing techniques for very large structures." The newest approach combines the Direct Methods with Isomorphous Replacement and Anomalous Dispersion Techniques. The combined procedure requires data 10 �Hauptman remembers when , as a child of five in the Bronx, he became interested in math at the same time he was learning to read. He earned his bachelor's and master's degrees in mathematics in the late 1930's from City College and Columbia University, respectively. After various technical positions in the military during and shortly after World War II, he joined the Naval Research Laboratory as a physicist-mathematician in 1947. It was there that he researched and published some 20 scientific papers that led to the mathematical solution for which he is so well known today. After he received his Ph.D. in mathematics from the University of Maryland in 1955, he joined their faculty on a part-time basis. His primary research continued at the Naval Research Lab where, beginning in 1965, he directed various divisions and branches until 1970. He was then asked by a professional colleague, Dorita Norton, to join the Medical Foundation of Buffalo. She was a UB research associate professor of biophysical sciences at Roswell Park and research director of the Medical Foundation. ''After 23 years with the Naval Research Lab, it was a difficult decision to leave. But the Navy had at that time decided it wanted its research activities to be more directly defense-related. Those pressures made the difference. I left for Buffalo," he commented. He pointed out that the change from military to medical was "quite refreshing." Then, he added, " Besides, I am interested in peaceful pursuits, not in making weapons. I detest military applications of scientific research - I'm lucky to have had the choice." Thus the unexpected formal transition from math to medicine was made. The same year that he joined the Medical Foundation, he joined the faculty of the School of Medicine. Besides research and teaching, his involvement has included various committees. He has been with the Foundation and UB now for 14 years. Dr. Hauptman took over administration of the Foundation in 1972 following the untimely death of Dr. Norton. Although administration was not his chosen calling, Dr. Hauptman deserves much of the credit for the international respect which the Foundation's research program now enjoys. The Medical Foundation's only work is basic biomedical research. With a staff of 25 Ph .D. scientists, its 15-member molecular biophysics group is possibly the largest in the country. The independent, non-profit institute conducts research on hormone-related disorders, including cancer, heart disease, diabetes, arthritis, birth defects, and related problems. " Though its primary responsibility is not teaching, courses are taught by its members. In fact , about a third of the staff have UB appointments," Hauptman said. Author of two books and 135 scientific articles and chapters, Dr. Hauptman has been honored with many other awards and distinctions. Further testing of the new methods and development of new computer programs are being carried out by Dr. Charles Weeks and Mr. Steven Potter at the Foundation . Dr. Hauptman also sees the opportunity to further improve the method through additional theoretical work. Since work on his newest technique was released , Dr. Hauptman has received numerous invitations to lecture on the method. He recently completed trips to Israel, Italy, France and India, touring labs and discussing his work. Today, Dr. Hauptman's direct methods are routinely used to solve thousands of complicated molecular structures. • Model of an actual crystal constructed by Dr. Hauptman. (For his artistic crystal forms, see pages 9 & 13). the quarterly of the Medical Foundation of Buffalo. Dr. Hauptman added , " Part of the reason for the resistance from the crystallography establishment was that the earlier crystallographers did not have a mathematical background." And while he claimed that he had solved a major problem in the discipline, Hauptman actually had no academic training in crystallography. What Dr. Hauptman had solved in 1958 was the " unsolvable" structure of colemanite, a natural 12-atom hydrous calcium borate - something never done before. not until Hauptman's method was used by others I ttowasrepeatedly solve complex structures that it became accepted, 15 or so years after he devised it. Dr. Hauptman related the story of how Seymour Geller, a wellknown crystallographer, told Hauptman that if he could solve a certain complex structure with his formulas, then Geller would be convinced . This did , in fact, take place. " In the late 1960's, Drs. Isabella and Jerome Karle set up their own X-ray diffraction equipment to apply the methods," he recalled. ''After solving dozens of structures at the Naval Research Lab, the final skepticism was removed." The collaboration between Dr. Karle and Dr. Hauptman led to their joint selection as recipients of the prestigious Patterson Award. ll �DOCTORS IN THE ARTS M Melding mathematics and the arts Known for his pioneering in crystallography, he also does a bit of pioneering in his art. He experiments with packing spheres, marble-like glass balls, into the various shaped objects. Packing the spheres into the crystals without any spaces or looseness is not as simple as it sounds. Gingerly holding one striking piece, he comments, " This one for example has 561 spheres inside. It is not filled in a random way but in a very definite order. This purple polyhedron has 923 spheres of two different sizes. You just cannot tightly pack spheres of a single size into an icosahedron (20-sided figure) . You have to have two different sized spheres in a very precise order and ratio." He explains the significance of the spheres-in-crystals. ''The idea of packing spheres into solid geometric figures is a whole new field - I am not aware of anyone else doing this type of thing, even from a mathematical standpoint." The reason why this has not been done before quickly became apparent . " It was a real challenge to fill the polyhedron with 923 balls. First, it had to be balanced on its point rather than on its base," he explained. He had to remove the several-faceted "cap", and fill the rest of the structure according to a very definite and precise strategy. "The hardest part was to fill the spheres to the top and , without letting any roll off, I had to quickly fit the cap on before the whole structure collapsed," he related. The 15-inch-high piece is now in a perfect equilibrium state. It took Dr. Hauptman about 40 hours to mathematically figure out the strategy - and only one hour to fill it . One may wonder how a mathematician makes the transition to art. Hauptman, however, is no stranger to the idea of fusing apparently different fields. Early in his career, he merged his mathematical talents with crystallography; when he came to Buffalo, he applied mathematics to medicine (see accompanying article). The intermingling of math and art started in his teenage years. " I always had an interest in shapes. I started first by making cardboard models of crystals," he recalled. About four years ago, one of the women at the Medical Foundation invited Hauptman to join her in an adult education class on stained glass making. " It occurred to me that making polyhedra out of stained glass would be more attractive than just painted cardboard models. They offered the possibility of looking into them. Their transparency was an opportunity to make the stellated forms in a meaningful way so you could see how the stellated form arose from the inner geometrical shape," he said. " Glass gives them a different effect they 're airier and lighter and more colorful." The 67-year-old Snyder resident finds the art possibilities limitless. Examining a large mounted cardboard polyhedron, he remarks, " This one has 59 stellated forms . It would be nice to make all of them but I don't think I'll live long enough to do all the things I want to do.'' • athematics and art are generally considered to be at opposite poles, but for Herbert Hauptman, Ph .D., melding math and art is only natural. The UB research professor of biophysics creates during his private time stunning crystal forms of multi-colored stained glass that are actually precise representations of geometrically complex shapes. The mathematician-artist displays some of his favorite pieces on large glass shelves in front of his living room picture window. ''All art is but an imitation of nature" - this 2,000year-old quote by Seneca clearly applies to Hauptman's crystal forms , many of which exist naturally as minerals, drugs , and other chemicals. With crystallography being the primary focus of his professional work , " my art is simply a natural outgrowth of my career interest," he commented. Pointing to the glistening, pointed glass objects, he added , "You can see that mathematics and art do have a lot in common." Dr. Hauptman has created about 35 pieces to date. They include the five basic geometric forms and also more complex stellated examples, those that are extended into star-like forms . He has green and blue pyramid-shaped objects, pastel-colored octahedra (8-sided figures) and their stellated forms , multi-colored dodecahedra (shapes with 12 equal rhombic or pentagonal faces) and airy pieces with star-shaped cutouts in each facet. The first public display of his work was last March in the J .C. Mazur Gallery at the Polish Community Center in Buffalo. His work was featured next to that of an internationally respected and award-winning Turkish painter. One wonders how he has the time to "<Vork on his art, with his busy role as executive and research director of the Medical Foundation of Buffalo. Because of his administrative commitments, the nationally respected crystallographer does much of his research during odd hours away from the office. He also finds time to devote to his family and still manages to spend an hour or so most evenings on his art. " I construct the forms in my basement while I listen to the melodies of Bach, Haydn and Beethoven," he remarked. " It takes about 15 to 20 hours to create the smaller pieces, and up to 100 hours to produce the most difficult ones." One shape, made of two interlocking tetrahedra or four-sided shapes, is composed of 48 separate pieces of stained glass. "Considerable time is spent figuring out the precise angles of the bevels," he explains. Grinding them to a knife edge, he emphasizes that " they have to be within a fraction of an inch or they won't fit together. A sound mathematical knowledge is required to produce the figures " - it can't be done by just anyone. Remarking about one of the photographs accompanying this article, Hauptman mused , " Now there's something that 's fascinating: a two-dimensional projection of a threedimensional projection of a four-dimensional cube." By Bruce S. Kershner 12 ��RESEARCH Phone-in program aids heart victims A By Marmie Houchens 50 per cent reduction in the death rate of heart attack victims now appears possible because of a research project at Buffalo General Hospital , headed by UB clinical assistant professor of medicine, Dr. John Visco. The area's largest health care institution is one of three hospitals in the country participating in the international project , called the Early Heart Attack Program. Now 90 per cent complete and in its fifth year, it is studying whether early intervention can reduce the staggeringly high mortality rate among heart attack victims. A 1983 report claims that 350,000 Americans die each year of heart attacks before reaching the hospital. 1n half of those deaths, the cause is believed to be from irregular heart rhythm , which can be treated quickly and safely with the injection of a stabilizing drug. With the Early Heart Attack Program (EHAP), you can phone in your heart attack and receive immediate life-saving help. The innovative program , housed in the Echocardiography Department at Buffalo General Hospital (BGH), is nothing to be taken lightly. It saves lives and gives heart attack patients something they never believed they would have again peace of mind. The operation and success of the program is so simple it is ingenious. Patients suspecting they are having a heart attack call a hot line number, and by using a CardioBeeper, specifically designed for the program , they send their electrocardiogram over the telephone. At the CCU unit trained nurses analyze the EKG strip on the spot. They then consult the patient on emergency in-home medical treatment , and within minutes a rescue squad brings the patient to the hospital. The goal of the program is to reduce the staggeringly high mortality rate of heart attack victims. According to Sandra Van Every, RN , EHAP coordinator, some 350 ,000 people in the United States die each year of heart attacks before reaching a hospital. In two out of three cases, the cause of death is sudden cardiac arrest , usually from ventricular fibrillation. The EHAP equips patients with a prefilled, auto-injectable syringe, called a LidoPen , so they can self administer lidocaine, a life-saving drug that stabilizes abnormal heart rhythm. nother advantage of the program is A that it encourages patients to seek immediate medical advice when symptoms of heart failure first occur. Mrs. Van Every points out that patient delay and denial is the weak link in the health care system which often leads to· fatalities . " When symptoms are noticed, patients are reluctant to call the doctor because they are uncomfortable calling at odd hours or because they deny possible consequences of their pain . The Early Heart Attack Program provides faster access into the medical system as well as immediate lifesaving treatment ," she commented . The EHAP is in its fifth year of operation at Buffalo General. It is a research study of former heart attack patients to determine if pre-hospital treatment can reduce the mortality rate. In addition to the emergency aspect of the program , another factor that is saving lives is a closer monitoring of heart patterns by more frequent checkups conducted over the phone with the Beeper system. " This additional information keeps 14 physicians informed of any significant change in heart patterns or rhythms and makes rapid clinical help available," said Mrs. Van Every. Approximately 900 of a targeted 1,000 patients have participated in the research study, sponsored and funded by Survival Technology, Inc. of Bethesda, Maryland. This includes patients at BGH ; Rhode Island Hospital ; and Duke University Medical Center and Durham County Hospital , Durham , North Carolina. Visco, cardiologist and medical diD r.rector of the EHAP, worked with Stanley Sarnoff, M.D. to establish the program . Dr. Sarnoff, founder of the internationally acclaimed Survival Technology, Inc., designed the CardioBeeper and the LidoPen . The syringe is adapted from his development of the AtroPen used for military purposes. In the research project , cardiac patients, divided into a control group (those following routine cardiac rehabilitation) and the systems group (those using the CardioBeeper system), are followed for one year after their discharge from the hospital. In addition to saving lives, a psychosocial survey, conducted with the study, points out that the system patients �RESEARCH have less emotional trauma, due largely to reduced fear of handling recurrent heart attacks. Another aspect of the program that promotes mental and emotional well being is their slow weaning from hospitalization . " It makes me feel very good that the staff is still interested in me after a year. I think because of their concern , my recovery was faster. And because of the Beeper- my security blanket- I don't have any fear," said Vietta Dixon, 68. Dr. Visco believes the emotional support provided by the program through its medical consultation and warm counseling promotes a speedier recovery, quicker return to work as well as social situations, and a faster reconstruction of a normal lifestyle. Much of this is credited to the alleviation of depression and stress in patients' lives. "I didn't realize how great this program was until I needed it . .. It is a great comfort ," one patient said. Final results of the EHAP will be completed by next summer. At that time, BGH will have the option of implementing the program on a full scale. Staff and patients are hopeful that the program will be continued . When it was devised , its hope was saving lives. The program does much more than offer survival. It provides a way for heart attack victims to again live a productive life without the oppressive fear of not being able to get help in the event of another heart attack. Aid is just a phone call away. • (Reprinted from "Pulsebeat':) Buffalo General's Does social life impact on cancer? By Catherine Kunz I t has long been suspected that social life might have a direct, determining impact on the course of cancer. In a recent study published in Cancer magazine, Drs. )ames Marshall and Donna Funch of the Department of Social and Preventive Medicine, deal with this im- portant and current issue. Dr. Marshall is an associate professor and Dr. Funch is an assistant professor. In this research , Marshall and Funch examine the impact of several aspects of social life on the length of survival of women with breast cancer. The original data for the study were collected on 352 women who began treatment for breast cancer at Roswell Park Memorial Institute between 1958 and 1960. Each patient was asked about the occurrence of several traumatic events in the five-year period �RESEARCH preceding her first recogmuon of the symptoms that led to a diagnosis of breast cancer. Information was collected concerning the number of "stressful life events " - deaths, serious illnesses, and divorces that occurred in her household in the five years before she became ill. The respondent was also asked certain questions about her "social environment" - the extensiveness of her social involvement and the social support available from persons within her social sphere. Social involvement was represented by the respondent's acquaintances and relatives, the number of non-religious and religious meetings she usually attended, and her status as married , rather than divorced , widowed, separated , or never married . These data were originally gathered for use in another study which dealt with the relationship between social trauma and breast cancer. Using the New York State Tumor Registry, which records cancer patient deaths in New York State, Marshall and Funch determined that of the 352 patients surveyed for this study, 283 had died . This study dealt with the survival time of only these 283 patients. According to the study, younger women exhibited a stronger link between the extent of their social involvement and level of stress and the length of their survival. Women who experienced a low level of stress and high level of involvement , prior to the illness, survived longer than women with high stress levels and less extensive support networks. Among older women, however, there was little evidence of any pattern associating survival with social stress and /or involvement. Marshall urged caution regarding the implications of this study, pointing out that some of the factors that appear to support a link between social environment and survival may result from other side-effects of the social environment. Women with more extensive support networks may be more apt to comply strictly with the necessary regimens - they may be more likely to seek earlier medical attention. Marshall acknowledges both of these as possibilities. The single, most powerful predictor of survival is still how early the disease is diagnosed. Might it be possible for social stress and support to be translated through percep- tion into processes that alter the cellular chemistry of breast cancer? Even with these findings, Marshall is skeptical. "We would like to think that , by some act of will , we could have some influence on the disease process. I'm not sure we can ." He calls attention to several limitations in this study which might have affected the findings. Firstly, Marshall and Funch studied women who died, not women who survived . While survival rate would presumably be influenced if the characteristics studied had any overwhelming impact on the likelihood of recovery, it is not known if this could have affected the outcome in some as yet unknown way. Secondly, the data may be limited in their ability to provide information regarding the emotional experiences of the subject. A full understanding of the role of social stress and involvement is necessarily related to the meaning of stress and involvement to that individual , Marshall and Funch believe. The data provide little information about the stressfulness of traumatic events, nor was the patient's level of social involvement necessarily an accurate representation of the support that she actually received in her life. Furthermore, the health status of the respondent may have colored her response to questions dealing with subjective facets of social life and experience. Finally, Marshall points out that this study considered only the quantity of survival. For a cancer patient , the quality of survival may be of equal or even greater importance. While stressful events and the extensiveness of one's support network may not have a direct physiological effect on the course of breast cancer, they affect one's ability to deal emotionally with the disease. Regardless of impact on long-term survival , social support greatly increases the quality of a cancer patient's short-term survival. "Clearly, these findings raise no questions as to the need of cancer patients for a supportive environment ," commented Marshall. Despite the inconclusiveness of Marshall and Funch's findings, it is their hope that these fmdings may help to inform the debate over the impact of social-psychological conditions on the course of cancer. • 16 Dolphins may offer clues in research By Mary Beth Spina P erpetually "smiling" dolphins whose skill and antics amuse audiences at the Niagara Falls (NY) Aquarium are "starring" in research which promises to unravel mysteries of marine life to the benefit of both humans and sea creatures. The surface of the playful dolphin's skin, a subject of interest to UB/Arvin Calspan researcher Dr. Robert Baier, exhibits special qualities which , if translated successfully in the laboratory, may lead to cleaner ocean environments, materials to prevent plaque buildup on human teeth , and a way to prevent atherosclerosis in humans. "One of the most unique qualities of these animals' skin is that it virtually repels any materials - on land or in the sea - which attempt to stick to it ," says Dr. Baier. A drop of oil, placed upon the skin, for instance, will "bead" rather than adhere. Ship bottoms, on the other hand , except those painted with the most poisonous state-of-the-art resins, consistently "collect" barnacles and other living materials from sea water which erode the surface paint. The fouling marine environment also puts a bacterial, slime film on even poisonous paint surfaces. Human teeth , not unlike the paint on the ship, "collect" bacteria and food particles which strongly adhere to them to form plaque, a living film which contributes to major dental diseases in children and adults. Ongoing studies by Dr. Baier and his colleagues and others at the University of Lund (Sweden) Dental School show that, unlike the topmost layer of human skin , the skin of a dolphin has a low drag, slippery surface much like that found on the inside surface of the human cheek. The human mucosal surface, like that of the dolphins ' skin , has a tremendous capacity to resist adherence of fouling materials with which it comes in contact. Using anatomical, histopathological , electron microscopic, and surface chemical measurements of the sea animals ' skin , taken during routine �RESEARCH routine medical examinations at the Niagara Falls Aquarium and blood drawn from dolphins in their natural habitat, the three have found that the antibody reacts against the antigenic determinants on the human white B cells associated with some leukemias. Although the UB/RPMI research team believes it will be some time in the future before the dolphin antibodies could be used to aid diagnosis of human blood disease, the absence of these proteins in the animals could be a signal of disease in the dolphin . • medical examinations, Dr. Baier believes that the secret of the dolphin epidermis can be found and may provide answers to a variety of questions. "By being able to formulate paints which will naturally resist fouling materials in seawater, and thus prevent erosion which causes state-of-the-art toxic chemicals to disperse in the oceans, we can subject the marine environment to less human pollution ," Dr. Baier theorizes. The information gained from the "good goop" which composes the dolphin's skin outermost layer may also lead to improved products to minimize disease-causing plaque on human teeth . "When people refer jokingly to escaping disaster by 'the skin of their teeth' they probably are unaware that there really is skin covering the teeth," Dr. Baier points out. But it is this very skin which actually appears to allow materials in the mouth to gather and collectively cause dental disease. Human blood vessels and arteries also appear to have a tendency in most people to bind lipids such as cholesterol, causing them to accumulate in a potentially deadly progression which eventually can block vital blood flow. Here again , the secrets of dolphin skin may also be valuable. Dr. Baier and his associate, Anne Meyer, who perfected a surface chemistry technique which allowed blood to flow freely over plastic surfaces used in the artificial heart , believe that information gained from dolphin skin may someday be critical in developing ways to prevent the buildup of plaque associated with atherosclerosis. Loss of smell can suggest a tumor By Catherine Kunz L hile Dr. Baier and his associates are W scrutinizing the skin of the "smiling," lively animals, another group of scientists at UB and Roswell Park Memorial Institute are focusing on the blood of the dolphin . Drs. Dennis Hohn and Roger Cunningham, associate professor at UB, in collaboration with RPMI's Dr. Elias Cohen , have found an antibody, present in the blood of both wild and captured dolphins, which may have potential as a reagent in testing for certain types of human leukemias. Using dolphin blood drawn during Both magnified 500X, skin of porpoise dorsal fin (center) looks similar to inside of human cheek (bottom). Top, a section of human skin magnified 50X. 17 oss of the sense of smell that lasts months may be the first sign of a certain type of brain tumor, says Dr. Louis Bakay of UB's Department of · eurosurgery in a recent report published in the journal of the American Medical Association and discussed in approximately 75 other publications. Although the benign, slow-growing intracranial tumors called olfactory meningiomas represent fewer than five per cent of all brain tumors, they are, unfortunately, rarely diagnosed in time and can lead to serious dementia and loss of vision . Early diagnosis, however, can be made if doctors recognize and act upon the first clinical symptom of the tumor, a reduction in the sense of smell leading eventually to complete "anosmia," or loss of the olfactory sense. This anosmia may remain the only neurological deficit for years until the tumor becomes large enough to cause loss of intellectual functions or vision . "When an olfactory meningioma is small , removal is not a large problem ," says Bakay. " If it is allowed to become large, then it presents a problem and, if not removed, can result in death ." Although it is important to take appropriate diagnostic measures at a time when a patient's only complaint is anosmia, Bakay notes a reluctance in both patients and physicians to attach to the loss of the sense of smell the importance that it demands. " Very frequently, pa- �RESEARCH Computed tomographic scan of an olfactory meningoma of average size. tients don't even mention their loss of smell to a doctor," observes Bakay. While patients often neglect to complain about the loss of their sense of smell , physicians all too often dismiss what complaints they do receive as trivial. Bakay stresses that, while a loss of this sense is a fairly common occurrence and only rarely results from a brain tumor, physicians should keep an olfactory meningioma in mind as a possible cause. Acquired , organic loss of the sense of smell can be caused by a variety of conditions. The common cold, various types of rhinitis and sinusitis, polyposis, nasal operations, and injuries can all result in anosmia . In the great majority of such causations, however, the condition is not permanent, although the return of the sense of smell may take many months. If, however, the olfactory sense does not return and no explanation can be found , further diagnostic measures are imperative, Bakay points out. While anosmia is generally considered a minor disability, in reality, it is not. Not only does it interfere with the full enjoyment of life, it is professionally disabling to such people as chefs, perfumers and tobacco blenders and can prove dangerous to workers employed in the chemical industry or housewives unable to smell escaping gas in the kitchen. Computed tomographic scan of very large tumor. "Some patients don't realize that they don't have their sense of smell until they are almost killed by a gas leak," says Bakay. B ecause of the insidious onset of the disease, it is difficult to diagnose an olfactory meningioma in its earlier stages if the loss of the sense of smell is overlooked. In the past , diagnosis and particularly the estimation of the size of olfactory meningiomas were difficult. Skull films , carotid angiography and radionuclide imaging were all used in diagnosis but proved inadequate or too intensive for routine screenings. Many patients were treated for prolonged periods under false diagnoses , including psychosis or senile dementia, primary eye disorders, chronic sinusitis, stroke, and epilepsy. An undiagnosed or improperly diagnosed olfactory meningioma may result in mental illness of many years ' duration . Many conditions in Bakay's study were treated as being dementia and were reevaluated only because of the patients' severe headaches or visual deterioration. Two of these patients were on the verge of being committed to mental institutions. A third had been a long-term inmate of a mental institution and had been seen by a neurologist only when it became obvious that the patient was go- 18 ing blind. A fourth patient was properly diagnosed just before he was scheduled to undergo a series of electroshock treatments. Bakay sees delayed or incorrect diagnosis of olfactory meningiomas as inexcusable in today 's age of computed tomographic (CT) scanning. Performed now in most major hospitals, CT scanning is free of the objections leveled against previous diagnostic methods and provides a fast and non-invasive method for depicting these tumors easily at a time when their only clinical manifestation is a loss of the olfactory sense. Proper awareness and meticulous screening of olfactory meningiomas, therefore, cannot be advocated strongly enough , Bakay feels . Compared to the total number of losses of smell , those caused by a brain tumor are few in number. However, Dr. Bakay has received several letters since the publication of his article from people with anosmia who had CT scans that did indeed diagnose tumors. With increasing alertness to the symptoms of the disease, it is hoped patients with olfactory meningiomas will enjoy earlier diagnosis and a resulting reduction in morbidity and mortality. • Drug may relieve genital herpes By Mary Beth Spina T he oral version of an antiviral drug which may spell relief for patients with recurrent genital herpes and other herpes-virus infections and the benefits of an anti-gout drtig in preventing occlusion of arterial grafts after coronary bypass surgery were among topics discussed at the Fifth Annual Drugs of the Decade program September 8 at UB 's Center for Tomorrow. Approximately 120 pharmacists and physicians attended the day-long program sponsored by UB's Schools of Medicine and Pharmacy, the Department of Pharmacology and Therapeutics, and the Buffalo Veterans Administration Medical Center. UB 's Office of Continuing Medical Education coordinated the event . Dr. Robert T. Schooley, a Harvard researcher and Massachusetts General �RESEARCH Hospital physician, told the audience that oral and intravenous forms of the antiviral drug acyclovir (Zovirax) appear effective in treating a wide range of problems linked to primary and recurrent herpes-virus infections. Intravenous and topical forms of the drug are available, with the oral version awaiting release by the U.S. Food & Drug Administration. Acyclovir was first synthesized in Burroughs-Wellcome laboratories under the supervision of Dr. Howard Schaeffer, former chairman of UB's Department of Medicinal Chemistry. The drug, which is a "second generation" antiviral agent, appears in clinical studies to have minimal adverse side effects while being highly specific in its action against most members of the herpesvirus family. While not a cure, intravenous and oral forms of acyclovir have demonstrated they can shorten recovery time, reduce viral shedding, and prevent or reduce severity of initial and recurrent infections. The drug is active against Varicella Zoster Virus, implicated in chicken pox, and herpes Zoster or "shingles" as well as Herpes Simplex II, associated with genital herpes. There is mounting evidence the drug may also prove useful in treatment of severe herpes labialis (cold sores) caused by Herpes Simplex I as well as mononucleosis and other infections associated with Epstein-Barr Virus. While the drug is gaining importance in treatment of initial infection among normal and immunocompromised pa- tients, it may be equally important in suppressing reactivation of herpes-virus which occurs under circumstances not well understood, Dr. Schooley said. Other antivirals such as Ara-A and interferon are effective against certain herpes-virus infections but acyclovir has been shown 160 times more active against Herpes Simplex Virus than Ara-A. The topical form of acyclovir is indicated in management of initial herpes genitalis and in limited, non-lifethreatening mucocutaneous Herpes Simplex Virus infections in immunocompromised patients. Dr. Schooley said that although acyclovir is a promising treatment for persons with recurrent genital herpes infections, it is probable the drug will have to be taken prophylactically to prevent reactivation. While acyclovir is not effective in treating infections caused by Cytomegalovirus, the Burroughs-Wellcome experimental drug BWB759U, now undergoing clinical phase I trials, has been designed to be specific against CMV. D r. Jules Constant, a UB cardiologist at Buffalo General Hospital, told the audience that the anti-gout drug Anturane is as effective and more convenient than aspirin/Persantine in preventing graft occlusions and reinfarction in patients who have had coronary bypass surgery. Anturane (sulfinpyrazone) not only features anti-platelet action which prevents occlusion and reinfarction but it also has the ability to raise the fibrillation threshold so important in preventing sudden death. This latter effect has not been shown with the aspirin/Persantine combination, he added. The medical management of the post coronary bypass patient, Constant, a clinical associate professor of medicine, noted, is of prime importance when one considers the statistics. "Fifteen to 20 per cent of grafts close by the end of the first year after surgery with many patients forming an early thrombus before they leave the hospital after bypass operations," he pointed out. In 50 per cent of women who have the surgery, there is clot formation which completely occludes the arterial grafts. A lesser but still impressive number of male bypass patients experience the same complication. Although cholesterol - eggs particularly - acquired a bad reputation in its suspected role in heart disease, Dr. Constant said more recent studies suggest the absolute level of cholesterol intake has less to do with the problem than does the intake of oxidized cholesterol and the amount of saturated fats in the diet. Since higher cooking temperatures seem responsible for the amount of oxidation, eggs fixed in ways which require less heat are preferable. On a low saturated fat diet, the post-coronary patient could eat five soft-cooked eggs every day and not experience a significant rise in serum cholesterol, he said. • The oral form of the antiviral drug acyclovir appears effective in treating problems linked to primary and recurrent herpesvirus infections. 19 �MEDICAL SCHOOL NEWS 1 Graduate education consortium formed By Bruce S. Kershner A n incredibly complex network of nine hospitals, each with dozens of departments and programs, interconnecting with thousands of medical faculty members and administrators distributed throughout the metropolitan area that's the only way to describe the graduate medical education system centered around UB 's Medical School. For decades, this system has worked. But now, an umbrella organization has been established to further enhance the elaborate medical education system and bring more cohesiveness, communication, and consistency to its educational mission. The new organization is known as The Graduate Medical and Dental Education Consortium of Buffalo, a name fittingly as complicated as the system it represents. The umbrella-like scope of the consortium is revealed by its hospital members: the eight teaching hospitals that include Buffalo General, Children's, Erie County, Veterans, Roswell Park, Mercy, Millard Fillmore, and Sisters of Charity. In addition, a University-related residency program in family medicine exists in Niagara Falls Memorial Hospital. A closer look further reveals the complexity of this system. A total of 32 separate hospital residency programs associated with the University are distributed throughout the nine participating hospitals. Seven of the programs rotate their residents among five hospitals, while usually maintaining a base of operations at one. Examples include internal medicine, ob/gyn, pathology, and urology. Internal medicine, for instance, is based in Erie County Medical Center but uses Roswell Park, Buffalo General, Children's, Mercy, Sisters', and Veterans hospitals as participating institutions. Ten residency programs are restricted to only one hospital, such as pediatric cardiology and child psychiatry (Children's), and neuropathology (ECMC). Further, several programs such as medicine, ob/gyn and pediatrics have many subspecialties which rotate their residents as well. Not covered by the Consortium are 13 independent, free standing residency programs not associated with the Medical School. These include a number of programs at Millard Fillmore, Mercy, and Sisters of Charity hospitals, as well as anesthesiology at Children's and ophthalmology at Erie County Medical Center. of by the UB Faculty Conceived Council's Committee for Graduate Education and Vice President John Naughton in 1982, the consortium had its first meeting last April. Its membership totals 80 and includes Dr. Naughton as chairman; William Feagans, dean of the Dental School; the chief executive officers from each of the teaching hospitals; department chairpersons and residency program directors from each Universitysupervised residency program; the chairperson of the Faculty Council's Graduate Education Committee; a basic science faculty representative; and one elected house staff physician from each University-supervised program. "The Consortium will provide a greater sense of community to the graduate medical and dental education system in Western New York," comments Dr. Donald Larson, UB associate vice president for clinical affairs and director of the Office of Clinical Affairs. Together with Nancy Glieco, assistant to Dr. Larson, his office provides the staffing and coordination for operating the Consortium, among other responsibilities. "The Consortium enables the medical education leadership to speak together on focused issues relating to graduate education. Existing problems can now become more clearly defined and solutions will become available," Dr. Larson elaborated. 20 The Consortium's m1ss1on is to serve as the formal organization through which all groups involved in University-supervised graduate medical and dental education can participate in planning and policymaking. Its primary goal is to assure that the quality and consistency of the programs remain high and that they meet the standards required for accreditation of the residency programs. Other goals are to develop and improve avenues of communication among all institutions and individuals involved and to identify and distribute resources equitably. These "resources" include human resources, that is, the house staff positions that must be allocated among the residency programs. J he problems that can be encounTtered by a resident are immediately evident when one realizes that there are departments of internal medicine in four different hospitals. Hospital residents must migrate to each hospital during their several years of training. During this period, they encounter differing conditions of employment, administrative procedures, education, and supervision. The Consortium's purpose is to equalize these differences where they create problems or are unnecessary, or to initiate changes which enhance their quality. For the residents, the issues are as close to home as salary, fringe benefits and vacation, as well as more mundane matters such as medical record-keeping and the. quality of consultation rooms. Even within the same residency program, grievance procedures differ from hospital to hospital, something that the Consortium will attempt to rectify. Of direct relevance to the quality of the educational program are matters such as quality and distribution of equipment and facilities and the quality of the libraries. The Consortium will also develop procedures for the periodic review and evaluation of each program. One benefit of the Consortium is that it will accelerate the process of ' J �MEDICAL SCHOOL NEWS concern of the administrative committee, chaired by Louis ]. Russo, director of Erie County Medical Cenre~ • Minority students assist in research E Dr. Robert Baier, UB/Calspan, shows Dr. Robert Grantham and summer Apprentice Program students a hip implant and a replica of the artificial human heart at one of the scientific seminars. Seated are Melissa E. Givens (left) and Constance West (right). Standing are from left Cynthia Ruiz, Todd White, Ingrid johnson, and Delphine Vanderpool. \ J integrating hospital residents into the various disciplines such as surgery, obstetrics, family medicine, and others. " The Consortium will not affect any non-University-associated freestanding residency programs,'' Dr. Larson points out . " However, affiliation agreements between the University and hospitals do not always address important issues relating to University-associated programs and cannot address problems associated with residency programs shared by more than one hospital." Dr. Larson compares the graduate medical and dental education system in Buffalo to a spider web. " Before the Consortium, the various programs and hospital relationships were like many individual strands connected to the University but not to each other. The Consortium connects all those strands so that each is affected and is responsive to the other. If one is pulled , they all pull together.'' The Consortium's coordinating board meets monthly, as does its house staff committee. The residen- cy program committee, comprising the entire consortium , meets quarterly. Dr. John Wright, chairman of the Department of Pathology and secretary of the Consortium, is the chairman of the coordinating board, which coordinates the functions of the Consortium and represents it to those outside of the organization. In addition, " it facilitates communication between the committees and acts as a vehicle for the organization to present actions to its membership," Dr. Wright comments. The residency program committee is chaired by Dr. Glen Gresham, also chairman and professor of the Department of Rehabilitation Medicine. It deals with accreditation requirements and the quality of graduate education. The house staff committee provides a forum to represent house staff on matters related to house staff performance and policies, and resource allocation of the programs. It is chaired by Dr. John Macaluso. Inter-hospital and hospitalUniversity relationships are a primary 21 ight minority high school students were involved in an unusual career opportunity this last summer, when they participated in the Summer Minority High School Student Research Apprentice Program, sponsored by UB's Schools of Medicine, Dentistry, and Pharmacy. Dr. Peter Ostrow, the Medical School's new associate dean for curricular and academic affairs, presented certificates to the students who participated in the innovative summer program at a luncheon August 24. Citing the degree of sophistication evident in the research projects which the students conducted this summer, Dr. Ostrow said they were "on a level which one would expect to see at scientific meetings. "Clearly, they represent a level of quality which would be on par with research projects conducted by college students and beyond," he told a group of more than 25 parents, students , faculty, high school counselors, and UB officials. Seven of the high school students presented posters outlining their research methodology and conclusions. Another student was unable to attend the closing ceremonies of the Program which were held in the Lippschutz Room at the School of Medicine. Dr. Charles Kaars, assistant to UB 's vice president for research and graduate studies, told the group that the Program has been an unqualified success. Explaining that the goal of the Program is to place academically talented minority high school students interested in science/medical careers with UB researchers, Dr. Kaars said response from students and faculty has been tremendous. �MEDICAL SCHOOL NEWS "Faculty and staff give their most valuable commodity to the Program and its students - and that commodity is time," he said. Now in its third year, the Program was funded this summer by a total of $12,000 in grants to the schools of Medicine, Dentistry and Pharmacy and the Research and Graduate Studies division from the National Institutes of Health. Faculty who take students to conduct ongoing research projects receive no financial compensation. "But," Dr. Kaars pointed out, "they find it a rewarding experience because they enjoy sharing their expertise with bright students for whom the Program is a first step toward a career in research." Dr. Maggie Wright , assistant Medical School dean for student affairs, noted that counselors and math and science teachers in Western New York area schools should be credited for their cooperation in assisting with identification of students interested in medically and research-oriented careers. She pointed out that some of the students who have initially participated in the summer program have gone on to conduct additional research with UB faculty through the undergraduate Summer Research Program sponsored through UB's Office of Equal Opportunity/Affirmative Action . "All of the students who have participated in our high school program are in college," Dr. Wright emphasized, "and we expect to see at least some in graduate and professional schools during the next years." The continuity offered by the UB summer programs, she noted, aids in increasing the numbers of minority representatives in the medical and scientific areas areas where minorities have in the past been typically underrepresented. Participating students in the summer apprentice program received a weekly salary and worked full-time in the laboratories of their mentors for eight weeks. Every effort was made to match students' interests with those of the faculty with whom they worked. In addition to their research , students attended seminars presented by UB faculty representing a variety of research/clinical areas. Faculty presenting seminars this summer were Dr. Robert Baier, UB/Calspan; Dr. Robert Cooke, director of the Children's Rehabilitation Center; Dr. Isaiah Meggett, Department of Family Medicine; and Dr. John Vena, Department of Social and Preventive Medicine. A sampling of the students' research projects included: "Effect of Anabolic Steroid Winstrol on Histomorphology of Dystrophic and Normal Chicken Muscle"; "A Study of the Effects of Alcohol on Liver Structure"; and "Effect of Varying Gas Concentrations on 0 2 Transport." • Ostrow is new associate dean D r. Peter Ostrow has brought with him a clear vision and a quick humor as the Medical School's new associate dean for curriculum and academic affairs. In his new role, he will be responsible for evaluating, interpreting and modifying the curriculum of the School. He will meet regularly with every faculty body and committee that influences the program of medical education, including the curriculum , academic status, year and course committees, faculty council committees, and Polity, the Medical School student association . Another duty is to orchestrate the "dean's" letters that are prepared for graduating students with the aim of placing them in the best possible residencies. He will also formalize the method of pairing students with those professors who will best meet their academic needs and provide advice on residency selection . "Actually," Dr. Ostrow comments, "my responsibilities are broadly defined at this time, so that I can take a creative role. Where my involvement in a program or aspect of the curriculum is most needed , that is where some of my energies will be 22 directed." Dr. Ostrow has brought with him some good experience from the University of Texas Medical School where he was a faculty member from 1977 through 1984 . He views the relationship of students to their teachers and mentors as all important . He obviously applied this philosophy well in Texas, since every student class there awarded him Outstanding Teacher Awards in both the basic and clinical sciences for each of the seven years of his tenure. " I feel that students must be recognized as part of the medical profession the moment they enter medical school," Ostrow points out . "The medical school must create an atmosphere of mutual respect for students to do their best ." He also emphasizes what he sees as the proper attitude of the student. " Students can look at their medical school experience as a burden or as an opportunity." If the student looks at it as a burden, or as competition with other students, Ostrow says, he or she will pose the question , "What do I have to know to get through medical school? " If on the other hand , the student views it as an opportunity, and as a "competition" to set the highest standard for oneself, then he or she will ask , " How much can I learn?' ' He reinforces these points with a quote from the great physician Dr. William Osler, " The hardest conviction to get into the mind of the beginner is that the education upon which he is engaged is not a college course, not a medical course, but a life course for which the work of a few years under teachers is but a preparation ." Wlike hy should an effective teacher Dr. Ostrow want to become an administrator? Ostrow explains that , in addition to his administrative role here, he will also teach . In fact , one of the things that attracted him to UB is the commitment of the dean and the institution to encouraging senior professors to continue their teaching , rather than restricting themselves to research and clinical activities. " UB has a high proportion �MEDICAL SCHOOL NEWS ology at the University of Texas and headed numerous university committees. He has participated in N.I.H. study sections involving research training for medical students. While in Texas, he initiated and coordinated the medical school's student support system . The author of one book chapter and 20 research articles, he has focused his research on diseases of the pituitary gland. He is a charter member of an international pituitary pathology group. Ostrow sums up his philosophy by stating "Nothing is more rewarding than medicine." Then he quantifies this by adding, "There are few careers in which the ratio of the satisfaction to the difficulty is as high as in medicine." • Orthopaedics holds Science Day T Associate Dean Ostrow of masters still teaching their subjects. That can only benefit the students, which in turn benefits the school by earning it a good reputation," he remarks. His goal as coordinator of the school's curriculum relates directly to this point - Dr. Ostrow .wants to develop further the school's reputation that will be formed by the impressions of the doctors we turn out into society. "The curriculum is one of the primary instruments to achieve that goal," he emphasizes. After attending UB 's undergraduate school, he received his Ph.D. in anatomy and the M.D. in 1971 from SUNY Downstate Medical Center. He completed his residency and fellowship in neuropathology at the Johns Hopkins Hospital. He was a faculty member of Johns Hopkins and the University of Texas Medical School until he returned to UB. He served as director of neuropath- 23 he 13th Annual Orthopaedic University Residents Scientific Day was held May 31, 1984, at the Erie County Medical Center. George E. Orner, Jr., M.D., professor and chairman, Department of Orthopaedic Surgery and Rehabilitation, University of New Mexico, was the visiting professor who delivered the 9th Annual David M. Richards, M.D., Memorial Lecture. His topic was an "Overview of the Management of Traumatic Peripheral Nerve Injuries of Extremities." Six orthopaedic residents completed their residency training, including Drs. David J. Bevilacqua, Joseph E. Buran, Ronald M. Carn, James J . Creighton, Jr., Peter E. Shields, and David J. Winnick. This academically productive group of orthopaedic residents presented five papers at national meetings in the past year. In addition, Dr. R. Geoffrey Wilber, an orthopaedic surgeon from the Case-Western Orthopaedic Program, completed a one-year Spine Surgery Fellowship with Dr. Edward H. Simmons. • �HOSPITAL NEWS WNY Apnea Center designated 0 n May 31, 1984, the Children's Lung Center was designated as the Regional Apnea Center for Western New York by the State Health Department. Apnea, a temporary cessation of effective breathing, is believed to be an important risk factor in Sudden Infant Death Syndrome (SIDS). The Apnea Evaluation Unit of the Lung Center was established in 1979 under the direction of Gerd ].A. Cropp, M.D., Ph.D., professor of pediatrics and assistant professor of physiology, Ian Nathanson, M.D., assistant professor of pediatrics, became director of the Unit in September of 1983. The Unit was established "in response to a growing need for the study of this sleep disorder which occurs in infants," says Dr. Nathanson. Patients seeking Apnea testing are eligible for State Aid. Subsequently, the state "needed a center that has good control . . . they wanted to find experts," states Dr. Nathanson, who is a specialist in pediatric pulmonology. Eligibility for state-funded Apnea testing will be determined by the newly designated Regional Apnea Center. Dr. Nathanson plans to work closely with hospital staff and community physicians throughout Western New York, to provide optimal care for infants at risk. • (From Children's Hospital's "Bambino':) Children's adds Sendex system I n a world of modern technology, Children's Hospital again became a forerunner in advanced medical care when it became one of only two hospitals nationwide to install the Sendex 70, a sophisticated computer system which will help save time and lives. The System 70 uses a complex computerized network to send Ian Nathanson, M.D., director of the Regional Apnea Center at Children's Hospital, monitoring patient's condition. medical images including X-rays, CT scans, Ultrasound and nuclear magnetic resonance images quickly and accurately over a regular telephone line. Jerald Kuhn, M.D., chief of radiology at Children's and professor of radiology and pediatrics, is coordinator of Sendex services. He decided upon installation of the machinery for two primary reasons: "We will be able to set up a consultative network with private physicians in emergency cases and other hospitals that do not have pediatric radiologists," states Dr. Kuhn. ''Also, as storage capacity (of patient files) increases, we hope to use the system as a teaching tool for specific cases." Dr. Kuhn has established a working relationship with radiologist Barry F. Bates of Foote Memorial Hospital in Michigan. Dr. Bates was 24 instrumental in development of the Sendex system, and Foote was the first hospital to have the machinery installed. In addition to his work with Dr. Bates, Dr. Kuhn uses the system to review and store pediatric cases. The Sendex has the capacity to store 36 images per disc, but the possibility for a storage capacity of 2,000 images is projected in the near future. "There is a movement in radiology to become completely digital (computerized)," Dr. Kuhn says. The limiting factor, however, is storage. To be effective, storage capacity must be increased to several hundred thousand images per disc, which Dr. Kuhn estimates will not become a reality for at least five years. High hopes for diversifying the system's usage are held by Dr. Kuhn. He would eventually like to set up a �HOSPITAL NEWS network of X-ray transmtsston interdepartmentally within the hospital. Plans also include that of a portable take-home model for radiologists who are on-call. This unit would be convenient and timesaving for both the radiologist and the Hospital. Research on the system's effectiveness is vital. " We have to determine how well it works," Kuhn says. Indicators lean towards positive findings . When comparing the Sendex, which has a market value of $30,000, to other such systems with market values of up to $300,000, the cost seems minimal. As to its medical importance, Dr. Kuhn offers much encouragement. • (From Children's Hospital's "Bambino':) Children's names new president T he new president of The Children's Hospital of Buffalo is Mr. J.E . Stibbards, administrator of the Hospital for Sick Children of Toronto, Ontario, for the past three years. He joined Children's on November 1. Chosen after an extensive nationwide search , Mr. Stibbards brings with him 20 years experience in children's hospitals and the health care field . He has served as administrator of Children's Hospital Medical Center in Cincinnati and as executive director of The Children's Hospital in Birmingham, Alabama. As administrator of the Hospital for Sick Children in Toronto, he had responsibility for the overall management of the 698-bed facility, the largest children's hospital in North America. Mr. Stibbards has an extensive educational background in the area of hospital administration, having received his H.O.M. Diploma, a Canadian program for professional qualification in the field , from the Canadian Hospital Association. Presently, he is a Ph.D. doctoral candidate with a concentration in hospital administration , pursuing his Ph.D. through Walden University in Minneapolis. He is also a graduate chartered accountant. A member of the American College of Hospital Administrators, he has also served as trustee, officer, and member of many societies and organizations related to the pediatric Jerald P. Kuhn, M.D., using Sendex device. 25 health care field . These organizations include the National Association of Children's Hospitals and Related Institutions (NACHRI) and the American Hospital Association. He has also been active in each community in which he has lived, served in a number of voluntary advisory capacities with such organizations as the Boy Scouts of America, the Newcomen Society of North America, and the United Way. • Medical building named for Miller T he David K. Miller Medical Office Building was dedicated at the Erie County Medical Center on September 21. Dr. Miller, who is an outstanding clinician, scholar and teacher, is 80 and lives in San Francisco. He returned for the ceremony to Buffalo where he served UB and the E.J . Meyer Memorial Hospital as chairman and director of medicine and the laboratories for more than 30 years. In 1967, he asked to be relieved of his duties but remained active in medicine until his retirement a year later when he was named emeritus professor of medicine at the University. Also returning to Buffalo to honor Dr. Miller were 77 of his former medical residents, some from as far away as Hawaii and California. They were joined by colleagues and friends to celebrate Dr. Miller's 80th birthday. The celebration opened with a medical symposium with topics of special interest to Dr. Miller. Dr. Miller earned the M.D. from Harvard University in 1929. After completing an internship at Boston City Hospital, he studied in Germany and Austria and was associated with the Rockefeller Institute for Medical Research before coming to Buffalo in 1937. He did research on the role of vitamins in nutrition and treatment of bacterial infections such as pneumonia and tuberculosis before antibiotics were introduced. • ��T The 138th class: 82 men, 53 women he 138th freshman class at the School of Medicine includes more minorities than any previous year, and the second highest number of women and Western New Yorkers, according to the profile of the new class developed by the Medical Admissions Office. The class comprises 82 men and 53 women, including 22 minorities. The minority percentage is high enough to rank UB in the top category in a national survey of American medical schools (see accompanying article). The 135 students were selected out of a pool of 3100 applicants and 580 interviewees. Seventy-seven originate from Western New York, seven from the rest of upstate, 48 from downstate, and only three from out-of-state. Graduates from UB, Cornell, SUNY Albany, and Canisius College had the highest representation, with other prominent schools including Harvard, Penn, and MIT. Although biology, biochemistry and chemistry undergraduate majors dominated, some members of the class had less typical majors, including electrical and chemical engineering, biomathematics, religion, political science, history, computer science, and foreign language. Six of the new students have Ph.D.'s, one has an optometry degree, and 14 have master's degrees. This year's new class mean MCAT scores averaged 9 .48 for all six categories, compared to last year's average of 9 .56. The undergraduate science G.P.A . averaged 3 .37 compared to 3.47 for last year. The five M.D.-Ph.D. entering students had MCAT scores averaging 12. Photos of the Anatomy Lab, where freshman medical students begin their studies. 27 �STUDENTS School is 19th in minority frosh By Bruce S. Kershner M ore minority medical students are being trained to enter society as physicians, because of the success of the minority recruitment program of UB 's School of Medicine. The Medical School was ranked in the top category in minority admissions in a just released survey of the nation's medical schools by New Physician magazine. UB was ranked 19th out of 124 medical schools in percentage of freshmen minorities, just behind Harvard . This is the highest of any of the 12 medical schools in New York State and the fourth highest of any medical school in the Northeast . The 1983-1984 entering class was 15 .3 per cent minorities according to the magazine's 'i\.nnual Minority Admissions Scorecard," which used last year's class figures in its survey. The minority percentage in this year 's entering class is even higher, 16.3 per cent , including 17 Blacks, three Hispanics and two Native Americans. The success of the recruitment program is of benefit to Western New York . Over the past three years, 34 per cent of UB's Medical School minority graduates have elected to remain in Buffalo to complete their five-year-long residencies. Last year, 50 per cent of UB 's new physicians remained in Buffalo. ew doctors usually select residency programs in the communities where they ultimately plan to practice. UB President Steven Sample remarked , "We're very pleased with this accomplishment. It is indicative of how hard the Medical School has worked to include minority representation .'' Dr. Maggie Wright, the assistant dean for student affairs, heads the Medical School 's minority recruitment program . "I attribute our success to the fact that we have a reputation for being a very good program for minorities," Dr. Wright commented . S everal factors have made UB 's minority program successful. " One reason why we are attractive is that the at- MEDICAL SCHOOL 83184 21. Johns Hopkins 15.1 12.9 mosphere both at this University and in the community is personally warm and friendly. Through our hospitality program , upperclassmen open up their homes at no cost , provide transportation and conduct tours," remarks Dr. Thomas Guttuso, chairman of the School's admissions committee and clinical assistant professor of ophthalmology. Besides the minority presence in the school's Office of Medical Education , Dr. Wright points out that the admission committee's sensitivity to the concerns of prospective minority students has made a difference. So has the commitment of the school's administration . Dr. John Naughton, vice president for clinical affairs and dean of 28 the Medical School, states, " We've committed a significant amount of our resources to development of the program and we're glad that it is competitive. Furthermore, the faculty has worked long and hard to make the program stronger and more successful." Dr. Wright adds, " Incoming student candidates have had the opportunity to get a head start on the challenging curriculum through the Summer Preparatory and Support Program. For the past several years, this program has been largely funded by the Medical School and staffed by volunteers ." This will change this September when the program will be one of those funded by a S137,000 grant from the federal Department of Health and �STUDENTS getting accepted to other schools they've proved themselves." • Bissonette tours 3rd world clinics By Mary Beth Spina D ui 0 > <( 0 ~ r L-----------------------~~ Human Services. Dr. Wright and others personally meet with and interview every student candidate. Dr. Wright discusses the program and financial assistance and tries to allay any concerns. Scholarships are available based on undergraduate performance. " Furthermore, our minority brochure is a big 'seller' and is distributed nationwide," Dr. Wright relates. Dr. Guttuso emphasizes that the focus should be as much on the quality of the minority students as on the quantity. "In our reviews, we seek out quality students. The result is that the quality of our minority students is on a par with or even above that of our majority students. These students would have no problem r. Raymond P. Bissonette, associate professor in the Department of Family Medicine, toured health facilities in two African nations this fall under a World Health Organization Fellowship. Dr. Bissonette toured clinics and hospitals in Kenya and Tanzania to identify areas where UB medical students may, in the future, elect to receive some of their training in primary care. He spent one month each at Tumu Tumu Hospital in Karatina, Kenya, and the Maryknoll Clinic in Shinyanga, Tanzania . Also, he plans to visit more than a dozen remote health stations and satellite clinics sponsored by the hospitals. The idea of medical training in Third World nations evolved as a result of several UB students who, on their own , went to these areas in the past. " For most, it was a powerful experience for they learned the potentials and limits of delivering primary care without the sophisticated technology which is an integral part of their training in modern , urban U.S. medical centers," says Dr. Bissonette. It is believed that if students have the opportunity to practice in Third World communities, they will be less intimidated by prospects of future practices in underserved rural and urban areas of the U.S. "Students who have gone to these parts of the world in the past from UB have developed a greater degree of confidence in their own abilities and knowledge and have received a dramatic lesson in cultural variables which affect how different peoples perceive health and sickness," Dr. Bissonette points out. They have also learned in some parts of the world that the " medicine" man can, when teamed appropriately with the Western-trained clinician , play a major and essential role in providing health 29 Dr. Bissonettewitbmedicalstudents. care. In addition , students have learned that basic sanitation procedures and reasonable nutrition , standard in developed countries, may be needed in underdeveloped nations in order to prevent a range of diseases. The two-month program which Dr. Bissonette envisions for fourth-year medical students and residents who wish to participate would be a two-way education experience. • Starkey wins PMI award T he AMA Division of Drugs selected a patient medication instruction (PMI) sheet written and designed by third year medical student Kathryn Starkey for the Department of Pharmacology and Therapeutics PMI award last May. UB sophomore medical students are given examples of the American Medical Association's PMI's and then later in a course are challenged to write their own for a different drug as an elective exercise. After scoring by the faculty, the 10 best are sent to the AMA Division of Drugs for final judging. PMI's help physicians do a better job improving patients ' compliance with a prescribed regimen . Medical students learn to write PMI 's and thus improve their ability to communicate effectively with patients. Proper education of patients about drugs they are prescribed is known to improve the effectiveness of therapy, as well as reduce adverse drug reactions. • ��PEOPLE The 'Wright' stuff T his season was a very good one for Dr. Maggie S. Wright, the Medical School's assistant dean of student affairs, who is responsible for the Medical School's minority program. This summer, a national survey by New Physician magazine announced results that ranked the UB Medical School among the top in minority medical admissions (see separate article). This July, Dr. Wright received $137,696 to support 70 minority and disadvantaged UB medical students, including 22 freshmen minority medical students. The funds are the result of a grant from the Department of Health and Human Services (Division of Disadvantaged Assistance, Health Career Opportunity). The two-year contract will be used to support the Summer Preparatory and Support Program and Summer Microbiology Program, and will provide tutorial support throughout the academic years. In addition, a program will be designed to prepare students for Part I and Part II of the National Board Examination, a qualifying license examination. In addition to the grant and the good news about the minority ranking, Dr. Wright was one of 28 persons honored at the 12th Annual Black Achievers in Industry Awards dinner October 7. The dinner, held at the Downtown Buffalo Convention Center, was sponsored by 1490 Enterprises, a non-profit community organization. Regarding the grant, Dr. Wright commented, "This will enable us to expand our support services to the students, and retention of our students will be even more assured. The grant will fund three new programs, the microbiology, board preparation, and tutorial support programs." She pointed out that the summer preparatory program has been a big attraction for UB and that minority students have responded positively to the program's effects on their careers. Dr. Maggie Wright with students in Farber Hall office. 31 Dr. Wright, a native of South Carolina, received the B.S. from South Carolina State College. She received a master's degree in counselor education and a Ph.D. in counseling and educational psychology from UB. She has also taught counseling and educational psychology here. Recently elected co-chairman of the American Association of Medical Colleges' Minority Section on Student Affairs for Northeast Medical Schools, Dr. Wright is chairman of UB 's Equal Opportunity/Affirmative Action Committee. She is on the Board of Directors of the Crippled Children's Guild, the ACT-SO Committee of the Buffalo National Association for the Advancement of Colored People, and the Niagara Frontier Sickle Cell Associa- en 0 w w ...J () a: <( :::;; ~ L------~...L._ _ __;:;._.....___.a: tion board. She is a former board member .of the Bethel Head Start Program and the Child and Adolescent Psychiatric Clinic of University Presbyterian Church. Dr. Wright, who moved to Buffalo in 1961, has long been involved in activities affecting the Black community. Formerly with the Buffalo Urban League, she initiated programs for senior citizens, youth arts and crafts workshops, and a Girl Scout program in the Jefferson Ave./Clinton St. area. A member of the Buffalo Alumni Chapter of Delta Sigma Theta sorority, she is a former director of counseling services at Erie Community College. • �PEOPLE Lebenthal awarded nutrition prize T he 1984 International Prize for Modern Nutrition was awarded to Emanuel Lebenthal, M.D., a UB pediatrician. He was selected because of two decades of outstanding research that has led to practical solutions for improving the nutritional status of children worldwide. The professor of pediatrics at Buffalo Children's Hospital received the award on September 11 in Locarno, Switzerland. There, he addressed an international gathering on "The Next Decade: Research in Infant Nutrition." The International Prize carries with it a cash award as well as an inscribed gold medal. He was chosen out of 11 candidates. Dr. Lebenthal has gained a world-wide reputation for his research that has shed light on problems of the digestive system in infantile feeding. Lebenthal and his colleagues are responsible for developing new and sophisticated treatment methods that have given Children's Hospital and the UB Medical School one of the best records in the world for treating chronic intractable diarrhea. "This is a big surprise. There are so many other people who deserve recognition," Dr. Lebenthal remarked. Then he added, " It is very rewarding, especially after working hard for so many years, to find that there's somebody out there who notices your work." Last spring, Dr. Lebenthal was successful in fulfilling his life-time goal of establishing the International Center of Infant Nutrition and Gastro-intestinal Disease. The first center of its kind, it is funded by a $3 million grant from the Agency for International Development. The center will train physicians from developing countries around the world to develop programs to treat intractable diarrhea. One of the world's major killers of children, this previously little understood ailment kills five million children annually. Dr. Lebenthal is working to establish satellite centers in Indonesia, Peru, and Thailand. Lebenthal received his M.D. from Hebrew University in Jerusalem. After teaching and doing research at Harvard, Dr. Emanuel Lebenthal with tiny patient. Stanford and Tel Aviv universities, he came to UB in 1976. He is editor and co-author of the two definitive reference works on children's digestive diseases, " Digestive Diseases in Children" and "Gastroenterology and Nutrition in Infancy." He is also editorin-chief of the journal of Pediatric Gastroenterology and Nutrition and on the editorial board of two other journals. He has published over 100 scientific ar• ticles and chapters. Lazar tours orient for RPMI D r. Louis Lazar, clinical assistant professor of medicine and family medicine, recently concluded an extensive tour of the orient as part of a fact-finding mission in cooperation with Roswell Park Memorial Institute. The Millard Fillmore Hospital physician visited hospitals in Japan, Singapore, Hong Kong, and China, where he studied new screening techniques for the early 32 detection of cancers in a family practice setting. Dr. Lazar visited doctors in several cities to discuss cancer research and other medical problems encountered in the orient. He also lectured in China on vein valve transplant techniques. While in Tokyo, he discussed a new and marked increase in breast cancers, which in the past have been fairly unknown in that country. His next stop, in Singapore, was arranged to discuss the overall health care system there. "Their people are very well taken care of," he said. "There are enough M.D.'s and beds for everyone. Nobody goes without medical care in Singapore.'' Said Dr. Lazar of the Hong Kong leg of his travels, "I was impressed with their modern ·facilities and modern innovations in therapy for carcinoma patients." Most notable was the use of exact plaster molds for each cancer patient's affected area. The mold of the cancerous area in the patient is used to record all treatments and surgery on the patient. He said this is the only place in the world where such a technique is used. Finally, as guest speaker in Shanghai, �PEOPLE Dr. Lazar lectured on vein valve transplantation, a technique he and colleagues at Millard Fillmore Hospital have developed. He was also invited to discuss a paper on lung cancer in China, written by Chang-Wen Hsie, M.D. , chief of the Department of Public Diseases, and director, Chest Tumor Lab at the Shanghai Chest Hospital. • (From Millard Fillmore Hospital's "Reporter':) Blue Shield salutes Greco D r. Pasquale Greco, clinical associate professor of urology, was honored recently for his 25 years of service to Blue Shield of Western New York, Inc. , his leadership as the Blue Shield board chairman since 1977, and his many contributions to medicine and the community. A board certified urologist, Dr. Greco was honored at a testimonial dinner at the Hyatt Regency Hotel in Buffalo in June. Dr. Greco is chairman emeritus at Millard Fillmore Hospital's Department of Urology, following 30 years as chief of urology. He is past-president of the medical staff at Millard , where he developed and served as the first director of Millard's Dialysis Department. He is also past chief of urology at Sheehan Emergency Hospital and past chief of urology at Columbus Hospital. • family physician who still makes house calls. He has served as president or chairman of numerous organizations, including the N.Y. State Academy of Family Physicians, Erie County Medical Society, Medical Staff of Deaconess Hospital, The Lakes Area Regional Medical Program, and Highgate Medical Building Corp. On the UB Medical School's faculty for 13 years, he volunteered to be acting chairman of the Department of Family Medicine in 1982 . During the next 1 V2 years, he helped to upgrade the residency program and attract an outstanding chairman to continue the department 's traditions. He was appointed by Governor Rockefeller to the 1968-70 Blue Ribbon Commission on Alcoholism , a panel which played a major role in modernizing policy and attitudes towards alcoholism. At the awards ceremony, May 22 , Dr. Joyce said , "The secret to our future as family physicians lies in our unique Dr. Link retires ·from School 84 S Family Physicians honor Joyce T he first ew York State Family Physician of the Year Award was received this year by Dr. Herbert E. Joyce (M'45), professor of family medicine at UB. Dr. Joyce was selected for the honor by the Board of Directors of the New York State Academy of Family Physicians for his "long and illustrious career as a dedicated family physician." Active in leadership positions in the community and his profession since his earliest days, Dr. Joyce is a practicing potential for a personal and compassionate relationship with our patients this unique potential does not exist in any other medical specialty or profession. We must maintain an undisputed integrity in the view of our patients." Dr. Joyce has also served on the boards of directors of Blue Shield and the United Fund, and continues on the Board of Professional Medical Conduct of the N.Y. State Department of Health. He is affiliated with Buffalo General Hospital and its Deaconess Division, and with Millard Fillmore and Lockport Memorial hospitals. During his Air Force career, he reached the rank of Lieutenant Colonel and, interestingly, was enlisted into the Mach Buster Club in 1956, as one of the earliest physicians to fly faster than the speed of sound. • Dr. Herbert joyce tudents are the usual recipients of report cards. But last June 15 , a doctor received a report card from students of Buffalo School 84 in that school's cafeteria. The doctor was Dr. Joseph Link, medical director of this public school for handicapped children for 40 years. He is clinical instructor in pediatrics and rehabilitation medicine at UB. The children presented the report card, along with gifts from class representatives, because Dr. Link - friend and pediatrician - retired on July 1 at age 70. At School 84, 116 students - whose physical handicaps range from cerebral palsy to muscular dystrophy - learn while they receive continuing therapy and medical care necessary for their daily lives. Dr. Link has been involved in the care of handicapped children since college and medical school days at Marquette University in Milwaukee. In 1948 he was named physician-in-charge at School84 , on the Erie County Medical Center grounds. At a dinner on July 7 at the Buffalo Marriott, Dr. Link was honored for his dedication to handicapped children by colleagues, teachers, and former students. • �PEOPLE International and American Colleges of Surgeons and a past president of the Erie County Medical Society. • DR. ANTHONY J. FEDERICO, CLINICAL ASSIStant professor of surgery, has been elected chairman of the Erie County delegation of the Medical Society of the State of New York . He is on staff at Mercy Hospital. • DR. HARRY SULTZ, PROFESSOR OF SOCIAL and preventive medicine in the School of Medicine and dean of UB's School of Health Related Professions, is now a member-at-large on the board of directors of the Allied Health Association of New York State. The association hopes to improve the quality of health care offered in New York by improving its health manpower. Dr. Sultz, a well-known epidemiologist and author, has long been involved in health care. After graduating from UB 's School of Dentistry in 1947, he practiced dentistry until he matriculated into Columbia University, where he received his master's degree in public health in 1962 . He then joined the medical faculty at UB and accepted the duties of dean of the School of Health Related Professions in 1979. The Buffalo native, who co-authored Nurse Practitioners: USA and Grantwriting/or Health Professionals has acted as consultant to local, state and national health boards, including the Division of Nursing, Bureau of Health Manpower, United States Department of Health , Education and Welfare, from 1971 to 1978. • Cynthia Pan with Dr. Roger Forden. DR. CYNTHIA PAN, CLINICAL ASSISTANT INstructor, has been voted " Outstanding First Year Pediatric Resident " by the Buffalo Pediatric Society. Dr. Pan, now a second-year resident at The Children's Hospital of Buffalo, was presented with the award by Roger A. Forden, M.D., president of the society. • DR. MICHELE ALEXANDER, RESEARCH ASSIStant professor of medicine and pediatrics, was recently elected to the Board of Directors of the American Lung Association of Western ew York . Dr. Alexander, the former coordinator of the Lung Association's Family Asthma Program and a long time volunteer, will serve a threeyear term on the Board. • DR. JOSEPH H. KITE, PROFESSOR OF MICRObiology, discussed " Immune cytotoxicity in studies of autoimmune thyroiditis " and "Markers for detecting differentiation of cells " as part of a People to People International Tissue Culture Research Delegation to Europe, May 3-24 , 1984. Twenty-three scientists from the United States visited research laboratories in England , Sweden , Czechoslovakia, and Germany for an exchange of information and technique in the broad area of cell biology. • DR. EUGENE HANAVAN, CLINICAL ASSISTANT professor of orthopaedics at Mercy Hospital , was elected president of the American Fracture Association at a recent meeting held in Knoxville, TN. He is a benefactor of UB's President 's Associates. In addition , he is a member of both the 34 DRS. MICHAEL COHEN, ACTING CHAIRMAN and professor of neurosurgery and pediatrics, and Patricia Duffner, assistant professor of neurology and pediatrics, have co-authored a new book , Brain Tumors in Children: Principles of Diagnosis and Treatment (Raven Press, New York , 1984 , pp. 378). Most previous works on the subject have been devoted to childhood tumors with the focus on pathology, anecdotal case reports, and surgical techniques. This book focuses on modern approaches to diagnosis and therapy. In particular, it is intended to be a compendium on the state of the art of treatment and the problems associated with such treatments, rather than an encyclopedic work on all brain tumors. Six of the book's 20 chapters were written by physicians with expertise in the principles of epidemiology, radiation therapy, chemotherapy, and neurosurgery. Four of the contributors, Drs. Arnold Freeman , David Klein , Martin Brecher and Daniel Lacey, are professors at the UB Medical School. Dr. Alan Leviton of Harvard and Dr. Larry Kun of the Medical College of Wisconsin also contributed. The bulk of the volume deals with common childhood intracranial tumors and their diagnosis and treatment . Complications of treatment , especially the long term effects, are described separately, while trends in treatment and survival provide the concluding discussion. Dr. Cohen , a UB graduate (M '61) , has been on UB 's faculty for 16 years. He has served as medical director for the United Cerebral Palsy Association of Western New York and served as acting director of pediatric neurology at Children's Hospital from 1968 to 1978. Dr. Duffner, also a UB graduate (M '72) , earned academic awards in her junior and senior years. She completed her residency at UB (Children's Hospital) and has been on the faculty since 1972 . She serves on numerous committees of the University, Children's Hospital , the American Academy of Pediatrics, and the American Cancer Society and is an examiner for the American Board of Neurology and Psychiatry. • �PEOPLE DR. LEONARD LA SCOLEA, JR., ASSISTANT professor of pediatrics, attended the May 1984 European Symposium on Infections of Haemophilus influenzae at the University Hospital of Terrassa, Spain. He lectured on rapid diagnosis of influenza infections, as well as on Chlamydia infections before hospital groups in Barcelona. • DE. ELLIOT ELLIS, CHAIRMAN AND PROFESsor of pediatrics, attended the ational Meeting of Pediatric Allergists/Immunologists and the 12th Congresso Argentino de Pediatrie where he spoke on childhood asthma, its pathophysiology, and pharmacologic management . • DR. ELLIOTT MIDDLETON, PROFESSOR OF medicine, visited the People's Republic of China in May under the auspices of the Chinese Medical Association and the Citizen Ambassador Program of People to People International. The Buffalo General physician was part of an American delegation of allergists and im munologists who presented seminars on recent advances in allergy and asthma to Chinese physicians. • DR. ROGERS S. DAYER, CLINICAL ASSOCIATE professor at UB and general surgeon at Buffalo General Hospital, has been elected president of the Buffalo Surgical Society. Other officers are: vice president , Dr. William C. Heyden, clinical instructor of surgery; secretary, Dr. Joseph E. Rutecki, clinical assistant professor of anatomy and surgery ; and treasurer, Dr. Michael E. Sullivan, clinical instructor in surgery. • DR. ENRICO MIHICH, RESEARCH PROFESSOR of Pharmacology and director of the Experimental Therapeutics Department and the Grace Cancer Drug Center at Roswell Park Memorial Institute, has been appointed by President Ronald Reagan to a six-year term on the prestigious ational Cancer Advisory Board (NCAB). Dr. Mihich has been associated with Roswell Park since 1957. He was appointed director of his department and The Grace Cancer Drug Center in 1971. Dr. Mihich , who has published over 100 journal articles, edited 12 books, and presented over 60 papers at national and international cancer conferences, also serves as adjunct professor of biochemical pharmacology at UB. He is editor of the scholarly series Biological Responses in Cancer and Cancer Immunology and Immunotherapy. The NCAB, comprised of lay persons, and basic and clinical cancer research Dr. john Naughton (right) accepts gift of two microscopes from David Collins, area manager of Nikon Corp., and also a UB alumnus. specialists, is a legally constituted body that influences the National Cancer Program in two major ways. First, it performs the second phase of research grant application review and recommends approval or disapproval to the director of the ational Cancer Institute (NCI). Second, the NCAB advises the CI director on issues such as major shifts in program emphasis, budget allocations, and the desirability of initiating proposed programs. Through its several subcommittees, the NCAB studies and analyzes every major aspect of program operations as the basis for recommendations to the director on program content and priorities. • DR. GERALD SUFRIN, CHAIRMAN AND PROfessor of urology, has been appointed to the American Urological Association's special Ad-Hoc Committee to Study the Safety and Clinical Effectiveness of Current Technology of Percutaneous and Non-Invasive Lithotripsy. Moreover, he has been appointed to the Scientific Exhibits Committee of the American Urological Association. • DR. JULIAN AMBRUS, RESEARCH PROFESSOR of medicine, was recently elected vice president of the Catholic Physicians Guild, Buffalo Chapter. The society finances medical students so they can spend time at various missionary hospitals in Third World countries. The Guild also supports medical schools in these �PEOPLE Medical Center, has been involved in new developments in the field of plastic and reconstructive surgery. He and his associates performed what is believed to be the first microvascular free flap transfer in the Western N.Y. area. Since july, 1983 , he and his associates have done a total of six free flap transfers. • countries. For those who wish to prepare for an assignment in a tropical country, they offer a one-week intensive selection course in tropical medicine in the fall and also a similar spring semester course at • Roswell Park Memorial Institute. DR. STEVEN LASSER RECEIVED A $8,84 7 grant from the Orthopaedic Research and Education Foundation to conduct research on his project " Effect of Continuous Direct Current on a Bone Tumor Model in the Rabbit ." He is a first year resident with the department of Orthopaedic Surgery. • THE BUFFALO PEDIATRIC SOCIETY HAS ANnounced the election of its officers for 1984-85 . Elected for one year, all the officers are attending on the medical staff of The Children's Hospital of Buffalo. President is Dr. Roger A. Forden, clinical assistant professor; vice president is Dr. James L. Cavalieri, II, clinical assistant professor; secretary is Dr. Linda A. Kam, clinical assistant professor; and treasurer is Dr. Ferdinand D. Dr. Roger A. Forden Yates, all of UB 's Department of Pediatrics. • DR. KULWANT S. BHANGOO, CLINICAL ASSIStant professor of surgery at Erie County REQUEST FOR ARTICLES The Buffalo Physician requests that our readers submit any interesting, well-written articles that they have wr~tten on the followmg subjects: 1. • MEDICAL HISTORY, especially but not limited to the University. 2. • PROFILES of distinguished or interesting UB Medical School alumni , present or former UB Medical School faculty, or current UB medical students. 3. • IMPORTANT PHILOSOPHICAL, ETHICAL OR OTHER ISSUES directly relevant to the medical community. 4. • BOOK REVIEWS of important or interesting books written by or about UB faculty or alumni. Though books of a technical nature will be considered, especially if they are significant, reviews of non-technical books are encouraged also, e.g. biographies, fiction, non-fiction for the layman . 5. • HUMAN INTEREST STORIES about anybody with a UB Medical School association, present or former. ARTICLES SHOULD IDEALLY BE TWO TO TEN TYPEWRITTEN DOUBLE· SPACED PAGES. PHOTOGAPHS (IN A SETTING RELATED TO THE ARTICLE) AND ILLUSTRATIONS ARE ENCOURAGED. SUBMITTED MATERIAL SHOULD BE ABOUT PEOPLE AND TOPICS WITH SOME ASSOCIATION WITH THE UB MEDICAL SCHOOL. The exception will be for articles about important philosophical, ethical, or other medically relevant issues. Articles not fitting the above categories are unlikely to be considered. DR. SAUL GREENFIELD, ASSISTANT PROFESsor of urology, is that department 's newest arrival. He will be based at Children's Hospital. A University of Pennsylvania School of Medicine graduate, he received his training in urology at Columbia University and Presbyterian Hospital in New York City. He spent one year as a fellow in pediatric urology at Children's Hospital. His investigative interest includes vesico-ureteral reflux , the diagnosis and management of renal abnormalities in utero, and urinary tract infections in children. • GEORGEANN CONSTANTINO, R.N. , M.S., INstructor in the Department of Urology, was awarded first prize for her scientific contributions at the recent national meeting of the American Urological Association Allied. The subject of Ms. Constantino's exhibit was "Cost Effective Treatment of Urinary Incontinence in Nursing Home Patients. " She collaborated with Dr. Kevin Pranikoff, assistant professor of urology. She and Dr. Pranikoff completed a four-year study on a group of patients at Erie County Home and Infirmary to find a more cost-effective method to treat incontinence due to senile dementia. A similar paper was presented by Ms. Constantinio at the 35th annual meeting of the Northeast Section, American Urological Association , in September where she was the only non-physician among 100 who presented papers. • DR. PAUL WEINMANN, CLINICAL ASSISTANT professor of dermatology, entered his photograph "Study in Stripes" in the M.D. Photo Show held last spring at Sisters ' Hospital and won the People's Choice Award , selected by the attendees of the show. The award was announced at a later date than the other awards and did not get announced in the July Buffalo Physician article about the photo show. • �CLASSNOTES 1920's DR. HOBART A. REIMANN (M'21) • was recognized for his contribution to medicine when his article on viral pneumonia was reprinted as a " Landmark" article in ]AMA, February 17, 1984. He lives in Wynnwood, MD. DANTE J. MORGANA (M'21} • of Lockport , New York , has retired after 62 years of practicing ophthalmology. In 1982, Dr. Morgana was the recipient of the President's Medal from Canisius College. reports his son, Peter, was awarded the Dean's four-year scholarship to the University at Buffalo School of Medicine. Peter is a member of the class of 1988. cine and physician at Mercy Hospital, has been elected director of the Blue Cross of Western New York, Inc., as a representative of the Medical Society of the County of Erie. IRMA M. WALDO (M'49) • of Hillsdale, New York, is the founder of an all-volunteer County Hospice Program for home care for terminally ill patients in Columbia County. Dr. Waldo is school physician for two school districts and medical director of the Baptist Nursing Home and County Alcoholism Center. ANTHONY C. NOTO (M'59} • is director of laboratories at Bon Secours Hospital in Grosse Pointe, Michigan. Dr. Noto is an assistant clinical professor at Wayne State School of Medicine. 1960's DR. HARRY L. METCALF (M'60} • clinical associate professor of family medicine at Millard Fillmore Hospital, was a contributing author of the special report , " The 1984 Report of the joint National Committee on Detection , Evaluation , and Treatment of High Blood Pressure," published in the May edition of Archives of Internal Medicine. 1950's 1940's RICHARD J . JONES (M'43) • of Chicago, Illinois , writes , "January 1984 , I retired from the AMA staff, where I served as director of the Division of Science and Technology. Have since entered into full-time private practice of internal medicine and enjoying it immensely." RALPH T. BEHLING (M'43) • of San Mateo, California, writes, " Retired in 1983 . I made the 40th Class Reunion , it was great seeing the old gang. I keep busy dabbling in real estate and playing tennis." DR. ARTHUR]. SCHAEFER (M'47) • clinical associate professor of ophthalmology at Buffalo General Hospital, received the Lucien Howe Award for an outstanding paper on surgery ("Surgery of the Upper and Lower Eyelids for Involutional Changes" ) from the Medical Society of the State of New York at its recent annual joint convention with the New York State Ophthalmological Society in New York City. PAUL T. BUERGER (M'49) • JAMES A. CURTIN (M' 50) • is a governor of the American College of Physicians for the Washington , D.C. metro area. Dr. Curtin, a specialist in internal medicine and infectious diseases, is chairman of the Department of Medicine at Washington Hospital Center, and is a professor of medicine at George Washington University. DR. THOMAS M. FWOD (M'66) • has left Joslin Clinic in Boston, Ma., after 14 years. He is the new medical director of the Atlanta Hospital and Regional Diabetes Center in Atlanta, Ga. MYRA R. ZINKE (M'50) • writes, " Beginning July 1, 1984, I will serve as staff psychiatrist at the Sheppard and Enoch Pratt Hospital in Towson, Maryland, in Geriatric Psychiatry. I completed a residency in psychiatry at the University of Maryland june, 1983 . Took a year's sabbatical in which I traveled , wrote and studied." DR. MILFORD C. MAWNEY (M'53) • clinical professor of medi- 37 DR. ARTHUR W. MRUCZEK (M'73} • clinical ins tructor of ophthalmology, was elected president of the Medical Society of the County of Orleans, 1984-1986. MELVIN PRATTER (M'73) • of Paxton , Massachusetts, is an associate professor of medicine and director of the Pulmonary Function and Exercise Physiology Laboratory at the University of Massachusetts Medical School. Dr. Pratter was the recipient of the Pulmonary Academic Award from NIH . HOWARD R. GOLDSTEIN (M'74) • was elected to a fellowship in the American College of Surgeons at the October meeting in San Francisco. Dr. Goldstein has a practice in adult and pediatric urology and is a clinical assistant professor of surgery at Rutgers Medical School. 1970's DR. JOHN STEFANO (M'75) • operates a laser facility in Winchester, Md ., in association with a cataract operating room in cooperation with jefferson Memorial Hospital. He is applying modern techniques of medical lasers, artificial implant materials, and microsurgery. He is a member of the American Academy of Ophthalmology, the Outpatient Ophthalmic Surgery Society, and the American Medical Association . He is boardcertified by the American Board of Ophthalmology and is a fellow of the American College of Surgeons. ARETA KOWAirVERN (M'72) • is associate director of pediatric JEFFREY P. POWELL (M'75) • has completed five years of Naval military service as chief of ARNOLD N. LUBIN (M'62) • is a specialist in pediatrics at the USAF Regional Hospital in Eglin , Florida. DONALD P. PINKEL (M'51) • received the Albert Lasker Award and the University of Buffalo Award. Dr. Pinkel , who resides in Rydal , Pennsylvania, is a professor of pediatrics at Temple University. hematology-oncology at Lutheran General Hospital, Park Ridge, Illinois, and is a clinical assistant professor at the University of Illinois at Chicago. RICHARD B. NARINS (M'63) • received an award from the family medicine residents of the Deaconess Hospital at their graduation ceremonies for outstanding training in the ambulatory specialties (in dermatology), June, 1984 . �--- - ----~-~--- ~-- - CLASSNOTES ENT at the Naval Hospital, Camp LeJeune, North Carolina. He is now in private practice, Suite 303, Chesapeake Medical Building, 200 Medical Parkway, Chesapeake, Virginia 23320 . EUGENE H. HIRSH (M'75) • a specialist in gastroenterologyinternal medicine in Atlanta , Georgia, was elected a fellow of the American College of Physicians in 1984. His wife Frieda has started a company manufacturing decorative knee coverings for infants and toddlers. The Hirsch's have two sons, Josh , 6, and Ben, 2. JOHN CORBELLJ (M'75) • ad- dressed the American College of Physicians meeting held in Kings Island , Ohio, October 1984. Dr. Corbelli 's topic was "The Cleveland Clinic Experience in Percutaneous Transluminal Coronary Angioplasty." WILLIAM I. COHEN (M'75) • writes "after two years as assistant professor of pediatrics at the University of Pittsburgh , I entered the private practice of developmental and behavioral pediatrics and family therapy (May, 1982). Since 1979, I have been teaching workshops on clinical hypnosis in Pittsburgh , Baltimore, and other eastern cities under the auspices of the Sheppard & Enoch Pratt Hospital , Baltimore. Currently writing a book with Drs. Mark King and Charlie Citrenbaum on modern hypnosis for habit disorders. DR. EDWARD J. ROCKWOOD (M'80) • completed a residency in ophthalmology at Cleveland Clinic Foundation. He married Joann Agnello, a former Millard Fillmore Hospital secretary, and now works at Bascom Palmer Eye Institute in Miami , Fl. He just published "Combined Malignant Lymphoma of the Eye and CNS (Reticulum-Cell Sarcoma)" in ANGEW M. DEL BALSO (M'78) • an alumnus of the Schools of Medicine and Dentistry (DDS '72), recently gave a Continuing Education Program at the combined meeting of the American Academy of Oral Pathology and American Association of Oral Surgeons in Boston. His topic was ''Advances in Diagnostic Imaging of the Maxillofacial Structures." Dr. De!Balso is currently serving as a commander in the Navy at the Bethesda Naval Hospital in charge of Head and Neck Radiology. a specialist in orthopaedics in Portland, Maine writes, "Just returned from Fellowship in England and Switzerland following residency in Rochester; Meredith and three PHILIP S. ANSON (M'79) • journal of Neurosurgery, Dr. Milford Maloney '53 daughters doing fine ; let us know if you 're passing by." 1980's ANITA VIGORITO (M'80) • writes, "Back in Buffalo after a year in private practice and involved in residency training and seeing private patients through the Department of Family Medicine.'' ELLEN M. TEDALDI (M'80) • resides in Bronx, New York , and is a specialist in internal medicine at the Columbia Presbyterian Medical Center. DR. BARRY S. FELDMAN (M'81) • recently joined a practice of preventive family medicine in Niantic, Ct. He completed his residency in family practice at Brookhaven Memorial Hospital of SUNY Stony Brook and is on staff at Lawrence and Memorial Hospitals. He resides in Niantic with his wife, Cecile, and son , David. has finished residency training in internal medicine and is now a staff physician at the Army Hospital , Ft. Stewart, Georgia. DAVID WELDON (M'81) • DEBORAH SUE MALUMED-BARTON (M'81) • has a private practice in family medicine in Long Beach , California. of OB-GYN at the Yale, New Haven Hospital. RICHARD L. COLLINS (M'83) • nounces he has opened an office for the practice of ophthalmology at 1487 Colvin Boulevard in Kenmore, New York . Dr. Areta Kowal-Vern '72 August, 1984. RICHARD R. LUBELL (M'80) • is an associate in the Department JAMES F. TWIST (M'80) • an- DR. RUSSELL J. VAN COEVERING II (M'77) • clinical instructor in gyn-ob at Buffalo General and Children's Hospitals, Department of Obstetrics and Gynecology, was a member of the American Fertility Society Delegation that lecture-toured throughout the People's Re- gist. She was formerly chief resident in the Department of Pathology. She specializes in anatomic and clinical pathology. public of China. Among the hospitals visited were the Capitol Hospital in Beijing and the Shanghai First Medical College. Lecture topics included laporoscopy, endometriosis, adhesion prevention , and estrogen replacement in menopause. DR. MARY GEORGE (M'80) • has been appointed to the medical staff of Millard Fillmore Hospital as associate patholo- 38 has accepted the position of second year resident in internal medicine at the Tufts University School of Medicine Hospital System in Boston , Massachusetts. Dr. Collins hopes to return to his hometown after completing his training in Boston in order to establish a private practice in internal medicine in the area. �DEATHS Reinstein's legacy: a natural preserve A fluence on Cheektowaga's history. He earned his law degree from UB in 1922 so that he could deal in real estate. He bought large tracts of undeveloped land in Cheektowaga at a time when only he envisioned the urbanization of the then agricultural town. By the 1960's, he owned all but two of the parcels of land along the entire stretch of Como Park Blvd. He gradually sold off much of the land to developers but his estate still retains up to 500 acres of mostly commercial property, including the Como Mall land . After he had acquired a large portion of southern Cheektowaga, he foresaw the need for future through-roads. As a result, he is responsible for the early planning and location of Walden Avenue and Como Park Blvd., two of the metropolitan area's major roads. Dr. Reinstein's crusty exterior belied his behind-the-scenes generosity. Reinstein Woods Preserve is only his most recent contribution. He is considered to be Cheektowaga's biggest single benefactor in terms of donated land . In 1951, he donated S10,153 for the Dr. Anna M. Reinstein living legacy of twelve lily-padded lakes and a pristine landscape of ancient trees, trillium flower beds, and beaver houses. This is Dr. Victor Reinstein's final philanthropy. Dr. Reinstein, who had been UB's oldest surviving medical graduate (M' 16), died last May 27 at the age of 89 of kidney and heart failure. Described in a Buffalo News Magazine cover story in 1978 as " the single most influential person in Cheektowaga's history," Dr. Reinstein will be remembered for his many generous contributions to Cheektowaga, UB, and the State. A descendant of German and Ukrainian-Polish nobility, Dr. Reinstein was born in Buffalo in 1894. Early on, he acquired a love of the outdoors, which led him ultimately to acquire and develop the 252-acre Reinstein Woods Preserve, a biologically remarkable sanctuary that is now in the process of being transferred to the State of ew York as an educational and research preserve. Significantly, the idea of using it as a major research location by UB is under consideration. Dr. Reinstein's interest in land largely explains his great in- Mrs. J ulia R einstein a dm iring wildflowers a long th e sh ore of th e R einstein Woods P r eser ve's largest lak e. (Inset: the late D r. Victor Reinstein .) "'~ 0 z § I c.. 39 �- -- ------ -~- ----- DEATHS her B.A. and law degrees from UB, while his second wife Julia Boyer taught at UB 's History Department for two years. Julia, whom he married in 1942 , is today Cheektowaga's only Town Historian. She maintains his papers, her historical collection , and with the help of her children , the estate and preserve. Surviving are sons Victor Jr. , and Robert , both of whom attended UB; daughter Julia Anna , and two grandchildren. With his other love of engineering, Dr. Reinstein personally surveyed and directed the construction of the 7.5-mile paved road system on the preserve, as well as the dams and lakes. He acquired the preserve in the 1930s, much of it owned by only one other owner since the Indians lost it. The preserve contains a large tract of virgin beech , cherry, and maple, some with diameters of five feet and over 300 years old. One naturalist found beech trees with graffiti carved by early settlers dated 1854 and 1872. The forest lighting resembles a green cathedral and it is one of the largest old growth stands in the State. The lakes are pure enough to drink from . Beaver houses dot the shore, while muskrat, mink , raccoon , fox , and deer roam its shores and waters. Memorial Loan Scholarship Fund to UB to finance women medical students from the Western New York area. In 1960, he donated $100 ,000 to build Cheektowaga's primary library, named also after his mother, Anna Reinstein . He later donated another $100 ,000 to enlarge the library, as well as to house the Reinstein papers and historical library. At Elmira College, his wife's alma mater, he established the Julia Boyer Reinstein Local History Foundation , housed in that college's library. In 1978 , he donated 2 Yz acres to the Town of Cheektowaga to construct the Julia Boyer Reinstein Library on Losson Road. Although the structure has not yet been built , the library fund he donated totals over $100 ,000. He donated land in the 1960s and 1970s to create several Cheektowaga neighborhood parks, one of them Nakomis Park . When the N.Y. Central Railroad planned to sell its land , Dr. Reinstein donated $225 ,000 to the town to acquire it, making Stiglmeier Park the largest town-owned park in New York State. B ut it is his private nature preserve for which he was proudest. It is expected that by 1985 , the preserve will be in State hands and open to educational groups and researchers. Besides the great value of the 152-acre preserve, probably several million dollars, Reinstein set up a $250 ,000 operating fund for the State to use for the preserve's expenses. A member of the last UB medical graduating class (1916) that did not require a premedical degree, Dr. Reinstein practiced medicine with his mother, Dr. Anna Mogilova Reinstein , in her downtown office until 1948 when she died . He saw patients at his home until 1960 when he retired . His mother, a gynecologist , received her M.D. in 1891 in Switzerland. The rest of his family all had UB associations. His father Boris received his second Ph.D. from UB, while his sister Nadina earned her M.D. here. His first wife, Honorine, earned The whole setting is remarkable enough , let alone that the vestpocket wilderness is located in highly urbanized Cheektowaga. To this day, few of the town's residents realize it is there. The preserve's roads curve everywhere because the doctor didn't want to cut down any of the large trees. He was very protective of it , even confronting trespassers who shot at him. He was awarded the Sertoma International Annual Award in 1969 for his philanthropy and was recognized by Cheektowaga in 1964 and by the Cheektowaga Police Benevolent Association • in 1980 for his donations. A secluded turtle pond and great blue heron habitat in the center of the Reinstein Woods Preserve. 40 �CALENDAR THE FORT LAUDERDALE CO~FER­ ENCE ON PEDIATRICS • February 7-10, 1985, The Fort Lauderdale Marriott Hotel and .'\1arina, Fort Lauderdale, Fl. C.redit hours: 20. Fee: Physicians in Practice, 275 and Allied Health Professionals. 150. THE SARASOTA NATIONAL CONFERENCE ON PEDIATRIC LUNG DISEASES • March 15-17. 1985, Sarasota Hyatt House, Sarasota, Fl. Sponsored by: Continuing Medical Education and the Department of Pediatrics, UB, and the Department of Pediatrics, University of South Florida, College of Medicine, Tampa, Fl. Credit hours: 20. Fee: Physicians in Practice. 275 and Allied Health Professionals 150. For the above two conferences please contact: Rayna Saville, coordinator, Continuing Medical Education, Children's Hospital of Buffalo, 210 Bryant, Buffalo, NY 1-t222 . (collect) 716-878-7630. ARRHYTHMIAS FOR FAMILY PHYSICIANS & INTERNISTS • Februaf)- 18-20, 1985, Marriott Harbor Beach Resort Hotel, Fort Lauderdale, Fl. Sponsored by Buffalo General Hospital, SUNY Buffalo, St. Michael's Hospital, llniv. of Toronto. Contact: Cardiac Study Fund (716) 836-5172, 8-!5-2165, Box 114, Hiler Branch. Buffalo, Y 14223. • DEPARTMENT OF PSYCHIATRY CONTINUING EDUCATION PROGRAMS • jan. 4, 1985, Friday, 10:30 a.m. - "Polygraphy: Reliability and Validity, Use and Abuse." Edward Katkin, Ph.D., professor and chairman, Department of Psycho- logy, UB • jan. 11, Friday, 10:30 a.m. '1\.mbiguous Genitalia: Counseling the Patient and Family." Tom Mazur, Psy D., clinical assistant professor of psychiatry, Department of Psychiatry; director, Psychoendocrinology Department, Children's Hospital • jan. 18, Friday, 10:30 a.m. "Family Courts From a Child's Perspective." Paul Steinhauer, M.D., professor of psychiatry, University of Toronto, Toronto, Ontario • jan. 25, Friday, 10:30 a.m. - '1\. Description of the Pre-School Evaluation and Treatment Program at Children's Hospital." Bruce Bleichfeld, Ph. D., clinical assistant professor, Department of Psychiatry, UB; director, Therapeutic Pre-School & Evaluation Program, Children's Hospital. The above four programs will take place in Erie County Medical Center Amphitheatre, 3rd floor. • jan. 10, Thursday, 10:30 a.m. - "Recent Developments in Reseach on Schizotypy." :\1ichael Raul in, Ph. D., associate professor, Department of Psychology, UB, and Daniel Trigoboff, Ph.D., Psychology Service- Buffalo VA Medical Center, Rm. 110-I. • jan. 30. Wednesday, 9-10:15 a.m. "Current Trends in Psycho-educational Assessment of Children." Mitchell Parker, Ph.D., Psychiatric Center Auditorium. For further information on these two groups of programs, contact Dept. of Psychiatry Office of Continuing Education at (716) 895-2986, 462 Grider St., Buffalo, NY 14215. • ------------------------------------------------------------------- IIIIII NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES BUSINESS REPLY MAIL FIRST CLASS PERMIT NO. 2210 BUFFALO, N.Y. POSTAGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, New York 14214 �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO, NEW YORK 14214 -----------------------------------------------------------------LET US HEAR FROM YOU Fill out this card (Please print or type all entries) Year MD Received _ _ _ __ Name Office Address _______________________________________________________________________ Home Address _______________________________________________________________________ If not UB, MD received from -------------------------------------------------------------In Private Practice: Yes 0 In Academic Medicine: Yes No 0 0 No Specialty ----------------------------------------------0 Part Time 0 Full Time 0 School Title ___________________________________ . Other: Medical Society Memberships ___________________________________________________________ News: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.? Please send copies of any publications, research or other original work. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, December 1984 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1984-December Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1984-v18n04-Dec Table Of Contents A list of subunits of the resource. Yellow Fever China Takes a Giant Leap Against PKU Herbert Hauptman Research Medical School News Hospitals Students People Classnotes Deaths Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-08-15 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v18n04 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB0HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1984 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/a12bbdc9bf95503a7202214e0c1f67b3.pdf b32e3a6c3b4ab8adcad954ef43309ad8 PDF Text Text ��-·· --· I ~====------------ contents BUFFALO PHYSICIAN STAFF EXECUTIVE EDITOR, UNIVERSITY PUBLICATIONS Robert T. Marlett ART DIRECTOR Rebecca Bernstein UNIVERSITY MEDICAL EDITOR Bruce S. Kershner PHOTOGRAPHY Jim Sulley David S. Ottavio Ed Nowak ADVISORY BOARD Dr. John Naughton, Dean School of Medicine Dr. Harold Brody Dr. James Kanski Dr. James P. Nolan Dr. Charles Paganelli Dr. Peter Regan Mr. James N. Snyder Dr. Eugene Michael Sullivan Jr. Dr. Mary Voorhess Dr. Martin Wingate Dr. John Wright Dr. Maggie Wright Ms. Rita Wolff 3 HEART TRANSPLANT • Team of UB physicians performs Upstate New York's first heart transplant at the VA Medical Center. This first operation offers a new lease on life for a patient not expected to live more than two or three months with his diseased heart. 6 SOME THOUGHTS ON THE VALUE OF LIFE • UB Physiology Professor John A. Krasney contends physicians ought to be concerned about increased attacks on animal research being launched by antivivisectionists. 14 DR. BARNEY CLARK AND THE ARTIFICIAL HEART • His widow, Una Loy Clark, views the death of her husband as a beginning for the future of the artificial heart. Dr. Clark had no regrets, she says. 15 HIGH TECH IN CELL CLONING • UB will house one of five monoclonal centers in the nation. It will manufacture antibodies for use by up to 50 UB research projects and by dozens of institutional and commercial labs. 16 THE DEATH OF McKINLEY • Retjred UB pediatrician weighs the question of whether it was the gunman or the doctors who killed the President. 18 RESEARCH • Computers arrive in the neurophysiology lab. Food stamps may be an ineffective way of enhancing the nutritional status of the poor, UB epidemiologists contend. 20 MEDICAL SCHOOL NEWS • The Department of Nuclear Medicine, one of the School's newest units, has proved to be among the most versatile of departments. Students pick the year's best professors. 27 HOSPITAL NEWS • Roswell Park receives major grant from American Cancer Society. Mercy hospitals form Mercy Health System. Buffalo General 's allergy research lab named for Carl E. Arbesman. 28 PEOPLE • Doctor helped patient again - after 40 years. Several from UB on " best doctors" list. Clarence pediatrician introduces rides home program for teenagers who have had too much to drink. 35 ALUMNI • 1,008 graduates on roll of dues-paying alumni for 1984. New medical alumni officers. Class reunion pictures. 44 CLASSNOTES • George W. Thorn's research career spans 60 years. Country Physician Anne Wasson retires. News of the Classes. 48 DEATHS TEACHING HOSPITALS The Buffalo General Children's Deaconess Erie County Medical Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Charity Veterans Administration Medical Center Produced by the Division of Public Affairs, Harry R. Jackson, director, in association with the School of Medicine, State University of New York at Buffalo COVER ART: Close-up of heart transplant operation at VA Medical Center: Carol Payne Zagon THE BUFFALO PHYSICIAN, (USPS 551-860) September 1984- Volume 18, Number 3. Published five times annually: February, May, July, September, December- by the School of Medicine, State University of New York at Buffalo, 3435 Mam Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. POSTMASTER: Send address changes to THE BUFFALO PHYSICIAN, 139 Cary Hall, 3435 Main Street, Buffalo, New York 14214. BUFFALO PHYSICIAN • 1 �Heart transplant team performing heart transplant on Mr. Snedeker. �HEART TRANSPLANT Successful operation at VA Medical Center is first in upstate area H e was not expected to live more than two or three months with his diseased heart. But 31 days after Donald Snedeker received the first heart transplant in upstate New York, he walked out of Veterans Administration Medical Center to return home. The successful hour-long operation was performed by a team of UB physicians. Joginder Bhayana, M.D., associate professor of surgery and chief of cardiothoracic surgery at VA Medical Center, led the team. He was assisted by Janerio Aldridge, M.D., assistant professor of surgery and staff surgeon, and David Cheeran, M.D., resident thoracic surgeon. Jacob Bergsland, M.D., VAMC staff surgeon, David Bonnheim, M.D., clinical assistant instructor in surgery, and personnel from the Organ Procurement Agency of Western NY recovered the donated heart from Elmira, NY, and brought it to the operating room. Andrew Gage, M.D., professor and acting chairman of UB's Department of Surgery and the hospital's chief of staff, added that the team "included a host of nurses, technicians and social workers:' Dr. Gage played a role in BUFFALO PHYSICIAN • 3 �planning the operation, organizing the team and "gener~lly acting as a facilitator." He described the transplant as bemg "at the frontier of surgery." The operation was performed very smoothly. "There were no major difficulties;' Dr. Gage commented. "It was ac~ually relatively easy because of the long and careful preparatton of the team!' Dr. Bhayana, describing the successful surgery, remarked "Once the heart started beating, we were elated. , d, We knew we had a success on our han s. Joseph Paris director of Veterans Hospital, confirmed the transplant w;s the first in the state outside of New ~ork City. Of the more than 900 heart transplants performed smce the first one in South Africa in 1967, most have taken place in the U.S., especially in California. About 24 have been performed in ew York City. Veterans Hospital is one of only 15 centers in the U.S. to do heart transplants, and one of only two Veterans Administration hospitals to do so. UB and Veterans Hospital have shared a long history in pioneering advances in cardiology. William M. Cha~da~k, M.D., associate professor of surgery (and then Veterans chtef of surgery) and Dr. Gage implanted the world's first selfcontained cardiac pacemaker in 1960. (Dr. Wilson Greatbatch, a UB electrical engineering professor, invented the device.) After experimentation with heart transplants using dogs and sheep, Drs. Chardack and Gage became interested in the idea of human transplants at Veterans. "Then Christian Barnard did it in 1967, proving it possible;' Dr. Gage said. "But because of the short longevity of heart transplant patients at the time it fell out of use for almost ten years. Then improved tech~iques and drugs greatly improved success rates, especially with the discovery of cyclosporine two to three years ago. It was then that our interest in transplants in Buffalo returned." D r. Gage and Dr. John aughton, dean of the Medical School and a cardiologist himself, discussed the idea at length. As a result, the dean appointed a study committee composed of representatives from th~ sp~cialties and affili~ted hospitals. Their aim was to determme tf there was suffictent local expertise to perform heart transplants. "The committee concluded the faculty did have the skills;' Dr. Gage explained. "The experience was especially strong at the VA and the committee therefore thought that the transplant program should begip there." Besides Veterans Hospital's almost 30 years of experience and its active cardiac surgical and nursing programs, the hospital was chosen for another reason. The high cost ?f the operation and care, perhaps $65,000-$70,000, exclustve of surgeons' fees, meant that there would be no ready source of payment of those fees. But v~terans do not have to ~ay for their care because costs are ptcked up by the VA. Thts contributed to the decisi5n to choose Veterans Hospital. Six months before the operation, Dr. Bhayana and his associates began to develop their program with intense effort. After more animal laboratory work they devised a protocol to do the transplant. By the time the patient was identified, they were ready for the operation. . After spending 4 Y2 weeks at the Batavta, .Y., Veterans Hospital, Mr. Snedeker was transferred May 2 to Buffal?'s Veterans Hospital. He had requested a heart transplant m Batavia, but was told he was three years older than the cutoff age of 50. Although Buffalds VA Hospital prot?cols also sp~ci~.ed a maximum age of 50, Dr. Gage emphastzed that flextbthty · possible. "Mr. Snedeker appears to be a young 53-year-old IS . th e program,"D r. G age exand we therefore included h'1m m 4 • BUFFALO PHYSICIAN plained as he discussed the selection process. D r. Gage described the other criteria for selection. H e said that a candidate must be basically healthy in every other respect, without any life-limiting diseases outside the heart. ~h e program can admit only those with end-stage heart d tsease, and the li fe expectancy is three mon ths or less. Snedeker's name was entered as a potential recipient into a national computer program by the Organ Procurement Agency of Western ew York. Dr. Gage said that the team expected a heart donation within four to five days. On the night of May 13, the availability of a heart became known. Drs. Bergsland and Bonnheim, with staff from the Organ Procu rement Agency of Western ew York, flew to Elmira and harvested the heart of Alonzo Williams. Mr. Williams, 21-years-old, had died of an accidental head injury suffered during a fight. The heart was flown to Buffalo and three hours after it was obtained, it was beating in Mr. Snedeker's chest. The operation was completed at 7 a.m. on May 14. Dr. Bergsland explained that only about four hours is available to transplant a heart. Snedeker's recovery from the operation was entirely uneventful. It followed a graduated scale of activities leading to a return to normal function. The patient was on a regular low sodium diet three days after the transplant. A standard cardiac rehabilitation program was begun, including bed exercises with arm and leg movements. Regular weekly biopsies of the transplanted heart showed no signs of rejection because of the cyclosporine medication. On June 14, one month after Donald Snedeker's operation, he left the hospital on his own, accompanied by his family. Although cyclosporine makes "the tremendous difference" in the success rate in heart transplants, tissue rejection remains a continual hazard. Mr. Snedeker "will be on cyclosporine for the rest of his life;' Dr. Bergsland said. "He will have to wear a mask whenever he goes into a crowd to prevent infection;' Dr. Bhayana added. Mr. Snedeker's condition will be followed by surgeons and immunologists on an outpatient basis. the greatest danger. of infection is within the first 12 months. Dr. Bhayana explained that the survival rate over the next three to four years is 80 per cent. Mr. Snedeker is a Korean conflict avy veteran from Middleport, N.Y., northeast of Buffalo. His heart ailment originated from childhood rheumatic fever. In 1962, he had a heart valve replaced. After a heart attack in September 1983, his condition continually worsened. By the time he entered the hospital, he required oxygen and was unable to walk. Snedeker had his first chance to speak in public at a press conference the day before he left the hospital on June 14. He enjoyed the fact that he could give his mother such a surprise gift - his second chance at life - on Mother's Day, also her 72nd birthday. Obviously emotional and grateful, he put his hand on his chest, and turning to his wife, said, "I have a new heart now, and I'm going to give all of it to my beautiful wife!' When the retired oil company truck driver was asked if he felt g.lad about going home early, he stated loudly, "You're damn nght!" And what about the fact that he made medical history in Western ew York? "I don't care if I was first or second or fourth - all I know is that I have a new heart and I feel better;' he exclaimed. Snedeker plans to enjoy his family and to go fishing for years to come. Dr. Gage says that the hospital plans to perform their sec?nd. heart ~ransplant operation possibly by the time this a.rttcle ts pubhshed. In fact, "the hospital's goal is to perform stx to 10 heart transplant operations over the next year;' he �J The heart transplant team: Top row (l·r}: Dr. A. Gage, Dr. D. Cheeran, Dr. J. Bhayana, Dr. J. Aldridge; bottom row (1-r}: Drs. J. Bergsland, D. Bonnheim. Heart transplant patient, Donald Snedeker and his wife (left} and mother (upper right}. UPDATE: Slm:e the tlrst heart transplant on Mar 14, •teraM HOSIIItJI perfonnell a secemt operation on AuiUSt 1. That patient llletl Shertlr atrBf. llue tD lntJmlalllleefllng and hlllh blooll pressure In the lullfiS. DniiD Mr. SnefleiiBf, who was othet· wise telatlrelr heantJr. the seCDnll patient was CDnsllletefl an emer· 18m:r traiiSIIIant because tile deter· toratlon llf his CDnllmon was much more serious. nwas pointed out that the tlrst wear SIIYfval rare tor heart ttaiiSPfant patients Is 60 to 10 per cent. Dr. BIJarana, thOUgh 111sa111101ntefl, salll the transplant program would centlnue. W8elcs tatet. at II8SS time, Butfalo General Hospital became tile seCGnll to pertonn a heart Dall$lllallt. As wftll the - operations, the team was lellllr Dr. hOSIIItJI In tile regJon Bharana. stated with apparently well-founded optimism. Discussions are in progress between the two cosponsors of the transplant program - UB and VA Hospital - and three of the DB-affiliated hospitals, Children's, Buffalo General and Erie County Medical Center. The talks could open the program to non-veterans if "sharing agreements" with other local hospital could be arranged. Such a program would require the approval. of heart transplants for reimbursemen~ purposes by health msurance carriers. If this can be accomplished, a non-veteran transplant recipient could be admitted to an affiliate<;f hospital and, following approval of the transplant by the msurance company, would be transferred to Veterans. "After the transplant and follow-up intensive care, the patient, at a safe time, would be transferred back to the other ho pital," Dr. Gage said. Veterans Hospital would bill the other hospital which would, in turn, bill the patient's insurance company. Such agreements are already in place for certain ~edical tests and immunologic procedures. The local and natwnal Blue Cross and Blue Shield Association are evaluating the option. Regardless of what financial arrangements are worked out, Dr. Gage reiterated the crucial role that UB has had in the program and pointed out, "This is a prime example of ho~ the. Medical School, working with the hospitals, can achieve Important results." • BUFFALO PHYSICIAN • 5 �- Some thoughts on the value of life Physicians need to be concerned about increased attacks on ani mal research by anti-vivisectionists By John A. Krasney, Ph.D. Professor of Physiology State University of New York at Buffalo 6 • BUFFALO PHYSICIAN T remendous advances have been made in many areas of medicine over the last 20 to 30 years. In the treatment of cardiovascular diseases, for example, some 80 per cent of new knowledge and technology was simply not available to cardiologists 15 years ago 1. People who suffered from serious heart disease died or were hopelessly crippled with prolonged, painful disease. There have been dramatic, almost miraculous diagnostic and therapeutic advances which have marked the past 10 to 15 years of cardiovascular research. These allow for the prompt identification of the cause of debilitating chest pain, as well as its almost instantaneous surgical correction. Without this kind of research, hundreds of thousands of lives would have been lost. From this perspective, medical research is probably one of the best investments of time, energy, talent, and money that has been made with public funds. These dramatic life saving advances in knowledge resulted from the efforts of research scientists, including many physicians, who were not content to simply manage their patient's disease problems, as did their predecessors, but insisted on deeper understanding of the way the body functions. These scientists are high-minded individuals who forego the rich rewards of medical practice and pass their new insights readily on to their clinical colleagues. The majority of biomedical investigations use experimental animals. In fact, virtually every major biomedical advance can be traced back to original critical studies using animals. Indeed, the extension of the average life span from 45 years at the turn of the century to 70 plus years today is dependent in a major way upon animal studies. The value of animal research has been proved beyond any doubt. It is not the purpose of this article, however, to address animal research that is not clearly for biomedical benefits, such as military, cosmetic or behavioral studies. In spite of the crucial and absolute dependence of biomedical research on animal experimentation and the development of the marvelous payoffs from tlrls type of research, health research using animals is currently being attacked by various anti-research groups or antivivisectionists. These attacks have involved invasion of research laboratories, vandalism, theft of data and research animals, and malicious allegations of cruelty and inhumane treatment in the media. Recent television programs and newspaper articles have emphasized unusual instances of abuse, with the obvious intent to create the impression that they are the rule rather than the exception. These publicity-seeking groups have succeeded in introducing a large number of legislative bills at the state and federal level which are aimed variously at limiting the use of animals in research, outright abolition of animal experimentation, or re- quiring the use of non-animal "alternative" research methodologies. As a result of this anti-research movement, biomedical research is threatened seriously. Physicians should be concerned about this situation because of their utter dependence upon animal experimentation in research for the ability to offer their patients the very best in medicines and diagnostic and therapeutic skills. ! MEDICAL ADVANCES AND ANIMAL RESEARCH People are surprisingly unaware of the advances in health care that have come about totally through research using animals. The fear of the crippling effects of poliomyelitis has been eliminated; young people no longer die of rheumatic heart disease; infectious diseases are treated with antibiotics. The role of insulin in maintaining thousands of productive lives is taken for granted. The medical and socioeconomic triumphs represented by cardiac valve replacement, correction of congenitally misplaced vessels in infants, heart transplantation, and aortocoronary bypass are products of recent research.1 Drs. Julius Comroe and Robert Dripps 2 have traced the evolution of the thousands of experimental steps necessary before modern heart surgery could have been accomplished. Surgeons regularly reported that the single most important component was the dog laboratory. That is where surgeons had to test hypotheses and techniques and perfect their skills. Table 1 describes some of the discoveries that had to be made before modern open-heart surgery, the coronary bypass procedure, and the hearttransplant could be achieved. It is useful to highlight several of these examples. Obviously, the pump-oxygenator had to be developed to keep the patient alive while the heart was stopped. The pump oxygenator was developed with crucial dependence on animal-based experiments. But the pump-oxygenator could not be developed until a potent anti-coagulant was available to prevent clotting. John Gibbon did not begin his work on the pump oxygenator until 1934 when heparin, a powerful anticoagulant, became available from animal experiments by Jay McLean. Landsteiner's work using monkeys, which led to the discovery of blood groups, blood typing, and blood transfusions, contributed to safe blood use in pump oxygenators. More basic information was required before surgeons could open the chest, stop the heart, open the heart, perform the corrective surgery, restart the heart, and bring the patient to a full recovery. Physiologists learned through thousands of separate animal studies about the existence and function of the heart's conducting system. These studies led to the development of electrical defibrillation, and the ability to detect and reverse serious cardiac rhythm ........ �disturbances. Current techniques of cardiopulmonary resuscitation are based on animal experiments. Indeed, the cardiac pacemaker, which was developed at UB, depended upon dog experiments. The technique of cardiac catheterization was developed through both animal and human experimentation. The idea for the "floating" cardiac catheter, which is placed in the pulmonary artery routinely in patients in intensive care units, came from basic pulmonary experiments using dogs in Buffalo. The above discussion and Table 1, while not exhaustive, indicate clearly that the cardiac surgeon did not jump from ignorance to the pinnacle of open-heart surgery in a single, giant step, or in a brief period of time. Thousands of interrelated stepping-stones had to be laid over several decades. The marvels of modern cardiology, which directly or indirectly influence virtually every family in America are based totally and irrevocably on careful performance of critically controlled animal experiments. The recent performance of the first heart transplant operation in Buffalo (see article elsewhere in this issue) can be directly related to these primary animal studies. The payoffs resulting from animal research in other areas of medicine have been equally fantastic (Table 2). In the decades of the 1920's and 1930's patients were confined for life to mental institutions, treated with cold water baths, and subjected to prefrontal lobotomy procedures. Pharmacological studies in animals led to the development of chlorpromazine and its tranquilizing derivatives which revolutionized the treatment of mental patients and allowed many of these people to return to society. As mentioned above, the discovery of insulin by Banting and Best in Toronto by studying dogs is a classic modern medical miracle. The dramatic advances in immunological diagnosis and therapy have depended in a major way on animal studies. The continuing success of cancer chemotherapeutic procedures requires the careful analysis of the results of highly sophisticated animal experiments. Unfortunately, the medical and scientific community has not clearly and systematically articulated the numerous contributions to health based on animal research. Virtually every family in the United States has been touched by the life-saving contributions or enhancement in quality of life to be traced directly to this expenditure of tax money. Millions of human adult and child lives have been saved by this research. With respect to the value and benefits of biomedical research to mankind, there is an obvious lack of communication between medical scientists and the tax paying public. 1 Current ongoing scientific research projects at the University at Buffalo include the following studies: nervous control and regulation of coronary circulation (dogs); the peripheral circulatory response to chronic hypoxia (sheep); effects of chronic alcohol consumption on the brain structure of aging rats; periodontal or gum disease in animals; development of blood clot dissolving enzymes for treatment of coronary occlusion and thromboembolic strokes (monkeys); the prevention of cerebral malaria (monkeys, pigeons, and chickens); the The Heart Transplant and Other CarTable 1• dlologv Advances That Depended on Animal Research: A Chronology WORK INITIATED OR CULMINATED DURING Management of Heart Failure Asepsis Blood pressure, heart rate Fluid & electrolytes, acidbase balance Surgical instruments & materials Relief of Pain Wound healing dogs many species many species Early 1900's Electrocardiography Cardiac catheterization Components of blood & plasma Nutrition Surgical techniques dogs dogs, rabbits, cats monkeys, dogs, rabbits, rodents many species dogs 1920's: Intravenous feeding Ventilation of ooen thorax dogs, rabbits, rodents dogs Transfusion, blood groups & typing Monitoring EEG Modern anesthesia & neuro· muscular blocking agents Anticoagulants Pump oxyqenator many species many species rats, mice, rabbits dogs, monkeys cats cats, dogs 1940's: Antibiotics many species 1950's: Blood preservation Blood 02, C02, pH Chemotherapy Cardiac pacemaker Floating cardiac catheter Open heart surgery many many many dogs, dogs, dogs 1960's: Selective coronary angiegraphy, ventriculography Assessment of cardiac, pulmonary, renal , hepatic, brain function Hypothermia & survival of ischemic organs Defibrillation Coronary collateral circulation Coronary bypass Modern CPR Pre-1900: 1930's: 1970's: 1980's: Elective cardiac arrest Vascular anastamosis Principles of intensive care Measurement of coronary blood flow in humans Myocardial preservation techniques Beneficial effects of exercise on heart (cardiac rehabilitation) Heart transplant Cyclosporin & anti-rejection drugs Artificial heart dogs many species many species species species species developed at UB developed at UB dogs many species dogs dogs dogs, pigs, primates dogs doas dogs dogs dogs dogs, developed at UB dogs dogs doqs monkeys dogs, porpoise BUFf-ALO PHYSICIAN • 7 �"VIrtually every major biomedical advance can be traced back to original critical studies using animals." 11: II: 1: I! II prevention of blood vessel growth in tumors (rabbits); the development and teaching of microsurgical techniques used in replantation of body parts (hand, fingers) and the correction of vascular, eye, neurologic, gynecologic, and urologic disorders (various animals); nerve repair and regeneration (various animals); the role of prostaglandins in renal function and toxemia of pregnancy (rabbits); guinea pigs as sources of antibodies for immunological studies; mechanisms of cardiac arrhythmias (dogs); prevention of rotavirus infection which causes diarrhea in human babies (mice); prostaglandins and the nervous control of circulation (various animals); development of drugs to treat muscular dystrophy using chickens; toxicological studies (various animals) and the prevention and treatment of hyaline membrane disease in premature infants (sheep). These are but a few examples of the basic investigations being carried out at UB which require animal study. These research efforts provide for a sustained input of crucial, new information which will ultimately lead to improved human therapeutic technologies. Furthermore, studies of animals provide information which is now used to treat other animals. Veterinary medicine is dependent upon basic animal studies for the development of vaccines, drugs, surgical techniques and other technological developments to maintain the health of pets, livestock, and zoo animals. Direct benefits to the dog have resulted from the considerable research done on it. 3 Treatment of dogs with heart disease using cardiac pacemakers, and the same cardiac augmentor drugs and diuretics used to treat humans is common. Splinting systems for fractures were developed for the dog by veterinarians, such as Otto Stader of Philadelphia. Dr. Salojonas, a veterinarian in New Haven, Connecticut, also specialized in fractures and internal fixation procedures. Dr. Kirschner developed an intramedullary pin for the internal fixation of long bones. These techniques were quickly adapted by the military service during World War II, and after the advent of antibiotics, they were especially successful in saving countless lives and limbs of humans, as well as animals. Many of the skeletal prostheses, including the artificial hip, were developed using the dog and have been beneficial to the dog. Prosthetic devices for bone replacement, trachea replacement, and bone fusion have relied on the dog. Fusion of spinal vertebrae in chronic disk dtsease and surgery to provide relief of herniated disks have benefited both dogs and humans. 3 MEDICAL EDUCATION AND ANIMALS Animals are used in the medical school teaching laboratory. This is based upon the premise that medical students learn better by "imprinting" based on a laboratory experience than they can from reading a textbook. A student mistakenly cutting through an artery during a cut down on the vein of an anesthetized animal is usually reminded that it is better to make the mistake in the laboratory than when he first encounters a patient in the emergency room. The direct observation of the beating heart in a living, l: 8 • BUFFALO PHYSICIAN anesthetized animal conveys more information than could ever be supplied by any textbook or videotape. The "hands-on" measurement of the pressures of the heart and the intellectual synthesis of the phases of the cardiac cycle from first hand data are crucial for any medical student. The understanding and the direct appreciation of the rate, rhythm, force and motion of the beating heart are as important to the physician as the behavior and sound of a well-tuned engine are for an auto mechanic to recognize. Most physicians will have no further opportunity to make such direct observations as their careers develop. In addition, animal subjects are essential to instruct medical students, potential surgeons, and surgeons in basic and advanced surgical techniques and skills. Only the uninformed and naive would suppose that a surgeon could jump from reading a textbook to applying sophisticated surgical techniques to a patient without hours of preparation in the animal laboratory. The onset of anaphylactic shock in a patient who is allergic to penicillin, or to bee stings, for example, is life threatening and must be recognized immediately and treated promptly. The direct observation of anaphylaxis in an experimental animal, in an educational setting, is a most powerful technique for teaching the physician to manage this lethal emergency. This type of training cannot be obtained from a textbook, a computer model, or a culture of tissue cells. I i I I I ANIMAL CARE PRINCIPLES In terms of the care of experimental animals, there can be no legitimate objection to treatment of these valuable resources as sentient creatures using the highest humane standards. Anesthetics should be used for potentially painful procedures, and analgesics should be administered to alleviate potential discomfort. Clean, well-ventilated housing with comfortable enclosures is essential. Care must be supervised by experienced veterinarians trained in proper care oflaboratory animals. Daily care should be implemented by trained veterinary technologists and caretakers. The animals at UB are cared for according to the Guiding Principles of Animal Care (page 13), as promulgated by the American Physiological Society, and the NIH Guide for Care of Laboratory Animals (Institute of Laboratory Resources). The humane standards required by state regulations and the Federal Animal Welfare Act are adhered to as well. The Laboratory Animal Facilities are certified by the American Association for Accreditation of ~aboratory Animal Care (AAALAC), an accreditatiOn body formed by scientists which has higher standards than those required by the Animal We~fare Act. In addition, experimental protocols are revt~we?, and investigations are monitored by an Instltutwnal Animal Care Committee. This committee consists of a veterinarian, experienced laboratory ~nimal investigators, and non-scientist representatives who ensure that high standards of humane care are maintained on a local basis. Animals ~re killed at the end of experiments by euth~nasta techniques promulgated by the Vetermary Medical Association. Investigators must submit an application for use I I I I l �of animals in research or education to UB's Laboratory Animal Care Committee. Research proposals using animals are reviewed and discussed by the committee and, if necessary, the investigator may be asked to discuss this project with the committee before approval is granted. The committee makes periodic site visits to laboratories to observe experimental procedures and to monitor proficiency of laboratory personnel in carrying out humane animal experimentation. Protocols are updated by regular required report. UB's animal care committee has the authority to suspend operation of a laboratory whenever it has reason to believe humane standards of animal care have been violated. THE ANTI-VIVISECTIONIST OTIVATION Although antivivisectionists may be concerned about hunting and trapping of animals, the killing of harp seals, or the demise of endangered species, their major focus is to place biomedical research in jeopardy. According to the dictionary, vivisection has a specific definition: "the practice of subjecting living animals to cutting operations, especially in order to advance physiological and pathological knowledge." Common usage has expanded the term to include all experimentation, surgical or nonsurgical, on animals. Reaction against vivisection for research reached its height in the last two decades of the 19th century and the first two of the 20th, and a resurgence began in the 1960s. The Victorian era was marked by an abhorrence of biologic reality and of the physical self of humans, and vivisection seemed to emphasize these lower aspects of the human race. Antivivisectionism is, and was related, in part, to emphasis on humanitarian sentiments. Indeed, the 18th century saw the rise of the cult of the pet with its sentimental anthropomorphism. 4 This sentimentality continues into modern times. The motivation for antivivisection activities is based primarily upon a kind of Disneyish anthropomorphism, or the imparting of human characteristics to animal creatures. 5 The emphasis of these groups is that the end does not justify the means. In the last century, Dr. Arthur Conan Doyle objected to the antivivisection movement as being antihuman. In 1886, he justified the killing of rabbits to relieve human suffering from rabies. He and Dr. William Osler were but two of the many prominent physicians who helped stem the tide of the antivivisection legislation near the turn of the century. 4 In this regard the late John Dewey wrote: "The point at issue in the subjection of animal experimenters to special super:rision and leg:islati.on is (thus) deeper than at fi~st sight appea~s: m.pnnciple, it involves the revival of the ammoslty to discovery and to the application to life of the fruits of discovery which, upon the whole, has been the chief foe of human progress, it behooves every thoughtful indiv~dual to ?e C<;J~St~ntly on the al~rt against every revival of this spmt, m whatever guise it presents itself'6 There is a sentimental and personal nature to the antivivisectionist argument. The idea that a civilized society should be able to tolerate the in- creased numbers of human deaths which might result from reducing the number of animal experiments may not be shared by the families of children dying from disease. One wonders how many dogs these people would trade for the life of a transplant patient such as Gary Coleman or Donald Snedeker, or how many newborn lambs they would trade for the life of one prematurely born human infant. It follows that the anti-research movement is distinctly anti-human in nature involving misanthropy at least three levels. At one level, it may be perceived that to rule out animal experimentation is to condone human suffering. At another level, the antivivisectionist makes no distinction between human life and animal life. The philosopher Peter Singer wrote in Animal Liberation, a 1975 book which became the bible of the antivivisection movement, that "an experiment cannot be justifiable unless the experiment is so important that the use of a retarded human being would also be justifiable." In other words, this "speciesism" argument makes no distinction between the value of human life and that of animal life. Speciesism is the animal kingdom's equivalent to ethnocentricity. Ultimately, the misanthropy usually devolves to outright hatred and personal attack of the researcher 7 and even to physical threats. "If killing animals for science Is wrong, then It Is also wrong to eat them or to use medicines developed through animal research." INCONSISTENCIES IN THE ANTIVIVISECTION MOV T The antivivisectionists are entitled to their own views, but if they wish others to take them seriously, they must demonstrate that they take their arguments seriously themselves. If killing animals for science is wrong, it is also wrong to eat them. It is well to recognize that the number of animals killed for food in this country is vastly greater (134 million cattle, hogs and sheep annually) than the number of animals killed in research laboratories. In addition, the standards for the care and killing of livestock for food consumption are lower than those mandated for laboratory animals. If these people are sincerely concerned about animal welfare, they should focus their activities on the much larger numbers of abused and potentially suffering animals used by the food industry, rather than to expend one's energies on attacking accredited laboratories maintaining high standards for humane care. If killing animals for medical research is wrong, it is also wrong to have medicines which were developed through animal research. It is inconsistent for antivivisectionists to go to the doctor and accept m.odern. diagnosis and therapeutic medicine, most of It denved from animal research. Antivivisectionists are animal lovers and often keep pets. But cats and dogs, 90 million in the U.S., are carnivores and to maintain them we have to kill off. other ~nimals for their food. It is 'easy to block out this !act 1f th~ ~rey comes in a can. Clearly, the destructiOn. of mll!wns of cattle, fish, sheep, pigs, ~nd horses IS required to support the biological exIstence. o! these creatures which are pleasurable, entertammg, and loved. The standards for the care and killing of animals for pet food are probably even BUFFALO PHYSICIAN • 9 �Table 2. WHEN INITIATED OR CULMINATED Pre-1900: Early 1900's: 1920's: 1930's: 1940's: 1950's 1960's: 1970's: 1980's: Selected Examples of Major Biomedical Advances That Depended on Animal Research (Other Than Cardiology} MEDICAL ADVANCE SPECIES STUDIED Treatment of Treatment of Treatment of Treatment of Treatment of Treatment of Treatment of Discovery of rabies dogs, rabbits anthrax sheep beriberi chickens smallpox cows histamine shock dogs pellagra rhesus monkeys, dogs rickets dogs penicillin Therapeutic use established in 1939 Discovery of Thyroxin many species Insulin & control of diabetes dogs Therapeutic use of sulfa drugs mice, rabbits Prevention of tetanus many species Treatment of rheumatoid arthritis rabbits, monkeys Therapeutic use of aureomycin dogs, cats, pigs, rodents Therapeutic use of streptomycin chickens, guinea pigs Discovery of Rh factor rhesus monkeys Prevention of diphtheria horses Whooping Cough (Pertussis) treatment _guinea pigs, rabbits Prevention of poliomyelitis rabbits, monkeys, rodents Discovery of DNA rats, mice Chlorpromazine & its tranquilizing derivatives rats, rabbits, monkeys Hypertension oral diuretics (thiazides) dogs, other species Cancer chemotherapy monkeys, rabbits, rodents Prevention of rubella monkeys Radioimmunoassay many species Prevention of surgical postoperative adhesions dogs Therapeutic use of cortisone rabbits, monkeys Corneal transplant rabbits, monkeys Cimetidine (tagamet) rabbits, rats, other treatment of gastric ulcer species many species Prevention of measles Modern treatment of coronary insufficiency dogs Viral origin of cancer dogs Treatment of leprosy monkeys, armadillos Immunotherapy technology many species Cerebral revascularization monkeys procedures Monoclonal antibodies mice, rabbits lower than those for animals raised for human consumption. The antivivisectionists are silent on these issues. As the final extension of the antivivisection position, it should be emphasized that as veterinary medicine depends upon animal research, these people ought not to take their pets to the veterinarian. 10 • BUFFALO PHYSICIAN These groups label themselves "pet-lovers:' Unfortunately, it is the irresponsibility of pet owners which leaves thousands of animals to undergo euthanasia in pounds each year. If the animals were cared for properly, they would not be running loose and starving on the streets. While responsible researchers are required to have an animal care committee, it seems curious that the antivivisectionists have put no priority into enforcement or pet care programs that would reduce the trementous number of animals abandoned by irresponsible owners. There is one more example of inconsistency in this movement. The focus of the anti vivisectionists is mainly on cats, dogs, rabbits and monkeys. There seems to be less concern about farm animals, or about rats, mice and other rodents which comprise 87 per cent of all experiments (by their own figures). The sentimentalism is selective. ANTIVIVISECTIONIST MYTHS In order to support their position, antivivisection groups have developed and disseminated a number of myths about animal experimentation. It is remarkable how tenuous and weak the anti-research viewpoint is when one considers that they support their arguments on the basis of these myths. Myth: Animal experimentation is cruel and animal housing Is stressful. Animal experimentation is described as being cruel by anti-research groups. Indeed, there is a peculiar tendency among some people to consider animal cruelty to be a far more serious offense than is cruelty to other humans. While pain is a prominent feature of human disease and it must be studied and understood, painful experiments are the exception in medical research rather than the rule. Painful experiments are extremely difficult to justify and generally are unacceptable. It is a basic principle that valid data cannot be obtained from sick or mistreated animals, or animals in pain. An exception would be in those rare cases where pain is part of the experiment. The antivivisectionist, however, complains that even to keep animals in cages is mistreatment and produces stress. The animals have to be kept someplace, however, and there is no scientific proof that well fed and watered animals maintained in quarters of the size prescribed by the Animal Welfare Act and AAALAC are stressed. Levels of stress indicators, such as plasma cortisol or catecholamines, are generally low in animals maintained in accredited housing. It would be foolish to deny that abuses and instances of animal cruelty occur in scientific research, but these are the exceptions rather than the rule. If_ a policeman goes bad, one does not ordinarily ehmmate the entire police force or attempt to hamper it in its work. Laboratories or investigators engagzng zn cruel practices should be prosecuted under existing anticruelty laws. In 1983 the National Institutes of Health made random site visits to ten institutions that were not AAALAC accredited but operate under approved ass~rances indicating full compliance with the NIH Gu1de. The conclusions from these visits were that �all the institutions shared a common concern that the care and use of laboratory animals must be in accord with good science and that the welfare of the animals was a priority. No incidents of animal abuse were observed. Myth: Animal experimentation is unnecessarily repetitive. Antivivisectionists charge that there is needless replication of animal experiments. While there is a need to confirm the results of investigations in other independent laboratories, research funds are not awarded to needlessly repeat experiments and to confirm established knowledge. Study sections which review grant proposals are composed of experts in various fields who are thoroughly familiar with current literature and they do not support proposals which repeat known experiments. Certainly, with the high cost of animals and the limited supply of research funds, researchers do not study animals unless it is absolutely necessary. Myth: Animals differ from man, so animal experiments are useless. This is clearly not the case as the results from animal models such as the armadillo model of leprosy, or the spontaneously hypertensive rat have led to major therapeutic advances. In most cases, the results of animal research are directly applicable to man. The differences that do exist have proved to be of trivial import, as attested by the documented dependence of the training of surgeons on animal studies. In fact, surgeons have been able to exploit some of the differences between man and dog. For example, the practice of keeping surgical patients in bed for lengthy periods of time led to numerous adhesions in abdominal organs in early surgical procedures up until the 1920s. Then one surgeon noticed that dogs got up and walked around as soon as they recovered from the anesthetic. Today, the technique of getting human patients up to move around the day after surgery to dramatically reduce adhesions has become a modern standard practice. 3 In any case, the argument that animals are different from man is usually not applied consistently by antivivisectionists since Singer's speciesism argument says we shouldn't consider animals as being different from man. Myth: The DES and thalidomide tragedies demonstrate animal research is unreliable. The anti-research groups are currently focusing their attention upon the number of animals required for toxicity testing. They complain that the large numbers of animals required for the LD-50 test are unnecessary and further, that the LD-50 test has been shown to be unreliable, citing the damage caused by DES and thalidomide. Unfortunately, while isolated cells may be useful for certain types of toxicity testing, the current alternatives to toxicity testing in animals are generally not clearly reliable. . . The emphasis on the thal1dom1de tragedy or the DES problems represents the usual illogical tactic of focusing on the exception, rather than the rule. The thalidomide episode emphasizes a need for more rigorous animal testing in certain instances, not less. Myth: Alternatives to animal studies are available. Animal experiments are further supposed to be unnecessary because "alternatives" to animal studies exist in the form of tissue culture, computer models, and the proper application of statistics. These, in fact, are not alternatives to animal studies, but are only adjunctive tools to research. The implication that a computer model can replace the study of the living heart or brain is misleading. Computer models are used to organize the data obtained from animal experiments in order to synthesize and aid thinking about how biological processes work. A model is only as good as the animal data put into it, and the validity of the model must be tested by comparing its predictions with the results obtained from further.animal experiments. These adjunctive tools were developed as aids to research by scientists who use animals. Reseachers have used these techniques in recent years to reduce the number of animals used in research, but they cannot serve as substitutes for the study of the experimental animal. "One wonders how many dogs these people would trade for the life of a transplant patient such as Gary Coleman." WHAT WILL HAPPEN IF THE ANTIVIVISECTIONIST$ SUCCEED? The public has come to expect a great deal from biomedical research in recent years and this discussion has attempted to demonstrate the marvelous strides and advances which have been derived from free scientific inquiry and a vigorous research enterprise. If the current antivivisection movement is allowed to continue to go unchallenged, animal research will be restricted seriously, or prevented, and the steady advance of medical science would cease. All hope of cures for cancer would be lost. New antibiotics capable of combating strains of microorganisms which develop immunity to existing antibiotics would no longer be available. Heart disease, stroke, and kidney disease would continue to ravage the population in epidemic proportions with no hope of eliminating the scourge of atherosclerosis. Research on neurological or neuromuscular diseases such as multiple sclerosis or muscular dystrophy would cease. Production of insulin and vaccines against polio, smallpox and other infectious diseases would be eliminated. In short, few new drugs, therapeutic techniques, or surgical advances would be forthcoming. The attempts by these groups to interfere with health research in this country represent an awesome responsibility and the antivivisectionists should be made to bear all the consequences of their actions. A classic example of antivivisectionist interference with science is the situation in Britain :Which. has led to the emigration of many brilliant mvesttgators to North America and elsewhere ?ecause of the restrictions to free scientific inquiry m that country. . What t~e ~merican .biomedical community has ~ned _to .av~td IS ~he settmg up of a system like that m Bntam, 1~ whtch eve:y scientist who proposes to conduct ammal expenmentation must obtain a licen.se from .the central government and must also obtam offi~1al approval for any particular experiments mvolvmg anything but the most inBUFFALO PHYSICIAN • 11 �"The final judgment of the basis for animal research must consider the value of life, especially human lite." 12 • BUFFALO PHYSICIAN nocuous procedures. As a result, the late Lord Adrian said: "When there is some doubt whether a particular kind of research or class experiment needs special certificates, etc. my own tendency has been to give up the idea and stick to what I know to be allowable. We certainly have been a good deal behind other countries in work on the central nervous system in the last 30 years. State regulation (of science) based on an act which dates from the last century has made us rather "unenterprising:•s It is useful at this point to consider the accomplishments thus far of the current antivivisectionist movement: In New York, the Metcalf-Hatch Act was repealed several years ago. This law had been in effect for more than 25 years and it required that community pounds give up their unclaimed animals, cats and dogs, to research institutions. This was judged to be a public service as it provided funds for operation of the pounds and reduced the number of animals required to be euthanized by the pound. It is currently estimated that about 20,000 dogs run loose on the streets of Buffalo. The Metcalf-Hatch Act had been passed to keep down the cost of animals for research and to reduce the incentive for pet-napping. When the Metcalf-Hatch Law was in effect dogs and cats for research could be obtained at a cost of $20 to $30 each. Now, after repeal, research grants (and the public which supports these research funds) must pay on the order of $200 per animal and the incentive for petnapping has returned. Thanks to the efforts of this vocal minority of anti-research people, we find ourselves in the bizarre situation where 10,000 or more cats and dogs are routinely killed in pounds in Erie County, while $200 or more per animal must be paid to federallylicensed vendors to bring unclaimed pound animals in from other states for research purposes. In Massachusetts, anti-research groups had the pound law repealed with an addendum prohibiting the transport of dogs and cats into the state for research purposes. Now the Massachusetts medical schools are forming facilities for the breeding of dogs and cats for research purposes. As a result, thousands of animals are being euthanized in pounds with no benefit to society whatever, while now a separate population of research animals is being bred at a great cost and then also euthanized. It is of interest that, over the past 80 years, no scientist has been convicted of animal cruelty. A temporary exception was Dr. Edward Taub, whose Maryland laboratory was invaded by police after a srttged antivivisectionist raid, and was initially convicted of animal cruelty by a Maryland court, but all of the convictions were subsequently overruled on the grounds that Maryland anti-cruelty laws did not apply to federally funded laboratories. Dr. Taub's studies involved limb use behavior in monkeys on which the sensory nerves to the arms had been cut. Since the monkeys had no sensation in their limbs, and therefore experienced no pain (a fact which antivivisectionists conveniently ignore), the monkeys tend to chew on their fingers . The techniques developed by Dr. Taub for the care of these monkeys and the limb movement studies have important relevance to rehabilitation of stroke patients. In all this furor and publicity, his monkeys were turned over to the NIH and his grant was suspended. Interestingly, NIH had to rely on Dr. Taub's expertise to take care of his monkeys. Current measures are being taken to reinstate Dr. Taub's research funds. NIH concluded recently that Dr. Taub did not mistreat his monkeys. While pound laws have been repealed in several other New England states, it is worthwhile noting that antivivisectionist attempts to repeal the pound law in California have been prevented thus far because the medical schools in that state have mounted a vigorous and sustained opposition campaign with the formation of the California Association for Biomedical Research. Similar well organized efforts by area medical schools have prevented attempts to repeal the pound law in Chicago, as well. THE MEDICAL COMMUNITY NEEDS TO SPEAK OUT The biomedical research community must begin a strong effort to communicate the methods and the basis of scientific discovery to the lay public. The current irrational attacks on science by antivivisectionists must be countered by rational arguments and descriptions of the payoffs from biomedical research must be supplied by both investigators and patients benefiting from such studies. These issues must be addressed both in the media, and to state and federal legislators. In addition, physicians must begin to play a stronger role in educating their patients as to the basis of the medical advances which doctors are using in current practice both to maintain and restore health. Up to now, the attitude of all but a few physicians has been to rely on others to defend the basis of the therapies they use on a daily basis. In fact, a few irresponsible physicians have actually agreed publicly with the antivivisectionists. It would seem that it is high time for the medical community and physician organizations to begin pulling themselves together in an organized way to combat this serious threat. Concerned physicians and allied health professionals can respond to antivivisectionist activities by writing letters to the newspapers and magazines, and especially to their sta~e and federal legislators. An organized political action movement, such as that carried out in California, has been proven to yield positive results. Those physicians who are concerned about whether coming out in public defense of animal research will influence their practice and turn some patients away c.an work in more unobtrusive ways by contributing time. and money to organizations which defend medt.cal research, such as the National Society for Medtcal Research. Local research defense societies can be formed. PLAUSIBLE SOLUTIONS The view of the Federation of American Societies for Experimental Biology is that most of the goals of. current proposed federal legislation coul.d be achteved by increasing the funding for the Agnculture a.n d Plant Health Inspection Service (APHIS), whtch enforces the Animal Welfare Act. �Unfortunately, the Reagan administration is intent at present on withdrawing much of the current level of funding for APHIS. At the federal level, several bills have been introduced into Congress that offer restrictions on animal experimentation. Senator Dole has introduced ~ Bill (S567) (with a simi~~r bill in the House) which strengthens the provlSlons of the Animal Welfare Act and requires the formation of institutional animal care committees. The American Physiological Society has recently endorsed the Dole Bill. The Society supports the concept of an institutional animal care committee which would review research proposals from the s~andpoint of humane care. In addition, the operatiOn of an existing agency already legislated as the Animal Welfare Act would be strengthened. It is the society's belief that the Dole legislation will meet the concerns of many of the animal rights groups with~mt serious ~nterfe~ence with t~e scientific process Itself. The biOmedical commumty must realize, however, that no amount of legislation will ever satisfy a significant number of antivivisectionists. In these groups, their only goal is to end all use of animals for research. In summary, the final judgment of the basis for animal experimentation must consider the value of life, in particular, human life. The assumption is that it is acceptable to experiment on lower animals to achieve human good. While Albert Schweitzer had reverence for all life, he specifically stated he approved of animal experimentation if carried out humanely. To quote the British dermatologist Shuster: "Modern knowledge and technology are too complex to be powered by an outdated ethic, a blinkered understanding, and a wet sentimentality:•s • BIBLIOGRAPHY 1. Randall, W.C. Is medical research in Jeopardy? The Physiologist 26:73-77, 1983. 2. Comroe, J.H. Jr. and Robert D. Dripps. Ben Franklin and Open Heart Sur· gery. Circulation Research 35:661·669, 1974. Gay, W.l. Health Benefits of Animal Research, The Dog as a Research Sub· ject. Physiologist 27:133-141, 1984. 4. Key, J.D. and A. E. Rodin. William Osier and Arthur Conan Doyle versus the antivivisectionists: some lessons from history for today. Mayo Clin1c Proc. a. 189·196, 1984. 5. Shuster, S. Why we need ammal research. Research Defense Society Lecture given at Royal Society, London, October 24, 1977. I. T. Noah, Monkey Business. The New Republic, June 2, pp. 20-23, 1982. 7. Visscher, M.B. Animal rights and alternative methods: two new twists 1n the antivivisection movement. The pharos of alpha omega alpha 42: 11-19, 1979. Guiding Principles in the Care and Use of Animals Approved by th e Council of The American Physiological Society A nimal experiments are to be undertaken only with the purpose of advancing knowledge. Consideration should be given to the appropriat~ness of experimental procedures, species of ammals used, and number of animals required. O_nly animals that are lawfully acquired shall be used 10 the laboratory, and their retention and use shall be in every case in compliance with federal, state and local laws and regulations, and in accordance with the IH Guide. Animals in the laboratory must receive every consideration for their con:fort; they must be properly _housed, fe_d; and their surroundings kept in a samtary condition. Appropriate anesthetics must be used to eliminate sensibility to pain during all surgical procedures. Where recovery from anesthesia is ne_c~ss~ ry du:ing the study, acceptable technique to mmimize pam must be followed. Muscle relaxants or paralytics are not anesthetics and they should not be used alone fo~ surgi~al r~straint. They may be used for surgery 10 conJunctiOn with drugs known to produce adequate analgesia. Where use of anesthetics would negate the results of the experiment such procedures should be carried out in strict ac~ordance with the NIH Guide. If the study requires the death of the animal, the animal must be killed in a humane manner at the conclusion of the observations. The postoperative care of animals shall be such as to minimi_ze discomfort and pain, and in any case shall be equivalent to accepted practices in schools of veterinary medicine. W~en animals are used by students for their educatiOn or the advancement of science, such work s~all be under the direct supervision of an expernenced teacher or investigator. The rules for the care of such animals must be the same as for animals used for research. • BUFFALO PHYSICIAN • 13 �Dr. Barney Clark and the artificial heart He was committed to experimentation , his widow said ''G od's most precious gift to us is life, and the second most precious is intelligence. We believe that we were given intelligence to progress. We believe that in gratitude to God we should prolong life as long as possible;' said Una Loy Clark, national spokeswoman for the American Heart Association. The widow of Dr. Barney Clark, the recipient of history's first artificial heart, Mrs. Clark spoke in the Buffalo Convention Center on April 25, at a conference on the "Quality of Life." Until the onslaught of heart disea e, Mrs. Clark explained, her husband was a very healthy man. He had retired from his Seattle dental practice two years previously and was enjoying his leisure. In 1979, he began feeling extreme fatigue and pain which was diagnosed as emphysema. A short time later, he was diagnosed with cardiomyopathy, a degenerative and usually fatal heart mu cle disease. Cardiomyopathy, a condition in which the heart muscle becomes flabby and unable to pump blood, is uncorrectable by exercise or surgery. Dr. Clark was forced to rely on medications, drugs which often had harmful side effects. The 59-year-old Clark's quest for a cure led him to the University of Utah Medical Center in October 1982 to investigate the option of an artificial heart. Dr. and Mrs. Clark discussed the procedure with Dr. William DeVries, head surgeon of the artificial heart team, and a member of the Utah American Heart Association Research Committee. Although the artificial heart had never been attempted in a human body, it had been implanted experimentally in cows and sheep, and the Clarks watched these animals move about in the barns. By Mary Kunz Through the difficult days that followed, Dr. Clark was troubled with nosebleeds, lung problems, and seizures, due to the new heart which was pumping more blood than had the inefficient old one. Mrs. Clark remembered, though, that there were also good days, as when Dr. Clark enjoyed trips to the shower, the X-ray lab, and once, as a surprise, to Dr. DeVries' office. Dr. Clark. she said, never complained. Although the artificial heart functioned properly, and the implantation wa considered successful, Dr. Clark experienced swings in his condition and other complications over the next few months. On March 23, 1983, almost four months after he had received the mechanical heart, he died. Mrs. Clark views the death of her husband, despite its U pon discovering that DeVrie was looking for a suitable human volunteer, the Clarks began considering the possibility. "I knew this was a way of telling us that we had run out of options," Mrs. Clark recalled. Dr. Clark remained calm and cheerful, and his wife says, "I began to realize the true stature of the man I had married 39 years before." The artificial heart team was looking for a volunteer who would fit certain criteria. He should be near death, Mrs. Clark wa told, and capable of handling stress. He had to be willing to live in Salt Lake City for the rest of his life, have the consent of family and wife, and ign a bleak, discouraging 13-page consent form. "My husband and I prayed every night," Mrs. Clark said. "We are a religiou family, members of the Church of Jesus Christ of Latter Day aints. We were influenced by our religious doco·ine." She and her hu ba~d, s~e related, discu.ssed their decision with no one except the1r children, and declmed all advice. After a Thank giving spent happily with their children and grandchildren, Barney Clark decided to volunteer. "I felt a calmness I had not felt in many months;' Mrs. Clark said. "I could not but interpret this to mean that the decision was right." Dr. Clark refused DeVrie 's air ambulance, electing for a common carrier trip. "He wanted to keep things as normal as possible;' Mrs. Clark sa1d. Present at the operation were several members of the heart team, who, Una Loy Clark related, "were as close as any immediate family." And, on December 2, 1982, an artificial heart beat for the first time in a human body. 14 • BUFFALO PHYSICIAN Mrs. Barney Ctarlc being a great loss, as a beginning for the future of the artificial heart as a measure against heart disease. "People ask me sometimes if Dr. Clark thought it was worth. it;' she told the audience. "I simply remind them of what he sa1d on TV - that, if he hadn't thought it was worth it, he would not have persevered through it." "H aving been his wife for 39 year , and by his side in t~e h?sp1tal, I knew him, his personality, and the work. mg of h1~ mmd;' she said. "I never once heard him complain, or expenence regrets at the course he had chosen. When he was ~sked if the new heart was painful, he said no, that at first •t. had bothered him, 'but now it doesn't; it just keeps on pumpmg.' ."He expected no great personal miracle. He looked for the Simple plea.sures ~n life, to enjoy interaction with his family, and conduct h1s busmess ~n his office. o promise was made to h1m, but he was dedicated to experimentation - undoubtedly there would be much learned. It was this" Mrs. Clark said, "that gave him the strength and purpose t~ make the decision he did." • �IP Injection 3-4 weeks Antibody a: UJ _J (!) UJ :.:: z :s <1: t'-' a: MONOCLONAL ANTIBODY PRODUCTION <1: :c L-------------------------------------------------------------------------------------~ U High-tech in cell cloning arrives in WNY School of Medicine will house one of five monoclonal centers in nation T he high technology of cloning cells for medical purposes will now establish a firm footing in Western ew York. This is because UB's School of Medicine will be the location of a new Monoclonal Antibody Center, one of only five central monoclonal centers in the nation. The laboratory will use the newest medical technology to clone cells that have been "programmed" to produce specific types of antibodies that can be directed at hig~ly defin~d antigen sites, such as sites in tumor cells, bactena and viruses. "The new center is being established in Erie County Medical Center's clinical center and was expected to be in operation. on June 1:' says Michael A. Apicella, M.D., acting director of the Center. He i UB professor of medicine and director of the Divi ion of Infectious Diseases. The monoclonal center will function as a service laboratory, manufacturing the antibodies for use by up to 50 other UB researchers and by dozens of institutional and commerciallaboratories in the U.S. which do not have the expertise or resources to develop these materials. It will support research by immunologists, endocrinologists, microbiologists, biologists and engineers. . . . . It is UB's newest contnbutJOn to the developing high technology industry in Western ~e:W York. is anticipated that the center will be self-sustaining within two years by generating income from royalties and services. At the pre~ent time the unit is supported by the Research FoundatiOn, Graduate School and School of Medicine. Although the antibodi.es will be u~ed i~ basic. r.esearch, they hold promi e for practical apphcatio~ m medicine. T.he new technology could be used to treat per~Istent gram-?e.ga~Ive bacterial infections, which are often resistant to antibiOtics. These include Staphylococcus, Salmonella, Tularemia and Brucellosis infections. Tumor antibodies could be developed to target specific types of tumors. An inter~sting application of the antibodies could be as a targetmg device or vehicle that could deliver cytotoxic drug to tumors. Private companies will be able to use the antibodies as biological reagents for identifying and diagnosing the prese~ce of a ~articular bacteria causing infection, or a tumor causing. mal~gnancy. As a basic research tool, the antibodies cloned at the center promise to shed light on the structure of the cell surface of bacteria and the actual sites on the cell surface where the antibodies attack. Dr. Apicella and his coinve tigators are !t currently using only mouse cells. The idea for the central laboratory was conceived thi·ee years ago by Alister Brownie, M.D., professor and chairman of the Department of Biochemistry, and John aughton, M.D., School of Medicine dean. Dr. Apicella brought the idea to fruition together with Philip LoVerde, Ph.D., associate professor of microbiology, Robert Genco, D.D.S., Ph.D., chairman of oral biology, and Ronald Berezney, Ph.D., associate professor of biological sciences. The laboratory will operate in cooperation with the Health-Related I nstruments and Device Institute, Inc. (HIDI) directed by Michael Anbar, Ph.D., chairman of the Department of Biophysical Sciences. In addition Dr. Raymond Kelleher, associate professor of biology at State University College at Geneseo, had a major role in development of the center. The antibodies are developed from the products of fusion of mouse spleen cells and plasmacytoma cells, certain malignant cells isolated from mice that manufacture the antibodies. The combination, called hybridoma, is a hybrid between the two cell types. The actual procedures work in the following way: After experimental mice are immunized, their spleens are removed. The spleen cells are washed and mixed with mou e plasmacytoma cells that are maintained in tissue culture. Polyethylene-glycol (PEG) is then added to fuse the two types of cells, the spleen and plasmacytoma cells. An antimetabolite, aminopterin, kills the malignant cells but not the spleen cells or hybrid fused spleen/malignant cell . The process enables these cells to be separated. After two weeks of growth, the clones become visible. Those cells identified as containing antibodies are separated and further cultured to produce large volumes. The hybridomas and antibody can be easily stored in freezers for long periods of time. When an order is placed by another laboratory, the specimens can be thawed and reconstituted for further use, or for additional antibody production. ~r. Apicella received his medical degree from Downstate Medical Center in 1963. During the month of April, 1984 he served on the World Health Organization's Panel on Encapsulated Bacteria. He is a member of the editorial board of Infection and Immunity, and received the U.S. Air Force's Re earch Development Award in Medicine in 1970. • BUFFALO PHYSICIAN • 15 �The death of McKinley Jacobsen probes who was to blame S By Mariann Caprino orne years ago, perhaps a score or more, Dr. A. Wilmot Jacobsen was given a scrapbook tha~ documented a slice of history - those few days m 1901 when Buffalo reigned as the nation's capital. The scrapbook contained newspaper articles, photographs, scientific dissertations and eve~ tempe~a~ure charts, all relating to the shooting of President Wilham McKinley at the Pan American Exposition and his death eight days later. The book had been compiled by Dr. Charles Stockton, one of McKinley's doctors who observed first-hand what some called the medical incompetence that led to McKinley's death. "I was presented with everything I ever wanted," Jacobsen says. "It would have taken months of work in dusty archives to get all the information contained in that scrapbook:' The controversy over the president's medical treatment was still fresh in the air when the young Dr. Jacobsen arrived in Buffalo in 1926 to start an outpatient department at Children's Hospital. "People who had been part of it were still around, though by now I don't think you could find anyone who has recollection of it:' he says. Still, in 1926 and for years to come, the veritable feud that had sprung up among various factions in the medical community was very much alive. "Whole families of doctors didn't speak to each other for years and years:' Jacobsen says. And every time a story cropped up in the newspapers commemorating the president's death,. talk i~ the Chil~ren's Hospital doctor's lounge would be m the air once agam. Jacobsen was already fascinated with the medical aspects of the case - let alone the social aspects - long before he even knew the scrapbook existed. "All the top doctors in ew York complained he died here in the sticks and suffered from bad medical care," says Jacobsen (who today, at the age of 85, still practices pediatrics. He joined 16 • BUFFALO PHYSICIAN PRESIDENT'S DO DENY REPORTS Of DISSENSION Dr. A. Wilmot Jacobsen (allfweJ reviewed evidence In adecade·IDnll debate wer whether doctors could have saved McKinley. (Below letrJ Dla11ram shows path of buller thtoUflh the President. Fonn of woman was used 11v mistake. the University of Buffalo faculty in 1926, and is today professor emeritus in pediatrics). While he believes the doctors involved probably did "botch the job:' Jacobsen also is ready to concede that the primitive state of medical technology of the day makes it difficult for us to pass judgment. "Today it could have been taken care of, and perhaps then as well, but they didn't know what the blood was doing, what the body fluids were doing, where the bullet was:' he says. But the investigation of the medical handling of McKinley's case properly begins, in Jacobsen's mind, with a much simpler question: Did the right man operate? McKinley was shot twice at close range while he stood in a receiving line in the Temple of Music. The assassin, a young anarchist named Leon Czolgosz, was later electrocuted. The first of Czolgosz's bullets ricocheted off McKinley's breastbone and was recovered later as his clothing was removed. The second bullet, however, deeply penetrated his abdomen, taking off a tip of the pancreas as it tore through the portly president. McKinley was rushed in the city's first electric ambulance to the Exposition hospital. A handful of students from the University of Buffalo Medical School attended the president until a group of professional doctors arrived. Taking over as chief of the medical team was Dr. Matthew D. Mann, a top surgeon of the day, but by no means a general surgeon. "He'd never operated on anything above the belly button:' Jacobsen says. That's because Dr. Mann was a gynecologist: "It was .very ill-advised to have a gynecologist operate on him, especially under these adverse circumstances," Jacobsen says. He also criticizes the decison to operate im- �mediately. According to Jacobsen, the president seemed to be in little pain, and he was even rallying as he lay resting. "There didn't seem to be any danger of shock, though the doctors feared internal hemorrhaging;' he said. The most logical choice to perform the surgery was Dr. Roswell Park, who, at the height of his career, was quite familiar with this type of operation. Alas, he was in Niagara Falls in another operating theater, and the decision to proceed was made before he could arrive on the scene. C ertainly the medical techniques of the day were rather limited. After all, antibiotics wouldn't come into widespread use for another 40-odd years. But the eagerness with which the doctors operated cost them the use of the few modern conveniences available at the time. For one thing, it was decided not to transport the president to the hospital, "though they were prepared to take him;' Jacobsen says. The primitive medical room at the Exposition, where McKinley had been taken from the Temple of Music, was used for his treatment. "The sun was just going down, and there was just one small window where light came in;' Jacobsen says. "In order to get more light on the operating site, one doctor held a mirror to reflect light onto the injured man." Instruments used were not of surgical quality - "they were more like those from a doctor's bag;' Jacobsen says. Dr. Park's maid brought over a fully equipped medical bag, but it lay in the next room unnoticed. Once the operation was underway, Dr. Mann was unable to trace the bullet. In addition, he did not notice the damage to the pancreas. But perhaps his two biggest errors were in not removing the tissue torn in the path of the. bullet a!'ld in not putting in a drain that would remove tox1c secretwns. McKinley, who ironically had scored one of his earliest triumphs as a lawyer by winning a malpractice suit, died eight days later, not of an infection, but of gangrene. The medical team came under fire from other doctors and from a host of what Jacobsen calls "Monday-morning quarterbacks" - those inexhaustible thinkers who relentlessly ask the question, "What if?" ''A very prominent lawyer got all the main doctors together and told them they should recognize this was slander and make a legal issue out of it in order to stop it," Jacobsen says. Soon the group issued a statement saying "there was never disagreement among the professional attendants as to ... the treatment of the case ... Every publication and all alleged interviews with us containing criticism of one another or of any of our associates are false and are nothing but scandal-mongering." Dr. Park was only loosely associated with this group, more because of his high profile than because of his involvement with treatment, yet he also signed the statement. Years later, in 1945 to be precise, he questioned the treatment and hinted that it was only because of "professional jealousy" that Dr. Mann didn't wait for him to get back to Buffalo and perform the surgery. Many people believed J?r. Par.k could have saved McKinley, not only bcause of his ~xpenence but also be.cause he advocated the logical medical treatment. Iromcally, perhaps, an incident occur~ed soon after the McKinley tragedy that provided concrete evidence that Park could have saved the president. "An interesting accident occurred several weeks after the assassination;' as Dr. Jacobsen relates it. ''A woman wanted to comm it suicide and read all the stories of how McKinley died of all these wounds. So she shot herself in the stomach and practically duplicated his wounds. She was a pretty good McK/nter died despite, or was It because ot, the doctors In attendance. shot, but it was Park who took care of her - he cleaned up the mess from the bullet and put a drain in, and she promptly got well:' Four U.S. presidents have died because of assassins' bullets. Abraham Lincoln and John F. Kennedy, who died of massive head wounds, probably never had a chance. But !"'cKinley and James Garfield, who lived for 80 days after bemg shot, are two whose deaths became controversial and who are believed might have had a chance if they had received proper medical care. For Jac.obse.n,. tha.t scrapbook on McKink 1 opened up a world of h1stonc mtngue he had often heard hinted of. He metic':'lously made slides of the scrapbook pages before donatmg the book to UB and he has taken his one-man show on the road to luncheons and group meetings. It never fails to attract interest. He may know his presentation by heart, but Jacobsen lets his audience decide whether it was the doctors, not the gunman, who killed McKinley. Reprinted with the permission of the Buffalo News Inc., where Caprino is a staff writer. �Dr. Beverly Bishop (at ffflht, above} with students and 'subJect' (as seen In ctose·up on next page}, demonstrating use ot computetfzed equipment to reconl and analyze data In neurophYSiology laboratory. Computer era changes the way neurophysiology lab is taught Innovation incorporates state-of-the-art tools Y ears ago, the oscilloscope and polygraph were state-of-the-art tools essential to the study of the human nervous system. Now the computer era has changed all that. For the first time in any academic institution, computers will become an integral part of a course in neurophysiology. Dr. Beverly Bishop, UB professor of physiology, has received a $10;000 grant to computerize UB's neurophysiology laboratory course in an innovative manner that may permanently lead to changes in the way this and other medical school courses are taught. Working with Dr. Bishop will be Thomas Moriarity, UB physiology teaching assistant. Neurophysiology, the medical science that studies the function of the nervous system, is an important component of the general physiology course taken in the first year of the Medical School program. Currently, laboratory experiments in neurophysiology are performed in the traditional manner of recording and analysing analog data. The traditional equipment now in use is gradually becoming obsolete and in need of replacement. This fact added to the urgency of launching this innovative microcomputer in$tructional system. A primary goal of the novel program is to promote interest in careers as physician18 • BUFFALO PHYSICIAN researchers by stimulating medical students' interest in the experimental approach. The recent trend has been toward fewer physicians entering the field of scientific investigation and research medicine. "The time has come to reverse this trend. The advent of the microcomputer can assist in this reversal," Dr. Bishop reports. By computerizing the teaching laboratories, medical students cane be introduced early to the "excitement and joy of research and experimentation which may spark the desire for a career as physician-investigator;' she adds. The grant was awarded by the ational Fund for Medical Education, which was chartered by Congress in 1954 to mobilize voluntary support for medical education. It has awarded over $57 million to medical schools, societies and consortia since its founding in 1949. The Fund's primary mission is to promote the best possible health care for the American people through improvement in medical education. The International Business Machines Corporation has elected to sponsor the project and provide the equipment. Dr. Bishop foresees the computerization of her course leading to similar modernization of other Medical School courses here at UB and elsewhere. "It will serve as a pro- totype for use at institutions across the nation;' she states. Although microcomputers have invaded most neurophysiological research laboratories, they have not yet been introduced into student laboratory experiments. Initially their exorbitant cost prohibited their use in teaching labs. Today, microcomputers are sufficiently inexpensive to become a personal possession. In spite of this, computers have not yet been widely used in medical teaching. In those cases where they have been used, their application is quite different from that planned at UB. After Dr. Bishop taught classical neurophysiology for many years, she took a break from teaching the course. During that time she realized that the only way to teach the subject with all the technological advances that have occurred was to teach it with the new technology. Not only does Dr. Bishop expect computerization of her course to attract future career researchers, she also feels it will clearly improve the effectiveness of the teaching itself. "The students will profit from this modernization because they will be able to perform their experiments more efficiently;' she explains. In addition, "hands-on experience with microprocessors should better prepare students for the real-world in which microprocessors are now an integral part of most modern medical equipment;' Dr. Bishop reports. Dr. Bishop points out that "because computers will be everywhere in the work place, medical students should learn what they can and cannot do for them." �ResearchUsing computers will drastically increase the capability to extract and analyze information, some of it previously inaccessible. Dr. Bishop points to the example of analyzing waveforms of single motor unit potentials, "an almost impossible task prior to the advent of the rapid digitizing capability" of the new technology. A nother benefit inherent in Bishop's approach is that "the work station" concept can be used in the student laboratory. This educational method is a new way to teach classes comprised of students with diverse academic backgrounds and career goals. "Rather than being tied to a fixed schedule, each student can progress at a rate commensurate with his own ability and motivation;' she explains. The computer program is the key to the ability to use this method since it can be designed to "adapt" to different learning rates. The benefits go beyond educational and career goals. Very simply, computerization can lead to a reduction in the number of experimental adnimals used for teaching neurophysiology (and other) courses. Using computers to analyze and store data, neural impulses recorded from a single animal can be shared by several groups of students. "At the conclusion of an experiment, all data can be pooled and each student will have more information regarding the experiment than in the traditional mode where each group of students has a different animal to study. Besides dealing with the sensitive issue of sacrificing animals, it can result in significant savings. The potential for application of Dr. Bishop's use of computers is great. Once the new course is established and refined, "the remaining sections of the medical physiology course such as the cardiovascular, respiratory, body fluids, and GI sections will follow this lead." Once the effectiveness of the course is demonstrated, it will become an example or prototype for other medical schools. Computer programs and manuals have to be devised for the course since none have ever been developed. Thus "the laboratory manual and computer programs could become a basic course for teaching neurophysiology at any institution," Dr. Bishop claims. • Food Stamps May not aid nutrition By Mary Beth Spina istributing food rather than food stamps may be a more effective method for enhancing the nutritional status of the nation's poor, two UB Medical School epidemiologists contend. James Marshall, associate professor of social and preventive medicine, and David I. Gregorio of the Health Systems Agency of Western New York, note that although the federal government is spending record amounts to fund the food stamp program, the expenditure is not necessarily translating into better nutrition for the poor. In a recently released study funded by the National Institutes of Health, the two found that the average intake of total calories and five essential nutrients by children in families below the poverty level did not significantly differ whether or not their families received food stamps. "Just as many more affiuent purchasers do not necessarily buy the foods and beverages which will give them the best in terms of nutrition, neither do their fellow purchasers who go to the supermarket armed with food stamps;' Dr. Marshall said. "When the food stamp program was instituted in 1964, it was believed that the poor could be better fed by a program which operated within regular channels of trade," Dr. Marshall explained. Earlier programs provided surplus government food such as powdered milk and cheese directly to the poor. Although the food stamp program increased the amount of money spent in the U.S. on food, he noted, there had been no comprehensive studies to determine whether levels of nutrition improve among those receiving the stamps. he UB study utilized data from the first Health and Nutrition Examination Survey, in which some 2, 774 pre-school and 3,509 school-age children answered questions about foods eaten in a 24-hour period before participation in the study. Both the children and adults responsible for feeding them were questioned on what was consumed by the youngsters during this time period. The foods and beverages were then analyzed to determine the proportion of recommended dietary allowances of calories, protein, iron, calcium and vitamins A and C they provided. Family participation in the food stamp program did not significantly affect the nutritional adequacy of the children's diets when other economic and social factors were taken into account, the researchers found. They did note, however, that children in families headed by women had more adequate consumption of the nutrients studied than did youngsters in households headed by males. White children fared somewhat better nutritionally than non-whites. Further, the higher the education level of the head of the household, the greater the nutritional adequacy. Drs. Marshall and Gregorio said that although their method of evaluating the diets, based on a 24-hour food consumption inventory, does not present a total picture of the children's nutrition, it does give an approximation of long-term dietary patterns and habits. "Clearly, more studies need to be conducted to determine what the most effective food subsidy programs would be in terms of providing adequate nutrition to this nation's poor;' Dr. Marshall emphasized. 11 ithin the federal food stamp program's annual cost of some $10 billion, there are still segments of the population below poverty level who do not receive even this assistance," he pointed out. Among youngsters in the study from families designated as "below the poverty level," less than half of the pre-schoolers and school-age children were in households that received the stamps. "There is no doubt that there are people tonight in the U.S. who will go to bed hungry and others who, if not actually hungry, have not received adequate nutrition for the day from thei.r food consumption," Dr. Marshall noted. Indeed, in many areas of the country, soup kitchens are serving record numbers of poor daily, and community food pantries designed to tide over those awaiting food stamps have difficulty keeping up with the demand. Only more careful study of the problem from a scientific point of ,·iew may be able to provide answers to how a government program could remedy these problems in the future, Dr. Marshall said. The ultimate answer may lie in direct food distribution, or in the introduction of nutritional advice into the food stamp program. At any rate, according to the study, the present effort is falling short. • BUFFALO PHYSICIAN • 19 �Dr. Joseph Prezlo (letrJ and Dr. Hank Kung take a break In the lab where Dr. Kung Is conducUng research to develop new Imaging agents. Nuclear Medicine New unit proves to be versatile I By Mary Beth Spina t's one of the School of Medicine's newest departments. But as one of the "new kids on the block;' historically speaking, the Department of Nuclear Medicine has already proved itself to be among the most versatile of departments through the scope and variety of services it provides the Western ew York area. A major, unique contribution, according to Acting Department Chairman Joseph A. Prezio, M.D., is the extensive Health Physics Program which operates out of the School of Medicine's facilities at 2211 Main St. During"the past 14 years in which the Health Physics Office has monitored use of radioactive materials at DB-affiliated and associated hospitals, these institutions have had improved compliance with radiation safety rules and regulations, resulting in better inspection reports from regulatory agen cies. In addition, the Office has relieved these facilities of much of the responsibility for maintaining compliance. Currently all the hospitals involved are covered under one broad radioactive materials license. The licen e is issued by the ew York State Department of Health and the uclear Regulatory Commission which is administered by the local Joint Radioisotope Committee ORC). Amendment and renewal applications for the license are prepared and submitted by the Health Physics Office. In addition, all associated documents, such as safety manuals, human-use reports, inventories, and other materials are prepared by the Office, sparing each institution the task of individual license maintenance and associated document preparation. The coordination of efforts in the area of radiation safety also eliminates the need for each institution to maintain a radioisotope safety committee; instead, each has a representative serve on the JRC. 20 • BUFFALO PHYSICIAN Members of the JRC are Dr. Prezio, chairman, Mercy Hospital; Dr. George Baeumler, Buffalo General and its Deaconess Division; Dr. Suraj Bakshi, Roswell Park Memorial Institute; Dr. Shantikumar Bedmutha, Erie County Medical Center; Dr. Merrill Bender, The Buffalo Medical Group; Dr. Kwangjoo, Sisters of Charity Hospital; Dr. Diana 0. Duszynski, Children's Hospital; Dr. Rudolph Sada, Lockport Memorial Hospital; Dr. Douglas Sirkin, Millard Fillmore Hospitals; Dr. Jehuda Steinbach, Veterans Administation Medical Center; Dr. Hank Kung, Research Division; Dr. Robert Ackerhalt, Central Radiopharmaceutical Services, located in Acheson Hall; Bill Quain, Health Physics Division; John Pulli, Veterans Administration Medical Center administration, and Francis Iannopollo, VAMC nursing serv1ce. Under the broad license, non-routine human uses of radiopharmaceuticals for research and clinical evaluation are approved locally by the Joint Radioisotope Committee and the local FDA-approved Radioactive Drug Research Committee. If the institutions operated under their own individual licenses, they would have to apply directly to the New York State D~partment of Health or FDA, a time-consuming process wh1ch would require longer time for approval. Another advantage of the broad license is that a single non-routine human use application can be extended for ap~roval for use at all of the affiliated hospitals, resulting in less time and paperwork. During compliance inspections periodically conducted by regulatory ~genC!es, the JRC health physicists- Bill Quain or John Nicholson - accompany the inspector and are :vada~le ~o answer ~uestion concerning procedures. Fewer surpnses. ~n e .dunng these inspections becau e the inspector 1s fam1har w1th the standard program of radioisotope recordkeeping, disposal, and other procedures developed by the Health Physics Office. • . Qu~in, who received a master's in public health in ra?!Oiog!Cal health from the University of Minnesota, and 1ch.o!son, a graduate of UB's B.S. degree program in nuclear med1cme technology, are employed full -time. �Medical School NewsC urrently, the joint Radioisotope Committee has authorized approximately 190 senior investigators to use radioactive materials in the institutions covered by the broad license. An additional 700 secondary users work under the direction of these investigators. Most of the work deals with biomedical research· the remainder is directed toward in vitro and in vivo clinical diagnostic and therapeutic studies. Because the Health Physics Program has primary responsibilities to assure that radioactive materials are used safely and in compliance with rules and regulations, users enjoy both lower personnel radiation exposures and assistance in compliance. Although some ho~p!tals cov.ered under the broad license employ health physiCists, the1r efforts are directed primarily within the hospital's departments of radiology and radiation therapy. Since strict control of low-level radioactive materials is essential to protect employees who work with the materials, as well as the public-at-large, unannounced inspections of offcampus locations are made every six months by the local Office's health physicists. Noting the seriousness with which the Health Physics staff take their responsibilities to protect individuals from accidental or deliberate misuse of radioactive materials, Dr. Prezio points out that some labs have been closed when repeated warnings to correct violations were ignored. "We don't hesitate to restrain their use of radioactive materials;' he says, "because we aren't dealing with parking infractions. These are violations which are potentially hazardous to the safety of employees working with radioactive materials or even to innocent bystanders who could be exposed to unnecessary dangers." Deficiencies have included failure to post warning signs in areas where radioactive materials are present, improper disposal of waste, poor recordkeeping concerning materials use, inadequate contamination surveys, or failure of employees to have adequate protection when working with the materials. "Deficiences which cannot be corrected on the spot are followed up from five to 30 days, depending upon the nature of the problem and the time required to correct it; says Quain. Key considerations of the health physicists are protecting hospital/research employees working with the materials; providing safety for support personnel, such as those in housekeeping and maintenance who may come in contact with radioactive materials use areas; and protecting the environment. Several hospitals generate radioactive waste which cannot be disposed of on site by decay, incineration, or other app.rov<:d methods . This waste is shipped to commercial disposal s1tes m appropnate waste containers provided by the Health Physics Office. An effective waste removal program for these materials has permitted uninterrupted use of them. According to Quain, materials used in radioimmunoassays (RIA) account for the bulk of radioactive waste generated in the off-campus facilities. The radiophar- Dr. Ackeman and Ms. Steves (center] lnstntct one ot the nuclear medicine technolow students In the lab. BUFFALO PHYSICIAN • 21 �maceuticals used in nuclear medicine for clinical diagnostic and therapeutic procedures have short half-lives allowing them to be disposed of locally after radioactive decay. A nother unique and vital contribution of the Health Physics Program is the course, "Basic R adiation Safety;' taught to research technicians and other involved in handling radioactive materials. More than 200 new employees, most of them research technicians, have attended the five-week course since it began in 1978. Individuals with previous formal training in radiation safety may have the course requirement waived. In the six year the course has been offered, Quain believes, there's been a decrease in deficiences found in the off-campus laboratories. Another boost to achieving a goal of more professional training for employees of laboratories which make use of radioactive materials has been the development of the uclear Medicine Technology Program co-sponsored by the UB Departments of Nuclear Medicine and Medical Technology (the latter a department in the School of Health Related Professions). Coordinated by Ann Steves, who has a dual faculty appointment in these departments, the program has graduated approximately 45 students since it wa established in 1977. One of only about 25 bachelor degree programs nationally offering a major in nuclear medicine technology, the UB program sees its graduates taking jobs all over the world. "At least a couple of our graduates have gone to areas in the midwest and southwest where they are employed to work on mobile nuclear medicine programs serving several small hospitals in a geographic area. Another graduate is working in Saudi Arabia;' says Ms. Steves. Having a degree in a high demand area, the UB graduates have considerable latitude in selecting where they will work. Upon graduation, they are eligible to take national certification examinations which will allow them to practice across the nation. As staff technologists in nuclear medicine, these graduates are responsible for operating and maintaining nuclear medicine equipment on a daily basis, preparing radiopharmaceuticals, assuring routine compliance with regulations, and interacting with patients served by the departments in which they work. Their f~eshman and sophomore years are spent in the core science curriculum at UB; in the junior year they are in a classroom setting taught by faculty in the Department of uclear Medicine and others. The senior year, they gain experience in clinical settings, rotating through various Buffalo hospitals affiliated with the program. Ms. Steves, who holds the B.S. in chemistry and the M.S. in health sciences education, recalls that when she entered the nuclear medicine technology field in 1969, there were few programs nationally which specialized in the field on the undergraduate level. "But I was lucky;' she explains. "I was trained by two of the pioneers in the field of nuclear medicine - Drs. Merrill Bender and Monte Blau." I n the area of physician education, the Department of uclear Medicine at UB has the fourth largest residency program in the specialty nationally, according to Dr. Prezio. Proud of the fact that a year ago, the Accreditation Council for Graduate and Medical Education presented the Department with a five-year renewal, he is equally proud that nearly 75 residents have completed the two-year program since 1969. 22 • BUFFALO PHYSICIAN (Above} Dr. Prezlo (seated} and nuclear medicine residents review data trom a carrllac Imaging stuflr. (Below} Bill Quain (lett} and John Nicholson examine materials used IJr tacuttr and researchers which are covered under the broad license. While many of these are pract1cmg in hospitals and laboratories in New York, others have gone cross-country to head departments of nuclear medicine. Most of the residents accepted into the program have a background in internal medicine, radiology or pathology, and are taught by 30 professional staff and faculty - full-time and clinical - who hold either M.D. or Ph.D. degrees. The residents rotate through Buffalo General and Mercy hospitals, Roswell Park Memorial Institute and the Veterans Administration Medical Center as well as through the Central Radiopharmacy and _the Health Physics Program. Selectives may be taken at Ene County Medical Center and Children's Hospital. All the education and training provided through the Department of Nuclear Medicine doesn't take place in Buffalo, however. Only recently a research agreement to encourage excha~ge of knowledge ~nd .to develop new brain imaging agents to diagnose neurologic disorders was formalized between the J?epartment and scientists at Beijing (China) ormal UniverSity. The agreement, work toward which was initiated four yea:s ago by former UB Department of uclear Medicine cha1rma~ Dr. Monte Blau and Dr. Bo-Li Liu, vice chairman of B Us Departme~H of Chemistry, is believed the first to encourage collaborative research in nuclear medicine between U.S. and Chinese scientists. . Dr. Blau presented sei?inars to UB's Beijing colleagues m 1.982, and last _Year, Dr. LIU lectured in Buffalo while engaged m collaborative research here. Dr. Hank Kung, director of research a?? dev~lopment in the local Department of Nuclear Medicme, will lecture in Beijing this fall. �------------------------------------------------- Medical School News-ween radioactive iodide and 1231 HIPDM. They will also study neutral lipid-soluble compounds labeled with Technetium-99 and Technetium-99m. 1231 HIPDM is an agent developed by Drs. Blau and Kung three years ago which promises in clinical trials to be a less expensive and more clinically practical alternative to other radiopharmaceuticals used to study brain function. Approved by the U.S. Food & Drug Adminstration as a clinically experimental agent, 1231 HIPDM has been patented by SUNY and licensed by Benedict Nuclear, Golden, Colorado. The agent has been undergoing clinical trials at Buffalo Veterans Adminsitration Medical Center, Duke University, the University of Cincinnati, the University of Indiana, and Northwestern University. Earlier clinical trials were also conducted at Harvard. B The agreement, says Dr. Kun~, p_rov!des a ui?-ique C?Pportunity for sharing research and soenti~c mfo_rmatwn wh1ch may lead to improved a~ents or tec~mques m t~e field of nuclear medicine which will benefit patients worldw1de. Funds to support the joint program are provided by the Department of uclear Medicine and the government of The People's Republic of China for their re~pective faculty. . As a direct outgrowth of th1s program, agents wh1ch may have potential as diagnostic brain imaging, tools h_ave been developed by Drs. Blau and Kung ':lnd BNU s chemistry ~ro­ fessor Xue-Bin Wang; results ofthe1r work have been published in the Chinese journal of Nuclear M~dicine. . During the agre~ment, c?llaborative research to_1mprove perfusion imaging w1ll study Isotope exchange reactwns bet- ut even as new imaging agents for the future are being developed by the Department's researchers, the Central Radiopharmacy located on UB's Main Street Campus in Acheson Hall daily produces and supplies radioisotopes used in diagnostic procedures to local hospitals and clinics. Dr. Robert Ackerhalt, director of the facility, notes that the Central Radiopharmacy was the first of its type to be established in the world and continues as one of the largest. The advantages of having a local facility such as the one in Acheson Hall are readily appreciated by physicians and hospitals which utilize its services. It allows materials used in nuclear medicine and which have a short half-life to be readily available and very cost effective. Each day before 5 a.m ., the two technologists at the Radiopharmacy begin preparing the radiopharmaceuticals ordered for that day by the participating hospitals. By 9 a.m ., the facility's four part-time drivers will have delivered the products to the hospitals' doors. Injected into patients or administered orally, the radioactive diagnostic drugs, when viewed with a special scanner, or gamma camera can reveal to the physician tumors and other diagnoses which would otherwise not be visible. Dr. Ackerhalt, who holds an undergraduate degree in pharmacy and a Ph.D. in chemistry, says that while certain safety precautions must be taken in dealing with the low-level radiation products, they are not of a nature which should instill fear in either physicians, hospital employees, or patients. "It should be noted;' he says, that "many procedures are more dangerous to patients than those employed in nuclear medicine." While today there are departments of nuclear medicine in most larger hospitals, Dr. Prezio predicts this may be changing before the end of the century. "The technologies which are developing so quickly in all areas of medicine and which allow physicians to 'see' indirectly into the body for diagnostic purposes may eventually merge;' he predicts. The resulting departments at medical schools as well as in larger hospitals - may bear the name "Department of Imaging Services;' incorporating state-of-theart technology in radiology and nuclear medicine, as well as techniques of ultrasound and uclear Magnetic Resonance devices. "Even the resident teaching programs will probably be combined as we approach the end of the century, allowing all imaging techniques to be taught as a single discipline rather than fragmented as they are today;' Dr. Prezio adds. Whatever the course imaging takes in the future, however, nuclear_ medicine will be one of its most important components as physiCians continue to seek new and better ways to diagnose disease. • BUFFALO PHYSICIAN • 23 �The year's best Students pick top profs T his time it was the medical students' turn to choose who would receive awards. They selected the Medical School's "Teachers of the Year;' announced at the May 30 Annual Faculty Meeting. There are almost 2400 faculty members in the School of Medicine. The 8th Annual Dr. Louis A. and Ruth Siegel 1984 Teaching Awards were given to four UB faculty members: • Dr. Murray J. Ettinger, associate professor of biochemistry (The PreClinical Award). • Dr. James M. Hassett, assistant professor of surgery and biophysical science (Clinical Award). • Dr. Raymond G. Schiferle, clinical assistant professor of family medicine (Volunteer Award). • Dr. Judith Anderson, former clinical assistant instructor in pediatrics, now with the ew York City Health Department (Buffalo House Staff Award). The awards are designed to recognize and give evidence of the importance of superior teaching in the clinical and preclinical years and to provide encouragement and incentive for teaching excellence. The Excellence in Teaching awards are chosen through student nominations which are in turn reviewed by an Awards Committee comprised of representatives of all four medical school classes. Students nominate individuals and also are asked to describe the merits and attributes of nominees. Teaching skills, an ability to stimulate thinking and develop understanding, demonstrating sensitivity toward the human condition, and providing a role model for students are the characteristics that receive serious consideration. The Awards Committee reviews and makes its decision based on the number of nominations and the quality of written statements. When asked about the award, Dr. Hass~tt replied, "I am fulfilling all my dreams doing what I am doing now my own practice, teaching and research. It is truly an honor for me to be rewarded by the students as being an excellent teacher. Receiving an award directly from the students is extremely gratifying - it's a thrill, like winning an Oscar." The awardees agreed that certain common ingredients are essential to be a good teacher. Dr. Anderson stated that "commitment, concern and care for the 24 • BUFFALO PHYSICIAN medical student is crucial;' while Dr. Hassett added that, "a teacher must have enough interest in the student to advise him or her to make the best career choice. An effective teacher of medicine should be broadly trained, not restricted to knowledge of one speciality, as so many are, says Dr. Ettinger. He feels that the sharing of knowledge with doctors in other fields contributes to this broadening experience. "Interaction with clinical doctors who utilize basic biochemical concepts daily tempers my teaching experience;' he stresses. Recognizing the role that a teacher plays in assisting the maturation of the student, Dr. Anderson remarked, "I approach the student with the attitude that 'I have passed your way before and am willing to "walk" with you till you get on your feet.' " Dr. Hassett agreed, saying "The teacher must help the student to make the transition from a smart, interested and enthusiastic person into a finite doer, who is able to use the available facilities and make decisions." While Dr. Hassett stated that "students must remember that education can be traumatic and tumultuous, productivity is often the result of such turmoil," Dr. Anderson added that effective teachers should also "try to make learning fun.'' The founder of the teaching awards is Dr. Louis A. Siegel, who received his M.D. from UB in 1923. An assistant professor in Ob-Gyn for 21 years, he was said to have been a dedicated clinical teacher, uniquely able to inspire both medical students and house officers with enthusiasm and the spirit of inquiry. In spite of increasingly severe physical handicaps due to rheumatoid arthritis, he maintained an active role as a professor. He left UB for health reasons in 1946. In 1977, Dr. Siegel endowed the Siegel Awards to the UB Medical School. He died january 31, 1981, in Los Angeles. • Faculty honors Guthrie, 7 others cited E ight UB Medical School faculty discovered they were recipients of awards at this year's Annual Faculty Meeting, May 30, 1984. The meeting held at the end of each academic year reviews the major faculty and Medical School developments that occurred during the preceding 12 months. ui 0 ~ 0 cii ~ I a. The rectptent of this year's major honor, the Stockton Kimball Award, is Dr. Robert Guthrie, professor of microbiology and pediatrics. A veteran of 26 years at UB, Guthrie is internationally recognized as the person who, in 1961, devised the PKU test, now called the "Guthrie" test, that screens children prone to phenylketonuria. His distinguished activities in research continue, as well as his efforts to pass bills in the State legislature that will mandate lead poisoning screening for all children and also establish an interagency commission to conduct and monitor statewide prevention efforts. Guthrie is the 20th person to receive the Stockton Kimball Award, which recognizes outstanding contributions to teaching, research and services. The criteria require: 1) evidence of academic accomplishments; 2) acceptance and recognition as an investigator; 3) significance of research contributions; 4) evidence of relationship of contributions to presence in Buffalo; 5) contribution to UB, as well as to self-serving goals; and 6) fulfillment of excellence in all of its meaning. Dr. Guthrie's predecessors in receiv- �Medical School News- At annual tacunr meetlnfl (clockwise trom left) 1. Dr. Evan calldns receives Dean's Awanl. z. Dr. Robert warner, acceptlnfl awanl tor Dr. Robert 6uthrle. 3. lL·RJDr. Marvin Herz, Mrs. S. Mouchly Small, and Dr. Small, with poltralt of Dr. Small. 4. Dr. WOTthlnflton Schenk: flllllnfl the Stockton Kimball Lecture. 1984 Louis A. and Ruth Siegel Teaching Awards: Drs. Murray Ettinger, James Hassett, Raymond Schiferle, and Judy Anderson (see accompanying article). The last award, presented by Dr. Marvin Herz, chairman of psychiatry, went to Dr. S. Mouchly Small, professor of psychiatry. Chairman of that depart· ment for 27 years until he stepped down in 1978, he is recognized for his leader· ship in the field of mental health. The 1965 Stockton Kimball Award winner was recently elected to his fourth term as president of the national Muscular Dystrophy Association. Also recognized were the 13 School of Medicine retirees who received emeritus status, and all new faculty appoint· ments. Twelve faculty who died during the year were remembered. I ing this honor include some of UB's most prominent faculty memb~rs: Drs. Ernest Witebsky, Mitchell Rubm, Hermann Rahn, Felix Milgram, O.P. Jones, Erwin Neter Leon Farhi, Donald Rennie Franci~ Klocke, and Giuseppe Andres, among others. The Dean's Award was presented by Dr. John aughton t~ ~nother nationally prominent phys1c1a~,. Dr. Evan Calkins, professor of me~ICIJ?e a~? d. h.ead of that department's Genatnc D1v1s10n. He is the co-director and co-founder of the new Western New York Geriatric Education Center and founded the Network for Aging in Western New York. The Harvard graduate has been with UB since 1961. Dr. E. Russel Hayes, professor of anatomical sciences, received the Distinguished Service Award. ~e. is known for his talents m orgamzmg quality academic program~ and . in working with students, mcl~dmg minorities. Dr. Harold Brody, cha1rman of anatomical sciences, describes him as "a true scholar and master histochemist, histologist, and optics specialist." The student-selected Best Teachers of the UB School of Medicine received the T raditionally, the Stockton Kimball Lecture is given each year by the previous year's recipient of the Stockton Kimball Award. The 1983 recipient, Dr. Worthington ("Bud") G. Schenk, Jr., professor of surgery, described "How To Measure Blood Flow:' Dr. Schenk related the medical history that led to methods to measure blood flow. His own interest began 31 years ago while he was reconstructing a vein and implanting a valve. As he watched the patient's leg redden with its restored blood supply, he wondered if it were possible to measure blood flow. He then decided to investigate. The first attempt to do so was undertaken by a German doctor in the 1800's, who created a crude U -shaped flow measuring device. Then Michael Faraday invented an electromagnetic flowmeter, the first to measure blood flow by this method. But "the electromagnetic idea lay dormant for 70 years" before further work was pursued, Dr. Schenk explained. Colon and Wedderer again attempted to measure blood flow in 1936 using electromagnetic currents. Their ap· paratus failed "because of deposits that formed on the poles, cutting off the cur· rent;' Dr. Schenk said. Ten years later, Ben (Swifty) Den· nison and Merrill Spencer retried the idea and discovered that an alternating current led to success. Dr. Schenk then related how an M.D. with no formal electronic education was able to invent what was essentially an electrical, not a medical, device. "Dr. Dennison got his electrical education on a World War II destroyer;' Schenk commented. "Out of boredom, he decided to read two electronics texts." Dr. Schenk heard about Dennison and Spencer's successful but crude device and sought to obtain a duplicate apparatus. "But the problem was, how do you duplicate a device that has no schematic or recorded dimensions?" he wondered. He went on, "In their church were two electrical engineers who agreed to figure it out. When they completed their analysis, they drove all the way from Bowman-Gray to Buffalo with their diagrams." Schenk and his associates managed to successfully duplicate the device. "It was a very touchy device, however. When I wasn't there, it wouldn't work. It was so sensitive that we knew when the elevator BUFFALO PHYSICIAN • 25 �Medical School Newswas passing our floor or when the spectrometer was operating because of its effects on the device;' Schenk reported. With the device in operation, Schenk applied it to medical resear~h_. H~ used it to study the effect of InJeCtion of chemicals on animal kidneys and tested the effects of animal cardiac damage on blood flow. Of significance, he was the first to record human hepatic blood flow. Using dogs, he induced artificial pancreatitis and learned that this disease no longer appears to be an inflammatory disease. Instead, "it appears to be an ischemic disease;' he remarked. "That means we've been on the wrong track all • this time." 0 ~------------~~-,r--------------------------------------------, ~ 5 ui 0 ~ 0 g I Q. Dean Naughton He's now a VP also A major University administrative reorganization is now in place - and with it, Dr. John Naughton has been appointed to the position of vice president for clinical affairs, in addition to his role as dean of the School of Medicine. Naughton had served as interim vice president for health ciences for 10 months after Dr. F. Carter Pannill resigned from that post. Also part of the reorganization is the creation of the new position of University provost. Dr. Steven Sample, UB president, selected William R. Greiner to be the provost who is now the University's chief academic officer. Greiner, a 49-year old professor of law, had served since December, 1983, as UB's interim vice president for academic affairs. The appointments mark a major restructuring of the University in which all academic divisions, both the health sciences and the academic departments, will report directly to a single chief academic officer. In Dr. aughton's new role as a vice president, he will be responsible for all the University's clinical relationships, including those with the affiliated and other area hospitals. As dean, he will report to Provo t Greiner on academic matters; as vice president, he will report to President Sample on clinical matters. Dr. aughton will oversee clinical relationships not just within the Medical School but within other professional schools as well. These include the schools of Dentistry, Pharmacy, ursing, and Health Related Professions. "The reorganization means there will be one voice for the Medical School regarding hospital affairs;' the new vice president for clinical affairs stated. "It unites, for the first time the clinical side and the basic science side 'of the School, as well as the hospital 26 • BUFFALO PHYSICIAN Dr. John NaulllltDn Is llf1W vice lftSident tot clinical attaiTS In adlllrlon ru IJeiiJf dean ~ rile St:hool ~ Medicine. boards and committees." Dr. aughton described another important change. "There will now be a direct interaction with Dr. Sample. It as ures a most effective relationship between the President and the University's clinical affairs - the President will not be a third party in the e matters." The change will assure smooth administration in other areas as well, Dean Naughton said. Faculty development programs, approvals, promotions, and the like will remain in one office, rather than having to pass through two offices. Some of the clinical roles of the other health science schools include the dental clinic, the Pharm.D. program, and the developing graduate education and research programs in the chools of Nursing and Health Related Professions. Dr. aughton will be assisted by Dr. Donald Larson, the new associate vice president for clinical affairs. Larson will oversee the Office of Clinical Affairs, which will administer matters dealing with the Graduate Medical/Dental Education Consortium, the medical and dental clinical practice plans, continuing medical education programs, the house staff association and coordination with other health science school deans. Dr. Larson is also a professor of biology and has been with UB since 1973. In an unrelated move, the School of Medicine has announced a new assistant dean for fiscal affairs. Anthony Campanella has been appointed to that position to replace Bernice Fiedler, who retired after seven years as assistant dean and 14 years at UB. Mr. Campanella previously served as the University's director of payroll for six years. He has worked at the University for 16 years. As the Medical School's chief fiscal officer, he will be responsible for the School's budget and salaries, as well as for processing of appointments. Regardless of the changes, Dr. aughton assured that "we will continue working to evolve a quality medical school and a strong health science program and to ensure that work initiated over the past few years to develop a cooperative effort among our programs will continue." • �Hospital News Major ACS grant Goes to Roswell Park T he American Cancer Society/Ann F. 1eehan Special Institutional Grant for Cancer Cause and Pre\'ention Research has been awarded to Roswell Park Memorial Institute, the , ew York State Department of Health's comprehensive cancer center m Buffalo. The fi\'e-year, 500,000 ~rant, being funded primarily through the bequest to the American Cancer Society (ACS) from the estate of Ann F. Meehan, will fund epidemiologic studies on cancer cause and pre\·ention. The studies "ill be conducted by Dt-. Curtis Mettlin. director of Cancer Control & Epidemiology at Roswell. . The research project will establish a program for the systematic collection of information from cancer patients admttted to the Institute and from healthy controls examined in its Cancer Pre,cntion-Detection Center. According to Dr. .:\Iettlin. who will conduct the studies. ''The informauon collected will allow us to re\'iew the life styles dietary and >moking habits, etc. -of a large number of cancer patients and people who don't ha,·e cancer. O\'Cr a fi,c-year period. By comparing this information. in.~ ca>e-control studv we will be able to test ddfcrent hypothes~; on the possible roles of cn,ironmental, dietary, occupational. familial. and other lactors in either causing or helpin~ to prewnt cancer at \'arious sites." The ACS estimates that the cause of approximately 80 per cent of all cancers is somehow related to one or more of these lifestyle factors. The t·esults of the Roswell Park study may be important in helping to focus on the relati,·c t·isk associated with each factor and identify those factors possibly protective against cancer. "Data gathered will be useful in developing guidelines for modtfication and educational programs for the public awareness of the life-style factors that may be important m cancer tause and prevention:' said Dr. Mettlin. • will be able to obtain better prices for services and supplies. v\'e will now ha\'e 887 beds with an annual operating budget of approximate!; 75 million. It will give us a better base on which to negotiate with vendors ... and to compete with other institutions." Expenses will be reduced by centralizing data processing and credit collection, and by coordinating laboratory services. Mr. Weber points out it will also enable the three hospitals to better serve the needs and expectations of their patients and the community. Mercy Hospital of Buffalo, incidentally. is celebrating its 80th anni,·ersary this year. • Mercy System Hospitals join forces Arbesman Lab r. Mary Annunciata. superior general of the Sisters of Mercy of the Buffalo Diocese, recently announced that Mercy Hospital of Buffalo, Kenmore Mercy Hospital, and St. Jerome's Hospital of BataYia, along with the Sisters of Mercy, ha\'C joined together to form the .:\1 crcy Health System of \.Vestern New York. A formal affiliation, not a mer~er, it is "a multi-hospital system established to enhance the working relationship between all three area Mercy hospitals," states Mr. Thomas \\Ieber. new acting coordinator of the system. The new system was formed to pro\'ide greater financial stability. "By working to~ether through a multi-hospital system, we Late allergist honored he allergy research laboratory at Buffalo General Hospital has been named in memory of Dr. Carl E. Arbesman, internationally known allergist who founded it in 1945. Dr. Arbesman, regarded as one of the founding fathers of allergy research and diagnostic techniques, died in 1982. A 1935 graduate of the UB Medical School, he served on the staff of Buffalo General for more than 40 years. A clinical professor of microbiology before he retired, he was on the Medical School • faculty for 41 years. At dedication of Allerw llesean:h Lab to tile late Dr. cart E. Alflesman ll·RJ: Dr. Elliott Middleton: David AlfleSman, Dr. AlfJesman's son: Dr. Robert E. Reisman, and Dr. Michael f. Noe. BUFFALO PHYSICIAN • 27 �GERALD SUFRIN, M.D. , HAS BEEN HONORED by being elected to the prestigious American Association of Genito-Urinary Surgeons. He is professor and chairman of UB's Department of Urology. Election to the association represents the highest form of peer and professional recognition that a urologic surgeon can attain. Membership is highly selective, being based on an individual's distinguished accomplishments in the field of urology, especially genito-urinary surgery and study and treatment of urological disorders. There arc only 75 active members. Dr. Sufrin also has been elected to the Research Committee of the American Urological Association, which develops long range planning for urological research. On the faculty of UB's School of Medicine for over three years, Dr. Sufrin is director of urology at Buffalo General Hospital. He was previously a research scientist at Roswell Park Memorial Institute and professor at Washington University School of Medicine. After earning his medical degree in 1966 from Upstate Medical Center, he completed his residency at Johns Hopkins Hospital. Dr. Sufrin is well known for his research in the diagnosis and treatment of diseases of the kidney, bladder and prostate, especially renal adenocarcinoma and bladder cancer. A member of the American Urological Association, the American Association for Cancer Research and New York Academy of Sciences, he is also on the Board of Trustees of the Foundation of Buffalo General Hospital. In addition, he is a member of Alpha Omega Alpha, the medical honor societv. Th~ American Association of GenitoUrinary Surgeons was founded in 1886 for the purpose of promoting the study of diseases of the genito-urinar·y organs. Among the or-iginal founding members was the noted Buffalo surgeon Dr. Roswell Park. The objecti\Cs of the association are implemented at its scientific meetings where in the past results of many fundamental advances in the diagnosis and treatmenr of genito-urinary disorders ha\-c been presented for the first • time. DR. CARLOS E. PALANT, RESEARCH ASSOciate professor of medicine, is one of 12 medical researchers in the United States named a Charles E. Culpepper Foundation Fellow. He is the first UB researcher to be named a fellow of the Foundation. He will receive $25,000 to allow him to continue specialized research in kidney disease. • DR. CAREL J. VAN OSS, PROFESSOR OF MIcrobiology, was recently appointed to three administrative positions: The LaMer Award Committee of the American Chemical Society, the Advisory Board of the journal of Col28 • BUFFALO PHYSICIAN loid and Interface Science, and the editorial board of the journal of Protein Chemistry. • DR. DONALD P. SHEDD, RESEARCH PROFESsor of surgery and chief of Roswell Park's Department of Head and Neck Surgery Oncology, was guest lecturer at the U nivcrsity of Pretoria, Republic of South Africa, dur·ing September. Dr. Shedd presented lectures on the diagnosis and treatment of tongue and larynx carcinomas. • CHARLES V. PAGANELLI, PH.D., PROFESSOR and associate chairman of physiology, has been appointed chairman of the University's President's Review Board (PRB) by P resid ent Steven B. Sample. The PRB is responsible for advising the president on decisions regarding appointment, promotion and tenure of UB faculty. A member of the faculty since 1958, Paganelli has served as associate and acting chairman of the Department of Physiology and also as director of graduate studies in that department. President Sample described Dr. Paganelli on his appointment, saying "He has an outstanding record as a scholar, and his distinguished academic career includes visiting professorships and ... numerous research projects:' He most recently served as a member of the Honors Council for the Presidential Scholars Honors Program. • DR. VICTORINO ANLLO, CLINICAL ASSISTANT professor of urology, has been elected president of the Erie County Medical Society for the period June 1984 to June 1985. He succeeds D r. J ames P hillips, clinical professor of medicine. Anllo is an attending urologist at Erie County Medical Center, Kenmore Mercy, and DeGraff Memorial hospitals. A graduate of the University of Madrid School in Spain, Dr. Anllo did postgraduate work at UB's School of Medicine in 1960. He has previously served as president of the Buffalo Urological Society and of the medical staff at DeGraff Memorial Hospital. D r. Leo E. Manning, clinical assistant professor of medicine, will serve as presidentelect; Dr. Allen L . Lesswing, clinical assistant professor of orthopaedics, is the new vice president; and D r. Nancy H . Nielsen, clinical assistant professor of medicine and microbiology, is the new secretary-treasurer. • DR. PHILIP K. Ll, RESEARCH ASSISTANT PROfessor of pediatrics and clinical assistant professor of pathology at Children's Hospital, has been asked to serve on the Research Committee of the New York Affiliate of the American Diabetes Association. This committee will evaluate statewide projects and recommend funding priorities. Dr. Li is director of clinical chemistry at Children's Hospital. • Dr. Vlctlllfno Anllo: president of Etfe Countr Medical Socletr. DR. MAREK ZALESKI, PROFESSOR OF MICRObiology, was recognized June 2 by a former U.S. Ambassador to Poland for his role in translating the "Bible of Solidarity" to English. R ichard Townsend Davis, who served as ambassador from 1973 to 1978, introduced the English translation of "The Spirit of Solidarity;' recently published by Harper & Row. The 128-page book, which is censored in Poland, contains 23 sermons and essays by Rev. Josef Tischner, the Polish priest and philosopher whose words have fueled and sustained the spirit of the Solidarity movement. Money received for the book will be donated to Editions Spotkania, the Polish emigre publishing house in Paris. • DR. JOHN LORE, PROFESSOR AND CHAIRMAN of otolaryngology, was a guest speaker at the April 14 to 17, 1984, ORL/Head and Neck 2nd Asian Congress at Genting Highlands, Malaysia. He spoke on several subjects including voice rehabilitation after laryngectomy; head and neck cancer - management policy; thyroid surgery and reconstruction following pharyngolaryngectomy. • ERIE COUNTY -MEDICAL CENTER'S 63RD Annual Graduation Ceremonies for house staff residents honored two UB faculty members on June 1, 1984. D r. G erald Logu e, professor of medicine �Peopleand attending hematologist, received the Outstanding Teacher of the Year Award. This award is chosen by internal medicine house officers at the Medical Center. D r. James Corasanti, clinical assistant instructor in medicine, received the orman Chassin Award as outstanding house officer. He is a resident with ECMC's Department • of Internal Medicine. DR. CARL GRANGER, PROFESSOR OF REHABI· litation medicine, attended the 9th International Congress of Physical Medicine and Rehabilitation in Jerusalem recently. Revolutionary new approaches to the problems of the victims of war, road accidents, stroke, and heart disease were discussed. He is also head of Buffalo General Hospital's Department of Rehabilitation Medicine. • DR. NEIL DASHKOFF, CLINICAL ASSISTANT professor of medicine since 1975, has been named director of the Coronary Care Unit at Sisters of Charity Hospital. A member of DR. JOSEPH PREZIO, CLINICAL PROFESSOR and chairman of nuclear medicine, has been appointed as representative from the 8th District Branch to the aminating Committee of the Medical Society of the State of New York. • DR. THOMAS J. GUTIUSO, THE MEDICAL School's director of medical admissions and clinical assistant professor of ophthalmology, was named director of Erie County Medical Center's Department of Ophthalmology. • DR. JOHN E. FISHER, CLINICAL ASSOCIATE professor of pathology, is the new president of the Western New York Society of Pathologists. He is also a clinical assistant professor of pediatrics at Children's Hospital. • DR. VENKATARAMAN BALU, ASSISTANT PROfessor of medicine, was recently elected a Fellow of the American College of Physicians. He is a cardiologist at Veterans Administration Medical Center. • DR. MAGGIE WRIGHT, ASSISTANT DEAN FOR 9 th INTERNATIONAL CONGRESS OF PHYSICAl MEDICINE ~ REHABiliTATION JERUSALEM ISRAEL MAI13·'8 1984 O')Wn' student affairs in the Medical School's Office of Medical Education, was elected cochairperson of the Minority Affairs Section of the AAMC Northeast Group on Student Affairs at a conference held in Baltimore, April 27. She will coordinate programs and evaluations of minority students interested in medicine in the Northeast, as well as faculty development. She is adjunct professor in UB's Department of Counseling and Educational Psychology. She received her Ph.D. from that department in 1981. Dr. Wright is also chairperson of UB's Equal Opportunity Affirmative Action panel, on the board of directors of the following organizations: Crippled Children Guild of Buffalo and Erie County; Peoples, Inc.; Child and Adolescence Psychiatric Clinic, Inc.; and AACP-ACT-SO. • tion, held at the Buffalo Marriott Hotel. Dr. Manning has had various papers on neurologic disorders published and is a member of the American Society of Neuroimaging. • DR. EDWIN H. JENIS, CLINICAL PROFESSOR OF pathology, was elected to a five-year term on the Board of Directors of Blue Shield of Western ew York, Inc., on March 28. Dr. Jenis is chairman of pathology at Millard Fillmore Hospital, and consultant in renal pathology at Georgetown Universitv School of Medicine, Washington, D.C. H~ is certified by the ational Board of Medical Examiners and the Board of Anatomic and Clinical Pathology. • DR. EHSAN AFSHANI, CLINICAL ASSOCIATE professor of radiology and pediatrics at Children's Hospital, was recently elected president of the Buffalo Radiological Society. This 100-member organization represents all • radiologists in Western New York. DR. CEDRIC SMITH , PROFESSOR OF PHARMA· cology and therapeutics, presented "Susceptibility to Hangovers in the General Population and in Alcoholics" at the 1984 ational Alcoholism Forum Celebrating Prevention. Held in April 1984 in Detroit, it also celebrated the 40th anniversary of the National Council on Alcoholism. • DR. DONALD RENNIE , VICE PRESIDENT FOR Dt. can Branger (center} wttll Ill. Joshua ChaCO (lett} and Dr. Alex Magora (1111htJ, bOth rl HadaSSah unlversltr HOSPital, Jerusalem, at conference In Israel. Sisters' medical staff since October 1980, he serves as chairman of the Research Committee of the Western New York Chapter of the American Heart Association and is the past president of the Western New York Cardiovascular Society. Dr. Dashkoff is a graduate of, ew York University Medical School and received his cardiac training at johns Hopkins Hospital in Baltimore, Md. • research and professor of physiology, has been selected to participate in SUNY's Faculty Exchange Scholars Program for the 1984 through 1987 academic years. The purpose of the program is to allow institutions throughout SUNY to profit from lectures and other interactions with well-established authorities in various fields. Visits by exchange scholars to other SUNY campuses normally are two to three days in duration. • DR. EDWIN J. MANNING, CLINICAL ASSOCIATE professor of anatomical sciences and neurologist at the Dent Neurologic Institute of Millard Fillmore Hospital, was recently selected to address the local American Association of Medical Assistants at their 25th Annual Convention. Dr. Manning lectured on Alzheimer's Disease at the conven- Dr. lllnald Rennie BUFFALO PHYSICIAN • 29 �The late Dr. Alfhur J. Ctamer lllflhtJ with Ewald lllschar, a paUent trom tour rtecartes ago. A special kind of reunion Doctor helped patient again - W hen Ewald Rischar spotted the profile of Dr. Arthur]. Cramer in his Williamsville home, it was more than the typical World War II reunion of American doctor and German patient. Dr. Cramer is a retired UB faculty member. The meeting holds the key to what Mr. Rischar hopes will be a better life if the American doctor can provide proof that he saved the German's life 39 years ago with a shot of penicillin to treat a kidney injury. The injury has plagued Mr. Ri char since an American bombing during the war left him pinned under an iron water pipe. He has been in and out of hospitals, unable to work steadily, since the pipe fell on him. But Mr. Rischar said he has been able to collect no more than 30 per cent compensation from the German 30 • BUFFALO PHYSICIAN after 40 years By Rod Watson government for his kidney treatments because they want him to prove the ill~ ness is linked to the wartime blast. That led Mr. Rischar, 56, and married with three sons, on a lifelong search to find a doctor a continent away whose name he did not even know. Physicians at home warned him it would be a hopeless endeavor, and other Germans he asked for assistance did not seem to understand the urgency of Mr. Rischar's mission. Finally, a U.S. Air Force general stationed in his home town of Rum sen, West Germany, helped Mr. R1schar place an ad in 1973 in the journal of the American Medical Association. The ad began "Were you there in '45?" and went on to describe the circumstances in which a 16-year-old German youth was pulled from death's door by an American physician. An Army captain with the 132nd Evacuation Hospital from 1938 to 1946, Dr. Cramer later returned to his native Buffalo to set up practice on Colvin Avenue and direct the pediatrics ward at Kenmore Mercy Hospital. He served on UB Medical School's faculty from 1948 to 1978. After 42 years of medicine, he retired in 1969 after suffering a stroke. In and out of the hospital himself, Dr. Cramer, now 75 , saw the ad while sitting in a wheelchair in Kenmore Mercy in 1973. However, he was too sick at the time to pursue it, even though he was sure he was the doctor being sought. He clipped the ad for future reference, but didn't uncover it until December 1982. After writing to the AMA in January 1983 and getting no response, Dr. Cramer wrote directly to Mr. Rischar last fall. Still, he didn't expect his former patient to show up so soon. Mr. Rischar borrowed money from his sister to make the trip and arrived in New York months later. After the German Embassy there refused to help and he couldn't locate friends he knew, he hopped a bus to Buffalo. The Cramers got a surprise phone �People- Dr. Elliott Middleton call from a stranger in the bus station, asking them if they knew an Ewald Rischar, and Dr. Cramer's son went down to rescue him. When Mr. R ischar walked in the house and caught a glimpse of Dr. Cramer's profile in another room, he immediately knew it was the same one he'd seen four decades ago, as he looked up from his sick bed. Dr. Cramer remembered him as a youth in shock with heavy perspiration, labored breathing and a chest filled with congestion. He gave the youthful Mr. Rischar a shot of penicillin, which was relatively rare at the time, and some sulfa pills he smuggled out of the hospital against orders barring "fraternization" with the Germans. "I went back the next day, because I didn't expect that he'd still be alive:' said Dr. Cramer. "The next day he was a different child entirely .... I was amazed at how promptly he responded, because I was pretty sure he wouldn't be alive!' "He got me my life back:' said Mr. Rischar, in broken English. Now he hopes a notarized letter from Dr. Cramer to German officials will be a second lifesaver and earn him reimbursement for the kidney treatments he • needs. (Repr~nted w1th perm1ss1on from the Buffalo News, where Mr. Watson is a writer.) POSTSCRIPT: Just before the printing of this issue, Dr. Cramer died , one month after his meeting with Mr. Rischar. His obituary is at the end of this issue. Before Dr. Cramer died, he did manage to send the notarized letter to Mr. Rischar in Germany, who reports that th ings are proceeding well. Dr. Bertram A. Portln Dr. Robert E. Reisman 'Best Doctors' Several from UB on list he best medical specialists in the U.S. include seven State University at Buffalo physicians, according to an updated list of the best American doctors in the May and June issues of Town and Country magazine. The 1984 update lists 1500 physicians, grouped according to two dozen or so medical specialties. The list was compiled by author John Pekkanen, who wrote the book The Best Doctors in the US. in 1978. Mr. Pekkanen went to the doctors themselves to ask: "To whom would you turn in case of your own illness?" For this 1984 update, he queried more than 300 physicians by phone, personal interview, and questionnaire. The doctors were polled only for those in their same specialty. To be judged by their peers to be superior doctors, physicians had to be selected multiple times by fellow specialists. Criteria included both the physician's research reputation and skills as a clinical doctor. The first updated list, which appeared in 1981, identified 10 other UB physicians among 3000 as the best in their specialities. Because the current list updates only a portion of the various medical specialties, the 1981 list remains the most up-to-date directory of the best medical specialists in the other fie lds. The updated lists added names of young physicians who had established themselves, and deleted those who had retired or who had requested to have their names taken off. The directory makes it clear that it does not and cannot list every outstanding physician in the country. There are literally thousands of superior doctors who do not appear on the list because they have not received the national attention and exposure that would make them widely known to other physicians. Listed in the Town and Country update are: • • • • • • • Dr. Elliott Middleton Jr., professor of medicine and pediatrics/allergy and immunology; Buffalo General and Children's. Dr. Robert E. Reisman, (M'56), clinical professor of medicine and pediatrics/allergy and immunology; Buffalo General. Dr. Bertram A. Portin, (M'53), clinical professor of surgery and chief of colon and rectal surgery; BGH, Sisters and St. Francis. Dr. Eugene R. Mindell, professor and chairman of orthopaedic surgery; ECMC. Dr. Richard Cooper, associate clinical professor of medicine with a special interest in breast cancer; Buffalo General. Dr. Edward Henderson, research professor of medicine with a special interest in leukemia; Roswell Park. Dr. M. Steven Piver, clinical professor of gynecology and a gynecological cancer surgeon; Roswell Park. Included in the 1981 edition in specialties not upd~tted for Town and Country are: • Dr. Irwin Friedman, clinical associate professor of medicine/general internist; Buffalo General. • Dr. Robin Bannerman, professor of medicine and pediatrics/medical genetics; Children's and BGH. • Dr. Jack Lippes, professor of gynecology/obstetrics; ECMC. • Dr. Robert Patterson (M'50), clinical associate professor of gynecology/obstetrics; Children's Hospital. BUFFALO PHYSICIAN • 31 �Dr. Eugene Mtndell Dr. Edwarrl Henderson Dr. Steven Piver Dr. Margaret H. MacGillivray, professor of pediatrics/pediatric endocrinology; Children's Hospital. • Dr. Alfred R. Lenzner, associate clinical professor of medicine/juvenile diabetes mellitus; Kenmore Mercy. • Dr. Elliot F. Ellis, professor of pediatrics/pediatric allergy; Children's. • Dr. Pearay Ogra, professor of pediatrics and microbiology/pediatric infectious disease; Children's Hospital. • Dr. Jerald P. Kuhn, professor of radiology/pediatric radiology; Children's. • Dr. Arnold I. Freeman, professor of pediatrics/pediatric hematology and oncology; Roswell Park. Besides the four faculty on the list who are UB alumni, seven other alumni are in the 1984 updated directory (the 1981 list was not checked for alumni): • J. Bradley Aust (M'49), University of Texas Medical School, San Antonio, TX, professor and chairman of surgery; GI surgery. • Eugene M. Farber (M'56), Stanford Medical Center, Stanford, CA, professor and chairman of dermatology; special interest in psoriasis. • Eugene Flamm (M'62), NYU Medical Center, New York, Y, associate professor of neurosurgery; special interest in aneurysm surgery. • Richard Gacek (M'56), State University of New York, Syracuse, Y, professor and chairman of otolaryngology. • Robert J. Hall (M'48), medical director, Texas Heart Institute, Houston, TX, clinical professor of medicine, Baylor; cardiology. • Jacob Lemann,Jr. (M'54), Medical College of W isconsin, Milwaukee, WI, professor of medicine; nephrology. • Lawrence W. Way (M'59), University of California Medical Center, San Francisco, CA, professor of surgery; special in- terest in stomach, duodenum, pancreas, biliary. upon this by saying "Try to involve the family as much as possible. Encourage them to treat the patient as a normal person. Maintaining a good outlook is so important. The patient should be discouraged from giving up his or her job because of an illness, and encouraged not to sit in front of a TV all the time, and to do things for himself, and by himself." Keeping current in the medical advances is clearly fundamental. "You must know what is going on and which directions are paying off in cancer research," says Dr. Henderson. "Being up to date gives you the long range view on what treatments can significantly make a difference;' explains Dr. Mindel!. The Directory points out that a large proportion of outstanding doctors are associated with medical schools. Dr. Mindell sheds light on this tendency. "Being at a teaching institution and involved in clinical research stimulates myself (and my residents) in turn. Clinical research requires one to report the results of your treatment to your peers. This assures superior treatment and care, together with good documentation, a large number of cases and long followup." In summary, quality research and quality care, were both major criteria used to select physicians. Dr. Piver perhaps touched on a simple but effective approach to one's patients: "Treat every patient as you would your own family." • 32 • BUFFALO PHYSICIAN R eferring to his widely regarded textbook, Allergy Principles and Procedures that he coauthored with Dr. Elliot Ellis, Dr. Middleton explained that "it uniquely brought us national recognition. Other excellent M.D.'s are not known simply because they don't publish as much." If publishing widely can bring national recognition, so can belonging to national medical organizations. Dr. Portin comments, "Because I am the president of various medical organizations, I am fortunate to have received national exposure." However a doctor receives national exposure, at least in the medical community, he or she has to still be selected by fellow specialists as superior both from a research reputation and as a clinical doctor. When asked what attributes and approaches make a difference in the quality of doctors' relationships with, and care of, their patients, several of the local physicians cited came up with common themes. One essential ingredient is to "treat your patients as whole people with a particular problem," states Dr. Elliott Middleton. "It is a great responsibility to maintain a humanity in the relationship," he added. " othing is more important than to listen to your patient," Dr. Edward Henderson emphasizes. Dr. Bertram Portin agrees, saying "To really listen to what your patient is saying, you must give them time, with no rush." A complete examination is also widely agreed to be a crucial ingredient. "There's no substitute for a very thorough evaluation of the patient's complaints. One must take the time to consider all of the patient's factors," comments Dr. Eugene Mindel!. "Never lie to your patients and always give them hope for the future," Dr. Steven Piver points out. Dr. Richard Cooper expand • Bauda Award Given to Jack Coyne T he Charles Bauda Award for excellence in family medicine was awarded this May to fourth year medical student Jack Coyne. The selection committee included Dr. David Holden, chairman of the Department of Family Medicine, and Dr. Raymond Bissonette, associate professor of family medicine. • �PeopleDrinking & driving Doctor helps teens avoid danger T By Bruce S. Kershner eenage drinking may not stop ?ut ~here is now an al.ternative to the dangerous combi~atwn of tee~ age dnnking and driving. That alternatiYe has been mtroduced to the Town of Clarence, a suburb that borders Amherst, by Russell Vaughan, M.D., clinical assistant professor of pediatrics. Called Clarence Against Drunk Driving, or CADD Cab, the program provides free confidential rides home for local teenagers who have been drinking or whose "ride home" has been drinking. The town's teenagers do not have to face the dilemma of being stranded at a party or going home in a car piloted by an intoxicated friend. Operated by teenagers under the guidance of several adults, the service is available from 10 p.m. to 2 a.m. on Friday and Saturday nights year round. It was launched last January 13, 1984. One to three students are stationed at the home base, currently a Clarence church, with a telephone and a CB radio. The students take incoming phone calls, noting the location, destination and caller's first name. One adult stays at the home base to advise on any problems that arise. When a call is received, a CADD Cab, usually a family car, is dispatched. Its driver and partner, always a male/female pair, are trained in CPR and armed with a blanket, first aid equipment and CB radio. The car picks up the passenger, transports him or her home and returns to the home base. The "cab's" partner also takes care of the passenger's needs. Dr. Vaughan, the father of three daugh~ers, learned abo~t a similar program last summer at a medical conference m Florida. When he returned, he inquired about other programs and met with Clarence High School parents, officials and students . .Fr~m there, it took off as a community project. An enthusiastic group of about 40 high school students met with Dr. Vaughan. and other adults to iron out the ground rules. Clare~ce High School handled the publicity while the Chem1cal People, an umbrella organization that deals with drug abu~e, do~ated money. The local Boy Scout Explorer Post affiliated Itself to offer both accident and liability msurance. All Clarence High School students are given cards listing th.e J?hone number. of the program. However, arry teenag~r withm the school distnct boundaries can call for a free and confidential ride home. Dr. Vaughan notes that "even those students who are resistant to the idea still keep the cards." Pointi~g to .two recent fatal crashes involving suspected drunken dnvers m Clarence and Niagara Falls, Dr. Vaughan t~ld the Buf!alo News, "Our progran: is designed to prevent the km~ of a~ndent we've seen involving drinking teenage drivers. Were trymg to prevent that by offering those kids another way home." . T~e idea for such a program was conceived April 1981 m Danen, Connecticut, after a citizen committee met to explore the dr':g .and alcohol abuse problem among Darien's teenag~rs. ~Ithm the next eight months, two Darien teenagers were killed m drunk driving accidents. After that, seYeral ~tud~~ts ,approached a principal, Donald Robbins, saymg, We ve got to do somethmg. A student questionnaire showed that 550 students favored the idea of a telephone hotlme for students to call if they needed a safe ride home; pr. Pedlatlfclan IIDIJett vaughan wltll rount llilrlent; Ire's concemed abOUt teenagers. roo. BUFFALO PHYSICIAN • 33 �Peopleonly 30 opposed it. Most importantly, 55 volunteered to be at the safe end of the line. Several meetings later, the afc Rides Program went into effect in April 1982. T he Safe Rides pmgram quickly became established in every town in the county and elsewhere in Connecticut, Massachusetts, Virginia, Maryland and North Camlina, over 90 programs in all. Says Mrs. Jane Hanley, adult advisor of the Darien program, "There is barely a day that goes by that I don't receive a request for information about the program." Much of the secret of the program's success is its confidentiality, and also its operation by teenagers themselves. Dr. Vaughan's investigations conv inced him that it worked best if teenage volunteers were the drivers. "It doesn't make sense to use adu lts. Kids are afraid adults will give them a lecture or be good friends of their parents;' he said in an interview. Research showed that when adults do the driving, 90 per cent of the calls arc from passengers and only 10 per cent from drinking teenagers. When teenagers pick up their peers, that ratio becomes 50-50. C larence students agree that the program's confidentiality makes it credible. Furthermore, the volunteers do not judge people who drink. They just want to get drunks off the road and make the roads safe for innocent drivers. Dr. Vaughan stresses that the pmgram benefits more than just that person who needs the ride home. The volunteers get '~hh involved in a community service project at an early age, they learn adult responsibilities and they learn how they can make a difference in the world. Perhaps the most gratifying results so far have been changes in the students themselves. "My volunteers report hearing conversations at parties and gatherings that indicate the students are looking at drinking and driving differently. Their attitudes appear to be changing, whether they use us or not;' Dr. Vaughan commented. Mrs. Hanley said, ''I've heard older people say that Safe Rides might, in effect, be encouraging kids to drink more. But that's not the way I hear it from Darien youngsters. With the existence of Safe Rides, it's becoming very 'in' for kids to take car keys away from their friends instead of letting them go barrelling off drunk down the road. It's not that kids are drinking less. But at least they have an alternative way to get home." She continued, "In Darien, there has been a definite change in attitude among teenagers about the acceptability of getting into a car with a drunk driver. They're aware that this is stupid." Dr. Vaughan's aim is to have the program established throughout all of Eric County. "I'm happy to say that school districts in Amherst, Springville and Grand Island are now organizing their own programs," the UB pediatrician remarked. "And I've had inquiries from the communities of Alden, Tonawanda, Lockport and Williamsville it's really encouraging." • ... What's Up, Doc?" UB pediatrician is featured in magazine cover story DR. BERNARD EISENBERG , CLINICAL ASSOciate professor of pediatrics and social and preventive medicine, wa the cover story of the Buffalo News Sunday Buffalo Magazine. The Children's Hospital physician was featured May 13, 1984 in "Ahh ... What's Up Doc? - A Day With A Pediatrician."• 34 • BUFFALO PHYSICIAN �AlumniDues-paying alumni 1,008 graduates on roll for 1984 A special thanks to the 1,008 duespaying medical alumni listed here. And to the nine reunion classes- 1934, 1939, 1944, 1949, 1954, 1959, 1964, 1969, 1974- who contributed $47,180 to the Medical School. 1934 J. Edwin Alford John V. Anderson John M. Constantine Alfred L. George J. Rothery Haight Michael D. Kraska Harry G. LaForge Nicholas Linderman Charles E. May John D. O'Connor Adolline Preisinger Earle G. Ridall W.G. Rocktaschel Myron G. Rosenbaum Maria N. Sarno Edgar A. Slotkin Joseph S. Tumiel Max B. Weiner Stanley J. Zambron 1937 1935 Wendell R. Ames John F. Argue Willard H. Bernhoft Russell F. Brace Raymond H. Bunshaw Benjamin Coleman Kenneth H. Eckhert Maurice B. Furlong James H. Gray Victor B. Lampka James Mark Bennie Mecklin Charles E. Moran Abner J. Moss Clayton G. Weig Kenneth M. Alford John Ambrusko William L. Ball Charles F. Banas Francis E. Ehret Theodore C. Flemming Soli Goodman Stanley J. Jackson George F. Koepf Angelo Lapi Rose M. Lenahan Robert v\'. Lipsett Alice Challen Lograsso James D. Maccallum M. Luther Musselman I rving Weiner David H . We intraub William F. White CLASS 1934 (AbiWeJ J. Edwin Alton/ OettJ and Hany 6. LaForge present reunion lift. (Below} FIRST ROW (seated}: Samuel R. Patti, Max B. Weiner, Edgar A. Slotkln, J. Edwin Alton/. SECOND ROW (seated}: John v. Anderson, William 6. IIDcktaschel, Marfa Naples samo, Rarmond R. Merers. Aldomne Preis· Inter, Hany 6. LaForge, Louis J. Schmm. THIRD ROW (standing}: Nicholas Linderman, Ealfe 6. Rldall, Henry J. Wiser, John M. Constantine, Clrrfstr casttglla, Joseph R. Saab, J. Rotllery Haltht, Joseph S. JIJmlel, Hany Bellman, Michael D. Kraska, Stanler J. Zamllton, James 6. Hantty, Chalfes E. Mar. John D. O'Connor, Alfred L. George. 1938 Charles F. Becker Russell J. Catalano James R . Cole George M. Cooper C harles Donatelli Norman J. Foit C.M. Furtherer Harry C. Law Samuel L. Lieberman Alfred A. M itchell H. Robert Oehler Eustace G. Phillies Maxwell Rosenblatt Walter L. Sydoriak R ichard N. Terry 1939 1936 Marvin L. Amdur Martin A. Angelo Richard C. Batt Donald Brundage Alfred Cherry John P. Crosby Edward G. Eschner Willard G. Fischer Jerome J. Glauber Irving Helfert Frank C. Hoak Thomas F. Houston William F. Lipp Thomas C. McDonough Robert B. ewell Victor L. Pellicano Harold F. Wherley R ussell L. Battaglia Grosvenor W. Bissell LaMoyne C. Bleich George C. Brady R uth C. Burto n Alfred H . D obrak William Dugan M att A. Gajewski J ohn H . Geckler Kenneth Goldstein M a rvin M ogil J ohn Ii'. Mont roy BUFFALO PHYSICIAN • 35 �- - - -- - - -~~ -- CLASS OF 1939 FIRST ROW (seated): John J. Squadrlto, SeotJe C. lll'adr. Ellzabetll P. Olmsted, Everett H. WUp, Frank T. Rlforglato. SECOND ROW (standing): Alfred H. Ooblalc, John H. Beckler, William o. Dugan, Antllonr V. l'ostolott, John Montn1J, Roy E. Seibel, John H. Remington, Kennetll Goldstein. John J. O'Brien Allen A. Pierce John T. Pitkin Philip B. Wels Floyd M. Zaepfel Elizabeth P. Olmsted A.V. Postoloff John H. Remington Frank T. Riforgiato Roy E. Seibel John J. Squadrito Everett H. Wesp Marvin N. Winer 942 1940 Julian J. Ascher John M. Benny Marshall Clinton Jr. Herbert H. Eccleston William Hildebrand Jr. Robert D. Hubbard Warren R. Montgomery Jr. Harold Palanker Russell E. Reitz Albert C. Rekate Norbert J. Roberts Robert H. Roehl C. Henry Severson Allan W. Siegner William 0. Umiker Stanley T. Urban John D. White Ralph T. Behling Paul K. Birtch Marvin L. Bloom Peter G. Brandetsas Salvatore J. Brucato Richard J. Buckley John M. Donohue Alfred S. Evans L. Walter Fix John P. Guinther Joseph V. Hammel Lawrence R. Hardy Richard J. Jones William S. Keenan Jr. Ruth F. Krauss Melbourne H. Lent Ronald E. Martin Georg-e Marvin Robert C. McCormick Franklin Meyer Amos J. Minkel Jr. Robert W. Moyce Kevin M. O'Gorman Walter R. Petersen Adrian J. Pleskow Col. Bradley W. Prior Charles C.B. Richards Nathan P. Segel Ralph E. Smith Jr. Burton R. Stein Winslow P. Stratemeyer Gertrude S. Swarthout James W. Taft Charles J. Tanner Jr. Edmund M. Tederous Hazel J. Trefts Louis A. Trovato Morris Unher Joseph A. Valvo John R. Williams Paul J. Wolfgruber 1944 Anthony M. Aquilina Willard H. Boardman Raymond G. Bondi Robert L. Brown Joseph P. Concannon Eileen L. Edelberg Herman Edelberg Richard W. Egan Newland W. Fountain Thomas F. Frawley Frank T. Frost Andrew A. Gage Harold P. Graser Raymond A. Hudson Sidney R. Kennedy Jr. Frank H. Long Jr. William K. Major Francis C. Marchetta John F. Mantione Casimir F. Pietraszek CLASS OF 1944 1943 1 Joseph T. Aquilina Berten C. Bean Anthony J. Cooper Robert W. Edmonds George A. Gentner Arnold Gross Donald W. Hall Eugene J. Hanavan Jr. Russell S. Kidder Jr. Harold L. Kleinman Daniel J. McCue Frederick E. Mott Albert J. Addesa Horace L. Battaglia Vincent S. Cotroneo George L. Eckhert Harrison M. Karp Diana D. Kibler Boris L. Marmolya Richard Milazzo Vincent J. Parlante John D. Persse Jr. Edward L. Schwabe Martha L. Smith William J. Staubitz Ellzabetll P. Olmsted, Everen H. Wesp (center) and George c. BradJ with 1939 class Iliff. FIRST ROW (seated): Newland w. Fountain, Wlllanl H. Boanlman, Hamid P. Graser, James F. Mohn, Eileen K. Edelbell, James R. Sullivan, Andrew A. Bate, Howanl R. Bamen, John F. Montlone. SECOND ROW (standing): Sidney R. Kennedy, Raymond A. Hudson, Frank H. LDng, t:aslmlr F. Pletraszelc, Her· man Edelbell, Thomas F. Frawley, Canol J. Shaver, Rlchanl W. Egan, Theodore C. Prentice, Rtlbert 6. Wllldnson, Clinton H. Strong, Rtlbert L. Blown, Sidney M. Schaer, Frank c. Man:hetta, William A. Potts, Antllonr M. Allulllna, Ravmond 6. Bondi. ----~~~~n-~-------, �AlumniWilliam A. Potts Joseph Ross Sidney M. Schaer Carrol J. Shaver Walter F. Stafford Jr. Clinton H. Strong James R. Sulli,·an Paul Weygandt R.G. Wilkinson Jr. 1946 Charles D. Bauer Donato J. Carbone Alexander R. Cowper John T. Crissey Lawrence H. Golden Edward F. Gudgel Ross Imburgia Daniel J. Riordan Arthur J. Schaefer James F. Stagg Joseph C. Todoro Jerome I. Tokars Victor C. Welch Jr. Frederick D. Whiting 1948 William H. Bloom Col. James G. Borman Joseph P. Gambacorta Raphael S. Good Myron Gordon Harold L. Graff Warren L. Hollis Judith Liss Landau Vernon C. Lubs John J. Marinaccio Ansel R. Martin Daniel G. Miller orman Minde Darwin D. Moore Cletus J. Regan Thomas C. Regan Lester H. Schiff Charles Shore Clare N. Shumway Jr. Edgar C. Smith Irwin Solomon Rebecca G. Solomon Edward R. Stone Paul Weinberg S. Paul Zola Thomas F. Frawler OetrJ and James R. Sullivan with 1944 class gm. 1945 Richard H. Adler William S. Andaloro Bruce F. Baisch orman Chassin George M. Ellis Jr. Edward G. Forgrave George W. Fugitt Jr. Richard M. Greenwald Donald N. Groff Herbert E. Joyce Ivan W. Kuhl Vito P. Laglia Victor C. Lazarus William . Mcintosh George A. Poda john K. Quinlivan Frederic D. Regan John G. Robinson William J. Rogers III Albert J. Rosso Joseph E. Rutecki Robert C. Schopp David J. Shaheen K. Joseph Sheedy Jacob M. Steinhart Wayne C. Templer George Thorngate IV Gilbert B. Tybring Charles E. Wiles Jane B. Wiles Carl J. Impellitier Charles A. Joy Harold J. Levy Eugene M. Marks Harry Petzing Amo J. Piccoli Herbert S. Pirson Albert G. Rowe Henry M. Tardif W. William Tornow Paul M. Walczak Myron E. Williams Jr. 1947 Bruce D. Babcock William C. Baker Edward S. Breakell William M. Bukowski J. Desmond Coughlin Daniel E. Curtin Robert J. Dean William S. Edgecomb Robert J. Ehrenreich Elbert Hubbard III Peter J. Julian Hans F. Kipping Edwin J. Lenahan Jr. Richard J. Marchand Donald C. uwer James F. Phillips Philip L. Reitz 1950 1949 Carmela S. Armenia J. Bradley Aust Jr. Alfred Berl Harold Bernhard Lawrence M. Carden Julia M. Cullen Philip C. Dennen George M. Erickson Joseph E. Griffin Robert C. Harvey Irving R. Lang Arthur Mogerman Jacqueline L. Paroski Frank A. Pfalzer Jr. William R. Ploss Edward W. Rosner Robert D. Sanford Max A. Schneider Fred Shalwitz James D. Stuart Pierce Weinstein James A. Werick Seymour Aberle Roland Anthone Sidney Anthone Lawrence D. Benken Robert E. Bergner George P. Bisgeier James J. Brandl Carl A. Cecilia Frank Chambers Jr. James A. Curtin Carmen D. Gelormini Robert N. Kling Richard J. Leberer Karl L. Manders Patricia A. Meyer Henry L. Pech Jr. Roy W. Robinson Clarence E. Sanford Helen F. Sikorski Yale Solomon George E. Taylor Hyman Tetewsky Edward C. Voss Jr. Gertrude L. Waite William S. Webster Sidney B. Weinberg Eugene J. Zygaj CLASS OF 1949 FIRST ROW (seated}: Edwarrl W. Rosnet, Lawrence M. carrlen, Julia CUllen, Judith INelnsteln, Ptetce INelnsteln. SECOND ROW (stanlllniiJ: Joseph E. Brittin, Irving R. Lang, PhiliP C. Dennen, William R. Ploss, Robert c. Harrer. �1954 Eugene L Beltrami Joseph L. Campo Nicholas C. Carosella Robert E. Carrel John L. Conboy Robert D. Foley Byron A. Genner III Florence M. Hanson Edward W. Hohensee William J. Howard John A. Kutrybala Jacob Lemann Jr. Allen L. Lesswing Sylvia G. Lizlovs Charles H . Marino Ernest H. Meese Donald J. Murray N. Allen Norman Harry T. Oliver Dr. Julia Cullen an4 Dr. lrrllff Lalit with 1949 class lift. 1951 Jay B. Belsky August A. Bruno Carl R . Conrad James S. Ferguson Allen L. Goldfarb Eugene V. Leslie Thomas J. Murphy John L. Musser Daniel A. Phillips Donald P. Pinkel Marvin J. Pleskow Robert E. Ploss Gerard E. Schultz Robert L. Secrist Bernard Smolens Eugene M . Teich James W. Weigel 38 • BUFFALO PHYSICIAN 1955 Vincent S. Celestino James R. Collins Louis R. Conti Lloyd Damsey Albert A. Franco Frank J. Gazzo Michael J. Gianturco Sami A. Hashim 1953 1952 Donald J. Adams John J. Banas Robert A. Baumler Alvin J. Brown Bruce F. Connell Barbara G. Corley Donald F. Dohn Melvin B. Oyster Neal W. Fuhr Albert A. Gartner Jr. Joseph E. Genewich Donald J. Kelley Melvin R. Krohn Victor A. Panaro John Y. Ranchoff Harry B. Richards James N. Schmitt Byron E. Sheesley S. Aaron Simpson Donald H. Sprecker Oliver J. Steiner Burton Stulberg Roy J. Thurn S. Jefferson Underwood Kurt J. Wegner James F. Zeller Walter A. Olszewski Robert J. Powalski Edward A. Rayhill Edwin B. Tomaka Marlyn W. Voss Paul L. Weinmann Alfred L. Weiss Edward F. Wenzlaff Donald M. Wilson George G. Bertino Stanley L. Cohen Thomas Comerford Jr. Felix A. Delerme Donald L. Ehrenreich Sander H. Fogel Samuel B. Galeota Thomas G. Geoghegan Jack Gold John W. Handel Curtis C. Johnson Herbert E. Lee Harley D. Lindquist Milford C . Maloney Richard J. Nagel Donald 0. Rachow Joseph F. Ruh Molly R. Seidenberg Harold Smulyan John 1 . Strachan Michael A. Sullivan Reinhold A. Ullrich Marvin Wadler CLASS OF 1954 lAIMNeJ Edwanl A. lfarhlll, Edwanl A. Dunlap with class gttt. (Below} FIRST ROW (seated}: Nlcllolas C. Garosel#a, Robert J. Pletman, Joseph L. campo, Allen L. Lesswlng, Paul L. Weinmann. SECOND ROW (standing}: Rlcllanl F. Marer, Jacob Lemann, Edwanl W. llocltstahler, Harrr T. Ollrer, Donald J. Murray, John A. ltutrrbala, Altrell L. Weiss. THIRD ROW (standing}: Edwanl A. Dunlap, Marlyn w. Louis c. Cloutier, Donald M. Wilson, Edwanl A. Rarhlll, Brron A. Benner Ill, llollert J. l'owalsld, William R. Kinkel. Kathryn M . Keicher John H. Kent Edward H. Kopf S. Joseph Lamancusa Winifred G. Mernan George L. Mye Jr. John H. Peterson Leonard R. Schaer Anthony B. Schiavi Ray G. Schiferle Jr. Gerard F. Smith Robert A. Smith James G. Stengel Barbara Von Schmidt Eugene B. Whitney Donald A. Wormer �Alumni1956 John D. Bartels M. David Ben-Asher Helene E. Buerger Robert B. Corretore joseph]. Darlak Peter S. Darrigo Edmond ]. Gicewicz Frederick P. Goldstein Francis B. Haber Dennis P. Heimback John M. Hodson Oliver P. Jones Sr. Joseph L. Kunz Sue A. McCutcheon Robert G. Mcintosh Frederick C. Nuessle Hugh F. O'Neill Erick Reeber Robert E. Reisman Paul C. Ronca Herman R. Schoene Bernard H . Sklar ·[In FOllNP~TIO\ ~ t lJ1C'tLJand Jwo ~ Unr/.-;,L Ct.aJ.J a.! ' CLASS OF 1959 1957 Arthur L. Beck Bronson M. Berghorn Harold C. Castilone Benny Celniker Marvin N. Eisenberg Gerald Friedman Myron Garsenstein Lorie A. Gulino Barbara]. Hetzer Kenneth K. Hines Harris H . Kane! Joseph F. Kij Jr. Charles E. Lowe Ross Markello Herbert Metsch Richard F. Miller Charles F. O'Connor ] ohn S. Parker Herbert Silver Robert B. Sussman Bernard D. Wakefield Edward ]. Weisenheimer Sherman Waldman 1958 john V. Armenia David A. Berkson Richard C. Boyle Melvin M. Brothman Ronald W. Byledbal Franklyn N. Campagna Gary . Cohen Bernice T. Comfort Robert C. Dickson Frederick W. Dischinger Domonic F. Falsetti (AIMWeJ Or. Rlchanl Falls. Dr. John J. McMahon. (BelowJ FIRST ROW (seatedJ: Mortimer A. Schnee, Elton M. llock, Daniel C. Kozera, Donn L. fdcht, Mart Ann Blshara, valentine Dedulln, Jacob Krfef18r. SECOND ROW (standlngJ: Marvin 6. Osotskr. John J. McMahon, Rlchanl Falls, James M. Cole, Rlchanl H. Musgnug, Joseph F. Monte, Russell Spoto, George F. Ramser, Ell M. Isaacs, Thomas D. Doeblln, Rarmond C. Thweatt, Constan· tine J.6. Cretelcos, William P. Blaisdell, Daniel H. Nlnburg, William J. Mangan, 6eol'll8 R. Baeumler. Jacob Krieger Joseph F. Monte Richard H. Musgnug Julius V. Rasinski Jr. Elton M. Rock Russell C. Spoto Jason H. Stevens Raymond C. Thweatt Donn L. Yacht 1960 Michael T. Genco John]. Giardino John F. Holcomb Leo A. Kane Marie L. Kunz Michael A. Mazza Lucien A. Potenza Richard A. Rahner Elliott Rivo Richard R. Romanowski Walter H. Rothman Samuel Shatkin Morton Spivack Alfred M. Stein Richard D. Wasson Morton B. Weinberg Reinhardt W. Wende James S. Williams Franklin Zeplowitz Harold B. Zimmerman Joseph A. Zizzi 1959 George R. Baeumler Mary Ann Z. Bishara William P. Blaisdell Robert ]. Brennen Constantine Cretckos Valentine Dedulin James R. Doyle Richard A. Falls Seymour D. Grauer Eli M. Isaacs Daniel C. Kozera William E. Abramson Joseph G. Antkowiak Robert Bernat Theodore S. Bistany Joseph A. Chazan D. Jackson Coleman Roger S. Dayer Edward ]. Graber Thomas ]. Guttuso James R. Kanski Jr. Franci ]. Klocke Harry H. Nakata Daniel A. Rakowski Charles ]. Riggio Gerald L. Saks John A. Tuyn 1961 Harold Brody Allan S. Disraeli Richard C. Hatch William ]. Hewett Norman E. Hornung Alonza C. Johnson BUFFALO PHYSICIAN • 39 �---- 2 Martin Cowan H arold C. Domres Jr. Sebastian Fasanello Anthony J. Floccare Joseph R . Gerbasi Roberta M. Gilbert J oseph W. H anss Jr. M. Peter Heilbrun Arthur C. Klein Morton P. K lein Gordon R . Lang Paul J. Loree Arnold . Lubin Michael M . Madden Anthony P. Markello Philip D. Morey Robert G. Ney Gerald E. Patterson Bernard Polatsch Melvin J. Steinhart 1963 Frank E. Ehrlich John R. Fanelli Ernest A. Fatta Anthony M. Foti Anita J. Herbert William C. Heyden Paul A. Lessler Albert J. Maggioli David . Malinov Don L. Maunz Richard B. arins Ronald G. Nathan Thomas J. Reagan John A. Repicci Henry A. Scheuermann Robert B. Spielman John N. Stumpf Eugene M . Sullivan Jr. Joseph C. Tutton Bela F. Ballo Jeffrey S. Carr Walter A. Ceranski Paul Cherkasky M ichael Feinstein William A. Flemming George R . Glowacki Michael Goldhamer Gerald B. Goldstein John S. Hazeltine Stephen P. Katz Charles T. Ladoulis Marilyn A. Lockwood Ronald S. Mukamal Lillian V. Ney David E. Pittman John F. Reilly Jr. maf 5 G) r ,~·~m lfv r( UNDATIO~.INC I! CLASS OF 1964 FIRST ROW lseatefl}: walter D. Hllltman, William Flemlnt, Daniel Keefe, J. Frederick Painton, David J. Weinstein. SECOND ROW lstandlntJ: Michael Feinstein, Rlchanl E. Wolin, Stephen P. Katz, lrrlnl Sterman, Elizabeth Boerlnt Serral8, Charles T. Ladoulls. Joseph A. DII'Dala, Leo M. Michalek, Jettrer S. Can, Anthonr V. Ferrari, Robert Wels. V'-. c~4 l\' of 19 64 Sheldon Rothfleisch William Salton Stephen C. Scheiber Elizabeth G. Serrage Irving Sterman Paul Sussman David J. Weinstein Richard W. Williams David C. Ziegler John E. Spoor 1965 William H. Adler III John J. Bird William C. Bucher Jr. Joseph G. Cardamone Lance Fogan Jerald Giller Anthony V. Grisanti Ira Hinden Sanford R . Hoffman Calvin Marantz R. Scott Scheer Robert N. Schnitzler Daniel S. Schubert Robert W. Schultz Joel Steckelman Louis Trachtman Maj. W. Scott Walls III Benjamin J. Wherley John R. Anderson Robert M. Benson orman Berkowitz Michael J. Costello Barry M. Epstein David J. Fugazzoto Douglas D. Gerstein John W. Gibbs Jr. Leon Hoffman Murray C. Kaplan Jacob S. Kriteman Roger J. Lagratta David L. Larson Anthony J. Logalbo John P. Menchini Donald E. Miller Dorothy M. Murray Thomas P. O'Connor Laird C. Quenzler Steven E. Rinner Harvey A. Schwartz J. Brian Sheedy Thomas P. Sheehan Arthur C . Sosis George S. Starr James M. Strosberg Linda Young Richard Young 1966 , &; 503-:J J, lf'C ]h.Ot.LMn.d Jfwd.'f ~,,.. 40 • BUFFALO PHYSICIAN - 96 David S. Berger Max M. Bermann James R. Blake David T. Carboy 1)\' - - Michael Madianos A. Thomas Pulvino Stephen D. Rader Paul T. Schnatz Arthur T. Skarin Paul Stanger Jacob Y. Terner Ronald H. Usiak Robert E. Winters r,, lj ~- ---~-- Robert Barone Thomas W. Bradley C. Wayne Fisgus Melvin Fox Patrick J. Kelly Kenneth Klementowski John N. Laduca Melvyn B. Lewis Jeffrey E. Lindenbaum Joseph F. Martinak Donald M . Pachuta Roger W. Seibel 1968 Leonard A. Argentine Lawrence D. Baker William E. Clack Gary H . Cramer Thomas J. Cumbo Lawrence J. Dobmeier George L. Druger Ronald J. Friedman Bruce H . Gesson Raymond Hansen Kenneth L. Jewel �Harvey I. Weinberg Madeline J. White Brian S. Joseph Richard F. Kaine Milton P. Kaplan Julian R. Karelitz Raymond A. Martin Kenneth W. Matasar Robert A. Milch Jonathan C. Reynhout Robert D. Rodner Paul S. Schulman Jean D. Williams Charles P. Yablonsky 1970 Ronald H. Blum Donald P. Copley Vincent G. Cotroneo Allen Davidoff Eben I. Feinstein Charles A. Fischbein Sigmund S. Gould Harvey Greenberg Mark S. Handler David E. Hoffman Scott D. Kirsch Stanley B. Lewin Richard A. Manch Martin N. Mango Donald H. Marcus Denis G. Mazeika Paul M. Ness Roy M. Oswaks Richard I. Staiman Dale A. Vanslooten Ilja J. Weinrich 1972 Richard A. Berkson Martin Brecher David S. Buscher John J. Dalessandro Patricia K. Duffner Robert Einhorn Robert Z. Fialkow Ian M. Frankfort John W. Kraus Robert B. Kroopnick Paul S. Kruger Alan I.Mandelberg Ira L. Mintzer Kenneth C. Rickler Stuart Rubin Stuart R. Roledano Harold J. Weinstein John W. Zamarra 1973 Robert Hartot (left} allll William Ma/01 pment 1969 class gm. 1969 Alan H. Blanc Joel B. Bowers James L. Cavalieri II Laurence A. Citro Lang M. Dayton Arthur L. DeAngelis Carl J. DePaula john R. Fisk Robert J. Gibson Timothy F. Harrington Robert M. Hartog Hanley M. Horwitz Russell G. Knapp Jr. Daniel B. Levin William K. Major Jr. Stephen W. Moore James A. Patterson Douglas L. Roberts Warren Rothman Thomas S. Scanlon Lester S. Sielski Michael F. Smallwood Ronald F. Teitler Joel H. Paull David W. Potts David M. Rowland Kenneth Solomon Ellen R. Fischbein Roger A. Forden Arthur R. Goshin Dennis J. Krauss Alan I. Leibowitz Michael L. Lippmann Bruce H. Littman Russell P. Massaro Frank A. Miller Alan M. Podosek Bruce M. Prenner Daniel J. Schaffer Arthur M. Seigel Shafic Y. Twal Robert M. Ungerer Harold M. Vandersea William S. Bikoff Yung C. Chan Jeremy Cole Nancy L. Dunn Robert G. Fugitt Kenneth L. Gayles Michael A. Haberman Jeffrey P. Herman Frederic M. Hirsh Robert Huddle Sharon Kuritzky Dana P. Launer James S. Marks Charles J. McAllister Arthur W. Mruczek Joseph M. Mylotte Garsutis K. Palys CLASS OF 1969 FIRST ROW (seated}: Daniel B. Levin, Joel B. Bowers, Dorotllea Downey Muscato, Robert Blbson, Hanley M. Herwltz. SECOND ROW (standlntJ: James J. While, Arthur DeAnii811S, Russell 6. Knapp, Robert M. HartoJ, James L. Cowallerl, Stephen W. Moore, William K. MaJet, Michael F. SmaiiWDOII, nmoriJJ F. HanfllftOn, DtuJias Roberts. Bemanl Muscato. 1971 Allen I. Berliner Jerald A. Bovino Kenneth J. Clark Jr. Terence M. Clark Eric M. Dail BUFFALO PHYSICIAN • 41 �Robert L. Penn John E. Przylucki Jon P. Rubach Barry Sanders Mark N. Scheinberg Arnold W. Scherz Gary J. Wilcox Jonathan Wise John Asheld Jr. Charles Bauer David Bendich William I. Cohen Sr. Marguerite Dynski Robert E. Fenzl Lilian Li Fu Tone Johnson 1974 Gordon L. Avery Daniel R. Beckman Daniel R. Botsford Jr. Richard J. Buckley Jr. James L. Budny E laine M. Bukowski Alan G. Burstein Thomas D. Chmielewski John H. Clark Stephen Commins Alva Dillon Jr. Thomas A. Donohue Jockular B. Ford Leslie G. Ford Donald R . Greene David W. Leffke Joseph P. Lemmer Hing-Har Lo Bruce F. Middendorf K athleen W. Mylotte Lawrence A. Oufiero a nford R . Pleskow J ohn C. Rowlingson Eric J. Russell Elliott A. Schulman Roy E. Seibel Jr. Louise M. Stomierowski R eginald M. Sutton Edward L. Valentine Paul H . Wierzbieniec Stuart A. Wolman 1975 Penny Asbell 42 • BUFFALO PHYSICIAN Nina Kostraba Charles atalizio Thomas Rosenthal Sylvia Regalia Spavento Stanley J. Szefler John Theobalds CLASS OF 1974 197 Stephen Bien Sonia Burgher Michael Bye David A. Dellaporta Adolfo Firpo-Betancourt Marshall Fogel Timothy Gabryel Thomas Hadley Ronald Marconi Walwin Metzger Erwin Montgomery Jr. Bernard M. Wagman John Wiles CAboveJ James A. Smith OetrJ and l'aul H. Wlellblenlec with 1974 class flltf. CAt lettJ FIRST ROW (seateiiJ: Bonlon L. AvetJ, John P. Manzella, Btuce H. Thlets, Elaine M. Bulalwsld, Leslie B. Fonl, Thomas D. Chmlelewsld, Alan B. Butsteln, Lawrence A. Dunem. SECOND ROW (stalllllntJ: Kathleen BralctJ, IIIIJ E. 8elbel, BraflleJ T. Jvax, Edwanl A. unllfOnl, Rlclranl J. Buclder, James L. Budnr, ca11 A. Jbdoro, John BralctJ, l'aul H. Wlel'llllenlec, James A. Smith, Btuce Mltlllenflort, Daniel R. Botstonl, Anthonr B. utlla, Bldeon B. Barnett, t:enrad WOlfrum, 8antonl R. Pleslalw, Darld W. Lettlte, Stephen Yemwlcll, Diane L. Matuszak. Carl J. Schmitt Richard P. Singer Reginald B. Stiles Russell J. VanCoevering II 1978 1977 John E. Billi Thelma Caison Elaine S. Chirlin edra J. Harrison Michael S. K ressner Bess I. Miller Jeffrey A. M agerman Mark J. Polis Theodore C. Prentice T homas A. R aab Albert Schlisserman Russell G. Brown R ichard R. Curran Stuart L. Dorfman Dean Mitchell Paul A. Paroski Covia L. Stanley Bernice J. Blumenreich Joseph E. Buran Jr. Michael R. Cellino Terence L. Chorba Frederick A. Eames Juanita A. Evereteze Andrea S. Gold Paul A. Koenig John M. LaMancuso Bruce D. Rodgers Robert J. Rose Peter E. Shields Ian K. Slepian Richard S. Urban 1979 Walter A. Balon Joel M. Bernstein 1980 Wesley Blank Joel Gedan Lloyd D. Simon �AlumniNew medical alumni officers elected Ellen Tedaldi Anita Vigorito Armenia, Tanner, Przylucki head slate for 1984-85 Dr. John E. Przylucki (M'73J, (not pictured} clinical instructor In surgery, is the association's new treasurer. He is affiliated with St. Joseph's Intercommunity, Millard Fillmore Suburban and Lafayette General Hospitals. 1981 James Bronk Susan Davis Barry Feldman Joel Fiedler Jonathan Gewirtz Todd Jacobson Robert A. Jakubowski Deborah Malumed Conrad May Michael T. Ross Brian Same Daniel Schaefer Brett Shulman Howard Sklarek David Small David Weldon 1982 Kevin Barlog Jill Brody Mark Chung Richard Corbello Robert A. Gianfagna F. Richard Heath Wendy Kloesz Sin Ping Lee Jessica Rockwell Arthur Schantz Robert Stern 1983 Jonathan A. Graff Dr. Carmelo S. Armenia f49J, new president of the Medical Al'!mnl Association, Is associate clmical professor of gyn-ob. He has ap· pointments at Millard Fillmore, Kenmore Mercy and Buffalo General Hospitals. He is also a member of the American College of Obstetricians and Gynecolo· gists American Society of Cytoiogy and the national, state and county medical societies. Dr. Charles J. Tanner (M'43J Is the association's new vice president. On staff at Mercy and other area hospitals, he Is also a surgeon for several major area industries. He Is a member of the national, state and county medical societies, the American College of Surgeons, AAAS and numerous other organizations. BUFFALO PHYSICIAN • 43 �George W. Thorn His research career spans 60 years T rying to condense the many "lives" of George W. Thorn, M.D. is an impossible task, like trying to condense the 2212 pages of the classic work, Harrison's Principles of Internal Medicine (he is one of its original editors). During his research career of almost 60 years, George Thorn (class of '29) established the foundations of modern endocrinology and metabolism. He was responsible for forming much of the basic knowledge of the adrenal gland, cortisone, adrenocorticotropic hormone, and steroids. Few know that he is partly responsible for what is possibly the first known organ transplant in history. Dr. Thorn brought kidney dialysis to this country and established a standard of practice for the procedure. And he initiated one of the first "health plans;' a harbinger of today's multispecialty group practices and health maintenance plans. Now he is professor emeritus at Harvard Medical School, as well as president of the Howard Hughes Medical Institute which he founded. At 77, he is quite in his prime, his sandy hair and blue eyes emphasizing his youthfulness. He believes in physical activity and demonstrates this with a solid game of tennis in addition to sailing and golf. A story was recounted some years ago that when Dr. Thorn was Hersey Professor of the Theory and Practice of Physic at Hughes Medical Institute, a patient mistook him for a young resident who was supposed to take his history and do a physical, just as the intern and medical student had. It is his arboretum, though, that has captivated his time and interest most outside of medicine. Dr. Thorn's fruitful life is mirrored in the maturing fruit and nut trees he planted during the 1950's at what is now the Thorn Arboretum at Coolidge Point, Manchester-by-the-Sea, Massachusetts. "An avocation becomes particularly significant as one approaches retirement ... An arboretum is a form of natural cultivation which is compatible with a professor's irregular hours and peripatetic movements," explains Dr. Thorn. "Absence for a few days or even a month is not disastrous, and it is obvious that one's efforts in developing an arboretum will be appreciated by others and one is in reality contributing to the pleasure of future generations:' This attitude in turn reflects the endeavors of a devoted 44 • BUFFALO PHYSICIAN educator who has a genuine interest in future generations . Those future generations, by the way, include over 5,000 medical students he has trained. In his various positions through the years, he was known to make every effort to become personally acquainted with both the researchers and their research. This helps to explain his amazing capacity to stay on top of new advances in nearly all medical fields he talked directly to many of those who were creating the new developments. This approach made him ideally suited to serve as editor for what might be considered the bible of medicine, Harrison's Principles of Internal Medicine. The work is now published in nine languages, and he was one of its original editors in 1946. He continued as editor for 31 years and then capped off this particular career by taking on the responsibility as chief editor for the 1977, 8th edition. 0 uring the Association of American Physicians' presentation of the George Kober Medal to Dr. Thorn in 1976, George Cahill, Jr., related an incident that occurred regarding Thorn and his book: "The importance of George Thorn and the book is told by Maxwell Wintrobe, the prior Chief Editor. During one of the editorial board meetings held in Sicily, in his usual daring and inquisitive manner, Thorn walked into the crater of (Mount) Aetna to see the fireworks firsthand. The wind shifted, and according to legend, a similar event millenia ago surrounded Euripides with brimstone and fire, and only his sandals and some ashes were subsequently found. Apparently the gods thought Thorn and the 'Book' more important, and the winds quickly shifted, and the Hersey Professor and Harrison Editor scrambled out unscathed." After entering the University of Buffalo School of Medicine at 19, he was attracted to the research efforts of Dr. Frank Hartman in physiology. In his second year of medical school, Thorn assisted in the earliest preparation of adrenal extracts. Before he graduated, he developed the first workable assay for adrenal cortical extract activity. His subsequent work in maintaining viability of adrenalectomized cats won him the American Medical Association's Gold Medal For Investigation - a unique achievement for someone so young. By Bruce S. Kershner Upon graduating, Thorn served as a house officer for a year at Millard Fillmore Hospital, and then went into practice with his uncle in his last three years in Buffalo. During that time, the Hartman-Thorn extract was given to patients suffering from Addison's Disease, with dramatic improvement. Fittingly, the daughter of one of those first patients treated in the early 1930's later attended UB's School of Medicine. The offer of a Rockefeller Fellowship wisked the precocious physicianresearcher away from Buffalo in 1934. The three-year fellowship took him first to Harvard and then to Ohio State, where he temporarily rejoined Dr. Hartman. His third year was with George Harrop at the biochemical division of Johns Hopkins' Department of Medicine . While there, he demonstrated that sex hormones had effects on mineral metabolism, and almost 20 years before aldosterone was characterized, he devised an assay for the mineralcorticoid potencies of adrenal extracts. Among the first subjects he tested for the metabolic effects of steroids were himself and his lifelong colleague and wife, Doris Thorn. She also assisted in laborious laboratory analysis of urine sodium concentrations. Following his fellowship, he joined the faculty at Johns Hopkins in 1938. B efore leaving Johns Hopkins, Thorn was the first to systematically isolate urinary steroids in humans. Thorn also demonstrated, in a classic published in 1940 with four associates, that slices of liver from adrenalectomized animals synthesized less glucose than those from animals treated with steroid. After a couple of years as an Army Major during World War II , George Thorn would have returned contentedly to Johns Hopkins. But with the sudden death of the distinguished physician, Soma Weiss, at Harvard, Thorn was called to replace her as Hersey Professor of the Theory and Practice of Physic and Brigham Hospital's Physician-in-Chief. His shrewd intuition coupled with a gambling instinct was to lead to repeated breakthroughs throughout Thorn's career. One young woman had become anuric following a traumatic delivery complicated by severe hemorrhage. Despite the high glucose infusions and anti-uremic care, her condi- �Classnotestion continued to deteriorate. Dr. Thorn took advantage of an opportunity created by the death of a male patient who had had a healthy kidney. Vessels in the woman's arm were surgically connected to the man's kidney in the early morning hours. Urine began ~o _flow freely from the kidney, and what IS likely the world's or at least North America's, first know~ transplant, had been accomplished. Although the attached kidney functioned for over a day, ~he woman's kidneys began to functiOn again, making it difficult to assess the significance of its contribution to the patient's recovery. After learning of the pioneering dialysis techniques developed by Kolff in the Netherlands, Thorn's life-long interest in renal disease brought this new technique to the Peter Bent Brigham Hospital. It was through his catalyzing leadership that his colleagues put the now worldwide standard procedure of dialysis into practical use. Successful renal dialysis then cleared the way for another first - the development of a widely accepted and practiced program of kidney transplantation. One of his residents remembers that when the first runs were made, all hands literally were used to hold the polyethylene tubing together. R ather than "restricting" himself to books, research, and patient care, George Thorn expanded his visions to include new medical institutions. In 1953, he was one of four nationally prominent physicians to meet with Howard Hughes and engineer the concept of an "institute without walls." Thus was born the Howard Hughes Medical Institute. Thorn chairs the innovative research facility, which he says "has developed a strong research program in twelve medical centers throughout the U.S. Its investigators and employees work closely with the affiliated university hospitals in these medical centers. At present, there are approximately 60 institute investigators located in addition to laboratories in biochemistry and hematology at the institute's base in Miami." Out-patient care at Dr. Thorn's hospital could be characterized as a quagmire in the 1960s. The Brigham's specialty clinics had drained off patients from the General Medical Clinic which had become almost relegated to the role of a "geriatric custodian." Although the "generalist" concept was still years to c_ome, Th_orn's foresight and imaginatt<;m_ led_ him to transform the specialty cl1mcs mto new general clinics. Each h_ad senior and junior attending physicians, house staff members and other phys_icians repr~senting nearly every specialty. Conceived by Dr. Thorn, this was one of the first "total" health approaches by an academic hospital. It fostered the Harvard Prepaid Community Health Plan and the subsequent health plans now established across the continent. Thorn also initiated the HarvardMIT Program in Health Sciences and ~echnology. This occurred just when bwlogy was coming into its own at MIT, and he took advantage of that unique opportunity. To get the program off the ground, he enlisted the help of a millionaire friend and MIT alumnus who donated a $10 million core en: dowment. The effort culminated in MIT's Whitaker College of Health Sciences which now attracts talented individuals to the health sciences who were in disciplines that formerly related only with difficulty to the medical field . Additionally, his role in inaugurating the Harvard-MIT Medical School Program gave birth to a medical education in bioengineering leading to a degree in one or both disciplines. Co-chairm'an of the Whitaker Foundation since 1974 he still contributes to the cross-fertiliza;ion of ideas that is essential to the rapid growth of any field. • Dr. GeotVe W. Thorn BUFFALO PHYSICIAN • 45 �D r. Anne Wasson (M'50) retired from the Frontier ursing Service of Hyden, Kentucky, after 12 years of service. During those years, she served as chief of clinical services, medical education coordinator and then dean for the Frontier School of Midwifery and Family Nursing, administrator of the Mary Breckinridge Hospital, and finally acting director of the Service. She left after an emotional farewell reception. She made an unforgettable impression on all that knew her. "Few persons in the (long) history of the Frontier Nursing Service have been as widely loved and as deeply admired as Dr. Anne," relates the Service's Quarterly Bulletin. Before she retired, Dr. Anne received the AMA's "Physician of the Year" award for the third time. This was followed by being made a Kentucky Colonel - an honor not easily come by. She was known for her common sense, deep human concern and the quiet warmth of her personality, some of which emerged in the many delightful anecdotes she told. She also impressed people with her practical interest in architectural design. She contributed significantly to the design of the Breckinridge Hospital and a nearby Community Health Center. Dr. Anne came to the nursing service by making a major career change after nearly 20 years of private medical practice in New Hampshire. Why did she give up a successful practice to come to Kentucky? She said she felt a need to give herself to a cause of wider scope. Now back in her home state of ew Hampshire, she works on the nineteenthcentury Colonial house she has owned for many years. She also plans to establish and operate a crafts business and to write a "really good book on the design and management of clinics." What Dr. Anne enjoyed most was her teaching, although she received much satisfaction with the administrative work, despite its challenge and headaches. In her honor, the Respiratory Therapy Department at Breckinridge Hospital was dedicated to her and a plaque was erected . • Anne Wasson Kentucky M.D. retires Dr. Anne INassoo WOifdng with patients at the Frontier Nursing Service In Hrrlen. tcr.• where she was an Integral part at the community tor 12 rears, after giving up ,.,vate practice In New Hampshire. ( �Classnotes1940's RUTHERFORD S. GILFILLAN, M'41 • His article, "A Comparison of Doppler Ultra Sound and Elevation Reactive Hyperemia in Ischemic Lesions of the Foot," will appear in the journal of Cardiovascular Surgery in 1984. Dr. Gilfillan was made an honorary member of the Northern California Vascular Society in 1983; he is retired and living in Dillon Beach, California. Bruce Babbitt, to a second fiveyear term on the Arizona State board of Medical Examiners. ment, Department of Pediatrics, SUNY, Downstate Medical Center, Brooklyn, New York. RICHARD H. MUSGNUG, M'59 • LAWRENCE B. SCHLACHTER, M'76 contributed a chapter, "Atrophies of the Skin," to Harper and Row's Textbook of Dermatology "Clinical Dermatology." Dr. Musgnug is in private practice in dermatology in Cherry Hill, New Jersey. VINCENT J. CAPRARO, M'45 • The World Congress on Pediatric and Adolescent Gynecology instituted a lecture in Dr. Capraro's name. The lecture will be presented by an invited speaker at the World Congress in 1986. Dr. Capraro has been made an honorary president of the American Chapter of the International Federation of Pediatric and Adolescent Gynecology. A. ARTHUR GRABAU, M'45 • retired from private practice in 1982 and is now residing at 110 Ocean Cove Drive, Jupiter, Florida, but still spends summers in Kenmore, New York. Dr. Grabau was a former director of Tuberculosis Control, Erie County Department of Health. GUY L. HARTMAN, M'46 • was recently elected president of the Southwestern Pediatric Society and executive secretary of the California Consortium of Child Abuse Councils. Dr. Hartman is associated with the Southern California Permanente Medical Group, Fontana, California. J. BRADLEY AUST, M'49 • has been elected chairman of the Board of Governors of the American College of Surgeons. Dr. Aust is professor and chairman of the Department of Surgery at the University of Texas Health Science Center. 1960's M. DAVID BEN-ASCHER, M'56 • writes that he has been reappointed by Arizona Governor, RUSSELL J. VAN COEVERING II, M'77 • and his wife have just one of three founders of a new medical device company, Biomedics, in Mercer Island, Washington. His company specializes in advanced data management systems for acute care and in biochemical sensors for monitoring. "We appear to be leaders in applying fiber-optics to biochemical monitoring," he says. returned from a lecture tour of the People's Republic of China with the American Fertility Society Delegation headed by Dr. James Daniell. Among the hospitals visited were the Capitol Hospital in Beijing and the Shanghai First Medical College. Lecture topics included laporoscopy, endometriosis, adhesion prevention and estrogen replacement therapy in the menopause. LEE N. BAUMEL, M'63 • is medical DR. HARVEY R. GOLDSTEIN, M'77 HOWARD HOCHBERG, M'61 • is director of the Eating Disorders Unit and director of the Department of Biofeedback at Beverly Hills Medical Center. DONALD J. WALDOWSKI, M'65 • started a private solo pediatric practice in Baldwinsville, New York. PAUL S. SCHULMAN, M'68 • is president-elect of the San Diego Radiological Society. Dr. Schulman is assistant clinical professor of radiology at U niversity of California, San Diego, and chief of radiology at the Community Hospital, Chula Vista, California. • was certified by the American Board of Gastroenterology in April. Dr. Goldstein received his sub-specialty tratntng in gastroenterology at the Scripps Clinic and Research Foundation, La Jolla, California. He joined the Millard Fillmore Hospital medical staff in the Department of Internal Medicine in 1982. SALVATORE A. DEL PRETE, M'78 • is now in Stamford, Connecticut, after leaving Dartmouth. His new office address is Hematology-Oncology Associates, 140 Hoyt Street, Stamford, Connecticut 06905. PAUL J. WOPPERER, M'78 • , a specialist in OB-GYN, 1s a clinical professor at the State University at Buffalo. 1970's MARTIN MANGO, M'71 • has been elected president of the Western ew York Society of Internal Medicine. 1950's • announces the association of Gary Kaufman, M'78, in the practice of neurological surgery in Atlanta, Georgia. Dr. Schlachter did residency training at Emory University in Atlanta and Dr. Kaufman did his training at Albert Einstein College of Medicine in New York City. KENNETH BROMBERG, M'75 • is assistant professor of pediatrics and medicine (infectious diseases) and director of recruit- JOHN CORBELL!, M'79 • presented a research paper on "Follow-up after Percutaneous Transluminal Coronary Angioplasty" during the American College of Physicians Meeting held in Atlanta, Georgia, in April. Dr. Corbelli is presently in fellowship in cardiology at the Cleveland Clinic. 1980's WESLEY S. BLANK, M'80 • writes, "My wife Nanette and I had a baby girl, Leah, on March 17, 1984. In addition, I have joined a group private practice in OB/GYN in Attleboro, Massachusetts." Dr. Blank's new address is 84 Arbor Way, Attleboro Falls, Massachusetts 02763. DAVID A. KOLB, M'80 • is a fellow in neuromuscular disease at University of North Carolina, Chapel Hill. Dr. Kolb was chief resident tn neurology tn 1983-1984. LLOYD SIMON, M'80 • writes that his new address is 50 Akerly Pond Lane, P.O. Box 319, Southold, New Jersey 11971. PETER YANG, M'80 • informs us that "My wife (Terry) and I are moving from Ann Arbor, Michigan, to Tucson, Arizona, where I'll be working in the department of radiology, section of neuroradiology. Our new address is 3749 Calle Barcelona East, Tucson, Arizona 85716. THOMAS P. GOODELL, M'81 • finished his family practice residency at Hays Army Hospital, Ft. Ord, California in June and assumed command of the !97th Infantry Brigade Health Clinic, Ft. Benning, Georgia. MICHAEL T. ROSS, M'81 • married Jean Del Piero on September 1. After completing emergency medicine residency in July, he joined the emergency medicine staff at Providence Hospital, So~thfield, Michigan. ISAIAH PINCKNEY II, M'82 • 1s currently chief resident of the Brookdale Family Practice Resident Program, Brooklyn, New York. DOUGLAS J. BATES, M'84 • wants you to know that his new address is 2060 E !25th Street, Cleveland, Ohio 44106. BUFFALO PHYSICIAN • 47 �DeathsJEROME H. SCHWARTZ (M'31) • died February 2, 1982, in Las Vegas, • Nevada. WILLIAM REESE LEWIS (M'32) • died September 25, 1983, in Lewiston, • New York. NIELS GERHARD MADSEN (M'35) • died January 8, 1984, at the age of 85, after a long illness. Dr. Madsen practiced family medicine and surgery for 31 years in Honeoye Falls, ew York, where he operated his own private hospital for 11 years. He retired in 1964 and lives in Scottsdale, Arizona until 1978. Dr. Madsen remarried in 1980 after his first wife died. He is survived by his wife, Lucy C. Ashely Madsen of State College, Pennsylvania; his daughter, who is an associate professor at Pennsylvania State University; and a son, Eugene Madsen, M.D., of San Luis Obispo, California. • GLENN J. COPELAND (M'39) • died on March 31, 1984 in Clifton Springs, ew York. • DR. FRANK MEYERS (M'29) • the first chief of medicine at Kenmore Mercy Hospital, died May 28, 1984, in Buffalo General Hospital. A Buffalo-area physician for 50 years, he retired from private practice in 1979. He was a clinical professor emeritus of medicine and an attending physician at Buffalo Genera] and Kenmore Mercy Hospitals at the time of his death. The Buffalo native served as an army lieutenant colonel during World War II in the 23rd General Hospital in Europe. Certified by the American Board of Internal Medicine, he was a member of the American College of Physicians, and the state and county medical societies. He was also a member of the medical honor society, Alpha Omega Alpha. Dr. Meyers is survived by his wife, Wanda; two daughters, Marilyn, a physician from St. Louis, and Mrs. George Triepel; a brother Stanley; two sisters, Clara and Helen; and three grandchildren. • DR. MARY E. PANTERA (M'21) • died June 12, 1984 in Buffalo at 87. Dr. Pantera was a member of the American Medical Association. The former Mary Rutkowski is survived by her husband, Stanislaus, D.D.S.; a sister, Helen; and a brother, Leo. DR. LYLE N. MORGAN (M'40) • died May 15, 1984, in Veterans Hospital at the age of 75. A native of Rochester, he practiced medicine for 40 years in Buffalo until he retired in 1980. He was affiliated with Buffalo General and Sisters Hospitals and was a Medica] School faculty member from 1943 to 1963. From 1927 to 1931, he was a pharmacist medica] corpsman with the U.S. avy. He was a member of the AMA and the Erie County Medical Society. He is survived by his wife, Marion; two sons, David and Lyle, Jr.; three daughters, Gail, Carol and Joyce; and 13 grandchildren. • DR. THURBER LeWIN (M'21) • one of Buffalds most distinguished ophthalmologists with a career here that spanned 50 years, died at the age of 86 on May 12, 1984 in Buffalo Genera] Hospital. Born in Buffalo, Dr. LeWin was a descendant of the founders of Ottawa, Canada. His maternal great-grandfather, John Rochester was a member of Parliament and mayor of Ottawa after Bytown and Rochesterville were merged to form the city. Dr. LeWin was honored twice by UB. The associate professor of ophthalmology received the 1981 Distinguished Alumni Award, and in 1974 he was presented the Samuel P. Capen Award for meritorius service to the University. The son of a physician, Dr. William C. LeWin, the younger Dr. LeWin was an intern at Buffalo General Hospital and was a resident surgeon at Wills Eye Hospital in Philadelphia. He had a master's degree in ophthalmology from the University of Pennsylvania. 48 • BUFFALO PHYSICIAN He was an attending eye surgeon on staff at Buffalo General, Deaconess, Emergency, and Children's hospitals . Dr. LeWin was a past president of the Buffalo Ophthalmologic Club and the Wills Hospital Society and a member of the Erie County Medical Society, American Academy of Ophthalmology and Otolaryngology, Medical Union Club, American Medical Association and Buffalo Academy of Medicine. A former Boy Scout whose interest never faded, Dr. LeWin served as camp physician at Scouthaven and was a member of the health and safety committee and the camping commitee of the Buffalo and Erie County Council of Boy Scouts of America. He also served on the council's executive committee and received the prestigious Silver Beaver Award for his outstanding contributions. Dr LeWin is survived by his wife, Mary; son, Alan, of Phoenix; daughter, Barbara of Darien, Conn.; a brother, Harvard, of Hume; a sister Elva, of Williamsville; eight grandchildren, and one greatgrandchild. • DR. CHRISTY F. CASTIGLIA (M'34) • died May 25, 1984 in Millard Fillmore Hospital after a brief illness. Dr. Castiglia, 74, practiced medicine on Buffalds West Side for 34 years. He had served on the medical staffs of Millard Fillmore, Columbus and ·Sheehan Emergency hospitals and the chest clinic of Erie County Medica] Center. Twenty days before he died, he attended the 50th anniversary reunion of his UB Medical School class in Buffalo (see article). Born in Buffalo, he practiced medicine in Holland, .Y., from 1939 to 1942. He served as a U.S. Army Captain from 1943 to 1944. A member of the national, state and county medical associations, he was also a member of the American College of Chest Physicians and the SPR Medical Club. He retired in 1978. He is survived by his wife Madeline; son Russell of Amherst; two daughters, Carolyn of Boulder Creek, California, and Corrine of Syracuse; two sisters, and nine grandchildren. • DR. ARTHUR J. CRAMER, JR. , (M'32) • died July 21, 1984, at the age of 75. A UB Medical School alumnus, he was on the School's faculty for 40 years. One of Kenmore Mercy Hospital's first chiefs of pediatrics, Dr. Cramer was proud of his role in helping to establish that hospital. He was also a former staff physician at Children's and DeGraff Memorial Hospitals and a former Kenmore health officer. The Buffalo native was a Kenmore pediatrician for 37 years. Dr. Cramer's practice was interrupted during World War II, when he served in the U.S. Army's 132nd Evacuation Hospital in Germany. While in Germany, he saved the life of a German youth, Ewald Rischar, who suffered kidney injuries in the Allied bombings. Mr. Rischar, now 56, tracked down Dr. Cramer a month before the doctor died to obtain a letter from him that he needed to qualify for government compensation (see full story in this issue). Dr. Cramer was an officer in the UB Alumni Association and donated to the University's building fund. He retired from medical practice in 1969 due to health, and retired from his University appointment in 1978. Surviving are his wife of 50 years, Florence; three sons, Arthur ]. III and Paul J., both of the Town of Tonawanda, and Robert]. of Freehold, NJ; a brother, Charles; and eight grandchildren. CORRECTION: WE ARE GLAD TO RETRACT THE DEATH NOTICE {WHICH WE RECEIVED IN THE MAIL) OF JOHN P. MURPHY (M'58) IN THE PREVIOUS BUFFALO PHYSICIAN ISSUE. He wrote " Say it isn't so! I'm still very much alive and practicing. The news of my death in the May issue of the Buffalo Physician was highly exaggerated !" �A MESSAGE FROM Ar '49 President, Medical Alumni Association The Executive Board is continuously looking for effective means to communicate with its Medical Alumni and increase the number of dues paying members. This year the Alumni Association will host two receptions: · A OLLEGE OF SURGEONS MEETING, SAN FRANCISCO Tuesday, October 23, 1984 Westin St. Francis Hotel, Elizabethan Room C 5:00 p.m. - 6:30 p.m. RICAN A S'N OF MEDICAL COLLEGES MEETING, CHICAGO Monday, October 29, 1984 Conrad Hilton Hotel, Room 415 6:30 p.m. - 8:30 p.m. An invitation to attend these receptions is extended to all Medical Alumni and faculty attending these meetings and to those Medical Alumni who live in the Chicago and San Francisco areas. Please signify your intention to attend by completing and mailing the form on the back cover. We are looking forward to meeting you. -~~~--------------------------------------------------------------- IIIIII BUSINESS REPLY MAIL FIRST CLASS PERMIT NO. 2210 BUFFALO, N.Y. POSTAGE WILL BE PAID BY ADDRESSEE sociation University at Buffalo 139 Cary Hall 3435 Main Street Buffalo, New York 14214 NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO, NEW YORK 14214 DR C K HU ANG 115 KIMBALL TOWE R SUNYAB BUFFALO "lY 14214 -----------------------------------------------------------------PLEASE DETACH AND RETURN University at Buffalo Medical Alumni Association D I plan to attend the Medical Alumni Reception in San Francisco, Tuesday, October 23 at the Westin St. Francis Hotel. D I plan to attend the Medical Alumni Reception in Chicago, Monday, October 29 at the Conrad Hilton Hotel. Name Address Class � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, September 1984 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine . Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1984-September Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical sciences Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1984-v18n03-Sept Table Of Contents A list of subunits of the resource. Heart Transplant Some Thoughts on the Value of Life Dr. Barney Clark and the Artificial Heart High Tech in Cell Cloning The Death of McKinley Research Medical School News Hospital News People Alumni Classnotes Deaths Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-07-06 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v18n03 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1984 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/15a7ecd357d8ca98708cf8bfab2fc3c8.pdf 64d21d7dcacb7083ed59ac33b071d661 PDF Text Text �MESSAGE FROM THE DEAN The Buffalo Physiaan has undergone a fine transition during the course of the 1983-84 academic year. With this edition Mr. Bruce Kershner begins his second year as the editor and his role as the major public relations officer for the School of Medicine. The past year's accomplishments have included an updating and expansion of the mailing list, a totally revised format which should be more readable, and the development of content that is both archival and current. While most of the new directions are the result of Bruce's efforts on the school's behalf, others have been involved as well. Included among those responsible for some of the changes are the members of the Advisory Committee and the production staff who meet with Bruce at regular intervals. Their critical comments and constructive suggestions have been very valuable to the progress that has been made. This combined with the expanded readership should help maintain a strong line of communication and information to our constituencies throughout the future. As always, your comments and suggestions about the direction of the Buffalo Physician will be most welcomed. - John Naughton, M.D. Corrections: J~f rrgm thR misspelling of Dr. Joseph PTI!zio's nanu and thf omissiOn of Dr. Ron Afarkllo's rum~£ as auihor of thR book m:iru• 1/ow Do liiu Spell Rel~ in lk .\Iay 1984 1SSU1! ofBufia.Jo Physician. �ContentsBUFFALO PHYSICIAN 3 MEDICAL CARE IN THE SOVIET UNION • Franz E. Glasauer, M.D., professor of neurosurgery, offers his impressions of a study tour of the medical profession and health system in the USSR. The Soviets have come a long way since the Russian Revolution, he reports. 8 CHRONIC DIARRHEA RESEARCH CENTER • Children's Hospital will become a major world center for the study and treatment of one of the major killers of children under five years old. 10 PHOTO SHOW • UB physicians claim 8 of 12 prizes at Eighth Annual Physician's Photo Show. 12 HOSPICE CONFERENCE • 150 health care professionals hear expert practitioner-panelists discuss this most important health movement. "The hardest thing is to switch from curing to caring," one panelist noted. 14 DES • Both male and female offspring of mothers treated with DES are at risk. STAFF EXECUTIVE EDITOR, UNIVERSITY PUBLICATIONS Robert T. Marlett ART DIRECTOR Rebecca Bernstein UNIVERSITY MEDICAL EDITOR Bruce S. Kershner PHOTOGRAPHY Jim Sulley David S. Ottavio Ed Nowak ADVISORY BOARD Dr. John Naughton, Dean School of Medicine Dr. Harold Brody Dr. James Kanski Dr. James P. Nolan Dr. Charles Paganelli Dr. Peter Regan Mr. James N. Snyder Dr. Eugene Michael Sullivan Jr. Dr. Mary Voorhess Dr. Martin Wingate Dr. John Wright Dr. Maggie Wright Ms. Rita Wolff 15 A CHALLENGE • Medical schools and undergraduate education both have roles to play in increasing the public's general health awareness, Pennsylvania dean avers. 17 RESEARCH • Astronauts visit Dr. Farhi's Physiology Lab for preview of shuttle experiment. Other UB research news. 21 MEDICAL SCHOOL NEWS • Early Assurance Program allows sophomore undergrad students to apply for Medical School admission here. Dr. and Mrs. Eckert endow visiting chair in surgery. More Medical School developments. 24 HOSPITAL NEWS • Children's uses Cabbage Patch Dolls to educate pediatric patients. John Jefferies resigns as Children's president. Other items. 25 STUDENTS • 143 are awarded MDs at 138th Annual Commencement. Eighty-eight per cent receive one of top three choices for residency program. Alpha Omega Alpha induction. Awards and honors. 31 ALUMNI • Jonas Salk and experts on herpes and AIDS are featured at record-setting Spring Clinical program. Senior Reception at the Albright-Knox. TEACHING HOSPITALS The Buffalo General Children's Deaconess Erie County Medical Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Charity Veterans Administration Medical Center Balfour Mount ------------------------------------------------------atHo~I~------- Conteren~. PEOPLE • Dr. Harry Metcalf helps set a police trap in drug abuse scheme. UB physicians participate in Asthma/Allergy callin program on TV. VIewing an exhibit ---------------------------------------------------at Sprtng Cllnlcai-CLASSNOTES • Nun/surgeon is leader in effort to form organiDavs. zation for religious-physicians. Dr. Virginia V. Weldon cited by Smith College. News of the Classes. 36 v, Produced by the Division of Public Affairs, Harry R. Jackson, director, in association with the School of Medicine, State University of New York at Buffalo COVER ART: Dr. Leon Farhi and photos of astronauts in UB Physiology Lab: Ed Nowak. Space Shuttle: NASA 40 44 DEATHS THE BUFFALO PHYSICIAN, (USPS 551-860) July 1984- Volume 18, Number 2. Published five times annually: February, May, July, September, December - by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. POSTMASTER: Send address changes to THE BUFFALO PHYSICIAN, 139 Cary Hall, 3435 Main Street, Buffalo, New York 14214. BUFFALO PHYSICIAN • 1 ��CAt lett) TapesfiY with emblem ot Uzbeklstm, Tashkent. ccenterJ St. Basil's cathedral seen from Red Square, Moscow. (Inset} One ot the ever·readv ambulance teams from the EmeiTiencv center, Samarkand, Uzbekistan. (Above ttghtJ NeurosuiTitcal operation tn process, Bunlenko Neurosul'fllcal Institute, Moscow. �THE CONTEMPORARY STATE OF PRIMARY HEALTH CARE Therapeutic and preventive care for the population is provided at home or at the place of work. Based on the locality principle it is closely connected to the dispensary medical care and pro,·ides all tv pes of medical aid for the hospital and the incorporated outpatient clinic. Outpatient care general and specialized is delivered by a widespread network of clinics, dispensaries and other primary health care facilities. The polyclinic is the core of all outpatient care and is staffed under a predetermined specialty/population base. Although various specialists may be present in urban polvclinics, there arc expected difficulties with the rural health care program. Sparse population and long dist<~nce tra\·el require dif~ krent practice patterns from those in urban factorv clinics. Local m~'dical centers arc organized to render medical a1d to workers of a production shop or of several small industrial shops. The division into lOl·alities allows for the regular follow-up of the people in that locality and assures immediate treatment. In 1976 there were 24,000 in-patient hospitals in the SO\·iet Union, 119.3 beds and 32.6 physicians per 10,000 population. The ambulance service is a major health care function. Its network of special establishments includes stations, hospitals. departments of ambulance sen·ice, and a pai·k of sanitary transports. In 1976, over 4,000 ambulance stations \\ere staffed by 30,000 physicians and 70,000 health care personnel. Unified emergency services in towns and villages provide maximum emergency medical aid for sudden illness and accidents and transport patients to inpatient facilities. On the request of the medical establishment theY also transport women in labor. Thu~ emergency medical sen·ice can delin·r qualified and specialized treatment at the scene of an accident or in the home of a severely ill patient. Out-patient care for children is assured on their discharge from the maternity home and until age 16. The children's Outpatient Clinics are centers for healthy children. Emergency aiel is provided by pediatricians who staff its emergency aid posts and by specialized pediatric ambulance teams. Second stage care is the concern of the district medical establishment such as the central district in-patient hospital or district hospital dispensaries. Here, villagers receive specialized treatment 4 • BUFFALO PHYSICIAN by internists, podiatrists, surgeons, ohstetricians, and gynecologists. The third stage is the regional medical facility or regional territorial hospitaL Here, specialized outpatient and inpatient treatment is rendered. The help of aircraft and automobile is available for emtTgency and immediate medical aid. Patients in need of highly skilled specialized treatment are admitted tO republican hospitals, scientific research institutes, or other appropriate institutions. In addition, there are mterrepubliean specialized centers for comprehensi,·e examination and treatment. An example of this is the cardiological center with its in-patient clinic of 1400 beds. ~luch importance has been attached to the development of the sanatoria and health resorts run bv the Central Council for the ~lanagei~ent ofll-ade Union Health Resorts. Their concern also is the leisure time of workers. MANPOWER AND EDUCATION ISSUES The So,iet Union has large numbers of health professionals in all fields and has increased their numbers in recent vcars. Maldistribution of professionals is not a problem because of"pay back." Three wars of senxe is required for a state ~upported education allowing assignment of manpower to needed areas. Jobs arc salaried according to government standards. Although professionals are free to t hange assignments. desired positions may be filled if a transfer is not possible. . The feldsher, a health professional \Vith a 250-year history in the lJSSR, is the equi'>alent of a middle. medical personnel similar to a physician's assistant. Given special educational experience, he may fulfill other roles such as a radiological technician, physiotherapist, or public health worker. Education: All children must complete a minimum of eight years of primary school which they attend six days a week. In the fifth grade students mmt select a second language and those who do well may take a competitive examination for entrance to a universitv or technical schooL · From first grade through the university all tuition remains free. Most university students receive a living allowance according to their academic standing and subjects. They are also entitled to dormitory accommodations. Under existing regulations, institute or university graduates must work at least three years at assigned positions to repay the state for the substantial cost of their education. On completion they may seck employment ann\here. The current seven-.vear medical education program follow~ graduation from secondary schooL There are three primary directions in medical educa~ion: I) Ther~p.euties, the equi,·alent to mternal medicme for adults; 2) Pediatrics, inmh ing children up to age 15 and 3) t~1C field of public health, hygiene and samtatJOn. Other programs such as stomatology and pharmacy are included in undergraduate medical education. Although the undergi·aduate medical curriculum varies according to the track selected by the student, subjects that apply to all areas include political theory, foreign languages, physical education, and basic sciences. Post-graduate medical education, or the seventh year of training, leads to a specialized doctor of much younger age than is produced under the North American model of education. Further post-graduate training may be pursued in a medical institute. Although the profession is centralized and standardized, hierarchy does exist in medicine. Specializ~d and research insti~utes treat special problems such a~ cardiOvascular disease, cancer, neui·oscience and other disorders that require specialized surgical and medical skills. Thus, t~is sy~t~m produces large numbers of physiCians to provide primary he~l th care. It also leaves the option for h1gh test performance graduates �I I _} to further their education in new and developing programs such as transplantation, ophthalmology. etc. For neurotraumatology, post-graduate education following medical school includes two to three vears of neurosurgery. For the specia!t}· of neurosurgery five years are required. Post-graduate studies are important for a scientific career such as an academician. SAMARKAND (Clockwise from top letrJ 1. Intensive Care (re-animation} Unit, BunlenlaJ Neurosur· gical Institute, Moscow. 2. Parlla· ment building with monument to WOrld War II, Tashkent. 3. Obstetrical Unit, Rrst Cltr Hospital, Tashkent. 4. Exterior view of Rrst Cltr Hospital. Samarkand is one of the most ancient cities in the world and once was the pride and capital of Tamerlane (Timur the Lame), the 14th century conqueror of Asia. The city is most sumptuous with sunbaked ruins, a splendor of glazed, blue-green tiles and brilliant mosaics of minarets and mosques. The broad streets, new buildings and trees provide an oasis atmosphere to the city. The city has a population of half-amillion and is a large center of developed industries, among them the wellBUFFALO PHYSICIAN • 5 �Dr. Blasauer In his Buffalo otftce. known tea-packing factory. It is also considered to be one of the major educational and research centers. The citv numbers 2S hospitals, with neurolog)· and neurosurgery services available in six of them. Here in Samarkand we visited the EmergenC)' Hospital. The Emngmcy Holprlal is not a hospital but, in fact, the headquarters of the Samarkand ambulance system. \Vhik it contains no beds, an occasional patient may walk in for outpatient care. Four other stations are affiliated with this central triage station which is staffed around the clock by physicians and nurses. The ambulance team usually consists of a physician and a nurse or a feldsher. This station is covered by IS physicians who arc on call for 24 hours, then off 72 hours. The entire emergency system has 104 physicians with 20 traumatologists, but no neurosurgeons. A meeting with four Samarkand neuro urgeons was also arranged. The neurosurgical unit described by the main spokesman consists of 60 beds. and some two or three operations a day are performed. Major operations cover tumors, trauma, vascular operations and cerebral scars. Superficial skull injuries are handled either by general surgeons or traumatologists. The annual tumor material consists of about IS gliomas, 40-SO meningiomas and an average of 1S cranio-pharyngiomas and pituitary tumors. qiiomas are routinely radiated followmg surg~ry. About 40-SO per cent of the operatwns are for 6 • BUFFALO PHYSICIAN herniated intervertebral discs. The treatment of hydrocephalus consists of anterior commissure opening, Torkildsen procedures and peritoneal shunts. The operating microscope is used only lor peripheral nerve surgery and neither CT scanner nor stereotactic procedures arc available. TASHKENT Tashkent, founded 20 centuries ago, is the modern capital of the Republic of "\\'hitc-Gold" Uzbekistan and one of the largest cities in the USSR. White-gold refers to cotton, the main wealth of the Republic, one of the richest and most advanced in Central Asia. First City Hospital: In Tashkent \\e \ isited the "First Citv Clinic of Abu Sina." The hospital, considered the finest in the city has received several annual awards. It comprises several buildings and its 1SOO beds have an annual inpatient census of some 2S,OOO. The average hospital stay of a patient is 1S days. In the hospital are most surgical/ medical specialty divisions that include cardiology, neurology, radiology and physiotherapy. There is no neurosurgery. Of the 1S6 medical staff members, six are neurologists. The hospital also has a postgraduate physician training program. After a pleasant overview by the .director we viewed the general surgical and obstetrical areas. While the plain operating rooms appeared adequate, the instrument sterilizers seemed antiquated. It was, therefore, the more surprising that a C0-2 laser was available for general surgery for opera- tions on the liver, lungs. stomach and infected abdominal cases. The obstetrical department averages some 20-30 deliveries a dav· Caesarian sections run about 7 per ce~·t. Early on, the newborn infant remains with the mother. The hospital also provides courses lor pre- and postnatal care. While the hospital and equipment seemed old compared to a modern U.S. hospital, one observed the delivery of a?equate~to-abovc average medical care. 1 he espnt-de-corps of the hospital staff was apparent. The entire nursing statT stood at attention as we walked through the spotless areas. The nurses wore a typical nursing hat with a cross on it which was absent on similar ones worn by female physicians. MOSCOW Moscow is a relatively new city. It was founded in 1147 as a village and fortress by Prince Yuri Dolgoruki. Today it is a city of power and platitudes. Its billboards exhort the public which crowd the sidewalks. In the sprawling city are vast squares and imposing buildings, and many of its wide streets are lined with linden trees. Skyscraping Moscow State University takes a lofty view of the l'v1osk\a River and of the entire central city. l\1oscow's metro is considered the world's most beautiful subway system and carries some ~ve million passengers a day. Of greatest Interest to the tourists is the Krcmli~ with its palaces, congress halls and vanous cathedrals and outside the .Kr~mlin wall, Red Squ~re. The highlight of our medical tour was �= - the visit to the Burdenko Neurosurgical Institute, one of three major centers for neurosurgery in the Soviet Union; the other two are in Leningrad and Kiev. Burdenko Neurosurgical Institute: The Director. Academician, Professor Alexandre Konovalov cordially welcomed us and responded franklv to our many questions on the institute and the practice of neurosurgery in the USSR. The Burdenko Neurosurgical Institute numbers 300 beds with an additional 60-bed unit for spinal injuries and is staffed bv some 15-20 neuroscientists. Among '2,600 operations performed each year at the institute, 1,000 arc for brain tumors. Their special interest in meningiomas, pituitary and parasellar tumors and those at the base of the skull results in brain tumor referrals from across the country. For some pituitary tumors, transsphenoidal surgery is used. The incidence and distribution of brain tumors are similar to numbers in Europe and the USA, while metastatic brain tumors run about 8-10 per cent. Endovascular surgery, the obliteration of vessels by means of detachable balloon catheters was pioneered at the institute bv Professor F.A. Serbinenko. In acu.te spinal trauma a variety of accepted treatment methods are used, such as hyperbaric treatment, cooling of the spinal cord, and decompressive laminectomy. Stabilization operations of the spine are carried out at various time intervals following injury. Apparently, Russians are unfamiliar with our popular "halo device" used for immobilization. Chronic patients are similarly treated in a rehabilitation center. Of special interest on treatment of spine injuries was the statement by Dr. Konovalov that, contrary to widespread publicity, they have no "wonder drug" in the USSR for spinal regeneration. The radiology department performs annually 10,000 CT scans and 3,000 angiograms. A body CT scanner is not available. Cerebral blood flow studies with xenon are an established procedure. Pneumoencephalography also is still frequently performed. Isotope studies are still very much in use for isotope cisternography, isotope brain scanning, and isotope flow studies. Patients with malignant brain tumors are routinelv treated with radiation therapy and· chemotherapy. A proton beam unit is available for the treatment of pituitary tumors, while the C0-2 laser, not commonlv used in clinical neurosurgery, is used for experimental surgery. Operating rooms at the Institute seem adequately equipped. The operating microscope is available with color monitors inside and outside the operating room. Of particular interest to us was the use of cadaver bone for cranioplasty. The donor skull, placed in formalin for several weeks, is washed carefully before implantation. Excellent cosmetic results are expected, the result of exact size and proper shape of the skull bone. We were told that most of these implants take and that preoperative and intra-operative antibiotics are not routinely used. The 20-bed Intensi...-e Care Unit is well-equipped with monitors for vital Wl.edical car? has come a long way • sznce the Russian L Revolution._J signs and various pressure measurements. Adjacent, an independent laboratory operates around-the-clock for blood gases. osmolalities and other chemical studies. The unit cares for postoperative patients, some very sick pre-operative patients such as those with severe subarachnoid hemorrhage and others with severe head trauma. The unit, headed by an independent physician, is usually referred to as .. reanimation service." LENINGRAD If Moscow is the heart of Russia, St. Petersburg is the head. Leningrad is a very beautiful city, with many canals and rivers. Not only has the city's name changed with history's wheel but it is also associated with many pages of the history, culture and revolutionat-y movement of R ussia. Institute of Experimental Medicine. Following the usual customary introduction we briefly visited a couple of the departments. The Institute, a collection of 92-year-old buildings, houses the basic sciences such as physiology, biochemistry, embryology. pharmacology, neuropathology, etc., as well as a computer department. 1oday, some 300 scientists work in a multi-disciplinary approach among the departments. In the past, the late physiologist Dr. I.P. Pavlov directed its physiology department. Department of Embryology: Cloning and experimental or behavior teratology are the two main research interests. Various drugs are studied for their teratological effects and the release of new ones arc based on the recommendation of this department similar to the FDA in our countrv. Virology: Here, studies on the defense mechanism against viruses such as arbo and influenza viruses are carried out. Current focus i.s on interferon and its action on cancer. Biochemistry: A scientist reporting on a cooperative Russian-American population study on cholesterol and triglyceride values noted a definite difference between the two. The studv considered their evaluation and influe~ce of these blood chemicals on heart disease. In a current study on Russian population, the effect of cholcsteml and triglycerides on cerebral stroke are being closely looked at. CONCLUSION Although it is impossible in a brief two weeks' trip to learn all about medicine in the USSR, we were able to get a glimpse into their medical system. There is no doubt it has come a long wav since the Russian Revolution. Th,ere is clearly better medical care for its citizens and a greater emphasis on medical programs. While a few special institutes are wellequipped and staffed with outstanding personneL the majority of general hospitals remain antiquated and lack modern equipment. It was our impression that the Russian people were friendly and most of our Russian colleagues genuinely cordial, expressing concern and hope for a better understanding between our two nations, especially among physicians as healers. Our visits to hospitals or institutes were always preceded by a short conference and frequently refreshments. While all our questions were politely answered by the director, we were never questioned on our medical system or about our specialty. \\'e were also disappointed in not being able to visit more hospitals. The excuses received were that either the building was under repair or examinations were being held. • BUFFALO PHYSICIAN • 7 �------- --- - Chronic diarrhea Buffalo will become major center for study & treatment of child-killing disease T By Bruce S. Kershner hrough the efforts of a UB physician , Emanuel Lebenthal, M .D. , Buffalo will become the world-wide center for the study and treatment of one of the world's major killers of children under five years old. The International Center of Infant Nutrition and Gastrointestinal Disease, the first of its kind , is the culmination of a 21-year-old dream for Leben thai who is professor of pediatrics at Buffalo Children's Hospital. He is also head of the hospital's Division of Gastroenterology and utrition. The new research center will be funded by a 3 million grant from the U.S. Agency for International Development (AID), it was announced March 5 at a press conference at Children's Hospital. The center, which will occupy the entire second floor of the hospital's Annex Building, will open in August , 1984. Dr. Lebenthal obtained the funding partly through the efforts of the entire W Y Congressional delegation especially Congressman Jack Kemp, Senators Moynihan and D 'A mato, Congressman owak and others. The institute, Congressman Jack Kemp noted, "will establish Buffalo as the global center for helping to save the lives of millions of poor children around the world suffering from diseases arising from malnutrition and dehydration." Among those represented at the press conference were Dr. Lebenthal; John Jefferies, Children's Hospital director; Dr. John Naughton, dean of UB's School of Medicine; M. Peter McPherson , director of AID; Congressman Jack Kemp; Congressman Henry Nowak; representatives for Senators Alfonse D'Amato and Daniel Moynihan and Congressman John LaFalce, and Leroy Coles of the Buffalo Urban League. The purpose of the center is to train physicians from around the world to treat acute and chronic diarrhea among infants. Its goal is also to conduct research and to instruct others on how to establish associate centers in other countries. The World Health Organization estimates that one billion children suffered from acute diarrhea in 1980 and more than five million die each year when the diarrhea progresses to a chronic state. Lebenthal predicts that "at least 20 per cent, or one million, of these children each year can be saved within the next ten years" due to the work of the center and its satellite centers on other continents. The Israeli-born doctor expects that the first associated centers will be located in Peru , Central America, Africa and Southeast Asia. M. Peter McPherson of AID noted, "It is a very unusual thing that we come this close to identifying such a major medical problem like this and can actually do something about it. If you look back in history, you find that opportunities like this are very rare indeed." Children's Hospital was chosen by the agency as the location of the center because of its national reputation, as well as the success of its treatment program directed by Dr. Lebenthal. Children's Hospital will contribute a large amount to the program, much of it to be raised by Western ew York donors. "The fact that the University is here in Buffalo is fortunate;' added Richard Heath, chairman of the Board of Children's Hospital. "With its ability to attract research, funding and the kind of faculty as represented here by Dr. Leben8 • BUFFALO PHYSICIAN (Cioctwtse trom toll leftJ 1. Dr. Lebenthal wttll Uny patient. 2. COngressmen Nowak and Kemp (center of photo} tour clinical tac/ltues at Children's Hospital. 3. (From lett} M. Peter McPherson of AID, Congressmen Kemp and Nowak, Richanl E. Heath of the Children's Hospital Boanl, and Dean Naughton at press conference. 4. Dr. Lebenthal (lettJ and Mr. McPherson. thai, projects like this are possible." Referring to another advantage made possible by UB's association with the institute, Dean aughton remarked , "Besides San Diego, we're the only medical school in the U.S. that is situated so near to an international border. It makes UB particularly suited for an international project of this nature." Research by Lebenthal and his colleagues has resulted in new and sophisticated treatment methods that have given Children's Hospital one of the best records in the world in treating chronic, intractable diarrhea. The mortality rate elsewhere in the United States had been up to 45 per cent; at Children's, the mortality rate over the last eight years has been 0 per cent. C hronic diarrhea begins when infections cause persistent injury to the mucus lining of the small intestine. A vicious cycle results because the injured small intestine leads to an intolerance of protein in routine infant feedings. Poor absorption of nutrients and lowered immune defenses worsen the condition further, followed by deficiencies in enzymes and hormones which permit an overgrowth of bacteria in the small bowel. Thus, the small intestine never repairs itself and infection and malnutrition continue. The ensuing dehydration ultimately leads to death. Chronic diarrhea is worst in poor countries because of inadequate nutrition and contaminated water and food. In the United States, the condition is most frequent among poor and disadvantaged groups_. Until recently, the knowledge of how to effectively treat the tllness has not been available where it was most needed. Lebenthal's unique center is expected to change all that. -- -- �The center will feature a short-term trammg program lasting six months and a long-term program of two years. Lebenthal explains, "The Center will not only train pediatric gastroenterologists but will develop an infrastructure of pediatricians and health professionals in the developing countries who will be involved in promoting the care of infants who develop chronic diarrhea." Twenty-three foreign doctors will be trained in the first pha e of the program. Workshops will also be offered annually. In the planning stages is an international symposium to be held in August, 1985. It is expected that 700 researchers and clinicians from around the world will hear presentations by 70 world authorities on infant nutrition and ga trointestinal diseases. Lecture by international scholars will be promoted, as well as visits by Buffalo center mentor to the associate research centers in other countries. The research program will focus on learning more about the reasons why acute diarrhea transforms into chronic diarrhea with resulting demise of the child. In addition, different treatment programs will be tested and compared in various host countries to identify the most effective methods. Lebenthal pointed out, "This is not one man' doing, it is the accomplishment of a team of 20 people." A partial list of fellow physicians who assisted were Drs. Robert Warner, Robert Cooke, Thomas Rossi and P.C. Lee. After teaching and doing research at Harvard, Stanford and Tel Aviv universities, Lebenthal came to UB in 1976. He was attracted partly because of Children's Hospital's reputation and the warmth of Buffalo's community. He is editor and coauthor of the two definitive reference works on children's digestive diseases, especially Textbook of Gastroenterology and Nutrition. He is also editor-in-chief of his medical specialty's international journal. After the press conference, Dr. Lebenthal left for Peru and Indonesia to continue his international efforts associated with the new institute. • BUFFALO PHYSICIAN • 9 �'Bubbleman Ill,' bv Dr. William TOrnow. 10 • BUFFALO PHYSICIAN �P hotographs from all O\·er the world taken by area physicians were on display during the Eighth Annual Physician's Photo Show April 8 to 12 at Sisters Hospital. Sponsored by the Sisters ~1edical Staff in cooperation with the Medical Societies of Niagara, Genesee and Orleans Counties. the event im ited doctors from all area hospitals to put their best photographic \VOrk up for public viewing during the exhibition. Eight of the 12 awards were received by UB faculty: FIRST PLACE COLOR- Dr. Joseph Link, clinical instructor in pediatrics and rehabilitation medicine, "Eskimo." SECOND PLACE COLOR- Dr. Albert Menno, clinical assistant professor of surgery, ''Cupide et Psyche." HONORABLE MENTION - Dr. l\lenno, "Entrance to the Chateau." Dr. Sixto Macede, clinical instructor in gyn-ob, "Autumn Reflections" and "Pumpkins Anyone?" Dr. Kenneth Eckhert, Jr., clinical assistant professor of surgery, "Underwater Christmas Tree." Dr. \Villiam Tornow, clinical assistant professor of pediatrics, "Bonding" and ''Bubbleman III.'' • Photo show UB faculty take 8 of 12 awards BUFFALO PHYSICIAN • 11 �-- - - - -- - - - - - - - - -- ----- --- Hospices blend physical, social & emotional care 'The hardest thing is to switch from curing to caring' By Mary Kunz and Bruce S. Kershner he hospice movement is a most important movement. Most health-related schools are under great pressure to rethink the roles of ' ' ' health professionals;' said Dr. John aughton, M.D., dean of UB's School of Medicine, during opening remarks to the audience gathered for "An Institute on Hospice Care." The conference, held April 26-27 in Buffalo, was organized by Hospice Buffalo, Inc., in cooperation with UB and Buffalo General Hospital. Throughout the two-day conference, which was attended by about 150 health care professionals, seven workshop were conducted. The workshops were divided by area into medicine, nursing, social work, occupational therapy, pastoral care, bereavement, and volunteer work. The progress made in hospice care and the challenge and pitfalls faced by member of hospice teams were then examined by the keynote speaker, Balfour Mount, M.D. He is the leading authority in orth America on hospice care and director of the Palliative Care Unit in Montreal's Royal Victoria Hospital. "The foundation of hospice care has to rest on expert medical care, with a skilled physician and nurse involved;' Mount said. "In one study done at our hospital, the patient population served by hospice care had a higher nurse dependency than any other unit. These are the sickest patients in the hospital. These are patients who require physical care. But;' he reminded the audience, "we can't pass by a bed and look at a patient's face without realizing that taking care of the physical needs isn't enough." Dr. Balfour Mount of North Montreal's Royal VIctoria Hospital. ><:: ~ 0 z cii § I a.. 12 • BUFFALO PHYSICIAN In the past, Mount explained, certain needs of patients have been neglected, such as their social context, their unanswered questions, and their dealing with pain. These needs must be met, he tressed, in all settings - in the home, in the chronic care unit, and elsewhere. He urged health care professionals to concern themselves with the goals of the hospice movement, in practice and in education. The hospice team, Mount illustrated, is all-important. The team must have expertise in all the spheres of patient care, and must overcome the problems and disillusionment which often go along with a profession whose eventual concern is death. In a field so demanding, stamina and teamwork are essential. "We've developed a physician-dominated, hierarchical system;' he noted. "This works well for operations, but it doesn't work well with hospice care. If we're saying that serving spiritual and social needs is equal to serving physical needs, how do we do that with physicians dominating? "I am impressed by the fact that our colleagues in the business world have long recognized the importance of the team,'' Mount said. "We operate in the health care system as though we never heard of it." Mount explained that hiring people for hospice teams is difficult due to a number of factors, including incomplete or vague descriptions of jobs, a small pool of applicants, a sense of urgency which might compel employers to hire "almost anyone;' a tendency to hire on fir t impressions, and union constraints. Selection of ho pice team members, he emphasized, �Mount said. "We have to be capable of making a diagnosis and bringing something to the problem." He added, dryly, that when all else fails, a hospice team member must not forget the last resort - to quit. Hospice work is terribly demanding, but, Mount concluded, it is necessary and rewarding. Working with a hospice often means almost unbearable exposure to pain, futility, and death. But there remains the satisfaction of fulfilling a basic need - to improve the quality of life. "Life is not easy;' Mount said. "Death is rarely easy. Frequently on a hospice team, we're called upon to face the discipline of unfulfillment ... We experience our vulnerability, the question of our awful freedom, our awesome aloneness and our need for meaning. "But what a challenging, rich, rewarding task it is," Mount said. "J switch he hardest thing for physicians and nurses to do is from attempts at curing to attempts at caring;' Dr. Robert Milch addresses Hospice Conference participants. should be made with careful research and screening. "You want a good fit, not someone you've conned into the situation;' he said. Those interested in hospice care should learn more about the psychological needs of patients. Mount explained that patients, used to being on the receiving end, feel useless and "depersonalized." He said that patients should be allowed to give as much as possible. Research should investigate the structure of family systems, so hospice team members can better understand the problems patients face at home. Studie should center also on the ways and problems of dealing with loss. H ospice team members, Mount said, face discouraging problems unique to their profession. These problems include di illu ionment, burnout, grief, and eventual apathy, due to the death of patients and the feeling of futility that often ensues. Because of the new concepts and roles associated with hospice care, misunderstanding and confusion occur frequently. Few people are completely sure of the others' roles. Problems in identity result from the fact that roles of hospice team members overlap. A social worker might become upset because other team members might appear to be taking over his or her job. A music therapist, because of the novelty of the field, might find that no one understands what a music therapist does. A physical therapist might become discouraged because instead of making progress, the patient does less and less every week. "There are reasons for us to be under stress in this work;' Robert Milch, M.D., associate professor of surgery and Hospice Buffalo's medical director, said of the palliative care approach of the hospice movement. He addressed the first session of the medicine workshop on the fundamentals of pain and symptom control. To put the need for palliative care in perspective, Milch explained that if one in three cancer patients is cured, that means that two out of three are not cured and therefore potentially in need of palliation. Both laymen and health care providers outside of ho pice care are prone to misunderstandings about it. Identifying the most fundamental misunderstanding, Dr. Milch quoted Samuel Johnson, "Those who do not feel pain seldom think it is felt." This is reflected in statistics concerning cancer patients. " ot everyone with advanced malignant disease is suffering from pain," Milch remarked. "Cancer does not necessarily equal pain. But the care-givers' estimate of the proportion of advanced cancer patients who experience pain is 25 to 30 per cent, while interviews with patient indicate 60-65 per cent experience pain." Another misconception is that a quiet-appearing sleep indicates the patient is not in pain. "You can definitely suffer from pain while asleep," he continued. In fact, sleep induction using barbiturates is to be avoided since barbiturates increase the perception of pain. Similarly, health care providers mu t recognize that patients not experiencing physical pain can still be experiencing non-physical pain, Milch explained. This type of pain includes fear, anxiety, depression, nausea and chronic insomnia. Fear of dying is not the only fear that patients with advanced malignancy encounter. Fear of isolation and rejection, fear of unbearable pain, fear of loss of identity, fear of leaving loved ones behind and helplessness are also common. "Even those hospice patients who have not experienced pain, fear that it will come - and those who no longer experience pain, fear it will come back;' Milch pointed out. Later that day, Lawrence Sherman, M.D., assistant clinical professor of surgery, and George Cohn, M .D., clinical professor of neurosurgery, discussed the use of transcutaneous electrical stimulation, epidural morphine and biofeedback to control pain. The next day, April 27, Sandra Tiller, M.D., clinical physician, University Health Service, Robert Moskowitz, M.D., associate clinical professor of medicine, Owen Bossman, M.D., clinical associate in medicine, and Dr. Lawrence Sherman participated in panel discussions on physician-patient-team interactions between the hospice program and the health care community. • BUFFALO PHYSICIAN • 13 �Long-term DES effects Both male and female offspring at risk A By Mary Beth Spina mounting list of long-term ide effects in newborn mice which have been given the synthetic estrogen DES (diethylstilbestrol) suggests that scientists should look more closely for potential problems in human offspring of mothers who took the drug, says noted tumor biologist and animal researcher Dr. Howard A. Bern. Dr. Bern, a University of California (Berkeley) scientist who delivered the John W. Cowper Lecture Series at Knox Hall this spring, was one of the first to observe a link between estrogens and malignancies of the vagina and cervix in newborn female mice given these hormones. It would be another ten years before a similar link would be reported between DES and such findings in young women whose mothers took DES in early pregnancy, ending the practice of administering the drug to the pregnant. An estimated one to three million - or more - pregnant women prone to miscarriages received the synthetic hormone between 1945 and 1970, ostensibly to promote full-term pregnancy. "But," says Dr. Bern, "there was no good evidence in animal studies or otherwise that it did, in fact, prevent the spontaneous abortions." At best, the endocrinology was uncertain and the reason the drug enjoyed such popularity among clinicians is still unclear. On the other hand, research by Dr. Bern and others using mice and other animal models as early as the 1960s showed abnormalities of the female reproductive organs linked to the administration of DES or natural estrogen. The newborn mouse - rather than the pregnant one was used in these and subsequent studies with DES because the neonatal mouse at birth shows sexual development equivalent to that of the infant human at the end of the first trimester of gestation. It is known that one to 1.5 million young women and presumably an equal number of young men born to DES mothers during the 25 years the drug was administered in the U.S. were exposed to the hormone. Research which revealed that DES daughters bear a one in 1,000 to a one in 10,000 risk of developing malignancies of reproductive organs seen in postmenopausal, but never in young, women, has more recently shown that DES sons may not entirely escape risk from similar intrauterine exposure. "Decreased fertility, low sperm count, testicular abnormalities and testicular tumors called seminomas are among disorders which have been reported in some sons of women who took the drug in early pregnancy;' Dr. Bern explains. A s recently as last year, a footnote on the DES story appeared in an article in the Journal of the American Medical Association. "A study of six siblings whose mother took DES in the first trimester of all her pregnancies showed one son with seminoma, one with oligospermia, one daughter with a clearcell carcinoma of the vagina, and another daughter with vaginal adenosis;' Dr. Bern relates. Even though use of DES has been largely discontinued since 1970 for pregnant women in the U.S. and elsewhere, it should not be assumed that the DES story is over. In parts of Puerto Rico, it has been observed recently 14 • BUFFALO PHYSICIAN (AbolleJ T-shaped utetuS with namJW and lnegular utettne cavtty. (Below} T-shaped uterus with constrtcuon. Lower haff at uterine cavttJ has bulbous appearance, and affected area at cervical canal has a tunnel shape. These abnormalities have been seen In some women exposed tn utero to DES. that some youngsters are showing abnormal, precocious breast development and other symptoms which suggest exposure to high levels of estrogen. Thus, some pregnant women in Puerto Rico may be similarly exposed. While evidence has been well documented as to the effects of DES on new-born mice given the drug as well as occasional vaginal cancer and other abnormal genital tissue development in human daughters and sons of DES mothers, ongoing animal studies suggest that the hormone may have yet other long-term effects. Various studies by Dr. Bern and his colleagues as well as other research elsewhere point to changes in the prostate and in the mammary gland, in the development of nervous and immune systems and in the patterns of enzyme levels in the liver of laboratory animals exposed to DES or other estrogens at or before birth. While not claiming that these animal model findings are entirely applicable to humans who have been exposed to the hormone in utero, Dr. Bern says that experimental findings at least suggest areas which invite further clinical investigation. "To date; he points out, "there have been few or no studies on humans in these important areas." Dr. Bern cautions that while findings of animal studies may not necessarily be predictive of parallel changes in humans, it is worth remembering that reproductive tract changes in male and female animal models parallel certain of the changes in the same organs of sons and daughters of women who took DES in early pregnancy. While DES is still marketed and prescribed for treatment of prostate cancer in males and as a "morning after" pill for young women, Dr. Bern - although not a physician - raises �some caution about the latter. "If it does work to prevent an unwanted pregnancy in young women who have been victims of rape for instance, then that's fine. But if it's given and doesn't work then the pregnant woman is confronted with another difficult decision," says Dr. Bern. Clearly, all the facts are not in, nor are they likely to be for some time to come in terms of early exposure to estrogen - either natural or synthetic. Funding for the Lecture Series was provided by The john W. Cowper Co. Inc. with additional support from UB's Faculty of Natural Sciences and Mathematics, the School of Medicine's Department of Physiology, and the Department of Biological • Sciences. Human biology It's missing in the liberal arts A By Ann Whitcher merican medical schools face special challenges in light of changing U.S. medical practice and exaggerated public expectations of what is good health care, said Dr. Edward]. Stemmler, dean of medicine at the University of Pennsylvania. Moreover, medical schools and undergraduate programs share responsibility for public education in health matters,. he said. "Human biology is a missing discipline in the liberal arts," continued Stemmler, addressing an April 20 seminar on "Higher Education and Health" sponsored by the Medical School and UB's Faculty of Educational Studies. Increased general health awareness can only help the public cope with medical advances, and with the burning medical issues of the day. "Eventually our society will find it necessary to withhold certain therapies from certain segments of the population;' he said. All the more reason, he added, "why we need an educated population which understands life in all its dimensions." The University of Pennsylvania medical dean argued that medical schools "are an integral part of higher education" and have a duty to participate in broader behavioral research than has been the ca e so far. On the other hand, he stated, the somewhat "rigid" structure of university liberal arts departments often precludes needed university-level study of the human body, even as some elementary school students arc now delving into beginning molecular biology. In short, the American public will benefit, he said, if it can be soundly educated in elementary human biology Quoting the noted bacteriologist and Pulitzer Prizewinning author Rene Dubos, Stemmler said the public must assume some responsibility for its own health, and abandon present unrealities in perceptions of what is appropriate health care: "It is meaningless and dangerous to encourage the notion that health is a birthright, or that freedom from di ease can be obtained through drugs or other medical treatment. Like political freedom, freedom from disease is not a commodity to be restricted by science or government. It cannot be obtained passively from a physician or at the corner drugstore . . . We must reconsider the wisdom of using longevity as the dominant criterion of social and medical practice. We must be prepared to recognize that an excessive concern with security and with the avoidance of pain has dangerous economic and biologic implications." As for the nation's medical schools, they must pay more attention to behavioral factors in health care and research; become more independent of federal control; and seek out those "sensitive, remarkably qualified" individuals now turned off by the competitive rush, otherwise known as "pre-med syndrome." This competition is so fierce and ultimately destructive, Stemmler said, that some of today's medical school applicants are known to contrive a pattern of social service, "not out of genuine dedication;' but out of a desire to bolster their applications in a fight for hard-to-obtain medical school places, even as the number of places has risen with post-war medical school expansion. schools, through their research and instructional M edical programs, must acknowledge the prominence today of behavior-influenced and behavior-engendered diseases. The list of the ten leading causes of death in 1900 included diseases not present on a similar list for 1980: tuberculosis, nephritis and diphtheria. Unfortunately, new diseases 'appear on the "top ten" list of the present era: accidents, cirrhosis, suicide, malignancy, chronic lung disease and heart disease. All, he said, are influenced to some degree by human behavior. Stemmler added that the almost exclusive emphasis on biomedical research and curative care in medical education has overshadowed needed attention to behavioral research. He also said the dependence of many medical schools on federal monies via the ational Institutes of Health necessarily affects the nature of American medical school education. These monies arc also concentrated in a few schools, he remarked. "Forty per cent of the medical schools now receive 80 per cent of the extramural funds of the ational Institute of Health;' Stemmler stated. Moreover, only 20 of these medical schools "have half of the IH budget for extra-mural research. Modern research is a capital-intensive venture and will gravitate to those universities which are able to invest in it." This "intrusion" of the federal government has a resulting effect on medical education, just as the development of Medicare and Medicaid has affected medical practice and the education of physicians since the 1960s. Medical school expansion in the post-World War II years has given us many more doctors, to the point that there is now a physician surplus in Stemmler's view. Also, this expansion encouraged the notion that medical schools "were agents of social change." Such an expectation on the public's part has had both good and bad effects, Stemmler reiterated. During a question-and-answer session, Stemmler speculated that medical school officials will likely need "several years to sort out some of these issues." While not denying the salutary effects of mass-media illustrations of health care in (soap operas and the like), Stemmler said the public nonetheless learns about health in too passive a manner. Also, the health craze as witnessed by the flurry of celebrity exercise books and packed aerobic classes at the nation's health spas, offers only a partial solution. "I don't think this is an educated health culture." Asked about the worth of medical education in places like Grenada, Stemmler said schools with "inadequate programs and facilities do students a great disservice. It is only secondary education." Stemmler's address was the concluding event in a series on "Higher Education and Human Values in the 21st Century;' presented this past academic year by the Department of Educational Organization, Administration and Policy, Faculty of Educational Studies. • BUFFALO PHYSICIAN • 15 �--~-- ~0. �ResearchShuttle astronauts visit UB Physiology Lab Group previews testing device they will take into space A !most two years before they launch into orbit around the earth, five space shuttle astronauts helped launch an experiment in Buffalo: Three physicians, one veterinarian and two physiologists visited UB April 25 through 27 to undergo testing on a rebreathing apparatus that will accompany them into space in January 1986. The unique device was developed in 1976 by Leon Farhi, f.D., professor and chairman of UB's Department of Physiology. Dr. Farhi is being assisted in his efforts by his co-investigators, Robert A. Klocke, M.D., UB professor of medicine and physiology; Albert J. Olszowka, M.D., associate professor of physiology; and r-.1ar} Anne Rokitka, Ph.D., research assistant professor of physiology. The six ASA astronauts, four men and two women, include two mission specialists (regular shuttle crC\'-' membe1·s) and four payload specialists (scientists who fly on only one particular mission). Commented UB President Steven B. Sample, "All of us here at UB are very pleased that a project initiated at this institution will be included as part of the NASA life sciences space shuttle program scheduled for next year. \\'c note that this participating pr~ject is one of only 24 selected out of more than 400 submitted to ASA for this mission." "We are very proud of Dr. Farhi and the entire Physiology Department for this and all its endea,·ors in research," Dr. John aughton remarked. "I wish to acknowledge Dr. Farhi, whose experiment will eventually be carried around the earth." The astronauts will be subjects on equipment that will measure their cardiac output and associated functions at rest and when exercising. One reason the UB experiment was selected by NASA was because it may shed light on a medical problem experienced by astronauts. Dizziness and near fainting have been encountered by astronauts after re-entry since the days of John Glenn and its exact cau e is unknown. "Our project was selected," Dr. Farhi explains, "because our question was important, our methodology was valid and we had an excell ent track record - we had many years of field experience." He adds that the UB project was also considered because "it complements and supports nearly all of the other 23 space PHOTI)S: NOWAK, NASA By Bruce S. Kershner shuttle experiments." Dr. Farhi pointed out that the entire mission is a broadminded approach to science as well as a cooperative scientific effort. Another reason why the experiment was selected for the space shuttle is that the equipment is unique because it is non-invasi,·e, i.e., it does not require blood samples from the patient or injection of drugs. Furthermore, it does not require expensive analyses. "We've lived with gravity all our lives, our ancestors have Ji,·ed with it all their Ji,·es, and so it is hard to think of it as a factor that can be changed," Dr. Farhi the space shuttle, and after re-entry. Dr. Farhi will be in Kennedy Space Center, Florida, to assist in on-ground monitoring just before the launch, during the launch and while the shuttle is in space. He will then go to Johnson Space Center in Texas to oversee monitoring during flight and will fly again to Kennedy to perform studies on the crew after re-entry. This will enable him to compare the effect of increased stress associated with the sudden gravitational change, followed by gradual acclimation to zero gra\·ity, followed again by re-acclimation to nor- explained. "Over the course of millenia, we have developed mechanisms that help us push the blood 'upstream; as it were. It is the study of these mechanisms that brings us here today. Clearly, we don't stand erect all the time. \Vhen v\e lie down, these mechanisms are 'turned off so to speak. Thc1·e is also evidence that these mechanisms arc turned off if we don't use them for a period of time. The question is, if these mechanisms arc inactive during flight, what happens to them when you return to earth?" These compensatory mechanisms may become disabled in astronauts who have not had to cope with the effects of gravity, as well as certain patients who have been bedridden for a long time. Dr. Farhl explains his rebreathing apparatus at press conference. (Page opposite} Astronaut using device T he cardiovascular behavior of the astronauts will be investigated before launch, under zero gravity conditions in mal gravity conditions. In actual lab test. It is already known that cardiac outpur increases significantly when there is a drop in gravity. "\\'e haYe a hint that cardiac output slowly decreases as the body gets used to the new condition. But vve don't know exactly what happens during readjustment," Farhi notes. He believes that ca1·diac output drops below normal for some period after re-entry and then finally returns to normal. It is the below normal output that might cause the dizziness and fainting experienced by astronauts. The first day at UB, the astronauts familiarized themselves with equipment and experimental procedures. On Thursday, April 26, they were te ted while at rest, and on Friday. April 27, the experiment was conducted while exercising. BUFFALO PHYSICIAN • 17 �~ r----------::;~~====~~-------------------------:~~-:;:;;~~~==~ 0 z iii 0 0I 0.. liJpJ Astronaut James Ba(jan on device In lab. limmediately above} MatVaret Seddon breathes Into Instrument as Millie Fulton/ and Dt. Falhllook on. (At tfghtJ Astronaut Seddon In reclining test POSition. 18 • BUFFALO PHYSICIAN Base-line measurements of the astronauts' cardiac, pulmonary and circulatory levels were obtained first. This is because pumping rates and oxygen consumption while exercising are different for each person because everybody has their own physiology and level of fitness. The only time that actual blood samples have been taken for the experiment were for lactic acid blood b:els for the base-line studies. Farhi's apparatus injects a sample of the exhaled gas into a mass spectrometer, where concentrations of oxygen, carbon dioxide and nitrogen are determined. The de\'ice also measures the volume of inhaled and exhaled gas from the astronauts. The amounts of carbon dioxide and oxygen that are produced and consumed, respectively, arc measured at intervals. From this data, rates of oxygen depletion and carbon dioxide accumulation can be compared at rest and at various exercise levels. This data, in turn, enables the researchers to calculate the amount of blood pumped through the lung, the way it is distributed through the lung, and the lung's volume. The six visiting astronauts were James P. Bagian, M.D., mission specialist and coordinator for space shuttle crew equipment; l\1argaret R. Seddon, M.D., mission specialist; and payload specialists Millie H.W. Fulford, Ph.D.; Francis A. Gaffney, l\l.D.; Roben \\'. Phillips, Ph.D., and veterinarian; and Bill Alvin \Villiams, Ph.D. The astronauts come from Philadelphia, San Francisco, Texas, Tennessee, and Colorado. Three payload specialists arc professors outside of their astronaut role, and one is an Environmental Protection Agency research scientist. �ResearchAt the press conference held on April 25, the astronaut all nodded enthusiastically when asked if they were looking forward to going up in space. Dr. Phillips remarked, "Space research is just coming of age. It's a new frontier - and we're just the first of many cicntists that will conduct research in space.~ D r. Phillips summed it up for all of the astronauts when he added, "I think the bottom line i just going along for the ride. Let's face it - it's fun. Almost everybody has dt·eamed of flying in space." Speaking before the packed press conference, Dr. Farhi remarked, "It is only appropriate that you should come to Buffalo, because one of the members of our faculty is rightly con idered to be one of the fathers of aerospace medicine ... About 40 years ago, Dr. Hermann Rahn investigated the possibility of getting to fly as high as 24,000 feet, which at that time was an enormous task. To accomplish this, he was given an "enormous" grant from the Air Force: " 500!" UB's space shuttle project is supported by grants totalling $21/2 million. The Department of Physiology has been working on the subject of gravitational effects on blood for many years. Although the department was among the lirst established when the medical school was founded in 1846, the modern department was developed by Hermann Rahn. Dr. Rahn, among other things, introduced the high altitude chamber. Dr. Farhi is a charter member of the Johns Hopkins Society of Scholars and was named Man of the Year by the WNY Heart Association in 1983. Raised in Lebanon, Farhi, who speak five languages, immigrated after medical school to Palestine in 1946. Four years after the new state of Israel was born, he went to the University of Rochester for post-doctoral training. It was there that he met Hermann Rahn in 1953. After spending several years back in Israel, he was invited by Dr. Rahn (who had by then moved to UB) to join the faculty here in 1958. The pioneering Dr. Rahn was re ponsible for stimulating Dr. Farhi's interest in physiology. "I owe all of my development to Hermann Rahn. I've had other great teachers, too, but he made the greatest difference," Farhi related. Dr. Farhi became chairman of the department in 1982. Development of Farhi's technique has been supported by NASA and by the National Institutes of Health. The space-qualified equipment that will be needed for these measurements is being built in Buffalo by Arvin/Calspan. • Horseshoe crabs May be useful in diagnosing leukemia A n experimental approach which utilizes a substance found in the blood of horseshoe crabs and their relatives, American and Saharan scorpions, appears promising in aiding diagnosis of certain leukemias and some connecti,·e tissue disordet·s in humans. UB immunologist Elias Cohen, Ph.D., who de,·eloped the assay at Roswell Park ~1emorial Institute, says it has potential to assist in diagnosing and monitoring Chronic Lymphocytic Leukemia (CLL) and the autoimmune disorder Systemic Lupus Erythematosus (SLE). Further research, Dr. Cohen adds, is in progress to determine the merit blood cells which indicate effectiveness of medications used in treatment of these conditions," says Dr. Cohen. This assay also ma7 have potential as an adjunct diagnostic tool, he adds. Cell clumping by the horseshoe crab blood was first reported in 1903 by the japanese scientist Noguchi, but it was not until the 1950's that its biomedical importance was ad,·anced. Since then, horseshoe crab blood has been used in pharmaceutical assays for endotoxins produced by bacteria and more recently, as probes of human cellular membrane constituents. It is known that these animal lectins are glyco-proteins which bind to specific carbohydrate-containing receptor sites on human cell surfaces causing the agglutination to occur. Further study is continuitig to determine the nature of the alteration which occurs in the cell membranes of the "hitc blood cells of CLL and SLE patients which promotes their reactions with these lcctins. Also invoh·cd in the studies leading to dC\·elopment of the assay arc Gerardo R. Vasta, Ph.D., now with the Uniwrsit\ of South Carolina School of Mcdicin~ m Charleston and George Ilodi, Ph.D.. of CJe,·eland, Ohio. • S18,000 grant of the a say in the diagnosis of rheumatoid arthritis, one of the most common connecti,·e tissue disorders. Dr. Cohen is a clinical associate professot· of pathology at UB. The simple, 30-minute assay involves adding lectin, an agglutinin found in blood of the sea creatures, to white blood cells taken from human patients. Normally, the white blood cells which are important in the body's defense system against disease only clump together slightly when added to the lectin. "But when the lectin is added to white blood cells from patients known to have CLL, high levels of clumping or agglutination occur," Dr. Cohen explains. A lower, but still significant level of agglutination occurs in white blood cells taken from SLE patients when combined with lectin from the crabs or scorpions. Research indicates that certain human white cells known as B cells clump more readily than other kinds, such as non activated T cells. Although there arc currently other laboratory tests available to assist in the diagnosis of CLL and SLE, they are more costly and time-consuming than the micro-lectin assay. "Once diagnosis has been confirmed using other tests available, our assay may be helpful in monitoring changes in the white Insures completion of cardiopulmonary project T he james H. Cummings Foundation of Buffalo ha> awarded an 18,000 grant to the Uni,·crsity at Buffalo Foundation to insure completion of a major cardiopulmonary research project. The Cummings grant allowed a matching grant by the Unin~rsity for a total of 36,000. John Bray, UB foundation director of corporate and foundation relations, said, "The Cummings grant was absolutely vital to the work of Dr. Sadis i\1atalon," as>istant professor of physiology, who is working on the "Pathophysiology of Sublethal Oxygen In In· jured Lungs." The research is being funded by a 320,000 grant from the National Heart, Lung and Blood Institute. Bray said the fcdnal grant did not allocate monies for the purchase of an automatic gamma counter system necessary for a crucial part of this project. "Without this equipment, Dr. Matalon could not finish the study in a projected time and would have jeopardized the entire grant." This is the second Cummings grant rccci,cd by the UB Foundation for medical equipment purchases. Dr. l\1atalon's research seeks to determine if the current usc of oxygen. used clinically for the correction of various respiratory and cat·diovascular diseases, is in fact causing BUFFALO PHYSICIAN • 19 �Researchdamage to m<~or body organs. Dr. ~latalon's previous findings indicate this may be the case. As this organ damage is silent it cannot be detected by routine clinical tests. The results of this medical research promise to offer new awareness on the possible limitations of oxygen treatment of patients with pulmonary disease and perhaps establish safe limits for ib usc. The James H. Cummings Foundation was organized in 1962 for charitable purposes in advancing medical science research and education in the United States and Canada. ~1r. Cummings also established a fellowship at the UB School of Medicine. :V1 r. Cummings founded the American Ferment Company which \Vas later purchased by Sterling Drug. He died in 1959. • Drop in smoking 7 per cent decline noted during 1983 1 he largest drop in cigarette smok- 'T ing ever recorded in a single year" was announced by Dr. Gerald P. :\1urphy at an American Cancer Society Science \Vriters' seminar recently. Dr. Murphy is president of the Cancer Society as well as director of Roswell Park :-. l cmorial Institute and research professor in UB's School of :\1t:dicine. The 7 per cent drop in per capita consumption of cigarettes in 1983 was ac-companied by a slightlv slower rate of increast: in lung nmcer deaths I(Jr men. A Society-sponsored Gallup Poll confirmed recent gon·rnment ligut-cs that the number of American smokers is shrinking. "An accelerating trend awa} from the usc of cigarettes is unmistakable:· Murphy said. By the end of 1983, only 29 per cent of American adults smoked, compared with 37 per cent in 1980. "It represented a decline of 31 billion cigarettes smoked during a 12 month period - an average drop of more than 2 Y2 billion cigarettes a month," Dr. :-.turphy stressed. • brushing and flossing," says Dr. Drinnan. Scraping the tongue, notes Drinnan, not only removes clinging food particles and bacteria but freshens the mouth as well. Noting that many other cultures consider the mouth unclean if the tongue has not been cleaned, Drinnan is unsut·c why the habit has nc,·cr caught on in the U.S. "For centuries, the Orientals have used tongue scraping as part of their oral health routine, as did the ancient Romans," he notes. Indeed, dcnttsts from the Eastern world who come to the U.S. arc usually taken aback that dental practitioners here do not ,., - u~.- · v:y-1. Blood gas analyzer Automatic unit installed A Tongue-scraping Called effective aid in cleaning the mouth S craped your tongue lately? \ou should, according to Alan J. Drinnan, :\1.D., D.D.S., a lJB clinical assistant proll-ssor of medicine and a professor of oral medicine in the School of Dentistry. "Although the tongue occupies about onethird of the oral ca\'ity, most Americans ignore it as if it weren't there when they're busy 20 • BUFFALO PHYSICIAN Instead, he recommends that dental patients usc either a tongue scraper especially designed for the purpose which is a,·ailable in the U.S. - or the inverted bowl of an ordinary spoon. It may be a long time bcf(Jre tongue scraping is as rcadil} accepted as a part of oral hygiene as is brushing and flossing, Drinnan concedes, but if more Americans tried it, they'd be surprised at how much cleaner their mouths would be. '·for a nation whose people spend untold dollars each year on mouthrinse, breath mints and other products to freshen the mouth and breath, it seems a bit absurd that one of the simplest and easiest methods to achic'c this goal has been ignored," he comments. • instruct their patients on the line art of tongue scraping. Although many Americans occasional!~ take a swipe at their tongues with the toothbrush, Drinnan recommends other de\ ices as more dfecti\T. "~lost people quite truthfully will ha\e an uncontmllable tenclenn· to activate the gag reflex if they actually. try to brush their tongues," he points out. n automated acid-base blood gas analyzer has been installed in the Pulmonary Function Unit at Millard Fillmore Hospital to replace a manual system that dates back to 1975 . According to Fran Cirbus, chief technologist, blood gas analyzing systems have developed considerably since 1975, and the new system is expected to save technical time and money. The equipment is used to measure pH, carbon dioxide and oxygen from arterial blood samples. In the past, technicians have had to do manual calculatiom of the results, and frequent manual calibrations of the equipment (to make sure the measurements were accurate). The new equipment docs these jobs automatically. Because of this, the system is more accurate and always ready to accept blood samples. Pulmonary technicians will spend less time preparing equipment li:Jr usc, so their time can be devoted to the patient having breathing tests. • �Medical School NewsEarly admissions New program reduces pre-med stress syndrome I ntense pressure and strain have traditionally been unavoidable for premedical students who prepare for and apply to medical school. For some premedical students, this will no longer be necessary now that the UB School of Medicine has established its Early Assurance Program (EAP). For the first time, the program allows premedical students to apply to the School of Medicine in their sophomore year, one to two years earlier than other students. If admitted to the EAP, a student can concentrate more on learning and personal development and less on the uncertainty and stifling competition that many premedical students experience in the junior and senior years. "Conceived of three to four years ago, the program ha finally been brought to fruition," Dr. Thomas]. Guttuso, chairman of the medical school's admission committee, related. Up to ten college sophomores per year will be given formal commitments of admission from the School of Medicine. The first group will enter the school in the fall" of 1986. Initially, the program will involve undergraduates already enrolled at UB. Dr. Guttuso anticipates that the University Honors Program will provide especially talented candidates for the program, though it will not be limited to the e students. Besides relieving the pre ure for medical school admission, the program has other objectives. One major objective is to identify and recruit promising minority students and encourage them to pursue a career in medietne. The program is also intended to enrich and expand undergraduate education by encouraging its students to pursue areas of interest, particularly in the humanities and social sciences, in addition to fulfilling premedical science requirements. It is not designed to accelerate the premedical curriculum, but to enrich the students' selection of courses beyond those in the traditional premedical program. "It will free up the selected students to take non-science cour e which they might not have taken; comments Dr. Guttuso. A particularly attractive aspect to the new program is that students accepted through it will not have to take the day-long Medical College Admissions Test (MCAT) required of other medical school applicants. In addition, it will enable tudents to benefit from an early association with medical school faculty advisors and to have acce s to summer research or clinical opportunities. Pursuit of thesis honors will be encouraged. Acceptance will be based on academic performance, aptitude, and demonstrated qualities of leadership. Commitment to human- John Robin (aboveJ is investigator with Dr. Eugene Mindel/ on a study of hlp ImplantS and associated bone and cartilage degen· erat/on In osteoarthritis (story at bottom of page}. istic and societal concerns that are increasingly associated with the practice of medicine will also be assessed. The program is designed to attract future health care leaders. Because only three semester of college academic achievement can be evaluated, applicants must, by the end of their sophomore year, have completed half of the premedical coursework. In return for having seats reserved in entering medical classes, selected undergraduates must fulfill certain requirements to remain in the Early Assurance Program. They must maintain a grade point average of 3.5. They must remain full-time students, complete all premedical requirements, and earn their bachelor's degrees. Also required is that they exhibit a high degree of maturity and emotional tability and display a commitment for a career in medicine. Students admitted through the progi-am must also formally agree that they will not enroll in another medical school. Students interested in the program can pick up applications at the Admissions Office, 133 Farber Hall, Main Street Campus or call (716) 831-3465. • Chair of surgery Endowed by Eckerts T he School of Medicine will get a new chair of surgery for visiting scholar . This i pos ible because of the generous philanthropy of Kenneth H. Eckhert, Sr., M.D., and his wife Marjorie. They have donated a trust of $152,000 to the Buffalo Foundation that will support the new academic chair. Dr. Eckhert earned his B.A. in 1931 and his medical degree in 1935, both from UB. He served on the Medical School's faculty from 1940 to 1981, when he retired to emeritu talus. He was former chief of surgery at Deaconess Hospital and senior cancer research surgeon at Roswell Park Memorial Institute. Among his professional and administrative duties, he was past head of the Eric County Medical Society, the American Red Cross (Buffalo Chapter), Social Services Board of Eric County and the Coordinating Council for Health, Hospital and Social Services of Eric County. Significantly, he was the first president of the Health Systems Agency of Western .Y., which was the first H.S.A. to receive approval by the federal government. Both the former Courier-Express and Buffalo Evening News awarded him the title of Man of the Year, in 1961 and 1970 respectively. He also received the Medical School Dean's Award and the Brotherhood Award from the Association of Christians and jews, both in 1968. He remains active in his profession as a member of the Health ystems Agency of 'A'estern .Y. Executive Committee and the N .Y. Statewide Health Coordinating Council. • Zimmer Award For Orthopaedic unit T he University's Department of Orthopaedic Surgery is one of only five such departments across the country selected to receive the first Zimmer Departmental Award from the Orthopaedic Research and Education Foundation. BUFFALO PHYSICIAN • 21 �"We arc delighted by this award," comments Eugene R. Mindel!, M.D., chairman of the department. "We are grateful to Zimmer which contributes generously to the Orthopaedic Research and Education Foundation, the major supporter of promising research projects which seek to understand the causes of musculo-skeletal injury in disease." The 10,000 grant will support studies of hip implants and associated bone and cartilage degeneration in osteoarthritis. John Robin, Ph.D., research assistant, will do the investigations in collaboration with Dr. Mindel!. They will study the patho-mechanisms of osteoarthritis of the hip, especially aseptic necrosis of the femoral head. The two hope to increase understanding of the basic mechanism of osteoarthritis. The Foundation's new Zimmer awards are underwritten by a grant from Bristol-Myers Company and its Zimmer Inc. subsidiar). Zimmer is a primary manufacturer of orthopaedic implants and related products. The awards were announced by the Foundation's president, Dr. Jorge Galank, chairman of the Rush Medical College's Orthopaedic Department in Chicago. • develop in animals who have either an extremely strong or a correspondingly weak immune response. Within an intermediate range of response, howeyer, the tumors develop and grow. Using the highly carcinogenic chemical methylcholanthrcnc, Dr. Prehn created tumors in genetically identical mice and transplanted them into their identical kin. After irradiating the bone marrow and thymus of the animals to remove their T and B cell producing capabilities, small amounts of increasing immunity were added to the mice via mouse spleen cells. At the lowest titration of spleen cells, the animals did not develop their transplanted tumors any further. , either did the tumors Immune response may be a trigger for it T 22 • BUFFALO PHYSICIAN Buswell Day Fellows receive certificates, report on research work T Cancer he long-held sun-eillance theory which suggests that cancer d<·vclops as a consequence of the immune system's failure to recognize and subsequently destroy aberrant cells is being actively challenged by a pioneering tumor immunologist who spoke at Bin April. Delivering the 14th Annual Ernest Witebsk) Memorial Lecture, Dr. Richmond T. Prehn said mounting laboratory evidence suggests that instead of its role as a protector, the immune response in some tumor systems may encourage development and growth of malignant tissue. Dr. Prehn conceded that much of the scientific community remains skeptical of the idea that cancer may indeed, sometimes be an autoimmune disease such as systemic lupus erythematosus and others. But, he adds, there's growing evidence to support the idea that cancer may in fact develop as a consequence of the body's attempt to defend itself. Dr. Prehn, the scientific director of the Institute for Medical Research in San Jose, said the most convincing evidence of cancer as an autoimmune condition is provided by animal research he's conducted during the past decade. In the research, he has demonstrated that transplanted tumors of certain types do not but perhaps only an extension of it." At the close of the lecture, Felix Milgrom, M.D., chairman of the Department of Microbiology, prescntcu the Ernest Witebsky Memorial Awards to three students for proficiency in microbiology. Receiving the awards were Dr. Joong Con Kim, graduate student in microbiology; medical student Mark J. Lodespoto, and dental student Scott J. Seier. • Dr. Richmond T. Prehn proliferate as the "super" immunity levels were reached. But at the intermediate level of immunity, the tumors developed rapidly. Dr. Prehn said that if the surveillance theory were always correct, the mice who received \Cry little immunity via the small amount of spleen cells would have developed the tumors rapidly. Surprisingly, they did not. "We have always believed that the suppression of the immune system which goes aiong with most chemotherapy for cancer is an adverse side effect," says Dr. Prehn. It may well be the very suppression of the fighting T and B lymphocytes of the immune response which leads to the improvement noted in patients who undergo such cancer treatment. Dr. Prehn cautioned, howe,·er, that what he has repeatedly observed in the animal experiments may not hold true for all tumor systems. "What I propose," he said, "is not a complete contradiction of the surveillance theory he culmination of months of research was reached when three Buswell schola· ; received their certificates on Buswell Day, i\.1arch 28, 1984. Dr. John Naughton, dean of the School of Medicine, referred to the Buswell Fellowships "as a first rate program" as he handed certificates to Dr. Myron Siegel, Department of Pediatrics (sponsor: Dr. E. Lebenthal); Dr. David O'Connell, Department of Pathology (sponsor: Dr. R. Heffner) and Dr. Thomas Rossi, Department of Pediatric (sponsor: Dr. E. Lebenthal). Two other physicians completed their fellowships last December and their certificates were mailed to them. They are Dr. Shigehiro Katayama of the Department of Medicine and Dr. John Georgitis of the Department of Pediatrics. Dr. Gcrd J. Cropp, professor of pediatrics and chairman of the Buswell committee, introduced the day-long seminar's speakers. Dr. Siegel described the results from his project which compared the effect of fat and carbohydrate composition on gastric emptying rates in premature infants. He found that long chain fatty acids arc better inhibitors than shorter chain fatty acids. He also concluded that systemic disease clearly affects emptying rates, while body position docs not. \!\'hat isn't clear is the identity and mechanism of the actual osmoreceptor that regulates emptying. "Experimental Allergic Myositis in Rats" was the topic of Dr. O'Connell. Dr. Pradip Rustagi elaborated on his research on antibodies in systemic lupus erythematosus, while Dr. Nahid Alavi followed with his description of prostaglandin biosynthesis in rabbit proximal tubular cells. Dr. Rossi compared the effects of continuous and restricted feedings on the recovery of malnourished rats. Interesting problems were encountered by Robert P. Kaye during his research into the effects upon human circulation caused by head-out immersion into different water temperatures. Mr. Kaye found that the immersion process and involuntary floating of 1 J �Medical School News- (From len across top} Buswell Day participants Dr. Genl Cropp, Dr. Myron Siegel, and Dr. Felix Milgrom. (Above} Slide of heart surgerv which illustrated lecture by Dr. Bruce Rabin (lower right}. J the immersed subjects interfered with the impedance electrocardiograph measurements of cardiac output. After repeated attempts and variations, he and his sponsor, Dr. Claes Lundgren, professor of physiology, discovered that the only way to counteract the interference was for the subject to wear a special dry suit. Mr. Kaye is a third year medical student at UB. Introducing the Buswell Day speaker, Bruce S. Rabin, M.D., Ph.D., was Dr. Felix Milgrom, chairman and distinguished professor of microbiology. Dr. Rabin is a past Buswell Fellow and a Buffalo nati,·e, now a sociate professor of pathology and director of clinical immunopathology at the University of Pinsburgh School of Medicine. Dr. Milgrom jested that what distinguished Dr. Rabin was not just his research but that he is one of the few prominent physicians to have done research in Buffalo who was actually born in Buffalo. Dr. Rabin described the state of the art regarding immunological aspects of human heart transplantation. He emphasized that cyclosporine is not the answer - that we need even better immunosuppression for heart transplants. The Buswell Fellowship Program was established in 1955 by Ralph Hochstetter, a pioneer oil producer and life-long Buffalo resident. He bequeathed the fellowship to strengthen medical research at UB and the University of Roche ter. Mr. Hochstetler named the fellowship after his si ter, Bertha, and his brother-in-law, Dr. Henry C. Buswell, a distinguished Buffalo physician considered to be one of"America's foremost diagnosticians of his day." Hochstetter Hall, occupied by the School of Pharmacy and Department of Biology, was named after Ralph Hochstetter. • BUFFALO PHYSICIAN • 23 �Hospital NewsCabbage Patch Dolls Help Children's educate its pediatric patients ''c abbagc Patch Dolls in Medical Service to the Community" That's one way to describe Children's Hospital's unique educational program for its pediatric patients, which uses Cabbage Patch dolls as the main instruments in teaching the youngsters. Having received 43 dolls as Christmas donations from both ew York State Governor Mario Cuomo and Brand Names Stores, the Hospital's Child Life Department decided upon a constructive use for them. They created a different ailment for every doll and treated them with medical dc,·iccs accordingly. This program lends the opportunity to teach the children, as each child can identify with the doll that shares the same illness that he or she has. Popular dolls include the "chemotherapy doll," the "trache doll," the "dialysis doll," and the "doll with the cast." Each doll is fitted with medical equipment resembling that with which patients arc fitted. The concept for this program was developed by Marcia Sarkin. director of the Child Life Department. At present, all of her staff members arc meeting with much success in using this program. Mrs. Sarkin's goal is eventually to train the entire medical staff so the program can be utilized more effectively throughout the hospital. • John Jefferies Resigns hospital post J ohn R. Jefferies, president of the Children's Hospital of Buffalo, announced his resignation 1arch 26 at the Hospital's annual meeting of the Board of Trustees. President of Children's since June of 1977, Mr. Jefferies will be leaving to rejoin his family in Utah, in order to tend to the increasingly serious medical needs of his immediate family. Richard E. Heath, chairman of the Board of Trustees, announced that a search committee has been formed to locate a successor. He said that Mr. Jefferies has made a significant contribution in his seven years in Buffalo, not only to Children's H ospital, but to the Western New York community as a whole. "Mr. Jefferies came to Buffalo at a time when our hospital was in serious distre s. Under his guidance and leadership, Children's Hospital has become an excellent and financially sound teaching medical 24 • BUFFALO PHYSICIAN cabbage Patch dolls with splints and l'l's. center that provides the highest quality pediatric and maternal health care." Mr. Jefferies stepped down from his role as president and chief executive officer at Children's on July l. • Man of Year Joseph Paris honored by Vietnam DAV J oseph Paris, director of Buffalo's Veterans Administration Medical Center, is the first recipient of the Man of the Year Award from the Disabled American Veterans, Vietnam Era Memorial Chapter 188. He was presented with the honor on April 29 by Joseph Delmonte, chairman of the veterans organization. The Buffalo News was told that 1r. Paris "docs not have the sort of well-known name that would bring curiosity seekers to the dinncr and sell a lot of extra tickets." Neither is he a political appointee to that important veterans post; instead he worked his way up from a contact reprcsentati,·c in 1946 to the directorship of one of the largest medical centers in the country. A member of the veterans' organization added, 'joe Paris is a disabled veteran himself who won the Silver Star, Purple Heart and other medal while serving in the Army in World War II." One veteran summed it up, 'joe Paris always goes one step further than he has to."• Louis Lazar Retires at Millard D r. Louis Lazar, clinical assistant professor of family medicine and medicine, stepped down a chairman of Millard Fillmore Hospital's Department of Family Practice in January after 12 years of service. "I think young doctors should come along with new ideas," said Dr. Lazar, who at age 65 plans to remain active in the department despite resigning as chairman. "Hopefully, I will continue practicing and consulting for a long time;' he said. Dr. Lazar was instrumental in organizing a separate Department of Family Practice at Millard Fillmore Hospital about ten years ago. Until then it was part of the Department of Internal Medicine. Of his role in establishmg the clinical Department of Family P1·actice, he aid, "It has been most rewarding. All in all I look back at a very pleasant 12 year of building a department from scratch." • (From Mzllard Fillmorr HoJpital\ "Reporter') �StudentsMessage from President of Medical Student Association Another academic year has come to an end. The May 19 commencement marked the start of a new phase for the Class of 1984. Their contributions to the school have been outstanding. I wish them the best in their new endeavors. Over 300 students, faculty and administrators enjoyed an evening of dancing, singing and humor at the Annual Medical School Follies, April 29. Producers Ed Williams and Stu Lerner, and directors Lori Loiacono and Camille Hemlock deserve credit for bringing us a great show. "Murmurs," the Medical School information hotline, is in full operation. Dial 831-3923 for the latest Medical School announcements. The tape is updated each week, so you can leave a message to be placed in the next tape. Orientation for the Class of 1988 will begin August 16. Students are already hard at work planning their welcome. Until then, enjoy the summer. -Alan Stein President, Polity >LU __J __J :::l (/) ::;; =; 12 0 J: !l. 138th Commencement 98 men, 45 women receive M.D. degrees S olemn sounds of "Pomp & Circumstance" filled the air as 143 new physicians silently filled the grand chambers of Kleinhans Music Hall. The restrained smiles that peeked out from beneath green graduating caps gave hints of the relief that the Medical School's Class of 1984 felt after four arduous years. This year's May 19 commencement was the Medical School's 138th and also the last to be held in Kleinhans Music Hall, the traditional location in recent years. ew University policy will require all future commencements to take place on campus. This year's medical degrees were given to 98 men and 45 women. In addition, 18 Ph.D.'s were granted by the Departments of Anatomical Sciences, Microbiology, Biochemistry, Biophysics and Pharmacology. The young physicians will soon be entering their residency programs in 14 states along the Eastern seaboard, Midwest, and Pacific Coast. "This is only a beginning - an important beginning - but also an ending in a long journey for you;' announced Dr. John Naughton, dean of the Medical School and interim vice president for health sciences. "All of us are prod of you and we are certain you will continue your medical accomplishments," Dr. Steven Sample, president of the University, said after congratulating the class. He referred to the great advances in medicine but contrasted them with crises in medicine that are also developing - the high costs, hospital closings, new diseases that emerge even as old ones are conquered. "These new crises are your real opportunities to advance the field of medicine;' Dr. Sample pointed out. "And lastly," Dr. Sample remarked , "let me suggest that you maintain throughout your careers a real thirst for knowledge. Said Einstein, 'The important thing is to not stop questioning. Curiosity has its own reason for existing. One cannot help but be in awe when he contemplates the mystery .of eternity, of life, of the marvelous structure of reality. It is enough if one merely tries to comprehend a little every day. ever lose a holy curiosity.' " Selected by his classmates to be this �- The following awards were announced at the Medical School Commencement: II BACCELLI AWARD: Charles L. Shapiro academic excellence in the clinical years ; GILBERT M. BECK MEMORIAL PRIZE IN PSYCHIATRY: Patricia J. Campbell academic excellence I ; BUFFALO SURGICAL SOCIETY PRIZE IN SURGERY: Robert W. Lasek academic excellence - junior, senior years CHILDREN'S HOSPITAL PRIZE: Evelyn D. Hurvitz excellence in understanding disease in childhood DEAN'S AWARD: James A. DeCaprio participation in extra-curricular activities in the Medical School while maintaining a high standard of academic excellence BERNHARDT & SOPHIE B. GOTTLIEB AWARD: Laura Jo Booth expertise in areas outside of Medicine NORMAN HABER MEMORIAL AWARD: Ira J. Schmelkin for proficiency in Otolaryngology i DR. HEINRICH LEONHARDT PRIZE IN SURGERY: Mark W. Anderson academic excellence LIBERMAN AWARD: Raymond G. Graber interest, aptitude in the study of Anesthesiology HANS J. LOWENSTEIN AWARD IN OBSTETRICS: James T. Fink academic excellence .:'1: MAIMONIDES MEDICAL SOCIETY AWARD: Mary T. Caserta proficiency in the basic sciences MEDICAL ALUMNI ASSOCIATION AWARD: Brian McGuinness community commitment DAVID K. MILLER PRIZE IN MEDICINE: John D. Lupiano demonstration of Dr. Miller's approach to caring for the sick competence, humility, humanity NEUROLOGY STUDENT AWARD: William J. Barbaresi academic excellence in clinical Neurology FREDERICK B. WILKES PEDIATRIC AWARD: William J. Barbaresi to the graduating student entering a career in Pediatrics who has best emplified Dr. Wilkes' skills and dedication to patients JOHN R. PAINE AWARD IN SURGERY: Douglas Floccare research of merit in the general field of Surgery MARK A. PETRINO AWARD: Michael P. McMullen demonstrated interest and aptitude for the general practice of Medicine CLYDE L. RANDALL SOCIETY AWARD IN GYNECOLOGYOBSTETRICS: Richard C. Nauheim academic excellence EMILIE DAVIS RODENBERG MEMORIAL AWARD: Kimberly J. Norris academic excellence in study of diabetes, its complications PHILIP P. SANG MEMORIAL AWARD: Charles S. White ability to relate well to patients, faculty and staff MORRIS & SADIE STEIN NEUROANATOMY AWARD: Evelyn D. Hurvitz excellence in Neuroanatomy UPJOHN AWARD: Andrew J. Francis research ability JOHN WATSON AWARD IN MEDICINE: Charles L. Shapiro enthusiasm for and commitment to scholarship in Medicine year's class speaker, Dr. John F. Tokoli referred to the arduous residency programs soon to begin, saying, "Do not think about the rigors that will befall you in six weeks -put those thoughts out of your mind. Today belongs to you and your beloved." Full smiles finally broke out across the faces of his classmate when he mused, "We have learned much, but what we do not know probably fills the bulk of Harrison's textbook." Dr. Tokoli concluded his light-hearted address by describing hi hopes for all the members of his class. Then he added, "And for next year's cia s, we hope the tuition will be less." Dr. Leonard A. Katz, professor of medicine and associate medical director for health maintenance projects of Health Care Plan, Inc., gave the commencement address, "You Can Make A Difference." "You are at a milestone in a journey that for each of you began a long time ago ... and here you are today, officially receiving your M .D. degree;' he said, congratulating them . He introduced the theme of his talk by stating, "I want each of you to believe that wherever you are, and whatever you arc doing, that you can make a difference." Then he continued, "As physicians, you will always be making a difference - in the lives of your patients, in the lives of the families who care about your patients, in the medical communities in which you are working, and in the live of future students, house officers and other physicians. "But in other ways, the ability to make a difference may be less obvious than it seems." D r. Katz suggested orne areas where new doctor can direct their influence, such as reducing the threat of nuclear war ("the ultimate medical hazard") or conquering ancient diseases in present-day poor countries. He also emphasized that, as physicians, they have the responsibility to lead the way by personal example 111 health. He pointed to cigarette smoking, regular exercise and use of seat belts as examples where physicians should make a difference in their own health habits before they can be examples for others. He then quipped, "The very fact that this graduation i taking place in Kleinhans Music Hall is clear testimony to the desire of this class to make a difference!" Dr. Katz related a story about the ancient god of healing Asclepius, who had two daughters. 26 • BUFFALO PHYSICIAN J �Students- "One of Asclepius' daughters was named Panacea. She believed that what we really needed to do was treat all the ill people and then every one would be well· in some wavs that's what the Am~rican medical ~ystem has believed until recently. There was another daughter however; her name was Hygeia. Hygeia believed that what we should do is teach people how to live their lives so that they would not become ill. This daughter of Asclepius and the followers of Hygeia are just now beginning to have a major impact on American medicine." Hillel, the quotable Jewish sage and rabbi of 2000 years ago, provided Dr. Katz with his final message: "If I am not for myself, who will be for me? But if I am for myself alone, what am I? And if not now, when?" This year's Medical School yea1·book The Iris was dedicated to Dr. Harold Brody, professor and chairman of the Department of Anatomical Sciences. This is the second time Dr. Brody has been honored in such a way. "For me, this year represents as with you an end and a beginning - an end to my first 30 years at UB and the beginning of my second 30," Dr. Brody commented. He then stressed the need for physicians to continue to develop their sensitivity to human feelings and their ability to genuinely relate to patients. Mere technical ability and knowledge is not enough, Dr. Brody stipulated, because there is a world of difference between a competent doctor and a good doctor. Following his response, Dr. Brody recited the Charge of Maimonides. Dean Naughton led the class in the Oath of Hippocrate and, with Dr. Sample and other prominent faculty members, the conferring of degrees took place, one by one, till all the graduates were seated • again. Scenes trom the Medical School's 13Bth Commencement Include signing the Great Book and receiving the traditional hood. Also pictured: UB President Steven B. 5am· pte who told graduates that medical cttses otter them grand opportunities and Om· mediatelY above} Class SPeaker John F. Talcott. BUFFALO PHYSICIAN • 27 �.... ~---------------------------------------------------------------------------- Match Day 88 per cent of sen iors get one of top choices S Match Dav: (counterclockwise from top left} 1. Juilv Klevan, Marte Nlgogosvan (center} and Thomas Mahl receive the good news. 2. Maurice J. WOlin (left} and Michael Kwasman congratulate each other. 3. Zlna Ha· Jduczok screams with delight, and 4. Rtzrov Dawkins Cleft} and Kenton Forte. 28 • BUFFALO PHYSICIAN uspense and silence were quickly replaced by smiles and sighs of relief as UB's fourth-year medical students learned which residency programs they were selected for on Match Day, held \\'ednesday, :\1arch 21. Dr. Dennis , adler, coordinator of the resident matching program and assistant professor of pediatrics, announced the results before a packed audience at the School of l\1edicine. The opening remarks were made by Dr. John Naughton, dean of the school. This year\ matching results were even more successful than last year's. Almost 88 per cent recei\cd one of their first three choices. with roughly two-thirds of those receiving their first choice. Of the remaining eight who were initially unmatched, seven were subsequently accepted for a 1-esidency program. Following their four years of training for their medical degrees, the matching program is second in importance only to commencement for the 132 students invoh·ed. Through the :\lational Resident ~latching Program of E\·anston, Illinois, medical students indicate their preferences for the cities and residency programs for which they want to be selected. Dean's letters of application are submitted and the students arc re\·icwcd and selected by the various programs. A computer then generates the matching results, which are delin·red to the School of :\1edicine. After receiving their medical degrees this May, the students will spend the next 3 to 6 years in dozens of cities across the nation completing the residency training that "ill give them the proper credentials for medical practice. Various hospitals in Buffalo will be the training location for 43 of the students. Besides Dr. adler, other faculty who assisted in preparing the Dean's letters were Drs. Steven Noyes, Margaret McAloon, Murray l\1orphy, Timothy Murphy, Donald Barone, Richard Curran, Herbert joyce, and Daniel 1orelli. • �........................................................................ Honor Society 'B Inducts 29 members 1 allistic Students and Inertial Guidance" was the topic directed toward 29 nev. medical honor society inductees at this year's Alpha Omega Alpha induction held March 13 (see accompanying article). James Holland, M.D., a UB 1edtcal School profe sor for 15 years, mused that as "ballistic students, you will shortlv explode on the medical scene outside ;f school for more training and eventually into the ~ommunities t.~at you \:ill serve." "Inertial gutdance, he satd, "refers to your educational .trajectories of different lengths and hetght. Some few will misfire - loose cannons that are a danger to all within ra~ge. But more of you will touch the stars m splendid arcs, lighting the sky wtth the brilliance of vour achievements." Dr. Holland, an Alpha Omega Alpha member since 194 7, is professor and chairman of Neoplastic Diseases at Mount Sinai School of Medicine in New l:ork. He is also pro!Cssor of m~dicine, chief of the Division of Medical Oncology and director of the School's Cancer Center. "The key word (in my lecture) is 'student,' however, because you should_, as a gifted subsegment of the po~ulauon, studv continuouslY and long after your form'a! exit from this University," he urged the third and fourth year medical students. "Education is not a spectator sport but a participatory working encounter. Each patient IS a research problem and you must investigate each as an unknown." Dr. Holland earned his medical degree from Columbia University in 19~7, after attending Pnnceton U mverslty where he was Phi Beta Kappa. Between 1955 and 1970, he served on the faculty of UB's School of Medicine. He received the Lasker Award in cancer chemotherapy in 1972, the A~erican Cancer Society National Award m 1981 and the Columbia University Gold 1edal for distinguished achievements in medicine in 1983. He has been a member of the World Health Organization Expert Advisory Panel on Cancer since 1976. A member of the editorial board ofJAA!A, he is also an associate editor of the American Journal of Medicine's medical oncology section. Coupled with all this administrative activitv, he has published over 407 articles ~r books in the field of cancer. Focusing on the world's major medical problems, Dr. Holland stressed what Dr. James Holland he believed to be the areas most in need of attention and participation by future physicians. The first "is the nuclear insanitv that purports to find greater safety i'n the hair trigger approach. We may be preparing for the final epidemic." He urged all doctors to actively participate in preventing nuclear catastrophe including involvement in the programs of organizations such as Physicians for Social Responsibility. Referring to tobacco consumption, Dr. Holland pointed out, "Every doctor's office should be a battle zone against the cigarette- we have been too inefTectual in fighting this most correctable public health problem which accounts for possibly 25 per cent of deaths each year in this country." Malnutrition he addressed as the third medical problem that should be a primary target of physicians. "We have bulging silos ... but not the social will to distribute the food to large parts of the world rampant with kwashiorkor and starvation," the distinguished visitor continued. The last of the four global medical problems that Dr. Holland urged future doctors to explore was overpopulation "which dooms whole nations to ignorance, poverty and disease." Two days later, first and second year medical students listened to Dr. Holland as he asked them to consider the "other" career option in medicine - medical reseat·ch. Entitling his speech "Rainbows and Pots of Gold," he challenged the future phvsicians to consider "the societal rewards of research (the 'rainbow'), not just the personal rewards of maximum income ('the pot of gold') associated with private practice." Rather than being just a black and white situation, Dr. Holland added, Students.. "research can be conducted in the office, too." Statistical studies comparing different treatments and schedules can contribute measurably to medical science, he indicated. Reiterating the title of his lecture to the freshmen and sophomores, he reminded them that "the real rainbow and the real pot of gold are the learning which continues and the beneficial knowledge which results." The ceremony was moderated by Michael E. Cohen, M.D., AOA advisory committee chairman and acting chairman of eurology. A history of the honor society was detailed by James W. Brennan, M.D., clinical assistant professor of ophthalmology. Inductees heard from William Barbaresi, a local AOA member, has been named to AOA's National Board of Directors. It represents the first time, at least in recent history, that Buffalo has been represented on that body. Ronald B. Boersma, M.D., clinical assistant professor of medicine, conducted the induction ceremony. "Your selection is not a prophecy of vour relative future rank or distinction ~vithin your profession, nor in accomplishment or in public service. It is, rather, svmbolic, both to vou and vour fellow st~dents of the tru~ ideals of the medical profession itself. These ideals are: first of all, moral character above and beyond reproach, for no one is fitted to practice medicine for whom this is not true. ext, but hardly second in importance, does come scholarship," Dr. Boersma stated. The new inductees of 1984 are: Susan Danahy, John Fitzgerald, Douglas Floccare, Kimberly orris, Edward Zane, Benson Zoghlin, James DeCaprio, Richard Rosenfeld, John Fong, Ira Schmelkin, John Lupiano, Thomas Mahl, Andrew Schneider, Charles Shapiro, Mark Steckel, William Barbaresi, Mary Caserta, William Healy, Evelyn Hurvitz, Karen Kimbrell, Colette Pruefer, Charles White, John Fisch, Christopher Lander, John Leddy, Elizabeth Maher, Gerard Nat, Roseann Russo, Timothy Wacker. • Heart scholarship Student awarded $750 A UB minorit) :tudent has been awa.rded an Amencan Heart Assouauon Student Scholarship totalling 750. The School of :\1edicinc sophomore, Eric Dobson, was selected by the national association's Stroke Council Exccuti\T Committee. Thomas R. Price, :\1.D., chairman of the BUFFALO PHYSICIAN • 29 �Studentsselection committee, said that the purpose of the award is to support academic training in the field of cerebrovascular disease o\·cr a twelve week period. Mr. Dobson will study stroke in association with sickle cell disease. In particular, he will investigate the early signs of stroke among school age children, such as headaches and increased school behavioral problems. Certain neurolog-ical signs arc exhibited by patients \vith stroke and he will try to correlate the c signs and develop a diagnostic screening tool that might discover early conditions that can lead to stroke. His sponsor will be James R. Humbert, M.D., professor of pediatrics and associate professor of microbiology. He works in Children's Hospital's Hematology-Oncology Department. • Outreach effort In Black community T his year's Student National Medical Association (SNMA) Community Outreach Program was held at the Prince of Peace Temple, Church of God in Christ, Tuesday, March 13. Five second-year medical students, Nilda Salaman, Eric Dobson, Howard Stark, Harry Timothee, and Rubens Pamics, who organized the project, presented a series of lectures covering health topics of particular interest to the Black community. After a question and answer period, the students then offered hypertension screen mg. The MA would like to thank Dr. James Nunn, clinical associate professor of family medicine, for the materials he donated for distribution, and Dr. Maggie Wright, assistant dean for student affairs, for her guidance and support. • Gorman awards Go to 3 students T hree UB medical students were awarded the United Federation of Food and Commercial Workers major scholarshp award, the Patrick E. Gorman Scholarship, March 2. Mr. John Hickey, president of local Chapter 34, presented a 4,000 check to John 1 aughton, M.D., dean of the School of Medicine in a ceremony at Farber Hall. The three medical students receiving the scholarship arc Elizabeth Maher~ Gerard 1 at and Kimberley Norris, all of Buffalo. The scholarship was named after Patrick Gorman, a BufTalo area resident who was the international union's chief executi\e officer for over 50 years. • 3rd world grants Two students win them T hird World Medical Scholarships have been awarded to two UB medical students by the ewman Center Medical Mission. Leslie Burton of Alleg-any, 0/.Y., and Thomas Burns of Williamsville each received At Gorman Scholarship Awanl Ceremonr: (from lett} Dean Naughton, winners KimberlY Norris, 6eranl Nat and Elizabeth Maher; and Mr. John Hlctcey. 30 • BUFFALO PHYSICIAN 1,000 awards that will pay for their trips to Third World nations. Liberia and Brazil arc the likely locations for their medical training during the next semester. The ewman Center Medical Mission B's was established three years ago by Catholic Campus 1inistry Parish to give fourth-year medical students the opportunity to gain experience and credit in poorer countries where medical services arc in need. Besides Liberia and Brazil, the Medical Mission sends its recipients to Mexico, Central America, and Tanzania, Africa. The Medical Mission's board selects individuals for the award after reviewing all applications, transcripts and letters of recommendation. The board has six members, including three UB medical school professors: Johannes Brentjcns, M.D.; Thomas Flanagan, Ph.D.; WilliamJames, M.D.; and Margaret Mary Wagner, UB campus minister. The medical students receive credit through a program at Duquesne University in Pittsburgh, Pa. This credit is then transferred to UB's School of Medicine. • Lisa Hernandez Receives $5,000 award U B minority student, Lisa Hernandez, has been awarded a 1984 Commonwealth Fund Fellowship in Academic Medicine by ational Fellowships, Inc. The B School of Medicine junior is one of 20 who received the 5,000 award across the nation. She will work under the direction of Gerald Logue, M.D., UB professor of medicine and head of the Division of Hematology. The Buffalo General Hospital physician will guide and oversee her work and also help her to apply for postgraduate training programs. Awardccs arc selected for their academic excellence and talent in biomedical research. She will spend 8 to 12 weeks learning the process of scientific investigation and the techniques of bio-medical research. The object of her research is to determine the sensitivity of certain kinds of cells to lysis, or disintegration, by human antibodies. The Commonwealth Fund "will play an important role in increasing minority representation among M.D.-le\·el faculty at the nation's medical schools," says Dr. David E. Rogers, chairman of the selection committee. 0/ational Medical Fellowships is a private, non -profit organization that gives financial assistance to minorities entering the medical profession. The Commonwealth Fund is a philanthropic foundation established in 1918 by Anna M. Harkness to meet society's longterm health care needs. Ms. Hernandez's home is in Staten Island, y • �Alumni- 'We are caught in a time of evolutionary change' Jonas Salk Jonas Salk gives Stockton Kimball Memorial Lecture ''w e are caught in a change of time. We must realize this in order to understand what is happening in our world;' said Dr. Jonas Salk, speaking at the Medical Alumni Association's Spring Clinical Day. "My purpose," he continued, "is to get you to see the events of the world as part of a great evolutionary process, and that humans arc a critical force in that process." The founding director and resident fellow of California's Salk Institute for Biological Studies, Dr. Salk delivered the Stockton Kimball Memorial Lecture at the Medical Alumni Luncheon. In his talk, "Metabiological Medicine; Salk pointed out the many ways in which evolution alters the values, makeup, and attitudes of the world, and why these attitudes must be understood and analyzed. Salk explained to the crowded audience of doctors how the population ex- By Mary Kunz plosion is really part of the broad evolutionary process. "Evolution is not a gradual process;' he said, "but rather punctuated equilibrium. There is a gradual change over a period of time, and then something occurs rather suddenly. I am proposing an evolutionary way of thought for survival. I see that we have become the process of evolution itself. In order for us to survive, it's necessary for us to survive to a point where we see problems in an evolutionary way." One must take into account not only the change in the number of people in the world, Salk urged, but the heightened interdependence between those people. "The world has become one," he said. "The problems of one are the problems of another. These worlds must find a way of resolving the problems that separate them." Salk used charts and example to show how pre-population explosion values and attitudes differed from those demanded by the world's present situation. An emphasis on independence and power, he pointed out, must shift to an emphasis on collaboration, since people have been brought closer together. Short-range concepts must give way to long-range and, instead of thinking of "parts; people must consider the "whole." Independence changes to interdependence, winning and losing become far less important and the focus changes to a striving for mutual benefit. "When everyone thought the world was Oat, and then everyone learned it was round, it was a perceptual change, unchanged in reality," Salk explained. "The change I'm referring to is not a perceptual change, but a change in reality; a change in 1·elationships, of man to man, and of man to self." Here, he said, "we begin to see value changes brought about by this change in reality." If the world is destined to survive, Salk implied, it would have no choice BUFFALO PHYSICIAN • 31 �~------~----------------------------------------------------------------------· but to accept the necessary changes in thought. As an example, he noted that the prevalence of nuclear weapons demands cooperation between nations. "The time will come," the scientist predicted, "when it will be necessary to find another philosophical basis for the world to continue, because of the impossibility of continuing with the antagonism that exists now." Salk described the three phases of earth's evolution: the physical sphere (or "pre-biological evolution;' before life), the biosphere, and the metabiosphere. As the addition of"lifc" marked the difference between the physical sphere and the biosphere, so the gaining of "consciousness" determined the change from the biosphere to the metabiosphere, the phase in which we are currently living. The metabiospherc, Salk said, is characterized by the emergence of human mind and culture. The emergence of consciousness marked the appearance of a complexity previously unseen in the evolutionary process, Salk pointed out. He noted that the unit of the physical sphere was simply the atom, and the unit of the biosphere was the cell, but that the unit of the metabiosphere is the mind. In this sphere, he said, we must resolve not simply the duality between nucleus and electrons, or gene and cell, but the balance between reason and intuition. "We know a great deal about prebiological and biological evolution, but little of metabiological evolution;' Salk said. "We can deal with atoms or cells, but few understand much about the mind. We are in need of wisdom in order to make appropriate choices:' The key to survival, he theorized, is to understand the evolutionary changes in the world and to sec the world in a broad, univcr a! sense. "I've tried today to suggest a need for looking into the future;' he concluded, "and a need to contribute to its outcome. We must guide human evolution, from a sense of responsibility for both today, and for future generations." • Clinical Day Herpes, AIDS experts on program ' 'T By Bruce S. Kershner he herpes virus has been found throughout almost all the phyla of the earth, including plants;' announced Andre ]. Nahmias, M.D. "It is not new, even as a sexually transmitted disease. What is 32 • BUFFALO PHYSICIAN new i the new strain (Type II) that has spread in epidemic proportions predominantly through sexual transmission." Dr. Nahmias was the first of the guest speakers at the 47th Annual Spring Clinical Day sponsored by the UB Medical Alumni Association and Continuing Medical Education. It was held Saturday, May 5, 1984, in the Buffalo Marriott Inn before a record audience of over 300 medical alumni and faculty. Doctor Nahmias took the opportunity to inform the physician audience of the known facts about the disease which was "picked up" by the press in an emotional atmosphere before it was suddenly replaced by AIDS. A national expert in herpes, Dr. ahmias is one of the 29 most cited virologists. He is professor of pediatrics and pathology and chief of the Infectious Diseases and Immunology Division at Emory University School of Medicine in Atlanta, Ga. Reviewing the history of the disease, Dr. Nahmias said it was first described in 1736, "by a Frenchman, of course." Its sexual transmission was confirmed in 1965 and the first organization to assist its victims was established in 1978. Herpes, Dr. ahmias pointed out, does have some not-yet-understood correlation with certain types of cancer. For instance, patients with cervical cancer have a high frequency of Herpes Simplex Virus II antibodies. And the virus has been demonstrated to cause cancer in vitro and in laboratorv animals. Not widely known is tha't Type I ("cold so1·e type") and Type II ("genital herpes") occur almost anywhere on the human body, including the eye and brain. Dr. Nahmias warned about making as- Andre J. Nahmias sumptions based on the location of herpes infections. Non-genital herpes infections are predominantly Type I, but one to seven per cent of such cases are Type II. When, however, one looks at the figures for herpes infections in nongenital areas below the waist or on the limbs, Type II is present 49 per cent to 91 per cent of the time. Dr. ahmias related another warning, "Herpes Simplex Virus on the mouth or genitals of children does not necessarily mean sexual abuse." Even infants born with herpes infection may have Type I. This does not, however, change the fact that mortality rates associated with neonatal herpes infections are still high. Because of the chance of error in diagnosing Type II infections, "laboratory confirmation is necessary before diagnosing herpes because a mistake will clearly result in psychological trauma;' he emphasized. Caesarian delivery should certainly be performed on women with active herpes, Dr. Nahmias explained, because the neonatal infection rate with vaginal delivery is 500 per 10,000. But it may not be recommended for women with past infections because of the much lower chance of neonatal infections (10 per 10,000). Dr. ahmias concluded with the most recent breakthrough in herpes: the development of a herpes vaccine for animals by microbiologist Enzo Paoletti, Ph.D., a 1971 UB alumnus. It was accomplished through gene splicing at the ew York State Health Department's Center for Laboratories and Research in Albany. �·-------------------------------------------------------------- AlumniA n overview of AIDS and one of its as ociated diseases, Kaposi's sarcoma, was presented by Alvin E. Friedman-Kien, M.D., professor of dermatology and microbiology at ew York University Medical Center. One of the earliest physicians to encounter the new disease, Dr. Friedman-Kien described his experience with the first puzzling cases of AIDS that appeared in New York City. Classic Kaposi's sarcoma, first described by Morris Kaposi in 1872, is a usually non-fatal disease of elderly Jewish and Italian men and typically appears on the lower extremities. Very rare, only 500 cases have been reported. Researchers realized only in retrospect that the development of AIDS may have some connection to the sudden appearance in the 1960's of a virulent and lethal form of Kaposi's sarcoma in Africa. At the time it was not known that its victims were also significantly immunosuppressed. In addition, he added, "high amounts of cytomegalovirus occurred in the Africans but not in the classical Kaposi's sarcoma form." Dr. Friedman-Kien does not" know how to explain the sudden occurrence of AIDS. "It was not just that it wasn't reported adequately or not recognized. It really did not exist in any measurable way until 1980;' he stated. He recalled how the first cases of the new skin cancer that he and other physicians saw were all restricted to ew York City and all to highly promiscuous homosexuals. The Yale graduate explained the different implications of AIDS-related Kaposi's sarcoma and AIDS-related opportunistic infections. The opportunistic infections such as Pneumocystis carinii, not Kaposi's sarcoma, kill AIDS patients, though the skin cancer does get worse as the infections take over. "80 per cent of AIDS/Kaposi's sarcoma patients without opportunistic infections survive, while the survival rate is zero after three years for AIDS patients with such infections. In fact, AIDS patients with Kaposi's sarcoma are relatively healthy compared to tho e with opportuni tic infections," he commented. AIDS-associated Kaposi's sarcoma can occur virtually anywhere, including the eye, ears and brain. "Its occurrence on the genitals and mouth causes us to suspect sexual transmittance," he remarked. He noted that Kaposi's sarcoma in the mouth is very common and usually means that it is also present in the esophagus, stomach and colon. He rejects the notion that lymphadenopathy among homosexuals and intravenous drug users represents a lAboveJ Rrst prize winner In the exhibit display at Spring Clinical Day b¥ Dr. David Rowland, But· talo General HOSPital. (Below} Physicians view exhibits at the Marriott. en 0 ~ 0 in 5 J: ~ ~------------------------~ ~nother successful event' Spring Clinical Day draws record turnout of 340 1st Prize: Clinical Application 1 e had another successful event 'W and an impressive turnout of 340, the largest in our history," outgoing Medical Alumni Association pt·esident Dr. E. :\1ichael Sulli' an (:\1'63) said of this year's Spring C-linical Day and Alumni Reunions. "In particular. we noticed the large number of out-of-towners, as well as local physicians, both alumni and non-alumni. The alumni reunions were really enjoyable and memorable," he remarked. The Class of'3+ celebrated their 50th Reunion by also contributing the largest class gift, almost 8,000. Besides the reunions and the distinguished speakers (see accompanying articles). 16 medical exhibits were displayed at the May 5 event. Prizes went to the following: of Digital Subtraction Angiography bv David Rowland, M.D., Angiology Staff, Department of Diagnostic Radiology, Buffalo General Hospital. 2nd Prize: ;\luclear :\1agnetic Resonance Imaging, bv William R. Kinkel, :\1.D.. I. Polachini, M.D., Dent Neurologic Institute. 3rd Prize: Pseudo-Aphakia 40 Years Later, by Joseph F. Monte, :\1.D., Department of Ophthalmologv, Buffalo General Ho·pital. The incoming alumni association president is Dr. Carmelo Armenia (:\1'4-9). He is UB clinical associate professor of gyn-ob at Buffalo General Hospital and a past president of the Eric Count) Medical Society. • BUFFALO PHYSICIAN • 33 �precursor or early form of AID . He believes, instead, that the mild condition may actually be the true form of AIDS and that lethal AIDS is the extreme form. The reason why the AIDS-prone population is overwhelmingly homosexual is still unclear, he said. But researchers are surprised to have recently discovered that the majority of healthy homosexuals have abnormal immune systems compared to the heterosexual population. As a group, their T-helper cells are mildly depressed compared to their Tsuppressor cells. This is similar to, though far less extreme than, that of homosexuals with AIDS. He cannot explain this alarming finding. Although AIDS has been acquired in 40 blood transfusion cases among nontarget groups, he still considers it unlikely that it is really transfusion-related. And finally, he rea ured the audience that no AIDS has been transmitted through routine contact with health care workers. "D arwin entirely changed medicine when he said that biology was largely the science of populations and probabilities," said one of America's most prominent public health scientists, Irving J. Selikoff, M.D. He is profe or of community medicine and professor of medicine, as well as director of the Environmental Sciences Laboratory at City University's Mount Sinai School of Medicine. With statistics and population studies forming much of the basis of medicine, C/l 0 ~ 0 in § I a. 34 • BUFFALO PHYSICIAN Dr. Alvin E. Frledman·Kien Dr. Selikoff reviewed the history of diseases. He demonstrated how the world's major killers have, one by one, been cured, controlled or decreased in their health effect. "The trend has been toward fewer deaths even for the modern killers of heart disease and stroke. The only major exception is for cancer, which rose 8. 7 per cent from 1973 to 1977," the award-winning researcher stated. Population studies began to indicate more and more that environmental differences were responsible for the trend. Cancer frequencies for certain organs differ from country to country. Cultural differences in exposure to carcinogens, not genetic differences, are the explanation, he said. This is clear because immigrants from a country of low stomach or lung cancer frequency are found to share the same higher frequencies as that of their new country. Although dietary and occupational differences (such as asbestos exposure) play a role, Dr. Selikoff made it very clear that cigarettes are the single greatest cause of population differences in cancer. He introduced the ubject of toxic hazards by relating a story. After Reagan's Environmental Protection Agency administrator left in disgrace over toxic waste cleanup, the new administrator called Selikoff and asked him, "How can I get top scientists to join an admini tration that wants to sell the Grand Canyon and buy Times Beach?" Dr. Selikoff didn't have a good answer. Then he quipped to the audience, "It turns out they didn't sell the Grand Canyon, but they did buy Times Beach!" Turning serious, he said, "America now has 22,000 toxic waste site and 14,000 school have friable asbestos. We also invest 300,000 new chemicals each year at the rate of 70 per hour'" Why is this so serious? Because far less than one per cent of these chemicals have been studied for their effects on humans. He emphasized that that means we arc adding a new environmental factor that could increase the frequency of cancer. Most disturbing is that, based on the "20 year effect;' the health effects of these new chemicals may not show up for a generation. • �Alumni- Senior Reception Held at Albright-Knox Clockwise from top lett: 1. Dr. David PfaiZBr (lett) and Alumni President Dr. E. Michael Sullivan. 2. (L to RJ Drs. Deborah Silberman, Joseph carrese, Richard Elman, Mrs. Elman and Marc KDIIIIclc. 3. Dean John Naufl/ltDn (rtght), Mrs. Naufl/ltDn (cenrerJ and guest. 4. to RJ Drs. carmello Armenia, James PhilliPS, John Richert (back to camera}, Mrs. PhilliPS. 5. to RJ Drs. Fred lbnem, Andy Tantcenbaum, Deborah Silberman, John McLaughlin (face partly hidden}, Richard Rosenfeld, and Eveline Jtaeger. 6. to RJ Mrs. Charles Tanner, Dr. l.Bon Farhl (center} and Dr. Tanner en· /or the roast beet. 7. Dr. John Drster (center} and trtentls en/or strolling musicians. a a a �Call the cops This physician did when 'Dr. Hirsh' called him By Harry Metcalf, M.D. Clinical Associate Professor of Family Medicine M y curiosity was piqued when my receptionist announced that a Dr. Hirsh was calling from ew Orleans. I knew a doctor by that name, but he was in the next room - one of my partners. A honeyed voice you could coat Southern fried chicken with lilted, "One moment, Dr. Metcalf, for Dr. Hirsh." At first, it appeared a simple case of professional courtesy. ("A patient of mine with disk disea e left for Buffalo without hi medication. Could you pre cribe a few days' supply of morphine and orgesic to tide him over till he returns home?") But when I questioned Hirsh further, his knowledge of his patient's condition was gauze-thin, and when I carefully told him that the story didn't ound credible, he didn't know what "credible" meant. That clinched it. I bade him goodbye. Then, to doublecheck, I phoned the office number he'd given me and got a phone booth. Filled with good-citizenly indignation, I reported the episode to the police, the county medical society, and my partners - one of whom, receiving a similar call two days later, responded as I had. Two weeks later, a story in the Buffalo News reported that several doctors in our region had fallen for the ruse, and that the "perpetrators" had escaped. One year later: The phone rang again - this time a "Dr. Berman calling from ew Orleans." Suspiciously, there wa n't even a secretary as intermediary this time. The doctor asked me to prescribe dimethyl morphine for a visiting patient with disk disease, but he repeatedly tripped over it pronunciation and didn't know the difference between grains and grams. "Dr. Berman:' I said, thinking to myself that it was time to do something about this, "I'll be happy to help your patient. Have him come to my office at 5 o'clock." It was almost 4 and I immediately phoned the police narcotics squad. I was keyed up and ready to help bust what could be a nationwide drug ring using doctors as dupes. A detective listened dutifully but gave me the distinct impres ion he did not view this as the ILLUSTRATION: KARL KOTAS �-~------------------------------------------------------------ Peoplecrime of the century. He said he would check to see if anyone was free to come to my office at the appointed time, but (yawn) he doubted it. The minutes ticked away. I treated other patients uneasily. The phone rang. o luck, sir - everyone is tied up. I suggested the police precinct closer to our office. More minutes raced by. It's 4:45 and my anxiety grew. I had set a trap for an addict. Was it about to spring shut on me? The narcotics officer called again. Nope, no detectives free there either. Now I was getting desperate. "Look;' I pleaded, "couldn't you pry a squad car free just in case the suspect shows up? If this guy is hostile and armed and I refuse him drugs, I could buy the farm right there." It was 5 p.m. The suspect was due and still no sign of the police. But 10 minutes later, two burly officers in blue arrive and my galloping pulse slowed down to a canter. I lodged them in a nearby examining room. Five minutes later, an unexpected development: A young woman arrived to pick up the Rx. I explained that it is illegal for me to" give a narcotic prescription to anyone but the person it's intended for, and she volunteered to return with the patient in half an hour. Much to my surprise, in just 10 minutes (he must have been waiting in the car), she did. A man in his early 30s, he came in hunkered over, favoring his left leg, and eased himself gingerly into a chair as though in extremis. Lo and behold, when I got him on the examining table, I found a scar in the lumbar region that is clearly a memento of disk surgery. B ut when I asked what hospital in New Orleans the surgery was performed in and who the surgeon was, he mumbled. He and his companion grew more nervous by the minute. I excused myself - "to get my prescription pad" - and returned with a police escort. The girl's eyes saucered. The man's hand shaked as he reached into his pocket for the identification the officers requested. I was amazed to see how quickly his back had straightened out. He quickly admitted his story was false, that his surgery was, in fact, performed right here in Buffalo. I offered to hospitalize him to get the help needed to handle his disk or pain problem. He refused. What happened next stunned me. The officers warned him that should he be involved in a similar episode ch arges will be placed. Then they told the couple they were free to go. "You mean;' I asked incredulously, "that all I've done is waste my time?" "Well;' explained an officer, "his ID checks out. If it didn't - if he'd been using a false name to get the morphine we would have had a case." He went on to say that even if I'd examined the man and written a prescription, that would have been perfectly legal, despite the fact that a phony doctor's call brought him to my office. Would I do it again? Remembering how hard it was to get police cooperation, probably not. ext time I'm suspicious of someone asking for drugs, I'll just refuse him. But either way, the point for all of us to remember is this: Don't take courtesy-request calls on faith from doctors you don't know. (Post-script: Dr. Metcalfs article was followed by a warning notice in the Bulletin of the Erie County Medical Society. Several more reports of this drug ruse occurred in the Buffalo area before the incidents ceased.) • (Copyright <£ and published by Medical Economics Company, Inc. at Oradell, N.J. 07649. Reprinted by permission.) Asthma call-in UB physicians participated T he first national call-in television show on asthma and allergies ever to be aired occurred May 7 on Lifetime Cable etwork, A panel of ten UB physicians answered questions for "Asthma/Allergy Update '84," carried by International Cable, CableScope and 1 iagara Frontier Cable. The doctors, selected by Dr. Elliott Middleton, professor of medicine and pediatrics, for their international reputations as allergy specialists included six from UB's Department of Medicine (Drs. Robert Reisman, Andrew Green, John Kent , Michael Tronolone, Marie Kunz, and Michael Fanning) and four from the Department of Pediatrics (Drs. ElliotT. Ellis, Steven Grabiec, Madeline Lillie, and James Cumella). The program was organized by the director of the Asthma Self Management Program Dr. Michelle Alexander who believes there is a genuine need for the update since "10-12 per cent of the children in the country have asthma and double that have allergies. It's a big problem," she said. In response to a letter that was sent out by Lifetime Cable, the ational Institute of Allergy and Infectious Diseases contacted Alexander and asked her if she would organize the "call-in." Alexander, in turn, arranged studio time with Lifetime Cable. "Asthma/Allergy Update '84" was produc- ed in cooperation with the Asthma and Allergy Foundation of America, the American Academy of Allergy and Immunology, the American College of Allergists, and the National Institute of Allergy and Infectious Diseases. Sponsored by Searle Laboratories, the program was the most comprehensive television program to be yet produced on the topics of asthma and allergies. • THE INTERNATIONAL AWARD OF MERIT WAS recently awarded to Joel M. Bernstein, M.D., Ph.D., by the Belgian-Dutch Society on Allergy in Otorhinolaryngology. Dr. Bernstein is assistant professor of otolaryngology and pediatrics at UB. He received the honor for his pioneer work and sustained research on the role of allergy and other immunological processes· in otitis media with effusion, an inflammation and infection of the middle ear marked by drainage of fluid. The award was presented April II, 1984, in The Hague, the 1 etherlands. Dr. Bernstein subsequently spoke at the First International Symposium on Immunology and Otolaryngology in Utrecht, the etherlands. After earning his bachelor's degree from Harvard in 195 7, Dr. Bernstein received his medical degree in 1961 and his Ph.D. in microbiology in 1979, both from UB. He is a Buffalo native. Elected to Alpha Omega Alpha, the medical honor society, Bernstein has received other awards in the past, including being named as one of the Fifteen Outstanding Pediatric Otologists in the country by LadieJ Home journal in 1981. A member of the Eric County, New York State and American Medical societies, he also belongs to the Pan American Medical Association, the American Audiology Society, and is a Fellow of the American College of Surgeons. • DR. PHILLIP ZEIDENBERG , RESEARCH ASSOciate professor of psychiatry and acting director of the Research Institute on Alcoholism, has been awarded a 20,000 grant from the Research Foundation of State University of ew York. The educational training grant will be used to provide financial stipends to four graduate students who are working on collaborative research projects with faculty from the School of Medicine and the Department of Psychology. • DR. SEBASTIAN G. CIANCIO, CLINICAL PROfessor of pharmacology and therapeutics in the School of Medicine, as well as professor and chairman of the Dental School's Department of Periodontics, received a citation from the Pharmacology and Therapeutics Division of the International and American Association for Dental Research for a decade of service. • BUFFALO PHYSICIAN • 37 �FIFTY YEARS AGO, FREDERICK NEUBURGER earned his medical degree from the University of Vienna. On February 27, he was honored at a luncheon for his five decades of distinguished and dedicated service in otolaryngology by the Austrian Consul and the UB School of Medicine. Dr. Neuburger, clinical associate professor emeritus of otolaryngology, was presented with a renewal of his diploma in commemoration of the original parchment from the University of Vienna. John Lon!, chairman and professor of otolaryngology, handed him a striking blue commemorative plaque in appreciation of his teaching and contribution to the department. He was also acknowledged for his special contribution to the Institute for the History of Medicine, which his late father had founded. After earning his medical degree and spending four years as surgical resident at the University of Vienna, Dr. Neuburger came to the United States in 1938. After residencies in otolaryngology in New York, he came to Buffalo General Hospital and Children's Hospital. He served in the armed forces for three years in an overseas evacuation hospital and at Walter Reed Memorial Hospital in Washington. He has been in private practice continuously since 1947. His commemorative plaque reads: "To Frederick K. Neuburger, M.D., in recognition of 50 years of dedication to the practice, teaching and academic contributions to otolaryngology at SUNY at Buffalo and affiliated hospitals. This appreciation is shared by the thousands of patients, residents and students who have benefitted by his skills and warm hearted understanding." • Cancer Society's 26th Annual Science Writers' Seminar, held April 1-4, in Daytona Beach, Florida. Dr. Sandberg's·presentation "Chromosomes and Cancer" traced the developments made in establishing chromosomal changes in human leukemias and cancers, and the role of oncogenes (cancer genes) in human cancer. • Avery A. Sandberg John E. Fisher DR. JOHN E. FISHER, CLINICAL ASSOCIATE professor of pathology and pediatrics, has been appointed the first chairman of the Standing Distinctions and Awards Committee of the newly reorganized Society for Pediatric Pathology. Before its reorganization, the group was known as the Pediatric Pathology Club. He has also been elected president of the hospital medical board of Children's Hospital in Buffalo. Also pathology director at the hospital, he was recently elected secretary of the Western ew York Society of Pathologists. • DR. LAWRENCE JACOBS WAS INVITED TO BE principal guest speaker at the dedication of the neuroscience center at the Geisenger Medical Center, Danville, PA, on March 29. He is on the faculty of the Departments of Ophthalmology, Neurology and Physiology. Dr. Jacob's address included his experience at the Dent eurologic Institute. He spoke on treatment of multiple sclerosis patients with interferon, and the study of some of these patients using uclear Magnetic Resonance (NMR). Dr. Jacobs and his family were also honored April 5 by Medaille College. They were presented with the john Peter Medaille Award for their involvement in numerous community organizations 111 the area. • fessor of surgery and Roswell Park researcher, received a 45,147 grant from the ationa! Cancer Institute to study early colorectal cancer therapy. • DR. BARRY ECKERT, ASSOCIATE PROFESSOR fe sor of medicine and chief of the Genetics & Endocrinology Department at Roswell Park Memorial I nstitute, was among 30 cancer investigators featured at the American 38 • BUFFALO PHYSICIAN DR. SABINA SOBEL, ASSISTANT PROFESSOR of anatomy, has been invited to present her work at a satellite symposium of the International Congress of Cell Biologists, August 23-24, in Tokyo, Japan. This symposium will be concerned with factors of mammalian reproduction and early de,·clopment. • DR. HAROLD BRODY, PROFESSOR AND CHAIR- DR. E. DOUGLAS HOLYOKE, RESEARCH PRO· Frederick Neuburger DR. AVERY A. SANDBERG , RESEARCH PRO· the fields of anatomy, experimental pathology, tumor biology, cellular aging and cell differentiation. Dr. Eckert currently holds an Established lnvestigatorship supported by the American Heart Association. • of anatomy, was invited by the N.Y. Academy of Sciences to speak at a conference .on "Internal Filaments: Structures in Search of a Function," held in New York City, May 21-23. Internal filaments are key elements of the cyto-skeletal architecture in most eukaryotic cells and arc of concern to cell biologists in man of the Department of Anatomical Sciences, has been appointed chairman of the publications committee of the Gerontological Society of America until 1986. A former president of the society, Dr. Brody was also editor-in-chief of thejoumal of Gerontology from 1975 to 1981. • DR. JOHN NAUGHTON , DEAN OF THE UB School of Medicine and interim vice president for health sciences, was named "Volunteer of the Year" at the annual assembly of the American Heart Association's Western New York Chapter. The award, one of the highest honors an A.H.A. chapter can bestow, is presented annually to the individual whose contributions during the previous year enabled the chapter to fulfill its program and service obligations to the community and work toward its ultimate goal: "To reduce premature death and Dean Naughton receives VOlunteer at the from Bonnie Hadden. ~r Awarrl disability from cardiovascular diseases." Bonnie Hadden of the A.H.A:s New York State Affiliate presented him with a Revere aughton received the award bowl. "Dr. because of his contributions in time, talent, organization and leadership," an A.H.A. spokesperson said. • DR. FRANCIS KLOCKE , PROFESSOR OF MEDIcine and physiology, has been named vice chairman of the American Heart Association's ational Council on Circulation. He serves as Erie County Medical Center's chief of cardiology. • DR. ENRICO MIHICH , RESEARCH PROFESSOR of pharmacology and therapeutics and director of Roswell Park's Experimental Therapeutics Department, will serve on the pro- �Peoplegram committee of the 14th International Cancer Congress, to be held in 1986 m Budapest, Hungary. • DR. GIUSEPPE ANDRES, PROFESSOR OF MIcrobiology, recently presented two overseas lectures. He spoke on "Recent View Concerning Autoimmune Renal Diseases" at the University of Bologna Medical School, Italy, and on immune complex diseases and the spleen in Hopital Cantonal Universitaire de Geneve, Basel, Switzerland. • DR. ALAN THOMAS AQUILINA, ASSISTANT professor of medicine, has been elected to Fellowship in the 60,000-member American College of Surgeons. Dr. Aquilina, a specialist in pulmonary medicine, was honored during the convocation ceremony at the College's Annual Session in Atlanta, April 26-29. Dr. Aquilina is one of 16,000 physicians honored with Fellowship in the College - about 250 have been elected this year. A 1974 graduate of niversity of Rochester School of Medicine, he has been in Buffalo for six years and is on the staff of the Erie County Medical Center. • DR. PHILIP T. LoVERDE , ASSOCIATE PROFESsor of microbiology, was appointed to a special study section of the ational Institutes of Health to review grant proposals of members of the Tropical Medicine and Parasitology Study Section. • DR. CLARA AMBRUS, RESEARCH PROFESSOR of pediatrics and Roswell Park researcher, was granted 22,727 from the March of Dimes to study the usc of enzyme reactors in managing phenylketonuria. • DR. JAMES LEE, PROFESSOR OF MEDICINE, was invited to present an update on essential hypertension at the 8th annual medical symposium held in Riyadh, Saudi Arabia. He is also Erie County Medical Center's director of hypertension services and medical director of the skilled nursing facility. • T cell network. He also lectured on interferon treatment of lymphoproliferativc malignancies at the 13th International Congress of Chemotherapy, Vienna, Austria, last September. • DR. MAREK B. ZALESKI , PROFESSOR OF MIcrobiology, spoke at the Fifth International Congress of Immunology, Kyoto, Japan, last August, 1983, on immunosuppression and genetics. He was also invited to be editor/advisor for immunogenetics publications, Marcell Dekka, Inc. • DR. GERALD P. MURPHY, RESEARCH PROFESsor of urology and director of Roswell Park Memorial Institute, received a Public Service Award from the State University of Buffalo Alumni Association on March 21 in Buffalo. Dr. Murphy was also awarded an Honorary Degree of Doctor of Laws from Daemen College, Buffalo, at their Kleinhans Music Hall commencement May 13. • DR. ELLIOT ELLIS, PROFESSOR AND CHAIRman of the Department of Pediatrics, spoke on childhood asthma at the ParkeDavis/Creighton School of Medicine seminar in Las Hadas, Mexico, December 1983. • DR. JOSEPH J. WINIECKI , CLINICAL INSTRUCtor in medicine, was named "Person of the Year - 1983" by the Foundation of the Deaconess Hospital. Willard G. Fischer, M.D., president of the Foundation, prcsente<;l Dr. Winiecki with the award. Dr. Winiecki, a member of the Buffalo General/Deaconess Hospital medical staff since 1965, has actively served on the Foundation's Board of Directors. He served as president of the Buffalo General Hospital Medical Staff in 1980. The award for the "Deaconess Person of the Year" is given in recognition of an individual's outstanding contributions to the Deaconess Hospital Division of Buffalo General Hospital and the community it serves. Dr. Winiecki received his M.D. from Georgetown Medical School, Washington, D.C. in 1953. • DR. GABOR MARKUS, RESEARCH PROFESSOR of biochemistry and Roswell Park Memorial Institute researcher, received a 76,000 grant from the American Cancer Society to study plasminogen activators and related proteases • in human tumors. DR. HAROLD 0. DOUGLASS, JR., RESEARCH associate professor of surgery and Roswell Park researcher, received a grant from the National Cancer Institute for 89,844 to study effective gastric and pancreatic cancer treatments. • DR. HOWARD OZER, ASSOCIATE PROFESSOR of medicine and microbiology, spoke in Sapporo, Japan, on human immunoregulatory Joseph J. Winiecki Sateesh K. Satchidanand DR. SATEESH K. SATCHJDANAND, ASSISTANT professor of pathology and a pathologist at Buffalo General Hospital, has been elected president of the Western New York Society of Pathologists. • James P. Nolan JUST APPOINTED TO THE PRESTIGIOUS POSItion of Governor-Elect of the American College of Physicians, Upstate ew York Region, is James P. Nolan, M.D. He is professor and chairman of the University's Department of Medicine. Founded in 1915, the 60,000 member American College of Physicians is a national medical specialty organization for doctors in internal medicine. Through rigorous membership requirements, continuing medical education and contact with health care providers, it works to upgrade the quality of medical care, education and research. On the UB School of Medicine faculty for 21 years, Dr. Nolan is also director of Erie County Medical Center's Department of Medicine. He is chairman of the board and president of Research for Health in Erie County, In c. and provides leadership in a wide range of university and academic affairs. Dr. olan is past president of the Buffalo General Hospital medical staff and has served on the editorial advisory board of the Journal of Medicine (Experimental and Clinical). A Yale graduate, he is widely recognized for his pioneering research in liver disease and the effects of endotoxins. Endotoxins are cell wall components formed by the death of certain bacteria which are normally found in large amounts in the intestines. Dr. Nolan has discovered that these toxins appear to be responsible for liver disease when the liver is adversely affected by alcoho lism or hepatitis. He has found that conventional antibiotics may actually worsen some liver diseases because they increase endotoxins. • BUFFALO PHYSICIAN • 39 �God & medicine Nun-surgeon active in group for clerical/religious MDs I By Bruce S. Kershner s there a doctor in the (retreat) house? For Sister Marguerite Dynski (M'75) and her physician-clergy associates, the answer would be a resounding "yes!" In the first such gathering of its kind, 25 nuns and priests who are physicians or medical students gathered together for a five-day workshop-retreat in Blue Point in Long Island, .Y., last October 21. The participants represented various Catholic orders coast-to-coast and in Canada. Citing the need to have networks of support, friends who understand and share their ideas, and the opportunity to pray together and as individuals, Dr. Dynski proclaimed the gathering a successful event. "The time is right because many of us were just getting into our practices and there is a need now for us to talk to one another. We're in it together and we're a positive force and didn't realize it." Dr. Dynski added, "By meeting here like this, I feel we're pioneering!' For many of the participants, it was the first opportunity to meet with other clergy-physicians. One colleague said, "It's like going through life thinking you were an orphan and then finding out you have brothers and sisters!' Dr. Dynski plays a primary role in the Association of Religious and Clerical Physicians which organized the historic meeting. She is the editor of the newsletter Lifeline, which serve as the communications link for the farflung network of members. She is a physician at Rochester General Hospital, .Y. Fifty years ago, such a meeting would have been impossible. Until 1935, Canon law did not permit nuns, brothers or priests to become medical doctors. However, in 1935, a member of the Society for Medical Mi sionaries persuaded the church to lift the restriction so that the Sisters could serve women in India where the culture did not allow them to be examined by males. Today, the association has identified 176 clergy-doctors nationwide, but it believes there are many more. The majority are in family practice and internal medicine. Dr. Dynski is one of only about eight who practice surgery. Between the 25 doctors who met, almost every medical pecialty is accounted for. �Classnotes"0 ne reason for needing support for one another," Dr. Dynski notes, "is that we each educate both the clerical and medical staff that we are working with in the holistic approach to medicine. We need, as physicians, to address the spiritual health as well as the emotional and physical health of our patients. We need a network or a forum for sharing items of professional interest since there may be no one else in the congregation \ve can talk to." Group discussions at the workshop included such subjects as "Medical Mora1 Issues," "Medical Legal Issues" and "Spirituality in a Pluralistic World." Being a member of both the clergy and the medical community can be difficult at times. The question of conflicting commitments to their profession and their communities must clearly be given serious, even agonizing, thought. Several work hop participants compared it to the balancing that has to be done by a married physician in order to give appropriate time to his or her family. Regarding the subject of malprac"tice, Dr. Dynski says, ''The mentality of litigation doesn't exist in some areas, but it' interesting - Sisters can be sued." De pite popular impression, most of the retreat participants agree that science and religion can and do mix. " o one makes fun of religion in the operating room," recalls one Sister. "Sophistication disappears in the face of the simple reality of life and death. I remember one time during surgery when we were losing a patient because of hemorrhaging we couldn't stop. There was nothing we could do. The chief surgeon turned to me and in a worried, pleading tone said, 'Don't just stand there. You're supposed to be praying.'" Dr. Dynski relates that it is often difficult to combine a spiritual life with an active life in medical service. "Finding moments of prayer may be almost impossible. At our workshop retreat, we found that many of us find God in our patients;' she said. Lifeline, the newsletter that she edits, is a quarterly and serves as a forum for any issue that relates to medicine and the clergy. She explains, "Our newsletter also publishes information about medically deprived areas in this country and in foreign countries. Hopefully, religious and clerical resident and physicians looking for a change would be aware of these needs and perhaps can help on a temporary or permanent basis." The association's second meeting will be October 3-6, 1984, in Omaha, ebraska. Any physician or medical student who wishes to have more information is invited to call or write to: Marguerite Dynski, SSJ, MD, 1445 Portland Avenue, Suite 307, Rochester, New York 14621, (716) 266-6580 or (716) • 544-7960. "No one makes fun of religion in the operating room ..." Sister Marguerite Dvnskl Virginia Weldon Honored by Smith College D r. Virginia V. Weldon (M'62), recently appointed deputy vice chancellor for medical affairs at Washington University School of Medicine in St. Louis, was honored during ceremonies at Smith College Wednesday, February 22, when she received the prestigious Smith College Medal from her alma mater. The a\'.ard cites \\'eldon for a life that exemplifies "the true purpose of liberal arts education:· She has also been named chairman-elect of the Council of Academic Societies of the Association of American :-.Iedical Colleges (AA:-.IC). She has been arcprcsentatiw to the Council of 'Academic Societies since 1976. AA:\IC's Council of Academic Societies is composed of 73 aca- VIrginia V. weldon: Smith College Medal winner. dcmic and scientific societies in the biomedical field with an estimated acti\·e membership of 100,000. \\'eldon is professor of pediatrics at Washington University, \·icc president of the \\'ashington University :-.Iedical Center, and a staff physician at Barnes and Children's Hospitals, sponsoring institutions of the \\'ashington U niversit\· :\ledical Center. \\'eldon came to \\'ashi,ngton University in 1968 as an instructor, and was named professor of pediatrics in 1979. A specialist in pediatric endocrinology, she has studied mechanisms of abnormal g~·o,, th 'in childhood. After earning her medical degree from UB, she completed her residency in pediatrics at the Johns Hopkins Hospital in Baltimore and later held a fellowship and instructorship at Johns Hopkins :-.tedical School. \\'eldon's professional memberships include the Endocrine Society, Society for Pediatric Research, Lawson Wilkins Pediatric Endocrine Society, the American Association for the Advancement of Science and the St. Louis Medical Society. She has served as a government consultant on several projects, most recently as chairman of the General Clinical Research Centers Advisory Committee of the National Institutes of Health. She is currently a member of the National Advisory Research Resources Council of the NIH. • BUFFALO PHYSICIAN • 41 �1920 1940 HOBART A. REIMANN (M'21) • EUGENE J. HANAVAN (M'41) • had an art icle on Vira l Pneumonia reprinted in thc.Jour· nal of the American Afedical Aswcia· lion, February 17, 1984, as a "Landmark" article. Dr. Reimann is retired and is a vis iting professor of med icine at Thomas Jefferson Universit). was selected president of the American Fracture Association at the executive meeting in January. Dr. Hanavan has a private practice in orthopaedic sun~cry in Buffalo. LOUIS FINGER (M'24) • writes that his new address is 501 E. 79 Street, New rork, New York 10021. 1930 RAYMOND R. MEYERS (M'34) • of Buflalo is a charter member of the Pres ident's C lub at Sisters H ospital, a charter Fell ow of the American Academy of Family P hysicians, past president of the Eric County Chapter of the Fami l) Physicians of NYS, and is acti\!: in many other professional organizations. Dr. Meyers is a retired Colonel in the ~l edica l Corps 74th Regiment N Y Guard and is also retired from au ive family practice. RICHARD AMENT (M'42) • has been elected secretary of the Counci l of Medical Specialty Societies (CMSS) at that national organization's annual meeting. He is a UB clinical professor of anesthesiology. C M SS is an umbrella organizat ion of the 24 major medical specialt} societies and represents 254,000 medical specialists. CMSS is one of the parent organizations of the Accreditation Council f(>r Graduate Medical Education and the Accreditation Council f(>r Continuing Medical Education. Dr. Ament is a representative to the Council from the American Society of Anesthesiologists. He was also elected treasurer of the \1\'orld Federation of Societies of Anesthesiologists (WFSA) at its 8th World Congress in Mani la, Philippines. WFSA is an internationa l organization made up of representatives of national anesthesiology societies from 63 countries. ALFRED S. EVANS (M'43) • is director of the American College of Epidemiology. Dr. Evans is the John Rodman Paul Professor of Epidemiology at Yale Uni,·ersity, School of ;...I edicine. ALTON A. GERMAIN (M'45) • retired from private practice in ;...1arch. Dr. Germain's office on Union Road served as the Town of Cheektowaga's first emergTnC) care facility until 1960 when St. Joseph Intercommunity Hospital was built. Dr. Germain served as chief of staff of the hospital from 1967-1968 and served as chief of the Department of General Practice from 1960-1975 . Dr. Germain plans to •·clax and pursue his painting and gardening hobbies. STEVEN G. CLINE (M'47) • reports that, "I was at Georgia Baptist H ospital in Atlanta, Georgia for 8 years, and for the past 21 years I ha\'C been chief of radiology at South Fulton Hospital, East Point, Georgia 30345. This is a 450 bed hospital. I am married and have 3 children, 3 step children and 3 grandchildren. I ha,·e not been back to the Uni,·ersity of Buffalo for almost 40 years but I plan on returning for my 40th reunion in 1987, and I look fo•·ward to seeing my former classmates at that time." DAVID 0. CLEMENT (M'49) • informs us that his address is 2 Church Street South, Ne\' Haven, Connecticut. PAUL l BUERGER (M'49) • , a specialist in OB/GYN. retired after 20 years in private practice and is now chief of sUI'gcry at Ft. SilL Oklahoma. His mailing address is 3318 Atlanta, Lawton, Oklahoma 7350.1. JACQUELINE l. PAROSKI (M'49) • has assumed the presidency of the medical staff at DeGraff ~1emorial Hospital in North Tonawanda, .Y. Formerly chief of pediatrics, she was appointed to the staff at DeGraff in 1955. 1950 WILLIAM R. KINKEL (M'54) • RE UEST The Buffalo Physician requests that our readers submit any interesting, well-written articles that they have written on the following subjects: FO ARTICLES 1 • MEDICAL HISTORY, especially but not limited to the University. 2 • PROFILES of distinguished or interesting UB Med ical School alumni , present or former UB Medical School faculty, or current UB medical students. 3 • IMPORTANT PHILOSOPHICAL, ETHICAL OR OTHER ISSUES directly relevant to the medical community. 4 . • BOOK REVIEWS of important or interesting books written by or about UB faculty or alumni . Though books of a technical nature will be considered , especially if they are significant, reviews of non-technical books are encouraged also, e.g. biographies, fiction , non-fiction for the layman. 5. • HUMAN INTEREST STORIES about anybody with a UB Medical School association , present or former. ARTICLES SHOULD IDEALLY BE TWO TO TEN TYPEWRITTEN DOUBLE·SPACED PAGES. PHOTOGRAPHS (IN A SETTING RELATED TO THE ARTICLE) AND ILLUSTRA· TIONS ARE ENCOURAGED. SUBMITTED MATERIAL SHOULD BE ABOUT PEOPLE AND TOPICS WITH SOME ASSOCIATION WITH THE UB MEDICAL SCHOOL. The exception will be for articles about important philosophical , ethical , or other medically relevant issues. Articles not fitting the above categories are unlikely to be considered . clinical professor of neurology, clinical associate professor of anatomy, and chairman of ;..tillard Fillmore Hospital's Department of Neurology. was elected to the honorary post of distinguished member of the American Society of ;'\leuroimaging at the Society's recent annual meeting in Boca Raton, Florida . Dr. K inkel is a past president of the nat ional society, and one of its founding fathers. PETER S. D'ARRIGO (M'56) • was elected president of the medical staff of Millard Fillmore Hospital for 1984-85 at a meet ing of the voting med ical staff on ~1 arch 1. C li nical assistant professor of medicine at U B, Dr. D'Arrigo joined the M ill ard Fill more H ospita l medical staff in Ju ly, 1962. H e was appointed chief of hematology in the Department of I nterna l M edicine in 1970. He is on the consulting staff at Roswell Pa rk :l\.1emorial Inst itute a nd an investigator in the Cancer and Acute Leukemia Gro u p B, anationwide associat ion of cancer researchers. H e is a lso the chair- �Classnotesman of the Millard Fillmore Hospital physicians' United Way campaign. SEBASTIAN S. FASANELLO (M'62) • has been elected president of the medical staff of Bry-Lin Hospital, Buffalo. He is also clinical assistant professor of psnhiauy MICHAEL M. MADDEN (M'62) • has been appointed associate head of Buffalo General Hospital's Department of Anesthesiology. On that hospital's staff since 1967, he will continue to oversee the ;\lurse-Ancsthctist Program. A UB clinical assistant professor of anesthesiolog}. he is a Diplomate of the American Board of Anesthesiologists and a member of the;\!.'{ State Society. Peter S. D'Arrtgo ANTHONY P. SANTOMAURO (M'56) • was elected president of the Association of Past Presidents of the ::\1cdical Society, County of Erie, at the group's 18th com·ocation. Dr. Santomauro was society president in 1971. Leonard Berman (l\.1'52), clinical assistant professor of surgery and society president in 19i2, was elected secretary. 1960 JOSEPH L FERMAGLICH (M'61) • is a clinical associate professor of neurology at Georgetown Uni\'Crsity. His new office address is 3301 New Mexico A\·enue, ;\!\\', Washington, D.C. 20016. SAAR PORRATH (M'61) • established the \Voman's Breast Center in Santa :\tonica, California. Dr. Porrath has been actively Iccturing nationally to increase awareness in breast diagnosis. He has been featured in L'SA 7oda;·, and on many local and national news and talk shows bringing the message of early detection to women. ROBERT E. WINTERS (M '61) • is "alive and kicking," and has a private practice in internal medicine in Santa ~:Ionica, California. He just stepped down after 3 years as president of the Clinical Faculty Association of the Department of Medicine, UCLA (950 members). Dr. Winters was recently promoted to clinical professor of medicine at UCLA. JOHN W. CUDMORE (M'62) • has been named president of Buffalo General Hospital's Medical Staff for 1984. He will head a medical staff of nearly 900 physicians. A clinical associate professor at UB, he is an associate surgeon at Buffalo General, where he has served for 16 years. RICHARD S. MERRICK (M'64) • recentlv was elected for a t\\·oyear term to the Executive Council of the California Society for the Treatment of Alcoholism and other Drug Dependencies. Dr. :\.Jerrick lives at 1970 Galerita DriYe, Rancho Palos \'crdes, California 90732. DAVID E. PITTMAN (M'64) • was recently appointed associate director of the Cardiac Catheterization Laboratory, Allegheny General Hospital, Pittsburgh. Dr. Pittman is an assistant clinical professor of medicine at the University of Pittsburgh Center of :\.1edicine. R. SCOTT SCHEER (M'65) • of Exton, Pennsyh ania, is director of radiology of ::\tcdical Imaging Se" ices. This group serves Pottstown :\.JemorialMedical Center, Norristown State Hospital and private offices with subspecialty care in Dx and Rx angiographic procedures, CT/N:\.1RI! uclear and Ultrasound Scanning. Dr. Scheer is also medical director of l\'Jobil Ultrasound, Inc., a private ultrasound sel'\·icc providing portable studies in physicians offices in Pennsylvania, New Jersey, Maryland and Delaware. RICHARD H. DAFFNER (M'67) • , a specialist in diagnostic radiology in Pittsburgh. Pennsylvania, reports that he "left Duke Uni,·ersity Medical Center in ::\larch 1983 for private practice with his own residency program ('feels good')." In March Dr. Daffncr was program chairman for a refresher course on Skeletal Radiology given in Phoenix, Arizona. enterology. Dr. Goldstein has a private practice in gastroenterology in Buffalo. DONALD H. MARCUS (M'77) • , an anesthesiologist in Los Angeles, has been reelected to the board of directors of the Southern California Pcrmanente Medical Group, a partnership of 1,600 doctors. Dr. :\.1arcus is a visiting instructor at UCLA. ELSIGAV SHAHAM (M'78) • is an 1970 PETER L CITRON (M'70) • , a specialist in hematology-oncology, is chairman of the Department of Internal :\.1edicinc at South Miami Hospital, Florida. BRUCE M. PRENNER (M'70) • of El Cajon, California, presented at the American College of Allergists in April 1984, "Preliminary Results of a l\J ulticenter Study of the Anti Allergy Pentapeptidc HEPP." JOHN E. KN IPP (M'72) • , a specialist in internal medicine and gastroenterology, was elected chief of medicine at the Cornwall Hospital, Cornwall, New \ork. instructor in OB/GYN at Har,·ard School of :\.1edicinc. Dr. Shaham lives at 154 Truman Road, :\Tewton, l\.lassachusetts 02159. TERENCE L CHORBA (M'79) • is working as an Epidemic Intelligence Sen icc Officer at the Center for Disease Control, Atlanta, Georgia. Dr. Chorba lin'S at 507 Durand Driw, Atlanta, Georgia 30307. BRUCE J. NAUGHTON (M'79) • is chief of Subsection Geriatrics Department of ::\1cdicinc a; ::"-Jorthwcstern Univcrsitv School of Medicine. Dr. ;\laugl;ton lin's at 711 South Dearborn #806, Chicago, Illinois 60605. JEREMY COLE (M'73) • has a private practice in pulmonary disease and internal medicine. His new oflice address is 8333 Reseda Boule' arc!, Northridge, California 91324. TIMOTHY NOSTRANT (M'73) • has been elected to Fellowship in the American College of Physicians. Dr. Nostrant, a specialist in internal medicine and gastroenterology, is on the staff of the Veterans Administration Hospital in Ann Arbor, Michigan, and is associate chief of gastroenterology at the Uni,·ersity of Michigan Hospital. JAMES M. KERN (M'76) • whose specialty is internal medicine joined the Metropolitan Clinic P.C .. a multispecialty clinic in Portland, Oregon, in April 1981. DAVID SOKAL (M'76) • is now working for the Center for Disease Control in Atlanta, Georgia. Dr. Sokal is living at 2940 Winfield Circle, Tucker, Georgia 30084. HARVEY R. GOLDSTEIN (M'77) • was recently certified as a Diplomat of the Board ofGastro- 1980 WESLEY S. BLANK (M'80) • writes that "My wife Nan and I just had a baby girl, Leah, born on March 17, 1984. Injuly, 1984, • I will be joining a group private practice in OB/GYN in Attleboro, l\.1assachusetts." SYLVIA J. TURNER (M '80) • writes that she ··recently moved to Dallas; Alan and I are eagerly awaiting the birth of our first child." Dr. Turner is a fourth-year psychiatry resident at Parkland Memorial Hospital. MARK M. CHUNG (M'82) • reports that "I will be a senior medical resident in the Department of Medicine, Long Beach, California, having transferred from the State University of New York at Stony Brook affiliated hospitals." ANDREW E. NULLMAN (M'84) • is a resident in internal medicine at the Medical College of Philadelphia. His new address is 7373 Ridge Avenue, Philadelphia, Pennsylvania 19128. BUFFALO PHYSICIAN • 43 �DeathsDR. L. EDGAR HUMMEL • died on March 12 while spending the winter in Pompano Beach. He was on UB's Medical School faculty for 36 years until 1974. He retired as superintendent of the E.J. Meyer Hospital in 1969 after 12 years. A specialist in blood disease, he was a longtime chairman of the Red Cross blood program, a Diplomate of the American Board of Internal Medicine, and a Fellow of the American College of Physicians and the International Society of Hematology. He also was a member of local, state and national medical societies. • DR. RUBEN MEDINA • former clinical a sistant professor of pathology, 56, died in Birmingham, Alabama, on February 27 while moving his family from Batavia to Corpus Christi. He was chief of laboratory service at the Veterans Hospital in Kerrville, Texas. After five years as director of clinical laboratories and chief pathologist at Our Lady of Victory, he became a staff pathologist at Veterans Hospital in Buffalo in 1975 and then became chief of laboratory service at Veterans Hospital in Batavia in 1982. Born in San Juan, Puerto Rico, Dr. Medina received his B.S. at the City College of New York and his medical degree at the Uni\ersity of Puerto Rico. He did his internship at Mercy Hospital in Buffalo from 1956-57. He was a Fellow of the American Society of Clinical Pathologists and a member of the American Society of Cytology, American Medical Association, and Association of VA Chiefs of Laboratory Service. He is survived by his wife, Gloria; four sons, Ruben Jr., Carlos, Robert and Frankie; and two daughters, Diane and Carmen. • DR. HARRY L. CHANT (M'28) • the first director of the Johns Hopkins Hospital Medical Care Clinic during his 24 years with the Hopkins, died February 28 in Concord, Mass., after a lengthy illnes . He was 78. Dr. Chant recently had been living in Massachusetts. Born in Manlius, N.Y., he was graduated from Canisius College and UB's School of Medicine. After an internship at St. Luke's Hospital in Jacksonville, Florida, and a post-internship at Bellevue Hospital in New York, he took his resident training in pediatrics and infectious diseases at the Edward]. Meyer Memorial Hospital in Buffalo. He had a general practice in Buffalo from 1931 until 1934, when he was appointed an assistant district health officer for the 1 ew York State Department of Health. In 1936, he was appointed chief health officer for the southern district of New r ork, ''here he was involved in the fluoridation of water and the control of communicable diseases, including a typhoid epidemic in Oswego. During that period, he received a Rockefeller fellow hip and. came to Baltimore to earn a master's degree in public health at the Johns Hopkins University. · In 1948, Dr. Chant established the Medical Care Clinic for indigents - the first of its kind in the country - and served as its director until 1951. In 1965, Dr. Chant became assistant dean of Hopkins' chool of Hygiene and Public Health. He retired in 1971 as assistant dean and professor of public health administration. After his retirement, he worked as a physician and consultant in geriatric medicine for the Prince Georges County Health Department. Dr. Chant is survived by his second wife, the former Ida Kerner, of Baltimore; two son , Peter and David; a daughter, Phyllis and four grandchildren. • DR. LOUIS A. VENDETTI (M'34) • Cheektowaga health officer for 32 years, died in Millard Fillmore Hospital, February 19. He was 74. Dr. Vendetti served as health officer for the town since 1952. Additionally, he was school physician in the Village of loan from 1950 to 1955. 44 • BUFFALO PHYSICIAN Dr. Vendetti practiced medicine until the time of his death. He was a graduate of Canisius College and the UB School of Medicine. A native of Buffalo, he was associated with Millard Fillmore Hospital, Sheehan Emergency Hospital and Sisters Hospital. He was a member of the Erie County Medical Society and New York State Health Officers Association. He also belonged to the Bacelli Club, Columbian Club and University of Buffalo Alumni Association. He was past chairman of the National Air and Water Pollution Association of America. Surviving are his wife, Carolyn; a daughter, Carol Ann; a brother, Edward; a sister, Mary Vito; and two grandchildren. • DR. JOHN W. PICKREN • 62, a nationally recognized authority on cancer pathology and chief cancer research pathologist at Roswell Park Memorial Institute, died March 24 at his home in Williamsville. Dr. Pickren was a clinical professor of pathology at the UB Medical School and clinical professor of oral pathology at the Dental School. Dr. Gerald P. Murphy, director of Roswell Park Memorial Institute, has announced establishment of the John W. Pickren Surgical Pathology Lecture to honor the memory of Dr. Pickren, who had been at Roswell Park since 1955. Dr. Murphy said that, john Pickren was an outstanding surgical pathologist who has made many significant contributions to his field throughout his career." A native of Salem, Arkansas, he was graduated from the U niversity of Arkansas Medical School and the Columbia University College of Physicians and Surgeons. He was a Diplomate of the American Board of Pathology. Dr. Pickren served in the avy Medical Corps in World War II and was chief of pathology at the t. Albans aval Hospital on Long Island during the Korean War. He was consulted frequently by clinicians and pathologists in this country and abroad and was considered the most authoritative arbiter in problem cases in diagnostic pathology in the state. He had published more than 150 articles in medical and scientific journals and was known nationally for his breast cancer research, which contributed to the development of diagnostic procedures widely used in cancer hospitals. At Roswell Park, he was chairman of the Cancer Committee and was an ad hoc inspector of pathology laboratories for the State Department of Health. In 1981, he received the William H. Wehr Award for distinguished clinical service at Roswell Park. He was a Fellow of the American College of Pathologists and a member of county, state, national and international medical and scientific societies. Dr. Pickren was an enthusiastic tennis player and had been honored for his role as a master matchmaker. He also was an ardent participant in the sport of curling. He is survived by his wife, Virginia; two daughters, Cheryl and Debra; two brothers, Dr. Thomas Pickren, his twin, and Harry Pickren; two sisters, and two grandchildren. • HIRAM L. KNAPP, JR. (M'15) • died March 14, 1984, in ewark Valley, New Jersey. For more than 30 years Dr. Knapp was ewark Valley's school physician and health officer. In 1965 he was honored by the Tioga County Medical Society for 50 years of devoted and faithful service and in 1968 he was honored with a testimonial dinner by his community. Dr. Knapp is survived by his wife Jessie and two • children. NIELS G. MADSEN (M'35) • died January 22, 1984, in Altoona, Pennsylvania. • CHARLES SHORE (M'48) • died October 14, 1983, in Los Angeles of polycystic kidney disease. Dr. Shore is survived by his wife Frances. • �DO YOU HAVE A SPECIAL TALENT IN MUSIC? THE ARTS? STAGE? SPORTS? UNUSUAL HOBBY? WRITING OUTSIDE OF MEDICINE? The BUFFALO PHYSICIAN is planning to present articles featuring UB physicians, alumni and medical students with outstanding talents outside of the medical profession. CalendarTHE 7TH NATIONAL CONFERENCE ON PEDIATRIC/ADULT ALLERGY AND CLINICAL IMMUNOLOGY • July 19-21, 1984, Four Seasons Hotel, Toronto, Ontario. A national conference designed for all physicians managing allergic and immunologic problems in children and adults. Program chairmen, Drs. Elliott Middleton Jr. and Elliot F. Ellis. Sponsored by UB Departments of Pediatrics and Medicine, Continuing Medical Education, the American Academy of Allergy and Immunology, and the Schering Corporation of America. Topics: Anaphylaxis, Asthma, Adverse Drug Reactions, Cystic Fibrosis, Theophylline Tox icity, Regula- tion ofigE Synthesis, Hymenoptera Allergy. THE CAPE COD PEDIATRIC CONFERENCE • August 10-12, 1984, Dunfey Hyannis Hotel, Cape Cod, Hyannis, Massachusetts. Chairman, Elliot F. Ellis, M.D. Sponsored by: Continuing Medical Education and the Department of Pediatrics, State University of New York at Buffalo. Credit hours: 20. Fee: Physicians in Practice, 275. For further information, contact Rayna Dutton, CME coordinator, Continuing Medical Education, Children's Hospital, 219 Bryant St., Buffalo, Y 14222. Telephone: (collect) 716-878-7630/ 7640. PLEASE LET US KNOW! Conlacl: Bruce S. Kersh ner, Universi ty M edical Editor, 136 C rofts H all, SU . Y Buffalo, Buffalo, ~y 14260. ------------------------------------------------------------------- IIIII I BUSINESS REPLY MAIL FIRST CLASS PERMIT NO. 2210 BUFFALO, N.Y. POSTAGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, New York 14214 NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO, NEW YORK 14214 QQ, l 2 A C: 6 JW I- c y '-l ll SUI\IY B 14214 BUFF LO \I Y -----------------------------------------------------------------~ LET US HEAR FROM YOU Fill out this card (Please print or type all entries) Name _________________________________________________ Year MD Received ___________ Office Address ________________________________________________________________________ HomeAddress ________________________________________________________________________ If not UB, MD received from - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - In Private Practice: Yes 0 No 0 In Academic Medicine: Yes 0 No 0 Specialty Part Time 0 Full Time 0 School Title ___________________________________ Other: Medical Society Memberships: NEWS: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.? _______________ Please send copies of any publications, research or other original work. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, July 1984 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals. Medical colleges -- New York (State) -- Buffalo -- Periodicals. Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1984-July Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine. Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1984-v18n02-July Table Of Contents A list of subunits of the resource. Medical Care in the Soviet Union Chronic Diarrhea Research Center Photo Show Hospice Conference DES A Challenge Research Medical School News Hospital News Students Alumni People Classnotes Deaths Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-07-06 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v18n02 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1984 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/399c5d7a1f9084f57b31495d6544fdd5.pdf d7e3dd56a2c4abcc40aa5d17a4653628 PDF Text Text �MESSAGE FROM THE DEAN The faculty and I will spend the next two to 'three months preparing for the School of Medicine's next accreditation visit by the committee representing the Liaison Committee on Medical Education. As is always the situation, an accredita­ tion visit provides an important opportunity for the Univer­ sity community to evaluate itselr'in relationship to its stated goals and objectives and to identify existing strengths and weaknesses. Out of that process comes the realization of our actual status as a modern day medical school. Although we, like all medical schools, are always faced with many more deficiencies and problems than we like, I think it fair to state that the health of the medical school at Buffalo is sound. Since the last visit in 1980, the State of ew York has confirmed its commitment to the Health Sciences Center in Buffalo by initiating construction of the new library, the dental school and the expansion of the Medical School. The construcoon projects will be completed beginning in late 1984 and by nid-1985. The renovations of Farber-Sherman-Cary Halls are underway. In addition, the School of Medicine is now joined by new facilities in all of its major teaching hospitals. These physical changes have been joined by several impor­ tant academic advances. The school has initiated an M.D.­ Ph.D. program, has strengthened its student advisor pro­ grams, has introduced new curricular material in the third year, has formed the graduate medical education consortium, and has embarked on implementation of a governed salary plan for its full-time clinical faculty. All of the above steps were long expressed concerns of the LCME visitors in 1966, 1972 and 1976. Although progress has taken a long time, the alumni, faculty and students should feel proud of what has been accomplished. Undoubtedly, the School of Medicine at Buffalo is one of which each of us can and should be very, very proud. - John Naughton, M.D. �ContentsBUFFALO 3 NICORETTE • A nicotine gum , the most promising method to date for quitting smoking , has been devised by Dr. Claes Lundgren, inventor and UB scientist , in cooperation with a Swedish company. STAFF 8 HOSPICE BUFFALO • " We're not in hospice care to be 'good guys' or because it's the work of the angels. We're doing this because it's good medicine," says Dr. Robert Milch , medical direc­ tor of Hospice Buffalo Inc. and cl inical professor of surgery at UB. PHYSICIAN EXECUTIVE EDITOR, UNIVERSITY PUBLICATIONS Robert T. Marlett ART DIRECTOR Rebecca Bernstein UNIVERSITY MEDICAL EDITOR Bruce S. Kershner PHOTOGRAPHY Jim Sulley David S. Ottavio Ed Nowak 10 LITTLE KNOWN MEDICAL SCHOOLS • Dr. O.P. Jones reviews the history of little known medical and osteopathic colleges in 19th century Buffalo. Boss Hogg. 13 NUCLEAR HOLOCAUST • Concerned physicians contend that the best medical survival plan in case of a nuclear war is to preclude the need for any such plan by ending the arms race. 17 RESEARCH • UB researchers have discovered a new drug that allows safer, less costly, and often more accurate diagnosis and management of stroke. The world's first heart-lung transplant to be conducted on a cystic fibrosis patient took place recently due to the efforts of UB professor of pediatrics, Dr. Gerd Cropp. An 80 per cent reduction in the chance of stroke triggered by heart surgery appears possible because of the research of Dr. Samuel Testicular Image usad tor diagnosis. Balderman . 23 MEDICAL SCHOOL NEWS • New York State's first comprehen­ sive geriatric education center has been established at UB. "Boss Hogg " and his brother endow fund in honor of their father, Solomon Booke of the Class of 1924. Other news. 26 HOSPITALS ~ The Buffalo General reports progress in develop­ ment of a regional health care network. Roswell Park dedicates new research center. Millard Fillmore Hospital plans acquisition of Sheehan Memorial. 28 BOOKS • How do you spell relief? UB physician is author of "The Doctor's Guide to You and Your Colon," a humorous, infor­ mative work with illustrations by Buffalo News cartoonist Tom Toles. 30 STUDENTS • Medical School talent show. Summer program for minorities appears effective in preparing for academic success. 32 PEOPLE • UB immunologist translates " The Bible of Solidar­ ity " into English . Other news of people you know. 36 CLASSNOTES • Spring Clinical Day slated for May 5. News of the classes. 39 DEATHS ADVISORY BOARD Dr. John Naughton , Dean School of Medicine Dr. Harold Brody Dr. James Kanski Dr. James P. Nolan Dr. Charles Paganelli Dr. Peter Regan Mr. James N. Snyder Dr. Eugene Michael Sullivan Jr. Dr. Mary Voorhess Dr. Martin Wingate Dr. John Wright Dr. Maggie Wright Ms. Rita Wolff TEACHING HOSPITALS The Buffalo General Children's Deaconess Erie County Medical Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Charity Veterans Administration Medical Center Produced by the Division of Public Affairs, Harry R. Jackson, director, in association with the Schoof of Medicine, State University of New York at Buffalo COVER ART: Mike Bunn THE BUFFALO PHYSICIAN , (USPS 551-860) May 1984- Volume 18, Number 1 published five times annually: February, May, July, September, December - by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York . POSTMASTER : Send address changes to THE BUFFALO PHYSI­ CIAN , 139 Cary Hall , 3435 Main Street, Buffalo, New York 14214. BUFFALO PHYSICIAN • 1 �Person trying to kick the habit chews gum when the urge to smoke strikes. Nicorette (nlc::ot6n- r e s • n c::ompl - x ) 2 mg �Nicorette UB physiologist invents 'most promising method yet ' for quitting smoking V isualize a smoke-free office with em­ ployees contentedly chewing away on gum as they go about their tasks. Such a scene is possible now that nicotine gum, the most promising method discovered to date for quitting smoking, has recently been introduced into the United States. Devised by Dr. Claes Lundgren, in­ ventor and State University of ew York at Buffalo scientist, and a Swedish company, it became commercially available as a prescrip­ tion drug on March 15. The gum as it now exists was developed by Leo Pharmaceuticals of Sweden. Known commercially as "Nicorette;' it is marketed by the pharmaceutical company Merrill Dow. It is now available in 15 coun­ tries, including Canada, Great Britain, Sweden and Switzerland. Except in Switzerland, where it was introduced in 1979, it is sold only as a prescription drug. The effectiveness of nicotine gum has been demonstrated repeatedly by tests. For those in one study who used the gum con­ sistently for three months or longer, 67-75 per cent kicked the habit within a year of starting the treatment. Virtually every other study indicated success rates of 35 per cent to 71 per cent after one year. The variation and lower rates of some of these studies, however, may have resulted from including smokers who did not continue using the gum during the minimum three month treatment period. Despite this, success rates of the nicotine gum are two to 3 Y2 times higher than the national success rate using all methods. It is estimated that 20 million people, or 3 7 per By Bruce S. Kershner BUFFALO PHYSICIAN • 3 �Dr. Lundgren In Physlo/ogv lab area. cent of all smokers, try to stop smoking each year, and only 20 per cent of these are successful. Other methods now used by smokers range from willpower ~nd quitting "c?ld turkey," to lower nicotine cigarettes, avers10n therapy usmg elcctnc shock, acupuncture, behavior modification programs, and support groups. If Nicorette becomes popular as the method used by smokers to quit their habit, it is safe to say that millions of ex-smokers would be generated each year, with hundreds of thousands of lives saved. When referring to "his" inventions, Dr. Lundgren explains that one or more of the following Swedish colleagues should be credited as co-inventors: ]. Lichtneckert, 0. Ferno, M. Arborelius and L. Akesson. The first two are associated with the gum. T he nicotine gum works like this: . . . Nicotine is physically add1ct1ve and IS the mgred1ent in cigarettes which makes it sodifficult to qu!t s~oking. The sometimes calming or stimulatmg effects of mcotme remforce the habit further. Social a.nd psychological factors of smo~­ .ng such as oral gratification, however, are unlikely on the1r ~w~ to prevent smokers fr?m quitt~n&" if they are rea.lly motivated. Though nicotine IS the add1~t1ve a~d p~ych.oactJve ingredient, it is not the most hazardous mgre?Ient m CJga.rette smoke. The carcinogenic tars, carbon monox1de, and rad10ac- 4 • BUFFALO PHYSICIAN tive chemicals are the most medically harmful components, but have no physically or psychologically pleasing effects on the smoker. By switching to nicotine gum, the smoker ceases most of the health hazards that are associated with smoking. However, the gum-user continues to experience much of the phys.ical and psychological effects of nicotine that may be pleasmg, without encountering the unpleasant withdrawal symptoms, or nicotine "fit" that nicotine-abstention would cause. Impor­ tantly, increas~d appetite and weight gain, often. cited as a reason why many return to smoking, can be avOided usmg the gum method. . Once the first hurdle, the smoking habit, is overcome, the second phase of quitting - nicotine withdrawal - becomes easier. icotine gum users rarely continue the treatment a~ter six months. The reason is unclear but a definite self-weanmg effect does occur for many of those who succeed, according to Dr. Lundgren. "It's extremely rare for subjects to remain Nicorette users over a long period of time;' says the gum's inventor. "In fact, the scheme for using this preparation is to get off the prepara­ tion as well - within four to six months. It turns out that people who use it start to wean themselves without knowing it. The mechanism behind that appears to be, in contrast to the cigarette, that the gum outlasts the nicotine dose. So you don't quite know when the nicotine supply is used up." Dr. Lundgren went on, "You might keep chewing all day, but the number of gum tablets per day goes down, and finally, you get off it." Besides being the most effective treatment yet, Nico~e.tte has other positive features and safety aspects. In a 1982 BntJsh study, subjects using the gum reported less severe withdrawal symptoms. In another study, 60 per cent of users thought the gum was the most effective aid they had tried in relieving the unpleasant symptoms of nicotine abstention. Another advantage of the gum is that smokers most likely to benefit from its use are those who have a high "physical" type of nicotine dependence - the heavy smokers and smokers of high nicotine brands. Remembering the early development period of the gum, Dr. Lundgren remarked that "an important consideration was the need to avoid accidental overdose, as with children." If a child consumed, pill form, the same amount of nicotine as found in 10 to 15 Nicorette tablets, it would be lethal. "The invention avoids the chance of overdose because you have to chew the gum to release the nicotine. If you don't chew it, no nicotine comes out. If you swallow 20 or 40 chewing tablets, little will happen; Lundgren explained. "Even If a child does chew several pieces, he will get extremely nauseated within seconds before serious toxic effects can take place:' (Remember your first puff on a cigarette?) . Even if nausea or vomiting does not prevent absorption, only a small per cent of the nicotine is released when the gum is swallowed whole. Furthermore, the taste when chewed is not like other sweet or minty gums; it has no sugar and has a peppery nicotine taste. D r. Lundgren conceived of his idea that led to the invention in 1967. "Like everyone else at the time, I saw smoking as a medical problem. I was a smoker at the time ... and became convinced that smoking was an addiction, not just a bad habit picked up from social and behavioral patterns. This notion was strengthened by the fact that the nicotine­ free cigarette had appeared, disappeared and reappeared as a commercial venture many times over the years and always miserably failed. Then they gradually learned it was not the nicotine but the other things in the smoke that were the serious �health problem." The idea of the invention struck Dr. Lundgren when he thought "What is more reasonable than a non-cigarette source of nicotine for smoking withdrawal?" He explained further, "My idea was to supply nicotine in a clean form, without the carcinogens and carbon monoxide, as a means of getting away from the real dangers of smoking - and without experienc­ ing the withdrawal symptoms. "The nice thing about the gum is that it allows self­ administration of the nicotine so the patient can regulate the supply of nicotine to his or her individual need," he observed. "The rate of release of nicotine is geared to the rate of chew­ ing and you learn to chew to your satisfaction. By chewing the gum, you are massaging it and exposing new surfaces to allow nicotine release." Dr. Lundgren brought his idea to the pharmaceutical com­ pany within days. They made the first prototype gum that same year. "The first preparations were a bit of a disappoint­ ment;' he remembers. This is because the acidity of the saliva interfered with the rate of nicotine absorption. The company resolved that problem with a special preparation, an ion­ exchange nicotine resin complex. Another unusual hurdle was something encountered by many inventors - skepticism. Lundgren found "total disbelief and substantial resistance to the idea, even among physicians. Imagine, offering nicotine in a chewing gum of all things'" The first country to approve the sale of the gum was Switzerland and it is still the only country to sell it over the counter. Canada was the second country to approve it (in 1979) and Sweden, Dr. Lundgren's native land, was the third. Nicorcttc will be available in packages of 96 pieces of gum and will sell for around $20 per package. Each piece will con­ tain 2 mg. of nicotine and will be packaged in child-resistant blister packaging. Most patients will require about ten pieces of gum per day during the first month of treatment. Patients can adjust the dosage to suit their needs, as long as it docs not exceed 30 pieces per day. Gum users are supposed to stop smoking and chew a piece of the gum whenever they have an urge to smoke. The nicotine is absorbed through the oral mucosa, the lining of the mouth. Blood levels of nicotine can approximate the levels produced by smoking except for the sudden elevated levels (the "rush") that accompanies the first few minutes of inhaling a cigarette. Thus, the "satisfying" physiological effects of nicotine still oc­ cur but in more moderate amounts. T he manufacturers recommend the user to initially chew the gum long enough to taste the sharp flavor, then hold it in the mouth chewing only enough to maintain the taste in the mouth . As the urge to smoke fades, patients should gradually reduce the number of pieces chewed each day. They should not, however, attempt to stop using the gum until the craving for nicotine is satisfied with just one or two pieces a day. As the makers stress, "the medication docs not take the place of your determination and will power." Although tests show the nicotine gum still has a significant success rate with unmotivated smokers, the invention is really designed for the smoker who is motivated to quit. "It may seem obvious, but the gum must be chewed to work. If you usc it, it will be highly effective, and if you don't, it won't," the UB physiologist points out. Motivation is important because the loss of some of the satisfaction associated with smoking will be replaced, by motivated individuals, with a very different kind of satisfac­ tion - the satisfaction of knowing they are on their way to kicking the habit. Lundgren with 'Nicorette: As with any medication, side effects arc possible. The most frequent reactions arc all mild: irritated mouth (19 per cent of users), gastric complaints and nausea (12 per cent), hiccups (8 per cent), flatulence (common to all gum-chewing) (7 per cent), as well as light headcdncss, salivation, headache and jaw muscle ache (from excessive chewing). Individuals with heart problems or active temporo­ mandibular joint disease should avoid the gum, as well as preg­ nant and nursing women. Obviously, it should not be used by non-smokers or children. Clacs Lundgren received . his M.D. in 1959 from the University of Lund, Sweden, and his Ph.D. from the same university in 1967. He came to UB in 1974, and is now pro­ fessor of physiology and director of the Hyperbaric Research Laboratory. In Mar~h 1983, the Office on Smoking and Health of the US. Public Health Service called smoking "the most widespread form of drug dependence in our country." The in­ troduction of nicotine gum into the United States may con­ ~ribute significantly in reducing that dependence as well as Its medical hazards and negative social and cosmetic effects. . Bu_t users of nicotine gum will still need to add one ingre­ dient If they arc to guarantee success - the motivation to quit. • BUFFALO PHYSICIAN • 5 �Needs & solutions Dr. Claes Lundgren has devised 14 inventions ''A By Bruce S. Kershner t times a need and a solution have both o~cur­ red to me within seconds. And at other times I see a need in a problem area and the solu­ tion is conceived more gradually." This is the way the creative process works for Dr. Claes Lundgren, who is a succes~ful_inventor and has, with a Swedish company, developed a mcotme gum that pro­ mises to be the most effective anti-smoking technique yet. The professor in the UB ~epa~tment of Physiology other­ wise spends his time at the U m_vers1ty as ~hrector of the Hyper­ baric Research Laboratory. H1s academic research focuses on the physiological problems ass~ciated with diving ~nd under­ water pressure. He IS Internationally recogmzed m the field of underwater physiology, but few reah~e that _Dr. L':'ndgren during his extra-curricular time has dev1sed 14 mventwns and over 100 patents. . . . . With the introduction of the mcotme gum mto the U mted States, that may change. With a success rate s~veral times higher than that of any ?t?er tested method, the mcot_me gum invention may ass1st millions of smokers to k1ck the1r ?abit, if they are motivated to do so (see accompanymg artiCle). Eight of 14 of Dr. Lundgren's patente_d inve_ntions are various improved underwater breathmg dev1ces. F1ve of these have been marketed and two of them are in regular use by the Swedish Navy for deep sea explorations. Describing one of his inventions, Dr. Lundgren observed that deep sea divers fatigue easily because of the difference in gas pressure between the divers' lungs _an? their breath!ng apparatus. With a special we1ght system ms1de the breathmg device that he developed, this pressure difference can be equalized and diving fatigue reduced. A second underwater device is a special means for in­ dividual rescue from sunken submarines. Two other examples are devices that economize and save breathing gas in scuba gear. One of these inventions allows the diver to stay un?er­ water three times longer than when usmg other known dev1ces, . . while carrying the same amount. of ga~. Another one of his successful mvent1ons IS a spec1al exer­ cycle that is mu~h. more ad_aptable than the conventional bicycle-like exerc1smg machme. Known techmcally as an ergometer, Lundgren'~ exercyc_le can be used in_any position, whether sitting, standmg or lymg down. Thus It can be used by rehabilitation and bed ~ ridden patients ~nd older peo~le. His device also has a centnfugal brake that simulates the wmd resistance of a real bicycle. I n his mild Swedish accent ove~laid with British inflections, Lundgren described one of h1s less successful mvenuons. Fifteen years ago, he developed a ':'ethod and apparatus for carrying out an instantaneous nat1onal opm1on poll. Us1~g a "black box" device that could be attached to a TV, an enure population cou_ld, at a given sig1_1al, register their opi~ions on topics by pushmg a button or msertmg a_ card. Th1s would send a brief electric surge at an exact t1me that could be measured above the background levels. The UB scientist's device would be largely tamper-proof an? t?e effects of "cheating" could be distinguished from genume 1mpulses. He doesn't know why the idea was never adopted, but technology 6 • BUFFALO PHYSICIAN advances, especially with computers, have changed the whole picture, anyway. He then expressed what is probably a common experience among inventors. "It's absolutely amazing;' Dr. Lundgren ex­ claimed, "You learn that when you approach people with an invention, you can have reactions that are 180° apart. Th1s happened with the chewing gum. Some of the people I ap­ proached with this idea that led to the gum thought 1t was one of the most idiotic things they ever heard of ... but some others said 'Now that's got real potential!' " Dr. Lun?gren agreed that a manufacturer's "creative" ability to recogmze an opportunity presented by a new invention is as important for its success as the creativity that led to the invention itself. Dr. Lundgren continues to create new ideas. He laments, however, that inventing is only a spare time activity on some weekends, and he wishes he had more time to pursue 1t. He is currently working on ways to prevent and relieve the "bends," an often lethal condition caused by surfacing from a dive too quickly. ew concepts in lightweight design for buildings and aircraft are also on his mind. Improvementon the current technology for saltwater to freshwater conversiOn is another idea he mentioned. A close collaborator m these endeavors is Dr. Joseph Mollendorf, associate professor in UB's School of Engineering. Lest we overlook his major professional activity, Dr. Lundgren works full-time on a number of University research projects in diving physiology. He and other researchers at h1s laboratory have been conducting studies for more than 10 years. Lundgren and his colleagues, Drs. Donald Hickey and William orf1eet, utilize a unique device for their research: a man-rated pressure chamber with the largest pressure range in the world. The chamber can simulate pressures from 60,000 feet of altitude to 5600 feet of seawater depth. It is equipped with apparatus that allows subjects to remain in it for weeks. The Office of Naval Research funds part of the effort. 0 ne object of research is how various mixtures of compressed gases affect divers' body functions. "Another line of interest," Dr. Lundgren says, "has to do with breath-hold diving (no breathing apparatus). Anybody who is faced with the danger of drowning depends on his or her ability to hold the b~e~th until they get to the surface." By studying breath-hold diVIng in his chamber, researchers can monitor physiological changes that occur as divers make rapid descents. Research in breath-hold diving has important implications for public safety because of the popularity of snorkeling and diving. With funding from the New York Sea Grant Institu_te, work in Dr. Lundgren's laboratory is now underway to In­ vestigate the stress on the blood circulation that breath-hold diving causes. Volunteer subjects do breath-hold dives under­ water in the pressure chamber to simulated depths of 66 feet. Their heart action is monitored and the researchers are on the lookout for too forceful a distension of the heart that may result as the high pressure forces blood into the chest and the heart. Heart distension might be one cause of otherwise hard to explain sudden deaths in swimmers and divers. Dr. Lundgren is supporting Dr. Richard Morin and UB professor of pediatrics Dr. Edmund Egan in a different field of physiology research - investigations into the mechanism behind the redistribution of blood into the lung at the mo­ ment of birth. "In the fetus, most of the blood that goes through the heart does not go through the lung. This changes at the moment of birth because it becomes redirected;' he explains. "That major readjustment is not clearly understood." What is clearly understood, though, is that the creative contributions of Claes Lundgren will continue as usual. • �·- • • • c \ ~ -,--\ ,-.::..,_ ,... - I Large photo shows Lundgren In hvperllarlc tacilltv. (Inset} His exercycle and breathing ap· paratus Inventions. -.. :- '. BUFFALO PHYSICIAN • 7 �Hospice Buffalo Good work and good medicine ''w By Bruce S. Kershner e're not in hospice care to be 'good guys' or because it's the work of the angels. We're doing this because it's good medicine - and it works. It is people getting into the trenches and working with patients who have unmet needs." This is how Dr. Robert Milch describes the motivation of physicians and other health care professionals who get involved in hospice care. M_il~h is the medical direc­ tor of Hospice Buffalo, Inc., and climcal assistant professor of surgery at UB. Hospice refers to the specialized program of care that assists people with advanced cancer to live meanmgful, pam­ free lives when palliative care is indicated. The first com­ prehensive conference on hospice _care in the r~gion will be held April 26-27 in Buffalo. Dr. Milch IS one of Its organizers and will present its first medicine workshop (see ,tccompanying article on "An Institute on Hospice Care) . Dr. Milch explained that he got mterested m hospice care in much the same way that others have - through direct ex­ perience with patients with advanced, intractable cancer. "I think that anyone who deals with these patients has got to be interested in new ways of pain and symptom control;' he stated. Referring to the origins of the concept of hospice care, Milch observed, "Historically, cancer patients have been the ones whose needs were least well met by the health care system. '(hey'vc always been the patient in the last room at the end of the hall with the curtain drawn closed." He added, "I would like to see the needs of this patient population met. I'd like to see quality care given to them. The rest will take care of itself." The need for more expertise in the area of symptom con­ trol, according to Dr. Milch, also contributed to the develop­ ment of the hospice care concept. Dr. Milch eloquently described what distinguishes hospice care from the traditional health care goals of "investigate, diagnose, treat, cure." "The fact that these patients arc dying is an emphasis that is thrust on us;' he explained. "You will very rarely hear those in hospice work refer to their patients as 'terminally ill' - it's meaningless. They are really patients with a shortened life expectancy or advanced malignant disease. But as soon as you use the label 'terminally ill; traditional care givers begin to withdraw. Hospice puts the emphasis not on the dying but on the living. The emphasis has to be on the living because that is what these people are doing. Let the others treat the tumor, we'll treat the patient." T hat treatment not only includes ways to relieve the pain and symptoms of the disease but also ?Piritu~l and psychological care oft~~ patient. An~ agam, unlike the traditional approach of medtcme, psychological and social sup­ port for the patient's family is an ess_ential part_ of hospice care. Remembering when he first got mvolved with Hosptce Buf­ falo Dr. Milch told how he was asked by Dr. 1om Doeblin of the local American Cancer Society to coordinate the an­ nual conference for physicians in 1977. Their annual meetings typically were attended by 60-80 physicians. When Milch said that he thought hospice care would be ~ great theme for the meeting, he was met with some skeptic ism. Few thought the 8 • BUFFALO PHYSICIAN idea would attract very many people. Dr. Milch confidential­ ly made a bet with Charlotte Shedd, founder of Hospice Buf­ falo, Inc., that more than 100 would attend. He would donate a certain amount to the organization for every person under 100 that attended the meeting, while she would similarly donate to Hospice Buffalo an amount for every person over 100. To their pleasant surprise, attendance at the meeting far exceeded both of their expectations. Shortly after, Dr. Milch signed on as the medical director of Hospice Buffalo. The local hospice movement took off with the support it got from the community. Buffalo General Hospital offered a five-bed palliative care unit to Hospice Buffalo. "Here's a private corporation supporting a community group in a totally unique and previously untried form of health care delivery - that's different;' Dr. Milch remarked, smiling. In 1979, Hospice Buffalo was designated one of ew York State's demonstration projects. Today, Hospice Buffalo, Inc., provides treatment and consultation to over 200 people each year, 8 per cent of the total terminally ill cancer patients in Erie County. It has 13 paid staff at its corporate office not far from UB's School of Medicine. Three physicians, including Dr. Milch, offer their services, as well as five home care nurses, two social workers and an occupational therapist. Also pro­ viding hospice care services are a nutritionist, a psychologist consultant, a pastoral care coordinator and a bereavement counselor. Hospice Buffalo gave over 300 presentations last year. Besides benefitting cancer patients and their families, hospice care has a direct benefit to society as well by reduc­ ing the high cost of care for these patients. According to some studies, the cost of care for dying pa­ tients may be twice that for other seriously ill patients, with the costs increasing as the probability of survival decreases. Because hospice care attempts whenever possible to place pa­ tients in their own homes, the medical costs associated with hospital and institutional care are avoided. �Conference on hospice care It's first of its kind in the area T Dr. Robert Milch (page opposite} and planning group tor Hospice conference (this page}. "It was not until we did a retrospective cost analysis for the insurance companies (after spending two years living on public contributions), that they agreed to cover the expenses of hospice care;' Dr. Milch pointed out. "We looked at 50 pa­ tients under traditional care in the last six months of life, and determined it had cost 6,800 per patient. Then we compared this to the cost for 50 patients under hospice care, primarily at home- and it cost 3,200 per patient. Hospice care is cost effective." I n 1979, 89 per cent of the 2000 cancer patients who died in Eric County did so in acute care settings such as hospitals and nursing homes. Last year, 89 per cent of patients cared for by Hospice Buffalo died in their homes, at lower cost and surrounded by family and familiar surroundings. Dr. Milch's primary role in the April "Institute on Hospice Care" "was to put forth the idea and then find very talented people to carry on from there. Susan Russ, the overall coor­ dinator, Cathy Hanrahan, the assistant coordinator, and Daniel Farstad arc among dozens who helped organize the conference;' he said. "We were searching for a way to communicate to the pro­ fessional and lay public not only what hospice is all about, but what it docs. There's a great sense among hospice workers of wanting to share what we know." The institute is being supported by Hospice Buf~alo, Inc., UB and Buffalo General Hospital, as well as Blue Sh1eld, Blue Cross, drug companies, and local organizations. A Buffalo native, Robert Milch is also a UB alumnus (BA '64, MD '68). A UB clinical assistant professor since 1978, he is also an associate surgeon at Buffalo General Hospital and Children's Hospital. He has served as president of b~th Hospice Buffalo and the ational Associauon of Hosp1ce Physicians. Outside of his patient care and work with the hospice movement, Milch conducts research in pain control and management of surgical patients. His extracurricular time is spent with his family and hobbies such as pl~ymg the banJ~· When asked about his shelf of books on mag1c and slight-of­ hand, he explained that he enjoyed dabbling in magic tricks and that it was also an excellent tool to cheer up his pcd1atnc patients. Then, with his typical broad smile and warm sense of humor, he chuckled, "All surgeons practice a little sleightof-hand - now you see it, now you don't!"_ . Returning again to the subject that most mterests hm1, he concluded, "The principles of hospice care arc apphcable throughout the med ical profession: I t scn~ i tizes one to the needs of the patients and their famd1c~ . I t IS a reaffi~mat1on of a ll the best in why we went into mcd1cmc and nursm!S a?,d social work . We have to be not JUSt carc-g1vmg, but canng. • he first comprehensive conference on hospice care to be held in the upstate New York/eastern Great Lakes region will be held April 26-27 in Buffalo, called "An Institute on Hospice Care;' it is sponsored by Hospice Buffalo, Inc. in cooperation with UB and Buffalo General Hospital. The two-day training institute, which includes seven con­ current workshops, is designed to help physicians and other health care professionals, clergy and volunteers understand the hospice concept, a specialized program of care that assists people with advanced cancer live meaningful, pain-free lives, when palliative care is indicated. Balfour Mount, M.D., the leading authority in North America on hospice care, will be the keynote speaker. He is director of the Palliative Care Unit at Royal Victoria Hospital in Montreal. Dr. Steven Sample, president of the University, will give the welcome address. · The Medicine Workshop's goal is to improve physicians' understanding of the principles of palliative symptom control and of how a physician-directed interdisciplinary team should apply these principles. Robert A. Milch, M.D., medical director of Hospice Buf­ falo and associate professor of surgery at UB, will present the first session (see accompanying article). He will review the fun­ damentals of pain and symptom control during the workshop devoted to medicine. Six other physicians will also speak. The next two sessions will discuss the usc of transcutaneous electrical stimulation, epidural morphine and biofeedback. The last medicine workshop session will offer panel discus­ sions on physician-patient-team interactions between the hospice program and the health care community. During the nursing workshop, Madelon Amenta, R.N., director of education and research for Forbes Hospice in Pitt­ sburgh, and Diane Lee, R.N., home care night R.N. for Hospice Buffalo, will identify the characteristics needed in nurses who must consider the care, and not the cure, of a pa­ tient in home care. The social work workshop is intended to expand the skills of social workers so they can counsel hospice patients and their families. Leading the occupational therapy workshop will be Phillip Shannon, chairman of the Department of Occupational Therapy at UB. Kent Tigges, UB occupational therapy pro­ fessor, who IS the resident OT consu ltant for Hosp ice Buffalo, will discuss how occupational therapists can help terminally­ ill patients live their last days to the fullest. The pastoral care workshop will explore the ethical issues of hospice care. Grief and its value will be spotlighted by the bereavement workshop. Sherri Alper, social worker at Fox Chase Cancer Center in Philadelphia, and Thomas Frantz, Ph.D., UB associat~ professor of educational psychology and co-founder of the L1fe and Death Transition Center in Buffalo, will speak. The seventh workshop wi ll examine the role of the volunteer in a hospice sett ing. It will stress understanding the sexuality and sensuality concerns of patients and their families. The speaker will be Ellen Christensen, director of UB's Sex­ uality Education Center. . Registration is $90. Students presenting current identifica­ tiOn from _an accredited university wil l be charged on ly $65. More mformatJOn can be obtained by writing to Hospice Buffalo, I nc., Institute '84, 2929 Main Street, Buffalo, N.Y. 14214, or by calling 716-838-4438. • BUFFALO PHYSICIAN • 9 �Little known schools 19th century medical school is source of confusion for historians By Oliver P. Jones, Ph.D., M.D., Distinguished Professor Emeritus in Anatomy 'Presented at the Surg1cal Staff Conference of the Millard Fillmore Hospital. 1 February 1980. This shows the first and onlv School ot OsteopaUJv In Buffalo located at 1331 Main Street from Januarv 1904 to June 1905. (This print from Booth's Historv of Osteopathv was klndlv furnished IJv Dr. Sherwood R. Mercer). L ess ~han two years after the Un!versity of Buffalo receiv­ ed Its charter, a pnvate rnecltcal school was opened. How this was received by the regular medical pro­ fession is best explained in an edit~rial by U B's Austin Flint, as follows: Dr. Congar, whose card will be found upon the advertis­ ing pages, proposes to open a private medical school in Buf­ falo for the purpose of giving a continued, regular, and thorough course of instruction. Dr. Congar has already had some experience in giving private instruction and examina­ tions, and while he has demonstrated to himself the success of the project, he has also demonstrated to others his com­ plete qualifications for the duty. The facilities which he now offers to his pupils are extraordinary, and ought to ensure him full rooms. The amount which he proposes to charge for a year's tuition - $50, is something more than the stu­ dent pays whose duty it is to clean office, carry medicines, and collect accounts, but the amount of his acquisitions in medicine and surgery, will, we venture to affirm, be also something greater. In this way only, by entering offices where tuition is demanded, and where regular and constant instruction is given, can young men ever be made good �- ll students and prepared to practice. The $50 thus paid, is $200 earned, for the student will/earn more in one year in such an office, than he can learn in three years in the office of any man, however extensive his practice, who leaves his stu­ dent to instruct himself. 1 Flint recognized that the weakest link in the chain of en.:nts (or obstacles) leading to the M.D. degree was the three year apprenticeship. Just like professors - preceptors were either good bad or indifferent. Some medical students lived in the hom~s of their preceptors and took part in the domestic af­ fairs of their instructor's household - by greasing the cloc­ tm's carriage, feeding the horse or running errands lor his wile. Other apprentices had out-elated books placed before them - however poorly they may have been prepared to analyze them - with no instruction or recitations conducted by their respective prcceptors. 2 Flint remarked that the three years spent were "often worse than lost, for it frequently happens that he (the student) imbibes the routine errors of the practitioner, whose dogmatical maxims constitute the only lessons he receives, which, if he would afterward progress, he is com­ pelled to unlcarn ."3 In the antebellum clays, the blame for poor or inadequate medical education was directed toward the medical school - but a far greater blame rested with the private teacher who admitted pupib to his office \\.holly un­ prepared to enter the study of medicine. 45 The f(Jrmation of a private medical school was an attempt to improve apprenticeships and elevate the standards for the practice of medicine. This school did not pose a threat to the University of Buffalo because it was devoid of degree gran­ ting privileges. Furthermore, Dr. Horace M. Congar was not only a regular physician (allopathic) but also a member of the Buffalo Medical Association and the Eric Count} Medical Society. This was quite different from what some homeopathists attempted to do 30 years later. D r. Elliott Hague, ophthalmologist and bibliophile, reported that, "Around 1879 lour new medical schools were f(JunJ in Buffalo ..."6 It was most frustrating to find this article of historic import devoid of bibliographic references. Dean Julian Park [an historian ofUB] used Hague's material and said, "In 1879 four such schools (with far less exacting standa.rds than Buffalo and Niagara) had been founded; all closed w1thm five years, two by court order ... 7 Dean Park did a most inex­ cusable thing for a professional historian, he did not seek out the source of Hague's information and verify it. ~s a ~1attcr of fact, he did not e\-cn usc the correct bibliographic reference for Hague's article. The main purpose of this paper is to cor­ rect these oversights and add some ncvv matenal. In March 1879, some homeopathists received a charter under an obsolete law entitled, "An Act for the Organization and Incorporation of Benevolent, Charitable, Scientific and Missionary Societies, passed April 12th, 1848."8 The Buffalo College of Rational Medicine began its classes in. ovember 1879 on the fourth floor and part of the third m the new building on Seneca Street, opposite the post oflic~. 9 This_ac­ tion was not approved by the Homeopathic Medical Societ} of Eric County.10 In spite of this, the new college moved to Mohawk Street corner of Pearl Street. In less than th1-ec months a new charter was obtained and the name was changed to Buff~do Homeopathic College of Physicians and Surgeons. 11 Figure 1 shows its location at 19 \.\'. Mohawk Street. Beca~Jse of its location, the publit referred to it as the "l\1ohawk Mechcal College" and the press called it "The N~w S~hool". to d!stingu}sh it from "The Old School" - the Umvcrslty of Buffalo. 1 he first commencement was held on 26 February 1880, and short­ ly thereafter, the name of the college was cha1~g~d to "The Col­ lege of Physicians and Surgeons."12 Hence, It Is obvious that ~= -· --~1 Dr. Hague and Dean Park did not do their homework. The Buffalo Cify Directory for 1880 lists Dr. S.W. Wetmore as clean and professor of surgery at the College of Physicians and Surgeons. To make matters not onl1 more complicated but interesting, Dr. Wetmore graduated from the University of Buffalo in 1862, became a professional grave robber, and demonstrator of anatomy at his alma mater.13 The "New School" was under fire from two sources - one outside and the other inside its walls. The Board of Censors of the Eric County Medical Society criticized the College of Physicians and Surgeons for its unlimited and unrestricted power to grant diplomas. Well known legal ad\ isors were asked to bring this before the attention of the Attorney General of the State for an order to present the case before the proper court. 14 In spite of the college's ill repute, it did striv<; for some respectability by insisting that a thesis had to be submitted before graduation. Dr. \VR. Crumb submitted a thesis on "The Pulse" and was duly graduated with an M.D. degree. 15 Later, Dr. R.V. Pierce claimed that Dr. J.T Walton, who worked at the World's Dispensary, had authored the thesis for a fcc of $5.00 but had not been paid. 'The bcsciged College of Physicians and Surgeons declared that Crumb's thesis was null and void, that he return the diploma and his graduation fee would be returned. That is the last that we hear of Dr. Crumb - the chances arc that he joined the ranks of the quacks. The Attorney General instituted an action in the Supreme Court in Buffalo to obtain a decree that the College was not legally incorporated. The result of the suit was that the Col­ lege was clcclarccl illegal and an injunction was obtained restraining the College from proceeding with its work. The defendants filed a demure which was overruled by .Judge Barkcr.16 He also said that the college could continue as a medical school but could not grant degrees. Hence, it was pro­ posed that the College of Physicians and Surgeons should af~ filiate with Alfred University in Allegany County, N.Y., but before this connection could be completed, an old law of 1826 was unearthed prohibiting such an affiliation of medical col­ leges outside of towns in which the college was locatcd. 17 Thereafter, an act was passed by the Legislature and signed by Governor Cornell entitled ':4n Act to R~:strict the Formation of Corporations Under an Act Entitled, /1n Act to Provide for the In ­ corporation of Benevolent, Charitable, Scientific and Afis1ionmy Societies.'" It was very cunningly devised, especially the title, to awrt suspicion and help it through.18 This also provided that all degrees hcrctof(Jn' and hereafter conferred by them shall be declared valid. The defunct Buff~tlo College showed itself again by announcing itself as "ready for the fall trade." Buffalo received some unexpected legal assistance when the New York County Medical Society found that they too had an eclectic school, called The United States Medical Col ­ lege, right in their backyard. This outraged the Society to say, "This thing shall not be." The outcome was to hme the Medical College's charter declared illcgaJ.19 However, just about that time the Legislature had passed a bill that legalized certain institutions in the State that had no legal charter and confer­ red on them the right of granting diplomas. It waited for Go-.:ernor Cleveland's signature. The E1·ie County Medical Soucty drafted a strong protest which resulted in the GonT­ nor refusing to sign the bill, and therefore it !~tiled to become ~ lav\.. 20 As a final note, an injunction was obtained refrain­ mg the College of Physicians and Surgeons from graduating a class. 21 This college was not listed in the Buffalo City Direc­ tory after 1883. Up to this point, one homeop.athic college obtainecl .thrcc Illegal charters and changed Its name two tunes. A fourth BUFFALO PHYSICIAN • 11 �Buffalo Homeopathic COllege of l'hVSicians and Sun.~Bons at 19 w. Mohawk Street. ccourtesv of Buffalo and Erie Countv Historical SocletvJ. such college was dubbed by the public and press as the "Mohawk Medical College" by virtue of its location at 19 W. Mohawk Street. The so-called Hamburg Canal College re­ mains elusive. It was never listed in the Buffalo City Directory from 1879 to 1883; it was not mentioned in the proceedings of the Eric County Medical Society and not in the newspaper accounts of the court proceedings. Since Hague 6 and Park 7 have been woefully inaccurate in their documentation, could it be that Hague referred to the Seneca Street location of the Buffalo College of Rational Medicine as the "Hamburg Canal College" because of its relative proximity to that area? At the moment this is the most logical solution to the bibliographic confusion since the beginning of the Hamburg Canal Col­ lege and the Buffalo College of Rational Medicine according to Hague and Park had identical life spans, 1879 to 1884. Hence, there were not four other medical schools founded in Buffalo from 1879 to 1884, as according to HagucG and repeated by Park, 7 but one that changed its name twice and was dubbed by the public and press by two local names refer­ ring to geographic location. Hermann Sass, librarian, Buffalo and Eric County Historical Museum, had an inquiry in 1976 about the possi ­ ble existence of an osteopathic school in Buffalo. He asked me about this, but I did not know the answer until about a year later. By a stroke of luck, Dr. Sherwood R. Mercer and I were on the same program at The College of ~hysicians of Philadelphia, 12January 1977. Dr. Mercer, professor emeritus of the history of medicine and osteopathy, Philadelphia Col­ lege of Osteopathic Medicine, spoke about the history of osteopathy and about Dr. Austin Flint. This afforded the op­ portunity to learn about ost~opathy in Buffalo. After this meeting he sent me a handwntten copy of a paragr~ph from Booth's History of Osteopathy. 22 Indeed, Buffalo dtd have a School of Osteopathy in 1904. It was called the Atlantic School of Osteopathy and was located at 1331 Main Street (Fig. 2). This posed several questions: How long did this school function in Buffalo? Was its charter granted either by the 12 • BUFFALO PHYSICIAN Legislature or the Board of Regents of the U nivcrsity of the State of New York? What happened to it after it wa remO\Td from Buffalo? The New York State Education Department referred me to the New York State Osteopathic Society in Seaford, 1 .Y. Dr. Ben C. Scharf, executive secretary, referred me to Dr. Ed­ ward P. Crowell, executive director of the American Osteopathic Association in Chicago. From then on the pieces began to fall in place. According to the Association's records, the Atlantic School of Osteopathy was founded in Wilkes­ Barre, Pa., in 1899. The college received its charter from the State of New Jersey. In 1904 it was moved to Buffalo in order to secure the greater advantages of a large city. It remained there until June 1905 when it was consolidated with the American School of Osteopathy in Kirksville, Missouri. Finally, just think that if Dr. Hague and Dean Park had done their homework, I would have been deprived the thrill of discovery. • FOOTNOTES I. Ed1tonal. Buffalo Med1ca/ J. 3 . 501-502, 1848 Z. W1Iham Fredenck Norwood. Medical EducatiOn m the Umted States Be/ore the C1v11 War, Ph1ladelph1a, Umv Penn Press. 1944 3. Flint, A. Ed1tona1 - Med1cal Reform. Buffalo Med. J. 1. 249-253, 1846 4. Ed1tonal Medical Reform and Pnvate Instructors Ibid 8: 122·124, 1852 5. Coventry. C B. Remarks on the self-reformation of the med1cal profesSIOn lb1d 5. 575-585, 1850. 8. Hague. E Development of med1cal education 1n Western New York. Particularly in Buffalo NY State J. Med 55: 3311-17. 1955 7. Park, J Med1c1ne starts the Un1vers1ty Pubs Buffalo and Efle Co H1st Soc. 8 48-58. t961 8. Editonal - Hahnemann's DISCiples Buffalo Express 3 March. 1879 8. Hahnemann's DISCiples Buffalo Express 31 March t879. 10. Homeopathic Action. lb1d. 9 May 1879 11. Ed1tonal - Buffalo College of Phys1c1ans and Surgeons, Buffalo Med. J N S 21. 89-90, 1881 1Z. The New School Buffalo Express, 27 February 1880 13. Jones. O.P Confessions of Three Grave Robbers Buffalo Phys1c1an 15: No.2. 12-19, 1981. 14. Sem1-Annual Meetmg of the Ene County Med1cal Soc1ety /b1d N.S 20: 562-64. 1881. 15. Dr Crumb's Thes1s Buffalo Express 23 Apnl 1881 11. Hon. Gregory Barker, DeCISIOn of Supreme Court Regard1ng the Legality of the Charter of the College ol Phys1c1ans and Surgeons of Buffalo. Buffalo Med J N S 21 · 49-60, 1881 17. Med1cal Departments Buffalo Express 20 February 1882; 25 February 1882; 15 March 1882. 22 March 1882. 18. Med1ca1 Colleges. Ibid. 2 July 1882 18. Disturbed Doctors. lb1d tO March 1883 ZO. Soc1ety Reports Buffalo Med. J N S 23.· 363-367, 1887 Zl. No Commencement Today. Buffalo Mornmg Express 8 June 1883 Zl. E R Booth History of Osteopathy and Twentieth-Century MediCal PractiCe. (C1nc1nnat1, Caxton Press, t905) pp 92-93 J �Nuclear holocaust Concerned physicians group feels the best medical survival plan is to preclude the need for any T J he spectre of nuclear war frightens people in every na­ tion. But probably no group is, or should be, more concerned about what happens after the missiles explode than the medical community. They will play an integral role in the picking up and glueing back together of the remaining pieces of human civilization. However, unlike the engineers who must rebuild the physical world or the bureaucrats who must try to restore law and order, medical professionals are faced with a peculiar situation. Their talents and knowledge will be most demand­ ed and will be demanded immediately. Very likely, doctors and nurses will be in short supply. Yet as the arms build-up continues to escalate, there is a growing concern among doc­ tors that any realistic medical nuclear disaster aid plan must preclude the need for any such plan at all. An expanding number of physicians are turning their energies toward preven­ ting nuclear holocaust rather than preparing for its aftermath. A result of this burgeoning anti-nuclear movement among medical professionals is Physicians for Social Responsibility (PSR), a Boston-based national organization "dedicated to the professional and public education on the hazards of nuclear weapons and nuclear war." The group recently endorsed a bilateral arms freeze as the "first step" in total nuclear weapons reduction. PSR was formed in 1961 by a group of Boston physicians who questioned the medical advisability of testing nuclear weapons in the atmosphere as well as the lack of available data on the biological consequences of a nuclear war. But after the 1963 signing of the Comprehensive Test Ban Treaty, in which PSR was credited as playing a major role in developing public awareness of the dangers of atmospheric explosions, PSR's organizing power began to wane and fell dormant until 1979, when another group of Boston physicians resurected the organization, this time in response to the perceived hazards of nuclear power and war. Shortly after its resurrection, the Three Mile Island incident grabbed the headlines and PSR membership began to soar. Currently, PSR has over 25,000 members and 110 chapters across the U.S. and an Advisory Board consisting of such medical notables as Robert Jay Lifton, H. Jack Geiger, a~d Jona E. Salk. Beginning in 1980, the PSR returned to Its original educational role by sponsoring a series of symposia on major American and Canadian college campuses concerned with "the medical consequences of nuclear war and nuclear weapons." The lecture approach was so successful it has been repeated and updated since its Harvard prem iere, and other campuses have played host to local chapter-inspired symposia over the past two years. Last spring, the UB Medical School hosted the Western ew York chapter's own seminar series on "Health Professionals in the Nuclear Weapons Era," which was repeated and expanded, this February, under the guidance of chapter president Tim Byers, UB assistant professor of sooal and preventive medicine and assistant research pr?fessor _of ex­ perimental pathology at Roswell Park Memonal Institute. Following are capsulized reports from those symposia held in Farber Hall of the Medical School. They were compiled by Linda Grace-Kobas, Mary Kunz, and John K. Lapiana. Nuclear Winter/ Nuclear Summer S urviving a nuclear holocaust is no easy task. If you are fortunate enough not to be instantaneously dematerialized, then the problem of side stepping powerful heat blasts as hot as the Sun's surface and avoiding looking at light flashes so intense as to explode the beholder's eyes still exists. After the immediate destructive consequences, any survivors would have to scavenge food and water in a contaminated world. Until recently such a scenario was thought catastrophic but, in a macabre way, somewhat survivable. However, scientists now believe the most destruc­ tive after-effect of nuclear war will not be what civil defense authorities have planned against for the past 39 years, but something physicists stumbled upon only last year - the nuclear winter. Soon after the last missile hits its target, explained Jonathan Reichert, UB profe sor of physics and astronomy, the effects of the nuclear winter will be realized. Temperatures could dip as much as 80 degrees in the aftermath of a "small war" in which only one-third of the superpowers' nuclear arsenals were launched, Reichert said at the first ses­ sion of the four-part PSR lecture series at UB. Photo of Hiroshima 11/C· tim showing "Kimono Effect" burn patterns caused bv nuclear blast. BUFFALO PHYSICIAN • 13 �-- ,, "The temperature will stay down for at least a few weeks," Reichert said. "That will be a crucial time for human survival." Reichert foresees additional problems if the war occurs during the summer, since the only clothes victims would have access to would be the light garments worn when the bombs explod­ ed. In addition, he noted, little, if any, fuel or electricity would be available for heating the shelters victims take refuge in. A substantial percentage of the sur­ vivors would not only die from radia­ tion's long range effects but could also succumb to the cold, Reichert predicted, adding that the nuclear winter would be more severe if the war were larger than his "limited" theoretical example. "In a big war, the nuclear winter could last months;' he said. "The sum­ mer temperatures would go down as low as 50 or 60 degrees below zero." Accor­ ding to recent research, Reichert add­ ed, few, if any, locations exist where the nuclear winter's deadly effects could be escaped. A nuclear winter's fuel would be pro­ vided by firestorms caused by the bomb's intense heat blasts. Such infer­ nos, Reichert conceded, "were missed by scientists for a long time;' who instead centered research on the after-effects of radioactivity and the bomb's destructive value. In addition to the rapid temperature drop and the possibility of "subzero readings in the middle ofjuly;' Reichert noted that the cold would most likely kill any surviving crops and prevent the sowing of new plants. Animal life, too, could be permanently upset. "The food chain;' he said, "would be severely disrupted." Whatever life survived the nuclear winter would then have to conquer what Fred Snell, UB professor_of biophysical sciences, called "the nuclear summer, the time when things get really hot." Such a "season" consists of constant clays of unbearably high temperatures resulting from the absence of the earth's protective ozone layer, which would be a casualty of the bombs' radiation. Without the ozone filtering the sun's rays and buffering the surface from scorching temperatures, Snell predicted daily temperatures would consistently hover well over 100 degrees. However, Snell warned that the loss of the ozone's ray-filtering effect would probably cause the most damage. "The unfiltered ultra­ violet rays would kill most plants and blind many an imals;' he said , adding that humans, too, would be in danger of losing their sight and would risk a hi gher probability of contracting skin cancer. 14 • BUFFALO PHYSICIAN Surviving World War III, Reichert concludes, is relatively impossible, whether you li ve in downtown Washington, D.C. or on the Canadian tundra. "It's not bad enough to be wor­ ried about being killed with heat, radia­ tion, and flying debris," he said, "but we will also be hit with severe temperatures and ultra-violet rays. The concept of the nuclear winter makes the picture all the more horrible." Snell, a former Army M.D., also discussed the medical consequences of a nuclear explosion, recalling his tour of duty surveying the biological damage caused by the first atomic bomb explo­ sion in Hiroshima, Japan . Although he visited the city 15 months after the historic detonation, Snell said little had changed since August 6, 1945. "Being in Hiroshima was a moving experience;' he recalled. "I wasn't sur­ prised with what I saw - the city was destroyed. "There was no rebuilding, the Red Cross Hospital was full of patients;' he said. "They were in the hallways, they were everywhere." While cataloging the patients, Snell said he became familiar with the three distinctive types of radiation effects. The immediately felt effects result in injuries that arc "too revolting;' he said. "There is severe burning and charring of the skin. Some of the burns were so intense that if a person was wearing different colored clothing, the pattern would be left behind as a scar." "Kimono Scars;' in which the intricate pattern of the tradi tiona] Japanese garb was etched onto the skin of the wearer, were frequent medical sights, Snell said. He also noted cases in which radiation caused victims' eyes to first expand and then "explode" inside the skull. Radiation's delayed effects, Snell noted, arc primarily manifest in the form of radiation sickness, "which gets worse and worse." The disease's first symptoms are diarrhea and vomiting, the result of radiation "burning out" the lining of the intestinal tract. Soon, he explained, purplish spots appear under the skin and hair begins to fall out. Open wounds will not heal because, Snell said, the body's immunological system has ceased to function. The pa­ tient is then, much like a victim of AIDS, at the mercy of any infection or disease. After six months, Snell noted, radia­ tion's long term effects begin to emerge. Pregnancies end in still births or abnor­ mal chi ldren, and other radiation­ inspired maladies arc fostered. But, he added, "we have no evidence so far" that radiation, for the Hiroshima survivors - - at least, has caused any genet ic mutations. While second generation studies arc currently being administered, Snell said he learned more than just practical medical knowledge while stationed in the decimated city. "What we must really do;' he said , "is to get together a strategy to ensure that (Hiroshima) wi!l never happen again." They'll forward your mail F or nuclear strategists, it presented an attractive scenario: days or even weeks before Soviet and U.S. leaders ac­ tually had to push the buttons launch ing the swarms of warheads that would turn most cities in the two nation into heaps of radioactive ash, major American cities would be evacuated in an orderly manner accord ing to previously design­ ed mass evacuation - or crisis reloca­ tion - plans. In 1980, President Reagan approved a seven-year, $4.2 billion program that called for relocating up to two-thirds of the American public in case of immi­ nent threat of nuclear war. ' l(> be ad­ ministered by the Federal Emergency Management Agency (FEMA), the plan called for herding masses of city dwellers into rural "host areas;' where they could presumably wait out the attack and, after the fallout abated, return home. The crisis relocation plans met with mass derision . Time magazine ridicul­ ed FEMA's plan to issue "emergency change-of-address cards" to the millions of people who would be relocated. Syn­ dicated columnist Ellen Goodman quoted Tom Halstead of Physicians for Social Responsibility as commenting that to evacuate urban populations you must have "I) clays of warning, 2) recep­ tive host commun ities, 3) a docile and cooperative evacuation population, 4) nice weather, and 5) cooperative enemies." Crisis relocation plans have since been put on hold in many states, New York included, and are being replaced with general all-purpose disaster plan­ ning and preparedness. Richard Herskowitz, director of disaster preparedness planning for New York State, appearing in the second lec­ ture on nuclear issues, said that adverse public opinion caused the state's own crisis relocation plan to be shelved in the last year. So definite was the change in direc­ tion from crisis relocation to general disaster planning, that even the massive state bureaucracy responded by chang- - �ing Herskowitz' title and duties. "The full operational plan for crisis relocation has been basically shelved," Herskowitz said. "We're sticking with the evacuation plan and general pre­ paredness for man-made disasters. Basically what's left of the civil defense plan i a generic evacuation plan, the fallout shelter survey program, and a preparedness program to plan, for ex­ ample, how to distribute food in certain areas during disasters." Herskowitz did not agree with the no­ tion that crisis relocation planning was bad, a premise shared by most members of the audience and his partner in the program, UB Psychologist orman Solkoff, who analyzed anxiety and paranoia and described how people deny their nuclear terrors. Solkoff call­ ed active civil planning for nuclear war a "nice seduction - you offer hope, but no real protection." Herskowitz countered that while his critics say there is no usc to plan for survival in a nuclear war, there is no real way of knowing whether such an event is or is not survivable and that doing away with such planning "would eliminate some possible direction for survival, insufficient as it is." He added, "The smaller the attack, the greater the effect of preparedness would be. The greater the attack, the smaller the effect of preparedness." A debate arose over whether an evacuation of American and/or Soviet cities could be initiated as a political tac­ tic to force the other side to the negotiating table, and whether, if under­ taken, could backfire by leading the other side to think that the evacuating nation was ready to fire its missiles. Herskowitz said he docs not believe any president would "frivolously" order an evacuation of cities but that such a movement might force the other side to reconsider its initial plans. Solkoff pointed out a deadly Catch-22: "If you started an evacuation too soon, the other side may attack as a preemptive strategy. If too late, you're dead." Solkoff, in his prepared address, noted that the U.S. and Soviet nion can fire at a single launching 12,000 warheads of 340 megatons, or 170 times each the yield of the first Hiroshima bomb. Physicist Carl Sagan has calculated that no more than 2,500 of these warheads exploding could initiate a long "nuclear winter" in which the Earth would be shrouded in darkness and icc. (Herskowitz' response: "Who made Carl Sagan the expert of everything?") Solkoff recommended, "We should confront our anxieties (about nuclear war). Only then will we be able to act to avoid a future final holocaust." Is it already too late? T imc is running out for nuclear dis­ armament, James Mang, the direc­ tor of the Western cw York Peace Center argued during his presentation in the series. Mang outlined the storied history of the disarmament or arms control move­ ment, warning that not enough progress is occurring to prevent nuclear war in the near future. "Presently, little has been happening in serious arms control negotiations;' Mang noted. "Although there are some possibilities existing which should be further explored." Heading the parade, he said, arc the flawed START talks, which "while seen as simply a means to give the notion of arms talks;' still allow the superpowers to continue mass-producing weapons. START talks, Mang explained, deal only with old, already operative wea­ pons, not with new, potentially more destructive arms which may legitimately be built as the disarmament discussions continue. Mang blamed the U.S. administra­ tion for the failure o( the Comprehen­ sive Test Ban Treaty conferences, which were "progressing fairly well" until Ronald Reagan c>ssumed the Presidency in 1981. The talks' most important fac­ tor, Mang stressed, was that the United States and Great Britain had finally ca­ joled the Soviet Union into allowing on­ site inspections of its nuclear facilities, "a very considerable concession;' Mang said, for the Russians. However, "the ad­ vent of the Reagan Administration stop­ ped any further negotiation" at the pro­ mising sessions, Mang noted, stressing that "getting back to the table on the Comprehensive Test Ban Treaty will be construed as an important first step towards other, more comprehensive, talks." Those "other talks;' Mang added, should include a "no first-use treaty" signed by every nuclear nation, a bilateral freeze on future weapons pro­ duction and a complete disarmament. Some progress toward a "no first-usc treaty" was accomplished, Mang ex­ plained; however the United States has yet to match the Soviet commitment to the concept. "The USSR has stated it will not usc nuclear weapons first," he said. "But the U.S. refuses to make that commitment." Still, the discussions arc, he continued, "helping to create a bet- ''If you started to evacuate too soon, the other side might attack as a preemptive strategy; it vou waited too long, though, vou could be dead!' BUFFALO PHYSICIAN • 15 �ter atmosphere for disarmament." ew emphases are being given to a bilateral freeze on arms production by the United States and the Soviet Union. Although talks between the two nations on the subject have yet to be formally broached, Mang noticed that support for the concept is being garnered from some more "non-traditional" sources. "The concept of a bilateral freeze has great significance in the world;' he said. "For the past two years the General Assembly of the United Nations has voted in favor of a freeze, with morena­ tions assenting to the call each year than the year before." At last count, he add­ ed, 119 nations had agreed to the UN­ inspired freeze asked for by the Mexican delegation. The freeze's general acceptability, ac­ cording to the polls, affords Americans a unique opportunity in an election year, Mang said, because candidates can be quizzed on specific aspects of arms control before votes arc cast. In addition to calling on them to pressure Presidential candidates to take anti­ nuclear stances, Mang advised the au~ dience to also explore Congressional avenues for arms control action. "We should ask Presidential candidates to call for a nuclear freeze;' he said, "but w~ can also ask Congress to begin en­ acting parts of a freeze rather than waiting for a President to do something." Gaining momentum in Europe, Mang explained, is the European Dis­ armament Movement (EDM), a group calling for a "combination of a freeze and the withdrawal of nuclear weapons from foreign territorY:' The EDM was instrumental in recent protests over deployment of Pershing II missiles in West Germany and Cruise missiles in Great Britain. "The movement's reason­ ing in continuing to fight against nuclear weapons," Mang said, is because "missiles like the Cruise and Pershing II have already been deployed on Euro­ pean soil, and there is little doubt that the build-up will continue!' However, despite the seemingly favorable attitude for either disarma­ ment or a freeze flourishing in many na­ tions, Mang said the world remains precariously close to destruction. "American-Soviet relations are at a tru­ ly disastrous point;' he assessed, "and the manufacturing of nuclear weapons is being accelerated. "The arms race is becoming more frightful not just because of more weapons being produced, but because of the kinds of weapons being developed and deployed - like the MX, the Tri­ dent missile, and the SS-20;' he said. "These are the kinds of weapons which 16 • BUFFALO PHYSICIAN will make arms control very difficult and hard to verify." The continuing build-up of difficult to document arms in a global climate of disarmament, Mang said, reflects "the attitudes of the governments who control these weapons - the mentality . war." IS A race to oblivion A re we winning the nuclear arms race, or is the USSR? Has the Reagan administration taken the right attitude toward nuclear arms and the threat of a nuclear war? If a nuclear war occurs, will it be controllable? These questions and others were discussed in another session. The lecture featured Walter Simpson, UB energy conserva­ tion officer, and Dr. Jerome Slater, UB professor of political science. Speaking on "Weapons Delivery Systems and the Strategic Balance;' Simpson argued that "the U.S. is not behind" in the nuclear arms race. everthcless, he pointed out, "something is completely meaningless about the concept of nuclear superior­ ity - both sides have so much!' Nuclear strength, Simpson explain­ ed, can be measured in a number of ways. In some respects, the USSR is ahead of the U.S. Simpson explained that the Soviets possess a greater number of ICBMs (Inter-continental Ballistic Missiles) and launchers than are owned by the U.S. He added , however, that these superior numbers do not necessarily mean that the USSR is at an advantage. "The U.S. has 10,350 warheads, each capable of destroying a mid-size city;' he noted. "The USSR has only 8,000!' In other respects, too, the U.S. leads the USSR. American technology, Simpson implied, is far ahead of Soviet technology. The U.S. has produced weapons that are more accurate and more quickly launched. In addition, Simpson said, U.S. weapons are 10 per cent more likely to function properly than are Soviet weapons. Another important factor, Simpson pointed out, is survivability. "Can your forces withstand attack?" he questioned. "This question is an in­ credible deterrent. In this respect, the U.S. has the edge." ew weapons, though, and dizzying advances in technology make nuclear superiority more and more difficult to estimate. Cruise weapons, launched in various ways, are not detectable by satellite, and might, Simpson said, represent the end of arms control. The new Pershing II missile, possessing a 100 ft. accuracy range, can carry the force of at least a Hiroshima-sized bomb. Of 18 tests of the Pershing II missile, Simpson noted, five were failures. This error ratio, though, is hardly reassuring to the Soviets. Counterforce strategy, Slater explain­ ed, consists of two parts - first, an ef­ fort to find a way to make deterrents more credible, and second, to find a way to make nuclear weapons more actual­ ly usable, should it be necessary. Current counterforce strategy dic­ tates that the U.S. is "not targeting USSR cities or population;' Slater noted, "but military targets - bases, missiles, ports, heavy industry, etc. Some nuclear weapons, though, are kept in reserve to destroy their cities in case they destroy ours!' In the last decade, Slater said, "American weapons have been aimed overwhelmingly at military targets. Our weapons have improved accuracy - the strategy seems more plausible." U.S. strategy, Slater explained, focuses on destroying the Soviet power structure, while protecting ours, so the U.S. Presi­ dent could, conceivably, carry on pro­ tracted nuclear war. At all times, the U.S. has a total of 30,000 nuclear weapons. In the next five years, the Reagan administration plans to add more - including increased numbers of the Trident II missile and a force of 10,000 Cruise missiles, to be operational by the early 1990's. This counterforce strategy, Slater warned, might not be as wise as it seems at first glance. "It sounds good;' Slater said. "It sounds very seductive. However, the closer you look at it, the worse it is." The strategy, the professor suggested, is "based on a simplistic view of the USSR!' The U.S. assumes that the Soviet government is inhuman, and that the threat of destruction to their military bases and power structure might deter them more than the possibility of the annihilation of their cities and civilian population. This belief, Slater implied, is without substantial evidence. Worse, however, is a more harmful idea counterforce policy seems to sup­ port - specifically, that nuclear war is "controllable." Slater called such a belief an "illusion;' and warned against its acceptance. ''Anything that increases that notion increases the risk that some day a government might decide to start a nuclear war;' he speculated, "and the idea that you're going to save more lives (by targeting military operations and not cities) could be wholly wrong - the confusion could be so great." • �Research- New drug Aids stroke treatment U By Bruce S. Kershner B researchers have discovered a new drug that will now allow safer, less costly and often more accurate diagnosis and management of stroke and other brain diseases. The chemical referred to as I 123 HIPDM, is designed for usc in the diagnostic brain-imaging technique call­ ed single-photon emission tomography (SPECT). Labeled with radioactive iodine, the diamine tracer compound has been pro­ ven effective in mapping bl_ood fl?w (perfusion) in the brains of patients with diseases that constrict or obstruct blood flow to the brain. These diseases include stroke, brain tumors, epilepsy, senile dementia and other ischemic cerebro­ vascular diseases. The great value of SPECT devices in diagnosing brain diseases sparked con­ siderable interest in new and better brain-imaging agents, especially those Dr. Kung reads SPECT scan. with high initial brain localization and prolonged retention. Hank Kung, Ph.D., and his associates worked four years to develop their new drug. Kung is an associate professor in the Depart­ ment of Nuclear Medicine. Because it was proven safe for human use, HIPD 1 is now regulated as an in­ vestigative drug under FDA's new drug approval process. One of the latest steps in the new drug's history is recent transfer of the rights of HIPDM by the SUNY Re­ search Foundation to a pharmaceutical company which plans to sell it to hospitals for stroke diagnosis. Besides HIPDM's pmven diagnostic effectiveness, it is actually more accurate in some circumstances than CAT scans and angiography. Its medical significance also lies in its other advan­ tages. Not only have earlier studies demonstrated its safety, but HIPDM, because of its less concentrated dosage, poses less of a risk of allergic reaction than the more concentrated doses of contrast media used in CAT scans. Several characteristics of HIPDM contribute to its relative inexpensiveness and ease of manufacture, important considerations at this time of rising medical costs. First, radioactive labell­ ing of the base compound docs not re­ quire extensive (and expensive) heating and purification. Instead, it is radio­ labelled by a fast and simple exchange reaction. The result is a product that is 97 per cent pure and virtually ready for clinical usc. Second, previously discovered effec­ tive brain-imaging agents that use radioactive fluorine, nitrogen or oxygen in positron emission tomographic (PET) imaging cannot be used in routine nuclear medicine clinics. This is because the short life of these chemicals and their complex chemical synthesis require an expensive on-site cyclotron. The SPECT. devices in which HIPDM would be used cost 36 per cent less ($225 vs. $350) to operate than the more common CAT scans. Since this figure is a nationwide average, higher and lower costs exist in some locations. "HIPDM provides a simple and effi­ cient technique as a routine nuclear medicine procedure to measure regional brain perfusion;' Dr. Kung comments, "and measuring regional brain perfusion has never been simple or efficient." The research was funded by a Veterans Administration grant of $25,000 and a UB Foundation/Depart­ ment of Nuclear Medicine grant of $100,000. Besides Kung, Dr. Monte Blau, formerly on the UB faculty, Dr. Jehuda Steinbach, clinical associate pro­ fessor in nuclear medicine, and Dr. Kenneth Tramposch also assisted. While HIPDM's effectiveness is re­ lated to its high brain uptake (especially its concentration in the gray matter of the brain), it works according to a very different mechanism than that of previous brain-imaging agents. Many of the radioactively labelled monoamincs, such as IMP, concentrate in the brain because of their lipid solubility and their affinity to "nonspecific high capacity" binding sites in brain cells. In contrast, Dr. Kung and his associates have developed a new class of gamma-emitting brain-imaging diamincs. These compounds take ad­ vantage of the "pH shift;' i.e., the pH gradient that exists between blood (pH of 7.4) and brain (intracellular pH of 7.0). They can diffuse freely into cells at high pH because they arc neutral and lipid soluble, while at lower pH, they become charged and can no longer dif­ fuse out. Six or so medical centers have now begun using 1-123 HIPDM, but Dr. Kung is confident that it will be in usc by 10 to 20 centers within several years. • BUFFALO PHYSICIAN • 17 �Transplant ""~ Hope for CF victims? g T I 0.. he world's first known heart-lung transplant to be conducted on a cystic fibrosis patient took place recently due to the efforts of UB pro­ fessor of pediatrics Dr. Gerd Cropp. The 25-year-old patient, whose heart and lung had been damaged by the disease, had been carefully selected and waited six months before a donor could be found. Richard Dinsbier; the patient, and Dr. Cropp had only four hours to fly to Pittsburgh where the operation was performed. "Any statements about the effects of the unusual operation on the propects of other cystic fibrosis (CF) patients would be premature:' Dr. Cropp stated. While the patient ultimately died of complications of transplant surgery, the operation is as important to CF victims as the first heart transplant in 1967, or the first artificial heart transplant io 1983. In both of these historic cases, the patients ultimately died but the knowledge gained was invaluable for subsequent and more successful attempts. ' "There is no question we have obtain­ ed a great deal of valuable information from this operation. The next time we do it, it will be safer and the chances of success will improve. In any case, such operations will always be very serious and at this time are only a last resort," Dr. Cropp commented. Cystic fibrosis is a genetic disorder that leads to clogging of small tubes from the glands that secrete mucus and other fluids. This can make the lungs susceptible to infection, damage the digestive system and eventually weaken the heart. Believed to occur once in every 2000 births, the disease has attack­ ed some 30,000 Americans. In an attempt to reduce the chance that the patient's body would reject the transplanted organs, he was given the experimental drug cyclosporine. Just tentatively approved for special applica­ tions by the Food and Drug Administra­ tion, the drug suppresses the body's natural rejection of foreign cells. While Mr. Dinsbier did not reject his new organs while he remained alive, his im ­ munosuppression left his system vulnerable and he died of cytomegalovirus and systemic yeast in­ fection, coupled with acute terminal bronchopneumonia. Dr. Cropp remains encouraged however. This kind of operation "may of- 18 • BUFFALO PHYSICIAN 0 z 0 .) Dr. Cropp fer a final attempt at therapy that, if suc­ cessful, may add many years oflongevity to these patients;' the UB professor said. "With even better drugs in the future, ~ore optimal preparation of the pa­ tients and more experience with their P?stoperative management, this could g1ve some a second lease on life." This. therapeutic approach may answer Important questions with regard to genetic control of the bodily function in this disease. If the transplanted lung does not become infected, it would sug­ gest. that th~ v.ulnerability of the lung in cystic fibrosis IS controlled by the genetic endowment of each cell. However, if the lung gradually assumes the abnormal­ ~tY: u~ually seen in cystic fibrosis, then It Is likely that the function of the cells in the lung is controlled by some hu­ moral factor which is produced somewhere in the body," Cropp explamed. According to Dr. Robert Beall na­ tional director of the Cystic Fibrosis Foundation, the surgery would provide researchers with new information not only on a new method to treat the disease, but also on the nature of how it attacks the body. Although both the patient and his physician were from the Buffalo area the tran~plant took place in Pittsburgh because It has the team m the U.S. with the greates~ exp~rience in heart-lung transplants m patients with lung disease. Besides being a professor of pediatrics, Dr. Cropp is also an assistant professor of physiology and director of the Children's Lung and Cystic Fibrosis Center at Children's Hospital. • Stroke New procedures lower risk after heart surgery A By Bruce S. Kershner n 80 to 87 per cent reduction in the chance of stroke triggered by heart surgery now appears possible because of the research of Dr. Samuel C. Balderman. Stroke is one of the common com­ plications resulting from cardiac surgery, affecting as many as 4000 peo­ ple annually, according to Dr. Balder­ man. A UB associate professor of car­ diothoracic surgery at the Veterans Ad­ ministration Medical Center and Erie County Medical Center, he has suc­ ceeded in reducing the percentage of pa­ tients who have strokes following heart surgery from the current 2 to 3 per cent average to 0.4 per cent. "I know of no one else that has reported an incidence that low;' he stresses. . Increasing longevity is not the only a1m of heart surgery. "You want patients not just to live longer, but also to live better;' Dr. Balderman says. Although the lives of nine out of ten patients who undergo heart surgery do improve, one out. of ten remains unimproved or ex­ pcncnces complications that reduce the quality of his or her life. Patients with complications due to stroke comprise 20 to 30 per cent of this category. Stroke results when blood supply to parts ~f the brain is reduced or suddenly cut off. When that occurs loss of brain functio.n o.ften results', including paralysis, blmclncss, loss of speech, loss �Research- J of balance, or other debilitating consequences. Not only does Dr. Balderman's new technique prevent strokes, it ac­ complishes this by sparing the patient much of the discomfort, risk and cost of medical and surgical examinations. "The test takes only three minutes," he notes. on-invasive techniques can identify those patients who arc prone to stroke. Because the examinations arc non­ invasive, that is, they do not require entering the body, physical discomfort and medical risks are essentially absent. unstable cardiac conditions. The advantage of Dr. Balderman's combined tests is that the traditional stethoscope exam is less accurate by itself and detects only about half of the arterial obstructions. In addition, the stethoscope test, unlike OPG, cannot differentiate patients with significant blockage requiring surgical correction from those with medically insignificant blockages. Because of this, all patients previously detected with bruits under­ go the cerebral angiography, which is physically uncomfortable, costly and has some medical risk. With the combined tests, only 9 of 32 patients now need to undergo the angiography; the OPG demonstrates that the arterial obstruc­ tions of the remaining patients are insignificant. T he first technique, oscultation, is a stethoscope exam of the carotid arteries located on the sides of the neck which c~rry blood to the brain and eyes. With the stethoscope, he listens for irregular sounds of blood circulation, called bruits that indicate some kmd of obstruction in the blood vessel. A bruit is recognized as a turbulence or "swooshing" of the blood, much like the sound a brook makes as it flows around protruding rocks. This technique has been used traditionally for many years. Dr. Balderman has found that a se­ cond technique, called ocular plethysmography (OPG), which measures the blood pressure in the op­ thalmic arteries, is useful in determin­ ing the presence of obstruction of the carotid artery. The ophthalmic arteries carry blood to the eyes from the carotid arteries. Used several days before surgery, this technique calls for the sclerae of the eyes to be anesthetized with special drops and cups placed over the eyes. These cups measure the intra­ ocular pressure in a way similar to that done in glaucoma tests. If the pressure is either low or unequal, arterial blockage is indicated. Specifically, a dif­ ference between the right and left eyes of 5 mm. of mercurv or more, or an eye to arm blood prcss~re r-atio of less than 0.69, differentiates those patients who have medically significant bruits and those who do not. After the patients with arterial obstructions have been singled out by the two techniques, they undergo a third evaluation called cerebral angiography. For this test, dye is injected into the carotid arteries and X-ray studies reveal the exact location of any significant blockages. The blockages arc then removed by a surgical operation. Per­ formed 10 to 14 days before heart surgery, the obstruction is surgically removed from the artery. Dr. Balderman adds that the procedure can also be per­ formed at the same time as the open heart surgery for those patients with 0 f the 500 patients that Dr. Balder­ man has screened over the last three years, he has identified 17 as having arterial obstructions. Because of him, 16 of the 17 patients had successful heart surgery without associated stroke. For them, both longevity and quality of li fc were improved. "However;' Dr. Balderman empha­ sizes, "no medical advancement is ever 100 per cent successful." One patient with no sign of a blockage and another with an apparently insignificant blockage, still experienced strokes related to their cardiac surgery. He is not clear why, but suspects that one had a very small blockage that couldn't be discovered. Dr. Balderman points out that in ad­ dition to the reduction in pain and suf­ fering, the prevention of stroke results in considerable monetary savings to society. While open heart surgery costs $15,000, a stroke can cost up to several hundred thousand dollars. His stroke­ preventing evaluations are administered free in Veterans Hospital and cost only $25 elsewhere. That means that the non-invasive techniques used to screen a total of 500 patients for stroke­ proneness cost no more than a fraction of the medical costs to treat a single stroke patient. After publishing his research in the journal of Thoracic and Cardiovascular Surgery last March, he has received a world-wide response from the medical community, including the Soviet bloc. The Veterans Hospital, Dr. Balder­ man says, is the only major facility that he knows of that is routinely screening candidates for cardiac surgery using OPG. Because of the great interest in his work, he expects the procedure to be adopted in many other hospitals soon. Dr. Baldcrman points out that the cooperation of Dr. Irineo Gutierrez and other colleagues, as well as the support of the Veterans Administration and the American Heart Association, were im­ portant to his research over the last three years. Dr. Ba/derman "'~ 0 z b 0I Q. BUFFALO PHYSICIAN • 19 �.:.: -~· .. . .,-? ·''"..( -# ... _ .... , . . . ~.""'--.* .' • •. •.. t ...... Dr. Balderman is pioneering other medical advances in cardiac surgery as well. He has determined the proper, crucial heart temperature to maintain during open heart surgery to pre\-cnt deterioration and damage. Until this June, when he published his research in the Annals of Thoracic Su~r;cry, the optimal temperature range to preserve the heart was not as clearly known. Earlier theories ranged from. 4-20°C. As a result of his research with dogs, we nO\\ know that J40C is ideal. During heart surgerv, doctors must stop the heart by cla'mp.ing the aorta to cut off the blood supply. "After 20 minutes the hcan begins to die without oxygen.' \\'e must s'ubjcct it to cold temperatures (hypothermia) to prevent damage to the heart," Baldcrman explains. To determine the ideal cold temperature, Dr. Baldennan performed tests and biopsies on the dogs' hearts and conrludcd that temperatures of 14-J80C preserved the heart best. More than J80C was too warm and less than J40C produced potential damage and few if anv benefits. lo cool the. heart, a modified saline solution containing potassium chilled to 40C is injected into it. This results in both chcr;1ical arrest and in preservation of the heart. To keep the heart cool, the solution is injected every 20 minutes un­ til the surgery is completed. The safe period of surgery can, when necessary, be extended up to three hours. 'lo refine the method further, Dr. Halderman is conducting more research on the best type of solution to inject in­ to the heart so that he can minimize the deterioration that can still occur during heart stoppage. With American Heart Association support, he is experimen­ ting vvith the addition of calcium­ blo~king agents to the solution. Right now, he is comparing and evaluating three calcium-blockers to sec which works best. His lab was one of the first to publish results showing that the calcium-blocker, verapamil, was beneficial during cardiac surgery. • Imaging Reduces need for surgery in testicular diseases S urgery may no longer be needed to diagnose a wide range of testicular di­ seases and problems because ra­ dionuclidc imaging has been demonstrated to be a safe and highly accurate substitute for diagnosing these problems. This finding 20 • BUFFALO PHYSICIAN .,. . . ... .·. ... (": . r.··· ... ~-=-~_ .~:..· 4. , ••• ~ -\ ... .. \ . ' . . . . ,r .. ' • .:a: .. ... t .. •• ·, -· . .r -. ·.. .. Testicular scan showing abnormal space occuiJYing lesion on left testicle. (Inset} Dr. Sutrin (left} and Dr. varma. resulted from a study by Dr. Jay Varma and Dr. Gerald Sufrin of the UB School of Medicine. Dr. Sufrin is chairman and pro­ essor of the Department of Urology; Dr. Var­ ma is clinical assistant instructor in urology. Dr. Sufrin wants to call attention to the simple, sate and inexpensiw technique to en­ courage its use. Because of its non-invasive nature, "it can be done in any hospital," Sufrin pointed out. The simple technique can accurately dif­ ferentiate, l(>r example, epididymitis from torsion of the spermatiL cord, two conditions heretofore notoriously hard to diagnose ex­ cept through surgery. Epididymitis, an in­ flammation of the cord-like structure along the testis, can cause infertility, high fever and sickness. Torsion, a severe twisting and con­ striction of the spermatic cord, can also cause infertility and death of the testicle. Both diseases are not uncommon in young men. "Out of the 109 cases we have studied so far, the radionuclide scan was 96 per cent ac­ curate in coming to a diagnosis for a wide range of testicular problems, including tor­ sion, epididymitis, tumors and abscesses,'' Dr. Varma commented in an interview with Urology Times. The radionuclide 1cchnetium-991\1 pertechnetate "is first injected into the vein in the patient's arm,'' Dr. Sufrin explained. After it has circulated through the body, a gamma camera is passed over the patient's scrotal region. This device rewrds on film the amount of 1·adionuclide accumulation. Computerized data accurately show the amount of blood flowing to the testicle and inside the scrotum, and depict areas of con­ centration in the tissues. If decreased blood flow is found on the scan, then a diagnosis of torsion is highly probable. If increased blood flow is shown, then testicular inflammation is the diagnosis. Because the physician can substitute the technique for surgery when diagnosing, the I 1 �Research- J always present risk in surgery and anesthesia is .often avoided. According to Dr. Varma, "the radionuclide docs not endanger patient or physician." If a medical problem is diagnosed by the imaging technique, then the physician can accurately assess the need for surgical in­ tervention. If epididymitis is diagnosed, for example, treatment docs not require surgery, and the patient is spared the unnecessary discomfort and risk that previously would have occurred. If torsion or tumor is diagnos­ ed, on the other hand, surgery will still be required to correct the ailment. As safe and accurate as the technique is, it is also inexpensive and simple. "The scan is very easy to interpret," Dr. Varma told the Urology Times. "When you look at the data you can immediately see if there is diminish­ ed or enhanced flow to the testes or epi­ didymis." Also associated with the study were Dr. Peter Ricci, assistant clinical professor of urology, and Dr. Joseph Prczio, acting chair­ man and clinical professor of the Department of Nuclear Medicine. • National prize For innovative surgery A n innovative surgical technique de­ veloped at UB has won first place in the Robert H. Ivy Society competition at the annual meeting of the American Socie­ ty of Maxillofacial Surgeons in Dallas. The technique involves replacing dislocated or damaged articular discs, which normally act as cushions between upper and lower jaws, with silastic implants. The pro­ cedure shows great promise as a cure for temporomandibular joint (jaw) pain when its cause is a defective disc. The team of researchers who developed the technique are UB plastic surgeons Russell W. Bessette, M.D., D.D.S., clinical assistant instructor in surgery; Samuel Shatkin, M.D., D.D.S., clinical associate pro­ fessor of surgery; Joseph Naticlla, D.D.S., UB professor of oral pathology, and University of Rochester radiologist Richard Katsburg, M.D. • FBD Theophylline may increase its chances P By Wendy Arndt Hunt reliminary findings of a pilot project suggest that the asthma drug theo­ phylline might increase a woman's chance of developing fibrocystic breast disease, especially if she is between the ages of 30 and 50, childless, and drinks more than Hindi-Alexander three cups of coffee each clay, said a UB School of Medicine researcher, who caution­ ed that since her study was based on a small number of subjects, her findings must be verified before any indictment can be made. "We don't know if theophylline is a risk fac­ tor or how much risk it involves," said Michele Hindi-Alexander, Ph.D., research assistant professor of medicine and pediatrics, who emphasized that she has no scientific justification to advise asthmatic women to alter their theophylline therapy at this time. An extensive investigation must be completed before, and if, any definitive state­ ment can be issued linking theophylline and fibrocystic breast disease (FBD). FBD, which occurs in about 10 per cent of adult women, is characterized by benign lumps of fibrous tissue in the breast. The lumps contain cysts, which can be fluid-filled or calcified. The disease can cause breast pain and tenderness, particularly during menstruation. Whether FBD leads to breast cancer or not is a current controversy. Theophylline, a bronchodilator, is the drug most frequently prescribed for patients with chronic asthma. For 15 years, Hindi-Alexander has been interested in asthma and the treatment of asthmatics. When an Ohio State University investigator published a study in 1979 that showed that caffeine increased the risk of FBD, Hindi-Alexander decided to research the effect of theophylline. Theophylline, like caffeine, is a methylx­ anthine, a derivative of xanthine. Mcthylx­ anthines inhibit the breakdown of cyclic adenosine monophosphate (cAMP) in the body. cAMP is an important body chemical that controls the function of cells. The aforementioned Ohio State Univer­ sity investigator found high levels of cAMP in women with FBD, and even higher levels in women with breast cancer. "Evidence that has been accumulated by others suggests that there may be some rela- tionship between tissue concentrations of cAMP and the development ofFBD, but the precise mechanism has not been determin­ ed," said Elliott Middleton, Jr., M.D., direc­ tor of the Division of Allergy and Clinical Immunology in the Department of Medicine and Department of Pediatrics in UB's School of Medicine. Hindi-Alexander's study involved a total of 200 women; 61 of them were asthmatics; 73 allergic, but nonasthmatic; and 66 non­ allergic and nonasthmatic. Of the 61 women with asthma, 41 had had theophylline thera­ py. All were patients at either the allergy or OB/GYN clinics at Buffalo General Hospital or the allergy clinic at ECMC. The identification of FBD was via a clinical classification system that Hindi­ Alexander devised with the help of a surgeon, two nurse practitioners, a gynecologist and a pathologist. Of all the subjects, 26 per cent had a moderate to severe case of FBD, 46 per cent had a mild case. As other studies have indicated, Hindi­ Alexander's study found that age, nullipar­ ity and caffeine, in descending order, arc the most significant risk factors for FBD. Her study, however, also pointed out the possibili­ ty that theophylline together with caffeine might contribute to the development of FBD. Because her sample population of women taking theophylline was too small, Hindi­ Alexander said, she has submitted a proposal for a second study, which would involve 400 women, 200 of whom would be asthmatics on theophylline. Regarding the findings of her first study, Hindi-Alexander said that age is still the highest risk factor for FBD. She explained that women between the ages of 30 and 50 arc the ones most prone to developing the disease. Nulliparity is the second highest fac­ tor. If a woman has never been pregnant, she is more likely to develop FBD than a woman who has children. Caffeine is the third highest risk factor. "This is the factor that a woman can do something about," Hindi-Alexander said, "especially if she is on theophylline." Hindi-Alexander, now director of the Asthma Self-Management Progmm in UB's School of Medicine, began her study when she was a clinical assistant professor in UB's School of Nursing. Her study was financed with a $4,000 Bio­ medical Research Support Grant from UB. Her collaborators were Maria Ziclezny, Ph.D., Naris Montes, R.N., and Bonnie Bullough, Ph.D., dean of UB's School of ursing. She will submit her article on her findings to the journal cif Allergy and Clinical Immunology. In March, 1984, she presented her find­ ings at the annual meeting of the American Academy of Allergy and C linical I m­ muno logy in Chicago. • BUFFALO PHYSICIAN • 21 ��Medical School NewsState's first comprehensive geriatric education center established One of only four in the United States; others at Harvard , Michigan , USC N ew York State's first comprehensive geriatric education center has just been established at UB. Selected as one of only four such centers in the United States, it will assume national leadership in training educators and health care providers in geriatric medicine how to develop the best possible educational programs in their fields. It went into full operation on January 25. The other centers arc at Harvard Univer­ sity, University of Michigan-Ann Arbor and University of Southern California. The program will be directed by Evan Calkins, M.D., professor in the UB School of Medicine, and Arthur Cryns, Ph.D., pro­ fessor in the UB School of Social Work. Trudy White will be director of Program Development. Proposed as a joint effort by U B, State University College at Buffalo and Canisius College, it is funded by a $200,000 a year federal grant from the Bureau of Health Pro­ fessions, Department of Health and Human Services. The grant was received by the School of Medicine. Drs. Cryns and Calkins conceived of their idea last year because they observed that "geriatrics was being taught piecemeal throughout many programs" and sometimes by non-specialists. "Let's systematize the teaching of geriatrics," the two professors decided, "and also give the faculty the com­ petence to teach the subjects as well as possi­ ble." Dr. Cryns added, "Fortunately, the government supported that idea." The first objective of the Western New York Geriatric Education Center will be to initiate the Faculty Development Program. The program aims to improve the geriatric and educational competencies of health care educators who teach at universities in the fields of geriatric medicine, clinical geron­ tology and health care services to the elder­ ly. This year-long faculty seminar series will be taught by both nationally-recognized and local experts in geriatrics and curriculum design. Participants from U B's Schools of Medicine, Nursing, Health Related Profes­ sions, Pharmacy, Dentistry and Social Work will be instructed during the first year. After that, participants from other area institutions of higher learning will be included. The pro­ gram intends to enhance the inter­ disciplinary geriatric and educational exper­ tise of all of its participants. In particular, participants will learn how to develop, im­ plement and evaluate educational programs within their respective disciplines. A Continuing Education Program will be the second objective of the Center. It will be designed to benefit the clinical and service competencies of geriatric health care prac­ titioners, either in private practice or in in- stitutions. Before actual program develop­ ment an extensive assessment of the educa­ tional needs of geriatric medical providers will be undertaken to assure that the pro­ gram will be responsive to their specific needs and problems. The program will begin in Summer 1984. Another objective of the Center will be to serve as a central clearing house for infor­ mation on geriatric education and aged health care. It will disseminate information to all panics needing it, and will work closely with libraries (especially UB's Ilealth Sciences Library) and other resource centers handling geriatric information. The Center will develop and make available educational materials for interested parties. This will in­ dude programmatic offerings developed into format that lend themselves to easy replica­ tion elsewhere. Under consideration is a monthly or bi-monthly Aged Health Letter, patterned after Harvard University's Health Letter. The Western New York Geriatric Educa­ tion Center will also serve as the new home of the Network in Aging of Western . ew York. The ctwork is a regional multidis­ ciplinary association of geriatric health care practitioners. It coordinates. and disseminates relevant geriatric and educational informa­ tion to the professional community and its members. Being primarily an association of health care professionals, it is an essential liaison among the University, the community and the real world of geriatric practice and care. The Center and the etwork will cosponsor many of their continuing educa­ tion programs. Although they will remain distinct, the Western New York Geriatric Education Center will complement the research and educational mission of the multidisciplinary Center for the Study of Aging already at UB. The new Center will be housed in Beck Hall in the Health Sciences complex on UB's Main Street Campus. Establishment of the Center in Western New York is fitting, since this area has an unusually higher proportion of elderly residents than the .S. or ew York State populations. Those 60 years and older com­ prise 17.6 per cent of the total regional population. This demographic trend towards a progressively "graying" population has been caused mainly by the contraction of hea,·y industry in the region and the resultant out­ migration of young adult families towards areas with stable or expanding employment opportunities. Of the region's elderly popula­ tion (65 years and older), some 82,154 or 39.7 per cent are 75 years or older; 11,102 or 5.4 per cent arc institutionalized; and 59,706 or 28.8 per cent live alone. Other relevant statistics arc that some 4.6 per cent of these elderly arc members of ethnic or racial minorities (Black, Hispanic), and 60.5 per cent arc females. The location of the Center in the Bufhtlo area has clear advantages. Many major pro­ grams for the study and care of the elderly have been firmly in place since 1963. len years ago, the pioneering Center for Study of Aging was initiated. In 1978, Dr. John Naughton, clean of the Medical School, recognized the importance of this emerging field by forming a Division of Geriatrics/Gerontology. A year later, the Net­ work for Aging in Western N.Y. was begun by Or. Calkins. The Veterans Administra­ tion Medical Center, across the street from the Health Sciences complex of the U B Campus, serves a large number of older per­ sons and has developed a number of pro­ grams to care for the elderly. It has 74 beds for its geriatric and nursing home units. Im­ ponant programs in geriatrics have also been established for UB's Schools of Nursing, Dentistry and the other health related schools and departments. Other area colleges also offer programs, and the Eric County Depart­ ment of Senior Services has a national reputation for its innovative prog-rams. Altogether, 175 specialists in g-eriatrics have registered themselves through the 1 ctwork for Aging in Western N.Y. The first speaker for the Center's new Faculty Development Program was Dr. Ed­ ward L. Schneider, a nationally known and well respected researcher in medical pro­ blems of aging. He is associate director of the National Institute on Aging, a unit of the prestigious National Institutes of Health. Dr. Schneider spoke on "Research in Aginf{: The National Institute on Aging's Perspccti,c" last January 25. Other prominent speakers scheduled in coming months include Dr. Marc Wekslcr, director of geriatrics at the Cornell U niver­ sity School of Medicine and Dr. Laurence Branch of 1-larvarcl Medical School. For more inf(Jrmation, call .Jan Dufky, administral<Jr, 716-831-3176. • Another first Agreement with Beijing A Chinese university and UB have for­ malized what appears tO be the first agreement between U.S. and Chinese scientists to conduct joint research in nuclear medicine. The three-year agreement between UB and Beijing Normal University (BNU) in BUFFALO PHYSICIAN • 23 �China will continue research on a new drug that will allow safer and often more accurate diagnosis of stroke and other brai_n diseases. The agreement establishes a faculty ex­ change progt·am and radiopharmaceutical collaboration between the two untvcrstttes. hospitals and at Roswell Park Memorial Institute. • From 'Boss' & brother B Initial contact with Chinese scientists oc­ curred in July 1980 at the St. Louis Inter­ national Radiopharmaceutical Chemistry Symposium. A BNU Department of Chemistry professor, Xue-Bin Wang, spent 16 months here conducting research with Hank Kung, Ph.D., and Monte Blau, Ph.D., both of UB's Department ·of Nuclear Medicine. Chaired by joseph Prezio, Ph.D., the department has as its director of research and development Dr. Kung. As a result of this research, the new diagnostic brain im­ aging drug was developed, and two papers were jointly published in the Chinese jour­ nal of Nuclear Medicine. Dr. Blau, then Department of Nuclear Medicine chairman, subsequently spent one month in China lecturing to physicians and scientists. This was followed by a two month visit to UB by Professor Bo-Li Liu, vice. president of B1 U's Department of Chemistry to conduct research and lecture. The agre~~1ent was reached shortly after. During its first year, two research projects will be pursued. The first project will con­ tin'uc research on the chemical developed by Dr. Kung and Dr. Blau, referred to as I 123HIPDl\1. (Sec article on Dr. Kunt(s research elsc"here in this issue). The second pr<~jcct, funded by a three-year N [ 11 grant of 300,000, will im·olve testing of Technctium-99 and ' lcchnetium-99m labeled neutral lipid soluble compounds. These compounds could show e\-cn more promise than HIPDM as valuable brain diagnosing tools for neurological diseases. Results from the research will be published jointly and further visits by Chinese scholars will be encouraged. Dr. Kung expects to lcc­ tLtre in China during this year. • Grad program Approved in Urology T he Department of u.vlogy recently received accreditation for its three­ year graduate mecltcal educatton pro­ gram in urology. The Accreditation Coun­ ~il for Graduate Medical Education, Residency Review Committee for Urology, recommended that the program have a max­ imum of nine residents with no more than three at each level of training. The residen­ cy program will utilize facilities at the Medical School's four pnmary teachmg Memorial gift Dr. Holden New chairman In Family Medicine A ppointed chairman of the Depart­ ment of Family Medicine is Dr. David M Holden, replacing former acting chairman Dr. Herbert Joyce. Dr. Holden was also appointed head of Buffalo General Hospital's Department of Family Medicine. Dr. Holden most recently held the posi­ tion of director of the Wichita Family Prac­ tice Residency Program at Wesley Univer­ sity of Kansas School of Medicine, where he was also professor of both pediatrics and family and community medicine. Previously, he was assistant dean and pro­ fessor of the medical schools of Michigan State University, University of Wyoming and University of North Dakota. After receiving his BA from Tufts Univer­ sity in 1959, he earned his medical degree from Yale University in 1963. From 1966 to 1969, he served in the Philip­ pines as a medical epidemiologist for the Malaria Eradication Program, and for the Epidemic Intelligence Service - Center for Disease Control in Atlanta, Georgia. He is a fellow of the American Academy of Pediatrics and the American Academy of Family Physicians. • By Linda Grace-Kobas ecause their father, the son of a Scottish tailor who emigrated to the V.S. shortly after the turn of the century, had such a hard financial struggle to complete medical school, two brothers have established an endowment fund in the UB School of Medicine to help future students avoid this burden. The father was Solomon Booke, UB Medical School alumnus, Class of 1924. That year's Iris, the University of Buf­ falo yearbook, includes his picture, depicting a bow-tied, serious young man with round spectacles and tidy, slicked­ back hair. The two sons are Frederick, a lawyer now residing in Pacific Palisades, California, and Sorrell, an actor whose primary current "residence" is Hazzard County, U.S.A., which he "runs" in the guise of Boss Hogg. The Booke brothers have donated $10,000 to the UB Foundation which will set up a fund to support the Medical School's Student Enrichment Program, which provides special grants to medical students. Dean John Naughton will ad­ minister the fund. The gift is actually a memorial to both of the brothers' parents. Their mother, Rose Yasgur, carried as great a load in Solomon's medical practice as he did, her sons said. "Our father being a general practi­ tioner, she did everything with him;' Sorrell remembered in an interview at the home of his uncle, Sidney A. Yasgur of Williamsville. "She got up with him in the middle of the night when the phone rang - as it inevitably did." The Booke brothers were born in Buf­ falo and lived here until the family mov­ ed to California when Sorrell was a young man. He is a graduate ofBuffalds Bennett High School, where he was valedictorian for his class. Frederick, who is nine years younger than Sorrell, attended Bennett until the family moved. Dr. Booke had established his family practice on the east side of Buffalo. "He was a general practitioner in the old style;' Sorrell said, "where the home was the office and the living room wa the waiting room. We gr~w up in that." The two sons spoke of their parents with admiration. "My father was making house calls until the year he died; Sorrell said, "even though he suffered from acute asthma." L------------------------------------------------------------24 • BUFFALO PHYSICIAN �Medical School News- The Booke brothers, ·Frederick (left} and Sorrell. flnsetJ Solomon Booke as pictured tn 1924 Iris.. Born in Scotland in 1898, Solomon Booke worked his way through medical school. He served in both world wars, having signed up for the second when a call went out for physicians. After moving from Buffalo to California to join his parents, Solomon worked in one of the first medical service groups established in the state. At age 50, he entered a new medical field, beginning a specialization in allergies. He became certified by both the Academy and Col­ lege of Allergy, and later served as medical director of the Sunair Founda­ tion in Tujunga, CA, which helps asthmatic children. His own asthmatic condition had been exacerbated by his war service, his sons said. Rose Yasgur was one of the first women students at Penn State, her sons related, but she was forced to leave when her mother died. First a chemistry ma­ jor, she later studied art in New York Ci­ ty during the Roaring Twenties. Rose and Solomon met and married in 1929, and Sorrell was born in 1930, '~ust after the crash;' he says. The Booke endowment fund will help support one student in need each year to begin with, the brothers said. . "One reason we decided to set up th1s fund was that our father had such a hard time," Sorrell said. "We want to help peo- pie avoid what he went through." F rederick good-naturedly accepts the fact that most interviewers' questions focus on Sorrell, who has risen to worldwide fame as Boss Hogg in the "Dukes of Hazzard" (the show is syn­ dicated in more than 70 nations). He even smiled when Sorrell introduced him to a television reporter - on camera - as, "my brother Fred. He has the same parents as I do." An accomplished actor, Sorrell has been in show business since he was a boy. He is a graduate of Columbia University and the Yale School of Drama. After earning a master of fine arts degree from the latter, he headed for Broadway, where he appeared in many successful plays. He did the "classics" in New York for 20 years, then went to California, where he appeared in Em my-winning and suc­ cessful television series and films. "I like to do all kinds of things," he said, adding that at Thanksgiving he did his first circus, erving as ringmaster -in his Hogg persona - in Evansville, Indiana. "With Hogg, I seem to have created an alter ego, who is taking over everything," Booke commented. He en­ joys being Hogg, however. "I have a lot of freedom in improvisa­ tion, making up lines, changing expres­ Sion;' he said. "The challenge is first to have developed quickly a chara~ter that fits the situation and is interesting, but you need variety. You have to keep look­ mg for new expressions. "There is no doubt that Hazzard County is portrayed as a land of con·up­ tion," Booke said. "But it's like a fairy tale, with 1ts elements of virtue - the Dukes - set up against corruption. Its message is that virtue can triumph over corruption, but it also recognizes that there_ is political and economic corrup­ tion m the world, portraying it as part of the wor)d. That's why people under­ stand it." Asked if he is ever condemned by politicians - particularly Southern politicians - for his portrayal, Booke sa1d smiling, "I get emulation from them, not condemnation. Everywhere I go in the south, the politicians dress in white, and are one step ahead of the law." His portrayal of Hogg is so real because he humanizes the character, Booke said, even though "the seven deadly sins just ooze out all over him." Frederick is associated with the law fir~ of Flame, Sanger and Grayson, wh1ch has offices in Lo Angeles, Palm Springs and Encino. • BUFFALO PHYSICIAN • 25 �BGH Network Rapid progress cited T he Buffalo General Health Care Net­ work celebrated its six-mon.th anniver­ sary in October and accordmg to coor­ dinator Joanne Barshter, the progress thus far reflects the philosophy of the group and the original objectives of the Network. "The affiliation is structured so that each member institution, maintains its own in­ dividual goals and priorities while pursuing the common objective of enhanced cost con­ tainments," Ms. Barshter said. "The philosophy of the Network is to work and plan together within the group to develop programs for the cost efficient provision of high quality patient care services." The liY<.: member hospitals include Lake Shore Hospital, Inc., l rving; Tri-County Hospital , Gowanda; Genesee Memorial Hospital, Batavia; Lockport Memorial Hospital, Lockport; and BG H. The Network relation­ ship among the live hospitals involves shared service activities, cooperative arrangements· and joint ventures, all aimed at meeting the challenges of an ever-changing environment. Among the many goals outlined by the Net­ work arc shared CT Scan services, complete laboratory referrals, shared pulmonary func­ tion services, joint pharmaceutical pur­ chases; enhanced medical staff interaction and continuing education programs; educa­ tion programs for hospital personnel and the possible formation of a for-profit corporation. A shared pulmonary function service has already been established between Genesee Memorial and Buffalo General. The shared system involves new equipment which allows remote pulmonary function testing on a shared computer basis. This new system, which was on-line October 5, increases both the capabilities and hours of the pulmonary function service at Genesee Memorial. Previous to this, patients at GMH had as much as a three day wait to undergo testing, and no pulmonary function tests were available after hours or on weekends. "The objective here was to develop and implement a cost-effective and accessible system for pulmonary function while improving its quality through the usc of up-to-date equip­ ment," Ms. Barshter said. Now, a new com­ puter unit at GMH can "talk" to the main computer at BGH, and a pulmonary func­ tion test can be performed at any time. It provides the community serviced by Genesee Memorial with the most up-to-date equip­ ment available for pulmonary function testing services. Another goal of the Network is to establish a shared CT Scanner system between at least three of the hospitals, BG li, Lockport Memorial and Genesee Memorial. Current­ ly, only Buffalo General has a computeriz­ ed tomography scanner; the other four hospitals either refer patients for scans, or utilize the mobile· CT unit which services their communities. Under the proposed net­ work program, remote units located at each of the participating network hospitals, would "plug-in" to a main frame computer located at Buffalo General. Each community hospital would have its own freestanding CT imaging unit, with the capability to do routine scans or more sophisticated scans on its own. The cost savings to the member hospitals arc realized from the standpoint that only one main frame computer is need­ ed. The remote units, made up of the imag­ ing unit and microprocessor, carry a price tag of approximately $400,000 as compared to the standard cost of a freestanding unit which can range anywhere from $800,000 to Sl.2 million. The CT Scan at Buffalo General is cur­ rently utilized 16 hours a day, as well as be­ ing readily available around-the-clock for emergencies. The new, state-of-the-art system proposed by the Network would com- requests that our readers submit any interesting, well-written ar­ ticles that they have written on the following subjects: FOR ARTICLES 1 • MEDICA especially but not limited to the University (Example: Sec O.P. Jones article in this issue). PR of distinguished or interesting UB Medical School alumni, present or former UB Medical School faculty, or current UB medical students. p ICAL, ETHICAL OR OTHER ISSUES directly relevant to the medical community. E of important or interesting books written by or about UB faculty or alumni. Though books of a technical nature will be considered, especially if they are significant, reviews of non-technical books are en­ couraged also, e.g. biographies, fiction, non-fiction for the layman (example: see Ross Markello article in this issue). about anybody with a UB Medical School association, present or former. ARTICLES SHOULD IDEALLY BE TWO TO TEN TYPEWRITTEN DOUBLE-SPACED PAGES. PHOTOGRAPHS (IN A SETTING RELATED TO THE ARTICLE) AND ILLUSTRATIONS ARE ENCOURAGED. SUBMITTED MATERIAL SHOULD BE ABOUT PEOPLE AND TOPICS WITH SOME ASSOCIATION WITH THE UB MEDICAL SCHOOL. The exception will be for articles about important philosophical , ethical, or other medically relevant issues. Articles not fitting the above categories arc unlikely 26 to be considered. • �Hospitalsplement the present unit at BGH and allow for more intricate studies at Buffalo General. Via microwave transmission, these services would also be available to the other Network hospitals. The proposal is now being re,·iew­ ed by representatives of the medical staffs at each Network hospital, and pending physi­ cian support, an application will be filed with the State Health Department for approval to go ahead with the shared system. Medical staff interaction is considered to be the key to success of the Net work, and to date, the physicians from all five hospitals have been very supportive of the Network concept. Beginning in January 1984, Family Medicine Residents from Buffalo General's University afliliated program will begin rotations at Genesee Memorial Hospital. Some residents arc already invok­ ed in a program underway at Tri-County Memorial, and a similar program is being investigated for Lockport Memorial. "A primary objective of the Network is to achieve greater efficiencies through multifacility proposals and to help Western New York by containing costs, keeping money within the system and enhancing doc­ tors' opportunities to practice," Ms. Barshter said. "We feel the hospitals of the Buffalo General Health Care Network offer a diver­ sified health care setting and provide a creative, challenging environment for those in training as well as health care professionals in practice." The etwork is demonstrating the ,·arious ways in which hospitals can work together while performing their respective roles within the overall delivery system. The member hospitals of the Buffalo General Health Care Network arc working to make health care more accessible and more cost-efTectiw· f(,­ the Western New York region as a "hole. Sheehan Hospital: bum centers will be con· solidated there. (H.tfmntedjrom Ruffalo Cmmd /!mpilaf'> "Pul>thmt ') • Dedication Sheehan RPMI honors Dr. Wehr Acquired by Millard Fillmore Hospital A dedication ceremony marking the opening of Roswell Park Memorial l n­ stitute's William H. Wehr Research Center was held Wednesday, January 18. The dedication represented the culmina­ tion of a 1.9 million project to centralize Roswell Park's research programs involving chemical carcinogens and immunodepriH·d mice in a facility with adequate biohazard containment safeguards. According to l nstitute director Dr. Gerald P. Murphy, "Roswell Park considers the William H. Wehr Research Center to be an important resource in expanding its basic research programs and helping to bring the answers to the cancer problems into clearer focus." Dr. Wehr spent a 37-ycar career at Roswell • Park. M illard Fillmore Hospital's president Jan Jennings announced its planned acquisition of Sheehan 1cmorial Hospital on July I, 1983. Sheehan Memorial Hospital, a 136-bed facility in downtown Buffalo, initiated the merger action f(>r a number of reasons. The hospital has unique financial problems but a very well defined patient care mission. The merger will guarantee its continuation and financial viability. The agreement will merge two burn treatment centers into one to be located at Sheehan. It also reinforces backup medical and professional services beyond the limits of a small hospital and pro,·ides direct access to specialized sen·ices that arc simp- ly not feasible for Sheehan. Further, it allows the entire expanding "Millard Family" a greater voice in health care planning in the community. The central issue, lH>We\Tr, is improved medical care to the communitY served by S~echan, Gates Circle and Subu;­ ban in a comprehensive patient care plan, hospital spokespersons indicate. Millard Fillmore llospital supports the corporate action because the addition of another operating hospital helps to better distribute costs and reimbursements through one corporate entity and spreads the overhead of many departments over three hospitals instead of two, its President jennings said. The unifying of burn treat­ ment centers provides efficiency in burn care and cost savings to both hospitals. It also pro­ vides a different setting through which the surgical and possibly other residencies can rotate, improving and diH·rsifying the case mtxcs. • BUFFALO PHYSICIAN • 27 �. . ~------------------------------------------~ -- How Do You Spell Relief? The Doctor's Guide to You and Your Colon by Martin Plaut, M.D., New York, Harper & Row, 1982, pp. 138, $10.95. This book is not funny it is hilarious! Scatology sells almost as well as sex in the U.S. and even better in Mediterranean cultures where preoc­ cupation with bowels passe·s for a na­ tional past-time. Billing it as "a candid, helpful guide to our #1 hidden health complaint;' Martin Plaut with the aid of several colleagues has composed a readable, light, informative myth debunker for the lay public. Dr. Plaut is a State University at Buffalo professor of medicine. The Buffalo News' Tom Toles (one of the more effective political cartoonists since Thomas Nast) adds a touch of class with clever illustrations, e.g. a character with enormous teeth . gnawing on a tree to extol the virtue of dietary fiber. "The ritual of painlessly moving the bowels provides the kind of special satisfaction that comes with something truly done. " In "How the Bowel Works;' the reader is taken step by step through the G I tract anatomically and physiologically. The range of shapes, sizes, frequency of stools as well as symptomatology assigrr-:­ ed to the bowels is presented with col­ orful metaphor and occasional onomatopoeia. While one movement a day occurs on average, three a day or twice a week is not abnormal. To have no movement for a week, e.g. on a trip, should be no cause for panic. ·: . . for those who take a vitamin and have a bowel move­ ment each morning, the in-out cycle must seem an ideal way to maintain health." "For most people with con­ stipation, no disease exists and none will be found." Loads of people suffer from a malady termed "apparent" colon disease. Con­ stipation, frequent stools, irregularity, alternating loose and firm stools, urgen­ cy, "sluggishness':, and a h?st of other complaints fall withm the wide range of normal and have no disease associated. Even pain prior to or during evacuation bodes no ill for disease. Lactose, the sugar in milk, causes distress in 15 per cent of Caucasians and 50 per cent of blacks by virtue of their lacking the en­ zyme for its digestion. The avoidance of 28 • BUFFALO PHYSICIAN milk will usually effect a cure. Other tips for managing apparent disease arc: drink lots of water, add bran to your diet, allow time for the bowel to move, and keep your complaints to yourself! In the 19th century, the medical pro­ fession attributed most illness to "auto­ intoxication" - poisons absorbed from stool too long resident in the colon. A good bit of therapeutics consisted of elaborate methods of cleansing the bowel. Famous chairpeople of medicine today still are honored with the title - fR»lSVERSt COLON SPltNIC fl[XUI\L Si'I~L L lNTESliNL Professor of Theory and Practice of Physik. ow, this upstart Plaut says these laxatives and enemas are a lot of - oops! It came as a surprise to this "physikian" that the fanfare over fiber in the diet is likely a passing fad. A very good recipe for bran muffins is presented. "Of all the ills to which man is heir, excessive gas is the most embarrassing dangerous." yet least Most bloating or excess gas can be traced to: • air swallowing; • drinking of beverages containing car­ bon dioxide - i.e. beer, soda; • hydrogen from the improper breakdown of lactose. Belchers can be helped by improved eating habits. For those who can't tolerate lactose, a prodigious quantity of gas will be formed. In fact, one student was reported to have passed gas 34 times a day and after drinking milk stepped up the output to 141 times - a veritable record for the Guinness Book of Records. "Travel expands the mind and loosens the bowels." �----------------------------------------------------- Books"Turista", "Montezuma's Revenge", and similar terms have been coined to describe diarrhea with associated illness which often attacks the traveler. Experts disagree as to the cause. It can be bad water or food but could a lso be from drinking water or milk containing bacteria different from those in our own intestine. Blood in the stool or continued watery diarrhea require attention. Lomotil, and kaopectate may provide symptomatic relief. Doxycycline, an an­ tibiotic, has been recommended pro­ phylactically if one contemplates leav­ ing a pile in a high risk area. Plaut presents a poop sheet of facts on turista that would be well worth the traveler's while copying and posting inside one's suitcase. "Although our four-legged ancestors went through life unen­ cumbered by hemorrhoids, piles likely annoyed the first human be­ ing who assumed the upright stature." For hemorrhoids , (described graphically by structure and function), preparation H, fibre and sitz baths help. When a ll else fails - surgery too will provide temporary relief. There arc three serious diseases of the colon diverticulitis, colitis, and cancer. Symptoms and what to do are aptly described. "Growing out of infancy is marked by three episodes: the first word, the first unaided step, and the first formed stool that thuds into the potty seat." While denying Freudian sophistica­ tion, Plaut has admirable insight to bowel preeminence in the lives of many. He is not nearly as primal as orman Mailer's Ancient Evenings. The latter is downright disgusting to those of tender sensitivity. It will take from one to two hours to read this book. Physicians shou ld recommend it to patients with bowel problems - or at least keep it around the house to produce heaps of laughter from half-loaded guests at cocktail parties. This is really a superb book - engag­ ing, informative, desensitizing, clever­ ly written - we would have expected no less from one of our own physicians of letters, (a regular guy) Martin Plaut. • Lou Leibowitz's Best Bran Muffins Ever as told to her by her mother 7 1 2 cups bran box raisins (2 1h cups) cups boiling water cup honey cup corn oil 11h cups molasses (12 oz. jar) 4 eggs, beaten 1 quart buttermilk 3 cups whole-wheat flour ('h cup soy flour may be substituted for part of flour to increase protein content) 5 teaspoons ba.king soda 1 teaspoon salt Optional additions: Nuts, dates, crushed pineapple, coconut. 1 • Place 4 cups of bran and raisins in a bowl and pour boiling water over. Stir and set aside to cool. 2 • Put honey in large bowl and stir in one at a time: oil, molasses, eggs, but­ termilk, and remaining 3 cups of bran. 3 • Combine flour, soda and salt. Add to second bran mixture. 4 • Stir in bran-raisin mixture. 5 • Spoon into greased muffin pans­ fill two-thirds full. 6 • Bake in preheated 4000 F. oven for 20 minutes or till lightly browned. 7 • Allow to cool slightly in pan, on racks. 8_ • Muffins come out more easily if g1ven a short rest period. Notes: Batter stores in refrigerator, if covered, for up to two months. Bring batter to room temperature before baking . Muffins freeze well. Recipe makes approximately 4 dozen muffins of 150 calories each. _.... BUFFALO PHYSICIAN • 29 �ui 0 ~ 0 <ii f20 I a.. Med School Talent Show From Broadway to doo-op and blues and medicine do mix, as demonstrated at the Second Annual Medical School Talent show on Music Januarv 21. Sponsored IJV the American Medical Student Association, the evening program featured 13 acts. Virtually everv type ot music was offered, trom easy listening and Broadway tunes, to classical and folk, doo-op, blues, countrv and hanl rock. The Dermatones sang 'SO's style songs such as "Blue Moon" with the accompanying attire and body movements. The emcee, Donnlca Moore, told how the group had considered other names, such as the Loclcjaws, Sore Throats and Tongue Depressors before choosing the Dermatones. Emcee Moore not only Introduced the acts but was the night's stand-up comedienne also. Referring to the easy listening music played IJV Rich Rosenfeld and Charlie Shapiro, she Joked that "It they don't make It as doctors, they can always do the wedding and bar mitzvah circuit." Exquisitely performed was a Beethoven sonata 1JV medical student Arthur Weissman, who has aPh.D. In music. Some other selections were "Those Were The Days" 1JV Deborah Shaunders, Don McClean's "Vincent" sung 1JV Larry Rammuno and Gershwin's "Summertime" sung 1JV Deborah Richter and Janice Pegels. Before the last act, comedienne Donnlca Moore posed the question "What did the schizoid say to the waitress?" Answer: "Separate checks, please:· Hanl rock IJV the group Thyroid Storm pumped the audience with adrenaline as the program ended. Howanl Stark (talking and acting amazingly like Mr. TJ. Mark Billinson, Charlie Shapiro, Camille Hemlock and tour others roared songs IJV Eric Clapton, J. Steinman and The Police. 30 • BUFFALO PHYSICIAN �Students-· Minorities Summer program effective T he School of Medicine's Summer Pre­ paratory and Support Program does appear to be dfecuve m prepanng minority medical students f(>r academic suc­ cess. That is the finding of a study by B graduate student Mary E. Finn, Ph.D., in collaboration with Maggie S. Wright, Ph.D., assistant dean for student affairs and Frank Schimpfhauser, Ph.D., assista~t clean for development and evaluation. In 1969, the School of Medicine initiated a program to recruit and retain minority s.tudents. The Summer Preparatory and Support Program, begun in 1975, is one of only seven or eight such programs among the nation's 127 medical schools that offer a credit-bearing first-year medical school course. The course is histology/embryology. The prc-matriculatory program aims to strengthen learning skills and offer course work prior to matriculating for the purpose of identifying students' strengths and weaknesses early so that improved academic support can be provided. The evaluation analyzed 82 UB minority medical students who entered between 1975 and 1980 and successfully completed their first two years at medical school. Sixty-fi,·e per cent of them participated in the summer program. The study f(>und that 43 per cent of the 82 students had little to no academic difficul­ ty and 26 per cent had some academic dif­ ficulty. Thirty-two per cent had considerable academic difficulty requiring the repetition of first or second year course work and five or more years to graduate. . The primary finding was that "participa­ llon in the ... program appears to have been helpful." Approximately 17 per cent more academically successful minority medical students participated in the summer pro­ gram, compared to those who were academically unsuccessful. Further analysis showed that, among students who were in the program, those who had considerable academic difficulty includ­ ed more men (67 per cent). This was despite the fact that the total sample was equally dtvtded between men and women. The report said "Participation in the . . program seems most beneficial for women minorit v students and less so for the men, or at lea;! In itself, the . program is not enough of a support mechanism to male minoritv students to allow them to complete medin;l school in four vears." The exact reason for this is not clca~. Another trend detected is that students who were non-science maJors tn undergraduate school arc more likely to ha,·e academic difficulty. One curious finding was that MCAT scores " do not appear to predict those who will and those who will not benefit" from the program. In fact, the students who ex­ perienced considerable academic difficulty had MCAT scores that "were in every in­ stance higher than" those who did better academically in the Medical School. Drs. Finn and Wright were to present the paper to the annual meeting of the American Educational Research Association April :n to 27 in New Orleans. • ''Program is most beneficial for women.'' BUFFALO PHYSICIAN • 31 �Solidarity Zaleski translates its 'Bible' T By Mary Beth Spina he collected sermons and essays of a Polish priest and philosopher which have fueled and sustained the spirit of Solidarity will be published this spring thanks to a UB immunologist and a Canisius College professor. . , ,. The works of Rev. jozcf ltschner translated into English by Dr. Marek Zaleski (M.D., Ph.D.) and Rev. Benjamin Fiore, S.j., will be published in May by Harper and Row. The 128-pagc Spirit of Solidarity, popularly known as the "Bible of Solidari­ ty," will retail in the U.S. f(H· 9.95. It has been translated into Italian, German, French, Flemish and Swedish. Dr. Zaleski is a professor in the Department of Microbiology. . Rev. Tischner's works arc today unavailable in Poland except for a few copies published by the Paris-based_ emigre publishing house, Editions Spotkama, whtch have been successfully smuggled m by oblig­ ing travelers. Monil's the two Buffalo translators would have received for thetr ef­ forts have been designated f(>r Edition' Spotkania. Former U.S. national security advisor Zbigniew Brzezinski wrote the foreword f(>r the translation. lie describes the Solidant} movcml'nt as a "distinctive combination of social classes and ideas held together by a transcendental belief in ultimate justice." This collection of 23 sermons and essays, he notes, forms the ethical basis for the Solidar­ ity movement which, Brzezinski points out, is a truly remarkable accomplishment. "In the course of several years of sustain­ ed struggle against an oppressive police regime, Solidarity did not innict a single death. on-violence and 'turnmg the other check' have been the lodestars of its social behavior," he writes. Zaleski, who left his native Poland 14 years ago for political reasons and joined UB's Department of Microbiology wtth the ate! of its chairman, Dr. Felix M ilgrom, dcscnbes his work on the translation as a "labor of love." A staunch supporter of Solidarity and an admirer of its leader, Lech Walcsa, Zaleski dedicated to the trade-union leader a book he recently co-authored, entitled Im­ munogmetics. A copy of the text, one of only four which have been wnttcn 111 thts specialized area of immunology, was presented toM rs. Dan uta Walesa when she ancndcd ceremonies in Oslo to collect the Nobel Peace Prize in behalf of her husband. 32 • BUFFALO PHYSICIAN Dr. Zaleski with his translation. It was then also she learned that Rev. Tischner's writings were to be published in English this spring. "Solidarity," explains Zaleski, "is more than a trade union movement for fair wages or improved working conditions. It is a unique commitment to a set of ethics which joins professor with laborer, artist with farmer, for a common good in the belief that man has dignity." The communists, who have officially outlawed Solidarity, have failed to silence the movement for a number of reasons. "The Catholic Church in Poland is a powerful f(>rce and one with which the government docs not dare openly make war," says Zaleski. Organized religions arc not as powerful and unified a social force in other captive Eastern European nations, he adds. In contrast to Solidarity's peaceful resistance, the outright defiance of freedom fighters in Hungary and Czechoslovakia easily provoked the sending in of troops and tanks. "The lessons taught the Ilungarians and the Czechs who sought freedom were not wasted on the Poles and later, the Solidar­ ity leaders, who saw another, more peaceful and perhaps ultimately more effective means of showing their displeasure with a govern­ ment which had failed them morally, ethical­ ly and economically," Zaleski points out. He believes the economic problems which have led to severe and extended shortages of food, clothing and other goods in Poland will spread to other captive Eastern Euro­ pean nations within the next few years. "It is inevitable that the unrest will spread," he explains, " because ethically and economically, the Soviets arc slowly strangl­ ing" Eastern Europe. The Soviets contract for commodities which they pay f(>r in rubles; the rubles have finlc or no value as hard currency on the international money market. "It is the same as delivering 100 pairs of shoes, let us say, to someone who pays you �Peoplein counterfeit money which cannot be used to buy more leather or equ ipment to make more shoes. But later, the same person agam tells you to make another 100 pairs of shoes and pays again in the same worth less cur­ rency," Zaleski explains. A businessman could say "no" the second time, but the Poles and the others do not have this option. "The Soviets and Polish government leaders have been publicly embarrassed by the fact Walesa was named to receive the Nobel Peace Prize. No doubt they were even more angered when he refused to seck per­ mission to travel to Oslo for the pnze ceremonies, gving as his reason that since Solidarity members were still imprisoned 111 Poland it would not be right for him to leave," Zaleski notes. Neither have the Soviets been pleased that Walcsa publicly announced that the money which accompanwd the prize wou ld go to the Polish people through ad­ ministration by the Catholic Church. "Solidarity, begun in Poland, wi ll spread," Zaleski predicts, "and is perhaps the, one hope for freedom in capti ve Eastern Euro­ • pean countries. Man of Year Schultz wins award T he 1984 "Man of the Year" Award of the American H eart Association, W Y Chapter, was presented to Robert W. Schultz, M.D., a UB professor, on Saturday, February 11. Dr. Schultz was chosen for the award because of his outstandin g dedication and support in the fight against heart disease. 1983's "Man of the Year", Leon E. Farh1, M.D. , also a UB professor, delivered the award to Dr. Schultz at the 4th Annual H eart Ball at the Buffalo Convention Center. Dr. Schultz's primary concern has been in the area of hypertension ; and in 1978, he founded the Hig h Blood Pressure Con trol Program of WNY. Since 1973, he has served as past president and on the Board of Direcwrs of the AHA's WNY Chapter, as well as on the Board of Directors of the NY State Affiliate of the AHA. A clinical assistant professor in the Department of Medicine, he has been at UB since 1970 and is a B Medical School a lum­ nus. He has a private practice on Delaware Avenue Buffalo and is in charge of the hemodi,alys is u~it at 1illard Fillmore H ospital. Dr. Schul tz was honored previously with the Distinguished Service Award of both the H eart Association ofWNY and the t ational Kidney Foundation in 1975 and 1976. • DR. ELIZABETH REPASKEY, CLINICAL ASSIStant professor of a natom ical sciences, has received a two-year Muscular D ystrophy As­ sociation gran t of$ 27,000 to study the role of spectrin in muscle a nd red blood cells. • DR. ALLEN RICHMOND, CLINICAL INSTRUC­ tor of otolaryngology, recently attended the 19th Congress of the International Associa­ tion of Logopaedics and Phoniatrics in Edin­ burgh Scotland. Dr. Richmond's research has 'in~olved modification of artificial larynx for laryngectomy patients. His clinical research includes the area of methods of treating aphasic patients, with graduate stu­ dent participation. Outside of the Univer­ sity, he has directed therapy and group discussions for the No-Voice C lu b, Buffalo Chapter, Internat ional Association of La ryngectomies. • SEVEN UB FACULTY IN THE MEDICAL SCHOOL have been named fellows of the American College of Surgeons: Dr. Cyril S. Bodner, clinical assistant professor in otolaryngology; Dr. Evan J. Evans, clinical instructor in surgery; Dr. James M. Hassett, J r., ass is­ tant professor in biophys1cal sc1ences; Dr. Douglas W. Klotch, ass istant professor _in otola ryngology; Dr. Keun Yong Lee, aSSIS­ tant professor in otolaryngology; Dr. Joel H. Paull, clinical instructor in surgery, and Dr. Thaddeus A. Zak, assistant professor in ophthalmology. • SEVERAL MEMBERS OF THE DEPARTMENT of Orthopaedic Surgery made presentations at the American Academy of Orthopaedic Surgeons meeting held in February in Atlanta, Georgia. Among them were Dr. Eugene Mindell, chairman_of the depart­ ment, and Dr. DavidS. Bevilacqua, speak- ing on "Pilon Fractures ( Intra-articular Frac­ tures) of the Distal Tibia." "Primary Malig­ nant Tumors of the Upper Extremity: Retrospective Analysis of 126 Cases" was the topic of three U B orthopaedic professors: D r. James Creighton, Dr. C layton Peimer and Dr. Mindell, as well as surgery professors Dr. Harold Douglass and Dr. Con stantine Karakousis. Dr. Mark Koniuch presented an exh ibi t o n "I !crbert Scaphoid Screw Fixation." • DR. JOHN F. REILLY WAS RECENTLY ELECTED president and D r. R ajinder S. Sach ar was elected treasurer of the Western New Yo rk Society of Internal Medicine. Bo th arc clinical instructors of medicine. • DR. ROBERT REIN , RESEARCH PROFESSOR in biophysics and Roswell Park's associate chi ef cancer research scientist in the Ex­ perimental Pa th ology Department , chaired a roundtable discussion on the Role of Pro­ teins in Cancer, at the annual meet in g of the National Foundation fiJr Cancer Researc h, September 13-19, in Woods H ole, Mass­ achusetts. • DR. GERALD SUFRIN, CHAIRMAN AND PRO· fcssor of the Depa rtment of Urology, reports hi s department will be presenting fiJUr papers at the annual meeting of the American Urological Associatin. This is the major national meeting in Urology. Dr. Sufrin has been selected to moderate a ses­ sion on renal adenocarcinoma a t the meeting. • DR. CHARLES E. WENNER, RESEARCH PRO­ fessor of biochemistry and researcher in Roswell Park's Experimental Bio lo gy Department, received a 59,015 gran t from the National Cancer Institute to study the effects of co-ca rc inogens on ce llula r m embrnn~. • DR. PHILLIP ZEIDENBERG, RESEARCH ASSO· ciatc professor of psychiatry and acting director of· the Research Instit ul e on Alcoholism, 1021 Main Street, has been awarded a $20,000 grant from the SU:--JY Research Foundation. The educational tra ining grant will be us­ ed to provide fin a ncial stipends to four g raduate stude nts who arc working on col­ laborative research projects with facu lty from the School of Medicine and the Department of Psychology. • DR. GIUSEPPE ANDRES, PROFESSOR OF Dr. Schultz: Man at the )tlar. microbiology in pathology and medicine, was appointed a member of the Review Committee, National Research Council, Na­ tional Academy of Sciences in Washingwn, D.C. H e will a lso se rve as editorial advisor BUFFALO PHYSICIAN • 33 �.- for the Proceedings of the Society for Ex­ perimental Biology and Medicine. On November 16, 1983, he conducted the "com­ bined staff clinic" of the Department of Medicine, Columbia College of Physicians and Surgeons, ew York City. • DR. THOMAS J. GUTTOSO, CLINICAL ASSIStant professor of medicine, has been named director of the Ophthalmology Department at the Erie County Medical Center. He is also chairman of the Medical School's Admission Committee. • DR. JAMES MOHN, PROFESSOR OF MICRO· DR. ROBIN M. BANNERMAN, DIRECTOR, JOINT biology, has been appointed by ew York Governor Mario Cuomo to the state legislated AIDS Advisory Council. The 14-member council was mandated by a bill signed by Governor Cuomo this summer. The council will advise New York State of­ ficials on their efforts to combat the lethal Acquired Immune Deficiency Syndrome. Specifically, the council will advise State Health Commissioner David Axelrod on "AIDS outreach activities, education and counseling programs for AIDS victims and their families, and affected employee groups such as nurses and corrections officers." This council is the second established under the AIDS legislation. The first is a panel of scientific experts which will help direct allocation of $4.5 million m state funds dedicated to AIDS research. Dr. Mohn was named to the panel , which is made up mostly of elected officials and heads of community, social and academic organizations, because of his knowledge of blood transfusions and diseases which can be ~arried in the process. Mohn is also head of the New York State Blood Council. Also appointed to the AIDS council was D r. Edward Mirand, director of edu­ cation at Roswell Park and a UB research profes or. • Divisions of Medical/Human Genetics in the Department of Medicine, Buffalo General and Children's Hospitals, has been elected a member of the Board of Directors of the American Society of Human Genetics for a three year term. • DR. HAROLD BRODY, CHAIRMAN AND PRO- DR. THOMAS DAO, RESEARCH ASSOCIATE DR. EMANUEL LEBENTHAL WAS PROGRAM 34 • BUFFALO PHYSICIAN professor of ob-gyn, was elected president of the Buffalo Gynecologic and Obstetric So­ • ciety for the current year. DR. K. MICHAEL CUMMINGS, CLINICAL AS- were featured in February on the WEER public radio program, "At Your Service." D r. Robert K ratzel, clinical assistant professor of microbiology, discussed "Threat of AIDS and the Safety of the Public Blood Supply" on February 12. On February 26, D r. Doris Rapp, clinical assistant professor of pediatrics, discussed food allergies and D r. Will iam Dillon, associate professor of gyn-ob, was interview­ ed on pregnancy and childbirth. • DR. ANDREW W. GREEN, CLINICAL INSTRUC­ DR. DANIEL C. KOZERO, CLINICAL ASSISTANT sistant professor of social and preventive medicine and researcher in Roswell Park's Cancer Control & Epidemiology Depart· ment, received a $3,275 grant from the Na­ tional Institutes of Health to develop and test a physicians' training program to teach them methods and techniques designed to help pa· • tients stop smoking. SEVERAL MEDICAL SCHOOL PROFESSORS tor of medicine, is the new president of the Buffalo Allergy Society. He is on the staff at Mercy Hospital. • DR. JAMES R. HUMBERT, PROFESSOR OF pediatrics, lectured on "Infections and Iron Deficiency: Clinical and Experimental Aspects" to the· Instituto Nacional de Pediatria in Mexico City on November 21, 1983. • fessor of the Department of Anatomical Sciences, has been appointed a member of the Committee on Hearing, Bioacoustics and Biomechanics of the ational Research Council. This is an advisory group to the federal government and is a principal operating agency of the National Academy of Sciences. The committee will look at dif­ ficulties of speech and communication due to the aging process. • professor of surgery and chief, Breast Surgery Department at Roswell Park, has been appointed to the American Cancer Society's National Task Force on Breast Cancer Control. • Dr. James Mohn ed the School of Medicine's Continuing Medical Education Office and Children's Hospital. • chairman for the Third National Conference on Advances in Pediatric Gastroenterology and utrition held February 9-12 in Fort Lauderdale, Florida, with the Department of Pediatrics at UB as a co-sponsor. Current concepts in gastrointestinal disease, new diagnostic and therapeutic techniques, and recent trends in the field of infant nutrition were discussed. Other local sponsors includ- Dr. Robert Grantham DR. ROBERT GRANTHAM, ASSISTANT PRO· fessor of psychiatry, was recently honored as a recipient of the Buffalo Branch- AACP Community Service Award. President of the Kenmore Rotary Club, Dr. Grantham has served on the board of the Buffalo Speech and Hearing Center and the Minority Ad­ visory Committee of the NYS Department of Mental H ygiene. He has been active in efforts this year to establish the Sickle Cell Disease Center of W Y, and he is co­ director of an innovative course for UB medical students on health care for the poor and disadvantaged. • DR. M. STEVEN PIVER, CLINICAL PROFESSOR and deputy chief of Roswell Park's Gynecologic Oncology Department, has been elected as an honorary fellow of the Texas Association of Obstetricians and Gynecologists. • DR. MARVIN I. HERZ, PROFESSOR AND chairman of the Department of Psychiatry, introduced State Mental Health Commis­ sioner D r. Steven Katz a t a program held October 19-20 at Gowanda Psychia tric �PeopleCenter. The conference offered continuing education credits. The conference theme was "Community and Institutional Perspectives in Rural Mental Health." Dr. Herz and Dr. Katz are long-time friends. • DR. CARL W. PORTER, RESEARCH ASSOCIATE professor of pathology and researcher in Roswell Park's Experimental Therapeutics Department, received a $44,531 grant from the National Cancer Institute to study anti­ cancer drug action on polyamines and mitochondria. • DR. JOHN LORE, PROFESSOR AND CHAIRMAN of the Department of Otolaryngology, chaired three sessions of the National Cancer Institute program, "Head and Neck Cancer: Integration of Rehabilitation and Treat­ ment;' held January 18-19 in Bethesda, Maryland. One of the sessions Dr. Lore chaired was on "Issues of Community or Center Care of the Head/Neck Cancer Patient." Dr. D o nald Shedd , research professor of surgery and chief of Head/ eck Surgery at Roswell Park Memorial I nstitute, chaired a session on laryngectomy and voice • restoration. DR. HARVEY D. PREISLER, RESEARCH AS­ sociate professor of medicine and deputy chief, Medical Oncology Department at Roswell Park, chaired a session on Acute Leukemia at the American Society of Hematology Meeting, December 3-6, in San Francisco. • DR. CHARLES W. PRUET, ASSISTANT PRO­ fessor of otolaryngology, was honored by be­ Ing selected as Medical School liaison officer for the U.S. Navy and as Commanding Of­ ficer of the Medical School Research Hospital Unit, Buffalo, NY. • DR. ALFRED R. LENZNER, CLINICAL ASSIStant professor of medicine, announces the relocation of his office for the practice of diabetic medicine to 2979 Elmwood Avenue, Kenmore 14217, as of January I, 1984. Dr. Lenzner was recently honored by the WNY Chapter of the American Diabetes Association in recognition of his many con­ tributions to the organization. • DR. ELLIOTT MIDDLETON, PROFESSOR OF medicine and pediatrics, spoke last October 23-25 on "Studies on the Immunological Pro­ perties of Human Peritoneal Mast Cells" before the 96th meeting of the American Clinical and Climatological Association in Bermuda. He also spoke on a related topic November 4-5 at the 4th Susan Dees Sym­ posium on Allergy and Immunology at Duke University in Durham, North Carolina. • DR. CEDRIC M. SMITH , PROFESSOR OF pharmacology and therapeutics, was invited as the Arkansas Medical Society Lecturer on Alcohol Problems and Their Treatments. The Arkansas State Medical Society sponsors an annual invited speaker for medical students at the University of Arkansas College of Medicine. In addition to the formal medical students lecture, Dr. Smith presented a semi­ nar dealing with the results of his recent research on alcohol post-intoxication syn­ dromes - the hangover and withdrawal. • Dr. Joseph Pezlo DR. JOSEPH PEZIO, CLINICAL PROFESSOR and acting chair of the Department of Nuclear Medicine, was recently elected treasurer of the 8th District Branch of the Medical Society of the State of New York. He was also elected national chairman of the Georgetown Medical Alumni Fund for 1983-85. • DR. ENRICO MIHICH, RESEARCH PROFESSOR of pharmacology and therapeutics and direc­ tor, Experimental Therapeutics Department at Roswell Park will serve on the program committee of the 14th I nternational Cancer Congress, to be held in 1986 in Budapest, Hungary. • DR. JOHN NAUGHTON, DEAN OF THE SCHOOL DO YOU HAVE A SPECIAL TALENT IN MUSIC? THE ARTS? STAGE? SPORTS? UNUSUAL HOBBY? WRITING OUTSIDE OF MEDICINE? The BUFFALO PHYSICIAN is pla nning to present articles featurin g UB physicia ns, alumni and m edical ~ tud e nt s with outstanding talents outside of the m edical professwn . PLEASE LET US KNOW! - Contact: Bruce s. Kershner, U ni versity M ed ical Editor, 136 Crofts H all , SUNY Buffalo, Buffalo, N Y 14260 of Medicine and UB vice president for clinical affairs, was invited by President Reagan to attend a reception for the Presi­ dent's Counci l on Physical Fitness and Sports. The reception took place on January 19 at the White House. • DR. FREDERICK M. OCCHINO, CLINICAL AS­ sistant professor of family medicine, was elected vice president of the Erie County Chapter of the ew York State Academy of Family Physicians. Dr. C linto n H. Stro n g, clinical associate professor of family medicine, was elected treasurer. • DR. MARY TAUB, ASSISTANT PROFESSOR OF biochemistry, received an NIH grant of $58,875 to conduct research on the regula­ tion of kidney epithelial cell growth by hor­ mones. She will work with a hormonally defined medium for growing kidney cells. Instead of just adding serum to the medium as previously done, she will add specific com­ ponents of serum, e.g., insulin transferin, an iron-binding agent, prostaglandin and 3-tri­ iodo thyranine hydrocortizone. • BUFFALO PHYSICIAN • 35 ��ClassnotesDear Colleague: Now that the cold of winter is behind us, we can look forward to the birth of Spring, and with that comes our annual Spring Clinical Day Program planned by the Alumni Board. Ji0i will have many fine exhibits from Alumni and members of the medical community to add to this educa­ tional program. The program "Today's Medical Challenges," as the name implies, will be a discussion of some of the more pressing medical problems, that have already, or will in the future, affect the quality of life and medical care of our pa­ tients. Ji0i have as our Stockton Kimball Lecturer, the well known Dr. Jonas Salk 1910 FRANCIS M. CRAGE, M'19 • is retired and living at 4410 ucces Drive, Santa Barbara, California. who, directly or indirectly, has affected ourselves and members of ourfamily as well as our patients. Within six years ofits in­ ception, the Salk vaccine reduced the in­ cidence ofpolio by as much as 95 per cent, preventing about 300, 000 cases of polio in the United States. It will be a pleasure to meet and hear this humanitarian. Members of the classes of 1929, 1934, 1939, 1944, 1949, 1954, 1959, 1964, 1969, 1974, be sure to notify your class chairman that you will be attending your reunzon. I'm looking forward to seeingyou at the above events. Eugene Michael Sullivan, M.D. President, Medical Alumni 1940 JOHN D. WHITE, M'40 • recei­ ,·ed permanent membership in the U.S. Coast Guard Auxiliary after ten years of active participa· tion in search and rescue duties in the Florida Keys. Dr. White is semi-retired and serves as a con· sultant to the Florida Health Pro· fessional Services, Inc., of South Florida. JOHN D. PERSSE, M'42 • f(>rmer chief of the Department of Surgery, Mercy Hospital of Buf· 1920 FRANCIS R. DANIELS, M'24 • would be happy to hear from any dassmates interested in a 60th Reunion. Dr. Daniels lives at 1302 Risa Place, Santa Ana, California 92705. 1950 ROBERT C. SHAPIRO, M'51 • of Scottsdale, Arizona, was elected president of the Arizona Psychiatric Society for 1983-1984. 1960 HARRY L. METCALF, M'60 • clinical associate professor of family medicine and president of the Highgate Medical Group, P.C., was recently elected to the Board of Directors of the American Academy of Familv Physicians, at their Annu;;l Meeting in :V1iami, Florida. The AAFP is the largest medical specialty organization and represents more than 55,000 family doctors throughout the United States. Dr. Metcalf has been a Delegate representing New York State at the AAFP since 1975. He has been a member of the ;'o.lillard Fillmore stafT since 1978. HARRY L. METCALF, M'60 • has been elected to the Board of Directors of the American Academy of Famil} Physicians. Dr. Metcalf is associate clinical professor of family medicine at the University at Buffalo School of Medicine. HOWARD L. STOLL, M'28 • who retired from active practice in 1983 was recently honored at a tea g-iven by the Village Board of Lntlc Valley, New York. J. ANTHONY BROWN, M'61 • has a solo practice in surgery ''in a small California city.'' Dr. Brown lives at 1347 Lamont Avenue Thousand Oaks, Californi~ 91362. 1930 CARMELO E. PATTI (M'32) • received the great honor of being W>ted by Steuben County citizens 1 ~to the Steuben County Hall of Fame. They chose him for his 50 years of charitable service to Hornell and its surrounding communities, especially to the Boy Scouts, Camp Fire Girls, and adult organizations. He was also honored for his Golden An· niversary in the practice of me· dtune 1932-1982 and as a 50th year member in the AMA, N.Y. State, Steuben County, and local medical societies. Until his retire­ ment, he was on the staff of St. John Mercy and Bethesda Hos· Pitals. falo and medical director of Blue Shield of WNY, has retired because of health problems. Dr. Persse was the recipient of the Distinguished Physicians Award of the medical-dental staff of Mercy Hospital. STEPHEN C. SCHEIBER, M'64 • has a new book, The Impaired Ph)lsil"ian, published by Plenum Medical Book Co., that was reviewed in}AMA , Dec. 2, 1983. Said the }A/'v!A reviewer, "this book develops as the foremost authority, if not the bible, for the evolving field of the medical pro­ fession's interest in our occupa­ tional hazards." JOHN RANDALL ANDERSON, M'67 Dr. C.E. Patti • of New Hartford New York informs us that aftdr four year~ in the Navy 1968-1972, one year of emergency medicine, then BUFFALO PHYSICIAN • 37 �lege of Education, Pennsylvania State University, Uniwrsity Park, Pennsylvania. MEDICAL ALUMNI REUNION STEPHEN J. LEVINE, M'72 • has relocated his Family Practice Of­ fice to the Catherine Horan Medical Building, Holyoke, Massachusetts 01040. Dr. Levine continues to have admitting privileges in medicine and pediatrics at Holyoke Hospital and Providence Hospital, Holyoke, Massachusetts. ROBERT L. PENN, M'73 • asso­ ciate professor of medicine at Louisiana State University at Shreveport, was recently award­ ed a three-year grant of$117,287 from the National Institute of Allergy and Infectious Diseases for USPHS Grant AI 19666 en­ titled "Intestinal Bacteriallnkc­ tion Due to Immunosuppres­ sion." MAY 5, 1984 Watch your mail for more detailed information from your class chairperson. • • • • • HOWARD R. GOLDSTEIN, M'74 • scientific sessions Stockton Kimball Luncheon spouses program bus tour of the campus individual class parties nine years of f~1mily practice he has returned to full-time emergency medic inc at St. Luke's Memorial Hospital Center. Dr. Harrv C. Metcalf MICHAEL COSTELLO, M'67 • of Fort Pierce, Florida, is in private practitT of general ,·ascular surgery. KENNETH L. JEWEL, M'68 • rT­ cently began operating New Jersey's first nuclear magnetic resonance ( M R) scanner. Dr. Jewel is director of the Depart­ ment of Radiology at Mountain­ side Hospital, Montclair, ;\/.J. He recently published two journal articles on new imaging techni­ quc·s. One, digital subtraction angiography (DSA), is a relative­ ly new technique that allows visualization of arterial anatomy. He describes another tee hnique, percutaneous fine-needle biopsy, as a safe, reliable and cost­ effective method or obtaining tissue for diagnosing malignant disease. 1970 ROY M. OSWAKS, M'71 • of Vir­ ginia Beach, Virginia, plans to deliver a paper entitled "Manage­ ment of the Clavicle In Vascular I_nj~ries," to the Virginia Surgical Souety and have it published in the American Su~t;eon. GERALD M. BERESNY, M'71 • an otolaryngologist, was appointed assistant professor of com­ munication disorders at the Col38 • BUFFALO PHYSICIAN was appointed assistant clinical professor of surgny at Rutgers Medical School at Camden. Dr. Goldstein, who is practicing adult and pediatric urology, is pediatric urologist at Cooper Hospital, University Medical Center. He and his wife, Judy, have three children, Lee, Lauren and Daniel 'lbdd. JOHN C. ROWLINGSON , M'74 • writes that he continues "as din·c­ tor of our department's Pain Management Center. We have been awarded a 5-year grant (with Orthopedics and Arthritis) to study back pain. We current­ ly run back education programs for University of Virginia employees, hoping to show that the incidence and severity of back problems can be reduced." He has had five articles and one book chapter published this year. RICHARD J. GOLDBERG, M.D., '74 • has just published a book en­ titled: The PJychosocial Dimen1ioni of Cancer. A Practical Guide for llealth -Care Prol'l"den (The Free Press, Ne,, York. 198:l). Dr. Goldberg, co-author of the volume with R.M . 'lull , is an associate director, department of psychiatr} at Rhode Island Hospital and the Women\ and Inf~mts Hospital, Providence, Rhode Island . ANIL B. MUKHERJEE, Ph.D., M'75 • is a geneticist in the Depart­ ment of I Iuman Genetics, ' a - �Deaths- Classnotes tiona! Institutes of Health, Bethesda, Maryland. Dr. M uk­ hnjee is also involved in emergency medical care. JOHN C. STUBENBORD, M'75 • finished his Family Practice residcnc7 at Georgetown Univer­ Sity and passed the American Boards of Family Practice in 1983. Currently he is completing sen10r year in the Int ernal Medicine program at the University at Buffalo School of Medicine. JOHN D. ZIMMERlY, M'77 • became board certifinl Obstetrics-Gynecology December 1983. 1n 1n ROBERT ANOliK, M'78 • is an as­ sistant clinical professor of pediatrics at the University of Medicine and Dentistry of New .Jersey. Dr. Anolik lives at 2705 DeKalb Pike, Norristown, Penn­ sylvania 19401. MARIO D. SANTilli, M'78 • announces that he is now associated with Richard L. Weiss, M.D.. in the practice of Orthopaedic Surgery. Dr. Santilli is director of l~e Sports Injury Clinic at the Ene County Medical Center. JOHN MARGOliS, M'78 • joined a new surgery clinic at the Aroostook Medical Center's Community General division in Fort Fairfield Maine on December 1, 19fl3. He ha~l just completed a live-year residency at Rhode Island Hospital in Pro­ VIdence. Dr. Margolis, with two colleagues, founded the Presque Isle Surgical Association last summer to provide better service for the patient, intergroup con­ sultation, and better surgical coverage. The Bangor, Maine, News reports "that an advantage Margolis brings to the associa­ tum is his recent training in the latest -sun,ical technique"• ' . . . We b ~ cncfn by his education." JOHN M. CANTY, M'79 • a spe­ cialist in cardiology, is an assis­ tant professor of medicine at the University at Buffalo School of Medicine. MICHAEl UWANOV, M'79 • has recently been appointed as direc­ tor of United H ealth Services' Emergency Mental Health Ser­ VIce at Binghamton General Hospital in central New York. Uljanov completed his residency 1n psychiatry last year at UB and Eric County Medical Cl·nter. One of his goals as new diredor is to remove the stigma some­ times attached to the idea of a psychiatric crisis center. His center has a crisis hotlinc, as well as counseling, referrals and sup­ port for hospital patients with emotional problems related to a physical illness. JOEl M. BERNSTEIN , M'79 • assistant professor of otolaryn­ gology and pediatrics, University at Buffalo, will be presented with an lmernational Award of Merit by the Belgian-Dutch Society on Allergy in Otorhinolaryngology for basic clinical research in the area of Immunology and Otor­ hinolaryngology. The award will be presented in April in the Hague, the Netherlands. Dr. Bernstein was a speaker at the First Int ernational Symposium on Immunology and Otolaryn­ gology held April 12-13, 1984, Utrecht, Netherlands. PHiliP R. SUlliVAN, M'79 • has completed his residency and has begun a private practice in inter­ nal medicine and pediatrics in Rochester, New York, in February. 1980 JOHN PETER SANTAMARIA, M'81 • is completing residency in pediatrics, and in july will begin a residency in cmeq~ency medi­ cine at Charlotte Memorial Hospital, Charlotte, North Carolina. Dr. Santamaria is first vice president of the North Carolina Child Passenger Safe­ ty Association. KEVIN SCOTT FERENTZ, '83 • is in residency training at the Uni­ versity of Maryland. "I just want­ ed to inform you of my change in address, 2717 Jenner Drive, Apt. B, Baltimore, Maryland, 21209 is my permanent addr~ss. I also recently got marncd. RICHARD D. JACKSON, M'83 • is in residency training at Lan­ caster General Hospital. Dr. .Jackson li ves at 1077 Gypsy Hill Road, Lancaster, Pennsylvama 17602. DAVID J. ROSENFElD, M'83 • lives at 130 Edgehill Road, Bala Cynwyd, Pennsylvania 19004. JOHN P. MURPHY (M'58) • died at the age of 74 on September 28, 1983. He was a resident of Penfield , New York. • JOSEPH J. PISA (M'26) • who practiced medicine in Buffalo for 55 years before retiring in 1981, died at age 85 on December 15, 1983. A Buffalo native , he died in Columbus I lospital , where he had served on the staff for so many years. He was also on the staff of Sisters llospital. He was a member of the AMA and the Eric County and Stale Medical Societies, as well as the Baccclli Medical Society and Alpha Phi Delta Fraternity. Shortly before his death, he was honored as the winner of the national Christopher Columbus Award presented by the ational Columbus Day Committee. His wife, .Jennie, daughter Serena, son Thomas, and f(>ur grandchildren survive him. • AliCE BUllETT BURKE (M'18) • died February 1, 1984 in Alameda, California at age 92 after a long illness. Dr. Burke was the wife of renowned Buffalo physician , Gary Burke. After leaving Buffalo, they practiced in Puerto Rico for some time and also did some missionary work. Dr. Burke and her husband were instrumental in establishing hospitals for the Navajo Indians at a time when children were dying for lack of medical attention. She retired in 1967 at the age of 75. She is survived by a son, Dr. Robert H. Burke, also a UB alumnus , (M'51). • FRANCIS R. COYlE (M'32) • died on Dncmber 12, 1983 , in Burlitlo following a long illness. Dr. Coyle, 76, was the head of a hosptal medical unit in Hawaii in World War I I. An Amherst resident, he was born in Scio, New York. He served his internship and residency at the old Buffalo City Hospital. After serving in the Army as a colonel, he operated an Amherst practice until retiring in 1960. He was on the staff of Sisters, Burlitlo General, and St. Francis Hospitals, and was a physician f(>r the Buffalo school system. I le is survived by a daughter, Bernadene; a son, Phillip; a brother, Victor; and a sister, Eleanor. • CARlETON A. HEIST (M'30) • died .January 13 at the age of 76 in Ball Pavilion, a nursing home in Harbor Creek, Pennsylvania. A resident of the Chautauqua County Village of Westfield f(Jr 48 years, he was a life member of the American College of Angiology. A World War II veteran, he was also a member of the College of Surgeons the American Medical Association and its ew York Stale and' Cha~tauqua chapters. His wife of 52 years, Ruth , two sons, two brothers, two sisters, and two grandchildren all survive him. • OR . AMBROSE MACIE died at age 59 on December 28, 1983, at Sisters Hospital after a long illness. An associate clinical professor of obstetrics and gynecology, he was also chief of staff for the equivalent depart­ ment at Sisters Hospital. A Buffalo native, he attended Canisius High School and Canisius College, where he was a star basketball player in the 1940s. He received his medical degree from Marqucllc University in 1950 and then served in the Navy during World War II. Coming to Sisters Hospital in the 1950s, hl' was elected prl'si­ dent of the hospital's medical staff in 1973. Past president of the Buffalo Gynecology Association, he was also elected chairman of the regional section of the American College of Obstetricians and Gynecologists. He was also a Fellow of the American Co ll ege of Surgeons, as well as a member of the American College of Obstetricians. He is survived by his wife, Madeline, two sons, three daughters, two sisters, a brother, and one grandson. • BUFFALO PHYSICIAN • 39 �CalendarDEPARTMENT OF PHARMA­ COLOGY & THERAPEUTICS SEM­ INAR SERIES o April 30, Mon­ day, 4 p.m. "Pennyroyal Oil As An Abortive Agent and a Toxin: Mechanistic and Structure Ac­ tivity Relationships." Sidney Nelson, Ph.D., Medicinal Chem­ istry, Pharmaceutics, University of Washington. 108 Sherman Hall, UB. May 9, Wednesday, 4 p.m. "Recent Advances in the Design of Mechanism-Based In~ hibitors of Clinically Relevant Enzyme Targets." Alan Kranz, Ph.D. , director of research, Syntex Corp., Inc., Toronto. For further information, call 716-831-2802. CLINICAL DERMATOLOGY UPDATE: A PROGRAM FOR NONDERMA­ TOLOGISTS • May 14, Monday, 8:30 a.m.-5:15 p.m. Webster many of the most common diseases of the skin, those which the nondermatologist is likely to sec, as well as some less common, but potentially severe diseases. Speakers will emphasize office based diagnosis and treatment of dermatologic problems. New treatments will be featured, in­ cluding treatment of acne with Accutane; acyclovir treatment of herpes infections; and treatment of fungal infections with ketoconazolc. 6 credits Category I of the Physicians Recognition Award of the AMA. Also ac­ cepted for 6 prescribed hours by the American Academy of Fami­ ly Physicians. Advance registra­ tion encouraged. The fcc for members of the Buffalo Academy of Medicine is $25; non­ members, $50; nurses and other ONE HUNDRED AND THIRTY-EIGHTH SCHOOL OF MEDICINE ANNUAL COMMENCEMENT MAY 19, 1984 2:00 P.M. KLEINHANS MUSIC HALL (Main Auditorium) For information: contact Dr. Jonathan Richert, Assistant Dean and Registrar, 140 Farber Hall, School of Medicine, SUNY Buffalo, Buffalo, NY 14214 (716) 831-3390. Hall, Millard Fillmore Hospital. Speakers: James Rasmussen, M.D., University of Michigan Medical School; Kevin Kulick, M.D. , UB/VAMC; Herman Mogavero, M.D., US/Buffalo Medical Group; David Stein, M.D., UB/Children's Hospital; Lincoln Krochnal, M.D., US/Westwood Pharmaceuticals; and Bruce Thiers, M.D., Medical University of South Carolina. This course will survey An .. DIJCCAI n P~V~Ir.:1.4..N health professionals, $25. Fee in­ cludes coffee breaks and lunch. Residents and UB medical students admitted free to scien­ tific program, but must register in advance. Sponsored by the Buffalo Academy of Medicine, the Children's Hospital of Buf­ falo, the UB Departments of Medicine and Dermatology, and UB Continuing Medical Educa­ tion. ROSWELL PARK ONCOLOGY SEM- INAR • June 7, Thursday, "Prevention of Cancer." Dr. Cur­ tis Mettlin. Roswell Park Memorial Institute, 666 Elm St., Buffalo 14263. Contact Gayle Bersani, (716) 845-4406. Fee: $45, physicians; $15, residents and allied health professionals; no fee, students. Pre-registration encouraged. American Academy of Allergy and Immunology, aod the Scher­ ing Corporation of America. Credit hours: 20. Fee: Physicians in Practice, 275 and allied health professionals, $150. Con­ tact Rayna Dutton, Children's Hospital, 219 Bryant, Buffalo, NY 14222. (Collect) 716878-7630. THE UNITED STATES/CANADA JOINT CONFERENCE ON NEURO­ LOGICAL EMERGENCIES IN CHILDREN AND ADULTS • June DEPARTMENT OF PSYCHIATRY CONTINUING EDUCATION PRO­ GRAMS • Patterns of Adapta­ 8-10. Inn on the Park, Toronto. Chairmen: Michael E. Cohen, M.D. and William j. Logan, M.D. Sponsored by: UB Conti­ nuing Medical Education, the UB Departments of eurology and Pediatrics, and the Depart­ ment of Pediatric Neurology, The Hospital for Sick Children, University of Toronto. Credit Hours: 20. Fee: Physicians in Practice, 275, and allied health professionals, $150. Contact Rayna Dutton , Children's Hospital, 219 Bryant, Buffalo, Y 14222. (Collect) 716878-7630. ASTHMA AND OTHER ALLERGIC DISEASES, MANAGEMENT BY PRI­ MARY CARE PHYSICIANS • June 9, Saturday. Hyatt Regency, Buf­ falo, NY. Chairmen: Elliott Mid­ dleton Jr., M.D., and Michele Hindi-Alexander, Ph.D. Spon­ sored by UB Continuing Medical Education, the UB Departments of Pediatrics and Medicine, and the ational In­ stitute of Allergy and Infectious Diseases. Credit Hours: 6. Fee: Free. Contact Rayna Dutton, Children's Hospital, 219 Bryant, Buffalo, NY 14222. (Collect) 716-878-7630. SEVENTH NATIONAL CONFERENCE ON PEDIATRIC/ADULT ALLERGY AND CLINICAL IMMUNOLOGY • July 19-21. Four Seasons Hotel, Toronto. Chairmen: Elliott Middleton Jr., M.D., and Elliot F. Ellis, M.D. Sponsored by: UB Continuing Medical Education, the UB Departments of Pediatrics and Medicine, the tion in Psychopathology in In­ fancy and Early Childhood: Principles of Clinical Diagnosis and Preventive Intervention. May 18, Friday, 10:30 a.m. Eric County Medical Center. Robert A. over, M.D. , research psych­ iatrist, Clinica~ Infant Research Unit Laboratory of Psychology and Psychopathology, National Institute of Mental Health; clinical associate professor of Psychiatry and Behavioral Sciences, Child Health and Development, George Washing­ ton University. Short Term Dynamic Psychotherapy: Evaluation, Technique and Outcome, an Audio Visual Presentation. June I (time and location to be announced). Peter Sifncos, M.D., professor of psychiatry, Harvard University; associate director, Department of Psychiatry, Beth Israel Hospital, Boston. (Day-long conference). Current Issues in Deinstitu­ tionalization. June 8, Friday, 10:30 a.m., Eric County Medical Center. Leona Bachrach, Ph.D. , research professor of psychiatry, Maryland Psychiatric Research Center, University of Maryland, School of Medicine, Department of Psychiatry. The Use of P sychotropic Medication in Medically Ill Patients. June 15, Friday, 10:30 a.m. Erie County Medical Center. Joseph Di Giacomo, M.D., associate pro­ fessor of psychiatry, University of Pennsylvania. To apply, call 716-895-2986 or write Dept. of Psychiatry, 462 Grider St., Buf­ falo, NY 14215. �- ............ __ _------------------------------------------------------------111111 BUSINESS REPLY MAIL FIRST CLASS PERMIT NO. 2210 BUFFALO, N.Y. POSTAGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, New York 14214 NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO, NEW YORK 14214 ---------------------------------------------------------------LET US HEAR FROM YOU Fill out this card (Please print or type all entries) Name ________________________________________________ Year MD Received ___________ OfficeAddress _______________________________________________________________________ HomeAddress ~--------------------------------------------------------------------- If not UB, MD received from - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ­ In Private Practice: Yes D No D In Academic Medicine: Yes D No D Specialty - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Part Time D Full Time D School Title ___________________________________ Other: 0 Medical Society Memberships: NEWS: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.? _______________ Please send copies of any publications, research or other original work. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, May 1984 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1984-May Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1984-v18n01-May Table Of Contents A list of subunits of the resource. Nicorette Hospice Buffalo Little Known Medical Schools Nuclear Holocaust Research Medical School News Hospitals Books Students People Classnotes Deaths Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-07-06 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v18n01 Extent The size or duration of the resource. 44 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1984 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/958c950dd4e7af0088e159578a31ec78.pdf 69ab419b5a33e3c8106883ba3db2f370 PDF Text Text �Dean's Message The revamped Buffalo Physician has completed its first year of trial with the publication of this edition. During the course of the past year, Mr. Bruce Kershner has assumed the void left by the retirement of Mr. Robert McGranahan, and he, together with the University's Publications Department and the guidance of Mr. Robert Marlett have continued and expanded the tradition left by Bob McGranahan. The advisory board has met with the editorial staff on a regular basis. This relationship has and will help bring to our readers a periodic publication that will be informative to all of the School of Medicine's constituents. In the latter regard, we have surveyed the mailing lists critically to make sure that the publication reaches all for whom it is intended. This has resulted in an expanded mailing list. To facilitate its mailing, the University's Public Affairs office has developed a centralized mailing service which will ensure rapid distribution as well as delivery to up to 10,000 readers and supporters (to take effect with the April issue). If you have ideas which will enhance the quality and content of the Buffalo Physician, please feel free to submit them either directly to the editorial staff or to my office for review by the advisory board and Bruce Kershner. Our goal is to ensure a very informative publication which will keep you abreast of the School of Medicine's progress and which will ensure good reading. - John Naughton, M.D. �Contents BUFFALO 2 PHYSICIAN STAFF Executive Editor, University Publications Robert T. Marlett Art Director Rebecca Bernstein Medical Editor Bruce S. Kershner Photography Jim Sulley David S. Ottavio Ed Nowak ADVISORY BOARD Dr. John Naughton, Dean School of Medicine Dr. Harold Brody Dr. James Kanski Dr. James P. Nolan Dr. Charles Paganelli Dr. Peter Regan Mr. James N. Snyder Dr. Eugene Michael Sullivan Jr. Dr. Mary Voorhess Dr. Martin Wingate Dr. John Wright Dr. Maggie Wright Ms. Rita Wolff TEACHING HOSPITALS The Buffalo General Children's Deaconess Erie County Medical Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Charity Veterans Administration Medical Center Produced by the Division of Public Affairs, Harry R. Jackson, director, in association with the School of Medicine, State University of New York at Buffalo You won't recognize it • Alumni returning for the annual Spring Clinical Days and reunions will find a "new Buffalo," on the move. 7 10 Mitchell I. Rubin • Dr. Rubin continues his reminiscences about Pediatrics and the development of the medical school. 12 Neck-breaking Surgery • Procedure pioneered by Dr. Simmons involves breaking the patient's neck or spine to correct a deformity. 13 A Gallery of Ghosts • In his recently published memoirs, Dr. Louis Bakay, retired chairman of Neurosurgery, describes "ten lost years" spent in Hungary during World War II. 17 Research • A computer program being developed at UB applies "artificial intelligence" in diagnosing possible malfunctions within the human nervous system. Roswell researcher investigates a disease that may be a precursor to AIDS. UB graduate develops vaccines for herpes and hepatitis in animals through gene splicing, seeks human vaccine. Heroin addicts are winding up on dialysis, a UB researcher reports. 21 Medical School News • UB's first clinical practice plan for fulltime faculty, the last one of its kind in New York State, means significant changes because of its reallocation of funding for medical programs and its regulation of full-time faculty incomes. Grant requested for genetics trianing. Spinal Surgery Pioneer • Dr. Edward Simmons, international pioneer in spinal surgery, has joined UB and Buffalo General Hospital, making Buffalo the treatment center for nearly all the world's cases of a severe spinal defect. 24 Hospitals • Joseph Paris, director of the Buffalo VA Medical Center, is also responsible for other hospitals, a clinic, an old soldiers home, and a national cemetery. Roswell Park reapproved by American College of Surgeons. 26 Students • Fifty medical research exhibits were displayed at the Third Annual Student Research Forum. 27 People • Dr. John Ambrusko spends part-time as a real-life "Love Boat" doctor. Dr. Robert Guthrie honored by the National Association of Retarded Citizens. Other news of people you know. 31 Classnotes • Alumni help is asked in locating " missing" graduates. 32 Deaths • Dr. Erwin Neter is dead at 74. Cover Art: Francis Specker THE BUFFALO PHYSICIAN, (USPS 551-860) February 1984 - Volume 17, Number 5 published five times annually: February, May, July, September, December - by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. POSTMASTER: Send address changes to THE BUFFALO PHYSICIAN, 139 Cary Hall, 3435 Main Street, Buffalo, New York 14214. Dr. Mitchell I. Rubin Dr. Edward SlmtmJns with patient Alumnus Enzo Paoletti reports on 11acc1ne diSCOIIetY �A Message From The President of the Medical Alumni Association Dear Colleagues: Planning for Spring Clinical Day and alumni reunions is well under way. Spring Clinical Day and the Stockton Kimball Luncheon on Saturday, May 5, are at the Buffalo Marriott Inn. As you can see from the program printed on page 35, an outstanding scientific program will be presented. Official registration material will be in the mail soon. The special reunion classes have all begun planning their individual class celebrations. The accompanying article tells all you out-of-towners about what to look for in the "new Buffalo." Come see us. The Medical Alumni Association will also host the reception for the Senior Medical Class on Sunday, April 8 at the Albright Knox Art Gallery. Mark your calendars now and plan to attend these special events. -Eugene Michael Sullivan, M.D., President Medical Alumni Association (Directlv above} The breakwall at the Erie Basin Marina, a new recreauonal area In the heart of downtown. 2 • BUFFALO PHYSICIAN (lett topJ Looking north down Main Street from the Marine Midland Jbwer. Note rapid transit tracks In the middle of the street. PHOTOS: FRANCIS SPECKER, EO NOWAK and THOMAS BUCHANAN �I ~--~·-- +- -----=- - The New Bullalo An amazing renaissance has begun - the Queen City is back on the track T wenty years ago, urban planners and designers were abandoning any hope for the Buffalo metropolitan area and with good reason. Population was declining quickly, the crime rate was skyrocketing, and business investment, with the economic prosperity which accompanies it, was in full exodus. Experts used charts and statistics to predict the theoretical demise of the Queen City, but the formulas lacked one important intangible - the resiliency of the city and its residents. Just as the civic coroners were pronouncing the city's imminent death, Buffalo began an amazing resurrection. Downtown construction blossomed, suburbanites began moving back between the city limits, and a new spirit, encapsulated in the Chamber of Commerce's catchy campaign anthem, "Talking Proud," swept the populace. The immediate origins of Buffalo's renaissance can be traced to the opening of the Convention Center Plaza, directly behind the old Statler Hilton. The Center is a modern, multi-purpose facility which can (and does) host anything from a medical convention or auto show to a computer fair or the "world's largest disco:' Responding to the Convention Center's success, the area hotel industry boomed as tourist agents recognized the potential of the city and its environs as a vacation resort. Cool summers can't be found in Florida, after all. The State-wide "I Love NY" promotion featured Buffalo as "a great city hiding in plain sight;' a reference not only to the James Caan motion picture filmed in the city five years ago, but also to the area's rich cultural and scenic heritage little known or forgotten outside its boundaries. (Right topJ The awanl-wlnnlng llbertv Bank building downtown. By John K. Lapiana BUFFALO PHYSICIAN • 3 �C apitalizing on Buffalo's new "tourist attraction" status was Chinese hotelier Clement Chen, builder and owner of the luxurious Hilton by the Waterfront. The newest jewel in the Hilton's world-wide crown, Chen's hotel boasts complete indoor recreational facilities, a first-class restaurant Qustine's), a cluster of small boutiques and businesses, and an impressive atrium. Following Chen's path were the Marriott and Hyatt hotel chains. Adjacent to UB's Amherst Campus is a ten-story Marriott Inn, home to Panache, which is, according to company statistics, the busiest bar and nightclub in any Marriott hotel. Nearing completion is Buffalo businessman Paul Snyder's Hyatt Regency on the corner of Main and Genesee Streets downtown. When completed, the Hyatt will be one of the world's architecturally unique hotels, combining the Edwardian features of the old Genesee Building with an 11-story new wing and an ultra-modern glass atrium extending over Main Street. Snyder's development is the last major phase of the city's new downtown Fountain Square, composed, too, of a new Liberty Bank building and the massive expansion of the ,...,... .,. ' I ... r. ,.,,... ,..... . ---- .. - .. au - .._ .... ,. = -..-.....-.: ~e.&&&&& --- -~-w : w a.,.. ,. ,..r,-~ - - .. . -== r="!' - - r""'! I I &U:: ~~ · ,.~. && r-tl'lr! ,.... .. Ill~ ~ ~~ landmark Goldome (formerly Buffalo Savings Bank) headquarters. The city's renewed interest in dramatic arts is reflected by the growth of the "Theatre District;' which extends on Main Street from Chippewa to Tupper. Buoyed by the Studio Arena Theatre, home of numerous first-run plays and pre-Broadway try-outs, the District is also home to the University's Center for Theatre Research and the opulent Shea's Buffalo. However, the major development and, many say, the key to a lasting recovery of the city, is the almost-completed Light Rail Rapid Transit (LRRT) system, which will carry commuters from UB's Main Street Campus to the heart of downtown in less than six minutes. Currently, stretches of the above- and below-ground system are being tested, and transit officials plan to welcome the first Buffalonians "on board" later this year. Despite some construction delays and an always tentative federal commitment, LRRT extensions are being planned to the Tonawandas and UB's Amherst Campus. At the system's current north end, the UB Main Street Campus is quickly evolving into one of the nation's largest Health Sciences educational centers. Over $4 7 million of rehabilitation and construction work has transformed the stately campus into a maze of bulldozers, cranes, and detours, but inconveniences set aside, officials believe the revitalized Main Street facility will signal the beginning of a new era in Buffalo health education. Highlighting the Main Street conversion is a $30 million addition to the Cary-Farber-Sherman Medical School complex coupled with rehabilitation of those already standing buildings. When finished, the giant complex will house only the School of Medicine, with present co-resident, the School of Dentistry, moving into new quarters in refurbished Squire and Foster Halls. Also nearing completion is the Health Sciences Library, an $8 million addition to Abbott Hall (the old Lockwood). The Library is presently quartered in Kimball Tower, a building it shares with the School of Nursing. T -........ .., - Wires and track bed tor rapid transn cars near the Martne Midland lbwer which straddles Main Street. 4 • BUFFALO PHYSICIAN he Main Street Campus is not Buffalo's only medical area growing and expanding. Within the past decade, Millard Fillmore Hospital established a suburban branch in Amherst and an all new Erie County Medical Center (ECMC) has been constructed adjacent to the old Meyer Memorial Hospital. There have also been rehabilitation projects and additions to Children's Hospital, Buffalo General, the VA Hospital (an addition which provided the UB Medical School with additional teaching space), and Millard Fillmore Hospital at Gates Circle. The $250,000,000 Buffalo General expansion is possibly the largest current hospital reconstruction project in the country. According to a recent survey, Buffalo is home to 16 hospitals, providing 773 beds per 100,00 residents and workplaces and laboratories for the city's thousands of physicians and surgeons. Finally, Buffalo's historic affin ity with water has not been overlooked. Condominium construction is blossoming on the Waterfront and the Erie Basin Marina has become the city's favorite recreational spot. Here, picnickers and boating enthusiasts congregate by day and "the jet set" landing there at dusk visits either Crawdaddy's or the Hilton's Le Club, two of Buffalo's most popular restaurants and nightclubs. Recent city-sponsored plans call for a Waterfront Village on the shores of Lake Erie consisting of a multimillion-dollar office and shopping complex. Buffalo is, Mayor James Griffin is saying on more and more occasions, "back on track" for the future. • �-----(ClockWise trom top rlghtJ New offlce bulldlnfiS tor high-tech firms line a downtown expressway. An addnton to the original LDckwood Library II the Main Stfflfll Cltnpus will hBIP expand and modBmiZB thll flcltnyas n becomBS the new Hunh SCIIHICBS Library. One Df the cars thll will run In the rapid transn SJSIBIII. An BSCBiator tunnel In lhB rapid transn stilton under CDnstructlon atlhB Main Stfflfll Cltnpus. BUFFALO PHYSICIAN • 5 �(Ciockw/SB from top) Sti'BBI SCBIIB In lhB nBW ThBatfB District. 6 • BUFFALO PHYSICIAN Ths munl·m/11/on dollar 6o/doms addnlon downtown tfrlnnBffy Buffalo Sar/ngs Bank). Ths atrium lobby at ths watsrtmnt Ninon. The htlldtiUartBtS of lhB Niagara Frtmtlsr rransn Allthortty wnh M&T Bank In /Bit backgmund. �the research laboratory and finally published our findings. Over the years, we met often for discussion of medical problems of common interest to us. Later I had a somewhat similar relationship with Dr. Felix Milgram who succeeded Ernest Witebsky. Philosophically I was very close to Hermann Rahn, the professor of physiology. We served together on the Executive Committee at the Medical School. We had lots of discussions about academic life and the medical school. It seemed we had a rather common point of view regarding the direction in which the medical school should go. Dr. Rubin (rlghtJ at recent recognition day symposium. Dr. Rubin Former head of Pediatrics continues his reminiscences By Ronald Elmer Batt Class of '58 EDITOR'S NOTE: This is the second part of a two-part article. The first appeared In the December Issue of the Buffalo Physician. MEDICAL EDUCATION AT THE UNIVERSITY OF BUFFALO. Question: May I ask you what your thoughts were on the direction of the medical school? Dr. Rubin: Well, you know when I first came there, the medical school was a very small structure on High Street. I am sure basic sciences were well taught. The clinical divisions were spread out around the various hospitals. I think the first full time academic person might have been David Miller at the Meyer, then john Stewart. We often had discussions about things before going to the medical school committee meetings. Over the years, I could see the medical school become a real academic environment for the clinical departments with great growth in the basic science departments. I also had a pleasant relationship with Professor of Anatomy O.P. Jones. Though we didn't do any work together, I could sit down and talk straight with him. I think there was a great spirit of academic interest at the medical school. I thought the medical school in those days was absolutely a first-rate school. The students could get a good indoctrination into fundamental medicine. Question: Who were the other people at the University with whom you associated? Dr. Rubin: I worked with Ernest Witebsky. We spent many hours together in Question: May I ask what was your viewpoint as to the direction of the medical school and what was the opposing viewpoint? Dr. Rubin: You know, sometimes there is no opposing viewpoint. Sometimes it is an unexpressed viewpoint. I kept pushing for more research, to bring on people who were research minded, as well as clinicians. They all had their training as pediatricians and became investigators on top of that. That was my training too. My original training was clinical pediatrics, then I added research. I just don't believe, and I didn't believe then, that we could develop a first-rate teaching program unless research was going on. Now, research in my mind was not just a matter of whether you proved something, but the fact that you asked questions, the fact that you asked yo urself some questions, the fact that you asked questions of the clinical material that you saw, the fact that you were looking for answers. And, I think, unless the faculty does that, the students don't get to do that. You know I believe in what is called the "Mentor Image." Going back to Dr. Park at H opkins, a distinguished teacher, he was a tall man and he used to carry his head a little bit on the side. There were residents who began walking that way! This was an image they wanted to copy. I think the teacher must set a good im age to be copied; it is like imprinting - imprinting the child, imprinting the animal. Unless you set up an environment with certain expectations, this doesn't come about. We had a lot of awfully good people in the Pediatric Department.B Many of them became chairmen of departments at other medical schools. We did have a commitment to learn. If the teacher doesn't have this mentor im age, I think it doesn't get down to the student. When I use the term "student or resident;' I also include the young doctors at the hospital. You know, most of the pediatricians in the community brought their patients to the Children's Hospital. We also asked them all kinds of questions. BUFFALO PHYSICIAN • 7 �We asked questions about their patients. We were allowed to make rounds on everybody's patients. But so were the practicing pediatricians also making rounds on everybody's patients when they were on service. doesn't carry the message of the fact that a patient has an immunologic disease to the basic science laboratory. I don't think any administrator can do that. I think you have to have body to body contact. Question: That 's one good way to see how other people are doing things. Dr. Rubin: Yes. We helped one another. Question: Were you involved in any attempts to build a university hospital at Buffalo? Dr. Rubin : I was involved in only one. They brought in ideas and we had some ideas. We shared them. We discussed them together. The residents also had the right and were encouraged to ask questions about all patients. We had good "give and take" with regard to patient study and care between all members of the staff. Of course, we were committed to teaching. You cannot teach unless you are committed to this kind of openness in patient study and care. I wasn't worried so much about the image of me. I was concerned with the patient and almost as concerned about how the residents and students would take this kind of hospital practice. We spent, I am sure, two years talking about the development of a new university hospital on the campus. I talked quite considerably to the Children's Hospital Board of Managers not to build further extensions to the Hospital but to build a Children's Hospital next to the proposed university hospital on the Main Street campus. They said we could not get ground on the campus, I always wanted the Children's Hospital close by the University. My relationships in my training at Hopkins and Washington University in St. Louis, and the Philadelphia Children's Hospital, showed me strongly the advantage of having pediatrics and the other clinical departments no more than white coat distance from the basic science departments. The feedback from clinical to basic science and from basic science back to clinical, to me was the best way for teaching, for developing research ideas in academic clinical medicine, and for a higher standard of patient care. I thought, with a university hospital bridged to the library and bridged to the basic science buildings, one could walk inside and see the immunologist and walk over and see the pharmacologist, and the physiologist, and other disciplines at a university which makes a world of difference in academic pursuit! I think of a medical school as part of a university system. It is a teaching institution. Patients are part of our teaching material. Unless you can have a close relationship with the people doing basic science, clinical departments suffer. I would encourage any medical school to have its clinical departments right next door. We had hoped we would have that in Buffalo; unfortunately we did not. I pushed and pushed and pushed for the Children's Hospital not to build more downtown but to build on the campus. I did not want the Children's Hospital to be part of a general hospital. I believed its function would be best served as a free standing institution. Of course, when nothing happened on the campus, that idea fell apart. For almost two years, designing floors, designing where the beds would be, what would be here and there, was one of the great exercises in futility. There was a great movement. In fact, there was some question that the Meyer Question: Dr. Stockton Kimball, the Dean? Dr. Rubin: Oh, he was a great man. Stockton kept his desk in his pocket. You asked Stockton a question, he would open up his coat pocket and pull a paper out and give you an answer right then. He was a great dean in many ways. Question: What made him so? Dr. Rubin: Well, because Stockton ''Feedback from basic science to clinical and back was to me, the best way for teaching.'' Photos from an earlier era of pediatric care at Children's Hospital. 8 • BUFFALO PHYSICIAN understood, I think, what had to be done, and he let you do it. He didn't interfere with what you thought had to be done. He didn't want you to take away anything from somebody else. If you showed him that you could do something, he was right behind you supporting you. He was for the development of the Medical School. The amazing thing was that, as I say, he kept his desk in his pocket. He always had his information with him. I think he understobd personality structure and almost everything else. He was a very important person for his time as Dean. His untimely death was tragic. Question: I remember talking with Dr. Randall. We had to search for a Dean with extraordinary capabilities because we do not have a university hospital. Dr. Rubin: Well, what it does is this: you have the Dean of the medical school sitting at the school related to the basic science faculty, then he comes over once a month to the hospital's board meeting and tries to relate to that. Well, the Dean might relate but that isn't where the close relations have to be. The relations have to be between the clinicians and the basic scientists. The administrator �Hospital might also go out to the campus. The General Hospital decided they would not go out, and I think that may have been a factor which held the Children's Hospital from wanting to go out . These two hospitals had an interlocking Board. The men were on the Board of the General and, to a large extent, their wives were on the Board of the Children's. I think we kept almost a family relationship in that sense. And, of course, many of the Buffalo General surgeons were surgeons at the Children's and so were the obstetricians. So there was a lot of interlocking both in faculty and in Board administration . But I think, had the University persisted in building a hospital , there was a chance that the Children's may have moved. I don't know positively that they would have. I made every effort to encourage them. Then the idea of a hospital at the Medical School fell apart and it was decided to build the new Erie County Medical Center at its present location. With further facility needs, the Children's expanded at its present location . Question: In terms of teaching and research, was there a substantial difference between the private University of Buffalo and the public State University of New York at Buffalo? Dr. Rubin: Do you know that stuff called money? That made a great difference. In the first place, the medical school was able to expand from small departments to "several member" departments, with broad interests in all aspects of their basic fields. Additional funds from the Medical School allowed us to come from a two man department to full-sized faculty, covering most aspects of pediatrics over a period of several years. Well, it made quite a difference when the budget for the department ran into a couple of hundred thousands of dollars every year for basic salaries. This expansion helped attract research money that could never have been attracted with a two man full-time faculty. For instance, one year we had a two million dollar grant for research. This was made possible because we had basic university salaries for faculty, which we didn't have before. Of course, the faculty comprised several able pediatricians who were in private practice. Question: Did most of the research grant money come in after New York State took over the University of Buffalo? Dr. Rubin: Yes, because then we were able to attract full-time faculty. We had to have additional full-time faculty before we could possibly do major research. Some research was being done at the hospital before on a limited scale. I came to the department with a commitment to do research and to develop full scale activity, both clinical and laboratory. The expansion of the University had made them possible entirely by the State support. It wasn't until the State of New York decided to take over at Buffalo that our school really expanded to the impressive image it has today. That doesn't mean that it wasn't a good medical school earlier - I'm not saying that at all. There were very able chairmen of the various departments but it was a small school and the clinical departments and research programs were underfunded and limited at the Children's. With faculty composed primarily of busy practitioners, and with limited available funds, research was limited . But the support of the Statler Foundation made research at the Children's Hospital possible even before we became a State School. Question: In the private University of Buffalo, what was the role of the Chancellor with regard to the medical school and the Dean with regard to the medical school? In other words, did the Dean have a free hand or was the Chancellor personally involved? Dr. Rubin: I think it was largely the Dean. When I came there, the Chancellor was Dr. Capen. Dr. Capen interviewed me; I was not interviewed by Dean Koch. falo;' and I think a lot of citizens in town who had supported the School had a similar fear. Well the community didn't lose out, they obtained a whole lot more for their money than they would have ever obtained in any other way. The opposition to the state was, I think, lack of unde rstanding of what it meant. Dr. Furnas carried the effort almost singlehanded. I presume Mr. Knox also had something to do with the transition. He was then Chairman of the Board. But certainly, Dr. Furnas, from the standpoint of the people at the University itself, carried the major effort. I can remember going to the meeting when he said, now we are going to change from having an annual budget of 14 million dollars, or something like that, to 140 million, or something like that. I can remember the meeting when he told us what it meant to become a State University. Oh, I think that was a tremendous move, from a local university, in a sense, to one of the big state universities in this country! Question: It surely has changed. Dr. Rubin: Yes, and I think for the better in every sense. A lot of good things are going on that never would have been developed without that change. 9 • BIBLIOGRAPHY AND NOTES: 8. (1) Question: Was that unusual for the Chancellor of the University to interview you? Dr. Rubin: Yes, I think so. He came down to the Children's Hospital to interview me. But I think Dr. Capen was that kind of a man . I think that he saw this as a new step in the development of pediatrics. He really understood the problems of a medical school. Capen asked me some interesting questions and we laughed a lot about things he asked. He was a distinguished scholar of the old school, a gentleman with a real understanding of the academic purpose. I think he played a big part, as did Dr. Furnas, in developing the medical school. Dr. Furnas took us into the New York State system , I think, against a lot of opposition on the Board of the University. Question: Why was that, Dr. Rubin? Dr. Rubin: Well, "being taken over" you know. It was being "run" from Buffalo, now it was going to be "run" from Albany. Of course, the University had its own local Board, and as you know, the ·man who pays the bills has a lot to say. I think they feared we were losing . our University, the "University of Buf- Letter from Dr. Philip Calcagno dated 4 October 1977. The names of those associates of Dr. Rubin who (2) (3) (4) (5) (6) (7) (8) (9) (1 0 ) ( 11 ) (1 2 ) (13 ) ( 14 ) (1 5 ) 9. became professors and chairmen of departments. Dr. Donal Dunphy, Professor and Chairman of the Department of Pediatrics, Iowa University School of Medicine. Dr. Charles U. Lowe, Director of Intramural Research NICHD. Dr. Lowe is presently functioning in the office of HEW associated with Dr. Julius Richmond . Dr. Lowe is also the editor of Pediatric Research and is internationally known. Dr. Fred Eagle, Dean, New York University. Dr. Joseph A. Bellanti, Professor of Pediatrics and Microbiology, Georgetown University. Director, lnterna· tional Center for Interdisciplinary Studies of lm· munology. Editor·in·chief of Pediatric Research . Dr. Charles Kennedy, Professor of Pediatrics, Georgetown University, Chief of Pediatric Neurology. Dr. Robert Miller, Chief. Clinical Epidemiology Branch of N.I.H ., National Cancer Institute. Dr. Thomas Aceto, Professor of Pediatrics, University of South Dakota. Dr. David Gardner, Professor of Pediatrics, Duke University. Dr. Charles Hollerman, Professor of Pediatrics, Univer· sity of South Dakota. Dr. Philip Bunnell , Professor and Chairman , Department of Pediatrics, San Antonio School of Medicine. Dr. Robert Clayton, Professor of Pediatrics, San Antonio School of Medicine. Dr. Arno Hohn , Professor of Pediatrics, South Carolina School of Medicine. Dr. Donald Pinkel, Professor and Chairman, Department of Pediatrics, Medical College of Wisconsin . Dr. Abner Levkoff, Professor of Pediatrics, Medical University of South Carolina. Dr. Philip Calcagno, Professor and Chairman, Depart· ment of Pediatrics, Georgetown University. This oral history memoir was developed with Dr. Rubin in February 1977. Saul Benison wrote : "While it is true that the oral history memoir may supply new and even unique information that is not to be found in the written record , its chief value lies in the fact that it is in actuality a first interpretation of a mass of primary and secon- dary data by a participant in past events." Saul Benison, " Rene Dubois and the Capsular Polysaccharide of Pneumococcus: An Oral History Memoir". Bulletin History of Medicine 1976, 50: 459. BUFFALO PHYSICIAN • 9 �Simmons, leading spinal surgeon, is new UB professor Move makes Buffalo a major spinal treatment center A s the phone calls that regularly come in from such places as Saudi Arabia, West Germany, South Africa, Japan and Greece indicate, Buffalo has entered the world arena, at least for one field of medicine. Because of the arrival of Dr. Edward Simmons, international pioneer in spinal surgery, Buffalo will now be the treatment center for nearly all of the world's cases of a severe deformity in ankylosing spondylitis (see accompanying article). Dr. Simmons is a new UB professor of orthopaedic surgery and the new head of Buffalo General Hospital's Department of Orthopaedic Surgery. During his distinguished career of 23 years with various Toronto hospitals and the University of Toronto, he was instrumental in bringing international recognition to Toronto in his field. The attention shifts to Buffalo and the University, now that he has moved here. Dr. Simmons is a prime example of the saying, "If you really want to get something done, ask a busy man." He has given over 400 scientific guest lectures and presentations on six continents and has conducted research on almost 90 projects. Meanwhile, he sees his office or hospital patients from 8 in the morning until 8 or 9 at night, six days a week and still finds time to have published over 75 articles and run his hospital department. If this weren't enough, he works just as ~ard at play: with his beloved yacht, he has won over 75 sailmg races. When first approached about coming to Buffalo, he dismissed the idea, wondering what Buffalo could offer him. "But then I thought there was no harm in looking at it. And I must say;' he continued, "having come and looked at it, I became very favorably impressed initially. The more I kept looking at it, the more and more impressed I became:' He views Buffalo as an opportunity to make a major contribution to a fine department of orthopaedic surgery, toward the goal of "making it one of the best orthopaedic centers in the nation. "I was most impressed by the fact that it has a very good medical school that is on the rise and has tremendous potential. The hospital has quite a tradition and history and is under superb management - they've done a terrific job," he remarked. Then he added, "I also like the direction that the dean is providing ... and the concrete proposals put forth by President Sample." The ambitious construction programs for both Buffalo General and the Medical School are of interest to him. He considers the construction changes as positive, as a real opportunity to increase the efficiency of inpatient care and the operating facilities. "However;' he emphasizes, "bricks and mortar don't make a fine institution; it's the people who work there who do." As far as his own personal role, he aims to further upgrade the University's and hospital's three spheres, patient care, research, and teaching. He plans to do all he can to develop the potential of his fellow orthopaedic physicians and reinforce them in pursuing their research interests. D r. Simmons described four of the research areas he would like to refine. 'Just introduced into this city is the ability to do spinal cord monitoring;' he notes. With the new computerized Pathfinder device, this technique reduces the chance of paralysis following spinal surgery by continually registering the electrical impulses from peripheral nerves through the spinal cord during surgery. If nerve impulses are interrupted, the surgeon can immediately recognize the problem and correct it before the changes become irreversible. His goal is to further perfect spinal cord monitoring to increase its accuracy and versatility. 10 • BUFFALO PHYSICIAN By Bruce S. Kershner When an artificial joint is placed in a damaged hip, it is subject to loosening over time. After a while, it may require replacement due to loosening or wear. "One of the hazards of hip surgery is injury to the sciatic nerve - that's a pretty profound complication," he comments. As with the spinal cord monitoring, he plans to refine the ability of the Pathfinder II to register when changes in conduction of the sciatic nerve are occurring during surgery so that permanent damage to it can be avoided. He believes that one of the causes of failure in low back disc surgery may be congenital differences in the nerve patterns of humans. "In answer to the question 'Is everybody the same or different?; a recent study by Dr. Leon Kadish and myself showed a definite variation, an anomaly level of 14%;' Simmons adds. Dr. Simmons would also like to do a control study to identify the human level of variability in nerve paths and roots in the neck region. Once the typical anatomical variations are known, these variations can be considered in planning future surgery. This will hopefully result in greater success. Also planned is more research on rehabilitating joint injuries and diseases that limit or prevent patients from walking. These include injuries from multiple bone fractures, hip injuries, stroke, muscular dystrophy and cerebral palsy. One device Dr. Simmons would like to further refine is a portable Suspensory Walking Device, an erect "jolly-jumper"-like apparatus with wheels and a suspension for the patient. While in Toronto, he was most recently professor of orthopaedic surgery at the University of Toronto and chief of the Orthopaedic Division of the Toronto East General and Orthopaedic Hospital. Dr. Simmons has also served as president of several organizations, including the Canadian Orthopaedic Association for the 7th Combined Meeting of Orthopaedic Surgery of the English Speaking World, the Scoliosis Research Society, the Cervical Spine Research Society, and the Canadian Orthopaedic Research Society. He has also received numerous honors, visiting professorships and lectureships. His philosophy about treating patients is consistent with the approach typically adopted by the best and most effective physicians. "If a patient comes in with a knee problem, I treat the whole person;' he explains. "Technical knowledge without caring is limited in what it can do. If the patient knows you have a genuine concern, it will assist the treatment." His popularity is evidence of this. When his staff was asked about patient attitudes toward Dr. Simmons, the immediate answer was "The first thing his patients say about him is 'Y'know, he really cares!' " T he idea of medicine as a career began early for Simmons, reinforced by the fact that his father had wanted to be a doctor. In medical school, he found that he really enjoyed surgery, so much so that he won the Chapelle Prize in Clinical Surgery at his graduation. As an intern, his interest in surgery lead him ultimately to develop orthopaedic surgery as his specialty. Medicine plays a large role with his family as well as his career. His wife was a nurse, his father-in-law and two brothers-in-law are doctors (one at Harvard), one of his sons is studying medicine, and another is a resident in orthopaedic surgery. To add variety, his daughter is a musician and his youngest son is in college studying law and foreign affairs. Dr. Simmons values his sailing not just for personal reasons but because it provides an excellent opportunity to be with his family, without any interference. He goes out on Lake Ontario every summer weekend he can. His interest in boating �Dr. EdwanJ Simmons, new UB professor ot orthopaedic surgery and new head ot Buttalo General Hospital's Department ot Orthopaedic Surgery, will bring Buttalo lntemauonal recogniUon In his field. surfaced with his early rowboating experiences on a small lake. When his family began to vacation at a Lake Ontario cottage, he went out with a dinghy and then a skiff with a sail. Yacht racing on Lakes Ontario and Huron is now a frequent pastime. In addition to sailing, he enjoys still and cine photography, and skiing. His move to Western New York was made even easier "because of its similar recreational opportunities to Toronto, especially its four seasons" and its snowy, hilly conditions conducive to skiing. With an opportunity now to help shape Buffalo's future in orthopaedic surgery, Dr. Simmons projected some of the challenges awaiting his field. Now that artificial joints have been developed, he feels that the next step is to perfect these joints so that erosion and loosening at the bone-joint interface can be reduced. A need also exists to "develop materials with the same viscoelasticity as bone," he added. Furthermore, orthopaedic surgeons should refine their ability to reconstruct and preserve natural joints as well as better artificial joints. Returning to his new impressions of Buffalo, he concludes, "Yes, Buffalo is a friendly city and I like the people. It's a fine opportunity to work here." • BUFFALO PHYSICIAN • 11 �(At lettJ Dr. Simmons (lettJ with patient In "halo device" after operation to raise post· tlon of head. (AborteJ Patient before operation. Neck breaking surgery Simmons pioneers techniques A By Bruce S. Kershner young German man travelled 4500 miles to Buffalo, only to have his neck broken. It was no accident, but a precisely planned surgical operation by the internationally known Dr. Edward Simmons, UB profes~or of orthopaedic surgery at Buffalo General Hospital. He is the world's expert on the correction and treatment of spinal deformity in ankylosing spondylitis, a chronic and usually progressive inflammatory disease involving the articulations of the spine and adjacent soft tissues. Dr. Simmons, who pioneered the procedure in Toronto, has performed nearly 90 per cent of neck osteotomies in the world since 1967. It involves literally breaking the patient's neck or spine to correct the deformity. Because of Dr. Simmons' expertise, Buffalo is now the major worldwide referral center for such surgery. The 40-year-old patient, Detlef Tschoepe, journeyed to Buffalo from his home in Aachen, West Germany, accompanied by his wife and his orthopaedic surgeon, Professor Jan Zilkens. The disease began in his mid-teens as pain in his heels, elbow and knee. Because he was an active athlete, "he blamed it on sports;' Dr. Simmons said. Although Tschoepe was told he had the disease as a teenager, the severe symptoms of spine curvature didn't begin until seven years ago. As his bones softened, his neck began to bend and then fused, interfering greatly with the operation of his family business. The disease primarily strikes men between 15- and 40-years-old. It begins as low back pain and stiffness, sometimes accompanied by sciatica-like pains and aches in hips, shoulders and buttocks. The symptoms usually start in the sacroiliac joints and progress up the spine. In the advanced cases, the vertebral joints become painful, gradually soften, and then fuse into solid bone. The result is a patient with a characteristic bent-over posture, rigid spine and waddling gait. One man that Dr. Simmons operated on had his spine so bent and rigid that he could only see backwards through his legs. Other patients have had their heads locked to their chests, making it difficult to eat or speak, and impossible to look at anything other than the ground. In all of his cases, the surgery corrects the deformity, allowing the patient to stand erect and look straight ahead. 12 • BUFFALO PHYSICIAN T he surgery, which lasted two hours on October 23, was performed with Mr. Tschoepe fully conscious during all but a few minutes of the operation. This was so he could answer the team's questions about any sensations or pains that could indicate whether any nerves were being pinched or the spinal cord was being damaged. With Mr. Tschoepe sitting erect and his head suspended by a "halo" device, Dr. Simmons removed a precisely measured quantity of bone from the posterior portion of the spine in the neck region between the last cervical vertebra and the first thoracic vertebra. This area had been administered a local anesthesia. During the few minutes of general anesthesia, Dr. Simmons lifted the patient's head backward to break the neck at the front of the spine opposite the spot where the bone had been cut out. This enabled him to raise the head to the forward position. To keep the head erect, Dr. Simmons connected the "halo" device around it to a special body cast. Mr. Tschoepe will wear this for four months while the natural healing process fuses the spine again where it was surgically broken. As prescribed by Dr. Simmons, he will then wear a neck brace for two more months. His personal orthopaedic surgeon, Dr. Zilkens, who observed the surgery, will monitor his recuperation back in West Germany. Although the surgery enables patients to return to a relatively normal lifestyle, it does not permit the person to bend the neck or turn the head. This did not seem to concern Mr. Tschoepe, however, when he left the hospital four days later to see nearby Niagara Falls. "He was so delighted just to be able to sit in the car and look around;' Dr. Simmons told the Buffalo News. The day after that, he flew back to Germany. Hereditary factors play an important role in the disease, whose prevelance in men is 3 to 4 per 1000, 10 times more frequent than in women. The severe cases of ankylosing spondylitis that Dr. Simmons treats represent only a small percentage of the total number of cases. Most people end up with "milder" forms of the disease, such as back, chest or joint pains or peripheral arthritis. Ironically, once ankylosis, or fusion, of the joints results, the pain usually disappears. early all ankylosing spondylitis patients possess the antigen HLA-B27 that is , closely associated with the spinal disorder. The role of the antigen is not known, but it is believed to be only a marker distinguishing those individuals that have an immune response that makes them susceptible to an as yet undefined infectious agent that causes the disease. • �A gallery of ghosts Bakay recalls war-torn Hungary H By Ann Whitcher is recollections are bitterly revealing of the cruelty of war. They also offer a moving account of medicine as it was practiced amid tremendous human suffering and political upheaval. In his recently-published memoirs, Gallery of Ghosts (Weller Publishing Co. Ltd., Toronto), Dr. Louis Bakay, recently retired chairman of the Department of Neurosurgery and prominent surgeon and researcher, describes "ten lost years." These were years spent in Hungary as it tipped toward the Axis, endured the pains of war, and finally, struggled under Soviet domination. The son of one of Hungary's most prominent surgeons, who was also head of the surgery department at the U niversity of Budapest Medical School, Bakay faced grueling hardship during the early war years as an ensign in the Hungarian medical corps, having received his medical degree, summa cum laude, from the University of Budapest Medical School in 1942. He recalls the middle-of-the-night arrival of 400 wounded Hungarian soldiers, by train, from the eastern front. They were dirty, lice-ridden, wounded, frostbitten, and hungry. "I had to stop them from entering the hospital before being properly deloused in order to prevent contamination by spotted fever, a deadly form of typhus caused by a lousetransmitted virus. This disease was rampant on the Eastern Front and poorly controlled in that pre-antibiotic era .... Preventive vaccine was laboriously and very slowly manufactured in small amounts. I never knew who got it, and we, who were constantly exposed by treating infected soldiers, never received it. Sometimes we had whole barracks full of patients with typhus and my motto was to keep on moving fast because then the slow moving louse could not catch up with me. This was considered a great joke;' he writes with wry candor, a prevailing tone in the book. Bakay and his fellow physicians frequently had to amputate limbs, many of which had been rendered useless by frostbite. Often these limbs bore other wounds as well. The danger of infection, including the dreaded gas gangrene, was high. For those soldiers who already had the feared condition, Bakay had only rather ineffective antibiotics on hand, namely the primitive early sulfa drugs. "So it was amputation after amputation, gangrenous fingers, hands, legs. Below the ankle, above the ankle, below the knee, above the knee. One dozen, two dozen, without distinction of rank. This was real war, the great equalizer of social differences. The leg froze just as easily in officers' boots as in the hobnailed brogans of common soldiers." There are other trenchant memories of those tormented years. Bakay recalls a lieutenant who "cracked" and shot himself to death. Bakay found among the soldier's personal effects the manuscript for a novel, a Madame Bovary-esque tale set in the Hungarian lowlands. In mid-1944, Bakay served at the front in the Carpathian mountains, when the Sixth Hungarian Army Corps held up a Soviet army. The losses were appalling. Writes Bakay: "We scrubbed for surgery in ice cold water with coarse soap that contained more sand than soap and abraded even the toughest skin. Yet we had to scrub mercilessly for a full half hour because rubber gloves were long gone and we operated with bare hands, covered with thin cotton gloves used more for cosmetic reasons than to maintain sterility.... Medicine, except for morphine (thanks to our poppy fields) was in short supply and so was everything else, including bandages and adhesive tape. We dressed wounds with rolls of crepe paper." Bakay received a de facto discharge from the Hungarian army in the fall of 1944, when expected new orders never arrived. He was definitely not launched into a happy situation, however. Hungary remained in its precarious position as part of the Axis powers. Hungarians knew the Russian forces were near, and that Budapest faced attack by the Red Army. "I felt that, should I survive the street fighting, a survival which was far from certain for a young man, I would probably end up as a prisoner of war or civilian deportee somewhere in the wastes of Russia. Where I was running was not clear to me. My confusion in this regard was typical of many members of the Hungarian middle class." In these harrowing days, many Hungarian families were split apart, "some members leaving, some staying behind watching the flood of refugees, among them perhaps a husband, wife or child trekking westward in dilapidated cars or horse drawn carriages on crowded highways in the autumn . " ram. B akay found refuge in a monastery, the Benedictine abbey of Pannonhalma in western Hungary, Transdanubia, halfway between Budapest and Vienna. The monastery had been placed under the protection of the International Red Cross and needed a surgeon. The protection was given with the understanding that the monastery would establish a hospital for refugees within its walls. The hospital's presence might save the monastery from destruction, it was thought. Bakay recalls the colorful monks who lived at Pannonhalma, and· the only other non-monastic member of the group, Herr Braunschweiler, representative of the International Red Cross; an organization not recognized by the Soviets at the time. Braunschwei ler was a colleague of Raoul BUFFALO PHYSICIAN • 13 �The Abbey of Pannonhatma In western Hungary, where Dr. Louts Batcav served as the surgeon of the tntemattonat Red Cross Hospital, trom November, 1944, to August, 1945. 1/) 0 ~ ..J 0 bJ: Q. 14 • BUFFALO PHYSICIAN �Wallenberg, whom Bakay had met briefly in Budapest. (Some believe Wallenberg, long missing, is still alive in Russian captivity. He has been the subject of several recent news reports.) The Benedictines included the easily-flattered "foxfaced" archabbot; Father Polykarp, a prominent medievalist who "grumbled about the onslaught of the modern world into their quiet domain but secretly enjoyed the presence of all these new people"; and Father Bertalan, who oversaw the abbey's surrounding lands "with appropriate earthiness." The latter "engineered fantastic deals to support the monastery and ended up with sides of beef or hogs, flocks of sheep, otherwise unavailable items of merchandise from quartermasters of whatever army in exchange for barrels of wine or spirit. All throughout he drank like a fish, drinking his opponents and business partners under the table, but stopping at midnight to be able to celebrate mass next morning with heavy head but empty stomach. Over and over again he had to appear at private audiences with the archabbot to do penance.... Yes, he was a bad monk, very bad indeed. But indispensable!' Bakay remembers, too, Father Hugo, a Ph.D. in mathematics and physics, in charge of the monastery's extensive physical facilities. One night, Father Hugo was asked to fetch a midwife to help Bakay deliver a refugee woman's baby. "It was the end of a dark and stormy night when the boy was born, the first in the monastery in many centuries of recorded history, but not the last." Then there was Father Tihamer, Bakay's "nemesis." Formerly a theologian and church historian of some renown, he had become "completely and hopelessly infatuated with modern psychology!' He preyed on Bakay as suitable research territory for his ersatz psychological probing. There must be some nefariousness in the surgical psyche, was the monk's apparent view. And so he would ask Bakay to choose from an array of what might be jokingly called "Freudian tarot cards;' especially when the tired Bakay emerged from the operating room. The cards featured an "assortment of criminals, idiots and sex maniacs of various degrees of depravity with a few normals interspersed, although frankly none of the 'normals' looked like somebody you would like to meet either;' Bakay remembers. " There would be Father Tihamer waiting for me, peering with an expectant smile through his gold-rimmed glasses. He was always anxious to make me repeat the test, fresh from the charnel house, so to speak. He was convinced that surgeons have a sadistic streak rising to a peak during an operation." More and more refugees came to the monastery, including Hungarian Jews, who were hidden only with great difficulty. Jewish children could be mixed in easily with non-Jewish youngsters, but it was necessary to keep the Jewish adults hidden at all times. Agents of the Hungarian Nazi government snooped around frequently, arriving without warning. "What the Jewish children did not know was that many of their parents were also hidden in the monastery, a heartbreaking decision we had to enforce for the sake of secrecy!' In the last days before the monastery closed its huge iron gates, a final wave of refugees arrived at the sanctuary built atop a hill. "For the first time in centuries, the whole nation felt the scourge of God, the reigning classes and the downtrodden ones, nationalists, fascists, cosmopolitans, liberals, right wing and left wing alike." As more refugees descended on the monastery, Bakay set up a hospital with equipment obtained from a municipal hospital 20 miles away. His surgical experience during this period was far-ranging, to say the least. There were two other physicians on hand, but both lacked surgical tra_ining and experience. A well-trained, older internist was dying of tuberculosis and diabetes. The other doctor, a "fledgling;' timid ophthalmologist, had only one year's training. Writes Bakay: "I had high hopes that he could at least help with enucleations of eyes that had to be done in people with ghastly facial injuries caused by mine and grenade explosions but I soon realized that I had to do it myself. He was quite useless even as an assistant at surgery. I finally assigned him to inoculations and other routine chores." Fortunately for Bakay, there were two experienced scrub nurses among the nuns who had taken refuge in the monastery. Also; high school girls, again from among the refugees, were hurriedly trained as nurses aides and as general help. Bakay also trained his sister, a Ph.D. in romance languages and art history, and living in Hungary today, as a surgical assistant. He also had a "find" in a young Polish woman with some training in anesthesia. Among the numerous problems Bakay faced was the lack of intravenous solutions, thus preventing blood transfusions. There was no lack of volunteers, but Bakay had only a few vials of serum, with which to type and cross match blood. "I lost many wounded to shock who possibly could have survived with transfusions. We wrapped them in blankets to keep them warm and watched them die. And my nuns prayed in the chapel, taking turns!' There was also the problem of sterilizing instruments and linen. No sterilizer was on hand and equipment stored as sterile soon ran out. Fortunately, the husband of the Polish anesthetist was the former third engineer of the Polish transatlantic liner "Batory!' "He fixed up one of the unused boilers to deliver enough heat and atmospheric pressure to be used as a surgical sterilizer. It broke down frequently and at the most inopportune moments, but our resourceful marine engineer was always at hand and resurrected it with the same aplomb as we assumed he fixed ship engines amidst a North Atlantic gale. Our sterilizer, a Rube Goldbergish pressure cooker had another drawback, it did not dry things sufficiently. Every time I slipped on my surgical cap, masks and gown I felt the ghostlike clammy embrace of moist linen ." Before the great influx of refugees at the monastery, Bakay performed mostly emergency surgery, treating perforated ulcers or cases of appendicitis. He recalls circumcising a young man. The prospects of such a procedure shocked Sister Pulcheria, the earthy and experienced surgical nurse. "When I tried to explain to her that the same operation was also performed on our Lord Jesus, she became more suspicious than ever. obody told her that. She was convinced that this was one of those Lutheran tricks. So I had to go ahead and do it alone!' Later, Bakay's spectrum of surgical experience grew wider still. "I also had to act as the surgeon of the local populace who had nowhere else to go. I fixed hernias, extracted teeth, removed a myomatous uterus and twisted ovarian cysts!' But Bakay also relates his errors of judgment, one of which haunts him still, a difficult case of acute appendicitis and peritonitis. After the Russian arrival, Bakay treated many of the women who had been raped by Russian soldiers, though he could not, given the Roman Catholic setting, perform abortions where needed. "I could have aborted them and would have willingly done it in some abandoned farmhouse but I could not do that to my monks who were so kind to me." Bakay also handled a simple x-ray machine. "It could be used only for fluoroscopic trans-illumination, no picture could be taken. I had no protective equipment, lead gloves or aprons and although I was vaguely aware of radiation damage, I manipulated broken arms and legs with unprotected hands under the screen. As a memento I now have no hair over the back of my right hand and the skin there is thinner than it should be." Some Russian soldiers were treated, too. Bakay recalls the lieutenant from the Caucasus with a fractured arm, who, suspicious of possibly hidden Germans, kept a loaded pistol under his pillow; ·and a 16-year-old baby-faced sentry who proudly showed Bakay pictures of his family. Ivan, a huge BUFFALO PHYSICIAN • 15 �I I --- -----------------------------~-------------------------- Cossack sergeant, was exceedingly grateful for Bakay's treatment, and asked if he could give the young surgeon a thankyou gift. "I could not accept any of his treasures, objects that had belonged to somebody else and had been obtained by force or even murder. Finally we reached an impasse, both of us embarrassed and uncomfortable. Suddenly his craggy face lit up in an enormous smile. He found the answer. 'Would you like to get somebody out of your way?' he said with a grin. 'An enemy of yours perhaps? Somebody you owe money to?' He was greatly disappointed when I turned down his offer~' Bakay remembers with special poignance Princess Stephanie, a speechless, partially paralyzed old woman who arrived at the monastery one day with her second husband, Prince Elemer Lonyay. Here was the former daughter-in-law of Emperor Franz Joseph, whose unstable first husband, the Crown Prince Rudolf, archduke and heir to the AustroHungarian throne, had taken his life and that of his 17 -yearold mistress in the 1889 tragedy at Mayerling. Before the tragedy, Stephanie had been the second lady, after the Empress, of a "glittering" monarchy which ruled 80 million people. Now she arrived with "what is called in neurological parlance thrombosis of the left middle cerebral artery with destruction (infarction) of the left hemisphere of the brain;' writes Bakay. The old princess died a few months later. Bakay, offered a sentimental remembrance of the princess, chose an ostrich fan. "It was granted but I never had a chance to collect it. By then I was on the run much of the time, changing addresses, sometimes in hiding, and an ostrich fan was the last thing I needed." B akay soon left the monastery, as his situation grew ever more precarious. His only protection was his Red Cross armband. Also, he did not speak Russian and he distrusted the translators who were known to distort messages for their own purposes. Father Polykarp, though he didn't know a word of Russian and was unfamiliar with the Cyrillic alphabet, was nevertheless adept at copying unfamiliar languages through his long years as a medievalist. His fluency in such languages as Hebrew, Arabic and Aramaic, also helped. The monk forged a document for Bakay using as a prototype a document written by a Russian and "then cloned with slight additions or deletions, as the situation demanded by the tireless Polykarp~' Returning to Budapest, the war now over, Bakay witnessed scenes of utter devastation: hordes of displaced peasants, and Jews on their way home from a German concentration camp. "It looked as if they (the Jews) were dying - and I believe that they were - but they were sent home just the same. They were lying side by side on a layer of straw, stretched out and motionless, with parched, jaundiced skin and swollen joints, their large, luminous eyes staring at the sky. They did not have the strength to chase away the flies swarming over their faces~' Budapest was in ruins. Bakay found his old apartment halfdestroyed and looted. But some of his books had survived, "drenched by rain and peppered with shell splinters and bullets." One survivor was Bergman's treatise on head injuries, an old text written after the Franco-Prussian war. It had been hit by "a fragment that pierced through most of the book, only to rest on a page right over the illustration of a depressed skull fracture caused by a similar shell fragment." · No heat was available in Budapest, and many retreated to their cellars. Windows were boarded up and glass was also unavailable. Greasepaper, gradually on hand, did allow some subdued, diffuse light in Budapest homes. The resourceful Bakay managed to restore one small room in his apartment by carefully dissolving the coating of old x-ray films, and inserting them between wooden partitions. The resulting "mosaic" window was "transparent enough to see the hazy outlines of the outside world, tinted blue. Some of the films 16 • BUFFALO PHYSICIAN I left intact. It offered an interesting piece of art deco, a skull here, a pelvis there. Girls who came up to my apartment were treated, not to the sight of my etchings, but to the world through an interesting window~' Other experiences, some bitter, some lovely, were to follow in chaotic Budapest. Bakay had a love affair with a woman involved in underground activities, was "shunned" in his hospital work for his associations with those not in official favor; and finally was forced to eke out a living by performing "ghost surgery;' and serving as a doctor in a seedy, flamboyant nightclub filled with prostitutes. The club, however, at least gave him a place to hide. Official terror was still "haphazard and disorganized .... It was sometimes enough simply not to be at home or at one's place of work to ward off evil. ... I certainly felt terrorized; hence my hide-outs in the girls' apartments. This was not a Suzy Wong type of situation about the prostitute with the golden heart. It was really quite pathetic, with me sitting all day long on a moth-eaten sofa, smoking endlessly, while the girl with the heart of gold slept (and even snored) on her bed, to be ready for another good night's work." In 194 7, Bakay escaped to Sweden, by presenting an outdated, invalid earlier offer for a Hungarian state scholarship in Sweden, and so received a Swedish visa on that basis. "Then came the last evening and farewell to my family. My mother sewed a diamond taken from one of her jewels into my underwear for me to sell when I needed money. I was penniless many times during the next years but I never sold the diamond. The closest I came to it was on a dark winter day in Stockholm, my pocket as empty as my stomach, my morale at an all time low but I still could not part with that diamond. It became more of a good luck charm than a financial asset. Today it is my wife's engagement ring." In Stockholm, Bakay worked at a well-known neurosurgical clinic run by Professor Olivecrona. The clinic, says Bakay, was "a Mecca for neurosurgeons from the four corners of the earth." Gradually, he approached a "normal life;' and began doing research at the Wenner-Gren Institute for Metabolic Research in addition to doing clinical neurosurgery. Bakay's Stockholm research in the use of isotopes in neurological study led to his coming to the United States, where similar work was underway at Massachusetts General Hospital. Bakay completed his neurosurgical training in this country, and soon joined the faculty of the Harvard Medical School and the staff of the Massachusetts General Hospital where he served until 1961. He was chairman of the UB Neurosurgery Department until 1983, and remains as a full professor in the medical school. Bakay is the author of The Blood-Brain Barrier (with Special Regard to the Use of Radioactive Isotopes); Cerebral Edema; Brain Tumor Scanning with Radioisotopes; The Treatment of Head Iry"uries in the Thirty ~ars' Mklr (1618-16'18), and Feluton (Halfway) Essays in Hungarian, and Head Injury. A t the close of his book, Bakay, now 66, recalls a "solitary, sentimental" return to Budapest a few years ago. "I listened to the laughter of lovers in parks where I used to take my sweethearts. I heard the staccato sounds on the cobblestones of Castle Hill of the high heels of a girl on her way to meet her man. These are the only sounds I care to remember. As far as former friends are concerned, I try to remember them as they were in the past, not as they are now." His final note is somber but lyrical: ''All emigres cherish a past, a secret never to be revealed. But it is always there hidden like an ikon in the dark corner of the room, flickering candlelight casting uncertain shadows on a veiled picture, reflections of the past. "I have broken the rules by revealing even a small part of it." Gallery of Ghosts is available at Elmwood Books on Elmwood • Avenue in Buffalo. -- - �Research Diagnosis Computer being used D By Milt Carlin iagnosis: Your sacral cord shows signs of being diseased. Who says so? Actually, such a diagnosis could come from a computer program being developed at UB under the guidance of Sargur . Srihari, Ph.D., an associate professor in the Department of Computer Science, in association with Dr. Jerry G. Chutkow, professor of neurology at the UB Medical School and former chairman of the University's Department of eurology. Srihari related in an interview that the project - in a preliminary stage of development - applies "artificial intelligence" in diagnosing possible malfunctions within the human nervous system. The project was suggested by Chutkow, who views it as a possible stepping-stone for development of diagnostic assistance programs in virtually all fields of medicine. Srihari noted that "neurological diagnosis is well-suited to computer technology." The computer program being evolved is based on what Srihari calls "an intricate functional-anatomical model." Working together and with others, computer expert Srihari and neurologist Chutkow have absorbed much information about each other's field of expertise. Srihari admits he knew virtually nothing about neurology as a medical science before he started developing what is now called an "Expert System for Computer-Aided Diagnosis." Chutkow, on the other hand, was unfamiliar with computer science except for "dabbling'' with a home computer. Currently, the two scientists are deeply involved in "educating" a computer to apply the logic of neurological science in diagnosing a nervous disorder. In one sense, it's a never-ending process as new research evidence in the field of neurology becomes available to add to the computer's store of "knowledge." Srihari is quick to point out that Stuart C. Shapiro, Ph.D., also a UB computer science faculty member and a recognized expert in the field of "artificial intelligence;' deserves much credit for his assistance in developing the project. In its present stage of development, the computer program is capable of "diagnostic conclusions to a limited degree;' Srihari pointed out. While other computer-aided neurological diagnostic systems are in various Computer scientist Sargur N. Sriharl, foreground, operates the kevboard that activates an "artificial In· telligence" computer program being developed at the Stlte Unlwrs/tv at Buffalo tor diagnosis of neurological problems. At his side, pointing to a tell-tale diagram of a cross-section of the spinal cord, as It appears on a video screen, Is Dr. Jerrv G. Chutkow, a tacultv member In the UB Department of Neurotogv. In the background are tour UB computer science students who are assisting IndeveiOIJifJflnt of the IJIO(Jram under the leadership of Srlharl, Chutkow and UB computer scientist Stuart C. Shapiro, not shown. The students, from lett, are Anmel CAmvJ c. Hsu from Taiwan, Douglas R. !Mlber of Buffalo, Marlc A. !Iogie of Lockport and Zhlgang Xlang from Beiilng. weber Is an undergraduate student In his senior vear and the other three are graduate students. stages of development elsewhere, Srihari believes the LISP (List Processing) technique being applied in the UB project is innovative. The technique, he explained, involves use of LISP computer language to guide the computer in its "reasoning" as it associates a patient's given neurological symptoms with a set of stored rules. "The computer;' Chutkow explained, "will apply the same logic, common sense and knowledge applied by a neurologist to analyze clinical symptoms, physical findings and laboratory data!' Operationally, the computer following a diagnostic session - will flash its "verdict" on a video screen and, on request, will display an anatomical diagram or picture in support of its diagnostic conclusions. Chutkow believes that a highly qualified neurological technician will be able to conduct the diagnostic chores now performed by a neurologist when the system is fully operational. "Hopefully;' he added, "computer linguistics will advance rapidly enough so that, in the future, the technician will be able to communicate verbally with the computer, using an established neurological vocabulary." H ere's how the system works, in its present. state of development: A patient undergoing examination is asked a standard set of questions as displayed, one by one, on a video screen. The answers given by the patient are recorded by use of a computer terminal keyboard. Questions relate to such factors as the patient's age; the patient's age at the onset of certain symptoms; the possibility of a lesion, bullet wound or disease; the type of symptom, or symptoms, and the duration of the complaint-related symptom or symptoms - hyperacute BUFFALO PHYSICIAN • 17 �(seconds to minutes), acute (10 minutes to a few hours), all the way to congenital (present since birth). Also recorded are the results of physical examinations relating to mental functions, vision, eye movements, other cranial nerve functions, general motor function, sensory responses and numerous reflexes - to obtain objective evidence of disease. When all is said and done, the computer will "think" about the information at its disposal and ask questions if certain information is lacking or unclear, Srihari related. Based on its own logic, acquired through "artificial intelligence," the computer will: pinpoint a neurological problem, ask for further medical tests to confirm existence of a specific problem, "decide" that no neurological problem exists, or confess that it doesn't know. The computer's diagnosis is keyed to a scoring system, which presently is being upgraded to include "weighted factors!' The original scoring system ranged from plus 10 (no neurological problem) to minus 10 (a specific problem). A score of zero - halfway between plus 10 and minus 10 - in the original scoring method indicated "answer unknown." If a neurological disorder is diagnosed, the computer obligingly will display its location in a diagram of the peripheral neuromuscular system or in a cross-section diagram of the spinal cord or brain. For display purposes, the number of cross-section diagrams of the central nervous system is being expanded from 20 to 70 segments to more accurately locate a neurological problem. A diagrammed segment displayed on the video screen would be in black-andwhite, with nerve tracts outlined in green, blue or red, depending on the type of information they represent. When the diagnostic procedure is completed, the computer program eventually will list alternative forms of treatment. Additionally, the computer, if asked, will detail how it made its diagnosis; will keep a permanent record of individual cases for future reference; will "learn" by adding pertinent data to its existing store of knowledge, and will be able to cite references in neurological literature. As case histories are added to the computer's memory, Chutkow explained, the computer's "depth of analysis" will expand. "It could become an expert teaching and training system" for both practicing neurologists and medical students specializing in neurology, he added. Looking farther down the road, 18 • BUFFALO PHYSICIAN Chutkow ponders the day when such computer programs, utilizing "artificial intelligence," might "give us some insight into how people think. "The brain, the spinal cord, the peripheral nervous system;' he asks rhetorically, "what specific roles do they play in the human thinking process?" he is confident that the Meanwhile, computer program being developed at UB eventually "will deal effectively with the anatomy and physiology of the nervous system" in carrying out its diagnostic duties. He emphasized that the program has been in the making only a matter of months and that it will take several years to reach the state of refinement anticipated. From a practical point of view, aside from educational benefits for medical students, neurologist Chutkow sees the "Expert System for Computer-Aided Diagnosis" serving two basic purposes in the hospital or doctor's office: 1. It would drastically trim the time needed to analyze a neurological problem, thereby freeing the doctor from much routine procedure. This would enable the neurologist to accommodate more patients, or perhaps spend more time in research. As envisioned by Chutkow, a neurologist skilled enough to develop a neurological data base could transmit it directly to a central computer center for analysis. Alternatively, he also suggested that highly skilled technicians trained by expert neurologists could be dispatched on a regular basis to small communities to develop a data base on patients and then transmit the result to the computer center. In either case, the computer analysis would be reviewed by a neurologist for internal consistency. "In this manner;' Chutkow noted, "if a truly expert program - one that can equal the accuracy of a neurologist is developed, then neurologists could handle many more patients than they do now." 2. It would provide confirmation of the neurologist's own diagnostic opinion, or perhaps dispute that opinion. As Chutkow put it, "We usually know, or think we know, what's wrong with a patient - but we need proof." Meanwhile, Srihari continues to improve on the project's sophistication. He currently is in the process of improving the graphic aspects. Immediate plans call for substituting actual textbook photographs for the diagrams that now represent the segmented views of the central nervous system. To further improve the "anatomical data base;' Srihari also is planning to utilize an already existing computer program that provides three-dimensional (3-D) video display capability. One such program, developed by a group of scientists at UB, produces 3-D displays by integrating on video tape a series of x-ray images from the relatively new breed of CAT (computer-assisted tomography) scanners. Such 3-D displays of a human organ or tissue can be rotated to show all sides and can be segmented in numerous ways to obtain a desired internal visual effect. Computer scientists have been demonstrating "artificial intelligence" know-how in recent years, but in limited areas. Aside from research projects whereby computers have been programmed to "outthink" worthy human opponents while playing chess, poker and other games, "artificial intelligence" programs have been developed for such chores as locating mineral deposits and identifying bacterial infections. Now, "artificial intelligence" is making its debut in the field of neurological diagnosis. • AIDS precursor? Han studies PALS W By Bruce S. Kershner hat may be a precursor to, or early form of, AIDS (acquired immune deficiency syndrome) has been discovered by Dr. Tin Han, UB research professor and Roswell Park Memorial Institute physician. PALS is the acronym for the medical condition, prison-acquired lymphadenopathy syndrome, detected among prisoners in state-wide New York correctional facilities. "These prisoners," according to Dr. Han, "represent the first well-documented cases of PALS in the United States." PALS is a mild syndrome marked by one of the characteristic symptoms of AIDS - the presence of enlarged lymph nodes. The other characteristic symptoms of AIDS are unexplained combinations of prolonger fever, weight loss, and night sweats. These, as well as AIDS-associated opportunistic infections such as pneumocystis carinii, pneumonia or atypical tuberculosis and malignancies such as Karposi's Sarcoma, have not been observed in the PALS patients. After studying the patients, Dr. Han learned that "most had histories of intravenous drug abuse." This was one of �Research Dr. Enzo Paoletti (lett) and Dr. Dennis Panlcali In the laboratory. 1 the things that made him suspect the connections to AIDS. Although Dr. Han's acronym refers to the prison inmate status of all his patients, he emphasizes that "the fact that they are all prisoners is incidental:' Heavy intravenous drug use is one of the relevant indicators of the syndrome. It is just that many prison inmates have histories of drug abuse. Dr. Han discovered abnormal laboratorv tests characteristic of PALS. An~lyses revealed abnormalities in certain types of white blood cells (the lymphocytes), which are produced by lymph nodes and normally attack foreign substances entering the body. Dr. Han's patients had reduced activity of natural killer cells, the lymphocytes that destroy all invading cells or organisms by puncturing their membranes. In addition, the proportion of helper cells in relation to suppressor cells was lower than normal. Natural killer cells and T-cells are very important in fighting infection and malignancy. All of these white blood cell abnormalities are also present in 99 per cent of AIDS patients. Despite certain similarities to AIDS, Dr. Han's patients have not exhibited any of the severe diagnostic signs and - symptoms of the syndrome and its associated spectrum of illnesses. "What is so intriguing;' Dr. Han points out, "is that the inmates, by all medical standards, are generally in good health." The patients were originally referred to Dr. Han from State-wide correctional facilities because their lymph node enlargement was suggestive of malignant lymphoma, or cancer of the lymph nodes. When biopsies were performed, they ruled out malignancies but revealed the white blood cells' immunological abnormalities. Because the inmates' general well-being has not, to date, been affected by these abnormalities, "there is really no treatment we can administer;' Dr. Han explains. "All we can do is closely monitor each prisoner's condition." A !though the possible relationship between PALS and AIDS is a new discovery, PALS has been found to be identical to the condition noted among some non-prisoners called generalized lymphadenopathy syndrome (GLS). The reversal of helper-suppressor T-cell lymphocytes observed in PALS has been previously associated with G LS; however, the abnormalities of natural killer cells in PALS is a new and significant discovery. Besides its virulency and lethal nature, the lack of knowledge about the causes (or treatment) of AIDS adds to the alarm. One theory centers around the possibility that, at least for homosexuals, semen exchange between male partners could produce an immunesuppressive state. Another possible theory is that a virus that has been associated with human T-cell leukemia and lymphoma might suppress the immune response. This theory is lent some support by Dr. Han's research. He found antigens of human T-cell leukemia virus in lymph node cells of four of five of his PALS patients. In the meantime, the etiology of both PALS and AIDS remains enigmatic. If, indeed, PALS is a mild or early form of AIDS, these studies document that the immune abnormality of natural killer cells may be another factor predisposing patients to develop AIDS. The benefit of discovering an early-stage AIDS or a mild variant is two-fold. Dr. Han says "treatment aimed at immunological restoration can be administered that much sooner and, subsequently, have a potentially greater impact on this fatal disease:' Secondly, if early symptoms can be identified before the disease sets in, the patients can be isolated and monitored earlier. 0 Vaccine sought Paoletti battles herpes V By Bruce S. Kershner accines for herpes and hepatitis in animals have been developed through gene splicing by Enzo Paoletti, Ph.D., a 1971 alumnus of UB's Roswell Park Graduate ·Division and the Medical School's Microbiology Department. After the successful development was announced, Paoletti and his associate Dennis Panicali, Ph.D., were hailed as part of a new breed of genetics researchers who are unlocking the genetic secrets of cell biology. Dr. Paoletti developed his animal vaccines at the New York State Health Department's Center for Laboratories and Research in Albany. He is confident that comparable vaccines will be developed for humans as well, especially a successful vaccine against genital herpes. No vaccine currently exists for genital herpes infections, which affect nine million Americans. Although a human vaccine for hepatitis B virus already exists, it is far too expensive, at $100 per vaccination, to treat the serious international health problem that now affects an estimated 200 million people worldwide. Paoletti's animal vaccine opens the door for developing an inexpensive vaccine, BUFFALO PHYSICIAN • 19 �Research perhaps as little as 35 cents per vaccination. But scientists say that it would be at least three years before human tests could begin. The new development is important not just because of its potential to protect against herpes and hepatitis, but because it established a reliable generic technique that can be applied to almost any other desired genes. Hence, the method might also be used to develop vaccines to protect against malaria and many other worldwide diseases. It should also be pointed out that, although the vaccine was developed using the herpes simplex (type 1) virus (which causes "cold sores" and other upper body infections), it can provide protection against the genital herpes (type 2) as well. This is because there is some immune cross-reaction between the two herpes viruses. Dr. David Axelrod, State Commissioner of Health, said "much work needs to be done, but this appears to be a promising direction against infectious diseases." The deputy director of the Center for Laboratories and Research, Dr. Herbert Dickerson, described Dr. Paoletti as "a very dedicated virologist who works intensely hard and who is very creative." And, according to the NY Times, fellow scientists referred to Paoletti and his associate as "DNA jocks," who use the latest technology and scientific advances to design viruses to work for humans as vaccines, instead of against us as diseases. The vaccines were devised through the innovative use of genetic engineering of the well-known vaccinia virus. This is the virus from which the word "vaccine" was derived. Almost 200 years ago, Dr. Edward Jenner used live vaccinia virus to immunize against deadly smallpox virus, the first effective vaccine in history. It is fitting that this same virus, through Dr. Paoletti's work, may be the source of major breakthroughs in other diseases. K nowing that different gene messages exist in segments of DNA, Dr. Paoletti isolated certain parts of the herpes simplex I virus and inserted them into identified pieces of vaccinia virus DNA. The immunizing trait of the vaccinia virus DNA segment is due to its ability to control the herpes virus segment. The new artificial gene composite was then introduced into a living cell that was also infected with ordinary vaccinia virus. The modified foreign genes incorporated with the genetic material of the vaccinia virus, creating a live recombinant vaccine. The new organism now contains harmless elements of herpes 20 • BUFFALO PHYSICIAN that the body still reacts to as a foreign substance. This activates its immune system that provides protection against the herpes virus in general. Hence, immunity without disease. After inoculating 40 mice, the researchers injected them with usually lethal doses of herpes. All of the protected mice survived, but 55-70 per cent of the control mice died. In the other part of the exp~riment, rabbits inoculated against hepatitis B produced antibody levels, which if extrapolated to humans, demonstrated immunological protection. This was determined by radioimmunoassay and other tests. Vaccinia virus has four major advantages over other viruses. First, the strains used are generally safe and further modifications can make them even safer. Second, they are stable and can be shipped safely even to parts of the world where refrigeration is inadequate. Third, the mass production of vaccinia vaccine can be inexpensive, making it a feasible treatment both in the developed and undeveloped parts of the world. Dr. Axelrod observed, "In comparison with other approaches, the production of sufficient quantities of recombinant vaccinia virus is relatively inexpensive and the technology for large scale production already exists!' A fourth advantage, and one particularly significant for the future, is that the vaccinia virus is large as viruses go. Because of its size, as many as six to 10 foreign genes could be inserted into one vaccinia virus organism. Such a polyvalent vaccine could provide protection against many diseases. Dr. Paoletti's discoveries have been confirmed by later experiments at the National Institutes of Health ( IH). Dr. Geoffrey Smith showed that his experimental vaccinia vaccine protected chimpanzees against hepatitis B virus infections. Because the chimpanzee's immune system is closely similar to that of humans, it provides further evidence that the genetically-engineered vaccines would protect humans as well. The Center for Laboratories and Research was established by the late Nelson Rockefeller, when he was governor of New York in the 1960's. Dr. Dickerman describes the laboratories as a smaller combination of the National Centers for Disease Control and the NIH. The nation's second oldest state public health laboratory, it is also the place where Coxsackie virus was first isolated and the first anti-fungal antibiotic, ystatin, was developed. Paoletti's research was sponsored by the Health Department, Health Research, Inc. and the IH. • Heroin danger Drug harms kidneys H eroin addicts are winding up on dialysis machines as the drug ruins their kidneys, creating the potential for a widespread social and economic problem. Heroin abuse is a common cause of kidney failure, Dr. Eugene E. Cunningham, of State University of New York at Buffalo, said in thejournal of the American Medical Association. Cunningham said he found heroinassociated nephropathy - HAN - is a common cause of end-stage kidney disease among patients ages 18 to 45 in the Buffalo area. "It seems that HA is a widespread problem in the United States, although the exact prevalence figures are not known;' Cunningham and colleagues said. "It affects primarily black men and, to a lesser extent, black women in the prime of life. "The social and economic impact of treating patients with end-stage renal disease has become a major cause of concern in the United States;' they said. "The economic impact of treating HAN may be striking." Cunningham said he sent a questionnaire to 130 dialysis units or sections of nephrology throughout the nation. Of those, 23 units in 14 cities responded. They reported a total of 98 cases of heroin-associated kidney disease. "Despite the small numbers responding to the questionnaire, the number of patients identified as having HAN was still substantial;' they said. Blacks may have a predisposition for the development of HAN, the researchers said. They said 92 patients - 93.9 per cent - were black. Black men made up the single largest group with 77 patients - 78.6 per cent. A federal program covers most of the costs of treating kidney disease, including dialysis and kidney transplantation - with a price tag of about $1 billion annually for 50,000 patients. A significant number of heroin addicts are maintained on dialysis apparently without regard to continued heroin abuse, said Dr. George D. Lundberg, JAMA Editor. A National Institutes of Health con sensus panel said in the journal that the government should not extend that precedent by picking up the tab for liver transplants for all liver patients as well. "The consensus panel takes the basic position that, unless the patient with advanced alcoholic liver disease is judged likely to abstain from alcohol, liver transplant would not be considered. • �Medical School News Practice plan Income ceiling set By Bruce S. Kershner W hile it is the first clinical practice plan ever adopted by UB's School of Medicine, the school is the last one in New York State and one of the last in the nation to have such a plan. The new plan will bring significant changes to the Medical School due to its reallocation of funding for medical programs and its regulation over full time faculty incomes. The UB Dental School adopted such a plan 13 years ago. Mandated by law and medical accreditation committees, the practice plan will establish a ceiling for UB fulltime faculty incomes that are derived from clinical practice associated with their academic functions at the school or its affiliated hospitals. The formula option just chosen by the faculty, the 250% option, now sets a ceiling for their income, not including certain supplementary sources. "Faculty and physicians who are not hospital-based and in private practice will not be affected by the new plan. This also applies to income not associated with clinical prac- tice," said Dr. John Naughton, dean of the Medical School. The plan was wholly mandated by State legislation in 1974 and is required by the Liaison Committee on Medical Accreditation established by the federal Department of Health and Social Services, the AMA and the AAMC. early a year of negotiations between the State Office of Employee Relations and United University Professions, the collective bargaining agency for faculty and staff, climaxed in the general state contract, which is "now a policy of the SUNY system;' the dean said. Of considerable note is that the contract gave SUNY the power to impose income ceilings unilaterally if the medical school faculties refused to negotiate limits themselves. The union represents more than 17,500 professional employees of the State University, including about 500 physicians from the State's four publicly-supported medical schools. Following the State's adoption of the general plan, "it was negotiated for each campus by local management-faculty teams;' Dr. Naughton explained. The management team in Buffalo included the dean; Dr. Carter Pannill, then vice president for health sciences; Mr. E.W. Doty, vice president for finance and management; Dr. Donald Larson, VIew ot extellor ot new wing being added to the carev..fattJer..Shennan medical school coll¥Jiex at the Matn Street campus. Completion Is proJected tor 1985. associate vice president for health sciences; and Dr. Ross Markello, who led the medical faculty representatives. This team revised the general contract, which was made official when it was approved in Albany on October 1, 1983. The new contract includes specific items and those variations that take into account the unique situations that differentiate the UB School of Medicine from others in the SUNY system. The most recent steps before the plan could be implemented were the formation of a Governing Board and the selection of one of the two formula options offered. These were decided on January 15, 1984. In the meantime, department chairmen have identified those faculty who will be members of the plan. The plan will be managed by Clinical Practice Groups, which will generally .be University and hospital departments, and in some cases, department divisions. The Governing Board will periodically oversee the implementation of the plan by the Clinical Practice Groups. Medical faculty required to belong to the plan include all full-time or BUFFALO PHYSICIAN • 21 �''The plan was mandated to ensure that faculty devote most of their effort to their primary task of teaching medical students!' geographic full-time faculty who 1) perform the professional clinical practice of medicine for which a fee or salary is customarily collected and 2) are paid a salary by SU Y alone or jointly by SUNY and its affiliated hospital programs. Approximately 15%, or 366 of 2400 faculty are now covered by the plan. Physicians not required to participate may obtain vo4Jntary membership. Faculty who are volunteer are not included, nor are any faculty who 1) are residents, interns or fellows or 2) do not engage in clinical practice (such as many of those in the basic science departments) or 3) engage in clinical practice solely in hospitals or health care institutions OT affiliated with or owned by UB. Over 2000 Medical School Faculty, almost 85% of the total, currently fall into one of these categories and are thus not covered by the plan. While the plan affects income derived from clinical practice at UB-afliliated medical institutions, it does not affect many other supplementary sources of income. Besides the basic State (and hospital) salary, the following income will remain unaffected by the plan: fringe benefits, royalties, honoraria for lectures and clinical practice income derived from hospitals not associated with UB. In some cases, income from research grants can be excluded. T he plan was legislated, State officials in Albany told the New York Times, "to ensure that faculty members devote most of their efforts toward their primary task of teaching medical students and not to outside consulting or the care of their private patients." A second aim of the legislation was to prevent physicians from using State nurses, equipment and office suites in State facilities for their private clinical practice, without reimbursing the State. "This agreement will guarantee full accountability to the public;' Dr. A. Norman Haffner said in a Times interview. He is the SUNY system's vice chancellor for research, graduate studies and professional programs. The agreement requires those fulltime physicians in the plan who engage in private practice to do so in medical facilities maintained by the University or its associated teaching hospitals. Dr. Naughton sees the plan as bringing a "new order" to the medical school while benefiting the quality of its teaching and research programs, its faculty and its financial status. "We will now be like the other 126 medical schools in the nation;' he emphasized, also pointing out that the school depends on the plan since it is now re22 • BUFFALO PHYSICIAN quired for accreditation. For those concerned about the new plan, a frequent question is "Won't it take away individual prerogatives of the full-time faculty physicians?" The dean answers, "Yes, to some degree, but not in a manner that will affect their actual roles as physicians in rendering care to patients." He explains that when physicians choose to join the full-time faculty, it is presumed that they are committing themselves full-time to the goals and functions of their department and the medical school. This is what differentiates them from the volunteer faculty. He feels it is inconsistent for fulltime faculty to consider themselves accountable to the chairman and the University for their research and teaching activity, but not for their private patient care functions. Referring to the new system, he observed, "It will bring 'programmatic integrity' to the process." Then he added, "The plan clearly defines, for the first time, the fulltime faculty in the system. This in turn will benefit the medical school." An expressed concern from voluntary faculty is that a faculty practice plan may stimulate competition between the full-time and voluntary faculty members. Dr. Naughton feels that the implication of such a threat is unfortunate because most full-time faculty are engaged in practice and have not done any damage to the voluntary physician community. In fact, the plan will serve to moderate the amount of practice the full time faculty can engage in, thus reducing the threat to the voluntary faculty. The plan is simply a small part of a long historical trend that permanently changed the relationship between the University and the voluntary doctor community years ago. He notes that "Practice plans are usually perceived in this way. The plan does legitimatize the right of SUNY's full-time faculty to perform a limited amount of practice. Historically, it was always thought that you could have a full-time faculty that could engage solely in teaching and research and that others would be engaged primarily in clinical activities. The facts are that the rules changed in the mid-1960's because of changes in the funding mechanisms for the support of medical education. It was recognized that research and educational dollars alone would be insufficient to maintain a quality, stable faculty and quality medical education. So from 1965 to now, a greater contribution of dollars from patient care has been required to enable medical schools to function." The dean Vlent on, "And so in a sense, there is an encroachment. But the other �Medical School News side of the coin is that, for UB, we don't own our own hospital. Because of this, there is no way that Buffalo full-time faculty will take away significant patient revenues from the voluntary faculty." One of the plan's primary benefits to the medical school is that, according to SUNY Vice Chancellor Haffner, the plan will provide sufficient financial incentives to allow the State-supported medical schools to compete against wealthier private schools for the best medical academicians. Part of this financial incentive is due to the disbursement of the clinical practice income in which the School of Medicine receives 5 per cent. This "Dean's Fund" will be used to expand and improve programs most in need. ot only docs this include research and education programs but also the hiring of new quality faculty members. Because it is a discretionary fund, the dean can use it as an incentive, and award amounts to selected faculty members. Similarly, the "overage;' or amount generated above the contractual ceiling, will be prorated to each department (by hospital) where it is generated. It will be used by the departments to buy equipment as well as to expand educational efforts. In particular, the new source of funds can be used to "nourish undernourished" departments or programs. "Because we can now utilize a new added resource," Dr. aughton reasoned, "we have one more fund with which to match other sources." W hile the practice plan can ultimately expand the medical faculty, some have expressed fears that it could initially result in some loss of faculty. aughton responded by saying Dr. "There's no reason to lose any faculty; however, there may be some physician faculty who opt out of the system because they perceive this change as not in their best personal interests." In answering the question, "Is it worth it to me as an individual to be part of the Medical School or not?", the dean feels that answer will be "determined by each faculty member's commitment to the goals of the medical school and the profession." At this time, the dean does not know what actual effect it will have on faculty stability. The faculty-elected Governing Board wil l be responsible for the day-to-day management of the plan. This will include authority to review accounts, transmit reports to the President of UB, and establish guidelines for expending clinical practice income. When necessary, procedures to preserve patient confidentiality will be developed. A majority vote is required to elect the Board, which will consist of one person from each clinical department. One at-large member from the basic science faculty will also be elected. The dean, the University president, and the affiliated hospital directors will be nonvoting members of the Board. The Governing Board will establish a billing and accounting system that will be followed by the Clinical Practice Groups. Individual plan members will not be permitted to bill directly for fees for professional services. The Clinical Practice Groups will be organized by clinical department and hospital. Because of the relatively large size of some department divisions, such as those in the Department of Medicine, divisions may be organized as separate Clinical Practice Groups. Plan members of each Group will combine their billing and accounting systems. Disbursement of clinical practice income will be according to Governing Board rules. The "250% option" that was recently approved by the faculty works like this: A full time faculty member may not earn a clinical practice income in excess of 250% of the established maximum State basic annual salary for academic rank. Since maximum State salaries range from $70,000 to $80,000 a year, the plan allows some members to earn a total of up to $178,000 a year in combined faculty and patient derived income. As explained previously, this does not include other non-clinical practice income from fringe benefits, royalties and the like. Average State salaries actually hover around $40,000 annually. The faculty may elect. to change the formula to the second available option one year later. This "incentive plan" does not impose a fixed ceiling on income. It permits a faculty member to earn a clinical practice income of more than 200% of the maximum State basic annual salary as long as any income over 200% is shared equally with the medical school. The formulas for disbursement are more complicated. Five per cent of all combined clinical practice income will be deposited into a "Dean's Fund" to be used for the benefit of the School of Medicine. As mentioned before, this may include new or expanded educational and research programs, faculty hiring and merit awards. However, $60,000 of this fund must be used for SUNY system-wide Health Sciences purposes. Buffalds share of this $60,000 has not yet been determined. A portion of the generated practice funds will be used to reimburse the affiliated hospitals for expenses related to . use of equipment, offices, nurses and other personnel, and supplies. For Buffalo, at the present time, this is roughly 15%. A third portion may be used to compensate for IRS established costs of practice. This includes physicians' expenses related to professional travel, membership dues and equipment use. It typically amounts to 10-25% of total clinical practice income. A fourth and largest portion is the clinical practice income, or salary, to the faculty member, which cannot exceed the contractual limits. What remains is the fifth portion called "overage." It is disbursed to each department, according to the prorated portion they generate. It may be used to purchase equipment, hire new faculty, or expand research and educational programs. • Genetics training Predoctoral grant sought A group of reviewers and administrators from the ational Institutes of Health came to the Amherst Campus for a site visit October 17 to review a predoctoral training grant proposal called "The Buffalo Genetics Training Grant:' This proposal for a predoctoral training grant in genetics is unusual in that it originated within and was formulated by members of the ucleic Acid Graduate Group, a group of researchers active in many areas of genetics in the Buffalo area. The goal of the proposal is "to establish a broad unified graduate program in genetics and to attract a larger number of excellent students to the area with the aid of a Genetics Training Grant:' Participating in the application are 20 faculty members from four academic departments; nine from Roswell Park Memorial Institute; six from the Department of Biochemistry; three from the Department of Biological Science, Division of Cell & Molecular Biology, and two from the Department of Microbiology. The program, if funded, will be administered .by a project director, Dr. Jeremy Bruenn (Department of Biological Sciences, Division of Cell & Molecular Biology) in conjunction with a Steering Committee consisting of Drs. David Rekosh (Biochemistry), Philip LoVerde (Microbiology), and Rosemary Elliott (Cellular & Molecular Biology, Roswell Park Memorial Institute). The site visitors interviewed 12 of the 20 faculty participants and 19 of 40 graduate students whose names appear on the proposal. BUFFALO PHYSICIAN • 23 �Mr. Joseph Pans, With Buffalo VA Medical Center In background. 1 VAMC head Paris directs Center A By Bruce S. Kershner !though many know that the Director of Buffalo Veterans Administration Medical Center (VAMC) is Joseph Paris, few realize that he is also Director of the VA Medical District #2. In this capacity, he oversees planning and budgeting activities of all VA facilities in Western and Central New York, including six hospitals, one clinic, a domiciliary or "old soldiers home" and a national cemetery. The Buffalo VAMC, which Mr. Paris has directed for over 11 years, is not only the largest VA tertiary-care medical center in upstate New York, but is also 24 • BUFFALO PHYSICIAN the largest non-psychiatric VA facility in the entire state. With Mr. Paris' responsibilities as District Director taking him frequently to Albany, Syracuse and other locations, he says, "Some people joke that I don't really work here." However, he is clearly a loyal and well-entrenched Buffalonian. Born in Rochester 66 years ago, he first worked in Buffalo with the Veterans Administration Regional Office and the VA Medical Center for ten years after serving as a 1st Lieutenant in World War II. Following an assignment at the VAMC in Batavia, NY, he returned a second time to Buffalo to serve as VAMC's Assistant Director during the height of the Vietnam War and ultimately became the Director in 1972 after a brief assignment as Director of the VAMC in Butler, PA. Look- ing back, he mused, "I just couldn't stay away' I'm in love with Buffalo." His two daughters are both UB alumni and also live in the Buffalo area. Located across the street from UB's medical school, the VAMC is now in the 33rd year of its affiliation with the School. Mr. Paris sees the relationship with the medical school as clearly symbiotic. He particularly appreciates the fact that the medical school's review and selection of new faculty assures high quality in the selection of those physicians, many of whom are also working at VAMC. "Here at our Medical Center, maintaining the highest standards of patient care requires that clinical practice must constantly change to keep pace with scientific developments. The vital interaction between the Medical School �Hospitals and our VAMC has ensured this movement. Clinical practices are continually at the cutting edge of progress. Interdisciplinary team treatment in geriatrics; internationally recognized accomplishments in pacemaking and cryosu rgery; · peripheral vascular surgery; open heart surgery; and nationallyrecognized achievements in the management of renal disease are examples of clinical progress. The excellence of these and other treatment programs hinges upon linkages among teaching, research and clinical care." Each year more than 200 residents and more than 290 medical students receive instruction at the VAMC. Their presence is a continual challenge keeping all levels of staff on their toes. Throughout the year, approxir:nately 1500 students in health care trammg affiliate at the local VAMC and "every bed here is a teaching bed;' he stresses. The Medical School and the VAMC have so many overlapping programs, it's difficult to keep track of all of them. An amusing example, he explained, occ~r­ red "one morning when I was gettmg ready f01- work, I was listening to a television program and heard an announcement publicizing an exercise program for senior citizens. Since I'm a senior citizen myself, I called the familiar-sounding number given for this 'Network for Aging in Western ew York! Sure enough, someone in my hospital answered the phone and gave me information about a joint university/hospital program which was being held throughout the city." Then he continued, "It would have been amusing to listen to their reaction if I had identified myself." P aris is proud of his hospit~l's r~la­ tionship with the Umvers1ty, especially because university researchers are interested in practicing state of the art medicine. "Did you know that the world's first implanted heart pacemaker was developed at this hospital in 1962?" he noted. Dr. William Chardack, together with Dr. Andrew Gage, both UB professors of surgery, and Wilson Greatbatch originated the revolutionary life-saving device which is now use? by up to three million people. At the time, Dr. Chardack was chief of surgery at the VAMC. Dr. Gage is presently chief of staff at the VAMC, as well as acting chairman of the Department of Surgery. "We now do 250 coronary bypass operations a year here;' he continued. "We also have an exciting event coming some time in 1984 - the hospital's first heart transplant!' In the medical administration field, Mr. Paris' specialty, he was responsi- ble for developing the Medical District Initiated Program Planning (MEDIPP). This was a significant step in health care planning for veterans because it is actually a grassroots planning effort that informs the federal government of the District's needs. Contrasting this to the former procedure where the Veterans Administration Central Office in Washington used to tell the District what they needed, Mr. Paris remarked, "it transfers control to those at the local level." Mr. Paris explained the concept of Diagnosis Related Groups (DRG) and how the VAMC will be applying this resource allocation method to its acute care discharges beginning with the 1985 budget year. However, with the accomplishments come some difficulties. "We are experiencing at the present time a great demand for patient care. This is partially due to the area's current economic conditions - we're bulging at the seams;' he commented. The VAMC presently treats over 13,000 inpatients and 160,000 outpatients annually. Regarding the continuing efforts to contain health care costs and federal budget cuts, Mr. Paris explained that VAMC has been an unusual exception because it has not been cut for the past three years. "But it has not had increases for three years either;' he emphasized, "and that is the same as budget cuts because of the effects of inflation." This has made any significant expansion impossible. He continued, "We could really use 7 to 9 more physicians, 15 to 17 medical residents and 20 to 25 more RN's and technicians." Even such routine hospital facility needs as airconditioning on all wards cannot be provided yet. ''Air-conditioning is not a simple matter - it costs $35 million," he remarked. One of his goals is to expand the hospital's research capabilities by increasing the current $1,250,000 research funding to $2,250,000 and the construction of a Research and Education Building. As far as VAMC's future, he sees it as serving a more aging veteran "due to fewer recent wars." Geriatrics will definitely be a major thrust in medicine; thus he hopes to work toward developing expanded geriatric programs at the VA and the University. His desire is to have additional faculty and resident positions and at least four fellows each year training in geriatric medicine. He is especially pleased that the University is planning to set aside a building for geriatric medicine to expand the program. Mr. Paris believes the time has come for the VAMC to move into a more leading role in patient care and to a preeminent position in education of the health professions in Western ew York. It is particularly fitting that VA Medical Center should be directed by a World War II veteran who was awarded the Purple Heart with Oak Leaf Cluster and the Silver Star. He is a member of the Disabled American Veterans, the Veterans of Foreign Wars and the American Legion, as well as the American Military Surgeons of the U.S., a Fellow in the American College of Hospital Administrators, member of the American Hospital Association, Association of American Medical Colleges Council of1eaching Hospitals and the Western New York Hospital Association. He is also on the Board of Directors and Executive Committee of the Health Systems Agency of W. .Y. and a member of the Statewide Health Coordinating Council of the State Health Planning Commission , and other professional organizations. Perhaps some of Joseph Paris' successful accomplishments in hospital administration can be attributed to the motto he practices at work each day "None of us is as smart as all of us." • RPMI recertified Meets ACS standards T he Commission on Cancer of the American College of Surgeons has awarded a Three-year Certificate of Approval to Roswell Park Memorial Institute. The certificate was presented to Dr. Gerald P. Murphy by commission official Dr. John Snyder. The Approvals Program was established by the American College of Surgeons in 1956 to encourage the best in cancer therapy. Different kinds of cancer respond best to different kinds of treatments: surgery, x-ray, chemotherapy, alone or in combination. The program encourages discussion of cancer problems among surgeons, medical oncologists, oncological radiation therapists, pathologists and other medical disciplines involving the diagnosis and treatment of cancer, thus assisting the attending physician in optimal treatment planning for his patient. In addition to having a clinical program which meets the requirements of the Commission on Cancer, Roswell Park has also met the requirement of having a wellfunctioning tumor registry. The registry keeps a record of each cancer patient, cured or not, and makes certain that follow-up examination and rehabilitation of patients are done in a systematic manner at specified intervals. Special studies of cancer cause and treatment are possible through the registry. • BUFFALO PHYSICIAN • 25 �Students > w ..J ..J :::;) til :::E ::; cii 5 X: D. Research exhibits Rttv medical research exhibits were on dlsPtav at the Thlrrl Annual Student Research Dav Forom held In Goodyear Hall on December 3. Students organize displays A bout 50 medical research exhibits were displayed at the Third Annual Student Research Forum held at UB on December 3, 1983. The participants included 27 students who completed a summer fellowship for interns which was designed to introduce medical students to biomedical research. Other medical students, fellows, and faculty were invited as well. Thomas D. Flanagan, Ph.D., and Randolph E. Sarnacki, Ph.D., directed the program. Most of the Medical School's departments were represented at the poster forum. The relationship between cancer and Vitamin A, allergy and diabetes mellitus were presented by Blackford Middleton, Joseph Bona, and Barbara O'Mara, respectively. "Microvascular Response to Angiography in Damaged Vessels" was the title of Michael Nancollas' poster. A small sample of other poster exhibits included: "Purification of Vitamin DDependent Ca2+ Binding Protein From Human Intestine" by John Bloor; "Holographic Representation of ComputerGenerated Intracranial Tumor Volumes Reconstructed From CT Data'' by Peter Economou and Thai Trong Do; "Investigation of Rat Liver Injury and Regeneration After Acetaminophen Poisoning" by Raymond Meeks, and "Role of Superoxide in Preventing Polyspermy" by Robert Moss. Abstracts of all the exhibits will be published soon. • 26 • BUFFALO PHYSICIAN C hrtstopher Lander, a thlrrl vear UB medical student, received the Dr. John B. Shetter Awarrl tor 1983. The awarrl was based on Mr. Lander's overall performance In his worlc In the laboratorr. Dr. Shetter (rtghtJ, clinical professor or pathology, presented the awarrl. Henrr E. Black, head or the Department or Medicine at Deaconess and a clinical associate professor or medicine and tam#· tv medicine, looks on. The awarrl was established In 1979 11v the Deaconess Medical staff. �• People • . .. ..· .. ..... . ... ... . . ... .. A practice in paradise Ambrusko, a real life 'Love Boat' doctor T wo weeks each year Dr. John Ambrusko (M'37), director of the Manatee County, Florida, Health Department, packs his black medical bag and heads off to sea. Far away from government offices and the rat race of city life, the white-haired and amiable Ambrusko takes on a new role as a ship's doctor, jaunting from Miami to assau on a 900-passenger Pan American cruise liner. "It's almost like going home;' said Ambrusko, who was a surgeon on a By Jay Greene destroyer in the South Pacific during World War II. "I always thought how beautiful it would be to be at sea if you weren't being dive-bombed, torpedoed or shot at. That happened a lot out there, you know." Dr. Ambrusko was a UB instructor of surgery in his early years, from 1949-55. He served as chief surgeon of Kenmore Mercy Hospital from 1950 1977. Before UB Joined the SUNY system, he was active in the Participating Fund for Medical Education, which was important in recruiting new Dr. John Ambrusko outstanding department heads. It also helped establish the Buffalo Physician magazine. He also served on UB's committees on admissions and on the health advisory committe. He is still a member BUFFALO PHYSICIAN • 27 �I • of the Erie County Medical Society. His role as ship's doctor began three years ago, when Ambrusko met the Emerald Seas ship doctor at a medical seminar. After trading landlubber and salty-dog stories, the suggestion was made that Ambrusko sign on for a series of four-day cruises. "I thought since I have state compensation and vacation time coming to me, it might be an interesting way to spend two weeks;' Ambrusko said during an interview in his ofice. "I liked it so much the first week I asked the captain if my wife could join me. It continued to be so enjoyable I asked if! could bring my entire family down." (Ambrusko has seven daughters). T wice a week at about 4 p.m., the Emerald Seas steams out of Miami against a setting sun with orchestras playing and passengers lining the decks waving their goodbyes. In the early evening, when the liner reaches international waters, the gambling tables open and the partying begins. For 18 hours through the night, passengers dance, drink, eat, sleep and get acquainted. By the time the ship docks in Nassau the next morning, Ambrusko says, he has his hands full. "It's an exciting ... a very stimulating time for all the passengers during the voyage. There are big family reunions, and a lot of the senior citizens overdo it ari.d need treatment:' Since that first tour of duty in 1980, Ambrusko has signed on for two others. His last cruise was almost a year ago, during the Thanksgiving holidays. "We have had so many problems lately, I haven't had the time," he explained. And steamship companies would love to have Ambrusko - if he had the time. After he introduced the newly developed medication "trans-derm" to seasick passengers, Ambrusko was offered several jobs on Swedish liners. Instead of sending passengers to bed for two or three days, doctors now place a small Band-Aid, containing transderm, behind the patient's ear. The medication is absorbed into the skin and protects against seasickness for 72 hours. "One of the reasons I took the job is the Emerald Seas specializes in threeand four-day cruises;' Ambrusko said. "I am always someplace where I can get back quickly in an emergency. I would be too apprehensive to be at sea for two whole weeks:' Before Ambrusko leaves terra firma, he contacts several local doctors and the health directors in Sarasota and Hillsborough counties. "I know some people will say, 'Here's our health director, and he's cruising around the 28 • BUFFALO PHYSICIAN Bahamas: But I don't leave here unless things are well in hand;' he said. Doctoring at sea differs little from that on land, except a physician is expected to do a lot more than hand out pills and perform minor surgeries. "It's a lot like the Love Boat;' Ambrusko said. "Each night the captain has a cocktail party and dinner for the VIPs. One night he was busy so I acted as host. It was quite delightful. There was a lieutenant governor, a sheriff and several entertainers on board that night." A mbrusko takes doctoring seriously. Before he entered World War II in 1943, he was a surgeon for six years at the world-famous Mayo Clinic in Minnesota. He spent the 25 years following the war at Kenmore Mercy Hospital. In 1977, Ambrusko was forced to leave surgery because he had developed cataracts in both eyes. He applied for the Health Department job in Bradenton, but believed it would only be temporary. "I never expected it would take me six years to get my eyes operated on;' said Ambrusko, shaking his head. "I always thought I would return to Buffalo to continue surgery. Do I miss it? Christ. It was my life .... "I look at myself now as the doctor of the community. My job is to prevent outbreaks of disease. Fortunately, we haven't had any problems. After all I've been through, this job is the champ." Ambrusko, who is 70, said if he is ever fired or decides to retire, he'll consider working four months a year as a ship's doctor. "Most doctors do it part-time. ot anything like the 'Love Boat' doctor, although we enjoy ourselves as much. "I like the respect that people give me when I walk down the deck after office hours;' he said. "It reminds me a lot of when I was chief surgeon. In the bureaucracy of a hospital, that's about the top. "The sea is something else. I love it. There's nothing so restful, peaceful as smelling salt air and looking at the horizon across blue water with good friends nearby." • (Reprinted from The Bradenton (Florida) Herald, 914183). Guthrie honored PKU pioneer recognized T he internationally recognized UB professor who devised the PKU test that has literally saved thousands of children from the anguish of mental retardation is the reci pi en t of one of the highest awards of the National Association of Retarded Citizens. Dr. Robert Guthrie was presented the Distinguished Research Award ovember 11 in Detroit at the Association's Annual Convention. A professor of pediatrics, Dr. Guthrie developed the simple screening tests that detect phenylketonuria (PKU) and other inherited metabolic diseases in newborn infants. ow a standard test in hospital nurseries, it is mandated by law in all but two states and is used worldwide. The Guthrie test, as it is now called, can identify the estimated one of every 5000 infants that has the hereditary disease that causes severe mental retardation if left untreated. More than 60 million babies have received the Guthrie test since it was devised 20 years ago. This means that at least 12,000 people are growing up normal that would have otherwise been retarded. PKU is a disorder of the liver which causes severe brain damage unless identified and treated with a special diet. The test uses a drop or two of blood taken from a baby's heel and analyzes it in a laboratory. Since he initially developed the test for PKU, he has also devised 30 other tests for a number of other newborn diseases. The analyses associated with the Guthrie test can detect, for example, galactosemia, a fatal defect in sugar metabolism and congenital hypothyroidism, an absence of thyroid hormone that produces cretinism. Dr. Guthrie's interest in mental retardation is not incidental; one of his six children and a niece arc retarded. Dr. Guthrie, 66, has lobbied for years for the mentally retarded. Some of his most recent efforts include pressing for legislation to screen children for lead poisoning and other diseases. A recipient of numerous other awards in the past, he is the author of more than 60 scientific articles and shares his expertise as a consultant to agencies in the U.S. and as far away as China and ew Zealand. A resident of Williamsville, he is also director of the University's Biochemical Genetics Laboratory. • DR. ICHIRO NAKAMURA, ASSISTANT PRO· fessor of pathology, presented a paper entitled "Natural Killer Cell-Like Effectors Regulate Hemopoietic Colony Formation In Vitro: A Model for Hybrid Resistance to Bone Marrow Graft?" at the 29th Annual Meeting of the Reticuloendothelial Society, Portland, Oregon, October 9-12. • DR. FRANK V. Mel. BOOTH , JUST APPOINTed assistant professor of surgery, has also been named director of the Surgical Intensive Care Unit at the Buffalo General Hospital. Dr. Booth most recently held the position of director of the Surgical Critical Care Units and assistant professor of surgery at the �People Johns Hopkins Medical Institutions in Baltimore. A native of the United Kingdom, he attended school in England and earned his undergraduate, graduate and medical degrees from Oxford University. • DR. FRANCESCO GIACOBBE, ASSISTANT clinical professor, has been appointed chief of pediatrics at Sisters Hospital. He has been on staff at Sisters since 1964. He is a member of the American Academy of Pediatrics and is certified by the American Board of Pediatrics. He has a private office practice in Kenmore. Dr. Giacobbe is also a Commander in the United States aval Reserve. • being conducted in conjunction with the University of Rochester Medical School and Walter Reed Army Medical Center. • University, Dana-Farber Cancer Center, Georgetown University, and the Hawaii Medical Association, among others. • DR. SHASHIKANT B. LELE, CLINICAL ASsociate professor in gynecology and obstetrics and associate chief of Roswell Park's Department of Gynecologic Oncology, was an invited speaker at the American College of Obstetricians and Gynecologists District II meeting with the Italian Obstetrics and Gynecology Society, September 28-0ctober 7, in Venice. Dr. Lele discussed the Roswell Park experience in managing advanced ovarian cancer and participated in a panel discussion on surgical management of cervical cancer. • DR. JAMES LEE, PROFESSOR OF MEDICINE, spoke at the 8th annual Saudi Medical Symposium In Riyadh, Saudi Arabia October 30- ovember 3 on an update on essential hypertension. A resident of Williamsville, he is medical director of the skilled nursing facility and director of hypertension services at the Erie County Medical Center. • Dr. Gerald P. Murphy Dr. Harold 0. Douglass, Jr. cancer." Dr. Francesco Giacobbe DR. STEVEN GUTMAN, ASSISTANT PROFESsor of pathology, presented a poster exhibit (co-authored by Dr. Ruth Solomon and Dr. M. Montes) entitled "A Comparison of the Chemstrip 9 with a Tricholoroacetic Acid Protein Precipitation Test for Screening Urines Prior to Cultures" at the fall meeting of th e American Society of Clinical Pathologists in St. Louis on September 19. • DR. CHUNG I. HONG, ASSISTANT RESEARCH professor of chemistry and Roswell Park cancer research scientist in neurosurgery, presented a lecture on Synthesis and Antitumor Actiuiry of ara-C Conjugates, August 25, at the Technical University of Munich, West • Germany. DR. LAWRENCE JACOBS, CLINICAl ASSIStant professor of physiology, has received a National Institutes of Health grant of 126,138 for a two-year continuation of a study of multiple sclerosis treatment using interferon. This research was begun by Dr. Jacobs in collaboration with physicians at Roswell Park Memorial Institute, and is now DR. HAROLD 0. DOUGLASS, JR., RESEARCH associate professor of surgery and chief, Upper Gastrointestinal and Endoscopy Service at Roswell Park, has been elected national chairman of the Gastrointestinal Tumor Study Group (GITSG), the first organized national effort devoted to the research and treatment of gastrointestinal tumors. Established by the National Cancer Institute (NCI) in 1973 and supported by NCI research grants, GITSG is a cooperative, multidisciplinary task force of 10 hospitals, cancer institutions, medical organizations, and universities, such as Roswell Park, Yale THE AMERICAN CANCER SOCIETY (ACS), THE largest voluntary group in the national fight against cancer, has elected D r. Gerald P. Murphy, director of Roswell Park, its national president, at its 70th Annual Meeting in ew York City. Dr. Murphy is also a UB research professor. Dr. Murphy's appointment marks the first time in ACS history that a physician from the Upstate New York area has been selected to guide the Society at the national level, and coincides with Roswell Park's 85th anniversary as the world's first cancer research facility. In recognition of Dr. Murphy's election, the New York State Division of the ACS presented a "restricted gift" of $500,000 to the national ACS. The "restriction" attached to the gift is that these funds be used exclusively to support new cancer research projects at Roswell Park in 1984. According to Mr. William Pinkel, executive director of the Society's New York State Division, the $500,000 endowment both honors Dr. Murphy and acknowledges "the Institute's long history of leadership and excellence in cancer research, treatment and education in the worldwide effort to conquer Dr. Murphy has served the ACS in a number of capacities since 1968, including national chairman of its Medical and Scientific Committee and president of both the New York State Division and the local Erie County Unit. Furthermore, Dr. Murphy has been selected to represent the general field of cancer on the newly formed Advisory Committee on Biological Sciences to Notre Dame University, Indiana. This voluntary committee will review certain advances in biology - including cancer, blood coagulation, molecular biology, cell culture, and comparative pathology - and make recommenBUFFALO PHYSICIAN • 29 �People dations to the University. Dr. Murphy has also accepted an invitation to join the editorial board of the new journal, Neoplasia. Dr. Murphy has been Institute director since 1970 and has been instrumental in making Roswell Park a world leader in cancer research, treatment, and education. During his tenure, many new facilities and new areas of cancer research have been established. He has been most vigorous in cancer control activities, particularly in conjunction with the American Cancer Society locally, statewide, and nationally. A member of many prestigious national and international organizations, Dr. Murphy is currently chairman of the Executive Council of the Society of Surgical Oncology; secretary-general of the International Union against Cancer; and executive board chairman of the Damon Runyon-Walter Winchell Cancer Fund. surgery at the Wayne State Medical School and the Massachusetts General Hospital before moving to Buffalo on July 1. He has published in the field with special interests in tumors of the hand, thoracic outlet syndrome and brachial plexus injuries. In the future, he hopes to do research on rigid fixation of hand fractures and microsurgery. • DR. GERALD SUFRIN , PROFESSOR AND chairman, Department of Urology, has recently been appointed to the Surgery, Anesthesiology, and Trauma Study Section of the National Institutes of Health. This study section reviews proposals submitted to the National Institutes of Health and evaluates their scientific merit for possible funding by the National Institutes of Health. In addition, Dr. Sufrin has recently been reappointed to the Research Grants and Fellowship Committee of the ational Kidney Foundation and to its Council on Urology. • chairman of orthopaedics at Case Western University. • DR. LEONARD WEISS, RESEARCH PROFESSOR of dermatology and director, Experimental Pathology, Roswell Park, discussed The Cancer Cell Periphery and Metastasis lne.fficiency at a meeting of the British Society for Cell Biology and Developmental Biology, September 14-16, in Aberystwyth , Wales. • THREE UB FACULTY AND A UNIVERSITY OF pediatrics and chief of Roswell Park's Department of Pediatrics, has been named editor of a new journal, Cancer Drug Delivery. Toronto immunologist have recently coauthored a text on immunogenetics, making it one of only four published in the field. Authors of the 514-page text, Immunogenetics, are Marek Zaleski (M.D.); E d ward Niles (Ph.D.); Roger Cunningham, (Ph.D.), and Torontds Stanislaw D ubiski (M .D.). Dr. Niles is associate professor of biochemistry; Dr. Zaleski is professor of microbiology; Dr. Cunningham is associate professor and associate director of UB's Ernest Witebsky Center for Immunology. The text, which is published by Pitman Publishing, Marshfield, Mass., is currently undergoing translation into ajapanese edition, with other foreign-language editions planned. • DR. MARTIN WINGATE, PROFESSOR OF OB- DR. MICHAEL ANBAR WILL SERVE AS CON- stetrics and gynecology and director of Continuing Medical Education, recently returned from Indonesia where he will serve as associate medical director of Family Health International. This is an intermediate agency ofUSAID or United States American International Development. He will act as a consultant for evaluating maternal family health and child clinics and will develop biomedical research plans in Indonesia. Dr. Wingate is also an assistant dean and a Millard Fillmore staff physician. • sulting editor, Physical Chemistry, for Medical Electronics. He is associate dean for applied research (School of Medicine), professor and chairman of the Department of Biophysical Sciences, and professor of dental materials in the School of Dentistry. He recently became executive director at the new Health Care Instruments and Device Institute (HIDI). He also serves as research professor in the Department of Biophysics at Roswell Park Memorial Institute. • TWO PHYSICIANS HAVE JUST JOINED THE DR. GIUSEPPE ANDRES, PROFESSOR OF faculty of the Medical School , Drs. Wendy Wolfman and Mark Koniuch. Dr. Wolfman , new research assistant professor, holds the M.D. from the University of Calgary and completed a residency in ob/gyn at the University of Toronto in 1980, was named a Fellow of the Royal College of Surgeons (FRCS), and served on the ob/gyn staff at the Medical College of South Carolina for two years before moving to Buffalo in March. Board-certified in ob/gyn, she currently is doing research on pelvic inflammatory disease and has special interest in pediatric and adolescent gynecology. Her husband Dr. Coleman Rotstein serves on the infectious disease staff at Roswell Park. Dr. Koniuch, new assistant professor, received his M.D. from the University of Michigan , completed a residency in orthopaedic surgery at the Henry Ford Hospital in Detroit, and trained in hand pathology, microbiology and medicine, spoke at a Course on Renal Diseases held by the Departments of Pathology and Medicine at Columbia University, NYC (October 17-18, 1983). The title of his lectures were "Immunologic Basis of Renal Diseases ," "Membrano-proliferative Glomerulonephritis;' "Immunopathogenesis of Tubulointerstitial Nephritis," and "Modern Concept Concerning the lmmunopathogenesis of Nephrotic Syndromes." During the same visit, he was invited guest of Columbia University to the presentation ceremony for the 1983 Louisa Gross Horwitz Prize for Biology to D r. Rita Levi-Montalcini, NYC. (Reprinted from Roswell Park Memorial Institute's "Scanner"). • DR. ARNOLD I. FREEMAN , PROFESSOR OF 30 • BUFFALO PHYSICIAN Dr. Michael Anbar DR. WORTHINGTON SCHENK, CHAIRMAN AND professor ofUB's Department of Surgery, has been invited by the Health Commission of Victoria, Australia, to learn first hand about the successful efforts being taken there to restrain rising hospital and medical expenditures. Controlling the costs of medical student and resident training will also be discussed. The meeting will take place m Melbourne. • DR. EUGENE MINDELL, CHAIRMAN AND professor of orthopaedic surgery, reports that Visiting Professor Dr. Kingsbury Heiple was cited for his service at the department's 6th Resident's Graduation May 1983. His citation read "In recognition of many years of dedicated service as a skilled clinician and outstanding educator." Dr. Heiple is also • DR. ROBIN BANNERMAN , PROFESSOR OF medicine and pediatrics at Children's and Buffalo General Hospitals, has recently published a chapter in a 1983 textbook, Principles and Practice of Medical Genetics, entitled "Hereditary haemolytic, hypoplastic and megaloblastic anaemias." • �Classnotes Missing Your help needed We need your help in locating missing class members. Please contact the Alumni Office if you have information on the alumni listed below. 1934: Dr. Paul L. Frank Dr. Harry S. Hymowitz Dr. Joseph Mackiewicz 1939: Dr. John Kenneth Bembenista Dr. Lawrence . Cheeley Dr. William J. Kasboum Dr. Carlo J. Marinello Dr. Lois Plummer Dr. Julian Potts 1920's FRANCIS R. DANIELS M'24 • would like to know if his classmates are interested in a 60th Reunion. His address is 1302 Risa Place, Santa Ana, California 92705. MARVIN A. BlOCK M'25 • has been re-elected to the executive board on Alcoholism of the American Medical Society. He is a resident of Buffalo and a clinical associate professor emeritus in medicine at UB. MILTON A. PALMER M'27 • received the first Rudy Spitzer Award in recognition of his 38 years of service to the Buffalo Eyebank and his 50 years with the Lions Club. Dr. Palmer resides in Lancaster. He was on UB's faculty from 1931 to 1951. 1944: Dr. Angel M. Ayala Dr. William S. Burgoyne Dr. Charles C. Casey Dr. William F. Havcmcycr 1930's RICHARD C. BATI M'36 • of Glens 1949: Dr. David 0. Clement 1940's JULIAN J. ASCHER M'40 • reports· 1959: that he retired from active practice in internal medicine in October 1983. Dr. Ascher is an assistant clinical professor emeritus at UB and attending physician at Buffalo General Hospital, Children's Hospital and the VA Hospital, Buffalo. Dr. John S. Carleton Dr. Clement H. Darby 1964: Dr. John J. Stout 1969: Dr. Charles J. Accettola Dr. Sasson J. Mukamal Dr. Henry P. Schwerner Dr. Marion Wind 1974: Dr. Gugu Nxumalo Dr. Ramon Rivera-Arquinzoni Dr. Jonathan Rosenberg Dr. Robin Trumball Falls, ew York, has retired from clinical radiological practice. ABRAHAM S. lENZNER M'41 • , adjunct professor of clinical psychiatry at Dartmouth Medical School, writes that his current research is on "Viral Antecedents and Alzheimer's Disease:' DR. WilliAM J. STAUBITZ M '42 • , UB professor and chairman emeritus, Department of Urology, has recently been elected president of the Society of Pelvic Surgeons. This is the leading professional society for the study of such diseases and Dr. Staubitz's election as president recognizes his long and distinguished contributions to this field of endeavor. ANNABEl MillER IRONS M'46 • retired from partnership with the Southern California Permanente Medical Group and has joined the staff of the VA Hospital, Cheyenne, Wyoming. Her husband, Alexander, has retired from his position on the technical staff of the Jet Propulsion Lab in Pasadena. PAUl C. WEINBERG M'48 • , professor of obstetrics and gynecology at the University of Texas, is in charge of the U niversity of Texas, Houston Medical School Affiliation, Austin, Texas. Medal Committee, American Association for the History of Medicine. Dr. Batt is clinical associate professor of gynecology and obstetrics at UB. 1960's WilliAM E. ABRAMSON M'60 • , Baltimore, Maryland, presented a poster presentation at the Annual Assembly of the Southern Medical Association, "The Drug Abusing Patient In Your Practice: Are You Prepared?" J. ANTHONY BROWN M'61 • is in private practice in Thousand Oaks, California. Dr. Brown is chief of staff at the Los Robles Hospital and chief of surgery at the Westlake Community Hospital. Dr. AllAN SALTZMAN M '67 • , Dr. Harold Bernhard DR. HAROLD BERNHARD M'49 • , UB clinical associate professor, was recently reelected secretary of the American College of Gastroenterology at a meeting in Los Angeles. An organization of 1800 specialists in digestive disease, the College's mission is to foster excellence in the treatment of digestive diseases through education and clinical research. Dr. Bernhard, with two other associates, has also published "Hepatic encephalopathy and altered cimetidine kinetics" in the September 1983 Clinical Pharmacology and Therapeutics. They determined that cimetidine dosage, in cirrhotic patients with a history of portal system encephalopathy, should be reduced to minimize the risk of central nervous system side effects caused by the 40 per cent decrease in total clearance of cimetidine. Dr. Bernhard is also Millard Fillmore Hospital's chief of the gastroenterology division of the Department of Medicine. 1950's SANFORD H. MEYERS M'53 • 1s retired and living at 6000 Casa Blanca, Scottsdale, Arizona 85253. RONALD E. BATI M'58 • has been appointed to the Section on Infertility Surgery, American Fertility Society and to the Oster clinical associate professor of medicine at Veterans Administration Medical Center, has been awarded a $22,000 grant from the Veterans Administration to study how the heart beat affects the exchange of gases in the lungs. WilliAM M. BURLEIGH M'67 • writes that he is still at the Eisenhower Medical Center as chief of clinical pathology and director of the School of Medical Technology. His new address is 5300 Waverly Drive, #K2 Palm Springs, California 92264. HAROLD l. KULMAN M'68 • is director of the Sarasota Vascular Laboratory and chief of surgery at the Sarasota Memorial Hospital, Sarasota, Florida. DR. ROBERT MILCH M'68 • , clinical assistant professor of surgery at Erie County Medical Center, will be hosting a two-day training Institute on Hospice Care on April 26 and 27, 1984, in Buffalo. He will review the fundamentals of pain and symptom control. Dr. Milch has been active in the hospice movement for many years. Also making presentations at the conference will be Dr. Lawrence Sherman, clinical instructor, and Dr. George Cohn, clinical professor, who will speak on the use of transcutaneous electrical stimulation, epidural morphine and biofeedback. Drs. Sandra Tiller, Robert Moskowitz, Owen Bossman and Lawrence Sherman will chair panel discussions on interactions between hospice programs and the health care community. BUFFALO PHYSICIAN • 31 �Classnotes MORRIS STAMBLER M'68 • and his wife announce the birth of their third child, Samuel, on October 17, 1983. They also have a daughter Elizabeth, 7, and a son Benjamin, 3. Dr. Stambler has a private practice in child and adult psychiatry and is an assistant professor of psychiatry at the Tufts University School of Medicine. JOHN R. FISK M'69 • has left academic medicine and writes "I recommend it highly." He has a private practice in pediatric orthopaedic surgery in Coral Stream, Illinois. 1970 's STANLEY KLUGHAUPT M'72 • is in private practice in internal medicine, gastroenterology, in Belleville, New Jersey. PAULS. KRUGER M'72 • was named a Fellow of the American College of Obstetrics and Gynecology in 1983. Dr. Kruger is a clinical instructor at SU Y Upstate. DR. KENNETH l. GAYLES M '73 • , UB clinical instructor of medicine, has been named clinical coordinator of medical service at the Deaconess Division of The Buffalo General Hospital. He will be responsible for administrative affairs of the Department of Medicine at the Deaconess Division and also provide departmental support for the Family Medicine Residency Program at the facility. Dr. Gayles replaces Dr. Henry E. Black, former clinical coordinator, who recently relocated to Florida. THOMAS A. LOMARDO, JR. M'73 • has a private practice in orthopaedics in Buffalo. JACOB D. ROZBRUCH M'73 • has been elected to the American Academy of Orthopaedic Surgery and also to the American Academy of Pediatrics. Dr. Rozbruch is an instructor at the Mt. Sinai School of Medicine. The Rozbruchs have two children, Joshua, 6, and Jenny, 14 months. ROGER M. SIMON M'73 • is in private practice 1n ophthalmology in Las Vegas, Nevada. His practice is limited to diseases and surgery of the retina and vitreous. THOMAS l. WALSH M'74 • is an assistant professor of psychiatry and pediatrics at Georgetown University. Dr. Walsh is a consultant to the Regional Institute for Children and Adolescents, State of Maryland. HENRY M. BARTKOWSKI M'76 • , assistant professor in neurosurgery, University of California at San Francisco, was recently awarded a three year IH grant to study "Nuclear Magnetic Resonance (NMR) in Brain Edema." DR. KEVIN KULICK M '76 • , a Buswell Fellow and clinical assistant professor of dermatology, has received a $20,000 grant from the Veterans Administration to continue studies of how ultraviolet light affects the body's immune system. He is also supervisor of the clinical immunology laboratory at Veterans Administration Medical Center. RICHARD P. SINGER "M'77 • has a private practice in neurology in Miami, Florida, and is a clinical assistant professor of neurology at the U ni\lersity of Miami. Dr. Singer is a Diplomate of the American Board of Psychiatry and eurology. JOHN J. BOYLE M'78 • writes that his new address is 132 Coolidge Street, Brookline, Massachusetts 02146. DR. SALVATORE A. DELPRETE M'78 • is a clinical instructor at Dartmouth-Hitchcock Medical Center. He is in his third year of a hematology/oncology fellowship program. Starting in July 1984, he will work in Stamford, Ct., with Drs. Grann, Erickson and Weinstein. Dr. Delprete was a Fellow of the American Cancer Society and is a member of the AOA Fraternity and the American College of Physicians. MARK GLASSMAN M'78 • and his wife Carol celebrated their 1st wedding anniversary in October. They are the proud parents of a baby daughter, Lisa, born in September. Dr. Glassman is a clinical assistant professor at Yale University and staff pediatrician at Norwalk Hospital, Norwalk, Connecticut. He is the author of 21 publications and three book chapters. CHRISTINE A. MARINO M'79 • is director of the Family Health Center and assistant professor, Department of Family Medicine at the University of Maryland. JAMES MILLER M'79 • recently began working as physician director with Mid-Ohio Valley Health, headquartered in Parksburg, West Virginia. He provides overall administrative direction for the department, which serves a six county area with a population of 150,000. He is also doing clinical activity in the children's, family planning and sexually transmitted disease programs. DOUGLAS H. MOFFAT M'79 • , clinical assistant professor of family medicine, UB, was named director of the Family Medicine Center in June 1983. 1980's CHRISTOPHER M. RIGSBY M'BO • is chief resident and instructor in the Department of Diagnostic Imaging at the Yale ew Haven Hospital. Dr. Rigsby lives at 124 S. Montowese Street, Great Oaks # 18, Branford, Connecticut 06405. BARRY STEWART FELDMAN M'81 • is a resident in family practice at the Brookhaven Memorial Hospital, Bellport, ew York. MICHAEL CANE M'83 • is currently a surgical resident at Buffalo General Hospital. A Williamsville resident, he is an AMA member. Deaths Erwin Neter dead at 74 UB prof remembered by colleagues T By Mary Beth Spina he life, the contributions and the accomplishments of the late Dr. Erwin Neter were honored by more than 300 of his friends, family and colleagues at a memorial service November 11 in Slee Concert Hall on UB's Amherst Campus. Dr. eter, since 1936 an internationally-known bacteriologist and immunologist with UB's Departments of Microbiology and Pediatrics and Children's Hospital's Department of Bacteriology, died November 2 at Georgetown University Medical Center. He had been stricken three weeks earlier with a heart attack in the Baltimore Airport en route home from attending professional meetings in the Washington area. He was 74. He officially retired from UB and Children's Hospital in 1979, 32 • BUFFALO PHYSICIAN but Dr. eter had remained active in research and professional actiVIties, maintaining an office at the Hospital. Called a "man without enemies" by the many who knew him, Dr. eter's impact upon science as well as his fellow man and society was emphasized by speakers at the memorial service. "We all knew Erwin Neter in many different ways;' UB medical dean and acting vice president for health sciences Dr. John Naughton said. Describing him as a dedicated servant, true scholar, and friend of people, medicine and society, Dr. Naughton noted that "Dr. Neter emulated all those characteristics we ourselves would like to emulate. "We have;' he continued, "lost a person of genius, intellect and compassion but he will continue to live through us who knew him." Dr. Elliot F. Ellis, chairman of the Departments of Pediatrics at UB and Children's Hospital, noted that Dr. Neter, a remarkable man, grew with the science of immunology during his long career. "Even prior to my coming to Buffalo," said Dr. Ellis, "I knew Dr. Neter as a helpful and caring scientist and physician. I had turned to him for advice in dealing with an epidemic of infant diarrhea which occur- �Deaths red in ew York City where I was then practicing." Dr. Bernhard Urbascek, director of the Division oflmmunology at the University of Heidelberg and a faculty member in Mannheim, Dr. Neter's hometown, said that "Erwin continues to live by virtue of his excellence. "He will always be alive in our minds. And it is doubtless that one of life's great privileges was to know him. His memory lives on in those he counted as his friends and those he loved." Rev. Carl Thitchener, minister of the Unitarian Universalist Church of Amherst, and Rabbi Paul Golomb of the UB Hillel Foundation also spoke at the service. Music was provided by the Camenae String Quartet. Dr. Neter was widely known as a pioneer in development of the passive hemagglutination test used to aid diagnosis of a variety of enteric or gut bacterial infections. He was credited with coining the term "enteropathogenic" for certain normally friendly Escherichia coli bacteria in the gut which can cause disease in infants. He served as director of bacteriology at Buffalo Children's Hospital and as professor of microbiology and pediatrics at UB from 1936 until 1979. He was also a consultant at Roswell Park Memorial Institute. Recently he was a leading investigator with Centers for Disease Control (CDC) on research which focused upon a common antigen shared by all enteric organisms and had been involved in a UB study last year which linked toxic shock syndrome with the diaphragm. Supported in his research for more than 20 years by grants from the ational Institutes of Health, Dr. Neter had more than 300 professional publications to his credit. He was founding editor-in-chief of the journal, Infection and Immunity, a widely cited microbiology journal. A member and past chairman of the Council of Biology Editors, Dr. eter had received many awards for his contributions to medicine - locally and internationally. Born in Mannheim, Germany, he was honored with an honorary doctor of medicine degree from his alma mater, the University of Heidelberg. He received his M.D. degree from that University in 1934, two years before he emigrated to Buffalo at the urging of his former teacher, the late Dr. Ernest Witebsky who was internationally known in the field of immunology. In addition to his love of science, Dr. eter was a supporter of culture in Buffalo, having served as president of the Buffalo Chamber Music Society for 21 years. A noted scientist, educator and researcher, his delight in encouraging young minds in the classroom and laboratory was as great as his dedication to blazing trails in his own research endeavors. He is survived by his wife, Dina Louise; one son, Stephen Jay, of Redwood City, Calif.; two brothers, Robert of Buenos Aires, Argentina, and Dr. John eter of Athens, Ga., and two grandchildren. Contributions in Dr. Neter's memory may be sent to the Buffalo Chamber Music Society or Children's Hospital of Buffalo. • bacteriologist and immunologist. He made most significant contributions to our understanding of the antigenic structure and pathogenicity of gram-negative enteric organisms. He was the author of over 400 research papers, numerous review papers, and a textbook of microbiology. He was also the editor of several journals and books. Erwin Neter was an expert academic teacher, and he ignited interest in microbiology in many generations of students of medicine, dentistry, pharmacy and nursing. He also was the mentor of ten postdoctoral fellows and three graduate students. Erwin Neter received well-deserved recognition for his work. In 1974 the University of Heidelberg bestowed upon him an honorary doctor degree. In 1977 he received this University's Stockton Kimball Award for his outstanding contributions in teaching, research and service. In 1983, he was named pediatrician of the year by the Buffalo Pediatric Society. Recently, a gram-negative bacterium was named Cedecea neteri in his honor. Other distinctions included the Gold Medal of Merit from the State of Baden-Wurttemberg, Germany, and the Commander's Cross of the Order of Merit of the Federal Republic of Germany. He served in the most prestigious position of chairman of the Board of Governors of the American Academy of Microbiology. Erwin Neter's contributions to our Department of Microbiology for over four decades were priceless. He was always ready to help us and to the last days of his life, took a very active part in practically all aspects of departmental activities. My wife and I had the unique privilege to be personal friends of Erwin and Louise Neter for over a quarter of a century. I will Milgrom eulogizes Neter D r. Felix Milgrom, chairman of the UB Department of Immunology, remembered his friend, Erwin Neter, in this eulogy delivered at the campus Memorial Service held for Dr. Neier on November 11, 1983. In 1936 a young physician arrived in Buffalo, fleeing from Nazi persecution in Germany. He brought with him his M.D. degree from Heidelberg and established himself in this community with the friendship and support of his senior colleagues, Ernest Witebsky and Kornel Terplan. Erwin Neter served this University and community for 47 years with the greatest competence and dignity. He held the rank of professor in the Departments of Microbiology and Pediatrics and for several decades he was director of the Bacteriology Laboratory at the Buffalo Children's Hospital and consultant bacteriologist at Roswell Park Memorial Institute. Erwin Neter was a world-renowned Dt. Erwin Netet always retain in grateful memory the encouragement that I received from Erwin after my first research presentations in Buffalo and his support during the 16 years of my chairmanship. I had also the pleasure to be associated in research collaboration with Erwin and to share with him in editorial work of the "Proceedings of the 6th International Convocation on Immunology." Erwin Neter was not shy or slow in expressing his feelings of appreciation and gratitude. I have in my files dozens of his short notes, such as "I enjoyed very much your lecture;' "Many thanks for your friendship," "Thank you for your constructive remarks," etc., etc. At this moment I sincerely regret that I only seldom reciprocated this kindness. BUFFALO PHYSICIAN • 33 �Deaths In remembering this outstanding scientist and physician, I could not think of anyone who fulfilled more sincerely the ancient Oath of Hippocrates. He consecrated his life to the service of humanity. He practiced his profession with conscience and dignity. His colleagues were his brothers. With purity and holiness he passed his life and practiced his art. The death of a man is a tragedy to his family and friends, but they are comforted by remembering his achievements and his continuous presence in the work that he accomplished. For all these years Erwin has been such an integral part of the Buffalo academic community that we cannot accept the fact of his departure. We do feel and will continue to feel his presence in an almost physical way. I will still ask for his advice in many matters even if I will have to guess his answers myself. In the liturgy of the Catholic Church the most touching mass for the departed was the Mass of Angels. In this mass that was not mournful, prayers were said for babies who died without sin. I also want my bidding farewell to Erwin not to be mournful. As innocent infants are believed to join angelic choirs, so I like to think that Erwin has now joined the celestial department of immunology in which he reassumed old discussions with Hans Sachs and Ernest Witebsky and in which he is waiting for me. • DR. MARCOS GALLEGO, 43 • died after a lengthy illness on December 8, 1983. He was a UB associate professor of obstetrics and gynecology. A native of the Philippines, he came to Buffalo in 1968 to complete his residency at UB. He had previously earned his medical degree at the Philippines' St. Thomas Medical College. An active researcher and teacher, he was well-liked and respected by his colleages and patients. Dr. Gallego became well-known for his talents and research in corrective gynecologic surgery for children and adolescents. He had been a consultant at the Buffalo Psychiatric Center and the iagara Falls Memorial Medical Center. Dr. Gallego was also on staff at Erie County Medical Center, Children's, Sisters of Charity, Millard Fillmore, and Buffalo General hospitals. A member of the A.M.A., Erie County, and New York State medical societies, and the Buffalo Gynecologic and Obstetrics Society, and the Association of Professors of Gynecology and Obstetrics, he was also a diplomate of the American College of Obstetrics and Gynecology. He is survived by wife Myrna, also a physician practicing obstetrics and gynecology, two children, four brothers, four sisters, and his parents. • resident at Bellevue in surgery and trauma. Dr. and Mrs. Harer moved to Oyster Bay in 1950. He was an assistant professor of clinical surgery at Bellevue, a post he greatly enjoyed in recent years. He also served as the official doctor for both volunteer fire departments in Oyster Bay, and served for ten years as assau County police surgeon. He had surgeon's privileges at several Long Island hospitals and was honored with two testimonial dinners upon his retirement in 1975; one by both firehouses and a second by all his friends in Oyster Bay. Dr. Harer is survived by his wife, Renie, and two brothers. • DR. THOMAS HUMPHREY (M'43) died on April 27, 1983 in Lake Isabella, California. He was born in Buffalo Jul y 23, 1917. DR. LOUIS A. TRIPPE M'40 • died November 22, 1983 in Sisters Hospital after a long illness. A Buffalo native, he was an associate clinical professor of obstetrics and gynecology at UB. After graduating from Canisius in 1936, he attended UB's Medical School, receiving his M.D. in 1940. He served his internship and residency at Meyer Memorial Hospital until 1942 when he joined the Army Air Forces as a flight surgeon. By the time he returned to the U.S. in 1945, he had served in Italy for three years and earned the Bronze Star, Soldier's Medal and four presidential citations. He began his practice three years after completing his residency at Meyer Hospital. He was an attending physician at Erie County Medical Center and Sisters, Children's, and Millard Fillmore Hospitals. An active golfer, he was elected president of the Brockfield Country Club of Clarence in 1969. Dr. Trippe was also a member of the American Academy of Obstetrics and Gynecology and numerous local, state, and national medical associations. His wife Antoinette, two children, two grandchildren and three sisters survive him. • George A. Harer M '40 • a practicing physician in Oyster Bay, Long Island, for 25 years until his retirement in 1975, died Thursday, September 29, 1983 at the Erie County Medical Center (ECMC) in Buffalo. Dr. Harer, a 1933 graduate of Hobart College, Geneva, .Y., was attending his 50th reunion at the time of his death. Born in Brooklyn, the second of five children, and raised in Patchogue, Long Island, Dr. Harer participated in both football and track during his high school and college days. He was a championship high jumper on both levels, and in more recent years his continued interest in football prompted him to serve as team physician during the varsity games at Oyster Bay High School. After graduating from Hobart in the midst of the Depression, he taught eighth grade in the public schools before completing his pre-medical requirements at Syracuse University. Dr. Harer continued his education at the University of Buffalo Medical School where he graduated in 1940. After working one year of rotating internship and two years in surgery at ECMC, he joined the Navy as a medical officer on a destroyer and served in the Pacific theater. He was awarded eight battle stars and a Bronze Medal with the combat "V" for valour earned in Leyte Gulf. Following the Second World War, Dr. Harer took a fellowship in pathology and anatomy at Strong Memorial Hospital in Rochester, N.Y. He spent two years as assistant resident and one year as chief 34 • BUFFALO PHYSICIAN Dr. Paul J. Jiudel OettJ and friend Dr. Edwin Mirand. Dr. Paul J. Trudel • a research scientist and professor at Roswell Park since 1960, died on September 26, at the age of 92. His close friend and associate, Deputy Institute Director and UB research professor, Dr. Edwin Mirand said, "Dr. Trudel will be sadly missed, as he was a good friend with many talents and accomplishments. He was the last student of the famous German hematologist, Dr. Victor Schilling." Born in Ulm, Germany; Dr. Trudel came to the United States to study at the University of Buffalo, where he earned his bachelor ('26) and master degrees ('28) in biology. He returned to Germany for further studies, and received a doctoral degree from the University of Munich in 1927. In 1928, he joined the faculty at the University of Buffalo as an associate professor of biology. In 1930, and for the following 30 years, Dr. Trudel worked in the clinical laboratory of what is now the J. N. Adam Developmental Center, as director. Following his retirement in 1960, he began his 23-year association with Roswell Park. • �BUFFALO PHYSICIAN • 35 �Calendar ALL-IMPORTANT ANTIBODIES AND their triple roles as protectors and destroyers of the human body and regulators of the immune response will be the topic of the inth International Convocation on Immunology June 25-28, according to Dr. James F. Mohn. Dr. Mohn is director of the State University at Buffalo's Ernest Witebsky Center for Immunology which sponsors the Convocation held alternate years. Each Convocation focuses upon specific areas of immunology and typically attracts scientists and clinicians from around the world as speakers. Dr. Felix Milgrom, chairman of UB's Department of Microbiology who chairs the current Convocation Committee, notes the upcoming program is designed to be of special interest to clinicians ranging from internists in various subspecialties to surgeons. "The growing information we have on the role of antibodies in health and disease is making it even more important that the practicing physician in the community be aware of the current 'state of the art' and the knowledge research is contributing in this area to clinical medicine;' says Dr. Milgrom. While many of the 50 speakers scheduled for the Convocation are from outside the Buffalo area, Dr. Milgrom proudly points out one-third are local immunologists, many of whom are internationally-known for their contributions to the ongoing study of antibodies. "We have known about antibodies for nearly a century;' Dr. Milgrom notes, "and at the beginning of the immunologic era, it was thought they were always the 'good guys' - the body's specific fighters created by the immune system components to combat those substances which are foreign to the human body!' But later, it was discovered that the so-called "good guys" could and indeed did have a darker side to their personality which contributed to the 36 • BUFFALO PHYSICIAN immunopathology of hypersensitivity reactions and also autoimmune disease . And just as the scientific and medical communities had adjusted themselves to believing antibodies could be beneficial or harmful, it was discovered that antibodies had yet a third role - that of regulators of cellular and humoral immune response. "We feel the time is ripe as we approach the 100th anniversary of the discovery of antibodies, that it is only appropriate that the Ninth Convocation be dedicated to this important topic," Dr. Milgrom explains. Important developments in antibody research which will be addressed at the Convocation include genetic coding of antibody formation and the technological advances in monoclonal antibody production which now make it possible to use antibodies in diagnosis and treatment of various diseases. "Our ability to now produce large amounts of monoclonal antibodies in the laboratory has been one of the greatest discoveries in medicine;' Dr. Milgrom emphasizes. Specific antibodies thus produced can not only be used to change regulatory status of the host but also be employed as "magic bullets" against disease by adding to them isotopes or other drugs. In leukemia, where therapy often depends upon knowing the type of lymphocyte involved, monoclonal antibodies can be used as detectives. "Neither will the harmful aspects of the antibody be ignored at the Convocation;' says Dr. Milgrom, "for Buffalo scientists pioneered work in the 1950s in the study of the pathological role of antibodies in diseases such as thyroiditis;' he adds. Among the local speakers will be internationally-known allergists Drs. Elliott Middleton, Elliot F. Ellis and Robert Reisman; Dr. J. Craig Venter, who with his wife, Dr. Claire Fraser, were the first to identify existence of autoan- tibodies to Beta-adrenergic receptors; Dr. Guiseppe Andres, a pioneer in the role of antibody and kidney disease; Dr. Philip T. LoVerde, who with Dr. David Rekosh, is currently attempting to develop a vaccine against certain parasitic infections, and Dr. Pearar L. Ogra, widely known for his work in pediatric virology, notably Respiratory Syncytial Virus. Others from UB set to speak include Dr. Mohn, a well-known immunohematologist and director of the Ernest Witebsky Center for Immunology who will discuss passive vaccination and serotherapy; Dr. Milgrom, a long-time researcher in the field of tissue immunology and transplantation on the subject of antibodies in xeno-and allograft destruction; Dr. Carel J. van Oss, who will discuss physicochemical properties of antibody-antigen interactions; Dr. Marek Zaleski on the role of class I and II MHC molecules in the antibody response to Thy-1 antigens; Dr. C. john Abeyounis, on antibodies to carcinoembryonic antigen; and Dr. john H. Kite Jr., on autoantibodies in spontaneous animal autoimmune diseases. Also: Dr. Ernst H. Beutner, known for his pioneering work in the role of antibody and various skin disorders; Dr. Heinz Kohler on hierarchical organization of idiotypic interactions; Dr. Evan Calkins on antibodies in aging; Dr. Richard Bankert on monoclonal antibodies in treatment of cancer and Dr. Boris Albini on identification of antigen 1n 1mmune complexes. Among out-of-town speakers will be Dr. Frank J. Dixon from Scripp Clinic on immune complex diseases; obel Prize winner Dr. Baruj Benacerraf on genetic control of antibody response; Dr. Bernard Amos of Duke University, a world-leading authority on antibodies in tumor immunology; Dr. P.L. Mollison, London, on removal of transfused blood cells; Dr. Paul I. Terasaki, Los Angeles, one of the world's leading specialists on HLA antigens and their application - medically and legally - in cases to determine parenthood; Dr. Kimishige Ishizaka, Baltimore, discoverer of IgE and its role in hypersensitivity; Dr. Rune Grubb, Lund (Sweden) on antibodies to gamma globulin, and Dr. Macklin McCarthy, Rockefeller Institute, one of the discoverers of the genetic role of DNA who will discuss antibodies in bacterial and fungal infections. Members of the Convocation committee are Drs. Abeyounis, Albini, Andres, Kite, Milgrom, Mohn, and van Oss. Information and registra tion inquiries should be addressed to Dr. Mohn at the Ernest Witebsky Center for Immunology, 210 Sherman Hall, State University of New York at Buffalo, Main Street Campus, Buffalo, N.Y. 14214. • ONCOLOGY SEMINARS • Thursday, April 12, 1984, "Tumors Involving the Skin," Dr. Ole Haltermann; Saturday, May 12, 1984, "Molecular Biology and Its Relevance to the Treatment of Colon Cancer," Dr. Arnold Mittelman. Each of the programs will be held at Roswell Park Memorial Institute, 666 Elm Street, Buffalo, NY 14263. Fee for each: $45 for physicians; $15 for residents and allied health professionals; no fee for students. Pre-registration encouraged. Contact person: Gayle Bersani, R. ., cancer control coordinator, (716) 845-4406. • THE FOURTH NATIONAL CONFERENCE ON RECENT ADVANCES IN PEDIATRIC LUNG DISEASES • March 16-18, 1984. Sarasota Hyatt House, Sarasota, Florida. Chaired by Gerd J.A. Cropp, M.D., Ph.D. Sponsored by the UB Office of Continuing Medical Education (1984 Program Series) and the Department of Pediatrics ofUR..::._ ,he University of South Florida, College of Medicine, Tampa, Florida. Credit Hours: 20. Fee: $275.00 for Physicians in Practice, $15o".OO for Allied Health Professionals. Contact Rayna �Dutton, CME Coordinator, (collect) 716-878-7630/7640, Children's Hospital, 219 Bryant St., Buffalo, NY 14222. MEDICAL ALUMNI REUNION • Saturday, May 5, 1984 v scientific sessions v Stockton Kimball Luncheon v spouses program v bus tour of the campus "" individual class parties Watch your mail for more detailed information from your class chairperson. TWO ADMINISTRATIVE PSYCHIATRY COURSES • to prepare candidates for the American Psychiatric Association examination in administrative psychiatry, will be offered this spring: March 28-31, 1984 in Dayton, Ohio by the Department of Psychiatry, Wright State University School of Medicine, Dr. Paul Rosenhauser, (513) 276-5233; and May 5-6, 1984 at the APA annual meeting in Los Angeles, Dr. Stuart L. Keill, chair of the APA Committee on Administrative Psychiatry, SU Y Buffalo, 3495 Bailey Ave. , Buffalo, Y 14215. • AN INSTITUTE ON HOSPICE CARE • Presented by Hospice Buffalo, Inc. in cooperation with UB and Buffalo General Hospital. April 26-27, 1984, Hyatt Regency Buffalo, NY. Contact Dr. Robert Milch, Erie County Medical Center, (716) 898-3000. This twoday training institute is designed to provide information about assessment, treatment planning, and strategies for the delivery of care for hospice patients and the role of the family in hospice. As an interdisciplinary institute, the program is directed toward physici<~ns, nurses, social workers, occupational therapists, clergy, volunteers, administrators, and management. Upon completion of the institute, participants will improve their appreciation for and understanding of the hospice philosophy; need for home care and inpatient services; need for and contributions of the various services offered by a hospice program; value of transdisciplinary treatment, planning, and delivery; various strategies for the delivery of care. ----- -------------------------------------------------------------I II BUSINESS REPLY MAIL FIRST CLASS PERMIT NO. 2210 BUFFALO, N.Y. POSTAGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, New York 14214 Ill NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAl N STREET BUFFALO, NEW YORK 14214 ---------------------------------------------------------------LET US HEAR FROM YOU Fill out this card (Please print or type all entries) Name ________________________________________________ Year MD Received ___________ Office Address _______________________________________________________________________ HomeAddress _______________________________________________________________________ If not UB, MD received from - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - In Private Practice: Yes 0 No 0 In Academic Medicine: Yes 0 No 0 Specialty -----------------------------------------------Part Time 0 Full Time 0 School Title ___________________________________ Other: Medical Society Memberships: NEWS: Have you changed positions, published , been involved in civic activities, had honors bestowed , etc.? _________ Please send copies of any publications, research or other original work. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, February 1984 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1984-February Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1984-v17n05-Feb Table Of Contents A list of subunits of the resource. You won't recognize it Mitchell I. Rubin Spinal Surgery Pioneer Neck-breaking Surgery A Gallery of Ghosts Research Medical School News Hospitals Students People Classnotes Deaths Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-07-06 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v17n05 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1984 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/c02dbf59fd913fd721bbf9087f8512b2.pdf 10981e410638cdce7a3f11f235f40f06 PDF Text Text �A "California connection" has been established between the Universitv at Buffulo and the School of Medicine during the course o(l983. President Steven B. Sample made an extended visit through the state during the spring and hosted meetings with alumni from all schools of the University. The response to his interest in them was enthusiastic. And he and his staff were encouraged to continue such personal contact and dialogue whenever possible. With the cooperation of Mr. James Snvder and the staff of the University at Buffulo Foundation: I was pleased to host a gathering of medical alumni in early November as part of my trip to the American Heart Association meeting in Anaheim. The reception was held in Los Angeles and the response was very gratifying. Alumni and their spouses travelled rather long distances to meet with my wife and me, Mr. Snyder and one of our very distinguished alumni and supporters, Dr. Albert Rekate. The event was indeed fulfilling and just as a similar function in Washington a few years ago indicated, our alumni want to continue to be a part of the scene in Buffalo no matter how fur removed thev are. A second ele~ent of the "Califi:>mia connection" resulted from President Sample's earlier \·isit. Frederick and Sorrel Booke, sons of a medical school alumnus and former practicing physician in Buffulo, renewed their acquaintance in Buffulo. Sorrel is better recognized as Boss Hogg of the Dukes of Hazzard television series. Since that time, the Bookc brothers have visited Buffalo, at which time a reception was held in their honor with members of their immediate and extended fumilies. As you will sec in future pages ofThe Buffulo Physician, they have established a scholarship fund in memory of their beloved fumilv. During the coming months' and years, the fuculty, my staff-and I will do all that we can to develop other "California connections" with our Ioval and dedicated alumni through the State of ew York and the country. Should alumni be interested in alerting us to possibilities which would serve to fucilitate such activities, please feel free to contact Mr. James Snyder of the UB Foundation or me directly. - j ohn Nattghum, M. D. �Contents Mitchell I. Rubin • Dr. Rubin recalls the development of UB's 2 Department of Pediatrics in the first part of a two-part series. BUFFALO PHYSICIAN STAFF Executive Editor, University Publications Robert T. Marlett Art Director Rebecca Bernstein Medical School Editor Bruce S. Kershner Photography Jim Sulley David S. Ottavio Ed Nowak ADVISORY BOARD Dr. John Naughton, Dean School of Medicine Dr. Harold Brody Dr. James Kanski Dr. James P. Nolan Dr. Charles Paganelli Dr. Peter Regan Mr. James N. Snyder Dr. Eugene Michael Sullivan Jr. Dr. Mary Voorhess Dr. Martin Wingate Dr. John Wright Dr. Maggie Wright Ms. Rita Wolff father figure, role model • Former associates pay tribute 7 toMentor, Dr. Rubin at special " Recognition Day." Low Infant Birth Weight • Although infant mortality has decling ed, this closely associated problem remains a serious threat to newborns. UB Research Increasing • In spite of a two-year decline since g the peak reached in 1980, official projections see a dramatic increase in new grant monies in 1984. 11 Quadriplegic Index • Test measures almost imperceptible changes signalling improvement in quadriplegic patients. 13 Spinal Cord Injuries • State-of-the-art techniques offer hope for treatment and management of these injuries. 14 Research • Photoradiation therapy proves to be a workable idea. A vaccine for schistosomiasis may be developed . Hard-driving workaholics appear to have lower risk for high blood pressure unless the problem runs in their families . 17 Hospitals • Carl Granger, new head of rehabilitation medicine at Buffalo General, arrives at a time of change . Sr. Mary Charles leaves Sisters. Military helicopters speed trauma injury victims to ECMC. ECMC installs fourth generation CT scanner. 20 Medical School News • 200 relatives attend Family Weekend .) HIDI ready to begin operations. House staff association serves residents . 22 Students • Jim Bentley's quadracycle turns heads. Class of 1987 arrives. Awards and honors. TEACHING HOSPITALS The Buffalo General Children's Deaconess Erie County Medical Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Charity Veterans Administration Medical Center Produced by the Division of Public Affairs, Harry R. Jackson, director, in association with the School of Medicine, State University of New )t)rk at Buffalo 25 Book Review • " The Youngest Science " by Lewis Thomas . People • John H. Talbott , a traveling , skiing editor. Other news 28 about people you know. 32 Alumni • Spring Clinical Day set for May 5, 1984. Classnotes • Kevin N. O'Gorman blends clinic and farm . News 33 of the classes . 34 Deaths • 36 Calendar • Cover Art: Kathy Mollk THE BUFFALO PHYSICIAN , (USPS 551 -860) December 1983 - Volume 17, Number 4 publ ished five times annually: February, May, July, September, December- by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. POSTMASTER: Send address changes to THE BUFFALO PHYSICIAN, 139 Cary Hall, 3435 Main Street, Buffalo, New York 14214. ��By Ronald Elmer Batt, M.D. Class of '58 EDITOR)S NaFE: This is Part I of a two-part article. The concluding portion will appear in the next issue ofthe Physician. T he Medical Department of the University of Buffalo was organized on August 25, 1846, under the leadership of eractitioner-professors- a tradition which persisted in Buffalo until World War II. Late in the 19th century, Johns Hopkins Medical School was founded on the German model with academic-professors at the head of the clinical and basic science departments. Johns Hopkins University set a new standard and established a tradition of medical education to be emulated by the other medical schools in this countrv. Within the Department of Pediatrics at Buffalo, t11e pra~titioner-professor traditi<;m evolved slowly, methodically and deltberately mto the full-time academic professor tradttion. DeWitt Sherman was professor of pediatrics at the University and ch~e~ of pediatrics_ at Buffalo Chilcfren's Hospital. Sherman chose Wtlltam Orr as_ hts su~cess~x an~ suggested ~e take a fellowship at Johns Hopkms Umversttv. Wtth the backmg of DeWitt Sherman, Orr welcome_d a1_1ybocfy who would contnbute to elevating the cahber of pedtatncs at the Buffalo Children's Hospital. D:. Orr brought _Wtlmot Jacobsen from Johns Hopkins to orgamze the outpatient department. Dr. Orr organized four pedatric divisions, each of which rotated on-service three months each year: (1) Orr and Cramer, (2) Jacobsen and Downey, (3) Bender and Stettenbenz, and (4) Israel and Fisher. He worked closely with Douglas Arnold who introduced weekly grand rounds to the hospital. He sent David Weintraub to johns Hopkins and welcomed Edward Bridges from Hopkins to develop the biochemistry laboratory. To round out the picture, Wilber Fisher had trained at Hopkins and Francis Goldsborough had trained under]. Whitridge Williams at Johns Hopkins. Complementing this strong Johns Hopkins tradition was the direct German full-time tradition: Dr. Kornel Terplan from Prague in pathology and Dr. Erwin eter from Heidelberg in bacteriology. By the end ofWorld War II there was assembled the critical mass of talent needed to introduce the academic-professor tradition into the Department of Pediatrics. Dr. Mitchell Rubin was called to Buffalo as the first full-time professor and chairman of the Department of Pediatrics at the University of Buffalo and pediatncian-in-chief of Buffalo Children's Hospital. Dr. Rubin develc:_:>ped and led the Department of Pediatrics to national prommence. This oral history memoir was developed with Dr. Rubin in February 1977 as part of a long term study of the history of medicine in Western ew York. The interviews were conducted by telephone between Buffalo and Charleston, S.C., and recorded with the permission of Dr. Rubin. PHOTO: JIM SULLEY �>w -' -' ::::> en :::; --, ~ 0 I c.. BUILDING A DEPARTMENT. Question : Dr. Rubin, when '\'Ott a~·riJ>ed in 1945, was Pediatrics prima~i~v a clinical department? Dr. Rubin : Yes. The full time people were in Pathology, Biochemistry, Bacteriology, and Radiology. Dr. Tcrplan was not full time at Children's Hospital for he was also Chairman of the Department of Pathology at the medical school and pathologist at Buffalo General Hospital. Question : Dr. IUtbin, when you de~•eloped the department at Buffalo Cbildren's Hospital, dtd you have in mi~td a model ftvm an_v place thnt you had trained? ''When I first got there, the lflajor effort was to develop a departlflent that had research going on and to attract young academicians to the program.'' 4 • BUFFALO PHYSICIAN Dr. Rubin: Yes. I guess the model was Johns Hopkins where I spent more than three vcars. It was then called the Harriet Lane Home, which was the Department of Pediatrics of the Johns Hopkins Medical School. I would guess our department was fushioned more after that image. I spent much time in the Out-Patient Department there; I was assistant head of it for one year, then ran it for one year and became quite responsible for a good part of the teaching. I think that was the image I had. And by the way, it is an image that I still carry with me. It is a good one. &search was always an important consideration, but so was academic excellence. When you studied a patient, you were supposed to know as much about him as one could know, whether it took going to the library or going to the laboratory or calling for information from anv source. Dr. Park, our chief, had a wav o(calling around the country or around th~ world to anybody who might have had some special knowledge in this particular field. It was always a very broad look at patients. Question: During your aetiJ>e years in Btt/fo.lo, ifyou take resemr:h, teaching and adminislreltion which were pmbab~v )'Ottr tln-ee major commitments, mnv I ask how wu divided wmr time among them?. . • Dr. Rubin: When I first got there, of course, the major effort was to try to develop a department that had more research going on and to .1ttract young academicians to the program. I think for the first few years more emphasis was spent on developing an academic orientation, increasing the amount of biochemical studies done on patients, relating the clinical work to x-ray, to pathology, .md to b.Kteriology. In the overall, I think the first part was mostly administrative re-organization of the department. You don't do these things alone. Dr. Douglas Arnold, who was then head of the Department of Pediatrics at the Children's Hospital, ;md William Orr who was professor of pediatrics in the Department at the Medical School, both gave up their positions when I came and the two positions were combined into one position for me. Dr. A. Wilmot Jacobsen resigned his position as head of the· Out-Patient Department. I would say the trio of them were tremen- dously supportive of what we were trying to do - trying to develop a more academic orientation in the Department of Pediatrics. These men were most helpful, and I think it was unusual. They were still in their prime of life, and yet willing to give up the status that thev had and turn it over to me. We could n~t have developed the Department of Pediatrics without their support and their willingness to give up their positions. We kept a pretty good balance among the group of us. At the same time, we had responsibility to teach. We developed all kinds of programs in the Out-Patient Department and we brought in specialists in various fields of pediatrics, such as endocrinology, biochemistry and hematology, and specialty laboratories were developed to support such programs. Of course., we subsequently attracted other specialists for the various specialties in pediatrics. If we were going to teach contemporary medicine we had to have people who were working especially in these areas. And a lot of time was spent in development of these programs. We developed an active research division almost simultaneously. It was quite obvious that this had to go along with the clinical eftort if we ·were going to have an academic department. You had to have a strong research endeavor going on in the department. We fortunately attracted people who were qualified to do first rate research, biochemical, immunologic, bacteriorlogic, hematological and other research. Finally all specialty fields in pediatrics were covered. Cardiology was a most active division under Dr. Lambert. We obtained a very large grant to start the genetics progam. Over the years, most aspects of pediatrics were developed as clinical programs, combined with research endeavor. Child psychiatry became an important program . We had a rather interesting opportunity at the Bulfulo Children's Hospital. New York State set up a program where patients could be referred to a "Center" by a private physician for consultation and thev enumerated the diseases they were willing to support: chronic kidnev disease, cvstic fibrosis of the pancreas, jm·ei1ile diabetes mellitus, chronic blood dvscrasias and "intractable" asthma2 . They w~uld pay for the hospital visit and laboratory work. A progr.1m was set up where the physician who referred the patient would come in with the patient, help study that patient .md receive some proportion of the fee. When the patient went back to the doctor's pri\'ate ofticc, after being studied and rdetTed back to him , he would be repaid by the state for the visits. \Ve worked in a very close relationship with the practitioners in the communitv. I think at the ve~·. earlv.. staaes b , the pediatricians in the communitv were made welcome. Several had been on the hospital staffbefore I arrived. Those who wanted to work and were qualified to work came in to work and teach with us. Finallv, over the years when any of the full-time fuculty were �on ward service, there was always somebodv in pri,·ate practice on with th~m. When ·I went on service at two month intervals, someone was on with me. This was true with every person in the department. Thus the men in practice were given an integral part of the teaching. Many of them became involved in research and they attended the clinics in the Out-Patient Department, developing specialty skills. They had conferences there long before I arrived on the scene. We finally got the conferences set up twice a week and it was amazing how many of the pediatricians came, even though it was in the middle of the morning and certainly must have interfered with their practice to some extent. I think we had a very good relationship with the pediatricians in the community. When I first got to Buffalo, there must have been eight or nine or maybe ten pediatricians in the community. Though the Meyer (now Erie County Medical Center) trained some, I would think until 1972 or so, the vast majority who were practicing were trained at the Children's Hospital. I think certainly, nw interest was to be sure we n~t only ·did 'good pediatrics in the hospital but we were able to improve the pediatric care of the community. That was part of our philosophy. Question: During your temm:, what was the association - fimnal or info1·111al - between the M0•er mzd Children's Hospitals? Dr. Rubin: Actually the Medical School was not at that time en.tirely responsible for the services at the Meyer. The Pediatric Department was primarily at the Children's. But we did send some students to the Meyer. And finally I used to come over and m~ke rounds at· 'rhe Meyer, as well as at the Children's, as chairman of the Pediatric Department. The Department of Pediatrics at the Mever then became much more intimatelv r~latcd to the total pediatric program of the Department of Pediatrics, although I think they taught students there long before I got there. But it was almost separated from the Children's Hospital, as if they were entirely different divisions of the school. Later, it was combined into a single division of the school, although Gustina was still head at the Meyer, then finally, Tom Bumbalo. Question: Did )'Ott ha!'e am association with the Well-Baby ciinics around the city? Dr. Rubin: Yes. Dr. Douglas Arnold was a strong supporter of the program. He was a consultant to the Department of Health for their well-baby clinics. He knew that I wanted to do some reaching there, so when he retired after I was in Buffulo for four or five years, he had me appointed consultant. We set up one-way vision screens for teaching new-born care. Finally, we had a one-way screen at the Hospital itself where I did interviews with the mothers and had a resident do the examination of the babies. On the other side of the screen we had medical students, residents, and public health nurses. They could sec and hear what was going on. And after we finished the care of the baby, regular well-baby care, we had coffee and cookies and sat around and discussed what we had observed - what we thought went wrong, and what we thought was needed to be done to help the fumily of this child. We spent a lot of time actually. We met once a week in this well-babv ~linic program. We finally had a psychologi;t and a psychiatrist sitting in on the interviews. Question: Was pediatric surgn;•a subspecialty ofgeneral surgery befon: ;'fott came? Dr. Rubin : There were no so-called "pediatric surgeons." There were several good general surgeons, mostly !Tom the Buffalo General Hospital, none who specialized exclusively in pediatrics. Dr. Ted Jewett was the first person at the Children's Hospital actually trained in pediatric surgery. For heart surgery the children were sent out of town. Question: Pediatric cardiac sttrgCI)', how was that initiated at Children's Hospital? Dr. Rubin: Ed Lambert was our pediatric cardiologist. Ed Lambert was first trained with us as a pediatric resident and I recommended that he go to Johns Hopkins to be trained by Helen Taussig, who helped Blalock design a major surgical operation for correction of a heart defect. Dr. Taussig was a house officer at Hopkins when I was there. We were good friends and have remained so ever since. Ed Lambert then came to But: fulo to head the Cardiac Department and strongly believed that if we were going to do major pediatric cardiac surgery, we ought to bring a pediatric cardiac surgeon to the hospital. I think success in this matter is due to Ed Lambert. He fought to bring Subramanian on. That division of the hospital has just blossomed. They have patients sent to them !Tom Hopkins and other major centers. As the surgical program expanded, Dr. Jewett brought Dr. Allen on as an associate, also a pediatric cardiac surgeon. The private surgeons do neurosurgery, ophthalmology, otolaryngology, orthopaedics, urology and general surgery, but I would sav that the major cardiac and the major complicated surgery such as esophageal fistulas and things ofthat sort arc done primarily by Jewett, Allen and Subramanian. I may have unintentionally omitted some surgic~ specialties, but almo;t all, if not all, branches of surgery arc represented, and competently. Question: Mav I ask wu about the Collabomtive Perinatal Stttd._v·of the National Institute ofNeurological Diseases and Stroke which was conducted between 1959 and 1965? Dr. Rubin: We developed a large program set up by the federal government where 13 universities received a grant to study the obstetrical fuctors related to child development. By the rime I left Buffulo, the program had been going on for six or seven years. Actually these children were studied from conception because certain obstetricians were involved in the study with us. They were studying the prenatal ~spccts and delivcn•. These children were followed ven• carefully by pediatric psychological an~i neurological examination. We had an intimate relationship with obstetrics with this srudy.3 Othenvise it was our responsibility to care for the children. We dc,·eloped a good sized premature unit under Dr. Weintraub. I think that was an important development, enabling us to do a much better job caring for the immature infunt. Question: Ofthe papn·s or books wu wrote, do haPe a fin•mite? )'Ott Dr. Rubin: I published a book in 1975, Pediatric Nephrowg:f. That book is just being translated into Spanish . I would guess that was my major effort. The best work I did was probably with Erika Bruck :md Philip Calcagno. With Erica Bruck we did studies on kidney functional disorders in various renal dise~ses. We also did a studv on the development of kidney fi.mction i;1 the young inf.1nt, which data was used by Homer Smith in his publications. I must sav, I could not sav thev were all mv ideas because they we~e just as much the ;deas of Erika Bruck and Philip Calcagno as mine. Calcagno and I later published several papers on the physiologic capacity of the kidney in early infancy and the premature bab~·, and the eftcct of various stress situations in babies as the kidney responded to stress of water depletion and various diets. Dr. Erwin Neter and I were also involved in investigative studies which were published. What research I did was alwavs with somebodv else. I needed somebody. who could spe1;d more time in the laboraton• than I could. I had the good fortune ofha,·ing good people around who were willing to work with me. Finally, one of the journals published a Festschrift for me when I retired !Tom the chairmanship of the department at BuffuJoS. A lot of nw old associates came back for a meeting ar' the Children's Hospital at this time. Their presentations formed the basis for the Festschrift. After being chairman, I stayed on for fi,·e years longer as fi.1U professor and then I was made professor emeritus when I fullv retired from SUNY and left Buffulo. · EDUCATION OF A CHAIRMAN. Question: Dr. Rubin, when: did you go to school? How did )'Oit get interested in medicine? Tell me about your career fivm the first you became interested in medicine right through coming to Bu.ffiw? Dr. Rubin: I got interested in medicine through the doctor who delivered me as a baby. He was, subsequently, chairman of the Department of Surgery in our medical school here in Charleston . I worked from high school on until I got to medical school. I did some work outside BUFFALO PHYSICIAN �''Dr Edward Park taught 111e the broad view of what health was about, how one looked at a health proble111, and how · one looked at a child. 11 6 • BUFFALO PHYSICIAN of medical school to help make enough funds to continue my education. I went to the College of Charl~ston, which has now become a much larger school than when I went there. It is now over 200 years old, one ofthe 13 early colleges in this ~ountry. The basic science program then was very elementary but it was a great school for English, literature, languages and history. From the college, I went to medical school where I had a Governor's Scholarship. In my senior year at medical school I had an internship at the Catholic hospital in town, the St. Francis Hospital. They were allowed to have senior students as interns. I graduated in 1925 from medical school and interned in the large community hospital used by the medical school, the Roper Hospital. From there I went to spend a year of internship in the Philadelphia Children's Hospital. Then I spent a few months in New York at the Willard ·Parker Hospital which was a contagious disease hospital. They had no contagious diseases at the Philadelphia Children's Hospital. I spent the next year working with Dr. Brennemann at the Children's Memorial Hospital in Chicago. In those days, one moved around from hospital to hospital, depending on what the emphasis of the different hospitals was in pediatrics. And, afi:er that, I spent a period of residency with Dr. Marriott at the St. Louis Chil~iren 's Hospital. Dr. Marriott's program had emphasis on the biochemical aspects of pediatric disorders. Dr. Hartmann was there. From there I went as resident at the J()hns Hopkins Hospital Department of Pediatrics uncter Dr. Edwards Park for about six months. 1 was made an instructor in pediatrics, first as assistant-in-charge of the Out-Patient Department, then the following ye.1r, in charge of the Out-Patient Department. I was asked to stay on, but l was offered a faculty position at the niversity of Pennsylvania in the Department of Pediatrics, so l went to Philadelphia. There I did a small amount of private practice. Howe,·er, most of my time was spent at the Children's Hospital, fiiully as an .1ssoci.1te professor. In 1945, l moved on to Buffalo as chairman of the Department of Pediatrics at the Universitv ofBuff.1lo, later the State University ofNe~,. \lxk at Buffalo, and pedianici.min-chief at the Buffalo Children's Hospital. l remained there until 1972. At retirement l came to Charleston, S.C., back to mv old medical school as consultant in pediatrics, primarily in nephrology, where l still am. In the early days of my tr.1ining, l spent a couple of months at Harv.1rd one summer working in the biochemistry laboratory of Dr. Foline, one of the great physiological chemists of the dav. Subsequently, I spent a summer at Vanderbilt University working in tissue culture studies. \\'hile at Hopkins, I spent some time working in the division of anatomy studying tissue culture. I would guess that most of my research afi:er getting back to Philadelphia and then moving on to Buffalo has been in the field of renal diseases in children. I published works with a very able young man in Philadelphia, Milton Rapaport, and then with Erika Bruck who is still at the Children's Hospital in Buffalo, then finally with Dr. Philip Calcagno. Question: Mav I take wu back to vour training yean? Could you si1/g!e out people who bad a ntal influence on your thinking - the Jllay you approached teaching, research or administration? Dr. Rubin : I can tell you a little bit about that. I would guess tl~ere were at least two persons whom I thought were the greatest clinical teachers I worked with. One was Dr. Edwards Park, who was chairman of the Department at Hopkins, a very distinguished person, a great teacher, a man of great humility who was also a distinguished in\'estigator. I guess what I got from him was the importance of thoroughness. And also, the importance of, as he would say, "looking things up" - reading, going to the laboratory to work something out, going to the library for studY. He would send you around the big morass of the Hopkins Medical School to this f.Ktilty member or that fucultv member to talk wi.th him about some clini~al or research problem that you may have had. I think he was the man that l Wt)uld sav turned me on for what little that l .1m. He turned one on in the broad look of what health was about - how one looked at a health problem, how one looked at a child. The second person that I think was a great intluence in my clinical development was Dr. Joseph Brennemann who edited a multiauthored text entitled B1·emuman's Pediatricfo. In his dav, this was sort of the bible of pediatrics, i~ addition to Holt and Howland7. Brennemann was a distinguished clinician chief at the Children's Memorial Hospital in Chicago. He had been an English teacher and if you split an inflniti,·e, that was .1lmost as bad as making .1 misdiagnosis. Every little nuance of the patient he saw and understood .1nd would comment about. Thev were nw two great clinical teachers. · . l guess my research interests prob.1blv started with Dr. Hartmann, the man who de,·eloped Hartmann's solution at the Children's Hospital in St. Louis .1t Washington University. In Get, I went back to gi,·e the first Hartmann Lecture several years later which made me ted ,·cry proud. Later, I began doing laboratory work .1t Hopkins under the direction of Dr. Emmett Holt. He was the head of research in the Department of Pediatrics at Hopkins. I think he played a good part in encouraging m\' research dlorts. l .1lso worked with Dr. V\rlrren Lewis, a distinguished anatomist in\'Olved in tissue culture studies. I spent almost a vea1~ half-time, in his laboratorv. I was in charge of the Out-Patient Dep-artment in the afternoons and, in the mornings l worked with Dr. Lewis. I think Drs. Park and Brennemann were �important as clinical teachers while Hartmann, Warren Lewis and Emmett Holt were important as investigative teachers for me. BIBLIOGRAPHY AND NOTES 1. Personal interviews bv the author: Norman Bender 10-8-76. Edward Bridge 4-18-77. Thomas Bumbalo 3-3-74. Wilber Fisher 5-23-77. Francis Gustina 10-5-74. A. Wilmot Jacobsen 10-26-75. Erwin eter 10-25-75. Mitchell Rubin 2-15-77. Korncl Terplan 2-3-74. David Weintraub 6-14-78. Frederick Wilkes 5-23-77. 2. Letter from Erika Bruck dated 16 November 1978. "Expanded State Aid for handicapped children has been in force since 1964 or '65. The following diseases arc covered: chronic kidncv disease, cystic fibrosis of the pancreas, juvenile diabetes mellitus, chronic blood dvscrasias and 'intractable' asthma. For e~ch of the first four conditions there has been a center at the Children's Hospital since 1965, under a designated specialist active as Center Director, with a specialty out-patient clinic as well as in-patient services. For intractable asthma, we did not have a center as long as we did not have a fi.JIJ-timc allergist- The Children's Hospital also has been a regional referral center for premature infunts since 1948, under a similar State Aid program- Mitchell Rubin, Charles Lowe and I testified to members of the N.Y. State Assemblv in 1964 in preparation for establishmen-t of this program." Mentor, father figure, role model Dr. Rubin hailed as each of these and more ''M By Bruce S. Kershner ent01; futher figure, inspiring teacher and outstanding physician whose creed was that 'all children are created equal.' " These were some of the words used to describe Dr. Mitchell I. Rubin, the man who propelled the University's Pediatrics Department and the Children's Hospital to national prominence after 1945. A day of honoring ceremonies and scientific sessions marked Friday, October 7, as "Dr. Mitchell I. Rubin Recognition Day," held at Children's Hospital and the Marriott Hotel. Dr. Rubin came to the University in 1945 as the first full-time professor and chairman of the Department of Pediatrics. He arrived at a time when the medical school was gradually shifting from the old practitioner-professor tradition, which emphasized hospital patient diagnosis and treatment, to the modern academic professor tradition, which emphasizes medical research and teaching as well. Dr. Rubin modeled the Pediatrics Department after the academicoriented program ofJohns Hopkins, where he had previously spent more than three vears. It was his academic and research-oriented approach that led him to upgrade the Medical School's Pediatrics Department. Dr. Rubin, in his gentle but persuasive way, managed to attract a host of fine physicians to the University, covering every specialty of pediatrics. He developed numerous programs and special laboratories. The rehabilitation clinic he established was the first in Buffillo and the second in the nation. At the same time, he helped develop an active program of research, which established a prolific record of publications. -' ~ c:: en 0 :r en zw ·3. Collaborative Perinatal Study ofthe National Institute of Neurological Diseases and Stroke 1959-1965. Pediatricians in charge: Donal Dunphy, Milton Westphal and Harry Beirne. Participating obstetricians: Richard Baetz, Donald Hall, Harry LaForge, Craig Benjamin, Mel James, Maurice Dewev, Theodore Schulman, Robert Patters~n, Louis Privitera, and Kenneth Niswander. The data was published in: iswander, K. and Gordon, M.: Women and Their Preg11a11cies. (Saunders) 1972. a: 0 -' I: (.) 0 f- 0 :r a. 4. Mitchell I. Rubin. ed. Pediatric Neplnv/qr)• (Baltimore: Williams & Wilkins) 1975. 5. Sherman Little, "Mitchell Irving Rubin, An Appreciation," Am&~: J. Dis. Childrm 115: 117-121,1968. "The program of teaching in the medical school was the result of his ability to organize and integrate into an eflC::cti\·e unit the activities of the \'Oiuntarv and the full-time staffs. Repeatedly thi~ program was voted by students to be the best in the medical school." 6. Joseph Brennemann, ed. Pmcticc of Pedianus (Hagerstown: WF Prior) 1937. 7. Luther Emmet Holt, ed. Diseases of Injimcy a11d Childhood ( ew York: Appleton 9th ed .) 1926. But it was not his accomplishments in research or administration that endeared him most to people. His former students and associates, many now in prominent positions throughout the world, remember him as being dedicated, pressing them to the limits of their ability - and very caring. This is evident from the fuct that they came from 15 cities to honor him this full, including Minneapolis, St. Louis, ashville, Tuscaloosa, Alabama, Washington, D.C., and cities in North and South Carolina. His attentive and reassuring bedside manner was no less memorable to the children he treated . As a pediatrician, he practiced the "whole approach" to the child. He investigated not just the child's physical problems but also the child's emotional state and Dr. Rubin (left} and the late Dr. Erwin Neter at Mitchell I. Rubin Recognition Dav. BUFFALO PHYSICIAN • 1 �(LettJ Dr. PhiliP calcagno catted Dr. Rubin the "Father ot modern nephrology. " (RightJ Dr. Charles R. warner (at rtghtJ, namesake ot Children's Hospital's rehab center, at Rubin event. relationship to parents. He was known to call around the world to Hospital; and Dr. Margaret MacGillvray, professor of pediatrics. anybody who had some special knowlcd!?c in a particular field. Earher 111 the day, a scientific session was held in Children's "We had a patient with mcmngltls, a disease With extremely unHospital. The six distinguished speakers were all former residents complicated symptoms," Dr. Thomas Aceto, Jr., now at Sc Lollis or associates of Dr. Rubin. Dr. Thomas Aceto spoke on "Doctor University, relates. "Well Into the second week of Illness, this child Shopping with a Child as Proxy Patient," which described how the continued to have fever and act very irritable. The attending docreasons for unsuccessfi.II treatment of child patients with complicated tors couldn't find the cause. We then asked Dr. Rubin to sec the symptoms and multiple ailments can sometimes be traced to emopatient in consultation. For some minutes, Mitchell stood quietly tionally and psychologically disturbed parents. The behavior and at the bedside and watched the child. He then asked 'Why docs hypochondria of such parents may not only induce psychosomatic he hesitate to move the right leg? Isn't that knee a bit swollen?' These diseases in the child but may actually hamper proper treatment were hitherto unobserved symptoms. The next day, the ward team through irrational distrust of doctors. Dr. Aceto was a UB faculty presented the finctii~gs to Dr. Erika ~ruck, who gently chided, 'Please, member in the 1970s. · do not present patients m my serviCe to Dr. Rubm before you pre"Curing Children with Leukemia" was the topic of Dr. Donald sent them to me. He always finds somethmg other pectiatnClans have Pinkcl (MD'S!), former UB faculty member now with Temple missed.' It turns out that this patient had a second disease University. He reviewed the history of breakthroughs in treating acute neuroblastoma.'' lymphocytic leukemia to the present day, where up to 50 per cent Fifty-eight years after graduating from the Medical School of the of leukemia patients can now be cured with different systems of University of Charleston, South Carolma, Dr. Rubm serves as conchemotherapy. · sulting p~diatrician at his alma mater. Fittingly, he became interested In a presentation entitled, "Appearances and Realities," National in medicine and pediatrics through the very doctor who dchvcred Institutes of Health physician Dr. Charles Lowe reminded the auhim as a baby. While at Johns Hopkins University, he met the man dience of75 that our success in drastically reducing infant mortality who served ;s his role model, Dr. Edwards Park. It was partly durrates should not let us forget another issue: low birth weight, which ing this time that he learned of the importance of the mentor conis responsible for post-neonatal deaths, disease and developmental cept, which worked so well with his students dunng illS 27 years delays in later life. Low birth weight has actually risen slightly since in Buffulo. 1950. Dr. Lowe was a UB professor from 1950 to 1964. Other speakers at the scientific session included Dr. Joseph Bellr. John Naughton, dean of the Medical School, spoke of him anti (MD'SS) and Dr. Philip Calcagno, both of Georgetown Univerin the evening ceremonies. The dean stated that Dr. Rubin helped Sity, and Dr. Jean Cortner of Children's Hospital of Philadelphia, fulfill "the need for humanism to balance out the technology" of formerly UB professor and chairman of Pediatrics. modern mecticine, and that he "exemplified excellence in aU its ways." Among the honors to Dr. Rubin, the 8th floor of Children's Dr. Philip Calcagno, former UB associate professor and now a Hospital will be named after him and a lectureship in his name will distinguished physician at Georgetown Um,·ersity, .called Dr. Rubm be established. the "Father of Modern Nephrology" because of his research acDr. Bernard Eisenberg told Dr. Rubin to "look around you and complishments and book Pediatric Nephrowgy. Nephrology is the sec your living legacy in the faces of your students, your pr~grams, study of the kidney and Its diseases. . . . . your department and your hospital." Dr. Rubin worked for many years trymg to establish a uni\'ersity Many of Dr. Rubin's former students arc now, like he was, direchospital on campus and to incorporate the then University of Buftors or chairmen of pediatrics departments around the world, infalo into the SU Y system. His first goal was not successful but, cludmg universities in New Zealand, Israel and Turkey, as well as as the president of the 'Buffulo Pediatric Society, Dr. John R. Warner, Georgetown University, Temple University, the Universities of noted, Dr. Rubin was one of those "mstmmcntai 111 ~hangmg UB Wisconsm, Pcnnsylvama and Michigan, the National Institutes of to SU y by changing it from a small local msmunon to a Health, New England Medical Center and many others. cosmopolitai~ and respectable university and medical school." " Now, ar,~I, Dr. Rubin continues to leave a 'legacy during his Also speaking before the enthusiastic audience of 165 were the retirement 111 Charleston, South Carolina. He is responsible for master of ceremonies Dr. Bernard Eiscnb.crg, chmcal assoCiate procstabhshmg the new Children's Rehabilitation Center in South fessor; Dr. Elliot Ellis, professor and chairman of the r;>cpartment Carolina. And he is the founder of the movement to establish South of Pediatrics; Dr. John R. Jcffnes, president of Children s Hospita!; Carolina's first Children's Hospital, a project that will be completed Dr. David Klein, past president of the mediCal staff at Children s • shortly. D 8 • BUFFALO PHYSICIAN �Low infant birth weight Still a serious threat to newborns T By Bruce S. Kershner he dramatic decline in infant mortalitv has caused the nation's social leaders and medical commumty to overlook the serious and closely associated problem of low infant birth weight. So says Dr. Charles Lowe, distinguished physician at the National Institutes of Health, in a lecture entitled "Appearances and Realities" on October 7 at Children's Hospital. The talk was part of events planned for "Dr. Mitchell I. Rubin Recognition Day" to honor the retired former UB chairman of pediatrics who propelled the Pediatrics Department and Children's Hospital to national prominence after 1945. Dr. Lowe was a professor at UB from 1950 to 1964. Low birth weight not only causes 66 per cent of all infant mortality, but is a serious problem for those inclividuals who survive early infancy. Low birth weight infants who initially sun•i,·e have much higher rates of post-neonatal death, illness and developmental delay in later life. The high infant mortality rate of past decades has been reduced so dramaticallv because of meclical advances in the area of infant care, particularly rc'garding premature infants. However, Dr. Lowe points out, we have been treating the symptom of the problem, infant mortality, and not the cause of the problem, low birth weight. The frequency of low birth weight has not changed in recent decades. In 1950, the frequency oflow birth weight infants was 7.8 per cent, while the 1982 frequency remains virtually the same at 7.9 per cent. The figu~e for the black population is twice as high. Dr. Lowe's aim in his research on the subject was to determine the reason for the continuing high rate oflow birth weight, especially among disadvantaged populations. Extensive data from his study of Washington, D.C. mothers, as well as data from other stuclies, showed surprising results, he said. Such factors as teenage pregnancy, quality of hospital care, the presence of prenatal care outreach programs, marital status, age and education make no difference in the frequency of low birth weight and infant mortality. On the other hand, drug use, alcohol abuse, smoking, diabetes, high blood pressure and other serious medical problems clearly do increase low birth weight, but comprise too small a percentage of the total to explain the current rates. D ata for prenatal care was then evaluated . It is commonly believed that frequent and early initiation of prenatal care will decrease low birth weight and infant mortality. However, a study of 160,000 births in Massachusetts concluded that prenatal care made only a negligible difference; it increased length of pregnancy by only 5 Y, days and birth weight by only 60 grams (1.9 oz .) . Dr. Lowe concludes that prenatal care still makes a real difference in infant health, but that stuclies such as that conducted in Massachusetts have built-in limitations. These limitations prevennhe true effect of prenatal care from becoming apparent or clearly measurable. This is because women who deliver prematurely must, by definition, have fewer prenatal visits to the doctor because of shortened pregnancies. Furthermore, prenatal doctor visits increase in the last month of gestation, something precluded by premature birth. Another reason is that pregnant women who have low prenatal care have higher rates of naturally aborted fetuses. Further complicating the matter is that there is no agreement a~ to what constitutes optimal prenatal care. Any method that will actually improve prenatal c.are, Dr. Lowe emphasizes, should be pursued. But, he adds, the meclical commumty has done just about all it can to deal with the problem. Improving the economic status of minorities and the clisadvantaged will help only to an extent, he feels, because the problem is also a psychosoCial one. He strongly believes that " what is happening among disadvan- Dr. Charles Lowe raged women," with high frequencies of low birth weight "is a lifetime problem and a hfe-style problem that reflects inadequacies in health care, JOb opportunities, nutrition, prenatal care, housing and personal views of the future. This is a social and economic problem, not a medical problem, and 1f we are to deal with it, we must begin early 111 th~ life of women who bear children. We can only accomplish this 1f we 1111t1ate comprehensive social change relating to the poor and disadvantaged." • UB research increasing Dramatic rise predicted for 1984 I By Linda Grace-Kobas n spite of a two-year decline in sponsored research expenclitures since they hit a peak in 1980, official projections foresee a dramatic increase in new grant monies coming to UB in 1984. This increase - expected to be about 27 percent above current figures - will result from the substantially enlarged number of grant proposals sent out by faculty members during the past year, Donald Rennie, vice president for research and graduate studies, told UB Council members in a special report this full. "If we hit the past amount of proposals funded, which is usually around 38 to 40 per cent," Rennie said, " we anticipate a dramatic turnaround in research expenditures." Rennie was optimistic in his presentation to the Council that the current ~ecline in research monies coming to UB will be reversed. He explamed how part of the hoped-for increase will be the result of more proposals being submitted and approved, and part will come from new .metho~s of tabulating the University's research projects. . The v1ce fJres1dent also noted that one of President Sample's pnmary goals IS to put UB among the top 20 research institutions ~n the country. With approximately $25 million in sponsored research 111 1983, however, he pointed out that UB has a long way to go to BUFFALO PHYSICIAN • 9 �attain the $70 to $80 million annually received by the top schools. "There is a large gap in even our most optimistic way of looking at our research figures and our goals," Rennie commented. "Reaching the top 20 will require major changes." Rennie pointed out that UB experienced almost two decades of steady growth in research funds in spite of an equally steady erosion of full-time faculty (see accompanying photo). He emphasized that the figures being used currently in research reports do not include projects being conducted by University faculty at major affiliated hospitals like Roswell Park, Millard Fillmore and Sisters. Including those projects could add approximately $20 million to the 1980 and 1981 research totals, he added. In the future, the Universiry will tally those figures in when determining total research expenditures, Rennie said. He explained later in an interview the reasons that most hospital research figures have not historically been included in Universiry reports : "Prior to my assuming my current position in the Research Office, this office was authorized to deal only with the Research Foundation; this was the narrowest definition of its role. During the past few years, we began to realize that we should be taking credit for grants received t hrough the affiliated h<;>sp1tals, even though the Research Foundation may not be authonzed to act li1 the1r behalf: "We want to include everybody, but there arc practical problems," he added . " There are four or five different business offices through which grants arc negotiated in the various hospitals, and that many accounting systems and ways to determme fiscal years. It takes more coordination than we've been able to effect so fur to get some kind of annual business report from each of them, but we are starting to get that . "It's simply a kind of practical problem that historically we just looked after campus affuirs," he remarked. " ow we have to take a broader view." During the Council meeting, President Sample commented that including the Roswell Park and other hospital grant figures will make UB "comparable to other research universities that have their own teaching hospitals." T he 1980-81 research peak, which was a 10 per cent increase over the previous year, was "regrettably" followed by a steady decline Rennie told the Council. This decline was caused bv two factors:' a large reduction in the amount of federal fi.mds, esp~cially from the Department of Health and Human Services (HHS), and the loss of some research faculty who took their grant monies with them when they left. The Health Sciences account for approximately 60 per cent of research dollars received here, Rennie noted, a percentage that has varied little over the past 20 years. I ati.!ral Sciences and Mathematics receive 19.7 per cent of funds awarded, with Engineering getting 9.1 percent. The 25 departments within the Medical School represent $10,275,355 or 41.4 per cent of the total research dollars expended in 1982-83. The Departments of Physiology, Medicine, Biochemistry, Microbiology, Pediatrics, Social and Preventive Medicine, Pathology and Biophysical Sciences had the greatest amount of research activiry in the Medical School. Physiology comprised the highest total for any department in the entire university. If one adds the estimated research dollars generated directly by the affi liated hospitals, the Medical School and its affiliates could comprise up to two-thirds of total University-related expenditures. Sixty per cent of research support comes from. HHS; the National Science Foundation prov1des 13.2 per cent, w1th other federal agencies - predominantly the Department of Defense- supplying another 13 per cent, &nme reported. . . Even while citing a proposed UB-Calspan JOint research center and the Health Instruments Center being developed, Rennie added " Frankh•, I don' t look to industrial support as being sufficient to ~lose the gap (in reaching the top 20 institutions). I am optimistic that we can increase industry support to five to 10 per cent of the total." In presenting the Council with a list of the top 20 departments getting research grants here (see chart), Rennie noted that nine depart10 • BUFFALO PHYSICIAN me~~s arc responsible for 50 per c"ent of University research activity. Th1s mdJCates the magmtude of the selling job we have to do to get the other 70 departments in the University keyed up," he remarked. He sa1d that the Humanities will be represented on the chart next year, in the wake of a $250,000 grant from the ational ~ndowment for the Humanities for a curriculum enrichment proJeCt w1th the Buffulo public schools. Approximately 32 per cent ofUB 's 1 267 fucultv members submitted proposals for research grants in the most re~ent report year, Renme sa1d - rangmg from a high of74 per cent of Natural Sciences faculty to as few as 6 per cent in Arts and Letters and Management . Average research expenditure per FTE faculty was $19,11 7 UB-wide; $11,854 in Academic Affuirs, and $30,857 in Health Sciences. Rennie closed h.is presentation to the Council by emphasizing the importance of mcreasing the research effort. Sample agreed: " It is to everybody's advantage in Buffulo and Western New York that we move to a comprehensive accounting of research expenditures, which are now diffused throughout the community and not as recognized as if we had our own teaching hospital." • DEPARTMENT DISTRIBUTION OF RESEARCH EXPENDITURE 1982-1983 Annual Activity Top Departments (in millions) 1 Physiology (2) 2.6 2 Chemistry (3) 1.9 3 Medicine (1) 1.8 4 Biolog ical Sciences (7) 1.5 5 Oral Biology (4) 1.4 6 Biochemistry (1 2) 1.3 7 Electri cal Engineering (6) 1.1 8 Microbiology (8) .9 9 Ped iatrics (19) .8 10 Pharmaceutics (10) .8 11 Social & Preventive Med . (>20) .7 12 Chemical Engineerin g (>20) .6 13 Geolog ical Sciences (11 ) .6 14 Medicinal Chemistry (1 8) .5 15 Pathology (14) .5 16 Biophys ical Sciences (1 6) .5 17 Physics & Astronomy (>20) .4 18 Psychology (>20) .3 19 Biochemical Pharmacology (>20) .3 20 Mathem atics (>20) .3 Numbers in parentheses indicate rank in 1980. DOLLAR VOLUME OF PROPOSALS 1973-1983 Year 1973 1974 1975 1976 19n 1978 1979 1980 1981 1982 1983 Dollar volume 38,587,900 37,722 ,601 43,741,243 52,451,433 52,516,802 50,478,309 64,146,979 66,375,655 70,976,765 67,016,229 85,154,Q84 % Increase (decrease) (8.5)% (2) 16 20 0 (4) 27 4 7 (6) 27 Sources: Budget Office Research Office �New Quadriplegic index () :::; () w Test measures imperceptible change 0 1- 0 T By Mary Beth Spina he ofi:en imperceptible changes signaling improvement in quadriplegic patients can for the first time be measured accurately using a test designed by UB researchers at Eric County Medical Center. Dr. Glen E. Gresham says the assessment, called the Quadriplegic Index of Function (QIF), can be used to plan therapy and other treatment as well as motivate patients for whom disease or injury to the spinal cord has restricted use of all limbs. Before now, says Dr. Gresham, "it's been difficult to assess progress in many quadriplegic patients because such progress typically occurs slowly over long periods of time." Dr. Gresham is professor and chairman of rehabilitation medicine at UB and director of ECMC's Department of Rehabilitation Medicine and Spinal Cord Injury Unit. Physicians and other health professionals have long been forced to rely on personal observation to assess quadriplegics' progress, he notes. And these subjective measurements have a high potential for inaccuracy. '·'There's a tendency for professionals to want to see progress which may not in fuct exist - in patients they personally like or to whom they feel close," Dr. Gresham explains. QIF, however, removes such subjective input. Tested with 30 patients at ECMC, QIF has proved a valid, reliable and sensitive instrument. In 20 of these cases, assessments administered by three different evaluators produced essentially similar scores. The test consists of two components. The first lists specific activities grouped under nine categories. Scoring ranges from 0 to 4 with higher numbers indicating greater independence at performing a task. The second component is a questionnaire which assesses the patient's level of understanding concerning personal care. In the first part of the test, the health professional scores the . patient's ability to transfer from one place to another (from wheelchair to bed, for example); his or her independence in grooming, bathing, feeding and dressing activities, attending to toilet needs, and sitting or lying in various positions for long periods; and his or her mobility in a wheelchair. The section on personal care includes questions on skin care, on diet/nutritional needs, on equipment or devices related to care, on symptoms of infections of the respiratory and urinary tracts and those of deep \'ein thrombosis, and on the patient's knowledge of medical and social services available in the community. Patients' total scores mav range from 0 to 100 ~vith higher numbers denoting greater independence and understanding of personal care requirements. A "perfect" score of 100 doesn't mean the patient is no longer disabled or is cured of spinal cord injury, of course. but if total scores increase over several weeks or months, they are reliable indicators of progress. Unlike other areas of m~dicine in. wl~ich pro~~ss is measured in terms of "cure," success 111 rehabilitation med1cme IS ofi:en gauged by barely perceptible improvements. While QIF is reliable, Dr. Gresham notes it may not always reveal true functional abilitv in patients. Some patients do not answer truthfully because or'cmotional problems created by illness or injury. Psychological counseling may be recommended for those who will not attempt to perform tasks physiologically consistent with the1r injury level, he says. D I !c.. r. Gresham says that only in the past 20 years have scientists actively sought to develop more sensitive, reliable methods to reflect levels of improvement among the disabled. "Part of the upsurge in interest," he says, "is a direct result of payment of patients' hospital and support costs by th1rd pames notably Federal and State governments." Those who pay want proof that treatments arc actually uscfi.il in restonng greater 111- Disabled patient exercising at ECMC Spinal Cord unit. dependence through improved function. But, on the other hand, patients with spinal cord injuries who improve enough to return to the workforce ofi:en find themselves in a Catch-22 situation. "Wheelchair-bound patients may require personal care assistants to help them dress, bathe and get to work, but if thev earn more than will allow them to quality for these services, their benefits will be cut," Dr. Gresham points out. Many patients who attempt to work ofi:cn find their incomes are inadequate to pay for necessary attendant care and other special services. Even so, Dr. Gresham emphasizes, it is still important for the patient to aim for the highest levels of independence possible. "It is conceivable that QIF scores may be used as an incentive," he adds. The patient who sees his or her score increase over several weeks or months is more likely to recognize progress gained through therapy which day-by-day might go unnoticed or appear insignificant. For this reason, Dr. Gresham recommends that QIF be taken only once a month. QIF, he notes, is easy to administer, is inexpensive and lends itself readil~' to computerization. Health professionals may obtain necessary matenals for the QIF free of charge from the Spinal Cord Injury Unit, Erie County Medical Center, 462 Grider St., Buffalo, N.Y. 14215. Those also involved in developing and testing QIF include Dr. Mana L.C. Lab1, research associate at UB; Dr. Sharon S. Dittmar, former. Spinal Cord Injury Unit (SCIU) coordinator now head of rehabilitation nursin~ ~t UB; physical therapist John T. Hicks; V!Sitmg urse Assoc1at1on occupational therapist Sandra Z. Joyce and Margaret A. Phillips, former coordinator of the SCIU at ECMC. • BUFFALO PHYSICIAN • 11 ��Spinal cord injuries State-of-art techn iques offer hope S By Bruce s. Kershner tate-of-the-art techniques in the treatment and management ofspinal cord injuries were the topic of the annual meeting of the Inter-Urban Spinal Cord Association September 22-23 at the Grand Island Holiday Inn. Six speakers, including two distinguished lecturers, presented their latest findings to the well-attended audience of 100-150. The meeting was moderated by Dr. Glen Gresham, professor and chairman of Rehabilitation Medicine at UB and director of Erie County Medical Center's (ECMC) Department of Rehabilitation Medicine and its Spinal Cord Injury Unit. One ofthe distinguished lecturers, Dr. Chandler A. Phillips, has developed a computer-controlled system that can enable many paralyzed individuals to stand and walk. Dr. Phillips is deputy director of the ational Center for Rehabilitation Engineering and associate professor of biomedical engineering at Wright State University in Davton, Ohio. ' What makes his system unique is that his device, the size of a camera case, is portable. Dr. Phillips pointed out "these devices arc the only ones in the world. Within ten years, the portable walking systems will be commercially available," and will be in routine use by paraplegics. Dr. Phillips is a member of the team that gained national attention when its computer-controlled system enabled a young paralyzed woman to walk ten feet to the podium to receive her diploma at Wright State's graduation ceremonies. Although the system is perfected for usc now, it will not be available commercially for l 0 vears because safetv tests must be conducted and the U.S. 'Food a1;d Drug Administration must review and approve its use. When it is commercially available, it will be helpful for many but not all paraplegics. It will not be useful to paralyzed individuals with deteriorated muscles or damaged peripheral nerves, for example. Distinguished lecturer, Dr. Allain B. Rossicr, a paraplegic and internationally-known specialist in spinal cord injury from Harvard University Medical School, spoke on "Management of the Neurogenic Bladder in Spinal Cord Injury." He described his new technique in diagnosing the paralyzed bladder, particularly in assessing the area of disturbance in the lower urinary tract that is responsible for improper functioning of the bladder. Micro-tip transducer catheters arc widely used, Dr. Rossicr says, but he has devised a unique type that has multiple transducers mounted in different locations in the lower urinary tract. Applied under sterile conditions, the transducers sinlllltancously and accurately record pressures in the urinary tract. This data enables the user to interpret the response and working relationship of the bladder neck and the urethra to determine why the bladder neck remains closed or open. Only when the source of the bladder dysfunction is known can schemes be devised to treat and manage it. Dr. Rossicr's catheter is the only such device in existence. r. Rossier is also chief of the Spinal Cord Injury Service at West Roxbury VA Medical Center in Boston and reccntlv received the Paralyzed Veterans of America's highest annual award . Speaking on the subject " Management of the RespiratorDependent High Quadriplegic," Dr. Charles Gibson, associate professor and head of the Rehabilitation Medicine Division of University of Rochester, also described a muscle-stimulating device. The phrenic nerve stimulator is a pacemaker-like apparatus that is implanted into the quadriplegic patient to substitute for a respirator. The stimulator can be used onlv for patients with no phrenic nerve damage or certain other respiratory problems. Dr. Gibson elucidated other techniques of respirator management in his lecture. " Radiographic Studies of the Mechanisms of Spinal Cord Injury" was the topic of Dr. George Alker, Jr., climcal professor and acting chaim1an of the UB Radiology Department. He described how, through radiology, he correlates neck injuries and the mechanisms that produce rhem. This he uses to more accurately recognize and diagnose the 111)~1)', and JUSt as Importantly, to prevent injUIJ'· Based on h1s _analys1~, he IS often able to recognize design flaws in a vehicle or 111dustnal environment conducive to causing neck injUI)' . Dr. Alker is also radiologist for ECMC's Spinal Cord Injury Unit. Reviewing the four-year experience of the Spinal Cord Inju;-y Unit from I 979 to 1983, Dr. Edward Stehlik, assistant clinical professor 111 the Departments of Medicine and Rehabilitation Medicine, spoke on "Diagnosis and Management of the Medical Complications of Spinal Cord InjUIJ'·" Among six complications associated with spinal cord injUI)', pulmonal)' embolism (and associated coronal)' arrest) IS the most. scr~ous. Quadnplcgics and paraplegics arc highly susceptible to this d1sease because their legs can' t be moved during the sp111al shock penod of several months and clotting can result. At the Spinal Cord Injury Unit, where Dr. Stehlik is an intemal medicine consultant, experiments have resulted in highly effective prevention and treatment of both this disease and deep vein thrombosis. T he intermittent external pneumatic compressor, a device which stimulates blood flow: was found to be an excellent preventative for these condltlons. anonwidc, the frequency of pulinonal)' embolism 111 sp111al cord patients IS 80 per cent, while at the Spinal Cord InjUI)' Unit, the frequency has been reduced to 16 per cent. Usc of subcutaneous heparin (5000 units, twice a day) has also been highly successful 111 prcvent111g deep vein thrombosis. Dr. Stehlik explained how a 100 per cent success rate, with no bleedmg, resulted from treatment of pulmonary embolism usincr intravenous heparin. More si~nificantly, the Spinal Cord Injul)' Unit achieved_ e~cellent results _us111g streptokinase to treat pulmonary embolism; It Is the only fucihty 111 the nation that has tried this method Hydralazine (20 mg. IM) received a good response in treating autoi!Omic hyperreflex, Dr. Stehlik reported . This is a syndrome associated with spmal cord patients in which the bladder or bowel becomes distended, increasing blood pressure and reducing pulse. The Inter-Urban Sp111alCord Association comprises physicians and other health and soCial serviCe professionals from Buffulo, Rochester and Syracuse, as well as ftom the Canadian cities ofToronto Hamilton, Kingston, London, Ottawa and Montreal. ~ D Quadriplegic student pedals stationary bicycle with aid of programmed electrical sUmulaUon-computertzed feedback system. BUFFALO PHYSICIAN • 13 �Photoradiation therapy An 'elegant' idea proves workable T en years ago, Dr. Thomas J. Dougherty, UB associate research professor and Roswell Park Memorial Institute researcher, applied for a federal research grant to help support his work on a promising investigational cancer treatment called photoradiation therapy (PRT). PRT, the photosensitization of malignant tumors, combines tissuepenetrating red light and a non-toxic sensitizer which, after being injected into the body, is retained preferentially in tumors. In pilot studies, Dr. Dougherty discovered that when visible red light struck the chemiCallysensitized cancer cells, the drug was activated, releasing a tumor-destructive oxygen. "An elegant idea," replied the grant reviewers, "but everyone knows that hght docs not penetrate tissue." Dr. Dougherty's application was rejected. Today, a decade later, skeptics arc no longer doubtfi.d that the "impossible" can be made possible. PRT has been used to treat. over 1,500 patients at more than 30 msntutes and hospitals both in the United States and abroad. Since 1976, Dr. Dougherty and IllS colleagues at Roswell Park have treated over 250 patients with bladder, lung, breast, skm, brain and head and neck cancers- and the result~ have generated a great deal of interest and excitement within the medical communi tv. PRT begins with an intravenous injection of hematoporphyrin derivative (HpD), a non-toxic, photochemically-active drug derived from mammalian blood. Three davs after injection, the HpD is reduced in n<;rmal tissue, but is retained by the malign,mcy. "We arc not totally certain wlw this retention occurs," cxplai~cd Dr. Dougherty, "but we think it's due to slower lymphatic draining and binding to certain cells in the tumor." Exposed to visible red light, H pD is activated and converts the light energy to highly reactive singlet oxygen, a substance that is lethal to the tumor. One month after treatment, patients, under ideal conditions, will demonstrate either a shrinkage or total eradication of the malignancy. And how does light penetrate tissue? "l~d light is the key," Dr. Dougherty contends. "Only red light or longer wavelengths can pcnct~tc tissue sufficiently to be uscfi.d ." The source of red light is incidental to treatment, continued Dr. Dougherty. "We usc lasers because thcv arc convenient, since small beams of light ~an be delivered easily through fiber optics." If . the proper wavelength, any source of red light \\'Ill have the same impact on malignant cells which have absorbed HpD. 14 • BUFFALO PHYSICIAN P By Coleen Karuza RT is not without its side-effects. Patients usually develop erythema- skin patchiness and discoloration - one to two days afi:cr treatment. "This condition," noted the researcher, "is usually short-lived and controllable." A second side-effect, which poses a potentially greater risk to the patient, can be prevented if the patient avoids the sun or other bright light for 30 days posttreatment. As Dr. Dougherty explains: "The sensitizer retained by malignant cells lingers for up to one month after therapy, making patients highly light-sensitive. Direct exposure to the sun or other bright light can cause swelling and second or third degree burns. There is no problem, however, if patients comply strictly with their physician's recommendations and avoid high-intensity light." Although it has been shown to shrink or eradicate the most stubborn malignancies, PRT has not, to date, relinquished its investigational status, and its use in the United States has been restricted to specialty fucilitics, such as Roswell Park . Dr. Dougherty expects this to change, stating that the therapy should be approved for standard usc in the countrv "within the next five vcars." PRT is currci;tly the treatment of ch~icc in Japan for a scle~t group of patients who suffer from lung cancer. In fact, physicians at the Tokyo Medical College, in consultation with Dr. Dougherty, have produced complete remissions in tour out of five patients with early-stage lung cancer, with no evidence of recurrence for up to 24 months afi:cr PRT. Not only is PRT possibly "curative" for early-stage lung lesions, but it is beneficial in advanced lung cancer as well. !~search Ius shown that some lung tumors, diagnosed initially as inoperable, can be shrunk by PRT and removed surgically. When clinical trials with PRT first began, Dr. Dougherty used PRT on patients with various skin tumors. Over 70 per cent of these patients responded with either shrinkage or the complete disappearance of the tumor. These types of malignancies arc considered "accessible," that is, within the light's reach . Recently, however, Roswell Park physicians have tested PRT against less accessible lesions - including those of the bladder, bronchi, stomach, and esophagus - by delivering the light through a fiber optic placed in an endoscope. A t the 13th International Cancer Congress in Seattle, Dr. Harold 0. Douglass, Jr. , also a UB professor at Roswell Park, reported lAIJoveJ Close-up of laser used In photoradtatton therapy, (BelOW} Dr. Thomas J. Dougherty, With laser unit. that PRT had reduced significantly nonrcsectable malignancies obstructing both the stomach and esophagus. "One patient whose esophagus was totally blocked by cancer was treated with PRT and has been asymptomatic for seven months," he said. For bladder cancer, PRT is "highly selective, safe, and may benefit both wide-spread or m situ lesions," noted Dr. Dougherty. Complete responses have been demonstrated in 10 out of 10 cases of early-stage bladder cancer after a two-year follow-up in Japan. ot all cancers may respond to PRT, but Dr. Dougherty believes that there arc definitely certain malignancies that arc likely to reap the benefits of the treatment. Based on Dr. Dougherty's and his associates' research and clinical experience, these malignancies include chest wall tumors (superficial, widespread), bladder (in situ, widespread), gynecological (in situ, .wide area types, such as vaginal and cervical), lung and trachea (early-stage, in situ) and head and neck (early-stage, recurring). Recently, excellent results have been obtained in certain eye tumors as well. . Whether used as primary treatment or adJUvant therapy to surgery, PRT has made many important contributions to oncology and its associated disciplines. Dr. Doughcrtv doesn't tout the therapy as a panacea, and �Research :::E a._ a: u; ~ 0 I a._ Schistosomiasis A vaccine may be developed A Centers using PRT and total number of patients treated as of January 1, 1983 U.S. # PATIENTS Roswell Park 250 Univ. of Southern California 100 Univ. of California at Irvine 100 Mayo Clinic 60 Grant Hospital (Columbus, Ohio) 40 Philadelphia Hospital < 40 U"niv. of Iowa < 40 Univ. of California at Davis < 40 ABROAD Japan (7-10 centers) 500 China (7-10 centers) 300 Australia 100 TABLE II: General PRT Procedures Day 0 Day 3-7 2-5 mg/kg (HpD I.V.) local application of red light (dye laser) Post-treatment erythema and edema (1-2 days) cause gross necrosis Post-treatment reduction or eradication of lesion (1-month) TABLE Ill: Cancers Most Likely to Benefit From PRT Characteristics superficial , widespread CIS, widespread CIS, dysplasia, wide areas (vaginal/cervical) lung/trachea early, CIS head and neck early, recurrence eye retinoblastoma, melanoma Tumors chest wall bladder gynecological agrees that certain elements of PRT could be honed by future investigation. "When sufficient studies have been performed at various institutions to give it a fuir and comprehensive test, there is every reason to believe that PRT will become a highly successful cancer treatment," he said. • By Mary Beth Spina collaborative effort by two UB researchers may point the way to a vaccine which will control schistosomiasis, a major health problem in many underdeveloped parts of the world. An estimated 500 million people are affected by the disease which is prevalent among rural populations in Third World countries and in sections of Puerto Rico, China, Japan and the Philippines. The disease is caused by parasitic blood flukes, which develop in snails living in freshwater lakes and rivers. Afi:er being released by the snail, the parasites enter unbroken skin of human victims who use the water for cooking, bathing and swimming. Once inside the skin, they migrate to the liver. During this migration, the parasites mature into adult male or female worms which mate and produce 300-3000 fertilized eggs daily per worm pair. The eggs and the host's immune response to them lead to obstruction of interior blood flow over a long period of time as well as to damage of the liver, spleen, intestines and bladder which contribute to disease and death. The disease, however, is curable in those not constantly re-exposed to the parasite. "Schistosomiasis," says Phillip LoVerde, Ph .D., an associate professor of microbiology, "is not only a serious health problem but contributes indirectly to poor economic conditions in an estimated 72 nations." Prof. LOVerde and his colleague, David &kosh, Ph.D., assistant professor of biochemistry, point out that only through pooling their expertise has the current project been possible. "The approach we are taking today would not have been feasible five years ago,'' Prof. &kosh emphasizes. Only because of the technological revolution in molecular biology and recombinant DNA, he notes, is it now possible to combine the skills of one member of the team trained in classical parasitology with those of the other in molecular biology. "We bring to this project different skills and different perspectives, merging two disciplines. This is important because creating an effective vaccine is a complex problem," Prof. &kosh adds. The joint research is supported by grants totaling almost $500,000 from the National Institute of Allergy and Infectious Disease and The Edna McConnell Clark Foundation. Though the UB researchers point out that their work is in its inf.mcy, they are optimistic that a vaccine can be developed. Specific proteins, which engender a hurrian immune response, can be found on the surface of the young developing parasite. The BUFFALO PHYSICIAN • 15 �Research genes cn<;Qding these proteins can then be isolated and translated into proteins in bacteria, using the latest of recombinant DNA methods. Once isolated, the proteins, as well as their chemically svnthesizcd fragments, will be tested· as· vaccines. Another approach involves identifying the proteins responsible for egg production in the female parasite and utilizing these in an effective vaccine. "Immunization against the parasite is perhaps the only method which could be considered practical as a means of controlling the disease in endemic areas," says Prof. LoVerde. "Medication is costlv and would not be effective in controlling the disease in individuals who face constant re-cxposure to the parasite in the water;" he points out. And controlling the snail population is equally impractical because moUuscicides are expensive and have negative environmental effects. Interestingly, while many world health problems such as smallpox arc being brought under control, schistosomiasis is increasing in prevalence and intensity of infection primarily because of attemi>ts by developing nations to improve the quality of life of their citizens. Ofi:en this means industrialization which cannot be accomplished without hydroelectric power which calls for building dams. The dams impound large bodies of water and provide a favorable habitat for the vector snails. "Therefore," Prof. Rckosh points out, "work on development of a vaccine for schistosomiasis is very timely. It's an exciting time for parasitology." The UB researchers look for many new developments, not only in schistosomiasis research, but in research on a number of other parasitic diseases in the next few years. • Type Ns An improved prognosis H By Mary Beth Spina ard-driving workaholics (ch~racter­ ized as Type A personahttes and generally considered prime candidates for heart attacks) appear actually to have lower risk for high blood pressur~ unless there's a high incidence of heart disease in their families, new findings bv a U B research team reveal. ·The findings were released by UB psychologist Marlon Koenigsberg, Ph.D., at the annual meeting of the Sooety for Psychophysiological Research held at Asilomar Conference Center Ill PaCific Grove, Cahf. Conducted in the UB Department of Familv Medicine, the study shows that in the abs~ncc of high incidence of heart disease 16 • BUFFALO PHYSICIAN z z :::> aJ w ~ ~ :i 0 ~ a: I- (/) :::> --' --' among close, blood relatives, Type As actually have a lower risk for hypertension than their relaxed, easy-going Type B counterparts. Included in the study were 141 males and an equal number offemales between 25-and 75-years old randomly selected from the patient population of the Deaconess Hospital Familv Medicine Center. Patients \\'ere classified as either Type A or B depending on their scores on a measure known as the Jenkins Activit\• Survev. Data also included the number of subjects' relatives with diagnosed heart disease, subjects' blood pressures, and whether or not they had hypertension. Results of the study showed that T)•pc A patients whose relatives had a high incidence of heart disease had higher diastolic blood pressures indicative of increased risk for heart disease. But Type As with a lower family incidence of heart disease had lower diastolic blood pressures despite their ambitious, competitive behavior patterns. Earlier work by study co-researcher Ed- wardS. Katkin, Ph .D., showed similar patterns among 45 college students. Dr. Katkin, chairman ofUB's Department of Psychology and president of the Society for Psychophysiological Research, found that blood pressures increased substantially during video game-playing among Type As who had family histories of heart disease. But Type As who had no such family history had blood pressure increases during game-plaving less than those experienced by Tvpe Bs who either had or did not have high incidence of heart disease among relatives. Conceding that the two studies provide researchers with more questions than answers, Dr. Koenigsberg says they suggest that Type A behavior alone is not a reliable predictor of future high blood pressure which can lead to heart disease. "But," he adds, "physicians might want to more aggressively push for changes in poor health habits - such as smoking and overcatmg - known to contribute to heart d!sease in Type A patients who have family htstories of cardiovascular problems." • ·. �Hospitals ~ <( Carl Granger 0 A newcomer at the General ci.i W hen we spoke, his book shelves were still empty, his walls still unadorned. But Dr. Carl Granger, one of the Medical School's newest arrivals, has brought with him a full agenda and a distinguished career. Professor of rehabilitation medicine and the new head of Buffalo General Hospital's Department of Rehabilitation Medicine. Granger comes at a time of change. The University is in the midst of a $55 million medical school and Health Sciences Library expansion and a $200 million enlargement is underway at Buffalo General Hospital. Granger looks at the construction as an opportunity to modernize his rehabilitation medical services as the hospital and University modernize. The temporary disruption and relocation of medical operations within the hospital itself are of little concern to him. What does worry Dr. Granger are the outdoor effects of the construction on the disabled patients that his department handles. In treating the disabled person, the external environment is as important as the patient's physical self. "Right now, we have the problem of access because of the difficulty of the parking and the barrier that distance is to patients with mobility problems," he commented, emphasizing that "minimizing the physical limitations of access is vital to the development of our outpatient program . We must give anention to serving our patients." Unfortunately, he adds, the massive constmction projects may not improve parking afi:er they are completed . Dr. Granger received his A.B. from Dartmouth (1948) and his M.D. from New York University-Bellevue Medical Center (1952) . Afi:er nine months of general pracnce m Huntington, Long Island, he sen'ed in the U .S. Army for almost seven years. It was 3: z 5 I a. during his military sen•ice that he completed his residency at Walter Reed General Hospital and chose his specialty field of rehabilitation and physical medicine. Upon leaving the Army, he joined the faculty of Yale Universitv and became assistant director of the Dep~rtment of Physical Medicine. He was actively involved both in teaching and in managing pediatric and adult patients in need of physical and occupational therapies over the next seven years. In 1968, Granger decided to move to Tufi:s University, Boston, where he was appointed professor and chairman of the Department of Physical and Rehabilitation Medicine, as well as physiatrist-in-chief at ew England Medical Center. His move to Tufi:s led to a fortuitous event for Dr. Granger. He met Dr. Glen Gresham and their productive relationship has continued to this day. It was, in fact, that relationship that led, years later, to Dr. Granger's decision to move to Buffalo. Dr. Gresham, now professor and chairman ofUB's Department of Rehabilitation Medicine moved here five years ago. While at Tufi:s, Granger and Gresham developed a new approach to rehabilitation medicine. "That's where we explored and expanded the use of functional assessment, a method of measuring the ability of a disabled person to participate in a range of identified activities," Granger explained . A recent result of their research is the book, Functional Assessment in Rehabilitation Medicine (in press). Granger also continued and expanded research in the use of electromyography, braces and splints and in the treatment of Bell's Palsy, stroke, rheumatoid arthritis and other diseases. He also sen'ed, among numerous other professional positions, as president of both the ew England Society of Physical Medicine and the American Academv of Plwsical Medicine and Rehabilit~tion. ' Dr. Granger moved to Brown University, Rhode Island, in 1978, where he was named Frederick Henry Prince Distinguished Scholar in Physical Medicine and Rehabili- -. BUFFALO PHYSICIAN • 17 �ration. " There, the emphasis was on community hospital operations. I also helped to organize a state-wide network of institutions, agencies and individuals interested in rehabilitation," he remarked matter-of-fuctly. As with his professional activities at Tufts and Yale, he held numerous positions in professional societies and committees, including the presidency of the International Federation of Physical Medicine and Rehabilitation. Functional assessment of disability continued as one of his primary research activities at Brown. He also spent significant time as project director of a multiinstitutional stroke followup study. Before leaving Brown, he spent 1982 at UB as lecturer in rehabilitation medicine. Developing and expanding all three spheres - the research, clinical and teaching programs - will be the focus of Dr. Granger's agenda for both the hospital's and University's Departments of Rehabilitation Medicine. He will help organize research activities, especially those involved with refining the functional assessment of disability. Computers will be used to assist in the measurement of disability. To accomplish this, grant monies will be sought to develop computer programs to collect and analyze the medical data. The data will also be evaluated to relate the costs of treatment to various types and degrees of disability. For example, in the treatment of a stroke patient, the costs of hospitalization, nursing home care and home rehabilitation will be compared . This information will be used to advise policy makers in devising better informed health care policies and help to answer the question "Where can we best allocate our limited health care resources?" I n the clinical sphere, Granger's plan is to establish an in-patient rehabilitation unit at Buffulo General. He also hopes to expand the outpatient program by having follow-up of outpatients with a variety of medical rehabilitation problems such as stroke, Parkinson's disease and chronic pain problems . Considerable time will also be spent refining the hospital's use of the expensive new icolet Pathfinder machine, which will measure the reaction of the spinal cord to stress during surgery. Dr. Granger's goal. is to expand the teaching program of h1s department by mvolving more medical students and res1dents in rehabilitation medicine, as well as res1dcnts in other primary care specialties and affiliated hospitals. Author of more than 50 publications, including one which received the Elizabeth and Sidney Licht Award for Soennfic Excellence in 1979, Granger IS still actively writing and editing. Among publications he is editing arc a new book on rehabilitation of the aged and a manual that provides the functional perspecnve ro patient care for the 18 • BUFFALO PHYSICIAN primary care physician. Besides his ongoing research on functional assessment of the disabled, he is also studving differences in the success of treatmc1;t of stroke patients at a community hospital. He found that treatment success improved after a rehabilitation unit was established at the hospital. More patients were able to go home for rehabilitation and fewer were institutionalized as a result of the new rehabilitation program. Poring over the charts on his desk , Dr. Granger was both pleased and puzzled over one result: the improvement for over-75-year-old stroke patients was nearly the same as that for 60-75year-old patients. Dr. Granger had expected that the greater age and less secure family and home support for the older patients would have led to a higher rate of institutionalization for that group. He hopes to learn the reason for this surprising result. On the less serious side, Granger will apparently have little problem adjusting to Western New York ' s recreational environment . "I enjoy most outdoor activities, especially downhill and cross-country skiing. Golf is an occasional sport as well." And cultural interests? " I enjoy them all, theatre, music, the arts." Then he emphasized, "But my work is my primary hobby." Granger has two children. Glenn, 30, is an airline employee in Rhode Island ; his daughter, Marilyn, 26, is interning in Hartford, Connecticut, after graduating from Thomas Jefferson Medical School in Philadelphia . One 1~ajor contribution of rehabilitation medicine to health care, according to Dr. Granger, is the multidisciplinary team approach, now being adopted by other medical fields. Looking toward the immediate future, Granger feels that the newly emerging role of his field is to pay close attention to disabled children as they become adults. " Our strategy should be tO prepare the younger patient to become as physically and vocationally self-sufficient as possible, as well as emotionally adjusted and able to participate in society," he comments. " Disability is an exploding epidemic in our country " due to the general aging trend of the population , Granger pointed out. " Because of this, we have to employ new and more effective methods to treat the increasing number of disabled patients." He agreed that the need for rehabiliation medicine is steadily growing. Now that Carl Granger is on board, meeting that need will now be even more assured . • Changes at Sisters Sr. Mary Charles leaves A ugust 19, 1983, marked the close of an era at Sisters Hospital. That's the day that Sister Marv Charles, administrator and president ofSisters Hospital smce l969left Buffulo to assume new duties wit~ the Daughters of Charity. S1ster Mary Charles now is executive direc- �Hospitals z z<( :2 LL ::::> ;2 w z<( 0 ~ 0 I a._ (Left) COunt¥ Executlve Ed Rutkowski greets Air NaUonal Guard IJBtsOnnel during helicopter landing at ECMC Sister MaiY Charles (above, leftJ has left as Sisters Hospital administrator. Her replacement: Sister Ellee~ Klnnamev (rlghtJ. J ) tor of the Daughters of Charity National Purchasing Services. She is responsible for n:-locating central purchasing facilities from Baltimore to the Midwest and organizing national purchasing contracts for over 40 Daughters of Charity hospitals from coastto-coast. Taking over as president of Sisters Hospital is Sister Eileen Kinnarnev, formerlv asststant vice-president for admit;istrative ;en•ices at Sisters. Sr. Eileen will direct the hospital's day-to-day operations until a permanent president is assigned by the Daughters of Chari tv. Siste~ Marv Charles' career in Buffulo began in 1968 when she came to Sisters as assistant administrator. She became administrator in 1969 and was named president in 1972. In addition to being the chief executive officer, she was also chairman of the hospital's board ?f trustees.. . Sister Man· Charles expcrnsc 111 hospttal financial matters has gained her the respect of both hospital administrators and businessmen. She holds fellowships in both the American College of Hospital Administrators and the Hcalthcarc Financial Management Association. Under her leadership, Sisters Hospital stayed clear of deficits which have plagued most hospitals in New York State. During Sister Marv Charles' tenure, Ststers Hosptta1 alwavs fini~hed its financial vear in the black. Sh~ directed Sisters Hospital through some of its major renovation and construction projects, including the building of the hospital's 80-bed Skilled Nursing Facility, completed in 1974; construction of the Seton Medical Office Building, finished in 1974; the laboraton', built in 1980· the establishment of the' Seton Familv H~alth Care Center in Alden in 1981, and modernization of the Special Care urscry last year. Other major projects included the construction of the current fiscal scn•iccs and data processing building, renovation of the intensive care unit and the building of the Dining Inn. • Trauma injuries Copter speeds them to ECMC A military helicopter, on August 5, landed in Eric Countv Medical Center's parking lot, the rc;ult of an agreement between the Count\' of Eric and the Air National Guard. The agreement allows a military helicopter to transfer personnel with trauma-reb ted injuries to the trauma intensive care unit at the medical center. Acccording to Dr. Roger E. Kaiser, the agreement establishes procedures and radio communications for military emergencies. He is an anesthesiologist attending at the medical center and flight surgeon for the I 07th Fighter Interceptor Group of the Air ational Guard stationed in Niagara Falls. He notes that in military accidents, the injuries arc almost always severe. Because of the care provided to patients in the trauma unit, he believes it is the best place to bring injured military personnel. . He adds that procedures developed may, the future, be considered for civilian disasters. On hand to formally confirm the agreement were Dr. Kaiser and County Executive ' • Edward Rutkowski. 111 (Reprinted from Update, the ECMC Newsletter) New CT scanner 4th generation model at ECMC A new CT scanner is expected to be online at the Eric Countv Medical Center in late fall. The fourth generation Picker model will provide a faster scan than the Pfizer model purchased seven years ago. Its two-second scan compares to an average 60 second scan of the Pfizer. Because of its speed in scanning, it will be able to view body parts not previously possible due to blood flow, breathing and other body functions, according to Mr. Calvin Suess, executive assistant, radiology, ECMC. He notes that as a better diagnostic tool, it will permit the radiologist to view more of the body's infrastructure. The department, he added, began to look at new models ofCT scanners about three years ago. "We are especially anxious to use the new Picker model on our spinal cord injury and trauma patients," he said. The new CT scanner will cost about Sl.l million . The current Pfizer model will be used primarily for research purposes, he • added. (Reprinted fivm Update, newslette r of ECMC) BUFFALO PHYSICIAN • 19 �Family Weekend 200 relatives of students attend Jl bout 250 retauves at the Medical School's ttrst, second and thtnl vear students enJoyed themselves, ate and listened to lectures during Family Weekend, held on Satunlay, October B. Or. John Naughton, dean at the medical school, addressed the group, which also heanl sctenUttc lectures on heart attacks, trauma and new research tn the areas at nephrology, pedtat11c endocrinology and canltotow. Between meats and lectures, the attendees touted vanous depattments on campus and at Erie Countv Medical Center. 20 • BUFFALO PHYSICIAN �Medical School News HIDI ready to begin operations Unit has almost $2 million in contracts W ith letters of intent for more than $1.7 million in contracts already in hand, Universitv officials expect that the Health Care Instrument and Device Institute (HID!) will be designated as a statefunded Center for Advanced Technology before 1984. Dr. Michael Anbar, executive director of HID!, reported on the status ofthe center's development in October to the board of directors of the New York State Science and Technology Foundation, which oversees the state's Centers for Advanced Technology Program. "We expect that the Foundation will desianate HIDI as a Center for Advanced Tecl~nology in mid-December," An bar said, "with funding from the state startmg Febmarv 1. We are sending our final proposal to. the foundation, and it will then be forwarded to the 1 ational Research Council for evaluation." Even before the official designation is given, researchers may have already started on projects within the HID! umbrella, Anbar added . "One company wants us to start on its project immediately," he said. At the board meeting, Anbar reported that the following companies have signed letters of intent for future projects with the Univcrsitv-based center: v VISIDYNE, for a contract of $700,000 for laser-based ophthalmological surgical devices. v Warner Lambert, a $250,000 contract for pyrolysis mass spectrometry; automatic camera, and histology posltlonmg de\'ICe. v A private sponsor, $175,000 for a cardiac monitoring and intervention system, and a venous valving system . v Church & Dwight, $140,000 for assessment of an anti-plaque system. v Olin Corporation, $86,000 for assessment of a periodontal preventative agent. v Board of Cooperative Educational Services (BOCES), $191,000 for instructional services. In addition, An bar said, local foundations have donated approximately $100,000, with another Sl 00,000 worth of equipment also being donated . The state will provide S1 million in funding upon HIDI's designation as a center. An bar emphasized that this listing includes letters of intent - not contracts - for projects conceived as of September. " By December, when we go to the state with our final budget proposal, there may By Linda Grace-Kobas be just as many new contracts," he said. "We arc negotiating with another half dozen companies. I n his presentation before the Foundation board, chaired bv William Donohue, State Commissioner of Commerce and former head of the Erie County Industrial Development Agency, Anbar noted that health care accounts for 6 per cent of the country's G P, with medical technology taking 55 per cent of the costs of health care. "The market for new instruments and devices will continue to grow," he said, "so that going into health care and technology is a wise idea ." Health technology is a " secondary technology, very close to the marketplace, and directed to applied as opposed to basic research," Anbar stated. He reviewed Buffulo's "track record" in health milestones: it was the site of the development of the heart pacemaker; its power source, the lithium battery; soft contact lenses; the intra-uterine device for birth control, and the PKU test for newborns. The developers ofthesc innovations are "all members of the HID! team," he added. In addition to the UB schools of Engineering, Education, Management, Medicine, Dentistry, Nursing, Pharmacy and Health Related Professions, Roswell Park and other affiliated hospitals will be involved in HID! projects, he said. Other area agencies involved will be Buffulo State College, Erie Communit~· College, Eric I BOCES, the Erie County and Amherst Industrial Development Agencies, and Western ew York Technology Development Center. HIDI's goals arc to conduct generic and applied research in mcdic:d technology to de,·elop new cost cffccti\'C and safe instruments and devices; assess existing instruments and devices for their performances under clinical conditions, and educate and train appropriate personnel needed nationwide to dc,·clop and implement medical technology in the most effective manner, Anbar said . A number of advisor\' committees have been established to guide the work of the new center. An bar is associate dean of medicine for applied research and chairman of the Department of Biophysical Sciences. Dr. John 1 aughton, Medical School dean and acting vice president for health sciences. scl'\·es as chairman of the HID! board of directors, which includes representation • from industry. Dr. Theresa Stephan House staff Association serves residents A mid the rigorous schedule of the hospital resident, a number of individuals have found a \vav to scl'\'C their fcll?w residents through an· organization unf.umhar to most of the Universin• medical communitv. The Buffulo Hous~ Staff Association, chaired bv Drs. Theresa Stephan and Fred Rodcms, provides support for more than 400 residents in three of the UB-affiliatcd tc~ching hospitals. Originating 111 1976 at the Enc Count\' Medical Center (ECMC) , the association I~ow has members in Buffulo General Hospital and the Veterans Administration Medical Center (VAMC) as well . The Buffulo House Staff Association according to its secretary, Dr. William Pullen, has taken the responsibility to concern itself with those topics for which the busv residents often have little time. The association aims to be a vehicle for communication by keeping all residents informed of important developments that affect them. It encourages participation in the organization. In particular, the association involves itself with development of the tr.1ining programs to ensure that their quality is maintained. To do this, association members have representation on all resident-related committees of hospital administration and fucultv at ECMC and VAMC. These include the co mmittees for quality assurance and utilization review, resident scheduling, education, infectious disease and environmental control, as well as the executive committee. On the scheduling committee, for example, association representatives recommend more flexible resident schedules as alternatives to the traditional scheduling systems. • BUFFALO PHYSICIAN • 21 �Jim Bentley's quadracycle turns heads He hopes to ride it to graduation come next May W hat has four wheels, travels up to 40 miles per hour and attracts giggles, neighborhood kids, doubletakes and newspaper photographers? The answer: Jim Bentley's " quadracycle." The ungainly vehicle, which looks something like a cross between a bicycle and a precursor to the Modcl-T Ford, is the creation of this fourth-vcar UB medical student from Coney Island , Brooklyn. The ll-foot-long red and black pedalpowered device has two scats, ten speeds, four wheels and an optional six-power minibike engine. Created out of parts from more than 20 bicycles, the quaint machine weighs several hundred pounds. Mr. Bentley, who loves bicycling, began the project several years ago when his girlfriend insisted she would go cycling with him onlv on a bicvcle built-for-two. " I livc'd right ne~t to a junkyard where I was able to find all kinds of bike parts," he explained. After a period as a two-wheeler, the vehicle was "improved" with suggestions from friends. From an old Good Humor ice cream wagon, Bentley said smiling, "I added axles " and transformed it into a tricvclc built-for-two. He test drove it along th~ bicycle lane adjacent to Brooklyn's busy Belt Parkway. His test-drives, he agrees, led to rubber-necking and didn' t do much to alleviate the chronic traffic ddays on that crowded frccwav. The next step-in the evolution of his unconventional vehicle occurred during Bentley's camping journey with his girlfriend from Concv Island to Massachusetts . Passing through a town, he squeezed between a truck and another \'chicle and broke the one front wheel. With no choice but to repair it right there, he hit upon the idea of adding a fourth wheel, "which opened up all kinds of possibilities." It was on his return trip through the Village of White Plains that a newspaper photographer chased and flagged him down to capture the unique contraption on film. He's been attracting newspaper photographers ever smcc. T he most unusual voyage his quadracycle has taken to date was to UB. As the Buf- 22 • BUFFALO PHYSICIAN Jaw News described it, just getting the cycle to Buffalo was an uphill , or rather, upstate struggle. " When I came here from ew York Citv in 1977, I could bring only a couple of pieces in a box," he said in an interview with the News. "So every time I went back home, I'd bring a few more pieces in the luggage compartment of the train. It didn ' t cost anything, but it sure took long enough." People wave, laugh, smile or shout - or ask lots of questions. Kids follow him and even dogs stare. " One thing is for sure," he adds " cvcrvbodv likes it." A; unass~ming fellow, Mr. Bentley can't figure out what all the commotion is about. He didn' t build it. to be outrageous or funny - he just built the vehicle to work. And work it docs, reaching speeds up to 40 miles per hour with its engine. Despite his busy schedule as a medical student, Bentley has managed to put his invention back together by taking advantage of spare time (and parts). A 33-year-old Vietnam veteran, he uses his vehicle simply for routine tasks like shopping or laundry. But its other use for camping trips prompted him to add his latest improvements, a motor and a generator. He didn' t plan on it, but now he must add other features such as blinkers, lights and odometers to comply with new regulations for mopeds. "I'll take longer to finish it, but I' ll pass every requirement and get it licensed," he said confidently. In the meantime, he can still pedal it. Mr. Bentley has additional plans. After he gets his quadracycle licensed he will add on an enclosed trunk. But more importantly, Bentley and his cycle have a special trip scheduled for this June: a triumphant ride to his graduation. Glancing back at his invention, he adds, " I can ' t wait to see all their eyes pop out." • ~ ~ 0 z g 0 I (l_ �---------------------------------------------------------------------Students Message from President of Polity, the Medical Student Organization Dear Colleagues: The arrival ofthe new 1st year class and the start of the new school year were heralded by the anmml orientatum program and Fall Fun & Field Day, Festivities included: a cookout, tennis, softball, SOCCer, I'Olfeyball and just plain Wajin' around, Many thanks to Sandy Levy, Sue Guralnick, Donnica Moore, and Mark Vickers for all thei1' work getting er>erything togethn~ Parents and families of medical stutknts were treated to a glimpse ofthe School on Family Day, There was an excellent turnout, The improvement in rapport between the school and families of stutknts should be of bmefit to both, Our annual medical school Halwween PartY took place on NoPember 5 and was enjoyed by alL Pla11S for the coming spring are a Dinner Dance Talent Show, january 21, and the infamous Follies, April29, This year, Bill Stephan, Han)' Timot!Jee m1d john 0/sewski !Jape m;ganized i11tramural teams in football, basketball, J>olleyball, soccer, baseball and hockey. Sincerely, Alan Stein President, Polity Clockwise from top rlght: Jim Bentley with his quadracvcle; vtew of the Class of 198 7 at Orientation; more freshmen med students In Farber parking tot; Dr. John A. Richert welcomes class. Class of 1987 135 are enrolled N oting that "the first day of school gets earlier C\'crv vear," Medical School Dean John 'Naughton welcomed the Class of 1987 to the Universitv and cono-ratulated the 135 members o~ being ac~epted to and cnr~lling; in one of the nation's "strongest" medical msntu nons. ' 'Have a strong sense that this is a medical school of historical record," the dean advised the newcomers, "It is old as many and older than most." Throughout the Medical School 's 135 year history, he said, a "large number of good scientists and physicians" BUFFALO PHYSICIAN • 23 �Students Sklarow Award Brian Lipman wins honor D Rain torced OrtentaUon picnic Inside. have graduated from it. "You arc in an environment committed to excellence.," Naughton stressed. "But you must also have an attitude of wanting to seck cxccllcncc." And should a student fuil to strive for that "UB excellence" or to meet his potential, the "School will let him go," the dean emphasized. aughton addressed the first-year class at the Medical School's annual student orientation program Friday, July 29. Classes were scheduled to begin the next Monday, one of the earliest starts in recent mcmorv, the Dean explained. . "The burden (oflearning) is now yours," he said. "The responsibility for growth will be more and more on \ 'OU ." By the time of gra-duation in 1987, aughton warned , "the world will be a much different place from what it is today," especially for the physician. Medicine, he said, "is undergoing an amazing metamorphosis.'' During the transition fi-om student to doctor, Naughton explained, students will "be secluded and protected from many of the changes occurring in medicir1e." But, he added, their UB education will help prepare them for those new medical worlds. The changes will not only be technical, he noted, but also humanistic, political, and sociological. "Currently, health sciences and medicine arc unchallenged in resources and this will change," he said. "The relationship between the doctor and patient will change and our priorities as physicians will change. These changes will affect us all." Naughton said that students must ex-_ amine the changes and measure the value of each, because as scholars and new physicians their "role in contributing to continued evolutions will be more" than any fuculty member's. Following aughton's remarks, John A. Richert, assistant Medical School dean and registrar, noted that the 135-member class of90 men and 45 women was culled from an application pool of about 3100. The 24 • BUFFALO PHYSICIAN most popular undergraduate majors for the class included, he said, biology, biochemistry, chemistry, physics, jour• nalism, and political science. Tough c ompetition Only one in 23 gets in r. Brian J. Lipman has won the 1983 Dr. Louis M. Sklarow Award, J. Milton Zeckhauser; president of the Foundation of Jewish Philanthropies, has announced. This award, established in memory of the distinguished Buffitlo physician, who died in 1976, is presented each year "to the outstanding graduate in medicine from the UB Medical School . . . who has shown by character and medical accomplishment great promise in becoming a fine physician and a person most likely to make a contribution to mankind and bring honor to his or her school.'' Dr. Lipman was chosen for this honor from a field of more than 15 candidates. The award carries a cash prize of $250. Dr. Lipman is anticipating a career in academic medicine and basic research. He is serving his residency at the ColumbiaPresbyterian Medical Center in New York City. . • T his September, the UB Medical School welcomed its 137th entering class. .Competition for seats was very high, and at the same time, the lowest turnover rate of applicants was experienced. One hundred thirtv-five were selected out of 570 interviewee~ and more than 3000 applicants. Now hard at work for several months, this year's class is comprised of 92 men and 43 women, including 15 minorities. The a\·erage age is 24. The youngest is 19; the oldest, 41. With 58 Western ew Yorkers, representation from this area is at one ofthe highest levels the school has seen in marw years. Fifty-two medical students originate· from down-state New York, 22 from the rest of ew York, and three fium out ofstate. They come from 63 different undergraduat~ schools, with the largest number from UB (27). Cornell, SU Y Albany, SUNY Binghamton, and Canisius College also are well-represented. Johns Hopkins, Hamilton, Universin• of Pennsylvania and Dartmouth arc among other i;,stitutions where students did undergraduate work. Twenty-two of the students have advanced degre~s, including four with Ph.D.'s, one with a law degree and 17 with masters. Thirty-four did not major in scientific fields while in undergraduate school. Two were admitted to the combined M.D. /Ph .D. pro~ram, knowri as the medical scientist trainmg program. Significantly, the new entering class' scores are higher than last year's class. Their average science GPA is 3.47 and their average MCKr score is 10. • Or. Brian J. Lipman (lett). Travelling fellow Walter Straus receives award W alter Straus (Class of ' 86) was recently awarded the 1983 Logan Clendening liavelling Fellowship in the History of Medicine, which is administered through the University of Kansas School of Medicine. His research topic was "Thomas Wakley and the Formative Years of the limcet: M~dical Reform and the Early Medical Press." He conducted his research at the Wellcome Institute for the History of Medicine, the British Museum and the Royal College of Surgeons. • �Book Reviews The Youngest Science by Lewis Thomas, M.D. , New York, The Viking Press, 1983, pp. 270, $14.75. ''A Life in Our Times." This is the third (The Medusa and the Snail; The Lives of a Cell) and, so far, the best book bv Lewis Thomas, growing out of a series of ~olumns in The New England journal of Medicine entitled "Notes of a Biology Watcher." The book is largely autobiographical, tracing medicine from the turn of the century (and • ''All the cbildnm in Hushing were jlll>enile delinqumts. We mamed the tonm in the CJ>eni11!J, li11!Ji11!J dourbells and ruuni11!J mvzmd the side of tbe house to bide, scmwling on the side~mlks with cokm:d clmlk, pmctici11!J for Halloll'em, whm Jl'e tumed into m111ials outright. . . . " I fRight) Author Lewis Thomas; a veteran medicine watcher. the medical education ofThomas ' futher) to the present day. Having achieved success and notoriety professionally, Thomas looks back critically upon medicine with enlightening humor and style. He is a master of the " biologic pa~able " subtly conveying philosophy through anecdote in nature. The Alfred P. Sloan Foundation sponsored this book - the third in the series designed "to make the process of scientific discovery more understandable, more real, and more exciting to the general reader." In my view, this is an important and timely book conveying to readers, professional or otherwise, the revolution that engulfed medicine in the middle decades of the twentieth century Lewis Thomas grew up in Flushing, ~n Long Island, in the home of a general practitioner futher and nurse mother. Educated at Princeton (entered at age 15) and Harvard (claims he was accepted because Hans Zinsser had known his futher and admired his mother), he interned at Boston City, followed bv a residencv in Medicine. In the process of a Neurology fellowship, he became involved with infectious disease and pursued microbiology for most of the remainder of his career. Thomas was chairman of Pediatrics and Medicine at Minnesota (can you imagine a combined chair?), Pathology, then Medicine and ultimately dean at NYU, dean at Yale, and president of MemorialSloan-Kettering. vThe IO\lllgest Science Notes ofa Medicine .Watcher Lewis Thomas Aurh.nt THE LNES OF ACELL Reminiscent of a John O'Hara, or F. Scorr Fitzgerald novel, Thomas begins with the era of his futhcr in which practicing medicine was almost entirely symptomatic; the only good drugs were digitalis and morphine. The preoccupation of academic medicine in the earlv years of the century was the ability to diagn~se a patient's illneSs and to predict' the subsequent natural course. The few times the internist had gratifying outcomes were surgical referrals. Thomas describes the life of a student and the house officer on the large wards of the Boston City Hospital in the mid 30's, and the Oslerian manner in which rounds were conducted. UB alumni can certainly recall similarlv the wards at the Buffilo Ge~eral Hospital ~nd at the former E .] . Meyer Hospital where rounds often consisted of a discussion of the patient, his/her illness, and even prognosis, in the center of the ward with the patient and wardmates straining to catch every word . "A skilled, e.xperienced physician might have dozms ofdijfirnzt jimnulntiom in his memory, . . . They•were plncebos, and tbey had been the pri1zcipal mainstay of medicim:, the sole teclmology, for so kmg a time - millennia that tbey had the incantatory jXlll>e1" ofrr:ligiotts BUFFALO PHYSICIAN • 25 �Book Reviews ritual. My father had little faith in the effectiveness ofany ofthem, but he used them daily in his practice. · "The reaynition ofspecific i/bwsses, based 011 what had bemleanzed abmtt the ,mtuml hist:urv ofdisease a1ui about the pathologic changes i;1 each ill1wss, was the real task of the doctor. If he could nmke an accurate diagnosis, he could forecast fivm this information what the likely ozacome was tu be for each of his patients' illnesses. "On the wanis of the great &stun teaching hospitals - the Peter &m Brigham, the Massachusetts Geneml, the &stun Cit1' Hospital, and &th Israel - itgradually daw,;ed on us that we didn't know much that was real~v usejitl, that n>e amid do nothing tu change the course of the great nllljority of the diseases we were so busy ana~vzing, that nzedici1ze, for all its facade as a leanzed proftssion, was in real life a profomui~v ignorant ocwpation'' A11 interesting questionnaire sent (in the mid 30's) to former graduates of the Harvard Medical School asking them their incomes and their advice to future physicians revealed those physicians who had been out of medical school for 20 years (in 1937) were making the 1983 equivalent of $37,000. Their advice to future physicians was to work hard and not to expect to make a lot of money. Another theme which runs through the book has to do with the nature of success in research. Having invested several years prior to the Second World War in laboratory and clinical investigation, Thomas had the good fortune of continuing his research in microbiology during the War at the end of which he was much sought afi:er for the bourgeoning investigation during the 40's, SO's and 60's. He was involved in very productive research in immunology as well as bacteriology and was able to attract large amounts of research money. He is very modest to point out, however, that success in research is ofi:en random and he relates several anecdotes which would help to cheer the young struggling investigator. While in the South Pacific during the War, he demonstrated through a series of experiments using rabbits that Group A Streptococcus infection uniformly produced myocarclitis. When he got back to the States, he found it impossible to reproduce these results. pie. He decided to try the raw liver treatment on pernicious anemia strictly on a chance basis (he could have selected iron deficiency or some other type of anemia). We now know, of course, that the liver extract cured the pernicious anemia but the discovery was to a large extent a random occurrence and not the result of carefullv planned research. I think it is important t~ state parenthetically that while the literature is replete with such cliscoveries, just as manv if not more are the result of carefully plann·ed and systematically executed research. Thomas has a fascination with linguistics and from time to time lapses into the derivation of terms in common usage. He gives an entertaining discussion of the evolution of the word "leech" which meant a doctor in Old English coming from a word which meant "an enchanter, speaking magic words " as opposed to "leech," the worm. A recurring theme of Thomas' writings has to do w1th the concept of cooperation and symbiosis. He uses every occasion to satirize the pompous hierarchical structure in medicine. One cannot help but wonder what his own style has been in the manv managerial positions he has held. Some ;f his more entertaining quotes have to do with his bias toward nurses and women. As a student and a young physician, he quickly unde_rstood (as many of us discovered) that nurses really mn a hospital. Most of the empathy comes from them as well. "Knowing what I know, I am all for the nurses. If they an: tu continue their proftssional ftud with the ducturs, if they wa1zt their pmftssw1llll stlltus enhanced and their pay increased, if they infuriate the docturs /ry their claims tu be equal pmftssionals, if tbey askfor tbe 11UXJII, I am on their side." It is obvious from Thomas' cliscussion of his activities with the Board of Health in New York and his part in the rehabilitation of the Bellevue Hospital that he has deep sensltlvltles to human beings in addition to his env1able talents as an investigator and writer. He ev~n went so fur as to have a private cliscuss1on With a political figure of yesteryear 1n New York City to secure funds for a new Bellevue Hospital - he found it to have been in vain. " In real life, resean:b is dependmt on the hzmum capacityfor making prr:dicti011s that are n>roljg, a,zd on the CJ>en mon: hunllln gift fin· bozmcing back tu try agai,z." " I thought I had final~1' reached the cente1· of the administmtil'e demonology and lazmched our appeal for help, but he displayed eqzumimtty; &1/evue had all the money it 1weded he said, and a.dded that the city ·should no; be spmding an.mwre 011a place 'filled 1vith bumsm Another anecdote has to do with the cliscovery ofthe cure for pernicious anemia. Allen Whipple in 1926 reported that raw liver improved anemia in dogs that had been subjected to repeated hemorrhage. Dr. George Minot at the Peter Bent Brigham Hospital in Boston had a practice of expecting investigation from new colleagues. Murphy, the newest recruit, was leafing through some papers and saw the article by Whip- Thomas resignedly discusses the role of management in a medical school or university. Inertial forces prevent the dean or the president from impacting the organization noticeably. While environments can constrain the most gifi:ed, creative, inspiring leadership produces more and better scholarly output than docs authoritarian manipulation. Thomas' plea for cooperation in medicine extends to a plea for cooperation 26 • BUFFALO PHYSICIAN in our society as-a-whole to manage political, SOCial and economic adversities that we fucc. Thomas delves into evolutionary biology (inc_ludm!? smatterings of teliology) to substantiate h1s pleas for cooperation. To confuse the_ issue, the sociobiologists claim incliv1duahsm and hierarchical stmctures have also evolved from biologic need. Perhaps men behave the way they do because that's how the women like them. " If I were the president of a major tmiz>ersity I would not want tu take on a medical school and if it already had one, I would be ~ying awake nights trying tu figure out ways tu get rid of it'' I can certainly relate to Thomas' description of being ill and hospitalized - the depersonalization, the game of cat and mouse that g;oes on with colleagues who are apprehenSive about caring for a fellow physician, etc. In Thomas' view, all medical personnel should be hospitalized, even if it's just with a case of the grippe, to identify with the utterly helpless position of a patient. House staff of vestervear will be amused with the irrevere;t poe~1s in the Appendix - "Allen Street," into which the morgue of the Massachusetts General Hospital opened. In my view, Lewis Thomas exemplifies one of the more scholarly people of our era; the man is honest, inquisitive, and writes in an extremely interesting fashion (much like ].K. Galbraith, without the arrogance). In fuct, it was his expertise with poetry as a house officer that may have prompted Franz Ingclfinger to have asked him in subsequent years to contribute a column in the cw England Journal. He has clcvcrlv demonstrated that meclicinc has passed fro1~ an era of sympathetic ignorance to one of depersonalized technologic excellence. He prefers the latter when he himself requires care. Recognizing the talents of such an individual, the Trustees of the State University of New York have appointed Thomas a University Professor without portfolio. We arc indeed honored to have such an individual on our fucultv. The Youngest Science requires two to three hours of reading time and is well worth it in terms of entertainment and education. It should be placed alongside Osler's Equanimitas as suggested rcacling for meclical students. " I haPe seen a lot of my inner self, mon: thmz most people, a1ui :~u'd think I would hm>egained some new insight, CJ>en some seme of illuminatimz, but I am as much in tbe dark as CJ>er." "Taking all in all, the hisrory ofhuman gm>enmzmts SU.!J!Jests tu nw that the 1111!11 of the earth haJ>e had a long enough nm at mmzing thmgs; tbeir record offol~l' is now so detailed and docummted as tu make an_1one ftar the fitture m their bmzds. It is time for a change. Put tbe women in chm;ge, I say." • - ROSS MARKELLO, M.D. Pmftssor of A nesthesiology �WE'D LIKE TO SEE YOU HERE BUFFALO PH.. ClAN Please send the latest information about yourself, together with a photo if possible, to the Buffalo Physician so your classmates can keep in touch with you. Use th~ c~:mve­ nient form on the back cover of this Issue. BUFFALO PHYSICIAN • 27 �THE JOURNAL of the American Medical Association Dr. John Talbott (above} and his wlte traveled tile u.s.. Central and South America, Euf'OIIe, and Asia In search of medical art to supplant the advertising that previously appeared on the covers of JAMA. (Right} The December 1, 1969 cover. Paul Van Hoyedenck 28 • BUFFALO PHYSICIAN Samples of Paul Van Hoyedenck's "cybs," the sculptured hand, legs and torso consisting of wheels, rods, nuts, bolts, and bits of electronic equipment, simulate the form and function of their natural counterparts . Whether conceived by the artist as components of a cybernetic man (p 1752) or as independently function ing entities, these metal and plastic creations project a disturbing image of a future surfeited with uncon · trolled devices. Planned control of medical, mechanical, and electronic devices is discussed on page 1745. �December 1, 1969 People John H. Talbott A traveling , skiing editor Vol 210, No 9 ~==--------------------------~ ~·------------------~-----------, EDIIOR'S NaTE: This article, written by Nancy Yams Hoffinanfur JAMA (May 20, 1983, Vol. 249, No. 19), was sztbstanticdly edited by Bruce S. Kershner fur publicatimt herr:. J Museum of Contemporary Art, Chicago ohn H. Talbott, M.D., has scaled the Andes, climbed the Colorado Rockies. Only last year, at 79, did he stop skiing ("Since I had never suffered a broken bone, I figured it was time to quit, not push my luck too far"). But he's still traveling, still lecturing. His bags are always packed and at the ready, just as they have been for years, whether for an expedition in 1929 with his Harvard Fatigue Laboratory to study the physiological effects of high altitude in Leadville, Colorado; for the International High Altitude Expedition to the Andes in 1935; for repeat physiological experiments in the California mountains 40 years later, or now, for trips to various places, to lecture and hold clinics on gout and arthritis. A perennial student as well, he graduated Phi Beta Kappa from Grinnell College in Grinnell, Iowa, his birthplace. He entered Harvard Medical School, Boston, in 1929 where he graduated magna cum laude and Alpha Omega Alpha. A lover of Manhattan's glitter, its museums and plays, Talbott interned at the Presbyterian Hospital in cw York, where he met his wife, Mildred, then a nursing student. After ten more years at Boston's Massachusetts General Hospital (MGH), with side trips for a Rockefeller Fellowship at Gottingcn, West Germany, in 1932, and a Harvard Fellowship in Innsbruck, Austria, in 1937, he logged five years in the Army. This was followed by 13 years in Buffalo as the first full-time chief o(medicine at the Buffitlo General Hospital, as well as a faculty member in that department in the then Universitv of Buffalo School of Medicine. He subsequently spent 12 years in Chicago as editor and editor emeritus of the Journal of the American Medical Association (JAM A). For the last 1 I years, he has been clinical professor of medicine at the Universitv of Miami School of Medicine in Florida. Everybody asks Talbott why he became an authority on gout. "When I joined the MGH staff as a Pel)' junior member; I was intrigued by metabolic disease, a consequence of my earlier work on acid-base balance in the blood with biochemist Lawrence ]. Henderson, godfather of the Harvard Fatigue Laboratory. He and David Bruce Dill, his technical directo[ were nw seminal influences. "At the MGH, Full~r Albright had staked his claim to most of endocrinology and to calcium and phosphorous metabolism; Walter Bauer made osteoarthritis, rheumatoid arthritis, and infectious arthritis his bailiwick. There wasn't much left over for me, except rare birds such as ochronosis and Tietze's syndrome- and gout." Practical as ever; Talbott chose gout. Since then, he has espoused controversial treatments for the condition. While he has now modified some of his recommendations of 40 years ago, many remain valid: restrictions only on such foods as liver, kidneys, brains, sweetbreads, and anchovies; and lots of fluids, including alcohol in moderation. "After all," notes T:1lbott, pragmatic as always, "most of my patients who drank wouldn't have stopped anyway. To this day, I have no proof that alcohol in moderation is deleterious." Talbott is particularly proud of the Harvard Fangue Lab whteh he helped found. "It happened once and will never happen agam. A. Lawrence Lowell, the president of Harvard, had a . vision of studying the phys10logy of fanguc as part of industrial medicine. The lab was funded bv the Rockefeller Foundation and tucked a;vav in the basement of the new Harvard Busii;ess School." The team examined all the environmental_ extremes_ assaulting man's frame: high altitudes, high humidity, high and low temperatures. In fuct, at Maclean Hospital In Waverly, Mass., 111 the carlv 1940s thev tried to shock schizophrenics' back t~ reaiity with hypothermia . It worked - but briefly, only during the emergence from the hypothermic state. As soon as their bodies returned to normal temperature, the schizophrenics reverted. T albott's work on environmental stress was Important to the military. In I951, he went on leave from what was then the University of Bufhlo Medical School to direct a military-civilian team in Korea. During the retreat from the Chosan reservoir, as many as 5,000 American combat troops were afflicted with frostbite, as were endless numbers of North Korean and Chinese Communist soldiers. Manv of the cncnw wore sneakers without socks in the bitter!~· cold Korean winter, when temperature~ dropped to -300F. "I saw more cases of frostbite than anyone else at the time, and I found out that' cortisone docs little for frostbite," Talbott savs. Was it difficult to go from Boston, the medical mecca, to Buffitlo? "Buffulo had much to ofter. They were going from proprietary medicine to full-time academic medicine and this was a challenge. As professor and chairman of the department, I enlarged my own field to encompass arthritis, not just gout. I recruited additional staff members, was given great leeway in emphasizing teaching and research. BUFFALO PHYSICIAN • 29 �We and our children liked Buffulo." Thlbott has two children: John, a psychiatrist at Cornell Medical Center, C\\' York City, and president-elect of the American Psychiatric Association (" He's written a lot more than I had at his age"), and Cherry, a computer saleswoman in California. While in Buffulo, Talbott was asked several times to be dean of the medical school. He always turned it down: "I was not interested in d~anly duties. Deans don't sec sick patients; deans don' t teach." A firm believer in regular daily exercise, Talbott shoveled snow in the winter and built and remodeled houses in the summer when he lived in Buffulo. On moving to Chicago, he sold the fumily car and took a 20-minute jaunt to work. ow, at 80, he rides a stationary bicycle morning and night. At 5'7" and I30 lbs., thinner than he was 10 years ago, Talbott looks frail but remains the same hardv Midwestern reed. Also while i;1 Buffulo, Talbott plied his other crafts, medical writing and medical editing. For I 2 years, he was editor of Medicine, "one ofthe best journals of internal medicine in the world." Then, in 1959, the AMA asked him to be editor ofJAMA: "Of course, I said 'Yes.' In those days, not so much today, there was only one fournal at which you could be eclitor fi.III-time. That journal ,;,as ]AMA. I was 57-years-old. It was time to move on. "I had 12 good years there [ten as editor, two as editor emeritus]. And I ended up with a fine staff: Lester King, the book editor who gave up his teaching at the University of Illinois to come with us; Henry Ricketts and George Fire, both of whom w~re at Harvard with me; Zenanas Danilcvicius, not a Harvard graduate as were the other three, but a Dachau Camp survivor, an Old World scholar fluent in six or eight languages; Sam Vaisrub, another European who came to us rrom Winnipeg, and, of course, Therese Southgate, an outstanding medical editor." 0 uring his ]AMA tenure, Talbott changed JAMA 's covers, which previously had been emblazoned with advertising, to carry reproductions of medical art. He dislikes ]AMA 's current covers, because their art is "general," rather than specifically meclical: "Mrs. "L1lbott and I looked high ;nd low in this countrv, in Central and South America, in Europe and Asia for medical art. We were succcssfi.II. We retrieved some 300 pieces of meclical art for JAMA covers." Talbott continues to be active in his profession. "When I left the AMA, I had several things I wanted to do. ow I' m doing them. I started my journal, Seminrm in Arthritis ami Rheumatism, 111 1970; not long after I became editor pro tempore of Merck The December 29, 1969 cover; a van Evck. 30 • BUFFALO PHYSICIAN Manual and now I continue on as a member of the editorial board. Surely, I had not planned to come to Florida. We had decided to retire to Boston, when Drs. Howell, Papper, and Harrington invited me to the University of Miami as clinical professor. You know, it was fun taking my Florida licensure exams after all those years, being on the other side of the desk - although I don't think peer review is worth the cost to the profession.'' Talbott stops, then says: "One thing must be understood. I do not get a salary. I do not want a salary. I teach, I sec patients, I write, I edit, but when I'm invited to lecture in Kyoto or Syd1iey or Seoul, I can go when I want." Talbott also maintains a small private prac.- tlce. "Until we moved to this retirement community at DelRay Beach six months ago, I was in the office every day by eight o'clock and worked all day. Now, I go to the office only one dav a week." I~ conclu;ion, Talbott reminisces, "Life has been good to me. It's a long way from Grinnell to DelRay, and it's been a good • journey, every step of the way." KUWAIT UNIVERSITY (IN KUWAIT, ARABIC GULF) organized an International Meeting of Diagnostic Imaging and of Laboratory Medicine, February 19-25, 1983. Besides European and Egyptian scientists, four U.S. scientists were invited. Two of them were from UB and Eric County Medical Center, Dr. George Alker from the D~partment of Radiology and D r. Desider A. Pragay, Department of Biochemistry and Chemistry Division of �People Erie Count\' Laboratories. The U.S. 'scientists all gave lectures in respective fields and all participated in scientific discussions during this one week meeting. • DR. PAUL DAVIS, PROFESSOR OF MEDICINE, HAS been awarded a SI09,700 research and de,·dopment grant from the Veterans Administration to study a mechanism by which thyroid hormone stimulates an enzyme to transport calcium from red blood cells into plasma. Dr. Davis is director of endocrinology at Erie County Medical Qnrc~ • D r. Richard Weiss, clinical assistant professor of orthopaedics, on "Occult Pain in the Professional Athlete"; Dr. Robin Bannerman, director of Human Generics, on Jacobsen's Disease; D r. Craig Blum, assistant professor of pediatrics, on "Boyd Amputation in Children"; D r. George Alker, acting chairman and clinical professor of radiology, on "CT Scanning of the CerYical Spine"; D r. G len G resham, chief of &habilitation Medicine at ECMC, on the Spinal Cord Injury Unit at ECMC, and D r. P.J. Davis, chief, Division of Endocrinology, on the current status of the treatment of osteoporosis. • Dr. Grant is also depurv director of the Community Mental Health Qnter ofBuffillo General Hospital. A graduate of UB, she sen·es as chair of the Erie Count\' Wclfure AdYison• Board and recently was ' 'icc p~esident of the Buftalo Ch;pter of the Amencan Heart Association. DR. DONALD L. EHRENREICH HAS BEEN APPOINT· ed acting head of the department of neurology, effective August I. An attending neurologist at Buffitlo General Hospital, Dr. Ehrenreich is currently a clinical assistant professor of neurology at UB. He succeeds Walter Olszewski, M.D. Follo\\~ng his post-graduate training in medicine and neurology at Buffillo General Hospital, Dr. Ehrenreich completed a clinical fellowship in neurology at the New England Medical Center Hospital in Boston. He is a diplomate of the American Board of Psychiatry and Neurology, as well as a member of various other professional • organizations. DR. KRISHNA KALYAN·RAMAN, UB ASSOCIATE PRO· fessor of neurology from 1971 to 1976, was recenth• invited to be an examiner for the Ameri~an Board of Psychiatry and Neurology. Dr. Kalyan-Raman is currently professor of chnical neurology at the Uni,·ersiry oflllinois College uf Medicine ar Peoria. He is also a Fellow of the American Academv of Neurology and the American College of Physicians. He recentlv published two articles, one on "Localized Myositis Presenting as Pseudothrombophlebitis" in ArtiHitis and Rlmm111tism, Vol. 25, No. 11; the second, '' M )'Opathic Arthogryposis With Seizures and Abnormal Electroencephalogram" in rhejounllllofPedintrics, Vol. 100, No. 2• DR. WILLIAM V. KINNARD, JR., BUFFALO GENERAL Hospital president, was elected chairman of the \-\'estern New York Hospital Association, Inc., at their annual meeting on June I 5, 1983. He is a UB clinical associate professor of medicine. • DR. EUGENE MINDELL, PROFESSOR AND CHAIR· man of the Orthopaedics Department since 1964, has been recently elected president of the American Board of Orthopaedic Surgerv and was JUst appointed the new associate editor of the ]om' nat of &ne aud Joint Smge~y. A University of Chicago Medical School graduate, Dr. Minddl serves as head of the Department of Orthopaedics at Eric County Medical Center (ECMC). His major interests haYe been 111 the field of musculo-skcleton pathology, bone tumors and orthopaedic resident education . As host of the 27th Annu.1l Meeting of the North American Orthopaedic Society, September 21 -24, Dr. Mindel! also spoke on the "Present Status of Surgical Treatment of Bone Sarcoma" and "The Effect of Radiation on Bone &pair Potential." Dr. John Naughton, dean and professor of the School of Medicine welcomed the socicrv and spoke on "Exercise~ in Cardiac &habilitation." Some of the other 20 speakers included: Dr. Clayton Peimer, assistant professor of orthopaedics, who spoke on the topic of nerYe repair; Dr. Peter F. Beagan Dr. E.ll. Mindel/ OR. HARVEY D. PREISLER, RESEARCH ASSOCIATE professor of medicine and Roswell Park Memorial Institute researcher, recciwd .1 $248,204 gr.mt to determine the response of extremely high doses of Ara-C in inducing remission of acute myelocYtic leukemia. Results to date arc promising, says Dr. Preisler, who is chairman of the rhrec-vear studv. Institutions from around the nation ,;·ill send {n their laboratorY data to Dr. Preisler, who will usc computers to jnalvze the inti>rmation. His consortium grant is unusual because it was awarded from manv institutions. • DR. PETER REGAN, UB PROFESSOR OF PSYCHIA· rrv, and Dr. Ellen Grant, clinical instructor of psychiarrv, ha,·e been appointed by Governor Cuomo to the select Commission on the future of the Stare/Local Mental Health Svstem. Dr. &gan also sen·cs as associate chief of Staff for education at \'ererans Administration Medical Center. The commission is charged with rc,·iewing the state's current mental health S\'Stem and preparing recommendations that will clearlv define the roles and responsibilities of stare and local gm-crnment in the planning, regulation and pro,·ision of mental health sen·ices. It will also examine current mechanisms for coordinating and funding mental health sen·ices and de,·ising recommendations for new financing methods that "ill promote effective and efticicnr care. Dr. &gan is also currenrlv the UB Medical School's director of health pohcv stud1es. DR. DONALD P. SHEDD, RESEARCH ASSOCIATE pr?fessor of surgery, was in the &public of South Afnca on a medical lecturing trip in SeptemberOctober, I 983. He participated in a meeting in head and neck cancer 1n Pretona and a seconri meeting in S~m Cin·. Dr. Shedd's assignment was as guest professor at the Uni,·ersitv of Pretoria. He gave lectures on cancer of the tongue and on cancer of the larynx. The duration of the trip was rh_ree weeks. Dr. Shedd is chief of the Department of Head and Neck Surgen: and Oncology at Ro>well Park Memon.1l Institute. • DR. S. MOUCHLY SMALL WILL BE RETIRING FROM the Department of Psvchiam· in 1984. At that rime, he will become p~ofcsso.r emeritus. In vie"' of his long and _distinguished scrYice to rhe Department of Psychiatry, School of Medicine, and the UniYersiry, a fund in his name is being established. A portrait of Dr. Small will be painted and displayed in an ,1ppropriare place of honor in the Medical School. The Department ofPsvchiarn· would welcome contributions from Dr. Small's former students and colleagues. Checks may be made payable to: S. Mouchly Small Fund, Department of Psychiatry, UB, and fonvarded to Dr. Man•in I. Herz, Department of Psvchiam•, 462 Grider Street, Room 575, Buftalo: l\ew York 14215. • DR. JOHN H. WARFEL, ASSOCIATE PROFESSOR OF anatomical sciences, was cited by the Chapel of the Four Chaplains in Philadelphia on September 25 for his dedicated sen·ice to the Volunteer Services for the Blind . Dr. Warfel has for almost 20 \'Cars sen·ed as narrator for recorded periodicals for the ,·isually handicapped. The Chapel of the Four Chaplains was established and dedicated bv President Truman in 1951 to commemorate the four military chaplains who ga,·e their )i,·es aboard a torpedoed ship in World \'\'ar II. BUFFALO PHYSICIAN • 31 �Alumni Message from President of the Medical Alumni Association Dear Colleagues: Now that the winte~· season is fast approaching, you should be planning an exciting getaway from the cold and snow in beautiful Puerto Vallarta, Mexico, at the Annual Medical Alumni Symposium, Februan 13-20, 1984. As in the past, topus ofgenml interest to all physicians will be presented with 18 houn ofCategory 1 credit for those attending the program. For further infonnation, please call the Alumni Office at (716) 831-2778. Another eJ>cnt to marl? in vour calenda1· is our senior class reception ag'ain being held at the love~v Albright-Knox Gallery. This year it will talu: place on Sunday, April 8. Attention reunion classes of1929, 1934, 1939, 1944, 1949, 1954, 1959, 1964, 1969 and 1974, as well as all alumni. Be sure and plan to attend Spring Clinical Day being held at the Man·iott hm, Satm•day, Mav 5, 1984. 1 hope to see and meet many ofyou at the above eJ>ents. Thank you Joy supporting yow· alumni association. Sincerely, Eugene Michael Sullivan, M.D. '63 President, Medical Alumni Association Class reunion chairmen: (top row, 1. to r.J CIVIle GeoiTJe '29; VIctor COhen '29; J. Edwin Alford '34; Harry G. LaFoiTJe '34. (2nd row, 1. to r.J GeoiTJe C. Brady '39; James R. Sullivan '44; Julia Cullen '49; Edwald A. Dunlap '54. (31d row, 1. to r.J Daniel C. Kozera '59; J. Frederick Painton '64; Richard E. Wolin '64; William MaJor '69. (4th rowJ Paul H. Wlellblenlec '74. Class of 1929: Dr. Clyde George Looking forward to our 55th reunion! Dr. Victor Cohen "We few, we happy few, we band of brothers" (Shakespeare, King Henry V) will meet encore 1n 1984. Do vour best to be with us. . Class of 1934. Dr. J. Edwitz Alford We arc 38 strong after 50 - We expect you all at the reunion. It should be bigger and better than ever. You will learn that S NYAB is making great strides for the future, particularly your Medical School. Dr. Harry G. LaForge If there was no UB there'd be no me M.D. Class of 1939: Dr. George C. Brady Our fortieth was great! Let's try again for our forty-fifth I Dr. Everett H. Wesp '39 Class of 1944: Dr. James R. Sullivan '44 Hope to sec all the classmates at &union. Class of 1949: Dr. Jttlia Cttllen '49 It's a date - to celebrate! 32 • BUFFALO PHYSICIAN Class of 1954: Dr. Edward A. Dttnlap We made 30 years. Tot badl Dr. Edward A. Rnyhill Class of 1959: Dr. John J. McMah011 Please come to our 25th reunion and renew old friendships. Dr. Daniel C. Kozera Class of 1964: Dr. J. Frederick Paintotz Dr. Richard E. Wolin As Co-chairmen of our 20th &union Class of 1964, Richard Wolin and Fred Painton are looking forward to meeting each of ~'OU on May 5, 1984, Spring Clinical Day, to renew old friendships. Class of 1969: Dr. William Major Hoping to have a large turnout of both in and out of town classmates. Class of 1974: Dr. PatJ-l H. Wierzbieniec Here's hoping that we can renew old fiicndships and sec how time has changed the faces . Dr. James A. Smith �Classnotes ~ O'Gorman blends clinic & farm ..: ~ 0 z 0 1- 0 He also owns a railroad station W By Bob Buyer when he was younger, Kevin N. O'Gorman was tempted to become a physician like his futher and a furmer like some of his Eden neighbors - and he even flirted with a railroad repair caTeer. As a man, he has been strong and lucky enough to be able to satisfy all his youthful notions. When decision times arrived, he adopted a tactic made fumous by a besciged general. He attacked in all directions . . Today, Dr. Kevin . O'Gorman is protcsSlonallv at home in a cattle barn, a meadow, a corn' tield and a physician's examining room and, what's more, he spends much of his working time in a railroad station which he owns. The railroad station on Depot Street in dowhtown Eden next to the Buffillo Southern Railroad tracks is where Dr. O'Gorman set up his medical offices. Two years ago, he bought and rebuilt the Eden Center station that except tor some garage service had been idle for vears. The station has n~w flooring, steps and ot: ficc partitions. But the Eden Center station sign, the railroad lantern fixtures and the grilled ticket window under the Railwav Express Agent sign leave little doubt abou't the building's first function or about Kevin O'Gorman 's railroad bias. O I Cl. f the new Buffillo Southern freight lines whose trains rumble bv the station-office several times a week, D~ O'Gorman said, "I'm not an owner, just an enthusiastic supporter." At 39, Dr. O 'Gorman has shown himself to be a heavyweight inside a 136-pound frame. After graduating from Canisius High School, he went to Cornell Universitv and majored in agricultural economics. Afterwards, he earned a master's degree at the UniV<:rsitv of Detroit. Then h~ spent four years in the Navy and saw service in the Vietnam War. A civilian again in 1972, he turned to medicine. After some academic brushing up at Canisius College, he entered the UB School of Medicine and graduated in 1978. He took his residency at Buffillo Mercy Hospital and while there acquired his railroad station . After a five-month remodelIng eftorr, Dr. O'Gorman last year opened hls office and began his general and internal medicine practice. Along the way, Dr. O'Gorman came to know the Feaslcv fumilv, Eden dairv furmcrs. Brothers Bill and Bob Fcaslev milk '200 cows and need a constant source ~f replacements. B eing men of parts themselves - Bill, a former supervisor, and Bob, a former Farm Bureau president, thought that Dr. O'Gorman, then still in medical school, could manage their replacement operation. In 1977, the Feaslcys and the O'Gormans acquired a !25-acrc farm on a high spot oft' Eden's Sandrock Road. Dr. O'Gorman and his wife, the former Joyce Henry, own the large home and two barns and some of the land . With the pasture and some additional land the O 'Gormans annuallv raise about 80 Fcaslcv Holstein heifers u.ntil thev are ready to )oin the milking team. . "Farming is my relaxation," Dr. O'Gorman said. When his medical obligations are met (they never totally are as his belted telephone beeper shows), he's oft' to Sandrock Road working crops and animal care. Dr. O'Gorman furms evenings, weekends and days off. Joyce O'Gorman handles much of the morning animal feeding, operating the mechanical silo feeder, and keeps things going at home while her husband practices at the railroad station or at a chmc. M rs. O'Gorman also monitors son Brendan, who has more to say than most 2 \/, -vcar-olds, and the family newcomer, 'Katherine, Brendan's Augustborn baby sister. "Joyce was in the hospital having Kathcnne dunng the Ene Countv Fair," Dr. O'Gorman said. "Between ha~·ing office hours, takmg care of the _furm, seeing Joyce at the hosp1tal and runnmg to the Fair, lite was pretty hairy for a fl:w davs," he concr~d. · While his wife was presenting Dr. O'Gorman w1th the1r first daughter, judges at the Ene County Fa1r were awarding him a tirst pnzc for the s!lage corn he had grown. If ra1smg h1s own fumily and the Feaslcvs' cattle fumily aren't enough, the O'Gorm~ns also have a tlock of Dorset sheep. "We usc the lamb for meat and sell some to friends" Dr. O'Gorman said. "Our flock began wi~h three, now \\'e have 35 ." The O'Gorman cattle raising schedule is flcx!blc, not casual. He plows, fits and plants when he can, which is often. The Feaslev brothers fill in at other times. "I take a fe\~' days off at planting time and hope that it doesn ' t rain." H e frequently,~alks with the Feaslcys, his da1rv alhes. If thev want the feed it's theirs,' ; Dr. O'Gorman 'said. "If not, w~ sell it. We usually figure things out in January." From the O'Gorman home, handsome beside a large box elder tree, the barns, the pasture and a small orchard full into view. The high terrain commands views that stretch from the mists arising from Niagara Falls to the lighthouse at Point Abino on Ontario's shores. The vista complements Dr. O 'Gorman's broad view of what life can offer. • (Repri11ted witb permission frvm the Buffolo News) . BUFFALO PHYSICIAN • 33 �-- - - ---------------------------------------------------------------------------· Classnotes ROBERT MASON JAEGER , (M'45) • chief of neurosurgerY at Lehigh Valley Hospital Center in Allentown, Pennsylvania, has been elected president of the PennsYlvania Medical Care foundation, a' resource center for Pennsylvania physicians on alternative methods of health care deliverY and financing, headquartered in Le-moyne, Pennsylvania. Dr. Jaeger is also serving as president of the Pennsylvania Neurosurgical Society for 1982-83, and has been elected to a three-year term as a corporate professional member of the Pennsvlvania Blue Shield. Dr. Jaeger resi-des in Allentown with his wife, Sibvl, and three children, and maintains a private practice there. • GUY L. HARTMAN (M'46) • recenth• gave the keynote address for tw~ meetings: The Third Annual MultiDisciplinary Child Abuse Symposium and the Spotlight on Parenting for the Riverside YWCA. He has also gi,·en television interviews and talks on poisonous plants. A pediatrician, he lives in Southern California. • HILLIARD JASON (M'58) • just published a book with his wife Jane, entitled "Teachers and Teaching in U.S. Medical Schools," published by Appleton-Century-Crofts. The book presents the findings and analvsis of a major study of full-time teachers, with a sample drawn from everY medical school in the U.S. Dr. jason is director of the National Center for !'acuity Development and professor of clinical psychiatry and furnil)' medicine at the University of Miami. • PAUL J. LOREE (M'62) • a UB clinical instructor, has been elected chairman S of the Ophthalmology Section of the Medical Society of the State of New York. A residen-t ofTonawanda, New York, he is also director of the Low Vision Clinic at the Eric Count\' Medical Center; attending ophthaimologist at Batavia State School for the Blind and DeGrafr Memorial Hospital; chief of ophthalmology at Kenmore MercY Hospital; and director of the New York State Ophthalmology Society. WALTER A. CERANSKI (M'64) • is an associate professor at the University of Arizona School of Medicine. He · is also a resident in St. joseph's Hospital where he is board-certified in fumily practice. A Phoenix resident, he is continuing medical education chairman of the Arizona Chapter of the American Association of family Physicians. • GEORGE R. COHEN (M'64) • who resides in the Lm Angeles .m:a, recently became a l'cllow of the Internati~nal College of Surgeons and the American AGJdenw of Facial Plas- Jason '58 tic and Rt:constructi\·e SurgerY. He is an assistant clinical instructor at Har- even UB professors, students or their relatives were among victims on board the Korean A1rlmcs plane that was shot down bv a Soviet MiG tighter on September I' 1983. ri\'C of the se,·en victims had links to the UB Medical School. Dr. A he Park, clinical assistant instructor of medical technology, her plwsician husband Min Sik, their daughter, Sarah, 4, and a son, Graham, 2 wcr~ on their wav to visit Min Sik's fumilv in Korea for a 10-dav vacation ":hen the Boeing 747 wa; shot down ncar Sakhalin, J Sovict-ocCUf;ied isl.md north of japan. Medical Technology Department spokespersons described Dr. Park as " a verY lovelY, charming person, who was a pleasure to work with and was very wefl thot;ght of by the staff and her patients." IronicallY, Dr. Park and her husband, both graduates of Korea Univcrsirv Medical School in Seoul, had just recei\'Cd word that thev had both passed their board examinations for licensure in 1'/c" York State. Ahe Park was graduated from the Korean medical school in 1977 and entered a UB residency program, which she would have completed next year, in April, 1980. She was doing her rcsid~ncy at Eric Count\' Medical Center. Min Sik had completed a therapeutiC radiology program at Roswell Park Memorial Institute, but was not currently in practice there at the time of the tragic incident. Both Ahe and Min Sik were reported to be in their earlY 30's. She is survived by fumily members currently residing in the Los Angeles area; his 34 • BUFFALO PHYSICIAN bor General Hospital - UCLA and is board certified in otolaryngology and head and neck surgery. • DENNIS PERRY DuBOIS (M'70) • of Williamsville, N.Y., has been elected to l'ellowship in the American College of Cardiology, a society with 12,000 members. Dr. DuBois, a graduate of Wagner College, New York Citv, is currentlY director of coronary care at B~1ffalo General Hospital. • DANIEL J. MORELLI (M'74) • clinical assistant professor and former medical director of the l'amilv Medicine Center at Millard Fillmo~ Hospital, has assumed the responsibilities as vice chairman of UB's Department of Family Medicine. He completed his postgraduate studies at Deaconess. • NORBERT SZYMULA (M'74) • clinical assistant professor at UB, has been named the assistant chairman for public education for the American Acadenw ofOtolaryngologic Allergy (AAOA ), headquartered in Washington, D.C. In this advisory role, Dr. Szymula designed an information pamphlet for the national societv. Dr Szvmula has been active on th~ speake;'s trail with lectures at the annual meeting of AAOA in Anaheim, Calif., in October and at St. Petersburg, !'lorida, Temple Univcrsin·, and HersheY, Pennsylvania. This November, h.e lectured at Buffulo's Veterans Administration Medical Center and then flew west again to speak about allergies at Northwestern UniversitY. In a related matter, Dr. Szvmula has had a paper about mold ~llergy accepted for publication .by the jour1Jal of Clinicnl Ecology. It should be published by the end of this vear or early 1984. • RUSSELL VAN COEVERING II (M'77) • announces the birth of his second daughter, Rose Ann. He recently attended the SYNTEX Investigators meetings on Triphasic and Biphasic Birth Control Pills in San francisco. He is a UB clinical assistant 111structor. MARK S. GLASSMAN (M'78) • has been appointed assistant professor of pediatrics at the Yale School of Medicine, ,titer completing his fellowship in pediatric gastroenterology at Children's Hospital of Philadelphia last June. He is a staff pediatrician at Norwalk Hospital, Ct. Dr. Glassman, who lives at 167 God!Tcv Road East, Weston, Ct. 06883, married Ctrol B. Shapiro in October 1982. GREG ROBERTS (M'78) • a psychologist, is currently in private practice in Sioux City, Iowa, where he resides. • JOHN P. SCANLON (M'78) • n:ccmlv joined Share-Health Plan of St. Paui, Minnesota, as an internist. He lives with his wife Connie and infunt daughter Erin. DOUGLAS H. MOFFAT (M'79) • clinical assistant professor, has been appointed to the position of medical director of the l'amilv Medicine Center at Deaconess' Hospital. l'ollowing completion of a residency in l'amilv Medicine at Deaconess, he entered - into private practice 111 Western Ne" York . • Deaths fumily is living in Korea. The fumily resided in Eggertsville. A lso aboard the plan was Chin Fan Kung, 60, futher of Dr. Hank F. Kung, . assistant pro!Cssor in the Department of Nuclear Medicine and srafr physicran at Veterans Administration Medical Center, and of Peter F. Kung, a graduare .;tudent 111 the Computer Science Department. _ . A Citizen ofTal\van, where he was a high school teacher, Mr. Kung had \'!Sited h1s sons for the summer and was returning home when he was killed. Another \'ICtlm of the Korean airplane tragedy was UB student \Voon Kwang S1ow, 22, who was graduated this spring with a double major in computer science and electrical engineering. O~e of ten children, he was returning to his homeland of Malaysia to estabhsh illS own software business. He had not seen his fumily in four years. While 111 the United States, his host; were members of the fumilv of Dr. Charles Fourt~er, UB associate professor of biology and associate dean of the Faculty of Natural SCiences and Mathematics. Fourtncr said that after deliberating whether or not to remain in America to pursue h1s master's degree, Siow decided that he missed his fumilv and wanted to go home. ' S ayuri Mano, 2~ , of Nagova, Japan, was the seventh UB-associatcd ,·ictll1~ of the Soviet attack on the plane. She had studied at B as a fine arts maJor for two semesters in 1982, and had attended a 12-week summer �-------------------------------------------------------~~~ Deaths I course in the Intensive English Language Institute in 1981 . Miss Mano transferred to Manhattan College of Fine Arts in New York City last full and received her degree there this summer. She was returning home aboard Flight 007. Kore.1n Airlines flights to Seoul arc popular among persons trawling to the Orient, cspeciallv Japanese. Tra,·clers can save about $40 bv taking a KAL flight to Seoul, then a short flight to Tokyo. Had the incident happened a week earlier, a Uni,·crsitv official remarked, cn:n more Buffulo students ma\' have been lost, since ab~ut half the graduating class of the summer Inrcn·sive English Language Institute program returned home then bv KAL to Seoul. • DR. WILLIAM B. CLAYTON Ill (M'77) • died of germ cell carcinoma on Aug11st 17 in his home in Appalachin , N.Y. He was 32 years old . He attended Union College in Schenectady where he was an outstanding studcnr, graduating magna mm !nude with honors in biology, a member of Phi Beta Kappa and Sigma Xi and a Nott scholar. After Jca,·ing Buffllo, he completed the fumil)' pr.Ktice residencv .md a teaching fellowship in fumily practice at Charles Wilson Memorial Hospital in Johnson Citv, N .Y. He then served as assistant director of the Familv Practice Program at \\iilson . . This past vcar he was chosen as the "Omstanding Teacher, Role Model , and Menror" bv the fumily practice residents (an annual award). He is survi,·ed by his wife, Eileen , and his daughter, Katie (3 \12 vcars old).• DR. EDWARD F. DODGE (M'28) • who practiced medicine in Niagara f.1lb ti>r 38 years, died September 19 .lt Sauer Memorial Home in \\'inona , Minn., where he lived for the last six \'Cars. A retired physician and surgeon, he practiced medicine in Niagara falls from 1929 to 1967 and was on the stafr o f Mounr St. M,m•'s Hospital and Niagara falls Memorial Medical Center He was medical direcror tor KimberlyClark Corp., Niagara Falls for 32 years. He enliHed as a Liemcnant Comm,mder in the U.S. ~an· during World W~r II. Bdo re graduating from the UB Medical School he .mended Niagara Falls area schools and the Universin· of Notre Dame. He was a member of St. Marv'; Church in Winona, the Niagara f.11ls Country Club, the Niagara Club, and the Youngsrown Yacht Club. The longtime stafr member at Mount St. Marv's Hospital was remembered as a fine fumily physician who served his patienrs well, hospital Chief of Staff Dr. Lester Schitt' said on beh.1lf of his ;t.lfr. Dr. Dodge, an avid goiter, was also remcmbcn:d as h.l\'ing \er\' loy•1l p.ltients because of his service and friendship, Dr. Schilt' said . He married Agnes Dell Dodge, who survi,·es, on September 25, 1928 in Niagara falls. He is also survi,·ed by a son, three daughters, 16 gr.mdchildren, and 12 great-grandchildren (!Tom the Ningmn Falls Gazette, 9/27/83)• DR. JACK C. FOLEY (M'46) • died on June 27, 1983, in Orm·ille, C.1liti>rni.1, where he lud practiced radioi<Jg'' since 1955. He lcaws a" it<: & fi,·c children . • DR. CHESTER J. KAMINSKI (M'38) • .1ssist.111t clinical professor of obstetrics & gynecology, died of cardiac arrest in Rochester, Julv 6, 1983, "hile ,·isiting his daughter~ Dr. K~minski, 69, was also on staff at Eric Counn· Medical Center (since 1973), Children's Hospital, and Millard Fillmore ·Hospital. A nati,·e of Buff.do, he m.1intained .1 pri,·ate practice on Bailey A\enuc. He was a fellow of both the American College of Surgeons .md the Americ.1n College of Gvnecologists. In addition, he was a member of the Butblo Obstetric .md Gvnecological Socictv and the medic.1l societies of Eric Cou ntv and Ne\\; York State. . An. acti\T member of the East Aurora Countn· Club, he is sun·i,·cd bv his wife Eileen (UB School of Nursing, '44), three d~ughters, a son, five grandchildren and a brother. • SCOTT A. LANE • UB medical studenr was killed in a motorcvcle accident on August 20 in Port Col borne, Ontario. A native of Buffulo, .he was born • January 4, 1962, the son of Alan and Joyce Ellis Lane. ~R . WILLIAM R. LEWIS (M'32) • of Lewiston died September 25 in Niagara falls Memorial Medical Center after a shorr illness . , He was born in Freeland , Pa. , and was a longtime rcsidenr of the ~i.1gara falls area. Dr. Lewis started his medical practice in 1933 and practiced general medicine tor 15 years before speciali zing in ophthalmologv from which he rcnrcd in 1979. He sen·ed 2 Y, vcars in the Arnw Medical Corps during World War II. He was a past presid~nt of the Niagara County Medical Society. Dr. John Armeni.1, a t<:llow ophthalmologist in the ,1rea, said Lc\\IS h.1d Members of the campus Korean community protest downing of civilian airliner by Soviets. the wide respect of the ophthalmologists in Western New York . "He was an cxtremelv conscientious doctor." He is su;_·i,·cd b\' his wif~, frances (Ardan ) Lewis; a d.lLighter, Mrs. Edw.lrd (M.ugaret) ~dgers ot Lewiston; a son, William R. Lewis, Jr. of Poughkeepsie, N .\.; illS SISter, Mrs. Norman (Martha) MacAskill of Niagara falls; and six grandchildren. DR. ROBERT R. NORTHRUP • prominent local physician from the Chautauqua Counn· town of Westfield , N.Y. died June 17, 1983 at age 75. His funeral was marked by an m ·crtlow crowd and an outpouring of altection tor the doctor who was well-known bv his communitv and noted for his vibrancy BUFFALO PHYSICIAN • 35 �Deaths and chantable acttvirics. Not long before his death, he was honored with rwo awards. The Medical Society of the State of New York, at irs !76th Annual Convention,. presented him with an award commemorating his half-century of serviCe to hrs patients. A month after that, We>tficld Rotary Club made him a Paul Harris Fellow, the highest honor the club can bestow 'o n a member. He was chosen because he was instrumental in establishing Westfield's first hospital in 1941; he also delivered irs first babv. A graduate of both Cornell and UB (M'32), he. won the Gibson Anatomical Award and Roswell Park Surgery Award whrlc a student here. He was a member of the Alpha Omega Alpha Honorary Medical Society and 1 u Sigma Nu Medical Fraternity. Shortly after completing his internship in BuffiJo, he mm·ed to .'v\'estficld. There he set up general practice and, except for three years ofser.'ICe dunng World War II, remained for the rest of his life. Known for his love of singing, he headed his church's choir and always led his fraternity organizations in song. With an abundance of humorous experiences during his 50 vcars of doctoring, Dr. orthrup shared one during an inter.·iew with the Westfield Republimu. "A woman came uno my office complaining of a backache. So I told her to stand up, went around to her back and pulled up her skirt. 'Where does it hurt~,' I said. • p here,' she said, pointing to her neck." Dr. Northrup also scr.·ed his community as a member and past pn:sident of the Westfield board of education for seven \'Cars. He assisted in the building of the present-day Westfield Acadm1~· and Central School. He was .1 member of the AMA, life member of the Medical Socierv of the State of Nc\\ York, a member of the American Acadcnw of Familv Pl;vsicians, past president of the Chautauqua County Medical Socicrv and fo~lll­ ding member of the Chaurauqua Count\' Mental Health Board. Dr. Northrup is sur.·ived b)' his wife Berry, two daughters, a son and a sister. • DR. HAROLD WASS (M'38) • 68, died on May 21. A Buffillo area resident, he was a clinical instructor at UB and associate in surgery from 1.961 to 1974. • DR. OLE HOLTERMANN • UB research assistant professor in microbiology and chief of Roswell Park Memorial Institute's Dermatology Department, died of cyanide poisoning October 14. Police reported the death of the 57-yearold Nor.vegian citizen as a suicide. Dr. Holtermann \\JS a cancer research dermatologist .lt the insrirure 'incc I 970 before r.1king over the dermatology department this year. After recci1·- ing his M.D. from the University of Copenhagen and his Ph.D. from the Universirv of Oslo, Nor.vav, he settled in the U.S. where he became assistant professor of microbiology at the University of 1 orre Dame. A spokesperson from the institurc said Dr. Holtermann was well liked and respected by fellow staffers. DR. MAX CHEPLOVE (M'26) • Medical pioneer and clinical professor emeritus died at age 81 on September 6 in Buff.J.lo. A prominent and dedicated phvsician for 54 years, his repuration gained him numerous honors and a devoted following of patients. He was a former chairman of the Department of General Practice at Millard Fillmore Hospital, as well as former president of the Eric County Medical Society, which he helped found. Dr. Cheplove was. named Erie County's" Family Doctor of the Year," a Bttjfoki Nell's "Ourstandmg Cmzen," both in 1968, and received the Samuel P. Capen Award for outstanding services to B bv an alumnus in 1970. While he was alive, the Eric County Chapter of rh~ New York Stare Academy of Family Plwsicians established the Max Cheplovc Annual Award for important contributions to fumily medicine. The death of Dr. Chcplove, who was the classical image of the oldfashioned fumily doctor, was considered by the Buffoki Ne~P.< to be the close of an era. Dr. Herbert Joyce, professor of fumily medicine, wrote of him sl~ortly before his death, "To me, you have always been the epitome of the tnre fumrly doctor- kindly, understanding, compassionate and devoted to your fumily and our profession." He continued, "So many of the ills that bcfull medicine in these tortuous times would nor exist if all physicians would emulate your pattern of professionalism ." . Despite a stroke and cancer, Dr. Cheplove remained busy and acm•e, visiting shut-in patients until he entered the hospiral. Two weeks before his death, he testified at a legal hearing ro help a cardiac patient get her Social Security benefits reinsrated. As word of Dr. Cheplol'e's weakened condition spread, people, many who were life-rime patients of his, flocked to his office. One patient ga1·e him a rose for every day the doctor was in the hospital. He was considered to be a medical pioneer because he kd the local tight to make t:~mily practice a highly respected subspecialrv. He held top local and state posts in rhe American Academy of General Practice and the American Academy of Family Physicians. Sur.·il'ing him arc his wife Svlvia (Cohen), one daughter and three grandchildren. • Calendar DIVISION OF COMPUTER MEDICINE OF THE DEPARTMENT OF FAMILY PRACTICE MICRO-COMPUTER COURSE • Course II (Advanced), Monday, Fcbruar.· 13, 1984, to Thursdav, Februa~· 16. 6-9 p.m. each da;•. Course II co1·crs derails of com purer hardware, including CPU3, memory, hard and floppy discs, printers, ere.; advanced programming in BASIC; and the CP/M, MP/M, and OASIS operating systems. ~imi~cdro scl'cn participants. $200 fee. For mformarion , conracr Holmes or Pam at 716-897-2700. DEPARTMENT OF PSYCHIATRY CONTINUING EDUCATION PROGRAM • Gmnd Founds: January 6, !984, "Children:s Fear of uclcar War: An Underestimated Clinical Factor~" Andrea JJcobson, M.D., Ph.D., moderator, assistant professor and d1rector of fumilv rherapv, UB; January 13, "Pe~onal Autonomy and Psychological Well-Being in Late Adulthood," Irene Hulicka, Ph .D. , proBUFFALO PHYSICIAN fcssor, State University College at Buffi.lo; Januar.• 20, "Thinking Ethics: A PreliminarY Report," James Warde, M.D., commissioner, Erie County Department of Mental Health; January 27, "The Impact of the Physical Environment on Human Behavior," Sara Czaja, Ph .D., president, Applied Ergonomics Group, Inc., adjunct .lS.'>istant professor, Department of Industrial Engineering, UB. All Grand Rounds arc held at 10:30 a.m. at the Eric Count\' Medical Center. U11ir>ersitv Acaden;ic Series: Januar.• 5, 198{ "The Neuropharmacology of Antidepressant Therapy,'' Richard \\'olin, M.D., clinical associate professor, Department of Psychiatry, UB; Januan• 12, "'vVhich Vietnam Vererar~s Get Post-Traumatic tress Disorder~" Norman Solkoff~ Ph.D., professor of psychology, UB; January 19, "Erectile Dysfunction : Medical, Psychological and Treatment Aspeers," Peter Russell, Ph .D., clinical psychologist, private practice; Kevin Pranikotf, M.D., assistant professor, Department of Urology, UB, and urologist, Erie County Medical Center. The foregoing three Academic Series programs will be held at 10:30 a.m ., each dare, in the Veterans Administration Medical Center. On January 25, at 9 a.m., Andrea Jacobson, M .D., assistant professor, Department of Psychiatry, UB, wrll conduct Grand Rounds in Psvchiarr.· at the Gowanda Psvchiarric Center, Forensic Classroo~. To apply for any of these contact: James M. Serapiglia, Ph. D., Department of Psychiatry, 462 Grider Srreer, Buffalo, N.Y. I42I5. THE THIRD NATIONAL CONFERENCE ON ADVANCES IN PEDIATRIC GASTROENTEROLOGY AND NUTRITION • February 9-12, 1984. Fort Lauderdale Ma~­ riott Hotel and Marina, Fort Lauderdale, Florida. Chairman: Emanuel Lcbenthal, M.D. Sponsored bv Continuing Medical Education a;1d the Department of Pediatrics, UB; All Children's Hospital, St. Petersburg, Florida; and the Department of Pediatrics, Universin• of South Florida, Tampa. 20 credit hours. Fcc: Physicians in practice, $275 ; allied health professionals, Sl50. For further information, please conracr Ravna Dutton, CME coordinator, Continuing Medical Education, Children's Hospital, 219 'Bryant Street, Buffulo, N.Y. 14222. Telephone (collect) 716-878-7630/7640. THE FOURTH NATIONAL CONFERENCE ON RECENT ADVANCES IN PEDIATRIC LUNG DISEASES • March 16-18, 1984. Sarasota H varr House, Sarasota, Florida. C,hairman: Gcrd J.A. Cropp, M.D., Ph.D. Sponsored by: Continuing Medical Educarion and the Department of Pediatrics, UB, and the Department of Pediatrics, University of South Florida, College of Medicine. For information, see entry above. �Calendar of movement in paralyzed patients. Others on the program include Dr. George J. Alker, Jr.. acting chairman of UB's Department of Radiology; Rochester's Dr. Charles J. Gibson; Dr. Edward A. Stehlik of UB and Erie County Medical Center's Spinal Cord Injury Unit; and Dr. Robert E. Cooke, medical director of Buffalo's Robert Warner Rehabilitation Center. Specialty meetings for physicians, rehabilitation nurses, physical and occupational therapists and counselors will be held at 2 p.m., Sept. 22. Members of the Inter-Urban Spinal Cord Association include Physicians and other health and social service professionals from Buffalo, Rochester, Syracuse; and Kingston, Ottawa, Thronto, Hamilton and London, Ontario. Patients and their families are invited to attend the Friday sessions at a reduced registration fee. Registration is $50 for health professionals. For further information, contact the Department of Rehabilitation Medicine, ECMC, 462 Grider St., Buffalo 14215. TASTE AND SMELL IN DISEASE • Dr. Susan S. Schiffman, a medical psychologist fom Duke University. will give a presentation on "Thste and Smell in Disease," sponsored by Thps Friendly Markets and UB's Multidisciplinary Graduate Group in Nutritional Science. Late September. Details to be announced. DR. MITCHELL I. RUBIN DAY • Friday. October 7, 1983. Kinch Auditorium, Children's Hospital [scientific session) and Buffalo Marriott Inn (reception and din- ner). This event will honor the multiple local and international contributions of Mitchell I. Rubin, M.D., to the teaching, practice and science of pediatrics. All colleagues. former students and friends are invited to attend both the scientific session during the day and the evening events at the Marriott. Please call or write: Mrs. Debbie Licata, Medical Staff Office, Children's Hospital, 219 Bryant Street, Buffalo, N.Y. 14222 (716-878-7406) for information and reservations. ONCOLOGY SEMINAR SERIES • "Metastasis." October 4-6, 1983. Chairperson, Dr. Leonard Weiss. "Molecular Events in Differentiation and Neoplasia:· November 10, 1983. Chairperson: Dr. Timothy O'Connor. "Update in Neurological Oncology." December 8, 1983. Chairper- son: Dr. Charles West. All programs in the series are held at Roswell Park Memorial Institute. A fee of $45 is charged for physicians for each seminar. Residents are assessed $15 and there is no fee for students. Contact: Gayle Bersani, cancer control coordinator. (716) 845-4406. Co-sponsors with Roswell Park are the American Cancer Society, New York State Division and Erie County unit. These seminars qualify for Category I credit toward the A.M.A. Physician's Recognition Award. prescribed credit by the American Academy of Family Physicians. and Category 2-D credit by the American Osteopathic Association. ------ ------------------------------------------------------------- IIIII I BUSINESS REPLY MAIL FIRST CLASS PERMIT NO. 2210 BUFFALO, N.Y. POSTAGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, New York 14214 NO POSTAG E STAMP NECESSARY IF MAILED IN THE UNITED STATES �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO, NEW YORK 14214 920003223400 MD 44 DR. ROBERT L. BROWN 156 BRANTWOOD ROAD NY 14226 BUFFALO -----------------------------------------------------------------LET US HEAR FROM YOU Fill out this card (Please print or type all entries) Name _________________________________________________ Year MD Received ___________ Office Address _______________________________________________________________________ HomeAddress _______________________________________________________________________ If not UB, MD received from -------------------------------------------------------------In Private Practice: Yes 0 No 0 In Academic Medicine: Yes 0 No 0 Specialty ------------------------------------------------Part Time 0 Full Time 0 School Title ___________________________________ Other: Medical Society Memberships: NEWS: Have you changed positions, published , been involved in civic activities, had honors bestowed, etc.? _______________ Please send copies of any publications, research or other original work . � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, December 1983 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1983-December Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1983-v17n04-Dec Table Of Contents A list of subunits of the resource. Mitchell I. Rubin Mentor, father figure, role model Low Infant Birth Weight UB Research Increasing Quadriplegic Index Spinal Cord Injuries Research Hospitals Medical School News Students Book Review People Alumni Classnotes Deaths Calendar Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-07-05 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v17n04 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1983 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/39a9629fe889f9ae427e133373550b0e.pdf 43052d0e46f535382b169e5abb05652c PDF Text Text Volume 17, Number 3, September 1983 �The University at Buffalo will alter its graduation ceremonies in 1984. President Steven Sample, in an attempt to increase the cohesiveness of the university academic community, has announced that there will be a General University Commencement on the morning of May 20, 1984 and a Professional and Graduate University Commencement that afternoon. These two major core events will be the focus for the granting of degrees and will in general, be in keeping with the earlier traditions of the University of Buffalo. Each professional school will have its own Convocation Services on the same day. In keeping with the past and more recent traditions, the School of Medicine's Convocations will include the administration of the Oaths of Hippocrates and of Maimonides, the signing of the Book of Physicians graduated from UB, the hooding of each graduate, and the awarding of the honors recognitions to graduates. As always, the parents and students will be honored at a reception which will follow the ceremonies. The commencement and convocation services will be held on the Amherst Campus. Although change often causes a degree of concern and anxiety for those involved, there is every reason to expect that the traditions of the past graduation ceremonies of the School of Medicine will be carrted forward with the same importance of dignity and respect that have characterized the 136 previous ceremonies. The faculty and I look forward to the parents of the graduates of the Class of 1984 and to the graduates sharing in providing a new era ofleadership and image for the School of Medicine and the University at Buffalo with the initiation of this revised format. -John Naughton, M.D. ., �Contents BUFFALO 1 Outreach • Major grants enable Family Medicine Department to bring new emphasis to its programs of rural medicine and preventive care. 6 The Perry, N.Y. Medical Center • A textbook case in small town medicine. 7 Car Seat Law • Family Medicine resident Dr. Lynda Karig Hohmann was recently selected as winner of a national award for her active role in getting the State law passed which requires special car seats for children under five. 8 Transplants • The survival rate is up, says organ transplantation pioneer Dr. Thomas Starzl of the University of Pittsburgh . 9 New course may be a first • Future physicians here are learning how to provide more effective care for the poor and disadvantaged. PHYSICIAN STAFF Executive Editor, University Publications Robert T. Marlett Art Director Rebecca Bernstein Health Sciences Editor Mary Beth Spina Photography Francis Specker Ed Nowak ADVISORY BOARD Dr. John Naughton, Dean School of Medicine Dr. Harold Brody Dr. James Kanski Mr. Daniel Newcomb Dr. James P. Nolan Dr. Charles Paganelli Dr. Peter Regan Mr. James Smigelski Mr. James N. Snyder Dr. Eugene Michael Sullivan Jr. Dr. Mary Voorhess Dr. Martin Wingate Dr. John Wright Dr. Maggie Wright TEACHING HOSPITALS The Buffalo General Children's Deaconess Erie County Medical Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Charity Veterans Administration Medical Center ., Produced by the Division of Public Affairs, Harry R. Jackson. director. in association with the School of Medicine. State University of New York at Buffalo 11 The Presidential Heartbeat • UB History Professor Milton Plesur discusses how health problems have affected the occupants of the White House. 16 AIDS • There is no significant evidence to support growing concern that AIDS may be transmitted via blood derivatives or transfusions, according to Dr. James F. Mohn, chairman of New York State's Council of Human Blood and Transfusion Services. 18 Research • Reports at the School of Medicine's first Research Day Symposium focus on treatment of accident victims, asthma research , the University's new NMR facility, and work on coronary artery and kidney diseases. Radiation plus drug treatment increases survival rates for patients with cancer of the uterine cervix. 23 Medical School News • Dean John Naughton named acting vice president for health sciences. New MD-PhD program trains medical scientists. Dean's staff reorganized . 12th annual Orthopaedic Day. UB ranks 24th nationally in percentage of minority students in med school. Rekate, Schenk, Katz honored at annual faculty meeting. 26 Students • Most MD graduates leave here $25,000 in debt. Summer programs provide exposure to research work for minority students. 31 People • Dr. Carl J. van Oss honored by Dutch government for his role in helping save Jews from the Nazis during the occupation of Holland in World War II. Other news about people you know. 36 43 44 Alumni • The annual register of dues-paying medical alumni lists 1,073 members. Classnotes • News of the classes. Calendar • A few coming events. Ctwer Plllto: Fralcls $IIICk.THE BUFFALO PHYSICIAN , (USPS 551-860) September 1983- Volume 17, Number 3 published five times annually: February, May, July, September, December - by the School of Medicine, State University of New York at Buf· falo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. POSTMASTER: Send address changes to THE BUFFALO PHYSICIAN , 139 Cary Hall, 3435 Main Street, Buffalo, New York 14214. ��Outreach Major grants enable Family Medicine to bring new emphasis to programs in rural medicine, preventive care P By Mary Beth Spina rojects ranging from a program to acquaint students with medical practice in underserved rural areas to a computerized system which will help physicians practice preventive medicine will be funded by $1.4 million in grants from the U.S. Public Health Service to faculty in the UB Department of Family Medicine. Approximately $525,000 of the total over t~e three-year funding period will be used for faculty support and residents' salaries, according to Dr. Herbert Joyce, acting chairman of the Department. The remaining $862,000 will underwrite four major projects designed to add new dimensions to either medical students' education or family medicine residents' training. Dr. Raymond Bissonette, associate professor, is director of these projects. Among them is a new program to stimulate medical students' interest in future practice in medically underserved areas. WorkUB medical student Ann Smith and Town Supervisor Ross Roberts on the main street of Perry, N.Y. (large photo). In inset photo, Ms. Smith assists Perry practitioner Or. Thomas Rosenthal in patient exam. Perry is one of several towns used to acquaint future physicians with rural practice. BUFFALO PHYSICIAN • 3 �rural health settings favorably influences medical students' decisions to consider practicing in such areas. "But even if the students choose not to locate in medically underserved areas, they will have a better understanding of the burdens of the rural family physician and the quality of medicine practiced on patients referred to them," Dr. Bissonette adds. Rural communities where students are being placed with preceptors include Warsaw, Gowanda, Arcade, North Collins. Ripley, Dansville, Perry. Persia, Otto. Westfield, Mayville, Wellsville, Andover and Castile-Pike. A Dr. Raymond Bissonette (left), Mrs. Holmes McGuigan, an administrative assistant, and Dr. Marlon Koenigsberg at Deaconess Family Practice Center. ing 40 hours per week at tasks commensurate with their skills and education levels, approximately 25 third- and fourth-year students will be placed with volunteer clinical faculty in rural settings. "Many young physicians discard the idea of rural practice simply because they have no experience with it. They picture country doctors as still practicing in lean-to's using flashlights and Boy Scout knives," says Dr. Bissonette. I n the past, UB students had the opportunity to work with rural physicians. but lack of money to defray living expenses and transportation to outlying areas discouraged many who otherwise would have participated. In addition to encouraging students to consider future careers in rural medicine, the new program allows faculty in remote areas to actively participate in UB's teaching effort. In order to maintain faculty status in the Department of Family Medicine, volunteer clinical faculty generally are expected to provide the equivalent of 288 hours of teaching supervision in their offices each year. "Family medicine must be taught in a setting which concentrates on delivery of primary ambulatory care. This simple reality escalates the importance of our volunteer clinical faculty,'' says Dr. Bissonette. Primary ambulatory care, he explains, must be rendered by physicians who provide continuous. comprehensive care emphasizing prevention and a focus on the entire family. "The hospital,'' he adds. "is not where family medicine is typically practiced. Nor is the clinic where the patient expects to see a different physician each visit." Dr. Bissonette believes the new program involving the rural physicians will demonstrate to often skeptical medical students that good medicine can be practiced in remote areas. "Prejudice against rural physicians by some of their urban colleagues stems from the fact that city doctors see those patients the country doctors refer for further diagnosis or treatment - leading to the erroneous belief that rural medicine is not quality medicine,'' Dr. Bissonette says. These consulting specialists, however. do not see the vast majority of the rural patients who are diagnosed and treated appropriately without referral. Diseases don't change when one crosses the city limits, but management of these diseases does change. Dr. Bissonette says, with the burden p rimarily borne by rural physicians whose skill and judgement are critical. Studies conducted at UB suggest that experience in 4 • BUFFALO PHYSICIAN second newly funded program involves development and implementation of an interdepartmental course for sophomore medical students between the Departments of Family Medicine and Pharmacology and Therapeutics. This elective, one-semester course. to be taught twice annually beginning in the fall, will focus on pharmacological management of illnesses commonly seen in ambulatory medicine, including hypertension, upper respiratory infections, otitis media, diabetes, congestive heart failure, headaches. vaginitis. arthritis. depression and anxiety. "These are common problems routinely presented to the family physician which almost always require control with medication," Dr. Bissonette says. "We designed the course because we did not believe most students had the opportunity to learn enough about the pharmacology used in treating these complaints." Thught by faculty in both departments, the course is a collaboration of clinicians and scientists addressing real world medical problems. Students will be presented material dealing both with medications used in treatment of conditions routinely seen by family physicians and with the management of medical problems for which there are no effective phamacologic agents. Drug interactions . appropri;~.te utilization of generic drugs. problems of patient compliance, special medication problems of the elderly, cost control, and collaboration with the pharmacist as a member of the health care team will be addressed. too. A lso funded through the USPHS grants is a program for student participation in clinical research projects under supervision of faculty in the Department. Coordinated by Research Assistant Professor Dr. Marlon Koenigsberg, the program emphasizes research conducted in ambulatory care settings. "Clinical research is an area in which most medical students have little or no opportunity to gain experience," says Dr. Koenigsberg. "and one which has virtually limitless oppor tunities." Student Megan Farrell has already begun work with Dr. Koenigsberg on a study to examine interaction of known risk factors identified with cardiovascular disease to determine if some combinations appear more likely to increase the odds of developing the disorder. "Smoking, genetic predisposition. obesity, hypertension and personality type have all been linked with cardiovascular disease," Dr. Koenigsberg says, "but we haven't known whether some combinations of factors are more likely to increase incidence than others." Student Rubens Panies is working with Dr. Richard Botelho, clinical assistant professor and medical director of Akron-Newstead Community Health Center of Buffalo General Hospital, in a study to determ ine factors which contribute to effective use of the breast cancer self-exam. Dr. Botelho says resu lts of in terview surveys conducted by Panies on women prior to routine con sultation at the Health Center may help develop strategies_ f~r influencing health behavior relevant to fe m a les hvmg in rural communities. .. �,, (Above) Dr. Richard Botelho, director of the Akron-Newstead Health Center (left), with student Rubens Panies. (Inset) Ross Roberts, Perry Town Supervisor, an active supporter of the Perry Medical Center (see next page). Noting that breast cancer is the most common form of malignancy among women, Dr. Botelho says some patients don't perform the self-exam routinely because they're afraid they'll find a suspicious lump. Others don't because they haven't been taught the technique. In another project, student Craig Schmidt is working with Dr. Frederick Cooley, clinical assistant professor of family medicine, to learn how several screening devices may help physicians identify patients with early medical problems related to alcohol. "Some patients have medical problems which can alert the physician to the possibility that the patient is an alcohol abuser," Dr. Cooley says. A combination of biological, physical and psychosocial screening devices. he feels, can more effectively permit the physician to "target" individuals who may have crossed the line to alcoholism. Then the doctor can introduce a line of conversation which can lead to early intervention of the problem. But early intervention- in itself- is not the goal. All the physician can say on the basis of such assessments, Dr. Cooley cautions, is that the patient appears to have medical problems or social difficulties related to alcohol overindulgence. As with any medical problem which requires behavior modification on the patient's part. accepting the fact that a problem exists and accepting treatment is up to the patient. Another grant-funded project headed by Dr. Koenigsberg concerns a computer program for a demonstration project in preventive medicine involving residents in the Family Medicine Program. "Appropriate patient screening varies with age, sex, history and other risk factors." he says. But if a busy physician does not carefully review each patient's record before office visits, necessary interventions may not be ordered in a timely fashion or may be undertaken with unnecessary and costly frequency. By entering a patient's age, sex and other information including past and current medical problems into an especially programmed computer, a physician can be proBUFFALO PHYSICIAN • 5 �vided with a printout of tests which should be ordered at the individual's next visit. This will supplement- but not replace - clinical judgment. " Research," says Dr. Koenigsberg, "is not limited to the laboratory setting. In fact, much information can be gained in the clinic to help a physician practice more comprehensive, prevention-oriented medicine." Toward this end, members of the Department who have been involved in research at UB and elsewhere are actively encouraging volunteer faculty interested in conducting studies to use either the Family Practice Center population base or patients in their own practice. Educationally-oriented projects, such as a seminar held recently on microcomputers, are used to acquaint community-based clinical faculty with resources available through UB for research. "Perhaps more than any other specialty area of medicine, family medicine has concentrated almost entirely on practice with little or no emphasis on research," Dr. Koenigsberg explains. This is because most of those who choose family medicine do so because they want full-time responsibility for delivering care; few are inclined toward research. But there are those who have an interest in clinical research among ambulatory patients and see a need for it. "It is for them that we are attempting to offer support through consultations on research, statistical design and other techniques necessary for planning viable research," Dr. Koenigsberg points out. In addition, there is an indication that residents recently graduated from the Family Medicine Program who are now practicing in Western New York have an interest in conducting clinical research projects. "Dr. Henry DiMuzio, who completed a residency here in July, for instance, worked with Dr. Koenigsberg on a study of factors which influence the outcome of teenage pregnancies. Resident Dr. Charles Grizzanti worked with Dr. Robert Seller, professor of family medicine. on research comparing the health of unmarried women with children to that of married mothers and the health of their youngsters. "Since family medicine graduates practice in a variety of settings- urban, rural and suburban, there is excellent opportunity for joint research projects with different populations," Dr. Koenigsberg points out. "A great many good research projects, I predict, will be conducted by our volunteer faculty once they understand its importance in their medical specialty and learn of the resources we are prepared to offer them," he believes. Faculty in Family Medicine interested in knowing more about research opportunities should contact Dr. Koenigsberg at 897-2700. • Perry, N.Y.: success in serving the 'underserved' T he Perry, N.Y., Medical Center could probably serve as a textbook case in small town medical practice. Located in a former supermarket building not 100 yards from an impressive stand of sweet corn, the Center was bustling on a warm Monday morning this July. An entire family climbed out of a station wagon for a visit to the Letchworth Family Medicine Group which has offices there: Grandma, flanked by two rambunctious older children, trailed Mom and the baby. An aged woman, her chin bent close to her chest, was gingerly steered across the parking lot by a gentleman of equal age but with a slightly spritelier step. A van bearing the seal of the Wyoming County Social Services Department disembarked a social worker, a young man and a teenage girl with a baby. The "couple" weren't more than children themselves. They walked into the County Mental Health Clinic which is also situated in the Center. Shingles displayed on the plate glass front window of the building announced that a dentist and a physician in single practice are also housed in the facility. So is a radiologist from the Wyoming County Hospital in nearby Warsaw who spends part of his week serving people in Perry. Town Supervisor Ross Roberts beamed as he talked about the Center. It opened about a decade ago. The late L. Erwood Kelly, former town supervisor, worked hard to get it established. Kelly thought it would help attract the physicians who were so badly needed in Perry in those days. A local man named William Thill thought so, too. He put up the money. The facility proved attractive to Dr. Thomas Rosenthal, a graduate of UB. He set up a family medicine practice there and then recruited Drs. J . Thomas Reagan and Rodney Logan to join him. They're from UB as well. UB medical students are also part of the scene. The town provides a rent-free furnished apartment for students taking Family Medicine clinical rotations with the Letchworth Group, enabling often financially-strapped doctorsto-be to experience small town practice first-hand without the added hardship of having to commute or pay for temporary quarters. One of these students, Ann Smith, was 6 • BUFFALO PHYSICIAN l I _!- r PERRY MEDICAL CENTER there this summer. She had always thought she'd like a small town practice, but thanks to her time in Perry, she said, she now knows it's for her. Having found her place, Ann Smith was spending all the time she could at the Family Medicine Group offices. She was there during all office hours, seeing, helping, assisting, learning to be a physician on the firing line just 100 yards from the corn where a lot of the tough medical action is. Drs. Rosenthal, Reagan and Logan .are. al~ practicing in Perry partly because they took part m similar preceptorship programs there. They are living proof that these programs do help get physicians into t:nder~~rved rural areas. In fact, Perry is probably not even m the underserved" category any more. • �Car seat law Dr. Hohmann, shown strapping young child into restraining seat, wants seat belts to be mandatory for 5-10 year-olds (inset). Resident helped get it passed N ew York State parents who have to pay $40 for legally-mandated approved car seats for their youngsters should consider the outlay one of the best investments they'll ever make, according to UB Family Medicine resident Dr. Lynda Karig Hohmann. Dr. Hohmann was recently selected as winner of one of 20 Mead-Johnson awards given to medical residents across the nation. She was recognized for her active role in getting the State law passed requiring the car seats for children under five. High commitment to family medicine, scholarship and leadership qualities are the criteria on which the awards are based. Many parents complain that having to spend $40 for an approved seat puts a strain on their budgets, Dr. Hohmann acknowledges. But- if you want to confine the issue to strictly monetary terms - the lifetime cost of caring for a youngster brain-damaged from being thrown through a car windshield in an auto accident can be as high as $6 million. Approximately 1,000 U.S. children under five annually die from head injuries suffered in auto accidents, and an additional 50,000-70,000 suffer head-related injuries, Dr. Hohmann notes. Proper child restraints could prevent 80-90 per cent of these injuries and deaths. · A third-year resident at Buffalo General's Deaconess Division, Dr. Hohmann says her intense interest in getting the New York State law on the books two years ago stemmed from her role as the mother of a young daughter, Heather, and from her work as a physician. "I have seen youngsters suffer severe injuries to the head and elsewhere because they were not restrained in a car at the time of an accident," she says. While some escape lightly with broken bones, others become virtually helpless, doomed to a lifetime of invalidism or institutional care. When Western New York's Thsk Force for Prevention of Mental Retardation and Developmental Disabilities was formed a few years ago, Dr. Hohmann signed up for the Committee on Child Safety which ultimately pushed the car seat law through the Legislature. Separate car accidents under virtually identical conditions involving her mother and a close acquaintance had brought the issue of auto safety vividly home to her. Her mother, who was not wearing a seat belt, suffered a broken hip and arm as well as a concussion which required several weeks of hospitalization. The acquaintance, who had buckled up before getting into his car, escaped injury. New York's child car seat law is matched by less than 10 other states. "The law which carries a $25 fine was never designed to be punitive - rather to be preventive," Dr. Hohmann explains. Most police who stop drivers and observe a young passenger not appropriately restrained will issue a citation for which the fine is usually waived after a car seat has been purchased. P arents who purchase the car seats to comply with the law but who don't use them properly are asking for trouble, Dr. Hohmann advises. A child sitting high on an unbuckled seat has an even greater chance of being hurled through the windshield in case of an accident, she points out. "Even newborns coming home from the hospital should be buckled into an approved infant car seat- and not ride in mother's arms," she cautions. "Many people aren't aware that a child - held by someone weighing only 100 pounds will be crushed against the dash or the windshield with a ton of force in an accident even at 30 miles-per-hour. The more the individual holding the child weighs and the greater the speed at the time of an accident, the greater the risk." Standard school buses- not included in the current New York State law- are poorly designed from a child safety point of view, Dr. Hohmann adds, but there may one day be a mandate which will require restraints to be used in these vehicles as well. The current law, Dr. Hohmann notes. is already being amended to make seat belts mandatory for children five to 10. Although the physician testified in Albany while the child car seat law was under consideration and made numerous pleas to civic groups to spur passage of the bill, she emphasizes she was only one of thousands of parents and health professionals who campaigned to get the law passed. She recently worked on a grant approved and funded by the New York State Health Department to Children's Hospital and Deaconess Division to ease the burden on some financially-pressed Western New York parents who really can't come up with the $40 for a seat. One hundred and twenty approved child car seats will be made available on a temporary basis free of charge to parents who meet certain financial guidelines. - MBS • PHOTOS: NOWAK BUFFALO PHYSICIAN • 7 �I Transplant survival rate up, pioneering surgeon tells UB group T he 1960's promise of human organ transplantation as a successful remedy for many who would otherwise face death from organ failure is finally coming to fruition, Dr_ Thomas Starzl told an overflow audience at the 13th Annual Ernest Witebsky Lecture in Farber Hall this spring. A pioneer in the field of human organ transplantation. the University of Pittsburgh surgeon noted that recent developments in immunosuppression have been a key factor in raising the survival rates of both grafts and patients during the past two decades. If the recipient's immune system is not adequately suppressed following transplantation of a donor organ, the risk is great that the body's defenses will "recognize" the graft as "foreign" and subsequently reject it. Although human organ transplants were hailed in the 1960s by the public and the medical community alike as a tremendous breakthrough, Dr. Starzl said, studies conducted at centers where the operations were being performed began to show disappointing long-term survival rates. After the initial glow of hope for transplantation as a cure for single organ failure, a feeling of gloom began to pervade the medical community- particularly those of its members intimately involved with the transplantations. "A period began," Dr. Starzl told the audience, "in which transplantation was considered more of a disease than a cure." T he picture has considerably brightened, however, with development of agents and combinations of agents which more successfully combat organ rejection in transplantation patients. Tracing the history of immunosuppressive drugs in organ transplants, Dr. Starzl pointed out that the agent Imuran was first used alone in the early 1960s, followed rather quickly by a combination of Imuran and steroids (Prednisone). By the mid-1960s, the Imuran-Prednisone combination was joined by anti-lymphocyte globulin (ALG) as doctors sought new agents to help them in their fight to save from death those who had received donor organs. A few years later, cytoxin, an anti-cancer drug, was often substituted for the Imuran. And by 1979, the idea of total lymphoid irradiation, thought to be potentially helpful, was rejected because of increased incidence of certain types of malignancies in those who received this treatment. By 1980, a new drug called cyclosporin appeared which, unlike some of its predecessors, did not cause bone marrow depression, an unwanted side effect of some other agents which had been used in immunosuppression. Today, the combination of Prednisone and cyclosporin has been shown to nearly double the survival rate of transplant patients and has given new hope to those who have long believed transplantation to be the only feasible alternative for those whose own body organs could no longer function. D r. Starzl noted that in addition to kidney transplants, practitioners are now seeing other organs such as the liver and the pancreas being transplanted with higher success and survival rates. "In the mid 1960s, our enthusiasm (for transplantation) exceeded the state of the art - we were deficient in the tools we then had for immunosuppression," Starzl pointed out. But today, the dreams of those earlier years are being realized as more lives are saved for longer periods of time. "The fact that organ transplantation is today at a point where it is a safer and more successful procedure would have undoubtedly given a great deal of pleasure to Dr. Witebsky," Dr. Starzl said. Witebsky was an internationallyrecognized pioneer in immunology who was on the faculty here for many years. Prior to Dr. Starzl's lecture, The Ernest Witebsky Memorial Awards for Proficiency in Microbiology were presented by Microbiology Department chairman Dr. Felix Milgram to John C. Roth, a medical student; Amy R. Bryan, a dental student; and Kathryn L. Wesley, a graduate student in medical technology. The Annual Ernest Witebsky Lecture is sponsored by the Ernest Witebsky Center for Immunology and the Department of Microbiology. • "New agents which fight rejection brighten the picture considerably." - THOMAS STARZL �I New course may be a first Future physicians are learning to provide care for the poor F uture physicians here are learning how to provide more effective care to the poor and disadvantaged in a medical course believed the first of its kind in the nation . The course, taught by 24 faculty at UB and by providers of community health and related services, aims to familiarize medical students with attitudinal and cultural differences affecting how health care is perceived and received by the poor. By recognizing and becoming more sensitive to these differences, future physicians will be better prepared to treat the poor, Dr. Maggie Wright hopes. "The poor typically have a greater mistrust of the health system than others. They may respond to care in ways which make them seem uninterested and uncooperative," says Dr. Wright, assistant dean for student affairs and director of minority programs at the School of Medicine. In reality, though, she suggests, differences in culture and attitude may be mostly to blame for the frequent unwillingness of the poor to seek care and to cooperate with those who provide it. The poor, says Dr. Wright, are more likely to break appointments, and less likely to seek care or practice preventive medicine than their counterparts in other socioeconomic groups. "Since the poor are more likely to seek care only sporadically, and then only in a hospital emergency room or clinic, they may never develop continuing, trusting relationships with primary physicians," Dr. Wright points out. This "care by crisis" phenomenon is partly caused by mistrust of the "system" but may more frequently be the result of poverty itself. "Not all who are poor or disadvantaged qualify for programs such as Medicaid which pay for health care. Many 'working poor' - those ineligible for publicly-financed care and not covered at work by health insurance -simply can't afford care for conditions which they do not perceive immediately as life threatening," Dr. Wright says. Indeed, the patient who fails to keep appointments, purchase needed medications, or comply with special treatment for a continuing illness may be "telling" the physician he or she cannot pay for it. "Medical jargon - often confusing even to better · educated patients in the middle and upper classes- can be so incomprehensible to the poor and uneducated or those not proficient in English that they give up trying to understand their illnesses or treatment plans," Dr. Wright believes.The physician who suspects the patient is not comprehending should ask appropriate questions to learn if this is the case. W hile those in all socio-economic classes share many types of medical problems, some problems are more prevalent among certain racial groups as well as the poor. "The hereditary blood disorder sickle cell anemia, for instance, is limited almost exclusively to Blacks in this country," says Dr. Wright. Other illnesses created or exacerbated by poor nutrition, poor health habits or substandard living conditions may almost exclusively reign in the province of the poor. "Understanding the ways the poor live can contribute to the information needed by the physician to make correct diagnoses for many of these patients," Dr. Wright points out. In general, she says, the course aims to make students aware of cultural differences, mores, language barriers and attitudes on the part of patients which can affect the physician's ability to provide effective care. Dr. Wright is pleased at the response and motivation of the 20 students who signed up for the elective offered at UB for the first time this year. The course is co-chaired by Dr. James Humbert and Dr. Robert Grantham. "It's also interesting that not all the students in the course were women or minorities- they were pretty much evenly divided in terms of race, and cultural backgrounds," Dr. Wright emphasizes. • BUFFALO PHYSICIAN • 9 ��By Milton Plesur Professor of History State University of New York at Buffalo C an good health be correlated with success in the White House? Or could the opposite be true? And, in any event, just what is the public entitled to know about the .health of the occupant of 1600 Pennsylvania Avenue? Four of the five Presidents rated "great" by historians in a 1962 poll had serious physical handicaps, whereas others, thought less capable, were healthier. Some Presidents were health enthusiasts and overachievers in office, but died relatively early deaths; other more sedentary types, some burdened with overweight, lived beyond their normal expectancies. Such paradoxes make impossible arriving at definitive conclusions on the subject of Presidential health. Even if the possibility of serious illness or incapacity will affect a President's performance in office and determine vital decisions, how can the im"Adapted by permission from The Presidency Reappraised. edited by Rexford G. Tugwell and Thomas E. Cronin, New York: Praeger Publishers, 1974. Copyright (c) 1974 by The Fund for the Republic, Inc. �TR: the most athletic. Taft: somewhat elephantine. pact of ill health be properly measured? Would Coolidge's performance, for example, have been less lackadaisical had he been less fatigued? Would Franklin D. Roosevelt have acted more vigorously at Yalta had he not been the victim of advanced sclerotic disease? Would healthy Wilson have compromised during the League of Nations debate? The course of history could well be linked with Presidential disorders. In a democratic society, we feel we are entitled to know everything about elected leaders, including their health. Much of this curiosity may be morbid, but the number of Presidents who have been seriously ill makes it imperative for the public to know all when the world's continuation could well depend upon a White House decision. Presidential physicians have been generally reluctant to divulge information. Perhaps in cases where public knowledge might have resulted in national panic - such as Grover Cleveland's operation for removal of a cancerous growth - secrecy is understandable. But this cannot always be justified. Wilson's doctor conspired with his wife to cover up a serious Presidential stroke; Franklin Roosevelt's physicians certainly seriously underplayed their patient's condition in 1944. The specifics of John Kennedy's adrenocortical deficit are still not completely realized. On the other hand, every conceivable and even intimate detail regarding Eisenhower's three major illnesses while in office was shared with the public. And the nation received regular medical bulletins about Lyndon Johnson's medical problems and the recovery made by Richard Nixon from viral pneumonia. Generally, though, the President's health has been regarded as a relatively private matter. a G iven what is known about Presidential health. the statistics seem to underscore the theory that the "burden" of the office is lethal. The earlier Presidents, evidently of tougher stock than their later counterparts, lived longer despite a shorter average life expectancy. Of the first eight Presidents, all but George Washington outlived the expectancy of life at the time of their inaugurations. The average age of death of the first 15, from Washington to Buchanan, was 74; those who served from Lincoln to FOR lived to an average age of 63. From the Civil War to 1968, only Cleveland, Thft, Hoover. Eisenhower, and TI-uman exceeded their life expectancies at the time of inauguration. Kennedy's optimistic remark about thriving under the pressure of office and Harry TI-uman's oft-quoted comment about "heat in the kitchen" are recalled; but most students of the office feel the job is wearying. Upon the death of any President in office, the press invariably speculates on issues of health and White House workload, and it has often been stated that physical fitness 12 • BUFFALO PHYSICIAN Wilson: his stroke was concealed. and relaxation were the only safeguards for the men at the top. But, again, the evidence is inconclusive. Theodore Roosevelt was the most athletic of Presidents. He enjoyed bouts with the punching bag (ruining his eyesight because of a boxing accident), originated the 50-mile hike, and wore off excess energy by learning jujitsu; yet, he died at 60. Woodrow Wilson rode horses and golfed inexpertly early in his Presidency; and, under the guidance of Walter Camp, he and the Cabinet performed- as others were admonished to - their "daily dozen." Warren Harding was a horseback rider and relaxed even more around a poker table. Calvin Coolidge's exercise was limited fishing, morning walks, and riding his celebrated electric hobby horse. Coolidge's sleep habits, amounting to about 11 hours a day, are well known, and yet he died at the same age as Theodore Roosevelt, the activist. Herbert Hoover was much like James Polk, in that he seldom took extended vacations, was relatively unrelaxed, and worked long hours; but he did go fishing and was known to toss a medicine ball. The "Great Engineer" reached 90, whereas Polk died a few months after leaving the White House. Franklin Roosevelt relaxed with swimming, poker games, and a stamp collection. Probably the most famous peripatetic President was TI-uman, who found his daily brisk walks, together with his piano playing and poker playing, therapeutic. Lyndon Johnson escaped to his 1exas ranch and Ronald Reagan treks to his Santa Barbara Shangri-La. While recreation is, thus, necessary for Presidents in order to counteract a pressured existence, the long-range effects are debatable. Nor is the size of the waistline any indicator of fitness for carrying the nation's burdens. The elephantine Thft had a voracious appetite, and, though he dieted intermittently. he at one point soared to about 350 pounds. Nevertheless, he lived into his 70s. Grover Cleveland hovered between 250 and 270 pounds, yet also reached three score and ten years. His love of wine and song, and the wellknown wenching and beer bouts of his Buffalo days, added to his girth and his multiple chins, but he never seemed as lethargic as Thft. In the precalorie-counting, precholesterol age, Chester Alan Arthur was famous for opulent dinners, heavy foods, and fine wines and liquors. The Presidential figure showed the effects of this happy life, and he suffered from chronic indigestion. Until recently, it was thought he died from apoplexy or chronic gall bladder disease at 56- scarcely a year after he left the White House. However, the latest evidence points to Arthur's demise from Bright's Disease, a fatal kidney ailment. Some of the more intimate publicity about Lyn,don Johnson concerned his constant battle with the pounds. His cook and the President's physician were in constant collusion in a half-successful battle to contain the Presidential intake. �Harding: he relaxed at poker. O Hoover: he lived to be 90. ne of the most fascinating Presidential medical stories is that of Franklin D. Roosevelt. Nearly asphyxiated at birth because of an overdose of chloroform administered to his mother, FDR was plagued all his life by a sensitive respiratory tract. A severe bronchitis attack in 1943 was noted by some as the beginning of his failing health. His well-being had been a matter of discussion ever since he first aspired to national political leadership following contracting polio at age 39. Heavy braces on his legs and crutches were necessary all the rest of his life. Aside from ever present bronchial and sinus trouble, Roosevelt's medical history was uneventful despite the constant specu lation. His personal physician, Dr. Ross T. Mcintire, declared in 1936 that the President, since taking office, had not missed a single day's work because of illness. But, eventually the pressures of domestic depression and global war did drain Roosevelt's energy. There was even a rumor that, in 1938, he suffered the first of a series of minor strokes, but this has never been substantiated. During the fourth-term campaign of 1944, Roosevelt displayed "good health" for the critics by riding for 56 minutes in an open car during a freezing Manhattan rain - a ride especially arranged to quiet those who pointed out how badly he had faltered in an earlier appearance at the Bremerton Naval Yard in Washington. The press noted that Dr. Mcintire insisted that the chief executive was not dying as rumor had it, nor was he even sick during 1944; in other words, according to Mcintire, the fatal stroke of April 12, 1945, was unforeseeable. The White House physician, however, did concede fatigue. but added that his patient's blood pressure was normal, and that there was no sign of arteriosclerosis. Following the Yalta Conference in early 1945, Vice President TI-uman admitted he was disturbed by the "boss's" appearance; correspondent Merriman Smith wrote that he saw the President "die" over a period of a year, a conclusion concurred in by millions who viewed the pictures of the President over that time span. There was no doubt FDR was truly sick, but it has never been proved that that sickness contributed to what many critics called an American sell-out to the Russians at Yalta. One story has it that he suffered a stroke at Hyde Park in late March, 1945, and, after recovering, went to Warm Springs, where he died of a massive cerebral hemorrhage. It seems inconceivable, however, that his personal physician would not have accompanied him if the situation had been all that precarious. The physician who attended FDR during his last illness, Dr. Howard G. Bruenn, in an account of his relationship with the President from March. 1944, to April, 1945, reported that Roosevelt was suffering from an enlarged heart. had hardening of the arteries, and that his blood pressure was alarmingly high. But, said Bruenn, FDR was FOR: a fascinating medical story. not dying. There was a gradual improvement and the campaign of 1944 passed without incident. Evidently, the President was able to perform his duties despite hypertension and fatigue, but his death due to a stroke was, in view of his medical history, clearly predictable. Dr. Bruenn's report, published a generation after FDR's death, was obviously more realistic than the optimistic and reassuring words of Dr.Mclntire. That Roosevelt was gravely ill had apparently been suspected by many even before his return from Yalta. Walter Lippmann, the journalist, for example, asserted that in 1944 Harry S . TI-uman was nominated in Chicago by a convention fully aware that it was "almost certainly choosing a President of the United States." However, those who hinted at the time that Roosevelt was not a well man were rebu ked as little better than fifth columnists by the White House retinue. The . Roosevelt story, then, was a complicated one and raised many questions. B efore assuming office, Eisenhower was in generally good health, but. during his incumbency, he suffered three major illnesses: coronary thrombosis (1955), major surgery to correct acute ileitis (1956), and a "small" stroke (1957). Nevertheless, he survived his work load in a manner that was amazing for a man of his years and for one with his medical history. In 1956, the physicians reported that, medically, he could serve another five to lO years in office; and several years later Dr. Paul Dudley White, Ike's chief physician at the time of the coronary, wrote me that "Eisenhower's illnesses had no effect on the conduct of his administration other than causing temporary absences which were well handled by his many and efficient assistants." Even before the heart attack, Eisenhower was annoyed about not being allowed, as he put it, to have a bellyache in private. After each illness, the public was informed of his blood pressure, pulse rate, and caloric intake; of the size of the damaged area around his heart; of the state of his eliminative processes, and even the size of his prostate gland. The first President to suffer from so many severe illnesses while in office, Eisenhower recovered nicely and survived for 14 years after the first heart attack. Perhaps a reevaluation of the whole question of physical handicaps is in order and it might even be argued that expert medical care more than compensated for the workload in this case. John Kennedy had a well-publicized medical past. Despite his popularization of the active life, he suffered constantly from back pain as a result of a ruptured disc caused initially by an early football injury and aggravated by war wounds. He underwent three operations on his back, one of them nearly resulting in his death. Aided by Novocain treatments, he mended well enough to be pronouncBUFFALO PHYSICIAN • 13 �Truman: his walks were therapeutic. Ike: every bellyache was public. ed in good health in 1960. But there were problems: while in Canada the next year, he stooped to turn earth for a tree planting. a move resulting in persistent pain for half a year. His therapy consisted of daily baths, a special brace, prescribed calisthenics and swimming. and the famous rocking chair. The back plagued him throughout a trip to Vienna- the one in 1961 during which he had his famous confrontation with Khrushchev - but he concealed discomfort. Dr. Janet lravell. his personal physician, described the new backache as a common variety not connected with his old ailments and made it clear there was no plan to reduce JFK's official duties. Since Eisenhower's illnesses, frank and even intimaL<! information about Presidential health carne to be expected, but Kennedy 's press aides and physicians were reluctant to disclose any health secrets. The back problem was common knowledge, but his adrenal glands were a mystery. It is possible that he suffered from classic Addison's Disease; but if not. he did have an adrenal deficiency. Robert Kennedy denied most strenuously that his brother had Addison's Disease. One cause of the disease is tuberculosis of the kidneys, but Dr. lravell stated that JFK had no visible signs of this and had not taken cortisone for years. (He did take. prophylactically, a cortisone-like medicine to make up for his adrenal deficiency when under stress). Kennedy's possible adrenal problems prompted a Lyndon Johnson enthusiast, in the preconvention campaign of 1960, to assert that Kennedy would be dead if it were not for cortisone injections. The Johnson forces thus countered Kennedy's reference to their man's severe 1955 heart attack. Another aspect of the JFK health story involved his relationship with Dr. Max Jacobson, who had the reputation oftreatingjet-setters, movie stars, and politicians with amphetamines in order to elevate their moods. Kennedy was treated by him for an infected hand and laryngitis. but Dr. lravell says she never saw Jacobson. and denies the story. While there is no proof that JFK received stimulants, Jacobson did administer them to others. and the Village Voice asked perhaps in a sensationalist manner whether the President was a "speed freak?" Lyndon B. Johnson furnishes another example of a President with severe medical problems. His history included recurring bronchial illnesses and heavy colds, threatened pneumonia, surgery for the removal of his appendix. a kidney stone, and acute myocardial infarction from which recovery took over five months in 1955. Concern for Johnson's heart began the day he became President. Back in Washington from the Dallas nightmare, he was examined and given a clean bill of health. The physicians would not predict whether or not he might suffer another attack, but they maintained that. after surviving so long with no trouble, he was no more likely to be stricken than someone 14 • BUFFALO PHYSICIAN JFK: backaches and Addison's Disease? with no history of cardiac trouble. As President, Johnson underwent a gall bladder operation in 1965. He prepared the nation for this surgery (the announcement skillfully timed not to upset the Stock Exchange) as far in advance as possible, remaining candid with the press and the public. He also endured the removal of a benign polyp from his throat as well as the repair of an abdominal hernia; and, in 1968, it was revealed he was suffering from an intestinal ailment (diverticulosis). Along with Johnson's growing unpopularity over the Vietnam War, his health figured in the historic "abdication" decision of March 31. 1968. He recalled that men in his family generally did not live much beyond 60 and he spoke of his own massive coronary, admitted to fatigue, and recalled Wilson's disability. For the first time, a President referred very candidly and intimately to his own health problems, associating them with politics. Four years later, LBJ suffered a second coronary. The damage was so severe that a third attack resulted in his death in January, 1973. I n 1981, Ronald Reagan became the oldest person elected President and speculation about age, health, and longevity has haunted his presidency. So persistent were these questions during the campaign that he vowed to resign the office if his physician found him unfit or senile. Also. Reagan declared he favored issuing periodic reports on his health. His medical history includes allergic rhinitis, inflammation of the nasal mucous membrane. some diverticula of the colon, the removal of prostatic stones and correction of an anatomical abnormality of part of the urinary bladder in 1967 (he since had a slight. temporary discomfort in the urinary tract in 1982). hay fever. and a hearing loss in both ears. Despite this list. Reagan's Presidential ailments have been relatively few and minor. His generally good health undoubtedly contributed to a rapid recovery from an assassination attempt in 1981 when he sustained a bullet wound in the chest. Dr. Dennis O'Leary, the hospital spokesman, in discussing the question of the public's right to know and the patient's privacy, asserted he would approve reporting anything that bore on the President's ability to function. Practically all the details were revealed. Reagan has been described as a marvelous physical specimen and his own best physician. He sleeps well and exercises, favoring chopping wood and horseback riding on his ranch. He realizes the value of vacations and weekends at Camp David, he paces himself. does not work excessively long hours, disciplines his appetite, and refrains from the excesses of work and indulgence that marked, for example, LBJ's life-style. Reagan is a classic example of the adage that to be old is not necessarily to be infirm. In today's media age. the policy is to put the spotlight . �LBJ: severe problems. on the candidates' health records and, indeed, generally to build them up as superhuman. Campaign propaganda now includes results of physical examinations. Certainly the political campaign is an endurance test and proves that stamina is essen tial. Politicians who are disability-prone obviou sly ough t n ot be elected and th e role of the physician is crucial. Some feel that a candidate waives the right to confidentiality when seekin g office. But the cases of Representative William F. Ryan (N.Y.), who died in 1972 during a campaign for reelection, and Senator Thomas Eagletqn, who was removed as Democratic "VicePresidential candidate that same year, raise questions about wh en a physician's respon sibility to the community overr ules the sacred relation with a patient. In both situations, and in others t hat could be cited, medical testimony was either confusing or not even offered. All this, however, does not imply that a President must be a perfect physical specimen; he is elected for his ability to deal with the issues and for his ability to endure the rigors of his office. Reasonably good health should be sufficient since there are many people who acqu it themselves well under handicaps. What should be of greater concern is how the onerous and mostly fatiguing ceremonial functions can be reduced. On the surface and on the basis of the superficial , .... Reagan: a marvelous specimen. Nixon: he had pneumonia. Reagan's good general health was a factor in his speedy recovery from the 1981 assassination attempt. evidence, it seems that illness tends to elevate the President in the eyes of historians and that the better ones achieved in spite of affliction. Perhaps the best example is Franklin Roosevelt, whose great empathy with the masses may have resulted from his own bout with polio. His optimism in the face of severe economic depression and during the war years might have been due, in part, to his personal experience in overcoming an illness that would have defeated a Jesser man. T here has been much speculation on how the burdens of Presidential life contribute to the health problem, but it is seldom pointed out that the pressure of ordinary life, with its petty details, is eliminated from the Presidential routine: household problems, banking, taxation, travel arrangements. and so on. Moreover, the chief executive enjoys the security of personal physician care. Dr. Paul Dudley White even declared that, despite Eisenhower's illnesses, he was better off for being in the White House, with its special care, than elsewhere. Another question is whether health problems really influence Presidential policy and style. Probably they did in the case of Theodore Roosevelt. and possibly they played a role in shaping the style of Wilson. But, in the cases of Franklin Roosevelt. Eisenhower, Kennedy, and Johnson, it seems more likely that a mature and self-disciplined personality confronted disease more positively. Thus, in some instances, poor health might be one test of a candidate's will, decision-making ability, initiative, and determination, rather than a formative force. By looking at the past health records of candidates. and by examining how they met crises, the public has one criterion for judgement; but how important it is, compared to other factors, is unclear. Also, it can not be stated unequivocally that someone healthy will be a weak President just because he never faced the test of serious illness. To share with the public or not to share the intimacies of Presidential health is a recurring question. Certainly, we have come a long way from the secrecy that surrounded FDR and JFK. The release by Presidents of their medical reports and medical histories is now expected. Invasion of privacy or not, there might be a medical panel convened to evaluate the politician's medical past. Intimate details are not as important as general implications as interpreted by a bipartisan panel of physicians. Also important would be an evaluation of how the past Presidents actually faced up to illness, and what health problems can most likely be caused or aggravated by the Presidency. Such an investigation could be made by physicians in consultations with historians. Then, at least the public could better judge whether health problems prior to the assumption of office would be of any consequence. • BUFFALO PHYSICIAN • 15 �by Mary Beth Spina AIDS There's no significant cause for alarm about the blood stipply T here's no significant evidence to support growing public concern that deadly AIDS (Acquired Immune Deficiency Syndrome) may be transmitted via blood derivatives or transfusions, according to Dr. James F. Mohn, chairman of New York State's Council on Human Blood and 'fransfusion Services. The director of UB's Ernest Witebsky Center for Immunology and head of New York State's newly-created AIDS Thsk Force, Dr. Mohn reported that there's no conclusive proof that blood transfusions actually transmitted the disease in the handful of cases in which they've been suspected. "Thirteen of the 1,641 AIDS cases reported in the U.S. through June 20 involved persons who did not fit any of the other known categories of patients - promiscuous male homosexuals, intravenous drug abusers, immigrant Haitians or hemophiliacs," said Dr. Mohn. The only factor these 13 people appeared to have in common was blood transfusions for surgery or medical problems. In only one case - that of a California infant - was a blood donor traced who later was diagnosed as having AIDS. And even this is not a clear-cut case of transmission by transfusion, Dr. Mohn emphasized. The infant, who suffered from hemolytic disease of the newborn. had received 17 exchange transfusions of blood and a unit of platelets. some of which was traceable to the donor with AIDS. Most infants with hemolytic disease receive at most three exchange transfusions, suggesting that the infant's immune system was already deficient at birth. "A recipient of the same AIDS donor's packed red cells has not developed the disease," Dr. Mohn pointed out. Of the 14 hemophiliacs who have developed AIDS, a dozen had no known risk factor other than receiving clotting Factor VIII which is fractionated from the blood of many donors. One of the 14 was a homosexual; another had a history of possible intravenous drug abuse. It appears statistically unlikely that this treatment of hemophilia is a threatening factor, Dr. Mohn said, when one considers that each of the approximately 18,000 hemophiliacs in the U.S. annually receives this blood product which is prepared from many thousands of donors. "In the past two years. moreover. 24 million units of blood have been administered to six million recipients in the U.S. with only 13 cases of AIDS even thought to be linked to transfusions." noted Dr. Mohn. 90 per cent of AIDS victims die within three years Because of diagnosis and 80 per cent after two, Dr. Mohn acknowledged that the public has every right to be concerned. "But there is nothing to date which would suggest that AIDS is a highly contagious disease which can be contracted by casual contact with a patient or from blood or blood derivative transfusions," he said. While AIDS appears to be blossoming into a full-blown epidemic, he added, it is an epidemic only among certain groups in the population rather than among the publicat-large. And contrary to what has been implied, he went on, AIDS should not be referred to as a "gay" disease. "Among confirmed cases of AIDS," Dr. Mohn said, "there appears to be no involvement of monogamous male 16 • BUFFALO PHYSICIAN homosexuals, suggesting that multiple sex partners may be a factor in contracting the disease." Indeed, one AIDS victim reported he had more than 1,000 different sex partners during the course of one year. Mystery continues to surround the disease because no infectious agent has been identified which causes the breakdown of cellular immunity of the victims and leaves them vulnerable to fulminating, overwhelming and deadly infection from organisms which normally live in peaceful co-existence with the human body. Theories as to the actual cause of AIDS include notions such as an invasion of the victims by an unspecified organism- possibly a virus, or a wearing out of the cellular immune system caused by an overburden of antigen. It is known that certain infectious diseases caused by viruses, notably cytomegalovirus. are capable of causing immunosuppression. The mystery of AIDS is compounded by the fact that it does not appear to have existed previously in the population. Unlike Legionnaires' Disease, which was ultimately traced to a single organism after the Philadelphia outbreak, AIDS had not been described previously in the medical literature. "That is not to say it never existed in an individual but prior to 1981 it apparently never spread through a population to the point of being reported," Dr. Mohn said. AIDS is not a mandatory reportable disease as far as the CDC or other health agencies are concerned. New York as of July 1 remains the sole state to require such reporting. About half the reported cases, Dr. Mohn noted, have been in New York- primarily in New York City- with the majority of the remainder centered in California and Florida. "The figures we have now may be conservative," he suggested. "for some gays estimate that for every case idenILLUSTRATION: MIKE BUNN .. �anti-hepatitis B core antibodies, immune complexes, absolute lymphocyte counts, ratio of helper T lymphocytes to suppressor T lymphocytes, beta-2 microglobulin, thymosin and interferon serum levels," according to Dr. Mohn. Such testing has been primarily confined to those at high risk for AIDS, so it is still not known what results of the tests would show among populations not at risk. Currently, a pilot study has been initiated at the Buffalo Regional Blood Services Center of the American Red Cross which involves routine screening of all blood donors for anti-hepatitis B core antibodies. This particular test was selected because of the high association of hepatitis B virus infection and AIDS. The Buffalo Blood Services Center was selected, Dr. Mohn said, because it has the highest number of blood donations annually in New York outside New York City and because the Western New York area is currently free of known or suspected cases of AIDS which originated locally. "While there is still no convincing evidence to show AIDS can be transmitted through blood transfusions, it is important that all safeguards be taken with blood being collected Statewide for use by patients," Dr. Mohn emphasized. H tified and reported, three others exist." W hile the syndrome associated with AIDS is unique, problems of immunosuppression and immunodeficiency are not unknown in the realm of medicine. Cancer chemotherapy, steroids and radiation are all medical treatments known to temporarily suppress immune function components. There are other congenital conditions in which people are born with an immunodeficiency forcing them to have to live in virtually germ-free environments. "With the AIDS cases," though, Dr. Mohn said, "the immunodeficiency is unique in that it arises spontaneously in previously healthy young individuals who present initial symptoms which include unexplained weight loss, night sweats and lassitude." Some, but not all, may develop Karposi's Sarcoma, a malignancy which usually targets older men of Mediterranean or Jewish descent. And while Karposi's is typically a slow-growing tumor in the elderly male, in the young homosexual, it appears as a rapidly growing, virulent malignancy. The first two cases of AIDS reported were, in fact, young male homosexuals who were promiscuous. Both had opportunistic infections as well as Karposi's Sarcoma - an unusual combination of disorders which alerted the medical community to a new syndrome. Oddly enough, the entire immune syste m does not appear to be wiped out - only the cellular immunity. "The humoral immunity seems to remain intact for AIDS victims do not die of measles, influenza or other diseases to which they acquired antibodies through previous exposure," Dr. Mohn noted. Further complicating the problem is the fact that to date there is no specific laboratory test which directly predicts or confirms AIDS. "Tests which have been proposed for AIDS screening of blood donors include those for e feels strongly that in light of the patterns of distribution of the disease it would be reprehensible for any health care personnel to refuse to care for AIDS patients on grounds that it might be passed through casual contact. "Those who have AIDS realize their chances for living much beyond a few years following diagnosis are extremely slim. For them to be treated as lepers or worse by those in the health field shows a lack of compassion and humanity on the part of those individuals who have taken oaths to serve the sick," Dr. Mohn pointed out. Until scientific investigation can pinpoint the cause of AIDS, every attempt should be made to treat those patients who have overwhelming, opportunistic infections, he said. Noting that a bill has been recently passed in New York State to provide $5,250,000 for research and other endeavors related to AIDS, Dr. Mohn said a multifaceted approach must be launched to arrive at conclusive answers to the many questions related to the disease. "The New York State Blood Council's AIDS Thsk Force [which has among its members respected and acknowledged authorities in virology, infectious diseases, epidemiology, hemophilia and blood collection, processing, and distribution as well as physicians, immunologists and others involved in problems of cellular immunity] believes recipients of blood transfusions Statewide can be assured that their risk of developing AIDS is remote," Dr. Mohn emphasized. Citizens should also be assured, he added, that all precautions to safeguard the blood supply as much as possible are being taken. Potential donors receive pamphlets concerning AIDS with the request that they withdraw if they feel they are in a high risk group. Donors are also screened for recent infections or clinical symptoms which might suggest AIDS. "There is a need to protect those who will need blood transfusions," said Dr. Mohn, "but there is also the necessity to obtain blood to fulfill the needs of patients who would otherwise die in hospitals across the State." Some potential donors have called blood banks worried that they may get AIDS from needles or from bags used in blood collection, Dr. Mohn said. Others have postponed necessary surgery because of fears of receiving blood from donors who might later be found to have the disease. But, said Dr. Mohn, "there is no reason for panic in the streets over AIDS. There is no good evidence that we are in for an all-out epidemic of the magnitude of the Plague - killing men, women and children indiscriminately." • BUFFALO PHYSICIAN • 17 �1st Research Day Five faculty report on major p roj ects T he School of Medicine's first Research Day Symposium, May 25, was highlighted by: v a report on a successful new way of treating accident victims which has been developed by a University-affiliated team; v news of recent developments in local asthma research; v information about UB's new Nuclear Magnetic Resonance facility, and v discussions of work being done rn Buffalo on coronary artery disease and on the causes of kidney diseases. Sponsored by the newly-formed Medical Research Association, the event lured approximately 400 faculty out of their offices and labs to the Amherst Campus to hear five colleagues summarize recent research activity and to view 80 posters depicting other investigative endeavors. This premiere of what is planned to be an annual event was called an important day for the School by Medical Dean John Naughton. Dr. Naughton said it is important for faculty to have the opportunity to exchange ideas and information on their studies and projects in order to open doors for future collaborations. Dr. Alexander Brownie, chairman of the committee which organized the effort, noted that numbers of faculty involved in research have tripled over the past two decades. Numbers of submitted research proposals and levels of funding have also grown, he said, at a time when faculty at other institutions have witnessed a decline. with major, multiple injuries Patients frequently survive their original trauma only to die days or weeks later of Multiple System Organ Failure (MSOF). but pioneering research headed by UB surgeon Dr. John R. Border has begun to change that. Dr. Border has provided some of the answers as to why MSOF occurs and laid the foundation for preventive treatment. He brought news of some of this work. MSOF, he said, is a result of biochemical changes set in motion when the stress of trauma on the human system creates a progressive protein malnutrition. It is most likely to occur in patients whose injuries total 18 • BUFFALO PHYSICIAN 50 or greater on the standard Injury Severity Score. 1)rpically, the potential MSOF victim has one or more major fractures combined with intraabdominal bleeding or other combinations of severe injuries. Ironically, many who develop the progressive protein malnutrition which leads to MSOF initially appear to be improving, but then go suddenly downhill. "We now know," Border said, "that the stress of severe, multiple trauma produces a chain of biochemical events which affect the body as a system; that system must be treated in order to prevent multiple system organ failure." When the body does not receive adequate amounts of protein to meet the dual demands of maintaining function and initiating repair of damaged tissue, it will draw upon its own resources of stored nutrients- particularly protein from muscle. The less muscle mass a patient has, the more quickly the protein malnutrition will progress. The body's organs do not fail randomly. but in a constant sequence, Border explained. First the cardiopulmonary system goes out in an easily reversible fasqion, followed by liver, stomach, brain and finally- and irreversibly - the heart and lungs. The time it takes for the fatal sequence to complete its course, or whether it occurs at all, depends primarily on treatment provided as soon as possible after the original trauma. "In the beginning," Border noted, "many of these patients had fat emboli cardiopulmonary failure symptoms develop within a few days after admission to the emergency room. However, by placing them on ventilators early and maintaining them on the equipment for as many days as necessary, we were able to prevent this complication. as well as others which initially affected heart and lungs." Getting the patient in an upright rather than prone position also aids greatly in cardiopulmonary functions, he said. This requires operative treatment of fractures so they can be immobilized while the patient is mobilized. Plaster and traction are not used. "Leaving the dying and dead bone, blood and muscle tissue in the fracture site as is done in conservative fracture therapy activates phagocytosis," Border explained. As the phagocytes feed, they release a host of agents which alter muscle and liver biochemistry and lead �Research to protein malnutrition. Thorough debridement of all wounds, open or closed, reduces this phagocyte activation. In terms of protein malnutrition, Border and his team noted that even if patients were given normally required amounts of protein and calories, they still could develop MSOF. "When we looked at gut and liver differences, plasma concentration and the rate of infusion in amino acids, we found multiple signs suggesting that malnutrition was occurring in the muscle," Border says. This led to a viscious cycle of organs robbing each other of essential amino acids (protein) and limited the function of all organs by limiting protein synthesis. A major factor in the treatment, then, is infusion of the patient with 400 to 600 per cent more amino acids than healthy people require. These are given with a glucose solution which provides 25 to 50 per cent more calories than normal. Glucose administered to trauma victims at levels of 100 per cent or more in excess of normal requirements can contribute to development of fat in the liver, leading to this vital organ's breakdown. The success of the UB research, funded over the years with approximately $3 million in grants from the National Institute of General Medical Services. is Dr. John Border, shown in the ECMC trauma unit, discussed new ways to treat injury victims. evidenced by increased patient survival rates where the techniques developed here are used. One recent report shows that in 22 patients whose fractures were treated surgically within hours of their trauma, only one death eventually occurred from MSOF. In contrast, there were 14 deaths in 49 patients treated with plaster and traction. This sort of result has been shown in published papers from Helsinki, Basel, San Antonio, and Nijmegen (The Netherlands), Dr. Border reported. The groundwork for the UB studies was laid by Dr. Border, the late Dr. Rapier McMenamy, Dr. V.S. Vaidnyanthan, Dr. Leisure Yu, Dr. Elizabeth Moyer, and Drs. John Siegel and Frank Serra formerly with the Buffalo General Hospital trauma research program. Studies led by Dr. Border are continuing with Drs. Michael An bar, Thm Paul, James McReynolds, John LaDuca, Roger Seibel and Worthington G. Schenk. This research concentrates on means of delaying or preventing the gastrointestinal-hepatic-brain failure complex characteristic of the beginning of MSOF. research conductM edultidisciplinary during the past four years Over 400 faculty attended the 1st Medical School Research Day. (Inset) Dr. Elliott Middleton reported on asthma research. PHOTOS: NOWAK under the auspices ofUB's NIH-funded Center for the Study of Asthma and Related Allergies has produced some important findings, Center Director Dr. Elliott Middleton told the audience. An estimated 7.4 million Americans suffer from asthma, making it a major cause of absenteeism from work and classroom. It is also a potentially fatal disease. killing approximately 3000 atmually. One of the more significant findings locally in the field of asthma research, said Dr. Middleton, is evidence found by Drs. J. Cratg Venter and Claire Fraser suggesting that some patients produce antibodies to beta adrenergic receptors. Normally, these beta receptors bind epinephrine and epinephrine-like compounds used for asthma treatment. These compounds ordinarily relax smooth muscle in airways leading to the lungs. but they cannot act if they are blocked from binding to their specific beta receptors. The fact that some asthmatics thus fight themselves may partially explain why some respond well to normal dosages of these compounds and others do not, Dr. Middleton explained. But, more importantly, the presence of these auto-antibodies may be an important factor in the causes of asthma, he said. Elsewhere, research efforts by Dr. David lriggle, professor of biochemical pharmacology, into the nature of D-4 leukotriene smooth muscle receptors as well as into the importance of calcium channels in asthma have led to the suggestion that calcium antagonists such as Verapamil may have potential as anti-asthmatic drugs, Dr. Middleton reported. And teams of researchers at Children's Hospital (including Dr. Stanley J. Szefler, who is now located in Denver, BUFFALO PHYSICIAN • 19 �Dr. Elliot F. Ellis and Dr. T.P. Lee) have found that combination therapy involving both the steroid methylprenisolone and TAO (troleandomycin) appears to benefit some severe asthmatics who have not responded well to other medications. TAO, an antibiotic first used to combat acne but no longer employed in fighting that disorder, appears to slow the clearance from the body of the accompanying steroid, allowing it to remain active for longer periods of time, Dr. Middleton said. Lastly, Dr. Middleton reported, local research on Oavonoids, a class of chemical compounds found widely in fruits, vegetables, nuts and seeds, suggests that some of these may play a role in the design of drugs for use in future treatment of asthma and other inflammatory diseases. Some Oavonoids, notably quercetin, appear to have strong anti-allergic activity, blocking the release of histamine from human white blood cells. Histamine release, Dr. Middleton pointed out, is what leads to constricted smooth muscle airway and other bodily expressions of allergic reactions such as hay fever and hives. "Some of the Oavonoids also affect many enzyme systems, can modify lymphocyte function, have spasmolytic activity and may have antiviral activity,'' Dr. Middleton suggested. Emphasizing that research results reported at the Symposium have been achieved through collaboration of faculty scientists representing several disciplines, Dr. Middleton said such multidisciplinary efforts should be encouraged. 0 ne of the most promising new developments in diagnostic medicine is Nuclear Magnetic Resonance (NMR), which utilizes magnetic forces 3,000 to 25,000 times the strength of the Earth's own magnetic field to create images of the body's interior. Now in experimental use in only a few medical centers in the U.S., NMR holds the promise of being more accurate than either CAT scans or x-rays, without causing ill effects or needing auxiliary agents to produce an image. Research on NMR being conducted at a new facility at UB was highlighted at the Research Day event by Dr. Philip L. Yeagle, a Medical School biochemist and supervisor of the facility. According to Dr. Yeagle, basic research is underway to contribute to the developing data base for the new technique. UB's recent acquisition of a 55-kilogauss super-cooled NMR device is expected to enhance capabilities of 20 • BUFFALO PHYSICIAN Dr. Philip L. Yeagle talked about US's NMR facility. both campus and hospital-based scientists who probe tissue at cellular and molecular levels for the causes of disease. Dr. Yeagle said the $210,000 UB device is designed to assist basic rather than clinical research. Its advantage, he noted, lies in its ability to more accurately measure properties of atoms and molecules in tissue samples than is possible with other techniques such as x-rays. Unlike the NMR. which is non-invasive, many of the other devices require the addition of reagents to tissue samples. These reagents can alter or destroy the molecules' properties. When a sample of a substance, such as a cell membrane, is placed in the NMR's magnetic field, the nuclei of atoms enter a series of energy level transitions which are measured and can be made to appear on a computer printout. Thus, the device not only shows the structure and environment of the molecules but also pinpoints concentrations of various components and their locations in tissue. While the principles governing nuclear magnetic resonance and the way in which NMR functions are complex. they can, in part, be compared to radio wave transmissions and reception. "It is known that the nuclei of some atoms of particular stable isotopes will absorb radio frequency energy when placed in a magnetic field," Yeagle explained. But like the radio which must be tuned to a given frequency to receive a specific station, the nuclei of various isotopes must receive a specific frequency which activates them to send back a signal, which can be measured using the NMR. Unlike an NMR full-body scanner, which may be tuned to send only the frequency which can be absorbed by hydrogen nuclei. the UB device has virtually unlimited capabilities in sending multiple frequencies known to activate nuclei of many isotopes. "Much of the individual device's capability lies in the strength of its magnetic field - expressed in kilogauss which surrounds the tissue sample or patient," Yeagle went on. The higher the kilogauss, the higher the radio frequencies which can be used and the greater the device's sensitivity. NMR. said Yeagle, has the capacity to aid research in virtually every area of medicine - from heart disease to cancer to inborn errors of metabolism. Yeagle's research is funded by $600,000 in grants from the National Heart, Lung and Blood Institute and the National Science Foundation, and will involve NMR and other tools to help clarify the complex relationship between cholesterol and protein at the cellular level. Since little research has been conducted on this interaction at the cell membrane, he hopes his research will provide a more complete picture to link the relationship of these nutrients and their location in the cell with diseases such as obesity and atherosclerosis. A significant finding has emerged from research conducted in UB's Division of Cardiology which is causing scientists and physicians alike to re-think traditional views on factors governing coronary blood flow in both healthy individuals and those with coronary artery disease. Dr. Francis J. Klocke reported on this work at the Symposium. "It had always been believed that Dr. Francis Klocke ) �Research the primary physiological factors controlling coronary blood flow were inflow pressure and vascular resistance," said Dr. Klocke, professor of medicine and chief of the Division. But research suggested by Dr. Ron Bellamy, formerly of UB, and continued by the cardiology research team headed by Dr. Klocke has proved the existence of a pressure within the heart wall which also opposes coronary blood flow. The data suggest this pressure to be a contributor to flow reductions in coronary artery disease. The role of this so-called "zero flow" pressure has particular implications, Dr. Klocke said, because it remains operative during diastole, the period of relaxation between heart beats when the heart receives most of its nourishment. This finding is important from a basic physiological standpoint. It provides greater understanding of the mechanics of coronary blood flow, Dr. Klocke pointed out. Noting that animal studies are underway at UB's Clinical Center located at Erie County Medical Center, Dr. Klocke emphasized that it may be some time before technology will be available which will allow physicians to measure zero flow pressure in patients. The possibilities, however, are exciting, he said. If zero flow pressure's role can be precisely determined in specific forms of heart disease, further research may suggest how the pressure may be either manipulated or controlled to aid in treatment. "We also now know that zero flow pressure is not an artifact of blood vessel capacitance, as some investigators suggested initially," Dr. Klocke added. In addition to their studies of zero flow pressure, the UB cardiology researchers at ECMC have developed a helium technique which allows the amount of blood flowing through a narrowed artery to be precisely defined. Before the technique was developed it was not possible to quantify blood flow in the area of the heart supplied by a diseased artery. A gas chromatograph used by the researchers to analyze blood helium concentration was designed by Dr. Klocke. Other work underway by the team he heads focuses on how autonomic nerves control blood flow to the heart and the phenomenon by which some patients with stenosis revascularize blood flow through collateral vessels. Research by the team has been (Above) /mmunoflourescence study of capillary wall of patient with Goodpasture's Disease - an immunologically caused kidney disease. Dr. Guiseppe Andres (inset) reported on kidney disease research. funded by the National Heart, Lung and Blood Institute over the past 15 years with the group receiving a recent renewal of a $2.5 million grant last fall. Others involved in the research have included Drs. Robert A. Klocke, Robert E. Mates, David G. Greene, John Krasney, John Canty, Avery Ellis and Thomas Aversano. T echnological advancements during the early 1950s which have enabled scientists to remove and examine small fragments ·of diseased kidney tissue from living patients have been instrumental in significantly changing the concepts of renal disease pathogenesis, UB's 1982 Stockton Kimball Award winner Dr. Guiseppe Andres told the audience. "When I graduated from medical school in 1949, there was a long-held theory that renal disease was caused by an inflammatory process, and was a single disease entity," said the UB professor of pathology, microbiology, and medicine. Thday, however, it is believed that 80 to 90 per cent of renal disease is a result of underlying immunological response of the host to an antigen yet unidentified -which renders cells of the kidney useless in their vital filtering function . And it is now known that the disease does not develop in precisely the same way or for the same reasons in every patient. The dramatic shift to emphasis on immunological rather than morphological origins of the disorder is credited to scientific research made possible by the advent of the needle biopsy and by development of light/electron microscopy and immunofluorescence techniques for testing tissue. "Until the early 1950s when Sweden's Alval and later Denmark's Iversen and Brun demonstrated that diseased renal tissue could be removed under local anesthetic from Jiving patients, it had not been possible to BUFFALO PHYSICIAN • 21 �Research "The kidney has been a driving force to stimulate research in other areas- in autoimmune disorders and other diseases in which the host response to antigen is an important component." • Radiation plus drug increases survival rate R Eighty posters outlining research projects were on display during the Day. examine evidence of the disease prior to autopsy," Dr. Andres pointed out. At autopsy, the typical sclerotic pattern seen microscopically in tissue appeared identical in nearly all who succumbed to renal disease, so the origins and pathogenesis of the disorder were obscured. "The new scientific tools were significant in that they helped us to gather evidence which pointed to an immunological basis for most renal disease," Dr. Andres said . "But, even more importantly on a clinical basis, they permitted us to differentiate among the disorders." Much of the credit for the changing concepts goes to Dr. Frank Dixon , head of the Scripps Clinic, an old friend of Dr. Andres who demonstrated that different types of renal disease may be produced by the same antigen and the same pathogenic mechanism. Research at UB-Buffalo General Hospital and elsewhere today focuses on better understanding of specific mechanisms of the immune response which go awry to cause disease of the kidneys. "The biggest problem facing researchers in renal disease is that the antigen is unknown in most cases," Dr. Andres said. But despite this missing- and vital - clue which may hold the key to future prevention or eradication of the disease, the knowledge gained over 22 • BUFFALO PHYSICIAN the past three decades has succeeded in spelling a longer lifespan and improved quality of life for many. "Dialysis and renal transplantation have prolonged life for patients who would have otherwise died from the poisonous body byproducts their kidneys could not clear," Dr. Andres said. And drugs such as the steroids and the immunosuppressant Imuran have also played a major role in reducing antibodies which would destroy renal tissue in those with organ transplants as well as in others who may or may not require dialysis. Experimental cyclosporin A also appears a valuable drug which may be used to reduce the rejection rate of donor organs and the destructive antibodies which would destroy the transplanted kidney. But, said Dr. Andres, it is not known yet whether that drug has value in treating the underlying immunological response which sets the disease in motion. Evidence gleaned from efforts by scientists such as Dr. Andres and his colleagues may ultimately lead to improved immunomodifiers and other agents which manipulate components of the immune system to halt the disease before irrepairable damage has occurred. While research on pathogenesis of renal disease has benefited thousands of patients over the past three decades. Dr. Andres pointed out it has also had wider implications. adiation therapy combined with the anticancer drug hydroxyurea appears to significantly increase survival rates for patients with cancer of the uterine cervix. according to results of a clinical study by a UB oncologist at Roswell Park Memorial Institute. Dr. M. Steven Piver, deputy chief of gynecologic oncology at RPM!. reports that 20 patients with localized Stage liB cancer of the cervix who received the combination therapy showed a 94 per cent five-year survival rate compared to 53 per cent for an equal number suffering identical disease who were treated with standard radiation and placebo. The patients had all undergone exploratory surgery that determines the disease had not spread outside the pelvis to the para-aortic lymph nodes. A clinical professor of gynecologyobstetrics at UB. Dr. Piver believes that if the study's findings are verified elsewhere. the combination treatment could save a substantial number of the 6.000 women who die annually in the U.S. from cervical cancer. While hydroxyurea has been used as a chemotherapeutic agent against multiple myeloma and some leukemias. its benefits in the cervical cancer study appear to stem from its ability to enhance effects of radiation on malignant cells. Dr. Piver says. This action has been demonstrated in cell culture and in transplanted animal tumors, he adds. and may be true in human patients. Presenting results of the RPMI-based study at the 19th Annual Meeting of the American Society of Clinical Oncology in San Diego. Dr. Piver pointed out that advances in radiation therapy have not produced a corresponding increase in survival rates among women with this relatively common form of cancer. "More significant strides: · he said. " have been made through development of the PAP lest which allows early detection of the disease:· Early detection and treatment. he noted. result in nearly a 100 per cent cure rate. "1echnology would allow us to kill virtually all the cells- healthy and malignant with enough radiation - but this approach is clinically unacceptable:· Dr. Piver emphasized. Hydroxyurea's role as a radiation enhancer allows a physician to use the standard dose of radiation to achieve better results by destroying malignant cells without harming large numbers of healthy ones. Early detection. though. is still the key in preventing deaths from cancer of the cervix. \ I �Acting VP Pannill leaves post \ J \ I M edical School Dean John Naughton has been named acting vice president_ for health sciences to replace Vice President F. Carter Pannill Jr., who resigned from the post effective July 31. After a six-month study leave. Pannill will return to teaching and research duties here as professor of medicine in February. 1984. Noting that Dr. Naughton will continue in his role as dean of the School of Medicine, President Sample said, "As a respected leader in the Western New York medical community. Dr. Naughton is known and admired throughout the University for his talents as chief academic officer of our Medical School. We are fortunate indeed to be able to draw upon his broad knowledge and administrative expertise in filling the post of Acting Vice President for Health Sciences." Dr. Naughton praised Dr. Pannill's "strong leadership" and said he "worked diligently and hard to insure strong programs in each of the health sciences: he revitalized the entire faculty, especially in the Medical School and Health Sciences areas." Commenting on his new appointment as acting vice president, Dr. Naughton described his two primary concerns. "The first will be to make sure that the quality of our programs doesn't suffer during the construction project on the Main Street campus," he said. "We will do all we can to facilitate the work of the faculty and the convenience of the students. "Another ongoing concern," he added, "is to protect the integrity of our program during times of fiscal austerity. We will also continue to foster stronger and stronger relationships with each of our teaching hospitals." Of the massive construction/renovation project currently underway on the Main Street campus, Dr. Naughton said, "It will give us, when completed, a facility that will make us very proud of being part of the state system. It will be most conducive to maintaining the quality of work by faculty and students." Dr. Naughton stated, "I look forward to the opportunity to work with the Dr. John Naughton in Medical School office. (Inset) Dr. F. Carter Panni/1 with gift at one of several farewell parties. PHOTOS: FRANCIS SPECKER BUFFALO PHYSICIAN • 23 �Health Sciences faculty and to continue the programs and work that Carter Pannil! began." "Dr. Pannill's many contributions to Health Sciences and the entire University have been exemplary," Sample commented, "and his outstanding leadership has served as a model to all of us in our academic community. Under his guidance, our health science programs have expanded in size and scope and have enhanced their national reputations. We owe him a debt of gratitude." • View of Farber Hall facing Bailey Avenue: it's surrounded by new construction. MDlPhD New program trains medical scientists I n the classnotes section of this issue, a note on the Class of 1964 reports that Dr. Franklyn Knox has been named dean of the Mayo Medical School. That same Dr. Knox was the first dual M.D.-Ph.D. graduate of the UB School of Medicine. His elevation at Mayo coincides with the full-scale launching here this fall of a "Medical Scientist TI-aining Program" leading to the combined M.D.-Ph.D. According to Dr. Donald S. Faber, director of the Division of Neurobiology and also coordinator of the new program, students have traditionally been able to earn both degrees here, but the usual pattern was that the individual took time either before or after medical school for the Ph.D. Now, for those accepted into the Program, it will be possible to work toward both degrees simultaneously, completing both in six, or perhaps seven years. The first two beginning students were accepted in 1982, and three more entered this August. The goal, reports Dr. Faber, is eventually to accept four beginning students each year (although a student accepted into the M.D. program only can apply during either the first or second year of med school). The new Program (similar to others offered at most upper tier medical schools in the U.S.) is designed to narrow the gap of knowledge and understanding that often separates highly specialized scientists from practicing physicians. Its graduates will bring both clinical and research skills to their work in the laboratories and classrooms of medical schools, teaching hospitals and research foundations. Ideally, says Dr. Faber, these will be 24 • BUFFALO PHYSICIAN review of "the state of the art" in each of those areas. Medical students, on the other hand, were simply presented with these findings in class lectures. Dual degree students also take a "Selective" course on ethics offered to all medical students, but with a special component focusing on the ethics of biomedical research. Dr. Stephen Wear (who has a joint appointment in philosophy and medicine) developed the offering especially for this group of students. Summers during the first two years are to be spent in active research work. Where the regular M.D. student goes on to clinical work in the third year, the student in the new Program will ordinarily turn to his or her Graduate School work at that point. Three years will be spent in that phase of the Program before the student finishes with approximately a year and a half of clinical rotations. he competition for such students is The Ph.D. portion of the work may be stiff, Dr. Faber notes. "We're comearned in Anatomical Sciences, Biopeting with institutions such as Duke, chemistry, Biophysical Sciences, the University of Rochester, and Washington University of St. Louis, Microbiology, Pathology. Pharmacology and Therapeutics, Physiology, Bioensome of which accept up to 15 students gineering, Psychology. Biological a year into their programs." Many of Sciences, or at Roswell Park. Each stuthese programs also receive federal dent will perform an original research funding, something UB hopes to attract project suitable for dissertation and as the offering here becomes more then prepare and defend the thesis. established. Clinical contacts will continue during Financial support of $6,000 per year for those in the Program is currently these grad school years through special provided by the School of Medicine and seminars emphasizing clinical issues. by the UB Graduate School which has attendance at weekly Grand Rounds agreed to fund four scholarships and a series of lectures in medicine. This pattern can be changed, of annually. Details of the Program are both flex- course, if for any individual it is more ible and in the formative stages. Essen- appropriate to take selected clinical tially the first two years will find the rotations along with graduate work. M.D.-Ph .D. student in the same basic The point is, notes Dr. Faber, that science classes as regular med students "we're trying to let the program evolve - with the difference that these dual as we learn from experience. We want program students will be assigned ex- to step back, look, and ask questions. tra research . For example, in a As we find the answers. the distinctions Physiology class last spring dual M.D.- between the medical and graduate Ph.D. students had to research two components of the program will topics of interest and prepare a short become even more blurred." • "superpeople" who will do both research and clinical work at the same time. If they elect to do only one or the other, however, they will at least have an understanding of both aspects of medicine. The demanding dual program, in Dr. Faber's view, tends to appeal to the very brightest students - those who recognize that medical school training alone will not meet their desire to be inquisitive scientists. Those applying are expected to equal or surpass the quality of students admitted either to the School of Medicine or the UB Graduate School. They will also have to demonstrate a sincere and continuing enthusiasm for their chosen scientific discipline. Students who have previously spent time in a research laboratory or who have publications to their credit will receive priority consideration. T �Medical School News Dean's staff is reorganized R eorganization of activities of the dean's staff has been announced by Dr. John M. Naughton. including appointment of Dr. Michael Anbar, recently named executive director of the Health Instruments Development Institute (HID!), as associate dean for applied research. Realignment of other duties was brought on by the absence of an associate dean for student and curricular affairs. the post recently vacated by Dr. Leonard Katz. Dr. Paul Davis has agreed to chair a search committee for this post. A candidate is to be identified by January 1. 1984. Staff members with realigned responsibilities are: ,. Dr. Jack Richert who has been assigned duties dealing with medical student registration, graduation certification, alumni affairs, financial aid. the academic calendar. and publication of the student handbook. course books and the School Register. He has been relocated to 139 Cary Hall and will be assisted by Mrs. Nancy Druar. Medical Alumni secretary. and Jill Kwiatkowski. ,. Dr. Maggie Wright will coordinate student counseling, the programs for minority and socially disadvantaged students, the preclinical and clinical advisors. the various summer programs. and the Leave of Absence Committee. In addition. she will staff the First and Second Year Committees. She will be assisted by Mr. Frank Roberts through December 31, 1983. and by Ms. Linda Gould. ,. Dr. Frank Schimpthauser will coordinate the Selective Committees and programs for years one and three. staff the Third and Fourth Years Committees. coordinate the preceptorship program, and staff the Accelerated Program. Siegel Awards Committee. and programs dealing with academic excellence, such as AOA. Thesis Honors, and the Awards Committee. In addition. he will continue to provide services related to teaching evaluations and educational evaluations. He will be assisted by Dr. Randolph Sarnacki and Ms. Cathy Cyrulik. Dr. Sarnacki will staff and coordinate the Summer Research Fellowship Committee. • 12th annual Orthopaedic Day T he 12th Annual University Orthopaedic Residents Scientific Day was held May 26 at the Erie County Medical Center. Kingsbury Heiple. M.D.. professor and chairman. Department of Orthopaedic Surgery. Case Western University, was the visiting professor and delivered the 8th Annual David M. Richards. M.D. Memorial Lecture, titled "Use of Fluted Rods in Subtrochanteric and Shaft Fractures of the Femur." Five orthopaedic residents presented scientific thesis papers: Dr. DavidS. Bevilacqua. "Pilon Fractures (Intra-articular Fractures of the Distal Tibia)": Dr. Joseph E. Buran. "An Analysis of Diaphyseal Fractures in Children Ages 2-12": Dr. Ronald M. Cam. "Silastic Arthroplasty for Acute Radial Head Fractures"; Dr. Peter E. Shields. "Shoulder Impingement Syndrome": and Dr. David J. Winnick, "One Stage Reduction and Reconstruction of Spastic Dislocations of the Hip." Four emeritus faculty were honored for their dedicated service as skilled clinicians and outstanding educators: Drs. James P. Cole, Russell B. Erickson (deceased). Joseph D. Godfrey. and George H. Marcy. • US ranks 24th in minority percentage T he UB Medical School ranked 24th in the nation among 124 medical schools in terms of the percentage of minority representation in its enrollment for 1982-83. Minorities constituted 10.8 per cent of Medical School enrollment here that year. The average for minority enrollment for the three years ending in 1982-83 was 8.9 per cent. according to figures compiled by The New Physician using data from the Association of American Medical Colleges· Directory of American Medical Education. Rekate, Schenk, Katz honored A wards and recognitions highlighted the Annual Faculty Meeting of the School of Medicine. May 25. at the Katharine Cornell Theatre at Amherst. Dr. Albert C. Rekate. retired professor of medicine and lecturer in rehabilitation medicine. was presented with the Dean's Award (the School of Medicine's Silver Medal) and Dr. W.G. Schenk. Jr.. professor and chairman. Department of Surgery. received the Stockton Kimball Award (Steuben crystal). The Dean's Award is presented for outstanding service to the school and the Kimball Award. for faculty accomplishment in scholarship and research. A special Distinguished Service Award went to Dr. Leonard A. Katz in recognition of his eight years of service as associate dean for student and curricular affairs and director of the Office of Medical Education. "Dr. Katz:· Dean John Naughton read in a special Dean Naughton presents award to Dr. Rekate. citation. "distinguished himself as a friend of numerous students. a leader of faculty. and a leader in the area of educational innovation. The Selective Program was nourished and subsequently flourished as a result of his foresight and his commitment to enlarging educational opportunity for medical students. His skills and talents were recognized when. in 1976. the Iris was dedicated to him. He represented the School of Medicine in many forums in the statewide and national scenes, and through his friendliness and dedication he helped earn the esteem and respect for the institution from our peer institutions. He truly was a ·man for all seasons: and is truly a distinguished servant of the School of Medicine of the University at Buffalo:· the dean said. The School's four past and present Distinguished Professors were saluted with the unveiling of framed photos and citations for each to be hung in the Lippschutz Conference Room in Farber Hall. The four are Dr. Ernest Witebsky, (deceased). named a Distinguished Professor of Bacteriology and Immunology in 1954: Dr. Hermann Rahn. named Distinguished Professor of Physiology in 1972: Dr. Oliver P. Jones. recognized as Distinguished Professor of Anatomical Sciences in 1976: and Dr. Felix Milgram. honored as Distinguished Professor of Microbiology in 1981. The Louis A. and Ruth Siegel Teaching Awards were presented to Dr. Alastair C. Brownie. professor and chairman. Department of Biochemistry. in the pre-clinical faculty category: Dr. Richard H. Ad ler. professor of surgery. in the clinical faculty grouping: and Dr. William C. Heyden. clinical instructor in surgery. among the volunteer faculty. Siegel commendation letters were awarded: ,. to six pre-clinical faculty [Dr. Murray Ettinger. associate professor of biochemistry: Dr. Perry Hogan. professor of physiology: Dr. Charles Severin. assistant professor of anatomical sciences: Dr. John Wright. professor and chairman. pathology: Dr. Stephen Gutman. assistant professor of pathology: and Dr. Sabina Sobel. assistant professor of anatomical sciences]. ,. to four clinical faculty [Dr. Sattar Farzan. clinical professor of medicine: Dr. Jules Constant. clinical associate professor of medicine: Dr. Bradley Truax. assistant professor of neurology. and Dr. Margaret MacGillivray. professor of pediatrics]. and ,. to two volunteer faculty [Dr. James Nunn. clinical associate professor of family medicine and clinical associate in medicine: and Dr. Norman Sfeir. clinical instructor in medicine]. Housestaff Awards went to: Dr. David DiMarco. clinical assistant instructor in surgery, and Dr. Sarah Elsaharty, clinical assistant instructor in urology. Three housestaff members received commendation letters: Dr. Gregory Ivins. clinical assistant instructor in surgery: Dr. Charles Chambers, clinical assistant instructor in medicine, and Dr. Michael Delissio, clinical assistant instructor in medicine. • BUFFALO PHYSICIAN • 25 �By Mary Kunz In debt Most students leave here owing $25 ,000 ''0 ne of the main problems in medical school is that there's no guarantee the cost will stay the same from year to year," sighed Debra Salter. a third-year medical student here. "You have to budget for more than when you go in." Her husband. Wallace Salter. also a medical student at the University, echoed her words. "Just plan on being in debt," he laughed. Debra and Wallace Salter are just two of many medical students trying valiantly to struggle their way through the skyrocketing costs of medical education today. Even in a relatively low-cost public institution such as UB. the task is not easy. In one year. medical school tuition here rose from $4,300 to $5.550- an increase of 30%. "Almost everyone's on loans," commented Dr. John A. Richert. assistant dean of the School of Medicine. He added that last year. "the total disbursement of funds we handled was over $4.000,000. Over $3,000,000 of that was in the form of loans." Debra Salter lamented that even guaranteed annual student loans for $5.000 are now insufficient. "It wasn't so bad in the past. because the tuition was under $5.000." she noted, "but now you're almost forced to take out an additional loan." Richert's statistics reflected this situation. "The bulk of students who go through this school are leaving in debt to the tune of $25,000," he pointed out. "And that's just for education." L oans may take the form of Guaranteed Student Loans, Health Professional Loans, or Auxiliary Loans to Assist Students (ALAS). Scholarships may be awarded through military programs, national minority fellowships, exceptional financial need scholarships, Regents Scholarships or Physician Shortage Scholarships. In addition. there is a State tuition waiver program called MOLD (for Medicine. Optometry, Law and Dentistry). About 100 of these tuition waivers were given last year to financially disad26 • BUFFALO PHYSICIAN . vantaged Buffalo medical students. Richert noted. "It's all based upon need," he explained. Debra Salter is the recipient of a Smith-Klein-Beckman Award, 30 of which are presented annually throughout the country. She is the first UB student to have received one. The money makes a big difference. because most medical students have little or no time to hold jobs, except in the summer. "They don't encourage you to hold a job. but they do encourage summer jobs," Wallace Salter said. "Most students work during the summer they like to see you do something in the medical field , to give you experience." Last summer, Wallace said, he worked in the geriatrics program of Buffalo's Veterans Administration Hospital, researching alcoholism. Even students with no financial need are encouraged to find extra work in the medical field in their summers or spare time. One such student is Sanford Levy. a second-year medical student here. Although his father, a physician himself, is able to pay his son's tuition with no trouble, Levy has spent many summers working in the field. ''I've been interested in medicine all along," Levy commented. "I worked in a psychiatric center for two summers. and one summer I did volunteer work in a neurological clinic. Another summer. I worked in the .Erie County Medical Center." He smiled, "Now that I'm in med school. I bum around during my summers." Levy is the recipient of one of UB's recently instituted Scholar Incentive Awards. These awards, he explained, provide $2,000 every year, renewable at the end of each year as long as the student passes his or her courses. Four Scholar Incentive Awards are given out every year - two to majority and two to minority students - based on students' MCAT scores and weighted grade point averages. Levy appreciates his award, but views it as a welcome stroke of luck rather than a necessity. "It's nice getting the break, but I'd be here whether or not I had it," he said. "It's a good program designed to encourage good students. For me, it was just a nice extra." Levy's parents are not unique in helping their son through medical school. Debra and Wallace Salter agreed that help from parents is nothing unusual. �------------------------------------------Students "I think it would be very difficult to get through without help from parents," commented Debra Salter. "It's not always the case, but most students do have help." D ebra's parents help their daughter and her husband by taking care of some of the extra, non-educational costs. The house on Stockbridge Avenue that the Salters occupy is owned by Debra's parents, who rent out the upstairs apartment. "Little costs add up," Wallace Salter pointed out. and the two of them have devised ways to cut corners on expenses. "We get just one textbook between us," Debra volunteered. "Textbooks are expensive." If not always easier on the bank account, marriage to another medical student has other advantages. "For us, it's easier than if we were single," Wallace Salter asserted. "Financially, it's tougher, but supportively, it's easier." Debra Salter suggested that the scholastic advantages of being married to another medical student lie in the fact that both are going through the same schedule and courses. "If one of us was a medical student and the other one wasn't, it would be difficult." she reasoned. "If you didn't have the common interest. it might pull you apart. With us. it's easier. We take the same classes together and we study together." The Salters met in Colorado and. after getting married, applied together to medical school. They were accepted at Albany before UB but chose UB because of its low tuition. "When we first got accepted at Albany, we thought. oh no!" Wallace Salter laughed. "Students facing a choice need to consider tuition. We're fortunate because UB is a very good school as well as a state school. It's the best school for your money." Levy, a Buffalo native, welcomed the opportunity to attend medical school in the area. "My decision to come to UB was a personal as well as a financial decision," he claimed. "Here, the tuition is lower. It's a state school - I think it's the best bargain around. You pay a lot less ..." Still, even a state medical school is far from inexpensive, and medical school remains a financial struggle for most students. Debra Salter was pessimistic. "For us, it's not so bad, because we've got only two years to go," she pointed out, "but beginning students will have it really hard." • Summer programs Minorities gain exposure to research work R ather than spending a leisurely summer, a group of academically talented minority students opted instead to spend the time gaining valuable experience working with UB researchers. Selected for their expressed interest in future careers in either science or medicine and a demonstrated academic achievement record, 18 undergraduates from institutions around the nation and seven area high schools participated in two separate programs. For an eight-week period they worked in laboratory settings on the Amherst and Main Street campuses as well as in teaching hospitals under supervision of faculty. Sixteen of the undergraduates in the Summer Research Program worked with faculty in the School of Medicine; two others were placed in Biological Sciences and Physics and Astronomy. Funding for this program was provided partly by monies from the Buffalo Foundation and partly by the School of Medicine. Five of those selected to participate in the Minority High School Student Research Apprentice Program worked in laboratories of School of Medicine faculty: two others, in Biological Sciences. Grants from the National In- stitutes of Health to Dr. Donald Rennie, vice president for research and graduate studies, and Assistant Medical Dean Dr. Maggie Wright and the School of Medicine supported this effort. Mrs. George Unger, coordinator of UB's Office of Affirmative Action. said the 18 undergraduates who came from as far away as Texas and Florida, had completed the sophomore year at their respective colleges and universities. The Program provided them with experience in research settings in the biological, physical and chemical sciences where minorities historically have been underrepresented . Every effort was made, she said, to match students with faculty who have similar interests. Students selected for either Program do more than merely observe in the laboratories- they are expected to expand both their research skills and knowledge by working on actual projects. Undergraduates in the Summer Program from outside Buffalo received a stipend which included their room and board; Buffalo participants received monies for transportation and incidental expenses. Those in the High School Apprentice Program were paid an hourly rate. Med Student Dennis Hollins (left), Or. Maggie Wright and Or. Robert Baier at session of summer program for minority students. ~ ~ 0 z g 0 I a.. BUFFALO PHYSICIAN • 27 �This is the second year the two Programs have been offered. D r. Charles Kaars. assistant to the vice president for research and graduate studies, who with Dr. Wright coordinated the Apprentice Program, noted that some 100 area students applied this year. Last year, he said, only about 30 sent in applications. Mrs. Unger and Drs. Kaars and Wright emphasized that a willing group of faculty who have volunteered to provide interested students with training to both increase their skills and encourage their career plans have been an important component in the success of the Programs. Student quality has been a factor as well. "It's a two-way street, with faculty. staff and students learning from each other." said Dr. Wright. The Combined Programs. she said. allow early identification of talented minority students locally and nationally at the high school and undergraduate levels who are interested in careers in science and medicine. creating opportunities designed to maintain their interest through working with scientific professionals and support staff. UB personnel also follow-up with the students and their advisors on their home campuses. In addition to actual "hands-on" laboratory experiences." the students attended seminars presented by faculty designed to further whet their appetites for scientific careers. At the conclusion of the Programs, participating students prepared oral presentations on their experiences for colleagues and faculty. Students enrolled in the Apprentice Program and their mentors were Rose Marie Bell. a senior in the City Honors Program. who worked with Dr. Claes Lundgren in the Department of Physiology: Maria C. Bunche, a West Seneca West junior. with Dr. Michael Hudecki. Department of Biological Sciences; Karleyton Evans, from Tonawanda who will be a freshman at Boston University this fall, with Dr. David Pendergast. Department of Physiology: David Love Jr.. a Buffalo student who will be a freshman at NYU, with Dr. Gail Willsky. Department of Biochemistry; Cynthia Ruiz, a junior at South Park High School. with Dr. Roberta Pentney. Department of Anatomical Sciences: Todd White. a junior at Williamsville East. with Dr. Francis Bellino, Department of Biological Sciences: and Marla L. Young, a Buffalo student who will be a freshman at Canisius. with Dr. Philip LoVerde in the Department of 28 • BUFFALO PHYSICIAN (From left) Students Marla Young and Lisa Falgout with Dr. Philip LoVerde, Department of Microbiology. Dr. Wright (Jeff) with undergraduates in the Minority Summer Research Program (front row, from Jeff): Toney, Adams, Brown, Morales, Roman, Bridges, Luchey, Dace and (back row, from Jeff) Bohannon, Falgout, Shanks, Daniel, Troup, Mays, de Ia Fuente, Bloodsaw, Dial and Agocha. Microbiology. Students and faculty participating in the Undergraduate Summer Research Program were: Vallee Adams, Clarksdale, Miss., with Dr. Murray Ettinger, Department of Biochemistry: Augus- tine Agocha. New York City, with Dr. Robert Noble, Department of Biochemistry; Roderick Bloodsaw, Eufala, Ala., with Dr. Lee Bernardis, Department of Medicine; Arline Bohannon, East Amherst, with Dr. Carmela Privitera, �Students Instruction sheets Student competition centered on providing clear information J Department of Biological Sciences; Diana Bridges, Buffalo, with Dr. Vijay Kumar, Department of Microbiology: Leslie Brown, Jacksonville, Fla., with Dr. Robert O'Shea. Department of Social and Preventive Medicine; Selwyn Daniel. Lansing. Mich .. with Dr. Margaret Acara. Department of Pharmacology and Therapeutics; Horacio de Ia Fuente. Huntington. N.Y.. with Dr. Bruce McCombe, Department of Physics and Astronomy: Alphonso Dial, Anniston. Ala .. with Dr. Daniel Kosman, Department of Biochemistry; Abel Doce. Bronx. with Dr. Boris Albini. Department of Microbiology; Lisa Falgout. New Orleans. with Dr. Philip LoVerde. Department of Microbiology: Ida Luchey. Buffalo, with Dr. Gerald Sufrin. Department of Urology: Adrienne Mays. Dallas. with Dr. Stefan Cohen, Department of Medicine; Margaret Morales, Brooklyn, with Dr. Donald Faber. Department of Physiology; Yvonne Roman, Brooklyn. with Dr. Daniel Amsterdam, Department of Medicine; Donna Shanks, Cincinnati, with Dr. Diane Jacobs. Department of Microbiology: Sheila Toney. Madison. Ala., with Dr. Mary Thub. Department of Biochemistry; and TI"aci TI"oup, St. Paul, Minn., with Dr. Bernice Noble, Department of Microbiology. • unior medical student Christopher Walsh and graduate student Sistine Chen took top honors during the 1982-83 school year in a unique, nationally judged competition among UB sophomore medical students for preparation of the best Patient Medication Instruction Sheet (PMI). The staff of the Division of Drugs of the American Medical Association (AMA) served as judges in the contest which dealt with patient instructions for taking codeine. The drafting of patient instruction sheets was introduced as part of the sophomore Pharmacology course with the aim of encouraging better understanding of drugs and more effective communication with patients, according to Dr. Cedric Smith. professor of pharmacology and therapeutics. Providing prescriptions and administering medicines involves explicit and implicit communications between physician and patient. Dr. Smith noted. It is widely recognized. he said, that these communications are only erratically "sent'' and even more erratically "received."' Some people have spoken of a "patient-doctor communication gap." Recognition of this gap. Dr. Smith said. was a motivating force behind development of a descriptive instructional note to be included with every drug - the so-called "patient package "The exercise is a wav to teach students to communicate" insert." Concurrent with developing national interest in such inserts, the UB Department of Pharmacology and Therapeutics was stimulated by its chairman, Dr. Edward A. Carr, Jr.. to introduce the topic of doctor-patient communications into the major course in Pharmacology which takes place in the latter half of the medical student's sophomore year. Dr. Carr hit on the idea of using preparation of a "patient package insert" as a competitive exercise in communication. The exercise is unique to the UB School of Medicine. among medical schools, Dr. Smith said. At first. students were given examples of different package inserts and at the time of the "competition" were simply given the name of a drug and asked to write an insert for it. They followed their own best opinion as to how to go about communicating with patients assumed to have no expert knowledge. T he best of these submissions. as assessed by departmental faculty. were then submitted to the staff of the U.S. Food and Drug Administration for their final adjudication of winner and runners-up. With discontinuation two years ago of the FDA's patient package insert program , new arrangements were explored with the Division of Drugs of the American Medical Association. That Division, headed by Dr. John Ballin. enthusiastically encouraged the department's efforts. Dr. Smith described the way the program was implemented this past year: "During the first part of the course. students were introduced to the concept of adequate and appropriate communication between doctor and patient regarding drugs being prescribed or administered. with special emphasis on how this system can be used to reinforce and augment the oral communication that everyone recognizes should take place. Students were provided examples of PMI's that have just been released by the A.M.A. These sheets contain at least the basic information on proper use of the medicine. its purposes. preparations for use, precautions and special instructions. "This past year, the competition was offered as a separate addendum to the Pharmacology course. Each of the student entries was scored by two faculty members. TYpescripts of the top 10 entries were submitted to the AMA Drugs Division. Overall. the division staff reported that the student submissions were excellent. The major problem, in their view. was that the texts seemed to be written for the professional and at too complex a level for many patients," Dr. Smith noted . The exercise is recommended for the future, he said, as a way to emphasize and teach students how better to communicate important information to patients. • BUFFALO PHYSICIAN • 29 �A 35 A .. tJ9390G r / 30 • BUFFALO PHYSICIAN �----------------------------------------------------------------------------- People 35 t 593905 van Oss He helped Dutch Jews evade the Nazis A UB professor who helped save hundreds of Dutch Jews from the Nazis during the occupation of Holland has been honored for his efforts by the government of the Netherlands. Dr. Carl J. van Oss, professor of microbiology and adjunct professor of chemical engineering who is also the consul of the Netherlands in Buffalo, was a teenager in Amsterdam when the Nazis took control of his native country in 1940. But before the War ended, he had established a reputation among those in the Resistance as a talented forger whose skill provided both Jews and British pilots downed over Holland essential identity cards with which to escape from the Germans. The identity cards- printed by the Dutch government but not issued before the fall of Holland - were captured by the Nazi occupiers who made them mandatory for the citizenry. The Nazis assigned Dutch Jews cards onto which they had printed a large "J". The elaborate background of the cards made effective removal impossible. His entry into what would become a full-time job and vital contribution to the Resistance began modestly enough, Dr. van Oss recalls. On a spring day in 1940, he was asked to alter the identity card for a Jewish classmate, Hanna Platz. The act was committed not out of a sense of immediate danger to Miss Platz but rather from a sense of indignity that the Nazis would consider the Dutch Jews different from their countrymen. Although the Dutch in the spring of 1940 could not guess at what the Nazis had in store for Jews, most were at least suspicious of the special "J". "We knew that having a card with a 'J' was not in one's best interest, but we didn't know it would be used to single out those who would one day be shipped from Holland to the camps at Dr. van Oss forged intricate /0 cards to help protect Jews. By Mary Beth Spina BUFFALO PHYSICIAN • 31 �Auschwitz, Buchenwald and the others," says Dr. van Oss. By carefully affixing Hanna Platz's picture to the card of a non-Jew who reported her own card "missing" and painstakingly duplicating a portion of the printed seal which covered onequarter of the photo, Dr. van Oss completed his first forgery. Care had to be taken to remove the outer layer of the photo without slicing through to the owner's fingerprint on the other side. Furthermore, sex, age and occupation of the card's original owner had to match the new recipient as closely as possible in order to appear plausible to the authorities. "Later. I realized how crudely that first card had been altered," Dr. van Oss smiles mischieviously. "but nevertheless. it was good enough to fool those who checked it." A s his skill became more widelyknown - especially among former classmates and their friends- Dr. van Oss found himself forging larger numbers of identity cards. Some individuals he knew personally; most. however, he did not. Some Jews with darker complexions needed the altered cards to assist them in leaving the country: they were aided by Resistance workers who spirited them across French or Belgian borders. Their destinations were usually the south of France, Spain or Portugal. Others required the changed cards in order to move from their homes to other parts of Holland where they would establish new identities under nonJewish names. Successful deception depended in part upon the skill of the forger. but there were other pitfalls. "If the new owner of the card, when checked by the Germans. could not quickly and naturally repeat his or her name, occupation and age as it appeared on the document. that could be and was a fatal memory lapse," says the UB professor. So while a forged card was essential for escape or evasion, it was by no means a guarantee. At the beginning of the war, there were an estimated 125,000 Jews living in Holland; at war's end, only about 25,000. "There were right and wrong ways to hide from the Nazis if one was Jewish," says Dr. van Oss. Having a fair complexion, blond hair, an ability to speak Dutch and a well-forged identity card was the best possible combination. "1)rpically,'' van Oss recalls, "the Resistance would separate children from their families, moving them to 32 • BUFFALO PHYSICIAN (Above) van Oss with Resistance medal in front of portrait of Queen Beatrix. (AI right) The van Oss family (from left): Ann, James, Mrs. van Oss, Dr. van Oss, Vivian. safe, rural areas where they would be placed with a Dutch family, posing as relatives or orphans. The parents would be given forged papers and either directed to another location in Holland or spirited outside the country." As the war progressed, the Nazis ordered all able-bodied Dutchmen to Germany to work in industries where workforces had been depleted by employees' conscription into service of the Fatherland. Luckily, Dr. van Oss was allowed toremain in Holland because of his "essential" job as a clerk with a company whose officers knew of his value to the Resistance. While the head of the company for whom he worked knew of his clandestine enterprises. his supervisor did not. Dr. van Oss "was frequently reprimanded for my lateness or absenteeism caused, of course, by the increasing demand for forged documents." A s the demand grew, he eventually solicited others in the Resistance whom he supervised in ~he fine art of forgery. The work was feverish. They knew by then that every document represented a life which could be lost if the papers were not completed in time. �----------------------------------------------------------------------------- People "We knew that the Jews were being rounded up and sent to detention camps in Holland. We still did not know, however, that these camps were merely way stations which led to death camps outside the country," says Dr. van Oss. The tools of forgery became more sophisticated. Where only pen and ink and a compass to complete the seal over the new card owner's picture had at first been necessary. soon an assortment of typewriters with different typefaces and a working knowledge of some 100 German officials' signatures were needed. Chemical tampering with the intricate background on the identity cards was considered as a way to speed up production but was rejected. "I thought many times that had the cards not already been prepared by the Dutch, the Germans would probably not have designed something as tamper-proof," the UB professor recalls. While many patriotic Dutch Gentiles gave their identity cards for use by Jews and downed British pilots, there were some district officials who sold blank identity cards for the right price. "These, of course, were preferred because we could fill in all information as needed to suit a recipient without having to alter anything," says Dr. van Oss. If the individual requiring a new card could pay, a small sum to defray expenses was asked by the Resistance. But no one was ever refused the valuable document for lack of funds. Those in the Resistance retained their own identity cards but for safety's sake used aliases when dealing with each other in their clandestine work. "My alias was van Delft - which I must admit was not very imaginative since it had been my late mother's maiden name," Dr. van Oss recalls. When he was picked up by the Germans one day in November. 1942. while visiting another Resistance member, he was questioned closely about several people - among them one van Delft. "I knew then they had heard the name in connection with the Resistance, but fortunately. they didn't know what van Delft looked like .... Arrested on suspicion of political crimes on orders of the German Army. Dr. van Oss was incarcerated for three months in Scheveningen Prison known later as the Orange Hotel because of the many Dutch imprisoned t h e re by the Germans. But perhaps because of his age and the convincing way he pleaded a lack of knowledge about Resistance activities. he was released. operated the prison. dealTheingGestapo more decently with those arrested on orders of the Army than those arrested by themselves. The food rations were meager but otherwise, Dr. van Oss recalls. treatment was not unusually harsh. "Some prisoners in other areas o.f the prison were beaten - these were Jews," he says sadly. Most of these ultimately were sent to concentration camps. His own cellmates were black marketeers considered by the Germans to be committing crimes against the government. "This was actually a slight misconception but probably true from the Germans' point of view. The Dutch did not consider black marketeers 'patriotic' to Holland - we saw them only as people in business strictly for the profits," Dr. van Oss adds. The day the Germans told the young van Oss he was free to leave the prison, he walked out and took the train home. Looking back, he does not recall being fearful of being arrested or held by the I t I ficial documents - including food cards. And when employees of the state-owned railroad struck against the Nazis, he was one of those summoned to help alter the occupation line on some 2000 workers' cards to prevent them from being imprisoned - or worse. The railroad employees, he notes, continued to get paid - not by the Germans, but from monies smuggled into Holland from England where Queen Wilhelmina had fled in 1940 to establish the Dutch government-inexile. Near the end of the war, it was estimated that 1000 Dutch a week in territory in the west still held by Germany were dying directly of hunger or of complications caused by malnutrition. The famous tulip bulbs which had produced the magnificent blooms heralding spring became a food source for the starving who ate them raw, or sliced and cooked them to make an unappetizing, but filling soup. While I I ' ----- - - The large J on the intricate background was impossible to alter. Germans. "I was a young man at the time and looked at the entire business as exciting, thrilling. Today. with a family and more responsibilities. I imagine I would indeed be scared," he says candidly. After his release. he went back to work for the Resistance and landed a new job as an inspector in a large bakery. "This job allowed me to set my own hours and not be conspiciously absent when forgeries required more of my time," he explains. In the latter years of the war, Dr. van Oss's work expanded to a variety of of- the bulbs weren't very tasty. Dr. van Oss recalls, they were better than nothing. Farmers began shrewdly to demand gold in payment for what little they had left to sell and those in the Resistance were hard put to smuggle food for those who. hidden, did not dare forage on their own. During this time, Dr. van Oss became expert at forging the signature of a certain German Army Captain Boldt whose name had to appear on bills of lading of foodstuffs allowed to cross into the western zone of Holland. Indeed, the UB professor became so BUFFALO PHYSICIAN • 33 �< I ---- --- ........................................................................................ I I • adept at writing the German's name that he doubts Boldt himself could have recognized the forgery. A fter all Holland was freed and Queen Wilhelmina returned from exile, Dr. van Oss was among those named to serve in the British Air Ministry Intelligence, attached to the new Dutch Air Force. With a rank equivalent to second lieutenant, he helped select those who would be trained in England for the new air force. "The Dutch government, wanting to be certain no one who had been a Nazi sympathizer would inadvertently be recruited, decided that members of the Resistance would be the best inquisitors of candidates," Dr. van Oss notes. Resuming his education after the war, Dr. van Oss received his doctorate in Paris and became director of the Laboratory of Physical Biochemistry at the National Veterinary College there prior to coming to the U.S. in 1963. Before joining UB in 1968, he had been employed by the Milwaukee (Wis.) Blood Center and Montefiore Hospital in New York City. Commenting on the award he received this year from the Netherlands' National Commission for the Commemorative Resistance Cross, Dr. van Oss estimates that of' approximately 100,000 eligible, perhaps only 20,00030,000 are still alive. It is estimated that another 100,000 Resistance members died during the war at the hands of the Germans. "I learned it was safer to be in the business of saving people than in spying. And those who did both were more likely to be killed," says Dr. van Oss. The UB professor begged his coconspirators to allow him to perform other tasks during the war, but he was never permitted to do so because of his great value as a forger. Even in the Resistance, everyone had his area of expertise, he says. France and other European nations honored their Resistance members a few years after World War II. Holland waited 38 years - unfortunately so, says Dr. van Oss, because many eligible have now died of old age. When his miniature medal arrived, it was a tangible reminder to Dr. van Oss of the hundreds of persons he helped save during a tragic chapter in his native country's history. While he has no way of knowing how many of those he helped survived the war, he estimates perhaps one-third of the 800 Jews for whom he forged papers either escaped from Holland or 34 • BUFFALO PHYSICIAN successfully deceived the Nazis. It is known that Hanna Platz, the recipient of his first forgery attempt, escaped from Holland and when last heard of, was living in New York City. • UB PSYCHIATRIST DR. S. MOUCHLY SMALL HAS BEEN reelected to his fourth term as national president of the Muscular Dystrophy Association (MDA). Active in MDA since it was begun in the 1950s by New York City relatives of dystrophy patients. Dr. Small served as chairman of the organization's Scientific Advisory Council (later Committee) for many years before being named to the presidency in 1980. Dr. Small's interest in the dystrophies dates to his days as a student at Cornell Medical College in the 1930s. • DR. DONALD P. SHEDD, CHIEF OF HEAD AND NECK at Roswell Park and associate research professor of surgery at UB, was an invited speaker at the Sixth Academic Otolaryngology Conference in Bristol, England. in July. His subject was "Surgical Approaches to Post Laryngectomy Speech Rehabilitation." Dr. Shedd is author of a book on this subject. with B. Weinberg. Surgical and Prosthetic Approaches to Speech Rehabilitation (G.K. Hall Co .. Boston. 1980). • FOUR AWARDS WERE PRESENTED AT THE TRADITIONal dinner dance for the Erie County Medical Center staff at the Holiday Inn on Grand Island. June 10. The dance followed graduation ceremonies for 72 physicians and dentists completing residency training. The Ignaz Phillip Semmel weiss Award for research (founded in 1975 by Dr. D.A. Pragay) was given to Dr. Thomas Little III, a resident in the Department of Medicine. for his work entitled: "The Application of Radio Immunoassay for Myoglobin Th Quantitate Its Presence and Its Physiological Role in the Myocardial Tissue." The Norman Chassin Award (founded by Dr. Norman Chassin) went to Dr. Paul Rosenberg, a resident in Medicine, in recognition of his selection as outstanding resident. The White Coat Award for Educators was given to Drs. Joseph Walsh and Joseph Mylott (Department of Medicine). • Or. He (right) at going-away party. DR. DA-XUN HE, WORLD HEALTH ORGANIZATION FELlow from Beijing. China, who studied library management at the Health Sciences Library for five months this year. was treated to a farewell party by Library staff prior to his return home. A dermatologist. Dr. He has been involved with library administration at the Chinese Academy of Medical Science's Institute of Medical Information for the past five years. The Institute. which is the national medical library of the People's Republic of China. is currently developing a National Biomedical Information Center and Network in cooperation with WHO. according to C.K. Huang. director of UB's Health Sciences Library. While at UB, Dr. He attended seminars with senior library staff as well as courses in health sciences librarianship at the School of Information and Library Studies. In ad- MOA President Or. S. Mouchly Small (right) with MOA executive committee member Sylvester L. Weaver on Labor Day telethon. �People McMaster University School of Medicine. is co-editor. Dr. Cohen organized and arranged funding for the conference on which the publication is based. It was held in March 1983 at Roswell Park Memorial Institute where Dr. Cohen is a UB research associate professor. dition, he worked on studies and special assignments. and met with University officials and library network groups to augment his training. Visits were made to health institutions both in Buffalo and in rural areas of Western New York. Dr. He also visited medical libraries at Columbia. Cornell, Harvard and Rochester Universities and the New York Academy of Medicine. DR. EVAN CALKINS, CHIEF OF THE DIVISION OF GERI· atrics/Gerontology. has received a Presidential Recognition Award from President Reagan for his leadership in developing the Network in Aging of Western New York, Inc. The professor of medicine was presented the award at a reception June 2 at the Buffalo Red Cross Auditorium by Dr. Bernard Kilbourn, District II director of the U.S. Department of Health and Human Services. He is one of 14 individuals in the state to receive the recognition. The Presidential Award Program was established to honor efforts of people in public and private agencies. businesses and groups who provide outstanding service to their communities through participation in volunteer activities and public-private partnerships. Dr. Calkins. president of the Network in Aging of Western ew York, Inc., also received a proclamation from Erie County Executive Edward Rutkowski for his service to the community in the field of aging. A Massachusetts native and graduate of the Harvard Medical School. Dr. Calkins joined UB in 1961. Former director of medicine at Erie County Medical Center and head of the Buffalo General Hospital's Department of Medicine. he has been program director of the Geriatrics Fellowship Program at the Buffalo Veterans Administration Medical Center since 1979. • Dr. James F. Phillips Medicine and Gastroenterology in Buffalo, he will serve a one-year term. He succeeds Dr. Edmond J. Gicewicz. A graduate of the UB School of Medicine. Dr. Phillips has previously served as the Society's president-elect. vice-president. and as chairman of the Ethics Committee, Negotiations Committee. and the Community Relations Committee. He is also a delegate from Erie County to the Medical Society of the State of New York. and a member of the American Medical Association. the American Society of Internal Medicine. the Medical Society of the State of New York. and the Western New York G.J. and Liver Society. Dr. Phillips is a clinical professor of medicine at UB. DR. GERALD SUFRIN, CHAIRMAN, DEPARTMENT OF Urology. has been appointed to the Special Study Section for Small Business Innovative Research Programs of the National Institutes of Health. by Harold M. Davidson. executive secretary of the group. The 12-member panel includes a pathologist. a toxicologist. a dermatologist. an anesthesiologist, and a specialist in liver disease. among others. The panel studies for the NIH and the Small Business Administration proposals for grants to develop technology innovations in health fields among the small business community. The purpose is both to meet federal research and development needs and to create jobs to stimulate economic growth. • DR. JOHN BORDER, DEPARTMENT OF SURGERY, was elected to active fellowship in the American Surgical Association at the last annual meeting of the Association in Boca Raton. Florida. May 12-14. Dr. Border will be introduced to the Assembly of the Association at its 1984 annual meeting in Toronto. April 25-27. Dr. Evan Calkins DR. JAMES F. PHILLIPS HAS BEEN ELECTED PRE· sident of the Medical Society of the County of Erie. Dr. Phillips was installed at the Society's annual meeting held at the Buffalo Marriott Inn. May 26. A specialist in Internal DR. ELIAS COHEN HAS BEEN RE-ELECTED TO HIS 17th year as editor of the Newsletter and Journal of the Blood Banks Association of New York State. In August. Alan R. Liss Inc. released its third book under Dr. Cohen's editorship. entitled Non-HLA Antigens in Health. Aging and Malignancy. Dr. Dharam P. Singal. Department of Pathology. DR. ROBERT J. GRANTHAM, ASSISTANT PROFESSOR in the Department of Psychiatry's Division of Community Psychiatry. was one of five individuals receiving a Buffalo Branch-NAACP Community Service Award this year. President of the Kenmore Rotary Club. Dr. Grantham has served on the board of the Buffalo Speech and Hearing Center and on the Minority Advisory Committee of the New York State Department of Mental Hygiene. He was active in local efforts to establish the Sickle Cell Disease Center of Western New York. and is co-director of an innovative course for UB medical students on health care for the poor and disadvantaged. He enjoys a number of civic affiliations in Kenmore-Thnawanda. Formerly assistant dean of UB's Division of Undergraduate Education. Dr. Grantham has been on the faculty since 1975. Jan R. Jennings MR. JAN R. JENNINGS IS THE NEW PRESIDENT OF Millard Fillmore Hospital. Mr. Jennings. who was voted 1983 Young Hospital Administrator of the Year by the American College of Hospital Administrators. comes to Millard from St. Luke's Memorial Hospital Center in Utica. New York. where he was the chief executive officer. During his three years there. a new surgery and recovery wing. a new intensive care unit and a new renal dialysis unit were added to the hospital. He executed steps to get Central New York's first FAA approved heliport and air transport at the hospital, implemented a public health information series and restructured corporate policy for responsible financial management of the hospital. In addition to his experience at St. Luke's. Mr. Jennings served as assistant administrator at two large Pittsburgh hospitals. He has a B.S. in business from Indiana University (Pennsylvania) and a master's in hospital administration from the University of Pittsburgh. • BUFFALO PHYSICIAN • 35 �---------------------------------------------------------------------------------· DUES PAYING ALUMNI 1982-1983 CALENDAR YEAR , JUNE 1, 1982 - MAY 31 , 1983 A special thanks to the 1 ,073 dues-paying medical alumni listed here. And to the nine reunion classes - 1933, 1938, 1943, 1948, 1953, 1958, 1963, 1968, 1973 who contributed $52 ,500 to the Medical School. 1933 Wilfrid M. Anna John L. Baube William G. Ford Henry Haines (left below) Donald Brundage Paul A. Burgeson Alfred Cherry John P. Crosby Edward G. Eschner Willard G. Fischer Jerome J. Glauber Irving Helfert Frank C. Hoak Eli A. Leven William F. Lipp Thomas C. McDonough Robert B. Newell Victor L. Pellicano Harold F. Wherley 1937 J. Curtis Hellriegel (right) Joseph W. Hewett Thomas C. Hobbie Ernest G. Homokay Franklyn A. Huber Louis Kolbrenner Murray A. Yost 1934 J. Edwin Alford John V. Anderson Alfred L. George John C. Kinzly Harry G. LaForge Charles E. May John D. o·connor Earle G. Ridall William G. Rocktaschel Myron G. Rosenbaum Edgar A. Slotkin Max B. Weiner Stanley J. Zambron 1935 Wendell R. Ames John F. Argue Willard H. Bernhoft Raymond H. Bunshaw Benjamin Coleman Kenneth H. Eckhert Maurice B. Furlong Victor B. Lampka Charles E. Moran Abner J. Moss Daniel D. Peschio Harry N. Thylor Clayton G. Weig 1936 Martin A. Angelo Richard C. Batt Alexander J. Bellanca 36 • BUFFALO PHYSICIAN Kenneth M. Alford John Ambrusko William L. Ball Charles F. Banas Francis E. Ehret Theodore C. Flemming Soil Goodman Stanley J. Jackson George F. Koepf Angelo Lapi Rose M. Lenahan Robert W. Lipsett Alice C. Lograsso James D. MacCallum M. Luther Musselman Irving Weiner David H. Weintraub William F. White Charles J. Woeppel 1938 Charles F. Becker Russell J. Catalano James R. Cole George M. Cooper Charles Donatelli Norman J . Foit Benjamin I. Gilson Harry C. Law Samuel L. Lieberman Alfred A. Mitchell H. Robert Oehler Eustace G. Phillies Maxwell Rosenblatt Vincent L. Rutecki Clarence A. Straubinger Walter L. Sydoriak Richard . Terry 1939 Russell L. Battaglia Grosvenor W. Bissell La Moyne C. Bleich George C. Brady 1943 A. (FIRST ROW): ALEXANDER SLEPIAN, ADRIAN J. PI.ESKOW, WILLIAM H. GEORGI, HAROLD P. GRASER, ALFRED F. LUHR, RAYMOND W. MITCHELL, KENNETH W. BONE. (SECOND ROW): RICHARD J. BUCKLEY, RICHARDS. FLETCHER, DUNCAN MacLEOD, LESTER W. FIX, CHARLES C. RICHARDS, JOHN M. DONOHUE, ROBERT C. McCORMICK, RONALD E. MARTIN. Ruth C. Burton Milton V. Caldwell Lloyd A. Clarke Alfred H. Dobrak William Dugan Matt A. Gajewski John H. Geckler Kenneth Goldstein Elizabeth P. Olmsted Anthony V. Postoloff Frank T. Riforgiato Roy E. Seibel John J. Squadrito Robert E. Storms Everett H. Wesp Marvin N. Winer 1940 Julian J. Ascher Marshall Clinton Jr. Herbert H. Eccleston William Hildebrand Jr. Warren R. Montgomery Jr. Harold Palanker Russell E. Reitz Albert C. Rekate Norbert J. Roberts Robert H. Roehl James P. Schaus Jr. C. Henry Severson Allan W. Siegner Louis A. Thippe William 0. Umiker Stanley T. Urban John G. Zoll 1941 Joseph T. Aquilina Berten C. Bean Anthony J. Cooper Robert W. Edmonds George A. Gentner Pasquale A. Greco Arnold Gross Donald W. Hall Eugene J. Hanavan Jr. Harold L. Kleinman Daniel J. McCue John J. O'Brien Allen A. Pierce John T. Pitkin Anthony J. Virgo Philip B. Wels Leonard Wolin Floyd M. Zaepfel A MESSAGE TO ALUMNI Dear Fellow Alumni: Your Alumni Board has been actively planning an interesting calendar of events for this coming year. We welcome your active participation as well as your ideas and suggestions for the association. It has been through the efforts of many that our organization has prospered over the years. Please mark your calendar for these special events: February 13-20, Medical Alumni trip to beautiful Puerto Vallarta for a medical accredited seminar; May 5 for the annual Spring Clinical Day. As these events fi"lalize more information will be available. I look forward to an enjoyable year working with you and your Alumni Board. Eugene Michael Sullivan, M.D. President, Medical Alumni Association �·--------------------------------------------------------------------- Alumni . . ., '".! P,r·" ll!~ FOUND~TilW I C.. 3 1943 (FIRST ROW): MARVIN L. BLOOM, JOSEPH VALVO, KEVIN O'GORMAN, WILLIAM C. NIESEN, PAUL J. WOLFGRUBER, (2ND ROW): ROBERT W. MOYCE, ANTHONY J. MARANO, SALVA10RE J. COLANGELO, CHARLES J. TANNER, EDMUND M. TEDEROUS, MORRIS UNHER, EDWARD M. TRACY, AMOS J. MINKEL. (3RD ROW): JOHN R. WILLIAMS, JOHN P. GUINTHER, JOSEPH J. RICOTTA, JOHN C. NINFO, THOMAS L. GRAYSON, RALPH T. BEHLING, WILLIAMS. KEENAN, BRONISLAUS J. GALOYS, IVAN L. BUNNELL, ERWIN R. CHILLAG, THOMAS H. HEINEMAN. 1942 Albert J. Addesa Horace L. Battaglia Vincent S. Cotroneo George L. Eckhert Harrison M. Karp Diana D. Kibler Boris L. Marmolya Richard Milazzo Vincent J. Parlante John D. Persse Jr. Edward L. Schwabe Martha L. Smith 1943 Ralph T. Behling Paul K. Birtch Marvin L. Bloom Richard J. Buckley Ivan L. Bunnell Peter A. Casagrande Salvator J. Colangelo Robert J. Collins John M. Donohue Alfred S. Evans B. Joseph Galdys Thomas L. Grayson Stewart L. Griggs Victor Guarneri John P. Guinther Thomas R. Humphrey Richard J. Jones William S. Keenan Jr. Ruth F. Krauss Melbourne H. Lent Anthony J . Marano Ronald E. Martin George Marvin Robert C. McCormick Amos J. Minkel Jr. Robert W. Moyce Kevin M. O'Gorman Walter R. Petersen Col. Bradley W. Prior Charles C. Richards Joseph J . Ricotta Gene D. Sherrill Alexander Slepian Rasph E. Smith Jr. Burton R. Stein Winslow P. Stratemeyer Charles J . Thnner Jr. Edmund M. Tederous Edward M. Tracy Hazel J. Trefts Louis A. Trovato Morris Unher Joseph A. Valvo La Verne G. Wagner John R. Williams Paul J. Wolfgruber 1944 Anthony M. Aquilina Willard H. Boardman Raymond G. Bondi Robert L. Brown Joseph P. Concannon Herman Edelberg Richard W. Egan Newland W. Fountain Thomas F. Frawley Frank T. Frost Andrew A. Gage Irwin A. Ginsberg Harold P. Graser Raymond A. Hudson Sidney R. Kennedy. Jr. Frank H. Long. Jr. Federico J. Maestre William K. Major Francis C. Marchetta Raymond C. Perkins Joseph Ross Sidney M. Schaer Carrol J. Shaver Byron M. Souder Walter F. Stafford. Jr. Clinton H. Strong James R. Sullivan R.G. Wilkinson. Jr. 1945 Richard H. Adler William S. Andaloro Bruce F. Baisch Vincent J. Capraro Norman Chassin George M. Ellis. Jr. Edward G. Forgrave George W. Fugitt. Jr. A. Arthur Grabau Richard M. Greenwald Herbert E. Joyce Ivan W. Kuhl J /.1. a: }0 ~. tA/fll.LJand .41urn Aund7Pd ( i1.JJ c /Y'i With check from Class of '48: Judith B. Landau and Lem H. Graff. Vito P. Laglia Victor C. Lazarus William D. Loeser William M. Mcintosh Eugene J. Morhous John G. Robinson William J. Rogers. III Joseph E. Rutecki David J. Shaheen K. Joseph Sheedy Jacob M. Steinhart George Thorngate. IV Gilbert B. 1)rbring Charles E. Wiles Jane B. Wiles 1946 John G. Allen Charles D. Bauer Donato J . Carbone Alexander R. Cowper John T. Crissey Maier M. Driver Curzon C. Ferris. Jr. Lawrence H. Golden Edward F. Gudgel Ross Imburgia Annabel M. Irons Charles A. Joy Harold J . Levy Eugene M. Marks Maynard H. Mires. Jr. Harry Petzing Amo J. Piccoli Herbert S. Pirson Albert G . Rowe Henry M. Thrdif W. William Tornow Paul M. Walczak Myron E. Williams, Jr. 1947 Salvatore Aquilina Bruce D. Babcock J . Desmond Coughlin Daniel E. Curtin Robert J. Dean William S. Edgecomb Robert J. Ehrenreich Elbert Hubbard III Robert M. Jaeger Peter J. Julian Hans F. Kipping Jack Lippes Richard J. Marchand Hallie B. Mont Donald C. Nuwer James F. Phillips Philip L. Reitz Daniel J. Riordan Arthur J . Schaefer Robert L. Segal John B. Sheffer James F. Stagg Joseph C. Todaro Jerome I. Tokars John H. Waite Victor C. Welch Jr. Frederick D. Whiting 1948 James G. Borman Daniel J. Fahey William F. Gallivan. Jr. Joseph P. Gambacorta Raphael S. Good Myron Gordon Harold L. Graff Robert J. Hall Warren H. Hanson Warren L. Hollis Judith Liss Landau Ansel R. Martin Daniel G. Miller Norman Minde Darwin D. Moore Norman L. Paul Cletus J . Regan Thomas C. Regan Lester H. Schiff Charles Shore Edgar C. Smith Irwin Solomon Rebecca G. Solomon Edward R. Stone Wilbur S. Thrner Jasper L. Vanavery. Jr. Paul Weinberg S. Paul Zola BUFFALO PHYSICIAN • 37 �• 1949 Frances R. Abel Carmela S. Armenia J. Bradley Aust Jr. Harold Bernhard Lawrence M. Carden Julia M. Cullen Joseph E. Griffin Irving R. Lang Jacqueline L. Paroski Frank A. Pfalzer. Jr. Robert D. Sanford Max A. Schneider Fred Shalwitz James D. Stuart James A. Werick Charles J. Wolfe 1950 Roland Anthone Sidney Anthone Lawrence D. Benken Robert E. Bergner George P. Bisgeier James J. Brandl Charles Brody Grace B. Busch Carl A. Cecilia Frank Chambers. Jr. James A. Curtin Adelmo P. Dunghe. Jr. Carmen D. Gelormini Robert N. Kling Richard J. Leberer Karl L. Manders Patricia A. Meyer Daniel F. Primeau Clarence E. Sanford Helen F. Sikorski Yale Solomon George E. Thylor Hyman Tetewsky Edward C. Voss. Jr. Gertrude L. Waite Anne A. Wasson Sidney Weinberg Eugene J. Zygaj 1951 Anthony C. Barone Jay B. Belsky Frank J. Bolgan Carl R. Conrad Leonard S. Danzig Harvey D. Davis James S. Ferguson William S. Glassman Allen L. Goldfarb Myron C. Greengold Eugene V. Leslie James V. Loverde Thomas J . Murphy John L. Musser Daniel A. Phillips Marvin J. Pleskow Robert E. Ploss Gerard E. Schultz Edward Shanbrom Bernard Smolens Eugene M. Teich James W. Weigel 1952 Donald J. Adams John J. Banas Robert A. Baumler 38 • BUFFALO PHYSICIAN 1953 (ON FLOOR}: HERBERT W. SIMPKINS, BERTRAM A. PORTIN, JOHN N. STRACHAN, JAMES M. ORR. (2ND ROW}: JOSEPH F. RUH, STANLEY L. COHEN, DONALD L. EHRENREICH, HARLEY 0. UNOOUIST, RICHARD J. NAGEL, HOWARD C. SMITH, CURTIS P. JOHNSON, MICHAEL A. SULLIVAN. (3RO ROW}: JACOB B. SHAM· MASH, MILFORD C. MALONEY, RONALD F. GARVEY. RAYMOND M. SMITH, HERBERT E. LEE, JOHN W. HANDEL, HAROLD SMULYAN, JACK GOLO, DONALD 0. RACHOW, THOMAS E. COMERFORD, JAMES W. CARLIN, JAMES R. COLEMAN. Alvin J. Brown Bruce F. Connell Barbara G. Corley Donald F. Dohn Melvin B. Oyster Neal W. Fuhr Albert A. Gartner Jr. Joseph E. Genewich Donald J. Kelley Melvin R. Krohn Milton C. Lapp Colin C. MacLeod Earl W. oble Ralph M. Obler Victor A. Panaro John Y. Ranchoff Travers Robbins James . Schmitt Wilbur S. Schwartz Byron E. Sheesley S. Aaron Simpson Donald H. Sprecker Oliver J. Steiner Burton Stulberg James Irme Szabo S. Jefferson Underwood Kurt J . Wegner 1953 George G. Bertino James W. Carlin Stanley L. Cohen James R. Coleman Thomas Comerford. Jr. Felix A. Delerme Donald L. Ehrenreich Sander H. Fogel Ronald F. Garvey Jack Gold John W. Handel Curtis C. Johnson Herbert E. Lee Harley D. Lindquist Edmund A. Mackey Milford C. Maloney Robert E. Maynard Richard J . Nagel James M. Orr Bertram A. Partin Donald 0. Rachow Joseph F. Ruh Molly R. Seidenberg Jacob B. Shammash Herbert W. Simpkins Harold Smulyan John . Strachan Michael A. Sullivan Reinhold A. Ullrich Marvin Wadler 1954 Eugene L. Beltrami Joseph L. Campo icholas C. Carosella Louis C. Cloutier Robert D. Foley Byron A. Genner Ill Florence M. Hanson Edward W. Hohensee William J. Howard Eugene C. Hyzy Benjamin C. Jenkins William R. Kinkel Jacob Lemann. Jr. Allen L. Lesswing Lucille M. Lewandowski Sylvia G. Lizlovs Charles H. Marino Ernest H. Meese Donald J. Murray N. Allen Norman Walter A. Olszewski Robert J . Pletman Robert J. Powalski Edward A. Rayhill Stephen A. Spink Edwin B. Tomaka Marlyn W. Voss Paul L. Weinmann Alfred L. Weiss Donald M. Wilson 1955 Vincent S. Celestino James R. Collins Louis R. Conti Robert T. Dean. Jr. C. Daniel Fagerstrom Albert A. Franco James M. Garvey Frank J. Gazzo Michael J. Gianturco Cleora K. Handel Sami A. Hashim Kathryn M. Keicher John H. Kent Edward H. Kopf S. Joseph LaMancusa H. Alvin Leonhardt Winifred G. Mernan George L. Mye. Jr. John H. Peterson Dwight H. Porter, Jr. Leonard R. Schaer Anthony B. Schiavi Ray G. Schiferle, Jr. Robert A. Smith James G. Stengel Richard T. Suchinsky Barbara VonSchmidt David F. Weppner Eugene B. Whitney John A. Winter 1956 George J. Alker. Jr. John D. Bartels M. David Ben-Asher Robert B. Corretore Mark A. Denlinger Richard R. Gacek Edmond J. Gicewicz Peter F. Goergen, Jr. Frederick P. Goldstein Dennis P. Heimback John M. Hodson Oliver P. Jones. Sr. Joseph L. Kunz Fred Lee Sue A. McCutcheon Robert G. Mcintosh Frederick C. Nuessle Hugh F. O'Neill Erick Reeber �Alumni Presenting the 1963 check: (from left) Richard B. Narins, Harvey L. Liebeskind, John N. Stumpf, Anthony M. Foti and Frank V. DeLau_s_. -----~~ Daniel A. Rakowski Eugene P. Rivera Gerald L. Saks John A. Thyn 1961 Robert E. Reisman Paul C. Ronca Bernard H. Sklar 1957 Axel W. Anderson. III Paul L. Archambeau Arthur L. Beck Bronson M. Berghorn Germante Boncaldo John R. Bongiovanni Benny Celniker Marvin N. Eisenberg Gerald Friedman Myron Garsenstein Lorie A. Gulino Barbara H. Hetzer Harris H. Kane! Jerome P. Kassirer Charles E. Lowe Ross Markello Herbert Metsch Richard F. Miller Charles F. O'Connor Frederick Reichel Donald E. Schaffer Joseph I. Schultz Herbert Silver Robert B. Sussman Bernard D. Wakefield Edward J. Weisenheimer Sherman Waldman 1958 Elroy E. Anderson John V. Armenia Ronald E. Batt David A. Berkson Richard C. Boyle Melvin M. Brothman Ronald W. Byledbal Franklyn N. Campagna Gary N. Cohen Bernice T. Comfort Dominick Cultrara William F. Deverell Robert C. Dickson Frederick W. Dischinger Domonic F. Falsetti John J. Giardino William L. Glazier John F. Holcomb Hilliard Jason Leo A. Kane Marie L. Kunz Michael A. Mazza John P. Murphy Robert J. Perez Lucien A. Potenza Richard A. Rahner Jason A. Reder Richard Romanowski Samuel Shatkin Morton Spivack Alfred M. Stein Richard D. Wasson Reinhardt W. Wende Franklin Zeplowitz Harold B. Zimmerman Joseph A. Zizzi 1959 George R. Baeumler Mary Ann Z. Bishara William P. Blaisdell Robert J. Brennen Robert A. Brenner James R. Doyle Richard A. Falls Seymour D. Grauer Logan A. Griffin John W. Kostecki Jacob Krieger Joseph F. Monte Ju lius V. Rasinsk i, Jr. Elton M. Rock Russell C. Spoto Joel Bernstein Harold Brody Eugene A. Cimino Carlo E. DeSantis Allan S. Disraeli Kenneth H. Felch Richard C. Hatch William J. Hewett Norman E. Hornung Michael Madianos James R. Markello Saar A. Porrath Stephen D. Rader Roger A. Ronald Arthur T. Skarin Paul Stanger Ronald H. Usiak Robert E. Winters 1962 Charles G. Adams Martin Cowan Harold C. Domres. Jr. Jac k C. Fisher Anthony J . Floccare Joseph R. Gerbasi Joseph W. Hanss. Jr. John L. Kiley Arthur C. Klein Jerald P. Kuhn Gordon R. Lang Paul J. Loree Michael M. Madden Anthony P. Mar kello Philip D. Morey Robert G. Ney Alan L. Pohl Bernard Polatsch Melvin J. Steinhart 1963 Lee N. Baumel David S. Berger Max M. Hermann James R. Blake David T. Carboy Frank E. Ehrlich Ernest A. Fatta Anthony M. Foti Anita J. Herbert William C. Heyden John J . Lamar. Jr. Paul A. Lessler Albert J. Maggioli David N. Mali nov Richard B. Narins Ronald G. Nathan Thomas J. Reagan John A. Repicci Henry A. Scheuermann Lawrence J. Sobocinski Robert B. Spielman John N. Stumpf Eugene M. Sullivan. Jr. Charles S. Tirone Joseph C. Thtton John M. Wadsworth 1964 Bela F. Ballo Walter A. Ceranski Paul Cherkasky Gregory L. Farry Michael Feinstein Anthony V. Ferrari William A. Fleming. Jr. George R. Glowacki Michael Goldhamer Gerald B. Goldstein Walter D. Hoffman David A. Leff Marilyn A. Lockwood Ronald S . Mukamal Lillian V. Ney David E. Pittman John F. Reilly, Jr. Sheldon Rothfleisch William Salton Stephen C. Scheiber Irving Sterman David J. Weinstein Richard E. Wolin David C. Ziegler 1960 William E. Abramson Joseph G. Antkowia k Robert Bernat Theodore S. Bistany Joseph A. Chazen D. Jackson Coleman Roger S. Dayer Gerard Diesfield Edward J. Graber Thomas J. Guttuso Donald A. Hammel James R. Kanski , Jr. Harris M. Kenner Francis J. Kloc ke Edwin R. Lamm Harry L. Metcalf Harry H. Nakata 1963 (SEATED): JASON E. RUDISILL, JOHN J. LaMAR, RICHARD B. NARINS, HARVEY LIEBESKINO, AN· THONY M. FOTI, FRANK V. OeLAUS, ROBERT B. SPIELMAN, OAV/0 N. MAL/NOV. (STANDING): EUGENE M. SULLIVAN, ANITA J. HERBERT, JOHN M. WADSWORTH, STEPHEN JOYCE, JOHN N. STUMPF, WILLIAM HEYDEN, GEORGE HOGBEN, LAWRENCE J. SOBOCINSKI, JOSEPH TUTTON, JOHN REP/CCI, JOHN FANELLI, THOMAS REAGAN, ALBERT MAGGIOLI. BUFFALO PHYSICIAN • 39 �1965 William H. Adler. Ill John J. Bird William C. Bucher, Jr. Lance Fogan Jerald Giller Anthony V. Grisanti Ira Hinden Gary H. Jeffery David 0. Lincoln Calvin Marantz Arthur M. Morris Robert N. Schnitzler Robert W. Schultz Joel Steckelman Donald J. Waldowski W. Scott Walls, Ill Benjamin J. Wherley J A )I. t1 1968 (LEFT 1IJ RIGHT) (1ST ROW): THOMAS J. CUMBO, SARAH G. SIRKIN, ROBERT MILCH LESBIA F. SMITH (2NO ROW): BRIAN JOSEPH, LAWRENCE DOBMEIER, JULIAN KARELITZ ALBERT BIGLAN ELMO KOLODNY (not pictured). ' ' 1966 Sean R. Althaus Louis J. Antonucci Jared C. Barlow Robert Barone Thomas W. Bradley Douglas C. Fiero C. Wayne Fisgus Melvin Fox Howard Friedman Edwin H. Jenis Melvyn B. Lewis Jeffrey E. Lindenbaum Joseph F. Martinak James J. Moran John J. O'Connor Donald M. Pachuta Edward J. Reich Helmut G. Schrott Roger W. Seibel Anthony B. Serfustini William L. Sperling John E. Spoor 1967 Robert M. Benson Richard H. Daffner David R. Dantzker Barry M. Epstein Russell R. Fiore Douglas D. Gerstein John W. Gibbs. Jr. Leon Hoffman Liberato Iannone Murray C. Kaplan John P. Kelly JacobS. Kriteman Allwyn J. Levine Anthony J. Logalbo John P. Menchini Donald E. Miller Laird C. Quenzler William C. Rader Steven E. Rinner J. Brian Sheedy Thomas P. Sheehan Arthur C. Sosis Franklin H. Spirn GeorgeS. Starr Linda Young Richard Young 1968 Lawrence D. Baker William E. Clack Geoffrey E. Clark Marc N. Coel 40 • BUFFALO PHYSICIAN Gary H. Cramer Thomas J. Cumbo Geraldine F. DePaula Lawrence J. Dobmeier Stephen A. Edelstein Ronald J. Friedman Bruce H. Gesson Kenneth L. Jewel Richard F. Kaine Milton P. Kaplan Z. Micah Kaplan Gary D. Karch Julian R. Karelitz David Kramer Raymond A. Martin Kenneth W. Matasar Robert A. Milch Jonathan C. Reynhout Robert D. Rodner Barbara Blase Sayres John E. Shields, Jr. Lesbia F. Smith Morris J. Stambler Richard M. Stamile Jeffrey Stoff Charles P. Yablonsky 1969 Joel B. Bowers James L. Cavalieri, II Lang M. Dayton Arthur L. Deangelis Robert J. Gibson David F. Hayes Louis Hevizy Hanley M. Horwitz Russell G. Knapp, Jr. Daniel B. Levin William K. Major, Jr. Richard T. Milazzo. Jr. James A. Patterson Douglas L. Roberts Warren Rothman Thomas S. Scanlon Robert S. Shaps Lester S. Sielski Ronald F. 1htler Harvey I. Weinberg Madeline J. White 1970 Ronald H. Blum Donald P. Copley Allen Davidoff Charles A. Fischbein Ellen R. Fischbein Roger A. Forden George D. Goldberg Arthur R. Goshin Dennis J. Krauss Michael L. Lippmann Bruce H. Littman Russell P. Massaro Bruce M. Prenner Jeffrey S. Ross Arthur M. Seigel Shafic Y 1Wal Robert M. Ungerer Harold M. Vandersea Allan S. Wirtzer 1971 Michael B. Baron Gerald M. Beresny Manny E. Christakos Kenneth J. Clark, Jr. Terence M. Clark Eric M. Dail Sigmund S. Gould Harvey Greenberg Mark S. Handler David E. Hoffman Scott D. Kirsch Douglas W. Klotch Stanley B. Lewin Martin N. Mango Donald H. Marcus Denis G. Mazeika Paul M. Ness Robert W. Palmer Joel H. Paull David W. Potts Kenneth Solomon Richard I. Staiman William C. Sternfeld Dale A. Vanslooten Ilja J. Weinrieb John M. Wendell Bennett G. Zier 1972 Richard A. Berkson Harold B. Bob Martin Brecher Robert A. Cooper John J. Dalessandro Patricia K. Duffner Robert Einhorn Ian M. Frankfort Michael Gordon Dennis R. Gross Linda A. Kamm John W. Kraus Robert B. Kroopnick Paul S. Kruger Alan I. Mandelberg Ira L. Mintzer Philip C. Moudy Dennis L. Natale Lawrence S. Pohl Kenneth C. Rickler Steven J. Rosansky Stuart Rubin Stuart R. Thledano 1973 William J. Ackerman William S. Bikoff �Alumni (From left, across the page) With the 1938 gift: Charles F. Becker (left) and James Brennan; Class of 1968 (from left): Albert Big/an, Julian Karelitz, Lesbia F. Smith and Robert Milch; Class of 1953 (from left): Michael A. Sullivan, Donald L. Ehrenreich and Milford C. Maloney. ~~~~~----~~~ Yung C. Chan Jeremy Cole Robert G. Fugitt Ke n neth L. Gayles Joseph M. Greco Mich ael A. Haber man Ra lph R. Ha llac Jeffrey P. Her man Frederic M. Hirsh Bruce R. Javors Paul Kuritzky Sharon Kuritzky Dana P. Launer James S. Marks Daniel J. McMahon Steven J . Morris Arth ur W. Mruczek Joseph M. Mylotte Patrick L. O'Connor Garsutis K. Palys Robert L. Penn Ira H. Pores John E. Przylucki Jacob D. Rozbr uch Jon P. Rubach Barry Sanders Mark N. Scheinberg Arnold W. Scherz Roger M. Simon Lynda Y. Sorrenti Young Dennis E. Stempien Gary J. Wilcox Charles E. Wiles. III Jonathan Wise 1173 (LEFT 1lJ RIGHT) (ON FLOOR): THOMAS D. WASSER, JOSEPH MYLOTTE, LAWRENCE ZEMEL, CHARLES McALLISTER, MICHAEL SANSONE, THOMAS E. GILLETTE, PATRICK L. O'CONNOR. (2ND ROW): DOUGLAS L. KIBLER, MARK N. SCHEINBERG, THOMAS A. LOMBARDO, TIMOTHY NOSTRANT, BARRY SANDERS, PAUL KUR/TZKY, SHARON KURITZKY, LINDA YOUNG, JOSEPH M. GRECO. (3RD ROW): JOHN PRZYLUCKI, AR· THUR C. SGALIA, ISRAEL JACOBDWin, ROBERT PENN, ROBERTS. LAMANTIA, RALPH R. HALLAC, JONATHON WISE, JACOB ROZBRUCH, DANIEL C. WISTRAN. (4TH ROW): DANIEL McMAHON, ROBERT FUGITT, ARTHUR MRUCZEK. 1974 Daniel R. Beckman R.J. Buckley, Jr. James L. Budny E laine M. Bukowski _,------------------------------------------------------------------------------------------------_J BUFFALO PHYSICIAN • 41 �PUERTO Alan G. Burstein John H. Clark Alva Dillon Jr. Thomas A. Donahue Jockular B. Ford Donald R. Greene David W. Leflke Joseph P. Lemmer Hing-Har Lo John P. Manzella Isaiah Meggett Bruce F. Middendorf Lawrence A. Oufiero Sanford R. Pleskow Dominick R. Prato John C. Rowlingson Elliott A. Schulman Roy E. Seibel, Jr. James A. Smith Louise M. Stomierowski Reginald M. Sutton Paul H. Wierzbieniec Stuart A. Wolman 1975 John Asheld. Jr. David Bendich James Burdick Coley Cassiano William I. Cohen Marguerite Dynski Robert E. Fenzl Tone Johnson Lillian Y. Li Charles Natalizio William G. Novak Thomas Rosenthal Michael Rowland Stephen W. Sadow Sylvia Regalia Spavento · Stanley J. Szefler Paul Thautman 1976 Henry Bartkowski Stephen Bien Michael Bye David A. Dellaporta Adolfo Firpo-Betancourt Timothy Gabryel Shin Liong Ronald Marconi Walwin Metzger Erwin Montgomery. Jr. Melvin Pohl Dennis R. Pyszcznski David Sokal Michael Thmul Bernard M. Wagman John Wiles 1977 Elaine S. Chirlin Avery Ellis Nedra Harrison Michael S. Kressner Alan S. Kuritzky Bess I. Miller Jeffrey A. Mogerman Mark J. Polis Theodore C. Prentice Thomas A. Raab Carl J. Schmitt Jeffrey P. Seltzer Janet C. Shalwitz Richard P. Singer Reginald B. Stiles R.J. Vancoevering II Ronald A. Vidal $849 per person double occupancy VALLARTA FEBRUARY 13·20 1984 BUFFALO, N.Y. DEPARTURE YOUR SEMINAR TRIP INCLUDES 1978 Nathaniel A. Barber Stephen E. Killian Kevin N. O'Gorman Paul A. Paroski Joel J. Reich John P. Scanlon I 1 I 1979 Robin H. Adair Walter A. Balon Joel M. Bernstein Bernice J. Blumenreich 'Terence L. Chorba Nancy G. Dvorak Frederick A. Eames Juanita A. Evereteze N. Joseph Gagliardi Eleonore R. Gaines Andrea S. Gold Margaret J . Graf Paul A. Koenig John M. LaMancuso Ramon J. Pabalan Bruce D. Rodgers Robert J. Rose Daniel H. Saltzman David D. Stahl 1980 Wesley Blank Barry Clark Joel Gedan Mark Gilbert Lloyd D. Simon Ellen Tedaldi 1 I 1 1 1 1 1981 Barry Feldman Edith Geringer Jonathan Gewirtz Martin Hoff Thdd Jacobson Robert A. Jakubowski Michael T. Ross Daniel Schaefer Howard Sklarek David Small Richard A. Smith Roberta Szcurek 1982 Richard Corbelli 1 • Round-tnp scheduled a1rl1ne transportation between Buffalo. NY and Puerto Vallarta. Mex1co All Registration Fees for Category I Medical Seminar Luxunous hotel accommodations for 7 n1ghts at the lovely Holiday Inn Hotel and Beach Resort The Hol1day Inn Hotel offers Restaurant and snack bar 1 Cocktail ounge and pools1de bar Meenng and banquet faCJ 1t1es for 200 persons 1 Water spor s from the hotel's own beach 1nclud1ng Ski· 1ng. parachute ndes. deep sea f·sh1ng. and sa11ing 1 All rooms a1r conditioned Complimentary beach towels and cha1se 'ounges Welcome cocktail party w1th hot and cold hors d'oeuvres and open bar Amencan breakfast daily Welcome rum punch upon arr•val at hotel All tax and serv1ce charges 1nclud1ng gratu1t1es for wa1ters and all 1ncluded meals Round tnp transfers between the a1rport and the hotel. •nclud1ng bag gage handl1ng Hosp1tal1ty desk at the hotel Opt onal Departure Cttle\ avatrable up n Reque' t For further Information call or write: (716) 831-2778 Medical Alumni Assoc . SUNY At Buffalo 139 Cary Hall 3435 M ain Street Buffalo, N .Y. 14214 CATEGORY I UNDER THE SUN 42 • BUFFALO PHYSICIAN �1925 MARGARET LODER HOGBEN, M'25 • was the recipient of the Americanism Award of Rye Post No. 128, American Legion. The award was given for outstanding services to the community. Dr. Hogben, former director of pathology at the United Hospital. Port Chester. New York. was a pioneer in many medical innovations, including the creation of one of the first blood banks in the country. She is one of the first women members of Alpha Omega Alpha. the national honor medical society. Among her many recognitions is her election as the first woman president of the Westchester County Medical Society. Dr. Hogben is now a resident of the Osborn Memorial Home in Rye where she is active in many of their activities. Her son. Dr. George Loder Hogben, M'63, is a practicing psychiatrist in Rye. New York. 1941 CARL J. GRAF, M'41 • recently retired from private practice in neurological surgery and is now living in Sea Island. Georgia. 1944 JOSEPH P. CONCANNON, M'44 • reports that he retired as director of radiation oncology and the Radiation Oncology Research Center of Allegheny General Hospital and is now in private practice with headquarters at the Medical Center of Bearri County. Pennsylvania. Dr. Concannon has published over 100 papers and abstracts. He is a Fellow of the New York Academy of Science and a Fellow, Faculty of Radiologists. Royal College of Surgeons of Ireland. 1947 CHARLES E. STAUDT, M'47 • is in private practice in Canton. Ohio. Dr. Staudt is a member of the Stark County Medical Society and the Ohio State Medical Association. 1948 GEORGE L. COLLINS, JR. , a Buffalo internist. has been elected to a three-year term on the Board of 11-ustees of the American Medical Association. The election was held during the Annual Meeting of the AMA House of Delegates in Chicago in June. Records indicate he is the first AMA 11-ustee to come from Buffalo since the AM A's founding in 1847. The 15-memberBoardof 11-ustees is the executive body Classnotes of the AMA. Dr. Collins. chief of cardiology at Roswell Park Memorial Institute, has been in private practice for more than 30 years. He received his B.S. from Yale University and his M.D. from UB. He is a member of the American Society of Internal Medicine. Dr. Collins is presently chairman of the Board ofTI-ustees of the Medical Society of the State of New York. He is also a pastpresident of the State Medical Society and of the Medical Society of the County of Erie and is a former chairman of the MSSNY Judicial Council, its Investment Committee, and the society-sponsored New York Medical Political Action Committee. He was also a founding member/director of the physician-owned Medical Liability Mutual Insurance Company. From 1979 to 1982. Dr. Collins was a member of the AMA Council on Constitution and By-laws. He has been a delegate or alternate delegate to the AMA for the past 12 years and was chairman of the New York delegation from 1977 to 1981. Among his many other affilmtions, Dr. Collins is a director of the Buffalo Sabres and a trustee of the State University of New York. which, with almost 400.000 students. is the largest system of higher learning in the country. 1959 MARY ANN ZAVISCA BISHARA, M'59 • has been elected to the boards of directors of the Niagara Chapter of the American Red Cross and Hospice of Nmgara. Dr. Bishara is currently serving as president of the Niagara County Medical Society. 1960 WILLIAM E. ABRAMSON, M'&O • has a private practice in psychiatry and is director of the Comprehensive Drug Abuse Program of Sheppard and Enoch Pratt Hospital. Towson. Maryland. The program has received the 1983 Distinguished Service Award from the Maryland Drug Abuse Administration. 1961 JOEL BERNSTEIN, M'61 • was one of eight international otologists invited to speak at the Symposium on Middle Ear Effusions held in Lake Lugano. Switzerland. In April Dr. Bernstein was a visiting professor at the Or. George L. Collins, Jr. University of Ghent. Belgium. where he delivered two lectures. Dr. Bernstein recently chaired a workshop on ENT Diseases and the Allergic Child. American Academy of Allergy and Immunology in Hollywood , Florida. 1964 FRANKLYN G. KNOX , M'64 • has been appointed director for education and dean of the Mayo Medical School. Rochester. Minnesota. Dr. Knox has been chairman of the Departments of Psychology and Biophysics there since 1974. The author of numerous papers. Dr. Knox has focused his research on the function of the kidney. He is a member of the Council of the American Physiological Society, chairman of the Council on the Kidney in Cardiovascular Di- sease of the American Heart Association. and chairman of the Grants Committee of the National Kidney Foundation. 1966 SEAN R. ALTHAUS, M'66 • has been elected president of the House Ear Institute Alumni Fellowship Group for 1983. He co-authored an article entitled "Some Observations on the Localizing Significance of Ear Dependent Positional Nystagmus" which appeared in Otolaryngology Head and Neck Surgery in February. Dr. Althaus also presented with several other physicians a paper on "Middle Fossa Surgery" at the spring meeting of the American Neurology Society in New Orleans in April. Dr. Althaus lives in Danville, California. BUFFALO PHYSICIAN • 43 �Classnotes 1966 ROBERT M. BARONE, M'66 • is an associate clinical professor of surgery at the University of California. San Diego. Dr. Barone was awarded an NCI grant for studying the treatment of liver metastases from colorectal cancer. The University of California School of Medicine is one of five study participant institutions in what is known as the Hepatic Thmor Study Group. This is the first cooperative study funded to investigate the effects of intraarterial chemotherapy using a totally implanted system. MICHAEL I. WEINTRAUB, M'66 • was recently promoted to the rank of clinical professor of neurology at New York Medical College. In April his book was released: Hysterical Conversion Reactions: A clinical guide to diagnosis and treatment. This monograph represents the first volume in the new neurology series: Neurologic Illness: Diagnosis and Treatment. In April. Dr. Weintraub appeared on the "Today Show." discussing with Betty Furness adverse medical complications of over-the-counter dietary drugs. 1968 SANFORD LEFF, M'68 • is chief of cardiology at the Interfaith Medical Center. Brooklyn. New York. 1972 GEORGE KOTLEWSKI, M'72 • is director of cardiodiagnostic services at Los Altos Hospital. Long Beach. California, and a member of the staff at the Long Beach Community Hospital. MARC LEKNER, M'72 • has returned to southern California to become co-director of the Orange County Neonatology Medical Group. Incorporated . STEVEN JAY ROSANSKY, M'72 • , a specialist in nephrology. was recently promoted to associate professor at the University of South Carolina. Dr. Rosansky has been recommended for direct fellowship to the American College of Physicians. He is currently the president of the South Carolina Chapter of Physicians for Social Responsibility. STUART RUBIN , M'72 , IAN M. FRANKFORT, M'72, and DANIEL J. McMAHON, M'73 • have opened their new Family Practice Office at 74 7 Hopkins Road, Williamsville. New York. STUART R. TOLEDANO, M'72 • , assistant professor of pediatrics at the University of Miami School of Medicine. has been appointed director of the Division of Pediatric Hematology-Oncology there. ERIC J. RUSSELL, M'74 • is in private practice in neuroradiology in Chicago. Illinois. Dr. Russell has an article in the July issue of JAMA on "Research in Interventional Neuroradiology." In June he presented papers at meetings of the American Society ofNeuroradiology and the American Society of'Head and Neck Radiology. Dr. Russell announces the birth of his daughter, Gabrielle Robin. on September 30, 1982. 1975 TONE JOHNSON, JR., M'75 • , a specialist in family practice. has been appointed chief medical officer, ambulatory care, at the Audie L. Murphy Veterans Administration Medical Center. 1976 HENRY M. BARTKOWSKI, M'76 • assistant professor at the University of California. San Francisco, has been promoted to acting chief of neurosurgery at San Francisco General Hospital. He has presented original research papers on "Nuclear Magnetic Resonance in Brain Edema" at national and international neurosurgical and neuroscience meetings. 1974 JOHN P. MANZELLA, M74 • has been elected to Fellowship in the American College of Physicians. Dr. Manzella. a specialist in infectious diseases. is on the staff of the York Hospital, York. Pennsylvania. and is a consultant at the Veterans Administration Hospital, University of Maryland. DENNIS R. PYSZCZYNSKI, M'76 • just completed a two-year postdoctoral fellowship in the Physiology Department. SUNYAB School of Medicine. and has taken a position in the pulmonary section of the Department of Medicine at the University of Missouri-Kansas City. School of Medicine. 1977 MARK POLIS, M'77 • has completed his training at New York University Medical Center and is in private practice in urology and male infertility in Williamsport, Pennsylvania. JEFFREY K. SEITELMAN, M'77 • is board certified in adult psychiatry and has just completed an advanced fellowship in administrative child psychiatry. Dr. Seitelman has started a practice in child, adolescent and adult psychiatry in Long Beach. California. 1979 PETER CONDRO, JR., M'79 • has finished a three-year internal medicine residency and a oneyear chief residency in medicine at the University of Maryland Hospital in Baltimore. Dr. Condro moved to Philadelphia in June to begin a nephrology fellowship at Temple University Hospital. 1980 LLOYD SIMON, M'BO • writes that he has just finished a residency in internal medicine at the University of Massachusetts Medical Center in Worcester, and is moving to Southold on eastern Long Island to open a solo practice in general internal medicine. STEPHEN BENHAM, M'BO • has recently completed three years residency in family practice at East Tennessee State University. Dr. Benham will be opening a solo practice in Sidney, New York. in August. Calendar PARENTS WEEKEND • October 8-9. Watch for details. NATIONAL DAIRY COUNCIL NUTRITION PROGRAM • Wednesday, November 30, and Thursday. December l. Featuring Dr. Noel Solomons, associate professor of clinical nutrition at Massachusetts Institute of Technology. UB is one of about 20 medical schools in the U.S. selected to participate in this National Dairy Council program which aims to enhance the present level of nutrition knowledge among physicians, medical students and other health professionals. The program is designed to 44 • BUFFALO PHYSICIAN create greater awareness of nutrition's role in clinical medicine and in health care and disease. Dr. Solomons will discuss "Assessment of TI-ace Mineral Nutriture" at University Citywide Medical Grand Rounds at 8 a .m .. November 30 at Roswell Park Memorial Institute's Hilleboe Auditorium. Following the Grand Rounds. he will join the Medical Morning Report Group at Buffalo General Hospital for discussion. After lunch. Dr. Solomons will address third-year medical students enrolled in the selective course "Nutrition Awareness: A Lifetime Interest" and will par- ticipate in several workshops including one on trace minerals. At 3:30p.m. he will present a lecture on "Zinc Absorption and Metabolism" at a location to be determined. On December 1, Dr. Solomons and UB's Dr. Pearay L. Ogra will discuss nutrition and i nfection/i m m uno logical response - time and place to be announced. FLEXIBLE FIBEROPTIC SIGMOIDO· SCOPY • November 12, 1983. Marriott Inn. Lectures and instruction in use of the instrumentation. Sponsored by Continuing Medical Education, UB, and the Pentax Corp. ANNUAL MEETING OF THE INTER· URBAN SPINAL CORD ASSOCIATION • Thursday and Friday. September 22-23, 1983. Grand Island Holiday Inn. Thpics will include recent advances in diagnosis. treatment and management of spinal cord injuries. Among featured speakers will be Dr. Alain B. Rossier, a paraplegic and internationallyknown specialist in spinal cord injury from Harvar.d University and West Roxbury (Mass.) Veterans Administration Medical Center; and Dr. Chandler A. Phillips, a Wayne State University physician on the team which has done pioneering work on computerized control �Calendar of movement in paralyzed patients. Others on the program include Dr. George J. Alker, Jr.. acting chairman of US's Department of Radiology; Rochester's Dr. Charles J. Gibson; Dr. Edward A. Stehlik of UB and Erie County Medical Center's Spinal Cord Injury Unit; and Dr. Robert E. Cooke, medical director of Buffalo's Robert Warner Rehabilitation Center. Specialty meetings for physicians, rehabilitation nurses. physical and occupational therapists and counselors will be held at 2 p.m., Sept. 22. Members of the Inter-Urban Spinal Cord Association include physicians and other health and social service professionals from Buffalo, Rochester. Syracuse; and Kingston, Ottawa, Thronto, Hamilton and London. Ontario. Patients and their families are invited to attend the Friday sessions at a reduced registration fee. Registration is $50 for health professionals. For further information, contact the Department of Rehabilitation Medicine, ECMC. 462 Grider St., Buffalo 14215. TASTE AND SMELL IN DISEASE • Dr. Susan S. Schiffman, a medical psychologist fom Duke University. will give a presentation on "Th.ste and Smell in Disease," sponsored by Tops Friendly Markets and US's Multidisciplinary Graduate Group in Nutritional Science. Late September. Details to be announced. DR. MITCHEll I. RUBIN DAY • Friday, October 7, 1983. Kinch Auditorium, Children's Hospital (scientific session) and Buffalo Marriott Inn (reception and din- ner). This event will honor the multiple local and international contributions of Mitchell I. Rubin, M.D.. to the teaching. practice and science of pediatrics. All colleagues, former students and friends are invited to attend both the scientific session during the day and the evening events at the Marriott. Please call or write: Mrs. Debbie Licata. Medical Staff Office, Children's Hospital. 219 Bryant Street. Buffalo, N.Y. 14222 (716-878-7406) for information and reservations. ONCOLOGY SEMINAR SERIES • "Metastasis." October 4-6, 1983. Chairperson, Dr. Leonard Weiss. "Molecular Events in Differentiation and Neoplasia." November 10, 1983. Chairperson: Dr. Timothy O'Connor. "Update in Neurological Oncology." · December 8. 1983. Chairper- son: Dr. Charles West. All programs in the series are held at Roswell Park Memorial Institute. A fee of $45 is charged for physicians for each seminar. Residents are assessed $15 and there is no fee for students. Contact: Gayle Bersani. cancer control coordinator. (716) 845-4406. Co-sponsors with Roswell Park are the American Cancer Society. New York State Division and Erie County unit. These seminars qualify for Category I credit toward the A.M.A. Physician's Recognition Award. prescribed credit by the American Academy of Family Physicians. and Category 2-D credit by the American Osteopathic Association. ------------------------------------------------------------------- III Ill BUSINESS REPLY MAIL FIRST CLASS PERMIT NO. 2210 BUFFALO, N.Y. POSTAGE WI LL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, New York 14214 NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO, NEW YORK 14214 LET US HEAR FROM YOU Fill out this card (Please print or type all entries) Name _________________________________________________ Year MD Received ___________ Office Address - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - HomeAddress _______________________________________________________________________ If not UB, MD received from - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - In Private Practice: Yes No In Academic Medicine: Yes l J No [", Specialty Part Time ;- Fu ll Time r School Title ___________________________________ Other: Medical Society Memberships: NEWS: Have you changed positions, publ ished , been involved in civic acti vities, had honors bestowed , etc.? _ _ _ _ _ _ ____ Please send copies of any publications, research or other orig inal work . � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, September 1983 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1983-September Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MIcFilm LD701 .B42 M5 no. 268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1983-v17n03-Sept Table Of Contents A list of subunits of the resource. Outreach The Perry, N.Y. Medical Center Car Seat Law Transplants New course may be a first The Presidential Heartbeat AIDS Research Medical School News Students People Alumni Classnotes Calendar Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-07-05 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v17n03 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1983 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/e839625ccc26424967f66a3330145629.pdf 59f49f28bdab1dcca12f5bd92a2b1323 PDF Text Text l J v �The School of Medicine and its departments together with the other units of the University at Buffalo were asked to review their research programs and to develop a research plan by President Steven B. Sample in late 1982. I am pleased to report that this review indicated that the multiple basic science and clinical science units which comprise the School of Medicine at Buffalo are either participating at an appropriate level in the biomedical research enterprise or are developing the research programs needed for a viable academic enterprise. More importantly, the faculty committee which coordinated the school's report recommended the formation of an organization for medical school investigators and the conduct of an annual research day. Both of these recommendations have been accepted. The school's first annual research day was held on May 27, 1983 in the Ellicott Complex on the Amherst Camp~s.. The re_sult was an exhilarating experience part1c1pated m by over 300 faculty, technicians, and graduate students. It brought together investigators who otherwise would have been uninformed about large amounts of significant work being conducted throughout the institution and it stimulated an awareness of the overall cohesiveness that can and does exist even in an institution as complex as a school of medicine. From my own personal perspective, the research day served to demonstrate the commitment and vitality of our faculty and to o?ce again demonstrate our capacities as a faculty m relationship to the other medical school faculti~s dispersed throughout the United States. Dr. Alastair Brownie and his committee established a fast pace which will be difficult to match with each succeeding year's meeting.• - John Naughton, M.D. �Contents BUFFALO 3 Anatomy • This most basic of the basic sciences, celebrated in medical student lore, is rapidly changing. Where anatomists once lurked in dark rooms, cutting up bodies, today they strain at the boundaries of the discipline, pushing toward cell and molecular biology and biochemistry. 8 Diet • The latest studies in Social and Preventive Medicine indicate that no nutritional regimen can yet be said to prevent malignancies. 9 Alzheimer's Disease • World-wide research is making inroads into unraveling the causes of this disease which leaves its victims "nonpersons." But a UB researcher cautions that not every confused elderly patient is suffering from irreversible senile dementia. PHYSICIAN STAFF Executive Editor, University Publications Robert T. Marlett Art Director Rebecca Bernstein Health Sciences Editor Mary Beth Spina Photography Francis Specker Ed Nowak ADVISORY BOARD Dr. John Naughton, Dean School of Medicine Dr. Harold Brody Dr. James Kanski Mr. Daniel Newcomb Dr. James P. Nolan Dr. Charles Paganelli Dr. Peter Regan Mr. James Smigelski Mr. James N. Snyder Dr. Eugene Michael Sullivan Jr. Dr. Mary Voorhess Dr. Martin Wingate Dr. John Wright Or. Maggie Wright TEACHING HOSPITALS The Buffalo General Children's Deaconess Erie County Medical Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Charity Veterans Administration Medical Center 13 Our Children in the Nuclear Age • Buffalo pediatrician Dr. Thomas Bumbalo cautions that the Nuclear Age with its promises of better health care also threatens those to whom it promises the good life. 16 Research Briefs • Local researchers conduct important work on artificial hearts. Roswell scientists test new brain cancer therapy. Electrical device promotes bone healing. New drug therapy promises help for Parkinson's victims. Five-year study assesses management of asthma. Hangovers may help prevent alcoholism. 21 22 Students • Low humor and high spirits at the Medical School Follies. 26 People • Dr. Robert Cooke, who created the Head Start Program, now runs the Children's Hospital Rehabilitation Center. Husband-wife team receives major grants. 29 30 Alumni • Alumni Association honors Class of 1983 at the AlbrightKnox. 33 Page 27: Drs. Claire M. Fraser and J. Craig Venter Medical School News • Sociologist asks 1983 grads to consider whether the benefits of transplants and dialysis outweigh the drawbacks. 154 students receive degrees. New institute seeks ideas for health devices. Spring Clinical Day • Coronary disease expert identifies smoking as the No. 1 threat to the heart. Commercialization and feminization seen ahead for medical practice. Class notes • Class of 1923 holds an unofficial reunion. Dr. Lynn Eckhert juggles several careers. News of the classes. Deaths. Page 22: Dr. Thomas Flanagan at Commencement Produced by the Division of Public Affairs, Harry A. Jackson, director, in association with the School of Medicine. State University of New York at Buffalo About our Cover: Muscle study by Andreas Vesalius from De Humani Corporis Fabrica, 1543, contrasts with modern microscopic studies of cell shapes in the Department of Anatomical Sciences. THE BUFFALO PHYSICIAN, (USPS 551·860) July 1983- Volume 17, Number 2 published five times annually: February, May, July, September, December _ by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York . POSTMASTER: Send address changes to THE BUFFALO PHYSI· ClAN, 139 Cary Hall, 3435 Main Street, Buffalo, New York 14214. ��Anatomy This most basic science is classic and traditional, yet rapidly changing A natomy is where Medicine begins, literally and figuratively. On its mastery rests the entire house of clinical knowledge and over its weighty books, challenging dissections and microscopic examinations, freshman medical students spend long and demanding hours as they start the journey toward the M.D. This most basic of the sciences is celebrated in medical student lore and its texts are among the masterpieces of medicine. Many a physician has a story to tell about his or her first encounters with a cadaver in gross anatomy, and the medical library without a dog-eared copy of Gray's Anatomy is rare. The field is classic and traditional, yet rapidly changing. Where anatomists once were stereotyped as lurking in dark rooms, obsessed by bone and muscle, today's anatomical studies at UB may involve use of sophisticated electron microscopy; tracking sloths through Central America's forest canopy; probing examinations of the structure of heart cells; investigations "on location" at Woods Hole of the reproductive system and cellular mechanisms of sea urchins; using huge "flying foxes" or smaller bats to understand the mechanics of mastication or retinal projection in man; or examining the effects upon the nervous system of aging or chronic alcoholism . The study of "Anatomy has changed," notes Dr. Barry Eckert, a member of the Department of Anatomical Sciences faculty here and director of its electron microscopy program. "The image of the anatomist has changed. He doesn't just sit around cutting up bodies. He (or she) is straining at the boundaries of the discipline, pushing toward cell and molecular biology and biochemistry." Dr. Harold Brody, chairman of the department, which is located on the third floor and basement levels of Farber/Sherman/Cary, agrees. His department has changed and is changing. While the heavy teaching typical of Anatomy faculty in health school settings remains, instruction has been streamlined with a view toward dividing (Large photo) Sea urchins are used in studies of fertilization and cell surface proteins. (Inset) Dr. Harold Brody, Anatomical Sciences chairman, has conducted long-term studies of the effeet of aging on the human brain. PHOTOS: FRANCIS SPECKER I!UFFALO PHYSICIAN • 3 �classroom and laboratory work more equitably. It has been traditional at Buffalo, that classes in Anatomy are scheduled six days a w~ek du.ri~g the fall semester. This year, Saturday classes will be ehmmated but this will not result in any decrease in faculty contact time. That this is considerable is a'ttested to by the fact that (for the faculty teaching Medical, Dental and Graduate students) gross anatomy contact time amounts to 22.5 hours a week while in histology/embryology there are 18 contact hours weekly. A unique feature of the Buffalo curriculum is the opportunity for students to take histology and embryolo~y during the summer before their first fall semester. This offering, directed by Dr. E. Russell Hayes, permits a student to lighten the fall semester program or to take elective courses not possible in the usual crowded schedule. The fourth Anatomy core course required of first year students is neuroanatomy, offered during the second semester of the first year. Gross anatomy and histology provide an understanding of structure from that which may be seen by the naked eye to ultrastructural features observed with the aid of the electron microscope. Embryology adds an understanding of how organ systems develop normally ~nd .the ~evelopmental basis for malformations due to genetics, mfect10n or trauma, while neuroanatomy concentrates on an in-depth study of the structure and function of the central nervous system and an understanding of how this information can be used to determine specific sites of injury in the clinical patient. W hile these courses are traditional (especially so in the case of gross anatomy) in preparing the student for a career in medical practice, they are not static in their presentation. The University of Buffalo in the late 1950's was anationally recognized center for discussion and implement~­ tion of medical school curricular changes and some of this same attitude prevails today. A major recent change in gross anatomy teaching involved the introduction of a tea11_1 approach to dissection ..1\v~- pers?n teams work on a rotatiOn~! basis, presenting their dissections to other students at their table, using X-rays, chalk boards etc. to explain their work. This presentation method is similar t~ that expecte~ of students in the clinical setting of the third year of medical school. Faculty members also prepare dissections themselves for class instruction. This new approach requires a more aggressive brand of teaching and a considerable faculty effort to develop course material, rather tha.n having faculty acting merely as ~esourc~ pe.rsons ~~ the laboratory. That this method of mstruct10n IS effective .. at least by student evaluation, was demonstrated by the h1gh rating awarded to this course in the Fall semester of the 1982-83 year. It is in the teaching of histology that some of the more pectacular changes have occurred in Anatomy. This science ~f the microscopic study of normal cells an? tissu~s was for a long time limited to the technology of the hght miCroscope. 4 e BUFFALO PHYSICIAN With the coming of electron microscopy, however, literally a new world has been opened to the· professional histologist and students. Students are still expected to be familiar with the normal structure of cells, tissues and organs as demonstrated by a number of different staining techniques, but they are also now introduced to transmission electron microscopy in which the ultrastructure of the cell may be examined, to scanning electron microscopy for examination of cell surfaces and to freeze fracture preparations in order to demonstrate membrane structure in tissues. Familiarity with each of these methods naturally adds to the work/study load of the student, but knowledge of the results of such ~echnological ad~ances is essential if the future physician IS to keep step With a changing medical and scientific enviro?ment. The ~i~tolo~y course will also include problem sol~mg opportumties this year. Using analytical skills learned m the laboratory and a knowledge of normal microscopic ~natomy, stu~ents will be asked to identify changes in tissues. that arise as a result of certain pathologic conditions. A. special honors program will also be initiated this year in histology and embryology. The latter course is offered as a le~ture course in the normal development of organ systems with frequent reference to developmental anomalies. Histology and embryology are taught by the same faculty and are coordinated by Dr. John Cotter. In neuroanatomy, US was one of the first medical schools in this .country to shift from microscopic slides of the human br~m stem to 2 x 2 slides which may be viewed by students With a carousel projector. This has permitted ~tu?e.nts to form themselves into study teams of five to six mdividuals and has been a stimulus for exchange of information am.ong stude.nts. An?ther recent departure has led to the sealing of bram specimens in plastic containers so students may examine material without the necessity of handling the specimen. . Each oft?~ four required courses, Dr. Brody pointed out, mvolves a chmcal correlation. It's one thing, say, to learn about the human face by dissecting it, but another still to maste.r ~ow to approach repairing damage to the face cause.d by mJu~y. In neur~anatomy, particularly, clinical correlat~on often mvolves tnps to affiliated hospitals for presentatiOn of cases under the direction of Drs. William Kinkel, Daniel Lacey and Walter Olszewski, all members of the Department of Neurology with joint appointments in Anatomy. U B nursing students, hospital nursing students and health educ.ation .majors are another component of the Anatomical Sciences teaching load. A single course coordinated by two faculty and team-taught by a number of professors has replaced previous separate offerings for these student groups. Here, three lectures and a recitation/demonstration are scheduled weekly, and small groups of students rotate through the gross anatomy lab for demonstrations. The co~solidation of this service teaching effort, Dr. Brody noted, IS yet another reflection of the departmental commit- �ment to opening more faculty time for research and graduate (From left to right) Dr. Sabina Sobel, working with mouse embryos; small bats from the Department's colony being fed by a student assistant; Dr. Roberta Pentney, with education. A teaching program not often recognized as a commit- sketches of brain neurons; Nastase, one of three two-toed sloths under study by Dr. ment of the department is its responsibilities to residents Frank Mendel; Dr. Kenneth Edds describing his work on how cells change shape. in the graduate medical programs of hospitals associated with the School of Medicine. Residents in neurology, tion. By learning more about mechanisms which prevent neurosurgery, ophthalmology, oral surgery, otolaryngology, this from happening, he and his associates hope to find clues gynecology and obstetrics, and orthopedic surgery either use to possible causes of infertility as well to as how fertility the laboratories of the department or its faculty for specializ- could be prevented. Grants from the National Institute for Child Health and ed anatomical advice. With the growing commitment by the medical school toward graduate education and the develop- Human Development and the National Science Foundation ment of a laboratory for dissection by residents in the new totaling $127,000 have been received for these studies. teaching building, there should be increasing involvement v A study of hyalin, a cell surface protein observed in sea urchins. Drs. of the department in the education of these physicians-in- Robert Summers, associate professor, and Bonnie Hylander, clinical assistant professor, are looking at this protein, releastraining. The Anatomical Sciences Ph.D. program enrolls between ed upon fertilization, which provides direction to embryonic eight and 16 students in a given year; the department of- cells, shaping and organizing them to perform specific funcfers a master's only as a step toward the Ph.D., or for those tions. Similar cell surface proteins in humans may play a with a degree in another health sciences area (a dentist, role in cancer - because of their failure to give direction nurse or therapist, for example, who could use the master's for growing, organizing and functioning smoothly. to expand his or her professional capabilities). No master's v An investigation of how sea urchin cells change shape. Dr. Kenneth candidates at all are accepted from among liberal arts and T. Edds, assistant professor and director of graduate studies sciences graduates interested only in the M.A. This spring in the department, is studying a primitive sea urchin cell four Ph.D.'s were awarded - a figure which matched 1982's. known as a coelomocyte which has functions similar to Recent doctoral work. Dr. Brody said, has been concentrated human blood cells in clotting and destroying invading in reproductive biology, functional morphology, bodies. To perform its functions, the coelomocyte changes neurobiology and cell biology. All but one doctoral graduate from a petaloid shape to one with protruding spikes. Better during the past two years has gone on to post-doctoral work; understanding of mechanisms which cause the cell to change may lead to a basic understanding of reasons behind the exception having entered medical school. configuration changes evident in some human cells. Dr. r. Brody considers it critical that each faculty member Edds has received a three-year $150,000 grant from the Nahave one semester each year to devote to full-time tional Science Foundation to continue this work. Drs. Summers. Edds and Schue! regularly join other research (in addition to ongoing course development and other faculty activities). The department in 1982 had a fund- scientists at the Marine Biological Laboratory at Woods Hole, ed research level of about $200,000, and while the chair- Mass., where researchers from around the nation gather durman has no dollar target in mind for expanded efforts, he ing summers to study and exchange information about funlooks forward to a time when each faculty member will be damentallife processes more easily observed in urchins and funded (approximately 50 per cent have research awards in other sea animals. effect at present). "I am not interested in amounts," the v A study of embryonic development. Dr. Sabina Sobel, assistant chairman emphasized. "If a person can support his or her professor, is working with mouse embryos to gain an research on $5,000 a year in outside funding, that's just as understanding of the behavior of cells during development. acceptable as bringing in a million and a half dollars:" The Using electronmicroscopy, chemistry and micromanipulaprimary goal is a self-supporting program that perm1ts the tion techniques, she is seeking answers to such questions person to do the research to which he/she is committed. as how embryonic cells move and organize themselves. Current research in the department includes work in v Studies of the development of heart muscle cells. Dr. Barry Eckert, cell motility, functional morphology, hematology, assistant professor, is a recently announced Established Inhistochemistry, reproductive biology and the nervous vestigator Fellow of the American Heart Association for a system. Among studies being conducted using techniques five year period beginning August, 1983. His work, also supranging from observational cinematography to electron ported by the National Science Foundation, is focused on intermediate filaments, composed of protein, which form the microscopy and a variety of animal subjects are: v A study of fertilization reactions in the sea urchin which may be im- cytoskeleton or internal structure of heart muscle cells. plicated in human problems such as spontaneous abortion and infertility. Relatively little research has been conducted in this area, Headed by Associate Professor Dr. Herbert Schue!, a but it is known th.at this portion of the cytoskeleton supports research group is focusing on defense mechanisms which muscle contractiOn. Dr. Eckert's thrust is to determine prevent polyspermy, the condition of having more than one whether some forms of heart disease have an auto-immune sperm penetrate an egg; this can lead to spontaneous abor- basis or begin in utero, caused by a factor which renders D BUFFALO PHYSICIAN • 5 �the filaments unable to function properly in muscle contraction. From 1979-1982, Dr. Eckert was also the recipient of the first Sinsheimer Foundation Award presented to a Buffalo faculty member. This three-year award supported earlier work which has led to his more recent honor. ,_- The effects of the combination of alcohol and aging on the brain. While studies have demonstrated that neurons or nerve cells in the brain can be destroyed by aging as well as by alcohol. little is known about the effects of the combination of the two. Dr. Roberta Pentney, clinical assistant professor, with a three-year $137,000 grant from the National Institute on Alcohol Abuse and Alcoholism, is continuing pioneering research on the effects of both variables on the dendrites which branch from each neuron like limbs on a tree, and provide the neuron with information. . . ,_- Studies of the effect of aging upon the human bram. Dr. Brody IS continuing a long time study of changes in morphology and cell populations of cerebral cortex and brain_ stem in t~e no~­ mal aging human and in individuals ."'nth Alzheimer s disease and senile dementia of the Alzheimer type. He was the recipient of the 1978 Robert W. Kleemeier Award by the Gerontological Society of America for outstanding research contributions in gerontology. ,_- Studies of the autonomic nervous system. Dr. Frances Sansone, associate professor, is examining specialized neurotransmittor cells in the sympathetic nervous system which show high degrees of fluorescence; he h~s cor:trib~ted information on nerve-muscle inter-relatwnships m muscular dystrophy. Dr. Richard Webber, professor, has in the past provided a great deal of information regarding normal fe~tures of t~e gross and microscopic structure of sympathetic nerves _m the lumbar region. Having recently returned from. a sixmonth sabbatical leave in Heidelberg, Germany, he IS now examining neuropeptides by immunohistochemical means in sympathetic ganglia of guinea pigs after surgical interruption of specific neural pathways. ,_- Studies of the visual system. While we consider sight to be the obvious activity related to the visual system, Dr. John Cotter, associate professor, has been examining projections from the eye of the bat which go to brainstem structures. These are related to reflex responses and may in addition reflect on an understanding of the evolution of the visual system and on behavioral responses of the animal. ,_- Studies of basal ganglia. The basal ganglia are large structures of gray matter located within the cerebral hemisphere. By connections with other regions of the central nervous system, they play an important role in a group of_ motor disturbances called dyskinesias which are charactenzed by involuntary purposeless movements. Dr. Charles Severin, assistant professor, by the placing of stereotaxic lesions and/or injections of drugs or tracer elements. studies the interaction of basal ganglia structures with other cell groups in the reticular formation of the brain stem. ,_- An observational study of two-toed sloths. Dr. Frank Mendel, a physical anthropologist and associate professor, h~s f?r a number of years been studying two-toed sloths for msight into "suspension modes," to which that anim~ i_s behavior~­ ly and morphologically adapte_d. Dr. Mendel Is m~erested m functional anatomy. His studies are prompted m part by fossil evidence, which suggests that common ancestors of man and living apes engaged in suspensory behavior; but he also wants to understand more about the sloths in their own right. how their blood is pumped "uphill," how the balance system in their inner ear differs from man. To learn about how these animals function in the wild, Mendel will go to Panama next winter to begin setting up on Sarro Colorado Island a network of cables in the tropical forest (where the sloths live, suspended high in the trees). Using the cable, he plans to glide through the trees on a gondola specially6 e BUFFALO PHYSICIAN designed for sloth watching by the UB Health Instruments facility. v- Studies using bats. Dr. Frank Kallen, who organized the bat colony facility and is a nationally recognized authority in the anatomy and physiology of these animals, works with giant Indian fruit bats, another group of smaller bats and tree shrews for research on mastication and swallowing. These latter studies are being performed in collaboration with Drs. Mendel and Dale Fish, clinical assistant professor of anatomy and physical therapy. The veins and hearts of the bats have been the focus of other studies by Dr. Kallen as have physiological processes associated with their hibernation behavior. ~ Studie~ in hematology. Dr. Chester Glomski, professor and VI~e-chairman of the department, has been a major contnbu~or to knowledge of comparative hematology, with emphasis on the study of blood cells in common laboratory animals. He has provided information on the structure of these cells. their chemistry and populations under normal and abnormal conditions. Such knowledge is a prerequisite for proper interpretation of effects of low dose X-irradiation upon the development of red blood cells. These studies have been supported in the past by the NIH and American Cancer Society. Dr. Elizabeth Repaskey, clinical assistant professor based at Roswell Park Memorial Institute, is interested in the presence of a protein, spectrin, which provides a supportive lattice work to the plasma membrane of red blood cells and rep_resents about 40 per cent of the total membrane protein. This same protein is now being examined in muscle and nerve cells. v- S~dies in histochemistry. Dr. E. Russell Hayes, professor, has ~ontnbuted basic information to the understanding of stainI~g ca~abilities of lipids, as well as specialized cells in the digesti~e syste_m and kidney. Most recently he has been involved m studies of middle ear mucosa in individuals with otitis media. Much of the department's research is supported by the electron microscopy program which also contributes heavily to the work of many other members of the UB scientific communi~y. Currently headed by Dr. Eckert, it was originally organ~zed by Dr. Summers. Before Summers joined the faculty, It would have been difficult for anyone not in Anatomy to use the equipment. In conjunction with a major renovation supported by Dean John Naughton, Dr. Summers deve~oped a ~rogram available to anyone in the University and It~ teachmg hospitals for which the scientist pays only a nom mal fee for materials and supplies. This program also �(On page at left) Dr. Thaddeus Szczesny using new scanning electron microscope. (This page, clockwise from top right) Anatomy Lab of the early 1900s; Dr. Charles Severin conducting tour of today's Gross Anatomy Lab for potential health sciences majors; and Dr. Barry Eckert, director of the electron microscopy program. The Department of Anatomical Sciences has roots deep in the history of the University and community. It traces its lineage to Dr. James Webster of the original medical school faculty of 1846. Controversy once surrounded early medical school practices and former Anatomy Chairman and now Distinguished Professor Emeritus Dr. Oliver P. Jones has previously reported in the Buffalo Physician some 19th century dealings by the school with grave robbers to obtain cadaver specimens. However, the present department enjoys a long standing special relationship with the community. Its body donation program originated by Dr. Jones, in Dr. Brody's view, represents what are undoubtedly the closest off-campus ties with the community of any of the basic science departments in the School of Medicine. A significant amount of staff time is devoted to a whole series of correspondence and careful arrangements following an inn common with many other units in the health sciences dividual's decision to will his or her body to science. Purschools at UB, Anatomy suffers from a critical shortage of suant to another long tradition, the department space. For example, Dr. Brody noted, a new faculty member acknowledges and handles this delicate interplay with both arriving August 1 will be confined to a combined office/lab appreciation and care. For without a common trust between no larger than the usual faculty office space. The long the community and the department in this venture, the awaited addition to Cary/Farber/Sherman, whose progress teaching programs for medical students and residents in can be viewed from Brody's third floor office, will provide graduate education programs would be severely jeopardized. The department looks ahead to the 80's and 90's with deliverance from this space problem. although Anatomy faculty will not occupy any personal space there. The gross anticipation. Opportunities for enhanced teaching and anatomy and histology labs will be relocated into the new research programs should be possible with the increased building, freeing up space presently occupied by these space and technology which will be available. This will finalfacilities for conversion into research laboratories. Anatomy ly be translated into better training for future health prowill also annex the fourth floor of Farber (presently occupied viders and those who will be the teachers of Anatomy in the by the Medical School's animal quarters) where the electron future. Human anatomy may not change but our understandmicroscope facility and other research laboratories will be ing does change. This will continue to be the challenge. • relocated. offers an annual four-week course to teach others the proper use of the equipment in the facility. The credit-free course is now taught by Dr. Thaddeus Szczesny, senior technician of the laboratory. A recently acquired $100,000 scanning electron microscope further increases the capabilities of researchers campus-wide, noted Dr. Eckert. Addition of the new microscope permits greater resolution of surfaces than was possible previously. The JEOL model JSM 35CF SEM, Dr. Eckert pointed out. is the only one of its type in the area. It complements the transmission electron microscope which is capable of magnifying the interior of cells and other substances. Those interested in utilizing the Laboratory's facilities may contact Dr. Eckert at 831-2301 or Dr. Szczesny at 831-3330. I BUFFALO PHYSICIAN • 7 �Diet Its relation to cancer is . still unclear, studies show A UB study which suggests that nutrients shown protective against some malignancies may promote The study focused on 311 males with cancer of the prosothers emphasizes the unclear relationship be- tate and 294 other males who did not have genitourinary tween diet and cancer, says internationally known or digestive disease symptoms or any other type of cancer. epidemiologist Dr. Saxon Graham. Another control group included males without cancer or Graham said that his recent study suggests that the genitourinary disease but with symptoms of digestive digreater the amounts of meats, fish, fats, and Vitamins A and sease. All were Roswell Park Memorial Institute patients C in the diet. the higher the incidence of prostate cancer. whose diagnoses were unknown to the study's investigators. But, he cautioned, the role of diet in cancer may be more Utilizing the food frequency method, interviewers complex than suspected. The study results app~ared April queried the men as to the frequency of ingestion of certain 15 in the Journal of the National Cancer Institute . foods known to contain specific amounts of the key nutrients. Retinoids associated with Vitamin A, for instance, have "The possible relationship between diet and prostate in some studies been found related to a somewhat reduced cancer, either direct or indirect. has been a subject of other risk of cancer of the oral cavity, larynx, lung, bladder and studies elsewhere," Graham pointed out. Some researchers cervix. Clinical and animal studies have suggested that reti- have theorized that diet may alter production of sexual hornoids appear to inhibit development of aberrant cells in tis- mones which, in turn, affects risk of cancer of the prostate. sue culture and animals. Other studies have suggested that prostate cancer paGraham, who has conducted many epidemiological tients ate more margarine and other fatty foods or were defistudies over the years exploring possible relationships be- cient in dietary zinc or protein compared to those without tween diet and cancer, said his recent study further em- the dis~ase. Still another researcher suggested prostate canphasizes the fact that there is no "ideal" diet which can be cer patients had diets more deficient in green and yellow said to promote or prevent various malignancies. vegetables. "Healthful" nutrients such as Vitamin A which may in"The contradictory findings of studies dealing with varhibit certain squamous cell cancers might increase risk of ious cancers and diet should be interpreted by physicians other types of malignancies or have no effect whatsoever and the lay public as indicative that at this time no nutritionupon risk, Graham maintained. And the "unhealthful" rea~ re~imens have yet been identified to prevent malignanputation of fats may be a "bum rap" in terms of their role Cies, Graham pointed out. in promoting some cancers, he added. Certainly, he said, it is especially confusing for the Graham previously found in a study of 3,500 women interested patient who attempts continually to alter his diet that diets high in fat do not appear to cause breast cancer, based on reports of research findings in the media. although earlier animal studies had suggested to the contrary and ecologic assessments have shown that as ~at he prob_lem becomes even more perplexing, he added, for consumption increases within a country so does mortahty . the patient who reads that greater ingestion of one nufrom breast cancer. In this earlier study, too, neither Vitamin tnent appears to help prevent one disease and yet promote c nor cruciferous vegetable intake seemed to lower risk as another. had been the case in some other studies. Until the time comes when enough evidence has been "Cancer is an extremely complex disease," pointed out gathered and tested to yield the "ideal" diet for preventing the epidemiologist. "Many who are exposed to known c~ncer, Graham suggests people attempt to eat balanced carcinogens never develop it and others do." diet~. If they cannot. and must use dietary supplements, he This suggests that several factors, possibly including advises they not go overboard with vitamin and mineral pills dietary habits, must be present for the disease to develop. and tablets which may not prevent cancer and may, in fact. be damaging in large amounts. he recent study suggests increased Vitamin A, animal Others participating in the study include Drs. Brenda fats and particularly Vitamin C in the diet increase the Haughey, James Marshall, Tim Byers and Mr. Thomas risk of prostatic cancer. The study further shows that the Rzepka of UB's Department of Social and Preventive Medirisk related to these nutrients for the disease is more ap- cine, and Drs. Roger Priore, Curtis Mettlin and J. Edson parent in males over 70. Pontes of Roswell Park Memorial Institute. • T T 8 • BUFFALO PHYSICIAN �Alzheimer's Disease Like cancer, it appears multifactoral with no single cause, event or exposure proven to be the deciding factor in its development A s hopeless as a diagnosis of senile or pre-senile dementia of the Alzheimer's type appears today, there's evidence that increasing, world-wide research is making inroads into unraveling some of the causes of the disease which leaves its victims "non persons" through gradual disintegration of their personalities. Losses of attention, memory, cognitive functions, judgment and emotional response go hand in hand with the disease which can strike individuals in their prime as well as others of advanced age. "Alzheimer's Disease - like cancer - appears to be multifactoral with no single cause, event or exposure proven to be the deciding factor in its development," according to Dr. Donald R. Crapper McLachlan, professor of physiology at the University ofThronto and staff neurologist at Thronto General Hospital. A former faculty member in UB's Department of Physiology, Dr. McLachlan, involved in Alzheimer's Disease research for nearly 20 years, spoke at a two-day program on the disorder at the Buffalo Hilton in May. Divided into two one-day sessions, the program, sponsored by UB's Department of Psychiatry and the University's Center for the Study of Aging, featured speakers geared to both the medical/scientific community and caretakers of Alzheimer's victims. Attracting 135 participants, the event was co-sponsored by the University ofThronto's Department of Physiology, the Societe Alzheimer of Canada, the Center on Aging of the University of Rochester Medical Center, the Network in Aging of Western New York and the Erie County Mental Health Association. Noting that Alzheimer's is typically identified as a presenile dementia, Dr. McLachlan said there is no evidence that the disease process operating in senile dementia of the Alzheimer's type is a different one. First described in 1906 by the physician whose name it bears, Alzheimer's Disease may strike those as young as their 40s although most diagnosed patients are usually older. A case reporting a patient as young as eight-years-old has appeared in the literature. "The virulence of the course in Alzheimer's varies," said the Thronto physician, "from 18 months to 19 years." More women appear to fall victim to the disorder, but Dr. McLachlan believes this may be partly explained because women typically live longer than men and thus increase their chances for the disease. And while Alzheimer's may have a genetic component, the risk of those who have a relative with the disorder contracting it themselves appears only slightly greater than for members of the general population. . "It is true there are some families who have a history of many relatives with Alzheimer's," Dr. M~La_chlan said, "but this is not a typical picture for the maJonty of those with the disorder." An interesting link reported through the efforts of researchers is with Chromosome 21 and its connection to Down's Syndrome. . "Those with Down's who die after age 35 typically have some signs of Alzheimer's at autopsy. characterized by the neuritic plaques and tangles. The incidence ?ft~e.se appe~s to increase with the age at death of the mdividual with Down's," Dr. McLachlan pointed out. B ut perhaps one of the more confusing aspects of Alzheimer's is that the tangles and plaques seen at autopsy in these patients can also be seen to lesser degrees in other, younger persons who have died from non-neurologic causes. Whether many of these individuals would have ultimately developed either pre-senile or senile dementia of the Alzheimer's type had they lived long enough, cannot be determined. But there is at least the implication that the seeds of the disease may be planted earlier than many have previously suspected. Discussing research in Canada and elsewhere, Toronto Dr. Umberto DeBoni (leh) witlt Gary Brice of tlte UB Center for tlte Study of Aging. BUFFALO PHYSICIAN • 9 �neurobiologist Dr. Umberto DeBoni said more people die annually of Alzheimer's than statistics reveal. . ·'The patient may die of infection, of pneumoma or other causes brought about in part by immobility necessitated by their illnesses, and these causes will be recorded on their death certificates." In reality, however, he said, they died of complications associated with Alzheimer·~· The public's recent awareness of the d1sorder has been helpful in aiding scientists gain needed, but still inadequate research funding for study of the disease. But, said Dr. DeBoni, this popular interest has also made some fearful that the slightest memory loss is their first sign of Alzheimer's. "It's true that memory is usually first affected in Alzheimer's patients, but not being able to bring to mind the name of someone known years ago is not abnormal," Dr. DeBoni noted. He pointed out it's been said that if you remember what it is you don't recall, you need not worry; the Alzheimer's patient typically does not recall what it is that cannot be remembered. "Neither," said Dr. DeBoni, "does personality appear to change radically during early Alzheimer's." The patient who tended to be docile before onset of the disease will perhaps begin to appear more withdrawn; those who become hostile, aggressive, and difficult to manage appear only to have had earlier inhibitions removed by the disease. Noting that costs of providing care for Alzheimer's patients who require institutionalization are phenomenal and growing as a major segment of the population reaches the age when the disease is more likely to be manifest, the Thronto scientist said more money must be available for research. Some scientists are exploring the hypothesis that a "slow"virus may be responsible for some of the changes seen in the brain at autopsy of these patients; others believe an autoimmune component may play an important role. And the Thronto group composed of Drs. McLachlan, DeBoni and Peter Lewis has reported research results which suggest that the nuclei of neurons and glial cells in the brain cannot read their genetic messages as efficiently as would be normal. Not all dementia is of the irreversible type T he confused, elderly patient who appears to suffer from irreversible senile dementia may be a victim of depression, inadequate diet or inappropriate medication, cautions a UB physician. "With the recent 'fad' of interest in Alzheimer's Disease, physicians may have a tendency to overlook the other types of dementia and depression which have similar clinical symptoms but are reversible,." Dr. Margaret Mitchell emphasized at a recent Buffalo conference on Alzheimer's. Since physiological changes go hand-in-hand with the aging process, virtually any drug the elderly patient takes should be considered suspect when symptoms of dementia occur, said the specialist in geriatric medicine. "Aspirin, digoxin, sedatives, anti-hypertensives and the atropine-like drugs should especially be examined when taking the patient's medical history," she indicated. Also not to be overlooked are a myriad of over-the-counter drugs which the elderly may be taking alone or in combination with their prescription medications. "A 'brown bag' review in which the patient or family gathers into a paper bag all medicines being taken and has it evaluated is useful in determining whether the symptoms of dementia are associated with medication," Dr. Mitchell suggested. In examining the patient with apparent irreversible dementia, the physician should also carefully explore metabolic factors which could account for the forgetfulness, confusion and personality changes. Hyperthyroidism, hypothyroidism, adrenal insufficiency. recurrent hypoglycemia and even hypothermia should be considered as possible causes, Dr. Mitchell said. "Especially in colder climates, the elderly may be more prone than physicians imagine to suffer from gradual hypothermia resulting from turning the thermostat low to save " Unfortunately, Alzheimer's can only really be diagnosed money," she pointed out. at autopsy. And, equally unfortunate, is the fact that Sensory deprivation brought on by glaucoma, cataracts to date no suitable animal model to study has been identi- or hearing problems may also make the elderly appear to fied," said Dr. DeBoni. It is primarily those cells which make be suffering from one of the dementias. us human - separating us from the animals - which are "If you don't hear what people are saying or can't see apparently most affected by the disease. clearly what's happening around you, you can tend to For a time, it was hypothesized that higher concentra- become withdrawn and uninterested," she said. tions of aluminum found in the brains of the Alzheimer's Inadequate diet may be another reason for the confuvictims at autopsy might be responsible for the disease. sion, listlessness and forgetfulness. "We now believe the aluminum itself is not a direct cause "Many elderly, especially if they live alone, may suffer but rather the results of an abnormal process which allows from insufficient calorie and protein intake, avitaminosis this toxic substance, found throughout nature, to gain en- particularly in the B vitamin category, malabsorption protrance into the brain," said Dr. DeBoni. blems and even malnutrition which leads to their clinical "Research funds are important to identify the causes," problems," emphasized Dr. Mitchell. said the Thronto scientist. "but also important are funds for 11-auma and tumors which cause or contribute to censeeking improved methods of treatment for those who al- tral nervous system symptoms should not be overlooked, either. Nor should the possibility of infections - ranging ready have the disease." He noted that in the days before the polio vaccines, there from subacute bacterial to fungal to viral -which may also were those who focused on finding the cause of the paralytic induce symptoms which appear to be dementia of an irreverdisease and others who sought better forms of treatment. sible type. "Both approaches are vital and especially so when you Still "another factor to be considered in some of these realize that 70 per cent of all dementias are the Alzheimer's patients," Dr. Mitchell said, "is whether they may be suffertype. Of 26 million Americans today over age 65, 15 per cent ing from tertiary syphilis." Despite advances in treatment have moderate to severe dementia of which 70 per cent is of venereal diseases, penicillin hasn't been around that long, she added, and may not have been on the market when some Alzheimer's," Dr. DeBoni emphasized. If the price tag for research is high, however, the money of the older people contracted the initial disease many years will be well spent. "It is less expensive for the public if a ago. cause and an effective treatment can be found than to pay The UB physician also noted that effects of atherofor the extensive future care which a majority of the victims sclerosis, low cardiac output syndrome and chronic interof the disease will require,'' he said. • mittent arrhymias may produce symptoms associated with 10 • BUFFALO PHYSICIAN �----Many of the reversible dementias can be treated effectively by physician and patient together, Dr. Mitchell said. She believes in developing "contracts" with patients to insure better results. "You might ask the patient who has no appetite to make a 'contract' with you to try to eat three meals a day- no matter how small they may be." It is also important, she said, for the physician to make corrections in medication or other treatment which will bring the reversible dementia to an end. senile, irreversible dementia. "'fransient ischemic attacks (Top) Dr. Margaret Mitchell. (Below) Dr. Donald R. Crapper McLachlan (left) with (TIAs), sarcoidosis, chronic renal failure and polycythemia UB's Dr. Seymour Axlerotl at Alzheimer's Conference. vera should be considered as well - as should the elderly patient's past occupational history and whether it included "Start low - go slow is the best advice when prescribextensive exposure to various herbicides, pesticides, ing medications unless it involves a life-threatening condichemicals or metals. tion," Dr. Mitchell said. "The half-life of many drugs is inepression among the elderly is more often firs~ di~gnosed creased in the elderly." 1hcyclic anti-depressants may be helpful for the patient by internists and physicians than by psych~atnsts, Dr. Mitchell said. Symptoms include loss of interest in pleasur- who suffers endogenous depression as may be electroshock. able activities, feeling of hopelessness, otherwise unex- The reactive depression, which may occur following a loss plainable weight loss or weight gain, insomnia or sleeping of spouse, for instance, may develop into an endogenous one Dr. Mitchell noted. ' too much, fatigue and loss of energy. "A good physical exam and medical history as well as In differentiating between the dementias and depression, Dr. Mitchell said depression can usually be traced to a neurological and mental status exam are most important," she summarized. its start by either family members or the pat~ent. . ".Th dis~ iss d~mentia-like symptoms as simply signs of Patients with depression- unlike those w1th dementia -may complain of a cognitive loss- "I can't remember growmg old IS a disservice both to the patient and to those how to add." The patient with Alzheimer's or certain demen- who may be responsible for his or her welfare especially tias aren't aware of such losses, or tend to attempt to con- when the condition can be treated effectively," Dr. Mitchell said. ceal them. Also speaking on the program was Dr. John Rowe, as"If you ask the dementia patient what day it is, he or she will attempt to answer- even if it's the wrong answer. ~ociate professor of medicine and director, Division of AgDepressed patients will be more likely to say they don't mg, Harvard Medical School, who addressed, "Management of the Dementia Patient." • know," said Dr. Mitchell. D BUFFALO PHYSICIAN • 11 �IZ • BUFFALO PHYSICIAN �By THOMAS S. BUMBALO, M.D. PERIL Our Children in the Nuclear Age: a better life or a possible catastrophic death? T he past 50 years have witnessed more progress in the practice of medicine than all the preceding decades. We have progressed from an era of a handful of therapeutic specifics to the present bulging sophisticated medical armamentarium. Fifty years ago we had digitalis for the treatment of heart failure, quinine for malaria, salvarsan for syphilis, codeine and morphine for the control of pain and, of course, good, old, reliable aspirin. Today we have chemotherapeutic drugs and antibiotics to control life threatening infections that in the past usurped most of the pediatrician's working hours. Thday, Pediatrics has progressed from the treatment of acute contagious diseases and their complications to the world-wide eradication of small pox, the countdown for measles elimination, the specific treatment and control of tuberculosis and the lowest infant mortality rate in the history of American medicine, 11.7 per 1,000 live births. Pediatrics from the very beginning has pioneered in the prevention of sickness and the welfare of children. Continuing its dedication in prevention, it has developed such new children's health services as perinatology, neonatology, developmental pediatrics, intensive care units for the critically sick child and rehabilitation of physically and mentally handicapped children. In the midst of all this progress we have dramatically cascaded from the Industrial Age with its legion of health problems to the Nuclear Age with its sophisticated electronics, biomedical engineering, computers and nuclear medical tools such as the n ew nuclear magnetic resonance technique. The Nuclear Age, that in the same breath promises a better life for all could also mean the potential catastrophic annihilation of the same masses to whom it promises the good life. ILLUSTRATION: BERNSTEIN BUFFALO PHYSICIAN • 13 �Recalling a much used cliche first uttered by the late electronic journalist, Edward R. Murrow. "fiTSt the good news and then some bad news," let us consider the good news of the Nuclear Age as it benefits children. In pediatric emergencies, the sophisticated techniques of computed tomography and nuclear·medicine can save valuable diagnostic time and enhance treatment of subcapsular hematoma of intra-abdominal organs. Periappendical abscess formation and the localization of other intra-abdominal abscesses can also be detectable by c.:r scanning. C-T scanners likewise play an important role in the diagnosis of cranial trauma as well as brain abscess and lesions of the vertebral column. 1 The new generation of C-T has proven to be a relatively simple but very accurate diagnostic tool in pediatric practice. A prestigious group of pediatric radiologists aptly appraise the current status of c.:r with this statement: "When appropriately utilized and meticulously performed, body C-T scanning in children can be an extremely valuable procedure in providing significant diagnostic information that is not otherwise available and may be the definitive diagnostic procedure in many instances. " 2 Ultrasonic imaging or sonography has also proven its usefulness in the diagnosis of lesions associated with abdominal trauma, such as injuries to the liver or spleen, resulting from violent auto-bumper impact when children are struck down by a motor vehicle. Pediatric nuclear medicine, the use of radioactive isotopes, assisted by digital computer, has made very impressive strides in the diagnosis of organ function. Radiopharmaceuticals currently are used in brain scanning, thyroid scanning, lung perfusion scanning, cerebrospinal Ouid shunt Oow studies, liver, spleen, kidney and bone scanning. Additional examples of the diagnostic scope of pediatric nuclear medicine are evaluation of the cardiovascular system in identifying intracardiac shunts and cardiac output, the determination of cerebral and renal blood Oow and detection of brain trauma and brain tumors. 3 In addition to these specific health benefits of the Nuclear Age, it is estimated that about 12 per cent of the nation's electricity needs, of which all of us are the beneficiaries, is generated by nuclear power. There is no denying that the Nuclear Age has contributed abundantly to the welfare of children. However. there is also no doubt that the Nuclear Age has the potential for much "bad news." One of the major hazards of the Nuclear Age is the potential escalation of the estimated whole body radiation that all of us are exposed to now and will be exposed to in the future. The increase in radiation exposure can come from a combination of natural environmental and man-made sources, such as diagnostic medical and dental radiological exposure as well as radiopharmaceutical sources. It is estimated that all of us receive 75 millirems whole body exposure per year from medical and dental diagnostic exposure alone. Regrettably, the current trend of "defensive medicine"medical practice to avoid the threat of malpractice litigation portends an increase from this source of radiation. The time is now to scrutinize the indications of radiological diagnostic procedures. Nuclear power plant accidents, such as the Three Mile Island nuclear reactor plant accident of March 28, 1979, can be an additional source of radiation exposure. Another problem that generates much controversy and debate is the lack of disposal facilities for radioactive materials. 4 As recently as April of this year, the Supreme Court ruled that states may ban new nuclear plants until the federal government devises a safe method for disposing of radioactive waste. Safe burial sites for low level wastes, such as those from the Three Mile Island clean-up and elsewhere, must be urgently resolved by the cooperative efforts of the nuclear power industry, the government and the public. If a safe resolution of this problem is not forthcoming, we will be confronted with yet 14 • BUFFALO PHYSICIAN another public health hazard. 'The effects of body radiation include an increased incidence of leukemia and other forms of neoplasia, damage to genes and chromosomes, increased incidence of congenital malformations, stillbirths, neonatal deaths, decreased fertility, increased incidence of cataracts, accelerated aging with decreased life span, and a profoundly altered ecology.s A ny discussion of the practice of medicine in the Nuclear Age, must of necessity include the apprehensions and fears of possible nuclear warfare. The alarming stockpiling of nuclear warheads by both the United States and the Soviet Union has once more urgently focused attention on the threat of a nuclear war and the destructive power of state of the art nuclear weapons. At best, the number of nuclear weapons stockpiled by the nuclear nations can only be an estimate. Current estimates place the number at 50,000-100,000 warheads. In order to comprehend the destructive power of nuclear warheads, consider that one kiloton bomb is equivalent to the energy released by the detonation of 1,000 tons ofT.N.T. and a single one megaton bomb explosion is equivalent to the destruction wrought by 1,000,000 tons ofT.N.T.& A one megaton hydrogen or thermonuclear bomb would have an explosive power 50 times the explosive power of the Hiroshima bomb. The first atomic bomb denotated fell on Hiroshima on August 6, 1945. Seconds later 64,000 civilians were dead or mortally wounded as the result of blast. bums, or irradiation injuries. The final count records 160,000 killed or maimed and 62,000 of the 90,000 buildings destroyed beyond recognition. The present armament of nuclear warheads has the potential of an incredible carnage of tens of millions, notwithstanding pre-warning, shelters, planned evacuation and all other civil defense efforts. Medical care would be almost nonexistent. Hospitals, medical supplies, medical personnel, transportation, electrical power and water supplies would be disrupted or destroyed. Without the benefit of medical care, most of the injured would experience a slow agonizing death from bums, shrapnel, shock, radiation, hemorrhage, infections and malnutrition. Psychological stress and social trauma would add to the suffering, chaos and destruction, and would make sudden death a blessing. The long term residue of radioactivity, at best, is unpredictable. The Hiroshima bomb resulted in an increased incidence of microcephaly and mental retardation in children who were exposed in-utero, at the time of the bombing. Other hazards confirmed by the Hiroshima and Nagasaki bombings are an increased incidence of still births, neonatal deaths, cataracts, leukemia, tumors and other degenerative diseases resulting in decreased life-span. The deleterious effects on the ecology can be equally profound and devastating. Fire and the lack of water would destroy the forests and create dust bowls with the disruption of the necessary balance in the plant and animal world and the slow starvation of all animals and human life. More specifically, it has been estimated that a 20 megaton thermonuclear bomb, the equivalent of20 million tons ofT.N.T., exploded on a clear day, at ground level, in the downtown area of a city the size of Buffalo, would create a fire ball one and one-half miles in diameter, with temperatures of 20-30 million degrees Fahrenheit. The entire downtown area, the streets and the earth below, and all living things would be vaporized, leaving a crater several hundred feet deep. At six miles from the epicenter, all people would be instantly killed by a huge heat Oash traveling at the speed of light. Within a 10 mile radius, the blast wave, 180 miles per hour winds and fires would inflict almost total casualties with at least 50 per cent dead and the remainder, injured. Even at 20 miles from the epicenter, 50 per cent of the population would be killed or maimed by the direct thermal radiation and blast pressures. Many more would be killed by random spon- �taneous fires fueled by oil and gasoline storage tanks and natural gas lines. These fires would have the capability to coalesce into an enormous firestorm 1,200 square miles in area, fanned by 100-120 miles per hour winds, creating temperatures capable of cooking and asphyxiating those in shelters. a I n 1950, Albert Einstein warned that "Radioactive poisoning of the atmosphere and hence annihilation of any life on earth has been brought within the range of technical possibilities. "7 The medical profession is dedicated to the prevention of disease and preservation of good health and life, and threat of nuclear warfare has become an urgent concern of all physicians and health scientists. The American Medical Association's House of Delegates at the 1981 Interim Meeting [and reaffirmed in the 1982 Annual Meeting] has resolved to inform the President of the United States and the Congress that there is no "adequate" medical response to a nuclear holocaust. The AMA delegates voted to prepare material to educate physicians and the public about the consequences of nuclear war. 8 The Executive Board of the American Academy of Pediatrics has likewise passed a resolution to convey to the President and the Congress and other public and private organizations the Academy's concern about the medical effects of a nuclear war and to inform its own members of the devastating consequences of nuclear war. Another resolution passed by District IX of the A.A.P. calls for the Academy to dispel the notion of a so-called limited nuclear war and to call on the governments of all nations to immediately and completely freeze nuclear weapons production, deployment and testing.• Similar resolutions against nuclear war have been passed by the World Association for Social Psychiatry and by the Physicians for Social Responsibility. However, it is more imperative that all these efforts to prevent nuclear warfare be directed to the governments of all nations. Dr. Edward Thller, known as the "father of the H-Bomb," believes that the "only way to prevent war is for America to regain its nuclear strength so that the Soviets will not be tempted to strike." Notwithstanding such reasoning, even by a recognized nuclear scientist, the fact remains that nuclear war is capable of destroying the Human Species and God's creation. Simply put, nuclep.r war is immoral, irrational and unjust, because it destroys everybody and everything. Th paraphrase Bertrand Russell, the world will have to listen to what scientists have discovered- if they cannot succeed, man will destroy himself by his half-way cleverness. A prominent psychiatrist of Western New York State, Dr. Armand DiFrancesco in discussing violence, has stated ''the survival of Mankind hinges on a change of attitude, a change from the spirit of having by means of violence, greed, and lust ... to a spirit of being ... being loving, kind, compassionate, sharing and helping." • Dr. Thomas S. Bumbalo, M.D., M.Sc. (Med.), is clinical professor, Pediatrics emeritus, UIB, and medical director, Erie County Medical Center -Retired. 1. Heller, R.M. , Coulam, C.M., Allen , J.H., Fleischer, A. Lee, G.S., Kirchner, S.G. and James E.: Diagnostic Imaging in Pediatric Emergencies, Southern Medical Journal. 73:844 (1980). 2. Berger, P.E. , Kuhn , J.P. , Brusehaber, J.: Techniques for Computed Tomography in Infants and Children , Radiologic Clinics of N. America. 19:399 (1981). 8. Treves, S.: Diagnostic Use of Radioactive Isotopes in Children; Editorial, Southern Medical Journal. 68:1321 (1975). 4. Carter, L.J.: Debate Over 3-Mile Cleanup: Science 210:166 (1980) . 5. Ervin , F.R ., Glazier, J.B., Aronrm, S., Nathan , D., Coleman, R., Avery, N., Shobet, S., Leeman , C.: Human and Ecological Effects 1n Massachusetts of an Assumed Thermonuclear Attack on the U.S.: New England Journal of Medicine. 266:1127 (1962). 8. Physicians for Social Responsibility, Inc.: The Medical Aspects of Nuclear War. 7. Syken, L.R. and Evernden, J.F.: The Verification of Comprehensive Nuclear Test Ban : Scientific American. 247:47 (1982). IL American Medical News. July 30, 1982. 8. News and Comments, American Academy of Pediatrics. August, 1982. 150 attend gala for local PSR T At PSR Gala: (top photo from left) Board Members Bumbalo (author of the accompanying article), Metzger and Greene, Dr. Tom Potts and Mrs. Bumbalo. (IIJIIt!l) County Legislator Joan Bozer and Dr. Tim Byers. he race to build bigger and more destructive nuclear weapons is an illogical. immoral and economically unsound contest which will yield no winners. speakers told an audience of about 150 attending the Physicians for Social Responsibility's Spring Gala at UB's Center forThmorrow. in late April. Unanimous in their advocacy of a bilateral arms freeze. UB energy conservation specialist Walter Simpson. Daemen College history professor Dr. Edward Cuddy and Rev. Vernon Bigler, Buffalo Methodist Conference superintendent. said groups such as PSR and its local Western New York chapter are vital in helping to educate the public about the consequences of an uncontrolled arms race. Formed a year ago, the local PSR chapter has 100 members today from among the community's health professionals. The aim of the group is to help alert the public to the dangers of nuclear weapons build-up and to encourage legislation which will lead to abolition of these arms worldwide. PSR board member Dr. James Metzger who introduced the speakers told the audience that August 6, 1945 was the most important day in history from the dawn of consciousness. "Man has had to deal with death all along but before, it was always on an individual basis. Now we are talking about actions which could lead to death of a species. We are now able to wipe ourselves out and despite rhetoric which comes from politicians and others the bottom line is just what Albert Einstein once said : "The unle~sh~ng of atomic energy has changed everything but our mode of thmkmg. Therefore we drift toward unparalleled catastrophe." Other members ofPSR's local advisory board introduced at the event were Drs. F. Carter Pannill Jr., UB vice president for health sciences; Leonard A. Katz, former associate dean of the School of Medicine; James P. Nolan, chairman, Department of Medicine at UB; Ivan L. Bunnell and David G. Greene, professors at the UB School of Medicine; UB periodontist David M. Maiman and long-time • Buffalo physician Dr. Thomas Bumbalo. BUFFALO PHYSICIAN • 15 �~--------------------------------------------------------------------------------------~. By MARY BETH SPINA Local project important to artificial heart A n approach championed by a UB scientist at Arvin/Calspan which allows blood to flow over man-made material without clotting proved a key factor in successful implantation of Seattle Dentist Barney Clark's artificial replacement heart. Described by developer Dr. Robert Baier as "an attempt to compromise Mother Nature," the approach requires precise control of the surface chemistry of the outer one-millionth of an inch of the flow surface of the material from which the artificial organ is fashioned, making it compatible with the blood at the interface of blood and material. If the surface chemistry is not precisely compatible, the circulating white particles within the blood will stick to the material, creating life-threatening thrombi and blood clots. The dilemma of achieving interface compatibility which had plagued artificial heart developers was solved when Dr. Baier and associate Anne Meyer recognized that by adding specific surface control agents, standard tough polyurethanes could be used to fabricate the organ. This is easily accomplished by providing a silicone coating to the mould over which the liquid man-made material is dipped or poured. Altering in this manner the surface chemistry of the critical blood-contacting layer of the stretchy urethane material - similar to that of which girdles are manufactured- permits the blood to slide easily over the polymer without leaving threatening deposits. "Mother Nature provides us with the clotting mechanism to prevent hemorrhaging," Dr. Baier explains, "but a delicate balance must be maintained so clotting occurs only when necessary, permitting blood to flow unimpeded otherwise." A similar interface problem occurs in atherosclerosis, he noted, when the surface chemistry of artery and vessel walls is altered by accumulation of plaque. "In atherosclerosis, however, rather than attempting to alter surface chemistry at the interface, treatment usually involves medication which reduces the 'stickiness' qf blood platelets involved in the clotting mechanism," Dr. Baier explains. This chemotherapeutic solution which works reasonably well in atherosclerosis was not feasible, however, in coaxing blood to flow over manmade polyurethane, he said. Instead, it was necessary to develop techniques which chemically alter the artificial material's surface so it mimics healthy, human artery tissue. So successful has the surface chemical approach to biomaterials development been that it allows not only implantation of an artificial replacement heart into a human patient but also won Dr. Baier the Society of Biomaterials' prestigious Clemson Award for Basic Research. While the UB-Arvin/Calspan scientist originally developed the technique in cooperation with physicians at Hershey (At left) Anne Meyer and Dr. Baier examine the interior surface of one of the Hershey "helper hearts." They will soon receive material talcen from the Kolff~arvik heart which had been implanted in Seattle dentist Barney Clark (above) for analysis and comparison with material from hearts implanted in calves and with material "off the shelf." 16 • ILLUSTRATION: MIKE BUNN �.:~====================---------------------- Research Briefs Medical Center who were using an artificial heart outside the patient's body as a temporary "helper heart," he and others strongly suggested it be adapted for the heart on which Dr. Wilhelm Kolff had been experimenting with calves. Prior to using this technique, Dr. Kolff found his artificial heart lasted no longer than 11 days without causing serious complications in the animals. Application of controlled surface properties to the critical interface of the materials which formed the artificial organ increased survival time to 92 days. (Pa.) C onvinced the interface problem had been solved, University of Utah scientists implanted the Kolff-Jarvik heart into Seattle dentist Barney Clark, who lived for 112 days after implantation, ultimately dying from general deterioration. "There is no doubt Dr. Clark was a courageous gentleman who donated his body to science," said Dr. Baier. Clark, said the UB scientist. did not consent to the implantation because he really believed it would give him a prolonged life of any quality. "He underwent the tortuous ordeal to aid medical science in hopes it would help future patients for whom the artificial heart might be the only alternative to death," Dr. Baier added. Although development of an artificial heart had been the center of considerable NIH-funded research in the early 1960s and 1970s, these monies were allocated elsewhere beginning in 1978, leaving scientists such as Dr. Baier to work on other projects. Ironically, two projects, indirectly related to the artificial heart and conducted by Dr. Baier and his colleagues ultimately provided additional keys to successful development of the technique which allowed Dr. Clark to receive his replacement organ. One project for Meadox Medicals, Inc., involved development of a tanning process for umbilical cord veins which allowed their successful use as replacement arteries in patients whose own saphenous veins could not be grafted. Dr. Baier noted that the work he and UB oral pathologists Drs. Joseph Natiella and Michael Meenaghan conducted for Meadox resulted in implantation of the Biograft into some 30,000 patients. Surface chemistry interface studies conducted by Dr. Baier and his associates with colleagues from the AvcoEverett Corp. produced a polyurethane product called Avcothane which is now widely used in the manufacture of intra-aortic balloon pumps. "Neither of these projects directly related to an artificial replacement heart." said Dr. Baier, "and yet the knowledge we gained through these privately-funded ventures provided us with information ultimately necessary to overcome the clotting problem for the Hershey and the Kolff-Jarvik hearts.'' Later this year, Dr. Baier and his colleagues will receive sections of material removed from Dr. Clark's heart. These sections will be qualitatively analyzed in the laboratory and compared with those taken from the calves' implanted hearts and with treated polyurethane ''off the shelf' to determine if changes occurred at the critical flow interface after the device was placed in the chest cavity of the Seattle dentist. In addition, the scientists will also attempt to determine whether the artificial material aided or blocked heart functions involved in receiving nutrients and expelling metabolic waste. "Although the heart's primary purpose is to act as a pump for the circulating blood, it has other, more obscure - but perhaps equally important functions,'' Dr. Baier explained. He and colleagues at SUNY at Stony Brook and in California are also working to develop an improved design for the artificial heart's power source. that Dr. Clark was attached to Noting a cumbersome external compressor which supplied power to his replacement organ, Dr. Baier said that in the planning stage is a compact. self-contained belt-encased coil which can be implanted around the waists of future recipients of artificial hearts. Such a device, he said, would allow these patients to be mobile, improving the quality of their new-found life and . eliminating risk of infection which accompanies use of power sources connected to the heart through permanent openings in the body. While Dr. Baier has little doubt that man-made substances will increasingly be developed to replace diseased organs and tissue, he emphasized there is room in medicine for artificial organs as well as donor or cadaver transplants. "In the future, we may find some heart patients will require two heartstheir own or a transplant and an implant in order to provide them all the functions of the organ," he said. Some organs, such as the liver, however, have such complex mechanisms and functions it may prove impossible to fabricate replacements which exactly duplicate all the tasks performed by the natural organ. • Dr. Dutzu Rosner Roswell scientist tests new brain cancer therapy T he solutions to some of the most complex problems are often right in front of us. Dr. Dutzu Rosner, associate chief of breast surgery at Roswell Park Memorial Institute, thinks that this may be the case in treating patients who have brain metastases from breast cancer with systemic chemotherapy - the same drugs that have been successful in other metastatic sites. He presented results of his study at a joint session on "Novel Therapeutic Approaches" at the American Association for Cancer Research/American Society of Clinical Oncology annual meeting, May 24, in San Diego. The complex problem in this case is the Blood Brain Barrier (BBB). thought by most to restrict the accessibility of the standard neoplastic drugs to the brain. But, as Dr. Rosner points out, "When radionuclide brain or computerized axial tomography (CT) scans are used for diagnosis, the radioisotopes or radioopaque compounds that do not cross the normal brain barrier penetrate the BBB to delineate brain tumors, so why should we assume that chemotherapeutics shouldn't be able to get to them?" Brain metastasis from breast carcinoma is an ominous development, with a median survival of less than two months if left untreated, and the effectiveness of whole brain radiation and corticosteroids is limited due to widespread disease, and improves survival only to a dismal 2.5 to 7.5 months. . Dr. Rosner's rationale for designing the first prospective, controlled clinical trial using systemic chemotherapy alone to treat brain metastasis was based on the fact that "most patients with brain metastasis have extensive metastasis elsewhere and that conventional whole brain radiation has limited effectiveness, since death usually results from extracranial disease ... He continued, "Our experience. as well as that of others, suggested that some cytotoxic agents may penetrate the BBB under certain -------------------------------------------------~ BUFFALO PHYSICIAN • 17 �circumstances and provided the basis for a pilot trial of chemotherapy, without irradiation, for patients with brain metastases from mammary carcinoma.'' The study included 71 breast cancer patients with brain metastases confirmed by either radionuclide brain scan and/or CT scan, and ~hose initial treatment was by systemic chemotherapy. The results of Dr. Rosner's study revealed that 51 per cent (36 of71) of the patients had objective responses- eight complete and 28 partial - to systemic chemotherapy. These results are similar to those obtained in patients treated for extracranial metastases. The median survival time for the 36 responders was 13.1 months in contrast to 3.0 months for the 35 non-responders; and 50 per cent of the responders (18 of 36) were long-term survivors, with median survival reaching 18 months. Of the 36 patients responding, 17 have become totally asymptomatic and have resumed a normal life during the period of remission, and 19 have shown marked improvement in their neurological status. The combination chemotherapy regimens used in the study were similar to those used for other metastatic sites for breast cancer at respective periods. Dr. Rosner's study also showed that patients who developed recurrent neurological symptoms and relapse of brain metastases can be retreated successfully with additional chemotherapy. "Our data suggest that chemotherapeutic agents do enter metastatic lesions in the brain, dura, and leptomeninges" states Dr. Rosner, and that "patients who develop brain metastasis in chemotherapy sensitive disease are capable of achieving a prolonged remission by systemic chemotherapy alone." • Electrical device promotes quicker healing of bones E lectrical devices, now used on .a limited basis to promote bone healmg, may routinely be used in the future to heal fractures more quickly than is otherwise possible, predicts the head ofUB's hand surgery program in the Department of Orthopedic Surgery. Dr. Clayton A. Peimer forecasts that healing time of many fractures may be routinely reduced from months to weeks or from weeks to days based on his experience with electrical bone stimulators (EBS) which can aid healing of broken bones in the hand. "EBS is used today in only a small number of orthopedic cases because most broken bones, if properly treated, will heal without further assistance," says Dr. Peimer. However, fractures which are open, infected or inadequately treated may demand use ofEBS. Other cases in which it may be helpful include those in which the patient suffers an illness which alters his natural recuperative powers or takes medications which retard healing. Dr. Peimer notes that of cases in which he has used EBS, two-thirds of the fractures healed properly which otherwise had not. 18 • BUFFALO PHYSICIAN Dr. K.L. Parthasarathy reviews liver scans. Bone grafting was required for many of those cases which did not respond to EBS. While research into the potential of EBS has been conducted for two decades, only within the past five years has the technique been used on more than a clinical research basis. There are two types ofEBS devices on the market today. The "invasive" one involves surgical implantation of electrical coils at the site of the unhealed fracture, or wires drilled into the fracture site. Exposed ends of the coils and/or wires allow electrical stimulation when connected to a control module. Implantation of EBS is used primarily on fractures which involve the long bones and those larger than those found in the hand. "For the smaller hand bones, the external version is usually preferable," says Dr. Peimer. After the fracture is properly aligned and set, a cast of plaster or lightweight fiberglass is applied. Guided by the patient's X-rays, the physician tapes a plastic positioning block onto the cast directly over the fracture site. 1\vo plastic pads containing electrical coils are connected to a portable control module and placed "book end" fashion with Velcro straps so they align with the positioning block at the fracture. By activating the control module attached to the "book ends," the patient creates the necessary electromagnetic field around the fracture site. Bone fractures of the hand may require some eight to ten hours of electrical stimulation for up to several weeks. Ideally, the treatment, which causes no pain, is administered while the patient sleeps. "It's been known for many years that calcium and phosphorus in bone possess electrical properties which can be activated under pressure," Dr. Peimer explains. Astronauts in a state of weightlessness are known to lose bone density because of absence of such pressure. Conversely, those who jog or gain weight and thus increase pressure on bone will increase bone density. While bone healing can be encouraged by applying a negative microelectrical current at fracture sites, too much negative current can cause bone to break down just as it does in presence of positive electrical fields, Dr. • Peimer says. - MBS Improved assays increase accuracy of liver diagnosis N ew or improved, yet simple, assays, or scans, can significantly increase the accuracy of initial diagnosis of liver metastasis, Roswell Park researchers report. After suspicious liver metastasis has been detected by laboratory tests, the liver is scan· ned to identify regions that should be biop· sied. Liver scanning has played a major role in cancer patient evaluation, particularly because of the frequency of liver metastasis in cancer patients and also because the liver is a difficult organ to visualize radiographi· cally, the researchers point out. Currently, several scanning devices and procedures are used, including the isotopic liver scan, computerized tomography (CT) scans, and ultrasonagraphy - the last two being the newest additions to the diagnostic armamentarium. According to Dr. Kondiah L. Parthasarathy, associate chief of Roswell Park's Nuclear Medicine Department, how· ever, all three clinical methods "have about the same degree of sensitivity." In a recent study published in Surgery. Gynecology & Obstetrics, 156:2, February. 1983, Dr. Parthasarathy and his colleagues assessed and compared the effectivenes of both the isotopic liver scan- the "classic" scanning device - and the CT scan in detecting liver metastasis in 40 colorectal cancer patients. The patient sample was, to a great extent, representative of all patients suffering metastatic disease because, as Dr. Parthasarathy points out, "approximately 10 per cent of colorectal cancer patients have associated synchronous metastasis to the liver." All of the patients had either a previous history or exhibited physical findings suggestive of liver m etastasis. Preoperative liver function tests and CT scans were ob· tained on each patient, and 36 had preoperative liver scans. The results of the exploratory surgery were measured against the results of the liver scans, CT scans and alkaline phosphatase levels. "Our study revealed that there is no advantage of using the CT scan over the liver scan," said Dr. Parthasarathy. The accuracy 1 J �Research Briefs 1 J rate of th e liver scan was 81 per cent. with a false-negative rate of 14 per cent, and a false-positive rate of 6 per cent. The accuracy rate of the CT scan was 85 per cent, with a 10 per cent false-negative rate and a 5 per cent false-positive rate. Although not assessed in the Roswell Park study, ultrasonography has been shown to be as accurate as isotopic liver scans. said the physician. "and substantially more cost-effective than CT scans." in similar studies conducted at other institutes. Dr. Parthasarathy contends that each of the three methods is "sound," but agrees that there is "still a need for a relatively simple and more specific scanning tool." Although the isotopic liver scan fared well in this study against a more sophisticated competitor, it is not without its limitations. Demonstration of focal filling defects within the liver by itself does not confirm the presence of metastatic disease; some benign disease may have similar scan features; and lesions less than 2 em. in diameter cannot be detected using presently available instrumentation techniques. "Nevertheless." said Dr. Parthasarathy, "the liver scan. despite its limitations, is still an effective diagnostic tool." • New drug therapy promises help for Parkinson's victims A 1 j n approach to drug therapy for Parkinson's Disease described by an Australian neurologist who visited Buffalo recently suggests that many suffering from this major cause of neurological disability in the elderly may be able to lead more productive lives. Dr. Paul Teychenne says research at NIH and elsewhere suggests that a newer medication in combination with lower initial dosages of older anti-Parkinson drugs appears to delay the adverse side effects which have often accompanied drug treatment for the disease. Formerly on the faculty of George Washington University and now of Sydney, Dr. Teychenne presented his findings to physicians at the Buffalo Veterans Administration Medical Center and Millard Fillmore Hospital's Dent Neurologic Institute May 16. Buffalo is one of a dozen U.S. cities Dr. Teychenne visited in cooperation with Sandoz Pharmaceuticals. Acknowledging the often dramatic results Which levodopa and Sinemet have brought to many Parkinson's patients suffering the triad of dyskinesia, muscle rigidity and bradykinesia, Dr. Teychenne said high doses of the drugs over time could sometimes produce adverse side effects worse than symptoms of the disease. Levodopa, which appeared on the American medical scene in the early 1970s, is converted by enzymes in brain neurons to produce dopamine, an essential chemical for transmitting nerve impulses which control posture and involuntary movement. Research has shown that there is a decline in dopamine among patients diagnosed with Parkinson's Disease. "We physicians made a mistake in the early days of levodopa which we did not realize until much later: we followed the pharmacological rule that medication had to be administered in doses large enough to produce adequate levels in plasma in order to really be effective," Dr. Teychenne says. Consequently, on normally high dosages oflevodopa and the subsequently developed anti-Parkinson drugs such as Sinemet. patients would do well for perhaps a year or so. only to fall victim to effects of dyskinesia which came to be associated with " end of dose failure." In these cases. beneficial effects of the drug ceased before time to take the next dose. And in some patients. Dr. Teychenne says, benefits of the drug began to last only an hour or so after administration. Another problem which revealed itself as time passed was the "on-off' phenomenon in which the drug appears to be effective only intermittently, leading to sudden and unpredictable immobility. While not all Parkinson's patients fell victim to these complications, the sufficient numbers who did were a signal for further research and development of new medications. he says. Citing results of current research and his own experience as a neurologist and scientific investigator. Dr. Teychenne advocates getting away from what he terms "the high dose philosophy.'' There is evidence, he says, which suggests patients may be started on lower daily doses than was previously believed -especially on the newer drug bromocriptine mesylate (Parlode!) which acts as a dopamine agonist. While Sinemet and other agents may still be used to control symptoms of Parkinson's intervals to identify the appropriate, therapeutic dosage. bromocriptine typically is started at a dosage of 2.5 mg or less daily. Increasing dosage by 2.5 mg every two to four weeks until desired control of symptoms is observed has produced good results in the majority of patients studied. While maximum effective dosage with bromocriptine' need not usually exceed 15 mg daily, in the higher doses it can cause reversible side effects including m ental disturbances and confusion. Dr. Teychenne also notes. however, that in his experience those on low dose bromocriptine can be given a drug "holiday" from the medication if the level of response appears to drop over time. Then the drug can be restarted with good results. With the best results noted in patients who had never been on levodopa or Sinemet previously, Dr. Teychenne advises that the other drugs may be combined with bromocriptine for these patients. - MBS • Five-year study assesses management of adult asthma A $400,000, five-year study will assess the effectiveness of programs which teach adult asthmatics to participate in management of their disease. Studies previously conducted at UB and elsewhere suggest the "cost" of the condition can be reduced for asthmatic youngsters who participate in such programs. Equally beneficial results for adults, however, have not been extensively evaluated. Dr. Paul Teycbenne discusse1 Parkinson's treatment. Disease in some patients, Dr. Teychenne says he considers bromocriptine a first line medication in bringing improvement in the clinical symptoms of the patient without either "end of dose" or "on-off' complications. Rather than starting with high dosages to achieve desired effects and dropping back at Dr. Michele Hindi-Alexander. director of the study funded by the National Heart. Lung and Blood Institute, says 300 adult asthma patients will participate in the project now underway. Most will be drawn from patient pools at Buffalo General Hospital Allergy Clinic and other UB hospital based BUFFALO PHYSICIAN • 19 �asthma treatment centers. Forty patients, randomly selected with mild, moderate and severe asthma, will participate in each of two programs planned each year over the period of the grant. One group will receive an education program consisting of sessions on self-management of asthma; pathophysiology and treatment. They will also receive peak flow meters to allow them to measure daily and record for one year, the amount of air they can blow from their lungs. The second group will receive the education program only; the third, only the peak flow meter devices for home use. The fourth group will receive neither. · At the end of the study, however, those who were not given peak flow meters and education programs will receive them. Dr. Alexander is hopeful the study will show how effectively patients in each of the groups were able to reduce the "cost" of their disease using the various techniques. Each year, she notes, asthmatics or thirdparty payers spend $62 million on hospitalization and another $540 million on medications and other treatments. These figures do not include "costs" of lost work days and absenteeism from school, or reductions in quality of life. Dr. Alexander and Dr. Elliott Middleton Jr., head of UB's Division of Allergy, believe if self-management can be equally beneficial to adults as well as younger patients, a majority will be able to reduce these "costs." The more patients learn to recognize and deal with early signs of oncoming attacks, the Jess likely it is that the device will restrict their normal activities. Hospital stays and emergency room visits can frequently be reduced, too, when the patients know how to pre-medicate prior to exposure to known "triggers" and perhaps Jearn to help reduce stress which may contribute to the severity of an attack, Dr. Middleton points out. During the study, participants will be questioned on their abilities to perform tasks they must do regularly and those they would like to do. This measurement of functional disability, says Dr. Alexander is a new application to the evaluation of asthma which has not been used in studies elsewhere. While Drs. Middleton and Alexander do not anticipate the study will produce "cures" for asthmatics, they do believe it will help many of them learn to understand their disease better so it interferes less with the quality of their lives. Also working with the study are research assistants Victoria Koprucki and Diane McGranor and consultants Drs. Robert Reisman, Elliot Ellis, and Maria Zielezky, and Robert Klocke. - MBS • Hangovers may play role in combating alcoholism T hose distasteful hangovers which can accompany drinking may actually be good for you, according to new evidence released by UB researchers. Findings of the studies suggest that, despite the unpleasant symptoms of hangovers, those who don't experience them after overimbibing appear more likely to become problem drinkers than those who do. UB's Dr. Cedric Smith said that while the likelihood of a hangover increases as one drinks more alcohol, approximately 50 per cent of those categorized as heavy drinkers or recovering alcoholics reported they did not have hangovers in their recent drinking years. 1\venty-three per cent said they had never had a hangover. 20 • BUFFALO PHYSICIAN "While we would expect to find less incidence of hangovers among those classified as light to moderate drinkers, it was surprising to find that such a high percentage of heavy drinkers and those who had been classified as alcoholics had not had them," said Smith, a UB professor of pharmacology and therapeutics. Smith conducted the studies with Grace Barnes, staff scientist at the US-affiliated Research Institute on Alcoholism, UB medical student Cynthia A. Pristach, and Dr. Robert B. Whitney of UB and Erie County Medical Center (ECMC). Noting there has been little systematic research on either frequency and symptoms of hangovers or their relationship to alcohol consumption, the researchers studied a sample of 1041 adults in Erie and Niagara counties and 43 others admitted to the inpatient Alcoholism Service at ECMC. Smith said in light of the interesting results, another study involving some 3000 adults will be initiated to look at alcohol consumption, incidence of hangovers and hangover symptoms in three population groups: college sophomores, adults in the general population and alcoholics who are receiving treatment. "While we are not saying that all heavy drinkers who fail to have hangovers will become alcoholics, our findings do suggest that those who do not have hangovers may be more at risk for developing patterns later which are associated with problem drinking," Smith emphasized. "Although outright 'aversion therapy' is currently used in only a few alcoholic treatment centers nationally, it may be found that those who learn early that one bad hangover is simply not worth the extra drinks the night before, subsequently limit alcohol consumption," Smith suggested. • �Studants Med School Follies: Low humor, high spirits Thr humor wa1 predidably low, but 1pirit1 wrn high in the Golden Ballroom of the Hotel Statlrr, April 24, ., the annual crowd-9lra1iDg Mrdical School Fo/Jir1 unfoldrd befon a large audient:r. Tbi1 rnd-of-tbr-yrar rvrnt enablr1 1tudents to let oH 1team whilr harpooning the profr11ion and thrir profr11or1. BUFFALO PHYSICIAN • 21 �--------· By JOHN K. LAPIANA Questions Medical sociologist asks the Class of 1983 to weigh value of transplants & dialysis I n the late 1960s, Betty Crocker symbolized more than just readymade frostings and devil's food cake mixes. For thousands of Buffalo schoolchildren, saving Crocker product boxtops meant saving lives. At that time, General Mills, manufacturer of the Betty Crocker line, promised to purchase costly kidney dialysis machines for area hospitals if grammar school children collected the required target number of boxtops. It was not long before mothers discovered ransacked cupboards, their contents strewn about, and decapitated Potato Buds boxes - the victims of grade schoolers' blitzkriegs. Despite the kidney machines' high costs. the campaign proved profitable for both General Mills and the young participants. Each box top returned meant a Betty Crocker product had been purchased, thereby fattening General Mills' coffers. The children benefitted, too, according to sociologist of medicine Renee C. Fox, by "being taught to care about others, to have some responsibility" and through the campaign to recognize "dialysis as symbolically associated with the basic values of our society.'' Actions like the Betty Crocker/kidney dialysis campaign exemplify how "American life, dialysis and organ transplantation are interwoven into a collective consciousness," Fox said. She noted, however, that although society currently accepts transplants and dialysis as both important and "logical" steps in combating some diseases, "disquieting" questions are being raised concerning the .necessity of these practices and possible psychological effects they can inflict on the receiver, donor and, consequently, the physician. "We seem to be in a societal mood for getting some clarification on whether we ought to be doing what we are doing (dialysis and trans~lan~tion)," Fox explained prior to dehvermg the keynote address for the School of Medicine's 137th Commencement. "There is fear and trembling associated with some of the recent advancements in medicine such as genetic engineering, and apprehension as to the unforeseen effects of manipulating bio-science." Z2 • BUFFALO PHYSICIAN Author of the widely-acclaimed book, The Courage to Fail: A Social View of Organ 1tansplants and Dialysis (with Judith P. Swazey), Fox has examined the non-medical, sociological and psychological impact of transplants and dialysis as well as the medical community's reaction to rapid, almost daily, advancements in those areas. A s part of her doctoral research at Harvard's Peter Bent Brigham Hospital, Fox chronicled the birth of dialysis and transplantation, two fields pioneered by the Brigham staff. "I was there when organ transplants first came into use," she said. "I had privileged access to the human, ethical, sociological and bio-medical point of view (of the procedures)." Fox noted that since the advent of dialysis and transplantation in the early 1950s, each has "been a lightning rod and symbolic center of medical and scientific as well as general societal issues. "The whole question of whether I am my brother's keeper takes on new meaning in organ transplantation," she said. "The operation asks us to give of ourselves in a very literal way." And, Fox advises, it is not a question just for the donor to answer. "The physician, donor's family and the recipient are all part of the act which asks deep philosophical questions," she said, adding that many body organs, most notably the heart, have deep, cultural "symbolic meanings.'' ·'We believe the heart is a privileged organ,'· Fox explained. ·'We are awed by it as opposed to the liver or kidneys." (Clockwise from top) Class speaker William Hanavan at Med Commencement; signing the Great Book of Physicians; taking the oath. Many participants in the transplantation process believe, she said, that the recipient of an organ will assume characteristics of the donor. "For many, we discovered, (organ transplantation) is an anthropomorphic experience," Fox noted, "pervaded with the sense that part of the donor's self, personality and character, and life history have been transmitted to the recipient along with the transplanted organ." Her research, Fox told the graduation audience , revolves around three "theme" issues- uncertainty, gift exchange and the allocation of scarce resources. The "key problem" concerning uncertainty, she said, "is the innate and unrelenting intolerance of individuals to other people's tissues and organs." She noted that new drugs are being tested by the Food and Drug Administration (FDA) which chemically attempt to decrease the possibility of arecipient rejecting a donated organ. In an upcoming collection of essays, Fox and Swazey are authoring a chapter on the "advent" of cyclosporin, "a new and promising immunosuppressive drug for dealing with rejection reaction." Currently, cyclosporin is on the FDA's �• Medical School News Reuee Fox is graduating, too trausplauts. from iuvolvemeut witb ui 0 ~ 0 cii § I 0.. "fast track" toward federal approval for regular use. "Although we ardently share the hope that cyclosporine will bring the advances in immunosuppressive therapy that are anticipated, and that some day the rejection reaction will be overcome," she said, "we find ourselves responding to the current celebration of cyclosporine with wariness. skepticism, and a tired sense of deja vu." According to Fox, cyclosporin may be just another in a series of drugs which have appeared during the last few decades, and been hailed at one time or another as a "wonder drug" - only to be found ineffective or even harmful. F ox structured additional research around "the theme of the gift," an area, she said, suggested to her from "the professional and popular literature (Which) were filled with metaphorical references to the 'gift of life' that dialysis, and especially organ transplantation represented." While transplantation may ultimately save a life, it may also cause a psychological "tyranny" on those involved in the process. "In organ transplantation, we came to realize, what is given and received is so extraordinary and unreciprocal, that it can lock donor, recipient and kin in a perpetual creditor-debtor vise," she said, thereby creating deep psychological as well as physical scars. In studying the gift exchange and rejection phenomenon, Fox discovered her "thematic" research area - resource allocation to costly medical treatments. Not only was the assignment of "scarce resources" such as medical dollars and limited equipment and facilities considered by them, Fox said, but she and Swazey also pinpointed attention on "the availability of transplantable organs, the willingness of persons to give of themselves to others in this form. and the vast personnel, talent. time, skill, energy, commitment, and compassion needed to care for patients with end-stage diseases who received dialysis and/or organ transplants." These intangible ingredients. she said, involved the "generosity and hope, devotion and suffering" of all involved in the transplantation process, including the medical professionals. The 1972 passage of Public Law 92-603 raised new questions in the transplantation field, by providing funds for transplantation and dialysis through Medicare, and creating, Fox said, a "mini-national health insurance program. "In principle, the coverage of most of the treatment costs of dialysis and transplantation covered by the law should have solved the difficult allocation of scarce resources which beset this therapy in the 1960s," she theorized. However, the law's passage only created additional worries and philosophical questions for doctors and legislators to ponder. Because of the availability of funds, virtually'no patient was denied dialysis or organ transplantation no matter what the disease or which stage it was in. "Both consciously and unconsciously, physicians suspended all biomedical as well as psychological and social criteria of judgement concerning who should be dialyzed and who not," Fox explained. "The availability of funds had also contributed to the rapid growth of proprietary dialysis centers, and to escalating discussions about the economic and ethical justification of profit-making in the provision of lifemaintaining treatments." Paralleling other medical costs, the funds the government must dole out for dialysis have skyrocketed. Originally, Congress predicted that the total Federal outlay would be in the $90-$110 million range, but the estimated costs in 1980 were $1 billion and experts project the figure to balloon to $4.6 billion by 1990. "The big question in the 1960s, 'why are we not providing abunBUFFALO PHYSICIAN • Z3 �dant resources for this life sustaining treatment?'," Fox noted, "has rapidly been giving way to 'why are we?' ." In response to the recent implantation of an artificial heart into dentist Barney Clark, Fox will visit Utah, where the operation was held, and interview the participants involved in the operation for another essay in her forthcoming book. F or Fox, speaking at a medical school commencement had a deeper additional meaning than just advising graduates about important bio-ethical issues. The nation's pre-eminent medical sociologist announced that she, too, was "graduating" - from studying transplants and dialysis. "I have been an observer, recorder, and analyst of (medical edu cation and the makings of a doctor)," she told the graduates. "Like you. I have learned from it, and been altered by it - albeit in a more vicarious way.·· While vow- ing to continue her work as a sociologist of medicine, Fox said her research on d ialysis and tran splan tation will be retired, a decision s h ared by h er collaborator, J u dith Swazey, a h istorian of medicine and science. "The reasons we are calling a moratorium on th is aspect of our research and writing are related to the human condition dimensions of medical work that endow it with its most profound meaning," she said, "and that also exact its heaviest toll from men and women like yourselves who undertake it. "The picture of an empty thoracic cavity awaiting the implantation of a heart and lungs from a b rain -dead donor at Stanford," she said, "and the sight of petitioning parents and t h eir tiny, dying children with huge eyes, bloated b ellies, pale hair and ochrecolored skin who made pilgrimages to Pittsburgh in the hope of obtaining a liver transplant, are indelibly etched in us." • The Hooding ceremouy. Sample confers 134 M.D:s, 20 Ph.D:s at I 37th Commencement U B President Steven B. Sample conferred the M.D. degree on 134 individuals and the Ph.D. on 20 others at the 137th Commencement. Karin Klingman. editor of the School's annual, The Iris, dedicated the 1983 edition to Dr. Thomas D. Flanagan. professor of microbiology. The graduating physicians were led in the Oath of Hippocrates by Medical Dean John Naughton and in the Charge ofMaimonides 24 • BUFFA LO PHYSICIAN Presideut Sample bauds out degree. by associate medical dean Dr. Leonard A. Katz. Dr. John A. Richert, assistant dean, supervised the graduates in the signing of the Book of Physicians. Hooding was conducted by Drs. Robert Mcisaac, James Nolan and Linda Pessar. Invocation and benediction were offered by Rabbi Joseph D. Herzog. The following awards were presented by Dr. Paul Davis: Thesis Honors: Lilly M. Barba, Edward J . Coleman, Cynthia A. Pristach and Allen D. Rosen; Baccelli Award: Eric Wittkugel; Gilbert M. Beck Memorial Prize in Psychiatry: Annette McDermott; Buffalo Surgical Society Prize: Edward J. Coleman; Children's Hospital Prize: Eric Wittkugel; Dean's Award: Margaret Kadree; Gordon S. Ehrlich Memorial Award: Eric Wittkugel. Bernhardt & Sophie B. Gottlieb Award: Kevin Ferentz; Norman Baber Memorial Award: David Rosenfeld; Dr. Heinrich Leonhardt Prize in Surgery: Laura Rosenberg; Bans J. Lowenstein Award in Obstetrics: John Feldenzer; Maimonides Medical Society Award: Annette McDermott; Medical Alumni Association Award: Lonny Behar; David K. Miller Prize in Medicine: Gregory Zuccaro; John R. Paine Award in Surgery: Allen Rosen. Mark A. Petrino Award: Michael Wenzel; Clyde L. Randall Society Award in Gynecology-Obstetrics: Suzanne Meyers; Emilie Davis Rodenberg Memorial Award: Antoinette Mangione; Philip P. Sang Memorial Award: Gregory Zuccaro; Morris & Sadie Stein Neuroanatomy Award: Keith Goldstein; Upjohn Award: James Corasanti; John Watson Award in Medicine: James Corasanti; Frederick B. Wilkes Pediatric Award: Therese Giglia. Alpha Omega Alpha Honor Medical Society: Carol Brumbalow, James Corasanti, Brooke Durland, John Feldenzer, Patricia Flanagan, Keith Goldstein, Gerald Grass. William Hanavan, Mitchell Karmel, Stephen Kinsman, Brian Lipman, Annette McDermott. Kenneth Murray, Gwenn Nichols, Robert Noble, Bernhard Rohrbacker, Allen Rosen, Eugene Ver, Stuart Wernikoff, Eric Wittkugel and Gregory Zuccaro. • �Medical School News HIDI seeks ideas for health devices T he newly-established Health Instrument and Device Institute (HIDI), co-sponsored by the State of New York, is asking faculty both to help in development of novel health care instrumentation and to submit ideas concerning health care needs that could be met by technological solutions. School of Medicine Dean John Naughton is director of HIDI with Dr. Michael Anbar, chairman of the Department of Biophysical Sciences, serving as executive director. A memo circulated by the Institute encourages faculty to propose the development of specific novel instruments and devices to be used for health care, in diagnosis, monitoring, and treatment of patients or in preventive medicine. Instruments that would interest the Institute, the memo explains, can be electronic, mechanical, electrical or a combination of these. They may be applicable to any health-related problem. The only criterion that must be met is "commercial marketability." The Institute will, however, give preference to devices that can be mass produced, since mass production "might provide a significant increase in employment in New York State and Western New York in particular." H IDI's policy will be to entitle the inventor to 40 per cent of the royalties the Institute receives from the sale of proprietary ideas or know-how to industry. The inventor will also be given the option to participate personally in the reduction of the idea to practice, the memo indicates, "if the InStitute receives appropriate industrial support to cover the expenses of the Preliminary phase of R&D." The Institute will use most of its discretionary funds to reduce to practice highly promising ideas that can be marketed. Inventors who actively participate in such a venture, without remuneration, will benefit from the higher royalties generally received in such cases, according to the HIDI memo. Another option for an inventor is to co-sponsor the R&D effort financially, Under a special agreement, benefiting from a 1 to 1 cost-sharing by the State and possibly from an additional contribution from HIDI's discretionary funds. Ideas submitted for evaluation will be kept in confidence and will remain pro- prietary to HIDI during the period of preliminary evaluation. Ideas not selected by the Institute will revert to the proposer and HIDI will retain no rights to them. The proposer will be notified within two months of the disposition of the idea. In the case an idea is not adopted for further study, HIDI will disclose in confidence to the proposer the reasons for its decision. Forms for disclosure of proposed novel technological ideas are being circulated with the memo and are also available in HIDI's temporary office, 118 Cary Hall. Forms may be directed to that address or be handed personally to Dr. An bar who, the memo says, will, upon request, be ready to sign a confidentiality agreement with an inventor. same HIDI forms as ideas for health care instrumentation. However, no confidentiality agreement will be used in these cases, the memo points out. • I n addition to novel ideas on potential devices, HIDI is soliciting ideas on needs in health care that could be met by appropriate technological solutions. "Even if you do not have a plausible solution in mind, but are aware of a definite need," faculty are being told, "you are invited to submit your conceived need to HIDI." The Institute will then examine the suggested need to determine whether it is novel and whether its existence is corroborated by health care personnel confronted with the same circumstances. If it is agreed that a non-existing technological solution is desirable, HIDI will solicit experts for ideas for such solutions. If a solution is proposed that is eventually adopted by HIDI for development and marketing, the person who first identified the need will be entitled to 4 per cent of the royalties received by the Institute; the inventor of the viable solution will receive 36 per cent of royalties. Unlike the case of technological device disclosures, HIDI will retain all needs disclosures in its files for further reference on a non-exclusive basis, The proposers will be entitled to financial remuneration if the need is technologically addressed by HIDI within two years from the date of disclosure. If more than one person recognizes the same need by filing a disclosure, all the proposers will equally share the need-finder's reward, the HIDI memo states. If the same need has been addressed by an inventor who suggests a viable solution to it, the inventor is entitled to the full 40 per cent reward. In the latter case, however, the other persons who identified the same need will not be eligible for any compensation. Identification of needs for technological solutions can be disclosed on the Dr. Michael Anbar AMA contributes SS800 to School T he School of Medicine has received a $5,843.61 gift from the American Medical Association's Education and Research Foundation, Dean John Naughton announced recently. According to a County Medical Society spokesperson, the gift was made possible through voluntary dues paid by local and national AMA members to support medical education. Doctors can request their contributions be given to a specific school or to medical research and education in general, thereby leaving disbursement to the Education and Research Foundation's discretion. After the ERF collects the pledged funds, it then awards the annual gifts to medical schools and other research centers. With the assistance of various local auxiliaries, the ERF collected over $1.4 million for awards during its 1982 campaign. While the AMA places no restrictions on the use of its gifts by recipient schools, it does request to be informed on the award's disbursement so "donors can be informed on the impact of their dollars.·' Helping to coordinate this year's effort were Edmund J. Gicewicz, M.D., president of the County Medical Society and Mrs. Kumao Sako, Auxiliary president. • BUFFALO PHYSICIAN • 25 �------------------------------------------------------------------------------------------. By WENDY ARNDT HUNT Man who created 'Head Start' runs Warner Rehab Center W hy, some · have asked, was Cooke who created the Head Start would the man responsible program, now annually funded with for the creation of the Head one billion dollars, and Cooke who adStart program who retired vised JFK on the necessity of Univerto sail the coast of Martha's sity Affiliated Facilities for the Mentally Vineyard, move to Buffalo? Retarded, which were built as ideal "There's nothing wrong with Buffalo. clinical care and training centers. If Buffalo is to be criticized, it's because Almost every state in the Union has a of its inferiority complex," said Dr. U.A.F. today. Robert E. Cooke, 62, who traveled west"Cooke came from the outside. He ward about a year ago with his wife and saw what needed to be done. And he's baby daughter to become the medical doing it," said Dr. Robert Guthrie, the director of Robert Warner RehabilUB professor of pediatrics who disitation Center at Children's Hospital covered in 1961 the newborn screening and UB's A. Conger Goodyear professor test that detects phenylketonuria, PKU, of pediatrics. an inherited metabolic error that can His wife, Sharon, said that because of damage the brain. Guthrie, who met all the negative publicity about the Cooke almost 20 years ago when they ~ity that suffered the Blizzard of '77, :.:: they did have reservations, but since ~ they have settled into their Orchard ~ Park home, they have found nothing u; but friendship and good times here. 12 Susan, their precocious two-year-old ~ toddler, has decided to grow up to Cl. become a goalie for the Buffalo Sabres. Cooke came to Buffalo, he said, (Above) Dr. Coolce witb baby daughter, (at right) witb patient at Rehab Center. because he wanted to synthesize the many experiences of his life to make a more creative rehabilitation center in Buffalo. He has brought with him not only experiences that span ye~s of t~achi~g at a prestigious Amencan umverstty and involvement on federal commissions, including John F. Kennedy's President's Panel on Mental Retardation, but also impressive credentials. It 26 • BUFFALO PHYSICIAN were bot~ guests on the Thday Show, said that his esteemed colleague is a tremendous resource person. Buffalo is fortunate to have the man who knows everyone who is anyone in maternal and child health, mental retardation and handicap prevention, Guthrie believes. A s Cooke sat in his small office overlooking Delaware Avenue and talked about himself, his fingers traced invisible lines on the arm of his chair. His head was bent, his eyes hidden, as though concentrating on the words and sentences he was rapidly piecing together to describe his career .... While attending medical school at Yale University, Cooke was drawn to the branch of medicine that deals with the development, care and diseases of children, because of the influential head of the pediatrics department: Dr. Grover Powers. After obtaining his M.D. �----------------------------------------------------------------- People in 1944 and serving two years in the Army Medical Corps. Cooke returned to Yale and delved into not only pediatrics, but also physiology and biochemistry. In 1956, he transferred to Johns Hopkins University, where he remained as pediatrician-in-chief for the next 17 years. During the decade of the '50s, Cooke became a father to five children. His eldest daughter, Wendy, now 29, was born severely retarded as was Robyn. who died a few years ago. Cooke shares this sorrow with Guthrie, whose 35year-old son is also mentally retarded. While Cooke was a professor at Johns Hopkins, he became associated with the Kennedys. The famous family had turned to Johns Hopkins for help in researching mental retardation, which they had also had to cope with personally. The relationship has endured to this day. Since 1968, he has chaired the Scientific Advisory Board of the Joseph P. Kennedy. Jr. Foundation. "This association," Cooke said, "made it possible for me to influence public policy. especially regarding retarded children." When JFK was elected president, Cooke was asked to become one of five transition task force members to formulate health and welfare programs that the incoming administration Would advocate. Some of their ideas were translated into Medicare, Medicaid and the National Institute of Child Health. The Institute, Cooke said, has been a major contributor to pediatric research. During Kennedy's aborted term. Cooke was named to the President's Panel on Mental Retardation. Three Nobel Prize winners sat alongside him to articulate 90 recommendations. 80 of which were instituted. ---- "Cooke saw what needed to ---.._ke done. And he's doing it." - ROBERT GUTHRIE After being appointed by President Lyndon B. Johnson to the Office of Economic Opportunities, Sargent Shriver (husband of Eunice Kennedy) asked Cooke to help him expand the Great Society. Cooke created Head Start. Both professionally and personally, Cooke likes kids. "He finds them fascinating," said his wife, who laughingly added that, of course, she's biased. But she sees another side of the man. She watches as he romps with their baby daughter and glories in her growth. The Cookes met while she was an assistant to the medical dean and he the vice chancellor for health sciences at the University of Wisconsin at Madison. Dr. Cooke had left Johns Hopkins to study medical ethics at Harvard University's divinity school, before moving on to Wisconsin, after which he took over as president of the Medical College of Pennsylvania. ' ' One tends, in life, to recombine, which leads to new directions," Cooke mused as he explained his goals for the rehabilitation center. Besides increasing the volume of community service and broadening the capabilities of the existing clinics, Cooke wants to establish three new ones. The newborn intensive care follow-up clinic has already been started. Working with the neonatalogists at Children's Hospital, the staff at the rehabilitation center will follow the high-risk babies and develop interventions for any identified problems. Because of - in part - the increasing number of children who suffer head injuries because of automobile accidents, Cooke wants to establish a brain injury clinic. Physical, behavioral and emotional problems can all be blamed on brain injuries. Cooke anticipates working in conjunction with Guthrie and the Western New York Thsk Force on Prevention of Mental Retardation and Developmental Disabilities. And, in cooperation with US's Department of Physical Therapy and School of Medicine, Cooke wants to develop a gait analysis program that would guide the treatment of children with neurologic deficits and limb problems. "I am impressed with US's cooperative spirit," Cooke said, noting that he is collaborating on several projects with faculty from several departments. With words of sincerity. he emphasized that he is happy to be in Buffalo. Buffalo is honored to have him here. • Husband-wife team receive major grants team at Roswell A husband-and-wife Park Memorial Institute have received more than $500,000 in grants to continue their pioneering research in allergic disorders and heart disease. Drs. J. Craig Venter and Claire M. Fraser were the first to identify presence of Beta-adrenergic receptor autoantibodies in patients with allergic asthma and allergic rhinitis as well as cystic fibrosis. Dr. Fraser was the first scientist to create monoclonal antibodies to cell surface Beta-adrenergic receptors which play an important role in such functions as relaxation of airway smooth muscle. The two scientists have been awarded a three-year $423,000 grant from the National Institute of Allergy and Infectious Disease to screen 200 patients at NIH and Children's Hospital's Allergy Unit for presence of the autoantibodies to Beta receptors in sera. Drs. Venter and Fraser's discovery of the autoantibodies two years ago has been hailed as a "breakthrough." The autoantibodies they identified appear to act as "blockers" of the beta receptors, possibly preventing epinephrine and epinephrine-like compounds from relaxing airway smooth muscle in asthmatics and others with allergic disorders. Dr. Fraser's $91,000 three-year-grant from the American Heart Association will focu~ on development of monoclonal antibodies to the cardiac Betaadrenergic receptors. Part of her research will focus on whether antigenic determinants recognized by the monoclonal antibodies are inside or outside the ligand-binding site of the cardiac Beta-receptor molecule. In addition, more precise determination of the antigenic determinants not available using other techniques may be made using the monoclonal antibodies. Ultimately, the research to be conducted by Dr. Fraser may contribute valuable information which could pave the way for improved drugs to treat heart disease and hypertension. Dr. Venter is Associate Chief of the Department of Molecular Immunology at Roswell Park Memorial Institute and an adjunct professor of biochemical pharmacology at UB. Dr. Fraser, a research instructor at UB, is a cancer research scientist in molecular immunology at RPM!. • BUFFALO PHYSICIAN • 27 �People DR. FRANCIS J. KLOCKE, CHIEF OF THE UB Division of Cardiology, served as a co-chairman for a prestigious National Heart. Lung and Blood Institute (NHLBI) workshop in Bethesda. Md., June 7 and 8. Titled "Outcome of Percutaneous TI-ansluminal Coronary Angioplasty," the workshop was attended by som:e 40 leading cardiologists and cardiac surgeons. Goals of the workshop are to review baseline and results of the NHLBI registry for the coronary procedure and to assess new developments related to it. A further goal is to identify future research directions in this area. • GRANTS TOTALING $210,561 HAVE BEEN AWARDed to four researchers at Roswell Park Memorial Institute. ,.. Dr. Thomas B. Shows, Human Genetics Department. a $82,727 grant from the National Institute of Child Health and Human Development to study celf hybrids as an approach to human development. ,.. Dr. Robert Rein, Experimental Pathology Department. a $54,780 grant from the National Foundation of Cancer Research to study the interactions of carcinogens and anticancer drugs with DNA and proteins. ,.. Dr. Harold C. Box, Biophysics Department, a $48,989 grant from the National Cancer Institute to study transfer mecha n isms in irradiated biological systems. ,.. Dr. Clara M. Ambrus, Biological Resources Department, a $24,065 grant from the March of Dimes to investigate the use of enzyme reactors for the management of phenylketonuria. • eluding the Buffalo Surgical Society, he is the son of the late Dr. Eugene Michael Sullivan, Sr., a well-known Buffalo area physician who died earlier this year. The senior Dr. Sullivan was a 1926 graduate of the School of Medicine and son of the late Dr. Michael A. Sullivan, a Buffalo area physician who was a graduate of the old Niagara Medical School. New Alumni President Sullivan and his wife, the former Roberta Ann Falkner of Orchard Park, have four children: Colleen, 15; E.M. III, 13; and twins, Amy and Aleen, 12. They live in Boston Hills. Other officers elected include Dr. Carmelo Armenia (Class of '49), vice president; Dr. Charles J. Tanner (Class of '43), treasurer; and Dr. Frank J. Bolgan (Class of '51), exhibits chariman. Also named were Dr. Franklin Zeplowitz (Class of '58) and Council at the Society's 36th annual meeting, April 30-May 4, in Denver. The Society of Surgical Oncology is dedicated to defining and promoting the surgeon's role in oncology. Originally founded in 1940 as the James Ewing Society, in honor of the renowned surgical pathologist at Memorial Sloan-Kettering Cancer Center in New York City, the Society today has an active membership of over 800 distinguished oncologists, pathologists, and surgeons. • DR. BRIAN J. D'ARCY HAS BEEN ELECTED A fellow of the American College of Cardiology. • MISS DEBRA S. SALTER, SOPHOMORE MEDICAL student, has successfully competed for aresearch grant from the Smith Kline Beckman Foundation for a project in "Five~ear Follow- GARY P. ANDELORA HAS BEEN NAMED Western New York Regional Representative of the Medical Society of New York, replacing Harry J. Dexter, who has retired after nearly 20 years. Mr. Andelora was formerly assistant director of continuing medical education at the UB School of Medicine. Prior to that, he was employed as a secondary school teacher in the West Seneca Central School System. • DR. EUGENE MICHAEL SULLIVAN JR., A GENeral/vascular surgeon with offices in Hamburg and Lackawanna, was elected president of the UB Medical Alumni Association at a business session May 7. A 1963 graduate of UB's School of Medicine, Dr. Sullivan received the B.A. in chemistry here and graduated from Manlius Military Academy. A member of the Board of Directors of Our Lady of Victory Hospital, he is on the surgical staff at OLV. South Buffalo Mercy Hospital and the Erie County Medical Center. A Diplomate of the American Board of Surgery and a Fellow in the American College of Surgeons, Dr. Sullivan interned at South Buffalo Mercy and received his residency training at Erie County Medical Center, then E.J. Meyer Memorial Hospital. A former captain in the U.S. Army, he served as medical advisor to the Korean Army and was a mem her of the surgical service at Valley Forge Hospital. Active in professional organizations in28 • BUFFALO PHYSICIAN New Medical Alumni officers: (from left) Drs. Zeplowitz, Tanner, Sullivan and Bolgan. Dr. John Przylucki (Class of '73), senior reception chairman. • DR. ARTHUR J. SCHAEFER, CLINICAL ASSOciate professor of ophthalmology, was a guest speaker at the 35th Annual Conference of the Wills Eye Hospital and Jefferson Medical College in Philadelphia on February 17. 18 and 19. He took part in a symposium on Ocular, Orbital and Eyelid Thmors. He gave a paper on the Resection of Malignant Eyelid Thmors and the Ophthalmic Plastic Reconstruction necessary following their removal. He also gave a paper in the Oculoplastic Surgery Workshop which included cosmetic and functional eyelid surgery. • DR. GERALD P. MURPHY, DIRECTOR OF ROSwell Park Memorial Institute in Buffalo, has completed a successful term as the president of the Society of Surgical Oncology, and was elected 1983 chairman of the Executive Up Study on Alcohol Intake Among Ob and Gyn Patients." This, under the auspices of the Department of Family Medicine. • DR. LYNDA M.K. HOHMANN, M.D., PGY-.2 OF the Department of Family Medicine Residency Program, has been awarded the Mead Johnson Award for outstanding resident in Family Medicine. This is a national award involving a monetary grant of $ 1,500, along with an all-expense paid trip to the Convention of the American Academy of Family Physicians, and other considerations. • DR. DANIEL J. MORELLI HAS BEEN NAMED VICE chairman of the Department of Family Medicine. • DR. DOUGLAS H. MOFFAT IS THE NEW DIRECtor of the Deaconess Family Medicine Center, 840 Humboldt Pkwy. This is the family practice center for the residency program in Family Medicine at UB. • �Alumni Reception Alumn~ Association honors Class of 1983 at the Gallery The Sculpture Court of the Albright-Knox Art Gallery was the badrdrop for the Medical Alumni Association's annual reception for graduating Medical School seniors, April24. The elegant affair featured a handsome buffet and classical music. �........................ By MARY BETH SPINA Sntoking is No. 1 threat to the heart ( Top) Dr. Robert J. Hall of the Texas Heart Institute. (Bottom this page) View of well-attended general Clinical Day session at Tbe Marriott. (Bottom, facing page) Exhibits area was crowded. I fyou want to cut the odds you 'll be among the millions who ann ually die of cardiovascular disease and stroke, kick the nicotine habit, advises the Thxas Heart Institute's medical director Dr. Robert J. Hall. In Buffalo to address the UB Medical Alumni Association's Spring Clinical Day at the Marriott Inn, May 7, the 1948 UB medical graduate said in an interview that smoking remains the number one risk factor associated with heart disease. "Of th e patients I've referred for coronary bypass surgery, 75 per cent were cigarette smokers,'' the cardiologist noted. Some 30 per cent suffered from hypertension; another 12 per cent from diabetes mellitus. Fifty to 60 per cent had family histories of card iovascular disease. Studies show, he emphasized, that cessation of smoking does more to reduce mortality from heart disease than dietary restrictions or regular exercise. "Certainly the benefits of these cannot be discounted," he added, "but statistically they do not appear to significantly alter risk." Nearly all the advances which have improved the outlook for those suffering from the nation's number one killer have occurred in the past 35 years, and Dr. Hall is excited by the potential promised by treatments either on the drawing board or in clinically experimental stages in the 1980s. One of the most promising appears to be delivery of therapeutic agents directly to the heart. The thrombolytic agent streptokinase, injected into artery or vein, for instance, appears to seek out, attack and destroy damaging blood clots. Removal of clots soon after formation could minimize damage to heart muscle by cutting the time vital tissue is deprived of oxygen. "Another exciting development is made possible by gene manipulation," he said. This involves manufacture of tissue plasminogen activator, or t-pa, "a naturally lytic substance, which could actually dissolve blood clots which accumulate in arteries." 'fracing the advances in diagnosis and treatment of cardiovascular disease, Dr. Hall cited development of coronary angiography in the 1960s as an accomplishment which significantly 30 • BUFFALO PHYSICIAN aided physicians in making more precise diagnoses. "Thirty-five years ago, physicians couldn't give patients the details on their heart disorders, primarily because we didn't have that much information ourselves," he pointed out. The 1970s brought coronary bypass surgery, which has increased longevity and quality of life especially for those with angina which has not responded to more conservative treatment. Heart transplants caught the public's attention in the 1960s, Dr. Hall said, but mortality rates were disappointing. Because of complications related to immunosuppression and rejection of donor hearts by recipients' natural defense mechanisms, the Thxas Heart Institute and its affiliated surgeons ceased to perform the procedure from 1969 until 1981, he indicated. " Recent development of the immunosuppressant cyclosporin, however, has increased success of other organ transplants and created renewed interest in the heart procedure. In 1982, surgeons at St. Luke's Hospital headed by Dr. Denton Cooley performed seven heart transplant operations. Placed on cyclosporin, six of the patients are alive today, showing no signs of organ rejection or recurrent infection associated with immunosuppression. Three heart-lung transplants performed in Houston have not fared as well, however, nor have three artificial replacement heart recipients. Failures of some of the more exotic surgical techniques which were admittedly performed on critically ill patients who had no other option but death should not cloud the accomplishments which daily save many others with heart disease, Dr. Hall contended. Aside from those who have been saved by medical advancements in cluding vasodilators, anticoagulants and coronary bypass surgery, others born with heart defects, which 40 years ago would have spelled a shortened lifespan, are today leading normal lives. "The 'blue babies', the ones born with tetralogy of Falot, had a limited life expectancy, when I began medical practice,' ' Dr. Hall recalled. T he prognosis for those with various forms of cardiovascular disease appears brighter today than ever before, h e said. "It's encouraging that the mortality �-~=---------------------------------------------------------------------- Spring Clinical Day rate attributed to heart disease has declined in the past few years.·· he noted. And while even a panel of experts in the field could not isolate the single factor to which the decline could be attributed, a combination of better diagnostic tools, improved treatment, and availability of specialized coronary care units should be credited. Just as important as any of these. though. are public and physician education programs which have led more to quit smoking and adopt regimens which emphasize prevention of heart disease . . "The advances are steadily increasIng the effectiveness of treatment of cardiovascular disease - but prevention is infinitely preferable," Dr. Hall emphasized. During the meeting, Dr. Hall, a clinical professor of medicine at Baylor College of Medicine, discussed "Treat?lent of You, The Physician, Pre, DurIng and Post Myocardial Infarction" and "Coronary Artery Bypass Surgery: Long Thrm Effect.·· Other presentations during the meeting included UB medical dean Dr. John Naughton, who developed the Widely used Naughton stress test to as~.ess physical fitness. speaking on Rehabilitation Exercises and Stress Testing;" "Intra Aortic Balloon Pumping" by Dr. Theodore L. Biddle. associate professor of medicine at the University of Rochester and director, Intensive Care Unit at Strong Memorial Hospital; "Surgical Treatment of Acute Evolving Myocardial Infarctions." by Dr. Jack J. Leonard, thoracic cardiovascular surgeon, Sacred Heart Medical Center, Spokane, Washington, and Dr. Peter A. Rossi, Lenox Hill Hospital, who spoke on "Transluminal Coronary Angioplasty." • Commercialization, feminization lie ahead for the practice of medicine I ncreasing commercialization, decreasing numbers of family practitioners and a growing feminization lie ahead for the profession of medicine, Dr. E. Grey Dimond, distinguished professor at the University of Missouri, predicted during the annual Stockton Kimball Lecture at the Medical Alumni Spring Clinical Day, May 7. at the Buffalo Marriott. More than 350 medical alumni jammed the hotel meeting rooms for this 46th annual event making it the most successful and enthusiastic ever, according to Dean John Naughton. Thn classes holding reunions set another record, presenting the School of Medicine an all-time high of $52,500 in reunion gifts for a variety of projects ranging from faculty ·development to programs directly benefiting medical students. The class of 1958 distinguished itself further with a gift of $12,525, the largest amount presented by a single medical class in the history of the Class Gifts Program. Five years ago, said Dr. Dimond, the medical profession viewed socialized medicine as the greatest dilemma facing its future. Thday, though, he said, it is the spectre of commercialized health care which is unsettling. A shrinking population and a shrinking dollar. he said, have led to a situation where competition for business has become a major factor in decisions to render care. This, he contended, is "a tremendous tragedy.'' "A charletan with enough charm can sell himself in the face of competition Dr. E. Grey Dimond based on financial considerations, and patients, for the most part, have no real ability to judge the quality of care they receive," he noted. "Good medical care, on the other hand, is dependent on the quality of the people selected to attend medical school- not just in terms of their ability to learn sophisticated information but in terms of their integrity, their honesty,'.' Dimond said. Many young physicians today, he noted. are not willing to work 70 or more hours a week. "The male physicians and more understandably the increasing numbers of female physicians who may also be raising families are more interested in regular hours, a regular paycheck without the expensive investment in equipment required to establish independent practice. And most find themselves running up enormous debts for their education, which must be paid." Primary care is in jeopardy because hospitals - and particularly those which are proprietary- are going to survive on tertiary care, Dr. Dimond warned. Family medicine, he said, will be the "funnel" through which cases will be channeled to the hospitals. And in many cases, family medicine will be administered by physicians who have signed contracts with hospitals to provide care. BUFFALO PHYSICIAN • 31 �Spring Clinical Day EMG (Left) Dr. Russell Bessette (cente) discusses ne;., surgical tecbnique. (Below) Medical DeaD Jobn Naughton witb Clinical Day visitor. C ompetition for the patient is coming at a time when the Federal Government and third-party payers are encouraging competition; at a time when hospitals have entered the marketplace to the point of setting up and staffing jogging facilities and screening clinics in shopping malls. Dr. Dimond explained. "The quality of medical care in the future will depend largely on the quality of our medical students. And while they should be humane, being humane isn't enough. They will also have to have enough information to be trustworthy.'' espite the "propaganda" of recent Dyears to encourage students to select residencies in family medicine, and despite the upturn which has occurred, Dr. Dimond said, the two top areas for residency-matching nation-wide this year were orthopedics and obstetrics-gynecology. Only 12 per cent of graduating medical seniors in the U.S. selected family medicine while 25 to 30 per cent opted for internal medicine. Among UB graduates for 1983, internal medicine was the overwhelming choice. Fifty-nine of the graduates selected this specialty area, followed by surgery and family practice which attracted 15 each. Six UB grads are going into anesthesiology; three into obstetrics-gynecology; two each into neurosurgery, radiology and urology, and one each into ophthalmology and oto32 • BUFFALO PHYSICIAN (Top) Class of 1958 gave recordsetting gift. (Rigbt) Dental Scbool Dean William Feagans views second prize ezbibit by Dr. Josepb Monte anti Robert Ley. laryngology. As for the feminization of medicine. Dr. Dimond pointed out that while six per cent of physicians in practice today are women. one third of students enrolled in medical schools are female. And while numbers of women studying nursing have declined, he noted, fifty-eight per cent of pharmacy students are women. In dentistry, however, only six per cent of students are female. At the Annual Alumni Luncheon, awards were presented for the top three exhibits of 17 entered in the Clinical Day competition. First place went to "The Computer as a Neurosurgical Instrument" and Drs. Patrick J. Kelly, Bruce A. Kall and Stephen Goerss of Sisters of Charity Hospital; second to Dr. Joseph F. Monte and photographer Robert Ley of Buffalo General Hospital's Department of Ophthalmology for "Corneal Distrophies and TI-ansplantation." "Diagnosis and Treatment of Temporomandibular Joint Pathology" by Drs. Russell W. Bessette, Richard W. Katzberg, Joseph R. Natiella and Samuel Shatkin of UB and the University of Rochester took third honors. • �Classnotes Class of 1923 holds an unofficial reunion T he School of Medicine's. Class ?f.1923 didn't officially hold a reunion at Spnng Chmcal Day. But that didn't prevent two of its seven living members- Drs. Herbert Burwig and Harry LaBurt - from taking advantage of the occasion to remi- LaBurt, M.D., Center for Extended Care. Another of the Class of 1923 to make a mark in psychiatry is Dr. Donald W. Cohen, a Buffalo native who retired in 1968 from the New York State Department of Mental Hygiene where he was an assistant commissioner. Thday a resident of Boca Raton, Fla., Dr. Cohen served in the Field Artillery Officers training camp in 1918 and was a UB athlete, playing on the varsity basketball teams of 1917-1921. He was team captain his final year. He wrote Dr. Burwig that as a psychiatrist he must report a recurrent dream - a dream that he is back in medical school. "I dream that while reviewing the day's work schedule, I see an exam posted I had never prepared for. I become severely agitated until awakening and realizing that it was only a dream." nisce. Dr. Burwig, a retired Thnawanda obstetrician/gynecologist, has kept in touch with the survivors of the class who 60 years ago walked across the stage to receive their M.D.'s from the then-University of Buffalo. Gathering information from each this spring, he comn the occasion of the 60th year since graduation from piled autobiographical material and sent copies to all. UB's School of Medicine, Dr. Carleton William Bullard Dr. LaBurt, active in the field of mental health for many wrote of the "adventuresome medical journey" he has years, today lives in Queens Village. After serving in the Army Air Corps in World War I, Dr. experienced. A Philadelphia native now a resident of Sun City Center, LaBurt, a native of Ralston, Pa., returned to Buffalo to earn the B.S. and M.D. degrees. After a year's internship at Buf- Fla., Dr. Bullard recalled his days as "a country doc in Black falo City Hospital and two years in private practice, he join- River, N.Y., for three years in my model 'T', and with horses .on a bobsled, with a lantern to find my way to an OB case ed Buffalo State Hospital. A medical inspector for the New York State Department buried in the snows of the Adirondacks or to see diphtheria, of Mental Hygiene, he was named in 1934 the clinical direc- smallpox, black measles, tetanus, blood poisoning, syphilis, tor of Harlem Valley State Hospital. There he established the gonorrhea . . . all the vitamin deficiency diseases ... system of family care for the mentally ill in New York as well pneumonia, the 'captain of death' . . . one big bundle of as the fi rst insulin shock therapy unit, in collaboration with medical tragedies of everyday practice not seen by medical students today." the late Dr. Manfred Sakel. Dr. Bullard continued, "We are a part of an era - very In 1943, Dr. LaBurt became senior director of Creedmore (Psychiatric) Hospital where he broke down the barriers of important gods to our patients who were dependent upon secrecy surrounding mental hospitals. Fostering and the miracles within the 40 bottles in our bag- with the only developing a hospital-community partnership, he promoted specific drugs digitalis and the opiates codeine, heroin and a psych ob iologic studies program at Creedmore relating to morphine. ''The hand on the shoulder, the hypnotic rattle of the the biology of the individual and childhood schizophrenia. In addition, he encouraged therapy studies in connection cuffs as god shook down the thermometer, the slow, careful counting of the pills for each saucer completed the Norman with insulin treatment, tranquilizers and other drugs. Last fall, a Citizen's Committee convened by Creedmore Rockwell scene of the Housecall. And now that is all in the Psychiatric Center designated the Center as the Harry past - including the Housecall. O ''We were important gods to our patients who were dependent on miracles in our bag." - CARLTON WILLIAM BULLARD Dr. Harry LaBurt (left) and Dr. Herbert Burwig reminisce about tbe Class of 1928. BUFFALO PHYSICIAN • 33 �----------------------------------------------------------------------------------------------. "Thday," he says. "it is still wonderful, more hypnotic and surely more exciting." After his time in Black River, Dr. Bullard attended the University of Pennsylvania Graduate School, taking courses in otolaryngology. Describing it as a "two-year weight losing course," he went on to research and helped in the development of endoscopy, bronchoscopy and esophagoscopy - then new medical diagnostic procedures - at the world's first clinic for retrieving foreign bodies from the lung and esophagus. "Patients were flown in worldwide, with reporters sleeping in the Hospital - all of which was truly exciting," he recalled. Branching into neuro-otology at a time prior to x-rays of the brain, he says, he became professor in that field at Washington University and later went into facial plastic and reconstructive surgery. This latter change, he noted, was prompted by the advent of penicillin which spelled "the demise of radical sinus and mastoid surgery." He adds that while he got his Boards in three specialties and still enjoys the meetings, he finds it "very difficult to understand today's medical jargon." Actually, he adds, the field of otolaryngology. as he first knew it. is now extinct. A nother graduate of the Class of 1923, Dr. Harold Butman, lives in Vero Beach, Fla. Retired since 1964, he was in private practice of internal medicine and pediatrics for some 38 years in the New York City area. A golfer who enjoys stamp collecting and Western art. he was an instructor at Adelphi College and is a Life Member of the American College of Physicians and a member of the Brooklyn Academy of Pediatrics. Dr. C.J. Durshordwe, another graduate who lives in Buffalo, distinguished himself in the field of anesthesiology and noted that when he became a Diplomate in the College of Anesthesiology in 1940, his certificate number was 93. He was head of the Departments of Anesthesia at both Buffalo General and Children's Hospitals and associate professor of anesthesiology at UB. At his retirement in 1975, he had served on the Board of 'Ihlstees of the International Anesthesia Research Society for 20 years- spending eight of them as chairman. One of the U.S. representatives in the World Congress of Anesthesiologists, he aided in drawing up this prominent group's charter. Dr. Durshordwe's interest in anesthesiology, he said, came during his four years with the Public Health Service as an assistant surgeon at the old Marine Hospital in Buffalo after he was discharged from the Army in World War I. He was the first anesthesiologist to be named to the honorary Roswell Park Medical Society. Dr. Burwig, who initiated this flood of memories on the part of his classmates, retired from his practice in 1969. Born in Berlin, he became a U.S. citizen in 1908 and also served briefly in the Field Artillery Officers Training Camp. He had been in general practice for 13 years when he decided to expand his education at the University of Pennsylvania Graduate School and at institutions in Berlin, Vienna and Budapest. Dr. Burwig holds Fellowships in FACS, FICS, ACOG. Noting that he delivered some 18,000 babies in his career, he recalled that on one hectic weekend, he went virtually all over Buffalo, delivering 23 youngsters from Friday afternoon to the following Monday morning. The remaining memher of the Class of 1923, Dr. Edward J. Zimmerman, who lives in Snyder, expressed the wishes of all in sending his greetings, regards and best wishes on the unique occasion of the Class's 60th anniversary. • 34 • BUFFALO PHYSICIAN Dr. Lynn Eckhert juggles many careers T he logistics sound like a nightmare. How does one manage to be acting chair of the Department of Family and Community Medicine at UMass Medical Center, associate dean of admissions for the medical school, an associate professor, a pediatrician with an active practice, wife and mother of three children? If you're Dr. Lynn Eckhert. you manage it all with crisp efficiency and cool matter-of-factness. Dr. Eckhert, 40, says, "I have a lot of good people working with me." She talks about her "very good support staff," mentioning her secretary Mary Ellen Foley by name. At home, she says, "I've had some excellent people to help me. They've sort of grown up with my family." Her goal in her newest position - the acting chair slot she has held since December- is "trying to coalesce the department back together. We've been drawn apart ·:~ .. ·· Sitting in her sunny corner office with its view of Lake Quinsigamond, Dr. Eckhert says she never expected to be where she is today. "This is not the road I would have taken," she says. "I never thought I'd have some of these opportunities.'' As a matter of fact, Dr. Eckhert began her medical career as a nurse. While she was getting a master's degree in nursing, she decided that she really wanted to be a doctor. She was accepted at the medical school at State University of New York at Buffalo. There were obstacles for women in medical school back then, Dr. Eckhert says, mainly because there was "no critical mass of women.'' Some instructors said that they did not like women in medicine, she recalls. Thday, however, about one-third of the medical students in the country are women. In her senior year of medical school, she married Dr. Louis E. Fazen III, then an intern in Buffalo. One of their shared areas of interest was international health. They've Dr. Lynn &khert �.. -------------------------------------------------~~~~;:: Classnotes traveled to Liberia, to Guatemala with the World Health Organization to study river blindness and to Afghanistan, Where Dr. Eckhert was with the U.S. Embassy and Dr. Fazen, With the Peace Corps. Her international experience led her to continue her studies and receive a doctorate in public health at Johns Hopkins University. In 1978, she was involved in the initial negotiations in China between UMass Medical School and Shanghai Medical College No. 1 to set up the scholars exchange program. Dr. Fazen is a fellow in pediatric intensive care at Children's Hospital Medical Center in Boston. Their children are Curtis, 7; Thrrey, 5; Bucky (Louis E. IV), 3. W hile Dr. Eckhert says she "wouldn't push anybody into medicine," she notes how her children "certainly have a preview of what it's like." Dr. Eckhert says that two-doctor families are "certainly much more common." Recurrent themes for young medical residents and medical students, she says, are when to have Children and how to manage. Some of the men students also ask how to manage, she says. "If they're about to marry a professional woman Whatever she's doing- they want to know how to combine things." - From the Worcester (Mass.) Gazette • Deaths . BENJAMIN GILSON, M'38 • died March 21 , 1983 at Pompano Beach, ~~ J. RICHARD LUNDQUIST, M'46 • died January 6, 1983, following a one Year illness. He devoted his professional career to the practice of llledicine in Pensacola, Florida, with the exception of military serVi_ce as a Flight Surgeon. He is survived by his wife. Mary E. Kirkpatrick Lundquist of 11 Manor Drive, Pensacola, Florida; one daughter, Kay Burley of Ft. Lauderdale; and three sons. Dirk, Eric and Scott of Pensacola. • MARY J. KAZMIERCZAK, M'l8 • the first Polish-American woman doct?r in New York State and, according to the Buffalo News. the hrst physician to introduce city-wide im~unization here against contagious di~.eases, died May 4 at age 89. Dr. Mary" as she was known on the East Side, had retired in 1963 after practicing in her home-office on Sycamore Street for 50 years. Dr. Kazmierczak interned at Children's ~ospital and from 1919 to 1943 worked In child health clinics for the Buffalo Health Department, in addition to her Private practice. During the diphtheria . . . epidemic of 1920. the News reported. she started an Immumzation Program at the German Roman Catholic Orphanage whe re she headed the m edical staff from 1920 to 1934. Following the success of that effort. she persuaded the Health Departm ent to institute imrnunization against scarlet fever, Thtanus and eve ntually whooping cough in its clinics. She also he lped establish St. Rita's Home for Exceptional Children in 1930. In 1949-50 and 1954-55. s h e was President of the Buffalo Board of Education. In professional circles, she was former president of the New York State Wome n's Medical Society and the Women's Physicians' League and was the first woman e lected a delegate to the Medical Society of New York convention. . In 1953. the University honored her "in recognition of outstandtng ability a nd distinguished accomplishme nt in the field of CIVIC affairs." • 1938 SAMUEL L. LIEBERMAN, M'38 • is retired after 35 years as chief of the Department of Anesthesiology at DeGraff Memorial Hospital, Thnawanda, New York. Dr. Lieberman was instrumental in establishing DeGraffs outpatient surgery program. In 1969 he began a training program in anesthesia for oral surgery at the hospital. He has published articles for professional journals on anesthesia and hospital-based outpatient surgery. In 1966 the Lieberman Award was established in his honor at UB. The award is given annually to medical students who show exceptional interest and aptitude in the field of anesthesiology. 1942 THE LEON YOCHELSON • Chair of Psychiatry and Behavioral Serhas been established at George Washington University through the generosity of his friends and colleagues. Dr. Yochelson. M'42, who died in 1982, had a distinguished professional career in clinical and academic psychiatry and served as chairman of the Department of Psychiatry at George Washington University. vi~es 1943 ALFRED S. EVANS, M'43 • has been named John Rodman Paul Professor of Epidemiology at Yale. Dr. Evans has been a professor of epidemiology and director of the Section of International Epidemiology and the WHO Serum Reference Bank at Yale since 1966. He is the author of numerous publications, including Viral Infections of Humans, published by Plenum Press, for which he received the American Medical Writers Award for the best book written for physicians in 1977. He was awarded the Thomas Parran Lectureship and Medal by the University of Pittsburgh in 1978. Dr. Evans is a fellow and member of the Board of Directors of the American College of Epidemiology and was president of the Society of Medical Consultants to the Armed Forces in 1980-81. EDGAR A. HAUNZ, M'43 • is professor emeritus of medicine, University of North Dakota School of Medicine where he was chairman of the Department of Medicine from 1955 to 1973. Dr. Haunz, whose specialty is diabetes, is a former chairman of the Board of Governors of the American Diabetes Association and has been a member of its Board of Directors for the past 10 years. He has received numerous awards including the American Diabetes Association National Pfizer Award for "Outstanding Clinician in Diabetes.'' He has 60 publications on diabetes and was a contributing author to the textbook, Diabetes Mellitus: Diagnosis aTJd Treatment, published by the American Diabetes Association. 1953 GEORGE V. STEVENS, M'S3 • is in private practice in otolaryngology, head and neck surgery in Gilroy, California. Dr. Stevens is vice president of the South County Medical Association and chief of surgery at Wheeler Hospital. He is the owner of Russkaya Farms and is a general partner in the Sunnyslope Medical Building Company which erected the first medical office complex in Hollister, California. 1955 ALAN HARTER, M'SS • has been named in the 1983 U.S. edition of Who's Who in Aviation and Space. Dr. Harter, who is now manager of occupational health services for the General Electric Company, was previously involved in the space program. He was chief of the launch site medical operations branch at the Kennedy Space Center, National Aeronautics and Space Administration, from 1966 to 1970. From 1970 to 1972 he was chiefmedi. cal services officer there. He received the NASA Certificate of Commendation in 1969, the NASA Superior Achievement Award in 1969, and was named to the Diplomate American Board of Preventive Medicine (Aerospace) in 1970. He holds the rank of colonel in the United States Air Force Reserve. He and his wife, Barbara, currently reside in Westfield, N.Y. 1956 MORTON A. STENCHEVER, M'S6 • is a professor and chairman of the Department of ObstetricsGynecology at the University of Washington, S eattle. Dr. Stenchever is president of the Association of Professors of Gynecology and Obstetrics and president of the Seattle Gynecology Society. He is also vice chairman of the Learning Resources Commission. American College of Obstetrics and Gynecology. He has over 100 publications in scientific journals BUFFALO PHYSICIAN • 35 �Classnotes and is on the editorial boards of Obstetrics and Gynecology and the Western Journal of Medicine. 1967 DOUGLAS DAVID GERSTEIN, . M'67 • has a private practice in ophthalmology in Vallejo. California, and is chief of staff at the Vallejo General Hospital. Dr. Gerstein is a member of the Golden Gate Gypsy Orchestra. 1970 THOMAS V. KRULISKY, M'70 • of Arcadia, California, is an active member of several local and state medical societies and committees. Dr. Krulisky is chairman of the Medical Consolation Monitoring Thsk Force and the Political Action Thsk Force of the California Psychiatric Society. He is also chairman of the Southern CalifQrnia Psychiatric Society Thsk Force. 1971 SCOTT D. KIRSCH, M'71 • is director of the family practice residency program at South Nassau Communities Hospital, Oceanside, New York. He also is assistant professor of clinical family medicine at SUNY. Stony Brook. 1974 PETER C. WELCH, M'74 • of Mt. Kisco. New York, has been elected to the Medical Board of the Northern Westchester Hospital Center and is also head of the hospital committee on infections. Dr. Welch is also a member of the Ethics Committee of the Westchester Academy of Medicine. 1976 LAWRENCE B. SCHLACHTER, M'76 • is opening a practice in adult and pediatric neurological surgery in Atlanta. Georgia, on July 1. "Jason age 5 and Dara age 3 are the latest additions to the Schlachter clan." he writes. 1977 LEWIS R. GRODEN, M'77 • recently completed an 18-month fellowship in cornea-external disease at Wills Eye Hospital in Philadelphia and is now in practice i_n Thmpa, Florida. Dr. Groden 1s clinical assistant professor at the University of South Florida. He has published and presented several papers in both basic research and clinical/surgical cornea. 36 • BUFFALO PHYSICIAN 1978 DENNIS GROVES, M'78 • has joined the medical staff of the Westchester Community Health Plan, White Plains, New York. STEPHEN E. KILLIAN,M'78 • has moved to Columbia, Maryland, to join the Patuxent Medical Group. Dr. Killian is a family practitioner. JOHN R. VALVO, M'78 • has completed urologic surgery residency at the University of Rochester Medical Center and will join the Northside Urologic Group in Rochester. Dr. Valvo has published over 25 scientific papers and was recently awarded the Penwalt Prize by the Rochester Academy of Medicine for the manuscript entitled, "Acute Scrotal Swelling in Children." 1928 1981 MICHAEL T. ROSS, M'81 • will present a paper, "Disregard of Alcohol-Related Illness in a Large Inner-City, Emergency Hospital," at the annual meeting of the University Association for Emergency Medicine. Dr. Ross is an emergency medicine resident at Wayne State University Medical School and the Detroit Receiving Hospital. 1928 (First Row) Albert J. Voelcle, Bruno G. Schutkeker, Thelma Brock, Eugenia F. Bukowska; (Second Row) Raymond J. Rick/off, Howard Stoll, Walter King, Bernard Mazur, Clyde George, Harry Spiegelman. 1938 (First Row) Benjamin P. Paull, Clarence J. Straubinger, Charles Donatelli, Carl Hertz, Samuel Lieberman, Chester J. Kaminski; (Second Row) Leo J. Doll, Richard Terry, Maxwell Rosenblatt, Alfred A. Mitchell, Charles F. Becker, Walter J. Sydoriak, H. Robert Oehler, Russell J. Catalano, Harry C. Law, Harold J. Elliott, Vincent L. Rutecki, James Brennan, Harry J. Bylebyl, Eustace Pbillies. 1948 Left to Right (First Row) Norman Minde, Daniel J. Fahey, Judith B. Landau, Oliver P. Jones, William H. Bloom, Leon H. Graff; (Second Row) Raymond E. Moffitt, Darwin D. Moore, George L. Collins, Jr., Vernon C. Lubs, Robert J. Hall, Myron Gordon, B. Edward Heckmann, Norman Paul. 1948 �Calendar THE 15TH NATIONAL CONFERENCE ON ADVANCES IN PEDIATRICS • August 12-14. 1983. Dunfey's Hyannis Hotel. Cape Cod, Hyannis, Massachusetts. Chairman, Elliot F. Ellis. 18 hours. Fee: $275 physicians in practice; $150 allied health professionals. FRONTIERS OF DRUG THERAPY • Marriott Inn. September 10. 1983. Sponsored by Continuing Medical Education. UB. DIABETES • Marriott Inn . September 15. 1983. Sponsored by Continuing Medical Education. UB. NEPHROLOGY • Buffalo Hilton. September 22. 1983. Sponsored by Continuing Medical Education. UB. MEDICAL SCHOOL ORIENTATION • August 10-11-12. New medical students will be welcomed with tours, speeches. parties and other activities. PARENTS WEEKEND • October 8-9. ---- --------------------------------------------------------------- IIIIII NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES BUSINESS REPLY MAIL FIRST CLASS PERMIT NO . 2210 BUFFALO, N.Y. POSTAGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, New York 14214 �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET BUFFALO, NEW YORK 14214 920029004800 0 39 OR. EVERETT H. ESP 135 LINWOOD AVE ' UE BUFF LO Y 142 9 -----------------------------------------------------------------~ LET US HEAR FROM YOU Fill out this card (Please print or type all entries) Name-- - - - - - - - - - - - - - - - - - - - - - - - - - - - Year MD Received _ _ _ __ Office Address _ _ _ _ - - - - - - - - - - - - - Home Address _ _ _ __ If not UB, MD received from In Private Practice: Yes In Academic Medicine: Yes [ No l No Specialty - - - - - - - - - - - - - - - - _ _ _ __ Part Time Full Time [ School Title _ _ Other: Medical Society Memberships: --~ -~ -- NEWS: Have you changed positions, published , been involved in civic activities, had honors bestowed , etc.? ------ -- -Please send copies of any publications, research or other original work . ------- � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, July 1983 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals. Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1983-July Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1983-v17n02-July Table Of Contents A list of subunits of the resource. Anatomy Diet Alzheimer's Disease Our Children in the Nuclear Age Research Briefs Students Medical School News People Alumni Spring Clinical Day Class notes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-07-05 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v17n02 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1983 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/29c2759192383ba7106ef15af7a0f549.pdf 86f2ef7b19ce6155571f97921ebbbc4d PDF Text Text �With this issue. The Buffalo Physician begins to move in new directions which we hope will be of interest to you. the alumni, faculty. staff and students of the School of Medicine. Most immediately noticeable. the magazine will be more compact and will ap­ pear more frequently - 5 times a year, in April, late June, early September, mid­ November and mid-January. This reflects an effort to be current in content and timely in notifying you of coming events. Our pages will continue to focus on the research and scholarly activities of the School and the individuals who make up the institu­ tion. on medical education, on alumni ac­ tivities. on issues in medicine and science, and - perhaps more so than in the past - on the hospitals affiliated with the School's clinical programs. An advisory board has been convened consisting of faculty and administrators - to help the new editors produce an interesting, informative magazine reflective of the School of Medicine and its accomplishments. Their suggestions for future content and for con­ tinued improvement from issue to issue will help shape the magazine's new direction. Suggestions from all readers are also solicited. as is news from alumni and informa­ tion from individuals associated with the school. The back cover is a handy return card for "class note" information. To share with us your ideas for stories, to submit manuscripts, etc., please contact the Office of University Publications, Mr. Robert Marlett, 136 Crofts Hall, State University of ew York at Buffalo. Buffalo, Y 14260 (716-636-2626). The School of Medicine. the oldest unit of this University, continues to be an important center of medical education and research. It is furthermore embarking on an expansion in plant ana facilities that will serve both to enrich and to bolster its contributions to the State and the re~ion. The Buffalo Physician, above all, will reflect and report this continu­ ing vitality. • - John Naughton, M.D. �Contents BUFFALO PHYSICIAN STAFF Executive Editor, University Publications Robert T. Marlett Art Director RebeccaBemstein Health Sciences Editor 3 Running • Too many distance runners train too much, too long, too slowly, a UB Physiology team headed by Dr. David Pendergast has found. It's important to be active, but it's also important not to overdo it. 6 Veterans • Details of a new study challenge some of the popular myths surrounding the development of stress disorders in veterans of the Vietnam War. 7 Doctor 's Orders • Researchers have identified four factors which contribute to one of the nation's most widespread, expensive health problems: patients' failure to comply with the doctor's orders. 9 Golden Discoverer • A UB Health Sciences librarian recalls a more flamboyant era in the practice of " medicine" when a Buffalo-produced elixir and an "in­ valids' hotel" were known throughout the nation. Mary Betb Spina Photography FrancisSpecker Ed Nowak ADVISORYBOARD Dr. John Naughton, Dean School of Medicine Dr. HaroldBrody Dr. James Kanski Dr. James P. Nolan Dr. CharlesPaganelli Dr. Peter&gan Dr. Mary Voorhess Dr. Martin Wingate Dr. John Wright Dr. MaggieWright Produud by the Division of Public Affairs, Harry R. Jackson, director, in association with the ~bool of Medicine,State University of New Yorkal Buffalo 11 The HSL • When Buffalo physicians need rapid re­ trieval of information to determine the best course of medical treatment, they rely on UB's Health Sciences Library, one of the most heavily used research libraries in the nation. 13 In Space • A research project designed by Dr. Leon Farhi will be on board the 1985 Life Sciences Space Shuttle. 14 Research Briefs • New therapy for schizophrenics. Sickle Cell Center opens. Do breast-fed babies have greater immunity to certain viruses? Roswell Park team investigates use of radiation treatment during cancer surgery. 19 People • Dr. Erwin Neter has a bacterium named for him. News of other individuals associated with the school. 22 Medical School News • New construction called most exciting development for Health Sciences faculty in a decade. First Research Day planned for May 25. How basic science departments fared in national rankings. Center for Health Instruments Development takes first step toward realization. 26 Students • Seniors receive first choices of residency assignments in exceptionally large numbers. 30 Calendar • Dr. Renee Fox will be Commencement speaker. Spring Clinical Days to focus on coronaries. 32 Classnotes • First blind Med School graduate ex­ periences return of his vision. News of the Classes. Deaths. ◄ Coverphoto: FrancisSpecker THE BUFFALOPHYSICIAN, (USPS S51-.'!60).May 1983 - Volume17, Number I pub­ lished five times annually: May, June, September, November,January - by the School of Medicine,Stale Universil)'of NewYorkat Buffalo,3435 Main Stnel, Buffalo,NewYork14214. Second dus postage paid at Buffalo, New York. POSTMASTER: Send address changes to THE BUFFALOPHYSICIAN, 139 Cary Hall, 343S Main Street, Buffalo, New York 14214. �wa , • doctoral al Education, chedcs work output of Lockport runner Pat Lehmann in Physiology lab test. �Running Too many distance runners train too much, too long, too slowly Y ou've seen him: natty In hi de lgner port wear cavorting through b er ad . po tu ring with macho exce in the fa hion pr ad in Gentleman· Quarterly, loping leanly along the tre ts of your neighborhood. glowing. vital. lhe picture of health. The di tance runner. Look again. advi UB phy iologi t David P nderga t. On clo er fook. the fla h and the fitne may fad . What you're likely to di cover I a middle-aged professional. hi career threatened. his marriag dissolving. hi body plagued by injurie . on the verge ofb coming anorexic. He' ob e s­ ed by. addicted to. his running. And ne·s headed for trouble. Glib a it ounds. this thumbnail sketch i applicabl to a great many di tance runner . according to r ult emerging from a five-year study conducted in connection with UB' Environmental Phy iology Lab by a team head d by Pendergast. The tudy involved approximately 800 marathon or 5-10-kilometer runners ranging in ag from pre-teen to 76-year -old. 1e ting was spread over six year . but concen­ trated on participants in the 1979 and 1980 Skylon Marathon rac . E entially. the team found marathon runn r divide rather n atly into th elit and th r t of u . And many of th r t of u quite imply. overdo il. Penderga t and hi team had v ral question th y hop d to an wer from t ts with the runner : They wanted to know how aging affect th body' car­ diova cular and metabolic y terns. Th y wanted to determin what phy lea! factor limit a p rson·s ability to deliv r energy over a long p nod of time, in oth r words. what are the flmiting factors in di tan e running. They want d to come up with a psycho ocial and injury profile of runners to determine whether their training re ults are good. bad. or Indifferent. Participant in th 1979 and 1980 Skylon ran through a erie of te ting talion in UB's p rformance lab. Runners HJled the lab morning and night. wher they w r mea ured and given feedback on their performanc . while the r sear­ cher com piled new data. Then in a ond phase oft ting. about 80 individual undertook a series of mor ophi ticat d mea ures and evaluation . Re ults indicated that phy I al activity facilitat growth and development. that p ople who are more active get larger and tronger. with more metabolic and aerobic power. Tnls finding. oT cour e. has been r ported prevlou ly. but th Penderga t tudy show d that the pro e i very peclfic to th way a per on train . Individual who do only long­ di lane running develop oxidative or aerobl power. but not anaerobic power or mu cle ma . The individual tend to or 30 p r cent higher in aerobic power than tho who train in way that also d velop anaerobic power and mu cle ma . The goals of di tance runners then, aid P nd rga t. may not o good for th ov rail development of a normal. healthy life tyle. In a coup! ofrunn r who began training anaerobically. mu cle ma w nt up. but di lance p rfor­ manc wors n d. They were unhappy about it. From the health tandpoint, this good n w /bad news yndrome eem to uggest that if young chi ldr n, for example, tak part in ju ton kind of activity. they develop that capabili­ ty and nothing els . "Th overall impact is negativ ... P ndergast notes. PHOTOGRAPHS : FRANCIS SPECKER A far a aging I concerned, the study found that grow­ ing older tal<es it toll on ver one. Even tho who "train" ar able to maintain th Ir full matur apacity only until the lat 20 and arly 30 when. a P ndergast put It. "all things decline." People who wer once active and stop. "lo e everything:· according to h re earch r. Tho who becom activ again later ( ay betw n 35 and 55) can in­ crea e their abilities to about 80 per cent of tho who kept active all along. the study found. But. ad tor port. the rate of a ing or decline. Pendergast found. is not tali tically dif­ ferent among tho e who train and tho e who don't. Everybody age . Th point that matter i the individual' ab olut lever of development. If you're higher on th fitne ale to begin with. you'll suffer th same amount of decline a omeone who do sn·t train. but you'll still enjoy a higher level of fitn than that per on. "You have to continue to be activ ... P nderga t advi e . Wh n you top. the fitne s level deteriorate and declin hows all the more. Pend rgast i currently continuing hi studie on the phy iological change which accompany aging with an ey toward d vi ing proper exerci e program for the elderly. Tho who train vigorou ly for marathon . P nderga t and hi fellow r s archer . [including Mr. Don Wll on. M . Mary Lou Wilson. M . Mary All hou e. and Ors. A. 01 zowka. P. Hogan and C. M y r ] discovered. read the sam book and train the sam way: "Much too much. too long and too low." Th training effect for di lance runners i int nsily­ r lat d. P nderga t aid. Marathon p op! train at low lev I ov r a long time: th y don't improve a mu ha th y would if they trained for short r p riod with mo re in ten ity. At low inten ily. th y go farlh r and farther. on the cla ic American assumption that mor is better. Thk the cas of lh 200-pounder who. In hi mid-30 . decide to become active. H start to walk , then finds h can run. His w ight drops, he lo body fat. he looks ter­ rific. Th amount of" troking" h r c iv sis unb li vable: it spur him on. A he keep running long r and long r distance . though. hi sy tern get into a tat of "Im­ balance." burning more energy than he take in in hi di t. H b gins to bum hi own prot in. ow hi muscle mas decrea . and though h can run fa ter, he' not improv­ ing in aerobic power: indeed, he' putting him elf in danger by catabolizing his own muscle mass. The same thing can happen with younger runners. Pendergast warn . The itua­ lion has be n called by om the "ma! anorexia" b cause the body begin to con ume its If as i th ca In that star­ vation di as which afnlct mostly younger worn n. r ubj t ut In Penderga t' tudy. ix marathon-runn back on their di lances and increas d their peed. Th y im­ proved their anaerobic performance by 20 per cent. put on mu cl ma and gain d w ight. Th tudie prove. P nd rga t aid. that long di tance running training can have negativ effi ct . if done improp r­ ly. 8 ide the p cifi impact on mu cle ma . thi kind of training, Pend rga t and hi fellow r archers found. put marathoners at risk to injury and general di a . "Many of th m." th UB physio logi t says. "simply don't fi I well." Chronic fatigue t in. I n on report on th finding of the re earchers. Dr. Eli­ zabeth Protas. an as istant profi ssor of physical th rapy. said sh and th rapi t Chri toph r Bork w re .. hocked" by the number of prior injurie r port d. About 40 per cent of participants aid th y had hurt them elv sin training durBUFFALO PHYSICIAN • 3 �man planned to complete the run in 2 hours and 30 minute when his phy iology dictated five hour . Pend rga t aid many such runners wer gratefu l to learn the goals they had et for them Iv were unreali tic. Th re are "a lot of peo­ ple rying to run in marathons who houldn't.'' he noted. "Tho e people hould be coun elect into other forms of xercise." Vo 2 BW 1 90 Ml•M ln"1 ELITE I Kg·' I 70 TRAINED ■ UNTRAINED L] / / 50 // / measure the ratio of fat to total body weight Toinaccurately the runners. researchers immersed the ubjects in a e 0 /,, / .,, .,,,,.,, / --- -- - ----- --- LBW kg 70 50 30.. _'""!!! 20!'--"! 3!'!' 0--"!'4 0!"'"-• s~o--• &•o --• 70--­ Age TOP PLATE Muimal a:i:ygenconsumption corr«t«l far body weight is platt«l as a fundian of age far all subj«t s studi«l . The dos«/ squans an train«/ malt runners, open •quans are untrain«l malt voluntttrS, open circles train«/ female runners and das«l circles an UDtrain«lfemale valUDt«n. A, an be seen, V02 / Kg increases during grawtb ud tben d«li11es during tbe agin1 praces.. It is impartut ta note tbe vi,ry bigb values reach«/ by 15-18 year aid ru11n•rsand tbat it d«nases by tbt time tbey an 20 years aid. Tbe women start lower tban men in each group, t711 in«l ud uatrlli11«l, rtsp«tivel:, . Tbt rate of decrease qf VO / Kg witb Ill• bep 11sat a.bout 30 :,ears of age and falls linear/:, witb I sim;far slope in al/ graup• te.t«l . BOTTOM PLATE The amount of body weight tbat is aat fat is platt«l as a fuadiaa of a,e . As cu beseen the values far train«/ men and aat7ain«l men inuuse, reach a peak and then decrease pro,ressinl :,. It is important to note tbat tbe clnunafic decrea,e in V01 / Kg between 15-18 years aid and 20 cu be campltlt:ly accounted far by the lar,e increase ill body wei1bt. The d«liae in V01 / Kg ahu 20 years aid is • product of bath losing muscle mass and tbe ln.a sparl capability of tbt car­ diova scular system. ing the previous thrc •month , Bork said . 11sts th marathoner went through inc luded a battery of item . An EKG·tr admlll te l. common ly u ct on heart patient to measure and compare the activity of the heart while at r st and during mild exertion. was u d tom asur the run­ ner · maximum m taboli m, or the maximum amount of energy liberated a they approached total exhaustion on the tr admill. 1readmill te t can be u ed to determine a ubject' aerobic power. Thi can be translated into a "cost-of-running value" which can be multiplied by the distanc of a run for a "total cost of running." Pendergast once ugge ted that Rosie Ru iz who claimed he ran the 1980 Bo ton Marathon in the third-fsi te t women' time in history up to that point might take a tr admilJ te t to ubstantiate her disputed feat. IL would have been more reliable than the lie-detector test th di qualified runner offered to take at the time, he said. Re ults from this kind of testing in the UB study were u ed to determine what l vels of performance in the 26.2 mile marathon. runners could r asonably expect. One young 4 • BUFFALO PHYSICIAN floatation tank in the Department of Phy iology. 'fypically. a marathon runner may have only six to seven p r cent of total body weight as fat compared to about 20 to 30 per cent body fat among males in the general population and ratio ranging from 25 to 30 pe r cent among females . The runners' muscle strength was tested in the Depart­ ment of Physical Therapy"s Kinesiology Laboratory with a CYBEX II dynamometer to measure how much force a mu cle exert aero s a joint through an entire range of motion . Runner also completed que tionnafre detailing their trainin_g habits. types of equipment they use ancf brief medical histories. These data not only help d provide in ight into th type of lnjurie mo t frequently incurred by marathon runners but also pointed out factors which may protect against injury. Participants finally underwent p ycho logical profiling conducted by Dr. Diane DeBacy. as ociate professor of physical education, to det rm ine their motivation. Personn I from Social and Preventive Medicine were in­ volved in the te ting program along with individuals from Phy iology, Physical Educallon. and Physical Therapy. The researchers id ntifi d three major groups of distance runn rs. First. are th highly competitive. in ten . elite. true athletes. The e are th individuals who in the testing gave lie to the concept of th "wall of pain," the infamou psycho logical barrier said to cau e marathoners to "crumb! " and lose their r solve. The so-called wall is probably a I gacy of ill­ prepar d contestants, P ndergast said. 'The real runne rs n v r fe I it." Th n come the "fun runners" who gel a kick out of the sport. train moderate ly and ar concerned about health and enjoyment. Finally. there's the larger group of average people who increase their training too rapidly and fail to develop the pro· per skeletal-muscular s u pport system. These people, said Pendergast. "aren't running for themselves. but are driven by the external reward which ociety offers" for their ac­ compli hments: the prais . the stroking. the celebration of the running lifestyle . Many ofth individuals have negative psychological and physical profiles. T heir injury rate is ten times higher than th "r al athletes" group: lhey'r especial­ ly prone to orthop die injury: and they increase th ir mileage oo fast. For a while. th reinforcement propel them to great rand greater achievement. but after a point, their abil ­ ity falls off. They run the same time this race as the last: perha ps the time is worse. Feedback becomes increa ing ly n gative . The thrill ls go o . They go bac k to th Ir old habits of probably not training at a ll. he p yc~o /so ial information gat1;1edIn the stu dy, Pender ­ T gast sa id, hows that runne rs m this category are so p ycho loglcally "addicted" to the spo rt that their jobs and home lives oflen suffer. Many are profes ional men who can let their job performance slide for a while. but their divorce rate is high. "We've documented this. although with limited numb rs." Pendergast aid. Cou ld the addiction be even "physical," given recent fin­ dings about "endorphin ," narcotic-li ke chemical substanc s produced by the brain_ in ~espon e to exerci e? Penderga t no_tes~hat a jump to this ~m d of conclu ion isn't on any nrm scientific gro u nd . T~e exis tence of endorphins, be notes. has been demon trated m everal st udies over the pa t five years bu_t two re~ent researc h projects have failed to verify the!; ex istence: T~ey undo u bted!~ exist." Pendergast said, "but the _question 1 how Il_l_uch you d need to exercise to have the brain produce them. Exercise. h said, is a powerful p ychological r I ase for �It's important to be active, but it's also important not to overdo it. (At left) UB swimmer Jeff Dunbar is dunked in Pliysiology pool in order lo measurehis percentageof body fat. (Above) RunnerPat lalimann pushes lo Jiis limit on the treadmillas Dave Eustace,internin the En­ vironmental Physiology Lab, adjusts mouthpiece on breathingapparatusused to measuremetabolicoutput. most runners. Many run because they have non-reli vable anxieti s. They may be bothered by life in general but when they're running, they·r away from all that. Alone and strain­ ing against only themselv s. they can et goals and m asurably achieve them. Th succes i swe t. If endor­ phin are there, they suppre anxiety. But with th sweetness also come h bitt r. If th com­ pulsive runner doesn't run one day, Penderga noted, he or she gets nervous; after three days. he may verge on the psychotic. "It's important to run and b activ :· Pender~a t. who is him elf a shorter distance runner. note . "But it not im­ portant to run beyond 40-60 minutes a day. three or four tim s a week.'' After that point, the average person runs a real risk of permanent damag . Most p opl who push them elves this way ar going to quit anyhow. the physiologist notes, "so th y gain no long-term advantage and they run the risk of sustaining an injury that could stay with th m for ver" - a twisted ankle, strained knee. pulled t n­ dons. hip problems, and shin splints. Penderga t. whose re earch cent rs on exerci e physiology. has also conducted studies on wimmers. skiers. oar men. and softball players. Th Buffalo Sabre , Buffalo Stallion , and Buffalo Bills teams hav undergone fitnes assessment in the U exerci e lab under his dir ction and he has headed teams which have put the Sabr through ext n iv phy ical testing. A member ol the UB !acuity lor over a decade. he holds a doctorate from UB, a mast r' from Pittsburgh, and did his undergraduate work at Bro kport Slate. "The average American," he ha observed. is" o decon­ ditioned he can just survive and nothing ls :· Fitness. Pendergast said: includes flexibility, anaerobic capacity. strength. endurance. and cardio-vascular condi­ tioning. "Certain minimal levels can b achiev d and main­ tained by everyone. regardless of age or present unfitncs ." But, moderation has to be part of the program b cau e sticking with it is th key. "You have to do the e exercises for your entire life span." • BUFFALOPHYSICIAN • 5 �By MARYBETHSPINA Veterans Study challenges myths about stress disorders D etails of a new study challenging ome of the popular myths surrounding the cfi velopment of tress disorders in veterans of the Vietnam War have been released by UB researchers. P ychologist Dr. orman Solkoff of the Medical School's Department of Psychiatry and Philip Gray. a sociology graduate student and Vietnam v teran. said their preliminary finding on a sample of 35 veteran indicat that closeness to combat and death and incidence of pel' onal injury app ar to be ignificanl factors in the dcv lopment of po t traumatic stress disorder amon~ the men. Other important factors were type of duty. branch of ser­ vice and participation in either direct or indirect killing. The preliminary Ludy of th 35 v t ran . 15 of whom wcr diagnosed as suffering from the tres disorder. i part of a continuing study of 100 Vietnam veterans in the Buf­ falo area being conducted by Solkoff. All tho in the tudy w re enlisted m n who shared similar socio-economic statu and family background prior to induction. The current age of tho e in the sample rages from 30 to 43. While the res archers found that presence of po t traumatic tre s di order did not appear to affect marital status. they did find a link bet ween current level of employ­ ment and the disorder. "Approximately 72 per cent of tho e veteran who did not have the di order were currently employed. compared to only 28 per c nt of the diagnosed group," Solkoff said, "even though their levels of education were about th ame. When pre-war and current occupational status were com­ pared, the non-slre s syndrome group had improved their level of employment igniflcantly more so than had the trc s sufferers in the dozen years since di charge from the rvice." V terans who served in the Marines w r likelier Lo uf­ fer from post traumatic stres yndrome. de pile the higher number of enlisted men in the Army. Solkoffadded. Tho e who erv d as foot-soldiers. or "grunt ." were more likely to u!Ter the di order than tho e who saw duty as cooks or radio operator . But th type of duty, in its If. did not appear to be a ignificant factor since the percentage of foot-soldier wa evenly split b tween the 15 in th Lres group and the 20 in the non-stres group within the ample . Solkoff said. ho e who were per onally close to death through rocket Tattack . b Ing shot at or b ing in area mined or booby trapped had a higher incidence of tr s disorder. as did those who experienced per onal injury or death of friend on the battlefield. In addition. 68 per cent of the disorder group aid they had direclly or indirectly killed during their tour of duly compar d to only 31 p r cent of the non-stres group. Discu ing war experience and the typ of wefcome the v tcrans received upon their return home did not eem to affect occurr nee of the di order. contrary to popular belief. the US re earcher conclude. A unique finding, they add. i that tho e who had negative atlitude toward education prior to induction w r more lik ly to suffer from the stre s syndrome. "The phra e ·my country right or wrong· appeared to fit the majority oflhose in both groups prior lo induction," Gray aid. "Only two had an galiv attitude about the war al that time and orlly three thought the U.S. involvement was wrong. Interestingly, these latter indiv idual were in the non-stress group. ··1t should al o be noted that tho who enli ted in the s rvice were much more likely to have d v lop d the disorder than those who wer draft d," Sol koff said. "but of those who 6 • BUFFALOPHYSICIAN enli ted 15 per nl did so as an alternative to a jail sentence for a previous offen e." The researcher also looked at the so ldier · drug use. "While 23 of the 35 veteran aid they used drugs primarily marijuana - while in Viet am. only eight of this group were in the stre s group." Solkoff point d out. Criteria for diagno i of post traumatic stress disorder includ sleep disorders. nightmares about war-r lated ex­ perience . anxiety. memory impairment. guilt and lowered threshold of stimulation. "In the pa t. tho e who could not recover from wartime xpcricnc wer said lo be uffering from a tran i nt itua­ tion disturbance," the US p ychologist explained. But inc 1981. the American Psychiatric Association has ct criteria for th disorder. defining it as a syndrome follow­ ing a psychologically traumatic event generally outside the range of u ual human experience. Events which may play a role include natural disaster . accidents. torlur . man­ made di asters or military combat. "Hopefully. tudie like thi one ongoing in coop ration with out-patients at the Buffalo VA Medical Center and veterans in the community will provide more insight into th extent of post traumatic stress di ord r. a well a it cau s," Solkoff said. S olkoffsaid th tudy, conduct din conjunction with Ors. Stuart Keill and Israel Alvarez at the VA M dical Center. includes 100 Vietnam veterans who shared similar combat xp rience . Half the group wer diagnosed as having th syndrome. and half xhibit d no identifiable symptoms. While much of th professional literatur deal with veterans suffering from the syndrome, never have differ nee be n examined among those who. despite similar ex­ periences. do not have it. he said. Solkoff noted a imilar post traumatic stress syndrome ha been identified among urvivors of Hitler's death camp . But again. he said. no one has ever looked to tho e who did _not suf~er from ~he syndrom to identify differences in their early hfe xpenences. personality traits or environ men- ... �Doctor's Orders: many don't comply T Prof. Solkoff (ins11l) and scen11 from com­ bat action Vi11taam . taJ episodes in which trigger the syndrome years after the {ul v nt have pa d. While tre associat d with traumatic experience can • not be aid to be de irable. Solkoff not d that for om p o­ ple. survivin~ the situation can b an nhancing xp ri nc . ··Ju t as th rear tho who deliberat Iy choo e occupa­ tion or hobbie which ar life-threatening and b com cx­ hilarated ea h time th y 'win: ther ar oth rs for whom ur­ viving tre ful experiences akin to death makes them feel more powerful," he explains. But for the majority ofthos who ulli r from xperiences in combat. pri on camps. or abu at the hands of an alcoholic mate. the exp ri nee r main powerful hackle - always sitting in th background of the mind. waiting for th appropriat timulus to call for h attendant emotional prob! ms when the situation i past. He pr diet that g n ralizations may al o b drawn from the veteran tudy of factors whi h influ nee how people generally d al with tressful iluation . "Victim of mugging or urvivors of airplan era h may al o exp ri nc post traumatic tr yndrome despite the relative briefne of their tre ful experiences." he pointed out. ln tudie con rning survivor of th d ath camp . it ha b en found that tho who w nt to I rael experienc d fewer problem than did tho e who went to other countries for re ttl ment after the war. ·· o doubt w may find that the way the veteran w r tr ated by their famili . friend and the public in general when th y arne horn ha som impact upon th Incidence of po t traumatic tre s syndrom :· Dr. Solkoff beli ve . Dr. Solkoff alt nded la t y ar' International Conference on the Holocaust and G no ide held in Tel Aviv and found that ome urvlvor ~ It their xp rience w re uniqu . that no on else had urviv d a ituation a terrible a their . Dr. Solkoff ay . ··w may find that om of the Vietnam vet ran . lik some Holocaust survivors. feel their situation were uniqu . that no one el ha experienced what they hav xp ri ne­ ed during combat or afterward." h add d. • stre wo UB r ear h rs hav identifi d four factors which contribute Loone of the nation' mo t wid - pread. expensive health prob! m : patients' failur to com­ ply with doctor's order . "A great d al of mon y pent on office call . trip to the mergency room. medication. ho pitalization and ophi ticated tests goes down the drain ea h year b cau the patient Ii ten to th physician' advi and then refu e to coop rate in the treatment r commend d." say Dr. Ray­ mond Bi onette, a ociate profe or of family m di inc. While frequently patients don't cooperat because th y don't hear what their physician say or fail to understand why certain treatments are recommended. ther ar many who hear and understand and till fail to comply. " on-compliance appears to b an even greater problem when changes in behavior or lifestyle which require the pa­ tient's cooperation ar part of the pr scribed treatment." Bis onette. a sociologi t. notes. It has been estimated that 20%-70% of all patients choo not to follow the prof, ssional advice of their physicians. '"Because non-compliance is a major health problem. there have been many tudies devoted to trying to identify the ·whys,'" Bissonette continues . Studi which fo used on education and per onality trait of patient and th nalur of their illnesses had inconsistent results with no sing! uait or group of factors appearing to be major contributors to the probl m. But a study by Bissonette and Dr. Robert Seller, UB pro­ fessor of family medicine. suggests four belief y tern ar prevalent in American society today which are major con­ tributors to he problem. They furth r suggest everal strategies which, if u d. may increas patient compliance. The four factors at work ar : erosion of the patient"s elf­ determinalion: cultural encoura~ement of elf-gratification: the labeling of prob! ms like cfrug addition, ob ily and alcoholism a "illne s." and th "ambulance is coming" syndrome. "Erosion of self-determination is one of th powerful cultural theme we identified a a major factor in the non­ compliance,'' Bi one te say . Recent generation , he not s. have grown up in an intellectual atmo phere which tends to plac r sponsibility for behavior outside the individual. Th e day , the idea of self-ct termination Is an alien thought It's one of our costliest health problems to many who believ they have littl or no control over what happen to them. "Changes in soci ty and th economy have been pow r­ ful re-inforcer of thi b lief ven to tho e of a gene ration which basically believed they had some control over their live ," he adds . he long-term employ c who is sudd nly terminated Tbecause of the economy i not likely to be convinced he or he has some control over wh ther they can p revent hav­ ing a h art attack In the futur . This ero ion of If­ determination is likely to increa e feelings that going on a diet or walking a mile a day will do little or no good any way. "Ther l also th growing cultural ncouragement to self ­ gratification r fleet d in self-actualization which I ad to dimini hing elf-re traint. elf-di cipline and se lf-d n ial," Bissonette point out. The obese pati nt who indulg s in calorie-lad n foods is • Continu d on pag 29 BUFFALOPHYSICIAN • 7 �Early advtr1j1ing or bill­ po1ti ng companies painted ads on barns, ftncts, and rocks.PitIU's ads wen no uception and also apptarttl in 4,000 newspaptu From San Francisco to New lork. . . ra~, . 8 • BUFFALOPHYSICIAN 0 Lr - -~\ ·a ,• '"' i-. j -l r -~ -·- r, . i.. ... S'..lra ·- • �.. By LUELLA S. ALLEN Golden Discoverer 'Eclectic' doctor's career spanned era of enormous medical change R ay Vaughn Pierce. M.D .. arriv d unnoticed in Buf­ falo in 1866 with his youn wife and child. a diploma from the Eclectic Me~ical Institute of Cin­ cinnati, and a bottle of tonic mixed to his order by a friendly pharmacist: "The Golden Medical Discovery." When he died in 1914 on his private island off the coast of Florida (where he raised exotic tame deer as a hobby), he left Buffalonians memories of a vivid career that included a patent medjcine dynasty that rivaled Lydia Plnkham's, terms in the New York Senate and the United States House of Representatives, speculative adventures in gold and coal mining. Pierce's Palace - Buffalo's first lux­ ury hotel, and a book - The People's Common Sense Medical Aduiser in Plain English: or Medicine Simplified which ran 100 editions. selling more than four million copies between 1875 and 1935. It might be expected that examination of three editions of the Acfuiser (1875. 1895. and 1935) would reflect and il­ lustrate the course of medical progress during this 60-year period. To be sure. there are many differences between edi­ tions. but Pierce was an astute businessman and would not lightly tamper with a formula of proven effectiveness. The Advise r. like the Golden Medical Discovery itself, remained basically a product of the time of its inception. 1875. That both the Adviser and the Discovery continued to sell until 1935 says as much about changing American medicine as it does about the unchanging frailties, fears, and curioslti of many of us. Pierce had a keen sense of his audience which dictates the revisions (and Jack of them) in successive edilions . He was a master strategist and, as he was to prove In his many courtroom battles, an expert at stealing his enemy's fire. He was also clever with Ms pen and quick to both use and abuse the power of the press. Many small newspapers at this time (1870-90) were dependent on the revenue from patent med icine advertising. Pierce was an early and effective u er of the advertising medium. Pierce used his literary, per­ suasive, and medical talents in creating the Adviser: the medium th rough which he dosed his readers with tincture of bas ic science, decoctions of basic hygiene, drachims of sexual titilation. and liberal spoonfuls of quotes from the classics. He also used the Aduiser to attack his detractors (The Buffalo Medical and Surgical Society) when it suited his purpose. Pie rce was born in 1840. In the autumn of 1864 he Rentered the Eclectic Medical Institute at Cincinnati, Ohio. .V. which had been founded by Wooster Beach. Following a five­ month course of study he graduated in February, 1865. The speaker at his commencement was J.M. Scudder, the ln­ stitute's professor of pathology and editor of the Eclectic Medi.ca l Journal. Scudder advised graduates to make a business of their profession. advice which Pierce took to heart. Pierce set up practice in Hydetown. Pennsylvania, as a specialist in "private" and female disease . but when the Titusville oil discovery turned that village into a boomtown, Pierce quickly relocated acquiring enroute a mythical degree from Philadelphia University oTMedicine and Surgery which he used in his newspaper advertising. He began distributing a free pamphlet. The Medical Ga2ette. which he wrote for the layman. In 1866 he sold his first botUe of The Golden Medical Discovery and left Titusville for Buffalo. ready for "city -practice ... By 1874 he had moved his office to Main Street, opened The World's Dispensary where the tonic was mixed and bottled, and was already out-nanking his imitators by plac­ ing nationwide ads In Harpers Weekly. claiming that Ger­ man chemists were baffled in their attempts to analyze the tru ingredients of the Discovery. In 1871. he published a pamphlet on Chronic DiSeases of the Generatiue and Urinary Organs and offered, for 1.00, to cure masturbation and venereal diseas by correspondence. The first edition of the AduiSer was published in 1875. On year later he began building Pierce's Invalids' Hotel. later known as Pierce's Palace. (Hospitals in the 1870's stiJI had a decld d social stigma). It was the first luxury hotel in Buffalo and no expen e was spar d. Designed in French Renaissance style by Buffalo architect Richard A. Waite. the hotel was located in what was then the midst of the city's park system. It stood on a 234 foot lot fronting on Prospect Av nu and running 332 feet deep to Fargo Avenue - an area now oc­ cupied by D'Youvllle College. The 250 rooms had fireplaces. 15 foot ceilings, Brussels carpets, esp cially designed fur­ niture. air shaJts and windows. a billiard room. gymnasium, bowling alley. tiled murals. the first elevator in Buffalo and one of the first telephones. When it opened in April. 1878, all of Buffalo and 200 members of th pr ss were invited. An orchestra played selections from Rossini. Schubert. and Verdi during the banquet. Local doctors may have scoffed at m dical "advertisers," but local businessmen took Pierce to their bosoms. He was invited to join the Buffalo Club and asked to run for the State Senate against a New York Clinton. Despite attacks by lhe Democratic press based on a charge of distributing lewd literature (the tract on Chronic Diseases ... ), Pierce beat Clinton and went to the state Senate - hailed as the "Golden Discovery of the Republican Party.'· Following a brief term of office in the 46th Congress. Pierce re igned in 1880 because of ilJness . The Palace burned in 1881, an event commemorated on a locally di tributed magic lantern stereopticon slide. Despit the fact Pierce was able to show he had suffered financial losses due to the fire. he had only recently taken out a large fire insurance policy and there was unproven speculation of fraud. A new Invalids' Hotel. on a more modest scale. was built that same year on Main Street near the Dispensary. For many years Pierce was an active officer in the Association of Manufacturers and Dealers in Proprietary Articles of the United States. where he successfully fought legis lation lhat would force manufacturers to list the ingredients of their wares. Pierce's later years were marked by many characteristic court battles and many uncharacteristically poor busine ventures. His Investments in gold minin,E!and steam engine manufacture were trtkingly unsuccessful. His last great court case was a victory that turned sour. In May. 1904. the editor of the Ladtes Home Journal. in an editorial entitled "The Patent Medicine Curse," listed the supposed ingredients of Dr. Pi rce·s Favorite Pr scrlption. claiming it contained among other things, opium and alcohol. The World's Dispensary filed a $200,000 libel suit and eventually was awarded damages of $16 .000 because. although lhe still popular Prescription may at one Lime have actually contain­ ed these substances, no dusty bottle could be found to substantiate the claims of the Journal editor. But the damage had been done. In 1904 sales fell from $193,000 to $78:000 and in 1905 Pierce actually lost $38,000. By June 1906 the first Federal Food and Drug Act went into effect. reforming patent medicine advertising . BUFFALO PHYSIClAN • 9 �(This page, from left) Plunge bath, Invalids' and Tourists' i Hate/; Turkisb bath cooling- , room. (Opposite page) Dr. Pierce and exterior view al ' Pierce'sPalace,built in 1878. 1 Shortly th r after a change in the leadership of the American Medical A ociatlon brought into being that organization's Council on Phannacy and Chemistry to in­ vestigate and evaluate patent medicines. (Previous AMA leaders had interests of their own in the patent medicln business). Perhaps sensing that his style and aptitudes wer better suited to the flamboyant era which was now drawing to a close. Pierce retir d from public and professional life. He spent his last years on his island, shoaling the alligators that attacked his pet deer. When he died of cerebral hemor­ rhage in 1914, his body was returned to Buffalo for burial in Fore t Lawn Cemetery. His stately mau oleum now overlooks Scajaquada Parkway. H istorically Pierce's career covered a period in American medicine that included enormous apparent changes in both theory and practice. Why was it that the Adviser. writ­ ten in 1875, was sti11 popular at the turn of the century? It is even more surprising that It continued lo sell until 1935. lwo million copies were sold between 1875 and 1895. lwo million more sold b tween 1895 and 1935. an indicalion of declining ales. but respectable figures nonetheless. What follows is a casual examination and comparison of three representative editions of the Adviser. which might b labeld "early." "middle," and ··1ate." In theory and training Pierce was an Eclectic. As their name implies, the Eclectics believed in selecting the best a pects of various medical systems. Unlike the Thomson­ ians. to whom they owed a theoretical debt. the Eclectics were organized professionally and had a school. Pierce followed this school in that he adopted variou aspects of medical theory and practice. His approach is evident in the Commonsense Medical Adviser. a discursive patchwork of qua i- cience, romantic id alism. and commonsen e - betudded with quotes from the classics. The tone of the writing in all three editions is unvary­ ing. Pierce has been "induced to prepare and publish an ex ­ tensive di sertation on Physiology. Hygiene. DI eases and Domestic Remedies ... pre ented in a style which cannot offend the most fastidiou and with studied avoidance of all language that can possibly displease the chaste ... " While medicine i not exactly "simplified" (it would be a stalwart reader who managed to plow through Pierce·s lengthy explanation of the lymphatic system). it is forever a subject of delight and awe. " o language," says Pierce. "can adequately describe the beauty 01 the circulatory system." Or in conclusion to his description of the brain: "Reason only attains its highest development in man, in whom it passes the bound of ordinary existence. and with the magic wand of love, reaches outward to the vast unknown, li(ting him above corporeal b in~. into an at­ mosphere of spiritual and divine Truth. · The long pa sages on Conjugal Love and Marriage. heavy with quota­ tions from Longfellow and Swedenborg, caution that "he who cannot refrain from furious sexual excitement is in no proper condition to propagate his species." Pierce was ap­ parently well aware of his readers' curio ity about sexual!10 • BUFFALO PHYSICIAN ty and d voted long passages to its discussion. (All three edi­ tions fall open naturally, aJter long years of use, lo these sec­ tions). By 1935. however. the chapter on Love and Marriage ha been shorten d and the chapter on Spermatorrho a (Masturbation) has been expanded. It is this sort of change. from edi ion to edition. that tands out more forcibly than the fact that the 1935 edition correcUy identifies the thyroid gland. whose function wa "unknown" in 1875 or 1895. There are some obvious differences among editions. In the first. the author still capitalizes all nouns and numbers ach paragraph. There are. of course, no references to the Invalids' Hotel, which had not yet been built. but Pierce refers to his staff of physicians and surgeons at the World's Di pensary (all "Sp cialists"). The chapters on Cerebral Physiology and Volilive 'Iempera.ment (phrenology and modified humoralism) are xtensive and herbal decoction are given a prominent po iUon in the opening chapter . Pierce's early infatuation with anything mechanical is evi­ dent. He promises that all correspondence will be answered on the type-writing machine "operated as fast as a person can think." This first edition also offered to analyze photographs of engaged couples to determine. by phrenology. the likelihood of marital success or failure. Byment1895hadthe ections on Phrenology and Human lempera­ been somewhat reduc d and the offer to analyze photographs is withdrawn. The herbal remedies are less prominently presented. Passing reference to Darwin. "th idea of natural evolution," is made - but in such a manner as to offend no one - "all proclaim Divine Power.·· The chapter on the process of digestion receives expansion, and the use of anti-toxin for Dipntheria is men­ tioned. but on the whole the greatest changes concern the new facilities available at the lnvalids' Hotel and the inclu­ sion of hundreds of testimonials. accompanied by photographs. of the relieved and recovered guests. In all edi­ tions it is discovered. at the end of disease cfescriptions. that medicines manufactured at the World's Dispensary wiJJ relieve most problems. Once the Invalids' Hotel is open. surgical procedures are also urged. Although Pierce rails against idleness - "People ... coddle themselves instead of practicing self-denial and ap­ pear to think the chief end of life is gratification.. - he wa at this lime planning the Palace where the same peo­ ple would be enjoined to visit the hotel where" teaks, eggs. and oysters are provided in abundance," and the Institution would endeavor to provide "amusements for all. recogniz· ing the great importance of pleasant occupation of the mind... The hotel also offered the very latest in mechanical therapies. "The Mechanical Aids in the Treat­ ment of Chronic Diseases" include such devices as "The Rotary Kneader" and various "'Manipulators" and "Oscilators." Most of the e were powered manually or by t am. Pierce repeatedly gives a spirited defen e of pro­ prietary medicine and medical advertising, perhap in reply to edito_rials In th Buffalo Medical and Surgical Pierce includes an editorial of his own. Journal. �"Quackery Rampant" in lhe Adviser. neatly aligning himself with the respectable representatives of profe sionafl m who were properly shocked by those who would flood the coun­ try "with cheap circulars." V. Mott Pierce, M.D., Ray Vaughn 's son, revised and edited the 1935 edition. Although V. Mott had benefitted academically and socially from his father's rise in the world (he attended Harvard where he was elected to the Hasty Pud­ ding Club). he was wise enough to avoid lampering with a proven product. o great attention i drawn to the fact that the Adviser has been revised by V. Mott, whose signature beneath hi photograph in the frontispiece is very 1ike his father's . Many of the engraved illustrations have been replac­ ed by photographs and a section on emergency first aid has been inserted as the first chapter . There is evidence of fur­ ther scientific advance . Phrenology is now dismis ed as a "pretension to science," the Dick Tust and Schick Tust are described. and an interesting array of electrical aids to health have been added to the facilities of the Invalids' Hotel. Most involve water and positive and negative polarities and all have impressive names: Galvanic and Faradic current machines, Cataphoresis , Franklinization. and High­ frequency and Sinusoidal treatments. From a standpoint of safety. to say nothing of "Common Sen e" the deleted material on phrenology might have been less harmful. There is also for the fir t time a lengthy chapter on the care of the new mother and baby. The testimonials are updated ex­ cept for tho in the chapter on Spermatorrhoea or Diseases of Men (perhaps because. for privacy's sake. no photographs had ever accompanied the letters from these patients and therefore there was no need to update the testimonials) . Other matters remain essentially - and perhaps comforting­ ly - the same . Old disea e names are retained alongside new ones: Quinsy (Tonsillitis). Remittent Fever (Bilious Fever); herbal recipes are still given (although moved to the back of the book); the chapter on Marriage is still awash with quotes from the Romantic poets; staff physician at the Hotel will still analyze urine sent by mail (carefully d tailed mail­ ing instructions on page 409). I n short. the many Americans who purcha ed the 100th edition of the Adviser would not be disappointed. They would find that the ame muddled and interesting sexual myths and taboos were operating in 1935 a had in 1875. that the complexitle of the gastrointestinal system and the brain were changed omewhat but were still very complex. and that th re were still a large number of diseases that could not be cured by vaccines but that the Golden Medical Discovery could cure nearly anything if the sufferer were only patient enough . While leafing through their Advisers, their eye would be caught here ana there by stirring scrap of poetry or confusing quotations from Spencer. which sure­ ly howed the book was a product of respectable cholarship . By 1935 the Adviser was a medical anachronism. but the continued sales indicate a continued need for what it offered - the illusion that in an increasingly complex and confu ing world of medicine there was sti11a possibility for retain­ ing some measure of responsibility for one's own health . Much of the Common Sense advice offered by Pierce was good - or certainly better than, for instance, the advice of those physicians who recommended castration as a cure for masturbation when Pierce opted for pure thoughts. outdoor exercise. and the Discov ry. Pierce is often reminiscent of Sylvester Graham when prescribing diet and exercise. and he was an early advocate of ventilation in factories and schoolrooms . He also urged that girls be allowed to run and climb like their brothers. "If you hear them say. 'She's a li~~leromp .' depend upon it. she is a bright. energetic girl Like many of the popular publication found in bookstores and library collections today. book on holistic health, natural diet. consumer health information. physical fitness. and Alex Comfort's " ... Joys." the Adviser provid ­ ed some r al help as well as meeting a need unmet by the medical profession - the need for everyman to be his own phy iclan. One generation turned to the Adviser in reaction to being purged, bled. and blistered; another turns to cur­ rent seff-help literature in r action to reports of exces ive surgery and X-rays. fear of unproven drug therapies. and overwhelming medical costs . In such situations a Common Sense Advi er (who may not alway be entirely common en­ sical) find a way to the bookshelf. • Luella S. Allen is sw ior assistant librarian and ha d, Media Resources Center, Health Sciences Library, UB. Refen nces and bibliography for this arlicle available upon request. The Common Sense Adviser was like today's holistic health and natural diet books PHOTOS: COURTESY ERIE COUNTY HISTORICAL SOCIETY BUFFALOPHYSICIAN • 11 �Architect'ssketch of new addition to the originalLockwood Library now under construction. Tbe completed structure will house llJI upuded Healtb Sciences Library. Health Library It's one of the most heavily used in the U.S. W hen Buffalo area physicians need rapid r trievaJ of information to det rmine the b t course of medical tr atment for a patient, they rely on UB' HeaJth Sciences Library. one of the most heavily u ed research libraries in the country. This ""information laboratory" provides n ded rvices to mor than 13.000 phy icians. cienti ts and health care profe ionaJ affiliated with over 100 inslitulions in an eight­ county area. La t year alone. the UB library re ponded to mor than 34.000 reference inquiries. performed over 6.500 computerized bibliographic searches and handled 20.000 interlibrary loans. In addition. its growing Media Resources Cent r circulated mor than 18,000 audiovi ual items. Several factors contribute to th incr asingly heavy use of the Health Sciences Library (HSL). Fir l. it serves faculty and staff in aJl UB HeaJth Science disciplines. which include 52 a ademic departments forming the most comprehensive h aJth science unit in the SU Y system. Also. the HSL is the only major biomedicaJ resource library in Western ew York, ervlng since 1974 as a health area library of the R gional Medical Library Program. a nationaJ medical in­ formation network. To rvice it user fully, the HSL has access to various data ba es through Bibliographic R trievaJ Servic s. Inc .. and the alionaJ Library of Medicine. The e include: .,.- MED LINE: citations from 3.000 biomedicaJ journal accessed through time- haring data systems by approx­ imately 400 major heaJlh sciences libraries and inslitutions: ,,., TOXLINE: 350,000 r ference and abstracts in the tox­ icology and pharmacology fields; ,,., CANCERL INE : a alionaJ Cancer In titute ( Cl) data ba containing 40.000 abstracts in cancer research: ,,., CANCERPROJ: another Cl data ba e composed of summaries of ongoing cancer re earch: .,.-CATLIN E: bibliographic data for all monographs. erials and technicaJ reports cataJogued at the ationaJ Library of Medicine sine 1965: .,.- S ER LIN E: information about 6,500 biom dlcaJ seriaJ titles. Including locator Information from 100 participating libraries: ,,., AVL INE: information on peer-reviewed and r com­ mended audio-vi ual instruction materiaJs in the heaJth sciences: .,.-EPILEPSY: citation and ab tract relaling to epil p­ y in Exerpta Medica: ,,., CHEMLINE : an interactive chemicaJ dictionary con­ taining information on 60,000 chemical sub lance : ,,., BACKFILE : includes data bas s prior to the last two years covered by MEDLINE , and .,.-MESH VOCABULARY FILE: bibliographic and ind x12 • BUFFALO PHYSICIAN ing information for aJI seriaJs indexed by MEDLARS . The HSL r c ntly reached an agreement with eight libraries in ho pitaJs affiliated with UB to formaJize efforts at strengthening and sharing collective r sources and ser­ vices, wnich will help participants provide a wider spectrum of heaJth-related information to their professionals and tudents. At present. many physicians and staff members at these participating inslitulions hold faculty appointments at UB, particularly in the Medical School. Participating hospitaJs in the library consortium are Buf­ falo General Ho pitaJ, Children·s Hospital. Erie County M dicaJ Center, Millard Fillmore HospitaJ, Mercy Hospital. Sisters of Charity Hospital. the Veteran Administration MedicaJ Center and the Research In titute on Alcoholism. As part of its commitment to ervice hospitaJs in outly­ ing areas. the HSL and other state libraries lobbied for and recently succeeded in getting - legislation adopted which will provide $59,000 lo 17 rural hospitaJ libraries in six counties for th development and improvement of other collections and to HSL for extension of needed services to them during the year. • New home planned aking held In early April for a project which Groundbr will re ult in a new home for the Health Sciences Library wa and a new Biomedical Information Center. Estimated com­ pletion date is March 1985. Designed by the archilecturaJ firm of Scaffidi and Moore of Buffalo, this project caJls for refurbishing the old Lockwood Library at Ma.in Street and constructing a 60,000 squar · foot addition to the ea t. The basement of the addition will house audio-visuaJ materlaJs and equipment and the first and second floors. reader stations and tacks. The hand omely-paneled, high -ceilinged ortginaJ Lockwood reading room with its ornate fireplace, multi- tory windows and chandeliers will be restored to its original integrity (the latter day low-hung fluore cent lighting fixture will be r moved). The second and third floors of the present struc­ ture [around th p riphery of the main reading room) will be converted into a modern EducationaJ Communications Center with studios and darkrooms. A new service road will be created off Diefendorf Loop. providing access to a smaJI handicapped parking area to b added on the outh side of th complex. The exterior of the addition will be either limestone or pre-cast concrete to match the originaJ struc­ ture. The main entryway lo the new library will face Diefen­ dorf Loop. • �Farhi's project will ride Life Sciences Space Shuttle A UB r earch proje l will b on board th 1985 Life Sciences Spare Shultl . Arvin /Cal pan Advanc d 1cchnology C nt r of Buffalo has be n awa rd d a 1.9 million contract to develop and con tru t equipment to be u ed in th project which ph iologi t Leon E. Farhi is headin_g lo study e1li cts of counterbalanc d gravity on the output ollhe human h art. Four "flying cienti l ·· to b ho en this year by ASA will a i tin the proj ct. one of25 nationally I ted to b aboard the Shutll . Farhi note that r ult from hi re earch may explain why many astronauts exp ri nc dizziness upon r -entry into the Earth's atmosphere. "We believe that O Gravity (gravity lo which the a tronauts ar subjected in pace) causes their blood to flow and circulate more quickly and asily. Wh n they sudd n­ ly r turn to th Earth' gravity of 1. th ir hear mu t ·re learn' quickly to pump the blood again t th incr a ed pre ur ," Farhi explain . While aboard th Shuttle. th ••flying i nti t ·· from ASA wiJI have their cardiac output mea ured u ing Farhi' device - both while at r t and while pedaling a bicy le at moderate and fast p ed . On a r gularly scheduled ba i . they will br ath into the device for 10-15 s cond while resting or exercising. Carbon dioxide will be mea ur>d at the mouth using a ma pectrometer which will feed the results into a computer. In ence. the r breathing devic i a ma k-like device worn over the fac which enable subject to breathe into an attached bag. Th y then rebreathe the sam air ov rand over durin th cours of the experiment. First. Farhi says. thcr is dilution of carbon dioxid in the lung by th air in Dr. Farhi in his Shuman Hall BY MARYBETHSPINA he rebrcathing bag. followed by a gradual rise a carbon dioxide eliminated by the blood pa ing through th lung begin to accumulat . Th analy i tak into account the tim r quired lo r tore the carbon dioxid level to value r orded prior to "rcbreathing" into th d vi . Al noted i th rat of ri e of the carbon dioxide level in the la l fi w ond of the man uv r. Farhi will compar r ult obtain d in orbit with tho e obtained from th ubj cl prior to and after th ir orbital mi ion. Hi method. Farhi not . u ing th n w r breathing d vice. ha b n validated by comparing it r ult with tho obtained imullan ou ly by an indep nd nt. accept d m thod of mea uring cardiac output on ubject at re t and while exerci ing. Unlik tho c other method , though. h point out. hi doe not require blood amp! from tne ubj ct . injection or inhalation of tra r . major change in art rial blood ox­ ygen or carbon dioxide I v l or xpen iv analytical equipm nt. I n addition to th device' valu to the i ntific proj t. It ha implication for pali nt on Earth. too. "With r finement. it could b u ed In th future to evaluat many cardiac pat! nt at less cost and di comfort." Dr. Farhi beli ve . Other measur m nts of the "flying cl ntists" lob made in onjun tion with the UB project while in orbit will b of blood amount in the lung and of th subj t · ability to x rcis at O Gravity. "Inclusion of our proj ct on the Shut­ tle Ives u a unique opportunity to mak mea ur m nt on cardiac output which would be diffi ult for u to do othcr­ wi - e en in a simulat d ttin :· Farhi not . Prior to the 1985 Shuttl launch. the four "flying i nlab. ti " to b aboard isling in th ci ntific project will vi il ffi the horn it of lh 25 researcher . Farhi b li v s thev will ~ vi it UB the latt r part of 1983 to further tudy th equip· ~ m nt which they will b using for this exp rim nt. : oting that NASA receiv d 400 applications for proj t ~ for the Shuttl . Farhi credits d velopm nt of th rebreathing : devic a a key factor in I ction of th UB xp rimcnt. u. "Without prior funding from the ational Heart. Lung g and Blood Institute. th U.S. Air Fore and th OITic of aval ~ R earch which aided development of the devic and the ... technique. w would not have stood a han of b Ing elected;' Farhi mpha izes. Prior to th laun h in 19 5. om of th scientist from Farhi' re earch t am ar exp cted to vi it th Johnson Spac Center for final pr paration . And Farhi will b on hand at the Kennedy Spa nt r to ch k the a tronauts prior to and following th ir journ y into pac . While th Shutt! orbit . h will fly to Johnson Space C nter wh r h will b in communication wilh th "flying i nli t " to collaborate with th m a they condu t the exp rimcnts for his proj t. Prai ing ASA for il upport of the project n on the Lii S i nee Mis ion. Farhi ay the ntir mi • ion ha b en a ··broad-mind d approach to cl nc a well a a coop ralive i ntifi ffort." Information gl an d from th 25 proj t will be readil har d with oth r i nti t . h note . r will collaborat with Dr. Farhi to d Calign.pand vngin lop and con truct th exp rimental quipm nt. Cal pan wa awarded lh 20-month contract on a com­ p tltiv basis by Manage m nt and 11chnical ervi o.. a ub idiary ofG n rat Electric Co. and contractor to ASA. Other memb r of th UB team involved in the 19 5 Shuttle project include John Favata. project ngine r. Dr. Albert 0 1 zowka. a ociate profi or of phy iology. and Dr. Mary Ann RokHka. a i tant profi sor: Dr. D nni Py zczynki. re earch associat . and Mr . Su an How , techni ian. • BUFFALOPHYSICIAN• 13 �New therapy Intermittent drugs for schizophrenics A UB psychia rist ha begun an innovaliv tudy to verify his earlier finding which uggcst chizo­ phr nia can b controlled in some patient by in­ tcrmitt nt rath r than daily drug th rapy. Major tranquilizers such as Haldol and Stelazinc hav roulin ly b n pre cribed on a daily ba i bccau ·e it wa believed chizophrenia was a progressive cond ition. R c nt r earch finding how that for many pati nls. th condition i in lead characterized by periods of cxac r­ bation and remi sion and uggc t that medication might be n ce ary only during a tuaJ period of the illne . "Although the major tranquiliz rs can control chizophrenia, in large. long-t rm doses. they can I ·ad to an irrever ible condition Turdive Dy kinesia Syndrom which has involuntary movemen as its primary symptom," explain Dr. Marvin I. Herz. profe or and chairman of UB" Departm nt of P ychialry. La t year, th re ult of two pilot tudie conducted by Dr. Herz and hi colleagu d monslrated active di ase ou ld be controlled in mo t tabiliz d schizophrenic who were seen we kly and received medication only prior lo x­ ac rbation . Of the 19. only two relapsed und r the regimen and required ho pilalizatlon. In another UB study of 145 schizophrenics and 80 of their family members. Dr. Herz and hi colleagu found that most recogniz d a prodromal period lasting at lea t two or thr e day prior to exacerbation. The prodromal period wa typically characterized by in omnia. increa ed ten ion. anorexia and difficulty concentraling. oting the importance of a "significant oth r"' such a spou e. friend or r lati ve b ing part of the pilot projects and current study. Dr. Herz explain th y may be more likely to recogniz ymptoms prior to exacerbation than would the pati nts. Th tudy which has recently begun will involve 150 s hizophrenics betw n 18 and 65 who hav had at least two hospitalization for their illn and have had tabiliz­ ed conclition for ix months or longer. All are outpatient of either the Erie County or Veterans Administration Medical Center or Community Corporation II. a community mental health fa ility. R eiving group therapy once aw ek. half the patient will be placecf on daily placebo: the other. activ m dication. If. during the cour e of th two-year study. patient b gin 14 • BUFFALOPHYSICIAN exacerbation A . th y will b given active m dicalion. t I a tone per on close to each patient will b involved in group education sions to make them mar aware of ymptom as ociated with the prodromal period and chizophrenia. '"For year . psychiatri t hav not includ d family memb rs in treating hizophrenic b cau it wa thought th y may have played a rol in causing the illnes :· ay Dr. Herz. It i now beli ved chizophr nia. which trikes mo t vic­ tim in their t en year and arly adulthood. is. in fact. mullifactorial. '"Whit w ·re not urc why the major tranquiliz r ap­ pear to control the condition. we think it may b b cau they increa the patient's ability lo cope with tress and d er a e dopamine activity in the brain which triggers or accompanie exacerbation :· Dr. Herz add . Although most schizophr nics were institulionaliz din the past. a majority hav b en relea cd into the communi­ ty b cause institutionalization was found to b harmful and b cause of political and financial rea on . " Ithough there are ome who have not been able to live ·outside" eitfier with family or on th ir own, many more maintained on outpatient lreatm nt program and medica­ tion live in the community and hold job . functioning in oci Ly.'' the VB p ychiatri t points out. Schizophr nia. which has symptoms of thought disorders. troubler lating to others. delusions and hallucina­ tions. may not in th future always be the often hopeless di ea it once was thought to b . "Re ar h. after all. is providing u with more an wer about all form of m ntal illn ss and improved way to tr at th m," Dr. Herz point out. And th results of the UB tudies may ultimat ly mak it po ible for more afflicted with chizophrenia lo I ad u ful live in th community with I dependence on m dicalion. Tho involv d with the tudie fund d by th w York State Health Re earch Council and the Rockland Res arch ln litutc of w York Stat include UB faculty Dr. Herman Szyman ki. Dr. Joseph Vana and Dr. Donald Bartlett: research assistant Ms. Jacquelin Simon and research nurse Martha Edward . The alional Jn titute of Mental Health has recently approved funding of $43 .000 for the initial year with larger amounts expected in the fu ture. - Mary Beth Spina �Research Briefs Navy swimmers use UB lab U II B's Environmental Phy iology Laboratory recenUy provided avy researchers with a unique environment which permits them to gather data on oxygen consumption by under­ water swimmers. Oxygen alon is seldom used by non­ military divers because at depth greater than 25 feet. ll can produce temporary brain dysfunction uch a convulsions. nausea and impaired mu cle coordination. In relatively shallow water. however. bottl­ ed and rebreathed oxygen enable divers to wlm longer than is possible u ing either air or oxygen-helium mixtures. The rebrcathed oxygen. contained in a small bottle on the swimmer's back. also eliminates the possibili­ ty of tell-tale bubbles escaping to reveal his location. U.S. avy studies are b ing conducted to determin precisely when oxygen toxicity can be predicted to occur in divers using essen­ tially pure oxygen rebreathlng device at cer­ tain depths. water temperatures and activity levels. The two-week research here, concluded by a team of avy divers in UB's Annular Immer­ sion Tonk. helped determine the rate of ox­ ygen utilizatlon in underwater swimmers who rebrealhed the gas during continuous thr e­ hour swims at a depth of eight feet. While the avy conducts most of Its under­ water research at its Experimental DiVing Unit (UDU) in Panama City, Fla .. it doe not have the capability lo allow monitoring of free swimming divers underwater. UB's Environm ntal Phy iology Laboratory. on the other hand. I the only facility of Its type in the world to have combined Navy ,wimm•rs usin1 Phy,io/017 capabiliUe for simulaling a range of en­ vironmental condilion and monitoring their effects on the body. LL Cmdr. Frank Butler. one of the subjects in the study and a avy physician. noted that the circular eonfiguralion of the UB Immer­ sion Tonk permits the divers lo swim con­ linuou I without breaking stroke for three hours and longer. Water temperatures In the study were varied from 50 to 70 degre . During the swims. two-man diving teams were connected to recording equipment on the rotating bridge above them which allowed charting of their body temperatures, their breathing mixture and the pressure levels of their oxygen containers. Later this spring. said Butler. some 50 avy divers equipped with the re breathing oxygen apparatu will be le ted at the Panama City facility to determine the safe operating l!m limil for oxygen divers at various deplh . Butler notes that Dr. Edward Thalmann. the s nior medical officer with lh Experimental Diving Unit. completed a three-year post­ doctoral fellow hip in underwater physiology al he School of Medicine. • Disease 'turns' hair white, not fright W hile scalp hair may appear lo sudd nly turn white. the cause is not fright. Con­ trary lo the old wives· talc. a condil!on called alopecia areata is more apt to be the cuiprit. say a UB dermatologi L While th cau e of alop cia is not known. it is suspected that genetics. emotional stre and immunologic mechani ms may each play a role in developm nt of th condition. "Propagation of the widely believed myth that fright can cause hair to turn white." says Dr. Fred Helm, "is ncouraged by people who claim to know someone who faced dang r and. day later, develop d white hair." Unexp ctcd color change can appear. Helm acknowledges. but i is due to dramatic hair loss rath r than a change in hair color. "A few gray hairs are hardly noticeable in p rson who have a full h ad of hair."" Helm explains. But when alopecia areata causes hair lo . the gray hair become more conpicuous simply because pigmented hair is lost first. In a ca e reported by Helm and Dr. Halina Milgrom. a patient involved ln an accident noticed his hair had "turned white" a few day later. The diagno I of alopecia area ta was made when typical patches of complete hair lo s developed. Six months following the original hair loss. the patienl had r grown a full. healthy head of white hair . "It i possible." ays Helm. "that alopecia areata represents a peculiar hair loss of diverse etiology." lnde d, i a ociation with vililigo and thyroid di ea e i su peeled by many scienli t . And thyroid di ea e ts it elf ignificantly associated with Addi on· Di ease. diabetes mellitus and p rniciou anemia. "In mo l case . alopecia arcata appears to be a self-limiting condition. with the hair trnlr. regrowing without u e of drugs," Helm points out. When all body hair is lo l. the condition i known a alopecia universali and may or may not b reversible. . .-Even if fright or stre play a role in development of alopecia areata." ays Helm. "they arc only an tndir ct cau e of the hair lo ." • Sickle Cell Center T he local fight against icklc cell anemia. a hereditary blood diseas more prevalent among Blacks. ha intensified with the open­ ing of th Sickl Cell Di ease Center of Western cw York. Located at Children' Hospital. th new om­ pr hensive Center is the culmination of efforts of UB faculty. rcpre entattve of community agencies and organizations involved with the di ea e. and eommunitv health care providers. · The Center alms to serve populations in the eight Western ew York counties by: providing m dical care. patient and community educa­ tion: stimulating r search, and oordinating all th e components to benefit sickle cell pa­ tients and their families. Co-directors of the Center arc Drs. Jame Humbert . UB prof. or MicroJcopic view of ,ial• t•II. • of pediatrics. and Frank Corbett. UB di rec Lor of urban affairs. Supported by only $100.000 from th Genetic Di ease Program of the ew York Stat Health D partment. the Cent r will of ncce ity depend a great deal upon exi ling community r ource . '"We applied to the Nalional In tilute of Health for a $10 million five-year grant. which was approved but not funded b cause of lack of Federal money ... said Dr. Humbert. But unBUFFALO PHYSICIAN• 15 �daunted. tho e involved decided they would attempt to provide as many services as possi­ ble with the resources available. "The deci ion to continue our plan for a Center \V3S helped by the fact that commu­ nity and volunteer organizations concerned with sickle cell and the health professionals who creen and treat the condition have had a good, long-term working relationship," Humb rt points out. Becau e of thi cooperation, the We tern w York area ha one of th lowe t d ath rate among sickle cell patients in the nation. "In some areas. the mortality is as high as 20 per cent. But In We tern ew York it I I than three per cent ... Humbert ays proudly. E timaling that ome 10.000 Western ew York Blacks carry the trail for the disease. Humbert says there are probably about 600 locally who have il. "Of this number. only 250 have been iden­ tified through physician and clinic record and aggr ssive follow-up. Thi mean another 350 who hould be receiving treatment are not," he emphasize . hoped the ..mi ing'" persons with the disease can be located. "The only \vay to prevent the diseas is to identify parents who both carry the trait. Arm­ ed with this Information, they can then make the dee! ions as to whether or not they want to have children ba ed on the odd that their children will either have the di eas or be car­ rier of it." Humbert points out. Those s eking more information about ickle cell disease or the treatment program should call the Center at 878-7369. Cooperating In the Center"s activities are the Sickle Cell Disease Par nt A oclation, the Niagara Frontier A sociation for Sickle Cell DI ea e Inc .. the cw York State Education Department's Office of Vocational Rehabilita­ tion, the Erle County Health D partrnent. Erle County Medical Center. Children's Hospital. Buffalo General-0 aconcss Hospitals. UB and Roswell Park Memorial Institute. • - Does breast feeding provide immunity? O ne role of the new Center is to attempt to locate th e "missing" suffer rs and encourage them to get treatment b fore they find themselve In life-threatening situations. There will also be a vigorous attempt made to contact patients of infants born in Western cw York who are identified at birth as car­ riers of the trait. " ew York is the only state which requires s reenlng for lckle cell trait at birth." Humbert notes, "and while parents of the e infant ar notified by the w York State Health D partment to follow-up with their phy ician . many do not." h add . Since the S<'reening t t be ame mandatory in 1975, om 3.800 young ters born in th ight We tern cw York counti s have been id nlified as carriers. The 72 born locally with the disea e are receiving care. "But the e figures do not include children who have the di ase and moved Into the area nor those born before 1975 who may. in fact. not be getting treatment anywhere." Humbert say. The greatest threat lo the person who has ickle cell disease I infection - sev re. over­ whelming infection which if not caught and treated in Lime can lead to death. "These patients have virtually no spl en function and alter d T-cell and neutrophll function which makes them immunodefi­ cient. They have difficulty in succe fully fighting off in~ ction:• Humbert explains. In­ deed. the sic kl cell patient can die within two or three hours of a raging infection if not treated imm dlately. ··while perhaps only 600 Western ew Yorkers have the disease. ther are literally thousands of people who are indirectly af­ fected by it - teachers of the e children. health provider . family memb rs. friend :· the UB pediatrician point out. T hrough Hunter. Brown; and and Cordia Association the efforts of Center staff Carolyn Maxine Holmes, and Thelma Barbara Nevergold. Diane Farley McLain of the lagara Frontier for Sickle Cell Disease Inc .. It is 16 • BUFFALO PHYSICIAN M.B. Spina A new four-year study to determine If brea t-fed babies exhibit a greater Im­ munity to certain vlru es than bottle-fed babie ha begun at UB and Children's Hospital. Funded by a $416.000 grant from the Na­ tional In tltute of Child Health and Human Development, UB virologist Or. Pearay L. Ogra and Or. David Wong will measure levels of an­ tibodies against two viruses In 100 nursing mothers and their infants. The researchers will take blood and milk samples from the mothers and blood samples from the infants. who will be tested for four years to determine the level and duration of protection against the viruses. The tatistics on these infants will be compared with those of bottle-fed infants. Researchers have found vidence that an­ tibodies acquired by a mother against r spiratory syncytial virus (RSV) and rubella. the agent which causes German measles. can be transmitted through breast milk. But the level and duration of this protection in the breast-fed infant has not been determined. Most children are expo ed to RSV by the time they're two y ars-old. but some have no clinical symptoms of disease while others develop severe respiratory infections. Pioneer­ Ing research by Ogra and his colleagues has uggested that RSV. for which there ls no vac­ cine. can cause bronchiolitis and appears to be a "trigger"" for asthma in children. Com­ plications of joint dis ase and encephalitis may follow a rubella infection in an Infant. Although there Is a vaccin for rubella. It is not administered until the infant's own im­ mune system becom adept at producing an­ tibodies upon exposure to the virus. usually ~ j! 15 ui c ic ~ ~ a. Dr,, Pnny O,n (/di) aad D,vid Wonr .,, studrinr immun, , ffKI• of bn•sl f-li nr. �Research Briefs at about 15 months-old. This gap leav the infant temporarily unprotected and vu lne rable to German mea le . "The length of immunity the antibodle In breast milk provide wllJ be an important fac· tor in the tudy;· Ogra points out. It is not known wh th r uch protection noticeably decreases when breast feeding top or whether it continue for several month . ··we may find the Immunity acqutr d through brea t milk gives the Infant an add­ ed 'boost' in fighting the viru e which may account, in part. for the varying degree of seventy of disease we see clinically in both RSV and rubella-in~ cted infants," the pediatric virologist adds . Breast milk. already known to be ~he most nutritionally perfect and economical food for infants. may thus have another advantage protection again t two common viral Infections. • Anti-viral vaccine studied A lipo omal vaccine being developed against a mouse virus by UB researchers may revolutionize future production of human anti-viral vaccine . UB microbiology profe or Dr. Thomas Flanagan ay If the vaccin is found to pre­ vent Sendai re plratory infection in mice. the same technique will be u d to develop a vac­ cine against human Re piratory Syncylial Viru (RSV). Sendai vlru was elect d for the animal vaccine devclopm nt and testing bccau of Its similarity to RSV. a viru which infect mo t children by age two. RSV. for which th re I currently no vaccine. has be n implicated In asthma and wheezing In UB tudics con­ ducted in the Division of lnfcctiou Di ca s at Children· Hospital. Flanagan note that sue ful anti-viral va cin uliliz either the whole live at­ tenuated or whol killed viru lo ·Umulate the body· production of antibodies to prot ct against future infection with the ame organi m . Re earch uggests. however. that only the antigenic determinants or p cine proteins which appear on the viru urface and extend down into its lipid bilayer may be necessary to tlmulat adequat anlibody production. Some viruses. such as Sendai and RSV. hav only two surface antig nic dete rminants. while many of their more complex viral cou in have mor imbedded in their surfac s. U ing a t chnique dev loped el where . the UB re arch rs are alt mpting to create. for the first time. an ef~ ctivc vaccine which in­ corporates only the e vital sp cific proteins. The technique. Dr. Flanagan explain . in• valve use of a det rgenl (Beta-D ocytgluco ide) to mul ify the viru · lipid bilayer. allowing the specific prot ins to float fr e. Wh n placed on DEAE biogel. which ha aw ak anionic charge. one of th two cndai virus antigenic determinants will cling to the gel. allowing the other to pass through. Other agents are us d to trap the second determinant. After aptur . the prol in and th d l rg nt arc combin d with pho pholipid . which allows the proteins to realign themselves ma configuration identical to that found on the actual virus particle. It l th oriz d that they mu t appear in the artificial lipid bilayer ex• actly as they did on the virus. or no effective antibodies will b evoked to protect again t future encounters with th actual virus. The detergent. It purpo e now rv d. i withdrawn by dialysi . leaving th specific pro­ teins in the artificial lipid bilayer . Dr. Flanagan points out the team will at· tempt to detcrmin if preci e configuration in the bilayer is e nUaJ for e!Tcctivc immuni7..a• lion by giving the antigenic determinants to the animals separately and in th llpo om . Successful immunization will be determin· cd by challenging the mic with the Sendai virus after they receive the va cines ither by injection. inhalation or Inge lion. Each rout of admini tration of the vaccin will al ob assessed for its c!Tectlv n in stimulating antibody production in the animals. Other mice will receive the whole live Sen­ dai or whole killed viru va cin by the sam routes. enabling th researchers to compare antibody levels achieved with the new and older vaccine techniques. "If the vaccin u ce fully prate t th · mice wh n later challeng d with th Sendai viru . we plan lo develop a imilar vaccin again l RSV which will first b le ted In animals and later. in humans:· Dr. Flanagan ay . Funded by a Re earch and Development Grant from UB"s School of Medicine. Dr. Flanagan i being assisted by microbiology graduate tudcnt Mohammed Al-Ahdal. Dr. Tunvccr F. Abidi and UB pediatrician and virologist Dr. David Wong. • Radiation tried during surgery R adiation administered during surgery. rather than pr • or po l·operativcly. may becom th future ··treatment of choice" for cancer patients with large abdominal or che t tumors, say a Roswell Park Memorial In· stltu e surgeon. According to Dr. Constantine Karakou i . re earch asso late profe sor of surgery and chief of the Soft Tumor Melanoma Service, "preliminary experiences at Ro well Park and other ho pltaJ have shown that intraoperativ radiotherapy minimizes the hazard as ociat d with high do of ext rnal beam racliation. and reduce th ri k of tumor recur· r nee which can result from less than optimal surgical margins ." Unlike exlernal beam radiation. which mu t penetrate a Jarg amount of healthy tissue before il reaches its target. intraoperative radiation makes direct contact with the surgically-expo d tumor or tumor b d. Because the radiation has no "barrier" of healthy tissue to permeat . the dosage can be reduced ignificantly. "What thl mean . " ex­ plained Dr. Karakousi "i thal the side effects a sociat d with high-dose radiation - skin discoloration. fibro is In the subcutaneous fat. loss of skin elasticity - arc virtually eliminated.·· Whal lntere urgeon mo t about in· traop rativ radiolherapy I I potential ap· plication to "'hard to treat" malignancies. uch as those found in the chest and abdomen. "The bowel. liver. and kidney in th abdomen and the lung in the thoracic cavity can not ludi1lian bt in1 1dminislt'ml durin1 1ur,try. tolerate high-doses of external radlalion, ·· said Dr. Ka.rakousls. For this reason. surgery re­ mains the primary treatment. "Wide surgical margin around the tumor in the area ar . how ver, dlfncult to obtain," Dr Karakou i pointed out. "'Therefore. to help destroy any mi roscoplc r ldual tumor not removed dur• lnJ1: urgcry, phy icians at Roswell Park usual­ ly ad mini ter low to moderate do of post­ operative exlernal radiation as adjuvanl lreal• ment. .. Pre-operativ radiation giv n in similar doses I al o an alternative that has been used by oth rs . While the effect of both pr • and po t· op •rativ radiation have b en good. in ome ca e . microscopic residual tumor not de troy d by this combined tr atment can lead to local (a we)] a y tcmic) tumor r cur· rence. "The more microscopic tumor there is. the more chan e there is of appearance of clone re i tant lo any treatment.·· said Dr. Karakou I . One of Lhc ben flt of in­ traoperalive radiotherapy howev r. is that It will destroy most of the r !dual immediately. ··1fsurg1 al margins re expected to be nar­ row. the urg on can admlni ter in­ traoperative radiation immediately following th removal of the gross tumor," lated Dr. Ka.rakousis. "It Is cs ential. however. that an the gross tumor be removed." The in­ traoperatlve do e is admini t red to the tumor bed while normal , uninvolved ti ue arc retracted and prot ct d. "The addi lonal do age. rcquir d po toperativc!y." said Dr. BUFFA LO PHYSICIAN • 17 �Karakousis. .. is quite low in the range of 3.000 rads. Lherefore minimizing the risk to en ilive normal tissue as ociated with high-dose radiation." Although only recently divested of its Oedgl­ ing status. lntraoperatlve radiotherapy ha been endorsed enthu ia tieally by oncology surgeon nationwide. Or. Karakousis at­ tribute this reception to the excellent preliminary results reported by Ro well Park and other hospital such a the Mayo Clinic and Ma sachu elts General Ho pilal. At Roswell Park. for example. thi therapy was given to thrc patients with abdominal soft ti ue sarcoma . All three patients had "difficult recurrent tumor . .. aid Dr. Karakousis. Immediately following gro tumor removal. 1.500 rads of intraoperativc radiatlon wer admini tered to the tumor bed for 15 minute . After a two-year follow-up. "each patient is doing well without tumor recurr nee ... th surgeon added. Dr . Karakou i believe that, because of its simplicity and inherent advantage . "in­ traopcrative radiation will become the pro­ cedure of choice in the future especially in dealing with large tumors where the surgical margin are expected to be narrow. With its use. a higher LOtal dose to the tumor bed i delivered and a lower one to the surrounding normal ti ue . so that a higher efficacy may b expected with le id effects... • - Colleen Karuza is about to shut off." Bes ettc explain . If the per on consciously decide to ignore this me sage to hlfl weight. the result is u ually no more serious than a foot or arm which "falls asleep." Among those who ar paraJyzed or simp ly too ill to aJter their po ition in bed or wheelchair. bedsore can develop. often necessitating surgical intervention with skin naps to promote healing of the lesions. B ll no e that adequate turning of palients i frequently impo Ible in in titutions which may be understaffed. Tho e who must care for elderly people or those incapacitated at home also often find it phy ically difficult to provide the n ce ary turning. Testing one dozen mattre es currently us­ ed to relieve ulcers against the new cushion. UB research professor and Arvin/Catspan Ad­ vanced Techno logy Center staff cientist Dr. Robert Baier found the cushion to be the only one which exert less than the 35-millim ter I vel of pr ure on human kin. The cu hion wa de igncd by Gaymar In­ du tries Inc .. a medical pecially firm in Or­ chard Park. The pat nt for the product i pen­ ding. More cxtensiv tc ting is planned with 25-50 patients at Buffalo General Hospital and the Buffalo Veterans Admini tralion Medical Center who will u e the cushion in the next few month . James Price. product manager for Gaymar. says the new. trademarked sof•care cushion utilizes a closed sy tern of fluid air dynamics which provid s optimum upport for the body. Each cushion is designed so the air pressure u cd is tailored to the pati nt's weight. When not in u e. the cu hion can be easily rolled for torage. Other inherent advantages of the cu hion arc it case in cleaning and use. light weight and lower expen e. \ Roswell testing ultrasound probe j R oswell Park Memorial In titute is one of two cancer research centers in the United State exp loring the effectiveness of ultra­ sound equipment designed specifically to detect pro late cancer. The equipment. con­ sisting of a large chair with a rectal probe. a scanner. and a 35mm single rcOcx camera. measure the volume of the prostate. Ultra­ sound image or pictures ta ken by th equip­ ment are recorded on film. and Illustrate any lesions. stones or other disorders. The process of using ultrasound techniques for prostate cancer detection is caJled tran­ srecta l onography. According to Dr. Gerald P. Murphy. director of Roswell Park and direc­ tor of the National Prostatie Cancer Project. · 'Thi techn iq ue appears lo be more accurate. le s painful. and ea ier to u e than any other screening tests to date ... Over 100 Roswell Park patients have been screened wilh the ultrasound equipment and th results appear to be encouraging. • Research exceeds $12 million ollowing is a compilation of res arch grant totals in effect in departments of the FSchool the 1982 calendar year. compared with totals of Medicine at the end of for previous years compiled by th Re earch Foundation of the State University of ew York. Research Foundation Grants Direct Costs DEPARTMENT Dean's Office New mattress may avoid sores A lightweight air cushion which shows promi e in eradi a1ing the problem of bed ores among bedridden or paralyzed pa­ tient i being tested at two local hospitals in a LIB study. Plastic urgeon Dr. Rus ell W Be elle note that bedsor . or dccubilll ulcers. con­ tilutc a major health prob) m for people con­ fined to a single position for several hours. ..When a mallrcss places pre urc ex­ ceeding 35 millim ters of mercury on the kin. blocking blood circulation through the capillaries. changes occur in outer layers of the kin as well a In entire columns of ti ue ex­ tending from epithelium LO bone. creating the ulc ·rs." Bessette explain . Tho e not paraJyzed and apabl of shifting position in bed or wheelchair arc le likely lo develop !:he ores. he adds. ·'Even during what is considered a good night' Jeep, people normally twi t and turn enough to prevent development of decubitus ulcers because proprioceptors in kin 'tell' the brain when the blood now through capillaries 18 • BUFFALOPHYSICIAN Basic Science Anatomy Biochemistry Biophysics Microbiology Pathology Pharmacology Physiology 1978/79 688.336 1979/80 836,954 1980/81 622.248 1981/82 402,963 12/1/82 I 73.825 77 .20 815,591 225.706 l.101.675 374.616 720.856 I ,535.022 75,753 706,029 405,591 967.923 566,562 754.526 1.965.540 81.300 797.006 199.553 882,325 401,353 518.610 1.600.000 87.650 762.410 295.241 8 76.840 452.376 344.325 l.535.338 119.000 1,112,308 399.000 783.042 308,649 298.150 2.275.445 4.850.674 5.441.924 4,480.047 4.354.180 5.015. l 19 253.024 15.915 2.134.704 7.250 228.605 44.400 3,746,480 98.000 205.000 150,000 42,362 6,000 1.628.347 87,782 80,561 540 500.873 300,000 Departments SUB-TOTAL Clinical Science Family Medicine Gyn/Obstetrics Medicine Neurology Neurosurgery Nuclear Medicine Orthopedics Otolaryngology Pediatrics Psychiatry Radiology Rehab. Medicine Soc. Prevent. Med. Surgery Urology Departments •• 2 .870 1.893.967 •• •• •• •• 116.104 300.156 I 69,621 •• •• 53,294 451.104 •• •• .. •• •• .. .. •• .. 2.272.346 8.353 306,190 179.418 49.646 496,577 236.093 •• 2,146.365 •• •• •• 6.174 4.800 335,212 66.938 5,780 31.426 25,182 692,385 250 •• •• 16.619 4.800 402.733 54.539 2.997 15.915 137.628 437,421 0 0 SUB-TOTAL 2,987.116 3,312.530 3,545.839 3,378.745 7.023.771 GRAND TOTAL 8,526.126 9,591,408 8.648.134 8.135.888 12,212,715 \ ' �People Bacteria named for Dr. Neter \ J M ost people agree it's an honor to have a namesake. A baby. per­ haps, or even a boat. But UB microbiology profes­ sor emeritus Dr. Erwin eter is one of that select group whose namesake is a newly identiffed sp cies of bacteria. The honor was bestowed upon him last fall by a team of researchers at the Centers for Disease Control, Wood Veterans Ad­ ministration Medical Center and the Medical College of Wisconsin at Milwaukee who christened the previous­ ly identified organism cedecea species 4 as Cedecea neteri. In an article in the Journal of Clinical Microbiology, the scientists noted the name honors Dr. eter for his many con­ tributions to knowledge of the family Enterobacteriaceae and its role In human disease. The bacterial namesake. however, is on­ ly the most recent of the honors accorded to Dr. Neter, an internationally-known bacteriologist who at 7 3 remains active in his field despite "official" retirement from UB and Buffalo Children's Hospital. In development of the pas ive A pioneer hemagglutination test used to aid \ l diagnosis of a variety of enteric or gut bacterial Infections. Dr. eter is also credited with coining the term "enteropathogenic" for those certain strains of normally "friendly" Escherichia coli bacterium in the gut which can cause disease in infants. More recently. he has become a leading Investigator in research which focuses on a common antigen shared by all enteric organisms. Presence or absence of this an­ tigen has been used in a recent study by CDC and Dr. eter with blindly labeled trains: the re ults are proving valuable for classification. Supported In his research for more than 20 years by grants from the National In­ stitutes of Health. Dr. Neter's contribu­ tions fill more than the 300 publications which bear his name. He was founding editor-In-chief In 1970 of the journal Infec­ published by the tion and Immunity American Society o(Microblology. which i the seventh most widely cited microbiology journal in the world. His contributions to medical cience impres ive though they may be - cannot overshadow his achievements as a teacher and a human being. Some 4 7 years ago, after earning a medical degree from the University of Heidelberg, ""Dr. eter came to Buffalo. "My fatner gave me life twice. Once. biologically. The other. when he urged me to Immigrate to the U.S.. " he says. He came to Buffalo at the suggestion of his former teacher, the late, Dr. Erwin Ntltr internationally-known UB immunologist Dr. Ernest Witebsky who, like Dr. eter, had fled the increasing persecution of the azis. Both would be among the growing number of skilled and talented scientists and teacher who Immigrated to the U.S. in those years. But after the war, Dr. eter re-established scientific collaboration with colleagues in his native country. mong the honors he has received i the A honorary degree of Doctor of Medicine from the Univer ity of Heidelberg nearly a decade ago. Another. presented in 1979. is the Federal Cross of Merit, the highe t civilian award the Federal Republic of Ger­ many can bestow . More recently. the American Society of Microbiologists nam­ ed him an honorary member as "an emi­ nent scientist who has made great con­ tributions to microbiology." one of only about 50 individuals to achieve this distinction among the 30,000-member organization. He also was presented the Stockton Kimball Award from UB's School of Medicine and named Buffalo Pediatri­ cian of the Year in 1982 by the Buffalo P diatric Soci ty. Despite his dedication to research. Dr. eter has taken time to be a teacher. often staying late to offer encouragement or guidance to UB graduate students in microbiology who might follow in his footsteps. Former president of the Buffalo Chamber Music Society. Inc .. hu band. father and grandfather, h has been de cribed by his colleague as a gentleman. And by that rarer description - a man without enemies. Even now. he continues to come to work in his office at Children's Hospital on a regular basi and recently wa elected to a five-year term as chairman of the American Academy of Microbiology. "I am grateful to this country - Tor the opportunities I've had. I still have much to do," he smile . - M. Spina BUFFALO PHYSICIAN • 19 �tissue pathology General. laboratory at Buffalo • ALCANCERJNSTJTUTEGRA NATIO totaling almost $900,000 have been TS Dr. FrederickHelm Helm beads Dermatology D r. Frederick Helm. chief of der­ matology at Ro well Park Mem­ orial In tilut . ha been appoint­ ed chairman of the Department of D rmatology at UB by Presi­ dent Steven B. Sample. A native of Cz ehoslovakia. Dr. Helm received the M.D. from the Univer ity of Graz (Au tria). After residency training in Au tria and at Tufts University. Deaconess HospitaJ and RPM!. he joined Roswell' D partm nt of D rmatology in 1963. Dr. Helm i a diplomat of the American Board of Dermatology and D r­ matopathology and a f llow in the American ofle~e of Phy ician and the Royal Colleg of Phy icians in Canada. He is affiliated with Erie County M dicaJ Center. Childr n's Ho pital. Buffalo GeneraJ Ho pitaJ and i a con ultant at the Vet ran Admini tration Medical C nt r. Brook MemoriaJ Hospital in Dunkirk and West Seneca D v lopmental Center. He serv d a attending chief of th D r­ mato'logy ervice at Millard Fillmore Hospital for eight year . A pa t pre ident of the Buffalo­ Rochester D rmatological Society. he is a memb r of veral profi ional organiza­ tion . including th International and American So ieti of D rmatopathology. the International Society of 'Tropical Der­ matology and Sigma Xi. In addition. Dr. H Im ha author d or co-authored 70 journal articl . many of which focus on hi re arch in kin cane r and tumor immuopathology. • Dpathology GA.ETA, PROFESSOR OF and a sociate professor of urology, was recently appointed director of the R. JOHN 20 • BUFFALOPHYSICIAN awarded to eight r searchers at Roswell Park. Dr. Enrico Mlhicb, research professor of pharmacology and therapeutics, was the reci­ pient of$547.631 to be u ed for cancer drug research. Dr . Boward Ozer, assistant pro­ fessor of medicine and microbiology. was awarded $62,265 for a study Involving lym­ phoma and myeloma. A $60.166 grant was awarded to Dr. T. Ming Cho, clinical assis­ tant professor of biochemistry. to investigate antigen-antibody complexes in breast cancer. Dr. Chu also received a $63.139 grant to study antigen markers In the diagnosis of prostate cancer. Dr. Richard B. Bankert received $59,905 to study monoclonal antibodies. Dr. Avery A. Sandberg, a research professor of medicine ln the genetics and endocrinology department, was awarded $74,944 to test drug sy terns. A 64.422 grant to study the effects of cocarcinogens on cellular mem­ branes was awarded to Dr. Charles E. Wen• ner, re earch professor of biochemistry, department of experimental biology. Dr. Carl W. Porter, associate profe sor of pathology. experimental therapeutic department was awarded $55 ,543 to investigate anticancer drug action on polyarnlnes and mitochondria. Dr. Zew Wajsman, research associate pro­ fessor. urologic oncology department recelv• ed $17,198 to evaluate and treat hladder cancer . • Dfessor R. REID HEFFNER, ASSOCIATE PRO· of pathology and neurology. published a scientific paper entitled "Surgical lreatment of Postphlebitic Syndrome with Vein Valve lransplant" In the American Jour­ nal of Surgery. • Dprofe R. FELIX MIi.GROM, DIST! GUISHED or and chairman of microbiology. recently attended the 14th Sympo ium of th Collegium Internationale Allergologicum In Sorr nto. Italy. He also attended with Dr . Ernst Beotner, profe or of microbiology. a meeting of th Deutsche Dermatologtsche Ge ell haft where he pre enled a cicntific paper entitled "Pathogene lmmunkom­ plexe.·· • T HE CHJLDRE 'S HOSPITAL OF BUFFALO has been President John R. Jefferies elected chairman of the atJonal Association of Children's Hospitals and Related Institu­ tions, Inc. ( ACHRI). NACHRI is an a ocla• lion of 72 leading children's hospitals throughout the United States and Canada. As m mbers. hospitals work to improve the qua­ lity of children's health care through educa­ tional and research activities and child ad­ vocacy efforts. • LEIBOVIC, PROFES­ DR.sor It.ofNICHOLAS biophysics, has been awarded a three-year $190,715 re earch grant from the atlonal Institutes of Health. The title of hi research is .. euraJ and Photochemical Adap­ tation of Photoreceptors." • T HE 1982 DR WILLIAM H. WEHR AWAFJJ was given to Dr. Fred Rosen In recogni­ tion of hi dlstlngui hed career in cancer re earch at Ro well Park Memorial Institute. Dr. Rosen joined the Ro well tafT in 1956 as a soclate cancer re earch scientist In the Experimental Therapeutics Department. In 1979, he served as associate Institute direc­ tor for scientific affairs until hi retirement in 1981. In addition. Dr. Rosen has served as research professor of biochemistry and ad­ junct professor of pharmacology at UB. • Dprofessor R. GERALD P. MURPHY, RESEARCH of urology and director of Roswell Park Memorial Institute. was elected national vice president and president-elect of the American cancer Society at their 69th an­ nual meeting in ew York City. Dr. Murphy was also awarded a silver medal by the University of Brussels' Faculty of Medicine at the European Organization for Research and lreatment of Cancer (EORTC) meeting in Bru els. Belgium. The award was given in honor of his outstanding contribu­ tions to the treatment of prostatic cancer as chairman of the atlonal Pro tatic Cancer Project. and for work achieved with colleagues at Roswell Park Memorial Institute. • D R. PETER NICKERSON, PROFESSOR of pathology. co-authored an article for the American Journal of Fbthology entitled "Ef­ fect of verapamll on blood pressure and le­ sions In heart and kidney of rats made hypertensive by deoxycorticosterone ." • PROFESSOR Dof pathology and research associate pro­ R. ADRIAN VLADUTIU, fessor of medicine. authored an article. "M proteins in serum of hospitalized patients." In th American Journal of Clinical Fbthology. • A $49,292 GRANT FROM LILYRESEARCH Research Laboratories was awarded to Dr. Edward Henderson, professor of medicine, to a sess the effectlvene and tox­ icity of the drug vinzolidlne. He is at Roswell Dr. Ftli:t Mil,rom �People P-ark Memorial Institute. • D R. JOHN E. FITZPATRICK IS THE RE­ clpient of a $7 .500 grant from the Associa­ tion for Research of Childhood Cancer. Inc .. to establish a pre-doctoral fellowship position . He is at Roswell Park. and Is a clinical associat pro~ sor of pathology. research ass! tant profe or of pediatrics. and clinical as lstant professor of medicine at UB. • DR. MARTIN WINGATE, ASSISTA T dean for continuing medical education and professor of Ob/Gyn. has been appointed director of undergraduate. graduate, and postgraduate education for Obstetrics and Gynecology at the Medical School. • Is director and vice president chapter as well. of the WNY • DR. BEVERLY P. BISHOP, PROFESSOR of physiology. was recently given an honorary membership In the American Phy !cal Therapy Association . She is author ofa numb r ofartlcle publi hed Ln the Jour­ nal of the American Physical Therapy Association and ha also written textbooks used by physical therapy educators in many U.S. unlvers!Ues. • Two FACULTY MEMBERS HAVE BEE elected omc rs of the medical staff ofK n­ more Mercy Hospital. D r. Michael A. Sullivan , clinical associate profe or of medicine. was el cted president and Dr . Gustave P. Milkey , clinical as ociate pro­ fessor of surgery, wa elected secretarytreasurer. • D R . JORN NAUGHT ON , DEA OF THE chool of M ·di ·in . i the n(·w president of the Association of M dical Schoob of ew York StatC'. the first lime an up tat d •an ha held the presidency of th' organization . aughton has al o been elected prcsidt'nl of 1h • We tern cw York Chapter of the American Hearl A o iatlon . • D R. JAMES H. COSGRIFF HAS BEE elected to the governing council of th stat Medical Society. He Is a clinical assistant professor of surgery at the Medical School. • D R. DONALD R. COONEY, ASSOCIATE professor of surgery and p dlatric . was PROFESSOR OF medicin /assistant professor of phy lology. was one of several ientists atten­ ding and pre entlng research at an Interna­ tional m etlng In Brussels recently. and was granted a private audience with Belgium's Queen Fabiola. Ors. Carlo Palant, clinical assistant in tructor in medicine: ahid Alavi, clinical assistant professor of medicine: and Elias Llanos. clinical assistant professor of medicine. also presented research at this meetln~ • D R. GABOR MARIWS. RESEARCH PRO­ fessor of biochemistry, receiv d a $72.005 American Cancer Society grant to study plasmlnogen activators and related proteases in human tumors. • D R. SYED A. FAROOQ, CLINICAL AS­ sistant professor of psychiatry and fami­ ly medicine, has been named a Fellow of the American Academy of Family Physicians. • DR. GLEN E. GRESHAM, PROFESSOR and chairman of rehabilitation medicine. has been appointed to the atlonal American Heart Association's Stroke Subcommittee. He CANCER REVIEW SERIES PROGRAM at Roswell Park ntltled "Cane r In the Workplace" wa r cently moderated by Dr . John Ven a, assistant profc or of social and preventive medicine. This ymposlum erved a a forum for primary prevention directed towards the general public and was attend d by representatives from industry and labor alike. • GERALD SUFR IN, PROFESSOR and chairman of urology, ha recently been appointed to the Medical Advisory Board of the National Kidney Foundation. • O. DOUGLASS, JR., RE­ search associate professor of surgery. gave the plenary lecture on surgical oncology at the Union International Cancer Congress In Seat­ tle. He has recently been elected as chalrman of the urglcal committee of the Gastrointes­ tinal Tumor Study Group and to membership In the Central Surgical Society. He Is newly appointed associate chairman for GI studies of the Eastern Cooperative Oncology Group and ha been appointed to the program com­ mittee of the Society for Surgical Oncology. • DR. CARL BENTZEL, A DR. DR. HAROLD recently honored by the Mayo Graduate School ofMedlcin when he received an award for "Thacher of the Year."' This wa given In honor of his exceptional abillty and interest in teaching surg ry. • $35.471 grant from the atlonal Cancer ln­ titute for clinical tudies conducted by the Pediatric Oncology Group . • Dr. Btvtrly Bi,bop DR. TARIK ELIBOL, CLINICAL ASSIS­ tant profe or of medicine. Is in private practice of gastroenterology. He was recently elected chief of the medical and dental staff at D Graff Memorial Hospital. • DR. MARCO S G. VIG UE RA, WAS RECENTLY certified In anesthe iology and el cted a Fellow of the American College of Anesthesi­ ology. He Is a member of sev rat medical societies and a clinical Instructor of anesthesiology at the Medical School. • CLI ICAL A o iatc Profes or and llcad of the Department of Anesthesiology at the Buffalo G ncral Ho pita I. wa gue t peaker at th· S •­ cond International Congress on th An<'slhclie Care of the rilically Ill Pali •nl which took place in Barcelona. pain . on ongr ·ss ovcmb ·r 19 and 20. 1982 . This was organized by the An sth •siolo~y Depart­ ment of the Univcr itv of Bare Iona Medical School. Dr . Vlgul ' ra ·di cu scd va!:>odilator therapy during ancsthc ia and surgery . • DR. NEDRA D DR. KWANG H. SHIM, J. HARRISON , M'77, clini­ cal assist.ant Instructor in surgery, has co­ authored an article With Dr. Philip Wei s, M'41. clinical professor of surgery, Jerome Scbentag and Martin Adelman. The arti­ cle Is entitled "Renal Handling ofGentamlcin by Normal and Ischemic Canine Kidneys" and wa published in The Journal of Laboratory and Clinical Medicine . • DR. MARIO MONTES DELrVERED A lecture to the Western New York Society of Pathologists entiUed "Cancer of the Lung: The Old and the New," and has co-author d three scientific articles for professional Journals. He is a clinical professor of pathology and clinical associate professor of dermatology at UB. • DR. ARNOLD I. FREEMAN , PRO­ fessor of pediatric . Is the recipient of a R. CEDR IC SM ITH ADDRESSED THE Annual Research Srmpo ium of the onh Carolina Al ohollsm Research Authority on "Pharmacological Approache · to thl' Search" for the prcvenlion and alleviation of alcohol problems. The th me of thi year's program. h Id in late January in Raleigh. orth Carolina. was Alcoholism - The Search for Source . Dr. Smith, profe or In the Depart­ m nt of Pharmaeolo y and Therapeutic . reported on r cent tudlc carried out by Cyn­ thia Pristach (medical student) . in collabora­ tion with Dr . Whitney of th D partmcnt of Alcoholism. Eric ounty Medical Center . The e Ludie tabli h a pharmacological ba I of the withdraw dl · yndrome . In addition. they provide valuable leads for the di covery of the roles of dietary factors in precipitating or aggravating the excessive con umption of alcoholi beverages. • BUFFALOPHYSICIAN • 21 �- ~ Building New projects at Main Street seen as most exciting developments in a decade T hr Main Street Campus building project expected to b gin by ay ar the "most ex­ citing developm nt for the Health Sciences faculty in ad cade." Vice Presid nt for H alth Science F. Carter Pannill aid recenUy. The trio of Main Str t projects are: l. Th H alth Science Library (a rehab of old Lo kwood Library to b accom­ panied by an addition to the rear. or Bailey Avenu ide): 2. the conversion of Squire Hall for Dental School use (again, with an addition, this time on the side of the building toward Main Street); and. 3. an addition to the Cary-Farber­ Sherman complex (for the basic science departments). All are to be underway by summer. While the construction news is gener­ ally good new for th local conomy and for tno e cone rn d with Univer ity ac­ creditation. the Main Street projects will bring with them certain inconveniences. 22 • BUFFALO PHYSIClA The Squire Hall and Cary-Farber­ Sherman projects will require the clo ing of Heyd Drive from ju t west of Squire to Diefendorf Loop. The Michael Road ntrance off Bailey will be exten­ sively used by construction traffic: and some space in the Michael lot will al o be lost. The clo ing of Heyd means an end to internal auto access through much of the northern end of the Main Str et Campus. As far as vehicular traf­ fic i concerned. th area ssentially will become a peripheral-acce campu . losing Heyd Drive is necessary Ccause the Carey-Farb r-Sherman b ad­ dition will sit atop the road's current path between the pre ent Health Sci nces complex and Harriman. The portion of Heyd in front of Squire will eventually be reopened. but it will be moved north toward Tower, making possible creation of a 60-car parking lot adjacent to what is now the main Squire (Top) Model of Cary-Earber-Sbermaaaddition. Second row: Squire Hall as it wi/1/oolcwitb addition (left) and plot plan for Main Street Campus after all projectNI renovationsare complete. entrance. Still further v hicular traffic changes will take place befor the opening of th rapid transit system in 1984. Betwe n now and th n. th present Main Street Campus entrance (Main Circl ) will be given over comp! tely to th transit y tern and will no longer provide vehicular acces to the campus proper. In its place, a new entry road. directly in front of Hayes at the intersection of Main Street and iagara Falls Boulevard. will be created. Thi proj ct is still under de ign, but is expected to b com pl t ct by October 1984. Of p cial interest to the School of Medicine i th $30 million basic sciences addition to Cary-Farber­ Sherman. This totally new construction is ac­ tually the first pha of a thr e-phas d �MedicalSchoolNews BUSWELLPROGRAM BRINGSSCIENTIFIC COMMUNITY UP-TO-DATE ON RESEARCH OF EIGHTFELLOWS T Cary-Farb r-Sherman project. Phas II will involve new ext rior cladding and intallation of energy-efficient window for existing building of the complex. Thls outside work will both help trim fuel bills and bring the older building into "visual sync'" with the new wing which will have a pre-ca t concrete rather than brick exterior. Phase Ill w!11center on in­ terior renovations in Cary-Farber­ Sherman after th School of Medicine become its sole occupant. When all three projects are complete. the School of Medicine administration will occupy space now occupied by Dentistry. All Cary-Farber-Sherman work is lated to be completed by January l. 1987. Phase II is under design now; Phase Ill i undergoing program review. a tep preliminary lo actual design work. The latter two pha es are expected to co t around $21 million. The Phase I addition to Cary-Farber­ Sh rman will provide new animal facilili s. spa e for an enlarged Student Health Service [which will s rve both campuses), and two Ooor of in truc­ lional lab for the basic science . It will add 90,000 square fi et of u able space. Lounge areas will be scattered throughout this building and through the rest of the Medical School complex when it is renovated. A small handicapped parking lot on the outh side of Sherman Han and a new ramp entryway to the overall com­ plex will be added as part of the Phase I contract. Finally. a $2.5 million utiliti and ewer improv ment proj ct is also ex­ pect d to be und rway at Main Street before the year is out. The VA Hospital i sharing costs of a new 48-inch s wer from the campus down Parkridge to the City's quarry disposal site. This is designed to end flooding problems in the area. • he 1982 Bu well Day Program. held in F'arbcr Hall March 2. featured a paper by Dr. Michael A. Apicella, professor of medicine and microbiology. Division of In~ ct!ous Di ease. Department of Medicine. UB. Dr. Apicella lectured on ..The Bacterial C ll Sur­ face as a Model for Vac lne Developm nt." Eight other scientific pre entations were made by Bu well fellows reviewing their ongo­ ing work for the medical re earch community. Tho e featured during the event. their topics and their faculty sponsors were: Dr. Thomas v . Intermittent Ros i. "Effects ofConlinuou Feeding on the Recovery of Malnourished Rats and on Intestinal and Pancreatic En­ zym s" (facully sponsor: Dr. E. Leb nlhal. D partment of Pediatrics): Dr. Nahld Alavi. "Effect of Light Chains on Functional Proper­ ties of Proximal Tubule Cell In Culture" (fa­ culty sponsor: Dr. C. Bentzel. Department of Medicine): Dr. John Georgiti . "Application of Rhinomanometry to Children" (faculty spon­ sor: Dr. E. Ellis. Departm nt of Pediatrics); Dr. Kevin Kulik. ·The Antibody Response in Cutaneou Lupus Erythematosus" (faculty sponsor: Dr. R. oble. Department of Medicine): Dr. Shtgehiro Katayama (with S.M. akeeb and J.B. Lee) "The Antihypertensive Endocrine Function of the Kidne,,. Pro taglandin-Rcnin Interaction in Renovascular Hypertension·· (faculty ponsor: Dr. J. Lee. Department of Medicine): Dr. Mvron Siegel "The Effect of Caloric Density on Ga tric Emptying in Premature Infants" (faculty ponsor: Dr. E. Lcbenthal. Depart­ ment of Pediatrics): and Dr. David O'Connell. "Studies of Inflammatory Mus le Disease In Humans and an Animal Model" {faculty spon­ sor: Dr. R. Heffner. Department of Pathology). Al o featured was a Medical Student Re earch Presentation by Ms. Lilly Barba. a fourth year medical student. whose span or was Dr. G. Andr . Her topic: "Acute Pneumonllf and Disapp arance of Ang!ot n­ sin Converting Enzyme !n the Rabbit Follow­ Ing Injection of Anti-angiotcnsin Converting Enzyme Antibodie :· The Buswell program is made possible by a bequest of Ralph Hochstetter. pre !dent of the Cliff Petroleum Company and a life-long resident of Buffalo. who died in 1955. I aving an estate of over $17 million equally divided between the University of Roche ter and the University of Buffalo. Und r term of the will. the Income from the beque t wa "to be employed and eparately administered as separate funds by the univer­ sities for the support of re earch fellows who shall be graduates in medicine from recogniz­ ed medical school and who shall have com­ pleted the necessary preliminary training to enable them to engage In re earch In their cho en field." The fellowships were to be known as the Dr. Henry C. and Bertha H. Buswell Fellow hips. Mrs. Buswell was Mr. Hochstcttcr·s sister and her hu band. Dr. Henry C. Bu well. had been a distinguished Buffalo physician, on of "America's foremost diagnosticians" of his day. The fin;t Bu well Fellow was appointed in 1957. In the intervening year . cvcral hun­ dred uch appointments have been made for r earch in mo t of the pre-clinical and clinical disciplines. Fellows have repre nted the full spectrum of experlenc and accompli hmcnts in m dical research from the lmmedlat postdoctoral to a obel laureate. According Loa background brochure on the Bu well program prepared by the Medical School. "this unusual re ourcc has provided a continuing and dependable source of re earch funding ... (and) ha been respon­ sible for many of the significant ac­ compli hments in medical re earch which have occurred at this institution. and in those departments which have aggrc ively com­ peted for fellowship appointments. has resulted in the development ofre arch teams and capabilities which would have been dif­ ficult to achieve through other means." Chairman of the Bu w II Committee Is Dr. Gcrd J. Cropp. profe or of pediatrics. • NEW MEDICALRESEARCH ASSOCIATION ORGANIZES MEDICAL SCHOOLRESEARCH SYMPOSIUM The newly formed Medical Re earch Assa talion (MRA) of the School of Medicine in cooperation with Dean John aughton has planned the School's first annual Re earch Sympo ium for Wednesday. May 25. 1983. It will be held in the Ellicott Complex of SU Y at Buffalo' Amherst Campus from 1:00 to 5:30 p.m .. pr ceding the annual meeting of the faculty chedukd for 7:30 that evening. The MRA. an organization of researchers in­ terested in promoting re earch In the School of M dicine. hopes that this fir t symposium will provide participants with an opportunity to learn about each other· research projects. The program of the symposium ha b en de igned to stimulate interaction among research r through a seri s of talks and po terse Ions. Four faculty members who e research i multi-disciplinary in nature have been invited to peak about their work. In order lo en ure School-wide reprc entatton. the MRA has invited each department to preenl a pecific number of po ters. Capping the Sympo ium will be an addr by Dr. Gui eppe Andres. Professor of Microbiology and Pathology and recipient of last year's Stockton Kimball Award for ex­ cellence In research. His talk. ··changing Con­ e ·pts in the Pathogenesis of N phrill ;· will be at 5:30 p.m. in the Millard Fillmore Academic Center. Room 170. where the other research talks will also be given. A reception in the Jane K eler Room will be held at 6:30 p.m. The annual meeting of the faculty will then take place across the hall In the Katharine Cornell Theater at 7:30 p.m. Dctalls about the Research Sympo ium and the Annual Meeting of the Faculty will be sent to every faculty memb r in the near future. • BUFFALOPHYSICIAN • 23 �Medical Science units are rated substantial R ating of thre basic cience departments in the School of Medicine in a recent national assessment of docloraJ pro­ gram quaJity how that the UB programs ar ub tantiaJ. but hav room for improv ment. Th tudy. which evaJuated the quaJity of program in six disciplinary cluster , was conducted by a committee named by the Conference Board of Associated Re arch Councils, which comprise he American Council of Learned Societie , the American Council on Education, the ationaJ Re arch Council and the Social S ience Research Council. Six­ teen separate measures said lo be "related to quaJity'· were studied, but th evaluation committ r frain d from combining them into a ing;Ie composite ranking r n ctive of total quality. Int ad. each m a ur is intended to stand independently. with valu giv n for both rank - where the program stood ba ed on raw data - and a tandard core. On the mea ure of faculty reputation. considered by ome observ rs lo be a handy tool for making ov rail com­ parison , the UB D partm nt of Physiology rank d 14th in the urvey among 94 department in its field eligi­ bl to be ranked at all. and placed fir t among public institutions in ew York State. Bioch mistry wa rated 69th among 13 programs nationally on the reputalional cale; and third in cw York State. Microbiology plac d 47 among 133 program nationally and, a wilfi Physiology. frrst among public institu­ tions In the Stat . R acting to rating for the three ba ic science departments. Dean of Medicine John au hton ~ lt that "in general in r lation to the other SU Y medical centers. the data reflect that we are do­ ing a good job." Becau e of projected Im­ prov ments in phy icaJ facilities and new facully hire . aughton continued, "my gue is that we mould ee ven better report next time around . . . If the urv y wer done today. we'd fare better." Though it lipp d even place na­ lionaJly in r putation factors since 1969 wh n th la t such Ludy wa done. Physiology i till in the top 10-15 per cent of all uch programs nationally. aughton pointed out. To stay there. he said. will take effort and an incr a c in outsid upport. Phy iology. under the leadership of Dr. Leon Farhi. will b com ven more in­ volved in underwater and pace phy iology. th dean aid. He mention­ ed lh exp riment that will go into pace on a huttle mis ion in the next few year. 24 • BUFFALOPHYSICIAN found the ratings for Micro­ Naughton bio1ogy a bit more difficult to a se . In facully reputation. that department dipped from 35Lh to 47th nationally from 1969 - till in the upper third of all pro­ grams. What puzzled the dean was that while Microbiology faculty rated very well in publications. the rating accorded to overaJI faculty reputation i much lower. "What' the incongruity?" the dean wondered. "ll makes you question the way they arrived at it." In fact, he noted. rating on individuaJ measures for this department varied widely. The slip of Biochemistry from 37th in overall faculty reputation in 1969 to 69th, aughton acknowl dged, i reflec­ tive of major problem the department suffered In the mid 1970s. One difficul­ ty was its location in exile in make-do facililie in the old Bell Plant off Elmwood Avenue. some miles removed from the r st of the Health Sci nee . Dur­ ing th sam tim . Bioch mi try' chair­ man. Dr. Eric Barnard. returned to England. causing a gap in leadership. Combined, the e factors led to ales en­ ing of energy in recruiting faculty. ew and nergetic leadership and upgrad d faciliti snow bod w II for Biochemistry. aughton feel . The rankings reflect the fact that Stony Brook came from nowhere to eel ip e the reputation of the UB Biochemistry department. This in­ dicates. aughton ug st d. that th down tat SU Y unit was abl to con­ centrate on building a strong basic ciences faculty in the first year of th creation of the rnedicaJ c nter there. possibly becau e there wa no outlet for developing clinical faculty. The Stony Brook HospitaJ came later. Th n, too. aughton aid, the my tique of an in­ stilution being dev lop d from th ground up eem to attract people who are er alive re earcher . Naughton said Stony Brook shouldn't overtake us overaJI in medical or basic sciences re earch and education "unless w fail to do our job." Ideally, aughton would like to see aJl three of these basic sciences programs rated in the top third or better and will "look closely al the results" of the ct.r­ rent assessm nts to "see what needs to be trengthened." Perhaps one area that needs work. he submitted, is making sure our faculty, "get exposed and known on the naUonaJ and international scene." Improvements are already visible, Naughton said. The return of all the basic sciences to Main Street and the resulting better moral among faculty may make them more comfortable mingling with their peers than they were previously when "things were in disarray." What will help all three basic science departments in the future. aughton aid. is that the necessary physical set­ ting for first-rate programs will soon be provided in an addition to the Health Sciences Complex expected to be under­ way shortly. In general. the dean said. each of the three departments has "very competent personnel. including nationally and in­ ternationally recognized scientists. If we can combine that talent with the proper physicaJ environment. we should b able to improve substantially. "It is important." aughton feels, for the UB Med School to rate as high as it can in nationaJ rankings - important for morale. for image and for recruiting the best graduate and medical students. • lnstuments center planned U B will receive a $50.000 plan­ ning grant to be used to develop a proposal for a Center for Advanced Technology in medical instrumentation. Governor Cuomo announced in late March. The proposal. developed by Dr. Michael An bar. chairman of the MedicaJ School"s Department of Biophysical Sci nc s. was one of three planning wer grant awarded: four universiti de !gnat d a "cent r for advanced technology.·· Anbar was "delighted" to receive n ws of the planning grant. "W will mov imm diately to develop a plan and ubmit lo Alban a grant ap­ plication for a very ub tanlial amount of funding that will aJlow us to develop the s ds of a biomedicaJ indu try in this state ... h commented. Terming lh deci ion lo grant UB th planning grant for a medicaJ instrum n­ lation center a "logicaJ and welcome,'· he added, ··suffaJo i the most ap­ propriate center in th late to carry the responsiblity for high technology in medical devic s b caus of its hi tory. current xten i e medicaJ r arch and indu trial ba e. Anbar noted BuffaJo' hi Lorie involvement in development of such biomedical device as the implan­ table cardiac pacemaker and the in· trauterine contraceptive device and the work don on hemodialysis and cryo urgery. "Our objective i to develop r latively maJI. mass-produced in truments. with emphasis on labor int nsive and con­ sum r d vices. as oppos d to research devices, .. An bar said. He emphasized that a major goal of then w c nter will be th er ation of job in tht ar a. "There i ad perate need to develop a new industriaJ ba in Western ew York,'' he said. although adding that the c nter·s mis ion will be to erv th en­ tire state. Anbar aid that his advisory board contains industrial repre en­ tatives who have been clo ely involved since the very beginning of planning for the new research center. ovel in truments developed and tested would be offered to industry at a substanliaJ di aunt if manufactured in WY. �-.- School News To achieve th goal . Anbar said. eed money will have to be inve ted to cover the budget of the Institute that is estimated at $'2 million per year. Half of this is expected to be receiv d from th State, and the other half from contribu­ tion from th Univ r ity. local ho pita! and local industry. Federal upport i al o expected. Contract and royaltie from indu try would gradually replace public upport. The proj cted budget. Anbar aid. hould support 30 to 40 profe ional . including graduate tud nt . It hould also allow ea h year the training of over 100 additional p r onnel in aifferent aspects of medi al technology. h continu d. Anbar aid he has worked out an ac­ tion plan to utilize the $50.000 planning grant to actually b gin th c nter. Po ibly, he said, some money from local indu try may also be forthcoming o that "when we com in with our final ap­ plication. we can already b in full wing.·· The Center would be operated on UB premi e u ing office and lab pace pro­ vid d by th Univer ity - mo t probably within th School of Medicine which An­ bar aid. ""ha been given the mandate to run with the project." An bar said repre entative of four ma­ jor area industrie are involved in the planning: American Optical. Mennen In­ struments. Si rra Research and We twood Pharmac uticals. executive budget for T hethi Governor· year propo e an appropriation First implantable urdi ac pauma/rrr beld in Dr. Andrew A . Gage's band. Dr. Gage, Dr. William M. Cbardac/r and Wilson Gre11tb acb (wbo construded tbe device) were members of tbe piontt ring pacema/rer tu m. Local industrie that tand to benefit. in addition to the medical in trumcnta­ tion indu try, Anbar said. include the electronic. optical, computer. com­ munication and plastics industrie . The In titute wou ld al o facilitate develop­ ment of model h alth care prog rams in the area. Anbar sugge ted. I n the UB proposal. which was develop­ ed in cooperation with the We tern ew York Technology Development Center. Anbar listed the major con­ siderations underlying the concept: ,,,,.There exi ts a erious world-wide need for low co t automated diagno tic and monitoring health care in truments. especially for ambulatory and home care. There is also a need for the technica l as essment of existing equipment. ,,,,.The e need could b met by com­ bining the potentials of academic. in· dustrial and clinical talent in the Buf­ falo area. ,,,,.A succes ful r earch and develop­ ment program could lead to a self­ u taining operation within a period of five years. v A succe sful R & D program could lead to a significant increase in employ­ ment of skilled per onnel. by increasing the production of local indu try and by attracting out-of- tate industry to th area. v A uccessful as es ment program would provid ample employment op· portunitie for engineers. nurs s and health care technician in technical ass ssment of health car in trument and device . The a essment informa­ tion would be marketed nation-wide to manufacturers who have lo comply with new Federal standards regarding Lhe ef­ ficacy and safely of medical equipmen . or hav to meet foreign comp titian in th international market. of $2.5 million to upport the tatewide advanced t chnolo y center program. In addition. many w York companies. including Ea tman Kodak. Xerox. Bausch and Lomb. IBM and American Telephone and Telegraph. have ommit­ ted more than that to the program. The four de ignat d univer ity t chnology nters and the area in which th y will specializ . as announ . ed by Cuomo ar : Cornell, agricultural biotechnology: Roche t r University. op­ tic : Polytechnic Institute of w York. telecommunication . and State Univer­ sity at Stony Brook. medical biot ch­ nology. In addition to UB. Columbia and Syracu e will receive planning grant of $50.000. Columbia for computers and information ystem and Syracu e for computer oftware engineering. In making the announcement. Cuomo said. "The creation of these center forge a partner htp b tween govern­ ment and two of New York' greate t trength - its univer iti and its leading centers of corporal re arch and development. If w are going to take ad­ vantage of the futur . w mu t prepare for it. We mu t make a concerned effort to lead the nation in partner hip among government, busin s . and academia in the search for the best method of ad­ vanced technology. What we do today. will hape tomorrow:· • BUFFALOPHYSICIAN• 25 �90% of seniors matched with 1 of top 3 choices Reactions to residency matching assignments ranged from bugs to handshakes to solitary peeking at the all-important notice slips. NATIONAL RESIDENTMATCHING PROGRAM TABULATION OF HOW STUDENTSWEREMATCHED ACCORDINGTO THEIR EXPRESSEDCONFIDENTIAL PREFERENCES Mtdical Sdiool Code Rank Ordtr No. of Student, UB 1 74 21 2 3 4 s 6 7 8 TOTALMATCHED APPLICANTS TOTALUNMATCHED APPLICANTS - 13 8 2 1 0 1 120 4 A 'l' INDICATF.SSTUDENTMATCHEDTO HOSPITALHE RANKED1ST CHOICE,'2' INDICATESSTUDENTMATCHEDTO HOSPITALHE RANK­ ED 2ND CHOICE,ETC. 26 �Students By JOHN K. LAPIANA I PHOTOS: FRANC IS SPECKER t wa . Edward Klingman xplain d watching hi daughter are n down th ai le toward the podium. the " ndpoint of 22 year of education." Aft r receiving h r nv lop . Karin Klingman care­ fully navigat d her way back to wh r h r fath r tood. barely avoiding the horde of hand shaking. back slapping and embracing m dical tud nt . "We ll?" he a ked. a Karin tood before him with her notice pee led open like a Polaroid nap hot. it gut xpo ed to the eag r. inquisitive lance of her cla mate . She tri d to how no emotion. but it was a losing battle. "It' St. Loui ... he an wered. he italing ju t a mom nt b for ru hing into her father· out tret :n d arm . S ond later. however. he abandoned him. s ar hing for oth r familiar face to hare her "good n w ... Edward Klingman "took hi dau hler. th doctor· .. lead. patting the bac k of any M dica l S hool admini trator. tudent or visitor. and hap p ily r llecting on hi child' felicitou fortune. "She' going to St. Loui . that' her first choice." he boa ted. "She could have gone omewher e l e. but the pro­ gram h 'II b working in (medicine pediatric ) i on of th 6e t in the field." The coupling of Kar in and St. Loui could have. a her father med to in ist. been ordained by the god . but in BUFFALO PHYSICIAN • 27 �ffi the cold. analytical world of medical chool admis ion , such :.:: romantic notions are quickly extinguished. The decision to :rl s nd Karin to the "Gateway of the West" was made not by g, a god or even by a lowly mortal; it was will d by a computer u, in a place far from heaven - a downtown Chicago office o building. ~ Karin i one of the "exceptionally" large number of UB a: medical tudents who received their first choic of r sidency u.. program thi year, the final step in an almost decade long ~ higher education. And while some may not hav been as for0 lunate as Karin. Leonard Katz. the Medical School's associat f dean for student and curricular affairs, explained that over 90 per cent of the graduating class wer a sign d to one of their first three residency choices. "This year has b n one of the best in the Medical School's history," Katz said. "Of the 123 tudents match d. only thr were not assigned a residency by the computer. That statistic is well below the national average of 7 .8 per c nt unmatched. " A "happy ending" was eventually had by all. Katz ex­ plained, ince "within hours" after students received their residency notifications, the lhr program -I ss tudents were matched via Medical School administrators' telephone calls. Unlike admission to ··undergraduate" medical schools where applications exceed openings. Katz notes the situa­ tion is reversed for resid ncie . "Th re are more places open than there are medical school graduate ," he said. "The potential for students to find place is very good." However, Katz notes entrance to cer­ tain programs. such as ophthalmology, dermatology and or­ thopedic surgery, is extremely competitive. Despite that dif­ ficulty. Katz said. many UB graduates will enter some of the "most outstanding and highly sough after program in the country:· Summary of Match results by discipline: (1983) Aautne,iology FIIDilyPractice Gen~ 3 14 13 Surgery lnlunal Mediciae Med/Peds Medicine-Pn/jminary 32 9 15 NturOSw-gery 1 OBIGYN 3 2 Otolaryngology Pedialria Psychiatry 16 Surgery 7 5 Transitional 1 Summary of Match placements by geographic area: (1983) New Yark Alab11Da Arizona California Ca1111«tic:ut Washin,ton,D.C. Illinois MarylSDd MicbigSD Mi"ouri 76 1 1 3 4 3 2 5 1 1 Nartl, Carolina 2 New Jusey 1 1 4 8 2 Nevada Obia Pe11111yl vaaia Rhode /slan.d Tennessee Tuas 1 2 Utah 1 VirgiDia 2 28 • BUFFALOPHYSICIAN (Buffa.lo:46) t 50 graduates are remaining in Buffalo to continue Alma their education in one of the Medical S hool's affiliated hospitals - a statistic Katz said he "couldn't be happier with. "'The quality of students remaining at UB is just great," he noted. adding that UB al o far d well in enticing '"high quality graduate from other chools."' Particularly com­ petitive UB programs, Katz aid , were medicine. gynecology obstetrics. and pediatric and other surgery program . As at most medical schools across the nation, at UB, "Match Day" has acquired a traditional. rituali tic air. Students gathered in front of F'arber Hall's Butler Auditorium hours prior to the handing out of the envelopes on March 16. But b fore Medical School officials would allow th anx ­ iou mob into the room. the class was shepherded out onto the building· teps for a final group photograph. Inside the auditorium, a member of the student government made cla announccm nts, the proces soon resembled a high school graduation an the pomp and cir­ cum lance. or an informal class day. Between hugs. wishes of good luck . and prematur farewells, students voled on awards and cheered faculty members, who vainly attemp­ ted to divert the audience' attention from the imminent awarding of the envelopes to the more mundane ar­ rangements for next month"s graduation day . Finally. as patience neared its end, the heads of various Medical School departments started their roll call and began to pa out the envelop s. Beginning with Peter Accetta. who will remain in Buffalo to complete fiis residency. to Gr gory Zuccaro. d stined for Rochester's Strong Memorial Hospital. each student experienced what one described as an "'emo­ tional D-Day."' Reactions ranged from Karin Klingman·s alt mpt a ub­ dued ecstasy to Richard Amarian ' thru ted fist and extend­ ed cry. "ye- -e- s:· And although 12 tudents could not boast a first three choice a signment, Katz concluded that "this y ar has b en a wonderful one from all perspectives." • �Students Student builds his own dulcimer U B medical tud nt Bob William i a m mber of a small but growing group of musician who ar reviving interest in an in trum nt which one teet red on th edge of oblivion. Al the tum of the century. almost anyone with a Sears Ro buck catalogue could r cogniz th trapezoid­ shaped instrument. wfiose strings are struck with tiny hamm rs, a the hammered dulcim r. Som w re known to b produced in Western ew York. Today. though. relatively few have seen the instrument, much less heard the sweet. harp-like sounds which ring from its string . Williams "discovered" the dulcimer at a ew Jer ey Bluegrass festival three years ago when he was a graduate student in anatomy at SUNY Stony Brook. A1r ady ac­ compli hed on the saxophone and five- tring banjo, he found his discovery enchanting and irresistible. Listening to its tones. he was determined to own one and learn to play it. Prices ranged from $300-$600, however - money he just didn't have. A pre-fab kit was available for a mor mode t $100, but he opted to build his own, unconcerned by his lack of wood­ working experience. Gathering all the information h could find on the instru­ ment. including a $3.50 book on how to build a dulcimer, he and a Stony l3rook colleague Guy D'Angelo spent their lunch hours in the lab constructing it. The frame, which ha to withstand two tons of pre ure a the strings are played, and two bridge which are part From page 7 Doctor's Orders not likely to want to practice any of these at the expense of If-gratification. So instead of following a ensible nutrition plan coupled with exerci , the patient continu s to pile on weight. becoming more susceptible to certain types of cane r, diab tes mellitus, heart problems and a host of other ailments. Anoth r cultural th me which has encouraged non­ compliance has been medicine· embracing of a range of pro­ blems, lab ling them as "illnesses·· for which there may be no cure and improvement only with vigorou patient cooperation. Many of these, including drug addiction. alcoholism and morbid obe ity. have been conv rted from being "sins·· to "illness."Bisson tte notes. "The important consequence of this developm nt is an in­ flation of the numb r of di eases inherently re i tant to cure and therefore problematic with respect to patient com­ pliance:· he says. While the mu brooming of medical knowledge and ophi Heated diagno Uc te ts has made inroad ~n a great many diseases, it has ironically served in many instances to widen the gulf between patient and physician. "People are so accustom d to the aw~me technology and special experti e associated with medicine today that most ot the instrument. were made of maple which is a hard wood. Softer poplar was us d for the oundboard. "Spruce would hav b en better," Williams explain "but it was more xp nsive and difficult to get in the sizes 1 n eded." Four gauges of wire, available on spools from dulcim r player Bill Spence's mail-order music hou e in Voorhee ville. were purchased for the strings. The tuning pins came from the mail ord r hous also. Tbe mall ham­ mers were crafted from some of the leftover wood. Final cost was about $60, not including th e Umat d 160 man-hour which Williams and D'Angelo put in. were attached and the instrument Thewasdayreadythe tostrings be tested was a tense time for the two. But the dulcimer. its soundboard decorated with handcarved whales, birds in flight and a lone horseshoe crab to d not the Long Island shor , produced lhe same sweet, harp-lik music Williams remembered from the Bluegrass festival. Since then. he' taught him elf to play 100 ong - mo t­ ly traditional and Celtic. While the instrument ls often confused with th Ap­ palachian or mountain dulcimer. an hour-glas stringed instrument trummed with the fingers. the two are quite dissimilar, Williams emphasizes. The hammered dulcimer, referred to in the Bible along with its cousin the psaltery, is more akin lo the zither, the autoharp and the Hungarian cymbalon. Williams hopes to make another dulcimer as well as a Celtic harp and a medieval bowed psaltery. a triangular shaped instrument play d. not surprisingly, with a bow. . "B~t being a medical tudent do sn't give you much fr time, he says. Enrolled in the accelerated program in the School of Medicine, Williams, who earned a Ph.D. in anatomy from Stony Brook. hopes to eventually practic family medicine in a rural or suburban area. ··1 liked doing research but I missed being around peo­ ple," he says in explaining hi career change. That he enjoys sharing his music with others was evi­ dent at a recent Medical School Th.lent ight in a crowded auditorium when he introduced listener to the haunting tones of his prized instrument. • - M. B. Spina suffer from the 'ambulance ls coming· syndrome," Bi sonette feels. That i • they believe for ev ry problem th r i an exp rt who is capable of solving it. "It's not unusual for peopl to turn their bodi ov r to th ·expert.' wheth r or not th y can tell the pert from non­ expert. just as easily and readily as they do the car of their automobile ," Bissonett explains. By understanding the belief ystems which encourage non-compliance, physicians and patients may be able to ao omething about the probl m. "For years. medicine's of1irtngs were limited and dealt with di ases which treatment coufd either cure or not cure. To­ day's growing number of medical problems are leaning mor toward those in which change in lifestyle. behavior modification and patient cooperation are increasingly important in order to effect cure or management or preven­ tion," Bissonette notes. adding that whether or not the pa­ tient truly understands the disea e seems to have no effect upon degree of compliance with treatment. "'But there i evidence that if the patient understands the 'whys' of the treatment - which increasingly includes b havioral changes - compliance will improve:· say UB researchers. The Ludy suggests that while sociocultural valu s and norm may be outside the control of the physician and pa­ tient. the physician' awareness of their importance may lead to more realistic as umptions about patient cooperation in following medical regimens. • - M.B. Spina BUFFALOPHYSICIAN• 29 �Renee Fox will address graduates Guest speaker for the School of Medicine's 1983 Commencement Exercises will be Dr. Renee Fox, pro­ fessor of sociology, University of Pennsylvania. and director of the Human Qualities of Medicine Pro­ gram of the James Picker Founda­ tion. Dr. Fox's topic will be ''The Graduation of a Medicine-Watcher." The commencement is scheduled for Kleinhans Music Hall at 7 p.m. on Sunday, May 22. Holding a Ph.D. in sociologyfrom Harvard, Dr. Fox is Annenberg pro­ fessor of the social sciences at Penn. She is author of four books. in­ cluding Essays in MediciaJ Sociology (1979) and Th Courag to Fail: A Social View of Organ Than plants and Dialysis (with Judith P. Swazey) (1974). She was editor of The Social Meaning of Death. a special issue of The Annal of the American Academy of Political and Social Science, January 1980. For the August 20, 1982, issue of Science she co-authored an article on critical care in the Pirst Central Hospital of the mainland Chinese City of Tianjin. Her nearly 50 published articles also include works on ethical aspects of biomedical advances, changes in attitudes of medical students. the "demedicalization"' of American society, medical curriculum and the impact of illness on the family. Dr. Fox has held research and teaching appointments at Harvard. Columbia and Fordham and has been a uisl ting professor in Belgtum. Canada and Zaire. She has been awarded flue honorary degrees and has received several prizes for her writing. A former member of the editorial advisory board of Science. she is currently on the boards of several scientific publications and a member of the editorial committee of the Univer­ sity of Pennsylvania Press. Also on the Commencement pro­ gram will be several graduating students: William Hanavan. the class speaker: Lonnie J. Behar. who will introduce the guest speaker: and editor Karin Klingman of the Iris who will announce the dedica­ tion of that publication. Dr. Leonard A. Katz, associate dean. will lead the graduates in the Charge of Mai­ monides. and Dean John Naughton will administer the Oath of Hip­ pocrates. After conferral of degrees by President Steven B. Sample, both M.D. and Ph.D. degree reci­ pients will be hooded, and M.D.s will sign the Book of Physicians as is the annual custom. To conclude the ceremony. honors and awards will be announced by Dr. Paul Davis. 30 • BUFFALOPHYSICIAN Fiftieth Anniversary Class of 1933 HEART FAIWRE: NEW CONCEPTSIN DIAGNO­ SISAND TREATMENT • Thursday, May 5. 19 3. Sheraton Inn. Buffalo Ea t. Spon or d by the Buffalo Academy of edicin . th Depart­ ment of M dieine, Buf­ falo General Ho pita!. and Continuing Medi­ cal Education. UB. Fee: $25. members of Lh Buffalo Academy of Medicine: $50 non­ member phy ician : 25 nurse and health profe ional . Thi fi include cofTec breaks and lunch. Residents and students of SU Y Buffalo chool of M di­ cine ar admitted with­ out fee but mu t regl t r in advance. They may purcha e lunch­ eon tickets at the r gi tration desk. A 20 p r p rson additional fee will be assessed for the banquet. This program will erve a a compr h n­ iv revi w and update on the ubj t of heart failure for physician Wilfrid M. Anna, M.D. Lockport. New York John L. Baube, M.D. Mt. Vernon, Ohio Alice L. Clark, M.D. Riveruiew, Florida Vincent J. DiMarco, M.D. Buffalo, New York Emil F. Ersay. M.D. Fbmpano Beach, Florida Jason E. Farber, M.D. Oakland. California William G. Ford, M.D. Snyder, New York orris H. Frank. M.D. Clearwater. Florida Henry Haines. M.D. Buffalo. New York J. Curtis Hellriegel. M.D. Buffalo. New York Joseph W. Hewett, M.D. Buffalo, New York Thomas C. Hobbie, M.D. Sodus. New York Ernest G. Homokay, M.D. Silver Creek, New York Franklyn A. Huber. M.D. Winter Park. Florida John C. Inman. M.D. who manage patients with eriou heart dia . Empha i will be placed on n w diagnos­ tic and urgical techni­ ques as well a new pharmacological agents available to the cliniian. Dr. Reae,, Foz Lake City, Michigan Louis Kolbrenner. M.D. Brooklyn, New York W. Donald Leslie, M.D. Buffalo, New York George M. Masotti. M.D. Williamsburg, Virginia Anthony J. Mogavero, M.D. San Diego, California Edward H. Morgat, M.D. Niagara Falls. New York John D. Mountain. M.D. Manhasset, New York orbert G. Rausch. M.D. Buffalo, New York Frances L. Sapowitch, M.D. Buffalo. New York Charles J. Sehuder. M.D. Williamsville. New York Henry H. Stelman, M.D. Buffalo, New York Thomas J. Syracuse, M.D. Buffalo, New York Louis A. Vendetti, M.D. Buffalo, New York Ross Vilardo, M.D. Orange Park, Florida Murray A. Yost, M.D. Buffalo, New York Gu t peakcr for the banquet will be Magdi Yacoub. FRCS. con ul­ tant cardiac urgeon. Harcfield Ho pital. Mid­ dle ex. England. Other visiting faculty include Shahbudin H. Rahim­ toola. M.D .. chief of Car­ diology. University of Southern California and Edmund H. Son­ nenblick. M.D .. director of ardiology. Albert Ein ein College of Medicine. UB facully on the program include Djavad T. Arani. M.O.. Department of Cardi­ ology. Buffalo Gen ral Ho pilal; Dennis P. Dubois. M.D .. Coronary Car Unit. Bu[Talo Gen­ eral. and Milford C. Maloney. M.D.. chair• man. Department of Medicin , Mercy Hospital. This offering meets criteria for 7 credit hours in Category l of the Phy ieians Re ogni­ lion Award of the Amer­ ican Medical Associa­ tion. It is also accept­ able for 7 prescribed hours by the Am rican • Continued inside back cover �Calendar Reuniondus chairpersons(smallerphotos,left to right):Row l. Dr. Ro~rl Milch '68; Dr. Charles Tiront '63. Row 2. Dr. Harold l. Graff '48; Dr. William H. Georti '43. Row 3. Dr. ThelmaBrock '28; Dr. LucienPoten­ za '58. Row 4. Dr. MichaelSullivan '53; Dr. Judith Landau '48. Row 5. Dr. WallerKing '28; Dr. Kevin O'Gorman'43. (Immediateleft) Dr. £. Grey Dimond, the 1983 StodclonKimball Ledure.(Top);and Dr. J. Cur­ tis Hellriegel, chairman,50th Anniversary Class (bottom). Coronaries '' E All you want to know about them v rything You Always Wanted To Know About Coronaries But Were Afraid to Ask," was the theme of the 46th Annual Medical Spring Clinical Day held in the ballroom of the Buffalo Marriott Inn (Millersport Hwy. near the UB Amherst Campus). Saturday, May 7. The event opened with an early morning continental breakfast. Class Reunions w r held in the ev ning. The first cientific se ion of the day tiegan with ""Ir atment of You. The Phy­ a presentation given by sician. Pre. During and Po t Myocardial Infarction." Dr. Robert Hall. a UB medical alumnus of the Class of '48, who is now clinical profes or of medicine. Baylor College of M dicine. and medical director. 1exas Heart In titute. Houston. UB Medical D an John aughton, who d v lop d the widely used aughton stress test to ass physical fitne • talked on "R habilitation Exercises and Stress 1esting" at 8:50. Simon H. St ntzer. M.D .. assistant professor of clinical medicin . ew York Medical College, followed at 9:10. Stentzer who is also chief. Hemodynamic Laboratory. and director, interventlonal cardiology, Lenox Hill Hospital, ew York. dlscu sed '"Iransluminal Coronary Anglioplasty." A panel discussion ended this bloc"k of programming. Moderator for thes fir t three s ssions was Joseph A. Zizzi, clinical a ociate professor of medicine. UB, and medical director. Eri aunty Medi al Center. anoth r 1948 UB School of Medicine alumnu . The second half of the morning ses ion featured presentations on: "In­ tra Aortic Balloon Pumping.·· by Theodore L. Biddle, M.D., associate professor of medicine. Univ rsity of Rochester. and director. Int n iv Car Unit. Strong Memorial Ho pita!: "Surgical Tr atment of Acute Evolving Myocardial Infarc­ tion . · · by Jack J. Leonard. M.D .. thoracic cardiova cular surgeon. Sacred Heart Medical C nter. Spokane, Washington; and "Coronary Art ry Bypa Surgery: Long 'Ierm Effect.' by Robert J. Hall. Frank J. Bolgan, clinical a ociate professor of surgery at UB and chairman of the Department of Thoracic and Cardiovascular Surgery, Millard Fillmore Ho pita), moderated these di cu ions. Again, a panel discussion followed. A bu iness meeting of the Alumni Association int rvened before th Annual Medical Alumni Luncheon and Stockton Kimball Memorial Lectur . which was given by E. Grey Dimond. M.D., distinguished professor of medicine. Univer ity of Mis ouri, Kansas City. Author of 21 books and 320 articles. Or. Dimond arncd hi M.O. at the Univer ity of Indiana and ha b n a distingui hed proi ssor of medicine al UMKC from 1968 to the pr cnt. He i al o a con ultant on health affairs lo lhc chancellor of that institution. wher he erv d for eleven years as provo t of health ciencc . He ha visit d the Peoples Republic of China three lime a group I ad r of medical education t am for the Chin e Medical Association. A on ultant on the Chin language edition of JAMA. the Journal of the Am ri an Medical A ociation. he al o is an honorary proi ssor at the Shanghai M di al College. On Saturday vening. reunion were held for the classes of 1928, 1933. 1938, 1943. 1948, 1953. 1958. 1963. 1968 and 1973. A full report on Clinical Days will app ar in h July Physician. BUFFALO PHYSICIAN • 31 �1920 Gift of sight returns Maxwell Lockie. M'29. L internationally known author­ ity on arthrltls. wa honored at a urprlse party in hi office on the 50th anniversary of hi profe · ional career. He tarted arthrlti clinic at John Hopkin Medical Institute. Baltimore: Buffalo General. Children's and Meyer Ho pital Dr. Lock.le was founder and past pr ident of th Ar­ thrill Foundation of We tern ew York and a pa t pr id nt of the American RheumaU m Asso­ clallon . T h gift of ight ha unexpectedly r turn d lo a young Cleveland phy­ ician who la l pring b came th first blind ludcnt lo gradual from UB's School of Medicine. Physicians are puzzled at the return of Dr. George Rafferty's eyesight. but the affable red-haired resident at Cleveland's Univer i­ ty Ho pital and his family ar ecstatic. Rafferty. who several years ago under­ went surgery to correct detached retinas. uffered from inoperable cataract and macular degeneration. a condition more prevalent in the eld rly. But neither. said physician , appeared the cau of the grow­ Ing blindness and piercing pain b hind the eyes which began its downhill course as he entered his junior year of medical school at UB. A Cleveland ophthalmologi t peculates the vision loss which left young Dr. Raffer­ ty blind may have been cau ed by optic neuritis which, over time. corrected itself. But no one can ever be certain as to why last fall the young resident in p ychiatry and father of two began to see the outline of doorway where before he could at b st only distinguish betw en llghtn and dark. "I had given up all hope that I would ever ee again," he says. And as the pain began to lessen and the vision continued to im­ prove. he became fearful that he might have a brief return of his sight only to lose it once again. R afferty. who b fore his vision los had planned a career in psychiatry to pecializ in treating the emotional pro­ blems of those with chronic or terminal il­ lness. waited for everal weeks to tell his family of his returning sight. "J had visited the ophthalmologist one day and during the vi it b came aware that I could actually see him." relates an excited Dr. Rafferty. When he returned home.he told his wife, Cathie. that he didn't want h r hopes up but h b licv d his vision had returned. Mrs. Rafferty and th couple's youngsters. Adam. who i nine. and Jaime. 5. are ecstatic. ··we Ju t can't believe that this has hap­ pened.' sh says. "and neither can George!" Whil doctors in Cleveland can give no guarantee that Dr. Rafferty's new-found vi­ ion is permanent. the young physician and his family believe in being optimistic. During the past ten years, they" have become experts at making the b st of what appeared to be "bad breaks." Raf~ rty suffered detached r tlnas in 1978, which were surgically and succe ful32 • BUFrLAO PHYSICIAN 1930 A. ~arch. M'31. reports T homas he i seml-r llred and do " occasional con ulting ." He retired a dir ctor of the VA Ho pital, Tucoma, Washington in 1973. Dr. Marsh I II t din Who' Who In the We t. T homa retired G. McDonough. M'36. in 1981. He had been clinical director. U.S. Public Health Service of W stern ew York. He also rved as an inurance medical examiner from 1972 -1981. Dr. luffuty at Cleveland Hospital. ly reattached. but he was told that he could not return to his job In Lockport. .Y.which had involved bending and lifting. That kind of work wa out forever. A high chool graduate who had up un­ til then worked as a laborer. truck driver and sometime guitar player. he was sent to ew York State's Office of Vocational Rehabilitation. There he told hi counselor he would like to go to college. Funds were made available and four years later, he graduated from UB with a 3.9 average and a double major in psychology and biology. Fired by his academic succe s and a growing dream of becoming a physician. he applied to UB' School of Medicine and wa accepted. But halfway through his freshman year, he became aware that the vision in the upper nasal quadrant of hi left eye had worsened. Examination by several phy ician in Buf­ falo and New York City revealed the macular degeneration. which had no cure. He was told his sight would worsen and he would probably become blind. With help from variou agencie and his family. how v r. he continued his medical studie . While the Rafferty are celebrating th return of his vision. there was one sad note. Ember, the young German Shepherd guide dog which Dr. Rafferty acquired nearly a year ago. had to be returned. "It was heartbreaking for all of us but Ember is a working dog who would have not b en happy a just a 'p t'," he say . • - M. B. Spina 1940 T. Donovan. Jr .. M"43. ha John retired after 32 years of ervice in radiology at Lockport Memor­ ial Ho pital. He served an intern­ ship at Sisters and upon comple­ tion of his residency at Meyer. h and his family moved to Lockport. Dr. Donovan has serv­ ed as president of the 8th District Branch of the Medical Society of the State of w York. president of the iagara County Medical Society and chief of the m dical staff at LMH. Jame retired Macalu o. M'44. ha after rving the Lockport M mortal Ho pita! for 36 years In family practlc . He I a member of the Lockport Academy of Medicine. A. Muell r. M'44. of Helmut West Vancouver. B . Canada, has been elected vie president of the American College of Radiology . H is director of diagnostic radiology at the Cancer Control Ag ncy of Brit! h Columbia and clinical profe or of radiology at the Univ rsity of British Columbia in Van ouv r. From 1950 to 1974, Dr. Mueller was a radlologi t at five lcxas ho pltals and maintained a �-·------------ -------- ------- ------ ---------------------------private practice In Dalla and Ir­ ving. He was al o a clinical In­ structor at the University of Southwe t lexas Medical School In Dallas. In 1974 he became dir ctor of the department of radiology at Aspen Vall y Ho pitaJ. and was a clinical in­ structor at the University of Col­ orado Medical School in Denver. Dr. Mueller joined the faculty of medicine at th University of British Columbia in 1979. M. Souder. M"44, is Byron retired and living at 2291 Har­ rison Street, Santa Clara, Califor­ nia 95050. P aul L. Weygandt. M'44, has retired from private practice (Orthopaedics) and currenUy conducts VA evaluation two day a week. He lives ac 871 Sycamor Lane. Akron. OH 44313 . Herbert r ntly E. Joyce, M'45. i cur­ acting chairman and clinical assistant profe or of family medicine. UB. Prior to June. 1982, he was in private practice full-time. He resld at 10 Gothi Ledge. Lockport. Y 14094. Eugene fessor R. Mindell. M'45, pro­ and chairman of Or­ thopaedics. UB, was rec ntly lected president-elect of the American Board of Orthopaedic Surgery and will serve as presi­ dent of the Am rican Board of Or­ thopaedic Surgery from July 1983 to July 1984. Desmond Coughlin, M'47. Joyce is a cllnical assi tant profc r of urology at Duke University. She i active In ra1 local, tale and national profe ional ocietles and is director of First Union atlonal Bank in North Carolina, orfolk Southern Railway. and the University of orth Carolina Asheville Founda­ tion. Dr. Coughlin live at 414 Vanderbilt Road. Asheville. C 28803. J. Enright, M'48, is an Tahomas sistant clinical profe or of surgery at Duke University . H 1 a i tant chief of surgical ervtce at the VA Medical Center in Asheville. C. and a contributor to the recently publi hed tex­ tbook on "Surgical Infectious Disea ... Dr. Enright lives at 21 Stockwood Drive. Asheville. NC 28803 Bernhard. M'49. Harold elected secretary of was the American Coll ge of Gastroen­ terology at its recent annual meeting in cw York City. He is a clinical associate profe or of medicine at the Medical School and ga tro nterology chief at Millard f'illmore Hospital. 1950 Pinke!, M '5 I. of Duarte. Donald California, has been appointed chairman of the department of pediatrics at lemple University School of edicine and St. Chrl topher 's Ho pilal for Children. Since 1978. Dr . Pink I ha been chairman of pediatrics and senior physician at the Familian Children· Center, City of Hope ational Medical Center In Duarte. Prior to that he wa the nrst chairman of the department of pediatric at the Medical Col­ lege of WI consin and pediatn­ cian-ln-chlef at Milwaukee Ch lid· ren's Ho pita!. He also erved a medical director of St. Jude Children· Ho pita! and wa pro­ fessor of pediatrics and preven­ tive medicine at the University of lennessee from 1961 to 1973. Dr . Pinke! ha erved a chief of pediatrics at Ro well Park and wa re carch fellow at the Children· Cancer Research f'oundatlon. Children· Ho pltal Medical Center in Bo ton. Dr. Pinkers numerous honors - all for his work In leukemia - Include the 1972 Albert Lasker Award for Medical Research, the David Kamofsky Memorial Award of the American Society for Clinical Oncology in 1978, and the Zimm rman Priz for Cancer Research, Hanover, Germany, In 1979. G. Borman. M '48. ovember from the United States Air Force . H resides at 635 We twood Dr.. Ab rdeen. MD 21001. Medicine . He has a private prac­ tice in Pittsfield. Simp on William . M'58 . Jame has been appointed chairman of the departm nt of urgery at Millard Fillmore Ho pita!. J. Pl tman. M'54, was 1960 Robert elected chief of staff at St. artin S. Clare's Hospital , Schcn ctady , wher he continues to rve as chief of urology. He lives at 2170 Lynnwood Dr .. Schenectady. Y. .David Ben-Asher. M'56. is a Mclinical a sociate of internal Wayne, M'60, ha Mbeen elected pre id nt of the Society of Medical Psychoanalyists. He Is a linical a sl tant profe or of psychiatry at cw York Unlver ity School of Medicine . medicine at the University of Arizona Colleg of Medicine. He J a member and past chairman of the Arizona Board of Medical Examiners. and a member of veral other local and national ocietlcs. Dr. Asher resides at 5635 E. 7th Street. Tue on. AZ 85711. R. Gacek, M'56 , has Rbeichardn professor and chairman of otolaryngology at Upstate Medical Center (SU Y) ince 1977. He i adjunct profe or of communicative di orders at Syracu Univ r ity and i also associated with the Institute for Sensory Research. Before coming to Syracuse he was a so lated with the University of Massachu­ setts Medical C nter. Harvard Medical School. Massachu el Eye and Ear Infirmary. The physician-educator has authored or co-authored 108 articles for scientific journals; Is a member of 15 national profes ional organization ; has received everal honors from professional societies; and ha served on numerous national medical com­ mittees. Dr. Gacek lives at 4921 Thnglewood Lane. Manl!u . Y 13210. Dr. Btrn&ltill '61 M. Bern t in. '61. clinical Joel a I tant profe or of otolaryn­ gology and pediatric . delivered two lecture at the Fifth Buffalo International Symposium on All rgy & Immunology, Toronto. Canada. Hi topics were: Slnu ill : and The Role of lgE Mediated Hyp rscn ltlvlty In Otitl Media. Dr. B rn teln wa also a guest speaker at th XII In­ ternational All rgology Associa­ tion in London in October and at the University of San Diego. His topic: "lmmunopathology of Rhlnll! ... herman Waldman. M'57. Sclinical E. Desanti . M'61. assistant profes or of Carlo chairman of the department pediatrics. has been elected to the nallonal board of tru tees of the Leukemia Society of America. He is past president of the ociety's W Y chapter and vice chairman of its national patient-aid committee . James Col.retired In l of ophthalmology and president of the medical staff of St. Mary' Ho pital. Rochester. eo.vYork. He ls an assistant professor of urgery at the Univer lty of Roche ter. L. Eis nbcrg. M'58. a M. Hochberg. M'61. ls Benson Howard radiologist in Randolph, New vice pre id nt of Monitoring G eorge L. Collins. Jr .. M'48. ha been elected chairman of the board of trustees of the Medical Society of th State of e\V York. He i a cancer research cientist at Ro well Park. clinical a istant profe sor of medicine at the Medical School. and a tru tee of the State University of New York . Classnote Hampshire. is erving a two-year term as president of the New Hampshire Radiology So iety. Products Group, Squibb Medical Sy terns. He live at 144 74 156th Ave. E. Woodinville. WA 98072. ason A. Red r. M'58. i an tephen C. Scheiber, M'64. of Jassistant STucson. professor of ob tetrlcs A r izona, has been Dr. Collins '48 and gynecology at the Universi­ ty of Ma sachus tts School of -------------------------------------------------------------....1 elected as a Pellow in the Ameri­ can College of Psychialri ts. He is BUFFA LO PHYSICIAN• 33 �■ co ditor of a new book, The Im­ paired Physician published by Plenum. Catanzaro, M"65, i an Antonino a oclate pro~ s or of medi­ cine at the University of Califor­ nia at San Diego. He is acUve in everal local. state and national profe ional societle , and ha authored and co-authored numerous article for profc sionai journal . Dr. Catanzaro's addres is University Hospital. 225 Dickerson Street. San Diego, CA 92103. L ance Fogan, M'65. is chief of the department of neurology. Kaiser Foundation Hospital. Panama City. California. and assistant clinical profe or at UCLA. Or. Fogan is chairman of the Medical Advt ory Board, Southern California Chapter, a­ tional Multiple Sclero is Society and also secretary-treasurer of the Los Angeles Society of eurology and Psychiatry. B. Serfustini. '66. is Aannthony associate clinical pro~ ssor of surgery and a member of the ports medicine department at the University of Nevada. He is national "on-site" evaluator for the American Physical Therapy A soclation. He lives at 3375 E. Maule St.. Las Vega . V 89120. lan M. Wag hul, M'66. whose Aspecialty i neurology, was one of 15 phy lcian in Florida appoint d to the Governor's Com­ rnitlee to Investigate insurance fraud . Dr . Wagshul is a clinical a sociate professor at the Univer­ sity of Miami and a guest lectur r at Florida International Unlverlty. R. Dantzker, M'67, will be David moving to Hou ton, Toxas in July 1983 to become professor of medicin at the University of Toxas Science Center and direc­ tor of the division of pulmonary medicine. Dr. Dantzker is cur­ rently an associate profe sor of medicine at the University of Michigan. L. Tl"eger. M'67. has a Calvin private practice in derma­ tology/internal medicine. He is assistant clinical profes or of medicine at the University of Washington. Seattle . W. Albert specialist Biglan. M'68. a In pediatric ophthalmology, wa recently pro­ moted to clinical a sociate pro­ fe or of ophthalmology at the University of Pittsburgh. Dr. Btglan Is the author and co­ author of numerous paper and articles for professional Journal . He Is currently erving a ex­ ecutive director of the American Diopter and Decibel Society. L. Smith, M'69. is pro­ Wilbur fessor of pediatrics and radiology at the University of Iowa . He co-authored "GasLroln­ testinal Imaging in Pediatrics" Lippencott. June 1982. Dr. Smith is director of pedlaLric radiology and director of educa­ tion-radiology at the University of Iowa. He lives at 2271 Cae Drive, Iowa City. The Elli ons have three childr n, Tl"avi . Heather, and A hley and their home addre s is Box 808. K ams Canyon, AZ 86034. W. Garro\vay. Neilassistant clinical M'70. is an professor of medicine at the University of Rochester. He is director of am­ bulatory service at Genesee Hospital and resides at 101 Thackery Road, Rochester, Y 14610. , M'70. clinical RasusselloclateMassaro in medicine/family medicine. has been elected the first president of the New York State Office of Mental Health Medical Staff President' Organization. Dr. Mas aro is pre Id nt of the medical-dental staff at the Buffalo Psychiatric Center. Bob, M'72. was recent­ Harold ly elected to the Board of Tl"ustecs of the Balllmore Coun­ ty General Hospital Foundation. He wa also named chairman of the Legislative Commission for the Maryland Academy of Fami­ ly Practice. 1980 Lawrence S. Pohl. Since M"72. has been medical direc­ tor of Raleigh Hills Hospital. an alcohol rehabilitation facility in the San Diego area. He is in fami­ ly medicine and live at 1819 Hid­ den Mesa Road. El Cajon, CA 92020. tephen Welk. M'72. ha been Scertified as a Diplomat of the 1970 Ellison, M'70, specializes in Carlpediatric and is currently Lhe pediatrician for the Hopi Indian ReservaUon In orthem Arizona . American Practice. R Board of Family ichard M. Green. M'73. was elected president of the Ven- tura County Chapter of the American Heart As ociatlon for 1982-83. He Is a Fellow of the American College of Cardiology and lives at 3445 1\vln Lake Rtdge, We tlake Village. CA 91361. R. Goldstein. M'74. Is in Howard private practice In Will­ ingboro. ew Jersey. His special­ ty Is adult and pediatric urology. Dr . Goldstein is author and co­ author of numerous articles and papers for professional journals. He writes that he and his wife Judy have three children. Lee. Lauren and Daniel. F. Marra. M'74, I director J ohn of the invasive laboratory. Maryland General Hospital. Baltimore. He wa the 1981 reci­ pient of the Golden Apple Award given by the hospital house staff to recognize dedication and ex­ cellence In medical teaching. Szymula. Norbert been named to M'74. has veral posi­ tions with the American Aca­ demy of Otolaryngic Allergy. He was appointed assistant chair­ man of the public education com­ mittee; elected a voting council member: and will erve on the faculty at a postgraduate seminar in fundamentals of otolarynglc allergy sponsored by th Univer­ sity of Tonnessee College of Medicine . Dr. Szymula is a clinical as istant professo r of oto­ laryngology at the Medical School. Drazek. M'76. i in George private practice in ophthal­ mology at the Wichita Clinic and a part-time clinical instructor at Kansas University School of WE'D LIKETO SEEYOU HERE Please send the latest information about yourse lf, toge ther with a photo if possible, to the Buffalo Physician so your classmates can keep in touch with you. Use the conve­ nient form on the back cover of this issue. 34 • BUFFALO PHYSICIAN �• Classnotes Medicine. His wife. Jane. specializes In rehabilitation medl· cine and is staff psychiatrist at St. Jos ph Medical Center. They have two son - Andrew (4 years) and Chri topher (1 year) - and re Ide at 312 S. B lmont. WI hita. KS 6721 . Marshall bana. going into private cardiolo~y pracllc in Connecticut." r P. Bowers. '78. i now a Rogccrttned pccialist in nu I ar medicine. He Is an a ociat in diagnostic radiology at th Guthrl Clinic and Rob rt Packer Ho pital. Sayre. PA. A. Fogel. M'76, of Ur­ Illinois. has been elected to Fellow hip in the Am rican College of Phy ician . Dr. Fogel. asp ciali t In internal medicine. I on the taIT of the Mercy. Burnham. and Cole Ho • pltal . obin H. Adair. M'79. recently Rgave birth to a son. Loren Mat­ E. Billi. M'77. I an instruc­ John tor in the department of inter­ nal medicine at the University of Michigan Medical School. He is directing the Advanc d Cardiac Lw Support training program for th University of Michigan and live at 12815 Drury Lane. Plymouth, Ml 48170. Seltzer. M'77. write "I Jeffrey wlll be completing a one-year fellow hip in cardiac pacemakers through th orth American So­ ciety of Pacing and Electrophysio­ logy. In Jun 1983. and wlll be Dr. Bowers '78 A. Paroski. Jr .. M'78. Paul in tructor in pediatric is an and preventive medicine at the University of Medicin and D n­ ti try of J. and a clinical in- D R. H. PAUL LO GSTRETH. M'45, DIED ON OVEMBER 7. 1982 , after a lengthy illness. A native of Pittsburgh, Dr. Longstreth attended the Univer­ sity of Buffalo from 1938 Lo 1941 as a pre-medical student lhen enrolled In the Medical School, graduallng in 1945. He interned at Allegheny General Ho pital In Pittsburgh, and returned to Buffalo in 1946 as re !dent physician in pathology and Internal medicine at E.J. Meyer Memorial Hospital until 1950. After four years of private practice. Dr. Long tr th served with the Army Medical Corps as a Major at Valley Forge Army Hospital. Returning to Buffalo. he was assi tant dean and chairman of admissions at the Medical School from 1957 lo 1959 and was assistant profe sor of medicine until he moved to Athens In 1978 to Join Health Services at the University of Georgia. He retired ln I 980. Dr. Longstreth had been a fellow of the American College of Chest Physician and a member of the Erl County MedJcal Society. the State Medical SocieLy and the American Medical Association. He was a past pre idenl of the Buffalo Academy of Medicine. a Diplomat of the American Board of Int rnal Medicine and its subspecialty Board of Pulmonary Disease. • D tructor in pediatric at Albert Einstein College of Medicine. H i director of the pediatric reidency program and a lstant dir ctor of pediatric at Newark B th I rael Medical Center. He i active In ev raJ profe ional oclelie and re ide at 114 Willoughby Ave .. Brooklyn. NY 11205. R. WARRENS. SMITH, M'29. A GENERAL PRACTITION­ er in the Town of Tonawanda area for 40 years. died Oc­ tober 30 In Bluff Point, where he had lived since retiring in 1975. He was 77 years old. Dr. Smith formerly was head of the general practice depart­ ment at Kenmore Mercy Ho pita! and a mem b r of Its medical staff for 25 years. In 1980 he was the first recipient of the ho pital's Sister of M dical Examiners. While at UB he won the Bu well Student Re carch Award. the John Wat­ son Award In Medicine and the Upjohn Research Award. Jo eph Gagliardi. Njoined the multi M"79. ha peclalty clinic In Longmont. Colorado. He completed hi r idency in Jun . 1982. He is living at 1100 Holly Ave.. Longmont. olorado 0501. Benham, M'80. i chief Strephcn Idem of the East Tonne e th w. She i a part-time clinical instructor at Georg Washington University where he pecializes in pediatrics. She lives at 1757 Redgate Farms Ct.. Rockville. MD 20850. State Univer tty Family Practice Re idency Program. The Ben­ hams have a daughter born June 24. 1982. Canty. M'79. John glv n a $12.000 Laires Campb II, M'81. Barbara writ from an Jo c. Califor­ ha be n Fellow hip from the cw York Ind p ndent Order ofOddfellow . Dr. Canty. a second-year fellow in cardiology. \Ya one of two cw York r ear­ chers to receiv the award. It I the first time in the award' 20-year hi tory that it ha been given to a Buffalo phy ician. Dr. Canty i an a ociatc, Am rican College of Phy ician and the Am rican College of Cardiology and a Diplomate. ational Board nia, that she and her hu band Kenneth have a son. Douglas Paul born August 4. 1981. After a five month leave of ab ence from Kaiser Ho pital, Dr. Campbell is In her econd year in Internal medicine. William . M"81. Freredidency lralning and is in living at 4016 Murdock Avenue, Bronx, Y 10466. Deaths Mechtilde Memorial Award. named for the ho pital' founding adminl trator. Dr. Smith did hi Intern hip at Buffalo General Hospital and worked for the U.S. Public Health Service in Buffalo in the early 1930' b fore entering private practice. • D R. ROBERT FRANZ. M"49. DIED OCTOBER 30 I HIS home in Lake View. following a long llln . He wa 65. He retired from practice in Buffalo about ix years ago due to his health. At that time Dr. Franz was attending urologist at Buffalo General and Children' , and wa an assistant clinical professor of urology at UB. He erved an lnternship at the former Meyer Memorial Ho pttal. Dr. Franz wa a urologist at Veteran Ho pltal. and also served on the staff of St. Joseph lntercommunity Hospital and SI ters Hospital. Dr. F'ranz was the first urologist in Western ew York to utilize aortography as a dtagno Uc measure. He headed a pro­ ject to tudy, diagnose and treat urinary cancer involving a group of employee of the former allonal Aniline Co. He erved a medical officer of the 23rd General Hospital at Fort Meade. MD. and a a I nd lease officer with the Allied Command in Paris. Dr. F'ranz was a fellow of the American College of Surgeons. He was a member of the American Board of Medical Ex­ aminers: American Board of Urologists: American Urological Association and its ortheast Section: n-oop I Post 665. American Legion: as weU a the American Medical Assocla­ llon and th Cate and county medical ocletie . He was a charter member and pa t president of the Buffalo Urological Society and the Medical Union of Buffalo. • ------------------------------------------------------------- BUFFALOPHYSICIAN• 35 �Deaths W. BAETZ DIED DECEMBER 13 I BUF­ DfaloRICHARD General Hospital. The 68-year-old ob tetrician was R. born In Lorain, Ohio, where he graduated from Oberlin Col­ lege and We tern Res rve University. Dr. Baetz began his Buf­ falo practice In 1946 and wa a oclated with both Buffalo General Ho pltal and Children's Hospital. He was al o a clinical assistant professor of Gyn/Ob at the Medical School. In addition Dr. Baetz wa well known as a researcher on fetal mortality, and during the 1950's and 1960's he worked on several projects under the sponsorship of the federal government. Dr. Baetz belonged to the Erie County Medical Society and the Buffalo Academy of Medlclne. He also served as president of both the Ro well Park Medical Society and the ew York State Obstetricians and Gynecologists Association. • HOR1'0 . M'30. DIED OF LUNG CA CER Don ARTHUR November 7 In Bluff Point, ew York, at the age of 78. R. J. He wa a Diplomate of the American Board of Internal Medicine. a Fellow of the College of Physician . and a member of the Up tale Society of Internal Medicine. • ARTHUR SIEGEL DTEDO JANUARY 31. 1983 DIn LOUIS Los Angeles, wher he had lived since 1946. R. The 83-year-old ob tetriclan and gynecologist was on staff at Buffalo General from 1930 to 1946. Born in ew York. he graduated from the Medical School In 1923. ln Lo Angeles. Dr. Siegel was an associate attendant and clinical professor emeritus of ob/gyn at the former Cedars of Lebanon Hospital. He was a member of the Erle County and New York State Medical Societies. Maimonides Medical Society, James A. Gib­ on Anatomical Society. and a Diplomat of the American Board of Obstetrics and Gynecology. • KULOWSKI. M'25, DECEMBER 23. 1982. ST. JJoACOB eph, MO: age 82. Specialty: Orthopaedic Surgery. Dr. Kulowski was born In Odessa, Ru la, he came to the United State in 1905. He trained as an orthopaedic surgeon and later became an associate professor at University of Iowa Medical School in Iowa. He b gan his medical career in St. Joseph in 1934 where he practiced medicine until his retirement in 1975. Dr. Kulowski was a member oflemple Adath Joseph, St. Joseph Lodge No. 78, A.F. & A.M.. a 32nd degree Scottish Rite Mason. a member of th Moila lemple Shrine and was chair­ man of the St. Joseph Ho pita) building campaign In 1954. Dr. Kulowskl was the author of two books on automotive safety and served as a con ultant to the automotive indu try. A navy veteran of World War II. he erved from 1942 to 1946 as an orthopaedic surgeon for the Pacific fleet and at­ tained the rank of commander. Dr. Kulowski is surviv d by his wife. Margaret. and five children. • R.HUBER HAMMA . MD '33. JULY 11. 1982. • F. PRESTEL. MD '40. SEPTEMBER 28. T HOMAS 1982. Buffalo. .Y. • CARL E. ARBESMA . 71. DIED SEPTEMBER 8 I DBuffalo General Hospital. The physician achieved Inter­ R. national acclaim as a dlagno tlcian and r earcher In the field of allergies and immunology. Dr. Arbe man. clinical professor of medicine and microbiology. director of the allergy research laboratory. and former director of the allergy division (1944-1976) at the Buf­ falo General Hospital. was elected president of the Interna­ tional A ociatlon of Allergology and Clinical Immunology. for a 3-year term. at the 10th International Congress. which was held In Jerusalem in ovember. 1979. 36 • BUFFALO PHYSICIAN Dr. Arbesman attained his M.D. at the University of Buf­ falo School of Medicine In 1935. and, soon after. completed allergy training at the Johns Hopkins School ofMedlcine. He opened his practice in Buffalo In 1939. sp cializing in medicln and allergy. In 1945. he organized the Allergy Research Laboratory at the Buffalo General Hospital. He became chief of lhe allergy division of lhe Buffalo General Hospital In 1944. a position that he held for 32 years. Dr. Arbesman was a member of many professional societies and h held honorary fellowships in many foreign organizations. such as the Brlti h, Canadian. Brazilian. Venezuelan. and Peruvian Societies of Allergy and Clinical Immunology. H also served on numerou committees and boards and con• trlbuted handsomely to the field. He once headed a team of scientists who received a grant from the ational In tltute of Allergy and lnfectlou Disease to study the feasibility of producing a d en ltizlng extract to protect usceptible p rsons against the ill effects of in ct sting . An avid golfer and squash player. he held the singles bad­ minton championship at the Montefiore Club for 10 year .• OLDHAM, M'38, DIED SEPTEMBER 14, D1982.J. REVITT in Clearwater. Florida. after a long illness. The R. Lockport physician served as city and county doctor for 38 years. He was also staff chief of Lockport Memorial and Mount View Hospitals and served on the Lockport board of health. Dr. Oldham did his undergraduate work at Notre Dame. He took his intern hip and residency at Buffalo General Hospital. During WW II, he was naval flight surgeon In the Pacific. Dr. Oldham wa active in boating and flying. He held a private pilot' licen e for 30 years. He was al o a breeder of how horse which he exhibit d in Canada. Pennsylvania and ew York. He retired from general practice in Lockport, Y, in August 1978 and moved to Belleair Beach. Florida. • R. J. FREDERICK PAINTON. M'27. DIED OCTOBER 8. Hi Dage was 78. The as oclate clinical professor of medicine erved as chief of medicine at Millard Fillmore Hospital from 1946 to 1971. At one time he was director of medJcal educa­ tion at th hospital. Dr. Painton was president of the Buffalo Academy of Medicine in 1957. He was a Diplomate of the American Board of Internal Medicine and was head of the W st m ew York Society of Internal Medicine. Dr. Painton served with the Army Medical Corps from 1941 to 1946. He retired from practice in 1975. He served on the UB Council from 1948 until the merger with the State. and was am mber of the Medical School's screening board. He did graduate work at Yale and Harvard and took his residency at M yer Memorial Hospital. He was active in several professional organizations. • R. CHARLES BULL. 64, A BUFFALO PHYSICIA FOR 22 Dyear. died Wednesday morning. March 23. 1983, in ew Rochelle Hospital Medical Center. Born February 5. 1919. in Columbia, S.C., he received hi B.A. from Lincoln University. Pa .. In 1940 and his M.D. from Howard Univ rsity In 1945. After an Internship at Homer G. Phillips Hospital. he took a re idency at Mercy Dougla Ho pita! in Philadelphia and the VA Medical Center In Buffalo. He entered private practic in Chester. S.C.. in I 94 7, and erved as a Captain in the U.S. Army Medical Corp from 1952-1955. Dr. Bull moved to Buffalo in 1957 where. after residency. he rved on th staff of the VA Medical Center from 1959-1981. In 1960, he joined the faculty of the UB Medical School as clinical associate in medicine and was cited on May 26. 1982, for long and outstanding ervice to the University, especially with the admission committee. During hi many years on the taff of Deacone Hospital. he served a term as chief of taff. He was also on th staff of The Buffalo General Hospital. He i urvived by his wife and 4 childr n. �From page 30 Calendar continues Academy of Family Physicians. For Cana­ dian thi program i ace ptable for 7 study credit hours for th ol • lege of Family Physi • cians of Canada. THE 6TH NATION AL BUFFALO CONFERENCE ON PEDIATRIC/ADULT ALLERG Y AN D CLINICAL IMM UNOLO G Y • July 14-16. 1983 . The Four Sea on Hotel. Toronto. Chairmen : Elliott Mid ­ dleton. Jr .. M.D .. and Elliot F. Elli . M.D . 20 hours. Fee: $275 physi­ cians in practice: 150 allied health profe · ionals. o- ponsorcd by the Department of Pediatric . Children Hospital and UB: Conti ­ nuing Medical Educa­ tion. UB. and the Scher­ i ng Corporation of America . Dao. "Modern Management Con• cepts in Leukemia and Lymphoma. " THE 15TH NATIONAL CONFERENCE ON AD­ VANCE S IN PEDI ­ ATRI CS. • Augu t 12-14. 1983 . Dunfcy·s Hyanni Hotel. Cap Cod. Hyanni . ta achu Lt . Chairman. Elliot F. Elli . 18 hour . Fee: 275 phy icians in practice: $150 allied health pro~ sional . Thoma Thur day. May 19. 1983. Chairp rson. Dr. Edward Hender on. "Disciplinary Ap • proach to Adoles­ cent Oncology. " Thur day. June 16. 1983 . Chairperson. Dr am ron Tubbi. All pro­ gram in thi rlc arc held at Roswell Park Memorial Institute. Fee for ach ar : 45 phy i­ cians : 15 residents and allied health profes­ sionals . o fee for stu· dents. Prior registralion encourag d. Contact Gayle B r ani. R cancer ontrol coor• dinator . 845-4406 . Th seminars qualify for atcgory I credit toward the A.M .A. Phy­ sicians Recognition Award. pre rib d cre­ dit by the American Academy of Family Phy lcian and Category 2-0 credit by the American Osteo ­ pathic Association. The mlnars are co • pon­ sor d by the Cancer FRONTIERS OF DRUG THERAPY • Marriott Inn. September 10. 1983. Spon ored by Continuing Medical Education. UB . DIABETES • Marriott Inn . September 15 . 1983 . Sponsored by onlinuing Ml'dical Education. UB. NEPHROLOGY • Buf­ falo Hilton . Sept mb r 22. 19 3. Sponsor d by onlinuing Medical Education. UB. ONCOLOGY SEMINAR SERIES • "Clinical and Basic Aspects of Breast Cancer." Thursday. May I 3. Chairperson. 12. Dr Control Program of Ro w II Park and the American anc r Society. cw York ity Div! ion. and Erie County Unit. THE FIRST INTERNA ­ TIONAL CONFERENCE ON ADVANCESIN CHILD NEUROLOGY • June 15-17, 19 3. heraton ­ Brock Hotel. iagara Falls. Ontario. Michael ohcn. M .D. and William Logan M.D .. chairmen 20 hours . Fe 275 phy icians in practic : 150 allied ht·alth professionals. Sponsored by the Dc ­ partm nt of Pediatrics. UB. and Children' Ho • pital: Continuing Medi­ cal Edu allon . UB. and the Hospital for Sick Children. Toronto. LABORATORY UPDATE FOR THE CLINI CIAN • Topic in Chemistry Testing . Marriott Inn. June 16. 1983 . Sponsored by Continuing Medical Education . UB. Call 831 -2766 for detail . ~----------------------------------------------------------------------------------------------- 111111 NOPOSTAC[ STA MP E ESSARY IF M AILED I THE U ITID STA.TIS BUSINESS FIRST CLASS REPLY CARD P£RM IT '0. 2.ZJ0 BUFFALO •. Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, ew York 14214 POSTAGE WILL BE PAID BY ADDRESSEE Y. �THEBUFFALO PHYSICIAN STATEUNIVERSITYOF NEW YORK AT BUFFALO 3435 MAIN STREET,BUFFALO,NEW YORK 14214 ------------------------------------------------------------------THE HAPPY MEDIUM Fill out this card; spread some happine pread ome news ; no postage needed. (Plea e print or type all entrie .) ame _________________________________ Year MD Received ____ _ Office Addres Home Addre If 110/ UB, MD r eived from __ In Private Practice: Yi In Academic edicine: Yi ----------------------------------pecialty _____________________________ 'o 0 Part Time _ Full Time chool Title ___________________ _ Other :-------------------------------------------di cal Society Memberships :------------------------------------ EWS: Have you changed po itions, published, been involved in civic activiti s, had honor Plea e end copies of any publication , re earch or other original work. be towed, etc.? ________ _ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, May 1983 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1983-May Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1983-v17n01-May Table Of Contents A list of subunits of the resource. Running Veterans Doctor's Orders Golden Discoverer The HSL In Space Research Briefs People Medical School News Students Calendar Classnotes Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-07-05 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v17n01 Extent The size or duration of the resource. 40 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1983 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/63bfd072f01c0dfd8a904ed265dd706e.pdf 416661798d3c225604df4c040ac5759a PDF Text Text �Dean Naughton From the desk of John Naughton, M.D. Dean, School of Medicine Dear Alumni and Alumnae: Over the course of the past four years the curriculum committee has made a series of recommendations designed to strengthen and to enhance the educational program in the School of Medicine. I am pleased to report that in the 1982-83 academic year many of the elements of an improved curriculum are in place, and that it appears that we are on the correct course pedagogically. The first year curriculum now offers a strong preparation in the basic sciences and opportunities for individual development and expression. Physiology is now taught over the course of one year, and its faculty and those in biochemistry are working to improve testing techniques and quality. The Human Anatomy course has been rearranged to give the students better direction in attaining the goals important to future physicians. The selective and clinical preceptorship programs are gradually bridging so that issues of social relevance and early clinical opportunities can serve to reinforce one another. The second year program has undergone only slight modifi~a­ tion. Major changes have occurred in the third year. Two maJO~ changes in the third year are the program of week-long breaks ak the end of clerkship experiences and the substitution of one wee of clinical work with a required selective experience. The form~r change was designed to facilitate the work of the faculty in its ro e as educational evaluation and advisor and to provide students a.mple opportunity to reappraise their performance before movwg into the next clerkship experience. The week long selective course provides a significant opportunity to participate in small ~r?u~ didactic education with integration of basic science and chnica science material. The School of Medicine has moved away from a totally ele~­ tive fourth year by requiring three specified experiences in ~ e fourth year, thus reducing elective opportunities to a total of hv~ per student. In addition, a clinical advisor program was introduce this year. Each student will be assigned an advisor upon entry to the third year, and this individual working closely with the student will have an instrumental role in helping define the fourth year experience and guiding the student's career selection after graduation. Although the work of curricular design and modification is never complete, I think the faculty have instituted signific.ant changes designed to enhance the faculty's role in medical students' academic and professional preparation.D �Volume 16, Number 4 Winter1982 THE BUFFALO PHYSICIAN (USPS 551-860] Published by the School of Medicine, State University of New York at Buffalo EDITORIAL BOARD Editor ROBERT 5. MCGRANAHAN Dean, School of Medicine DR. JOHN NAUGHTON Photography HUGO H. UNGER EDWARD NOWAK Visual Designers RICHARD MACAKANJA DONALD E. WATKINS Associate Editor TERI ROBERTS CONSULT ANTS President, Medical Alumni Association DR. ROBERT A. BAUMLER Vice, President, Faculty of Health Sciences DR. F. CARTERPANNILL President, University Foundation JOHNM. CARTER Director of Public Affairs HARRY JACKSON 2 12 14 15 22 28 29 30 35 36 37 38 40 43 44 48 49 50 Teaching Hospitals The Buffalo General Children's Deaconess Erie County Medical Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Charity Veterans Administration Medical Center 61 68 THIS ISSUE Dean Naughton's Message (inside front cover) Spring Clinical Day 9 Classes Give $45,000 Boys Will Be Boys by O.P. Jones, Ph.D., M.D. Distinguished Professor Emeritus Barbados Seminar Graduates with Medical School Appointments Dr. Cooke Erie County Sailing/Faculty Serves Faculty Honored Athletic Day Summer Head Start Physicians Honored/MECO Research Exhibit Summer Fellowships Follies utrition Dr. Gresham Alumni Officers People The Classes In Memoriam The cover by Don Watkins depicts nutrition, pages 44-47. THE BUFFALO PHYSICIAN, (USPS 551-860). Winter, 1982 - Volume 16, Number 4 published quarterly Spring, Summer, Fall, Winter - by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. POSTMASTER : Send address changes to THE BUFFALO PHYSICIAN, 139 Cary Hall, 3435 Main Street, Buffalo, New York 14214. Copyright 1982 by The Buffalo Physician. WINTER, 1982 1 �Th e speake rs : Drs. De nnis O 'Leary, Jam e s Phillips , Stanl ey Reise r, M ilford Mal on ey, Lawre n ce Altman , Robe rt Mil ch , Dani el Forward. Spring Clinical Day Dean John N aughton The 45th annual Spring Clinical Day drew a record crowd of approximately 300 at the Marriott Inn . In welcoming the physicians Dean John Naughton thanked them for their continuing support - especially the class gift program in its seventh year. "The day of federal and state support is dwindling; this is why we need your help in maintaining quality." The Dean predicted that by 1989 the building program for the medical school and the health sciences on the Main Street campus would be completed. This includes a new teaching center and labs , centralized animal facility and student health , and library renovation. He spoke of curriculum changes that include selective courses for first year students and the one week break betwe en clerkships. Dr. Naughton noted that the first annual parents day for first year students was a success. This fall the parents of third year students will be invited. The President of the Medical Alumni Association, Dr. Norman Chassin, M'45, spoke of the harmonious relationship with the Medical School. "Spring Clinical Days, started in 1938, was one of the first continuing medical education programs in the nation, " he said. The Physician Communicates with Sick Patients "There is a great need to communicate - especially stressful news to patients." This is what Dr. Stanley Joel Reiser said . He noted in the 5th century physicians were told to conceal things from their patients, and to turn patients attention away from what the physicians were doing. Greek doctors were told to do nothing to upset their patients. And how the doctor looked and approached the patient was very important. "The patients confidence in the doctor depended on th e physicians appearance. " The associate professor of medical history at Harvard Medical School noted that doctors treated death news very cautiously. "Often the doctor would tell a third party, who in turn would break the news to the patient and the family. The right of the patient to know was suppressed. People believed that truth would destroy the patient and harm the physician. " 2 THE BUFFALO PHYSICIAN �In 1846 the AMA established the first code of ethics which said, physicians should not make gloomy prognostications, and only give truth when absolutely necessary. Physicians should be ministers of hope and comfort to the sick. The life of a sick person could be shortened by words from the physician, so he should avoid all words of depression. Words were as dangerous as drugs. It wasn't until the mid-nineteenth century that Oliver Wendell Holmes observed that some patients might want to know the truth. But could they stand the truth? A Yale doctor, in 1840, noted that consultants often were harmful to the patient, and that lying underminded the patient's confidence in the physician and the medical profession. He suggested that the patient should not know everything, but when asked the physician should tell the truth. An English woman physician, Dr. Saunders, who founded Hospice, suggested that patients need the truth so they can fully cooperate in therapy. Patients must be aware of what is wrong with them. In the 1960's a survey showed that 90 percent of the physicians did not tell their patients they had cancer, but 18 years later another survey revealed that 98 percent of physicians did tell their patients if they had cancer. "The modern dilemma: very few people have discussed the problems of dying. Bad news is terrible to bear for both the patient and family. No one wants to talk and the patient is suspicious. Often this transfers the burden to those less competent to cope with the situation," Dr. Reiser said. In conclusion he said, "there is no reason to withhold information from the patient, but the timing of this disclosure is important. Reveal the truth. Bad news is not as devastating to the patient as previously thought." "The patient and the family must take an active part in decision making along with the physician. This process must start from the beginning of the illness and the patient must be encouraged to ask questions." This is what Dr. Robert Milch, M'68, said. He is president, National Association of Hospice, physician, medical director, Hospice Buffalo and a clinical associate professor of surgery. "Anxiety is caused by the unknown. Understanding is important especially when the patient has a malignant disease. An atmosphere of honesty, fairness and truth must prevail," Dr. Milch said. Continuing he said, "the patient must be seen as a whole person, and each physician must be involved with the patient. The fears of the patient must be considered. They know that one-third are cured; two-thirds die." Dr. Milch noted that simple, little things are important- bedside talk at eye level; hold a hand; wipe a brow. "Pain and loneliness are most common among cancer patients. Never saynothing can be done." In conclusion Dr. Milch said, "a positive attitude by everyone - family, nurses, therapists, physician, hospital - involved in the case is important. The family must be supported by physicians who will answer questions truthfully. We must strive for even better technical and passionate care." WI TER, 1982 3 �The Physician Communicates with the Healthy Public "Medicine is daily news and medical advances have traditionally been reported in newspapers. This started in 1799 when Dr. Waterhouse used newspapers routinely." This is what the New York Times medical correspondent said. "And 183 years later newspapers are still reporting medical news and controversies such as small pox, herpes and others." Dr. Lawrence K. Altman noted that the medical profession is not a private enterprise. "Third party payments for education, research and care has caused the most recent medical interest by the public. The public pays, is involved, and is entitled to know how the money is spent. Physicians used to be entrepreneurs, but not today. Most of their income comes from third parties." The physician/columnist noted that science writers also inform the public through the press. "The medical profession is also an important part of the audience." Dr. Altman reminded his colleagues that the federal gove~n­ ment has long been a medical partner through VA and commumty hospitals and more recently civilian care in civilian hospitals. He touched on the high cost of dialysis care in hospitals and the low~r cost of dialysis care in the home. Can our government afford this under our present system? "There is much public criticism of medicaid/medicare, but only a few have been prosecuted for wrong doing." Dr. Altman related how in 1825 Dr. William Beaumont treated a patient, Saint Martin, and supported him for two years. The patient had a gunshot wound in the stomach and was known as "the man with the lid on his stomach." The physician made 238 observations of his patient's stomach. Dr. Beaumont financed his own research for eight years. According to Dr. Altman World War II brought great changes in medicine. Applied research was expanded and funded by the THE BUFFALO PHYSICIA �government. Society reaped huge dividends but there was no annual report to the taxpayer. In 1970 there were some priorities set for responsibility reporting in newspapers of significant advances. Dr. Altman also made these observations: -medicine is a public institution and physicians are public servants; -rounds discussion is now public information; -the medical profession receives as much attention at the state department; -medical journalists and editors also have a public responsibility; -researchers must be accountable to the public; - an educated patient is a better patient; -don't hide medical problems from the public; - physicians must learn to communicate so people can be educated; - there must be a more honest approach by all - doctors, scientists, journalists; -credibility is the basis of good journalism; -journalists must probe more into how things are done because the taxpayer is paying the bill; -physicians must speak out to correct errors; -American public wants the best health care. "There has been great fear and disdain by doctors of the press. The public conceived researchers and physicians as arrogant because they would not share information with people through the press. Doctors have failed to meet their responsibility by not giving the people information through the press. This can be turned around if doctors will cooperate with the press and give correct information. Most people want to learn more about their bodies. Doctors have been slow and reluctant to help. Only recently have physicians filled the void by talking to consumers," Dr. Altman concluded. Drs. Walter Walls, Lawrence Carden, Richard Buckley. Dr. James Phillips, M'47, reviewed his experiences with a "Topics in Medicine" TV program that was on Channel 4 for 16 months. Some people called him "The Tuesday Doctor." Drs. Marvin Black, Samuel Shatkin, Robert Schultz, The Anthones. WINTER, 1982 5 d- �Exhibit winner: "Percutaneous Transluminal Coronary Angioplasty" by Dr. Neil Dashkoff, Elizabeth T. Sloan, R.N. , B.S.N., Erie Count y Medical Center. Siste r, Dr. Dynski, M '75, Dr. Jack Richert. The clinical professor of medicine noted that physicians are medical communicators to patients, relatives and family. "We are showing and talking." Dr. Phillips did not give medical advice on his TV program, but told his viewers to see their own physician if they had problems. He concentrated on telling people about the hazards of smoking. He also discussed liver and heart disease and the fraud of vitamin sales pitches. Often strangers, who had seen Dr. Phillips on TV, would approach him on the street, in restaurants or in the hospital to ask him questions. "The public has a terrific appetite for medical information . Television is great opportunity and responsibility for the medical profession because we can talk to 50 or 100,000 people. Perhaps physicians should become TV doctors," he said. Dr. Phillips praised the Buffalo medical writers for their interesting and informative articles. In conclusion he predicted that Dean Naughton would have a department of medical education information in the Medical School before the end of the century. The Physician Communicates with other Physicians The advantages of the office computer to the physician was the main thrust of Dr. Daniel J. Forward's remarks. The clinical associate professor of medicine at the Medical College of Wisconsin told how he utilized the computer to keep comprehensive records of patients. "It is a great help to everyone on the health care team." Dr. Forward uses the computer for data and image transmission, digital x-ray, information retrieval, inter and intra office communication and for documentation of patient care. "It gives the physician instant access to a huge volume of material. In some cases you can have several pages of vital information at your fingertips almost instantly." 6 THE BUFFALO PHYSICIA �In his illustrated talk Dr. Forward displayed a multitude of information on patient X that included complete history, effectiveness of current and past medication, drug allergies, therapy, data base, and office visits. "Using the computer helps assure quality of care. It makes communication with the patient and members of the health care team easier and more efficient. Rapid calculations and evaluations can be made. It is more economical than hand written reports. The future for computers is now," Dr. Forward concluded. Questions Ignored Half of our patients don't follow our advice, according to Dr. Milford C. Maloney, M'53, and this is just one of the many pitfalls in medical communications. The clinical associate professor of medicine listed several other potential pitfalls- the government, media, HSA, third parties, hospital administration, workman's compensation and peer review. "We spend a lot of time talking to patients. We are ineffective because we ignore their questions and speak in terms that the patient cannot understand. Often we neglect to tell them about side affects of an illness or medication," Dr. Maloney said. The president of the Medical Society of Erie outlined defective interview syndromes: flawed data base, low therapeutic content, failure to demand primary data, and inappropriately high control style. "All too often physicians refer patients to a consultant and the patient is not told the whole story. Many consultants don't follow up." Successful referrals depend on the purpose and need of the referral by both the patient and the referring physician; communicating this need and purpose; attention to the problem; communicating the consultants findings to the referring physician; and deciding who takes the responsibility for the patients continuing care. "Don't ever assume that your patient understands the nature of his illness or the therapy/medication you prescribe," Dr. Maloney concluded. Drs. Dennis Pyszczynski, Virgil Boeck, Gustave DaLuiso, Frederick Painton. WI TER, 1982 7 d- �Observations from the panel discussion: -the computer revolution may be more profound on society than the industrial revolution; - computer revolution will multiply brain power; -computers are dumb; physicians must feed correct information into them; - technology and rejection of the past are features of modern medicine; -the interview is an excellent technique to verify information; - a good physicial diagnosis interview may be better than any machine; -we must use the best of the past with our modern technology. Effective Communications "It started out as a news story, but probably was the greatest one of our time." That is what Dr. Dennis S. O'Leary said of the attempted assassination on President Ronald Reagan. "We went through a very intense experience telling this story to the world." The Dean for Clinical Affairs at the George Washington University Medical Center said, "simple principles guided me in my role as a communicator. Effective communications is the secret in having things work out well. But there is a broad gray area between the publics right to know and the patient's privacy. " Dr. O'Leary listed four principles of successful communications - talk to the level of other people ; be direct, don't sell people short, they aren't stupid; put yourself in the position of your patient - change chairs with them; don't cater to one group over another. In this case the groups were - the President and his wife , the physicians who were caring for him, the hospital, media, public, government, white house staff, secret service and police. Runn er-up exhibit: " Cataract Extraction and Correction of Aph akia " by Dr. Joseph F. Monte, Robert Ley, photographer, Bu ffalo Ge neral Hospital. CATARACT EXTRACT ION Elltacapsutar 8 THE BUFFALO PHYSICIAN �Drs. Charles Tanner, John Przylucki, Robert Baumler, Norman Chassin, John Naughton, Dennis O'Leary. Dr. O'Leary noted that he was not typical of his colleagues because he grew up with a mix of physicians and journalists. "Many accused me of being anti-dramatic in my approach, and I plead guilty with intent." Third place Exhibit: " Mitral Regurgitation Secondary to Ischemic Heart Disease " by Drs. V. Balu , A.R. Zaki Masud, Joginder N. Bhayana, David Dean , Stephen He rshowitz , Veterans Administration Medical Center. MITRAL REGURGITATION-. EC0NDL >Y TO ISCHEMIC HEART DISEASE V Sou~[ ..> o..d " 0 "tl .lo.J•nd.o- N Bhoyono MD ly of New Yotk at Buffalo - u ~ 0 .... ':::=:=:=:=:.. ... 0 • . ,.. H .. 0 .. D WINTER, 1982 9 d- �Dr. j effe rs on Unde rwo od, N an cy Druar. The physician-educator noted that during the first hours after the assassination attempt the TV network news commentators floundered and groped for solid information on the president's condition. "I felt sorry for them because there was a news vacuum. When this happens there is speculation and rumors." Who would brief the press, the public and the world was the big question. It was unanimously agreed by members of the White House and hospital staff that a doctor would have the most credibility. Government officials noted that in the past the White House had not always reported "with great fidelity" the president's health status in a crisis. Since this was a patient care related matter Dr. O'Leary was selected. He also knew the status of the other victims, press secretary James S. Brady, a Secret Service Agent and a Washington police officer. Dr. O'Leary admitted that he received no guidance in how to handle a press conference. He had no written statement because "people wanted to be talked to, not read to." He used lots of detail to avoid speculation and rumor. However, presidential aide Lyn Nofzinger did tell him, "just because someone asks you a question, doesn't mean you have to answer it." Dr. O'Leary admitted he had some advantages at this first press briefing - it was a news story, not a science story; he had good news to convey; he was not dealing with science writers; he had all the information and the press had none. 10 THE BUFFALO PHYSICIAN �The Tuesday news conference, on the second day, was much tougher, according to Dr. O'Leary. There were many more pointed questions - the President was doing well; he was not drugged; and he could govern. It was hectic around the hospital too - 300 calls were coming in hourly; a suite had to be built for the President. Soon the hospital got into a routine of issuing two press releases a day through the White House press secretary. The 1800 hospital employees were very cooperative. Even though there was no policy against talking to the media, very few did. The first family had expressed some unhappiness because numerous medical experts gave interviews to the media based on second-hand information. So on the fifth day after the shooting the President's physicians were assembled at a news conference to explain the operation. When a person becomes a patient he reads the newspaper, watches TV and listens to the radio. "What he hears about himself should be accurate and coincide with what his doctor told him," Dr. O'Leary said. There was one slip on the 12th day when the White House said the President was coming home. When the latest lung X-rays were checked there was something that indicated that he should not go home. Dr. O'Leary had one disappointment. He couldn't sell the media on a story about the tricky procedure on anesthetizing someone after they'd just eaten a big lunch as the President had. Dr. O'Leary lauded the media for the patience, accuracy and thoroughness in reporting the assassination attempt and the President's recovery. In conclusion Dr. O'Leary said, "people can comprehend if you give them a chance. They can assimilate bad news too. I have strong feelings about communications which may be important to our own health.D Drs. Norman Chassin, Dennis O'Leary. WINTER, 1982 Senior medico/ students - Ralph Mastrangelo, Jonathan Warach, Joseph Gioia, Stephen Pollack, Lois McNall y, Jeff Bilotta, Ja y Laval, David Orgel, Michelle Urban , and Richard Corbelli. 11 �9 Classes Give $45,000 to the Medical School lll1 F JOWL ) Til)\ I\·.· ]h(JU(Jafld ~,l g32 Drs. O.P. Jon es, Richard Ament. Drs. T ed Fle ming. Charles Bannas. Drs . Owen Bossman , Sebastian Fasane llo. 12 THE BUFFALO PHYSICIAN �Drs. Edward Weisenheimer, R. Ronald Toffolo. Drs. Harold Pescuvitz, Jerome Tokars, William Bukowski , Richard Kenline, John Waite, Arthur Schaefer. ·. ..., "lJ"u.<JanJ. Drs. John P. Kelly, Jonathan S. Ehrlich. Drs. Benjamin Obletz, Harvey Slocum, Ernest Homokay, Myrtle Wilcox Vincent, Elmer Friedland. ~ rt ~./ .~-'""''7.a:u. a. Drs. Steven f. Levine, Linda Kam. �THE LOZINA PROCESS OR BOYS WILL BE BOYS Oliver P. Jones, Ph.D., M.D. Distinguished Professor Emeritus In previous years there had been periodic combats between two classes in the Pharmacy Department plus four classes in the Medical Department, combined as allies, to rush three classes in the Dental Department. Ordinarily, these rushes were a trial of strength between opposing groups for the temporary possession of a cane. In the present instance, the cane had either been forgotten or lost, because it turned out to be the roughest and fiercest engagement in the history of the University of Buffalo. In football games, punching and kicking are prohibited. The same restrictions were supposed to exist in cane rushes. But there were no restrictions in the combats of 10, 11 and 12 October 1899. Everything was given and taken. Punching was gentle by comparison, kicking was indulged in by everyone. Both sides were out to win. Each group had talked a good deal and each thought that defeat would be an increasing source of annoyance. They were not particular how they won. The strength of the combatants was greatly exaggerated in the local newspapers. For example, the Dents who numbered 300 were supposed to have attacked a smaller body of Medics and Pharmics of about 250 strong. According to the class lists in The Iris the combined classes of the Medics and Pharmics was only 300 in 1900, and the Dents had a little more than half that number - 191. The rush, or combat, was staged in the court between two university buildings located at 24 High and 25 Goodrich Streets. The so-called "campus" of U.B. was 150' x 80'. How did I come by all these interesting and amusing morsels? From 1969 to 1974, the rare book section of the Health Science Library was in the lowest level of stacks in what was formerly Capen Hall - now Farber Hall. These books had neither been catalogued nor indexed. I had to browse through most of the books bequeathed to U.B. -because some were also stored in what was then Lockwood Memorial Library on the Main Street campus. Among the rare books were letter files of the 8th District Dental Society. I learned to recognize the important volumes by the color of their spines, size and location. By browsing, I uncovered many things of historical import that would have been lost to me had this collection been stored in the orthodox manner by a proper library staff. Thus it was that I discovered a diary written by a dental student in 1899 while attending the University of Buffalo Dental Department. It was among the letter files of the 8th District Dental Society. Its author, William H. Leak (D '02), came from Watertown, N.Y. Dr. Leak went on to become in charge of the oral hygiene service in the Public Schools of New York State. He was well ahead of his time in 1920, because he believed that all constructive education for the preservation of the teeth should commence, along with other instruction to the expectant mother, at the beginning of pregnancy. Presented before the Tri Beta Club at Canisius College in April 1980. 14 THE BUFFALO PHYSICIA �This first entry in the diary is: 1983 WINTER GET-AWAY College Life 1899 Continuing Medical Education Seminar sponsored by Monday, Sept. 25. Leave home (Watertown, N.Y.) with the best wishes of many friends and with the usual weepings of partings. I am kept company by "Dave" Fawdray who is also going to study in the same department. While in the train we sit mostly in silence, wondering how we will like being "Put off at Buffalo." We arrive in Buffalo on time and are met by "Deasic" Demarse (sic), at the depot, who aids in finding the streets. We decide to board at 405 Delaware. In the evening we took a stroll. In addition to Leak (D '02) and Fawdray (D '02), Watertown was represented by Philip R. "Deasic" De Norse (L '01) and Burton T. Simpson (M '03). U/B MEDICAL ALUMNI ASSOCIATION and 7th & 8th DISTRICT BRANCH MEDICAL SOCIETIES March 4 - 12, 1983 BARBADOS Cunard Paradise Beach The entry relevant to this narrative was on Tuesday, 10 October 1899: It is the same old thing every day so, I have concluded to jot down only the important things. Today, however, we had a little more than the usual in that the Juniors made a rush on us Freshmen in the upper amphitheater. Holler (George J., Lecturer in Physiology). as Cook (Dexter A.,) opens the door and enters, "And here comes another little animale." Via Wardair, Toronto to Barbados, direct non-stop. $1,229 per person, includes: air fare; one night Valhalla Inn, Toronto; 7 nights Cunard Paradise Beach; ground transportation; 18 o/o tax Barbados. Trip Information: Call Eighth District, Medical Society, 716-842-2535. This entry is followed by five pages of clippings from the Courier Express and Buffalo Review. The last Dental entry was on 15 January 1901 -"Extracted my first tooth." Then there are some sporadic entries about hockey, Y.M.C.A. and the theater as well as clippings. This narrative is a distillate from six local papers and the yearbook - Iris - for 1900, triggered by Leak's entry for 10 October 1899 mentioned above. 10 October 1899. It all started harmlessly enough when, in accordance with annual custom, senior pharmics assisted by the medics, initiated the freshmen (farmers as they were called). They were introduced to the use of salt water baths and a new way of using soap. (Italics added). Then they proceeded to show the newly initiated the city - at their own expense. The undertaking was so successful that in their zeal the pharmics pounced upon the unfortunate dent. He was about to be subjected to Lozina Process (Italics added). when a group of his classmates came to his rescue. A fierce fight ensued between these rival factions and the victim was carried away by his friends. WINTER, 1982 15 d- �11 October 1899. The day after the initiation of the freshmen pharmics, the peace and quiet of the Medical School (24 High St.) was disturbed by the dents who proceeded to clear out Alumni Hall of the few medics and pharmics. Burtin T. Simpson, President of the freshman medical class, was captured and carried to the camp of the Dents, who threatened to use him for experimental operations. All along the line the Dents repulsed their assailants, until the discomfitted Medics turned a fire hose on them. The Dents concluded that since it was impossible to get any more thoroughly soaked, they might as well charge in face of the blinding stream. The Dents finally captured the hose and the Medics and Pharmics retreated in disorder to their quarters. A party of Dents fought their way to the top of the Medical School where they found a cadaver undergoing the process of bleaching. "The cadaver was picked up, according to a Dent, and thrown into the quadrangle where several hundred students were fighting." They also took possession of the blue and white flag from the staff of the Medical School. Arbitration was finally resorted to and the victorious Dents withdrew, still in the possession of the captive Burton T. Simpson. During the melee, someone called the police and two officers were sent from the Third Precinct. Captain Killeen went to the scene later and found everything quiet. However, if they had arrived earlier, they would not have interfered because the students were on their own property. 12 October 1899. On the third day of the combat, the Dents, just to show that they were fearless, hoisted the captive flag on their staff. Their spartan message was "Come and take it." In anticipation of a counter attack, they locked the windows on the first floor and mounted several of their classmates as guards for the rear door. For the allies, Medics and Pharmics, retaliation was the order of the day because they had been defeated so ignominiously the day before by a surprise attack and outnumbered. Notices were posted in the corridors of 24 High St. enjoining all students to be present at 3 p .m. No explanation was made. None was needed. President Simpson selected five of the sturdies among those who volunteered to storm the Dental School and captured at least one Dent. In those days, the capture of prisoners in college rushes meant that the losers must forsake all other ambitions for the time being and come to the rescue of their classmate. However, the allies were not quick enough to prevent the intended victims from locking the back door. Thwarted in their attempt to penetrate the Dental School, the allies commandeered some ladders and leaned them on the east side second floor level in the driveway between what used to be "Doc" Leonard's house. They had expected to 16 THE BUFFALO PHYSICIA �gain entrance before the Dents could come from the first floor. Several glass windows were broken but the Dents greeted the invaders with fists and clubs. Opposing students were shoved from window sills and ladders upon heads and shoulders of the throng of supporters below. Many scalps were lacerated, one shoulder dislocated and two Medics fainted from exhaustion. The Dents, to add to the effectiveness of their defense, mixed buckets full of soapy plaster of paris and deluged the invaders with fiendish delight. The Medics and Pharmics lost their professional appearance and became instant replicas of hod-carriers. This so infuriated the allies that they used a battering-ram of sorts to demolish windows on the ground floor. They gained entrance to one of the laboratories, one of the finest in the state, wrecked it and then fought their way to the third floor of the Dental School. (It was not until1902 that the fourth floor was added). The Dents repulsed them and retained possession of the flag. One Medic was forced out a window and fell 20-25 feet onto the heads and shoulders of his compatriots without injury. However, the Medics at length had 30 prisoners and loaded them into a plumber's wagon borrowed from D.F. Rust of 126 Washington Street. A rope was tied to the tongue and the protesting prisoners were hauled away. Down Main Street to Chippewa, over to Franklin, to Seneca, then east to Michigan and up Michigan to High St. and the university. The Dents, who had as many prisoners to their credit, took a wagon owned by the GermanAmerican Brewery and did likewise. In the meantime, a rescue force from the Pearl Street police station was called out. They and other officers formed lines in front of 24 High Street to prevent the Dents from entering the carriage-way through the building. Both sides claimed victory. The Dents because they had captured a class president and the medical school flag. The Medics and Pharmics because they captured more prisoners, broke more windows and demolished a dental laboratory. Later, the flag which had been in dispute was returned by the Dents to Dr. Mann, Dean of the Medical Department. FINIS There comes a time to stay, a time to leave. With this issue I am heading for a new career, a new challenge, adventure and life style. This magazine was born in 1967 as The Buffalo Medical Review. The current name was adopted in 1969. It has been a good 16 years. Your support and loyalty has been gratifying. To the many contributors - photographers, printers, graphic artists, writers, associate editors - my sincere thanks. To my successor - good luck and continu- ed success. (EDITOR).O The Commercial summed it up with "Boys ever will be boys." According to Dr. Matthew D. Mann, Dean of the Medical Facility, the authorities intended to make the best of a bad matter by treating it lightly. He said, "Oh, the boys had a little squabble. I don't think the damge will amount to a great deal- possibly there may be a broken window or two." The Courier went on to say, "If punishment is meted out to one, justice should demand that it be given to all. Expulsion of students from the college would mean that the institution would have to close." So much for what has been gleaned from the six local newspapers of that period. Now let us turn to what the students had to say about this imbroglio in their yearbook. However, before doing this, I must explain something that aroused my curiosity which persisted off and on, for about a year, namely, the Lozinna WINTER. 1982 17 d- �process. It was only mentioned in the Courier and was not mentioned per se in the Iris. Since the Pharmacy students were about to subject a Dental student to the Lozinna process, I was gullible enough to think they were using a pharmacological term. Dr. A.F. Sisson, lexicographer, was unable to find a clue in the Library of Congress. The National Medical Dictionary furnished a hint by stating that Lozione was Italian for lotion. There was nothing in the Courier Express library about Lozina process. Dr. Glenn Sonnedecker, Professor of Pharmacy, University of Wisconsin, had not seen Lozina process mentioned in any of his pharmacohistorical works. However, he suggested that "perhaps it was a joking reference to some locally renowned antic by a student, or faculty member of that name." The 1900 class yearbook does provide a clue about the meaning of the Lozina process. For example, the freshmen Medics ('03) initiated the Pharmics (some Dents included) "in accordance with the traditional custom of our Alma Mater." But the Pharmics ('01) in their class history state that "they (the seniors) also kindly instructed us in the use of salt water, and a new way of using soap." Junior Dents ('01) were more explicit and detailed in their class history about the initiation of the freshmen: The first acquaintance the freshmen had with the Juniors was when a few, about 12 in number, began the initiation of some forty "Freshies." Coralling them in the Lecture Hall in the basement, the Juniors put them through. This process (Italics mine) consisted principally of making the Freshmen remove sundry parts of their wearing apparel, eat soap, drink salted milk, chew tobacco, and lastly, the slapperatus was applied in the rear (pygalgia) ... The term Lozina process does not appear in any of their class histories nor doggerels. It only appeared in one of the six local newspapers. Buffalo has had a considerable population of Italian extraction, hence, the newspaper reporter may have misunderstood what the students told him, so that lozione in Italian became lozina in the printed text. There is no doubt from the class histories that the initiates had been subjected to lotions of various sorts. At least the first four letters of the two words coincide. This is my best interpretation for this minor linguistic mystery. So much for the newspaper accounts of the initiation and annual fracas. What have the class historians and fellow contributors said? The 1900 Iris contains eleven class histories (4 medical, 2 pharmical, 2 legal, and 3 dental). The budding lawyers were taught at the Ellicott Square building, and, therefore, were far removed from the scene of the fracas. Of the histories emanating from the other professional departments, that of the Senior Pharmics is the most detailed. C.E. Sunderlin, Class Historian, must have kept a diary, or else saved newspaper clippings like William did. Sunderlin's historical account of what happened from 10 to 12 October 1899. It corroborates what most of the local newspapers published. The Junior Pharmics, in addition to supplying a clue about the Lozina Process, added this verse: 18 THE BUFFALO PHYSICIA �A rush, a scramble, A tackle, a fall, Sixty wounded, five senseless, Shoulders broken that is all. Both Senior Medics and Senior Dents claimed they were too staid to participate in the rushes. However, it was impossible for them to be merely spectators in this instance. Both sides claimed victory. The Medics said, "The fight continued for several hours, the Medics having more points (prisoners?) to their credit when the struggle was stopped, by whom, we all know." This referred to Dean Matthew D. Mann who persuaded the Dents to return the captured flag. (By the way, this was the first medical class to receive four years of instruction). The Dents maintained they would not have entered the fracas, "had not the honor and good reputation of our institution been at stake." By and large, the Dents relied more on versification than prose to record the events. Some stanzas from Lines on the Rush follow While plaster rained from a cloudless height, Til Medics and Pharmics were wigged out white; The "dental engines" were brought into play Skulls, crossbones and forceps were used in the fray. The Dents drove back the opposing force, The infirmary patients cheered themselves hoarse; The raiders abandoned their "Spying Kop", Their nervy rush was brought to a stop. And one, whose feelings on death were dull, Seized from the table a hapless skull, Which he horridly hurled at the fighting mass, As Samson hurled the maxilla of an ass. Another scaled to a dizzy height, And captured the pennant of "Blue and White," And cheers went up from the crowd in the court When they saw that the Dents had captured the fort. In 1980, U!B contributed approximately $294 million in direct and indirect expenditures to Erie County's business volume. The University, its faculty, staff, students, and visitors directly contributed $168 million to the total and stimulated expenditure of another $126 million. Twenty thousand jobs depend on U!B. While the impact of an institution is most easily measured in dollars and cents, the Regional Economic Assistance Center's study points out that U!B makes other significant contributions to the educational, cultural and recreational life of the area - major contributions defying quantification.D For the benefit of those who have seen or been in the hallowed halls of 24 High Street, this explanation is necessary. For example, in order to gain access to the roof and seize the flag, the Dents had to reach the third floor and then ascend the spiral iron staircase to the penthouse on the roof. This staircase was between the Histology laboratory and the Gross Anatomy dissecting room with Mortui Vivos Docent over its doors. The penthouse had gas heated vats for leaching cadaverous remains for the osteological collections. The Dents did not throw a "cadaver" according to the Courier but rather a hapless skull. The windows of the third floor were such as to preclude the possibility of throwing a cadaver into the quadrangle. They had pivoted sashes 30 inches wide and 6 feet high and 18 inches from the floor. As a matter of fact it would have been difficult for a student to fall out of a window, let alone to throw a cadaver saturated with embalming fluid. A part of a cadaver, yes, but a whole one, no. The Junior Dents were quite boastful in their verse, "The Rush": WI TER, 1982 19 d-- �OH! 0 E fine day early last fall, When the college had opened to nearly all, The Medics a "rush" prepared to make: A terrible thing, 'twas their mistake. They scrapped and tugged as if very strong, While the Dentals tumbled them down headlong. They were thrown on the steps, they tumbled and rolled And stopped outdoors on the pavement cold. Now, Medics dear, a lesson take, And when a rush you wish to make, Don't reckon your strength by your big fat men, For if you do you'll get left again. The freshmen Dents, puffed with pride, verified the capture of the flag in Our Rush. From the Medical College they took the flag They did, they did. From their windows they floated that beloved rag They did, they did. The Medics soon passed the word around And every Pharmic was quickly found Together they swore they'd pull the shack down, Of the Dents, Dents, Dents. It is surprising that the Junior and Sophomore Medics did not record anything about the rush. Even more surprising is that the Freshmen Medics did not write about their valiant class president, Burton T. Simson. However, he was mentioned in the newspapers because the press knew of his prowess as left tackle on the great U.B. football team of 1899. Little did they know that Simpson, as a student intern, was to assist at the operation on President McKinley after the shooting at the Pan American Exposition. Later he became the third Director of what is now called the Roswell Park Memorial Institute. The Buffalo Commercial said, "Boys ever will be boys, and the boys of the University of Buffalo are no exemption to the general rule - or law of nature. Once or twice a year, about this season, the students indulge in escapades and personal encounters a la Caine (canne) rush." The Dental Department suffered the most physical damage. The student body could not be expelled because that would have meant a loss of tuition, the mainstay of the University's sustenance. In those days, the University of Buffalo was still a proprietary school, perceived by Chancellor Fillmore in 1846. This method did not always work out to the benefit of the faculty. For example, when there was money left over, it was divided among the faculty; when there was a deficit, that too was divided. There is no record in the minutes of meetings of the Medical Department that money was dispensed to defray the costs of restoring damaged University property. Maybe the two faculties did not have a dividend that year. 20 THE BUFFALO PHYSICIAN �A year later, it is interesting that the Medical Faculty had a warning of what might happen. In the minutes for 12 September 1900, Dr. Herbert M. Hill, Professor of Chemistry, Toxicology and Physics, asked for instruction regarding problem rows among the students. Should he call upon the police department if necessary? "After some discussion in which it was thought that a wellconducted initiation row should not be discouraged, Dr. Hill was instructed by the Dean (Mann) to use his discretion in the matter." Dr. Hill had ample reason to be apprehensive, his laboratories were on the ground floor . Finally, the unsung heroes were the janitors who had to clean up after the scrimmages. Epilogue This was not the last of the rushes, because a year later the severity of the combats between the Dents on one hand, and the combined forces of the Medics and Pharmics is reflected in the correspondence between Dean Barrett of Dentistry and Dean Mann of Medicine. Each dean claimed that the other should pay for the damages inflicted upon their respective buildings. Only 60 feet separated the two buildings, yet the deans relied on mail for communication. (This is not extraordinary since some members of the same faculty would not communicate, let alone cooperate with one another). At the Medical Faculty meeting of 4 November, 1901, Dean Mann read a letter from Dean Barrett in response to one sent to him regarding the damages done to the medical building by the Dental students, in which he stated that in sometime past he (Dean Barrett) had sent a similar appeal to the Medical Department, and since it had received no recognition, he therefore considered it an even stand-off. Apparently Dean Barrett's interpretation prevailed because the minutes are sterile on that point. Enough was enough! So Dr. Roswell Park brought up the subject of hazing and disorderly conduct of the students in general at a meeting of the Medical Faculty, 2 February 1902. It was moved, seconded, and passed that the following resolution be published in the medical catalogue: So-called initiation of freshmen, having in any form, or any other disreputable or disorderly conduct within the precincts of the University is strictly prohibited and will render the offenders liable to expulsion. It was moved and carried that the proposed rule be sent to the Dean of each Department. These resolutions were published in the catalogues of the four departments (medicine, pharmacy, law and dentistry). And furthermore, Dr. Park also gave talks before various fraternal organizations, as late as 1906, about the matter of hazing.D WINTER, 1982 21 The references are arranged in the order quoted or paraphrased material first appeared in the article. 1. Rushed Things. Buffalo Courier 12 October 1899. 2. Battle Again. Ibid 13 October 1899. 3. Hurt in a Rush. Buffalo Express 13 October 1899. 4. Pitched Battle. Buffalo Commercial 13 October 1899. 5. Combined Forces Beat the " Dents. " Buffalo Evening News 13 October 1899. 6. College Men Make Rushes. Buffalo Enquirer 12 October 1899. 7. Students with Bruished Heads. Ibid 13 October 1899. 8. Annual Scrimmage of Medical Students . Buffalo Review 14 October 1899. 9. Students of the University of Buffalo. The Iris (Hauser, Buffalo, 1900) . 10. John S. Billings, The National Medical Dictionary (Lea Brothers, Philadelphia, 1890) II, 85. 11 . Obituary, Dr. Burton T. Simpson. Buffalo Evening News 6 March 1946. 12. Records, Minutes of Meetings, 1897-1907. Medical Department of University of Buffalo. V .3 Microfilm copy is in the Archives, State University of New York at Buffalo. �A report from the Association of American Medical Colleges (March, 1980) shows that 289 U/B Medical School graduates are on the faculties of medical schools from coast to coast. Sixteen members of the 1962 class are affiliated with other medical schools; 15 from the 1970 and 1966 class; 14 from the 1969 class; and 13 from the 1954 class. The complete list follows. GR-YR FACULTY MEMBER NAME C UR RENT S CH0 CL 1921 REIMANN, HOBART ANSTETH H~HNEMANN 1924 MAR~ORSTON, 19 32 SLOCUM, HARVEY C U TEXAS MED 1934 1934 MAY, C E SHERMAN, PINCUS SUNY BUFFALO SCH MED EINSTEIN COLL MEDICINE 1935 REXFORD, E eaSTON UNIV SCH 1939 SZYMANSKI, FREDERICK J RUSH MEDICAL COLLEGE 1940 19 4 0 1940 KANE, FRANCIS KLINE, JO~N RICHARD REKATEt A C CORNELL U MEDICAL COLL U ARIZONA COLL MEDICihE SUNY BUFFALO SCH MED 1941 1941 1941 AQUILINA, JOSEPH T GRAFt CARL J WELS, P B SUNY BUFFALO ~CH PI,(D UNIV IOWA COLL MEDICINE SUNY BUFFALO SCH MED 1942 1942 1942 CLIFFORD, F J KIRKLIN, MARGARET K STAUBITZt WILLIAM J SUNY BUFFALO SC~ MED U ALABAMA SCH MEDICINE SUNY BUFFALO SCH MED 1943 19'+3 1943 19'+3 1943 1943 1943 19'+3 BIRTCHt P K BUNNELL, I L EVANSt ALFRED S FARBER, EUGENE M FARRAR, REGII'aLD PILIERO, P PETER TABRAHt FRANK L UNHERt M SUNY BUFFALO SCH MED SUNY BUFFALO SCH MED Y~LE UNIV SCH MEDICINf STANFORD U SC~ MEDICINE EINSTEIN COLL MEDICINE EINSTEIN COLL MEDICINE UNIV HAWAII SCH MEDICINE SUNY BUFFALO SCH MED 1944 1944 1944 BROWN, ROBERT L GAGEt A A GRASER, HAROLD P SUNY BUFFALO SCH MED SUNY BUFFALO SC~ MED SUNY BUFFALO SCH MED 1945 19'+5 1945 1945 1945 1945 ADLER, R H CAPRARO, V FAIRBAIRN, JOHN F JEWETTt THEODORE C ROBINSON, J G STEINHART, J M SUNY SUNY MAYO SUNY SUNY SUNY MEDICAL COLL U SOUTHERN CAL SCH ME D J ~ 22 BUFFALO BUFFALO MEDICAL BUFFALO BUFFALO BUFFALO 8R-GALVESTO~ MEDICI~E SCH MEO SC~ MED SCHOOL SCH MED S~H MED SCH MED THE BUFFALO PHYSICIA �1947 1947 1947 1947 1947 1947 LASSER, ELLIOTT C MARSH, WILLIAM L MIRES JR, MAYNARD HAROLD ANDERSENt M N BAHNt ROBERT C LIPPESt J NICHOLSt D SHEFFER, JOHN B WAITE, J H U CAL SAN DIEEO SCH MED GEO WASH U SC~ MEDICINE DARTMOUTH MEDICAL SCHLOl SUNY BUFFALO SCH MED MAYO MEDICAL SCHOOL SUNY BUFFALO ~CH MED SUNY BUFFALO SCH MED SUNY RUFFALO SCH MEO LSU SCH MED-NEW ORLEANS 1948 1948 1948 1948 1948 1948 1948 1948 ESSIG, HARRY C GOODt RAPHAEL S GORDO~, M HALLt ROBERT J KILeY, RALPH A NISWANDER, KENNETH R SUTTON, ALRERT P WEINBERGt PAUL C SUNY STONY PRCOK SCH ~ED UNIV MIAMI SC~ MEDICINE ~~~ YORK MEDICAL COLLEGE B~YLOR COLLEGE MEDICINE ~AYO MEDICAL SCHOOL U CAL SCH MEDICINE-DAVIS EINSTEIN COLL MEDICINE U TEX MED SCH-SN ANTONIO 1949 1949 1949 1949 1949 ARMENIA, C AUSTt J BRADLEY EGAN, JOHN DANIEL SHARP, JOHN T THIEDEt HENRY ARMSTRONG SUNY BUFFALO SCH MED U TEX MED SCH-SN ANTONIO CREIGHTON U SCH MEDICINE u ILLINOIS COLL MED-ALSM U ROCHESTER SCH MED/DENT 19 50 1950 195 0 1950 1950 1950 COHEN, FLOSSIE CURTINt JAMES A DUNN, JAMES CLARENCE SOLOMON, YALE SOT0MAYOR, ZOlLO R WHITCHER, CHARLES EDWARD WAYNE ST U SCH MEDICINE G[O WASH U SC~ MEDICINE U ARIZONA COLL MEDICINE SUNY STONY BRCOK SCH MED UNIV PUERTO RICO SCH MED STANFORD U SC~ MEDICINE 1951 1951 1951 HEERDTt MARK E LESLIEt EUGENE V TEICHt EUGENE UNIV TENNESSEE COLL MED SUNY BUFFALO ~CH MED SUNY STONY BROOK SCH MED 1952 1952 1952 ALTSHULER, KENNETH l SATURENt PHOEBE ESTHER SIGMAN, EUGENE M U TEX S'WSTN ~EDICAL SCH NEW YORK MEDICAL COLLEGE L CONNECTICUT SCH MED 1953 1953 CONSTANTINE, H SMULYANt HAROLD BROWN U BIO/MED SCIENCES SUNY UPSTATE MEDICAL CTR 1954 1954 1954 1954 1954 1954 1954 1954 1954 1954 1954 1954 1954 BELTRAMI, E BURCHELL• R C CASCIOt FRANK FUCHSt RUTH GREENE, LAWRENCE STANLEY HOHENSEE, E W LEMANN JR, JACOB MAYERt RICHARD F OLSZEWSKit W A RAAB, SPENCER 0 VOSSt MARLYN WILLIAM WILSON, D M YOUKERt JAMES E SUNY BUFFALO SCH MED U CONNECTICUT SCH MED U KENTUCKY COLL MEDICINE MOUNT SINAI SCH MEDICINE UNIV ~0 SCH MED-KANS CTY SUNY BUFFALO SCH MED ~EDICAL COLL ~ISCONSIN U MARYLAND SC~ MEDICINE SUNY BUFFALO SCH MED U ARKANSAS COLL MEDICINE U MARYLAND SC~ ~EDICINE SUNY BUFFALO SCH MED ~EDICAL COLL WISCONSIN 1946 1946 1946 WINTER, 1982 23 d- �GR-YR FACULTY MEMoER NAME CUR RENT S CH0 0 L 1955 1955 1955 1955 1955 1955 ALTER, ~ILTON BAKER, J B BELLt BERTRAND M FOLEYt JOHN FRANCIS GOLDFARBt S GORDON, JOSEPH TEMPLE UNIV SCH MEDICINE MEDICAL COLL WISCONSIN EINSTEIN COLL MEDICINE U NEBRASKA COLL MEDICINE U WISCONSIN MEDICAL SCH SUNY STONY BR OOK SCH ~E ~ 1956 1956 1956 1956 1956 1956 1956 1956 1956 1956 1956 1956 ALKER JRt GEORGE J BARNETTt EUGENE V GACEK, RICHARD R GOLDFARB, CHARLES GRABOW, JACK D JONESt OLIVER PERRY LEE, FRED MAKLANSKYt D MIGEONt 8 R PFAFF, WILLIAM IJ SIMON, MANFRED STENCHEVER, MORTON A SUNY PUFF~LO SCH MED U CAL SCH MEDICINE-LA SUNY UPSTATE ~EOICAL CT~ COLL MED/OENT NJ-NJ MEC M~YO ~EDICAL SCHCOL SUNY RUFFALO SCH MED U MICHIGAN MECICAL SCH ~OUNT SIN•I SCH MEDICINE JOH~S HOPKINS U SCH ~ED U FLORIDA COLL MEDICI~[ EINSTEIN COLL MEDICINE UNIV WASHINGTON SCH MED 1957 1957 1957 1957 1957 1957 1957 1957 1957 BRU~ELLt PHILIP A FRIEDMAN, GERALD HAMILTO~ III, THOMAS P KASSIRERt JEROME P LEVINSON, W E MARKELLO, ROSS MESSIGNER, S SCHNATZ, J DAVID SlLVERt H U TEX MED SCH-SN ANTO~IC MOUNT SINAI SCH MEDICINi U SOUTHERN CAL SCH MED TUFTS UNIV SC~ MEDICINE U CAL SCH MED-SAN FRA~ SUNY BUFFALO SCH MED SUNY BUFFALO SCH MED U CONNECTICUT SCH MED U CONNECTICUT SCH MED 1958 1958 1958 1958 1958 1958 1958 1958 1958 1958 BELLANTI, J A DISCHINGER, F W FRIEDBERG, EUGENE GENCO, M T JASON, HILLIARD KATZt LOUIS KIVOWITZt JULIAN SPIVACK, MORTON STEIN, ALFRED M VLADt PETER GEORGETOWN UNIV SCH MED U ROCHESTER SCH MED/DEN COLUM PIA UNIV COLL P&S SUNY PUFFALO SCH MED LNIV MIAMI SC~ MEDICINE EINSTEIN COLL MEDICINE U CAL SCH MEDICINE-LA EINSTEIN COLL MEDICINE SUNY BUFFALO SCH MED SUNY BUFFALO SC~ MED 1959 1959 1959 1959 1959 CLAYTONt ROBERT JAMES ISAACS, ELI M MUSGNUG, RICHARD H O•KONJEWSKlt R F WAYt L W U lEX MED SCH·S~ ANTONI WAYNE ST U SCh M~DICINE JEFFEPSON MEDICAL COLL ALBANY MEDICAL COLLEGE U CAL SCH MED-SAN FRAN 1960 1960 1960 1960 1960 1960 ARCHIEt JULIAN T CHAZANt JOSEPH A DAYER, ROGER S FAJGELt HARNS C GERSHBERGt MYRON R GIANTURCOt D T RUSH MEDICAL COLLEGE U VERMO~T COLL MEDICINE SUNY BUFFALO SCH MED BOSTON UNIV SCH MEDICIN COLUMBIA UNIV COLL P&S DUKE UNIV SCH MEDICINE 24 THE BUFFALO PHYSICIA �1960 1960 196 0 1960 1960 1960 GOLDBERG, DANIEL A KLOCKEt FRANCIS J LASCAR!, ANDRE D LAURIA, JOHN IGNATIUS LICHTMAN, MARSHALL A RAKOWSKI, D A EINSTEIN COLL MEDICINE SUNY BUFFALO SCH MED STHRN ILLINOIS U SCH ME SUNY BUFFALO SCH MED U ROCHESTER SCH ~ED/DE~ SUNY BUFFALO SCH MED 1961 1961 1961 1961 1961 1961 1961 1961 1961 1961 BOVEt KEVIN E BRODY, HAROLD COHENt M E FERMAGLICH, JOSEPH PROSNITZt LEONARD R SCHNATZt P T SKARINt ARTHUR THOR STANGER, P TAMER, DOLORES URETSKYt S C U CINCINNATI COLL MED SUNY BUFFALO ~CH MED SUNY BUFFALO ~CH MED GfORGETOWN U~IV SCH MED YALE UNIV SCH MEDICINE CASE WESTN RES U SCH MED HARVARD MEDICAL SCHOOL U CAL SCH MED·SAN FRAN UNIV ~IAMI SC~ MEDICINE MOUNT SINAI SCH MEDICINE 1962 1962 1962 1962 1962 1962 1962 1962 1962 1962 1962 1962 . 1962 1962 1962 1962 AHLGREN, E WARNER COVINO, BENJAMIN G CUDMOREt J W DOZORETZt RONALD I FlSHERt J C GURTNER, GAIL H HEILBRUN, M P JACOBSt RAE RODNEY KLOCKE, ROBERT A KUHNt J P LANG, GCRDON R SELIKOWITZt STUART M STEINHARTt M J WEICHSEL, MORTON E WELDONt VIRGINIA V WITTENBERG, JACK TEXAS AIM VNI~ MED SCH U MASSACHUSETTS MED SCH SUNY BUFFALO ~CH MED EASTER~ VIRGI~IA MED SCH U CAL SAN DIEfO SCH MED JOHNS HOPKINS U SCH MED UNIV UTAH COLL MEDICINE U KANS~S COLL HL SCI/HSP SUNY BUFFALO SCH MED SUNY BUFFALO SCH MED U ILLINOIS COLL MED-ALSM DARTMOUTH MEDICAL SCHOOL ALBANY MEDICAL COLLEGE U CAL SCH MEDICINE-LA WASHINGTON U ~EDICAL CTR HARVARD MEDIC~L SCHOOL 1963 1963 1963 1963 1963 1963 1963 1963 1963 ABRAHAM, G N EHRLICH, FRANK E FOT I, ANTHONY M HAMILTON, ROBERT W HER8STRITTt JOSEPH G HOGPENt GEORGE LEDER NATHAN, RONALD G SCHRIVERt JOHN A ZELLER, ROBERT S U ROCHESTER SCH MED/DENT MEDICAL COLL OF VIRGINIA SUNY BUFFALO SCH MED BOWMAN GRAY SCH MEDICINE SUNY STONY BROOK SCH MED MOUNT SINAI SCH ~EDICINE U ARIZONA COLL MEDICINE U OREGON HL SCIENCES CT~ B~YLOR COLLEGE MEDICINE 1964 1964 1964 1964 1964 1964 1964 1964 1964 1964 1964 1964 BLOCK, B GOLDSTEIN, GERALD BRUCE KATZt STEPHEN P KELLER, DAVID W KRELLENSTEINt DANIEL J LADOULISt CHARLES THEODORE LEEDS, LEROY J MEANSt E 0 ROSE, NOEL R SCHEIBER, S C TAYLORt J MICHAEL WOLIN, R E SUNY BUFFALO SCH MED U ARIZONA COLL MEDICINE SUNY STONY BRCOK SCH MED w•sHINGTON U ~EDICAL CTR MOUNT SINAI SCH MEDICINE U TEXAS MED BR-GALVESTO~ BAYLOR COLLEGE MEDICINE U CINCINNATI COLL MED ~AYNE ST U SC~ MEDICINE U ARIZONA COLL MEDICINE TUFTS UNIV SCH MEDICI~E SUNY BUFFALO SC~ MED d- �' --· -- ------ -- GR -YR FACULTY MEMBER NAME CURRENT SCHOOL 1965 1965 1965 1965 1965 1965 1965 1965 BERMAN, STEVEN ~ CATANZARO, ANTONIO KNOX, FRANKLYN G MC ~ARTINt DANIEL E POTTER, BERNARD S RAY, MICHAC::L SCHUDER, ROBERT J WAGNER, EDWARD H UNIV HAWAII SCH MEDICINE L CAL SAN DIEGO SCH MED M~YO MEDICAL SCHOOL UNIV LOUISVILLE SCH MED SUNY STO~Y BRCOK SCH ~ED SUNY BUFFALO SC~ ~ED SUNY BUFFALO SC~ MED U NO CAROLINA SCH MED 1966 1966 1966 1966 1966 1966 19b6 1966 1966 1966 1966 1966 1966 1966 1966 BARO NE, ROBERT MICHAEL CHRISTODOULOU, JAMES CLEP-'MONSt JOAN E FARINA, A T FELDMAN, BERNARD ~OSEPH FIERRO, MARCELLA F FISGUS, CARL WAYNE LADUCA, JOHN N LEBERt MARTIN EDWARD LEHANEt DANIEL EDWARD MC DONALD, BRUCE MICHAEL PACHUTA, DONALD M PRESANT, CARY A SCHILLER, NELSON B SCHROTTt HELMUT G U CAL SAN DIEGO SCH ~ED CORNELL U MEDICAL COLL SUNY STONY BRCOK SCH ~ED NEW YORK U SC~ MEDICINE RUSH MEDICAL COLLEGE MfDICAL COLL OF VIRGINIA MEDICAL UNIV S CAROLINA SUNY BUFFALO SCH MED HtRVARD MEDICAL SCHOOL BAYLOR COLLEGE MEDICINE GEO WASH U SC~ MEDICINE U MARYLAND SC~ MEDICI~E WASHINGTON U ~EDICAL CT~ U CAL SCH MED-SAN FRAN UNIV IOWA COLL MEDICINE 1967 1967 1967 1967 1967 1967 1967 DAFFNERt RICHARD H DANTZKERt DAVID R HOFFMAN, LEON LARSON, DAVID L SALTZMAN, ALAN R SULLIVANt ALBERT L VENUTO, ROCCO CHARLES DUKE UNIV SCH MEDICINE U MICHIGAN MECICAL SCH MOUNT SINAI SCH MEDICINE U TEXAS MED BR-GALVESTON SUNY BUFFALO SCH ~ED BOSTON UNIV SCH MEDICINE SUNY BUFFALO SCH MED 1968 1968 1968 1968 1968 1968 1968 1968 1968 1968 1968 ANDRES, ~OEL M BALTIMOREt ROBERT SAMUEL BOGARD, BRUCE N COELt MARC N HOPENSt THEODORE JOSEPH, BRIAN SALIT MURPHYt PAUL KEVIN RAYMOND, HOWARD WARREN SCHLAERTHt ~OHN B SCHLAERTHt KATHERINE R STOFF, JEFFREY STUART U FLORIDA COLL MEDICINE UNIV SCH MEDICINE SUNY STONY BRCOK SCH MED U CAL SAN DIE€0 SCH MED U TEX MED SCH-SN ANTONIO HARVARD MEDlC~L SCHOOL HJRSHALL UNIV SCH MED U WISCONSIN ~EDICAL SCH U SOUTHERN CAL SCH MED U SOUTHERN CAL SCH MED H.RVARD MEDICAL SCHOOL 1969 1969 1969 1969 1969 1969 CITRO, LAURENCE A DE ANGELISt ARTHUR FINCH, ALBERT 8 LIEBLING, MICHAEL ROY MOLTZ, DAVID ALBERT HOSHMAN, STEPHEN U PENNSYLVANIA SCH MED EINSTEIN COLL MEDICINE (~STERN VIRGI~IA HED SCH U CAL SCH MEDICINE-LA EINSTEIN COLL MEDICINE £INSTEI~ COLL MEDICINE 26 Y~LE THE BUFFALO PHYSICIA �1969 1969 1969 1969 1969 1969 1969 1969 NAKAMURA, HACHIRO PERLINO, CARL A RABIN, BRUCE S ROBERTS, DOUGLAS L SCHREI8ER, DAVID STEVEN S~ITH, WILBUf\ L WOLFF, WILLIAM G ZAVISCAt FRANK GORDON SUNY STONY BRCOK SCH MED EMORY UNIV SCH MEDICINE UNIV PITTSBURGH SCH MED SUNY BUFFALO SCH MED HARVARD MEDICAL SCHOOL INDI~NA U SCH MEDICIN~ SUNY STONY BKCOK SCH ~ED WfST VIRGINIA U SCH MED 1970 1970 19 70 1970 1970 1970 19 70 1970 1970 1970 1970 1970 1970 1970 1970 BALISTRERI, WILLIAM FRANCIS BLU~, RONALD HOWARD CONTI, SEBASTIAN COPLEY, DONALD P DILLON, WILLIAM P ECKHERT, NANCY LYNN FEINSTEIN, EBEN I KERMAN, SUSAN HARRISON KRULISKY, THOM~S V LEIBOWITZ, ALAN 1 LITTMMJ, BRUCE H LZERNIEJEWSKI, RICHARD THOMAS NOVt.K, JAN M PINE, JEFFREY R ZMYSLINSKI, RONALD W U CINCINNATI COLL MED HARVARD MEDICAL SChOOl U CAL SCH MEDICINE-DAVIS SUNY BUFFALO SCH MED SUNY BUFFALO ~CH MED U MASSACHUSETTS MED SCH U SOUTHERN CAL SCH MED EINSTEIN COLL MEDICINE U SOUTHERN CAL SCH MED SUNY BUFFALO SCH MED MEDICAL COLL OF VIRGINIA RUSH MEDICAL COLLEGE SUNY BUFFALO SCH MED E~ORY UNIV SC~ MEDICINE U OF SO CAROLINA MED SCH 1971 1971 1971 1971 1971 19 71 1971 1971 1971 1971 1971 1971 1971 ABELES, MICHA BARON, MICHAEL B CROt-JEN, ARTHUR C DE ANGELISt LAWRENCE JOSEPH EllERSTEIN, NORMAN S HALL, JOHN M HAROLDSt JAY ALAN LICHTMAN, JEFFREY BRUCE NADLER, DENNIS A R 0 S EN , DE N r, I S J STEIN, MARVIN STUART, CHARLES A TWAROG, FRANCIS JOHN U CONNECTICUT SCH MED U MASSACHUSETTS MED SCH MOUNT SINAI SCH MEDICIN~ EINSTEIN COLL MEDICINE SUNY BUFFALO SCH MED U CINCINNATI COLL MED VANDERBILT U~IV SCH MED E~ORY UNIV SC~ MEDICINE SUNY BUFFALO SC~ MED U MASSACHUSETTS ~ED SCH MOUNT SINAI SCH MEDICI~~ U TEXAS MED BR-GALVESTON H'RVARD MEDIC'L SCHOOL 1972 1972 1972 1972 1972 1972 1972 1972 1972 1972 1972 1972 BLANCHARDt RICHARD F BOMMER, WILLIAM J GOLDMAN, RICHARD STEPHEN HOLLAND, SANFORD J KOTRADY, KONRAD PETER LYMA~, GARY H MINTZER, IRA LEO MURRAY, WILLIAM T NATALE, DENNIS LLOYD SIEGELt ARTHUR SILVERMAN, ANDREW YECKES SMITH, CRAIG R 8UFFALO SCH MED U CAL SCH MEDICINE-DAVIS UNIV NEW MEXICO SCH MED COLL MED/DENT NJ-NJ MED UNIV UTAH COLL MEDICINE U SOUTH FLORICA COLL ~ED HARVARD MEDICAL SCHOOL hARVARD MEDIC~l SCHOOL EINSTEIN COLL MEQICINE SUNY STONY BROOK SCH ~E~ U TEX MED SC~-SN ANTO~IO JOHNS HOPKINS U SCH MED 1973 1973 ABRAMOWITZ, BRUCE MARK ElliSt DEMETRIUS BOSTON UNIV SCH MEDICIN~ UNIV PITTSBURGH SCH MED WINTER, 1982 SU~Y 27 d- �FACULTY 1973 1973 HABER~A~t MICHAEL A LOEWENSTEIN, JOHN ISAAC BOSTO~ 1974 1974 1974 1974 BUKOWSKI, ELAINE MARIE LOt HING-HAR SCHULMA~, ELLIOTT ARNOLD SYBERT, VIRGINIA PHYLLIS DUKE UNIV SCH MEDICINE EMORY UNIV SC~ MEDICI NE TEMPLE UNIV SCH MEDICINE UNIV WASHINGTON SCH ~ED 1975 1975 LARI, STEVEN JUD ZINNt STEVEN L U MINNESOTA MEDICAL SCH TfMPLE UNIV SCH MEDICI~E 1976 SPURLING, TIMOTHY JOHN U~IFORMED Dr. Cooke ~EMBER NAME CUPRENT SCHOOL GR-YR EMORY UNIV SC~ ~EDICINE UNIV SCH MEDICINE SVCS OF HL SCI Dr. Robert E. Cooke, has been appointed medical director of the Dr. Robert Warner Rehabilitation Center of The Children's Hospital of Buffalo. He was also named the A. Conger Goodyear Professor of Pediatrics at the School of Medicine. Dr. Cooke was previously a consultant to the Department of Mental Health in Massachusetts, and also served on the Board of Trustees of the Eunice Kennedy Shriver Center, Waltham , Mass., and as chairman of the Scientific Advisory Board of the Joseph P. Kennedy Jr. Foundation in Washington, D.C. His many other academic appointments have included: professor of pediatrics, Medical College of Pennsylvania; President, Medical College of Pennsylvania; Vice Chancellor for Health Sciences, University of Wisconsin-Madison; professor of history of medicine, University of Wisconsin Medical School; visiting professor, Department of Social and Preventive Medicine, Harvard Medical School; Given Foundation professor and chairman of pediatrics, The Johns Hopkins University School of Medicine; and pediatrician-in-chief, Johns Hopkins Hospital; in addition to many other national and local appointments. In the mid 1960's, Dr. Cooke was chairman of the National Steering Committee that created Project Head Start. A graduate of Sheffield Scientific School , he earned his medical degree from Yale University School of Medicine, and also holds an honorary doctorate from the University of Miami. Dr. Cooke is a member of the American Academy of Pediatrics, a Distinguished Fellow of the American Psychiatric Association, and a member of the American Pediatric Society, among numerous other organizations. Dr. Cooke is also the recipient of many awards.O 28 THE BUFFALO PHYSICIA �Lake Erie Sailing Dr. Ted Bistany and his crew have been battling Lake Erie for 10 years. They have sailed against the best sailors in the county, engaged storms, high winds and deadly calm. This year in his 11th attempt, Dr. Bistany and his crew came up winners in the 236-mile Lake Erie race - Buffalo to Toledo. There were 25 boats in the race that started on a Friday at 10:30 a.m. and ended at 3:19a.m. the following Sunday. According to Dr. Bistany there were really three races- the firs t from Buffalo to Long Point; the second from Long Point to Pelee (120 miles) ; the third from Pelee to the finish . Dr. Bistany, M'60, is a clinical assistant professor of medicine at the Medical School.D Medical Society Committees Twenty-two faculty members are serving ' on committees for the Erie County Medical Society during 1982-83. They are : Drs. James R. Nunn, M'55, clinical assistant professor of family medicine and clinical associate in medicine - Legislation; Allen L. Lesswing, M'54, clinical instructor in orthopedics - Public Health; M. Luther Musselman, M'37, clinical associate professor of medicine - Medical Education; William J. Breen, M'55, clinical assistant professor of medicine Economics; and Thomas W. Bradley, M'66, clinical instructor in family medicine - Peer Review. Elected to the Ethics Committee for threeyear terms were: Drs. Joseph L. Camp, M'54, clinical instructor in medicine and Nancy H. Nielsen, M'76, clinical a ssis tant professor of medicine and microbiology. Peer Review Committee members were also elected. They include: Drs. Timothy J. Collard, clinical instructor in orthopedics; Rob ert G. Fugitt, M'73; Joseph M. Greco, M'73, clinical assistant professor of urology ; William K. Major, Jr., M'69, clinical assistant professor of surgery; Elton M. Rock, M '59, WI TER, 1982 clinical assistant professor of medicine ; and James A. Smith, M'74, clinical instructor in orthopedics. Elected to three-year terms on the aminating Committee were: Drs. John J. Banas, M'52, clinical instructor in medicine ; Glenda D. Donoghue, clinical assistant professor of nuclear medicine; William E. O'Brien, Buffalo; and Andrew W. Tramont, clinical instructor in family medicine. Also elected were two additional delegates to the Medical Society of the S tate of New York for two-year terms. They are: Drs. Joseph A. Prezio, clinical assistant professor of medicine and clinical professor of nuclear m e dicine, chairman-elect; and Frank J. Bolgan, M'51, clinical associate professor of surgery. Dr. Edmond J. Gicewicz, M ' 56, clinical assistant professor of surgery and Dr. Victorino Anllo, clinical assistant professor of urology, will also serve as delegates. The alternate delegate to the State Society elected for a two-year term is Dr. Frederick R. Beerel , clinical assistant professor of medicine.D 29 �Faculty Honored Drs. Aquilina, N aughton Dr. Giuseppe A. Andres, professor of microbiology, pathology and medicine, won the prestigious Stockton Kimball award at the annual Medical School faculty meeting for his outstanding contributions to teaching, research and service. Dean John Naughton also presented Deans Awards to Drs. Joseph T. Aquilina, clinical professor of medicine, and Charles D. Bull, clinical associate in medicine. Also honored were four faculty members for distinguished teaching and nine retirees. Collectively the retirees have served the University 260 years. They are: Drs. Kenneth M. Alford, Gordon H. Burgess, William Dickson, Joseph Dziob, Francis Ehret, Donald Kerr Grant, Samuel Guest, George Koepf, and Robert Warner. All are emeritus. The Louis A. and Ruth Siegel awards ($500 each) for distinguished teaching went to Drs. Charles Severin, assistant professor of anatomical sciences; Richard Sills, assistant professor of pediatrics; and Robert Corretore, M'56, clinical assistant professor of family medicine. Dr. Ira Landsman, M'79, clinical assistant instructor in pediatrics, won the House Staff Teaching Award. Dr. Andres joined the faculty in 1970. He came from the University of Rome where he headed its laboratory of immunopathology for seven years. He was born in Torino, Italy in 1924, and received his M.D. from the University of Pisa in 1949. He was on the faculty and has been a Fellow in the departments of medicine and pathology at the Universities of Pisa, Rome, Columbia College of Physicians and Surgeons and Stockholm's Karolinska Institute. Dr. Andres has authored many scientific articles in which he has made highly significant contributions by the technique of electronmicroscopic and immunoferri tin studies (there are in the world few who are technically qualified) of renal diseases and renal homografts which are tissue grafts from outside the body. He is a member of the American Association of Pathologists and Bacteriologists; serves on the National Research Council's Committees for Electronmicroscopy, Immunology, and Institute for Organ Transplantation; belongs to the European Society for Clinical Investigation , the Societa Italiana de Microscopia Elettronica, and Societa de Italiana de Allergia e Immunologia. Dr. Aquilina joined the faculty in 1951 as assistant in medicine. He received his medical degree in 1941 from U/ B. He is a Buffalo native. He was graduated from Grover Cleveland High School and received his BA from U/ B in 1937. He took his internship and residency at the E.J. Meyer Memorial Hospital. He was chief, cardiovascular section, 235th General Hospital , France during World War II. After returning from the service h e did postgraduate work at London School of Tropical Medicine/ Hygiene in England and the Michael Reese Hospital, Chicago. Dr. Aquilina was chief of medicine , VA Medical Center from 1968-77 and 1980-81. He is currently associate chief, medical service. In 1974 he won the Erie County American Legion Award for 25 years of "compassionate expertise in the healing arts." H e is a Diplomate, National Board of Medical Examiners and American Board of Internal Medicine and a Fellow, American College of Physicians. He has been active in several local , state and national professional organizations and has chaired and served on 13 30 THE BUFFALO PHYSICIA �medical school/hospital educational committees for second, third and fourth year students. He has authored or co-authored 19 scientific papers from professional journals. His major interests: internal medicine and drug evaluation. Before coming to Buffalo in ovember, 1949 he was assistant chief, medical service at the Batavia VA Hospital for three years. In 1970 he was appointed clinical professor of medicine at U/B. He is a past president of the Baccelli Medical Club of Buffalo. Dr. Bull was cited for his long service to the university, especially with the admissions committee. He joined the faculty in 1960. He received his M.D. from Howard University in 1945. Dr. Alford joined the faculty in 1946 as an instructor in pediatrics. He received his M.D. from U/B in 1937. He retired 36 years later as clinical professor pediatrics. Dr. Alford did his undergraduate work at Colgate University; his internship at Buffalo General Hospital and Hospital for Sick Children, Toronto, where he also took a one year residency. His other post-graduate work was at Children's Hospital, Boston and Buffalo Children's Hospital. In 1971-72 he was a Fellow in Adolescent Medicine at Harvard. Dr. Alford served in the European Theatre during World War II (1941-46) and received five battle stars and the Bronze Star. He was a Major when discharged. Before coming to Buffalo he was a pediatrics instructor at the University of Toronto. Since 1950 he has been an attending or consultant at Children's and Buffalo General Hospitals. He is a Fellow, American Board of Pediatrics. He has been active in several medical societies and civic organizations. Dr. Burgess received both his BA and MD degrees from U/B in 1957 and 1963 respectively. He joined the faculty in 1975. He is retiring as a clinical assistant professor of dermatology. The 46year-old physician died July 17 at Millard Fillmore Hospital. Dr. Dickson joined the faculty in 1975 as a clinical instructor in gynecology/obstetrics. He received his BA degree from Hobart College in 1939; his MD from the University of Rochester in 1943. He took his intership and residency at Strong Memorial and Bellevue Hospitals. In 1950-51 he was a clinical assistant professor at the University of California. He is a Fellow, American College of Obstetrics and Gynecology. Dr. Dickson was a Lieutenant in the United States Navy from 1944-46. He will continue to be on the staff of the WCA and JGH Hospitals in Jamestown, NY. He also plans to continue his private practice. Dr. Dziob joined the faculty in 1946 as an assistant in surgery. He is retiring 36 years later as a clinical associate professor of surgery. He received his Ph.D. in 1932 from Providence College; his MD in 1936 from Jefferson Medical College. He graduated cum laude from Providence. Dr. Dziob took his internship and residency at New York City Hospital in pathology and general surgery (1937-41). He is a Diplomate, American Board of General Surgery and a Fellow, American College of Surgeons and American Association Surgery of Trauma. WI TER, 1982 31 Drs. Naughton , Bull Drs. Naughton, Andres �Drs. Na ughton, Kaepf Dea n Naughton, Dr. Guest Dr. Sills Dr. Warn e r Dr. Severin Dr. Ehret joined the faculty in 1944 as an assistant in medicine . He received his MD from U/B in 1937. He retires a clinical associate professor of medicine after 48 years. Dr. Guest received his BA from the State University of Iowa and his M.D. from Chicago Medical School in 1941. He joined the U/B faculty in 1951 as an assistant in anesthesiology. He retired 31 years later as a clinical associate professor of anesthesiology . He interned at the North Chicago Community Hospital and took his residency at Batavia's VA Hospital, 1946-49. He served in the United States Army as a Captain from 1942-46. Dr. Guest has been chief, department of anesthesiology at the Buffalo VA Medical Center since 1950 and director of the anesthesiology residency program (1950-1965) . From 1975-82 he was medical director of the respiratory therapy department at the VA, and for 20 years he was attending anesthesiologist at Erie County Medical Center and Buffalo State Hospital (1955-70). The last six years he has been adjunct clinical professor, respiratory therapy department, Erie County Community College. Dr. Guest is a Diplomate, American Board of Anesthesiology and a Fellow, American College of Anesthesiologists. He has been an active member of several professional societies and has authored several scientific articles for professional publications. Dr. Kerr-Grant received his B.S. and M.D. from the University of Adelaide in 1942. He joined the U/B faculty as an associate in pediatrics in 1963. He is taking an early retirement to return to England. After 19 years on the faculty, he is an associate professor of pediatrics. Dr. Koepf joined the faculty in 1941 as an assistant in medicine . He received his medical degree from U/B in 1937. He took pre-medicine at Ohio State University . He retires 41 years later as an assistant clinical professor of medicine. He took his internship and residency at Buffalo General Hospital. During World 32 THE BUFFALO PHYSICIAN ' �War II he served as a Lieutenant in the Army Medical Corps Reserves. He was also a John Harris Fellow in medicine at Johns Hopkins. Dr. Koepf founded the Medical Foundation of Buffalo in 1956 as an independent biomedical research institute. It started as a three-man operation and grew into one of the world's leading research organizations with a staff of 60, including 25 doctoral level scientists. The president of the Foundation noted that the non-profit institute conducts basic research on hormone related disorders including cancer, heart disease and diabetes. The Foundation is supported by grants from the National Institutes of Health, National Science Foundation, endowment income and charitable gifts. Dr. Koepf was also one of the co-founders of the Buffalo Medical Group along with Drs. Ramsdell Gurney, M'29, and Murray Howland. Dr. Warner has served on Governor Hugh Carey's Advisory Council on the Disabled since 1977. He was also a member of the ew York State Delegation to the White House Conference on the Disabled and served for one year on the Advisory Council of the New York State Division of the Office of Vocational Rehabilitation. An associate professor of pediatrics at the Medical School, Dr. Warner is also a visiting teacher and chief of the rehabilitation division, pediatric staff, Buffalo General Hospital; a consultant, Millard Fillmore Hospital; and a consultant in rehabilitation medicine, Erie County Medical Center. A veteran of the Army Medical Corps, he is a graduate of Harvard College and received his M.D. from the University of Chicago. After graduation he took a rotating internship at Buffalo General Hospital in 1939, followed by a special internship in pediatrics at Children's Hospital - the beginnings of a long relationship. Dr. Warner has received many awards and honors. They include: the third annual Pediatrician of the Year Award; Variety Club Man of the Year, 1965; Greater Buffalo Advertising Club Man of the Year, 1974; Outstanding Citizen Award from the Mayor of Buffalo, 1977; Harvard Man of the Year Award, presented by the Harvard-Radcliffe Club of Buffalo, 1979; Presidential Citation from Variety Clubs International, 1980; and Communication and Leadership Award from Toastmasters International, 1980. I Dean aughton summarized the school's progress and activities during the past year. "It was very hectic; there was many activities on many fronts, but we are becoming a cohesive school." He praised the faculty for their leadership in making improvements in education, research and service. He noted that the building program for the medical school and health sciences was "back on track" and should be completed early in 1986. Dr. Thomas Guttuso, M'60, clinical assistant professor of ophthalmology, was introduced as the chairman of the admissions committee. Dr. Edward A. Carr, Jr., professor and chairman of pharmacology and therapeutics, reviewed the activities of the faculty council. New faculty members were introduced by the department chairmen.D WI TER, 1982 33 Dr. Dziob �Dr. Alexander Brownie with students. Mark Venditti Beth Maher and friend. �Athletic Day Students and faculty relaxed and had fun. Doris Unger, Cathy Cyrulik, Dr. Leonard Katz. I �Dr. Charles Ande rson with patient and students. Dr. Michael Rudnick with students in the lab. Summer Head Start Veronica Nwabi-Lazorus, Brawn, Dr. Wright. Ten potential medical students got a head start on their professional education during an eight-week summer session (June 7 - July 30). This was the eighth year that courses were offered in histology, embryology plus introduction to biochemistry and gross anatomy. Coordinator of the preparatory support program was Dr. Maggie Wright, assistant dean of student affairs and director of minority programs. The students also learned about study skills, test wiseness, and participated in a preceptorship program. During the first week there was a special orientation session featuring Dr. Leonard Katz, associate dean for student/curricular affairs and professor of medicine. Other guest speakers were Drs. John Richert, Randy Sarnacki and Frank Corbett. The teaching faculty: Drs. Murray Ettinger, biochemistry; E. Russell Hayes, Joseph Rutnick, Chester Glomski, Harold Brody and Michael Meenaghan, all members of the anatomy department. There were also four teaching assistant/tutors assigned to the program.D Danna Dr. Arthur Lee, associate professor 36 of surgery. THE BUFFALO PHYSICIA �Four Physicians Honored Four physicians at the Erie County Medical Center were honored at the 62nd graduation ceremonies for hospital residents. The ceremonies were sponsored by the medical-dental staff of the hospital. The Ignatius Semmelweiss Award was given to two people: Moses Derechin, M.D. (resident in pathology) for work on a new cancer detection test and Irene Lee, Ph.D. (postdoctoral fellow in chemistry) for her work on calcium test interferences in dialysis patients. The Semmelweiss Award was created in 1974 by Dr. Desider Pragay, clinical associate professor of biochemistry, pathology and director of the chemistry department of the Erie County Laboratory. The award is named for Ignatius Semmelweiss, the pioneer in antiseptic and aseptic procedures for surgery, obstetrics/gynecology in the mid-1800s in Austria and Hungary. The Norman Chassin Award is named for the attending in medicine at the medical center. The outstanding teacher of the year award is selected by the medical residents at the medical center. It was given to Charles Chambers, M.D. (intern in the department of medicine). Finally, the White Coat Award of the residents was given to Allan Friedman, M.D. (attending physician, Buffalo General Hospital). It was the 8th annual award given a faculty member by the graduating residents.D During the summer 24 first and second year medical students were introduced to primary care. Several students were in hospitals, health clinics and physicians' offices in the Buffalo area, but most were in eastern New York cities. The Medical Education Community Orientation (MECO) Program, sponsored by the American Medical Student Association, is in its sixth year. James Fink, third-year student, directed the program. The physician/preceptors participated voluntarily. Most of the students were on six-week stipends, but several worked longer. Among the contributors were: the Annual Participating Fund for Medical Education (APFME). New York State Academy of Family Physicians, Lamb Foundation, Jeffrey Fell, Gebbie Foundation, Buffalo Academy of Medicine, Medical Society of Erie County, and Cornell Foundation. There were also several private contributors. The students who participated in the MECO program are: Paul Berkowitz, Diane Flanagan, Charles Shapiro, Lynda Stidham, Karen Schupak, Deborah Silberman, Robert Lasek, Robert Amberger, Tim Dyster, Carl Turissini, Richard Banner, Jon Wardner, Richard Rosenfeld, John Leddy, Susan Ascher, Gerard Brogan, Jr., James Wasserman, Joe Curletta, Marc Siegel, Shirley Vandermey, Bonnie Richardson, Paula Rothman, Carmen A. Alvarez and Judi Leichman. The preceptors are: Drs. Andrew Ageloff, Hirsch, Gerd J.A. Cropp, Willies, Michael Dunn, John Conboy, Emerson C. Reid, Oyster, Alfred Malinov, J. Martin Zianaman, Robert Katz, Ausabec, Levine, Irving Aronow, Edward Hutcheiss, Tom Gerbasi, Shirley Lippsett, Fred Grella, Donald Robinson, Schocket, and Don Collure.D WINTER, 1982 37 MECO Program �Dr. Mario Rattazzi with one of the 40 exhibits. Drs. James Hassett, James McReynolds, Michael Anbar, Robert Mc!saa c. 200 Attend First Annual Studen ti Departmen tal Research Exhibit Dean John Naughton, Dr. Leonard Katz. Dr. Thomas Flanagan, Andy Francis, Mary Caserta. �Clockwise from lower left: Drs. Sandy Matalon, Murray Ettinger, Robert Summers, Jeff Boidt, Andrew Snyder, Francis Klocke, Nicholas Lebowitz, Herman Szymanski, Michael An bar, Peter Hogan, Barry Eckert, Joseph Caruana, the exhibits, Cindy Pritach, Alexander Brownie, Peter Hogan, Gracia Constantino, David Crawford, Nancy Glieco. 39 �Summer Fellowships Twenty-seven medical students participated in the annual summer fellowship program. For the first time this program is supported by a three-year, $90,450 grant from the National Institutes of Health, according to Dr. Thomas Flanagan, professor of microbiology, the program director. The grant supports summer research efforts of medical students, according to associate director Dr. Randolph E. Sarnacki, assistant professor of social and preventive medicine. Trainees were selected from applicants who are undergraduate medical stvdents. The students worked in laboratories under the tutelage of a mentor, who was responsible for their training. The mentors were recruited on the basis of their research competence and their experience in training young investigators. Dr. Mario T. Rattazzi, professor of pediatrics, is acting chairman of the summer fellowship research committee while Dr. Flanagan is on leave. John Badia ... Dr. Leonard Freeman, Nuclear Medicine, Montefiore Hospital "Quantification of Time-Activity Dynamics in the Transit of 99mTc-IDA Analogs through the Common Bile Duct for the Evaluation of Partial Ductal Obstruction." John C. Bowen ... Dr. Michael D. Garrick, Biochemistry "Automated Determination of Reticulocyte Count Via Hemolysate RNA Concentration." Mary Caserta ... Dr. Richard Sills, Hematology, Children's Hospital - "Pathophysiology of the Anemia Associated with Haemophilus Influenzae Meningitis." James M. Esser ... Dr. Jerome Roth, Pharmacology- "Contribution of MAO, COMT and PST to Metabolic Inactivation of Catecholamines in the Nigrostriatal System of the Rat." Alan G. Finkel ... Dr. Charles Severin, Anatomy - "Efferent Projections of the Dorsal Raphe Nucleus in the Rat." Nicholas Flores ... Dr. Edwin Naylor, Pediatrics - "Maple Syrup Urine Disease: An Evaluation of Current Diagnostic and Management Procedures." Andrew Francis ... Dr. Jerome Roth, Pharmacology- "Activity of Neuron-Specific Enolase in Biological Fluids After Brain Damage: Continuation." Ira Handler . . . Dr. Edmund Egan, Neonatology, Children's Hospital - "Perinatal Disease, Visuomotor Development & Cognitive Function in Middle Childhood." Erica Heit ... Dr. Allan Lewis, Pediatric Surgery, Children's Hospital - "Aerosol Immunization in Prevention of Overwhelming Post-Splenectomy Sepsis." Patricia C. Hsia ... Dr. Barry Eckert, Anatomy- "Organization of Intermediate Filaments in Primary Cell Cultures." Michael Lahood ... Dr. Michael Garrick, Biochemistry "Characterization & Sequencing of Embryonic Rat Globin Genes." Paul Lindner ... Dr. Norman Solkoff, Psychiatry, ECMC "Sex Difference in Habituation." 40 THE BUFFALO PHYSICIAN �Raymond Meeks ... Dr. Joseph Caruana, Jr. , Surgery, V.A. Hospital- "Investigating the Effects of Increased Endogenous Insulin: Glucagon Ratio on Rat Liver Regeneration after CCL' Poisoning.'' Amy L. Miller ... Dr. Scott Peterson, Boston University, Biology - "The Mechanism of Insulin Receptor Down Regulation." Paul Nancollas ... Dr. Dilip Sinha, Cell & Virus 4, RPMI "The Requirements of Growth of Human Mammary Epithelial Tumor Cells in Collagen Gel Primary Culture." David 0' eil ... Dr. Mario Rattazzi, Pediatrics , Children's Hospital- "Towards Enzyme Replacement Therapy in Tay-Sachs Disease: Immunohisto-chemical Detection of Native & Modified Human B-hexosaminidase in Cat Tissues." Randall I. Rosenthal . . . Dr. Saxon Graham - "Distant Dietary Recall - A Methodological Study." Emilia A. Rutigliano ... Dr. Peter Kanter , Experimental Therapeutics, RPMI- "Biochemical Mechanism of Action of AB163 and NSC-278214." Michael Sansano, Jr .. . . Dr. Alan Reynard, Pharmacology"The Effects of Lipopolysaccharide on the Binding of Cell Surface Antibody in Smooth and Rough Phenocopies of E. Coli ." Juliet Seigle ... Dr. S. Matalon, Physiology - "Effects of Resuming Air Breathing After Prolonged Exposure to 100 o/r o' on the Alveolar Permeability." Elizabeth Spatola ... Dr. Norman Solkoff, Psychiatry, ECMC - "Non-maternal Care & Child Development." Michelle Stram-Foltin ... Dr. Bruce Dow, Neurobiology "Neural Mechanisms of Color Perception in the Monkey." Donald Tingley . .. Dr. A. Spector, Dept. of Ophthalmology , College of Physicians & Surgeons, Columbia University. Eveline Traeger .. . Dr. Herbert Schuel, Anatomy- "Role of Arachidonic Acid in the Prevention of Polyspermy." John A. Ulatowski ... Dr. William McHugh, Neurology, Millard Fillmore - "Metoprolol in the Treatment of Essential Tumor." James J. Woytash ... Dr. Michael Meenaghan, Oral Pathology - "Evaluation of Human Explant Specimens Used in Vascular Reconstructive Surgery: A Light & Transmission Electron Microscopic Study." SanS. Yuan ... Dr. J. Medige, Orthopaedics , ECMC- " The Effects of Radiotherapy on Bone Strength."D WI TER, 1982 41 �Potty Flanagan, Guen Nicholas, Kevin Ferentz, Amy Schueckler, Douglas Jackson. The Bond Lindo Peterson, Amy Schueckler, Lauro Jo Booth. 42 THE BUFFALO PHYSIC lA �Peter Accetta, Nevan Baldwin, Mark Vendetta, Bill Hanavan. Laura fa Booth, Linda Peterson. Medical School Follies Some 400 students, faculty and friends attended the third annual Medical School Follies last spring. It was an evening of laughs, music, song and dance sponsored by the second year medical students. After cocktails the guests were treated to over 24 acts performed by students and faculty, ranging from the sublime to the ridiculous.D Drs. Murray Ettinger, Alan Reynard, Leonard Katz, Thomas Flanagan, John Wright, Alexander Brownie. WINTER, 1982 43 The Dancer �Nutrition Lectures H UMAN genetic and biological variations in populations living at sea level and in the high altitudes of the Andes in South Ainerica was the theme of Dr. Jered Haas' nutrition lecture. He is associate professor of the division of nutritional sciences, at Cornell University. He told his audience of anthropology, medical students, and faculty of his research in Bolivia and Peru how the people of that part of the world adapted to continuous living at high altitudes. He compared the individual and group behavior of these people with those in orth America and Europe. In his illustrated lecture Dr. Haas mentioned several functioning domains physical performance, nervous system function, nutrition, reproduction, health, intellectual ability, affective functioning, growth and development, and cross tolerance and resistance to stress. "People are shorter and weigh less in the high altitudes when compared to those who live at low altitudes," he said. "One of the major deficiencies of the Andean country is the lack of good land to increase food production which in turn would improve the growth and development of the people. Good nutrition is related to work capacity, growth and development," the Cornell scientist said. In conclusion he noted that the birth weight of babies is less in high altitudes and this increases the mortality risk. "Indian women are better adapted to the environment and have larger babies because they have lived in the high altitudes for many generations. "0 Malnutrition is severe in the developing countries as well as many areas in North America, according to the associate director of clinical research at MIT. Dr. R.K. Chandra noted that 57 percent of children under 5 years of age in orth America die of malnutrition. "In United States hospitals 20 to 40 percent of adults admitted for major surgery have malnutrition," professor Chandra said. 44 In his illustrated lecture the India born researcher said he had been interested in the relationship between nutrition and immunity since early age. He showed examples of the impact of nutrition on immunity and its clinical significance. Dr. Chandra also discussed the effects of disease and infection on well nourished and malnourished children. " utritional supplements are very helpful to people of all ages when they are undernourished. Children usually rally in a few days when given nutritional supplements." Dr. Chandra noted: - there is inter-action between nutrition, immunity and infection; -nutrition must be balanced - not too much or too little; - a baby's weight at birth is very important to his growth; -malnutrition can affect several disease states.D Drugs Dr. Maurice Lipton noted that there are many conflicting opinions among scientistresearchers on the use of certain drugs to treat various disorders and diseases. "Some of the drugs were effective, but later the same drug was proved to be not reliable in the treatment of the same disorder." The University of North Carolina psychiatry professor discussed two causes and concepts of disease. "The toxic theory - in ancient days it was believed that the devil was responsible for toxins in the body. Later there was the vitamin deficiency theory. These two theories have been in competition with each other for many thousands of years, but in 1959 the theory changed from the toxic concept to the vitamin deficiency theory." Dr. Lipton noted that Dr. Freud believed in the toxic theory of mental illness. "Today starvation is the major cause of illness in the under-developed nations. Protein malnutrition is killing kids in third world countries. Malnutrition occurs in many Central American, African and Asian nations. The central nervous system in developing humans must have the proper nutritional intake." The director of biological sciences research said, "we have diseases of regulation in this country and Western Europe. Some of these are growth, hypertension, THE BUFFALO PHYSICIA �diabetes and cancer. We do not have nutritional diseases, but lead toxins are prevalent." Dr. Lipton also mentioned briefly Dr. Linus Pauling's "theory of optimum concentration of molecules to keep the mind running properly. The more you use the better - use lots - as Dr. Pauling suggests, in the treatment of the common cold." Dr. Lipton made several other observations: -man does not eat to prevent illness; he eats for pleasure; -in the last 50 years the major area of advancement in public health has been nutrition; -only the elderly and babies have nutritional problems in the United States; -food additives often make kids have hyperkenesis, and there is evidence to prove this correlation; - the original idea that schizophrenia was of biological origin is nonsense; - many of the drugs used to treat schizophrenia patients in the early days were later proved to be ineffective; - when an illness is puzzling, we often think malnutrition is the cause; this is nonsense; - there is an interesting interaction between social stimulation and malnutrition being studied in Central America. Dr. Lipton does not believe that the large amounts of sodium glucomate that is present in our food today is damaging. In conclusion he said, "there are a lot of new things and magical thinking taking place today in the field of nutrition."D Aging "I am more interested in aging than nutrition." That is what Dr. Edward J. Masoro, professor and chairman of physiology at the University of Texas Health Science Center at San Antonio, told faculty and students. The educator cited laboratory animal studies that proved under feeding in early age assures longer life. "Nutrition manipulation will probably delay aging in humans. Food restriction delays all disease processes." Dr. Masoro discussed the four major characteristics of aging: mortality, body composition, physiologic decline, and age-related disease. "All of the mechanisms responsible for length of life have not been fully explored. WINTER, 1982 But aging research for humans and medical progress has improved the length of life." The professor noted that physiologic change is evident with aging in both animals and humans. "Lean body mass is lost with aging." In conclusion Dr. Masoro said, "we need more exploration of specific food items. We must pressure Congress for more money to use in government institutions for 30-year studies on nutrition and aging."D " utrition is not just what we eat." That was the theme of Dr. RichardS. Rivlin's nutrition lecture on "Control of Vitamin Metabolism by Hormones and Drugs." The professor of medicine at Cornell Medical College went on to say that vitamin deficiency affects the way nutrition is utilized. This is as basic to clinical diseases as to biochemistry. The chief of nutrition service at Memorial Sloan-Kettering Cancer Center reviewed the biochemistry of vitamin B-2 in his slide presentation. He noted that vitamin B-2 deficiency causes cataract, discolorment of the skin, muscle apathy and loss of weight. He also discussed how hormones control vitamins and molecule action. "Vitamin metabolism is important to brain activity," Dr. Rivlin said. "Finding vitamin deficiency is very difficult and complex. " Dr. Rivlin told the students and faculty that boric acid, used to preserve food, can caus~ nutrition deficiency. He specifically mentwned a study of boric acid interaction among ew York City people . In conclusion Dr. Rivlin said, "this is a very interesting and exciting field. Nutrition involves much more than just what people eat."D Taurine "Taurine is essential and important in the development of the brains of all species, including humans." Dr. John Sturman discussed his research involving taurine on laboratory animals - rats, cats, puppies, rabbits and monkeys - in a nutrition lecture. The researcher/educator of New York State's Institute for Basic Research and Mental Retardation noted that taurine also affects the retina and liver. "There was a major breakthrough in the taurine story when Dr. Hayes and his Boston colleagues pinned down the cause of retina degeneration in cats when there was an absence of taurine in the diet. 45 d- �Dr. Sturman made several other observations: - there is no evidence that taurine affects smell; - taurine is metabolized in the liver; - the magnitude of concentration is one of the problems with taurine; - how cholesterol is handled during the first few weeks of life is very important and may influence how it is handled in later life; - there is no taurine in synthetic formulas; -humans have been on taurine-free diets for years; -human milk is loaded with cholesterol. In conclusion Dr. Sturman noted that the cartons that synthetic formulas come in cost more than the ingredients. "The synthetic formula industry is huge."O Nutrition and Health "Nutrition and health is the great question of our time. Everyone is obsessed with health in this country. People want to be healthy because of the high cost of being ill." That was the theme of Dr. M.C. esheim's nutrition lecture. He also discussed recent human nutrition developments and dietary guidelines. The director of nutritional sciences at Cornell University noted that 15 to 20 million Americans are recipients of on-going food programs (food stamp, school lunch, breakfast feeding, elderly programs, etc.) . "There is much people can do on their own to stay healthy. They can eat properly, exercise and have good personal habits. They can control their health to a certain extent by good nutritional and dietary practices," he said. "There is much disagreement in the nutrition community on the relationship between diet and chronic illness. But there is good evidence that diet and environmental factors are responsible for heart disease. Studies from around the world indicate that diet may play an important part in some chronic diseases." Dr. esheim noted that colon cancer and breast cancer among women is higher in the United States when compared to other countries. The scientist-educator discussed epidemiologic evidence and clinical studies that show the relationship between diet and 46 heart disease. "There is a correlation between cholesterol and incidence of heart disease." He mentioned the dietary goals adopted by a Senate select committee on nutrition in 1977. This is further proof of interest in nutrition and health by governmental agencies. Dr. esheim made several other observations: -fiber intake is important; - don't overeat - keep weight down; -reduce consumption of sugar, salt, beef and eggs; -use alcoholic beverages with moderation; -smoking and diabetes contribute to heart disease; - density of diet (calories per pound) has increased; - eat more fruits, vegetables, poultry and fish; -and a better diet will decrease mortality in some instances. In conclusion Dr. Nesheim said, "all studies indicate that we need to change our dietary patterns if we are to achieve better health. In the next few years we will see much more publicity on diet changes. The public will demand more advice on diet and nutrition."O Life Style Diet, environment and life style all contribute to cancer, according to Dr. W.J. Visek, professor of clinical sciences at the University of Illinois. "Forty percent of cancer in males and 60 percent in females may be diet related." He listed several environmental factors that cause cancer - tobacco, alcohol, sunlight, occupations, radiation, genetic and congential. The scientist-educator noted several studies that indicate that cancer is more prevalent in the western world than in developing nations. "The intake of fat, protein, calories and fibers is very important and often is correlated with cancer and heart disease." In another study Seven-day Adventists, who are vegetarians, and drink no coffee or alcoholic beverages, have a lower rate of cancer than the average population. MorTHE BUFFALO PHYSICIAN �mons, on the other hand, who are meat eaters, but refrain from drinking and smoking, have less cancer than the average population. Scottish people, who are big meat eaters, have a high rate of colon cancer, according to Dr. Visek. "Fiber and vitamin A may be common denominators in the fight against cancer. People in South African nations have a high fiber intake, and less cancer. Diets that are high in animal fat are also high in calories and this is bad. If a person is 25 percent overweight, he has a 40 percent greater chance of dieing from cancer. Fats have nine calories per gram while protein and carbohydrates have only four calories per gram. In conclusion Dr. Visek suggested: -cancer is not an inevitable fact of life; -fat is a promoter of cancer; not an initiator; -unsaturated fats are worse than saturated fats; -fiber inhibits the absorption of fats; - breast cancer and colon cancer are highly correlated.O diet as compared to the highly refined western diet. Studies show calories increase carcinagensis in animals and unsaturated fats increases colon and mammary cancers. Breast cancer is uncommon in Japanese women, but higher in upper socio-economic groups, according to Dr. Newberne. Breast cancer is influenced by body weight and height. The nutrition expert suggests: - a balanced diet must not be deficient in fruits, vegetables, meat, eggs, and milk; - a high starch diet may cause cancer; - esophageal cancer may be related to diet (low copper and zinc levels) and geographic areas; -vitamin A is important in the nutritional fight against cancer; -bran is a good source of fiber, but there are many other good fibers; -protein content and concentration has an affect on cancer; -eating beef is not necessarily bad for your health.D Brain Growth Cancer utrition is not the total answer to cancer, according to Dr. P.M. Newberne, professor of nutritional pathology at Massachusetts Institute of Technology. "But if we can provide a better diet from an early period in life we may be able to resist things that cause cancer." "The theory that 80 to 90 percent of cancer in humans is environmental is wrong. We develop cancer within our own bodies but why, we do not know," Dr. ewberne said. The scientist took note of studies that show obesity causes many diseases - colon and breast cancer, heart disease, hypertension and diabetes - just to mention a few. "Epidemology has given us the most information on human cancer, but there are many other studies underway that will give us additional data." The MIT professor said that Japanese who have moved to Hawaii and California had more colon tumors in the second generation after moving than those who remained in Japan. Africans don't have as much color cancer because they have more fiber in their WINTER, 1982 Two visiting nutrition experts, cosponsored by Tops Friendly Markets, agreed that food intake is important to brain growth and affects behavior. "At the turn of the century we didn't think nutrition affected the brain and behavior. The old brain sparing concept was proven false," Dr. Dave Levitsky said. The Cornell University psychology professor noted that this concept has changed because of tests on laboratory animals. "Many people believe food additives affect children's behavior, but this is not true. But when parents change their children's diet, they behave differently. Children show a delay in their brain growth because of poor nutrition. The changes are irreversible when children and animals have poor nutrition during the time of peak brain growth. The brain is smaller in malnurished animals," Dr. Levitsky said. The Cornell professor noted a South African study in 1950 that showed that children who suffered malnutrition had an IQ lag. He also indicated that often nutrition and environment are inner-related. 47 �Pigs are excellent models in studying nutrition, according to Dr. Levitsky. They also used rats, monkeys and rabbits in their laboratory experiments. "When food was restricted animals often became frantic and showed a lot of emotion." Food quantit.Y and composition is v,ery important to the brain function, accor-ding to Dr. G. Harvey Anderson, professor of nutrition at the University of Toronto. "The foods we eat actively affect brain biochemistry and ultimately this affects our behavior." The educator-scientist noted that food intake affects our sleep, pain, emotions , memory, apathy, motor coordination and depression. In his illustrated lecture Dr. Anderson showed how different diets affected laboratory animals. "Severe malnutrtion in rats changed their behavior. This also holds true for humans," he concluded.D Dr. Gresham Dr. Glen E. Gresham, professor and chairman of the department of rehabilitation medicine at U/B and director of rehabilitation medicine at Erie County Medical Center, was active in programs related to both stroke and spinal cord injury rehabilitation during the 1981-82 academic year. In the American Heart Association, Dr. Gresham was appointed to the Stroke Program Subcommittee of the national headquarters in Dallas and attended its annual meeting in New Orleans. At that time, the Stroke Committee of the Western New York Chapter was asked to develop guidelines for stroke rehabilitation services in the home. The W.N.Y. Stroke Committee also sponsored a major stroke education event in May, featuring Jacqueline Mayer Townsend. Also during 1981-82, Dr. Gresham completed three years of service as chairman of the Stroke Committee for the New York State Affiliate of the AHA and was a keynote speaker for a fall CME course on cognitive rehabilitation held in Rochester. He continues as chairman of the Stroke Committee of the W.N.Y. Chapter. In June, he gave a guest lecture on "Hemiplegia" at the Canada West Medical Congress in Vancouver. Dr. Gresham, who is also director of the spinal cord injury unit at Erie County Medical Center, is the first physician from Buffalo to 48 be elected to membership in the American Spinal Injury Association. During 1981-82, he continued to work with a newly developed Quadriplegia Index of Function and gave presentations about this new evaluation technique at the Inter-Urban SCI Meeting in Minnowbrook, ew York, the American Congress of Rehabilitation Medicine in San Diego, the American Spinal Injury Association in New York City, and the W.N.Y. Section of the American Physical Therapy Association in Buffalo. Dr. Gresham's co-workers in the development and testing of the Quadriplegia Index of Function were Sharon S. Dittmar, R.N., Ph.D.; Maria L.C. Labi, Ph.D.; John T. Hicks, R.P.T.; Sandra Z. Joyce, O.T.R.; and Margaret A. Phillips, R.N., M.S. The SCI Unit at Erie County Medical Center celebrated its third anniversary of successful operation on July 2, 1982. This unit, the first and only one of its kind in Buffalo, serves the seven counties of Western ew York. The celebration ceremonies featured a lecture by Dr. Murray Freed, noted SCI authority from Boston University, which was followed by a formal recognition by Dr. Gresham and Mr. James A. Phillips, administrator, of the contributions of all those persons whose dedication and service have made this program a success.D THE BUFFALO PHYSICIAN �Medical Alumni Officers Dr. Baumler Dr. Robert A. Baumler is the new president. He is a 1952 Medical School graduate and assistant clinical professor of medicine and associate physician at the Buffalo General Hospital. He has been on the faculty since 1956. Dr. Baumler took a rotating internship at the E.J. Meyer Memorial Hospital. He took his residency in medicine at the Buffalo General Hospital in 1953-55. This was followed by a cardiology residency at the New England Center Hospital in Boston. The physician-educator is a Fellow of the American College of Cardiology and the American College of Physicians. He is on the clinical cardiology council of the American Heart Association. Dr. Baumler is president of the Buffalo Academy of Medicine. He is a past president of the Western ew York Heart Association and the Medical Historical Society of Western ew York. He served in the United States Army in Dr. Eugene M. Sullivan Jr., is the new vice-president. He received both his bachelor's and medical degrees from U/B in 1959 and 1963 respectively. He joined the faculty in 1967 and is a clinical instructor in surgery. Dr. Sullivan had a rotating internship at Buffalo Mercy and then took his residency at the E.J. Meyer Memorial Hospital July 1964- September 1964, and September 1966 to July 1971. From September 1964 to September 1966 he was a medical advisor to the Korean Army. He also served 12 months at the Valley Forge General Hospital in the medical division of the Korean Military Advisory Group. Dr. Sullivan is a Fellow, American College of Surgeons and is a member of five other professional associations. He is an attending on the staffs of three hospitals- Our Lady of Victory, Buffalo Mercy and Erie County Medical Center.D Dr. Sullivan 1945-46.0 WINTER, 1982 49 Dr. Przylucki Dr. John E. Przylucki is the new treasurer. He received his bachelor's degree from Georgetown University in 1969 and his M.D. from U/ B in 1973. He joined the faculty in 1973 and is a clinical instructor in surgery. Dr. Przylucki took his residency in surgery at the Millard Fillmore Hospital from 1973-77, and has been director of the Intensive Care Unit at the hospital since he completed his residency. He is affiliated with St. Joseph's Intercommunity Hospital and is active in several local, state and regional professional associations.D �People Fourteen faculty and resident staff from the Department of Urology at U/B and Roswell Park Memorial Institute have presented scientific papers at the Northeast Section of the American Urological Association. The faculty and residents involved were Drs. Salah A. Elsaharty, clinical assistant instructor in surgery; J. Edson Pontes, associate professor; Zew Wajsman, research associate professor; Sunmolu Beckley, clinical assistant professor; Gerald Sufrin, professor and chairman; Kevin Pranikoff , assistant professor; Imre V. Magoss, professor; Jitendra Varma, clinical assistant instructor; Barry Malin, clinical assistant professor ; John F.M. Gaeta, professor of pathology and associate professor of urology; Shiro C. Imahori , clinical assistant professor of pathology; Gerald P. Murphy, research professor of urology; G. Swaneck, R. Rabinowitz, and Lenore S. Englander, clinical associate professor of pathology.O Dr. Eugene A. Gorzynski, professor of microbiology, has been elected a Fellow of the Infectious Diseases Society of America.O Dr. Felix Milgram, professor and chairman of microbiology, presented three seminars in Caracas , Venezuela recently. He was a visiting lecturer at Louisiana State University.O Front Row L toR: Drs. Joseph Kij, Sr., John Leone, Samu e l Costilone, Meyer Riwch un , M ilton Palmer. Back Row L to R: Drs. Richard Sounders, J. Frede rick Painton , Herbert Berwald, Lawrence Carlino. Dr. Lawrence Jacobs, clinical assistant professor of ophthalmology, clinical associate professor of neurology, and research assistant professor of physiology, was elected to the American eurological Association.D Dr. John F. Reilly, Jr., M'64, clinical instructor in medicine, has been elected president of the Western New York Society of Internal Medicine. Others elected were: Drs. Elton M. Rock, M'59, vice president, and Martin Mango, M'71 , secretary. Both are clinical assistant professors of medicine . Dr. Rajinder S. Sachar, clinical instructor in medicine, was elected treasurer.O Dr. Avirachan Tharapel , assistant professor of pediatrics, is the recipient of a $9,991 grant entitled: "Fragile-X chromosome study in families with X-linked mental retardation. " The grant is issued through the March of Dimes: Birth Defects Foundation and is from July 1982 through June 1983.0 Dr. Judith Hirsch, research assistant professor of physiology, has been awarded the Scholl Fellowship from the National Sudden Death Syndrome Foundation. She will join the Division of Pulmonar:, Disease to work with Drs. Gerd J.A. Cropp, professor of pediatrics/ assistant professor of physiology, and James A. Russell, assistant professor of pediatrics, on the study of heart oscillations in babies considered at risk of Sudden Infant Death.O Dr. Franz Glasauer, professor of neurosurgery, participated in a Soviet-American eurosciences study tour in Central Asia in May. During the visit he presented papers and visited hospitals and research institutes in several cities including the Burdenko Institute for Neurosurgery in Moscow. He was elected to the board of trustees of the Foundation for International Education in Neurological Surgery, Inc.O Five faculty members have co-authored three papers for scientific journals. They are : Drs. Margaret MacGillivray, Mary Voorhess, professors of pediatrics; Philip K. Li, assistant professor of pediatrics; Theodore I. Putnam, clinical assistant professor of pediatrics; and Erika Bruck, professor emeritus, pediatrics.D The 1927 Class at Spring Clinical Day 50 THE BUFFALO PHYSICIA �The 1932 Class at Spring Clinical Day First Row L toR: Drs. Angelo Leone, Leo Kopec, Arthur Cro me r, Jr., Myrtle Wilcox-Vincent. Second Row L to R: Drs. William Lewis, Carmela Patti, Marion Chimera, Roy Reed, Frank Leone, Joseph Smolev, Robert orthrup, Benjamin Obletz. Third Row L to R: Drs. Ha r vey Sloc um, Ra ym ond McCarth y, El mer Friedland, Arthur Strom , Ernest Homokay. Dr. Pearay L. Ogra , professor of pediatrics/ microbiology, presented a seminar at the Interasma Congress , Salsomagiore, Italy. He was a visiting professor of infectious diseases at Harbor-University of California at the Los Angeles Medical Center.O Dr. Ernst H. Beutner , professor of microbiology, presented three papers and a lecture for the Japanese Dermatological Association at the 16th International Congress of Dermatology in Tokyo . He also presented a seminar at the University of South Florida , Tampa.O Dr. Robin M. Bannerman, professor of medicine/ pediatrics , received a $175,000, twoyear grant from DHEW / MCJ for his Human Genetic Program.O Dr . Arnold I. Freeman, professor of pediatrics and head of the department at Roswell Park Memorial Institute, spoke at the 2nd International Meeting of Tumor Pharmacotherapy . His topic: "Childhood Leukemia CNS Prevention. " Dr. Freeman also authored an article for a scientific journal.O WI TER , 1982 Dr . Alejandro G. Paves , clinical instructor in gyn-ob, has moved from Warsaw , NY to Washington, DC . His new address is 1016 N. Scheuber Road #52 , Centralia , WA 98531.0 Dr. Duane T. Freier , professor of surgery, has been named chief of the department of surgery at Buffalo General Hospital. Since July 1980 he has served as chief of surgery at the Deaconess Division of Buffalo General and is director of the Medical School 's Renal Transplantation Program.O A 20-bed unit , designed to meet th e medical needs of persons no longer able to function normally because of drug abuse , is open at Erie County Medical Center. Dr. Nathaniel C. Webster is the director and psychiatric management is provided by Dr. Oscar Lopez, clinical assistant professor of ps ychiatry. Several members of the health care team will try to help patients 16 or older to break drug dependencies, clear up associated medical problems, solve their problems and find needed community service agency help.D Dr. Irwin Friedman, clinical associate professor of medicine , was selected to receive the Teacher of the Year Award by the medical residents at the annual graduation ceremonies at the Erie County Medical Center.D 51 �The 1937 Class at Spring Clinical Day Front Row L to R: Drs. Irving Weiner, Robert Lipse tt, Rose Lenaha n, Cha rles Banas, David Wein traub, John A m b rusko. Back Row L to R : Drs . Geo rge Koep f, S oli Goodman, Theod ore Fle mming, Charles Woeppel, Leon Roe, Jame s MacCa ll um , W illia m Ball , Samu el Dispe nz a, Richard Block , Willi am Whit e, Edw in Kriedeman n, Fran cis Eh re t, M. Luther Musselma n. Carolyn Haynie, a fourth year medical student, is the recipient of a $2,000 Rock Sleyster Memorial Scholarship. This is given to an outstanding third-year minority student who is interested in pursuing a career in psychiatry by the American Medical Association, Division of Educational Standards and Evaluation.D Dr. Djavad T. Arani has been appointed director of the angiology department at Buffalo General Hospital succeeding Dr. Ivan I. Bunnell, clinical professor of medicine, who was director for 14 years and is remaining with the department. Dr. Arani is a clinical associate professor of medicine at the Medical School.D Dr. Willard G. Fischer, M'36, has been reelected president of the Foundation of Deaconess Hospital, a division of Buffalo Ge neral Hospital. Elected to the board of directors for three-year terms were: Drs. Kenneth H. Eckhert, Jr., M'68, clinical assistant professor of surgery; Henry E. Black, clinical associate professor of medicine and clinical assistant professor of family medicine; and Harold C. Castilone, M'57, clinical assistant professor of gyn-ob.D 52 Three faculty members at Roswell Park Memorial Institute have received federal grants from the National Cancer Institute. The largest grant, $199,286, was awarded to Dr. Edward D. Holyoke of the surgical oncology department to study the pathophysiology of cancer metastasis. He is a research professor of surgery at the Medical School. Dr. Thomas L. Dao, research associate professor of surgery, has received a grant of $73,905 for a breast cancer study. Dr. Harold 0. Douglass, Jr., surgical oncology department at Roswell, is the recipient of a $31,683 grant for a study involving patients with gastric and pancreatic cancer. He is a research associate professor of surgery at the Medical School.D Three faculty members will attempt to identify factors which trigger post traumatic stress syndrome among Vietnam veterans. According to Dr. orman Solkoff, professor of psychiatry, the study will be conducted with Drs. Stuart Keill, clinical professor of psychiatry and Israel Alvarez, clinical assistant professor of medicine and nuclear medicine, at the Veterans Administration Medical Center. Approximately 100 Vietnam veterans will be interviewed.D TH E BUFFALO PHYSIC IAN �Dr. Ramesh Kohli, clinical instructor in medicine, is the medical director of the Hemodialysis Unit at the Deaconess Division of Buffalo General Hospital.D Dr. P.C. Lee, associate professor of pediatrics, has co-authored five papers for scientific journals with Drs. Brooks, Lebenthal, Kim, Carmody, Barrett, Ogra, and Riepenhoff-Talty. Dr. Lee also addressed the joint meeting of the American Institute of Nutrition and the American Society for Clinical utrition and the Canadian Society for Nutritional Sciences at Pennsylvania State University.O Dr. Elliott Middleton, professor of medicine/pediatrics, was a guest speaker at a symposium in Copenhagen on Cellular and Neurogenic Mechanisms in the Nose and Bronchi. He also spoke at the 2nd International Conference on Immunopharmacology in Washington, D.C.D Dr. Stanley J. Szefler, assistant professor of pedia tries/pharmacology/therapeutics, spoke at Fitzsimmons Army Hospital, in Denver and was a visiting professor at the University in London, Canada.D Four faculty members have received a $59,000 award from the Dr. Louis Sklarow Memorial Fund to study the influence of hormanes and other factors on glucose control and lipid metabolism in patients with insulin dependent diabetes mellitus. They are: Drs. Margaret Macgillivray and Mary Voorhess, professors of pediatrics; and Drs. Luis Mosovich and Philip K. Li, associate professors of pediatrics.D Dr. Erwin Neter, professor emeritus of pediatrics/microbiology, wrote a chapter entitled, "Microbiology of the Genitourinary System" for Medical Microbiology. He also co-authored a scientific article with Dr. Howard S. Faden, associate professor of pediatrics. In addition, Dr. Neter co-authored an article for the Journal of Pediatrics with Drs. T. Dennis Sullivan and Leonard J. LaScolea, both assistant professors of pediatrics. Dr. Neter spoke at the State University of California, Long Beach. His topic: "HostParasite Relationships: Recent Developments." He also presented two lectures in Heidelberg, West Germany recently. He was named man of the year, 1982 by the Buffalo Pediatric Society and elected chairman of the American Academy of Microbiology for 1982-83. He has also been appointed to the editorial board of a new publication, Diagnostic Immunology.D Front Row L to R: Drs. Oliver P. Jones, Edward Schwabe, Frances Gulliksen, Horace Battaglia , Harrison Karp. Back Raw L to R: Drs. William Staubitz, Richard Milazzo, Baris Marmolya , Albert Addesa, Vincent Parlante, Charles Baudo, Kent Brown, Leon Yochelson, Michael Jurca , Richard Ament, Vincent Cotroneo, Urban Throm. The 1942 Class at Spring Clinical Day WI TER, 1982 53 People �People Dr. Giuseppe A. Andres, professor of microbiology in pathology and medicine, participated in the 8th International Congress of Nephrology in Athens, and the International Meeting on Advances in Clinical Immunology of Liver and Kidney Diseases and Therapy in Erice, Italy. He addressed the annual meeting of the American Association of Pathologists, Minisymposia of the Federation of American Societies for Experimental Biology in New Orleans. In addition, he gave a lecture entitled "Basement Membranes in Disease" for the Gordon Research Conference at Proctor Academy in Andover, New Hampshire . Dr. Andres is associate editor of Diagnostic Immunology and is appointed to the Transplantation Immunology Committee of the National Institute of Allergy and Infectious Diseases.D Dr. Emanuel Lebenthal, professor of pediatrics, was a visiting professor in nutrition at the Albert Einstein College of Medicine recently. His topics: "Milk Protein Allergy - Fact or Fiction"; "Perinatal Malnutrition"; "Impact of GI Development on Infant Nutrition." He was also a visiting professor and lecturer at Brown University. His topic was "The Impact of the ontogeny of the gut on infant nutrition." In addition, he attended the 5th Annual Alden H. Blackman Memorial Lecture at Brown University and spoke on "Lactose Intolerance - A Developmental Approach." Dr. Lebenthal has co-authored several articles for professional journals.D Dr. Peter Nickerson, professor of pathology, has co-authored three scientific articles for professional journals. He is also chairman of the "freshman orientation committee at the Medical School.D Dr. James R. Humbert, professor of pediatrics, was invited to speak at St. Justine Hospital, Montreal on "Iron Deficiency and Infections," and "Neutrophil Dysfunction in Oncology Disorders in Children." He also spoke at the University of Geneva Medical School, Switzerland recently. He has also coauthored an article for the Journal of Pediatrics. The title: "Newborn Screening for Hemoglobinopathies in New York State: Experience of Physicians and Parents of Affected Children."D Dr . Adrian Vladutiu has been promoted to professor of microbiology. He has authored and co-authored five scientific articles in professional journals recently. In addition, Dr. Vladutiu has received a $7,000 GRS grant.D First Row L toR: Drs. Robe rt Dean, Victor Welch, Daniel Riordan. William Bukowski , William Edgecomb, William Rob ert Ja ege~ Second Row L to R: Drs. Harold Peskovitz, Hans Kipping, Edward Breakell, Arthur Schaefe r, Daniel Curtin, Frederick Whiting, Anthony Merlino, Carl Nicosia. Third Row L to R: Drs. John Waite, Elbert Hubbard, Richard Kenline , Jam es Stagg, Edwin Lenahan, John Sheffer. Fourth Row L to R: Drs. C. Newer, James Phillips, Anthony Prezyna, Jerom e Tokars. Bake~ The 1947 Class at Spring Clinical Day 54 THE BUFFALO PHYSICIA �The 1952 Class at Spring Clinical Day Front Row L toR: Drs. Ralph Obler, Silvon Simpson, Roy Thurn, Eugen e Loeser, Burton Stu/berg, Oli ver Ste iner, John Ranchoff. Bock Row L to R: Drs. James Zeller, Milton Lapp, Robert Baumle r, Alfred Laza rus, Robert Wilson, Neal Fuhr, Jefferson Underwood, A lvin Brown, Albert Cartner, Joseph Gene wich, Me lvin Oys te r, Victor Pana ro. Or. Fred Rosen, former associate institute director for scientific affairs at Roswell Park Memorial Institute, received the sixth annual Dr. William H. Wehr Award, in August, in recognition of his distinguished career in cancer research at the Institute. Dr. Rosen joined the Institute staff in 1956 as associate cancer research scientist in the Experimental Therapeutics Department; and in 1979, he served as associate institute director for scientific affairs until his retirement in 1981. In addition, Or. Rosen served as research professor of biochemistry and adjunct professor of pharmacology at the Roswell Park Graduate Division at U/ B; and research professor of biology at Niagara University and Canisius College. Dr. Rosen is a member of many national scientific organizations including the American Association for Advancement of Science, the Endocrine Society, and the American Chemical Society. He has authored or collaborated on ov er 100 scientific publications. The Award is named after Or. William H. Wehr, who devoted his entire 37-year medical career to Roswell Park. He was one of the first ca nce r researchers in the nation to use radium in cancer treatment, and was instrumental in the growth and development of the Institute into a world leader in the fields of cancer research, treatment and education. Dr. Wehr died in 1980.0 WI TER, 1982 Elliot F. Ellis, professor and chairman of pediatrics , lectured at the University of California, Irving and Memorial Hospital Medical Center; Washington State Allergy Society, Tacoma; and the 30th annual Scientific Assembly of the West Virginia Chapter, American Academy of Family Physicians. His topics: "Allergy and Asthma Update "; "Theophylline Madness." He gave three lectures in Las Hadas, Mexico at the 6th annual Postgraduate Course in Pediatrics and also participated in several workshops on Food Allergies, Allergic Disease and Diagnostic Techniques in Clinical Allergy. In addition, Dr. Ellis spoke at the Baystate Medical Center Monthly Pediatric Teaching Seminar on "Immunotherapy in Allergic Diseases." He also addressed the Florida Allergy Society and the American Academy of Pediatrics (Chapter I, District II) in Syracuse.O Dr. Andrea Jacobson has been appointed assistant professor of psychiatry, in charge of famil y studies. Dr. Jacobson received her M.D. from the University of California, Irvine in 1976 and her Ph.D. in psychology from Johns Hopkins University in Baltimore in 1972. Her psychiatric residency was at the University of Wisconsin. Prior to coming to Buffalo, she was a member of the South Bay Medical Psychiatric Group in California and taught in the Stanford psychiatry department.O 55 �The 1957 Class at Spring Clinical Day First Row L to R: Drs. Jam es Collins , Germonte Bon caldo, John Bongiovanni , Robe rt Sussman , Phili p Brune ll , Myron Go rsens tei n, Benn y Ce lnik e r. Second Row L to R: Drs. Josep h Kij , Jr ., John Parker, Paul A rchambeau , Robe rt Ca rpe nt e r, Charl es O'Con nor, She rm an Wa ld m an , John Cusick, Sol Messinge r, Harold Castiglion e. Thi rd Row L to R : Drs. Hilliard Jas on , Gregory Thors e ll, Be rnard Wak efie ld, Edwa rd Weise nh ei m e r, Bronson Bergho rn , Je rom e Kassire r, Ronald Toffo lo. Dr. Norman Solkoff, profes&or of psychiatry, participated in the International Conference on the Holocaust and Genocide in Tel Aviv. His topic: "Critical Review of the Literature: Survivors and Children of Survivors of the Holocaust. "0 Dr. Brian Joseph, associate professor of psychiatry, consulted and taught recently at the Ashkelon Regional Mental Health Clinic in Israel. He also consulted with the Israeli Defense Forces' (department of psychiatry) regarding traumatic neurosis based on his experience as a flight surgeon in Vietnam.D Dr . Steven Gutman, assistant professor of pathology, talked to the Western New York Division, American Association of Clinical Chemists in Ithaca. His topic: "Colorometric Determination of Glycosylated Hemoglobin in Diabetic Patients."D Dr. Margaret H. McAloon is a clinical associate professor of medicine at the Ambulatory Care Center, Buffalo General Hospital. She is a 1971 graduate of the Medical College of Pennsylvanian U/B has formed a library consortium of health institutions in Buffalo that embraces the eight teaching hospitals - Buffalo General/Deaconess, Children's, Mercy, Erie County Medical Center , Millard Fillmore , Research Institute on Alcoholism, Sisters of 56 Charity and the VA Medical Center. The consortium will encourage the libraries to formalize their cooperative efforts to strengthen and share collective resources and services; to provide more effective library and information services to meet the educational and health care needs of these institutions.D A U/ B professor who is internationally known for his pioneering research in biopharmaceutics and pharmacokinetics has received the 1982 Volwiler Research Achievement Award from the American Association of Colleges of Pharmacy. Dr. Gerhard Levy, 53 , distinguished professor of pharmaceutics and the director of the Clinical Pharmacokinetics Research Center at U/B, was selected to receive the award because of his innovative research , which has significantly altered the direction of pharmaceutical education. The award, established to honor Ernest H . Volwiler, retired president and research director of Abbott Laboratories , is presented to pharmacy faculty members who differentiate themselves via their research.D Dr. Robin M. Bannerman, professor of medicine/pediatrics, was a guest lecturer at the VA Medical Center, St. Louis recently. His topic: "Background to Agent Orange: Some Previous Environmental Cases including Seveso and Love Canal."D THE BUFFALO PHYSICIAN �Dr. Martin B. Wingate, assistant dean for continuing education, and professor of ob/ gyn, was recently honored for having attained the highest level of achievement in both practice of medicine and the management of health care organizations. Dr. Wingate is among the first physicians in the country to be awarded membership in the American College of Physician Executives and be recognized for excellence in medical management. Physician executives add a new resource to health care organizations. Having demonstrated excellence in all aspects of patient care, the physician executive adds to these clinical skills the management training and experience necessary to more efficiently organize the highest quality health care services in a time of ever increasing costs and technology.O Dr. Nicholas Varallo of Lockport has been appointed to the Lockport Memorial Hospital Medical Staff with privileges in famil y medicine. Dr. Varallo completed a Fifth Pathway Program at U/B and is a graduate of the Autonoma University of Medicine in Guadalajara , Mexico. He served as a pediatric resident at Buffalo Children's Hospital and was chief resident in family practice at iagara Falls Memorial Medical Center prior to his appointment.D Dr. Marvin Herz, professor and chairman of psychiatry, received a Distinguished Alumnus Award from the University of Chicago Medical School. He is the principal investigator for a NIMH $52 ,140 Graduate Training Grant, "Medical Student Education, Psychiatry." Recently he also gave grand rounds presentations at the New York Hospital-Cornell Medical Center , Westchester Division, White Plains, the University of Rochester, N.Y. , and Gowanda Psychiatric Center. Dr. Herz also participated on a panel at the Society for Psychotherapy Research in Vermont; conducted a workshop at the Massachusetts Mental Health Center, Boston; presented papers at the annual meeting of the American Psychiatric Associ ation in Toronto; and at a symposium on "Contemporary Issues in Partial Hospitalization at St. Vincent's Hospital and Medical Center, New York City; and at Wadsworth VA Medical Center, Brentwood Division, Los Angeles. He was also faculty course coordinator " Prevention of Relapse in Schizophrenia," in Toronto at the American Psychiatric Association meeting.O Dr. Robert J. Grantham, assistant professor of psychiatry, is president-elect (1982-83) of the Rotary Club of Kenmore.O First Row L to R: Drs. An th ony Floccare, George Tze tzo, David Carlson, Anth ony Markello, Sebastian Fasanello, Gerald Patterson, Pau l Loree. Second Raw L toR: Drs. Gail Gurtner, Arthu r Kl ein, Ja mes Bum bolo, Mor ton Klein, Ph ilip Morey, Michael Madden, Joseph Gerbasi, Joseph Armenia, Robert Ney. Third Row L to R: Drs. Charles Adams, Gordon Lang, James Graber, Philip Weisinger, Robert Klocke, Owen Bossman. The 1962 Class at Spring Clinical Day WINTER, 1982 57 People �People Drs. John W. Cudmore, M'62 and RogerS. Dayer, M'60, have assumed responsibility for the medical and administrative supervision of the emergency clinic at Buffalo General Hospital. Both are clinical associate professors of surgery. Dr. Dayer was also elected secretary of the hospital's medical staff.D Five faculty members are new officers of the Western New York Society of Internal Medicine. Dr. John F. Reilly, Jr., M'64, clinical instructor in medicine, is the new president. Other officers: Drs. Elton M. Rock, M'59, clinical assistant professor of medicine, vice president; Mantin Mango, M'71, clinical assistant professor of medicine, secretary; Rajinder S. Sachar, clinical instructor in medicine, treasurer; Robert Scheig, professor of medicine, and Carl J. Sheusi both delegates to the New York State Society of Internal Medicine.D Five pharmacology and therapeutics faculty members have authored or co-authored scientific articles for professional journals. They are: Drs. Robert J. Mcisaac and Cedric M. Smith, professors; Jerome A. Roth, associate professor; and Paul J. Kostyniak and James R. Olson, assistant professors.D Dr. Ganesh N. Deshpande, assistant professor of pedia tries, spoke at the Cryobiology Association meeting in Houston on "Functional Evaluation of Human Polymorphonuclear Leukocytes (PMN); and Cryopreserved in a Dextran Glycerol Buffer (DGB).D Dr. Frank J. Cerny, research assistant professor of pediatrics/microbiology, spoke on "Exercise Breathing Pattern in Black and White Children and Young Adults" in Minneapolis at the American College of Sports Medicine Conference; and in Boston at the Fifth International Symposium on the Biochemistry of Exercise. His topic: "Exercise-Induced Loss of Muscle Enzymes." He also co-authored an article, "Characteristics of Adjustment of Lung Diffusing Capacity to Work" for the Journal of Applied Physiology.D Dr. Marie Riepenhoff-Talty of Hamburg has been named director of the virology laboratory at Children's Hospital. Formerly assistant director of the laboratory, Dr. Riepenhoff-Talty received a doctoral degree in microbiology, specializing in virology, from U/B.D F'ront Row L to R: Drs. Jam es Giambrone, Thomas Angustine, Jr., Jahn Kelly, Robert Brawn , Laird Quenzler, Richard Daffner. Back Row L to R: Drs. Ronald Levy, Thomas O'Connor, Jonathan Ehrlich, Donald Miller, Paul Goldfarb, Thomas Sheehan, Arthur Sosis, John Gibbs. The 1967 Class at Spring Clinical Day 58 THE BUFFALO PHYSICIAN �The 1972 Class at Spring Clinical Day First Row L to R: Drs. Karen Price, Lind a Kam , Robe rt Kraopnik, Denn is Grass. Joseph Oliver, George Lu ndgre n. Secon d Row L to R: Drs. Ion Frankfort, A lan Ast, Stuart Ru bin, Robert Einhorn, Steph en Levine. Thi rd Row L to R: Drs. Richard Sa vage, Robert Cooper, John Kraus, Philip M oudy, Richa rd Dolina r. Dean John Naughton is the new president of the Western New York Chapter of the American Heart Association. Dr. Arthur Orlick is first vice-president, and Dr. Glen E. Gresham, professor and chairman of rehabilitation medicine, is second vicepresident.D Dr. Melinda S. Kwong, assistant professor of pediatrics , spoke on "Microvascular Permeability in Asphyxia" at the MidAtlantic Conference on Perinatal Research in Hershey, PA recently.D Two assistant professors of pediatrics, Drs. Leonard J. LaScolea and T. Dennis Sullivan, co-authored a scientific article with Dr. Erwin Neter, professor emeritus, for Pediatrics. The title: "Relationship between the Magniture of Bacteremia in Children and the Clinical Disease ." Dr. LaScolea also co-authored another article for the Journal of Clinical Microbiology.D Dr. Frank Schimpfhauser, associate professor of social and preventive medicine and assistant dean for development/ evaluation, has been elected to the board of directors, Mental Health Association of Erie County.O WI TER, 1982 Dr . Helen M. Caldicott, president of Physicians for Social Responsibility, has been named 1982 Humanist of the Year by the Amherst-based American Humanist Association. Dr. Caldicott, a pediatrician who works full time for nuclear arms control, received the award on June 19 during the association's annual conference at the Massachusetts Institute of Technology in Cambridge, MA. She was the 1981 Medical School commencement speaker.D Dr. Gerald Sufrin, professor and chairman of urology, has been elected to membership in the Endocrine Society, a leading organization in endocrinologic research.D Four faculty members at Children's Hospital have been promoted, according to Dr. Elliot Ellis, professor and chairman of pediatrics. They are: Drs. Edmund A. Egan, II, to professor of pediatrics, chief, division of neoantology; Norman S. Ellerstein, to associate professor of pediatrics, director of p edi a tric housestaff program; Robert C. Welliver, to associate professor of pediatrics, division of infectious disease; Robert L. Gingell, to clinical associate professor of pediatrics, division of cardiology.D 59 �People Drs. A.O. Vladutiu, professor of pathology and research associate professor of medicine, and L.S. Baitman co-authored a scientific article published in the American Journal of Clinical Pathology entitled, "M-components at the Application Point in Serum Protein Electropheresis.D More than 200 scientists and physicians from Europe, Asia, Africa, South America, the U.S. and Canada attended the seventh international conference on Defined Immunofluorescence, Immunoenzyme Studies and Related Labeling Techniques at the Niagara Falls Hilton and the International Convention Center in June. The conference is organized by U/B's departments of microbiology and periodontics and the International Service for Immunodermatology Laboratories. A dozen invited speakers from as many nations d.iscussed the latest in indirect and direct immunofluorescence, immunoelectromicroscopy and immunoenzyme testing- methods developed within the past twenty years to aid in diagnosing scores of illnesses, including the autoimmune disease.D Steve Kaminsky Steven G. Kaminsky, Senior Graduate Student in the Department of Pathology, won two awards at the National Student Research Forum held in April1982 at the University of Texas Medical Branch in Galveston, Texas. Steven was first place winner of the James W. McLaughlin Award in Infectious Diseases and Immunology and second place winner of the Mead Johnson Award (Graduate Student Category). The James W. McLaughlin Award was established at the University of Texas Medical Branch and recognizes the best paper in the fields of infectious diseases and immunology. The Mead Johnson Award is given for overall excellence in research. The paper was entitled "Genetic Defect of atural Killer Activity in SJL Mice: Role of the Thymus." The results of the study clearly demonstrate that there is a marked effect by the thymus in the regulation of the Natural Killer (NK) cell population in SJL mice and that this effect may indicate a new role for the thymus in immune regulation. The major professor and faculty sponsor was the late Dr. Gustavo Cudkowicz, Professor of Pathology and Microbiology.D 60 Dr. Gerald P. Murphy, research professor of urology and director of the National Prostatic Cancer Project with headquarters at Roswell Park Memorial Institute, has received confirmation of the American Cancer Society's approval and support for a Phase II efficacy study on interferon treatment for prostate cancer patients, beginning this summer at three centers in the United States. The limited study on 25 selected patients will be conducted at Roswell Park Memorial Institute under the direction of Dr. J. Edson Pontes, associate professor of urology and chief of urologic oncology; the University of Iowa Hospitals and Clinics, under the direction of Dr. Stefan A. Loening, associate professor of urology; and the University of California Medical Center, San Diego, under the direction of Dr. Joseph D. Schmidt, head, division of urology. The studies will be coordinated through the National Prostatic Cancer Project ( PCP) headquarters staff. Dr. Murphy indicated that previous Phase I studies at Roswell Park Memorial Institute have provided the basis for this multiinstitutional study, which will be one of the first such multicenter undertakings against this important cancer.D Ten new faculty members have been appointed to Children's Hospital according to Dr. Elliot Ellis, professor and chairman of pediatrics. They are: Drs. Robert E. Cooke, A. Conger Goodyear professor of pediatrics, director of Rehabilitation Center; Charles E. Francemone, M'79, assistant professor of pediatrics, division of Ambulatory Pediatrics; Irene . Sills, assistant professor of pediatrics, division of endocrinology, director of Metabolic Disease Program; Ping-Cheung Lee, associate professor of pediatrics, division of gastroenterology/nutrition; Andrew M. Missett, assistant professor of pediatrics, division of Ambulatory Pediatrics; David T. Wong, assistant professor of pediatrics, division of infectious disease; Irene N. Burns, M'78, clinical instructor of pediatrics; Linda A. Cardone, M'79, clinical instructor of pediatrics; Kathleen N. Conboy, R.N., PNA, clinical instructor of pediatrics, division of allergy/clinical immunology; Madelaine D. Murad, clinical instructor of pediatrics.D THE BUFFALO PHYSICIAN �People Dr. Om P. Bahl, professor and chairman of the department of Biological Sciences, received the Medical and Life Science Award of the National Council of Asian Indian Organizations in North America at its recent convention in Chicago. Dr. Bahl was honored for his work with a hormone he is using for detection of pregnancy and the diagnosis and management of some types of malignant tumors.D Two pediatrics faculty members, Drs. Stanley J. Szefler and Elliot F. Ellis, coauthored an article for the Journal of Allergy in Clinical Immunology. The title: "Steroidspecific and Anticonvulsant Interaction Aspects of Troleandomyucin in Steroid Therapy."D Dr. Ichiro Nakamura, assistant professor of pathology, is working on a project, "Lytic and Nonlytic Functions of Cytotoxis T Lymphocytes." It is funded by the Medical School Research Development Account.D Dr. John Gaeta, professor of pathology and associate professor of urology, presented "Clinical Correlations of Prostate Cancer Pathology" at the American Urological Association seminar on Prostate Cancer Management in Washington, D.C.D Dr. Sateesh Satchidanand, assistant professor of pathology, was a guest lecturer at Buffalo General Hospital Nursing School. His topic: "The Polyp Cancer Sequence."D Two faculty members received grants from the Arthritis Foundation of Western New York. Dr. Patrick B. Costello, assistant professor of medicine, received an $8,000 grant for a study of aspirin hydrolysis in human body fluids. Dr. Floyd Green, professor of medicine/microbiology, received $3,200 for the purchase of a computer.D The lOth anniversary of the Buffalo General Hospital Community Mental Health Center was celebrated in June. Dr. June Jackson Christmas, director of the behavioral sciences program at the School of Biomedical Education at the City College of New York, Was the featured speaker.D WINTER, 1982 The Classes of the 1920s Dr. Dante Morgana, M'21, an ophthamologist who has practiced in Lockport for 59 years, received the Canisius College President's Medal during the college's 116th commencement ceremony in May. Although Dr. Morgana is now semi-retired, he remains a member of the honorary staff at Lockport Memorial Hospital and does consulting and office work at his office in the Bewley Building, Lockport.D Dr. Marvin A. Block, M'25, professor of medicine (emeritus), received a special achievement award at the third annual conference of the New York Federation of Alcoholism Counselors held recently at Niagara University. Dr. Block was a pioneer in the fight against alcoholism and is recognized worldwide as an authority on the disease.D Dr. Joseph J. Pisa, M'26, retired in January, 1981. He lives at 664 Seventh St., Buffalo, N.Y. 14213. He continues to be active in several local professional organizations.D Dr. Bruno Schutkeker, M'28, received the Hyman L. Levin Award for "dedication to furtherance of mental health in the community" from the Mental Health Association of Erie County.D The Classes of the 1930s Dr. Thomas S. Bumbalo, M'31, professor emeritus, was re-elected president of the Board of Directors of Buffalo Hospice, Inc.D Dr. Benjamin E. Obletz, M'32, Emeritus professor of Orthopaedics, was honored by the Department of Orthopaedic Surgery for his 75th birthday and 50th anniversary graduation from the Medical School. He was also awarded a University Chair with the following inscription: "In grateful recognition of many years of dedicated service as a skilled clinician and outstanding educator."D Dr. John M. Constantine, M'34, has retired. He is living at 309 Grove St., Oneonta, N.Y. 13820.0 Dr. Carl L. Streicher, M'35, retired last year from his ophthalmology practice. He spends his time boating, playing golf, tennis, fishing and traveling. He lives at Lake Havasu City, Arizona 86403.0 61 �Dr. Willard G. Fischer, M'36, has been reelected president of the Foundation of the Deaconess Hospital, a division of Buffalo General.D Dr. Bernard S. Stell, M'36, presented a special program - "Beyond the Stereo Camera" at the PSA International Convention in New Orleans in August. He showed how to use one or two SLR cameras to make 3-D portraits, nature close-ups and stereomacrography shots. Part I described the use of non-stereo equipment for making those type of stereo views, Part II illustrating (with 2-D slides) the relationship between cameras and accessories, and Part III showed stereograms of the results of the described techniques. In the process a new term "Natural Vision Focus" was compared to "Selective Focus." The fact that Dr. Stell has 4 stars in pictorial and nature and 3 in stereo attests to his expertise in these subjects, and to the fact that both 3-D and 2-D photographers were abb to learn much from his presentation in New Orleans. Dr. Stell lives at 16029 Meadow Park Drive, Sun City, Arizona 85351.0 The Classes of the 1940s Dr. Burton L. Olmsted, M'41, was recently elected President of the New England Society of Plastic and Reconstructive Surgeons at the annual meeting in Laconia, New Hampshire. He is now living at 8 Rock Wall Lane, Cape Elizabeth, Maine 04107.0 Dr. Pasquale A. Greco, M'41, clinical associate professor of urology, has been reelected chairman of the board of directors of Blue Shield of Western New York.D After 15 years of active Pathology Practice in Lancaster, CA, Dr. Thomas R. Humphrey, M'43, is semi-retired. He is presently serving as a pathologist for a small rural district hospital in Lake Isabella, which is located in the foothills of the Sierra Madre Mountains near Bakersfield, CA and Sequoia National Park. Dr. Humphrey is a Diplomate, American Board of Pathology and lives at Rt. #1, Box 393-A, Lake Isabella, CA 93240.0 62 Dr. Thomas F. Frawley, M'44, gave the annual John H. Talbott Lecture in March at Roswell Park Memorial Institute. His topic: "Diabetes, ew Perspectives on an Old Disease." Dr. Frawley is president of the American College of Physicians. He is Emeritus Professor of Medicine at St. Louis University. After graduating from U/B Dr. Frawley took his residency in internal medicine at the Buffalo General Hospital. Following two years of Army service, Dr. Frawley returned as a Research Fellow in Medicine at the Buffalo General Hospital from 1947 through 1949 and then pursued further clinical and research training at the Peter Bent Brigham Hospital. He then moved to Albany Medical College as head of the Division of Endocrinology and Metabolism and in 1959 was made Professor at that institution. In 1963, Dr. Frawley became Chairman of the Department of Internal Medicine at St. Louis University School of Medicine. In 1974, he left the post of Chairman but stayed with the University to head the Section of Endocrinology. During his distinguished teaching career, Dr. Frawley has won the Outstanding Teacher Award at both Albany and St. Louis. His research in the field of diabetes and hypoglycemia have been widely recognized, and he is a member of many prestigious societies including the Association of American Physicians.D Dr. Casimir F. Pietraszek, M'44, clinical professor of medicine, was elected to a threeyear term by Blue Cross of Western New York as a corporation member representing the Erie County Medical Center.D Dr. Herbert E. Joyce, M'45, acting director and clinical assistant professor of family medicine, is the project director for a $235,473 continuation grant from the Department of Health and Human Services. It is for the departments of family medicine at the Deaconess Division of Buffalo General Hospital and will run through August, 1983.0 Dr. John K. Quinlivan, M'45, clinical instructor in surgery, has been elected a member of the American Society for Aesthetic Plastic Surgery.D THE BUFFALO PHYSICIAN �Dr. Eugene M. Marks, M'46, has been director of medicine and environmental health at the Remington Arms Co., Inc., Bridgeport, CT since 1968. He started his industrial-medical professional career in 1952 in Niagara Falls. He was honored in April when he was elected director of the American Occupational Medical Association's 67th annual conference in Toronto. After his internship and residency at the E.J. Meyer Memorial Hospital, he served in the United States Army Medical Corps in Korea and Japan (1948-51). Dr. Marks is a Fellow of the American College of Preventive Medicine and the American Academy of Occupational Medicine. He lives at 22 Grand Place, Newtown, CT 06470.0 Dr. Louis Hertz, M'47, is in family practice and his new address is P.O. Box 130, Loomis, CA 95650.0 Dr. Paul C. Weinberg, M'48, is in the Departments of Family Medicine and Psychiatry at the University of Texas Health Science Center at San Antonio. The professor has written several book chapters dealing with human sexuality. Dr. Weinberg resides at 8007 Oak Star, San Antonio, TX 78229.0 The Classes of the 1950s The 1981 Blue Shield Tribute is dedicated to Dr. George E. Taylor, M'50 , of Cuba, N.Y. He is the immediate past president of the 8th District Branch Medical Society and a past president of the Medical Society of the County of Allegany.D Dr. Ronald F. Garvey, M'53, has been elected the first president of the Parkland Surgical Society. Dr. Garvey is a clinical professor of surgery at Southwestern Medical School and serves as chief of surgery at St. Paul Hospital in Dallas, Texas, where he is in private practice.D Dr. Edward W. Hohensee, M'54, clinical associate professor of ophthalmology, has been appointed to a five-year term on the medical advisory board of the New York State Commission for the Blind and Visually Handicapped.D WI TER, 1982 Drs. Shram, Pe te rson Dr. S. Paul Shrum, M'54, and John Peterson, M'55, are working here at Armed Forces Hospital , Dhahran, Saudi Arabia. Dr. Shrum is in Emergency Medicine. Dr. Peterson is chief of the department of obstetrics/gynecology. The photo shows a moment of relaxation at a local art display. Both are serving under contract to the government of Saudi Arabia to provide medical services to Royal Saudi Air Force personnel and their dependents. The hospital is a newly established American managed 150-bed general hospital. It is part of the newly developing system of health care being developed in Saudi Arabia.D Dr . James R. Nunn, M'55, clinical professor of family medicine, has been reelected to the board of directors of Blue Shield of Western New York.D Dr. David Benjamin Asher, M'56, is a clinical associate professor of Nephrology at the University of Arizona School of Medicine. He is past president of the Arizona State American Medical Association and a Fellow, American College of Physicians. Dr. Asher 63 �was recently elected president of the Arizona State Board of Medical Examiners and is currently on the National Board of Trustees of the United Synagogues of America. He resides at 5635 E. 7th Street, Tuscan, AZ 85711.0 Dr. Marvin . . Eisenberg, M'57, is President of the Medical Society, County of Orange. The radiologist resides at 36 Randall Heights, Middletown, NY 10940.0 Dr. Sol Messinger, M'57, is the new president of the Western New York Society of Pathologists. He is a clinical assistant professor of pathology at the Medical School.D Dr. Williams Dr. James S. Williams, M'58, is the new chairman of the surgery department at the Millard Fillmore Hospital. He comes from Rochester, N.Y. area where he served as chief of surgery at the Joseph C. Wilson Health Center, attending surgeon at Strong Memorial Medical Center and Rochester General Hospital and surgical consultant at the Willard Psychiatric Center.O Dr. Julius V. Rasinski, Jr., M'59, is in his 17th year as team physician for the California Angels baseball team. He was appointed to the President's Council for Physical Fitness. He lives at 1500 Katella St., Orange, CA 92667.0 The Classes of the 1960s Dr. Theodore Bistany, M'60, of the Buffalo Yacht Club won the PERF A Class race for the biggest boats at the Niagara Frontier Invitational Regatta. Most of the PERF A boats are 30-feet or longer. On the second day of racing Dr. Bistany took second in his Tartan 41. He is a clinical assistant professor of medicine.D Dr. Andre Lascari, M'60, has been appointed chairman and professor of the department of pediatrics at the Medical College of Pennsylvania (formerly Women's Medical College) in Philadelphia. His new home address is 213 Gypsy Road, Gulph Mills, PA.D 64 Dr. John I. Lauria, M'60, assistant professor and chairman of anesthesiology, has been appointed to a five-year term on the State Board for Medicine by the New York State Board of Regents.O Dr. Michael Cohen, M'61, associate professor of pediatrics and neurology, was recently elected to the American Neurological Association.D Dr. Howard M. Hochberg, M'61, is vice president, Monitoring Product Divisions at Squibb Medical Systems, Inc. His address is Squibb Medical Systems Group, 13208 Northrup Way, Bellevue, WA 98005.0 Dr. Roberta M. Gilbert, M'62, gave two presentations at the National Conference on Breast Cancer in New Orleans last spring. They dealt with the Psychosocial Aspects of Breast Cancer Treatment and Follow-up. Dr. Gilbert's office is at 8901 W. 74th Street, Shawnee Mission, KS 66204.0 Dr. Arthur C. Klein, M'62, is on the faculty of the University of Southern California. He is a anesthesiologist, and is active in many local and regional professional societies. His address is 1938 N. Hobart Blvd., Los Angeles, CA 90027.0 Dr. Elizabeth G. Serrage, M'64, of Cape Elizabeth, Maine, is president-elect of the Maine Society of Eye Physicians and Surgeons. Her private practice is in Portland.O Dr. Lillian Vitanza Ney, M'64, of Jamestown, N.Y. has been elected to Fellowship in the American College of Cardiology. Dr. Ney is a graduate of Wells College, Aurora, .Y. She is currently director of cardiology at Woman's Christian Association Hospital in Jamestown, NY.O Dr. Gary H. Jeffery, M'65, is presidentelect and treasurer of the Buffalo Ophthalmological Society.O Dr. H. Elliott Larson, M'65, is on the scientific staff of the U.K. Medical Research Council, London, England. He was named a Fellow, THE BUFFALO PHYSICIA �Royal College of Physicians in 1981. He has been active in infectious disease research and has co-authored several scientific papers. In The Lancet - "Impairment of Human Polymorphonuclear Leucocyte Function by Influenza Virus" (1976); Pseudomembranous Colitis: Presence of Clostridial Toxin" (1977); "Clostridi urn Difficile and the Etiology of Pseudomembranous Colitis" (1978) . In the British Medical Journal- "Undescribed Toxin in Pseudomembranous Coli tis" (1977); British Journal of EXP, Pathology- "Influenza Viruses and Staphylococci in Vitro: Some Interactions with Polymorphonuclear Leucocytes & Epithelial Cells" (1977); Br. F. Dis. Chest - "Impaired Polymorphonuclear Leucocyte Chemotaxis After Influenza Virus Infection" (1980) ; Journal of Medical Virology - "Isolation of Rhinoviruses & Coronaviruses from 38 Colds in Adults" (1980); Journal of Infectious Diseases - "Epidemiology of Experimental Enterocecitis Due to Clostridium Difficile" (1980) . Dr. Larson lives at 52 Cleveland Road, London, W. 13 Ave., England.D Dr. Douglas Klatch, M'71, has been named director of the department of otolaryngology at the Erie County Medical Center. He has been assistant director of otolaryngology since July 1980. The assistant professor of otolaryngology, completed graduate training in surgery at Long Island's North Shore Hospital and the E.J. Meyer Memorial Hospital followed by a head and neck oncology fellowship at U/ B and a maxillofacial trauma fellowship in Basel, Switzerland. He served in the U.S. Army.D Dr. Robert M. Barone, M'66, is an associate clinical professor of surgery at the University of California at San Diego. In February, the FDA approved the Infusoid Implantable Pump. In May, he left the San Diego Tumor Institute to start a new practice of Oncology in San Diego with two surgical oncologists and a medical oncologist. Dr. Barone lives at 7813 Via Capri, LaJolla, CA 92037.0 Dr. Steven J. Morris, M'73, will be elected to Fellowship in the American College of Physicians in April, 1983 during the Convocation ceremony at the College's Annual Session in San Francisco. Dr. Morris is a specialist in gastroenterology and is on the staff of the Crawford W. Long Hospital, Piedmont Hospital. He has been a resident of Atlanta for three years.D Dr. John E. Spoor, M'66, was elected Chairman, New York State Emergency Medical Services Council for 1982. He was also elected Chairman of Emergency Medicine of the Medical Society of New York State for 198283. He resides at RD #1, Box 157, Laurens, NY 13796.0 Dr. Michael A. Sansone, M'73 has been elected secretary of the Buffalo Ophthalmological Society.D Dr. Robert A. Milch, M'68, clinical instructor in surgery, was re-elected vice president of Buffalo Hospice, Inc. He was also reelected president of the National Association of Hospice Physicians.D Dr. Wilbur L. Smith, M'69, was promoted to professor of radiology and pediatrics in July at the University of Iowa. He is living at 2271 Coe Drive, Iowa City, IA.D WI TER, 1982 The Classes of the 1970s Dr. Thomas V. Krulisky, M'70, is an assistant clinical professor at the University of Southern California. He has recently been appointed the Medical Director of Edgemont Hospital in Los Angeles. Dr. Krulisky resides at 250 Oakhurst Lane , Arcadia, CA 91506.0 Dr. Irene A. Burns, M'74, is in private practice of pediatrics and adolescent medicine in Batavia. She is affiliated with Genesee Memorial Hospital and St. Jerome's Hospital in Batavia, and Children's Hospital of Buffalo. She lives at 222 West Main Street, Batavia, NY.D Dr. Norbert Szymula, M'74, clinical associate professor of otolaryngology , presented a paper - "Human Mycotic Infections" at the 42nd annual meeting of the American Academy of Otolaryngologic Allergy in New Orleans in October.D 65 I D r. Klatch �Dr. Stephen W. Sadow, M'75, is a Diplomate, American Board of Surgery. He completed a Fellowship in peripheral vascular surgery at Beth Israel Hospital, ewark, .J. r~cently. He lives at 78 Locust Avenue, Millburn, NY 07041.0 Dr. Michael Robert Bye, M'76, is an assistant professor in pediatrics at Temple University. His address is 135 Cynwyd Road, Bala Cynwyd, PA 19004.0 Dr. Walwin D. Metzger, M'76, an internist, has moved to Florida from Ohio. He is living at 7909 Apt. C, Landmark South, Tampa, FL 33615.0 Golden Buffalo Award Drs. Alan I. Leibowitz, (SUNY at Buffalo 1970) and John F. Breen (Georgetown 1969) both former faculty members and house officers at the State University of New York at Buffalo presented the Golden Buffalo Award to a graduating student at the University of South Florida College of Medicine (Tampa). Dan Riggs (Class of 1981). Karen L. Mahakian (Class of 1982). Drs. Leibowitz and Breen are currently faculty members at the University of South Florida College of Medicine and created the award to honor their teachers during their "Golden" years at Buffalo. The award is made for competency, humanity and humility in medicine. It will be presented yearly to a deserving graduate who is nominated by his or her class, then selected by Drs. Leibowitz and Breen. The award hangs in the Health Sciences Library at USF. A cash award is also given. Other Buffalo alumnae are encouraged to create such an award at their current institution and contact Dr. Leibowitz in Tampa.D Drs. Leibowitz, Riggs, Breen. 66 THE BUFFALO PHYSICIA �Dr. Joseph Misiti, M'76, clinical assistant instructor in surgery, has been appointed to the associate staff of Lockport Memorial Hospital with privileges in vascular and general surgery. He has been a trauma Fellow at the Erie County Medical Center, where he also took his internship and residency. Dr. Misiti lives at 231 Transit Road, Lockport, NY.D Dr. Kevin Greenidge , M'77, was invited to give a paper and course at the 1982 American Academy of Ophthalmology annual meeting in San Francisco in November . The course outlined the correct protocol for argon laser trabeculoplasty, argon laser iridotomy, and argon laser treatment of the iris to enlarge the pupil , and to deepen the chamber angle. The paper's title: "The Effect of Agron Laser Trabeculoplasty on the Glaucomatous Diurnal Curve ." Dr. Greenidge is associated with the Wills Eye Hospital in Philadelphia.D Dr. Kenneth L. Glick, M'78, is instructor in medicine , Johns Hopkins and medical director of Sinai Hospital of Baltimore, Home Care-Hospice Program. During his internship he received the Howard K. Rathbun Award for clinical excellence. From July, 1981 to June, 1982 Dr. Glick was chief medical resident at Baltimore City Hospitals. He has joined a group of internists in Owings Mills, a Baltimore suburb. The Glick's have two girls, Dana, born in June , 1979, and Jorie , born in April , 1982. Mrs. Glick (Sandy] is teaching at Villa Julie College. They live at 2202 Oxeye Road, Baltimore, MD 21209.0 Dr. Alan Kuritzky, M'77 , is a clinical instructor at the Medical School. The nephrologist is associated with Drs. Robert Schultz, M'65, and Theodore Herman, both clinical assistant professors of medicine.D Dr . Daniel P. Rollo, M'78, finished ob/gyn residency at Hershey Medical Center and is now in private group practice. He resides at 118 Garden Avenue , Myerstown, PA 17067.0 WI TER , 1982 Dr. Jeffrey Steier, M'78, has completed training in neurology at the Mayo Graduate School of Medicine.D Dr. Donald Armenia , M'79, is affiliated with Buffalo Mercy Hospital and the Erie County Medical Center. He recently opened an ophthalmology practice in West Seneca, NY with Dr. Michael Sansone , M'73.0 Dr. Ramon J. Pabalan, M'79, has completed three years of family medicine residency at the University of Cincinnati. He is now in emergency medicine residency at the University Hospital in Jacksonville, FL. He is living at 7201 Arlington Expressway, #102, Jacksonville , FL 32211.0 Dr. Bruce D. Rodgers, M'79 , a chief resident in obstetrics and gynecology at U/B was awarded the Russell J. Van Coevering Sr. Award for excellence in wholistic health care . The award was instituted in memory of the late Dr. Russell J. Van Coevering Sr. by his family. It is awarded to the physician in the ob/ gyn residency program who shows an outstanding sense of compassion, understanding, and empathy for the patient. Dr. Rodgers graduated Summa Cum Laude in 1975 from Manhattan College, and was elected to Phi Beta Kappa. He is a member of the James A. Gibson Anatomical Honor Society, and Alpha Omega Alpha Medical Honor Society. The award was presented to Dr. Rodgers in June at Buffalo Children's Hospital. He is a clinical assistant instructor at the Medical School.D Dr. Douglas A. Waldo , M'79 , has completed his residency at Boston City Hospital in internal medicine. He has entered active duty with the United States Air Force to repay his scholarship . He is an internist and chief of clinical medicine at Malmstrohm AFB . He is living at 2018-5th Avenue N, Great Falls, MT 59401.0 The Classes of the 1980s Dr. Thomas J. Dougherty, M'80 , of the radiation medicine department at Roswell Park Memorial Institute , received a $69 ,345 grant from the National Cancer Institute for studies involving intraoperative photoradiation therapy.D 67 �In Memoriam Dr. Leon Yochelson, M'42, died of cardiac arrest June 22 at George Washington University Hospital. His age was 64. He was chairman of the Psychiatric Institute of Washington and former chairman of the psychiatric department at George Washington University. An authority on the relationship between law and psychiatry, Dr. Yochelson was a former co-chairman of the university's Institute of Law, Psychiatry and Criminology. In addition to teaching and wrjting on the law and psychiatry, he often was called as an expert witness in trials where testimony on forensic psychiatry was needed. He joined the medical faculty at GWU as an assistant clinical professor in 1949 and held the rank of professor of psychiatry and behavioral sciences at his death. He also had taught at Catholic University, Howard University, the University of Oklahoma and elsewhere. He was a training and supervisory analyst at the Washington Psychoanalytic Institute for many years. In addition to serving as chairman of the Psychiatric Institute of Washington, he was chairman of the Psychiatric Institute Foundation, its research and education arm. He was chairman of the Psychiatric Institutes of America. As a private physician, Dr. Yochelson had maintained a practice in psychiatry here since 1948. At his death, he was chairman of Professional Associates, a group practice. After an internship at St.Elizabeths Hospital in Washington, he served in the Army in the Pacific and Australian theaters during World War II. After the war he returned and graduated from the Washington School of Psychiatry and the Washington Psychoanalytic Institute. He was a staff physician at George Washington University Hospital, Sibley Memorial Hospital, the Children's Hospital National Medical Center and the Psychiatric Institute of Washington. Dr. Yochelson was an examiner of the American Board of Psychiatry and Neurology, a charter member of the American Academy of Psychiatry and Law, a Fellow of the American College of Psychiatrists, and a member of numerous other professional organizations.O 68 Dr. Howard E. Rogers, a retired surgeon who practiced 45 years in Buffalo, died of a heart attack July 28 at Lakeland Regional Medical Center in Lakeland, Florida. He graduated from the Medical School in 1925, and interned at Sisters of Charity Hospital and the former St. Mary's Hospital. Dr. Rogers worked as an attending surgeon at Sisters and Millard Fillmore Hospitals and had a private practice until he retired in 1970 and moved to Sebring, Florida.O Dr. Marvin H. Milch, M'32, died August 28 in Millard Fillmore Suburban Hospital after a long illness. The 75-year-old ophthalmologist was in private practice 43 years before his retirement in 1975. He had been active in several local, regional and national professional societies.O Dr. Howard B. Lawrence, M'35, died in Tucson, Arizona February 12 after a long illness.D Dr. Frank A. Trippe, M'16, died November 26, 1981 at the age of 91. He lived in Erie, PA.D Dr. Gordon H. Burgess, 46, a retired dermatologist, died July 17 at Millard Fillmore Hospital. While active in his profession, he was a clinician with the dermatology department at Roswell Park Memorial Institute and an assistant clinical professor of dermatology at the Medical School. He earned his bachelor's degree in geology from U/B in 1957 and graduated from the School of Medicine in 1963. During the Vietnam War, he served as a Captain in the Medical Corps at Fort Sam Houston, Texas and Fort Leonard Wood, Missouri. He was a contributor to numerous scientific journals and medical textbooks and an active member of several professional societies. Dr. Burgess was a Diplomate on the American Board of Dermatology, and a member of the Geological Society of America and the Canadian Geological Society.O THE BUFFALO PHYSICIAN �A Message from Robert A. Baumler, M.D. '52 President, Medical Alumni Association The annual Spring Clinical Day - May 7, 1983 - is being planned now and we expect it to be clinical and practical while incorporating the more recent developments on the 'Doctor's Disease' - coronary artery disease. It should prove of great interest and utility to all Buffalo physicians as well as alumni. The U/B Medical School classes of '73, '68, '63, '58, '53, '48, '43, '38, '33 and '28 will be celebrating their quinquennial reunions but all alumni will want to come back, meet their classmates, and see what's going on at the school. Spring Clinical Day is again being held at the new Marriott Inn across from the Amherst Campus with scientific exhibits, the morning cardiology program and the afternoon Stockton Kimball speaker. Mark the date on your calendar now and be sure to come.D Robert A. Baumler, M.D. '52 ----------------------------------------------------------------------------------------------------- IIIIII BUSINESS REPLY CARD FIRST CLASS PERMIT NO. 2210 POST AGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, New York 14214 BUFFAlO, N.Y. NO POSTAGE STAMP NECESSARY IF MAilED IN THE UNITED STATES �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET, BUFFALO, NEW YORK 14214 20 32234 lllD 44 DR. ROBERT L. BROWN 1 56 t; R HI o'o K A 6 FFALO '( 1422b THE HAPPY MEDIUM Fill out this card; spread some happiness; spread some news; no postage needed. [Please print or type all entries.) Name - - - - -- - - - - - - - - - - - -- - - - - - - - - - - - - - - - Year MD Received---OfficeAddress - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - -- - - - - ----HomeAddress - - - - - - - - - - - - -- - - - - -- -- - - - - - - - - - - - - - - - - - - - - - - - - linotUB,MDreceivedhom------------------- - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - InPrivatePractice: Yes D NoD In Academic Medicine: Yes D SpecialtY-------------------------------------~ No D Part Time 0 Full Time D School ---------------------------------------Title Other: Medical Society Memberships:------------------------------~------------~ NEWS: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.? - - - - - - - Please send copies of any publications, research or other original work. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 1982 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1982-Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1982-v16n04-Winter Table Of Contents A list of subunits of the resource. Dean Naughton's Message Spring Clinical Day 9 Classes Give $45,000 Boys Will Be Boys by O.P. Jones, Ph.D., M.D., Distinguished Professor Emeritus Barbados Seminar Graduates with Medical School Appointments Dr. Cooke Erie County Sailing/Faculty Serves Faculty Honored Athletic Day Summer Head Start Physicians Honored/MECO Research Exhibit Summer Fellowships Follies Nutrition Dr. Gresham Alumni Officers People The Classes In Memoriam Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-07-02 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v16n04 Extent The size or duration of the resource. 72 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1982 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/7b2ab21373177855aa8706a469149613.pdf d15184ea85f02c63e7972237ace119b1 PDF Text Text School of Medicine State University of New York at Buffalo Volume 16 Number 3 Fall 1982 The Buffalo Physician �Dean Naughton From the desk of John aughton, M.D. Dean, School of Medicine Dear Alumni and Alumnae: The School of Medicine initiated its academic year on August 16. 1982. I am pleased to report that the Admissions Committee has selected another very promising class of future physicians. Its composition and characteristics are comparable in many respects to those of the previous classes selected. The general f ea tu res in­ clude a composition of 84 men and 51 women, 57 percent of whom are from the overall Western ew York region, and 16 percent of whom are classified as under-represented minorities or educationally disadvantaged students. Seventy-five tudents came from twenty different universities and colleges within SUNY - Buffalo, Cornell, Canisius and Columbia having the major representation. The overall academic preparation of the class is strong. Two students were admitted to the 1.D.-Ph.D. program bringing the number enrolled in this program to three. We anticipate admitting four a year be inning in the 1983-84 academic vear. On October 9 and 10 the School of edicine will host its se~ond annual Parents Week-end. At that time, the facul­ ty, staff and I look forward to meeting many of the parent of the entering class as well as parents of the third year class. The new class will be the last selected under the leadership of Dr. Harry Metcalf. Harrv did an excellent job over the last five years. The directorship ~f the Admissions Office and Chair­ manship of the Admissions Committee has been a sumed by Or. Thomas Guttuso, a Buffalo alumnus and an Ophthalmologi t. Tom has served the committee and the school well in the past. I look forward to his contributions and leadership in the years to come.a �Fall 1982 Volume 16, Number 3 THE BUFFALO PHYSICIAN (USPS 551-860) Published by the School of Medicine, State University of New York at Buffalo EDITORIAL BOARD Editor ROBERT 5. MCCRA AHA 2 Dean, School of Medicine OR. JOHN AUGHTO Photography U HUGOH. EDWARD GER OWAK Visual Designers WATKI 6 13 14 15 RICHARD MACAKANJA OONALDE. 3 4 5 Associate Editor TERI ROBERTS 16 23 24 26 27 CO SULTA TS President, Medical Alumni Association DR. ROBERT A BAUMLER 28 30 Vice, President, !=acuity of Health Sciences DR.F.CARTERPA ILL President, University Foundation JOH M. CARTER Director of Public Affairs HARRY JACKSO 37 38 42 43 44 Teaching Hospitals 51 The Buffalo General Children's Deaconess Erie County Medical Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Charity Veteran Administration Medical Center 56 I THIS ISSUE Dean aughton's Message (inside front cover) Commencement Iris Dedication Students Honored "Beyond Medical School," by Or. DeWitt Stetten Angioplasty Chronobiology by Dr. William J.M. Hrushesky Calcium Blockers "Bioethics in Ob/Gyn" by Dr. Myron Gordon Alumni Honored Halloween Party Stress Conference Alumni Tours Reception for Seniors The Progress and development of the Buffalo Medical School Library, 1846-1981 by F.X. Roberts Heart Muscle Surgery/Cancer Seminars Dues Paying Alumni, 1982 Continuing Education/Orthopaedic Scientific Day MEGO/Career Opportunities/Cancer Programs People The Classes In Memoriam Dr. Robert Baumler's Message (inside back cover) The cover by Barbara Evans depicts specialization that was alluded to by the commencement speaker page 6. THE BUFFALO PHYSICIA , (USPS 551-860). Fall, 1982 - Volume 16, umber 3 publi hed quarterly Spring, Summer, Fall, Winter - by the School of Medicine, State University of ew York at Buffalo, 3435 Main Street, Buffalo, ew York 14214. Second cla s postage paid at Buffalo, ew York. POSTMASTER: Send address changes to THE BUFFALO PHYSICIA , 139 Cary Hall, 3435 Main Street, Buffalo. ew York 14214. Copyright 1982 by The Buffalo Physician. FALL, 1982 1 �George Rafferty and colleagues. 136thAnnual Commencement In his welcome to the graduates and their families Dean John aughton praised the class for their excellency academically, socially and for their role in university/community life. "Everyone of you did very well in the national matching. We are happy that 52 of you are staying in Buffalo for your residency." Dr. aughton noted that the first medical class had 17 graduates in 1847. "Today we are awarding 142 (92 men, 50 women] Doctor of Medicine degrees, and 24 Doctor of Philosophy degrees. The first class spent 90.00 a year for their medical educa­ tion, plus $3.00 a week for living allowance." Dean aughton introduced several dignitaries including President Steven 8. Sample, who conferred the degrees. For the second consecutive year a brass band replaced the organist and the reception was at the Buffalo Convention Center. Also the class selected an outside commencement speaker, Dr. DeWitt Stetten Jr., senior scientific advisor, ational Institutes of Health. Dr. Leonard Katz, associate dean led the graduates in the Charge of Maimonides and Dean aughton administered the Oath of Hippocrates. Doing the hooding was Drs. Elliot F. Ellis, Diane Jacobs and James P. olan. Dr. John Richert, assistant dean, presided over the signing of the Book of Physicians. 2 THE BUFF ALO PHYSICIA �.. When Dr. John Wright returned to the University of Buffalo from Johns Hopkins to become Chairman of the Department of Pathology, he found the department's sophomore course was not popular. Many students felt it was disorganized and believed that its emphasis was not directed at preparation for clinical work. Dr. Wright has been so successful in changing Pathology 600 that it is difficult to imagine starting the third year without his teaching. Dr. Wright saw his course, not primarily as the transmission of facts, but as an opportunity to form models of disease processes. In so doing, he shifted the emphasis away from strict morphology and towards pathophysiology, thereby allowing students lo integrate the mass of preclinical facts into meaningful clinical concept . Dr. Wright's usefulness, however, did not end there; the very depth with which he understood disease lead him to integrate into the course some of the ethical issues surrounding its treatment. Thus, Wright, the pathologist, emerged as an intellectual and ethical role model for the clinical doctor. Certainly, this commitment to teaching and familiarity with patient care has its roots in Dr. Wright's training. After completing medical school, a rotating internship and a year of medicine in Winnipeg, he felt restricted by the pressure to specialize and saw in pathology a means to remain a generalist without sacrificing depth. He came to Buffalo in 1963 to complete his study of pathology and, on finishing a fellowship, accepted a position on the Johns Hopkins faculty, which he held for seven years. He miss­ ed the direct contact with patients his choice of pathology denied him, but soon discovered that his affection for people could find expression in teaching. Buffalo won him back in 1974 with its fine pathology faculty, good residents and the dual challenge of reorganizing the sophomore course and the department in general. Our exposure to Dr. Wright has shown us that a doctor can be deep without being egocentric, can teach without being in­ timidating and can lead without being dictatorial. Certainly, we are better off for having met Dr. Wright, for he fulfilled a critically important role in our medical education, pro iding outstanding in­ tellectual and professional leadership at a time we most needed it, and for that he has earned our lasting gratitude and with it this dedication. Stephen /. Donovan for The Class of 1982 For Dr. Wright this was the second yearbook dedicated to him. The 1977 class also honored him with the Iris dedication. In his response professor Wright noted that it was nice to be remembered. "My major contact with you folks was early in your education." He also shared something very personal with the students and his colleagues. "I am an identical twin. My brother lives 1500 miles from here and is an engineer. Three years ago I received a call from a physician telling me that my twin brother was a patient of his. He was seriously ill. After many tests, delays and com­ plications it was revealed that he had Hodgkins Disease. It was almost like having the disease myself. I relate this to you because what I went through you will soon encounter. You will be emersed in human suffering and pain. This will be a devastating stres for you. De-personalization is one way to shake off stress. I know you FALL, 1982 3 Ann Curry, Ors. Pann,/1, Steven Sample. · Iris Dedication to Dr. John Wright Dr. Norman Chassin d- �Daniel J. Boorstin, a Pulit­ zer Prize-winning historian and 12th Librarian of Congress spoke at the 136th general uni­ versity commencement. Pre­ sident Steven B. Sample con­ ferred degrees on most of the 4,647 graduates at the Buffalo Convention Center. The 1982 graduate count includes 321 doctoral candidates, 1,267 can­ didates for the master's de­ gree, and 3,086 bachelor's degrees. President Sample presented attorney Howard T. Saperston Sr., with the Chancellor's Medal, the highest award the university can bestow for ex­ ceptional contributions to the community. □ Andrew Hordes, Ors. Stellen, Sample. will chose an alternate approach - improve the system. get in­ volved with your patients; don't withdraw from them." In conclusion, Dr. Wright said, "I know you will be a credit to your school, your teachers, your patients and most importantly to yourselves. "O Dr. Wright 23 Students Honored Twenty-three medical students won special awards. Or. Kamal Tourbaf, clinical professor and chairman of the awards committee, presented the awards at commencement. William E. Schu, Daniel E. Ford, Robert . Stern each won two awards. The awards and honors: Thesis Honors - Jeff Bilotta, Michael A. Cesar, Joan 0. Cho, Steven I. Goldstein, Stephen M. Hershowitz, Andrew R. Hordes, David I. Kurss. Baccelli Award - (academic excellence in the clinical years] - Peter J. Sofia. Gilbert . Beck Memorial Prize in Psychiatry (academic ex­ cellence] - George A. Rafferty. Buffalo Surgical Society Prize in Surgery (academic ex­ cellence - junior, senior years) - William E. Schu. II. Children's Hospital Prize (excellence in understanding dis­ ease in childhood] - Susan J. Gallagher. Dean's Award (participation in extra-curricular activitie in the medical school while maintaining a high standard of academic excellence) - Stephen B. Pollack. 4 THE BUFF ALO PHYSICIAN �Gordon S. Ehrlich Memorial Award (to the graduating student who has best demonstrated an interest in and knowledge of pediatric pulmonary disease) - Paul . Rosenberg. Bernhardt & Sophie 8. Gottlieb Award (expertise in areas out­ side of medicine) - William E. Schu, II. orman Haber Memorial Award (proficiency in Otolaryngology) - Jonathan B. Warach. Dr. Heinrich Leonhardt Prize in Surgery (academic ex­ cellence) - Elizabeth Paroski-Barlog. Lieberman Award (interest, aptitude in the study of Anesthesiology) - Michael A. Cesar. Hans J. Lowenstein Award in Obstetrics (academic ex­ cellence) - Daniel E. Ford. Maimonides Medical Society Award [proficiency in the basic sciences) - Marcia A. McAvoy. Medical Alumni Association Award (community commitment) - John S. Santelli. David K. Miller Prize in Medicine (demonstration of Dr. Miller's approach to caring for the sick - competence, humility, humanity) - Daniel E. Ford. Mark A. Petrino Award (demonstrated interest and aptitude for the general practice of medicine) - Cathereine L. Bilodeau. Clyde L. Randall Society Award in Gynecology-Obstetrics (academic excellence) ancy Gail Belleisle Murphy. Emilie David Rodenberg Memorial Award (academic ex­ cellence in study of diabetes, its complications) - Robert M. Stern. Philip P. Sang Memorial Award (ability to relate well to patients, faculty and staff) - Arlene R. Curry, Gail A. Greendale. Morris & Sadie Stein euroanatomy Award (excellence in neuroanatomy) - Robert M. Stern. Upjohn Award (research ability) - Jeff Bilotta. John Watson Award in Medicine [enthusiasm for and commit­ ment to scholarship in medicine) - Ralph Mastrangelo. Frederick B. Wilkes Pediatric Award (to the graduating stu­ dent entering a career in Pediatrics who has best exemplified Dr. Wilkes' skills and dedication to patients) - Warren W. Wasiewski. HO OR MEDICAL SOCIETY Kevin J. Barlog, Jeff Bilotta, Elliot K. Chartash, Robert P. Dudek, Daniel E. Ford, Richard V. Homan, Marcia A. McAvoy, ancy G.B. Murphy, Steven J. ierenberg, Jessica C. Rockwell, William E. Schu, Peter J. Sofia, Robert M. Stern, Warren W. Wasiewski, Richard A. Wolf, Gerald . Yacobucci.O Drs. Alexander Brownie, Mary Voorhess. Catherine Bilodeau, Dean Naughton. DOCTOR OF PHILOSOPHY John A. Anstrom, Roger Alan Daley, Dale Roth Fish, Jeffrey David Green, Bonnie Lee Hylander (Anatomy); Gordon Hunter Downie (Pathology); John H. Eldridge, Susan A. Krasny, Karen A. Olson, Christopher J. Papasian, Tzi-Kang Peng (Microbiology}; Rodney Ferguson, Finn Hansen, arender Kalyan, Thomas Koroscil, Gabriel Lando, Vera da Silva, Stephen Walsh (Biochemistry); Claire Marie Fraser, Richard Francis Hart (Phar­ macology); Henry Manuel, Harold B. Pinkofsky (Biophysical Sciences); John A. Sterba, Richard A. Stockton {Physiology) .0 FALL, 1982 5 d- �"BEYO D MEDICAL SCHOOL" by DeWitt Stetten, Jr., M.D., Ph.D. Senior Scientific Advisor, IH Commencement Address students: Michael Cesar. /onolhon Woroch, Poul Rosenberg. //onor THE OPE I G sentence of Hippocrates' Aphorisms has been translated, "Life is short and the art long, the occasion fleeting, ex­ perience fallatious, and judgement difficult." The difficulty of judgement is revealed by an anecdote attributed to a former Dean of Harvard edical School, David Edsall. It is reputed that during a commencement ceremony he congratulated the members of the graduating class upon the vast amount of information which they had acquired in the preceding four years. He warned them, however, that approximately 50% of what they had just learned would be proven wrong during their professional lifetimes. "My problem," he added, "is that I cannot, at this time, tell you which 50% is right and which 50% is wrong. I believe that Edsall's proposition of half-century ago is certainly still true. The final judgements as to the accuracy of what you have here learned will be left to you and will be determined by the nature of your con­ tinuing education. The problem may be viewed in another fashion. Some years ago, the Yale historian of science, Derek DeSolla Price, studied the nature of the annual growth in size of the literature of each of several sciences. It is my recollection that he ascertained that the growth of the medical literature was presently in an exponential phase and exhibited a doubling time of approximately ten years. Clearly there is a fraction of the medical literature which is non­ sense. But if we assume that this fraction remains sensibly con­ stant over the years, we can then conclude that the fraction of medical literature worth noting is constant and that the growth of medical knowledge parallels the growth of medical literature, doubling each decade. Stated in more familiar terms, this means that assuming your faculty here has taught you everything which is known about medicine in 1982, if you fail to add to this reservoir of knowledge in the years ahead you will, after 10 years, be ap­ proximately half-educated - after 20 years one-quarter educated 6 THE BUFFALO PHYSICIA �- after 30 years one-eighth educated - and after 40 years, as your professional careers approach conclusion, your knowledge of medicine will encompass only one-sixteenth of what will then be known. This projection, in my opinion, argues forcibly for the ab­ solute requirement that the education of the physician must con­ tinue throughout his professional career, and one of your obligations in the years ahead will be to determine the channels of continuing education which are best suited to your needs. I hope by this time that you have all acquired the habit of con­ sulting the current medical literature and that many of you have initiated subscriptions to some of the more important medical journals. This habit, once established, will persist throughout your lifetimes. You will, I hope, purchase new texts and new editions of old texts in your selected fields of activity and consult these fre­ quently. You will, in most cases, secure residency training over the years ahead, taking advantage of this elegant pedagogic device which achieves that desired goal - total immersion of the can­ didate into a structured educational and training program. Over ensuing years some of you may find opportunity for brief re­ juvenating residency experiences. Others will take the various short courses in one or another area of medicine which are being offered either by medical societies or by academic medical centers. Some of you may establish permanent ties with such centers and in this way affiliate permanently with one of the in­ stitutions which is generating, scrutinizing and disseminating new medical knowledge. In my observations, this is perhaps the most effective way by which a physician can keep current with his field. The grand rounds, the combined clinics, and the lunches in the doctor's dining rooms all are part of such an association. Bear in mind that the process of growth of knowledge is a continuous one and any serious lapse in the continuing process will be overcome only with the outlay of much effort. I have long felt that the process of educational maturation is, in fact, a transfer of the major responsibility from the teacher to the student. Up to the present in each of your careers what you have learned and whether you have learned has been deter­ mined in large part by the exertions of your faculty who have browbeaten you with grades and rewarded you with diplomas. From this point forward, however, to an ever increa ing degree, whether the process continues depends upon you the student. If you do not accept this responsibility, the investment which your medical school has made into each of your careers will have been forfeited. An entirely separate and distinct aspect of how to cope with the exuberant growth of knowledge is open to each of you. Every physician wishes to feel quite secure within the realm of his ac­ tivities. He wants to know that his diagnostic and therapeutic procedures are expert and current - both for his own gratification and that of his patient. He wants to be certain to provide the best available services and to avoid commission of mistakes, par­ ticularly if they might subsequently be construed as malpractice.· A popular defense against all of these problems is the determina­ tion to specialize. FALL, 1982 7 David Gol!segen, Dean aughlon. President Steven B. Sample outlined the priorities and goals of his administration during his "State of the University" address in April. His five goals: strengthened research, aggressive recruit­ ment of the best students in ew York State, im­ provements in the quality of student life, expanded com­ mitment to public service and revitalization of the Western ew York economy. Dr. Sample will be formally inaugurated as the 12th president of UIB on Sunday, October 10. □ d- �/\fork Chung. Specialization is not a new response to a burgeoning field of knowledge. Thus there was a happy time when a single automobile mechanic could be relied upon to perform all of the many func­ tions required to maintain and service an automobile. The same man would remove dents from fenders, regrind valves, repair the transmission and align the front wheels. Of ten he also sold gas­ oline and repaired tires. Today, at least in more densely settled areas, one rarely finds such diversely talented mechanics and the car owner must therefore locate a body specialist, a transmission specialist and a tire expert. Even more ancient than specialization among auto mechanics is specialization among performing musicians. The violinist is not expected to be competent on the flute and we should be surprised to find a percussionist who also plays the harp. As long as orchestra music contained no more than four voices, each performer could keep track of what was going on in other portions of the orchestra and the system worked pretty well. However, with the addition of woodwinds, brasses and per­ cussion instruments to the initial string ensemble, a new kind of musician had to be invented. This was the conductor. He was not required to be a virtuoso on any particular instrument, but necessarily was expected to have some familiarity with the per­ formance capabilities of all instruments. His role was that of the great synthesizer. He put the show together. The question may be raised, in view of the ever increasing number of medical and surgical specialities, whether there is need to develop yet another specialty - a medical conductor - who can interpret reports derived from each of the specialties and can syn­ thesize, for the patient, the best course of action. In my ex­ perience, physicians of this category and quality are today scarce. The majority of graduates of American medical schools expect to enter one or another specialty and the standard route of entry is through an approved residency training program followed, in many cases, by examination and certification. As a result, I believe, of the explosion in medical knowledge, new sub­ specialties continue to appear so that today we have, for example, surgeon-plastic surgeon, surgeon-thoracic surgeon, internist­ cardiologist, or internist-hematologist. I was startled to learn a few weeks ago that a distinguished internist of my acquaintance, who was specialized in endocrinology, felt himself unqualified to care for a patient with a myocardial infarct. There were, he felt, many minutiae in the care of a coronary accident with which he could not maintain familiarity. This, he told me, was the business of a cardiologist. Among the youngest of the specialties is, of course, family practice which is of ten taken to include those branches of medicine otherwise in the domain of the internist and the pediatri­ cian. This is certainly an important and fascinating domain to cover, but the coverage must necessarily be broad and therefore somewhat shallow. My limited contact with physicians of this category leads me to believe that much of their time is spent in the performance of two major activities. One of these is triage, which is the selection of the appropriate specialist to consider the needs of the patient. This function, it has long seemed to me, will sooner or later be effectively computerized and it is not difficult to visualize a program which will assign each patient to the appro8 THE BUFF ALO PHYSICIA �priate specialist with relatively infrequent mistakes. Except in emergency situations, such mistakes should generally not be irretrievable. The second function of the generalist, the family physician, will be always the care of relatively minor illnesses. In some practices this latter activity is being assumed with increasing frequency by persons receiving considerably less formal educa­ tion than is needed for a doctoral degree. This is an area in which one or another type of Physician's Assistant can often perform ad­ mirably under the relatively remote surveillance of a physician. Furthermore, I have encountered a number of persons who, after a few years of family medical practice, return to an academic center to undertake a residency in one or another specialty. Various reasons for this change, of course, are given but mostly they seem to relate to the fact that the general practitioner works harder and often earns less than does his specialist colleagues. I suspect that a contributory reason is that the generalist sooner or later becomes overwhelmed by the vast amount of information which he must try to master if he is to assume responsibility for the care of patients suffering from widely diverse conditions. Rather than try to con­ sume the whole pie, it is ever so much easier to cut out a narrow slice. Undoubtedly, many of you will elect to specialize. You will become psychiatrists, gastroenterologists, orthopedists, or ophthalmologists and inevitably you will find your own specialities very engrossing. Many of you will cancel your sub­ scriptions to the more general journals since you will scarce! find the time to cover the journals dealing with your own specialty. Certainly, as you become progressively more and more specializ­ ed, you will be forced to reduce your attention to the patient as a whole - to his domestic and employment environments and to such problems that he may have which are outside the immediate domain of the organ system or the group of diseases which com­ prise your specialty. Over the past several years I have had the op­ portunity of observing, at a very personal level, how the process of specialization both serves the needs of the patient and simultaneously may fail to direct the patient to persons or agencies that might be of great assistance to him. In what follows I do not mean specifically to indict th~ profession of ophthalmology. I fully believe that analogous situations may be encountered in any specialty or subspecialty of medicine or surgery. My personal inclination, however, relates predominantly to diseases of the e e and loss of vision. Last summer I published a brief paper in the ew England Journal of Medicine in which I described some of the difficulties which I had encountered in the process of adjusting to my own blindness. As a result of this publication, I was deluged with letters and telephone calls - mostly coming from blind persons or their relatives seeking information as to how they might improve the quality of their lives. I have now heard from at least 500 per­ sons who have taken the trouble to share with me their problems, their frustrations, and such solutions as they have discovered. The accumulated information is, of course, anecdotal, but some of the anecdotes are, I think, revealing. Take, for instance, the case of a friend of mine - a man of approximately 70 years who has a mark­ ed intention tremor of both hands. The tremor is a coarse one and FALL, 1982 9 Dr. DeWitt Stetten Jr. Dr. Edward Corr Jr. d- �Harold Ginsberg. Dr. Leonard Katz can readily be seen from across the room. He developed a cataract which his ophthalmologist diagnosed and treated in a conven­ tional fashion. After removal of the cataract he prescribed a con­ tact lens for the aphakic eye, which completely frustrated my friend who was totally unable, because of his tremor, either to in­ sert or remove the lens. In this instance it would appear that the ophthalmologist had concentrated his attention upon the patient's eye to such an extent that he neglected to look at the patient. In this instance a complete physical examination of the patient was not required in order to forecast the inadequacy of the prescrib­ ed treatment. A mere inspection of the patient would have suf­ ficed. The ophthalmologist, however, failed to come out from behind his ophthalmoscope and look upon the patient's fundus but upon the patient. As medical students, I am sure you have been taught that the proper approach to a patient entails a more or less complete history and a more or less complete physical examination. I can recall a lecture of 50 years ago given by the late Dana Atchley at the College of Physicians and Surgeons to our second year class an introductory lecture to physical diagnosis. The lecture dealt with what one can learn about the patient during the three seconds which elapse between the time he enters your office and the time he is comfortably seated beside your desk. One notes the patient's hair, facies, skin color, eyes, lips, neck, hands, fingernails, gait and posture. I can still recall Dr. Atchley simulating for us the facies, the tremor, the gait and the posture of Parkinsonism. Often, as he pointed out, the diagnosis can be made during those initial three seconds. In order to do so, however, the physician must look up at his patient. It has certainly been my experience, confirmed by anecdotes from other patients, that many specialists today do not, in fact, take a complete history, do not perform a complete physical examina­ tion. Such histories and physicals as are commonly elicited by most specialists relate almost entirely to the interests and tools of their specialty. This practice seems to me to overlook the fact that every patient presenting himself to a physician is fundamentally a human being in need of humane understanding. When each of you first came to medical school you were also merely human beings. You had graduated from colleges where a portion of your time and effort was devoted to a group of subjects called the humanities. Inclusion of these in your curriculum was designed to stress your humanism. Then, as medical students, your education was directed chiefly to the generalities of health and disease. The specialties were certainly introduced to you but in no sense were you, at that time, converted into specialists. Your teachers, J trust, stressed the importance of looking at the whole patient which includes his oc­ cupational and domestic environments. During the residency years ahead for most of you this perspective will change. You will find yourselves devoting increasing attention to the patient's car­ diovascular system, gastrointestinal system, pulmonary system; to his tumor, his eye or his skin; and with decreasing frequency will you find the time and effort to take a good close look at the whole patient. In other words, as you progressively become specialists, there will be a decreasing concern in humanism. My chief text this evening is to caution you not to let the broad 10 THE BUFF ALO PHYS ICIA �.. humanistic approach to the patient's many problems slip away. There are complications arising from each specialized category of diseases which may not normally come to the attention of the con­ cerned specialist. Consider, for instance, the patient under treat­ ment by an orthopedic surgeon whose arms have been im­ mobilized for good and sufficient reason, but who at the moment is troubled by an itch on his nose which he cannot scratch. Consider the patient who has had a colostomy and whose social life has been jeopardized by anxiety about odor, borborygmi or leakage. Consider the visually handicapped person who, for the 20th time, runs into the edge of a coffee table and bruises his shins at a height precisely 12 inches off the floor. What help, if any, can he expect from his ophthalmologist to see to it that this particular complica­ tion of blindness does not occur again. I have learned a great deal from the stud of the many letters received since the publication of my ew England Journal of Medicine article, and much of what I have learned is, I believe, not widely known to the ophthalmological world. As an example may I cite advice received from a blind retired woman who noted, as she was losing her vision, that blind persons have great problems not only in reading, but also in writing. Therefore, in an­ ticipation of total loss of vision she had herself schooled in touch typewriting and is today a very proficient typist, even though total­ ly blind. This has permitted her to write her memoirs and to main­ tain an active correspondence. I have not found this particular prescription in any textbook of ophthalmology, yet its good sense is entirely obvious and to me very appealing. One might expect that since the majority of individuals losing their vision are seen by ophthalmologists that they would normally be referred to experts in rahabilitation, in the treatment of low vi­ sion, and in the many goods and services which are provided by very many agencies catering to the needs of the blind. Clearly the blind, as a population, have some political clout. Blindness is, I believe, the only disease mentioned by name on Form 1040 of the Internal Revenue Service. Yet such anticipated referral frequent­ ly does not occur. I have heard from a woman in Cambridge, assachusetts, who was blind for 18 years and wa seen by 12 ophthalmologists before anyone directed her to the invaluable Talking Books Program, which is run by the Aids for the Blind and Physically Handicapped at the Library of Congress. This agency provides a choice of almost one-half million books which have been read onto records or tapes, together with appropriate tape players, to permit enjoyment of this material. Service, incidental­ ! , is entirely free and distribution is made through regional public libraries. I have even heard of one ophthalmologist who dis­ courages the use of these products by his patients on the grounds that the Talking Books Program is "mere! a crutch." This attitude is, in my opinion, foolish and perhaps sadistic. The Talking Book is no more of a crutch to the blind individual than is the printed book to the normally sighted. Besides which, what is wrong with crutches? A curious evidence of the ophthalmologist's insensitivity to the needs of the partially sighted came from a telephone call which I received from a visually handicapped patient under treat­ ment at a very famous ophthalmology clinic. He told me that in the waiting room where he spent many hours there was a large stack FALL, 1982 11 1onuel Saint-Mortin. George Rafferty d- �of magazines and newspapers for the entertainment of the clientele, but not a single journal or book in large print which the visually handicapped patient might have read. It ha appeared to me and to a number of my correspondents that the ophthalmologist may often develop a hostility to blindness. He sees blindness as an evidence of his failures and these he wishes to sweep under the rug. Alternatively he comes to the attitude, "Thi man is blind and I can do nothing for him." It is this statement which I find par­ ticularly troublesome. More precisely he might state, "This man is blind and I can do nothing for his vision. There are, however, quite a few things which I can do for him." In the hope of reviving the kind of humanistic sensitivity with which all physicians should hopefully be equipped, I have su gested to a number of ophthalmologists that during the three­ year residency training in this specialty, short periods of time be assigned to experiences which stimulate the condition of deteriorating vision. It should be entirely possible to equip each resident for a period of one or more days with a pair of fro ted spectacles through which he can see little but light and dark. In ad­ dition, it might be worthwhile to provide him with an absolute blindfold for a period of time. Optical devices are available which mimic many of the more common specific defects of vision such a tubular vision, hemianopsias, loss of central vision, etc. I believe that every opththalmologist should experience these sensations. Furthermore, I would not be satisfied to have him sit quietly in hi office or remain in bed during these experiences. I think it is im­ portant that each new ophthalmologist encounter the real problems of the visually handicapped. Let the blindfolded oung doctor go on rounds. Let him talk to patients in the OPD. In i t that he get his lunch by going through the cafeteria line, an interestin experience for someone who cannot see. Let him accompany his spouse to an art gallery, a motion picture, or a theatre, so that he i aware of the limitations which blindness imposes upon these and similar experiences. I would hope that ophthalmologists who have passed through such a brief course of training would have better understanding of the problems with which their patients are dail confronted and would, in consequence, practice a more u eful kind of medicine. It is an interesting exercise to consider other specialties in which such simulated clinical experiences might be included in training. Every would-be orthopedic surgeon might be im­ mobilized for a brief period in one or another plaster cast. One could equip the trainee in otology with ear plugs for a while. One might even dust the would-be dermatologist with "itching powder." It is more difficult to design stimulation experience of this sort for the trainee in cardiology or oncology. Still, in some way we must sustain such humanism as survives the rigors of medical education. We must, from time to time. tear the urologist away from his cystoscopic view of the world. We must induce the ophthalmologist to come out from behind his ophthalmoscope and look at his patient. If we fail in thi way, we may expect the increasing resentment of the patient population. If we succeed we may hope that even in an era of high specialization, medicine will still be practiced in the grand tradition of Hip­ pocrates, of Galen, of Ambroise, Pare and William Osler. □ 12 THE BUFF ALO PHYSICIA �Angioplasty Angioplasty, a nonsurgical technique, is used to treat severe narrowing of arteries. In­ troduced in 1964 by Oregon's Drs. M. Judkins and C. Dotter, it was used to dilate narrowed arteries in legs of patients with severe peripheral vascular disease which made them unacceptable bypass surgery candidates. During the then somewhat crude procedure, catheters of increasing size were used to dilate clogged blood vessels. Because of complications - vessel injury and hemorrhage the procedure was abandoned in this country. In Switzerland ten years later, Dr. A. Gruntzig and associates used a double lumen balloon catheter to dilate narrowed parts of blood vessels in patients. Following great success in peripheral and renal arteries, the first percutaneous coronary angioplasty known as PTCS was done successfully in 1977. Since then, some 3000 procedures - using improved instrumentation have been reported around the world. At 73 national centers, over 1500 cases have been monitored by IH's ational Heart, Lung and Blood Institute. Nine have been done at the Erie County Medical Center by cardiology atten­ ding eil Dashkoff, clinical assistant professor of medicine. ationally, most cases have involved single vessel disease; the remainder double or triple vessel disease. Two-thirds of the lesions have been located in the left anterior descending coronary artery. The others in the right or circumflex coronary arteries. In his report to the medical/dental staff, Dr. Dashkoff said, "We are on the frontier of angioplasty. With more refined instrumenta­ tion and experience, results will continue to improve. "The more you do, the better you become." He noted two catheters - one inside the other - are used during the procedure. The outer or guide catheter is used to enter the coronary artery where the lesion is located. FALL. 1982 The inner or balloon catheter then moves down the coronary artery under fluoroscopic/pressure monitoring until it passes the lesion. Once there, it is inflated/deflated for 10-15 seconds by a controlled pressure pump. The cycle of inflation/deflation is repeated until the lesion of arteriosclerotic plaque is com­ pressed against the vessel wall and/or is cracked open to allow blood to flow un­ restricted through the widened blood vessel. Dr. Dashkoff noted some 10-15 percent of bypass surgery patients are candidates for coronary angioplasty. Those who are careful­ ly selected have a short history of angina less than a year - when lesions are softer/noncalcified and lesions are in the proximal part of one or more coronary arteries. "Because of possible rare complications heart attack or death - there is cardiac stand­ by which we hope is cancelled," Dr. Dashkoff said. He compared the $25,000 cost for bypass surgery to a $4,000-$5,000 for angioplasty. In both, he noted comparable complications and a 15 per cent recurrence rate during the first year. One of the nice things about angioplasty, he said, is that it is less complicated to repeal than surgery. He noted success with cor­ onary angioplasty is currently 63 percent. "It is a promising, nonsurgical alternative for selected patients," he said. He credited Beth Sloan, RN, as instrumen­ tal in helping to get the procedure underway at the medical center. The use of angioplasty in renal artery dis­ ease was reviewed by radiology attending Bhupendra epani. He has performed some 30 cases at the medical center. The first, in February 1980, was a patient of Dr. Joseph Walsh. "He helped to establish a protocol for renal artery angioplasty at the medical center," he said. "The patient is still doing well." He pointed to a local/national success rate of 85 percent for the well-accepted procedure in renal artery disease. □ 13 �Chronobiology by William J.M. Hrushesky, M'73 Assistant Professor of Medicine, Laboratory Medicine, Pathology University of Minnesota Chronobiology is the study of the temporal relationships of biologic phenomena. The biology of all living things on this planet has evolved with a certain and locally definable cosmological reality. One of the essential qualities of the milieu, in which we find ourselves, is a constantly changing but re ularly recurrent arrangement of strong and weak geophysical, heliophysical lunophysical and other less well-defined cosmological forces. The rhythmic arrange­ ment and rearrangement of these bodies and the resultant force patterns engendered by these spatial rearrangements "mark time" in our corner of the universe. As the heliodependent chemistry of life came into being, the very first hurdle which had to be overcome was the storage of enough energy to "hold that life together" during the regularly recurrent span of time in which no direct source of energy would be available. Adaptability to the circadian reality of our planet was a sine qua non of life. This regular­ ly recurrent lack of solar energy was also the impetus for the development of chemical envelopes (membranes) to protect and keep the molecules of life aggregrated. The relative absence of energy during half of this "cell's" life has also led to the development of organelles and intracellular "batteries." The homeostasis of biology has retained this es­ sential circadian periodicity throughout evolution. It is such a basic life property that derangements often have lethal conse­ quences. Its most obvious mark upon us is the one-third of our entire lives which we spend asleep. Life probably developed in that part of the earth's surface where day and night length are of relatively equal duration throughout the year and in a fluid atmosphere which changes its physical properties relatively slowly and gradually in response to the dailv and annual rearrangements of the earth and sun. As the molecules and cells of life generally spread from the equator, however, methods of coping with seasonal differences in energy availability of a very great degree 14 became required. Elaborate life cycles of single cells and specialized cellular organelles, as well as complicated, permanent arrangements of cells evolved. Storing energy over regularly recurrent long spans of low energy availability ultimately resulted in the development of organisms with complex plans for keeping their "life stuff" together through these long periods of energy dearth. Many millennia passed before life left the sea. During these millions of years organisms came into being whose territories bordered large land masses. The tremendous regularly recurrent magnetic and gravitational forces of the moon upon the earth resulted in massive regular monthly movements of the fluids covering the earth. These movements had to be dealt with by these living organisms. Therefore, in order to deal with each of these three physical rhythms, as well as others with less obvious cosmological casuality, this "life" has built into its biochemistry and genetics multiple highly complex interacting networks. These three physical rhythms have left an in­ delible imprint upon every earth-born life form. Endogenous rhythmic properties of life are common to all living organisms on earth. Chronobiology takes each of the interact­ ing time frames into consideration per se, defines and quantifies their biological effects, and uses the understanding engendered to ask scientific and biomedical questions very much more effectively and precisely than can be done if these essential rhythmic qualities of !if e are not carefully considered. \ ' ' ' ' I I I I I I ,, I 'I I 12 I , , , 2'- , ,,, I I I I I I I I I \ ' ' ' Logo Clock THE BUFF ALO PHYSICIA �Calcium Blockers Calcium blockers, a new group of drugs, have been approved by the FDA to treat angina. The approval follows three years of clinical trials in this country. Among physicians to use the drugs in the study is Dr. Francis Klocke, M'60. He is director of car­ diology at the Erie County Medical Center and professor of medicine/physiology at U/B. Dr Hrushesk} CHRO OBIOLOGY RESEARCH PROGRESS REPORT The Chronobiology Cancer Research Program at the Masonic Cancer Center has clinical, preclinical, and basic components. The ongoing research addresses the pefinition and use of biologic rhythms for cancer treat­ ment, diagnosis, and prevention. A large number of mouse and rat studies have demonstrated very large and predictable differences in the lethal toxicity of seven anti­ cancer agents, which depend upon the circa­ dian stage these drugs are given. Clinical studies at the Masonic Cancer Center have demonstrated for the first time that the extent of bone marrow suppression of a chemotherapy regimen depends in part upon the circadian stage and what season these agents are administered. This research has shown that the manner in which cisplatin is metabolized and excreted is also time­ dependent. Furthermore, the kidney damage associated with the administration of cisplatin is much less severe when the drug is given at a time of day when the human kidney normally excretes the highest concentrations of potassium. This research program has also allowed the development of a chronobiological method for predicting which patients are destined to develop doxorubicin-induced con­ gestive heart failure. This predictive capacity may allow avoidance of this lethal drug com­ plication in the future. □ FALL, 1982 He notes the calcium blockers are not a panacea. Rather, they are an addition to drugs currently used to treat angina. "Our clinical experience has been limited," he said. "It will be a few years before we clearly understand the role of each of the calcium-blocking drugs - Nifedepine, Verapamil and Diltiazem. The drugs have been in use in Europe for 20 years. What is known is that they stop the calcium molecules from causing blood vessels to con­ tract spasmodically. By changing the rate calcium enters and leaves cells, blood vessels are dilated. Once open, blood flow to the body is in­ creased and the heart works less hard. Also, dilated blood vessels within the heart in­ crease blood flow to the heart muscle, the op­ posite of what occurs with angina. In angina, pain occurs when the heart does not receive enough oxygenated blood. Dr. Klocke notes the calcium blockers may aid in treating the irregular and rapid heart beats known as arrhythmia and tachycardia. The most common or effort-related form follows physical exertion or emotional excite­ ment. Blood pressure and heart rate in­ creases. These patients use beta blockers. The rest or no-exertion form of angina may result from spasms in the arteries. Because blood flow to the heart muscle is restricted, these patients may be helped by the calcium blockers, Dr. Klocke said, along with the nitrates including nitroglycerin they now use. Also candidates for the calcium blockers, according to Dr. Klocke, are patients who, because of asthma or weak hearts, are unable to tolerate common drugs such as nitroglycerin or beta blockers. □ 15 �BIOETHICS I OBSTETRICS GY ECOLOGY: If ot ow, When? A D Myron Gordon, M.D. Class of 1948 Albany, ew York Few invitations have pleased me as much as that which I received from your President, Dr. John Bartels, asking me to address this Socie­ ty. As an Alumnus of the Medical School and as a colleague and friend to many of you, I was particularly delighted by this opportunity to participate in this annual tradition which honors the founder of our Medical School and University. In searching for a subject for tonight's presentation several considerations came to mind. I could take the easy path of reminscences - about my arrival in Buffalo on December 29, 1944 during that winter of constant cold and snow, of ew Year's Eve at the U.S.O. at the Hotel Genesee; of my first classes at the High Street Medical School; of that freshman class of ASTP's, V-12's, civilians - and 6 women; of our first in­ troductions to the "magnificent" Juniors and Seniors - first to be admired, then to be emulated, and finally to be consulted as ad­ visors and friends; of our first encounter with house staff; of the first stethoscope - carried so carelessly in the back pants pocket so that the jacket might catch on it, exposing for all to see this symbol of a doctor; of our Professors, O.P. Jones, Jumphries, Edwards, Griffith and Youngbird, the incomparable Samuel Sanes, Harry Laforge, Edward Winkler, and that true gentle person, Clyde Randall. Discarding the sentimental. I might have reviewed the !ife of that young man from Austerlitz, New York who, at the age of 35 and with a few other stalwarts, founded the Medical School from which the University of Buffalo gestated, and for whom this lecture was nam­ ed. Prom the Department of Obstetrics and Gynecology, Albany Medical College. Presented by invitation as the James Platt White, M.D. Lecture al the Buf­ folo Gynecologic and Obstetric Sacie­ ly, Buffalo, ew York, April 15, 1980. 16 In deference to those who accompany the members here tonight and hoping that I might prevent the development of the glassy-eyed stare that comes over those who "have ears but they hear not" 1 , I also rejected a purely scientific subject from my Department files. Again, I might have selected the easy path of a travelogue about my recent trip to the People's Republic of China, but I was con­ cerned that the instant experts are becoming so numerous as to leave no organization unin­ formed on the quantity and quality of medical care in China. On a more positive note, after con­ siderable deliberation, I chose to speak to you on the subject of bioethics in our discipline for several reasons: Firstly, as I reviewed the life of Professor James Platt White,2 I was struck by his own concern for the ethical aspects of teaching and practicing medicine, and by the high ethical esteem in which he was held by his colleagues and contemporaries. Secondly, medicine in general, and Obstetrics and Gynecology in particular is un­ dergoing rapid transformations in its practice and, more importantly, in the individual and collective goals of its practitioners. Whenever such transition occurs, ethical issues tend to surface, become prominent, and force a re­ examination of values and goals. Lastly, at the time of my graduation from medical school in 1948 my ethical awareness was only momentarily awakened by the Hip­ pocratic Oath which was administered to us. During my years of training, ethics largely referred to abortion, to my relationships to other physicians, and lo admonitions that I treat patients and nurses courteously. When I became a practicing physician and applied to professional societies for membership to be ethical seemed to revolve around not splitting fees. The code of ethics of the A.M.A. was rapidly filed under "A". It has only been dur­ ing the past decade in which bioethics has been receiving increasing recognition within medical education as a discipline with its own curriculum. research and accolytes (professors), that my own sensitivity to bioethical issues in Obstetrics and Gynecology has been sufficiently raised to bring me to choose this as the subject of this presentation. In 1974, at one of my last A.C.O.G. Ex­ ecutive Board meetings as District II ChairTHE BUFF ALO PHYSICIA �man, I proposed a clinical-ethical problem to the Board. The President's response was to form a Committee on Bioethics, and to ap­ point me as its Chairman. I was certain that I did not have the background, education, knowledge, or the temperment for the Com­ mittee's work, and I was even more certain that I was about to develop an acute case of "foot-in-mouth" disease. Five years later, I was surprised that I may have learned something about the subject and that the Com­ mittee may have even made some con­ tributions to the College and to the Specialty. I am not a bioethicist or bioethician, nor have I ever had formal classroom ethical education. I do not speak "Ethic," and I probably would not recognize a deontologist or a consequentialist if I stumbled over one. I am, like many of you, involved in bioethical considerations in my daily clinical endeavors without being conscious of it. Bioethics deals with the concepts of morality, moral problems and judgements as related to the health sciences. It raises the question as to what is right or what ought to be done in situations which call for a moral deci­ sion. There are no automatic systems or Professor White fomulas for arriving at ethical answers or to make one moral, or to punish one if not moral. Bioethics does not campaign for a particular life style or value. As pointed out by Dr. Edmund Pellegrino,' the current revival of bioethics is rooted in several recent phenomena of great social im­ portance: (1) The multiplicity, growth and complexity of new medicomoral problems, (2) The emergence of moral pluralism, (3) The increasing demand by patients for greater participation in decision-making and to be acting as their own moral agents. To these I would add a fourth of particular im­ portance to our specialty, the growing emphasis on equal human rights, i.e., women's rights. Examination and application of the bioethical aspects of Obstetrics and Gynecology cannot be assigned by us, the practitioners, to a selected "clergy," the ethicians, who will teach, discuss, research and write on these problems as though in some ways to act as surrogates for us. Churchill has pointed out that Medicine is a powerful culture with a tradition that con­ stitutes the nature and substance of the profession. It is transmitted to each new generation of physicians as learned standards of conduct, parameters of moral choices, and reorientation of value systems. At the center of this culture is the "cultic activity", the en­ counter with patients The ethics of medicine, i.e., it's moral and aesthetic tone, character and quality, revolves around this clinical en­ counter.• Pellegrino has designated this as the meeting place of "ethics and the moment of clinical truth" - the link to the "act of clinical decision." Bioethics, like most other under­ takings in which we involve ourselves must have relevance to the major theme of our work, the physician-patient relationship. Thus, the clinician must be directly involved in the examination and exposition of this in­ terface between ethics and clinical medicine.• The theme of my presentation tonight is that our profession, Obstetrics and Gynecology, is in its essential nature more deeply rooted in bioethics than other specialties. Consequently, many of the issues and problems which we are encountering in practice, in dientity, and in professional in­ teractions have significant bioethical com- FALL, 1982 17 d- �ponents which arise from this special relationship. It then follows that the answers and solutions to these issues and problems will have to be sought as much within the dis­ cipline itself as in the outside forces which we perceive as playing determinant or adversary roles in our professional lives. This special ethical nature of Obstetrics and Gynecology which I have emphasized was identified by the Committee on Bioethics as due to the specialty's involvement in three particularly sensitive areas which impact on both the individual and society: (1) the ability to procreate (or not to procreate). (2) sexual function, and (3) sexual identity. In addition, I would suggest a fourth area of special con­ cern, (4) the family relationship. Thus, for each area of bioethical concern which applies to the general field of medicine, additional considerations must be given to their specific application in Obstetrics and Gynecology. To clarify this thesis a bit, I would like to review a few of the issues upon which the Committee on Bioethics deliberated during my tenure as Chairman. The Committee was established by the Executive Board of the American College of Obstetricians and Gynecologists in June, 1974 "to identify, evaluate, and make recommendations re­ garding ethical issues which affect the specialty of Obstetrics and Gynecology." At its first meeting the Committee developed a list of subjects which could be considered of ethical concern to the specialty (Table 1). It is readily apparent that these subjects relate to various aspects of clinical practice, research, patient-physician relationship, public image, and even malpractice. Because of their relative importance three of the first issues taken under consideration were perinatal research, induced abortion, and sterilization. The membership of the original committee was nicely balanced between clinicians, academicians and researchers, and this balance has been maintained as replacements have occurred. In addition to an excellent staff, the committee was provided with the services of two consultant bioethicians, the late Dr. Andre E. Hellegers of the Kennedy Institute of Ethics and Dr. Jack Provansha of Loma University School of Medicine who provided the essential elements of expertise in clinical and classroom bioethics needed to make the Committee's work coherent and ethically consistent. 18 On Perinatal research,• the Committee reaffirmed the College's commitment to biomedical research as essential to its con­ tinuing concern for the mother and fetus. It recognized that the Obstetrician-Gynecologist in daily practice has always accepted the dual responsibility presented by the pregnant woman and her fetus, and therefore, the com­ peting concerns which may be present in research and medical care do not diminish the physician's responsibilities in making ap­ propriate clinical decisions. It also noted that research on the in-utero fetus should not harm the fetus, and, in particular, not make the decision to abort irrevocable. In developing two statements on induced abortion/, the Committee emphasized several cogent points for physicians to con­ sider. It emphasized the importance of the physician's traditional role as a counselor, and that he or she guards against acting only as a technician. In this vein, that statement also pointed out the common ethical issues of abortion with other surgical-medical procedures, i.e., the need for informed con­ sent, competence to do the procedure, ap­ propriate charges, etc. The Committee then went on to point out the differences from other surgical procedures, in particular, the nature and value of the fetus, and that, even if in the judgment of the physician abortion is indicated, it should not be considered as a trivial matter. In both of the final statements, special emphasis was placed on the concept that by inducing abortion as the resolution to the competing welfare interests of the women and her fetus, the physician does not necessarily have an adversary relationship to the fetus, and that destruction of the fetus is not the primary purpose of the abortion. In the statement on Ethical Considerations in Sterilization,• the Committee recognized that the usually elective nature of the procedure presents the possibility for later regrets and that because of its relationship to procreation, sterilization of the individual may affect the common good, i.e., society. As the Committee noted in its statements on abortion, certain general principles apply to sterilization as to other aspects of medical practice including that the physician assist the patient in her right to seek or refuse health care, that the physician act primarily with the patient's good in mind, and that the physician not become merely the agent of patients or THE BUFF ALO PHYSICIA �------- others especially in matters involving medical judgment and personal conscience. As in all surgical procedures, the physician should determine that sterilization is appropriate, that there are not contraindications, that the procedure selected is the best for the patient and that the physician is competent to perform it. The statement also affirms the importance of proper counseling to truly informed consent and it reaffirms the unethical nature of linking sterilization to the withholding of medical care. It finally points out both the ethical and medical problems raised by age and time restrictions which are now a part of governmental regulations and law. The development of this last statement il­ lustrates in a personal way some of the points I have been trying to make. In the early 1970's I actively opposed the development of regulations for sterilization within the municipal hospital system. I must say that I played a truly adversary role to the individuals and groups who were the ad­ vocates of stringent regulations for steriliza­ tion. Eventually these were also embodied in a City ordinance and in good part, into Federal regulation. As I look back now from the vantage point of my experience in developing the College's ethical policy, I believe that there was a need for guidelines FALL, 1982 - ------------~------ - and even some regulation, and that the earlier publication of such a statement of ethical principles as was eventually developed by our professional organization might have defused or certainly modified some of the more stringent aspects of the present regulations. We find ourselves today as professionals frequently at odds with the health care concepts championed by signifi­ cant groups of our constituents (women). Possibly our own examination of both the ethical and scientific aspects of these areas of concern might provide more agreement rather than controversy between us. ot everything that the Connittee con­ sidered was so important or, in modern terms, "so heavy." For instance, we responded to a request for an opinion on contraceptive advertising on television by stating that while not specifically an ethical issue, adver­ tisements should not be viewed as replacing sex education and that the audience's freedom of choice might be abridged by an unexpected encounter with objectionable advertising. Parenthetically and off the record, the Committee noted that an en­ vironmentalist television viewer might find detergent commercials obscene!! For those of you who have the good fortune to work with, to read, or to listen to the late Andre Hellegers, you knew as we did, the sharpness and impishness of his wit and the clarity and fairness of his intellect. This last statement on ethical principles governing the administration of drugs was devised in response to letters of inquiry from Fellows concerned about the issue of laetrile and their ethical responsibility to patients who want the physician to prescribe it. While most of the Committee was engaged in discussion and anecdotes about quackery and the rights of the physician, Andre quietly composed the following which the Committee immediately adopted almost without change. Like Andre, it was precise, balanced and witty with just a touch of humor. 1. Physicians shall not be obligated to ad­ minister a drug which is unproven as to safety or effectiveness, even if the patient wants it. 2. Physicians shall not be obligated to withhold a drug which has been deter­ mined to be safe and effective, if the physi­ cian wishes to administer it and the patient to take it. 19 d- �3. Physicians shall not be obligated to ad­ minister or to withhold a drug which has been determined to be safe but ineffective if given for placebo effect. 4. Placebos should be used with great cir­ cumspection, since they may undermine patient-physician relationships, both in the particular and in the aggregate, by lessen­ ing trust. The Committee is aware of the fact that the determination of whether a drug is in fact safe and effective is the appropriate subject for scientific inquiry and regulation. These are matters of science and of law and are in­ dependent of the above guidelines which are purely matters of ethics."• During the five years of my tenure, the Committee considered a number of subjects (Table II). The results of these deliberations have been adopted as College policy, served as the basis for answers to queries by Fellows or other organizations, or, have been referred to other interested groups within the College for incorporation in their own work. We are the principal physician to women, yet it is women's groups who are frequently our severest critics. It is they who are trying on their new-found self-awareness, and flex­ ing muscles of influence and power. They are concerned about applied medical technology, physician-patient relationships, sexual identi­ ty and function, and their own human rights. Legislatures and regulatory agencies have taken the bit in their teeth and are running away with health care issues - sterilization, funding of abortion, requiring drug informa­ tion, fee limits and so on. We offer advice and, frequently, it is ignored, denigrated, or dis­ torted. When we read or hear of new regulations or laws, our responses run the course of anger, frustration, rejection, and finally resignation. One does not have to recite the litany of abuses which we perceive as having been directed at us by an ever in­ creasing population of lawyers and administrator-bureaucrat types. One only has to mention such terms as informed consent, malpractice, wrongful birth, FDA and Federal regulation, to excite an autonomic "battle" reaction in any group of Obstetricians­ Gynecologists. I fear, however, that these "battles" will never be won for us in either the legislature (lawyer controlled) or governmental agency (bureaucrat controlled). 20 I believe that it is with the public itself, our constituency, our patients with whom we must increase communication, erase mis­ understanding, restructure our image and demonstrate our own initiative in dealing with their concerns. I submit that the explora­ tion and development of the bioethical aspects of many of these issues off er us a readily available mechanism to increase this communication, and because these and similar issues are an integral part of many of the problems which we face as a profession, provide us with useful approaches to their solution. Well, where have I led tonight? I hope not as a prophet of doom, suggesting the need to repent, or that maybe it is already too late. I do not mean that we Obstetrician­ Gynecologists have been chosen for any special trial, nor have we been selected to lead any new charge against the entrenched guns of the enemy. I do think that we are aware of the ethical concerns in the practice of medicine, perhaps better than most, having been involved in a specialty in which com­ peting concerns abound and having had a long history of self-examination and inquiry. We should develop and strengthen our own bioethical muscles, recognize areas of con­ cern early, and develop the ethical concepts associated with new treatment modalities, and particularly, new technology, at the same time as we develop the scientific protocols and operating standards concerning their use. When we have done so, we should make the public and our patients aware of these ethical concerns and conclusions. Because we need the discipline of classroom ethics to assist in our examination of clinical bioethics, I might suggest the recruitment of a departmental bioethicist, perhaps shared with the Department of Pediatrics, as we do perinatologists and neonatologists. This "house ethicist" might even be a graduate student, since "board cer­ tified" bioethicists may be in short supply, who would participate in regular clinical con­ ferences, teach students and house officers and carry out research projects. Further along the bioethicist might initiate "Clinicoethical" rounds with the students, house staff and in­ terested attendings. Certainly there is an abundance of "case material" on our services for such rounds and conferences. THE BUFF ALO PHYSICIAN �Several other suggestions come to mind, but I think that I have made my point and would do better to avoid the boredom of overstatement of a case. Since it is always helpful when trying to make a point to draw upon, the precedence of authority and tradition, I draw your attention to the Charge to the Graduating Class delivered by Professor James P. White, M.D. on February 26th, 1867 at the commencement in the Medical Department of the University of Buffalo. 10 In the eloquent and formal manner of that day, he emphasized many aspects of the ethical relationships of the physician to his patients, his community and to his colleagues. He exhorted these new graduates to learn about their place of prac­ tice and its people, to teach prevention, to not become political partisans, to continue their professional education, and to constantly im­ prove the mind as a superior means of serving mankind. He made a special plea for the new physician not to depricate other practitioners, to meet together often (as you do tonight), and to lessen the groundless censure of the com­ munity by gradually "enlightening the public mind with medical matters." T t TUI I:\ l'f:111 "• I\ \I~ " l' \\ IIITI. ll (1 r Cover page of Monograph Dr. White then spoke of the University of Buffalo and its founding, and encouraged their support in the future. He concluded this marvelous exhortation to exemplary behavior and practice by warning that it will not be a life which includes rest on the Sabbath, leisure time or nights of uninterrupted sleep, but that "if pursued with right motives and religious trust as your last and greatest reward, a fadeless inheritance." For my own conclusion, I cannot promise a similar reward for your kind attention tonight, but can instead only complete the aphorism from which I drew the title of this presenta­ tion. IF I AM OT MYSELF, WHO WILL BE FOR ME? IF I AM FOR MYSELF O LY, WHAT AM I? IF OT OW, - WHE ? FALL, 1982 Professor Jomes Plott White's Charge to the Graduating Closs, February 26, 1867. 1. First location, the only one 2. Learn about your home and its people. 3. Teach prevention as well as cure. 4. Do not become political partisans. 5. Continue education. 6. Progressive but not o faddist. 7. Ethical relationships. 8. Meet together often. 9. Inform public on medico/ molters. 10. Charge well for services, but fairly. 11. Have concern for Alma Mater. 21 d- �TE SIO S OR ETHICAL DILEMMAS FOR OBSTETRICI /GY ECOLOGISTS ETHICAL CO CERNS TABLE I: Ethical Concerns to the Obstetrician-Gynecologists Induced Abortion Malpractice Contraceptive (Teens) Sterilization Adoption Artificial Insemination Genetic Counseling Out-of-Hospital Delivery Shored Responsibility Hysterectomy Feta/ Monitoring Cesarean Section Patient Relationships Resident Participation Venereal Disease Hormone Treatment Informed Consent Research TABLE II: Ethical Problems Considered by the Committee on Bioethics 1. Ethical Considerations in Fetal Research 2. Some Ethical Considerations in Abortion 3. Further Ethical Considerations in Induced Abortion 4. Ethical Considerations in Sterilization 5. Ethical Aspects of Informed Consent 6. Broadcast 1. ABORT/0 2. GO TRACEPTIO 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Advertising of Contraceptives 7. Administration of Laetrile 8. Sterilization as o Prerequisite to Obstetrical Care 9. Support of Bioethico/ Research on Amniocentesis 10. Adoption -ADOLESGE T T U EXPECTED COMPLICATIO S a. Hemorrhage-Pregnancy, O.R. b. Patient in shock c. Convulsing patient d. Post-op death e. eonatal death DYi G PATIE T I FORM/ G PATIE TS - CA GER. AB ORMAL FETUS/I FA T ADOPT/O I FERTILITY - U SUCCESSFUL TREATME T I FORMED CO SE T STERILIZAT/O - FAILURE PRE ATAL, GE ETIG, HEALTH GOU SELING SEDUCTIVE PATIE T OBSTETRICAL COMPLIGATIO S - C. SECTIO DEGISIO PROBLEMS OF EO ATE APPLIGATIO OF TECH OLOGY COMPETIT/O - MIDWIFE, FAMILY PHYSIC/A URSE F. Vann. M.D. Personal Comm. 3. HIGH RISK OBS PATIE 14. 15. 16. ETHICAL CO SIDERATIONS I STERILIZATIO REGOG IZES ELECTIVE ATURE A D IMPORTA CE ACT PRIMARILY FOR PATIE T'S GOOD PHYS/CIA OT MERELY AGE T CO SIDERATIO SAS I ALL SURGERY GOU SELING - LI KAGE - I FORMED CO SE T AGE A D TIME RESTRICT/O SMAY BE U ETHICAL A D MED/CALLY U WISE REFERE CES • Psalm 115 Verses 5 and 6: The Holy Bible, King James Version. 1 /avert, C.T.: Jomes Platt White, A Pioneer in American Obstetrics and Gynecology, fr. Hist. Med., 489, Autumn 1948. 1 Pellegrino. E.D.: Ethics and the Moment of Clinical Truth, /.A.M.A. Editorial 239: 960, 1978. 'Churchill, L.B.: The Ethicist in Professional Education, Hastings Center Report; 9:13, December 1978. 'Ethical Consideration in Perinatal Research; Statement of Policy, American College af Obstetricians ond Gynecologists, May 1975. • Some Ethical Considerations In Abortion; Statement of Policy, American College of Obstetricians and Gynecologists, October 1975. 'Further Ethical Consideration In Induced Abortion: Statement of Policy, American College of Obstetricians and Gynecologists, December 1977. • Ethical Considerations in Sterilization; Statement of Policy, American College of Obstetricians and Gynecologists, 1979. • Minutes, Committee on Bioethics; American College of Obstetricians and Gynecologists, March 13-14, 1978. ,. Charge to the Graduating Closs. Professor James P. White, M.D .. Pub/: Joseph Warren and Co., Printers. Buffalo, Y: Delivered at the Commencement in the Medical Department of the University of Buffalo, February 26, 1867. 22 ETHICAL CO SIDERATIO S RESEARCH IN PERI ATAL REAFFIRMED CO TINUI G CO GER FOR BOTH MOTHERS A D FETUS SHOULD BE ETHICAL PROBLEMS OF ABORTIO SEPARATE HUMA EXPERIME TATIO IS ESSE TIAL PERSO AL ETHICS PARAMOU T RESPO SIBILITY OR SE SITIVITY FOR APPROPRIATE CL/ ICAL MA AGEME T RESEARCH I VOLVI GI -UTERO FETUS PROLO GING OR SHORTE I G LIFE OF PREVIABLE FETUS ETHICAL CONSIDERATIO I INDUCED ABORTIO PHYSIC/A 'S TRADIT/O AL ROLE LAW A D ETHICS ETHICAL ISSUES COMMO TO ALL SURGICAL A D MEDICAL PROCEDURES SPECIAL ETHIC PROBLEMS -Special nature and value of the fetus -Danger of disvaluing fetal life -Maintain sensitivity to larger human values COU SELING JS ETHICAL RESPO SIBILITY PHYSIC/A SHOULD OT ACT SOLELY AS TECH IGIA THE BUFF ALO PHYSICIA �Two Alumni Honored Two alumni, Drs. Jack Lippes, M'47, and Albert Rekate, M'40, were honored along with three others at the 43rd annual U/B Alumni Association Installation and Awards Banquet in June. Dr. Rekate was the 1982 winner of the Samuel P. Capen Alum­ ni Award, given for exceptional service to the University, its students, staff and alumni. The professor of medicine is a teacher­ administrator at the Medical School. His students, past and pre­ sent, constantly articulate the positive effect he has had on their careers. Dr. Lippes, professor of Gyn/Ob, was one of three to receive the Distinguished Alumni Award. He invented an intrauterine contraceptive used world-wide and consultant to world governments of emerging nations. He is author of numerous ar­ ticles on reproductive physiology, birth control, obstetrics and gynecology. Dr. Lippes is a consultant to The Population Council of Rockefeller University, past medical director of Planned Parenthood of Buffalo and past president of the ational Associa­ tion of Planned Parenthood Physicians, among several memberships. Dr. Rekate is semi-retired and splits his time between South Carolina and Buffalo, Dr. Rekate teaches in the rehabilitation summer student program for freshmen medical students. He al o teaches residents in the physical medicine and rehabilitation program. He has held numerous academic appointments, in­ cluding chairman of the medical admissions committee, associate dean of the school of Health Related Professions, and acting chairman of the department of rehabilitation medicine. In the community he serves on the board of directors of Buf­ falo Hearing and Speech Center and continues to lend his exper­ tise to medical organizations in South Carolina. He has held numerous positions at E.J. Meyer Memorial Hospital, including director; is a Fellow of the National Research Council and Diplomate, American Board of Internal Medicine. Dr. Rekate is also a generous benefactor of the U/B School of Medicine. Other recipients of Distinguished Alumni Awards were: Herald Price Fahringer, prominent attorney and defender in First Amendment trials; and Judge Mary Ann Killeen, supervising Judge of Erie County Family Court and civic servant. The George W. Thorn Award for commendable career/civic accomplishments by a young graduate was given to Orrin D. Tobbe, whose rapid succession of promotions in banking currently finds him a senior vice president of Marine Midland Bank. □ FALL, 1982 23 Dr. Lippes Dr. Rekate �Halloween Party Costumes and make-up made identification im­ possible at the first an­ nual student/faculty halloween party. □ Pholos b1· Amy Schueckler and \fork Sloon 24 THE BUFF ALO PHYS I CIA �FALL, 1982 �discussed the problems of physicians under 40 and over 40. Those who turn to drugs and Stress Conference Dr. Bissell "We must learn to laugh and live with stress." This was the theme of Dean aughton's opening welcome and remarks at the Stress and the Physician Conference attended by some 150 physicians and their wives. "I have more than a passing interest in this subject because just recently I put together a chapter on stress and heart disease. The Medical School is very interesting too because we are living in an era of drug and alcohol abuse. We must be understanding of these problems and salvage people and make them productive," Dean aughton said. He noted that we have developed a psy­ chology that stress is bad. "This is wrong. Stress is good for us. We must have the ability to cope and respond to it. Our inability to deal with stress is the major underlying problem." Dean aughton also discussed briefl the behavioral patterns of different personalities. "People who are more hostile and aggressive are more susceptible to heart disease," he said. The conference was co-sponsored by the Erie County Medical Society, Medical Alumni Association and the Continuing Medical Education office. The main speaker, Dr. Merville Vincent gave an overview of physicians who don't know how to handle stress. "It often begins in medical school, continues on through in­ ternship and residency. Once the physician gets into practice he becomes more busy, has longer hours and less time for family life. He wants power and money and feels indispensi­ ble. Fatigue/exhaustion takes over and he looks for an escape. "At this point the young physician must step back, look at himself and get off the treadmill. If he doesn't he often turns to booze, drugs and another woman. They won't admit they have a problem; often they treat themselves and this is double trouble. The next step could be suicide," Dr. Vincent said. The medical director of Homewood Sanitarium, Guelph, Ontario noted that pride keeps many physicians from seeking help. He 26 alcohol are certain they can quit anytime, but usually they can't. The Homewood Sanitarium admitted 93 physicians as in­ patients from 1960-67 and 280 since 1967 for drug/alcohol problems. Dr. Vincent noted that considerable progress has been made in treating the stress problem since 1975. There has been earlier recognition of the problem; steps have been taken to prevent it; there has been improved treatment plus a positive program of rehabilitation. "We must deal with the problem rather than ignore it," Dr. Vincent said. The Cana­ dian Medical Association and the Department of ental Health (USA) have had con­ ferences on stress. Almost every state has a special committee dealing with the problems and there is a growing interest in medical schools to deal with the problem. Dr. Ross Markello discussed the physi­ cian's career, life cycles and career changes. The U/B anesthesiology professor outlined four stages of the physician:s <;:areer: 1. The physician is setting up his practice (age 20-45); establishing professional identity and relationships; becoming known in the community as a capable, responsible physi­ cian. 2. id-career crisis (45-55); he reassesses his progress relative to his life-long am­ bitions; he may decide to level off or shift career emphasis. 3. Decline and disengagement (55-65); he learns to accept reduced levels of power and responsibility; may have new sources of satisfaction (family, hobbies). 4. Bowing out (65 and over); adjusting to drastic changes in life style; using experience on behalf of others; writing and working with professional organizations. Dr. arkellG noted that surveys show that 90 percent of physicians like medicine and are pleased with their choice of a profession. He talked about "dual career couples" and predicted that within 10 or 20 years there will be more women (60%] than men in medical school. In discussing the physician's life cycle Dr. Markello noted the changing home respon­ sibilities of parenthood and the adjustments necessary in dealing with the adolescent. THE BUFF ALO PHYS ICIA �"Suddenly the children are off to college and this is another adjustment problem. And when the physician becomes a grand-parent that could be a problem in dealing and un­ derstanding the younger generation." The physician-educator noted that burnout could come at any age, but it is more likely in mid-life. He suggested two good books on career changes: "Pathfinders", and "Shifting Gears." "Physicians are reluctant to consult psy­ chiatrists and growing old gracefully is very difficult for most physicians," Dr. Markello concluded. The president of the American Medical Society on Alcoholism discussed the legal im­ plications in dealing with problem physicians. Dr. LeClaire Bissell noted the impaired physi­ cian may have an alcohol or drug problem, may be senile or have some other illness, may be ignorant because of poor training; may not be reading or attending continuing education courses. "Many of us don't know how to approach and talk to an alcoholic or drug addict. This is not a game for amateurs," Dr. Bis~ell said. She discussed the different state rules that deal with the impaired physician, and noted that there were many excellent films and books available on the subject. Dr. Bissell listed four dangers in dealing with the impaired physician: libelous slander; tortureous interference with his practice; malicious prosecution and con­ spiracy. "Often when a physician is impaired it takes years for medical committees or the courts to stop him from practice. It is impor­ tant that the physician get appropriate and ex­ cellent treatment for his problem," Dr. Bissell concluded. In his luncheon address, attended by many wives, Dr. Vincent talked about marital problems. 1. Time wives become depressed because there isn't enough time together. This started in medical school, continued through residency and setting up practice; 2. Communication requires time; often the physician's professional role is carried over into the home; 3. Anger is built up during the day by both parties and of ten it all spills out at home; 4. Wive's expectation from husband, who is of ten too busy to take on home/family responsi bi Iiti es; 5. Mis-use of money. Often physicians over-spend, over-borrow and make poor in­ vestments. His worst enemy is his borrowing power. When budgeting is successful, it is the woman who does it; 6. The closeness to women patients often gives the wife reasons to be jealous. As a solution Dr. Vincent said, "talk things out together. Line up your family goals and priorities together and stick to them. Time together is crucial." In conclusion Dr. Vincent said, "sexual problems don't come from lack of education. The mind is the most important sex organ." □ /photo b) Jomes £. Kell}-/ 1982 Alumni Tours October 8 - 17 GREECE complete - Buffalo - $1299 complete - JFK- $1149 Departures from many other cities Features: Eight nights Royal Olympic Hotel (center of Athens); continental breakfasts, seven dinners; full day three-island cruise in­ cluding lunch. October 8 - 18 GREEK CRUISE OPTIO complete - Buffalo - $1599 complete - JFK - $1449 Six nights Royal Olympic Hotel; continental breakfasts, five dinners; 3 days/3 nights deluxe cruise of Greek Islands including all meals. For more information, contact Bill Dock, U/B Alumni As~ociation, Center for Tomorrow, Buffalo, ew York 14260. HAWAII (Oahu, Maui, Kauai) 12 days, 11 nights, October 12 and ovember 2 departures. $1195 from ew York; other cities less. Call 1-800-225-3060 for details. FALL, 1982 27 Dr. Vincent �from lower left: Jo Brody, Joe Failla, Charle Andrews: students/friends; The Brody's, .\fichoel Sellman; Charles icholos, Marcia McAvor, William Penhallurick; Dr. and ,\frs. Martin Wingate, Dr. Donald Lorson. □ Clockwise Medical Alumni Association Hosts 9th Annual Reception for Seniors Approximately 250 students, faculty, alumni and their spouses attended the annual cocktail-reception for seniors at the Albright-Knox. □ 28 THE BUFF ALO PHYS ICIA �J Clockwise from lower left: Two guests; Jerry Sufferin, President Sreven Som pie; Deon oughlon, Or. Robert Schultz; Charles icholson ond friend; The Stern Pollocks, Kevin Vorlog; Peter Sofio and friend: Wendy Kloez, Joseph Woyne: Dr. and Mrs. Felix filgrom; Arlene Curry and friend: David Levine, Patricia Guilts. □ FALL, 1982 29 �The Progressand Development of the Buffalo Medical School Library,1846-1981 By: F.X. Roberts Graduate Student Department of Higher Education History, like life, must be continuous or die; character and institutions may be altered but slowly; a serious interruption of their development throws them into national amnesia ... Will Durant - The _Story of Civilization Dr. Joseph Warren, in his address to the Medical School graduating class in 1874, men­ tions the venue of the School's first lectures given in the period 1847-1849, that is, in rooms over the old post office at the corner of Washington and Seneca Streets in downtown Buffalo. At this same location was housed the Medical College Library described in the October, 1846 Annual Circular as: (consisting of over 500 volumes including all the late and standard works upon every department of medicine and surgery, with the collateral sciences." The development of this core collection was taken in hand by Dr. James P. White, ear­ ly in 1847, when he was appointed, at a meeting of the faculty, as a committee of one for fitting up the library. Or. White continued lo direct the development of the Library in the Medical School's second home on Virginia Street, where it moved in 1849, until his death in 1881. Among the many efforts made by Or. White to expand the collection was the arrangement for a standing order for the publication of the Smithsonian Institute. But, even taking into consideration the intervening Civil War, no rapid growth in bound volumes appears to have occurred for a period of three decades. But by 1884 it is being recorded in 30 the Annual Announcement of the Medical School that the college library has on its shelves some 1,500 bound volumes. At the same time, however, numerous pamphlets were being added, as well as files of the leading medical journals. Spending a fairly large percentage of available funds on jour­ nals, as distinct from books and other materials, is not an unfamiliar phenomenon in libraries with a scientific orientation, which may be part of the explanation for the slow growth in the book collection during this period. It is perhaps not surprising, in a period when students were being reprimanded for bringing cadavers into the School in order to develop their knowledge of anatomy [Faculty meeting of April 24, 1847: "Resolved that no medical student shall be allowed to bring to the Institution a subject for the purposes of dissection, and if any student shall be guilty of doing so it shall be deemed adequate cause for expulsion."), that the faculty were called upon to subscribe the sum of 1,050 each to, among other things, support the development of the Library. Also, it is understandable, in a time when little or no education in the field of librarianship was extant, that the first person to be designated "librarian" was the Demonstrator of Anatomy, Mr. Corydon Laford, whose library work was merely add­ ed on to his other duties with no increase in salary. The Library at this time also seems to be undergoing some of those feelings of isolation and loneliness felt by libraries in educational settings where most of the teaching is done through the textbook method. This was true of the teaching at Buffalo Medical School during the period of the last decade of the 19th cen­ tury, where fairly extensive lists of textbooks were printed in each of the School's annual catalogs. Students were expected to own copies of most, if not of all, of these textbooks. THE BUFF ALO PHYSICIA �They were expressly forbidden to borrow a library copy for class use! At any rate, the information in the annual catalogs of the Medical School for this period sounds plaintive enough: "The regular college librarian is in daily attendance from 2-10 p.m., and students are not only permitted but urged to make free use of the facilities offered." Part of this apparent lack of use might be attributed to the restrictions on opening hours. But by the last decade of the century the hours were changed to 9 a.m. - 6 p.m., and the plea for students to make use of the Library disappears from the information an­ nouncements during this period. What has been added, however, gives a better insight into the direction that the development of the Library was then taking. It is pointed out, for example, that all the latest textbooks are available, as well as books of reference. The fact that foreign medical journals are available is specifically stated, as is the fact that the collection is now carefully cataloged. At the turn of the century this more replete and orderly-sounding library reported a bound book collection of some 7,000 volumes. Part of this growth was owing to the gift to the libraries of two deceas­ ed members of the faculty, Dr. Julius F. Miner, and Dr. George . Burwell. To the gift of the library of Dr. Burwell was attached the sum of $2,500 to be placed in a trust fund for the maintenance of the Burwell Collection and/or use by the Medical Library for other purposes deemed appropriate by the faculty. It was in 1893, when much of this real growth in the Library began, that the Medical School moved to a new three-story building on High Street, close to the Buffalo General Hospital. This location was to be its home un­ til 1953. Much of what to today's ear sounds like the language of hyperbole was used to describe this new building: "This is the hand­ somest and best adapted building for all the medical sciences in the United States." And it was also called "the most tasteful, comfort­ able and best arranged medical college edifice in the United States; perhaps even the world." The Medical Library also got its share. The "magnificent college library," it was called; and if it could not quite measure up in terms of service provided (e.g. the new card catalog was still in preparation), it was, FALL, 1982 •✓ / - ~ _--- - ..... ---. ./ , ~ _-~-· . I .. -;- -:~-=-T" ---- =-:-..:::--=. The Library was on the top floor of this building. in physical appearance, very appealing to judge by the full-page artist's impression of it in the 1893 Annual Announcement and from the photographs of it in the History of Medicine Library collection. These show a large salubrious-looking, well-lighted room (at first with gas fixtures, but later, in the early part of the new century, with electric lights). Off this space were alcoves with book presses. A large rec­ tangular, heavy oak table filled with center space. The ornate, Victorian-style woodwork was also of oak. The alcoves contained round, oak reading tables. Above the alcoves a balcony surrounded the room at a height of about ten feet where there were more wall shelves for books, and some free-standing book bays. The outer edge of the balcony was enclosed by an ornate balustrade. Comfortable-looking window seats were also provided, in addition to the seating at the various reading tables on the main floor and 31 d- �on the balcony. At the opening of the High Street building in 1893, Dr. Charles Cary, in his address, included the following informa­ tion on the Library: "The library rooms are fireproof, and contain our present library of about 4,000 volumes and 5,000 unbound pamphlets. They are capable of holding about 40,000 volumes." After the death of Dr. White, Dr. Matthew Mann took over as head of the Library Com­ mittee. During these early years decisions affecting the Medical Library were made by vote of the faculty with the advice of the Library Committee. The "librarian" (so­ called) was regarded as a clerical assistant retained to carry out the directives of the Committee or its Chairman. After the first person iven the title of "librarian" (Mr. Corydon Laford] left in 1852 there is no record of the position having been filled until 1889 when a Ms. Sarah P. Sheldon was hired. She stayed until 1894. At about this time. under the direction of Dr. Mann, and with the help of the superintendent of the Buffalo Library, who sent a trained assistant to the college to help Ms. Sheldon, the first card catalog of the collection was prepared. And it was during this period, in the middle of the last decade of the 19th century, that the services and ac­ tivities of the Library began to expand into relationships beyond the confines of the Medical School itself. By 1894 Dr. Mann was able to report that the cataloging project was nearly complete, and when finished it would provide a com­ plete index of the collection that would be at the disposal of anyone in the medical prof es­ sion who cared to make use of it. The Library Committee urged that ties with the library of the Sur eon-General's Office in Washington, D.C. be strengthened, especially in the matter of further subscription support for Dr. John Shaw Billings' very useful Index Medicus. This action was in part prompted by cor­ respondence with Dr. Billings, but also 32 because the Library Committee recognized how useful access to a larger, more extensive medical library collection would be for the School's needs. An early example of in­ terlibrary loan is cited in October, 1894, when it was noted by the Committee that: "The librarian was authorized to draw books from the Surgeon-General's library at Washington under the rules laid down by that library." The Medical Library's collection con­ tinued to grow even to the point that in 1895 it engaged in a cooperative program to ex­ change duplicate books and journal files with other libraries. It was also in 1895 that the Library was registered. by the ew York Board of Regents, as the edical Department Library of the University of the State of ew York. From the outset, however, problems with appropria lions from external bodies seem to have been part of life, as a report from the Library Committee in December of 1895 indicates. This report shows, too, that, in terms of the currency of the time, the Library was increasing its operating budget: "Dr. Mann reported that the college library was now placed on the Regents list, but that owing to some misunderstanding it had only receiv­ ed $100 from the Regents' Appropriation, and he urged the necessity of making ap­ propriations in definite sums for the college library at the beginning of the fiscal year as the moneys spent at different times during the past year amounted to over $600." After Ms. Sheldon left in 1894, the position of "librarian" remained vacant until 1900 when a Ms. Harriet Staff eldt was hired as an "assistant in the library." During this period the yearly appropriations voted by the f acuity for library use ranged between $400-$500, and we also find Dr. Mann requesting: "Some provisions be made for more bookcase room in the library." By 1902 this request had developed into one for a new addition to the Library. The new addition granted was a space of an ad­ ditional two rooms on the first floor of the High Street building. By January, 1903 these were completely refurbished with new floors, and wall cases and tables from the Main Library. All of this growth went without a hitch, except that Dr. Mann had to approach the faculty again for an extra 550 to complete the furnishings of the new library rooms. He got it. THE BUFFALO PHYSICIA �Dr. Mann, having done yeoman work as head of the Library Committee to bring the collection and the physical facilities of the Library to a very commendable stage in their development, left his position as Chairman of the Library Committee, to be replaced by Dr. Irving Phillips Lyon, who is also occasionally listed in the Annual Announcement as "Librarian." This is the first instance in which the Chairman of the Library Committee is specifically so designated, but in fact it would appear that no professionally trained librarian had, to this point, ever had a hand in the Medical Library's development in any long term sense. The individuals cited as working in the Medical Library (and mentioned in the An­ nual Announcement as "the regular college librarian" or "a competent librarian in daily attendance"), having been merely assistants to the head of the Library Committee, who acted as "Librarian," had not undergone the type of library training which would have made them professional librarians in the modern sense. These remarks are in no way meant to impugn the competence of these in­ dividuals in terms of their work in the Medical Library, but only point out that at this time (ca. 1900) professionally trained librarians were rare commodities, and formal library training was, if not in its infancy, just beginning to walk upright. In 1905 the person with the longest connec­ tion with the edical Library, first in the role of "assistant librarian" and later of "librarian," Ms. Grace Persch, was hired. About June, 1905 Dr. Lyon recommended that Ms. Persch be sent to Chautauqua, at the School's expense, for a six-week course in library work. Upon her return Ms. Persch entered into her work as "assistant librarian ' and stayed with the Medical School until 1936, having been appointed full "Librarian" in 1918. It is not recorded what Ms. Persch's starting salary was, but in February, 1912 she took the probably quite courageous step of sending a communication to the faculty ask­ ing that her salary be increased to $12 per week. The secretary records in the minutes of that meeting that: "After considerable (my italics) discussion it was moved and carried that she be granted the raise." Ms. Persch. it appears, was nothing if not resourceful. This is shown by the fact that in 1913 she again solicited the faculty, this time FALL, 1982 for permission to sell textbooks to the that con­ students. Again it is recorded siderable discussion ensued, and "several plans were proposed.'' Dr. Williams believed that the School should share in whatever profits were made. In the end, however, Dr. Stockton moved that Ms. Persch be granted the privilege asked for, and this was carried out. A well-deserved victory for the hardworking and long-suffering Ms. Persch. Having joined such organizations as the Association of edical Librarians, and the American Bibliographic Society, the Medical School found itself more and more called upon to engage in library-related activities outside the bounds of its own walls, or beyond the exigencies of its own needs. One of these activities was helping to build up a basic collection of books for a new medical library recently established in San Francisco, which in the first decade of the 20th century was still a developing city needing to call upon the East for help in such matters. Ors. Park and Stockton suggested a plan whereby books for this worthy cause would be received into the Medical Library at Buffalo by soliciting every regular physician in the area. The material would then be processed and packed for transhiprnent to San Francisco. o doubt the burden of this task fell upon Ms. Persch, as did the job of drawing up the list of current journals held by the Library "(to) be mailed to all members of the profession.'' It is not clear if this statement means in Buffalo or nationwide. Either way s. Persch deserved her raise! Internally the edical Library was having the usual number and variety of day-to-day problems, though some perhaps were more peculiar to a library in a medical school. For example, much time and effort, and finally some money, was spent on curing the problem of keeping fumes from the chemistry room out of the Library. Other problems ranged from how to get more window light on the side of the Library on which the German American Brewing Company was contemplating building a high brick wall, (in the end this was never put up), to who should pay expressage on books ordered from the Surgeon-General's Library. (It was decided that the individual orderin the material should pay.). To anyone in the contemporary library world who thinks that the mutilating of library books is an outcome of present day un33 d- �disciplined youth brought up in a throw-away society, the following difficulty which the Medical Library was undergoing in 1915 may provide a more balanced perspective: At the Library Committee meeting of January 4, 1915, the matter of mutilation and of cutting out articles from journals and books was thoroughly discuss­ ed. Dr. Lyon recommended that a notice be posted in the library, the following notice being submitted for posting: 'Any student detected in mutilating or clipping any jour­ nal or book contained in the library will be summarily expelled from the School without redress. Any others will be refused all further use of the library, and will be prosecuted to the full extent of the law.' This notice was posted, but it is not reported what effect it had on the problem. Other "library material" which perhaps was not as readily and illegally appropriated, but which in any event was available for cir­ culation, was that provided from the Medical Library's early involvement in the area of loaning out resource materials for study, that is, bones. As reported in the Annual An­ nouncement during the period 1908-1910: "A complete bone library is available for the students' use. This is located in the college library and may be made use of in the same manner as are the books.(?) Bones are also provided for home study and are loaned to any student who makes a deposit for their return." Eventually this interesting collection moved itself to the Anatomy Department and was loaned out from there. In the early years of the 20th century the Medical Library's collection grew through in­ creased appropriations and through the dona­ tion of the libraries of various individuals from the Buffalo medical community, and deceased members of the medical teaching faculty. The White. the Burwell, and the Miner collections have already been men­ tioned. It was about this time (ca. 1910) that Abraham Flexner gave the Buffalo Medical Library high marks in his oft-cited report on medical education in the U.S. and Canada. He 34 was only luke warm about the medical school per se; but teaching techniques have progressed in medical education, both in Buf­ falo and nationwide since 1910. In the second decade of the 20th century the Medical School was the recipient of the library of Dr. Roswell Park who died in 1914. As this was a rather extensive collection, and as various stipulations were attached, a cer­ tain amount of planning had to be done related to receiving it. On February 24, 1914 the following letter was sent to the Dean of the Medical Department of the University of Buffalo by Dr. Park's son, Mr. Julian Park: y Dear Dr. Williams: It has always been the intention and desire of my father that his Medical Library should be given to the University of Buffalo at his death. This collection is to be carefully kept and known as the Roswell Park Library. I am therefore offering it to you as such, in the hope that you will be able to accept it and care for the same. That is to say that this Library is to be kept in separate and suitable cases, marked as above indicated. If you will signify your willingness to take this, we will arrange re­ garding the removal of the same. Yours very truly, Mr. Julian Park This offer elicited much discussion in the Library Committee, and in the faculty as a whole. It was decided to empty the room used as a periodicals room and to make this room available for Dr. Park's library. The work of the Park bequest was com­ pleted by 1916, and the Medical School's an­ nual catalog for that year announced: The private medical library of the late Roswell Park, for many years Professor of Surgery, is installed in a special room. This valuable collection of books, journals and reprints, numbering several thou­ sand was generously bequeathed to the College by the terms of Dr. Park's will, and is at the disposal of students and alumni, and of the medical profession of the city, for study and reference. THE BUFFALO PHYSICIA �In 1918-19 closer links were developed between the Medical Library and the Grosvenor Library, which was a fairly 1arge research library located near the Medical School's High Street building. This was to be done through a program of sharing the burden of acquiring journals relevant to the study of medicine. A cooperative relationship between the two institutions existed at many levels. For ex­ ample a recommendation coming out of the interaction at this time, "that the libraries consult each other before ordering a new periodical or (a) book of the more expensive kind" was honored. In fact the relationship remained close even after the Grosvenor Library became a division of the Buffalo and Erie County Library System. And it was in 1961/62 that the full medical collection of the Grosvenor was amalgamated with the collec­ tion of the Medical Library of the University of Buffalo. The early cooperation between the Grosvenor Library and the University of Buf­ falo Medical School has thus resulted in a useful contribution to the growth of the Medical Library collection. The 1930s and the 1940s were relatively un­ eventful decades for the Medical Library, if not for the world in general. Growth in terms of bound volumes and other materials con­ tinued, of course. At the beginning of this period the University of Buffalo Medical Department's Annual Announcement for 1931/32 states: The Library located at 24 High Street contains more than 22,000 bound volumes, including reference works, periodicals, transactions and reports and about 51,000 unbound pamphlets. Its facilities are available to students and to members of the Medical Profession in Buffalo and vacinity. In 1936, after 31 years of faithful service, Ms. Persch retired. Her monetary rewards had by that time risen to well over $2,000 per annum, and she had, in the latter part of her career, been given aid in the form of various "assistant librarians." The Library's operatin budget, too, had increased dramatically in the 31 years of Ms. Persch's tenure from the 500 or $600 per year available in 1905 to $5,000 or $6000+ avaHable in the late 1930s. FALL, 1982 It was during the decade of the 1940s that the Medical Library changed its status to that of the Medical/Dental Library when in 1944 the essential books from the Dental Library collection were moved into the Medical Library on High Street. Space considerations prevented the full Dental collection from be­ ing amalgamated at that time, but the remainder of the collection was stored until such time as a new building would be ready for the relocation of the full Medical/Dental collection. By the end of the decade of the 1940s the medical/dental collection had grown to about 34,000 bound volumes and some 55,000 un­ bound pamphlets. It was at this time (i.e. 1950/51/52) that the collection was reclassified and recataloged under the Library of Congress system. The plan was to have the work done ready for the move from High Street to the Library's new quarters in Capen Hall on the University's ain Street Campus. This move took place in 1953. With the integration of the Biology, Phar­ macy and ursing collections in March, 1961 the Medical/Dental Library became the Health Sciences Library. The decades of the 1950s and 1960s were difficult years for the newly-established Health Sciences Library. The staff did what it could with a bad situation, and while "users of the Health Sciences Library are amiable, . . . their patience is rapidly wearing thin through the overcrowding in the Reading Room and stacks," so stated the Director in one of his Annual Reports at the time. The official view of the state of the Health Sciences Library during this period can be best given by quoting again from the Annual Report of the Director of Libraries to the University President during the middle years of the 1960s decade: The Health Sciences Library with a collection of 70,000 volumes falls below the standards of 100,000 volumes for libraries to support a comprehensive Bio-Medical research program. However, our library surpasses the standards of 1,200 to 1,500 suggested as adequate for periodicals subscriptions: we have 1,701. 35 d- �Also the Library's reference service is showing much improvement, according to the Director. And the Library is moving ahead with the times by acquiring a photo-copying machine, making material easier to lend to local hospitals. However, the Director still feels constrained to mention again and again in his reports the inadequate physical facilities provided for the Library in Capen Hall. When the present Librarian, Mr. C.K. Huang, took over in July, 1970, many of the problems related to the Library's physical facilities in Capen Hall were still to be solved. evertheless, at the start of the decade of the 1970s the Health Sciences Library contained about 100,000 bound volumes, and was receiv­ ing more than 3,000 periodicals. By the early years of the decade it had established links, through the SU Y Bio-Medical Com­ munications etwork, with other medical collections in New York State. It had also in­ creased its usage of the National Library of edicine through interlibrary loan, and had begun to speed up these activities through agreements with other regional networks and through the use of teletype and computer terminals. Despite the fact that the new Librarian had to report cutbacks in operating funds and freezes in hiring imposed by the State in 1972 and 1973, he was also able to point out that, while shortage-of-space problems were an ever-present fact of life in the Capen Hall facility, the Heal th Sciences Library "had maintained its status as the heaviest user among the 22 participating institutions of the SU Y Bio-Medical Communications etwork." The Library had also increased its attendance count by 22%, and its ILL requests by some 46%. It was, however, with no small sigh of relief that the Health Sciences Library was able to vacate its cramped quarters in Capen Hall, partly as a result of a strong recommen­ dation of the AAMC accreditation visit in 1972, and move to its present quarters in the 36 Stockton Kimball Tower in July, 1974. Here facilities, while not ideal, provide more space in which to expand and continue the growth areas already started on. Among these are the audiovisual section, a media resources center for medical students, and a History of Medicine collection, which presently has about 10,000 volumes of rare and valuable medical books. In the area of modern library technology, in addition to the innovations already mentioned, the library also has access to the MEDLINE network and the TOXLI E network via on-line computer information retrieval systems for searching over 3,000 international health science jour­ nals. Other more recent data bases now available are CancerLit and BIOSIS. The Library is also a resource library as part of the medical library program of ew York and New Jersey. From its modest beginnings in 1846 to its present position in the 1980s, the Medical Library/Health Sciences Library has grown to be a leading medical resource facility in New York State and in the U.S. It has by no means solved all of the problems related to running such a facility, be they space problems, per­ sonnel problems, collection building problems, problems of interlibrary loan or, the most persistent of all, fiscal problems. But it has emerged through the many tribulations and commendations outlined here to be a leader in the field of medical librarianship. In its immediate future, the Health Sciences Library looks forward to the comple­ tion of the renovation of the Main Street Cam­ pus, where in a spacious, well-planned, free­ standing library building it can continue the tradition started in 1846 at the corner of Washington and Seneca in downtown Buffalo, and add to its stature as one of the leading Health Sciences library facilities in the United States. □ THE BUFFALO PHYSICIA �He was not feeling well. As he began to collapse, his training in emergency medicine prompted him to remain calm. That's how orman Kolb recalled his first heart attack some weeks back and the subsequent surgery that enables him to walk two miles a day and to be among a small group of patients lo survive acute shock from a heart attack and subsequent emergency surgery. He was transferred to the Erie County Medical Center. Here, insertion of an intra-aortic balloon catheter reduced the strain on his severely damaged heart. Still, cardiologist eil Dashkoff, assis­ tant professor of medicine, was uncertain whether his patient would survive. Mrs. Diane Kolb recalls the numerous warnings over the next ten days. "It was touch and go," she said. The cardiac angiograms pointed to a large portion of the heart muscle no longer func­ tioning. That, Dr. Dashkoff said, impaired the function of the remaining normal heart muscle. Mrs. Kolb remembers the call Saturday for permission to proceed with surgery. The odds, she said, were not good. "There were so many times when he could have died. I just knew he would make it," she said. Over the next few hours, the surgical team of Drs. S. Subrama­ nian and Murray Andersen, professors of medicine, removed the portion of heart muscle not functioning and reattached the remainder. "Against all odds," Mrs. Kolb recalls, " orman was still with us." Three days after surgery, the intra-aortic balloon catheter was removed. Soon after, the patient was weaned off the ventilator, then transferred from intensive care to the cardiac rehabilitation unit. Before long, he was averaging 1000 paces a day in the hospital corridors. How did he feel a week after surgery? "Never better," Mr. Kolb said. " o pain, no shortness of breath. Just great." Mak­ ing a difference in his quality of life at the medical center were the nursing and house staff. The day of his heart attack was the day Mr. Kolb was promoted to a more demanding job. It was one filled with stress. Today, a typical day for Mr. Kolb includes assisting his wife in her small bridal shop. And there are plans for fishing and travel. "Thanks to my medical care, I have a future," he said. □ Heart Muscle Surgery Cancer Seminars Oct. 7-8, "Cancer in the Elderly - An Inter­ disciplinary Perspective"; Chairperson: Dr. Evan Calkins Oct. 8-9, "Annual Meeting of the ew York State Cancer Programs Association." Oct. 14, "Symposium on Dentistry and Cancer"; Chairperson: Dr. Norman Schaaf. Oct. 21, "Computers in Medical Practice"; Chairperson: Fil E. Vanvoris, MBA, MA. FALL, 1982 ov. 4, "Lung Cancer: Diagnosis and Therapy"; Chairperson: Dr. Ronald Vin­ cent. Issues in ov. 18, "Contemporary Osteoporosis"; Chairperson: Dr. Julian L. Ambrus. Dec. 9, "Comprehensive Care of the Ad­ vanced Cancer Patient"; Chairperson: Dr. Edward Bockstahler. 37 �Dues Paying Alumni, 1982 (calendar year, June 1, 1981 to May 31, 1982 inclusive) A special thanks to the dues-paying medical alumni listed here. And to the nine reunion classes -1932, 1937, 1942, 1947, 1952, 1957, 1962, 1967, 1972 - who contributed $45,000 to the Medical School. All of us at the School of Medicine appreciate your support and participation. Bradley Hull Russell S. Kidder Abraham S. Lenzner Daniel J. McCue James L. McGrane John J. O'Brien Allen A. Pierce Roman Shubert Anthony J. Virgo Philip 8. Weis 194Z 1936 Murray A. Bratt arion J, Chimera Elmer Friedland Frank G. Leone Harold Levy W. Reese Lewis Hugh J. McGee Robert R. orthrup Benjamin E. Obletz Bronislaus S. Olszewski Harvey C. Slocum Joseph M. Smolev Arthur W. Strom Myrtle W. Vincent arvin L. Amdur Richard C. Batt Paul A. Burgeson Alfred Cherry John P. Crosby Edward G. Eschner Willard G. Fischer Jerome J. Glauber Avrom M. Greenberg Irving Helfert Frank C. Hoak Eli A. Leven William F. Lipp 1937 1933 Wilfrid M. Anna Henn· Haines J. Cu~ti Hellriegel Joseph W. Hewett Thomas C. Hobbie Ernest G. Homokay Franklyn A. Huber Louis Kolbrenner Murray A. Yost 1934 J. Edwin Alford John V. Anderson Alfred L. George John C. Kinzly Harry G. Laforge Charles E. May John D. O'Connor Earle G. Ridall Myron G. Rosenbaum Edgar A. Slotkin Max B. Weiner 1935 Wendell R. Ames John F. Argue Willard H. Bernhoft Russell F. Brace Raymond H. Bunshaw Benjamin Coleman Kenneth H. Eckhert Victor B. Lampka Bennie Mecklin Charles E. Moran Daniel D. Peschio Clayton G. Weig George S. Young Albert J. Addesa Richard Ament Horace L. Battaglia Charles A. Bauda Vincent S. Cotroneo George L. Eckhert Harrison M. Karp Boris L. Marmolya Richard Milazzo Vincent J. Parlante John D. Persse William J. Staubitz Leon Yochelson 1939 193Z Kenneth M. Alford John Ambrusko William L. Ball Charles F. Banas Richard M. Block Francis E. Ehret Theodore C. Flemming Soll Goodman Stanley J. Jackson George F. Koepf Edwin Kriedemann Ro e . Lenahan Robert W, Lipsett Alice C. Lograsso James D. Maccallum M. Luther 1usselman Leon M. Roe Irving Weiner David H. Weintraub William F. White Charles J. Woeppel 1938 Charles F. Becker Russell J. Catalano George M. Cooper orman J. Foil Chester J. Kaminski Samuel L. Lieberman Alfred A. Mitchell H. Robert Oehler Eustace G. Phillies Maxwell Rosenblatt Clarence A. Straubinger Walter L. Sydoriak Richard . Terry 38 Russell . Battaglia Grosvenor W. Bissell La Moyne C. Bleich Ruth C. Burton Milton V. Caldwell Llovd A. Clarke Alf~ed H. Dobrak William Dugan Matt A. Gajewski John H. Geekier Kenneth Goldstein Harold M. Harris Henry V. Morelewicz Elizabeth P. Olmsted A. V. Postoloff Frank T. Riforgiato Roy E. Seibel John J. Squadrito Robert E. Storms Everett H. Wesp Marvin N. Winer 1943 1940 Julian J. Ascher Edward R. Cannon arshall Clinton Herbert H. Eccleston William Hildebrand Evan W. Molyneaux Warren R. Montgomery Thomas F. Prestel Ru sell E. Reitz Albert C. Rekate orbert J. Roberts Robert H. Roehl C. Henry Severson Allan W. Siegner Louis A. Trippe William 0. Umiker Stanley T. Urban John D. White 1941 S. Yale Andelman Joseph T. Aquilina Berten C. Bean Anthony J. Cooper Robert W. Edmonds George A, Gentner Pasquale A. Greco Donald W. Hall Eugene j. Hanavan Ralph T. Behling Marvin L. Bloom Richard J. Buckley Ivan L. Bunnell Peter A. Casagrande Robert J. Collins John M. Donohue Alfred S. Evans L. Walter Fix Thomas L. Grayson Stewart L. Griggs Thomas R. Humphrey Richard J. Jones Ruth F. Krauss Melbourne H. Lent Anthony J. Marano Ronald E. Martin Randolph J. cConnie Franklin Meyer Robert W. Moyce John C. info Walter R. Petersen Charles C. Richards Joseph J. Ricotta Gene D. Sherrill Alexander Slepian Gertrude S. Swarthout Ralph E. Smith Charles J. Tanner Hazel J. Trefts Louis A. Trovato Morris Unher Joseph A. Valvo La Verne G. Wagner John R. Williams Paul J. Wolfgruber THE BUFF ALO PHYSICIA �1944 Anthony M. Aquilina Willard H. Boardman Raymond G. Bondi Clifford F. Bramer Robert L. Brown Eileen L. Edelberg Herman Edelberg Richard W. Egan ewland Fountain Thomas F. Frawley Frank T. Frost Andrew A. Gage Irwin A. Ginsberg Harold P. Graser Raymond A. Hudson Sidney R. Kennedy Frank H. Long James E. Macaluso Francis C. Marchetta James Mezen Casimir F. Pietraszek Joseph Ross Sidney M. Schaer Carrol J. Shaver Walter F. Stafford Clinton H. Strong James R. Sullivan Paul Weygandt 1945 Richard H. Adler William S. Andalora Bruce F. Baisch orman Chassin Geor e . Ellis Edward G. Forgrave George W. Fugitt Arthur Grabau Richard . Greenwald Ivan W. Kuhl Vito P. Laglia Victor C. Lazarus William D. Loeser H. Paul Longstreth William clntosh Stuart J. Miller John K. Quinlivan John G. Robinson William J. Rogers Albert J. Rosso K. Joseph Sheedy Jacob M. Steinhart Joseph D. Tannenhaus Wayne C. Templer George Thorngate TV Gilbert B. Tybring Charles E. Wiles Jane B. Wiles 1946 Charles D. Bayer Donato J. Carbone Alexander R. Cowper John T. Crissey Lawrence H. Golden FALL, 1982 Edward F. Gudgel Ross Imburgia Annabel M. Irons Charles A. Joy Harold Levy Eugene M. Marks Harry Petzing Amo J. Piccoli Herbert S. Pirson Albert G. Rowe Henry M. Tardif Paul M. Walczak 1947 Bruce Babcock William C. Baker Edward S. Breakell William M. Bukowski teven Cline Daniel E. Curtin Robert J. Dean William S. Edgecomb Robert J. Enrenreich Col. Henry S. Gardner Elbert Hubbard III Peter J. Julian Hans F. Kipping Jack Lippes Richard J. Marchand David H. Nichols Donald C. 1 uwer Harold Pescovitz James F. Phillips Phillip L. Reitz Jr. Daniel J. Riordan Arthur J. Schaefer John 8. Sheffer James F. Stagg Joseph C. Todoro Jerome I. Tokars John H. Waite Victor C. Welch Frederick D. Whiting Robert H. Wildhack 1948 Col. James G. Borman Raphael S. Good Myron Gordon H~rold L. Graff Warren H. Hanson \, arren L. Hollis Judith L. Landau Vernon C. Lubs John J. Marinaccio Ansel R. Marlin Daniel G. filler orman inde Darwin D. Moore Cletus J. Regan Lester H. Schiff Edgar C. Smith Irwin Solomon Rebecca G. Solomon Edward R. Stone Jasper L. Van Avery Paul Weinberg s. Paul Zola 1949 Carmelo S. Armenia J. Bradley Aust Alfred Berl Harold Bernhard Lawrence M. Carden Julia M. Cullen Philip C. Dennen Joseph E. Griffin Irving Lang Arthur Mogerman Jacqueline L. Paroski Frank A. Pfalzer Robert D. Sanford Max A. Schneider Fred Shalwitz Irma M. Waldo Pierce Weinstein James A. Werick Charles J. Wolfe 1950 Roland Anthone Sidney Anthone Robert E. Bergner James J. Brandl Charles Brody Carl A. Cecilia Frank Chambers Anthony Conte Adelmo P. Dunghe Carmen D. Gelormini Robert . Kling Richard J. Leberer Karl L. Manders Patricia A. Meyer Robert J. Patterson Henry L. Pech Jr. Roy W. Robinson Clarence E. Sanford Vincent Scamurra Helen F. Sikorski Yale Solomon George E. Taylor Hyman Tetewsky Edward C. Voss Jr. Gertrude L. Waite Anne A. Wasson William S. Webster Sidney B. Weinberg 1951 Jay B. Belsky Carl R. Conrad Leonard S. Danzig Harvey D. Davis Allen L. Goldfarb Ludwig R. Koukal Harold P. Krueger Eugene V. Leslie Thomas J. Murphy John L. Musser Daniel A. Phillips Marvin J. Pleskow Robert E. Ploss Robert L. Secrist 39 Edward Shanbrom Bernard Smolens James W. Weigel 1952 Donald J. Adams John J. Banas Robert A. Baumler Alvin J. Brown Bruce F. Connell Barbara G. Corley Bernie P. Davis Donald F. Dohn eal W. Fuhr Albert A. Gartner Jr. Joseph E. Genewich Donald J. Kelley Melvin R. Krohn Milton C. Lapp Alfred Lazarus Eugene W. Loeser Jr. Colin C. MacLeod Ralph M. Ohler Victor A. Panaro John Y. Ranchoff Harry Richards Travers Robbins James . Schmitt Byron E. Sheesley S. Aaron Simpson Donald H. Sprecker Burton Stulberg James lrme Szabo Roy J. Thurn S. Jefferson Underwood Kurt J. Wegner Charlotte C. Weiss James F. Zeller 1953 George G. Bertino Stanley L. Cohen Thomas Comerford Jr. Felix A. Delerme Donald L. Ehrenreich Sander H. Fogel Jack Gold John W. Handel Curtis C. Johnson Herbert E. Lee Edmund A. Mackey Milford C. Maloney Robert E. aynard Richard J. agel James Orr Molly Panner Seidenberg Bertram A. Portin Donald 0. Rachow Joseph F. Ruh Howard C. Smith Harold Smulyan Robert S. Sobocinski John . Strachan Michael A. Sullivan Reinhold A. Ullrich d- �1954 Eugene L. Beltrami Joseph L. Campo icholas C. Carosella Louis C. Cloutier John L. Conboy Robert D. Foley Byron A. Genner III Robert W. Haines Florence M. Hanson William J. Howard Eugene C. Hyzy William R. Kinkel Allen L. Lesswing ylvia G. Lizlovs Charles H. Marino Ernest H. Meese Donald J. Murray . Allen orman Walter A. Olszewski Robert J. Pleiman Robert J. Powalski Edward A. Rayhill Edwin B. Tomaka Marlyn Voss Paul L. Weinmann Donald M. Wilson 1955 Vincent S. Celestino James R. Collins Louis R. Conti James M. Garvey Frank J. Gazzo ichael J. Gianturco Cleora K. Handel Sarni A. Hashim Sylvan H. Horwald Kathryn Keicher John H. Kent Edward H. Kopf S. Joseph Lamancusa Winifred G. Mernan George L. Mye Leonard R. Schaer Anthony B. Schiavi Ray G. Schiferle Robert A. Smith James G. Stengel Barbara Von Schmidt Eugene B. Whitney John A. Winter Donald A. Wormer 1956 M. David Ben-Asher Helen Buerger Robert 8. Corretore Edmond J. Gicewicz Peter F. Goergen Frederick P. Goldstein Oliver P. Jones Joseph L. Kunz Fred Lee Thoma Luparello Sue A. Mccutcheon Robert G. McIntosh Frederick C. uessle Paul C. Ronca Bernard H. Sklar Herbert Tanney 1957 Arthur L. Beck Jr. Bronson M. Berghorn Germante Boncaldo John R. Bongiovanni Philip A. Brunell Robert E. Carpenter Harold C. Castilone Benny Celniker Frank J. Chafe] John K. Cusick Marvin N. Eisenberg Gerald Friedman Myron Carsen tein Lorie A. Gulino Barbara H. Hetzer Harris H. Kane) Charles E. Lowe Ross Markello ol Messinger Herbert Meisch Richard F. Miller Charles F. O'Connor John S. Parker Herbert Silver Robert Su man Bernard D. Wakefield Edward /. Weisenheimer Sherman Woldman 1958 Edward C. Ale si Elroy E. Anderson fohn V. Armenia ranklyn . Campagna Dominick Cultrara Robert C. Dickson Frederick W. Dischinger Domonic F. Falsetti Eugene A. Friedberg John J. Giardino William Glazier John F. Holcomb Leo A. Kane arie L. Kunz Michael A. Mazza Robert J. Perez Lucien A. Potenza Richard A. Rahner Elliott Rivo Richard R. Romanowski Samuel Shatkin Morton Spivack Alfred M. Stein Richard D. Wasson Morton 8. Weinber Reinhardt W. Wende James S. Williams Franklin Zeplowitz Harold B. Zimmerman 40 1959 George R. Baeumler Mary Ann Bishara Robert J. Brennen Robert A. Brenner Donald L. Cohen James Doyle Richard Falls Joseph A. Ferlisi eymour D. Grauer Logan A. Griffin Morton H. Heafitz John W. Kostecki William J. Mangan Joseph F. Monte Julius V. Rasinski Jr. Elton M. Rock Russell C. Spoto 1960 William E. Abramson Joseph G. Antkowiak Robert Bernot Joseph A. Chazan Roger S. Dayer Gerard J. Diesfeld Edward J. Graber Thomas J. Guttuso John H. Harrington James R. Kanski, Jr. Harris M. Kenner Francis J. Klocke Harry L. Metcalf Harry H. akata Daniel A. Rakowski Eugene P. Rivera Gerald L. Saks Robert H. Sauer Marvin Shapiro John A. Tuyn 1961 Joel M. Bernstein Harold Brody Carlo E. Desantis Allan S. Disraeli Paul D. French Henry F. Goller Richard C. Hatch William J. Hewett orman Hornung James R. Markello Brenton H. Penwarden Saar A. Porrath Paul T. Schnatz Arthur T. Skarin Ronald H. Usiak Howard C. Wilinsky Robert Winters 1962 Charles G. Adams artin Cowan Sebastian Fasanello Jack C. Fisher Anthony J. Floccare Joseph R. Gerbasi Jame E. Graber Joseph W. Hanss Jr. Mark P. Heilbrun John L. Kiley Paul J. Loree Arnold . Lubin Michael M. Madden Anthony P. Markello Philip D. Morey Robert G. ey Alan L. Pohl Bernard Polatsch William P. Scherer III Melvin J. Steinhart Anthony C. Trippi George R. Tzetzo Philip I. Weisinger 1963 David S. Berger Max M. Bermann David T. Carboy Frank E. Ehrlich Ernest A. Falla Anthony Foti Donald A. Levine George . Lockie David 1. Malinov Richard B. arins Robert Post Henry A. Scheuermann Robert B. Spielman Eugene M. Sullivan Charles S. Tirone Jo eph C. Tutton John M. Wadsworth 1964 Walter A. Ceranski William A. Fleming George R. Glowacki Gerald B. Goldstein Arnold H. lsraelit David A. Leff Marilyn A. Lockwood Ronald S. Mukamal Lillian V. ey David E. Pittman John F. Reilly Sheldon Rothfleisch tephen C. Scheiber Elizabeth G. Serrage Irving Sterman David J. Weinstein Richard W. Williams Richard E. Wolin 1965 William H. Adler III John J. Bird William C. Bucher Joseph G. Cardamone Lance Fogan Jerald Giller Anthony V. Grisanti THE BUFF ALO PHYSICIAN �Ira Hinden Gary H. Jeffery Calvin Marantz R. Scott Scheer Robert . Schnitzler Daniel S. Schubert Robert W. Schultz Joel Steckelman Benjamin J. Wherley 1966 Sean R. Althaus Louis J. Antonucci Jared C. Barlow Robert Barone Thomas W. Bradley Bernard J. Feldman James D. Felsen C. Wayne Fisgus Kenneth Klementowski Jeffrey E. Lindenbaum Edward J. Reich Charles Rubin Roger W. Seibel Anthony B. Serfustini William L. Sperling John E. Spoor Murray A. Yost Jr. 1967 John R. Anderson Thomas Augustine Jr. Robert M. Benson orman Berkowitz Richard H. Daffner David R. Dantzker David J. Fugazzoto Douglas Gerstein James P. Giambrone John W. Gibbs Jr. Leon Hoffman Ronald P. Josephson Richard G. Judelsohn John P. Kelly Michael M. Kline Jacob . Kriteman Allwyn J. Levine John P. Menchini Donald E. Miller Dorothy M. Murray Laird C. Quenzler Steven Rinner Harvey A. Schwartz J. Brian Sheedy Thomas P. Sheehan Arthur C. Sosis George S. Starr James M. Strosberg Linda Young Richard Young 1968 William E. Clack Georfrey E. Clark Thomas J. Cumbo Lawrence J. Dobmeier FALL, 1982 Ronald J. Friedman Kenneth Jewel Richard F. Kaine Z. Micah Kaplan Gary D. Karch Julian R. Karelitz David Kramer Kenneth W. Matasar Jonathan C. Reynhout Robert D. Rodner Barbara Blase Sayres John E. Shields Jr. Morris Stambler Charles P. Yablonsky 1969 Joel B. Bowers James Cavalieri Lang M. Dayton Arthur De Angelis Carl J. Depaula Robert J. Gibson David F. Hayes Louis Hevizy Hanley M. Horwitz Russell G. Knapp Jr. Richard T. Milazzo James Patterson Douglas L. Roberts Thomas S. Scanlon Lester S. Sielski Ronald F. Teitler Harvey Weinberg Madeline J. White 1970 Ronald H. Blum Peter L. Citron Donald P. Copley Allen Davidoff Carl Ellison Eben Feinstein Charles A. Fischbein George D. Goldberg David S. Irwin Dennis J. Krauss Thomas V. Krulisky ichael L. Lippmann Bruce H. Littman John Rider Jerfrey S. Ross Robert M. Ungerer Harold . Vandersea Martin . Mango Denis G. Mazeika Joel H. Paull David Potts Kenneth Solomon Richard I. Staiman William C. Sternfeld llja J. Weinrieb John M. Wendell Bennett G. Zier 1972 Richard Berkson Harold B. Bob john ). D'Alessandro Robert Z. Fialkow Ian . Frankfort Allan G. Gasner Robert B. Kroopnick Stephen). Levine Robert H. Levitt urray A. orphy Philip C. oudy Dennis L. atale Karen A. Price Jame S. Rosokoff Stuart Rubin Arthur L. Siegel Stuart R. Toledano 1973 ancy L. Dunn Robert Fugitt Joseph M. Greco ichael A. Haberman Ralph R. Hallac Marie H. Heller Jeffrey P. Herman Sharon Kuritzky Paul Kuritzky Dana P. Launer John Lowenstein Arthur W. Mruczek Joseph M. Mylott Garsutis Palys Melvin Pratter John E. Przylucki Steven T. Pugh Jacob D. Rozbruch Barry Sanders Arnold W. Scherz Jonathan Wi e 1974 1971 Michael B. Baron Jerald A. Bovina icholas J. Capuana anny E. Christakos Kenneth J. Clark Jr. Terence . Clark Harvey Greenberg ark S. Handler David E. Hoffman coll D. Kirsch Stanley 8. Lewin Gordon L. Avery Daniel R. Beckman James L. Budny Elaine . Bukowski Alan G. Burstein John H. Clark Thomas Donohue Jockular B. Ford John F. Marra Isaiah Megget Kathleen W. Mylotte Lawrence Oufiero 41 Sanford R. Pleskow Dominick R. Prato John C. Rowlingson Elliott A. Schulman Roy E. Seibel Louise M. Stomierowski orbert Szymula 1975 Penny Asbell John Asheld David Bendich Coley Cassiano Marguerite Dynski Robert E. Fenzl Tone Johnson Charles atalizio Peter eumann Thomas Rosenthal Michael Rowland Sylvia Regalia Spavento tanley J. Szefler Michael Taxier 1976 Russell Bessette tephen Bien Sonia Burgher Michael Bye Adolfo Firpo Betancourt Timothy Gabryel Thomas Hadley hin Liang Walwin etzger Melvin Pohl Dennis R. Pyszczynski Geraldine K. Sledzieski Thomas Small John Wiles William Wood 1977 John E. Billi edra J. Harrison Michael S. Kressner Alan S. Kuritzky Jeffrey A. Mogerman Mark J. Polis Thomas A. Raab Carl ). Schmitt Janet Shalwitz Linda Smith Reginald 8. Stiles Russell Van Coevering Ronald A. Vidal 1978 Thomas R. Achtyl athaniel A. Barber Richard R. Curran Scott D. Goldstein Stephen E. Killian George E. Ruta John P. Scanlon d- �1979 Walter A. Balon Michael R. Cellino Terence L. Chorba Frederick A. Eames Steven . Elias Natale ). Gagliardi Andrea S. Gold uzanna L. Lin Bruce D. Rodgers Daniel H. Saltzman 1980 Wesley Blank Mark Gilbert Donna Jamieson Richard Lubell Lloyd D. Simon Ellen Tedaldi 1981 Stanley Bukowski Robert A. Jakubowski Fred C. 01 on Richard A. Smith Continuing Education September 24-25 "Primary Care of the Injured Hand", Buffalo Hilton, Program Director, Dr. Clayton Peimer, Assistant Professor of Orthopedics. October 1-2 " utrition", Center for Tomorrow, SU Y/AB, Amherst Campus, Program Director, Dr. Robert Cooper, Chairman and Associate Professor of Pharmacy. October 9 "The Role of the Primary Care Physician in Geriatric Medicine", Holiday Inn, Jamestown, Program Director, Dr. B. Rappole. October 21 "Computer Management For Office Medical Practice", Hilliboe Auditorium, Roswell Park Memorial Institute, Program Directors, Fil Vanvoris, Adjunct Associate Professor, Center for Management Development and Dr. Robert Cerveny, Associate Professor of Management Information Systems. October 28-30 "Recent Advances in Pediatric Lung Diseases," Dr. Gerd J.A. Cropp; Hyatt Hilton Head Island, South Carolina. ovember 18 "Osteoporosis", Hilliboe Auditorium, Roswell Park Memorial Institute, Program Directors, Dr. Clara Ambrus, Research Professor, Department of Pediatrics and Dr. Martin Wingate, Professor, Department of Obstetrics and Gynecology. □ Orthopaedic Scientific Day 10-Game Grid Slate Includes Buffalo State The U/B Bulls will play a 10game football schedule next fall. Sept. 11 - at Cortland State College; Sept. 18 - at Baldwin-Wallace College ( ) ; ept. 25 - U IVERSITY OF ROCHESTER; Oct. 2 BUFFALO STATE COLLEGE; Oct. 9 - at Canisius College; Oct. 16 - ITHACA COLLEGE; Oct. 23 - BROCKPORT STATE COLLEGE; Oct. 30 ORWICH U IVERSITY; ov. 6 - at Albany State University; ov. 13 - at Alfred University. Home games are in caps. □ The 11th Annual University Orthopaedic Residents Scientific Day was held ay 20, at the Erie County Medical Center. Dr. C. McCollister Evarts, Dorris H. Carlson, Professor and Chairman, Department of Orthopaedics, University of Rochester Medical Center, was the Visiting Professor and delivered the 7th Annual David M. Richards, M.D. Memorial Lecture which was titled "Total Hip Arthroplasty in Patients With Congenital Hip Dysplasia." Six Orthopaedic Residents presented scientific thesis paper : J. David Bannon, M.D. - "Capito Hamate Fusion for Kien­ bocks Disease." Roman B. Cham, M.D. - "Absorbable vs. on-absorbable Suture in the Microneural Repair of Sciatic er es in Rats." aury Harris, M.D. - "Review of Base of the eek Osteotomy for Slipped Capital Femoral Ephiphysis." John C. Haumesser, M.D. - "Traction Radiograph of the Hip: A Review of its Use in the Evaluation of Pediatric Hip Pathology." Ramdev Mudiyam, M.D. - "Review of Surf ace Hip Replace­ ment Arthroplasty." ario D. Santilli, M.D. "The Use of Polytetronflouroethelyne in Ligamentous Reconstruction of the Knee: A Preliminary Report." □ 42 THE BUFF ALO PHYSICIA �During the summer, 23 first and second year medical students were introduced to primary care. Six of the students were in Jamestown, ew York, while the others were in hospitals, health clinics and physicians' offices in Buffalo and several other cities in the state. The Medical Education Community Orientation (MECO) Program, sponsored by the American Medical Student Associa­ tion, is in its fifth year. Two students (Richard Jackson, 3rd year; Erike Swanson, 4th year) directed the program. Most of the students were on six week stipends, while several worked for seven or eight weeks. Among the contributors were - the Annual Participating Fund for Medical Education (APFME), ew York State Academy of Family Physicians, Lamb Foundation, Jeffrey Fell, Gebbie Foundation, Buffalo Academy of Medicine, Medical Societ of Erie County, and Cornell Foundation. There were also several private con­ tributors. The 17 physicians participated voluntarily. The students participating in the MECO program are: Jamie Hibit, Younghee Limb, Doug Jackson, Melinda Cameron, Suzanne Meyers, John Fisch, R. James Koness, Kristin Brodie, Louis Kovoussi, Mark Antos, Michelle Stram-Foltin, John Fitzgerald, Mitchell Karmel, James Fink, Michael Pond, Andrew Schneider, Richard Jackson, Sharon Alger, Madeline Lalia, Am Schueckler, Raymond Chan, Douglas Floccare, Tim Dahlgren, and Paul Bergstrand. The preceptors from WCA Hospital in Jamestown are: Ors. Wiecha, Bert Rappole, James Bumbalo, M'62, William Ellis, George Lewis, and Heverly; Barry i<line, Buffalo V.A. Hospital; Lutinski, Plattsburg; James Dunlop, M'69, Grand Island; Frederick Occhino, orth Collins; James Rafferty, Roswell Park Memorial Institute; John Conboy, M'54, Kenmore; S. oyes, Erie County edical Center; James Stover, Saranac Lake; T. Franpz; Paul Buerger, '49, Lockport; and Donald Robinson, M'74, Hamburg. □ MECO Program Cancer Programs October 8, 9, 1982 Annual Meeting of the ew York State Cancer Programs Association Career Opportunities "You Can Make It If You Try" was the theme of the program "Career Opportunities in Medicine for Minorities. The one-day program was co-sponsored by the Student ational Medical Association and the Office of Medical Education. Dean John aughton and Dr. aggie S. Wright, assistant dean for student affairs, introduced the program. Dr. James 8. McDaniel Jr., clinical assistant professor of Gyn/Ob, spoke to the 22 potential medical students about "Health Care eeds for the Poor and Underserved in Buffalo and Western ew York." "A Place for You in Health Sciences" was the topic of Dr. Lester Smith, clinical associate professor of medicine and director of the Center for the Aging. The U/8 student participants: Margaret Kadree, Dawn Mellish, Kim Woods, Linda-Jo Saunders, Fitzroy Dawkins, David Kountz, John Diggs, elly Boggio, Carla Dixon and Lisa Hernandez. Eric Dobson was program coor­ dina tor.D FALL, 1982 43 Roswell Park Memorial Institute Buffalo, .Y. January 21 - 22, 1983 Cancer Control Research in the Cancer Center Holiday Inn Bethesda, Maryland For further information con­ tact: Curtis Mettlin, Program Coordinator, Roswell Park Memorial Institute, 666 Elm Street, Buffalo, ew York 14263, Telephone: 716-8454406. �People Dr. William professor of presented two Medical Center, R. Bartholomew, associate microbiology/pathology, lectures at Cedars-Sinai Los Angeles recently. □ Dr. Carl J. van Oss, professor of microbiology, lectured at the Central Laboratory of the etherlands Red Cross Blood Transfusion Service in Amsterdam recently. He also represented U/B at the first Bioprocessing Science Working Group Meeting of the Universities Space Associa­ tion, NASA Headquarters, Washington, D.C.O Dr. Ernst H. Beutner, professor of microbiology, lectured on "Immune Responses to Scratching" at the 3rd annual Dermatopathology Colloquim at Guy's Hospital, London recently. He also presented a paper at the 3rd International Conference on Psoriasis at Stanford University. Dr. Beutner also reported on "Stratum Corneum Antigens" at a conference in Cardiff, Wales. □ Dr. Russell J. isengard, professor of microbiology, addressed the Chilean Society of Periodontology in Santiago, Chile recently on "Clinical and Immunological Aspects of Inflammatory Periodontal Disease." □ Dr. Ambrose A. Macie, clinical assistant professor of Gyn/Ob, is chairman of the ew York Section 6, American College of Obstetricians and Gynecologists. Dr. Joseph J. Ricotta, M'43, is vice-chairman. □ Several alumni and faculty member have been elected as department chiefs for one year on the medical staff of Lockport Memorial Hospital. They are: Ors. John Bodkin, M'76, chief and clinical instructor in family medicine; Joseph Genewich, M'52, chief of medicine; Joseph Daly, clinical in­ structor and chief of Ob/Gyn; Albert Franco, M'55, chief of staff and clinical assistant profes or of radiology; Thomas Regan, M'48, vice chief of staff; and Wayne Fricke, M'66, chief of surgery. □ Dr. Jerome A. Roth, associate professor of pharmacology and therapeutics, has authored an article for Biochemistry magazine. □ 44 Dr. Josie Linn Olympia, clinical associate professor of psychiatry, is president of the Western ew York Psychiatric Society. She is also director of medical education at the Buf­ falo Psychiatric Society. She is also director of medical education at the Buffalo psychiatric center and assistant chief of the psychiatric service at the Veterans Administration Medical Center. President-elect is Dr. Murray Morphy, M'72, assistant professor of psy­ chiatry; secretary, Dr. John Wadsworth, M'63, clinical associate professor of psychiatry; treasurer, Dr. Victoria H. Besseghini, clinical assistant professor of psychiatry. □ Dr. Arnold I. Freeman, professor of pediatrics, received a $59,093 ational Cancer Institute grant for clinical studies of treatments of childhood cancer. He is at Roswell Park Memorial Institute. □ Dr. Carl W. Porter, research associate professor of pathology, received a $46,286 ational Institute grant for anti-cancer drug studies. He is in the experimental therapeutics department at Roswell Park. □ Dr. Joseph M. Bernstein, clinical assistant professor of otolarngology, has co-authored three scientific articles for publication in professional journals. The titles and journals are: "Are Immune Complexes a Factor in the Pathogenesis of Otitis Media with Effusion?", Am. J.Otolaryngol 3:20-25, 1982; "Chemotactic Activity in Middle Ear Effusions," Otolaryngol Head, eek Surg. 89:1007-1012, ov.-Dec., 1981. "The Role of IgE-Mediated Hypersensitivity in Otitis Media with Ef­ fusion," Otolaryngol Head eek Surg. 89:874878, Sept.-Oct., 1981.D Dr. Enrico Mihich, research professor of pharmacology/therapeutics, received a $112,878 ational Cancer Institute grant. □ Two faculty members, Ors. Erwin eter and L.J. LaScolea, Jr., have co-authored an ar­ ticle for the Journal of Clinical Microbiology. Dr. LaScoleas is assistant professor of pediatrics/microbiology and Dr. eter is professor emeritus of pediatrics and microbiology. □ Three pediatric professors, Drs. Pea ray L. 0 ra. Marie Riepenhoff-Talth, and Philip K. Li, have co-authored a scientific article for the Journal of Medicine. □ THE BUFF ALO PHYSICIA �Dr. John W. Georgitis, research assistant professor of pediatrics, was a panel partici­ pant at the American Academy of Allergy meetings in Montreal. He also co-authored an article for Annals of Allergy. □ Dr. Leonard J. LaScolea, assistant professor of pediatrics, spoke at the annual meeting, American Society for Microbiology in Atlanta recently. His topic: "Clinical Specimen Procurement and Transport." □ Dr. Huberto W. Prado, clinical instructor in psychiatry, is the new chief of out-patient services at the Buffalo Psychiatric Center. He will coordinate 50 treatment programs at 35 locations in the four counties served by the Center. He has been on the staff since 1971, most recently as chief of the Center's iagara­ Orleans unit. □ Dr. Dedenia D. Yap, clinical assistant professor of psychiatry, is the new chief of the Niagara-Orleans unit, Buffalo Psychiatric Center. □ Dr. Elliott Middleton Jr., professor of medicine/pediatrics, addressed the 38th an­ nual meeting of the American Academy of Allergy in Montreal recently. He also spoke on "Asthma, Calcium, and Calcium An­ tagonists" at the American Association of Cer­ tified Allergists. □ "Interrelationships Between Vitamin A and Iron Metabolism" was the topic of a nutri­ tion lecture given by Dr. Robert E. Hodges, professor of medicine/biochemistry, Univer­ sity of ebraska Medical Center, Omaha. □ The Buffalo Medical Arts Society honored two long standing members for their services to the Western New York community. Dr. Theodore Ciesla, M'31, performed services for the Erie County Health Department and was director of the Chest Clinic before his retirement in 1975. Dr. Edmond Gicewicz, M'57, was also honored for his many com­ munity activities. The clinical assistant professor of surgery at U/8 is president-elect of the Erie County Medical Society. □ Dr. Richard E. Wolin, M'64, clinical assis­ tant professor of psychiatry, is the new presi­ dent of the Bry-Lin Hospital medical staff. Dr. Enrique A. Willmott, clinical assistant professor of psychiatry, is secretary­ treasurer. Dr. Sebastian S. Fasanello is Dr. S. Subramanian, professor of surgery, spoke in Guadalajara, exico on surgery for children at meetings of the pediatric section, Puerto Rico Medical Association and Puerto Rico Chapter of the American Academy of Pediatrics. He is also chief of cardiovascular surgery at Children's Hospital. □ A group of 31 Buffalonians and former Buffalonians attended a luncheon in May at the 82nd Meeting of the American Society for Microbiology in Atlanta, Georgia. One of the highlights of the luncheon was to pay tribute to Dr. Erwin eter, professor emeritus of microbiology/pediatrics, who was made an Honorary Member of the ational Society. The function was organized by Dr. W. Bartholomew, President of the Western ew York Branch of the American Society for Microbiology .0 Left to right: Ors. Mary Smaron, Chicago; Eileen Hinks, Philadelphia; Arthur Crist, Harrisburg; Anne Morrisse)', eter, Buf­ Cleveland: Victoria Wicher, Albany; Erwin falo: Konrad Wicher, (back}, Buffalo. president-elect. □ Dr. Dogan M. Perese, clinical associate in neurosurgery, is president of the medical staff of Our Lady of Victory Hospital. Dr. Joseph F. Kij, M'57, is vice president, and Dr. Frank E. Ferro is secretary. □ FALL, 1982 45 �People Seven faculty members participated in the joint national meeting of the Society of the Head/ eek Surgeons in Florida recently. Dr. John M. Lore, professor/chairman of otolaryngology, president of the society of head and neck surgeons and chairman of the department of otolaryngology at Sisters Hospital, was one of the principal speakers at the meeting. Also making presentations from the University of Buffalo were Dr. Frank Marchetta, secretary of the Society of Head and eek Surgeons, and Dr. Jean G. Haar, both clinical associate professors of otolaryngology; Dr. Monica B. Spauling, assis­ tant professor of medicine/pediatrics; Dr. Douglas Klotch, and Dr. Keun Y. Lee, both assistant professors of otolaryngology; and Dr. Anjum Khan, research assistant instructor of otolaryngology.O Dr. Reinhold Schlagenhauff, associate professor of neurology, spoke on Elec­ tromyographical/clinical analysis in the tar­ sal tunnel syndrome at the 12th World Congress of eurology in Kyoto, Japan. The paper was co-authored by Dr. T. Hattori of Chiba Japan. □ · Dr. Tee-Ping Lee, research assistant professor of pediatrics, lectured at the 18th annual meeting of the American Academy of Allergy in Montreal. □ Dr. Marie Reipenhoff-Talty, assistant professor of pediatrics, spoke in Atlanta at the American Society of Microbiology. She also co-authored two scientific articles for scien­ tific journals recently. □ Dr. Edwin W. aylor, research associate professor of pediatrics, has co-authored an ar­ ticle for a scientific journal. □ Dr. Cedric M. Smith, professor of phar­ macology and therapeutics, wrote an article for the ew York State Journal of Medicine, "Alcohol and Drug Problems in Medical Patients: A Comprehensive Survey of Physicians Perceptions. "D Or. orman S. Ellerstein, assistant professor of pediatrics, gave a series of lec­ tures on medial issues in child protection and advocacy at the Child Protection Services Training Institu le Seminar in Plainsview, .Y. recently. □ Dr. H. Sherwood Lawrence gave the 12th annual Ernest Witebsky Memorial Lecture. His topic: " ew Immunological Basis for Clinical Responses to Tran sf er Factor Therapy." Dr. Lawrence is the Jeffrey Bergs­ tein Professor of Medicine, Head of Inf ec­ tious Disease at ew York University. □ Dr. Ganesh . Deshpande, assistant professor of pediatrics, spoke at the 10th an­ nual Western Genetics Conference. □ Ors. Robert Guthrie, professor of pediatrics, and Edwin W. aylor, associate professor of pediatrics, have co-authored two scientific articles for professional journals. □ Four pediatrics faculty members have co­ authored an article for the Journal of Clinical Endocrinology. They are Ors. Philip K. Li, assistant professor of pediatrics· Margaret H. MacGillivray, and Mary L. Voorhess, both professors of pediatrics; and Theodore I. Put­ nam, clinical assistant professor of pediatrics. □ Dr. Georgirene D. Vladutiu, research associate professor of pediatrics, addressed the annual meeting of the Federation of American Societies for Experimental Biology recently in ew Orleans. □ Dr. ancy A. Owens, assistant professor of pediatrics and microbiology, has co-authored two scientific articles for professional jour­ Dr. Gerd J.A. Cropp, professor of pediatrics, addressed the annual meeting of the American Lung Association/ American Thoracic Society in Los Angeles on "Manage­ ment of Asthma: The Pumonologist's Ap­ "Arterial Destruction during Continuous Methacholine Inhalation in Rhinitis, Suspected and Proven Asthma," was the topic for Dr. Gerd J.A. Cropp at the annual meeting of the American Academy of Allergy in Mon­ treal. He is a professor of pediatrics. □ proach." □ 46 nals. □ THE BUFF ALO PHYSICIA �Dr. Lucille Hurley, professor of nutrition, University of California/Davis, lectured at the edical School in May. Her topic: "Trace Metals in Early Development." □ Three faculty members are new officers in the Western ew York Society of Pathologists. Dr. Sol Messinger, M'57, clinical associate professor of pathology, is president. Ors. Sateesh Satchidanand, assistant professor of pathology, is secretary; and John Fisher, clinical assistant prof.essor of pathology/pediatrics, is treasurer. □ Several hundred scientists and physicians from around the world attended the 8th Inter­ national Convocation on Immunology spon­ sored by the Ernest Witebsky Center for Im­ munology in June. The Convocation, which focused on "Regulation of the Immune Response," featured 40 scientists from eight foreign coun­ tries and the United States. They presented the most current findings in this area of research. Sir Gustav J.V. Nossa}, director of the Walter and Eliza Hall Institute of Medical Research, Melbourne Australia, delivered the Ernest Witebsky Memorial Lecture. His topic: "Unifying Concepts of Tolerance and Im­ mune Regulation." The lecture has been es­ tablished in memory of the late Dr. Witebsky, an internationally-known immunologist at U/B who served as the Center's first direc­ tor. □ Or. Gerald P. Murphy, director of Roswell Park emorial Institute, was elected 1982 president of the Society of Surgical Oncology, at its 36th annual meeting in Marco Island, Florida. He is a research professor of urology at U/B.O Dr. Julius Axelrod, a 1970 obel Prize winner in medicine for his research on the autonomic nervous system, spoke at the School of Medicine recently. Dr. Axelrod who is with the ational Institutes of Health, discussed "Lipids and the Receptor Mediated Transmission of Signals Through Membranes." His visit was spon­ sored by U/B's Biomembranes Group, an in­ terdisciplinary graduate group. □ FALL, 1982 Dr. Edward Marine, clinical associate professor of medicine and family medicine, was honored by the United Scleroderma Foundation of Western ew York recently. The medical director of Health Care Plan was instrumental in the formation of the self-help group and for arranging monthly meetings. □ Buffalo General Hospital received a gift of more than 1.1 million to its building fund campaign in memory of a physician who was on its medical staff in the early 1900s. The gift, from the estate of the late David T. Wende, a former Buffalo resident, in memory of his father, Dr. Grover W. Wende, boosts the amount raised by the campaign to $11,196,720. The drive had a goal of $10 million. Or. Wende, who was nationally known in the fields of dermatology and radiation therapy, served many years on the hospital staff. He also served as a professor of der­ matology at the University of Buffalo Medical School and as president of the American Der­ matological Association from 1911-1912. A hospital spokesman said the radiology department planned for the hospital's new facilities on High Street will be named the Crover W. Wende Radiological Suite. The bequest is the largest single contribution to the building fund drive. □ Dr. Emma K. Harrod, clinical-research assistant professor of rehab medicine, is the new president of the Crippled Children's Camps. She has been a member of the board for five years. She is attending physician in the rehab medicine department, Erie County edical Center. She is also on the staff of Children's and Buffalo General Hospital and is a pediatrician with the Health Care Plan. □ Two faculty members received ational Cancer Institute grants recently. Dr. E. Douglas Holyoke, research professor of sur­ gery, received a $47,356 grant to study and treat patients with early stage colon and rec­ tum cancer. Dr. Avery A. Sandbery, research professor of medicine, received a $54,809 grant to study chromosomes of human bladder tumors. Both are on the Roswell Park emorial Institute staff. □ 47 �Roswell Park Memorial Institute dedicated a new bone marrow transplant unit in April. □ Dr. James Hassett, Jr., assistant professor of surgery at U/8 has been named director of the trauma intensive care unit at the Erie County Medical Center. It is a component of the trauma research center, one of a handful in the country funded by the ational Institutes of Health, that is headed by Dr. John Border. Dr. Hassett comes from Buffalo General Hospital where he directed emergency ser­ vices and coordinated trauma and surgical on­ cology services. After graduation from Canisius College with a BS degree in biology, he earned the MD degree at Loyola University and con­ tinued graduate training in surgery at Buffalo General Hospital. He also served for three years in the U.S. avy at its regional medical center in Portsmouth, Virginia. A Diplomate of the American Board of Medical Examiners, he has published in his field. □ Dr. Erwin eter, professor emeritus of pediatrics and microbiology at U/B and direc­ tor of Bacteriology at Children's Hospital from 1936-1981, has been named Pediatrician of the Year by the Buffalo Pediatric Society. This fourth annual award for distinguish­ ed service in the field of pediatrics was presented to him at the Society's recent dinner dance at the Marriott Inn. Dr. eter has also served as a consultant bacteriologist at Roswell Park Memorial Institute from 1948 to the present, and he was a member of the SU YAB Center for Im­ munology from 1969-1980. A native of annheim, Germany, he has received numerous other honors throughout his lengthy medical career. They include the SU YAB Stockton Kimball Award, 1977; Gold Medal of Merit, State of Baden­ Wurtemmburg, Germany, 1978; Commander's Cross of the Order of Merit of the Federal Republic of Germany, 1979; Honorary Life Membership, Reticuloendothelial Society, 1980; and Honorary Membership, American Society for Microbiology, 1982. In addition, the Erwin eter Award was established in his honor in 1979 as an annual student award by the Western New York Branch of the American Society for Microbiology. Dr. eter has authored more than 400 publications. □ 48 The Western ew York Branch of the American Society for Microbiology celebrated the beginning of its second decade at the spring meeting at the Erie County Medical Center in February. One of the highlights of the meeting was the presentation of the Erwin eter Award for the best graduate student poster presen­ tation. The Erwin eter Award was initiated by the Branch in 1979 and has been awarded on an annual basis as a tribute to Dr. Erwin eter, professor emeritus, for his contribu­ tion in the field of Microbiology. This year, Ken T. Miyasaki from the Department of Oral Biology was presented the award for his poster presentation "Purification of a Serogroup-Defining Antigen from a Clinical Isolate of Actinobacillus octinomycetem­ comitons" by K. Miyasaki and R. Genco. In addition to the oral and poster presen­ tations, a guest speaker, Dr. J.W. Costerton from the University of Calgary, presented his work on "The Bacterial Glycocalyx in ature and Diseases." Drs. William Bartholomew and Daniel Amsterdam, department of microbiology, were re-elected president and vice president. Other officers elected were P. Hammond, secretary-treasurer (department of oral biology) and . Stinson, alternate councilor {department of microbiology). □ Dr Erwin eter presenting the 4th Annual Erwin eter Award lo Kenneth Miyasaki for his poster presentation. □ THE BUFFALO PHYSICIA �Three pediatric professors, Drs. Joel M. Bernstein, Elliot F. Ellis, Philip K. Li, have co­ authored a scientific article for Otolargynology Head & eek Surgery. □ Four faculty members from Kyungpook ational University in Daegu, Korea, have been invited to U/B as visiting scholars for the fall 1982 semester. Dr. Jung-Seung Chung will work in the department of linguistics; Dr. Young-Ooo Kwon, department of mechanical engineering; Or. Sung-Ho Lee, department of obstetrics and gynecology, and Dr. Chang­ Sup Seong, department of otolaryngology. Kyungpook ational University is one of a number of foreign institutions with which U/B has formal agreements for academic, research and informational exchanges. Other institutions are located in Canada, Japan and China. □ Dr. Diane M. Jacobs, professor of microbiology, presented a seminar at the University of Health Sciences, Bethesda, Maryland. □ Dr. Felix Milgrom, distinguished professor and chairman of microbiology, lectured at Stanford University on "Studies on Pathogenic Immune Complexes" recently. He also presented a seminar at the University of Toronto. □ Three faculty members, Dr. W.R. Kinkel, L. Jacobs and Reid Heffner, co-authored a scientific article for Cerebovascular Diseases, "Pathological Correlations of C.T. Images in Cerebral Ischemia and Infarction. "O Dr. Gerald Sufrin, professor/chairman of the urology department at the Buffalo General Hospital, has been appointed to the editorial board of investigative urology, a leading research journal in this field. □ Dr. Joseph Daly, clinical instructor in ob/gyn, is the chief of ob/gyn at the Lockport Memorial Hospital. □ Dr. Rudolph Sada, clinical associate in nuclear medicine, is director of nuclear medicine at the Lockport Memorial Hospital. The hospital recently purchased some new nuclear equipment including a sophisticated computer. □ FALL, 1982 Five faculty members and one third-year medical student participated in the annual Buswell Day Scientific Symposium. Dr. Helen Ranney, professor of medicine, University of California, San Diego, was the lecturer. Dean John aughton presented certificates to the Buswell Fellows - Ors. Yoshifumi Abe, Her­ man V. Szymanski, Hideho Arita, Christine Pristech, Michelle M. Cloutier and Thomas M. Rossi, after their presentations. □ Dr. S. Mouchly Small, professor of psy­ chiatry, has been renominated for a third year as President of the ational Muscular Dystrophy Association. He has also been nam­ ed one of the vice-presidents for the 5th Inter­ national Congress on euromuscular Diseases in France in September. □ Dr. Marvin I. Herz, professor and chair­ man of psychiatry, was a panelist for the American College of Psychiatry Update Series in Orlando, Florida. He also visited Stony Brook where he presented a lecture, and has published a scientific article in Inter­ national Journal of Partial Hospitalization. □ "Adverse Reactions to Drugs" was co­ authored by Ors. Elliot F. Ellis, professor and chairman of pediatrics, and Stanley J. Szefler, assistant professor of pediatrics. The article appeared in Practice of Pediatrics. □ Three faculty members have been elected officers of the ew York State Society of Anesthesiology, District 7. Drs. James P. Bur­ dick, M'75, is president-elect; clinical instruc­ tors in anesthesiology, Hashim M. Iyoob, is secretary and Suresh C. Sharma is treasurer. □ Dr. Oguz K. Sarac, clinical associate professor of surgery, is acting chief of surgery at the Deaconess Division of Buffalo General Hospital. □ Two faculty members are new officers at Sheehan Memorial Emergency Hospital. Dr. John G. Zoll, M'40, clinical associate professor of neurosurgery, is vice president; Dr. Rolan­ do T. Velasquez, clinical instructor ob/gyn, is secretary. Ors. Jeremiah O'Sullivan is presi­ dent and Charles S. arasi is treasurer. □ 49 People �People Dr. Gerald J. Hardner, clinical associate professor of urology, has been elected Presi­ dent of the Sisters of Charity Hospital Medi­ cal Staff for 1982-83. Dr. Hardner is also chief of urology at Sisters Hospital. Other staff officers for new terms, which begin April 1, include Dr. Paul Milley, clinical associate professor of pathology/anatomy, president-elect; Dr. Elton Rock, M'59, clinical assistant professor of medicine, secretary; and Dr. Joseph Anain, clinical assistant professor of ototaryngology, treasurer. □ Or. Edmond J. Gicewicz, '56, clinical assistant professor of surgery, has recently been installed as president of the Erie Count edical Society at its annual meeting. He is also athletic physician for sports at U/B, an Erie County medical examiner and examining physician and medical officer for several local companies. Other principal officers are: president-elect, Dr. James F. Phillips, M'47, clinical professor of medicine; vice president, Or. Victorino Anllo, clinical assistant professor of urology; and secretary-treasurer, Dr. John M. Hodson, '56, clinical assistant professor of urology. □ Or. Barry S. Eckert, assistant professor of anatomy, was invited to present a poster of his research at a symposium entitled "Spatial Organization of Eukoryotic Cells" held in Boulder, Colorado, April 30-May 2, to honor Dr. Keith R. Porter upon his retirement from the University of Colorado. Over his 45-year career, Dr. Porter has contributed extensively to the technology of Elecron Microscopy and discovered such cell organelles as ribosomes, lysosomes, microtubules and endoplasmic reticulum. The symposium was organized and attended by Dr. Porter's former students and postdoctoral fellows. □ Three alumni have been elected officers of the Buffalo Ophthalmological Society. Dr. Kenneth V. Klementowski, M'66, is president. Ors. Michael Sansone, M'73, is secretary and Gary Jeffrey, M'65, is treasurer. He is also a clinical instructor in ophthalmology. Dr. Klementowski is chairman of the division of ophthalmology at DeGraff Memorial Hospital and a member of the staff at Kenmore Mer­ cy, Buffalo General and Lockport Memorial Hospitals. □ Harrington lecturer Dr. Poul ,\larks is congratulated by Deon oughton for his excellent presentation on cancer research. Dr. 1orks is president and chief executive officer of Sloon Kellering.D 50 THE BUFF ALO PHYSICIAN �Dr. Robert Summers, associate professor of anatomy, represented the department as a delegate to the interest group in gross anatomy teaching of the American Associa­ tion of Anatomists. Gross Anatomists from over 40 medical and dental schools attended the meeting. Or. Summers was named to head a committee to survey Dental Gross Anatomy Programs in U.S. and Canadian dental schools. Dr. Summers also presented seminars in the departments of biology at Wayne State University and the University of otre Dame. He spoke on the "Role of the Cortical Reaction in Surface Changes During Fertilization" and on "The Establishment of a Human in vitro Fertilization Clinic: Procedures and Poli tics. "O Dr. Kenneth Edds, assistant professor of anatomy has received a three year grant of $150,000 from the Cell Biology Program of the ational Science Foundation for a study on "The Formation and Function of Coelomocyte Filopodia. " □ Two graduate students in the department of anatomical sciences were the recipients of teaching and research awards. Ms. Judith Henderson received an award from the graduate school as one of five outstanding teaching assistants in the University during the 1981-82 year. Her advisor is Dr. Kenneth Edds, assistant professor of anatomy. One of the awardees for the 1980-81 year was Jeffrey Boldt, who is completing his degree under the tutlage of Dr. Herbert Schue], associate professor of anatomy. Ms. Linda Parysek received a Presidential Scholarship to attend the 1982 Electron Microscopy Society of America meeting held in Washington, O.C. in August. The award was ponsored by the EM Society of America (E SA) and was based on an abstract sub­ mitted for presentation at this meeting. Nine medical students were among 45 U/B health science students to be named to the 1982 edition of Who's Who Among Students in American Universities and Colleges. They were: Michael Cesar, Richard Collins, James Corasanti, James Decaprio, Kevin Ferentz, David Gottsegen, Margaret Kadree, Isaiah Pinchney and Erika Swahson. Students were selected on the basis of academic achieve­ ment, community service, extracurricular ac­ tivities, leadership and future potential. More than 1,300 institutions from the U.S., District of Columbia and several foreign countries are represented in the 1982 listings. □ Three f acuity members are newly elected officers in the Buffalo Radiological Society. They are: Ors. Oscar J. Llugany, vice presi­ dent; Ehsan Af shani, secretary; Edward Dziob, treasurer. All are clinical assistant professors of radiology. Dr. Brian Block, a radiologist at Mount St. Mary's Hospital, Lewiston, is the new president. □ Three clinical assistant professors of ob/gyn are the new officers in the Buffalo Gynecologic and Obstetric Society. Ors. Mar­ vin J. Pleskow, M'51, is president; Daniel Kozera, vice president; John aples, treasurer; orman Courey, clinical professor, is secretary. □ The Classes of the 1920's Dr. Elmer T. McGroder, M'21 has retired. He is a past president of the Medical Society of the County of Erie. □ The Classes of the 1930's Dr. Thomas S. Bumbalo, M'31, has been re­ elected president of the Erie County Board of Health. □ Also. this spring, Ms. Parysek was one of the recipients of the 1982 Willard B. Elliot Award. The award, sponsored by the Buffalo Chapter of the Society of Sigma XI and nam­ ed for the former Professor of Biochemistry, is in recognition of research accomplishment and scholarly achievement. Ms. Parysek's ad­ visor in her thesis work is Dr. Barry Eckert, assistant professor of anatomy. □ FALL, 1982 Dr. David H. Weintraub, M'37, is assistant professor of pediatrics at Case Western Reserve University Medical School. In 1981 he was nominated for a "Teaching Excellence Award." He is also a clinical professor, emeritus, at U/B. Dr. Weintraub lives at 3175 Laurel Rd., Shaker Heights, Ohio 44120.D 51 The Classes �Dr. ,\forks The Classes of the 1940's In May, the ew York University School of edicine, department of anesthesiology, pre­ sented Richard Ament, M'42, with its Distinguished Alumnus Award in recognition of meritorious service to the specialty of anesthesiology. He is a clinical professor of anesthesiology at U/B and is treasurer of the Council of Medical Specialty Societies. He represents the American Society of Anesthesiologists. □ The urology department honored Dr. William J. Staubitz, professor and chairman emeritus at a special dinner in May. Dr. Staubitz graduated from the Medical School in 1942 and was chairman of the urology department for 18 years. The dinner recogniz­ ed Dr. Staubitz's contributions to the School of Medicine as well as his distinguished career as an academic urologist and leader in American Urology. □ Dr. Eugene arks, M'46, has been elected director of the American Oc­ cupational Medical Association for 1982-85. He is with the Remington Arms Co., Inc., Bridgeport, CT. Dr. Marks is a Fellow, American College of Preventive Medicine. He lives at 22 Grad Place, ewtown, CT. 06470.D Dr. Richard J. Valone, M'46, moved to Phoenix in 1977 from Utica, .Y. where he had practiced for 25 years. He is now in prac­ tice with a group of ophthalmologists in Arizona. His office address: 601 West Gleneagles Dr., Phoenix, AZ. 85023.D Dr. William H. Bloom, M'48, is president, Long Island euroscience Academy and the Penataquit Civic Association. He is a past president of the Suffolk County Medical Society; Suffolk Academy of Medicine and secretary of the 2nd district branch, SS Y. Dr. Bloom lives at 158 S. Penataquit Ave., Bayshore, .Y. 11706.D The Classes of the 1950's Dr. Joseph Genewich, '52, is the new chief of medicine at Lockport Memorial Hospital. □ Dr. Robert J. Collins, M'43, retired in July. He will live in Jupiter, Florida in the winter and at 81 Linden Ave., Buffalo, .Y. 14214 the rest of the year. He has been a clinical associate professor of gyn/ob at the Medical School. Dr. Collins has also been active in state, regional and national societies. □ Dr. John T. Donovan, M'43, of Lockport has been appointed to the nominating committee of the Medical Society of the State of ew York representing the 8th district branch. □ Dr. Andrew A. Gage, M'44, has been elected to a two-year term on the board of governors of the American College of Surgeons. He is professor of surgery at U/B and chief of staff and chief of surgery at the Veterans Administration edical Center. □ Dr. John K. Quinlivan, M'45, chief of plastic surgery at Mercy Hospital, has been elected a member of the American Society for Aesthetic Plastic Surgery. He is a clinical in­ structor in surgery at U/B. □ 52 Dr. Kenneth S. Mesches, M'53, is assistant clinical professor at the University of Califor­ nia and chief of staff at Santa Rosa Memorial Hospital. General surgery is his specialty. He is a Diplomate, American Board of Surgery. He lives at 7260 Bennett Valley Rd., Santa Rosa, CA. 95404.0 Dr. O.P. Jones. M'56, distinguished professor emeritus, authored an article that appeared in the March issue, The American Journal of Surgery, "The Peripatetic Surgeon in Valhalla." □ Dr. Philip A. Brunell, M'57, is professor of pediatrics at the University of Texas, San An­ tonio. He resigned the department chair­ manship, after six years, to take a three month sabbatical in Amsterdam during the summer. He has also been associate editor of the new "Red Book" {a report of the committee in in­ fectious disease of the Academy of Pediatrics). He lives at 12818 King's Forest Drive, San Antonio, Texas 78230.D THE BUFF ALO PHYSIC IA �Dr. Harry L. Metcalf, M'60, clinical assis­ tant professor of family medicine, has been reappointed to the Commission on Public Health and Scientific Affairs of the American Academy of Family Physicians. □ Dr. Gordon Burgess, M'63, clinical assis­ tant professor of dermatology, has retired. □ Dr Toffolo Dr. R. Ronald Toffolo, M'57, has been ap­ pointed chairman of the department of radiology at the Millard Fillmore Hospitals, both Gates Circle and Suburban. Dr. Toffolo, a native Buffalonian is a Diplomate of the American Board of Radiology with special competence in nuclear medicine. He is a clinical assistant professor of radiology and clinical instructor in nuclear medicine at U/B. □ Dr. Marie Kunz, M'58, is helping to stan­ dardize health care on ew York State cam­ puses. The acting director of the U/B health office is also re-establishing a venereal dis­ ease clinic. □ Dr. Mary Ann Zavisca Bishara, '59, has been elected president of the iagara County Medical Society for the next two years. The anesthesiologist lives at 679 Mt. View Dr., Lewiston, .Y. 14092.D Dr. Daniel C. Kozera, M'59, is vice presi­ dent elect of the Buffalo Gynecol­ ogical/Obstetrical Society for 1982. He was also selected "Citizen of the Year" (1981) for the Field of Medicine awarded by the American-Polish Eagle of Buffalo. Dr. Kozera is a clinical assistant professor at U/B. □ The Classes of the 1960's Dr. Thomas Guttuso, M'60, is the new chairman of the admissions committee at the Medical School. He is a clinical assistant professor of ophthamology. □ FALL, 1982 Dr. Frank E. Ehrlich, M'63, has moved to Johnstown, Pa. where he is chairman of the at department of emergency medicine Conemaugh Valley Memorial Hospital. He is living at 1086 Franklin Street, Johnstown, Pa. 15905.D Dr. John L. LaMar, Jr., M'63, is president of the physician's sponsored LP.A., Southern Intercounty edical Association. He is also fund raising chairman for the Board of Trustees, Pennsville Public Library. The pediatrics specialist lives at 44 Supawna Rd., Salem, .Y. 08079.D Dr. Ronald S. Mukamal, M'64, is president of the orth Carolina Association of Jewish en. The surgeon lives at 201 Maple St., Whiteville, N.C. 28472.D Dr. Harvey Bigelsen, M'65, is president of the Arizona Board Homeopathic Medical Ex­ aminers. He was appointed by the Governor. He has been on the Board of the American Holistic Association and currently is state coordinator. Dr. Bigelsen lives at 12609 80th Place, Scottsdale, AZ. 85251.D Dr. Louis Antonnuci, '66, ophthalmology attendin , spoke on management of diabetic retinopathy at the fourth annual seminar on diabetes/visual impairments sponsored by the Blind Association of W Y and the American Diabetes Association. He is a clinical assistant professor of ophthal­ mology. □ Dr. John J. O'Connor, '66, is assistant clinical professor at George Washington University. He is also a clinical instructor in surgery. He is a Fellow of the College of urgeons; president of the Greater Metropolitan Surgical Endoscope Society; director of colon/rectal surgery service, Columbia Hospital for Women. Dr. O'Connor. 53 �his wife, Patricia, and daughter, Erin Eileen, live at 7111 Heathwood Ct., Bethesda, MD. □ Dr. Harold C. Kulman, M'68, is director of the Sarasota Vascular Laboratory. His specialty is vascular general surgery. Dr. Krulman lives at 5527 American Dr., Sarasota, Florida 33581.D The Classes of the 1970's Dr. Thomas V. Krulisky, M'70, was ap­ pointed medical director, Edgemont Hospital, Los Angeles in February. He is a assistant clinical professor at the University of outhern California. He is a member of the psychiatry committee, Southern California Psychiatric Societ . Dr. Krulisky lives at 250 Oakhurst Lane, Arcadia, CA. 91006.D Dr. Jerald Bovino, M'71, is a clinical assis­ tant professor of surgery at the Medical College of Ohio in Toledo. He is also director of ophthalmology education and chairman of the retinology section, St. Vincent Hospital edical Center. In 1979 he published an arti­ cle, "Sciera! Spreading Forceps for Drainage of Subretinal Fluid" for the American Journal of Ophthalmology. He co-authored two ar­ ticles for the same journal in 1980 and 1982 " easurement of the Relative Afferent Pupillary Defect in Retinal Detachment" and "Jntrocular Foreign-Body Hazard during Vitrectomy." In JAMA in 1982 he co-authored, "When Friends or Patients Ask About Retinal Detachment." Dr. Bovino lives at 5339 Brooklawn Dr., Toledo, Ohio 43623.D '71, was elected Dr. Thomas G. DiSessa, to Who's Who in California in May. The assis­ tant professor of pediatrics at UCLA is a Fellow, American Academy of Pediatrics; American College of Cardiology; Society of Pediatric Echocardiography; and American Society of Echocardiography. His third son, Peter Richard, was born February 7, 1982. Dr. DiSessa has co-authored a book, "Two Dimenional Echocardiography Clinical and Pathological Correlations" that will be published in 1983 by The Little Brown Co. Dr. DiSessa has also co-authored scientific articles for The American Heart Journal, The Journal of Pediatrics, and The American Journal of Cardiology. The OiSessa family lives at 6843 Chisholm Ave., Van uys, CA. 91406.D 54 'or. Gerald Coniglio, M'72, has been ap­ pointed to the medical staff of Lockport Memorial Hospital in orthopedic surgery. A native of Mt. Morris, Dr. Coniglio graduated from SUNY at Buffalo Medical School. He completed an internship in anesthesiology at the Upstate Medical Center in Syracuse and served as a surgical resident at St. Joseph's Memorial Hospital in Syracuse. Prior to joining the staff at LMH, Dr. Coniglio completed a four year residency in orthopedics at the Southwestern Michigan Area Health Education Center and was a member of the medical staff at Park Ridge Hospital in Rochester. □ Dr. Kenneth L. Gayles, M'73, spends some of his leisure time making music with his 15 brothers and sisters. The clinical instructor in medicine is a cardiovascular disease specialist. □ Dr. William J.M. Hrushesky, M 73, assis­ tant professor of medicine and laboratory medicine and pathology at the University of innesota, has been awarded a $290,000 NIH grant to study the clinical application of chronobiology in cancer. □ Dr. James S. arks, '73, is chief of the Research/Epidemiology Branch, utrition Division, Center for Disease Control, Atlanta. He has authored or co-authored over 25 papers on Legionnaires Disease and other general topics in Child Health and Epidemiology. Dr. Marks is active in several professional societies and lives at 3165 King Arthur Ct., Atlanta, GA. 30345.D Dr. Elaine arie Bukowski, M'74, is assis­ tant professor of anesthesiology at Duke University. She joined the faculty in 1979. Dr. Bukowski has been appointed to two national committees - blood and blood products and scientific exhibits for the 1983 meeting of the American Society of Anesthesiologists in Atlanta. She lives at 600 Brookview Dr., Chapel Hill, NC 27514. She reports that the moderate climate is en­ joyable. □ Dr. Richard J. Goldberg, '74, is assistant professor of psychiatry at Brown University. He has authored two articles recently: "Anx­ iety Reduction by Self-Regulation: Theory, THE BUFF ALO PHYSICIA, �Practice, and Evaluation" in the April 1982 Annals of Internal Medicine; " anagement of Depression in the Patient with Advanced Cancer" in the July 24/81 JAMA. Dr. Goldberg lives at 182 Freeman Parkway, Providence, RI. 02902.D Dr. John C. Rowlingson, M'74, is associate professor of anesthesiology and director of the Pain Management Center, University of Virginia edical Center. He is active in several state and regional professional societies. Dr. Rowlingson lives at 2590 Cedar Ridge Lane, Charlottesville, VA. 22901.D Or. associate American on the orbert Szymula, M'74, clinical professor, was named a Fellow, Academy of Otolaryngology. He is staff of the Lockport Memorial Hospital. □ Dr. Stanley J. Szefler, M'75, assistant professor of pediatrics, presented two papers at the American Academy of Allergy annual meeting in ontreal recently. He also co­ authored an article "Adverse Reaction to Dru s" for Practice in Pediatrics. □ Dr. Steve Bien, M'76, started his practice July 1 in Farmington, aine (Box 4565, RFD 2, 04938).D Dr. John Bodkin, M'76, clinical instructor in family medicine, is the new chief of famil medicine at Lockport Memorial Hospital. □ Dr. Carl Jay Bodenstein, '78, i associated with Variety Children's Hospital in Miami and his specialty is neonatology. He resides at: 9761 SW 120th St.. Miami, FL. 33176.D Dr. Mark S. Glassman, M'78, is a Fellow in Pediatric Gastroenterology at the University of Pennsylvania. He has co-authored a chapter in "Failure to Thrive in Infanc and Early Childhood", (Johns Hopkins University Press) and he will present a paper on " utritional Uniqueness of the Child" at a symposium on pediatric nutrition by the University of Pennsylvania, Children's Hospital. He lives at 891 . Pennock St.. Philadelphia, PA. 19130.D FALL, 1982 The Classes of the 1980's Dr. Wesley S. Blank, M'80, is finishing his second year of residency at orth Shore University Hospital, Manhasset, .Y. Ob/Gyn is his specialty. In December, 1981 he married anette Reiner of Great eek, .Y. They honeymooned in Finland cross-country skiing. They live in building 4/5, Apt. 3-J. 300 Communit Dr., Nanhasset, 11030.D Or. Thomas J. Dougherty, M'80, received the Crowdle Award for outstanding achieve­ ment in chemistry from Canisius College. The associate professor of pathology and radiobiology at U/B pioneered a treatment for cancer using light to shrink tumors. He is now head of the division of radiation biology al Roswell Park Memorial Institute. The award is named in the memory of Dr. James H. Crowdle, former chairman and member of the Canisius College chemistry department for -10 years. □ Or. David S. Duani, M'80, was among 20 recipients of a $1,500 award from the American Academy of Family Physicians (AAFP) to help finance his graduate training in family medicine. The AAFP is the second largest medical organization in the nited States representing the nation's family doc­ tors. The ead Johnson Awards for Graduate Education in Family Practice, given annually by the cademy since 1952 to aid young physicians planning careers as family doctors, are made possible by a grant from the Phar­ maceutical Division and utritional Division of Mead Johnson & Company, Evansville, In­ diana. Dr. David Duani was selected from a field of 150 candidates on the basis of scholastic achievement, leadership qualities and qualifications for, and interest in family prac­ tice. He is currently a family practice resident at the University of Virginia Medical Center, Department of Family Practice, Charlottesville. □ Or. Brett C. Shulman, '81, is a resident in internal medicine at Strong emorial Hospital, Rochester, .Y. He lives at 928 East­ brooke Lane, Rochester, Y 14678.D 55 �In Memoriam Dr. Gustavo Cudkowicz, professor of pathology/microbiology, died May 25 of cancer. He joined the faculty in 1969. He was principal cancer research investigator at Roswell Park Memorial Institute for three and one-half years before coming to U/B. A native of Zurich, Switzerland, he receiv­ ed his medical degree cum laude from the University of Milan (Italy) where he was also a resident in radiology and later joined its ational Cancer Institute. A post-doctoral fellow at the University of Uppsala (Sweden). he also pursued postgraduate studies at the Oak Ridge ational Laboratory before joining Roswell's staff. At OR L he completed a course in ad­ vanced industrial and research radioisotope techniques subsequently served as a biologist there, and participated in the graduate stu­ dent program at the Un'iversity of Tennessee's Institute of Radiation Biology. One of Dr. Cudkowicz's major discoveries was that the mechanism of graft rejection of bone marrow transplants differs from the mechanism operating in rejection of solid organs such as the kidney. He conferred with scientists in the United States and in other world cities and served on a number of editorial boards for prestigious scientific publications. In recent years he had organized and co­ directed a number of international sym­ posiums on immunology. In 1980 he was the recipient of the first Marie T. Bonazinga Award for outstanding research presented by the Reticulo Endothelial Society and in 1981 was elected an honorary life member of the French Society of Immunology. He was also a member of numerous professional societies including the American Association of Pathologists, the Society for Ex­ perimental Biology and Medicine, the American Association for the Advancement of Science, the Transplantation Society, the American Association for Cancer Research, the American Association of Immunologists, the International Society for Experimental Hematology, the Reticuloendothelial Society and the ew York Academy of Sciences. He had completed a bibliography of more than 130 original scientific articles, chapters or books. □ Dr. elson G. Russell Jr., assistant clinical professor of medicine/emeritus, died May 15. The 74-year-old internist was an active Episcopal layman. He was on the Medical chool faculty 14 years and was in practice 45 years. He was on the staff of Buffalo General Hospital. He served with the U.S. Army Medical Corps during World War II in Europe. When discharged he was a lieutenant colonel. Dr. Russell, a member and a past vestryman at St. Paul's Cathedral, received the Bishop's Cross in 1968 as Episcopal layman of the year. He was active in several professional and civic organizations. He received his MD from McGill University. □ Dr. Vincent I. Bonaf ede, M'30, died April 7 in Mount Morris, .Y. after a long illness. □ Dr. Caryl A. Koch, M'23, died April 28 at Buffalo General Hospital. The 83-year-old physician lived in Orchard Park for 50 years and retired in 1974. He was a physician for the Orchard Park school system for 10 years. Dur­ ing the two world wars he was in the U.S. aval Medical Corps. In 1942 he was in charge of the first naval hospital in England. He was a navy commander when discharged. Dr. Koch was on the staff of Mercy Hospital, and Our Lady of Victory in Lackawanna. He was active in several professional associations as well as lodges and fraternal Dr. Cudkowicz organizations. □ THE BUFF ALO PHYSICIA �A Message from Robert A. Baumler, M.D. '52 President, Medical Alumni Association Fellow Alumni of the University of Buffalo Medical School: As newly elected president of your governing board for 19821983, I hope to do what I can to serve both you and our school dur­ ing my brief tenure. Our program committee under the chair­ manship of Dr. Charles Tanner will be meeting through the summer to plan next year's Spring Clinical Day and if any of you have any suggestions we shall be glad to hear them. Physician , perhaps more than any other alumni, have had their identities set and their lives changed by their medical degree, which perhaps accounts for the special relationship medical alumni have come to have with their alma mater. That bond can still be reciprocally Robert A. Baumler . .\1.D. '52 ratifying. □ -------------------------------------------------------------------------------------------------111111 BUSINESS FIRST CLASS REPLY CARD P RMIT NO. 2210 POST AGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, ew York 14214 BUFFALO, .Y. 'OPOST G TAMP CESSAR't If MAILED I. TH U. ITTD TATTS �THE BUFF ALO PHYSIC! STATE U IVERSITY OF EW YORK AT BUFFALO 3435 M I STREET, BUFFALO, EW YORK 14214 R 44 D 92 0032234 • 0 E T RO T 000 RO 0 Y Ff LO 14226 MIM,-,11111..,..,_, • ._.,_.. THE HAPPY MEDIUM Fill out this card; spread some happiness; spread ome news; no postage needed. (Plea e print or type all entries.) ame ---------------------------------- Year MD Received ---- Office Address-----------------------------------------­ Home Address-----------------------------------------If not UB, MD received from ____________________________________ In Private Practice: Yes 0 In Academic Medicine: Yes D o O Specialty _____________________________ o O Part Time O Full Time 0 Schoo] ____________________ Title ---------------------- Other:---------------------------------------------Medical Society Memberships:-----------------------------------NEWS: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.?----- Please send copies of any publications, research or other original work. _ _ _ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Fall 1982 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1982-Fall Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1982-v16n03-Fall Table Of Contents A list of subunits of the resource. Dean Naughton's Message Commencement Iris Dedication Students Honored "Beyond Medical School," by Dr. DeWitt Stetten Angioplasty Chronobiology by Dr. William J.M. Hrushesky Calcium Blockers "Bioethics in Ob/ Gyn" by Dr. Myron Gordon Alumni Honored Halloween Party Stress Conference Alumni Tours Reception for Seniors The Progress and development of the Buffalo Medical School Library, 1846-1981 by F.X. Roberts Heart Muscle Surgery/Cancer Seminars Dues Paying Alumni, 1982 Continuing Education/Orthopaedic Scientific Day MECO/Career Opportunities/Cancer Programs People The Classes In Memoriam Dr. Robert Baumler's Message Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-07-02 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v16n03 Extent The size or duration of the resource. 60 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1982 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/1c60ae35b07bef69ad14db4f5b0119ed.pdf 32f026badea554e38be32e0514c2b488 PDF Text Text THE L0 BUFFA VOLUME S C H O O L O F M E D IC I N E 16 STATE NUMBER PHYSICIAN 2 UNIVERSITY SUMMER OF NEW 1982 YORK AT BUFFALO �Dean Naughton From the desk of John Naughton, M.D. Dean, School of Medicine Dear Alumni and Alumnae: I was pleased to learn recently that of two important criteria used to measure a Medical School's status, SU YAB's School of Medicine and Faculty of Health Sciences fared very well. Since the measures related directly to our educational and research missions, I was even more delighted. Since a great deal of my time is spent dealing with operational and policy issues, it seem­ ed appropriate to share these bits of information with you. In the educational arena, you should be pleased to know that this School of Medicine is among the leaders in the areas of graduate and post-graduate biomedical education as well as in the medical student and house staff education and training. Ac­ cording to the data made available through the Chronicle of Higher Education, SU YAB ranked sixth among the 126 schools of medicine for total number of students enrolled. More impor­ tantly, in the Doctor of Philosophy programs and post-doctoral student programs, SUNYAB's School of Medicine ranked 20th and 29th, respectively. This is indeed an enviable ·record. A strong school of medicine and graduate center must also have a strong commitment to scholarship and to research activity. Several issues ago, the multiple research programs conducted throughout the pre-clinical and clinical departments were reviewed for you. I was pleased to learn that on a per capita faculty expenditure basis, SU YAB ranked 31st among the nation's medical schools. This represents a marked improvement over earlier years and places the institution in the first quartile of extramarally supported institutions. It also correlates quite nicely with the biomedical educational mission. I report these two aspects of progress and status with you so that you can develop a sense of perspective and appreciation about the total nature and mission of your school of medicine. Hopefully, you share with me a sense of pride and accomplish­ ment for the work being done by the faculty and students. □ �Summer1982 Volume 16, umber 2 THE BUFF ALO PHYSICIAN ( SPS 551-8601 Published by the School of Medicine, State University of New York at Buffalo EDITORIAL BOARD Editor ROBERT 5. MCGRA AHA Dean, School of Medicine DR.JOH AUGHTON Photography 14 U OWAK 19 20 Visual Designers 21 HUGOH. EDWARD GER RICHARDMACAKA JA Do ALD E. WATKI S Associate Editor TERI ROBERTS CONSULTA TS President, Medical Alumni Association DR. 2 8 ORMA CHASS! Vice President, Faculty of Health Sciences DR.F.CARTERPA ILL President, University Foundation JOH M. CARTER Director of Public Affairs HARRY JA K 0 Teaching Hospitals The Buffalo General Children's Deaconess Erie County Medical Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Charity Veteran Administration Medical Center THE BUFFALO PHYSIC IA 22 24 26 28 30 31 32 33 34 35 36 37 38 41 44 I THIS ISSUE Dean aughton's Message (inside front cover) Post Graduate Matching Guido Baccelli, Physician, Statesman, Citizen of Rome The Clinical Years Student Awards/Fifth Pathway/Transfers Exercise, Good Health Dr. Ronald Martin Parents' Weekend Dr. Koslow CAT Scanning for the Clinician Athletic Day Infectious Disease Dr. Warner Summer Fellowships Physiology Chairman CAPO Program Pediatric Conferences Dr. hardack Better Vision/Continuing Medical Education People la ses In Memoriam Dr. Chassin's Message (inside back cover) The cover by Donald Watkins refers to story on Page 8. THE BUFFALO PHYSICIA . (USPS 551-860). Summer, 1982 - Volume 16, umber 2 published quarterly Spring, Summer, Fall, Winter - by the S hool of Medicine, State University of ew York at Buffalo, 3435 Main Street, Buffalo, ew York 14214. Second clas po tage paid at Buffalo, ew York. POSTMASTER: Send address changes to THE BUFFALO PHYSICIA , 139 Cary Hall, 3435 Main treet, Buffalo, ew York 14214. opyright 1982 by The Buffalo Physician. SUMMER, 1982 1 �Steve Goldstein, John fisgus, Michael Waxman Post Graduate Matching Jessica Rockwell. Sue fischeck Eighty-eight percent of the senior medical students received their first, second or third choices in the annual ational Resident Match Program. Twenty-three of the 143 students did not par­ ticipate in the national program and matched themselves. Two other students are not taking internships. According to Dr. Leonard Katz the 1982 match was the best in the school's history. "The caliber of the programs matched was excellent." The most popular programs were medicine, 55; surgery, 21; pediatrics, 20; family practice, 14; and Ob/Gyn, 13. Dean John aughton told the students "that their contributions to the school and the community during the last four years were appreciated. You are a good class; thi:-;;is a gratifying match; the Buffalo based programs are doing well. We wish you well after you graduate." Fifty-three students selected Buffalo based programs for their residency and another 40 will remain in ew York State. The most popular Buffalo post-graduate programs were medicine, 33; sur­ gery, 17; pediatrics, 21; family practice 14; and ob/gyn, 13. Students selected superior programs at Yale, Dartmouth, Johns Hopkins, Case Western Reserve, New York University, Presbyterian and Montefiore Hospitals, University of Rochester, Minnesota and Virginia. Match Day began 30 years ago. This year 13,044 fourth-year students throughout the nation were matched with hospitals and programs of their choice. Faculty members who assisted in the U/B program were: Ors. Dennis adler, pediatrics; Joseph Caruana, surgery; Murray Morphy, ob/gyn and psychiatry; John Richert, family medicine. Abati, Andrea D., YU Medical Center, ew York, Pathology C Adler, Daniel J., Lenox Hill Hospital, ew York, Medicine C Alleyne, Michael G., SU Y/Buffalo, Anesthesiology Andrews, Charles F., University of California (Irvine], V.A. Long Beach Hospital, Medicine C Augustino, Michael, University of Miami Affil. Hosps., Ob/Gyn C Barlog, Elizabeth, SUNY /Buffalo, Buffalo General Hospital, Surgery C Barlog, Kevin, SU Y/Buffalo, Buffalo General Hospital, Surgery C Bartlett, Michael, University of Rochester Assoc. Hospitals Program, Rochester, .Y., Medicine C Baumwell, Ivan A., Millard Fillmore Hospital, Medicine C Preliminary 2 THE BUFF ALO PHYS ICIA �,. Beneitone, Roger J., University of Connecticut Affiliated Hospitals, Farmington, Conn., Medicine C Bilodeau, Catherine L., SU Y/Buffalo, Family Practice C Bilotta, Jeffrey, Presbyterian Hospital, New York, Medicine C Blossom, Mark, Medical College of Pennsylvania, Philadelphia, Medicine C Brody, Jill, SU Y/Buffalo, Medicine C Preliminary Cesar, Michael, Millard Fillmore Hospital, Medicine C Chartash, Elliot K., Temple U. Hospital, Philadelphia, Medicine C Chirlin, Robert, Cose Western Reserve University Hospital, Cleveland, Pediatrics C ew York, Medicine C Cho, Joan 0., Harlem Hospital, Chung, Mark, University Hospital SU Y /Stony Brook, N. Y., Medicine C Hospital Center, New York, Cochrane, Cheryl, Montefiore Surgery C Preliminary Contessa, Benjamin, assau County Medical Center, East Meadow, . Y., Ob/Gyn C Corbelli, Richard, Millard Fillmore Hospital, Medicine C Crandall, E. Scott, SU Y /Buffalo, Ob/Gyn C Cunningham, Kevin, SU Y /Buffalo, Ob/Gyn C Curry, Arlene, St. Vincent Hospital, N. Y., Medicine C DeLeo, Rosemary, Ulster County Family Practice Program, Kingston, . Y., Family Practice C Dew, Thomas, SU Y/Buffalo, Pediatrics C . Y., Donovan, Stephen J., Bronx Municipal Hospital Center, Psychiatry C Dudek, Robert P., Millard Fillmore Hospital, Surgery C Engelbert, Marc S., Mt. Sinai Hospital, N. Y., Ob/Gyn C . Y., Ob/Gyn C Erickson, Amelia A. The ew York Hospital, . Y., Surgery C Failla, Joseph, North Shore Hospital, Manhasset, Faillace, Frank A., Medical College of Virginia, Richmond, Medicine C . Fischbeck, Susan, Case Western Reserve University Hospital, Cleveland, Pediatrics C Fischer, Sheila R., Montefiore Hospital, N. Y., Pediatrics Social Fisgus, John R., SU Y /Buffalo, Medicine C Pediatrics Ford, Daniel E., Johns Hopkins Hospital, Baltimore, Medicine C Freedenberg, Debra, Yale- ew Haven Medical Center, Conn., Pediatrics C Gallagher, Susan J., SU Y/Buffalo, Medicine C Pediatrics Gasparo, Beth Ann, Eastern Virginia Graduate Medical School, orfolk, Va., Pediatrics C Primary Geering, Timothy, Cincinnati General Hospital, Cincinnati, Family Practice C Gelormini, Joseph L., SU Y/Buffalo, Medicine C Gianfagna, Robert A., SU Y/Buffalo, Medicine C Preliminary Gibbons, Olga, Downstate Medical Center, Kings County Hospital, Brooklyn, Family Practice C Ginsberg, Harold, University of California, San Francisco, Research Fellowship Gioia, Joseph F., Millard FiJlmore Hospital, Pathology Goldberg, Jody, Montefiore Hospital Center, . Y., Pediatrics C Goldberg, Rochelle, Medical College of Pa., Philadelphia, Medicine C SUMMER, 1982 3 Paul Rosenberg, Lindo Rabinowitz �The Jay Levat's Linda-Jo Saunders, Lauracinnie Jenkins Goldstein, Steven I., YU-University Medical Center, . Y., E TC Golia, Anthony, Millard Fillmore Hospital. Medicine C Preliminary Gordon, Randi, Case Western Reserve University Hospital, Cleveland, Pediatrics C Gottsegen, David ., Duluth Family Practice Research, Duluth, Minn., Family Practice C Graf, Jeannette 0., Long Island Jewish Hospital. .Y., Pediatrics C Granese, Diana R., SU Y/Buffalo, Ob/Gyn C Greendale, Gail A., Rhode Island Hospital, Providence, Medicine C Preliminary Grobe, Lydia H., SU Y/Buffalo, Erie County Medical Center, Surgery C Halabi, Mohamed K., American University of Beirut Medical Center, Lebanon, Ob/Gyn Harster, Gerald A., Montefiore Hospital. Pittsburgh, Flexible Healy, Elaine, Westchester County Hospital, Valhalla, .Y., Medicine C Heath, Richard, SU Y/Buffalo, Medicine C Herschowitz, Stephen M., assau County Medical Center, East Meadow, N. Y., Medicine C Preliminary Homan, Richard, Hershey Medical Center, Hershey, Pa., Family Practice C Hordes, Andrew R., Maine-Dartmouth Family Practice, Augusta, Maine, Family Practice C Hurley, Patrick T., University of Virginia Medical Center, Charlottesville, Va., Medicine C Primary Jain, Rakesh K., Georgetown V.A. Program, Washington, D.C., Medicine C Photos b~· Ed llovak Jenkins, Lauracinnie, SU Y/Buffalo, Medicine C Preliminary Kane, Matthew J., SU Y/Buffalo, Medicine C Preliminary 4 THE BUFFALO PHYSICIA �Kawecki, Annette R., Framingham Union Hospital, Framingham, Mass., Flexible University of Maryland Hospital, Baltimore, Pediatrics C Kelly, Mary A., Millard Fillmore Hospital, Medicine C Kloesz, Wendy, University of Maryland Hospital, Baltimore, Fami­ ly Practice C Korwin, Debbie, SU Y/Buffalo, Pediatrics C Kousourou, Harry H., University Hospital SU Y /Stony Brook. . Y., Medicine C Kurss, David I., SU Y /Buffalo, Ob/Gyn C Leberer, Joseph P., SU Y /Buffalo, Buffalo General Hospital, Keane, Virginia, Surgery C Lee, Sin Ping, . Y. Infirmary/Beekman Downtown Hospital, . Y., Ob/Gyn C Leon, Michelle, University of Missouri, Kansas City Affiliated Hospitals, Kansas City, Medicine C Levat, Jay M., Montefiore Hospital Center, . Y., Medicine C Levine, David C., Lenox Hill Hospital, . Y., Surgery C Maisonave, Marvin, SU Y /Buffalo, Medicine C Pediatrics Marchand, Paul, Kaiser Foundation, Santa Clara, Ca., Medicine C Mason, Amy J., Rochester General Hospital, Rochester, . Y., Medicine C Mastrangelo, Ralph, orth Shore Hospital, Manhasset, . Y., Medicine C McAvoy, Marcia, SU Y /Buffalo, Medicine C Preliminary McDonnell, Mar~aret P., SU Y/Buffalo, Ob/Gyn C Mc ally, Lois M., YU Medical Center, .Y. Surgery C Mendola, Janet, SU Y/Buffalo, Psychiatry C Mennen, Martin, Baylor College Affiliated Hospitals, Houston, Texas, Flexible Moll, Jeffrey, Sinai Hospital, Baltimore, Medicine C Murphy, ancy, Thomas Jefferson University, Philadelphia, Medicine C Elaine Healy, Dr. Katz Cathy Cyrulik, Mary Shapiro S M ER, 1982 5 �Chor/es Andrews. Jeff Bilotta icholson, Charles, SU Y/Buffalo, Medicine C Preliminary Nierenberg, Steven J., Montefiore Hospital Center, . Y., Medicine C Preliminary orris, Andrew M., Millard Fillmore Hospital, Medicine C Preliminary Marvin Maisonave, Isiah Pinckney ybord, Elsa, St. Louis University, St. Louis, Pathology Orgel, David, SU Y/Upstate Medical Center, Syracuse, . Y., Pediatrics C Penhallurick, William, Yale- ew Haven Medical Center, Conn., Anesthesiology Peters, ancy, Millard Fillmore Hospital, Medicine C Pinckney, Isaiah, Brookdale Hospital Medical Center, Brooklyn, Family Practice C University Hospital, Cleveland, Medicine C Pollack, Stephen, Erie County Medical Center, Opthalmology Rabinowitz, Linda, Yale- ew Haven Medical Center, Conn., Pediatrics C Pleskow, Douglas, Case Western Reserve Rafferty, George, Case Western Reserve University Hospital, Cleveland, Psychiatry C Roche, Steve A., University of Texas Southwestern Medical School Program, Dallas, Psychiatry C Rockwell, Jessica, Brigham and Women's Hospital, Boston, Ob/Gyn C Rosenberg, Paul ., SUNY /Buffalo, Medicine C Preliminary Ross, Josephine R., SU Y/Buffalo, Pediatrics C Rougeux, Richard, SU Y/Buffalo, Pediatrics C Saint Martin, Manuel, Cedars-Sinai Medical Center, Los Ange/es, Surgery C 6 THE BUFF ALO PHYSICIA �Sammis, Cynthia L., Maine-Dartmouth Family Practice, Augusto, Moine, Family Practice C Santelli, John S., University of Maryland Hospital, Baltimore, Pediatrics C Saunders, Linda-Jo, ossou County Medical Center, East Meadow, . Y., Surgery C Schantz, Arthur, Long Island Jewish Hospital, . Y., Surgery C Schechter, William, Presbyterian Hospital, .Y. Pediatrics C Schenk, Gregory P., SU Y /Buffalo, Family Practice C Schertzman, Donald, assou County Medico/ Center, East Meadow, .Y., Medicine C Preliminary Schneider, Steven, Highland Hospital, Rochester, . Y., Family Practice C Schu, William, SU Y /Upstate Medical Center, Syracuse, N. Y., Surgery C Sellew, Ann, ew York Hospital, N. Y., Psychiatry C Serna, Joe R., Jr., Phoenix Hospital Affiliated, Phoenix, Pediatrics C Silbiger, Sharon R., University of Mass., Coordinated Program, eurology C Worcester, Smith, Alford, Downstate Medical Center, Kings County Hospital, Brooklyn, Family Practice C Sofia, Peter J., Millard Fillmore Hospital, Surgery C Preliminary Speach, Albert, Jr., Millard Fillmore Hospital, Surgery C Preliminary Spurdon, Chantel H., University of Rochester Hospital Programs, Rochester, . Y., Ob/Gyn C Stegemann, Philip M., SU Y/Buffalo, Buffalo General Hospital, Surgery C Stephens, Susan M., Travis Air Force Bose, David Grant Medical Center, Fairfield, Co., Pediatrics C Sterman, Ilene, SU Y /Buffalo, Pediatrics C Stern, Marc F., SU Y/Buffolo, Medicine C Stern, Robert, Millard Fillmore Hospital, Medicine C Preliminary Swanson, Erika, Medical Center/Beaver County, Beaver, Po., Family Practice C Thomas, Robert C., Jr., SU Y/Buffalo, Erie County Medical Center, Surgery C Van Gorder, Thomas R., Millard Fillmore Hospital, Surgery C Vitale, Gerard F., orth Shore Hospital, Monhosset, . Y., Surgery C Vogt, David G., SU Y/Buffalo, Erie County Medical Center, Surgery C Preliminary Wadell, James C., Millard Fillmore Hospital, Medicine C Preliminary Warach, Jonathan 8., SU Y/Buffalo, Medicine C Preliminary Wasiewski, Warren W., SU Y /Buffalo, Pediatrics C Waxman, Michael D., ew Rochelle Hospital Medical Center, ew Rochelle, . Y., Medicine C Wayne, Joseph T., St. Louis University Group Hospital, St. Louis, Medicine C Pediatrics Weiner, Judith G., SU Y/Buffalo, Medicine C Preliminary Wolf, Richard, Dartmouth-Hitchcock Center, Hanover, .H., Medicine C Yacobucci, Gerald ., Millard Fillmore Hospital, Surgery C S MMER, 1982 7 Elaine Healy Annette Kawecki, Dr. Murray Morphy �GUIDO BACCELLI (1832 - 1916) PHYSICIAN, STATESMA A D CITIZE OFROME by Thomas S. Bumbalo, M.D., M.Sc. (Med.) Clinical Professor, Pediatrics - Emeritus - U/B Medical Director, Erie County Medical Center - Retired Massimo Carrella, M.D. Assistant Professor, Medicine - U/B Attending Physician, Erie County Medical Center Guido Baccelli, one of the greatest clinicians of the 19th century and the major contributor to the Renaissance of Italian Medicine, was born in Rome on ovember 25, 1832.1 Baccelli was a decendent of an old and illustrious noble Florentine family that had moved to Rome in the 1700's. Baccelli's father, a well-known surgeon and father of eight children, apparently had not enjoyed the luxury of great wealth. Guido Baccelli's son, Alfredo, an author and politician who published a biography of his father in 1931, wrote that his father inherited "un barile d'aceto (a barrel of vinegar,) some land and a house." 2 While a student at the University of Rome from which he graduated at the age of 22 years, Baccelli was inspired and fascinated by the works of the great masters of medicine, amongst whom were Giovanni Bat­ tista Morgagni - the Italian anatomist of Padua whose "De Sedibus et Causis Mor­ borum" made pathological anatomy a science and the anatomist, Marcello Malpighi. However, he was not always the serious stu­ dent while serving his assistantship (the equivalence of today's residency) at the San­ to Spirito Hospital. Baccelli's conduct was not much different from present-day House Officers who engage in such pastimes as a game of dice or bridge on payday nights. Baccelli, too, on payday nights, enjoyed a spirited game of Zecchinetto, an Italian game of cards. During Baccelli's early medical career, the stethoscope was not generally used in Ita­ ly, even though Rene Laennec, the dis­ tinguished French physician had discovered the stethoscope in 1819, thirteen years before 8 Dr. Boccel/i Baccelli's birth. Baccelli insisted on always using the tubular monaural stethoscope for auscultation rather than the common practice of the time of placing the ear to the patient's chest. For this practice, Baccelli became known as "the doctor who vists patients with the trumpet." Very early in his career, Baccelli demonstrated a profound interest in academic medicine in both the fields of research and teaching. Only two years after graduation from Medical School, at the age an assistant of 24, he was appointed professor of Medical Jurisprudence by the University of Rome. Early in his career he possessed an intense interest in the field of pathology. At a time when the University of Rome lacked an organized Pathology program, Baccelli busied himself correlating the clinical findings of his patients with find­ ings revealed at the autopsy table, perform­ ing an incredible number of autopsies, well in the thousands, before he was appointed a full professor. THE BUFF ALO PHYSICIA �At the early age of 32 years, his alma mater appointed him a full professor in the department of Clinical Medicine. He spent the next 60 years as a dedicated and devoted teacher, watching many of his students dis­ tinguish themselves as important members of the Italian clinical and academic community. Among those that so distinguished themselves was the beloved clinician Augusto Murri (1841 - 1932) who studied in Berlin, Paris and Florence under the dis­ tinguished clinicians of the time, including the French physician Jean Baptiste Bouillaud of infectious endocarditis fame; Ludwig Traube, the German physician of Traube's semilunar space fame; and Theodor Frerichs, the Berlin physician of Frerichs theory fame. Augusto Murri worked with Baccelli as his assistant and eventually became Baccelli's successor. 3 In memorializing Baccelli, Augusto Murri stated that indeed Baccelli had no reason to be envious of Murri's former distinguished teachers.• Baccelli possessed all the attributes of a great teacher. He was a warm, kind and vigorous man with a forceful drive and a deep scientific curiosity. He was colorfully articulate and eloquent. As a classical Lalin scholar, at times he would draw on his ready knowledge of Latin by presenting clinical data and preparing scientific papers entirely in Latin. Baccelli was blessed with a marvelous memory, a singular versatility and the capability to ferret out necessary data to arrive at a correct clinical diagnosis. He in­ sisted on using elementary methods to arrive at a diagnosis by correlating a careful medical history with a carefully performed physical examination. He also advocated the use of a formula that synthesized older knowledge and methods with modern analysis to arrive at a diagnosis. Baccelli had an excellent knowledge of anatomy and in his teachings, he stressed the importance of applied anatomy in diagnosis. He instilled in his students and colleagues an awareness and a critical, but always compassionate, analysis of their shortcomings. He also stimulated students and colleagues to always consider the value of clinical observations, together with reliable laboratory and research data in studying patients. Seasoned clinicians who attended his lectures and medical rounds were frequently awed and amazed by the vastness of Baccelli's medical SUMMER, 1982 knowledge. Baccelli was the ferment that generated interest and stimulated students and colleagues to study and learn and then translate their medical knowledge to the welfare of their patients. Indeed, he was that rare combination of a diligent researcher, a dedicated teacher and a superb clinician with the eloquence of a Roman orator. Baccelli's presentation at a medical meeting in Paris in 1887, prompted the French physi­ cian Jean Baptiste Bouilland to say, "Today you have heard the Demosthenes and the Cicero of Science." An interesting anecdote that is documented in the Italian Medical literature relates to Baccelli's encounter with the papal government of Rome before the unification of Italy. Cardinals of the Papal Government of the time capriciously and frequently negated even the most modest of Baccelli's requests. Baccelli was considered anti-papal, and eventually he had to make a public declaration refuting malicious accusations against him. However, Baccelli's popularity and enthusiastic acceptance by his students and members of the medical community of Rome served to shield him from further resistance and propaganda eminating from the Papal Government. In essence, like in modern medicine, Baccelli was harassed by governmental bureaucracy which he was compelled to resist and oppose. 5 CLI ICIA , RESEARCHER A D TEACHER Baccelli's description of aphonic pec­ toriloquy, which became known as the Baccelli sign, contributed considerably to his international reputation as a clinician. The Baccelli sign is the transmission of the sound of the whispered voice through a serous plural effusion but not transmitted through a purulent plural effusion, thus making it relatively simple to distinguish between a serous and a purulent plural effusion. Another diagnostic sign developed by Baccelli was the percussion of the ilium bone as an aid in the diagnosis of an ovarian tumor. In that era, before the advent of such sophisiticated diagnostic tools as x-ray, ultra sound and CAT scan these clinical signs played an important role in clinical diagnosis. 9 d- �Baccelli's knowledge of malaria [the word malaria comes from two Italian words - maJ aria meaning bad air) and his research in the transmission of malaria gave impetus to the reclamation of swampy lands in the Com­ pagna Romana. In a lecture on malaria presented at the University of Palermo in 1902, Baccelli not only gave evidence of his profound knowledge of malaria, but also his knowledge of ancient medical history. He recalled that Hippocrates was the first to es­ tablish the relationship of malaria with stag­ nant water. Baccelli opened this particular lecture by addressing the audience as "illustrious and valiant colleagues and belov­ ed disciples." This rather flowery and ornate introduction is indicative of the gallantry of the era and also the high esteem Baccelli had for his colleagues and students. At a time when the Laveran theory of the transmission of malaria was not wholly accepted in Rome, Baccelli supported the theory of Alphonse Laveran (1845 - 1922), the French discoverer of the malaria parasite, plasmodium vivax. 5 Baccelli classified malaria according to the presenting symptoms and the intensity of the symptoms, using such terminology ad diaphoretic, syncopal, lethargic, biliary, catharral and rheumatoid.a In 1890, Baccelli introduced the use of Quinine intravenously in the treatment of malaria. Undoubtedly, malaria of some 90 years ago was more virulent and justified such heroic methods of treatments. The animal research that introduced intravenous use of Quinine again was evidence of Baccelli's keen mind as a researcher. The rationale for the intravenous treatment was to get to the red blood cells that carried the parasite. He first administered Quinine hydrochloride intravenously to rabbits with resultant total failure. Baccelli attributed the death of the research rabbits to the acidity of the Quinine hydrochloride. He then used a neutralized solution of Quinine intravenous­ ly and the rabbits survived. The use of the neutralized solution of Quinine hydrochloride intravenously in the treatment of malaria met with gratifying success. Baccelli also learned that by administering the Quinine solution at the decline of the fever peak, it prevented the next temperature spike. In an attempt to sterilze blood, Baccelli introduced the use of corrosive sublimate 10 (corrosive mercuric chloride] intravenously in the treatment of syphilis, septecemia and erysipelas and also the use of phenol in the treatment of tetanus. The research methodology differed little from Paul Ehrlich's research that led to the successful treatment of syphilis with the combination of arsphenamine and copper, known as Salvar­ san or 606, the 606th different chemical that Ehrlich tested in his search for a cure of syphilis. or did Baccelli's research methodology differ appreciably from 20th century research that, eventually in 1945, won the Nobel Prize for Fleming, Florey and Chain for their penincillin research. Their research in essence, too, was a search for an internal antiseptic. Baccelli's treatment of these grave diseases led Virchow to remark, "that which Lister did for the surface of the body, Baccelli has done for the blood."' In addition, Baccelli introduced, in Italy, oxygen therapy for the treatment of pneumonia which he administered to . King Vittorio Emanuelle IL He also introduced, in Italy, venesection in the treatment of hypertensive nephritis. Between 1852 and 1863, Baccelli publish­ ed, in three volumes, a scholarly dissertation entitled "Pathology of the Heart and the Aor­ ta" in which he presented a critical analysis of the known medical data in the field of car­ diopathy.1 Indeed, Baccelli's volume of car­ diac knowledge compared very favorably with the prestigious works of the Irish physi­ cian, William Stokes and the Heidelberg physician, Nikolas Friedreich. In 1876, Baccelli applied his untiring energy and research skills in the treatment of aortic aneurysm by the introduction of a coil of metal in the walls of the aneurysm. In more recent times, surgeons, using much the same principle, have treated the anomalous dystrophy of the abdominal wall in infants, known as omphalocele, by implanting a fine plastic mesh in the dystrophic anterior ab­ dominal wall. Baccelli was among the first clinicians to focus attention to host reaction, in disease processes, in evaluating patient response to specific disease. He used tuberculosis as a classic model, explaining that the mycobacterium tuberculosis is capable of causing pulmonary tuberculosis with cavita­ tion in one patient, central nervous system THE BUFFALO PHYSICIA �tuberculosis in another and tuberculous enteritis in yet another patient, depending on the reaction of the host to the tubercle bacillus and the "locus minoris resistentiae" of the patient. Baccelli repeatedly cautioned the Italian medical community to keep abreast of new medical knowledge and never to be content with the bare medical knowledge required to guarantee a medical diploma and the license to practice medicine. Was Baccelli one of the forefathers of con­ tinued medical education? Baccelli's fame was truly recognized in­ ternationally. He was not only the number one clinician in Italy but one of the greatest clinicians of his time. He was honored by the Medical Institute of France and the Medical Academies of England and America. Not­ withstanding all these honors, Baccell_i _was never appointed a member of the presllgious Italian Academy of Lincei, even though he was recommended for membership by its President, Quintino Sella. Obviously, professional rivalry and envy were not in­ vented in the 20th century. Baccelli con­ tributed abundantly to the Italian, Germany and French medical literature with a total of 132 published papers by the end of his medical career.• In addition, Baccelli was the founder of the prestigious Italian medical journal Policlinico and also the founder of the Italian Society of Internal Medicine. ST A TESMA A D CITIZE Perhaps the impetus for Baccelli's active career as a stateman and citizen of Rome was the memory of the past gradeur and greatness of the Roman Empire. E_vidence ~f this was his fascination with Latin and his burning interest in the antiquity of Rome and the fame of the great men of ancient Rome. 9 In 1874, Baccelli was elected a Deputy of the Italian Parliament. From 1880 - 1884, he served as Minister of Education in the Italian Cabinet. He served a second term as Minister of Education from 1893 - 1896 under Prime Minister Crispi. From 1901 - 1903, he served as Minister of Agriculture, Industry and Commerce. As the Minister of Educa­ tion, he sponsored many reforms in the Italian educational system. He was a forceful proponent and supporter of the ~utonomy_of the institutions of higher learnmg. He m­ sisted that the universities had the sole right SUMMER. 1982 to confer degrees but the government had the sole right to grant a license to practice a profession, much like today's practice in our country. Remembering how, before the unification of the many Italian republics into a united nation, Italy had been invaded, plundered and humbled by a great assortment of Euro­ pean armies including the Austrians, the French, the Germans, the Flemish, Spanish and Hungarians, Baccelli as a statesman and citizen and even as a doctor of medicine worked to help build a strong, viable Italy that no longer would be an easy mark for the conquering armies of Europe. Bacc~lli _ad­ vocated legislation to develop and mamtam a healthy population, particularly the youth, by proposing a rigid program of physical acti~ity including a variety of sports and gymnasllcs. He believed that a program of physical, men­ tal and moral education would produce a new generation strong and healthy in body and mind just as existed in Ancient Rome. Indeed Baccelli, as a statesman, had an in­ satiable desire to use the Roman classics and Roman antiquity for their moral, political and educational value. He referred frequent­ ly to an aphorism of the times, "mens sana, in corpore sano" (a healthy mind in a healthy body). As the minister of agriculture, he ad­ vocated some form of manual labor in the fields as part of the elementary school curriculum to teach children the fundamen­ tals of agriculture. Indeed, in today's educational system, Dr. Jean Mayer, the world recognized nutritionist and President of Tufts University, in his belief to broaden the scope of liberal education stated, "Although our students most probably will not end up being farmers, it is important that they know something about agriculture." While in office, Baccelli also established the "Tree Feast Day," Arbor Day in our society, to encourage the planting and maintenance of trees. He was also credited with the im­ proved culture of wheat in Italy. From 1901 to 1903 while the Minister of Agriculture, Industry and Commerce, Baccelli became concerned about the effects of alcoholism - particularly in the working class. With the industrial transition of the era and its resultant stress on the worker, Baccelli recognized the dangers of alcohol and recommended a reasonable use of wine in 11 d- �preference to stronger alcoholic beverages. With a mild resemblance to the modern "Madison Avenue" hucksters of our times, he promoted a competition amongst Italian wineries to produce a wine of modest cost and lower alcohol content which he dubbed "Vino Popolaro", wine of the people. As a statesman, physician, citizen and humanist, he advocated obligatory drainage of malaria lands. The merit of this plan was the eventual reduction in the incidence of malaria and improvement of the national economy. He deemed it urgently necessary to improve the condition of the land, the quality of water and he deemed it equally urgent to irrigate the land to improve productivity and the health of the citizens. Baccelli was able to persuade the Italian Parliament to compel land owners to improve their lands. He con­ tended that the land was sacred and the abuse of the land, in essence, constituted a social crime. He also, without success, tried to in­ stitute a land reform program that provided equitable distribution of land. A program that has never met with total success anywhere in the world! Baccelli was responsible for the construc­ tion of the Passeggiata Archeologica (the Archeological Promenade) which runs from the Palatine Hill, one of the seven hills of Rome, to the Terme Antonine Spa. Lined with shady trees, this promenade stands as one of Rome's interesting landmarks. The archeological restoration of the Forum, the Vestal Virgins Temple, the Concordia Temple and the Vista Temple were in part due to Baccelli's intense interest in ancient Rome. Baccelli also vigorously supported the archeological excavation of Pompeii, which today stands as one of the outstanding archeological wonders of the world. Another admirably quality of Baccelli was his democratic idealism. While he enjoyed an intimate association with the aristocracy, the politicians and the plutocrats of Rome, he never made himself subservient to any of them, particularly to the aristocracy. He promoted the dignity of the individual and in­ sisted that justice and peace for all hinged on public and individual virtue and integrity. Baccelli was an ardent patron of opera and music. He had a keen fondness of domestic animals, particularly cats. He also was an ar­ dent hunter, but with a poor hunting reputa­ tion. 12 After the death of his wife, about whom lit­ tle is written, Baccelli met an old friend and former patient, the Princess Eleanora Cenci Vicovaro. Baccelli lived and traveled with the Princess until her demise caused by diabetes mellitus. After the death of Princess Vicovaro, Baccelli returned to Rome and was at once rejuvenated by the rising ferment in prepara­ tion of World War I. In October of 1915, ap­ proaching the age of 85, Baccelli suffered a bout of bronchopneumonia with a recurrence two months later followed by heart failure and death on January 10, 1916. Baccelli will live forever amongst the names of great men. He left an indelible mark in medicine, in education, in public health and in communal welfare. It can safely be stated that his entire life was dedicated to the welfare of his fellow man, the appreciation of the greatness of ancient Rome for which he had an everlasting love and a profound drive to help make his Italy, once more, a great na­ tion. Indeed Baccelli was "the true son of Rome, the greatest citizen of Rome." □ BIBLIOGRAPHY 1. Enciclopedia ltaliana, Roma, lstituto Giovanni Trec­ cani. 1949, Vol. 5, p.779. 2. Baccelli, A.: Guido Baccelli Ricordi. apoli, Edizione La Riforma Medica, 1931, p.1. 3. Castiglioni, A.: A History of Medicine, ew York. Alfred A. Knopf, 1947, 2nd Edition. p.840. 4. Murri, A.: Guido Baccelli cittadino e insegnante, II Policlinico, Sezione Medica, 23:l (1916). 5. Manzi. L.: Proceedings of the XXIII International Congress of the History of Medicine, London, Wellcome Institute, Vol. 2, p. 1116. 6. Baccelli, G.: L'Infezione de malaria, Cassella Medica di Roma, 30:393 (104). 7. Maragliano. E.: Guido Baccelli clinico, II Policlinico Sezione Medica. 23:25 [1916). 8. Gorrini, G.: Guido Baccelli, La vita, !'opera, ii pen­ siero, Torine, S. Lattes Co.,1916 p.31. 9. Gsanarelli, G.: Guido Baccelli uomo politico e medico sociale, II Policlinico, Sezione Medica, 23:71 (1916). THE BUFFALO PHYSICIA �The Baccelli Medical Club of Buffalo I .. 1910 the Italian University Club of Buffalo was organized by a group of professional men. Membership was limited to Italian decent graduates of the schools of Medicine, Dentistry, Law and Pharmacy of the University of Buffalo. The preambles of the club, in part, read, "To perpetuate and foster, in America, the rich professional and cultural heritage of Italian Arts and Science." Monthly meetings of the club were rotated to then prestigious hotels in Buffalo; the Genesee Hotel, the Iroquois, the Broezel, the Lafayette and the original Hotel Statler which later was renamed the Buffalo Hotel, when the Statler was built facing McKinley's monument. Annually, a sumptuous banquet was held in honor of all the new university graduates of Italian decent. In 1918, when many of its members were called to arms in World War I, the club was disbanded. In 1920, the club was reorganized as the Italian Medical Group of Buffalo. Membership was limited to physicians of Italian decent. In 1924, the name of the club was changed to the Baccelli Medical Club of Buffalo, in honor of Dr. Guido Baccelli. The name Baccelli was suggested by Dr. Joseph S. Giau-Franceschi, a Buffalo Radiologist who had studied in Italy while Baccelli was Italy's Minister of Education. In 1948, the Baccelli Medical Club sponsored an annual meeting, together with the Buffalo Academy of Medicine, bringing to Buffalo distinguished American Physicians of Italian decent. In addition, in 1948, the Bacelli Medical Club established the Guido Baccelli Award which is granted to a graduating student of our medical school who has distinguished himself in a medical research project while a student. The award, in addition to a com­ memorating plaque, includes a stipend of $200. As of today, the Baccelli Medical Club has a membership of 141 physicians representing all the disciplines of Medicine and Surgery, many of whom have distinguished themselves as teachers in our medical school. The club continues to meet monthly with a dinner, followed by an address by a prominent physician or researcher for which the membership receives CME credits. Guido Baccelli (1832-1916) Physician and Citizen of Rome Guido Baccelli, one of the greatest clinicians of the 19th cen­ tury and the major contributor to the Renaissance of Italian Medicine, was born in Rome on November 25, 1832. Baccelli was a descendent of an old and illustrious noble Florentine family that had moved to Rome in the 1700's.D SUMMER, 1982 13 �Deon John Naughton The Clinical Years Dr. Evon Calkins "As a class you have done very well in your first two years. The faculty is very proud of your academic accomplishments. We ex­ pect a lot from you in the next two clinical years." That is what Dean John aughton told the 138 third year students at the fourth annual one-half day of orientation. The students started their clinical rotations the next day at the teaching hospitals. Continuing, Dean aughton said, "People will see you as physicians wherever you go in the hospitals. I wish you well." Six faculty members participated in the case history presen­ tation. Before introducing the patient to the students, Dr. Evan Calkins talked briefly about the ingredients for proper manage­ ment and the person as a patient and the person as a physician. The professor of medicine and chairman of the curriculum committee said, "All disciplines use the same "raw materials'' a good history, physical examination, laboratory assessment, careful discussion with the patient and family and a well-thought­ out plan of management. As a student, it is essential to improve one's skill in these fundamental clinical disciplines as one proceeds throughout the entire third year course. "Patients are never compartmentalized the way we physicians compartmentalize our different disciplines. Patients almost always present problems involving several disciplines. As students, what one learns in one "course" is applicable in all courses. As physicians, one must develop some degree of mastery of all of these disciplines, and look at the patient from a holistic point of view. "The development of an integrated approach to the entire patient is one of the biggest challenges faced by students during the third year." Patient X, a 19-year-old college student, and her mother were interviewed for 30 minutes by physicians and students. For the past seven years the young lady had suffered from psoriasis, and for five years from continuously active rhematoid arthritis. The four physicians who interviewed the patient were: Drs. Lawrence ). emeth, clinical assistant professor of pediatrics; Linda F. Pessar, assistant professor of psychiatry; Brummitte Wilson, assis­ tant professor of dermatology; and Evan Calkins. This demonstrated the "team concept" that the students would be in­ volved with during their careers. Case Summary: In 1975 she began to notice itching of the scalp, increased dandruff and a rash on the scalp, arms and shins characteristic of psoriasis. She received steroid ointment in a coal tar base with some improvement. In March 1977 she fell on the right knee which became sore and developed an effusion. She fell, again, on June 13, 1977, when the knee was still swollen. Shortly thereafter she developed fever, soreness, swelling and stiffness of both wrists with similar involvement of the metacarpalphalangeal joints, PIP joints, elbows, neck and shoulders. She was hospitalized at the Children's Hospital on May 31, 1977 where she was found to spike a daily fever of 101 degrees. There was a grade iii harsh systolic murmur on the left in the left intercostal space. There was no splenomegaly. Psoriasis was evident, especially on the scalp. 14 THE BUFF ALO PHYS I CIA �Dr. Evan Calkins, the patient and her mother. Dr. Lawrence emeth. There was an effusion of the right knee with swelling and tenderness of both ankles, PIP joints and wrists. She was treated with aspirin 12 tablets daily with some im­ provement in her rheumatologic picture, but developed tinnitus, nausea, GI symptoms and confusion. She was then placed on In­ docrin, 25 mg. three times daily. I first saw her on July 29, 1977. She was extremely an­ tagonistic at the prospect of seeing another physician, discourag­ ed, and negative about her illness. On physical exam she was slightly plump but attractive, despite her sullen expression. Her general examination revealed only the apical systolic murmur. There was moderate soft tissue thickening of both wrists. There was slight limitation of dorsiflexion of the right wrist and slight tenderness and soft tissue thickening of the PIP joints and MP joints. Her neck was held in a slightly anterior flexed position and showed limitation in attempts to extend it. Rotation was good. Motion of the spine was good. Elbows and shoulders were benign. Examination of the hips showed pain at the extremities of rotation on the right and some limitation of internal rotation of the left hip. The knees showed minimal soft tissue thickening but no effusion. Ankles were slightly swollen and tender. There was quite marked soft tissue swelling and tenderness of the right third metatarsal head and of the left first metatarsal head. There were patches of psoriasis over her scalp with con­ siderable loss of hair especially in the frontal area. She had been told by her dermatologist that her hair had "gone to sleep" because of the shock of the acute illness. Laboratory data revealed a hemoglobin of 10.9 and a white cell count 11.9 with normal differential. Sedimentation rate 62. Rheumatoid factor negative. A A negative (although, on several occasions, it was positive in a dilution of 1:28). Urine examination showed a trace of protein on several occasions. Initially, I followed her on a conservative program. This in­ cluded aspirin, approximately 6 tablets daily and Indocin ap­ proximately 3 tablets daily. She remained at home on a program including, predominantly, bed rest. Schooling was by a home tutor. d- SUMMER, 1982 15 Dr. Theodore Popodemetriou and patient. �.. Drs. John Lourio, Fronk Evans. Jomes Nolan, Leonard Kotz, Roseanne Berger, Jomes O'Leary. Unfortunately, one full year of conservative treatment was not accompanied by any significant improvement. The sedimen­ tation rate remained extremely high. Although evidences of ac­ tive joint involvement were confined to a few joints, only, it was obvious that she still had active rheumatoid disease. Her psoriasis also continued to be active. Clearly, some measure should be initiated to try to arrest the continuous activity of this young person's disease. Despite the fact that, traditionally, the presence of psoriasis is deemed to be a contraindication to gold therapy, careful consultation with several colleagues indicated that this was a relative rather than absolute contraindication. On June 28, 1978 we started, very carefully, with a program of intramuscular Mychorysine inj ec­ tions. These were continued until May 10, 1979 by which time she had received a total of 450 mgm. of gold preparation. Unfor­ tunately, this was not accompanied by any improvement. Urinalyses continued to show proteinuria, in trace amounts and this, together with the lack of clinical response, led to a decision to discontinue treatment on May 10, 1979. On October 16, 1979 I wrote to Dr. Hoak, her dermatologist, as follows: "For some time I had felt that low dose steroid therapy would be justified with this young person, particularly because, at this stage of life, it is essential that she begin to achieve a greater degree of independence from her parents and begin to "live her own life". She was adverse to steroids, fearful of gaining weight and getting a "puffy face". evertheless, she finally consented and on July 5, we started her on prednisone in a dose which, after a bit of trial and error, stabilized at 5 mgm. in the morning and 2.5 mgm. in the evening. She continued to take Indocin, one tablet every morning, aspirin 6 tablets daily, ferrous sulfate and cream for the psoriasis." In late September 1979 she tried to undertake part-time employment in the record room at the Children's Hospital. The weight of the records proven to be too much for her sore wrists, and she had to give up this position. She started college on a close to full-time basis in the fall of 1980. She did well in her studies and with her social life. 16 THE BUFF ALO PHYSICIAN �.. Her condition remained somewhat the same until February 1981. By this time, both her psoriasis and arthritis were somewhat better. I had been concerned, however, because she was develop­ ing a puffy face even on a very low dose of Prednisone (5 and 6 mgm. per day alternating). She had missed her menstral period in January. She was beginning to show rather striking striae and other evidences of Cushingoid appearance. Concerned that she might be developing an adrenal tumor, I switched her from Prednisone to Cortisone, 4 tablets daily for 3 days and then obtained a serum cortisol level. This returned at 5.8 UG/DL [normal range between 6 and 29 UC/DL). Over the course of the ensuing three months her course was characterized by increasing "Cushingoid" appearance, and in­ creasing erythroderma which began to extend over her entire body. She was treating the skin lesions with large doses of steroid ointment (2.5% hydrocortisone in vase line base). Her der­ matologist consistently maintained that her Cushingoid appearance could not be due to the amount of steroids she could be absorbing through her skin. By May, 1981, however, it was apparent that this thesis was in error. At the advice of Or. Hans Kipping, she was switched to a much more dilute concentration of corticosteroid (1% ). with gradual resolution of her erythroderma and decrease in her Cushingoid appearance. By mid June, 1981 her features were beginning to return toward normal. Articular symptoms, which had been in abeyance during the 4 to 6 months, began to become somewhat more active again. We were able, however, to reduce her oral Prednisone to 2 mgm. per day, which dose she is taking al present. I should point out that, approximately two years ago, as a result of discussions with a priest, Susan achieved a much more constructive attitude toward life, herself, and her illness. Although this optimistic spirit was tested and tried, greatly, dur­ ing the spring of 1981, it has stood her in great stead. She has achieved a positive outlook on life, a much greater sense of responsibility for her own illness, and a determination to con­ tribute something in life, and to enjoy life, despite her continuing chronic illness. d- SUMMER, 1982 17 �Both she and her parents have been quite concerned over the fact that she has gradually developed hyperextension deformities of several fingers. Measures to prevent these from becoming worse have been discussed with Dr. Papademetriou. The orthopedic aspects of her case are being followed, carefully, so that surgical intervention can be initiated in a preventive rather than purely curative fashion. In summary, Susan has managed to adapt to two difficult chronic illnesses. Both are of unknown cause, uncertain cure, and poorly understood interrelationship. Both lead to certain obvious changes in appearance, and in capability to participate in normal activities of a young adult. Susan has responded well to this challenge. At times, however her combination of diseases becomes "too much" for her and even for her physicians, and the entire system comes under great stress. We have always been honest with her and her parents and believe that we have a good relationship. After the patient and her mother left, Dr. Theodore Papademetriou, clinical professor of orthopedics, showed slides and questioned the students. Medical management comments were made by Ors. Martin Wingate, professor of gyn/ob, emeth, Papademetriou, Wilson and Calkins. Dr. Pessar noted that Susan was a very courageous person and that her emotional life had also been affected by her illness. Dr. Pessar told the students that they would have tensions in dealing with patients. Most of the time patients can best be helped by primary physicians, rather than psychiatrists. The students learned what was to be expected of them during their two years of clerkship from several faculty members who discussed their respective disciplines. They were: Ors. James olan, professor and chairman of medicine; Erika Bruck, professor of pediatrics - emeritus; James Evans, associate professor of surgery; James O'Leary, professor and chairman of gyn/ob; Roseanne Berger, clinical assistant professor of family medicine; John Lauria, associate professor and chairman of anesthesiology; and Linda Pessar. Dr. Leonard Katz, associate dean, congratulated the students on the excellent job they had done on the boards. He talked brief­ ly about the transition to the clinical years and said, "very ex­ citing times are ahead for all of you. As young physicians you must learn to communicate with your patients and other members of the health team." In closing Dr. Calkins told the students how they would be evaluated and reviewed. "Half way through your rotation an evaluation will be made of your strengths and weaknesses. You will have a chance to discuss this with your preceptor and make adjustments. Your student days are behind you; your professional days ahead; respect your patients and dress properly.'' □ 18 THE BUFFALO PHYSICIAN �Student Awards Six second and third year students shared eight awards in a mini convocation on the first day of classes. After the ceremony they joined their classmates in a picnic at Baird Field on the Main Street Campus. James Corasanli won three awards - the Ernest Witebsky Memorial in microbiology and the Douglas Riggs in pharmacology and the Kornell Terplan in pathology. Charles White won two awards - the Jomes A. Gibson & Wayne J.Atwell in anatomy and the Edward L. Curvish in biochemistry. Annette McDermott also won this award. Other award winners Josephine Ross, Charles Boudo in Family Practice; Mitchell Karmel, John Sheffer, pathology; Patrick Hurley, Farney R. Wurlitzer in psychiatry. □ Fifth Pathway Twenty-one entering fifth pathway medical students, who will be here for nine months for clinical training, were in­ troduced by Dr. John Richert, assistant dean. They are: Philip J. Aliotta, Agnes Blau, Francis J. Catanzarita, Kevin J. Ciccone, Ke­ vein J. Egan, Donna L. Ehlers, Philip V. Felice, Paul R. Hokr, Thomas C. Kockinas, John R. Macaluso, Milan Mirolovich, Mark . Monroe, Thomas C. Moy, David J. Odland, David W. Reagan, Roy R. Reardon, Robert P. Rosenberg, Judith E. Sherman, Charles V. Sperazza, Robert A. Weiner, and John V. Yacono. Fifteen American students, who had completed their basic science requirements, came to the campus August 3 for an inten­ sive two week orientation. Then they joined the junior class for the clinical years. The transfer students came from both foreign and American universities. The four-year HEW grant expired ac­ cording to Ors. John Richert and Joseph Aquilina, co-directors of this year's program. The new students from City University of ew York Virginia Chang, Alex Frank, Steven Lee, Peter Mazzoni, Allison Pataky, and ewton Seiden; from University of Padova, Italy Nicholas Aquino; from University Auton de Tamaulipas, Tam­ pico, Mexico - Edward J. Coleman; from Faculte Libre de Medecine, Lille, France - John C. Krusz; from St. George's University, Granda, WI - Francis C. Mezzadri; from American University of the Carribean, Plymouth, Montserrat - JoAnn C. Pravata; from University of Tennessee Center - Brooke D. Durland; from SU Y Downstate Medical Center - Bradley H. Cresto!; from ew York Medical College - Ronald D. Greco; and from Loyola University - Michael S. osanov. Individual picture taking followed the session. □ SUMMER, 1982 19 15 Transfers �Exercise and Good Health Exercise makes an important contribution to health and makes physical and physiologic improvement to many body systems, according to Dr. Ralph S. Paffenbarger Jr. "Exercise is winning the battle as insurance that helps prevent heart attacks." The Stanford University professor of epidemiology noted ex­ ercise has been the most striking change in our life style of the 20th century. "It is not a health fad. It is not as lonely as it used to be." The Harrington lecturer zeroed in on several studies that prove physical activity prevents heart attacks. "Even a moderate amount of physical activity can reduce heart attacks." Dr. Paffenbarger observed that there was a lower rate of heart disease among farmers, mail carriers, construction men, railroad workers, and others who have occupations that require physical effort. High energy output on the job lessens heart attack risk. "Smoking, obesity, diet and high blood pressure are major risk factors that often lead to heart attacks," the physician­ educator said. "Less smoking has been one of the major factors in the reduction of heart attacks in the last decade." He cited a study of San Francisco longshoremen from 1951 to 1972 that proved conclusively that physical activity reduces heart attacks. Even people who had a history of heart .problems were not harmed by high energy output. People who participated in vigorous sports had fewer heart attacks than people who did nothing. Long term physical activity proved to be good for men. Dr. Paffenbarger cited a study of the life style of 50,000 former Harvard and University of Pennsylvania students. Most of the physical activity of this group was centered around yard work, walking, jogging, climbing steps and sports. Those who walked less than five blocks a day were a higher risk (coronary disease) than those who played vigorous sports. "The less active a person is the more likely he is of having a heart attack," Dr. Paffen­ barger said. "People with a family history of heart problems - who also are diabetic, smoke, have high blood pressure and are obese can lower the risk of heart attacks by exercising," the physician said. From a clinical view people with hypertension are the greatest heart risks; those with a sedintary life style, smokers and obese people are also likely heart victims. People who have a family history of heart problems are least likely heart victims. Dr. Paffenbarger made these observations: - the style and level of activity is important; - the greater the physical activity the lower the heart attack risk; - men who have been active in their teens must maintain their activity during their adult life or they will be more likely to have a heart attack; - conversely men who were inactive in early life will decrease their heart attack risk if they increase their physical activity; - an active life style both at work and during leisure time reduces the risk of heart attacks; - people who don't smoke and aren't obese or hypertensive are less likely to have heart attacks; 20 THE BUFF ALO PHYSICIA �- men who have survived one heart attack will be more likely to live and survive another if they maintain some physical activi­ ty as opposed to being sedintary; - walking rapidly burns up lots of energy; - work up a sweat; - do something you enjoy - jog, swim, run, play golf, tennis or squash; - happiness is high energy output; - physical activity makes for a longer life. In the future we must find out what kind of exercise is need­ ed and best for all of us. We must learn more about the intensity, frequency, timing and duration of exercise. We must learn how to measure physical activity. In conclusion Dr. Paff enbarger said, "The true test of in­ telligence is not how much we know or how we do it, but how we behave when we don't know what to do." □ Dr. MartinRetires Dr. Ronald E. Martin, M'43, of Eden, .Y. retired in January as director of clinics at the Buffalo Psychiatric Center. He recalls the days of house calls and delivering babies at home. As a battalion surgeon with the 10th Ar­ mored Division, he was on the front lines, dispensing first aid. During the Battle of the Bulge he was captured by the Germans. For two weeks he treated German and American wounded, until the Americans attained supremacy. "There was no way of moving hundreds of wounded, so we just sat there," he recalled. For gallantry in action, Dr. Martin was personally awarded the Silver Star by General George S. Patton. "He was a man who wasn't afraid to come up to the front lines," Dr. Martin says. "Most generals saw nothing of the action." Returning home, Dr. Martin joined his un­ cle, Dr. Grover Priess, in his general practice in Eden. In 1951, he was recalled as an army reservist and sent back to Germany for two years, this time doing administrative work as a regimental surgeon with the 2nd Armored Division. SUMMER, 1982 Then it was home again, where he worked with his uncle under the elder doctor's death in 1966. Dr. Martin then set up his own prac­ tice, mainly in pediatrics, the great love of his medical life. In 1976 he joined the staff of the Buffalo Psychiatric Center. "The tenure at the psychiatric center has given me an entirely different view of what psychiatric hospitals are like. I hope in the future the public will come to know that these people aren't treated badly; it's not in­ carceration." He is sorry to see the medical profession become, in the eyes of an old-time general practitioners depersonalized. " owadays it's not as rewarding - you depend on your labs rather than actually physically diagnosing," Dr. Martin said. He's looking forward to spending more time in his pre-Civil War home, and catalogu­ ing his extensive collection of antique medical implements and books. Many of them came from the estate of another doctor­ predecessor, a Dr. Shaw who returned from treating the Civil War wounded to set up practice in Eden 117 years ago. □ 21 �J Parents' Weekend .... Dr. Kotz Dr. Middleton. Dean Approximately one-half of the families of first year medical students attended the first annual parents weekend last October. The guests toured and saw demonstrations in several of the basic science departments anatomical sciences, biochemistry, biophysics and physiology - on the main street campus. There was a reception for parents and students at the Buffalo/Erie County Historical Society. On Sunday after­ noon there were special tours and demonstrations of several clinical departments at the Erie County Medical Society. Dean John aughton talked briefly to the parents about medical education. Other faculty participants: Ors. George Alker, Michael Anbar, Harold Brody, Alexander Brownie, Edward Carr, Richard Condit, John Cotter, Barry Eckert, Murray Ettinger, Karen Ferguson, Chester Glomski, Glen Gresham, Perry Hogan, Leonard Katz, Frances Klocke, Frank Mendel, James olan, Jan ovak, David Pendergast, John Richert, Randolph Sarnacki, Frank Schimpfhauser, Maggie Wright and Joseph Zizzi. Student volunteers were: James Corasanti, James DeCaprio, Lin­ da Peterson, Juliet Seigle, Roni Shimony and Deborah Silberman. □ aughton 22 THE BUFF ALO PHYS ICIA �I A view of the city from the top floor. Dr. Gresham Morion Morionowsky Dr. Francis Klocke SUMMER, 1982 23 �Dr. Koslow Dr. Alan R. Koslow, M'78, is involved with a collection of implements detailing medical progress in recent centuries. Several thou­ sand pieces of medical memorabilia, recently unwrapped after two decades of obscurity in a basement, were catalogued recently at Stanford University Medical Center's Lane Library by a third-year surgical resident with a yen for history and collectibles. Many of the objects pay unwitting tribute to superstition. The oldest instrument, dating back to about 1690, is a scarifier which was used to suck blood and serum from the ill. The rationale for the painful treatment now known to be useless was the ancient belief, spawned by the Greek philosopher Hip­ pocrates, that the body was comprised of humors - bite, blood and phlegm - which needed to be drained when one became dominant. The scarifier consists of one or more blades, about a quarter inch long, and a separate cup. After cuts were made, the cup was placed on the body heated, so that as it cooled it would draw out blood. Later models were equipped with ad­ justable blades a testament to technological skill but still fell short of today's medical knowledge. Dating back more than 100 years ago or­ nately carved scalpels and saws, usually with ebony or ivory handles. The intricate, artistic designs caused death for those persons whose skin was opened, since the nooks and crannies on the sculptured surfaces were marvelous spawning grounds for infection in a day before sterilization. As recently as the turn of the current cen­ tury, specially designed forceps were used to crush heads of infants who were too large at their moment of birth to pass through their mother's pelvis. Such devices predated the now-routine Caesarean section, which allows the baby to be removed while sparing the mother and baby's life. From dusty boxes stored in the basement for more than two decades, Dr. Koslow iden­ tified, photographed and catalogued the 24 collection he estimates to be valued at about $500,000. The pieces had been wrapped in "1959 newspapers, which gives us a clue that they were wrapped up when the Medical Center moved down from San Francisco 22 years ago," Koslow said in a recent inter­ view. Some of the more historically significant pieces, including an 1890 syringe kit belong­ ing to Dr. Oliver Wendell Holmes, are on public view in a lone display case in the library. But most of the material remains locked up in a basement case awaiting available funds for permanent display facilities. Peter Stangl, Lane Library director, said no arrangements have been finalized for public display of the collection, which he calls "significantly large. "We are genuinely hoping to find some way to display these materials in a manner which will give them the· respect they deserve. But even until then, the cataloguing efforts of Kowlow enable our staff to preserve the valuable material we have or hope to receive in a safe and proper manner." According to Dr. Koslow, "The important thing about the collection is the scope. It has an example of just about every major field, except for anesthesia." Dr. Koslow is hesitant to rank the medical collection against other universities, but he estimates that it might be in the top 10 or so in the nation in terms of quality and quantity. Most of the pieces arrived at Stanford haphazardly, often as bequests from widows or their attorneys, unsure what to do with a doctor's personal instruments. But their fate until Dr. Koslow's arrival was uniform - obscurity. "It was serendipity, really," said Stangl about how Koslow's talents were matched with the collection. Claire Still, who retired as medical history librarian at Lane, chatted one day with Dr. Koslow and learned he had attended the University of Buffalo. She asked if he knew a young medical student who had catalogued a small implement collection there. THE BUFF ALO PHYSIC IA �Dr. Koslow knew him well. It was he. And for the next few months, the surgical resident spent the miniscule hours of free time he was able to budget each week at identifying the wide array of often gruesome, sometimes beautiful, and occasionally puzzling tools. Using a skill picked up on vacation trips, Dr. Koslow photographed - using a light box and the advice of Medical Center staff photographers - each item for additional cataloguing. "I consider myself more of an historian than a collector in that I get as much joy from cataloguing and working with someone else's as I do from my own collection." Dr. Koslow, an admittedly addicted collector, does maintain his own small medical artifacts collection and also, as a hobby, collects stamps - all with medical themes. "Just about everything I do is medical," laughs Koslow. The painstaking work for Dr. Koslow at Lane Library involved matching various im­ plements with various catalogues, many of which were in the Lane Collection. "What you do is you look back a year at a time until the particular item isn't there anymore. Then you figure it was introduced the next year, and that's often how you date objects," he explained. Storing data mentally is a crucial skill for the cataloguer. "There was one particular scissors, I just couldn't identify," said Dr. Koslow. "I just kept it in the back of my mind until one day I ran across it in a catalogue." While the collection as a whole, Dr. Koslow estimates, is worth about $500,000, in­ dividual implements are worth from about $5 to $300, while several large surgical kits range in value up to about $6,000. "Those came from a day when the sur­ geon had to supply his own tools. The cases were ornate and the doctor carried it around from operation to operation. Before steriliza­ tion became a common practice in the last decades of the 19th century, the knives often were simply wiped off and put back in their crushed velvet container, where an often deadly array of germs waited on the metal to be inflicted into the next patient. SUMMER, 1982 "We can learn a lot about medicine by looking at these knives," said Dr. Koslow. For example they would make double-sided knives, "so in an amputation they could go around first one side and then without turn­ ing the knife, they could reach around and get the other side. "Speed was essential in the days before anesthesia, because of the humane need to finish as soon as possible to reduce the patient's suffering." While many of the devices, including the scarifiers, are testaments to outdated and now rejected practices, the collection in­ cludes several precursors of hope. Among these are two listerizers, looking a bit like kerosene lamps, which were used to vaporize carbolic acid as a disinfectant. Starl­ ing around 1870, these devices were the first major breakthrough in surgical infection con­ trol and drastically reduced deaths. From the 1840s comes a trephine set, used to drill holes in people's heads to release "evil humors" from the brain. While the superstitious practice, which originated in prehistoric times, is of course extinct, the technique has been adapted to modern day surgery. Doctors occasionally cut a hole in the skull to release the pressure of blood or water on the brain. As for Dr. Koslow, he is taking two years off after his third year of residency to pursue a two-year research project in Bethesda, Maryland under the auspices of the American Red Cross. He is researching early signs in the development of hardening of the arteries, and he hopes after the project and two more years of residency to practice vascular sur­ gery - and continue collecting. □ 25 �CAT Scanning for the Clinician Computerized tomography (CT) has dra,wn much more atten­ tion than have any of the large number of advances in medical technology that took place in the 70's. CT became the target of public and political concern as an epitome of the "costly and un­ necessary" medical gadgetry. CT also became the acclaimed greatest achievement in modern medical diagnosis as reflected in the 1979 obel Prize for Medicine. It is not surprising, therefore, that the Continuing Medical Education symposium on "CAT Scan­ ning for the Clinician," was very well attended. This symposium, sponsored by the Departments of Biophysical Sciences and Radiology, included presentations by members of the two sponsoring departments. The symposium was opened by Dr. Martin Wingate, assistant dean -for continuing medical education and professor of Gyn/Ob. After a short in­ troduction about the physical principles of CT by Dr. Michael An­ bar, professor and chairman of biophysical sciences, each of the participating clinicians described the uses of CT in the area of his specialty. The seven physicians who made presentations were: Drs. George J. Alker Jr., acting chairman and clinical professor of radiology, and acting director of the radiology department, Erie County Medical Center; Paul E. Berger, clinical associate professor of pediatric radiology; James M. Hassett Jr., assistant professor of surgery, and director of emergency services, Buffalo General Hospital; David Hayes, clinical assistant professor of radiology; Donald J. Kelley, clinical instructor in surgery; Eugene V. Leslie, professor of radiology; and Jan M. ovak, assistant professor of medicine. 26 THE BUFF ALO PHYSICIA �It was evident that CT has numerous unique applications in a variety of areas ranging from neurosurgery to internal medicine, and from emergency medicine to pediatrics. The presentations, which were followed by numerous questions from the audience, culminated in a panel discussion about the usefulness and cost effectiveness of CT as compared with other diagnostic methods. It was the consensus of the panelists that CT offers unique diagnostic information with a relatively low risk lo the patient (compared with other radiological modalities). It was also pointed out that the high sensitivity and specificity of CT scanning make it a cost­ effective technique in spite of the high cost of the equipment. This is especially true of the numerous cases where CT can be per­ formed on an ambulatory basis, while alternative procedures re­ quire hospitalization. At the end of the day participants of the symposium were in­ vited to visit the CT installations at Erie County Medical Center, Buffalo General Hospital and Children's Hospital and thus they had the opportunity to see the CT scanners in action. (MA) □ Ors. Leslie, Novak 27 �f'red McAdam Athletic Day Steve Pollack and friend 28 THE B FF ALO PHYS I CIA �Or. Leonard Kotz and students Mike Wenzel Pot Flanagan, Sharon Alger �Ors. Wesl, Murphy, Apecillo Infectious Disease Man shares his environment with a range of living organisms. Some are helpful. These aid man to fight disease. Others are harmful. These are the concern of the infectious disease division at the medical center. Its aim - to identify, treat and prevent them. Heading the newly-reopened division is Dr. Michael Apicella, professor of medicine. He returns to the Erie County Medical Center after two-and-a-half years at the University of evada (Reno) where he held a similar post. Long interested in Neisseria gonorrhea, he did research in Buffalo from 1970 to 1978. Another area of interest for Dr. Apicella is meningitis. Endocarditis and brain abscesses are the concern of Dr. Timothy West, assistant professor of medicine. His studies on staphylococcal infections have led to a test that is used to pinpoint its presence in man. The Indiana Medical School graduate completed an infectious disease fellowship at Charleston, South Carolina's Veterans Hospital before coming to Buffalo. Anerobic organisms which grow in the absence of oxygen are what interest Dr. Timothy Murphy, assistant prof e sor of medicine. He is taking a close look at those implicated in GI infec­ tions and lung abscesses. He also is studying anti-microbial agents and penicillin­ binding proteins. From his work on the latter has come a test to pinpoint its presence. Dr. Murphy completed a fellowship in infectious disease at Tufts Medical School where he earned the MD degree. □ 30 THE BUFF ALO PHYSICIA �Dr. RobertWarner As a state employee, Dr. Robert Warner, 70, is mandated to retire in May from the center he has directed since it was organiz­ ed in 1955. Dr. Warner credits Dr. Mitchell Rubin, former head of pediatrics at Children's Hospital with being way ahead of his time in 1955 when he thought to establish the Rehab Center. What had begun as a clinic for physically crippled children over the years under Dr. Warner's push has widened to take in the mentally crippled. Dr. Warner peeked into his case record book and said that 5,134 children have come to the Rehab Center for help. Dr. Warner is equally proud of his idea that led Dr. Robert Guthrie to develop his simple test for the genetic disorder known PKU, a birth defect that untreated, leads to mental retardations. "That test, now required by law in 46 states and used in the other four and all over the world, has saved thousands of children from mental retardation and saved many millions in public and private care funds." Dr. Warner has served on Governor Hugh Carey'_s Advisory Council on the Disabled since 1977. He was also a member of the New York State Delegation to the White House Conference on the Disabled and served for one year on the Advisory Council of the New York State Division of the Office of Vocational Rehabilita­ tion. An associate professor of pediatrics at the Medical School, Dr. Warner is also a visiting teacher and chief of the rehabilitation division, pediatric staff, Buffalo General Hospital, a consultant, Millard Fillmore Hospital; and a consultant in rehabilitation medicine, Erie County Medical Center. A veteran of the Army Medical Corps, he is a graduate of Harvard College and received his M.D. from the University of Chicago. After graduation he took a rotating internship at Buffalo General Hospital in 1939, followed by a special internship in pediatrics at Children's Hospital - the beginnings of a long relationship. Dr. Warner has received many awards and honors. They in­ clude: the third annual Pediatrician of the Year Award; Variety Club Man of the Year, 1965; Greater Buffalo Advertising Club Man of the Year, 1974; Outstanding Citizen Award from the Mayor of Buffalo, 1977; Harvard Man of the Year Award, presented by the Harvard-Radcliffe Club of Buffalo, 1979; Presidential Citation from Variety Clubs International, 1980; and Communication and Leadership Award from Toastmasters International, 1980.D SUMMER, 1982 31 Dr. Worner �Summer Fellowships Twenty-three medical students participated in the annual summer fellowship program. For the first time this program is supported by a three-year, $90,450 grant from the ational Institutes of Health, according to Dr. Thomas Flanagan, professor of microbiology, the program director. The grant supports summer research efforts of medical students, according to associate director Dr. Randolph E. Sarnacki, assistant professor of social and preventive medicine. Trainees were selected from applicants who are undergraduate medical students. The students worked in laboratories under the tutelage of a mentor, who was responsible for their training. The mentors were recruited on the basis of their research competence and their experience in training young investigators. Two students - Richard Collins and Ross Greenberg - are continuing their research started last year. Others in the program are first and second year students. They each receive a $1,200 sti­ pend for ten weeks work. David Barber, " utrition and the Ability to Repair Damage to D A;" Sponsor: Dr. J. Spence. Robert Burns, Jr., "Measurement of Normal utritional Parameters in the Elderly Population;" Sponsor: Dr: Evan Calkins. Mary T. Caserta, (A.) "Red Cell Abnormalities in Association with Viral Infections;" (B.) "Effects of Phosphodiesterase Inhibitors (PI) upon the Deformability of Sickle Cells;" Sponsor: Dr. Richard Sills. Richard Collins, " eural Retubulization by Microvein Graf­ ting;" Sponsor: Dr. Clayton Peimer. James Corasanti, "Mice with Carcinogen;" Sponsor: Dr. Gabor Markus. Susan Danahy, "The Interrelationships between Insulin Bin­ ding and Degradation in Primary Cultures of Rat Hepatocytes;'' Sponsor: Dr. John Amatruda. Andrew Francis, Jr., "Characterization of Brain Phenolsulfotransferase;" Sponsor: Dr. Jereome Roth. Gerald Grass, "The Relationship of Personality Type and Family History of Cardiovascular Disease to Hypertension and Coronary Heart Disease;" Sponsor: Dr. James Blascovich. Ross Greenberg, "Diastolic Impedance of the Coronary Cir­ culation;" Sponsor: Dr. Robert Mates. Robert Herman, "The Pathogenesis of Respiratory Synctial Virus Infection in the Cotton Rat;" Sponsor: Dr. Pearay Ogra. James Holmes, "Ventilatory Adaption to Exercise in Restric­ tive Lung Disease: Sickle Cell Anemia;" Sponsor: Dr. Frank Cerny. Margaret Kadree, "Study of Pathophysiology of Microvascular Occlusion due to Cerebral Malaria and Exploration of Therapeutic Agents which may Prevent the Occlusion;" Sponsor: Dr. Julian Ambrus. Michele Kaufman, "Assessment of Hormonal Factors which Influence Fetal Growth in Infants of Diabetic Mothers;" Sponsor: Dr. Margaret MacGillivray. Stephen Kinsman, " eurotoxicity: Structural and Functional Changes Induced on a Single Central euron;" Sponsor: Dr. Donald Faber. 32 THE BUFFALO PHYSICIA �Karin Klingman, "Incidence of Ampicillin and Cephalosporin­ Resistant Enterobacteriaceae Causing Serious Community Ac­ quired Infections;" Sponsor: Dr. Joseph Mylotte. Gwen Nichols, "Aging on the Function of the Autonomic er­ vous System;" Sponsor: Dr. Robert Mcisaac. Mark igogosyan, "Effects of High Pressure on Active Sodium Transport Across Toad Urinary Bladder;" Sponsor: Dr. Suk Ki Hong. Cynthia Pristach, "Critical Variables Predicting ature and Severity of Alcohol Withdrawal;" Sponsor: Dr. Cedric Smith. Karen Schupak, "Incidence, Morbidity and Motality of Pneumococcal Disease at the Buffalo VA Medical Center;" Spon­ sor: Dr. Thomas Beam. Eveline Traeger, "Role of Fertilization Envelope Hardening in the Prevention of Polyspermy;" Sponsor: Dr. Herbert Schue!. Charles White, "Development of a Computer Assisted Medical Information Acquisition System;" Sponsor: Dr. Robert Spangler. Maurice Wolin, "Determination of Diffusion Coefficients; · Sponsor: Dr. Leon Farhi. Benson Zoghlin, "Aging on the Function of Sympathetic Ganglion;" Sponsor: Dr. Robert Mcisaac. □ Dr. Leon E. Farhi is the new chairman of the physiology department. He is internationally known for his pioneering work on the effects to man of carbon monoxide, one of the major en­ vironmental pollutants. The physiology professor joined the U/B faculty in 1958. In the last 25 years he has received numerous grants to study man's relationship with the environment. Recently he captured a coveted spot for one of his experiments on a future flight of the space shuttle. His proposal for a blood-circulation experiment, which can be carried out on the shuttle but not here on earth, was chosen by the ational Aeronautics and Space Administration as one of 25 for a future shuttle trip that will be devoted entirely to the life sciences. A native of Cairo, he received the BS degree from the Inter­ national College of the American University and the MD degree from the Universite St. Joseph, Beirut. Before coming to Buffalo, he was on the faculty of Hebrew University-Hadassah Medical Center and completed post-doctoral fellowships at the University of Rochester and Johns Hopkins University. Dr. Farhi has been active in various scientific organizations, including the American Physiological Society, Aerospace Medical Association, the Undersea Medical Society, the American Thoracic Society and the American Heart Association. He has also served in editorial capacities for Undersea Biomedical Research and the Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology and been consultant to various health-related and scientific groups. □ SUMMER, 1982 33 Physiology Chairman Dr. Forhi �CAPDProgram Elaine, 31, is a graduate student in English. Richard, 60, and Leonard, 51, are retired. All have end-stage renal disease. Because of this, all were candidates for a new program at the medical center that allows them to be dialyzed through the peritoneal (abdominal) cavity rather than be tied to a large dialysis machine. Continuous ambulatory peritoneal dialysis or CAPD as the program is called is the first ever in Western ew York and one of the few in the nation. It is headed by Dr. J. Joseph Walshe, clinical assistant professor of medicine. The new program followed a year of planning by him, Dr. Rocco Venuto, M'67, associate professor of medicine, (director of renal ser­ vice) and two nurses specialized in renal dialysis. They are Chris Krol and Jo ce Atelson (the latter now lives in Philadelphia). A simple, safe procedure, CAPD allows patients to use the peritoneal membrane that lines the abdominal cavity as a filter to cleanse blood of impurities. Following the surgical implantation of an indwelling catheter in the abdominal wall, urses Chris Krol and Debbie Ruffino review CAPD procedure with Dr. Venuto. the patient merely adds and drains special fluid. Because some two quarts are always in the abdominal cavity, the patient, dialyzed continuously, can go about his or her business. The fluid exchange is performed by the patient four times a day over a 30-minute period (ten to add fluid, another 20 to drain it). Similar programs at other major medical centers met with varying success, according to Dr. Walshe. The approach at the medical center is different, he said. A coordinated team and a specialized four-bed unit are used. Here four skilled nurses train and treat patients. Other team members are a social worker, a dietitian, a psychologist and a medical director. Currently, one patient a week is in train­ ing. With more nurses, nursing team leader Deborah Ruffino looks for an increase in the num her of patients. To avoid infection, a major complication of the new treatment, unit nurses JoAnna Doherty and Sr. Anne Marie Ball stress the importance of a clean environment. Patients also are shown how to use special clamps and sterile dressing during the fluid ex­ change. They also learn about function of kidneys, the role of diet, etc. Once a month, patients return to the renal clinic for a tubing change at Erie County Medical Center. According to Dr. Walshe, CAPD is not for every patient. Rather, patients must be carefully selected. Some are not psy­ chologically motivated. Others have special medical problems. He notes the enthusiasm of four patients in a pilot program. "Their body chemistries were much improved over hemodialysis and intermittent peritoneal dialysis." For patients, not being tied to a dialysis machine, controlling the treatment and hav­ ing a better sense of well being is making a difference. With current knowledge, Or. Walshe believes CAPD is an effective treatment for some 35 to 50 percent of patients who have end-stage renal disease. With new research findings will come other forms of treatment, he said. But for now he believes CAPD provides the greatest freedom and independence to patients over other forms of dialysis. □ THE BUFF ALO PHYSICIA �Seventh International Conf ere nee on Defined Immunofluorescence, Immunoenzyme Studies and Related Labeling Techniques June 8 -11, 1982 Niagara Hilton, iagara Falls, .Y. This Conference meets the criteria for 18 hours of Category I of the Physicians Recognition A ward of the American Medical Association in the framework of Continuing Medical Education. It is the first in this series to be held in the U.S.A. It is being organized, with the advice from the !UIS-World Health Organization Subcommittee on Standardiza­ tion in Immunofluorescence, by the Depart­ ment of Microbiology, Schools of Medicine and Dentistry, SUNY AB, the Department of Periodontology, School of Dentistry, SUNYAB, and the International Service for Immunodermatology Laboratories (ISIL). Three courses have been designed to present application modes of labeled-antibody techniques to practicing physicians and in­ terested scientists: one course covers Clinical Applications of Immunofluorescence and Related Labeling Techniques; another covers Laser Fluorescence Activated Cell Sorters and Use of Monoclonal Antibodies in Im­ munofluorescence and Immunoenzyme Techniques; the third covers the topic of Con- trols and Quantitation of Immunocyto­ chemistry. The Conference's over-all objective is the promotion of well-characterized and quan­ ti ta ti ve labeled-antibody studies with emphasis on their application to public health, clinical medicine, and research. More than forty invited speakers from the U.S.A. and overseas will present "the state of the art" in plenary sessions and symposia. Workshops will provide opportunity to pre­ sent and discuss recent research. Topics covered at the Conference will encompass methodology of immunofluorescence, im­ m unoenzyme and related techniques; application of these techniques to the study of autoimmunity, biophysics and biochemistry; use of these techniques in bacteriology, dermatology, endocrinology, mycology, nephrology, neurology, oral biology, parasitology, physiology, tumor im­ munology and virology. For further information, please contact R. isengard, SUNY AB, 210 Sherman Hall, Buf­ falo, ew York 14214, or call (716) 831-3787, 2905, or 831-3625. The local organizing and planning com­ mittee: E.H. Beutner, Secretary General; R.J. isengard, Chairman of Finance Committee; S. Krasny, Chairman of Accommodations Committee; 8. Albini, G.A. Andres, T.P. Chorzelski, V. Kumas, F. Milgrom, P. Orga. □ June 21-25 "The 2nd International Symposium on Infant utrition and the Development of the Gastrointestinal Tract," Dr. Emanuel Lebenthal; Sheridan Brock Hotel, Niagara Falls, Canada. July 15-17 "The 5th ational Buffalo Con£ erence on Pediatric/ Adult Allergy and Clinical Immunology," Ors. Elliott Middleton and Elliot F. Ellis; The Four Seasons Hotels, Toronto, On­ tario. July 22-24 "The 14th ational Advances in Pediatrics," Dr. Elliot F. Ellis; Harrah's Marina Hotel, Atlantic City, ew Jersey. September 10-11 "The 4th Neonatal/Perinatal Fall Symposium Presents: Pharmacology and Therapeutics," Dr. Ralph J. Wynn; Buf­ falo Marriott Hotel. October 28-30 "Recent Advances in Pediatric Lung Diseases," Dr. Gerd J.A. Cropp; Hyatt Hilton Head Island, Hilton Head Island, South Carolina. SUMMER, 1982 35 Pediatric Conferences �Dr. Chardack Dr. William Chardack, a graduate of the University of Paris, joined the faculty of the Department of Surgery of the University of Buffalo in 1949, when Dr. John Stewart and Dr. John Paine, then co-chairmen of the Department of Surgery, recommended his ap­ pointment as Assistant Chief, Surgical Service on the Staff of the Veterans Administration Hospital. As the first surgeon in the Hospital, which then was in preparation for receiving its first patients in January 1950, he was in charge of its early surgical organization. After Dr. James McCallum, the first Chief of Surgery, resigned to enter the private practice of surgery. Dr. Chardack became Chief of the Surgical Service, serving in this position until 1968. In the intervening years Dr. Chardack was the key person in the VA Hospital in the building of a strong program in surgical care, education and research. His personal contributions to surgical knowledge are many. In 1950 Dr. Chardack, with Dr. Mccallum, performed the first successful resection of a Pancoast tumor. Before that time, this type of lung cancer was thought to be inoperable and incurable. Since then their method has been accepted as stan­ dard surgical treatment for this cancer. Dr. Chardack introduced a wide variety of procedures in cardiac surgery, head and neck surgery, and vascular surgery to the VA Hospital practice and to the community. In 1953 he performed a resection of the ab­ dominal aorta and replacement by a homograft, which was the first operation of this type to be performed in this part of the country. He was among the first surgeons in this community to perform cardiac valvular surgery. He made noteworthy contributions to the surgical treatment of pulmonary em­ physema and esophageal cancer. He became known world-wide for his pioneering work on the development of the implantable car­ diac pacemaker. Dr. Chardack established a surgical animal research program at the VA Hospital 36 in 1952. In the 1950's and early 1960's this research program developed major in­ novations to the development of synthetic skin for the treatment of burns, coronary artery surgery, and cardiac pacemakers. The work on the development of a substitute for skin in burned patients stimulated others to continue similar research. The work on cor­ onary arterial surgery led to the development of the extensive and successful open heart surgical program which now exists at the VA Hospital. Most important, it was in the Surgical Research Laboratory that ex­ perimental work on the implantable cardiac pacemaker began in 1958. The first use of a pacemaker in a patient with heart block was in 1960. Since then its success has been shown in the dramatic reduction in death rate from heart block as well as in the improvement in the quality of life for those patients with pacemade heart rhythm. The VA Hospital establish.ed an indepen­ dent surgical residency training program when it first opened and was affiliated with the Medical School for the teaching of medical students. In the next ten years, Dr. Chardack developed a coherent un­ dergraduate surgical clerkship and an out­ standing surgical residency program. Many of the surgeons in this community had surgical training at the VA Hospital. In the mid-1960's, perceiving that the future development of high quality medical education rested on University affiliated programs, Dr. Chardack was instrumental in merging the surgical residency training program with the E.J. Meyer Memorial Hospital and the Buffalo General Hospital for the substantial benefit of all. About the same time he established the first Thoracic Surgical Residency training program in Buffalo and he remained as Program Director of this until 1974. The strengths of the educational programs he es­ tablished continue to flow into our current un­ iversity teaching effort. Dr. Chardack has always been an active contributor to the Medical School. These ac­ tivities were epitomized by his efforts as a co­ founder (with Dr. Small) of the School's Faculty Council. Dr. Chardack was first Presi­ dent of the Faculty Council, a body which has evolved into an important policy-making unit of the Medical School faculty, much used by the Dean of the School of Medicine in faculty governance. (A.A.G.)O THE BUFFALO PHYSICIAN �The Erie County Medical Center has developed a two-prong program that may improve the vision of patients with retinitis pigmentosa, according to Dr. Leonard Temme, assistant professor of physiology at the Medical School. This degenerative disease of the retina reduces vision in a patient to the size of a keyhole. The program has helped four patients increase their vision. The patients are first seen in the eye vision clinic. Here func­ tion of the central vision and peripheral areas of the retina are determined. Those who have full function in the central vision area are candidates for retraining. "When cones in this area are intact, the stimulation of light and color prompts signals to the brain. But this area also blocks signals from the perophery where rod action is faulty. Thus, signals to the brain go haywire and the patient is unable to see," Dr. Temme said. Research in the laboratories of Dr. Werner oell, professor of physiology, points to the presence of degenerative remnant cells. These continue to function and provide information to the brain. By retraining the subject, the remnant cells may be used to im­ prove vision. Through a new look at an old way to view blind areas of the retina - psychophysics - Dr. Temme has identified a number of patients for retraining. After determining how abnormal their remnant cells are, he used a grid. Its series of lined patterns are projected on a screen. Then, as a patient views the pattern, the response from the central vision area of the retina is blocked. This, Dr. Temme says, permits signals from the periphery of the retina to reach the brain. He points to the patient who, in a matter of eight hours, is able to retrain himself to see things in areas where he had no previous sight. □ Continuing Medical Education June 6 - Contemporary Hotel. Stereotactic Technique - Buffalo Hilton June 17 - Use of Calcium Blocking Agents In Iscemic Heart Disease - Roswell Park Memorial Institute, Hilleboe Auditorium. Sept. 11 - Frontiers Of Drug Therapy - Buffalo Hilton Hotel. Sept. 24, 25 - Primary Care of the Injured Hand - Buffalo Hilton Hotel. Oct. 1, 2 - Nutrition - Center For Tomorrow, Amherst Campus, SUNYAB. SUMMER, 1982 37 Better Vision Dr. Temme �Dr. Klein People Dr. Welner Dr. Fisher Three Medical School faculty members are the new medical board officers at Children's Hospital. They are: Ors. David M. Klein, president; Daniel H. Welner, president-elect; and John E. Fisher, secretary-treasurer. Dr. Klein is head of the department of neurosurgery at Children's Hospital and an associate professor of neurosurgery at U/B. A graduate of the George Washington School of Medicine, Washington, D.C., Dr. Klein has been a member of the Hospital staff since 1963. He is a charter member of the American Society of Pediatric eurosurgery, a Fellow of the American College of Surgeons, and he belongs to numerous other medical groups. The president-elect, Dr. Welner, will become staff president in 1984 following Dr. Klein's term. He is an attending physician al Children's, as well as a clinical associate professor of Pediatrics at U/B and a Fellow of the American Academy of Pediatrics. Dr. Welner received his M.D. from Cornell University and has been on the Hospital staff for 32 years. Secretary-treasurer Dr. Fisher is a cer­ tified anatomic and clinical pathologist and a clinical assistant professor of Pathology at U/B. He graduated from the University College of Dublin, Ireland. Dr. Fisher holds Fellowships in the College of American Pathologists and the American Society of Clinical Pathologists. He has been on the Hospital staff for 11 years and is an attending pathologist. □ Or. Gustavo Cudkowicz, professor of pathology/microbiology, presented papers at workshops at Rockefeller University and Bethesda, Maryland recently. □ 38 Dr. William Tornow, an area pediatrician took the Best of Show award at the sixth an­ nual Physician's Photo Show sponsored by the Sisters Hospital medical staff. He is a clinical assistant professor of pediatrics at U/B. Other winners in the competition were Dr. Albert Menno, Sisters Hospital, clinical assistant professor of surgery, first place in color; Dr. Grant Golden, St. Josephs Hospital, second place in color and first place in black and white; and Dr. Paul Milley, Sisters Hospital, clinical associate professor of pathology/anatomy, second place black and white. □ Dr. Erwin Neter, professor emeritus of pediatrics/microbiology, was elected an honorary member of the American Society for Microbiology. He had the highest recogni­ tion in the society based upon.his outstanding contributions to microbiology. He also spoke to the Microbiology Honor Society of the California State University at Long Beach on "Host-Parasite Relationships: Recent Developments." □ Dr. Mary L. Voorhess, professor of pediatrics, has been elected a Fellow of the American Association for the Advancement of Science for "clinical investigation of the diagnosis and management of tumors of neural breast origin in childhood. □ Dr. Elliot F. Ellis, professor and chairman of pediatrics, spoke at a seminar of The American Academy of Allergy, ew England Deaconess Hospital. His topics: "Therapy of Childhood Asthma" and "Theophylline and Deri vates. "O Dr. S. Mouchly Small, professor of psy­ chiatry, has been elected to the executive committee, American Board of Psychiatry and eurology.0 Dr. Giuseppe Andres, professor of microbiology/pathology, gave two lectures during the Columbia University Renal Diseases Conference. His topics: "Im­ munologic Basis of Renal Disease" and "Mem brano-Prolif era live Glomerulone­ phritis."O THE B FFALO PHYSIClA �Ors. Murray A. Yost, Jr., clinical associate professor of gynecology/obstetrics and psy­ chiatry, and Philip K. Li, assistant professor of pediatrics and pathology, attended the Seminar in Laboratory Medicine and Hospital Management at Tianjin Medical College in Tianjin, The People's Republic of China. Dr. Li is the program director and it is sponsored by Tianjin Medical College and the China ational Chemical Import and Ex­ port Corp. □ Co-authors of an article, "Sociomedical Issues in the Curriculum: A Model for Institutional Change," in the Journal of Medical Education are Ors. Peter Gessner, professor of pharmacology and therapeutics; Leonard Katz, professor of medicine; and Frank Shimpfhauser, assistant dean for development and evaluation. □ Dr. Oliver H. Beahrs, internationally known head and neck surgeon, received the Roswell Park Medal of the Buffalo Surgical Society in March. The professor emeritus at the Mayo Medical School discussed factors affecting mortality and morbidity in head and neck surgery. □ People The annual giving campaign sponsored by Sisters Hospital Foundation raised $270,726 during 1981. Proceeds of the campaign were turned over to Sisters Hospital and are being used for health care equipment, the Special Care ursery (intensive care unit for new­ born babies). Seton Family Health Center in Alden, special surgical facilities, the Cardiac Rehabilitation Center, continuing education for nurses and for Lifeline, a com­ munications link between the home-bound elderly or disabled persons and the hospital. □ Dr. Gerald Sufrin is the new head of the urology department at Buffalo General Hospital and U/B. He received his M.D. at Upstate Medical Center, Syracuse. He comes to Buffalo from the Jewish Hospital, St. Louis. □ Four faculty members are the new of­ ficers of the Buffalo General Hospital Medical Staff. Dr. James R. Kanski, M'60, clinical associate professor of medicine, is the new president. Vice-president elect is Dr. John W. Cudmore, M'62, clinical associate professor of surgery. Ors. Roger S. Dayer, M'60, clinical associate professor of surgery, and Walter T. Zimdahl, clinical associate professor of medicine, are secretary and treasurer respectively. Dr. Michael T. Genco is president-elect. □ Dr. William C. Aungst, research associate professor of medicine, has been elected vice president and president-elect of the New York State Division, American Cancer Socie­ ty. He is associate director for clinical affairs at Roswell Park Memorial Institute. □ Dean and Mrs. John aughton were guests of President and Mrs. Reagan February 2 at a White House reception for the Council on Physical Fitness. □ SUMMER, 1982 Two new faculty members have joined the psychiatry department. Dr. C. Timoth Golumbeck is assistant professor and direc­ tor of residency training. He received his M.D. from The Johns Hopkins Universit Medical School. He took his residency there and at the Henry Phipps Psychiatric Clinic. Dr. Giovanni A. Fava is a research assistant professor. He received his M.D. in 1977 from the University of Padau School of Medicine, Italy. He was a resident in psychiatry at the Institute of eurology and Psychiatry. □ Four faculty members are officers of the Erie County Medical Center Medical-Dental Staff. Dr. Carimir F. Pietraszek, M'44, is the new president. He is a clinical professor of medicine and chief of tuberculosis and pulmonary disease. Dr. John R. Border, professor of surgery, is president-elect and director of the trama research center. The new treasurer is Or. Richard Bettigole, associate professor of medicine/pathology and director of hematology and the blood bank. Dr. Joseph R. Gerbasi, M'62, represents the volunteer staff. He is clinical associate professor of surgery. Dr. Ralph Argen. clinical assistant professor of medicine, will be secretary to the advisory board. □ 39 Dr. Pietroszek �People Dr. Cooney Dr. Donald R. Cooney, has been ap­ pointed surgeon-in-chief and chairman of the department of pediatric surgery at Children's Hospital. Dr. Cooney has served as associate chief of surgery since February, 1980, when he joined the Hospital staff. Before coming to Buffalo, he was an attending pediatric sur­ geon at the Mayo Clinic, Rochester, Minn., as well as assistant professor of Surgery at the Mayo Medical School. Dr. Cooney, an associate professor of pediatrics and surgery at U/8, is a Fellow of the American Academy of Pediatrics, the American College of Surgeons and numerous other national and local professional societies. He is the author of many medical journal articles and is the recipient of numerous awards, including the 1979 Teacher of the Year award from the Mayo Medical School. Dr. Cooney, who received both his B.S. and M.D. degrees from Ohio State Univer­ sity, was previously a clinical instructor and resident in Surgery at Ohio State University, Indiana University and SU YAB. Dr. Cooney replaces Dr. Theodore C. Jewett Jr., M'45, surgeon-in-chief since 1957. Dr. Jewett will continue on as associate chief/ director of surgical education in the department of surgery. Dr. Jewett is professor of surgery at U/8. □ Dr. Timothy E. O'Connor, an organic chemist, has been appointed associate direc­ tor for scientific affairs at Roswell Park Memorial Institute. The native of Ireland has had 30 years of experience in cancer research. □ Dr. Lazarus Dr. Victor C. Lazarus, M'45, clinical assis­ tant professor of urology, has been elected president of the Medical Staff at Millard Fillmore Hospital. Dr. Lazarus, an attending urologist, succeeds Dr. Frank J. Bolgan, M'51, chairman of the Department of Thoracic and Cardiovascular Surgery. Other new officers are: president-elect. Dr. Peter D'Arrigo, M'56, clinical assistant professor of medicine and attending in Medicine: secretary, Dr. Norman Hornung, M'61, clinical instructor in urology, attending urologist: and treasurer, Dr. Henry Carls. attending surgeon. He is a clinical associate in surgery at U/B.O 40 Dr. Lawrence D. Jacobs, clinical assistant professor of ophthalmology and clinical associate professor of neurology and research assistant professor of physiology, has written a scientific report published in the November 1981 issue of Science magazine. The article is entitled, "Intrathecal Interferon Reduces Ex­ acerbations of Multiple Sclerosis.'' □ The Erie County Medical Center will open Western ew York's only in-patient unit for the treatment of drug addicts. It will be a 20-bed unit in a wing of the hospital's 9th floor. Patients 16 years and older will receive a 14 to 21-day treatment to rid their bodies of their drug dependence. The program will include 24-hour observation, counseling and post-hospital follow-up with existing services. □ Dr. Saxon Graham, professor and chair­ man of social & preventive medicine, has been named to the board of directors of the American College of Epidemiology. □ Dr. Dennis Sullivan, assistant professor of pediatrics, has taken over as program direc­ tor of the pediatric services of Children's Hospital at the Roberto Clemente West Side Health Center. Or. Sullivan has been chief of ambulatory pediatrics at Children's Hospital. □ Fifteen area urologists, most of whom are either U/8 alumni or faculty members, received special awards recently for their 25 years of service. Dr. Datta G. Wagle, clinical assistant professor, made the awards to Ors. Lawrence Carden, M'49; Robert Franz, M'49; George Futitt, M'45; Thomas Kaiser, M'43; Melbourrne Lent, M'43; Victor Lawarus, M'45; William Staubitz, M'42; Edgar Slotkin, M'34; Joseph D. Errico, Edward Fink, Maurice Gonder, Pasquale Greco, Imre Magoos, William Miesen, G.S.M. Wilson. □ Dr. Sambamurthy Subramanian, professor of surgery, was honored as "Man of the Year" by the Bailey-Delavan Businessman and Taxpayers Association in February. He is chief of cardiovascular sur­ gery at Children's Hospital. □ THE BUFFALO PHYSICIA �The Classes The Classesof the 1920s Dr. Lawrence L. Carlino, M'27, has been in private practice since 1929. He has had senior surgical privileges in three hospitals in the Lewiston area since 1968. He is spend­ ing his winters at his Miami home. He still lives most of the year at 920 Mohawk St., Apt. 203, Building One, Lewiston, N.Y. 14092. He has authored a physics book, "The Protospin Theory of the Universe," that will be off the press in early summer. He is active in several local and state professional societies. □ Dr. L. Maxwell Lockie, M'29, has joined the Millard Fillmore Hospital staff as a con­ sultant in rheumatology. He is professor of therapy and medicine at U/B. Dr. Lockie's involvement in medicine dates back to the late 1920s when he graduated from the University of Buffalo, School of Medicine, and began his residency at Buffalo General Hospital. In 1931, while working as an assistant resident at Johns Hopkins Hospital in Baltimore, Maryland, Dr. Lockie started an arthritis clinic. He co-founded the American Rheumatology Association in 1957 and has acted as president. In addition to his term as president, Dr. Lockie served as chairman for the Association's Liaison Committee and acted as the liaison between the committee and the Food and Drug Administration. He believes that his success in this liaison posi­ tion was due to his education in phar­ maceuticals. Dr. Lockie earned a degree from the University of Buffalo, School of Phar­ macy, in 1923. During his career, Dr. Lockie pioneered the use of British anti-lewisite (B.A.L.) as a treatment for gold poisoning. Dr. Lockie's research efforts also included studies on gout. By learning how to produce gout at­ tacks, Dr. Lockie discovered causes for these attacks. Therefore he was able to treat gouty patients effectively by adjusting their diets. Dr. Lockie has co-authored more than 125 medical papers and textbook chapters. He is a Professor of Therapy and Medicine at the State University of ew York at Buffalo and travels throughout the world, lecturing on arthritis. □ SUMMER, 1982 The Classesof the 1930s Or. Samuel R. Patti, M'34, has retired. He has been active in several professional or anizations. He lives at 501 Deer St., Dunkirk, .Y. 14048.D Dr. Niels G. Madsen, M'35, has retired and lives at 840 Galen Or., State College, Pa. 16801. He remains active in several professional organizations plus UKEWATCH, World Constitution & Parlia­ ment Association, Union of Atomic Scientists, Union of Concerned Scientists, American Humanists, PLANETARY CITIZE , AACP, PUGWASH, and Unitarian-Universalist Fellowship Association. □ The Classesof the 1940s Dr. Ronald E. Martin, M'43, of Eden was honored at a special retirement party in January for his 30 years of service as a general practitioner. The last five years he has been director of clinics at the Buffalo Psychiatric Center. During World War II he was a battalion surgeon with the 10th Ar­ mored Division. He was captured by the Ger­ mans during the Battle of the Bulge and treated both Germans and Americans. For 12 years he devoted his day off to serving at the Cattaraugus Indian Reservation. He was also deputy Erie County medical examiner for several years. □ Dr. Louis Hertz, M'47, is in family prac­ tice. His office address: 3465 Taylor Road, P.O. Box 130, Loomis, Ca. 95650.0 Dr. George L. Collins, Jr. M'48, has been elected a delegate from the Medical Society of the State of New York to the House of Delegates of the AMA for two years. He is a clinical assistant professor of medicine. □ The Classesof the 1950s r. Milford C. Maloney, M'53, a car­ diologist, was named "1982 Man of the Year" of the Western ew York Chapter, American Heart Association. He is past president of the chapter, clinical professor of medicine at U/B, and president of the Erie County 41 �Medical Society. He is also chairman of the department of medicine at Mercy Hospital, and past president of the U/B Medical Alum­ ni Association. □ diagnostic breast center at Santa Monica Hospital. He has authored many scientific ar­ ticles and lives at 527 N. Alpine Dr., Beverly Hills, Ca. 90210.D Dr. William R. Kinkel, M'54, has been elected president of the American Society of euroimaging. He is clinical professor of neurology and anatomy and director of the Dent Neurologic Institute at Millard Fillmore Dr. August J. D'Alessandro, M'65, is af­ filiated with the Fairfield Hills Hospital, Newtown, Ct. where he is unit chief psychiatrist-geriatric and treatment services. He is also a consultant at the Wassaic Development Center, Wassaic, N.Y. and medical director, Catholic Family Services, Danbury, Ct. He and his wife and two children live in ewtown, Ct. 06470, Box W.D Hospital. □ Dr. H. Albin Leonhardt, M'55, was elected a member of the International Arthroscopic Association last September. The orthopedic surgeon lives at 35 E. Madison Ave., Florham Park, .J.07932.D Dr. John H. Peterson, M'55, is chairman of the gynecology/obstetrics department at Armed Forces Hospital, Dhahran, Saudi Arabia. His work involves the organization and administration of this department. He has had many unique clinical experiences and opportunities. Before going to the Middle East Dr. Peterson was clinical professor of gyn/ob at Buffalo General Hospital and clinical assistant professor at U/B. He plans to return to Buffalo in January, 1983. His ad­ dress is Box 570, Dhahran Airport, Dhahran, Saudi Arabia. □ Or. Jean George Haar, M'56, is the new chairman of the otolaryngology department at Buffalo General Hospital. He is clinical professor of oral and maxillofacial surgery at the Medical School. In 1951 he received a DOS from U/B.D Dr. Germante L. Boncaldo, M'57, was a consultant in clinical rheumatology at Ghubu Hospital, Okinawa, Japan in December. 1982.D The Classesof the 1960s Dr. Harry Metcalf, M'60, has been ap­ pointed to the commission on public health and scientific affairs of the American Academy of Family Physicians. He is director of admission and clinical assistant professor of family medicine. □ Dr. Saar Porrath, M'61, is assistant clinical professor of radiology at UCLA Medical School. Dr. Porrath directs the newly opened 42 Dr. Patrick J. Kelly, M'66, associate professor of neurosurgery at U/B was among nine honored as "Citizens of the Year in Buf­ falo Medicine," by The Buffalo News. He uses computer and CAT scan x~ray to create a model or "road map" of the human brain and tumors. This system was developed while he was at the Erie County Medical Center. He is now chief of neurosurgery at Sisters Hospital. He has authored several manuscripts for medical magazines in recent months. His several medical memberships include the American & World Society for Stereotactic and Functional eurosurgery, and the Congress of Neurological Surgeons. He lives at 96 Cleveland Ave., Buffalo, .Y. 14222.D The American College of Physicians [ACP) announced that Dr. Stanley J. Bodner, of Donelson, T , has been elected to Fellowship in the 53,000-member national medical specialty society. Dr. Bodner, a specialist in Internal Medicine and Inf ec­ tious Diseases, was honored during the Con­ vocation ceremony at the College's Annual Session in Philadelphia, April 19-22, 1982. Dr. Bodner is one of 16,000 physicians honored with Fellowship in the College 649 have been elected this year. A 1967 graduate of the U/B School of Medicine, Dr. Bodner has been a resident of Hermitage and Mt. Juliet for eight years and is on the staff of the Donelson, Southern Hills, ashville Memorial Madison Hospitals. He is an Assis­ tant Clinical Professor in the Department of Medicine at Vanderbilt University School of Medicine. □ THE BUFFALO PHYSICIA r �Dr. Anthony J. LoGalbo, M'67, recently moved from Upstate ew York to Denver. He is an orthopaedic surgeon. He is living at 8651 Jamison Ave., Englewood, Colorado 80112.D Dr. Erwin J. Haas, M'68, was elected a Fellow, American College of Physicians recently. He conducted the 6th annual Grand Rapids infectious diseases symposium last year. He is married to Kristen Kitfsteiner, MD. They have two children and live at 2150 E. Beltline SE, Grand Rapids, Michigan 49506.D Dr. Milton P. Kaplan, M'68, is assistant clinical professor of medicine (dermatology) at the University of Southern California Medical School. His new address is 2190 Westshore Lane, Westlake Village, Ca. 91361.D The Classesof the 1970s Or. Donald George, M'76, is assistant professor of pediatric gastroenterology at the University of Florida. He lives in Gainesville, Florida 32610.D Or. Patrick R. Hayes, M'76, completed his residency in neurology at Ohio State Univer­ sity in July. He has been board certified by the American Board of Psychiatry and Neurology. He lives at 5248 Dory Lane, Columbus, Ohio 43220.0 Or. Carlos Schenck, M'76, lives at 4715 Girard Ave., South, Minneapolis, Minnesota 55409.D Or. Brian S. Kaufman, M'77, in July became assistant professor of medicine at the Chicago Medical School and director of the medical surgical intensive care unit of the orth Chicago Veterans Administration Hospital. Or. Kaufman completed a two-year fellowship at the Ellis Hospital Critical Care .Y. before moving to Center, Schenectady, Or. eil Carroway, M'70, is assistant clinical professor of medicine at the Univer­ sity of Rochester Medical School. He has been director of ambulatory services at Genesee Hospital since January 1981. He lives at 101 Thachez Rd., Rochester, .Y. 14610.D Dr. Bernard Traub, M'77, has been ap­ pointed associate pathologist at Millard Fillmore Hospital. □ Dr. Stanford S. Davidson, M'71, is assis­ tant clinical professor of ophthamology at the Jules Stein Eye Institute, UCLA Medical School. Dr. Davidson, his wife Joan and children Lisa, Josh and Alex live at 1525 Via Arco Palos, Verdes Estates, Ca. 90274.D Dr. Duret S. Smith, M'77, is chief resident, orthopedic surgery at Upstate Medical Center, Syracuse. In July he begins a Fellowship in surgery of the hand with Dr. John Madden in Tucson, Arizona. □ Or. Joseph Manno, M'72, is chief of the ophthalmology department, Metropolitan Eye and Ear Hospital, Atlanta, Ga. His home address: 5375 Long Island Dr., N.W., Atlanta, Ga. □ Dr. Paul H. Wierzbieniec, M'74, is a Fellow, American Academy of Orthopedic Surgeons. He is a clinical instructor in orthopedics at U/8. □ Dr. John J. Bodkin II, M'76, has been elected chief, department of family practice, Lockport Memorial Hospital, ew York. He is a clinical instructor in family medicine at the Medical School. He lives at 185 Bramble .Y. □ Court, Williamsville, SUMMER, 1982 Chicago. □ Dr. Kenneth L. Glick, M'78, is entering private practice in July. His specialty is inter­ nal medicine. He has been chief medical resident at Baltimore City Hospital and in­ structor in medicine at Johns Hopkins University. During his internship in 1978-79 he won the Howard K. Rathbun Award for clinical excellence. He lives at 7 Sugarloaf Court #210, Baltimore, Md. 20209.D The Classesof the 1980s Dr. Brian Chamides, M'81, is serving his residency at ew York Hospital, Cornell Medical Center, in pathology. He live at 434 E. 70 St., Apt. 6-D, ew York, .Y. 10021.D 43 �In Memoriam Dr. Elias Blaustein, M'54, died in Tustin, California February 28.D Dr. Howard R. Lawrence, M'35, died February 13. The 10-year Tucson resident was 70 years old. He was born in Hornell, .Y., attended Colgate before entering medical school. He retired from the military in 1965 after serving as a flight surgeon and hospital com­ mander with the Air Force. Dr. Lawrence moved to Tucson in 1972 and founded Pima Emergency Physicians Inc., which provides emergency physicians for St. Mary's Hospital. He served as the cor­ poration's first president. While at St. Mary's, he served as a director of the department of emergency medicine. He was also a member of the hospital's executive committee and was the quality medical-care coordinator. He was a diplomate of the American Board of Preventive Medicine and the American Board of Surgery. He was also a fellow of the American College of Preventive Medicine, the American College of Emergency Physicians, the International College of Surgeons and the U.S. Air Force Surgical Society, which he helped found in 1957.0 Dr. Ralph M. Colton, M'24, died March 6. The 86-year-old general practitioner retired two years ago. He was a past president of DeGraff Memorial Hospital's medical staff. He started to practice in North Tonwanda in 1943. Dr. Colton's father, the late Dr. Albert J. Colton, was a physician. One of Dr. Ralph's sons is a physician in St. Paul, Minneosta. Dr. Ralph Colton served on the Niagara County and orth Tonawanda boards of health. □ 44 Dr. Kathryn J. McMorrow, M'43, died February 2 in the Fort Wayne, Inc. Hospital. The 61-year-old physician was the only woman graduate in the 1943 class. She had practiced in Mount Clemens, Michigan since 1944. She was a Diplomate, American Board of Physical Medicine and Rehabilitation and a Fellow of the Royal Society of Health in London, England. She was also a Fellow, American Academy of Policital and Social Services. Dr. McMorrow interned at Sisters Hospital. She spent most of her career in ichigan hospitals except for 1950-51 when she was chief resident in physical medicine and rehabilitation at Columbia Presbyterian Hospital, ew York City. □ Dr. Gordon J. Culver, M'37, died February 17 in Buffalo General Hospital after a long ill­ ness. The 67-year-old headed the hospital's radiology department for 36 years before retiring in 1980. He also retired as clinical professor of radiology at U/B. Dr. Culver was a Fellow, American College of Radiology. He was active in several local, regional and national professional organizations. □ Dr. Solomon Rosokoff, M'35, died February 22 in DeGraff Memorial Hospital after a lengthy illness. He was president of the hospital's medical staff in 1947 and main­ tained his family practice of medicine from his Tonawanda office. His age was 71. Dr. Rosokoff served under General George Pat­ ton as an executive officer in the 2nd Ar­ mored Division, coordinating evacuation of the wounded from aid stations to medical treatment companies. The lieutenant colonel served in orth Africa, Sicily, England, France, Belgium, the etherlands, and Ger­ many for 32 months. He was decorated for heroism with a Bronze Star with an oak leaf cluster, a European Theater Ribbon and seven battle stars. He was also honored with the Fourreguerre Medal by the Belgian government. Dr. Rosokoff was among the first American troops to enter Berlin at the end of the European war. He was an active member of several professional societies and civic organizations. Among the several sur­ vivors is a son, Dr. James Rosokoff, a 1972 Medical School graduate. □ THE B FF ALO PHYSIC IA r - �A Message from orman Chassin, M' 45 President, Medical Alumni Association Dear Fellow Alumni: It is with great pleasure that I invite you to personally par­ ticipate in the affairs of the Medical Alumni Organization. Your individual efforts specifically contribute to the success of your organization and I urge you to send in your dues as tangible evidence of your much needed and appreciated support. Dr. Chassin -------------------------------------------------------------------------------------------------- 111111 NO POSTAGE STAMP C ARY IF 1AILED INTH U ITED STA TES BUSI NESS REPLY CARD FIR T CLASS PERMIT 0. 2210 POSTAGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, ew York 14214 BUFFALO, .Y �THE BUFFALO PHYSICIA STATE U IVERSITY OF EW YORK AT BUFFALO 3435 MAI STREET, BUFFALO, NEW YORK 14214 9200 OR. 32 400 D ROBERT L. 000 BRO 156 BRAT BUFFALO 44 ROAD Y 14226 ............... ,........ ""'"' THE HAPPY MEDIUM Fill out this card; spread some happiness; spread some news; no postage needed. (Please print or type all entries.) Name -------------------------------- Year MD Received ___ _ Office Address----------------------------------------­ Home Address----------------------------------------­ If not UB, MD received from-----------------------------------In Private Practice: Yes D No D Specialty ___________________________ In Academic Medicine: Yes D No D Part Time D Full Time D Schoo] ___________________ _ _ Title Other: Medical Society Memberships:---------------------------------NEWS: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.? ____ Please send copies of any publications, research or other original work. _ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Summer 1982 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1982-Summer Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1982-v16n02-Summer Table Of Contents A list of subunits of the resource. Dean Naughton's Message Post Graduate Matching Guido Baccelli, Physician, Statesman, Citizen of Rome The Clinical Years Student Awards/Fifth Pathway/Transfers Exercise, Good Health Dr. Ronald Martin Parents' Weekend Dr. Koslow CAT Scanning for the Clinician Athletic Day Infectious Disease Dr. Warner Summer Fellowships Physiology Chairman CAPD Program Pediatric Conferences Dr. Chardack Better Vision/Continuing Medical Education People Classes In Memoriam Dr. Chassin's· Message Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-07-02 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v16n02 Extent The size or duration of the resource. 48 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1982 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/dcd06ed533b2e36bb0df0dbf30ffcdc9.pdf 631219349a8c365057f618070552ed09 PDF Text Text School of Medicine Slate lkliversity ci New York at BLtralo �Dean Naughton From the desk of John Naughton, M.D. Dean, School of Medicine Dear Alumni and Alumnae, Although too early to pass judgement on the proposed changes in public policy directed to the support of medical education, there is little doubt that current and prospective medical students are filled with a high degree of anxiety and uncertainty. This has been exacerbated by the apparent reality that the cost of a medical student's education will continue to escalate during a period of which the support resources will continue to diminish. Already some private medical schools have announced tuition levels for 1983-84 approaching 20,000 dollars per annum. The Federal Government has proposed reduction in such programs as the National Health Service Corps, and it would like to withdraw from the federally supported and guaranteed student loan program. While the SUNY systems current level of 4300 dollars per annum looks pale compared to those of some private medical schools, it seems large compared to most other publicly supported institutions. The students, faculty and I realize and appreciate that a part of the real world the cost of medical education will increase, and that the cost must be borne in large part by the students and their families. However, we also realize that the quality of medical professionals should not be jeopardized and that the medical profession should not be accessible only to a single class of citizen. Accordingly, I encourage each of you to familiarize yourself with the magnitude and severity of the problems and dilemmas with which we are faced. Where possible use your influence to modify and mold public policy, and to the degree possible please continue to support this medical school emotionally, intellectually and fiscally so that we can weather the storm and the problem of the 80's in a successful manner. Thank you for your continued help and assistance.O �Spring1982 Volume 16, Number 1 THE BUFFALO PHYSICIAN (USPS 551-860) Published by the School of Medicine, State University of New York at Buffalo EDITORIAL BOARD Editor ROBERTS . McGRANAHAN Dean, School of Medicine DR. jOHN NAUGHTON Photography HUGOH . UNGER EDWARD NOWAK Visual Designers RICHARD MACAKAN)A DONALD E. WATKINS Associate Editor TERI ROBERTS CONSULT ANTS President, Medical Alumni Association DR. NORMAN CHASSIN Vice President, Faculty of Health Sciences DR. F. CARTER PANNILL President, University Foundation jOHNM. CARTER Director of Public Affairs HARRY jACKSON Teaching Hospitals The Buffalo General Children's Deaconess Erie County Medical Center Mercy Millard Fillmore Roswell Park Memorial Institute Sisters of Charity Veterans Administration Medical Center 2 3 4 5 8 12 15 16 18 19 20 21 22 23 24 26 27 28 29 30 31 32 34 36 37 44 48 IN THIS ISSUE Dean Naughton's Message (inside front cover) Nine Class Reunions, May 8 Dr. Chassin's Message Palliative Care Unit The 1985 Class Advisor's Luncheon Frosh Picnic Continuing Medical Education/Dr. Donahue Eight Faculty Retire Dr. Hayes' Health Center BRSG Grants Sexually-transmissible Diseases Construction/Mrs. Kimball Dr. Hess Dr. Rosner Gift Athletic Day Dr. Fisher Biochemistry Symposium A Summer Head Start Dr. Daniels Erie County Interns, Residents New Treatment Delays Births The Bat A New President Pediatric Continuing Education People The Classes In Memorial Spring Clinical Day, May 8 (inside back cover) The cover design is by Barbara Evans- see page 27. THE BUFFALO PHYSICIAN, (USPS 551-860) Spring, 1982- Volume 16, Number 1, published quarterly Spring, Summer, Fall, Winter - by the School of Medicine, State University of New York at Buffalo, 3435 Main Street, Buffalo, New York 14214. Second class postage paid at Buffalo, New York. Please notify us of change of address. Copyright 1982 by The Buffalo Physician. SPRING, 1982 1 �Nine Class Reunions, May 8 Nine classes will have reunions during the 45th annual Spring Clinical Day, May 8. Approximately 600 physicians and their wives will attend the reunion dinners. Dr. Elmer Friedland of Buffalo, New York is chairman of the 50 year class reunion. Other members of this class: (from Buffalo) Drs. Andrew Charters, Francis Coyle, Leo Kopec, Marvin Milch, Benjamin Obletz. (From New York State) Robert Boyle, Sayville; Murray Bratt, Rocco Stio, Rochester; Arthur Cramer, Jr., Grand Island; Angelo Leone, Medina; Frank Leone, Utica; Harold Levy, Newburgh; William Lewis, Lewiston; Lawrence Loewinthan, Flushing; Raymond McCarthy, Orchard Park; Robert Northrup, Westfield; Bronislaus Olszewski, Dunkirk; Carmelo Patti, Hornell; Myrtel Vincent, Vestal; Ernest Homokay, Silver Creek; Thomas Hobbie, Sodus. (From out of state) Elmer Peterson, Escondido, California; Harvey Slocum, Galveston, Texas; Joseph Smolev, Passaic, New Jersey. (From North Carolina) Hugh McGee, Whispering Pines; Roy Reed, Winston Salem. (From Florida) Marion Chimera, Stuart; Arthur Strom, Naples; Francis Maher, East Dorset, Vermont.D Dr. Charles Banas, M'37 Pictures were not available for these reunion chairpersons: Drs. Ronald Toffolo, M'57, Owen Bossman, M'62, John P. Kelly, M'67, and Linda Kam, M'72. 2 THE BUFFALO PHYSICIAN �from the desk of Norman Chassin, M' 45 President, Medical Alumni Association The coming spring season is a busy one for the Medical Alumni Association. On Thursday, March 18, 1982 we are co-sponsoring a program arranged in conjunction with the Erie County Medical Society Education Committee and the Medical School Office of CME. "Changes in Physician's Lifestyle" will be held at the Buffalo Marriott Inn. Physicians experienced in medical treatment of other physicians will discuss the issues of stress patterns and responses in physicians, the adaptive and impaired physician , the physician's marriage, "burn-out" and career changes among other subjects. On Sunday, April 25, 1982, local Alumni will be invited to a reception sponsored by the Medical Alumni Association at the Albright Knox Art Gallery welcoming the Senior Class into the Association. Plans are well underway for the 45th Annual Spring Clinical Day to be held Saturday, May 8, 1982 at the Buffalo Marriott Inn. The days events will include 14 scientific exhibits and a 6-hour CME program on "The Physician and Communications in Medicine". At the morning session local and out of town speakers will analyze elements operating in the physician's communication with individual sick patients with the healthy public and with other physicians. A special session will examine the complex medical and communications technology that will be increasingly available in the 1980s. The Stockton Kimball Memorial Luncheon will feature an award lecture by Dr. Dennis S. O'Leary of George Washington University relating the story of his participation as television interpreter for the medical team involved in the President Reagan assassination attempt. The day will be climaxed by reunion celebrations for the 5 year classes, 1932-1972. We anticipate meeting many returning Alumni during the course of this event.D SPRING, 1982 3 Dr. Chassin �Palliative Care Unit Drs. Magno, Milch Hospice patient Joyce Harrison relaxes in her room on the Palliative Core Unit ot BGH during o visit from Hospice Buffalo volunteer Elaine Ridler. The Palliative Care Unit at the Buffalo General Hospital, was formally dedicated September 28. The five-bed PCU, located on the first floor, is operated in cooperation with Hospice Buffalo, Inc. and is the only such unit in Western New York. Under the direction of Dr. Robert A. Milch, M'68, clinical instructor in surgery and medical director for Hospice Buffalo and a member of the BGH Department of Surgery, the PCU offers a specialized plan of care to persons with end-stage cancer. In general, patients who enter the hospice program have a life expectancy of three to six months. The guest speaker at the dedication ceremonies for the new Unit was Dr. Josefina B. Magno, president of the National Hospice Organization. Dr. Magno cited growth in the support of Hospice programs among physicians who at first were "very hostile" to the Hospice concept. " We (physicians) were taught not to treat symptoms but ra ther the underlying medical problem," Dr. Magno said. "But in a hospice program, the focus is on treating symptoms because treatment of the primary problem is no longer effective," she said. Dr. Magno established the hospice program at Georgetown University Medical Center and at one time was director of Hospice of Northern Virginia. She gave special praise to the efforts of Charlotte Shedd, executive director, and Dr. Milch, and other volunteers, who have worked hard the last several years. This is a grass-roots effort that has succeeded. About 95 percent of the estimated 10,000 patients being cared for annually in hospice programs in the United States have terminal cancer.D On hand for the dedication ceremonies of the new PCU were Mrs. Charlotte Shedd, head of Hospice Buffalo, Inc.; Dr. Robert Milch, medical director of Hospice Buffalo, Inc.; Dr. William V. Kinnard, president of BGH; Dr. fosefino B. Magno, president of the Notional Hospice Organization; and Henry Nowak, United States Congressman, 37th District. 4 TH E BUFFALO PHYSICIAN �Dean John Naughton Dr. John Wright Dr. Carter Pannill Jr. The most women to enter medical school- 50- received a rousing ovation from 85 new male students at the opening orientation session in August. In his welcome Dean John Naughton told the 135 new students that the new career they were about to embark on would be a challenge the rest of their lives. "We are here to stimulate and help you. We want you to be fine physicians." Dr. Naughton told the group of some of the traditions and the faculty-alumni accomplishments of the 135 year old school they were entering. He challenged them to cherish these traditions. "There have been many changes in medical education in the last decade. The funding of medical education is shifting from the government to the private sector. Individual responsibilities are back in vogue. The challenges are here and I encourage you to keep abreast of this changing world. It will be vastly different during the next decade. Good luck." Dr. F. Carter Pannill Jr., vice president for the faculty of health sciences, welcomed the new students for President Robert Ketter. "We are pleased with the posture of this medical school and this class represents a high point for us. You are among 3,000 students in the five health sciences schools [dentistry, nursing, pharmacy, health related professions). and I hope you will get acquainted with your colleagues." Dr. Leonard Katz said, "We are proud of you. This is a remarkable class. We hope to challenge you during the next four years and we want you to challenge us." The associate dean for student and curricular affairs told the students not to be concerned with the many stresses and strains that lie ahead. "This is normal and you can cope with it." The chairman of admissions told the students something about themselves. Dr. Harry Metcalf said, "You are older and wiser. Your average age is 23.2 (youngest 20, oldest 37); 14 have MA's; four have Ph.D's; one is a dentist; 98 are science majors; 11 are minorities; 65 are from Western New York; 58 from downstate; 9 from Upstate; and you come from 69 undergraduate schools. SPRING, 1982 5 The 1985 Class d- �Dr. Frank Schimpfhauser, who heads the office of educationevaluation and research, told how his staff works with students and faculty to improve teaching and learning. "We are here to help and counsel you during the next four years." The chairman of the orientation committee, Dr. Peter Nickerson, was introduced and congratulated the sophomores and juniors who were helping with the three days of orientation. Dr. Martin Wingate, assistant dean for medical education, warned the students that their education just begins when they graduate. He urged them to attend some special programs during the next four years and thereafter. There was an afternoon picnic at the end of the first day with faculty and upperclass students, plus tours, picture taking, registration and briefings. During the second day of orientation the new students had rap sessions with second year students that covered a wide variety of topics. Mr. David Bouman and Dr. Jack Richert spoke about financial aid. The students also met and heard a few words from their first year instructors and Dr. Martin E. Plaut, professor of medicine. The third and final day of orientation featured a clinical case presentation by clinical and basic science faculty, luncheon with advisors and administrators and a hospital visit with the preceptors. Drs. Peter Nickerson, Harry Metcalf, Leonard Katz, John Naughton, Martin Wingate, Carter PannilJ, John Richert, Frank Schimpfhauser. 6 THE BUFFALO PHYSICIAN .. �.. "This is your first day as medical students. Your contact with patients is a privilege and it must be sensitive." That is what Dr. John Wright, professor and chairman of pathology told the first year class at the clinical correlation session. "What we are talking about today you will be dealing with the rest of your clinical years, perhaps throughout your medical careers." Drs. Richard Emanuel and Robert Scheig introduced and interviewed patient X, a 55-year-old white male. He was admitted to Buffalo General Hospital in February 1976 because of two months of progressive accumulation of fluid which initially was periorbital, but subsequently involved his feet, legs, penis, scrotum and abdomen. During this time he had experienced a weight gain of 30 pounds and became fatigued quite easily. He stated that he had no energy. This was the first episode of such symptoms. He denied abdominal pain, shortness of breath, chest pain or blood in his stools. He did admit to one episode of vomiting blood two months prior to admission, but did not see a physician at that time. There was no history of peptic ulcer disease or ingestion of aspirin. During the two weeks prior to admission he noted that he was awakened twice at night to urinate. He was a chief gardner, enjoyed his work, was happily married, had several children and was in good health. He had quit smoking 30 years ago, but drank from 1112 to 21/z pitchers of beer daily. He drank no wine or whiskey, only an occasional high ball. He is a dedicated, self disciplined man. The students were given a detailed outline of the patient's physical examination and laboratory tests. In the hospital the patient was initially treated conservatively with bed rest and Aldactone (a diuretic) 100 mg four times per day. He lost 42 pounds and his abnormal girth decreased from 49 to 38 inches over five weeks. He was transfused to a hematocrit of 31. His platelets, which were initially normal, dropped to 50SPRING, 1982 7 · Dr. Cedric Smith �Clockwise from lower left: Drs. John Wrigh t, Steph en Ba rron, Peter Nicke rson, Margaret Acara, Leonard Katz, Frank Schimpfha user. 60,000. This was thought to be due to a sequestration of platelets Advisor's Luncheon in his markedly enlarged spleen. He then had a drop in hematocrit from 31 to 24 over several days with heme + stool. Because of the falling hematocrit he was sent to surgery where an end to side splenorenal shunt with splenectomy was performed. He did well post-surgically and was discharged on Lasix 20 mg per day (a diuretic), Aldactone 25 mg, three times per day, and ferrous sulfate which he continued only for a few weeks. He has done well since 1976 with no signs of encephalopathy and has had to take no medications except for a brief period during July, 1981 when he was given insulin because of diabetes mellitus. He has consumed no alcohol since his shunt surgery. Dr. Robert Scheig noted that he was an ideal patient; a nice person who has done well from recovering from a serious disease. Patient X never lost a days work, ate well and didn't realize he was an alcoholic. He never experienced a hang-over from his beer drinking. During his illness his wife was loyal and stood by him. 8 THE BUFFALO PHYSICIAN �The patient said, "My beer drinking was a hobby that sort of got out of hand. Now I drink tea without sugar or milk." Dr. Wright showed slides of the liver and how the blood circulates. He touched on the pathology of liver disease. "Not all alcoholics develop liver disease. Liver disease isn't the only toxic affect of alcohol." Dr. S.S. Shenoy, clinical assistant professor of radiology, showed several cases of liver disease in various stages. He showed X-rays of the liver and arteries and talked about radiologic aspects and how they are addressed clinically. He also mentioned diagnostic implications. Dr. Scheig, professor of medicine, gave an overview of physical diagnosis, bio-chemistry and physiology of alcohol and liver disease. "The liver is a factory that transforms things you eat and drink into you. Each liver cell is not like every other cell. They may look alike, but they are not necessarily alike. Less than two ounces of whiskey a day improves your health; but more than two ounces a day is bad for your health." Clockwise from right: Drs. John Richert, Joseph Caruana, Cedric Smith, students, Edward Carr Jr., Israel Alvarez. d- �Dr. Cedric Smith, professor of pharmacology and therapeutics, talked about alcohol abuse and drinking patterns the occasional binge, constant drinking, and decades of drinking. He touched on brain, nerve and pancreas damage and withdrawal sickness of heavy drinkers. "Today we can sort out the high risk patients." Dr. Smith noted that in a survey of alcoholics, 87 per cent said medical care helped them shake the habit. "This is your role as a physician. Every person deserves the best of medical and diagnostic care whether they have cancer, diabetes or something else. Don't refer your patient to someone else without a complete physical. Dr. Joseph Caruana, assistant professor of surgery, talked briefly about the surgical aspects. "The treatment is based on physiology, biochemistry and anatomy and other things you will be learning in your basic science courses. Surgery is not very successful; two-thirds of the people don't leave the hospital; they die. Surgical management is only part of the picture. It is difficult to pick; the patient who should have surgery for alcoholism. Clock w ise from right: Drs. Randy Sorna cki , Soli Mata lon, Suki Hong, Ri chard Em anu e l, Jack Klingman, Marvin Bl ack. �Drs. Robe rt Sche ig, Leonard Katz, Cedric Smith, Morvin Block, Joseph Caruana. Usually the ones who have successful surgery would also do well without it. The best surgical risks are people who have good liver function." Dr. Marvin Block, M'25, clinical associate professor of medicine/emeritus, headed the panel discussion that followed. "You are in a great profession - the best in the world. One of every 10 adults who come to your office may be an alcoholic, and you may not recognize it." He defined an alcoholic as "any individual whose drinking produces adverse conditions." The internationally prominent expert on alcoholism told the students "to reach out to these people and make them believe that you care about them, their families and their problem." Then he issued a stern warning to them: "Watch your own drinking patterns. It is a problem in the profession; there are lots of drinking physicians." Dr. Brock also made these observations: - early detection and prevention is important; - alcohol is a sedative; a healthy body can handle some of it; -most alcoholics eat very well and go undiagnosed; - 90 per cent of violent crimes are committed by alcoholics; -it is a very prevalent disease; denial is always used; - alcoholics have a very low tolerance with any kind of suffering; -the unhappy, uncomfortable, miserable person feels better when he drinks because he gets into the unreal world. Dr. Leonard Katz said, "As a gasterneterologist he was in contact with many alcohol related problems. Twenty-four per cent of all adults are heavy alcohol users and 60 per cent of Western New Yorkers are heavy consumers. Rehabilitation is very low - five to ten per cent, but if the problem is identified early 60 to 80 per cent can be saved." Dr. Katz admitted that there is an alcohol-drug problem among medical students, "Alcoholism is and will continue to be a part of your life as a physician. There is a very thin line between alcohol consumption and good and bad health. The outlook is dark even with early intervention. It is a chronic disease and must be treated like diabetes. We must give the alcoholic life-long support. SPRING, 1982 11 d- �Drs. Israel Alvarez, clinical assistant professor of medicine and nuclear medicine, and Stephen Barron, assistant professor of neurology, are co-directors of the preceptorship program. The 39 other preceptors are: Drs. Michael Adragna, James Allen, Benjamin Antanacio, Gilda Antruace, Sidney Anthone, Ruben Cartagena, Joseph Caruana, James Cavalierie, Carl Cecilia, John Conboy, Donald Copley, Richard Cowan, Neda Cruz, Richard Curran, Donald Donius, William Heyden, Fred Hirsch, Ernest Kane, Maria Klaus, Paul Kuritzky, K.H. Lee, Jerome Meyer, Eugene Mindell, James Nunn, Lynn Pace, F. Carter Pannill, Robert Patterson, Richard Peer, Kevin Pranikoff, Emerson Reid, Robert Schulman, Eddie Skipper, Barbara Steinbach, Jehuda Steinbach, Eugene Steinberg, Ronald Teitler, Michael Tronolone, Bradley Truax, and David Wiechec.O Frosh Picnic �Dr. Katz Raymond Chan, Lauria JoBooth, Dr. Richert, Amy Schueckler, Richard Collins, Kevin Rosteing. 13 d- �Frosh Picnic Dr. Brownie Dr. Richert �Dr. John M. Donohue, M'43, chief of staff at Kenmore Mercy Hospital for the past 18 years, has been named the recipient of the second annual Sister Mechtilde Memorial Award. The Sister Mechtilde Award, established in 1980, honors Sister Mary Mechtilde O'Connor, the hospital's founder and first administrator, a responsibility she undertook at a time in life when most persons contemplate retirement. Previously, for three decades, she administered various parish schools. Sister Ellen Mahon, present administrator of Kenmore Mercy described Sister Mechtilde as a legend in her time and said, "Dr. Donohue's daily life reflects the values and devoted service to mankind exemplified by Sister Mechtilde." Dr. Donohue joined Kenmore Mercy as a staff physician specializing in internal medicine and cardiology when the hospital opened in 1951 and was chief of medicine for four years preceding his appointment as chief of staff in May 1963. Born in Oyster Bay, Long Island, Dr. Donohue was educated at Syracuse University and the U/B Medical School, his father's alma mater, and interned at Henry Ford Hospital, Detroit. In World War II he was a U.S. Army Captain. Dr. Donohue is responsible for the quality of medical care provided by the nearly 250 physicians on the Kenmore Mercy staff, is an associate with Buffalo Cardiology Associates, P.C., and is a consultant at Millard Fillmore Hospital. He is also a former member of the Council of Clinical Cardiology of American College of Chest Physicians, past president of the Western New York Society of Internal Medicine, and currently medical director board member of the Monumental Life Insurance Co. of New York. He and his wife, Frances, have four children. The Second Annual Sister Mary Mechtilde Memorial Award Dinner was part of a celebration of the 30th anniversary of the founding of Kenmore Mercy Hospital and the 150th anniversary of the founding of the Sisters of Mercy.D 1982 Continuing Education Programs ... March 25 - "Neurology and Psychiatry: An Interface", Sheraton InnBuffalo East, Program Director, Dr. Brian Joseph, Assistant Professor of Psychiatry. April 1-2 - "New Developments in Hepatobiliary and Pancreatic Disease", Buffalo Hilton, Program Director, Dr. Robert Scheig, Professor of Medicine. April12- "Alzheimer's Disease", Marriott Inn, Program Director, Gary Brice, Assistant to Director, Center for the Study of Aging. May 12-13 - "Sports Medicine", Sharaton Brock, Niagara Falls, Program Director, Dr. Martin Wingate, Assistant Dean for Continuing Medical Education. May 20-21 - "Selected Topics in Geriatric Medicine", Niagara Hilton, Program Director, Dr. Evan Calkins, Professor of Medicine. June 3-5 - "Contemporary Stereotactic Techniques", Buffalo Hilton, Program Director, Dr. Patrick Kelly, Associate Professor of Neurosurgery. September 11 - "Frontiers of Drug Therapy", Buffalo Hilton, Program Dire ctor, Dr. Edward Carr, Professor and Chairman, Department of Pharmacology and The rapeutics. September 24-25 - "Primary Care of the Injured Hand". Buffalo Hilton, Program Director, Dr. Clayton Peimer, Assistant Professor of Orthopedics. October 1-2 - "Nutrition", Niagara Hilton, Program Director, Dr. Robert Cooper, Chairman and Associate Professor of Pharmacy. SPRING, 1982 15 Dr. Donahue Dr. Donahue �Eight Faculty Retire Eight Medical School faculty members, who reached the age of 70 on or before the last day of August have retired. Collectively they have served the University 265 years. They are: Drs. Carl E. Arbesman, Kenneth H. Eckhert Sr., Rolf E. Flygare, Jerome J. Glauber, Murray S. Howland Jr., Edwin F. Lathbury, Carl A. Stettenbenz, and Herbert Weinfeld. All are emeritus. Dr. Arbesman, who is clinical professor of medicine and microbiology, director of the Allergy Research Laboratory, and former Director of the Allergy Division (1944-1976) at the Buffalo General Hospital, was elected President of the International Association of Allergology and Clinical Immunology, for a 3-year term, at the 10th International Congress, which was held in Jerusalem, Israel, in November, 1979. He has been on the faculty 41 years. Dr. Arbesman attained his M.D. degree at the School of Medicine in 1935, and, soon after, completed his allergy training at the Johns Hopkins School of Medicine. He opened his practice in Buffalo in 1939, specializing in Medicine and Allergy. In 1945, he organized the Allergy Research Laboratory at the Buffalo General Hospital, a unit which he still heads. He became Chief of the Allergy Division of the Buffalo General Hospital in 1944, a position that he held for 32 years. Dr. Arbesman is a member of many professional societies and he holds honorary fellowships in many foreign organizations, such as the British, Canadian, Brazilian, Venezuelian, and Peruvian Societies of Allergy and Clinical Immunology. He has served on numerous committees and boards and has contributed handsomely to the field. Dr. Eckh ert Sr. Dr. Eckhert received both his bachelor's and M.D. degrees from U/B in 1931 and 1935 respectively. In 1958 he received an Honorary Doctor of Science degree from Wagner College. Dr. Eckhert joined the faculty in 1940 after taking his internship/residency at Deaconess Hospital. In 1955-56 he had a Fellowship in Surgery at Roswell Park Memorial Institute. In 1968 he was the recipient of the Dean's Award for contributions to the University and the community. He was named Man of the Year by the Courier Express and the Buffalo Evening News in 1961 and 1970 respectively. In 1968 he was the recipient of a special award from the Christians and Jews. Dr. Eckhert is a Fellow, American College of Surgeons. He is a past president of the Erie County Medical Society and has served since 1976 as Councillor of the 8th District, New York State Medical Society. Dr. Eckhert has also been chairman, Commission on Education of the New York State Medical Society. He is former chief of surgery, Deaconess Hospital, and honorary member of the surgery staff at Deaconess and Buffalo General. He organized and served as first president of the United Health Foundation and in 1979 was chairman of the dedication week program for the new blood center. He retires as clinical instructor in family and legal medicine at the Medical School. 16 THE BUFFALO PHYSICIAN �Dr. Flygare, assistant professor of anatomy, has been on the faculty 19 years. He received his three degrees from U/B bachelor of science in 1937; master of science in 1963; and Ph.D. in anatomy in 1970. He served in the armed forces from 1940-45. Dr. Glauber, a 1936 U/B Medical School graduate, joined the faculty in 1948 as assistant in otolaryngology. He retired 33 years later as a clinical assistant professor of otolaryngology. He did his undergraduate work at Canisius College. Dr. Glauber interned at Millard Fillmore Hospital and took his residency in otolaryngology at the E.J. Meyer Memorial Hospital, 1940-43. He served with the United States armed forces as a Major from 194346. He has been affiliated with three hospitals - Millard Fillmore, Children's and St. Francis. He is still active in several professional societies at the County, State and National levels. He is continuing his private practice in otolaryngology. Dean Naughton, Dr. Glauber Dr. Howland, clinical professor of medicine, has been on the faculty 42 years. He received his M.D. from Harvard in 1937, and came to Buffalo two years later. Dr. Lathbury, a 1936 U/B Medical School graduate, died August 13, 1981. He had been on the faculty for 33 years. He was a clinical assistant professor of otolaryngology at the time of this retirement. He took his internship and residency at Buffalo City Hospital. During World War II he served in the United States Army Medical Corps. Dr. Lathbury had been associated with three hospitals - St. Francis, Millard Fillmore and Buffalo General. He had been active in numerous professional organizations. Dr. Stettenbenz, clinical assistant professor of pediatrics, has been on the faculty 42 years. In 1931 he received his bachelor's degree from Hobart College where he was Phi Beta Kappa. In 1935 he received his M.D. from U/B. He joined the faculty in 1939 as assistant in pediatrics. Dr. Stettenbenz interned at Buffalo General and Children's Hospitals from 1935-1938. The following year he was chief pediatric resident at Children's. He is a Fellow, American Academy of Pediatrics, and has been active in county and state professional associations. In recent years he has been consulting pediatric attending at Children's Hospital on the courtesy pediatrics staff at Sisters of Charity Hospital. Dr. Weinfeld, research professor of biochemistry, has been on the faculty 14 years. He was educated at the College of New York City, bachelor of science degree in 1942; University of Michigan, M.S. in 1948; and Ph.D. in 1952, majoring in biochemistry. He took post graduate work at Sloan-Kettering Institute in 1952. He was on the staff at Roswell Park Memorial Institute from 1955-1980 in the medicine C department as chairman of the department of biochemistry graduate division. He served in the United States Army in World War II. Dr. Weinfeld has been active in several professional societies.D SPRING, 1982 17 Dean Naughton, Dr. Arbesman �Dr. Hayes' Health Center II The rural Mississippi health center is a dream come true for Dr. Maxine Hayes, M'73. It all started during her second year in medical school when she spent the summer in community health on the Mississippi Delta (her home). Dr. Hayes' seven weeks at the Tufts Delta Medical Center in Mound Bayou gave her a sense of direction, commitment and sensitivity. She knew from this experience that treating medical problems was not enough without attempting to solve the social problems that were present. She saw unemployment, poverty and malnutrition. From this moment in 1971 Dr. Hayes decided to do something about it and she has. After graduating from the Harvard School of Public Health the young pediatrician established a comprehensive health care facility outside Jackson that is serving the 57,000 residents of rural Rankin county. Now a lecturer in the Department of Maternal and Child Health and Aging, Dr. Hayes is a major force in increasing the School's emphasis in rural and community health. This emphasis is designed to train community health professionals committed to improving the quality of health care in medically underserved areas. Dr. Hayes developed a new curriculum for the Rural Health Services course she taught last spring that included numerous seminars with practicing rural health professionals. She also led students on a field trip to the health center she directs, the Hinds-Rankin Urban Health Innovations Project (HRUHIP). and to other public and non-profit health programs in the rural areas of central and east-central Mississippi. Beginning last summer, students worked on a statistical evaluation of the effectiveness of HRUHIP services, using data from neighboring counties without comparable services as a control. By drawing together the components of teaching, field study and program evaluation, Dr. Hayes is providing students with an extensive training experience. 18 Dr. Hayes, a native of Jackson, stresses that "planning for rural health services is often very different than planning for urban services. For example, in terms of providing health services, the high rate of infant mortality in Mississippi means the perinatal period (the time between conception and one year after birth) becomes a critical focus for health planners. But to be effective, clients must be kept within the health care system for that time." And this requires a careful program of risk evaluation, health education, treatment, delivery and follow-up all set into a tracking system that keeps patients in the program. The successful operation of all functions of HRUHIP requires meticulous recordkeeping, says Dr. Hayes. "Data collection and analysis is really the cornerstone of a costefficient system that lets us know how best to provide care." In a larger context, she believes that the status of health care in Mississippi is jeopardized by five important factors. These are: Medicaid and other reimbursement mechanisms that discriminate against the rural and married poor; private physicians who see publicly supported and group practices threatening them; the tendency for health services to become more specialized and technologically intensive; regulatory and other disincentives to preventive health programs; and difficulty in hiring and retaining skilled professionals.D THE BUFFALO PHYSICIAN �Ten faculty members, based at Children's Hospital, received Biomedical Research Support Grants totaling $47,827. Dr. Elliot F. Ellis, professor and chairman of pediatrics is the principal investigator and responsible for allocation of the BRSG funds. The program is sponsored by the National Institutes of Health and provides research funds based on a percentage of the total NIH research grants held by an institution during the previous year. The program is designed to support new or exploratory research projects and to provide "seed money" to young investigators. The 10 research projects are: Dr. F.J. Cerny, assistant professor of pediatrics: The Metabolic and Hormonal Consequences of Intermittent Versus Continuous Exercise in Insulin Dependent Diabetes Mellitus. Amount: $4,000. Dr. J. W. Georgitis, clinical assistant instructor in pediatrics: Determination of Nasal Airway Resistance in Normal Children and Children with Allergic Rhinitis. Amount: $5,000. Dr. M.P. Karp, clinical assistant instructor in surgery: Gastrointestinal Motility and Transit in Newborn Puppies with Experimental Intestinal Atresia. Amount: $5,650. Dr. M.M. McDonald: Newborn Hypercoagulability Studies (with Special Reference to the Occurance of Intracranial Hemorrhage]. Amount: $5,395. Dr. B.H. Park, professor of pediatrics and microbiology: The Use of Flow Cytometry and Cell Sorter as a New Methodology in Biomedical Research. Amount: $6,400. Dr. J.R. Russell, assistant professor of pediatrics: Modulation of Neurotransmitter Release in Airways. Amount: $5,700. Dr. M.R. Siegel, clinical assistant instructor in pediatrics: The Role of Bile Salts in the Release of Enterokinase from Intestinal Mucosa. Amount: $3,000. Dr. C.W . Snyder: A Comparison of Two Methods of Psychological Preparation for Young Children Requiring Restorative Dental Treatment. Amount: $575. Dr. M.R. Talty, assistant professor of pediatrics: Characterization of the Interaction Between Mouse Enterocytes and Murine Rotavirus. Amount: $4,000. Dr. G.D. Vladutiu, research assistant professor of pediatrics: Enzyme Replacement Therapy: Specific In Vitro Neuronal Uptake of B-Hexosaminidase in Cats with GM 2 Gangliosidosis. Amount: $2,049.0 The Leukemia Society of America (WNY Chapter] and Roswell Park Memorial Institute will sponsor a symposium on "Multiple Myeloma," Saturday, May 1 (9 a.m.-1 p.m.] in Hilliboe Auditorium at RPMI. For more information please contact the Leukemia Society of America at 883-5400.0 SPRING, 1982 19 BRSGGrants �Sexually-transmissible Diseases Top row (left to right): Drs. Mehdi Shayegani (State Health Department); Erwin Nete r; William B artholomew; Konrad Wicher; Richard Lee (Children's Hospital); Roy Stevens (State Health Dept.). Lower row: Drs. Sally Hipp (State H ealth D ept.); Virginia Clark (Roches te r); William Lawton (State Health Dept.) and Nancy Nielsen (Buffalo General Hospital). Three Medical School faculty members participated in the two-day symposium - sexually-transmissible diseases - recently at the Erie County Medical Center. Faculty from the University of Rochester and members of the State Department of Health's division of laboratory and research reviewed the diagnosis, treatment and prevention of these diseases. Their discussions covered diseases commonly associated with sexual transmission. These included syphilis (Treponema palli dum), gonorrhea (Neisseria gonorrhoeae), chancroid (Haemophilus ducreyi) and lymphogranuloma venereum (Chlamydia trachomatic). They also discussed organisms such as Trichomonas vaginalis, Gardnerella vaginalis, Ureaplasma urealyticum, Herpes simplex and hepatitus B virus. The speakers emphasized an estimated 1.6 to 2 million cases of gonorrhea occur annually in this country. They also said the annual incidence of trichomoniasis ranges between 600,000 to a million, nongonococcal urethritis from 800,000 to a million, syphilis from 75,000 to 80,000 cases and genital herpes from 150,000 to 200,000 cases. The numbers, they said, indicate a serious problem that is not recognized by many. They noted human suffering to be enormous. The women involved, they added, bear an inordinate share of the burden through sterility, ectopic pregnancy, fetal and infant death and mental retardation. They noted the medical cost to treat the diseases and complications caused by sexually-transmitted diseases runs close to $2 billion. They added the problem of sexually-transmissible disease is compounded by patient apathy, neglect and ignorance. In some of the newly-recognized infections, they pointed to insufficient laboratory technology for isolation/identification of microorganisms which also contributes to the problem. Dr. Charles Brinton, University of Pittsburgh, was the dinner speaker. In the review of his studies of pilli vaccine for gonorrhea, he noted the vaccine is currently being field-tested. The symposium was arranged by the State Department of Health's division of laboratories and research and the WNY branch of the American Society of Microbiology. Chairing the program were Drs. Erwin Neter, professor of pediatrics and microbiology; Konrad Wicher, professor of microbiology and director of bacteriology and serology/immunology laboratories, State Department of Health; Sally Hipp, State Department of Health; and William Bartholomew, assistant director, clinical microbiology and immunology, Erie County Medical Center, and associate professor of microbiology, clinical associate professor of pathology.D 20 THE BUFFALO PHYSICIAN �Construction Projects Eight construction projects - valued at $100 million - will be underway by next October 1, at Amherst and Main Street, Dr. John Neal, vice president for facilities planning, predicted recently. The eight which should be underway by next year are well along in planning now. The three Main Street projects which should be underway in 12 months are: 1. The Biomedical Information Center which will occupy the present Abbott Library and a new wing approximately as large as the existing structure. 2. The "much-ballyhooed" Squire project - which will include renovation of the present union and construction of a new wing toward Main Street as clinic space for the School of Dentistry. 3. Phase I of the Basic Sciences addition to Cary-Farber-Sherman. This will consist of new construction connected to both Cary and Farber and filling up the space in between. The five Amherst campus projects: 1) Physical Education - Phase II. This facility "every bit as big as Phase I" will be connected to that building. (Phase I is scheduled for opening in the fall of 1982 after installation of "enormous equipment" including a one-piece, one-acre wooden arena playing surface. Phase II will contain small gymnasiums, swimming pools, weight rooms, etc.). 2) Student Activities Building - To be located east of Knox, this building will essentially duplicate facilities now located on the ground and first floors of Squire. 3) Management School Building- To be built south of O'Brian and Baldy. 4) Social Sciences Phase I - To be connected to both O'Brian and the Management structure. 5) A Computing Center - To be built west of Fronczak and connected to it.D SPRING, 1982 Mrs. Kimball Donates Scrap Book On the 80th anniversary of President William McKinley's death in Buffalo, Mrs. Stockton Kimball presented a scrapbook to the U/B archives that was kept by one of the president's Buffalo doctors, Charles G. Stockton, a grandson. The gift was made in memory of Dr. Kimball, dean of the Medical School from 1946 to 1958 to President Robert L. Ketter and Saktidas Roy, libraries director. President McKinley was shot in Buffalo September 6, 1901 while visiting the city's Pan American Exposition. He died eight days later. The scrapbook, each page outlined in funeral black, contains newspaper clippings, medical reports and other items related to the shooting and death of the president, including his care in Buffalo's Milburn House, controversies surrounding that care, transport of the body to Washington and burial services in McKinley's native Ohio. University Archivist Shonnie Finnegan said that while the scrapbook has historical value, it is particularly interesting for its medical journal articles and for the look at the florid journalistic style of the period it offers. When initial press accounts gave the president a favorable prognosis, sentences like this were common: "The latest news from the bedside of President McKinley is of the most cheerful character." But when McKinley died on September 14, a Buffalo headline read: "President McKinley Dead/His Soul Freed/at 2:15 O'Clock." Clippings also list the tributes paid the slain president by world leaders, including Andrew Carnegie, Edward VII of England, President Porfirio Diaz of Mexico, and Willian Jennings Bryan. The swearing-in of Theodore Roosevelt as the nation's 26th president on September 14, 1901, in Buffalo's Wilcox Mansion is also documented.D 21 �Dr. Hess Dr. H ess Dr. Orvan W. Hess, M'31, received the Scientific Achievement Award of the American Medical Association at its 128th Annual Meeting (1979) and the George Washington Kidd Award for outstanding achievement in a professional career from Lafayette College (1980). Dr. Hess has had a broad range of experience as a practitioner of Obstetrics and Gynecology, innovator of techniques of obstetrical care, pioneer in the development of medical instrumentation and administrator of the Title XIX program in Connecticut as its first Director of Health Services. He is a member of numerous scientific societies and health agencies including the American College of Obstetricians and Gynecologists, American Board of Obstetrics - Gynecology, American College of Surgeons, Institute of Electronic Engineers (BME), American Association for the Advancement of Medical Instrumentation, International Telemetering Association and Sigma Xi. He is past-President of the Connecticut State Medical Society and the Connecticut Health Association, Inc. He is currently Clinical Professor of Obstetrics and Gynecology and Director of a Regional Perinatal Monitoring Program at Yale University School of Medicine and is actively involved with PSRO and HSA in Connecticut. For several years he has been a Delegate to the American Medical Association. A member of international organizations, Dr. Hess has participated in medical conferences in Tokyo, Geneva and other European cities. As U.S. representative to the All-India Congress of Obstetrics-Gynecology, he lectured at Calcutta and Bombay. Dr. Hess has had a continuing interest in methods of delivery of health care and in medical education. With a group of professionals he attended a seminar in London, organized by the AMA, to study the British Health System. He has published articles dealing with the reorganization of that system of provision of health care, the National Health Planning Act (P.L. 93-641), medical technology and modern trends in medical education. As a Research Fellow in OB-GYN, he conducted pioneer investigations of the nature of healing of incised uterine wounds (cesarean section) in humans and the effect of such factors as vitamin A deficiency, ovarian follicular hormone (theelin) and cortisone on the ultimate tensile strength of uterine incisions in laboratory animals. After entering private practice in New Haven (1937) he held faculty appointments which allowed him to pursue his research interest in transplantation of placental and embryonic tissues and in methods of detecting fetal ECG. During this period penicillin, developed in England, became available to a group of doctors associated with Yale University School of Medicine. Dr. Hess played a catalytic role in its therapeutic application for the first time in the U.S. for a patient, extremely ill with post-abortal streptococcal septicemia, who made a miraculous recovery. Dr. Hess, called to active military duty in 1941, served as a surgeon with a front-line evacuation hospital accompanying Gen. George Patton's Armored Division during invasions of North Africa, Sicily, France and Holland. With Dr. Charles Rose , M'29 and Dr. Stuart Welch, Professor of Surgery, Tufts School of Medicine and later Chairman of Dept. of Surgery at Albany 22 THE BUFFALO PHYSICIAN �Medical School, he co-authored a paper describing their extensive experience with treatment of severe vascular injuries among battle casualties. Soon after the liberation of Paris, his medical unit was assigned the care of casualities with gas bacillus infection where he was further impressed by the value of penicillin in the treatment of infection. On returning to practice after WW II, Dr. Hess resumed research on fetal ECG begun while a Resident at Yale where he initiated a project to study fetal heart activity and fetal distress. Joined by Dr. Edward Hon, full-time research investigator, a method of detecting fetal ECG with abdominal sensors was achieved. With the apparatus devised for continuous monitoring of fetal heart rate, Dr. Hess studied effects of uterine contractions, various drugs and post-maturity. In 1954 he first described a technique for radiotelemetry of fetal heart and uterine activity. Recently, he has reported the development of a non-invasive technique of transmitting these parameters employing ultrasound for detection. Dr. Hess finds time for hobbies of tennis, fly-fishing in Catskill mountain streams and surf-casting near his cottage on the dunes at Cape Cod while his wife Carol (Smith '27 and Yale Art School '29) continues her interest in art. Their two daughters, graduates of Wellesley, both hold Yale Graduate degrees. Katherine, (M.D. Yale '54) a pediatric cardiologist, is currently Director of Medical Services for FAA Eastern Seaboard Region. Carolyn (Yale '54) is a consultant in Regional Planning in Connecticut. Of the Hess' five grandchildren, two are students at Yale University, one attends Mt. Holyoke College, one attends Hobart College and one plans to enter Phillips Exeter next year.D Dr. Rosner Gift The U/B Foundation has received a gift of $225,000 from the estate of Edward L. Rosner, M.D. This gift represents the principal and accumulated income of a residuary trust that Dr. Rosner established to benefit the School of Medicine of the State University of New York at Buffalo. The fund is established as a memorial to Dr. Rosner's mother, Elizabeth. Dr. Rosner, a 1926 graduate of the Medical School, stipulated that the principal be invested by the Foundation with the income to be used annually to grant scholarship loans to deserving students pursuing a medical course of study. The U/B Foundation, in cooperation with the School of Medicine and Office of Financial Aid, will administer the fund. The foresight and generosity of Dr. Rosner in providing for today's students is, and will continue to be, appreciated by those who will benefit from his philanthropy.D SPRING, 1982 23 Roswell Park Memorial Institute Continuing Education Seminars Contact: Gayle Bersani, R.N., RPMI 666 Elm St., Buffalo, N.Y. 14263 Phone (716) 845-4406 Thursday, April 1, 1982 "Tumors Involving the Skin", Chairperson: Dr. Ole Hoi termann. Thursday, May 6, 1982 "Controversies in the Management of Childhood and Adolescent Cancer", Chairperson: Dr. Arnold Freeman. Saturday, June 5, 1982 "Cancer of the ColonRectum", Chairperson: Dr. Arnold Mittelman. �Bladder baJJ Athletic Day It was a chilly spring day for the annual athletic event, but all the participants - students and faculty - had a good time. Annette Kawecki and Elaine Healy were the winners in the dash. In the one mile race Elliot Chartash and Paul Rosenberg finished first and second, respectively. Speedy John Diggs captured the 100-yard dash and was outstanding in soccer. Jeff Moll led thesecond year students to a 2-1 win over the frosh in bladder ball.O Therese Giglia, Barbara Ostrav. Dr. Alexander Brownie, Leslie Dopkins. 24 Mike Wenzel, john Diggs . THE BUFFALO PHYSICIAN �Dr. Leonard Katz, Renata Wajsman, Elaine Healy, john Diggs. Dr. John Richert �Dr. Fisher II Dr. Jack C. Fisher, M'62, professor of surgery at the University of California, San Diego, has been elected Chairman of The Plastic Surgery Research Council. The Council is a national organization of Plastic Surgeons and affiliated basic scientists whose principal interests are laboratory and clinical investigation in biomedical areas pertinent to reconstructive surgical practice. Members of the Council have traditionally engaged in experimental studies of wound healing, microcirculatory physiology and replantation, tissue transplantation, nerve injury, and craniofacial biology. The 27th annual meeting of The Plastic Surgery Research Council was hosted by Dr. Fisher in San Diego in March, 1982. Dr. Fisher is a native of Buffalo, New York, completed undergraduate studies in the College of Arts and Sciences at U.B. , and received his M.D. degree in 1962 from the School of Medicine. Following graduation, Dr. Fisher served a residency in general surgery at the University of Minnesota Hospital and at Boston University Medical Center. He was a clinical associate in the surgery branch of the National Cancer Institute from 1964-66. His plastic surgery training was completed at the University of Virginia Medical Center in Charlottesville, Virginia, where Dr. Fisher remained on the faculty until1975. In 1975 he was named head of the new division of plastic surgery at UCSD where he now directs a graduate training program in plastic and reconstructive surgery. Dr. Fisher's clinical interests are in problem wound management and congenital childhood deformities . His research laboratory has actively pursued studies in skin allotransplantation, immunosuppression following burn injury, and mechanisms of chronic radiation injury. Dr. Fisher also directs a Field Surgical Program, taking an entire mobile surgical team to sites in rural Mexico several times each year, for the purpose of repairing congenital birth defects. Dr. Fisher has published more than 50 scientific or clinical articles and has authored or co-authored four textbooks. His honors at the University of Buffalo were Alpha Omega Alpha, and The Leonhardt Prize in Surgery. Dr. Fisher resides in La Jolla, California with his wife Patricia and his three children.D 26 THE BUFFALO PHYSICIAN �The research talks. search chemis t. Biochemistry Symposium A proven format and the stimulus of new ideas from biochemists working at U/B, its affiliated hospitals, Roswell Park Memorial Institute and the Medical Foundation of Buffalo, made the Second Annual Biochemistry Department Research Symposium lively and productive again this year. Faculty, students and staff met in the afternoons of April 9 and 10 in the spacious Spaulding Dining area and lecture rooms in the Ellicott Complex of the Amherst campus. New faculty members, Joseph Spence and Gail Willsky, post-doctoral fellows and members of the research and clinical faculty gave short talks of a general nature to the audience with its diverse background and interests. Detailed research findings were presented in poster sessions open to every participant from junior undergraduate students to senior faculty as well as technical and research staff. Talks and poster sessions were organized around the four clusters of research activity represented in the Biochemistry Department: gene expression; proteins and metalloenzymes; membranes; and endocrinology/nutrition/metabolism. Each afternoon ended with social gatherings to encourage further exchange of ideas and the exploration of possible co-operative research efforts. At the final "wrap-up" sesSPRING, 1982 sian, Chairman Alexander C. Brownie observed that the symposium had been just what Webster's dictionary said a symposium is: "a social gathering where there is a free interchange of ideas." He ended his overview with the suggestion that riext year an eminent scientist be invited to visit the department and attend the symposium as a participant, observer and benevolent critic. This visit would be supported by the Rapier H. McMenamy Memorial Fund. Prior to his death, Professor McMenamy was an internationally recognized scholar and served as Director of Graduate Studies in the Biochemistry Department.O Dr. Lau ro Garrick, r esearch associate. Dr. joseph Spence, assistant professor of biochemistry. �A Summer Head Start Dr. Tomasulo works with th e students in th e m orning lob sessions. Eight potential medical and dental students got a head start on their professional educations during eight weeks (June 10August 6). This was the seventh year that courses were offered in histology , embryology , biophysics, biochemistry and gross anatomy. Co-ordinator of the preparatory support program was Dr. Leonard Katz. During the first week there was a special orientationintroduction session featuring Dean John Naughton and Dr. Katz. During the summer there were four guest speakers, Drs . John Richert, Randy Sarnacki, Frank Corbett and Ms. Vaughan. Every Friday afternoon Dr . Eddie Skipper, clinical instructor in medicine , conducted a preceptorship program at the Veterans Administration Medical Center. The new students were introduced to medical terms and taught study skills and speed reading. Also assisting with the program were Manuel Saint Martin, Margaret Kadree, Robert Morrow and Mark HendersonD �It is impossible to associate the word "retirement" with a person as vital and up-to-the-minute in thought, word and deed as Dr. Francis R. Daniels. Therefore, it's no surprise to learn that the Santa Ana surgeon has no idea of retiring from medicine, even though he is closing his office and eliminating the regular practice of surgery. "I want to use my free time to attend medical meetings, and become active on a number of medical-organization committees," Dr. Daniels explained. "During my 26 years of surgical practice in Orange County, I did serve on many hospital committees, especially surgical and utilization, but patient care took priority over committee service. Now I will be able to study issues, form opinions, and perhaps be an influence on the state and national level in medical administration." Dr. Daniels was graduated from the University of Buffalo (New York] with a B.S., followed by an M.D. degree in 1924. There was no debate about selecting an area of specialization. It was surgery all the way. The new young Dr. Daniels served a surgical internship at Rochester, New York, then proceeded to New York City for a year's residency in pathology at New York Hospital, then a surgical residency at New York's Hospital for the Ruptured and Crippled. There he worked under world-famous hernia specialists Drs. W.B. and Bradley Coley, J.P. Hoquet, and Carl Burdich. As a grande finale to the varied residencies, Dr. Daniels completed yet another in surgery at Bellevue Hospital. It was a highly qualified young surgeon who began practice in Rochester, New York. He became a Fellow of the American College of Surgeons, and a Diplomate of the American Board of Surgeons. During his time in Rochester, Dr. Daniels was Vice Regent for the International College of Surgeons. He was on the surgical staff of several of the city's hospitals, and was also chief of surgery of Monroe County Hospital. A full Commander in the Navy in World War II, Dr. Daniels was chief of surgery at the U.S. Naval hospital in Milford Haven, Wales, during the European phase of the war, then joined the hostilities in the Pacific on the U.S.S. Solace. When Dr. Daniels moved to California and applied for staff privileges at what has become Western Medical Center, there were few American Board surgeons, especially in Orange County. The surgical committee was quick to approve this accomplished applicant, but the next question was finding patients. "Mr. Malinowsky, the administrator at that time, was a big help in getting me started," Dr. Daniels reminisced. "He let me work in the Emergency Room." That was the beginning of a busy, more-than-quarter-of-acentury career in the operating suites of Santa Ana Community Hospital (today's WESTMED], St. Joseph, Haag Memorial Presbyterian, Doctors, and Riverview Hospitals. Obviously, to someone like Francis R. Daniels, "retirement" is an impossible word.D SPRING, 1982 29 Dr. Daniels Dr. Daniels and his wife spent the Christmas holidays in Switzerland, his wife 's native land. They have a son, who is a third-year medical student. Their daughter is in hospital administratian.D Dr. Daniels �Typical morning rounds with attending physicians, house staff members and students. From left - Drs. Milton Weiser, professor of medicine, Kamal Tourbaf, clinical professor of medicine, George Forrest, clinical assistant instructor in medicine, Dham Gupta, clinical assistant instructor in psychiatry, and medical students- Lilly Barba and Pat Diesfield. Erie County Medical Center Interns, Residents Dr. Kamal Tourbaf, clinical professor of medicine, reviews X-rays with Drs. Rajendra Rustgi, John LaMancuso, M'79, and fourth year student, Gary Rosteing. Among the 66 internal medicine interns and residents at Erie County Medical Center, 25 are U/B Medical School graduates. Approximately one-third of the ECMC housestaff and fellows are also U/B graduates.D An informal patient progress discussion with faculty, house staff and students. 30 THE BUFFALO PHYSICIAN �Drs. Jeffrey Haiken and Mark Gallman, 3rd year house officers; William Shu and Elaine Healy, both 3rd year medical students. New Treatment Delays Births Dr. Frank J. Bottiglieri, M'79, used the drug ritodrine successfully in triplet gestation. He is a senior resident in ob/gyn at the Johns Hopkins Hospital. "This is probably the first time in the United States that the drug has been effective in the case of triplets," he said. "The woman, who was in danger of losing her unborn babies, has three healthy baby boys because of a new drug that prevents premature delivery. This new drug gives a lot of women hope, because prematurity is the number one problem in losing babies," Dr. Bottiglieri said. Two of the babies weighted 41fz pounds, the other 51fz pounds. Had they been delivered five weeks premature, two would have weighed less than two pounds and would probably have died. The delivery was relatively routine. The 22-year-old mother had three other children. It cost about $800 a day to keep a premature baby alive in a hospital. Many premature babies must be hospitalized for as long as six months. "The womb is a better place for a 27-week fetus than a hospital's intensive care nursery." Dr. Bottiglieri noted that the drug has been used experimentally for several years and some of the testing was done at Johns Hopkins University in Baltimore. "There are several side effects, including an increased heart rate and a loss of potassium. We would not use ritodrine except on healthy mothers."D SPRING, 1982 31 �The Bat: A Rare and Uniquely Valuable Research Animal A colony of giant Indian fruit bats (Pteropus gigantus} in Dr. Frank Kallen's laboratory in the Department of Anatomical Sciences. They are among the largest bats in existence. MAN, in his quest for medical knowledge, routinely studies experimental animals functionally similar to himself. Another fruitful approach to the study of life, however, involves animals which differ markedly from man. Certain bodily structures or physiological activities, shared by all animals, can become highly modified, or exaggerated, for a specialized form of existence. Such specializations often serve as excellent experimental models for similar, but less welldeveloped systems in other living creatures, including man. Bats are an example of such exotic experimental animals. As the only mammal capable of true flight, they represent at the outset a remarkable example of anatomical and metabolic efficiency. But beyond that, they have developed considerable specializations among their own kind. Different species of bats, for example, show diversity in modes of flight, orientation and 32 feeding. Some bats, along with certain rodents, comprise the small, select group of mammals capable of true hibernation. For animals of such small size and high peak energy requirements, bats existing in the wild have been known to live for as long as 21 years. Studies of their ability to echolocate, the so-called "bat sonar", have led among other things, to a better understanding of how humans, suffering from blindness, employ echolocation. The easily accessible blood vessels of the bat wing have proven to be an ideal model for the investigation of their microcirculation. Bats have been of interest to Dr. Frank Kallen, professor of anatomical sciences, for well over 20 years. More than half this time has been spent at U/B, where Dr. Kallen, his colleagues and his students have studied many aspects of bat anatomy and physiology. The bat cardiovascular system has been an area of particular interest to Dr. Kallen. This interest led to Dr. Kallen's long-standing acquaintance with Dr. Perry M. Hogan, associate professor of physiology at SUNYAB. The principal emphasis of Dr. Hogan's research has been in the field of bioelectric potentials, particularly as they relate to the initiation and coordination of the heartbeat. Drs. Kallen and Hogan have focused their collaborative investigation on the system of rhythmically contracting veins in the bat wing, the so-called "venous hearts" of the European literature. The pulsations of these In the Department of Physiology, Dr. Perry Hogan assembles the prototype suction microelectrode system now being used to record electrical activity from single cells in living, contracting bat wing veins. �vessels are apparently necessary to return blood from the wing during flight. [Unlike birds, bats have wings which are folds of skin extending from enormously elongated forelimbs and fingers. This living tissue must be continually nourished, right out to the wingtips.) Results from other laboratories showed that the contractions of the wing veins were essentially independent of neurogenic influence. They may well be the best example of a purely myogenic contractile mechanism to be found among mammals. This in itself makes these vessels favored sites for the study of contraction in smooth muscle cells. But in addition, recently-published evidence has suggested that these muscle cells at times show transmembrane action potentials similar to those of pacemaker cells and conducting tissue of the heart. At other times they appear to behave like regular cardiac muscle, which is normally exerted by an action potential originating in the pacemaker cell and propagating through the specialized conducting system. Since the heart is, in fact, a highly modified blood vessel, the term "venous heart" used in describing these specialized veins may be far more appropriate than many scientists had previously believed. Such veins may prove to be an enormously useful, simplified model of the heart itself. Two of the leading investigators of bat veins have been, Dr. Hans-Jorg Huggel, and Dr. John Peristiany, both of the Institute of Comparative Anatomy and Physiology at the University of Geneva in Switzerland. The mutual interests of these investigators and Drs. Kallen and Hogan have led to a research venture which is not only interdisciplinary but international in scope. Huggel and Peristiany have made repeated visits to Buffalo; Prof. Huggel has been in residence here for periods totalling several months. They have provided Hogan and Kallen with what for several reasons appears to be exceptional suitable bats for study of wing veins, the giant fruit bats of India Pteropus giganteus. The animals are housed in Dr. Kallen's laboratory, where samples of living, isolated vein are prepared for examination in Dr. Hogan's laboratory. There, novel procedures for microelectrode analysis have been developed that promise to permit what no other investigators have been able to achieve; that is, a detailed study of transmembrane electrical pl¥enomena associated with single venous smooth muscle SPRING, 1982 cells, both in vitro and in vivo. The immediate goal of this collaboration is to identify the mechanisms underlying both pacemaker activity and conduction phenomena in the contracting veins. The ultimate goals center about gathering basic information which may tell us a great deal about the extent to which the heart may still behave like a vessel in the peripheral circulation and vice versa. In the future, this type of information could provide a more rational basis for determining the degree to which therapeutic measures centered about a failing heart might be aided or hindered by hitherto unsuspected simultaneous actions involving the circulatory system as a whole. Other members of the Department of Anatomical Sciences are also making use of these bats. Dr. Roberta Pierson-Pentney and Dr. John Cotter have obtained evidence that the visual systems in the brains of the fruit bats are much more highly developed than are those in the small, insect-eating bats (Myotis luci fugus) common to the Western New York area. Dr. Mildred Gordon and coworkers are investigating variations in physiological adaptability of bat sperm, and the potential application of such variation to problems of human population control. Still other studies are in the planning stage, so that maximum benefit may be obtained from the presence of these rare and uniquely valuable experimental animals.D Dr. Roberta Pierson-Pentney {left) and Dr. John Cotter (right] perfuse a bat to preserve the brain for neuroanatomical research. Dr. Hans-Jorg Huggel (center) previously removed contractile wing veins for cardiovascular experiments. �ANew President Dr. Steven B. Sample took the reins as U/B's 12th president on March 1. He comes to Buffalo from the University of Nebraska where he was executive vice president for academic affairs and dean of the Graduate College. An administrator with ten years experience, he has led a major graduate faculty at Nebraska as well as a large and diversified undergraduate program, that embraces campuses in Lincoln and Omaha, plus a medical center. In addition to his association with a state-wide system of higher education, he has been both a professor of electrical engineering and a senior scientist in a private research and development firm. While teaching at Purdue University he developed a unique honors program in electrical engineering and an honors curriculum in pure mathematics. The 40-year-old chief executive also has a background in the arts and social sciences. He was a timpainist with the St. Louis Philharmonic from 1955 to 1958. He was the youngest person (14) ever to have performed with the Philharmonic on a regular basis. Dr. Sample's appointment last October by the Trustees, on recommendation of Chancellor Clifton R. Wharton and the U/B Council, results from a six-month nationwide search. The search began in April, 1981 when President Robert L. Ketter announced his intention to step down January 1, 1982, after almost 12 years in the position. Mr. Robert I. Millonzi, chairman emeritus of the University Council and head of the presidential search advisory committee, noted that of more than a dozen candidates interviewed, Dr. Sample had credentials that best suited the mission of the university center. Dr. Sample became executive vice president for academic affairs at the University of Nebraska in 1974. That university enrolls nearly 40,000 students and has a faculty of 3,000, a supporting staff of 9,000 and an annual budget of $300 million. UN has essentially the same components as U/B - the arts and sciences, business, fine arts, education, law, medicine, nursing, dentistry, pharmacy, engineering and architecture, a graduate college, and continuing education. There are also colleges of public administration and home economics, and an Institute of Agriculture and Natural Resources. 34 Dr. Sample Nebraska's was the first graduate college west of the Mississippi; today the University has more than 260 separate degree programs, 35 at the doctoral level. In his role at Nebraska, Dr. Sample was responsible for overall administration of graduate studies and was the chief academic officer for the entire system. During his tenure, the University of Nebraska has strengthened standards for promotion and tenure, improved faculty salaries, nearly doubled the University's share of federal research funds, clarified its role and mission relative to other institutions in the State, established a system of tuition waivers for graduate assistants, and integrated academic and fiscal planning. He teaches, also The new U/B president holds an appointment as full professor of electrical engineering and taught each fall semester on the Lincoln campus. He is a member of the Nebraska Educational Television Commission; a member of the board of directors of Design and Manufacturers Corporation, a major manufacturer of home appliances; one of only two members from Nebraska on the Council on Foreign Relations, a group which has played a major role in shaping American foreign policy over the last half century; and a member of the Academic Affairs Committee of the Board of Governors of Nebraska Wesleyan University. THE BUFFALO PHYSICIAN �Before joining the University of Nebraska, Dr. Sample was deputy director for academic affairs for the Illinois Board of Higher Education. That agency oversees 13 public university campuses, 47 public community colleges, more than 50 private institutions which receive direct State aid, and an extensive student aid program at both public and private institutions. In the post, which he assumed in 1971, Dr. Sample and his staff were responsible for review of requests for new academic programs, for revising the state-wide master plan for higher education, for developing role and mission statements for each of Illinois' public colleges and universities, for reviewing budget requests for new and expanded programs, and for administering grants to encourage inter-institutional and interstate cooperation in higher education. Tenure at 29 While serving with the Illinois Board, Dr. Sample was on leave from Purdue where he was appointed an assistant professor in the School of Electrical Engineering in 1966. In 1970, at age 29, he was awarded tenure and promoted to associate professor. In that same year, he was named one of 35 national Fellows in Academic Administration by the American Council on Education. His fellowship year was spent in the Office of the President at Purdue. Dr. Sample's research has been in the area of electrohydrodynamics; his teaching in the fields of electromagnetic theory and the electrical properties of materials. With funds from the National Science Foundation, SPRING, 1982 he supported at Purdue a research program which generated a number of papers, articles and graduate student theses. Consistently cited by students as one of Purdue's top teachers, he taught graduate courses and a televised course for practicing engineers, and established an honors program for electrical engineers. Under that program, undergraduates could follow individuallytailored programs leading directly to a master's degree. Before entering academe, he was a senior scientist with Melpar, Inc., a research and development firm, and assistant director of that company's Electronics Research Laboratory. A number of papers and basic patents have resulted from his later work as a consultant for several industrial firms in the field of soHd state controls for appliances. One of those patents was issued when he was a graduate intern with Xerox Corporation in Rochester in 1963. A native of St. Louis, Missouri, Dr. Sample received his baccalaureate degree with highest honors in electrical engineering from the University of Illinois in 1962. He earned the master's and Ph.D. in the same field from the same university in 1963 and 1965 respectively. He is a member of Sigma Xi and the Institute of Electrical and Electronics Engineers, and the author of a number of papers on both scientific and educational topics. The U/B President married Kathryn Nancy Brunkow of Park Ridge, Illinois in 1961. They have two daughters, Michelle Louise, 19, and Melissa Ann, 13.0 35 �People Dr. Martin E. Plaut, professor of medicine, has been named associate chief of medicine at Sisters of Charity Hospital. He held a similar position at Buffalo General Hospital the last 10 years. He is a Fellow of the American College of Physicians and the Infectious Disease Society of America. Dr. Plaut has published 50 scientific articles in the field of internal medicine and infectious disease. The Doctors Guide to You and Your Colon is his most recent book.D Dr. Frank Mendel, assistant professor of anatomical sciences, is studying the habitat and behavior of sloths, branch clinging Central American mammals. Dr. Mendel is a physical anthropoligist and his specialty is relating the anatomy of an animal to its environment. The U/B animal facility is the home of the three sloths, but often Dr. Mendel takes them to his own fenced back yard for study.D Pediatric Continuing Education Programs Dr. Elias Cohen, research associate professor of microbiology/clinical associate professor of psychiatry, was appointed to the editorial board of the Journal of Soviet Oncology. He was also reappointed to the editorial board of Annals of Clinical Laboratory Science.O Two faculty members are newly elected officers of the Buffalo Plastic Surgery Society. Dr. Hanley M. Horowitz, M'69, is vice president, and Dr. Joel H. Paull, M'71, is treasurer. Both are clinical instructors in surgery. Dr. Kulwant S. Bhangoo is the new president.D Dr. Gerd J .A. Cropp, professor of pediatrics, was a visiting professor at Sophia Hospital, University of Rotterdam, The Netherlands recently. He is also chief of the division of pulmonary disease at Children's Hospital.O March 25-27 "National Conference on Advances in Infant Nutrition and Pediatric Gastroenterology," Dr. Emanuel Lebenthal; Sarasota Hyatt House, Sarasota, Florida. April16-17"The 4th Annual Neonatal/Perinatal Spring Symposium Presents: Infectious Diseases," Dr. Ralph J. Wynn; Niagaraon-the Lake. June 21-25"The 2nd International Symposium on Infant Nutrition and the Development of the Gastrointestinal Tract," Dr. Emanuel Lebenthal; Sheridan Brock Hotel, Niagara Falls, Canada. July 15-17"The 5th National Buffalo Conference on Pediatric/Adult Allergy and Clinical Immunology," Drs. Elliott Middleton and Elliot F. Ellis; The Four Seasons Hotels, Toronto, Ontario. July 22-24 "The 14th National Advances in Pediatrics," Dr. Elliot F. Ellis; Harrah's Marina Hotel, Atlantic City, New Jersey. September 10-11 "The 4th Neonatal/Perinatal Fall Symposium Presents: Pharmacology and Therapeutics," Dr. Ralph J. Wynn; Buffalo Marriott Hotel. October 28-30 "Recent Advances in Pediatric Lung Diseases," Dr. Gerd J.A. Cropp; Hyatt Hilton Head Island, Hilton Head Island, South Carolina. 36 THE BUFFALO PHYSICIAN �President Robert L. Ketter received an honorary doctorate at the 103rd Founder's Day ceremony of Lehigh University in October.D The first dean of the School of Health Related Professions at U/B has been appointed a member of the Board of Health Promotion and Disease Prevention at the Institute of Medicine, National Academy of Sciences, Washington, D.C. Over the next two years, Dr. J. Warren Perry and his 14 colleagues will identify and examine key problems and issues in public health. Dr. Perry was elected to the Institute in 1973. Dr. Herman Rahn, distinguished professor of physiology at U/B, and Dr. Gerhard Levy, distinguished professor of pharmaceutics at U/B, are the only other Buffalonians to be elected to the 400-member organization.D Dr. Jerome A. Roth, associate professor of pharmacology and therapeutics, spoke at the Workshop on Sulfate Metabolism in the Netherlands recently.D Dr. Gerhard Levy, an internationallyknown pioneer of pharmaceutics and pharmacokinetics at U/B, received the Oscar B. Hunter Memorial Award in Therapeutics from the American Society for Clinical Pharmacology and Therapeutics in March, during the organization's annual convention in Lake Buena Vista, Florida. The award honors individual scientists for outstanding contributions to clinical pharmacology and therapeutics through meritorious drug research, excellence in patient care and a distinguished teaching career. Dr. Levy, 53, has been the director of the Clinical Pharmacokinetics Research Center at U/B for the past two years. The $2 million center, funded with a five-year grant from the National Institute of General Medical Sciences, is one of 10 in the nation that deals specifically with the pharmacology and toxicology of drugs. The center monitors and analyzes the way different people absorb, metabolize and respond to medicinal agents, with the goal being to optimize the therapeutic value and minimize..- the toxic effects of important and widely-used drugs.D SPRING, 1982 Dr. V. Balu, assistant professor of medicine, presented scientific papers at International meetings in Hong Kong and Jerusalem last November and December. "Does Mitral Revascularization Improve Mitral Regurgitation in Coronary Artery Disease" was presented at the 7th AsiaPacific Congress on "Disease of the Chest." This was at the plenary session on recent advances in the treatment of coronary disease. In Jerusalem at the International Society and Federation of Cardiology, Scientific Council on Rehabilitation of Cardiac Patients, The 2nd World Congress on Cardiac Rehabilitation, Dr. Balu presented two papers "Does Left Ventricular Aneurysmectomy Improve Exercise Performance" and also a poster session on the "Long-term Survival of Patients with Coronary Artery Disease and Mitral Regurgitation. "D Dr. Henry E. Black has been named "Man of the Year" by the Foundation of Deaconess Hospital, Inc. Dr. Black is clinic chief of the department of medicine at the Deaconess Hospital Division of Buffalo General Hospital and has been on its medical staff since 1974. The annual award is given to the individual who best promotes the mission of Deaconess Hospital in the community. Dr. Black is a clinical assistant professor of medicine and family medicine at the Medical School.D Dr. Robert L. LaDuca, clinical associate in family medicine, has been recertified as a Diplomate of the American Board of Familv Practice.D · A new device which electrically stimulates maximum muscle contractions without producing pain promises to speed recovery for patients recovering from a variety of orthopedic ailments, says a State University at Buffalo physical therapist. Alfred Caffiero, U/B clinical instructor and co-chief of the physical therapy department at St. Joseph Intercommunity Hospital, says preliminary studies of ElectroStim 180, dubbed the "Russian-like" stimulator, show the device can strengthen weak muscles in less time than can be achieved by exercise alone. The device has been on the U.S. market for several months.D 37 People �People "In recognition of her many years of distinguished service as History of Medicine librarian at the Health Sciences Library," Mildred F. Hallowitz has been named History of Medicine librarian emeritus, October 1, 1981, following her retirement. Prior to her previous appointment as head of the Serials and Bindery Department at the Health Sciences Library in 1972, Ms. Hallowitz had served since 1965 in both the Acquisitions and Cataloging Departments of Central Technical Services of the University Libraries. She assumed her present position as History of Medicine librarian in 1974. Established in 1846, the History of Medicine Collection contains valuable, rare resources in this specialized field and has grown steadily. Saktidas Roy said it was only in recent years, however, "through the untiring effort and leadership of Ms. Hallowitz that the collection was well organized and proper bibliographic records were established so the collection could become readily accessible to and meet the needs of faculty, students, and researchers at the University and in the health community." The collection has now earned recognition as a major resource on the subject among the academic health sciences libraries, Roy said. Ms. Hallowitz was the major organizer of the Friends of the Health Sciences Library group through which numerous gifts from the community were received and the "Rudolph E. Siegel Student Essay Contest on the History of Health Sciences" was launched. She is a member of the American Association for the History of Medicine, American Academy for the History of Dentistry, and the History of Medicine Group of the Medical Library Association. She is presently serving as president of the Medical Historical Society of Western New York, the first woman and non-M.D. member ever elected to such a post in the long history of the organization.D Dr. Edwin W. Naylor, research associate professor of pediatrics, presented lectures in Heidelberg, West Germany recently. The topics: "The Role of the Pathogen and of the Hose in Pathogenesis of Bacterial Infections: An Overview," and "Enteropathogeneticity: Recent Developments."O 38 Dr. Joel M. Bernstein, assistant professor of otolaryngology, attended the 12th International Congress of Otolaryngology, Budapest, Hungary, this past summer. He cochaired a session on "Borderline Topics of Immunology and Disease of the Ear, Nose and Throat." Two lectures were presented at this Congress: Neutrophile Dysfunction in Recurrent Upper Respiratory Tract Infection and Biology of Immune Responses (An Overview). Dr. Bernstein also attended the annual meeting of the American Academy of Otolaryngology and Head & Neck Surgery, New Orleans, La., Sept. 18-24. The 2 papers presented were as follows: The Role of Coagulase Negative Staphlococci in Otitis Media with Effusion (Co-authors- Dr. Erwin Neter, and Diane Dryja). and The Spectrum of Pathology in Chronic Otitis Media with Effusion (Co-author- Dr. John Fisher).D The Rush Hall alcoholism treatment program of Bry-Lin Hospital, will open a new 14-bed treatment unit bringing the facility's capacity to 46 inpatients. Twenty-five to thirty nursing staff members and four alcoholism counselors will be added for the unit.D Three faculty members of the Pediatrics Department have received grants. Dr. Danny Shen, research assistant professor of pediatrics, has received a grant from the American Heart Association for $7,283. It is for the Disposition and Metabolism of Quinidin in Children from July 1, 1981 through June 30, 1982. Dr. E. Lebenthal, professor of pediatrics, has received a $170,673 National Institutes of Health grant for the Digestability of Starches and Pancreas Development from August 1, 1981 to July 31, 1984. Dr. Robin M. Bannerman, professor of medicine and pediatrics, is the recipient of a $30,997 grant from Health Research, Inc. for Cooley's Anemia in Western New York from July 1, 1981 through September 30, 1982.0 Dr. Louis Bakay, professor and chairman of the department of neurosurgery, was elected to the Council, Medical Historical Society of WNY and the Erie County Historical Society.D THE BUFFALO PHYSICIAN �Four faculty members are officers in the New York State Academy of Family Physicians. Dr. James R. Nunn, M'55, clinical associate in medicine and clinical assistant professor of family medicine, is presidentelect. Dr. Fredric Hirsh, M'73, clinical instructor in family medicine, is president; the new vice-president is Dr. Louis Lazar, clinical assistant professor of family medicine, and Dr. Clinton H. Strong, M'44, clinical assistant professor of family medicine, is treasurer. The secretary is Dr. Frederick M. Occhino, D.O., clinical assistant professor of family medicine.D Dr. W. Jack Stelmach received the 13th annual Dr. Max Cheplove Award of the Erie County Chapter of the New York State Academy of Family Physicians. Dr. Stelmach is past president of the American Academy of Family Physicians and a clinical professor of medicine at the University of Missouri Medical School in Kansas City.D Dr. Barbara J. Howell, professor of physiology, headed a faculty committee that developed the specifics of the Presidential Scholars program. This is a freshman honors class of 21 that started at U/B in the fall of 1981. As honors students, they each receive a $2,000 scholarship and special academic planning assistance. President Robert L. Ketter proposed the program a year ago. The Presidential Scholars must maintain a 3.5 grade point average. In 1982 SUNY is initiating an honors program system-wide, offering 40 honors scholarships for full tuition and room and board.D Dr. James R. Olson, assistant professor of pharmacology and therapeutics, has been awarded a $78,019 NIH grant on the "Mechanism(s) for Toxicity of Chlorinated De benzodioxins. "0 Dr. Barbara R. Rennick, professor of pharmacology and therapeutics, has been appointed to the editorial board of the Journal of Pharmacology and Experimental Therapeutics. Dr. Rennick also received a grant from Hoffmann-LaRoche Foundation. She has also co-authored an artiqle for the American Journal of Physiology.D SPRING, 1982 Dr. Kenneth B. Touw, assistant professor of pharmacology and therapeutics, received a $7,000 grant from the Western New York Chapter, American Heart Association.D Since October a new CAT body scanner has been in operation at Sisters of Charity Hospital.D Dr. Conrad G. May, family practice physician at Sisters of Charity Hospital, has joined the staff of the Seton Family Health Center in Alden.D Dr. Cedric Smith, professor of pharmacology and therapeutics, was a visiting professor at the University of Kentucky in December.D Dr. Barbara R. Rennick, professor of pharmacology and therapeutics, co-authored an article, "Renal Tubule Transport and Electrolyte Effects of Amiloride in the Chicken," for the Journal of Pharmacology and Experimental Therapeutics.D Dr. Jerome A. Roth, associate professor of pharmacology and therapeutics, received a $1,870 SUNYAB Research Development Grant.D Millard Fillmore Hospital has been fortunate enough to be included in a group of 300 teaching hospitals to receive a Miles Learning Center Videodisc Player. The center, which includes a videodisc player and remote control, is a $3,000 unit donated by Miles Pharmaceuticals. Eight videodiscs, on various medical topics, will be donated by Miles Pharmaceuticals to Millard Fillmore on a monthly basis. In addition, the company will continue producing medical information discs to donate, so hospitals utilizing the centers can develop videodisc libraries. Dr. M. Luther Musselman, M'37, director of medical education, believes the acquisition of the center is an advancement not only for the education department but Millard Fillmore as a whole. He feels it is a most important and useful teaching tool and is pleased to have "the most modern videodisc player presently available." Only one other player will be made available in the Buffalo area.D 39 People �People Two Medical School faculty members participated in the American Heart Association 's annual meeting in Dallas recently. Dr. Francis J. Klocke, professor of medicine and physiology was invited to present the prestigious "state of the art" address on chronic ischemic heart disease. His topic: "Myrocardial Perfusion in Chronic IHDControlling Mechanisms, Functional Consequences and Unsolved Problems. Dr. Klocke is also chief of the division of cardiology at U/B . In addition, U/B clinical associate professor Dr. D.R. Arani presented research findings on "Simultaneous Quantitation of Collateral Flow and Adjacent Left Ventricular Flow in Patients with Left Anterior Descending Occlusion." The research is coauthored by Drs . D.G. Greene , Ivan L. Bunnell, Klocke, and Gretchen Smith.D Two Medical School faculty members have been appointed by SUNY Chancellor Clifton R. Wharton Jr. to the Chancellor's Review Committee for the statewideUniversity Awards Program. Named to the ad hoc committee are Drs. Judith Van Liew, associate professor of physiology, and Michael Duffey, assistant professor of physiology. The committee is charged with holding forums to gather information on and to review the University Awards Program , its philosophy and concepts. Over its 27-year history, the Program, administered by the Joint Awards Council, has dispensed $15 million to SUNY scientists. Most of these funds have been awarded to scientists in the early stages of their careers. The program currently has $750,000 earmarked for research projects and, until this year, was the most significant expenditure of Research Foundation funds for research development.D Dr. Gabor Markus, research professor of biochemistry, received a $72 ,745 American Cancer Society grant to study plasminogen activators and related proteases in human tumors.D Dr. Hermann Rahn, distinguished professor of physiology, received an honorary Doctor of Medicine degree from the University of Bern in December.D 40 Dr. Howard Ozer, assistant professor of medicine/microbiology received a $106,000 grant from the Schering Corporation for interferon research on solid tumors and lymphomas. Dr. Ozer is in the medical oncology department at Roswell Park Memorial Institute.D While visiting the Peoples Republic of China in November President Robert L. Ketter signed a three-year agreement for scholarly exchange and collaboration between U/B and the Beijing Municipal System of Higher Education. Each institution agreed to accept up to the equivalent of four visiting scholars for each academic year. They will also exchange 15 to 18 visiting graduate students a year, and publications authored by faculty and staff. The Beijing Municipal System is composed of eight universities and specialized institutes.D The pediatrics department in conjunction with Children's Hospital sponsored a summer program to give minority high school students experience in medical research. It was funded by a grant from the Department of Health and Human Services . The three students worked with faculty and staff in the divisions of pulmonary disease, cardiology and infectious disease . Dr. Edmund Egan II, associate professor of pediatrics and physiology, directed the program.D The Erie County Mental Health Advisory Board and the Mental Hygiene Community Services Board gave a diploma to Dr. S. Mouchly Small, professor of psychiatry, in recognition of his tenure on the Board and his significant contributions of time and effort to the community.D Dr. Daniel R. Pieroni, associate professor of pediatrics, gave a seminar at the European Congress of Ultrasound in Florence, Italy. He also gave several seminars in CardioUltrasonology at the International School of Ultrasonology in Erice-Trapani , Sicily. Dr. Pieroni also lectured at the University Hospital in Trieste, Italy on, "Long-Term Follow-Up Status of the Adult with Congenital Heart Disease."D THE BUFFALO PHYSICIAN �Dr. James A. ' Russell, assistant professor of pediatrics, is the recipient of two grants from the National Institutes of Health. "Bronchoactive Component in Cotton Bracts," for $176,855 is through March 1984. "Modulation of Neurotransmitter Release in Airways," is $159,242 through June 30,1984.0 Dr. J. Craig Venter, assistant professor of pharmacology and therapeutics, co-authored an article with Claire M. Fraser and Michael Kaliner recently in the New England Journal of Medicine. It is entitled, "Autonomic Abnormalities and Autoantibodies to BetaAdrenergic Receptors. "0 Dr. Peter Nickerson, professor of pathology, was appointed vice chairman of the admissions committee at the Medical School.D Dr. Gustavo Cudkowicz, professor of pathology and microbiology, was appointed chairperson of the Medical School's committee for faculty appointments and promotions to research rank recently. He was also appointed chairperson of a medical school scientific review committee for the allocation of research development funds to medical school faculty by the Research Foundation.D Dr. Cedric M. Smith, professor of pharmacology and therapeutics, was awarded a New York State Health Research Council grant for $16,000 December 1982 entitled, "Neuronal Mechanisms of Alcohol Withdrawal Signs."D Dr. Jerome A. Roth, associate professor of pharmacology and therapeutics, presented a lecture entitled, "Kinetic Model for the Metabolism of Catecholamines in the Human Brain" at McGill University, Montreal.D Dr. Edwin W. Naylor, research associate professor of pediatrics, published an article entitled, "Newborn Screening for Urea Cycle Disorders," in Pediatrics recently. He also co-authored an article with E.J. Gradner entitled, "Adrenal Adenomas in a Pq.tient with Gardner's Syndrome," in Clinical Genetics.O SPRING, 1982 Dr. Erwin Neter, professor emeritus of pediatrics and microbiology, co-authored an article recently with D.M. Dryja entitled, "Use of Penicillin and Nafcillin Discs as an Aid to Identification of Pasteruella Multocida," which appeared in the Journal of Medicine. He also co-authored another article with R. Boulden in Immunological Communications entitled, "Amoinoglycosides and Polymyxin by Salmonella Antibodies."D Two faculty members/alumni have been elected officers of the DeGraff Memorial Hospital staff. Dr. Melvin M. Brothman, M'58, is the new president and Dr. Jacqueline L. Paroski, M'49, is vice president. President-elect is Dr. Leslie A. Szirmai, clinical assistant professor of pediatrics. Dr. George Egri, clinical assistant professor of urology, is secretary and Dr. H. William Sippel was re-elected treasurer.O In January Children's Hospital began a $11 million project to complete the interior of the top eight floors of its Variety Tower. When the project is completed in 1983 the majority of the hospital's pediatric and maternity beds will be relocated there. The project is financed by a $7 million fund raising campaign.O Drs. Amol Lele, director of the Women's Clinic at The Children's Hospital and William P. Dillon, M'70, assistant professor of obstetrics/gynecology recently received their sub-specialty certification in Maternal-Fetal Medicine upon passing board exams in that division.D Dr. John Border, professor of surgery, was elected vice president of the American Association for the Surgery of Trauma. He also directs the Erie County Medical Center's trauma research center. The professional association, founded in 1938 by a group of surgeons interested in the cultivation and improvement of the science and art of surgery for trauma, numbers over 500 members. Dr. Border directs one of a small number of national trauma research centers. For his work to improve trauma care and understanding of patients' response to injury, he earned the American Trauma Society's Curtis P. Artz Award.O 41 People �People Dr. Clifton R. Wharton Jr., chancellor of the State University of New York, has been elected chairman of the board of trustees of the Rockefeller Foundation. He will succeed the Rev. Theodore M. Hesburgh, president of the University of Notre Dame.D Dr. C. William Aungst, associate director for clinical affairs at Roswell Park Memorial Institute, was recently elected 1981-1982 vicepresident/president-elect of the American Cancer Society, New York State Division. He is a research associate professor of medicine at the Medical School.O The first annual Millard Fillmore Golf Open was organized by Dr. Paul Wierzbieniec, M'74, clinical instructor in orthopedics. Over $1,000 was raised for the hospital's development fund . The tourney was at the Crag Burn Country Club in East Aurora. Dr. Wierzbieniec, with four birdies, and Dr. Paul Walczak, M' 46, clinical associate professor of surgery, with five birdies, lead their team to the best overall gross score of 66. Dr . Wierzbieniec shot the low gross score of the day with a 70. The other two team members were Dr. Harry Metcalf and Mr. Frank Harding. The low net score for a four-man team was a 50, shot by the team of Barone-CarlsJoyce-Kuberka, with two teams tying for second place: Painton-Piedad-TramontFerguson, and Lombardo-McMahonPrzylucki-Rainstein, each with a 55.0 Three Medical School faculty members participated in a day-long seminar on Prostaglandins recently. The topics presented were - "Prostaglandins in Toxemia of Pregnancy," Dr. Rocco C. Venuto, associate professor of medicine at U/B; "Hypertension, Sodium and the Prostaglandins," Dr. James B. Lee, U/B professor of medicine and a pioneer in prostaglandin research.D "Intrathecal Interferon Reduces Exacerbations of Multiple Sclerosis" was authored by Dr. Lawrence Jacobs for Science magazine. He is a neurologist at the Dent Neurologic Institute, Millard Fillmore Hospital , and clinical assistant professor of ophthalmology and physiology. Assisting in the research project was Drs. Judith O'Malley and Arnold Freeman, research associate professors of pediatrics.D 42 "Control of Vitamin Metabolism by Hormones and Drugs" was the topic of the first nutritional lecture in December by Dr. Richard S. Rivlin, professor of medicine at Cornell Medical College. Dr. David R. Pendergast, associate professor of physiology, gave the second lecture in the series. His topic: "Implications of Nutrition in Exercise and Sports."D Dr. Howard Ozer, assistant professor of medicine/microbiology received a $59,000 grant from the National Cancer Institute, to study immunoregulation by T cell subsets in myeloma and chronic lymphocytic leukemia. He is in the medical oncology department at Roswell Park Memorial Institute. He also received a $76,975 grant to conduct a phase II clinical trial of human fibroblast interferon (HFIF) in lymphoma and myeloma patients, which represents one of the most comprehensive clinical trials on interferon undertaken to date.D A three-year, $500,000 grant has been awarded to the School of Nursing by the Department of Health and Human Services to establish a gerontology specialty in the adult health nurse practitioner master's program. Patrick Burns, project director and assistant professor said the grant will be used to foster more positive attitudes toward the care of the elderly by educating 30 nurse practitioners in gerontology and sponsoring two courses: "Humanistic Aging" and "Aging and the Environment" for all U/B seniors and graduate students.D The American Association of Clinical Chemists, Upstate N.Y. Chapter celebrated its 25th anniversary in a meeting at the Marriott Hotel in October. During the celebration, six people were given recognition for their activities in the field of "education and advancement of clinical chemistry." Two of these awardee's were from Buffalo, and both members of Erie County Medical Center. Their names: Dr. Desider A. Pragay, clinical associate professor of biochemistry and pathology, director of chemistry laboratory, Erie County Medical Center and Thomas Rejent, B.S., chief toxicologist, medical examiners' division, Erie County Medical Center. The awards consisted of a plaque and a check of $100 given by Fisher Scientific Company on the occasion.D THE BUFFALO PHYSICIAN �Dr. Richard Ahlin's curriculum vitae numbers 57 pages, and 24 hours each day are not enough for all this remarkable medical scientist wants to accomplish. Admittedly a compulsive type, he is the senior scientific officer, Division of Immunology, Chicago's Cook County Hospital and the Hektoen Institute for Medical Research. Dr. Ahlin '67, who majored in immunology at U/B, recently told an international symposium on the prevention and detection of cancer about research he has conducted on prostate cancer, working with 25 of his hospital's patients. As editor of Spanish, Japanese, German and United States medical journals, Dr. Ahlin is recognized in many parts of the world. He edited the "Handbook of Cryosurgery" and has held the most important local, national and international offices in that society.D Dr. Saxon Graham, clinical professor and chairman of the department of Social and Preventive Medicine, has been named to serve on the American College of Epidemiology's Board of Directors. The new organization has approximately 300 members, all of whom are epidemiologists. Dr. Graham is a Fellow in the ACE.D Dr. Joong 0. Rhee, clinical associate professor of psychiatry, presented, "Neuroleptic Malignant Syndrome: Two Case Reports and Overview," at the 12th Congress Confederation Medical Association in Asia and Oceania and the 23rd General Scientific Meeting of the Korean Medical Association, Seoul, Korea, recently.D Dr. Gustavo Cudkowicz, professor of pathology and microbiology, attended the 12th International Congress of Chemotherapy, Florence, Italy recently and was the chairman of the symposium on "Cancer Immuno Chemotherapy: Experimental Models of Cell-mediated Immunity" and presented a symposium paper entitled "Natural Killer Cells: Regulation of Activity via Cellular Interactions." He also visited the Istituto Superiore di Sanita, Rome, Italy and presented a seminar to the Section of Virology entitled "Regulation of Natural Killer Cell Activity in Mice," Dr. Gudkowicz also participated in the International SymSPRING, 1982 posium sponsored by the World Health Organization on "Prospective Biological Products for Viral and Nonbacterial Diseases held in Munich. He presented a lecture entitled "Natural Killer Cells: Regulation of Activity and Role in Viral Infections." He was also a keynote speaker for the Canadian Society of Immunology at the annual meeting of the Canadian Federation of Biological Societies held in Montreal.O Dr. John Gaeta, professor of pathology and associate professor of urology, participated in a meeting of National Prostatic Cancer Project at the University of Iowa Department of Urology. His topic: "Pathology Features of 300 Cases of Prostate Cancer. "0 Dr. Lawrence D. Jacobs, clinical assistant professor of ophthalmology and research assistant professor of physiology, has been elected secretary-treasurer of the American Academy of Neurology. He is also affiliated with the Dent Neurologic Institute of Millard Fillmore Hospital.O Dr. Marvin I. Herz, professor and chairman of psychiatry, has been appointed to the Psychosocial and Biobehavioral Treatments Subcommittee of the Treatment Development and Assessment Research R~view Committee, National Institutes of Mental Health. He has also made a presentation regarding fiscal and other barriers to the use of partial hospitalization. To the joint session with the American Association for Partial Hospitalization, American Psychiatric Association 33rd Institute on Hospital and Community Psychiatry, he presented the role of partial hospitals in the comprehensive mental health system - real and ideal in San Diego. He was guest speaker at a Colloquium on Biobehavioral Sciences, Neuropsychiatric Institute, UCLA. His topic was, ''The Problem of Relapse in Schizophrenia."O Dr. Stuart Keill, clinical professor of psychiatry, has assumed the presidency of the American Association of Psychiatric Administrators. He has been appointed chairman of the committee of certification in administrative psychiatry of the American Psychiatric Association and chairman of the public psychiatry committee of the New York State Psychiatric Association.D 43 People �The Classes The Classes of the 1920's Dr. Max Cheplove, M'26, is chairman of the medical advisory committee, Erie Community College. The Max Cleplove Award is given annually to a physician for his contributions to the practice of family medicine.D The Classes of the 1930's Dr. August V. Belott, M'31, retired last fall. He is living at 4000 E. Fletcher Ave., Apt. D206, Tampa, Florida 33612.0 Dr. Virgil-Henry F. Boeck, M'31, clinical assistant professor of medicine, Emeritus, is among the 298 New York State physicians honored for 50 years of service to the public by the Medical Society of the State of New York.O Dr. Raymond R. Meyers, M'34, is recovering from a stroke he had in 1980. He has spent the last 45 years as a family physician in the Riverside Black Rock area of Buffalo. He is a charter member of the Academy of Family Physicians and past president of Phi Kappa Lambda, national medical fraternity. Dr. Meyers is looking forward to returning to his profession soon.D Dr. Bernard S. Stell, M'36, has been elected "associate" by the Photographic Society of America for his "beneficial guidance of photographers through many lectures explaining innovative products to improve techniques; for his extensive exhibition record in three divisions; and for his ability to inject enthusiasm and interest into photographic workshops in Arizona." In the stereo slide division of the 23rd Sydney International Exhibition of Photography, Dr. Stell's "Rose in Blue Droplet" won a silver award. At the Los Angeles County Fair 25th Annual International Exhibition of Photography Dr. Stell won a bronze medal for "Hummingbird 81A" and "Skylon, Canada"; and honorable mention ribbons for "The Antique" and "Nephila Spider" in the stereo division. In the pictorial division his "Black Light, Red Flowers - HM" and "Pacific View" won ribbons along with "Alert & Ready" and "Saguaro Cactus - HM" in the nature division. Dr. and Mrs. Stell live at 16029 Meadow Park Drive, Sun City, Arizona 85351.0 44 The Classes of the 1940's Dr. Eugene J. Hanavan, M'41, clinical assistant professor of orthopedics, was welcomed officially as a Fellow of the International College of Surgeons at a convocation ceremony in the Hotel del Coronado, San Diego.O Dr. Richard Ament, M'42, clinical professor of anthesiology, has been elected treasurer of the Council of Medical Specialty Societies and deputy treasurer of the World Federation of Societies of Anesthesiologists. In addition, he has been re-elected vicechairman of the American Medical Association, Section Council for Anesthesiology and to the nominating committee for the American Board of Anesthesiology. Dr. Ament was recently appointed as a member of the Delphi Panel which is projecting 1990 manpower needs in anesthesiology for the office of graduate medical education of the Health Resources Administration, Department of Human Health Services.D Dr. William J. Follette, M'42, is retiring after 32 years on the Englewood, N.J. Hospital staff. He is a former chief of the ear, nose, throat department with a specialty in otolaryngology and rhinoplasty. He and Mrs. Follette intend to eventually live in Martha's Vineyard. Currently they are living at Lambs Lane, P.O. Box X, Cresskill, N.J. 07626.0 Dr. Leon Yochelson, M'42, is professor of psychiatry and behavorial sciences at George Washington University Medical School. He is chairman of the Psychiatric Institutes of America and was re-elected to the Board of Directors, Federation of American Hospitals. Dr. Yochelson lives at 7914 Orchid Street, N.W., Washington, D.C. 20012.0 Dr. Alfred S. Evans, M'43, is president of the Society of Medical Consultants to the Armed Forces. He is living at 38 Dogwood Circle, Woodbridge, Ct. 06525.0 Dr. Robert Moyce, M'43, is retired and living in Newport Beach, California.O Dr. Thomas F. Frawley, M'44, president of the American College of Physicians; emeritus professor and chairman of medicine, St. Louis University School of Medicine, was installed THE BUFFALO PHYSICIAN �as a Fellow (honorary) Royal College of Physicians, Ireland at a ceremony held at the Royal College, Dublin, in October, 1981. Dr. Frawley is also a Fellow (honorary) of the Venezuelan Society of Internal Medicine. These awards were given in recognition of Dr. Frawley's research and contributions in the field of endocrinology and the role he has played in advancing medical education in the United States. Dr. Frawley is currently chairman, department of Graduate Medical Education, St. John's Mercy Medical Center, St. Louis.D Dr. Irwin Ginsberg, M'44, is seeking federal funds for research to validate his belief that air pollutants are a major cause of middle ear disease. He is fighting a proposal to relax auto emission standards now pending in Congress. The clinical professor of otolarngology believes the proposal holds the potential of aggravating a serious health problem. Unless the middle ear disease is treated, children will often have permanent hearing loss, according to Dr. Ginsberg.D Dr. Raphael S. Good, M'48, has accepted a new position, vice chairman of phychiatry and behavioral sciences and associate professor of psychiatry and ob/gyn, at the University of Texas, Galveston. He was formerly associated with the University of Miami Medical School where he was director of psychiatric consultation-liaison. He is immediate past president of the American Society Psychosomatic Ob/Gyn.D Dr. Carmela S. Armenia, M'49, clinical associate professor of ob/gyn and a past president of the Erie County Medical Society, has been elected to a two-year term as president of the 8th District Branch of the New York State Medical Society. Others elected are: Drs. Frederick R. Downs, M'70, clinical instructor in family medicine, secretary; Harvey J. Blanchet, Jr., president-elect; and treasurer, William T. Ellis.D Dr. Carm ela A rm enia The Classes of the 1950's Dr. Anne A. Wasson, M'50, is working parttime as voluntary faculty at the University of Kentucky Schools of Medicine and Nursing. She is also principal investigator of the rural oncology demonstration grant, division of nursing grant, rural primary care nursing grant, and interim director of frontier nursing service. She works at Frontier Nursing Service, Hyden, Kentucky 41749.0 Dr. Eugene Leslie, M'51, resigned as radiology department chairman in July. He will continue as professor of radiology and clinical professor of nuclear medicine.D Dr. Bruce F. Connell, M'52, was invited by the New York Academy of Medicine to lecture on "Anesthetic Plastic Surgery of the Ages of Fifties, Sixties and Seventies in the Decade of the 80's" and "Anesthetic Plastic Surgery of the Face." He is associate clinical professor of surgery, California College of Medicine, Irving.D Dr. Victor Panaro, M'52, clinical professor of radiology and clinical associate professor of nuclear medicine, has been named to the National Commission on Radiologic Practice. He also was re-elected house delegate, radiology, State Medical Society.D Dr. Milford C. Maloney, M'53, clinical associate professor of medicine, has been elected a Fellow of the American College of Cardiology.D Dr. Edward W. Hohensee, M'54, has been appointed to a five-year term on the medical advisory board of the New York State Commission for the Blind and Visually Handicapped. He is a clinical assistant professor of ophthalmology.D Dr. William R. Kinkel, M'54, clinical professor of neurology and clinical associate professor of anatomy, was elected president of the American Society of Neuroimaging. He is also chairman of the neurology department and director of the Dent Neurologic Institute at Millard Fillmore Hospital.D 45 �Dr. John B. Baker, M'55, a neurologist, lives at 801 9th Ave., Albany, Ga. 31701.0 Dr. George J. Alker, Jr., M'56, was a visiting professor of neuroradiology in the People's Republic of China recently. He is clinical professor of radiology and clinical associate professor of nuclear medicine.D Dr. Joseph A. Bellanti, M'58, discussed developments in immunology recently at a meeting of the Baccelli Medical Club of Buffalo. He is director of the immunology and virology laboratories at Georgetown University Medical Center. He has published more than 150 medical articles. At one time he was on the staffs of Millard Fillmore and Children's Hospitals in Buffalo.D Dr. Ronald W. Byledbal, M'58, is a psychiatrist. His office is 990 Sonoma Avenue, #12, Santa Rosa, Ca. 95404.0 The Classes of the 1960's Dr. Kenneth E. Bell, M'61, is associate clinical professor of ob/gyn at the University of California, Irvine. He is chief of the ob/gyn department at Kaiser-Permanente Medical Center in Anaheim. He was recently elected to the board of directors of the Southern California Permanente Medical Group. Dr. Bell lives at 6320 Vera Crest Drive, Long Beach, Ca. 90815.0 Dr. Eugene A. Cimino, M'61, is a consulting ophthalmologist at the University of Rochester. He lives at 43 E. Boulevard, Rochester, N.Y. 14610.0 Dr. Marc Lowen, M'62, has been elected to Sinai Hospital's medical staff.D Dr. Frank E. Ehrlich, M'63, is the new chairman of the emergency department at St. Agnes Hospital in Baltimore.D Dr. David E. Pittman, M'64, has been elected a Fellow, Society of Cardiac Angiography. Dr. Pittman, as assistant clinical professor of medicine at the University of Pittsburgh Medical School, lives at 551 Pebblewood Court, Pittsburgh, Pa. 15237.0 Dr. Richard E. Wolin, M'64, is the new president of the Bry-Lin Hospital Medical Staff. The clinical assistant professor of psychiatry is a Fellow of the American 46 Psychiatric Association and past president of the Western New York District Branch, APS. Dr. Wolin is also associated with the Erie County Medical Center, Niagara Falls Memorial Medical Center and Millard Fillmore and Lafayette General Hospitals.D Dr. James L.M. Moran, M'66, is associate clinical professor of ob/gyn at the University of Southern California Medical School. He has been in private practice for eight years and a senior staff member at St. John's Hospital in Santa Monica. He served in the U.S. Navy Medical Corps for two years before taking his residency at USC (1969-73). He lives at 510-21st Place, Santa Monica, Ca. 90402.0 Dr. Larence D. Baker, M'68, is living at 1992 Clairmeade Avenue, Atlanta, Ga. 30329.0 The Classes of the 1970's Dr. Thomas V. Krulisky, M'70, is assistant clinical professor of psychiatry at the University of Southern California Medical School. He has been appointed clinical director, USC Alternatives Project. This is a research program to deliver lower cost inpatient psychiatric treatment in a residential setting. Dr. H. Richard Lamb, professor of psychiatry at USC, directs the program. Dr. Krulisky is also president of the medical staff at Edgemont Hospital. The Krulisky's are the parents of a baby girl, Kelly Joe, born August 25, 1981. They live at 3306 Haven Way, Burbank, Ca. 91504.0 Dr. Alan I. Leibowitz, M'70, is assistant dean for student affairs at the University of South Florida Medical College, Tampa. He is continuing his work in gastroenterology and his research in endotoxins and hepatic diseases that he started in Buffalo with Dr. James Nolan. Dr. Leibowitz lives at 15405 Timberline Drive, Tampa, Fl. 33624.0 Dr. Stanley Lewin, M'70, is practicing in Harrisburg, Pa. He is a cardiologist.O Dr. Bruce M. Prenner, M'70, is assistant clinical professor of medicine at the UCSD Medical School, LaJolla, California. Recently he presented clinical research data at international meetings in Switzerland and France. Dr. Prenner lives at 11702 Shadow Glen Rd., El Cajon, Ca. 92020.0 THE BUFFALO PHYSICIAN �Dr. Arthur M. Seigel, M'70, is assistant clinical professor of neurology and pediatrics at the Yale University Medical School.O Dr. Robert DiBianco, M'72, is assistant clinical professor of medicine at Georgetown University. The cardiologist is affiliated with the VA Medical Center, Washington, D.C., and the Washington Adventist Hospital, Takoma Park, Md. The DiBianco's have a new son, David Anthony, born December 5, 1981. Dr. Di Bianco was elected a Fellow, Council on Clinical Cardiology of the American Heart Association in November. He is associated with three other cardiologists in part-time private practice. The DiBianco's live at 5319 28th St., N.W., Washington, D.C. 20015. Recently Dr. DiBianco has co-authored three articles for scientific journals- "Bruit Alternans; Effects of Acebutolol on Chronic Stable Angina Pectoris; Comparison of Nadolol & Placebo in Stable Angina Pectoria."O Dr. Stephen W. Welk, M'72, has joined the Cleveland Hill Medical Group in family practice, after practicing eight years in rural northern Idaho. He lives at 9490 Keller Road, Clarence Center, N.Y. 14032.0 Dr. Louis W. Irmisch III, M'75, is a second year resident in internal medicine at Millard Fillmore Hospital.O Dr. Tone Johnson, M'75, is living in Cheyenne, Wyoming where he is in family practice.O Dr. Marshall A. Fogel, M'76, has recently finished two years with the Public Health Service Corps at the Frances Nelson Health Center in Champaign. He is now practicing with Christie Clinic in internal medicine, and also serves as head of clinical education for Mercy Hospital in Champaign, Illinois.O Dr. Helen Marie Findley, M'77, recently opened a new office in internal medicine in Orchard Park with her husband, Albert Schlisserman, M'77, who is an ophthalmologist.O Dr. Harvey R. Goldstein, M'77, has a twoyear fellowship in gastroenternology at the Scripps Clinic. He lives at 1066 N. Torrey Pines Boulevard, LaJolla, Ca. 92034.~ He is on the USC Medical School faculty.O SPRING, 1982 Dr. Gladys Wells Hegtley, M'77, is associated with Howard University where she is a medical officer in the Emergency Room. She also opened a private practice in September, 1981. She has two sons, Devin J. born in March, 1981 and Thomas W. born in January, 1979. They live at 210 Kendle Street, Upper Marlboro, Md. 20772.0 Dr. Albert Schlisserman, M'77, has returned from Richmond, Virginia where he has completed his training at the Medical College of Virginia. He has recently opened an office in West Seneca for the practice of ophthalmology.O Dr. Janice D. Williams, M'77, has completed her ob/gyn residency and will be working for the U.S. Public Health Service in Mt. Vernon, N.Y. the next three years.O Dr. Stephen E. Killian, M'78, completed his residency in family practice at the University of Virginia. He has joined a four-man group in Boiling Springs, North Carolina.O Dr. Salvatore A. DelPrete, M'78, recently completed his training in internal medicine. In July, 1981 he began a year of research on small cell carcinoma of the lung.'This is part of a 3-year Hematology-Oncology program at Dartmouth leading to board eligibility in both medical sub-specialties. Dr. DelPrete has been working in local ER's. He also teaches part of a course offered for emergency medical tasks (EMT's] in Vermont. He lives at RFD 2, White River Junction, Vermont 05001. The DelPrete's have a son, Michael, born in March, 1980.0 Dr. John R. Valvo, M'78, is chief resident in Urological Surgery at Strong Memorial Hospital, Rochester, New York. He presented two papers to the Northeastern Section of the American Urological Association held in Ottawa, Ontario entitled, "The Surgical Management of Renal Cell Carcinoma Involving the Inferior Vena Cava" and "The Management of the Acute Scrotum in Children."D Dr. Robert Braco, M'79, is in a residency program at the University of Iowa Hospitals and Clinics, Iowa City, Iowa.O 47 �In Memoriam Dr. Russell J. Van Coevering, M'49, died Jan. 12 in Mercy Hospital after a brief illness. The assistant clinical professor was immediate past president of the Buffalo Gynecologic and Obstetric Society. The 56year-old physician was on the staffs of Children's, Buffalo General and Mercy Hospitals. During the Korean conflict he was a Lieutenant Commander and Flight Surgeon in the United States Navy. He was a Fellow, American College of Obstetrics and Gynecology and an active member of several other professional socieities. Among the survivors is a son, R.J. II, a 1977 Medical School graduate.O Dr. Stephen A. Graczyk, M'20, died January 23 in St. Joseph Intercommunity Hospital. The 86-year-old internist was a past president of the Erie County Medical Society and served two terms as president of both the Erie County Unit of the American Cancer Society and the Western New York Geriatrics Society. He retired in 1970. He was one of the founders of St. Joseph's Hospital and served as its first chief of staff. He was also a founder of St. Rita's Home for Children. Dr. Graczyk had private audiences with four of the last five Popes and Pope John XXIII named him a Knight of St. Gregory. The physician served both World Wars. He was a Lieutenant Colonel with the 23rd General Hospital for three and one-half years in Africa, Italy and France during WW II. He was assistant clinical professor of medicine at the Medical School and was on the faculty 37 years. For many years he also taught nurses in three Buffalo hospitals. The community leader was active in sports; served for 25 years as announcer on Father Justin's Rosary Hour on radio ; headed the 1924 fund drive for St. Francis High School in Athol Springs and was the first president of the fund-raising organization called Father Justin's Drivers. He was a past president of St. Luke's Guild of Catholic Physicians; the Medical Arts Society and the U/ B Medical Alumni Association. He served on the Medical Advisor Committee of Blue Cross for 27 years and on the Medical Advisory Committee of the Erie County Home and Infirmary and from 1962-68 he was medical director of the care of the aging for Catholic Charities. 48 Dr. Graczyk was a Fellow, American College of Physicians and American Geriatrics Society. He was an active member/participant in several state, regional , national and international professional societies.O Dr. Pincus Sherman, M'36, died January 27, 1981 in New Rochelle, New York.O Dr. Wilfred W. Fuge, 76, died December 6, 1981 in Boca Raton, Florida. The Buffalo surgeon was a member of the Medical School faculty for 33 years (1938-1971). He was on the staffs of Buffalo General and Children's Hospitals. He served in the U.S. Army Medical Corps from 1940 to 1946. He was a Diplomate, American College of Surgeons. When he retired he was a associate clinical professor of surgery. He was a native of Pennsylvania and received his medical degree from the University of Pennsylvanian Dr. Domenic S. Messina, M'35, died December 26, 1981, in Sisters Hospital after a brief illness. The 72-year-old physician had been in semi-retirement since 1975. He was a founding member and the first president of the Roswell Park Surgical Society to promote education and training in the treatment of cancer. This organization, probably the first of its kind, was the forerunner of the American Cancer Society. Dr. Messina served on the surgery staffs of Roswell Park, Deaconess, Children's and St. Joseph's Hospitals. During World War II he served with the Medical Corps in Africa and Europe. He had been active in several professional organizations.O Dr. Charles Frederick Althaus, M'46, died October 18 of cancer at his Los Altos Hills, California home. The 69-year-old physician was the former medical chief of El Camino Hospital in Mountain View, California. The Yonkers New York native served in the Army Medical Corps as a major and was in charge of an American Military Hospital in Turkey from 1949 to 1952. His illness brought him in contact with the Hospice program and he was a supporter of this organization. Dr. Althaus was a champion sailboat racer and won several Thistle Class competitions in California.O THE BUFFALO PHYSICIAN �45th Annual Spring Clinical Day Saturday, May 8, 1982 Marriott Inn, Millersport Highway, near Maple Theme: "The Physician and Communications in Medicine." Stockton Kimball Memorial Luncheon Speaker: Dennis S. O'Leary, M.D., professor of medicine/pathology; dean for clinical affairs, the George Washington University Medical Center. He will talk about his participation as media interpreter for the medical team after the President Reagan assassination attempt. Dr. O 'Leary Exploration of the dynamics involved in communication between: 1) Physician and Healthy Public 2) Physician and Sick Patients 3) Physician and Other Physicians Nine class reunions: 1932, 1937, 1942, 1947, 1952, 1957, 1962, 1967,1972. ---------------------------------------------------------------------------------------------------- III II I BUSINESS REPLY MAIL FIRST CLASS PERMIT NO. 2210 POSTAGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, New York 14214 BUFFALO, N .Y. NO POSTAGE STAMP NECESSARY IF MAILED IN THE UNITED STATES �THE BUFFALO PHYSICIAN STATE UNIVERSITY OF NEW YORK AT BUFFALO 3435 MAIN STREET, BUFFALO, NEW YORK 14214 020003223400 BROWN ROBERT L. OR. 156 BRANTWOOD ROAD BUFFALO NY 14226 THE HAPPY MEDIUM Fill out this card; spread some happiness; spread some news; no postage needed. (Please print or type all entries.) N a m e - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Year MD Received---Office A d d r e s S - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Home A d d r e s s - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - If not UB, MD received f r o m - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - fuPrivatePffictice: Yes 0 No 0 In Academic Medicine: Yes 0 SpeciallY--------- - - - - - - - - - - - - - - - - - - - - - - - No 0 · Part Time 0 Full Time 0 School--------------------------Title Other: NEWS: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.?-------- Please send copies of any publications, research or other original work. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Document A resource containing textual data. Note that facsimiles or images of texts are still of the genre text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Spring 1982 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1982-Spring Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine. Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1982-v16n01-Spring Table Of Contents A list of subunits of the resource. Dean Naughton's Message Nine Class Reunions, May 8 Dr. Chassin's Message Palliative Care Unit The 1985 Class Advisor's Luncheon Frosh Picnic Continuing Medical Education/Dr. Donahue Eight Faculty Retire Dr. Hayes' Health Center BRSG Grants Sexually-transmissible Diseases Construction/Mrs. Kimball Dr. Hess Dr. Rosner Gift Athletic Day Dr. Fisher Biochemistry Symposium A Summer Head Start Dr. Daniels Erie County Interns, Residents New Treatment Delays Births The Bat A New President Pediatric Continuing Education People The Classes In Memorial Spring Clinical Day, May 8 Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Date Created Date of creation of the resource. 2018-07-02 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v16n01 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Rights Holder A person or organization owning or managing rights over the resource. Copyright 1982 University at Buffalo, State University of New York Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).  https://digital.lib.buffalo.edu/files/original/015c2a3cb1eecfaf3add6a79ac3c9e9c.pdf 262e0da7f2510e4e01122b656825ff62 PDF Text Text ~OILIU~\IE llui lrlEIJ.2 119tSll School of Medicine State University of New York at Buffalo �Dear Alumni and Alumnae: The School of Medicine entered into a new era on October 10, and 11, 1981 when it held a Parents' Weekend for the parents of the Class of 1985. The faculty and I were pleased and honored to host 116 parents. Approximately half of the parents who attended the campus were from the Western ew York and upstate areas and the remainder from the ew York City area. The program included an afternoon of visits to the Preclinical Departments, a session with me and members of my staff, a reception at the Historical Society, and a morning at the Erie County Medical Center. Included among our goals was the opportunity for parents to observe and learn first hand the experiences shared in by their sons and daughters, to become acquainted with the faculty and to learn how patients are utilized in integrating preclinicai and clinical skills and competencies. From the desk of John Naughton, M.D. Dean, School of Medicine The weekend, by all accoun_ts, was a howling success. It permitted a much needed opportunity for faculty and administrative reappraisal and renewal, and provided a forum in which the needs and expectation of faculty were matched with those of parents and students. I am pleased to report that this adventure was indeed successful and fulfilling, and that we are committed to adding it as a regular function of the School of Medicine's practices for the years to come. □ �Volume 15, Winter 1981 umber 4 THE BUFFALO PHYSICIAN (U PS 551-860) Published by the School of Medicine, State University of EDITORIAL BOARD Editor ROBERTS. MCCRA AHA Dean, School of Medicine DR. JOH AUGHTON Photography U HUGOH. EDWARD GER OWAK Visual Designers RICHARD MACAKA JA DO ALOE. WATKI S Associate Editor 2 3 7 8 9 10 11 13 14 TERI ROBERTS CO SULTANTS President, Medical Alumni Association DR ORMA CHASS! Vice President, Faculty of Health Sciences DR F. CARTER PA ILL President, University Foundation ]OH M. CARTER Director of Public Affairs HARRY JACKSO Teaching Hospitals The Buffalo General Children's Deaconess Erie County Medical Center Mercy Millard Fillmore Ro well Park Memorial Institute Sisters of Charity Veterans Admini !ration Medical Center 15 16 18 21 23 24 25 26 28 30 36 45 46 50 60 ew York at Buffalo I THIS ISSUE Dean aughton's Message (inside front cover) Spring Clinical Day Social/Ethical Organicity/Depression Malnutrition Community Care Medicine Urology/Cataract Surgery Dr. Pickren As I Remember Stockton Kimball by Dr. O.P. Jones Continuing Medical Education 9 Classes give $41,200 Mexican Seminar Women's Auxiliary Gift Roswell Park Seminars Dr. Mecklin Dr. Graham/$178,699 Grant Vascular Physiology, Disease Symposium Faculty Honored A Scientist Visits China by Dr. D.A. Pragay Facing Hodgkin's Diseae at 24 and After by Dr. Tom Raab, M'77 Medical Alumni Officers The Classes People In Memoriam Dr. Chassin's Message (inside back cover) The cover design is by Barbaro Evans. THE BUFFALO PHYSICIA , (USPS 551-860). Winter, 1981 olume 15, umber 4 published quarterly Spring, Summer, Fall, Winter - by the School of Medicine, State Univer ity of ew York at Buffalo, 3435 Main Street, Buffalo, ew York 14214. Second clas postage paid at Buffalo, ew York. POSTMASTER: Send addre s change to THE BUFFALO PHYSICIA , 139 Cary Hall, 3435 Main Street, Buffalo, ew York 14214. Copyright 1981 by The Buffalo Physician. WI TER, 1981 1 �Members of the 1931 class from lower left - Ors. Francis Oderkirk, Thomas Bumbalo, Gustave Oaluiso, Ellwyn Heier, Joseph Godfrey, Francis Keefe, Walter Walls, John Kuhl and his oldest daughter. Spring Clinical Day The crowd was larger than usual at the Buffalo Convention Center that heard Dean John aughton welcome physicians at the opening session of the 44th annual Spring Clinical Day. Dr. aughton thanked them for their continued support and especially the class gifts. He also noted that the budget log-jam had been broken and the Health Sciences Center on the Main Street Campus would become a reality in a few years. "I congratulate the Medical Alumni Association for putting on this outstanding program. The Medical School is becoming more and more involved with programs and problems of the aging." In his remarks as moderator Dr. Harold Brody, M'61, said, "this morning will be spent in a multidisciplinary approach to aging in the fact that we will deal with social, behavioral and ethical concerns in caring for the elderly as well as considering several areas of medical specialty care. Ors. Dickman, Brody "Let me introduce at least one controversial area in caring for the aged. Older Americans as a class are deprived of many necessities. They must retire from economic productivity while often still vigorous. They are socially stigmatized and taken advantage of by society. Their income is often cut at least in half and they can hardly afford proper food and health care at a time when it is crucial. On one hand we have conquered many diseases that had prevented people from reaching full maturity but now are not sure of what comes next." The professor and chairman of the department of anatomical sciences at U/B noted that since World War II our society has become accustomed to youth. During the next 50 years, while this baby boom ages, our society will become strongly age-heavy. One in nine Americans is now over 65 and in 50 years it will be one in every five. Many doctors have paid only off-hand attention to the later years. One study shows that interest in and respect for the elderly deteriorate during the process of medical education. Yet, when today's medical students are at the height of their careers, they will spend three-fourths of their time and effort caring for the elderly. 2 THE 8 FFALO PHYSICIAN �"Unfortunately, physicians today, even when well intentioned, do not always know ho\-Yto treat the old. Richard Besdine points out that few know what is clinically normal in old age and what are signs of trouble. Although the leading gerontological research in the world is done in this country, physicians still shrug off some treatable conditions with resigned reference to the patient's age, misunderstanding symptoms expectable in the elderly and prescribe as they would for someone younger. What is particularly important is that at times they fail to consider the effects on health of accumulated losses - loss of loved ones, of purpose, of power. "The program committee has brought to us alumni, faculty members in our medical school and visitors, to present information on a number of medical and social problems which have an impact upon care for the aged. It has been said that "without controversy, there is no progress". I hope that the discussion this morning will provoke some controversy and much progress in our own thinking for this rapidly growing area of medicine". Dr. Brody concluded. Geriatric medicine is a new area of health care that has not been fully accepted around the world, according to Dr. Robert Dickman, M'68. "It was first developed in Great Britain in 1948; in 1942 the American Geriatric Society was formed in the United States; and in the late 1950' s the ational Ins ti tu le of Aging was formed." The assistant professor of family medicine at Case Western Reserve University Medical School said, "there are many arguments (political and idealogic) against geriatric medicine as a specialty, but old people and their health problems are here to stay. Ten percent or more in this country are 65 and older and these people consume nearly 25 percent of all health care resources. By the year 2,000 they will consume nearly 40 percent of all health care resources. Every day 1,000 new people, age 65. enter the geriatric stream. The fas test growing group in the United States are those 75 and over and they need more health care." Social, Ethical Members of the 1956 class at the Stockton Kimball luncheon - Drs. Helen Buerger, Mark Denlinger, Arthur Kloss, ,\tfrs. Klass, Edmond Gicewicz, orman Haber and Eric Reeber. WI TER, 1981 3 d- �Ors. Eugene Cimino, M"61, Corio OeSontis, M'61; Harold Brody, M'61, Richard Buckley, i\1'43, Chor/es Tonner, Jr., ,\1'43, Herbert Lee, M'53. The medical director of University Hospital Geriatric Assessment noted that the needs of the elderly are very profound. "Their educational, social and intellectual problems are a constant worry to physicians. But the vast majority of elderly in the United States are happy, healthy, productive, well housed, lead independent lives and are reasonably financially secure. Only about five percent are institutionalized." Dr. Dickman asked several questions: How do we allocate resources? What about informed consent? How do we measure competence of a patient? What about quality of life? Do children always act in the best interest of their parents? What about proxy consent? In this day of economic belt tightening, how do we provide for the elderly? The physician-educator suggested that alternate strategies must be developed by physicians when treating the elderly. "We must look to the non-physician (therapist, nurse, social worker) for help. A better balance of treatment is needed. We can't write them off because of age." Second p/oce exhibit winner - Ors. Alker, Kelly: "Stereotoclic Loser Microsurgery for the Treatment of Brain Tumors." 4 THE BUFF ALO PHYSICIAN �First place exhibit winner - Drs. Antonucci, Armenia· "Monochromatic Light Ophthalmoscopy." He noted that home care is a massive undertaking, often better, but also very costly. "And when resources are scarce, how do we make decisions. What are our obligations to the elderly?" Dr. Dickman made several other observations: - medical students need a much broader exposure to eriatric medicine; - the ultimate challenge of geriatric medicine is understanding the complexities of the issues on a medical, social and ethical plane; - the patient must be involved in decision making; - don't use chronological age as an indication of quality of life; - arguments of equity and fairness must be considered; - our economic friends will be of little help in making decisions on health care for the elderly; - there are many moral tensions in geriatric medicine that tug at us in many directions; - falling and drug overuse are big problems for the elderly. Dr. Wholey In conclusion Dr. Dickman said, "as our aging population rows, attitudes of our society toward aging will probably change for the better in the years ahead." WI TER, 1981 5 d- �Dr Robert Schultz. M'65, 1rs. Stockton Kimball, Dr Lawrence Golden. M'46 Ors. Eugenio F Bukowska. M'28, Clyde W. George. M'29. Thelma Brock, M'28, Bruno G Schutkeker, M'28. [)rs. Milford Maloney, ."1'53, Lawrence Carden, M'49, Joseph Godfrey, ."1'31. Advancements in the technique of percutaneous transluminal angioplasty have led to a growing recognition of its therapeutic potential, according to Dr. Mark H. Whole . "A well defined technique with appropriate guidelines and controls has now been developed as a cardiovascular radiologic procedure with close cardiovascular surgical cooperation. Improved balloon technology and clear cut indications have facilitated selection of patients, increased success rates, and reduced complications." The associate clinical professor of radiology at the University of Pittsburgh medical school outlined the specifications for peripheral, iliac, renal and coronary artery angioplasty and discussed the techniques, advantages and problems of the various approaches. Dr. Wholey is also chairman of the radiology department at Shadyside Hospital, Pittsburgh. The Eugene Sullivan's - father/son. DEPRESSION is the diagnosis most often over-looked or omitted, according to Dr. ichael Lynch, clinical assistant professor of psychiatry at U/B. "This is disasterous and unfortunate for the elderly patient." To prove his point Dr. Lynch discussed a case history of a 77year-old woman, who had spent seven months in a state hospital. "She was hard of hearing and it was assumed she was dimented. The first diagnosis was chronic organic brain syndrome. Her home had been sold, her furniture distributed, and she had no adequate mental status brain examination upon being admitted to the hospital. This was a classic example of a chronically aged patient mistakenly diagnosed as organic. She was really suffering from a psychotic convulsive depression. When she was properly treated (therapy and depressant drugs) she recovered and today is driving her new automobile. Even her sense of humor returned." The physician-educator noted that just a few years ago obesit. was the most over-looked diagnosis, but today it is depression. "Psychiatrists view aging as a process of impairment of physical or mental capacity. This can occur at any age - 20, 30, 40, 50, 60 or 80. Too often this is diagnosed as organic," Dr. Lynch said. 6 THE BUFF ALO PHY !CIA �"All too often the chronologically aged and depres ed per on is regarded as senile or having hardening of the arteries. This is not always true. Diagnosis should be made on positive findings and examination and substantiated by lab tests. A depressed person will never admit it. "A mental status examination is important for the depressed elderly person to find out what is really wrong. This will determine the patient's current mental condition, and enables the physician to establish a base-line of current findings," Dr. Lynch said. A sensorial examination is also important. "This will give us clues into organic impairment. An examiner should ask questions involving memory, orientation, concentration, insight, judgement, etc." The psychiatrist noted that a 70 or BO-year-old depressed person probably would have food stains on their clothing, be slouched, bent, have poor personal hygiene, be verbally underproductive or mute and repeat himself. These traces have nothing to do with organic impairment. He also discussed Kahn's ten questions (place. year, week, month, your age, who is president. etc.) when interviewing patients. Dr. Lynch made several other observations: - aging is often more apparent than real; - depression is more common in the elderly and physicians should be alert to it; - snap diagnosis of senility without adequate examination may doom the patient; - the depressed person should be treated and returned to society; - organic patients do not have a persistent negative quality, but they may ramble and have fewer thoughts; - a careful sensorial examination is imperative; - people who have an organic impairment are often also depressed; - a mental status examination determines whether the patient is depressed or organic; - when an elderly person is un-cooperative or when rehabilitation fails the person is probably depressed; - a person has aged when his physical or mental capacity has been impaired regardless of his chronological age. In conclusion Dr. Lynch said, "look beyond the patient's chronological age and determine whether organicity is actually Dr. Michael Sullivan and colleogue. Organicity vs. Depression Dr. Lynch present. □ WINTER, 1981 7 d- �Drs. Pryzlucki, Naughton, Jones. Schultz. Sullivan, Chassin, Baumler. Malnutrition Dr. Cerra Hospital based mal-nutrition is a major problem, but it is reversible with proper therapy, according to Dr. Frank Cerra, associate professor of surgery at U/B. "Often the patient is malnurished at home before coming to the hospital. Forty percent of all medical hospital admissions have significant mal-nutrition. Among routine surgical admissions, 25 percent have significant mal-nutrition which makes the morbidity four to eight times greater. Only recently has hospital based mal-nutrition been recognized, although it has been with us for a long time." Dr. Cerra said, "Take a complete history of the patient and follow up with a complete physical examination. Studies show that when physicians take time to correct mal-nutrition, morbidity is reduced. Mal-nutrition is reversible with good therapy." The physician-educator suggested the use of the central route of feeding tube with full nutrition support. "The peripheral supportive therapy (IV-therapy, non-central vein cannot correct mal~ nutrition. Don't be lured into this trap. The positive calorie, positive nitrogen balance regiment (20% lipid-amino acid] has not served the test of time to date. In the next few years this may be reliable, but not today." Dr. Cerra noted that Buffalo hospitals are being surveyed regularly for mal-nutrition among patients. He found 28 percent (one in three] were mal-nurished. He described mal-nutrition "as a lean body mass inappropriately low for the age and activity level of the patient." The surgeon said, "You must convince yourself that the malnutrition problem exists. One of the major problems with patients is what criteria should be used in diagnosis." Or. Cerra made several other observations: - mal-nutrition costs millions of dollars to every hospital in terms of complications, life, cost utilization and disability; - one of three patients that are admitted for emergency surgery are mal-nurished; - of the medical male emergency patients admitted, 50 percent have significant mal-nutrition; - criteria are prognostic indicators of infection risks in surgery; B THE BUFF ALO PHYSICIA �- an obese person is often ·mal-nurished because they don't use their fat that is stored for energy. In conclusion Dr. Cerra said, "we have a problem; good therapy exists, and if we use it we can correct mal-nutrition. The results are excellent." Mr. Cliford Whitman said, "The need for community care services for the elderly is highlighted by the expanding number of elderly and by the present design of our health care system." The commissioner of the department of senior services, County of Erie went on to say that the elderly are 11 percent of our population and they take 30 percent of our health care and use nursing homes, hospitals and physicians more and more. By the year 2,030 our elderly population will double in size, with the largest contingent being over 75. "Since 1978 nursing home care for the elderly has increased five times. Home care has expanded too, with many families taking considerable responsibility. But many families today cannot cope with the increased financial and physical burdens of health care for their relatives," Mr. Whitman said. "Is the future model of health care going to be institutional care, community care or a combination of both? Community care is the more balanced type for the aged." He listed several more recent developments in Erie County as - meals on wheels, legal services corporation, 50 nutrition sites, protective service program, health care centers, neighborhood services, transportation system, group screening and nursing homes without walls. "In Erie County we have tried to put all the fragmented services of the elderly into a package - Co-ordinated Care Management Corporation - so the elderly will receive better, more efficient care. This is supported by the Robert Wood Johnson Foundation." r. Whitman also noted: - 89 percent of nursing home residents are elderly and twice as likely to need hospital care; - cost of long term care is enormous; Dr. Whitman Community Care Ors. Schullz, Chassin, Jones. WI TER. 1981 9 d- �- we don't have a balanced system of allocating resources; who gets our limited resources; - medical costs have risen 300 percent in the past decade; 900 percent in nursing homes; - in 1979, $17.8 billion was spent on nursing home care of which 56 percent was provided by public funds; and by the year 2,000 this will increase five times; - 64 percent of Erie County's multi-million dollar medicaid budget goes for nursing home care; - many problems of the elderly are more social than medical; - much of our long term health care is high cost institutional care and this is not desirable; - 80 percent of services of aged are provided by their families, which proves that most families are not abandoning their relatives; - in the future there must be more interaction of various health agencies, hospitals, physicians and the community; - financing in this era of 'belt-tightening' is a big problem; - the church, family, friends and volunteers must continue to be effective support system; - the concept of case management and assessment is a part of any good health service system and is the challenge of the future. In conclusion Mr. Whitman said, "We must meet the issues head on and work together as a community jointly and cooperatively so we can improve the over-all system and aid the doctors so there will be better long term care for all ages." J Medicine older people drugs may produce more 'side affect~· than desired affects. Drugs are not magic. They affect, not only the main target, but many different cells and organs." This was the warning of Dr. Evan Calkins, professor of medicine at U/B. "When toxic symptoms show in a patient from the use of one drug, we tend to add another drug to correct the problem, rather than considering whether the first drug has to be given and continued. Drug therapy must be used cautiously in older people." The head of geriatrics at the Veterans Administration Medical Center noted that often we misdiagnose a disease, which in reality is the normal aging process. "The most effective comprehensive care starts with correct diagnosis. The medical advances of the last 50 years have led to the conquest and prevention of life threatening diseases, but we have not been able to eradicate chronic illness which leads to disability, but not death. Multiple diseases in the elderly are a problem, and it is difficult to make the right diagnosis in some cases. Common diseases often look different in 10 THE BUFFALO PHYSICIAN �Dr. Gonder Urology Cataract Surgery The Buccaneer Eye Surgeon When dealing with the elderly urologic patient, evaluation and choice of treatment must be guided by throughtful consideration to avoid compromising the quality of life in the remaining years, according to Dr. Maurice Gonder, clinical associate professor of urology. "Radical surgical intervention as well as prophylactic surgery does not serve the best interests of the elderIy in most cases." Dr. Gonder continued, "Indications for urologic surgery in the elderly should be well defined and the type of therapy chosen individualized so as to maintain the optimum quality of life possible for the longest period of time." Among the male population of the ortheastern United States, at age 70 approximately 1 % will die each month. "If several systemic diseases are present, such as arteriosclerotic heart disease and diabetes. the mortality will be higher. These cases tolerate urologic disease and consequent surgery less well," he said. "It is imperative that hematuria and persistant urinary tract infections be evaluated urologically. However, prophylactic surgery for benign disease is seldom indicated. A palliative approach aimed at improving or maintaining the quality of life without unduly shortening it is a proper and compassionate goal," Dr. Gonder concluded. Senescent cataracts are a very common affliction of the elderly, according to Dr. Edward W. Hohensee, clinical assistant professor of ophthamology. "The mere presence of a cataract does not mean that cataract surgery is indicated. The visual disabilit of each individual patient must be determined. Each patient's visual wants and needs must be assessed, before cataract surgery is undertaken. "The newer techniques of small incision, extracapsular surgery (namely phaco-emulsification), and the increasing popularity of intrapocular lenses, have made the management of cataract surgery more controversial," Dr. Hohensee said. He noted that many of the earlier claims for phacoemulsification have not stood the test of lime. 1.0.L. implantation carries risks inherent for the short term and the long term, which increases the potential of poor visual results of surgery. "The primary physician is in a good position to help his patient decide when, and if, his cataract needs to be removed. Because of the many options open lo the patient, i.e. intracapsular vs. extracapsular; and cataract spectacles or contact lens vs. I.O.L.'s, a second opinion is often not only prudent, but also enlightening," Dr. Hohensee concluded. The reader is referred to an editorial "The Buccaneer Eye Surgeon" by George Weinstein in the December 1980 issue of Ophthalmic Surgery (Vol. 11, o. 12, p. 831). "It seemed to start with phaco-emulsification, although it surely had been around a long time before that. Phaco-emulsification, though, did appear to release on the American scene a large number of previously unheard of eye surgeons whose excellent technical skills and business acumen remain untinged by traditional medical ethics. The trend continued with the introduction of intraocular lens implants, and has now been further ex12 THE 8 FF ALO PHYSICIA �tended with radial keratotomy. The phenomenon certainly must be one of the most talked about (and least written about} in the modern ophthalmic era. "What have been the common factors during each of these episodes? Firstly, each has developed around a new technical advance whose merits, while controversial, appear promising. Secondly, the printed and electronic media have been the means for introducing information about the new technique not only to the public at large, but to the medical profession. But the third, and by far the most important ingredient in this fa mi liar formula is the buccaneer eye surgeon who is willing to turn the potentially useful but still unproven surgical procedure into personal profit. one of us is unaware that a large number of such individuals become wealthy, unashamedly advertising their high-priced services to attract that gullible consumer, the patient. "There is nothing evil about phaco-emulsification, intraocular lens implantation or radial keratotomy per se. But those who perform these operations to plunder the public are the shame of ophthalmology. Let us not remain silent about them. Our society has made the task more difficult by tying the hands of medical societies and state licensure boards with "restraint of trade" regulations and legal precedents. But no one not the Federal Trade Commission nor the attorneys who are so readily available to represent all forms of scoundrels, need tell us what we know to be true: The ethics of the medical profession are based on the interests of the patient, not those of the physician. The bucaneer eye surgeons are not our folk heros: They should be exposed to the public for what they are." □ Dr. John W. Pickren, chief of the pathology department at Roswell Park Memorial Institute, received the fifth annual Dr. William H. Wehr Award, Friday, August 14 at the Plaza Suite, in recognition of his distinguished career in cancer research at the Institute. Dr. Pickren joined the Institute staff in 1953 as chief of pathology, and throughout his career he has been studying the metastasis, or spread, of cancer. In addition to his duties at Roswell Park, Dr. Pickren is a clinical professor of pathology at the School of Medicine, and a volunteer clinical professor of oral pathology at the School of Dentistry. Dr. Pickren is a member of many national and international scientific organizations including the American College of Pathologists, the American Society of Clinical Pathologists and the International Society of Cytology. He has authored or collaborated on over 120 scientific publications. The award is named after Dr. William H. Wehr who devoted his entire 37-year medical career to Roswell Park. He was one of the first cancer researchers in the nation to use radium in cancer treatment. □ WI TER, 1981 13 Dr. Hohensee Dr. Pickren �As I Remember Stockton Kimball by Oliver P. Jones, Ph.D., M.D. Distinguished Professor Emeritus When Dr. Michael Sullivan left four telephone numbers of places where I might contact him, I thought he was urgently in need of an anatomical consultation. Instead, Mike told me about the Stockton Kimball Lectureship. I was flabbergasted because I had already received the Stockton Kimball Award and did not realize that a local person would be asked to deliver this prestigious lecture at the Spring Clinical Day luncheon. It just so happened that my recent literary efforts had been focused on Frank Hastings Hamilton, our first dean and professor of surgery. This, I thought, might be a good starting point for a talk leading up to Stockton Kimball. After all, I was his first Assistant Dean and Chairman of the Admissions Committee for eight years and 12 years respectively. At that time, there were no other assistant and associate deans. My narrative begins with Frank Hastings Hamilton, who was indeed a peripatetic surgeon. He taught at nine medical schools and was co-founder of three that are still active. Early in his career, Hamilton developed one of the greatest of all gifts, the faculty of imparting to others what we know ourselves. He maintained that no man can teach what he does not know. Hamilton served as Dean for three years, without pay. Even though deanships were a far cry from the highly organized form of business they have since grown to be, he resigned and was followed by Austin Flint, Sr. Flint served for one year, but what an eventful year it was by being involved in medical and civic affairs. On 18 January 1850, Dr. James Platt White demonstrated the normal delivery of a child before 20 members of the graduating class. This took place in the janitor's quarters of the school at Main and Virginia Streets. At that time, it was morally correct to feel the genital area but immoral to view it. To make a long story short, the University of Buffalo induced the County Attorney to bring criminal libel proceedings against Dr. Horatio . Loomis for a derogatory letter to the editor signed "L", which was purported to have been written by him. The trial lasted five days. The University lost its case. but so much national publicity was given to it that the profession has long since now thoroughly vindicated Dr. White. Dr. Austin Flint Sr. gave excellent coverage for this milestone in medical education under his editorship of the Buffalo Medical Journal. In order to advance this narrative and relieve the pressure on your ischial tuberosities, let us go to 1878. Some may call this a vintage year because the faculty voted to dispense with the office of the dean and, instead, to elect annually a President and Secretary of the faculty. By the way, heretofore, the dean only received an annual expense account of $50 for 50 students; $75 for 75, and $100 for 100 or more. The question is: Did any dean solicit medical applicants after the class reached 99? It is also noteworthy that in 1878, Dr. Charles G. Stockton received his M.D. degree from the University of Buffalo. Six years later he was named Professor of Material Medica and 14 THE BUFF ALO PHYSICIA �Therapeutics at iagara University. Distasteful as it may be to present day alumni, I must tell you that after enjoying many years as a top notch School of Medicine, the University of Buffalo fell to the lowest of the low. In 1883 iagara University was granted a charter to establish a medical school. Two of the three editors of the Buffalo Medical Journal wrote that the new school would conform to standards which they had advocated and that the new college would not be brought into rivalry with other medical schools because there was, in the present vicinity no medical school which could approach the high standards of iagara University. The reference was, of course, to the Buffalo College of Ph sicians and Surgeons and the University of Buffalo. I am not unmindful of the subsequent merger with the University of Buffalo School of Medicine, but that is another story. Suffice it to say, the merger with iagara University did not save U.B. from the scathing criticism by Abraham Flexner in 1910. However, modesty does not prevent me from saying that Flexner had good words about the Anatomy Department, and particularly the Medical Library, which was one of the three best in the United States - the others being Jefferson and Galveston. Or. Stockton remained at iagara University for three years and was then called to the Chair of Theory and Practice of Medicine and Clinical Medicine at his alma mater. Contrary to the local news media, he never served as dean of the School of Medicine. He died in 1931 and Chancellor Samuel P. Capen said: It would be impossible for us to conceive what the University would be were Charles G. Stockton's 43 years of service to be subtracted from it. It would be an entirely different institution, of that we can be sure. I am not thinking now of his conspicuous scientific achievement or of his skill as a clinical instructor. I am not thinking of a reputation which accrued to the Medical School by reason of his association with it. I'm thinking of something less tangible but even more potent. His greatest contribution to the University that he loved and served was, all unconsciously, to print the stamp of his magnificent personality indelibly on it. His courage, dignity and sincerity have, by that mysterious alchemy that governs human relations, entered into our institutional body and molded us somewhat in his image. To the University of Buffalo Dr. Stockton is not and never can be a tradition. He is and will remain a living force, even when his name is no longer commonly recalled. Because he was a great part of us for more than a generation. we are what we are and what we shall become. Dr. Stockton's grandson, born in 1902, was his namesake. (From here on formality will be dropped, and our dean will be referred to as - Stockton.) Young stockton graduated from Hutchinson Central School in 1919. (I believe he attended Park School before that and attributed his miserable handwriting to the fact that he wore mitten to keep his hands warm.) He went to Harvard College where he met a notWINTER, 1981 15 Continuing Medical Education February 21-24, 1982 "Arrhythmias", (Florida), Program Director, Or. Jules Constant, Clinical Associate Professor of Medicine. July 23-30, 1982 Medical/Dental Meeting, (Pembroke College, Oxford, England), Program Director, Dr. Martin Wingate, co-sponsored by SU Y/AB, McMaster University and University of Rochester. Contact: Dr. Martin Wingate, 135 Cary Hall, 3435 Main Street, Buffalo, N.Y. 14214. Call: (716) 831-2766. d- �Ors. Patrick Kelly. John ton, Louis Antonucci I oughDrs. Fronk Hook, Jerome Pellicono Glouber, Victor Ors. Donald Barone, Eugene Leslie Drs. Wolter Walls, Wolter 0. Westinghouse m'i 9.1\)81 ~1~·"'-' -l\il\ f )ll l JI ' .1 s.oooF.. 3~ J h(JLl<'J,andl'(llA~:,; ~ oJI9 31 so-good professor of organic chemistry who failed him. This teacher was Conant, who later became President of Harvard. He was graduated cum Ioude from U.B. School of Medicine in 1929 and interned at the Buffalo General Hospital. He then joined his grandfather in the practice of internal medicine.After the death of his grandfather, Stockton studied for nine months at Guy's Hospital in London and for 15 months at the Pathological Institute in Freiberg, Germany, under the noted pathologist - Dr. Ludwig Aschoff. In 1932, while attending an educational conference in ice, he met Sylvia Becker, a native of Manchester, En land. They were married in 1936 and later raised three daughters - Carolyn, Margaret and Rosalind. I met Stockton in September 1944 at an Executive Committee meeting. When he was an Associate in Pharmacology, Dean Koch, also Professor of Pharmacology, had an opportunity to assess his talents. Hence, it was only natural that he should select Stockton to be an assistant dean to succeed Dr. Edgar Hummel. Stockton was responsible for the first permanent type of Admissions Committee. It was the recommendation of the Long Range Planning Committee that the number of representatives on the Admissions Committee should be half pre-clinical and half clinical faculty. Mind you, no one of the first committee had had any previous experience in such matters and very little, if any, expertise about the intricacies of interviewing prospective students. Bear in mind in 1945 that the committee was permitted by the government to select only veterans, 4 F's and women. The results were disastrous. Out of a class of 74, 43 percent did not graduate with their class. Of the 49 who did graduate, seven had transferred from other schools. In the 1920 to 1940 period, Dean Ross V. Patterson of Jefferson Medical College, addressed every freshman class and said, "Gentlemen, look to your left and then to the right. One of you will not be here next year." Some wags have inputed this lo U.B. But we did not have to do this, and, as a proprietary school we could not afford to do so. When Dean Koch died in 1946, Stockton succeeded him as our 18th dean and I was appointed Assistant Dean and Chairman of the Admissions Committee. As I mentioned earlier, at that time 1 - ... 16 THE B FFALO PHYSICIA �9 Classes Give $41,200 to the Medical School Drs. Herb Pirson, Harald Levy Drs. Carlo Desantis, Harold Brody Drs. Edmond Gicewica, Helen Buerger Sue McCutcheon, Drs. Martin Mango, Scoll Kirsch mcu, 9r.,81 ti or)[I l Tl .I ·. 3500-; m'19~,8I Drs. Mary Henrich, Donald Hall WINTER, 1981 17 P~' T:'mll/o FOll[ JIO.I . 2.000 ~;. J UR) J h(JtU1,-(]fl.J1 l l~ -~ Cluuaf 197I �there were no other assistant and associate deans. During the next the Admissions Committee brought the attrition rate down below the national average. This was achieved not by watering down our courses, but by improving the admissions technique after studying carefully the cause of each failure. In the analysis of the freshman medical failures, we grouped them into five categories: (1) poor scholarship; (2) financial difficulty; (3) family problems; (4) personal reasons including emotional instability and loss of motivation and (5) language difficulty. Then we analyzed the reasons for the acceptance of the failures to the School of edicine. For example, we studied them under the headings of (1) general record; (2) academic record; (3) recommendations; (4) interviews; (5) medical faculty parent, and (6) assigned by armed forces. In spite of the fact that we were no longer assigned medical students by the armed forces and that we no longer admitted sons and daughters of the medical faculty who were not qualified, we still had a group of acceptable students whose general record was adequate throughout or whose letters of recommendation were more than just satisfactory, but who failed for some unknown reason. I am a little ahead of my story, so let us return to 9 February 1946, when Stockton came to the dissecting room with tears in his eyes. Dean Koch had died and I was asked to represent the University at his funeral in Lawrenceburg, Indiana. I accompanied Mrs. Rose Koch, her sister and the body, until the late dean and the professor of anatomy became separated in the switching yards at Cincinnati. After a delay, we continued to Lawrenceburg. Which reminds me that there had been a viewing in Buffalo at Brady's Funeral Home. In 1946, Stockton sent me to Louisville for a meeting of premedical advisors and chairmen of Admissions Committees. It was there that I met Dr. Hardy Kemp, dubbed the traveling dean, because he had served at Vermont, Ohio State, and Wayne edical Schools. He enunciated a law, clearly and proudly, namely: 12 years, An applicant's acceptability is inversely proportional to the amount of pressure brought to bear on the Admissions Committee. Continuing Education Seminar February 10-17, 1982 Hotel Akumal Caribe (Yucatan Peninsula, Mexico) $757 U.S. - Meals Extra Prices includes air, hotel, round trip transfers, welcome and departure cocktail parties. ot included in the price - 10% service charge and room tax ($8.80 per day). Fly United Airlines from Buffalo to Chicago to Cancun. U/B Alumni Association (716) 831-3557 After a trial and error period, I finally embraced Kemp's law and practiced it - with success. On one occasion, when Stockton was out of town, Sylvia received an air mail parcel labeled "Keep Refrigerated", etc. After Stockton returned he discovered it was from an applicant in Colorado. The contents of the box were several trout. He came to my house, gave me half and said that I should share in this responsibility. It was of course too late to return them. I ate the trout and rejected the applicant. On another occasion, he received a check for $1,000 and a case of Scotch, which we dutifully returned - even in the lean years as a private university. y assistant deanship was not without some occupational hazards. In those days, it was my duty to sign all letters of rejection for the Admissions Committee and letters notifying students that they were denied the opportunity to advance in their pursuit of a career in medicine. In ordinary parlance, they had flunked. One 18 THE BUFFALO PHYSICIAN �such student did not get through anatomy. After a tour of duty in the armed forces, he returned to U.B., repeated the first year and failed again. After receiving my letter, he called all members of the Executive Committee in the middle of the night. He called Sylvia so frequently that she finally left the phone off the hook. He threatened to knock my teeth through the pharynx and beyond, and to run over my children in the street. Katie, my late wife, locked herself in a room with our children while I called the police. One officer, faking my voice, answered the phone at my house and made an appointment to meet the student at a certain street corner. He was apprehended and taken into custody. By the way, he had thrown beer bottles and bricks through the windows of the Registrar's and Dean's office at 24 High Street. Chancellor Capen, Stockton and the University lawyer said it was up to me to press charges. Shall we say, the student was disciplined. Apparently, some students want to be rejected, if they are going to be rejected at all, by the top man and not his subordinate. I had several other close encounters which did not involve Stockton. Stockton severed the "Gordion Knot", so to speak, at an early date in his deanship. Some rejected medical applicants had been accepted by the School of Dentistry. At that time, the first two years of medicine and dentistry were identical. At the completion of the first year, some of these dental students would apply for admission to the medical school's second year class and were accepted. Stockton and I soon noticed that all transfer applicants from St. Bonaventure failed in the second year. Therefore, we stopped this practice because first, it increased our attrition rate. Secondly, it was not fair for the Dental Admissions Committee to spend their time and energy trying to select a good class only to have them fly-the-coop, so to speak. Stockton maintained that if dental students wanted a medical degree, they had to obtain their D.D.S. first and then enter the third year of medicine. Therefore, we decided to reject all applicants from St. Bonaventure. The result was we were asked to inspect that university's facilities. Stockton drove Dr. Francis Kenny, Father Sekelsky and myself to Olean. We spent the day examining laboratories and questioning the science faculty. We were wined and dined and then made our recommendations. On the way home, Dr. Kenny and I had a thrilling experience, for we did not know that Stockton had such a heavy right foot. Some years later, a couple of St. Bonaventure students were accepted and they performed well in medical school and others have continued to do so. Drs. John Pryzlucki, Louis Antonucci. The odd thing about this period of time, students from Canisius were out-performing those from U.B. We considered it complacency on the part of our students, for once they were accepted, they just coasted along. And, it may come as a shocker for some of you to know that our dental students bested the medical students on identical gross anatomy practical examinations. Some of you are very likely wondering why so much time has been spent on the Admissions Committee. Many years ago, I addressed several alumni groups - even on the west coast. The thrust of my remark was: WINTER, 1981 19 d- �The healthy complexion, composition and success or failure of the alumni association, as well as the School of Medicine itself, is determined by the standards adopted and adhered to by the Committee on Admissions. Some physicians believe - perhaps rightly so - that they learned more from their classmates, through association and the stimulating effects of keen mental competition, than they did from their professors. Indeed, some deans consider the task of selecting medical students much more important than the selection of a medical faculty. Drs. John Pryi.lucki, Patrick Kelly. After Stockton became dean, he inaugurated a long overdue practice, namely, that of having members of the freshman class meet members of the faculty at his home on Cleveland Avenue and subsequently at his place on Cayuga Road. This social occaion was held on Sunday afternoon preceding the first day of school. Our first two deans - Hamilton and Flint - held levees for the graduating class in the evening. According to a medical student's diary (1848-1849), Hamilton served sherry. Stockton later modified his program so as to include an orientation program on Saturdays. Mrs. Kimball reminded me that Stockton insisted, because of the freshmen present and his young daughters that only a very good non-alcoholic punch be served. She also told me that she and the three daughters prepared about 3,000 cookies of different varieties. Maybe this was Stockton's reaction to his experience as an entering student to the school in 1925. He had to pay the first installment of the $325 tuition by Saturday before classes began. On Monday morning, at 9 o'clock sharp, he went to a pre-assigned seat in Alumni Hall, probably the fourth row for the "g's" to "k's". He then listened to Dr. R.R. Humphrey, who introduced himself, wrote his name on the blackboard, and then lectured about the cell, mitosis, fertilization, etc. as the introduction to histolo y and embryology. At the end of the hour, Stockton then carried his own microscope (a requirement in those days) to the third floor of 24 High Street, and after a brief lecture about optical physics began the laboratory work in microscopic anatomy. At that time, tockton did not realize that the reason for selecting 77 freshmen was restricted by the seating capacity of that laboratory. It was indeed an informal experience. Before Stockton became dean, it was customary for the Department of Anatomy to hold a Christmas party for the entire staff, including the cleaning women. Of course, free-loaders came from the Department of Pathology, Dental School and the aintenance Department. Punch was served which eventually was dubbed - Anatomy punch - without formaldehyde. (Formula kindly furnished upon request.) After Stockton became dean, he asked Anne Deeley, Registrar, to have me mix that punch for his Christmas party. Two punch bowls were required, one for the dean's office where faculty were received and one for the registrar's office, where all of the other personnel were entertained. He came to me and said that there was too much whiskey in the punch. I replied that there was no whiske in it. He said, " o 20 THE B FF ALO PHY !CIA �whiskey?" I reiterated, " o whiskey". He did not ask me about the brandy. Anne Deeley heard about this and threatened to shoot me if I put any water in it. Stockton and I went to several medical education meetings and usually had separate accommodations. On one occasion we had to share a double bed in Albany. I did not know that he was subject to bruxism. Hence, at night he would grind his teeth and then turn over in bed with all the coverings, leaving me chilled sufficiently to awaken and retrieve them. I did not check with Sylvia about this. On the more serious side Stockton was instrumental in promoting the school's policy of full time heads for the clinical departments. The Psychiatry Department was set up on this basis during his administration. Departments of Legal Medicine and Anesthesia were added to the faculty. He was deeply interested in the Annual Participating Fund for Medical Education, organized to support the basic science departments, and served as a member of its Executive Committee. Because he was so highly esteemed in the field of medical education, he was invited by the International Cooperative Association to survey the medical school of the University of Paraguay and make recommendations for its improvement. Many of our faculty could not comprehend why he was so selected. Of course, they did not know that Stockton had spent two months in 1943 studying malaria and other tropical diseases at the Army Medical School at Walter Reed Hospital. After that he went on a six week expedition to Costa Rica and Guatemala to investigate these diseases. This study was sponsored by the Markle Foundation. Hence, he was familiar with some of the problems in Paraguay. As a result of his survey, the University received a contract under which members of its faculty taught in Paraguay and Paraguay sent representatives to Buffalo for observation and study. A big chunk of our combined energies from 1946 to 1953 were expended on the planning of the new medical school building on the Main Street campus, the former Capen Hall now Farber Hall. We went through ten proposed plans. If some of you are wondering who was responsible for such a decision, all you have to do is focus your attention on me - because I was chairman of the committee for the new building of the Long Range Planning Committee. The faculty voted to accept the committee's recommendation. Subsequent hassles were nothing compared to that one. Stockton appointed me liaison officer between the chairman of the Building and Grounds Committee, Treasurer and architect. Women's Auxiliary Gift The Women's Auxiliary of the Erie County edical Association has given the Medical School $9,170.36 to support educational experiences of medical students. This gift comes from the AMA's Education and Research Foundation for medical education. The unrestricted funds granted by AMA-ERF each year represent gifts from individual physicians, members of the AMA Auxiliary and others in the state and nation. □ Stockton and I got along well until I just could not keep up with one of his idiosyncracies. (At some future occasion when I am studying celestial anatomy, my former students will have a field day with mine.) He seldom forewarned me when he would be out of town or out of the country. Therefore, after eight years as Assistant Dean I resigned but retained the chairmanship of the Admissions Committee. He had a successful administration because of his connection with the Association of American Medical Colleges as treasurer and member of the Executive Committee. The School of Medicine WINTER, 1981 21 d- �in particular and the University in general profited by his appointment to the Accreditation Committee of the A.A.M.C. Stockton visited and inspected, with a team that also included representatives from the A.M.A., a dozen or so medical schools. Upon his return he related to the various department heads, how they might improve their teaching and the conduct of departmental affairs. (We did not have chairmen in those days). But today, some chairmen emulate heads. He therefore was privy to information that the accreditation of our medical school was pulling out of the lowest 25 percent and approaching the 50 percentile in the ranking of other medical schools. Some of you may have heard me say that we were a successful team because he was a forward looking dean and I a backward looking assistant dean. We worked for the good of the order. We did not always agree about pedagological matters. For example, there is no doubt that the jump from college to medical school is a great one and that necessary readjustments must be made. There is no question of the efficacy of a carefull designed counseling program, but there is danger in an amateur form of guidance and counseling conducted by persons who, even though they be physicians, have not been adequately trained for it. This perhaps is a sign of the period in which we live, for there is a tendency to assume that proficiency in one field presupposes some authority in another. However, those who are eventually to become physicians and leaders in the community have to get to think independently. We also disagreed about the role of the teacher. In those days, 35 years ago, I did not know that our first dean - Frank Hastings Hamilton - said," o man can teach what he does not know." Nor did I know about an ancient Chinese saying. "You can not buy a teacher." The following is an excerpt from a letter I wrote to Stockton about a year before he died: Third place exhibit winners - Ors. Boehmke, Portin, Teitler: "Flexible F,beroptic Sigmoidoscopy." I have maintained for a long time that the most important molding influence upon the student is the teacher, not only because of his scholarship and knowledge, his dedication and approach to the subject, but because of his philosophy of life, his intellectual processes and even his own life, he serves as a model for the student. Unfortunately, there are some who will never be good teachers regardless of the courses that they may take. Good teachers must have or develop, a certain sensitivity that gives them the "feel of the class" so to speak. But the teacher cannot be expected to "make a silk purse out of a saw's ear". The student should also have a medical school environment which will enable him to demonstrate or develop initiative, independence and resourcefulness after he has had the basic medical sciences - and even while he is taking them - should the opportunity present itself. I have also maintained that there is a proper place for healthy degrees of tension, anxiety and even frustration, otherwise students would not work hard enough to bring out the best in themselves and to get to the bottom of dif22 THE BUFFALO PHY ICIA �ficult and challenging situations. Optimum and maximum mental efficiency are not demonstrated nor developed in the absence of emotional tension. The big questions are how much should there be and what is the best way to produce it? Obviously, it should not be produced to the extent that some students may prefer to transfer to another medical school at the end of the second year rather than to face certain clinicians in the third and fourth years. To the contrary one of the best ways to produce the required amount of anxiety and tension is for a student to have a teacher who is well prepared and who knows his subject thoroughly, insist that the student be orderly, accurate, clear and concise when describing his observations. One who expects a student to develop and refine his powers of observations in all sensory modalities. In other words, we need good and experienced teachers which is a far cry from those educated by educators. Students soon learn to appreciate and respect scholarship in their teachers and increase their own tension as a result of an unconscious identification - using the teacher as a model. A certain degree of tension and anxiety helps the student organize and integrate his material and even enhances his own motivation. This should be the goal of examinations. Also, the right manner of responsibility at the right time may elicit enough anxiety or frustration to uncover hidden talents in the student. Just before leaving for Chicago to attend meetings on Medical Education and Licensure, I heard that Stockton was sick. I went to his Cayuga Road home and was met at the door by a houseguest. She informed me that the family was at the Buffalo General Hospital. I could no longer assist him. He died 7 February 1958, age 55, of staphylococcic septicemia. The Association of American Medical Colleges sensed a tremendous loss and wrote: As an educator, Dr. Kimball made significant contributions to the entire field of medical education and practices. Under his leadership as dean, the University of Buffalo, School of Medicine rapidly developed its education and research activities and participated actively in experiments of national significance in medical education ... And at home, Chancellor Clifford C. Furnas declared that: Roswell Park Memorial Institute Continuing Education Seminars Contact: Gayle Bersani, R. ., RPM! 666 Elm St., Buffalo, .Y. 14263 Phone (716) 845-4406 Thursday, February 11, 1982 "Soft Tissue Tumors", Chairperson: Dr. E. Douglas Holyoke. Thursday, March 4, 1982 "What's ew in Urologic Oncology", Chairperson: Dr. J. Edson Pontes. Thursday, April 1, 1982 "Tumors Involving the Skin", Chairperson: Dr. Ole Holtermann. Thursday, May 6, 1982 "Controversies in the Management of Childhood and Adolescent Cancer", Chairperson: Dr. Arnold Freeman. Saturday, June 5, 1982 "Cancer of the ColonRectum", Chairperson: Dr. Arnold Mittelman. The loss of Dean Kimball is more than a tragic loss to us who know him so intimately at the University. It is a cause of sorrow in the whole Buffalo community and the world of medicine which he has served in a most outstanding manner for more than 25 years. He was truly a great man, whose memory will always be most highly revered by his multitude of friends and colleagues. You have now heard two eulogies delivered by two former Chancellors of the University of Buffalo-one for the grandfather and the other for the grandson. It seems ever more fitting that the Alumni Association perpetuate the memory of Stockton Kimball WI TER, 1981 23 d- �by arranging this Annual Stockton Kimball Lectureship. But, we could not have had the second without the first and, indeed, great grandfather Stockton was also a physician. After Stockton's death, I remained in contact with his family by way of our daughters. For example, his daughter Rosalind and my daughter Carolyn traveled by Eurailpass for three months in 1963 throughout Europe. They finall reached Copenhagen, where Dr. and rs. Harold Brody were on sabbatical leave. The Brodys put the girls up while they frantically knitted sweaters in order to travel beyond the Arctic Circle. As a teacher I cannot resist taking advantage of a captive audience to give you something to ponder. You have been very patient for about an hour. ow, do you realize that during that time, all of you - myself included - lost cells from the cerebral cortex at the rate of 4,167 per hour? This has been going on within all of us since birth. However, you may be consoled, because at the ame time, you will have regenerated erythrocytes (RBC) at the rate of ten billion or 10xl0 9 per hour to replenish the ones that were destroyed. Think about it! It has been an honor and pleasure to deliver this year's Stockton Kimball lecture. Thank you for your kind attention. □ Dr. Dr. Mecklin honors Bennie Mecklin, M'35, received two recently. The citizens of Depauville, .Y. paid tribute to him in August upon his retirement, and in September the Academy of Family Physicians honored him at their annual meeting in Las Vegas. After serving a year's internship at the Buffalo Deaconess Hospital, he opened his practice in Depauville June 29, 1936. From May 12, 1941, to October 15, 1945, he was a First Lieutenant in the Medical Corps. Except for this Army service and a year of post graduate study at Mt. Sinai Hospital, ew York City, Dr. Mecklin has devoted his 46-year career to the practice of family medicine in Jefferson County. Dr. Mecklin was named a charter diplomate of the American Board of Family Practice in August 1971 and a Fellow of the American Academy of Family Physicians in October 1972. A past president of the Medical Society of Jefferson County, he has been president of the medical staffs of both Mercy Hospital and the House of the Good Samaritan. In 1961 he was elected president of the General Practitioners of Jefferson County. He is a former member of the Flower Library Board of Trustees and had served part time as an assistant clinical professor of medicine in family practice at the Upstate Medical Center medical school, Syracuse. An active member of Degel Israel Synagogue, he has served as a trustee of the synagogue and was one of the original group who helped build the present synagogue . He has served as president of the local B'nai B'rith, chairman of the United Jewish Appeal and was the recipient of the ational State of Israel Solidarity Award in 1978. Discussing the changes in the medical profession during his career with a Watertown Times writer, Dr. Mecklin said he "deplores" the increase in governmental influence in private practice. He "applauds" the initial purpose of Medicaid, providing medicine for those who never saw a doctor and improved care for children and senior citizens. "Unfortunately," he said, "lime has not been kind to the ideology and there are many abuses, foremost among them the limiting of care and drugs thus making Medicaid clients second class patients." Citing the amount of paperwork, he said he feels "all the good these programs do is often negated by the burden of this paper work. urses spend so much time writing and filling out forms that there is not enough time for good nursing care. Doctors are forced to record and re-record voluminous reports to appease hospital accreditation boards. Patients, especially senior citizens, are confused by all the forms and of ten lose touch with what they are or are not entitled to," he said. Dr. and rs. Mecklin are now living in Lake Worth, Florida 33463.D �Dr. Saxon Graham is the ,new chairman of the department of social and preventive medicine. He succeeds Dr. Glen Gresham, who has been acting chairman the last two years. Dr. Gresham will continue as chairman of rehabilitation medicine. Dr. Graham has been on the faculty since 1956 as director of the doctoral program in medical sociology. The prominent epidemiologist is internationally known for his research on the protective effects certain nutrients appear to have against some cancers. The clinical professor of medical sociology has a $2 million grant from the National Cancer Institute. He has authored or coauthored more than 100 articles for professional journals. He has been a special consultant to the World Health Organization and has been active in many other national and international professional societies. Dr. Graham received his AB from Amherst College in 1943; his AM and Ph.D. from Yale University in 1949 and 1951. He also did post graduate work at the University of California, Berkeley. Before coming to Buffalo he was on the faculties at Chatham College, Pennsylvania State University and the University of Pittsburgh. He was also a cancer research scientist at Roswell Park Memorial Institute. Dr. Graham is currently a member of the American Cancer Society's division of cancer control and epidemiology and chairman of the advisory committee on study of long-term effects of plutonium for Los Alamos Scientific Laboratory. □ $178,699Grant Fifteen basic science faculty members will share a $178,699 Biomedical Research Support Grant from the Division of Research Resources, National Institutes of Health. Dean John aughton is program director and in charge of administering the grant. This is currently the only active program of its kind which supports biomedical research activities in the federal government. This is the 20th year U/B has received a BRSG. Principal investigators are: assistant professors of biophysics, Ors. Yau-Kwan Ho and Victor Kai-Hwa Chen; assistant professor of biochemistry, Dr. Joseph T. Spence; professor of biochemistry, W. Roy Slaunwhite, Jr.; associate professors of pharmacology and therapeutics, Drs. Jerrold Winter and Jerome Roth; professor of pharmacology and therapeutics, Barbara Rennick; assistant professor of ob/gyn, Dr. Kent Crickard; assistant professors of medicine, Ors. Timothy E. West and Timothy F. Murphy; assistant professors of anatomy, Drs. Barry S. Eckert and Sabina J. Sobel; and assistant professors of microbiology, Ors. Philip T. LoVerde, Vijay Kumar and Bernice Noble. □ WINTER, 1981 25 Dr. Graham Dr. Saxon Graham. �Drs Robert Berne, University of Virginia Medical School, Loring Howell, University of Washington ,\leclico/ School. The reception. Dr . Joy Goff man, Boston University ,\fedicol School, Kenneth Touw, UIB faculty. 26 THE BUFFALO PHYSICIA �Ors. Judah Folkman, Harvard Medical Center, Beverly Bishop. and Hermann Rohn, UIB faculty. Dr. Robert Motes, UIB, Deon John Naughton. Drs. Vandenvater, Joseph Caruana. Andrew Gage. U/B faculty. Vascular Physiology, Disease Symposium Fifteen visiting faculty members from prestigious medical schools from coast to coast participated in a Vascular Physiology and Disease symposium at the Buffalo Hilton. Dr. Stephen Mellander, a renowned vascular physiologist from the University of Lund, Sweden organized the three-day meeting. Participatin with the visiting professor of physiology at U/B were seven other Medical School faculty members, including Dean John aughton. The symposium promoted the exchange of ideas between internationally prominent research scientists and practicing physicians interested in vascular disorders. The program participants talked about basic and applied problems concerned with the function and control of the peripheral circulation in health and disease. There were three basic themes - vascular regulatory mechanisms and dysfunctions, capillary oxygen exchange and mechanisms for new vessel development. The symposium attracted not only physiologists, but also clinical pharmacologists, pathologi ts, cardiologists, internists and surgeons. In addition to the four general discussion sessions there was one banquet address by Dr. Loring B. Rowell, professor of physiology and medicine at the University of Washington, Seattle. His topic: "Interorgan Blood Flow Distribution in Health and Disease. "D WI TER, 1981 27 Dr. Craig VP.nter, U/B. �Faculty Honored I I Ors Klocke, Phillips, Deon oughlon Ors. Hogon. F'orzon, Deon oughton NI E FACULTY EMBERS were honored at the annual edical School faculty meeting. Dean John aughton pre ented the Dean's award to Dr. James F. Phillips. clinical professor of m dicine, for his "outstanding contributions to the chool of edicine and the University." He was specifically cited for his out tanding clinical teaching. The annual Stockton Kimball award for contributions to teaching, research and service went to Or. Francis J. Klocke, prof es or of medicine and physiology. The Louis A. and Ruth Siegel awards ($500 each) for distinguished teaching went to Ors. Perry Hogan, associate prof e sor of physiology; Sattar Farzan, clinical associate professor of medicine; and Thomas C. Rosenthal, clinical assistant professor of family medicine. Or. Hogan won the same award last year. Dr. Ganesh Raghu, clinical instructor in medicine, won the House Staff Teachin Award. Eight other faculty members were acknowledged for teaching excellence - Ors. Alexander Brownie, professor and chairman of biochemistry; Angel Gutierrez, clinical a sociate in medicine; Francis Klocke; John Lamb, clinical assistant instructor in medicine; Mary Voorhees, professor of pediatrics; Bruce Weneck, clinical assistant instructor in pediatrics; C. David Widger, clinical assistant professor of pediatrics; and John Wright, professor and chairman of pathology. Dr. Harry G. LaForge, M'34, clinical professor of gyn/obemeritus, was given a special award by Dean aughton for his many years of support and dedication to the edical School especially during the transition of U/B from a private in titution to state. Dr. LaForge was one of the founders of APFME and erved on the faculty for 35 years. Three staff members were cited b Dean aughton for their long dedicated service to the school. They were: s. Lois Lewis, ecretary; Bernice Fiedler, assistant dean; and Dr. John Richert, assi tant dean, registrar and clinical assistant professor of ocial and preventive medicine. �Deon Naughton, Bernice Fiedler, Lois Lewis Dr. Richert, Deon Naughton, Dr Roghu Dr. Phillips, a 1947 Medical School graduate, is a past president of the Medical Alumni Association (1976). He is associate physician at the Buffalo General Hospital, where he also took his internship/residency in pathology and medicine. In 1951-52 he was chief resident in medicine at the hospital. He attended Canisius College three years before entering medical school. Dr. Phillips is a Diplomate, American Board of Internal Medicine. He has published many articles and served on numerous boards and committees of professional-educational societies and associations. Currently he is one of two physicians serving on the U/B Council. He is also secretary-treasurer of the Medical Society of the County of Erie. Dr. Klocke, a 1960 Medical School graduate, has been on the faculty since 1965. Two years later he was given tenure and promoted to associate professor. Dr. Klocke is an outstanding cardiologist as well as a teacher and researcher. He has authored or co-authored 48 articles on coronary disease for scientific journals. He has served on the editorial boards of the American Journal of Physiology and the Journal of Applied Physiology. Dr. Klocke is chief investigator of a five-year, $2.5 million grant aimed at increasing basic knowledge of cardiopulmonary dysfunction, improved diagnosis and treatment of heart-lung disease. He is a member of the National Advisory Committee to the Mayo Foundation's Biotechnology Research Resource and Program Project, Rochester, Minnesota. He has been elected to the prestigious Association of American Physicians. Election to membership is based on candidates' distinguished activity in patient care, teaching and research. In the fall of 1976 Dr. Klocke was among seven United States heart specialists to visit the U.S.S.R. The team of cardiologists and cardiovascular surgeons presented research and clinical findings in a joint symposium. They visited Moscow, Leningrad and Irtrusk, Siberia. □ WINTER, 1981 29 Dr. Lof'orge, Deon Naughton Naughton, Deon Rosenthal Dr. �On the Great Wall. A Scientist Visits China by D.A. Pragay, M.D. Clinical Associate Professor of Biochemistry Recently China introduced a general policy of modernization. The symbolic "four leaps forward" means advancement on the industrial, military, agricultural and scientific fields in order to catch up with the West. This program of modernization might give an impression of certain backwardness in China on the technical field. In order to avoid misunderstanding, one has to clarify, however, that technical knowledge is just part of what we call culture and civilization and we have to understand that the Chinese culture is one of the oldest on Earth and one of the most inventive compared to any other culture. The basic milestones of the cultural development of mankind are the invention of writing, of the wheel and of the arch (and possibly the building of large ships) by the human genius. All these milestones were invented in China and in the MesopotamianEuropean culture. Beyond these factors, for the archeologist and the historian there are several "markers" to characterize human cultural development: written documents, pottery, textiles, buildings. Many of the materials for these "markers" were invented in China. This becomes self-evident if we will consider a few illustrative examples. It is interesting in itself to observe these two great cultures: the Western European and the Chinese as they progressed or fell back throughout the centuries. The Greco-Roman culture probably matched the Chinese culture but it fell back after the Fall of Rome. At that time Western Europe was a field of smokin ruins where a few cloisters tried to keep the flame of culture alive and preserve what little was left. This probably characterized Western Europe from 500 AD to about 1200 AO (during the Medieval Age). During this same time the Chinese culture progressed and invented many things and contributed greatly to the culture and progress of the whole mankind. After 1200 AD Western Europe suddenly began to develop a new virulent culture based on the ever present Greco-Roman heritage with initiativeness, a curious intensive ense of practicality, daring and innovations never heard before. This activity created a culture and progressed to heights never seen before, while the Chinese, especially in certain areas like science. fell back. It is difficult to write in detail about these tremendously important issues in a few sentences but a few illustrative examples will be able to characterize the progressive Chinese culture during the edieval Age and subsequently I will present impressions of the present situation. Looking at different markers of culture let us consider a few. Paper was invented in China by Tsai Lun in 105 AD (previous to this, China used bamboo strips and later silk, while European culture used clay, papyrus, wax, animal skins to write on and preserve records). Paper was imported by Japan about 600 AD; the invention of paper spread to the Arabs about 750 AD and reached Europe in 1150 AD. Block Printing (of whole page) was invented in China around 700 AD. Later, movable printing was invented by Pi Sheng in 1040 (400 years before Gutenberg). This invention could not "take root" 30 THE BUFF ALO PHYSICIA �, \ because of the problems connected with the enormous number of Chinese ideograms (several thousands). So the Chinese never invented printing machines or typewriters (but developed writing into a beautiful art of calligraphy). In Europe, totally independently, the movable printing was invented in 1440 by Gutenberg and became an instant success and later led (XIX century) to the invention of large printing machines and the typewriter. Thanks to the block printing however, novels, detective storie and a publication which could be called a newspaper were block printed in China since 700-800 AD (the time of the Arab invasion and of Charlemagne in Europe). A large encyclopedia was printed in China in 1368 (the time of the Hundred Year War in Europe). Porcelain was invented in China around 700 AD (the time of Tang dynasty) and refined in 800 AD and later, especially in the time of the Ming dynasty (after 1400 AD). (Valuable Ming dynasty porcelain was found recently by scuba divers in the sunken Spanish galleons in the Caribbean Sea: Atosha, Tolosa, etc. These porcelain dishes and cups were still usable after centuries of being exposed to seawater.) Independently from China, porcelain was invented in Western Europe in 1710 (by Bottger in Meissen). Silk was used in China as a textile material since 2600 BC. It was unknown to Europe until 550 AD when two Byzantian monks smuggled out of China silk worm eggs and mulberr tree seeds. Since 600 AD silk became known in the Byzantine Empire, spread to the Arabs, Spain, Venice and the rest of Europe. Bonsai trees were "invented" in China around 1000 AD from where it went to Japan in 1200 AD but reached Europe only fairly recently. Tea was known in China for at least 3000 years. Herbal medicine is used world wide but in China it reached levels rarely attained anywhere else and it is still in use. A wealth of information in this field is still waiting to be explored by the s stematic Western science. Gunpowder was also invented in China around 800 AD but it was used in fire crackers only. The invention reached Europe around 1300 AD and gained immediate use in cannons. The Great Wall was begun by the Chinese about 200-300 BC. The total length was reached in the time of Ming dynasty (13681644 ADJ and was about 1500 miles. {The arch was invented about 100 BC in China and was incorporated into the Wall.) It became known that this is the only man-made object which can be seen from Space. (Other people also built walls throughout history but only one became really infamous: the Berlin Wall built on Russia's orders. aybe nothing is accidental.) Contrary to other beliefs, the compass and clock are not Chinese but Western inventions. During our visit we saw a Chinese clock which has elaborate water-£ alls, but no mechanical parts. The Chinese additionally made contributions of incalculable value in architecture, sculpture, art, jewelry, etc. In continuation I will describe my impressions during this trip - different aspects of the present day life of the Chinese the way it looks to a Western visitor. As mentioned earlier, the Chinese Government embarked on a new policy and invites more and more scientists who are inWINTER, 1981 31 Community Hospital in Harbin. New Construction. d- �valved in different fields and their names known in certain areas of activity. Some preference (because of language) is given to scientists of Chinese origin. The trip I participated in basically consisted of seven scientists of which four were of oriental extraction (two of them served only as interpreters). Our invitation came from the Heal th Ministry of Heilung Kiang Province and of Tianjin (Tientsin] to Dr. Djang, Professor of Pathology, who organized the group. We visited and lectured in five different cities of China during three weeks of stay ( anchang, approx. 500,000 inhabitants, Hanzhou {Hangchow], approx. 400,000 Tianjin (Tientsin), 7 million, Harbin, 2.5 million, Beijing (Peking), 8 million). The trip was done on trains (about 2300 km) and on airplanes (4000 km] and lasted for 22 days. General impressions about life concerning clothing, food, housing, political life, culture and science follow. CLOTHI Part of the Forbidden (Peking). City in Beijing G In different places one can see on exhibit wonderful varieties of silk dresses of past emperors, empresses, mandarins during a time when millions of people in old China were dressed in rags. Mao's revolution brought uniformity: everybody is dressed in a simple blue (sometimes khaki) uniform made of good solid material (wool or cotton]; no exception made even to the highest ranking officials. I did not see people poorly dressed wherever I went. Even the hat was uniform and simple. Men and women alike wore slacks. Larger cities show some Western influence which can be observed in Western type and more colorful dresses, sometimes even jewelry. This change is restricted to large cities and even there it is quite a slow process. Children wear school uniforms; small children wear colorful dresses. o obvious sign of rank could be seen on members of the Armed Forces. To the Western eye, shoes were unusually simple (slipper like) but ever one wore them. TRA SPORT A TIO There are a few personal cars and those are for official use and for dignitaries, not for private use. (Communists claim that theirs is a classless society, but one can see differences in housing or in transportation. Mr. Anybody does not have a chance to use a car, only bicycles]. There seems to be enough gasoline. China is self sufficient (I learned there that China has begun to even export oil to the U.S.A.). The makes of cars are usually Russian or Japanese and a few Chinese ("Red Flag"). There were many trucks, Russian, Czech, Hungarian and Japanese made, and buses were mainly of Chinese manufacture. The Chinese manufactured trucks were similar to original Russian, Czech and Hungarian design, and the same is true of airplanes, such as the Tupolev type made in China. Chinese-made trains run frequently and on time. On trains there are two classes: regular (for Mr. Anybody) and first class for officials, dignitaries and foreigners. Long distance trains have separate small compartments with two double births for first class passengers and regular class have large compartments with three level births sufficient to accommodate 30-35 persons. (I can interject here that foreign visitors always have to pay more for transportation and services than the Chinese do. Foreigners in China have to use a special type of money which is totally different from the one the Chinese themselves use.) 32 THE BUFFALO PHYSICIA �On the roads there are a lot of bicycles (Chinese made). During rush hour a "river of people" is moving in the streets. (One can realize sometimes what one billion people could mean.) The traffic on an average street is slow. A lot of people walk, sometimes carrying loads or pulling twowheeled carriages loaded with bulk material. Many times people have a wooden yoke on their shoulders with two baskets at each end carrying loads in them. Sometimes one can see two-wheeled carriages pulled by one or two small Mongolian horses or by tractor motors. Sheep can be seen on the roads of large cities. Public highways are not good. In the cities you have very large tree lined wide avenues of 4-6 lanes where the extreme right or left la·nes are for bicycles who almost never keep to their lanes! Traffic in cities is a nightmare. Traffic lights are not always observed. Often the shoulders of the roads are very muddy; on a completely clear day we saw a truck stuck in the mud, while on the paved road there was continual heavy traffic. HOUSI G Characteristic small houses are on the countryside and larger buildings for communes. Intensive building activity can be seen in the countryside and we also observed intensive building activity in cities, especially in Beijing (Peking) where large apartment buildings are being built. These new apartment buildings are unlike any other Chinese city buildings built in the past. In those cities where there were European concessions before the war, there were large European style buildings (cities on Shandong peninsula and in Shanghai, plus Tientsin). Houses usually were surrounded by tall brick walls as fences (both in cities and in the countryside). In Tientsin the after-effects of the 1976 earthquake are very much evident. Many people live in makeshift little brick houses built on the two sides of large avenues along brick wall fences. A few years ago China did not want to accept any foreign aid. (In 1981 she did.) One quite unusual fact caught our attention all the time: in many large cities in the middle of the very wide avenues, people were drying valuable seeds of millet and barley. obody seemed to attend those valuable food items but we were told they are never stolen. Similarly, valuable building material could be seen stored on the side of roads - unattended - never stolen. GE ERAL ASPECTS OF LIFE In general, wherever I went people were friendly and very polite, under the circumstances well dressed and well fed. I did not see beggars which were probably commonplace in old China. Children were well fed, well dressed and well disciplined (probably sometimes too well?) Many people of the old generation (60-80) speak English quite well. There is a generation (30-50) which does not know anything about the West, let alone Western languages. The young generation, students of the universities are extremely eager to learn Western languages or learn about technical advancement in the West. The Polaroid camera was a traffic stopper. (They also listened very eagerly to our lectures!) In large cities the Chinese television has a special channel which teaches English, Mathematics and Mechanics practically every day. China also has an organizaWI TER, 1981 33 Acupuncture neck. used for surgery on the Harbin Medical School. d- �eed (barley and millet) drying in the middle of a paved street. tion similar to the Peace Corps and oung people by the thousands volunteer to work abroad, mostly in African countries. People are extremely honest, tipping is almost an offense. They go out of their way to find you if you lost something. Accepting a gift of any value, especially from a foreigner is always a problem. One can observe bureaucrac but probably no corruption. In general there was an outgoing, very warm reception for Americans and people spontaneously stress the friendship with the U.S.A., but I observed everywhere the expression of certain enmity toward anything Russian. Large billboards on the streets literally advertised American goods and also proclaimed friendship with the U.S. or announced the establishment of direct airline connecting Beijing (Peking) with ew York. The political atmosphere in the country is freer than in the oviet Union or its satellites and is comparable to the atmosphere in Yugoslavia. Such comparison is difficult however, because there are striking differences. For example: one ha to show good work records so that one can get accepted on an official list in order to buy a bicycle, while there is no such problem in Yugoslavia or Hungary. Also, one needs special permission to go from one city to another. This regulation is also practiced in the USSR but not in Yugoslavia, Poland or Hungary. Compared to the China of the past, Chinese are more self-confident, better fed, better clothed, with higher standards of morality. Still, there are a lot of problems in the country. In general, for man of the still existing problems, the former so-called Cultural Revolution serves as scapegoat. SCIE CE We visisted five different hospitals. We listened to discussions with scientists, visited medical schools and attended operations carried out with acupuncture. The general impression was that preventive medicine is stressed and although it does not seem that there are enough beds in hospitals for extended care, families and relati es help with this. The family is a tightly knit group, traditionall strong and families are trained to off er home care for patients who would otherwise need extended care in hospitals. The statistics show that TB and VO occurrence is way down in the general population, and there is no drug problem. All these are in contrast to old China. The surgery and internal medicine services we saw seemed to be quite adequate or good. Although I can't judge too well the performance of internal medicine, the statistics are convincing. Traditional herbal medicine seems to be quite effective. Surgery service seems to be very good. The surgery we observed with the help of acupuncture was excellently performed: one was a tumor surgery on the breast, the other one a tumor excision from the thyroid. Four needles were used for thyroid surgery and about 10 on the breast surgery. A pulsating weak electric current wa applied to the needles. The patients were conscious during the entire time of the operation. It was astonishing that while surger and medical ervices were so good, the laboratory services were way behind. We did not see blood gas machines, and in the five hospital laboratories we 34 THE B FF ALO PHYSICIA �saw only one flame photometer for Na and K. The number of tests done in chemistry was small (10-15) and methods were very old, quite unknown presently in the West (idometric titration for urea, hydoxy quinoline method for Mg). All laboratories lacked instruments - everything was done manually - quality control is not done. China recently began to manufacture chemicals (inorganic, some organic) but the purity is not specified on the labels. They do their own radioactive labelling of some organic molecules but the workers in the isotope laboratory do not wear films or badges. The few instruments we saw were Chinese made; theEe were very few imports. Hematology and Microbiology laboratories using traditional methods were more appropriately performing, but using very old methods for some tests (e.g. Salili hemoglobinometer). The physician's and nurse's education appeared well organized. In medical schools research is encouraged but funds are missing. There were few journals available for publications. Among the journals only two were organized in such a way to be able to publish in the English language. Chemical chemists and clinical pathologists as such do not exist. A regular laboratory technician's education does not exist. The existing training is haphazard, random and consists of on-the-job training of high school graduates. I was told that the level of high school education is lower than in the West. Libraries of the hospitals and medical schools in general were poor. There were a few books which were written in the West (and those older publications) and even fewer Western journals were available. Everywhere one could see that in the field of science the bi gest road blocks are the language barrier and the lack of funds. These are the obstacles of the "leap forward" to the field of medicine and laboratory medicine. An illu tration of the language difficulties: I saw a Chinese typewriter the size of a writing desk, with 2500 individual Chinese ideograms made of a metal alloy, which must be moved into place manuall with the use of a small device; a skilled typist who has memorized the position of the 2500 characters may generate half a page of Chinese writing in 20 to 30 minutes. The Chinese claim they continue their efforts to reform their writing but one could see the enormous problems connected with this. A somewhat lesser problem is the numerical system where the Western type arabic numerals are slowly adopted instead of the cumbersome old Chinese way of writing the numbers. Summarizing all these, one could say that the Chinese have to overcome enormous mass of difficulties in their effort for modernization in order to bridge the technical scientific gap which exists with the West. Among these difficulties the key points are: books, training, possible reforms of writing, counting, technical education, and language barrier. All these need outside help, trainin and above all, money. One should not forget however, that we talk about the technical development which could be conceived part of the culture. But Chinese culture is more than 5000 years old, productive and rich. At times it created and preceded the West by centuries by inventing printing, porcelain, silk, etc. They had overcome even more difficult times and the probability exists that they will overcome the present difficulties also. □ WI TER, 1981 35 Bicycles during "rush hour". �Facing Hodgkin'sDisease at 24 and After by Tom Raab, M'77 Clinical Instructor /Medicine Dr Raab I have Hodgkin's Disease. I've known since October, 1975. I had just started my junior year in the School of Medicine when my weight began to drop and I had a succession of night sweats. A typical "physician treating thyself," I jumped to the conclusion that it might be tuberculosis, but a PPD X 2 was negative. The night sweats began to come more frequently. I wasn't sure what was going on, so I went to the chief medical resident at Meyer Memorial Hospital, Dr. Scott ordlick, who was my preceptor. Scott took a cursory history but did no physical examination. "Sounds as if you have a cold," he told me. Two days later, when I was again on call, I woke up with a bad cough and another night sweat. I went back to Scott. He recommended a chest X-ray, which I had at Meyer. The medical resident who read it told me that it was normal and that my symptom complex was probably a viral syndrome, nothing to worry about. At that time I was living at home. My mother had been telling me that I looked a little pale, wasn't eating as much as usual and seemed a lot more tired. She had been after me to get a check-up. I called her and told her that I had had it. The next day I went to turn in the write-up required of all third-year medical students to Scott ordlick. He seemed at a loss for words. "Tom," he finally said. "Your chest X-ray wasn't normal after all. We're going down to review it with Dr. Farzan (Sattar Farzan, attending in pulmonary medicine) and Dr. Ha es (David Hayes, attending in radiology]. Could you meet me in Dr. Farzan's office in about 20 minutes?" "Is it TB?" I asked. " o," he said. "I wish I could tell you it's TB." I went back to the floor, drew some bloods on a patient, then went to Dr. Farzan's office. Scott was just leaving. "Hey, big boy," he said, "get in touch with me when you get done." Dr. Farzan asked me about my symptoms. I told him that I had been having night sweats for two or three months, first relatively infrequently but now once and sometimes two times a night; that I had been losing about a pound a week and that I wasn't sure whether or not I had a fever at that time. The chest X-ray, he told me, had picked up a tumor. He pointed it out on the film. The date was Friday, October 23. Dr. Farzan made an appointment for me to enter the hospital onday for a diagnostic work-up. I had had previous chest X-rays taken at Our Lady of Victory when I worked there. I called to get copies. Then I left the hospital after breaking down into tears in front of one of my classmates. On my way home I stopped at my dad's place of work. He was standing outside his office at the end of the hall talking to one of his associates. He looked up and saw me. "What's wrong, Tom?" he asked, coming to me. We went into his office and I told him that I had to go into the hospital - that I had a tumor in my chest. "Oh, my God!" he said, and then "How are you doing?" "Oh, pretty good," I told him. I went home and asked mom to come out of the kitchen. 36 THE BUFF ALO PHYSICIAN �"What for, I'm busy," she said. "Please come out here," I said again, and she did. When I told her my news we both broke down into tears in each other's arms, but after our composure was restored we decided that we could deal with whatever the future held. I called Mary Jane, a girl I had been dating for three yea_rs. We had planned to get married after medical school. Meanwhile she had taken a job in ew York. I told her I had a tumor and later made re ervations for her to come to Buffalo the next day. That night things looked pretty black. I wa frightened. Mary Jane came home from ew York and we spent the weekend together. Then she went back to. ew York and. ~onday morning, my father drove me to the hospital. I to?k ~ medical t~xt for something to read, and as a source of informatwn 1f I needed 11. I admitted myself and went to J-1. "Do you know you're scheduled for a thoracotomy tomorrow morning?" the head nurse asked. " I responded. "I think you have the wrong 0 , I don't," patient." "You're Tom Raab, aren't you?" she said. "Look at the schedule. Didn't they tell you about it." Sure enough the schedule said "Tom Raab mediastinoscopy, possible medialsternotomy, and possible thoracotomy 7:30 AM Tuesday." I was al~ost speechless. When Scott, the chief resident who had originally ordered the chest films, came into my room I was on the verge of hysteria. "Scott, what's going on?" I asked. "They tell me I've got to go for a thoracotomy." " ow wait a minute, Tom," he told me. "We've gotten that straightened out. We want to do some _t~sts first and find out just what's going on. Then we'll make a dec1s10n. If thoracotomy seems indicated, we'll do it Friday." . . I learned later that an intern who was later to be a chief resident had slowed things down by saying "Let's ~et a piece of the tis ue before we commit this guy to thoracotomy. The week began with a number of tests - a repeat chest Xray a liver-spleen scan a thyroid scan, blood tests, tomograms. On Th~r day they told me 1hat the only _wa to i:na_kea firm diagnosis was by biopsy. They would start with med1stmosco~y and go to medialsternotomy if they couldn't obtain tissue. The ti su~ results would determine whether they did thoracotomy and excised the tumor. That evening my family came in - my mother, f ?ther, ~ister and her husband, younger sister and brother. I wa~ m a P_n~?te room and the nursing staff graciously allowed us to vwlate visiting hours. Some of the nurses from B-1, where I had worked as a student, brought over a cake and we had a little party, 13 of us. Then it came time to be prepped and everyone stepp~d ~ul. The guy nicked me three times. I thought he was begmnmg the surgery in the room. Then I went out to say goodbye to my family. My mother and sisters broke into tears. My brother - the only one besides myself who didn't break down - just said "You know you'll do all right, Tom." Then my dad came over. I extended my hand, but he tarted 0 WI TER, 1981 37 Introduction One of the last things that Or. Samuel Sanes did during his final hospitalization was to listen to a tape of Dr. Tom Raab's story of his struggle with Hodgkin's Disease. His own story, "A Physician Faces Disseminated Reticulum Cell Sarcoma in Himself," was drawing to an end. He had suggested to Dr. Raab that readers of The Buffalo Physician, particularly recent graduates, might be interested in what Dr. Raab had to say. He had asked him to tape the story with the aim of having it transcribed and editing it, if necessary. When he heard it, he concluded that little editing was necessary. He was greatly moved, and said so. He then dictated the following paragraphs as an introduction. * * * "I met Tom Raab in the spring of 1976, when he was undergoin chemotherapy. Assuming that he might be a medical student, I introduced myself. We became friends. He visited in our home and my wife and I went to his parents' home for his graduation party. "Twice we participated in discussions of our disease, once for the sophomore class of the School of Medicine, again for a university class in Death and Dying. "I am 72. Tom is 26, but our common disease has given us an empathy not normally to be expected between people of such diversity in age. "I think that you will be interested in his story, that it will fortify some of what l have said in my preceding articles. I do not expect to be here to read it myself, but I hope that Tom will be around for many years yet." -Samuel Sanes, M.D. d- �I I to cry and wrapped his arms around me in a display of emotion I had never seen before. In that one moment I realized how much I meant to him and what a traumatic experience this was for my parents. The next morning two good friends, John Small, a fell ow classmate, and his wife Susie, awakened me at 6 AM to share my anxiety. Half an hour later the nurse came in for the pre-ops. Then my parents arrived. "It was funny," John told me later. "You just sat there on the edge of the bed, talking away, and your voice got slower and slower until you finally lay down and went to sleep." It wasn't necessary to do any more than the mediastinoscopy. Dr. Wright (John Wright, chairman of the Department of Pathology) came over from the university and read the frozen section. It was Hodgkin's Disease. I went to the recovery room and then, at 4 PM, back to my room. When Dr. Farzan walked in I said, "Gee, it's very nice of you to come in and see me." "Tom," he said. "I saw you and talked with you in the recovery room." I didn't remember it, though he said that I had recognized him and answered questions appropriately. So many medical students came by during the next few hours that the intern who was overseeing my case finall decreed that no one could see me except my immediate family. I had to get some rest. I guess I slept. I really don't remember. I had night sweats again. The next morning I felt as if I had been worked over by a rubber hose. Every muscle in my body ached. This was attributed to a postoperative systemic reaction. Apparently there had been ome seizure activity after the acetylcoline administration. I was judged to be stable and sent home. ar Jane came back from ew York again and spent the weekend. On Monday, ovember 3, I went back to the hospital to see Dr. Rose Ruth Ellison, head of the Department of Oncology. She recommended that I go to Roswell Park emorial Institute for staging of my disease and therapy as indicated. The institute, she said, had the most experience in treating Hodgkin's Disease. She picked up the phone and called Dr. Leon Stutzman of the edicine B service, telling him that she would like to ref er me there. "When can he come down?" Dr. Stutzman asked. She gave me the phone. ''I'd like to come in as soon as possible," I told him. He said that afternoon would be fine. I took my mother with me. Dr. Stutzman reviewed my history and what had been done to date. He then examined me, noting that I was "a husky white male in no acute distress." A nurse drew blood for preliminary tests. Dr. Stutzman scheduled me for lymphangiography Thursday, ovember 6, and admission to the hospital for a stage-in laparotomy the following week. I spent the week at home. The Medical School gave me a leave of ab ence for an undetermined time. The lymphangiography on Thursday took about three hours. Dye was injected into my feet, from which it was slowly absorbed 38 THE B FF ALO PHYSICIA �up into the lymph vessels of my legs and then into the abdomen over the next hours. I was admitted to the hospital in case there was some systemic reaction. That night I spiked a temperature and found out what it is like to have blood cultures taken as I had so frequently taken them for other patients and would do thereafter. My own gave no clue as to the cause of my fever, which was assumed to be secondary to the dye. The preliminary report on my lymphangiography was that it was positive, which would have meant Stage 3 Hodgkin's Disease. I went home on a pass that weekend. Mary Jane flew in again and spent Saturday and Sunday with me. I had to go back to the hospital Monday, but Tuesday was a holiday, Veterans' Day, and I had another pass, so we had that day together too. Then she went back to ew York and I went back to the hospital. I was scheduled for my exploratory laparotomy Thursday. I talked to ary Jane on the phone the night before. She wished me luck and said she was sorry that she couldn't be there, but she had a commitment to her job. I guess, in retrospect, that I was beginning to see the end of a relationship that I had thought more significant than it really was. I didn't sleep much that night. I sat up and talked with the nurses. The induction of anesthesia went relatively smoothly the next morning. I went to sleep and the next thing I knew I was on the table and the surgeons were still working over me, apparently closing the abdomen. Then I drifted off again and woke up in the recovery room. I had a 10½-inch incision down my belly and was a little sore but when I asked for pain medication the nurse told me that I couldn't have any until I was fully awake. Back in my room I found my mom and dad, a nurse whose father works with mine, and some of the nurses from the floor. I said "Hello" to them but not much else. I slept on and off throughout the rest of the day. I do remember being threatened with a catheter. Boy, did that scare me! But the resident said "Give him eight hours - if he doesn't pee by midnight we'll do it." At midnight they extended the deadline another two hours. I beat it by half an hour when I urinated at 1 :30 without any difficulty. Over the next few days I didn't have much time to think what was going on. The gas pains, healing of the incision, getting up and walking kept me occupied. By now it was less than a month after the initial X-rays and I had been a patient in two hospitals and gone through two surgeries. Finally the gas pains subsided and I started to eat again. Some of my nurses were very sympathetic, very understanding. Others were very cold. It was one of the latter who walked in the morning after surgery. "Okay," she told me. "Get out of bed so I can make it. You can wash yourself - here's your water, wash cloth and towel." I didn't feel too comfortable about getting out of bed, but I didn't want to make her mad, so I did. When I complained to my doctors, they agreed that she was pushing things. WI TER, 1981 39 d- �Recuperation went very well, however. Dr. tutzman told me that the staging laparotomy had been ne ative, and my diagnosis changed from Stage 3 to "nodular clerosing Stage lb," which had a more hopeful prognosis. I was scheduled for total body radiation to be given in two courses - the upper body first and then the lower body in an foverted V. "What are the genetic risks?" I asked Dr. Stutzman. "Well, the smart thing would be never to have kid ," he told me. Before I could react or question him he excused himself to go to a meeting. That night two good friends, Hal and Paula (now Hal and Paula Crispell) showed up. That was the only time I cried in the hospital - and they cried with me. But we talked it out, and I decided that I'd made it this far and I could deal with this new trauma and continue on. In the coming months I shed many a tear with Hal and Paula. I didn't cry often, but there were times when I just had to. I remember once when I came home after a visit to Roswell Park. I sat down on the couch in my parents' front room and all of the emotional frustration I was feeling just poured out in tears. I let them flow. I felt the whole damn thing was absurd and ridiculous. It still eems that way. I was discharged ovember 23 after my laparotomy. Radiation therapy began ovember 26. The area to be irradiated was mapped out carefully and I was tattooed in a couple of places to mark the limits so that the fields of this and any future radiation wouldn't overlap. After my first two treatments there was a break for Thanksgiving. I had dinner with my parents. Mary Jane had come home, but I couldn't make her understand what I was going through. In the old days when I had put an arm around her she would grab my belly playfully. ow she continued to do this, despite the pain it caused with the incision there. She went back to ew York after the weekend and I went back to Roswell Park. Radiation wasn't much fun. I had a superficial sunburn effect, developed a sore throat and a candida infection. (I found out what it's like to use mycostatin as a mouth wash - it's not the tastiest thing in the world, though effective against candida.) I was fatigued all the time. Since most of my radiation was above the diaphragm I didn't suffer nausea and vomiting. One of the pluses of radiation therapy was that I met some really nice people, including Cindy, the girl who gave me most of my treatments over the prescribed five weeks. By ew Year's Eve I was finished with radiation. Mary Jane had come home and we went to a ew Year's Eve party given by some friends of hers in South Buffalo who knew about my diagnosis and were very understanding. During the dinner one of them asked how the therapy had one and I said, "Oh, pretty good." What are you on therapy for?" one of the other gue ts asked. "Hodgkin's Disease, a form of cancer," I responded. 40 THE BUFF ALO PHYSICIA �At that point my zone of personal space probably quadrupled. When we went back into the front room I sat at one end of the couch. o one sat down by me. It was obvious that ome people would rather stand than sit next to a cancer patient. I left shortly after, feeling for the first time the stigma of my disease in other person's minds. My doctors at Roswell Park had decided not to give me another course of radiation to the lower part of my body. In lead I was scheduled for six months of systemic chemotherapy. It seemed like an improvement when Dr. Stutzman told me. I signed the usual agreement that I didn't hold the in titute responsible for my treatment, that I realized that the drugs I would receive were experimental and was willing to accept the side effects. "There's only one major long-term side effect," Dr. Stutzman pointed out. "What's that?" I asked. "Sterility," he responded. At that point I didn't have any real choice. Chemotherapy was to begin that day, January 28. It was already too late for the sperm bank. Dr. Stutzman did tell me that some patients had recurrences of spermatogenesis four to five years after the cessation of chemotherapy. I was to take five drugs. Two, vincristine and vinblastine, would be administered intravenously on Days 1 and 8 of a 28-day cycle. The other three - procarbazine, prednisone and chlorambucil - would be taken orally. Meanwhile I had had to decide what to do about medical school. I had gone to Assistant Deans John Richert and Leonard Katz and told them my problems. "I would like to stay in school," I explained, "but I will not be able to take night calls. And I will have to miss time from rotations when I go in for my injections." They had made arrangements for me to return on a modified level. I was scheduled to do pediatrics and ob-gyn at South Buffalo Mercy and surgery, without night call, at Meyer Memorial. As a fourth-year student I would have to make up the surgery time that I had missed when I was learning surgery from the patient's viewpoint. By the time I started ob-gyn my relationship with Mary Jane had deteriorated to an infrequent phone call or letter wondering how I was doing. I started to date other girls. This had its problems. y doctors had warned me that during chemotherapy, as during radiation, I must avoid persons with viruses and other inf ections. What was a minor disease in them could be a major one with my weakened resistance. Once I made a date with a pretty clerk in the hospital to take her out for a fish fry and maybe a show Friday evening. On Thursday she came in with a runny nose and a cough. WI TER, 1981 41 d- �"I don't think we'll be able to go out tomorrow night," I told her. "Why?" she asked. "Because you have a cold," I replied. "What's wrong?" she said. "It's just a little cold. We can still go out. I'm not really sick." "I have Hodgkin's Disease and I'm on chemotherapy," plained. ''I have to avoid people who are overtly sick." I ex- "Come on, what are you talking about?" she persisted. I turned around and lifted my hair, which was now shoulder length but actually all grew from the top of my head. I was bald from about an inch below that, where m hair had not come back after radiation. "Oh my gosh, you really do have something. don't you?" she exclaimed. We talked it out and she finally understood, so things worked out pretty well. But this was a sequence that was to be repeated time and again over the next six months. Even doctors didn't always prove understanding, though most of them did. I had to take time out for the injections and the nausea that followed them. Fortunately I never developed any severe vomiting. From the physical viewpoint things weren't unbearable, but the psychological problem was more difficult to deal with. I knew that every time I walked into the hospital I was going to come out sicker than when I went in. "You miss an awful the chief of one service At that point I had ei ht weeks - less than lot of time because of that chemotherapy," through which I was rotating commented. missed a total of eight days in the previous some of my classmates who weren't ill. "Well," I asked in rather a defensive way, "do you want me to repeat this rotation next year." "Oh no," he replied. I was just commenting on the time you missed. You go right ahead." When I finally finished chemotherapy on June 30, 1976, Dr. Stutzman told me that the next two years would be the most critical as far as relapse. I was to watch for recurrent symptomology and come into the institute monthly for chest X-rays. blood study rates and CBCs. I had managed to keep up with my class. I felt pretty comfortable. I was starting to regain some of the weight I had lost. I had gone from 186 to 155 pounds prior to therapy and was now back in the 165-170 range. At the beginning of my fourth year I had questions I had to answer. I wanted to know if I could live on my own and take care of myself. My parents were supportive. They gave me the money I needed to set up an apartment and told me to go ahead and try it. I could always come home if it proved too much. It didn't. I even learned that I could cook. I took on a subinternship to see if I could handle night calls and function as an intern would have to do. 42 THE BUFF ALO PHYSICIA �I was able to cope with the stress. All went well and I finished the subinternship during the snowstorm which made Buffalo famous throughout the world, the Blizzard of '77. I even received honors for my work. Socially I became a hedonist. The dating process was relatively easy. Fourth-year medical students get along well with nur es and it wasn't too difficult to get a date. It was fun to date different girls, but I still hoped to find someone who would understand me, who would bolster my morale and tell me I was going to be fine, who could accept all that I had gone through. It seemed that there was always something that was unacceptable - the fact that I had cancer, or the fact that I couldn't have kids. I had decided on internal medicine as a career. I liked the program at Buffalo and was still too fatigued to con ider interviewing all over the country. I applied for the university program and asked for an early decision. I was accepted, so that was pretty well squared away. My fellow students elected me their class representative to speak at graduation. I was to choose my own topic. Because I had seen an obvious lack of communication between the patient, some doctors and the. family I chose that as my subject. Eighteen months have passed. I am well into m. residency. I still watch myself for symptomology, drop in at Roswell Park at regular intervals for the recommended X-rays and blood tests. Otherwise I lead a relatively normal life. How has all of this changed me? I guess I've become a here-and-now type of person. I enjoy life today for what it's worth and look forward to tomorrow, but I don't live with the understanding that life's going to go on forever as so many people my age do. I appreciate my parents more. I said so at the close of my graduation speech. I said that there were two people I really wanted to thank for everything they had done, and added, "Thank you, om and Dad, I love you." That made my mom more tearyeyed than she had been before. I know my brother and sisters better. My brother and I are rather different individuals. Before my illness we had our ups and downs, didn't really understand each other. ow we can talk. We know each other not just as brothers but as friends. My little sister and I are kind of similar. She is pretty special. She worries a lot, did anything she could to help. My big sister and I are nearest in age. We seldom disagree about anything but we did tease each other and fought. ow we, too, have become very close. Then there are my friends. I got the lea t support from those I depended on most. Others, who I didn't realize cared so much, were always there when I needed them. It has taken a long time to understand and forgive Mary Jane. I thought I loved her and she loved me and would be there when I needed her. She wasn't. I still hope in time to find one special person who will love me as I want to be loved and be willing to share my life. I guess the person I've come to know best of all is myself. I WI TER, 1981 43 d- �know who I am, what I want, just what I can handle. I've been able to meet the stresses of internship and residency. My hair has grown back curlier than it was before. I don't have to ask a girl if she's got a cold anymore. I can go out with her even if he' ot the sniffles. Do I still think about dying? Yes. Death is a question that is difficult to deal with. Patients can talk about it with each other, but not with those who have never had their disease. Someone will tell me, "I know what you're going through." "Bullshit," I think, "you don't know what I'm going through you haven't been there." Another person will say, "I have a risk of dying too - I could be hit by a car while crossing the street." So can I. But he doesn't have to walk around knowin that he has a malignancy, wondering if it is regrowing, if it i going to shorten his !if e. I was lucky. Stage lb wasn't so bad. David, who wa admitted to Roswell Park at the same time I was, was dead eight months later. He had leukemia and developed an acute abdominal infection which he no longer had the reserve to deal with. I was lucky in other ways, too. I could stay in my home town, continue in medical school. And my disease didn't crush me financially. My parents financed my education, so I am loan free. My initial bills at Meyer Memorial, $1500 to $1600 for five days, were met by Blue Cross and Blue Shield. Since my treatment was experimental, I went on protocol at Roswell Park. That meant I didn't have to pay an thing. If I had, the bills would have totaled between 10,000 and $15,000 for my staging laporotomy, hospitalization, radiation, chemotherapy and monthly visits. Right now I run an 80-85% chance of surviving five ears, a little less than a normal 26-year-old. The two-year period after chemotherapy was over in June. ow my goal is five years, and then things will begin to fit into a more normal pattern. If I have had no recurrence, my life expectancy will go back lo near normal. Do I regret having had cancer? Yes, I regret it. It's not something I would have volunteered to go through. But it wasn't a bad experience. It's been a very good experience, a very warm and enriching experience. I've gained a lot of understanding about what people are like, what to expect or not expect from them in a crisis situation, what I can expect from m self. And I am now a doctor. aybe, if I'm lucky and continue in remission, I'll be able to apply some of what I have learned in treating other patients. □ 44 THE B FF ALO PHY ICIAN �Medical Alumni Officers Dr. Chossin Dr. orman Chassin, M'45, was elected president. He is a clinical associate professor of medicine and has been on the faculty since 1951. Dr. Chassin took his internship and residency in internal medicine at the E.J. Meyer Memorial Hospital from 1945 to 1951. The following two years he was a Captain in the United States Army Medical Corps. Dr. Chassin is chief of medicine at Kenmore Mercy Hospital and attending at Eri_e County Medical Center. He 1s also affiliated with illard Fillmore Hospital. In 1974 he gave up his private practice. Dr. Chassin is chairman of the medical advisory committee of Rosa Coplon Home and co-chairman of the committee on education, human values and ethics at the Medical School. He is a member of the Western ew York Society of Internal edicine and has served on the Kenmore Mercy Hospital Foundation. One of his major interests is trying to improve communications among 11 segments of the medical com- Dr. Robert A. Baumler is the new vice president. He is a 1952 Medical School graduate and assistant clinical professor of medicine and associate physician at the Buffalo General Hospital. He has been on the f acuity since 1956. Dr. Baumler took a rotating internship at the E.J. Meyer Memorial Hospital. He took his residency in medicine at the Buffalo General Hospital in 1953-55. This was followed by a cardiology residency at the ew England Center Hospital in Boston. . The physician-educato~ 1s a Fellow of the Amencan College of Physicians and the American College of Cardiology. He is on the clinical cardiology council of th e American Heart Association. Dr. Baumler is president of the Buffalo Academy of Medicine. He is a past president of the Western ew York Heart Association and the Medical Historical Society of Western ew York. He served in the United States Army in 1945-46.0 Dr. Baumler munity. □ WI TER, 1981 45 Dr Sullivan Dr. Eugene M. Sullivan Jr., is the new treasurer. He received both his bachelor's and medical degrees from U/B in 1959 and 1963 respectively. He joined the faculty in 19~7 and is a clinical instructor m surgery. . Dr. Sullivan had a rotating internship at Buffalo Mercy and then took his residency at the E.J. Meyer Memorial Hospital July 1964 - September 1964, and September 1966 to July 1971. From September 1964 to September 1966 he was a medical advisor to the Korean Army. He also served 12 months at the Valley Forge General Hospital in the medical division of the Korean Military Advisory Group. Dr. Sullivan is a Fellow, American College of Surgeons and is a member of five other professional associations. He is an attending on the staffs of three hospitals - Our Lady of Victory, Buffalo Mercy and Erie County edical Center. □ �The Classes The Classesof the 1930's Dr. Vincent I. Bonaf ede, M'30, was named "physician of the year" for his 50 years of service as a doctor by the Livingston County Medical Society. He recently retired as director of the Craig Developmental Center at Sonyea. Dr. Bonaf ede was director of Craig from 1960 to 1976 and was a member of the medical staff for over 20 years before his directorship. He is a past president and a past secretary of the Livingston County Medical Society and a former officer of the state medical society. He also is an active member of the Mount Morris Rotary Club and is on the executive committee of the Genesee Council, Boy Scouts of America. Dr. Bonafede is married to the former Carolyn Constantine of Mount Morris, .Y. □ Dr. Joseph Godfrey, M'31, has not retired. Since appearing on the Spring Clinical Day program and participating in the 50th reunion of his class he has been giving lectures and clinics in several states, Canada, and China. In May he conducted clinics at the Oakland aval Regional Medical Center; then to China for an Orthopaedic meeting; then lectures in Colorado Springs to the American Orthopaedic Association and to Lake Tahoe for a Sports Medicine Seminar. Dr. Godfrey had to skip the invitation to be the President's guest at the Canadian Orthopaedic Association in Halifax. □ Dr. Elmer Peterson, M'32, now retired and living at 1732 El Dorado Court, Vista, California, was honored as the pioneer psychiatrist of San Diego County at an officer installation dinner for the San Diego Psychiatric Society on June 12, 1980, in the Atlantis Restaurant, San Diego. He was cited for his contribution to community mental health in San Diego County, where the SOPS now has a membership of nearly 1,000. Dr. Peterson was the county's first psychiatrist in full-time private practice. He also founded the first private psychiatric hospital south of Los Angeles County - Vista Hill, Chula Vista, California, in January, 1945.D Dr. Kenneth Eckhert, M'35, has been appointed a member of the State Health Coordinating Council by Governor Carey. Dr. 46 Eckhert is clinical instructor in family and legal medicine at U/B; past president of the Erie County Medical Society and chairman of the Western ew York Comprehensive Health Planning Council. □ Dr. iels G. Madsen, M'35, has retired from private general practice and lives at 540 Galen Drive, State College, Pa. 16801. He has also been active in several state and national professional organizations. □ Dr. Williard G. Fischer, M'36, has been re-elected president of the Foundation of Deaconess Hospital of Buffalo General Hospital. □ Dr. Fred Gorman, M'36, of Moss Creek Plantation recently retired from the Coastal Empire Mental Health Center in Beaufort. Dr. Gorman retired from the center after serving as a staff physician working in the center's branch offices in neighborhood counties. This past year, Or. Gorman was voted Employee of the Year by his co-workers at the center. Before moving to Hilton Head in 1970, Dr. Gorman was associated with a private general family practice in Corning, N.Y. Dr. Gorman served as staff physician for Project Hope in icaragua in 1967. He was then a permanent staff member in Sri Lanka for the next two years. Gorman's wife, Jean, owns Manana, an island shop; and they have four children. Their address: P.O. Box 1455, Hilton Head, S.C. 29925.D The Classesof the 1940's Dr. Abraham S. Lenzner, M'41 is a visiting professor of psychiatry at Dartmouth Medical College. His new address is RFD Box 215, Bragg Hill Road, Norwich, Vermont 05055.0 Dr. John D. Persse, M'42, is medical director for Blue Shield of Western ew York. He had been chief of surgery at Mercy Hospital (1951-71). and in June received the Distinguished Physician's Award from the Hospital staff. He recently retired from active practice. Dr. Persse is a Diplomate, American Board of Surgery and a Fellow, American College of Surgeons. He lives at 80 Carriage Drive, Orchard Park, .Y. 14127.D THE B FF ALO PHYSICJA �Dr. Leonard Berman, M'46, clinical associate professor of surgery, has recently given a lecture entitled "Esophagogastroduodenoscopy" to the Gibson Anatomical Society. □ The Classesof the 1950's Dr. Earl W. oble, M'52, is chief of medical services at Ba th Veterans Hospital. He has had a fellowship in geriatric medicine at the Buffalo VA Hospital. □ Dr. Bertram A. Portin, M'53, a Buffalo physician, was elected President of the American Society of Colon and Rectal Surgeons at its national conference . in Colorado Springs. He is the first Buff aloman elected to the post. He is Chief o~ Colon ~nd Rectal Surgery at Sisters of Chanty Hospital and is also on staff at Buffalo General/Deaconess and St. Francis Hospitals. He currently serves as asso~i~te clinical professor at the School of Med1cme and is chairman of the Colon and Rectal Surgery Division. Dr. Partin holds a fellowship in the American College of Surgeons. □ Dr. William R. Kinkel, M'54, has been elected president of the American Soci.ety of euroimaging. The Society has been m existence since 1977. The clinical professor of neurology and clinical associate prof ess~r of anatomy is a pioneer in Computerized Tomography Scanning. Dr. Kinkel has authored and co-authored a textbook and many articles. □ Dr. Ernest H. Meese, M'54, is an assistant clinical professor of surgery at the University of Cincinnati. He has been elected to the board of trustees, Ohio Division of the American Cancer Society, 1981-83. He is past president of the Hamilton County Unit, AM~, and a member of its executive board. He 1s also on the board of trustees of the Southwestern Chapter of the American Heart Association. Dr. Meese lives at 174 Pedrett Road, Cincinnati, Ohio 45238.D Dr. Ross Markello, M'57, has accepted a position as associate dean and professor of anesthesiology at the University of Pittsburgh Medical School. Dr. Markello has been associated with U/B since 1961 and associate dean since 1978.0 WINTER, 1981 The Classesof the 1960's Dr. Theodore S. Bistany, M'60, of the Buffalo Yacht Club finished second in his Tartan-41 iagara in the Performance Handicap Racing Formula at the annual iagara Frontier Regatta in June. He is a clinical assistant professor of medicine. □ Dr. Joel M. Bernstein, M'61, clinical assistant professor of otolaryngology and pediatrics, attended the Xllth International Congress of Oto-Rhino-Laryngology in Budapest, Hungary, in June. He moderated a symposium on, "Borderline Topics on Immunology and Otolaryngology." He also delivered papers on, " eutrophile Defects," and "An Overview of the Immune System in Head and eek Inflammatory Disease." □ Dr. Harold Brody, M'61, chairman and professor of the department of anatomical sciences has been named ad hoc advisor to the 1981 White House Conference on Aging. Delegates are charged to formulate a national aging policy for future presentation to the President and Congress. Dr. Brody, an internationally-known researcher in the field of aging, has also held several consultant positions with the ational Institute of Aging and has been named one of five editors of a new journal, eurobiology of Aging. The journal focuses on original clinical and basic science research in the area of neurobiology. The editorial area to which Dr. Brody has been named deals with the cerebral cortex. □ Dr. Robert A. Klocke, M'62, has been elected a Fellow, American College of Physicians. He will be honored at the college's annual meeting in April. Dr. Klocke is professor of medicine and associate professor of physiology at the Medical School. Or. Klocke has also been elected president of the board of directors of the American Lung Association of Western New York. □ Dr. Philip D. Morey, M'62, of Williamsville has been elected a fellow of the American College of Physicians. He is a clinical assistant professor of medicine. □ 47 d- �Dr. Daniel J. Krellenstein, M'64, is assistant professor of thoracic surgery at Mt. Sinai Medical School. He lives at 10 East End Avenue, ew York, .Y. 10021.D Dr. Stuart R. Tolendano, M'72, is assistant professor of pediatrics and acting director of the division of hematology/oncology at the University of Miami, Florida 01696.D Dr. Bert A. Lies Jr., M'64, has been appointed director of orthopedic rehabilitation at the Children's Hospital Rehabilitation Center. Dr. Lies, on the hospital medical staff since 1969, is clinical assistant professor of orthopedics at the Medical School. □ Dr. Bruce Abramowitz, M'73, Boston, Massachusetts, has been elected to Fellowship in The American College of Cardiology. This category of membership is limited to physicians with specialty certification and advanced training. Dr. Abramowitz is a graduate of Rutgers College and U/B. He is currently an assistant professor of medicine at Boston University Hospital. □ Dr. Stephen C. Scheiber, M'64, was promoted to professor of psychiatry, University of Arizona School of Medicine. He was also elected president of the American Association of Directors of Psychiatric Residency Training. □ Dr. Robert Schultz, M'65, clinical assistant professor of medicine, was re-elected president of the board of directors of the American Heart Association, Western ew York Chapter. □ Dr. Howard R. Goldstein, M'74, has recently finished a fellowship in pediatric urology at Babies Hospital, .Y.C. He has gone into private practice in adult and pediatric urology in Burlington County, .J. Dr. Goldstein, his wife, Judy, and two children, Lee Joshua and Lauren Sarah, live at 1617 Fort Duquesne Drive, Cherry Hill, .J.08003.D Dr. James Cavalieri II, M'69, has been elected a Fellow, American Academy of Pediatrics. He is a clinical assistant professor of pediatrics at the Medical School. □ The Classes of the 1970's Dr. Jeffrey G. Rothman, M'70, of Staten Island, .Y. has been elected to Fellowship in the American College of Physicians, the 51,000-member national medical specialty society. Dr. Rothman, a specialist in endocrinology and metabolism, will be honored during the Convocation ceremony at the College's Annual Session in Philadelphia, April, 1982. He has been a resident of Staten Island for four years and is on the staff of The Staten Island Hospital and SUNYDownstate Medical Center. He lives at 489 Maine Avenue, Staten Island, ew York 10314.D Dr. David W. Potts, M'71, is no longer in the Air Force. He has moved to Greenville, S.C. where he is assistant director of medical education and chief of infectious disease at the Medical College of South Carolina. Dr. Potts is living at 105 Port Royal Drive, Greenville, S.C. 29615.D 48 Dr. Craig Blum Dr. Craig Blum, M'75, has been appointed associate chief of orthopedics at Children's Hospital. His responsibilities included orthopedic care of hospital in-patients and out-patients and resident/intern education. He received his BA in 1971 from Williams College. Dr. Blum completed his internship at Deaconess Hospital in Buffalo and during his residency in Buffalo, he rotated through Children's. He had a fellowship in orthopedic rehabilitation at Rancho Los Amigo Hospital in Los Angeles, Calif., and served on the pediatric orthopedic staff at the Alfred I. DuPont Institute in Wilmington, Del. before returning to Buffalo to work at Children's. □ THE B FF ALO PHYSICIA �- Dr. John C. Stubenbord, M'75, is a clinical assistant instructor in family practice at the Georgetown University Medical School. He is no longer on active duty with the USAF, but is now a major in the USAFR, MC. He started his second year of residency July 1. He is the son of the late Dr. Jess Stubenbord, M'37. Dr. John is active in several professional organizations. He lives at Apt. 1, 2428-20th Street, .W., Washington, D.C. 20009.0 Dr. Al B. Benson III, M'76, began an Oncology Fellowship at the University of Wisconsin in August. He has an American Cancer Society grant. Prior to this he was a clinical assistant professor of medicine at the University of Illinois where he was involved in public health service work. He lives at 1914 Kendall Avenue, Madison, Wisconsin 53705.0 Dr. Steve Bien, M'76, is acting director of the BAMEC Family Practice Residency Program in Battle Creek, Michigan. He lives at 573 E. Roosevelt, Battle Creek, Michigan 49017.D Dr. Thomas Foreman, M'76, presented a research paper at the 13th annual Surgical Residents' Day at Millard Fillmore Hospital. □ Dr. Lewis R. Groden, M'77, has completed his ophthalmology residency in Pittsburgh and has started a fellowship in Cornea Service at Wills Eye Hospital, Philadelphia. He is living at Academy House, Apt. 35-G, 1420 Locust Street, Philadelphia, Pa. 19102.D Dr. edra Harrison, M'77, discussed ''Three Primary Carcinomas" at the 13th annual Surgical Residents' Day at Millard Fillmore Hospital. □ Dr. Richard P. Newman, M'77, is in the first group to complete a neurology residency at the Dent Institute, Millard Fillmore Hospital. He has authored several scientific papers which have been presented at the annual meetings of the American Academy of eurology. He is now a staff fellow with the Experimental Therapeutics Branch, National Institute of eurological Communicative Disorders, and Stroke, ational Institutes of Health. His research interests are in neuropharmacology of Parkinson's Disease WINTER, 1981 and other movement disorders. Dr. ewman lives at 2016 Baltimore Road, Apt. 1-41, Rockville, Maryland 20851.D Dr. Duret S. Smith, M'77, is chief resident of orthopaedic surgery at Upstate Medical Center, Syracuse. He recently presented a paper "The Use of Computerfed Tomography in Congenital Dislocation of the Hip" at the Eastern Orthopaedic Association annual meeting in Boca Raton, Florida. Dr. Smith lives at 750 E. Adams Street, Syracuse, .Y.13210.O Dr. Bernard Traub, M'77, has been appointed associate pathologist at Mil1ard Fillmore Hospital. He recently completed his residency at the hospital. □ Dr. John D. Zimmerly, M'77, has begun private practice in orth Babylon, N.Y. this past summer after completing a four-year obgyn residency at Sisters Hospital. He resides at 79 Cherokee Avenue, West Islip, .Y. 11795.D Dr. Stephen Gawronski, M'78, presented a research paper at the 13th annual Surgical Residents' Day at Millard Fillmore Hospital. □ Dr. Dennis Groves, M'78, won the Dexter Levy Award for "outstanding bedside manner" at the annual medical residents' day at Millard Fillmore Hospital. He spoke on "Experimental Use of Metaclapromide." He is a clinical instructor in medicine. □ Dr. Stephen E. Killian, M'78, has completed his residency in Family Practice at the University of Virginia. He has entered group practice in Boiling Springs, orth Carolina. His address is PO Box 842, Boiling Springs, .c. 28017.D Dr. John R. Valvo, M'78, a urological surgery resident at Strong Memorial Hospital, Rochester, .Y. presented papers at two meetings. In May, he presented two papers to the American Urological Association held in Boston, Mass. entitled, "Giovanni Battista Morgagni: His Contributions to Urology" and "Automated Water-Path Ultrasonic Evaluation of the Scrotum". In June, he presented a paper entitled, " uclear Scanning in the Acute Pediatric Scrotum" to the combined 49 d- �People meeting of the Canadian Urological Association and the British Association of Urological Surgeons held in Montreal, Quebec. □ The Classes of the 1980's Dr. James Egnatichik, M'79, presented a research paper at the 13th annual Surgical Residents' Day at Millard Fillmore Dr. Barbara Ruth Hirsch, M'80, is a resident at Mt. Sinai Hospital after completing her internship at Long Island Jewish Hospital. □ Hospital. □ Dr. Steven Elias, M'79, presented a research paper at the 13th annual Surgical Residents' Day at Millard Fillmore Dr. Robert Braco, M'80, discussed "Pancreatic Bystadenoma" at the 13th annual Surgical Residents' Day at Millard Fillmore Hospital. □ Hospital.□ Dr. Stanley Szefler, assistant professor of pediatrics/pharmacology and therapeutics, is the principal investigator for a study of synthetic corticosteroids. The project is funded by a $302,000 ational Heart, Lung and Blood Institute grant. Others working with Dr. Szefler are - Ors. Elliot F. Ellis, professor and chairman of pediatrics; Tee-Ping Lee, research assistant professor and a member of Children's Hospital Division of Allergy and Clinical Immunology; William Jusko, professor of pharmaceutics and director of the Millard Fillmore Hospital Clinic Pharmacokinetics Laboratory. This research team is associated with the Allergy/ Asthma Research Center at Children's Hospital. □ Pristach was judged to be a close second, and third place went to Greg Zuccaro. These PPI's were also judged to be excellent. This project is now in its third year and has hearty support by Dr. Millstein. The students are all in their third year of medicine. □ The Department of Pharmacology and Therapeutics invited medical students in the spring semester Pharmacology course to write a patient package insert (PPI) for extra credit. The PPI was to be modeled after those being prepared by the Food and Drug Administration, and their purpose is to acquaint the public with the actions of a drug and its possible undesirable actions. Eighty-five students wrote a PPI for digoxin. The five best were submitted to Dr. Lloyd G. Millstein, Deputy Director, Division of Drug Advertising and Labeling, Food and Drug Administrations, Department of Health and Human Services for evaluation. The PPI prepared by Alan Rosen was judged to be the best and Dr. Millstein stated that it closely approximated the kind and tone of information the FDA thinks is important in patient information. The PPI submitted by Cynthia Dr. Enrico Mihich, research professor of pharmacology and therapeutics, and director of the Experimental Therapeutics Department at Roswell Park Memorial Institute, has received a ational Cancer Institute grant of $124,343 to coordinate an advanced education and training program in drug development and cancer therapeutics. □ 50 Dr. Francis V. Hanavan has been appointed chairman for the next three years of the Department of Health Education Professions in the School of Health Related Professions at the State University of New York at Buffalo. He has served as acting chairman for the past year. □ The department of pediatrics at Children's Hospital has awarded three research summer apprenticeships made to students on the basis of academic achievement and potential. The purpose of the program is lo introduce talented high school students from minority backgrounds to careers in biomedical research. It is funded by a grant from the Division of Research Resources of the ational Institutes of Health. □ THE BUFF ALO PHYSICIA �- Two professors of physiology have received renewal grants. Dr. Robert B. Reeves is the project director for a $31,545 grant from the ational Institute on Child Health & Human Development for his study of Oxygen and Carbon Monoxide Equilibria with Fetal Blood. Dr. Claes E. Lundgren is the recipient of a U.S. avy, Office of aval Research grant for $347,268 to continue his study on the Effects of Static Lung Loading on Cardiorespiratory Function in Submerged Exercising Subjects at Depth (hyperberic chamber simulates pressure on lungs and Medical Sciences to study antidotes to metal poisoning. The metals involved are mercurials and aluminum. □ Dr. Lawrence Jacobs, attending neurologist at the Dent eurologic Institute at Millard Fillmore Hospital was elected secretary-treasurer of the American Academy of eurology at its annual meeting in Toronto. He is a clinical assistant professor of ophthalmology and a research assistant professor of physiology at the Medical School. □ heart). □ Dr. Harry A. Sultz, dean of the School of Health Related Professions at U.B., is the author of a newly published book, "Grant Writing for Health Professionals." He is also a professor of the department of social and preventive medicine. □ Mildred Hallowitz, History of Medicine librarian, has assumed the office of president of the Medical Historical Society of Western ew York. She is the first woman and nonM.D. member ever elected to that post. Other officers and council members elected for 1981-82 were: Ors. Victor L. Cohen, M'29, clinical associate professor of pediatrics, Emeritus, past president; Richard Lee, professor of medicine, vice president; James W. Brennan, M'38, clinical assistant professor of ophthalmology, treasurer; Ronald Batt, M'58, clinical associate professor of gyn/ob; Gustave Daluiso, M'31; and Max Landsberger, clinical associate in pediatrics, Emeritus, council members at large. Other members include: C.K. Huang, adjunct professor of medical communications; Ors. Thomas Bumbalo, M'31, clinical professor of pediatrics; Carl J. Schmitt, M'77; Robert L. Brown, M'44, associate dean, school of medicine and associate professor of medicine; William J. Breen, M'55, clinical assistant professor of medicine; and Louis Bakay, professor and chairman of department of neurosurgery. □ Dr. Paul J. Kostyniak, assistant professor of pharmacology and therapeutics and Dr. Thomas Clarkson at the University of Rochester have a $250,000 five-year grant from the ational Institute of General WI TER, 1981 A decade of research on fertilized eggs conducted by two U.B. physiologists may help farmers increase poultry production and provide insight into the mechanisms of the human lung. The research has focused on diffusion, the process by which the chick embryo takes in oxygen and eliminates carbon dioxide and water vapor during 21 days of incubation. Ors. Hermann Rahn, distinguished professor of physiology, and Charles V. Paganelli, acting chairman and professor of physiology, report that after studying the fertilized avian eggs of 90 species and 15 orders, the number and size of the pores in the shell are critical for adequate diffusion. The 60gram chicken egg contains approximately 10,000 pores in the shell, while the 600-grarn egg of the rhea has 18 times that number. □ Dr. John H. Siegel, professor of surgery and research professor of biophysics, has been reappointed to the State Board of Medicine by the ew York State Board of Regents. □ The Deaconess Division of Buffalo General Hospital has established a MultiDiscipline Amputee Clinic at its facility. The new clinic is under the direction of Ors. William H. Georgi, M'43, clinical associate professor of rehabilitation medicine and pediatrics, and Allen L. Lesswing, M'54, clinical instructor in orthopedics. □ Dr. Theodore Papademetriou, clinical professor of orthopedics, has been elected to the Western ew York Chapter, Arthritis Foundation Board of Directors. □ 51 d- �Front Row L to R: Thomas Ciesla, Jonathan Logan, Wende Logan, Carlo Desantis, Eugene Cimino, Alfred Messore. Bock Row L lo R: Edwin Manning, Gerald Schwartz, Henry Goller, Frederick Cieslak. James Markello, Ronald Usiak, William Hewett, Harold Brody, Richard Baker. Michael Cohen. People Dr. Carl W. Porter, clinical assistant professor of pathology, has been awarded $63,569 from the ational Cancer Institute for his investigation of anti-cancer drug action on the metabolism and/or function of polyamines. He is also a researcher in experimental therapeutics at Roswell Park Memorial Institute. □ Two 1979 Medical School graduates, Ors. Donald Armenia and Roger Kaiser, along with Ors. Robert Baron and David Armenia were the first to describe and co-author an article about "Water-Skier's Enema." The article appeared in the May, 1980 ew England Journal of Medicine. Several other publications have also picked up the article. □ Dr. Michael S. Laskowski, Sr., research professor of biochemistry-Emeritus, has been ranted $35,000 from the ational Science Foundation to continue his study of enzymes and their role in body defense against disease. □ Paul W. Sweet of Orchard Park has been named vice president for finance at Children's Hospital. Mr. Sweet, who will oversee the hospital's financial operation, previously was director of financial affairs at Mount St. Mary's Hospital, Lewiston. Immediate past president of the Western ew York chapter of the Hospital Financial Management Association, he holds a bachelor's degree in accounting from U/B. □ 52 The U/B School of ursing has established a graduate program in anesthesiology. The ideas were proposed by Dr. John I. Lauria, professor and chairman of anesthesiology at the Medical School. Co-directors of the new specialty are Dr. John L. Plewes, assistant professor of anesthesiology, and Ira P. Gunn, a retired army Colonel, who during her 21 years of military service developed the first master's degree program for nurse anesthetists. □ The Buffalo General Hospital's drive to raise $10 million toward a $166 million building and renovation program has surpassed 80 percent of its goal. The drive has raised more than $8 million in pledges. Construction will probably begin in the spring of 1982.D THE BUFFALO PHYSICIA �Dr. Beverly Bishop, professor of physiology, is directing research on the "Effect of Total Body Rotation on the Jaw Jerk." The project is designed to explore the effect of "vastibular activation on masseteric muscle activity." Also working on the project is Dr. R.S. Hichenbottom, assistant professor of physical therapy, and Douglas Kelsey, a graduate student. □ Two faculty members were featured speakers at the Fourth International Symposium on Affinity Chromatography, in The etherlands. Dr. Carel J. van Oss, U/B professor of microbiology and adjunct professor of chemical engineering, spoke on the "Role of Attraction and Repulsion of van der Waals in Affinity and Hydrophobic Chromatography." Dr. Eugene Sulkowski, associate research professor of microbiology and Roswell Park Memorial Institute scientist, discussed "Surface Topography of Inter£ eron; A Probe By Metal Chelate Affinity Chromatography." □ Joseph Paris, director of Veterans Hospital, recently was honored for 40 years of service with the federal government. Mr. Paris, director of the hospital since July, 1972, was presented the VA's Administrator's Exceptional Service Award. □ SUNY Chancellor Clifton R. Wharton, Jr., was one of five to receive an honorary degree from the City University of ew York in June. He was awarded a Doctor of Humane Letters. The citation: "his knowledge of economics and your talent for persuasion in the high reaches of government, you have brilliantly steered two courses, one devoted to eradication of world hunger abroad, another devoted to enhancing education here." Chancellor Wharton is also chairman of the United States Board for International Food and Agricultural Development. □ Dr. Harry Sultz and Frances S. Sherwin have co-authored a book, Grant Writing for Health Professionals. Dr. Sultz is dean of the School of Health Related Professions and professor of social and preventive medicine. Little, Brown and Company are the publishers. □ Front Row L 10 R: orman Haber, Mark Denlinger, Edmond Gicewicz. Sue McCutcheon, Helene Buerger, Eugene Barnell, Erick Reeber, Joseph Kunz. Second Row L lo R: Carl Schueler, Dennis Heimback, Jean Haar. Hugh o· eill. Robert Bartels. Robert Reisman, Paul Ronca, Robert Corretore, Peter Goergan. Frederick uessle, O.P. Jones. Third Row L 10 R: Herman Schoene, John Hodson, George Alker. Peter D-Arrigo. Edward Fox, Anthony Santomauro, Manfred Simon, Arthur Klass. The Class of 1956 at Spring Clinical Day WINTER, 1981 53 People �People Dr. Desider A. Pragay, clinical associate professor of Biochemistry and Pathology of the Medical School SU Y, presented a lecture on aging during an international meeting (VJ Latin-American Congress of Clinical Chemistry) held in Santo Domingo in May. He works closely with a research group headed by Dr. Evan Calkins, head of the geriatrics division of the V.A. Medical Center. □ Forty scientists, researchers and physicians from the U.S. and several foreign countries are attending the seventh summer program at the Ernest Witebsky Center for Immunology to learn methods for immunologic research and diagnosis. Speakers were: Drs. Bruce McDonald, University of Massachusetts; R.M. Zarco, Cordis Larboratories, Miami, Fla.; Robert M. akamura, Scripps Clinic and Research Foundation, LaJolla, Calif.; R.F. Ritchie, Foundation for Blood Research, Scarborough, Maine. □ Dr. Shepard Goldberg, executive director of the Child and Adolescent Psychiatric Clinic, has been named the 1981 recipient of the Hyman Levin Award by the Mental Health Association of Erie County. The award is presented for outstanding service in the field of mental health. Dr. Goldberg is a clinical assistant professor of psychology at the Medical School. □ Two faculty members are newly elected officers of the medical staff at Columbus Hospital. Dr. Joseph S. Calabrese, clinical assistant professor of ob/gyn, is the new president. Dr. Alberto J. Gonzalez, clinical instructor in medicine, is secretary. Dr. Edward M. Apen is vice president, and Dr. Ignatius S. Bertola, treasurer. □ Dr. S. Mouchly Small, professor of psychiatry, was re-elected to a second term as president of the Muscular Dystrophy Association's annual meeting in Scottsdale, Arizona in May. He has been a member of the MDA's board of directors since 1973 and worked with the association for 29 years. He served as chairman of the association's scientific advisory committee from 1975 to 1980. In his opening remarks to the corporate membership, Dr. Small said, "Among all national health agencies, MDA continues to have the most comprehensive free patient and community service programs. MDA has continued its proud tradition of growth and progress in our fight against muscle disease. In the past year, our association raised more money than ever before. But because of rapidly rising costs, for the first time in years, our expenditures on program and related services exceeded our income." □ Front Row L to R: Edward Fial, Edward Gudgel, Harold Levy, William Walsh, Ross Imburgia. Bock Row L to R. Harry Petzing, Charles Joy, Amo Piccoli, Paul Walczak. Charles Bauer. Stanley Cyran, Robert Potts, lbert Rowe, Eugene Marks, Herbert Pirson, Lawrence Golden, Willard Tornow, Joseph aple . The Class of 1946 at Spring Clinical Day 54 THE 8 FF ALO PHYS ICIA �The Class of 1951 at Spring Clinical Day Front Row L to R: Ludwig Koukal, Eugene Leslie, Anthony Barone. Carl Conrad. Frank Bolgan. Robert ecrist. Bock Row L to R: Robert Burke, Donald Barone. James Lo erde. Adolf Smith. Gerard Schultz. Milton Robinson, Allen Goldfarb, Marvin Pleskow. Dr. Frank J. Cerny, assistant professor of pediatrics, was a panel member at the Annual eeting of American College of Sports Medicine in Miami, Florida. His topic was, "Breathing Pattern during Exercise in Children with Cystic Fibrosis. "O Dr. Robert Guthrie, professor of microbiology and pediatrics, has authored an article, "Nutritional Aspects of Inborn Errors of Metabolism," appearing in the textbook of Gastroenterology and utrition in Infancy. □ Dr. Robin M. Bannerman, professor of medicine and pediatrics, has authored two chapters in the Textbook of Obstetrics and Perinatology. They are: Chapter 1, "Basic Human Genetics," and Chapter 16, "Genetic Diseases and Birth Defects. "O Dr. Luis L. Mosovich, associate professor of pediatrics, has received the "Dr. Frederick B. Wilkes Teacher of the Year Award" for 1980-81 by the pediatric house staff al Children's Hospital. □ The IH - Heart, Lung and Blood Institute, has awarded a $302,933 grant to three faculty members from the department of pediatrics for the period May 1, 1981 through April 30, 1985. They are Drs. Stanley J. Szefler, M'75, assistant professor of pediatrics and pharmacology and therapeutics; WI TER, 1981 Elliot F. Ellis, professor and chairman, department of pediatrics; and Tee-Ping Lee, research assistant professor of pediatrics. The title of the grant is "Corticosteroid Pharmacologic Action and Disposition. □ Dr. Guiseppe A. Andres, professor of microbiology in pathology and medicine, presented a lecture, "Mechanisms of Immunologically-Mediated TubuloInterstitial Injury," at the annual meeting of the ew York Society of ephrology at Cornell University. □ Dr. Peter ickerson, professor of pathology, has been appointed chairman of the Freshman Orientation Committee for the Medical School. □ Three faculty members have co-authored an article entitled "Beta-Adrenergic Receptors of Human Polymorphonuclear Leukocytes" for Research Communications in Chemical Pathology and Pharmacology. They are: Drs. Stanley J. Szefler, M'75, assistant professor of pediatrics and pharmacology and therapeutics, Tee-Ping Lee, research assistant professor of pediatrics, and Elliot Ellis, professor and chairman of the department of pediatrics. Dr. Szefler has also co-authored an article for Clinical Pharmacology and Therapeutics entitled "Effect of Erythromycin Base on Theophylline Kinetics. "O 55 People �The Class of 1931 at Spring Clinical Day Front Row L to R: Walter S. Walls. Michael Barone. Dean Dolce. Back Raw L to R: Francis Kenny, Francis Keefe, James Long, Harold Schweitzer, Orvan Hess, Thomas Bumbalo, Ellwyn Heier, Gustave Daluiso. Joseph Godfrey. John Kuhl, Walter Westinghouse, Angelo aples, Theodore Ciesla, Virgil Boeck. Donald Donovan, Francis Oderkirk. People Dr. Barry S. Eckert, assistant professor of anatomy, has received a two-year $80,000 grant from the ational Science Foundation to conduct his research, Analysis of the Cytoskeleton by Antibody Microinjection.O Dr. Roberta P. Pentney, clinical assistant professor of anatomy, has received a Research Development Funding for Quantitative Studies of Purkinje Neurons in Young and Old Alcoholic Rats. □ Dr. Marvin Herz, professor and chairman of psychiatry, was the chairperson of a panel on Psychoanalysis and the Treatment of Psychoses at a meeting of the American Academy of Psychoanalysis in Houston, Texas. He was also chairperson of a symposium on the Problems of Relapse in Schizophrenia at the American Psychiatric Association meeting in New Orleans. □ Dr. Robert Payne Gatewood, Jr., clinical instructor in medicine, has been elected to Fellowship in The American College of Cardiology. He is currently in private practice with Buffalo Cardiology Associates. □ 56 ot only is Ruth L. Smiley stepping down as the acting chair of the Department of Occupational Therapy, but she's also stepping out of U/B. She said it is time for her to leave. After all, she said, she has been in the field since 1952 and on the U/B campus since 1966. Perhaps she'll travel. Maybe she'll do consulting. One of these days she'll move back to her home on Long Island. But she has no set schedule. □ Two clinical assistant professors of urology are officers in the Buffalo Urologic Society. They are: Ors. Datta Wagle, president; and Gerald Hardner, secretarytreasurer-elect. Dr. Wagle is also director of the department of urology and hemodialysis at St. Joseph Intercommunity Hospital. □ Dr. F. Fero Sadeghian, clinical assistant professor of surgery, has been elected president of the Buffalo Surgical Society. Other officers are: Ors. James E. Allen, professor of surgery, vice president; John R. Border, professor of surgery, secretary· and treasurer, Louis C. Cloutier, M'54.D THE BUFF ALO PHYSICIA �Three faculty members have been elected officers of the Buffalo Radiologic Society. Dr. Elbert W. Phillips, clinical assistant professor of radiology and associate chief radiologist at Buffalo General Hospital, has been installed as president. Other elected officers were: Drs. Oscar J. Llugany, clinical assistant professor of radiology, secretary; Ehsan Afshani, clinical associate professor of pediatrics and radiology, treasurer; and Brian Block, vice president. □ Dr. John R. Border, professor of surgery, won the Curtis P. Artz award in recognition of his effective synthesized clinical and investigative activity to improve trauma care and advance the understanding of the pathophysiologic response to injury. The award was made by the American Trauma Society Board of Directors. □ Dr. Gerald P. Murphy has been elected president-elect of the Society of Surgical Oncology. He is director of Roswell Park Memorial Institute and research professor of urology. □ Dr. Lawrence Jacobs, clinical assistant professor of ophthamology, has been elected secretary-treasurer of the American Academy of eurology. He is also attending neurologist at the Dent Neurologic Institute at Millard Fillmore Hospital and a research assistant professor of physiology. □ Dr. Gerd J.A. Cropp, professor of pediatrics, spoke at the annual meetings of the American Pediatric Society and the Society for Pediatric Research in San Francisco recently. □ Dr. Elliot Ellis, professor and chairman of the department of pediatrics has been appointed to the American Academy of Allergy's Executive Committee. The elevenmember committee sets policy for the AAA. During April and May Dr. Ellis was invited to speak to three professional organizations _ The ew York Allergy Society, American Academy of Allergy and the Seventh Annual Advances in Neonatology and Pediatric Respiratory Care Program. □ Dr. Merrill A. Bender, clinical professor of nuclear medicine, was named to the USP Advisory Panel on Radiopharmaceuticals. Dr. Bender is chief of the department of uclear edicine at Roswell Park emorial Institute. □ Ors. Gerd J.A. Cropp, professor of pediatrics, and Michele Hindi-Alexander research assistant professor of pediatrics, co~ authored an article, "Community and Family Programs for Children with Asthma. "D Front Row L lo R: Donald Brundage, Thomas Houston. Richard Britt. Doris . Pieri. Frank Hoak, Victor Pellicano, Edward Eschner. Back Row L lo R: John Cangelosi. Hubbard Meyers. John Crosby. Charle ~lelcher. Jerome Glauber, Willard Fischer. Bernard Stell, Paul Burge on. Stephen Pieri. Marvin Amdur. Eli Levine. The Class of 1936 at Spring Clinical Day WI TER. 1981 57 p 1 eop e �People Dr. Gustave Cudkowicz, professor of pathology and microbiology, was an invited lecturer on "regulation of natural killer activity via thymus-dependent and thymusindependent mechanisms" at the International Course on Human Immunology and Cancer Immunomodulation, Institute de Recherches Servier, Paris, France. While in Paris, he visited Dr. Jean Dausset, Hopital Saint Louis, and presented a seminar entitled "Thymic Influences over Differentiation of K Cells." □ Dr. Carel J. vanOss, professor of microbiology, was invited to attend the Fourth International Symposium on Affinity Chromatography and Related Techniques sponsored by the University of Nymegen and Organon-Oss, Veldhover, The etherlands. While there he chaired a session entitled "affinity chromatography and related techniques" and also presented a paper. □ Dr. Cornelius J. O'Connell, clinical associate professor of medicine & microbiology, was re-elected president of the Western ew York Society of Internal Medicine. He was also elected to the board of directors of the ew York State Society of Internal Medicine. □ Dr. Boris Albini, associate professor of microbiology, was appointed to the board of editorial advisors of Immunological Communications. □ Dr. Donald J. Higby, research assistant professor of medicine, has received an $83,229 grant to conduct a research training program in cancer chemotherapy to develop specialist physicians with a rigorous academic background in basic sciences, in an attempt to bridge the gap between bedside medicine and the laboratory. It is sponsored by the ational Cancer Institute and is a joint project with the Education Department. Dr. Higby is also associate chief of the medical oncology department. □ Dr. Gerd J.A.Cropp, professor of pediatrics and chief of the division of pulmonary disease at Children's Hospital, recently participated in the European Working Group for Cystic Fibrosis in Berne, Switzerland. His topic was energy costs of breathing in cystic fibrosis and their relation to severity of pulmonary disease. □ 58 Dr. Carel J. vanOss, professor of microbiology, was one of the featured speakers at the Fourth International Symposium on Affinity Chromatography, Veldhoven, The etherlands. He is working on purification of interferon and spoke on the "Role of Attraction and Repulsion of van der Waals in Affinity and Hydrophobic Chromatography. "O Dr. John Gaeta, professor of pathology and associate professor of urology, presented a paper, "Morphology and Grading of Prostate Cancer" to the ational Prostatic Cancer Project Group in Boston recently. □ June 11, 1981 was proclaimed "Dr. Samad Day in Buffalo" by Mayor James D. Griffin. Dr. Iqbal A. Samad, clinical assistant professor of medicine, was honored for his extensive work in pulmonary diseases. He is currently coordinator of the Pulmonary Function Lab at Sisters Hospital and a consultant in pulmonary diseases al Sheehan Memorial Emergency Hospital. Dr. Samad holds fellowships in the Royal College of Physicians and the American College of Chest Physicians, and has also published approximately 20 scientific papers on various aspects of pulmonary disease. □ Blue Cross of Western ew York, Inc. recently re-elected members of its Executive Committee and other standing committees. Dr. Carmelo S. Armenia, M'49, clinical associate professor of gyn/ob, was re-elected a member and a director of the plan as a representative of the Erie County Medical Society. Re-elected to the Executive Committee and a member of the Nominating Committee is Dr. Charles J. Woeppel, M'37, clinical associate professor of gyn/ob. Dr. Donald B. Thomas, M'50, is a member of the Qualifications Committee. Physicians newly elected to represent the Medical Society of the County of Orleans are Drs. Arthur W. Mruczek, M'73, clinical instructor in ophthalmology, and David B.L. Meza, III. □ Dr. Pasquale A. Greco, M'41, clinical assistant professor of urology, was re-elected chairman of Blue Shield of Western ew York. □ THE BUFF ALO PHYSIC IA �The medical staff of St. Joseph Intercommunity Hospital has recently elected new officers. Ors. Eugene J. Zygaj, M'S0, clinical associate in gyn/ob, was elected president; Edward W. Bockstahler, M'54, vice president; Datta G. Wagle, clinical assistant professor of urology, secretary; and Anibal A. Vasquez, treasurer. □ Mercy Hospital recently honored four physicians for 25 years of service at the hospital. They are: Ors. Daniel E. Curtin, Jr., M'47, clinical assistant professor of orthopedics; Joseph F. Ruh, M'53, clinical instructor in family medicine; James V. LoVerde, M'51; and Robert E. Bergner, M'S0, clinical associate in medicine. □ Dr. Justin M. Uku, clinical assistant professor of pathology, has been named chief medical examiner of Erie County. He heads a 10-member professional staff that investigates all deaths in Erie County which are possibly not caused by natural reasons, and operates the county morgue in the old Meyer Hospital. Or. Uku went to medical school in Glasgow, Scotland and later interned at Colindale Hospital in London. He then returned to his homeland to become chief medical examiner for the Federation of igeria, and later the deputy chief medical advisor to the federation. Dr. Uku joined the Erie County Medical Examiner's staff in 1973 as associate chief medical examiner and has been in charge of the medical examiner's office since Dr. Judith M. Lehotay's death in the spring. □ Dr. Gustavo Cudkowicz, professor of pathology and microbiology, was elected honorary member for life of the French Society of Immunology recently in recognition of his contribution to the success of the 4th International Congress of Immunology held in Paris, France. He was also appointed an associate editor of The Journal of Immunology for a two-year term. □ Dr. Guiseppe Andres, professor of microbiology in pathology and medicine, was consultant for the Immunopathology Section of the WHO Committee on Nomenclature and Histological Classification of Renal Disease, and consultant at large for other imm unopathological problems in Athens, Greece recently. □ WINTER, 1981 ► Dr. Boris Albini, associate professor of microbiology; Dr. Guiseppe Andres, professor of microbiology in pathology and medicine; and Ingrid Glurich have coauthored an abstract entitled, "Effect of thymectomy and bursectomy on serum sickness in chickens." Dr. Andres presented this abstract at the VIIlth International Congress of Nephrology in Athens, Greece. □ The action and disposition in the body of one of .~odern medicine's most potent group of anll-mflammatory drugs, synthetic corticosteriods, are being studied by a multi di ci pli nary team of researchers and physicians at U/B's Allergy/ Asthma Research Center and Children's Hospital. The study is funded by a $302,000 ational Heart, Lung and Blood Institute grant. Or. Stanley Szefler, M'75, a pediatric clinical pharmacologist at U/B is one of the principal investigators. Other investigators include Or. Elliot F. Ellis, professor and chairman of pediatrics and an internationally-known pediatric allergist; and Dr. Tee-Ping Lee research assistant professor and member of the Children's Hospital Division of Allergy and Clinical Immunology. □ Ors. Marvin Herz, professor and chairman of psychiatry and Herman Szymanski research assistant professor of psychiatry: are the recipients of a $40,000 grant from the ew York State Office of Mental Health. It will be used to conduct a controlled study of Intermittent vs. Maintenance Medication in Schizophrenia. □ Dr. Robert J. Kratzel, clinical instructor in microbiology, was appointed scientific director of the American Red Cross Blood Services for the Buffalo region. □ Dr. Daniel Amsterdam, clinical assistant professor of microbiology and medicine. was reappointed to serve on the editorial board of the Journal of Clinical Microbiology. □ The board of governors of the American Academy of Microbiology recently elected Dr. William R. Bartholomew, associate professor of microbiology and clinical associate professor of pathology, to fellowship in the Academy. □ 59 People �In Memoriam Dr. Edwin F. Lathbury, M'36, died August 13 at his summer residence in Lake of the Bays, Ontario. His age was 70. He took his internship and residency at the E.J. Meyer Memorial Hospital and continued on the staff at the Meyer. The assistant clinical professor of otolaryngology was also on the staff of St. Francis, Children's, Sisters and Millard Fillmore Hospitals. During World War II he was a Lieutenant Colonel with the U.S. Medical Corps, 101st Airborne Division in the European theatre. He was decorated 11 times - Silver Star for meritorious service; General Commendation Medal; European Theatre of Operations Medals with three stars for participating in the ormandy, Ardennes (Battle of the Bulge) and Rhineland campaigns and the General Occupation Medal. He was also presented a Presidential Unit Citation Medal earned by the 101st Airborne Division for valor in European combat. Dr. Lathbury was chief of otolaryngology at Swindon General Hospital, England. He had been active in several professional societies. □ Dr. William W. Pierce, M'32, died August 14 of a heart attack in Jewish Hospital, St. Louis, Mo. while visiting his son. His age was 71. The otolaryngologist was a past president and chief of staff of the Lockport, .Y. Memorial Hospital. □ Dr. Earl A. Brandl, M'59, died unexpectedly August 27 at his home. His age was 52. He had been medical director of the Harrison Radiator Division of General Motors since 1970. After receiving his medical degree Dr. Brandl earned a public health degree as a resident in occupational medicine at the University of Michigan Medical School. He had been active in several professional societies. □ Dr. Michael A. Glucksman, M'54, died August 3 in Brunswick, Georgia. □ Dr. Byron Johnson, '45, died September 7 in Fresno, California. □ 60 Dr. Michael Laskowski Sr., research professor of biochemistry-emeritus, died June 8 in Millard Fillmore Hospital. The 76-yearold researcher-educator suffered a heart attack. From 1966 to 1976 he was a principal cancer research scientist in enzymology, a laboratory he headed at Roswell Park Memorial Institute. The much honored scientist received the 1973 Jacob F. Schoelkoph Medal by the Western New York Section, American Chemical Society, and in 1972 he went to Munich to accept the E.K. Frey Award that applied the technology of the use of inhibitors in surgical procedures. His work with enzymes that dissolves protein led to advances in surgical techniques. His work with enzyme inhibitors reduced the threat of hemorrhaging caused by enzyme breakdown of the blood's clotting components. In 1978 he and his son, Dr. Michael Laskowski Jr., were presented the Alfred Jurzykowski Foundation Award for enzyme research at the Polish Institute of Arts and Sciences in America in New York City. The elder Laskowski came to the United States from Poland in 1941. He was on the faculty of the ew York School of Social Research, arquette University, the Universities of Arkansas and Minnesota, and later a Fulbright exchange professor at the University of Paris. He was a Fellow, American Association for the Advancement of Science. □ Dr. Frederick J. Stone, M'32, died June 14 in the iagara Lutheran ursing Home of Buffalo. He interned at Millard Fillmore Hospital and joined the staff in 1934. He was a member of several professional societies. □ THE BUFF ALO PHYSIC IA �D Message from Dr. Norman Chassin: • A reminder to all Medical Alumni - especially Reunion Classes of 1972, '67, '62, '57, '52, '47, '42, '37, '32 - to mark your calendar now and plan to attend the Medical Alumni Association "Spring Clinical Day" on May 8, 1982. All events will held at the beautiful Marriott Hotel {opened Spring 1981) across from the Amherst Campus. Return Hotel Reservation cards at once, as we are holding a block of rooms at $46-$52/day for a limited time. The scientific program is in preparation and will carry CME credit. • All area Medical Alumni who have paid dues are invited to attend a reception at Albright Knox Gallery on Sunday, April 25, 1982. This Association sponsored event will honor the graduating Senior Class and will serve as an invitation to the new graduates to become active Medical Alumni. Dr. Chassin • The annual Winter Medical Seminar (CME Program arranged by Medical Alumni Association) is part of the U/B General Alumni trip to Hotel Akumal Caribe (Mexico's Yucatan Peninsula) to be held February 10-17, 1982. If you desire to join the trip and you haven't yet reserved, contact Mr. William Dock (716-831-3567}at once. • The Board of Directors welcomes all Alumni to participate in as many of these functions as possible. □ -----------------------------------------------------------------j-jjjjj"" o~:~~-----STAMP ECl SARY IF MAILED I THE U lnD STATES BUSINESS REPLY MAIL FIRSTCLA5S P Rt.11T 0. 2210 POSTAGE WILL BE PAID BY ADDRESSEE Buffalo Physician 139 Cary Hall 3435 Main Street Buffalo, ew York 14214 8 FFALO, .Y. �THE BUFF ALO PHYSICIAN ST ATE UNIVERSITY OF NEW YORK AT BUFF ALO 3435 MAI STREET, BUFFALO, NEW YORK 14214 ------------------------------------------------------------------""" THE HAPPY MEDIUM Fill out this card; spread some happiness; spread some news; no postage needed. (Please print or type all entries.) Name---------------------------------- Year MD Received---- Office Address-----------------------------------------Home Address------------------------------------------ If not UB, MD received from------------------------------------In Private Practice: Yes O In Academic Medicine: Yes o O D No SpecialtY------------------------------ O Part Time O Full Time D School--------------------Title Other:--------------------------------------------Medical Society Memberships:------------------------------------ NEWS: Have you changed positions, published, been involved in civic activities, had honors bestowed, etc.?----- ·- Please send copies of any publications, research or other original work. � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo Physician Magazine Description An account of the resource <em>The Buffalo Physician</em> (formerly the <em>Buffalo Medical Review</em>) was published quarterly by the State University at New York at Buffalo School of Medicine and Biomedical Sciences and the Office of Publications. The magazine informed its alumni, friends and community about the school’s pivotal role in medical education, research and advanced patient care in our region. Identifier An unambiguous reference to the resource within a given context LIB-HSL008 Subject The topic of the resource State University of New York at Buffalo. School of Medicine--Periodicals Medical colleges--New York (State)--Buffalo--Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Buffalo physician, Winter 1981 Subject The topic of the resource State University of New York at Buffalo. School of Medicine -- Periodicals Medical colleges -- New York (State) -- Buffalo -- Periodicals Publisher An entity responsible for making the resource available State University of New York at Buffalo. School of Medicine Robert L. Brown History of Medicine Collection Date A point or period of time associated with an event in the lifecycle of the resource 1981-Winter Contributor An entity responsible for making contributions to the resource State University of New York at Buffalo. School of Medicine Relation A related resource MicFilm LD701 .B42 M5 no.268-271, Buffalo physician and biomedical scientist Format The file format, physical medium, or dimensions of the resource application/pdf Language A language of the resource eng Type The nature or genre of the resource Text Still Image Identifier An unambiguous reference to the resource within a given context LIB-HSL008_1981-04-Winter Alternative Title An alternative name for the resource. The distinction between titles and alternative titles is application-specific. Buffalo medical review Table Of Contents A list of subunits of the resource. Dean Naughton's Message Spring Clinical Day Social/Ethical Organicity/Depression Malnutrition Community Care Medicine; Urology/Cataract Surgery Dr. Pickren As I Remember Stockton Kimball by Dr. O.P. Jones Continuing Medical Education 9 Classes give $41,200 Mexican Seminar Women's Auxiliary Gift Roswell Park Seminars Dr. Mecklin Dr. Graham/$178,699 Grant Vascular Physiology, Disease Symposium Faculty Honored A Scientist Visits China by Dr. D.A. Pragay Facing Hodgkin's Diseae at 24 and After by Dr. Tom Raab, M'77 Medical Alumni Officers The Classes People In Memoriam Dr. Chassin's Message Date Created Date of creation of the resource. 2018-01-18 Is Part Of A related resource in which the described resource is physically or logically included. Buffalo Physician Magazine LIB-HSL008 Is Version Of A related resource of which the described resource is a version, edition, or adaptation. Changes in version imply substantive changes in content rather than differences in format. v15n04 Extent The size or duration of the resource. 52 p. Spatial Coverage Spatial characteristics of the resource. New York (State) -- Buffalo Is Format Of A related resource that is substantially the same as the described resource, but in another format. Journals and magazines (periodicals) Rights Holder A person or organization owning or managing rights over the resource. Available for use. Source material in the public domain Rights Information about rights held in and over the resource <a href="http://rightsstatements.org/vocab/InC-EDU/1.0/">IN COPYRIGHT - EDUCATIONAL USE PERMITTED</a>. This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. In addition, no permission is required from the rights-holder(s) for educational uses. For other uses, you need to obtain permission from the rights-holder(s).